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cdm

Description Current unit price INTENSIVE CARE UNIT 6,158.00 ICU IN DOU 4,785.00 ICU- 5TH FL OVERFLOW 4,785.00 DOU IN ICU 3,824.00 TELE IN ICU 3,941.00 TELEMETRY UNIT 3,941.00 TELE- 5TH FL OVERFLOW 3,062.00 TELE ON M/S 3,941.00 TELE ON M/S 3,941.00

TELEMETRY 3,941.00 PRIVATE ROOM 2,323.00 PRIVATE ROOM 2,323.00 PRIVATE ROOM 2,323.00 PRIVATE ROOM 3,217.00 MED/SURG IN DOU 1,681.00 MED SURG ON PRIVATE ROOM ON TELE 2,163.00 SEMIPRIVATE ROOM 2,163.00

SEMIPRIVATE ROOM 1,950.00 SEMIPRIVATE ROOM 2,510.00 SEMIPRIVATE ROOM 2,896.00

IC ON SPINE UNIT 2,500.00 PRIV ISOLATION 1,805.00 PRIV ISOLATION 2,690.00 PRIV ISOLATION 1,805.00 ISOLATION STERILE ENVIR 2,323.00 ISOLATION STERILE ENVIR 2,690.00 ISOLATION STERILE ENVIR 2,323.00 SEMIPRIVATE REHAB 2,479.00

SURG PROC SINGLE/MINOR 315.00 ER I&D ABSCESS SIMPLE 603.75 ER I&D ABSCESS COMPLEX 603.75 ER I&D CYST PILONIDAL SIMPLE 603.75 ER I&D CYST PILONIDAL COMPLEX 5,233.20 ER INSERT BLADDER CATHETER 325.50 ER INCISON/REM FB SUBQ SMP 1,098.30 ER INSERT TEMP BLADDER CA 325.50 ER I&D HEMATOMA/SEROMA/FLUID 5,233.20 ER ASP ABSC/HEMA/CYST/BULLA 599.55

ER AVULSION NAIL PLATE SINGLE 366.45 ER VAC HEMATOMA SUBUNGAL 174.00 EXCISION OF NAIL 2,046.45 ER RPR LAC SMP SCALP 536.55 ER RPR LAC SMP SCALP 2.6-7.5 CM 536.55 ER RPR LAC SMP SCALP 7.6-12.5 CM 536.55 ER RPR LAC SMP SCALP 12.6-20CM 536.55 ER PRP LAC SMP FACE <2.5CM 536.55

ER RPR LAC SMP FACE 2.6-5CM 536.55 ER PRP LAC SMP FACE 5.1-7.5CM 536.55 ER PRP LAC SMP FACE 7.6-12.5CM 536.55

cdm

ER PRP LAC INT SCALP/AXIL 2.6-7.5CM 1,271.55 ER PRP LAC INT SCALP/AXIL 7.6-12.5C 536.55 ER PRP LAC INT NECK 2.6-7.5 CM 536.55 ER RPR LAC INT FACE/EAR <2.5CM 1,271.55 ER RPR LAC INT FACE/EAR 2.6-5CM 536.55 ER RPR LAC CPLX FOREHD 2.6-7.5CM 1,866.90 ER DRESS/DEB BURN 602.70 ER EXPL PENTR WOUND EXTREMITY 5,233.20 ER ARTHROCENT ASP/INJ JT INTER 1,073.10 ER ARTHROCENT ASP/INJ JT MAJOR 1,073.10

SURG PROC MULT/INTRMDTE 493.50 ER TX SHLDR W/MAN/ANESCL 6,253.80 ER TX ELBOW CHILD W/MAN CLSD 635.25 ER TX FX RADIUS/ELNA/W/MAN CLS 2,213.40 ER TX DISL (I-P) HAND W/O ANES 635.25 ER APPL SPLINT ARM LONG 451.50 ER APPL SPLINT ARM SHORT STAT 451.50 ER APPL SPLINT FINGER STATIC 451.50

ER APPL SPLINT LEG LONG 451.50 ER APPL SPLINT LEG SHORT 451.50 ER CNTRL NOSEBLEED ANT SMP 455.70

ER TX SHLDR W/MAN CLSD 635.25 ER NERVE BLOCK 1,751.40 ER INJ TRIGGER POINT 1/2 MU 826.35 SURG PROC EXTENSVE 813.75 SURG PROC COMPLEX 1,207.50 BEHAV CHNG SMOKING 3-10 MIN 63.00 SURG PROC MAJOR 2,310.00 TREAT HUMERUS FX W/MANI 1,034.90

ER NURSE TRIAGE ONLY/PT LWOBS 98.20 ER VISIT LVL I 240.00 ER VISIT LVL II 711.00 ER VISIT LVL III 1,001.00 ER VISIT LVL IV 1,506.00 ER VISIT LVL V 2,658.00 CRIT CARE E&M 3074 MIN 2,898.00 CRITICAL CR E&M ADDL 30 963.90 TRANSFUSION BLD/BLD COMP 1,365.00 HYD IV INFUSION, INIT 467.25

IV HYD INF EA ADD HR 119.70 IV INF INIT DRG <=1HR IV 603.75 IV INF DRUG EA ADD HR 119.70 INV INF SEQUENTL 1HR 174.30 IV INF CONC DFFRNT DRUG 72.45 SC RX INF, UP TO 1HR 591.15 SC TX INF, ADDL HR 174.30 INJ SUBQ/IM 247.80

INJ DRUG INTRA ARTERILA 222.60 IVP INITIAL MED 247.80 IVP SEQ ADD DFFRNT DRUG 247.80

cdm

IVP SEQ ADD SAME DRUG 152.25 IMM ADMIN SNGL/COMBO VAC 119.70 IMMUNIZATION ADMIN EACH ADD 76.65 CORONARY THROMBLYSIS IV 752.85 MOD SEDAT PHYS/QHP 5YRS> 515.55 ER MOD SEDAT PHYS/QHP <5 YRS 515.55 MOD SED PHYS/QHP EA 15 MIN 236.25 ASP ABS/HEMAT/CYST 457.80 ASPIR/INJ SMALL JOINT 1,072.05 ET INTUBATION 771.75

THRCNTSIS FOR ASPIRATION 1,744.05 INSERTION OF CHEST TUBE 1,744.05 INSRT NONTUNNL CV CATH 5> 3,508.05 PERITONEOCENTESIS INIT 1,744.05 SPINAL PUNCTR LUMB DIAG 1,601.25 MISC ER CHARGE CONVERSION - FEEDTUBE INSERT 2,747.85 PERCU END GASTM 2,747.85

CHG GASTRO TUBE 2,747.85 EGD W/ESOPH VAR BND 2,747.85 EGD W/SCLEROTHRPY 2,747.85

GASTROSCOPY 2,747.85 GASTRO W/BIOPSY 2,747.85 EGD 2,747.85 EGD W/HOT BX 2,747.85 EGD W/BIOPSY 2,747.85 ENDO W/ESOPH VARCL INJ 2,747.85 EGD W/BALLOON DILATION 2,747.85 EGD W/HEAT PROBE 2,747.85

ERCP W/STONE RM 7,104.30 ERCP W/LIHO 7,104.30 ERCP W/STENT INSR 8,323.35 ERCP W/STENT RMVL 8,323.35 ERCP W/ABL LESN 7,104.30 ERCP STENT EXCHANGE W/DILATE 11,730.60 ERCP 7,104.30 ERCP W/SPHINCTR 7,104.30 SIGMOIDOSCOPY FLEX 1,814.40 FLEX SIGMOID W/POLYPCTMY 2,905.35

FLEX SIGMOID W/TATTOO 1,814.40 FLEX SIGMOID W/BX 1,814.40 CA SCRN FLX SIG 1,169.70 CA SCRN COLONOSCPY HIGH RISK 2,542.05 CA SCRN COLONOSCOPY 2,542.05 COLONOSCOPY 2,861.25 COLONSCPY W/CAUTERY 2,861.25 COLON/OSTOMY W/STENT 8,323.35

ENTEROSCOPY 3,095.40 EGD W/DIL MALNY 1,873.20 EGD W/DIL GDWR 2,747.85

cdm

COLONSCPY W/BIOPSY 2,861.25 EGD W/RMVL FB 2,747.85 COLONSCPY W/SCLEROTHERAPY 2,861.25 COLONSCPY W/STENT PLCMNT 8,323.35 COLONSCPY W/TATTOO 2,861.25 COLONSCPY W/INJCT POLYP 2,861.25 COLONSCPY W/DECOMPRESSION 2,861.25 COLONSCPY W/HOT BX 2,861.25 HEMORRHOIDECTOMY LIGATION 1,685.25 ENDOSCOPY W/INS PROSTHESIS 8,323.35

DILATION ESOPHAGUS 4,591.65 ENTRSCPY W/BX 3,095.40 SPHNCTRTM CAN HYDRA 260GW 2,280.60 EXTRCTR RTRVL 12MMBALLON9 1,021.65 SPHNCTRTM CAN HYDRA 450GW 1,021.65 LTHOTRP 30MM BSKT 4.2MM 2,281.15 CANNULA XL RPD EXCHNG 509.60 STENT 10MMX80MM NON COVRD 6,973.55

BSKT WIREGIDED 2.0CM 1,841.70 BSKT RTRVL TRAPE 2.5CM 1,841.70 COLONSCPY W/SNARE POLYP 2,861.25

COLONOSCOPY LTD 2,861.25 CONV PEG TO PEJ 3,095.40 EGD W/POLYPECTOMY/FULGARATION 2,747.85 COLON/THROUGH STOMA 6,001.80 SPHNCTRTM RX44 .035 20MM 1,841.70 COLONOSCOPY W/DILATION 2,861.25 COLONOSCOPY W/CNTRL HEMOR 2,861.25 ENDO W/CNTRL HEMORRHAGE 2,747.85

RIGID SIGMOIDOSCOPY 1,814.40 NASOBILIARY DRAIN/TUBE 399.00 COLONOSCOPY W/REMOVAL FOREIN BODY 2,851.80 COLONOSCOPY W/ABLATION 2,851.80 ERCP W/BALLOON DILATION 7,083.30 ERCP W/BIOPSY 7,083.30 E&MNP LVL I 123.90 E&MNP LVL II 147.00 E&MNP LVL III 195.30 E&MNP LVL IV 245.70

E&MNP LVL V 321.30 E&MEP LVL II 147.00 E&MEP LVL III 147.00 E&MEP LVL IV 195.30 PT EVAL LTD 224.70 PT EVAL INTERM 336.00 PT EVAL EXT 448.35 PT EVAL HM/WK SITE BSC 113.40

PT REEVAL LTD 113.40 PT REEVAL EXT 448.35 PT PARAFFIN BATH BSC 99.75

cdm

PT MCL TEST INIT 30 MINS 249.90 PT MCL TEST ADDTL 15 MINS 99.75 PT MCL TX W/MOD INIT 30 MINS 232.05 PT MCL TX W/MOD ADDTL 15 MINS 93.45 PT MECH TRACTION BSC 99.75 PT IONTOPHORESIS 15 BSC 80.85 PT US EA 15 BSC 99.75 PT THER EX EA 15 99.75 PT THER EX EA 15 #2 153.30 PT NEUROMUSC REED EA15 99.75

PT NEUROMUSC REED EA15# 48.30 PT GAIT/STR TRN EA 15 99.75 PT GAIT/STR TRN EA15 #2 147.00 PT THERAPEUTC MASSG EA15 99.75 PT MANUAL THERAPY EA 15M 95.55 PT GRP 1 THER PROC 2+ 190.05 PT GRP2 THERAPTC PROC(2+ 379.05 PT PROSTH FIT/TRN EA 15 99.75

PT THERAPEUTC ACT EA 15 99.75 PT THERAPEUTC ACT EA15#2 48.30 PT SLF CR/HM MGMT EA 15 99.75

PT SLF CR/HM MGMT EA15#2 48.30 PT COMM/WK REINT TRN EA1 99.75 PT ESTIM BASIC 99.75 MOBILITY CURRENT STATUS 0.01 MOBILITY GOAL STATUS 0.01 MOBILITY DC STATUS 0.01 BODY POSITION CURRENT STATUS 0.01 BODY POSITION GOAL STATUS 0.01

BODY POSITION DC STATUS 0.01 CARRYING CURRENT STATUS 0.01 CARRYING GOAL STATUS 0.01 CARRYING DC STATUS 0.01 SELF CARE CURRENT STATUS 0.01 SELF CARE GOAL STATUS 0.01 SELF CARE DC STATUS 0.01 OTHER PT OT CURRENT STATUS 0.01 OTHER PT GOAL STATUS 0.01 OTHER PT DC STATUS 0.01

SUB PT CURR STATUS 0.01 SUB PT GOAL STATUS 0.01 SUB PT DC STATUS 0.01 MOBILITY CURRENT STATUS 0.01 MOBILITY CURRENT STATUS 0.01 MOBILITY CURRENT STATUS 0.01 MOBILITY CURRENT STATUS 0.01 MOBILITY CURRENT STATUS 0.01

MOBILITY CURRENT STATUS 0.01 MOBILITY GOAL STATUS 0.01 MOBILITY GOAL STATUS 0.01

cdm

MOBILITY GOAL STATUS 0.01 MOBILITY GOAL STATUS 0.01 MOBILITY GOAL STATUS 0.01 MOBILITY GOAL STATUS 0.01 MOBILITY DC STATUS 0.01 MOBILITY DC STATUS 0.01 MOBILITY DC STATUS 0.01 MOBILITY DC STATUS 0.01 MOBILITY DC STATUS 0.01 MOBILITY DC STATUS 0.01

BODY POSITION CURRNT STAT 0.01 BODY POSITION CURRNT STAT 0.01 BODY POSITION CURRNT STAT 0.01 BODY POSITION CURRNT STAT 0.01 BODY POSITION CURRNT STAT 0.01 BODY POSITION CURRNT STAT 0.01 BODY POSITION GOAL STATUS 0.01 BODY POSITION GOAL STATUS 0.01

BODY POSITION GOAL STATUS 0.01 BODY POSITION GOAL STATUS 0.01 BODY POSITION GOAL STATUS 0.01

BODY POSITION GOAL STATUS 0.01 BODY POSITION DC STATUS 0.01 BODY POSITION DC STATUS 0.01 BODY POSITION DC STATUS 0.01 BODY POSITION DC STATUS 0.01 BODY POSITION DC STATUS 0.01 BODY POSITION DC STATUS 0.01 CARRYING CURRENT STATUS 0.01

CARRYING CURRENT STATUS 0.01 CARRYING CURRENT STATUS 0.01 CARRYING CURRENT STATUS 0.01 CARRYING CURRENT STATUS 0.01 CARRYING CURRENT STATUS 0.01 CARRYING GOAL STATUS 0.01 CARRYING GOAL STATUS 0.01 CARRYING GOAL STATUS 0.01 CARRYING GOAL STATUS 0.01 CARRYING GOAL STATUS 0.01

CARRYING GOAL STATUS 0.01 CARRYING DC STATUS 0.01 CARRYING DC STATUS 0.01 CARRYING DC STATUS 0.01 CARRYING DC STATUS 0.01 CARRYING DC STATUS 0.01 CARRYING DC STATUS 0.01 SELF CARE CURRENT STATUS 0.01

SELF CARE CURRENT STATUS 0.01 SELF CARE CURRENT STATUS 0.01 SELF CARE CURRENT STATUS 0.01

cdm

SELF CARE CURRENT STATUS 0.01 SELF CARE CURRENT STATUS 0.01 SELF CARE GOAL STATUS 0.01 SELF CARE GOAL STATUS 0.01 SELF CARE GOAL STATUS 0.01 SELF CARE GOAL STATUS 0.01 SELF CARE GOAL STATUS 0.01 SELF CARE GOAL STATUS 0.01 SELF CARE DC STATUS 0.01 SELF CARE DC STATUS 0.01

SELF CARE DC STATUS 0.01 SELF CARE DC STATUS 0.01 SELF CARE DC STATUS 0.01 SELF CARE DC STATUS 0.01 OTHER PT OT CURR STATUS 0.01 OTHER PT OT CURR STATUS 0.01 OTHER PT OT CURR STATUS 0.01 OTHER PT OT CURR STATUS 0.01

OTHER PT OT CURR STATUS 0.01 OTHER PT OT CURR STATUS 0.01 OTHER PT GOAL STATUS 0.01

OTHER PT GOAL STATUS 0.01 OTHER PT GOAL STATUS 0.01 OTHER PT GOAL STATUS 0.01 OTHER PT GOAL STATUS 0.01 OTHER PT GOAL STATUS 0.01 OTHER PT DC STATUS 0.01 OTHER PT DC STATUS 0.01 OTHER PT DC STATUS 0.01

OTHER PT DC STATUS 0.01 OTHER PT DC STATUS 0.01 OTHER PT DC STATUS 0.01 SUB PT CURR STATUS 0.01 SUB PT CURR STATUS 0.01 SUB PT CURR STATUS 0.01 SUB PT CURR STATUS 0.01 SUB PT CURR STATUS 0.01 SUB PT CURR STATUS 0.01 SUB PT GOAL STATUS 0.01

SUB PT GOAL STATUS 0.01 SUB PT GOAL STATUS 0.01 SUB PT GOAL STATUS 0.01 SUB PT GOAL STATUS 0.01 SUB PT GOAL STATUS 0.01 SUB DC STATUS 0.01 SUB DC STATUS 0.01 SUB DC STATUS 0.01

SUB DC STATUS 0.01 SUB DC STATUS 0.01 SUB DC STATUS 0.01

cdm

OT EVAL LTD 224.70 OT EVAL INTERM 336.00 OT EVAL EXT 448.35 OT EVAL HM/WK SITE BSC 113.40 OT REEVAL LTD 113.40 OT REEVAL EXT 448.35 OT MCL EVAL INIT 30 MINS 249.90 OT MCL EVAL ADDTL 15 MINS 99.75 OT MCL TX INITL 30 MINS 232.05 OT MCL TX ADDTL 15 MINS 93.45

OT PARAFFIN BATH BSC 99.75 OT WHIRLPOOL BSC 198.45 OT ESTIM MAN EA 15 BSC 99.75 OT IONTOPHOR EA 15 BSC 99.75 OT US EA 15 BASIC 99.75 OT THERAPTC EXER EA 15 99.75 OT THERAPTC EXER EA15 #2 48.30 OT NEUROMUSC REEDUC EA1 99.75

OT NEUROMUSC REEDUC 15 # 48.30 OT THERAPTC MASSGE EA15 99.75 OT MANUAL THERAPY EA 15M 87.15

PT ORTH FIT/TRN EA 15MIN 99.75 OT THERAPTC ACT EA 15 99.75 OT THERAPTC ACT EA 15 #2 48.30 OT COG SKL DEV EA 15 99.75 OT SLF CARE HM MGMT EA15 99.75 OT SLF CARE HM MGMT 15#2 48.30 OT COMM/WK REINT TRNG 15 99.75 OT COMM/WK REINT TRNG15# 48.30

OT ORTHO MGMT/TRN EA 15 99.75 MOBILITY CURRENT STATUS 0.01 MOBILITY GOAL STATUS 0.01 MOBILITY DC STATUS 0.01 BODY POS CURRENT STATUS 0.01 BODY POS GOAL STATUS 0.01 BODY POS DC STATUS 0.01 CARRYING CURRENT STATUS 0.01 CARRYING GOAL STATUS 0.01 CARRYING DC STATUS 0.01

SELF CARE CURRENT STATUS 0.01 SELF CARE GOAL STATUS 0.01 SELF CARE DC STATUS 0.01 OTHER OT CURRENT STATUS 0.01 OTHER OT GOAL STATUS 0.01 OTHER OT DC STATUS 0.01 SUB OT CUR STATUS 0.01 SUB OT GOAL STATUS 0.01

SUB OT OP DC STATUS 0.01 MOBILITY CURERNT STATUS 0.01 MOBILITY CURRENT STATUS 0.01

cdm

MOBILITY CURRENT STATUS 0.01 MOBILITY CURRENT STATUS 0.01 MOBILITY CURRENT STATUS 0.01 MOBILITY CURRENT STATUS - MOBILITY GOAL STATUS 0.01 MOBILITY GOAL STATUS 0.01 MOBILITY GOAL STATUS 0.01 MOBILITY GOAL STATUS 0.01 MOBILITY GOAL STATUS 0.01 MOBILITY GOAL STATUS 0.01

MOBILITY DC STATUS 0.01 MOBILITY DC STATUS 0.01 MOBILITY DC STATUS 0.01 MOBILITY DC STATUS 0.01 MOBILITY DC STATUS 0.01 BODY POS CURR STATUS 0.01 BODY POS CURR STATUS 0.01 BODY POS CURR STATUS 0.01

BODY POS CURR STATUS 0.01 BODY POS CURR STATUS 0.01 BODY POS CURR STATUS 0.01

BODY POS GOAL STATUS 0.01 BODY POS GOAL STATUS 0.01 BODY POS GOAL STATUS 0.01 BODY POS GOAL STATUS 0.01 BODY POS GOAL STATUS 0.01 BODY POS DC STATUS 0.01 BODY POS DC STATUS 0.01 BODY POS DC STATUS 0.01

BODY POS DC STATUS 0.01 BODY POS DC STATUS 0.01 BODY POS DC STATUS 0.01 CARRYING CURR STATUS 0.01 CARRYING CURR STATUS 0.01 CARRYING CURR STATUS 0.01 CARRYING CURR STATUS 0.01 CARRYING CURR STATUS 0.01 CARRYING CURR STATUS 0.01 CARRYING GOAL STATUS 0.01

CARRYING GOAL STATUS 0.01 CARRYING GOAL STATUS 0.01 CARRYING GOAL STATUS 0.01 CARRYING GOAL STATUS 0.01 CARRYING GOAL STATUS 0.01 CARRYING DC STATUS 0.01 CARRYING DC STATUS 0.01 CARRYING DC STATUS 0.01

CARRYING DC STATUS 0.01 CARRYING DC STATUS 0.01 CARRYING DC STATUS 0.01

cdm

SELF CARE CURRENT STATUS 0.01 SELF CARE CURRENT STATUS 0.01 SELF CARE CURRENT STATUS 0.01 SELF CARE CURRENT STATUS 0.01 SELF CARE CURRENT STATUS 0.01 SELF CARE CURRENT STATUS 0.01 SELF CARE GOAL STATUS 0.01 SELF CARE GOAL STATUS 0.01 SELF CARE GOAL STATUS 0.01 SELF CARE GOAL STATUS 0.01

SELF CARE GOAL STATUS 0.01 SELF CARE GOAL STATUS 0.01 SELF CARE DC STATUS 0.01 SELF CARE DC STATUS 0.01 SELF CARE DC STATUS 0.01 SELF CARE DC STATUS 0.01 SELF CARE DC STATUS 0.01 SELF CARE DC STATUS 0.01

OTHER OT CURR STATUS 0.01 OTHER OT CURR STATUS 0.01 OTHER OT CURR STATUS 0.01

OTHER OT CURR STATUS 0.01 OTHER OT CURR STATUS 0.01 OTHER OT CURR STATUS 0.01 OTHER OT GOAL STATUS 0.01 OTHER OT GOAL STATUS 0.01 OTHER OT GOAL STATUS 0.01 OTHER OT GOAL STATUS 0.01 OTHER OT GOAL STATUS 0.01

OTHER OT GOAL STATUS 0.01 OTHER OT DC STATUS 0.01 OTHER OT DC STATUS 0.01 OTHER OT DC STATUS 0.01 OTHER OT DC STATUS 0.01 OTHER OT DC STATUS 0.01 OTHER OT DC STATUS 0.01 SUB OT CURR STATUS 0.01 SUB OT CURR STATUS 0.01 SUB OT CURR STATUS 0.01

SUB OT CURR STATUS 0.01 SUB OT CURR STATUS 0.01 SUB OT CURR STATUS 0.01 SUB OT GOAL STATUS 0.01 SUB OT GOAL STATUS 0.01 SUB OT GOAL STATUS 0.01 SUB OT GOAL STATUS 0.01 SUB OT GOAL STATUS 0.01

SUB OT GOAL STATUS 0.01 SUB OT DC STATUS 0.01 SUB OT DC STATUS 0.01

cdm

SUB OT DC STATUS 0.01 SUB OT DC STATUS 0.01 SUB OT DC STATUS 0.01 SUB OT DC STATUS 0.01 E-FLU 30 306.60 E - SP 30 306.60 E-SP LANG 30 306.60 E-V 30 306.60 SP TX 15 99.75 SP TX 30 200.55

SP TX 60 415.80 SP GRP 15 162.75 SP GRP 30 327.60 SP GRP 60 491.40 SW TX 15 99.75 SW TX 30 200.55 SW TX 60 415.80 SP SWAL EVAL PHARYN LTD 276.15

SP EVAL SWALLOWING ENDO CINE/VIDEO 1,206.65 SP EVAL SWAL/LARYNG CINE/VIDE 1,243.40 ST MCL SPEECH EVAL 766.50

ST MCL SPEECH/LANG TX 60 MINS 408.45 SP EVAL CINE VIDEO 276.15 SP COG SKL DEV EA 15 102.90 LARYNG VIDEOSTROBOSCOPY 276.15 SWALLOW CUR STATUS 0.01 SWALLOW GOAL STATUS 0.01 SWALLOW DC STATUS 0.01 MOTOR SPEECH CUR STATUS 0.01

MOTOR SPEECH GOAL STATUS 0.01 MOTOR SPEECH DC STATUS 0.01 LANG COMP CURR STATUS 0.01 LANG COMP GOAL STATUS 0.01 LANG COMP DC STATUS 0.01 LANG EXP CURRENT STATUS 0.01 ATTENTION CURRENT STATUS 0.01 ATTENTION GOAL STATUS 0.01 ATTENTION DC STATUS 0.01 MEMORY CURR STATUS 0.01

MEMORY GOAL STATUS 0.01 MEMORY DC STATUS 0.01 VOICE CURRENT STATUS 0.01 VOICE GOAL STATUS 0.01 VOICE DC STATUS 0.01 OTH SP LANG CURRENT STATUS 0.01 OTH SP LANG GOAL STATUS 0.01 OTH SP LANG DC STATUS 0.01

LANG EXPRESS GOAL STATUS 0.01 LANG EXPRESS DC STATUS 0.01 SWALLOW CURR STATUS 0.01

cdm

SWALLOW CURR STATUS 0.01 SWALLOW CURR STATUS 0.01 SWALLOW CURR STATUS 0.01 SWALLOW CURR STATUS 0.01 SWALLOW CURR STATUS 0.01 SWALLOW GOAL STATUS 0.01 SWALLOW GOAL STATUS 0.01 SWALLOW GOAL STATUS 0.01 SWALLOW GOAL STATUS 0.01 SWALLOW GOAL STATUS 0.01

SWALLOW GOAL STATUS 0.01 SWALLOW DC STATUS 0.01 SWALLOW DC STATUS 0.01 SWALLOW DC STATUS 0.01 SWALLOW DC STATUS 0.01 SWALLOW DC STATUS 0.01 SWALLOW DC STATUS 0.01 MOTOR SPEECH CURR STATUS 0.01

MOTOR SPEECH CURR STATUS 0.01 MOTOR SPEECH CURR STATUS 0.01 MOTOR SPEECH CURR STATUS 0.01

MOTOR SPEECH CURR STATUS 0.01 MOTOR SPEECH CURR STATUS 0.01 MOTOR SPEECH GOAL STATUS 0.01 MOTOR SPEECH GOAL STATUS 0.01 MOTOR SPEECH GOAL STATUS 0.01 MOTOR SPEECH GOAL STATUS 0.01 MOTOR SPEECH GOAL STATUS 0.01 MOTOR SPEECH GOAL STATUS 0.01

MOTOR SPEECH DC STATUS 0.01 MOTOR SPEECH DC STATUS 0.01 MOTOR SPEECH DC STATUS 0.01 MOTOR SPEECH DC STATUS 0.01 MOTOR SPEECH DC STATUS 0.01 MOTOR SPEECH DC STATUS 0.01 LANG COMP CURR STATUS 0.01 LANG COMP CURR STATUS 0.01 LANG COMP CURR STATUS 0.01 LANG COMP CURR STATUS 0.01

LANG COMP CURR STATUS 0.01 LANG COMP CURR STATUS 0.01 LANG COMP GOAL STATUS 0.01 LANG COMP GOAL STATUS 0.01 LANG COMP GOAL STATUS 0.01 LANG COMP GOAL STATUS 0.01 LANG COMP GOAL STATUS 0.01 LANG COMP GOAL STATUS 0.01

LANG COMP DC STATUS 0.01 LANG COMP DC STATUS 0.01 LANG COMP DC STATUS 0.01

cdm

LANG COMP DC STATUS 0.01 LANG COMP DC STATUS 0.01 LANG COMP DC STATUS 0.01 LANG EXP CURRENT STATUS 0.01 LANG EXP CURRENT STATUS 0.01 LANG EXP CURRENT STATUS 0.01 LANG EXP CURRENT STATUS 0.01 LANG EXP CURRENT STATUS 0.01 LANG EXP CURRENT STATUS 0.01 LANG EXPRESS GOAL STATUS 0.01

LANG EXPRESS GOAL STATUS 0.01 LANG EXPRESS GOAL STATUS 0.01 LANG EXPRESS GOAL STATUS 0.01 LANG EXPRESS GOAL STATUS 0.01 LANG EXPRESS GOAL STATUS 0.01 LANG EXP DC STATUS 0.01 LANG EXP DC STATUS 0.01 LANG EXP DC STATUS 0.01

LANG EXP DC STATUS 0.01 LANG EXP DC STATUS 0.01 LANG EXP DC STATUS 0.01

ATTENTION CURRENT STATUS 0.01 ATTENTION CURRENT STATUS 0.01 ATTENTION CURRENT STATUS 0.01 ATTENTION CURRENT STATUS 0.01 ATTENTION CURRENT STATUS 0.01 ATTENTION CURRENT STATUS 0.01 ATTENTION GOAL STATUS 0.01 ATTENTION GOAL STATUS 0.01

ATTENTION GOAL STATUS 0.01 ATTENTION GOAL STATUS 0.01 ATTENTION GOAL STATUS 0.01 ATTENTION GOAL STATUS 0.01 ATTENTION DC STATUS 0.01 ATTENTION DC STATUS 0.01 ATTENTION DC STATUS 0.01 ATTENTION DC STATUS 0.01 ATTENTION DC STATUS 0.01 ATTENTION DC STATUS 0.01

MEMORY CURR STATUS 0.01 MEMORY CURR STATUS 0.01 MEMORY CURR STATUS 0.01 MEMORY CURR STATUS 0.01 MEMORY CURR STATUS 0.01 MEMORY CURR STATUS 0.01 MEMORY GOAL STATUS 0.01 MEMORY GOAL STATUS 0.01

MEMORY GOAL STATUS 0.01 MEMORY GOAL STATUS 0.01 MEMORY GOAL STATUS 0.01

cdm

MEMORY GOAL STATUS 0.01 MEMORY DC STATUS 0.01 MEMORY DC STATUS 0.01 MEMORY DC STATUS 0.01 MEMORY DC STATUS 0.01 MEMORY DC STATUS 0.01 MEMORY DC STATUS 0.01 VOICE CURRENT STATUS 0.01 VOICE CURRENT STATUS 0.01 VOICE CURRENT STATUS 0.01

VOICE CURRENT STATUS 0.01 VOICE CURRENT STATUS 0.01 VOICE CURRENT STATUS 0.01 VOICE GOAL STATUS 0.01 VOICE GOAL STATUS 0.01 VOICE GOAL STATUS 0.01 VOICE GOAL STATUS 0.01 VOICE GOAL STATUS 0.01

VOICE GOAL STATUS 0.01 VOICE DC STATUS 0.01 VOICE DC STATUS 0.01

VOICE DC STATUS 0.01 VOICE DC STATUS 0.01 VOICE DC STATUS 0.01 VOICE DC STATUS 0.01 OTH SP LANG CURR STATUS 0.01 OTH SP LANG CURR STATUS 0.01 OTH SP LANG CURR STATUS 0.01 OTH SP LANG CURR STATUS 0.01

OTH SP LANG CURR STATUS 0.01 OTH SP LANG CURR STATUS 0.01 OTHER SP LANG GOAL STATUS 0.01 OTHER SP LANG GOAL STATUS 0.01 OTHER SP LANG GOAL STATUS 0.01 OTHER SP LANG GOAL STATUS 0.01 OTHER SP LANG GOAL STATUS 0.01 OTHER SP LANG GOAL STATUS 0.01 OTHER SP LANG DC STATUS 0.01 OTHER SP LANG DC STATUS 0.01

OTHER SP LANG DC STATUS 0.01 OTHER SP LANG DC STATUS 0.01 OTHER SP LANG DC STATUS 0.01 OTHER SP LANG DC STATUS 0.01 MOBILITY DC STATUS 0.01 BODY POS GOAL STATUS 0.01 SP TX 45 299.25 SP GRP 45 488.25

SW TX 45 299.25 E FLU 45 305.55 E GLU 60 414.75

cdm

E SP 45 305.55 E SP 60 414.75 E SPLANG 45 305.55 E SPLANG 60 414.75 E V 45 305.55 E V 60 414.75 SP TRK 15 - E SP SGD 60 414.75 SP SGD TX 15 99.75 SP SGD TX 30 200.55

SP SGD TX 45 299.25 SP SGD TX 60 414.75 E COG STD 60 414.75 THERAPEUTC REC 1:1 15MIN 72.45 THERAPY 2D IND REC 36.75 THERAPEUTIC ACTIVITY GRP 15.75 FINE MOTORGROUP 67.20 GROSS MOTORGROUP 67.20

REC THERAPY GRP 2DISPL 34.65 COGNITIVE REMEDIATNGRP 67.20 THERAPTC REC GROUP 15MIN 67.20

COMM REENT GRP 15MIN 34.65 COMM REENT 2 DISPL 15MN 34.65 FINE MOTOR IND 15 MN 72.45 GROSS MOTOR IND 15 MN 72.45 INST/TRN PAT/FAM 15INIT 72.45 COMM REENT 1:1 INIT15MN 72.45 REC EVAL 15MN 81.90 SURGERY 1 HOUR MAJOR 5,898.00

SURGERY MAJOR EA ADD MIN 101.00 LAMINAR FLOW ROOM 280.35 SURGERY 1/2 HR MAJOR 2,899.00 SURGERY ADD MIN MAJOR 102.00 SURG LASER PROC 1/2 HR 4,816.00 SURG LASER PROC 1ST HR 6,915.00 SURG LASER PROC ADD MIN 126.00 SURGERY 1HR COMPLEX 7,895.00 SURGERY ADD MIN COMPLEX 135.00 SURG 1HR OH 10,064.00

SURG ADD MIN OH 167.00 SURG 1HR CARDIAC 6,987.75 SURG ADD MIN CARDIAC 119.70 RECOVERY RM 1/2 HOUR 638.40 PACU EACH ADD MIN 15.75 SPEC PROC 1ST 1/2HR 480.90 SPEC PROC ADD MIN 14.70 BLOOD PATCH 1,751.40

NERVE BLOCK 1,751.40 INSERTION CVC W/PORT >5YRS 6,668.55 INSERTION CVC > 5YRS 2,686.95

cdm

INSERT PICC >5YRS 2,601.90 PLACEMENT TESIO TYPE CATH 7,086.45 REMOVAL TESIO TYPE CATH 2,500.05 CARDIOVRT ELECTRC/ELECTV 1,699.95 ANESTHESIA 1 HOUR 1,149.75 ANESTHESIA EA ADD MIN 15.75 NITROUS OXIDE 143.85 OP ANES 1ST 1/2 HOUR 573.30 OP ANES ADD MINUTES 14.70 ANES 1 HR OPEN HEART 1,149.75

ANES OPEN HEART ADD MIN 14.70 NITROUS OXIDE 143.85 SLOW GROWER SUSCEP 173.25 EEG AWAKE/DROWSY 630.00 EEG AWAKE/ASLEEP 630.00 EEG COMA OR SLEEP ONLY 630.00 EEG DIGITAL ANALYSIS 630.00 RECOVERY TIME 1HR 360.15

RECOVERY TIME 30 MIN 82.95 INFLUENZA VACC ADMIN 119.70 PNEUMOCOCCAL VACC ADMIN 119.70

SURG PROC I 145.95 SURG PROC II 294.00 SURG PROC III 394.80 TRANSFUSION BLD/BLD 0 TO 8 HRS 1,062.60 TRANSFUSION BLD MORE THAN 8 HRS 1,593.90 IV INF HYD INIT < = 1HR 467.25 IV INF HYD EA ADD HR 119.70 IV INF INIT TO 1 HR 603.75

IV INF RX EA ADD HR 119.70 IV INF SEQ RX TO 1 HR 174.30 IV INF CONCURRENT RX 72.45 SC THER INF UP TO 1HR 591.15 SC THER INF ADDL HR 247.80 NURSING IV ADMIN 57.75 INJ SC/IM 247.80 CHEMO IM/SQ 204.75 IVP INITIAL 247.80 IVP SEQ ADD DIF RX 247.80

IVP SEQ ADD SAME RX 152.25 CHEMO INJ SUBQ RESV 446.25 INJ CHEMO INIT DRUG IVP 591.15 INJ CHEMO ADD DRUG IVP 418.95 CHEMO IV <=1H INIT 1,024.80 CHEMO INF EA ADD HR 174.30 CHEMO INF EA ADD HR 174.30 CHEMO INF SEQ ADD DRUG 352.80

PLASMA PHERESI 3,752.70 IV INF CONCURRENT 72.45 INTRATHECAL INJCT DRUG DELIVERY 883.05

cdm

TELEMEDICINE VISIT 262.50 INJ GALACTO/DUCTO PROC 316.05 BRST PREOP PL NDL 1ST LS 345.45 BRST PREOP NDL ADD L 345.45 ASPIR/INJ MAJOR JOINT 625.80 THRCNTSS W/ TB INSERT 1,536.15 DILATION ESOPH OVER G/W 1,726.20 PLC NG TUBE W FLUORO 357.00 INJ ABSC/CYST PREV CATH 185.85 PL GASTROSTOMY TB PERC 2,511.60

PLACE DUOD/JEJ TUBE PERC 2,511.60 CHANGE GTUBE TO GJ PER 2,511.60 REPLACE DUOD/JEJ TB PERC 956.55 REPL GJ TUBE PERC 956.55 INJ NEPHROSTOGRAM 185.85 INJ F/CYSTO OR VCUG 355.95 INJ BRAIN CANAL 1,548.75 SPINAL PUNCTR LUMB DIAG 1,132.95

EYE DETECT/LOCAL FOR/BDY 435.75 MANDIBLE LTD/3VW MAX 196.35 MANDIBLE 4VW MIN 1,060.50

FACIAL BONES 2VW MAX 435.75 FACIAL BONES 3VW MIN 900.90 NASAL BONES 3VW MIN 448.35 ORBITS 4VW MIN 900.90 SINUSES 2VW MAX 515.55 SINUSES 3VW MIN 679.35 SKULL < 4 VIEWS 710.85 SKULL 4VW MIN 840.00

TM JOINTS UNILATERAL LEFT 196.35 TM JOINTS UNILATERAL RIGHT 196.35 NECK FOR SOFT TISSUES 435.75 SIALOGRAPHY 867.30 CHEST PREEMPLMNT 354.90 CHEST 1 VIEW PA OR AP 354.90 CHEST 1 VIEW INFANT 354.90 CHEST 1 VIEW PORTABLE 354.90 CHEST 2VW PA OR AP & LAT 458.85 CHEST 2 VIEWS W/LORDOTIC 507.15

CHEST APICAL LORDOTIC 394.80 CHEST 2 VIEWS W/OBLIQUES 788.55 CHEST 2 VIEWS W/OBLIQUES LEFT 788.55 CHEST 2 VIEWS W/OBLIQUES RIGHT 788.55 CHEST COMP 4 VW MIN 710.85 CHEST COMPLETE W/FLUORO 819.00 CHEST DECUBITUS VIEWS 475.65 CHEST DECUBITUS VIEWS LEFT 475.65

CHEST DECUBITUS VIEWS RIGHT 475.65 PACEMAKER INSERT FL&RAD 699.30 PACEMAKER INSERT FL&RAD 699.30

cdm

RIBS UNILATERAL 2 VIEW LEFT 543.90 RIBS UNILATERAL 2 VIEW RIGHT 543.90 RIBS UNI 3V MIN W/PA CXR LT 689.85 RIBS UNILATERAL 3 VIEW W/PA CXR RT 689.85 RIBS BILAT 3VW MIN 733.95 RIBS BI 4V MIN W/PA CXR 879.90 STERNUM 2VW MIN 601.65 STERNCLAVR JNTS 3VW MIN 306.60 SPINE ENTIRE 2-3 VIEWS 1,060.50 SPINE ANY LEVEL SNGL VW 233.10

SPINE ANY LEVEL SNGL VW 233.10 SPINE CERVICAL 3 VW MAX 219.40 SPINE CERVICAL 4-5 VW 338.25 SPINE CERVICAL 6 VW MIN 338.25 SPINE THORACIC 2 VIEWS 495.60 SPINE THORACIC 4VW MIN 196.35 SPINE LUMBAR 2 VIEWS 543.90 SPINE LUMBAR MIN 4VWS 809.55

SPINE LUMBAR AP/LAT/BEND 910.35 LUMB BENDNG VWS MIN 4VWS 338.10 PELVIS 1 VIEW 507.15

PELVIS MIN 3 VWS 1,043.70 SACROILIAC JOINTS 2 VWS 196.35 SACROILIAC JOINTS 3 VWS 558.60 SACRUM COCCYX 2 VWS 543.90 MYELOGRAPHY LUMBAR INJ, CERVICAL 2,232.30 MYELOGRAPHY LUMBAR INJ THORACIC 2,232.30 MYELOGRAPHY LUMBAR INJ LUMBOSACRAL 2,232.30 DISCOGRAPHY LUMBAR 2,868.60

CLAVICLE COMPLETE 375.90 CLAVICLE COMPLETE LEFT 375.90 CLAVICLE COMPLETE RIGHT 270.90 SCAPULA COMPLETE 427.35 SCAPULA COMPLETE LEFT 427.35 SCAPULA COMPLETE RIGHT 427.35 SHOULDER SINGLE VIEW LEFT 393.75 SHOULDER SINGLE VIEW RIGHT 393.75 SHOULDER 2 VIEWS MINIMUM LEFT 507.15 SHOULDER 2 VIEWS MINIMUM RIGHT 507.15

ACROMIOCLAVICULAR JTS BI 449.40 HUMERUS 2 VIEW MINIMUM LEFT 448.35 HUMERUS 2 VIEW MINIMUM RIGHT 448.35 ELBOW 2 VIEWS LEFT 393.75 ELBOW 2 VIEWS RIGHT 393.75 ELBOW 3 VIEW MINIMUM LEFT 507.15 ELBOW 3 VIEW MINIMUM RIGHT 507.15 ELBOW ARTHROGRAPHY LEFT 582.75

ELBOW ARTHROGRAPHY RIGHT 582.75 FOREARM 2 VIEWS LEFT 448.35 FOREARM 2 VIEWS RIGHT 448.35

cdm

UPPER EXTREMITY INFANT RIGHT 196.35 WRIST 2 VIEWS 408.45 NAVICULAR 2 VIEWS LT 408.45 NAVICULAR 2 VIEWS RT 408.45 WRIST 2 VIEWS LEFT 408.45 WRIST 2 VIEWS RIGHT 408.45 WRIST 3 VIEWS MINIMUM LEFT 507.15 WRIST 3 VIEWS MINIMUM RT 507.15 WRIST ARTHROGRAPHY LT 640.50 WRIST ARTHROGRAPHY RT 640.50

HAND 2 VIEWS 393.75 HAND 2 VIEWS LT 393.75 HAND 2 VIEWS RT 393.75 HAND 3 VIEWS MINIMUM LT 448.35 HAND 3 VIEWS MINIMUM RT 448.35 FINGER(S) 2 VIEWS LT 381.15 FINGER(S) 2 VIEWS RT 381.15 HIP UNI SINGLE VIEW LT 448.35

HIP UNI SINGLE VIEW RT 448.35 HIP LT 1 VIEW WITH PELVIS 319.20 HIP UNI 2 VIEWS LT 585.90

HIP UNI 2 VIEWS RT 585.90 HIP RT 1 VIEW WITH PELVIS 319.20 HIP BI COMP(AP PELVIS) 679.35 HIP ARTHROGRAPHY LT 1,246.35 HIP ARTHROGRAPHY RT 725.55 HIP IMAGING OPERATIVE PROCEDURE LT 859.95 HIP IMAGING OP PROCEDURE RT 859.95 FEMUR 1 VIEWS-LT DX 319.20

FEMUR 1 VIEWS RT DX 319.20 FEMUR 2 VIEWS LT 435.75 FEMUR 2 VIEWS RT 435.75 PATELLA 1-2 VIEWS LT 354.90 PATELLA 1-2 VIEWS RT 354.90 KNEE 1-2 VIEWS LT 354.90 KNEE 1-2 VIEWS RT 354.90 KNEE 3 VIEWS LT 196.35 KNEE 3 VIEWS RT 196.35 KNEE COMP 4 VIEW MIN LEFT 481.95

KNEE COMP 4 VIEW MIN RT 481.95 KNEES/BILAT AP STANDING 196.35 KNEE ARTHROGRAPHY LT 640.50 KNEE ARTHROGRAPHY RT 640.50 TIBIA/FIBULA 2 VIEWS LT 448.35 TIBIA/FIBULA 2 VIEWS RT 448.35 LOWER EXT INFANT AP&LAT LT 196.35 LOWER EXT INFANT AP&LAT RT 196.35

ANKLE 2 VIEWS LT 354.90 ANKLE 2 VIEWS RT 354.90 ANKLE 3 VIEWS MINIMUM LT 492.45

cdm

ANKLE 3 VIEWS MINIMUM RT 492.45 ANKLE ARTHROGRAPHY LT 546.00 ANKLE ARTHROGRAPHY RT 546.00 FOOT 2 VIEWS LT 354.90 FOOT 2 VIEWS RT 354.90 FOOT 3 VIEWS MINIMUM LT 448.35 FOOT 3 VIEWS MINIMUM RT 448.35 OS CALCIS 2 VIEWS 354.90 OS CALCIS 2 VIEWS LT 354.90 OS CALCIS 2 VIEWS RT 354.90

TOE(S) 2 VIEWS LT 354.90 TOE(S) 2 VIEWS RT 354.90 ABDOMEN SINGLE VIEW(KUB) 354.90 ABDOMEN W/DECUB OR ERECT 427.35 ABDOMEN ACUTE SERIES 501.90 ESOPHAGUS 1,476.30 ESOPHAGUS 1,476.30 SWAL FUNC W CINE/VIDEO 1,110.90

UPPER GI W/KUB 296.10 UPPER GI W/SMALL BOWEL 428.40 UPPER GI AIR/KUB 296.10

UPPER GI AIR/SMALL BOWEL 428.40 SMALL BOWEL 910.35 COLON BARIUM ENEMA 1,036.35 COLON HYPAQUE ENEMA 1,157.10 COLON BARIUM ENEMA W/AIR 1,157.10 CHOLANGIOGRPHY OPERATVE 1,060.50 ENDO CATH BILIARY SYSTEM 1,173.90 ENDO CATH PANCREAS DUCT 1,173.90

ERCP BILIARY&PANCREATIC 1,173.90 PYELOGRAPHY RETROGRADE 1,144.50 PYELOGRAPHY RETROGRADE 1,144.50 ANTEGRADE NEPHROSTOGRAM 1,144.50 ANTEGRADE NEPHROSTOGRAM 1,144.50 CYSTOGRAPHY COMPLETE 331.80 CYSTOGRAPHY COMPLETE 331.80 URETHROCYSTOGRAPHY RETR 544.95 URETHROCYSTOGRAPHY VOID 355.95 HYSTEROSALPINGOGRAPHY 416.85

ANGIO EXTREMITY UNILAT LT 8,530.20 ANGIO EXTREMITY UNILAT RT 8,530.20 VENOGRAM EXTREMITY UNI LT 3,206.70 VENOGRAM EXTREMITY UNI RT 3,206.70 AAA REPAIR IMAG 1,915.80 AAA CUFF DEPLOY IMG 555.45 TRNSCTH PERIPHERAL STENT 2,615.95 FLUOROSCOPY <1HOUR 275.10

FLUOROSCOPE EXAM EXTENSIVE 1,181.25 FLURO VEIN DEVICE 275.10 FLURO VEIN DEVICE 275.10

cdm

FLUORO BX/ASP/INJ/GUIDE 1,723.05 FLUORO GUIDE SPINE INJ 489.30 BONE AGE STUDIES 190.05 SURGICAL SPECIMEN 1,583.80 BRST PREOP PL NDL LOC W 900.90 MAMMARY DUCT/GALACT SNG 459.90 MAMMARY DUCT/GALACT MULT 459.90 MAMMOGRAPHY UNILAT DIAG 222.60 MAMMOGRAPHY UNILAT AUGMENT 222.60 MAMMOGRAPHY UNILAT F/U 222.60

MAMMOGRAPHY BILAT DIAG 418.95 MAMMOGRAPHY BILAT F/U 418.95 MAMMOGRAPHY SCREENING 300.30 MAMMOGRAPHY BILAT/IMPLANTS 300.30 G TUBE REMOVAL OR REPAIR 242.70 FNA W GUIDANCE 345.45 BIOPSY BONE SUPERFICIAL 345.45 BIOPSY BONE DEEP 2,565.15

ASPIR/INJ SMALL JNT 771.75 ASPIR/INJ INTERM JNT W/US 771.75 ASPIR/INJ MAJOR JOINT 771.75

PERC VERTPLSTY 1 BDY T 659.40 PERC VERTPLSTY 1 BDY L 659.40 PERC VERTPLSTY EA ADD BD 659.40 INJ SHOULDER ARTH/CT MRI 652.05 INJ HIP ARTHROGRAM 185.85 INJECT PROC SACRO JNT 3,375.75 THORACENTESIS W/TUBE INS 345.45 THRCNTSS W/ TUBE INSERT 1,536.15

THORACENTESIS /W IMAGE GUIDE 3,439.80 PLEURAL DRAINAGE /W IMAGE GUIDE 3,439.80 INSERT PLEURAL CATH 9,070.95 INSERTION OF CHEST TUBE 1,654.80 INSERTION OF CHEST TUBE 1,654.80 REPAIR ART BLOCKG VISCRL 501.90 REPAIR ART BLOCKG AORTIC 11,883.90 PERC ANGIOPLASTY ILIAC 185.85 PERC ANGIOPLASTY FEMPOP 185.85 ANGIOPLASTY - VENOUS 15,876.00

INJ VENOGRPHY EXTRMTY 185.85 PLC CATH SUPERIOR VENACAVA 562.80 PLC CATH VEIN 1ST ORDR 185.85 PLC CATH VEIN 2ND ORDR 185.85 PLC CATH RT HRT/PULM ART 185.85 PLC CATH LT/RT ARTERY 185.85 PLC CATH RETRO BRACH ART 185.85 PLC CATH EXTRM ARTERY 185.85

PLC CATH AV SHUNT 185.85 PLC CATH AV SHUNT ADDT 1.00 PLC CATH AV SHUNT INITIAL 2,048.15

cdm

PLC CATH AORTA 525.00 PLC CATH ART 1ST ORDR 185.85 PLC CATH ART 2ND ORDR 185.85 PLC CATH ART 3RD ORDR 185.85 PLC CATH ART ADD ORDR 185.85 CERVICOCEREBRAL ARCH ANGIO 13,249.95 CRTD COMMON EXTRA CRANIAL UNILATERL 13,249.95 PLC CATH ART ABD 1ST 185.85 PLC CATH ART ABD 2ND 185.85 PLC CATH ART ABD 3RD 185.85

PLC CATH ART ABD ADD 185.85 INS CATH REN ART 1ST UNILATE 6,882.75 INS CATH REN ART 1ST BILAT 8,204.70 INS CATH REN ART 2ND UNILAT 7,980.00 INS CATH REN ART 2ND BILAT 8,870.40 PERC CATH PORTAL VEIN 185.85 INSRT NONTUNNL CV CTH 5> 3,433.50 INSRT NONTUNNL CV CTH 5> 3,433.50

INSRT TNL CV CTH5>WO PMP 1,060.50 INSRT TUNNL VAD 5>W PORT 7,889.25 PICC LINE INSERTION 2,431.80

REPAIR CV CATH WO SQ PMP 2,431.80 REPAIR CVAD W SQ PUMP 2,431.40 REPLCE NONTUNNL CV CATH 2,633.15 REPLCE NONTUNNL CV CATH 2,633.15 REPLACE TUNNELED CV CATH 2,633.40 RPLC TUNNL CVAD W PORT 7,889.25 RPLC CVAD W/O PUMP 2,633.15 REMV TUNL WO PMP/PRT 2,431.80

RMV TUNLD CVAD W SQ PORT 2,056.95 DECLOT VASC DVC THROMB 732.90 REPOSITN CV CATH W/FLURO 2,431.80 CONTRST EVAL EXISTNG CVD 153.40 THROMBECTOMY AV FISTULA 2,283.35 THROMB NONCOR INITL VSL 5,280.45 THROMB NONCOR ADD VESSLS 3,759.90 VENOUS STENT PLACEMENT 23,714.25 VENOUS STENT PLACEMENT EA ADD VESS 8,969.65 IVC FILTER REPOSITIONING 12,453.00

IVC FILTER REMOVAL W/IMG GUID 12,453.00 RETRIEVAL FORIEGN BODY 13,298.25 TRNSCTH BIOPSY 1,698.90 TRNSCTH THRPY NONCORO 472.50 IVC FILTER REMOVAL 2,718.45 IVC FILTER REMOVAL 13,298.25 PERC TRNSCTH RTRVL FB 2,718.45 TRNSCTH OCCLUSION 6,555.15

PERC CATH INTRVASC STENT 185.85 PERC CATH INTRV STNT ADD 185.85 TRNCTH THRPY ARTERY NON COR 4,691.40

cdm

TRNCTH THRPY VENOUS NON COR 4,691.40 TRNCTH THRPY AORV NON COR FU 10,485.30 PLC VENA CAVA FILTER 5,808.60 IR PTA ILIAC ARTERY INITIAL 17,658.15 IR PTA ILIAC ARTERY INITIAL W/STENT 17,658.15 IR PTA ILIAC ARTERY ADDT 17,658.15 IR PTA ILIAC ARTERY ADDT W/ STENT 17,658.15 IR PTA FEM-POP ART 17,658.15 IR PTA FEM-POP ART W/ STENT 37,487.85 IR PTA TIBIAL/PERONEAL INIT ART 17,658.15

IR PTA TBL/PERONEAL INIT ART W/STNT 37,487.85 IR PTA TIBIAL/PERONIEAL ADDT ART 17,658.15 IR PTA TBL/PERONEAL ADDT ART W/STNT 17,658.15 TRANSCATH IV STENT PERC ART EA ADD 31,002.30 TRANSCATH IV STENT PERC ARTERIAL 32,996.45 PLC NG TUBE W FLUORO 357.00 PERC CHOLECYSTOSTOMY 5,610.15 INJ PERC TRANSHEP CHOLE 807.45

INJ CHOLE THRU EXST CATH 185.85 INSRT BILIARY DRAIN CATH 5,610.15 PL STNT INT/EXT BILE DRN 5,610.15

CHANGE BILIARY DRAIN CTH 7,171.50 REVISE/REINSERT TTUBE 3,226.65 DX BILIARY ENDO W/T TUBE 8,473.50 BILIARY ENDO DIL WO STNT 5,610.15 BILIARY ENDO DIL W/STENT 5,610.15 BILIARY DUCT STONE EXTR 5,610.15 DRAIN PERITONEAL ABSCESS 4,009.95 BX ABD/RETROPER PERC NDL 2,757.30

IR TUNNELED INTRAPERIOTONEAL CATH 9,974.10 INSRT PERM INTRAPTNL CTH 4,620.00 EXCH ABSC/CYST DRN CATH 2,095.80 INJ ABSC/CYST PREV CATH 355.95 PL GASTROSTMY TB PERC 2,511.60 PLACE DUOD/JEJ TUBE PERC 2,511.60 CHANGE G-TUBE TO G-J PER 2,511.60 REPLC G TUBE W/CONTRAST & FLUORO 1,599.15 REPLC G TUBR W/O FLUORO 947.10 CHANGE G-TUBE TO G-J PER 2,511.60

REPLACE G/C TUBE PERC 956.55 REPL DUOD/JEJ TUBE PERC 956.55 REPL G-J TUBE PERC 956.55 FLUORO EXAM OF G/CLN TB 408.45 BX RENAL PERC NDL 466.20 CHANGE URETER STENT PERC 4,644.15 CHNG EXT/INT URETR STENT 1,729.35 REMVE RENL TUBE W/FLUORO 653.10

ASP/INJ RENL CYST/PELVIS 1,078.35 ASP/INJ RENL CYST/PELVIS 1,078.35 ASP/INJ RENL CYST/PELVIS 1,078.35

cdm

CHANGE URETER STENT PERC 4,644.15 PERC DRN INJ RENL PELV 3,858.75 INSERT URETERAL TUBE 185.85 INJ NEPHROSTOGRAM 185.85 EST NEPH TRACT TO KIDNEY 3,859.15 CHANGE NEPHROSTOMY TUBE 6,672.75 INJ URETERAL CATHETER 185.85 ASPIR BLADDER W/INS CATH 5,713.05 CHANGE CYSTO TUBE COMPLT 2,070.60 INJ CORPORO CAVERNOSOGRM 416.85

ASPIRATION OF NUCLEUS PULPOSUS 11,993.10 INJ EDIDURAL LUMB/CAUD 1,759.80 MYELOGRAM LUMBAR 993.30 DISCOGRAPHY CERV/THOR 5,959.80 VERTPLSTY KYPHOPL FLUORO 993.30 SHOULDER ARTHROGRAPHY 652.05 ELBOW ARTHROGRAPHY 582.75 WRIST ARTHROGRAPHY 640.50

HIP ARTHROGRAPHY 725.55 SI JOINT ARTHROGRAPHY 1,182.30 KNEE ARTHROGRAPHY 640.50

ANKLE ARTHROGRAPHY 546.00 PERITONEOGRAM 1,584.45 CHOLANGIOGRPHY EXST CATH 910.35 CHOLANGIO PERC TRANSHEP 807.45 PERC POSTOP BIL CALC REM 3,461.85 PERC ENTEROCLYSIS COMP 469.35 BILIARY DIL W/WO STENT 1,006.95 ANTEGRADE NEPHROSTOGRA 1,144.50

CORPORA CAVERNOSOGRAPHY 619.00 URETHROCYSTOGRAPHY; RETROGRADE 1,439.70 PERCUTANEOUS NEPHROSTOMY 3,035.55 URETERAL CATH OR STENT 3,774.75 PERINEOGRAM 771.75 THORACIC W/SERL COMPLT 3,106.95 ABD AORTOGRPHY BY SERIAL 2,936.85 ABD AORTA W/BI LWR EXT 3,106.95 ANGIO BRACHIAL RETROGRD 2,631.30 ANGIO EXTERNAL CAROTID UNI LT 13,205.85

ANGIO EXTERNAL CAROTID UNI RT 13,205.85 ANGIO CAROTID CEREB UNI LT 8,530.20 ANGIO CAROTID CEREB UNI RT 8,530.20 ANGIO CAROTID CERV UNI LT 13,205.85 ANGIO CAROTID CERV UNI RT 8,530.20 ANGIO EXTREMITY UNILAT 3,058.65 ANGIO EXTREMITY UNILAT LT 3,058.65 ANGIO EXTREMITY UNILAT RT 3,058.65

ANGIO EXTREMITY BILAT 3,648.75 RENAL ARTERY 1ST ORDER UNILAT 12,203.15 RENAL ARTERY 2ND ORDER UNILAT 12,203.15

cdm

RENAL ARTERY 1ST ORDER BILAT 12,203.15 RENAL ARTERY 2ND ORDER BILAT 12,203.15 VISCERAL SELECTIVE COMP 3,373.65 ANGIO ADRENAL UNILAT SEL 5,763.45 ANGIO ADRENAL UNILAT SEL LT 5,763.45 ANGIO ADRENAL UNILAT SEL RT 5,763.45 PLACE URETERAL STENT EXISTING TRACT 11,777.85 PLACE URETERAL STENT NEW 11,777.85 ANGIO ADRENAL BILAT SEL 8,530.20 PLACE URETERAL STENT W/SEP NEPHROST 11,777.85

PLACE NEPHROSTOMY CATHETER 7,908.60 CATH PLACE COMMON CAROTID UNI 13,249.95 CATH PLACE CAROTID UNI 21,668.85 ANGIO PELVIC SELECT/SUP 4,877.50 CATH PLACE SUBCLAVIAN UNI 13,249.95 CATH PLACE VERTEBRAL UNI 21,668.85 CATH PLACE EXTERNAL CAROTID UNI 8,627.85 ANGIO PELVIC SELECT/SUP 2,936.85

PULMONARY UNI SELECTIVE 2,936.85 PULMONARY UNI SELECTIV LT 2,936.85 PULMONARY UNI SELECTIV RT 2,936.85

PULMONARY BI SELECTIVE 3,106.95 ANGIO PULM NONSEL CATH 2,286.90 ANGIO INTERNAL MAMMARY 2,286.90 ANGIO ADD VESSL SELECTVE 628.95 ANGIO A/V DIALYSIS SHUNT 6,981.45 AV SHUNTGRM W/O DIR ACESS 6,981.45 VENOGRAM EXTREMITY UNI 3,206.70 VENOGRAM EXTREMITY UNI LT 3,206.70

VENOGRAM EXTREMITY UNI RT 3,206.70 VENOGRAM EXTREMITY BI 6,235.95 INFERIOR VENACAVAGRAM 2,975.70 INFERIOR VENACAVAGRAM 2,975.70 SUPERIOR VENACAVAGRAM 2,975.70 VENOGRAPHY RENAL UNILAT 3,106.95 VENOGRAPHY RENAL UNILAT LT 3,106.95 VENOGRAPHY RENAL UNILAT RT 3,106.95 VENOGRAPHY RENAL BILAT 3,106.95 VENOGRAPHY ADRENAL UNI 5,763.45

VENOGRAPHY ADRENAL UNI LT 5,763.45 VENOGRAPHY ADRENAL UNI RT 5,763.45 VENOGRAPHY ADRENAL BI 5,763.45 VENOGRM VNUS SINUS/JUGUL 1,989.75 VENOGRAPHY SUP SAGITTAL 1,729.35 VENOGRAPHY ORBITAL 1,729.35 HEPATIC VENGRPHY W/EVAL 2,732.10 HEPATIC VENGRPHY W/EVAL 2,732.10

HEPATIC VENGPHY WO/EVAL 2,631.30 TRNSCTH EMBOLIZATN 1,356.60 TRNSCTH INFUSION 5,280.45

cdm

TRNSCTH INF NON-THROMB 5,280.45 ANGIO EXIST CATH P THRPY 900.90 ANGIO EXIST CATH P THRPY 900.90 DIALYSIS CATH AND KIT; 50 CM 1,358.70 PERC PLACE IVC FILTER 18,159.75 TRNSCTH PERIPHERAL STENT 5,811.75 APLASTY PERIPHERAL ART 5,280.45 APLASTY ADD PERIPHRL ART 1,911.00 APLASTY VISCERL ART INIT 6,332.55 APLASTY VISC ARTERY ADDL 1,729.35

TRNSCTH BIOPSY 1,729.35 ANGIOPLASTY VENOUS 5,775.00 PERC THEPATIC BIL DRAIN 3,571.05 PERC PLACE DRN CATH/ST 4,464.60 CHANGE PERC DRAIN CATH 469.35 PERC DRN ABSC W/CATH 1,896.30 PERC DRN ABSC W/CATH 1,896.30 FLUOROSCOPY < 1 HOUR 1,879.85

FISTULASINUS TRCT STDY 783.30 US GUIDE VASCULAR ACCESS 993.30 PICC REMOVAL 275.10

FLUOROGUID FOR VEIN DVCE 275.10 FLUORO BX/ASP/INJ/GUIDE 275.10 FLUORO GUIDE SPINE INJ 489.30 AAA STENT GRAFT 2,530.30 PLC VASC CLSURE DEVICE 147.00 APLASTY AV FISTGRPFT ART 15,924.30 G TUBE REMOVAL 242.70 FNA W GUIDANCE 385.35

ASP ABS/HEMAT/CYST 437.85 BX MUSCLE PERC NDL 1,080.45 BIOPSY BONE SUPERFICIAL 345.45 BIOPSY BONE DEEP 345.45 DRN PELVIC ABCESS 6,757.80 VACUUM ASSISTED CORE BIOPSY DEVICE 1,604.40 VACUUM ASSISTED CORE BX INTRO12 229.95 VACUUM ASSISTED CORE BX SMARK CELER 645.75 PNEUMONOSTOMY PERC DRN 1,002.75 BX PLEURA PERC NDL 345.45

BX LUNG/MEDIAST PERC NDL 3,969.00 THRCNTSS W/ TUBE INSERT 1,536.15 INSERT PLEURAL CATH 9,070.95 INSERTION OF CHEST TUBE 1,536.15 THORACENTESIS W/IMAGE 3,439.80 PLEURAL DRAINAGE W/IMAGE 3,439.80 PERC RF ABLTN LUNG TUMOR 9,525.60 CT UNLISTED MISC SCAN 1,620.15

PERC BIOPSY LYMPH NODE 345.45 PERC BX UPPER EXT SUPERFICIAL 6,977.25 BX LIVER PERC NDL 1,698.90

cdm

PERC DRN LIVER ABSC/CYST 2,841.30 PERC ABLTN LIVR TUMOR 10,337.25 BX PANCREAS PERC NDL 345.45 EXT DRN PSEUDOCYST PERC 2,841.30 PERC DRAIN ABD ABSCESS 2,841.30 DRAIN SUBDIAPHR ABSCESS 345.45 DRN RETROPERIT ABSC PERC 2,841.30 BX ABD/RETROPER PERC NDL 379.05 DRN RENAL/PERIRENAL ABSC 345.45 BX RENAL PERC NDL 345.45

ASPIR BLADDR W/ INS CATH 5,715.15 PERC ASPIR INTERVERT DISC / TISSUE 1,879.50 INJ EDIDURAL LUMB/CAUD 1,760.85 CT HEAD STEALTH W/O CM 2,857.05 CT STROKE CODE 2,857.05 CT HEAD/BRAIN WO CONTRST 2,857.05 CT HEAD/BRAIN W CONTRAST 3,030.30 CT HEAD/BRAIN WO/W CONTR 3,402.00

CT ORBIT W/O CM 2,587.20 CT EAR W/O CM 2,853.90 CT ORBIT W/CM 3,030.30

CT EAR W/CM 3,402.00 CT ORBIT WO/W CM 3,384.15 CT EYE/EAR/FOSSA W/WO CM 3,360.00 CT SINUS W/O CONTRAST 1,708.35 CT SINUS W/O CONTRAST 1,708.35 CT MAXILLOFACIAL W/O CM 3,030.30 CT SCAN FOR LOCALIZATION 3,030.30 CT SINUS WITH CONTRAST 1,704.15

CT MAXILLOFACIAL W/CM 3,335.85 CT SINUS WO/W CONTRAST 2,049.60 CT MAXILLOFACIAL WO/W CM 3,360.00 CT SOFT TISS NECK WO CM 2,587.20 CT SOFT TISS NECK W CM 2,737.35 CT NECK W/WO CONTRAST 1,397.35 CT SFT TISS NECK WO/W CM 2,646.00 CTA HEAD WO/W CONTRAST 1,508.85 CTA NECK WO/W CONTRAST 1,525.65 CT THORAX W/O CONTRAST 2,709.00

CT THORAX W/O CONTRAST 2,709.00 CT THORAX WITH CONTRAST 2,950.50 CT THORAX WITH CONTRAST 2,950.50 CT THORAX WO/W CONTRAST 3,096.45 CTA CHEST WO/W CONTRAST 1,353.45 CT SPINE CERVICAL W/O CM 3,410.40 CT SPINE CERVICAL W/CM 3,218.25 CT SPINE CERVICL WO/W CM 3,408.30

CT SPINE THORACIC W/O CM 3,410.40 CT SPINE THORACIC W/CM 3,218.25 CT SPINE THORACIC WO/W 3,408.30

cdm

CT SPINE LUMBAR W/O CM 3,453.45 CT SPINE LUMBAR W/CM 3,587.85 CT SPINE LUMBAR WO/W CM 3,408.30 CTA PELVIS WO/W CONTRAST 1,525.65 CT PELVIS W/O CONTRAST 2,709.00 CT PELVIS WITH CONTRAST 3,030.30 CT PELVIS WO/W CM 3,117.45 CT UPPER EXTRMTY W/O CM 2,381.40 CT UPPER EXTRMTY W/O CM LT 2,381.40 CT UPPER EXTRMTY W/O CM RT 2,381.40

CT UPPER EXTRMTY W/ CM 2,658.60 CT UPPER EXTRMTY W/CM LT 2,658.60 CT UPPER EXTRMTY W/ CM RT 2,658.60 CTA UP EXTREMITY WO/W CM 1,525.65 CTA UP EXTREMITY WO/W CM LT 1,525.65 CTA UP EXTRMTY WO/W CM RT 1,525.65 CT LOWER EXTRMTY W/O CM 2,655.45 CT LOWER EXTRMTY W/O CM LT 2,655.45

CT LOWER EXTRMTY W/O CM RT 2,655.45 CT LOWER EXTRMTY W/ CM 2,964.15 CT LOWER EXTRMTY W/ CM LT 2,964.15

CT LOWER EXTRMTY W/ CM RT 2,964.15 CTA LWR EXTRMTY WO/W CM 1,525.65 CTA LOWR EXTRMTY WO/W CM LT 1,525.65 CTA LOWR EXTRMTY WO/W CM RT 1,525.65 CT ABD/PEL W ORAL CONT ONLY 2,041.50 CT ABD/PEL W/O CM 2,041.50 CT ABDOMEN W/O CM 3,315.90 CT ABD/PEL W/ 2,852.40

CT ABDOMEN W/ CM 3,897.60 CT ABD/PEL W/ORAL & IV CM 5,924.10 CT ABD W/WO PEL W CM 2,852.40 CT UROGRAM(A/P W/WO) 2,936.40 CT ABD/PEL W/WO CONTRAST 2,852.40 CT ABDOMEN WO/W CM 4,740.75 CTA ABD/PELVIS W/WO CON; 3D POST 4,770.15 CTA ABDOMEN WO/W CM 4,251.45 CTA ABD LE RO WO/W CONT 1,525.65 PERC DRN ABSC W/CATH 2,314.20

3D IMAGING W POSTPROCESS 136.50 CT SINUS W/O CM LTD 841.05 CT GUIDANCE NDL PLACEMNT 2,475.90 CT GD PAREN ABL 1,339.80 CT LOWER EXTRMTY WO/W CM 2,756.25 PERC THERAPATIC BIL DRAIN 1,569.75 FNA W GUIDANCE 345.45 US FNA LIVER PERC 345.45

US FNA LYMPH NODE 345.45 US FNA MUSCLE PERC NDL 345.45 US FNA PANCREAS PERC 345.45

cdm

US FNA RENAL PERC 345.45 US FNA SALIVARY GLAND 345.45 US FNA THYROID PERC 1,203.30 FNA W GUIDANCE 345.45 US BIOPSY FNA BREAST 345.45 ASP ABS/HEMAT/CYST 437.85 ASPIT BREAST CYST 441.00 BX BRS PERC CORE W/GUIDE 512.55 BX BRS PERC W/DEVICE 4,193.70 BRST PREOP PL NDL 1ST LS 441.00

BRST PREOP PL NDL ADD LS 345.45 PLC BRS CLP PERC 480.90 ASPIR BREAST CYST 1,387.75 US BREAST ABCESS DRAINAGE DEEP 6,015.45 BX MUSCLE PERC NDL 1,080.45 THRCNTSIS FOR ASPIRATION 1,654.80 THRCNTSS W/ TUBE INSERT 1,536.15 THORACENTESIS W/IMAGE 3,439.80

PLUERAL DRAINAGE W/IMAGE 3,439.80 REPAIR FEM ORAL ANEURYSM 1,522.50 INJ PERC EXT PSEUDANYSM 703.50

PERC BIOPSY LYMPH NODE 1,080.45 BX SALIVARY GLAND NDL 2,101.05 UNLISTED SALIVARY GLAND 738.15 BX LIVER PERC NDL 1,698.90 PERC DRN LIVER ABSC/CYST 2,841.30 INSRT BILIARY DRAIN CATH 5,610.15 BX PANCREAS PERC NDL 1,698.90 DRN PERITONEAL ABSC 2,841.30

US PARACENTESIS ABD W/O IMAGING 2,257.50 US PARACENTESIS ABD W/IMAGING 2,257.50 PERITONEOCENTESIS SUBSQ 1,003.80 BX ABD OR RETRO MASS PERC NDL 3,969.00 IINSERT CATH W/IMAGE GUID ASCITES 12,467.70 DRN RENAL/PERIRENAL ABSC 2,841.30 BX RENAL PERC NDL 466.20 BX BREAST 1ST LESION US IMAG 4,233.60 BX BREAST ADD LESION US IMAG 1.00 ASP/INJ RENL CYST/PELVIS 1,698.90

PERC DRN/INJ RENL PELV 5,321.40 ASPIR BLADDR W/ INS CATH 5,713.05 INJ&CATH HYSTRO/SONOHYST 206.85 DRN PELVIC ABSC PERC 4,109.70 BX THYROID PERC NDL 375.90 PERC THEPATIC BIL DRAIN 1,006.95 PERC DRN ABSC W/CATH 708.75 US SOFT TISSUE HEAD/NECK 836.85

US CHEST & OR MEDIASTINM 836.85 ULTRASOUND BREAST COMPLETE 789.60 ULTRASOUND BREAST LIMITED 789.60

cdm

US ABDOMEN COMPLETE 1,084.65 US ABD LTD SNGLE/QUAD/FU 901.95 US RETROPERITONEAL COMP 1,063.65 US RETROPERITONEAL LTD 779.10 US TRANSPLANT KIDNEY 779.10 US OB COMP<14WKS 1STGEST 214.35 US OB COMP<14WK ADD GEST 214.30 US OB COMP>14WK SGL GEST 1,109.85 US OB COMP>14WK ADD GEST 1,314.60 US OB COMP W FETL ANATMY 534.85

US OB FETLANAT ADDL GEST 350.20 US OB LTD 1OR> FETUS 1,242.15 US OB F/U PER FETUS 805.35 US OB TRANSVAGINAL 214.35 DOPPLER VELOCIM FETA UA 423.15 DOPPLER VELOCIM FET MCA 423.15 US TRANSVAGINAL NOT OB 402.15 HYSTEROSONOGRAPHY 402.15

US PELVIC COMPLETE 1,109.85 US PELVIC COMPLETE 1,109.85 US PELVIC LTD/FU 805.35

US SCROTUM CONTENTS 1,151.85 US SCROTUM CONTENTS 1,151.85 US EXTREMITY NON VASCULR 787.05 US EXTREMITY NON VASCULAR LT 787.05 US EXTREMITY NON VASCULAR RT 787.05 US EXTREMITY NON VASCULAR LTD 290.75 US EXTREMITY NON VASCULAR COMP 449.75 US COMPRESSN REP PSEUDAN 1,191.75

US GUIDE VASCULAR ACCESS 993.30 US GUIDE NEEDLE PLACEMNT 993.30 US GUIDANCE INTRAOPERATV 1,314.60 DUPLEX CAROTID BI/COMP 1,630.65 EXTRACRANIAL ART LTD 681.45 EXTRACRANIAL ART LTD LT 681.45 EXTRACRANIAL ART LTD RT 681.45 UE/LE ART STUDY LTD 423.15 UE OR LE ART STUDY COMP 373.80 LE ART IMAGING COMP 375.90

LE ART IMG COM BILAT 750.75 LE ART IMAGING COMP LT 750.75 LE ART IMAGING COMP 750.75 LE ART IMAGING LTD 505.05 LE ART IMAGING LTD LT 505.05 LE ART IMAGING LTD RT 505.05 UE ART IMG COM BILAT 750.75 ART IMAGING U/E COMPLETE LT 750.75

ART IMAGING U/E COMPLETE 750.75 ART IMAGING U/E LIMITED 505.05 ART IMAGING U/E LIMITED LT 505.05

cdm

ART IMAGING U/E LIMITED RT 505.05 DUPLX EXT VEINS BIL 1,513.05 DUPLX UE/LE VEIN UNILAT 1,126.65 DUPLX UE/LE VEIN UNILAT 1,126.65 DUPLX UE/LE VEIN UNILAT LT 1,126.65 DUPLX UE/LE VEIN UNILAT RT 1,126.65 ART/VEN FLOW ABD COMP 681.45 ART/VEN FLOW ABD LTD 681.45 DUPLX AORT&IVC&ILIAC COM 431.55 AORT/INF/IV/BPG LTD 582.75

ART/VEN FLOW PENILE COMP 681.45 ART/VEN FLOW PENILE LTD 431.55 SCAN HEMODIALYSIS ACCESS 431.55 SENTINEL NODE INJECTION 185.85 THYROID UPTAKE MULTIPLE 544.50 THYROID IMAG W/UPTK MULT 1,112.30 THYROID IMAGING ONLY 716.45 THYROID C/M IMG NCK/CHST 1,559.25

THYROID C/M IMG ADD AREA 793.80 THYROID C/M IMG WHOL BDY 1,559.25 THYROID C/M IMG WHOL BDY 1,559.25

PARATHYROID IMAGING W SPECT 1,537.75 PARATHYROID IMAGING W SPECT & CT 1,537.75 REDCELL SPL/HEP SEQUESTR 1,350.30 LYMPHATICS & LYMPH NODES 1,346.10 LIVER IMAGING (SPECT) 1,022.70 LIVER/SPLEEN IMAG STATIC 1,417.50 LIVER/SPLEEN VASC FLOW 2,501.10 HEPATOBILIARY IMG W/GBLD 2,408.70

GASTRIC EMPTYING STUDY 1,987.65 ACUTE GI BLOOD LOSS IMG 1,417.50 BONE IMAGING LIMITED 1,080.45 BONE IMAGING WHOLE BODY 1,624.35 BONE IMAG 3 PHASE STUDY 2,189.25 BONE IMG TOMOGRM (SPECT) 852.60 VASCULAR FLOW STUDY IMAG 894.60 CARDIAC R/S SINGLE STUDY 3,612.00 CARD TOM(SPECT)REST&EXCR 3,613.00 CARDIAC R/S LEXISCAN (1 DAY) 3,613.00

CARDIAC R/S TM W/ IMAGING (1 DAY) 3,613.00 CARDIAC R/S LEXISCAN (2 DAY) 3,613.00 CARDIAC R/S TM W/ IMAGING (2 DAY) 3,613.00 MYOCARDIUM IMG INFARCT 1,215.90 GATED HEART PLANAR SNGL 1,417.50 PULM PERF PARTICULATE 1,293.60 PERF/VENT REBRE/WO 1,662.15 VENT IMG AEROSOL MULT VW 1,662.15

BRAIN IMG LTD < 4 VIEW 877.80 BRAIN IMG STATIC MIN 4 VW 1,111.95 BRAIN IMG FLOW MIN 4 VIEW 1,875.30

cdm

BRAIN IMG TOMGRAM(SPECT) 852.60 CISTERNOGRAM 855.75 SHUNT EVALUATION 967.05 CSF TOMOGRAPHIC (SPECT) 967.05 CSF LEAK DETECTION 967.05 KIDNEY IMG VASC/FUNCTION 988.05 KIDNEY IMG FLW/FNCT W/DR 1,249.50 KIDNEY IMG FLW/FNCT W/WO 1,946.70 KIDNEY IMAGING (SPECT) 852.60 TESTICULAR VASCULAR LTD 883.05

TUMOR LOCALIZATION LTD 1,105.65 TUMOR LOCAL MULTI AREAS 1,105.65 TUMOR LOCAL WHOLEBODY 1,559.25 TUMOR LOCAL WHOLEBODY 1,559.25 TUMOR SPECT 2,379.30 TUMOR LOC W/B 2+ DAYS 1,640.10 INFL PR LCL/LTD 1,193.85 ABSCESS LOCAL WHOLE BODY 1,559.25

ABSCESS LOCALIZE WHLBDY 1,795.50 ABCESS SPECT 967.05 INJ RADPHAM LOC NO IMAGE 693.00

RADPHARM TX ORAL 423.15 RADPHARM TX IV 1,051.05 RADIOPHARM INPT STAY 1.00 CARDIO STRESS TRACE ONLY 597.75 INDIUM IN111 AUTOWBC DOSE 4,200.00 TC99 SESTAMIBI DOSE 228.90 TC-99M BICISAT DOSE/25MCI 4,506.00 TC99 MEDRONAT UPTO 30MCI 38.85

TL201 CHLORIDE 1MCI 65.10 TC-99M MYOVIEW 288.75 TC99 DISOFENIN VIAL 117.60 TC99 PERTECHN PER MCI 2.10 I 123 SOD CAP PER 100MCI 57.75 TX I131 SID CAP PER MCI 124.45 DX I131 SID CAP PER MC 399.00 TC99 MEBROFENN DOSE/15MCI 117.60 TC99 PYROPHOSPHATE DOSE 88.20 TC99 PENTETATE DOSE/25MCI 38.85

TC99 ALBUM MAA DOSE/10MCI 38.85 TC99 SULF COLL DOSE/20MCI 49.35 TC99 RBC DOSE/30MCI 226.80 TC99 MERTIATID DOSE/15MCI 448.35 INIII OXYQUINOLINE PER 0.5 MCI 3,480.75 IN111 PENTETRTD DOSE/6MCI 5,418.00 SR89 1MCI 1,528.80 IN111 DTPA .5MCI 484.05

IN111 OXYQNL PER 0.5MCI 4,992.75 TC99 EXAMETAZM DOSE/25MCI 3,417.75 TC99 TILMANOCEPT DIAG 0.5 MCI 1,260.00

cdm

GA67 CITRATE 1MCI 51.45 XENON 133 10 MCI 64.05 MRI ORB/FACE/NECK WO CM 3,627.75 MRI ORB/FACE/NECK WO CM 3,627.75 MRI ORB/FACE/NECK W/CM 2,890.65 MRI ORB/FACE/NECK W/CM 2,890.65 MRI ORB/FACE/NECK WO/W C 3,461.85 MRA HEAD W/O CONTRAST 576.45 MRA HEAD W/O CM (VENOUS & ARTERIAL) 3,298.30 MRA HEAD W/CONTRAST 1,572.90

MRA HEAD WO/W CONTRAST 1,572.90 MRA NECK W/O CONTRAST 1,572.90 MRA NECK W CONTRAST 1,572.90 MRA NECK WO/W CONTRAST 1,572.90 MRI BRAIN W/O CONTRAST 3,627.75 MRI BRAIN WITH CONTRAST 3,627.75 MRI BRAIN WO/W CONTRAST 5,156.55 MRI BRAIN WO/W CONTRAST 5,156.55

MRI CHEST W/O CONTRAST 3,627.75 MRI CHEST W/CONTRAST 1,694.75 MRI CHEST WO/W CONTRAST 2,246.25

MRA CHEST W/CONTRAST 2,245.95 MRI SPINE CERVICL W/O CM 3,627.75 MRI SPINE CERVICAL W/CM 3,627.75 MRI SPINE THORAC W/O CM 3,627.75 MRI SPINE THORACIC W/CM 3,627.75 MRI SPINE LUMBAR W/O CM 3,627.75 MRI SPINE LUMBAR W/CM 3,627.75 MRI SPINE CERV WO/W CM 5,156.55

MRI SPINE THOR WO/W CM 5,156.55 MRI SPINE LUMBAR WO/W CM 5,156.55 MRI PELVIS W/O CONTRAST 1,570.65 MRI PELVIS W/ CONTRAST 3,627.75 MRI PELVIS WO/W CONTRAST 2,109.45 MRI UP EXT NONJNT W/O CM 1,570.65 MRI UP EXT NONJNT W/O CM LT 3,339.75 MRI UP EXT NONJNT W/O CM RT 1,570.65 MRI UP EXT NONJNT W/CM 1,694.75 MRI UP EXT NONJNT W/CM LT 1,694.75

MRI UP EXT NONJNT W/ CM RT 1,694.75 MRI UP EXT NONJNT WO/WCM 3,627.75 MRI UP EXT NONJNT WO/W CM LT 3,627.75 MRI UP EXT NONJNT WO/W CM RT 3,627.75 MRI UP EXT JNT W/O CM 1,572.90 MRI UP EXT JNT W/O CM LT 1,572.90 MRI UP EXT JNT W/O CM RT 1,572.90 MRI UP EXT JNT W/ CM 1,572.90

MRI UP EXT JNT W/CM LT 1,572.90 MRI UP EXT JNT W/ CM RT 1,572.90 MRI UP EXT JNT WO/W CM 1,572.90

cdm

MRI UP EXT JNT WO/W CM LT 1,572.90 MRI UP EXT JNT WO/W CM RT 1,572.90 MRI LE NONJNT W/O CM 1,570.65 MRI LE NONJNT W/O CM LT 1,570.65 MRI LE NONJNT WO CM RT 1,570.65 MRI LE NONJNT W/CM 1,694.75 MRI LE NONJNT W/CM LT 1,694.75 MRI LE NONJNT W/CM RT 1,694.70 MRI LE NONJNT WO/W CM 3,627.75 MRI LE NONJNT WO/W CM LT 3,627.75

MRI LE NONJNT WO/W CM RT 3,627.75 MRI LOWR EXT JNT W/O CM 3,627.75 MRI LOWER EXT JNT W/O CM LT 3,627.75 MRI LOWR EXT JNT W/O CM RT 3,627.75 MRI LOWR EXT JNT W/ CM 1,694.75 MRI LOWR EXT JNT W/ CM LT 1,694.75 MRI LOWR EXT JNT W/ CM RT 1,694.75 MRI LE JNT W/WO CM 2,246.25

MRI LE JNT W/WO CM LT 2,246.25 MRI LE JNT W/WO CM RT 2,246.25 MRI ABDOMEN W/O CM 3,627.75

MRI ABDOMEN W/ CM 3,627.75 MRI ABDOMEN WO/W CM 5,156.55 MRA ABDOMEN W/ CM 1,572.90 MRI AUTOINJECTOR SYRINGE KITS 157.95 MRI CONTINUUM INFUS PUMP ADMIN SET 172.20 TRDMILL FOR DETECTION OF CMPRT SYND 438.35 SIGNAL AVERAGED EKG 677.25 TILT TABLE SCAN PROC 1,317.75

EKG TRACE ONLY 399.00 CARDIO STRESS TRACE ONLY 718.20 RHYTHM EKG 219.45 ECHOCARDIOGRAM M MODE+2D 1,061.55 EVENT MONITOR RECORDING 187.95 EKG MNTR 24HRS 208.95 EKG MNTR SCAN W REPORT 973.35 ECHOCARDIOGRAM LIMITED 442.05 DOPPLER ECHO PULSE/CONT 381.15 DOPPLER ECHO LIMITED 393.75

DOPPLER ECHO COLOR FLOW 300.30 STRESS TTE COMPLETE 2,718.45 ECHOCARDIOGRAM EX STRESS 2,191.35 DOBUTAMINE STRESS ECHO 2,191.35 ADMIN ECHO CONTRAST AGENT 275.10 TRANSESOPHAGEAL ECHO 3,518.55 ECHO TEE PER & INTRA PROCEDURE 1,743.00 TRNSTHOR ECHO CMPLETE 1,743.00

PERI PROCEDURAL PPM EVAL 700.35 PERI PROCEDURAL DFIB EVAL 892.50 PM DEVICE PROGR EVAL SNGL 218.40

cdm

PM DEVICE PROGR EVAL DUAL 218.40 PM DEVICE PROGR EVAL DUAL 218.40 ICD DEVICE PROGR EVAL SNGL 218.40 ICD DEVICE PROGR EVAL DUAL 218.40 ICD DEVICE PROGR EVAL MULTI 218.40 PRGRMG DEV EVAL IMPLTBL SYS 216.30 INTERROGATE SUBQ DEFIB 216.30 ELECTROPHYSIOLOGY EVAL 216.30 LEADLESS C PM INS/RPL VENTR 54,828.90 LEADLESS C PM REMOVE VENTR 13,765.50

PROG EVAL INPER LEADLS PM 216.30 INTERGT EVAL INPER LEADLS PM 216.30 MISC CARDIOLOGY CONVERSION - PLACEMENT IMPELLA 2.5 16,271.85 LT ATRIAL APP ABL 12,600.00 I&D HEMA SEROMA FL 2,375.10 PERICARDIOCENTESIS INTL 1,913.10 PERC INSERT IABP DEV 5,913.60

PERC IABP REMOVAL 117.60 LEAD INSERT/PM PERM/AV 36,480.15 INSRT PM GEN ONLY W/MULTI LEADS 27,628.65

RMV&RPLC PM GEN SNGL LD SYS 23,678.55 RMV&RPLC PM GEN DUAL ID SYS 27,628.65 RMV&RPLC PM GEN MULTI ID SYS 27,628.65 LEAD INSERT/PM PERM/VENT 29,474.55 INSRT ICD GEN ONLY W/DUAL IDS 80,621.10 INSRT ICD GEN ONLY W/MULTI IDS 80,621.10 RMV&RPLC ICD GEN SNGL ID 80,621.10 RMV&RPLC ICD GEN DUAL IDS 80,621.10

LEAD INSERT/PM PERM/ATR 29,474.55 RMV&RPLC ICD GEN MULTI IDS 80,621.10 UPGRADE TO DUAL CHAMBER 36,480.15 REPOSITION LD RA OR RV 10,048.50 INS/RPL DUAL CHMBR GENER 27,628.65 INS/RPL SNGL CHMBR GENER 23,681.70 REM PCMKR PULS GEN ONLY 10,048.50 INSRT TRAN ELCTRD SNGL 22,480.50 INSRT TRAN ELCTRD DUAL 22,480.50 REVSN/RELOC PM SKN POCKT 6,636.00

REPS TRNSV LD RT ATR/VNT 3,054.60 INSRT/REPO AICD & LD 50,086.05 INSERTION AICD PULS GEN 80,621.10 DFIB DC PRELIFE 0.01 SUBCUT REM AICD PLS GEN 10,048.50 REM AICD LDS TRANSVEN 10,048.50 REM TRANSV PM ELCTD SNGL 10,048.50 REVISION SKIN PKT AICD 6,636.00

REM PCMKR TRAN ELCT DUAL 10,048.50 P/M AICD ELECTRD RPR SGL 10,048.50 P/M AICD ELECT REPR DUAL 10,048.50

cdm

IMPL PT ACTIV CARD RCDR 21,105.00 REMV PT ACTIV CARD RCDR 3,486.00 INSRT LD VEN LTVENT INIT 38,769.15 INSRT LD VEN LTVENT PREV 12,771.15 REPS PREV LD VEN LTVENT 10,048.50 PLC CATH ART 1ST ORDR 185.85 PLC CATH ART 2ND ORDR 185.85 PLC CATH ART 3RD ORDR 185.85 PLC CATH ART ABD 1ST 185.85 PLC CATH ART ABD 2ND 185.85

PLC CATH ART ABD 3RD 185.85 PLC CATH ART ADD ORDR 185.85 PLC CATH RT HRT/PULM ART 185.85 PLC CATH LT OR RT PA 2,293.20 PLC CATH SEGMNTL ARTR 185.85 INJ VENOGRPHY EXTRMTY 185.85 INJ VENOGRAPHY EXTREMITY 185.85 VENOUS CATH SAMPLING 750.75

PLC CATH AORTA 525.00 PLC CATH BRACH ARTERY 185.85 PLC CATH EXTRM ARTERY 185.85

PLC CATH VENACAVA 9,141.30 PLC CATH AV SHUNT 185.85 VENOUS SAMPLING VIA CATH 9,141.40 PERC APLASTY BRACHIOCEPH 5,280.45 PERC ANGIPLSTY RENL/VISC 501.90 REPAIR ART BLOCKG AORTIC 5,418.00 PERC ANGIOPLASTY ILIAC 5,280.45 PERC ANGIOPLASTY FEMPOP 5,280.45

PERC ANGIOPLSTY TIBIOPER 5,280.45 PERC ANGIOPLASTY VENOUS 4,717.65 PERC CATH INTRVASC STENT 31,002.30 TRANSCATH IV STENT PERC ARTERIAL 31,002.30 TRANSCATH IV STENT PERC VENOUS 31,002.30 TRLUML PERIP ATHRE ILIAC ARTERY 31,994.55 PERC CATH INTRV STNT ADD 14,205.45 TRANSCATH IV STENET PERC ART EA ADD 31,002.30 TRANSCATH IV STENT PERC VEN EA ADD 31,002.30 PTA ILIAC ARTERY 17,653.65

ILIAC REVASC ADD-ON 17,653.65 PTA ILIAC ARTERYWITH STENT 31,002.30 PTA ILIAC ARTERY WITH STNT EACH ADD 17,653.65 FEM/POPL REVAS W/TLA 17,653.65 PTA SFA-POPLITEAL ARTERY WITH STENT 31,002.30 TIB/PER REVASC W/TLA 17,653.65 TIB/PER REVACS ADD-ON 17,656.80 PTA TIBIOPERONEAL ART WITH STENT 31,002.30

REVSC OPN/PRQ TIB/PERO STENT 17,656.80 PTA FEMPOP ART W ATHERECTOMY N STNT 83,259.75 PTA TIBPER ART W ATHERECTOMY N STNT 52,274.25

cdm

PTA TIBPER ART W ATHRECTOMY EA ADD 31,002.30 PTA TIBPER ART W ATHR N STNT EA ADD 27,090.00 VASC EMBOLIZE OCCLUDE ARTERY 31,994.55 VASC EMBOLIZE OCCLUDE VENOUS 31,994.55 ENDOVAS AAA REPR W/2 PART 13,557.60 XPOSE FOR ENDOPROSTH FEM 8,746.50 ENDOVASC EXTEND PROSTH INIT 7,823.55 ENDOVAS AAA REPR W/3-P PART 15,600.00 TRNSCTH THRPY NONCORO 472.50 TRNSCTH TX NOT THROMBO 4,879.35

TRNSCTH TX NOT THROMBO 4,879.35 EXCH INTRAVASCULR TX CTH 1,223.25 TRNETH THRPY ARTERY NON COR 4,691.40 TRNETH THRPY VENOUS NON COR 4,691.40 TRNETH THRPY A OR V NON COR FU 10,485.30 TRNETH THRPY AORV N COR CNTNUE CARE 10,485.30 THROMB NONCOR INITL VSL 5,280.45 THROMB NONCOR ADD VESSLS 3,759.90

SEC ART THROMB ADD 7,379.40 PERC MECH THROMBECTMY VN 5,290.95 MECH THRMBCTMY VN RPEAT 5,280.45

PLC VENA CAVA FILTER 5,808.60 INTRVASC US NON COR 1ST 4,319.70 INTRVASC US NON COR A 1,986.60 REMOVAL OF FOREIGN BODY 2,718.45 RETRIEVAL FORIEGN BODY 13,298.25 PERIPHERAL ATHRECTOMY 11,085.90 PERIPHERAL ATHERECTOMY PTA FEM POP 31,002.30 PERI ATHERECTOMY PTA TIBIO PER ART 31,002.30

TRLUML PERIP ATHRC BRCHIOPH 33,801.00 CAROTID STNT W PRTCTN 10,629.15 CRTD STNT W/O PROTECTIO 8,381.10 CERVICOCEREBRAL ARCH ANGIO 13,249.95 CRTD COMMON EXTRA CRANIAL UNILATERL 13,249.95 CRTD COMMON INTRACRANIAL UNILATERL 13,249.95 CRTD INTERNAL CIRCULATN UNILATERAL 21,668.85 SUBCLAVIAN CIRCULATION UNILATERAL 13,249.95 VERTEBRAL CIRCULATION UNILATERAL 21,668.85 THORACIC W/SERL COMPLT 3,106.95

BRACHIAL RETROGRADE 2,631.30 ENDOVASC REPR ABDM AORTA 1,916.25 ABDOM ANEURYSM ENDOVAS RPR 7,823.55 ABD AORTOGRPHY BY SERIAL 2,936.85 ABD AORTA W/BI LWR EXT 3,106.95 INSRT CATH REN ART 1ST UNILAT 12,203.10 INSRT CATH REN ART 2ND+UNILAT 12,203.10 INSRT CATH REN ART 1ST BILAT 12,203.35

INSRT CATH REN ART 2ND+BILAT 12,203.10 VISCERAL SELECT/SUPRA 5,126.10 ANGIO ADD VESSL SELECTVE 628.95

cdm

ANGIO PELVIC SELECT/SUP 2,936.85 ANGIO ADRENAL BILAT SEL 9,179.10 ANGIO EXTREMITY UNILAT 3,058.65 ANGIO EXTREMITY BILAT 3,648.75 PULMONARY UNI SELECTIVE 2,936.85 PULMONARY BI SELECTIVE 3,106.95 ANGIO PULM NONSEL CATH 2,286.90 ANGIO INTERNAL MAMMARY 2,286.90 ANGIO A/V DIALYSIS SHUNT 752.85 APLASTY PERIPHERAL ART 5,280.45

APLASTY ADD PERIPHRL ART 1,911.00 APLASTY VISCERL ART INIT 6,332.55 FLUOROSCOPY <1HOUR 730.80 APLASTY VISC ARTERY ADDL 1,729.35 ANGIOPLASTY VENOUS 5,775.00 TRNSCTH EMBOLIZATN 1,356.60 VENOGRAM EXTREMITY UNI 3,206.70 VENOGRAM EXTREMITY BI 840.00

SUPERIOR VENACAVAGRAM 2,975.70 INFERIOR VENACAVAGRAM 2,975.70 VENOGRAPHY RENAL UNILAT 8,530.20

VENOGRAPHY RENAL BILAT 8,530.20 VENOGRAPHY ADRENAL UNI 8,530.20 VENOGRAPHY ADRENAL BI 8,530.20 TRNSCTH INFUSION 5,280.45 ANGIO EXIST CATH P THRPY 900.90 ANGIO A/V DIALYSIS SHUNT 752.85 INSRT ENDO VASC IVC FILTER 18,159.75 REDO ENDO VASC IVC FILTER 12,461.40

RMV ENDO VASC IVC FILTER 12,461.40 ILIAC ART BI W CARD CTH 1,874.25 PLC VASC CLSURE DEVICE 147.00 RT/LT HEART CATH (SEPTAL OPENING) 12,508.65 CATH RT HEART 12,737.55 CATH LT HRT VGRAM/PRESSURES 12,737.55 CATH RT/LT HRT VGRAM/PRESSURES 12,737.55 CATH CORONARY ANGIO ONLY 12,737.55 CATH CORS/BYPS GRFTS 12,737.55 CATH RT HRT + CORORANY ANGIO 12,737.55

CATH RT HRT + COR/BYPS GRAFTS 12,737.55 CATH LT HRT VGRAM/PRES + CORS 12,737.55 CATH LT HT VGRM/PRES+CORS+GRFTS 12,737.55 CATH RT/LT HRT VGRAM/PR CORS 12,737.55 CATH RT/LT HRT VGRM/PRES+COR+GRFT 12,737.55 LT HRT TRANS SEPTAL PUNCTURE 12,737.55 PHARM EX STUDY PRESSURE MEASURE 1,042.30 EX STUDY PRESSURE MEASURE 1,042.30

RA/RV ANGIOGRAPHY 449.40 AO ROOT SUPRAVALVULAR ANGIOGRAPHY 468.50 PULMONARY ARTERY ANGIOGRAPHY 542.60

cdm

PERC VALVULOPLSTY AORTIC 12,877.20 MITRAL BLN VALVPLASTY 16,271.85 PUL ART BALLOON REPR PERCUT 11,250.00 PUL ART BLN REPR PERCUT EA ADD 0.01 ENDOMYOCARDIAL BIOPSY 2,208.15 IVUS CORONARY INIT VESSL 1,874.25 IVUS CORONARY EA ADD 1,167.60 PRESSURE WIRE FFR 2,650.20 PRESSURE WIRE FFR EA ADD 1,050.00 PERC CORON THROMBECT 11,450.25

ECMO/ECLS INITIATION VENOUS 5,250.00 CARDIOVERSION ELEC 1,699.95 CATH RTFLOW CATHETER 3,504.90 INSRT/REPL TEMP PM LEAD 22,475.25 CENTRAL LINE INSERTION CL 4,551.75 CENTRAL LINE INSERT CL PERIPHERAL 4,551.75 CARD CATH ABORTED PROC 407.40 CARDIAC ALCOHOL ABLATION 309.75

EP TEST AICD LEAD & GEN 3,036.60 PERC CLOSURE SEPTAL DEFECT 42,884.10 EP STUDY ABLATION ATRIAL ARRYTHMIA 66,526.95

EP STUDY ABLATION VENT ARRYTHMIA 66,526.95 ABLATE ARRHYTHMIA ADD-ON 1.00 EPS ABL XSEPTAL ATR ARRYTHMIA 66,526.95 EP COMP STUDY W/INDUCTN 9,996.00 COMP EP W/O INDUC/ARRYTH 6,598.20 INDUCTN ARRHYTHMIA BY EP 3,297.00 ANALYSIS ANTI TACH PMKR SYSTEM 2,037.00 EP EVAL AICD LEADS INIT 13,347.60

EP EVAL AICD SUBSEQ 2,029.65 ABLATIONAV NODE 17,213.70 EP CARDIAC MAPPING 6,069.15 BUNDLE OF HIS RECORDING 5,707.80 COMP EP EVAL/LA FRM CS R 9,138.95 EP POST DRUG INFUSION 6,069.15 US GUIDANCE INTRA OPERATIVE 1,256.85 LV PACING AND RECORDING DURING EPS 5,364.45 PTCA MAIN CORONARY ARTERY 24,012.45 PTCA BRANCH MCA EA ADD 24,012.45

PTCA ATHERECTOMY MCA 45,788.40 PTCA ATHRCTMY BRNCH MCA EA ADD 45,788.40 STENT MCA 36,471.75 STENT DES MCA 46,336.50 STENT BRANCH MCA EA ADD 36,471.75 STENT DES BRANCH MCA EA ADD 46,336.50 PERC TOTAL REVASC MCA 36,471.75 PERC TOTAL REVASC DES MCA 46,336.50

PERC TOTAL REVASC MCA EA ADD 36,471.75 PERC TOTAL REVASC DES MCA EA ADD 46,336.50 PREC TOTAL REVASC OF OR THRU GRAFT 36,471.75

cdm

PERC TOTAL REVASC DES GRAFT 46,336.50 PERC TOTAL REVASC GRAFT EA ADD 36,471.75 PERC TOTAL REVASC DES GRAFT EA ADD 46,336.50 PERC TOTAL REVASC DURING MI 36,471.75 PERC TOTAL REVASC DES DURING MI 46,336.50 PERC TOTAL REVASC CTO 36,471.75 PERC TOTAL REVASC DES CTO 46,336.50 PERC TOTAL REVASC CTO EA ADD 36,471.75 PERC TOTAL REVASC DES CTO EA ADD 46,336.50 MISC CATH LAB CONVERSION -

DEFIB DC ATLAS II DRV265 96,571.65 DEFIB DC EPIC II+DR V255 99,144.15 DFIB DC VIRTUOSO 122,965.50 DFIB DC VITALITY 2 T165 110,617.50 DFIB LUMAX 340 DRT 105,086.10 DFIB CURRENT DR RF 114,015.30 DEFIB DC CONFIENT HE 115,762.50 DEFIB DC TELIGEN HE 112,675.50

CARDIOVERTER/DFIB DC 105,000.00 PM BIVENTRICULAR SYSTEM 66,150.00 PM BIVENTRICULAR 97,650.00

DFIB SC EPIC II VR 93,999.15 DFIB SC VITALTY 2 T175 92,610.00 DEFB SNGL SECURA D224VR 104,958.00 DEFIB DC CONSULTA DR 125,023.50 DEFIB DUAL CHAMBER SYSTEM 77,175.00 DEFIB DUAL CHAMBER 110,250.00 DFIB SC VIRTUOSO D154VW 104,958.00 CARDIOVERTER/DFIB SC 105,000.00

DFIB CONCERTO CRTD 152,806.50 DFIB PRELIFE 0.01 DEFIB CONSULTA CRT-D 146,632.50 DEFIB MAXIMO II 82,320.00 DFIB CONTAK CD AVIII 117,048.75 DEFIB SINGLE CHAMBER SYSTEM 58,800.00 DEFIB SINGLE CHAMBER 88,200.00 DFIB EPIC HF V337 118,335.00 DFIB EPIC II HF V355 127,338.75 DFIB KRONOS LVT 347406 168,627.40

DEFIB LUMAX 340 HFT 115,762.50 DFIB RENEWAL 3 RF 129,911.25 DEFIB COGNIS 100D 140,355.60 DEFIB BIV LIVIAN HE H229 140,201.25 DEFIB BIV LIVIAN H220 135,056.25 CARDIOVERTER/DFIB OTHER 80,850.00 PM DC ADAPTA S 34,986.00 IMPLANTABLE LOOP RECORDER 42,000.00

IMP LOOP RECORDER LINQ 55,597.50 PM DC RR ADAPTA ADDR01 39,102.00 PM SENSIA DR 23,152.50

cdm

PM DC RR CYLOS DR 28,297.50 PM DC RR CYLOS DRT 40,645.50 DEFIB BIVENTRICULAR SYSTEM 110,250.00 DEFIB BIVENTRICULAR 158,025.00 PM DC RR INSIGN ULTR DR 32,156.25 PM DC RR INSIGNA ULTRA 32,156.25 PM DC PHILOS II 23,152.50 PM DC PRELIFE 0.01 PM DC RR PHILOS II DR T 35,500.50 PM DC EVIA DR-T 23,152.50

PM DC RR SENSOR 33,185.25 PM DC RR VICTORY DR 35,464.80 YM DC RR VICTORY XLDR 26,409.60 PP DC ZEPHYR XLDR 38,036.25 PPM ACCENT DR 33,087.60 PPM ALTRUA 60 DDDR 31,899.00 PPM REPLY DR 29,326.50 PM DC RATERESPONSIVE 40,395.60

PM DUAL CHAMBER SYSTEM 36,750.00 PM DUAL CHAMBER 47,250.00 PPM ALTRUA 60 SSIR 29,326.50

PM SC RR ADAPTA SR01ID 28,297.50 PM SC RR CYLOS VR 26,754.00 PM SC RR INSIGNIA ULTRA 29,583.75 PM SC RR PHOLOS II SR 19,756.80 PM SC RR PROTOS VR 26,239.50 PM SC RR VERITY ADX MS 23,271.15 PM SC RR VICTORY 24,104.35 PM SC RR ZEPHYR 5620 21,161.70

PM SC SYMPHONY 2250 29,583.75 PM SC RATERESPONSIVE 35,805.00 PM BIV CONTAK RNWL H120 48,620.25 PM FRONTIER II 5586 35,464.80 PM SNGL CHAMBER SYSTEM 31,500.00 PM SINGLE CHAMBER 36,750.00 PM INSYNC III 8042 51,450.00 LD PM TRANSVEN VDD SPASS 7,276.50 IMP ADP/EXT LD PM NSTM 2 2,858.65 IMP LD CARDV/DFIB EC DC 37,248.75

LD VDD SINGLE PASS 8,400.00 LD DFIB RIATA ST 34,959.75 LD DEFIB LINOX SD 30,870.00 LD DEFIB ENDOTK RELIANCE 30,870.00 LD DFB ENDOTK RL ACT FX 28,297.50 LD DEFIB SPRINT FIDELIS 31,384.50 LD DEFIB 42,000.00 LD PM SETROX 3,987.40

LD CAPSURE SENSE 3,858.75 LD PM TENDRIL ST 4,501.35 LD 1888TC SDX 5,015.85

cdm

LD PM FINELINE II 2,957.85 LD PM NOT TRNSVEN VDD SP 4,908.75 LD PM CAPSURE SP NOVUS 4,042.50 LD PM THINLINE 4,590.60 LD PACEMAKER RA/RV 5,250.00 IMP LD PM/CARDDFIB COMB 35,227.50 LD EPICARDIAL 7,350.00 LD LV QUICKSITE XL 20,580.00 LD LT VENT COROX 10,290.00 LD LT VENT ACUITY 19,242.30

LD LT VENT ATTAIN 12,656.70 LD LFT VENT COR VEN SYS 12,810.00 LD LV/CORONARY SINUS 21,000.00 PACE LD VENT 5,625.90 PACING STRMLINE LEAD 486.15 STENT BSCI LIBERTE 5,015.85 STNT EV3 EVERFLEX II 7,203.00 STNT E3 EVERFLEX III 7,717.50

STNT EV3 EVERFLEX 6,044.85 STNT EV3 VISIPRO 5,402.25 STNT EV3 EVERFLEX IV 8,489.25

STNT CORDIS SMART BILIARY 2 9,677.85 STENT ABBOTT ULTRA 5,015.85 STNT ABBOTT ABSOLUTE 6,945.75 STENT CARDIAC DES I 13,362.30 STENT CARDIAC DES II 15,802.50 STENT CARDIAC BARE METAL I 9,534.00 STENT CARDIAC BARE METAL II 10,500.00 STNT UNI PLUS 20/55 5,145.00

STNT COAT/COV W DELV SYS 6,930.00 STNT CORDIS SMART 5,488.35 STNT DES TAXUS 10,547.25 STNT CORDIS SMART I 6,431.25 STNT DES CYHER 10,032.75 STNT CORDIS SMART II 7,722.75 STNT DES ENDEAVOR 10,160.85 STNT CORDIS SMART III 8,113.35 STNT DES XIENCEV 10,057.95 STNT CORDIS SMART BLIAR 6,734.70

STNT DES PROMUS 10,547.25 STENT HERCULINK 7,203.00 STNT CORDIS PRECISE 9,955.05 STENT OMNILINK 7,066.50 WSTNT TBRNCH ENDP UNIST+ 8,085.00 STNT NCOAT/COV W DEL SYS 4,410.00 STNT NCOAT/COV DEL SYS2 9,817.50 STNT CORDIS SMART BILIARY 1 8,895.60

STNT DES TAXUS LONG 14,148.75 STNT CAROTID ABBOTT 12,605.25 STENT PERIPHERAL 1 6,174.00

cdm

GW MAGIC TQ 260 1,160.25 STENT PERIPHERAL 2 7,203.00 STNT CORDIS BLUE SLALOM 7,062.30 STNT CORDIS GEN SLALOM 6,721.05 STNT CORDIS GEN PRO 1 5,987.10 STNT CORDIS GEN PRO 2 6,084.75 STNT CORDIS GEN PRO 3 6,574.05 STNT CORDIS GEN PRO 4 6,818.70 STNT CORDIS GEN PRO 5 7,306.95 STNT COAT/COV W DEL SYS2 6,709.50

STNT COAT/COV W DEL SYS3 17,163.30 STNT E COAT/COV W DELSYS 10,032.75 STENT PROPEL SINUS W/STEROID 7,297.50 STNT COAT/COV WO DEL SYS 12,321.75 STNT COAT/COV W DELV SYS 1,821.75 STNT ATRIUM I CAST 8X38X80 13,247.85 STNT MEDTRONIC DRIVER 4,630.50 STENT ABBOTT VISION 4,630.50

STNT UNI PLUS 14/90 5,098.80 STNT NCOAT/COV DEL SYS2 8,085.00 STNT ESOPH ULTRAFLEX SYS 8,264.55

STNT TBRNCH ENDP UNIST+ 9,817.50 STENT CARDIAC DES 7,700.00 STENT CARDIAC BARE METAL 5,250.00 STNT COLONIC WALLFLEX 12,836.25 STNT U UROLUMEIMP 4,410.00 STNT URETERAL 1,215.90 STENT, URETERAL 6X22-32 964.95 STNT BILIARY 681.45

STNT EXP BIL LD 5,145.00 ST STENT 1,032.15 STNT U TEMP $ 938.70 STNT VAR LNTH 480.90 CATH HEMODIAL LONG TERM 2,020.20 DIALYS CATH 14.5 F 2,217.60 CATH DIALYSIS 28CM 2,562.00 CATH TRIPLUMEN 394.80 VAS CATH 1 4,672.50 CATH INF PERPH/CENTRL/ML 2,337.30

CATH INF PERPH/CNTRL/ML2 1,105.65 CATH VAS COVIDIEN 4,672.50 CATH INF PICC 513.45 CATH INF UNIFUS ANGIODYN 1,037.40 CTH INFUSION 1 1,680.00 CTH INFUSION 2 1,102.50 CATH PICC TRIPLE LMN ANGIODYNAMICS 1,057.35 BLN WEDGE PRESSURE CATH 348.60

BLN SIZING AMPLATZER 1,706.25 BLN VIATRAC PLUS ABBOTT 1,876.35 CATH CT DUAL PICC ANGDNM 826.35

cdm

CATH CT DL PICC 2 1,057.35 CATH PICC BARD SNGL 2,331.00 CTH PICC BARD DBL 2,457.00 CTH PICC BARD TRP 2,814.00 CTH CT SINGLE PICC COOK 826.35 CATH PICC BS VAXCEL 551.25 CATH PICC COOK 634.20 CATH PICC DLBDL 732.90 CATH CT DUAL PICC COOK 983.85 CATH PICC CT 1,129.55

CATH PERITONEAL DIALYSIS 1,008.00 CATH, POWERPORT 8FR. 2,623.95 KIT, SUBPORT 7FR 1,604.40 CLOSURE, LAA LARIAT 45,952.20 DEV CLOSR VASC IMP/INSRT 1,334.55 CLOSURE PERCLOSE AT 1,296.75 CLOSURE STARCLOSE 1,569.75 CLOSURE BOOMERANG DIAG 1,193.85

CLOSURE BOOMERANG PERIPH 1,262.10 FILTER KAND FEMORAL 6,945.75 FILTER VENA CAVA BARD 11,025.00

FILTER VC ARGON 7,717.50 FLTR VC GREENFIELD 12INT 6,438.60 FILTER VENA CAVA 9,788.10 FILTER VC GREEN 5,365.50 FILTER VC JUG 5,365.50 FILTER VC OPTEASE 8,720.25 FILTER VC TRAPEASE 6,405.00 FLTR VC TRAPEASE CORDIS 7,045.50

SEPTAL OCCLUDER AGA MED 44,577.75 IVC FILTER REMOVAL KIT 5,512.50 CATH CVP 226.80 CATH (SLIC) 6" 1,608.80 CATH LONG TERM 933.45 CATH RADIAL ART 267.75 CATH SWGZ THERM 361.20 CATH SWGZ S CURVE 446.25 CATH SWGZ 5F 945.00 CATH SWGZ 8F 1,262.65

CATH GROSHONG 534.45 CATHETER, CRUZ DBL 1,092.00 KIT, HEMODIALYSIS 12FR 721.35 INTR HEMOSTASIS FASTCATH 369.10 CATH BLN TIS DISSCT NVAS 1,001.70 CATH US INTRAVASCULAR 3,753.75 CATH IVUS VOLCANO 3,344.25 CATH VLC PRESSURE WR 3,344.25

CATH IVUS BS ICROSS 3,318.00 CATH IVUS BS ATLANTIS 3,060.75 CATH IVUS BS ICROSS 3,318.00

cdm

CATH PRESSURE WIRE 7,087.50 CATHETER EKOS 24,953.25 CATH NAVVIS PRESSURE WIRE 5,775.00 EMBOLECTOMY 2X60 551.25 CATH THROMBECTOMY ANGIOTECH 7,612.50 COIL EMBOLIC 1,228.50 COIL MEDITECH 3MM 448.35 CATH THROMBECTOMY BART 2,858.10 CATH THROMB EMB DIVER 2,858.10 CATH THROMB AJET DVX ULTRA 7,280.70

CATH THROMB SPIROFLEX VG 11,061.75 COIL EMBOLIZATION COOK 490.35 VASCULAR PLUG 8,452.50 EMBOSPHERES 6,331.50 EMBOLIC AGENT LI 33,337.50 CATH FGRTY DCLOT 718.20 CATH COBRA 539.70 CATH FGRTY IRR 387.45

COIL EMBOLIC DETACH 762.30 CATH CROSS BOSS 4,501.35 CATH THROMB/EMBOLECTMY 2 511.35

CATH THROMB/EMBOLECT 4 3,465.00 CATH THROMBECTOMY ARGON 7,297.50 CATH THROMB SPIROFLEX ULTRA 8,977.50 CATH EMBOLECTOMY 954.45 EMBOLIC PROTECT CAROTID MOMA 9,518.25 EMBOLZN PROTECTION WIRE 7,563.15 EMBOLZN PROTCT CORDIS 8,730.75 EMBOLZN PROTCT INVATEC 8,720.25

EMBOLZN PROTCT ABBOTT 10,263.75 CATH OCCLUSION 2 499.80 CATH BLN OCCLUSN CS 446.25 CATH BLN OCCLUSION LARIAT 8,620.50 CATH OCCLUSION 1,392.30 SHTH LSR SPECT 500001 11,061.75 SHTH LSR SPECT 500012 11,061.75 SHTH LSR SPECT 500013 11,061.75 CATHETER, SPECTRANETICS COR LASER 14,663.25 CATHETER LSR SPECT PERIPHERAL 15,435.00

COIL COOK 1 716.10 COIL MEDITECH VORTEX 633.15 COIL COOK 2 327.60 COIL COOK DETACH 3MM 526.05 COIL PUSHER 549.15 COIL PUSHER MEDITECH 1,021.65 SUTURE TIGHTENER LARIAT 2,656.50 CANNULA, SOFTIP LARIAT 3,979.50

CUTTER, SURE CUT LARIAT 5,302.50 CATH ABLATION 7,950.60 RFA CATH 15 CM X 3.0 CM 7,950.60

cdm

CATH DIL 88.20 DILATOR INSERTS 286.65 COIL INTERLOCK 2,483.25 CATH MICRO MEDITECH 2,511.60 ABLATION DEVICE,ISOLATOR 23,109.45 CATH ATHER SILVERHAWK 15,408.75 CATH ATHER SILVRHK EXL 16,952.25 CATH, URETERAL VAN ANDEL 265.65 CATH ADD 554.40 CATH ABL NONCARD ENDO 1,522.50

CATH ANGIO 1,015.90 CATH ANGIOGRAM 320.25 SHTH VASCULAR 370.65 CATH VALET MICRO CATHETER 5,775.00 CATH GUIDE ACCESS / SUPPORT 1.00 CATH CRDS OUTBACK RE-ENTRY 11,061.75 CATH GUIDING 499.80 CATH COOK 5F 65CM C2 204.75

CATH LANGSTON 6F 1,015.35 CATH 5F COOK 125CM 237.30 CATH GLIDE ST 5F 65CM 472.50

SHEATH COOK 6F 348.60 CATH GUIDE MORPH AT STEERABLE 9,187.50 CATH DIAGNOSTIC RADIAL 477.75 CATH TERUMO SUPPORT 1,942.50 CATH GUIDING 2 2,448.60 CATH FRONTRUNNER CORDIS 5,659.50 CATH CORDIS PERIPHERAL MICRO GLIDE 1,701.00 CATH ENABLER-P ENDOCROSS 1.00

CATH GUIDING 3 116.55 CATH GUIDING 4 2,012.85 CATH GUIDE VERIPATH 630.00 CATH GUIDELINER 2,280.60 CATH RADIAL TERUMO 887.25 SHTH SAFE PEEL BARD 7 463.05 SHTH PEELAWAY 2 218.40 SHTH PEELAWAY 493.50 SHEATH, RENAL AMP 30FR 17CM 181.15 SHEATH PEELAWAY COOK 425.25

SHEATH GLIDE RADIAL 1,078.35 SHEATH TRANSEPTAL MEDTRONIC 708.75 SHTH DESTINATION 90CM 787.50 SHTH RAMP 1 1,125.60 SHTH TRANSEPTAL 8F 160C 945.00 SHTH CONTRA 1 GDE 55CM 889.35 SHEATH CRIBIFORM 80 2,726.85 GINTRO EP IC FC NON-PEEL 1,023.75

GINTRO FASTCATH 169.15 GINTRO SAFL 609.55 GINTRO SEPT 609.55

cdm

SHEATH MORPH AP STEERABLE 6,037.50 SHTH SAFE LONG 25CM 551.25 INTRO EP IC NLSR NGD 2 127.60 SHEATH SHUTTLE 960.75 INTRO EP IC NLSR NGD 2 127.60 SHTH MEDITECH 11F 30CM 539.70 INTRO EP IC NLSR NGD 3 1,638.00 SHTH 4F INTRO KT 235.20 SHTH 6F LOCKING 275.10 SHTH 9F 23CM 217.35

SHTH FLEXOR 5F 45CM 511.35 SHTH CK FLOW 16F 866.25 SHTH CK FLOW 22 1,487.85 SHTH VC REMOVAL 982.80 SHTH TERUMO P 4F 10CM 134.40 SHTH BRITE TIP 6F 23CM 365.40 SHTH STIFF MICRO 418.95 SHTH BRITE TIP 6F 11CM 359.10

SHTH COOK MICRO 5F 328.65 SHTH FLEXOR 6F 23CM 436.80 SHTH FLEX 6F 45CM 551.25

SHTH FLEX 7F 80CM 763.35 SHTH FLEX 8F 65CM 579.60 SHTH MICRO MAK 501 275.10 SHTH COOK ST MICRO 5F 470.40 SHEATH CK FLOW 14 535.50 SHTH TERUMO PAS 538.65 INTRO SHEATH ARROW 554.40 SHEATH COOK FEM WORK STATION 3,472.35

SHTH INTRO II 443.10 INTRO EP IC NLSR NGD 4 527.10 CATH GDE CARD 925.05 OCELOT CATHETER 29,363.25 SHTH INTRO 227.85 SHTH GUIDE LASER VISISHEATH 1,535.10 SHTH INTRO LN 1,110.90 SHTH W/VALVE 544.95 GINTRO EP IC FC PEELAWAY 590.10 SHEATH TUNN ORANGE 321.30

SHEATH, URET ACC 12/14F 708.75 SHTH ACC TUNL 725.55 CATH VSL SIZING PERFORMA 1,105.65 CATH THROMB AJET PUMPSET 1,706.25 GW MICROVENA .035/260 511.35 GW GLIDE RADIAL 668.85 GW THRUWAY 300 842.10 WIRE GDE 1,173.90

GW AMPLATZ BSCI 383.25 GW STAR BEN 35/150 949.20 GW 300 CH XSPT 614.25

cdm

GW STAR BEN 38/180 279.30 GW STAR BEN 38/260 764.40 GW AMPLATZ SS ST 145 990.15 GW AMPLATZ SS 75 300.30 GW AMPLATZ SS 180 1,399.65 GW THRUWAY 190 771.75 GW COOK 035X260 475.65 GW 185 FRTE FLOPPY 614.25 GW 145 ADDWR EXTENSION 614.25 GW MAGIC TQ 180 1,160.25

GW 185 FRTE MOD SPT 614.25 GW STAR 180 472.50 GW STAR 260 653.10 GW 185 FORTE XSPT 614.25 GW 185 FORTE XSPT WO MKR 614.25 CATH CARD LEH/GP 1,036.35 GW 182 CH PT XSPT 614.25 GW 182 CH FLOPPY 614.25

GW 182 MAILMAN 614.25 GW MEIER 300 1,963.50 GW AMPLATZER 260 -

GW 182 LUGE 614.25 GW 35/175 669.90 GW AMPLATZ SS 260 1,399.65 GW 180 PT GRPHX INT 614.25 GW 300 PT GRPHX INT J 614.25 GW 185 FRTE MOD SPT 614.25 GW 1,925.70 GW ASAHI CON PRO 180 1,023.75

GW 1,249.50 GW INTUITION 590.10 GW KINETIX 731.85 GW, FINDR WIRZ LARIAT 10,216.50 GW 1,509.90 GW CATHETER EXCHANGE 432.60 GW CV/SD 257.25 GW CV/VR 601.65 GW J 119.70 GW ST/HD 355.95

WIRE EXCH 303.45 IVC REMOVAL KIT 2 3,675.00 GW BSCI V-18 CONTROL 773.85 GW TIP DEFLECTING COOK 527.10 WIRE TIP DFLCT 460.95 GW TIP DEFLECTING 527.10 GW ST JUDE VENTURE DF TP 3,344.25 CATH TORNUS 3,575.25

GUIDEWIRE IV 490.90 GW GLIDE 150CM 315.00 GW FINECROSS 150CM 2,454.90

cdm

GW COOK BENTSON C 35 145 215.25 GW 018/180 ANG 510.30 GW 035/180 STR 378.00 GW LOC WHOLEY 621.60 GW .035J 150CM 121.80 GW 0.32J 260CM 214.20 GW COOK STR 035 145CM 145.95 GW COOK J 035 260 222.60 GW COOK ST 035 260 202.65 GW COOK 3J 032 145 149.10

GW COOK 032 360 253.05 GW COOK 025 180 217.35 GW COOK 035 180 180.60 GW COOK ROSEN 035 180 184.80 GW SHINOBI 180 960.75 GW CRDS J TIP .065 127.05 GW WHOLLY 511.35 GW LOC EXT 392.70

GW ASAHI PW J 180 567.00 GW AMPLATZER 260 401.10 GW CRD SWAN .025 121.80

GW TERUMO FINECROSS 2,310.00 GUIDEWIRE DUAL FLEX 473.55 GCATH MEDTRON AVE8F ZUMA 318.80 GW EV3 035X260 511.35 GW APPROACH COOK 1,105.65 GW COOK ROADRUNNER 819.00 GW HT SUPRA CORE 35 300 747.60 GUIDEWIRE II 181.15

GW CORDIS REGATTA 590.10 GUIDEWIRE III 299.25 GW CHOICE FLOP J 508.20 HAWKINS II 20GA X 5CM 309.75 HAWKINS II 20GA X 7.5CM 309.75 GUIDE,BALLOON SINUSPLASTY 2,016.00 SINUS GUIDE WIRE 984.40 GUIDEWIRE V 941.85 CATH GLIDE WIRE 618.45 GLIDEWIRE, TERUMO 424.20

WIRE, GUIDE A/T 729.75 GW STINGRAY 185/300 1,706.25 GW STINGRAY EXTENSION 591.15 GDE CATH 940.80 GDE ENDO 175.35 GW EXCHANGE DEVICE 668.85 ADVANCER ROTABLATOR 2,173.50 C/S MISC GUIDES PROCEDRL -

LUBRICANT ATHERECTOMY 1,050.00 SYS COR ROTLNK CATH/BURR 9,250.50 CATH ROTALINK PLUS 9,089.85

cdm

CATH ATHERECTOMY DIRECTIONAL - CATH ATHERECTOMY ROTATIONAL - BLN SV 018 1,755.60 BLN PERIPHERAL 1 3,034.50 BLN PERIPHERAL EV3 1,837.50 CATH, JETSTREAM NAVITUS 25,725.00 CATH ANG TRANSLUMNL NLSR 1,774.50 BLN AGIL TRAC 1,466.85 CATH BLN SCIMED 1,569.75 CATH BLN CORDIS 1,535.10

CATH BLN MEDTRONIC 1,569.75 CATH BLN GUIDANT 1,569.75 BLN CORDIS OPTA PRO 1,081.50 BLN CORDIS MAXI LD 1,934.10 BLN CORDIS POWERFLEX 1,197.00 BLN ABT VIATRAC PLUS 1,876.35 BLN PERIPHERAL TRIREME 8,400.00 BLN BMQ 035 1,160.25

BLN XXL 035 1,160.25 BIN XXL PERIPHERAL 1,755.60 BLN ULTRA THIN SDS 1,092.00

BLN PERIPHERAL DCB 10,951.50 BLN PERIPHERAL DCB LONG 12,054.00 CATH ANG TRANSLUM NLSR2 1,214.85 CATH ANG TRANSLUM NLSR3 1,991.85 CATH CLEARWAY RX PRFUSN 4,116.00 CATH ANG BLN NC RNGR 16 1,178.40 GCATH MEDTRON AVE6F ZUMA 318.80 CATH GUIDING 499.80

CATH GUIDING 2 2,448.60 CATH BLN CUT INTERVENTNL 4,620.00 BLN CUT ANGIOSCULPT P1 4,630.50 BLN CUT ANGIOSCULPT P2 5,015.85 BLN CUT ANGIOSCULPT COR 4,116.00 CATH BLN CORDIS AVIATOR 2,178.75 CATH BLN CORDIS OPTI PRO 1,081.50 CATH STINGRAY 5,916.75 CATH,DILATATION HIPRES B 1,877.40 DILATOR, URTRL PLYETH 192.15

KIT,NEPHROSTOMY DLTN BLL 2,012.85 KIT,URINARY TRCT OCCL BL 1,126.65 KIT ABLATION PROBE NEEDLE - CATH SINUS BLN 7 16 MM 3,319.05 CATH SINUS BLN 7 16 MM 3,319.05 CATH, SINUS DEGREE A/S 1,804.70 CATHETER, SINUS LAVAGE 983.85 CATH BLN DIL NONVASCULAR 858.90

BALLOON DILATION 6X10CM 1,080.45 BALLOON DILATION 21F 75CM 1,877.40 KIT, OCC BLLN CTH 5F 65CM 1,126.65

cdm

BALLOON, DILATION 7FR 1,818.60 BALLOON, DILATION 18FR 1,935.15 BALLOON, DILATION 6FR 1,379.70 CATH ANGIO BALN 275.10 CATH ART BALLN 1,914.15 CATH BAL HEMO GU 257.25 CATH BALLOON AORTIC 5,400.15 IMPELLA 2.5 DEVICE 75,600.00 CANNULA ANGIO VAC 63,000.00 CIRCUIT ANGIO VAC 18,375.00

SYSTEM ANGIO VAC 76,125.00 CATH BALOON SV 1,749.30 BLN VLVPLASTY MTRL 11,319.00 CTH BLN PLSTY 2 2,773.05 CATHETER BLN PLASTY 3 3,262.35 CATH DLTTN BLLN 1,954.05 BLN BRAUN LARGE 6,037.50 CATH OC BLN 1,896.30

CATH BRACHYTHER SEED ADM 5,460.00 CATH DRAINAGE BILIARY 785.40 CATH DRAINAGE 621.60

CATH INTRASPINAL 1,299.90 KIT URET CATH 5F 6X6CM 2,470.65 SET, CATH URETERAL 5F 6MMX6CM 1,539.30 CATH URETERAL 145.95 CATH URETERAL 270.90 CATH URETERAL 539.70 CATH GUIDE RADIAL 887.25 CATH TRANSIT 1,911.00

CATH MINNIE SUPPORT 1,015.35 MODEL-D 6F IMPULSE FR3 129.15 MODEL-6F RUNWAY FR3.5 436.80 CATHETER IMAGER II 215.25 CATHETER IR DIAGNOSTIC 150.15 CATH SUPRAPUBIC 522.90 CATH, SUPRAPUBIC 14G 409.50 CATH SUPRAPUBC/CYSTOSCOP 465.15 CATH CHOLNG 361.20 CATH BRONCH ASPR 690.90

CATH FOLY TEMPG 370.65 CATH EPIDURAL 1,671.60 CATHETER EPIDURAL 19 GA 2,287.00 SET EPIDURAL 19 GA 3,244.50 CATH CHOLNG 982.80 CATH ERCP 495.60 CATH INFU 725.55 CATH INFU SYS 1,765.05

CATH INTERAUTER 295.05 CATH JEJUNOS/BKR 1,681.05 CATH MUSHROOM 296.10

cdm

CATH NEPHROSTOMY 783.30 CATH NEPHROSTOMY ANGIODYNAMIC 535.50 CATHMULTISUC 279.30 MISC CATH SUPPLY - CTH PACING 6F CRD QD 252 418.95 CATH EP DIAG NOT3D 19OR< 1,286.25 CATH PACING 6F DECA 2,252.25 CATH DIAG EP JOSEPHSON 992.25 CATH PCING 6F 5MM CRD Q 826.35 CATH PACING 6F BIPOLAR 598.50

CATH DIAG EP SUP CRD SF 1,071.00 CATH PACING 6F BIPOLAR 771.75 CATH EP DIAG NOT3D 20OR> 1,991.85 CATH PACING 7F DUODECA 5,294.10 CATH EP OTH THN COOL TIP 4,215.75 CATH EPT BLZR LC 5 5,093.55 DEV LDLOCK SPECTRA518018 958.65 DEV LDLOCK SPECTRA518019 958.65

DEV LDLOCK SPECTRA518020 958.65 SNARE AMPLTZ 4MM 1,732.50 SNARE, ANGIOTECH 1,774.50

SNARE EZBENT TIP BSCI 590.10 PACE INTRO/LEAD 638.40 PACE LEAD SUTWIR 300.30 CABLE TP PACEMAKER 1 194.25 WATCHMAN ACCESS SYSTEM 5,250.00 SHEATH TRNS SNGL CRV14FR 2,572.50 SHEATH TRNS DBL CRV 14FR 2,572.50 SHTH TRNS SNGL SHRT CRV 2,572.50

SHTH TRANS DBL SHRT CRV 2,572.50 SHTH RAD SNGL SHRT CRV 2,572.50 SHTH RAD DBL SHRT CRV 14 2,572.50 SHTH REV CRV SHRT 14FR 2,572.50 SHTH TRANS RAD SNGL 14FR 2,572.50 SHTH TRANS RAD DBL 14FR 2,572.50 OBTURATOR EA 514.50 WATCHMAN LAA CLOSURE DEVICE 58,800.00 21MM LT ATRIAL APP ABL 30,870.00 24MM LT ATRIAL APP ABL 30,870.00

27MM LT ATRIAL APP ABL 30,870.00 30MM LT ATRIAL APP ABL 30,870.00 33MM LT ATRIAL APP ABL 30,870.00 21MM LT ATRIAL SHRT ABL 30,870.00 21MM LT ATRIAL SHRT ABL 30,870.00 24MM LT ATRIAL SHRT ABL 30,870.00 27MM LT ATRIAL SHRT ABL 30,870.00 30MM LT ATRIAL SHRT ABL 30,870.00

33MM LT ATRIAL SHRT ABL 30,870.00 TAXUS STNT RESEARCH 1.00 STNT RESEARCH 0.01

cdm

IMPELLA 2.5 RESEARCH 102,900.00 AXIALIF STABILIZATION 35,257.95 BN GRFT INFS LG 25,673.55 MAXBRAID WHITE 213.15 FIBERWIRE #5 359.10 FIBERWIRE #2 223.65 BN BLOCKS 2,512.65 BN CHIPS 1,242.15 BN GRFT 3,026.10 BN GRFT, SYN STRIP 11,348.40

BND MTL PARHAM 123.90 BUTTON FX SPINE 1.00 CAP END FEM/TIB CANAL 1.00 JURGEN BALLS 73.55 CBLE FIX BN 1.00 CEMT BN 996.45 COMPRESS CLAMP 1,552.95 EXFX COLLES 2,140.95

EXFX HF BALJT/R 1.00 EXFX HF CN RD LG 1.00 EXFX SET SM 5,659.50

FEM NAIL 1.00 FEM RD 1.00 GDE PINS 135.45 GDE PINS HIP 201.60 IMP BN 1.00 NAIL INTRAMEDULLARY TYP1 1.00 NAIL INTRAMEDULLARY TYP2 1.00 NAIL INTRAMEDULLARY TYP3 1.00

NAIL TIBIA 1.00 NUT 1.00 PIN ABSORBABLE 1.00 PIN HABIE 1.00 PIN MLT FIXATN 1.00 PIN NUFLD BRAKOF 1.00 PIN STEINMAN PL 1.00 PIN STEINMAN THR 1.00 PLATE AO SPECIAL TYP2 1.00 PLT BN HEAVY 1.00

PLT BN LIGHT 1.00 PLT BN SMALL 1.00 PLT CERV SPINE 1.00 PLT COMP HIP 1.00 PLT COMP TUBE 1.00 PLT COMPRESION 1.00 PLT CRANI 1.00 PLT E CLOVLEAF 1.00

PLT E COMP BRD 1.00 PLT E COMP DCP 1.00 PLT E COMP DHS 1.00

cdm

PLT E COMP NRW 1.00 PLT E CONDYLR 1.00 PLT E L BUTRES 1.00 PLT E MINI 1.00 PLT E MULT FRG 1.00 PLT NEURO 1.00 PLT E SEM TUBE 1.00 PLT E T 1.00 PLT E T BUTRES 1.00 PLT E T OBLIQ 1.00

PLT E T SMALL L 1.00 PLT E 1/3 TUBE 1.00 PLT MICRO 1.00 PLT RECONTSRCT 1.00 PLT SM FRAG AO 1.00 PROS BN PLUG 1.00 RD ANCHOR SUTURE 1.00 RD HARINGTN 1.00

SCRW BN 1.00 SCRW BN 1.00 SCRW BN 1.00

SCRW CANN 1.00 SCRW CERV EXPAN 1.00 BONE SCREW INFAST 1.00 KIT, INFAST 1.00 SCRW COMPRESS 1.00 SCREW CORTX 1.00 SCRW E CANCL4.0 1.00 SCRW E CANCL6.5 1.00

SCRW E CORTX 1.00 SCRW E MALEOLA 1.00 SCRW E SCHANZ 1.00 SCRW E WASHER 1.00 SCRW F/X SPINE 1.00 SCRW FIXATION 1.00 SCRW HD/CRNI 1.00 SCRW HERBERT 1.00 SCRW HIP LAG 1.00 SCRW MANDBL MSH 1.00

SCRW MICRO BON 1.00 SCRW PEDCLE/SA 1.00 SPINAL FIXATN 1.00 SPINAL LINK BLT 1.00 STPL FX AS 1.00 STPL SERRATED 302.40 WASHER SPIKED 1.00 WIRE KIRCHNER PL 1.00

WIRE KIRCHNER TH 1.00 ANCHOR 5MM W/2ULTRBRD 1.00 ANCHOR CORKSCREW 5MM 1.00

cdm

ENDOBUTTON 4MM 1.00 ANCHOR,5MM W/2#ULTRA 1.00 ANCHOR SUPER/MINI QUICK 1.00 SCREW SURETAC A/T 1.00 PUTTY, BONE 1ML 1,774.50 PUTTY, BONE 4,965.45 PUTTY, BONE 5ML 4,502.40 PUTTY, BONE DBM 5CC 7,563.15 PUTTY, BONE 10ML 6,945.75 PUTTY, BONE DBM 10CC 10,591.35

PUTTY, BONE OP-1 27,011.25 PUTTY, BONE 7,332.15 BEAD,OSTEOSET 25ML 5,582.85 PUTTY,INJ HIGHSTR 5ML 9,132.90 PUTTY INJ HIGHSTR 15ML 14,148.75 INFUSE BMP, SMALL 17,235.75 INFUSE BMP, MED 24,438.75 INFUSE,BMP LARGE 27,011.25

INFUSE,BMP LARGE 27,011.25 FIXATOR, WRIST 1.00 BONE CHIP CORT/CANC 30ML 2,021.25

BONE CHIP CANC 30ML 2,460.15 PLATE DALL MILES 5HL 1.00 PLATE DALL MILES 7HL 1.00 PLATE DALL MILES 9HL 1.00 PLATE DALL MILES 11HL 1.00 PLUG, BONE A/T 1.00 GRIP SMALL 1.6MM 1.00 GRIP MED 2.0MM 1.00

CABLE SLEEVE MED 2.MM 1.00 HIP SLEEVE 2MM 1.00 CABLE SLEEVE 2.0MM 1.00 CEMENT, INJ 5ML 6,737.85 ANCHOR STATEK 1.00 IMP WEDGE 1.00 CEMT BONE PALACOS REG 906.15 CEMT RESTRC RG 747.60 CEMT SURG SIMP 648.90 CEMENT, PALA W/GENT 2,281.65

AXIALIF STABILIZATION 35,257.95 ANCH/SCRW BN/BN TISS/BN 1.00 BONE SCREW INFAST 1.00 CEMENT, KYPHON 1,433.25 CEMENT CONFIDENCE SPINAL SYS 11CC 11,025.00 CEMENT CONFIDENCE SPINAL SYSTEM 10,500.00 NEEDLE OSSEOFLEX 1.0 15,750.00 KIT, KYPHON 20/3 22,767.15

BONE CEMENT PREP AND INJECTION SYS 3,338.85 KIT, INFAST 6,997.20 CEMENT, BONE W/TOB 2,194.50

cdm

KIT, VERTEBROPLASTY 17,569.65 IMP ANCH MITEK GII 853.35 IMP ANCH INNOVAS BIOROC 852.60 IMP ANCH MITEK MICRO 852.60 IMP ANCH MITEK ROTATRCUF 852.60 IMP ANCH MITEK SUPER 852.60 KIT ARTHREX BIOTENODESIS 262.50 GRAFT TENDON 4,504.50 IMP HIP BIPOLAR 2 - BIOMET IMP HIP ULTRA HIGH 63,000.00

BIOMET IMP HIP HIGH DEMAND 52,500.00 STRYKER IMP HIP BIPOLAR 26,250.00 IMP HIP BIPOLAR - IMP HIP BIPOLAR 26,250.00 STRYKER IMP HIP ULTRA HIGH 63,000.00 STRYKER IMP HIP HIGH DEMAND 52,500.00 IMP HIP HIGH DEMAND - IMP HIP HIGH DEMAND 52,500.00

STRYKER IMP HIP MED DEMAND 50,400.00 IMP HIP MED DEMAND 50,400.00 IMP HIP NONDEMND MATCH -

IMP HIP LOW DEMAND 47,250.00 STRYKER IMP HIP LOW DEMAND 47,250.00 BIOMET IMP HIP LOW DEMAND 47,250.00 IMP HIP REVISION - IMP HIP REVISION 126,000.00 STRYKER IMP HIP UNIPOLAR 26,250.00 IMP HIP UNIPOLAR - IMP HIP UNIPOLAR 21,000.00

BIOMET IMP HIP UNIPOLAR 26,250.00 BIOMET IMP HIP BIPOLAR 26,250.00 IMP KNEE HYBRID - BIOMET IMP KNEE LOW DEMAND 42,000.00 BIOMET IMP KNEE MED DEMAND 44,100.00 BIOMET IMP KNEE HIGH DEMAND 48,300.00 IMP KNEE HIGH DEMAND - IMP KNEE HIGH DEMAND 48,300.00 BIOMET IMP KNEE ULTRA HIGH 57,750.00 BIOMET IMP KNEE PARTIAL 44,100.00

IMP KNEE MED DEMAND 48,300.00 IMP KNEE MED DEMAND 44,100.00 IMP KNEE LOW DEMAND 42,000.00 IMP KNEE NONDEMND MATCH - IMP KNEE REVISION - IMP KNEE REVISION 105,000.00 IMP KNEE UNI - IMP KNEE PARTIAL 73,500.00

STRYKER IMP KNEE LOW DEMAND 42,000.00 STRYKER IMP KNEE MED DEMAND 44,100.00 IMP SHOULDER PRIMARY -

cdm

STRYKER IMP KNEE HIGH DEMAND 48,300.00 STRYKER IMP KNEE ULTRA HIGH 57,750.00 STRYKER IMP KNEE PARTIAL 44,100.00 IMP HIP SPACER 1.00 IMP KNEE SPACER 17,647.35 PROSTHESIS CUSTOM 1.00 PROS HIP 601.65 PROS HIP 1.00 PROS HIP ACET INSERT 1.00 BIOMET IMP MED DEMAND 50,400.00

IMP HIP MED DEMAND - 813S HIP ACTBCU 1.00 813S HIP ACTBCU 1.00 PROS HIP FENSTE 1.00 PROS HIP HD/NEC 1.00 PROS HIP/FEMSTE 1.00 PROS JNT SPEC 1.00 PROS KNE/INSERT 1.00

PROS KNE/TIBIAL 1.00 PROS KNEE 1,419.60 IMP ANKLE 126,000.00

IMP TOTAL ELBOW 94,500.00 IMP TOTAL WRIST 42,000.00 IMP TOTAL TOE 47,250.00 IMP ENTERNAL FIXATOR 147,000.00 C/S MISC PROSTH ORTHO - IMP SHOULDER PRIMARY 84,000.00 IMP SHOULDER REVISION 105,000.00 IMP SHOULDER REVERSE 126,000.00

MISCOR PROSTH - PROS FINGER JNT 1,674.75 PROS RADIAL HEA 827.40 PROS TOE GREAT 1,331.40 PROS ULNAR HEAD 1.00 CLIP ANEURP 948.15 SHNT CATH PERT 1,242.15 SHNT PERITOVEN 2,167.20 SHNT RESV 1,761.90 SHNT VALVE FL P 2,358.30

IMPL SLEEVE TYPE 1,159.20 KT ANUERO/CRAN 1,430.10 KT CRANIOPLAST 3,189.90 CATHETER, VENT 15CM 1,481.55 SYSTEM, HAKIM STD VALVE 4,733.40 SHUNT, CAROTID 17FR 710.85 SHUNT INAHARAPRUITT 2,189.25 DURAGEN 2X2 2,079.00

DURAGEN 3X3 3,864.00 DURAGEN 4X5 5,829.60 DUREPAIR 2X2 2,085.30

cdm

DUREPAIR 3X3 3,257.10 DUREPAIR 4X5 6,518.40 DURA PATCH 1,905.75 CATH, PERIT LP 90CM 1,078.35 CATH, PERIT STD 90CM 955.50 CATH, PERIT MP 90CM 1,157.10 CATH, PERIT STD 120CM 1,023.75 DURAMATRIX 2X2 2,749.95 DURAMATRIX 3X3 3,672.90 DURAMATRIX 4X5 5,440.05

CATH, VENT STD 20CM 906.15 SYSTEM,LUM/PER CATH 2,891.70 VALVE, STRATA REG 15,821.40 VALVE,CSF SM.MP 2,856.00 VALVE, CSF REG LP 3,035.55 VALVE, CSF REG MP 3,652.95 CATH,VENT STD 23CM 921.90 CONNECTOR, SHUNT Y 313.95

CONNECTOR, DRAIN 65.10 CONNECTOR, CATH R/A 464.10 CATH, VENTRIC 35CM 962.85

PENILE IMP 1,828.05 PENILE PROS IMPL 9,417.45 PMP INFLDEFLAT 361.20 PROS BREAST 1.00 PROS MAMRY GEL 1.00 PROS PENILE BOD 11,816.70 PROS PENILE CON 4,063.50 PROS PENILE IMP 12,866.70

PROS PENILE PUM 11,816.70 PROS TESTICULAR 4,373.25 PROS URINARY 1.00 SLING, MONARCH PLUS 5,377.05 SLING, PELVILACE 1.5CM 6,148.80 SLING, TUTOPLAST FASCIA 2,572.50 SLNG, TTPLST FSCIA 6X8CM 6,276.90 KIT, TRANSVAGINAL 4,814.25 IMP PMP INF PROGRAMMABLE 13,207.95 IMP PROSTHESIS BREAST 2,887.50

PROBE CRYOABLATION 1,223.25 PROS PENILE AMS 700 13,026.30 PROS PENILE INFLATABLE 1,050.00 PROS PENILE NINFLATABLE 9,240.00 IMP PROS URINARY SPHINCT 15,592.50 PROS PENILE AMS AMBICOR 12,521.25 PROS PENILE MNTR ALPHA I 12,311.25 SLING, MONARCH PLUS 5,377.05

KIT, TRANSVAGINAL 4,814.25 SLING, PELVILACE 1.5CM 6,148.80 PELVISOFT 4X7 2,701.65

cdm

PELVISOFT 6X8 4,296.60 PELVICOL 2X7 2,623.95 PELVICOL 6X8 4,887.75 SPHERE, EYE 16MM 329.70 SPHERE, OCULAR 20MM 3,344.25 EYE GLAUC IMP 3,437.70 EYE IOL 1,304.10 EYE LENS D 200.55 EYELNSN SIN 1,761.90 EYELNSN SIN 2,640.75

LENS INTRAOCULAR 1,134.00 EYE SPHERE 1.00 NOSE SPLT 1.00 EYE GRFT HUMAN 1,703.10 BAND, SCLERAL 40 157.50 IMPLANT SPONGE, SCLERAL 420.00 MEMBRANE DIAMOND DUSTED 25G 825.30 STRIP, SCLERAL 220 163.80

IMPLANT TIRE, SCLERAL 102.90 IMPLANT, CORNEA 7MM 3,035.55 EAR OSICUL 1.00

IMPLANT PISTON .6 X 4.25MM 1,023.75 EAR TUBE 257.25 EAR TUBE 362.25 EAR TUBE T 1,100.40 TUBE REUT BOBB 1.14 367.50 TUBE REUT BOBB 1.27 243.60 TUBE, SHEEHY 1.27 129.15 TUBE, GOODE T 1.14 298.20

PLATE, ORBITAL FLR 3,148.95 EYE CIRC/BA 257.25 EYE SILICONE SP 336.00 EYE TIRE/S 601.65 IMPL. TOTAL OSSIC 1,963.50 IMP, COCHLEAR SOUND PROCESSOR 1.00 IMP, COCHELAR ABUTMENT 4X9MM 1.00 UNIT, BAHA DRILLING 5,659.50 KIT, SINGLE USE W/BLADE,DRILL,GUIDE 2,818.20 IMPLANT, DORNHOFFER .8 984.90

IMPLANT, VARIO 1.75 1,917.30 IMPLANT, VARIO 3MM 1,854.30 PISTON,3.5X6 MM 1,225.35 PISTON, 6X4.5MM 1,023.75 PISTON 6X4.75MM 1,058.40 APPLEBAUM 2.0MM 1,782.90 SHEEHY P.O.P 4.75MM 1,132.95 CONN, SILVERSTEIN 1,761.90

IMPLANT, EYELID .6 1,501.50 IMPLANT, EYELID 1.6 1,638.00 C/S MISC PROSTH ENT/EYE -

cdm

GRF GRTX PTCH2MM 187.95 GRFT ALL/TYPES 2,352.00 GRFT PATCH 2,042.25 GRFT PTCH 807.45 GRFT VASC BIF D 3,129.00 GRFT VASC STR B 6,510.00 GRFT VASC STR G 2,381.40 GRFT VASC STR G 3,731.70 PTCH SOFT TISUE 1,577.10 GRAFT 47MM TAPER 30CM 2,079.00

CATH THROMB XPEEDIOR ULTRA 6,251.70 GRAFT 47MM TAPER 45CM 2,753.10 GRAFT 6MM X 40CM 2,512.65 GRAFT BIF 12X6 40CM 3,966.90 AXILLOBIFEM ORAL GRAFT 11,494.35 GRAFT 6MM 60CM RING 6,303.15 GRAFT 8MM 40CM RING 3,899.70 GRAFT 8MM 60CM RING 5,895.75

GRAFT 8MM 40CM REM RING 3,010.35 GRAFT 8MM 70CM REM RING 4,857.30 GRAFT DYNAFLO 8M 80CM 9,775.50

GRAFT DISTAFLO 6M 80CM 11,290.65 GRAFT VENAFLO 6M 50CM 3,954.30 GRAFT,VESSEL GUARD 2,512.65 GRAFT STR 5MM 10CM 1,134.00 PATCH ACUSEAL .8X7.5 CM 1,405.95 GRAFT PATCH 2CM 9CM 1,378.65 GRAFT PATCH .3X3 794.85 GRAFT PATCH 1 951.30

GRAFT BIF 12X7 40CM 3,270.75 GRAFT BIF 16X8 40CM 3,580.50 GRAFT STR 6MM 15CM 2,310.00 GRAFT STR 6MM 60CM 2,743.65 GRAFT STR 8MM 60CM 2,675.40 GRAFT BIF 20X10 40CM 3,270.75 GRAFT STR 10MM 30CM 2,686.95 GRAFT STR 12MM 30CM 2,778.30 GRAFT STR 26MM 30CM 2,916.90 GRAFT, VASCULAR ST DBL V 1.00

PATCH BOVINE 1X8 CM 953.40 PATCH, PERICARDIUM 1.00 ENVELOPE ECM, CORMATRIX 10,237.50 GRAFT DYNAFLO 7MM 50CM 6,989.85 FELT, TEFLON 5X5 CM 292.95 FELT, TEFLON 15X15 CM 740.25 IMP, VASOSHIELD 5X6CM 2,454.90 IMP, VASOSHIELD 6X10CM 4,245.15

PATCH, FELT 6X6 1,284.15 GRAFT, PATCH 2X3 1,842.75 GRAFT, PATCH 6X8 7,177.80

cdm

PLEDGET SOFT MED 77.70 PLEDGET SOFT LARGE 129.15 GRFT VASCULAR 622.65 OH RING MITRAL 6,123.60 OH RNG MITRAL/TRICUSPID 12,950.70 OH VALVE AORTIC 19,205.55 OH VALVE CONDUIT 19,156.20 OH VALVE MITRAL 19,205.55 VALVE,AORTC BVN3000TF19 72,765.00 VALVE,MITRAL 6900PTFX25 40,948.95

VALVE,MITRAL6625ESRLP27 18,007.50 VLVE,AORTC MOSAIC305C19 37,249.80 VLVE,AORTIC R50019 24,644.55 VALVE, MITRAL M70025 23,933.70 VLVE,MTRL MOSAIC 310C29 36,164.10 RING,MITRAL 4450M26 16,423.05 RING,TRICUSPID 4900T28 15,828.75 VALVE, MITRAL 19MJ501 25,534.95

VALVE, AORTIC S50019 23,471.70 C/S MISC PROSTHESIS CV - GRFT PROCNE SKN 1,856.40

TISS CONNECTIVE HUMAN 2,454.90 ALLOGRAFT,SPINE MEMBRANE 2X3CM 6,997.20 EPIFIX PER SQUARE CENTIMETER 1,558.20 SLING, TPLST 2X7 2,572.50 SLING, TPLST FSCIA 6X8CM 6,276.90 ALLOGRFT BARD FASLATA 8 1,198.75 IMP RING/TUBE 536.55 TISS CONNECTIVE NHUMAN 2,859.15

IMP PORT INDWELLING 2 4,042.50 IMP PORT INDWELLING 708.75 IMP PORT ANGIODYNAMIC CT80 3,087.00 IMP PORT NAVILYST1 2,572.50 IMP PORT NAVILYST2 2,572.50 IMP PORT BARD 1 2,794.05 IMP PORT BARD 2 4,321.80 GEL GRFTN 601.65 GEL VOICE 1ML. RADIESSE - GEL GRFTN 10CC 2,769.90

IMP COLLAGEN A/S 2,020.95 PROS SHEET SILA 481.95 FASTNERS 1,023.75 IMP CLIP/TUBE 560.70 BARRIER ADHESION 1,276.80 BARRIER INTERCEED 3X4 1,558.20 FILM, SURGIWRAP LG 1,706.25 FILM, SURGIWRAP SM 1,365.00

BARRIER, SEPRAFILM 1,515.15 BARRIER ADHESION 2 2,356.20 MESH MARLEX PERFIX PLUG 1,186.50

cdm

MESH, HERNIA POLYESTER LT RT 1,023.75 MESH REABSR CONT 1.5MM X .50MM 5,592.30 MESH, ULTRAPRO PLUG 1,965.60 GRFT MESH MARLX 1,157.10 MESH, BARD 1 375.90 GRFT MESH MRSLN 286.65 GRFT MESH PROLN 655.20 IMP MESH 262.50 MESH GRTX DUAL 884CM1OVL 855.75 MESH GRTX DUAL 96CM 1THK 855.75

MESH GRTX DUAL+285CM1OVL 1,953.00 MESH GRTX DUAL+432CM2THK 1,134.00 MESH GRTX DUAL+884CM1OVL 2,320.50 INCLOSE - MESH 1.00 MESH, VAG 5CM X 17CM 1,928.85 MESH PROCEED 8X10 8,464.05 MESH PROCEED 6X8 5,232.15 MESH PROCEED 4X6 2,890.65

MESH PROCEED 10X13 13,079.85 MESH VENTRIO ST SM OVAL 3,858.75 MESH VENTRIO ST MED OVAL 5,659.50

MESH VENTRIO ST LG OVAL 7,203.00 MESH VENTRIO ST X-LG OVAL 9,672.60 MESH VENTRALEX ST SM W/STRAP 2,829.75 MESH VENTRALEX ST MED W/STRAP 3,395.70 MESH, DUAL 3X5 2,664.90 MESH, PERMACOL 7X11 26,059.95 MESH ALLOMAX BIO 16X20 CM 50,143.15 MESH, PERMACOL 6X8 16,258.20

MESH, PERMACOL 4X6 9,672.60 MESH, DUAL 10X14 12,734.40 MESH, DUAL 7X10 7,815.15 MESH,DUAL 6X8 5,689.95 MESH, DUAL 6X6 1,413.30 MESH, ULTRA 3X6 1,072.05 MESH, ULTRAPRO 12 2,384.55 MESH, SYSTEM LG 2,346.75 MESH, VENTRAL MED 3,076.50 MESH, VENTRAL SM 2,572.50

MESH, PLUG LG 1,512.00 MESH, PLUG MED 1,498.35 MESH, PLUG SM 996.45 PATCH, HERNIA MD 2,709.00 PATCH, HERNIA SM 2,544.15 MESH, BARD 3X6 402.15 MESH, BARD 2X12 517.65 MESH, BARD 1X4 375.90

MESH, KUGEL MED 1,772.40 MESH, KUGEL SM 1,715.70 MESH, KUGEL LG OVAL 5,551.35

cdm

MESH,KUGEL MD OVAL 4,378.50 MESH,KUGEL SM OVAL 2,966.25 MESH, KUGEL CIRCLE 2,728.95 MESH, BARD 10X14 866.25 MESH, BARD 6X6 490.35 MESH, TITANIUM 4X6 1,911.00 MESH,PERMACOL 4X4 6,148.80 SEAMGUARD 1.00 SEAMGUARD, 25MM 1,945.65 BN GROWTH STIM 18,914.70

SPINAL STIM GENRTR 1.00 IMP GEN NEUROSTIMULATOR 1.00 GENERATOR, IMPLANT PULSE 1.00 LEAD STIMULATION 1.00 LEAD SENSING 1.00 NEURSTIM+EXT ITRL2 ISTIM 1.00 KIT, DBS LEAD 1.00 TUBE, DBS ELECTRODE 1.00

CABLE, DBS ELECTRODE 1.00 ELECTRODE, DBS 1.00 IMP LD NEUROSTIMULATOR 1.00

PROGRAMMER PT NEUROSTIM 5,746.15 PROGRAMMER, PT 7438 1.00 STIMULATOR, SOLETRA 1.00 PROGRAMMER, PT 7436 1.00 STIMULATOR,KINETRA 1.00 OST DRS DDRM 4X4 54.60 OST DRS DDRM 8X8 144.90 OST SKIN PROTEC 38.85

OST SKIN PROTEC 38.85 OST PCH FEC 38.85 OST PCH 2 1/4IN 703.50 FLOWSWITCH 87.15 ADPTR KC TUBE FEEDING 128.10 BRSH ENDO 169.05 CAN ERCP 466.20 CONEC GROSHONG 288.75 CONEC Y 139.65 CONT ENTRAL 177.45

COV TEMP PRB 214.20 STERILE PROBE COVERS 5X48INCHES 103.95 DISC MOLNAR ANGIOGRAPHY 266.70 DRN CHSTP/VAC 703.50 ELCTRD NERVE 302.40 EXT DRN BG 317.10 MANIFOLD DUMP BAG 78.75 GLV RADIATION 539.70

HMOCNCTR, FRES 787.50 HEMOSTAT TOPICAL 5ML 983.85 HUMI 427.35

cdm

INFL SYR 413.70 KT MANIFOLD 2V 207.90 TUBING, ARTERIAL EXTENSION 9" 20.15 MANIFOLD DISP 612.15 MANIFOLD, 3 PORT 47.25 MULTIPORT MANIFOLD 129.40 NDL COAXIAL 183.75 NDL BONE BX 442.05 VERTEBRAL BODY BIOPSY NEEDLE 811.15 NDL BX 336.00

HANDLE/STYLET KIT 527.25 NDL EYE IRRIG 172.20 NDL ONE WALL 57.75 NDL GREEN BIOPSY 254.10 NDL HUBER 214.20 NDL. EPID HUSTEAD 87.15 NDL, EPID LUTZ 113.40 NDL HUBER 214.20

NDL MYELOGRAM 119.70 NDL PERCUTAN 4,410.00 NDL SCLERO 472.50

NDL SPINAL A/S 169.05 NDL SPINAL SPC 210.00 NDL TRANSEPTAL BRK MED 1,405.95 OST BLT A/S 54.60 OST PASTE KARYA 79.80 OST SKIN BARIER 65.10 OST START ST 166.95 PD BED DRMCR 250.95

PLEUR EVAC 1,362.90 SPLNT NASAL 506.10 ST CONTRAST DELIVERY 191.10 STETHESCOPE DISP 174.30 GARMENT COMPRESSION 340.20 SYR DISP 131.25 SYR FLUID DISP 495.60 SYR TB 5.25 SYR 10C CONTRL 33.60 SYS BX 464.10

TB CULTURE 154.35 TB DECOMP/FED 915.60 TB ENTRL FEED 739.20 TB FEED 247.80 TB FEED 5 FR 187.95 TB GASTROS 1,659.00 KT BUCHBNDR YSTENT 131.25 KT DUOSTAT 319.20

KT COPILOT 436.80 KT Y ADAPTER 25.85 DOCKING STATION GW 347.55

cdm

SHTH PEELAWAY PP 23CM 367.50 EDGE, GW CATHETER HOLDING DEVICE 542.85 SHTH PEELAWAY PP 13CM 446.25 TB STOM LV/EV 286.65 TP HYPAFIX 131.25 TRACH HL 198.45 MISCMED SUPPLY GEN - ADPT CATH 243.60 BLN RETREVAL 1,003.80 BSK RETRV 779.10

KIT, URINE METER 350 518.70 CATH FOLY 2W ALL 210.00 CATH FOLY 3W ALL 394.80 CATH FOLY 30C 3 152.25 CATH TOUCHLESS 177.45 BX FORCEPS 2,155.65 BIOSPY GUN 655.20 BX FRCP FB24 690.90

CATH INSRT TOOL 97.65 CRT CHST TB INST 674.10 DVCE INFL 370.65

KT CATH DIALYSH 2,142.00 KT CATH PERC 536.55 KT DISP TRNSDU 126.00 KT DRN CATH 821.10 FEM SAFEGUARD 24CM 590.10 KT FTUBE ENTRAL 622.65 KT GASTROSTOMY 821.10 KIT DEVICE NOVASURE 5,634.30

KT JEJUCATH+ND 589.05 KT NEDL BX 2,400.30 KT PNEUMOTHORAX 968.10 KT COOK PNEUMOTHORAX 968.10 KT PUMP BRST 380.10 KT SHEATH/CATH 852.60 KT SKIN CR 115.50 ST CATH DRN 745.50 ST NEPHROSTOMY 842.10 TRY ANGIOGRM H/P 717.15

TRY ANS SPINAL 282.45 TRY BX TISU 381.15 TRY CATH FO+B+ 267.75 TRY CATH FO+BA 235.20 TRY CATH ST 119.70 TRY CATH W/O CA 187.95 TRY TRIP/LUMEN 659.40 TRY VASC CATH 988.05

KIT VAS CATH LONG 4,672.50 TRY VENOGRM H/P 531.30 EQ BD GARIATRC D 597.45

cdm

EQ CRT CRD ARES 222.60 EQ CRT ISOLATION 222.60 EQ PMP IV D 191.10 HR IN LARYNGOSCOPE 110.25 GLIDESCOPE SHEATH 172.55 NEEDLE, SOFT 20GA 226.80 ASPIRATOR, EAR 152.25 NEEDLE SUBDERMAL PAIR 1,016.40 SET, HASKAL TIPS - KIT, MONITORING TRIPLE 311.85

BRSH CYTOLOGY 290.85 BUTTON GASTRO 1,262.65 GASTROSTOMY TUBE 1,100.40 INTRODUCER SET 633.15 JEJUNOSTOMY SET 554.40 PROBE, DOPPLER 1,013.25 ST ADMN SOL A/T 348.60 ST GASTRO JEJUN 1,210.65

ST GASTROJEJUN 2,339.40 ST GASTROSTOMY 1,006.95 ST IRR 757.05

TB GASTROSTOMY 469.35 PRECISION GLIDE NDL 30G 1.5 121.80 PRECISION GLIDE NDL 22G 1.5 71.50 SPINAL NDL 25G 3.50" 314.20 SPINAL NDL 22G 7" 329.70 DEVICE BX BONE KYPHX SZ3 928.20 BIOPSY SITE MARKER 645.75 QUINCKE PT 22G 6" NDL GUI 18G 3.5" 1,785.90

C-ARM COVERS 351.10 RF CANNULA CURVED 22G 50MM 1,443.50 COTTON ROLL 1LB 336.00 DRN CHEST 288.75 GROUNDING PAD NEURO THERM 1,020.35 SAFETY SYRINGE 1ML 25G 5/8" 175.35 PRECISION GLIDE NDL 25G 1.5" 71.50 SPINAL NDL 22G 5" 309.75 DRN HEMOVAC 282.45 PRECISION GLIDE NDL 20G 1.5" 59.25

DRN JACKPRAT 297.15 DRN WOUND SET 362.25 DRN WOUND SUCT 488.25 NDL DEPTH MARKER 336.00 NDL BX 822.15 NEEDLE, ECHOSTIM A/T 155.40 NDL BX SFTIS 460.95 NDL BX T CUT 265.65

PRB ANORECTAL 625.80 GEL CONDUCTIVE 70.35 KIT, PAIN PUMP 1,786.05

cdm

CLIP, SCALP ACRA-CUT 231.00 CEMT FEMORAL PRESSURZR 321.30 SPNG FEMORAL CANAL 207.90 BURR 5MM 15 DEG 1,419.60 BURR, 4MM 70 DEG 1,683.15 BLADE, 4MM RAD 60 1,035.30 BLADE, 4MM X 22.5CM 1,848.00 BURR, 3.2 TARDY 1,000.65 BURR, 3MM 40 DEG 928.20 BURR, 3.2 SEPTO 1,205.40

BURR, 4MM 15 DEG 1,640.10 BURR, 3.2 ROUND 964.95 BLADE, 3.5 SINUS 914.55 BLADE, 3.6 55 DEG 1,608.60 BURR, 2.9 PEDIATRIC 974.40 BLADE, 4MM RAD 938.70 BURR, 4.5 MM ROUND 1,608.60 BURR, 4.5 AGGRESSIVE 1,546.65

KT ACCESS 5,008.50 KT ACLACCESS 1,638.00 KT ACU W/WIRE 581.70

KT CPM ACCES 222.60 KT ICP DRN SY 1,051.05 KIT, DBS BX. PLUS 2,281.65 KT INF CONT 546.00 KT INSRT LNDMRK 297.15 KT SHLDR SUSPN 217.35 PERFOR DISP NEUR 1,173.90 TRY BN MARROW 451.50

TRY BN MARRW H/P 400.05 DRILL BITS ALL 369.60 BURR, CUT 7X30MM 591.15 BURR, CUT 1.0 X 30M 693.00 BURR, CUT 1.5 X 30M 824.25 BURR, CUT 2X30M 428.40 BURR, CUT 2.5X48M 638.40 BURR, CUT 3X8MM 512.40 BURR, CUT 4X30M 559.65 BURR, CUT 4X48M 374.85

BURR, DIAMOND .5X48M 661.50 BURR,DIAM .7X48M 748.65 BURR, DIAM 5X48M 622.65 BURR, CYLINDR 2.2MM 866.25 BURR, CYLINDR 3.0MM 945.00 BURR, CRANI 2.2X16 361.20 BURR, SKEETER .6CUT 897.75 BURR SKEETER 1.0 CUT 976.50

BURR SKEETER .6 DIAM 1,146.60 BURR SKEETER 2.3 CUT 181.15 PIN SKULL MAYFLD 1.00

cdm

BAG, DRAINAGE BECKER 348.60 BAG, DRAINAGE REPLACE W/ LUER 327.60 BLD ARTHRO CUT/TRIM 481.95 BLD ARTHROSCPY 581.70 BLD BONE OS/SG 296.10 WRAP COMPRESSION 480.90 BLD ORTHOTOME 1,727.25 BLD ORTHOI 661.50 BLD OSCILLATOR 472.50 SYRINGE PULSATOR 217.35

BLD SAW GIGLE 264.60 BATTERY, W.LORENZ 446.25 BATTERY, W.LORENZ 446.25 BN TAP 418.95 BRSH BONE INTRA 270.90 DISP BURR BATTERY PACK 465.15 BURR BONE 598.50 BURR BN DIAMOND 254.10

BURR DIAMOND 229.95 BURR OPTHA 543.90 BURR OST A/S 700.35

BURRS 1MM 139.65 BURRS 2MM 265.65 BURR STRYKR 147.00 BURR SWANSON 207.90 BURR TYPE I 854.70 CAN ACUFEX 279.30 CAN ARTHRO 260.40 CAN KIT 305.55

CATH PASSER 667.80 CATH PERTNL A 652.05 CEMT GUN KT 747.60 CEMT MIX CHAM 665.70 CEMENT REMV SYSTEM 2,717.40 CEMT DELIV SYS 2,700.60 CLIP, SCALP ACRACUT 231.00 CLIP, SPRING 1,706.25 CRANIAL PRES SET 2,109.45 DIFFUSER, MAESTRO 153.30

CARTRIDGE, OIL MAESTRO 217.35 SYNTHES CANNULATED BIT 2,494.80 CANN,ULTRA FAST-FIX 1,962.90 PUSHER, KNOT 1,013.90 DRILL BIT 2MM 308.70 DRIVER DISP SCREW 1,727.25 DRN LUM SET 1,460.55 GRIPS DALL MILE 1,527.75

KT BN PREP 2,000.25 BECKER EXTERNAL DRAINAGE 1,119.30 KIT, EXT DRAIN ICP 1,584.45

cdm

KIT, L/P SHUNT W/NEEDLE 3,195.15 KIT,NAVPAK 2,631.30 KIT,NAVPAK W/NIM 2,631.30 KT, NEEDLE PEDICAL ACCESS BEVEL TIP 9,893.10 KIT,VENTRICULOSTOMY 1,965.60 KIT JOIMAX 16,206.75 KNF GRAF 282.45 KT HNDL BN CEMT 511.35 PERFORATOR 11/7 MM 1,522.50 PIN GDE ALL 423.15

PIN, PERC 100MM 1,358.70 QUICKANCHOR MITE 964.95 SCREW,DIST 12MM 348.60 SCREW,DIST 12MM 348.60 KIT, MAXCESS MODULE 5,325.60 KIT, CANNULA 5.5MM 181.65 KIT, PRSSR MON INTRCMPRT 687.75 RESERVOIR, LUM/PERIT 1,678.95

RESERVOIR, VENT 12MM 2,073.75 TAP CANNLTD SM 640.50 TENDON PASSER 490.35

TRAY, LP ADULT 136.50 VALVE, CSF STD HP 1.00 BLADE, FULL RADIUS 3.5 428.40 BLADE, ABRADER 3.5 480.90 BLADE, ABRADER 2.9 471.45 BLADE, BONE CUT 5.5 683.55 BLADE, STONECUT 5.5 448.35 WAND ARTHRO VAPOR 925.05

TOOL GORE SMOOTHER 7.9MM 1,771.20 BIT, DRILL CANN 4.5MM 888.30 BLADE, MENISCUS (BEAVER) 148.05 CANNULA ARTH 8X76 MM 250.95 MENDER, MENISCUS 819.00 BLADE, SAW OSCILLAT HALL 339.15 BLADE, RECIP CON MED 630.00 BLADE, SAW RECIP 50 163.80 BLADE, SAW RECIP 44 183.75 BLADE, SAW RECIP MICROAR 133.35

BLADE, SAW SAGITTAL 109.20 BLADE, SAW SAG 2.5CM 128.10 BLADE, SAW SAG 1.4CM 114.45 BLADE, SAW OSS12MM 81.90 BLADE, SAW OSC 10MM 96.60 BLADE, SAW OSS 18MM 121.80 BLADE, SAW SAG 7MM 84.00 BLADE, SAW SAG 7MM 1.5 103.95

BLADE, SAW RECIP 25MM 97.65 BURR, CUTTING 2.0MM 108.15 BURR, CUT 3.0MM 48MM 137.55

cdm

BURR, CUT 5MM 48MM 148.05 BURR, OVAL 4.0MM 181.65 BURR, DIAMOND 4MM 222.60 BURR, DIAM 2.5 X 38MM 661.50 BURR, CUT 3MM 102MM 147.00 BURR, SWANSON 2.0 156.45 BURR, SWANSON 4.0 152.25 RASP, TEAR XCUT 446.25 RASP, SMALL 339.15 BURR, SIDE TAPERED 1.2 91.35

DRILL WIRE PASS 1.5 171.15 BLADE, SAW BRAZOL 515.55 BLADE, SAW SAG 4CM 244.65 BLADE, SAW SAG 5CM 238.35 BLADE, SAG 25.40MM 202.65 BLADE, OSC 12.5MM 235.20 BLADE, SAG 29.46MM 236.25 RASP, SAGITTAL 406.35

BURR, XC DIAMOND 4.0 748.65 DRILL NEURO 3MM 871.50 RASP, HELICOIDAL 3.2 805.35

DISC, DIAMOND 25.44M 739.20 BURR, FLUTED LONG 9.1 754.95 MAESTRO BURRS ALL TYPES 827.40 TRP FINGER 217.35 TIP, CUSA MICRO CVD 2,253.30 TIP, CUSA STANDARD CVD 2,166.15 PAD, POLAR CARE KNEE 1,255.80 SUT CLIP SCALP 144.90

SUPPORT HEAD PRONE 8 X 8 149.10 MISC SURGERY IMPLANTS CONVERSION - PLAIN 60 TGI408 D/A 170.10 DEXON 50 D1 D/A 249.90 VICRYL 60 S29 126.00 VICRYL 80 TG1408 153.30 PROLENE, 90 TG1408 145.95 NYLON 50 R5 130.20 SILK 40 C1 D/A 74.55 SILK 60 TG1408 D/A 131.25

MERSILENE 50 RD1 D/A 132.30 ETHILON 80 BV1305 137.55 ETHILON 110 TG1604 201.60 GRIP LARGE 2.0MM 1.00 ETHIBOND 0 TIP1 LOOP 210.00 LIGATING CLIPS MD 60.90 LIGATING CLIPS M/LG 74.55 LIGATING CLIPS LG 99.75

ETHIBOND 30 V5 MULTI 467.25 PROLENE 70 BV1756 226.80 PROLENE 50 C1, C1 235.20

cdm

PROLENE 70 BV1 MULTI 331.80 PROLENE 70 BV1756 D/A 549.15 TICRON 20 CV316/DA W/B 1,030.05 TICRON 20 CV316/ DA 1,041.60 PROLENE 80 BV1305 DA 369.60 TICRON 20 CV305 D/A 569.10 TICRON 20 CV305 WH/BL 934.50 TICRON 30 CV331 DA 597.45 WIRE, PACING ORANGE 129.15 STEEL, #7 CCS 418 156.45

STEEL, #6 CCS1 49MM 490.35 SUT CLIP HEMO 669.40 RELOAD,ENDO GIA 2.5MM 1,932.00 STPLR,ENDO GIA UNVRSL12M 1,997.10 POLYSORB 20 ENDO 413.70 AS CLIP 290.85 AS DGIA50 1,757.70 AS EEAXX A/T 1,866.90

AS ENDOCLIP 1,119.30 AS ENDOSTITCH 1,644.30 AS GIA A/T 992.25

AS LDSXX A/T 565.95 ROTIC 55 1,590.75 TROCAR 11MM. W/XPNDBLE 889.35 TROCAR 15MM ENDOPATH 814.80 AS CLIP SKN 392.70 AS STPL/DV PS 1,559.25 AS STPL AUTO 2,137.80 AS STPL SKN 275.10

AS STPL TA30/90 1,172.85 AS 30/55/90 652.05 MULT BAND LIGATOR 1,365.00 UCLIP, O.H. 945.00 UCLIP, GEN 551.25 SEAL 5MM DISP 101.85 SUT BUTTON 185.85 SUT CARD ETHIBN 144.90 SUT CATG IVVI 1,061.55 SUT CATG I 26.25

SUT CAT VX 389.55 SUT CLIP AUTO 276.15 SUT CLOS ETHIBN 61.95 SUT CLOS ETHLON 148.05 SUT CLOS GUT 45.15 SUT CLOS PROLEN 160.65 SUT CLOS SLK SK 45.15 SUT CLOS STEEL 105.00

SUT CLOS VIC&JE 61.95 SUT CLP LIGA AS 148.05 SUT CV TICRON 207.90

cdm

TICRON BL 3-0 CV-305 / D.A. 198.45 SUT ENDOLOOP 220.50 SUT ENDOLOOP 2 680.40 SUT EXTRA 207.90 SUT EYE 201.60 SUT GI GUT 155.40 SUT MERSILENE 226.80 SUT MICRO ETHLN 236.25 SUT MICRO SUPR 177.45 SUT NEURO NLON 81.90

SUT PAK STEEL 139.65 SUT PDS 148.05 SUT PLAST VIC 282.45 SUT RETRACTO TAPE 95.55 SUT RETEN A/T 172.20 SUT SURGIGRIP 226.80 SUT WIRE 75.60 WIRE WISCONSN 220.50

CUTTER, LINEAR ENDO ST 60 MM 1,969.80 ADD LATER - CUTTER LINEAR 55MM 762.30

RELOAD BLUE 55MM 463.05 CUTTER 75MM BLUE 985.95 RELOAD BLUE 75MM 606.90 STAPLER, INT FASCIA 934.50 STAPLER LINEAR 60MM BLUE 741.30 RELOAD 60MM BLUE 420.00 STAPLER LINEAR 90MM YLLW 796.95 RELOAD 90M YELLOW 489.30

RELOAD 90MM GREY 447.30 STAPLER LINEAR 30MM BLUE 828.45 STAPLER LINEAR 30MM WHTE 792.75 STAPLER LINEAR 30MM GRN 717.15 RELOAD 30MM BLUE 390.60 RELOAD 30MM WHITE 401.10 STAPLER LINEAR 55MM BLUE 1,332.45 STAPLER ENDO 35MM BLUE 1,293.60 STAPLER ARTIC 35MM BLUE 1,664.25 RELOAD ENDO 30MM BLUE 706.65

STAPLER, POWER LDS 1,895.25 STAPLER ENDO 45MM LONG 1,979.25 CUTTER, ENDO 45MM BLUE 1,558.20 RELOAD ENDO 45MM BLUE 720.30 RELOAD ENDO 45MM WHITE 733.95 RELOAD 45MM BLUE 6 ROW 828.45 STAPLER ARTIC 45MM BLUE 1,269.45 APPLIER ENDOCLIP MD/LG 717.15

APPLIER ENDOCLIP LG 744.45 STAPLER CIRC 25MM 1,807.05 STAPLER CIRC 21 ENDO 1,802.85

cdm

STAPLER CONTOUR BLUE 2,266.95 RELOAD CONTOUR BLUE 1,258.95 SILK 20 SH 830 127.05 PDS 30 SH, SH 255.15 PDS 30 SH MULTI 514.50 ETHILON 90 BV1004 171.15 ETHILON 90 CS B6 181.65 ETHILON 100 BV754 199.50 ETHILON BLK MON 10-0 MICRO 5" 183.75 NYLON 90 HSV6 326.55

NYLON 90 DRM5 359.10 NYLON 100 DRM4 383.25 NUROLON 40 TF C/R 151.20 GORE CV0 THX3 245.70 CHROMIC 0 MO5 221.55 CHROMIC TIES 120.75 CHROMIC 0 BP1 99.75 CHROMIC 30 SH, SH 66.15

CHROMIC 0 ENDOLOOP 157.50 VICRYL 0 ENDOKNOT 250.95 VICRYL 0 ENDOLOOP 18 159.60

VICRYL 0 TIES 102.90 VICRYL 1 CT1 MULTI 136.50 VICRYL 20 CP2 154.35 ETHIBOND 5 V40 154.35 ETHIBOND 20 SH 136.50 ETHIBOND 30 RB1 MULTI 87.15 C/S MISC SURG SUTURES - DEVICE ETRIO-314H 2,223.90

ENDO OVERTUBE 984.40 PROBE DILATOR 2.5 MM 321.30 DILATOR ISOLATED STERILE DISPOSIBLE 2,866.50 23 G ENDOLASER PROBE 914.55 SOL A/F 270.90 TORQUE DEVICE 97.65 DILATR ENDOSCOPE 2,308.95 ENDO FORCEP DISP 690.90 TIP, SCISSOR ENDOCUT CVD 411.60 ENDO SHEARS 762.30

FRCP BIPOLAR DISP 2,012.85 KT ENDO ACCESS 381.15 KT ENDO HERNIA 3,558.45 KT LAP CHOLECY 1,972.95 KT RETRACT ENDO 1,779.75 NDL LAPSCOPE 427.35 COAG LAPOROSCPY 1,186.50 DVCE SOFT TIS 1,144.50

DEVICE, PURSE STRING 10" LONG 1,018.50 DEVICE PARMAFIX TACK 4,620.00 ELCTRD DISECT NDL 1,149.75

cdm

ENDO BLADE SYS 1,907.85 ENDO DISSECT 823.20 ENDOPOUCH SPEC 624.75 KITTNER ENDO 310.80 PRB ENDO PH 546.00 SRGIPRT TRC A/S 1,021.65 SURGINEEDLE 369.60 SUT ENDO SUT ASST DISP 1,060.50 SUT SURGPRT CNVR 217.35 SYSTEM, FUSION LAP 2,454.90

SYSTEM LAP FUSION OPEN 2,030.70 SCALPEL HARMONIC 1,882.65 TIP SURGIGATOR 80.85 TIPS/IRRIGATOR 77.70 TUBING NEZAT 243.60 TROCAR,GEL PRT BLLN 12M 470.40 HOOK, HARMONIC 5MM 1,003.80 HARMONIC, HAND CONTROL 2,241.75

SHEARS HARMONIC 5MMXL 2,281.65 CAUT PLASMA BLADE 4.0 2,012.85 HARMONIC, FOCUS 2,494.80

HARMONIC ACE23P 2,119.95 RF ABL COOL TIP NEEDLE 15,177.75 HARMONIC, ACE36P 2,406.60 POUCH, ENDO RETRIEVAL 613.20 DISSECTOR BLUNT 5MM 202.65 BABCOCK, ENDO 10MM 1,436.40 TROCAR ENDO 5MM 406.35 TROCAR ENDO 12MMXLONG 499.80

TROCAR ENDO 15MM 814.80 TROCAR FLEXPATH 15MM 369.60 THORACOPORT 12MM 497.70 TROCAR ENDO 11MM 521.85 TROCAR ENDO 12MM 474.60 TROCAR BLUNT TIP 12MM 513.45 CATH, TROCAR A/S 316.05 DEVICE ENDOCLOSE 480.90 KIT CARTER THOMASON 866.25 KIT, 4CLOSURE 778.05

NEEDLE, CORSON 937.65 SYSTEM, GELPORT 2,958.90 SYSTEM IRRIG CONMED 576.45 TRCR,ENDSTRCTRL BLLN10MM 1,226.40 TRCR,NDO BLLN BLNT TP10M 1,038.45 TRCR,ENDO BLLN DSTNTION 1,741.95 POUCH SPECIMAN ENDOCATCH 1,555.05 DEVICE, LAP DISC LONG 2,701.65

DEVICE, LAP DISC 2,829.75 WARMER,SCOPE DISP 162.75 TRAP, ENDOSCOPIC* 1.00

cdm

STYLETTE PLST 161.70 STYLETTE WIRE 287.70 STYLETTE WIRES 341.25 EQ CELLSAVER 187.95 CELLSAVER BWL/PK 575.40 CELLSAVER RSRVOR 374.85 NET DISP RETRIEVAL 472.50 PD DEFIB 546.00 PK CELL SAVER 840.00 FILTER EMBOLIC PROTECTION OH 4,378.50

AORTIC ROOT CANN 175.35 KIT CATH BALLOON AORTIC 12FR 1,034.25 WX,BNE H20 SOL.ALKYLN OX 588.00 CLAMP, VASC MINI RED 151.20 PROBE, VASC 2.0 130.20 FILTER, OXY GAS LINE 0. 123.90 OCCLUDER, VASC 1.0MM 359.10 CLAMP, SNGL MED 30 369.60

CLAMP,DBL.MED.30 528.15 DEVICE, COOLING PEDI 761.25 DEVICE, COOLING ADUL A/S 2,310.00

SHNT CAROTD BYP 416.85 SHNT CATH VENT 652.05 SHNT CORONARY 451.50 WX,BNE H20 SOL.ALKYLN O 588.00 CANNULA RETRO 9FR 701.40 CANNULA, RETRO LONG 831.60 KIT, VENOUS A/S 1,719.90 CANNULA, VENOUS FEMORAL BIO 25F 1,719.90

KIT, BOWEL LOW VOLUME 595.35 CANNULA, AORTIC 5.2 308.70 CANNULA AORTIC 24F 2,005.50 CANNULA, VENOUS 32F 396.90 CATHETER VENT SUMP LEFT 284.55 CANNULA, VENOUS 28F 323.40 CANNULA, VENOUS 29F 344.40 CANNULA, VENOUS 32/40 333.90 CANNULA, MOD. SFT TIP 276.15 PUNCH, AORTIC 3.6M 368.55

PUNCH, AORTIC 4.5M 313.95 TUBE, CHEST 36FT 132.30 TUBE, CHEST R/A 36FR 148.05 TUBE, CHEST 32FR 74.55 CANNULA, VEIN 18G 105.00 CANN,INT MAMM 1MM 157.50 CANN, INT MAMM 2MM 128.10 CLIP, LIGATING A/S 65.65

CLIP, HEMO TITANIUM MED/LG GR 65.65 CLIP, LIGATING MD/LG 65.65 CLIP, SPRING SOFT 6MM 138.60

cdm

CLIP, SPRING BLACK 6MM 82.95 INSERT,FOGARTY 61MM 157.50 BLADE, STERNAL REDO 431.55 GUIDE, SUTURE STERILE 242.55 CABLE, PACING W/ CLIP 157.50 CABL TP PCMKR 2 157.50 ELECTRODE, REDIPAK 326.55 HEMOSTAT, FIBRILLAR 980.70 HEMOSTAT, FIBRILLAR 980.70 DRESSING, ALGINATE 90.30

DRESSING, ARGLAES SM 301.35 DRESSING, ARGLAES LG 352.80 DEVICE, HEARTSRING PROXIMAL SEAL 2,937.90 DEVICE, TISSUE STAB 12,862.50 SYSTEM, OCTOPUS 8,206.80 LIPIGARD BLOOD FILTER 297.70 ANS BREATH/CIR 187.95 BARS ARCH 316.05

BLD DERM GRAFT 348.60 BLD MICRO ENT 1,300.95 CANN SAPH VEIN 87.15

CARD SUCKER 320.25 CLAMP, MUSCLE BX 172.20 CLAMP, SINGLE 60GM 369.60 OH BLOWER MISTER 446.25 OH CANULA PRFUSN 334.95 OH CANULA PRFUSN 373.80 CABLE, PACING A/T 181.15 CARTRIDGE, SILVER 164.85

CLMP,RES OUTLT STR W/QCK 114.45 PAD SENSA TRAC 259.35 CARTRIDGE, HDR 190.05 OCCLUDER VAS A/S 295.05 OH CATH B AORTIC 9,975.00 OH CONNECTORTUBE 1 161.70 OH FLTRBLD CD 1,071.00 OH PMP/CANN 2,243.85 CARDIOVASC.PROC.KIT,ALV. 732.90 OH PUMP SUPPLIES 980.70

OH PUNCH AORTIC 256.20 OH RESEVIOR CARD 980.70 OH SUPPORT HEART 4,981.20 OH ETHICON VEIN HARV KT 3,679.20 PLEDGET CV TEF 427.35 PMP CONTROL 259.35 RESERV REINFUSN 1,216.95 MECHANICAL DLTR SYSTEM 9 4,347.00

ST THERMODILUTN 141.75 STRIPPER VEIN 287.70 SUCT CANNL GYN 395.85

cdm

SUCT CV FLX/INTR 476.70 SUCT VACURET SET 181.65 VEIN STRIPPER 668.85 3LV PRESR REL 243.60 LD EXTENDER BULLDDOG 948.15 WIRE, MYO TEMP 24" 144.90 TIP, CUSA MICRO CVD 2,253.30 TIP, CUSA STANDARD CVD 2,166.15 ELCTRD EXPACE 508.20 CATHETER, PASSPORT 1,782.90

SPHINCTRTOME/HYDRATOME 2,281.15 ELECTRODE, ROLLER 24FR 937.65 VALVE, ENDO SEAL 157.50 VISE, TORQUE HANDLE 144.90 SYRINGE, INFLATION 342.30 INTRODUCER SUP/PUB 16F 210.00 INTRODUCER SUP/PUB 14F 481.95 UTERINE SOUND 591.15

DILATOR COOK 217.35 DLTR CK 6F 20CM 129.15 DLTR BYRD STEEL 1,330.35

DILATOR COOK TEF BYRD 920.85 HEMOSTATS SFT GRP 472.50 EVC GU TUR 275.10 FILIFORM GU 450.45 FOLLOWER 8FR 595.35 KIT,DILATR RENAL 6-30F 20/30CM W/8F 1,173.90 KT, DLTR URTRL 618FR 843.15 KIT, PROSTATE BX 18G 329.70

KIT, BX PROSTATE CAT 357.00 KIT,OCC BLLN CTH 5F 65C 1,126.65 KIT, URIN DIV 7FR 1,033.20 KIT, MALECOT NEPHO 24F 529.50 KIT, URTERSCPY SHTH FLEX 616.35 KIT,RETRACTOR PERI/GYN W/O STAYS 432.60 HOOK, STAY ELASTIC 3MM 392.70 HOOK, STAY ELASTIC 5MM/12MM 91.35 ST DILAT URETH 780.15 STONE EXTRACTOR 762.30

VALVE REFLUX CK 198.45 C/S MISC UROLOGICALS - CATH MUSHROOM 296.10 CATH NEPHROSTOMY 783.30 EXTR LOOP STONE 507.15 BSK SEGURA 1,438.50 BASKET, STONE RET 3F 1,185.45 BASKET, PARACHUTE 3.1 1,569.75

BASKET, HEMISPHERE 2.4F 1,438.50 BASKET, ATLAS 3.2F 962.85 BASKET, HEMISPHERE 4.5F 762.30

cdm

EXTRACTOR, NITINOL 2.2F 1,156.05 BASKET, NITINOL 3F 1,638.00 FORCEP, STONE GRSP 2.6F 1,188.60 FORCEP, STONE GRASP 3.2 1,842.75 EXTRACTOR, STNE NTNL 3. 1,092.00 FORCEP, URETER BX 3F 2,281.65 BRUSH, BX 3F 387.45 BSK STONE 1,479.45 KNF URETHROT 840.00 CATH NEPHRO 16F 30CM 701.40

KIT, NEPHRO 24/7F 701.40 KNIFE, HALF MOON 914.55 KIT, RENAL DIL 6-30F 157.50 LOOP, CUTTING 24F 591.15 LOOP RESECTOSCOPE DISP 361.20 PRB LITHOTRIP 940.80 SYSTEM, BIOPSY 15GA X 15CM DISP 914.55 BUTTON NSL SPTAL MD SLC 1,023.75

DEV RETRIEVAL INSERTABLE 1,876.35 SET, CANNICULAS INT 717.15 SET, FIBEROPTIC CANN 990.15

MORCLLTR LAP GYNCR XTRCT 1,115.65 MORCELLATOR 1,115.10 SYS TRNSVG ANCH PRCIS TK 1,561.90 WND,COBLATOR RFLX 45W/C 1,331.40 CIRC BELL A/S 33.60 BLADE, 4MM RAD 40 1,026.90 KT URETHRAL WARM CATH 1,193.85 TROCAR LAPSCOPE 638.40

SIDEBITE CLAMP INSERTS 222.60 SINUS ILLUMINATION SYS 2,188.75 SPACER,BALLOON SINUSPLASTY 4,090.80 CANNULA, INF 4MM 241.50 SCRAPER, MEMBRANE 825.30 BLADE, RADIAL 8MM 247.80 PUNCH, CORNEAL 8.5 492.45 PROBE, LASER 20G 669.90 KNIFE, SLIT CUT 216.30 PROBE, LASER 25G 499.80

SHEATH, ON-Q 8" 325.50 KIT, TOTAL PLUS 2500 2,068.50 KIT, TOTAL PLUS 25G 2,760.45 TUBING, VGFI 414.75 NEEDLE, SOFT TIP 20G 655.20 PROBE, PRASS SLIM 1,750.00 SPONGE, HELISTAT 781.20 HEMOSTAT ABSORBABLE SURGICAL 4X4" 10,307.55

FALLOPIAN RING 385.35 CANNULA EYE 207.90 CONEC Y PARALLEL 305.55

cdm

DERMACARRIER 220.50 DRN TUBE 586.95 VAVD KIT 630.00 CANNISTER VAC ASSIST CLOSURE 505.05 SYSTEM INCISION WOUND MANAGEMENT 5,197.50 EYE INFUSION/GAS 3310 423.15 FIB OPTIC ASSEMB 6,267.45 HYSTEROCATH 250 520.80 INFLATOR GAUGE MEDTRONIC 446.25 KIT,ESSURE PERM BRTH CRL 7,074.90

KT AUTOLOGUS GRWTH FCTR 1,509.90 KIT, PLATELET SEPARATION 3,092.25 KIT, SPRAY APPLICATOR 349.65 TIPS, SPRAY APPLICATOR 324.45 KNF MICRO 15 243.60 KNF SHTED 486.15 KNF SURG EYE 177.45 KIT, TRANSGASTRIC 22FR 2,042.25

KIT, WRENCH W/ SCREWDRIVER 538.65 LZ FIBER 2,167.20 MICRO GRID 229.95

HEART HUGGER 1,345.05 MICROPICK 6 MM. 23 G 117.60 CANNULA 6MM 128.10 POLYTIP VFI CANNULA 6MM 217.35 NDL EYE IRR 370.65 PRB CRYO 1,407.00 PRB OCCUTOME 1,003.80 TB EYE CAN/INT 162.75

TISSUE ATTACH 1,165.50 TISSUE EXPANDER 4,118.10 TUBING PHACO 520.80 WAND 3.5MM 90 DEG 1,481.55 WAND 3.0MM 50 DEG 1,426.95 VACUMIX 520.80 PROBE, ABLATION 90 DEG 1,242.15 PROBE, 3MM 90 DEG 942.90 RETRIEVER, SUTURE 344.40 C/S MISC SURG SPECIALTY -

KIT, ON Q 400ML 1,945.65 KIT, CATHETER 7.5" W/NEEDLE 984.90 KIT, CATHETER 2.5" W/NEEDLE 410.55 KIT, CATHETER 1" W/NEEDLE 630.00 KIT, CATHETER 5" W/NEEDLE CUSTOM 990.15 NEEDLE, ON Q 16GX8 162.75 KIT, ON Q 100ML 827.40 KIT, ON Q 270ML 990.15

CANNULA, RECIPRCTING II 510.30 LNR SUCT W/TB 264.60 NDL COOK PERC IR 72.85

cdm

NDL BX CHIBA 316.05 LAPAROSCOPIC VESSEL FSN 2,021.25 PK CUSTOM TOTAL JOINT 930.30 STOMAPHYX KIT 11,061.75 STOMAPHYX KIT 11,061.75 SYS GASTRIC BANDING 18,450.60 REALIZE GASTRIC BAND 16,515.45 REALIZE INJECTION PORT 4,887.75 TROCAR,GEL PRT BLLN 12M 470.40 FRCP,CTTNG BPLR 5MM SHFT 402.15

MANIPULATOR, UTERINE 257.25 POLYSORB 0 ENDO 413.70 CORD, ACTIVE RESECT 185.85 MRKR,MRGN MP FOR BRST BX 193.20 BONE WAX 2.5 GR 59.85 KIT,C/V ADVANCED 9FR 787.50 KIT, NERVE BLOCK 681.45 NEEDLE, WHITACRE 27G 93.45

LAMINA OTO EPIDSC1417000 1,016.40 CATH, URTL ANES LUB/STN 291.90 DEVICE, CAPIO TRANSVAG 1.00

DEVICE,CAPIO OPEN 1.00 SYS TRNSVG ANCH VSCA PRS 1.00 ADPT TUOHY BORST 413.70 BG BILE 19 OZ 347.55 BG COLL W/TB DRN SYS II 151.20 BG ICP DRNAGE 241.50 CANNULA, RF CRVED SHRP 254.10 CANNULA, RF ACTV TIP 308.70

CANNULA, RF W/MRKR 324.45 CIRC BELL A/S 33.60 CUSH PLST 66.15 GRIP SIDEKICK HANDLE 491.40 NEEDLE, ECHOSTIM A/T 155.40 PRB ENDOCULAR 1,149.75 TRAY,EPID DBL DECK 15G 689.85 TRAY, UNIVERSAL BLCK 350.70 SPLINT, NASAL DENVER 372.75 SPLINT, THERMOPLAST 141.75

SPLINT, BIVALVE 357.00 SPLINT, DOYLE 11 AW NSL 349.65 PACK LAMIN MEROCEL 153.30 BLADE, SCREW TIP 15 DEG 85.05 PACKING, KENNEDY 193.20 TAMPON, NASAL DOYLE 179.55 KT COLLAGEN PLG HEMOSTAT 2,988.30 KT FILL IMPLANT 131.25

KT MICROPUNCT INTRO 329.20 KT PERC BLDR SUS 3,196.20 KT SIALOGRAPHY 428.40

cdm

KIT, C/V ADVANCED 9F 315.00 ABSORBABLE HEMOSTATIE PARTICLES 1,228.50 ABSRBLE FLOWABLE SEALANT 984.90 ST SPRAY FIBRIN SEALANT 1,161.30 SYS BX ASAP DETACH 520.80 TRY ARTRL LIN 313.95 KIT, TRANSTRACH 3,858.75 SUCTIN, ANDREWS DISP 298.20 SEALANT, COSEAL 8ML 4,376.40 SEALANT DURASEAL 5ML 4,095.00

ANS SPLY EPID 381.15 ANS SPLY GEN MI 732.90 ANS SPLY SDLBLK 296.10 SPONGE, BICOL 505.05 BLD BEVR 186.90 BLD BEVR 248.85 BLOOD DISP CARIR 226.80 CARTRIDGE, OIL MAESTRO 217.35

WAND 3.5 90 DEG BIP 1,304.10 WAND 3.5MM 90 DEG 1,678.95 WIRE CERCLAGE 155.40

WAND 2.3MM 35 DEG 1,255.80 APPLIER CLIP20/20 MED 516.60 RELOAD CLIP 20/20 371.70 APPLIER CLIP 20 SM 510.30 APPLIER CLIP 20 SM 510.30 CAUT EYESTAT 236.25 CAUT PEN+CRD 569.10 CAUTERYPSHBTTNPNCLW/HLDR3PN 67.20

CAUT PEN+TIP+CRD 274.05 COAG BLADE SYSTEM 708.75 DRN ABRAMSON 369.60 DRN BLAKE 290.85 DRAIN, SILICONE ROUND HUBLESS 19FR 192.15 DRN HEMO NEDLE 177.45 DRN HEMO TUBE 394.80 DRAIN,PENROSE XRAY 18"X14" W/ CLIP 116.55 DRN RESRVR 75.60 DRN SUMP SHIRL 290.85

DRAIN, WOUND ROUND 10FR 77.70 ELCTRD DISECT NDL 718.20 RETAINER VISCERA 290.85 SPNG PATECOT 154.35 SPNG SCLERALS 274.05 STIM/LOC111 NERV 391.65 SUCT TUBNG VAC 217.35 BITE KIT 357.00

TB T DISP 287.70 TB VNT COL BTN 531.30 TB,ENDO BLCKR W/CONN 9F 984.90

cdm

THERM PROBE REC 276.15 TP GLOW & TELL 339.15 HANDPIECE,VERSAJET HYDRO 23,539.95 WIPE/SPONGE INST 145.95 SEAL, SCOPE WARMER 76.65 SYSTEM, CPAP 274.50 CANNULA, SUMP 10/10 317.10 TB,CLBRTN SNGL FOR LP BN 984.90 DRAPE, PELVIC SINGLE STP* 748.65 PROBE, LASER SUCTION 101.85

PROBE,WAND 7/8X9 STRL DS 132.30 MISCSURG OTHER - CASE, CARRYING(PAIN PMP) 121.80 BND BIND ABD 322.35 BND BIND ABD 302.40 BND HEMOSTAT DRY PAD 464.65 BND HEMO RADIAL 668.85 BND HYG 6/10 354.90

BND SHLD EYE WCK 638.40 BND STKNG KNEE 200.55 BND STKNG THGH 302.40

BND TBGZ A/S 265.65 DRAINAGE, WOUND 308.70 DRS ANTIMICROBIAL I 87.15 DRS AQUA PROTEC 418.95 DRSNG.,ANTIMCRB.SFT.SIL. 339.15 DRS GRANUFOAM 603.75 DRS GZ OWENS 57.75 DRS HEMOSTATIC 401.65

DRS KNEE SPLNT 316.05 DRS OPSITE SM 155.40 DRS SORB 4X4 143.85 DRS WHITE FOAM 177.45 C/S MISC DRESS/BANDAGES - DRESSING, NASOPORE 827.40 MEROGEL, INJECTABLE 717.15 DRESSING, MEROPACK 609.00 DRESSING, MEROGEL 630.00 SEPRAGEL 2ML 520.80

DRS PCKNG NASAL 222.60 DRESSING, NASOPORE 827.40 DRSNG,STAMMBERGER SINU-FOAM 945.00 PACKING WND 80.85 SPHERE, STEALTH 211.05 HANDPIECE SOMNOPLASTY 2,182.95 CLMP VES 729.75 BACKFLUSH HNDL, 23G.BLNT 606.90

DSP ILM FORCEPS TIP 827.40 DSP INSTRUMENT TIP 906.15 FRCP GRSPNG 952.35

cdm

INST DRILL AIR 67.20 INST ERSR WT FLD 286.65 INST EXTR STN GU 1,242.15 INST EYEGLID INF 174.30 INST FRCP GRSP 1,210.65 INST HOLDER NEDL - INST HOOK GRSP 207.90 INST LANCING ALL 241.50 INST LAPAROSCOPE 47.25 INST LARNGOSCOPE 61.95

INST MED/SURG 61.95 INST MEDASTNSCOP 70.35 INST NEPHRASCOPE 48.30 INST PACE STYLE 1,593.90 INST PROCTOSCOPE 61.95 INST RETR STAYS 1,305.15 INST RETRAC WILK 432.60 INST RETRT MINI 185.85

INST RETRT ENDO 652.05 INST SCP INTB FL 400.05 INST SET CASPERI 61.95

INST SYS MXFCL PLT 1.00 INST ULTRTM SPHN 1,345.05 INST URETEROSCOP 674.10 INST VITRECT LIGHT PIP 466.20 INST URETHROTOME 45.15 INST WIRE SNARE 379.05 KT CATH CARD 4,147.50 KT CS DEL SYS BIOTRONIK 4,630.50

KT CS DEL SYS GUIDANT 4,630.50 KT NASOPK 207.90 KT TRANSSEPTAL 1,283.10 KIT, THYROPLASTY 1.00 PAPILLOTOME W GW 745.50 SNARE STERILE 131.25 GASTRIC OVERTUBE 6,772.50 SNARE OV/CRS/HEX 336.00 ST FLUID DELIV 582.75 TRY ARTHOSCOPY 67.20

TRY CHEST 74.55 TRY CRANIOTOMY 77.70 TRY CRD ARST H/P 1,075.20 TRY CRDVASC H/P 67.20 TRY CUTDOWN H/P 375.90 TRY CYSTO H/P 47.25 TRY D & C 67.20 TRY EAR H/P 77.70

TRY ENT MIN H/P 47.25 TRY EXM VAG H/P 400.05 TRY EYE 67.20

cdm

TRY FACIAL 67.20 TRY GALLBLADDER 67.20 TRY GNITO/URO HP 53.55 TRY GROSHONG 2,337.30 TRY HAND 67.20 TRY HEMOCLIP 53.55 TRY HYSTERECTMY 67.20 TRY HYSTEROSCPY 67.20 TRY INST DHS 67.20 TRY INST GEN 67.20

TRY INST MAJ H/P 77.70 TRY INST MIN H/P 67.20 TRY INST PLST HP 67.20 TRY INTESTINAL 67.20 TRY INTUBATON HP 400.05 TRY KIDNEY 67.20 TRY LAMINECTOMY 77.70 TRY LAPARP LZ 47.25

TRY LARYNGOSCOP 67.20 TRY LUMB PUNCT 289.80 TRY MAJ 77.70

TRY MAJ FOOT 67.20 TRY MAJ ORTHO 77.70 TRY MAJ ORTHO 67.20 TRY MICRO INST 77.70 TRY MIN 67.20 TRY MIN ORTHO 47.25 TRY MNTR CVP 331.80 TRY MYELOGRAM 286.65

TRY NEURO 67.20 TRY OH 77.70 TRY OH MICAB 8,130.15 TRY OH VALVE 67.20 TRY PARCNTS H/P 456.75 TRY PELVISCOPY 67.20 TRY PERICRD H/P 1,212.75 TRY PO CAR OH HP 1,703.10 TRY MPROSTATCTMY 67.20 TRY RECTAL 67.20

TRY SADLE BLOCK 389.55 TRY SHOULDER 67.20 TRY SMR NASAL 67.20 TRY SPECIALTY 67.20 TRY SPEC PRO H/P 77.70 TRY SUT MIN H/P 74.55 TRU TB CHST H/P 400.05 TRY TB MLRBT HP 264.60

TRY THORACENTES 475.65 TRY TOTAL HIP 191.10 TRY TROCR CHEST 365.40

cdm

TRY TUR SU H/P 47.25 TRY UMBL ART CTH 546.00 FEM COMP ARCH 365.40 FEM STAT LOCK 205.80 MISCTRY - BLNKT BAIR HUGG 546.00 CABLE PACING 375.90 EQ BLOOD WARMER 222.60 EQ CRADL WO HT D 63.00 EQ CT SURG 145.95

EQ CTARTHRO 394.80 EQ DOPL DUAL FRQ 222.60 EQ DRILL MIDAS 270.90 EQ EYE ASP/CRYO 222.60 EQ EYE ASP/OCUTM 222.60 EQ EYE VITRECTOR 1,543.50 EQ GARDNER TONGS 42.00 EQ ILLUM FIBOP 2,470.65

EQ LZ HNDPC 95.55 EQ LZ MODEL 8 2,135.70 EQ LZ SB 1,479.45

EQ LZ SB 380.10 EQ MNTR ARTRL SU 297.15 EQ MNTR CVP 127.05 EQ MNTR HEMOD/GS 569.10 EQ NEURO SECTOR 9,544.50 EQ OXIMETER 217.35 EQ PHACO 222.60 EQ PMP GYNEFLOW 95.55

EQ PMP IV DUAL 110.25 EQ PMP/SYR INFUS 110.25 EQ PURIFR AIR D 207.90 EQ SG DERMATOME 222.60 EQ SG GRFT MSH 222.60 EQ STRYKER UT 222.60 EQ T U N A GENERATOR 1,215.90 EQ VIDEO PRINTER 222.60 EQ ANS MNTR ART 110.25 HR KT INST S/U 63.00

EQ MISC - SCISSORS, MICRO 1.0 760.20 LENS, BIOM WIDE 447.30 KIT, FRAGMATOME 497.70 LENS, FLAT STERILE 298.20 KIT, VISCOUS FLUID 523.95 WND,COBLATOR RFLX 45W/CB 1,331.40 KNIFE, V LANCE 20GA 274.05

PACK, VITRECTOMY 299.25 DRP BARRIER CV 508.20 DRP XRAY SHIELDING 286.65

cdm

DRP CAMERA 290.85 DRP EYE SPEC 127.05 DRP LASER 319.20 DRP MICRO W AR 287.70 DRP STERILE 219.45 OHS CUSTOM PK 9,997.05 PK ARTHROSCOPY 2,123.10 PK BASIC 274.05 PK CATARACT 767.55 PK CUSA 1,272.60

PK CUSTM BASIC 1,177.05 PK CUSTM MINOR 1,164.45 PK, CUSTOM ENT 498.75 PK CUSTM ORTHO 476.70 PK, CUSTOM TOT JOINT 930.30 PK CYSTO 300.30 PK EXTREMITY 519.75 PK EYE 1,664.25

PK EYE CUSTOM 3,346.35 PK EYE PHACO 1,149.75 PK HIP 661.50

PK LAP 198.45 PK LAPAROS 708.75 PK LUNG PERFUSN 3,927.00 23 GA. TOTAL PLUS PAK 2,679.60 PK OCCUTOME 2,137.80 PK ORTHO 539.70 PK ORTHO/NEURO 3,363.15 PK PERI/GYN 276.15

PK VITRECTOMY 1,272.60 C/S MISC SURG PKS/GOWNS - TRY TRACH 71.40 AW ANS 432.60 AW NASL 191.10 CONCHA W/SOL 40.95 CYL O2 E 257.25 HD GEAR CPAP 259.35 HL ENDO T 214.20 INCENTIVE SPIRO 170.10

NEB LG RESV 275.10 METER PEK FLO 334.95 MSK CPAP 349.65 MSK NASAL CPAP 418.95 TB ENDTRACH 641.55 TB ET RAE 87.15 TB LRYNX 145.95 TB TRACH RUSCH 520.80

TB TRACH DISP 348.60 TB TRACH XLT 297.15 TB TRACH SHILY 493.50

cdm

TB TRCH CUF SPK 536.55 TRACH BUTTON 558.60 ET TUBE MLT 5.0 113.40 ET TUBE REINFORCED 219.45 TUBE, NG SUMP 18FR 96.60 CATH, EPI PERIFIX 101.85 KIT, CATH EXCHANGE 147.00 CTH,AIRWYXCHNG 11FR100CM 384.30 KIT,INTRODUCER 7FR 472.50 TUBE, BRONCH 35FRL 453.60

TUBE ENDO CUFF W/BLOCKER 7.0MM 955.50 SET, ENDOTRACHEAL TUBE UNIBLOCKER 984.40 BLT SPEC 30.45 BOOT UNNAS 169.05 PILLOW ABDUCTION 488.25 PILLOW ABDUC SHL 700.35 SPPRT LUMB/SAC 286.65 BRCE WRIST 257.25

SPLNT ARTH 344.40 SPLNT FUNCTION 354.90 SPLNT CATG A 260.40

SPLNT CATG B 127.05 SPLNT CATG D 310.80 SPLNT CATG E 480.90 COLLAR CERV A/S 375.90 COLLAR CERV FM 161.70 FRAME ANDREWS 466.20 HALTER HD A/S 296.10 STRAP, ANKLE DISTRACTOR 349.30

PANNUS RETENTION STRAP 42.00 SHOE BUNNY BOOT 295.05 SLING & SWATH 191.10 SLING IMOBL A/S 586.95 SPLNT HAND A/T 191.10 TRAC BOOT LRG 287.70 TRAC TOWER USE 864.15 SLEVE KNEE COMP 481.95 SLEVE TH EX LGE 708.75 AID TOILET TISSUE 267.75

AID TOILET TONGS 144.90 BRCELT WANDR GRD 418.95 BRSH SUCT DENTUR 144.90 CUFF PUSH 365.40 FM HAND EXERCISE 381.15 GLV W/C 203.70 HLDR UTENSL 129.15 LIFT LEG 276.15

MIRR QUAD INSPCT 303.45 SCISSORS LOOP 303.45 SCOOP CATH & ROD 1,031.10

cdm

SUCTION DENT BRSH 144.90 SUPP FOAM ARM 243.60 MISC CENTRAL SUPPLY CONVERSION - BASIC METABOLIC PANEL 296.10 BMP ION CAL 247.80 COMP METABOLIC PANEL 371.70 ELECTROLYTE PANEL 162.75 HEPATIC FUNCTION PANEL 241.50 LIPID PANEL 346.50 RENAL FUNCTION PANEL 283.50

KETONES SERUM QUANT 174.30 ALBUMIN SERUM 128.10 AMMONIA 169.05 AMYLASE URINE 219.45 AMYLASE 182.70 BILIRUBIN TOTAL 155.40 BTYP NATRIURETC PEPTIDE 252.00 BILIRUBIN DIRECT 136.50

BLD UREA NITROGEN QUAN 174.30 CARCINOEMBRYONIC AG 202.65 CALCIUM 24HR URINE 219.45

CALCIUM URINE QUAN 191.10 CA, IONIZED 220.50 CALCIUM 129.15 CHLORIDE 143.85 CHOLESTEROL TOTAL 76.65 DIRECT LDL 114.45 CK MB FRACTION 235.20 CARBON DIOXIDE 143.85

CORTISOL TOTAL 280.35 CREATINE KINASE TOTAL 171.15 CREATININE 24HR URINE 219.45 CREATININE CLEARANCE 241.50 CREATININE BLOOD 96.60 CREATININE URINE 191.10 C-REACTIVE PROTEIN 153.30 PROTN SPINAL FLD SEMI QN 140.70 DIGOXIN 278.25 PHENYTOIN TOTAL 195.30

ESTRADIOL 303.45 FERRITIN 267.75 GLUCOSE BLD BY MONIT DEV 157.50 FOLIC ACID 178.50 GGT 207.90 GLUCOSE TOLERANCE 3SPEC 171.15 GTT EA ADD >3SPEC 72.45 GLUCOSE POST DOSE 78.75

GLUCOSE QUANT 160.65 HBS ANTIGEN 304.50 GONADTOPN CHORNC(HCG)QNT 109.20

cdm

CHOLESTEROL HDL 114.45 HEMOGLOBIN GLYCATED 217.35 IRON 164.85 LACTATE(LACTIC ACID) 174.30 LDHLACTIC DEHYDROGENASE 166.95 LEUKOCYTE ALKAPHSPHTASE 241.50 LIPASE 194.25 MAGNESIUM 163.80 MAGNESIUM URINE 24HR 219.45 MAGNESIUM URINE 191.10

MYOGLOBIN SERUM 312.90 OSMOLALITY BLOOD 245.70 OSMOLALITY URINE 245.70 PHOSPHORUS URINE 24 HR 219.45 PHOSPHORUS 166.95 PHOSPHORUS URINE 191.10 PHOSPHATASE ALKALINE 174.30 POTASSIUM SERUM 143.85

POTASSIUM URINE 185.85 POTASSIUM 24HR URINE 219.45 PREALBUMIN 189.00

PSA TOTAL 233.10 PARATHORMONE 274.05 PROTEIN URINE RANDOM 168.00 PROGESTERONE 303.45 PROTEIN URINE QUAN 24 HR 219.45 PROTEIN TOTAL 133.35 PROSTATE CANCER SCREEN 126.00 TRANSTERASE AST(SGOT) 108.15

TRANSAMINASESGPT (ALT) 106.05 SODIUM URINE 171.15 SODIUM 24HR URINE 219.45 TRIIODTHYRN (T3) UPTAKE 101.85 THYROXINE TOTAL 202.65 IRON BINDING CAPCTY 227.85 THYROXIN FREE 304.50 TRIGLYCERIDES 141.75 TROPONIN I 250.95 TROPONIN SCREEN 363.30

TSH 219.45 UREA NITROGEN 24HR URINE 219.45 UREA NITROGEN URINE 191.10 URIC ACID BLOOD 128.10 CYANOCOBLMN(VIT B12) 194.25 HEMATOCRIT AUTOMATED 54.60 HEMATOCRIT ISTAT 48.30 BLOOD HEMOGLBN 54.60

CBC WITHOUT DIFF 158.55 CBC/PLT/AUTO DIFF (5) 154.35 DIFF MANUAL 54.60

cdm

PLATELET COUNT (AUTO) 115.50 PLATELET COUNT (MAN) 216.30 RETIC COUNT FLOW CYTO 132.30 RETICULOCYTE CNT, MANUAL 143.85 WBC AUTO 56.70 CELL COUNT MISC BODY FLD 165.90 CELL COUNT MISC W/DIFF 207.90 NASAL SMEAR EOSINOPHILES 182.70 SEDIMENTN RATENONAUTO 147.00 SMEAR MALARIA 196.35

CRYST ID BODY FLD EX URN 117.60 BLEEDING TIME 126.00 FDP DDIMER SQNT OR QUAL 189.00 FIBRINOGEN ACTIVITY 239.40 PROTHROMBIN TIME 160.65 PTT PLASM 218.40 ACTIVATED CLOTTING TIME 288.75 URINE W/O MICRO AUTO 58.80

UA AUTO W/MICRO 108.15 URINALYSIS MICRO ONLY 69.30 UA SPEC GRAV NON AUTO 48.30

URINE SINGLE ITEM 51.45 BILE PIGMENTS URINE 48.30 URINALYSIS CHEMICAL QUAL 43.05 HEMOSIDERIN QUAL 163.80 PH BODY FLUID EXCEPT BLD 47.25 SPGR EXCEPT URINE 51.45 UROBILINOGN URIN SEMI QN 113.40 RBC ANTIBODIES SCREEN 244.65

ANTIBDY IDENT RBC EA PNL 292.95 RBC AG EXCPT ABO/RHO EA 165.90 BLD TYP AG SCR EA UNIT 175.35 BLD TYPE RHO(D)ONLY 73.50 BLD TYPE ABO ONLY 135.45 COLD ANTIBODY SCREEN 244.65 COLD AGGLUTINATN TITER 143.85 COLD AGGLUTININE SCREEN 50.00 COMP TST EA UT INCUB TCH 239.40 COOMBS DIRECT 73.50

DIRECT COOMBS POLY 73.50 DIRCT CMBS C3 73.50 FFP THAWING, EA UNIT 60.00 RBC AUTO 56.70 COMP TST EA UT SPIN TECH 176.40 COMP TST EA UT AHG TECH 201.60 CRYOGLOBULINS QUAL 119.70 H FLU DIR OBSERVATN 138.60

HETEROPHILE AB SCREEN 163.80 PREGNANCY TESTTUBE 88.20 RHEUMATOID FACTOR QUAL 61.95

cdm

RHEUMATOID FACTOR QUANT 155.40 VDRL/RPR QUAL 128.10 STREP A ANTIGEN SCREEN 79.80 ANAEROBIC ID 131.25 BETA LACTAMASE 66.15 CDT A IA DIR 174.30 CRYPTOCOCCAL ANTIGEN 211.05 CULTURE OTHER SOURCE 151.20 CULT BLOOD AERO/ANAERO 241.50 CULTURE FLUID EX CSF 217.35

C.DIFFICILE TOXIN B 236.25 CULTURE FUNGI MOLD 105.00 CULTURE CAMPYLOBACTERIO 202.65 GIARDIA ANTIGEN 181.65 CRYPTOSPORIDIUM ANTIGEN 181.65 CULTURE CATH TIP 252.00 INFECTIOUS AGENT ANTIGEN DETECTION 181.65 CULT FUNGI ID ADD 241.50

CULTURE WOUND/ABCESS 224.70 CULTURE AEROBIC DEF ID 119.70 CULTURE ANAEROBIC ISOL 127.05

CULTURE CSF 216.30 CULTURE ENVIORNMTL 57.75 CULTURE EYE 254.10 CULTURE FUNGI BLOOD 265.65 CULTURE FUNGI ISOLT SKIN 265.65 CULTURE FUNGI OTHER 231.00 CULTURE GENITAL 153.30 CULTURE STOOL 178.50

CULTURE AFB 279.30 SMEAR AFB 173.25 CULTURE THROAT 177.45 STOOL FOR WBC 45.15 CULTURE TYPNG SEROLOGIC 93.45 CULTURE URINE COLONY CT 340.20 CULTURE TYPING 3.20 CULTURE VRE SCREEN 163.80 RESPIRATORY SYNCYTIAL VIRUS AG 215.25 CULTURE STREP SCREENING 151.20

VIBRIO CULTURE 194.25 STOOL ADD'L PATHOGEN ISOL/IDENT 194.25 CULTURE YERSINIA 202.65 EXAM MACRO PARASITE 74.55 EXAM MACRO ARTHROPOD 74.55 FAT STAIN FECES/URIN/ETC 163.80 INDIA INK PREP 102.90 KOH PREP 142.80

GC CULTURE 140.70 KINYOUN STAIN 157.50 GRAM STAIN 127.05

cdm

O&P DIR SMR CONC & ID 163.80 OCCULT BLD OTHR SOURCE 91.35 OCCULT BLD FECES ONE SPC 65.10 OCCULT BLD STL 13 91.35 EXAM PINWORM TP SITE 74.55 CULTURE SPUTUM 337.05 WET MOUNT/KOH OTHER SOURCE 74.55 SUSCEPTIBILITY STUDIES 53.55 SENSITVTY MIC 256.20 SHIGA TOXIN ANTI 181.65

MEAT FIBERS FECES 99.75 SUSCEPTIBILITY STUDIES DISK 53.55 HOMOGENIZATION TISSUE FOR CULTURE 26.25 ACETAMNOPHN QU 235.20 ALCOHOL ETHYL URINE 53.55 ALCOHOL (ETHANOL) 151.20 AMPHETAMINE QUAL 25.20 BARBITURATES QUAL 53.55

BENZODIAZEPINES QL 53.55 CARBAMAZAPINE 190.05 GENTAMYCIN 292.95

COCAINE QL 53.55 LITHIUM 127.05 OPIATES QUAL 53.55 PHENOBARBITAL 166.95 SALICYLATE 143.85 THC(MARIJUANA) QUAL 53.55 THEOPHYLLINE 279.30 TOBRAMYCIN 303.45

VALPROIC ACID 275.10 VANCOMYCIN 250.95 DRUGS OF ABUSE SCR 176.40 SPEC STAIN TRICHROME O&P 163.80 SPECIAL STAIN 231.00 DARK FIELD EXAM INC COLL 329.70 GLUCOSE BODY FLUID 126.00 URIC ACID OTHR SOURCE 200.55 SODIUM BLOOD 148.05 FROZEN BLOOD THAW UNIT 30.00

CAPILLARY PUNCTURE 72.45 VENIPUNCTURE 15.75 HANDLING FEE LABCORP* 5.25 LVL IV SURG PATH GROSS 45.15 BONE MARROW SMEAR INTRP 45.15 CYTOPATH SMEAR,OTHER SOURCE 63.00 CONSULT ADDITIONAL SITE EACH 24.15 CYTO FILTER PREPARATION/INTERP -

CONSULT INITIAL SITE 28.35 THIN PREP DIAGNOSTIC GYN 63.00 CONVENTIONAL DIAGNOSTIC GYN 63.00

cdm

THIN PREP NON-GYN 153.30 CYTO SMEAR 34.65 CYTO SMEAR >5 SLIDES 48.30 CYTO SPIN 70.35 IMMUNOHISTOCHEM EA ADDL 25.00 FINE NEEDLE INTERP 75.60 IMMUNOHISTOCHEMISTRY EACH 52.50 IMMUNOPEROXIDASE STAIN EACH 50.00 THIN PREP SCREEN GYN 63.00 CONVENTIONAL SCREEN GYN 63.00

IMMUNOHISTOCHEMISTRY STAIN 50.00 CYTO TOUCH PREP 27.30 QUICK STAIN 45.15 QUICK STAIN ADDITIONAL 12.60 SURGICAL PATHOLOGY LEVEL VI 269.85 SURGICAL PATHOLOGY LEVEL I 33.60 SURGICAL PATHOLOGY LEVEL II 35.70 SURGICAL PATHOLOGY LEVEL III 85.05

SURGICAL PATHOLOGY LEVEL IV 99.75 CONSULT/REPORT REFFERED SLIDES 51.45 CONSULT/REPT COMPREHENSIVE REVIEW 51.45

CONSULT DURING SURGERY 19.95 FROZEN SECTION 1ST TISSUE BLOCK 54.60 DECALCIFICATION PROCEDURE 49.35 FROZEN SECTION EACH ADDL BLOCK 28.35 SURGICAL PATHOLOGY LEVEL V 194.25 GROUP II SPECIAL STAINS 105.00 GROUP I SPECIAL STAINS 115.50 CYTO SMEARS OTHER SOURCE 81.90

HISTOLOGY PREPARATION 1.00 FRESH FROZEN PLASMA 24 114.35 FRESH FROZEN PLASMA SINGLE 114.35 PLATELET PHERESIS 892.80 RED BLOOD CELLS DEGLYCEROLIZED 674.40 CRYOPRECIPITATE 101.65 RED BLOOD CELLS 430.80 FRESH FROZEN PLASMA DOUBLE 218.30 FRESH FRZN PLASMA JUMBO 349.95 RED BLOOD CELLS LEUKOREDUCED 481.65

PLATELET PHERESIS LEUKOREDUCED 892.80 RED BLOOD CELLS AUTOLOGOUS 400.00 FRESH FROZEN PLASMA 24 PRODUCT 36.30 FRESH FROZEN PLASMA PRODUCT 38.10 PLATELET PHERESIS PRODUCT 559.00 RBC DEGLYCERIZED PRODUCT 774.40 CRYOPRECIPITATE PRODUCT 36.30 CRYOPRECIPITATE POOLED PRODUCT 423.50

FRESH FROZEN PLASMA MEDIUM PRODUCT 76.25 FRESH FROZEN PLASMA JUMBO PRODUCT 76.25 RBC LEUKOREDUCED PRODUCT 278.30

cdm

PLATELET PHERESIS LEUKOREDUCED PROD 532.40 AUTOLOGUS PRODUCT 419.25 MISC LAB CONVERSION - OCCULT BLD, FECAL IMMUNO TEST 79.00 MISC LAB - ALLERGEN IGE TREES, EA 4.29 ALLERGEN IGE FOOD, EACH 4.00 ALLERGEN FOOD SCREEN 5.71 ALLERGEN IGE GRASSES, EACH 4.00 ALLERGEN IGE WEEDS, EA 4.00

ALLERGEN IGE ZONE 19, EACH 3.86 ALPHA-1-ANTITRYPSIN,TOTAL 5.26 ANGIOTENSIN CONVERTING ENZ - ANGIOTENSIN CONVERTING ENZ CSF 24.30 ACETYLCHOL RECPTR BLKNG ABS 24.88 ACETYLCHOL RECPTR BINDING ABS 26.72 ACETYLCHOL RECPTR MODULATING ABS 80.00 ADRENOCORTICOTROPIC HORMONE 23.31

ADENOVIRUS AB 13.14 ANTIDIURETIC HORMONE 29.19 ALPHAFETOPROTEIN TM 7.29

ALDOLASE 2.85 ALDOSTERONE 18.40 AMIKACIN 13.14 AMIODARONE 20.16 AMEBIASIS AB 37.45 CYTOPLASMIC ANCA 2.43 PERINUCLEAR ANCA 2.43 ANTINUCLEAR AB 4.16

ATYP PERINUCLEAR ANCA 2.43 ANDROSTENEDIONE 72.90 ANTISTREPTOLYSIN O 3.95 ASPERGILLUS FUMIGATUS 7.27 ASPERGILLIUS FLAVUS 7.27 ASPERGILLIUS NIGER 7.26 ASPERGILLUS ANTIGEN 103.85 B PERTUSSIS IGG AB 116.75 B PERTUSSIS IGA AB 116.75 B PERTUSSIS DNA EA 52.09

BETA 2 MICROGLOBULIN 10.42 BCR/ABL1 MAJOR BREAKPOINT 196.97 BCR/ABL1 MINOR BREAKPOINT 195.00 B HENSELAE IGG AB 5.83 B HENSELAE IGM AB 5.83 B QUINTANA IGG AB 5.83 B QUINTANA IGM AB 5.82 BLASTOMYCES ABS 17.34

BRUCELLA IGG AB 12.61 BRUCELLA IGM AB 12.62 C1 ESTERASE INHIBITOR 9.21

cdm

CD4 CD3 RATIO PROFILE 50.00 COMPLEMENT C2 5.96 COMPLEMENT C3 4.20 COMPLEMENT C4 4.20 COMPLEMENT C5 31.50 CANCER ANTIGEN 125 8.33 CANCER ANTIGEN 15 3 11.66 CANCER ANTIGEN 19 9 10.42 CANCER ANTIGEN 27.29 10.51 CALCIUM IONIZED 7.89

CARDIOLIPIN IGG AB 10.82 CARDIOLIPIN IGM AB 10.82 CARDIOLIPIN IGA AB 10.82 CATECHOLAMINES PLASMA 26.29 CATECHOLAMINES URINE 19.75 CYCLIC CITRULLIN PEPTIDE 10.42 CENTROMERE B ABS 15.00 CERULOPLASMIN 5.03

COMPLEMENT TOTAL CH50 5.26 CHLAMDIA IGG ABS 13.14 C PNEUMONIAE IGG AB 37.20

C PNEUMONIE IGA AB 37.20 C PNEUMONIAE IGM AB 37.20 CHLAMYDIA PSITTACI IGG AB 98.50 CHLAMYDIA PSITTACI IGM AB 102.25 CHLORIDE 24 HR URINE 2.85 CREATININE URINE CHLORIDE 2.00 CREATININE URINE MICRO 4.00 CREATININE URINE 3.29

CHLORIDE RANDOM URINE 6.25 CLOZAPINE 16.65 CYTOMEGALOVIRUS IGG AB 5.83 CYTOMEGALOVIRUS IGM AB 5.83 CYTOMEGALOVIRUS PCR 129.02 CYTOMEGALOVIRUS PCR QNT 126.10 COCCIDIOIDES AB CF 40.00 COCCIDIOIDES AB ID 40.00 COCCIDIOIDES AB CSF 15.72 CORTISOL 24 HR URINE 11.39

COXSACKIE A7 IGG 22.50 COXSACKIE A9 IGG 22.50 COXSACKIE A16 IGG 22.50 COXSACKIE A24 IGG 22.50 COXSACKIE A7 IGM 32.50 COXSACKIE A9 IGM 32.50 COXSACKIE A16 IGM 32.50 COXSACKIE A24 IGM 32.50

COXSACKIE B1 AB 4.88 COXSACKIE B2 AB - COXSACKIE B3 AB 4.85

cdm

COXSACKIE B4 AB 4.85 COXSACKIE B5 AB 4.85 COXSACKIE B6 AB 4.85 C PEPTIDE 6.77 C PNEUMONIAE PCR 129.12 C REACTIVE PROTEIN HIGH SENS 7.22 CRYPTOCOCCAL AG CSF 10.74 CRYPTOCOCCAL AG 9.57 CRYPTOCOCCAL AB 23.00 COPPER 15.77

CYCLOSPORINE 16.65 CYSTATIN C 47.25 CYSTIC FIBROSIS PROFILE 108.14 CYSTICERCOSIS AB CSF 27.90 CYSTICERCOSIS AB SERUM 100.00 DHEA SULFATE 10.82 DIHYDROTESTOSTERONE 42.00 ANTI DNA (DS) ABS 7.29

DRUG SCREEN 61.65 EPSTEIN BARR VIRUS IGG AB 6.51 EPSTEIN BARR VIRUS IGM AB 15.00

EPSTEIN BARR NUCLEAR AG 29.26 EPSTIEN-BARR EARLY ANTIGEN AB IGG 15.00 ENDOMYSIAL IGA AB 12.48 ENTEROVIRUS PCR 103.98 ERYTHROPOIETIN 7.29 ESTRADIOL 21.50 ESTROGEN TOTAL 18.30 ESTRONE 20.00

ESTRIOL 15.11 ETHYLENE GLYCOL 16.82 FACTOR II DNA ANALYSIS 82.45 FACTOR V R2 DNA ANALYSIS 206.25 FACTOR VIII ACTIVITY 64.56 FACTOR V LEIDEN MUTATION 72.75 FOLATE HCT 7.23 FOLATE RBC 7.23 FOLLICLE STIMULATING HORMONE 6.65 G6PD RBC 4.38

G6PD QUANTITATIVE 4.38 GAD 65 AUTOANTIBODY 31.25 GASTRIN 9.21 GLOMERULAR BASMENT MEMEBRANE 29.79 GAMMA GLUTAMYL TRANSFERASE 2.85 GROWTH HORMONE 8.20 GIARDIA LAMBLIA AG 9.95 HELICOBACTER PYLORI IGG 12.80

HELICOBACTER PYLORI IGM 20.81 H1N1 PCR 112.50 HANTAVIRUS IGG 65.00

cdm

HANTAVIRUS IGM 65.00 HAPTOGLOBIN 6.79 HEPARIN INDUCED PLATELET 55.00 HEPATITIS ACUTE PANEL 19.04 HEPATITIS A ANTIB 4.66 HEPATITIS A IGM AB 4.66 HEPATITIS B CORE AB 4.94 HEPATITIS B CORE IGM AB 5.32 HEPATITIS BE AB 6.65 HEPATITIS BE AG 5.83

HEPATITIS B SURFACE AG 3.33 HEPATITIS B SURFACE AB 3.33 HEPATITIS B SURF AB QUANT 20.79 HEPATITIS C AB 5.73 HEPATITIS C GENOTYPE 187.22 HEPATITIS C PCR 119.89 HGB SOLUBILITY 7.00 HGB ELECTROPHORESIS 8.75

HISTOPLASMA MYCELIAL AB 8.33 HESTOPLASMA YEAST AB 8.33 HISTOPLASMA MYCELIAL ID AB 8.34

HISTOPLASMA CAPSULATUM 61.75 HIV 1,2 ANTIBODIES 6.79 HIV 1&2 ABS 16.00 HIV-1 RNA QUALITATIVE 56.78 HIV-1 RNA PCR 87.30 HIV 1&2 RAPID RESULT 16.00 HIV-1 REVERSE TRANSCRIPTASE 200.00 HIV DRUG SUSCEPTABILITY 136.00

HIV QUANTIFICATION 50.00 HIV 1/O/2 AG/AB 13.58 HIV 1 DIFFERENTIAL 19.40 HIV 2 DIFFERENTIAL 19.40 HUMAN LEUKOCYTE AB B27 22.47 HOMOCYSTEINE 29.10 BETA 2 GLYCOPROTEIN IGA AB 5.00 BETA 2 GLYCOPROTEIN IGG AB 5.00 HSP70 (ANTI-68KD) AB 100.00 BETA2 GLYCOPROTEIN IGM AB 5.00

HERPES SIMPLEX 1 VIRUS IGG 14.22 HERPES SIMPLEX 2 VIRUS IGG 17.88 HERPES SIMPLEX 1&2 VIRUS IGM 13.30 HERPES SIMPLEX 1 DNA PCR 51.65 HERPES SIMIPLEX 2 DNA PCR 51.65 HTLV I/II ABS 6.13 HEAVY METAL LEAD 20.81 HEAVY METAL LEAD URINE 10.00

HEAVY METAL ARSENIC 20.81 HEAVY METAL ARSENIC URINE 10.00 HEAVY METAL MERCURY 20.81

cdm

HEAVY METAL MERCURY URINE 10.00 ANTI-HU ANTIBODIES 29.45 IMMUNOGLOBULIN A 4.60 IMMUNOGLOBULIN D 9.16 IMMUNOGLOBULIN E 6.65 IMMUNOGLOBULIN G 4.60 INSULIN GROWTH FACTOR 15.63 IMMUNOGLOBULIN G QUANTITATIVE 4.09 IMMUNOGLOBULIN G SUBCLASS 1 12.50 IMMUNOGLOBULIN G SUBCLASS 2 12.50

IMMUNOGLOBULIN G SUBCLASS 3 12.50 IMMUNOGLOBULIN G SUBCLASS 4 12.50 ALBUMIN, CSF 17.25 IGG, SERUM 17.25 ALBUMIN, SERUM 17.25 IMMUNOGLOBULIN M 4.60 IGG, CSF 17.25 IMMUNOFIXATION 12.39

IMMUNOFIXATION URINE 22.50 INSULIN 4.16 INFLUENZA A PCR MODIFIER 59 112.50

INFLUENZA A/B PCR 225.00 JAK2 MUTATION ANALYSIS 202.53 KAPPA LIGHT CHAINS 20.00 LAMBDA LIGHT CHAINS 20.00 LEVETIRACETAM (KEPPRA) 18.75 LAMOTRIGTINE LAMICTAL 30.66 LASA 29.55 LEAD BLOOD 3.65

LEGIONELLA PNEUMOPHILA AB 13.14 LEGIONELLA URINE AG 20.81 LEPTOSPIRA IGM AG 50.00 LIPID PANEL 4.50 LIPOPROTEIN NMR 22.96 LUTENIZING HORMONE 9.86 LUPUS ANTICOAGULANT 30.00 LYME IGG AB 7.81 LYME IGM AB 7.82 LYME PCR 112.29

LYME IGG/IGM WESTERN BLOT 12.50 MYELIN ASSOCIATED GLYCOPROTEIN 29.45 MICROALBUMIN URINE 3.91 MYLELIN BASIC PROTEIN CSF 14.15 METANEPHRINES FRACTIONATED FREE 36.46 METANEPHRINES 24 HR URINE 21.90 METHOTREXATE 17.71 METHYMALONIC ACID 20.84

MYOGLOBIN 9.64 MYOGLOBIN URINE 13.14 MITOCHONDRIAL AB 8.76

cdm

METHYLENETETRAHYDROFOLATE REFUCTASE 81.16 MUMPS IGG AB 6.00 MYCOPLASMA PNUEMONIAE IGG 6.65 MYCOPLASMA PNEUMONIAE IGM 6.65 ANTI INTERMYOFIBRILLAR 7.86 NOROVIRUS GI GII PCR 81.16 OLIGOGLONAL BANDING 28.61 OXALATE URINE 104.00 P2Y12 150.00 PROCALCITONIN 180.00

PROSTATIC ACID PHOSPHATASE 4.23 PROTEIN TOTAL 3.66 PROTEIN ELECTROPHORESIS 4.41 PROTEIN TOTAL URINE 9.15 PROTEIN ELECTROPHORESIS 24 HR URINE 9.15 PROTEIN TOTAL URINE 3.50 PROTEIN ELECTROPHORESIS URINE 3.50 PHOSPHATIDYLSERINE IGA AB 23.00

PHOSPHATIDYLSERINE IGG AB 23.00 PHOSPHATIDYLSERINE IGM AB 23.17 PHOSPHOLIPIDS 9.52

PLATELET ANTIBODIES 121.00 PORPHOBILINOGEN URINE 2.96 PRIMIDONE 7.50 PHENOBARBITAL 7.49 PROCAINAMIDE 15.00 PROGESTERONE 9.16 PROLACTIN 7.49 PROTEIN C FUNCTIONAL 26.29

PROTEIN C ANTIGEN 35.05 PROTEIN S FUNCTIONAL 33.29 PROTEIN S ANTIGEN TOTAL 18.73 PROTEIN S ANTIGEN FREE 18.72 PROSTATE SPECIFIC ANTIGEN TOTAL 6.67 PROSTATE SPECIFIC ANTIGEN FREE 6.66 PARTIAL THROMBOPLASTIN TIME 7.45 PTH INTACT 5.73 Q FEVER IGG 17.40 QUINIDINE 12.62

RENIN ACTIVITY 14.15 RI ANTIBODIES 29.45 RIBOSOMAL P ABS 35.00 RNP ANTIBODIES 8.53 RAPID PLASMA REAGIN 3.11 RUBELLA IGG AB 4.85 RUBELLA IGM AB 9.99 RUBEOLA IGG AB 7.88

SALMONELLA TYPHI TOTAL 72.00 ANTI SARCOLEMMA 7.85 SCLERODERMA 70 ABS 11.46

cdm

SEROTONIN 21.47 SEX HORMONE BINDING GLOBULIN 17.53 SIROLIMUS (RAPAMUNE) 21.90 SMITH ANTIBODIES 8.54 SHIGRENS ANTI SSA 7.73 SJOGRENS ANTI SSB 7.73 SMOOTH MUSCLE AB 8.76 STRONGYLOIDES IGG AB 34.10 T CELLS HELPER CD4 30.00 TRIIODOTHYRONINE FREE 5.00

TRIIODOTHYRONINE REVERSE 21.90 TRIIODOTHYRONINE TOTAL 6.65 THYROIXIN FREE 64.00 TACROLIMUS 48.00 TESTOSTERONE TOTAL 6.65 TESTOSTERONE FREE 14.19 THRYOMBIN ACTIVITY 23.66 THYROGLOBULIN QUANTITATIVE 4.34

THYROGLOBULIN AB 8.11 CREATININE URINE 10.00 TOXOPLASMA IGG AB 8.32

TOXOPLASMA IGM AB 11.83 THYROID PEROXIDASE AB 5.73 TRANSFERRIN 5.50 THYROID STIMULATING IMMUNOGLOBULIN 49.77 TISSUE TRANSGLUTAMINASE 18.75 URIC ACID 24 HR URINE 2.85 URIC ACID, URINE 8.19 TRIGLYCERIDES 14.50

LIPOPROTEIN 14.50 VDRL CSF 4.82 VITAMIN B1 14.24 VITAMIN B6 21.90 VITAMIN D1, 25 17.00 VITAMIN D 25 HYDROXY 55.00 VMA 24 HR UNINE 10.82 VARICELLA ZOSTER IGG AB 8.32 VARICELLA ZOSTER PCR 216.74 WEST NILE VIRUS RT PCR 221.00

WEST NILE VIRUS IGG AB 15.70 WEST NILE VIRUS IGM AB 15.70 VONWILLEBRAND FACTOR AG 65.71 YO ANTIBODIES 29.45 BACTERIAL ORGANISM ID 12.61 FUNGAL ORGANISM ID 27.16 SMEAR AFB 10.76 AFB CONCENTRATION 8.88

CULTURE AFB 10.77 CULTURE CLOSTRIDIUM DIFFICILE 9.16 CULTURE CTYOMEGALOVIRUS 25.00

cdm

CULTURE TYPING 5.00 CULTURE CHLAMYDIA TRACHOMATIS 9.02 CULTURE FUNGAL BLOOD 10.85 CULTURE HERPES SIMPLEX 20.81 CULTURE LEGIONELLA 20.03 CULTURE MYCOPLASMA PNEUMONIAE 30.66 CULTURE MYCO UREAPLASMA 18.31 CULTURE VIRAL 39.29 C DIFFICILE TOXIN B 43.20 C DIFFICILE TOXIN GENE 80.00

SMEAR CRYPTOPORIDIUM 5.75 SMEAR ISOSPORA 5.75 CHLAMYDIA TRACHOMATIS NAA 17.71 NEISSERIA GONORRHOEAE NAA 17.71 HELICOBACTER PYLORI STOOL AG 32.86 OVA AND PARASITE CONCENTRATION 3.30 OVA AND PARASITE STAIN 3.30 LEGIONELLA PNEUMOPHILA DFA 35.05

MYCOBACTERIUM TUBERCULOSIS PCR 83.24 STREP PNEUMONIAE AB 31.04 STREP GRP B AG 31.04

AFB ID BY DNA PROBE 109.75 ORG ID BY SEQUENCING 250.00 MTB AST CONFIRMATION 21.66 MTB SUSCEP BROTH 351.00 TISSUE GRIND 45.00 MAC SUSCEP BROTH 156.00 NOCARDIA SUSCEPTIBILITY BR 173.25 RAPID GROWER SUSCEP 173.25

SLOW GROWER SUSCEP 165.00 CLOSTRIDIUM DIFFICILE CYTOTOXIN 43.20 CYTOTONIX B PRODUCTION 120.00 ASSAY TEST FOR BLOOD FECAL 79.00 QUANTIFERON TB GOLD 55.00 ALBUMIN BDY FLD 16.00 AMYLASE BDY FLD 29.00 BLD TYPE RHO(D)ONLY 15.00 CHOLESTEROL TOTAL 16.00 COCCIDIOIDES, CSF 26.00

CREATININE BDY FLD 16.00 CRYPTOCOCCAL AG 27.00 CULTURE AEROBIC DEF ID 26.00 CULTURE AFB 59.00 CULTURE TYP NUC ACID PER 21.00 FIBRINOLYSIS 92.00 FIBROGEN ACTIVITY 48.00 GLUCOSE BDY FLD 16.00

GRAM STAIN 24.00 HMOGLBN FETAL(KLEIHAUER) 256.00 HIV1 AG W/HIV 1&2 44.00

cdm

HERPES SIMPLEX VIRUS, PCR 75.00 LIPASE BODY FLUID 5.60 LDH BDY FLD 16.00 INFLUENZA PCR 75.00 MTB DNA BY PCR 165.00 P2Y12 62.00 PLATELET FUNCTION ASSAY 42.00 PLT AGGREGATE 62.00 PROTEIN OTHER SOURCE 35.00 ACTIVATED COAGULATION TIME 40.00

SENSITIVITY ETEST/EA AB 27.00 SICKLING OF RBC 18.00 SMEAR AFB 23.00 TB CONCENTRATE 6.00 QUANTIFERON GOLD TB 122.00 TISSUE GRIND FOR CULTURE 59.00 TRIGLYCERIDES FLD 16.00 URIC ACID OTHER SOURCE 6.16

MISC LAB - M TUBERCULOSIS PCR CSF 92.00 PATHOGEN DETECTION 60.00

MISC LAB - ANTIBDY IDENT RBC EA PNL 113.00 ANTIBODY IDENT COMPLEX 93.00 AG SCRN RGNT SER EA UNIT 71.00 BLD TYPE ABO ONLY 27.00 COOMBS DIRECT 23.00 RBC ANTIBODIES SCREEN 68.00 RBC ANTIBDY ELUTION EACH 132.00

BLD TYPE RHO(D) ONLY 27.00 RH PHENOTYPE 81.00 RBC ANTIGEN PATIENT 45.00 TITRATION EA AB 120.00 COMPAT UNIT SCREEN 82.00 ANTIBODY INHIBITION 73.00 CROSSMTCH IMMED SPIN 87.00 CROSSMTCH 37C 87.00 CROSSMTCH AHG 87.00 ENTEROVIRUS RNA QL RTPCR 200.00

HEMGLBN METHEMOGLBN QUAN 93.00 VARICELLA ZOSTER AB IGG 200.00 ENTEROVIRUS PCR CSF 190.00 HERPES SIMPLEX VIRUS PCR CSF 172.00 MISC LAB - CHLAMYDIA DNA AMP PROBE 20.00 GC DNA AMP PROBE 20.00 STONE ANALYSIS 35.00

ANTIBODY IDENTIFICATION 29.00 COLD AGGLUTININE SCREEN 30.00 COLD AGGLUTININE TITER 80.00

cdm

DIFFERENTIAL RED CELL ABSORPTION 34.50 HEMAGGLUT INHIBITION (HAI) 40.00 IRRADIATION BLOOD 30.00 BLOOD TYPING ABO 17.25 ANTIHUMAN GLOBULIN TEST 9.00 ANTIBODY SCREEN 23.50 ANTIBODY ELUTION RBO 58.00 RH (D) 8.50 RH PHENOTYPING 23.50 RBC ANTIGENS 52.00

ANTIBODY TITER 58.00 ANTIGEN COMPATIBILITY SCREENING 34.50 ANTIBODY INHIBITOR 34.50 PRETREATMENT WITH CHEM AGNTS 29.00 PRETREATMENT WITH ENZYMES 17.25 MULT SLEEP LATENCY TEST 1,612.80 POLYSOMNOGRAPHY 2,780.25 POLYSOMNOGRAPHY CPAP 4+ 3,857.70

ACEBUTOLOL 200MG CAP 5.25 ACEBUTOLOL 400MG CAP 5.25 ACETAMINOPHEN 325MG 5.25

ACETAMIN/DIPHENHYDRAMINE 1.00 ACETAZOLAMIDE 250MG 5.25 METHAZOLAMIDE 50MG 18.10 ACETAZOLAMIDE 500MG SEQ 5.25 ACYCLOVIR 200MG 5.25 ALBUTEROL TAB 2MG 3.15 ALBUTEROL REPETAB 4MG 5.25 ALBUTEROL 4MG 5.25

ALENDRONATE 5MG 13.65 ALENDRONATE 10MG 16.80 SIMETHICONE/SOD BICARB/CIT AC 5.25 ALENDRONATE 35MG 88.20 ALENDRONATE 70MG 82.95 ALFUZOSIN 10MG 10.35 ALISKIREN 300MG 12.60 ALLOPURINOL 100MG 5.25 ALLOPURINOL 300MG 5.25 ALPRAZOLAM .25MG 5.25

ALPRAZOLAM .5MG + TABLET 5.25 ALPRAZOLAM 1MG TABLET 5.25 AMANTADINE 100MG 5.25 AMILORIDE 5MG 5.25 AMINOCAPROIC ACID 500MG 16.80 AMINOPHYLLINE 100MG 3.15 AMINOPHYLLINE 200MG 5.25 AMIODARONE 200MG 18.90

DRONEDARONE 400MG+ 27.20 HYDROXYZINE HCL 50 5.60 AMITRIPTYLINE 10MG 5.25

cdm

AMITRIPTYLINE 25MG 5.25 AMITRIPTYLINE 50MG 5.25 AMITRIPTYLINE 75MG 5.25 AMITRIPTYLINE 100MG 5.25 AMITRIPTYLINE 150MG 5.25 AMLODIPINE 2.5MG 16.80 AMLODIPINE 5MG 16.80 AMLODIPINE 10MG 40.95 AMLODIPIN/BENAZEPR 5/10 13.65 AMLODIPIN/BENAZEPR 5/20 14.70

AMOXICILLIN/CLAV 250MG 17.85 AMOXICILLIN/CLAV 875MG 35.70 AMOXICILLIN/CLAV 500MG 35.70 AMOXICILLIN 250MG 5.25 AMOXICILLIN 500MG TABLET 5.25 AMPICILLIN 250MG 5.25 MISOPROSTOL 100 MCG 5.25 AMPICILLIN 500MG 5.25

MISOPROSTOL 200MCG 8.40 ANALGESIC OTC TAB/CAP 5.25 ALKA-SELTZER BLUE TB EFF 5.25

ASPIRIN 81MG 5.25 APREPITANT PER 5MG 358.70 CALCIUM CARB 500MG (TUMS) 1.00 ASCORBIC ACID 100MG 3.15 ASCORBIC ACID 500MG 5.25 ASPIRIN EC 165MG 5.25 ATORVASTATIN 20MG 17.85 ATTAPULGITE 750MG TAB 5.25

ADD LATER - AZATHIOPRINE 50MG 5.25 BENZOCAINE LOZEN 1.00 BETA CAROTENE 10000U 5.25 CALCIUM ACETATE 667MG 5.25 CALCIUM 250MG/VIT D 5.25 CAPECITABINE 500MG 45.15 CETYLPYRDN/BENZOC TR 18S 1.00 CEPASTAT 47.25 CHLORPHENIRAMINE 4MG 5.25

CYCLOPHOSPHAMIDE 25MG 16.80 CYCLOPHOSPHAMIDE 50MG 182.70 CYCLOSPORINE 25MG 15.75 NEORAL 25MG 1.65 CYCLOSPORIN 100MG CAP 25.20 SPRYCELL 70MG TAB 367.50 DICLOFEN/MISOPRO 75/.20 8.40 DIMENHYDRINATE 50MG 3.15

DIPHENHYDRA 25MG 5.25 LEUCOVORIN CALCIUM 50 11.55 DOCUSATE CA 240MG 5.25

cdm

DOCUSATE SOD 100MG 14.70 DOCUSATE SOD 250MG 5.25 RALTEGRAVIR 400 MG TAB 117.80 FAMOTIDINE 20MG 9.45 FERROUS GLUCONATE 324 MG TAB 5.25 FERROUS GLUCONATE 300MG 5.25 FERROUS SULF 160MG 5.25 FERROUS SULF 325MG 5.25 FERROUS SULFATE 200MG 5.25 FIBER 5.25

GLUCOSE 2.10 IBUPROFEN TAB 200MG 5.25 IBUPROFEN 400MG 5.25 IBUPROFEN 600MG 5.25 IBUPROFEN 800MG 5.25 IRON POLYSACCHAR 150MG 5.25 LAXATIVE OTC TAB/CAP 1.00 LOMUSTINE 10MG 31.50

LOMUSTINE 40MG 121.80 LOPERAMIDE 2MG 17.85 MAGNESIUM CHLORIDE 5.25

MAGNESIUM OXIDE 400MG 5.25 MAGNESIUM GLUCON 500MG 5.25 MERCAPTOPURINE 50MG 17.85 METHOTREXATE 2.5MG 18.90 METHYLCELLULOSE PKT 5.25 METHYLDOPA 125MG 3.15 ABACAVIR 300MG 6.30 MULTIVIT THERAP/MIN 5.25

MULTIVITAMIN CAP 5.25 MULTIVITAMINSM 5.25 MYCOPHENOLATE 250MG 17.85 CELLCEPT 200 MG/ML ORAL SUSPENSION 25.95 NIACIN 50MG 3.15 UBIDECARENONE(COENZYME Q10)100MGCAP 3.10 NIACIN 250MG 5.25 MELATONIN 3MG TABLET 5.25 NIACIN ER 500MG 5.25 NICOTINE RESN 2MG GUM EA 5.25

PSEUDOEPHED 30MG 5.25 PSEUDOEPHED 60MG 5.25 PYRIDOXINE 50MG 5.25 PYRIDOXINE 100MG 1.00 QUININE 200MG 5.25 QUININE 325MG 17.85 SIMETHICONE 80MG 1.00 SODIUM BICARBONATE 325MG 1.00

SODIUM BICARBONATE 650MG 1.00 SODIUM CL 1GM 5.25 SODIUM CL 1GM 5.25

cdm

THIAMINE 50MG 5.25 THIAMINE 100MG 5.25 SUDAFED 30MG 0.05 VITAMIN A 1000 U 5.25 VITAMIN B12 100MCG 5.25 VITAMIN D 400U 5.25 VITAMIN E 200IU 5.25 NEBIVOLOL 5+ 12.60 VITAMIN E 400IU 5.25 ACETAMIN 650MG/20.3ML 5.25

ACETAMINOPHEN 160/5ML ORAL CUP 6.35 APA 160MG PER 5ML+ 37.50 ALUM MG HYDROX SUSP 30ML 1.00 ALUMINUM HYDROXIDE 150ML 1.00 ALUMINUM HYDROXIDE 360ML 2.10 INFANT TYLENOL 160 MG PER 5 ML 32.75 MOEXIPRIL HCL 15+ 9.05 BENEFIBER 4GM PKT 9.45

NUTRISOURCE FIBER (BENEFIBER) 5.25 BISMUTH SUBCARD 015ML 2.10 NYSTATIN 100000 17.80

CITRATE MAGNESIUM 300ML 8.40 DEXTROMETHORPHANGUAIF 5.25 DIMENHYDRINATE LIQUID 3.15 DIPHENHYDRA 12.5MG/5ML 5.25 DOCUSATE 10MG/ML 17.85 ERGOCALCIFEROL 8000U/ML 39.90 ANTACID OTC TABS 0.05 FERROUS SULFATE 300 0.23

GLUCOSAMINE CAP 5.25 VARENICLINE TARTRATE 1+ 16.15 GUAIFENESIN 100MG/5ML 5.25 GUAIFENESIN DM 5ML 2.50 DEXTROMETHORPHAN POLISTIREX 70.10 IBUPROFEN 100MG/5ML CUP 5.25 IPECAC 30ML 16.80 KAOLINPECTIN 30ML 1.00 LAXATIVE OTC 030ML 1.00 LEVULOSE/FRUC 15ML 5.25

LOPERAMIDE 10ML 7.35 PRECOSE 50MG 0.85 MAGNESIUM SULF 16.80 PAREGORIC 5ML 3.15 PEPTOBISMOL 15ML 1.00 PSYLLIUM 7GM 56.70 PSYLLIUM PKT 2.10 SALIVA SUBST 120ML 31.50

SENNA SYRUP (SENNOSIDES 8.8MGPERTSP 5.60 SENNA SYRUP 176MG/5ML 0.60 SIMETHICONE 15ML 79.80

cdm

SORBITOL 70% 2.10 VITAMIN C 500MG/10ML 2.10 VITAMINS ADCSO 5.25 VITAMIN E 50U/ML 5.25 LAXATIVE 0-30ML 1.00 METHYLCELLU PKT 5.25 OTC ANALGESIC 5.25 OTC ANALGESIC 5.25 OTC LAXATIVE 1.00 DOCUSATE SODIUM 100 MG 1.00

VITAMIN B12 1000MCG TAB - VIT B12 250MCG 0.14 CYANOCOBALAMIN 100 MCG 5.25 ACETAMIN/CAFFEINE/BUTAL 16.80 ACETAMIN/ISOMETHEP/DIC 5.25 AMMONIUM ALUM POWDER 5.25 AMPRENAVIR 150MG 8.40 ANAGRELIDE 0.5MG 26.25

ANASTROZOLE 1MG 44.10 ABILIFY 15MG 57.35 ARIPIPRASOLE 5MG+ 41.20

ARIPIPRAZOLE 2 114.40 ARIPIPRAZOLE 10MG 48.30 ATAZANAIR 150MG 40.55 REYATAZ 200MG 114.15 STRATTERA 10MG 14.70 STRATTERA 18MG 14.70 STRATTERA 40MG 15.75 STRATTERA 60MG 15.75

ATENOLOL 100MG 5.25 ATENOLOL 25MG 5.25 ATENOLOL 50MG 5.25 ATORVASTATIN 10MG 16.80 ATORVASTIN 80MG TABLET 16.35 AZITHROMYCIN 250MG TABLET 30.45 BACLOFEN 10MG 5.25 PERPHENAZINE 8MG 8.65 BACLOFEN 20MG TAB 5.25 BALSALAZIDE 750MG 5.25

BENAZEPRIL 5MG 5.25 BENAZEPRIL 10MG 5.25 BENAZEPRIL 20MG 5.25 BENZONATATE 100MG 5.25 BENZTROPINE .5MG 5.25 BENZTROPINE 1MG 5.25 BETHANECHOL 10MG 5.25 BETAXOLOL 20MG 5.25

BICALUTAMIDE 50MG 85.05 BISOPROLOL 5MG 5.25 BISOPROLOL 10MG 5.25

cdm

BISOPROLOL/HCTZ 2.5/6.25 5.25 BISOPROLOL/HCTZ 5/6.25 5.25 BISOPROLOL/HCTZ 10/6.25 5.25 BROMOCRIPTINE 2.5MG 11.55 BUDESONIDE 3MG CAP 11.55 BUMETANIDE 1MG 5.25 BUMETANIDE 2MG 3.15 BUPROPION 75MG 5.25 BUPROPION 100MG 5.25 BUPROPION SR 100MG 7.35

BUPROPION 150MG SR KIT 13.65 BUSPIRONE 5MG 5.25 BUSPIRONE 10MG 8.40 BUSPIRONE 15MG 11.55 CALCITRIOL .25MCG 5.25 CALCITRIOL .5MCG 9.45 CANDESARTAN 8MG 5.25 CANDESARTAN 16MG 5.25

CAPTOPRIL 12.5MG 5.25 CAPTOPRIL 25MG 5.25 CAPTOPRIL 50MG 8.40

CARBAMAZEPINE 100MG 5.25 CARBAMAZEPINE ER 200MG 5.25 CARBAMAZEPINE 200MG 5.25 CARBIDOPA/LEVOD 10/100 5.25 CARBIDOPA/LEVOD 25/100 5.25 CARBIDOPA/LEVO 25/100CR 11.55 CARBIDOPA/LEVOD 25/250 5.25 CARBIDOPA/LEVOD 50/200 16.80

CARISOPRODOL 350MG 5.25 CARISOPRODOL/ASA 13.65 CARVEDILOL 3.125MG 16.80 CARVEDILOL 6.25MG 8.40 CARVEDILOL 12.5MG 8.40 CARVEDILOL 25MG 13.65 COREG CR (CARVED) 10MG 17.55 COREG CR (CARVED) 20MG 17.55 COREG CR (CARVED) 80MG 17.55 CEFADROXIL 500MG 15.75

ADD LATER - CEFUROXIME AXETIL 250MG 17.85 CEFUROXIME AXETIL 500MG 35.70 CEFADROXIL HYDRATE 500 3.80 CELECOXIB 100MG 16.80 CELECOXIB 200 MG 4.60 CEPHALEXIN 250MG 5.25 CEPHALEXIN 500MG 8.40

CHLORAMBUCIL 2MG 5.25 CHLORDIAZEPOXIDE 5MG 5.25 CHLORDIAZEPOXIDE 10MG 5.25

cdm

CHLORDIAZEPOXIDE 25MG 5.25 CHLOROQUINE 250MG 15.75 CHLOROQUINE 500MG 16.80 CHLOROTHIAZIDE 500MG 5.25 CHLORPROMAZINE PER 5 MG 5.25 CHLORPROMAZINE 25MG 5.25 CHLORPROMAZINE 50MG 5.25 CHLORPROMAZINE 100MG 5.25 CHLORPROMAZINE 200MG 5.25 CHLORPROPAMIDE 250MG 5.25

CHLORTHALIDONE 25MG 5.25 CHLORTHALIDONE 50MG 3.15 CHLORZOXAZONE 500MG 6.30 CILOSTAZOL 100MG 7.35 CINACALCET 30MG 47.25 CITALOPRAM 20MG 16.80 CIPROFLOXACIN 250MG 17.85 CIPROFLOXACIN 500MG 22.05

CIPROFLOXACIN 750MG 22.05 CLARITHROMYCIN 250MG 17.85 CLARITHROMYCIN 500MG 18.90

CLINDAMYCIN 150MG 17.85 CLINDAMYCIN 300MG 18.90 CLOMIPRAMINE 25MG 5.25 CLOMIPRAMINE 50MG 5.25 CLOMIPRAMINE 75MG 15.75 CLONAZEPAM .5MG 5.25 CLONAZEPAM 1MG 5.25 CLONAZEPAM 2MG 5.25

CLONIDINE .1MG 5.25 CLONIDINE .2MG 5.25 CLONIDINE .3MG 5.25 CLOPIDOGREL 75MG 16.80 TICAGRELOR(BRILINTA)90MG TAB 29.05 PLAVIX 300MG TAB 87.15 CLORAZEPATE CAP 3.75MG 3.15 CLORAZEPATE CAP 7.5MG 5.25 CLOZAPINE 25MG 5.25 CLOZAPINE 100MG 14.70

COLCHICINE TAB .6MG 5.25 COLESEVELAM 625MG 5.25 CONJUGATED ESTR .3MG 5.25 CONJUGATED ESTR .625MG 5.25 CONJUGATED ESTR .9MG 5.25 CONJUGATED ESTR 1.25MG 5.25 CYANOCOB/FA/PYRIDOX TAB 4.20 CYCLOBENZAPRINE 10MG 5.25

CYPROHEPTADINE 4MG 5.25 DANAZOL 100MG 11.55 DANTROLENE 25MG 5.25

cdm

DAPSONE 100MG 5.25 DEPSONE 25 MG TABLET 17.10 DIDANOSINE 400MG 48.30 DEMECLOCY TAB 150MG 24.15 DESIPRAMINE 25MG 3.15 DESIPRAMINE 50MG 5.25 DESMOPRESSIN .1MG 14.70 DESMOPRESSIN 4MCG/ML 10ML 502.45 DEXAMETHASONE .5MG 5.25 DEXAMETHASONE 1.5MG 5.25

DEXAMETHASONE 2MG 5.25 DEXAMETHASONE 4MG 5.25 DEXAMETHASONE 1MG 5.25 DIAZEPAM 2MG 5.25 DIAZEPAM 5MG 5.25 DICLOFENAC 50MG 5.25 DICLOFENAC 75MG 8.40 DICLOXACIL 250MG 17.85

DICYCLOMINE 10MG 5.25 AMYLASE/LIPASE/PROTEASE 8.40 PANCREASE MT16 10.65

DIGOXIN .125MG 5.25 DIGOXIN .25MG 5.25 DIGOXIN 250 MCG/5ML ORAL SOLN 20.10 DILTIAZEM 30MG 5.25 DILTIAZEM 60MG 5.25 DILTIAZEM 90MG 5.25 DILTIAZEM HCL 30 1.15 DILTIAZEM SR 90MG 5.25

DILTIAZEM SR 120MG 5.25 DILTIAZEM SR 60MG 5.25 DILTIAZEM CD 120MG 5.25 DILTIAZEM CD 180 MG 8.40 DILTIAZEM CD 240 MG 11.55 DILTIAZEM CD 300 MG 14.70 DIPHENHYDRAMINE 50MG 5.25 DIPHENOXYLATE/ATRP TAB 17.85 DIPYRIDAMOLE 25MG 5.25 DIPYRIDAMOLE 75MG 17.85

DIPYRIDAMOLE/ASA SR CAP 8.40 DISOPYRAMIDE 100MG 5.25 DISOPYRAMIDE 150MG 5.25 DISOPYRAMIDE CR 100MG 5.25 DISOPYRAMIDE CR 150MG 5.25 DISULFIRAM 250MG 3.15 DIVALPROEX NA 125MG 5.25 DIVALPROEX NA 250MG 5.25

DIVALPROEX NA 500MG 5.25 DIVALPROEX NA 500MG ER 7.35 DIVALPROEX NA 250MG ER 6.30

cdm

DOLASETRON 50MG 255.15 DOLASETRON 100MG 347.55 DONEPEZIL 5MG 35.70 DONEPEZIL 10MG 26.25 DOXAZOSIN 2MG 5.25 DOXAZOSIN 4MG 5.25 ERGOTAMINECAFF 5.25 LACTOBACILLUS CAPS 5.25 SACCHAROMYCES BOULARDII 250 31.50 LAMIVUDN/ZIDOVUDN150/300 66.15

LIOTHYRONINE 5MCG 5.25 LIOTHYRONINE 25MCG 5.25 PHENOBARB/BELLAD EXT 5.25 VALPROIC SPRINKLE 125MG 5.25 VALPROATE 250MG 17.85 ATOVAQUONE 750/5 5ML 66.15 PENTAMIDINE ISETHIONATE 300+ 597.25 AZITHROMYCIN200/5 22.5ML 689.85

BOWEL EVACUANT 4000ML 1.00 CARBAMAZEPINE 200MG/10ML 14.70 LEVOCARNITINE 120ML 32.55

VALPROATE 250MG/5ML 33.60 VALPROIC ACID 250MG/5ML 6.30 DOXEPIN 10MG 5.25 DOXEPIN 25MG 5.25 DOXEPIN 50MG 17.85 DOXYCYCLINE 100MG 5.25 DOXYCYLINE IV 100 116.85 DOXYCYCLINE 100 MG CAPSULE 2.40

DULOXETINE 20MG 14.70 DULOXETINE 30MG 15.75 CYMBALTA(DULOXE) 60MG 17.65 DUTASTERIDE .5MG CAP 13.65 SUSTIVA 600MG/TAB 59.85 EFAVIRENZ 200MG 26.25 ENALAPRIL 2.5MG 5.25 ENALAPRIL 5MG 5.25 ENALAPRIL 10MG 5.25 ENALAPRIL 20MG 8.40

EMTRICITABINE/TENOFOVIR 40.90 EMTRIVA 200MG CAP 53.55 ENTACAPONE 200MG 9.45 EPLERENONE 25MG 16.80 ERGOTAMINE/BELL/PB 16.80 ERYTHROMYCIN BASE 250MG 5.25 ERYTHROMYCIN BASE 333MG 17.85 ERYTHROMYCIN BASE 500MG 17.85

ERYTHROMYCIN STEAR 250MG 5.25 ERYTHROMYCIN STEAR 500MG 17.85 ESOMEPRAZOLE 20MG 19.95

cdm

ESOMEPRAZOLE 40MG 19.95 ESCITALOPRAM 10MG 10.50 ESTRADIOL 1MG 5.25 ESTROG1.25/METHYLTST 2.5 5.25 ESTRONE SULFATE 1.25MG 3.15 ESTROPIPATE 0.625MG 3.15 ESTROPIPATE 1.25MG 3.15 ETHACRYNIC ACID 25MG 5.25 ETHAMBUTOL 400MG 5.25 EXEMESTANE 25MG 28.35

EZETIMIBE 10MG 12.60 ETODOLAC 200MG 3.15 ETODOLAC 300MG 5.25 ETIDRONATE 200MG 15.75 FAMCICLOVIR 500MG 57.75 FELBAMATE 600MG 5.25 FELODIPINE 2.5MG 7.35 FELODIPINE 5MG 5.25

FELODIPINE 10MG 9.45 FENOFIBRATE MIC 48MG 5.25 FEXOFENADINE 180MG 11.55

FEXOFENADINE 60MG 5.25 FEXOFEN/PSEUDO 60120 6.30 FINASTERIDE 5MG 11.55 FINASTERIDE 1MG 7.35 FLAVOXATE 100MG 3.15 FLECAINIDE 50MG 5.25 FLECAINIDE 100MG 5.25 FLUCONAZOLE 100MG 35.70

FLUCONAZOLE 200MG 57.75 FLUCONAZOLE 150MG 134.40 FLUCYTOSINE 500MG 31.50 FLUDROCORTISONE .1MG 5.25 FLUOXETINE 10MG 17.85 FLUOXETINE 20MG 18.90 FLUPHENAZINE 2.5MG 5.25 FLUPHENAZINE 1MG 3.15 FLUPHENAZINE 5MG TAB 16.80 FLURAZEPAM 15MG 5.25

FLUTAMIDE 125MG 5.25 FLUVASTATIN 20MG 5.25 FLUVASTATIN 40MG 16.80 FOLIC ACID 1MG 5.25 FLUVOXAMINE 50MG 14.70 FLUVOXAMINE 100MG 15.75 FLUVASTATIN XL 80MG 9.45 FOSINOPRIL 10MG 5.25

FOSINOPRIL 20MG 5.25 FOSINOPRIL 40MG 14.70 FUROSEMIDE 20MG 5.25

cdm

FUROSEMIDE 40MG 5.25 FUROSEMIDE 80MG 5.25 GABAPENTIN 600MG 13.65 GABAPENTIN 100MG 5.25 GABAPENTIN 300MG 5.25 GABAPENTIN 400MG 11.55 GALANTAMINE 4MG 11.55 GALANTAMINE 8MG 12.60 GEMFIBROZIL 600MG 17.85 GLIMEPIRIDE 1MG 5.25

GLIMEPIRIDE 2MG 5.25 ALISKIREN 150MG 11.55 GLIMEPIRIDE 4MG 5.25 GLIPIZIDE XL 2.5MG 5.25 GLIPIZIDE 5MG 5.25 GLIPIZIDE XL 5MG 5.25 GLIPIZIDE 10MG 5.25 GLIPIZIDE XL 10MG 5.25

GLYBURIDE 1.5MG MICRONIZ 3.15 GLYBURIDE TAB 2.5MG 3.15 GLYBURIDE TAB 5MG 5.25

GLYCOPYRROLATE 1MG 5.25 GLYCOPYRROLATE FORTE 5.25 GRANISETRON 1MG TAB 234.15 GRISEOFULVIN UMICRO 250 5.25 GUAIFENESIN 200MG 3.15 GUAIFENESIN 600MG 5.25 GUANFACINE 1MG 5.25 HALOPERIDOL .5MG 5.25

HALOPERIDOL 1MG 5.25 HALOPERIDOL 2 MG 5.25 HALOPERIDOL 5MG 5.25 HYDRALAZINE 10MG 5.25 HYDRALAZINE 25 MG 5.25 HYDRALAZINE 50MG 5.25 HYDRALAZINE 100MG 3.15 HYDROCHLOROTHIA 25MG 5.25 HYDROCHLOROTHIA 50MG 5.25 HYDROCORTISONE 5MG 5.25

HYDROCORTISONE 10MG 5.25 HYDROCORTISONE 20MG 5.25 HYDROXYCHLOROQUINE200MG 17.85 HYDROXYUREA 500MG 5.25 HYDROXYZINE 10MG 5.25 HYDROXYZINE 100MG TAB 16.80 HYDROXYZINE PAMOATE 50MG 17.85 HYDROXYZINE PAMOATE100MG 16.80

HYOSCYAMINE .125MG 5.25 HYOSCYAMINE LA .375MG 5.25 IMATINIB 100MG TABLET 467.15

cdm

IMIPRAMINE 10MG 5.25 IMIPRAMINE 25MG 5.25 IMIPRAMINE 50MG 16.80 INDAPAMIDE 2.5MG 3.15 INDAPAMIDE 1.25MG 3.15 INDOMETHACIN 25MG 17.85 INDOMETHACIN 50MG 17.85 INDOMETHACIN SR 75MG 17.85 IRBESARTAN 150 MG 16.80 IRBESARTAN 300 MG 9.45

ISONIAZID 100MG 5.25 ISONIAZID 300MG 5.25 ISOSORBIDE 5MG 5.25 ISOSORBIDE 10MG 5.25 ISOSORBIDE 20MG 5.25 ISOSORBIDE MONO 20MG 5.25 ISOSORBIDE MONONITR 30MG 9.45 ISOSORBID MONONI ER 60MG 5.25

ISOSORBIDE SL 5MG 5.25 ISRADIPINE 2.5MG 3.15 ISRADIPINE 5MG 5.25

ITRACONAZOLE 100MG 33.60 KETOCONAZOLE 200MG 16.80 KETOROLAC 10MG 16.80 LABETALOL 100MG TAB 5.25 LABETALOL 200MG TAB 5.25 LAMIVUDINE 100MG 24.15 LAMIVUDINE 150MG 36.75 LAMOTRIGINE 25MG 17.85

LAMOTRIGINE 100MG 30.45 LURASIDONE (LATUDA) 40 MG TAB 211.35 PREVACID 15MG TAB 21.00 PREVACID 30MG TAB 21.00 LEFLUNOMIDE 10MG 35.70 LEFLUNOMIDE 20MG 35.70 LETROZOLE 2.5MG 42.00 ADD LATER - LEVETIRACETAM 250MG 7.35 LEVETIRACETAM 500MG 8.40

LEVOFLOXACIN 250MG 33.60 LEVOFLOXACIN 500MG 40.95 LEVOTHYROXIN .088MG 5.25 LEVOTHYROXIN .025MG 5.25 LEVOTHYROXIN .05MG 5.25 LEVOTHYROXIN .075MG 5.25 LEVOTHYROXIN .15MG 5.25 LEVOTHYROXIN .112MG 5.25

LEVOTHYROXIN .125MG 5.25 LEVOTHYROXIN .1MG 5.25 LEVOTHYROXIN .175MG 5.25

cdm

LEVOTHYROXIN .2MG 5.25 LEVOTHYROXIN .3MG 5.25 LINEZOLID 600MG TABLET 326.55 LISINOPRIL 5 MG 5.25 LISINOPRIL 10MG 5.25 LISINOPRIL 20 MG 5.25 LISINOPRIL 40MG 16.80 LISINOPRIL/HCTZ 20/12.5 5.25 LISINOPRIL/HCTZ 20/25 5.25 LITHIUM CARBONATE 300MG 5.25

LITHIUM CARB 150MG 5.25 LOPINAVIR/RITONAVIR TAB 29.40 LOSARTAN HCTZ 50/12.5 5.25 PHENYLEPHRN/GUAF 30/600 5.25 POTASSIUM CITRATE 10MEQ 3.15 POTASSIUM CL 10MEQ 5.25 POTASSIUM CL 8MEQ 5.25 SAQUINAVIR 200MG 18.90

DOXEPIN 10MG/ML 5ML 35.70 DOXYCYCLINE 25MG/5ML 60M 5.25 ERYTHROMY ET 200MG/5ML 5.25

FUROSEMIDE 10MG/ML 60ML 44.10 FUROSEMIDE 40MG/5ML UD 5.25 GUAIFENESINPHENYLDEXTR 5.25 ITRACONAZOLE 10M/M 150ML 564.90 MISC CODE ORAL 10 10.50 MISC CODE ORAL 30 31.50 MISC CODE ORAL 70 73.50 MISC CODE ORAL 150 157.50

MISC ORAL 300 315.00 ACYCLOVIR 800MG 16.80 ALBUTEROL 8MG SR 5.25 AMOXAPINE 50MG 17.85 AMOXICILLIN 250MG 5.25 CHLORPROPAMIDE 100MG 5.25 CLOTRIMAZOLE TROCHE 5.25 CORTISONE 25MG 5.25 NICARDIPINE SA 5.25 CARDENE SR 60 15.75

CARDENE SR 45 5.25 ACTIVATED CHARCOAL 50GM TUBE 105.20 DICLOFENAC XR 100MG 15.75 DICLOFEN/MISOPRO 50/.20 8.40 DIPYRIDAMOLE 50MG 16.80 DISULFIRAM 250MG 3.75 ERYTHROMY ET 250MG 5.25 ERYTHROMY ET 400MG 16.80

ETOPOSIDE 50MG 448.35 ETIDRONATE 400MG 33.60 FLUCYTOSINE 250MG 5.25

cdm

LUVOX 25MG 1.00 GANCICLOVIR 250MG CAP 35.70 RIBAVIRIN 200 63.00 GUANFACINE 2MG 5.25 HYDROXYZINE PAMOATE 25MG 5.25 IRON POLYSACC/B12/FA CAP 5.25 ISOSORBIDE 40MG TAB 5.25 ISOSORBIDE SR 40MG 5.25 LEVODOPA 500MG 3.15 SYNTHROID 0.137MG 5.25

LIOTHYRONINE 50MCG 3.15 LITHIUM 300MG 5.25 LITHIUM CARBONATE 450MG 5.25 LOMUSTINE 100MG 208.95 LORATADINE 10MG 16.80 LORATADINE/PSE 5/120 8.40 LORATADINE/PSE 10/240 15.75 LORAZEPAM .5MG 5.25

LORAZEPAM 1MG TABLET 5.25 LOSARTAN 50MG 16.80 LOSARTAN 25MG 5.25

LOVASTATIN 20MG 16.80 LOVASTATIN 10MG 7.35 LOXAPINE 10MG 5.25 LOXAPINE 25MG 5.25 AMITIZA (LUBIPROS)24MCG 13.80 MECLIZINE TAB 12.5MG 5.25 MECLIZINE TAB 25MG 5.25 MEGESTROL 20MG 5.25

MEGESTROL 40MG 5.25 MELOXICAM 7.5MG 11.55 MELPHALAN 2MG 5.25 MEMANTINE 5MG 9.45 MEMANTINE 10MG 9.45 MEPROBAMATE 200MG 3.15 MEPROBAMATE 400MG 5.25 MESALAMINE 400MG TAB 5.25 MESALAMINE DR (DELZICOL) 400MG CAP 12.90 MESALAMINE 250MG CAP 5.25

METAPROTERENOL 10MG 5.25 METAXOLONE 400MG 5.25 METAXOLONE 800MG 12.60 METFORMIN 500MG 5.25 METFORMIN 850MG 16.80 METFORMIN XR 500MG 5.25 METHENAMINE 500MG 3.15 METHIMAZOLE 5MG 5.25

METHIMAZOLE 10MG 5.25 METHOCARBAMOL 500MG 5.25 METHOCARBAMOL 750MG 5.25

cdm

METHYLDOPA 250MG 5.25 METHYLDOPA 500MG 5.25 METHYLERGONOVIN .2MG 5.25 METHYLPRED 2MG 3.15 METHYLPRED 16MG 35.70 METHYLPRED 4MG 5.25 METHYLPRED DOSEPAK 259.35 METOCLOPRAMIDE 5MG 5.25 METOCLOPRAMIDE 10MG 5.25 METOLAZONE 10MG 5.25

METOLAZONE 2.5MG 5.25 METOLAZONE 5MG 5.25 METOPROLOL 50MG 5.25 ASPIRIN 325MG TAB 0.08 ASPIRIN EC 325MG 5.25 METOPROLOL 25MG 2.10 METRONIDAZOLE 250MG 5.25 ALVIMOPAN 12MG 2,236.50

METRONIDAZOLE 500MG 5.25 MEXILETINE 150MG 5.25 MEXILETINE 200MG 5.25

MEXILETINE 250MG 5.25 MIDODRINE 2.5MG 8.40 MIDODRINE 5MG 16.80 MINOCYCLINE CAP 100MG 18.90 MIRTAZAPINE 15MG SOLTAB 13.65 MIRTAZAPINE 30MG 18.90 MIRTAZAPINE 15MG 16.80 MINOXIDIL 2.5MG 5.25

MODAFINIL 100MG 16.80 MODAFINIL 200MG 27.30 MINOXIDIL 10MG 5.25 MISOPROSTOL 100MCG 5.25 MISOPROSTOL 200MCG 5.25 MOEXIPRIL 7.5MG 5.25 MONTELUKAST 10MG 13.65 MOXIFLOXACIN 400MG 42.00 MYFORTIC 360MCG 27.30 NABUMETONE 500MG 16.80

NABUMETONE 750MG 16.80 NADOLOL 20 MG 5.25 NADOLOL 40MG 16.80 NAPROXEN 250MG 5.25 NAPROXEN 275MG 16.80 NAPROXEN 375MG 17.85 NAPROXEN 500MG 17.85 NAPROXEN DS 550MG 16.80

NATEGLINIDE 60MG 5.25 NATEGLINIDE 120MG 5.25 NEFAZODONE 50MG 6.30

cdm

NEFAZODONE 100MG 6.30 NELFINAVIR 250MG 36.75 NEOMYCIN 500MG 17.85 NEVIRAPINE 200MG 31.50 NICARDIPINE SR 30MG 13.65 NICARDIPINE 20MG 5.25 NICARDIPINE 30MG 5.25 METOPROLOL TARTRATE 100MG 5.25 NIFEDIPINE 10MG 5.25 NIFEDIPINE 20MG 16.80

NIMODIPINE 30MG 47.25 NISOLDIPINE 10MG 5.25 NISOLDIPINE 20MG 5.25 NITROFURANTOIN TAB 50MG 5.25 NITROFURANTOIN CAP 100MG 17.85 NITROFURANTOIN/NITRO 16.80 NITROGLYCERIN CAP 2.5MG 5.25 NITROGLYCERIN CAP 6.5MG 5.25

NITROGLYCERIN SL .3MG 1.00 NITROGLYCERIN SL .4MG 5.25 NITROGLYCERIN SL .6MG 1.00

NORTRIPTYLINE 10MG 3.15 NORTRIPTYLINE 25MG 5.25 SPACER AEROCHAMBER 226.80 NORTRIPTYLINE 50MG 5.25 ONDANSETRON 4MG ODT 94.50 ONDANSETRON 8MG ODT 180.60 ONDANSETRON 4MG TAB 99.75 ONDANSETRON 8MG TAB 177.45

OLANZAPINE 5MG 18.90 OLANZAPINE 7.5MG 31.50 OLANZAPINE 2.5MG 16.80 OSELTAMIVIR 75MG 24.15 OSELTAMIVIR PHOSPHATE 30+ 49.90 OSEL TAMIVIR PHOSPHATE 45+ 49.90 OSELTAMIVIR 60MG PER 5ML 64.90 OSELTAMIVIR (TAMIFLU) 6MG/ML ORAL 13.90 OLANZAPINE ZYDIS 5MG 35.70 OLMESARTAN 20MG 6.30

BENICAR 5MG TAB 7.90 OMACOR 1GM/CAP 4.20 OXAPROZIN 600MG 16.80 OXAZEPAM 10MG 5.25 OXAZEPAM 15MG 5.25 OXAZEPAM 30MG 5.25 OXCARBAZEPINE 300MG 9.45 OXYBUTYNIN 5MG 5.25

OXYBUTYNIN EXT REL 5MG 13.65 OXYBUTYNIN EXT REL 15MG 14.70 PANTOPRAZOLE 40MG 17.85

cdm

ZEMPLAR 1MCG 31.50 PAROXETINE 10MG 17.85 PAROXETINE 20MG 17.85 PAROXETINE 30MG 17.85 PAROXETINE CR 12.5MG 17.85 PAROXETINE CR 25MG 13.65 PENICILLIN V POT 250MG 5.25 PENICILLIN V POT 500MG 17.85 POTASSIUM PHOSPHAT 1.45G 5.25 MISCELNEOUS ORAL LIQUID 5.25

ACTIV CHAR 50G/240ML SRB 79.80 PRASUGREL 10MG 41.20 CEFADROXIL 125MG/5ML 5ML 5.25 CEFADROXIL 250MG/5ML 5ML 17.85 CHLORAL HYDRAT 500MG/5ML 5.25 CHLORPROM CON 100M/M 1ML 43.05 COUGH/COLD PREP 05ML 3.15 MAGIC MOUTHWASH 44.10

METAPROTERENOL 10MG/5ML 3.15 POLYETHYLENE GLYCOL255GM 71.40 DARIFENACIN HYDROBOMIDE 15+ 31.65

ACHAR 50G/240ML 79.80 RISPERIDONE .25MG 15.75 RISPERIDONE .5MG 15.75 CON ESTROGENMET .625/5 5.25 CONJ ESTROG.625MEDROX2.5 5.25 ERGOCALCIFEROL 50000U 5.25 LEUCOVORIN CA 5MG 15.75 LEUCOVORIN 10MG 35.70

LEUCOVORIN CA 25MG 101.85 MEBENDAZOLE 100MG 15.75 IVERMECTIN 3 32.75 MEDROXYPROGEST 2.5MG 5.25 MEDROXYPROGEST 5MG 5.25 MEDROXYPROGEST 10MG 5.25 METHENAMINE ATR 3.15 NIFEDIPINE EXT REL 90MG 15.75 NIFEDIPINE EXT REL 60MG 13.65 NIFEDIPINE EXT REL 30MG 8.40

PENTAZOCINE/NALOXONE 5.25 PENTOSAN POLYSULF 100MG 14.70 PENTOXIFYLLINE 400MG 5.25 PERINDOPRIL 2MG 5.25 PERPHENAZINE 2MG 3.15 PERPHENAZNE/AMITRIP 4/25 5.25 PHENAZOPYRIDINE 100MG 5.25 PHENAZOPYRIDINE 200MG 17.85

PHENYTOIN 50MG 5.25 PHENYTOIN 100MG 5.25 PHENYTOIN 30MG 5.25

cdm

PHYTONADIONE 5MG 5.25 PILOCARPINE TAB 5MG 15.75 PINDOLOL 5MG 3.15 PINDOLOL 10MG 5.25 PIOGLITAZONE 15MG TAB 17.85 PIROXICAM 10MG 5.25 PIROXICAM 20MG 17.85 POTASSIUM CITRATE 540MG 2.10 PRAVASTATIN 10MG 16.80 PRAVASTATIN 20MG 17.85

PRAMIPEXOLE .25MG 14.70 PRAMIPEXOLE .125MG 5.25 PRAMIPEXOLE 1MG 13.65 PRAMIPEXOLE 1.5MG 13.65 PRAZOSIN 1MG 5.25 PRAZOSIN 2MG 5.25 PRAZOSIN 5MG 17.85 PREDNISOLONE 5MG 5.25

PREDNISONE 1MG 5.25 PREDNISONE 5MG 5.25 PREDNISONE 10MG 5.25

PREDNISONE 20MG 5.25 PREGABALIN 25MG CAP 9.20 PREGABALIN 50MG CAP 8.40 PREDNISONE 50MG 5.25 PREGABALIN 75MG CAP 8.40 PRIMAQUINE PHOS 26MG 3.15 PRIMIDONE 50MG 5.25 PRIMIDONE 250MG 5.25

PROBENECID 500MG 5.25 PROBENECID/COLCHICINE 3.15 PROCAINAMIDE 500MG SR 5.25 PROCAINAMIDE 750MG SR 17.85 PROCAINAMIDE CAP 500MG 5.25 PROCHLORPERAZINE 5MG 5.25 PROCHLORPERAZINE 10MG 17.85 PROCHLORPERAZINE 25MG 16.80 QUINIDINE 200MG 5.25 QUINIDINE 300MG 5.25

SUCCIMER 100MG 35.70 SUTENT 50MG TAB 1,188.60 THEOPHYLLINE 400MG 5.25 THEOPHYLL SA 100MG 5.25 THEOPHYLLINE ANHYDROUS 200+ 2.35 THEOPHYLLINE ANHYDROUS 300+ 31.50 THEOPHYLL SA 100MG 5.25 THEOPHYLL SA 200MG 5.25

THEOPHYLL SA 300MG 5.25 THIABENDAZOLE 500MG 5.25 THIOTHIXENE 2MG 3.15

cdm

VESANOID 10MG CAP 105.00 TRIAMTRENHCTZ 37.5/25MG 5.25 POTASS CIT/CITRIC AC 5ML 2.10 PROMETHAZINEPHEN /COD 5.25 STAVUDINE 1MG/ML 200ML 287.70 SYRUP SIMPLE 60ML 31.50 THIABENDAZOLE 500MG/5ML 17.85 VENLAFAXINE 37.5MG TB GENERIC 13.65 EMBOSPHERE MICRO 500-700 2,698.50 MICAFUNGIN 9.85

MICAFUNGIN SODIUM 50 14.75 MICAFUNGIN (MYCAMINE) 100 MG VIAL 1,472.65 EFFEXOR XR 75MG 21.00 VENLAFAXINE SA 75MG 21.00 CLINDAMYCIN 300MG /50ML 261.45 EXENATIDE 10+ 1,820.45 EXENATIDE 5+ 1,551.25 TRIPLE MIX (LID,DIP,MAA)+ 126.00

GI COCKTAIL (LID/DON/MAA) 126.00 RIVASTIGMINE 4.6+ 50.90 RIVASTIGMINE 9.5MG 49.15

VERAPAMIL SA 120MG 13.65 SODIUM CHOLRIDE BUFFERED 31.50 TIMOLOL MALEATE 0.25%+ 362.55 BUPIVACAINE & EPI 0.5% 50ML 62.10 PENTOBARBITAL 50MG 54.60 BUPIVACAINE-EPI 0.25% 50ML 26.25 ASCORBIC ACID 500MG 0.25 ATARAX 25MG 0.92

ETHAMBUTOL HCL 100+ 3.70 RFG - CALCITONIN NASAL SPRAY 561.20 MICAFUNGIN 491.40 METHYLPRENISOLONE 40MG 45.15 TELMISARTAN 80MG TAB 14.85 CASTOR OIL 16.80 SODIUM CHLORIDE BUFFERED 5.25 AMPHOTERICIN B IRRIG 0.005% 315.00 ALTEPLASE (100MG) 143.85

ALTEPLASE 100MG 14,364.00 ALTEPLASE 50MG 7,182.00 GREEN FOOD COLOR 12.60 MAGIC MOUTHWASH+ 126.00 SODIUM THIOSULFATE 100+ 67.40 MISC. LIQUID 10 10.50 SULFISOXAZOLE 500MG 5.25 ACYCLOVIR 40MG/ML 5ML 15.75

HYDROMORPHONE PF 1MG 78.75 HYDROMORPHONE PF 1MG 7.90 ALBUTEROL 05ML 5.25

cdm

AMANTADINE 10MG/ML 5ML 17.85 AMOXICLN/CLV 400/5 100ML 375.90 AMOX/CLAVULANATES+ 387.20 AMOXICLN/CLAV 125/5 5ML 16.80 AMOXICLN/CLAV 250/5 5ML 17.85 AMOXICILLIN 125/5 80ML 32.55 AMOXICILLIN 250/5 100ML 5.25 AMPICILLIN 125/5 100ML 3.15 AMPICILLIN 250/5 100ML 5.25 CEPHALEXIN 250MG/5 100ML 18.90

CHOLESTYRAMINE LIGHT 5.25 CITALOPRAM 10MG/5ML 5ML 10.50 CLARITHROMCN 250/5 100ML 43.05 HYDROMORPHONE 2MG TAB 5.25 HYDROMORPHONE 2MG 78.75 CLINDAMYCIN PAL 5ML 77.70 CODGUAIFENESIN 010ML 5.25 CODGUAIFENESIN 4OZ 3.15

CODGUAIFENPSEUDO 4OZ 5.25 COLESTIPOL 5GM 5.25 DEXAMETHASONE .5/5 5ML 16.80

DEXAMETHASONE .5/5 5ML 16.80 DIPHENOXYLATE/ATRP 5ML 5.25 DONNATAL 010ML 5.25 DOXYCYCLINE 10MG/ML 10ML 21.00 FLUCONAZOLE 40MG/ML 35ML 585.90 FLUOXETINE20MG/5ML/120ML 16.80 GABAPENTIN 250MG/5ML 5.25 SENEXON 17.6 MG/10ML LIQUID 7.90

GLUCOSE 31GM 18.90 GLUCOSE GEL (INSTA-GLUCOSE) 31 GRAM 28.20 IMMUNE GLOBULIN, GAMMA 0.5G 543.45 HALOPER CONC 2MG/ML 5ML 205.80 IMMUNE GLOBULIN,GAMMA(IGG) 12 212.10 IMMUNE GLOBULIN,GAMMA (IGG) 10 227.35 IMMUNE GLOBULIN, GAMMA 500MG 226.95 HALOPERIDOL 2MG/ML 120ML 18.90 HYDROXYZINE 10MG/5ML 17.85 DEXTROAMPHETA/AMPHET SA 53.85

IODINE/POT IODIDE 1.00 PEGINTERFERON ALFA-2A 180 2,659.85 ISONIAZID 50MG/5ML 5.25 LACTOBACILLUS GRANULES 17.85 LACTULOSE 10GM PKT 5.25 INSULIN GLARGINE 3ML PEN+ 246.70 LACTULOSE 20GM PKT 10.50 LACTULOSE UD 30ML 5.25

KEPPRA SOLN 500MG/5ML 40.95 LITHIUM CITRATE 5ML 3.15 LOPINAVIR/RITONAVIR 5ML 49.35

cdm

LIDOCAINE VISC 30ML 17.85 LIDOCAINE VISCOUS 2% ORAL CUP 6.80 LINEZOLID 100MG/5ML 150M 1,065.75 LORAZEPAM INTENSOL 30ML 323.40 MEGESTROL 40MG/ML 20ML 39.90 LIDO MULTIDOSE USE 20ML N/C 1% VIAL 95.55 LIDOCAINE 1% MDV 20ML 26.25 KAYEXELATE 30GM PWDR 73.50 KCL 10% ORAL LIQ 30ML 5.25 KCL 20% ORAL LIQ 15ML 5.25

POTASSIUM CL 20MEQ PKT 5.25 POTASSIUM SUPPL 5.25 KCL 25MEQ EFF 16.80 ACETAZOLAMIDE 500MG 94.50 ABCIXIMAB 10MG 2,275.35 ACYCLOVIR 500MG INJ 195.30 ACETYLCYSTEINE PER 100MG 5.25 FOMEPIZOLE 1.5 MG INJ 5,418.00

ADALIMUMAB PER 20MG 1,509.90 ADENOSINE 60MG/20ML INJ 1,455.45 ADENOSINE 6MG THERAPEUTC 120.95

CLEVIDIPINE BUTYRATE 50ML 1,141.90 MERREM 1G 32.55 MEROPENEM PER 100MG 33.60 MEROPENEM 1G/NS 50 ML 20.80 ALBUMIN 25% 50ML 364.35 ORENCIA (ABATACEPT) 94.50 ALDESLEUKIN 22MU VIAL 4,587.85 ALPROSTADIL 500MCG/1ML 1,467.90

ALTEPLASE PER 1MG 143.85 ALEMTUZUMAB PER 10MG - ALEMTUZUMAB PER 10MG - ALEFACEPT PER 0.5MG 139.65 AMIKACIN PER 100MG 5.25 FENTANYL 0.05MG/ML 2ML VIAL 94.50 AMINOCAPROIC ACID 5GM 595.35 FENTANYL PF 2ML VIAL 78.75 FENTANYL CITRATE 5ML VIAL 78.75 AMINOPHYLLINE 25M/M 10ML 95.55

MORPHINE/NALTREXONE 31.35 SUBOXONE 2-0 .5MG 25.45 SUBOXONE 8MG - 2 MG 45.60 AMINOPHYLLINE 500MG 88.20 AMIODARONE HCL 10MG 2.55 AMIODARONE 150 MG/100ML 247.60 AMIODARONE 900 MG VIAL INJ 61.80 AMPHOTER B LIP COMP 10MG 113.40

AMPHOTERICIN B 50MG 112.35 PHENYLEPHRINE HCL 10 4.40 CLINDAMYCIN 300MG/50ML 40.95

cdm

AMPHOTER B LIPOSOM 10MG 164.85 AMPICILLIN 500MG 43.05 AMPICILLIN 1GM 46.20 AMPICILLIN/SULB 1.5GM 48.30 AMPICILLIN/SULB 3GM 91.35 AMRINONE 5MG/ML 20ML 529.20 THROMBATE 3EA IU 14.85 APROTININ PER 10000KIU 14.70 ANTITHYMOCYT GLB EQ250MG 1,466.85 ARGATROBAN PER 5MG 90.30

ASPARAGINASE 10000U/10ML 240.45 ATROPINE 1MG/ML 1ML 93.45 AZITHROMYCIN 500MG INJ 154.35 AZTREONAM 500MG 58.80 AZTREONAM 1GM 107.10 AZTREONAM 2GM 214.20 BACITRACIN 50000U 271.95 BACLOFEN .5MG/ML20ML AMP 1,107.75

BACLOFEN IT SCREEN KIT 527.10 BENZTROPINE 2MG/2ML 114.45 METRONIDAZOLE/SODIUM 9.85

BETAMETHASONE 6MG/ML 133.35 BETHANECHOL 5MG/ML 87.15 BEVACIZUMAB PER 10MG 288.75 BORTEZOMIB 0.1 2,013.10 BENDAMUSTINE HCL 1 9,233.30 BIVALIRUDIN PER 1MG 11.55 VERAPAMIL 2.5MG/ML 2ML 8.90 VERAPAMIL INJ 2.5MG/ML 4 ML 29.04

BLEOMYCIN 15 UNITS 357.00 BOTULINUM TOXIN A PER U 28.35 XEOMIN 100-UNIT VIAL 21.40 BUPIVACAINE .25% 10ML 95.55 BUPIVACAINE .25% 30ML 114.45 BUPIVACAINE .25% 50ML 235.20 BUPIVACAINE .5% 10ML 95.55 BUPIVACAINE-EPI 0.5% 10ML 17.85 ON-Q PAIN PUMP - SILVERSOAKER 100ML 718.20 BUPIVICAINE 1.3% LIPOSOME (EXPAREL) 2,154.60

BUPIVACAINE .5% 50ML 214.20 STRYKER PUMP 400ML 1,650.60 BUPIVACAINE .5% 30ML 112.35 ON-Q DULA SELECT-A-FLOW 2,877.00 MAGNESIUM SULFATE 50% 2ML 148.05 BUPIVACAINE .75% 10ML 102.90 BUPIVACAINE .75% 30ML 126.00 BUPIVACAINE/EPI.5% 30ML 95.55

BUTORPHANOL PER 1MG 18.90 CALCITONIN 400IU/2ML 645.75 CALCIUM GLUC 10% 10ML 95.55

cdm

TAC TOPICAL SOLUTION 89.25 LET (LIDO/EPI/TETRACAINE) 63.00 CAPREOMYCIN 1GM 276.15 CARBOPLATIN 50MG 834.75 CASPOFUNGIN PER 5MG 186.90 CEFAZOLIN 500MG 46.20 CEFAZOLIN 1GM 46.20 CEFAZOLIN 1GM 46.20 CEFAZOLIN 1 G/ D5W 50 ML DUPLEX BAG 31.75 CEFAZOLIN 2GM-D5W 50 ML DUPLEX BAG 54.85

CEFEPIME 1GM 110.25 CEFEPIME 2GM 204.75 DALBAVANCIN 500MG INJ 178.80 CEFOTAXIME 1GM 88.20 CEFOTAXIME 2GM 139.65 CEFOXITIN 1GM 68.25 CEFOXITIN 2GM 137.55 CEFTAZIDIME 1GM 93.45

CEFTAZIDIME/AVIBACTAM(AVCAZ)2.5VINJ 359.10 CEFTAZIDIME 2GM 181.65 CEFTRIAXONE 250MG 95.55

CEFTRIAXONE 500MG 166.95 CEFTRIAXONE 1GM 284.55 CEFTAROLINE 400 MG VIAL 309.95 CEFTRIAXONE 1GM 284.55 CEFTRIAXONE 2GM 558.60 CEFUROXIME 750MG 84.00 CEFUROXIME 1.5GM 161.70 CHLORAMPHENICHOL 1GM 119.70

CETUXIMAB PER 10MG 252.00 PERAMIVIR 200MG/20ML - FLU VACINE (FLUVIRIN) 75.60 CHLORDIAZEPOXIDE 100MG 107.10 FLU VACCINE 2012-2013 75.60 FLU VACCINE 2014 TO 2015 128.70 INFLUENZA VACCINE 0.5ML INJ 2015 20.05 CHLOROPROCAINE PF 2% 20 ML INJ 148.00 CHLOROPROC MPF 3% 20ML 175.35 CHLOROTHIAZIDE 500MG 152.25

CHLORPROMAZINE 25MG/ML 95.55 CIDOFOVIR 75MG/ML 5ML 2,998.80 CIMETIDINE 150MG/ML 2ML 114.45 CIPROFLOXACIN 200MG INJ 139.65 DILTIAZEM 125MG 47.25 DILTIAZEM 125MG/125ML IVPB PREMIX 108.70 DILTIAZEM 125 MG IN D5W 125 ML IVPB 75.60 CIRPOFLOXACIN 400MG PMX 250.95

CISATRACURIUM 2MG/ML 5ML 90.30 CISATRACURIUM 20MG/10ML 129.10 CISPLATIN PER 10MG 213.15

cdm

CLADRIBINE PER 1MG 342.30 CLINDAMYCIN 300MG/2ML 170.10 CLINDAMYCIN 600MG/4ML 261.45 CLINDAMYCIN 900MG/6ML 312.90 MORPHINE DEPODUR 10 MG/ML 1 ML VIAL 2,704.55 CLONIDINE PER 1MG 683.55 COLCHICINE 1MG/2ML 82.95 COLISTIMETHATE 150MG 480.90 CORTICORELIN OVINE 1MCG 22.05 COSYNTROPIN .25MG/ML 200.55

CYCLOPHOS 100MG 158.55 CYCLOSPORINE 250 MG AMP INJ 243.00 CYTARABINE 100MG 20.15 NELARABINE 50MG 568.10 DACARBAZINE 100MG 233.10 DALTEPARIN 2.5K INT UNIT 142.50 DALTEPARIN 5000IU 115.60 DALTEPARIN 2.5K INT UNITS 115.60

DANTROLENE 20MG/70ML 683.55 DAPTOMYCIN PER 1MG 1.70 DARBEPOETIN ALFA PER1MCG 18.90

DARBEPOETIN ALFA 60 2,364.50 DARBEPOETIN ALFA 100 27.05 DAUNORUBICIN PER 10MG 471.45 DEFEROXAMINE 500MG 207.90 DESMOPRESSIN PER 1MCG 31.50 DEXAMETHA 10MG/ML 12ML 112.35 DEXAMETHASONE 4MG/ML 5ML 354.90 PROCHLORPERAZINE EDISYLATE 5 -

DEXAMETHASONE 4MG/ML 1ML 102.90 DEXTROSE 25% 10ML SYG 138.60 DEXTROSE 50% 50ML 160.65 DEXTROSE 50% 50ML 160.65 DEXTROSE 25% PEDIATRIC 28.20 HYDROCODONE/HOMATR 5-1.5MG/5ML 5.25 DIAZEPAM SYG 10MG/2ML 114.45 DICYCLOMINE 10MG/ML 2ML 381.15 CASPOFUNG 5MG 186.90 CARBAMAZEPINE EREL 100MG 5.25

CARBAMAZEPINE EREL 200MG 8.40 CARBAMAZEPINE EREL 400MG 13.65 SULFAMETHOX/TRIM DS TAB 5.25 METOPROLOL EXT REL 50 MG 5.25 METOPROLOL EXT REL 100MG 5.25 METOPROLOL EXT REL 25 MG 5.25 NALTREXONE 50MG 35.70 KEMADRIN 6MG TAB 3.85

PROMETHAZINE 25MG 5.25 PROMETHAZINE 50MG 16.80 PROPAFENONE 150MG 5.25

cdm

PROPAFENONE 225MG 16.80 PROPAFENONE HCL 225+ 42.55 PROPOXYPHENE 50MG 5.25 PROPOXYPHENE 65MG 5.25 PROPOXYPHENE/APAP100/650 5.25 GYOPRANOLOL 10MG TAB 5.25 PROPRANOLOL 20MG TAB 5.25 PROPRANOLOL 40MG TAB 5.25 PROPRANOLOL 80MG TAB 5.25 PROPRANOLOL 60MG LA CAP 16.80

PROPRANOLOL 80MG LA CAP 17.85 PROPRNOLOL 120MG LA CAP 5.25 PROPRNOLOL 160MG LA CAP 16.80 PROPYLTHIOURACIL 50MG 5.25 PSEUDOEPHED/GUAIFENESIN 1.00 PYRAZINAMIDE 500MG 16.80 ETHIONAMIDE 250 31.50 PYRIDOSTIGMINE 60MG 5.25

PYRIDOSTIGMINE 180MG 5.25 PYRIMETHAMINE 25MG 5.25 QUETIAPINE 25MG 14.70

QUETIAPINE 100MG 17.85 QUINAPRIL 5MG 5.25 QUINAPRIL 10MG 5.25 QUINAPRIL 20MG 5.25 QUINAPRIL 40MG 5.25 QUININE 260MG 17.85 RALOXIFENE 60 MG 22.05 RAMIPRIL 1.25MG 3.15

RAMIPRIL 2.5MG 5.25 RAMIPRIL 5MG 5.25 RAMIPRIL 10MG 13.65 RANEXA 500MG TAB 11.55 REPAGLINIDE 0.5MG 11.55 REPAGLINIDE 1MG 13.65 REPAGLINIDE 2MG 13.65 RIFABUTIN 150MG 35.70 RIFAXIMIN 200MG 17.85 RIFAXIMIN 550+ 114.30

RIFAMPIN 150MG 8.40 RIFAMPIN 300MG 17.85 RISEDRONATE NA 35MG 73.50 RISEDRONATE NA 5MG 9.45 RIMANTADINE 100MG 16.80 RISPERIDONE 1MG TABLET 17.85 RISPERIDONE 2MG 35.70 RISPERIDONE 3MG 40.95

RISPERIDONE 4MG 47.25 RISEDRONATE NA 30MG 69.30 RIZATRIPTAN 10MG 82.95

cdm

RITODRINE 10MG 33.60 RIZATRIPTAN 10MG MLT 82.95 ROSIGLITAZONE 4MG 14.70 ROSIGLITAZONE 8MG 17.85 RIVASTIGMINE 1.5MG 14.70 RITONAVIR 100 MG 16.80 DARUNAVIR ETHANOLATE 600+ 115.75 DARUNAVIR (PREZISTA) 400MG TAB 121.40 ROPINIROLE 0.25MG 14.70 ROPINIROLE 1MG 7.35

ROPINIROLE 5MG 7.35 SALSALATE 500MG 3.15 SALSALATE 750MG 5.25 ROSUVASTATIN CALCIUM 40 29.40 ROSUVASTATIN CA 10MG 11.55 SELEGILINE 5MG 36.75 SERTRALINE 50MG 17.85 SERTRALINE 100MG 17.85

SEVELAMER 400MG TAB 3.15 SEVELAMER 800MG 6.30 LANTHANUM 1000MG CHEWABLE TAB 73.60

VIAGRA 25MG 40.95 SILDENAFIL 100MG 50.40 REVATIO 20MG 43.05 ALPROSTADIL 1.25MCG 18.00 SIMVASTATIN 5MG 18.90 SIMVASTATIN 10MG 18.90 SIMVASTATIN 20MG 18.90 JANUVIA 100MG 18.90

JANUVIA 50MG 18.90 SOD/POT PHOS 1.25G 5.25 SOLIFENACIN SUCC 5MG 16.90 VISICARE (SOLIFEN) 10MG 34.20 SOTALOL 80MG 17.85 SOTALOL 160MG 31.50 SOTALOL 240MG 35.70 SPIRONOLACHCTZ 25MG 5.25 SPIRONOLACHCTZ 50MG 16.80 SPIRONOLACTONE 25MG 17.85

SPIRONOLACTONE 50MG 5.25 SPIRONOLACTONE 100MG 5.25 STAVUDINE 30MG 30.45 STAVUDINE 40MG 35.70 STAVUDINE 20MG 18.90 SUCRALFATE 1GM 5.25 SULFADIAZINE 500MG 5.25 SULFASALAZINE 500MG 5.25

SULINDAC 200MG 5.25 SUMATRIPTAN 25MG 87.15 TACROLIMUS ORAL PER 1MG 16.80

cdm

TACROLIMUS (PROGRAF) 0.5 MG CAPSULE 15.60 TAMOXIFEN 10MG 35.70 TAMSULOSIN .4MG 16.80 TEGASEROD 6MG 12.60 TELMISARTAN 40MG 7.35 TEMAZEPAM 15MG 5.25 TEMAZEPAM 7.5MG 5.25 TENOFOVIR 300MG 60.90 TERAZOSIN 1MG 5.25 TERAZOSIN 2MG 5.25

TERAZOSIN 5MG 5.25 TERBINAFINE 250MG 49.35 TERBUTALINE 5MG 5.25 TETRACYCLINE 250MG 5.25 TETRACYCLINE 500MG 5.25 THEOPHYLLINE ANHYDRO 80 3.15 THEOPHYLL SA 200MG 3.15 THEOPHYLL SA 300MG 5.25

THEOPHYLL TIM 3.15 THIORIDAZINE 10MG 5.25 THIORIDAZINE 25MG 5.25

THIORIDAZINE 100MG 5.25 THIORIDAZINE 200MG 5.25 THIOTHIXENE 1MG 3.15 THIOTHIXEME 5MG 17.85 THIOTHIXENE 10MG 5.25 TIAGABINE 4 MG 7.35 THYROID 30MG 5.25 THYROID 60MG 5.25

THYROID 120MG 5.25 TICLOPIDINE 250MG 17.85 TIMOLOL 5MG 3.15 TIZANIDINE 4MG TAB 16.80 TOLAZAMIDE 100MG 5.25 TOLAZAMIDE 250MG 5.25 TOLTERODINE LA 2MG 17.85 TOLTERODINE 1MG 8.40 TOLTERODINE 2MG 17.85 TOPIRAMATE 25MG 7.35

TOPIRAMATE 100MG 14.70 TOPIRAMATE 200MG 18.90 TORSEMIDE 20MG 5.25 TORSEMIDE 100MG 18.90 TRANDOLAPRIL 2MG 5.25 TRAMADOL 50MG 5.25 TRAMADOL/APAP TAB 5.25 TRAZODONE 50MG 5.25

TRAZODONE 100MG 5.25 TRAZODONE 150MG 5.25 TRIAMTERENE 50MG 5.25

cdm

TRIAMTERENE 100MG 3.15 TRIAMTERENEHCTZ 75/50MG 5.25 TRIAMTERENE/HCTZ 50/25 5.25 TRIAZOLAM .125MG 5.25 TRIAZOLAM .25MG 5.25 TRIFLUOPERAZINE 2MG 5.25 TRIHEXYPHEN 2MG 5.25 TRIHEXYPHEN 5MG 5.25 TRIMETHOBENZAMIDE 100MG 5.25 TRIMETHOBENZAMIDE 300MG 5.25

TRIMETHOPRIM 100MG 5.25 VANCOMYCIN 250MG 49.35 VENLAFAXNE 150MG CAP XR 14.70 VENLAFAXINE 37.5MG CAP XR 13.65 VENLAFAXINE 25MG TAB 5.25 VENLAFAXINE 37.5MG TB BRAND 5.25 VENLAFAXINE 50MG TAB 5.25 VENLAFAXINE 75MG TAB 5.25

VENLAFAXNE 100MG TAB 5.25 VERAPAMIL SR 100MG 6.30 VERAPAMIL SR 200MG 7.35

VERAPAMIL 40MG 5.25 VERAPAMIL 80MG 17.85 VERAPAMIL 120MG 5.25 VERAPAMIL SUST REL 240MG 5.25 VERAPAMIL SR 180MG 5.25 VITAMIN RENAL FORMULA 5.25 NEPHRO-VITE TABLET (FOLIC ACID/VITB 5.25 MISC LIQUID 30 31.50

MISC LIQUID 70 73.50 MISC LIQUID 150 157.50 MISC. LIQUID 300 315.00 CHOLESTYRAMINE 9GM 13.65 SULFAMETH/TRIM SUSP 20ML 5.25 METOCLOPRAM 5MG/5ML 5.25 NITROFURANTOIN 25 5.25 NYSTATIN 5ML 35.70 OXCARBAZEPINE 300 454.65 PAROXETINE SUSP 10MG/5ML 17.85

SERTRALINE 100MG/5 ML SUSPENSION 33.75 PENICILLIN G POTASSI 20000000 168.25 PENICLLN VK 250/5 100ML 5.25 PHENYTOIN 100MG/4ML 3.15 POTASSIUM GLU 10MEQ/15ML 5.25 POTASSIUM IODIDE 30ML 5.25 PREDNISONE 5MG/5ML 5.25 PREDNISONE 5MG/ML 1ML 3.15

PREDNISOLONE 5MG/5ML 5.25 PREDNISOLONE 3MG/3ML+ 31.50 PROMETHAZINE /COD 5.25

cdm

PROMETHAZINE 6.25MG/5ML 5.25 PROMETHAZINE DM 5.25 RISPERIDONE 1 607.95 SIROLIMUS 1MG/ML 1ML 35.70 SOD CITRATE/CITR AC 30ML 2.10 SUCRALFATE 1G/10ML SUSP 5.25 VANCOMYCIN ORAL SOLN 125 MG 14.20 VANCOMYCIN 1G/20ML 173.25 DIFICID (FIDAXOMICIN) 200 MG TAB 745.30 METHOTREXATE 5MG INJ 80.85

SULFAMETHOX/TRIMETH 10ML 208.95 SORAFENIB 200MG 175.35 SULFASALIZINE 500MG EC 3.15 THEOPHYLLINE SUSR 600MG 7.35 TRIAMCIN 4MG 9.45 URSODIOL 300MG 18.90 VALACYCLOVIR 500MG 18.90 VALACYCLOVIR 1GM 28.35

VALSARTAN 40MG 6.30 VALGANCICLOVIR 450MG 132.30 VALSARTAN 80MG 13.65

VALSARTAN 160MG 16.80 VALSARTAN/HCTZ 80/12.5 7.35 VALSARTAN/HCTZ 160/12.5 8.40 VANCOMYCIN 125MG 25.20 VORICONAZOLE 50MG TAB 34.65 POSACONAZOLE 200MG 2,441.25 POSACONAZOLE 100MG DR TABLET 406.05 VORICONAZOLE 200MG TAB 137.55

WARFARIN 2.5MG 5.25 WARFARIN 1 MG 5.25 DABIGATRAN CAP 25.50 RIVAROXABAN (XARELTO) 10 MG TABLET 51.05 ELIQUIS (APIXABAN) 5MG TAB 32.90 ELIQUIS (APIXABAN) 2.5MG TAB - WARFARIN 3 MG 5.25 RIVAROXABAN (XARELTO) 15 MG TAB 66.90 RIVAROXABAN (XARELTO) 20 MG TAB 66.90 EDOXABAN 30 MG 11.65

WARFARIN 2MG 5.25 WARFARIN 4MG 5.25 WARFARIN 5MG 5.25 WARFARIN 6 MG 5.25 WARFARIN 7.5MG 5.25 WARFARIN 10MG 5.25 ZAFIRLUKAST 20MG 5.25 ZALEPLON 5MG 11.55

ZALEPLON 10MG 14.70 ZIDOVUDINE 100MG 18.90 ZINC SULFATE 220MG 5.25

cdm

ZOLPIDEM 5MG 9.45 ZIPRASIDONE 20MG 19.95 ZIPRASIDONE 40MG 21.00 ZIPRASIDONE 60MG 23.10 ZONISAMIDE 100MG 8.40 ZIPRASIDONE 80MG 23.10 ZONISAMIDE 25MG 4.90 CYCLOSPORINE 100MG/ML SL 35.70 TUSSIORGANIDIN 010ML 5.25 ZIDOVUDINE 10MG/ML 5ML 16.80

MISC. INJ 30 7.90 MISC. INJ 70 73.50 MISC INJ 150 157.50 MISC INJ 300 315.00 MISC INJ 300 315.00 MISC BIOTECH 10 10.50 MISC BIOTECH 30 31.50 MISC BIOTECH 70 73.50

MISC BIOTECH 300 315.00 MISC BIOTECH 800 840.00 MISC CHEMO 10 10.50

MISC CHEMO 30 31.50 MISC CHEMO 70 73.50 MISC CHEMO 150 157.50 MISC CHEMO 300 315.00 MISC CHEMO 800 840.00 METHOTREXATE 1GM 258.30 TRANEXAMIC ACID 100 MG/ML 554.25 AMMON CHLORI 100MEQ/20ML 161.70

AMPICILLIN 2GM 46.20 AMPICILLIN 250MG 50.40 ANTICOAGULANT SOD CITRAT 87.15 ASCORBIC ACID 1GM/2ML 93.45 ATRACURIUM 10MG/ML 5ML 412.65 ATROPINE .4MG/.5ML 114.45 ATROPINE 1MG/10ML PFS 192.15 AZATHIOPRINE 100MG/20ML 645.75 BUMETANIDE 2.5MG/10ML 112.35 BUMETANIDE 1MG/4ML 93.45

BUPRENORPHINE .3MG 87.15 CALCITRIOL 1MCG/1ML 136.50 CALCIUM CHLOR 10%10MLSYR 224.70 CALCIUM CHLOR 10% 10ML 95.55 CARBOPROST 250MCG/1ML 1,628.55 CEFOTETAN 1GM 76.65 CEFOTETAN 1G / 50 ML D5W 110.75 CEFOTETAN 2GM 152.25

CLINDAMYCIN 600MG PMX 261.45 CLINDAMYCIN 900MG PMX 312.90 CORTICOTROPIN PER 40U 541.80

cdm

SULFAMETHOX/TRIMETH 5ML 166.95 CROTALIDAE POLYVALENT IMMUNE FAB 10,243.80 CYANOCOBALAMIN 100MCG 82.95 CYANOCOBALAMIN 1000MCG 95.55 DALTEPARN 7.5KIU(FRAGMN) 115.60 DALTEPARIN 10000IU 115.60 DENILEUKIN 150MCG/ML 2ML 7,600.30 DEXMEDETOMIDINE 200MCG 355.95 CABERGOLINE 0.5 54.15 GRANISETRON 100MCG 81.90

IMIPENEM/CILASTATIN 500MG 169.05 COAL TAR SHAMPOO+ 22.00 GADOPENTETATE DIMEGLUMINE 10ML 52.50 MUPIROCIN 2% OINT+ 282.55 METRONIDAZOLE 0.75% GEL+ 189.20 HYDROCORTISONE 1% CREAM 7.60 HYDROCORTISONE 1% OINTMENT 25.15 OCTREOTIDE 100MCG 6.55

OCTREOTIDE 50MCG/ML 1ML 78.20 SANDOSTATIN LAR DEPOT 20 IM 701.00 BUPROPION XL 300MG 5.25

BUPROPION XL 150MG 5.25 PYRIDOSTIGMINE BROMIDE 180+ 22.60 METHOTREX 5MG 61.95 CARDIOPLEGIC SOLUTION 315.00 CARDIOPLEGIA (BUCKBERGS) IV SOL 500 195.00 MIDAZOLAM 2MG/ML 78.75 NICARDIPINE 20MG IN D5 200ML 672.00 PERFLUORONOCTANE 2,620.80

LOTEPREDNOL 0.5%+ 428.55 BRIMONIDINE TARTRATE 0.15%+ 480.70 TESTOSTERONE 23.10 BAZA ANTIFUNGAL 5 OZ 35.10 BAZA ANTIFUNGAL 2 OZ 35.10 IODOSORB GEL 40GM 209.75 MICROGUARD POWDER 58GM 42.80 MICROGUARD CREAM 2OZ 37.50 SPOT 79.80 XYLOCAINE 2% EPI 1.7ML DENTAL 6.00

VISIPAQUR(IODIXANOL) 320 50ML BOTLE 7.45 DEXTROAMPHETAMINE 5MG 13.65 DEXTROAMPHETAMINE ER 10 MG CAPSULE 20.90 QUINIDINE GLUCONATE 324MG 5.25 QUINIDINE GLUCONATE 324MG 5.25 BISACODYL/MAGNESIUM CITRATE 16.80 ALBUTEROL SULFATE 90 118.15 PETROLATUM OPTH 6.30

LANOLIN/MINOIL/PETROLAT UNG 23.30 TOBRAMYCIN SULFATE 1.2+ 1,190.70 BACITRACIN/POLYMYXIN B SULFATE 5.25

cdm

LEVOCARNITINE 200 40.30 POLYVINYLPYRROLIDONE 5% 76.50 CORTICORELIN OVIN TRIFLU 100 34.20 CALC 500 MG/VITD+ 0.04 DIGOXIN .5MG/2ML 93.45 DIGOXIN IMMUNE FAB 40MG 2,388.75 DIHYDROERGOTAMI 1MG/ML 95.55 DIMETHYL SULFOXIDE DMSO 50% 50 ML 50.40 DILTIAZEM 50 MG 322.35 DILTIAZEM INJ 50 MG/10 ML 10.90

DIPHENHYDRA 50MG/ML 95.55 DIPYRIDAMOLE 10MG/2ML 155.40 DOBUTAMINE 250MG/20ML 601.65 DOLASETRON 12.5MG/.625ML 214.20 DOLASETRON MESYLATE 100 19.95 DOPAMINE 200MG AMP 68.25 DOPAMINE 400MG AMP 156.45 DOXAPRAM 20MG/ML 1ML 480.90

DOXORUBICIN 50MG INJ 425.25 DROPERIDOL 5MG/2ML 114.45 DROPERIDOL 010ML 200.55

DROTRECOGIN ALFA 5MG 978.60 DROTRECOGIN ALFA 20MG 3,915.45 CALC DISOD EDETATE 1GM 276.15 EDROPHONIUM 10MG/ML 15ML 48.30 EDROPHONIUM 10MG/ML - ESTRADIOL VAL SYR 20MG 137.55 ENALAPRIL 1.25MG/1ML 95.55 ENALAPRIL 1.25MG/ML 2ML 199.50

VISIPAQUE(IODIXANOL)320 150ML BOTLE 7.45 IODIXANOL 320 8.00 OMNIPAQUE (IOHEXOL) 300 150ML BOTLE 7.10 ENOXAPARIN 100MG SYR 338.10 BARIUM SULFATE 8.40 EZ-DOSE 157.50 BARIUM SULFATE 33.00 ENOXAPARIN 60MG SYR 201.60 BARIUM ENEMA KIT 16.80 BARIUM SULFATE 0.01

POLIBAR ACB BAG 74.85 ENOXAPARIN 30MG SYG 99.75 ENOXAPARIN 40 MG SYR 136.50 ENOXAPARIN 80MG SYR 267.75 EPHEDRINE 50MG/ML 95.55 ENOXAPARIN 120MG SYR 390.60 EPINEPHRINE 1:1000 1ML 95.55 EPINEPHRINE 1:1000 30ML 0.18

EPINEPHRINE AUTOINJECTOR 172.10 EPOETIN NONESRD 1000U 204.75 EPOETIN NONESRD 1000U 204.75

cdm

EPINEPHRINE 0.1 MG 6.35 EPTIFIBATIDE PER 5MG 84.00 EPTIFIBATIDE 20MG 195.50 ERTAPENEM 500MG 115.50 ERYTHROMY LA 500MG 138.60 ERYTHROMYCIN 500 MG VIAL INJ 171.50 ESOMEPRAZOLE 40MG INJ 115.50 GADOPENTETATE DIMEGLUMINE 5ML 26.25 ESMOLOL 10MG/ML 10ML 171.15 BREVIBLOC PRMXD 10MG/ML 596.40

ESTRADIOL CYP 5MG/ML 1ML 95.55 ESTRADIOL VALERATE 2 75.15 ESTRADIOL VALERATE 2 62.35 ETANERCEPT 25MG 887.25 ETHANOLAMINE 5% 2ML 324.45 ETHYL ALCOHOL 1ML 158.55 ETOMIDATE 20MG/10ML AMP 120.70 ETOMIDATE 40 MG/20ML VIAL 75.60

FAMOTIDINE 10MG/ML 2ML 160.65 FENOLDOPAM 10MG/ML 1ML 1,671.60 FLUCONAZOLE 200MG PMX 515.55

FLUCONAZOLE 400MG PMX 809.55 FOLIC ACID 5MG/ML 1ML 93.45 FUROSEMIDE 100MG/10ML 175.35 FUROSEMIDE 10MG/ML 2ML 93.45 FONDAPARNX 0.5MG 46.20 FUROSEMIDE 40MG/4ML 91.35 FILGRASTIM 480MCG/1.6ML 5.25 TBO-FILGRASTIM GRANIX 1MCG 5.65

FILGRASTIM 300MCG/1.0ML 5.25 TBO-FILGRASTIM(GRANIX)1MCG 1,204.55 SARGRAMOSTIM PER 50MCG 137.55 GANCICLOVIR 500MG 543.90 GENTAMICIN 10MG/ML 2ML 80.85 GENTAMICIN PMX 80MG 94.50 GENTAMICIN PMX 100MG 100.80 GENTAMICIN 100 MG NS INJ 50 ML 25.60 GENTAMICIN PMX 120MG 107.10 GENTAMICIN 40MG/ML 2ML 88.20

GLATIRAMER ACETATE 20MG 143.85 GLUCAGON 1MG 311.85 GLYCOPYRROLATE 0.2MG/ML 5ML VIAL 432.95 ROBINUL 1MG INJ VIAL 433.00 GLYCOPYRROLATE 0.2MG/ML INJ 5ML SYR 44.10 GLYCOPYRROLATE .2MG/ML 10.50 GLYCOPYRROLATE 0.4 MG/2 ML 14.50 GRANISETRON INJ .1MG 81.90

HALOPERIDOL 5MG/ML 1ML 93.45 HEPARIN 100U/ML 10ML 57.75 HEPARIN 5000U/ML 1ML 112.35

cdm

HEPARIN 1000U/ML 30ML 285.60 HEPARIN 1000 UNITS/ML 500ML 27.90 HEPARIN 1000U/ML 10ML 95.55 HEPARIN 1000 UNIT/ML INJ 10 ML 26.88 HETASTARCH 500ML 411.60 HYALURONIDASE PER UNIT 53.90 HYDRALAZINE 20MG/1ML 93.45 HYDROCORTISONE SUCCINATE 100 MG 30.55 HYDROCORTISONE SS 100MG 175.35 HYDROCORTISONE SS 250MG/2ML 380.10

HYDROCORTISONE SS 500MG/4ML 584.85 HYDROCORTISONE SS 1GM/8ML 937.65 HYDROMORPHONE 50 MG AMP INJ 142.45 HYDROMORPHONE 40MG/20ML MDV 98.30 IBUTILIDE PER 1MG 1,465.80 IMIPENEM/CILASTATIN 250 259.35 INDOMETHACIN 1MG 227.85 RHO (D)IMM GLOB PER 100U 84.00

RHO IMMUNE GLOB IV 300MCG 1500IU 80.85 INFLIXIMAB PER 10MG 285.60 INSULIN HUMAN 144.90

CONCENTRATED INSULIN U-500 5.25 INS HUM 50/50 10ML 144.90 INSULIN REGULAR INFUSION 5 109.55 INSULIN REGULAR, HUM 5 5.25 HUMALOG 75/25 PER 5 UNITS 753.35 INS HUM REG DOSE 15.75 INS ANALOG LISPRO 10ML 339.15 INSULIN LISPRO 300-UNIT VIAL SQ INJ 244.05

INSULIN LISPRO PER 5 UNITS 5.25 NOVOLOG INSULIN ASPART PER 5 UNITS 5.25 HUM INSULIN NPH/REG 5 UNIT 365.15 INS HUM 70/30 DOSE 15.75 NPH HUMAN INSULIN 100 PER VIAL 365.15 INSULIN NPH SQ INJ PER ML 30.20 IRON DEXTRAN 165 50MG 78.75 IRON DEXTRAN 267 50MG 78.75 IRON SUCROSE PER 1MG 3.15 IVIG 5 GRAMS 2,273.25

IVIG GAMUNEX PER 500MG 327.60 KETOROLAC 15MG/ML 1ML 88.20 KETOROLAC 30MG/VIAL INJ 11.85 DICLOFENAC INJ 37.5 MG/ML 20.70 LEPIRUDIN 50MG 758.10 LEUPROLIDE DEPOT 3.75MG 2,437.05 LINEZOLID INJ PER 200MG 468.30 MANNITOL 25% 50ML 95.55

MECHLORETHAMINE 10MG 730.80 ADD LATER - MEROPENEM PER 100MG 32.55

cdm

MEROPENEM 500MG/NS 50 MI IVPB 15.40 METHOCARBAMOL 1GM/10ML 95.55 METHYLDOPATE 250MG/5ML 235.20 METHYLERGONOVINE .2MG 95.55 METHYLPRED A 40MG/ML 221.55 METHYLPRED A 80MG/ML 308.70 METHYLPRED SS 40MG 96.60 METHYLPRED SS 125MG 243.60 METHYLPRED SS 125MG INJ 42.45 MILRINONE LACT PER 5MG 292.95

MILRINONE (PRIMACOR)10/MG/10ML VIAL 47.25 AVELOX 400MG INJ 229.95 NA FERRIC GLUC 12.5MG 35.70 NALBUPHINE 10MG/ML 1ML 95.55 NALBUPHINE INJ 20 MG PER 1ML AMP 39.30 NESIRITIDE PER 0.1MG 148.05 NEOSTIGMINE 1:1000 10ML 74.65 NEOSTIGMINE 5MG/5ML INJ SYRINGE 31.50

NEOSTIGMINE 1:2000 1ML 87.15 SCOPOLAMINE HYDROBRO 0.4 26.25 ONDANSETRON 2MG/ML VL 1MG 30.45

ONDANSETRON PF 28.35 OXYTOCIN 10U/ML 1ML 95.55 PAMIDRONATE 30MG 1,960.35 PALONOSETRON PER 25MCG 142.80 PAPAVERINE 30MG/ML 10ML 292.95 PAPAVERINE 30MG/ML 2ML 95.55 PEGFILGRASTIM 6MG 13,283.55 PENICILLIN G BENZ 100KU 30.25

PENICILLIN G BENZ 1.2MU 111.30 PENICILLIN G BENZ 2.4MU 361.20 PROCAINE 10% 107.10 PENICILLIN G 100,000 UNITS 289.30 PENICILLIN G BE/PR 2.4MU 283.50 PHENOBARB 65MG 5.25 PHENOBARBITAL INJ 65 MG/ML 82.30 PHENTOLAMINE 5MG/ML 424.20 PHENTOLAMINE INJECTION 5MG/VIAL 510.00 PHYTONADIONE 1MG/.5ML 95.55

PROCAINAMIDE100MG/ML10ML 107.10 PROCAINAMIDE 500MG/ML2ML 95.55 PROCHLORPERAZN 10MG SYRD 133.35 PROMETHAZINE 25MG/ML 46.20 PROPRANOLOL 1MG/ML 95.55 PYRIDOXINE 100MG/ML 126.00 RISPERIDONE PER 0.5MG 25.20 SUCCINYLCHL 20MG/ML 1ML 110.25

SUCCINYLCHOLINE 140MG 13.05 SUMATRIPTAN 6MG INJ 381.15 MORPHINE 25MG/ML 10ML VIAL 43.55

cdm

SUMATRIPTAN 6MG INJ KIT 643.65 TENECTEPLASE 50MG 12,923.40 TERBUTALINE 1MG/ML 93.45 THIAMINE 100MG/ML 1ML 95.55 TOBRAMYCIN 40MG/ML 2ML 46.20 TORSEMIDE 10MG/ML 5ML 89.25 TRIMETHOBENZ 200MG INJ 95.55 VANCOMYCIN 500MG 51.45 VORICONAZOLE PER 10MG 23.10 ZOLEDRONIC ACID 4MG VIAL 4,424.90

ZOLEDRONIC ACID 1MG 51.75 ZIPRASIDONE PER 10MG INJ 108.15 FENTANYL .05MG/ML 2ML 94.50 FENTANYL .05MG/ML 2ML 94.50 FENTANYL .05MG/ML 5ML 6.30 FENTANYL .05MG/ML 10ML 28.35 FENTANYL .05MG/ML 20ML 84.00 MORPHINE (DURAMORPH) 1MG/ML 10 ML 59.85

MORPHINE 10MG/ML 1ML 86.10 PILL CRUSHER 49.35 COCCI SKN TST 1:10 181.65

TETANUS/DIPHTHERIA TOXOIDS TENIVAC 128.25 BOOSTRIX TDAP VACCINE SYRINGE 0.5ML 192.55 DIPHTH TT PERT (DTWP) 93.45 DIPH,PERT(ACELL),TET PED 141.45 FACTOR 9 COMPL PER 100IU 436.80 FACTOR IX PER UNIT 436.80 4F-PCC KCENTRA 5.55 FACTOR VIIA PER 1MCG 6.30

FACTOR 8 RECOMB PER100IU 495.60 FLU SPL VACC >3YRS 75.60 HAEMOPHIL B/TET TOX .5ML 121.80 HEPATITS A VAC 720U/.5ML 134.40 HEPATITS A VAC 1440U/1ML 301.35 HEPATITIS A VAC 25U/.5ML 176.40 HEPATITIS A VAC 50U/1ML 353.85 HYLAN GF20 2ML SYR 1,216.95 ORTHOVISC 30 MG/2ML SYRINGE 2,348.50 HYDROXYZINE 25 MG INJ 5.60

HYDROXYZINE 50MG INJ 75.60 INDIGO CARMINE AMP 95.55 INDOCYANINE GREEN 25MG 431.55 INS GLARGINE 10ML 224.70 INSULIN GLARGINE HUMAN PER VIAL 638.40 INSULIN GLARGINE PER 5 UNIT 5.25 INSULIN DETEMIR LEVEMIR PER 5 UNITS 5.25 INS HUM NPH 10ML 144.90

ISONIAZID 100MG/ML 328.65 ISOPROTERENOL 1:5000 5ML 192.15 ISUPREL 1 MG INJ AMPUL 1,315.40

cdm

KANAMYCIN 1GM 371.70 KETAMINE 10MG/ML 20ML 88.20 KETAMINE 50MG/ML 10ML 93.45 KETAMINE 100MG/ML 5ML 93.45 KETOROLAC 30MG/ML 2ML 102.90 LABETALOL 5MG/ML 20ML 453.60 LABETALOL 5MG/ML 4ML SYR 171.15 LABETALOL 20MG/4 ML SYRINGE 26.25 KEPPRA 500MG/5ML INJ 157.50 LEVETIRACETAM 1500MG/100ML PMIX IVP 516.45

LEVETIRACETAM 500MG/100ML PMX IVPB 206.85 LEVOFLOXACIN 750MG PMX 256.20 LEVOFLOXACIN 500MG PMX 193.20 LEVOFLOXACIN 250MG PMX 123.90 LEVOTHYROXIN .2MG/VIAL 598.50 LEVOTHYROXINE 100 MCG VIAL - LEVOTHYROXINE .5MG 651.00 LIDOCAINE PMX .8%/250 ML 121.80

LIDOCAINE .5% 50ML 107.10 LIDOCAINE 1% /EPI 30ML 93.45 LIDOCAINE 0.5%/EPI 50ML 40.05

LIDOCAINE 1%/EPI 5ML 95.55 LIDOCAINE 1% 30ML 95.55 LIDOCAINE 1% 2ML 95.55 LIDOCAINE 1% 5ML 95.55 LIDOCAINE 1.5% /EPI 30ML 138.60 LIDOCAINE/EPI 1.5% INJ 30 ML 82.56 LIDOCAINE 1.5% 20ML 91.35 LIDOCAINE 1.5% DOSE 87.15

LIDOCAINE 2%/EPI 5ML 95.55 LIDOCAINE 2% VIAL 5ML 95.55 LIDOCAINE 2% VIAL 5ML 95.55 LIDOCAINE 4% 5ML 89.25 LIDOCAINE SYG 100MG 170.10 LIDOCAINE 2% 5ML VIAL 18.65 LIDOCAINE 4% 25ML 158.55 LORAZEPAM 2MG/ML 1ML SYG 95.55 LORAZEPAM 2MG/ML 1ML 571.20 LIDOCAINE 2% EPI 1.7ML 6.30

MAGNESIUM SULF 50% 2ML 95.55 MAGNESIUM SULF 4% 100 ML 30.45 MAGNESIUM 2 GRAM IVPB PREMIX 49.65 MEASLES/MUMPS/RUB VACC 438.90 MEASLES VACCINE 240.45 MEPIVICAINE 1% 30ML 133.35 MEPIVICAINE 2% 20ML 160.65 METHYLENE BLUE 1% 10ML 95.55

METHYLPRED SS 1GM 1,363.95 METHYLPRED SS 500MG 907.20 METOCLOPRAMINE 10MG VIAL INJ 14.85

cdm

METOPROLOL 5MG/5ML CART 95.55 MEZLOCILLIN 1GM 123.90 MEZLOCILLIN 2GM 233.10 PNEUMOC VACC POLYS 23VAL 313.95 PREVNAR 13 VACCINE 0/5 ML SYRINGE 1,197.00 POTASSIUM ACET 2MEQ/ML 46.20 POTASSIUM CL 2MEQ/ML 46.20 POTASSIUM CL 10MEQ/50ML 93.45 POTASSIUM CL 10MEQ/100ML 142.80 POTASSIUM PHOS 3MM/ML 46.20

RABIES IMM GLOB IM/SC 518.70 RABIES VACCINE IM 840.00 RETEPLASE 18.1MG 6,462.75 RUBELLA VACCINE 221.55 QUINUPR/DALFROPRST 500MG 443.10 TERIPARATIDE 750MCG/3ML 2,108.40 TESTOSTERONE CYPIONATE 200 MG 178.90 TETANUS TOXOID .5ML 95.55

TIGECYCLINE 1 MG INJ 5.25 TIROFIBAN PER 0.25MG 42.00 UROKINASE 250000U 2,664.90

VITAMIN A 100000U/2ML 216.30 HYDROCOD/APAP 7.5/750 5.25 HYDROCOD/HOMATROP 10ML 16.80 HYDROCODONE/ACET 10ML 5.25 LORTAB ELIXIR 10MG-300MG/15 ML 2.95 HYDROCOD/APAP 7.5/500 5.25 HYDROCOD/IBUPROF 200/7.5 5.25 HYDROMORPHONE 4MG TAB 17.85

MEPERIDINE TAB 50MG 5.25 MEPERIDINE TAB 100MG 5.25 METHADONE 5MG/5ML ORAL 5.25 METHADONE 10MG/ML 94.50 METHADONE 10MG TAB 17.85 METHADONE 5MG TAB 5.25 FLUMAZENIL 10ML 516.60 FLUOROSCEIN 25% 2ML 190.05 FLUORESCEIN 10% 5ML 221.55 FLUOROURACIL 50MG/ML10ML 95.55

FLUPHENAZINE HCL 2.5 95.55 FLUPHENAZINE DEC 25MG/ML 105.00 FONDAPARINUX 5MG/0.4ML 46.20 FONDAPARINUX 2.5MG/0.5ML 46.20 HEPATITS B IMM GLOB .5ML 408.45 HEPATITIS B IMM GLOB 1ML 816.90 HEPATITIS B VAC ADULT 542.85 HYALURONAT/CHONDRO .5ML 934.50

LABETALOL 5MG/ML 20ML 453.60 NOREPINEPHRINE 4MG/4ML 114.45 NOREPINEPHRINE IN D5W 85.05

cdm

LIDOCAINE TRACH KIT 170.10 MAGNESIUM SULF 50% 10ML 95.55 MAG SULFATE INJ 50%-20ML VIAL 41.85 MEDROXYPROGEST 150MG/ML 227.85 MIDAZOLAM 1MG/ML 10ML VL 220.50 MIDAZOLAM 1MG/ML 5ML VL 169.05 MIDAZOLAM 1MG/1ML 2ML VL 119.70 MIDAZOLAM 5MG/ML 5ML VL 427.35 MIDAZOLAM INJ 10 MG 8.90 MINOCYCLINE 100MG 302.40

MULTIVITAMIN INJ 10ML 138.60 MUMPS VACCINE 271.95 MYCOPHENOLATE 500MG INJ 155.40 NAFCILLIN 1GM 46.20 NALOXONE 1MG/ML 2ML 449.40 NALOXONE .4MG/ML 1ML 153.30 NALONONE 0.4MG/ML 247.80 NALOXONE 1MG/ML 10ML 645.75

NEOSTIGMINE 1:1000 10ML 79.80 NICARDIPINE 25MG/10ML 204.75 NITROGLYC PMX 50MG/250ML 68.25

NITROGLYCERIN 50MG/10ML 863.10 OLANZAPINE 1MG/ML 10ML 109.20 OLANZAPINE 10 224.90 NITROPRUSSIDE 50MG/5ML 66.15 OFLOXACIN 400MG/10ML 334.95 ORPHENADRINE 30MG/ML 2ML 95.55 OXACILLIN 1GM 278.25 OXACILLIN 2 GM INJ 162.35

PANCURONIUM 10MG/10ML 363.30 PANCURONIUM 2MG/ML 2ML 105.00 PANTOPRAZOLE 40MG IV 123.90 PARICALCITOL 5MCG/ML 1ML 149.10 PENICILLIN G POT 1MU 95.55 PENICILLIN G POT 5MU 169.05 PENICILLIN G NA 5MU 121.80 PENICILLIN G PROC 1.2MU 30.25 PENICILLIN G PROC 2.4MU 49.90 PENICILLIN G PROC 600KU 87.15

PENTAZOCINE SYR 30MG 95.55 PHENYLEPHRINE HCL 10 17.85 PHENYLEPHRINE IN D5W 66.15 PHENYLEPHRN 10MG/ML 1ML 95.55 PHENYTOIN 100MG/2ML 46.20 PHENYTOIN 250MG/5ML 46.20 PHYSOSTIGMINE 2ML 95.55 PHYTONADIONE 10MG/ML 1ML 93.45

PIPERACILLIN 2GM 246.75 PIPERACILLIN 3GM 359.10 PIPERACILLIN 4GM 396.90

cdm

PIPERCLLN TAZOBACT 2.25G 142.80 PIPERCLN TAZOBACT 3.375G 192.15 PIPERCLLN TAZOBACT 4.5G 235.20 PIPERCLLN/TAZO 2.25GMPMX 142.80 PIPERCLLN/TAZO 3.375PMX 192.15 PIPERCLLN/TAZO 4.5GM PMX 235.20 POLYMIX B 500MU 166.95 POTASSIUM CL 2MEQ/ML 46.20 PROCAINAMIDE 500MG/ML 4M 199.50 PROPOFOL 10MG/ML 100ML VIAL APP 226.80

PROPOFOL 10 MG/ML 50 ML VIAL - APP 113.40 PROTAMINE 10MG/ML 5ML 114.45 PRAXBIND 2.5 G/50 ML INJ 3,500.00 PROTAMINE 10MG/ML 25ML 403.20 QUINIDINE GLUCONATE 80 107.10 REGADENOSON 0.4MG/5ML INJ 1,050.00 RIFAMPIN 600MG 905.10 ROPIVACAINE 5MG/ML 30ML 60.90

ROPIVACAINE 7.5MG/ML20ML 57.75 ROPIVACAINE 2MG/ML 200ML 160.65 SCOPOLAMINE.4MG/ML 87.15

SODIUM ACET 2MEQ/ML 20ML 93.45 SODIUM BICARB 4% ADDITIV 96.60 SODIUM BICARB PED 4.2% 61.95 SODIUM BICARB 8.4% 10ML 190.05 SODIUM BICARB 50ML VL 142.80 SODIUM BICARBONATE 8.4% 153.30 SODIUM CHLORIDE CONC 95.55 SODIUM CHLORIDE 10% 15ML 6.30

SODIUM CL .9% INJ 50.40 SOD PHOS 3MM/ML 30ML 93.45 TACROLIMUS 5MG/ML 1ML 615.30 TESTOSTERONE CYPIONATE 1000 MG 555.60 TETANUS IMMUNE GLOB 250U 380.10 THEOPHYLLINE .5011GM 473.55 THEOPHYLLINE 400MG/500ML BAG 31.50 TOLAZOLINE 25MG/ML 184.80 TRACE METALS SYG 5ML 93.45 TRIAMCINOLONE 50 MG VIAL INJ 105.85

TRIAMCINOLONE 40 MG VIAL INJ 59.45 TROMETHAMINE 18G/500ML 1,285.20 VALPROATE INJ 500MG/5ML 66.15 VANCOMYCIN 1GM 99.75 VANCOMYCIN 750 MG IVPB 182.65 VASOPRESSIN 20U/ML 221.55 VECURONIUM 10MG VIAL 137.55 VERAPAMIL HCL 2.5 359.10

VITAMIN C 100MG/ML 10ML 82.95 COUMADIN 5MG IV 498.75 ZIDOVUDINE 200 MG VIAL INJ 202.60

cdm

ZINC SULF 1MG/ML 93.45 ACETAMINOPH/COD 12MG/5ML 5.25 ACETAMINOPHENC 30MG 5.25 ACETAMINOPHENC 60MG 5.25 ALFENTANIL .5MG/ML 2ML 106.05 ALFENTANIL .5MG/ML 5ML 174.30 ALFENTANIL .5MG/ML 10ML 238.35 VANCOMYCIN 1G/D5W 250ML 102.40 ASA/BUTALBITAL/CAFF CAP 5.25 ASA/BUTALBITAL/CAFF TAB 5.25

CARISOPRODOL/ASA/COD 5.25 CHLORAL HYDRAT CAP 500MG 3.15 COCAINE SOLN 10% 4ML 305.55 COCAINE SOLN 4% 4ML 258.30 CODEINE INJ 30MG 86.10 CODEINE TAB 15MG 5.25 CODEINE TAB 30MG 5.25 FENTANYL 12MCG/HR PATCH 58.80

FENTANYL 25MCG/HR PATCH 73.50 FENTANYL 50MCG/HR PATCH 120.75 FENTANYL 75MCG/HR PATCH 191.10

FENTANYL 100MCG/HR PATCH 238.35 FENTANYL 400MCG LOZ STK 44.10 FENTANYL 600MCG LOZ STK 60.90 FENTANYL 800MCG LOZ STK 72.45 HYDROCOD/APAP 5/325 + TABLET 5.25 HYDROMORPH 10MG/ML 5ML 135.45 HYDROMORPHONE 2MG INJ 86.10 HYDROMORPHONE 4MG INJ 86.10

HYDROMORPH 10MG/ML 10ML 86.10 HYDROMORPHONE 10MG/50ML 100.80 LEVORPHANOL TAB 2MG 5.25 MEPERIDINE SYG 25MG/ML 86.10 MEPERIDINE SYG 50MG/ML 93.45 MEPERIDINE SYG 100MG/ML 86.10 MEPERIDINE 10MG/ML 50ML 299.25 METHOHEXITAL 500MG 124.95 MORPHINE (DURAMORPH) 0.5 MG/ML 10ML 86.00 MORPHINE PCA 50 MG SYRINGE 169.80

MORPHINE SYG 2MG/ML 86.10 MORPHINE 4 MG INJ SYRINGE 9.40 MORPHINE 25MG/ML 4ML VIAL 74.15 MORPHINE 8 MG SYRINGE 9.50 MORPHINE 15 MG VIAL INJ 7.90 MORPHINE 15 MG/ML 20 ML VIAL 60.50 MORPHINE SUL ER CAP 30MG 12.60 MORPHINE SUL ER CAP 60MG 24.15

DEPODUR 15 MG INJ 2,704.55 PCA HYDROMORPHONE 2.10 GLYCERIN ADULT 1.00

cdm

ISOSULFAN BLUE 10M/M 5ML 2,011.80 DOCETAXEL 1MG 155.65 DOXORUBICIN (ADRIAMYCIN) 10 MG INJ 866.25 DEXRAZOXANE 500MG 2,172.45 TEMSIROLIMUS 25MG/ML 6,043.80 HEPARIN 1000 UNIT/ML INJ 862.75 PREMIX BAG - ETOPOSIDE PER 10MG 7.35 AZACITIDINE 100 MG INJECTABLE VIAL 2,594.00 FLUDARABINE PHOS 50MG 360.15

FOSPHENYTOIN PER 50MG 52.50 GEMCITABINE PER 200MG 506.10 GOSERELIN IMPLNT 3.6MG 3,656.10 IDARUBICIN 5MG 2,547.30 EPIRUBICIN HCL 200MG/100ML 32.40 IFOSFAMIDE 1GM 940.80 INTERFERON ALFA 2B 1MU 64.05 IRINOTECAN PER 20MG 642.60

LEUPROLIDE DEPOT 7.5MG 2,304.75 MESNA 200MG 203.70 METRONIDAZOLE 500MG 229.95

MITOMYCIN 5MG 751.80 MITOXANTRONE PER 5MG 1,296.75 NAFCILLIN 2GM 46.20 OXALIPLATIN PER 0.5MG 43.05 OXALIPLATIN 0.5MG 30.10 OXALIPLATIN 0.5MG 22.45 PACLITAXEL (TAXOL) 300 MG INJ 532.90 PEMETREXED PER 10MG 204.75

ALBUMIN 5% 250ML 284.70 PROPOFOL 10MG/ML 20ML 45.35 PROPOFOL 10MG/ML 50ML 246.75 PROPOFOL 10 MG/ML 50 ML VIAL 86.30 PROPOFOL 10 MG/ML 100 ML VIAL 226.80 PYRIDOSTIGMINE 10MG/2ML 87.15 RITUXIMAB 100MG/10ML 1,807.05 VEDOLIZUMAB 300 MG 20,239.80 CETUXIMAB (ERBITUX) 2MG/ML VIAL 5,291.00 ROCURONIUM 10ML 192.15

ROCURONIUM BROMIDE 10 123.85 TICARCILLIN/CLAV 3.1GM 290.85 TRASTUZUMAB PER 10MG 242.55 VINBLASTINE 10MG INJ 208.70 VINCRISTINE 1MG 290.85 VINCRISTINE 2MG 118.55 VINORELBINE PER 10MG 501.90 CODEINEBUTAL 30MG 5.25

CODEINE/BUTALBITAL/ASA/CAFFEI+ 3.40 DRONABINOL 2.5MG CAP 32.55 HYDROCODONE/CPM PK 5ML 9.45

cdm

HYDROCODONEPP 5.25 METHYLPHENIDATE 5MG 5.25 METHYLPHENIDATE 10MG 3.15 MIDAZOLAM 5 MG/5ML 59.00 MORPHINE 10MG/5ML 5.25 MORPHINE SULFATE 10MG 31.50 MORPHIN CONC 20MG/ML 1ML 3.15 MORPHINE 10MG TAB 3.15 MORPHINE TAB 15MG 8.40 MORPHINE SUL CR TAB 60MG 28.35

MORPHINE SULCR TAB 100MG 42.00 MORPHINE SUL CR TAB 15MG 8.40 MORPHINE TAB 30MG 14.70 MORPHINE SUL CR TAB 30MG 14.70 OXANDROLONE 10MG TAB 85.05 OXANDROLONE 2.5MG TAB 18.90 PERCOCET 10/325 12.20 OXYCODONE/ACET 5/325 TABLET 5.25

OXYCODONE 15MG 19.95 TAPENTADOL (NUCYNTA) 50MG ER 18.40 TAPENTADOL 75+ 15.05

TAPENTADOL HYDROCHLORIDE 100+ 20.05 OXYCODONEASA 5.25 OXYCODONE 5MG 17.85 OXYCODONE CONTR REL 10MG 8.40 OPANA ER (OXYMORPHONE) 10 MG 28.95 OXYCODONE CONTR REL 20MG 15.75 OXYCODONE CONTR REL 40MG 28.35 OXYCODONE CONT REL 80MG 52.50

OXYCODONE 20MG/ML 1ML 7.35 OXYCODONE 100 MG/5ML SUS 30 ML BTLE 1,397.85 PEMOLINE 18.75MG 5.25 PEMOLINE 37.5MG 11.55 PHENOBARB 30MG 5.25 PHENOBARB 60MG 5.25 PHENOBARB 100MG 5.25 PHENOBARB 20MG/5ML 5.25 REMIFENTANIL 1MG/3ML 124.95 REMIFENTANIL 2MG/5ML 118.65

THIOPENTAL 0500MG INJ 137.55 THIOPENTAL 0500MG INJ 137.55 OXICONAZOLE 1% 15GM 179.55 B&O SUPPRETTES 17.85 OPIUM BELLADONNA 60MG 17.85 ACETYLCHOLINE CL 1% 370.65 ACETYLCYSTEINE 10% 4ML 25.20 ACETYLCYSTEINE 10% 10ML 149.10

ACETYLCYSTEINE 20% 4ML 26.25 ACETYLCYSTEINE 20% 10ML 232.05 ACETYLCYSTEINE 20% 30ML 512.40

cdm

ALBUTEROL 90MCG 17GM 193.20 ALBUTEROL SULFATE 90+ 258.15 ALBUTEROL .5% 20ML 150.15 ALBUTEROL .0839% 3ML 10.50 AMYL NITRITE VAP 80.85 ARTIF TEARS METHYLC 15ML 124.95 ARTIFICIAL TEARS UD 2.10 ARTIFICIAL TEARS 15ML 90.30 CYCLOSPORINE OPTH 31.50 ATROPINE 1% 2ML OS 78.75

ATROPINE 1% 15ML OS 154.35 ATROPINE 1% 3.5GM OO 95.55 AZELASTINE NASAL SP 34ML 286.65 BACITRACIN 3.5GM OO 19.95 BECLOMETH INH 80MCG 7.3G 290.85 BECLOMETH INH 40MCG 7.3G 231.00 PULMICORT 180MCG 120DS 576.45 PULMICORT 90MCG 430.50

BUDESONIDE NASAL INH 7G 184.80 CARBAMIDE PEROX 15ML 72.45 CROMOLYN 13ML NASAL SOLN 160.65

CROMOLYN 8.1GM INHALER 375.90 FLUNISOLIDE .025% 25ML 333.90 FLUNISOLIDE 7GM 329.70 FLUNISOLIDEMENTHOL 7 GM 168.00 FLUTICASONE .05%16GM 330.75 FLUTICASONE 110MCG 13GM 362.25 FLOVENT DISKUS 100 MCG (FLUTICASONE 1,026.95 FLOVENT DISKUS 250 MCG INHALATION 884.10

FORMOTEROL INH 12MCG CAP 7.35 HYALURON SYG 12MG/ML.8ML 577.50 HYALURON 10MG/ML .85ML 989.10 HYALURON 10MG/ML .8ML 1,568.70 HYALURON SYG 7.5MG/.75ML 2,169.30 INHALER SPACER UNIT 226.80 IPRATOPIUM 18MCG/PF 14G 184.80 IPRATOPIUM .02% SOLN 15.75 IPRATROPIUM.03% NAS SPR 184.80 IPRATROP/ALBUT INH14.7GM 206.85

ISOTONIC COLLYRIUM 15ML 55.65 LANOLINCLBUTA 3.5GM 90.30 LANOLINCLBUTA .7G UD 34.65 MOMETASONE 17GM NS 170.10 ASMANAX 220MCG INH 510.30 NEDOCROMIL SOD 16.2GM 254.10 NITROGLYCERIN 13.8G SPRY 206.85 OCULAR LUBRICANT 5.25

CARBOXYMETHYLCELULOSE REFRESH 0.4ML 1.65 OXYMETAZOLINE 15ML .05% 80.85 OXYMETAZOLINE 20ML .05% 101.85

cdm

PHENYLEPHRN.125% 30ML DR 34.65 PHENYLEPHRN .25% 15ML SP 59.85 PHENYLEPHRN .5% 15ML SP 55.65 PHENYLEPHRINE 1% DROPS 55.65 PIRBUTEROL INHALER 250.95 POLYVINYL ALCOH 15ML 93.45 PROPARACAINE .5% 15ML 45.15 PROPARACAINE .5% 15ML 45.15 SALMETEROL DISKUS 50MCG 443.10 SALMET/FLUT DSK50/100 28 472.50

SALMET/FLUT DSK50/100 28 472.50 SALMET/FLUT DSK50/250 28 472.50 SALMET/FLUT DSK50/250 28 472.50 SALMET/FLUT DSK50/500 28 659.40 SODIUM CL.9% 3ML NEB 1.00 SODIUM CHLORIDE 45ML 109.20 SODIUMCAL SOLN 500ML 374.85 SUMATRIPTAN NASAL SP 5MG 115.50

SUMATRIPTAN NAS SP 20MG 115.50 TETRAHYDRAZOL .1% 15ML 55.65 TRIAMCINOLONE AQ INHALER 258.30

ACYCLOVIR 5% 15GM 184.80 ACYCLOVIR CREAM 5% - 5G TUBE 2,695.50 ALLEVYN ADH DRESSING 3X3 32.55 ALLEVYN ADH DRESSING 5X5 93.45 ALUM SULF/CA ACET 120G 5.25 AVEENO OILATED 240G 99.75 BACITRACIN 15GM 59.85 BACITRACIN 30GM 93.45

BACITRACIN/POLYMXN 30GM 103.95 BACITRACIN/POLY 10G PWD 129.15 BENZALKONIUMHA 15.75 BENZOCAINE GEL 45.15 BENZOIN TINCTURE 17.85 INTEGUSEAL MICROBIAL SEALANT 454.65 BLISTEX 9.9G 17.85 BUTOCONAZOLE 2% 28GM CR 237.30 BUTOCONAZOLE 2% 5GM 72.45 CADEXOMER PAD 4X6CM BX5 27.30

CADEXOMER PAD 6X8CM BX3 57.75 CALMOSEPTINE 71GM 38.85 CAMPHOR/PHENOL 22.5ML 31.50 SARNA 240ML 72.45 CAPSAICIN .025% 42.5GM 254.10 CAPSAICIN .075% 30GM 312.90 CHAPSTICK 2.10 CHLORHEXIDINE 120ML 95.55

CHLORHEXIDINE GLUCONATE 4% 5.25 CHLORHEXIDINE 960ML 95.55 COD LIVER OILZ 28GM 31.50

cdm

CARRING DERMAL DSG 3 OZ 193.20 DIPHENHYDRA 2% 30GM 84.00 DIPHENHYDRAMINE & ZINC CREAM 27.10 DIPHENHYDRACALAM LOTION 78.75 EMOLLIENT LOTION 109.20 EMOLLIENT LOTION 109.20 EMOLLIENT 60GM 80.85 HAMMELIS WATER 50% 40GM 56.70 HYDROACTIVE DRSG GEL 15G 78.75 HEXACHLOROPHENE PACKET 3.15

HYDROACTIVE DRESSING 4X4 78.75 HYDROCORTI .5% 30GM CRM 103.95 HYDROCORTISONE .5% 30GM 103.95 HYDROCORTISONE CR.1% 30GM 7.60 KERILOTION 84.00 LACTIC ACID 5% PYRR 2.5% 44.10 AMMONIUM LACT 12% LOT 160.65 LANOLIN 30GM 43.05

LANOLIN 60GM 34.65 LIP OINTMENT 2.10 MEDICATED SOAP 120.75

METHYL SALIC/MENTHOL ETC 56.70 METHYL SALICYLAT 38GM 34.65 MICONAZOLE 100MG 7.35 MICONAZOLE 47GM 370.65 MICONAZOLE 2% 30GM CRM 250.95 MICROFIBRILLAR SHEETS 726.60 MOISTURIZING CREAM 93.45 NEOMYCIN 5GM 189.00

NEOMYCIN/HCTS 1% 20GM 254.10 NEOMYCINPOLYMY 15GM 76.65 NEOMY/POLYMYX B/PRAM CREAM+ 31.50 NEOMYC/POLYMY/BACIT 30G 103.95 NEOMYCINPOLYMY PCKT 1.00 NICOTINE TRANSDERMAL 7MG 47.25 NICOTINE TRANSDERML 14MG 50.40 NICOTINE TRANSDERML 21MG 55.65 PERIFOAM 124.95 PERMETHRIN 1% 60ML 109.20

PETROLATUM 30GM 5.25 PREPARATION H OINT 30GM 50.40 PRAMOXINE/MINERAL OIL/ZINC OX 19.30 POVIDONEIODINEDOUCHE 34.65 POVIDONEIODINE PAD 16.80 POVIDONEIODINE SOLN 5.25 SELENIUM SULFIDE 1% 45.15 SODIUM CL.9% 15ML NEB 5.25

BLAIREX NASAL MOIST GEL 10.50 SWEEN CREAM 2 OZ 30.45 TERBINAFINE 1% 15G 232.05

cdm

TOBRAMYCIN POWD 1.2GM 1,190.70 TOLNAFTATE 1% 10ML 99.75 TOLNAFTATE 1% 15GM 103.95 A & D UNG 2OZ 9.20 VITAMIN E CRM 60GM 80.85 ZINC OXIDE 30GM 45.15 ACETAMINOPHEN 120MG 1.00 ACETAMINOPHEN 325MG 1.00 ACETAMINOPHEN 650MG 5.25 ACETAMINOPHEN 1 G IV 81.25

AMINOPHYLLINE 250MG SUPP 5.25 AMINOPHYLLINE 500MG SUPP 5.25 ASPIRIN 300MG SUPP 1.00 ASPIRIN 600MG SUPP 5.25 BISACODYL 10MG 5.25 GLYCERIN ADULT 1.00 GLYCERIN INFANT 1.00 HCBISMUTH BENZ 30GM 144.90

HCBISMUTHBENZ 5.25 PHENYL MERCURIC SUPP 2.10 SODIUM PHOS ENEMA 43.05

SODIUM PHOS PED ENEMA 34.65 BOWEL EVACUANT 129.15 BOWEL EVACUANT 95.55 BOWEL EVACUANT 21.00 TRIGLYCERIDES MED CHAIN 5.25 TWO CAL HN 240ML 33.60 ALBUTEROL/IPRATROPIUM3ML 9.45 APRACLONIDINE .5% 5ML 294.00

APRACLONIDINE 1% .1ML 56.70 BETAXOLOL .25% 2.5ML OS 77.70 BENZOCAINEANTIPY 15ML 58.80 BETAXOLOL .5% 5ML OPHTH 163.80 LUMIGAN 0.01% 2.5 ML 564.70 BUTORPHANOL 2.5ML NS 500.85 BUDESONIDE PWDR 200MCG 515.55 BUDESONIDE/FORMOTEROL INH+ 974.05 BRINZOLAMIDE 1% 5ML 109.20 CALCITONIN INJECTION 200 U/ML VIAL 10,016.35

BUDESONIDE INH .5MG/2ML 25.20 CARBACHOL .01% 1.5ML 318.15 BRIMONIDINE .15% 5ML OS 177.45 BRIMONIDINE TARTRATE OPH 0.2% 114.20 CARBACHOL 1.5% 15ML 184.80 CARBACHOL 3% 15ML 144.90 CARTEOLOL 1% 5ML OS 154.35 CIPROFLOXACIN 2.5ML OS 94.50

CIPROFLOX OO 0.3% 3.5G 197.40 CROMOLYN 10MG/ML 2ML NEB 5.25 CYCLOPENTOLATE 1% 2ML 84.00

cdm

CYCLOPENTOLATE 2% 2ML 134.40 DESMOPRESSIN .01% 2.5ML 815.85 DEXAMETHASONE .1% 5ML OS 84.00 DEXAMETHASONE .1%15ML OS 287.70 DEXAMETHA/NEO/POLY 3.5GM 168.00 NEO/POLYMYX B/DEXAMETH OPTH+ 57.60 DICLOFENAC .1% 5ML 294.00 DIPIVEFRIN .1% 5ML OS 144.90 DORNASE ALPHA 2.5ML 307.65 DORZOLAMIDE 2% 5ML OS 189.00

DORZOLAMIDE/TIMOLOL 5ML 176.40 DORZOLAMIDE/TIMOLOL EYE DROP 425.20 ECOTHIOPHATE .125% 5ML 129.15 ECOTHIOPHATE .25% 5ML 284.55 EPINEPHRINE 1:1000 30ML 133.35 EPINEPHRINE 1.125% .5ML 5.25 ERYTHROMYCIN 1GM UD OPHT 80.85 ERYTHROMY OPTH 3.5GM 93.45

FLUORESCEIN 2%2ML 134.40 FLUORESCEIN STRIP 6.30 FLUOROMETH ACET .1% 5ML 168.00

FLUOROMETHALONE .1% 184.80 FLUOROMETHALONE.25% 5ML 234.15 FLURBIPROFEN .03% 2.5ML 284.55 GELATIN ABS 149.10 GATIFLOXACIN .3% 5ML OS 254.10 GATIFLOXACIN(ZYMAR)0.5% EYE DROP - GENTAMICIN .3% 3.5GM OO 120.75 GENTAMICIN .3% 5ML OS 140.70

TRIFLURIDINE 1% 929.25 HOMATROPINE 2% 15ML 179.55 HOMATROPINE 5% 1ML 44.10 HOMATROPINE 5% 15ML 133.35 KETOROLAC 0.5% .4ML 321.30 KETOROLAC 0.5% 5ML OS 269.85 LATANOPROST .005% 2.5ML 294.00 LEVOBUNOLOL .5% 5ML 170.10 LEVALBUTEROL 0.63MG/3ML 12.60 LEVALBUTEROL 1.25MG/3ML 12.60

XOPENEX HFA MDI 208.95 LEVOFLOXACIN .5% 5ML OS 174.30 MEDRYSONE 1% 5ML OS 160.65 METAPROTERENOL .4% UD 14.70 METAPROTERENOL .6% UD 14.70 METAPROTERENOL 15ML 267.75 METIPRANOLOL .3% 5ML OS 134.40 NAFARELIN 2MG/ML 10ML NS 3,553.20

MOXIFLOXACIN .5% 3ML OS 254.10 NAPHAZOLINE .1% 15ML 161.70 NAPHAZOLINE NASAL 49.35

cdm

NAPHAZOLINEPHENIR 15ML 124.95 NEO/POLY/HYDROCORTIS OPH 197.40 NEO/POLY/HYDROCORTIS OPH 197.40 DEXAMETH/NEOMYCIN 5ML OS 197.40 NEOMYC/POLY/GRAMICID10ML 176.40 NEOMYC/POLY/BACITRA 3.5G 124.95 SODIUM CHLORIDE 5% 15ML 120.75 SODIUM CHLORIDE 5% 3.5GM 124.95 SODIUM CA SOLN 30ML 49.35 SODIUMCA PLUS SOL 500ML 775.95

BENZOTETRA SPRAY 56ML 276.15 BENZOCAINE 85GM 154.35 BENZOCAINE 60ML SPRY 140.70 BETAMETHASONE .05% 15G C 193.20 BETAMETHASONE .05% 15G O 129.15 BETAMETHASONE .05% 20MLL 285.60 BETAMETHASONE .1% 15GM C 193.20 BETAMETHASONE .1% 15GM O 184.80

CARBOLFUCHSIN 30ML 45.15 CALCIPOTRIENE CR/OT 60GM 603.75 CIPROFLOXACIN/HC 10ML OT 400.05

CLINDAMYCIN 1% 7.5G GEL 232.05 CLINDAMYCIN LIQ 60ML 282.45 CLOBETASOL .05% 30GM 325.50 CLOBETASOL OINTMENT 0.05% 30 GRAM 210.75 CLOTRIMAZOLE 1% 15GM CRM 117.60 CLOTRIMAZOLE 1% 30GM 229.95 CLOTRIMAZOLE 1% 30ML 228.90 CLOTRIMAZOLE 1% 45GM VAG 184.80

CLOTRIMAZOLE 100MG 34.65 CLOTRIMZOL/BETAMETH 30ML 214.20 CLOTRIMZOL/BETAMETH 15GM 160.65 CLOTRIMZOL/BETAMETH 45GM 270.90 CLONIDINE HCL 0.1MG TTS 84.00 CLONIDINE HCL 0.2MG TTS 85.05 CLONIDINE HCL 0.3MG TTS 129.15 COLLAGENASE 30G 285.60 DESONIDE .05% 15GM 63.00 DESOXIMETASONE .25% 15GM 179.55

ECONAZOLE 1% 15GM 160.65 ERYTHROMY 2% 60ML 149.10 ESTRADIOL 0.05 PATCH 34.65 ESTRADIOL 0.1 PATCH 43.05 ESTRADL 24HR PTCH/.05MG 35.70 ESTRADL 24HR PTCH/.1MG 35.70 ESTRADIOL 25MCG 18.90 ETHYL CHLORIDE 117.60

FERRIC SUBSULFATE 60ML 2.10 FIBRIN SEALANT KIT 2ML 2,074.80 FIBRIN SEALANT PATCH 3,110.15

cdm

EVICEL FIBRIN SEALANT 5ML KIT 2,065.32 FLUOCINOLONE .01% 15GM 134.40 FLUOCINOLONE .01% 20ML 168.00 FLUOCINOLONE .025% 15GM 129.15 FLUOCINOLONENE .025% 15 197.40 FLUOCINONIDE .05% 15GM 237.30 FLUOCINONIDE .05% 15GM 237.30 FLUOCINONIDE .05% 30GM 294.00 FLUOCINONIDE 0.1% CREAM + 963.90 FLUOCINONIDE .05% 30GM 294.00

FLUCINONIDE .05% 20ML 276.15 GELATIN ABS 50 168.00 GELATIN ABS 100 270.90 GELATIN ABS 100 270.90 GELATIN ABS 12X7 84.00 GELETIN ABS POWD 1GM 294.00 GENTAMICIN .1% 15GM CRM 189.00 GENTAMICIN .1% 15GM UNG 140.70

GENTIAN VIOLET 1% 84.00 HYDROCORTISONE .1% 15GM 152.25 HYDROCORTISONE .2% 15GM 120.75

HYDROCORTISONE .5% 120M 229.95 HYDROCORTISONE 1% 120ML 176.40 HYDROCORTISONE 1% 10GM 150.15 HYDROCORTISONE 1% 30GM 189.00 HYDROCORTISONE 2.5% 30GM 84.00 HYDROCORTISONE 2.5% 20GM 72.45 KETOCONAZOLE 2% CREAM 282.45 KETOCONAZOLE 2% SHAMP120 177.45

AMMONIUM LACT 12% LOT 160.65 LEECH MEDICAL EACH 43.05 LIDOCAINE 2% JELLY 5ML 77.70 LIDOC 2.5/PRILOC 2.5 5G 93.45 LIDOC 2.5/PRILOC 2.5 30G 316.05 METRONIDAZOLE .75% 30GM 184.80 METRONIDAZOLE .75% 70GM 210.00 MICROFIB COLLAGEN 1GM 981.75 MOMETASONE .1% 15GM 184.80 MOMETASONE .1% 45GM 316.05

MUPIROCIN 2% 1GM UD 17.85 MUPIROCIN 2% 282.55 MUPIROCIN 2% 15GM 144.90 NEOMYCIN 10GM 25.20 NITROGLYCERIN 2% 30GM 154.35 PERUBALSAM 120ML 184.80 NEO/BAC/POLY/HC 7.5GM 133.35 NEO/BAC/POLY/HC 15GM 197.40

TACNEOMYCINGR 30GM CRM 250.95 NYSTATIN AND TRIAMCINOLONE CRM 15 G 705.20 TACNEOMYCINGR 60GM CRM 528.15

cdm

TACNEOMYCINGR 15GM 210.00 TACNEOMYCINGR 30GM UNG 344.40 TOBRAMYCIN POWD 1.2GM 1,819.65 TRIAMCIN A 5GM 117.60 UREA CRM 90GM 148.05 UREA LOTION 10% 180ML 77.70 DINOPROSTONE 10MG 1,204.35 HYDROCORTISONE 100MG60ML 84.00 MESALAMINE 4G/60ML 149.10 MESALAMINE SUPP 1 G 102.25

INDOMETHACIN 50MG SUPPOSITORY 116.05 MESALAMINE 500MG SUPP 34.65 POLYSTYRENE SULF 30GM 254.10 DESFLURANE 240ML 558.60 ISOFLURANE 100ML 558.60 ETHIODIZED OIL 37% 10ML 441.00 SUFENTANIL 2ML 241.50 SUFENTANIL 5ML 300.30

MISC EENT PRODUCT 89.25 ACETIC ACID 2% 15ML 170.10 ACETIC ACID 2%/HYDROC 1% 142.80

OFLOXACIN .3% 5ML OTIC 166.95 OFLOXACIN .3% 5ML OS 204.75 OLOPATADINE 5ML OS 267.75 PENTAMIDINE 300MG 1,718.85 PHENYLEPHRN 10% 5ML OS 149.10 PHENYLEPHRN 2.5% 5ML OS 140.70 PHENYLEPHRN 2.5% 2ML OS 44.10 PHENYLEPHRN 2.5% 15ML OS 149.10

PHENYLEPH/CYCLOPENT 5ML 168.00 PILOCARPINE .25% 15ML OS 95.55 PILOCARPINE .5% 15ML OS 140.70 PILOCARPINE 1% 15ML OS 154.35 PILOCARPINE 1% 2ML OS 50.40 PILOCARPINE 2% 15ML OS 117.60 PILOCARPINE 2% 2ML OS 84.00 PILOCARPINE 3% 15ML OS 120.75 PILOCARPINE 4% 15ML OS 120.75 PILOCARP 4% GEL 5GM 276.15

PILOCARPINE 6% 15ML OS 149.10 POLYMIXBACIT OPTH UNG 103.95 POLY/NEO/HYDROCORTI OTIC 197.40 POL/NEO/HYDROCORTI SUSP 189.00 PREDNISOLONESULF 5ML 206.85 PREDNISOLONE .12% 5ML 150.15 PREDNISOLONE 1% 5ML 133.35 PREDNISOLONE 1% 10ML 160.65

PREDNISOLONE/NE 184.80 PREDNISOLON/GENTAMI 1/.3 197.40 PREDNISOLON/GENTAMI 3.5G 229.95

cdm

RIMEXOLONE 1% 10ML 150.15 SCOPOLAMINE .25% 5ML 154.35 SODIUM SULFACET 10% 5ML 206.85 SULFACETAMIDE 10% 3.5GM 161.70 SULFACETAMIDE 30% 15ML 189.00 SULFACETAMIDE S 10% 15ML 193.20 SULFACETAMIDE 5ML 264.60 SULFACETAMID/PREDNI 3.5G 176.40 TALC STERILE POWDER 402.15 TETRACAINE .5% 1ML 31.50

TIMOLOL .25% 5ML OS 184.80 TIMOLOL .25% 5ML GEL 206.85 TIMOLOL .5% 5ML GEL 242.55 TIMOLOL .5% 5ML OS 232.05 TIOTROPIUM 18MCG INH 6 136.50 TUDORZA PRESSAIR 400MCG INH 929.25 TOBRAMYCIN OO 3.5GM 210.00 TOBRAMYCIN/DEXAMETH3.5GM 239.40

TOBRAMYCIN INH 300MG 5ML 129.15 TOBRAMYCIN/DEXAMETH 5ML 226.80 TOBRAMYCIN/DEXMETH 2.5ML 140.70

TRAVOPROST OS .004%2.5ML 117.60 TRIFLURIDINE 1% 7.5ML OS 270.90 TRIMETHPRM/POLYMYXN 10ML 182.70 TROPICAMIDE .5% 15ML 226.80 TROPICAMIDE 1% 1ML 103.95 TROPICAMIDE 1% 15ML 239.40 VISION BLUE .06% 17.85 MISC TOPICAL 10 10.50

MISC TOPICAL 30 31.50 MISC TOPICAL 70 73.50 MISC TOPICAL 150 157.50 MISC TOPICAL 300 315.00 MISC ENT 10 10.50 MISC ENT 30 31.50 MISC ENT 70 73.50 MISC. ENT 150 157.50 MISC ENT 300 315.00 MISC CMPD 10 10.50

MISC CMPD 30 31.50 MISC CMPD 150 157.50 MISC CMPD 300 315.00 CHLORHEXIDINE 0.12% 15ML ORAL SUSP 5.25 CONJUGATED ESTR CRM 42GM 161.70 DINOPROSTONE .5MG GEL 855.75 GENTIAN VIO/BRL GR .66ML 3.15 IODOCHLORHYDROX 20GM 160.65

IODOCHLORHYDROX 3% 30GM 103.95 LIDOCAINE 2% 30GM JELLY 89.25 LIDOCAINE 2.5% 35GM 117.60

cdm

LIDOCAINE 4% 50ML TOP 197.40 LIDOCAINE 5% 35GM UNG 140.70 LIDOCAINE 5% PATCH 25.20 LIDOCAINE 5% PATCH TOPICAL 61.62 MAFENIDE ACETAT 113GM 140.70 MICROFIB COLLAGEN 5GM 3,467.10 MINOXIDIL 2% 60ML 732.90 MOMETASONE .1% 55ML 234.15 NITROGLYCERIN 0.1MG/HR 12.60 NITROGLYCERIN 0.2MG/HR 12.60

NITROGLYCERIN 0.3MG/HR 12.60 NITROGLYCERIN 0.4MG/HR 12.60 NITROGLYCERIN 0.6MG/HR 12.60 NITROGLYCERIN UNG UD 5.25 NYSTATIN TOP CRM 15GM 140.70 NYSTATIN TOP POWD 15GM 206.85 NYSTATIN TOP POWER 100,000 U/G 173.00 NYSTATIN TOP UNG 15GM 197.40

NYSTATIN TOP UNG 30GM 319.20 NYSTATIN VAG TAB 100MU 5.25 PAPAIN UREA OINT 30G 211.05

OXYBUTYNIN3.9MG/DAY PTCH 47.25 PAPAIN UREA OINT 6GM 64.05 PENCICLOVIR 1% 2GM 163.80 PERMETHRIN 5% 60GM 160.65 PHENOL 5% 50ML 45.15 SCOPOLAMINE 1.5MG PATCH 90.30 SILVER NITRATE APPL 3.15 SILVER SULFADIA 1% 50GM 176.40

SILVER SULFADIA 1% 400G 500.85 SOD HYPOCHLORITE 480ML 30.45 SULFANILAMIDEA VAG CR 206.85 SULCONAZOLE 1% 30ML 264.60 SULCONAZOLE 1% 15GM 132.30 SULFATHIAZOLES 210.00 SULFATHIAZOLES 210.00 SURGICEL 1/2 X 2 479.85 TAZAROTENE 0.1% 30G GEL 349.65 TERCONAZOLE 80MG VAG SUP 117.60

TERCONAZOLE .4% VAG CR 269.85 TERCONAZOLE .8% 20G VAGC 226.80 TESTOSTERONE 5MG/24HR 22.05 TESTOSTERONE 5MG/24HR 22.05 TESTOSTERONE 50 60.55 TETRACAINE .5% 30G 109.20 TETRACAINE 2% TOP 134.40 THROMBIN 5000U 558.60

THROMBIN 10000U 679.35 TOPICAL ENZYME COMBO 30G 385.35 TOPICAL ENZYME COMBO 6GM 99.75

cdm

TRIAMCIN .025% 15GM CRM 103.95 TRIAMCIN .025% 15GM UNG 103.95 TRIAMCINOLONE ACETONIDE CREAM 0.5% 69.95 TRIAMCIN .025% 60ML 442.05 TRIAMCIN .025% 80GM CRM 184.80 TRIAMCIN .1% 15GM CRM 179.55 TRIAMCIN .1% 15GM UNG 129.15 TRIAMCIN .1% 80GM UNG 365.40 TRIPLE DYE APPL 3.15 MISC RECTAL 10 10.50

MISC RECTAL 30 31.50 MISC RECTAL 70 73.50 MISC RECTAL 150 157.50 MISC RECTAL 300 315.00 CLOTRIMAZOLE VAG TAB 31.50 INDOMETHACIN 50MG SUPP 18.90 PRAMOXINE HYDRO 206.85 PRAMOXINE HYDRO 15GM 154.35

PROCHLORPERAZN 25MG SUPP 34.65 PROMETHAZINE 12.5MG SUPP 31.50 PROMETHAZINE 25MG SUPP 34.65

PROMETHAZINE 50MG SUPP 34.65 SEVOFLURANE 250ML 1,242.15 VARICELLA VIRUS VACC 359.10 TIOCONAZOLE 4.6GM 276.15 WOUND CLEANSER 84.00 PERFLUORON PER 5ML 2,438.10 SEVOFLURANE PER DOSE 266.70 BARIUM KIT 97% 340G 13.65

BARIUM SUSP 1.5% 1900ML 120.75 BARIUM SUSP 60% 355ML 16.80 GASTROGRAFIN 66-10 120ML BOTTLE 502.85 GASTROGRAFIN 66-10 30ML BOTTLE* 173.10 HOCM < = 149MG/ML ID 1ML 1.00 HOCM 250 299MG/ML ID 1ML 2.35 HOCM 350 399MG/ML ID 1ML 24.70 OMNIPAQUE (IOHEXOL) 240 10ML VIAL 7.45 LOCM 300 349MG/ML ID 1ML 3.70 OMNIPAQUE(IOHEXOL)300 50ML BOTTLE 8.15

MR CONTRAST GAD BASE 1ML 22.60 DIFINITY 1.1MG/ML 489.30 SINCALIDE 5MCG VIAL 403.20 RESOURCE BREEZE 250 ML* 96.60 ARGINAID* 282.45 BENEFIBER* 2.10 ISOSOURCE 1.5 1000 ML* 97.65 BOOST PUDDING 5 OZ* 33.60

ENSUR FIB 240ML* 33.60 BOOST DIABETIC (DM)* 12.60 DIABETISHIELD 250 ML* 36.75

cdm

DIABETISOURCE AC 1000 ML* 95.55 ISOCAL HCN LIQUID 8OZ* 54.60 ISOSOURCE HN 250 ML* 33.60 JEVITY 240 ML* 33.60 JEVITY+ RTH1000* 93.45 NOVOSOURCE RENAL 250 ML* 42.00 NUTRIHEP 250 ML* 164.85 OSMOLITE RTH * 45.15 OSMOLITE 240ML * 33.60 PEDIASURE 250 ML* 18.90

PEPTAMEN 250 ML* 53.55 PEPTAMEN-PREBIO 1000 ML* 60.90 RESOURCE BENEPROTEIN* 33.60 REPLETE-FIBER 1000 ML* 44.10 PROFECT* 47.25 BENECALORIE* 47.25 PEPTINEX 1.0 250ML* 88.20 SUPLENA/REPLENA 240ML* 43.05

MCT OIL 0-10ML + 5.25 RESOURCE 2.0 250 ML* 33.60 TWO CAL HN240ML* 33.60

ISOSOURCE HN 1000 ML* 36.75 KANANA BANANA - FOOD DYE (COLOR) 5.25 AA 4.25% ELEC/CA D5W2000 824.25 CLINIMIX 4.25% AA-5% DEXTROSE 361.10 CLINIMIX 4.25% AA 10% DEX 2000 217.50 CLINIMIX 5% AA-20% DEXTROSE 205.05 CLINIMIX 5% AA-15% DEXTROSE 238.70

DEXTRAN 40 D5W 500ML 801.15 DEXTRAN 40 NACL .9 500ML 801.15 D2.5 1/2 L RINGERS 250ML 602.70 D2.5 1/2 L RINGERS 500ML 141.75 D2.5 NACL.45 250ML 110.25 D2.5 NACL.45 500ML 141.75 D2.5 NACL.45 1000ML 200.55 D2.5W 1000ML 200.55 D5 L RINGERS 500ML 200.55 D5 LRINGERS 1000ML 200.55

D5 NACL.2 1000ML 200.55 D5 NACL.45 1000ML 228.90 DEX 5%-1/2 NORMAL SALINE & 20KCL 210.00 DEX 5%-1/2 NORMAL SALINE & 30KCL 210.00 DEX 5%-1/2 NORMAL SALINE & 10KCL 210.00 DEX 5%-1/2 NORMAL SALINE & 40KCL 210.00 D5 NACL.9 250ML 110.25 D5 NACL.9 1000ML 200.55

DEX 5%-0..9NS & 20KCL 210.00 0.9NS & 20KCL 210.00 D5W 50ML 110.25

cdm

D5W 100ML 110.25 D5W 150ML 141.75 D5W 250ML 115.50 D5W 500ML 186.90 D5W 1000ML 200.55 D10W 250ML 110.25 D10W 500ML 141.75 D10W 1000ML 200.55 ISOLYTE P D5 1000ML 254.10 ISOLYTE R D5 1000ML 200.55

ISOLYTE S 1000ML 266.70 L RINGERS 1000ML 200.55 LACTATED RINGERS IV SOLUTION 500 ML 8.15 MANNITOL 20% 500ML 471.45 NACL .45 1000ML 141.75 NACL .9 50ML 110.25 NACL .9 100ML 110.25 NACL .9 250ML 115.50

NACL .9 250ML 115.50 NACL .9 500ML 186.90 NACL .9 1000ML 200.55

NACL .9 1000ML 200.55 NACL 3% 500ML 141.75 NA LACTATE M/6 500ML 171.15 STERILE WATER 1000ML 141.75 AA 3% WITH ELEC 1000ML 421.05 AA 5.5% 500ML 391.65 AA 5.5% WITH ELEC 500ML 414.75 AA 8.5% WITH ELEC 500ML 616.35

AA 10% 500ML 592.20 TOTAL PARENTERAL NUTRITION 1,753.50 AA HBR CHAIN 6.9% 750ML 722.40 AA ESSENT 5.4% 250ML 479.85 AA HEPATIC FORMULA 500ML 810.60 AA RENAL FORMULA 250ML 675.15 DEXTROSE 40% 500 IN 1L 254.10 DEXTROSE 50% 500 IN 1L 200.55 DEXTROSE 60% 500 IN 1L 254.10 DEXTROSE 70% 500 IN 1L 141.75

FAT EMULSION 10% 200ML 299.25 FAT EMULSION 10% 500ML 467.25 FAT EMULSIONS 20%$ 143.15 FAT EMULSION 20% 200ML 370.65 FAT EMULSION 20% 250ML 94.00 ACETIC ACID.25%IRR500ML 141.75 HEPARIN 25000 PMX 500ML 127.05 HEPARIN 25,0000 U IN 0.45% NS 500ML 48.20

IRR SOLN G WITH HANG 1L 141.75 RINGERS IRR 1000ML 200.55 NACL .9 IRR 500ML 82.95

cdm

EYE WASH 31.50 SORBITOL3.3% 2000ML 200.55 STERILE WATER IRR 500ML 82.95 ST IV EXT Y+FLW 81.90 NON-FORMULARY MED - CHEMO PREP - CLARIFICATION OF ORDERS - CMTE/PRESENT TIME & PREP - DRUG HISTORY - DRUG INFO WRITTEN -

IV TO PO - KINETIC CALCULATIONS - KINETIC DAILY MONITOR/ADJ - MEDICATION RECONCILIATION - PHARMACY COMP - PHARMACY TO DOSE - PT.SAF.ISS-DISEASE ST.CON - RENAL EVALUATION -

REQUESTED CHART REVIEW - THERAPEUTIC INTERVENTION - THERAPY CHG RECOMMEND -

TRAINING/PRECEPTING - WARFARIN MONITORING - WARFARIN MONITORING (WAR) - TRAINING/PRECEPTING (TRAIN) - CMTE/PRS TIME & PREP & PRST (CTME) - ANTIBIOTIC EVALUATION & RECOM (AER) - EPOGEN EVALUATION (EE) - RENAL EVALUATION (RE) -

RENAL DOSING (RD) - PT SAFETY ISSUE-CONTRAINDIC (PSI) - PHARMACY TO DOSE (PTD) - PHARMACY COMPOUNDING (PC) - PATIENT'S OWN MEDICATION EVAL (POM) - CHEMO DOSE EVAL/DOSE CHECK (CHEMO) - PATIENT INFO/HISTORY (PIH) - NON-FORMULARY MED (NFM) - NEWSLETTER ARTICLE (NA) - MUE REVIEW (MUE) -

MEDICATION RECONCILIATION (MR) - IV-TO-PO (IVPO) - INVESTIGATIONAL DRUG PREP (IDD) - DRUG-DRG/FOOD OR LAB INTERACT (DDI) - KINETIC-ACTIVE FOLLOW (KA) - KINETIC-PASSIVE FOLLOW (KP) - DRUG INFORMATION (DI) - TPN-ACTIVE FOLLOW (TPNA) -

TPN-PASSIVE FOLLOW (TPNA) - PATIENT COUNSELED (PTC) - DRUG TX CONSULTATION (DTC) -

cdm

CPR/CODE ATTENDED (CODE) - CLARIFICATION OF ORDERS (COO) - CHART REVIEW (CR) - THERAPY CHANGE RECOMMENDATION (TCR) - PHARMACY SETUP-CLIN TRIAL 400.00 DISPENSATION-CLIN TRIAL 42.00 CLOSE OUT-CLIN TRIAL 300.00 EPOGEN EVALUATION - MISC PHARMACY CONVERSION - ST IV ADM Y 99.75

SET ADM BLOOD Y 53.55 SET ADM BLOODY&P 119.70 ST IV PEDI 177.45 ST IV METRIC 161.70 SET ADD IV 2SITE 89.25 FLTR INLINE BLD 154.35 ST IRG CYS CNT 123.90 TUBING IV EXT W/ 12.60

MNTR VEN PRES 169.05 PCA IV SET 90.30 SET ADM IV 99.75

CATH IV PLCMNT 131.25 TB PRES LINE 75.60 FILTER NEEDLE 154.35 OH KT MNTR ART 1,039.50 HEMO BAG BLOOD 1,638.00 HH ST IV ADM 91.35 HH ST EXT FLTR 96.60 ST IV EXT Y+FLW 81.90

AER TX DEMO AND/OR EVAL* - AEROSOL TREATMENT 204.75 CBT 1ST HOUR 327.60 MECHANICAL CHEST WALL OSCILL 1,013.25 HAND HELD NEB TREATMENT 204.75 USN TX DEMO AND/OR EVAL* - ULTRASONIC TX 127.05 ABG ANALYSIS 171.15 ABG ANALYSIS - VENOUS 116.55 CPR 771.75

INTUBATION 771.75 BREATHING EXERCISE 75.60 SPTM IND DEMO AND/OR EVA 127.05 TRACH CHANGE ALL TYPES 105.00 INCENTIVE SPIROMETRY INT 114.45 IPPB TX 127.05 CPAP INIT/MGMT 444.15 VOLUME VENTILATOR INTL 970.20

VOLUME VENT SUBSQ/DLY 970.20 BRONCHOSCOPY W BIOPSY 3,258.15 BRONCH THRU TRACHEOSTMY 2,394.00

cdm

TRANSBRONCH LUNG BIOPSY 3,258.15 TRANSBRONCH NDLE BIOPSY 3,258.15 BRONCH ASPIRATN INITIAL 3,258.15 BRONCH ASPIRATN SUBSEQ 3,258.15 OXYGEN HOURS 114.45 OXYGEN HOOD HOURS 36.75 TCPO2 MULTIPLE SITES 505.05 TCPO2 ONE SITE 309.75 VC TX ASSESSMENT 187.95 FLOW VOLUME LOOPS 266.70

BRONCHOSCOPY DX W/BRSH 3,258.15 COOXIMETRY O2 SAT 157.50 SPIRO SCREEN 266.70 BRONCHOSPASM EVAL PRE/PS 444.15 DIFFUSION CAPACITY 365.70 LARYNGOSCOPY DIAGNOSTIC 252.00 VD/VT STUDY 266.70 INDIRECT CALORIM S/U 27.30

SKIN TST INTRDRML 25.20 PO2 50% HEMOGLB SAT W/O2 725.55 BIPAP INITIAL 444.15

FUNCTIONAL RESID CAPAC 304.65 MDI TREATMENT 127.05 PULSE OX EXER TOL 87.15 PULSE OX SINGLE 85.05 CPAP MGMT DLY/SUBSEQ 444.15 BIPAP MANAGEMENT DLY 444.15 CHST WALL MANIPULATN INI 127.05 CHST WALL MANIPULATN SUB 127.05

PULSE OXIM MULT DETRM 91.35 BLOOD GAS ARTERIAL STICK 157.50 ADD LATER - BRSH BRONCH MICRO WAX PLG 223.65 SKIN TST HISTOPLASMOSIS 17.85 SKIN TST MUMPS 17.85 SKIN TST TRICHINOSIS 17.85 SKN TST COCCIDIODMYCOSIS 17.85 KITNRVERTBLK22GX6/18GX6 161.70 LINE, EXTENSION MINIBORE 6" 79.80

INJ PARAVERT FACET CER/THOR 1 LEV 3,066.00 FLUORO BX/ASP/INJ/GUIDE 275.10 FLUORO GUIDE SPINE INJ 411.60 EPI INJ LUM/SAC SINGLE LEV W/IMAG 3,066.00 EPI INJ LUM/SAC ADD LEV W/IMAG 1,599.15 CERV/THORAC EPI INJ SING LVL W/IMAG 3,066.00 CERV/THORAC EPI INJ ADD LVL W/IMAG 1,599.15 DISCOGRAM LUMBAR W/IMG 13,126.05

INJ PARAVERT FACET L/S 1 LEV 3,066.00 INJ EPI LUM/SAC W/O IMAGING 3,066.00 INJ EPI CERV/THORAC W/O IMAGING 3,066.00

cdm

INFUS PUMP;CATH PLC;CERV/THOR 3,066.00 INFUS PUMP;CATH PLC;LUMB/SAC 5,292.00 INJ SACROILIAC JOINT W/IMAGING 654.15 INJ KNEE;ARTHROGRAM MAJOR JT 351.75 INJ SHOULDER ARTHOGRAM 353.85 DISCOGRAM INJ LUMBAR;EA LVL 1,351.35 DISCOGRAM INJ CERV/THOR; EA LVL 1,034.25 DISCOGRAPHY CERV/THOR W/IMAGING 13,127.10 INJ MAJOR JOINT W/O IMAGING 1,072.05 PN CNTRL LVL 1 INIT 15 659.40

INJ BOTOX OF FACIAL NERVE 1,071.00 PN CNTRL LVL 1 EA ADDMN 45.15 INJ BOTOX OF NECK MUSCLE 1,601.25 PN CNTRL LVL 2 INIT 15 925.05 INJ BOTOX OF EXTR/TRUNK MUSCLE 1,601.25 PN CNTRL LVL 2 EA ADD MN 61.95 INJ FACET L/S 2ND LVL W/IMG ADD-ON 1,071.00 PN CNTRL LVL 3 INIT 15 263.55

INJ FACET L/S 3RD LVL W/IMG ADD-ON 1,071.00 PN CNTRL LVL 3 EA ADD MN 23.10 NERVE BLOCK INJ OCCIPITAL 1,601.25

POST PROC RECOV INIT 15 113.40 INJ STELLATE GANGLION CERV 3,071.25 EPIDUROGRAM 1,033.20 SECONDARY RECOV/OBSERV 80.85 INJ CARPAL TUNNEL - INJ SINGLE TENDON SHEATH 1,071.00 INJ BOTOX 1-4 MUSCLES EA ADD 2,295.30 INJ BOTOX 1-4 MUSCLES 2,295.30

DESTROY L/S FACET JNT AD 2,107.35 DESTROY LUMB/SAC FACET 3,579.45 KT UNIBLK20GX1.5 27GX1.25 161.70 KIT, CATHETER ACCESS PORT 432.60 SYRNGEANGIOENDIOPLSTCDISP 432.60 ENDO GUARDUS OVERTUBE 2,778.30 NDLESPNL20GX6W/WING 77.70 CTHTR EPDRL NYLN 20GX36 127.05 GLOVE RADIATION LATEX SIZE 9 499.80 GLOVE RADIATION SIZE 8.5 499.80

GLOVE RADIATION SIZE 8 499.80 GLOVE RADIATION SIZE 7.5 499.80 NDLE,EPDRLLMBR20GX4.5"TUOHY 108.15 NDLE,EPDRLLMBR20GX2"TUOHY 137.55 RADIATION GLOVES SIZE 7 992.25 NDLE SPNL DISP 18GX5.5X140MM 149.10 NEEDLE, SPINAL 18GX8" 173.25 NEEDLE, SPINAL 20G 8" 165.90

ELCTRDENDLEMNPLR26GA37MM 162.75 NDLESPNL22GX51/2MTHUB 156.45 TUBE KIT 472.50

cdm

RF CANNULA 22G 253.05 NEEDLE SPINAL 23GX3.5" 100.80 NEEDLE SPINAL 22GX3.5" 79.80 NEEDLE TUOHY 18GX6" 163.80 EPSILON RULER 211.05 TUBE KIT 472.50 NEEDLE, SPINAL 22GX6" 145.95 NEEDLE, SPINAL 25GX8" 162.75 SINERGY INTRODUCER 785.40 OBS 624 UNIT 1/HR 530.25

OBS 624 UNIT ADD HR 53.55 DIR ADM OBS CHF/CP/AS X1 184.65 OBS CHF/CHP/ASTH 1ST HR 530.25 OBS CHF/CHP/ASTH ADDL HR 91.35 BEHAV CHNG SMKG 3-10 MINS 63.00 BEHAV CHNG SMKG>10 MINS 85.05 RECOVERY TIME 1HR 360.15 RECOVERY TIME 30MIN 82.95

O/S FEE CARTIDGE/FILTER 938.70 CONT RENAL REPLACE THRPY 2,365.65 HEMODIALYS TRAIN/CONSULT 336.00

UNSCHED DIAL ESRD PT 2,143.05 HEMODIAL RENL FAIL 2,143.05 HEMODIALYSIS PERFUSION 3,374.70 DIALYSIS ONE EVALUATION 1,050.00 CHURCH MUTUAL INC CO CFH -

Hospital Name: Alvarado HospitalOSHPD Facility No: 106370652Effective Date of Charges: 7/1/15 - 7/1/2016

Evaluation & Management Services (CPT Codes 99201-99499) 2015 CPT CodeEmergency Room Visit, Level 2 (low to moderate severity) 99282Emergency Room Visit, Level 3 (moderate severity) 99283Outpatient Visit, established patient, 15 minutes 99213

Laboratory & Pathology Services (CPT Codes 80047-89398) 2015 CPT CodeBasic Metabolic Panel 80048

82805Complete Blood Count, automated 85027Complete Blood Count, with differential WBC, automated 85025Comprehensive Metabolic Panel 80053Creatine Kinase (CK), (CPK), Total 82550Lipid Panel 80061Partial Thromboplastin Time 85730Prothrombin Time 85610Thyroid Stimulating Hormone 84443Troponin, Quantitative 84484Urinalysis, without microscopy 81002 or 81003Urinalysis, with microscopy 81000 or 81001

Radiology Services (CPT Codes 70010-79999) 2015 CPT CodeCT Scan, Head or Brain, without contrast 70450CT Scan, Pelvis, with contrast 72193Mammography, Screening, Bilateral 77057Ultrasound, Abdomen, Complete 76700Ultrasound, OB, 14 weeks or more, transabdominal 76805X-Ray, Lower Back, four views 72110X-Ray, Chest, two views 71020

Medicine Services (CPT Codes 90281-99607) 2015 CPT CodeEchocardiography, complete 93307Inhalation Treatment, pressurized or nonpressurized 94640

Surgery Services (CPT Codes 10021-69990) 2015 CPT Code

Other Common Outpatient Procedures (list as needed) 2015 CPT Code

ER VISIT LVL IER VISIT LVL IVER VISIT LVL V

In response to requests from hospitals and the public, OSHPD has developed this form to assist hospitals in collecting and submitting the average charge for 25 common outpatient procedures performed by hospitals, as required by AB 1045 (Chapter 532, Statutes of 2005). Use of the OSHPD form is voluntary, but highly encouraged, as it allows hospitals to report and the public to compare uniform information regarding common outpatient procedures.

Blood Gas Analysis, including 02 saturation

Count of Reported Procedures (minimum 25 required)Instructions for Completing AB 1045 Common Outpatient Procedure Form1. Enter Hospital Name and OSHPD Facility Number. Revise Effective Date of Charges, if necessary.2. Enter Average Charge for at least 25 commonly performed outpatient procedures. For Evaluation & Management Services, do not include related ancillary charges. For all other procedures, include related ancillary charges.

(e.g., supplies, drugs, lab, use of operating room, etc.) should be included in the average charge for that procedure.3. Do not change procedure descriptions or CPT code references. Use "Other Common Outpatient Procedures" (rows 62-71) if you are unable to select procedures from list.4. Submit completed form as Excel (.xls) file, along with chargemaster and percent change in gross revenue calculation, by e-mail to [email protected] or by standard mail on CD.

NOTE: The CPT codes are included on this form to help identify the listed procedures based on the frequencies across hospital-based ambulatory surgery data. The average charge for all related services and procedures

Average Charge$621.00

$1,001.00$160.00

$287.00$166.00$154.00$150.00$359.00$167.00$321.00$211.00$156.00$213.00$243.00

$57.00$104.00

$2,771.00$2,944.00

$1,056.00$1,074.00

$784.00$446.00

Average Charge$240.00

$1,506.00$2,658.00

In response to requests from hospitals and the public, OSHPD has developed this form to assist hospitals in collecting and submitting the average charge for 25 common outpatient procedures performed by hospitals, as required by AB 1045

, but highly encouraged, as it allows hospitals to report and the public to compare uniform information regarding common outpatient procedures.

25

1. Enter Hospital Name and OSHPD Facility Number. Revise Effective Date of Charges, if necessary.2. Enter Average Charge for at least 25 commonly performed outpatient procedures. For Evaluation & Management Services, do not include related ancillary charges. For all other procedures, include related ancillary charges.

(e.g., supplies, drugs, lab, use of operating room, etc.) should be included in the average charge for that procedure.3. Do not change procedure descriptions or CPT code references. Use "Other Common Outpatient Procedures"

4. Submit completed form as Excel (.xls) file, along with chargemaster and percent change in gross revenue

: The CPT codes are included on this form to help identify the listed procedures based on the frequencies. The average charge for all related services and procedures

Alvarado Hospital

Alvarado HospitalOSHPD No. 106370652 July 1 2015

The facility did a 5% across the board rate increase on 1/1/2016 based on increased operating expenses

The facility did a 5% across the board rate increase on 1/1/2016 based on increased operating expenses

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