Department,Item Description,CDM Number,CPT / HCPCS, Professional Fee Price , Technical Fee Price Anesthesia,ANESTHESIA PRO FEE PER MINUTE,4300001,, 19.50 , Anesthesia,ASA Level III Charge,4300020,,, 95.75 Anesthesia,LARYNGASCOPY AND INTUB ANES,4300023,,, 504.75 Anesthesia,PICC PLACEMENT REPAIR/REPLACE TECH FEE,4300025,36584,," 2,357.25 " Anesthesia,"36584 REPLACEMENT, COMPLETE, OF A PERIPHERALLY INSERTED CENTRAL VENOUS CATHETER (PICC), WITH ProFee",4300026,36584, 382.25 , Anesthesia,ANESTHESIA LEVEL 1 CHARGE,4300027,,," 1,210.75 " Anesthesia,ANESTHESIA LEVEL 2 CHARGE,4300028,,," 1,863.75 " Anesthesia,PICC PLACEMENT INITIAL TECH FEE,4300030,36569,," 2,357.25 " Anesthesia,MIDLINE CATH PLACEMENT INITIAL TECH FEE,4300032,36569,," 2,527.50 " Anesthesia,"36569 INSERTION OF PERIPHERALLY INSERTED CENTRAL VENOUS CATHETER (PICC), WITHOUT SUBCUTANEOU ProFee",4300034,36569, 286.75 , Anesthesia,ADDUCTOR CANAL BLOCK TECH FEE,4300036,64447,, 880.00 Anesthesia,"64447 INJECTION, ANESTHETIC AGENT; FEMORAL NERVE, SINGLE ProFee",4300037,64447, 162.25 , Anesthesia,BRACHIAL PLEXUS BLOCK TECH FEE,4300040,,," 1,111.50 " Anesthesia,ANESTHESIA GAS PER MINUTE,4300043,,, 4.25 Cardiopulmonary,DIFFUSION CAPACITY,1,94729,, 250.50 Cardiopulmonary,EKG 12 LEAD,4500001,93005,, 291.75 Cardiopulmonary,Electrocardiogram 12 Lead,4500001,93005,, 291.75 Cardiopulmonary,93010 EKG INTERPRETATION & REPORT ProFee,4500002,93010, 69.00 , Cardiopulmonary,93041 ECG RHYTHM W/O REPORT CHARGE,4500003,93041,, 175.50 Cardiopulmonary,95816 EEG TECHNICAL CHARGE,4500009,95816,, 908.25 Cardiopulmonary,EEG TECHNICAL,4500009,95816,, 865.00 Cardiopulmonary,93225 HOLTER MONITOR 12 TO 48 HOUR CHARGE,4500010,93225,, 846.25 Cardiopulmonary,HOLTER MONITOR 12 TO 48 HOUR,4500010,93225,, 846.25 Cardiopulmonary,93226 HOLTER MONITORING - SCANNING CHARGE,4500011,93226,, 803.00 Cardiopulmonary,HOLTER MONITOR SCANNING,4500011,93226,, 803.00 Cardiopulmonary,9322552 HOLTER MONITOR LESS THAN 12 HOURS CHARGE,4500013,93225,, 423.50 Cardiopulmonary,94727 NITROGEN WASHOUT CHARGE,4500016,94727,, 400.25 Cardiopulmonary,94729 DIFFUSION CAPACITY CHARGE,4500018,94729,, 250.50 Cardiopulmonary,94060 BRONCHODILATION RESPONSIVENESS CHARGE,4500019,94060,, 546.75 Cardiopulmonary,BRONCHODILATION RESPONSIVENESS,4500019,94060,, 546.75 Cardiopulmonary,94375 FLOW VOLUME LOOP CHARGE,4500020,94375,, 201.00 Cardiopulmonary,FLOW VOLUME LOOP,4500020,94375,, 201.00 Cardiopulmonary,94664 PATIENT INSTRUCT EVALUATION CHARGE,4500021,94664,, 146.75 Cardiopulmonary,PATIENT INSTRUCT EVALUATION,4500021,94664,, 146.75 Cardiopulmonary,94640 NEBULIZER 1 CHARGE,4500030,94640,, 149.75 Cardiopulmonary,INCENTIVE SPIROMETRY,4500034,94150,, 82.00 Cardiopulmonary,94667 CHEST PHYSIOTHERAPY INITIAL CHARGE,4500036,94667,, 175.50 Cardiopulmonary,94002 VENTILATOR FIRST DAY CHARGE,4500037,94002,," 1,308.00 " Cardiopulmonary,82803 ARTERIAL BLOOD GAS,4500041,82803,, 255.75 Cardiopulmonary,ARTERIAL BLOOD GAS,4500041,82803,, 255.75 Cardiopulmonary,36600 ARTERIAL PUNCTURE,4500042,36600,, 65.50 Cardiopulmonary,36600 ARTERIAL PUNCTURE CHARGE,4500042,36600,, 65.50 Cardiopulmonary,ARTERIAL PUNCTURE,4500042,36600,, 65.50 Cardiopulmonary,94010 TIDAL VOLUME W VITAL CAPACITY CHARGE,4500043,94010,, 273.50 Cardiopulmonary,TIDAL VOLUME W VITAL CAPACITY,4500043,94010,, 273.50 Cardiopulmonary,94668 CHEST PHYSIOTHERAPY SUBSEQUENT CHARGE,4500044,94668,, 100.75 Cardiopulmonary,PEAK FLOW CHARGE,4500046,,, 277.50 Cardiopulmonary,82375 CO OX CARBON MONOXIDE,4500047,82375,, 180.75 Cardiopulmonary,82375 CO OX CARBON MONOXIDE CHARGE,4500047,82375,, 180.75 Cardiopulmonary,CO OX CARBON MONOXIDE,4500047,82375,, 180.75 Cardiopulmonary,83050 CO OX METHEMOGLOBIN,4500048,83050,, 56.00 Cardiopulmonary,83050 CO OX METHEMOGLOBIN CHARGE,4500048,83050,, 56.00 Cardiopulmonary,CO OX METHOMOGLOBIN,4500048,83050,, 56.00 Cardiopulmonary,85018 CO OX HEMOGLOBIN,4500049,85018,, 45.25 Cardiopulmonary,85018 CO OX HEMOGLOBIN CHARGE,4500049,85018,, 45.25 Cardiopulmonary,CO OX HEMOGLOBIN,4500049,85018,, 45.25 Cardiopulmonary,94660 NONINVASIVE VENTILATION CHARGE,4500050,94660,," 1,308.00 " Cardiopulmonary,31720 SUCTION CHARGE,4500053,31720,, 275.75 Cardiopulmonary,94003 CONT VENT-SUBSEQUENT DAY CHARGE,4500054,94003,," 1,308.00 " Cardiopulmonary,94760 PULSE OXIMETRY SINGLE CHARGE,4500055,94760,, 85.50 Cardiopulmonary,PULSE OX,4500055,94760,, 85.50 Cardiopulmonary,93017 STRESS TEST CHARGE,4500060,93017,," 1,049.25 " Cardiopulmonary,STRESS TEST,4500060,93017,," 1,049.25 " Cardiopulmonary,93018 STRESS TEST INTERPRETATION ProFee,4500061,93018, 201.00 , Cardiopulmonary,93016 STRESS TEST SUPERVISION ProFee,4500062,93016, 201.00 , Cardiopulmonary,DR CUNNINGTON STRESS TEST INTERP AND REP,4500065,93018, 201.00 , Cardiopulmonary,DR CUNNINGTON STRESS TEST SUPERVISION,4500066,93016, 201.00 , Cardiopulmonary,94644 CONTINUOUS NEBULIZER INITIAL HOUR CHARGE,4500067,94644,, 149.00 Cardiopulmonary,94645 CONTINUOUS NEBULIZER EA ADDITIONAL HOUR CHARGE,4500068,94645,, 149.00 Cardiopulmonary,94642 PENTAMIDINE TREATMENT CHARGE,4500069,94642,, 296.75 Cardiopulmonary,94761 PULSE OXIMETRY MULTIPLE CHARGE,4500070,94761,, 142.50 Cardiopulmonary,95816 EEG INCL REC AWAKE/DROWSY ProFee,4500071,95816, 206.75 , Cardiopulmonary,EEG PRO FEE,4500071,95816, 196.75 , Cardiopulmonary,94762 PULSE OXIMETER RECORDING CHARGE,4500077,94762,, 206.75 Cardiopulmonary,94726 PLETHYSMOGRAPHY CHARGE,4500078,94726,, 668.25 Cardiopulmonary,PLETHYSMOGRAPHY,4500078,94726,, 668.25 Cardiopulmonary,94070 BRONCHOSPASM EVALUATION,4500079,94070,," 1,325.00 " Cardiopulmonary,94070 BRONCHOSPASM EVALUATION CHARGE,4500079,94070,," 1,335.50 " Cardiopulmonary,BRONCHOSPASM EVALUATION,4500079,94070,," 1,335.50 " Cardiopulmonary,94618 6 MINUTE WALK TEST CHARGE,4500080,94618,, 558.25 Cardiopulmonary,OXYGEN THERAPY CHARGE DAILY,4500081,,, 409.50 Cardiopulmonary,AEROSOL DAILY CHARGE,4500082,,, 503.50 Cardiopulmonary,HEATED AEROSOL DAILY CHARGE,4500083,,, 598.25 Cardiopulmonary,ED OXYGEN VISIT CHARGE,4500084,,, 149.75 Cardiopulmonary,AEROSOL VISIT CHARGE,4500085,,, 153.00 Cardiopulmonary,HEATED AEROSOL VISIT CHARGE,4500086,,, 197.00 Cardiopulmonary,94640 NEBULIZER 2 - 3 CHARGE,4500100,94640,, 381.00 Cardiopulmonary,94640 NEBULIZER 4 - 5 CHARGE,4500101,94640,, 550.00 Cardiopulmonary,94640 NEBULIZER 6 OR MORE CHARGE,4500102,94640,, 634.75 Cardiopulmonary,HI - VNI THERAPY CHARGE,4500103,,, 551.25 Cardiopulmonary,95012 FENO WITH PFT EXHALED NITRIC OXIDE CHARGE,4500104,95012,, 55.25 Cardiopulmonary,Exhaled Nitric Oxide,4500105,95012,, 52.50 Cardiopulmonary,ED NONINVASIVE VENTILATION CHARGE,4500106,94660,," 1,308.00 " Cardiopulmonary,ED EKG CHARGE,4500107,93005,, 291.75 Cardiopulmonary,ED EKG PROFEE CHARGE,4500108,93010, 69.00 , Cardiopulmonary,ED VENTILATOR CHARGE,4500110,94002,," 1,308.00 " Cardiopulmonary,ED HI - VNI THERAPY CHARGE,4500111,,, 551.25 Cardiopulmonary,M SCHOLES STRESS TEST INTERP AND REP,4500065M,93018, 201.00 , Cardiopulmonary,M SCHOLES STRESS TEST SUPERVISION,4500066M,93016, 201.00 , Cardiopulmonary,93799 OTHER CARDIOVASCULAR PROC TechFee,,,, 886.75 Cardiopulmonary Rehab,93798 CARDIAC REHAB SUBSEQUENT VISIT CHARGE,4700001,93798,, 222.75 Cardiopulmonary Rehab,93798 CARDIAC REHAB INITIAL VISIT CHARGE,4700002,93798,, 444.75 Cardiopulmonary Rehab,PR COPD SUBSEQUENT VISIT PER HR CHARGE,4700004,G0424,, 222.75 Cardiopulmonary Rehab,PR COPD 1ST VISIT PER HOUR CHARGE,4700005,G0424,, 444.75 Cardiopulmonary Rehab,PR NON COPD PER 15 MIN OTHER CHARGE,4700006,G0238,, 112.25 Cardiopulmonary Rehab,PR NON COPD PER 15 MIN STRENGTHENING,4700007,G0237,, 112.25 Cardiopulmonary Rehab,PR NON COPD GROUP SESSION CHARGE,4700008,G0239,, 222.75 Cardiopulmonary Rehab,PR PHASE III RW CENTER,4700009,,, 40.00 Cardiopulmonary Rehab,PR PHASE III INITIAL ASSESSMENT,4700011,,, 75.00 Cardiopulmonary Rehab,93668 SET PAD INITIAL VISIT CHARGE,4700012,93668,, 444.75 Cardiopulmonary Rehab,93668 SET PAD SUBSEQUENT VISIT CHARGE,4700013,93668,, 222.75 Central Supply,DRESSING CHANGE TRAY CENTRAL LINE,88,,, 21.75 Central Supply,XS OVAL HRDV,202,,, 893.25 Central Supply,SMALL OVAL HRDV,203,,, 976.25 Central Supply,DVT BOOTS LARGE 23,697,,, 338.00 Central Supply,20FR GASTROSTOMY TUBE,704,,, 164.00 Central Supply,#16 GASTROSTOMY TUBE,705,,, 164.00 Central Supply,3 COBAN LATEX FREE,735,,, 11.25 Central Supply,4X4 TEGADERM DRESSING,736,,, 6.75 Central Supply,2X2 TEGADERM DRESSING,737,,, 4.00 Central Supply,STERI-STRIP 1/4X1-1/2,742,,, 30.75 Central Supply,STERI-STRIP 1/2 X 2 IN,743,,, 30.75 Central Supply,STRAP CATHETER LEG 30INCH,759,,, 29.75 Central Supply,BAG BILE 9OZ,760,,, 69.00 Central Supply,SINGLE USE BULB SYRINGE 2 OZ STE - EAR,761,,, 45.25 Central Supply,16FR 5CC COUDE CATHETER FOLEY RED,762,,, 191.25 Central Supply,18FR 5CC COUDE CATHETER FOLEY RED,763,,, 191.25 Central Supply,20FR 5CC COUDE CATHETER FOLEY RED,764,,, 191.25 Central Supply,22FR 5CC COUDE CATHETER FOLEY RED,765,,, 191.25 Central Supply,16FR 30CC CATHETER FOLEY STERILE,767,,, 121.25 Central Supply,DISPOZ-A-BAG FLIP-FLO 19OZ MED-LEG BAG,770,,, 5.50 Central Supply,BAG URINE DRAINAGE 2000ML,771,,, 97.25 Central Supply,16FR 5CC CATHETER FOLEY SILICONE STERILE,772,,, 121.25 Central Supply,18FR 5CC CATHETER FOLEY SILICONE STERILE,774,,, 121.25 Central Supply,20FR 5CC CATHETER FOLEY SILICONE STERILE,775,,, 121.25 Central Supply,22FR 5CC CATHETER FOLEY SILICONE STERILE,776,,, 121.25 Central Supply,TRAY CATHETER URETHRAL 15FR,782,,, 95.75 Central Supply,TRAY BARD ADD A FOLEY STERILE,784,,, 196.50 Central Supply,FOLEY DRAINAGE BAG 16FR,785,,, 303.75 Central Supply,FOLEY DRAINAGE BAG 18FR,786,,, 303.75 Central Supply,LUMBAR PUNCTURE TRAY ADULT 22G X3.5 STRL,860,,, 123.75 Central Supply,DUODERM HYD GEL,891,,, 6.00 Central Supply,SAF CLENS AF 12 FL OZ,892,,, 28.25 Central Supply,4INX4IN DUODERM CGF,893,,, 11.25 Central Supply,DRESSING DUODERM 4X4 EXTRA THIN,894,,, 23.50 Central Supply,DRESSING DUODERM 2.5INX2.5IN CGF BORDER,895,,, 5.75 Central Supply,DUODERM 4X4 CGF W BORDER,896,,, 9.50 Central Supply,BARRIER SENSI-CARE PROTECTIVE 4OZ,902,,, 19.50 Central Supply,AQUACEL EXTRA AG 2X2,905,,, 15.75 Central Supply,DRESSING WOUND 6INX6IN AQUACEL-AG,906,,, 64.75 Central Supply,DRESSING AQUACEL AG HYDROFIBER ST.(2X45),907,,, 59.00 Central Supply,AQUACEL FOAM 5X5IN,908,,, 22.75 Central Supply,AQUACEL 4X4 FOAM DRESSING,910,,, 8.25 Central Supply,IMMOBILIZER 16IN UNIV KNEE STRAIGHT STAY,919,,, 144.75 Central Supply,COLLAR FORM FIT CERVICAL MEDIUM MED-LONG,935,,, 139.25 Central Supply,SLING SPECIALTY ARM MEDIUM,939,,, 51.00 Central Supply,SLING SPECIALTY ARM LARGE,940,,, 51.00 Central Supply,SLING SPECIALTY ARM XLARGE,941,,, 51.00 Central Supply,SPLINT CLAVICLE ADJ BUCKLE LRG,945,,, 255.00 Central Supply,SUPPORT WRIST/FOREARM RIGHT SM-COCK UP,946,,, 124.25 Central Supply,SPLINT B A T H WRIST RIGHT SMALL-COCK UP,954,,, 124.25 Central Supply,SPLINT B A T H WRIST LEFT SMALL-COCK UP,956,,, 124.25 Central Supply,MASTISOL LIQUID ADHESIVE 2/3CC VIAL,999,,, 15.00 Central Supply,PAD TEMPERATURE THERAPY 15X22IN,1002,,, 136.25 Central Supply,POUCH DRNBL 12IN UPTO 2 1/2IN BARRIER,1009,,, 27.25 Central Supply,CLAMP FOR DRAINABLE POUCH BEIGE,1010,,, 5.75 Central Supply,GARMENT CALF STANDRD UP TO 17-WHITE DVT,1012,,, 338.00 Central Supply,GARMENT BARIATRIC CALF UPTO 28-PINK DVT,1014,,, 338.00 Central Supply,ICE BAG- LARGE CONSTANT ICE BAG,1024,,, 28.50 Central Supply,IRRIGATION TRAY STERILE,1037,,, 104.00 Central Supply,1X8 DRESSING - GAUZE XEROFORM,1048,,, 42.75 Central Supply,HAT SPECIMEN CONTAINER W/MEASURE,1051,,, 29.75 Central Supply,SUTURE REMOVAL TRAY,1058,,, 2.50 Central Supply,GRADUATE-CONTAINER INTAKE OUTPUT CLEAR,1063,,, 16.25 Central Supply,REMOVER STAPLE SKIN,1065,,, 113.25 Central Supply,ACE BANDGE ELASTC MATRX 2X5YD SELFCLOSE,1067,,, 24.25 Central Supply,ACE BANDGE ELASTC MATRX 3X5YD SELFCLOSE,1068,,, 28.50 Central Supply,ACE BANDGE ELASTC MATRIX 4X5YD SELFCLOSE,1069,,, 31.50 Central Supply,SPONGE 4X4 BOX GAUZE SPONGE,1087,,, 96.25 Central Supply,SUPER SPONGE 4X4IN AVANT STERILE 2 PK,1088,,, 45.25 Central Supply,DRESSING - ABD PAD 5INX9IN STERILE 1FTS,1089,,, 49.50 Central Supply,3X36 GAUZE PETROLATUM LF STERILE,1097,,, 32.75 Central Supply,5X9 DRESSING - GAUZE XEROFORM NS,1099,,, 42.75 Central Supply,1 KLING DRESSING SOFFORM,1101,,, 36.00 Central Supply,2 KLING DRESSING SOFFORM,1102,,, 42.75 Central Supply,3 KLING DRESSING SOFFORM,1103,,, 44.75 Central Supply,4 KLING DRESSING SOFFORM,1104,,, 49.50 Central Supply,6 KLING DRESSING SOFFORM,1105,,, 53.75 Central Supply,2X3 DRESSING TELFA NONADHERENT,1109,,, 8.50 Central Supply,3X4 DRESSING TELFA NONADHERENT,1110,,, 31.50 Central Supply,BULKY 4.5 FLUFF DRESSING,1112,,, 12.75 Central Supply,8X6 DRESSING ADHESIVE SURGICAL,1114,,, 30.75 Central Supply,hemorrhoidal multi-band ligator,1145,,, 79.50 Central Supply,ligasuresmall curved jaw,1165,,," 1,135.00 " Central Supply,THIGH STOCKING ANTI-EMB MED-REG 6PR/BX,1224,,, 246.00 Central Supply,"THIGH STOCKING,ANTI-EMB,MEDIUM-LONG",1225,,, 246.00 Central Supply,"THIGH STOCKING,ANTI-EMB,LARGE-LONG",1226,,, 246.00 Central Supply,STOCKING TED ANTIEMB SML KNEE,1227,,, 206.25 Central Supply,STOCKING TED ANTIEMB MED KNEE,1228,,, 206.25 Central Supply,STOCKING TED ANTIEMB LARGE KNEE,1229,,, 206.25 Central Supply,KNEE STOCKING TED ANTI-EMBOLISM MED LONG,1230,,, 206.25 Central Supply,STOCKING TED ANTI-EMBOLISM LRGE LNG KNEE,1231,,, 206.25 Central Supply,STOCKING TED ANTIEMB XL KNEE,1232,,, 206.25 Central Supply,AQUACEL 4X5,1274,,, 21.75 Central Supply,OPTIPORE SPONGE,1275,,, 3.50 Central Supply,#20FR 30CC FOLEY 3WAY CATH,1279,,, 137.75 Central Supply,#22 30CC FOLEY 3WAY CATH,1280,,, 137.75 Central Supply,SM SHORT THIGH HI,1291,,, 246.00 Central Supply,SM REGULAR THIGH HI,1292,,, 246.00 Central Supply,MED SHORT THIGH HI,1293,,, 246.00 Central Supply,LARGE SHORT THIGH HI,1294,,, 246.00 Central Supply,LARGE REGULAR THIGH HI,1295,,, 246.00 Central Supply,2X KNEE HIGH,1296,,, 206.25 Central Supply,3X KNEE HIGH,1297,,, 206.25 Central Supply,DRESSING -TEGADERM 4X10,1299,,, 14.25 Central Supply,#12 FR 5 CC FOLEY CATHETER,1300,,, 121.25 Central Supply,#14 FR FOLEY CATHETER,1301,,, 121.25 Central Supply,24 FR FOLEY CATHETER,1302,,, 121.25 Central Supply,18FR 30CC FOLEY CATHETER,1304,,, 121.25 Central Supply,TRACH CLEANING TRAY,1310,,, 65.00 Central Supply,12 KNEE IMMOBILIZER PED,1313,,, 144.75 Central Supply,CHILD LEFT HAND WRIST SPLINT,1318,,, 124.25 Central Supply,CHILD RIGHT HAND WRIST SPLINT,1319,,, 124.25 Central Supply,X SM RIGHT HAND WRIST SPLINT,1320,,, 124.25 Central Supply,XSM LEFT HAND WRIST SPLINT,1321,,, 124.25 Central Supply,MED SHOULDER IMMOBILIZER,1323,,, 113.25 Central Supply,ADULT ARM BOARD,1340,,, 36.00 Central Supply,DRESSING ADAPTIC OIL 3X3,1345,,, 34.75 Central Supply,3X8 ADAPTIC,1346,,, 28.50 Central Supply,SM ARM BOARD,1347,,, 36.00 Central Supply,ACE BANDAGE 6 X 5YD,1348,,, 45.25 Central Supply,BARD CATHETER PLUGS,1349,,, 19.50 Central Supply,#12 SALEM SUMP W/ANTI REFLUX,1350,,, 98.25 Central Supply,#14 FR SALEM SUMP W/ANTI REFLUX,1351,,, 98.25 Central Supply,#16 FR SALEM SUMP W/ANTI-REFLUX,1352,,, 98.25 Central Supply,#18FR SALEM SUMP W/ANTI REFLUX,1353,,, 98.25 Central Supply,HEEL/ELBOW PROTECTOR,1354,,, 150.25 Central Supply,ENEMA,1357,,, 106.75 Central Supply,IDOFORM PACKING STRIP 1/2,1364,,, 66.25 Central Supply,2 IDOFORM PACKING STRIP,1365,,, 66.25 Central Supply,KENDALL EYE PAD,1366,,, 65.00 Central Supply,SCROTUM SUPPORT / MEDIUM,1370,,, 79.25 Central Supply,SCROTUM SUPPORT - LARGE,1371,,, 79.25 Central Supply,IRRIGATION STARTER SET,1372,,, 26.75 Central Supply,BABY BOTTLE,1393,,, 29.75 Central Supply,3X9 VASELINE GAUZE,1395,,, 24.25 Central Supply,1/2 X 72 VASELINE GAUZE,1396,,, 10.50 Central Supply,PERI CARE BOTTLES,1401,,, 15.50 Central Supply,SITZ BATH,1405,,, 5.25 Central Supply,BULB SYRINGE 60 ML / ASPECTO,1406,,, 71.25 Central Supply,MONTGOMERY STRAP,1418,,, 37.75 Central Supply,KIDNEY STONE FILTER,1421,,, 3.00 Central Supply,DRAIN PENROSE 1/4,1554,,, 64.50 Central Supply,LARGE RIGHT MESH,1562,,, 453.75 Central Supply,LARGE LEFT MESH,1567,,, 620.25 Central Supply,X-LARGE RIGHT MESH,1568,,, 453.75 Central Supply,X-LARGE LEFT MESH,1642,,, 620.25 Central Supply,FOLEY RIBBED 8 PEDI / 3CC,1791,,, 121.25 Central Supply,INFANT FEEDING TUBE,1813,,, 104.00 Central Supply,26FR 5CC FOLEY CATH SILICONE COATED,1992,,, 121.25 Central Supply,THD KIT,2107,,," 1,252.00 " Central Supply,TEGADERM IV ADVANCE DRESSING,2668,,, 6.75 Central Supply,POLYPROPYLENE MESH(LG SHIELD HRD),2709,,, 749.75 Central Supply,UNNABOOT 4,2951,,, 20.00 Central Supply,MEDIUM RECTANGLE (REPLACE LG OVAL),2987,,," 1,476.25 " Central Supply,26FR 30CC FOLEY,3009,,, 121.25 Central Supply,22 GASTROSTOMY TUBE,4044,,, 164.00 Central Supply,RETANGLE XLG PTFE,4151,,," 1,953.50 " Central Supply,KANGAROO NASOGRASTRIC FEEDING TUBE,4209,,, 34.75 Central Supply,AQUACEL FOAM DRESSING 7X7,4349,,, 16.50 Central Supply,LARGE LOOP SLING DISP,4389,,, 76.50 Central Supply,XLARGE LOOP SLING DISPOSABLE,4390,,, 76.50 Central Supply,LOOPLIMB SLING,4391,,, 160.50 Central Supply,BAIR UPPER BODY BLANKET,5178,,, 22.00 Central Supply,MESH SHIELD L/SO LARGE,5190,,, 749.75 Central Supply,PICC DRESSING TRAY,5205,,, 32.50 Central Supply,DELUXE UNVERSAL WRIST/FOREARM RIGHT,5287,,, 124.25 Central Supply,RESOLUTION 360 CLIPS,5296,,, 690.25 Central Supply,AQUACEL AG SURGICAL DRG 3.5X10W/SILVER,5349,,, 90.25 Central Supply,DELUXE UNIVERSAL WRIST/FOREARM LEFT,5388,,, 124.25 Central Supply,XS RIGHT WRIST SPLING,5404,,, 124.25 Central Supply,ANKLE STIRRUP PLUS,5434,,, 222.25 Central Supply,DRESSING CHANGE KIT,5527,,, 21.75 Diagnostic Imaging,CT Brain/Head w/o Contrast,3100001,70450,," 2,413.00 " Diagnostic Imaging,CT Pelvis w/ + w/o Contrast,3100002,72194,," 3,322.50 " Diagnostic Imaging,CT IAC w/o Contrast,3100003,70480,," 2,044.75 " Diagnostic Imaging,CT Neck Soft Tissue w/o Contrast,3100004,70490,," 2,044.75 " Diagnostic Imaging,CT Neck Soft Tissue w/ + w/o Contrast,3100005,70492,," 3,322.50 " Diagnostic Imaging,71270 CT Chest w/ + w/o Contrast,3100006,71270,," 3,322.50 " Diagnostic Imaging,CT Chest w/ + w/o Contrast,3100006,71270,," 3,322.50 " Diagnostic Imaging,CT Spine Thoracic w/o Contrast,3100007,72128,," 1,510.50 " Diagnostic Imaging,74150 CT Chest w/o Contrast,3100008,74150,," 2,044.75 " Diagnostic Imaging,CT Abdomen w/o Contrast,3100008,74150,," 2,044.75 " Diagnostic Imaging,CT Chest High Resolution,3100009,71250,," 1,908.00 " Diagnostic Imaging,CT Spine Lumbar w/ Contrast,3100011,72132,," 2,262.25 " Diagnostic Imaging,CT Pelvis w/o Contrast,3100012,72192,," 2,044.75 " Diagnostic Imaging,CT Spine Lumbar w/o Contrast,3100014,72131,," 2,303.00 " Diagnostic Imaging,CT Spine Lumbar w/ + w/o Contrast,3100015,72133,," 2,727.00 " Diagnostic Imaging,CT Spine Cervical w/o Contrast,3100016,72125,," 2,303.00 " Diagnostic Imaging,CT Pelvis w/ Contrast,3100017,72193,," 2,262.25 " Diagnostic Imaging,CT Brain/Head w/ + w/o Contrast,3100018,70470,," 2,890.50 " Diagnostic Imaging,74170 CT Abdomen w/ + w/o Contrast,3100019,74170,," 3,322.50 " Diagnostic Imaging,CT Abdomen w/ + w/o Contrast,3100019,74170,," 3,322.50 " Diagnostic Imaging,CT Adrenal Protocol,3100019,74170,," 3,322.50 " Diagnostic Imaging,CT Liver Protocol,3100019,74170,," 3,322.50 " Diagnostic Imaging,CT Renal Mass Protocol,3100019,74170,," 3,322.50 " Diagnostic Imaging,CT Spine Thoracic w/ + w/o Contrast,3100020,72130,," 2,890.50 " Diagnostic Imaging,71260 CT Chest w/ Contrast,3100021,71260,," 2,603.50 " Diagnostic Imaging,CT Chest w/ Contrast,3100021,71260,," 2,603.50 " Diagnostic Imaging,CT Maxillofacial w/o Contrast,3100022,70486,," 2,044.75 " Diagnostic Imaging,CT Renal Stone Study,3100023,74176,," 4,138.25 " Diagnostic Imaging,CT Sinus w/o Contrast,3100024,70486,," 2,044.75 " Diagnostic Imaging,CT Brain/Head w/ Contrast,3100025,70460,," 2,262.25 " Diagnostic Imaging,CT Neck Soft Tissue w/ Contrast,3100026,70491,," 2,262.25 " Diagnostic Imaging,CT Chest w/o Contrast,3100027,71250,," 2,044.75 " Diagnostic Imaging,74160 CT Abdomen w/ Contrast,3100028,74160,," 2,262.25 " Diagnostic Imaging,CT Abdomen w/ Contrast,3100028,74160,," 2,262.25 " Diagnostic Imaging,CT Maxillofacial w/ Contrast,3100030,70487,," 2,164.50 " Diagnostic Imaging,70496 CT Angio Brain/Head,3100031,70496,," 3,475.25 " Diagnostic Imaging,74175 CT Angio Abdomen,3100033,74175,," 3,475.25 " Diagnostic Imaging,CT Angio Abdomen,3100033,74175,," 3,475.25 " Diagnostic Imaging,71275 CT Angio Chest,3100034,71275,," 2,670.50 " Diagnostic Imaging,CT Angio Chest,3100034,71275,," 3,475.25 " Diagnostic Imaging,CT Angio Pelvis,3100035,72191,," 3,475.25 " Diagnostic Imaging,CT Angio Abdomen Aorta + Iliofemoral,3100036,75635,," 3,475.25 " Diagnostic Imaging,CT IAC w/ Contrast,3100041,70481,," 2,164.50 " Diagnostic Imaging,CT IAC w/ + w/o Contrast,3100042,70482,," 2,581.00 " Diagnostic Imaging,CT Maxillofacial w/ + w/o Contrast,3100043,70488,," 2,581.00 " Diagnostic Imaging,CT Sinus w/ +  w/o Contrast,3100043,70488,," 2,581.00 " Diagnostic Imaging,CT Spine Thoracic w/ Contrast,3100044,72129,," 2,262.25 " Diagnostic Imaging,CT Lower Leg w/o Contrast Bilateral,3100057,73700,," 4,088.25 " Diagnostic Imaging,CT Lower Leg w/ Contrast Bilateral,3100060,73701,," 4,200.00 " Diagnostic Imaging,CT Lower Leg w/ + w/o Contrast Bilateral,3100063,73702,," 5,366.75 " Diagnostic Imaging,74176 CT Abdomen and Pelvis w/o Contrast,3100068,74176,," 4,138.25 " Diagnostic Imaging,CT Abdomen and Pelvis w/o Contrast,3100068,74176,," 4,138.25 " Diagnostic Imaging,74177 CT Abdomen and Pelvis w/ Contrast,3100069,74177,," 4,772.00 " Diagnostic Imaging,CT Abdomen and Pelvis w/ Contrast,3100069,74177,," 4,772.00 " Diagnostic Imaging,CT Enterography w/ Contrast,3100069,74177,," 4,772.00 " Diagnostic Imaging,74178 CT Abdomen and Pelvis w/ + w/o Contrast,3100070,74178,," 6,644.75 " Diagnostic Imaging,CT Abdomen and Pelvis w/ + w/o Contrast,3100070,74178,," 6,644.75 " Diagnostic Imaging,CT Abdomen w/o Cont + Abd/Pel w/ Contras,3100070,74178,," 6,644.75 " Diagnostic Imaging,CT Spine Cervical w/ + w/o Contrast,3100081,72127,," 2,727.00 " Diagnostic Imaging,CT Spine Cervical w/ Contrast,3100082,72126,," 2,262.25 " Diagnostic Imaging,70498 CT Angio Neck,3100083,70498,," 2,670.50 " Diagnostic Imaging,CT Angio Neck,3100083,70498,," 2,670.50 " Diagnostic Imaging,CT Angio Brain/Head,3100085,70496,," 2,670.50 " Diagnostic Imaging,74174 CT Angio Abdomen and Pelvis,3100088,74174,," 3,240.25 " Diagnostic Imaging,CT Angio Abdomen and Pelvis,3100088,74174,," 3,240.25 " Diagnostic Imaging,CT Ankle w/ Contrast Left,3100301,73701,," 1,965.50 " Diagnostic Imaging,CT Ankle w/o Contrast Left,3100302,73700,," 2,044.75 " Diagnostic Imaging,CT Elbow w/ Contrast Bilateral,3100303,73201,," 3,475.25 " Diagnostic Imaging,CT Elbow w/o Contrast Bilateral,3100304,73200,," 3,020.50 " Diagnostic Imaging,CT Elbow w/ + w/o Contrast Bilateral,3100305,73202,," 6,277.25 " Diagnostic Imaging,CT Wrist w/ + w/o Contrast Bilateral,3100305,73202,," 6,277.25 " Diagnostic Imaging,CT Elbow w/ Contrast Left,3100306,73201,," 1,965.50 " Diagnostic Imaging,CT Elbow w/o Contrast Left,3100307,73200,," 1,510.50 " Diagnostic Imaging,CT Elbow w/ + w/o Contrast Left,3100308,73202,," 4,832.75 " Diagnostic Imaging,CT Elbow w/ Contrast Right,3100309,73201,," 1,965.50 " Diagnostic Imaging,CT Elbow w/o Contrast Right,3100310,73200,," 1,510.50 " Diagnostic Imaging,CT Elbow w/ + w/o Contrast Right,3100311,73202,," 4,832.75 " Diagnostic Imaging,CT Femur w/ Contrast Left,3100312,73701,," 1,965.50 " Diagnostic Imaging,CT Femur w/o Contrast Left,3100313,73700,," 2,044.75 " Diagnostic Imaging,CT Femur w/ + w/o Contrast Left,3100314,73702,," 3,322.50 " Diagnostic Imaging,CT Femur w/ Contrast Right,3100315,73701,," 1,965.50 " Diagnostic Imaging,CT Femur w/o Contrast Right,3100316,73700,," 2,044.75 " Diagnostic Imaging,CT Femur w/ + w/o Contrast Right,3100317,73702,," 3,322.50 " Diagnostic Imaging,CT Foot w/o Contrast Bilateral,3100318,73700,," 4,088.25 " Diagnostic Imaging,CT Foot w/ Contrast Left,3100319,73701,," 1,965.50 " Diagnostic Imaging,CT Foot w/o Contrast Left,3100320,73700,," 2,044.75 " Diagnostic Imaging,CT Foot w/ + w/o Contrast Left,3100321,73702,," 3,322.50 " Diagnostic Imaging,CT Foot w/ Contrast Right,3100322,73701,," 1,965.50 " Diagnostic Imaging,CT Foot w/o Contrast Right,3100323,73700,," 2,044.75 " Diagnostic Imaging,CT Foot w/ + w/o Contrast Right,3100324,73702,," 3,322.50 " Diagnostic Imaging,CT Forearm w/ Contrast Bilateral,3100325,73201,," 3,475.25 " Diagnostic Imaging,CT Forearm w/o Contrast Bilateral,3100326,73200,," 3,020.50 " Diagnostic Imaging,CT Forearm w/ + w/o Contrast Bilateral,3100327,73202,," 6,277.25 " Diagnostic Imaging,CT Forearm w/ Contrast Left,3100328,73201,," 1,965.50 " Diagnostic Imaging,CT Forearm w/o Contrast Left,3100329,73200,," 1,510.50 " Diagnostic Imaging,CT Forearm w/ + w/o Contrast Left,3100330,73202,," 4,832.75 " Diagnostic Imaging,CT Forearm w/ Contrast Right,3100331,73201,," 1,965.50 " Diagnostic Imaging,CT Forearm w/o Contrast Right,3100332,73200,," 1,510.50 " Diagnostic Imaging,CT Forearm w/ + w/o Contrast Right,3100333,73202,," 4,832.75 " Diagnostic Imaging,CT Hand w/ Contrast Bilateral,3100334,73201,," 3,475.25 " Diagnostic Imaging,CT Hand w/o Contrast Bilateral,3100335,73200,," 3,020.50 " Diagnostic Imaging,CT Hand w/ Contrast Left,3100336,73201,," 1,965.50 " Diagnostic Imaging,CT Hand w/o Contrast Left,3100337,73200,," 1,510.50 " Diagnostic Imaging,CT Hand w/ + w/o Contrast Left,3100338,73202,," 4,832.75 " Diagnostic Imaging,CT Hand w/ Contrast Right,3100339,73201,," 1,965.50 " Diagnostic Imaging,CT Hand w/o Contrast Right,3100340,73200,," 1,510.50 " Diagnostic Imaging,CT Hand w/ + w/o Contrast Right,3100341,73202,," 4,832.75 " Diagnostic Imaging,CT Hip w/ Contrast Bilateral,3100342,73701,," 4,009.50 " Diagnostic Imaging,CT Hip w/o Contrast Bilateral,3100343,73700,," 4,088.25 " Diagnostic Imaging,CT Hip w/ Contrast Left,3100344,73701,," 1,965.50 " Diagnostic Imaging,CT Hip w/o Contrast Left,3100345,73700,," 2,044.75 " Diagnostic Imaging,CT Hip w/ + w/o Contrast Left,3100346,73702,," 3,322.50 " Diagnostic Imaging,CT Hip w/ Contrast Right,3100347,73701,," 1,965.50 " Diagnostic Imaging,CT Hip w/o Contrast Right,3100348,73700,," 2,044.75 " Diagnostic Imaging,CT Hip w/ + w/o Contrast Right,3100349,73702,," 3,322.50 " Diagnostic Imaging,CT Humerus w/ Contrast Bilateral,3100350,73201,," 3,475.25 " Diagnostic Imaging,CT Humerus w/o Contrast Bilateral,3100351,73200,," 3,020.50 " Diagnostic Imaging,CT Humerus w/ Contrast Left,3100352,73201,," 1,965.50 " Diagnostic Imaging,CT Humerus w/o Contrast Left,3100353,73200,," 1,510.50 " Diagnostic Imaging,CT Humerus w/ + w/o Contrast Left,3100354,73202,," 4,832.75 " Diagnostic Imaging,CT Humerus w/ Contrast Right,3100355,73201,," 1,965.50 " Diagnostic Imaging,CT Humerus w/o Contrast Right,3100356,73200,," 1,510.50 " Diagnostic Imaging,CT Humerus w/ + w/o Contrast Right,3100357,73202,," 4,832.75 " Diagnostic Imaging,CT Urogram,3100358,74178,," 6,644.75 " Diagnostic Imaging,CT Knee w/ Contrast Left,3100359,73701,," 1,965.50 " Diagnostic Imaging,CT Knee w/o Contrast Left,3100360,73700,," 2,044.75 " Diagnostic Imaging,CT Knee w/ + w/o Contrast Left,3100361,73702,," 3,322.50 " Diagnostic Imaging,CT Knee w/ Contrast Right,3100362,73701,," 1,965.50 " Diagnostic Imaging,CT Knee w/o Contrast Right,3100363,73700,," 2,044.75 " Diagnostic Imaging,CT Knee w/ + w/o Contrast Right,3100364,73702,," 3,322.50 " Diagnostic Imaging,CT Tibia/Fibula w/ Contrast Left,3100365,73701,," 1,965.50 " Diagnostic Imaging,CT Tibia/Fibula w/o Contrast Left,3100366,73700,," 2,044.75 " Diagnostic Imaging,CT Tibia/Fibula w/ + w/o Contrast Left,3100367,73702,," 3,322.50 " Diagnostic Imaging,CT Tibia/Fibula w/ Contrast Right,3100368,73701,," 1,965.50 " Diagnostic Imaging,CT Tibia/Fibula w/o Contrast Right,3100369,73700,," 2,044.75 " Diagnostic Imaging,CT Tibia/Fibula w/ + w/o Contrast Right,3100370,73702,," 3,322.50 " Diagnostic Imaging,CT Orbits Sella w/ Contrast,3100371,70481,," 2,164.50 " Diagnostic Imaging,CT Orbits Sella w/o Contrast,3100372,70480,," 2,044.75 " Diagnostic Imaging,CT Orbits Sella w/ + w/o Contrast,3100373,70482,," 2,581.00 " Diagnostic Imaging,CT Shoulder w/ Contrast Bilateral,3100374,73201,," 3,475.25 " Diagnostic Imaging,CT Shoulder w/o Contrast Bilateral,3100375,73200,," 3,020.50 " Diagnostic Imaging,CT Shoulder w/ + w/o Contrast Bilateral,3100376,73201,," 3,475.25 " Diagnostic Imaging,CT Shoulder w/ Contrast Left,3100377,73201,," 1,965.50 " Diagnostic Imaging,CT Shoulder w/o Contrast Left,3100378,73200,," 1,510.50 " Diagnostic Imaging,CT Shoulder w/ + w/o Contrast Left,3100379,73202,," 4,832.75 " Diagnostic Imaging,CT Shoulder w/ Contrast Right,3100380,73201,," 1,965.50 " Diagnostic Imaging,CT Shoulder w/o Contrast Right,3100381,73200,," 1,510.50 " Diagnostic Imaging,CT Shoulder w/ + w/o Contrast Right,3100382,73202,," 4,832.75 " Diagnostic Imaging,CT Sinus w/ Contrast,3100383,70487,," 2,164.50 " Diagnostic Imaging,CT Wrist w/ Contrast Bilateral,3100384,73201,," 3,475.25 " Diagnostic Imaging,CT Wrist w/o Contrast Bilateral,3100385,73200,," 3,020.50 " Diagnostic Imaging,CT Wrist w/ Contrast Left,3100386,73201,," 1,965.50 " Diagnostic Imaging,CT Wrist w/o Contrast Left,3100387,73200,," 1,510.50 " Diagnostic Imaging,CT Wrist w/ + w/o Contrast Left,3100388,73202,," 4,832.75 " Diagnostic Imaging,CT Wrist w/ Contrast Right,3100389,73201,," 1,965.50 " Diagnostic Imaging,CT Wrist w/o Contrast Right,3100390,73200,," 1,510.50 " Diagnostic Imaging,CT Wrist w/ + w/o Contrast Right,3100391,73202,," 4,832.75 " Diagnostic Imaging,CT Heart Calcium Scoring,3100392,75571,, 195.50 Diagnostic Imaging,CT Lung Cancer Screening,3100393,G0297,, 550.00 Diagnostic Imaging,CT Mastoids w/o Contrast,3100394,70480,," 2,044.75 " Diagnostic Imaging,CT Temporal Bones w/o Contrast,3100395,70480,," 2,044.75 " Diagnostic Imaging,CT Mastoids w/ Contrast,3100396,70481,," 2,164.50 " Diagnostic Imaging,CT Mastoids w/ + w/o Contrast,3100397,70482,," 2,581.00 " Diagnostic Imaging,CT Sternoclavicular Jts w/o Contrast,3100400,71250,," 2,044.75 " Diagnostic Imaging,CT Sternum w/o Contrast,3100401,71250,," 2,044.75 " Diagnostic Imaging,CT Angio Chest PE,3100402,71275,," 2,670.50 " Diagnostic Imaging,CT Clavicle w/o Contrast Bilat,3100403,73200,," 3,020.50 " Diagnostic Imaging,CT Clavicle w/o Contrast Left,3100404,73200,," 1,510.50 " Diagnostic Imaging,CT Clavicle w/o Contrast Right,3100405,73200,," 1,510.50 " Diagnostic Imaging,CT Scapula w/o Contrast Bilat,3100406,73200,," 3,020.50 " Diagnostic Imaging,CT Scapula w/o Contrast Left,3100407,73200,," 1,510.50 " Diagnostic Imaging,CT Scapula w/o Contrast Right,3100408,73200,," 1,510.50 " Diagnostic Imaging,CT Clavicle w/ Contrast Left,3100409,73201,," 1,965.50 " Diagnostic Imaging,CT Clavicle w/ Contrast Right,3100410,73201,," 1,965.50 " Diagnostic Imaging,CT Scapula w/ Contrast Bilat,3100411,73201,," 3,475.25 " Diagnostic Imaging,CT Scapula w/ Contrast Left,3100412,73201,," 1,965.50 " Diagnostic Imaging,CT Scapula w/ Contrast Right,3100413,73201,," 1,965.50 " Diagnostic Imaging,CT Clavicle w + w/o Contrast Left,3100414,73202,," 4,832.75 " Diagnostic Imaging,CT Clavicle w/ + w/o Contrast Right,3100415,73202,," 4,832.75 " Diagnostic Imaging,CT Scapula w + w/o Contrast Bilat,3100416,73202,," 6,277.25 " Diagnostic Imaging,CT Scapula w/ + w/o Contrast Left,3100417,73202,," 4,832.75 " Diagnostic Imaging,CT Scapula w/ + w/o Contrast Right,3100418,73202,," 4,832.75 " Diagnostic Imaging,CT Clavicle w/ + w/o Contrast Bilat,3100419,73206,," 6,277.25 " Diagnostic Imaging,CT Clavicle w/ Contrast Bilat,3100421,73201,," 3,475.25 " Diagnostic Imaging,CT Ankle w/ Contrast Bilateral,3100422,73701,," 4,009.50 " Diagnostic Imaging,CT Ankle w/o Contrast Bilateral,3100423,73700,," 4,088.25 " Diagnostic Imaging,CT Ankle w/ + w/o Contrast Bilateral,3100424,73702,," 5,366.75 " Diagnostic Imaging,CT Ankle w/ + w/o Contrast Left,3100425,73702,," 3,322.50 " Diagnostic Imaging,CT Ankle w/ Contrast Right,3100426,73700,," 2,044.75 " Diagnostic Imaging,CT Ankle w/o Contrast Right,3100427,73700,," 2,044.75 " Diagnostic Imaging,CT Ankle w/ + w/o Contrast Right,3100428,73702,," 3,322.50 " Diagnostic Imaging,CT Femur w/ Contrast Bilateral,3100429,73701,," 4,009.50 " Diagnostic Imaging,CT Femur w/o Contrast Bilateral,3100430,73700,," 4,088.25 " Diagnostic Imaging,CT Femur w/ + w/o Contrast Bilateral,3100431,73702,," 5,366.75 " Diagnostic Imaging,CT Foot w/ Contrast Bilateral,3100432,73701,," 4,009.50 " Diagnostic Imaging,CT Foot w/ + w/o Contrast Bilateral,3100433,73702,," 5,366.75 " Diagnostic Imaging,CT Hand w/ + w/o Contrast Bilateral,3100434,73202,," 5,366.75 " Diagnostic Imaging,CT Head Stroke Protocol,3100435,70450,," 2,413.00 " Diagnostic Imaging,CT Hip w/ + w/o Contrast Bilateral,3100436,73702,," 5,366.75 " Diagnostic Imaging,CT Humerus w/ + w/o Contrast Bilateral,3100437,73202,," 5,366.75 " Diagnostic Imaging,CT Knee w/o Contrast Bilateral,3100438,73700,," 4,088.25 " Diagnostic Imaging,CT Knee w/ + w/o Contrast Bilateral,3100439,73702,," 5,366.75 " Diagnostic Imaging,CT Knee w/ Contrast Bilateral,3100440,73701,," 4,009.50 " Diagnostic Imaging,XR Facial Bones 3+ Views,3200002,70150,, 555.00 Diagnostic Imaging,XR Small Bowel via Enteroclysis Tube,3200003,74251,, 464.50 Diagnostic Imaging,XR Upper GI w/ Air w/ Small Bowel,3200004,74249,, 717.50 Diagnostic Imaging,XR Spine Thoracolumbar 2+ Views,3200006,72080,, 307.00 Diagnostic Imaging,XR Mandible Less Than 4 Views,3200007,70100,, 400.25 Diagnostic Imaging,XR Mastoids Complete,3200008,70130,, 539.50 Diagnostic Imaging,XR Nasal Bones 3+ Views,3200009,70160,, 380.00 Diagnostic Imaging,XR Sinuses Paranasal Complete,3200010,70220,, 505.75 Diagnostic Imaging,XR Sinuses Paranasal < 3 Views,3200011,70210,, 331.50 Diagnostic Imaging,XR Skull Complete,3200012,70260,, 643.25 Diagnostic Imaging,XR Sternoclavicular Joint(s),3200013,71130,, 307.00 Diagnostic Imaging,XR Ribs 3 Views Bilateral,3200014,71110,, 594.50 Diagnostic Imaging,XR Sacrum/Coccyx 2+ Views,3200015,72220,, 392.50 Diagnostic Imaging,XR Spine Cervical 4 or 5 Views,3200016,72050,, 682.25 Diagnostic Imaging,XR Spine Thoracic 3 Views,3200017,72072,, 473.75 Diagnostic Imaging,XR Spine Thoracic 2 Views,3200018,72070,, 317.00 Diagnostic Imaging,XR Sternum 2+ Views,3200019,71120,, 321.00 Diagnostic Imaging,XR Chest 1 View,3200020,71045,, 267.50 Diagnostic Imaging,XR Chest 2 Views,3200021,71046,, 331.50 Diagnostic Imaging,XR Abdomen KUB 1 View,3200022,74018,, 331.50 Diagnostic Imaging,XR Abdomen 2 Views,3200023,74019,, 352.25 Diagnostic Imaging,XR IVP,3200024,74400,, 712.00 Diagnostic Imaging,XR Upper GI,3200025,74240,, 442.50 Diagnostic Imaging,XR Upper GI Including Esophagus,3200025,74240,, 442.50 Diagnostic Imaging,XR Barium Enema Complete,3200026,74270,, 415.25 Diagnostic Imaging,XR Barium Enema w/ Air Complete,3200027,74280,, 616.00 Diagnostic Imaging,XR Upper GI w/ Air Contrast,3200028,74246,, 660.50 Diagnostic Imaging,XR Small Bowel w/ Multiple Series,3200029,74250,, 534.00 Diagnostic Imaging,XR Upper GI w/ Small Bowel,3200030,74245,, 733.75 Diagnostic Imaging,XR Cholangiogram in OR,3200031,74300,, 744.25 Diagnostic Imaging,XR Mandible Complete 4+ Views,3200032,70110,, 624.50 Diagnostic Imaging,XR TMJ Open and Closed Bilateral,3200033,70330,, 466.75 Diagnostic Imaging,XR Chest 3 Views,3200034,71047,, 378.00 Diagnostic Imaging,XR Chest 4+ Views,3200035,71048,, 400.25 Diagnostic Imaging,XR Ribs w/ PA Chest Bilateral,3200036,71111,, 563.75 Diagnostic Imaging,XR Spine Lumbosacral 4+ Views,3200037,72110,, 527.75 Diagnostic Imaging,XR Spine Lumbosacral w/ Bending 6+ Views,3200038,72114,, 580.00 Diagnostic Imaging,XR Cholangiogram T-Tube Check,3200039,47531,, 587.00 Diagnostic Imaging,XR Abdomen Series + Chest 1 View,3200042,74022,, 375.75 Diagnostic Imaging,XR Foreign Body Localization Child 1 Vw,3200043,76010,, 270.00 Diagnostic Imaging,XR Esophagus,3200044,74220,, 446.25 Diagnostic Imaging,XR Bone Age Studies,3200045,77072,, 360.00 Diagnostic Imaging,XR Neck Soft Tissue,3200046,70360,, 274.50 Diagnostic Imaging,XR Orbits Complete,3200047,70200,, 472.25 Diagnostic Imaging,XR Pelvis 1 or 2 Views,3200048,72170,, 331.50 Diagnostic Imaging,XR AC Joints Bilateral,3200049,73050,, 284.50 Diagnostic Imaging,XR Osseous Survey Complete,3200050,77075,, 992.25 Diagnostic Imaging,XR Skull < 4 Views,3200051,70250,, 376.25 Diagnostic Imaging,XR Spine Cervical 2 or 3 Views,3200052,72040,, 492.00 Diagnostic Imaging,XR Zygomatic Arches,3200053,70150,, 280.75 Diagnostic Imaging,XR Spine Lumbar 1 View,3200054,72020,, 221.75 Diagnostic Imaging,XR Bone Length Studies Scanograms,3200056,77073,, 310.25 Diagnostic Imaging,XR Osseous Survey Infant,3200057,77076,, 422.25 Diagnostic Imaging,XR Spine Cervical 6+ Views,3200058,72052,, 758.25 Diagnostic Imaging,XR Spine Lumbosacral 2 or 3 Views,3200059,72100,, 421.25 Diagnostic Imaging,XR Knee 1 View Standing AP Bilateral,3200060,73565,, 393.00 Diagnostic Imaging,XR Spine Cervical 1 View,3200061,72020,, 253.50 Diagnostic Imaging,XR Spine Scoliosis 1 View,3200062,72081,, 442.50 Diagnostic Imaging,XR Shoulder Complete 2+ Views Bilat,3200063,73030,, 698.75 Diagnostic Imaging,XR Shoulder Complete 2+ Views Left,3200064,73030,, 350.75 Diagnostic Imaging,XR Shoulder Complete 2+ Views Right,3200065,73030,, 350.75 Diagnostic Imaging,XR Hand 1 View On One Film Bilateral,3200067,73120,, 362.75 Diagnostic Imaging,XR Wrist 2 Views Bilateral,3200068,73100,, 317.00 Diagnostic Imaging,XR Sacroiliac Joints 3+ Views,3200070,72202,, 319.50 Diagnostic Imaging,XR Humerus Left,3200071,73060,, 364.75 Diagnostic Imaging,XR Humerus Right,3200072,73060,, 364.75 Diagnostic Imaging,XR Shoulder 1 View Bilat,3200073,73020,, 317.50 Diagnostic Imaging,XR Shoulder 1 View Left,3200073,73020,, 317.50 Diagnostic Imaging,XR Humerus Bilat,3200076,73060,, 539.00 Diagnostic Imaging,XR Clavicle Bilat,3200077,73000,, 680.00 Diagnostic Imaging,XR Elbow 2 Views Bilateral,3200078,73070,, 658.75 Diagnostic Imaging,XR Elbow Complete 3+ Views Bilateral,3200079,73080,, 921.50 Diagnostic Imaging,XR Femur 1 View Left,3200080,73552,, 598.50 Diagnostic Imaging,XR Ankle 2 Views Bilateral,3200081,73600,, 471.00 Diagnostic Imaging,XR Ankle Complete 3+ Views Bilateral,3200082,73610,, 808.25 Diagnostic Imaging,XR Foot 2 Views Bilateral,3200083,73620,, 477.25 Diagnostic Imaging,XR Foot Complete 3+ Views Bilateral,3200084,73630,, 808.25 Diagnostic Imaging,XR Forearm 2 Views Bilateral,3200085,73090,, 640.25 Diagnostic Imaging,XR Hand 2 Views Bilateral,3200086,73120,, 658.75 Diagnostic Imaging,XR Hand Complete 3+ Views Bilateral,3200087,73130,, 795.25 Diagnostic Imaging,XR Calcaneous Bilateral,3200088,73650,, 641.75 Diagnostic Imaging,XR Femur 2 Views Bilat,3200090,73560,, 505.75 Diagnostic Imaging,XR Knee 1 or 2 Views Bilateral,3200090,73560,, 505.75 Diagnostic Imaging,XR Knee 3 Views Bilateral,3200091,73562,, 756.00 Diagnostic Imaging,XR Knee Complete 4+ Views Bilateral,3200092,73564,," 1,260.00 " Diagnostic Imaging,XR Tibia/Fibula Bilateral,3200093,73590,, 726.25 Diagnostic Imaging,XR Scapula Bilat,3200094,73010,, 696.50 Diagnostic Imaging,XR Wrist 2 Views Left,3200095,73100,, 410.25 Diagnostic Imaging,XR Wrist Complete 3+ Views Bilateral,3200096,73110,, 705.00 Diagnostic Imaging,XR Ankle 2 Views Left,3200097,73600,, 271.25 Diagnostic Imaging,XR Ankle 2 Views Right,3200098,73600,, 271.25 Diagnostic Imaging,XR Ankle Complete 3+ Views Left,3200099,73610,, 405.25 Diagnostic Imaging,XR Ankle Complete 3+ Views Right,3200100,73610,, 405.25 Diagnostic Imaging,XR Clavicle Left,3200101,73000,, 392.50 Diagnostic Imaging,XR Clavicle Right,3200102,73000,, 392.50 Diagnostic Imaging,XR Elbow 2 Views Left,3200104,73070,, 380.00 Diagnostic Imaging,XR Elbow 2 Views Right,3200105,73070,, 380.00 Diagnostic Imaging,XR Elbow Complete 3+ Views Left,3200106,73080,, 461.25 Diagnostic Imaging,XR Elbow Complete 3+ Views Right,3200107,73080,, 461.25 Diagnostic Imaging,XR Femur 1 View Right,3200108,73552,, 344.50 Diagnostic Imaging,XR Femur 2 Views Left,3200108,73552,, 344.50 Diagnostic Imaging,XR Femur 2 Views Right,3200109,73552,, 344.50 Diagnostic Imaging,XR Finger(1st Digit) 2+ Views Left,3200110,73140,, 250.50 Diagnostic Imaging,XR Finger(1st Digit) 2+ Views Right,3200115,73140,, 250.50 Diagnostic Imaging,XR Foot 2 Views Left,3200120,73620,, 324.25 Diagnostic Imaging,XR Foot 2 Views Right,3200121,73620,, 324.25 Diagnostic Imaging,XR Foot Complete 3+ Views Left,3200122,73630,, 405.25 Diagnostic Imaging,XR Foot Complete 3+ Views Right,3200123,73630,, 405.25 Diagnostic Imaging,XR Forearm 2 Views Left,3200124,73090,, 367.25 Diagnostic Imaging,XR Forearm 2 Views Right,3200125,73090,, 367.25 Diagnostic Imaging,XR Hand 2 Views Left,3200126,73120,, 331.50 Diagnostic Imaging,XR Hand 2 Views Right,3200127,73120,, 331.50 Diagnostic Imaging,XR Hand Complete 3+ Views Left,3200128,73130,, 399.00 Diagnostic Imaging,XR Hand Complete 3+ Views Right,3200129,73130,, 399.00 Diagnostic Imaging,XR Calcaneous Left,3200130,73650,, 321.00 Diagnostic Imaging,XR Calcaneous Right,3200131,73650,, 321.00 Diagnostic Imaging,XR Hip 2-3 Views Left,3200132,73502,, 348.50 Diagnostic Imaging,XR Hip 2-3 Views Right,3200133,73502,, 348.50 Diagnostic Imaging,XR Hip 1 View Left,3200134,73501,, 179.25 Diagnostic Imaging,XR Hip 1 View Right,3200135,73501,, 179.25 Diagnostic Imaging,XR Knee 1 or 2 Views Left,3200138,73560,, 253.50 Diagnostic Imaging,XR Knee 1 or 2 Views Right,3200139,73560,, 253.50 Diagnostic Imaging,XR Knee 3 Views Left,3200140,73562,, 379.25 Diagnostic Imaging,XR Knee 3 Views Right,3200141,73562,, 379.25 Diagnostic Imaging,XR Knee Complete 4+ Views Left,3200142,73564,, 415.25 Diagnostic Imaging,XR Knee Complete 4+ Views Right,3200143,73564,, 415.25 Diagnostic Imaging,XR Lower Extremity Infant (0-1yr) Left,3200144,73592,, 372.25 Diagnostic Imaging,XR Lower Extremity Infant (0-1yr) Right,3200145,73592,, 372.25 Diagnostic Imaging,XR Tibia/Fibula Left,3200146,73590,, 363.75 Diagnostic Imaging,XR Tibia/Fibula Right,3200147,73590,, 363.75 Diagnostic Imaging,XR Ribs 2 Views Left,3200148,71100,, 460.75 Diagnostic Imaging,XR Ribs 2 Views Right,3200149,71100,, 460.75 Diagnostic Imaging,XR Ribs w/ PA Chest Left,3200150,71101,, 627.50 Diagnostic Imaging,XR Ribs w/ PA Chest Right,3200151,71101,, 627.50 Diagnostic Imaging,XR Scapula Left,3200152,73010,, 400.25 Diagnostic Imaging,XR Scapula Right,3200153,73010,, 400.25 Diagnostic Imaging,XR TMJ Open and Closed Left,3200160,70328,, 395.50 Diagnostic Imaging,XR TMJ Open and Closed Right,3200161,70328,, 395.50 Diagnostic Imaging,XR Upper Extremity Infant (0-1yr) Left,3200162,73092,, 288.00 Diagnostic Imaging,XR Upper Extremity Infant (0-1yr) Right,3200163,73092,, 288.00 Diagnostic Imaging,XR Wrist 2 Views Right,3200164,73100,, 236.25 Diagnostic Imaging,XR Wrist Complete 3+ Views Left,3200166,73110,, 354.25 Diagnostic Imaging,XR Wrist Complete 3+ Views Right,3200166,73110,, 354.25 Diagnostic Imaging,XR Swallowing Function w/ Speech,3200170,74230,, 444.00 Diagnostic Imaging,XR Fluoroscopy Under 1 Hour,3200171,76000,, 534.00 Diagnostic Imaging,BD Bone Density DEXA Axial Skeleton,3200173,77080,, 591.25 Diagnostic Imaging,XR Foreign Body Localization Eye,3200174,70030,, 294.50 Diagnostic Imaging,XR Femur 1 View Bilat,3200179,73551,, 454.25 Diagnostic Imaging,XR Hips 2 Views w/AP Pelvis Bilat,3200180,73551,, 253.50 Diagnostic Imaging,XR Hips 3-4 Views w/AP Pelvis Bilat,3200181,73551,, 253.50 Diagnostic Imaging,XR Toe(s) 2+ Views Left,3200195,73660,, 250.50 Diagnostic Imaging,XR Toe(s) 2+ Views Right,3200196,73660,, 250.50 Diagnostic Imaging,XR Toe(s) 2+ Views Right,3200196,73660,, 250.50 Diagnostic Imaging,77002 FLUOROSCOPIC GUIDANCE FOR NEEDLE PLACEME,3200197,77002,," 1,820.25 " Diagnostic Imaging,20610 INJECTION AND OR ASPIRATION MAJOR JOINT,3200198,20610,," 1,001.50 " Diagnostic Imaging,74430 CYSTOGRAPHY,3200200,74430,, 668.25 Diagnostic Imaging,74455 URETHROCYSTOGRAPHY VOIDING,3200201,74455,, 734.50 Diagnostic Imaging,74450 URETHROCYSTOGRAPHY NOT VOIDING,3200202,74450,, 668.25 Diagnostic Imaging,51600 INJ PROC CYSTO OR VOID URETHROCYSTO,3200204,51600,, 201.00 Diagnostic Imaging,51610 INJ PROC LTD RETRO URETHROCYSTO,3200206,51610,, 201.00 Diagnostic Imaging,MG Breast Tissue Specimen Surgical Left,3200213,76098,, 101.25 Diagnostic Imaging,US Paracentesis,3200217,49083,," 1,970.75 " Diagnostic Imaging,23350 ARTHROGRAPHY SHOULDER INJECTION PROC,3200218,23350,," 1,005.00 " Diagnostic Imaging,73615 ARTHROGRAPHY ANKLE RADIOLOGIC EXAM,3200220,73615,," 1,824.75 " Diagnostic Imaging,27648 ARTHROGRAPHY ANKLE INJECTION PROCEDURE,3200221,27648,," 1,006.75 " Diagnostic Imaging,XR Pelvis Complete 3+ Views,3200224,72190,, 409.50 Diagnostic Imaging,25246 ARTHROGRAPHY WRIST INJECTION PROCEDURE,3200225,25246,," 1,006.75 " Diagnostic Imaging,27093 ARTHROGRAPHY HIP INJECTION PROCEDURE,3200226,27093,," 1,006.75 " Diagnostic Imaging,27370 ARTHROGRAPHY KNEE INJECTION PROCEDURE,3200227,27370,," 1,006.75 " Diagnostic Imaging,24220 ARTHROGRAPHY ELBOW INJECTION PROCEDURE,3200228,24220,," 1,006.75 " Diagnostic Imaging,XR Hips 2 Views Bilat,3200233,73521,, 547.50 Diagnostic Imaging,XR Hip 2-3 Views w/AP Pelvis Left,3200234,73502,, 395.50 Diagnostic Imaging,XR Hip 2-3 Views w/AP Pelvis Right,3200235,73502,, 395.50 Diagnostic Imaging,XR Hip 1 View w/ AP Pelvis Left,3200236,73501,, 348.50 Diagnostic Imaging,XR Hip 1 View w/ AP Pelvis Right,3200237,73501,, 348.50 Diagnostic Imaging,US Thoracentesis,3200238,32555,," 1,823.50 " Diagnostic Imaging,XR Tube Placement NG Gastric (Stomach),3200239,43752,, 699.25 Diagnostic Imaging,20550 INJECTION TENDON SHEATH OR LIGAMENT,3200240,20550,, 790.50 Diagnostic Imaging,"10160 PUNCTURE ASPIRATON OF ABCESS HEMAT, CYSTS, ETC",3200242,10160,, 810.50 Diagnostic Imaging,38505 Biopsy or Excision of Lymph node,3200243,38505,," 3,357.25 " Diagnostic Imaging,20552 INJECTION-TRIGGER POINT 1 or 2 MUSCLES,3200247,20552,, 827.00 Diagnostic Imaging,XR Finger(s) 2+ Views Left,3200301,73140,, 250.50 Diagnostic Imaging,XR Finger(s) 2+ Views Left,3200301,73140,, 250.50 Diagnostic Imaging,XR Finger(s) 2+ Views Right,3200302,73140,, 250.50 Diagnostic Imaging,XR Finger(s) 2+ Views Right,3200302,73140,, 250.50 Diagnostic Imaging,XR Spine Thoracic 1 View,3200303,72020,, 221.75 Diagnostic Imaging,XR Shoulder 1 View Right,3200304,73020,, 183.25 Diagnostic Imaging,XR Lower Extremity Infant (0-1yr) Bilat,3200305,73592,, 630.00 Diagnostic Imaging,73040 ARTHROGRAPHY SHOULDER RADIOLOGIC EXAM,3200321,73040,, 364.75 Diagnostic Imaging,73085 ARTHROGRAPHY ELBOW RADIOLOGIC EXAM,3200331,73085,," 1,824.75 " Diagnostic Imaging,73252 ARTHROGRAPHY HIP RADIOLOGIC EXAM,3200333,73252,," 1,005.00 " Diagnostic Imaging,27369 ARTHROGRAPHY KNEE INJECTION PROCEDURE,3200336,27369,," 1,006.75 " Diagnostic Imaging,73580 ARTHROGRAPHY KNEE RADIOLOGIC EXAM,3200337,73580,," 1,005.00 " Diagnostic Imaging,MRI TMJ,3300001,70336,," 2,710.00 " Diagnostic Imaging,MRI Brain w/o Contrast,3300002,70551,," 3,235.00 " Diagnostic Imaging,MRI Pituitary w/o Contrast,3300002,70551,," 3,235.00 " Diagnostic Imaging,MRI Brain w/ Contrast,3300003,70552,," 3,005.25 " Diagnostic Imaging,MRI Pituitary w/ Contrast,3300003,70552,," 3,570.00 " Diagnostic Imaging,MRI Brain w/ + w/o Contrast,3300004,70553,," 3,983.50 " Diagnostic Imaging,MRI Pituitary w/ + w/o Contrast,3300004,70553,," 3,983.50 " Diagnostic Imaging,MRA Chest w/ Contrast,3300005,71555,," 2,813.25 " Diagnostic Imaging,MRA Chest w/o Contrast,3300006,71555,," 2,408.00 " Diagnostic Imaging,MRI Spine Cervical w/o Contrast,3300007,72141,," 3,235.00 " Diagnostic Imaging,MRI Spine Cervical w/ Contrast,3300008,72142,," 2,833.25 " Diagnostic Imaging,MRI Spine Thoracic w/o Contrast,3300009,72146,," 2,390.75 " Diagnostic Imaging,MRI Spine Thoracic w/ Contrast,3300010,72147,," 2,833.25 " Diagnostic Imaging,MRI Spine Lumbar w/o Contrast,3300011,72148,," 3,235.00 " Diagnostic Imaging,MRI Spine Lumbar w/ Contrast,3300012,72149,," 2,833.25 " Diagnostic Imaging,MRI Spine Cervical w/ + w/o Contrast,3300013,72156,," 3,983.50 " Diagnostic Imaging,MRI Spine Thoracic w/ + w/o Contrast,3300014,72157,," 3,983.50 " Diagnostic Imaging,MRI Spine Lumbar w/ + w/o Contrast,3300015,72158,," 3,983.50 " Diagnostic Imaging,MRA Pelvis w/ Contrast,3300016,72198,," 2,357.75 " Diagnostic Imaging,72198 MRA Pelvis w/ Contrast,3300017,72198,," 2,833.25 " Diagnostic Imaging,MRA Pelvis w/o Contrast,3300017,72198,," 2,833.25 " Diagnostic Imaging,MRA Abdomen w/o Contrast,3300018,74185,," 2,005.00 " Diagnostic Imaging,MRA Abdomen w/ Contrast,3300019,74185,," 3,257.50 " Diagnostic Imaging,MRA Neck w/ + w/o Contrast,3300020,70549,," 3,464.00 " Diagnostic Imaging,MRA Neck w/ Contrast,3300021,70548,," 2,833.25 " Diagnostic Imaging,MRA Neck w/o Contrast,3300022,70547,," 2,710.00 " Diagnostic Imaging,MRA Brain/Head w/ + w/o Contrast,3300023,70546,," 3,464.00 " Diagnostic Imaging,MRI Chest w/ Contrast,3300024,71551,," 2,833.25 " Diagnostic Imaging,MRI Chest w/ + w/o Contrast,3300025,71552,," 3,464.00 " Diagnostic Imaging,MRI Pelvis w/o Contrast,3300026,72195,," 2,357.75 " Diagnostic Imaging,MRI Pelvis w/ + w/o Contrast,3300027,72197,," 3,464.00 " Diagnostic Imaging,MRI Abdomen w/ Contrast,3300028,74182,," 2,833.25 " Diagnostic Imaging,MRI Abdomen w/ + w/o Contrast,3300029,74183,," 2,944.25 " Diagnostic Imaging,MRA Upper Extremity w/ Contrast Left,3300034,73225,," 2,833.25 " Diagnostic Imaging,MRA Upper Extremity w/ Contrast Right,3300035,73225,," 2,833.25 " Diagnostic Imaging,MRA Upper Extremity w/o Contrast Left,3300036,73225,," 2,357.75 " Diagnostic Imaging,MRA Upper Extremity w/o Contrast Right,3300037,73225,," 2,357.75 " Diagnostic Imaging,MRI Abdomen w/o Contrast,3300038,74181,," 2,357.75 " Diagnostic Imaging,MRI Chest w/o Contrast,3300039,71550,," 2,357.75 " Diagnostic Imaging,MRA Brain/Head w/ Contrast,3300040,70545,," 2,833.25 " Diagnostic Imaging,MRA Brain/Head w/o Contrast,3300041,70544,," 2,005.00 " Diagnostic Imaging,MRI Pelvis w/ Contrast,3300042,72196,," 2,357.75 " Diagnostic Imaging,MRI Face Neck Orbit w/o Contrast,3300043,70540,," 2,357.75 " Diagnostic Imaging,MRI Face Neck Orbit w/ Contrast,3300044,70542,," 2,833.25 " Diagnostic Imaging,MRI Face Neck Orbit w/ + w/o Contrast,3300045,70543,," 2,944.25 " Diagnostic Imaging,MRI Calcaneus w/o Contrast Left,3300065,73718,," 2,709.00 " Diagnostic Imaging,MRI Calcaneus w/o Contrast Right,3300066,73718,," 2,709.00 " Diagnostic Imaging,MRI Calcaneus w/ Contrast Left,3300068,73719,," 2,833.25 " Diagnostic Imaging,MRI Calcaneus w/ Contrast Right,3300069,73719,," 2,833.25 " Diagnostic Imaging,MRI Calcaneus w/ + w/o Contrast Left,3300071,73720,," 2,940.00 " Diagnostic Imaging,MRI Calcaneus w/ + w/o Contrast Right,3300072,73720,," 2,940.00 " Diagnostic Imaging,73725 MRA LWR EXT BILAT,3300082,73725,," 2,403.25 " Diagnostic Imaging,MRI Breast w/ + w/o Contrast Bilateral,3300084,77049,," 4,740.50 " Diagnostic Imaging,MRA Abdomen w/ + w/o Contrast,3300086,74185,," 3,640.75 " Diagnostic Imaging,MRA Lower Extremity w/ Contrast Left,3300301,73725,," 2,833.25 " Diagnostic Imaging,MRA Lower Extremity w/o Contrast Left,3300302,73725,," 2,357.75 " Diagnostic Imaging,MRA Lower Extremity w/ Contrast Right,3300303,73725,," 2,833.25 " Diagnostic Imaging,MRA Lower Extremity w/o Contrast Right,3300304,73725,," 2,357.75 " Diagnostic Imaging,MRI Ankle w/ Contrast Left,3300305,73722,," 2,833.25 " Diagnostic Imaging,MRI Ankle w/o Contrast Left,3300306,73721,," 2,803.50 " Diagnostic Imaging,MRI Ankle w/ + w/o Contrast Left,3300307,73723,," 2,944.25 " Diagnostic Imaging,MRI Ankle w/ Contrast Right,3300308,73722,," 2,833.25 " Diagnostic Imaging,MRI Ankle w/o Contrast Right,3300309,73721,," 2,803.50 " Diagnostic Imaging,MRI Ankle w/ + w/o Contrast Right,3300310,73723,," 2,944.25 " Diagnostic Imaging,MRI Elbow w/ Contrast Left,3300311,73222,," 2,833.25 " Diagnostic Imaging,MRI Elbow w/o Contrast Left,3300312,73221,," 2,803.50 " Diagnostic Imaging,MRI Elbow w/ + w/o Contrast Left,3300313,73223,," 2,944.25 " Diagnostic Imaging,MRI Elbow w/ Contrast Right,3300314,73222,," 2,833.25 " Diagnostic Imaging,MRI Elbow w/o Contrast Right,3300315,73221,," 2,803.50 " Diagnostic Imaging,MRI Elbow w/ + w/o Contrast Right,3300316,73223,," 2,944.25 " Diagnostic Imaging,MRI Femur w/ Contrast Left,3300317,73719,," 2,833.25 " Diagnostic Imaging,MRI Femur w/o Contrast Left,3300318,73718,," 2,709.00 " Diagnostic Imaging,MRI Femur w/ + w/o Contrast Left,3300319,73720,," 2,710.00 " Diagnostic Imaging,MRI Femur w/ Contrast Right,3300320,73719,," 2,833.25 " Diagnostic Imaging,MRI Femur w/o Contrast Right,3300321,73718,," 2,710.00 " Diagnostic Imaging,MRI Femur w/ + w/o Contrast Right,3300322,73720,," 2,710.00 " Diagnostic Imaging,MRI Foot w/ Contrast Left,3300323,73719,," 2,833.25 " Diagnostic Imaging,MRI Foot w/o Contrast Left,3300324,73718,," 2,709.00 " Diagnostic Imaging,MRI Foot w/ + w/o Contrast Left,3300325,73720,," 2,710.00 " Diagnostic Imaging,MRI Foot w/ Contrast Right,3300326,73719,," 2,833.25 " Diagnostic Imaging,MRI Foot w/o Contrast Right,3300327,73718,," 2,710.00 " Diagnostic Imaging,MRI Foot w/ + w/o Contrast Right,3300328,73720,," 2,710.00 " Diagnostic Imaging,MRI Forearm w/ Contrast Left,3300329,73219,," 2,357.75 " Diagnostic Imaging,MRI Forearm w/o Contrast Left,3300330,73218,," 2,357.75 " Diagnostic Imaging,MRI Forearm w/ + w/o Contrast Left,3300331,73220,," 2,710.00 " Diagnostic Imaging,MRI Forearm w/ Contrast Right,3300332,73219,," 2,357.75 " Diagnostic Imaging,MRI Forearm w/o Contrast Right,3300333,73218,," 2,710.00 " Diagnostic Imaging,MRI Forearm w/ + w/o Contrast Right,3300334,73220,," 2,357.75 " Diagnostic Imaging,MRI Hand w/ Contrast Left,3300335,73219,," 2,357.75 " Diagnostic Imaging,MRI Hand w/o Contrast Left,3300336,73218,," 2,710.00 " Diagnostic Imaging,MRI Hand w/ + w/o Contrast Left,3300337,73220,," 2,357.75 " Diagnostic Imaging,MRI Hand w/ Contrast Right,3300338,73219,," 2,357.75 " Diagnostic Imaging,MRI Hand w/o Contrast Right,3300339,73218,," 2,710.00 " Diagnostic Imaging,MRI Hand w/ + w/o Contrast Right,3300340,73220,," 2,357.75 " Diagnostic Imaging,MRI Hip w/ Contrast Left,3300341,73722,," 2,833.25 " Diagnostic Imaging,MRI Hip w/o Contrast Left,3300342,73721,," 2,803.50 " Diagnostic Imaging,MRI Hip w/ + w/o Contrast Left,3300343,73723,," 2,944.25 " Diagnostic Imaging,MRI Hip w/ Contrast Right,3300344,73722,," 2,833.25 " Diagnostic Imaging,MRI Hip w/o Contrast Right,3300345,73721,," 2,803.50 " Diagnostic Imaging,MRI Hip w/ + w/o Contrast Right,3300346,73723,," 2,944.25 " Diagnostic Imaging,MRI Humerus w/ Contrast Left,3300347,73219,," 2,357.75 " Diagnostic Imaging,MRI Humerus w/o Contrast Left,3300348,73218,," 2,710.00 " Diagnostic Imaging,MRI Humerus w/ + w/o Contrast Left,3300349,73220,," 2,357.75 " Diagnostic Imaging,MRI Humerus w/ Contrast Right,3300350,73219,," 2,357.75 " Diagnostic Imaging,MRI Humerus w/o Contrast Right,3300351,73218,," 2,710.00 " Diagnostic Imaging,MRI Humerus w/ + w/o Contrast Right,3300352,73220,," 2,357.75 " Diagnostic Imaging,MRI Knee w/ Contrast Left,3300353,73722,," 2,833.25 " Diagnostic Imaging,MRI Knee w/o Contrast Left,3300354,73721,," 2,803.50 " Diagnostic Imaging,MRI Knee w/ + w/o Contrast Left,3300355,73723,," 2,944.25 " Diagnostic Imaging,MRI Knee w/ Contrast Right,3300356,73722,," 2,833.25 " Diagnostic Imaging,MRI Knee w/o Contrast Right,3300357,73721,," 2,803.50 " Diagnostic Imaging,MRI Knee w/ + w/o Contrast Right,3300358,73723,," 2,944.25 " Diagnostic Imaging,MRI Tibia/Fibula w/ Contrast Left,3300359,73719,," 2,833.25 " Diagnostic Imaging,MRI Tibia/Fibula w/o Contrast Left,3300360,73718,," 2,709.00 " Diagnostic Imaging,MRI Tibia/Fibula w/ + w/o Contrast Left,3300361,73720,," 2,710.00 " Diagnostic Imaging,MRI Tibia/Fibula w/ Contrast Right,3300362,73719,," 2,833.25 " Diagnostic Imaging,MRI Tibia/Fibula w/o Contrast Right,3300363,73718,," 2,710.00 " Diagnostic Imaging,MRI Tibia/Fibula w/ + w/o Contrast Right,3300364,73720,," 2,710.00 " Diagnostic Imaging,MRI MRCP,3300365,74181,," 2,357.75 " Diagnostic Imaging,MRI Shoulder w/ Contrast Left,3300366,73222,," 2,833.25 " Diagnostic Imaging,MRI Shoulder w/o Contrast Left,3300367,73221,," 2,803.50 " Diagnostic Imaging,MRI Shoulder w/ + w/o Contrast Left,3300368,73223,," 2,944.25 " Diagnostic Imaging,MRI Shoulder w/ Contrast Right,3300369,73222,," 2,833.25 " Diagnostic Imaging,MRI Shoulder w/o Contrast Right,3300370,73221,," 2,803.50 " Diagnostic Imaging,MRI Shoulder w/ + w/o Contrast Right,3300371,73223,," 2,944.25 " Diagnostic Imaging,MRI Wrist w/ Contrast Left,3300372,73222,," 2,833.25 " Diagnostic Imaging,MRI Wrist w/o Contrast Left,3300373,73221,," 2,803.50 " Diagnostic Imaging,MRI Wrist w/ + w/o Contrast Left,3300374,73223,," 2,944.25 " Diagnostic Imaging,MRI Wrist w/ Contrast Right,3300375,73222,," 2,833.25 " Diagnostic Imaging,MRI Wrist w/o Contrast Right,3300376,73221,," 2,803.50 " Diagnostic Imaging,MRI Wrist w/ + w/o Contrast Right,3300377,73223,," 2,944.25 " Diagnostic Imaging,MRI Sacrum/Coccyx w/o Contrast,3300378,72195,," 2,357.75 " Diagnostic Imaging,MRI Sacrum/Coccyx w/ Contrast,3300379,72196,," 2,357.75 " Diagnostic Imaging,MRI Sacrum/Coccyx w/ + w/o Contrast,3300380,72197,," 3,464.00 " Diagnostic Imaging,MRI Clavicle w/o Contrast Left,3300381,73218,," 2,710.00 " Diagnostic Imaging,MRI Clavicle w/o Contrast Right,3300382,73218,," 2,710.00 " Diagnostic Imaging,MRI Scapula w/o Contrast Left,3300383,73218,," 2,710.00 " Diagnostic Imaging,MRI Scapula w/o Contrast Right,3300384,73218,," 2,710.00 " Diagnostic Imaging,MRI Clavicle w/ Contrast Left,3300385,73219,," 2,357.75 " Diagnostic Imaging,MRI Clavicle w/ Contrast Right,3300386,73219,," 2,357.75 " Diagnostic Imaging,MRI Scapula w/ Contrast Left,3300387,73219,," 2,357.75 " Diagnostic Imaging,MRI Scapula w/ Contrast Right,3300388,73219,," 2,357.75 " Diagnostic Imaging,MRI Clavicle w/ + w/o Contrast Left,3300389,73220,," 2,357.75 " Diagnostic Imaging,MRI Clavicle w/ + w/o Contrast Right,3300390,73220,," 2,357.75 " Diagnostic Imaging,MRI Scapula w/ + w/o Contrast Left,3300391,73220,," 2,357.75 " Diagnostic Imaging,MRI Scapula w/ + w/o Contrast Right,3300392,73220,," 2,357.75 " Diagnostic Imaging,MRA Lower Extremity w/ + w/o Cnt Left,3300393,73225,," 2,357.75 " Diagnostic Imaging,MRA Upper Extremity w/ + w/o Cnt Left,3300394,73225,," 2,357.75 " Diagnostic Imaging,MRA Lower Extremity w/ + w/o Cnt Right,3300395,73225,," 2,357.75 " Diagnostic Imaging,MRA Upper Extremity w/ + w/o Cnt Right,3300396,73225,," 2,357.75 " Diagnostic Imaging,MRI Brachial Plexus w/o Contrast Lt,3300397,73218,," 2,710.00 " Diagnostic Imaging,MRI Brachial Plexus w/ + w/o Contrast Lt,3300398,73220,," 2,357.75 " Diagnostic Imaging,MRI Brachial Plexus w/o Contrast Rt,3300399,73218,," 2,710.00 " Diagnostic Imaging,MRI Brachial Plexus w/ + w/o Contrast Rt,3300400,73220,," 2,357.75 " Diagnostic Imaging,NM Myocardial SPECT Rest and Stress EO,3400001,78452,," 5,617.25 " Diagnostic Imaging,78306 NM Bone Imaging Whole Body,3400002,78306,," 1,176.50 " Diagnostic Imaging,NM Bone Imaging Whole Body,3400002,78306,," 1,176.50 " Diagnostic Imaging,NM Kidney Imaging Single w/ Pharm,3400003,78708,," 1,180.50 " Diagnostic Imaging,78320 NM Bone Spect,3400004,78320,, 955.25 Diagnostic Imaging,NM Bone Spect,3400004,78320,, 955.25 Diagnostic Imaging,NM Parathyroid Imaging,3400005,78070,, 955.25 Diagnostic Imaging,NM Gastrointestinal Blood Loss Imaging,3400006,78278,, 812.50 Diagnostic Imaging,NM Cardiac MUGA EO,3400007,78472,, 955.25 Diagnostic Imaging,NM Liver/Spleen Static,3400008,78215,," 1,021.50 " Diagnostic Imaging,NM Hepatobiliary Imaging,3400009,78226,," 1,180.50 " Diagnostic Imaging,NM Gastric Emptying Study,3400010,78264,," 1,253.75 " Diagnostic Imaging,NM Lung Perfusion Imaging,3400011,78580,," 1,171.75 " Diagnostic Imaging,NM Kidney Morphology w/ Vascular Flow,3400012,78701,," 1,389.00 " Diagnostic Imaging,NM Thyroid Imaging,3400013,78013,, 937.00 Diagnostic Imaging,NM Lung Vent/Perf Imaging,3400014,78582,," 1,200.75 " Diagnostic Imaging,NM Lung Ventilation Imaging,3400015,78579,," 1,107.75 " Diagnostic Imaging,NM Bone Imaging Limited,3400016,78300,," 1,064.75 " Diagnostic Imaging,NM Bone Three Phase Study,3400017,78315,," 1,396.50 " Diagnostic Imaging,NM Hepatobiliary Imaging w/ Drug,3400018,78227,," 1,861.75 " Diagnostic Imaging,NM Myocardial SPECT Single Study EO,3400019,78451,," 4,356.75 " Diagnostic Imaging,NM Intestine Imaging Meckels,3400020,78290,, 955.25 Diagnostic Imaging,NM Liver Imaging Spect,3400021,78205,," 1,021.25 " Diagnostic Imaging,NM Kidney Imaging Multiple w/+w/o Pharm,3400022,78709,," 1,179.75 " Diagnostic Imaging,NM Thyroid Uptake Single or Multi,3400023,78014,," 1,128.00 " Diagnostic Imaging,NM Sentinel Node,3400024,78195,," 1,361.25 " Diagnostic Imaging,US Abdomen Complete,3500001,76700,, 933.25 Diagnostic Imaging,US Head/Neck Soft Tissue,3500002,76536,, 480.25 Diagnostic Imaging,US Breast Limited Bilat,3500003,76642,," 1,098.50 " Diagnostic Imaging,76801 US OB < 14 Weeks Single,3500004,76801,, 691.00 Diagnostic Imaging,US OB < 14 Weeks Single,3500004,76801,, 691.00 Diagnostic Imaging,US OB < 14 Weeks Multi,3500005,76802,, 691.00 Diagnostic Imaging,US OB Greater Than 14 Weeks Multi,3500006,76810,, 812.50 Diagnostic Imaging,76817 US OB Transvaginal,3500007,76817,, 606.00 Diagnostic Imaging,US OB Transvaginal,3500007,76817,, 606.00 Diagnostic Imaging,US AAA Screening Medicare,3500009,76706,, 788.00 Diagnostic Imaging,US Renal Artery Duplex Bilateral,3500011,93975,," 1,378.75 " Diagnostic Imaging,US Retroperitoneal Complete,3500012,76770,, 775.00 Diagnostic Imaging,US Ankle Brachial Index,3500014,93922,, 317.00 Diagnostic Imaging,US OB Limited,3500015,76815,, 428.00 Diagnostic Imaging,76856 US Pelvic Complete,3500016,76856,, 769.50 Diagnostic Imaging,US Pelvic Complete,3500016,76856,, 769.50 Diagnostic Imaging,US OB Greater Than 14 Weeks,3500017,76805,, 691.00 Diagnostic Imaging,US Retroperitoneal Limited,3500018,76775,, 788.00 Diagnostic Imaging,US Lower Ext Venous Duplex Bilateral,3500019,93970,," 1,154.00 " Diagnostic Imaging,US Scrotum (Contents) w/ Doppler if ind,3500021,76870,, 665.25 Diagnostic Imaging,US Carotid Duplex Bilateral,3500022,93880,," 1,068.25 " Diagnostic Imaging,US Lower Ext Arterial Duplex Bilateral,3500023,93925,," 1,134.00 " Diagnostic Imaging,76830 US Transvaginal Non-OB,3500024,76830,, 606.00 Diagnostic Imaging,US Transvaginal Non-OB,3500024,76830,, 606.00 Diagnostic Imaging,US OB Follow Up,3500025,76816,, 410.75 Diagnostic Imaging,US Bladder Scan,3500026,76857,, 350.75 Diagnostic Imaging,US Lower Ext Arterial Duplex Left,3500028,93926,, 569.25 Diagnostic Imaging,US Lower Ext Arterial Duplex Right,3500029,93926,, 569.25 Diagnostic Imaging,US Breast Limited Left,3500030,76642,, 537.00 Diagnostic Imaging,US Breast Limited Right,3500031,76642,, 537.00 Diagnostic Imaging,US Chest,3500032,76604,, 442.00 Diagnostic Imaging,US Axilla Left,3500033,76882,, 578.75 Diagnostic Imaging,US Soft Tissue Lower Ext Left,3500033,76882,, 578.75 Diagnostic Imaging,US Soft Tissue Upper Ext Left,3500033,76882,, 578.75 Diagnostic Imaging,US Axilla Right,3500034,76882,, 578.75 Diagnostic Imaging,US Soft Tissue Lower Ext Right,3500034,76882,, 578.75 Diagnostic Imaging,US Soft Tissue Upper Ext Right,3500034,76882,, 578.75 Diagnostic Imaging,US Upper Ext Venous Duplex Bilateral,3500035,93970,, 781.50 Diagnostic Imaging,US Upper Ext Arterial Duplex Left,3500037,93931,, 573.25 Diagnostic Imaging,US Echocardiogram 2D + M-Mode,3500039,93306,," 1,936.25 " Diagnostic Imaging,US Echocardiogram 2D + M-Mode EO,3500039,93306,," 1,936.25 " Diagnostic Imaging,US Abdomen Limited,3500040,76705,, 733.00 Diagnostic Imaging,76942 US GUIDANCE FOR NEEDLE PLACEMENT SUPV,3500041,76942,," 1,820.25 " Diagnostic Imaging,US Guided Needle Placement,3500041,76942,," 1,820.25 " Diagnostic Imaging,US Intraoperative,3500042,76998,, 960.25 Diagnostic Imaging,US Upper Ext Arterial Duplex Bilateral,3500043,93930,," 1,144.50 " Diagnostic Imaging,US Upper Ext Arterial Duplex Right,3500044,93931,, 573.25 Diagnostic Imaging,US Breast Biopsy w/ US Guide Left,3500045,19083,," 3,100.00 " Diagnostic Imaging,US Breast Biopsy w/ US Guide Right,3500045,19083,," 3,100.00 " Diagnostic Imaging,US Fetal Biophysical Profile w/o N-Str,3500050,76818,, 694.25 Diagnostic Imaging,XR Placement CVAD w/ Fluoro,3500053,77001,, 972.50 Diagnostic Imaging,US Breast Complete,3500055,76641,," 1,006.75 " Diagnostic Imaging,US Breast Complete Right,3500056,76641,," 1,006.75 " Diagnostic Imaging,US Breast Complete Bilat,3500057,76641,," 2,013.50 " Diagnostic Imaging,US Echo 2D Limited EO,3500059,93308,, 724.25 Diagnostic Imaging,55700 PROSTATE BIOPSY,3500060,55700,," 5,470.00 " Diagnostic Imaging,76872 US TRANSRECTAL,3500061,76872,, 729.50 Diagnostic Imaging,US Transrectal,3500061,76872,, 729.50 Diagnostic Imaging,US Breast Device Plcmnt w/US Guide Left,3500067,19285,," 1,823.50 " Diagnostic Imaging,US Breast Device Plcmnt w/US Guide Right,3500067,19285,," 1,823.50 " Diagnostic Imaging,20551 INJECTION SINGLE TENDON ORIGIN/INSERTION,3500069,20551,, 790.50 Diagnostic Imaging,US Hips Infant Dynamic,3500072,76885,, 405.50 Diagnostic Imaging,US Aorta IVC Iliac Duplex Complete,3500073,93978,, 788.00 Diagnostic Imaging,US Fine Needle Aspiration w/ Guidance,3500077,10005,," 1,470.00 " Diagnostic Imaging,US Breast Tissue Specimen Surgical Left,3500301,76098,, 101.25 Diagnostic Imaging,US Breast Tissue Specimen Surgical Right,3500302,76098,, 101.25 Diagnostic Imaging,US Soft Tissue Abd/Pel,3500303,76705,, 606.00 Diagnostic Imaging,US Soft Tissue,3500304,76882,, 578.75 Diagnostic Imaging,US Lower Ext Venous Duplex Left,3500305,93971,, 781.50 Diagnostic Imaging,US Lower Ext Venous Duplex Right,3500306,93971,, 781.50 Diagnostic Imaging,US Upper Ext Venous Duplex Left,3500307,93971,, 781.50 Diagnostic Imaging,US Upper Ext Venous Duplex Right,3500308,93971,, 781.50 Diagnostic Imaging,US Guided Joint Inj/Asp Finger Specify,3500313,20604,," 1,033.50 " Diagnostic Imaging,US Guided Joint Inj/Asp Toes Specify,3500314,20604,," 1,033.50 " Diagnostic Imaging,US Guided Joint Inj/Asp Ankle Lt,3500315,20606,," 1,033.50 " Diagnostic Imaging,US Guided Joint Inj/Asp Ankle Rt,3500316,20606,," 1,033.50 " Diagnostic Imaging,US Guided Joint Inj/Asp Elbow Lt,3500317,20606,," 1,033.50 " Diagnostic Imaging,US Guided Joint Inj/Asp Elbow Rt,3500318,20606,," 1,033.50 " Diagnostic Imaging,US Guided Joint Inj/Asp Wrist Lt,3500319,20606,," 1,033.50 " Diagnostic Imaging,US Guided Joint Inj/Asp Wrist Rt,3500320,20606,," 1,033.50 " Diagnostic Imaging,US Guided Joint Inj/Asp Hip Lt,3500321,20611,," 1,033.50 " Diagnostic Imaging,US Guided Joint Inj/Asp Hip Rt,3500322,20611,," 1,033.50 " Diagnostic Imaging,US Guided Joint Inj/Asp Knee Lt,3500323,20611,," 1,033.50 " Diagnostic Imaging,US Guided Joint Inj/Asp Knee Rt,3500324,20611,," 1,033.50 " Diagnostic Imaging,US Guided Joint Inj/Asp Shoulder Lt,3500325,20611,," 1,033.50 " Diagnostic Imaging,US Guided Joint Inj/Asp Shoulder Rt,3500326,20611,," 1,033.50 " Diagnostic Imaging,US Soft Tissue Buttocks or Pelvic Wall,3500336,76857,, 350.75 Diagnostic Imaging,US Soft Tissue Chest or Upper Back,3500337,76604,, 442.00 Diagnostic Imaging,US Soft Tissue Groin,3500338,76882,, 578.75 Diagnostic Imaging,US WBI Complete Bilateral,3500339,93922,, 317.00 Diagnostic Imaging,77067 MG Mammo Digital Screening Bilateral,3600003,77067,, 355.75 Diagnostic Imaging,MG Mammo Digital Screening Bilateral,3600003,77067,, 355.75 Diagnostic Imaging,77067 MG Mammo Digital Screening Left,3600004,77067,, 137.00 Diagnostic Imaging,MG Mammo Digital Screening Left,3600004,77067,, 225.75 Diagnostic Imaging,77067 MG Mammo Digital Screening Right,3600005,77067,, 137.00 Diagnostic Imaging,MG Mammo Digital Screening Right,3600005,77067,, 225.75 Diagnostic Imaging,77066 MG Mammo Digital Diagnostic Bilat,3600006,77066,, 417.50 Diagnostic Imaging,MG Mammo Digital Diagnostic Bilat,3600006,77066,, 417.50 Diagnostic Imaging,77065 MG Mammo Digital Diagnostic Left,3600007,77065,, 256.75 Diagnostic Imaging,MG Mammo Digital Diagnostic Left,3600007,77065,, 256.75 Diagnostic Imaging,77065 MG Mammo Digital Diagnostic Right,3600008,77065,, 256.75 Diagnostic Imaging,MG Mammo Digital Diagnostic Right,3600008,77065,, 256.75 Diagnostic Imaging,MG Breast Needle Localization,3600018,19281,," 1,823.50 " Diagnostic Imaging,G0279 MG BREAST TOMOSYNTHESIS BILAT DIGITAL DIAGNOSTIC,3600023,G0279,, 91.50 Diagnostic Imaging,G0279 MG BREAST TOMOSYNTHESIS UNILAT DIGITAL DIAGNOSTIC,3600023,G0279,, 91.50 Diagnostic Imaging,G0279 MG BREAST TOMOSYNTHESIS UNILAT DIGITAL DIAGNOSTIC,3600023,G0279,, 91.50 Diagnostic Imaging,77063 MG BREAST TOMOSYNTHESIS DIGITAL SCREENING,3600024,77063,, 91.50 Diagnostic Imaging,MG Breast Tissue Specimen Surgical Right,3600301,76098,, 101.25 Diagnostic Imaging,71250 CT Abdomen w/o Contrast,3700027,71250,," 1,908.00 " Diagnostic Imaging,71250 CT Chest w/o Contrast,3700027,71250,," 1,908.00 " Diagnostic Imaging,XR Wrist 1 View On One Film Bilateral,3700068,73100,, 317.00 Emergency,16035 ESCHAROTOMY FIRST INCISION TechFee,1700002,16035,," 1,155.00 " Emergency,92960 CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL TechFee,1700010,92960,, 886.75 Emergency,59409 VAGINAL DELIVERY ONLY TechFee,1700012,59409,," 2,774.50 " Emergency,96372- Subq/IM Injection,1700016,96372,, 187.25 Emergency,G0168 WOUND CLOSURE BY ADHESIVE TechFee,1700020,G0168,, 80.75 Emergency,"96360 - Hydration, first hour",1700034,96360,, 315.00 Emergency,"96361- Hydration, each additional hour",1700035,96361,, 145.50 Emergency,"96374- IV Injection, single/initial",1700039,96374,, 315.00 Emergency,"96375- IV Injection, add new drug",1700040,96375,, 258.50 Emergency,"96365- IV tx, first hour",1700047,96365,, 359.00 Emergency,"96366- IV tx, each additional hour",1700048,96366,, 227.50 Emergency,36591 COLLECT BLOOD FROM IMPLANT VENOUS ACCESS DEVICE TechFee,1700049,36591,, 101.25 Emergency,29799 UNLISTED PROCEDURE CASTING/STRAPPING TechFee,1700050,29799,, 162.75 Emergency,99281 - Level 1,1700053,99281,, 303.25 Emergency,99282 - Level 2,1700054,99282,, 321.25 Emergency,99282 Level 2 ED TechFee,1700054,99282,, 321.25 Emergency,99283 - Level 3,1700055,99283,, 452.25 Emergency,99283 Level 3 ED TechFee,1700055,99283,, 452.25 Emergency,99284 - Level 4,1700056,99284,, 706.00 Emergency,99284 Level 4 ED TechFee,1700056,99284,, 706.00 Emergency,99285 - Level 5,1700057,99285,," 1,146.00 " Emergency,99285 Level 5 ED TechFee,1700057,99285,," 1,146.00 " Emergency,99291 Level 6 ED TechFee,1700058,99291,," 1,861.75 " Emergency,"Critical Care, First Hour 99291",1700058,99291,," 1,861.75 " Emergency,99281 Level 1 - ED Visit,1700059,99281,, 396.75 Emergency,99282 LIMITED SERVICE ProFee,1700061,99282, 405.50 , Emergency,99283 INTERMEDIATE SERVICE ProFee,1700062,99283, 602.25 , Emergency,99284 EXTENDED SERVICE ProFee,1700063,99284, 810.50 , Emergency,99285 COMPREHENS. SERVICE ProFee,1700064,99285," 1,678.75 ", Emergency,99291 CRITICAL CARE E&M-UNSTABL ProFee,1700065,99291," 1,952.25 ", Emergency,99292 CRITICAL CARE E&M-UNSTABL ProFee,1700066,99292, 822.25 , Emergency,92953 Temporary External Pacing TechFee,1700067,92953,," 1,020.00 " Emergency,31720 CATHETER ASPIRATION NASOTRACHEAL SPX TechFee,1700069,31720,, 275.75 Emergency,36430 TRANSFUSION BLOOD/BLOOD COMPONENTS TechFee,1700070,36430,, 862.75 Emergency,92950 CARDIOPULMONARY RESUSCITATION TechFee,1700071,92950,," 1,329.75 " Emergency,62270 SPINAL PUNCTURE LUMBAR DIAGNOSTIC TechFee,1700074,62270,, 349.00 Emergency,31502 INTRO PROC ON LARYNX TechFee,1700079,31502,, 400.25 Emergency,36680 PLACEMENT NEEDLE INTRAOSSEOUS INFUSION TechFee,1700080,36680,, 372.25 Emergency,82948 GLUCOSE BLOOD REAGENT STRIP TechFee,1700085,82948,, 42.75 Emergency,"10060 INCISION AND DRAINAGE OF ABSCESS (EG, CARBUNCLE, SUPPURATIVE HIDRADENITIS, CUTANEOUS O ProFee",1700089,10060, 352.25 , Emergency,"10120 INCISION AND REMOVAL OF FOREIGN BODY, SUBCUTANEOUS TISSUES; SIMPLE ProFee",1700092,10120, 468.00 , Emergency,11000 DEBRIDEMENT OF EXTENSIVE ECZEMATOUS OR INFECTED SKIN; UP TO 10% OF BODY SURFACE ProFee,1700094,11000, 155.00 , Emergency,11010 DEBRIDEMENT INCLUDING REMOVAL OF FOREIGN MATERIAL AT THE SITE OF AN OPEN FRACTURE AND/ ProFee,1700095,11010, 149.75 , Emergency,"11042 DEBRIDEMENT, SUBCUTANEOUS TISSUE (INCLUDES EPIDERMIS AND DERMIS, IF PERFORMED); FIRST ProFee",1700096,11042, 330.50 , Emergency,"11730 AVULSION OF NAIL PLATE, PARTIAL OR COMPLETE, SIMPLE; SINGLE ProFee",1700097,11730, 321.00 , Emergency,11740 EVACUATION OF SUBUNGUAL HEMATOMA ProFee,1700098,11740, 111.00 , Emergency,11760 REPAIR OF NAIL BED ProFee,1700099,11760, 539.00 , Emergency,"12001 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK ProFee",1700100,12001, 510.50 , Emergency,"12002 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK ProFee",1700101,12002, 563.00 , Emergency,"12004 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK ProFee",1700102,12004, 676.25 , Emergency,"12005 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK ProFee",1700103,12005, 865.25 , Emergency,"12006 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK ProFee",1700104,12006," 1,005.00 ", Emergency,"12011 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS M ProFee",1700105,12011, 536.75 , Emergency,"12013 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS M ProFee",1700106,12013, 607.75 , Emergency,"12014 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS M ProFee",1700107,12014, 736.00 , Emergency,"12015 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS M ProFee",1700108,12015, 823.00 , Emergency,"12031 REPAIR, INTERMEDIATE, WOUNDS OF SCALP, AXILLAE, TRUNK AND/OR EXTREMITIES (EXCLUDING HA ProFee",1700109,12031, 644.50 , Emergency,"12032 REPAIR, INTERMEDIATE, WOUNDS OF SCALP, AXILLAE, TRUNK AND/OR EXTREMITIES (EXCLUDING HA ProFee",1700110,12032, 726.25 , Emergency,"12034 REPAIR, INTERMEDIATE, WOUNDS OF SCALP, AXILLAE, TRUNK AND/OR EXTREMITIES (EXCLUDING HA ProFee",1700111,12034, 786.00 , Emergency,"12035 REPAIR, INTERMEDIATE, WOUNDS OF SCALP, AXILLAE, TRUNK AND/OR EXTREMITIES (EXCLUDING HA ProFee",1700112,12035, 932.75 , Emergency,"12041 REPAIR, INTERMEDIATE, WOUNDS OF NECK, HANDS, FEET AND/OR EXTERNAL GENITALIA; 2.5 CM OR ProFee",1700113,12041, 613.50 , Emergency,"12042 REPAIR, INTERMEDIATE, WOUNDS OF NECK, HANDS, FEET AND/OR EXTERNAL GENITALIA; 2.6 CM TO ProFee",1700114,12042, 806.75 , Emergency,"12044 REPAIR, INTERMEDIATE, WOUNDS OF NECK, HANDS, FEET AND/OR EXTERNAL GENITALIA; 7.6 CM TO ProFee",1700115,12044, 854.00 , Emergency,"12045 REPAIR, INTERMEDIATE, WOUNDS OF NECK, HANDS, FEET AND/OR EXTERNAL GENITALIA; 12.6 CM T ProFee",1700116,12045," 1,008.75 ", Emergency,"12051 REPAIR, INTERMEDIATE, WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANE ProFee",1700117,12051, 650.25 , Emergency,"12052 REPAIR, INTERMEDIATE, WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANE ProFee",1700118,12052, 815.75 , Emergency,"12053 REPAIR, INTERMEDIATE, WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANE ProFee",1700119,12053, 836.00 , Emergency,"12054 REPAIR, INTERMEDIATE, WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANE ProFee",1700120,12054," 1,097.75 ", Emergency,"13100 REPAIR, COMPLEX, TRUNK; 1.1 CM TO 2.5 CM ProFee",1700121,13100, 830.50 , Emergency,"13101 REPAIR, COMPLEX, TRUNK; 2.6 CM TO 7.5 CM ProFee",1700122,13101," 1,047.50 ", Emergency,"13120 REPAIR, COMPLEX, SCALP, ARMS, AND/OR LEGS; 1.1 CM TO 2.5 CM ProFee",1700123,13120, 874.00 , Emergency,"13121 REPAIR, COMPLEX, SCALP, ARMS, AND/OR LEGS; 2.6 CM TO 7.5 CM ProFee",1700124,13121," 1,314.25 ", Emergency,"13131 REPAIR, COMPLEX, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS AND/OR ProFee",1700125,13131," 1,014.00 ", Emergency,"13132 REPAIR, COMPLEX, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS AND/OR ProFee",1700126,13132," 1,581.25 ", Emergency,"13151 REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; 1.1 CM TO 2.5 CM ProFee",1700128,13151," 1,249.00 ", Emergency,"16020 DRESSINGS AND/OR DEBRIDEMENT OF PARTIAL-THICKNESS BURNS, INITIAL OR SUBSEQUENT; SMALL ProFee",1700129,16020, 190.50 , Emergency,"16025 DRESSINGS AND/OR DEBRIDEMENT OF PARTIAL-THICKNESS BURNS, INITIAL OR SUBSEQUENT; MEDIUM ProFee",1700130,16025, 510.50 , Emergency,"16030 DRESSINGS AND/OR DEBRIDEMENT OF PARTIAL-THICKNESS BURNS, INITIAL OR SUBSEQUENT; LARGE ProFee",1700131,16030, 532.25 , Emergency,20520 REMOVAL OF FOREIGN BODY IN MUSCLE OR TENDON SHEATH; SIMPLE ProFee,1700132,20520, 881.00 , Emergency,20525 REMOVAL OF FOREIGN BODY IN MUSCLE OR TENDON SHEATH; DEEP OR COMPLICATED ProFee,1700133,20525," 1,270.00 ", Emergency,"20600 ARTHROCENTESIS, ASPIRATION AND/OR INJECTION, SMALL JOINT OR BURSA (EG, FINGERS, TOES); ProFee",1700134,20600, 172.50 , Emergency,"20605 ARTHROCENTESIS, ASPIRATION AND/OR INJECTION, INTERMEDIATE JOINT OR BURSA (EG, TEMPOROM ProFee",1700135,20605, 200.00 , Emergency,"20610 ARTHROCENTESIS, ASPIRATION AND/OR INJECTION, MAJOR JOINT OR BURSA (EG, SHOULDER, HIP, ProFee",1700136,20610, 354.75 , Emergency,21480 CLOSED TREATMENT OF TEMPOROMANDIBULAR DISLOCATION; INITIAL OR SUBSEQUENT ProFee,1700137,21480, 165.50 , Emergency,23500 CLOSED TREATMENT OF CLAVICULAR FRACTURE; WITHOUT MANIPULATION ProFee,1700139,23500, 767.25 , Emergency,"23650 CLOSED TREATMENT OF SHOULDER DISLOCATION, WITH MANIPULATION; WITHOUT ANESTHESIA ProFee",1700140,23650," 1,134.00 ", Emergency,24600 TREATMENT OF CLOSED ELBOW DISLOCATION; WITHOUT ANESTHESIA ProFee,1700141,24600," 1,504.75 ", Emergency,"24640 CLOSED TREATMENT OF RADIAL HEAD SUBLUXATION IN CHILD, NURSEMAID ELBOW, WITH MANIPULATI ProFee",1700142,24640, 483.50 , Emergency,"26410 REPAIR, EXTENSOR TENDON, HAND, PRIMARY OR SECONDARY; WITHOUT FREE GRAFT, EACH TENDON ProFee",1700143,26410," 2,778.50 ", Emergency,"26700 CLOSED TREATMENT OF METACARPOPHALANGEAL DISLOCATION, SINGLE, WITH MANIPULATION; WITHOU ProFee",1700144,26700," 1,305.75 ", Emergency,"26720 CLOSED TREATMENT OF PHALANGEAL SHAFT FRACTURE, PROXIMAL OR MIDDLE PHALANX, FINGER OR T ProFee",1700145,26720, 536.75 , Emergency,"26750 CLOSED TREATMENT OF DISTAL PHALANGEAL FRACTURE, FINGER OR THUMB; WITHOUT MANIPULATION, ProFee",1700146,26750, 631.00 , Emergency,"26770 CLOSED TREATMENT OF INTERPHALANGEAL JOINT DISLOCATION, SINGLE, WITH MANIPULATION; WITH ProFee",1700147,26770," 1,044.25 ", Emergency,"27250 CLOSED TREATMENT OF HIP DISLOCATION, TRAUMATIC; WITHOUT ANESTHESIA ProFee",1700148,27250," 2,184.00 ", Emergency,27550 CLOSED TREATMENT OF KNEE DISLOCATION; WITHOUT ANESTHESIA ProFee,1700149,27550," 1,906.50 ", Emergency,27560 CLOSED TREATMENT OF PATELLAR DISLOCATION; WITHOUT ANESTHESIA ProFee,1700150,27560," 1,268.75 ", Emergency,27840 CLOSED TREATMENT OF ANKLE DISLOCATION; WITHOUT ANESTHESIA ProFee,1700151,27840," 1,624.25 ", Emergency,"28190 REMOVAL OF FOREIGN BODY, FOOT; SUBCUTANEOUS ProFee",1700152,28190, 755.00 , Emergency,"28490 CLOSED TREATMENT OF FRACTURE GREAT TOE, PHALANX OR PHALANGES; WITHOUT MANIPULATION ProFee",1700153,28490, 472.25 , Emergency,"28510 CLOSED TREATMENT OF FRACTURE, PHALANX OR PHALANGES, OTHER THAN GREAT TOE; WITHOUT MANI ProFee",1700154,28510, 469.75 , Emergency,28630 CLOSED TREATMENT OF METATARSOPHALANGEAL JOINT DISLOCATION; WITHOUT ANESTHESIA ProFee,1700155,28630, 593.00 , Emergency,29105 APPLICATION OF LONG ARM SPLINT (SHOULDER TO HAND) ProFee,1700156,29105, 265.50 , Emergency,29125 APPLICATION OF SHORT ARM SPLINT (FOREARM TO HAND); STATIC ProFee,1700157,29125, 234.50 , Emergency,29130 APPLICATION OF FINGER SPLINT; STATIC ProFee,1700158,29130, 155.00 , Emergency,29505 APPLICATION OF LONG LEG SPLINT (THIGH TO ANKLE OR TOES) ProFee,1700159,29505, 238.50 , Emergency,29515 APPLICATION OF SHORT LEG SPLINT (CALF TO FOOT) ProFee,1700160,29515, 301.00 , Emergency,"29700 REMOVAL OR BIVALVING; GAUNTLET, BOOT OR BODY CAST ProFee",1700161,29700, 158.25 , Emergency,29740 WEDGING OF CAST (EXCEPT CLUBFOOT CASTS) ProFee,1700162,29740, 296.25 , Emergency,"30300 REMOVAL FOREIGN BODY, INTRANASAL; OFFICE TYPE PROCEDURE ProFee",1700163,30300, 251.00 , Emergency,"30901 CONTROL NASAL HEMORRHAGE, ANTERIOR, SIMPLE (LIMITED CAUTERY AND/OR PACKING) ANY METHOD ProFee",1700164,30901, 337.50 , Emergency,"30903 CONTROL NASAL HEMORRHAGE, ANTERIOR, COMPLEX (EXTENSIVE CAUTERY AND/OR PACKING) ANY MET ProFee",1700165,30903, 403.50 , Emergency,"30905 CONTROL NASAL HEMORRHAGE, POSTERIOR, WITH POSTERIOR NASAL PACKS AND/OR CAUTERY, ANY ME ProFee",1700166,30905, 554.50 , Emergency,"31500 INTUBATION, ENDOTRACHEAL, EMERGENCY PROCEDURE ProFee",1700167,31500, 644.50 , Emergency,"31505 LARYNGOSCOPY, INDIRECT; DIAGNOSTIC (SEPARATE PROCEDURE) ProFee",1700168,31505, 165.50 , Emergency,"31530 LARYNGOSCOPY, DIRECT, OPERATIVE, WITH FOREIGN BODY REMOVAL; ProFee",1700169,31530," 1,005.00 ", Emergency,"32554 THORACENTESIS, NEEDLE OR CATHETER, ASPIRATION OF THE PLEURAL SPACE; WITHOUT IMAGING GU ProFee",1700170,32554, 378.00 , Emergency,"32551 TUBE THORACOSTOMY, INCLUDES CONNECTION TO DRAINAGE SYSTEM (EG, WATER SEAL), WHEN PERFO ProFee",1700171,32551," 1,060.25 ", Emergency,33210 INSERTION OR REPLACEMENT OF TEMPORARY TRANSVENOUS SINGLE CHAMBER CARDIAC ELECTRODE OR ProFee,1700172,33210, 909.00 , Emergency,33010 PERICARDIOCENTESIS; INITIAL ProFee,1700173,33010, 604.25 , Emergency,"36000 INTRODUCTION OF NEEDLE OR INTRACATHETER, VEIN ProFee",1700174,36000, 47.00 , Emergency,"36600 ARTERIAL PUNCTURE, WITHDRAWAL OF BLOOD FOR DIAGNOSIS ProFee",1700176,36600, 84.50 , Emergency,"40830 CLOSURE OF LACERATION, VESTIBULE OF MOUTH; 2.5 CM OR LESS ProFee",1700177,40830, 647.50 , Emergency,42809 REMOVAL OF FOREIGN BODY FROM PHARYNX ProFee,1700178,42809, 660.50 , Emergency,"43760 CHANGE OF GASTROSTOMY TUBE, PERCUTANEOUS, WITHOUT IMAGING OR ENDOSCOPIC GUIDANCE ProFee",1700179,43762, 468.00 , Emergency,"46050 INCISION AND DRAINAGE, PERIANAL ABSCESS, SUPERFICIAL ProFee",1700180,46050, 393.00 , Emergency,"46083 INCISION OF THROMBOSED HEMORRHOID, EXTERNAL ProFee",1700181,46083, 452.25 , Emergency,49082 ABDOMINAL PARACENTESIS (DIAGNOSTIC OR THERAPEUTIC); WITHOUT IMAGING GUIDANCE ProFee,1700182,49082, 358.00 , Emergency,"51702 INSERTION OF TEMPORARY INDWELLING BLADDER CATHETER; SIMPLE (EG, FOLEY) ProFee",1700184,51702, 350.75 , Emergency,"62270 SPINAL PUNCTURE, LUMBAR, DIAGNOSTIC ProFee",1700185,62270, 296.25 , Emergency,"65205 REMOVAL OF FOREIGN BODY, EXTERNAL EYE; CONJUNCTIVAL SUPERFICIAL ProFee",1700186,65205, 187.25 , Emergency,"65220 REMOVAL OF FOREIGN BODY, EXTERNAL EYE; CORNEAL, WITHOUT SLIT LAMP ProFee",1700187,65220, 165.50 , Emergency,"65222 REMOVAL OF FOREIGN BODY, EXTERNAL EYE; CORNEAL, WITH SLIT LAMP ProFee",1700188,65222, 216.75 , Emergency,69200 REMOVAL FOREIGN BODY FROM EXTERNAL AUDITORY CANAL; WITHOUT GENERAL ANESTHESIA ProFee,1700189,69200, 242.50 , Emergency,"69210 REMOVAL IMPACTED CERUMEN REQUIRING INSTRUMENTATION, UNILATERAL ProFee",1700190,69210, 169.75 , Emergency,"43753 GASTRIC INTUBATION AND ASPIRATION(S) THERAPEUTIC, NECESSITATING PHYSICIAN'S SKILL (EG, ProFee",1700192,43753, 127.75 , Emergency,92950 PHY CPR ProFee,1700193,92950," 1,074.25 ", Emergency,92953 PHY EXTERNAL PACING ProFee,1700194,92953, 96.75 , Emergency,92960 PHY CARDIOVERSION EXTERNAL ProFee,1700195,92960, 596.50 , Emergency,92977 CORONARY THROMBOLYSIS BY INTRAVENOUS INFUSION ProFee,1700196,92977," 1,561.00 ", Emergency,94060 PFT PHYS REVIEW & INTERP ProFee,1700198,94060, 299.25 , Emergency,99288 EMS/ALS CARE W/DIRECTION ProFee,1700199,99288, 271.75 , Emergency,"20550 INJECTION(S); SINGLE TENDON SHEATH, OR LIGAMENT, APONEUROSIS (EG, PLANTAR FASCIA) ProFee",1700200,20550, 196.50 , Emergency,"31603 TRACHEOSTOMY, EMERGENCY PROCEDURE; TRANSTRACHEAL ProFee",1700201,31603," 1,173.00 ", Emergency,"31605 TRACHEOSTOMY, EMERGENCY PROCEDURE; CRICOTHYROID MEMBRANE ProFee",1700202,31605," 1,008.75 ", Emergency,32160 THORACOTOMY; WITH CARDIAC MASSAGE ProFee,1700203,32160," 3,076.00 ", Emergency,"36425 VENIPUNCTURE, CUTDOWN; AGE 1 OR OVER ProFee",1700204,36425, 434.75 , Emergency,59409 VAGINAL DELIVERY ONLY (WITH OR WITHOUT EPISIOTOMY AND/OR FORCEPS); ProFee,1700205,59409," 3,833.25 ", Emergency,92002 EYE EXAM NEW INTERMEDIATE ProFee,1700206,92002, 244.25 , Emergency,36680 PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION ProFee,1700211,36680, 167.50 , Emergency,"96367- IV tx, sequential infusion",1700213,96367,, 227.50 Emergency,"96376- IV Injection, add same drug",1700214,96376,, 258.50 Emergency,"94770 Carbon dioxide, expired gas determination by infrared analyzer",1700217,94770,, 308.25 Emergency,94770 PULM DIAG TESTING AND THERAPIES TechFee,1700217,94770,, 308.25 Emergency,94770 PULMONARY DIAGNOSTIC TESTING AND THERAPIES TechFee,1700217,94770,, 308.25 Emergency,51702 INSJ TEMP NDWELLG BLADDER CATHETER SIMPLE TechFee,1700218,51702,, 304.25 Emergency,51701 INSJ NON-NDWELLG BLADDER CATHETER TechFee,1700219,51701,, 289.25 Emergency,99152 MOD SED SAME PHYS/QHP INITIAL 15 MINS 5/> YRS,1700221,99152,, 210.00 Emergency,99153 MOD SED SAME PHYS/QHP EACH ADDL 15 MINS,1700222,99153,, 42.00 Emergency,16000 INITIAL TX 1ST DEGREE BURN LOCAL TX TechFee,1700223,16000,, 333.00 Emergency,16020 DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ SMALL TechFee,1700224,16020,, 333.00 Emergency,16025 DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ MEDIUM TechFee,1700225,16025,, 333.00 Emergency,16030 DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ LARGE TechFee,1700226,16030,, 333.00 Emergency,11000 DBRDMT EXTENSV ECZEMA/INFECT SKN UP 10% BDY SURF TechFee,1700227,11000,, 349.00 Emergency,11001 DEBRID EA ADD 10% BOD SUR TechFee,1700228,11001,, 349.00 Emergency,65220 RMVL FB XTRNL EYE CORNEAL W/O SLIT LAMP TechFee,1700229,65220,, 400.25 Emergency,94640 PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT,1700230,94640,, 149.75 Emergency,29105 APPLICATION LONG ARM SPLINT SHOULDER HAND TechFee,1700234,29105,, 234.50 Emergency,29125 APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC TechFee,1700235,29125,, 234.50 Emergency,29130 APPLICATION FINGER SPLINT STATIC TechFee,1700236,29130,, 234.50 Emergency,29240 STRAPPING SHOULDER TechFee,1700237,29240,, 234.50 Emergency,29260 STRAPPING ELBOW/WRIST TechFee,1700238,29260,, 234.50 Emergency,29280 STRAPPING HAND/FINGER TechFee,1700239,29280,, 234.50 Emergency,23500 CLSD TX CLAVICULAR FRACTURE W/O MANIPULATION TechFee,1700240,23500,, 367.50 Emergency,23650 CLSD TX SHOULDER DISLC W/MANIPULATION W/O ANES TechFee,1700241,23650,, 367.50 Emergency,24600 TREATMENT CLOSED ELBOW DISLOCATION W/O ANES TechFee,1700242,24600,, 367.50 Emergency,24640 CLTX RDL HEAD SUBLXTJ CHLD NURSEMAID ELBW W/MANJ TechFee,1700243,24640,, 367.50 Emergency,26720 CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/O MANJ EA TechFee,1700244,26720,, 367.50 Emergency,26750 CLTX DSTL PHLNGL FX FNGR/THMB W/O MANJ EA TechFee,1700245,26750,, 367.50 Emergency,26740 ED TREAT CLOSED FINGER FRACTURE WO MANIP TechFee,1700246,26740,, 367.50 Emergency,26600 CLTX METACARPAL FX W/O MANIPULATION EACH BONE TechFee,1700247,26600,, 367.50 Emergency,24576 CLTX HUMERAL CONDYLAR FX MEDIAL/LAT W/O MANJ TechFee,1700248,24576,, 367.50 Emergency,24560 CLOSED TREAT HUM EPICON FRAC MEDIAL OR LAT; W/OUT MANIP TechFee,1700249,24560,, 367.50 Emergency,23620 CLTX GREATER HUMERAL TUBEROSITY FX W/O MANJ TechFee,1700250,23620,, 367.50 Emergency,23600 TREAT HUMERUS FRACTURE TechFee,1700251,23600,, 367.50 Emergency,24500 TREAT HUMERUS FRACTURE TechFee,1700252,24500,, 367.50 Emergency,24530 CLOSED TREAT HUMERAL FRAC W/W/OUT INTERCON EXT W/OUT MANIP TechFee,1700253,24530,, 367.50 Emergency,24999 UNLISTED PROCEDURE HUMERUS/ELBOW TechFee,1700254,24999,, 367.50 Emergency,25600 CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ TechFee,1700255,25600,, 367.50 Emergency,25560 CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/O MAN TechFee,1700256,25560,, 367.50 Emergency,25500 TREAT FRACTURE OF RADIUS TechFee,1700257,25500,, 367.50 Emergency,24650 CLOSED TX RADIAL HEAD/NECK FX W/O MANIPULATION TechFee,1700258,24650,, 367.50 Emergency,25630 TREAT WRIST BONE FRACTURE TechFee,1700259,25630,, 367.50 Emergency,29505 APPLICATION LONG LEG SPLINT THIGH ANKLE/TOES TechFee,1700261,29505,, 234.50 Emergency,29530 STRAPPING KNEE TechFee,1700262,29530,, 234.50 Emergency,29540 STRAPPING ANKLE &/FOOT TechFee,1700263,29540,, 234.50 Emergency,29580 STRAPPING UNNA BOOT TechFee,1700264,29580,, 234.50 Emergency,27824 CLTX FX W8 BRG ARTCLR PRTN DSTL TIBIA W/O MANJ TechFee,1700265,27824,, 367.50 Emergency,27538 CLTX INTERCONDYLAR SPI&/TUBRST FX KNE W/WO MAN TechFee,1700266,27538,, 367.50 Emergency,27760 CLTX MEDIAL MALLEOLUS FX W/O MANIPULATION TechFee,1700267,27760,, 367.50 Emergency,27530 CLTX TIBIAL FX PROXIMAL W/O MANIPULATION TechFee,1700268,27530,, 367.50 Emergency,27750 CLTX TIBIAL SHAFT FX W/O MANIPULATION TechFee,1700269,27750,, 367.50 Emergency,27816 CLTX TRIMALLEOLAR ANKLE FX W/O MANIPULATION TechFee,1700270,27816,, 367.50 Emergency,28470 CLOSED TX METATARSAL FRACTURE W/O MANIPULATION TechFee,1700271,28470,, 367.50 Emergency,28510 CLTX FX PHLX/PHLG OTH/THN GRT TOE W/O MANJ TechFee,1700272,28510,, 367.50 Emergency,10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE TechFee,1700273,10060,, 448.25 Emergency,10061 INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE TechFee,1700274,10061,, 448.25 Emergency,12031 REPAIR INTERMEDIATE S/A/T/E 2.5 CM/< TechFee,1700275,12031,, 428.00 Emergency,12032 REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM TechFee,1700276,12032,, 428.00 Emergency,12034 REPAIR INTERMEDIATE S/A/T/E 7.6-12.5 CM TechFee,1700277,12034,, 428.00 Emergency,12035 REPAIR INTERMEDIATE S/A/T/E 12.6-20.0CM TechFee,1700278,12035,, 428.00 Emergency,12041 REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.5CM/< TechFee,1700279,12041,, 428.00 Emergency,12042 REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.6-7.5 CM TechFee,1700280,12042,, 428.00 Emergency,12044 REPAIR INTERMEDIATE N/H/F/XTRNL GENT 7.6-12.5CM TechFee,1700281,12044,, 525.00 Emergency,12045 REPAIR INTERMEDIATE N/H/F/XTRNL GENT 12.6-20 CM TechFee,1700282,12045,, 525.00 Emergency,12051 REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.5 CM/< TechFee,1700283,12051,, 428.00 Emergency,12052 REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.6-5.0 CM TechFee,1700284,12052,, 428.00 Emergency,12053 REPAIR INTERMEDIATE F/E/E/N/L&/MUC 5.1-7.5 CM TechFee,1700285,12053,, 428.00 Emergency,12054 REPAIR INTERMEDIATE F/E/E/N/L&/MUC 7.6-12.5 CM TechFee,1700286,12054,, 428.00 Emergency,12001 SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/< TechFee,1700287,12001,, 294.50 Emergency,12002 SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM TechFee,1700288,12002,, 294.50 Emergency,12004 SIMPLE RPR SCALP/NECK/AX/GENIT/TRUNK 7.6-12.5CM TechFee,1700289,12004,, 294.50 Emergency,12005 SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 12.6-20.0CM TechFee,1700290,12005,, 428.00 Emergency,12006 SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 20.1-30.0CM TechFee,1700291,12006,, 428.00 Emergency,12011 SIMPLE REPAIR F/E/E/N/L/M 2.5CM/< TechFee,1700292,12011,, 294.50 Emergency,12013 SIMPLE REPAIR F/E/E/N/L/M 2.6CM-5.0 CM TechFee,1700293,12013,, 294.50 Emergency,12014 SIMPLE REPAIR F/E/E/N/L/M 5.1CM-7.5 CM TechFee,1700294,12014,, 294.50 Emergency,12015 SIMPLE REPAIR F/E/E/N/L/M 7.6CM-12.5 CM TechFee,1700295,12015,, 294.50 Emergency,30300 REMOVAL NASAL FOREIGN BODY-ER SERV PROCE,1700296,30300,, 268.75 Emergency,30901 CONTROL ANT. NASAL HEMORRHAGE- ER SERV P,1700297,30901,, 268.75 Emergency,"30903 CONTROL ANT. NASAL HEMOR,COMP- ER SERV P",1700298,30903,, 268.75 Emergency,30905 CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY 1ST TechFee,1700299,30905,, 268.75 Emergency,"49082 INCISION PROC ON THE ABDM, PERITONEUM, AND OMENTUM TechFee",1700300,49082,, 521.75 Emergency,32554 THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING TechFee,1700301,32554,, 622.75 Emergency,36592 COLLECT BLOOD FROM CATHETER VENOUS NOS TechFee,1700302,36592,, 101.25 Emergency,31500 INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE TechFee,1700303,31500,, 262.50 Emergency,32551 TUBE THORACOSTOMY INCLUDES WATER SEAL TechFee,1700304,32551,," 1,890.00 " Emergency,43762 PERQ REPLACEMENT GTUBE NOT REQ REVJ GSTRST TRC TechFee,1700305,43762,, 262.50 Emergency,10080 INCISION & DRAINAGE PILONIDAL CYST SIMPLE TechFee,1700307,10080,," 1,050.00 " Emergency,10140 I&D HEMATOMA SEROMA/FLUID COLLECTION TechFee,1700308,10140,," 2,100.00 " Emergency,10120 INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE TechFee,1700309,10120,, 525.00 Emergency,10121 INCISION & REMOVAL FOREIGN BODY SUBQ TISS COMPL TechFee,1700310,10121,," 2,100.00 " Emergency,11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1 TechFee,1700311,11730,, 262.50 Emergency,69200 RMVL FB XTRNL AUDITORY CANAL W/O ANES TechFee,1700312,69200,, 262.50 Emergency,69210 REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT TechFee,1700313,69210,, 120.75 Emergency,"99292 Critical Care, Each Additional 30 Min",1700314,99292,, 603.75 Emergency,99292 Level 6 EA 30 Min TechFee,1700314,99292,, 603.75 Emergency,"96368- IV tx, concurrent infusion",1700500,96368,, 227.50 Emergency,29540 STRAPPING ANKLE,1700501,29540, 101.00 , Emergency,29540 STRAPPING; ANKLE AND/OR FOOT ProFee,1700501,29540, 101.00 , Emergency,29530 STRAPPING KNEE,1700502,29530, 116.00 , Emergency,29530 STRAPPING; KNEE ProFee,1700502,29530, 116.00 , Emergency,29240 STRAPPING SHOULDER,1700503,29240, 108.00 , Emergency,"29240 STRAPPING; SHOULDER (EG, VELPEAU) ProFee",1700503,29240, 108.00 , Emergency,29260 STRAPPING ELBOW/WRIST,1700504,29260, 109.00 , Emergency,29260 STRAPPING; ELBOW OR WRIST ProFee,1700504,29260, 109.00 , Emergency,"96401 CHEMO ADMIN, NON-HORMONAL ANTI NEOPLASTIC",1700505,96401,, 246.00 Home Health,Bill Only COVID 19 Specimen Collection,53000001,G2023,, 80.00 Lab,Reticulocyte Count Automated,200032,85044,, 72.75 Lab,Urease Test for H. pylori,2000012,87076,, 85.00 Lab,GTT 1 HR OB,2000013,82950,, 91.50 Lab,Glucose Tolerance (Gest) 1 Hr,2000013,82950,, 91.50 Lab,Lactate Dehydrogenase,2000014,83615,, 61.75 Lab,84075 Component,2000015,84075,, 31.50 Lab,Alkaline Phosphatase,2000015,84075,, 31.50 Lab,Amylase Level,2000016,82150,, 203.50 Lab,Post TR Bili,2000017,82247,, 97.25 Lab,Pre TR Bili,2000017,82247,, 97.25 Lab,Bilirubin Fractionation,2000017,82247,, 97.25 Lab,Bilirubin Total,2000017,82247,, 97.25 Lab,Blood Urea Nitrogen,2000018,84520,, 65.25 Lab,Chol,2000019,82465,, 69.75 Lab,82550 CPK TOTAL,2000020,82550,, 117.25 Lab,Cardiac Profile,2000020,82550,, 117.25 Lab,Creatine Kinase,2000020,82550,, 117.25 Lab,CK-MB,2000021,82553,, 167.50 Lab,CKMB and %MB,2000021,82553,, 167.50 Lab,Creatinine,2000022,82565,, 71.00 Lab,Electrolyte Panel,2000023,80051,, 127.00 Lab,Glucose Lvl,2000024,82947,, 91.50 Lab,Gamma Glutamyl Transferase,2000025,82977,, 179.25 Lab,Aspartate Aminotransferase,2000026,84450,, 66.25 Lab,Alanine Aminotransferase,2000027,84460,, 227.50 Lab,Uric Acid,2000028,84550,, 161.75 Lab,Hemoglobin,2000029,85018,, 27.25 Lab,Hemoglobin and Hematocrit,2000029,85018,, 27.25 Lab,85014 HEMATOCRIT,2000030,85014,, 27.25 Lab,Hematocrit,2000030,85014,, 27.25 Lab,PT/ PTT,2000031,85730,, 65.50 Lab,PTT,2000031,85730,, 65.50 Lab,Retic Cnt Auto,2000032,85044,, 72.75 Lab,ESR,2000033,85651,, 135.00 Lab,White Blood Cell Count,2000034,85048,, 36.00 Lab,White Cell Count w/Man Diff,2000034,85048,, 36.00 Lab,Platelet Count,2000035,85049,, 37.75 Lab,85610 Protime,2000036,85610,, 67.75 Lab,Prothrombin Time and INR,2000036,85610,, 67.75 Lab,Antistreptolysin O Ab LC,2000037,86063,, 200.00 Lab,Mono Scrn,2000038,86308,, 153.00 Lab,Rheumatoid Arthritis Factor LC,2000039,86431,, 161.75 Lab,"RPR, Rfx Qn RPR/Confirm TP LC",2000040,86592,, 63.50 Lab,Basic Metabolic Panel,2000041,80048,, 174.75 Lab,CMP,2000042,80053,, 269.50 Lab,Hep Fnct Pnl,2000043,80076,, 181.25 Lab,Renal Pnl,2000044,80069,, 201.00 Lab,Hepatitis Panel (4) LC,2000045,80074,, 224.50 Lab,85007 Manual Diff,2000046,85007,, 32.75 Lab,Blood Culture,2000048,87040,, 201.00 Lab,Body Fluid Culture,2000049,87070,, 173.00 Lab,Ear Culture,2000049,87070,, 173.00 Lab,Eye Culture,2000049,87070,, 173.00 Lab,Nasal Culture,2000049,87070,, 173.00 Lab,Wound Culture,2000051,87070,, 173.00 Lab,Genital Culture,2000052,87070,, 173.00 Lab,MRSA Culture,2000053,87081,, 173.00 Lab,Occult Blood Screen 3,2000054,82270,, 70.50 Lab,Post Vas,2000056,89321,, 182.50 Lab,Semen Analysis Post Vas,2000056,89321,, 182.50 Lab,MIC Urines (MicroScan),2000057,87186,, 83.25 Lab,Minimum Inhibitory Concentration,2000057,87186,, 83.25 Lab,"Susceptibility, Aer + Anaerob LC",2000057,87186,, 83.25 Lab,Calcium Level Total,2000058,82310,, 118.25 Lab,Gram stain,2000059,87205,, 53.75 Lab,Gram Stain Report,2000059,87205,, 53.75 Lab,Phosphorus Level,2000060,84100,, 173.00 Lab,Albumin Level,2000061,82040,, 78.00 Lab,Red Cell Count,2000062,85041,, 48.75 Lab,Wet Mount,2000063,87210,, 127.00 Lab,Chloride Level,2000064,82435,, 65.00 Lab,Alcohol Level,2000065,80320,, 153.00 Lab,Antinuclear Antibodies Direct LC,2000066,86038,, 37.75 Lab,CEA LC,2000067,82378,, 192.00 Lab,Digoxin Level,2000069,80162,, 130.25 Lab,Digoxin Lvl,2000069,80162,, 130.25 Lab,Phenytoin Lvl,2000070,80185,, 143.25 Lab,Drug Screen Urine,2000071,80306,, 120.75 Lab,Lipid Panel w/Direct LDL,2000072,80061,, 235.00 Lab,Lipid Pnl,2000072,80061,, 235.00 Lab,"Lithium (Eskalith(R)), Serum LC",2000073,80178,, 136.25 Lab,"Rubella Antibodies, IgG LC",2000075,86762,, 153.00 Lab,Theophylline Level,2000077,80198,, 146.75 Lab,Triglycerides,2000078,84478,, 98.25 Lab,82248 Bilirubin Direct,2000079,82248,, 97.25 Lab,Bilirubin Direct,2000079,82248,, 97.25 Lab,Protein Total,2000080,84155,, 74.00 Lab,UA w Micro,2000082,81001,, 91.50 Lab,Pregnancy Test Serum Qual,2000083,84703,, 172.50 Lab,TB Skin Test,2000084,86580,, 96.25 Lab,Potassium Level,2000086,84132,, 60.00 Lab,CBC w/ Differential,2000087,85025,, 140.00 Lab,CBC w/ Manual Differential,2000089,85027,, 104.75 Lab,Strep A Scrn,2000090,87880,, 65.50 Lab,Magnesium Level,2000091,83735,, 105.50 Lab,Phenobarb Lvl,2000092,80184,, 143.25 Lab,Thyroid Stimulating Hormone,2000093,84443,, 181.25 Lab,Mycoplasma pneu. IgG/IgM Abs LC,2000098,86738,, 153.00 Lab,Urine Culture,2000100,87086,, 173.00 Lab,Throat Culture,2000101,87071,, 173.00 Lab,"Mumps Antibodies, IgG LC",2000102,86735,, 136.25 Lab,"Felbamate (Felbatol(R)), Serum LC",2000104,80339,, 131.25 Lab,82784 IGG SUBCLASS,2000117,82784,, 90.00 Lab,82787 Component,2000118,82787,, 90.25 Lab,LA Ven,2000120,83605,, 203.50 Lab,85613 Component,2000122,85613,, 136.25 Lab,85732 Component,2000123,85732,, 136.25 Lab,Sodium Level,2000124,84295,, 45.25 Lab,Anaerobic Culture LC,2000125,87075,, 277.50 Lab,"Gabapentin (Neurontin), Serum LC",2000127,80171,, 173.25 Lab,H. Pylori Antibody IgG,2000128,86677,, 173.00 Lab,Homocyst(e)ine LC,2000129,82131,, 201.00 Lab,Tobramycin Level,2000132,80200,, 164.50 Lab,Vancomycin Lvl,2000133,80202,, 175.00 Lab,"AChR Binding Abs, Serum LC",2000134,84238,, 326.75 Lab,"ACTH, Plasma LC",2000135,82024,, 176.50 Lab,Androstenedione LCMS LC,2000136,82157,, 233.25 Lab,HCV Real-Time PCR Qn LC,2000137,87522,, 911.25 Lab,"HCV RT-PCR, Quant (Graph) LC",2000137,87522,, 911.25 Lab,17-OH Progesterone LCMS LC,2000138,83498,, 164.00 Lab,Aldolase LC,2000139,82085,, 49.50 Lab,"Anti-DNA(SS)IgG, Ab, Qn LC",2000140,86226,, 50.25 Lab,Anti-dsDNA Antibodies LC,2000141,86225,, 74.00 Lab,Mitochondrial (M2) Antibody LC,2000143,83516,, 58.25 Lab,Actin (Smooth Muscle) Antibody LC,2000145,86255,, 58.25 Lab,86800 Component,2000146,86800,, 140.00 Lab,Thyroglobulin Antibody LC,2000146,86800,, 140.00 Lab,"Aldosterone LCMS, Serum LC",2000148,82088,, 278.75 Lab,"Alpha-1-Antitrypsin, Serum LC",2000150,82103,, 127.00 Lab,Angiotensin-Converting Enzyme LC,2000152,82164,, 76.00 Lab,"Calcium, Ionized, Serum LC",2000153,82330,, 69.75 Lab,"Calcium, 24Hr Urine LC",2000154,82340,, 34.75 Lab,Cancer Antigen (CA) 15-3 LC,2000155,86300,, 71.25 Lab,CA 19-9 LC,2000156,86316,, 71.25 Lab,Ceruloplasmin LC,2000157,82390,, 54.25 Lab,Complement C2 LC,2000159,86160,, 138.50 Lab,"Complement C3, Serum LC",2000160,86160,, 66.25 Lab,"Complement C4, Serum LC",2000161,86160,, 65.00 Lab,"Complement, Total (CH50) LC",2000162,86162,, 95.25 Lab,"Creatinine, 24hr Ur LC",2000163,82570,, 59.50 Lab,"Creatinine, Urine LC",2000164,82570,, 44.75 Lab,"DHEA, Serum LC",2000166,82626,, 116.75 Lab,DHEA-Sulfate LC,2000167,82627,, 104.00 Lab,Estradiol LC,2000170,82670,, 58.25 Lab,"Fecal Fat, Qualitative LC",2000171,82705,, 144.75 Lab,Fibrinogen Activity LC,2000173,85384,, 51.00 Lab,HDL Cholesterol,2000175,83718,, 39.25 Lab,"5-HIAA,Quant.,24 Hr Urine LC",2000176,83497,, 65.00 Lab,"Immunoglobulin G, Qn, Serum LC",2000177,82784,, 46.25 Lab,"Immunoglobulin M, Qn, Serum LC",2000178,82784,, 46.25 Lab,"Immunoglobulin A, Qn, Serum LC",2000179,82784,, 46.25 Lab,82784 IMMUNO,2000179,82784,, 46.25 Lab,"Immunoglobulin A, Qn, Serum LC",2000179,82784,, 46.25 Lab,82785 Component,2000180,82785,, 186.50 Lab,"Immunoglobulin E, Total LC",2000180,82785,, 186.50 Lab,86376 Component,2000181,86376,, 144.00 Lab,"Albumin, Random Urine LC",2000184,82043,, 34.75 Lab,86147 Component,2000186,86147,, 63.00 Lab,86235 Component,2000188,86235,, 246.50 Lab,82784 Component,2000190,82784,, 32.75 Lab,EBV Antibody Profile LC,2000199,86664 / 86665,, 229.26 Lab,83021 Component,2000206,83021,, 40.50 Lab,Immunofixation Elect LC,2000211,86334,, 82.00 Lab,86334 Component,2000211,86334,, 82.00 Lab,"Osmolality, Urine LC",2000214,83935,, 26.75 Lab,"PTH, Intact LC",2000215,83970,, 181.25 Lab,Prealbumin LC,2000216,84134,, 50.25 Lab,"Sex Horm Binding Glob, Serum LC",2000218,84270,, 130.25 Lab,"Serotonin, Serum LC",2000219,84260,, 382.25 Lab,"Testosterone, Free, Direct LC",2000220,84402,, 289.25 Lab,Free T4 Level,2000221,84439,, 137.75 Lab,Transferrin LC,2000222,84466,, 91.00 Lab,T3 Free,2000223,84481,, 137.75 Lab,Triiodothyronine (T3) LC,2000224,84480,, 125.25 Lab,"Varicella-Zoster V Ab, IgG LC",2000225,86787,, 62.25 Lab,"Calcitriol(1,25 di-OH Vit D) LC",2000226,82652,, 457.50 Lab,"Vitamin B6, Plasma LC",2000227,84207,, 97.25 Lab,Osmolality LC,2000228,83930,, 34.75 Lab,"GM1 Antibody IgG, IgM LC",2000229,83520,, 416.25 Lab,"Sjogren's Ab, Anti-SS-A/-SS-B LC",2000231,86235,, 246.50 Lab,85305 Component,2000233,85305,, 126.00 Lab,85306 Component,2000234,85306,, 126.00 Lab,Amphet Conf Ur LC,2000242,80324,, 84.50 Lab,"Oxcarbazepine (Trileptal),S LC",2000248,80183,, 159.75 Lab,84153 Component,2000251,84153,, 150.25 Lab,"Protein Total, Qn, 24hr Ur LC",2000252,84155,, 67.25 Lab,Pregnancy Test Urine,2000254,81025,, 127.00 Lab,Sputum Culture,2000256,87070,, 173.00 Lab,"AFP, Serum, Tumor Marker LC",2000257,82105,, 188.50 Lab,Tobramycin Level Peak,2000258,80200,, 164.50 Lab,Tobramycin Level Trough,2000259,80200,, 164.50 Lab,Gentamicin Lvl Peak,2000260,80170,, 162.75 Lab,Gentamicin Lvl Trough,2000261,80170,, 162.75 Lab,Vanco Pk,2000262,80202,, 175.00 Lab,Vanco Tr,2000263,80202,, 175.00 Lab,"Rotavirus Ag, EIA LC",2000265,87425,, 69.75 Lab,B-Type Natriuretic Peptide,2000269,83880,, 201.00 Lab,Platelet Antibody Profile LC,2000271,86022,, 224.00 Lab,"Beta-2 Microglobulin, Serum LC",2000272,82232,, 149.75 Lab,"FDP, Plasma LC",2000276,85362,, 100.75 Lab,"Lamotrigine (Lamictal), Serum LC",2000277,80175,, 173.25 Lab,Factor VIII Activity LC,2000278,85240,, 282.25 Lab,"H. pylori, IgG Abs LC",2000285,86677,, 130.75 Lab,"Giardia lamblia Ag, EIA LC",2000286,87329,, 65.50 Lab,"Vitamin D, 25-Hydroxy LC",2000287,82306,, 55.25 Lab,IGF-1 LC,2000288,84305,, 282.25 Lab,"Histoplasma Abs, Qn, DID LC",2000291,86698,, 136.25 Lab,"C-Peptide, Serum LC",2000293,84681,, 174.50 Lab,80185 Component,2000299,80185,, 144.75 Lab,80186 Component,2000300,80186,, 144.75 Lab,86256 Component,2000304,86256,, 124.25 Lab,84156 Component,2000307,84156,, 33.75 Lab,83520 Component,2000309,83520,, 173.00 Lab,86256 Panel,2000310,86256,, 173.00 Lab,Leukocyte Alkaline Phos Score LC,2000313,85540,, 98.25 Lab,Antibody Screen LC,2000314,86870,, 89.25 Lab,D-Dimer,2000317,85379,, 105.75 Lab,86780 Component,2000318,86780,, 116.75 Lab,Thyroid Peroxidase (TPO) Ab LC,2000319,86376,, 84.50 Lab,"Vitamin B1 (Thiamine), Blood LC",2000320,84425,, 155.00 Lab,82043 Component,2000321,82043,, 63.50 Lab,82570 Component,2000322,82570,, 45.25 Lab,82570 Microalb,2000322,82570,, 63.50 Lab,"Cryoglobulin, Ql, Serum, Rflx LC",2000324,82595,, 31.50 Lab,HLA B 27 Disease Association LC,2000325,86812,, 224.50 Lab,"Reducing Substance, Feces LC",2000326,84377,, 95.75 Lab,"Sirolimus (Rapamune), Blood LC",2000327,80195,, 351.50 Lab,"C-Reactive Protein, Cardiac LC",2000338,86141,, 100.75 Lab,Lipoprotein (a) LC,2000339,83520,, 97.25 Lab,Antithrombin Activity LC,2000345,85300,, 211.25 Lab,"Methylmalonic Acid, Serum LC",2000352,83921,, 253.00 Lab,"TgAb+Thyroglobulin,IMA or LCMS LC",2000354,86800,, 98.25 Lab,"TgAb+Thyroglobulin,IMA or RIA LC",2000354,86800,, 98.25 Lab,Thyroglobulin by IMA LC,2000355,84432,, 98.25 Lab,RPR Qn LC,2000357,86593,, 42.00 Lab,86593 Component,2000357,86593,, 42.00 Lab,"Levetiracetam (Keppra), S LC",2000360,80177,, 173.25 Lab,Antimyeloperoxidase (MPO) Abs LC,2000367,83516,, 216.75 Lab,"Parvovirus B19, Human, IgG/IgM LC",2000369,86747,, 117.25 Lab,Lyme Western Blot LC,2000372,86617,, 231.75 Lab,86617 Component,2000373,86617,, 82.00 Lab,UA w Culture if Ind,2000376,81001,, 91.50 Lab,"Protein,Total,Urine LC",2000381,84155,, 30.75 Lab,84154 Component,2000389,84154,, 65.00 Lab,"Eosinophil, Urine LC",2000390,87205,, 29.00 Lab,"Catecholamines, Plasma LC",2000393,82384,, 274.50 Lab,"Growth Hormone, Serum LC",2000397,83003,, 111.00 Lab,"Topiramate (Topamax), Serum LC",2000407,80201,, 177.50 Lab,Complement C7 Level LC,2000409,86160,, 138.50 Lab,KOH Prep,2000412,87206,, 76.00 Lab,Striational Antibodies LC,2000413,86255,, 196.00 Lab,"AChR Blocking Abs, Serum LC",2000414,84238,, 519.50 Lab,AChR Modulating Antibodies LC,2000415,84238,, 751.25 Lab,DLDL,2000418,83721,, 132.25 Lab,"Cortisol, Urinary Free LC",2000420,82530,, 138.50 Lab,"Hep A Ab, IgM LC",2000421,86709,, 142.50 Lab,"pH, Urine LC",2000425,83986,, 30.75 Lab,86788 Component,2000436,86788,, 145.00 Lab,86789 Component,2000437,86789,, 145.00 Lab,"Renin Activity, Plasma LC",2000439,84244,, 300.00 Lab,"Metanephrines, Frac., Pl. Free LC",2000440,83835,, 488.25 Lab,HCV RNA NAA Qual rfx to Quant LC,2000441,87521,, 795.25 Lab,Cortisol - AM LC,2000443,82533,, 77.25 Lab,VGCC Antibody LC,2000445,83519,, 536.75 Lab,86735 Component,2000451,86735,, 40.50 Lab,86762 Component,2000452,86762,, 40.50 Lab,86765 Component,2000453,86765,, 40.50 Lab,Histoplasma Gal'mannan Ag Ur LC,2000455,87385,, 247.25 Lab,"Blastomyces Abs, Qn, DID LC",2000456,86612,, 52.00 Lab,"Tacrolimus (FK506), Blood LC",2000459,80197,, 259.00 Lab,"Itraconazole, Serum/Plasma LC",2000461,80299,, 426.50 Lab,"C1 Esterase Inhibitor, Func LC",2000462,86161,, 130.25 Lab,"C1 Esterase Inhibitor, Serum LC",2000463,86160,, 44.75 Lab,Protein C-Functional LC,2000465,85303,, 335.75 Lab,"Calculi, Urinary LC",2000467,82360,, 88.75 Lab,Thyroxine (T4) LC,2000469,84436,, 19.50 Lab,82103 Component,2000474,82103,, 40.50 Lab,82104 Component,2000475,82104,, 40.50 Lab,GTT 2 HR PP,2000476,82950,, 91.50 Lab,Glucose Tolerance Post Prandial 2 Hour,2000476,82950,, 91.50 Lab,86225 Component,2000478,86225,, 65.00 Lab,86431 Component,2000479,86431,, 65.00 Lab,86235 Lupus Profile,2000480,86235,, 65.00 Lab,"Oxalate, Quant, 24-Hour Urine LC",2000489,83945,, 44.75 Lab,Apolipoprotein A-1 LC,2000491,82172,, 48.25 Lab,t-Transglutaminase (tTG) IgA LC,2000492,83516,, 197.00 Lab,"Gastrin, Serum LC",2000493,82941,, 174.50 Lab,Thyroid Stim Immunoglobulin LC,2000495,84445,, 497.25 Lab,"Sodium, Urine LC",2000496,84300,, 18.50 Lab,"Potassium, Urine LC",2000497,84133,, 20.75 Lab,CCP Antibodies IgG/IgA LC,2000498,86200,, 59.50 Lab,"RNA, Real Time PCR (Non-Graph) LC",2000503,87536,, 804.50 Lab,"Myoglobin, Urine LC",2000504,83874,, 218.00 Lab,"Nicotine and Metabolite, Quant LC",2000506,80323,, 273.00 Lab,"Calprotectin, Fecal LC",2000509,83993,, 471.00 Lab,Celiac Ped Screen w Reflex LC,2000512,83516,, 247.25 Lab,"Mumps Antibodies, IgM LC",2000516,86735,, 58.25 Lab,Histoplasma capsulatum Abs. LC,2000520,86698,, 235.75 Lab,Bartonella Antibody Panel LC,2000521,86611,, 153.75 Lab,IA-2 Autoantibodies LC,2000523,86341,, 484.00 Lab,"Hep B Core Ab, Tot LC",2000524,86704,, 61.75 Lab,Helper T-Lymph-CD4 LC,2000525,86361,, 250.50 Lab,"Varicella-Zoster Ab, IgM LC",2000526,86787,, 206.75 Lab,"Thyrotropin Receptor Ab, Serum LC",2000527,83520,, 285.25 Lab,86002 Component,2000529,86002,, 46.25 Lab,86003 BASIC FOOD,2000530,86003,, 46.25 Lab,L. pneumophila Serogp 1 Ur Ag LC,2000531,87449,, 214.25 Lab,Pinworm Prep - Enterobius LC,2000536,87172,, 29.75 Lab,"Reverse T3, Serum LC",2000543,84482,, 421.50 Lab,"Viscosity, Serum LC",2000546,85810,, 56.00 Lab,"Susceptibility, Haemophilus LC",2000554,87184,, 83.25 Lab,"Lead, Blood (Adult) LC",2000555,83655,, 80.00 Lab,F202-IgE Cashew Nut LC,2000558,86003,, 44.75 Lab,F013-IgE Peanut LC,2000564,86003,, 44.75 Lab,IgE Peanut w/Component Reflex LC,2000564,86003,, 44.75 Lab,F256-IgE Walnut LC,2000565,86003,, 44.75 Lab,83883 Component,2000587,83883,, 107.75 Lab,Activated Protein C Resistance LC,2000588,85307,, 296.25 Lab,Protein S-Functional LC,2000589,85306,, 328.50 Lab,Anti-Yo Antibodies LC,2000598,86255,, 558.75 Lab,Hemoglobin A1c w/eAG,2000608,83036,, 101.25 Lab,Resp Syncytial Virus,2000619,87807,, 155.75 Lab,RSV,2000619,87807,, 155.75 Lab,Factor VIII Antigen LC,2000622,85244,, 404.25 Lab,"Chlamydia trachomatis, NAA LC",2000624,87491,, 316.25 Lab,MRSA Screen Culture,2000625,87081,, 88.75 Lab,"HSV, IgM I/II Combination LC",2000629,86694,, 67.25 Lab,"Vitamin A, Serum LC",2000635,84590,, 76.75 Lab,Chromogranin A LC,2000640,86316,, 430.50 Lab,IgE Milk w/ Component Reflex LC,2000649,86003,, 44.75 Lab,t-Transglutaminase (tTG) IgG LC,2000652,83516,, 197.00 Lab,"Magnesium, Urine LC",2000666,83735,, 28.50 Lab,Factor II Activity LC,2000668,85210,, 471.50 Lab,G006-IgE Timothy Grass LC,2000671,86003,, 44.75 Lab,"W003-IgE Ragweed, Giant LC",2000673,86003,, 44.75 Lab,E005-IgE Dog Dander LC,2000685,86003,, 44.75 Lab,F203-IgE Pistachio Nut LC,2000689,86003,, 44.75 Lab,PTHrP (PTH-Related Peptide) LC,2000695,83519,, 329.25 Lab,"Hydrocodone + Metabolites, U LC",2000702,80361,, 91.00 Lab,82570 METANEPHRINES,2000708,82570,, 27.75 Lab,83835 Component,2000709,83835,, 27.75 Lab,Apolipoprotein B LC,2000710,82172,, 25.75 Lab,B.pertussisB.parapertussis PCR LC,2000728,87798,, 224.50 Lab,82550 Component,2000732,82550,, 48.50 Lab,82552 Component,2000733,82552,, 48.50 Lab,Occult Blood Diagnostic 1st Spec,2000734,82272,, 70.50 Lab,Bill Only ABSC,2000749,86850,, 144.25 Lab,Bill Only DAT,2000751,86880,, 108.25 Lab,Bill Only ABO/Rh,2000753,86900,, 51.25 Lab,Compatible - REF Crossmatch,2000760,86922,, 657.50 Lab,Incompatible - REF Crossmatch,2000760,86922,, 657.50 Lab,Least Incompatible - REF Crossmatch,2000760,86922,, 657.50 Lab,"Amino Acid Profile, Qn, Plasma LC",2000762,82139,, 222.75 Lab,Cell Count and Diff Body Fluid SMH,2000766,89051,, 38.25 Lab,Crystal Analysis Body Fluid SMH,2000767,89060,, 23.50 Lab,Anaerobic Culture Body Fluid SMH,2000768,87075,, 23.50 Lab,Cryptosporidium EIA LC,2000771,87328,, 240.50 Lab,Histoplasma Gal'mannan Ag Ser LC,2000773,87385,, 190.00 Lab,"Methotrexate (MTX), Serum LC",2000785,80375,, 172.25 Lab,"Crystal,Synovial/Joint Fl LC",2000789,89060,, 23.50 Lab,"Cell Ct, Synovial w/o Crystals LC",2000793,89051,, 8.00 Lab,Acetaminophen Level,2000800,80329,, 127.00 Lab,Acetone Serum,2000801,82009,, 39.75 Lab,84080 Component,2000802,84080,, 51.50 Lab,Ammonia LC,2000803,82140,, 146.75 Lab,CA 125 in the Presence of HAMA LC,2000805,86304,, 263.50 Lab,Cancer Antigen (CA) 125 LC,2000805,86304,, 263.50 Lab,86644 Component,2000806,86644,, 167.25 Lab,86645 Component,2000807,86645,, 167.25 Lab,Cortisol LC,2000808,82533,, 77.25 Lab,"Erythropoietin (EPO), Serum LC",2000809,82668,, 206.25 Lab,"Estrogens, Total LC",2000810,82672,, 236.25 Lab,"FSH, Serum LC",2000812,83001,, 233.25 Lab,HBsAg Screen LC,2000815,87340,, 154.25 Lab,HCV Antibody LC,2000816,86803,, 124.25 Lab,"Lead, Blood (Pediatric) LC",2000822,83655,, 80.00 Lab,"Metanephrines, Frac, Qn, 24-Hr LC",2000824,83835,, 392.00 Lab,Progesterone LC,2000828,84144,, 236.25 Lab,84484 Troponin Quantitative,2000829,84484,, 167.50 Lab,Troponin-I,2000829,84484,, 167.50 Lab,Prolactin LC,2000830,84146,, 273.00 Lab,PSA Diag,2000833,84153,, 134.00 Lab,PSA Screen,2000834,G0103,, 134.00 Lab,"Rubeola Antibodies, IgG LC",2000835,86765,, 209.00 Lab,Salicylate Level,2000836,80329,, 82.00 Lab,Fecal WBC,2000837,89055,, 54.25 Lab,Carbamazepine Level,2000838,80156,, 146.75 Lab,"Testosterone, Serum LC",2000839,84403,, 162.00 Lab,Valproic Acid Lvl,2000840,80164,, 146.75 Lab,"Viral Culture, General LC",2000841,87252,, 468.75 Lab,Gentamicin Lvl,2000849,80170,, 162.75 Lab,Haptoglobin LC,2000850,83010,, 153.75 Lab,"Luteinizing Hormone(LH), S LC",2000851,83002,, 244.75 Lab,HSV Culture and Typing LC,2000852,87255,, 166.00 Lab,Carbon Dioxide Level,2000854,82374,, 69.75 Lab,COLLECTION: Venous Draw,2000855,36415,, 20.75 Lab,"Calcium, Random Urine LC",2000857,82340,, 51.00 Lab,"Catecholamines,Ur.,Free,24 Hr LC",2000858,82384,, 185.50 Lab,86665 Component,2000859,86665,, 83.75 Lab,Insulin LC,2000862,83525,, 52.00 Lab,Hep Be Ab LC,2000863,86707,, 97.25 Lab,Hep Be Ag LC,2000864,87350,, 97.25 Lab,Hep B Surface Ab LC,2000866,86706,, 105.75 Lab,"Hep A Ab, Total LC",2000867,86708,, 127.00 Lab,"Chloride, Urine LC",2000868,82436,, 30.25 Lab,"Sodium, 24 hr Urine LC",2000870,84300,, 30.75 Lab,"Uric Acid, 24 hr Urine LC",2000872,84560,, 48.25 Lab,86663 Component,2000873,86663,, 62.25 Lab,86664 Component,2000874,86664,, 70.50 Lab,"Cyclosporine, Blood LC-MS/MS LC",2000877,80158,, 113.75 Lab,E0181 RBC CPD 500 LR,2000878,P9016,, 760.00 Lab,E0336 RBC CPD AS1 500 LR,2000878,P9016,, 760.00 Lab,E0382 RBC CP2D AS3 500 LR,2000878,P9016,, 760.00 Lab,E4531 Aph RBC ACDA AS1 LR,2000878,P9016,, 760.00 Lab,E4532 Aph RBC ACDA AS1 LR 1,2000878,P9016,, 760.00 Lab,E4533 Aph RBC ACDA AS1 LR 2,2000878,P9016,, 760.00 Lab,E4543 Aph RBC ACDA AS3 LR,2000878,P9016,, 760.00 Lab,E4544 Aph RBC ACDA AS3 LR 1,2000878,P9016,, 760.00 Lab,E4545 Aph RBC ACDA AS3 LR 2,2000878,P9016,, 760.00 Lab,E3046 Aph Plt ACDA LR Irr,2000879,P9035,," 2,022.25 " Lab,E3056 Aph Plt ACDA LR Irr 1,2000879,P9035,," 2,022.25 " Lab,E3057 Aph Plt ACDA LR Irr 2,2000879,P9035,," 2,022.25 " Lab,E3058 Aph Plt ACDA LR Irr 3,2000879,P9035,," 2,022.25 " Lab,E3077 Aph Plt ACDA LR,2000879,P9035,," 2,022.25 " Lab,E3087 Aph Plt ACDA LR 1,2000879,P9035,," 2,022.25 " Lab,E3088 Aph Plt ACDA LR 2,2000879,P9035,," 2,022.25 " Lab,E3089 Aph Plt ACDA LR 3,2000879,P9035,," 2,022.25 " Lab,Post TR Antibody Screen 3,2000880,86850,, 89.25 Lab,Pre TR Antibody Screen 3,2000880,86850,, 89.25 Lab,Antibody Screen Gel 2,2000880,86850,, 89.25 Lab,Bill Only Antibody Titer,2000885,86886,, 555.75 Lab,Post TR ABO/Rh,2000894,86900,, 53.75 Lab,Pre TR ABO/Rh,2000894,86900,, 53.75 Lab,ABO Only,2000894,86900,, 53.75 Lab,ABO/Rh,2000894,86900,, 53.75 Lab,Post TR DAT Poly Tube,2000899,86880,, 85.25 Lab,DAT Poly Tube,2000899,86880,, 85.25 Lab,Post TR Crossmatch,2000901,86922,, 113.50 Lab,Pre TR Crossmatch,2000901,86922,, 113.50 Lab,Blood Bank ID Number,2000901,86922,, 108.00 Lab,Compatible - XM AHG Gel Interp,2000901,86922,, 113.25 Lab,Incompatible - XM AHG Gel Interp,2000901,86922,, 113.25 Lab,Least Incompatible - XM AHG Gel Interp,2000901,86922,, 113.25 Lab,"BLOOD TYPING, RH",2000902,86901,, 48.50 Lab,Rh Only,2000902,86901,, 48.50 Lab,Influenza A/B,2000903,87804,, 155.75 Lab,Vitamin E LC,2000905,84446,, 66.25 Lab,"Testosterone, Total, Women, Children, and Hypogonadal Males, LC/MS-MS LC",2000909,84403,, 42.75 Lab,"Carotene, Beta LC",2000913,82380,, 35.50 Lab,"Hep B Core Ab, IgM LC",2000917,86705,, 55.00 Lab,87491 Component,2000919,87491,, 153.00 Lab,87591 Component,2000920,87591,, 153.00 Lab,Glucose Body Fluid SMH,2000926,82945,, 21.75 Lab,Total Protein Body Fluid SMH,2000927,84157,, 32.50 Lab,25-Hydroxyvitamin D LCMS D2+D3 LC,2000928,82306,, 131.50 Lab,Procalcitonin LC,2000929,84145,, 331.50 Lab,Bill Only Antigen Screening,2000942,86904,, 51.25 Lab,Human Epididymis Protein 4 LC,2000945,86305,, 477.50 Lab,"Synthetic Cannabinoids,Scr,Ur LC",2000947,80307,, 180.75 Lab,Path Review of Periph Smear,2000949,85060,, 47.25 Lab,Pathology Slide Consultation SMH,2000949,85060,, 47.25 Lab,BK Quant PCR (Plasma/Serum) LC,2000957,87799,, 760.75 Lab,"Neuron-specific Enolase, Serum LC",2000960,86316,, 228.25 Lab,81003 24 HR,2000974,81003,, 8.00 Lab,82131 24 HR,2000975,82131,, 58.25 Lab,82140 24 HR,2000976,82140,, 49.75 Lab,82340 24 HR,2000977,82340,, 49.75 Lab,82436 24 HR,2000978,82436,, 17.25 Lab,82507 24 HR,2000979,82507,, 46.00 Lab,82570 24 HR,2000980,82570,, 17.25 Lab,83735 24 HR,2000981,83735,, 25.50 Lab,83935 24 HR,2000982,83935,, 25.50 Lab,83945 24 HR,2000983,83945,, 44.25 Lab,84105 24 HR,2000984,84105,, 17.25 Lab,84133 24 HR,2000985,84133,, 17.25 Lab,84300 24 HR,2000986,84300,, 17.25 Lab,84392 24 HR,2000987,84392,, 17.25 Lab,84560 24 HR,2000988,84560,, 17.25 Lab,Antiglomerular BM Ab LC,2000991,83520,, 214.25 Lab,Bill Only ABID Panel,2000996,86870,, 252.50 Lab,"Pancreatic Elastase, Fecal LC",2001009,82656,, 514.00 Lab,Anti-DNase B Strep Antibodies LC,2001015,86215,, 147.00 Lab,B-hCG Qnt,2001025,84702,, 217.50 Lab,Lipase Level,2001026,83690,, 120.75 Lab,88342 Immunohistochemistry,2001027,88342,, 155.83 Lab,"88300 Surgical Pathology, Level 1 - Gross Exam Only",2001028,88300,, 19.25 Lab,"2019 Novel Coronavirus (CoVID-19), NAA LC",2001030,87635,, 171.00 Lab,"SARS-CoV-2, NAA LC",2001030,87635,, 171.00 Lab,COVID-19 Testing Send Out - IL State,2011091,U0001,, 171.00 Lab,Proinsulin LC,20010279,84206,, 308.00 Lab,"Pyruvic Acid, Blood LC",20010280,84210,, 24.75 Lab,C-Reactive Protein,20010282,86140,, 74.50 Lab,82088 Component,20010283,82088,, 257.25 Lab,84244 Component,20010284,84244,, 257.25 Lab,85660 Component,20010286,85660,, 92.00 Lab,87116 Component,20010289,87116,, 22.00 Lab,87206 CULTURE MYCOBACTERIA,20010290,87206,, 22.00 Lab,CMV Quant DNA PCR (Plasma) LC,20010306,87497,, 492.00 Lab,"Creat Clearance, Normalized LC",20010310,82575,, 81.00 Lab,F008-IgE Corn LC,20010318,86003,, 15.50 Lab,E4526 Aph RBC ACDA AS1 LR Irr,20010322,P9040,," 1,077.75 " Lab,E4527 Aph RBC ACDA AS1 LR Irr 1,20010322,P9040,," 1,077.75 " Lab,E4528 Aph RBC ACDA AS1 LR Irr 2,20010322,P9040,," 1,077.75 " Lab,E4538 Aph RBC ACDA AS3 LR Irr,20010322,P9040,," 1,077.75 " Lab,E4539 Aph RBC ACDA AS3 LR Irr 1,20010322,P9040,," 1,077.75 " Lab,E4540 Aph RBC ACDA AS3 LR Irr 2,20010322,P9040,," 1,077.75 " Lab,83516 GLIADIN AB PROFILE,20010324,83516,, 52.50 Lab,GAD-65 Autoantibody LC,20010325,83519,, 74.50 Lab,Scabies Exam,20010328,87169,, 76.00 Lab,Insulin Antibodies LC,20010337,86337,, 37.50 Lab,Factor V Leiden Mutation LC,20010360,81241,, 441.75 Lab,Factor V Leiden Mutation LC,20010360,81241,, 441.75 Lab,Fungus (Mycology) Culture LC,20010372,87101,, 138.50 Lab,"JAK2 Mutation Analysis, Qual LC",20010373,81270,, 545.25 Lab,Heparin Anti-Xa LC,20010374,85520,, 234.50 Lab,81206 Component,20010375,81206,, 453.00 Lab,81207 Component,20010376,81207,, 453.00 Lab,"Calcitonin, Serum LC",20010379,82308,, 282.75 Lab,HCV Genotyping Non Reflex LC,20010384,87902,, 900.75 Lab,IGF-BP3 LC,20010385,83520,, 141.00 Lab,"17-Hydroxypregnenolone, MS LC",20010386,84143,, 224.75 Lab,87015 Component,20010392,87015,, 67.75 Lab,87206 Component,20010393,87206,, 67.75 Lab,"Hered.Hemochromatosis, DNA LC",20010400,81256,, 534.50 Lab,Anti-Myelin Assoc Glycop IgG LC,20010405,86255,, 129.25 Lab,Anti-Myelin Assoc. Gly. IgM LC,20010406,86256,, 183.75 Lab,Oxycodone and Metabolite LC,20010416,80365,, 174.75 Lab,Oxycodone/Oxymorphone (GC/MS) LC,20010416,80365,, 174.75 Lab,Bill Only Antigen Type - Tier I,20010421,86905,, 144.25 Lab,Bill Only Antigen Type - Tier II,20010423,86905,, 273.00 Lab,Bill Only Antigen Type - Tier III,20010425,86905,, 350.50 Lab,Bill Only Antigen Type - Tier IV,20010427,86905,, 428.25 Lab,Free T4 by Dialysis/Mass Spec LC,20010433,84439,, 208.25 Lab,86666 Component,20010447,86666,, 175.75 Lab,"Antinuclear Antibodies, IFA LC",20010451,86038,, 130.25 Lab,80307 Component,20010453,80307,, 48.00 Lab,"HLA Class 1,2 Antibody Screen LC",20010456,86828,, 324.75 Lab,81240 THR RISK,20010461,81240,, 169.25 Lab,81291 THR RISK,20010462,81291,, 169.25 Lab,85300 THR RISK,20010463,85300,, 169.25 Lab,85303 THR RISK,20010464,85303,, 169.25 Lab,85306 THR RISK,20010465,85306,, 169.25 Lab,85307 THR RISK,20010466,85307,, 169.25 Lab,85420 THR RISK,20010467,85420,, 169.25 Lab,85613 THR RISK,20010468,85613,, 169.25 Lab,85705 THR RISK,20010469,85705,, 169.25 Lab,85732 THR RISK,20010470,85732,, 169.25 Lab,86146 THR RISK,20010471,86146,, 169.25 Lab,86147 THR RISK,20010473,86147,, 169.25 Lab,86618 Component,20010477,86618,, 147.50 Lab,Group A Strep Culture,20010478,87081,, 46.25 Lab,"Dexamethasone, Serum LC",20010483,80375,, 155.25 Lab,81219 Component,20010500,81219,, 748.00 Lab,CALR Mutation Analysis LC,20010500,81219,, 748.00 Lab,Thyroglobulin by RIA LC,20010518,84432,, 150.25 Lab,Vitamin B12 Level,20010525,82607,, 139.00 Lab,Iron Level,20010526,83540,, 88.75 Lab,Folate Level,20010527,82746,, 139.00 Lab,Ferritin,20010528,82728,, 126.00 Lab,83540 Iron Panel,20010530,83540,, 88.75 Lab,83550 Iron Panel,20010531,83550,, 88.75 Lab,Cortisol Dexamethasone Reflex LC,20010538,82533,, 124.00 Lab,86003 FOOD,20010541,86003,, 44.75 Lab,Clobazam (ONFI) LC,20010548,80339,, 240.75 Lab,87529 HSV 1 & 2,20010551,87529,, 126.00 Lab,"Immunofixation, Urine LC",20010558,86335,, 146.25 Lab,86008 Component,20010560,86008,, 45.50 Lab,86008 ALLERGEN PEANUT,20010573,86008,, 51.50 Lab,"H. pylori Stool Ag, EIA LC",20010581,87338,, 223.75 Lab,Cystic Fibrosis Profile LC,20010591,81220,, 386.75 Lab,87900 Component,20010593,87900,, 417.50 Lab,87902 Component,20010594,87902,, 417.50 Lab,BK Quant PCR (Urine) LC,20010595,87799,, 609.75 Lab,Endomysial Antibody IgA LC,20010601,86255,, 148.75 Lab,Fructosamine LC,20010602,82985,, 67.25 Lab,82785 Allergen Profile,20010604,82785,, 77.00 Lab,86003 Area 8,20010605,86003,, 24.50 Lab,84402 Component,20010608,84402,, 217.00 Lab,84403 Component,20010609,84403,, 217.00 Lab,Everolimus LC,20010613,80169,, 255.00 Lab,"Copper, WB LC",20010620,82525,, 82.50 Lab,"Zinc, Whole Blood LC",20010621,84630,, 129.00 Lab,"JAK2 V617F, RFX CALR/MPL LC",20010634,81270,, 555.75 Lab,12+Oxycodone+Crt-Unbund LC,20010636,80307,, 375.50 Lab,"IgG, Subclass 4 LC",20010637,82787,, 146.25 Lab,Bowel Disorders Cascade LC,20010645,83516,, 306.00 Lab,81402 Component,20010646,81402,, 750.50 Lab,MPL Mutation Analysis LC,20010646,81402,, 750.50 Lab,"JAK2 V617F Qual, Rfx E12-15 LC",20010649,81270,, 529.25 Lab,"Epi proColon(R), Septin 9 LC",20010650,81327,, 364.00 Lab,86003 CITRUS,20010656,86003,, 27.00 Lab,F340-IgE Carmine Red Dye LC,20010658,86003,, 27.00 Lab,F220-IgE Cinnamon LC,20010659,86003,, 27.00 Lab,82570 HIAA 5,20010661,82570,, 71.25 Lab,83497 Component,20010662,83497,, 71.25 Lab,86605 Component,20010667,86605,, 96.00 Lab,86606 Component,20010668,86606,, 96.00 Lab,HIV Ag/Ab Scrn,20010669,87389,, 77.25 Lab,"Methadone Screen, Urine LC",20010670,80307,, 32.25 Lab,"Posaconazole, Serum/Plasma LC",20010674,80299 / 80187,, 536.25 Lab,87529 Component,20010680,87529,, 201.50 Lab,"GI Profile, Stool, PCR LC",20010682,0097U,, 860.00 Lab,84155 Component,20010684,84155,, 147.00 Lab,84165 Component,20010685,84165,, 147.00 Lab,84156 UPEP,20010687,84156,, 147.00 Lab,84166 UPEP,20010688,84166,, 147.00 Lab,Clostridium difficile Amplification,20010693,87493,, 201.00 Lab,QuantiFERON-TB Plus(Client Incubated) LC,20010696,86480,, 66.25 Lab,Vitamin B3 (Niacin+Metabolite) LC,20010697,84591,, 410.50 Lab,82172 N FIBRO,20010699,82172,, 61.50 Lab,82247 N FIBRO,20010700,82247,, 61.50 Lab,82465 N FIBRO,20010701,82465,, 61.50 Lab,82947 N FIBRO,20010702,82947,, 61.50 Lab,83010 N FIBRO,20010703,83010,, 61.50 Lab,83883 N FIBRO,20010704,83883,, 61.50 Lab,84450 N FIBRO,20010705,84450,, 61.50 Lab,84460 N FIBRO,20010706,84460,, 61.50 Lab,84478 N FIBRO,20010707,84478,, 61.50 Lab,HCV FibroSure LC,20010709,81596,, 214.25 Lab,Plasminogen Act Inhibitor-1 LC,20010710,85415,, 43.00 Lab,MaterniT21 PLUS Core LC,20010713,81420,," 1,260.00 " Lab,Free Valproic Acid (Depakote) LC,20010714,80165,, 150.25 Lab,ID,20010723,87077,, 40.00 Lab,Bill Only CMV,20010724,86644,, 63.00 Lab,Bill Only Alloadsorption,20010725,86978,, 118.75 Lab,Bill Only Autoadsorption,20010726,86978,, 86.25 Lab,Bill Only Stromal Adsorption,20010727,86978,, 161.75 Lab,"Bill Only RBC, Pre-treat",20010728,86970,, 118.75 Lab,Bill Only Elution,20010729,86860,, 194.25 Lab,Bill Only Enzyme Treat,20010731,86971,, 144.25 Lab,"Cell Count, Serous Fluid LC",20010732,89051,, 73.50 Lab,"Cannabinoid Confirmation, Ur LC",20010733,80349,, 66.25 Lab,86021 Component,20011001,86021,, 220.50 Lab,86255 Component,20011003,86255,, 116.75 Lab,82784 Celiac Comp,20011004,82784,, 116.75 Lab,83516 Component,20011005,83516,, 26.25 Lab,84156 IFE AND UPEP,20011007,84156,, 73.50 Lab,86335 Component,20011008,86335,, 73.50 Lab,84166 IFE AND UPEP,20011009,84166,, 73.50 Lab,82784 Celiac Panel,20011011,82784,, 78.75 Lab,83516 CELIAC PANEL,20011012,83516,, 78.75 Lab,86255 CELIAC PANEL,20011013,86255,, 78.75 Lab,86695 Component,20011016,86695,, 78.75 Lab,86696 Component,20011017,86696,, 78.75 Lab,86148 Component,20011019,86148,, 68.25 Lab,83502 Component,20011024,85302,, 115.50 Lab,85230 Component,20011025,85230,, 115.50 Lab,80188 Component,20011027,80188,, 77.25 Lab,80184 Component,20011028,80184,, 143.25 Lab,87340 PRENATAL PROFILE,20011030,87340,, 48.50 Lab,86850 PRENATAL PROFILE,20011031,86850,, 41.00 Lab,85025 PRENATAL PROFILE,20011032,85025,, 36.25 Lab,86762 PRENATAL PROFILE,20011033,86762,, 67.25 Lab,86900 PRENATAL PROFILE,20011034,86900,, 14.00 Lab,86592 PRENATAL PROFILE,20011035,86592,, 20.00 Lab,86901 PRENATAL PROFILE,20011036,86901,, 14.00 Lab,87045 Component,20011038,87045,, 68.25 Lab,87046 Component,20011039,87046,, 68.25 Lab,87427 Component,20011040,87427,, 68.25 Lab,Thiopurine Metabolites LC,20011041,80299,, 630.00 Lab,87177 Component,20011042,87177,, 112.50 Lab,87209 Component,20011043,87209,, 112.50 Lab,HSV-2 IgG Supplemental LC,20011045,86696,, 105.00 Lab,Amphetamine GC/MS Ur LC,20011051,80324,, 44.75 Lab,Barbiturate GCMS Ur LC,20011052,80345,, 48.50 Lab,Cannabinoid GCMS Ur LC,20011053,80349,, 44.75 Lab,Cocaine GCMS LC,20011054,80353,, 48.50 Lab,"Phencyclidine (GC/MS), Urine LC",20011055,83992,, 44.75 Lab,"Opiates Confirmation, Urine LC",20011056,80361,, 48.50 Lab,Tramadol GCMS Ur LC,20011057,80373,, 99.75 Lab,Meper/Normep GCMS Ur LC,20011058,80362,, 99.75 Lab,Oxycodone/Oxymorphone Confirm LC,20011059,80365,, 99.75 Lab,Benzodiazepines Conf Ur LC,20011060,80346,, 48.50 Lab,Fentanyl/Norfentanyl Conf Ur LC,20011061,80354,, 99.75 Lab,80324 Component,20011063,80324,, 157.50 Lab,80359 Component,20011064,80359,, 157.50 Lab,Anaerobe Identification Only LC,20011065,87076,, 89.25 Lab,83520 SULFATIDE,20011068,83520,, 609.00 Lab,82951 Component,20011070,82951,, 157.50 Lab,82952 Component,20011071,82952,, 52.50 Lab,82974 Component,20011073,82974,, 68.25 Lab,82950 Component,20011074,82950,, 89.25 Lab,Aerobic Culture Body Fluid SMH,20011075,87070,, 26.25 Lab,LDH Body Fluid SMH,20011076,83615,, 26.25 Lab,82728 Anemia Panel,20011078,82728,, 63.00 Lab,82746 Anemia Panel,20011079,82746,, 63.00 Lab,83540 Anemia Panel,20011080,83540,, 63.00 Lab,83550 Anemia Panel,20011081,83550,, 63.00 Lab,82607 Anemia Panel,20011082,82607,, 63.00 Lab,Hex Phase Phospholipid LC,20011083,85598,, 70.50 Lab,PTT-LA Incub Mix LC,20011084,85732,, 112.50 Lab,PTT-LA Mix LC,20011085,85732,, 33.75 Lab,dRVVT Mix LC,20011086,85613,, 51.50 Lab,dRVVT Confirm 117923 LC,20011087,85613,, 51.50 Lab,dRVVT Confirm 117924 LC,20011087,85616,, 51.50 Lab,"SARS-CoV-2 (COVID-19) Antibody, IgM LC",20011088,86769,, 166.50 Lab,"SARS-CoV-2 (COVID-19) Antibody, IgG LC",20011089,86769,, 166.50 Lab,"SARS-CoV-2 (COVID-19) Antibody, IgA LC",20011090,86769,, 166.50 Lab,CYTOPATHOLOGY Add On,20200011,88112,, 78.00 Lab,LEVEL II SURGICAL PATHOLOGY Add On,20200012,88302,, 60.75 Lab,LEVEL III SURGICAL PATHOLOGY Add On,20200013,88304,, 105.50 Lab,LEVEL IV SURGICAL PATHOLOGY Add On,20200014,88305,, 114.75 Lab,LEVEL V SURGICAL PATHOLOGY Add On,20200015,88307,, 389.25 Lab,HIV 1/0/2 LC,30087389,87389,, 112.50 Lab,XR Hip 1 View Bilateral,32000347,73501,, 358.25 Lab,BUN,2000018AO,84520,, 65.25 Lab,CREATININE,2000022AO,82565,, 71.00 Lab,Bill Only Phlebotomy,VENIPUNCTURE,36415,, 20.75 Med-Surg,92950 CPR CHARGE,1100001,92950,," 1,155.00 " Med-Surg,"92960 CARDIOVERSION, ELECTR CHARGE",1100008,92960,, 886.75 Med-Surg,31502 TRACH TUBE CHANGE OUT CHARGE,1100009,31502,, 296.75 Med-Surg,36430 BLOOD ADMINISTRATION CHARGE,1100010,36430,, 861.75 Med-Surg,Transfuse Platelet Product,1100010,36430,, 861.75 Med-Surg,Transfuse Red Blood Cells Leukoreduced,1100010,36430,, 861.75 Med-Surg,Blood Glucose Monitoring POC RE,1100018,82948,, 44.75 Med-Surg,Glucose Nursing POC,1100018,82948,, 44.75 Med-Surg,Urinary Catheter Care,1100020,51702,, 213.00 Med-Surg,Pulse Oximetry,1100024,94760,, 104.75 Med-Surg,36415 ONC-VENIPUNCTURE CHARGE,1100028,36415,, 17.25 Med-Surg,96360 IV HYDRATION INITIAL CHARGE,1100035,96360,, 315.00 Med-Surg,96372 SQ/IM INJECTION CHARGE,1100036,96372,, 141.00 Med-Surg,36592 VENOUS ACCESS MS CHARGE,1100037,36592,, 92.75 Med-Surg,36591 PORT ACCESS MS CHARGE,1100042,36591,, 92.75 Med-Surg,IP PORT FLUSH CHARGE,1100043,96523,, 195.75 Med-Surg,Cardiac Monitoring,1100045,,, 294.00 Med-Surg,ROOM/BED: Semi-Private,1100046,,," 1,092.00 " Med-Surg,ROOM/BED: Monitered Bed,1100047,,," 1,691.00 " Med-Surg,ROOM/BED: Swingbed,1100048,,, 798.00 Med-Surg,96361 HYDRATION/IV FLUID EACH ADDL HOUR CHARGE,1100058,96361,, 145.50 Med-Surg,96365 IV THERAPEUTIC 1ST HR CHARGE,1100059,96365,, 359.00 Med-Surg,96366 IV INF DRUG THRPY ECH ADDT HR CHARGE,1100060,96366,, 227.50 Med-Surg,96367 IV INF SEQUENTIAL UP TO 1 HR CHARGE,1100061,96367,, 227.50 Med-Surg,96374 IV PUSH SINGLE OR INITIAL DRUG CHARGE,1100062,96374,, 315.00 Med-Surg,96375 IV PUSH ADD ON DIFF DRUG CHARGE,1100063,96375,, 258.50 Med-Surg,96376 IV ADDITIONAL PUSH SAME DRUG CHARGE,1100064,96376,, 258.50 Med-Surg,96415 CHEMO INFUSION EACH ADDITIONAL HOUR CHARGE,1100069,96415,, 271.25 Med-Surg,ROOM/BED: Respite,1100072,,," 1,092.00 " Med-Surg,ROOM/BED: Bill Only,1100101,,, 45.50 Med-Surg,ROOM/BED: Isolation,1100102,,," 1,497.00 " Med-Surg,99231 LEVEL 1 VISIT STABLE IMPROVING 15 MIN ProFee,1150004,99231, 101.50 , Med-Surg,99232 LEVEL 2 VISIT MINOR COMPLICATION 25 MIN ProFee,1150005,99232, 183.25 , Med-Surg,99233 LEVEL 3 VISIT UNSTABLE MAJOR COMPLICATION 35 MIN ProFee,1150006,99233, 264.75 , Med-Surg,99238 HSP DISCH DAY MGMT 30 MIN ProFee,1150007,99238, 189.50 , Med-Surg,99239 INPT DSCHRG >30 MIN ProFee,1150008,99239, 271.25 , Med-Surg,99218 LEVEL 1: DETAILED HX/EXAM: STRAIGHTFORWARD 30 MIN ProFee,1150009,99218, 258.50 , Med-Surg,99219 LEVEL 2: COMP HX/EXAM: MODERATE 50 MIN ProFee,1150010,99219, 346.25 , Med-Surg,99220 LEVEL 3: COMP HX/EXAM: HIGH 70 MIN ProFee,1150011,99220, 472.25 , Med-Surg,99234 LEVEL 1: DETAILED HX/EXAM: STRAIGHTFORWARD SAME DAY 40 MIN ProFee,1150012,99234, 378.00 , Med-Surg,99235 LEVEL 2: COMP HX/EXAM: MODERATE SAME DAY 50 MIN ProFee,1150013,99235, 428.25 , Med-Surg,99236 LEVEL 3: COMP HX/EXAM: HIGH SAME DAY 55 MIN ProFee,1150014,99236, 554.25 , Med-Surg,99224 SUBSEQUENT OBSERVATION CARE ProFee,1150015,99224, 101.50 , Med-Surg,99225 SUBSEQUENT OBSERVATION CARE ProFee,1150017,99225, 189.50 , Med-Surg,99226 SBSQ OBS STAY 25 MIN ProFee,1150018,99226, 271.25 , Med-Surg,99217 OBSERVATION CARE DISCHARGE MANAGEMENT ProFee,1150019,99217, 189.50 , Med-Surg,99304 ADMIT LOW 25 MIN ProFee,1150020,99304, 258.50 , Med-Surg,99305 ADMIT MODERATE 35 MIN ProFee,1150021,99305, 352.75 , Med-Surg,99306 ADMIT HIGH 45 MIN ProFee,1150022,99306, 516.50 , Med-Surg,99307 VISIT LOW 10 MIN ProFee,1150023,99307, 113.75 , Med-Surg,99315 SWINGBED DIS <30 MINS ProFee,1150024,99315, 189.50 , Med-Surg,99316 SWINGBED DIS >30 MINS ProFee,1150025,99316, 271.25 , Med-Surg,99308 VISIT MODERATE 15 MIN ProFee,1150026,99308, 143.50 , Med-Surg,99309 VISIT MOD/HIGH 25 MIN ProFee,1150027,99309, 187.50 , Med-Surg,99310 VISIT HIGH 35 MIN ProFee,1150028,99310, 220.50 , Med-Surg,99221 LEVEL 1 ADMIT STRAIGHTFORWARD 30 MIN ProFee,1150100,99221, 258.50 , Med-Surg,99222 LEVEL 2 ADMIT MODERATE 50 MIN ProFee,1150101,99222, 352.75 , Med-Surg,99223 LEVEL 3 HIGHLY COMPLEX 70 MIN ProFee,1150102,99223, 516.50 , Med-Surg,99251 INPATIENT CONSULT 20 min,1150103,99251, 230.00 , Med-Surg,99251 INTL INPT CNSLT 20MIN/STFOWARD ProFee,1150103,99251, 230.00 , Med-Surg,99252 INPATIENT CONSULT 40 min,1150104,99252, 299.00 , Med-Surg,99252 INTL INPT CNSLT 40MINS/STFOWARD ProFee,1150104,99252, 299.00 , Med-Surg,99253 INPATIENT CONSULT 55 min,1150105,99253, 398.00 , Med-Surg,99253 INTL INPT CNSLT 55 MINS/LOW ProFee,1150105,99253, 398.00 , Med-Surg,99254 INPATIENT CONSULT 80 min,1150106,99254, 522.00 , Med-Surg,99254 INTL INPT CNSLT 80MIN/MOD ProFee,1150106,99254, 522.00 , Med-Surg,99255 INPATIENT CONSULT 110 min,1150107,99255, 668.00 , Med-Surg,99255 INTL INPT CNSLT 110MIN/H ProFee,1150107,99255, 668.00 , Nutritional Services,97802 MEDICAL NUTRITIONAL INITIAL EVAL-15 MIN Charge,7200008,97802,, 29.00 Nutritional Services,97803 NUTRITIONAL REASSESSMEN CHARGE,7200009,97803,, 29.00 Outpatient Clinic Services,99195 THERAPEUTIC PHLEBOTOMY CHARGE,6300001,99195,, 378.00 Outpatient Clinic Services,96360 IV FLUIDS INITIAL CHARGES,6300002,96360,, 315.00 Outpatient Clinic Services,96361 IV FLUIDS EACH ADDTL HOUR CHARGE,6300003,96361,, 145.50 Outpatient Clinic Services,96372 INJECTION SQ OR IM CHARGE,6300004,96372,, 141.00 Outpatient Clinic Services,96401 INJ CHEMO NONHORMONAL SQ OR IM CHARGE,6300005,96401,, 246.00 Outpatient Clinic Services,96402 INJ CHEMO HORMONAL SQ OR IM CHARGE,6300006,96402,, 246.00 Outpatient Clinic Services,96374 IV PUSH MEDS SINGLE WITH INITIAL SUBSTAN CHARGE,6300007,96374,, 315.00 Outpatient Clinic Services,96375 IV PUSH OF SAME MED OR WITH ANOTHER CHARGE,6300008,96375,, 258.50 Outpatient Clinic Services,96409 IV PUSH CHEMO SINGLE OR INITIAL SUBSTANC CHARGE,6300009,96409,, 372.00 Outpatient Clinic Services,96411 IV PUSH CHEMO EACH ADDTL SUBSTANCE AND D CHARGE,6300010,96411,, 321.50 Outpatient Clinic Services,96413 IV CHEMO SINGLE INITIAL UP TO 1 HOUR CHARGE,6300011,96413,, 472.25 Outpatient Clinic Services,96415 IV CHEMO EACH ADDTL HOUR CHARGE,6300012,96415,, 271.25 Outpatient Clinic Services,96365 IVPB INITIAL AND UP TO 1 HOUR CHARGE,6300013,96365,, 359.00 Outpatient Clinic Services,96366 IV PB EACH ADDTL HOUR UP TO 8 HR CHARGE,6300014,96366,, 227.50 Outpatient Clinic Services,36592 VENOUS ACCESS SPEC CLINIC CHARGE,6300015,36592,, 101.25 Outpatient Clinic Services,96417 ADD SEQUENTIAL CHEMO INFUSION CHARGE,6300022,96417,, 271.25 Outpatient Clinic Services,96367 ADD SEQUENTIAL INFUSION IV CHARGE,6300023,96367,, 227.50 Outpatient Clinic Services,96376 IVP ADDTL SEQUENTIAL SAME DRUG CHARGE,6300024,96376,, 258.50 Outpatient Clinic Services,96523 PORT FLUSH CHARGE,6300025,96523,, 195.75 Pharmacy,tolterodine 2 mg ERCap [PANA],4000001,,, 50.23 Pharmacy,Penicillin V Pot 250 mg Tab [PANA],4000002,,, 5.00 Pharmacy,digoxin 50 mcg/mL (0.05 mg/mL) Oral Elix [PANA],4000005,,, 369.60 Pharmacy,cyclobenzaprine 10 mg Tab [PANA],4000008,,, 5.00 Pharmacy,sodium chloride Ophth 5% Sol [PANA],4000010,,, 71.93 Pharmacy,bupivacaine 0.25%-EPINEPHrine 1:200K Inj [PANA],4000011,,, 55.58 Pharmacy,ceFAZolin 1 g Inj [PANA],4000012,J0690,, 28.50 Pharmacy,rivastigmine 1.5 mg Cap [PANA],4000013,,, 17.48 Pharmacy,clindamycin 150 mg/mL IV Sol 2ml [PANA],4000014,,, 18.50 Pharmacy,docusate sodium 150 mg/15 mL Oral Liq [PANA],4000016,,, 5.00 Pharmacy,mannitol 25% IV Sol 50 mL [PANA],4000017,J2150,, 18.50 Pharmacy,furosemide 10 mg/mL Inj Sol 10ml [PANA],4000019,J1940,, 18.50 Pharmacy,furosemide 10 mg/mL Inj Sol 2ml [PANA],4000020,J1940,, 18.54 Pharmacy,furosemide 10 mg/mL Inj Sol 4ml [PANA],4000021,J1940,, 55.94 Pharmacy,methocarbamol 500 mg Tab [PANA],4000023,,, 5.00 Pharmacy,salsalate 500 mg Tab [PANA],4000024,,, 7.13 Pharmacy,diphenhydrAMINE 12.5 mg/5 mL Oral Liq [PANA],4000026,Q0163,, 5.00 Pharmacy,propafenone 150 mg Tab [PANA],4000029,,, 6.13 Pharmacy,fentaNYL 50 mcg/hr Transderm ER Film [PANA],4000030,,, 65.90 Pharmacy,hydrALAZINE 10 mg Tab [PANA],4000031,,, 5.00 Pharmacy,acetylcysteine 20% Inh Sol 30 mL [PANA],4000033,J7608,, 62.52 Pharmacy,lidocaine 1% Inj Sol 20 mL MDV [PANA],4000035,J2001,, 18.50 Pharmacy,tuberculin purified protein 5 TU/0.1 mL [PANA],4000036,,, 306.90 Pharmacy,anastrozole 1 mg Tab [PANA],4000038,,, 50.55 Pharmacy,hydrocort/neomycin/polymyxin B Otic Sol [PANA],4000039,,, 77.00 Pharmacy,fluticasone-salmeterol 250-50 mcg Inh [PANA],4000040,,, 385.98 Pharmacy,oxcarbazepine 150 mg Tab [PANA],4000042,,, 5.66 Pharmacy,senna 8.6 mg Tab [PANA],4000043,,, 5.00 Pharmacy,"nystatin 100,000 units/mL Oral Susp [PANA]",4000044,,, 63.52 Pharmacy,venlafaxine 37.5 mg ERCap [PANA],4000045,,, 15.61 Pharmacy,cloNIDine 0.1 mg Tab [PANA],4000046,,, 5.00 Pharmacy,trastuzumab 440 mg IV kit [PANA],4000047,J9355,," 15,085.50 " Pharmacy,acetaminophen 325 mg Tab [PANA],4000049,,, 5.00 Pharmacy,predniSONE 10 mg Tab [PANA],4000050,J7512,, 5.00 Pharmacy,betaxolol Ophth 0.25% Susp [PANA],4000053,,, 819.80 Pharmacy,acetaminophen 650 mg Supp [PANA],4000054,,, 5.00 Pharmacy,aMILoride-hydrochlorothiazide 5-50 mg [PANA],4000055,,, 5.00 Pharmacy,cefuroxime 250 mg Tab [PANA],4000059,,, 15.47 Pharmacy,metoclopramide 5 mg/mL Inj Sol [PANA],4000060,J2765,, 18.50 Pharmacy,albuterol-ipratropium Inh Sol 3 mL [PANA],4000062,J7620,, 8.10 Pharmacy,insulin glargine 100 units/mL SubQ Sol [PANA],4000063,J1815,, 711.59 Pharmacy,cefepime 1 g Inj [PANA],4000064,J0692,, 37.65 Pharmacy,cloNIDine 0.1 mg/24 hr Transderm ER Film [PANA],4000065,,, 82.89 Pharmacy,albuterol 0.083% Inh Sol 3 mL [PANA],4000067,J7613,, 5.00 Pharmacy,bupivacaine 0.5%-EPINEPHrine 1:200K Inj [PANA],4000069,,, 57.29 Pharmacy,Dextrose 5% 0.45% NaCl and KCl 40 mEq/L [PANA],4000070,J3480,, 18.50 Pharmacy,divalproex sodium 250 mg Oral EC Tab [PANA],4000071,,, 6.61 Pharmacy,loperamide 2 mg Cap [PANA],4000072,,, 5.00 Pharmacy,phytonadione 10 mg/mL Inj Sol [PANA],4000074,J3430,, 159.20 Pharmacy,traZODone 50 mg Tab [PANA],4000075,,, 5.00 Pharmacy,glycopyrrolate 0.2 mg/mL Inj Sol 2 mL [PANA],4000077,,, 79.06 Pharmacy,azithromycin 250 mg Tab [PANA],4000078,,, 29.19 Pharmacy,cloNIDine 0.2 mg/24 hr Transderm ER Film [PANA],4000079,,, 266.14 Pharmacy,indapamide 2.5 mg Tab [PANA],4000080,,, 5.81 Pharmacy,glyBURIDE 5 mg Tab [PANA],4000081,,, 5.00 Pharmacy,miconazole Top 2% Crm [PANA],4000082,,, 12.37 Pharmacy,dilTIAZem 180 mg/24 hours ERCap [PANA],4000084,,, 5.00 Pharmacy,acetaZOLAMIDE 500 mg ERCap [PANA],4000085,,, 18.36 Pharmacy,"nystatin Top 100,000 units/g Oint [PANA]",4000086,,, 65.63 Pharmacy,levETIRAcetam 500 mg Tab [PANA],4000087,,, 5.00 Pharmacy,tenecteplase 50 mg IV Inj [PANA],4000088,J3101,," 19,344.17 " Pharmacy,clarithromycin 500 mg Tab [PANA],4000089,,, 22.56 Pharmacy,amoxicillin-clav 250-62.5 mg/5 mL Liq [PANA],4000091,,, 27.18 Pharmacy,SUMAtriptan 100 mg Tab [PANA],4000092,,, 62.85 Pharmacy,cephalexin 250 mg Cap [PANA],4000093,,, 5.00 Pharmacy,sotalol 80 mg Tab [PANA],4000094,,, 9.61 Pharmacy,nitroglycerin 0.2 mg/hr Transderm ER [PANA],4000095,,, 7.13 Pharmacy,promethazine 25 mg Supp [PANA],4000098,,, 66.39 Pharmacy,magnesium sulfate 50% Inj Sol 10 mL [PANA],4000099,J3475,, 18.50 Pharmacy,magnesium sulfate 50% Inj Sol 2 mL [PANA],4000100,J3475,, 18.50 Pharmacy,prochlorperazine 5 mg Tab [PANA],4000101,Q0164,, 5.00 Pharmacy,carBAMazepine 100 mg ER Tab [PANA],4000104,,, 5.00 Pharmacy,cefepime 2 g Inj [PANA],4000105,J0692,, 56.38 Pharmacy,iron polysaccharide 150 mg Cap [PANA],4000106,,, 5.00 Pharmacy,clonazePAM 0.5 mg Tab [PANA],4000108,,, 5.00 Pharmacy,propranolol 60 mg ERCap [PANA],4000109,,, 7.72 Pharmacy,Dextrose 5% 0.45% NaCl and KCl 10 mEq/L [PANA],4000110,J3480,, 18.50 Pharmacy,carbidopa-levodopa 50 mg-200 mg ER Tab [PANA],4000111,,, 6.53 Pharmacy,cefOXitin 1 g Inj [PANA],4000112,J0694,, 40.73 Pharmacy,gabapentin 400 mg Cap [PANA],4000113,,, 5.00 Pharmacy,niacin 500 mg ERCap [PANA],4000116,,, 5.00 Pharmacy,flunisolide 250 mcg/inh Inh Aer w/Adapt [PANA],4000117,,, 245.07 Pharmacy,cephalexin 125 mg/5 mL Oral Liq [PANA],4000118,,, 5.00 Pharmacy,metFORMIN 850 mg Tab [PANA],4000119,,, 5.00 Pharmacy,benzocaine/butamben/tetracaine topical 14%-2%-2% Aer [PANA],4000120,,, 181.00 Pharmacy,atenolol 25 mg Tab [PANA],4000121,,, 5.00 Pharmacy,clobetasol Top 0.05% Crm [PANA],4000122,,, 564.21 Pharmacy,Sodium Chloride 0.9% with KCl 40 mEq/L intravenous solution 1000 mL [PANA],4000123,J3480,, 44.18 Pharmacy,naproxen 250 mg Tab [PANA],4000124,,, 5.00 Pharmacy,pantoprazole 40 mg IV Inj [PANA],4000125,S0164,, 43.88 Pharmacy,"Ophth irrigation, extraocular Sol [PANA]",4000127,,, 99.00 Pharmacy,montelukast 4 mg Chew Tab [PANA],4000128,,, 28.00 Pharmacy,travoprost 0.004% Ophth Sol [PANA],4000129,,, 449.46 Pharmacy,warfarin 2.5 mg Tab [PANA],4000133,,, 5.00 Pharmacy,dexamethasone-tobramycin Ophth Oint [PANA],4000135,,, 228.85 Pharmacy,tetrahydrozoline Ophth 0.05% Sol [PANA],4000136,,, 6.30 Pharmacy,hydrALAZINE 25 mg Tab [PANA],4000138,,, 5.00 Pharmacy,rocuronium 10 mg/mL IV Sol [PANA],4000139,,, 50.00 Pharmacy,meclizine 12.5 mg Tab [PANA],4000140,,, 5.00 Pharmacy,Multiple Vitamins Tab [PANA],4000142,,, 5.00 Pharmacy,metroNIDAZOLE 500 mg Tab [PANA],4000144,,, 5.00 Pharmacy,lidocaine Top 2% Gel w/Appl 30ml [PANA],4000145,,, 93.00 Pharmacy,tropicamide Ophth 1% Sol [PANA],4000146,,, 7.99 Pharmacy,azaTHIOprine 50 mg Tab [PANA],4000147,J7500,, 8.80 Pharmacy,succinylcholine 20 mg/mL Inj Sol [PANA],4000150,J0330,, 89.91 Pharmacy,NIFEdipine 30 mg ER Tab [PANA],4000151,,, 5.00 Pharmacy,clopidogrel 75 mg Tab [PANA],4000153,,, 25.55 Pharmacy,valproic acid 250 mg Cap [PANA],4000154,,, 5.00 Pharmacy,ciprofloxacin 250 mg Tab [PANA],4000155,,, 5.00 Pharmacy,dextromethorphan-guaiFENesi 10-100mg/5mL [PANA],4000156,,, 5.00 Pharmacy,fosinopril 20 mg Tab [PANA],4000159,,, 5.00 Pharmacy,amLODIPine 5 mg Tab [PANA],4000160,,, 6.16 Pharmacy,bacitracin top zinc 500 units/g Oin [PANA],4000161,,, 5.00 Pharmacy,allopurinol 100 mg Tab [PANA],4000162,,, 5.00 Pharmacy,enalapril 1.25 mg/mL IV Sol [PANA],4000164,,, 18.50 Pharmacy,valACYclovir 500 mg Tab [PANA],4000166,,, 27.09 Pharmacy,OLANZapine 2.5 mg Tab [PANA],4000170,,, 41.99 Pharmacy,dihydroergotamine 1 mg/mL Inj Sol [PANA],4000172,J1110,, 433.46 Pharmacy,aspirin 81 mg Oral EC Tab [PANA],4000174,,, 5.00 Pharmacy,traMADol 50 mg Tab [PANA],4000176,,, 5.00 Pharmacy,vancomycin 1 g IV Inj [PANA],4000177,J3370,, 71.55 Pharmacy,cyclophosphamide 1 g IV Inj [PANA],4000178,J9070,," 2,272.51 " Pharmacy,digoxin 250 mcg/mL (0.25 mg/mL) Inj Sol [PANA],4000179,J1160,, 28.03 Pharmacy,QUEtiapine 100 mg Tab UD [PANA],4000180,,, 24.29 Pharmacy,dexamethasone 1 mg/mL Oral Conc [PANA],4000181,J8540,, 20.11 Pharmacy,zinc oxide Top 20% Oint [PANA],4000182,,, 18.68 Pharmacy,amantadine 100 mg Cap [PANA],4000183,,, 12.37 Pharmacy,acetaminophen 500 mg Tab [PANA],4000184,,, 5.00 Pharmacy,hydrochlorothia-triam 25-37.5 mg Tab [PANA],4000185,,, 5.00 Pharmacy,triamcinolone Top 0.1% Crm [PANA],4000186,,, 20.93 Pharmacy,ketorolac 30 mg/mL Inj Sol [PANA],4000189,J1885,, 25.88 Pharmacy,hydrALAZINE 20 mg/mL Inj Sol [PANA],4000190,J0360,, 58.86 Pharmacy,buPROPion 100 mg ER Tab [PANA],4000191,,, 6.33 Pharmacy,pentoxifylline 400 mg ER Tab [PANA],4000192,,, 5.62 Pharmacy,guar gum oral Pwdr [PANA],4000193,,, 5.00 Pharmacy,glimepiride 2 mg Tab [PANA],4000194,,, 5.00 Pharmacy,phenytoin 125 mg/5 mL Oral Susp [PANA],4000196,,, 5.00 Pharmacy,fluorescein ophthalmic 1 mg Tes,4000197,,, 5.00 Pharmacy,warfarin 4 mg Tab [PANA],4000201,,, 10.05 Pharmacy,lamoTRIgine 25 mg Tab [PANA],4000202,,, 5.00 Pharmacy,homatropine Ophth 2% Sol [PANA],4000203,,, 86.85 Pharmacy,acyclovir 50 mg/mL IV Sol [PANA],4000204,J0133,, 60.00 Pharmacy,potassium chloride 20 mEq/15 mL Oral Liq [PANA],4000207,,, 20.32 Pharmacy,erythromycin-sulfiSOX 200-600 mg/5 mL [PANA],4000208,,, 5.30 Pharmacy,ketorolac 10 mg Tab [PANA],4000209,,, 8.09 Pharmacy,dexamethasone Ophth 0.1% Sol [PANA],4000210,,, 168.45 Pharmacy,sodium bicarbonate 8.4% IV Sol vial [PANA],4000211,,, 89.55 Pharmacy,loperamide 1 mg/5 mL Oral Liq [PANA],4000215,,, 5.00 Pharmacy,fluconazole 200 mg/100 mL-NS IV Sol [PANA],4000216,J1450,, 40.50 Pharmacy,nitroglycerin 50 mg/250 mL-D5W IV Sol [PANA],4000218,,, 86.96 Pharmacy,phenylephrine Ophth 10% Sol [PANA],4000219,,, 125.00 Pharmacy,carisoprodol 350 mg Tab [PANA],4000221,,, 5.00 Pharmacy,QUEtiapine 25 mg Tab [PANA],4000222,,, 14.17 Pharmacy,levobunolol Ophth 0.5% Sol [PANA],4000225,,, 20.93 Pharmacy,furosemide 40 mg Tab [PANA],4000227,,, 5.00 Pharmacy,metolazone 2.5 mg Tab [PANA],4000229,,, 12.32 Pharmacy,PHENobarbital 65 mg/mL Inj Sol [PANA],4000230,J2560,, 83.57 Pharmacy,isosorbide dinitrate 10 mg Tab [PANA],4000231,,, 5.00 Pharmacy,pioglitazone 15 mg Tab [PANA],4000233,,, 26.27 Pharmacy,clotrimazole 10 mg Loz [PANA],4000234,,, 12.06 Pharmacy,busPIRone 5 mg Tab [PANA],4000235,,, 5.00 Pharmacy,silver sulfADIAZINE Top 1% Crm [PANA],4000236,,, 33.71 Pharmacy,metFORMIN 500 mg Tab [PANA],4000239,,, 5.00 Pharmacy,megestrol 40 mg/mL Oral Susp [PANA],4000240,,, 15.85 Pharmacy,dilTIAZem 5 mg/mL IV Sol 10ml [PANA],4000243,,, 19.63 Pharmacy,dilTIAZem 5 mg/mL IV Sol 5ml [PANA],4000245,,, 18.50 Pharmacy,primidone 50 mg Tab [PANA],4000247,,, 5.00 Pharmacy,buPROPion 150 mg ER Tab [PANA],4000248,,, 7.26 Pharmacy,bicalutamide 50 mg Tab [PANA],4000250,,, 5.00 Pharmacy,acetaminophen 160 mg/5 mL Oral Susp [PANA],4000252,,, 5.00 Pharmacy,azelastine 0.05% Ophth Sol [PANA],4000253,,, 226.38 Pharmacy,cortisone 25 mg Tab [PANA],4000254,,, 11.72 Pharmacy,carvedilol 6.25 mg Tab [PANA],4000256,,, 7.31 Pharmacy,PARoxetine 10 mg Tab [PANA],4000259,,, 5.00 Pharmacy,carvedilol 12.5 mg Tab [PANA],4000260,,, 8.00 Pharmacy,rOPINIRole 1 mg Tab [PANA],4000262,,, 9.37 Pharmacy,venlafaxine 75 mg Tab [PANA],4000263,,, 8.19 Pharmacy,nicotine 14 mg/24 hr Transderm ER Film [PANA],4000264,,, 8.03 Pharmacy,potassium phosphate 3 mmol/mL IV Sol [PANA],4000265,,, 62.85 Pharmacy,atropine 0.1 mg/mL Inj Sol [PANA],4000266,J0461,, 40.50 Pharmacy,donepezil 5 mg Tab [PANA],4000268,,, 5.00 Pharmacy,nitroglycerin 0.1 mg/hr Transderm ER [PANA],4000269,,, 6.97 Pharmacy,torsemide 20 mg Tab [PANA],4000270,,, 5.00 Pharmacy,protamine 10 mg/mL Inj Sol [PANA],4000271,J2720,, 121.63 Pharmacy,guaiFENesin 600 mg ER Tab [PANA],4000272,,, 5.00 Pharmacy,polyethylene glycol 3350 Oral Pwdr [PANA],4000276,,, 7.01 Pharmacy,meloxicam 7.5 mg Tab [PANA],4000277,,, 11.62 Pharmacy,levothyroxine 100 mcg (0.1 mg) Tab [PANA],4000278,,, 5.00 Pharmacy,bacitracin/neomycin/polymyxin B Oph Oint [PANA],4000279,,, 138.13 Pharmacy,hydrOXYzine hydrochloride 2 mg/mL Syrup [PANA],4000280,,, 5.00 Pharmacy,sodium chloride 0.9% Irr Sol 1000 mL [PANA],4000281,,, 15.92 Pharmacy,phenylephrine-promethazine Oral Syrup [PANA],4000284,,, 5.00 Pharmacy,"EPINEPHrine-lidocaine 1:100,000-1% 20 mL [PANA]",4000285,,, 18.50 Pharmacy,levothyroxine 88 mcg (0.088 mg) Tab [PANA],4000286,,, 5.00 Pharmacy,propranolol 10 mg Tab [PANA],4000287,,, 5.00 Pharmacy,entacapone 200 mg Tab [PANA],4000288,,, 18.53 Pharmacy,thiamine 100 mg/mL Inj Sol [PANA],4000289,J3411,, 46.64 Pharmacy,chlordiazePOXIDE 5 mg Cap [PANA],4000290,,, 5.00 Pharmacy,SUMAtriptan 6 mg/0.5 mL SubQ Sol [PANA],4000291,J3030,, 233.75 Pharmacy,HYDROmorphone 2 mg Tab [PANA],4000296,,, 5.00 Pharmacy,potassium chloride 20 mEq ER Tab [PANA],4000298,,, 5.00 Pharmacy,diphenhydrAMINE 50 mg/mL Inj Sol [PANA],4000301,J1200,, 18.50 Pharmacy,magnesium oxide 400 mg Tab [PANA],4000303,,, 5.00 Pharmacy,LORazepam 0.5 mg Tab [PANA],4000304,,, 5.00 Pharmacy,acetaminophen 120 mg Supp [PANA],4000306,,, 5.00 Pharmacy,DOCEtaxel 20 mg/mL 1ml [PANA],4000307,J9171,, 247.50 Pharmacy,temazepam 15 mg Cap [PANA],4000308,,, 5.00 Pharmacy,magnesium hydroxide 8% Oral Susp 30 mL [PANA],4000309,,, 8.78 Pharmacy,cyanocobalamin 500 mcg Tab [PANA],4000310,,, 5.00 Pharmacy,ascorbic acid 500 mg Tab [PANA],4000311,,, 5.00 Pharmacy,promethazine 12.5 mg Supp [PANA],4000313,,, 14.60 Pharmacy,famciclovir 500 mg Tab [PANA],4000315,,, 47.60 Pharmacy,captopril 12.5 mg Tab [PANA],4000318,,, 6.44 Pharmacy,methotrexate 2.5 mg Tab [PANA],4000319,J8610,, 23.39 Pharmacy,aspirin 325 mg Oral EC Tab [PANA],4000321,,, 5.00 Pharmacy,repaglinide 0.5 mg Tab [PANA],4000322,,, 25.59 Pharmacy,valproic acid 250 mg/5 mL Oral Syrup [PANA],4000324,,, 5.00 Pharmacy,ampicillin-sulbactam 2 g-1 g Inj [PANA],4000325,J0295,, 76.56 Pharmacy,amoxicillin 250 mg/5 mL Oral Liq [PANA],4000326,,, 5.00 Pharmacy,etoposide 20 mg/mL IV Sol [PANA],4000327,J9181,, 37.35 Pharmacy,ciprofloxacin Ophth 0.3% Sol [PANA],4000330,,, 38.25 Pharmacy,tamoxifen 10 mg Tab [PANA],4000332,,, 7.10 Pharmacy,piperacillin-tazobactam 3.375 g IV Inj [PANA],4000333,J2543,, 93.58 Pharmacy,sodium bicarbonate 650 mg Tab [PANA],4000334,,, 5.00 Pharmacy,diazePAM 2 mg Tab [PANA],4000336,,, 5.00 Pharmacy,sulfacetamide Ophth 10% Sol [PANA],4000338,,, 139.13 Pharmacy,colesevelam 625 mg Tab [PANA],4000339,,, 14.98 Pharmacy,timolol Ophth 0.25% Sol [PANA],4000340,,, 56.25 Pharmacy,isopropyl alcohol Top 70% Liq [PANA],4000341,,, 10.31 Pharmacy,hydrocortisone Top 1% Crm [PANA],4000343,,, 14.96 Pharmacy,gemfibrozil 600 mg Tab [PANA],4000344,,, 9.10 Pharmacy,levothyroxine 50 mcg (0.05 mg) Tab [PANA],4000345,,, 5.00 Pharmacy,bisacodyl 10 mg Supp [PANA],4000347,,, 5.00 Pharmacy,piperacillin-tazobactam 4.5 g IV Inj [PANA],4000348,J2543,, 80.88 Pharmacy,pantoprazole 40 mg Oral EC Tab [PANA],4000351,,, 5.00 Pharmacy,oxytocin 10 intl units/mL Inj Sol [PANA],4000352,J2590,, 18.50 Pharmacy,diphenhydrAMINE 25 mg Cap [PANA],4000353,Q0163,, 5.00 Pharmacy,acyclovir Top 5% Oint [PANA],4000354,,," 1,007.37 " Pharmacy,vasopressin 20 units/mL [PANA],4000358,,, 651.94 Pharmacy,levothyroxine 125 mcg (0.125 mg) Tab [PANA],4000359,,, 5.00 Pharmacy,prochlorperazine 5 mg/mL Inj Sol [PANA],4000362,J0780,, 83.25 Pharmacy,"nystatin Top 100,000 units/g Crm [PANA]",4000364,,, 65.63 Pharmacy,dexamethasone 4 mg Tab [PANA],4000365,J8540,, 5.00 Pharmacy,adenosine 3 mg/mL IV Sol 2ml [PANA],4000366,J0153,, 49.28 Pharmacy,adenosine 3 mg/mL IV Sol 4ml [PANA],4000367,J0153,, 72.27 Pharmacy,atropine 1 mg/mL Inj Sol [PANA],4000368,J0461,, 51.56 Pharmacy,lisinopril 10 mg Tab [PANA],4000369,,, 5.00 Pharmacy,inFLIXimab 100 mg IV Inj [PANA],4000370,J1745,," 3,561.83 " Pharmacy,ceFAZolin 500 mg Inj [PANA],4000371,J0690,, 28.50 Pharmacy,polymyxin B-trimethoprim Ophth Sol [PANA],4000372,,, 50.40 Pharmacy,warfarin 5 mg Tab [PANA],4000373,,, 5.00 Pharmacy,carbachol Ophth 0.01% Sol [PANA],4000374,,, 92.93 Pharmacy,flecainide 50 mg Tab [PANA],4000376,,, 7.57 Pharmacy,calcium carbonate 500 mg Chew Tab [PANA],4000377,,, 5.00 Pharmacy,methylene blue 10 mg/mL Inj Sol [PANA],4000378,,, 458.70 Pharmacy,EPINEPHrine 0.1 mg/mL SYRINGE Inj Sol [PANA],4000381,J0171,, 27.00 Pharmacy,ibuprofen 400 mg Tab [PANA],4000383,,, 5.00 Pharmacy,buPROPion 75 mg Tab [PANA],4000385,,, 5.00 Pharmacy,benztropine 1 mg Tab [PANA],4000386,,, 5.00 Pharmacy,nicotine 21 mg/24 hr Transderm ER Film [PANA],4000388,,, 9.44 Pharmacy,megestrol 40 mg Tab [PANA],4000389,,, 5.13 Pharmacy,Sodium Chloride 0.9% with KCl 20 mEq/L intravenous solution [PANA],4000390,J3480,, 37.64 Pharmacy,nystatin-triamcinolone Top Crm [PANA],4000391,,, 246.27 Pharmacy,ampicillin-sulbactam 1 g-0.5 g Inj [PANA],4000392,J0295,, 46.19 Pharmacy,misoprostol 100 mcg Tab [PANA],4000394,,, 5.00 Pharmacy,FLUoxetine 10 mg Cap [PANA],4000395,,, 9.07 Pharmacy,zafirlukast 20 mg Tab [PANA],4000396,,, 11.22 Pharmacy,triamcinolone Top 0.025% Oint [PANA],4000397,,, 41.81 Pharmacy,carbamide peroxide Otic 6.5% Sol [PANA],4000398,,, 6.26 Pharmacy,leuprolide 30 mg/4 months Kit [PANA],4000399,J9217,," 17,655.46 " Pharmacy,docusate sodium 100 mg Cap [PANA],4000400,,, 5.00 Pharmacy,oxybutynin 5 mg ER Tab [PANA],4000402,,, 13.04 Pharmacy,gabapentin 300 mg Cap [PANA],4000403,,, 5.16 Pharmacy,budesonide 0.25 mg/2 mL Inh Susp [PANA],4000406,J7626,, 21.38 Pharmacy,lidocaine Viscous 2% Sol 15 mL [PANA],4000407,,, 5.00 Pharmacy,sodium chloride bac'stat 0.9% Inj 30 mL [PANA],4000410,,, 18.50 Pharmacy,raloxifene 60 mg Tab [PANA],4000411,,, 26.73 Pharmacy,benztropine 1 mg/mL Inj Sol [PANA],4000412,J0515,, 163.87 Pharmacy,verapamil 2.5 mg/mL IV Sol 2ml amp [PANA],4000414,,, 71.09 Pharmacy,verapamil 2.5 mg/mL IV Sol 4ml vial [PANA],4000415,,, 92.06 Pharmacy,sterile water bac'stat Inj Sol 30 mL [PANA],4000416,A4216,, 18.50 Pharmacy,dilTIAZem 120 mg/24 hours ERCap [PANA],4000419,,, 5.00 Pharmacy,cefTAZidime 500 mg Inj [PANA],4000420,J0713,, 36.27 Pharmacy,amoxicillin 250 mg Cap [PANA],4000422,,, 5.00 Pharmacy,montelukast 10 mg Tab [PANA],4000423,,, 5.00 Pharmacy,hydrOXYzine hydrochloride 25 mg Tab [PANA],4000424,,, 5.00 Pharmacy,mexiletine 200 mg Cap [PANA],4000425,,, 11.35 Pharmacy,morphine SR 15 mg [PANA],4000426,,, 7.02 Pharmacy,ammonium lactate Top 12% Crm [PANA],4000427,,, 52.31 Pharmacy,prednisoLONE sodium phos 15mg/5mL Susp [PANA],4000428,J7510,, 5.00 Pharmacy,diazepam 2.5 mg rectal kit [PANA],4000430,,, 297.36 Pharmacy,acyclovir 200 mg Cap [PANA],4000431,,, 5.00 Pharmacy,hydrochlorothiazide 25 mg Tab [PANA],4000432,,, 5.00 Pharmacy,mupirocin Top 2% Oint [PANA],4000433,,, 106.87 Pharmacy,nitroprusside 25 mg/mL IV Sol [PANA],4000434,,, 990.00 Pharmacy,midodrine 2.5 mg Tab [PANA],4000435,,, 6.34 Pharmacy,furosemide 20 mg Tab [PANA],4000436,,, 5.00 Pharmacy,bumetanide 0.25 mg/mL Inj Sol [PANA],4000437,,, 18.50 Pharmacy,methylPREDNISolone 500 mg Inj [PANA],4000438,J2930,, 76.30 Pharmacy,loteprednol Ophth 0.5% Susp [PANA],4000440,,, 538.21 Pharmacy,dexamethasone 4 mg/mL Inj Sol 1ml [PANA],4000443,J1100,, 18.50 Pharmacy,dexamethasone 4 mg/mL Inj Sol 5ml MDV [PANA],4000444,J1100,, 25.92 Pharmacy,carBAMazepine 100 mg/5 mL Oral Susp [PANA],4000445,,, 5.00 Pharmacy,albuterol-ipratropium 100-20 mcg/inh Aer [PANA],4000446,,, 983.43 Pharmacy,insulin lispro 100 units/mL [PANA],4000447,J1815,, 75.66 Pharmacy,ibuprofen 600 mg Tab [PANA],4000448,,, 5.00 Pharmacy,bromocriptine 2.5 mg Tab [PANA],4000449,,, 23.51 Pharmacy,fentaNYL 25 mcg/hr Transderm ER Film [PANA],4000450,,, 79.75 Pharmacy,PAClitaxel 6 mg/mL IV Sol 16.7ml [PANA],4000451,J9267,, 162.80 Pharmacy,PAClitaxel 6 mg/mL IV Sol 5ml [PANA],4000452,J9267,, 52.44 Pharmacy,PAClitaxel 6 mg/mL IV Sol 50ml [PANA],4000453,J9267,, 277.86 Pharmacy,imipramine 10 mg Tab [PANA],4000455,,, 5.00 Pharmacy,amiodarone 50 mg/mL IV Sol 3ml [PANA],4000457,J0282,, 18.50 Pharmacy,gentamicin 40 mg/mL Inj Sol [PANA],4000458,J1580,, 18.50 Pharmacy,methylPREDNISolone 4 mg Tab [PANA],4000459,J7509,, 5.36 Pharmacy,ibuprofen 100 mg/5 mL Oral Susp [PANA],4000462,,, 5.00 Pharmacy,gentamicin Ophth 0.3% Oint [PANA],4000463,,, 88.60 Pharmacy,albuterol CFC free 90 mcg/inh Inh [PANA],4000464,,, 87.65 Pharmacy,colchicine 0.6 mg Tab [PANA],4000467,,, 41.81 Pharmacy,carbidopa-levodopa 25 mg-100 mg Tab [PANA],4000469,,, 5.00 Pharmacy,labetalol 5 mg/mL IV Sol [PANA],4000470,,, 28.13 Pharmacy,"EPINEPHrine-lidocaine 1:100,000-2% 20 mL [PANA]",4000471,,, 18.50 Pharmacy,apracloNIDine Ophth 1% Sol [PANA],4000472,,, 166.37 Pharmacy,vinorelbine 10 mg/mL IV Sol 5ml [PANA],4000474,J9390,, 161.21 Pharmacy,lithium 300 mg Tab [PANA],4000475,,, 5.00 Pharmacy,fludrocortisone 0.1 mg Tab [PANA],4000476,,, 5.00 Pharmacy,heparin 5000 units/mL Inj Sol [PANA],4000477,J1644,, 19.50 Pharmacy,imipramine 25 mg Tab [PANA],4000479,,, 5.00 Pharmacy,ePHEDrine 50 mg/mL [PANA],4000480,,, 156.06 Pharmacy,oxyCODONE 20 mg ER Tab [PANA],4000481,,, 31.50 Pharmacy,doxycycline hyclate 100 mg Tab [PANA],4000485,,, 20.95 Pharmacy,cyclophosphamide 500 mg IV Inj [PANA],4000486,J9070,," 1,136.29 " Pharmacy,loratadine 10 mg Tab [PANA],4000489,,, 5.00 Pharmacy,glipiZIDE 5 mg Tab [PANA],4000490,,, 5.00 Pharmacy,ipratropium 0.02% Inh Sol 2.5 mL [PANA],4000491,J7644,, 6.60 Pharmacy,Al hydrox/Mg hydrox/sim 400-400-40mg/5mL [PANA],4000494,,, 11.01 Pharmacy,Sodium Chloride 3% Sol 500 mL [PANA],4000497,J7131,, 23.08 Pharmacy,phenol Top 1.4% Spry [PANA],4000498,,, 9.38 Pharmacy,PHENobarbital 32.4 mg Tab [PANA],4000499,,, 5.00 Pharmacy,nabumetone 500 mg Tab [PANA],4000500,,, 5.16 Pharmacy,cefTRIAXone 2 g Inj [PANA],4000502,J0696,, 28.50 Pharmacy,amoxicillin-clavulanate 500-125 mg Tab [PANA],4000503,,, 14.19 Pharmacy,nicotine 7 mg/24 hr Transderm ER Film [PANA],4000504,,, 8.00 Pharmacy,metoprolol 1 mg/mL Inj Sol [PANA],4000505,,, 18.50 Pharmacy,verapamil 120 mg ER Tab [PANA],4000506,,, 5.00 Pharmacy,probenecid 500 mg Tab [PANA],4000507,,, 5.00 Pharmacy,simethicone 80 mg Chew Tab [PANA],4000508,,, 5.00 Pharmacy,dexamethasone-tobramycin Ophth Susp [PANA],4000509,,, 226.29 Pharmacy,oxyCODONE 5 mg Tab [PANA],4000510,,, 5.00 Pharmacy,midazolam 1 mg/mL Inj 5ml Sol [PANA],4000512,J2250,, 18.50 Pharmacy,midazolam 1 mg/mL 2ml Sol [PANA],4000513,J2250,, 18.50 Pharmacy,flumazenil 0.1 mg/mL IV Sol [PANA],4000514,,, 30.49 Pharmacy,levalbuterol 0.31 mg/3 mL Inh Sol [PANA],4000517,J7614,, 7.50 Pharmacy,"emollients, Top Gel [PANA]",4000518,,, 16.87 Pharmacy,enoxaparin 80 mg/0.8 mL SC Sol [PANA],4000522,J1650,, 71.55 Pharmacy,enoxaparin 100 mg/mL SubQ Sol [PANA],4000523,J1650,, 89.46 Pharmacy,enoxaparin 40 mg/0.4 mL SC Sol [PANA],4000524,J1650,, 35.73 Pharmacy,calcium chloride 100 mg/mL Inj Sol [PANA],4000525,,, 40.76 Pharmacy,linezolid 2 mg/mL IV Sol [PANA],4000527,J2020,, 165.00 Pharmacy,sodium chloride 0.9% 10 mL syringe [PANA],4000528,A4216,, 18.50 Pharmacy,morphine 2 mg/mL preservative-free Sol [PANA],4000532,J2274,, 18.50 Pharmacy,methylPREDNISolone 40 mg inj [PANA],4000534,J2920,, 27.01 Pharmacy,methylPREDNISolone 125 mg inj [PANA],4000535,J2930,, 43.57 Pharmacy,zoledronic acid 4 mg/5 mL IV Sol [PANA],4000537,J3489,," 2,305.30 " Pharmacy,bupivacaine 0.25% PF Inj Sol 10 mL [PANA],4000541,,, 18.50 Pharmacy,bupivacaine 0.5% PF Inj Sol 10 mL [PANA],4000542,,, 18.50 Pharmacy,Sodium Chloride 0.45% w KCl 20 mEq/L [PANA],4000543,J3480,, 18.50 Pharmacy,povidone iodine Top 10% Sol [PANA],4000546,,, 6.10 Pharmacy,oxymetazoline Nasal 0.05% Spry [PANA],4000547,,, 5.00 Pharmacy,phenylephrine nasal 0.25% Sol 15 mL [PANA],4000550,,, 14.25 Pharmacy,bacitracin/neomycin/polymyxin B Top Oint pkt [PANA],4000552,,, 5.00 Pharmacy,potassium chloride 2 mEq/mL IV Sol [PANA],4000553,J3480,, 18.50 Pharmacy,CARBOplatin 10 mg/mL IV Sol 15ml [PANA],4000557,J9045,, 86.70 Pharmacy,CARBOplatin 10 mg/mL IV Sol 45ml [PANA],4000558,J9045,, 196.80 Pharmacy,buPROPion 150 mg/24 hours XL Tab [PANA],4000560,,, 5.87 Pharmacy,DAPTOmycin 500 mg IV Inj [PANA],4000562,J0878,," 1,469.99 " Pharmacy,memantine 10 mg Tab [PANA],4000563,,, 5.00 Pharmacy,bevacizumab 25 mg/mL IV Sol 16ml [PANA],4000564,J9035,," 9,367.95 " Pharmacy,bevacizumab 25 mg/mL IV Sol 4ml [PANA],4000565,J9035,," 2,341.95 " Pharmacy,terbutaline 1 mg/mL Inj Sol [PANA],4000566,J3105,, 18.50 Pharmacy,acetylcysteine 20% IV Sol 30 mL [PANA],4000567,J0132,, 646.25 Pharmacy,charcoal-sorbitol 50 g Oral Susp 240 mL [PANA],4000571,,, 88.69 Pharmacy,calcium acetate 667 mg Cap [PANA],4000572,,, 5.00 Pharmacy,solifenacin 5 mg Tab [PANA],4000574,,, 54.55 Pharmacy,"galantamine 8 mg oral Cap, ER [PANA]",4000575,,, 23.87 Pharmacy,calcium-vitamin D 500 mg-200 units Tab [PANA],4000577,,, 5.00 Pharmacy,mometasone 220 mcg/inh Inh Aer Pwdr [PANA],4000578,,, 221.88 Pharmacy,meperidine 100 mg/mL Inj Sol [PANA],4000579,J2175,, 23.55 Pharmacy,Sodium Chloride 0.9% Sol 100 mL mini-bag [PANA],4000580,J7040,, 22.37 Pharmacy,Sodium Chloride 0.9% Sol 50 mL mini-bag [PANA],4000582,J7040,, 22.37 Pharmacy,clindamycin 150 mg/mL IV Sol 4ml [PANA],4000583,,, 18.50 Pharmacy,heparin flush 100 units/mL [PANA],4000587,J1642,, 18.50 Pharmacy,ocular lubricant Oint [PANA],4000589,,, 24.34 Pharmacy,lidocaine 1% PF Inj Sol 5 mL [PANA],4000591,J2001,, 18.50 Pharmacy,lidocaine 0.5% PF Inj Sol [PANA],4000592,J2001,, 56.66 Pharmacy,lidocaine 5%-D7.5% Inj Sol 2 mL [PANA],4000593,J2001,, 41.06 Pharmacy,lidocaine 0.8% Sol [PANA],4000594,J2001,, 33.37 Pharmacy,zinc sulfate 220 mg Cap [PANA],4000604,,, 5.00 Pharmacy,cholecalciferol 1000 units oral tablet [PANA],4000605,,, 5.00 Pharmacy,sitaGLIPtin 50 mg oral tablet [PANA],4000606,,, 64.44 Pharmacy,budesonide-formoterol 80 mcg-4.5 mcg/inh [PANA],4000610,,, 510.26 Pharmacy,budesonide-formoterol 160 mcg-4.5mcg/inh [PANA],4000611,,, 533.62 Pharmacy,magnesium sulfate 2 g/50 mL [PANA],4000616,J3475,, 65.61 Pharmacy,magnesium sulfate 4 g/50 mL [PANA],4000617,J3475,, 36.50 Pharmacy,ferrous sulfate 220 mg/5 mL Oral Elix [PANA],4000618,,, 5.00 Pharmacy,PEMEtrexed 100 mg IV Inj [PANA],4000619,J9305,," 2,232.52 " Pharmacy,irinotecan 20 mg/mL IV Sol 5ml [PANA],4000620,J9206,, 112.20 Pharmacy,tetanus/diphtheria/pertussis acel (Tdap) [PANA],4000627,,, 156.40 Pharmacy,mepivacaine 1% PF Inj Sol 30 mL [PANA],4000628,J0670,, 30.60 Pharmacy,lidocaine Top 2% Gel w/Appl 5ml [PANA],4000631,,, 27.00 Pharmacy,vinCRIStine 1 mg/mL IV Sol [PANA],4000632,J9370,, 48.38 Pharmacy,DOXOrubicin 2 mg/mL IV Sol [PANA],4000633,J9000,, 19.99 Pharmacy,DOBUTamine 12.5 mg/mL IV Sol [PANA],4000634,J1250,, 25.38 Pharmacy,ranitidine 25 mg/mL Inj Sol [PANA],4000637,J2780,, 58.01 Pharmacy,thyroid desiccated 60 mg Tab [PANA],4000639,,, 5.00 Pharmacy,denosumab 60 mg/mL [PANA],4000641,J0897,," 4,022.89 " Pharmacy,glucagon 1 mg Inj [PANA],4000642,J1610,, 566.28 Pharmacy,"influenza virus vaccine, quadrivalent [PANA]",4000643,,, 140.35 Pharmacy,propylthiouracil 50 mg Tab [PANA],4000645,,, 9.75 Pharmacy,enalapril 5 mg Tab [PANA],4000646,,, 5.00 Pharmacy,furosemide 10 mg/mL Oral Liq [PANA],4000648,,, 5.00 Pharmacy,levalbuterol 0.63 mg/3 mL Inh Sol [PANA],4000649,J7614,, 7.50 Pharmacy,aspirin 325 mg Tab [PANA],4000651,,, 5.00 Pharmacy,acetaminophen-tramadol 325-37.5 mg Tab [PANA],4000652,,, 5.00 Pharmacy,bisoprolol-hydrochlorothiazide 10-6.25mg [PANA],4000655,,, 5.00 Pharmacy,clorazepate 3.75 mg Tab [PANA],4000656,,, 15.13 Pharmacy,bethanechol 10 mg Tab [PANA],4000657,,, 5.00 Pharmacy,tiZANidine 4 mg Tab [PANA],4000658,,, 5.68 Pharmacy,amiodarone 200 mg Tab [PANA],4000659,,, 12.46 Pharmacy,doxepin 25 mg Cap [PANA],4000664,,, 5.00 Pharmacy,carbidopa-levodopa 25 mg-250 mg Tab [PANA],4000665,,, 5.00 Pharmacy,amoxicillin-clav 600-42.9 mg/5 mL Liq [PANA],4000668,,, 12.96 Pharmacy,bupivacaine 0.25% Inj Sol 50 mL [PANA],4000669,,, 26.28 Pharmacy,sevelamer 800 mg Tab [PANA],4000671,,, 31.75 Pharmacy,bacitracin Ophth 500 units/g Oint [PANA],4000672,,, 173.35 Pharmacy,promethazine 6.25 mg/5 mL Oral Syrup [PANA],4000673,Q0169,, 5.00 Pharmacy,prazosin 1 mg Cap [PANA],4000674,,, 6.69 Pharmacy,naloxone 0.4 mg/mL Inj Sol [PANA],4000675,J2310,, 90.23 Pharmacy,sodium thiosulfate 25% IV Sol 50 mL [PANA],4000676,,, 295.54 Pharmacy,EPINEPHrine 0.15 mg Inj kit [PANA],4000677,J0171,, 515.63 Pharmacy,flurbiprofen Ophth 0.03% Sol [PANA],4000678,,, 32.74 Pharmacy,ondansetron 2 mg/mL Inj Sol 20ml MDV [PANA],4000679,J2405,, 79.50 Pharmacy,brinzolamide Ophth 1% Susp [PANA],4000680,,, 753.83 Pharmacy,LORazepam 2 mg/mL Inj Sol [PANA],4000681,J2060,, 18.50 Pharmacy,sucralfate 1 g Tab [PANA],4000684,,, 5.00 Pharmacy,phenazopyridine 100 mg Tab [PANA],4000685,,, 10.12 Pharmacy,Polyvinyl Alcohol 1.4% [PANA],4000688,,, 20.85 Pharmacy,tetracaine Ophth 0.5% Sol [PANA],4000690,,, 46.03 Pharmacy,predniSONE 20 mg Tab [PANA],4000693,J7512,, 5.00 Pharmacy,isosorbide mononitrate 30 mg ER Tab [PANA],4000695,,, 6.29 Pharmacy,cefTRIAXone 250 mg Inj [PANA],4000696,J0696,, 55.61 Pharmacy,phenylephrine Top 0.25% Supp [PANA],4000697,,, 5.00 Pharmacy,Dextrose 5% with 0.9% NaCl and KCl 20 mEq/L intravenous solution [PANA],4000699,J3480,, 37.65 Pharmacy,ciprofloxacin 400 mg/200 mL IV Sol [PANA],4000700,J0744,, 19.50 Pharmacy,docusate-senna 50 mg-8.6 mg Tab [PANA],4000701,,, 5.00 Pharmacy,atropine/hyoscyamine/PB/scopolamine liq [PANA],4000705,,, 41.13 Pharmacy,vitamin A & D Top Oint [PANA],4000707,,, 14.96 Pharmacy,sulfamethox-trimetho 80-16mg/mL inj 5 mL [PANA],4000708,,, 25.89 Pharmacy,Sodium Chloride 0.45% BOLUS IV 1000 mL [PANA],4000711,,, 20.89 Pharmacy,Sodium Chloride 0.45% IV Sol 1000 mL [PANA],4000711,,, 20.89 Pharmacy,verapamil 180 mg ER Tab [PANA],4000712,,, 9.35 Pharmacy,Lactated Ringers Injection 1000 mL [PANA],4000716,J7120,, 19.91 Pharmacy,Lactated Ringers Injection 1000 mL BOLUS [PANA],4000716,J7120,, 19.91 Pharmacy,acetaZOLAMIDE 250 mg Tab [PANA],4000717,,, 10.81 Pharmacy,guaiFENesin-pseudoephed 600-60 mg ER Tab [PANA],4000718,,, 5.00 Pharmacy,clindamycin 150 mg Cap [PANA],4000719,,, 5.00 Pharmacy,insulin isophane-regular 70-30 units/mL [PANA],4000720,J1815,, 121.05 Pharmacy,codeine-promethazine 10 mg-6.25 mg/5 mL [PANA],4000723,,, 5.00 Pharmacy,bisoprolol-hydrochlorothiazide 5-6.25 mg [PANA],4000725,,, 5.00 Pharmacy,metroNIDAZOLE 500 mg/100 mL IV Sol [PANA],4000726,,, 18.50 Pharmacy,atropine-diphenoxylate 0.025-2.5 mg Tab [PANA],4000728,,, 5.00 Pharmacy,lidocaine-prilocaine Top 2.5%-2.5% Crm [PANA],4000730,,, 37.19 Pharmacy,sulindac 150 mg Tab [PANA],4000731,,, 5.00 Pharmacy,amoxicillin-clavulana 250-125 mg Tab [PANA],4000732,,, 22.19 Pharmacy,topiramate 25 mg Tab [PANA],4000734,,, 7.88 Pharmacy,phenytoin 100 mg ERCap [PANA],4000738,,, 5.00 Pharmacy,phenytoin 50 mg Chew Tab [PANA],4000739,,, 5.00 Pharmacy,acetaminophen-codeine 300 mg-30 mg Tab [PANA],4000740,,, 5.00 Pharmacy,mepivacaine 1% Inj Sol 50 mL [PANA],4000741,J0670,, 31.14 Pharmacy,levofloxacin 250 mg Tab [PANA],4000743,,, 55.22 Pharmacy,sulfamethox-trimethoprim 800-160 mg Tab [PANA],4000745,,, 5.00 Pharmacy,bisoprolol-hydrochlorothiazi 2.5-6.25 mg [PANA],4000747,,, 5.00 Pharmacy,guaiFENesin 100 mg/5 mL Oral Liq [PANA],4000749,,, 5.00 Pharmacy,spironolactone 25 mg Tab [PANA],4000751,,, 5.00 Pharmacy,Dextrose 5% in Lactated Ringers [PANA],4000752,J7121,, 19.88 Pharmacy,levothyroxine 25 mcg (0.025 mg) Tab [PANA],4000753,,, 5.00 Pharmacy,acetaminophen-codeine 120 mg-12 mg/5 mL [PANA],4000755,,, 5.00 Pharmacy,warfarin 3 mg Tab [PANA],4000756,,, 5.00 Pharmacy,levothyroxine 75 mcg (0.075 mg) Tab [PANA],4000757,,, 5.00 Pharmacy,chlorproMAZINE 10 mg Tab [PANA],4000759,Q0161,, 16.12 Pharmacy,sterile water Inj Sol 10ml [PANA],4000762,A4217,, 18.50 Pharmacy,sterile water Inj Sol 50ml [PANA],4000763,A4217,, 18.50 Pharmacy,Dextrose 5% 0.45% NaCl and KCl 20 mEq/L 1000 mL [PANA],4000764,J3480,, 33.49 Pharmacy,nystatin-triamcinolone Top Oint [PANA],4000765,,, 350.94 Pharmacy,nortriptyline 25 mg Cap [PANA],4000766,,, 5.50 Pharmacy,droperidol 2.5 mg/mL Inj Sol [PANA],4000770,J1790,, 18.50 Pharmacy,nadolol 20 mg Tab [PANA],4000771,,, 23.22 Pharmacy,hydrocortisone 2.5% Rectal Crm w/Appl [PANA],4000773,,, 218.33 Pharmacy,ALPRAZolam 0.5 mg Tab [PANA],4000774,,, 5.00 Pharmacy,pentamidine 300 mg Inh Pwdr for Recon [PANA],4000775,J2545,, 550.74 Pharmacy,sterile water Irr Sol 1000 mL [PANA],4000776,A4217,, 7.79 Pharmacy,cefTRIAXone 1 g Inj [PANA],4000778,J0696,, 77.63 Pharmacy,citalopram 20 mg Tab [PANA],4000779,,, 10.10 Pharmacy,alteplase 100 mg IV Inj [PANA],4000780,J2997,," 29,041.18 " Pharmacy,esmolol 10 mg/mL IV Sol [PANA],4000781,,, 32.81 Pharmacy,sodium chloride 0.9% Inj Sol 10 mL [PANA],4000782,A4216,, 18.50 Pharmacy,sodium chloride 0.9% Inj Sol 20 mL [PANA],4000783,A4216,, 18.50 Pharmacy,tolterodine 2 mg Tab [PANA],4000784,,, 12.74 Pharmacy,amitriptyline 25 mg Tab [PANA],4000785,,, 5.00 Pharmacy,triamcinolone Top 0.1% Paste [PANA],4000788,,, 201.48 Pharmacy,calcium carbonate 1250 mg Tab [PANA],4000789,,, 5.00 Pharmacy,calcium gluconate 100 mg/mL Inj Sol [PANA],4000790,J0610,, 41.18 Pharmacy,chlordiazePOXIDE 25 mg Cap [PANA],4000792,,, 5.00 Pharmacy,homatropine Ophth 5% Sol [PANA],4000794,,, 65.03 Pharmacy,potassium chloride 20 mEq/100 mL IV Sol [PANA],4000795,J3480,, 32.71 Pharmacy,phentolamine 5 mg Pow,4000796,J2760,," 1,385.34 " Pharmacy,gentamicin Ophth 0.3% Sol [PANA],4000798,,, 98.29 Pharmacy,tamsulosin 0.4 mg Oral Cap [PANA],4000799,,, 15.80 Pharmacy,theophylline 80 mg/15 mL Oral Elix [PANA],4000800,,, 46.95 Pharmacy,predniSONE 1 mg Tab [PANA],4000801,J7512,, 5.00 Pharmacy,antipyrine-benzocaine Otic Sol [PANA],4000806,,, 44.81 Pharmacy,CISplatin 1 mg/mL IV Sol 100ml [PANA],4000807,J9060,, 119.13 Pharmacy,CISplatin 1 mg/mL IV Sol 200ml [PANA],4000808,J9060,, 238.26 Pharmacy,CISplatin 1 mg/mL IV Sol 50ml [PANA],4000809,J9060,, 81.23 Pharmacy,terbutaline 5 mg Tab [PANA],4000811,,, 5.00 Pharmacy,gemcitabine 200 mg IV Inj [PANA],4000812,J9201,, 56.25 Pharmacy,amitriptyline 10 mg Tab [PANA],4000813,,, 5.00 Pharmacy,baclofen 10 mg Tab [PANA],4000816,,, 5.00 Pharmacy,benzonatate 100 mg Cap [PANA],4000817,,, 9.38 Pharmacy,codeine/phenyle/prometh 10-5-6.25mg/5mL [PANA],4000818,,, 9.97 Pharmacy,glipiZIDE 2.5 mg ER Tab [PANA],4000820,,, 5.00 Pharmacy,triamcinolone ace 40 mg/mL Inj 1ml SDV [PANA],4000821,J3301,, 40.03 Pharmacy,sevoflurane Inh Liq 250 mL [PANA],4000824,,, 435.36 Pharmacy,Dextrose 5% with 0.9% NaCl Sol 1000 mL [PANA],4000826,J7042,, 19.80 Pharmacy,methylPREDNISolone 1 g Inj [PANA],4000827,J2930,, 138.21 Pharmacy,erythromycin Ophth 0.5% Oint [PANA],4000829,,, 70.16 Pharmacy,hyoscyamine 0.125 mg Dis Tab [PANA],4000830,,, 5.00 Pharmacy,methylPREDNISolone 40 mg/mL Inj 1ml SDV [PANA],4000833,J1030,, 47.57 Pharmacy,cyanocobalamin 1000 mcg/mL Inj Sol [PANA],4000835,J3420,, 32.78 Pharmacy,oseltamivir 75 mg Cap [PANA],4000836,,, 57.96 Pharmacy,ferrous sulfate 325 mg Tab [PANA],4000838,,, 5.00 Pharmacy,cephalexin 250 mg/5 mL Oral Liq [PANA],4000839,,, 5.39 Pharmacy,leuprolide 22.5 mg/3 months Kit [PANA],4000841,J9217,," 15,340.99 " Pharmacy,gemcitabine 1 g IV Inj [PANA],4000842,J9201,, 128.43 Pharmacy,bismuth subsalicylate 262 mg/15 mL Susp [PANA],4000843,,, 5.00 Pharmacy,meropenem 500 mg IV Inj [PANA],4000844,J2185,, 65.25 Pharmacy,tobramycin Ophth 0.3% Sol [PANA],4000845,,, 85.00 Pharmacy,triamcinolone Top 0.1% Oint [PANA],4000847,,, 20.93 Pharmacy,dextrose 25% IV Sol 10 mL syringe [PANA],4000848,,, 37.62 Pharmacy,ranitidine 150 mg Tab [PANA],4000849,,, 6.00 Pharmacy,betamethasone-clotrimazole Top Crm [PANA],4000850,,, 76.80 Pharmacy,meropenem 1 g IV Inj [PANA],4000851,J2185,, 102.00 Pharmacy,insulin regular 100 units/mL Inj Sol [PANA],4000853,J1815,, 121.05 Pharmacy,promethazine 25 mg/mL Inj Sol [PANA],4000857,J2550,, 18.50 Pharmacy,carBAMazepine 100 mg Chew Tab [PANA],4000859,,, 5.00 Pharmacy,propranolol 80 mg ERCap [PANA],4000860,,, 8.80 Pharmacy,promethazine 25 mg Tab [PANA],4000861,Q0169,, 5.00 Pharmacy,candesartan 16 mg Tab [PANA],4000862,,, 11.90 Pharmacy,fluticasone-salmeterol 500-50 mcg Inh [PANA],4000863,,, 629.13 Pharmacy,brimonidine Ophth 0.2% Sol [PANA],4000864,,, 81.63 Pharmacy,digoxin immune FAB 40 mg Inj [PANA],4000865,J1162,," 12,008.70 " Pharmacy,indomethacin 25 mg Cap [PANA],4000866,,, 5.00 Pharmacy,carbidopa-levodopa 10 mg-100 mg Tab [PANA],4000867,,, 5.00 Pharmacy,insulin NPH human isophane [PANA],4000869,J1815,, 121.05 Pharmacy,azithromycin 500 mg IV Inj [PANA],4000872,J0456,, 53.25 Pharmacy,povidone iodine Top 7.5% Soap [PANA],4000874,,, 15.53 Pharmacy,fentaNYL 0.05 mg/mL Inj Sol 2ml [PANA],4000875,J3010,, 18.50 Pharmacy,fentaNYL 0.05 mg/mL Inj Sol 5ml [PANA],4000876,J3010,, 18.50 Pharmacy,sod biphosphate-sod phosphate Enema [PANA],4000877,,, 6.38 Pharmacy,cefdinir 125 mg/5 mL Oral Susp [PANA],4000882,,, 15.94 Pharmacy,acetylcysteine 10% Inh Sol 30 mL [PANA],4000883,J7608,, 75.01 Pharmacy,nitroglycerin 0.4 mg sublingual Tab [PANA],4000886,,, 5.00 Pharmacy,clarithromycin 250 mg/5 mL Oral Liq [PANA],4000887,,, 36.56 Pharmacy,sulfamethox-trimetho 200-40 mg/5 mL Susp [PANA],4000888,,, 5.00 Pharmacy,pyridoxine 50 mg Tab [PANA],4000889,,, 5.00 Pharmacy,sertraline 25 mg Tab [PANA],4000890,,, 5.00 Pharmacy,tobramycin Ophth 0.3% Oint [PANA],4000891,,, 565.91 Pharmacy,simethicone 40 mg/0.6 mL Oral Liq [PANA],4000892,,, 13.13 Pharmacy,doxazosin 4 mg Tab [PANA],4000895,,, 5.00 Pharmacy,amoxicillin 125 mg/5 mL Oral Liq [PANA],4000896,,, 5.00 Pharmacy,vancomycin 500 mg IV Inj [PANA],4000897,J3370,, 28.50 Pharmacy,chlordiazePOXIDE-clidinium 5-2.5 mg Cap [PANA],4000898,,, 5.89 Pharmacy,oxyCODONE 10 mg ER Tab [PANA],4000899,,, 16.91 Pharmacy,tobramycin 40 mg/mL Inj Sol [PANA],4000900,J3260,, 18.50 Pharmacy,aspirin 81 mg Chew Tab [PANA],4000903,,, 5.00 Pharmacy,diclofenac sodium 75 mg Oral EC Tab [PANA],4000906,,, 5.00 Pharmacy,bumetanide 1 mg Tab [PANA],4000908,,, 7.34 Pharmacy,nitroglycerin 2% Top Oint [PANA],4000909,,, 10.33 Pharmacy,folic acid 1 mg Tab [PANA],4000911,,, 5.00 Pharmacy,dorzolamide-timolol Ophth 2%-0.5% Sol [PANA],4000912,,, 269.72 Pharmacy,enoxaparin 150 mg/mL SubQ Sol [PANA],4000913,J1650,, 98.37 Pharmacy,pseudoephedrine 30 mg Tab [PANA],4000915,,, 5.00 Pharmacy,codeine-guaiFENesin 10 mg-100 mg/5 mL [PANA],4000918,,, 5.00 Pharmacy,haloperidol 5 mg/mL Inj Sol [PANA],4000920,J1630,, 26.96 Pharmacy,ampicillin 1 g Inj [PANA],4000921,J0290,, 38.55 Pharmacy,cefTRIAXone 500 mg Inj [PANA],4000922,J0696,, 18.50 Pharmacy,bisacodyl 5 mg Oral EC Tab [PANA],4000924,,, 5.00 Pharmacy,lisinopril 5 mg Tab [PANA],4000926,,, 5.00 Pharmacy,"penicillin G benz 600,000 units/mL syr [PANA]",4000927,J0561,, 299.84 Pharmacy,digoxin 125 mcg (0.125 mg) Tab [PANA],4000928,,, 9.60 Pharmacy,diclofenac sodium 50 mg Oral EC Tab [PANA],4000929,,, 5.52 Pharmacy,zolpidem 5 mg Tab [PANA],4000930,,, 17.32 Pharmacy,lidocaine 2% Inj Sol 20 mL MDV [PANA],4000931,J2001,, 18.50 Pharmacy,mirtazapine 15 mg Tab [PANA],4000933,,, 10.16 Pharmacy,gabapentin 100 mg Cap [PANA],4000934,,, 5.00 Pharmacy,Sodium Chloride 0.9% Sol 100 mL [PANA],4000935,J7040,, 18.50 Pharmacy,Sodium Chloride 0.9% Sol 1000 mL [PANA],4000936,J7040,, 18.99 Pharmacy,Sodium Chloride 0.9% Sol IV BOLUS 1000 mL [PANA],4000936,J7040,, 18.98 Pharmacy,Sodium Chloride 0.9% Sol 250 mL [PANA],4000937,J7040,, 18.50 Pharmacy,Sodium Chloride 0.9% Sol 50 mL [PANA],4000938,J7040,, 18.50 Pharmacy,Sodium Chloride 0.9% Sol 500 mL [PANA],4000939,J7040,, 18.50 Pharmacy,metoprolol 25 mg ER Tab [PANA],4000940,,, 5.00 Pharmacy,betaxolol Ophth 0.5% Sol [PANA],4000943,,, 116.25 Pharmacy,"nystatin Top 100,000 units/g Pwdr [PANA]",4000944,,, 68.65 Pharmacy,levalbuterol 1.25 mg/3 mL Inh Sol [PANA],4000945,J7614,, 25.12 Pharmacy,warfarin 1 mg Tab,4000947,,, 5.00 Pharmacy,glyBURIDE micronized 3 mg Tab [PANA],4000948,,, 5.00 Pharmacy,hydroxychloroquine 200 mg Tab [PANA],4000949,,, 16.35 Pharmacy,oxaprozin 600 mg Tab [PANA],4000950,,, 13.74 Pharmacy,EPINEPHrine 0.3 mg Inj kit [PANA],4000951,J0171,, 515.63 Pharmacy,phenylephrine Ophth 2.5% Sol [PANA],4000954,,, 101.58 Pharmacy,fluticasone-salmeterol 100-50 mcg Inh [PANA],4000955,,, 385.98 Pharmacy,mannitol 20% IV Sol 500 mL [PANA],4000956,,, 71.44 Pharmacy,cefTAZidime 1 g Inj [PANA],4000957,J0713,, 32.48 Pharmacy,propofol 10 mg/mL IV Emul [PANA],4000960,J2704,, 18.50 Pharmacy,azithromycin 200 mg/5 mL Oral Liq [PANA],4000964,Q0144,, 21.80 Pharmacy,electrolyte replacement Oral Sol 1000 mL [PANA],4000965,,, 22.09 Pharmacy,dextromethorphan-guaiFENesin 30-600mg ER [PANA],4000966,,, 5.00 Pharmacy,scopolamine 1.5 mg Transderm ER Film [PANA],4000967,,, 80.25 Pharmacy,neomycin 500 mg Tab [PANA],4000968,,, 5.12 Pharmacy,labetalol 100 mg Tab [PANA],4000969,,, 8.55 Pharmacy,dilTIAZem 30 mg Tab [PANA],4000970,,, 5.00 Pharmacy,timolol Ophth 0.5% Sol [PANA],4000971,,, 63.75 Pharmacy,pilocarpine Ophth 2% Sol [PANA],4000972,,, 121.21 Pharmacy,ketorolac 60 mg/2 mL [PANA],4000973,J1885,, 18.50 Pharmacy,ibutilide 0.1 mg/mL IV Sol [PANA],4000974,J1742,," 1,492.48 " Pharmacy,celecoxib 100 mg Cap [PANA],4000975,,, 17.31 Pharmacy,benazepril 10 mg Tab [PANA],4000976,,, 5.00 Pharmacy,ketoconazole Top 2% Crm [PANA],4000977,,, 77.25 Pharmacy,oxybutynin 5 mg Tab [PANA],4000978,,, 5.00 Pharmacy,haloperidol 2 mg Tab [PANA],4000979,,, 5.00 Pharmacy,piperacillin-tazobactam 2.25 g IV Inj [PANA],4000981,J2543,, 66.38 Pharmacy,hydrOXYzine hydrochloride 10 mg Tab [PANA],4000982,,, 5.00 Pharmacy,atropine Ophth 1% Sol [PANA],4000985,,, 76.88 Pharmacy,ondansetron 4 mg Dis Tab [PANA],4000986,Q0162,, 83.60 Pharmacy,cefdinir 300 mg Cap [PANA],4000987,,, 19.18 Pharmacy,sodium chloride 0.9% Inh Sol 3 mL [PANA],4000988,,, 5.00 Pharmacy,fluticasone Nasal 0.05 mg/inh Spry [PANA],4000993,,, 213.15 Pharmacy,clotrimazole Top 1% Crm [PANA],4000994,,, 32.21 Pharmacy,riTUXimab 10 mg/mL IV Sol 10ml [PANA],4000996,J9310,," 3,100.42 " Pharmacy,riTUXimab 10 mg/mL IV Sol 50ml [PANA],4000997,J9310,," 15,502.08 " Pharmacy,Dextrose 5% 0.45% NaCl IV Sol 1000 mL [PANA],4000998,,, 20.85 Pharmacy,alteplase 2 mg IV Inj [PANA],4000999,J2997,, 476.36 Pharmacy,cholecalciferol 400 intl units Tab [PANA],4001000,,, 5.00 Pharmacy,insulin lispro-lispro protamine 25-75 [PANA],4001001,J1815,, 683.68 Pharmacy,hydrOXYzine hydrochloride 50 mg/mL 1 mL Inj [PANA],4001002,J3410,, 73.43 Pharmacy,dicyclomine 10 mg Cap [PANA],4001004,,, 5.00 Pharmacy,calcitriol 0.25 mcg Oral Cap [PANA],4001005,,, 5.00 Pharmacy,chlorhexidine Top 4% Soap [PANA],4001010,,, 15.38 Pharmacy,lamoTRIgine 100 mg Tab [PANA],4001011,,, 19.48 Pharmacy,petrolatum topical - Oin,4001012,,, 11.81 Pharmacy,norEPINEPHrine 1 mg/mL IV Sol [PANA],4001014,,, 39.62 Pharmacy,pneumococcal 23-valent vaccine Inj Sol [PANA],4001015,,, 311.90 Pharmacy,risperiDONE 0.5 mg Tab [PANA],4001017,,, 16.05 Pharmacy,gentamicin Top 0.1% Oint [PANA],4001018,,, 246.88 Pharmacy,Vitamin B Complex Cap [PANA],4001020,,, 5.00 Pharmacy,metoclopramide 10 mg Tab [PANA],4001022,,, 5.00 Pharmacy,levothyroxine 112 mcg (0.112 mg) Tab [PANA],4001023,,, 5.00 Pharmacy,amoxicillin-clavulanate 875-125 mg Tab [PANA],4001024,,, 18.94 Pharmacy,dorzolamide Ophth 2% Sol [PANA],4001025,,, 114.73 Pharmacy,propranolol 1 mg/mL IV Sol [PANA],4001027,J1800,, 36.00 Pharmacy,phytonadione 5 mg Tab [PANA],4001028,,, 43.01 Pharmacy,pegfilgrastim 6 mg/0.6 mL SubQ Inj [PANA],4001031,J2505,," 20,562.49 " Pharmacy,ertapenem 1 g Inj [PANA],4001032,J1335,, 386.33 Pharmacy,enoxaparin 30 mg/0.3 mL SC Sol [PANA],4001033,J1650,, 27.99 Pharmacy,enoxaparin 60 mg/0.6 mL SC Sol [PANA],4001034,J1650,, 53.69 Pharmacy,Multiple Vitamins w/ Mins Tab [PANA],4001035,,, 5.00 Pharmacy,"rabies vaccine, 2.5 intl units IM Inj [PANA]",4001036,,," 1,011.00 " Pharmacy,dextrose 50% IV Sol 50 mL syringe [PANA],4001037,,, 45.00 Pharmacy,Dextrose 5% in Water IV Sol 100 mL [PANA],4001038,J7060,, 18.50 Pharmacy,Dextrose 5% in Water IV Sol 1000 mL [PANA],4001039,J7060,, 18.50 Pharmacy,Dextrose 5% in Water IV Sol 250 mL [PANA],4001040,J7060,, 18.50 Pharmacy,Dextrose 5% in Water IV Sol 50 mL [PANA],4001041,J7060,, 18.50 Pharmacy,Dextrose 5% in Water IV Sol 500 mL [PANA],4001042,J7060,, 18.50 Pharmacy,Dextrose 10% in Water Sol 1000 mL [PANA],4001043,,, 29.14 Pharmacy,diazepam 5 mg/mL Inj Sol [PANA],4001044,J3360,, 86.48 Pharmacy,sodium bicarbonate 8.4% 50 mL syringe [PANA],4001045,,, 45.00 Pharmacy,RHo (D) immune globulin 150 mcg/mL Inj [PANA],4001046,J2792,, 551.32 Pharmacy,morphine 10 mg/mL preservative-free Sol [PANA],4001047,J2274,, 18.50 Pharmacy,naloxone 1 mg/mL Inj Sol [PANA],4001053,J2310,, 108.90 Pharmacy,eye vitamins and minerals Tab [PANA],4001055,,, 5.00 Pharmacy,escitalopram 10 mg Tab [PANA],4001056,,, 16.22 Pharmacy,metaxalone 800 mg Tab [PANA],4001057,,, 45.75 Pharmacy,ezetimibe 10 mg Tab [PANA],4001059,,, 38.56 Pharmacy,dutasteride 0.5 mg Cap [PANA],4001060,,, 22.69 Pharmacy,divalproex sodium 250 mg ER Tab [PANA],4001063,,, 9.18 Pharmacy,hydrocortisone 100 mg Inj [PANA],4001064,J1720,, 60.43 Pharmacy,acyclovir Top 5% Crm [PANA],4001067,,," 1,816.02 " Pharmacy,levofloxacin 500 mg/100 mL IV Sol [PANA],4001068,J1956,, 30.27 Pharmacy,levofloxacin 750 mg/150 mL IV Sol [PANA],4001069,J1956,, 33.52 Pharmacy,sodium chloride Nasal 0.65% Spry [PANA],4001073,,, 8.70 Pharmacy,aminophylline 25 mg/mL IV Sol [PANA],4001075,J0280,, 30.20 Pharmacy,potassium chloride 10 mEq ER Tab [PANA],4001076,,, 5.00 Pharmacy,metoprolol 25 mg Tab [PANA],4001078,,, 5.00 Pharmacy,PEMEtrexed 500 mg IV Inj [PANA],4001079,J9305,," 11,162.58 " Pharmacy,tiotropium 18 mcg Inh Cap [PANA],4001080,,, 224.51 Pharmacy,"Ophth irrigation, Balanced Salt Sol [PANA]",4001081,,, 32.54 Pharmacy,"ophthalmic irrigation, intraocular Balanced Salt Solution Sol [PANA]",4001081,,, 72.25 Pharmacy,azaCITIDine 100 mg Inj [PANA],4001083,J9025,," 1,698.46 " Pharmacy,racepinephrine 2.25% Inh Sol 0.5 mL [PANA],4001084,,, 7.03 Pharmacy,charcoal 50 g Oral Susp 240 mL [PANA],4001085,,, 84.38 Pharmacy,DULoxetine 30 mg Cap [PANA],4001087,,, 35.96 Pharmacy,lactulose 10 g/15 mL Oral Syrup [PANA],4001089,,, 5.00 Pharmacy,darifenacin 7.5 mg ER Tab [PANA],4001091,,, 41.46 Pharmacy,PAClitaxel protein-bound 100 mg IV Inj [PANA],4001092,J9264,," 4,547.43 " Pharmacy,ipratropium CFC free 17 mcg/inh Inh Aer [PANA],4001094,,, 948.68 Pharmacy,"fentaNYL 12 mcg/hr TD film, ER [PANA]",4001095,,, 76.13 Pharmacy,oxaliplatin 5 mg/mL IV Sol 10ml [PANA],4001096,J9263,, 739.20 Pharmacy,oxaliplatin 5 mg/mL IV Sol 20ml [PANA],4001097,J9263,, 330.00 Pharmacy,tigecycline 50 mg IV Inj [PANA],4001098,J3243,, 457.12 Pharmacy,meperidine 25 mg/mL Inj Sol [PANA],4001101,J2175,, 24.32 Pharmacy,meperidine 50 mg/mL Inj Sol [PANA],4001102,J2175,, 25.14 Pharmacy,lidocaine 4% PF Inj Sol 5 mL [PANA],4001108,J2001,, 19.49 Pharmacy,lidocaine 2% PF 5 mL syringe [PANA],4001109,J2001,, 18.50 Pharmacy,fenofibrate 54 mg Tab [PANA],4001110,,, 5.00 Pharmacy,ondansetron 2 mg/mL Inj Sol 2ml SDV [PANA],4001112,J2405,, 18.50 Pharmacy,EPINEPHrine 1 mg/mL Inj Sol [PANA],4001114,J0171,, 65.63 Pharmacy,silver nitrate Top Stick [PANA],4001115,,, 5.00 Pharmacy,aliskiren 150 mg oral tablet [PANA],4001116,,, 20.48 Pharmacy,zoledronic acid 5 mg/100 mL IV Sol [PANA],4001119,J3489,," 2,762.16 " Pharmacy,ethyl chloride Top 100% Spry [PANA],4001120,,, 80.00 Pharmacy,hepatitis B adult vaccine 20 mcg/mL Sus [PANA],4001121,,, 169.11 Pharmacy,oseltamivir 30 mg Cap [PANA],4001126,,, 53.18 Pharmacy,oseltamivir 45 mg Cap [PANA],4001127,,, 59.15 Pharmacy,brimonidine-timolol Ophth 0.2%-0.5% Sol [PANA],4001128,,, 425.12 Pharmacy,irinotecan 20 mg/mL IV Sol 2ml [PANA],4001131,J9206,, 68.31 Pharmacy,fosphenytoin (PE) 100 mg/2 mL Inj Sol [PANA],4001132,Q2009,, 67.50 Pharmacy,fosphenytoin (PE) 500 mg/10 mL Inj Sol [PANA],4001133,Q2009,, 18.73 Pharmacy,tetanus and diphther tox (PF) [PANA],4001134,,, 258.50 Pharmacy,pantoprazole 40 mg oral Gran [PANA],4001135,,, 62.16 Pharmacy,vinorelbine 10 mg/mL IV Sol 1.0ml [PANA],4001142,J9390,, 90.00 Pharmacy,dimethyl sulfoxide 50% Irr Sol 50 mL [PANA],4001143,J1212,," 1,296.31 " Pharmacy,DOPamine 1.6 mg/mL-D5W IV solution [PANA],4001144,J1265,, 58.28 Pharmacy,vitamin E 400 units Cap [PANA],4001148,,, 5.00 Pharmacy,ferumoxytol 30 mg/mL [PANA],4001151,Q0138,," 3,300.55 " Pharmacy,octreotide 20 mg IM Inj [PANA],4001160,J2353,," 8,973.53 " Pharmacy,bortezomib 3.5 mg Inj [PANA],4001161,J9041,," 5,230.50 " Pharmacy,fulvestrant 50 mg/mL IM Inj [PANA],4001163,J9395,," 7,054.74 " Pharmacy,fludarabine 25 mg/mL IV Sol [PANA],4001164,J9185,, 660.00 Pharmacy,esterified estrogens 0.625 mg Tab [PANA],4001167,,, 11.23 Pharmacy,pregabalin 100 mg Cap [PANA],4001168,,, 30.68 Pharmacy,pregabalin 25 mg oral capsule [PANA],4001169,,, 30.68 Pharmacy,doxycycline 100 mg IV Inj [PANA],4001171,,, 79.73 Pharmacy,phenytoin 50 mg/mL Inj Sol [PANA],4001173,J1165,, 18.50 Pharmacy,prednisoLONE Ophth acetate 1% Susp [PANA],4001175,,, 366.14 Pharmacy,phenylephrine 10 mg/mL Inj Sol [PANA],4001176,J2370,, 18.50 Pharmacy,"Penicillin G Pot 5,000,000 units vial [PANA]",4001180,J2540,, 56.93 Pharmacy,Lip Balm 4.25gm [PANA],4001181,,, 5.00 Pharmacy,magnesium citrate 8.85% Oral Liq 296 mL [PANA],4001182,,, 7.88 Pharmacy,castor oil Oral Liq 60 mL [PANA],4001185,,, 16.65 Pharmacy,nateglinide 60 mg Tab [PANA],4001186,,, 6.61 Pharmacy,PHENobarbital 20 mg/5 mL Oral Elix [PANA],4001189,,, 5.00 Pharmacy,lactobacillus rhamnosus GG 80 mg cap [PANA],4001195,,, 5.00 Pharmacy,CARBOplatin 10 mg/mL IV Sol 60ml [PANA],4001196,J9045,, 356.40 Pharmacy,citric acid-sodium cit 334-500 mg/5 mL [PANA],4001197,,, 11.16 Pharmacy,Ammonia Inhalant 15% [PANA],4001198,,, 5.00 Pharmacy,calamine Top 8% Lotion [PANA],4001199,,, 5.89 Pharmacy,benzocaine Top 20% mucous membrane spray [PANA],4001200,,, 75.53 Pharmacy,omega-3 fatty acids 1000 mg Cap [PANA],4001202,,, 5.00 Pharmacy,thiamine 100 mg Tab UD [PANA],4001203,,, 5.00 Pharmacy,Thiamine Mononitrate (Vit B1) [PANA],4001203,,, 5.00 Pharmacy,pravastatin 20 mg Tab [PANA],4001206,,, 9.36 Pharmacy,Dextrose 5% with 0.2% NaCl intravenous solution Dextrose 5% with 0.2% NaCl Sol [PANA],4001209,,, 23.97 Pharmacy,fluconazole 50 mg Tab [PANA],4001210,,, 21.01 Pharmacy,aspirin 300 mg Supp [PANA],4001212,,, 5.47 Pharmacy,HYDROmorphone 1 mg/mL Inj Sol [PANA],4001213,J1170,, 18.50 Pharmacy,topotecan 4 mg IV Inj [PANA],4001214,J9351,, 985.19 Pharmacy,piperonyl butoxide-pyrethrins Top [PANA],4001217,,, 37.84 Pharmacy,psyllium 3.4 g/12 g oral Pwdr [PANA],4001218,,, 5.00 Pharmacy,atropine-diphenoxylate Oral Liq [PANA],4001219,,, 26.25 Pharmacy,pramipexole 0.25 mg Tab [PANA],4001220,,, 11.06 Pharmacy,oseltamivir 6 mg/mL Oral Liq [PANA],4001222,,, 51.17 Pharmacy,"rabies immune globulin, human 300 intl units/mL Sol [PANA]",4001223,,," 2,343.39 " Pharmacy,regadenoson 0.4 mg/5 mL IV Sol [PANA],4001225,J2785,, 801.76 Pharmacy,dexrazoxane 500 mg IV Inj [PANA],4001227,J1190,," 1,810.09 " Pharmacy,palonosetron 0.25 mg/5 mL IV Sol [PANA],4001228,J2469,," 1,359.00 " Pharmacy,hyaluronidase 150 units/mL Inj Sol [PANA],4001230,J3470,, 184.14 Pharmacy,ascorbic acid 500 mg/mL Inj Sol [PANA],4001231,,, 298.60 Pharmacy,vecuronium 10 mg IV Inj [PANA],4001232,,, 38.25 Pharmacy,dantrolene 20 mg IV Inj [PANA],4001233,,, 292.52 Pharmacy,ticagrelor 90 mg Tab [PANA],4001234,,, 24.06 Pharmacy,immune globulin 10% IV Sol 50 mL [PANA],4001236,J1599,," 1,831.50 " Pharmacy,acetaminophen-HYDROcodone 325-10 mg Tab [PANA],4001237,,, 5.87 Pharmacy,acetaminophen-HYDROcodone 325-7.5 mg Tab [PANA],4001238,,, 5.00 Pharmacy,acetaminophen-HYDROcodone 325-5 mg Tab [PANA],4001239,,, 5.00 Pharmacy,midazolam 5 mg/mL Sol [PANA],4001240,J2250,, 18.50 Pharmacy,aztreonam 1 g Inj [PANA],4001242,,, 110.85 Pharmacy,octreotide 30 mg IM Inj [PANA],4001245,J2353,," 15,882.45 " Pharmacy,sodium chloride 14.6% IV Sol 40 mL [PANA],4001246,J7131,, 18.50 Pharmacy,sodium nitrite 3% IV Sol 10 mL [PANA],4001247,,, 171.88 Pharmacy,trypan blue Ophth 0.06% Sol [PANA],4001248,,, 110.00 Pharmacy,cholestyramine aspartame 4 g/5 g Pow UD [PANA],4001249,,, 12.57 Pharmacy,cholestyramine light 4 g/5.7 g Pow [PANA],4001249,,, 12.57 Pharmacy,omalizumab 150 mg SubQ Inj [PANA],4001250,J2357,," 3,509.19 " Pharmacy,leucovorin 100 mg IV Inj [PANA],4001256,J0640,, 90.00 Pharmacy,fluorouracil 50 mg/mL IV Sol [PANA],4001257,J9190,, 18.50 Pharmacy,leucovorin 350 mg IV Inj [PANA],4001260,J0640,, 231.00 Pharmacy,acetaminophen 10 mg/mL [PANA],4001262,J0131,, 116.82 Pharmacy,bupivacaine liposome 1.3% 13.3 mg/mL Sus [PANA],4001263,C9290,," 1,039.49 " Pharmacy,iron sucrose 20 mg/mL IV Sol 10ml [PANA],4001264,J1756,, 330.00 Pharmacy,pantoprazole 20 mg Oral EC Tab [PANA],4001266,,, 19.75 Pharmacy,DOCEtaxel 20 mg/mL 4ml [PANA],4001267,J9171,," 4,016.65 " Pharmacy,progesterone 50 mg/mL IM Sol [PANA],4001269,J2675,, 107.55 Pharmacy,ethanol 98% Inj Sol 5 mL [PANA],4001270,,, 330.97 Pharmacy,isosulfan blue 10 mg/mL Inj Sol [PANA],4001271,,," 3,368.75 " Pharmacy,ketamine 10 mg/mL Inj Sol [PANA],4001273,,, 81.00 Pharmacy,tbo-filgrastim 300 mcg/0.5 mL [PANA],4001274,J1447,, 749.58 Pharmacy,tbo-filgrastim 480 mcg/0.8 mL [PANA],4001275,J1447,," 1,199.67 " Pharmacy,octreotide 100 mcg/mL Inj Sol [PANA],4001276,J2354,, 80.36 Pharmacy,DOCEtaxel 20 mg/mL 8ml [PANA],4001278,J9171,," 8,033.30 " Pharmacy,apixaban 2.5 mg Tab [PANA],4001279,,, 31.43 Pharmacy,denosumab 120 mg/1.7 mL [PANA],4001281,J0897,," 7,316.82 " Pharmacy,enoxaparin 120 mg/0.8 mL SC Sol [PANA],4001283,J1650,, 268.31 Pharmacy,methacholine 100 mg Inh Pwdr for Recon [PANA],4001284,J7674,, 225.00 Pharmacy,micafungin 50 mg IV Inj [PANA],4001285,J2248,, 308.55 Pharmacy,levothyroxine 100 mcg (0.1 mg) Pow [PANA],4001287,,, 348.43 Pharmacy,ceftaroline 600 mg Inj [PANA],4001290,J0712,, 554.86 Pharmacy,albumin human 25% IV Sol 50 mL [PANA],4001291,P9047,, 247.50 Pharmacy,nalbuphine 20 mg/mL Inj Sol [PANA],4001293,J2300,, 28.02 Pharmacy,sodium hypochlorite topical 0.125% Sol [PANA],4001294,,, 5.00 Pharmacy,metoprolol 50 mg Tab [PANA],4001295,,, 5.00 Pharmacy,bromfenac ophthalmic 0.07% [PANA],4001299,,, 703.96 Pharmacy,neostigmine 1 mg/mL [PANA],4001300,J2710,, 18.78 Pharmacy,glycopyrrolate 1 mg Tab [PANA],4001301,,, 5.00 Pharmacy,pyridostigmine 60 mg Tab [PANA],4001302,,, 5.00 Pharmacy,orphenadrine 30 mg/mL Inj Sol [PANA],4001303,J2360,, 83.25 Pharmacy,rifampin 300 mg Cap [PANA],4001305,,, 7.57 Pharmacy,pneumococcal 13-valent conjugate vaccine [PANA],4001308,,," 1,183.37 " Pharmacy,ferric carboxymaltose (as elemental iron) 50 mg/mL Sol [PANA],4001309,J1439,," 3,412.53 " Pharmacy,diazepam 10 mg rectal kit [PANA],4001311,,, 352.74 Pharmacy,diazepam 20 mg rectal kit [PANA],4001312,,, 400.47 Pharmacy,telavancin 750 mg Pow [PANA],4001313,J3095,," 1,359.39 " Pharmacy,aprepitant 40 mg oral capsule [PANA],4001315,J8501,, 311.59 Pharmacy,divalproex sodium 125 mg Oral EC Cap [PANA],4001316,,, 5.00 Pharmacy,lanreotide 120 mg/0.5 mL SC Sol [PANA],4001317,J1930,," 23,921.70 " Pharmacy,bupivacaine 0.75% intrathecal Sol 2 mL [PANA],4001319,,, 18.50 Pharmacy,nivolumab 10 mg/mL 4ml [PANA],4001320,J9299,," 3,461.14 " Pharmacy,sodium ferric gluconate 12.5 mg/mL inj [PANA],4001321,J2916,, 104.94 Pharmacy,apixaban 5 mg Tab [PANA],4001323,,, 31.43 Pharmacy,sugammadex 100 mg/mL 2ml [PANA],4001325,,, 285.00 Pharmacy,sugammadex 100 mg/mL 5ml [PANA],4001326,,, 602.94 Pharmacy,decitabine 50 mg IV Inj [PANA],4001327,J0894,," 5,928.62 " Pharmacy,melatonin 5 mg Tab [PANA],4001328,,, 5.00 Pharmacy,lidocaine Top 4% Crm [PANA],4001331,,, 22.50 Pharmacy,edaravone 30 mg/100 mL [PANA],4001333,C9493,," 1,827.74 " Pharmacy,theophylline 100 mg/24 hours Oral ER Cap [PANA],4001334,,, 8.18 Pharmacy,iron sucrose 20 mg/mL IV Sol 5ml [PANA],4001335,J1756,, 165.00 Pharmacy,nivolumab 10 mg/mL 10ml [PANA],4001336,J9299,," 8,652.86 " Pharmacy,heparin 25000 units-NaCl 0.45% 500 mL [PANA],4001338,J1644,, 28.53 Pharmacy,niCARdipine 2.5 mg/mL Inj Sol [PANA],4001340,,, 90.48 Pharmacy,Spot Endoscoptic Marker [PANA],4001341,,, 83.60 Pharmacy,pembrolizumab 25 mg/mL 4ml [PANA],4001342,J9271,," 13,937.30 " Pharmacy,oxacillin 1 g Inj [PANA],4001344,J2700,, 66.38 Pharmacy,etomidate 2 mg/mL IV Sol [PANA],4001345,,, 36.00 Pharmacy,durvalumab 50 mg/mL 2.4ml [PANA],4001346,C9492,," 2,775.89 " Pharmacy,durvalumab 50 mg/mL 10ml [PANA],4001347,C9492,," 11,566.20 " Pharmacy,aztreonam 2 g Inj [PANA],4001348,,, 212.85 Pharmacy,nitrofurantoin macrocrystals 50 mg Cap [PANA],4001349,,, 16.57 Pharmacy,nivolumab 10 mg/mL 24ml [PANA],4001350,J9299,," 20,766.87 " Pharmacy,sodium polystyrene sulfonate Pwdr [PANA],4001351,,, 61.31 Pharmacy,immune globulin 10% IV Sol 100 mL [PANA],4001352,J1599,," 3,663.00 " Pharmacy,immune globulin 10% IV Sol 200 mL [PANA],4001353,J1599,," 7,326.00 " Pharmacy,desmopressin 4 mcg/mL IV Sol [PANA],4001354,J2597,, 262.07 Pharmacy,cyclopentolate Ophth 2% Sol [PANA],4001355,,, 73.78 Pharmacy,morphine 4 mg/mL Inj Sol [PANA],4001357,J2274,, 18.50 Pharmacy,leuprolide 45 mg/6 months Kit [PANA],4001358,J9217,," 26,483.57 " Pharmacy,amiodarone 50 mg/mL IV Sol 9ml [PANA],4001363,J0282,, 31.73 Pharmacy,imipenem-cilastatin 500 mg-500 mg Pow [PANA],4001364,J0743,, 87.00 Pharmacy,tetracycline 500 mg Cap [PANA],4001365,,, 59.06 Pharmacy,"epoetin alfa epbx 40,000 units/mL preservative-free Sol [PANA]",4001366,Q5106,," 1,455.96 " Pharmacy,bisoprolol 10 mg Tab [PANA],4001367,,, 5.00 Pharmacy,ciprofloxacin 200 mg/100 mL IV Sol [PANA],4001368,J0744,, 18.50 Pharmacy,benzocaine Top 20% Spry [PANA],4001369,,, 17.51 Pharmacy,ketorolac-phenylephrine ophthalmic 0.3%-1% Sol [PANA],4001370,C9447,," 1,023.00 " Pharmacy,bupivacaine 0.75% preservative-free Sol [PANA],4001371,,, 18.50 Pharmacy,moxifloxacin-triamcinolone 1 mg-15 mg/mL Sus [PANA],4001372,,, 82.50 Pharmacy,lidocaine-phenylephrine ophthalmic 10 mg-15 mg/mL Sol [PANA],4001373,,, 67.50 Pharmacy,tranexamic acid 100 mg/mL Sol [PANA],4001374,,, 22.50 Pharmacy,pyridostigmine 180 mg Tab [PANA],4001375,,, 93.03 Pharmacy,Omidria Irrigation in BSS [PANA],4001376,,, 973.88 Pharmacy,Shugarcaine Solution [PANA],4001377,,, 93.56 Pharmacy,Lidocaine & Bupivacaine Mix Compound [PANA],4001378,,, 18.50 Pharmacy,LR with Epinephrine IRR [PANA],4001379,,, 83.58 Pharmacy,Vancomycin Oral Solution [PANA],4001380,,, 5.00 Pharmacy,Gentamicin Irrigation Compound [PANA],4001381,,, 136.50 Pharmacy,Marcaine: Carbocaine 1:1 Ratio for Local Block Compound [PANA],4001382,,, 21.49 Pharmacy,cemiplimab 350 mg/7 mL Sol [PANA],4001383,J9119,," 30,030.00 " Pharmacy,sodium hyaluronate ophthalmic 23mg/mL Syringe 0.6 mL[PANA],4001384,,, 908.68 Pharmacy,Sodium Chloride IRR w/ Epinephrine [PANA],4001385,,, 84.78 Pharmacy,sodium chloride 0.9% Sol 3000ml [PANA],4001386,,, 61.88 Pharmacy,physiological irrigating solution Lactated Ringers Sol [PANA],4001387,,, 56.48 Pharmacy,ado-trastuzumab emtansine 100 mg Pow [PANA],4001388,J9354,," 10,106.61 " Pharmacy,GI Cocktail [PANA],4001389,,, 15.08 Pharmacy,Fortaz & Solu-Cortef Mix Compound [PANA],4001390,,, 82.83 Pharmacy,carfilzomib 10 mg Pow [PANA],4001391,J9047,," 1,239.70 " Pharmacy,carfilzomib 60 mg Pow [PANA],4001392,J9047,," 4,969.25 " Pharmacy,amphotericin B liposomal 50 mg Pow [PANA],4001393,J0289,, 815.57 Pharmacy,methylPREDNISolone acetate 80 mg/mL Sus [PANA],4001394,J1040,, 117.98 Pharmacy,micafungin 100 mg Pow [PANA],4001394,J2248,, 505.68 Pharmacy,gemcitabine 1500 mg/15 mL Sol [PANA],4001395,J9201,, 272.25 Pharmacy,insulin regular human recombinant 1 unit/mL-NaCl 0.9% Sol [PANA],4001395,J1815,, 138.60 Pharmacy,famotidine 10 mg/mL Sol [PANA],4001396,,, 18.50 Pharmacy,famotidine 20 mg Tab [PANA],4001397,,, 51.11 Pharmacy,dexmedetomidine 4 mcg/mL-NaCl 0.9% Sol [PANA],4001398,,, 866.25 Pharmacy,chlorhexidine topical 0.12% Liq [PANA],4001399,,, 5.00 Pharmacy,dexmedetomidine 4 mcg/mL-NaCl 0.9% drip [PANA],4001400,,, 277.20 Pharmacy,ofloxacin ophthalmic 0.3% Sol [PANA],4001402,,, 15.71 Pharmacy,Epinephrine and BSS Compound [PANA],4001403,,, 15.51 Pharmacy,Fortaz Ophthalmic Dilution [PANA],4001404,,, 5.00 Pharmacy,ketorolac ophthalmic 0.5% Sol [PANA],4001405,,, 80.15 Pharmacy,Orthopedic Intra-Op Irrigation [PANA],4001406,,, 5.00 Pharmacy,Buffered Lidocaine 1% with Epi [PANA],4001407,,, 18.50 Pharmacy,Ancef Ophthalmic Dilution [PANA],4001408,,, 13.37 Pharmacy,Urology Intraoperative Anesthetic [PANA],4001409,,, 5.00 Pharmacy,Orthopedic Intra-Op Irrigation 3 [PANA],,,, 5.00 Rehab Services,Eval of Oral and Pharyngeal Swallowing Fx Chg,92610,92610,, 859.50 Rehab Services,Group Therapy Private,5000001,,, 64.50 Rehab Services,Group Therapy Private Pay,5000001,,, 111.50 Rehab Services,Manual Therapy Charge Units,5000002,97140,, 161.00 Rehab Services,Manual Therapy Charge Units,5000003,97140,, 161.00 Rehab Services,OT Manual Therapy Charge Units,5000003,97140,, 161.00 Rehab Services,Unattended Electrical Therapy Charge,5000006,G0283,, 66.25 Rehab Services,Unattended Electrical Therapy Charge,5000006,G0283,, 66.25 Rehab Services,OT Unattended Electrical Therapy Charge,5000007,G0283,, 66.25 Rehab Services,Unattended Electrical Therapy Charge,5000007,G0283,, 66.25 Rehab Services,PT Sensory Integration Charges,5000008,97533,, 127.75 Rehab Services,Sensory Stimulation Charge,5000009,97533,, 127.75 Rehab Services,PT Wheelchair Management Charges,5000010,97542,, 74.00 Rehab Services,Wheelchair Charge,5000011,97542,, 74.00 Rehab Services,Selective Debridement Charge,5000012,97597,, 301.00 Rehab Services,Selective Debridement Addition Charge,5000013,97598,, 246.50 Rehab Services,97140 MANUAL THERAPY TECHNIQUES PLUS EA 15 MIN CH,5000018,97140, 161.00 , Rehab Services,97140 MANUAL THERAPY TECHNIQUES PLUS EA 15 MIN CHARGE,5000018,97140,, 161.00 Rehab Services,97140 MANUAL THERAPY TECHNIQUES PLUS EA 15 MIN CHARGE.,5000019,97140,, 161.00 Rehab Services,ELECTRICAL STIMULATION UNATTENDED PLUS U CH,5000020,G0283,, 95.75 Rehab Services,ELECTRICAL STIMULATION UNATTENDED PLUS U CHARGE,5000020,G0283,, 95.75 Rehab Services,G0283 ELECTRICAL STIMULATION UNATTENDED PLUS U CHARGE.,5000021,G0283,, 95.75 Rehab Services,Ultrasound Charges,5000022,97035,, 116.75 Rehab Services,Ultrasound Charges,5000023,97035,, 116.75 Rehab Services,Attended E-Stim Charges,5000024,,, 123.00 Rehab Services,Attended E-Stim Charges,5000025,,, 123.00 Rehab Services,Gait Training Charges,5000026,97116,, 124.25 Rehab Services,Mechanical Traction Charge,5000027,97012,, 159.25 Rehab Services,PT Massage Charge Units,5000028,97124,, 114.25 Rehab Services,Massage Charge Units,5000029,97124,, 114.25 Rehab Services,OT Massage Charge Units,5000029,97124,, 114.25 Rehab Services,Non-Selective Debridement Charge,5000030,97602,, 281.25 Rehab Services,Whirlpool Full Body Charge,5000031,97022,, 169.25 Rehab Services,97032 APPLICATION OF TENS UNIT EA 15 MIN CH,5000033,97032,, 120.75 Rehab Services,97032 APPLICATION OF TENS UNIT EA 15 MIN CHARGE,5000033,97032,, 120.75 Rehab Services,97032 APPLICATION OF TENS UNIT EA 15 MIN CHARGE.,5000034,97032,, 120.75 Rehab Services,Vasopneumatic Device Charge,5000035,97016,, 120.75 Rehab Services,Vasopneumatic Device Charge,5000036,97016,, 120.75 Rehab Services,PT Work Hardening Charge,5000041,97545,, 401.25 Rehab Services,Work Reconditioning Initial Charge,5000041,97545,, 421.50 Rehab Services,Work Reconditioning Charge,5000042,97545,, 421.50 Rehab Services,Work Hardening Additional Hours Charge,5000043,97546,, 258.75 Rehab Services,Work Reconditioning Additional Hours Charge,5000043,97546,, 271.75 Rehab Services,Work Reconditioning Additional Hours Charge,5000044,97546,, 271.75 Rehab Services,Aquatic Therapy Charges,5000045,97113,, 106.50 Rehab Services,Aquatic Charge,5000046,97113,, 106.50 Rehab Services,Tx of Speech/Lang/Voice/Comm/Auditory Chg,5000047,92507,, 333.00 Rehab Services,Tx of Speech/Lang/Voice/Comm/Auditory Chg Medicaid,5000047,92507,, 333.00 Rehab Services,Treatment of Swallowing Dysfunction Charge,5000049,92526,, 282.75 Rehab Services,92611 EVALUATION OF ORALPHARYNGEAL SWALLOWING CHARGE.,5000051,92611,, 859.50 Rehab Services,Fluoroscopic Evaluation of Swallow Function Charge,5000051,92611,, 859.50 Rehab Services,Fluoroscopic Evaluation of Swallow Function Charge,5000051,92611,, 859.50 Rehab Services,92611 FLUOROSCOPIC EVALUATION OF SWALLOWING UN CHARGE.,5000052,,, 859.50 Rehab Services,Therapeutic Exercise Charges,5000053,97110,, 114.25 Rehab Services,OT Therapeutic Exercise Charges,5000054,97110,, 114.25 Rehab Services,Therapeutic Exercise Charges,5000054,,, 114.25 Rehab Services,Therapeutic Activities Charge,5000055,97530,, 114.75 Rehab Services,OT Therapeutic Activities Charges,5000056,97530,, 114.75 Rehab Services,OT Therapeutic Activities Charges,5000056,97530,, 114.75 Rehab Services,Therapeutic Activities Charges,5000056,97530,, 114.75 Rehab Services,ADL Training Charges,5000057,97535,, 117.25 Rehab Services,Neuromuscular Reeducation Charges,5000058,97112,, 114.75 Rehab Services,Neuromuscular Reeducation Charges,5000059,97112,, 114.75 Rehab Services,OT Neuromuscular Reeducation Charges,5000059,97112,, 114.75 Rehab Services,97110 THERAPEUTIC EXERCISE PLUS EA 15 MIN CH,5000064,97110,, 128.75 Rehab Services,97110 THERAPEUTIC EXERCISE PLUS EA 15 MIN CHARGE,5000064,97110,, 128.75 Rehab Services,97110 THERAPEUTIC EXERCISE PLUS EA 15 MIN CHARGE.,5000065,97110,, 128.75 Rehab Services,97110 THERAPEUTIC EXERCISE-CONTRACT PCMH-15MIN CHARGE,5000065,97110,, 128.75 Rehab Services,PT Community/Work Reintegration Charge,5000069,97537,, 121.25 Rehab Services,Community/Work Reintegration Charges,5000070,97537,, 121.25 Rehab Services,Orthotic Mgmt and Training Charges,5000071,97760,, 117.25 Rehab Services,Orthotic Mgmt and Training Charges,5000072,97760,, 117.25 Rehab Services,PT Skills and Agility Charge,5000074,97750,, 190.75 Rehab Services,97750 TESTS AND MESUREMENTS EA 15 MIN CHARGE.,5000075,97750,, 190.75 Rehab Services,29125 SPLINT FOREARM HAND UNTIMED CH,5000078,29125,, 264.75 Rehab Services,29125 SPLINT FOREARM HAND UNTIMED CHARGE,5000078,29125,, 264.75 Rehab Services,29125 SPLINT FOREARM HAND UNTIMED CHARGE.,5000079,29125,, 264.75 Rehab Services,29130 SPLINT FINGER UNTIMED CHA,5000080,29130,, 176.00 Rehab Services,29130 SPLINT FINGER UNTIMED CHARGE,5000080,29130,, 176.00 Rehab Services,29130 SPLINT FINGER UNTIMED.,5000081,29130,, 176.00 Rehab Services,PT Cognitive Function Charge,5000082,G0515,, 140.00 Rehab Services,G0515 DEVELOPMENT OF COGNITIVE SKILLS EA 15 MI CHARGE.,5000083,G0515,, 140.00 Rehab Services,Prosthetic Training Charges,5000084,97761,, 113.75 Rehab Services,PT Prosthetic Training Charges,5000084,97761,, 113.75 Rehab Services,Prosthetic Charge,5000085,97761,, 113.75 Rehab Services,PT Orthotic Mgmt/Train Establish Charge,5000086,97763,, 113.75 Rehab Services,OT Orthotic Mgmt/Train Establish Charge,5000087,97763,, 113.75 Rehab Services,Group Therapy Charge,5000090,97150,, 74.50 Rehab Services,Group Therapy Provided,5000091,97150,, 74.50 Rehab Services,MAINTENANCE PROGRAM CH,5000092,,, 32.00 Rehab Services,MAINTENANCE PROGRAM CHARGE,5000092,,, 32.00 Rehab Services,MAINTENANCE PROGRAM PRO RATED CH,5000093,,, 16.00 Rehab Services,MAINTENANCE PROGRAM PRO RATED CHARGE,5000093,,, 16.00 Rehab Services,GROUP CLASSES PRO RATED CH,5000094,,, 53.00 Rehab Services,GROUP CLASSES PRO RATED CHARGE,5000094,,, 53.00 Rehab Services,97140 OT LYMPHEDEMA MGMT LE CHARGE.,5000097,,, 162.75 Rehab Services,97140 OT LYMPHEDEMA MGMT UE.,5000098,,, 161.00 Rehab Services,SPORTS ENHANCEMENT INITIAL ASSESSMENT CH,5000104,,, 64.50 Rehab Services,SPORTS ENHANCEMENT INITIAL ASSESSMENT CHARGE,5000104,,, 64.50 Rehab Services,EXCEL CLASSES CH,5000525,,, 127.75 Rehab Services,EXCEL CLASSES CHARGE,5000525,,, 127.75 Rehab Services,Behav/Qual Analysis of Voice and Resonance Charge,5000526,92524,, 401.25 Rehab Services,Speech Sound Prod w/ Language Charge,5000527,92523,, 401.25 Rehab Services,Speech Sound Production Eval Charge,5000528,92522,, 401.25 Rehab Services,Speech Fluency Eval Charge,5000529,92521,, 401.25 Rehab Services,Aphasia Assessment Charge,5000530,96105,, 401.25 Rehab Services,PT Low Complex Units,5000531,97161,, 310.25 Rehab Services,PT Moderate Complex Units,5000532,97162,, 310.25 Rehab Services,PT High Complex Units,5000533,97163,, 310.25 Rehab Services,PT ReEval Units,5000534,97164,, 197.00 Rehab Services,OT Low Complex Units,5000535,97165,, 310.25 Rehab Services,OT Moderate Complex Units,5000536,97166,, 310.25 Rehab Services,OT High Complex Units,5000537,97167,, 310.25 Rehab Services,OT ReEval Units,5000538,97168,, 197.00 Rehab Services,97169 ATC EVALUATION - LOW COMPLEXITY CH,5000539,97169,, 310.25 Rehab Services,97169 ATC EVALUATION - LOW COMPLEXITY CHARGE,5000539,97169,, 310.25 Rehab Services,97170 ATC EVALUATION - MODERATE COMPLEXITY CH,5000540,97170,, 310.25 Rehab Services,97170 ATC EVALUATION - MODERATE COMPLEXITY CHARGE,5000540,97170,, 310.25 Rehab Services,97171 ATC EVALUATION - HIGH COMPLEXITY CH,5000541,97171,, 310.25 Rehab Services,97171 ATC EVALUATION - HIGH COMPLEXITY CHARGE,5000541,97171,, 310.25 Rehab Services,97172 ATC RE-EVALUATION CHA,5000542,97172,, 197.00 Rehab Services,97172 ATC RE-EVALUATION CHARGE,5000542,97172,, 197.00 Rehab Services,PT Canalith Repositioning Charge,5000543,95992,, 177.75 Rehab Services,Standardized Cognitive Eval Charge,5000544,96125,, 449.75 Rehab Services,96112 PEDIATRIC DEVELOPMENTAL TESTING 1ST HOUR CHARGE.,5000545,96112,, 371.25 Rehab Services,96113 PEDIATRIC DEVELOPMENTAL TESTING EA. ADD'L 30 MIN CHARGE.,5000546,96113,, 186.25 Rehab Services,92607 ST EVALUATION AAC SPEECH GENERATING DEVICE 1 HOUR,5000547,92607,, 390.00 Rehab Services,92608 ST EVALUATION AAC SPEECH GENERATING DEVICE EA. ADD'L 30 MINUTES,5000548,92608,, 120.00 Surgery-Pro Fee,"49505 REPAIR INITIAL INGUINAL HERNIA, AGE 5 YEARS OR OLDER; REDUCIBLE ProFee",6700001,49505," 2,869.00 ", Surgery-Pro Fee,"47563 LAPAROSCOPY, SURGICAL; CHOLECYSTECTOMY WITH CHOLANGIOGRAPHY ProFee",6700002,47563," 4,144.50 ", Surgery-Pro Fee,"45378 COLONOSCOPY, FLEXIBLE; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR ProFee",6700003,45378," 1,586.75 ", Surgery-Pro Fee,"45380 COLONOSCOPY, FLEXIBLE; WITH BIOPSY, SINGLE OR MULTIPLE ProFee",6700005,45380," 1,844.75 ", Surgery-Pro Fee,"43249 ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH TRANSENDOSCOPIC BALLOON DILATION ProFee",6700006,43249," 1,955.00 ", Surgery-Pro Fee,"36590 REMOVAL OF TUNNELED CENTRAL VENOUS ACCESS DEVICE, WITH SUBCUTANEOUS PORT OR PUMP, CENT ProFee",6700008,36590," 1,084.00 ", Surgery-Pro Fee,"19083 BIOPSY, BREAST, WITH PLACEMENT OF BREAST LOCALIZATION DEVICE(S) (EG, CLIP, METALLIC PE ProFee",6700011,19083," 1,961.50 ", Surgery-Pro Fee,"19303 MASTECTOMY, SIMPLE, COMPLETE ProFee",6700012,19303," 3,788.50 ", Surgery-Pro Fee,38792 INJECTION PROCEDURE; RADIOACTIVE TRACER FOR IDENTIFICATION OF SENTINEL NODE ProFee,6700013,38792, 203.00 , Surgery-Pro Fee,"38525 BIOPSY OR EXCISION OF LYMPH NODE(S); OPEN, DEEP AXILLARY NODE(S) ProFee",6700014,38525," 1,780.75 ", Surgery-Pro Fee,38790 INJECTION PROCEDURE; LYMPHANGIOGRAPHY ProFee,6700015,38790, 416.00 , Surgery-Pro Fee,64721 NEUROPLASTY AND/OR TRANSPOSITION; MEDIAN NERVE AT CARPAL TUNNEL ProFee,6700016,64721," 2,700.25 ", Surgery-Pro Fee,"11200 REMOVAL OF SKIN TAGS, MULTIPLE FIBROCUTANEOUS TAGS, ANY AREA; UP TO AND INCLUDING 15 L ProFee",6700018,11200, 235.00 , Surgery-Pro Fee,"49520 REPAIR RECURRENT INGUINAL HERNIA, ANY AGE; REDUCIBLE ProFee",6700019,49520," 3,315.50 ", Surgery-Pro Fee,"49585 REPAIR UMBILICAL HERNIA, AGE 5 YEARS OR OLDER; REDUCIBLE ProFee",6700020,49585," 2,427.00 ", Surgery-Pro Fee,"21930 EXCISION, TUMOR, SOFT TISSUE OF BACK OR FLANK, SUBCUTANEOUS; LESS THAN 3 CM ProFee",6700022,21930," 1,918.50 ", Surgery-Pro Fee,76937 ULTRASOUND GUIDANCE PICC PLCMT ProFee,6700024,76937, 84.00 , Surgery-Pro Fee,"36561 INSERTION OF TUNNELED CENTRALLY INSERTED CENTRAL VENOUS ACCESS DEVICE, WITH SUBCUTANEO ProFee",6700025,36561," 2,712.25 ", Surgery-Pro Fee,"11401 EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), ProFee",6700027,11401, 371.75 , Surgery-Pro Fee,"19081 BIOPSY, BREAST, WITH PLACEMENT OF BREAST LOCALIZATION DEVICE(S) (EG, CLIP, METALLIC PE ProFee",6700028,19081," 1,878.75 ", Surgery-Pro Fee,"11402 EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), ProFee",6700029,11402, 431.50 , Surgery-Pro Fee,"49587 REPAIR UMBILICAL HERNIA, AGE 5 YEARS OR OLDER; INCARCERATED OR STRANGULATED ProFee",6700030,49587," 2,656.00 ", Surgery-Pro Fee,"11422 EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), ProFee",6700031,11422, 473.25 , Surgery-Pro Fee,"11442 EXCISION, OTHER BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWH ProFee",6700033,11442, 532.75 , Surgery-Pro Fee,"11424 EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), ProFee",6700034,11424, 692.50 , Surgery-Pro Fee,"11602 EXCISION, MALIGNANT LESION INCLUDING MARGINS, TRUNK, ARMS, OR LEGS; EXCISED DIAMETER 1 ProFee",6700035,11602, 571.25 , Surgery-Pro Fee,"38500 BIOPSY OR EXCISION OF LYMPH NODE(S); OPEN, SUPERFICIAL ProFee",6700036,38500," 1,199.75 ", Surgery-Pro Fee,"11406 EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), ProFee",6700037,11406, 957.25 , Surgery-Pro Fee,"49507 REPAIR INITIAL INGUINAL HERNIA, AGE 5 YEARS OR OLDER; INCARCERATED OR STRANGULATED ProFee",6700038,49507," 3,361.75 ", Surgery-Pro Fee,49568 IMPLANTATION OF MESH OR OTHER PROSTHESIS FOR OPEN INCISIONAL OR VENTRAL HERNIA REPAIR ProFee,6700039,49568," 1,368.50 ", Surgery-Pro Fee,49560 REPAIR INITIAL INCISIONAL OR VENTRAL HERNIA; REDUCIBLE ProFee,6700040,49560," 3,663.75 ", Surgery-Pro Fee,"45330 SIGMOIDOSCOPY, FLEXIBLE; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING O ProFee",6700041,45330, 532.75 , Surgery-Pro Fee,"11750 EXCISION OF NAIL AND NAIL MATRIX, PARTIAL OR COMPLETE (EG, INGROWN OR DEFORMED NAIL), ProFee",6700042,11750, 623.00 , Surgery-Pro Fee,"21012 EXCISION, TUMOR, SOFT TISSUE OF FACE OR SCALP, SUBCUTANEOUS; 2 CM OR GREATER ProFee",6700043,21012," 1,619.75 ", Surgery-Pro Fee,"44361 SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDI ProFee",6700044,44361," 1,344.00 ", Surgery-Pro Fee,"44360 SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDI ProFee",6700045,44360, 994.75 , Surgery-Pro Fee,"11426 EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), ProFee",6700046,11426," 1,016.75 ", Surgery-Pro Fee,49402 REMOVAL OF PERITONEAL FOREIGN BODY FROM PERITONEAL CAVITY ProFee,6700047,49402," 4,035.25 ", Surgery-Pro Fee,29131 APPLICATION OF FINGER SPLINT; DYNAMIC ProFee,6700048,29131, 161.25 , Surgery-Pro Fee,"11404 EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), ProFee",6700049,11404, 633.00 , Surgery-Pro Fee,"11008 REMOVAL OF PROSTHETIC MATERIAL OR MESH, ABDOMINAL WALL FOR INFECTION (EG, FOR CHRONIC ProFee",6700050,11008," 1,561.50 ", Surgery-Pro Fee,"19120 EXCISION OF CYST, FIBROADENOMA, OR OTHER BENIGN OR MALIGNANT TUMOR, ABERRANT BREAST TI ProFee",6700051,19120," 1,852.25 ", Surgery-Pro Fee,"47001 BIOPSY OF LIVER, NEEDLE; WHEN DONE FOR INDICATED PURPOSE AT TIME OF OTHER MAJOR PROCED ProFee",6700052,47001, 512.75 , Surgery-Pro Fee,"11403 EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), ProFee",6700053,11403, 525.00 , Surgery-Pro Fee,"46230 EXCISION OF MULTIPLE EXTERNAL PAPILLAE OR TAGS, ANUS ProFee",6700054,46230," 1,040.00 ", Surgery-Pro Fee,"44389 COLONOSCOPY THROUGH STOMA; WITH BIOPSY, SINGLE OR MULTIPLE ProFee",6700055,44389," 1,498.50 ", Surgery-Pro Fee,46270 SURGICAL TREATMENT OF ANAL FISTULA (FISTULECTOMY/FISTULOTOMY); SUBCUTANEOUS ProFee,6700056,46270," 1,835.75 ", Surgery-Pro Fee,"27328 EXCISION, TUMOR, SOFT TISSUE OF THIGH OR KNEE AREA, SUBFASCIAL (EG, INTRAMUSCULAR); LE ProFee",6700057,27328," 3,083.00 ", Surgery-Pro Fee,11771 EXCISION OF PILONIDAL CYST OR SINUS; EXTENSIVE ProFee,6700058,11771," 2,082.75 ", Surgery-Pro Fee,"23071 EXCISION, TUMOR, SOFT TISSUE OF SHOULDER AREA, SUBCUTANEOUS; 3 CM OR GREATER ProFee",6700059,23071," 1,107.00 ", Surgery-Pro Fee,"19307 MASTECTOMY, MODIFIED RADICAL, INCLUDING AXILLARY LYMPH NODES, WITH OR WITHOUT PECTORAL ProFee",6700060,19307," 4,746.50 ", Surgery-Pro Fee,"37609 LIGATION OR BIOPSY, TEMPORAL ARTERY ProFee",6700061,37609," 1,275.75 ", Surgery-Pro Fee,"25075 EXCISION, TUMOR, SOFT TISSUE OF FOREARM AND/OR WRIST AREA, SUBCUTANEOUS; LESS THAN 3 C ProFee",6700062,25075," 1,484.25 ", Surgery-Pro Fee,"11642 EXCISION, MALIGNANT LESION INCLUDING MARGINS, FACE, EARS, EYELIDS, NOSE, LIPS; EXCISED ProFee",6700063,11642, 734.50 , Surgery-Pro Fee,"11606 EXCISION, MALIGNANT LESION INCLUDING MARGINS, TRUNK, ARMS, OR LEGS; EXCISED DIAMETER O ProFee",6700064,11606," 1,292.50 ", Surgery-Pro Fee,"11443 EXCISION, OTHER BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWH ProFee",6700065,11443, 656.00 , Surgery-Pro Fee,"10121 INCISION AND REMOVAL OF FOREIGN BODY, SUBCUTANEOUS TISSUES; COMPLICATED ProFee",6700066,10121, 783.00 , Surgery-Pro Fee,"45171 EXCISION OF RECTAL TUMOR, TRANSANAL APPROACH; NOT INCLUDING MUSCULARIS PROPRIA (IE, PA ProFee",6700067,45171," 2,842.50 ", Surgery-Pro Fee,"22902 EXCISION, TUMOR, SOFT TISSUE OF ABDOMINAL WALL, SUBCUTANEOUS; LESS THAN 3 CM ProFee",6700068,22902," 1,818.25 ", Surgery-Pro Fee,"28092 EXCISION OF LESION, TENDON, TENDON SHEATH, OR CAPSULE (INCLUDING SYNOVECTOMY) (EG, CYS ProFee",6700069,28092," 1,605.50 ", Surgery-Pro Fee,"38900 INTRAOPERATIVE IDENTIFICATION (EG, MAPPING) OF SENTINEL LYMPH NODE(S) INCLUDES INJECTI ProFee",6700070,38900, 621.00 , Surgery-Pro Fee,"19125 EXCISION OF BREAST LESION IDENTIFIED BY PREOPERATIVE PLACEMENT OF RADIOLOGICAL MARKER, ProFee",6700071,19125," 2,082.75 ", Surgery-Pro Fee,"19302 MASTECTOMY, PARTIAL (EG, LUMPECTOMY, TYLECTOMY, QUADRANTECTOMY, SEGMENTECTOMY); WITH A ProFee",6700072,19302," 3,765.25 ", Surgery-Pro Fee,"27619 EXCISION, TUMOR, SOFT TISSUE OF LEG OR ANKLE AREA, SUBFASCIAL (EG, INTRAMUSCULAR); LES ProFee",6700074,27619," 2,192.00 ", Surgery-Pro Fee,"21931 EXCISION, TUMOR, SOFT TISSUE OF BACK OR FLANK, SUBCUTANEOUS; 3 CM OR GREATER ProFee",6700075,21931," 2,221.75 ", Surgery-Pro Fee,"11641 EXCISION, MALIGNANT LESION INCLUDING MARGINS, FACE, EARS, EYELIDS, NOSE, LIPS; EXCISED ProFee",6700076,11641, 644.00 , Surgery-Pro Fee,"11400 EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), ProFee",6700077,11400, 311.25 , Surgery-Pro Fee,"11643 EXCISION, MALIGNANT LESION INCLUDING MARGINS, FACE, EARS, EYELIDS, NOSE, LIPS; EXCISED ProFee",6700078,11643, 919.75 , Surgery-Pro Fee,55110 SCROTAL EXPLORATION ProFee,6700079,55110," 1,542.50 ", Surgery-Pro Fee,"10061 INCISION AND DRAINAGE OF ABSCESS (EG, CARBUNCLE, SUPPURATIVE HIDRADENITIS, CUTANEOUS O ProFee",6700080,10061, 715.75 , Surgery-Pro Fee,19300 MASTECTOMY FOR GYNECOMASTIA ProFee,6700081,19300," 2,218.50 ", Surgery-Pro Fee,49565 REPAIR RECURRENT INCISIONAL OR VENTRAL HERNIA; REDUCIBLE ProFee,6700082,49565," 3,802.75 ", Surgery-Pro Fee,"49320 LAPAROSCOPY, ABDOMEN, PERITONEUM, AND OMENTUM, DIAGNOSTIC, WITH OR WITHOUT COLLECTION ProFee",6700083,49320," 2,080.75 ", Surgery-Pro Fee,"11604 EXCISION, MALIGNANT LESION INCLUDING MARGINS, TRUNK, ARMS, OR LEGS; EXCISED DIAMETER 3 ProFee",6700084,11604, 812.75 , Surgery-Pro Fee,"11623 EXCISION, MALIGNANT LESION INCLUDING MARGINS, SCALP, NECK, HANDS, FEET, GENITALIA; EXC ProFee",6700086,11623, 778.75 , Surgery-Pro Fee,"11423 EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), ProFee",6700087,11423, 579.00 , Surgery-Pro Fee,"26115 EXCISION, TUMOR OR VASCULAR MALFORMATION, SOFT TISSUE OF HAND OR FINGER, SUBCUTANEOUS; ProFee",6700088,26115," 1,954.00 ", Surgery-Pro Fee,"11603 EXCISION, MALIGNANT LESION INCLUDING MARGINS, TRUNK, ARMS, OR LEGS; EXCISED DIAMETER 2 ProFee",6700089,11603, 683.75 , Surgery-Pro Fee,"11644 EXCISION, MALIGNANT LESION INCLUDING MARGINS, FACE, EARS, EYELIDS, NOSE, LIPS; EXCISED ProFee",6700090,11644," 1,240.50 ", Surgery-Pro Fee,"27045 EXCISION, TUMOR, SOFT TISSUE OF PELVIS AND HIP AREA, SUBFASCIAL (EG, INTRAMUSCULAR); 5 ProFee",6700092,27045," 3,714.50 ", Surgery-Pro Fee,"44205 LAPAROSCOPY, SURGICAL; COLECTOMY, PARTIAL, WITH REMOVAL OF TERMINAL ILEUM WITH ILEOCOL ProFee",6700093,44205," 5,614.25 ", Surgery-Pro Fee,"19110 NIPPLE EXPLORATION, WITH OR WITHOUT EXCISION OF A SOLITARY LACTIFEROUS DUCT OR A PAPIL ProFee",6700095,19110," 1,662.75 ", Surgery-Pro Fee,"21011 EXCISION, TUMOR, SOFT TISSUE OF FACE OR SCALP, SUBCUTANEOUS; LESS THAN 2 CM ProFee",6700096,21011," 1,375.00 ", Surgery-Pro Fee,"21554 EXCISION, TUMOR, SOFT TISSUE OF NECK OR ANTERIOR THORAX, SUBFASCIAL (EG, INTRAMUSCULAR ProFee",6700097,21554," 3,431.25 ", Surgery-Pro Fee,"11440 EXCISION, OTHER BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWH ProFee",6700098,11440, 360.75 , Surgery-Pro Fee,"11441 EXCISION, OTHER BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWH ProFee",6700099,11441, 446.75 , Surgery-Pro Fee,"45338 SIGMOIDOSCOPY, FLEXIBLE; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY SNA ProFee",6700100,45338," 1,172.25 ", Surgery-Pro Fee,"23075 EXCISION, TUMOR, SOFT TISSUE OF SHOULDER AREA, SUBCUTANEOUS; LESS THAN 3 CM ProFee",6700101,23075, 927.50 , Surgery-Pro Fee,46040 INCISION AND DRAINAGE OF ISCHIORECTAL AND/OR PERIRECTAL ABSCESS (SEPARATE PROCEDURE) ProFee,6700102,46040," 1,828.25 ", Surgery-Pro Fee,"58662 LAPAROSCOPY, SURGICAL; WITH FULGURATION OR EXCISION OF LESIONS OF THE OVARY, PELVIC VI ProFee",6700104,58662," 4,319.75 ", Surgery-Pro Fee,"11421 EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), ProFee",6700105,11421, 395.00 , Surgery-Pro Fee,"26160 EXCISION OF LESION OF TENDON SHEATH OR JOINT CAPSULE (EG, CYST, MUCOUS CYST, OR GANGLI ProFee",6700106,26160," 2,191.00 ", Surgery-Pro Fee,"45005 INCISION AND DRAINAGE OF SUBMUCOSAL ABSCESS, RECTUM ProFee",6700107,45005, 953.75 , Surgery-Pro Fee,"21014 EXCISION, TUMOR, SOFT TISSUE OF FACE AND SCALP, SUBFASCIAL (EG, SUBGALEAL, INTRAMUSCUL ProFee",6700108,21014," 2,495.25 ", Surgery-Pro Fee,"11640 EXCISION, MALIGNANT LESION INCLUDING MARGINS, FACE, EARS, EYELIDS, NOSE, LIPS; EXCISED ProFee",6700110,11640, 520.75 , Surgery-Pro Fee,"27327 EXCISION, TUMOR, SOFT TISSUE OF THIGH OR KNEE AREA, SUBCUTANEOUS; LESS THAN 3 CM ProFee",6700111,27327," 2,078.25 ", Surgery-Pro Fee,"45990 ANORECTAL EXAM, SURGICAL, REQUIRING ANESTHESIA (GENERAL, SPINAL, OR EPIDURAL), DIAGNOS ProFee",6700112,45990, 529.25 , Surgery-Pro Fee,10080 INCISION AND DRAINAGE OF PILONIDAL CYST; SIMPLE ProFee,6700113,10080, 603.25 , Surgery-Pro Fee,64795 BIOPSY OF NERVE ProFee,6700114,64795," 1,140.25 ", Surgery-Pro Fee,"25111 EXCISION OF GANGLION, WRIST (DORSAL OR VOLAR); PRIMARY ProFee",6700115,25111," 1,548.00 ", Surgery-Pro Fee,"45381 COLONOSCOPY, FLEXIBLE; WITH DIRECTED SUBMUCOSAL INJECTION(S), ANY SUBSTANCE ProFee",6700116,45381," 1,789.50 ", Surgery-Pro Fee,"19101 BIOPSY OF BREAST; OPEN, INCISIONAL ProFee",6700117,19101," 1,250.50 ", Surgery-Pro Fee,"19285 PLACEMENT OF BREAST LOCALIZATION DEVICE(S) (EG, CLIP, METALLIC PELLET, WIRE/NEEDLE, RA ProFee",6700118,19285, 923.00 , Surgery-Pro Fee,"47562 LAPAROSCOPY, SURGICAL; CHOLECYSTECTOMY ProFee",6700119,47562," 4,026.50 ", Surgery-Pro Fee,49561 REPAIR INITIAL INCISIONAL OR VENTRAL HERNIA; INCARCERATED OR STRANGULATED ProFee,6700120,49561," 4,532.75 ", Surgery-Pro Fee,"11300 SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, TRUNK, ARMS OR LEGS; LESION DIAM ProFee",6700121,11300, 205.50 , Surgery-Pro Fee,36556 INSERTION OF NON-TUNNELED CENTRALLY INSERTED CENTRAL VENOUS CATHETER; AGE 5 YEARS OR O ProFee,6700122,36556, 817.25 , Surgery-Pro Fee,"44388 COLONOSCOPY THROUGH STOMA; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING ProFee",6700123,44388," 1,316.50 ", Surgery-Pro Fee,"69110 EXCISION EXTERNAL EAR; PARTIAL, SIMPLE REPAIR ProFee",6700124,69110," 1,659.50 ", Surgery-Pro Fee,"10140 INCISION AND DRAINAGE OF HEMATOMA, SEROMA OR FLUID COLLECTION ProFee",6700127,10140, 440.00 , Surgery-Pro Fee,"49525 REPAIR INGUINAL HERNIA, SLIDING, ANY AGE ProFee",6700128,49525," 3,123.50 ", Surgery-Pro Fee,"10160 PUNCTURE ASPIRATION OF ABSCESS, HEMATOMA, BULLA, OR CYST ProFee",6700129,10160, 378.50 , Surgery-Pro Fee,"21933 EXCISION, TUMOR, SOFT TISSUE OF BACK OR FLANK, SUBFASCIAL (EG, INTRAMUSCULAR); 5 CM OR ProFee",6700130,21933," 3,490.75 ", Surgery-Pro Fee,"38505 BIOPSY OR EXCISION OF LYMPH NODE(S); BY NEEDLE, SUPERFICIAL (EG, CERVICAL, INGUINAL, A ProFee",6700132,38505, 465.50 , Surgery-Pro Fee,"11444 EXCISION, OTHER BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWH ProFee",6700133,11444, 819.50 , Surgery-Pro Fee,"11462 EXCISION OF SKIN AND SUBCUTANEOUS TISSUE FOR HIDRADENITIS, INGUINAL; WITH SIMPLE OR IN ProFee",6700134,11462," 1,203.25 ", Surgery-Pro Fee,"11201 REMOVAL OF SKIN TAGS, MULTIPLE FIBROCUTANEOUS TAGS, ANY AREA; EACH ADDITIONAL 10 LESIO ProFee",6700137,11201, 71.75 , Surgery-Pro Fee,19000 PUNCTURE ASPIRATION OF CYST OF BREAST; ProFee,6700138,19000, 393.75 , Surgery-Pro Fee,"46922 DESTRUCTION OF LESION(S), ANUS (EG, CONDYLOMA, PAPILLOMA, MOLLUSCUM CONTAGIOSUM, HERPE ProFee",6700139,46922, 933.00 , Surgery-Pro Fee,10081 INCISION AND DRAINAGE OF PILONIDAL CYST; COMPLICATED ProFee,6700140,10081," 1,106.00 ", Surgery-Pro Fee,11770 EXCISION OF PILONIDAL CYST OR SINUS; SIMPLE ProFee,6700141,11770," 1,072.00 ", Surgery-Pro Fee,"27618 EXCISION, TUMOR, SOFT TISSUE OF LEG OR ANKLE AREA, SUBCUTANEOUS; LESS THAN 3 CM ProFee",6700142,27618," 1,623.25 ", Surgery-Pro Fee,"21552 EXCISION, TUMOR, SOFT TISSUE OF NECK OR ANTERIOR THORAX, SUBCUTANEOUS; 3 CM OR GREATER ProFee",6700143,21552," 2,072.75 ", Surgery-Pro Fee,"21557 RADICAL RESECTION OF TUMOR (EG, SARCOMA), SOFT TISSUE OF NECK OR ANTERIOR THORAX; LESS ProFee",6700144,21557," 4,551.25 ", Surgery-Pro Fee,"27047 EXCISION, TUMOR, SOFT TISSUE OF PELVIS AND HIP AREA, SUBCUTANEOUS; LESS THAN 3 CM ProFee",6700145,27047," 2,267.00 ", Surgery-Pro Fee,"28043 EXCISION, TUMOR, SOFT TISSUE OF FOOT OR TOE, SUBCUTANEOUS; LESS THAN 1.5 CM ProFee",6700146,28043," 1,380.50 ", Surgery-Pro Fee,"25071 EXCISION, TUMOR, SOFT TISSUE OF FOREARM AND/OR WRIST AREA, SUBCUTANEOUS; 3 CM OR GREAT ProFee",6700147,25071," 1,681.50 ", Surgery-Pro Fee,11772 EXCISION OF PILONIDAL CYST OR SINUS; COMPLICATED ProFee,6700148,11772," 2,604.50 ", Surgery-Pro Fee,"19084 BIOPSY, BREAST, WITH PLACEMENT OF BREAST LOCALIZATION DEVICE(S) (EG, CLIP, METALLIC PE ProFee",6700149,19084," 1,391.75 ", Surgery-Pro Fee,"19281 PLACEMENT OF BREAST LOCALIZATION DEVICE(S) (EG, CLIP, METALLIC PELLET, WIRE/NEEDLE, RA ProFee",6700150,19281, 639.50 , Surgery-Pro Fee,55040 EXCISION OF HYDROCELE; UNILATERAL ProFee,6700151,55040," 1,587.75 ", Surgery-Pro Fee,20103 EXPLORATION OF PENETRATING WOUND (SEPARATE PROCEDURE); EXTREMITY ProFee,6700152,20103," 2,420.00 ", Surgery-Pro Fee,"23065 BIOPSY, SOFT TISSUE OF SHOULDER AREA; SUPERFICIAL ProFee",6700153,23065, 295.75 , Surgery-Pro Fee,"55000 PUNCTURE ASPIRATION OF HYDROCELE, TUNICA VAGINALIS, WITH OR WITHOUT INJECTION OF MEDIC ProFee",6700154,55000, 452.25 , Surgery-Pro Fee,"22903 EXCISION, TUMOR, SOFT TISSUE OF ABDOMINAL WALL, SUBCUTANEOUS; 3 CM OR GREATER ProFee",6700155,22903," 2,058.75 ", Surgery-Pro Fee,"27329 RADICAL RESECTION OF TUMOR (EG, SARCOMA), SOFT TISSUE OF THIGH OR KNEE AREA; LESS THAN ProFee",6700156,27329," 6,653.75 ", Surgery-Pro Fee,"11621 EXCISION, MALIGNANT LESION INCLUDING MARGINS, SCALP, NECK, HANDS, FEET, GENITALIA; EXC ProFee",6700157,11621, 554.75 , Surgery-Pro Fee,19001 PUNCTURE ASPIRATION OF CYST OF BREAST; EACH ADDITIONAL CYST (LIST SEPARATELY IN ADDITI ProFee,6700158,19001, 155.75 , Surgery-Pro Fee,"21555 EXCISION, TUMOR, SOFT TISSUE OF NECK OR ANTERIOR THORAX, SUBCUTANEOUS; LESS THAN 3 CM ProFee",6700159,21555," 1,655.25 ", Surgery-Pro Fee,"11626 EXCISION, MALIGNANT LESION INCLUDING MARGINS, SCALP, NECK, HANDS, FEET, GENITALIA; EXC ProFee",6700160,11626," 1,365.00 ", Surgery-Pro Fee,"11624 EXCISION, MALIGNANT LESION INCLUDING MARGINS, SCALP, NECK, HANDS, FEET, GENITALIA; EXC ProFee",6700161,11624," 1,004.75 ", Surgery-Pro Fee,"54520 ORCHIECTOMY, SIMPLE (INCLUDING SUBCAPSULAR), WITH OR WITHOUT TESTICULAR PROSTHESIS, SC ProFee",6700162,54520," 1,573.50 ", Surgery-Pro Fee,"11450 EXCISION OF SKIN AND SUBCUTANEOUS TISSUE FOR HIDRADENITIS, AXILLARY; WITH SIMPLE OR IN ProFee",6700163,11450," 1,209.75 ", Surgery-Pro Fee,"28750 ARTHRODESIS, GREAT TOE; METATARSOPHALANGEAL JOINT ProFee",6700164,28750," 2,801.00 ", Surgery-Pro Fee,"46221 HEMORRHOIDECTOMY, INTERNAL, BY RUBBER BAND LIGATION(S) ProFee",6700165,46221, 870.00 , Surgery-Pro Fee,"45382 COLONOSCOPY, FLEXIBLE; WITH CONTROL OF BLEEDING, ANY METHOD ProFee",6700166,45382," 2,047.00 ", Surgery-Pro Fee,"45384 COLONOSCOPY, FLEXIBLE; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY HOT B ProFee",6700167,45384," 1,957.00 ", Surgery-Pro Fee,"46255 HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, SINGLE COLUMN/GROUP; ProFee",6700168,46255," 1,816.00 ", Surgery-Pro Fee,"46260 HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, 2 OR MORE COLUMNS/GROUPS; ProFee",6700169,46260," 2,163.00 ", Surgery-Pro Fee,"46945 HEMORRHOIDECTOMY, INTERNAL, BY LIGATION OTHER THAN RUBBER BAND; SINGLE HEMORRHOID COLU ProFee",6700170,46945," 1,030.00 ", Surgery-Pro Fee,"46946 HEMORRHOIDECTOMY, INTERNAL, BY LIGATION OTHER THAN RUBBER BAND; 2 OR MORE HEMORRHOID C ProFee",6700171,46946," 1,145.00 ", Surgery-Pro Fee,"64488 TRANSVERSUS ABDOMINIS PLANE (TAP) BLOCK (ABDOMINAL PLANE BLOCK, RECTUS SHEATH BLOCK) B ProFee",6700172,64488," 1,539.00 ", Surgery-Pro Fee,"46600 ANOSCOPY; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN ProFee",6700173,46600, 327.00 , Surgery-Pro Fee,"43250 ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH REMOVAL OF TUMOR(S), POLYP(S), O ProFee",6700174,43250," 1,618.00 ", Surgery-Pro Fee,46948 HEMORRHOIDECTOMY BY TRANSANAL DEARTERIALIZATION ProFee,6700175,46948," 2,163.00 ", Surgery-Pro Fee,"55700 BIOPSY, PROSTATE; NEEDLE OR PUNCH, SINGLE OR MULTIPLE, ANY APPROACH ProFee",6850004,55700, 832.50 , Surgery-Pro Fee,"52310 CYSTOURETHROSCOPY, WITH REMOVAL OF FOREIGN BODY, CALCULUS, OR URETERAL STENT FROM URET ProFee",6850005,52310," 1,336.50 ", Surgery-Pro Fee,54162 LYSIS OR EXCISION OF PENILE POST-CIRCUMCISION ADHESIONS ProFee,6850006,54162, 850.25 , Surgery-Pro Fee,"54840 EXCISION OF SPERMATOCELE, WITH OR WITHOUT EPIDIDYMECTOMY ProFee",6850007,54840," 1,468.75 ", Surgery-Pro Fee,"52281 CYSTOURETHROSCOPY, WITH CALIBRATION AND/OR DILATION OF URETHRAL STRICTURE OR STENOSIS, ProFee",6850008,52281," 1,432.25 ", Surgery-Pro Fee,"55250 VASECTOMY, UNILATERAL OR BILATERAL (SEPARATE PROCEDURE), INCLUDING POSTOPERATIVE SEMEN ProFee",6850009,55250," 1,528.50 ", Surgery-Pro Fee,"43235 ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; DIAGNOSTIC, INCLUDING COLLECTION OF S ProFee",6850010,43235," 1,102.50 ", Surgery-Pro Fee,"43239 ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH BIOPSY, SINGLE OR MULTIPLE ProFee",6850011,43239," 1,369.50 ", Surgery-Pro Fee,"43246 ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH DIRECTED PLACEMENT OF PERCUTANEO ProFee",6850012,43246," 1,365.00 ", Surgery-Pro Fee,"43251 ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH REMOVAL OF TUMOR(S), POLYP(S), O ProFee",6850014,43251," 1,557.00 ", Surgery-Pro Fee,"43255 ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH CONTROL OF BLEEDING, ANY METHOD ProFee",6850015,43255," 1,510.50 ", Surgery-Pro Fee,"45300 PROCTOSIGMOIDOSCOPY, RIGID; DIAGNOSTIC, WITH OR WITHOUT COLLECTION OF SPECIMEN(S) BY B ProFee",6850021,45300, 428.00 , Surgery-Pro Fee,"45385 COLONOSCOPY, FLEXIBLE; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY SNARE ProFee",6850027,45385," 2,123.75 ", Surgery-Pro Fee,52000 CYSTOURETHROSCOPY (SEPARATE PROCEDURE) ProFee,6850028,52000, 961.75 , Surgery-Pro Fee,G0121 SCRN COLONOSCOPY PT NOT H ProFee,6850029,G0121," 1,586.75 ", Surgery-Pro Fee,"G0105 COLONOSCOPY SCREEN, HIGH RISK ProFee",6850030,G0105," 1,586.75 ", Surgery-Pro Fee,"11420 EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), ProFee",6850031,11420, 318.75 , Surgery-Pro Fee,"44380 ILEOSCOPY, THROUGH STOMA; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING ProFee",6850032,44380, 576.75 , Surgery-Tech Fee,Incision and Drainage Abscess Simple,1200002,,," 1,134.00 " Surgery-Tech Fee,Incision and Drainage Abscess Complex,1200003,,," 2,335.50 " Surgery-Tech Fee,Amputation,1200004,,," 2,099.50 " Surgery-Tech Fee,Biopsy Artery Temporal,1200007,,," 1,785.75 " Surgery-Tech Fee,Needle Localization Breast,1200008,,," 2,469.25 " Surgery-Tech Fee,Biopsy Breast,1200009,,," 1,785.75 " Surgery-Tech Fee,Lumpectomy Breast,1200010,,," 2,797.25 " Surgery-Tech Fee,Excision Chalazion,1200011,,," 1,753.00 " Surgery-Tech Fee,Debridement Subcutaneous Tissue,1200013,,," 1,589.75 " Surgery-Tech Fee,Debridement,1200014,,," 2,480.00 " Surgery-Tech Fee,Repair Eyelid,1200015,,," 1,631.00 " Surgery-Tech Fee,Biopsy Simple,1200016,,," 1,870.50 " Surgery-Tech Fee,Biopsy Complex,1200017,,," 2,480.00 " Surgery-Tech Fee,Biopsy Lymph Node,1200018,,," 1,873.25 " Surgery-Tech Fee,Excision Simple,1200019,,," 2,151.00 " Surgery-Tech Fee,Excision Complex,1200020,,," 2,853.00 " Surgery-Tech Fee,Removal Foreign Body Simple SURG,1200021,,," 1,589.75 " Surgery-Tech Fee,Removal Foreign Body Complex,1200022,,," 2,480.00 " Surgery-Tech Fee,Hemorrhoidectomy,1200023,,," 8,760.00 " Surgery-Tech Fee,Repair Wound Complex,1200026,,," 3,715.00 " Surgery-Tech Fee,Meatotomy,1200027,,," 2,769.75 " Surgery-Tech Fee,Excision Cyst Pilonidal,1200030,,," 2,684.75 " Surgery-Tech Fee,Application Skin Graft,1200031,,," 2,792.75 " Surgery-Tech Fee,Repair Tendon,1200032,,," 2,792.75 " Surgery-Tech Fee,Vasectomy,1200033,,," 3,303.25 " Surgery-Tech Fee,Removal Toenail,1200034,,," 1,407.75 " Surgery-Tech Fee,Appendectomy,1200036,,," 3,242.75 " Surgery-Tech Fee,Appendectomy Laparoscopy,1200037,,," 9,491.50 " Surgery-Tech Fee,Bunionectomy Complex,1200039,,," 9,373.50 " Surgery-Tech Fee,Arthroscopy Simple,1200040,,," 4,189.00 " Surgery-Tech Fee,Arthroscopy Complex,1200041,,," 5,304.75 " Surgery-Tech Fee,Intraocular Lens - Custom,1200043,,, 806.00 Surgery-Tech Fee,Intraocular Lens - Standard,1200043,,, 806.00 Surgery-Tech Fee,Insertion Implant Ocular,1200044,,," 3,756.00 " Surgery-Tech Fee,Vitrectomy,1200045,,," 4,803.00 " Surgery-Tech Fee,Cholecystectomy Laparoscopy,1200048,,," 8,819.50 " Surgery-Tech Fee,Repair Pelvic Prolapse,1200049,,," 6,470.25 " Surgery-Tech Fee,Closed Reduction with Casting,1200051,,," 1,792.75 " Surgery-Tech Fee,Application Cast,1200052,,, 349.00 Surgery-Tech Fee,Colostomy Closure,1200053,,," 4,160.25 " Surgery-Tech Fee,Repair Hammer Toe,1200055,,," 6,328.50 " Surgery-Tech Fee,Repair Hernia Laparoscopic,1200056,,," 15,505.50 " Surgery-Tech Fee,Repair Hernia Complex,1200058,,," 9,565.50 " Surgery-Tech Fee,Insertion Venous Access Port,1200062,,," 4,252.25 " Surgery-Tech Fee,Removal Venous Access Port,1200063,,," 1,179.25 " Surgery-Tech Fee,Diagnostic Laparoscopy,1200064,,," 6,045.25 " Surgery-Tech Fee,Disection Lymph Node Simple,1200066,,," 3,322.00 " Surgery-Tech Fee,Implantation Metatarsal Joint,1200067,,," 5,555.25 " Surgery-Tech Fee,Excision Neuroma,1200069,,," 3,715.00 " Surgery-Tech Fee,Orchiectomy,1200071,,," 5,650.25 " Surgery-Tech Fee,Orchiopexy,1200072,,," 6,501.25 " Surgery-Tech Fee,Open Reduction Internal Fixation Ankle,1200073,,," 21,000.00 " Surgery-Tech Fee,Open Reduction Internal Fixation Patella,1200074,,," 12,089.75 " Surgery-Tech Fee,Removal Hardware,1200075,,," 3,564.75 " Surgery-Tech Fee,Repair Testicular Torsion,1200077,,," 3,466.75 " Surgery-Tech Fee,Tracheostomy,1200078,,," 2,360.25 " Surgery-Tech Fee,Ligation Tubal,1200080,,," 3,817.75 " Surgery-Tech Fee,Repair Fistula Vagina,1200081,,," 2,929.50 " Surgery-Tech Fee,Bowel Resection,1200083,,," 5,199.75 " Surgery-Tech Fee,Resection Colon,1200084,,," 5,431.50 " Surgery-Tech Fee,Mastectomy Simple,1200085,,," 11,025.00 " Surgery-Tech Fee,Lysis Adhesions,1200086,,," 3,474.25 " Surgery-Tech Fee,Colostomy,1200089,,," 4,507.00 " Surgery-Tech Fee,Cholecystectomy,1200090,,," 4,420.00 " Surgery-Tech Fee,Laparotomy Exploratory,1200091,,," 4,585.50 " Surgery-Tech Fee,Disection Lymph Node Radical,1200092,,," 5,319.50 " Surgery-Tech Fee,Repair Ulcer Peptic,1200093,,," 5,027.00 " Surgery-Tech Fee,Carpal Tunnel Release,1200094,,," 7,684.50 " Surgery-Tech Fee,Pterygium,1200096,,," 1,679.75 " Surgery-Tech Fee,Circumcision,1200097,,," 4,405.75 " Surgery-Tech Fee,Minor Surgical Procedure,1200101,,, 462.75 Surgery-Tech Fee,Sling Operation,1200102,,," 6,249.50 " Surgery-Tech Fee,Removal Sling,1200103,,," 6,249.50 " Surgery-Tech Fee,Application Cast Lower Extremity,1200105,,, 161.00 Surgery-Tech Fee,Repair Tendon Lower Extremity,1200107,,," 3,110.75 " Surgery-Tech Fee,Insertion Central Venous Line,1200109,,," 2,480.00 " Surgery-Tech Fee,Cauterization Condyloma,1200110,,," 2,161.75 " Surgery-Tech Fee,Excision Cyst Ganglion,1200111,,," 7,665.00 " Surgery-Tech Fee,Probing Lacrimal Structure,1200112,,," 1,133.50 " Surgery-Tech Fee,Release Tarsal Tunnel,1200116,,," 2,869.50 " Surgery-Tech Fee,Fasciotomy Plantar,1200117,,," 3,354.75 " Surgery-Tech Fee,Injection Intermediate Joint,1200120,20605,, 385.50 Surgery-Tech Fee,Release Tendon Upper Extremity,1200121,,," 3,211.25 " Surgery-Tech Fee,Colonoscopy Biopsy,1200129,,," 3,151.00 " Surgery-Tech Fee,Colonoscopy Polypectomy,1200132,,," 3,151.00 " Surgery-Tech Fee,Sigmoidoscopy Flexible,1200133,,," 1,485.00 " Surgery-Tech Fee,Sigmoidoscopy Flexible Ablation Lesion,1200135,,," 2,220.50 " Surgery-Tech Fee,Esophagogastroduodenoscopy Biopsy,1200139,,," 2,424.50 " Surgery-Tech Fee,Esophagogastroduodenoscopy Peg Tube Insertion,1200148,,," 2,456.25 " Surgery-Tech Fee,Esophagogastroduodenoscopy Gastrotomy Tube Change,1200150,,," 2,470.50 " Surgery-Tech Fee,Organ Harvest,1200159,,, 757.25 Surgery-Tech Fee,Removal Foreign Body Pin,1200165,,," 3,313.75 " Surgery-Tech Fee,Extraction Cataract,1200168,,," 4,968.00 " Surgery-Tech Fee,Fistulotomy,1200171,,," 6,104.50 " Surgery-Tech Fee,Excision Lesion Eyelid,1200173,,," 1,631.00 " Surgery-Tech Fee,Colonoscopy,1202200,,," 4,862.25 " Surgery-Tech Fee,Esophagogastroduodenoscopy,1202201,,," 4,254.50 " Surgery-Tech Fee,Cystourethroscopy,1202205,,," 5,069.00 " Surgery-Tech Fee,Hydrocoelectomy,1202206,,," 6,501.25 " Surgery-Tech Fee,Release Trigger Finger,1202207,,," 6,350.50 " Surgery-Tech Fee,Repair Spermatocele,1202208,,," 3,301.75 " Surgery-Tech Fee,Arthroplasty Digit,1202209,,," 4,374.50 " Surgery-Tech Fee,Arthroscopy Shoulder Simple,1202210,,," 8,709.75 " Surgery-Tech Fee,Arthroscopy Shoulder,1202211,,," 10,330.50 " Surgery-Tech Fee,Arthroscopy Shoulder Complex,1202212,,," 12,854.25 " Surgery-Tech Fee,Examination Under Anesthesia,1202213,,, 608.00 Surgery-Tech Fee,Arthroscopy Knee Simple,1202214,,," 11,686.50 " Surgery-Tech Fee,Arthroscopy Knee,1202215,,," 14,575.25 " Surgery-Tech Fee,Arthroscopy Knee Complex,1202216,,," 16,438.50 " Surgery-Tech Fee,Arthroscopy Hip,1202217,,," 16,703.00 " Surgery-Tech Fee,Cubital Tunnel Release,1202218,,," 8,235.75 " Surgery-Tech Fee,Open Reduction Internal Fixation Digit,1202220,,," 5,788.25 " Surgery-Tech Fee,Open Reduction Internal Fixation Radius,1202226,,," 18,081.00 " Surgery-Tech Fee,Application Wound Vac Lower Extremity,1202227,,, 504.50 Surgery-Tech Fee,Mastectomy Modified Radical,1202227,,," 19,425.00 " Surgery-Tech Fee,Cholecystectomy Open,1202228,,," 12,075.00 " Surgery-Tech Fee,Lymphadenectomy Inguinal,1202228,,," 7,800.00 " Surgery-Tech Fee,Debridement Finger,1202229,,," 4,725.00 " Surgery-Tech Fee,Lymphadenectomy Head/Neck,1202229,,," 7,950.00 " Surgery-Tech Fee,Release Contracture De Quervains,1204003,,," 8,085.00 " Surgery-Tech Fee,Sclerotomy Laser,1204004,,," 3,675.00 " Surgery-Tech Fee,Dupuytrens Contracture Release,1204005,,," 8,400.00 " Surgery-Tech Fee,Repair Achilles Tendon,1205001,,," 11,156.25 " Surgery-Tech Fee,Repair Great Toe Fracture,1205002,,," 11,116.50 " Surgery-Tech Fee,Open Reduction Internal Fixation Calcaneus,1205003,,," 19,494.50 " Surgery-Tech Fee,Metatarsal Head Resection,1205004,,," 7,546.50 " Surgery-Tech Fee,Destruction of Internal Hemorrhoid by Thermal Energy,1205005,,," 4,337.75 " Surgery-Tech Fee,Ligament Repair Ankle,1205006,,," 12,561.25 " Surgery-Tech Fee,Recession Gastrocnemius,1205007,,," 8,400.00 " Surgery-Tech Fee,Open Reduction Internal Fixation Tibia,1205008,,," 14,752.50 " Surgery-Tech Fee,Arthrotomy Ankle,1205009,,," 9,077.25 " Surgery-Tech Fee,Arthroscopy Ankle,1205010,,," 9,533.00 " Surgery-Tech Fee,Hemorrhoid Banding,1205011,,," 1,983.50 " Surgery-Tech Fee,Sphincterotomy,1205012,,," 7,000.00 " Surgery-Tech Fee,Fissurectomy Anus,1205013,,," 7,000.00 " ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,, ,,,,,