chrg# cdsc cdept csrv cupr crev# 3095 med/surg, semi ... - CT.gov

CHRG# CDSC CDEPT CSRV CUPR CREV# 

3095 MED/SURG, SEMI-PRIVATE 121 1178 0 3090 

3111 INFLUENZA VIRUS INJ ADMIN 771 0 62.73 3090 

3129 PNEUMONIA INJECTION ADMIN 771 0 62.73 3090 

3202 PSYCHIATRIC UNIT 124 1714.44 0 3200 

3251 PSYCHIATRIC EXEMPT UNIT 124 1714.44 0 3200 

3400 ICU, SEMI-PRIVATE 200 2356 0 3400 

3418 INFLUENZA VIRUS INJECTION ADMIN 771 0 62.73 3400 

3426 PNEUMONIA INJECTION ADMIN 771 0 62.73 3400 

3467 OB/GYN, SEMI-PRIVATE 121 1178 0 3460 

3509 NURSERY 170 1267.5 0 3500 

7716 HC HOSPICE 0 0 7620 

23408 ITEL, SEMI-PRIVATE 121 1178 0 3140 

100040 OPERATING ROOM 1ST 1/2 HR, 1 PERSON 360 0 1506.38 3600 

100057 OR EA ADDL 15 MIN, 1 PERSON 360 0 173.82 3600 

100099 OPERATING ROOM 1ST 1/2 HR, 2 PEOPLE 360 0 3012.75 3600 

100107 OR EA ADDL 15 MIN, 2 PEOPLE 360 0 347.63 3600 

100115 SHAPE MATCH TECHNOLOGY FEES 360 0 2500 3600 

100123 CRYOSURGERY TECHNICAL FEES 360 0 2578.13 3600 

100131 HOLMIUM LASER TECH FEES 360 0 1437.5 3600 

100149 OPERATING ROOM 1ST 1/2 HR, 3 PEOPLE 360 0 4519.13 3600 

100156 OR EA ADDL 15 MIN, 3 PEOPLE 360 0 521.44 3600 

100172 LASER ABLATION TECHNICAL FEES 360 0 1750 3600 

100180 ESWL TECHNICAL FEE 360 0 4300 3600 

100198 HOLMIUM LASER STAND BY FEE 360 0 350 3600 

101006 PROC DISCONT WO ANES 360 0 772.5 3600 

101014 PROC DISCONT W/ANES 360 0 1390.5 3600 

200055 RECOVERY ROOM 1ST 15MIN 710 0 286.8 3650 

200063 RECOVERY ROOM EA ADD'L 15MIN 710 0 78.22 3650 

300038 DELIVERY ROOM 720 0 2417.53 3510 

300053 OR C-SECTION EA ADDL 15MIN,1 PERSON 722 0 200.85 3510 

300061 OR C-SECTION 1ST 1/2 HR, 2 PEOPLE 722 0 2549.25 3510 

300079 PACU-MCH/15 MIN 710 0 191.19 3510 

300087 OR C-SECTION EA ADDL 15MIN, 2PEOPLE 722 0 424.88 3510 

300111 AMNIOCENTESIS 720 0 505.35 3510 

300129 OR C SECTION TWINS 1ST 1/2 HR,2 PEO 722 0 2502.9 3510 

300137 OR CSECTION TWINS EA ADD 15 MIN 2PE 722 0 208.58 3510 

300418 FETAL NON STRESS TEST 920 0 380.71 3510 

300558 NEWBORN HEARING SCRN 470 0 548.49 3510 

300665 CIRCUMCISION 723 0 1031.25 3510 

300707 CATH OF UMBILICAL 720 0 64.38 3510 

300798 ARTERIAL BLOOD DRAW 300 0 40.9 3510 

300806 COLLECTION-CAPILLARY 300 0 26.33 3510 

300814 VERSION 720 0 3331.15 3510 

300822 PKU SCREEN 300 0 71.84 3510 

300830 CYSTIC FIBROSIS TEST 300 0 29.39 3510 

300855 TRANS BILI CHECK 310 0 28.33 3510

300905 IMMUN ADMIN INJ 30 MIN 940 0 158.36 3090 

400127 MED/SURG IV THERAPY ADD'L HR 260 0 72.85 3090 

400135 MED/SURG IV THERAPY 1ST HR 260 0 377.53 3090 

400143 MED/SURG IV TX ADD'L SQ < 1 HR 260 0 229.6 3090 

400150 MED/SURG IV TX CONCURR INF 260 0 77.84 3090 

400168 MED/SURG CATH URETHRA SMPL 761 0 125.74 3090 

400176 MED SURG INSER TEMP FOLEY CATH 761 0 361.94 3090 

400184 MED/SURG CMPT CATH/BALLOON 761 0 171.8 3090 

400192 MED/SURG TRNSFSN BLOOD/COMPT 391 0 828.41 3090 

400200 MED/SURG INJECTION SC, IM 940 0 92.46 3090 

400218 MED/SURG OBSERVATION BLOOD ADMIN 391 0 828.41 3090 

400226 MED/SURG NON BILLABLE OBS PER HR 099 0 0 3090 

400259 MED/SURG FLOOR RECOVERY PER HOUR 710 0 45.32 3090 

410092 ITEL OBSERVATION PER HOUR 762 0 75 3140 

410100 ITEL DIRECT OBSERVATION PER UNIT 762 0 1279.42 3140 

411116 ITEL IV TX HYDRATION 31 TO 60 MIN 260 0 229.52 3140

411124 ITEL IV TX HYDRA ADD'L HOUR 260 0 202.49 3140 

411132 ITEL IV PUSH INITIAL 940 0 194.78 3140 

411140 ITEL IVP EA ADD'L SEQ 940 0 177.54 3140 

411157 ITEL IVP SEQ SAME DRUG>30 MIN 940 0 158.36 3140 

411165 ITEL IV THERAPY ADD'L HR 260 0 72.85 3140 

411173 ITEL IV THERAPY 1ST HR 260 0 377.53 3140 

411181 ITEL IV TX ADD'L SQ 30 MIN 940 0 158.36 3400 

420083 ICU IV THERAPY ADD'L HR 260 0 72.85 3400 

420091 ICU IV THERAPY 1ST HR 260 0 377.53 3400 

420109 ICU IV TX ADD'L SQ 30 MIN 940 0 158.36 3460 

430074 MCH IV THERAPY ADD'L HR 260 0 72.85 3460 

430082 MCH IV THERAPY 1ST HR 260 0 377.53 3460 

430090 MCH IV TX ADD'L SQ < 1 HR 260 0 229.6 3460 

430108 MCH IV TX CONCURR INF 260 0 77.84 3460 

430116 MCH INJECTION SC, IM 940 0 92.46 3460 

430124 MCH NON BILLABLE OBSERVATION PER/HR 099 0 0 3460 

440016 PSYCHIATRIC OBSERVATION PER HOUR 762 0 81 3200 

440024 PSYCHIATRIC NON BILLABLE OBSERV HRS 099 0 0 3200 

500058 ACU-E&M LEVEL 1 761 0 108.14 3720 

500108 ACU-E&M LEVEL 2 761 0 161.13 3720

500157 ACU-E&M LEVEL 3 761 0 201.09 3720 

500207 ACU-E&M LEVEL 4 761 0 282.3 3720 

500553 ACU-SPEC PROC RM 1 HR 361 0 750 3720 

500751 PROC DISCONT WO ANES 361 0 378.36 3720 


501759 ISCHEMIC EXER TEST 740 0 139.97 3720 

501817 PORT OR PICC FLUSH ONLY 940 0 160.86 3720 

501908 PICC LINE INSERTION 761 0 2277.17 3720 

502005 VISIT 1 IV THER INIT 260 0 377.53 3720 

502013 VISIT1 IV TX ADD HRS 260 0 72.85 3720 


502104 VISIT2 IV TX ADD HRS 260 0 72.85 3720 


502252 IV TX HYDRAT 31-60 MIN 260 0 229.52 3720 

502260 IV TX HYDRA ADD'L HR 260 0 74.73 3720 

502500 INJECTION SC,IM 940 0 74.34 3720 

502559 POSTOP INJECT SC, IM 940 0 74.34 3720 

502609 IV PUSH INITIAL 940 0 112.06 3720 

502658 IVP EA ADD'L SEQ 940 0 112.56 3720 

502708 POSTOP IVP INITIAL 940 0 112.06 3720 

502716 POSTOP IVP AD'L SEQ 940 0 112.56 3720 

502757 VACCINE INJ 940 0 77.55 3720 

502781 DECLOTTING CENTRAL LINES 260 0 329.09 3720 

502799 VENOUS DRAW THROUGH PORT 761 0 101.75 3720 

502856 BLOOD DRAW THRU CENTRAL LINE 260 0 93.6 3720 

502898 CATHFLO ACTIVASE OF HI-TECH LINES 260 0 329.09 3720 

502906 ACU FLOOR RECOVERY PER HOUR 710 0 45.32 3720 

503003 BLOOD ADMIN-ACU 391 0 828.41 3720 

503052 PHLEBOTOMY 940 0 124.36 3720 

503102 AUTOL. BLOOD TRANSF. 300 0 0 3720 

503201 INJ EPIDU/BLOOD CLOT 761 0 614.57 3720 

504001 RECOVERY ROOM/15 MIN 710 0 69.85 3720 

504043 IMMUNOTHERAPY INJECTION 940 0 83.16 3720 

504050 PARA/THORACENTESIS 361 0 898.18 3720 

504068 LUMBAR PUNCTURE-SPINAL TAP 361 0 614.57 3720 

504100 EPIDURAL L SPINE INJECTION 361 0 2125.42 3720 

504118 H1N1 IMMUN ADMIN 771 0 54.99 3720 

504134 NERVE/JOINT INJECT 1 SITE 361 0 2200 3720 

504142 NERVE/JOINT INJECT 2 SITES 361 0 2400 3720 


504167 NERVE/JOINT INJECTION 4 SITES 361 0 2800 3720 



580050 CANCELLED N/C 940 0 0 3720 

580100 NO SHOW N/C 940 0 0 3720 

590018 ENDO VISIT 999 0 0 3720 

590026 IV THERAPY VISIT 999 0 0 3720

590034 ACU VISIT 999 0 0 3720 

590042 ENDO DUAL VISIT 999 0 0 3720 

600106 SPEC PROC RM PM 1 HR 761 0 401.7 3720 

690065 OMNIPAQUE 240 PER ML 255 0 4.25 3720 

700054 CONSULT RET GI N/C 510 0 0 3710 

700104 CONSULT INT GI N/C 510 0 0 3710 

700203 PROC DISCONT WO ANES 099 0 0 3710 


700229 COLONOSCOPY 750 0 2219.71 3710 

700237 GASTROSCOPY 750 0 2136.79 3710 

700245 BRONCHOSCOPY 761 0 2060.81 3710 

700252 LARYNGOSCOPY 361 0 2150.34 3710 

700260 TEE PROBE 361 0 0 3710 

700278 SIGMOIDOSCOPY 750 0 945.16 3710 

700286 POLYPECTOMY 750 0 1068.4 3710 

700294 PORT OR PICC FLUSH ONLY 940 0 160.86 3710 


700310 IVP EA ADD'L SEQ 940 0 112.56 3710 

700328 POSTOP IVP INITIAL 940 0 112.06 3710 

700336 POSTOP IVP AD'L SEQ 940 0 106.42 3710 

700344 ACU FLOOR RECOVERY PER HOUR 710 0 45.32 3710 

700351 BLOOD ADMIN GASTRO 391 0 828.41 3710 

700393 G TUBE REPLACEMENT 361 0 804.77 3710 

700401 PEG BUTTON CHANGE 361 0 687.84 3710 

700419 PILL CAM ENDOSCOPY 750 0 2737.5 3710 

700427 CANCELLED N/C 940 0 0 3710 

700435 NO SHOW N/C 940 0 0 3710 

700443 ENDO VISIT 999 0 0 3710 


700468 BONE MARROW ASPIRATION 360 0 589.83 3710 

800060 E&M EST PATIENT (BRIEF) 761 0 108.14 3730 

800078 E&M EST PATIENT(LIMITED) 761 0 161.13 3730 

800086 E&M EST PATIENT(INTERMEDIATE) 761 0 201.09 3730 

800094 E&M EST PATIENT(EXTENDED) 761 0 282.3 3730 

800102 E&M EST PATIENT(COMPLEX) 761 0 384.27 3730 

800136 SKIN TAG REMOVAL = 15 LESIONS 761 0 161.12 3730 

800144 SKIN TAG REMOVAL EA ADDL 10 LESIONS 761 0 155.41 3730 

800151 UNNA BOOT 761 0 199.64 3730 

800169 SELECTIVE DEBRIDEMENT 20 CM 761 0 870.92 3730 

800185 NON SELECTIVE DEBRIDEMENT 761 0 118.98 3730 

800193 ART DOPPLER MULTILEVEL BILATERAL 921 0 514.61 3730 

800201 FINGERSTICK 761 0 9.94 3730 

800219 PUNCTURE ASPIRATION ABSCESS 761 0 652.55 3730 

800227 I&D POST OP WOUND 761 0 2974.31 3730 

800235 NEG PRESSURE (VACUUM) WD TX 50SQ CM 761 0 145.01 3730

800250 I&D, ABSCESS, SIMPLE 761 0 528.65 3730 

800268 I&D, ABSCESS, COMPLEX 761 0 634.38 3730 

800276 I&D, HEMATOMA 761 0 4712.8 3730 

800284 DEBRIDE, PART THICKNESS 761 0 257.79 3730 

800292 DEBRIDE, FULL THICKNESS 761 0 870.92 3730 

800300 DEBRIDE, SUB-Q TISSUE 761 0 970 3730 

800318 DEBRIDE, SUB-Q TISSUE, MUSCLE 761 0 530.95 3730 

800326 DEBRIDE, SUB Q TISSUE, MUSCLE, BONE 761 0 1406.08 3730 

800334 PARING OF BENIGN LESION 761 0 146.03 3730 

800342 PARING OF BENIGN LESIONS, 2-4 761 0 161.12 3730 

800359 PARING OF BENIGN LESION, >4 761 0 161.12 3730 

800367 BIOPSY SINGLE LESION 761 0 198.19 3730 

800375 BIOPSY, SKIN, ADD'L LESION 761 0 182.13 3730 

800383 SIMPLE REPAIR SUPERFICIAL 2.5-7.0CM 761 0 589.32 3730 

800391 SIMPLE REPAIR 7.5-12.5 CM 761 0 721.96 3730 

800409 DEBRIDEMENT OF NAILS, 1-5 761 0 161.12 3730 

800417 DEBRIDEMENT OF NAILS, 6+ 761 0 161.12 3730 

800425 AVULSION OF NAIL PLATE 761 0 278.87 3730 

800433 AVULSION OF ADD'L NAIL 761 0 81.03 3730 

800441 EXCISION OF NAIL AND MATRIX 761 0 360.56 3730 

800466 SKIN SUBSTITUTE APPLY UP TO 25 SQ 761 0 669.6 3730 

800474 SKIN SUB APPLY EA ADD'L 25 SQ CM 761 0 669.6 3730 

800482 APLIGRAF PER SQ CENTIMETER 636 0 77.44 3730 

800490 ELECTRICAL CAUTER 1ST LESION 761 0 160.68 3730 

800508 WOUND CAUTERY, CHEMICAL 761 0 266.9 3730 

800516 EXCISE BENIGN TRUNK/ARM/LEG

800730 EX MAL LES FACE EAR EYE NOSE 4.0 CM 761 0 4259.34 3730 

800797 DEBRIDE SUB Q EA ADD 20 SQ CM 761 0 486.9 3730 

800805 DEBRIDE SUB Q MUSCLE /FASCIA ADD 20 761 0 486.9 3730 

800813 DEBRIDE SUB Q MUS/FAC/BONE ADD 20 761 0 1513.66 3730 

800821 BILAT ABI UPR LOWR 1-2 LEVELS 761 0 188.57 3730 

800839 UNILAT ABI UPR LWR 1-2 LEVELS 921 0 188.57 3730 

800847 BILAT ABI UPR LWR 1-2 LVLS 2ND PRC 921 0 342.86 3730 

800854 MLCW RT LWR EXTREMITY 761 0 219.6 3730 

800862 MLCW LT LWR EXTREMITY 761 0 219.6 3730 

800870 MLCW BILAT 761 0 439.2 3730 

800888 UNNA BOOT RT LWR EXTREMITY 761 0 199.64 3730 

800896 UNNA BOOT LT LWR EXTREMITY 761 0 199.64 3730 

800904 UNNA BOOT BILAT 761 0 399.29 3730 

800912 EXC BENIGN LES TRUNK/ARM/LEG 2.1-3 761 0 1513.66 3730 

800920 EXC BENIGN LES TRUNK 3.1-4.0 CM 761 0 3222.04 3730 

800938 EXC BENIGN LES TRUNK >4.0 CM 761 0 3222.04 3730 

800946 EXC BENIGN LES SCALP 2.1-3.0 CM 761 0 3222.04 3730 

800953 EXC BENIGN LES SCALP 3.1-4.0 CM 761 0 3222.04 3730 

800961 EXC BENIGN LES SCALP >4.0 CM 761 0 4259.34 3730 

800979 EXC BENIGN LES FACE 4.0 CM 761 0 4259.34 3730 

801035 EXC MAL LES TRUNK/ARM/LEG 1.1-2 CM 761 0 816.24 3730 

801043 PARING OR CUTTING SINGLE BENIGN LES 761 0 146.03 3730 

802108 REMOVE TUNNEL CVA CATH W/O SUBQ 761 0 1099.08 3730 

802116 EXCISION NAIL, MATRIX, PART OR COMP 761 0 782.55 3730 

802124 APPLICATION RIGID CONTACT LEG CAST 761 0 454.02 3730 

802132 OPTILOCK 5 X 5 DRESSING 270 0 8.34 3730 

802157 PROMOGRAM MATRIX DRESSING 270 0 17.73 3730 

802165 PRISMA MATRIX W/SILVER 270 0 21.02 3730 

802173 INTERDRY AG SHEET 270 0 119.48 3730 

802181 DUODERM XTRA THIN 4 X 4 270 0 4.47 3730 

802199 DUODERM GCF 4 X 4 270 0 6.66 3730 

802207 MEPILEX FOAM 4 X 8 270 0 16.53 3730 

802215 MEPILEX AG 4 X 4 SILVER FOAM 270 0 18.45 3730 

802223 MEPILEX BORDER 3 X 3 270 0 5.64 3730 



802256 MELGISORB ROPE 1.1 X 12.5 270 0 7.76 3730

802264 MELGISORB AG 6 X 6 270 0 40.18 3730 

802272 MEPITEL 2 X 3 270 0 8.61 3730 

802280 MEPITEL 3 X 4 270 0 23.58 3730 

802298 MEPITEL 4 X 7.2 270 0 22.37 3730 

802306 COBAN 3M LITE COMP WRAP 270 0 25.76 3730 

802314 COBAN 4 X 5 YD 270 0 25.6 3730 

802322 HYDROFERA 9 MM TUNNEL DRESSING 4X4 270 0 16.97 3730 

802330 MEDIHONEY HCS 4.5 X 4.5 270 0 2.57 3730 

802348 MEDIHONEY CAL ALGINATE .75 X 12 270 0 4.59 3730 

802355 COBAN 3M COMPRESSION WRAP 270 0 25.63 3730 

802363 ELASTO-GEL PLUS TAPE 4X4 270 0 10.55 3730 

802371 STIMULEN COLLAGEN POWDER 270 0 26.84 3730 

802389 MATRIX SKIN SUBSTITUTE PER SQ CM 278 0 25.69 3730 

802397 HYDROGEL GOLD DUST FILLER 270 0 13.14 3730 

900019 PROTHROMBIN TIME, ANTI COAG 300 0 12.44 4875 

900027 ANTI COAG CLINIC VISIT 510 0 108.14 4875 

900050 CARDIOVERSION PROC 480 0 2459.7 3511 

900068 CARDIOVERSION QUICK COMBO PADS 270 0 137.75 3511 

900209 SPEC PROC RM-1/2 HR 761 0 971.33 3511 

900258 SPEC PROC RM-1 HR 761 0 1942.66 3511 

900308 SPEC PROC RM-1 1/2 HRS 761 0 2913.99 3511 

900357 SPEC PROC RM- 2 HRS 761 0 3885.32 3511 

900365 MONITORED ANESTHESIA 1ST 1/2 HR 370 0 173.81 3511 

900373 MONITORED ANES EA ADD'L 15 MIN 370 0 28.98 3511 

900381 INSERT TEMP PACEMAKER 761 0 9637.92 3511 

900399 ICU NURSING TIME PER HOUR 761 0 90 3511 

1000157 BLOOD DRAW THRU CENTRAL LINE 260 0 93.6 4320 

1000165 BLOOD DRAW THRU SQ PORT 260 0 101.75 4320 

1000199 PICC INSERTION 761 0 2277.17 4320 

1000215 CATHFLO ACTIVASE OF HITECH LNS 260 0 329.09 4320 

1000256 PICC LINE REPOSITION 761 0 1536.55 4320 

1000264 SQ PORT FLUSH 269 0 160.86 4320 

1000272 AUTOLOGOUS BLOOD TRANSFUSION 300 0 0 4320 

1000280 IV TEAM VISIT 999 0 0 4320 

1000298 HICKMAN CATHETER REPAIR 260 0 973.04 4320 

1000504 E & M LEVEL 1 761 0 108.14 4320 

1000512 E & M LEVEL 2 761 0 161.13 4320 

1000520 E & M LEVEL 3 761 0 201.09 4320 

1000538 E & M LEVEL 4 761 0 282.3 4320 

1000546 E & M LEVEL 5 761 0 384.27 4320 

1000553 BLOOD ADMINISTRATION 391 0 828.41 4320 

1000561 PHLEBOTOMY 940 0 124.36 4320 


1000587 IV PUSH SEQ SAME DRUG>30 MIN 940 0 110.29 4320 

1000595 IV PUSH EA ADD'L SEQ 940 0 74.73 4320 

1000603 INJECTION SC, IM 940 0 74.34 4320 

1000611 IV TX HYDRA 31 TO 60 MIN 260 0 229.52 4320


1000637 VACCINE INJECTION 940 0 77.55 4320 

1000645 IMMUNO THERAPY INJECTION 940 0 83.16 4320 

1000652 IV THERAPY 1ST HR 260 0 415.28 4320 

1000660 IV THERAPY ADD/L HR 260 0 80.14 4320 

1000678 IV TX ADD'L SEQ < 1 HR 260 0 102.33 4320 

1000686 IV TX CONCUR INF 260 0 77.84 4320 

1100056 PICC 4 FR KIT 278 0 148 4320 

1100064 MIDLINE CATHETER 278 0 130 4320 

1100072 MAXIMUM BARRIER KIT 270 0 63 4320 

1100098 4 FR INTRODUCER 278 0 52.5 4320 

1100122 PICC 5 FR KIT 278 0 190 4320 

1100130 PICC 4 FR MST KIT 278 0 78 4320 

1100148 PICC 5 FR MST KIT 278 0 78 4320 

1100205 HICKMAN REPAIR KIT 270 0 285 4320 

1300052 FACILITY FEE-MINIMAL 450 0 195.46 3780 

1300102 FACILITY FEE-BRIEF 450 0 319.68 3780 

1300151 FACILITY FEE-LIMITED 450 0 507.32 3780 

1300201 FACILITY FEE-INTERME 450 0 808.72 3780 

1300250 FACILITY FEE-EXTEND 450 0 1202.08 3780 

1300300 FACILITY FEE-NO CHRG 450 0 0 3780 

1300508 CRITICAL CARE 1ST-HR 450 0 2121 3780 

1300516 CRITICAL CA EA 30 MN 450 0 1060.5 3780 

1300557 LWBS-TRIAGE ONLY 098 0 14 3780 

1300706 NES PHY FEE-MINIMAL 981 0 0 2120 

1300722 NES PHY FEE-LIMITED 981 0 91.07 2120 

1300730 NES PHY FEE-INTERMED 981 0 91.07 2120 

1300748 NES PHY FEE-EXTENDED 981 0 91.07 2120 

1300755 NES PHY SEE NOTE* 981 0 0 2120 

1300763 NES PHY FEE-COMPREHE 981 0 91.07 2120 

1301506 I&D ABSCESS SIMPLE 450 0 528.65 3780 

1301514 I&D ABSCESS COMPLEX 450 0 697.82 3780 

1301522 I&D PILONIDAL CYST S 450 0 318.26 3780 

1301530 I&D PILONIDAL CYST C 450 0 1306.38 3780 

1301548 RMVL SUBC FB SMPL 450 0 1123.16 3780 

1301555 RMVL SUBC FB CMPLX 450 0 1832.09 3780 

1301563 I&D HEMATOMA SEROMA 450 0 5184.08 3780 

1301571 PUNC ASP ABSC CYST 450 0 717.81 3780 

1301605 DEBR W/OPEN FX/DIS 450 0 958.01 3780 

1301613 DEBRIDE OPEN FX/BONE 450 0 958.01 3780 

1301639 DEBR SKN & SUBC TISS 450 0 1067 3780 

1301704 AVUL NAIL PLATE SMPL 450 0 306.76 3780 

1301712 EVAC SUBUNGUAL HEMAT 450 0 48.2 3780 

1301720 EXC NAIL MATRIX INGE 450 0 860.81 3780 

1301738 REPAIR NAIL BED 450 0 396.62 3780 

1301746 WDG EXC NAIL FOLD 450 0 95.44 3780 

1301753 SMPL BODY SC

1301761 SMPL BODY SC 2.6-7.5 450 0 648.25 3780 

1301779 SMPL BDY SC 7.6-12.5 450 0 794.16 3780 

1301787 SMPL BDY SC 12.6-20 450 0 151.26 3780 

1301795 SMPL BDY SC 20.1-30 450 0 232.43 3780 

1301803 SMPL BODY SC >30.0 450 0 261.34 3780 

1301811 SMPL FACE < 2.5 450 0 648.25 3780 

1301829 SMPL FACE 2.6-5.0 CM 450 0 181.51 3780 

1301837 SMPL FACE 5.1-7.5 CM 450 0 151.26 3780 

1301845 SMPL FACE 7.6-12.5CM 450 0 151.26 3780 

1301852 SMPL FACE12.6-20.0CM 450 0 261.34 3780 

1301886 TX SUPERFIC WND SMPL 450 0 1679.69 3780 

1301894 LYR BDY SCALP

1302629 RADIAL SHFT FX W/MAN 450 0 708.51 3780 

1302645 FX CARE W/MAN ULNA 450 0 184.12 3780 

1302660 ULNAR SHFT FX W/MAN 450 0 708.51 3780 

1302678 DISTAL RADIUS FX W/O 450 0 341.95 3780 

1302686 DISTAL RADIUS FX W/M 450 0 3036.46 3780 

1302694 NAVICULAR FX W/O MAN 450 0 341.95 3780 

1302710 CARPAL BONE FX W/MAN 450 0 1315.8 3780 

1302744 DSTL RADIOULNAR W/M 450 0 341.95 3780 

1302777 I&D ABSC FINGER SMPL 450 0 581.52 3780 

1302785 I&D ABS FINGER CMPLX 450 0 2695.73 3780 

1302793 REP EXT TEN HAND PRI 450 0 1914.46 3780 

1302819 METACARPAL FX W/MAN 450 0 198.85 3780 

1302827 THUMB DISLOC W/MAN 450 0 341.95 3780 

1302843 METACAR DIS W/M WO A 450 0 292.05 3780 

1302850 IP JNT DISL W/M WO A 450 0 184.12 3780 

1302868 PHALANGEAL FX W/O M 450 0 341.95 3780 

1302876 PHALANGEAL FX W/MAN 450 0 184.12 3780 

1302900 IP JOINT FX W/MAN 450 0 184.12 3780 

1302926 DIST PHALANX FX W/M 450 0 184.12 3780 

1302934 CLS TX TIB/FIB FXW/M 450 0 2290.2 3780 

1302942 CL TX DIS FEM FXWO/M 450 0 341.95 3780 

1302967 IP JT DIS W/M W/O A 450 0 305.72 3780 

1302975 AMP FINGER SGL W/FLA 450 0 3555.44 3780 

1302983 AMPU FINGER/THB W/C/ 450 0 3199.9 3780 

1303007 HIP DISLOC W/O FIXTN 450 0 591.82 3780 

1303023 POST HIP DISLC W/O A 450 0 657.58 3780 

1303049 CL TX FEM SHT FX;W/M 450 0 3475.2 3780 

1303064 TIB PLATEAU FX W/O M 450 0 341.95 3780 

1303080 KNEE DISLOC W/O ANES 450 0 341.95 3780 

1303098 PATELLAR DSLOC W/O A 450 0 165.7 3780 

1303114 M MALLEOLUS FX W/O M 450 0 341.95 3780 

1303122 CL TX MED MAL FX W/M 450 0 3725.04 3780 

1303130 PROX FIB/SHFT W/O M 450 0 341.95 3780 

1303148 DIST FIB FX W/O M 450 0 341.95 3780 

1303155 DIST FIB FX W/MAN 450 0 198.85 3780 

1303171 BIMALLEOLAR FX W/MAN 450 0 708.51 3780 

1303189 TRIMALLEOLAR FX WO M 450 0 341.95 3780 

1303197 ANKLE DISLOC W/O ANE 450 0 708.51 3780 

1303205 TRIMALLEOLAR FX W/MA 450 0 708.51 3780 

1303213 ANKLE DISLOC W/ANES 450 0 1794.06 3780 

1303239 REMOVAL FB FOOT SUBC 450 0 1027.64 3780 

1303270 CALCANEAL FX W/O M 450 0 341.95 3780 

1303296 TALUS FX W/O M 450 0 341.95 3780 

1303304 METATARSAL FX W/O M 450 0 341.95 3780 

1303320 FX TOE/PHANLANX W/MA 450 0 199.09 3780 

1303346 FX PHALANX W/M 450 0 199.09 3780 

1303353 MTP JNT DIS W/O ANES 450 0 341.95 3780

1303361 IP JNT DIS W/O ANES 450 0 184.12 3780 

1303395 SPLINT LONG ARM 450 0 149.97 3780 

1303403 SPLINT SHORT ARM 450 0 160.7 3780 

1303411 SPLINT FINGER STATIC 450 0 149.97 3780 

1303429 HIP SPICA CAST;1 LEG 450 0 366.73 3780 

1303437 CAST LONG LEG 450 0 231.23 3780 

1303445 CAST SHORT LEG 450 0 520.2 3780 

1303452 SPLINT LONG LEG 450 0 200.09 3780 

1303460 SPLINT SHORT LEG 450 0 149.97 3780 

1303494 RMVL FB NASAL 450 0 74.47 3780 

1303502 EPISTX ANT SIMPLE 450 0 136.18 3780 

1303510 EPISTX ANT CMPLX PKG 450 0 480.32 3780 

1303528 EPISTX POST INITIAL 450 0 128.04 3780 

1303544 ET INTUBATION 450 0 1272.13 3780 

1303577 LARYN D/R DX NO NEWB 450 0 6821.85 3780 

1303585 LARYNG IND RECT DIAG 450 0 94.68 3780 

1303593 LARYN DIR FOR ASPIRA 450 0 3547.36 3780 

1303635 THORACENTESIS W/O IMAGING 450 0 1141.68 3780 

1303650 TUBE THOR W/SEAL (HEMOTX) 450 0 614.76 3780 

1303676 TRANSFSN BLOOD/COMPT 391 0 828.41 3780 

1303684 INS CNT'L VEN CATH>5 450 0 1275.21 3780 

1303700 ARTERIAL BLD DRAW DX 450 0 44.99 3780 

1303718 PLMT INTRAOSSEOUS 450 0 168.16 3780 

1303726 CHEILOPLASTY LIP 450 0 1061.61 3780 

1303734 CHEILOPLASTY < V.HGT 450 0 781.32 3780 

1303742 CHEILOPLASTY > V.HGT 450 0 1612.24 3780 

1303759 LAC VESTIBULE 2.5 CM 450 0 707.76 3780 

1303775 LAC MOU/TONG < 2.5 450 0 115.24 3780 

1303791 DRAIN ABSCESS CYST 450 0 227.1 3780 

1303809 DRG ABCESS PAL,UVULA 450 0 707.76 3780 

1303817 I&D PERITONSLR ABSC 450 0 342.99 3780 

1303833 DENTOGLVEOLAR STRUCT 450 0 237.78 3780 

1303858 CONT OROPHAR HEM SIM 450 0 98.73 3780 

1303882 UNLTED PROC;NASO-PHA 450 0 222.13 3780 

1303890 CHG GASTROSTOMY TUBE W/O IMG/GUID 450 0 1891.56 3780 

1303916 L&D LSCHIO/PERI ABSC 450 0 4962.78 3780 

1303924 INCIS DRAIN PERIA AB 450 0 1407.59 3780 

1303932 INC THRMBSCL HEM/EXT 450 0 513.94 3780 

1303965 CMPT CATR/BALLOON 450 0 171.8 3780 

1303973 INSER TEMP FOLEYCATH 450 0 361.94 3780 

1303981 TX OF PENIS LESION 450 0 215.48 3780 

1303999 I&D VULVA OR PERI AB 450 0 415.06 3780 

1304005 I&D BARTHOLIN GLD/AB 450 0 351.42 3780 

1304039 LUMBAR TAP/DX 450 0 399.61 3780 

1304054 INJ ANES TRIGEMINAL 450 0 286.64 3780 

1304062 INJ ANES PERIPHERAL 450 0 781.18 3780 

1304070 INJ EPIDU/BLOOD CLOT 450 0 781.18 3780

1304088 RML FB EXT EYE/CONJL 450 0 107.61 3780 

1304096 RML EMBED CONJCTL FB 450 0 199.86 3780 

1304104 RML FB CORN W/O SLIT 450 0 96.86 3780 

1304112 RML FB CORN W/SLIT 450 0 107.61 3780 

1304138 RML FB EYELID 450 0 452.43 3780 

1304146 CANTHOTOMY 450 0 2225.84 3780 

1304153 DRAIN X EAR ABS/HEMA 450 0 162.82 3780 

1304161 DRAIN X AUD CANAL AB 450 0 302.39 3780 

1304179 RML FB EXT AUD W/O A 450 0 74.47 3780 

1304187 RML IMPLD CERUMEN 450 0 121.04 3780 

1304195 INJ PROPHYLACTIC DX 940 0 81.77 3780 

1304203 IV INJECT INITIAL 940 0 123.27 3780 

1304211 IVP EA ADD'L SEQ 940 0 123.82 3780 

1304229 IM ANTIBIOTIC 940 0 81.77 3780 

1304237 GASTRIC LAVAGE 450 0 622 3780 

1304245 NASO W/ENDO (DIAG) 450 0 94.68 3780 

1304252 CPR 450 0 1146.74 3780 

1304310 DLS TIBIA FX W/MAN 450 0 2061.18 3780 

1304328 LARYN,FLEX FIBER;DX 450 0 386.96 3780 

1304336 PERICARDIOCEN INITIA 450 0 1090.64 3780 

1304344 INS/RE TEM ELE/PM CA 450 0 9587.08 3780 

1304369 ANOSCOPY BY BRUSH/WA 450 0 138.31 3780 

1304401 PERIT ABD PARA OR PE 450 0 1090.63 3780 

1304443 I&D SCROTAL ABSCESS 450 0 1451.54 3780 

1304492 VAG DELIV IN ED 450 0 4053.87 3780 

1304526 THROMBOL,CORONARY,IV 450 0 545.04 3780 

1304534 IV THERAPY 1ST HOUR 260 0 415.28 3780 

1304542 VACCINE INJ EA ADD'L 940 0 72.38 3780 




1304583 IV TX ADD'L SQ < 1 HR 260 0 112.56 3780 

1304591 IV TX CONCURR INF 260 0 85.62 3780 

1304609 IV THERAPY ADD'L HR 260 0 80.14 3780 

1304617 TEMP TRANSCUT PACING 450 0 491.7 3780 

1304625 CARDIOVERSION EXTERN 450 0 2705.67 3780 

1304633 EKG RHYTHM STRIP 730 0 57.56 3780 

1304658 CHEM CAUT GRAN TISSU 450 0 293.59 3780 

1304682 MASTOTOMY, DEEP ABSCS 450 0 4149.4 3780 

1304690 DEBR SKIN PART THICK 450 0 324.67 3780 

1304724 IVP SEQ SAME DRUG >30 MIN 940 0 121.32 3780 

1304732 CATH FOR COLLECT OF SPEC-STR CATH 300 0 140.8 3780 

1304765 MONITOR FOR COMPARTMENT SYNDROME 450 0 302.39 3780 

1304773 AMPUTATION FINGER/THUMB PRIM/SEC SG 450 0 3555.44 3780 

1304781 PERCUTANEOUS CHOLECYSTOSTOMY 450 0 6509.02 3780 

1304799 REPAIR FLEX TENDON PRIM W/O GRAFT 450 0 5992.59 3780 

1304807 I & D INTRAORAL, SUBLINGUAL ABSCESS 450 0 707.76 3780

1304815 SHAVING SKIN LESION 1 (

1400050 PC FACILITY FEE-MIN 456 0 136.81 3780 

1400100 PC FACILITY FEE-BRIE 456 0 223.76 3780 

1400159 PC FACILITY FEE-LIM 456 0 355.12 3780 

1400209 PC FACILITY FEE-INTE 456 0 566.09 3780 

1400258 PC FACILITY FEE-EXT 456 0 647.27 3780 

1400308 PC-FAC FEE-NO CHRG 456 0 0 3780 

1400407 PC LWBS-TRIAGE ONLY 098 0 9.8 3780 

1401504 I&D ABSCESS SIMPLE 456 0 581.52 3780 

1401512 I&D ABSCESS COMPLEX 456 0 697.82 3780 

1401520 I&D PILONIDAL CYST S 456 0 318.26 3780 

1401538 I&D PILONIDAL CYST C 456 0 1306.38 3780 

1401546 RMVL SUBC FB SMPL 456 0 1123.16 3780 

1401553 RMVL SUBC FB CMPLX 456 0 1832.09 3780 

1401561 I&D HEMATOMA SEROMA 456 0 5184.08 3780 

1401579 PUNC ASP ABSC CYST 456 0 717.81 3780 

1401587 DEBR SKN UPTO 10%TBS 456 0 254.96 3780 

1401595 DEBR SKIN PART THICK 456 0 324.67 3780 

1401611 DEBR SKN & SUBC TISS 456 0 1067 3780 

1401645 REM SKIN TAGS;UPTO15 456 0 177.23 3780 

1401678 DEBR NAILS 1-5 456 0 177.23 3780 

1401686 AVUL NAIL PLATE SMPL 456 0 306.76 3780 

1401694 EVAC SUBUNGUAL HEMAT 456 0 48.2 3780 

1401702 EXC NAIL MATRIX INGE 456 0 860.81 3780 

1401710 REPAIR NAIL BED 456 0 396.62 3780 

1401728 WDG EXC NAIL FOLD 456 0 95.44 3780 

1401736 SMPL BODY SC 30.0 456 0 261.34 3780 

1401793 SMPL FACE < 2.5 456 0 648.25 3780 

1401801 SMPL FACE 2.6-5.0 CM 456 0 181.51 3780 

1401819 SMPL FACE 5.1-7.5 CM 456 0 151.26 3780 

1401827 SMPL FACE 7.6-12.5CM 456 0 151.26 3780 

1401835 SMPL FACE12.6-20.0CM 456 0 261.34 3780 

1401876 LYR BDY SCALP

1402106 CMPLX SC EXTS EA ADD 456 0 159.43 3780 

1402122 CMPLX FACE EXTS2.6-7 456 0 736.56 3780 

1402155 CMPL NOS/LIPS1.1-2.5 456 0 838.51 3780 

1402189 BURNS-SML W/O ANES 456 0 209.79 3780 

1402197 BURNS-MED W/O ANES 456 0 174.82 3780 

1402239 CHEM CAUT GRAN TISSU 456 0 293.59 3780 

1402270 EXPL WOUND EXTREMITY 456 0 1841.03 3780 

1402288 RMVL MUSC FC SMPL 456 0 848.42 3780 

1402296 REM FB MUS/TEND COMP 456 0 2169.94 3780 

1402312 ARTHROCENTESIS-SML 456 0 532.33 3780 

1402320 ARTHROCENTESIS-INTM 456 0 286.64 3780 

1402338 ARTHROCENTESIS-LRG 456 0 286.64 3780 

1402361 TX NASAL FX W/O STAB 456 0 3689.86 3780 

1402502 ELBOW DSL W/O ANES 456 0 165.7 3780 

1402510 NURSEMAIDS SUB W/M 456 0 220.95 3780 

1402528 FX RADIAL HEAD W/O M 456 0 341.95 3780 

1402585 ULNAR SHFT FX W/MAN 456 0 708.51 3780 

1402593 DISTAL RADIUS FX W/O 456 0 341.95 3780 

1402601 DISTAL RADIUS FX W/M 456 0 3036.46 3780 

1402668 DSTL RADIOULNAR W/M 456 0 341.95 3780 

1402692 I&D ABSC FINGER SMPL 456 0 581.52 3780 

1402700 I&D ABS FINGER CMPLX 456 0 2695.73 3780 

1402718 REP EXT TEN HAND PRI 456 0 1914.46 3780 

1402726 METACARPAL FX WO/MAN 456 0 341.95 3780 

1402734 METACARPAL FX W/MAN 456 0 198.85 3780 

1402775 IP JNT DISL W/M WO A 456 0 184.12 3780 

1402783 PHALANGEAL FX W/O M 456 0 341.95 3780 

1402791 PHALANGEAL FX W/MAN 456 0 184.12 3780 

1402817 IP JOINT FX W/MAN 456 0 184.12 3780 

1402825 PHALANX DISTAL FX WO 456 0 341.95 3780 

1402833 DIST PHALANX FX W/M 456 0 184.12 3780 

1402841 IP JT DIS W/M W/O A 456 0 305.72 3780 

1402957 PATELLAR DSLOC W/O A 456 0 165.7 3780 

1403039 TRIMALLEOLAR FX W/MA 456 0 708.51 3780 

1403070 REMOVAL FB FOOT SUBC 456 0 1027.64 3780 

1403146 FX TOE/PHANLANX W/MA 456 0 199.09 3780 

1403161 FX PHALANX W/M 456 0 199.09 3780 

1403179 MTP JNT DIS W/O ANES 456 0 341.95 3780 

1403187 IP JNT DIS W/O ANES 456 0 184.12 3780 

1403211 SPLINT LONG ARM 456 0 149.97 3780 

1403229 SPLINT SHORT ARM 456 0 160.7 3780 

1403237 SPLINT FINGER STATIC 456 0 149.97 3780 

1403278 CAST SHORT LEG 456 0 520.2 3780 

1403286 SPLINT LONG LEG 456 0 200.09 3780 

1403294 SPLINT SHORT LEG 456 0 149.97 3780 

1403328 RMVL FB NASAL 456 0 74.47 3780 

1403336 EPISTX ANT SIMPLE 456 0 136.18 3780

1403344 EPISTX ANT CMPLX PKG 456 0 480.32 3780 

1403351 EPISTX POST INITIAL 456 0 128.04 3780 

1403492 PERICARDIOCEN INITIA 456 0 1090.64 3780 

1403567 CHEILOPLASTY LIP 456 0 1061.61 3780 

1403575 CHEILOPLASTY < V.HGT 456 0 781.32 3780 

1403591 LAC VESTIBULE 2.5 CM 456 0 707.76 3780 

1403617 LAC MOU/TONG < 2.5 456 0 115.24 3780 

1403625 DRAIN ABSCESS CYST 456 0 227.1 3780 

1403641 I&D PERITONSLR ABSC 456 0 342.99 3780 

1403674 UNLTED PROC;NASO-PHA 456 0 222.13 3780 

1403708 L&D LSCHIO/PERI ABSC 456 0 4962.78 3780 

1403724 INC THRMBSCL HEM/EXT 456 0 513.94 3780 

1403740 ANOSCOPY BY BRUSH/WA 456 0 138.31 3780 

1403799 CATH URETHRA SMPL 456 0 125.74 3780 

1403807 INSER TEMP FOLEYCATH 456 0 361.94 3780 

1403831 I&D BARTHOLIN GLD/AB 456 0 351.42 3780 

1403906 INJ ANES TRIGEMINAL 456 0 286.64 3780 

1403922 INJ ANES PERIPHERAL 456 0 781.18 3780 

1403930 RML FB EXT EYE/CONJL 456 0 107.61 3780 

1403948 RML EMBED CONJCTL FB 456 0 199.86 3780 

1403955 RML FB CORN W/O SLIT 456 0 96.86 3780 

1403963 RML FB CORN W/SLIT 456 0 107.61 3780 

1403989 RML FB EYELID 456 0 452.43 3780 

1403997 DRAIN X EAR ABS/HEMA 456 0 162.82 3780 

1404003 DRAIN X AUD CANAL AB 456 0 302.39 3780 

1404011 RML FB EXT AUD W/O A 456 0 74.47 3780 

1404029 RML IMPLD CERUMEN 456 0 121.04 3780 


1404045 VACCINE INJ EA ADD'L 940 0 72.38 3780 



1404078 IV THERAPY 1ST HOUR 260 0 415.28 3780 

1404086 IV THERAPY ADD'L HR 260 0 80.14 3780 

1404094 IV TX ADD'L SQ < 1 HR 260 0 112.56 3780 

1404110 INJ PROPHYLACTIC DX 940 0 81.77 3780 

1404128 IM ANTIBIOTIC 940 0 81.77 3780 

1404136 IV INJECT INITIAL 940 0 123.27 3780 

1404144 IVP EA ADD'L SEQ 940 0 82.2 3780 

1404185 TEMP TRANSCUT PACING 456 0 491.7 3780 

1404268 DRAIN ABCESS, PALATE, UVULA 456 0 707.76 3780 

1404276 IVP SEQ SAME DRUG >30 MIN 940 0 121.32 3780 

1404292 I&D UPPER ARM; BURSA 456 0 4149.4 3780 

1404318 REPAIR FLEX TENDON PRIM W/O GRAFT 456 0 5992.59 3780 

1404326 I&D INTRAORAL, SUBLINGUAL ABSCESS 456 0 707.76 3780 

1404334 SHAVING SKIN LESION 1 (< .05CM) 456 0 124.16 3780 

1404342 AVUL NAIL PLATE, SIMPLE, EA ADD'L 456 0 89.13 3780 

1404359 OPEN TXT DISTAL PHALANGEAL FX FNGR 456 0 5445.73 3780

1404375 SUTURE REMOVAL-DKH 456 0 0 3780 

1404383 REMOVAL FB UPPER ARM, SUBCUTANEOUS 456 0 515.86 3780 

1404391 FINE NEEDLE ASPIRATION, W/O IMAGING 456 0 165.08 3780 

1404409 REPR LAC 2.6CM 456 0 781.32 3780 

1404425 I&D OF VULVA OR PERINEAL ABCESS 456 0 415.06 3780 

1404433 THROMBOLYSIS, CEREBRAL, BY IV 456 0 294.84 3780 

1404441 IRRIGATION OF IMPLANTED VAD 456 0 176.95 3780 

1404458 CLOSED TX TIBIA SHAFT FX W/O MAN 456 0 313.14 3780 

1404466 ENDOMETRIAL SAMPLING(BIOPSY) 456 0 259.73 3780 

1404474 VENIPUNCTURE ED 300 0 16.01 3780 

1404490 STRAPPING KNEE 456 0 133.91 3780 

1404508 STRAPPING ANKLE OR FOOT 420 0 133.91 3780 

1404516 FINGER SPLINT STATIC 270 0 16.83 3780 

1404524 SEDATION(MODERATE) 456 0 0 3780 

1404532 BLOOD STICK/HEEL, FINGER, EAR 456 0 26.33 3780 

1404540 VENIPUNCTURE BY MD FOR DIAG/THER 456 0 121.28 3780 

1404565 EXC BENIGN 1.1 TO 2.0 CM 456 0 1767.11 3780 

1404573 BLADDER IRRIGATION-SIMPLE LAVAGE 456 0 359.38 3780 

1404581 PREG MONOCLONAL URINE 270 0 64.64 3780 

1404706 SUPERFICIAL WOUND DEHISCENCE PACK 456 0 595.21 3780 

1800010 ANESTHESIA CONSULT N/C 360 0 0 3600 

1800051 BONE MARROW TRAY 270 0 22.5 3711 

2000065 CATH TRAY STRAIGHT 270 0 13.9 3800 

2000123 PARA/THORACENTESIS 270 0 32.65 3711 

2000164 CATHETER TRAY FOLEY 270 0 0 3800 

2000230 VOLDYNE 270 0 10.8 3800 

2000255 URINE DRAINAGE BAG 270 0 11.2 3800 

2000305 MED/SURG ROUTINE M&S 270 0 48.4 3800 

2000313 MED/SURG SUPPLY-TEL 270 0 49.45 3800 

2000339 MED/SURG SUPPLY-ICU 270 0 49.45 3800 

2100626 CARDIOVERSION QUICK COMBO PADS 270 0 137.75 3800 

2201069 G-TUBE REPLACEMENT 270 0 95 3711 

2201184 PEG BUTTON 270 0 400 3711 

2201192 PEG KIT 270 0 398 3711 

2201200 POLYPECTOMY SNARE 270 0 21 3711 

2201234 SCLEROSING NEEDLE 270 0 74 3711 

2201325 BALLOON DIALATOR 270 0 410 3711 

2201333 DILATOR KIT 270 0 300 3711 

2201341 ESOPHAGEAL BANDER 270 0 482 3711 

2201614 PULMONARY BIOPSY FORCEP W/NEED 19G 270 0 152 3711 

2201622 HOT BIOPSY FORCEPS 270 0 152 3711 

2201630 BIOPSY FORCEP 270 0 14.93 3711 

2201663 PICC 4FR KIT 270 0 148 3721 

2201671 PICC 5FR KIT 270 0 190 3721 

2201689 PICC 4FR MST KIT 270 0 78 3721 

2201697 PICC 5FR MST KIT 270 0 78 3721

2201713 MIDLINE CATHETER 278 0 130 3721 

2201739 EPIDURAL TRAY 270 0 20.7 3721 

2201804 ROTH BASKET 270 0 170 3711 

2201820 PROBE INJ GOLD 7FR 270 0 430 3711 

2201903 SPOT MARKERS 278 0 114.35 3711 

2202000 RESOLUTION CLIP 270 0 350 3711 


2202513 PARATHORA TRAY 270 0 51 3721 

2202521 LUMBAR PUNCTURE TRAY 270 0 22.82 3721 

2202547 MAXIMUM BARRIER KIT 270 0 63 3721 

2202554 TRAY STRL ESI PK(JEFFERSON GRP) 270 0 53.76 3721 

2202562 PULMONARY STANDARD FORCEP 270 0 99 3721 

2202570 PULMONARY BIOPSY W/NEEDLE 20G 270 0 189 3721 

2202588 PULMONARY RADIAL JAW 4 FORCEP 270 0 99 3721 

2300119 OXYGEN SETUP-ONC 270 0 21.9 3800 

2300200 OXYGEN-ONC 270 0 36.75 3800 

2500007 ACL BIO TRANSFX 40MM 278 0 566.5 3800 

2500023 ACL BIO TRANSFX 50MM 278 0 566.5 3800 

2500049 ACL BONE PLUG 278 0 295.7 3800 

2500080 ACL CAN SCREW 10X35 278 0 381.1 3800 

2500106 ACL CAN SCREW 11X35 278 0 381.1 3800 

2500122 ACL CAN SCREW 12X35 270 0 381.1 3800 

2500148 ACL CAN SCREW 9X35 278 0 381.1 3800 

2500163 ACL DRILL PASSER 270 0 436.7 3800 

2500189 ACL G/PIN 2,4 NITINOL 270 0 86.5 3800 

2500205 ACL G/PIN 2,4 SUTR EYE 270 0 210.1 3800 

2500247 ACL PTLA GRAFT DRILL 270 0 463.5 3800 

2500262 ACL RND SCREW 10X28 278 0 399.65 3800 

2500288 ACL RND SCREW 11X28 278 0 399.65 3800 

2500304 ACL RND SCREW 8X28 278 0 399.65 3800 

2500320 ACL RND SCREW 9X28 278 0 399.65 3800 

2500361 ACL TRANSFX SP KIT 270 0 298.7 3800 

2505022 ART BIOCORK W/FIB 5.0 278 0 535.6 3800 

2505048 ART BIOCORK W/FIB 6.5 278 0 535.6 3800 

2505147 ART BIOTENO SCR 4.75 278 0 463.5 3800 

2505162 ART BIOTENO SCR 4x10 278 0 463.5 3800 

2505188 ART BIOTENO SCR 5.5 278 0 463.5 3800 





2505287 ART CANNULA 6x7 270 0 77.25 3800 

2505303 ART CANNULA 8.25x7 270 0 77.25 3800 

2505329 ART CANNULA 8.25x9 270 0 145.25 3800 

2505402 ART DRILL TIP 2.4 270 0 98.9 3800 

2505428 ART ESU PROBE/HNDL 270 0 140.15 3800 

2505469 ART FASTFIX CURVED 278 0 505.5 3800

2505485 ART FASTFIX KNT PSHR 270 0 306.95 3800 

2505501 ART FASTFIX STRAIGHT 278 0 505.5 3800 

2505527 ART FWIRE #2 2 STRANDS 278 0 80.35 3800 

2505543 ART FWIRE #2 BLUE W/NDL 278 0 76.2 3800 

2505568 ART FWIRE #5 STRAND/BLUE 278 0 101.95 3800 

2505584 ART FWIRE LP NDL PN 278 0 165.3 3800 

2505782 ART ABLATION WAND 90 DEG 270 0 360.5 3800 

2505808 ART SH AGRESS 2.5MM MINI 270 0 90 3800 

2505824 ART SH TOMCAT 3.5MM 270 0 90 3800 

2505840 ART SH TOMCAT 4.0MM 270 0 169.95 3800 

2505857 ART SH TOMCAT 4.0MM ANGLED 270 0 90 3800 

2505865 ART SH RESECT 2.5MM MINI 270 0 169.95 3800 

2505881 ART SH RESECT 3.5MM 270 0 90 3800 

2505907 ART SHAV RESECT 4.0MM 270 0 169.95 3800 

2505923 ART SHAV FULL RAD 5.5 270 0 191.6 3800 

2505949 ART SHAV TOMCAT 5.0MM 270 0 90 3800 

2505964 ART SH BUR 6 FLUTE 4.0MM 270 0 90 3800 

2505980 ART SH BUR 6 FLUTE 5.5MM 270 0 101.25 3800 

2506004 ART SH BUR ROUND 4.0MM 270 0 90 3800 

2506020 ART STAR SLEEVE 270 0 216.3 3800 

2506046 ART SUT LASSO 25 LT 270 0 288.4 3800 

2506061 ART SUT LASSO 25 RT 270 0 288.4 3800 

2506087 ART SUT LASSO 90 DEG 270 0 267.8 3800 

2506103 ART SUT PASS WIRE 270 0 231.75 3800 

2506129 ART SUT RETRVR LG 270 0 145.25 3800 

2506145 ART SUT RETRVR MD 270 0 145.25 3800 

2506202 ART MAIN PUMP TUBING 270 0 117 3800 

2506244 ART PUMP TUBING SINGLE 270 0 157.6 3800 

2506327 ART FIBERWIRE #2 BL STD TAPERED NDL 278 0 41.9 3800 

2510006 ASNIS 4.0 DRILL 1.4 270 0 271.4 3800 

2510022 ASNIS 4.0 DRILL 2.7 270 0 532.05 3800 

2510048 ASNIS 4.0 DRILL 4.0 270 0 331.65 3800 

2510063 ASNIS 4.0 SCRW 10-70 278 0 262.65 3800 

2510089 ASNIS 4.0 THD G/WIRE 270 0 102.7 3800 

2510105 ASNIS 4.0 WASHER 278 0 94.55 3800 

2510121 ASNIS 5.0 DRILL 2.0 270 0 271.4 3800 

2510147 ASNIS 5.0 DRILL 3.5 270 0 331.65 3800 

2510162 ASNIS 5.0 DRILL 5.0 270 0 331.65 3800 

2510188 ASNIS 5.0 SCW 20-80 278 0 274.9 3800 


2510220 ASNIS 5.0 WASHER 278 0 94.55 3800 

2510246 ASNIS 6.5 DRILL 3.2 270 0 82.5 3800 

2510261 ASNIS 6.5 DRILL 4.9 270 0 780 3800 

2510287 ASNIS 6.5 DRILL 5.6 270 0 877.5 3800 

2510303 ASNIS 6.5 drill 6.5 270 0 344.95 3800 

2510329 ASNIS 6.5 DRILL 8.0 270 0 877.5 3800 

2510345 ASNIS 6.5 SCRW 40-120 278 0 344.95 3800


2510386 ASNIS 6.5/8.0 WASHER 278 0 81.6 3800 

2510402 ASNIS 8.0 SCRW 40-120 278 0 364.2 3800 

2515021 ENT CAUTERY LO TEMP* 270 0 0 3800 

2515062 ENT EAR TUBE ACTIVENT 270 0 73.35 3800 

2515088 ENT EAR TUBE MIRCON 270 0 224.35 3800 

2515104 ENT EAR TUBE T 270 0 85.45 3800 

2515120 ENT EAT TUBE REUTER BOB 270 0 73.35 3800 

2515146 ENT GEL FILM 270 0 108.75 3800 

2515161 ENT MEROCEL NASAL PK 270 0 42.65 3800 

2515187 ENT MICRO DRAPE OPMI 270 0 74.15 3800 

2515203 ENT MYRINGOTMY BLADE 270 0 43.25 3800 

2515229 ENT NASAL SPLINT 270 0 89.75 3800 

2515260 ENT NIM ENDO TUBE #6 270 0 486.15 3800 



2515328 ENT NIM SUBDER ELECT 270 0 225.55 3800 

2515344 ENT PHENOL APPLICATOR 270 0 73.95 3800 

2515369 ENT SEPTAL BUTTON 270 0 160.7 3800 

2515385 ENT SHAVER BLADE 2.0 270 0 311.45 3800 

2515401 ENT SHAVER BLADE 4.0 270 0 302.4 3800 

2515427 ENT SHAVER BLADE T&A 270 0 252.95 3800 

2515443 ENT SHAVER STR SHOT 270 0 64.25 3800 

2515468 ENT SUCTION CAUTERY* 270 0 0 3800 

2515484 ENT VARI STIM 270 0 101.95 3800 

2515526 ENT COBLATOR EVAC X-TRA W/CABLE T&A 270 0 381.6 3800 

2515542 ENT COBLATOR REFLEX 45 270 0 351.5 3800 

2515567 ENT COBLATOR REFLEX 55 270 0 411.25 3800 

2515575 ENT PRASS MONOPOLAR PROBE 270 0 281.2 3800 

2515583 LAP IRRIG/SUCTION 270 0 60 3800 

2515591 LAP SHAFT 270 0 99.9 3800 

2515609 LAP HANDLE 270 0 179.8 3800 

2515617 MAXTRAX ANKEL BOOT 270 0 65.4 3800 

2515625 LG BIOPSY FORCEP 270 0 34.65 3711 

2515641 ESSURE LEFT 278 0 1500 3800 

2515658 ESSURE RIGHT 278 0 1500 3800 

2515666 CRYO PROBE 270 0 5962.5 3800 

2515674 ARGON GAS 6000 PSI 270 0 260.52 3800 

2515682 HELIUM GAS 6000 PSI 270 0 271.85 3800 

2515690 ENT PRASS STIM 270 0 184 3800 

2515708 URO PERIGEE SLING 278 0 3390 3800 

2515716 URO MONARC SLING 278 0 2190 3800 

2515724 200 MICRON FIBER 270 0 800 3800 

2515732 365 MICRON FIBER 270 0 700 3800 

2515740 550 MICRON FIBER 270 0 880 3800 

2515757 1000 MICRON FIBER 270 0 1880 3800 

2515765 980 SIDE FIBER 270 0 1700 3800

2515773 LAP UNIV TROCAR SLEEVE 5MM 270 0 42.69 3800 

2515781 ART PUSHLOCK 4.5X18.5 MM 278 0 680 3800 

2515807 URO URETAL STENT 4.8 X 26 278 0 308.16 3800 

2515815 URO APOGEE SLING 278 0 2990 3800 

2520005 EXFIX EBI DRILL 2.0 270 0 554 3800 

2520021 EXFIX EBI DRILL 2.7 270 0 554 3800 

2520047 EXFIX EBI FIXA 04103 270 0 5318 3800 

2520104 EXFIX EBI PIN 270 0 284 3800 

2520120 EXFIX MON DRILL 2.2 270 0 269.2 3800 

2520161 EXFIX MON PIN 270 0 148.3 3800 

2520187 EXFIX MON ROD 15x200 278 0 280.15 3800 

2520203 EXFIX MON ROD 15x250 278 0 295.31 3800 

2520245 EXFIX MON TRIAX CLMP 278 0 675.7 3800 

2525020 EYE ANT CHAMB MAINTAINER 270 0 96 3800 

2525046 EYE CONFORMER 270 0 46.35 3800 

2525061 EYE CORNEAL PROTECT 270 0 83.45 3800 

2525160 EYE DRAPE INCISE POUCH 270 0 45.75 3800 

2525228 EYE HEMOS ERAS 18GA* 270 0 0 3800 

2525244 EYE HEMOS ERAS 23GA 270 0 100.6 3800 

2525269 EYE I&A CANNULA 270 0 232 3800 

2525277 EYE TORIC LENS 276 0 345 3800 

2525285 EYE IOL STANDARD 276 0 300 3800 

2525293 EYE MULTIFOCAL LENS 276 0 745 3800 

2525301 EYE KNIFE 15 DEGREE 270 0 43.25 3800 

2525327 EYE KNIFE 3.5 ANGLE 270 0 74.15 3800 

2525343 EYE KNIFE 5.7 270 0 76.45 3800 

2525368 EYE KNIFE FEATHER 270 0 93.8 3800 

2525384 EYE KNIFE GRIESHABER 270 0 94.25 3800 

2525400 EYE KNIFE KELLAN 270 0 90.65 3800 

2525426 EYE KNIFE, 4.0 ANGLED 270 0 84.45 3800 

2525442 EYE LACRIMAL INT CRWFRD 270 0 209.05 3800 

2525566 EYE PACK INFINITY FMS 270 0 262.65 3800 

2525624 EYE RETRCTOR IRIS 270 0 85 3800 

2525707 EYE SPHERE-SILICONE 270 0 52.65 3800 

2525723 EYE VARI CAUTERY* 270 0 0 3800 

2530004 GYN DERMABOND PEN 270 0 99.4 3800 

2530020 GYN FALOP BAND (2) 270 0 133.9 3800 

2530046 GYN HYST BAG URO CAT 270 0 55.6 3800 

2530061 GYN HYST ROLL BALL 22 270 0 301.3 3800 

2530087 GYN HYST Y TUBE 270 0 42.85 3800 

2530103 GYN HYSTCOPE LOOP 22 270 0 301.3 3800 

2530129 GYN HYSTCOPE TUBING 270 0 234.85 3800 

2530145 GYN INTERCEED 278 0 411.9 3800 

2530160 GYN LOOP ELEC T-STYL 270 0 41.7 3800 

2530186 GYN STAC VAC TUB SM/LG 270 0 55.8 3800 

2530202 GYN THERMAL ABLATOR 270 0 1266.9 3800 

2530228 GYN UTERINE MANIPUL 270 0 139.05 3800

2530244 GYN VAG PACKING* 270 0 0 3800 

2535003 LAP CHOLE CATH KUMAR 270 0 92.7 3800 

2535029 LAP END LINCUT 45 278 0 614.6 3800 

2535045 LAP END LINCUT 45DLU 278 0 241.78 3800 

2535060 LAP ENDO CLOSE 270 0 78.4 3800 

2535086 LAP ENDO RETRACT 270 0 270.3 3800 

2535102 LAP ENDOCLIP 10MM 278 0 208 3800 

2535128 LAP ENDOCLIP 5MM 278 0 287.75 3800 

2535144 LAP ENDOCLOSE 270 0 79.75 3800 

2535169 LAP ENDODISSECT 270 0 322.3 3800 

2535185 LAP ENDODISSECTOR 270 0 230.35 3800 

2535227 LAP ENDOPOUCH 270 0 266.65 3800 

2535243 LAP ENDORETRACT 270 0 278.15 3800 

2535268 LAP ENDOSCISSOR 270 0 252.6 3800 

2535300 LAP TROCAR 12MM 270 0 211.8 3800 

2535326 LAP TROCAR 5MM 270 0 160.05 3800 

2535342 LAP TROCAR 7/8MM 270 0 175.15 3800 

2535367 LAP TROCAR HASSON 270 0 278.75 3800 

2535383 LAP VERES NDL 120MM 270 0 66 3800 

2535409 LAP VERES NDL 150MM 270 0 72.1 3800 

2540003 MESH DULEX OVAL 278 0 1130.95 3800 

2540029 MESH DULEX RECTANGUL 278 0 1424 3800 

2540045 MESH KUG COMP 7X9OVL 278 0 1807.65 3800 

2540060 MESH KUGEL LG OVAL 278 0 1335.15 3800 

2540086 MESH KUGEL MD OVAL 278 0 1263.8 3800 

2540102 MESH KUGEL SM OVAL 278 0 855.95 3800 

2540128 MESH KUGEL XLG OVAL 278 0 2142.4 3800 

2540144 MESH MARLE 10X14 278 0 452.05 3800 

2540169 MESH MARLEX 1X4 278 0 238.95 3800 

2540227 MESH PERFIX, X-LG 278 0 976.45 3800 

2540243 MESH SURGIPRO 3X5 278 0 98.65 3800 

2540268 MESH SURGPRO 6X6 278 0 192.8 3800 

2540284 MESH VENTRALEX MED 278 0 947.6 3800 

2540300 MESH VENTRALEX SMALL 278 0 793.1 3800 

2545002 MIS A-LINE TRANS KIT 270 0 86.5 3800 

2545028 MIS BAIR HUGGER ALL 270 0 46.35 3800 

2545044 MIS BILE BAG* 270 0 0 3800 

2545069 MIS CATH EMBBOLECTOMY 278 0 49.95 3800 

2545085 MIS CATH FOLEY 270 0 43.25 3800 

2545101 MIS CATH FOLEY BAG* 270 0 0 3800 

2545127 MIS CATH FOLEY KIT 270 0 290.45 3800 

2545143 MIS CATH TRIPLE LUMEN 278 0 178.45 3800 

2545168 MIS CHOLANG CATH* 270 0 0 3800 

2545200 MIS CORNWALL SYRINGE* 270 0 0 3800 

2545242 MIS CYSTO TUBING* 270 0 0 3800 

2545267 MIS DERMATOME blade 270 0 257.5 3800 

2545283 MIS DISP VEIN STRIPP 270 0 119.9 3800

2545309 MIS DRAIN BAKER JEJUN 270 0 298.3 3800 

2545325 MIS DRAIN HEMOVAC 270 0 49.05 3800 

2545341 MIS DRAIN J P 270 0 163.9 3800 

2545366 MIS DRAIN SALEM SUMP* 270 0 0 3800 

2545382 MIS DRAIN T TUBE 10FR* 270 0 0 3800 

2545408 MIS DRAIN T TUBE 12FR* 270 0 0 3800 

2545465 MIS DRAPES C/ARM* 270 0 0 3800 

2545481 MIS ESU SMOKE/P FILTER* 270 0 0 3800 

2545507 MIS ESU SMOKE/PENCIL 270 0 59.9 3800 

2545523 MIS ESU SMOKE/TUBING 270 0 43.25 3800 

2545549 MIS FRED ANTIFOG* 270 0 0 3800 

2545564 MIS GEL FOAM 100 270 0 85.35 3800 

2545580 MIS GEL FOAM 12 -7* 270 0 0 3800 

2545606 MIS GIGLI SAW BLADE 270 0 64.7 3800 

2545622 MIS HICKMAN DUAL 278 0 354.3 3800 

2545648 MIS HICKMAN SINGLE 278 0 418 3800 

2545663 MIS HOLLISTER KIT 270 0 41.2 3800 

2545689 MIS LEVEEN SHUNT 270 0 915.4 3800 

2545705 LIGASURE V 270 0 973.35 3800 

2545721 MIS LIGASURE MAX 270 0 278.1 3800 

2545747 MIS LIGASURE STD 270 0 316.1 3800 

2545762 MIS LIGASURE XTD 270 0 335.25 3800 

2545788 MIS LVL I ANES 270 0 97.3 3800 

2545804 MIS MICROSCOPE DRAPE* 270 0 0 3800 

2545820 MIS PUDDLE VAC 270 0 80.35 3800 

2545861 MIS SQ PORT DBL LMN 278 0 1081.5 3800 

2545887 MIS SQ PORT SNGL LMN 278 0 515 3800 

2545903 MIS SURGICEL 4X8 270 0 130.65 3800 

2545929 MIS TAPE UMBILICAL 270 0 56.3 3800 

2545945 MIS THOROCEAL 270 0 145.9 3800 

2545960 MIS TRACH TUBE 270 0 209.3 3800 

2546000 MIS TRU-CUT NEEDLE 270 0 94.2 3800 

2546042 MIS U-DRAPE* 270 0 0 3800 

2546083 MIS URIMETER* 270 0 0 3800 

2546125 MIS VEIN PIK 270 0 61.8 3800 

2546141 MIS VEIN STRIPPER DISPO 270 0 80.35 3800 

2546166 MIS VENA CAVA CLIPS 270 0 396.75 3800 

2546208 MIS VESSSEL LOOP RED* 270 0 0 3800 

2546216 APLIGRAF PER SQ CM 636 0 77.44 3800 

2550002 ORT BLADE INDI TOME 270 0 317.25 3800 

2550028 ORT CAST ARM LONG 270 0 82.4 3800 

2550044 ORT CAST ARM SHORT 270 0 61.8 3800 

2550069 ORT CAST HIP SPICA 270 0 288.4 3800 

2550085 ORT CAST LEG LONG 270 0 154.5 3800 

2550101 ORT CAST LEG SHORT 270 0 78.8 3800 

2550127 ORT CAST SPLINT ARM 270 0 82.4 3800 

2550143 ORT CAST SPLINT LEG 270 0 92.7 3800

2550226 ORT CRV-TC CART MED 270 0 780.25 3800 

2550242 ORT CRV-TC NDL MED* 270 0 0 3800 

2550267 ORT CURV-TECH CART LG 270 0 780.25 3800 

2550283 ORT CURV-TECH NDL LG* 270 0 0 3800 

2550309 ORT DALL-MILE CBL BD 278 0 696.9 3800 

2550325 ORT DALL-MILE CBL SS 1.6 278 0 402.3 3800 

2550341 ORT DALL-MILE CBL VI 278 0 658.4 3800 

2550366 ORT DALL-MILE G/C LG 278 0 1380.25 3800 

2550382 ORT DALL-MILE G/C MD 278 0 1403.2 3800 

2550465 ORT DALL-MILES CBL SS 2.0 278 0 501.32 3800 

2550481 ORT DALL-MILES G/C 5MM 278 0 1380.25 3800 

2550507 ORT DALL-MILES PL 8" 278 0 711.65 3800 

2550523 ORT FLEX OSTEO CRV 12 270 0 268.85 3800 

2550549 ORT FLEX OSTEO CRV 15 270 0 268.85 3800 

2550564 ORT FLEX OSTEO FLT 10 270 0 268.85 3800 



2550622 ORT FLEX OSTEOTOMES 270 0 580.9 3800 

2550648 ORT FLEXI LUM 270 0 86.5 3800 

2550689 ORT GRAFT CAN/CORT 270 0 737.5 3800 

2550705 ORT Graft DBM 10cc 278 0 2231.92 3800 



2550762 ORT GRAFT PRO-OS 15CC 278 0 1468.32 3800 

2550788 ORT GRAFT PRO-OS 30CC 278 0 1990.88 3800 

2550804 ORT GRAFT PRO-OS 500 278 0 2340 3800 

2550820 ORT JURGAN BALL .045* 278 0 13.32 3800 

2550846 ORT JURGAN BALL .062* 278 0 13.32 3800 

2550861 ORT JURGAN BALL 3/32* 278 0 13.32 3800 



2550929 ORT JURGAN BALL X003* 278 0 13.32 3800 

2550945 ORT JURGAN BALL X006* 278 0 13.32 3800 

2550960 ORT KNEE IMMOB 18" 270 0 139.05 3800 

2550986 ORT KNEE IMMOB 23" 270 0 166.85 3800 

2551000 ORT KNEE IMMOB 28 270 0 213.2 3800 

2551026 ORT KNEE IMMOBILIZER 13" 274 0 98.9 3800 

2551042 ORT K-WIRE SMTH .035* 278 0 7.5 3800 

2551067 ORT K-WIRE SMTH .045* 278 0 15 3800 

2551083 ORT K-WIRE SMTH .054* 278 0 7.5 3800 

2551109 ORT K-WIRE SMTH .062* 278 0 7.5 3800 

2551125 ORT K-WIRE THD .062 278 0 52.85 3800 

2551141 ORT LAMIN PILLOW* 270 0 0 3800 

2551166 ORT MINI C/ARM DRAPE* 270 0 0 3800 

2551208 ORT MITEK GII 278 0 560.3 3800 

2551224 ORT MITEK MICRO 278 0 568.55 3800 

2551240 ORT MITEK MINI 278 0 558.25 3800

2551281 ORT MITEK SUPER 278 0 531.5 3800 

2551307 ORT PLATE HUMERAL I/R 278 0 873.85 3800 

2551323 ORT QUICK STICK CMP SYN 270 0 169.95 3800 

2551349 ORT REDI DRAPE 270 0 124.7 3800 

2551364 ORT RUSH PIN 278 0 192.8 3800 

2551380 ORT SAW BL HALL 138 270 0 110 3800 

2551406 ORT SAW BL HALL 239 270 0 110 3800 

2551463 ORT SAW BL MS-123 270 0 41.2 3800 

2551489 ORT SAW BL MS-124 270 0 41.2 3800 

2551505 ORT SAW BL MS-131 270 0 77.25 3800 

2551521 ORT SAW BL MS-132 270 0 41.2 3800 

2551547 ORT SAW BL STRY 105 270 0 114.65 3800 

2551562 ORT SAW BL STRY 114 270 0 65.5 3800 

2551588 ORT SAW BL STRY 115 270 0 114.65 3800 

2551604 ORT SAW BL STRY 150 270 0 117.25 3800 

2551620 ORT SAW BL STRY 175 270 0 84.94 3800 

2551646 ORT SAW BL STRY 225 270 0 114.65 3800 

2551661 ORT SAW BL STRY 325 270 0 138.45 3800 

2551687 ORT SIDEWNDR DRL 3.2 270 0 236.4 3800 

2551703 ORT SIDEWNDR DRL 4.3 270 0 236.4 3800 

2551729 ORT SIDEWNDR DVICE 270 0 341.45 3800 

2551745 ORT SPECIMEN SOCK* 270 0 0 3800 

2551760 ORT STEIN PIN SM 1/8 278 0 41.2 3800 

2551802 ORT STEIN PIN SM 3/32* 278 0 0 3800 

2552040 ORT STOCK IMPERV 12"* 270 0 0 3800 



2552107 ORT UNI WRIST SPLT RIGHT 270 0 0 3800 

2552123 ORT WATER PIK 270 0 60 3800 

2552149 ORT WATER PIK IM* 270 0 0 3800 

2552156 ORT UNI WRIST SPLT LEFT 270 0 0 3800 

2552164 ORT WATER PIK SHRT 270 0 51.3 3800 

2552305 MITEK SUTURE GRASPER 60 270 0 430 3800 

2552313 ORT SAW B1 PRECISION CARTRIDGE 270 0 300 3800 

2552321 STAPLE LIN CUT 45 278 0 493.58 3800 

2552339 ACL ENDOBUTTON CL ULTRA 278 0 454 3800 

2552347 GYN ERS KIT 270 0 60.3 3800 

2552354 ACL ENDO CANNULATED DRILL 4.5 270 0 234.86 3800 

2552362 SINGLE PACEMAKER 275 0 7750 3800 

2552370 DUAL PACEMAKER 275 0 9450 3800 

2552388 LOOP MONITOR IMPLANT 278 0 7990 3800 

2552396 PACEMAKER LEAD 275 0 1030 3800 

2552412 URO STENT URET 4.8 X 24 278 0 308.16 3800 

2552420 URO STENT URET 4.8 X 22 278 0 308.16 3800 

2552438 URO GLIDE WIRE .035 270 0 87.74 3800 

2552446 URO CYSTOSCOPIC INJ NEEDLE 5 FR 270 0 22.35 3800 

2552453 TIER 1 DRILL 270 0 625 3800

2552461 TIER 1 INSERTS 278 0 6250 3800 

2552479 TIER 1 NAILS/RODS 278 0 2500 3800 

2552487 TIER 1 PLATES 278 0 2500 3800 

2552495 TIER 1 SCREWS/ANCHORS 278 0 625 3800 

2552503 TIER 1 SHELLS 278 0 6250 3800 

2552511 TIER 1 STEMS 278 0 7500 3800 

2552529 TIER 1 WIRES 278 0 375 3800 

2552545 TIER 2 DRILL 270 0 400 3800 

2552552 TIER 2 INSERTS 278 0 4000 3800 


2552578 TIER 2 PLATES 278 0 1500 3800 


2552594 TIER 2 SHELLS 278 0 4000 3800 

2552602 TIER 2 STEMS 278 0 4000 3800 

2552610 TIER 2 WIRES 278 0 200 3800 

2552628 TIER 3 DRILL 270 0 150 3800 

2552636 TIER 3 INSERTS 278 0 1500 3800 


2552651 TIER 3 PLATES 278 0 500 3800 

2552669 TIER 3 SCREW/ANCHOR 278 0 150 3800 

2552677 TIER 3 SHELL 278 0 1500 3800 

2552685 TIER 3 STEMS 278 0 1000 3800 

2552693 TIER 3 WIRES 278 0 75 3800 

2552701 TIER 1 MISC ORTHO CONSUMABLE 270 0 2500 3800 



2552735 TIER 1 MISC OTHER CONSUMABLE 270 0 2500 3800 





2552776 TIER 1 HEAD 278 0 3750 3800 

2552784 TIER 2 HEADS 278 0 2000 3800 

2552792 TIER 3 HEADS 278 0 750 3800 

2552800 TIER 1 ALLOGRAFT 278 0 12500 3800 



2552834 TIER 1 URETHRAL STENTS 278 0 12500 3800 

2552842 ENT SPEAR TIP BLADE 270 0 15.79 3800 

2552859 URO SLING MINIARC 278 0 2930 3800 

2552867 HARMONIC SCALPEL DISSECTING HOOK 270 0 412 3800 

2552875 HARMONIC HAND SWITCH ADAPTOR HSA08 270 0 110 3800 

2552883 HARMONIC SCALPEL ACE 270 0 1002.6 3800 

2552891 HARMONIC BLADE WRENCH TLB01 270 0 163.8 3800 

2552909 SUPRALOOP 270 0 194.84 3800 

2552925 ORT PEEK ANCHOR 3.5 278 0 480 3800 

2552933 ORT PEEK ANCHOR 5.5 278 0 490 3800

2552941 TKA X3 TRIATHLON CS INS 278 0 2655 3800 

2552958 TOPAZ WAND 270 0 816.75 3800 

2552966 ASNIS MICRO 1.7 CANNULATED DRILL 270 0 486 3800 

2552974 MORCELLATOR CUTTER 12 MM 270 0 1105.43 3800 

2552982 ASNIS MICRO 2.0 CANNULATED SCREWS 278 0 364.5 3800 

2552990 ASNIS MICRO .8 X 100 K WIRE 270 0 64.13 3800 

2553006 INTRODUCER KIT 6 FR 270 0 184.5 3800 

2553014 TISSUE EXPANDER(BREAST) 278 0 3138.75 3800 

2553022 ALLODERM PER CM 278 0 79.7 3800 

2553048 NEPTUNE MANIFOLD 4 PORT 270 0 41.33 3800 

2553055 NEPTUNE MANIFOLD SINGLE PORT 270 0 24.86 3800 

2553063 ART PUSHLOCK 4.5 X 24 MM 278 0 765 3800 

2553071 CONTOUR URETERAL STENT 8 X 56 278 0 306.9 3800 

2553089 BREAST IMPLANT 278 0 1012.5 3800 

2553097 TIER 1 URO SLING 278 0 12500 3800 

2553105 TIER 2 URO SLING 278 0 7000 3800 

2553113 TIER 3 URO SLING 278 0 2000 3800 

2553121 LAP TROCAR 5MM XL 270 0 127.21 3800 

2553139 MIS EZ CLEAN CAUTERY TIP 270 0 11.36 3800 

2553147 GREENFIELD FILTER 278 0 2137.5 3800 

2553154 GREENFIELD FILTER PLAT GUIDE WIRE 278 0 213.75 3800 

2553162 GREENFIELD FILTER OTHER GUIDE WIRE 278 0 54.34 3800 

2553170 GREENFIELD FILTER REMOVAL SET 270 0 531 3800 

2553188 GREENFIELD FILTER ACCESS KIT 270 0 128.25 3800 

2553196 GREENFIELD FILTER TRAY 270 0 169.88 3800 

2553204 NEPHROSTOMY KIT 270 0 405 3800 

2553212 GYN RUMI UTER MANIP TIP 270 0 98.71 3800 

2553220 GYN RUMI II UTER MANIP KOH-EFF 270 0 202.5 3800 

2553238 POWER PORT VVE MRI 8FR 278 0 850 3800 

2553246 ENT SINUFOAM DRESSING 270 0 150.75 3800 

2553501 TIER 4 ORTHO IMPLANT 278 0 10000 3800 

2555001 PORT DUAL LUMEN HICK 278 0 354.3 3800 

2555027 PORT DUAL LUMEN SUBQ 278 0 819.9 3800 

2555043 PORT SGL LUMEN HICKM 278 0 300.75 3800 

2555068 PORT SGL LUMEN SUB-Q 278 0 513.7 3800 

2555076 HYDROSET 3CC 278 0 1381.8 3800 

2555084 HYDROSET 5CC 278 0 2350 3800 

2555092 HYDROSET 10CC 278 0 4512 3800 

2555100 HYDROSET 15CC 278 0 6486 3800 

2555118 MIS POWER PORT DUO 9.5 FR 278 0 1383.75 3800 

2555126 VITAGEL 270 0 956.25 3800 

2555134 TOT VITAGEL PLASMA SEPARATOR 270 0 67.5 3800 

2555142 ART SUREFIRE SCORPION NEEDLE 270 0 350 3800 

2555159 SONICBEAT-35CM(SB-0535PC)ADAPTOR 270 0 787.5 3800 

2555167 THUNDERBEAT 35CM TB0535PC ADAPTOR 270 0 1237.5 3800 

2555175 PACEMAKER-AIGIS 270 0 1237.5 3800 

2555183 POWER PORT VVE MRI LARGE 8FR 278 0 1103.75 3800

2555191 BALLOON SINUPLASTY 270 0 2328 3800 

2555209 ART 6.5 PEEK ZIP ANCHOR 278 0 2756.25 3800 

2555217 TOURNIQUET 270 0 46.8 3800 

2555225 TROCHANTERIC LONG LOCKING NAIL KIT 278 0 3796.87 3800 

2555233 BEADED CABLE & SLEEVE 278 0 894.37 3800 

2555241 END CAP 278 0 354.37 3800 

2555258 U-BLADE LAG SCREW SET TI 278 0 1434.37 3800 

2555266 DISTAL DRILL 270 0 345.93 3800 

2555274 GUIDE WIRE BALL 278 0 413.33 3800 

2555282 SIDEWINDER 278 0 450.56 3800 

2555290 SIDEWINDER DRILL 270 0 324 3800 

2555308 CANCELLOUS BONE SCREW 278 0 234 3800 

2555316 TRIDENT HEMISHERIC SOLID BACK 300 0 2295 3800 

2555324 TRITANIUM HEMISPHERICAL SOLID BACK 278 0 2925 3800 

2555332 TRIDENT HEMISPHERICAL CLUSTER 278 0 2925 3800 

2555340 TRITANIUM HEMISPHERICAL CLUSTER 278 0 2925 3800 

2555357 ACCOLADE TMZF HIP STEM 278 0 5895 3800 

2555365 ACCOLADE HFX 278 0 2137.5 3800 

2555373 NEUTRAL HOOD 278 0 2092.5 3800 

2555381 TRIDENT 0 X3 INSERT 278 0 2092.5 3800 

2555399 TRIDENT 0 INSERT 278 0 2092.5 3800 

2555407 TRIATHLON TS BASEPLATE 278 0 3735 3800 

2555415 TRIATHLON TS PLUS TIBIAL 278 0 2655 3800 

2555423 TRIATHLON CEMENTED STEM 278 0 2720.25 3800 

2560142 SHAVER FULL RAD 270 0 0 3800 

2565000 STAPLE CONTOU 3.5 DLU 278 0 398.25 3800 

2565026 STAPLE CONTOU 4.7 DLU 278 0 398.25 3800 

2565042 STAPLE CONTOUR 3.5 278 0 1444.6 3800 

2565067 STAPLE GIA 80 DLU3.8 278 0 282.75 3800 

2565083 STAPLE GIA 80 IN 3.8 278 0 449.8 3800 

2565109 STAPLE ILS 21MM EEA 278 0 663.3 3800 



2565166 STAPLE ILS 33 278 0 604.9 3800 

2565182 STAPLE LIGACLIP LG 278 0 186.05 3800 

2565208 STAPLE LIGACLIP MED 278 0 196.7 3800 

2565224 STAPLE LIGACLIP SM 278 0 196.45 3800 

2565240 STAPLE LIN CUT 55 278 0 221.15 3800 

2565265 STAPLE LIN CUT 55DLU 278 0 177.8 3800 

2565281 STAPLE LIN CUT 80 278 0 334.9 3800 

2565307 STAPLE LIN CUT 80DLU 278 0 255.65 3800 

2565323 STAPLE LINEAR 30 278 0 212.1 3800 

2565349 STAPLE LINEAR 30DLU 278 0 149.8 3800 

2565364 STAPLE LINEAR 60 278 0 215.15 3800 

2565380 STAPLE LINEAR 60DLU 278 0 161.35 3800 

2565406 STAPLE LINEAR 90-4.8 278 0 171.85 3800 

2565448 STAPLE POLYROTIC 200 278 0 461.7 3800

2565463 STAPLE PURSESTRING 278 0 191.35 3800 

2565489 STAPLE PURSTRING 278 0 191.85 3800 

2565521 STAPLE ROTIC 55-3.5 270 0 508.03 3800 

2565588 STAPLE SKIN* 278 0 0 3800 

2565604 STAPLE TA 90 278 0 277.7 3800 

2570026 SYN L drill 3.2 270 0 166.85 3800 

2570042 SYN L DRILL 4.5 270 0 145 3800 

2570281 SYN L PL DCP NR 08 H 270 0 232.8 3800 

2570422 SYN L Pl T-4 H 278 0 296 3800 

2570448 SYN L Pl T-6 H 278 0 0 3800 

2570489 SYN L SCR CANC 55-80 270 0 78.8 3800 

2570505 SYN L SCR CANC 85-110 270 0 88.05 3800 

2570521 SYN L SCR CANC FL THD 270 0 78.8 3800 

2570547 SYN L SCR CORT 14-70 270 0 52.55 3800 

2570588 SYN L WASHER* 278 0 55.5 3800 

2570604 SYN L WASHER SPIKED 278 0 270.4 3800 

2570620 SYN MN DRILL 1.1* 270 0 177 3800 

2570646 SYN MN DRILL 1.5 270 0 149.85 3800 

2570661 SYN MN DRILL 2.0 270 0 154.5 3800 

2570687 SYN MN DRILL 2.7 270 0 166.85 3800 

2570703 SYN MN K-WIRE 0.6* 270 0 0 3800 

2570729 SYN MN K-WIRE 0.8* 270 0 0 3800 

2570745 SYN MN K-WIRE 1.0* 270 0 0 3800 

2570760 SYN MN PLATE 1/4 TUB 3H 278 0 143.7 3800 






2570885 SYN MN PLATE L 2.0 LT 278 0 121.3 3800 

2570901 SYN MN PLATE L 2.0 RT 278 0 121.3 3800 

2570927 SYN MN PLATE L 2.7 LT 278 0 121.3 3800 

2570943 SYN MN PLATE L 2.7 RT 278 0 121.3 3800 

2570968 SYN MN PLATE STR 3H 278 0 121.3 3800 



2571024 SYN MN PLATE T 2.0 278 0 121.3 3800 

2571040 SYN MN PLATE T 2.7 278 0 121.3 3800 

2571123 SYN MN WASHER SPIKED 278 0 180.75 3800 

2571222 SYN SM 3.5 RECON 09 H 278 0 882 3800 

2571321 SYN SM DRILL 2.5 270 0 166.85 3800 

2571347 SYN SM DRILL 3.5 270 0 166.85 3800 

2571362 SYN SM K-WIRE 1.25 270 0 210.1 3800 

2571388 SYN SM K-WIRE 1.6 270 0 210.1 3800 

2571404 SYN SM K-WIRE 20. 270 0 210.1 3800 

2571487 SYN SM PL CLVR 03 H 278 0 622 3800 

2571503 SYN SM PL CLVR 04 H 278 0 666 3800

2571529 SYN SM PL LCDCP 05 H 278 0 302.8 3800 






2571644 SYN SM PL T-OBL 3/3 H 278 0 444 3800 

2571669 SYN SM PL T-OBL 3/4 H 278 0 470 3800 

2571685 SYN SM PL T-OBL 3/5 H 278 0 484 3800 

2571701 SYN SM PL T-RT 3 H 278 0 271.9 3800 

2571727 SYN SM PL T-RT 4 H 278 0 281.2 3800 

2571743 SYN SM PLATE 1/3 TUB 2H 278 0 119.75 3800 







2571941 SYN SM WASHER 278 0 53 3800 

2571966 SYN SM WASHER SPIKED 278 0 273.45 3800 

2575009 TOT BONE CEMENT 278 0 302.45 3800 

2575025 TOT BONE CEMENT W/TOB 278 0 856.65 3800 

2575041 TOT BONEDRY FEM WICK 270 0 79.65 3800 

2575066 TOT BUR 3MM 270 0 259.55 3800 

2575082 TOT BUR 4MM 270 0 259.55 3800 

2575108 TOT BUR EGG 270 0 274.4 3800 

2575124 TOT CEMENT MIX KIT 270 0 213.6 3800 

2575140 TOT HEWSON SUT PASS 270 0 170.5 3800 

2575165 TOT IM BRUSH 270 0 41.25 3800 

2575207 TOT KNIFE SLIT BLADE 270 0 83.45 3800 

2575223 TOT SAW BL STRY 250 270 0 121.35 3800 

2575249 TOT SAW BL STRY 328 270 0 117.25 3800 

2575264 TOT STERI-SHLD HELM 270 0 84.55 3800 

2575280 TOT SUPER SUCKER 270 0 55.6 3800 

2580009 URO AMPLATZ DILATORS 270 0 525.3 3800 

2580041 URO BAL DIL URO MAX4 270 0 628.3 3800 

2580066 URO BALL TIP ELECTRODE 270 0 282.5 3800 

2580082 URO CATH ALCOC 22 270 0 102.4 3800 

2580108 URO CATH ALCOC 24 270 0 102.4 3800 

2580124 URO CATH CARSON 0-TIP 270 0 741.6 3800 

2580140 URO CATH CONE 10 270 0 45.3 3800 

2580165 URO CATH CONE 8 270 0 45.3 3800 

2580181 URO CATH COUDE (ALL) 270 0 55.1 3800 

2580207 URO CATH COUNCIL 16 270 0 52.95 3800 

2580223 URO CATH COUNCIL 20 270 0 52.95 3800 

2580249 URO CATH MALECOT ALL 270 0 45.3 3800 

2580306 URO CATH SILC 20/30CC* 270 0 0 3800

2580322 URO CATH SILIC 22/3WAY* 270 0 0 3800 

2580363 URO CATH WHISTLE 4FR 270 0 44.05 3800 

2580389 URO CATH WHISTLE 5FR* 270 0 0 3800 

2580405 URO CATH WHISTLE 6FR 270 0 41.3 3800 

2580421 URO DEV-URINARY W/SLING 278 0 1236 3800 

2580447 URO EHL PROBE 3.3-1050 270 0 321.05 3800 

2580462 URO EHL PROBE 3.3-770 270 0 405.8 3800 

2580488 URO EHL PROBE 5 270 0 533.25 3800 

2580504 URO EHL PROBE 9 270 0 351.5 3800 

2580629 URO GD WIRE .038 270 0 53.55 3800 

2580645 URO GD WIRE RING TORQ 270 0 79.95 3800 

2580660 URO GD WIRE SENSOR 270 0 145.25 3800 

2580686 URO GD WIRE STIFF 270 0 95.8 3800 

2580702 URO GLIDE WIRE .038 270 0 126.7 3800 

2580728 URO LEVEEN INFLATOR 270 0 154.5 3800 

2580744 URO LEVEL I IRRIGATION 270 0 99.15 3800 

2580769 URO LIDOCAINE BRISTO 270 0 0 3800 

2580785 URO LONE STAR RETR 270 0 178.2 3800 

2580801 URO LONE STAR STAYS 270 0 79.2 3800 

2580827 URO MAL REENTRY20 270 0 247.2 3800 

2580843 URO NDL FASCIAL INCIS 270 0 78 3800 

2580868 URO NEPH KAYE TAMP 270 0 251.2 3800 

2580884 URO NEPH LAWSON RETR 270 0 391 3800 

2580900 URO NEPH VTC CATH 12FR 270 0 317.95 3800 

2580926 URO NEPHRO MAX 270 0 566.5 3800 

2580942 URO OCCLUS BAL CATH 270 0 319.3 3800 

2580967 URO OPT URETHTOME 270 0 345.05 3800 

2580983 URO OPT URETHTOME 1/2 270 0 345.05 3800 

2581049 URO PUP STENT 278 0 226.6 3800 

2581064 URO S/P CATH INTRODU 270 0 64.25 3800 

2581080 URO SAPS 270 0 160.7 3800 

2581106 URO SLING GYNECARE TVT 278 0 1537.3 3800 

2581122 URO SLING MID URETHRAL 278 0 1274.65 3800 

2581148 URO STENT POSITIONER 270 0 49.45 3800 

2581163 URO STENT PRC END/PYE 270 0 465.55 3800 

2581189 URO STENT PUP 278 0 226.6 3800 

2581205 URO STENT PUSHER/POSITIO 270 0 247.2 3800 

2581221 URO STENT TAIL 30 278 0 370.8 3800 

2581247 URO STENT TAIL 32 278 0 370.8 3800 

2581262 URO STENT TAIL 34 278 0 370.8 3800 

2581288 URO STENT URET 6X20 278 0 296.65 3800 

2581304 URO STENT URET 6x22 278 0 296.65 3800 




2581403 URO STONE BSKT 0-TIP 270 0 463.5 3800 

2581429 URO STONE BSKT SEG 3 270 0 442.9 3800

2581445 URO STONE BSKT SEG 4 270 0 442.9 3800 

2581460 URO STONE CONE RET 270 0 442.9 3800 

2581486 URO STONE GRASP TRICP 270 0 426.4 3800 

2581502 URO SURSEAL II 270 0 53.5 3800 

2581528 URO TOOMEY SYRINGE* 270 0 0 3800 

2581544 URO TURP BALL 24 270 0 244.1 3800 

2581569 URO TURP BALL 27 270 0 244.1 3800 

2581585 URO TURP KNIFE 24FR 270 0 231.75 3800 

2581601 URO TURP LOOP 24 270 0 227.1 3800 

2581627 URO TURP LOOP 27 270 0 223.15 3800 

2581643 URO TURP STAMEY PERC 270 0 134.55 3800 

2581684 URO URET ACCS SHEATH 270 0 300.8 3800 

2581700 URO URET DUAL LUMEN 278 0 216.3 3800 

2581726 URO URETERAL STENT 278 0 296.65 3800 

2581742 URO UROST TUBE ADAP* 270 0 0 3800 

2590008 SPECIAL ORDERS 270 0 0 3800 

2591022 TKA TRIATHLON CR FEMORAL CEMENT 278 0 3960 3800 

2591030 TKA TRIATHLON PS FEMORAL CEMENT 278 0 3960 3800 

2591048 TKA TRIATHLON CR PA FEM BEADED W/PA 278 0 4660 3800 

2591055 TKA TRIATHLON ASYMETRIC+B13 PATELLA 278 0 960 3800 

2591063 TKA ASYMETRIC ALL POLY PATELLA 278 0 1180 3800 

2591071 TKA TRIATHLON CR TIBIAL INSERT 278 0 1780 3800 

2591097 TKA TRIATHLON CR TIBIAL INSERT X3 278 0 2655 3800 

2591105 TKA TRIATHLON PS TIBIAL INSERT X3 278 0 2360 3800 

2591113 TKA TRIA PRIM TIB BP CRUCIF NON-POR 278 0 2080 3800 

2592004 THA TRIDENT HEMI SOLID BACK SHELL 278 0 2805.12 3800 

2592012 THA HEMI CLUSTER CEMENTLESS SHELL 278 0 2691.76 3800 

2592020 THA VITALOCK CLUSTER SHELL 270 0 1606.2 3800 

2592038 THA TRIDENT CROSSFIRE INSERT 278 0 1375.9 3800 

2592046 THA TRIDENT ALUMNA ID HEAD 278 0 1990.1 3800 

2592053 THA TRIDENT 10 DEG X3 ID HEAD 278 0 2607.64 3800 

2592061 THA V40 ALUMNA HEAD 32MM 278 0 1500.1 3800 

2592079 THA V40 CORCR LFIT HEAD (METAL) 278 0 964.75 3800 

2592087 THA V40 BIOLOX DELTA HEAD 36MM 278 0 2627.52 3800 

2592095 THA TI SLEEVE FOR ALUMNA HEAD 278 0 339.55 3800 

2592103 THA ALUMNA HEAD V40 36MM 278 0 1707.15 3800 

2592111 THA ANATOMIC HEAD V40 COCR LFIT36MM 278 0 2385 3800 

2592129 THA ANA C/TAPER BIOLOX D-HEAD 36MM 278 0 1877.95 3800 

2592137 THA ANA HEAD V40 BIO DELTA HEAD36MM 278 0 2627.52 3800 

2592145 THA CANCELLOUS BONE SCREW 6.5 278 0 281.55 3800 

2592152 THA MERIDIAN PA HIP STEM #6/14MM 278 0 5105.9 3800 

2592160 THA CITATION TMZF HA#2 LT 278 0 4928.2 3800 

2592178 THA ACCOLADE TMZE HIP STEM 278 0 5895 3800 

2592186 THA ACCOLADE PLUS TMZF HIP STEM 278 0 7196 3800 

2592194 THA ARTISAN BONE PLUG 278 0 267.05 3800 

2592202 THA CEMENT PLUG SIZED 278 0 292.7 3800 

2592210 THA UNIVERSAL DISTAL SPACER 278 0 306.4 3800

2592228 THA ACCOLADE C CS 127NK 278 0 3149.45 3800 

2592236 THA ACCOLADE C CS 132NK 278 0 3149.45 3800 

2592244 THA DEFINITION CEMENTED HIP STEM 278 0 3339.25 3800 

2592251 THA RELIANCE DIST CENTRALIZER 278 0 209.8 3800 

2592269 THA RELIANCE PF HIP STEM 278 0 2137.5 3800 

2592277 THA UHR BIPOLAR 26 278 0 1241.95 3800 

2592285 THA UNITRAX MODULAR ENDO HEAD 278 0 649.9 3800 

2592293 THA UNITRAX V40 TAPER SLEEVE 278 0 273.36 3800 

2592301 THA TRIDE ECCENTRIC X3 HEAD 36MM ID 278 0 3805.31 3800 

2592319 THA DALLMILES CBL/SLV SET 2MM SS 278 0 701.1 3800 

2592327 THA DALLMILES BEADED CBL SET 2MMVIT 278 0 524.7 3800 

2592335 THA DALL MILES MED GRIP&22MM CABLE 278 0 1101.5 3800 

2593002 GAMMA TROCHANTERIC LOCKING NAIL 278 0 2317.5 3800 

2593010 GAMMA LAG SCREW 278 0 877.5 3800 

2593028 GAMMA CROSS SCREW 278 0 319.6 3800 

2593036 GAMMA SET SCREW 278 0 315 3800 

2593044 GAMMA CAP SCREW 278 0 315 3800 

2593051 GAMMA KIRSCHNER WIRE 270 0 210 3800 

2593069 GAMMA DRILL 270 0 350.5 3800 

2593077 GAMMA GUIDE WIRE BALL TIP 270 0 322.5 3800 

2594000 OMEGA STANDARD LAG SCREW 278 0 459.3 3800 

2594018 OMEGA SUPER LAG SCREW 278 0 524.9 3800 

2594026 OMEGA COMPRESSION SCREW 278 0 130.7 3800 

2594034 OMEGA 3.6 BONE DRILL 270 0 295.25 3800 

2594042 OMEGA CORTICAL SELF-TAPPING SCREW 278 0 81.35 3800 

2594059 OMEGA STD BARREL KEYLESS PL 2HOLE 278 0 656.1 3800 


2594075 OMEGA STD BARREL KEYLESS PL 4HOLE 278 0 703 3800 






2600054 GELFOAM 270 0 119.85 3510 

2600104 PACK C-SECTION 270 0 269.95 3510 

2600203 GYN INTERCEED 278 0 411.9 3510 

2600302 MCH MIS CATH FOLEY 270 0 43.25 3510 

2600401 MCH STAPLE CRICKET 270 0 0 3510 

2902005 ONC IV THER 1ST HR 260 0 377.53 3700 

2902013 ONC IV THER ADD'L HR 260 0 72.85 3700 

2902021 INITIAL PLACEMENT OF PUMP/CASSETTE 335 0 766.56 3700 

2902039 REFILL/MAINTENANCE OF PUMP/CASSETTE 335 0 664.34 3700 

2902047 EACH ADDITIONAL VACCINE 771 0 65.8 3700 

2902054 IV TX ADD'L SQ < 1 HR 260 0 102.33 3700 

2902062 SINGLE VACCINE ADMINISTRATION 771 0 70.5 3700 

2902070 LUMBAR PUNCTURE 761 0 363.28 3700 

2902088 BONE MARROW ASPIRATION 761 0 630.99 3700

2902096 BONE MARROW BIOPSY 761 0 630.99 3700 

2902104 IV TX CONCURR INF 260 0 77.84 3700 


2902153 IV TX HYDRAT 31 60 MIN 260 0 229.52 3700 


2902203 ONC INJECTED SC, IM 940 0 74.34 3700 


2902302 IVP EACH ADD'L SEQ 940 0 74.73 3700 

2902310 IVP SEQ SAME DRUG>30 MIN 940 0 110.29 3700 

2902401 GLUCOSE CHECK 300 0 11.58 3700 

2902419 INSER FOLEY CATH 761 0 361.94 3700 

2902427 LEVEL I NV 761 0 77.24 3700 

2902500 CHEMO INFUSD 1ST HR 335 0 766.56 3700 

2902518 CHEMO INFUSD AD'L HR 335 0 147.36 3700 

2902609 CHEMO INF SEQ 1ST HR 335 0 300.46 3700 

2902658 CHEMO CNS REQ SPINAL INC LUMBAR PUN 331 0 524.92 3700 

2902708 CHEMO IVP INITIAL 331 0 437.14 3700 

2902716 CHEMO IVP EA ADD'L 280 0 250.38 3700 

2902807 CHEMO SC/IM NON-HORM 335 0 122.8 3700 

2902856 CHEMO SC/IM HORMONAL 335 0 122.8 3700 

2903003 BLOOD ADMIN-ONCOLOGY 391 0 828.41 3700 

2903110 PORT FLUSH ONLY 280 0 160.86 3700 

2903557 PNEUMON VACCINE ADMIN 771 0 70.5 3700 

2904100 CONSULT ONLY ONC N/C 940 0 0 3700 

2904118 EKG ONCOLOGY 730 0 258 3700 

2990018 CHEMOTHERAPY VISIT 999 0 0 3700 

2990026 NON CHEMOTHERAPY VISIT 999 0 0 3700 

2990034 VENOUS DRAW THROUGH PORT 761 0 101.75 3700 

2992089 CHEMO PUMP RENTAL 270 0 51.84 3700 

2992097 CHEMO SPILL KIT 270 0 9 3700 

2992105 CHEMO PUMP KIT 270 0 74.35 3700 

2992113 ONCOLOGY OXYGEN 270 0 36.75 3700 

3003704 ONCOLOGY E&M LEVEL 3 510 0 201.09 3700 

3004108 CONSULT ONLY ONC N/C 940 0 0 3700 

3090016 BLEOMYCIN SULFATE 15 VIAL 636 0 0 4290 

3090032 DOXORUBICIN HCL 10 MG VIAL 636 0 0 4290 

3090065 FLUDARABINE PHOSPHAT VIAL 636 0 0 4290 

3090081 VINCRISTINE SULFATE 1MG/ML 2ML VIAL 636 0 0 4290 

3090099 VINBLASTINE SULFATE 10 MG VIAL 636 0 0 4290 

3090107 DOCETAXEL 20 MG VIAL 636 0 0 4290 

3090123 DOXORUBICIN HCL 20 MG LIPO VIAL 636 0 0 4290 

3090156 RITUXIMAB 100MG VIAL 636 0 0 4290 

3090198 TRASTUZUMAB 440MG VIAL 636 0 0 4290 

3090214 VINORELBINE TARTRATE 10 MG VIAL 636 0 0 4290 

3090222 CARBOPLATIN 50 MG VIAL 636 0 0 4290 

3090255 CYLOPHOSPHAMIDE 500 VIAL 636 0 0 4290 

3090263 IRINOTECAN HCL 20 MG VIAL 636 0 0 4290

3090271 ETOPOSIDE 20 MG VIAL 636 0 0 4290 

3090289 FLUOROURACIL 50 MG VIAL 636 0 0 4290 

3090297 GEMCITABINE HCL 200 VIAL 636 0 0 4290 

3090370 METHOTREXATE SODIUM VIAL 636 0 0 4290 

3090388 INTERFERON ALFA-2B R 636 0 0 4290 

3090396 EPOETIN ALFA 2 MU VIAL 636 0 0 4290 





3090461 CISPLATIN 50 MG VIAL 636 0 0 4290 

3090487 MITOXANTRONE HCL 2 M 636 0 0 4290 

3090495 MITOMYCIN 5 MG VIAL 636 0 0 4290 

3090503 MITOMYCIN 20 MG 636 0 0 4290 

3090511 ONDANSETRON HCL 2 MG VIAL 636 0 0 4290 

3090529 TOPOTECAN HCL 4 MG VIAL 636 0 0 4290 

3090545 PAMIDRONATE DISODIUM 636 0 0 4290 

3090552 PAMIDRONATE DISODIUM 90 MG VIAL 636 0 0 4290 

3090578 ELLENCE 100 MG VIAL 636 0 0 4290 

3090586 FERRLECIT I.V. 62.5 MG IV INJ 636 0 0 4290 

3090594 ZOMETA 4MG VIAL 636 0 0 4290 

3090602 ZOLADEX 3.6MG IMPLANT 636 0 0 4290 

3090644 LUPRON DEPOT 22.5MG SYRINGE 636 0 0 4290 

3090651 ANZEMET 20MG/ML 5ML VIAL 636 0 0 4290 

3090669 NEULASTA 6MG. SYRINGE 636 0 0 4290 

3090677 NEUPOGEN 300 MCG VIAL 636 0 0 4290 

3090685 NEUPOGEN 480 MCG VIAL 636 0 0 4290 

3090727 ELOXATIN 50MG VIAL 636 0 0 4290 

3090750 VELCADE 3.5MG. VIAL 636 0 0 4290 

3090768 ALIMTA 500MG. VIAL 636 0 0 4290 

3090784 BEVACIZUMAB 25MG/ML VIAL 636 0 0 4290 

3090792 ERBITUX 2MG/ML 50ML VIAL 636 0 0 4290 

3090834 AZACITIDINE 100MG VIAL 636 0 0 4290 

3090867 EPOETIN ALFA 40MU VIAL 636 0 0 4290 

3090883 FASLODEX 50MG/ML SYRINGE 636 0 0 4290 

3090891 PACLITAXEL 100MG VIAL 636 0 0 4290 

3090925 MESNA 1 GM/10ML VIAL 636 0 0 4290 

3090933 OCTREOTIDE 20MG LAR DEPOT KIT 636 0 0 4290 

3090974 ABRAXANE 100 MG IV VIAL 636 0 0 4290 

3091014 CYCLOPHOSPHAMIDE 1 GM VIAL 636 0 0 4290 

3091022 CYCLOPHOSPHAMIDE 2 GM VIAL 636 0 0 4290 

3091030 CYTARABINE 500 MG VIAL 636 0 0 4290 

3091055 DACARBAZINE 200 MG VIAL 636 0 0 4290 

3091063 MITOMYCIN 5 MG VIAL 636 0 0 4290 

3091071 VINCRISTINE 1 MG/ML 1ML VIAL 636 0 0 4290 

3091089 LEUCOVORIN 50MG VIAL 636 0 0 4290 

3091097 VECTIBIX 5CC 100MG VIAL 636 0 0 4290

3091105 ARANESP 200MG 1.4ML 636 0 0 4290 

3091113 IFOSFAMIDE 100MG INJ VIAL 636 0 0 4290 

3091139 TORISEL KIT-25MG 636 0 0 4290 

3091147 DACOGEN 50MG VIAL 636 0 0 4290 

3091154 COSMEGEN 0.5MG VIAL 636 0 0 4290 

3091162 EPOGEN 10000 UNITS VIAL 636 0 0 4290 

3091170 EPOGEN 4000 UNITS 636 0 0 4290 

3091188 SANDOSTATIN LAR DEPOT 30 MG KIT 636 0 0 4290 

3091196 BENDAMUSTINE 100 MG VIAL 636 0 0 4290 

3091204 EPOGEN 2000 UNITS/ML 636 0 0 4290 



3091238 IXABEPILONE 15 MG VIAL 636 0 0 4290 

3091246 ROMIPLOSTIM 250 MCG INJ 636 0 0 4290 

3091253 ROMIPLOSTIM 500 MCG INJ 636 0 0 4290 

3091261 CAD CASSETTE W/IV SOLUTION 270 0 0 4290 

3091279 LEVOLEUCOVORIN 50MG VIAL INJ 636 0 0 4290 

3091287 AZACITIDINE 1 MG WASTAGE 636 0 0 4290 

3091295 BEVACIZUMAB 10MG WASTAGE 636 0 0 4290 

3091303 CISPLATIN 50 MG WASTAGE 636 0 0 4290 

3091311 CARBOPLATIN 50MG WASTAGE 636 0 0 4290 

3091329 CYCLOPHOSPHAMIDE 100MG WASTE 636 0 0 4290 

3091337 CYCLOPHOSPHAMIDE 100 MG WASTE 636 0 0 4290 

3091345 CYCLOPHOSPHAMIDE 100MG WASTE 636 0 0 4290 

3091352 DOCETAXEL 1 MG WASTAGE 636 0 0 4290 

3091360 DOXORUBICIN HCL 10MG VL WASTAGE 636 0 0 4290 

3091378 DOXORUBICIN HCL 10 MG LIPO WASTE 636 0 0 4290 

3091386 GEMCITABINE HCL 200 VIAL WASTAGE 636 0 0 4290 

3091394 RITUXIMAB 100MG VIAL WASTAGE 636 0 0 4290 

3091402 TOPOTECAN HCL 4 MG VIAL WASTAGE 636 0 0 4290 

3091410 ALTIMA 10 MG WASTAGE 636 0 0 4290 

3091428 ANZEMET 10MG WASTAGE 636 0 0 4290 

3091436 BENDAMUSTINE 1 MG WASTAGE 636 0 0 4290 

3091444 BLEOMYCIN SULFATE 15 UNIT WASTE 636 0 0 4290 

3091451 COSMEGEN .5MG VIAL WASTAGE 636 0 0 4290 

3091469 CYTARABINE 500MG VIAL WASTAGE 636 0 0 4290 

3091477 DACARBAZINE 200 MG VIAL WASTAGE 636 0 0 4290 

3091485 DACOGEN 1MG WASTAGE 636 0 0 4290 

3091493 ELLENCE 2MG WASTAGE 636 0 0 4290 

3091501 ELOXATIN .5 MG WASTAGE 636 0 0 4290 

3091519 EPOETIN 1000 UNITS WASTAGE 636 0 0 4290 






3091576 EPOETIN 1000 UNITS WASTAGE 636 0 0 4290

3091584 EPOGEN 1000 UNITS WASTAGE 636 0 0 4290 




3091626 ERBITUX 10MG WASTAGE 636 0 0 4290 

3091634 ETOPOSIDE 10 MG WASTAGE 636 0 0 4290 

3091642 FASLODEX 25MG WASTAGE 636 0 0 4290 

3091659 FERRLECIT IV 12.5 MG IV WASTE 636 0 0 4290 

3091667 FLUDARABINE PHOSPHAT 50MG WASTAGE 636 0 0 4290 

3091675 FLUOROURACIL 500MG WASTAGE 636 0 0 4290 

3091683 IFOSFAMIDE 1GRAM WASTE 636 0 0 4290 

3091691 IRINOTECAN HCL 20 MG VIAL WASTAGE 636 0 0 4290 

3091709 IXABEPILONE 1 MG VL WASTAGE 636 0 0 4290 

3091717 LEUCOVORIN 50 MG VL WASTAGE 636 0 0 4290 

3091725 LEVOLEUCOVORIN .5 MG VL INJ WASTE 636 0 0 4290 

3091733 LUPRON DEPOT 7.5MG SY WASTAGE 636 0 0 4290 

3091741 MESNA 200MG WASTAGE 636 0 0 4290 

3091758 MITOMYCIN 40 MG VIAL WASTAGE 636 0 0 4290 

3091766 MITOMYCIN .25MG WASTAGE 636 0 0 4290 

3091808 INTERFERON ALFA 2B50 MMU INJ VIAL 636 0 0 4290 

3091816 FERUMOXYTOL 510 MG/17ML 636 0 0 4290 

3091824 PEMETREXED 100 MG VIAL INJ 636 0 0 4290 

3091832 RASBURICASE 1.5 MG VIAL INJ 636 0 0 4290 

3091840 HEPARIN 1000 UNITS/ML SDV 2 ML 636 0 0 4290 

3091857 DENOSUMAB 120 MG VIAL 636 0 0 4290 

3091865 DENOSUMAB 60 MG SYRINGE 636 0 0 4290 


3092707 FOSAPREPITANT DIMEGLUMINE 636 0 0 4290 

3092715 OPRELVEKIN 5 MG VIAL 636 0 0 4290 

3092723 LEUPROLIDE ACETATE 30 MG 636 0 0 4290 

3092731 LEUPROLIDE ACETATE 22.5 MG 636 0 0 4290 

3092749 LEUPROLIDE ACETATE 45 MG 636 0 0 4290 

3092756 LEUPROLIDE ACETATE 7.5 MG 636 0 0 4290 

3092764 LEUPROLIDE ACETATE SUSP 636 0 0 4290 

3092772 ERIBULIN 1 MG/2 ML 636 0 0 4290 

3092780 CARFILZOMIB 60 MG VIAL 636 0 0 4290 

3092798 PERTUZUMAB 420 MG VIAL 636 0 0 4290 

3092806 TEMOZOLOMIDE 100 MG VIAL 636 0 0 4290 

3092814 VINBLASTINE 1MG/ML 636 0 0 4290 

3092822 DEXRAZOXANE 500 MG VIAL 636 0 0 4290 

3092830 DARBEPOETIN 40 MCG/ML VIAL 636 0 0 4290 

3092848 HEPARIN 50,000 UNITS/5 ML VIAL 636 0 0 4290 

3300225 CR PHASE IV-PUTNAM 940 0 44.82 4130 

3300233 CARDIAC REHAB PHASE II NO CON ECG 943 0 100.01 4130 

3300332 SUPERVISED PHASE III CARDIAC 940 0 100.01 4130 

3300415 CARDIAC PHASE II 943 0 100.01 4130 

3300704 GLUCOSE REAGENT STRP 300 0 9.94 4130

3300712 GLUCOSE STRIP SUBSEQ 300 0 9.94 4130 

3340056 PULM REHAB LEVEL 4 940 0 44.82 4130 

3340114 PULMONARY EVAL 510 0 97.56 4130 

3340205 P/R MD INT DOSE INHL 460 0 70.46 4130 

3340403 P/R ONE TO ONE WALK MONITOR 948 0 148.46 4130 

3340502 P/R ONE TO ONE STAIRS MONITOR 948 0 148.46 4130 

3340601 P/R GRP ACTIVITY 948 0 148.46 4130 

3400223 CARDIAC REHAB PHASE IV-PLAINFIELD 940 0 44.82 4130 

3400504 CARDIAC EVAL 940 0 81.3 4130 

3500170 BLINK REFLEX, ORBICULARIS OCULI 922 0 112.56 4200 

3500212 REPETITIVE STIM, NEUROMUSC JUNCTION 922 0 246.56 4200 

3500220 SENSORY 1 TO 2 SITES 922 0 225.12 4200 

3502366 SENSORY 3 TO 4 STUDIES 922 0 450.24 4200 





3502416 SENSORY 13 OR MORE STUDIES 922 0 1463.28 4200 

4000014 LEVEL 4 GROSS/MICRO 310 0 124.76 4010 

4000022 BM SMEAR INTERPRE 300 0 200.09 4010 

4000030 LEVEL 1 GROSS EXAM 310 0 29.93 4010 





4000089 DECALCIFICATION 310 0 187.39 4010 

4000097 SPECIAL STAIN GP I 310 0 108.36 4010 

4000105 SPECIAL STAIN GP II 310 0 115.25 4010 

4000113 MD COMPLETE CONSULT 999 0 0 4010 

4000121 CONSULT DURING SURG 999 0 0 4010 

4000139 FIRST FROZEN SECTION 310 0 146.74 4010 

4000147 ADDITIONAL FROZEN 310 0 76.56 4010 

4000154 PAP SCREEN 311 0 65.65 4010 

4000162 PAP SMEAR MD 999 0 0 4010 

4000170 PAP DIAGNOSTIC 311 0 61.82 4010 

4000188 SMEAR TZANK 310 0 101.53 4010 

4000196 SMEAR SEMEN 310 0 232.05 4010 

4000204 SMEAR BREAST DISC 310 0 151.13 4010 

4000212 CYTO THINPREP SCREEN 311 0 90.09 4010 

4000220 THIN PREP MD 999 0 0 4010 

4000238 CYTO THINPREP DIAG 311 0 90.09 4010 

4000246 CYTO GASTRIC BRUSH 310 0 140.99 4010 

4000253 CYTO BREAST CYST 310 0 175.57 4010 

4000261 CYTO BREAST ASPIRATE 310 0 175.57 4010 

4000279 CYTO BRONCH BRUSH 310 0 207.6 4010 

4000287 CYTO CSF 310 0 214.5 4010 

4000295 CYTO OVARY CYST 310 0 144.24 4010

4000303 CYTO SPUTUM 310 0 170.17 4010 

4000311 CYTO URINE 310 0 223.6 4010 

4000329 CYTO FINE NEEDLE ASP 310 0 241.3 4010 

4000337 CYTO PERITONEAL FLD 310 0 207.6 4010 

4000345 CYTO PLEURAL FLUID 310 0 207.6 4010 

4000352 CYTO THYROID ASP 310 0 144.24 4010 

4000360 CYTO BRONCH WASH 310 0 207.6 4010 

4000378 NONGYN MISCELLANEOUS 310 0 207.6 4010 

4000386 CYTO LUNG FNA 310 0 102.25 4010 

4000394 CYTO PERICARDIAL 310 0 207.6 4010 

4000402 CYTO GASTRIC WASH 310 0 207.6 4010 

4000410 IMMUNOHISTOCHEMISTRY 999 0 0 4010 

4000428 HER-2/NEU 310 0 280.5 4010 

4000436 ESTROGEN RECEPTOR 310 0 280.5 4010 

4000444 REFERRED BLOCKS 310 0 182.39 4010 

4000451 UNLISTED PROCEDURE 310 0 59.54 4010 

4000469 HER-2/NEU 999 0 0 4010 

4000477 REFERRED SLIDES 999 0 0 4010 

4000485 MD COMPLETE CONSULT 999 0 0 4010 

4000493 CONSULT DURING SURG 999 0 0 4010 

4000501 SMEAR ECC 310 0 73.26 4010 

4000519 SMEAR DIAPHRAM SCRAP 310 0 73.26 4010 

4000527 ST EVAL FNA/ADEQUACY 310 0 116.81 4010 

4000535 SMEAR NGYN 310 0 73.26 4010 

4000543 CYTO POST BRONCH SPUTUM 310 0 207.6 4010 

4000550 MANUALLY QUANTITATIVE 310 0 280.5 4010 

4000568 IN SITU HYBRIDIZATION 310 0 334.07 4010 

4000576 MD REVIEW TOUCH PREP 310 0 106.17 4010 

4000584 ISH PROBE 310 0 94.77 4010 

4000592 GENE REARRANGEMENT 310 0 311.05 4010 

4000600 BCR/ABL MAJOR BREAKPOINT 81207 310 0 450 4010 

4000618 BCR/ABL MAJOR BREAKPOINT 81206 310 0 450 4010 

4000626 AUTO FISH 310 0 603.69 4010 

4000634 EVAL OF FNA ADEQUACY, EA PASS 310 0 28.29 4010 

4000642 FLOW CYTOMETRY, FIRST MARKER 310 0 192.33 4010 

4000659 TOUCH PREP, EA ADD SITE 310 0 64.77 4010 

4000667 IHC, COMPUTER ASSISTED 310 0 313.48 4010 

4000675 ARCHIVED TISSUE, MOLECULAR STUDY 310 0 68.22 4010 

4000683 IN SITU HYBRID(FISH), EA PROBE 310 0 64.42 4010 

4000691 IN SITU HYBRID(QUANT),EA PROBE,COMP 310 0 603.69 4010 

4000709 IN SITU HYBRID(QUANT),EA PROBE,MAN 310 0 491.85 4010 

4001004 IMMUNOHISTOCHEMISTRY W/CHARGES 310 0 75.28 4010 

4001012 DIRECT IMMUNOFLUORESCENSE 310 0 75.28 4010 

4001020 FLOW CYTOMETRY 310 0 31.61 4010 


4100020 CEA 300 0 67.45 4010 

4100038 FERRITIN 300 0 70.61 4010

4100046 DIGOXIN 300 0 50.41 4010 

4100053 GENTAMYCIN BASELINE 300 0 73.16 4010 

4100061 PHENOBARBITAL 300 0 61.77 4010 

4100079 FOLIC ACID 300 0 52.27 4010 

4100087 TEGRETOL 300 0 61.45 4010 

4100095 GLYCOHEMOGLOBIN 300 0 34.52 4010 

4100103 T3 UPTAKE 300 0 26.71 4010 

4100111 T4 (THYROXINE) 300 0 30.84 4010 

4100129 TSH 300 0 68.64 4010 

4100137 GENTAMYCIN PEAK 300 0 73.16 4010 

4100145 VALPROIC ACID 300 0 50.35 4010 

4100160 DILANTIN 300 0 58.13 4010 

4100178 VITAMIN B12 300 0 61.25 4010 

4100186 ACETOMINOPHEN 300 0 71.93 4010 

4100194 TOBRAMYCIN PEAK 300 0 57.29 4010 

4100202 FREE T4 300 0 47.67 4010 

4100210 TOBRAMYCIN BASELINE 300 0 84.35 4010 

4100228 HCG BETA SUBUNIT 300 0 63.44 4010 

4100236 THEOPHYLLINE 300 0 54.64 4010 

4100244 VANCOMYCIN,RANDOM 300 0 56.02 4010 

4100251 VANCOMYCIN TROUGH 300 0 56.02 4010 

4100269 VANCOMYCIN PEAK 300 0 56.02 4010 

4100277 UREA NITROGEN 24HR 300 0 21.77 4010 

4100285 PREG TOXEMIA PANEL 300 0 0 4010 

4100293 METHEMOGLOBIN 300 0 55.71 4010 

4100301 TROPONIN I LEVEL 300 0 58.24 4010 

4100319 FACTORY MUTUAL PNL 2 300 0 65.39 4010 

4100327 POTASSIUM,PLASMA 300 0 16.34 4010 


4100418 FLUID APPEARANCE 300 0 26.72 4010 

4100426 FLUID PH 300 0 37.38 4010 

4100434 GENTAMYCIN,RANDOM 300 0 73.16 4010 

4100442 TOBRAMYCIN,RANDOM 300 0 111.41 4010 

4100459 LDL,DIRECT 300 0 35.81 4010 

4100467 GLUCOSE 1HR,NF 300 0 19.83 4010 

4100475 ACETONE (BLOOD) 300 0 24.67 4010 

4100483 MICROALB.RANDOM UR 300 0 27.36 4010 

4100491 MICROALB.24HR UR 300 0 27.36 4010 

4100509 ALBUMIN (BLOOD) 300 0 16.64 4010 

4100517 FLUID ALBUMIN 300 0 30.55 4010 

4100525 ALCOHOL 300 0 41.93 4010 

4100533 HDL 300 0 28.92 4010 

4100541 AMMONIA (BLOOD) 300 0 51.81 4010 

4100558 AMYLASE 300 0 27.22 4010 

4100566 FIBRONECTIN 300 0 487.7 4010 

4100574 CSF CHLORIDE 300 0 22.17 4010 

4100582 BILIRUBIN, TOTAL, NEONATAL 300 0 20.13 4010

4100590 BILIRUBIN TOTAL 300 0 20.13 4010 

4100608 BILIRUBIN DIRECT 300 0 20.13 4010 

4100616 BILIRUBIN, INDIRECT 300 0 0 4010 

4100624 IRON 300 0 23.03 4010 

4100632 TIBC 300 0 0 4010 

4100640 UIBC 300 0 36.16 4010 

4100657 CALCIUM 300 0 18.1 4010 

4100665 FLUID CHLORIDE 300 0 29.77 4010 

4100673 CARBON MONOXIDE (CO) 300 0 50.54 4010 

4100681 CALCIUM URINE RANDOM 300 0 29.95 4010 

4100699 CHLORIDE (CL) 300 0 16.34 4010 

4100707 CHOLESTEROL 300 0 17.26 4010 

4100715 PCP (TDAS) 300 0 92.43 4010 

4100723 BENZO (TDAS) 300 0 92.43 4010 

4100731 COCAINE (TDAS) 300 0 92.43 4010 

4100749 AMPT (TDAS) 300 0 92.43 4010 

4100756 THC (TDAS) 300 0 92.43 4010 

4100764 OPIATES (TDAS) 300 0 92.43 4010 

4100772 BARBITURATES (TDAS) 300 0 92.43 4010 

4100780 CPK 300 0 32.89 4010 

4100798 IRON/TIBC 300 0 0 4010 

4100806 IRON SATURATION 300 0 0 4010 

4100814 CREATININE CLEARANCE 300 0 38.31 4010 

4100822 CREAT JP DRAINAGE 300 0 23.64 4010 

4100830 CREATININE RANDOM UR 300 0 30.55 4010 

4100848 PH BLOOD 300 0 61.63 4010 

4100855 BICARBONATE (HCO3) 300 0 17.39 4010 

4100863 BLOOD GASES 300 0 68.79 4010 

4100871 GGTP 300 0 29.58 4010 

4100889 PROTEIN 24HR URINE 300 0 26.71 4010 

4100897 CHLORIDE UR RANDOM 300 0 26.43 4010 

4100905 LUTEINIZING HORMONE 300 0 75.64 4010 

4100913 CALCIUM 24HR URINE 300 0 30.07 4010 

4100921 PROLACTIN 300 0 78.51 4010 

4100939 HDL PANEL 300 0 54.91 4010 

4100947 CHLORIDE 24HR URINE 300 0 26.43 4010 

4100954 LIPASE 300 0 28.88 4010 

4100970 CREATININE 24HR UR 300 0 23.64 4010 

4100988 ELECTROLYTES & MG 300 0 110.7 4010 

4100996 LDH 300 0 25.46 4010 

4101002 LACTOSE TOL FASTING 300 0 0 4010 

4101010 LACTOSE TOL 1/2 HR 300 0 0 4010 

4101028 LACTOSE TOL 1HR 300 0 56.36 4010 

4101036 LACTOSE TOL 2 HR 300 0 17.18 4010 

4101044 LITHIUM LEVEL 300 0 29.52 4010 

4101051 MAGNESIUM 300 0 25.55 4010 

4101069 MAGNESIUM,UR.RANDOM 300 0 44.27 4010

4101077 OSMOLALITY SERUM 300 0 29.29 4010 

4101085 PSA DIAGNOSTIC 300 0 71.93 4010 

4101093 PSA SCREENING 300 0 71.93 4010 

4101101 ALKALINE PHOS 300 0 20.97 4010 

4101119 PHOSPHOROUS 300 0 17.55 4010 

4101127 PHOSPHORUS,RANDOM UR 300 0 18.4 4010 

4101135 POTASSIUM (K),SERUM 300 0 24.05 4010 

4101143 POTASSIUM (K),FLUID 300 0 24.44 4010 

4101150 LYTES 300 0 34.62 4010 

4101168 COMP.METABOL.PNL NF 300 0 55.55 4010 

4101176 COMP.METABOL.PNL FST 300 0 55.55 4010 

4101184 BASIC METABOL.PNL NF 300 0 49.88 4010 

4101192 BASIC METABOL FSTING 300 0 49.88 4010 

4101218 HEPATIC FUNCTION PNL 300 0 53.31 4010 

4101226 RENAL FUNCTION PANEL 300 0 65.65 4010 

4101234 TOTAL PROTEIN 300 0 19.32 4010 

4101242 PROTEIN UR RANDOM 300 0 18.1 4010 

4101259 CSF PROTEIN 300 0 13.25 4010 

4101267 SALICYLATE 300 0 38.64 4010 

4101275 COSTISOL STIMULATION 300 0 220.55 4010 

4101283 SODIUM (NA),SERUM 300 0 25.19 4010 

4101291 SODIUM (NA),FLUID 300 0 24.44 4010 

4101309 GLUCOSE 24HR URINE 300 0 17.01 4010 

4101317 POTASSIUM 24HR URINE 300 0 17.44 4010 

4101325 GLUCOSE FASTING 300 0 15.88 4010 

4101333 IGG 300 0 70.98 4010 

4101341 IGA 300 0 70.98 4010 

4101358 IGM 300 0 70.98 4010 

4101366 RA FACTOR,QUANT 300 0 37.42 4010 

4101374 POTASSIUM RANDOM UR 300 0 17.44 4010 

4101382 FLUID GLUCOSE 300 0 17.01 4010 

4101390 SGOT 300 0 42.97 4010 

4101408 SGPT 300 0 18.83 4010 

4101416 TRIGLYCERIDES 300 0 20.45 4010 

4101424 GLUCOSE 2HHP 300 0 35.1 4010 

4101432 BUN 300 0 17.01 4010 

4101440 CREATININE 300 0 20.38 4010 

4101457 BUN/CREA RATIO 300 0 0 4010 

4101465 CREATININE,FLUID 300 0 23.64 4010 

4101473 URIC ACID 300 0 16.08 4010 

4101481 GLUCOSE RANDOM 300 0 15.88 4010 

4101499 PHOSPHOROUS 24HR UR 300 0 18.4 4010 

4101507 SODIUM URINE RANDOM 300 0 17.58 4010 

4101515 AMYLASE RANDOM URINE 300 0 29.58 4010 

4101523 B NATRIURETIC PEPTIDE 300 0 122.01 4010 

4101531 FSH SERUM 300 0 75.64 4010 

4101549 SODIUM 24HR URINE 300 0 17.58 4010

4101556 GASTRIC PH 300 0 29.77 4010 

4101564 CSF GLUCOSE 300 0 17.01 4010 

4101572 FLUID AMYLASE 300 0 27.22 4010 

4101580 CRP,HIGH SENSITIVITY 300 0 52.61 4010 

4101598 OSMOLALITY URINE 300 0 35.69 4010 

4101606 CORTISOL,SUPPRESSION 300 0 57.96 4010 

4101614 HOMOCYSTEINE 300 0 111.72 4010 

4101622 TESTOSTERONE 300 0 195.39 4010 

4101630 CORTISOL AM 300 0 85.34 4010 

4101648 CORTISOL PM 300 0 85.34 4010 

4101655 CORTISOL BASELINE 300 0 85.34 4010 

4101663 CORTISOL 1/2HR 300 0 85.34 4010 

4101671 CORTISOL 1HR 300 0 63.28 4010 

4101689 CORTISOL BASELINE,DX 300 0 63.28 4010 

4101697 CORTISOL,POST SUPPRE 300 0 63.28 4010 

4101705 BLOOD GASES CORD VEN 300 0 101.28 4010 

4101713 BLOOD GASES CORD ART 300 0 101.28 4010 

4101721 FLUID TOTAL PROTEIN 300 0 19.5 4010 

4101739 CHALLENGE URINE 300 0 11.34 4010 

4101747 1 HOUR GTT 300 0 56.36 4010 

4101754 2 HOUR GTT 300 0 17.18 4010 

4101762 3 HOUR GTT 300 0 17.18 4010 

4101770 4 HOUR GTT 300 0 17.18 4010 

4101788 5 HOUR GTT 300 0 17.18 4010 

4101796 6 HOUR GTT 300 0 17.18 4010 

4101804 GLUCOSE FASTING 300 0 15.88 4010 

4101812 GLUCOSE 1HR 300 0 35.1 4010 

4101820 GLUCOSE 2 HR 300 0 56.36 4010 

4101838 GLUCOSE 3HR 300 0 17.18 4010 

4101846 CHALLENGE FST.URINE 300 0 0 4010 

4101853 GLUCOSE FASTING 300 0 0 4010 

4101861 GTT/ 1/2HR 300 0 0 4010 

4101879 GTT FASTING 300 0 0 4010 

4101887 GLU CHALLENGE FST 300 0 0 4010 

4101895 GLU CHALLENGE 1 HR 300 0 0 4010 

4101903 GLUCOSE 1HR 300 0 0 4010 

4101911 GLUCOSE 2 HR 300 0 0 4010 

4101929 GLUCOSE 2HR 300 0 56.36 4010 

4101937 GLUCOSE 3 HR 300 0 17.18 4010 

4101945 GLUCOSE 3HR W/URINE 300 0 0 4010 

4101952 GLUCOSE 1HR 300 0 0 4010 

4101960 AMYLASE 24HR URINE 300 0 29.58 4010 

4101978 CKMB 300 0 54.44 4010 

4101986 URIC ACID(NOT BLOOD) 300 0 29.77 4010 

4101994 FLUID BILIRUBIN 300 0 22.88 4010 

4102000 FLUID LDH 300 0 25.46 4010 

4102018 URIC ACID 24HR URINE 300 0 20.98 4010

4102026 TIME & VOLUME URINE 300 0 16.45 4010 

4102034 DLDL 300 0 56.49 4010 

4102042 UREA,URINE,RANDOM 300 0 24.84 4010 


4102075 C3 300 0 42.68 4010 

4102083 CA 125 300 0 73.98 4010 

4102091 C4 300 0 42.68 4010 

4102109 PREALBUMIN 300 0 51.86 4010 

4102117 PROGESTERONE 300 0 74.16 4010 

4102125 HIV 300 0 45.13 4010 

4102133 NT BNP 300 0 179.64 4010 

4102182 RUBELLA ICG 300 0 51.17 4010 

4102190 T3 TOTAL 300 0 50.42 4010 

4102208 T3 FREE 300 0 60.22 4010 

4102216 INTACT PTH 300 0 167.55 4010 

4102232 URINE DRUG SCREEN 300 0 166.05 4010 

4102240 CHEM 8 + METABOLIC LAB 300 0 40 4010 

4102257 CHEM 8 + HEMATOCRIT LAB 300 0 10 4010 

4102265 CREATININE, BLOOD, LAB 300 0 20 4010 

4102273 TROPONIN LAB 300 0 40 4010 

4102281 BILIRUBIN, UNCONJUGATED 300 0 0 4010 

4103156 BILIRUBIN, CONJUGATED 300 0 20.13 4010 

4103164 IONIZED CALCIUM 300 0 90 4010 

4103206 VENOUS BLOOD GASES 300 0 68.79 4010 

4103214 CAPILLARY BLOOD GASES 300 0 68.79 4010 

4200002 SLIDE/ONCOLOGY 300 0 0 4010 

4200010 PROTHROMBIN TIME 300 0 16.86 4010 

4200028 PTT 300 0 23.55 4010 

4200036 FIBRINOGEN 300 0 33.29 4010 

4200044 FDP 300 0 25.06 4010 

4200051 INR 300 0 0 4010 

4200069 BLEEDING TIME 300 0 18.9 4010 

4200077 HEMOGRAM 300 0 33.9 4010 

4200085 HEMOGRAM 300 0 0 4010 

4200093 H + H 300 0 17.55 4010 

4200101 FETAL HGB SCREEN 300 0 29.4 4010 

4200119 WRIGHT STAIN 300 0 12.24 4010 

4200127 CBC/AUTO DIFF 300 0 40.68 4010 

4200135 CBC/MANUAL DIFF 300 0 60.46 4010 

4200143 RBC COUNT 300 0 21.39 4010 

4200150 WBC COUNT 300 0 14.23 4010 

4200168 HEMOGLOBIN 300 0 10.68 4010 

4200176 HEMATOCRIT 300 0 10.68 4010 

4200184 PEROXIDASE STAIN 310 0 90.81 4010 

4200192 WBC & DIFFERENTIAL 300 0 14.23 4010 

4200200 WBC & MANUAL DIFF 300 0 32.52 4010 

4200218 DIFFERENTIAL/AUTO 300 0 0 4010

4200226 DIFFERENTIAL/MANUAL 300 0 0 4010 

4200234 SMEAR REVIEW 300 0 0 4010 

4200242 SED RATE WESTERGREN 300 0 21.25 4010 

4200259 SED RATE WESTERGREN 300 0 21.25 4010 

4200267 ABSOLUTE EOS CT 300 0 14.23 4010 

4200275 PLATELET COUNT 300 0 18.1 4010 

4200283 PLATELET CT/NA CITR 300 0 20.72 4010 

4200291 RETICULOCYTES 300 0 16.45 4010 

4200309 NASAL SMEAR FOR EOS 300 0 16.87 4010 

4200317 EOSINOPHIL SMEAR 300 0 25.06 4010 

4200325 ANA SCREEN 300 0 53.41 4010 

4200333 DNA SCREEN 300 0 71.51 4010 

4200341 DNA TITER 300 0 77.67 4010 

4200358 FLUID RBC 300 0 38.22 4010 

4200374 FLUID WBC 300 0 22.03 4010 

4200382 ANA TITER 300 0 77.67 4010 

4200390 ANA PATTERN 300 0 0 4010 

4200408 FLUID DIFFERENTIAL 310 0 0 4010 

4200416 OBSTETRIC PANEL 300 0 157.79 4010 

4200424 SPINAL FLUID PANEL 300 0 0 4010 

4200432 CSF RBC 310 0 39.03 4010 

4200440 CSF WBC 310 0 39.03 4010 

4200457 MD SMEAR REVIEW 310 0 0 4010 

4200465 CSF DIFFERENTIAL 310 0 28.77 4010 

4200473 MIXING STUDIES 300 0 0 4010 

4200481 GRISWOLD RUB. OCC. H 300 0 83.2 4010 

4200499 CBC/AUTO DIFF 300 0 40.68 4010 

4200507 CBC/MANUAL DIFF 300 0 60.46 4010 

4200515 OBSTETRIC PANEL 300 0 157.79 4010 

4200523 WBC & DIFFERENTIAL 300 0 14.23 4010 

4200531 WBC & MANUAL DIFF 300 0 32.52 4010 

4201000 CBC-ONCOLOGY 300 0 26.85 4010 

4300026 BACTERIAL AG, CSF 300 0 134.36 4010 

4300034 H PYLORI CULTURE 300 0 152.62 4010 

4300059 LEGIONELLA AG,URINE 300 0 65.47 4010 

4300067 BRONCHIAL CULTURE 300 0 43.96 4010 

4300075 ACID FAST STAIN 300 0 43.49 4010 

4300083 KOH PREP 300 0 20.7 4010 

4300091 GRAM STAIN 300 0 16.45 4010 

4300109 VANCO RESIST.ENTERO 300 0 23.42 4010 

4300117 METH.RESIST.STAPH SC 300 0 23.42 4010 

4300125 GP.B STREP SCREEN 300 0 23.42 4010 

4300166 GIARDIA CRYPTO AG 300 0 90.81 4010 

4300174 FUNGUS SKIN 300 0 55.48 4010 

4300182 CYCLOSPORA SP STAIN 300 0 38.16 4010 

4300190 ANAEROBIC ISOLATION 300 0 38.22 4010 

4300208 MACRO PARASITE EXAM 300 0 61.25 4010

4300216 TISSUE HOMOGENOUS 300 0 35.88 4010 

4300232 STOOL ADD.PATH. 2 300 0 21.39 4010 

4300240 DEFINITIVE ID AER 1 300 0 28.71 4010 

4300257 DEFINITIVE ID AER.2 300 0 28.71 4010 

4300265 DEFINITIVE ID AER.3 300 0 28.71 4010 

4300273 DEFINITIVE IS AER.4 300 0 42.27 4010 

4300281 DEFINITIVE IS AER.5 300 0 28.71 4010 

4300299 DEF.ID ANAEROBIC 1 300 0 45.79 4010 





4300349 DEF. ID FUNGUS 1 300 0 62.6 4010 

4300356 DEF.ID FUNGUS 2 300 0 54.05 4010 

4300364 DEF. ID FUNGUS 3 300 0 54.05 4010 

4300372 DEF.ID FUNGUS 4 300 0 54.05 4010 

4300380 DEF. ID FUNGUS 5 300 0 54.05 4010 

4300398 BETA STREP GROUPING 300 0 30.55 4010 





4300489 THROAT SCREEN PEDS 300 0 23.42 4010 

4300497 RAPID GROUP A STREP 300 0 23.42 4010 

4300505 CRYPTOCOCCUS AG 300 0 66.99 4010 

4300513 C.NEOFORMANS AG(CSF) 300 0 95.42 4010 

4300521 INFLUENZA A/EIA 300 0 72.48 4010 

4300539 INFLUENZA A 300 0 34.48 4010 

4300547 ENVIRONMENTAL-NH 300 0 0 4010 

4300554 ENVIRONMENTAL-DKH 300 0 0 4010 

4300562 GRAM STAIN 300 0 16.45 4010 

4300570 WET PREP 300 0 15.18 4010 

4300588 OVA & PARASITES 300 0 98.21 4010 

4300620 FUNGUS CULTURE 300 0 58.35 4010 

4300638 MYCOPLASMA IGM 300 0 87.75 4010 

4300646 COLONY COUNT 300 0 31.31 4010 

4300653 RAPID RETROVIRAL 300 0 45.13 4010 

4300661 CSF CULTURE 300 0 41.09 4010 

4300679 GC SCREEN 300 0 27.55 4010 

4300687 BETA STREP SCREEN 300 0 23.42 4010 

4300695 SALM/SHIG STOOL CULT 300 0 38.22 4010 

4300703 CAMPY STOOL CULT 300 0 38.22 4010 

4300711 SHIGA TOXIN STOOL CU 300 0 72.48 4010 

4300729 GENITAL CULTURE 300 0 44.8 4010 

4300737 BLOOD CULTURE 300 0 49.91 4010 

4300745 URINE CULTURE 300 0 28.77 4010 

4300752 RESP CULTURE 300 0 33.71 4010

4300760 WOUND CULTURE 300 0 44.8 4010 

4300778 BLOOD CULTURE #3 300 0 284.7 4010 

4300786 SENSITIVITY,MIC 300 0 30.71 4010 

4300794 KB SUSCEPTIBILITY 300 0 24.12 4010 

4300802 SINGLE KB SENSITIVIT 300 0 28.21 4010 

4300810 E-TEST SENSITIVITY 300 0 45.23 4010 

4300828 BLOOD CULTURE #2 300 0 190.84 4010 

4300836 TB CULTURE W/SMEAR 300 0 167.12 4010 

4300844 RESP.SYNCYTIAL VIRUS 300 0 49.74 4010 

4300851 AEROBIC ISOLATE ID 300 0 82.42 4010 

4300869 PARASITE/ISOLATE ID 300 0 41.99 4010 

4300877 CATH TIP CULTURE 300 0 28.77 4010 

4300885 GASTRIC ASP CULTURE 300 0 57.98 4010 

4300893 EYE CULTURE 300 0 39.45 4010 

4300901 EAR CULTURE 300 0 39.45 4010 

4300919 TRICHROME STAIN 310 0 58.35 4010 

4300927 MISC. CULTURE 300 0 90.81 4010 

4300935 ENVIRONMENTAL-OTHER 300 0 24.44 4010 

4300943 THROAT CULTURE 300 0 34.51 4010 

4300950 ANTHRAX CULTURE 300 0 62.6 4010 

4300968 PINWORM PREP 300 0 17.26 4010 

4300976 TICK ID DKH 300 0 39.72 4010 

4300984 C.DIFFICILE TOXIN 300 0 76.44 4010 

4300992 VARICELLA ZOSTER IMM 300 0 97.7 4010 

4301008 CRYPTOSPORIDIA AG 300 0 51.44 4010 

4301016 GIARDIA AG 300 0 51.81 4010 

4301024 BRONCHIAL BRUSH, QUANT 300 0 57.27 4010 

4301032 CHROM. FOR MRSA 300 0 23.84 4010 

4301040 SHIGA TOXIN, STOOL 300 0 96.99 4010 

4301057 YERSINIA CULTURE 300 0 17.01 4010 

4302014 INFLUENZA B 306 0 34.48 4010 

4302022 GROUP B STREP SCREEN, WITH SENSITI 300 0 43.5 4010 

4302030 CULTURE,TYP; IMMUNOLOGIC 300 0 27.08 4010 

4302048 COAGULASE TEST 300 0 30.55 4010 

4302055 C DIFF TOXIN B 300 0 190.4 4010 

4302063 NAP1 300 0 190.4 4010 

4400016 TYPE & CROSS,1 UNIT 391 0 88.53 4010 

4400024 RH 300 0 14.18 4010 

4400032 BLOOD TYPING ABO 300 0 16.49 4010 

4400040 TYPE CHECK 300 0 16.49 4010 

4400057 RH CHECK 300 0 14.18 4010 

4400065 TYPE & CROSS 4 UNITS 391 0 180.12 4010 



4400099 SPEC ANTIGEN TYPING 300 0 25.16 4010 

4400107 CORD BLOOD TYPING 300 0 47.67 4010 

4400115 ANTI HU GLOB TITER 300 0 24.68 4010

4400123 ANTI TITER-ALBUMIN 300 0 24.68 4010 

4400131 ANTI TITER-SALINE 300 0 24.68 4010 

4400156 CROSSMATCH, AHG 300 0 35.1 4010 

4400164 XM W/O TS 300 0 0 4010 

4400172 4 UNIT COMPATIBILITY 300 0 0 4010 







4400263 ANTIBODY TITER 300 0 57.98 4010 

4400271 COLD AGG ABSORBTION 390 0 84.7 4010 

4400289 ANTIBODY IDENTIFICAT 300 0 108.05 4010 

4400297 RHOGAM 636 0 122.05 4010 

4400305 DIRECT COOMBS 300 0 28.28 4010 

4400313 ANTIBODY SCREEN 300 0 26.41 4010 

4400321 TYPE AND SCREEN 300 0 32.83 4010 

4400339 DU, CORD BLOOD 300 0 23.03 4010 

4400347 BLOOD BK MD SERVICE 300 0 0 4010 

4400354 TRANSFUSION REACTION 300 0 194.91 4010 

4400362 ABO TYPE 300 0 16.49 4010 

4400370 RH 300 0 14.18 4010 

4400388 ANTIBODY SCREEN 300 0 20.85 4010 

4400396 DU 300 0 23.03 4010 

4400404 DAT, ANTI-IGG 300 0 28.28 4010 

4400412 DAT, BROAD SPECTRUM 300 0 28.28 4010 

4400420 ANTIBODY ID 300 0 108.04 4010 

4405007 FFP/CRYO, THAWING, EA UNIT 300 0 29.79 4010 

4405015 CROSSMATCH, IMMEDIATE SPIN 300 0 29.79 4010 

4405023 CROSSMATCH, 37C INCUBATION 300 0 29.79 4010 

4405031 ANTIBODY ID PANEL 2 300 0 108.04 4010 

4405049 ANTIBODY ID PANEL 3 300 0 108.04 4010 

4405056 ANTIBODY SCREEN 2 300 0 20.85 4010 

4405064 ANTIBODY SCREEN 3 300 0 20.85 4010 

4405080 DAT, C3B 300 0 28.28 4010 

4405098 SPECIAL ANTIGEN TYPING 2, PATIENT 300 0 25.16 4010 

4405106 SPECIAL ANTIGEN TYPING 3, PATIENT 300 0 25.16 4010 

4405114 SPECIAL ANTIGEN TYPING 1, UNIT 300 0 25.16 4010 



4500013 FIBRIN CLOT 300 0 0 4010 

4500021 URINALYSIS 300 0 25.54 4010 

4500039 MACROSCOPIC URINE 300 0 0 4010 

4500047 URINALYSIS/CIC 300 0 25.54 4010 

4500054 BILIRUBIN, URINE 300 0 11.75 4010 

4500062 URINE MICROSCOPIC 300 0 19.83 4010

4500070 PH URINE 300 0 11.34 4010 

4500088 SPEC.GRAVITY URINE 300 0 11.34 4010 

4500096 GLUCOSE, URINE 300 0 11.34 4010 

4500104 FAT URINE 300 0 31.27 4010 

4500112 D-DIMER 300 0 93.57 4010 

4500120 PREG MONOCLONAL URIN 300 0 64.64 4010 

4500138 KETONES - URINE 300 0 11.34 4010 

4500146 PROTEIN,URINE 300 0 22.17 4010 

4500153 OCCULT BLOOD URINE 300 0 11.75 4010 

4500161 OCCULT BLOOD FECES 300 0 20.23 4010 

4500179 NITRATE URINE 300 0 11.75 4010 

4500187 REDUCING SUB - URINE 300 0 22.17 4010 

4500195 RUBELLA SCREEN 300 0 94.08 4010 

4500203 FLUID SPEC.GRAVITY 300 0 25.18 4010 

4500211 PH FECES 300 0 18.75 4010 

4500229 MONO TEST 300 0 45.83 4010 

4500237 COLD AGGLUTININS 300 0 72.48 4010 

4500252 PREG MONOCLONAL SERU 300 0 64.64 4010 

4500260 FECAL FIBER 300 0 14.5 4010 

4500278 RPR 300 0 35.1 4010 

4500286 SEMEN POST VAS 310 0 90.81 4010 

4500294 FLUID CRYSTALS 310 0 49.6 4010 

4500302 SEMEN FERTILITY 310 0 103.03 4010 

4500310 LYME EIA (IGG & IGM) 300 0 118.86 4010 

4500328 GARDNERELLA 300 0 151.13 4010 

4500336 TRICHOMONAS 300 0 151.13 4010 

4500344 CANDIDA SPECIES 300 0 151.13 4010 

4500351 GC DNA 300 0 178 4010 

4500369 CHLAMYDIA DNA 300 0 178 4010 

4500377 VARICELLA ZOSTER IMM 300 0 86.26 4010 

4500385 H.PYLORI AB IGG 300 0 109.92 4010 

4500393 FIBRONECTIN 300 0 94.48 4010 

4500401 ROTAVIRUS 300 0 101.53 4010 


4500435 LACTIC ACID 300 0 55.75 4010 

4500443 GENTAMYCIN(ONCE DAILY DOSING) 300 0 73.16 4010 

4500450 TOBRAMYCIN(ONCE DAILY DOSING) 300 0 84.35 4010 

4500468 AMNISURE 300 0 233.17 4010 

4500476 D-DIMER(DIC) 300 0 93.86 4010 

4600011 CERULOPLASMIN 300 0 81.64 4010 

4600029 DHEA SULFATE 300 0 168.68 4010 

4600037 CA 125 300 0 38.75 4010 

4600045 THYROID STIM.IMMUNO 300 0 215.73 4010 

4600052 CHOLINESTERASE ,RBC 300 0 93.15 4010 

4600060 NORTRIPTYLINE 300 0 93.15 4010 

4600078 VIT D 125 DIHYROXY 300 0 232.05 4010 

4600086 PROTEIN C,ANTIGENIC 300 0 163.35 4010

4600094 TESTOSTERONE T & F 300 0 282.43 4010 

4600102 CYCLOSPORINE, BLOOD 300 0 183.17 4010 

4600110 ALPRAZOLAM (XANAX) 300 0 171.73 4010 

4600128 RISTOCETIN COFACTOR 300 0 163.35 4010 

4600136 C PEPTIDE 300 0 158.02 4010 

4600144 TRAZADONE - DESYREL 300 0 90.09 4010 

4600151 CHORIONIC GONADOTROP 300 0 61.25 4010 

4600169 HETEROPHILE AGGLUT. 300 0 54.93 4010 

4600177 CA 15-3 300 0 79.68 4010 

4600185 PROTEIN S, ANTIGENIC 300 0 167.12 4010 

4600193 CYSTINE, 24HR URINE 300 0 97.63 4010 

4600201 SUCROSE HEMOLYSIS 300 0 53.43 4010 

4600219 LIDOCAINE 300 0 88.53 4010 

4600227 IGG INDEX & SYN RATE 300 0 211.45 4010 

4600235 APOLIPOPROTEIN A1/B 300 0 166.17 4010 

4600243 SCLERODERMA ANTIBODY 300 0 135.07 4010 

4600250 ACETYLCHOLINE RECEPT 300 0 220.55 4010 

4600268 MERCURY, BLOOD 300 0 82.57 4010 

4600276 CADMIUM,URINE 300 0 117.52 4010 

4600284 PORPHOBILINOGEN 24HR 300 0 64.09 4010 

4600292 PORPHYRINS 24HR URIN 300 0 141.18 4010 

4600300 RBC,FOLIC ACID 300 0 108.36 4010 

4600318 CA19-9 300 0 73.98 4010 

4600326 CITRATE, 24HR URINE 300 0 193.83 4010 

4600334 RBC PROTOPORPHYRIN 300 0 241.93 4010 

4600342 ALCOHOL (URINE) 300 0 81.64 4010 

4600359 ANTI-CARDIOLIPIN AB 300 0 283.92 4010 

4600367 STREPTOZYME 300 0 77.87 4010 

4600375 ANTI-DNASE (STREP) 300 0 96.14 4010 

4600383 TULAREMIA ANTIBODY 300 0 207.61 4010 

4600391 LYSOZYME SERUM 300 0 148.85 4010 

4600409 MEXILETINE 300 0 169.46 4010 

4600417 LEAD URINE 24HR 300 0 67.93 4010 

4600425 ANDROSTENEDIONE 300 0 212.94 4010 

4600433 ANTI-GLIADIN AB 300 0 212.94 4010 

4600441 ANTI RETICULIN AB 300 0 171.73 4010 

4600458 ENDOMYSIAL ANTIBODY 300 0 198.45 4010 

4600466 IMMUNOFIXATION SERUM 300 0 130.35 4010 

4600474 MYOGLOBIN RANDOM UR 300 0 80.15 4010 

4600482 MAGNESIUM 24HR URINE 300 0 57.27 4010 

4600490 ANTI HISTONE AB 300 0 122.85 4010 

4600508 CANNABINOIDS (URINE) 300 0 80.15 4010 

4600516 PLASMINOGEN,PLASMA 300 0 240.44 4010 

4600524 DHEA 300 0 232.77 4010 

4600532 ANTI NEUT CYTO PROF 300 0 287.87 4010 

4600540 THIOTHIXENE 300 0 107.64 4010 

4600557 VIT B1/THIAMINE 300 0 159.51 4010

4600565 ECHOVIRUS AB 300 0 164.13 4010 

4600573 HLA A,B TYPING DNA 300 0 924.69 4010 

4600581 BETA 2 MICROGLOBULIN 300 0 101.53 4010 

4600599 METHANOL 300 0 106.86 4010 

4600607 ANTI-PARIETAL CELL 300 0 112.19 4010 

4600615 MANGANESE BLOOD 300 0 148.85 4010 

4600623 HYDROXYPROLINE TOTAL 300 0 225.94 4010 

4600631 HEP DELTA AB HDV 300 0 61.02 4010 

4600649 HEP C AB 300 0 136.58 4010 

4600656 ZINC PROTOPORPHYRIN 300 0 72.87 4010 

4600664 THYROGLOBULIN 300 0 143.46 4010 

4600672 PERPHENAZINE 300 0 103.81 4010 

4600680 PRE-ALBUMIN 300 0 84.7 4010 

4600698 FACTOR XIII ACTIVITY 300 0 149.57 4010 

4600706 MAGNESIUM RBC 300 0 76.65 4010 

4600714 RHYTHMOL PROPAFENONE 300 0 106.86 4010 

4600722 INHALENT TOXIN PANEL 300 0 109.92 4010 

4600730 DUST PANEL (RAST) 300 0 114.47 4010 

4600748 INTRINSIC FACTOR AB 300 0 90.09 4010 

4600755 MOLD (PANEL) 300 0 114.47 4010 

4600763 FRUCTOSAMINE 300 0 75.45 4010 

4600771 METHYLPHENIDATE 300 0 82.42 4010 

4600789 HGB FREE PLASMA 300 0 57.98 4010 

4600797 TOXOPLASMA IGM 300 0 60.41 4010 

4600805 TOXOPLASMA IGG 300 0 58.35 4010 

4600813 CLOMIPRAMINE/NORCLOM 300 0 180.9 4010 

4600821 DRUG ABUSE MECONIUM 300 0 125.91 4010 

4600839 TRIFLUOPERAZINE 300 0 145.8 4010 

4600847 IMMUNOFIXATION URINE 300 0 177.06 4010 

4600854 PROZAC 300 0 109.92 4010 

4600862 THROMBIN TIME 300 0 62.6 4010 

4600870 VITAMIN E 300 0 116.81 4010 

4600888 T4 FREE BY DIALYSIS 300 0 71.46 4010 

4600896 NAPROXEN 300 0 95.42 4010 

4600904 ETHYLENE GLYCOL 300 0 150.35 4010 

4600912 ANTI-NEUT CYTO AB 300 0 240.44 4010 

4600920 VISTARIL 300 0 101.53 4010 

4600938 ZINC 24HR URINE 300 0 161.07 4010 

4600946 HEMOGLOBIN ELECTROPH 300 0 83.37 4010 

4600953 BABESIA MICROTI 300 0 122.74 4010 

4600961 CLOZARIL 300 0 100.75 4010 

4600979 FREDRICKSON CLASSIFI 300 0 122.15 4010 

4600987 POLIO VIRUS AB 300 0 224.38 4010 

4600995 MESORIDAZINE 300 0 127.47 4010 

4601001 ANTI HU ANTIBODY 300 0 122.14 4010 

4601019 DRUGS OF ABUSE 300 0 161.63 4010 

4601027 HERPES SIMPLEX II 300 0 130.52 4010

4601035 FLUPHENAZINE 300 0 145.02 4010 

4601043 COPPER, 24HR URINE 300 0 89.46 4010 

4601050 ADH,PLASMA 300 0 204.56 4010 

4601068 BORDETELLA PERTUSSIS 300 0 109.92 4010 

4601076 MULTIPLE SCLEROSIS 2 300 0 519.03 4010 

4601084 CHLAMYDIA CULT 300 0 117.52 4010 

4601092 CHLAMYDIA CULT 300 0 117.52 4010 

4601100 WELLBUTRIN 300 0 167.12 4010 

4601118 TOXOCARA AB SCREEN 300 0 98.48 4010 

4601126 AMINO ACID SC-URINE 300 0 116.03 4010 

4601134 PROTEIN BOUND GLUCOS 300 0 32.83 4010 

4601142 COMPLEMENT C2 300 0 96.14 4010 

4601159 HISTAMINE 24HR URINE 300 0 332.02 4010 

4601167 LSD, URINE 300 0 111.41 4010 

4601175 FELBAMATE (FEBATOL) 300 0 109.92 4010 

4601183 LIBRIUM 300 0 142.74 4010 

4601191 DILANTIN FREE 300 0 128.25 4010 

4601209 PM1 ANTIBODY SERUM 300 0 125.91 4010 

4601217 RBC OSMO FRAGILITY 300 0 124.41 4010 

4601225 TSH RECEPTOR AB 300 0 323.25 4010 

4601233 TEMAZEPAM 300 0 117.52 4010 

4601241 SELENIUM (URINE) 300 0 193.12 4010 

4601258 SELENIUM (SERUM) 300 0 193.12 4010 

4601266 COCAINE, RANDOM UR 300 0 79.37 4010 

4601274 BORATE (URINE) 300 0 67.15 4010 

4601290 CPK ELECTROPHORESIS 300 0 101.53 4010 

4601308 ANTI GLOMULAR MEMBRA 300 0 217.23 4010 

4601316 17-KETOSTERIODS URIN 300 0 222.89 4010 

4601324 TRILISATE 300 0 119.08 4010 

4601332 DIPHENHYDRAMINE 300 0 151.91 4010 

4601340 FLECAINIDE/TAMBACOR 300 0 122.14 4010 

4601357 COPPER (RBC) 300 0 115.25 4010 

4601365 COPPER SERUM 300 0 89.46 4010 

4601373 PYRUVATE 300 0 141.96 4010 

4601381 NEURONTIN LEVEL 300 0 108.36 4010 

4601399 PLATELET AB PROFILE 300 0 285.48 4010 

4601407 HANTAAN VIRUS 300 0 130.52 4010 

4601415 IRON 24HR URINE 300 0 113.75 4010 

4601423 RISPERDOL LEVEL 300 0 108.36 4010 

4601431 BIOTINIDASE ACTIVITY 300 0 308.49 4010 

4601449 MYELIN BASIC PROTEIN 300 0 156.46 4010 

4601456 ZOLOFT, SERUM 300 0 109.92 4010 

4601464 ARSENIC, BLOOD 300 0 143.46 4010 

4601472 PURKINJE CELL AB(YO) 300 0 90.81 4010 

4601480 FRAGILE X DNA 310 0 590.52 4010 

4601498 VIRAL ISOLATION UMAS 300 0 158.02 4010 

4601506 IGG 300 0 70.98 4010

4601514 IGA 300 0 70.98 4010 

4601522 IGM 300 0 61.82 4010 

4601530 PORPHYRINS, RANDOM U 300 0 86.26 4010 

4601548 PROCAINAMIDE NAPA 300 0 112.97 4010 

4601555 TRANSFERRIN 300 0 73.26 4010 

4601563 LDH ISOENZYMES 300 0 106.86 4010 

4601571 ANTIMITOCHONDRIAL AB 300 0 90.81 4010 

4601589 MALARIA SMEAR 300 0 57.27 4010 

4601597 HERPES SIMPLEX IGM 300 0 191.56 4010 

4601605 HERPES TYPE I 300 0 93.86 4010 

4601613 ANTI-JO-1 ANTIBODY 300 0 135.07 4010 

4601621 ASCARIASIS AB 300 0 207.61 4010 

4601639 EFFEXOR/VENLAFAXINE 300 0 83.2 4010 

4601647 FIBRONECTIN AGGREGAT 300 0 267.15 4010 

4601654 3-A-ANDROSTANEDIOL-G 300 0 138.91 4010 

4601662 HLA-DRB,DQB1 TYPING 300 0 430.43 4010 

4601670 PHYTANIC ACID, SERUM 300 0 259.48 4010 

4601688 FILARIASIS 300 0 245.77 4010 

4601696 VISCERAL LARVA MIGRA 300 0 259.48 4010 

4601704 STRONGYLOIDES AB 300 0 207.61 4010 

4601712 ANTI EXTRACT.NUC.AG 300 0 131.3 4010 

4601720 HEINZ BODIES STAIN 300 0 22.17 4010 

4601738 FACTOR 8 VW FACTOR 300 0 152.62 4010 

4601746 FACTOR IX ACTIVITY 300 0 138.91 4010 

4601753 FACTOR VII ACTIVITY 300 0 225.94 4010 

4601761 PORPHOBILINOGEN RAND 300 0 80.15 4010 

4601779 ANTI THROMBIN 3 300 0 171.73 4010 

4601787 FACTOR VIII 300 0 155.68 4010 

4601795 FACTOR V 300 0 623.06 4010 

4601803 B.PERTUSSIS CULTURE 300 0 64 4010 

4601811 CIDAL TROUGH LEVEL 300 0 99.97 4010 

4601829 U UREALYTICUM/M HOMI 300 0 116.81 4010 

4601837 ACTH 300 0 296.92 4010 

4601845 ACID PHOS,PROSTATIC 300 0 64.87 4010 

4601852 T3 FREE 300 0 131 4010 

4601860 T3 TOTAL 300 0 106.86 4010 

4601878 INSULIN 300 0 85.48 4010 

4601886 C1Q BINDING ASSAY 300 0 184.73 4010 

4601894 ALPHA I ANTITRYPSIN 300 0 92.37 4010 

4601902 ZINC SERUM 300 0 79.37 4010 

4601910 COMPLEMENT C3 300 0 90.81 4010 

4601928 RAJI CELL ASSAY 300 0 206.05 4010 

4601936 COMPLEMENT C4 300 0 90.81 4010 

4601944 ESTROGEN TOTAL 300 0 163.35 4010 

4601951 HAPTOGLOBIN 300 0 84.7 4010 

4601969 RHEUMATOID FACTOR QU 300 0 37.42 4010 

4601977 HEMOSIDERIN RAND UR 300 0 422.3 4010

4601985 RETROVIRAL SEROLOGY 300 0 45.13 4010 

4601993 FEBRILE AGGLUTININS 300 0 112.97 4010 

4602009 5HIAA URINE 24HR 300 0 97.7 4010 

4602017 AMINOLEVULINIC ACID 300 0 133.58 4010 

4602025 VISCOSITY BODY FLUID 300 0 88.53 4010 

4602033 THORAZINE LEVEL 300 0 150.35 4010 

4602041 VITAMIN B6 300 0 183.86 4010 

4602058 OXALATE 24HR URINE 300 0 97.7 4010 

4602066 VASO INTESTINAL PEP 300 0 237.38 4010 

4602074 ALDOLASE 300 0 58.76 4010 

4602082 AMINO ACID SC-PLASMA 300 0 88.53 4010 

4602090 ANTI MICROSOMAL AB 300 0 109.92 4010 

4602108 ANTI-THYROGLOBULIN 300 0 120.58 4010 

4602116 ESTRADIOL E2 NONPREG 300 0 211.45 4010 

4602124 B12 BINDING CAPACITY 300 0 116.81 4010 

4602132 IONIZED CALCIUM 300 0 89.5 4010 

4602140 NORPACE 300 0 92.37 4010 

4602157 SUB ABUSE PANEL 300 0 80.15 4010 

4602165 17 KETOGENIC STEROID 300 0 101.53 4010 

4602173 BETA CAROTENE 300 0 77.87 4010 

4602181 CHOLINESTERASE 300 0 144.24 4010 

4602199 CLONOPIN/CLONAZEPAM 300 0 44.27 4010 

4602207 CRYOGLOBULINS 300 0 44.27 4010 

4602215 HLA B27 300 0 125 4010 

4602223 HYDROXYPROLINE FREE 300 0 220.55 4010 

4602231 ELAVIL 300 0 135.07 4010 

4602249 MELLARIL 300 0 103.81 4010 

4602256 ANTI SMOOTH MUSCLE 300 0 112.19 4010 

4602264 ALDOSTERONE 300 0 278.59 4010 

4602272 CATECHOLAMINE,FRAC/U 300 0 170.17 4010 

4602280 VMA QUANTITATIVE 300 0 657.41 4010 

4602298 METANEPHRINE FRACT. 300 0 128.25 4010 

4602306 CORTISOL FREE, URINE 300 0 128.69 4010 

4602314 17 KETOSTEROIDS TOT 300 0 98.48 4010 

4602322 HUMAN GROWTH HORMONE 300 0 213.6 4010 

4602330 PTH C TERM MIDREGION 300 0 248.82 4010 

4602348 COMPLEMENT CH50 300 0 154.18 4010 

4602355 LACTIC ACID 300 0 72.48 4010 

4602363 LEAD ADULT 300 0 81.41 4010 

4602389 COMP C1Q NONBINDING 300 0 96.14 4010 

4602397 HEAVY METALS 24HR UR 300 0 225.94 4010 

4602405 MERCURY URINE 24HR 300 0 158.02 4010 

4602413 EBV AB SCREEN 300 0 82.51 4010 

4602421 DOXEPIN/SINEQUAN 300 0 127.47 4010 

4602439 ALK PHOS ISOENZYMES 300 0 112.19 4010 

4602447 ANGIO-CONVERT ENZYME 300 0 109.92 4010 

4602454 PROGESTERONE 300 0 119.09 4010

4602462 PTH N TERM INTACT 300 0 248.82 4010 

4602470 SEROTONIN-SERUM 300 0 258.77 4010 

4602488 VITAMIN A 300 0 119.94 4010 

4602496 XYLOSE TOLERANCE 300 0 135.85 4010 

4602504 IMIPRAMINE 300 0 129.74 4010 

4602520 CATECHOLAMINE,FRAC/P 300 0 171.73 4010 

4602538 C ESTERASE INHIBITOR 300 0 104.59 4010 

4602546 CYANIDE,BLOOD 300 0 145.8 4010 

4602553 CRYOFIBRINOGEN 300 0 35.1 4010 

4602561 HEPATITIS A AB 300 0 67.15 4010 

4602579 THYROID AB GROUP 300 0 155.18 4010 

4602587 SOMATOMEDIN C 300 0 196.89 4010 

4602595 ALUMINUM 300 0 198.45 4010 

4602603 HEP B SURFACE AG 300 0 79.37 4010 

4602611 FAT FECES/LIPIDS 72H 300 0 211.45 4010 

4602629 HEP B SURFACE AB 300 0 81.64 4010 

4602637 IGG SUBCLASSES 300 0 242.71 4010 

4602645 HEP B CORE AB 300 0 866.24 4010 

4602652 DESIPIRAMINE 300 0 156.46 4010 

4602660 GASTRIN 300 0 106.86 4010 

4602678 ZARONTIN 300 0 136.63 4010 

4602686 VITAMIN D (25 OH) 300 0 105.24 4010 

4602694 ARSENIC,URINE 300 0 166.4 4010 

4602702 HISTAMINE, BLOOD 300 0 223.6 4010 

4602710 HEPATITIS BE AG & AB 300 0 67.15 4010 

4602728 ESTRONE 300 0 167.9 4010 

4602736 HALDOL 300 0 103.19 4010 

4602744 LUNG MATURITY PROF 1 300 0 99.19 4010 

4602751 OLIGOCLONAL BANDS 300 0 151.13 4010 

4602769 TOCAINIDE 300 0 154.18 4010 

4602777 L/S RATIO 300 0 159.51 4010 

4602785 CALCITONIN,SERUM 300 0 161.79 4010 

4602801 PNEUMONITIS HYPERSEN 300 0 202.48 4010 

4602819 17 HYDROXYCORTICOST 300 0 122.85 4010 

4602827 ERYTHROPOIETIN 300 0 101.53 4010 

4602835 ESTROGEN/PROG RECEPT 300 0 458.71 4010 

4602843 GLUCOSE 6 PHOSPHATE 300 0 58.76 4010 

4602850 HYDROXYZINE,SERUM 300 0 88.53 4010 

4602868 EPI FLUOR AB TISSUE 310 0 271.7 4010 

4602876 LAMOTEIGINE, SERUM 300 0 93.86 4010 

4602884 PAXIL/PAROXETINE 300 0 109.92 4010 

4602892 ATROPINE, RAN URINE 300 0 169.46 4010 

4602900 URINE CYTOLOGY MPNJ 310 0 90.81 4010 

4602918 AMINO ACID, QUANT 300 0 152.62 4010 

4602926 TOXOPLASMOSIS CSF 300 0 63.28 4010 

4602942 TEGRETOL EPOXIDE 300 0 128.25 4010 

4602959 HEXOSAMINIDASE A ACT 300 0 207.61 4010

4602967 HTLV I/II AB 300 0 100.75 4010 

4602975 FATTY ACID/LONGCHAIN 300 0 122.14 4010 

4602983 MYCOPLASMA IGG 300 0 87.75 4010 


4603007 AMBIEN (ZOLPIDEM) 300 0 139.69 4010 

4603015 HEPATITIS C RIBA 300 0 111.61 4010 

4603023 RAST ALLERGEN 1 300 0 18.71 4010 

4603031 RAST ALLERGEN 2 300 0 18.71 4010 

4603049 RAST ALLERGEN 3 300 0 18.71 4010 

4603056 RAST ALLERGEN 4 300 0 18.71 4010 

4603064 RAST ALLERGEN 5 300 0 18.71 4010 

4603072 RAST ALLERGEN 6 300 0 18.71 4010 

4603080 RAST ALLERGEN 7 300 0 18.71 4010 

4603098 RAST ALLERGEN 8 300 0 18.71 4010 

4603106 RAST ALLERGEN 9 300 0 18.71 4010 

4603114 RAST ALLERGEN 10 300 0 18.71 4010 

4603122 RAST ALLERGEN 11 300 0 18.71 4010 

4603130 RAST ALLERGEN 12 300 0 18.71 4010 

4603148 AMIODARONE/DESETHYL. 300 0 131.3 4010 

4603155 LORAZEPAM,SERUM 300 0 109.14 4010 

4603163 LYMPH SUBSET PROF II 300 0 535.8 4010 

4603171 RAST TEST W/ALLERGEN 300 0 45.83 4010 

4603189 BETA-GLUCOSIDASE ACT 300 0 274.76 4010 

4603197 HEP C RNA, QUAL 300 0 296.92 4010 


4603239 P24 ANTIGEN 300 0 150.35 4010 

4603247 CMV EARLY AG/CULTURE 300 0 112.97 4010 

4603254 HEP B SURFACE AB/EH 300 0 81.64 4010 

4603262 CA 19-9 300 0 136.11 4010 

4603270 C PEPTIDE,URINE 300 0 82.42 4010 

4603288 HEMOSAMINIDASE A&B 300 0 166.4 4010 

4603296 ALDOSTERONE,URINE 300 0 278.59 4010 

4603304 ESTROGEN,URINE 300 0 99.19 4010 

4603312 T3 FREE BY DIALYSIS 300 0 131.3 4010 

4603320 METHOTREXATE 300 0 109.92 4010 

4603338 BARBITURATES, ID 300 0 149.57 4010 

4603346 MOLYBDENUM,RBC 300 0 76.31 4010 

4603353 ANABOLIC STEROIDS 300 0 177.84 4010 

4603361 DIBUCAINE NUMBER 300 0 99.97 4010 

4603379 LYME EIA/CSF 300 0 129.74 4010 

4603395 FACTOR II 300 0 255.71 4010 

4603403 FACTOR X 300 0 151.13 4010 

4603411 FACTOR XI 300 0 151.13 4010 

4603429 FACTOR XII 300 0 255.71 4010 

4603452 LEUK/LYMPHOMA EVAL 310 0 148.85 4010 

4603460 LIPOPROTEIN (A) 300 0 93.86 4010 

4603478 PREGNENOLONE 300 0 171.73 4010

4603486 BARBITURATES,SERUM 300 0 142.74 4010 

4603494 BARBITURATES,URINE 300 0 57.27 4010 

4603502 IBUPROFEN 300 0 154.96 4010 

4603510 ESSENT. FATTY ACIDS 300 0 82.42 4010 

4603528 PORPHYRINS,PLAS.(TOT 300 0 116.81 4010 

4603536 IGD 300 0 119.08 4010 

4603544 BETA 2 MICROGLOB,UR 300 0 82.17 4010 

4603551 MYELIN ASSOC. GLYCOP 300 0 380.12 4010 

4603569 MYCOPLASMA CULTURE 300 0 149.57 4010 

4603577 HGB A2 & F BY COLUMN 300 0 70.2 4010 

4603585 XANTHINE 300 0 107.64 4010 

4603593 THALLIUM,SERUM 300 0 166.4 4010 

4603601 CADMIUM,BLOOD 300 0 117.52 4010 

4603619 H.INFLUENZAE B VAC.R 300 0 117.52 4010 

4603627 HEP C RNA, QUANT 300 0 317.53 4010 

4603635 METHYLMALONIC ACID 300 0 121.22 4010 

4603643 OXYCODONE,SERUM 300 0 104.59 4010 

4603650 CYSTINE,SERUM 300 0 116.81 4010 

4603676 PSA, FR 300 0 125.91 4010 

4603684 RI AUTOANTIBODY 300 0 209.11 4010 

4603692 ACT.PROTEIN C RESIST 300 0 133.58 4010 

4603759 HLA A,B,C TYPING DNA 300 0 947.18 4010 

4603767 CYCLIC AMP,URINE 300 0 269.43 4010 

4603791 SPECIAL SEROLOGY 300 0 92.37 4010 

4603809 EHRLICHIA AB 300 0 120.82 4010 

4603817 ELECTROPHOR,24HR UR 300 0 115.25 4010 

4603833 IMMUNOFIX,24HR UR 300 0 67.93 4010 

4603874 CHROMOSOME KARYOTYPE 310 0 448.05 4010 

4603882 IMURAN LEVEL 300 0 210.67 4010 

4603890 STOOL CULTURE,VIBRIO 300 0 64.31 4010 

4603908 FUNGUS,BLOOD CULT 300 0 99.97 4010 

4603924 ISLET CELL ANTIBODY 300 0 96.3 4010 

4603932 CYSTINE & HOMOCYSTEI 300 0 66.43 4010 

4603940 LEGIONELLA CULT&FA 300 0 126.69 4010 

4603957 LEGIONELLA AB (IFA) 300 0 95.42 4010 

4603965 CARISOPRODOL 300 0 183.17 4010 

4603973 VIRAL CULT,CSF 300 0 49.48 4010 

4603981 CSF CULT RO ENTEROVI 300 0 106.02 4010 

4603999 CSF CULT RO HSV 300 0 49.48 4010 

4604005 CSF CULT RO CMV 300 0 82.42 4010 

4604013 HISTOPLASMOSIS AG,UR 300 0 66.15 4010 

4604021 HYDROCARBONS & VOLAT 300 0 87.75 4010 

4604039 ORGANIC ACIDS,URINE 300 0 133.56 4010 

4604047 Q FEVER ANTIBODY,IFA 300 0 43.09 4010 

4604062 TB CULT./DUPONT/UMAS 300 0 58.22 4010 

4604070 BONE MARROW CULTURE 300 0 130.52 4010 

4604088 SENSITIVITY UMASS 300 0 51.16 4010

4604096 ORG ID AEROBIC UMASS 300 0 0 4010 

4604104 ORG ID ANAEROBIC 300 0 69.49 4010 

4604112 PNEUMOCYSTIS CARINII 300 0 83.2 4010 

4604120 ANTI SPERM AB IGG 310 0 72.48 4010 

4604138 ANTI SPERM AB IGA 310 0 72.48 4010 

4604146 ANTISPERM AB IGM 310 0 72.48 4010 

4604153 T CELL CLONALITY INT 300 0 0 4010 

4604161 TYPHUS FEVER AB IGG 300 0 145.8 4010 

4604179 TYPHUS FEVER AB IGM 300 0 145.8 4010 

4604187 ALK PHOS BONE SPECIF 300 0 46.87 4010 

4604195 HGB/THAL INTERPRET. 300 0 94.64 4010 

4604203 FLOW CYTOMETRY EA CE 310 0 148.85 4010 

4604211 BABESIA MORPHOLOGY 300 0 229.71 4010 

4604229 CHROMIUM,SERUM 300 0 78.75 4010 

4604245 CODEINE,SERUM QUANT. 300 0 203.78 4010 

4604252 NICOTINE,SERUM 300 0 159.51 4010 

4604278 ITERLEUKIN 2 300 0 148.85 4010 

4604286 LISTERIA AB,SERUM 300 0 143.46 4010 

4604302 CA27.29 MARKER 300 0 38.75 4010 

4604310 SULFONYLUREA PNL,SER 300 0 101.23 4010 

4604328 SULFONYLUREA SCR. UR 300 0 132.8 4010 

4604336 BRUCELLA CANIS IGG 300 0 67.15 4010 

4604344 PREDNISONE 300 0 146.51 4010 

4604351 GLIPIZIDE 300 0 106.08 4010 

4604369 TRYPTASE 300 0 151.13 4010 

4604377 ALA-D,ERYTHROCYTES 300 0 112.97 4010 

4604385 UPG-S,ERYTHROCYTES 300 0 112.97 4010 

4604393 HISTOPL.MYCELIAL AB 300 0 95.42 4010 

4604401 HISTOPL.YEAST AB 300 0 95.42 4010 

4604427 A1 ANTITRYPSIN,STOOL 300 0 92.37 4010 

4604435 IODINE,URINE 300 0 97.7 4010 

4604443 ADENOVIRUS,CSF 300 0 61.82 4010 

4604450 LYME WB IGG 300 0 67.93 4010 

4604468 LYME WB IGM 300 0 67.93 4010 

4604476 BABESIA AB IGG 300 0 78.04 4010 

4604484 BABESIA AB IGM 300 0 78.04 4010 

4604492 IBT RAST ALLERGEN 1 300 0 26.85 4010 










4604591 IBT RAST ALLERGEN 11 300 0 26.85 4010


4604617 SGPG 300 0 0 4010 

4604625 FETAL HGB QUANT. 300 0 83.2 4010 

4604633 ANTI-RETICULIN, IGA 300 0 90.81 4010 

4604641 TOPAMAX(TOPIRAMATE) 300 0 104.59 4010 

4604658 ORGANIC ACIDS,PLASMA 300 0 109.14 4010 

4604666 HELICOBACTER AG,STOO 300 0 242.9 4010 

4604674 URINE ETP,RANDOM 300 0 106.08 4010 

4604682 TOTAL PROT,UR,RANDOM 300 0 52.32 4010 

4604690 LISTERIA AB,CSF 300 0 204.56 4010 

4604716 AFP 300 0 79.13 4010 

4604724 HCG 300 0 32.57 4010 

4604732 ESTRIOL 300 0 86 4010 

4604740 METHOTREXATE 300 0 77.87 4010 

4604757 TETRAHYDROCANNABINOL 300 0 72.09 4010 

4604765 CARBOXY-THC 300 0 48.95 4010 

4604773 FLUORIDE 300 0 148.85 4010 

4604781 CHLAMYDIA,DIRECT AG 300 0 95.42 4010 

4604799 IGF BINDING PROTEIN3 300 0 117.52 4010 

4604807 HEPATITIS BE AG 300 0 87.04 4010 

4604815 HEPATITIS BE AB 300 0 88.53 4010 

4604823 NARCOLEPSY ASSOC AG 300 0 430.43 4010 

4604831 TRYPSINOGEN,SERUM 300 0 154.18 4010 

4604849 ANTI-OVARIAN ANTIBOD 300 0 123.63 4010 

4604856 A1 ANTITRYPSIN PHENO 300 0 109.92 4010 

4604864 ARYLSULPHATASE A ACT 300 0 269.43 4010 

4604872 FK506 300 0 71.78 4010 


4604898 FREE CORTISOL,BLOOD 300 0 145.8 4010 

4604906 DEXAMETHASONE 300 0 129.74 4010 

4604914 T CELLS,TOTAL CT. 300 0 233.38 4010 

4604922 WBC 300 0 14.23 4010 

4604930 ABS. CD4 &CD8 300 0 128.14 4010 


4604955 LSD CONFIRM. BY GCMS 300 0 148.85 4010 

4604963 LUVOX LEVEL 300 0 109.92 4010 

4604989 CHROMOGRANIN-A 300 0 125.91 4010 

4604997 HEP B CORE AB, IGM 300 0 97.7 4010 

4605002 ADENOSINE DEAMINASE 300 0 66.43 4010 

4605010 PNEUMOCYSTIS CARINII 300 0 135.85 4010 

4605028 ALPHA SUBUNIT 300 0 127.47 4010 

4605036 GLUT.ACID DECARBX AB 300 0 122.14 4010 

4605044 COZ PLASTIC OCC HEAL 300 0 154.18 4010 

4605069 ALPHA 1 ACID GLYCOPR 300 0 82.42 4010 

4605077 MICROPOLYSPORA FAENI 300 0 93.86 4010 

4605085 THEROACTINOMYCES SPP 300 0 76.31 4010 

4605093 ALTERIA ALTERNATA 300 0 93.86 4010

4605101 ASPERGILLUS FUMIGAT. 300 0 99.19 4010 

4605119 AUREOBASIDIUM PULLUL 300 0 93.86 4010 

4605127 PENICILLIUM NOTATUM 300 0 93.86 4010 

4605135 PHOMA HERBARUM 300 0 93.86 4010 

4605143 TRICHODERMA VIRIDE 300 0 93.86 4010 

4605184 CAR (WB) 300 0 0 4010 

4605200 BUPIVACAINE/MARCAINE 300 0 149.57 4010 

4605218 OSTEOCALCIN 300 0 199.23 4010 

4605226 AMINO ACID,SINGLE ID 300 0 145.8 4010 

4605234 AMINO ACID PANEL,SER 300 0 551.13 4010 

4605242 AMINO ACID PANEL,UR 300 0 57.5 4010 

4605259 ASPERGILLUS,IGE 300 0 35.88 4010 

4605267 CLADOSPORIUM,IGE 300 0 35.88 4010 

4605275 PENICILLIUM,IGE 300 0 35.88 4010 

4605283 CHAETOMIUM,IGE 300 0 35.88 4010 

4605291 MOUSE DROPPINGS,IGE 300 0 35.88 4010 

4605309 RAT DROPPINGS,IGE 300 0 35.88 4010 

4605317 PIGEON DROPPINGS,IGE 300 0 35.88 4010 

4605325 COCKROACH,IGE 300 0 35.88 4010 

4605333 PROPOXYPHENE 300 0 112.97 4010 

4605341 METHIONINE 300 0 164.13 4010 

4605358 BENZODIAZEPINES,SERU 300 0 243.75 4010 

4605390 CYSTIC FIBROSIS GENE 300 0 191.25 4010 

4605408 FORMIC ACID 300 0 100.75 4010 

4605416 PNEUMO.IGG TYPE 1 300 0 97.7 4010 



4605440 PNEUMO.IGG TYPE 19F 300 0 97.7 4010 

4605457 PNEUMO.IGG TYPE 23F 300 0 97.7 4010 


4605473 TRICHINELLA TITER 300 0 44.66 4010 

4605507 FACTOR II MUTATION G 300 0 180 4010 

4605549 AFP 300 0 73.54 4010 

4605556 NORFLUNITRAZEPAM 300 0 54.93 4010 

4605564 7-AMINOFLUNITRAZEPAM 300 0 54.93 4010 

4605572 FLUNITRAZEPAM 300 0 54.93 4010 

4605663 TSH (3RD GENERATION) 300 0 167.12 4010 

4605671 VITAMIN K1 300 0 225.16 4010 

4605689 METANEPHRINES,PLASMA 300 0 193.83 4010 

4605697 LATEX SPECIFIC IGE 300 0 95.42 4010 

4605705 DIPHTHERIA AB 300 0 133.58 4010 

4605713 ULTRACENTRIFUGATION 300 0 114.47 4010 

4605721 LIPOPROTEIN PROFILE 300 0 61.82 4010 

4605796 5,10MTHFR C677T INTE 300 0 258.75 4010 

4605804 HEMOCHROMATOSIS ANAL 300 0 303.75 4010 

4605812 PARASITE CONCENTRA. 300 0 58.22 4010 

4605853 SP.STAIN FOR PARASIT 300 0 64.87 4010

4605879 METHADONE,UR 300 0 100.75 4010 

4605887 HEPATITIS E IGM 300 0 133.58 4010 

4605895 HEPATITIS E IGG 300 0 106.08 4010 

4605937 EPM1 300 0 0 4010 

4605978 VITAMIN B12 300 0 124.41 4010 

4605986 FOLATE 300 0 124.41 4010 

4605994 FERRITIN 300 0 106.08 4010 

4606000 BENZENE 300 0 93.86 4010 

4606018 FACTOR 5 LEIDEN 300 0 101.25 4010 

4606034 HLAB INTERPRETATION 300 0 0 4010 

4606059 WESTERN EQUINE ENCEP 300 0 679.5 4010 

4606067 CALIF.EQUINE ENCEPH 300 0 568.4 4010 

4606075 EASTERN EQUINE ENCEP 300 0 53.43 4010 

4606083 ST LOUIS EQUINE ENCE 300 0 53.43 4010 

4606091 WEST NILE,SER,ACUTE 300 0 0 4010 

4606109 WEST NILE,SER,CONVAL 300 0 0 4010 

4606117 WEST NILE,CSF,ACUTE 300 0 0 4010 

4606125 WEST NILE,CSF,CONVAL 300 0 0 4010 

4606158 TISSUE CULT.NON-NEOP 310 0 397.26 4010 

4606166 TISSUE CULT.NEOPLAST 310 0 455.35 4010 

4606174 CHROMOSOME ANAL.5CEL 310 0 602.65 4010 

4606182 CHR.ANAL.ADD.KARYOTY 310 0 151.13 4010 

4606190 ADD.CELLS COUNTED 310 0 115.25 4010 

4606208 FRAGILE X CHROMOSOME 300 0 0 4010 

4606216 CHROMOSOMAL/LEUKEMIA 300 0 0 4010 

4606224 DIPHTHERIA TOXOID AB 300 0 106.08 4010 

4606240 PNEUMO TYPE 3 AB 300 0 104.59 4010 

4606257 PNEUMO TYPE 7F AB 300 0 104.59 4010 

4606265 PNEUMO TYPE 9N AB 300 0 104.59 4010 

4606273 PNEUMO TYPE 14 AB 300 0 104.59 4010 

4606281 IGM (HIS) 300 0 74.82 4010 

4606299 IGA (HIS) 300 0 74.82 4010 

4606307 IGG (HIS) 300 0 74.82 4010 

4606315 IGE (HIS) 300 0 74.82 4010 

4606323 IGG SUBCLASS 1 (HIS) 300 0 108.36 4010 




4606380 3LA DR4 300 0 27.5 4010 

4606398 PROSTAGLANDIN D2 300 0 240.44 4010 

4606406 IGA TRANSGLUTAMINASE 300 0 55.05 4010 


4606422 PHOSPHOGLYCERATE KIN 300 0 156.46 4010 

4606430 PROTEIN C,FUNCTIONAL 300 0 161.79 4010 

4606448 PROTEIN S,FUNCTIONAL 300 0 175.07 4010 

4606455 ANA AB/LUPUS PROF 300 0 90.81 4010 

4606463 SMOOTH MUSCLE AB 300 0 90.81 4010

4606471 PARIETAL CELL AB 300 0 90.81 4010 

4606489 MITOCHONDRIAL AB 300 0 90.81 4010 

4606497 C3/ LUPUS PROF 300 0 90.81 4010 

4606505 C4 / LUPUS PROF 300 0 90.81 4010 

4606513 SS-B AB/LUPUS PROF 300 0 135.07 4010 

4606521 SS-A AB/LUPUS PROF 300 0 135.07 4010 

4606539 SM AB EIA/LUPUS PROF 300 0 135.07 4010 

4606547 SM/RNP AB LUPUS PROF 300 0 135.07 4010 

4606554 RIBOSOMAL P PROTEIN 300 0 84.7 4010 

4606562 SCL-70 AB/LUPUS PROF 300 0 135.07 4010 

4606570 THYROID PEROXIDASE 300 0 109.92 4010 

4606588 MYOCARDIAL AB/LUPUS 300 0 90.81 4010 

4606596 RETICULIN AB/LUPUS 300 0 90.81 4010 

4606604 DNA AB/LUPUS PROF 300 0 104.59 4010 

4606612 STRIATED MUSCLE AB 300 0 90.81 4010 

4606620 RHEUMATOID FACTOR/LU 300 0 42.77 4010 

4606638 N-METHYLHISTAMINE 300 0 172.51 4010 

4606646 CREATININE,24HR UR 300 0 13.72 4010 

4606653 EHRLICHIOSIS,PCR 300 0 235.82 4010 

4606661 COMPLEMENT AG,EACH 300 0 42.68 4010 

4606679 IGG PHOSPHATIDYLSERI 300 0 155.68 4010 

4606687 IGM PHOSPHATIDYLSERI 300 0 155.68 4010 

4606695 TOTAL AMYLASE 300 0 93.86 4010 

4606703 PANCREATIC ISOENZYME 300 0 93.86 4010 

4606745 CMV AB,IGG 300 0 108.36 4010 

4606752 CMV AB,IGM 300 0 115.25 4010 

4606760 ADENOVIRUS AB 300 0 98.48 4010 

4606778 CHLAMYDIA GROUP AB 300 0 122.85 4010 

4606786 OPIATES,QUANTITATIVE 300 0 117.52 4010 

4606794 CD3% 300 0 243.63 4010 

4606802 CD3/CD4(HELPER)ABS 300 0 238.19 4010 

4606810 ABS.LYMPH CT. 300 0 28.21 4010 

4606828 PYRUVATE KINASE,RBC 300 0 127.47 4010 

4606836 TROPHERYMA WHIPPELII 300 0 352.63 4010 

4606844 CARDIO CRP/SENSITIVE 300 0 79.37 4010 

4606851 H.PYLORI,IGM 300 0 109.92 4010 

4606869 H.PYLORI,IGA 300 0 131.3 4010 

4606877 MICROSPORIDIA,STOOL 310 0 108.36 4010 

4606885 IGA SUBCLASSES 1 300 0 136.63 4010 

4606893 IGA SUBCLASSES 2 300 0 141.96 4010 

4606901 IGA TOTAL 300 0 70.98 4010 

4606919 HGE IGG TITER 300 0 116.81 4010 

4606927 HGE IGM TITER 300 0 116.81 4010 

4606935 INHIBIN A 300 0 168.24 4010 

4606943 H.PYLORI CULTURE 300 0 127.47 4010 

4606950 FACTOR VIII 300 0 29.95 4010 

4606968 FACTOR 8 INHIBITOR 300 0 45.79 4010

4606976 SUBSTITUTION PLASMA 300 0 23.03 4010 

4606984 RMSF IGG 300 0 145.8 4010 

4606992 RMSF IGM 300 0 145.8 4010 

4607008 STOOL EXAMINATION 300 0 90.78 4010 

4607016 ISOPROPYL ALCOHOL 300 0 123.63 4010 

4607024 ECSTASY (MDMA) 300 0 111.41 4010 

4607032 CEA 300 0 48.1 4010 

4607040 CA27-29 300 0 54.21 4010 

4607057 LASA-P 300 0 54.21 4010 

4607065 H2N ONCOGENE 300 0 54.21 4010 

4607073 ATAXIA PROF.INTERP. 310 0 0 4010 

4607081 MALARIA ANTIBODIES 300 0 74.82 4010 

4607099 PROTEIN S TOTAL 300 0 84.7 4010 

4607107 PROTEIN S FREE 300 0 109.92 4010 

4607115 ECSTASY,URINE 300 0 122.14 4010 

4607123 MACROAMYLASE 300 0 221.33 4010 

4607131 CARNITINE TOTAL 300 0 127.47 4010 

4607149 CARNITINE,FREE 300 0 127.47 4010 

4607156 KEPPRA/LEVETIRACETAM 300 0 109.92 4010 

4607164 CHYLOMICRONS 300 0 130.52 4010 

4607172 GLUCAGON 300 0 114.47 4010 

4607180 PYRILINKS D,DEOXYPYR 300 0 112.19 4010 

4607198 CREATININE (PYRILINK 300 0 30.55 4010 

4607206 PROTEIN ELECTRO,SERU 300 0 65.65 4010 

4607214 PROTEIN ELECTRO,UR 300 0 140.47 4010 

4607222 C REACTIVE PROTEIN 300 0 28.21 4010 

4607230 PRIMIDONE 300 0 97.7 4010 

4607248 IGE 300 0 109.92 4010 

4607255 DOT DRUG SCREEN 300 0 83.2 4010 

4607271 LEGIONELLA FLUOR.ST. 300 0 72.31 4010 

4607289 LEGIONELLA CULTURE 300 0 64.31 4010 

4607297 ANA/FLUID 300 0 88.53 4010 

4607305 SOMATOSTATIN 300 0 238.88 4010 

4607313 PCB(POLYCHLOR.BIPHEN 300 0 127.47 4010 

4607321 HEP B DNA BY PCR 300 0 282.81 4010 

4607339 LUPUS ANTICOAGULANT 300 0 424.51 4010 

4607347 ANTI THROMBIN 3 300 0 103.03 4010 

4607354 PROTEIN C,FUNCTIONAL 300 0 131.3 4010 

4607362 PROTEIN S,FUNCTIONAL 300 0 135.07 4010 

4607370 FIBRINOGEN 300 0 64.09 4010 

4607388 APC RESISTANCE 300 0 115.25 4010 

4607396 PLASMINOGEN 300 0 51.87 4010 

4607404 LIV-KIDNEY MICROS AB 300 0 109.92 4010 

4607412 HPV DNA/RNA AMPLIFIC 300 0 124.77 4010 

4607420 ANTI CARDIOLIPIN IGG 300 0 152.62 4010 

4607438 ANTI CARDIOLIPIN IGM 300 0 152.62 4010 

4607446 IGG,CSF (CSFI) 300 0 72.48 4010

4607453 IGG,SERUM (CSFI) 300 0 70.98 4010 

4607461 ALBUMIN,CSF (CSFI) 300 0 30.55 4010 

4607479 ALBUMIN,SERUM (CSFI) 300 0 28.21 4010 

4607487 IGG SUBCLASS 1 300 0 96.14 4010 

4607495 IGG SUBCLASS 2 300 0 96.14 4010 

4607503 IGG SUBCLASS 3 300 0 96.14 4010 

4607511 IGG SUBCLASS 4 300 0 96.14 4010 

4607529 PHENYLALANINE,PLASMA 300 0 83.03 4010 

4607537 PHOSSERINE AB (IGG) 300 0 155.68 4010 

4607545 PHOSSERINE AB (IGM) 300 0 155.68 4010 

4607560 HTLV I/II PCR 300 0 235.82 4010 

4607578 HTLV I DNA 300 0 235.82 4010 

4607586 HTLV II DNA 300 0 235.82 4010 

4607594 CHAGAS DISEASE SEROL 300 0 0 4010 

4607602 B2 MICROGLOBULIN,CSF 300 0 119.08 4010 

4607610 TRICHINOSIS AB,IGG 300 0 74.82 4010 

4607628 CITRATE,SERUM 300 0 193.12 4010 

4607636 TESTOSTERONE,TOTAL 300 0 195.39 4010 

4607644 TESTOSTERONE,FREE 300 0 193.12 4010 

4607651 IMMUNOGLOB.PCR CHAIN 300 0 0 4010 

4607669 RAPAMYCIN(RAPAMUNE) 300 0 103.03 4010 

4607677 KAPPA CHAIN 24HR UR 300 0 81.64 4010 

4607685 LAMBDA CHAINS 24HR U 300 0 81.64 4010 

4607693 KAPPA & LAMBDA LT CH 300 0 0 4010 

4607701 THIAZIDE DIURETIC SC 300 0 287.76 4010 

4607719 C3A 300 0 90.81 4010 

4607727 INTERLEUKIN 6 300 0 240.44 4010 

4607735 LDL SUBPARTICLES 300 0 207.61 4010 

4607743 HCG 300 0 61.25 4010 

4607750 ESTRIOL 300 0 98.63 4010 

4607768 PROTEINASE 3 AB 300 0 116.73 4010 

4607776 HLA B27 300 0 125 4010 

4607792 HOMOVANILLIC ACID 300 0 177.84 4010 

4607800 CREATININE 300 0 13.72 4010 

4607818 HEPATITIS B S AB 300 0 93.86 4010 

4607826 TRYPSIN,FECES 300 0 61.82 4010 

4607834 C.DIFFICILE AB 300 0 122.85 4010 

4607842 PARATHYROID H REL PR 300 0 348.06 4010 

4607859 IGF-II 300 0 123.63 4010 

4607867 BACTERIAL AG DETECT. 300 0 34.32 4010 

4607875 MORPHINE,FREE,SERUM 300 0 117.52 4010 

4607909 OXCARBAZEPINE/TRILEP 300 0 106.86 4010 

4607917 C1 ESTERASE INHIBIT 300 0 109.92 4010 

4607925 METANEPHRINES,PLASMA 300 0 210.54 4010 

4607933 TETANUS ANTITOXOIDAB 300 0 124.41 4010 

4607941 CSF FOR EBV BY PCR 300 0 319.8 4010 

4607958 PROTEIN 14-3-3 300 0 292.95 4010

4607974 ANTI-STREPTOLYSIN O 300 0 67.15 4010 

4607982 S.CEREVISIAE IGG 300 0 123.63 4010 

4607990 S.CEREVISIAE IGA 300 0 123.63 4010 

4608006 P-ANCA, IFA 300 0 123.63 4010 

4608014 BRAIN NATRIUR PEPTID 300 0 198.45 4010 

4608022 RHEUMATOID FACTOR,FL 300 0 88.53 4010 

4608030 KAPPA/LAMBDA IGA NEP 300 0 41.99 4010 

4608048 KAPPA/LAMBDA IGG NEP 300 0 41.99 4010 

4608055 KAPPA/LAMBDA IGM NEP 300 0 41.99 4010 

4608063 LT. CHAINS KAPPA 300 0 41.99 4010 

4608071 LT. CHAINS LAMBDA 300 0 41.99 4010 

4608089 ZONISAMIDE 300 0 101.53 4010 

4608097 ANTICARDIOLIPIN AB 300 0 0 4010 

4608105 TOTAL OPIATES 300 0 126.69 4010 

4608121 OLANZAPINE 300 0 109.92 4010 

4608139 VARICELLA AB IGG,EIA 300 0 45.6 4010 

4608147 VARICELLA AB IGM,EIA 300 0 97.7 4010 

4608154 CREAT.URINE,RANDOM 300 0 13.72 4010 

4608162 METHYLMALONIC ACID 300 0 35.88 4010 

4608170 MUMPS AB,IGM 300 0 106.08 4010 

4608188 MUMPS AB,IGG 300 0 132.7 4010 

4608196 LYME,DNA,PCR,BLOOD 300 0 264.81 4010 

4608204 IGE 300 0 124.41 4010 

4608212 H.PYLORI AB IGG 300 0 67.93 4010 

4608220 PROLACTIN 300 0 174.79 4010 

4608238 IGE 300 0 124.41 4010 

4608246 IGA 300 0 67.15 4010 

4608253 IGM 300 0 67.15 4010 

4608261 PNEUMOCOCCAL ABS 300 0 67.15 4010 

4608279 TETANUS AB IGG 300 0 67.15 4010 

4608287 DIPHTHERIA AB IGG 300 0 59.54 4010 

4608295 HEMOPHILUS INFLU B 300 0 59.54 4010 

4608303 IGG1 SUBCLASS 300 0 67.15 4010 

4608311 IGG2 SUBCLASS 300 0 67.15 4010 

4608329 IGG3 SUBCLASS 300 0 67.15 4010 

4608337 IGG4 SUBCLASS 300 0 67.15 4010 

4608345 VALPROIC ACID,FREE 300 0 41.21 4010 

4608352 CARNITINE,URINE 300 0 129.74 4010 

4608360 ACYLCARNITINE,URINE 300 0 51.16 4010 

4608386 C.TRACHOMATIS AMP 300 0 264.81 4010 

4608394 N.GONORRHOEAE AMP 300 0 264.81 4010 

4608410 PROMYELOCYTIC LEUKEM 300 0 0 4010 

4608428 CMV DNA,PCR 300 0 296.92 4010 

4608436 ARSENIC,HAIR 300 0 88.53 4010 

4608444 ARSENIC,NAILS 300 0 88.53 4010 

4608451 STRONGYLOIDES AB IGG 300 0 138.91 4010 

4608469 GAMMA HYDROXYBUTRIC 300 0 158.31 4010

4608477 IGG B2 GLYCOPROTEIN 300 0 109.8 4010 

4608485 IGM B2 GLYCOPROTEIN 300 0 109.8 4010 

4608493 IGA B2 GLYCOPROTEIN 300 0 109.8 4010 

4608501 DNA PROBE,EACH 310 0 148.07 4010 

4608519 IN SITU HYBRIDIZATIO 310 0 133.58 4010 

4608535 RHEUMATOID FACTOR,FL 300 0 119.08 4010 

4608543 GASTRIC OCCULT BLOOD 300 0 19.83 4010 

4608550 ANTITHROMBIN III,AG 300 0 65.65 4010 

4608568 QUETIAPINE LEVEL 300 0 107.18 4010 

4608576 CELEBREX 300 0 182.39 4010 

4608584 LEUKOCYTE ALK.PHOS. 300 0 74.82 4010 

4608592 DNA,SINGLE STRANDED 300 0 80.15 4010 

4608600 AMIKACIN,TROUGH 300 0 88.53 4010 

4608618 AMIKACIN,PEAK 300 0 90.09 4010 

4608626 AFP,DIANON 300 0 73.54 4010 

4608634 POLIO TYPE 1 300 0 88.53 4010 

4608642 POLIO TYPE 2 300 0 88.53 4010 

4608659 POLIO TYPE 3 300 0 88.53 4010 

4608667 METHADONE,SERUM 300 0 186.3 4010 

4608675 VON WILLEBRAND MULTI 300 0 221.17 4010 

4608683 BABESIOSIS DNA,PCR 300 0 92.51 4010 

4608717 NEOCOMPLETE PARANEOP 300 0 0 4010 

4608725 PHOSPHOFRUCTOKINASE 300 0 114.47 4010 

4608733 E.HISTOLYTICA AB EIA 300 0 174.79 4010 

4608741 INHIBIN A (UCONN) 300 0 83.2 4010 

4608758 ALPHA FETOPROTEIN 300 0 73.54 4010 

4608766 PLT AGG,EA. AGENT 300 0 76.38 4010 

4608774 MTHFR A1298C MUTATIO 300 0 0 4010 

4608790 ANTI MITOCHOND.TITER 300 0 28.02 4010 

4608808 HYDROCODONE 300 0 96.14 4010 

4608816 GRANULOCYTE AB 300 0 70.7 4010 

4608824 SOURCE 300 0 0 4010 

4608840 CYCLIC CITRULLINE AB 300 0 163.35 4010 

4608857 INHIBIN A 300 0 43.52 4010 

4608865 HEPARIN ANTI XA 300 0 145.8 4010 

4608873 LEGIONELLA IGM 300 0 92.37 4010 

4608881 LEGIONELLA AB 300 0 109.92 4010 

4608899 INHIBIN A 300 0 254.15 4010 

4608907 CENTROMERE AB 300 0 119.92 4010 

4608956 SOLUBLE TRANSFERRIN 300 0 264.81 4010 



4608980 EA.ADD.DRUG RESISTAN 300 0 872.37 4010 

4608998 HERPES SIMPLEX CULT 300 0 102.34 4010 

4609004 HSV TYPING 300 0 0 4010 

4609012 17 OH PREGNENOLONE 300 0 169.46 4010 

4609020 5'NUCLEOTIDASE 300 0 93.86 4010

4609038 RUBEOLA AB,IGG 300 0 132.8 4010 

4609046 SEX HORMONE BIND GLB 300 0 84.25 4010 

4609053 HGE IGG AB 300 0 76.31 4010 

4609061 HGE IGM AB 300 0 76.31 4010 

4609079 REPTILASE 300 0 140.6 4010 

4609087 HEPTIMAX HCV RNA PCR 300 0 379.4 4010 

4609095 FIBRINOGEN,FUNCTIONL 300 0 88.53 4010 

4609103 HSV IGM AB 300 0 141.96 4010 

4609111 HSV IGM AB TITER 300 0 108.36 4010 

4609129 CREATININE,URINE 24H 300 0 35.88 4010 

4609137 UREAPLASMA,URINE 300 0 133.58 4010 

4609145 PTT(LAC)SCREEN 300 0 53.43 4010 

4609152 LUPUS ANTICOAGULANT 300 0 76.31 4010 

4609160 REVERSE T3 300 0 298.94 4010 

4609178 COCCIDIOIDES AB(IGG) 300 0 206.05 4010 

4609186 INTERLEUKIN 2 RECPT 300 0 220.55 4010 

4609202 EHRLICHIOSIS AB(G&M) 300 0 0 4010 

4609210 DIHYDROTESTOSTERONE 300 0 195.39 4010 

4609228 INSULIN AUTOANTIBODY 300 0 129.85 4010 

4609251 17-OH-PROGESTERONE 300 0 204.56 4010 

4609269 INHIBIN B 300 0 308.1 4010 

4609277 VITAMIN B2 300 0 294.4 4010 

4609285 CONC/INFECT.AGENTS 300 0 48.1 4010 

4609293 SP.STAIN/PARASITES 300 0 35.88 4010 

4609301 HEPATITIS C GENOTYPE 300 0 915.24 4010 

4609343 LYMPH SUBSET V 300 0 228.25 4010 

4609368 CHLAMYDIA AB PROF 300 0 257.21 4010 

4609376 SICKLE CELL SCREEN 300 0 41.21 4010 

4609384 MONOCYTIC EHRLICHIA 300 0 435.83 4010 

4609392 FIFTH'S DISEASE 300 0 845.43 4010 


4609418 HCV RNA,BDNA,QUANT. 300 0 349.57 4010 

4609434 SEROTONIN RELEASE 300 0 196.17 4010 

4609475 RUBELLA AB IGG 300 0 51.16 4010 

4609483 RUBELLA AB IGM 300 0 140.47 4010 

4609491 TISSUE I.F. SKIN 310 0 206.83 4010 

4609509 N TELOPEPTIDE (NTX) 300 0 34.8 4010 

4609517 CARB DEF TRANSFERRIN 300 0 122.14 4010 

4609525 HEXOSAMINIDASE A 300 0 184.73 4010 

4609533 ACYLCARNITINE,QUANT. 300 0 127.47 4010 

4609541 EGG WHITE ALLERGEN 300 0 34.32 4010 

4609558 COW MILK ALLERGEN 300 0 34.32 4010 

4609566 PEANUT ALLERGEN 300 0 34.32 4010 

4609574 D FARINAE MITE ALLER 300 0 34.32 4010 

4609582 ALTERNARIA TENUIS 300 0 34.32 4010 

4609590 DOG DANDER ALLERGEN 300 0 34.32 4010 

4609608 CAT DANDER ALLERGEN 300 0 34.32 4010

4609616 SACCHAROMYCES IGG AB 300 0 214.96 4010 

4609624 SACCHAROMYCES IGA AB 300 0 214.96 4010 

4609632 ALDOST.ACTH RESP.EA. 300 0 278.59 4010 

4609657 LEPTIN LEVEL 300 0 91.59 4010 

4609665 ORGANIC ACIDS,QUAN,U 300 0 366.94 4010 

4609673 NARCOLEPSY PANEL 300 0 430.43 4010 

4609681 HEPARIN ASSOC ABS 300 0 83.2 4010 

4609699 PTH INTACT 300 0 248.82 4010 

4609707 CALCIUM (PTH INTACT) 300 0 44.27 4010 

4609731 THROMBOPLASTIN INHIB 300 0 70.2 4010 

4609749 HSV 1 IGG TYPE SPEC 300 0 87.75 4010 

4609756 HSV 2 IGG TYPE SPEC 300 0 130.52 4010 

4609764 PROPREDICTR 6MP 300 0 224.81 4010 

4609772 CHROM.IN SITU HYBRID 310 0 193.83 4010 

4609780 MOL. CYTOGENETICS 310 0 142.74 4010 

4609806 TISS.NON NEOPLASTIC 310 0 780 4010 

4609814 INTERPHASE IN SITU H 300 0 191.56 4010 

4609822 TISS.NEOPLASTIC 300 0 239.73 4010 

4609830 CHROMOSOMES,FISH 300 0 0 4010 

4609848 CATECHOLAMINE,UR 300 0 191.56 4010 

4609855 CREATININE,UR RANDOM 300 0 30.55 4010 

4609863 CHROMOSOME ANALYSIS 310 0 518.91 4010 

4609871 ANTI SSA ANTIBODY 300 0 135.07 4010 

4609889 ANTI SSB ANTIBODY 300 0 135.07 4010 

4609897 PS-1 GENE 300 0 0 4010 

4609905 PLASMINOGEN ACT INH1 300 0 0 4010 

4609913 BETA 2 TRANSFERRIN 300 0 368.28 4010 

4609921 ZELDOX(ZIPRASIDONE) 300 0 155.42 4010 

4609939 GAD-65 AB 300 0 172.51 4010 

4609947 IGA PHOSPHATIDYLSERI 300 0 155.68 4010 

4609954 BRUCELLA IGG 300 0 67.15 4010 

4609962 BRUCELLA IGM 300 0 67.15 4010 

4609988 TYPE2 COXSACKIE A AB 300 0 87.75 4010 




4610028 TYPE10 COXSACKIE A 300 0 87.75 4010 

4610036 TYPE16 COXSACKIE A 300 0 87.75 4010 

4610044 TYPE 4 ECHOVIRUS AB 300 0 87.75 4010 




4610085 TYPE30 ECHOVIRUS AB 300 0 87.75 4010 

4610093 POLIO VIRUS 1,CF 300 0 87.75 4010 

4610101 POLIO VIRUS 2,CF 300 0 87.75 4010 

4610119 POLIO VIRUS 3,CF 300 0 87.75 4010 

4610127 COXSACKIE B1 AB 300 0 87.75 4010

4610135 COXSACKIE B2 AB 300 0 87.75 4010 

4610143 COXSACKIE B3 AB 300 0 87.75 4010 

4610150 COXSACKIE B4 AB 300 0 87.75 4010 

4610168 COXSACKIE B5 AB 300 0 87.75 4010 

4610176 COXSACKIE B6 AB 300 0 87.75 4010 

4610184 IGG,ANTI-IGA AB 300 0 116.03 4010 

4610192 LYME DNA PCR,URINE 300 0 219.05 4010 

4610200 RBC 300 0 19.11 4010 

4610218 HEMOGLOBIN 300 0 14.5 4010 

4610226 HEMATOCRIT 300 0 26.33 4010 

4610234 LCM IGG AB 300 0 95.42 4010 

4610242 LCM IGM AB 300 0 95.42 4010 

4610259 BETAPACE LEVEL 300 0 119.8 4010 

4610267 H.INFLUENZAE TYPE B 300 0 47.32 4010 

4610275 STREP.PNEUMONIAE 300 0 39.72 4010 

4610283 N.MENINGITIDIS GP A 300 0 39.72 4010 

4610291 N.MENINGITIDIS GP B 300 0 39.72 4010 

4610309 N.MENINGITIDIS GP C 300 0 39.72 4010 

4610317 N.MENINGITIDIS GP Y 300 0 39.72 4010 

4610325 N.MENINGITIDIS GPW13 300 0 39.72 4010 

4610333 GP B STREPTOCOCCUS 300 0 39.72 4010 

4610341 E.COLI AG 300 0 39.72 4010 

4610358 CSF HSV 300 0 264.81 4010 

4610366 ENTEROVIRUS,PCR 300 0 338.13 4010 

4610416 ALDOSTERONE,PLASMA 300 0 278.59 4010 

4610424 ASPERGILLUS 300 0 76.31 4010 

4610432 GEL DIFF.EA AG/AB 300 0 46.54 4010 

4610440 ADENOVIRUS CULTURE 300 0 80.93 4010 

4610457 ADENOVIRUS TISS INOC 300 0 106.02 4010 

4610465 CMV DNA,QL,PCR 300 0 303.75 4010 

4610473 TPMT MUTATION ANALYS 300 0 371.25 4010 

4610481 VIRAL CULTURE,COMPRE 300 0 101.09 4010 

4610499 FREE KAPPA,SERUM 300 0 188.5 4010 

4610507 FREE LAMBDA,SERUM 300 0 188.5 4010 

4610515 ACHR BLOCKING AB 300 0 209.11 4010 

4610523 ACHR MODULATING AB 300 0 278.59 4010 

4610531 SKELETAL MUSCLE AB 300 0 258.77 4010 

4610549 DHEA,URINE 300 0 329.75 4010 

4610556 REDUCING SUBST.FECES 300 0 77.81 4010 

4610564 ENTEROVIRUS CULTURE 300 0 167.12 4010 

4610572 CRYPTOCOCCUS AG,SERU 300 0 62.9 4010 

4610580 LYME,PCR,FLUID 300 0 113.75 4010 

4610598 LYME,PCR,CSF 300 0 113.75 4010 

4610606 LYME WB IGG/IGM,CSF 300 0 145.08 4010 

4610614 HSV I,IGG 300 0 100.38 4010 

4610622 HSV II,IGG 300 0 98.56 4010 

4610630 LYME WB IGG/IGM FLD. 300 0 145.08 4010

4610648 PLASMINOGEN ACT INH1 300 0 0 4010 

4610663 HISTOPLASMA AB ID 300 0 74.82 4010 

4610671 HEXAGONAL PH.NEUT. 300 0 224.01 4010 

4610689 HISTOPLASMA AB PROF 300 0 0 4010 

4610697 BABESIA AB/IGG/IGM 300 0 0 4010 

4610705 RENIN ACTIVITY,PLASM 300 0 227.84 4010 

4610721 SPOROTHRIX AB 300 0 191.56 4010 

4610739 21-HYDROXYLASE AB 300 0 191.56 4010 

4610754 NARCOLEPSY ASSOC. AG 300 0 448.76 4010 

4610762 ALPHA THALASSEMIA 300 0 706.91 4010 

4610770 N-TELOPEPTIDE (NTX) 300 0 251.1 4010 

4610788 ALPHA-2-ANTIPLASMIN 300 0 191.56 4010 

4610804 HEPATITIS PNL,ACUTE 300 0 273.26 4010 

4610812 M.TUBERCULOSIS,DNA 300 0 420.55 4010 

4610820 DIPHTHERIA AB 300 0 42.77 4010 

4610838 PNEUMOCOCCAL AB 300 0 49.6 4010 

4610846 IGG SUBCLASS 1 300 0 58.76 4010 

4610853 IGG SUBCLASS 2 300 0 58.76 4010 

4610861 IGG SUBCLASS 3 300 0 58.76 4010 

4610879 IGG SUBCLASS 4 300 0 58.76 4010 

4610887 IGE 300 0 49.6 4010 

4610895 IGG 300 0 49.6 4010 

4610903 IGM 300 0 49.6 4010 

4610911 IGA 300 0 49.6 4010 

4610929 H.INFLUENZA TYPE B 300 0 42.77 4010 

4610937 TETANUS AB 300 0 42.77 4010 

4610945 CMV,RAPID CULTURE 300 0 99.97 4010 

4610952 CMV CONVENTIONAL CUL 300 0 99.97 4010 

4610960 ACYLGLYCINES 300 0 539.63 4010 

4610978 FACTOR XIII,FUNCTION 300 0 275.54 4010 

4610986 FIBRINOGEN AG 300 0 45.83 4010 

4610994 COCAINE,BLOOD 300 0 119.8 4010 

4611000 TB CULTURE 300 0 225.94 4010 

4611018 ACID FAST/FLUOR.SMR 300 0 64.87 4010 

4611026 ACETAMINOPHEN 300 0 87.04 4010 

4611034 HYDROCODONE 300 0 103.81 4010 

4611042 DNA,SINGLE STRANDED 300 0 176.28 4010 

4611059 ROPIVACAINE 300 0 170.17 4010 

4611067 IGG TRANSGLUTAMINASE 300 0 59.44 4010 

4611075 ACYLCARNITINE,PLASMA 300 0 61.82 4010 

4611083 ORGANIC ACIDS,URINE 300 0 420.55 4010 

4611091 ACYLGLYCINE ANALYSIS 300 0 420.55 4010 

4611109 HLA DR,DQ CLASS II 300 0 510.75 4010 

4611117 YEAST SENSITIVITY 300 0 286.98 4010 

4611125 CMV DNA,QN,PCR,REAL 300 0 350.65 4010 

4611133 PORPHYRINS,UR RANDOM 300 0 112.19 4010 

4611141 C.TRACHOMATIS RNA 300 0 166.73 4010

4611158 N.GONORRHOEAE RNA 300 0 156.46 4010 

4611166 CORTISONE,SERUM 300 0 177.06 4010 

4611174 MYOGLOBIN 300 0 60.32 4010 

4611216 T OR B CELL CLONAL R 300 0 0 4010 

4611224 SOLUBLE LIVER AG AB 300 0 92.37 4010 

4611232 INTERLEUKIN 5 300 0 373.23 4010 

4611240 ACID PHOSPHATASE,TOT 300 0 67.15 4010 

4611257 C.PNEUMONIAE/PSITTAC 300 0 312.13 4010 

4611265 LYME SKIN BIOPSY 300 0 195.39 4010 

4611273 SUB ABUSE PANEL 300 0 80.15 4010 

4611281 CARDIOLIPIN IGA AB 300 0 113.75 4010 

4611299 HPV DNA HIGH RISK 300 0 99.94 4010 

4611307 SALMONELLA AB 300 0 64.09 4010 

4611315 CONCENTRATION,INF.AG 300 0 45.83 4010 

4611323 TRYPTOPHAN 300 0 74.82 4010 

4611331 HSV 1&2,DNA,PCR 300 0 294.58 4010 

4611349 HSV 1 IGM,IFA,CSF 300 0 67.93 4010 

4611356 HSV 2 IGM,IFA,CSF 300 0 107.64 4010 

4611364 HSV 1 IGG,CSF 300 0 64.87 4010 

4611372 HSV 2 IGG,CSF 300 0 96.92 4010 

4611380 RICKETTSIA CONORII 300 0 229 4010 

4611398 INSULIN,FREE 300 0 165.62 4010 

4611406 CANDIDA IGG AB 300 0 53.43 4010 

4611414 CANDIDA IGA AB 300 0 53.43 4010 

4611422 CANDIDA IGM AB 300 0 53.43 4010 

4611430 ANGIOTENSIN CONV CSF 300 0 96.14 4010 

4611448 KETAMINE&META SCREEN 300 0 165.62 4010 

4611455 PARVO B19 DNA,PCR 300 0 195.39 4010 

4611463 B CELLS,TOTAL CT. 300 0 203.78 4010 

4611471 NATURAL KILLER(NK) 300 0 211.45 4010 

4611497 NORWALK LIKE VIRUS 300 0 196.42 4010 

4611513 DENGUE FEVER IGG AB 300 0 109.14 4010 

4611521 DENGUE FEVER IGM AB 300 0 109.14 4010 

4611539 H.PYLORI AB(IGG) 300 0 81.64 4010 

4611547 S.PNEUMONIAE AG 300 0 134.36 4010 

4611562 BCR/ABC QUANT. 300 0 0 4010 

4611570 CYSTIC FIBROSIS TEST 300 0 20.55 4010 

4611588 VITAMIN C 300 0 223.6 4010 

4611596 C1 INHIB.FUNCTIONAL 300 0 74.04 4010 

4611612 BERYLLIUM 300 0 97.76 4010 

4611638 IMMUNOFLUOR,INDIR,AB 300 0 182.39 4010 

4611646 VWF PROTEASE W/RF IN 300 0 314.47 4010 

4611653 VWF INHIBITOR 300 0 0 4010 

4611661 CLARITIN LEVEL 300 0 177.06 4010 

4611679 PROINSULIN 300 0 246.55 4010 

4611687 SELENIUM,BLOOD 300 0 144.24 4010 

4611695 ANTICARDIOLIPIN AB 300 0 0 4010

4611703 HYPERCOAG. NON-PREG 300 0 0 4010 

4611711 HOLD/CHEMISTRY 300 0 0 4010 

4611729 HOLD/BLOOD BANK 300 0 0 4010 

4611737 HYPERCOAG.PNL HOLD 300 0 0 4010 

4611745 HYPERCOAG.PNL.PREG. 300 0 0 4010 

4611752 MYELIN BASIC PROT.AB 300 0 274.76 4010 

4611760 ZINC,PLASMA 300 0 102.45 4010 

4611778 TRAMADOL 300 0 170.14 4010 

4611786 TRIGLYCERIDES(VAP) 300 0 337.39 4010 

4611794 HIGH RES.FRACT.LIPO. 300 0 337.39 4010 

4611810 THC,DELTA-9,SERUM 300 0 75.3 4010 

4611828 B CELLS,TOTAL CT. 300 0 242.71 4010 

4611836 FISH DIGEORGE 300 0 0 4010 

4611844 DNA PROBE,EA. 300 0 119.09 4010 

4611851 CHROMOSOME,HYBRID. 300 0 182.39 4010 

4611877 CMV QUANT. PCR 300 0 360.23 4010 

4611885 LEUK.HISTAMINE REL. 300 0 219.83 4010 

4611893 CHEMILUMINESCENT ASY 300 0 64.09 4010 

4611927 VGKC AB 300 0 0 4010 

4611935 AMPHETAMINE 300 0 77.87 4010 

4611943 PARKINSON EVAL PANEL 300 0 0 4010 

4611950 B.PERTUSSIS AG,DFA 300 0 67.15 4010 

4612008 PINK1 DNA SEQ.TEST 300 0 0 4010 

4612016 VIRUS ISOLATION,P.ID 300 0 61.82 4010 

4612024 TISSUE CULT.DEF.ID 300 0 48.1 4010 

4612032 OXYCODONE,URINE,GCMS 300 0 41.21 4010 

4612040 FLUOR./AFB SMR. 300 0 58.76 4010 

4612057 TB CULTURE 300 0 116.71 4010 

4612065 TB CULTURE W/SMR 300 0 0 4010 

4612073 GASTRIC PARIETAL AB 300 0 73.26 4010 

4612081 AFP 300 0 92.03 4010 

4612099 NUCLEIC ACID PROBE I 300 0 152.62 4010 

4612107 ASIALO GM1 AB(IGM) 300 0 127.47 4010 

4612123 MORPHINE,URINE 300 0 80.15 4010 

4612164 HER2,ELISA 300 0 273.26 4010 

4612172 FENTANYL & METAB.UR 300 0 72.09 4010 

4612230 UTG1A128 GENETIC VAR 300 0 26.72 4010 

4612248 AMINO ACIDS, QUANT. 300 0 416.72 4010 

4612255 PROTHROMBIN AB (G&M) 300 0 207.61 4010 

4612263 ANNEXIN V IGG AB 300 0 90.81 4010 

4612271 ANNEXIN V IGM AB 300 0 90.81 4010 

4612289 EBV DNA QUAL. 300 0 362.51 4010 

4612297 IMMUNOFIXATION, CSF 300 0 124.41 4010 

4612305 ELECTROPHORESIS, CSF 300 0 80.15 4010 

4612313 PROTEIN, TOTAL, CSF 300 0 16.06 4010 

4612321 TESTOSTERONE, TOTAL 300 0 199.06 4010 

4612339 SEX HORMONE BNG GLOB 300 0 121.66 4010

4612347 ALBUMIN 300 0 19.11 4010 

4612354 YERSINIA AB 300 0 69.49 4010 

4612362 JAK-2 300 0 337.5 4010 

4612370 LIPASE, URINE, RANDOM 300 0 53.43 4010 

4612388 ARGIN-VASOPRES, URINE 300 0 143.46 4010 

4612396 OSMOLALITY, URINE 300 0 32.83 4010 

4612404 MYELOPEROXIDASE AB 300 0 53.17 4010 

4612412 EHRLICHIOSIS AB 300 0 0 4010 

4612420 CREATINE, SERUM 300 0 19.83 4010 

4612438 GALACTOSE I-PHOS URI 300 0 95.42 4010 

4612461 TISSUE CULT NON NEOP 300 0 221.13 4010 

4612479 CT 15 TO 20 CELLS/KA 300 0 178.53 4010 

4612495 CHROMOSOME ADD HIGH 300 0 122.4 4010 

4612503 UROVYSION 300 0 306.6 4010 

4612511 AB, BORDETELLA 300 0 70.98 4010 

4612529 CARISOPRODOL/MEPROBA 300 0 74.82 4010 

4612537 BROMIDE 300 0 107.9 4010 

4612545 ALPRAXOLAM, URINE 300 0 170.95 4010 

4612552 CHROMOSOME INSITU HY 300 0 112.31 4010 

4612560 FISH, SUBTELOMERE INT 300 0 0 4010 

4612677 HPV TYPING IN SITU 300 0 237.38 4010 

4612727 LEXAPRO 300 0 155.42 4010 

4612735 GALACTOSEMIA GENE AN 300 0 19.11 4010 

4612743 AUTOSOMAL DOMINENT ATAXIA 300 0 0 4010 

4612750 LYME WB, SERUM 300 0 0 4010 

4612800 CONGENITAL VENOUS THROMOSIS PROFILE 300 0 0 4010 

4612826 HERPES VIRUS 6 AB 300 0 0 4010 

4612834 HSV DNA DETECTOR 300 0 0 4010 

4612842 KAPPA/LAMBDA LIGHT CHAINS, URINE 300 0 76.31 4010 

4612867 PARASITE PROFILE 300 0 0 4010 

4612883 IBD DETECTION 300 0 0 4010 

4612891 QUINIDINE 300 0 97.7 4010 

4612909 BILE ACIDS, TOTAL 300 0 81.64 4010 

4612917 N. MENINGITIDIS IGG 300 0 63.38 4010 

4612925 MENINGITIS AG PANEL 300 0 48.1 4010 

4612933 NEUROMYELITIS OPTICA 300 0 549.51 4010 

4612941 APOLIPOPROTEIN B 300 0 72.48 4010 

4612958 YEAST SENS TO FLUCON 300 0 156.46 4010 

4612974 HERPES VIRUS 6 IGG 300 0 70.98 4010 

4612982 HERPES VIRUS 6 IGM 300 0 70.98 4010 

4612990 IGG 300 0 67.15 4010 

4613006 APTT 300 0 63.38 4010 

4613014 ANTITHROMBIN, PLASMA 300 0 63.38 4010 

4613022 PROTEIN C ACTIVITY 300 0 67.15 4010 

4613030 PROTEIN S ACTIVITY 300 0 67.15 4010 

4613048 PROTEIN S AG, FREE 300 0 67.15 4010 

4613055 H. INFLUENZAE TYPE B IGG 300 0 129.74 4010

4613063 TISSUE PREP 300 0 82.42 4010 

4613071 CD38 300 0 101.53 4010 

4613089 NEISSERI GONORRHOEAE 300 0 99.97 4010 

4613097 B.PERTUSSIS DNA 300 0 457.93 4010 

4613105 NEFAZODONE 300 0 83.2 4010 

4613113 ACTIN AB IGG 300 0 106.86 4010 

4613121 IGA ENDOMYSIAL AB 300 0 152.62 4010 

4613139 HISTAMINE, PLASMA 300 0 209.89 4010 

4613147 PLACENTAL LACTOGEN 300 0 381.62 4010 

4613154 WB, CSF 300 0 122.85 4010 

4613162 FLUORESCENT AB, CSF 300 0 282.43 4010 

4613170 SP.GRAVITY, FLUID 300 0 26.72 4010 

4613188 OSMO, FECES 300 0 122.85 4010 

4613196 FIP1L1-PDGFRA GENE 300 0 145.02 4010 

4613204 SODIUM, FECES 300 0 100.75 4010 

4613212 POTASSIUM, FECES 300 0 100.75 4010 

4613220 CHLORIDE, FECES 300 0 29.77 4010 

4613238 MAGNESIUM, FECES 300 0 111.41 4010 

4613253 RITALIN, URINE 300 0 103.81 4010 

4613261 PROSTAGLANDINS D2, UR 300 0 457.93 4010 

4613279 CA72-4 300 0 103.03 4010 

4613287 N.GONORRHOEAE 300 0 148.07 4010 

4613295 C.TRACHOMATIS 300 0 148.07 4010 

4613303 CELEXA 300 0 183.17 4010 

4613311 CD 57 LYMPHOCYTE CT 300 0 114.47 4010 

4613329 ANTIMICROBIAL SUSC 300 0 183.17 4010 

4613337 BSAG 300 0 69.49 4010 

4613345 METHSUXIMIDE 300 0 158.02 4010 

4613352 THALASSEMIA, BETA DNA 300 0 670.5 4010 

4613378 CORTISOL, SALIVARY 300 0 120.58 4010 

4613386 HLA TYPING, CELIAC 300 0 317.06 4010 

4613394 5HIAA, RANDOM URINE 300 0 121.36 4010 

4613402 PTT, ACTIVATED 300 0 53.43 4010 

4613410 CREAT. RANDOM, URINE 300 0 30.55 4010 

4613428 TEICHOIC ACID AB W/REFLEX 300 0 135.85 4010 

4613436 METANEPHRINE, RANDOM URINE 300 0 236.6 4010 

4613444 NIACIN 300 0 115.25 4010 

4613451 ULTRAM, URINE 300 0 174.01 4010 

4613469 TB DIRECT DETECT DNA AMPLIFICATION 300 0 336.57 4010 

4613477 TYSABRI AB 300 0 464.04 4010 

4613485 HLA DQB1 CLASS II DNA 300 0 267.87 4010 

4613519 THALLASEMIA, BETA, DNA 300 0 16.77 4010 

4613527 MYCOPHENOLIC ACID 300 0 68.17 4010 

4613535 QUANTIFERON GOLD 300 0 224.52 4010 

4613550 IA - 2 AB 300 0 292.7 4010 

4613568 LACTOFERRIN, STOOL 300 0 243.79 4010 

4613576 CYSTATIN C 300 0 210.44 4010

4613584 GLYCOMARK 300 0 136.34 4010 

4613592 STREPTOMYCIN 300 0 370.5 4010 

4613600 THYROXIN BINDING CAPACITY 300 0 52.58 4010 

4613626 DEOXYCORTICOSTERONE 300 0 110.12 4010 

4613634 ALDACTONE/SPIRONOLACTONE 300 0 210.6 4010 

4613642 CHROMATIN ANTIBODY 300 0 107.25 4010 

4613659 BK VIRUS DNA, QN, PCR 300 0 729.3 4010 

4613667 HA1C WITH MPG 300 0 93.21 4010 

4613675 CITRATE URINE, RANDOM 300 0 337.35 4010 

4613683 ESTRIOL 300 0 62.6 4010 

4613691 ASPERGILLUS ANTIBODY 300 0 20.7 4010 

4613709 TIN 300 0 195 4010 

4613717 NICOTINE/COTININE, URINE 300 0 99.45 4010 

4613725 LYME DISEASE C6 ANTIBODY 300 0 487.5 4010 

4613733 PROTEIN S ANTIGEN, TOTAL AND FREE 300 0 702 4010 

4613741 ATOMOXETINE 300 0 349.05 4010 

4613758 VITAMIN D 300 0 82.68 4010 

4613766 HEPATITIS A AB, IGM 300 0 187.68 4010 

4613774 KRAS 300 0 1012.5 4010 

4613816 INFLUENZA A RNA 300 0 229.13 4010 

4613824 SWINE FLU H1 GENE 300 0 229.13 4010 

4613832 PL-7 AUTOABS 300 0 160.16 4010 

4613840 PL-12 AUTOABS 300 0 160.16 4010 

4613857 MI-2 AUTOABS 300 0 160.16 4010 

4613865 KU AUTOABS 300 0 160.16 4010 

4613873 EJ AUTOABS 300 0 160.16 4010 

4613881 OG AUTOABS 300 0 160.16 4010 

4613899 SRP AUTOABS 300 0 160.16 4010 

4613907 JO-1 AUTOABS 300 0 160.16 4010 

4613915 REFLEX HPV DNA 300 0 99.94 4010 

4613923 COMPLEMENT-C5 300 0 160.37 4010 

4613931 OVA AND PARASITES 300 0 321.53 4010 

4613949 TRICHROME 300 0 241.57 4010 

4613956 ABILIFY 300 0 158.31 4010 

4613964 PT-QUEST 300 0 49.83 4010 

4613972 PTT-LA 300 0 49.83 4010 


4613998 ANA SCREEN 300 0 42.97 4010 

4614004 ANA TITER 300 0 15.35 4010 

4614012 ANA PATTERN 300 0 0 4010 

4614020 CRYPTOCOCCUS AG, CSF 300 0 33.11 4010 

4614038 LEGIONELLA AG, URINE 300 0 35.61 4010 

4614046 BUPRENORPHINE, URINE 300 0 339.3 4010 

4614053 COTININE, URINE 300 0 132.6 4010 

4614061 AMPHETAMINES, UR QUANT 300 0 188.08 4010 


4614087 T3 ANTIBODY 300 0 230.1 4010

4614095 LIDOCAINE AUTO ABS 300 0 263.25 4010 

4614103 FREE HEMOGLOBIN, URINE 300 0 109.2 4010 

4614111 PH, URINE 300 0 29.82 4010 

4614129 CALCIUM, URINE 300 0 29.82 4010 

4614137 URIC ACID, URINE 300 0 29.82 4010 

4614145 CITRATE, URINE 300 0 38.22 4010 

4614152 SODIUM, URINE 300 0 29.82 4010 

4614160 SULFATE, URINE 300 0 29.82 4010 

4614178 PHOSPHORUS, URINE 300 0 29.82 4010 

4614186 MAGNESIUM, URINE 300 0 29.82 4010 

4614194 POTASSIUM, URINE 300 0 29.82 4010 

4614202 CREATININE, URINE 300 0 29.82 4010 

4614210 CALCIUM OXALATE, URINE 300 0 29.82 4010 

4614236 BETA-HYDROXYBUTYRATE 300 0 126 4010 

4614244 IRON, LIVER TISSUE 300 0 180.48 4010 

4614251 CREATININE, URINE, QUEST 300 0 14.46 4010 

4614269 EARLY ALZHEIMERS EVALUATION 300 0 45.66 4010 

4614285 LEFLUNOMIDE 300 0 273 4010 

4614350 ANTI NEURONAL NUC AB TYPE 1 300 0 97.33 4010 



4614384 ANTI GLIAL NUC AN TYPE 1 300 0 97.33 4010 

4614392 PURKINJE CELL CYTO AB TYPE 1 300 0 97.33 4010 

4614400 PURKINJE CELL CYTO AB TYPE 2 300 0 97.33 4010 

4614418 PURKINJE CELL CYTO AB TYPE TR 300 0 97.33 4010 

4614426 AMPHIPHYSIS AB 300 0 97.33 4010 

4614434 CRMP 5 IG G 300 0 97.33 4010 


4614459 P/Q TYPE CA CHANNEL AB 300 0 95.13 4010 

4614467 N TYPE CA CHANNEL AB 300 0 95.13 4010 

4614475 ACH REC BINDING AB 300 0 95.13 4010 

4614483 ACHR GANGLIONIC NEURONAL AB 300 0 95.13 4010 

4614491 NEURONAL (V-G)K+ CHANNEL AB 300 0 95.13 4010 

4614509 RETOVIRAL SEROLOGY 300 0 1755 4010 

4614574 TAY SACHS MUTATION ANALYSIS 300 0 11.19 4010 

4614590 PRO-BNP NT 300 0 188.67 4010 

4614608 TARTRATE RESISTANT ACID PHOS 300 0 119.68 4010 

4614616 CYMBALTA 300 0 312 4010 

4614624 THYROTROPIN 300 0 401.7 4010 

4614632 CODEINE ALLERGEN 300 0 78 4010 

4614640 PORPHYRINS, FECAL, QUALITATIVE 300 0 116.26 4010 

4614673 XYLENE PANEL 300 0 124.26 4010 

4614715 COMPLETE MYOTONIA EVALUATION 300 0 11.48 4010 

4614731 17 OH PROGESTERONE 300 0 77.82 4010 

4614749 ANA SCREEN 300 0 42.97 4010 

4614756 5HIAA UR, 24 HR 300 0 30.94 4010 

4614764 ACETYLCHOLINE MODULATING AB 300 0 33.74 4010

4614772 CHROMAGRANIN A 300 0 105 4010 

4614780 CMV DNA QUANT RT PCR 300 0 146.07 4010 

4614798 DNA (DS) AB, CRITHIDIA 300 0 116 4010 

4614806 ENDOMYSIAL AB SCREEN 300 0 67.32 4010 

4614814 RBC FOLATE 300 0 49.6 4010 

4614822 H PYLORI AG, STOOL 300 0 134.4 4010 

4614830 HERPES SIMPLEX CULTURE 300 0 121.71 4010 

4614848 HYDROCODONE URINE 300 0 130 4010 

4614855 INSULIN LIKE GROWTH FACTOR 1 300 0 114.42 4010 

4614863 LEAD, BLOOD 300 0 34.68 4010 

4614871 LEPTIN LEVEL 300 0 150 4010 

4614889 LYME, PCR, FLUID 300 0 256 4010 

4614897 U UREALYTICUM/H HOMINIS CULT 300 0 44.08 4010 

4614905 RENIN ACTIVITY, PLASMA 300 0 154 4010 

4614913 QUETIAPINE (SEROQUAL) 300 0 154 4010 

4614921 ANCA SCREEN 300 0 48 4010 

4614939 SCA5 DNA TEST ATHENA 300 0 13.01 4010 


4614954 MIRAS SPEC POLG 1 ATHENA 300 0 13.01 4010 

4614962 SIL1 DNA TEST ATHENA 300 0 13.01 4010 

4614988 SCA13 SELECT EXON ATHENA 300 0 13.01 4010 


4615001 SETX DNA TEST ATHENA 300 0 13.01 4010 

4615019 TTPA DNA TEST ATHENA 300 0 13.01 4010 

4615027 PTT LA 300 0 47.3 4010 

4615035 HEXAGONAL PHASE CONF 300 0 58.37 4010 

4615043 DRVVT SCREEN 300 0 31.06 4010 

4615050 DRVVT 1:1 MIX 300 0 31.06 4010 

4615068 DRVVT CONFIRMATION 300 0 58.37 4010 

4615076 LACTOFERRIN, STOOL 300 0 154.13 4010 

4615084 LYME DISEASE, C6 AB'S 300 0 69.14 4010 

4615092 HOMOCYSTEINE 300 0 253.94 4010 


4615118 CHOLINESTERASE, SERUM 300 0 31.99 4010 

4615126 THYROXINE BINDING GLOBULIN 300 0 60.04 4010 

4615134 ESTRIOL 300 0 98.2 4010 

4615175 SODIUM QUEST 300 0 0 4010 

4615241 PEDIATRIC LEAD LEVEL 300 0 17.88 4010 

4615258 RH PHENOTYPING COMPLETE 300 0 90 4010 

4615266 RBC AG, OTHER THAN ABO OR D, EA 300 0 42 4010 

4615274 DAT, EA ANTISERA 300 0 34.5 4010 

4615282 ELUTION, EACH 300 0 112.5 4010 

4615290 ANTIBODY SCREEN, EA MEDIA 300 0 58.5 4010 

4615308 AB ID/EA PANEL & MEDIA 300 0 95.85 4010 

4615316 AB ID/EA SELECTED REAGENT CELL 300 0 15 4010 

4615324 PRE TREAT W/ENZYM PER CELL 300 0 18 4010 

4615332 PRE RX RBC'S W/CHEM/DRUGS/CELL 300 0 67.5 4010

4615340 INCUBATION SERUM & DRUGS, EA 300 0 195 4010 

4615357 DIFF/AUTO ADS OF SERUM, EA ADS 300 0 97.5 4010 

4615365 INCU W/INHIBITORS, PER ALIQUOT 300 0 82.5 4010 

4615373 DILUTION OF SERUM, PER ALIQUOT 300 0 24 4010 

4615381 INDIRECT TITER, PER AB 300 0 112.5 4010 

4615399 SEPARATE BY DENSITY GRAD, RETICS 300 0 180 4010 

4615407 AG SCREEN W/PT SERUM, PER UNIT 300 0 119.4 4010 

4615415 ANTIGEN TYPE/UNIT, NOT LABELED 300 0 149.1 4010 

4617205 GLIADIN(DEAM PEP) AB, IGG 300 0 21 4010 

4617213 GLIADIN(DEAM PEP)AB, IGA 300 0 21 4010 

4617221 FTA-ABS 300 0 48.8 4010 

4617239 IODINE, RANDOM URINE 300 0 104.27 4010 

4617247 BUPRENORPHINE 300 0 150 4010 

4617254 NALOXONE 300 0 150 4010 

4617262 PSA, POST PROSTATECTOMY 300 0 38.37 4010 

4617270 ESTRIOL 300 0 56.4 4010 

4617288 BULLOUS PEMPHIGOID(BP230 IGG) 300 0 79.5 4010 

4617296 MYCOBACTERIUM, BLOOD CULTURE 300 0 78.83 4010 

4617304 IGM ANTIBODY CAPTURE 300 0 76.14 4010 

4617312 IGG ANTIBODY CAPTURE 300 0 76.14 4010 

4617320 IGA ANTIBODY CAPTURE 300 0 76.14 4010 

4617338 IGG IMMUNOBLOT G39/40 300 0 76.14 4010 

4617346 IGG IMMUNOBLOT 49736 300 0 76.14 4010 

4617361 BABESIA, AMPLIFIED PROBE TECHNIQUE 300 0 178.24 4010 

4617387 A PHAGOCYTOPHILUM, AMP PROBE TECH 300 0 178.24 4010 

4617403 LYME, AMP PROBE TECHNIQUE 300 0 178.24 4010 

4617411 BABESIA ANTIBODY 300 0 61.23 4010 

4617429 BABESIA BLOT IGG 300 0 86.5 4010 

4617437 BABESIA BLOT IGM 300 0 86.5 4010 

4617445 A PHAGOCYTOPHILUM, IGM 300 0 51.67 4010 

4617452 A PHAGOCYTOPHILUM, IGG 300 0 51.67 4010 

4617460 HME IGG 300 0 61.23 4010 

4617486 E CHAFFEENSIS, AMPLIFIED PROBE TECH 300 0 178.24 4010 

4617494 ACUTE TICK BORNE DISEASE PANEL 3 300 0 0 4010 

4617502 ACUTE TICK BORNE DISEASE PANEL 4 300 0 0 4010 

4617510 C-TELOPEPTIDE 300 0 64.88 4010 

4617528 NALOXENE, QUANT, URINE 300 0 107 4010 

4617536 IGG SUBCLASS 4 300 0 116.21 4010 

4617544 COENZYME Q10 300 0 65.43 4010 

4617551 LYME DISEASE C6 AB'S, TOTAL 300 0 61.71 4010 

4617569 BK VIRUS DNA 300 0 250.81 4010 

4617577 TRICHOMONAS VAGINALIS CULTURE 300 0 24.01 4010 

4617585 BILE ACIDS, FRACTIONATED & TOTAL 300 0 129.05 4010 

4617593 CALPROTECTIN, STOOL 300 0 140.07 4010 

4617601 IA-2 ANTIBODY 300 0 160.5 4010 

4617619 HE4, OVARIAN CANCER MONITORING 300 0 273.92 4010 

4617627 VZA DNA, QL PCR 300 0 160.5 4010

4617635 ANTI MULLERIAN HORMONE ASSESSMENT 300 0 109.14 4010 

4617643 TSH ANTIBODY 300 0 114.9 4010 

4617650 CYSTIC FIBROSIS SCREEN 300 0 191.25 4010 

4617668 HEMOCHROMATOSIS ANALYSIS 300 0 303.75 4010 

4617676 FACTOR II MUTATION GENE 300 0 180 4010 

4617684 SILVER, URINE 300 0 97.76 4010 

4617692 SILVER, BLOOD 300 0 97.76 4010 

4617700 LEAD, BLOOD(OSHA) 300 0 40.96 4010 

4617718 CHROMIUM, RBC 300 0 105.75 4010 

4617726 H PYLORI AB, IGG 300 0 51.57 4010 

4617734 TAPENTADOL, QUANT, URINE 300 0 0 4010 

4618815 ACCUTYPE IL28B 300 0 250 4010 

4618823 DPD GENE MUTATION 300 0 700 4010 

4618831 LEAD, URINE 300 0 80.3 4010 

4618849 CREAT, URINE 300 0 80.3 4010 

4618856 CA 125, ROMA 300 0 1042 4010 

4618864 HE4, ROMA 300 0 57.22 4010 

4618872 DYE TEST 300 0 786 4010 

4618880 IGM ELISA, TOXO 300 0 786 4010 

4618898 PARTICLE AGGLUTINATION, TOXO 300 0 786 4010 

4618906 CHLAMYDIA ANTIBODY, LGV 300 0 156.08 4010 

4618914 CHLAMYDIA ANTIBODY, IGM, LGV 300 0 156.08 4010 

4618922 ARSENIC, RANDOM URINE 300 0 88.53 4010 

4618930 COBALT, RANDOM URINE 300 0 97.76 4010 

4618948 CREATININE, RANDOM URINE 300 0 67.93 4010 

4618955 MERCURY, RANDOM URINE 300 0 116.81 4010 

4618963 LEAD, RANDOM URINE 300 0 67.93 4010 

4618971 CADMIUM, RANDOM URINE 300 0 175.57 4010 

4618989 THALLIUM, RANDOM URINE 300 0 97.76 4010 

4618997 VZV IMMUNITY SCREEN 300 0 97.7 4010 

4619003 WEST NILE IGG, SERUM 300 0 47.25 4010 

4619011 WEST NILE IGM, SERUM 300 0 47.25 4010 

4619029 A1AT PHENOTYPE 300 0 145.29 4010 

4619037 ACETONE 300 0 64.15 4010 

4619045 ACYLCARNITINE PROFILE, PLASMA 300 0 132.44 4010 

4619052 ACTH, PLASMA 300 0 202.17 4010 

4619060 BETA 2 MICROGLOBULIN, SERUM 300 0 127.04 4010 

4619078 ACTIN(SMOOTH MUSCLE) ANTIBODY 300 0 90.61 4010 

4619086 ACHR BINDING ABS, SERUM 300 0 92.5 4010 

4619094 ACHR BLOCKING ABS, SERUM 300 0 92.5 4010 

4619102 ACHR MODULATING ANTIBODIES 300 0 92.5 4010 

4619110 ACTIVATED PROTEIN C RESISTANCE 300 0 120.33 4010 

4619128 ANTI-DS DNA ANTIBODIES 300 0 107.89 4010 

4619136 ANTISCLERODERMA-70 ANTIBODIESANT 300 0 140.78 4010 

4619144 AMIKACIN PEAK, SERUM 300 0 118.35 4010 

4619151 BETA-HYDROXYBUTYRATE 300 0 64.15 4010 

4619169 ACYLCARNITINE PROFILE, PLASMA 300 0 132.44 4010

4619177 ALDOLASE 300 0 76.25 4010 

4619185 ALDOLASE 300 0 319.97 4010 

4619193 ALPHA 1 ANTITRYPSIN, SERUM 300 0 105.44 4010 

4619201 AFP, SERUM, TUMOR MARKER 300 0 174.76 4010 

4619219 AMINO ACID PROFILE, QN, PLASMA 300 0 225 4010 

4619227 ANDROSTENEDIONE 300 0 229.86 4010 

4619235 ANGIOTENSIN-CONVERTING ENZYME 300 0 114.59 4010 

4619243 APLIPOPROTEIN A-1 300 0 121.64 4010 

4619250 APOLIPOPROTEIN B 300 0 121.64 4010 

4619268 ARSENIC, BLOOD 300 0 148.97 4010 

4619276 BILE ACIDS 300 0 134.48 4010 

4619284 ARIPIPRAZOLE 300 0 426.37 4010 

4619292 5 HIAA, QUANT, 24 HR URINE 300 0 84.83 4010 

4619300 ANTIGLOMERULAR BM AB 300 0 90.61 4010 

4619318 ANTIPARIETAL CELL ANTIBODY 300 0 90.61 4010 

4619326 ANTI-TSH AUTOANTIBODY 300 0 369 4010 

4619334 ANTI-MULLERIAN HORMONE(AMH) 300 0 101.63 4010 

4619342 ANTIMYELOPEROXIDASE (MPO) ABS 300 0 101.63 4010 

4619359 ANTIPROTEINASE 3(PR-3) ABS 300 0 101.63 4010 

4619367 ALK PHOS, TOTAL 300 0 40.61 4010 

4619375 ALK PHOS ISOENZYME 300 0 116.12 4010 

4619383 ALK PHOSPHATASE, BONE SPECIFIC 300 0 116.12 4010 

4619391 ANTITHROMBIN ACTIVITY 300 0 86.24 4010 

4619409 ANTITHROMBIN ANTIGEN 300 0 84.94 4010 

4619417 ANTISTREPTOLYSIN O AB 300 0 57.33 4010 

4619425 ANTICARDIOLIPIN AB, IGA, QN 300 0 199.76 4010 

4619433 ANTICARDIOLIPIN AB, IGG, QN 300 0 199.76 4010 

4619441 ANTICARDIOLIPIN AB, IGM, QN 300 0 199.76 4010 

4619458 ANTI-DNASE B STREP ANTIBODIES 300 0 104.09 4010 

4619466 ANTIHISTONE ANTIBODIES 300 0 140.78 4010 

4619474 ANTI-JO-1 300 0 140.78 4010 

4619482 ANTIPANCREATIC ISLET CELLS 300 0 155.32 4010 

4619490 ANTITHYROGLOBULIN AB 300 0 113.96 4010 

4619508 BK QUANT PCR(PLASMA/SERUM) 300 0 336.33 4010 

4619516 ANTIEXTRACTABLE NUCLEAR AG 300 0 140.78 4010 

4619524 ANTINEUTROPHIL CYTOPLASMIC AB 300 0 140.78 4010 

4619532 BARTONELLA ANTIBODY PANEL 300 0 79.88 4010 

4619540 BPERTA + BPERTG 300 0 103.57 4010 

4619557 CALIFORNIA ENCEPHALITIS AB 300 0 103.57 4010 

4619565 EAST EQUINE ENCEPHALITIS AB 300 0 103.57 4010 

4619573 ST LOUIS ENCEPHALITIS AB 300 0 103.57 4010 

4619581 WESTERN EQUINE ENCEPHALITIS AB 300 0 103.57 4010 

4619607 ANTI-CENTROMERE B ANTIBODIES 300 0 140.78 4010 

4619706 LAMOTRIGINE(LAMICTAL)SERUM 300 0 141.8 4010 

4619714 LEVETIRACETAM(KEPPRA), S 300 0 141.8 4010 

4619722 IMMUNOGLOBULIN D, QUANT, SERUM 300 0 73.01 4010 

4619730 IMMUNOGLOBULIN E, TOTAL 300 0 129.31 4010

4619748 INSULIN 300 0 89.82 4010 

4619755 LD, BODY FLUID 300 0 47.43 4010 

4619763 LACTOFERRIN 300 0 155.79 4010 

4619771 LEAD, BLOOD, ADULT 300 0 95 4010 

4619789 LEAD, BLOOD, PEDIATRIC 300 0 95 4010 

4619797 L/S RATIO 300 0 172.6 4010 

4619805 LIPOPROTEIN(A) 300 0 102.78 4010 

4619813 IODINE, SERUM OR PLASMA 300 0 141.8 4010 

4619821 PG, A F 300 0 129.76 4010 

4619839 LIPID-ASSOCIATED SIALIC ACID 300 0 105.44 4010 

4619847 IMMUNOFIXATION, URINE 300 0 232.94 4010 

4619854 INSULIN ANTIBODIES 300 0 130.39 4010 

4619862 INTRINSIC FACTOR ABS, SERUM 300 0 118.35 4010 

4619870 LEGIONELLA PNEUMOPHILIA ABS 300 0 120.15 4010 

4619888 L. PNEUMOPHILA SEROGP 1 UR AG 300 0 94.19 4010 

4619896 HLA B 27 DISEASE ASSOCIATION 300 0 63 4010 

4619904 IL28B POLYMORPHISM GENOTYPE 300 0 120 4010 

4619912 ALBUMIN, SERUM 300 0 35.8 4010 

4619920 ALBUMIN, CSF 300 0 40.61 4010 

4619938 ARSENIC, 24 HR URINE 300 0 148.97 4010 

4619946 CREATININE, 24 HR URINE 300 0 40.61 4010 

4619953 IMMUNOGLOBULIN, QN 300 0 73.01 4010 

4619987 IGG, SUBCLASS 300 0 108.36 4010 

4619995 HISTAMINE, PLASMA 300 0 231.86 4010 

4620019 HOMOCYST(E)INE, PLASMA 300 0 132.44 4010 

4620027 IGF-BP3 300 0 101.63 4010 

4620035 INHIBIN B 300 0 101.63 4010 

4620043 LEAD, 24 HR URINE 300 0 95 4010 

4620050 MERCURY, 24 HR URINE 300 0 127.67 4010 

4620068 HYDROCODONE + METABOLITES, U 300 0 152.78 4010 

4620076 HYDROCODONE AND METABOLITE 300 0 152.78 4010 

4620084 IGF-1 300 0 166.91 4010 

4620092 HEPARIN ANTI-XA 300 0 68.69 4010 

4620100 HGB SOLUBILITY 300 0 40.79 4010 

4620118 HEPARIN INDUCED PLATELET 300 0 144.18 4010 

4620126 IND ANTIPLATELET ALLOANTIBODY 300 0 144.18 4010 

4620134 IMMUNOFIXATION ELECTROPHORESIS 300 0 175.39 4010 

4620142 INHIBIN A, ULTRASENSITIVE 300 0 371.57 4010 

4620159 HELICOBACTER PYLORI, IGA 300 0 113.92 4010 

4620167 HELICOBACTER PYLORI, IGM AB 300 0 113.92 4010 

4620175 HSV, IGM I/II COMBINATION 300 0 152.66 4010 

4620183 HEP B CORE AB, TOT 300 0 94.66 4010 

4620191 HEP B CORE AB, IGM 300 0 92.43 4010 

4620209 HEP B SURFACE AB 300 0 84.31 4010 

4620217 HEP BE AB 300 0 90.79 4010 

4620225 HEPATITIS A AB, IGM 300 0 97.27 4010 

4620233 HSV CULTURE AND TYPING 300 0 268.79 4010

4620241 HEP BE AG 300 0 90.45 4010 

4620258 HISTOPLASMA ANTIGEN, URINE 300 0 94.19 4010 

4620266 HCV GENOTYPING NON REFLEX 300 0 898.34 4010 

4620274 HSV 1/2 PCR 300 0 275.54 4010 

4620308 PHENOBARBITAL, SERUM 300 0 59.96 4010 

4620316 PRIMIDONE 300 0 86.85 4010 

4620324 VANCOMYCIN TROUGH, SERUM 300 0 70.91 4010 

4620332 ZONISAMIDE(ZONEGRAN), SERUM 300 0 94.53 4010 

4620340 PORPHOBILINOGEN, QN, RANDOM UR 300 0 44.24 4010 

4620357 PREALBUMIN 300 0 76.35 4010 

4620365 PROGESTERONE 300 0 109.2 4010 

4620373 PROINSULIN 300 0 88.14 4010 

4620381 ZINC, PLASMA, OR SERUM 300 0 59.61 4010 

4620399 PROTEIN C ANTIGEN 300 0 62.91 4010 

4620407 PROTEIN C FUNCTIONAL 300 0 72.38 4010 

4620415 PROTEIN S, TOTAL 300 0 60.68 4010 

4620423 PROTEIN S, FREE 300 0 80.22 4010 

4620431 PROTEIN S FUNCTIONAL 300 0 80.22 4010 

4620449 PNEUMOCYSTIS SMEAR, DFA 300 0 62.79 4010 

4620456 NICOTINE METABOLITE, URINE 300 0 72.08 4010 

4620464 PHENOBARBITAL, SERUM 300 0 59.96 4010 

4620472 PHENYTOIN, FREE, SERUM 300 0 72.08 4010 

4620480 MTHFR 300 0 157.5 4010 

4620498 OLANZAPINE(ZYPREXA) 300 0 94.53 4010 

4620506 OXCARBAZEPINE (TRILEPTAL),S 300 0 94.53 4010 

4620514 MITOCHONDRIAL (M2) ANTIBODY 300 0 60.41 4010 

4620522 NMO IGG AUTOANTIBODIES 300 0 67.76 4010 

4620530 MAGNESIUM, RBC 300 0 35.07 4010 

4620548 MAGNESIUM, URINE 300 0 35.07 4010 

4620555 MERCURY, BLOOD 300 0 85.11 4010 

4620563 METANEPHRINES, FRAC, QN, 24-HR 300 0 88.67 4010 

4620571 METANEPHRINES, FRAC., PL. FREE 300 0 88.67 4010 

4620589 METHADONE (DOLOPHINE), SERUM 300 0 85.44 4010 

4620597 MYELIN BASIC PROTEIN, CSF 300 0 90.06 4010 

4620605 MYOGLOBIN, SERUM 300 0 67.58 4010 

4620613 MYOGLOBIN, URINE 300 0 67.58 4010 

4620621 OLIGOCLONAL BANDING 300 0 105.26 4010 

4620639 ORGANIC ACID ANALYSIS, URINE 300 0 86.16 4010 

4620647 METHYLMALONIC ACID, SERUM 300 0 86.16 4010 

4620654 OXYCODONE AND METABOLITE 300 0 101.85 4010 

4620662 OXYCODONE AND METABOLITE 300 0 101.85 4010 

4620670 OXALATE, QUANT, 24-HOUR URINE 300 0 67.43 4010 

4620688 PH, STOOL 300 0 18.75 4010 

4620696 LYSOZYME, SERUM 300 0 98.18 4010 

4620704 PLATELET AUTOANTIBODY PANEL 300 0 78.48 4010 

4620712 PNEUMOCOCCAL IMMUNITY 14 TYPE 300 0 78.48 4010 

4620720 LIVER-KIDNEY MICROSOMAL AB 300 0 65.72 4010

4620738 MUMPS ANTIBODIES, IGG 300 0 68.3 4010 

4620746 MYCOPLASMA PNEUMONIAE, IGG AB 300 0 69.35 4010 

4620753 MYCOPLASMA PNEUMONIAE, IGM AB 300 0 69.35 4010 

4620761 PARVOVIRUS B19, HUMAN, IGG/IGM 300 0 78.66 4010 

4620779 PARASITE EXAM, BLOOD 300 0 21.48 4010 

4620787 NOROVIRUS, RT-PCR 300 0 183.69 4010 

4620795 CYCLOSPORINE, BLOOD 300 0 94.5 4010 

4620803 ETHOSUXIMIDE(ZARONTIN) SERUM 300 0 85.52 4010 

4620811 CYSTIC FIBROSIS PROFILE 300 0 120 4010 

4620829 FACTOR II, DNA ANALYSIS 300 0 90 4010 

4620837 FACTOR V LEIDEN MUTATION 300 0 112.5 4010 

4620845 FRAGILE X, PCR REFLEX SOUTHERN 300 0 350.25 4010 

4620852 CYSTINE, QUANTITATIVE, URINE 24 HR 300 0 88.29 4010 

4620860 GABAPENTIN(NEURONTIN), SERUM 300 0 94.53 4010 

4620878 C-TELOPEPTIDE, SERUM 300 0 97.83 4010 

4620886 COPPER, SERUM 300 0 64.95 4010 

4620894 CORTISOL, URINARY FREE 300 0 87.5 4010 

4620902 DEXAMETHASONE, SERUM 300 0 94.53 4010 

4620910 FELBAMATE(FELBATOL), SERUM 300 0 94.53 4010 

4620928 URINE CREATININE ASSAY 300 0 27.08 4010 

4620936 CRYOGLOBULIN, QL, SERUM 300 0 33.9 4010 

4620944 DHEA, SERUM 300 0 132.3 4010 

4620951 DHEA-SULFATE 300 0 116.36 4010 

4620969 DIHYDROTESTOSTERONE 300 0 135.14 4010 

4620977 ERYTHROPOIETIN(EPO)SERUM 300 0 98.36 4010 

4620985 ESTRADIOL 300 0 146.28 4010 

4620993 ESTROGENS, TOTAL 300 0 113.51 4010 

4621009 FECAL FAT, QUALITATIVE 300 0 26.67 4010 

4621017 ASSAY OF FOLIC ACID RBC 300 0 90.63 4010 

4621025 GASTRIN SERUM 300 0 92.34 4010 

4621033 GLUCOSE, BODY FLUID 300 0 20.54 4010 

4621041 ASSAY OF G6PD ENZYME 300 0 50.76 4010 

4621058 FRUCTOSAMINE 300 0 78.9 4010 

4621066 HAPTOGLOBIN 300 0 65.82 4010 

4621074 ASSAY OF 5 HIAA 300 0 56.55 4010 

4621082 GAD 65 AUTOANTIBODY 300 0 61.67 4010 

4621090 FECAL REDUCING SUBSTANCES 300 0 28.83 4010 

4621108 FREE T4 BY DIALYSIS/MASS SPEC 300 0 47.19 4010 

4621116 C-PEPTIDE SERUM 300 0 72.59 4010 

4621124 HCG, BETA SUBUNIT, QNT, SERUM 300 0 62.27 4010 

4621132 HEMATOCRIT 300 0 8.26 4010 

4621140 FACTOR II ACTIVITY 300 0 45.32 4010 

4621157 AUTOMATED RBC COUNT 300 0 10.05 4010 

4621165 FACTOR VIII ACTIVITY 300 0 112.5 4010 

4621173 FACTOR X ACTIVITY 300 0 112.5 4010 

4621181 FACTOR IX ACTIVITY 300 0 112.5 4010 

4621199 FDP, PLASMA 300 0 24.04 4010

4621207 FETOMATERNAL HEMORRHAGE SCREEN 300 0 23.15 4010 

4621215 DILUTE RUSSELLS VIPER VENOM 300 0 67.5 4010 

4621223 DRVVT MIX 300 0 67.5 4010 

4621231 COMPLEMENT C3, SERUM 300 0 41.89 4010 

4621249 COMPLEMENT C4, SERUM 300 0 41.89 4010 

4621256 COMPLEMENT, TOTAL(CH50) 300 0 70.9 4010 

4621264 ENDOMYSIAL ANTIBODY IGA 300 0 42.07 4010 

4621272 GROWTH HORMONE ANTIBODIES 300 0 54.92 4010 

4621280 DIPHTHERIA ANTIOXOID AB 300 0 52.32 4010 

4621298 C6 PEPTIDE B BURGDORFERI 300 0 59.44 4010 

4621306 CYTOMEGALOVIRUS(CMV)AB, IGG 300 0 50.22 4010 

4621314 CYTOMEGALOVIRUS(CMV)AB, IGM 300 0 58.78 4010 

4621322 EPSTEIN BARR ANTIBODY 300 0 45.78 4010 

4621330 EPSTEIN BARR NUCLEAR ANTIGEN 300 0 53.38 4010 

4621348 H PYLORI IGG, ABS 300 0 50.63 4010 

4621355 HCV ANTIBODY 300 0 49.82 4010 

4621363 HCV ANTIBODY VERIFICATION 300 0 54.04 4010 

4621371 INFECTIOUS AGENT CONCENTRATION 300 0 34.97 4010 

4621389 FLOURESCENT/ACID AGENT 300 0 28.11 4010 

4621397 VIRUS INOCULATION TISSUE 300 0 136.43 4010 

4621405 VIRUS INOCULATION SHELL VIA 300 0 25.61 4010 

4621413 H PYLORI STOOL AG, EIA 300 0 170.45 4010 

4621421 ENTEROVIRUS RT PCR 300 0 631.56 4010 

4621439 HCV RNA PCR QUALITATIVE 300 0 183.69 4010 

4621447 HCV GENOTYPING NON REFLEX 300 0 1347.51 4010 

4621454 GLIADIN IGG/IGA AB PROF, EIA 300 0 60.41 4010 

4621462 FREE K + L LT CHAINS, QN, SERUM 300 0 71.16 4010 

4621470 FREE K+L CHAINS, QN URINE 300 0 71.16 4010 

4621488 CANDIDA ANTIBODIES IGG, IGA, IGM 300 0 225 4010 

4621496 CHLAMYDIA ANTIBODY 300 0 94.88 4010 

4621504 CHLAMYDIA ANTIBODY IGM 300 0 66.47 4010 

4621512 COXSACKIE VIRUS GRP B AB 300 0 168.75 4010 

4621520 EPSTEIN BARR CAPSID VCA 300 0 94.95 4010 

4621538 CADMIUM, BLOOD 300 0 121.13 4010 

4621546 CALCITONIN, SERUM 300 0 140.18 4010 

4621553 CATECHOLAMINES, PLASMA 300 0 132.18 4010 

4621561 CATECHOLAMINES, UR, FREE, 24 HR 300 0 132.18 4010 

4621579 CERULOPLASMIN 300 0 56.21 4010 

4621587 CHLORIDE, 24 HR URINE 300 0 26.33 4010 

4621595 BUPROPION(WELBUTRIN) 300 0 150.93 4010 

4621603 CITALOPRAM(CELEXA) 300 0 184.8 4010 

4621611 CHROMIUM, PLASMA 300 0 106.17 4010 

4621629 CITRIC ACID(CITRATE), URINE 300 0 145.56 4010 

4621637 CANNABINOID CONFIRMATION, UR 300 0 94.53 4010 

4621645 CLOMIPRAMINE, SERUM 300 0 94.53 4010 

4621652 COLD AGGLUTININ TITER, QUANT 300 0 42.2 4010 

4621660 C1 ESTERASE INHIBITOR, SERUM 300 0 62.84 4010

4621678 C1 ESTERASE INHIBITOR, FUNC 300 0 62.84 4010 

4621686 CCP ANTIBODIES IGG/IGA 300 0 68.52 4010 

4621694 CA 27.29 300 0 108.93 4010 

4621702 CA 15 3 300 0 108.93 4010 

4621710 CA 19 9 300 0 108.93 4010 

4621728 CA 125 300 0 108.93 4010 

4621736 CHROMOGRANIN A 300 0 108.93 4010 

4621744 CHLAMYDIA CULTURE 300 0 102.57 4010 

4621751 CULTURE TYPING 300 0 29.21 4010 

4621769 CHLAMYDIA TRACH DNA AMP PROBE 300 0 183.69 4010 

4621777 N GONORRHOEAE DNA AMP PROBE 300 0 183.69 4010 

4621785 TISSUE CULTURE LYMPHOCYTE 300 0 609.8 4010 

4621793 CHROMOSOME ANALYSIS 15 20 300 0 652.4 4010 

4621801 CYTO/MOLECULAR REPORT 300 0 20.99 4010 

4621819 CK TOTAL 300 0 34.13 4010 

4621827 CK ISOENZYMES 300 0 70.11 4010 

4621835 CALPROTECTIN, FECAL 300 0 172.2 4010 

4621843 ALK PHOS TOTAL 300 0 27.08 4010 

4621850 ALK PHOS ISOENZYME 300 0 77.42 4010 

4621868 HAEMOPHILUS INFLUENZAE B AG 300 0 48 4010 

4621876 HLA CLASS 2 LOW RESOLUTION 300 0 96.81 4010 

4621884 HLA CLASS 2 LOW RESOLUTION 300 0 131.25 4010 

4621892 HLA CLASS 2 HIGH RESOLUTION 300 0 131.25 4010 

4621900 10 DRUG-BUNDLE 300 0 21.99 4010 

4621918 MECONIUM 5 PANEL 300 0 150.9 4010 

4621926 9 DRUG BINDLE 300 0 19.7 4010 

4621934 TOPIRAMATE(TOPAMAX), SERUM 300 0 62.42 4010 

4621942 VANCOMYCIN TROUGH, SERUM 300 0 70.91 4010 

4621959 HERED HEMOCHROMATOSIS, DNA 300 0 165 4010 

4621967 VITAMIN D, 25 HYDROXY 300 0 154.95 4010 

4621975 CATECHOLAMINES, PLASMA 300 0 132.18 4010 

4621983 THIOPURINE METHYLTRANSFERASE 300 0 337.5 4010 

4621991 TRAZODONE, SERUM 300 0 94.53 4010 

4622007 ZONISAMIDE(ZONEGRAN), SERUM 300 0 94.53 4010 

4622015 LACOSAMIDE 300 0 420.18 4010 

4622023 NALOXONE SCREEN, TOTAL URINE 300 0 532.68 4010 

4622031 VIT B12 UNSAT BINDING CAPACITY 300 0 75 4010 

4622049 THALLIUM 300 0 114.95 4010 

4622056 HEMOGLOBIN CHROMOTOGRAPHY 300 0 94.53 4010 

4622064 T-TRANSGLUTAMINASE(TTG)IGA 300 0 60.41 4010 

4622072 T-TRANSGLUTAMINASE(TTG)IGG 300 0 60.41 4010 

4622080 TRYPTASE 300 0 67.76 4010 

4622098 LEPTIN, SERUM 300 0 67.76 4010 

4622106 LIPOPROTEIN BLD HR FRACTION 300 0 131.36 4010 

4622114 VITAMIN B6 300 0 128.58 4010 

4622122 VITAMIN B2, WHOLE BLOOD 300 0 137.25 4010 

4622130 VITAMIN B1(THIAMINE), BLOOD 300 0 111.17 4010

4622148 THYROID STIM IMMUNOGLOBULIN 300 0 266.19 4010 

4622155 VITAMIN E, SERUM 300 0 74.24 4010 

4622163 TRANSFERRIN 300 0 66.86 4010 

4622171 TRIGLYCERIDES 300 0 30.11 4010 

4622189 TRIIODOTHYRONINE(T3) 300 0 74.24 4010 

4622197 TRIIODOTHYRONINE, FREE, SERUM 300 0 88.67 4010 

4622205 VANILLYLMANDELIC ACID, 24HR URINE 300 0 81.14 4010 

4622213 VITAMIN A, SERUM 300 0 56.33 4010 

4622221 ZINC, PLASMA, OR SERUM 300 0 59.61 4010 

4622239 VWF ACTIVITY 300 0 120.14 4010 

4622247 VON WILLEBRAND FACTOR (VWF) AG 300 0 120.14 4010 

4622254 HEXAGONAL PHASE PHOSPHOLIPID 300 0 95.82 4010 

4622262 RBC SICKLE CELL TEST 300 0 27.2 4010 

4622270 THROMBIN TIME 300 0 30.23 4010 

4622288 VISCOSITY, SERUM 300 0 61.13 4010 

4622296 ANTINUCLEAR ANTIBODIES, IFA 300 0 63.26 4010 

4622304 BETA2 GLYCOPROTEIN 1 AB, G, A, M 300 0 133.17 4010 

4622312 NDNA SCREEN 300 0 63.11 4010 

4622320 ANTI HU ANTIBODIES 300 0 63.11 4010 

4622338 PARANEOPLASTIC PROFILE 1 300 0 63.11 4010 

4622346 HUMAN EPIDIDYMIS PROT 4, SERIAL 300 0 112.91 4010 

4622353 B CELLS TOTAL COUNT 300 0 75.63 4010 

4622361 NK CELLS TOTAL COUNT 300 0 75.63 4010 

4622379 T CELLS TOTAL COUNT 300 0 74.81 4010 

4622395 T CELL ABSOLUTE COUNT/RATIO 300 0 245.93 4010 

4622403 HELPER T LYMPH CD4 300 0 140.15 4010 

4622411 MICROSOMAL ANTIBODY 300 0 65.72 4010 

4622429 THYROID PEROXIDASE(TBO)AB 300 0 65.72 4010 

4622437 VDRL, CSF 300 0 22.35 4010 

4622445 HEP A (RFLX TO IGM) 300 0 64.85 4010 

4622452 HEP A AB, IGM 300 0 58.89 4010 

4622460 TOXOPLASMA GONDII AB, IGG, QN 300 0 84.72 4010 

4622486 TOXOPLASMA GONDII AB, IGM, QN 300 0 75.38 4010 

4622502 VARICELLA-ZOSTER AB, IGM 300 0 67.46 4010 

4622510 VARICELLA-ZOSTER V AB, IGG 300 0 67.46 4010 

4622528 WEST NILE VIRUS AB IGM 300 0 244.04 4010 

4622536 WEST NILE VIRUS ANTIBODY 300 0 186.62 4010 

4622544 THYROGLOBULIN ANTIBODY 300 0 75.98 4010 

4622551 HCV AB W/RFLX TO VERIFICATION 300 0 74.73 4010 

4622569 HCV ANTIBODY VERIFICATION 300 0 81.06 4010 

4622577 OVARIAN MALIGNANCY RISK ROMA 300 0 262.5 4010 

4622585 STOOL CULTURE, VIBRIO ONLY 300 0 12.35 4010 

4622593 ORGANISM ID, BACTERIA 300 0 42.27 4010 

4622601 TRICHOMONAS CULTURE 300 0 34.7 4010 

4622619 FUNGUS(MYCOLOGY) CULTURE 300 0 40.38 4010 

4622627 ORGANISM ID, YEAST 300 0 54.05 4010 

4622635 ORGANISM ID, MOLD 300 0 54.05 4010

4622643 UREAPLASMA MYCOPLASMA HOMINIS 300 0 80.52 4010 

4622650 MYCOBACTERIA CULTURE 300 0 56.55 4010 

4622668 OVA AND PARASITE SMEARS 300 0 46.59 4010 

4622676 FLOURESCENT STAIN/ACID STAIN 300 0 28.11 4010 

4622684 FUNGUS STAIN 300 0 28.11 4010 

4622692 SMEAR COMPLEX STAIN 300 0 65.1 4010 

4622700 VIRAL CULTURE, GENERAL 300 0 136.43 4010 

4622718 VIRUS INOCULATION TISSUE 300 0 136.43 4010 

4622726 VIRUS INNOCULATION SHELL VIA 300 0 25.61 4010 

4622742 VIRAL CULT, RAPID, RESPIRATORY 300 0 25.61 4010 

4622759 GENET VIRUS ISOLATE HSV 300 0 179.19 4010 

4622767 VIRUS, VARICELLA ZOSTER AG, DFA 300 0 62.79 4010 

4622775 HBSAG SCREEN 300 0 54.05 4010 

4622783 CMV QUANT DNA PCR(PLASMA) 300 0 224.22 4010 

4622791 HBV REAL TIME PCR, QUANT 300 0 224.22 4010 

4622809 HCV RT PCR QUANT(NON GRAPH) 300 0 224.22 4010 

4622817 VZV REAL TIME PCR 300 0 183.69 4010 

4622825 CRYPTOCOCCUS ANTIGEN, SERUM 300 0 15 4010 

4622833 SIROLIMUS(RAPAMUNE), BLOOD 300 0 72.6 4010 

4622841 TACROLIMUS(FK506)BLOOD 300 0 71.85 4010 

4622858 PTHRP(PTH RELATED PEPTIDE) 300 0 73.97 4010 

4622866 QUETIAPINE(SEROQUEL) 300 0 169.87 4010 

4622874 RISPERIDONE(RISPERDAL)SERUM 300 0 94.53 4010 

4622882 TAY SACHS, BIOCHEMICAL, SERUM 300 0 0 4010 

4622890 PTH, INTACT 300 0 216.05 4010 

4622908 PSA TOTAL 300 0 96.29 4010 

4622916 PSA, ULTRASENSITIVE, W/O SERIAL 300 0 96.29 4010 

4622924 PSA FREE 300 0 96.29 4010 

4622932 PROTEIN, BODY FLUID 300 0 19.5 4010 

4622940 PROTOPORPHYRIN FEP/ZPP 300 0 75.11 4010 

4622957 RENIN ACTIVITY, PLASMA 300 0 115.14 4010 

4622965 SELENIUM, BLOOD 300 0 133.62 4010 

4622973 SELENIUM, SERUM/PLASMA 300 0 133.62 4010 

4622981 SEROTONIN, WHOLE BLOOD 300 0 91.1 4010 

4622999 SEX HORM BINDING GLOB, SERUM 300 0 113.75 4010 

4623005 TESTERONE FREE 300 0 133.28 4010 

4623021 TESTOSTERONE TOTAL 300 0 135.14 4010 

4623047 REVERSE T3, SERUM 300 0 82.49 4010 

4623054 PTT-LA MIX 300 0 33.9 4010 

4623062 STREPTOZYME 300 0 30.23 4010 

4623070 SJOGRENS AB, ANTI SS A/SS B 300 0 93.86 4010 

4623088 RETICULIN IGA ANTIBODIES 300 0 63.11 4010 

4623096 TETANUS ANTITOXOID IGG AB 300 0 78.48 4010 

4623104 RABIES NEUT ABS TITRAT(RFFIT) 300 0 88.47 4010 

4623112 SACCHAROMYCES CEREVISIAE PANEL 300 0 64.2 4010 

4623120 HIV-2 ANTIBODY SCREEN 300 0 70.79 4010 

4623138 RUBELLA ANTIBODIES, IGG 300 0 75.33 4010

4623146 RUBEOLA ANTIBODIES, IGG 300 0 67.46 4010 

4623153 RUBEOLA ANTIBODIES, IGM 300 0 67.46 4010 

4623161 T PALLIDUM AB (FTA-AB) 300 0 71.85 4010 

4623179 RNA, REAL TIME PCR(NON GRAPH) 300 0 659.03 4010 

4623187 POTATO WHITE, IGG 300 0 41.02 4010 

4623195 ORANGE, IGG 300 0 41.02 4010 

4623203 LAMB'S QUARTER, IGE 300 0 41.02 4010 

4623211 BLUEGRASS KENTUCKY, IGE 300 0 41.02 4010 

4623229 MUGWORT, IGE 300 0 41.02 4010 

4623237 PLANTAIN ENGLISH, IGE 300 0 41.02 4010 

4623245 PINE WHITE, IGE 300 0 41.02 4010 

4623252 YEAST BAKERS, IGE 300 0 41.02 4010 

4623260 GLUTEN, IGE 300 0 41.02 4010 

4623278 TOMATO, IGE 300 0 41.02 4010 

4623286 POTATO WHITE, IGE 300 0 41.02 4010 

4623294 CHICKEN, IGE 300 0 41.02 4010 

4623302 PORK, IGE 300 0 41.02 4010 

4623310 BEEF, IGE 300 0 41.02 4010 

4623328 RICE, IGE 300 0 41.02 4010 

4623336 BLUE CHEESE MOLD, IGE 300 0 41.02 4010 

4623344 APPLE, IGE 300 0 41.02 4010 

4623351 OAT, IGE 300 0 41.02 4010 

4623369 BANANA, IGE 300 0 41.02 4010 

4623377 STRAWBERRY, IGE 300 0 41.02 4010 

4623385 GRAPE, IGE 300 0 41.02 4010 

4623393 BROCCOLI, IGE 300 0 41.02 4010 

4623401 BARLEY WHOLE GRAIN, IGE 300 0 41.02 4010 

4623419 CARROT, IGE 300 0 41.02 4010 

4623427 PEANUT, IGE 300 0 41.02 4010 

4623435 CARMINE/RED DYE-COCHINEAL, IGE 300 0 41.02 4010 

4623443 CASHEW NUT, IGE 300 0 41.02 4010 

4623450 ORANGE, IGE 300 0 41.02 4010 

4623468 MACADAMIA NUT, IGE 300 0 41.02 4010 

4623476 PECAN NUT, IGE 300 0 41.02 4010 

4623484 EGG YOLK, IGE 300 0 41.02 4010 

4623492 CASEIN, IGE 300 0 41.02 4010 

4623500 PEACH, IGE 300 0 41.02 4010 

4623518 TURKEY, IGE 300 0 41.02 4010 

4623526 PEAR, IGE 300 0 41.02 4010 

4623534 BLUEBERRY, IGE 300 0 41.02 4010 

4623542 GREEN PEA, IGE 300 0 41.02 4010 

4623559 GREEN BEAN, IGE 300 0 41.02 4010 

4623567 WHEY, IGE 300 0 41.02 4010 

4623575 WALNUT FOOD, IGE 300 0 41.02 4010 

4623583 YOGURT, IGE 300 0 41.02 4010 

4623591 GARLIC, IGE 300 0 41.02 4010 

4623609 SHRIMP, IGE 300 0 41.02 4010

4623617 COCONUT, IGE 300 0 41.02 4010 

4623625 ONIONS, IGE 300 0 41.02 4010 

4623633 PINEAPPLE, IGE 300 0 41.02 4010 

4623641 BRAZIL NUT, IGE 300 0 41.02 4010 

4623658 TUNA, IGE 300 0 41.02 4010 

4623666 MELON HONEYDEW, IGE 300 0 41.02 4010 

4623674 GREEN BELL PEPPER, IGE 300 0 41.02 4010 

4623682 CUCUMBER, IGE 300 0 41.02 4010 

4623690 CRAB, IGE 300 0 41.02 4010 

4623708 LETTUCE, IGE 300 0 41.02 4010 

4623716 CHEESE CHEDDAR, IGE 300 0 41.02 4010 

4623724 PISTACHIO NUT, IGE 300 0 41.02 4010 

4623732 ALMOND, IGE 300 0 41.02 4010 

4623740 WATERMELON, IGE 300 0 41.02 4010 

4623757 KIWI FRUIT, IGE 300 0 41.02 4010 

4623765 BREWER'S YEAST, IGE 300 0 41.02 4010 

4623773 SCALLOP, IGE 300 0 41.02 4010 

4623781 BING CHERRY, IGE 300 0 41.02 4010 

4623799 PLUM, IGE 300 0 41.02 4010 

4623807 LOBSTER, IGE 300 0 41.02 4010 

4623815 WHEAT, IGE 300 0 41.02 4010 

4623823 GLUTEN, IGG 300 0 41.02 4010 

4623831 WHEAT, IGG 300 0 41.02 4010 

4623849 EGG WHITE, IGG 300 0 41.02 4010 

4623856 SOYBEAN, IGG 300 0 41.02 4010 

4623864 TOMATO, IGG 300 0 41.02 4010 

4623872 EGG YOLK, IGG 300 0 41.02 4010 

4623880 PEANUT, IGG 300 0 41.02 4010 

4623898 WHEAT, IGE 300 0 41.02 4010 

4623906 MILK(COW), IGE 300 0 41.02 4010 

4623914 SOYBEAN, IGE 300 0 41.02 4010 

4623922 EGG WHITE, IGE 300 0 41.02 4010 

4623930 CORN, IGE 300 0 41.02 4010 

4623948 CAT HAIR/DANDER, IGE 300 0 41.02 4010 

4623955 DOG HAIR/DANDER, IGE 300 0 41.02 4010 

4623963 ASPERGILLUS FUMIGATUS, IGE 300 0 41.02 4010 

4623971 D PTERONYSSINUS, IGE 300 0 41.02 4010 

4623989 D FARINAE, IGE 300 0 41.02 4010 

4623997 TIMOTHY, IGE 300 0 41.02 4010 

4624003 COCKROACH GERMAN, IGE 300 0 41.02 4010 

4624011 PENICILLIN NOTATUM, IGE 300 0 41.02 4010 

4624029 CLADOSPORIUM HERBARU, IGE 300 0 41.02 4010 

4624037 ALTERNARIA TENIUS, IGE 300 0 41.02 4010 

4624045 OAK WHITE, IGE 300 0 41.02 4010 

4624052 SYCAMORE AMERICAN, IGE 300 0 41.02 4010 

4624060 PIGWEED ROUGH, IGE 300 0 41.02 4010 

4624078 BERMUDA GRASS, IGE 300 0 41.02 4010

4624086 MUCOR RACEMOSUS, IGE 300 0 41.02 4010 

4624094 MAPLE/BOX ELDER, IGE 300 0 41.02 4010 

4624102 ASH WHITE, IGE 300 0 41.02 4010 

4624110 BIRCH WHITE, IGE 300 0 41.02 4010 

4624128 RAGWEED SHORT/COMMON, IGE 300 0 41.02 4010 

4625000 HONEY BEE, IGE 300 0 27.35 4010 

4625018 HORNET WHITE FACE, IGE 300 0 27.35 4010 

4625026 YELLOW JACKET, IGE 300 0 27.35 4010 

4625034 WASP, IGE 300 0 27.35 4010 

4625042 HORNET YELLOW, IGE 300 0 27.35 4010 

4625059 CANDIDA ALBICANS, IGE 300 0 27.35 4010 

4625067 HELMINTHOSPORIUM HALO, IGE 300 0 27.35 4010 

4625075 FUSARIUM MONILIFORME, IGE 300 0 27.35 4010 

4625083 AUREOBASIDIUM PULLUL, IGE 300 0 27.35 4010 

4625091 PHOMA BETAE, IGE 300 0 27.35 4010 

4625109 EPICOCCUM PURPURASCE, IGE 300 0 27.35 4010 

4625117 STEMPHYLIUM BOTRYOSU, IGE 300 0 27.35 4010 

4625125 HORMLDENDRUM HORDEI, IGE 300 0 27.35 4010 

4625133 ALDER SMOOTH, IGE 300 0 27.35 4010 

4625141 BEECH AMERICAN, IGE 300 0 27.35 4010 

4625158 CEDAR WHITE, IGE 300 0 27.35 4010 

4625166 ELM AMERICAN/WHITE, IGE 300 0 27.35 4010 

4625174 WALNUT POLLEN, IGE 300 0 27.35 4010 

4625182 WILLOW BLACK, IGE 300 0 27.35 4010 

4625190 HICKORY WHITE, IGE 300 0 27.35 4010 

4625208 WHITE POPLAR, IGE 300 0 27.35 4010 

4625216 OYSTER, IGE 300 0 27.35 4010 

4625224 HAZELNUT/FILBERT, IGE 300 0 27.35 4010 

4625232 DOG EPITHELIA, IGE 300 0 27.35 4010 

4625240 BAHIA GRASS, IGE 300 0 27.35 4010 

4625257 COCKROACH AMERICAN, IGE 300 0 27.35 4010 

4625265 HAZELNUT TREE, IGE 300 0 27.35 4010 

4625273 WHITE MULBERRY, IGE 300 0 27.35 4010 

4625281 CEDAR MOUNTAIN, IGE 300 0 27.35 4010 

4625299 SHEEP SORREL(DOCK), IGE 300 0 27.35 4010 

4625307 NETTLE, IGE 300 0 27.35 4010 

4625315 SWEET VERNAL, IGE 300 0 27.35 4010 

4625323 ORCHARD GRASS, IGE 300 0 27.35 4010 

4625331 RED TOP, IGE 300 0 27.35 4010 

4625349 JOHNSON GRASS, IGE 300 0 27.35 4010 

4625356 COTTONWOOD TREE, IGE 300 0 27.35 4010 

4625364 DOCKWEED YELLOW, IGE 300 0 27.35 4010 

4700019 PARAINFLUENZA TY III 300 0 85.48 4010 

4700027 INFLUENZA TYPE A AB 300 0 106.08 4010 

4700035 INFLUENZA TYPE B AB 300 0 105.3 4010 

4700043 ADENOVIRUS AB/CF 300 0 85.48 4010 

4700050 RESPIRATORY SYNC CF 300 0 85.48 4010

4700068 PARAINFLUENZA TYPE I 300 0 85.48 4010 

4700076 PARAINFLUENZA TYPEII 300 0 85.48 4010 

4700084 RESP SYNCYTIAL PANEL 300 0 109.92 4010 

4700092 MUMPS AB IGG 300 0 53.41 4010 

4700100 CSF VIRAL STUDIES 300 0 106.02 4010 

4700118 RUBEOLA AB-IGM 300 0 61.45 4010 

4700134 COXSACKIE AB PANEL 300 0 87.75 4010 

4700142 FLUORESCENT TREP AB 300 0 54.25 4010 

4700159 VIRAL WOUND SWAB 300 0 106.02 4010 

4700167 CSF VDRL 300 0 20.97 4010 

4700183 LEPTOSPIRA 300 0 54.25 4010 

4700191 BLASTOMYCOSIS 300 0 45.86 4010 

4700209 ASPERGILLOSIS TITER 300 0 99.19 4010 

4700217 LEAD-CHILD 300 0 22.88 4010 

4700225 FUNGUS SENDOUT 300 0 232.77 4010 

4700241 SSA ANTI-RO TITER 300 0 135.07 4010 

4700266 PEMPHIGUS PEMPHIGOID 300 0 171.73 4010 

4700274 STONE ANALYSIS 300 0 50.54 4010 

4700282 CYSTIC FIBROSIS SCR 300 0 106.08 4010 

4700290 ALPHA FETO PROTEIN 300 0 73.54 4010 

4700308 LYME ELISA UCONN 300 0 129.74 4010 

4700316 RABIES ANTIBODY 300 0 95.96 4010 

4700324 RUBEOLA/MEASLES 300 0 61.45 4010 

4700332 CAT SCRATCH FEVER 300 0 382.25 4010 

4700340 ZINC,RBC 300 0 45.61 4010 

4700357 SCLERODERMA IMMCO 300 0 169.46 4010 

4700365 HUMORAL IMMUNITY IBT 300 0 448.05 4010 

4700373 CA-125 (DIANON) 300 0 91.91 4010 

4700381 LASA-P (DIANON) 300 0 94.54 4010 

4700399 DM/70K (DIANON) 300 0 84.7 4010 

4700407 AFP (DIANON) 300 0 85.88 4010 

4700415 HCG (DIANON) 300 0 61.25 4010 

4700423 ESTRIOL UNCONJUGATED 300 0 98.63 4010 

4700431 CA15-3 (DIANON) 300 0 79.68 4010 

4700449 ESTRIOL (UCONN) 300 0 49.6 4010 

4700456 ATAXIA PROFILE 300 0 70.2 4010 

4700464 SULFATIDE ANTIBODY 300 0 130.52 4010 

4700472 HTLV-2 300 0 158.73 4010 

4700480 MELAS MUTATION INTER 300 0 26.72 4010 

4700506 HSV DNA DETECTOR, PCR 300 0 70.2 4010 

4700522 MARKER, FLOW CYTOMETER 300 0 237.52 4010 

4700530 AEROBIC ISOLATE ID 300 0 82.42 4010 

4700597 ANAEROBIC/ISOLATE ID 300 0 109.92 4010 

4700605 LIPID PEROXIDASE 300 0 216 4010 

4800017 STAT TEST 300 0 0 4010 

4800025 HOLD EXTRA TUBE 300 0 0 4010 

4800033 HOME VISIT 300 0 0 4010

4800041 SPE COLL TRAVEL/MILE 300 0 0 4010 

4800058 SPE COLL TRAVEL/FLAT 300 0 0 4010 

4800066 SPE COLL TRAVEL/FLAT 300 0 0 4010 

4800074 NURSING HOME VISIT 300 0 0 4010 

4800082 VENI, EVENING 300 0 16.01 4010 

4800090 VENI CAPILLARY 300 0 26.33 4010 

4800108 VENI ROUTINE DAYS 300 0 16.01 4010 

4800116 VENI BY ED 300 0 16.01 4010 

4800124 VENIPUNCTURE NIGHT 300 0 16.01 4010 

4800157 VENI, BLOOD DRAW SERVICE ONLY 300 0 16.01 4010 


5500020 IRRAD.PLTS,SGL DONOR PER UNIT 390 0 974.55 4100 

5500046 PLTS,WBC-REDU,IRR,PER UNIT 390 0 193.08 4100 

5500079 CELLS,WBC/REDU,IR,PER UNIT 390 0 566.45 4100 

5500129 PLATELET INFUS. SET 270 0 25.75 4100 

5500152 PROCESSING & STORAGE 390 0 476.81 4100 

5500160 DESTRUCTION OF BLOOD 300 0 235.69 4100 

5500186 PHENOTYPE ROUTINE 300 0 141.96 4100 

5500194 PHENOTYPE OFF HOURS 300 0 124.54 4100 

5500210 HLA TYPING 300 0 270.38 4100 

5500228 HLA TYPING (DR) 300 0 420.42 4100 

5500251 CELLS,WBC REDUCED,PER UNIT 390 0 435 4100 

5500301 ALBUMIN 25%/50ML 390 0 92.07 4100 

5500327 PLATELETS, PER UNIT 390 0 126.88 4100 

5500335 SOLVENT DET.PLASMA PER UNIT 390 0 220.67 4100 

5500343 CRYOPRECIP. PER UNIT 390 0 81.35 4100 

5500350 FRSH FRZ PLASMA PER UNIT 390 0 175.74 4100 

5500368 PLATELET SGL DONOR PER UNIT 390 0 770.93 4100 

5500442 FACTOR 9 PER UNIT 636 0 0 4100 

5500459 PLATELETS, 1 UNIT, LEUKOCYTE REDUCE 390 0 218.25 4100 

5600010 MRI KEN CSPINE W/O CONTRAST 612 0 1373.37 4275 

5600028 MRI KEN CSPINE W CONTRAST 612 0 1646.07 4275 

5600036 MRI KEN CSPINE W W/O CONTRAST 612 0 3051.54 4275 

5600044 MRI KEN LSPINE W/O CONTRAST 612 0 1523.91 4275 

5600051 MRI KEN L SPINE W/CONTRAST 612 0 1646.07 4275 

5600077 MRI KEN NECK W O CONTRAST 611 0 1352.39 4275 

5600085 MRI KEN NECK W CONTRAST 611 0 1622.64 4275 

5600093 MRI KEN NECK W WO CONTRAST 611 0 3003.41 4275 

5600101 MRI KEN D SPINE W O CONTRAST 612 0 1523.91 4275 

5600119 MRI KEN D SPINE W CONTRAST 612 0 1523.91 4275 

5600127 MRI KEN D SPINE W WO CONTRAST 612 0 3051.54 4275 

5600135 MRI KEN SHLDR WO CONT LT 610 0 1839.86 4275 

5600143 MRI KEN SHLDR WO CONTRAST RT 610 0 1839.86 4275 

5600150 MRI KEN SHLDR W CON LT 610 0 2299.83 4275 

5600168 MRI KEN SHLDR W CON RT 610 0 2299.83 4275 

5600176 MRI KEN SHLDR W WO CO LT 610 0 3003.41 4275 

5600184 MRI KEN SHLDR W WO CO RT 610 0 3003.41 4275

5600218 MRI KEN KNEE WO CONT LT 610 0 1839.86 4275 

5600226 MRI KEN KNEE WO CONTRAST RT 610 0 1839.86 4275 

5600234 MRI KEN KNEE W CONTRAST LT 610 0 2299.83 4275 

5600242 MRI KEN KNEE W CONT RT 610 0 2299.83 4275 

5600259 MRI KEN KNEE W WO CO LT 610 0 3003.41 4275 

5600267 MRI KEN KNEE W WO CONT RT 610 0 3003.41 4275 

5600275 MRI KEN WRIST WO CONT LT 610 0 1839.86 4275 

5600283 MRI KEN WRIST WO CON RT 610 0 1839.86 4275 

5600291 MRI KEN WRIST W CON LT 610 0 2299.83 4275 

5600309 MRI KEN WRIST W CON RT 610 0 2299.83 4275 

5600317 MRI KEN WRIST W WO CO LT 610 0 3003.41 4275 

5600325 MRI KEN WRIST W WO CO RT 610 0 3003.41 4275 

5600334 MRI KEN ELBOW WO CON LT 610 0 1839.86 4275 

5600341 MRI KEN ELBOW WO CON RT 610 0 1839.86 4275 

5600358 MRI KEN ELBOW W CON LT 610 0 2299.83 4275 

5600366 MRI KEN ELBOW W CON RT 610 0 2299.83 4275 

5600374 MRI KEN ELBOW W/WO CONT LT 610 0 3003.41 4275 

5600382 MRI KEN ELBOW W/WO CON RT 610 0 3003.41 4275 

5600390 MRI KEN ANKLE WO CON LT 610 0 1839.86 4275 

5600408 MRI KEN ANKLE WO CON RT 610 0 1839.86 4275 

5600416 MRI KEN ANKLE W CONT LT 610 0 2299.83 4275 

5600424 MRI KEN ANKLE W CON RT 610 0 2299.83 4275 

5600432 MRI KEN ANKLE W/WO CON LT 610 0 3003.41 4275 

5600440 MRI KEN ANKLE W/WO CO RT 610 0 3003.41 4275 

5600457 MRI KEN UPEX NO JT WO LT 610 0 1352.39 4275 

5600465 MRI KEN UPEX NO JT WO RT 610 0 1352.39 4275 

5600473 MRI KEN LO EX NO JT WO LT 610 0 1839.86 4275 

5600481 MRI KEN LO EX NO JT WO RT 610 0 1839.86 4275 

5600499 MRI KEN ABDOMEN W/O CONT 610 0 1430 4275 

5600507 MRI KEN ABDOMEN W/CONTRAST 610 0 2299.83 4275 

5600515 MRI KEN ABDOMEN W/WO CONTRAST 610 0 4516.22 4275 

5600523 MRI KEN CHEST W/O CONTRAST 610 0 1373.37 4275 

5600531 MRI KEN CHEST W/CONTRAST 610 0 1373.37 4275 

5600549 MRI KEN CHEST W W/O CONTRAST 610 0 1373.37 4275 

5600556 MRI KEN FACE W/O CONTRAST 611 0 1352.39 4275 

5600564 MRI KEN FACE W/CONTRAST 611 0 1622.64 4275 

5600572 MRI KEN FACE W W/O CONTRAST 611 0 3003.41 4275 

5600580 MRI KEN HEAD W/O CONTRAST 611 0 1373.37 4275 

5600598 MRI KEN HEAD W/CONTRAST 611 0 1646.07 4275 

5600606 MRI KEN HEAD W W/O CONTRAST 611 0 3051.54 4275 

5600614 MRI KEN IAC'S W W/O CONTRAST 611 0 3051.54 4275 

5600622 MRI KEN IAC'S WO CONTRAST 611 0 1373.37 4275 

5600630 MRI KEN PIT/SELLA W W/O CONTRAST 611 0 3051.54 4275 

5600648 MRI KEN HIP W/O CONTRAST LT 610 0 1839.86 4275 

5600655 MRI KEN HIP W/O CONTRAST RT 610 0 1839.86 4275 

5600663 MRI KEN HIP W W/O CONT LT 610 0 3003.41 4275 

5600671 MRI KEN HIP W W/O CONT RT 610 0 3003.41 4275

5600689 MRI KEN HIP W/CONT RT 610 0 2299.83 4275 

5600697 MRI KEN HIP W/CONT LT 610 0 2299.83 4275 

5600705 MRI KEN MRCP 610 0 1430 4275 

5600713 MRI KEN ORBITS W/O CONT 611 0 1352.39 4275 

5600721 MRI KEN ORBITS W/CONT 611 0 1622.64 4275 

5600739 MRI KEN ORBITS W W/O CONT 611 0 3003.41 4275 

5600747 MRI KEN PELVIS W/O CONT 610 0 1358.58 4275 

5600754 MRI KEN PELVIS W/CONT 610 0 1627.56 4275 

5600762 MRI KEN PELVIS W W/O CONT 610 0 1627.56 4275 

5600770 MRI KEN TMJ BILAT 610 0 1373.37 4275 

5600788 MRI KEN TMJ UNI LT 610 0 1373.37 4275 

5600796 MRI KEN UNILAT RT 610 0 1373.37 4275 

5600820 MRI-KEN UPEX NO JT W LT 610 0 1622.64 4275 

5600838 MRI KEN MRI UPEX NO JT W RT 610 0 1622.64 4275 

5600846 MRI KEN UPEX NOJT W/WO LT 610 0 3003.41 4275 

5600861 MRI KEN BREASTS W W/O CON 610 0 4018.46 4275 

5600879 MRI KEN BREAST UNI W W/O LT 610 0 3187.11 4275 

5600887 MRI KEN BREAST UNI W W/O RT 610 0 3187.11 4275 

5600895 MRI KEN MAMMO CAD 610 0 59.8 4275 

5600903 MRI KEN BREAST W/O CONTRAST 610 0 3226.24 4275 

5600911 3D RECONSTRUCTION KEN 610 0 631.49 4275 

5600937 MRI KEN LOEX NO JT W LT 610 0 2299.83 4275 

5600952 MRI KEN LOEX NO JT W RT 610 0 2299.83 4275 

5600960 MRI KEN LO EX NOJT W W/O LT 610 0 3003.41 4275 

5600978 MRI KEN LOEX NO JT W W/O RT 610 0 3003.41 4275 

5600986 MRV KEN WO CONTRAST 610 0 552.02 4275 

5600994 MRV KEN W W/O 610 0 552.02 4275 

5601018 MRA KEN LOEX W W/O CONT LT 616 0 2060.06 4275 

5601026 MRI KEN L SPINE W WO CONTRAST 612 0 3051.54 4275 

5601034 MRI KEN ELBOW WO CON LT 610 0 1839.86 4275 

5601042 MRI KEN UPEX NO JT W/WO RT 610 0 3003.41 4275 

5601059 MRI KEN PIT/SELLA W/O CONTRAST 610 0 1373.37 4275 

5601505 MRA KEN LO EX W W/O CONT RT 616 0 2060.06 4275 

5601513 MRA KEN LOEX W W/O BILAT 616 0 3190.4 4275 

5601521 MRA KEN CHEST W W/O CONT 618 0 1897.94 4275 

5601539 MRA KEN HEAD W W/O CONTRAST 615 0 1373.37 4275 

5601547 MRA KEN HEAD W/CONTRAST 615 0 1373.37 4275 

5601554 MRA KEN HEAD W/O CONTRAST 615 0 2687.53 4275 

5601562 MRI KEN NECK W/O CONTRAST 615 0 1373.37 4275 

5601570 MRA KEN NECK W W/O CONT 615 0 2687.53 4275 

5601588 MRA KEN AB W W/O CONTRAST 618 0 1373.37 4275 

5601596 MRA KEN PELVIS W W/O CONT 610 0 1373.37 4275 

5601604 MRI KEN UPEXT JOINT W/CON LT 610 0 2299.83 4275 

5601612 MRI KEN UPEXT JOINT W/CON RT 610 0 2299.83 4275 

5601620 MRI KEN UPEXT JOINT W/O CON LT 610 0 1839.86 4275 

5601638 MRI KEN UPEXT JOINT W/O CON RT 610 0 1839.86 4275 

5601646 MRI KEN UPEXT W/WO CONTRAST LT 610 0 3003.41 4275

5601653 MRI KEN UPEXT W/WO CON RT 610 0 3003.41 4275 

5691001 MRI KEN GADO PER ML 636 0 15.34 4275 

5701016 ABD AORTA ULTRASOUND 402 0 349.91 4253 

5701024 ABD LTD ONE ORGAN 402 0 441.67 4253 

5701032 ABDOMINAL ULTRASOUND 402 0 441.67 4253 

5701040 AV FISTULA OR PSEUDO ANEURYSM 921 0 305.99 4253 

5701057 BIOPHYSICAL PROFILE 402 0 276.9 4253 

5701065 BREAST ULTRAS BILAT 402 0 283.2 4253 

5701073 BREAST US UNILAT-LT 402 0 184.08 4253 

5701081 BREAST US UNILAT-RT 402 0 184.08 4253 

5701099 CAROTID DUPLEX W C/F 921 0 465.78 4253 

5701107 CHEST PLEURAL EFFUS 402 0 567.55 4253 

5701115 COLOR DOPP ABD LTD 921 0 515.42 4253 

5701123 COLOR DOPPLER ABDOM 921 0 610.64 4253 

5701131 ECHO EXT. NON VAS 402 0 287.98 4253 

5701149 HYSTERO PROCEDURE 761 0 289.84 4253 

5701156 HYSTEROSONOGRAPHY 402 0 567.55 4253 

5701164 OB-1ST TRI 1 FETUS 402 0 174.86 4253 

5701172 OB-1ST TRI ADD FETUS 402 0 771.81 4253 

5701180 OB-2ND TRI 1 FETUS 402 0 386.85 4253 

5701198 OB-2ND TRI ADD FETUS 402 0 771.81 4253 

5701206 OB-3RD TRI 1 FETUS 402 0 386.85 4253 

5701214 OB-3RD TRI ADD FETUS 402 0 771.81 4253 

5701222 OB- FOLLOW UP 402 0 205.44 4253 

5701230 OB-LIMITED 402 0 184.08 4253 

5701248 OB-TRANSVAGINAL 402 0 288.77 4253 

5701255 PELVIC ULTRASOUND 402 0 330.83 4253 

5701263 PELVIC-NON OB TRANSV 402 0 287.98 4253 

5701271 PELVIS LIMITED OR APPENDIX 402 0 330.83 4253 

5701289 PERIVASC-ARM-UNIL LT 921 0 305.99 4253 

5701297 PERIVASC-ARM-UNIL RT 921 0 305.99 4253 

5701305 PERIVASC-LEG-UNIL LT 921 0 305.99 4253 

5701313 PERIVASC-LEG-UNIL-RT 921 0 305.99 4253 

5701321 PERIVASC-ARM-BILAT 921 0 694.64 4253 

5701339 PERIVASC-LEG-BILAT 921 0 694.64 4253 

5701347 RENAL ULTRASOUND 402 0 349.91 4253 

5701354 TESTICLE 402 0 567.55 4253 

5701362 THYROID ULTRASOUND 402 0 567.55 4253 

5701370 PLF US MEDICARE EXAM AAA SCREEN 402 0 247.88 4253 

5701388 BONE DENSITY FX EVAL 320 0 126.6 4211 

5701396 BONE DENSITY (DEXA) 320 0 442.19 4211 

5701404 HEAD OR NECK ULTRASOUND 402 0 567.55 4253 

5800206 FULL NIGHT POLYSOMNOGRAM > AGE 6 740 0 2454.04 4460 

5800214 POLYSOMNOGRAM < 6 HRS > AGE 6 740 0 1840.53 4460 

5800255 TITTRATION POLYSOMNOGRAM > AGE 6 740 0 2454.04 4460 

5800263 TITRATION POLYSOMNOGRAMAGE 6 740 0 1840.53 4460 

5800305 MULTIPLE SLEEP LATENCY TEST 740 0 2094.07 4460

5800313 MULTIPLE SLEEP LATENCY TEST

6001036 PROF FEE STRESS TEST MD SUPERVISE 985 0 48.41 4120 

6001101 PROF FEE STRESS TEST REPORT ONLY 985 0 39.51 4120 

6012298 EKG P.A.T. 730 0 258 4120 

6012306 EKG P.A.T. PLAINFIELD 730 0 258 4120 

6050631 MED STAFF CORD SALARY RECOVERIES 0 0 6050 

6090013 ALBUTEROL S04 U.O. 250 0 11.57 4120 

6090021 ALBUTEROL INH HFA 250 0 102.7 4120 

6090039 DOBUTAMINE 636 0 50.61 4120 

6090047 ATROPINE BRISTO-JECT 250 0 6.23 4120 

6090054 LOPRESSOR 5MG 250 0 6.23 4120 

6090062 AMINOPHYLLIN 250 0 8.9 4120 

6090070 CARDIZEM 25MG 250 0 8.9 4120 

6090500 PERSANTINE PER 10MG 636 0 5.46 4120 

6100093 SKULL AP & LAT 320 0 108.88 4211 

6100176 SKULL 320 0 210.83 4211 

6100259 SINUSES 320 0 108.88 4211 

6100333 MASTOIDS 320 0 131.66 4211 

6100416 NASAL BONES 320 0 131.66 4211 

6100580 MANDIBLE 320 0 468.2 4211 

6100663 TMJ BILATERAL 320 0 202.56 4211 

6100747 ORBITS/FOREIGN BODY 320 0 131.66 4211 

6100820 ORBITS 320 0 131.66 4211 

6100903 FACIAL BONES 320 0 108.88 4211 

6101323 SOFT TISSUE NECK 320 0 131.66 4211 

6102503 CHEST AP OR LATERAL ONLY 320 0 108.88 4211 

6102552 CHEST PA & LAT 320 0 144.07 4211 

6102602 CHEST W OBLIQUES 320 0 108.88 4211 

6102651 CHEST ER PORTABLE 320 0 108.88 4211 

6102701 RIBS ONE SIDE-LEFT 320 0 166.73 4211 

6102719 RIBS ONE SIDE-RIGHT 320 0 166.73 4211 

6102750 RIBS BILATERAL, R&L 320 0 337.32 4211 

6102800 STERNUM 320 0 108.88 4211 

6102859 STERNOCLAVICULAR JTS 320 0 131.66 4211 

6102909 CHEST/DECUBITIS R&L 320 0 108.88 4211 

6102958 CHEST DECUB ONLY 320 0 131.66 4211 

6103006 CHEST HOUSE PORTABLE 320 0 108.88 4211 

6103055 CHEST, P.A.T. 320 0 144.07 4211 

6103253 CERV SPINE TWO VIEW 320 0 108.88 4211 

6103303 CERV SPINE OBL ONLY 320 0 108.88 4211 

6103352 CERV SPINE - W/OBL 320 0 179.26 4211 

6103402 CERV SPINE W FLEX EX 320 0 179.26 4211 

6103451 CERV SPINE - TRAUMA 320 0 119.75 4211 

6103501 DORSAL SPINE 320 0 108.88 4211 

6103550 DORSAL SPINE 2 VIEWS 320 0 108.88 4211 

6103600 LS SPINE ROUTINE 320 0 108.88 4211 

6103659 LUMBAR SP W FLEX EXT 6VIEWS 320 0 177.09 4211 

6103709 SACROCOCCYGEAL SPINE 320 0 114.32 4211

6103758 BONE DENSITY FX EVAL 320 0 126.6 4211 

6103808 ENTIRE SPINE SURVEY 320 0 219.26 4211 

6103857 SCOLIOSIS FULL STUDY 320 0 219.26 4211 

6103907 PELVIS 1 OR 2 VIEWS 320 0 108.88 4211 

6103956 METASTATIC SERIES 320 0 219.26 4211 

6104004 SACROILIAC JOINTS 320 0 131.66 4211 

6104012 JOINT ASPIRATION/INJ W/FLOURO 761 0 461.65 4211 

6104053 LS SPINE-SHOOT-THRU 2 VIEWS 320 0 108.88 4211 

6104103 CERV SPINE LAT ONLY 320 0 131.66 4211 

6104152 SCOLI F/UP (SCREEN) 320 0 131.66 4211 

6104202 LS SPINE W UPRIGHT MIN 4 VIEWS 320 0 142.99 4211 

6104251 LS SPINE W OBLIQUES MIN 4 VIEW 320 0 142.99 4211 

6104509 FINGER 2 OR MORE-LT 320 0 108.88 4211 

6104517 FINGER 2 OR MORE-RT 320 0 108.88 4211 

6104558 LS SPINE&OBL&FLEX&EX 6 VIEWS 320 0 177.09 4211 

6104608 SKELETAL SURVEY 320 0 210.83 4211 

6104657 FINGER,SINGLE-LEFT 320 0 108.88 4211 

6104665 FINGER,SINGLE-RIGHT 320 0 108.88 4211 

6104707 HAND LEFT 320 0 108.88 4211 

6104756 HAND RIGHT 320 0 108.88 4211 

6104764 HAND-BILATERAL 320 0 202.56 4211 

6104806 NAVICULAR VIEWS-LT 320 0 108.88 4211 

6104855 NAVICULAR VIEWS-RT 320 0 108.88 4211 

6104905 WRIST LEFT 320 0 108.88 4211 

6104954 WRIST RIGHT 320 0 108.88 4211 

6104962 WRIST-BILATERAL 320 0 202.56 4211 

6105001 FOREARM-LEFT 320 0 117.99 4211 

6105019 FOREARM-RIGHT 320 0 117.99 4211 

6105050 HUMERUS-LEFT 320 0 131.66 4211 

6105068 HUMERUS-RIGHT 320 0 131.66 4211 

6105258 SHLDR NO TRAUMA-LT 320 0 108.88 4211 

6105266 SHLDR NO TRAUMA-RT 320 0 108.88 4211 

6105274 SHOULDER NO TRAUMA-BILAT 320 0 202.56 4211 

6105308 AC JTS, W&WO WTS R&L 320 0 131.66 4211 

6105357 CLAVICLE-LEFT 320 0 117.99 4211 

6105365 CLAVICLE-RIGHT 320 0 117.99 4211 

6105407 SCAPULA-LEFT 320 0 131.66 4211 

6105456 SCAPULA-RIGHT 320 0 131.66 4211 

6105753 TOE-LEFT 320 0 108.88 4211 

6105761 TOE-RIGHT 320 0 108.88 4211 

6105803 FOOT LEFT 320 0 108.88 4211 

6105811 FOOT RIGHT 320 0 108.88 4211 

6105829 FOOT-BILATERAL 320 0 202.56 4211 

6105852 HEEL(OS CALC)-LEFT 320 0 108.88 4211 

6105860 HEEL(OS CALC)-RIGHT 320 0 108.88 4211 

6105902 ANKLE LEFT 320 0 131.66 4211 

6105910 ANKLE RIGHT 320 0 131.66 4211

6106009 LOWER LEG-LEFT 320 0 132.44 4211 

6106017 LOWER LEG-RIGHT 320 0 132.44 4211 

6106025 ANKLE-BILAT 320 0 194.4 4211 

6106058 KNEE NO TRAUMA-LEFT 320 0 108.88 4211 

6106066 KNEE NO TRAUMA-RIGHT 320 0 108.88 4211 

6106074 KNEE NO TRAUMA-BILAT 320 0 202.56 4211 

6106108 KNEE W/OBLIQ-LEFT 320 0 108.88 4211 

6106116 KNEE W/OBLIQ-RIGHT 320 0 108.88 4211 

6106124 KNEE W/OBLIQUE-BILAT 320 0 202.56 4211 

6106157 FEMUR-LEFT 320 0 131.66 4211 

6106165 FEMUR-RIGHT 320 0 131.66 4211 

6106504 HIP (PELV INCL)BILAT 320 0 337.32 4211 

6106512 HIP (PELVIS INCL)-LT 320 0 108.88 4211 

6106520 HIP (PELVIS INCL)-RT 320 0 108.88 4211 

6106553 HIP RECHECK-LEFT 320 0 108.88 4211 

6106561 HIP RECHECK-RIGHT 320 0 108.88 4211 

6106751 ELBOW W/OBLIQ LEFT 320 0 108.88 4211 

6106769 ELBOW W/OBLIQ RIGHT 320 0 108.88 4211 

6106801 HAND/WRIST BONE AGE 320 0 108.88 4211 

6106900 HIPS PEDIATRIC BILAT 320 0 202.56 4211 

6107007 SHLDR TRAUMA-LEFT 320 0 108.88 4211 

6107015 SHLDR TRAUMA-RIGHT 320 0 108.88 4211 

6107023 SHOULDER TRAUMA-BILAT 320 0 202.56 4211 

6107205 KNEE W/PATELLA-LEFT 320 0 108.88 4211 

6107213 KNEE W/PATELLA-RIGHT 320 0 108.88 4211 

6107221 KNEE W/PATELLA-BILAT 320 0 202.56 4211 

6107239 FEMUR-BILAT 320 0 202.56 4211 

6107247 LOWER LEG-BILAT 320 0 202.56 4211 

6107254 LONG BONE SURVEY 320 0 219.26 4211 

6107304 BONE LENGTH 320 0 126.6 4211 

6107502 ABDOMEN (KUB/FLAT) 320 0 108.88 4211 

6107551 ABDOMEN FLAT&UPRIGHT 320 0 108.88 4211 

6107759 BARIUM SWALLOW 320 0 258.75 4211 

6107809 GI SERIES 320 0 258.75 4211 

6107858 BE 320 0 258.75 4211 

6107957 ABDOMEN W/ DECUBITIS 320 0 108.88 4211 

6108005 SMALL BOWEL SERIES 320 0 258.75 4211 

6108054 GI WITH SMALL BOWEL 320 0 473.82 4211 

6108104 T TUBE CHOLANGIOGRAM 320 0 587.63 4211 

6108153 OR CHOLANGIOGRAM 320 0 180.88 4211 

6108203 OR SCOUT FILM 320 0 108.88 4211 

6108252 RETRO PYELOGRAM 320 0 512.49 4211 

6108302 RETRO PYELOGRAM 320 0 512.49 4211 

6108351 CYSTOGRAPHY 320 0 275.95 4211 

6108401 VOID CYSTO URETHROG 320 0 275.95 4211 

6108757 IVP WITH TOMOGRAPHY 320 0 512.49 4211 

6108807 BE DOUBLE CONTRAST 320 0 341.97 4211

6108906 CYSTO SCOUT FILM 320 0 108.88 4211 

6108914 ABD/KUB PORTABLE 320 0 108.88 4211 

6108922 STEROID INJECTION UNDER FLOURO 761 0 2125.42 4211 

6108930 RT UPPER EXTREMITY VENOGRAM 320 0 1781.06 4211 

6108948 LT UPPER EXTREMITY VENOGRAM 320 0 1781.06 4211 

6108963 RT LOWER EXTREMITY VENOGRAM 320 0 1781.06 4211 

6108971 LT LOWER EXTREMITY VENOGRAM 320 0 1781.06 4211 

6110126 CORE BREAST BIO 320 0 800.51 4211 

6110134 CORE BREAST BIO 320 0 800.51 4211 

6110159 COR BRST BIO PROC-LT 761 0 1538.23 4211 

6110167 COR BRST BIO PROC-RT 761 0 1538.23 4211 

6110175 CORE BIO CLIP PLA-LT 761 0 222.95 4211 

6110183 CORE BIO CLIP PLA-RT 761 0 222.95 4211 

6110209 NEEDLE LOC-LEFT 320 0 423.63 4211 

6110217 NEEDLE LOC-RIGHT 320 0 423.63 4211 

6110308 NEEDLE LOC PROC-LT 761 0 289.84 4211 

6110316 NEEDLE LOC PROC-RT 761 0 289.84 4211 

6110357 NDLE LOC ADDL LES-LT 761 0 61.64 4211 

6110365 NDLE LOC ADDL LES-RT 761 0 61.64 4211 

6110423 MAMMO DIAG DIGITAL 401 0 535.08 4211 

6110431 MAMMO DIAG DIGITAL-RIGHT 401 0 237.32 4211 

6110449 MAMMO DIAG DIGITAL-LEFT 401 0 237.32 4211 

6110456 DKH MAMMO SCREEN DIGITAL 403 0 468.2 4211 

6110506 FLOURO GUIDANCE FOR NEEDLE PLCMT 320 0 715.02 4211 

6110514 DKH MAMMO SCREENING IMPLANTS 403 0 468.2 4211 

6110522 COR BRST BIO PROC-ADD'L LESION 761 0 1538.23 4211 

6110555 ICAD SCREENING MAMMO 403 0 61.85 4211 

6110563 ICAD DIAGNOSTIC MAMMO 401 0 61.85 4211 

6110571 SINUS TRACT PROCEDURE 320 0 587.63 4211 

6110589 SINUS TRACT INJECTION 320 0 668 4211 

6110597 MAMMO DIAG EXTRA VIEWS LT 401 0 237.32 4211 

6110605 ANKLE-ARTH W/RAD-LT 320 0 781.66 4211 

6110613 ANKLE-ARTH W/RAD RT 320 0 781.66 4211 

6110654 ELBOW ARTH W/RAD-LT 320 0 781.66 4211 

6110662 ELBOW ARTH W/RAD-RT 320 0 781.66 4211 

6110704 KNEE-ARTHROGRAM-LT 320 0 781.66 4211 

6110712 KNEE-ARTHROGRAM-RT 320 0 781.66 4211 

6110753 HIP-ARTHROGRAM-LT 320 0 420.9 4211 

6110761 HIP-ARTHROGRAM-RT 320 0 420.9 4211 

6110803 WRIST-ARTHRO-LT 320 0 781.66 4211 

6110811 WRIST-ARTHRO-RT 320 0 781.66 4211 

6110852 SHLDR-ARTHROGRAM-LT 320 0 781.66 4211 

6110860 SHLDR-ARTHROGRAM-RT 320 0 781.66 4211 

6110902 MAMMO DIAG EXTRA VIEWS RT 401 0 237.32 4211 

6110910 MAMMO DIAG EXTRA VIEW BILAT 401 0 535.08 4211 

6110928 PORT INJECTION FOR PATENCY 761 0 411.37 4211 

6110936 CONV TO GASTRO JEJUNOSTOMY TUBE 761 0 1502.01 4211

6110944 GASTROSTOMY TUBE REPLACEMENT 761 0 1094.67 4211 

6110951 INSERT GASTRO JEJUNOSTOMY TUBE 761 0 1502.01 4211 

6110969 GASTROSTOMY TUBE PLACEMENT 761 0 1502.01 4211 

6110977 JEJUNOSTOMY TUBE RE PLACEMENT 761 0 1094.67 4211 

6110985 JEJUNOSTOMY TUBE PLACEMENT 761 0 1502.01 4211 

6110993 MAMMO SCREEN DIGITAL RT 403 0 284.82 4211 

6111009 BIOPSY SPECIMEN 320 0 534.77 4211 

6111058 MAMMO SPECIMEN LEFT 320 0 534.77 4211 

6111066 MAMMO SPECIMEN RIGHT 320 0 534.77 4211 

6111108 ABSCESSOGRAM 320 0 587.63 4211 

6111157 HYSTEROSALPINGOGRAM WITH RADIOLOGY 320 0 587.63 4211 

6111207 NEPHROSTOGRAM-LT 320 0 275.95 4211 

6111215 NEPHROSTOGRAM-RT 320 0 275.95 4211 

6111256 NEPHR TUBE CHGE-LT 320 0 818.94 4211 

6111264 NEPHR TUB CHGE-RT 320 0 818.94 4211 

6111306 PERCUT NEPHROS-LT 320 0 2925.41 4211 

6111314 PERCUT NEPHROS-RT 320 0 2925.41 4211 

6111355 TOMOGRAPHY 320 0 2195.26 4211 

6111405 CERVICAL MYELO W/RAD 320 0 1399.81 4211 

6111454 LUMBAR MYELO W/RAD 320 0 1399.81 4211 

6111504 DORSAL-MYELO W/RAD 320 0 1399.81 4211 

6111553 LUMBAR PUNC 761 0 363.28 4211 

6111702 URETERAL STENT PL-LT 320 0 1250.67 4211 

6111710 URETERAL STENT PL-RT 320 0 1250.67 4211 

6111751 DRAINAGE CATH CHANGE 320 0 818.94 4211 

6111801 BILIARY DRAINAGE 320 0 1264.84 4211 

6111850 DRAINAGE-ABDOMEN 320 0 1368.44 4211 

6112007 C-ARM OR < 1 HR 360 0 245.08 4211 

6112015 C-ARM OR > 1 HR 360 0 400.16 4211 

6112056 C-ARM ACU < 1 HR 360 0 245.08 4211 

6112064 C-ARM ACU > 1 HR 360 0 743.15 4211 

6112106 FLOURO GUIDANCE FOR SPINE INJECTION 320 0 321.41 4211 

6112155 C-ARM ICU > 1 HR 360 0 400.16 4211 

6112163 C-ARM ICU < 1 HR 360 0 131.96 4211 

6112205 C-ARM PACEMAKER 320 0 400.16 4211 

6112502 FLOURO CHARGE 320 0 163.75 4211 

6112551 FLUORO CHRG W RAD OR CASE XA 320 0 163.75 4211 

6112700 HICK CATH/TRIP LUMEN 320 0 2313.63 4211 

6112858 MAMMO NEEDLE LOC ADD'L BILAT 401 0 532.8 4211 

6113005 KNEES STANDING-BILAT 320 0 202.56 4211 

6113500 ORBITS-WATER VIEW 320 0 108.88 4211 

6113559 NOSE TO RECTUM/FB 320 0 131.66 4211 

6113609 PERCUTAN IN/EX DRAIN 320 0 1150.37 4211 

6113757 LUMBAR PUNC/INSERT 761 0 63.9 4211 

6113807 WRST-ARTH PRO/INS-LT 761 0 529 4211 

6113815 WRST-ARTH PRO/INS-RT 761 0 529 4211 

6113856 SHLDR-ARTH PRO/INS-LT 320 0 589 4211

6113864 SHLDR-ARTH PRO/INS-RT 761 0 589 4211 

6113906 ELBW ARTH PRO/INS-LT 761 0 589 4211 

6113914 ELBW ARTH PRO/INS-RT 761 0 589 4211 

6113955 HIP-ARTH PRC/INS-LT 761 0 727.5 4211 

6113963 HIP-ARTH PRC/INS-RT 761 0 727.5 4211 

6114003 KNEE-ARTH PRO/INS-LT 761 0 727.5 4211 

6114011 KNEE-ARTH PRO/INS-RT 761 0 727.5 4211 

6114052 ANKLE-ARTH PRO/IN-LT 761 0 727.5 4211 

6114060 ANKLE-ARTH PRO/IN-RT 761 0 727.5 4211 

6114102 PERC NEPH PROC-LT 761 0 1968.9 4211 

6114110 PERC NEPH PROC-RT 761 0 1968.9 4211 

6114151 HYSTERO PLACE/INSERT 761 0 289.84 4211 

6114508 ABSCESS INJ VIA CATH 761 0 668 4211 

6114557 DRAINAGE-ABDOMEN-PRO 761 0 2630.11 4211 

6114607 NEPHROST PROC-LT 761 0 1968.9 4211 

6114615 NEPHROST PROC-RT 761 0 1968.9 4211 

6114656 NEPHRO TUBE CHG-LT 761 0 3035.16 4211 

6114664 NEPHRO TUBE CHG-RT 761 0 3035.16 4211 

6114706 CHEST W APICAL VIEW 320 0 131.66 4211 

6114755 CHEST INS & EXP LAT 320 0 131.66 4211 

6114805 BA SWALLOW-MODIFIED 320 0 221.76 4211 

6114854 CHEST PA INS & EXP 320 0 131.66 4211 

6114904 BONE DENSITY (DEXA) 320 0 442.19 4211 

6114953 CERV SPINE PORT LAT 320 0 131.66 4211 

6115000 PORT INJECTION PROC 761 0 92.17 4211 

6115059 PORT INJECTION W/RAD 761 0 411.37 4211 

6115109 MAMMO DUCTOGR-LT 320 0 565.03 4211 

6115117 MAMMO DUCTOGR-RT 320 0 565.03 4211 

6115158 ABDOMEN WITH LATERAL 320 0 108.88 4211 

6115208 MAMMO DUCT MULTI-LT 320 0 565.03 4211 

6115216 MAMMO DUCT MULTI-RT 320 0 565.03 4211 

6115307 MANDIBLE (LIMITED) 320 0 131.66 4211 

6115356 MASTOIDS (LIMITED) 320 0 108.88 4211 

6115406 FACIAL BONES (LTD) 320 0 108.88 4211 

6115455 TMJ UNILATERAL 320 0 108.88 4211 

6115505 SI JOINTS-2 VIEWS 320 0 114.32 4211 

6115604 SHOULDER 1 VIEW LT 320 0 108.88 4211 

6115612 SHOULDER 1 VIEW RT 320 0 108.88 4211 

6115653 ELBOW (2 VIEWS) LT 320 0 108.88 4211 

6115661 ELBOW (2 VIEWS) RT 320 0 108.88 4211 

6115703 UPPER EXT LT 320 0 108.88 4211 

6115711 UPPER EXT RT 320 0 108.88 4211 

6115752 WRIST RT (2 VIEWS) 320 0 108.88 4211 

6115760 WRIST LT (2 VIEWS) 320 0 108.88 4211 

6115802 HAND LT (2 VIEWS) 320 0 108.88 4211 

6115810 HAND RT (2 VIEWS) 320 0 108.88 4211 

6115851 MAMMO DUCT-PROC-LT 761 0 56.49 4211

6115869 MAMMO DUCT PROC-RT 761 0 56.49 4211 

6115901 HIP-2 VIEWS LT 320 0 108.88 4211 

6115919 HIP-2 VIEWS RT 320 0 108.88 4211 

6115950 LOWER EXTR INFANT LT 320 0 219.26 4211 

6115968 LOWER EXTR INFANT RT 320 0 219.26 4211 

6116008 FOOT LT (2 VIEWS) 320 0 108.88 4211 

6116016 FOOT RT (2 VIEWS) 320 0 108.88 4211 

6116057 STRESS VIEWS (S) 320 0 124.23 4211 

6116107 ABDOMEN LATERAL & AP 320 0 108.88 4211 

6116156 MAMMO NEEDLE LOC UNIL 401 0 216.97 4211 

6116206 COR BRST BIO PROC BILATERAL 761 0 3076.46 4211 

6116214 CORE BIO CLIP PLA BILATERAL 761 0 445.9 4211 

6116222 CORE BREAST BIO BILATERAL 320 0 1601.02 4211 

6116230 NEPHROSTOMY TUBE REMOV UNDER FLOURO 761 0 1326.11 4211 

6116248 VENOGRAM FOR IVC 360 0 2928.8 4211 

6116255 DKH MAMMO DIAGNOSTIC W/IMPLANTS 401 0 535.08 4211 

6116263 PICC LINE INSERTION W/O PORT 761 0 2277.17 4211 

6116271 CENTRAL LINE INSERT W/PORT OR PUMP 761 0 3694.71 4211 

6116289 CENTRAL LINE INSERT W/O PORT OR PMP 761 0 2908.85 4211 

6120000 MAMMO SCREEN DIGITAL LT 403 0 459.05 4211 

6170013 HYSTEROSALPINGOGRAM W/O RADIOLOGIST 320 0 587.63 4211 

6170021 FLUORO-GUIDANCE CENTRAL VENOUS LINE 320 0 433.18 4211 

6180053 IVP 320 0 512.49 4211 

6190052 CORE BRST CLIP-LT 278 0 114.35 4211 

6190060 CORE BRST CLIP-RT 278 0 114.35 4211 




6191605 VISIPAQUE 320 PER ML 636 0 1.5 4211 

6192009 DIGITIZED NC MAMMO 999 0 0 4211 

6192033 LOC NEEDLES 270 0 56 4211 

6192041 STEREO TRAY 270 0 18.36 4211 

6192066 NEPHROSTOMY KIT 270 0 405 4211 

6192074 CYSTO CONRAY SUPPLY 270 0 33.39 4211 

6196299 DI SUPPLY TRAY 270 0 40 4211 

6196307 TRIESENCE INJ PER MG 636 0 8.04 4211 

6196315 VOLUMEN PER BOTTLE 255 0 14.06 4211 

6200059 BRAIN SCAN 340 0 1616.16 4240 

6200158 BONE SCAN 340 0 584.68 4240 

6200356 LIVER & SPLEEN SCAN 340 0 809.93 4240 

6200505 LUNG SCAN PERFUSION ONLY 340 0 623.4 4240 

6200653 KID IMAG W/VAS FLOW 340 0 931.73 4240 

6200703 KID IMAG W/FUNCTION 340 0 931.73 4240 

6200752 KIDNEY IMAGING ONLY 340 0 931.73 4240 

6200802 KID IMAG COM V&F STU 340 0 931.73 4240 

6200901 THYROID ISOTOPE SCAN 340 0 328.07 4240 

6201107 BLOOD FLOW STUDIES 340 0 423.52 4240

6201206 MYO-IMAGING-INFARCT 340 0 920.14 4240 

6201503 GATED HEART - MUGA 340 0 703.22 4240 

6201602 HIDA SCAN WITH CCK 340 0 1199.48 4240 

6201701 VENTILATION STUDY 340 0 637.1 4240 

6201800 GI BLEEDING SCAN 340 0 895.86 4240 

6201909 LUNG SCAN P & V 340 0 1143.83 4240 

6202006 MECKEL'S DIVERT SCAN 340 0 716.09 4240 

6202105 G.I. REFLUX SCAN 340 0 716.09 4240 

6202204 BONE SCAN 3 PHASE 340 0 879.2 4240 

6202303 RADIONUCLIDE V.C.U.G 340 0 968.99 4240 

6202402 BONE SCAN LIMITED 340 0 584.68 4240 

6202501 TESTICULAR WITH FLOW 340 0 931.73 4240 

6202600 BONE SCAN SPECT 340 0 1086.48 4240 

6202709 KIDNEY WITH SPECT 340 0 968.99 4240 

6202907 BRAIN WITH SPECT 340 0 1616.16 4240 

6203004 CARD SPECT RST OR EX 340 0 1312.18 4240 

6203103 CARD SPECT RST & EX 340 0 1374.86 4240 

6203608 LIVER WITH SPECT 340 0 1086.48 4240 

6204101 EJECT FRACTION-SPC 340 0 0 4240 

6204150 WALL MOTION & SPECT 340 0 0 4240 

6204259 GASTRIC-EMPTYING 340 0 531.21 4240 

6204358 LYMPHATIC IMAGING 340 0 773.45 4240 

6204408 WHITE BC SPECT 340 0 1661.22 4240 

6204457 WHITE BC WHOLE BODY 340 0 1661.22 4240 

6204507 WHITE BC LIMITED 340 0 1661.22 4240 

6204515 THYROID- I123 SCAN ONLY 340 0 328.07 4240 

6204523 THYROID - 123 UPTAKE ONLY 340 0 328.07 4240 

6204531 THYROID I123 SCAN AND UPTAKE 340 0 380.99 4240 

6204549 THALLIUM SPECT RST & EX 340 0 1374.86 4240 

6204556 THALLIUM SPECT RST OR EX 340 0 1312.18 4240 

6204580 THYROID PARA SCAN 340 0 576.5 4240 

6204598 LUNG SCAN SPLIT FUNCTION W/P&V 340 0 1106.63 4240 

6204606 SPECT 340 0 1300.41 4240 

6204622 PROF FEE CARDIAC SPECT REST/EXER 985 0 108.93 4240 

6204630 PRO FEE CARDIAC SPECT REST/EXERCISE 985 0 129.26 4240 

6204648 PROF FEE MUGA STUDY 985 0 108.93 4240 

6204655 HIDA SCAN 340 0 1234.01 4240 

6204705 LUNG SCAN PERFUSION W/SPLIT FUNCT 340 0 511.87 4240 

6290506 KINEVAC 636 0 173.63 4240 

6290605 1 DOSE MYOVIEW 343 0 156.17 4240 

6290753 1 DOSE CERETEC 343 0 2812.5 4240 

6290951 TECHNESIUM 6-10 343 0 9.56 4240 

6291108 ALBUMIN 343 0 49.4 4240 

6291207 PENTETATE 343 0 86.06 4240 

6291306 SULFUR COLLOID 343 0 26.6 4240 

6291405 TC-99M ISOTOPE 343 0 59.19 4240 

6291504 MEDRONATE 343 0 26.6 4240

6291603 PYROPHOSPHATE 343 0 53.2 4240 

6291611 I 123 - 200 343 0 489.89 4240 

6298053 SESTAMIBI ISOTOPE 343 0 952.51 4240 

6299002 SOD CHLORIDE 100ML 258 0 92.43 4240 

6299036 THALLIUM 1 MCI 343 0 31.59 4240 

6299044 THALLIUM 1 DOSE RE INJECTION 343 0 31.59 4240 

6300503 NEONATAL HEAD 402 0 183.97 4251 

6300750 THYROID ULTRASOUND 402 0 567.55 4251 

6300800 BREAST US UNILAT-LT 402 0 184.08 4251 

6300818 BREAST US UNILAT-RT 402 0 184.08 4251 

6300826 BREAST ULTRAS BILAT 402 0 283.2 4251 

6301006 ECHOCARDIOGRAM 2D+M 480 0 651.78 4251 

6301055 ECHO-2D LIMITED 480 0 651.78 4251 

6301154 DOBUTAMINE-STRESS EC 480 0 1451.86 4251 

6301204 STRESS & REST ECHO 480 0 1451.86 4251 

6301501 ABDOMINAL ULTRASOUND 402 0 441.67 4251 

6301550 COLOR DOPPLER ABDOM 921 0 610.64 4251 

6301600 COLOR DOPP ABD LTD 921 0 515.42 4251 

6301659 DOPPLER ECHO 480 0 449.44 4251 

6302004 PELVIS LIMITED OR APPENDIX 402 0 330.83 4251 

6302509 RENAL ULTRASOUND 402 0 349.91 4251 

6302756 ABD AORTA ULTRASOUND 402 0 349.91 4251 

6302806 COLOR DOPP AORTA+VC 921 0 451.52 4251 

6303002 OB-2ND TRI 1 FETUS 402 0 386.85 4251 

6303051 OB-FOLLOW UP 402 0 205.44 4251 

6303101 FOLLOWUP LEV 2 OB-US 402 0 205.44 4251 

6303507 PELVIC ULTRASOUND 402 0 330.83 4251 

6303754 US-CYST ASPIRATION GUIDE 402 0 384.03 4251 

6303804 US-CYST ASPI PROC 761 0 712.4 4251 

6303853 US-PELVIS-CYST-PROC 761 0 1863.68 4251 

6304000 TESTICLE 402 0 567.55 4251 

6304505 CHEST PLEURAL EFFUS 402 0 567.55 4251 

6304752 BIOPHYSICAL PROFILE 402 0 276.9 4251 

6304760 CHEST-ULTRASOUND 402 0 567.55 4251 

6304778 US INTRAPERITONEAL CATHETER 402 0 1368.44 4251 

6304786 US INTRAPERITONEAL CATH PROC 761 0 5231.07 4251 

6304794 US INTRAPERITONEAL CATH REMOVAL 402 0 1368.44 4251 

6304802 US INTRAPERI CATH REMOVAL PROC 761 0 4649.84 4251 

6304810 US PLEURAL TUNNEL CATH REMOVAL 402 0 1368.44 4251 

6304828 US PLEURAL TUNNEL CATH REMOVAL PROC 761 0 455.91 4251 

6304836 US MEDICARE EXAM AAA SCREEN 402 0 247.88 4251 

6304844 PROF FEE DOPPLER ECHO ROUTINE 985 0 115.59 4251 

6304851 PROF FEE CONTRAST ADMIN FOR 93306 985 0 63.22 4251 

6304901 INJ(S) BICEP TENDON SHEATH,LIG 761 0 462.06 4251 

6305056 HYSTEROSONOGRAPHY 402 0 567.55 4251 

6305106 HYSTERO-PROCEDURE 761 0 289.84 4251 

6305759 ECHO EXT. NON VAS 402 0 287.98 4251

6306005 COLOR FLOW DOPPLER 480 0 253.27 4251 

6306252 PERIVASCU-LEG-BILAT 921 0 694.64 4251 

6306302 PERIVASC-LEG-UNIL LT 921 0 305.99 4251 

6306310 PERIVASC-LEG-UNIL-RT 921 0 305.99 4251 

6306351 PERIVASCU-ARM-BILAT 921 0 694.64 4251 

6306369 PERIVASC-ARM-UNIL LT 921 0 305.99 4251 

6306377 PERIVASC-ARM-UNIL-RT 921 0 305.99 4251 

6306500 CAROTID DUPLEX W C/F 921 0 465.78 4251 

6306757 PELVIC-NON OB TRANSV 402 0 287.98 4251 

6306807 OB-TRANSVAGINAL 402 0 288.77 4251 

6307003 TRANSESOPHAGEAL ECHO 480 0 1049.63 4251 

6307052 AMNIOCENTESIS W/ULTR 402 0 289.84 4251 

6307250 BREAST CYST ASP PRO 402 0 712.4 4251 

6307268 FNA WITH IMAGING GUIDANCE 761 0 863.45 4251 

6307367 RENAL CYS/PEL PRO-LT 761 0 1863.68 4251 

6307375 RENAL CYS/PEL PRO-RT 761 0 1863.68 4251 

6307508 OB-LIMITED 402 0 184.08 4251 

6307557 OB-1ST TRI 1 FETUS 402 0 174.86 4251 

6307565 OB-1ST TRI ADD FETUS 402 0 141.6 4251 

6307573 OB-2ND TRI ADD FETUS 402 0 771.81 4251 

6307581 OB-3RD TRI 1 FETUS 402 0 386.85 4251 

6307599 OB-3RD TRI ADD FETUS 402 0 771.81 4251 

6307664 PARACENTESIS GUIDE 402 0 384.03 4251 

6307672 PARACENTESIS PROC W/O GUIDANCE 761 0 991.48 4251 

6307755 NEEDLE LOC(US)-LT GUIDE 402 0 384.03 4251 

6307763 NEEDLE LOC(US)-RT GUIDE 402 0 384.03 4251 

6307797 NEEDLE LOC-PROC-LT 761 0 289.84 4251 

6307805 NEEDLE LOC PROC-RT 761 0 289.84 4251 

6307854 NEEDLE BIOPSY-LT GUIDE 761 0 384.03 4251 

6307862 NEEDLE BIOPSY-RT GUIDE 761 0 384.03 4251 

6307870 DOPPLER ECHO ROUTINE FULL 480 0 1524.65 4251 

6307888 DOPPLER ECHO ROUTINE W/CONTRAST 480 0 1524.65 4251 

6307896 ABDOMINAL PARACENTESIS W/IMAGE GDE 761 0 1001.25 4251 

6309009 PRO FEE ECHOCARDIOGRAM 2D + M 985 0 46.53 4251 

6309058 PRO FEE 2D LIMITED 985 0 26.06 4251 

6310056 US-BIO-MISCELLANEOUS GUIDE 402 0 384.03 4251 

6310155 US-BIOPSY PROC-LIVER 761 0 1863.68 4251 

6310163 US-BIOPSY-LIVER GUIDE 402 0 384.03 4251 

6310205 US-BIOPSY PROC-ABD 761 0 1003.52 4251 

6310254 US-BIO PRO BREAST LT 761 0 1105.74 4251 

6310262 US-BIOPSY-BREAST GUIDE 402 0 384.03 4251 

6310270 US-BIO PRO-BREAST RT 761 0 1105.74 4251 

6310296 US-BIO-PROC BREAST BILATERAL 761 0 2211.48 4251 

6310304 US-BIOPSY PRO-KIDNEY 761 0 1003.52 4251 

6310312 US-BIOPSY-KIDNEY GUIDE 402 0 384.03 4251 

6310353 US-BIOPSY PROC-LUNG 761 0 1748.79 4251 

6310361 US-BIOPSY-LUNG GUIDE 402 0 384.03 4251

6310403 US-BIOPSY PROC-PANCR 761 0 1863.68 4251 

6310411 US-BIOPSY-PANCREAS GUIDE 402 0 384.03 4251 

6310452 US-BIOPSY PROC-RETRO 761 0 1003.52 4251 

6310460 US-BIOPSY-RETROPER GUIDE 402 0 384.03 4251 

6310478 US-BIOPSY PROC-LUNG ADD'L LESION 761 0 1748.79 4251 

6310502 US-GUIDED PROC-DRAIN 761 0 291.33 4251 

6310528 US-BIOPSY-LYMPH NODE GUIDE 402 0 384.03 4251 

6310536 US-GUIDED DRAINAGE GUIDE 402 0 384.03 4251 

6310544 US-BIOPSY PROC-LYMPH NODE 761 0 1437.46 4251 

6310551 US-BIOPSY-ABD GUIDE 402 0 384.03 4251 

6310577 US-BIO-PROC-BREAST ADD'L LESION 761 0 1105.74 4251 

6310619 US-CORE BIOPSY THYROID 761 0 620.99 4251 

6310627 US-BIOPSY-THYROID GUIDE 402 0 384.03 4251 

6310700 US-BIOPSY PROC-THYROID ADD'L LESION 761 0 620.99 4251 

6311013 BREAST CYST ASPIRA GUIDE 402 0 384.03 4251 

6311021 US-BIOPSY PROC-BONE DEEP 761 0 3093.14 4251 

6311039 US-BIOPSY PROC NECK OR THORAX 761 0 3093.14 4251 

6311047 US-BIOPSY PROC-SOFT TISSUE 761 0 774.02 4251 

6311054 US-BIOPSY PROC BONE SUPERFICIAL 761 0 865.02 4251 

6311062 AV FISTULA OR PSEUDO ANEURYSM 921 0 305.99 4251 

6311070 US-BIOPSY-BONE DEEP GUIDE 402 0 384.03 4251 

6311088 US-BIOPSY-BONE SUPERFICIAL GUIDE 402 0 384.03 4251 

6311096 US-BIOPSY-NECK OR THORAX GUIDE 402 0 384.03 4251 

6311112 US-BIOPSY-SOFT TISSUE GUIDE 402 0 384.03 4251 

6320063 ARTERIES LOW EXT-LT 921 0 286.44 4251 

6320071 ARTERIES LOW EXT-RT 921 0 286.44 4251 

6320113 ARTERIES UPP EXT-LT 921 0 286.44 4251 

6320121 ARTERIES UPP EXT-RT 921 0 286.44 4251 

6320253 ABD LTD ONE ORGAN 402 0 441.67 4251 

6320352 U S-INFANT HIPS 402 0 281.34 4251 

6320402 U S-INFANT HIPS-LTD 402 0 184.08 4251 

6320550 THORACENTESIS GUIDE 402 0 384.03 4251 

6320659 ULTRASOUND GUIDANCE 402 0 384.03 4251 

6320709 CENTRL LINE PLACEMNT 402 0 77.29 4251 

6320758 CENTRAL LINE PROC 761 0 1159.28 4251 

6320808 THORACENTESIS PROC 761 0 1037.89 4251 

6320907 US-PLEURAL TUNNEL CATH PROC 761 0 4649.84 4251 

6320915 US-PLEURAL TUNNEL CATHETER 402 0 1368.44 4251 

6320923 US-BREAST CLIP PLACEMENT 761 0 1256.51 4251 

6320931 VASCULAR STUDY LIMITED 921 0 515.42 4251 

6320949 VASCULAR STUDY COMPLETE 921 0 610.64 4251 

6320956 HEAD OR NECK ULTRASOUND 402 0 567.55 4251 

6350052 IV START INJECTION 940 0 112.06 4251 

6390058 DEFINITY CONT-PERFLU 636 0 208.07 4251 

6390108 US VACUUM DRAIN BTL & TUBING SUPPLY 270 0 128.25 4251 

6390116 US PLEURAL CATHETER SUPPLY 278 0 1181.25 4251 

6390124 US PERITONEAL CATHETER SUPPLY 278 0 1181.25 4251

6390132 US-MIDLINE CATHETER 278 0 130 4251 

6390157 PICC KIT 270 0 148 4251 

6401210 PET/CT SKULL TO THIGH INITIAL 404 0 6699.84 4220 

6401228 PET/CT SKULL TO THIGH SUBSEQUENT 404 0 6699.84 4220 

6401251 PET/CT WHOLE BODY MELANOMA INITIAL 404 0 7724.53 4220 

6401269 PET/CT WHOLE BODY MELANOMA SUB 404 0 7724.53 4220 

6401509 PET/CT-LIMITED AREA 404 0 1775.06 4220 

6401608 PET-BRAIN-METAB EVAL 404 0 3732.34 4220 

6401616 PET-BRAIN-PERFU EVAL 404 0 3732.34 4220 

6401707 PET-MYOCAR META EVAL 404 0 3407.43 4220 

6401715 PET-CARD-REST-OR-STR 404 0 3407.43 4220 

6401723 PET-CARD FULL MULTI 404 0 3407.43 4220 

6401731 PET/CT SKULL TO THIGH INI NOPR 404 0 6699.84 4220 

6401749 PET/CT SKULL TO THIGH SUB NOPR 404 0 6699.84 4220 

6401756 PET/CT WHOLE BODY MELANOMA IN NOPR 404 0 7724.53 4220 

6401764 PET/CT WHOLE BODY MEL SUB NOPR 404 0 7724.53 4220 

6490106 PET-FDG-ISOTOPE 343 0 992.77 4220 

6500102 MRI-ABDOMEN W/O CONT 610 0 1430 4270 

6500110 MRI-ABDOMEN W/CONTRA 610 0 2299.83 4270 

6500128 MRI-ABDOMEN W/WO CON 610 0 4516.22 4270 

6500219 MRI-C SPINE W/O CONT 612 0 1373.37 4270 

6500227 MRI-C SPINE W CONTRA 612 0 1646.07 4270 

6500235 MRI-C SPINE W/WO CON 612 0 3051.54 4270 

6500300 MRI-CHEST W/O CONTR 610 0 1373.37 4270 

6500318 MRI-CHEST W/CONTRAST 610 0 1373.37 4270 

6500326 MRI-CHEST W/WO CONTR 610 0 1373.37 4270 

6500409 MRI-FACE W/O CONTRAS 611 0 1352.39 4270 

6500417 MRI-FACE W/CONTRAST 611 0 1622.64 4270 

6500425 MRI-FACE W/WO CONTR 611 0 3003.41 4270 

6500508 MRI-HEAD W/O CONTRAS 611 0 1373.37 4270 

6500516 MRI-HEAD W CONTRAST 611 0 1646.07 4270 

6500524 MRI-HEAD W/WO CONTRA 611 0 3051.54 4270 

6500607 MRI-IAC'S W/WO CONTRAST 611 0 3051.54 4270 

6500615 MRI-IACS-WO 611 0 1373.37 4270 

6500623 MRI-UPEXT JOINT W/CONTRAST LT 610 0 2299.83 4270 

6500631 MRI-UPEXT JOINT W/CONTRAST RT 610 0 2299.83 4270 

6500649 MRI-UPEXT JOINT W/O CON LT 610 0 1839.86 4270 

6500656 MRI-PIT/SELLA W/WO CO 611 0 3051.54 4270 

6500664 MRI-UPEXT JOINT W/O CONTRAST RT 610 0 1839.86 4270 

6500672 MRI-UPEXT W W/O CONT LT 610 0 3003.41 4270 

6500680 MRI-UPEXT W W/O CONT RT 610 0 3003.41 4270 

6500706 MRI-HIP WO CONTR-LT 610 0 1839.86 4270 

6500714 MRI-HIP WO CONTR-RT 610 0 1839.86 4270 

6500722 MRI-HIP W&WO CON-LT 610 0 3003.41 4270 

6500730 MRI-HIP W&WO CON-RT 610 0 3003.41 4270 

6500748 MRI-HIP-W/CONT-RT 610 0 2299.83 4270 

6500755 MRI-HIP-W/CONT-LT 610 0 2299.83 4270

6500805 MRI-LS SPINE W/O CON 612 0 1523.91 4270 

6500813 MRI-LS SPINE W/CONT 612 0 1646.07 4270 

6500821 MRI-LS SPINE W/WO CO 612 0 3051.54 4270 

6501001 MRI-MRCP 610 0 1430 4270 

6501100 MRI-NECK W/O CONTRAS 611 0 1352.39 4270 

6501118 MRI-NECK W/CONTRAST 611 0 1622.64 4270 

6501126 MRI-NECK W/WO CONTRA 611 0 3003.41 4270 

6501209 MRI-ORBITS W/O CONTR 611 0 1352.39 4270 

6501217 MRI-ORBITS W/CONTR 611 0 1622.64 4270 

6501225 MRI-ORBITS W/WO CONT 611 0 3003.41 4270 

6501308 MRI-PELVIS W/O CONTR 610 0 1358.58 4270 

6501316 MRI-PELVIS W/CONTRAS 610 0 1627.56 4270 

6501324 MRI-PELVIS W/WO CONT 610 0 1627.56 4270 

6501407 MRI-D SPINE W/O CONT 612 0 1523.91 4270 

6501415 MRI-D SPINE W CONTRA 612 0 1523.91 4270 

6501423 MRI-D SPINE W/WO CON 612 0 3051.54 4270 

6501506 MRI-TMJ BILAT 610 0 1373.37 4270 

6501514 MRI-TMJ UNILAT-LT 610 0 1373.37 4270 

6501522 MRI-TMJ UNILAT-RT 610 0 1373.37 4270 

6501605 MRI-SHLDR WO CON-LT 610 0 1839.86 4270 

6501613 MRI-SHLDR WO CON-RT 610 0 1839.86 4270 

6501621 MRI-SHLDR W CON-LT 610 0 2299.83 4270 

6501639 MRI-SHLDR W CON-RT 610 0 2299.83 4270 

6501647 MRI-SHLDR W/WO CO-LT 610 0 3003.41 4270 

6501654 MRI-SHLDR W/WO CO-RT 610 0 3003.41 4270 

6501704 MRI-SHLDR-ARTHRO-LT 610 0 2299.83 4270 

6501712 MRI-SHLDR-ARTHRO-RT 610 0 2299.83 4270 

6501803 MRI-KNEE WO CON-LT 610 0 1839.86 4270 

6501811 MRI-KNEE WO CON-RT 610 0 1839.86 4270 

6501829 MRI-KNEE W CONT-LT 610 0 2299.83 4270 

6501837 MRI-KNEE W CONT-RT 610 0 2299.83 4270 

6501845 MRI-KNEE W/WO CO-LT 610 0 3003.41 4270 

6501852 MRI-KNEE W/WO CO-RT 610 0 3003.41 4270 

6501902 MRI-WRIST WO CON-LT 610 0 1839.86 4270 

6501910 MRI-WRIST WO CON-RT 610 0 1839.86 4270 

6501928 MRI-WRIST W CON-LT 610 0 2299.83 4270 

6501936 MRI-WRIST W CON-RT 610 0 2299.83 4270 

6501944 MRI-WRIST W/WO CO-LT 610 0 3003.41 4270 

6501951 MRI-WRIST W/WO CO-RT 610 0 3003.41 4270 

6502009 MRI-ELBOW WO CON-LT 610 0 1839.86 4270 

6502017 MRI-ELBOW WO CON-RT 610 0 1839.86 4270 

6502025 MRI-ELBOW W CON-LT 610 0 2299.83 4270 

6502033 MRI-ELBOW W CON-RT 610 0 2299.83 4270 

6502041 MRI-ELBOW W/WO CO-LT 610 0 3003.41 4270 

6502058 MRI-ELBOW W/WO CO-RT 610 0 3003.41 4270 

6502108 MRI-UPEX NO JT WO-LT 610 0 1352.39 4270 

6502116 MRI-UPEX NO JT WO-RT 610 0 1352.39 4270

6502124 MRI-UP EX NO JT W-LT 610 0 1622.64 4270 

6502132 MRI-UP EX NO JT W-RT 610 0 1622.64 4270 

6502140 MRI-UPEX NOJT W/WO-LT 610 0 3003.41 4270 

6502157 MRI-UPEX NOJT W/WO-RT 610 0 3003.41 4270 

6502207 MRI-BREASTS W/WO CON 610 0 4018.46 4270 

6502215 MRI-BRST-UNI W/WO-LT 610 0 3187.11 4270 

6502223 MRI-BRST-UNI W/WO RT 610 0 3187.11 4270 

6502231 MRI-MAMMO-CAD 610 0 59.8 4270 

6502249 MRI-LEFT KNEE WO SHAPEMATCH TECH 320 0 1839.86 4270 

6502264 MRI-RT KNEE WO SHAPEMATCH TECH 320 0 1839.86 4270 

6502272 MRI BREASTS W/O CONTRAST 610 0 3226.24 4270 

6502280 3D RENDERING W/INTER CT,MRI,US 610 0 631.49 4270 

6502306 3D RECONSTRUCTION 610 0 631.49 4270 

6502405 MRI-ANKLE WO CON-LT 610 0 1839.86 4270 

6502413 MRI-ANKLE WO CON-RT 610 0 1839.86 4270 

6502421 MRI-ANKLE W CONT-LT 610 0 2299.83 4270 

6502439 MRI-ANKLE W CONT-RT 610 0 2299.83 4270 

6502447 MRI-ANKL W/WO CO-LT 610 0 3003.41 4270 

6502454 MRI-ANKL W/WO CO-RT 610 0 3003.41 4270 

6502504 MRI-LOEX NO JT WO-LT 610 0 1839.86 4270 

6502512 MRI-LOEX NO JT WO-RT 610 0 1839.86 4270 

6502520 MRI-LO EX NO JT W-LT 610 0 2299.83 4270 

6502538 MRI-LO EX NO JT-W-RT 610 0 2299.83 4270 

6502546 MRI-LOEX NOJT W/WO-LT 610 0 3003.41 4270 

6502553 MRI-LOEX NOJT W/WO-RT 610 0 3003.41 4270 

6502603 MRV-WO CONTRAST 610 0 552.02 4270 

6502611 MRV-W&WO 610 0 552.02 4270 

6502629 MRI PIT/SELLA W/O CONTRAST 610 0 1373.37 4270 

6590301 MRI-GADO PER ML 636 0 15.34 4270 

6600050 MRA-LO EX W/WO CO-LT 616 0 2060.06 4270 

6600068 MRA-LO EX W/WO CO-RT 616 0 2060.06 4270 

6600076 MRA-LOWER EXT W/WO-BILAT 616 0 3190.4 4270 

6600100 MRA-UP EX W/WO CO-LT 618 0 775.62 4270 

6600118 MRA-UP EX W/WO CO-RT 618 0 775.62 4270 

6600209 MRA-CHEST W/WO CONTR 618 0 1897.94 4270 

6600258 MRA-HEAD W/O CONTR 615 0 1373.37 4270 

6600266 MRA-HEAD W/CONTRAST 615 0 1373.37 4270 

6600274 MRA-HEAD W/WO CONTR 615 0 2687.53 4270 

6600316 MRA-NECK W/O CONTRA 615 0 1373.37 4270 

6600324 MRA-NECK W/WO CONTRA 615 0 2687.53 4270 

6600365 MRA-AB W/WO CONTRAST 618 0 2536.31 4270 

6600407 MRA-PELVIS W/WO CONT 610 0 1373.37 4270 

6700207 CT ABDOMEN W CONTRAS 352 0 1538 4260 

6700215 CT ABDOMEN W&W/O CON 352 0 1474.91 4260 

6700223 CT ABDOMEN W/O CONT 352 0 1179.93 4260 

6700306 CT C SPINE W/CONTRAS 352 0 906.59 4260 

6700314 CT CERVICAL SPINE W/O 352 0 1086.48 4260

6700405 CT CHEST HIGH RESOLU W/O 352 0 1086.48 4260 

6700454 CT CHEST W CONTRAST 352 0 1299.35 4260 

6700462 CT CHEST W&W/O CONT 352 0 1625.1 4260 

6700470 CT CHEST W/O CONTRAS 352 0 1086.48 4260 

6700603 CT D SPINE W/CONTRAS 352 0 906.59 4260 

6700652 CT DORSAL SPINE 352 0 1086.48 4260 

6700702 CT FACIAL/MAND W/CONTRAST 351 0 1179.93 4260 

6700710 CT FACIAL/MAND W/O CONTRAST 351 0 1179.93 4260 

6700728 CT FACIAL/MAND W/WO CONTRAST 351 0 1474.91 4260 

6700801 CT HEAD W & W/O CONT 351 0 1474.91 4260 

6700819 CT HEAD W CONTRAST 351 0 1179.93 4260 

6700827 CT HEAD W/O CONTRAST 351 0 1179.93 4260 

6700900 CT I.A.M. W/CONTRAST 351 0 1474.91 4260 

6700918 CT I.A.M. W/O CONTRA 351 0 1179.93 4260 

6701007 CT LO EXT W /CON-LT 352 0 1474.91 4260 

6701015 CT LO EXT W/CON RT 352 0 1179.93 4260 

6701023 CT LO EXT WO CON-LT 352 0 1179.93 4260 

6701031 CT LO EXT WO CON-RT 352 0 1179.93 4260 

6701098 SCANOGRAM-LEGS 352 0 449.6 4260 

6701106 CT LUMBAR SP W/CON 352 0 906.59 4260 

6701114 CT LUMBAR SPINE W/O CONTRAST 352 0 1086.48 4260 

6701205 CT NECK W/CONTRAST 351 0 1179.93 4260 

6701213 CT NECK W/O CONTRAST 351 0 1179.93 4260 

6701221 CT NECK W/WO CONTRAS 351 0 1474.91 4260 

6701304 CT ORBITS W/CONTRAST 351 0 1474.91 4260 

6701312 CT ORBITS W/O CONT 351 0 1179.93 4260 

6701320 CT ORBITS W/WO CONTR 351 0 1474.91 4260 

6701403 CT PELVIS W/CONTRAST 352 0 1258.62 4260 

6701411 CT PELVIS W&W/O CONT 352 0 1558.49 4260 

6701429 CT PELVIS W/O CONTRA 352 0 1086.48 4260 

6701502 CT PITUITARY W/CONT 351 0 1474.91 4260 

6701510 CT PITUITARY W/O CON 351 0 1179.93 4260 

6701528 CT PITUITARY W/WO CONTRAST 351 0 1474.91 4260 

6701809 CT SAC/COCC W/CONTRA 352 0 1258.62 4260 

6701817 CT SAC/COCC W/O CONT 352 0 1086.48 4260 

6701908 CT SI JTS W/CONTRAST 352 0 906.59 4260 

6701916 CT SI JTS W/O CONTRA 352 0 674.12 4260 

6702005 CT SINUS W/CONTRAST 351 0 1179.93 4260 

6702013 CT SINUS W/O CONTRAS 351 0 1179.93 4260 

6702021 CT SINUS W/WO CONTRA 351 0 1474.91 4260 

6702104 CT TEMP BNS W/O CONT 351 0 1179.93 4260 

6702112 CT TEMP BNS W/WO CON 351 0 1474.91 4260 

6702120 CT TEMP BONES W/CONT 351 0 1474.91 4260 

6702153 CT TM JOINTS 351 0 1179.93 4260 

6702203 CT UP EX W/WO CO-LT 352 0 1004.25 4260 

6702229 CT UP EX WO CON-LT 352 0 910.67 4260 

6702237 CT UP EX WO CON-RT 352 0 910.67 4260

6702245 CT UP EXT W/ CON-RT 352 0 1086.48 4260 

6702252 CT UP EXT W/CON-LT 352 0 1086.48 4260 

6702351 CT-ANGIO ABDOMEN 352 0 1496.5 4260 

6702369 CT ANGIO ABDOMEN & PELVIS W&W/O 352 0 1863.48 4260 

6702450 CT-ANGIO CHEST 352 0 1179.02 4260 

6702500 CT-ANGIO EXTR LOWER 352 0 1870.62 4260 

6702559 CT-ANGIO EXTR UPPER 352 0 1036.36 4260 

6702609 CT-ANGIO HEAD 351 0 1870.62 4260 

6702658 CT-ANGIO LEGS RUNOFF 352 0 1870.62 4260 

6702708 CT-ANGIO NECK 351 0 1870.62 4260 

6702757 CT-ANGIO PELVIS 352 0 1036.36 4260 

6705008 CT-BIOPSY ABD MASS 352 0 1080.9 4260 

6705107 CT-BIOPSY ABD PROC. 360 0 1003.52 4260 

6705206 CT-BIOPSY KID PRO-LT 761 0 1003.52 4260 

6705214 CT-BIOPSY KID PRO-RT 761 0 1003.52 4260 

6705305 CT-BIOPSY KIDNEY-LT 352 0 1080.9 4260 

6705313 CT-BIOPSY KIDNEY-RT 352 0 1080.9 4260 

6705404 CT-BIOPSY LIVER 352 0 1080.9 4260 

6705412 CT-BIOPSY LIVER PROC 761 0 1863.68 4260 

6705503 CT-BIOPSY LUNG 352 0 1080.9 4260 

6705511 CT-BIOPSY LUNG PROC. 761 0 1748.79 4260 

6705602 CT-BIOPSY PANC. PROC 761 0 1863.68 4260 

6705610 CT-BIOPSY PANCREAS 352 0 1080.9 4260 

6705701 CT-BIOPSY RETRO 352 0 1080.9 4260 

6705800 CT-BONE BIOPSY 352 0 1080.9 4260 

6705818 CT-BONE BIOPSY PROC 761 0 865.02 4260 

6705909 CT-KID ABS/DR PRO-LT 761 0 4978.45 4260 

6705917 CT-KID ABS/DR PRO-RT 761 0 4978.45 4260 

6705925 CT-KIDN ABCESS/DR-LT 352 0 691.73 4260 

6705933 CT-KIDN ABCESS/DR-RT 352 0 691.73 4260 

6706014 CT-KIDNEY CYST PRO-LT 761 0 1863.68 4260 

6706022 CT-KIDNEY CYST PRO-RT 761 0 1863.68 4260 

6706105 CT-LIVER ABS/DR PROC 761 0 1863.68 4260 

6706113 CT-LIVER ABSCESS/DR 352 0 1368.44 4260 

6706204 CT-LUNG AB PUN/DR PR 761 0 1037.89 4260 

6706212 CT-LUNG ABSCESS/DRA 352 0 1368.44 4260 

6706303 CT-PANC ABS DRA PROC 761 0 618.61 4260 

6706311 CT-PANCREAS ABS/DR 352 0 1368.44 4260 

6706402 CT-PERITON ABS/DRAIN 352 0 1368.44 4260 

6706410 CT-PERITON DRAIN PRO 761 0 506.16 4260 

6706501 CT-RETRO ABS DRA PRO 761 0 506.16 4260 

6706519 CT-RETRO ABS/DR 352 0 1368.44 4260 

6706600 CT-SHLDR/ARTHRO-LT 352 0 697.38 4260 

6706618 CT-SHLDR/ARTHRO-RT 352 0 1086.48 4260 

6706709 CT-SUB/DI ABS DRA PR 761 0 506.16 4260 

6706717 CT-SUB/DIA ABS/DRAIN 352 0 1368.44 4260 

6706725 CT LOWER EXT BILAT W/CONTRAST 352 0 2877.88 4260

6706733 CT INTRAPERITONEAL CATHETER 352 0 1368.44 4260 

6706741 CT INTRAPERITONEAL CATH PROC 761 0 5231.07 4260 

6706758 CT INTRAPERI CATHETER REMOVAL 352 0 1368.44 4260 

6706766 CT INTRAPERI CATH REMOVAL PROC 761 0 4649.84 4260 

6706774 CT PLEURAL TUNNEL CATH REMOVAL 352 0 1368.44 4260 

6706782 CT PLEURAL TUNNEL CATH REMOVAL PROC 761 0 455.91 4260 

6706790 CT PLEURAL TUNNEL CATH PROC 761 0 4649.84 4260 

6706808 CT PLEURAL TUNNEL CATHETER 352 0 1368.44 4260 

6706816 CT BIOPSY NECK PROC 761 0 1342.01 4260 

6706824 CT BIOPSY NECK 352 0 1080.9 4260 

6706832 CT KIDNEY CYST ASPIRATION LT 352 0 1080.9 4260 

6706840 CT KIDNEY CYST ASPIRATION RT 352 0 1080.9 4260 

6706857 CT ABDOMEN & PELVIS W/CONTRAST 352 0 2949.82 4260 

6706865 CT ABDOMEN & PELVIS W/O CONTRAST 352 0 1474.91 4260 

6706873 CT AB AND PELVIS W , W/O CONTRAST 352 0 2949.82 4260 

6706881 CT-SI JOINT INJECTION 761 0 1103.53 4260 

6706899 CT LUMBAR FACET INJECTION 761 0 1352.47 4260 

6706907 CT-SI JOINT NEEDLE GUIDANCE 352 0 1080.9 4260 

6706915 CT BONE BX DEEP VERTEBRAL BODY 761 0 3222.05 4260 

6706923 CT GUIDANCE 352 0 1080.9 4260 

6706956 CT CHEST LIMITED STUDY 352 0 449.6 4260 

6706964 3D RECONSTRUCTION CHARTE 350 0 631.49 4260 

6706972 CT GUIDED CELIAC PLEXUS NEUROLYSIS 761 0 2130.95 4260 

6790125 GASTROVIEW PER ML 636 0 0.39 4260 

6790158 READICAT PER BOTTLE 255 0 14.4 4260 

6790174 CT VACUUM BTL & DRAIN TUBING 270 0 128.25 4260 

6790182 CT PLEURAL CATHETER SUPPLY 278 0 1181.25 4260 

6790190 CT PERITONEAL CATHETER SUPPLY 278 0 1181.25 4260 

6790208 CT BONE BIOPSY KIT 270 0 528.75 4260 


6801013 ABDOMEN FLAT & UPRIGHT 320 0 108.88 4212 


6801039 ABDOMEN W/ DECUBITIS 320 0 108.88 4212 



6801062 ANKLE RIGHT 320 0 131.66 4212 

6801070 ANKLE LEFT 320 0 131.66 4212 

6801088 ANKLE BILAT 320 0 194.4 4212 

6801096 CERV SPINE TRAUMA 320 0 119.75 4212 

6801104 CERV SPINE W/OBL 320 0 179.26 4212 


6801120 CERV SPINE OBL ONLY 320 0 108.88 4212 



6801153 CHEST PA & LAT 320 0 144.07 4212 


6801179 CHEST DECUB ONLY 320 0 131.66 4212





6801229 CHEST P A T 320 0 144.07 4212 

6801237 CHEST / DECUBITIS R & L 320 0 108.88 4212 

6801245 CLAVICLE LEFT 320 0 117.99 4212 

6801252 CLAVICLE RIGHT 320 0 117.99 4212 

6801260 DORSAL SPINE 320 0 108.88 4212 


6801286 ELBOW W/OBLIQ LEFT 320 0 108.88 4212 

6801294 ELBOW W/ OBLIQUE RIGHT 320 0 108.88 4212 

6801302 ELBOW(2 VIEWS)LT 320 0 108.88 4212 

6801310 ELBOW(2 VIEWS) RT 320 0 108.88 4212 


6801336 FACIAL BONES 320 0 108.88 4212 

6801344 FACIAL BONES(LTD) 320 0 108.88 4212 

6801351 FEMUR BILAT 320 0 202.56 4212 

6801369 FEMUR LEFT 320 0 131.66 4212 

6801377 SHOULDER NO TRAUMA BILAT 320 0 202.56 4212 

6801385 SHOULDER TRAUMA BILAT 320 0 202.56 4212 

6801393 SI JOINTS 2 VIEWS 320 0 114.32 4212 

6801401 SINUSES 320 0 108.88 4212 


6801427 SKULL 320 0 210.83 4212 

6801435 SKULL AP & LAT 320 0 108.88 4212 



6801468 STERNUM 320 0 108.88 4212 

6801476 TMJ BILATERAL 320 0 202.56 4212 


6801492 TOE LEFT 320 0 108.88 4212 

6801500 TOE RIGHT 320 0 108.88 4212 

6801518 UPPER EXT LT 320 0 108.88 4212 

6801526 UPPER EXT RT 320 0 108.88 4212 

6801534 WRIST LEFT 320 0 108.88 4212 

6801542 WRIST RIGHT 320 0 108.88 4212 

6801559 WRIST LT (2 VIEWS) 320 0 108.88 4212 

6801567 WRIST RT (2 VIEWS) 320 0 108.88 4212 

6801575 WRIST BILATERAL 320 0 202.56 4212 

6801583 FEMUR RIGHT 320 0 131.66 4212 

6801591 FINGER 2 OR MORE LT 320 0 108.88 4212 

6801609 FINGER 2 OR MORE RT 320 0 108.88 4212 

6801617 FINGER SINGLE LEFT 320 0 108.88 4212 

6801625 FINGER SINGLE RIGHT 320 0 108.88 4212 

6801633 FOOT LEFT 320 0 108.88 4212 

6801641 FOOT RIGHT 320 0 108.88 4212

6801658 FOOT LT(2 VIEWS) 320 0 108.88 4212 

6801666 FOOT RT(2 VIEWS) 320 0 108.88 4212 

6801674 FOOT BILATERAL 320 0 202.56 4212 

6801682 FOREARM LEFT 320 0 117.99 4212 

6801690 FOREARM RIGHT 320 0 117.99 4212 

6801708 HAND LEFT 320 0 108.88 4212 

6801716 HAND RIGHT 320 0 108.88 4212 

6801724 HAND LT(2 VIEWS) 320 0 108.88 4212 

6801732 HAND RT(2 VIEWS) 320 0 108.88 4212 


6801757 HAND BILATERAL 320 0 202.56 4212 

6801765 HEEL (OS CALC) LEFT 320 0 108.88 4212 

6801773 HEEL(OS CALC) RIGHT 320 0 108.88 4212 

6801781 HIP(PELV INCL) BILAT 320 0 337.32 4212 

6801799 HIP(PELVIS INCL) LT 320 0 108.88 4212 

6801807 HIP(PELVIS INCL)RT 320 0 108.88 4212 

6801815 HIP RECHECK LEFT 320 0 108.88 4212 

6801823 HIP RECHECK RIGHT 320 0 108.88 4212 

6801831 HIP 2 VIEWS LT 320 0 108.88 4212 

6801849 HIP 2 VIEWS RT 320 0 108.88 4213 

6801856 HIPS PEDIATRIC BILAT 320 0 202.56 4212 

6801864 HUMERUS LEFT 320 0 131.66 4212 

6801872 HUMERUS RIGHT 320 0 131.66 4212 

6801880 KNEE NO TRAUMA BILAT 320 0 202.56 4212 

6801898 KNEE NO TRAUMA LEFT 320 0 108.88 4212 

6801906 KNEE NO TRAUMA RIGHT 320 0 108.88 4212 

6801914 KNEE W/OBLIQ LEFT 320 0 108.88 4212 

6801922 KNEE W/OBLIQ RIGHT 320 0 108.88 4212 

6801930 KNEE W/OBLIQUE BILAT 320 0 202.56 4212 

6801948 KNEE W/PATELLA BILAT 320 0 202.56 4212 

6801955 KNEE W/PATELLA LEFT 320 0 108.88 4212 

6801963 KNEE W/PATELLA RIGHT 320 0 108.88 4212 

6801971 KNEES STANDING BILAT 320 0 202.56 4212 




6802011 LOWER LEG BILAT 320 0 202.56 4212 

6802029 LOWER LEG LEFT 320 0 132.44 4212 

6802037 LOWER LEG RIGHT 320 0 132.44 4212 

6802045 LS SPINE ROUTINE MIN 2 VIEWS 320 0 108.88 4212 

6802052 LS SPINE W OBLIQUES MIN 4 VIEWS 320 0 142.99 4212 

6802060 LS SPINE W UPRIGHT MIN 4 VIEWS 320 0 142.99 4212 


6802086 LS SPINE SHOOT THRU 320 0 108.88 4212 

6802094 LUMBAR SP W FLEX EXT 6 VIEWS 320 0 177.09 4212 


6802110 MAMMO DIAG DIGITAL LEFT 401 0 237.32 4212

6802128 MAMMO DIAG DIGITAL RIGHT 401 0 237.32 4212 

6802136 DDC MAMMO SCREEN DIGITAL 320 0 468.2 4212 

6802144 MANDIBLE 320 0 468.2 4212 

6802151 MANDIBLE(LIMITED) 320 0 131.66 4212 

6802169 MASTOIDS 320 0 131.66 4212 

6802177 MASTOIDS(LIMITED) 320 0 108.88 4212 


6802193 NASAL BONES 320 0 131.66 4212 

6802201 NAVICULAR VIEWS LT 320 0 108.88 4212 

6802219 NAVICULAR VIEWS RT 320 0 108.88 4212 


6802235 ORBITS 320 0 131.66 4212 


6802250 ORBITS WATER VIEW 320 0 108.88 4212 


6802276 RIBS BILATERAL R & L 320 0 337.32 4212 

6802284 RIBS ONE SIDE LT 320 0 166.73 4212 

6802292 RIBS ONE SIDE RT 320 0 166.73 4212 

6802300 SACROCOCCYGEAL SPINE 320 0 114.32 4212 


6802326 SCAPULA LT 320 0 131.66 4212 

6802334 SCAPULA RT 320 0 131.66 4212 

6802342 SHLDR NO TRAUMA LT 320 0 108.88 4212 

6802359 SHLDR NO TRAUMA RT 320 0 108.88 4212 

6802367 SHLDR TRAUMA LT 320 0 108.88 4212 

6802375 SHLDR TRAUMA RT 320 0 108.88 4212 



6802409 MAMMO DIAG EXTRA VIEWS LT (DNLSON) 401 0 237.32 4212 

6802417 MAMMO DIAG EXTRA VIEWS RT(DNSLN) 401 0 237.32 4212 

6802425 MAMMO DIAG EXTRA VIEWS BILAT(DNLSN) 401 0 535.08 4212 

6802433 MAMMO SCREEN DIGITAL RT DANIELSON 403 0 459.05 4212 

6802441 MAMMO SCREEN DIGITAL LT DANIELSON 403 0 284.82 4212 

6802458 MAMMO SCREENING IMPLANTS DANIELSON 403 0 468.2 4212 


6901011 ABDOMEN FLAT & UPRIGHT 320 0 108.88 4213 


6901037 ABDOMEN W/DECUBITIS 320 0 108.88 4213 



6901060 ANKLE LEFT 320 0 131.66 4213 

6901078 ANKLE RIGHT 320 0 131.66 4213 

6901086 ANKLE BILAT 320 0 194.4 4213 

6901094 CERV SPINE TRAUMA 320 0 119.75 4213 

6901102 CERV SPINE W/OBL 320 0 179.26 4213 


6901128 CERV SPINE OBL ONLY 320 0 108.88 4213



6901151 CHEST PA & LAT 320 0 144.07 4213 


6901177 CHEST DECUB ONLY 320 0 131.66 4213 





6901227 CHEST P A T 320 0 144.07 4213 

6901235 CHEST / DECUBITIS R & L 320 0 108.88 4213 

6901243 CLAVICLE LEFT 320 0 117.99 4213 

6901250 CLAVICLE RIGHT 320 0 117.99 4213 

6901268 DORSAL SPINE 320 0 108.88 4213 


6901284 ELBOW W OBLIQUE LEFT 320 0 108.88 4213 

6901292 ELBOW W/OBLIQ RIGHT 320 0 108.88 4213 

6901300 ELBOW (2 VIEWS) LT 320 0 108.88 4213 

6901318 ELBOW(2 VIEWS)RIGHT 320 0 108.88 4213 


6901334 FACIAL BONES 320 0 108.88 4213 

6901342 FACIAL BONES (LTD) 320 0 108.88 4213 

6901359 FEMUR BILAT 320 0 202.56 4213 

6901367 FEMUR LEFT 320 0 131.66 4213 

6901375 SHOULDER NO TRAUMA BILAT 320 0 202.56 4213 

6901383 SHOULDER TRAUMA BILAT 320 0 202.56 4213 

6901391 SI JOINTS 2 VIEWS 320 0 114.32 4213 

6901409 SINUSES 320 0 108.88 4213 


6901425 SKULL 320 0 210.83 4213 

6901433 SKULL AP & LAT 320 0 108.88 4213 



6901466 STERNUM 320 0 108.88 4213 

6901474 TMJ BILATERAL 320 0 202.56 4213 


6901490 TOE LEFT 320 0 108.88 4213 

6901508 TOE RIGHT 320 0 108.88 4213 

6901516 UPPER EXT LT 320 0 108.88 4213 

6901524 UPPER EXT RT 320 0 108.88 4213 

6901532 WRIST LEFT 320 0 108.88 4213 

6901540 WRIST RIGHT 320 0 108.88 4213 

6901557 WRIST LT(2 VIEWS) 320 0 108.88 4213 

6901565 WRIST RT(2 VIEWS) 320 0 108.88 4213 

6901573 WRIST BILATERAL 320 0 202.56 4213 

6901581 FEMUR RIGHT 320 0 131.66 4213 

6901599 FINGER 2 OR MORE LT 320 0 108.88 4213

6901607 FINGER 2 OR MORE RT 320 0 108.88 4213 

6901615 FINGER, SINGLE LEFT 320 0 108.88 4213 

6901623 FINGER SINGLE RIGHT 320 0 108.88 4213 

6901631 FOOT LEFT 320 0 108.88 4213 

6901649 FOOT RIGHT 320 0 108.88 4213 

6901656 FOOT LT(2 VIEWS) 320 0 108.88 4213 

6901664 FOOT RT(2 VIEWS) 320 0 108.88 4213 

6901672 FOOT BILATERAL 320 0 202.56 4213 

6901680 FOREARM LEFT 320 0 108.88 4213 

6901698 FOREARM RIGHT 320 0 117.99 4213 

6901706 HAND LEFT 320 0 108.88 4213 

6901714 HAND RIGHT 320 0 108.88 4213 

6901722 HAND LT (2 VIEWS) 320 0 108.88 4213 

6901730 HAND RT (2 VIEWS) 320 0 108.88 4213 


6901755 HAND BILATERAL 320 0 202.56 4213 

6901763 HEEL(OS CALC) LEFT 320 0 108.88 4213 

6901771 HEEL(OS CALC) RIGHT 320 0 108.88 4213 

6901789 HIP(PELV INCL) BILAT 320 0 337.32 4213 

6901797 HIP(PELVIS INCL) LT 320 0 108.88 4213 

6901805 HIP(PELVIS INCL) RT 320 0 108.88 4213 

6901813 HIP RECHECK LEFT 320 0 108.88 4213 

6901821 HIP RECHECK RIGHT 320 0 108.88 4213 

6901839 HIP 2 VIEWS LT 320 0 108.88 4213 

6901847 HIP 2 VIEWS RT 320 0 108.88 4213 

6901854 HIPS PEDIATRIC BILATERAL 320 0 202.56 4213 

6901862 HUMERUS LEFT 320 0 131.66 4213 

6901870 HUMERUS RIGHT 320 0 131.66 4213 

6901888 KNEE NO TRAUMA BILAT 320 0 202.56 4213 

6901896 KNEE NO TRAUMA LEFT 320 0 108.88 4213 

6901904 KNEE NO TRAUMA RIGHT 320 0 108.88 4213 

6901912 KNEE W/OBLIQ LEFT 320 0 108.88 4213 

6901920 KNEE W/OBLIQ RIGHT 320 0 108.88 4213 

6901938 KNEE W/OBLIQ BILAT 320 0 202.56 4213 

6901946 KNEE W/PATELLA BILAT 320 0 202.56 4213 

6901953 KNEE W/PATELLA LEFT 320 0 108.88 4213 

6901961 KNEE W/PATELLA RIGHT 320 0 108.88 4213 

6901979 KNEES STANDING BILAT 320 0 202.56 4213 




6902019 LOWER LEG BILAT 320 0 202.56 4213 

6902027 LOWER LEG LEFT 320 0 132.44 4213 

6902035 LOWER LEG RIGHT 320 0 132.44 4213 

6902043 LS SPINE ROUTINE MIN 2 VIEWS 320 0 108.88 4213 

6902050 LS SPINE W OBLIQUES MIN 4 VIEWS 320 0 142.99 4213 

6902068 LS SPINE W UPRIGHT MIN 4 VIEWS 320 0 142.99 4213


6902084 LS SPINE SHOOT THRU 2 VIEWS 320 0 108.88 4213 

6902092 LUMBAR SP W FLEX EXT 320 0 177.09 4213 


6902118 MAMMO DIAG DIGITAL LT 401 0 237.32 4213 

6902126 MAMMO DIAG DIGITAL RIGHT 401 0 364.62 4213 

6902134 PDC MAMMO SCREEN DIGITAL 403 0 468.2 4213 

6902142 MANDIBLE 320 0 468.2 4213 

6902159 MANDIBLE(LIMITED) 320 0 131.66 4213 

6902167 MASTOIDS 320 0 131.66 4213 

6902175 MASTOIDS(LIMITED) 320 0 108.88 4213 


6902191 NASAL BONES 320 0 131.66 4213 

6902209 NAVICULAR VIEWS LT 320 0 108.88 4213 

6902217 NAVICULAR VIEWS RT 320 0 108.88 4213 


6902233 ORBITS 320 0 131.66 4213 


6902258 ORBITS WATER VIEW 320 0 108.88 4212 


6902274 RIBS BILATERAL R&L 320 0 337.32 4213 

6902282 RIBS ONE SIDE LEFT 320 0 166.73 4213 

6902290 RIBS ONE SIDE RIGHT 320 0 166.73 4213 

6902308 SACROCCYGEAL SPINE 320 0 114.32 4213 


6902324 SCAPULA LEFT 320 0 131.66 4213 

6902332 SCAPULA RIGHT 320 0 131.66 4213 

6902340 SHLDR NO TRAUMA LT 320 0 108.88 4213 

6902357 SHLDR NO TRAUMA RT 320 0 108.88 4213 

6902365 SHLDR TRAUMA LEFT 320 0 108.88 4213 

6902373 SHLDR TRAUMA RIGHT 320 0 108.88 4213 



6902407 MAMMO DIAG EXTRA VIEWS LT(PLAINFLD) 401 0 364.62 4213 

6902415 MAMMO DIAG EXTRA VIEWS RT(PLNFIELD) 401 0 364.62 4213 

6902423 MAMMO DIAG EXTRA VIEWS BILAT PLNFLD 401 0 535.08 4213 

6902431 MAMMO SCREEN DIGITAL RT PDC 403 0 284.82 4213 

6902449 MAMMO SCREEN DIGITAL LT PDC 403 0 284.82 4213 

6902456 PDC MAMMO SCREENING IMPLANTS 403 0 468.2 4213 

7000011 MRI-ABDOMEN W/O CONT PLF 610 0 1430 4273 

7000029 MRI-ABDOMEN W/CONT PLF 610 0 2299.83 4273 

7000037 MRI-ABDOMEN W/WO CON PLF 610 0 4516.22 4273 

7000045 MRI-C SPINE W/O CONT PLF 612 0 1373.37 4273 

7000052 MRI-C SPINE W CONTRA PLF 612 0 1646.07 4273 

7000060 MRI-C SPINE W/WO CON PLF 612 0 3051.54 4273 

7000078 MRI-CHEST W/O CONTR PLF 610 0 1373.37 4273 

7000086 MRI-CHEST W/CONTRAST PLF 610 0 1373.37 4273

7000094 MRI-CHEST W/WO CONTR PLF 610 0 1373.37 4273 

7000102 MRI-FACE W/O CONTRAS PLF 611 0 1352.39 4273 

7000110 MRI-FACE W/CONTRAST PLF 611 0 1622.64 4273 

7000128 MRI-FACE W/WO CONTRAST PLF 611 0 3003.41 4273 

7000136 MRI-HEAD W/O CONTRAST PLF 611 0 1373.37 4273 

7000144 MRI-HEAD W/CONTRAST PLF 611 0 1646.07 4273 

7000151 MRI-HEAD W/WO CONTRAST PLF 611 0 3051.54 4273 

7000169 MRI-IAC'S W/WO CONTRAST PLF 611 0 3051.54 4273 

7000177 MRI-IAC'S WO CONTRAST PLF 611 0 1373.37 4273 

7000185 MRI-PIT/SELLA W/WO CONT PLF 611 0 3051.54 4273 

7000193 MRI-HIP WO CONT LT PLF 610 0 1839.86 4273 

7000201 MRI-HIP WO CONT RT PLF 610 0 1839.86 4273 

7000219 MRI-HIP W&WO CON LT 610 0 3003.41 4273 

7000227 MRI-HIP W&WO CON RT PLF 610 0 3003.41 4273 

7000235 MRI-HIP W/CONT RT PLF 610 0 2299.83 4273 

7000243 MRI-HIP-W/CONT LT PLF 610 0 2299.83 4273 

7000250 MRI-LS SPINE W/O CON PLF 612 0 1523.91 4273 

7000268 MRI-LS SPINE W/CONT PLF 612 0 1646.07 4273 

7000276 MRI-LS SPINE W/WO CO PLF 612 0 3051.54 4273 

7000284 MRI MRCP PLF 610 0 1430 4273 

7000292 MRI-NECK W/O CONTRAST PLF 611 0 1352.39 4273 

7000300 MRI-NECK W/CONTRAST PLF 611 0 3003.41 4273 

7000318 MRI-NECK W W/O CONTRAST PLF 611 0 1622.64 4273 

7000326 MRI-ORBITS W/O CONTRAST PLF 611 0 1352.39 4273 

7000334 MRI-ORBITS W/ CONTRAST PLF 611 0 1622.64 4273 

7000342 MRI-ORBITS W W/O CONT PLF 611 0 3003.41 4273 

7000359 MRI-PELVIS W/O CONT PLF 610 0 1358.58 4273 

7000367 MRI-PELVIS W/CONT PLF 610 0 1627.56 4273 

7000375 MRI-PELVIS W W/O CONT PLF 610 0 1627.56 4273 

7000383 MRI-D SPINE W/O CONT PLF 612 0 1523.91 4273 

7000391 MRI-D SPINE W / CONT PLF 612 0 1523.91 4273 

7000409 MRI-D SPINE W W/O CON PLF 612 0 3051.54 4273 

7000417 MRI-TMJ BILAT PLF 610 0 1373.37 4273 

7000425 MRI-TMJ UNILAT LT PLF 610 0 1373.37 4273 

7000433 MRI-TMJ UNILAT RT PLF 610 0 1373.37 4273 

7000441 MRI-SHLDR W/O CON LT PLF 610 0 1839.86 4273 

7000458 MRI-SHLDR WO CON RT PLF 610 0 1839.86 4273 

7000466 MRI-SHLDR W CON LT PLF 610 0 2299.83 4273 

7000474 MRI-SHLDR W CON RT PLF 610 0 2299.83 4273 

7000482 MRI-SHLDR W W/O CON LT PLF 610 0 3003.41 4273 

7000490 MRI-SHLDR W W/O CONT RT PLF 610 0 3003.41 4273 

7000524 MRI-KNEE WO CONT LT PLF 610 0 1839.86 4273 

7000532 MRI-KNEE WO CON RT PLF 610 0 1839.86 4273 

7000540 MRI-KNEE W CONT LT PLF 610 0 2299.83 4273 

7000557 MRI-KNEE W CONT RT PLF 610 0 2299.83 4273 

7000565 MRI-KNEE W W/O CONT PLF 610 0 3003.41 4273 

7000573 MRI-KNEE W W/O CONT RT PLF 610 0 3003.41 4273

7000581 MRI-WRIST WO CON LT PLF 610 0 1839.86 4273 

7000599 MRI-WRIST WO CON RT PLF 610 0 1839.86 4273 

7000607 MRI-WRIST W CON LT PLF 610 0 2299.83 4273 

7000615 MRI-WRIST W CON RT PLF 610 0 2299.83 4273 

7000623 MRI-WRIST W/WO CO LT PLF 610 0 3003.41 4273 

7000631 MRI-WRIST W/WO CO RT PLF 610 0 3003.41 4273 

7000649 MRI-ELBOW W0 CON LT PLF 610 0 1839.86 4273 

7000656 MRI-ELBOW WO CON RT PLF 610 0 1839.86 4273 

7000664 MRI-ELBOW W CON LT PLF 610 0 2299.83 4273 

7000672 MRI-ELBOW W CON RT PLF 610 0 2299.83 4273 

7000680 MRI-ELBOW W/WO CO LT PLF 610 0 3003.41 4273 

7000698 MRI-ELBOW W/WO CO RT PLF 610 0 3003.41 4273 

7000706 MRI-UPEX NO JT WO LT PLF 610 0 1352.39 4273 

7000714 MRI-UPEX NO JT WO RT PLF 610 0 1352.39 4273 

7000722 MRI-UP EX NO JT W-LT PLF 610 0 1622.64 4273 

7000730 MRI-UP EX NO JT W-RT PLF 610 0 1622.64 4273 

7000748 MRI-UPEX NOJT W/WO LT PLF 610 0 3003.41 4273 

7000755 MRI-UPEX NOJT W/WO RT PLF 610 0 3003.41 4273 

7000763 MRI-BREASTS W/WO CON PLF 610 0 4018.46 4273 

7000771 MRI-BRST UNI W/WO LT PLF 610 0 3187.11 4273 

7000789 MRI-BRST-UNI W/WO RT PLF 610 0 3187.11 4273 

7000797 MRI-MAMMO-CAD 610 0 59.8 4273 

7000805 MRI BREASTS W/O CON PLF 610 0 3226.24 4273 

7000813 MRI PIT/SELLA W/O CONTRAST PLF 610 0 1373.37 4273 

7000854 MRI-LOEX NO JT WO-LT PLF 610 0 1839.86 4273 

7000862 MRI-LOEX NO JT WO-RT PLF 610 0 1839.86 4273 

7000870 MRI-LO EX NO JT W-LT PLF 610 0 1622.64 4273 

7000888 MRI-LO EX NO JT-W-RT PLF 610 0 1622.64 4273 

7000896 MRI-UPEX NOJT W/WO-LT PLF 610 0 3003.41 4273 

7000904 MRI-UPEX NOJT W/WO-RT PLF 610 0 3003.41 4273 

7000912 MRI-ANKLE WO CON-LT PLF 610 0 1839.86 4273 

7000920 MRI-ANKLE WO CON-RT PLF 610 0 1839.86 4273 

7000938 MRI-ANKLE W CONT-LT PLF 610 0 2299.83 4273 

7000946 MRI-ANKLE W CONT-RT PLF 610 0 2299.83 4273 

7000953 MRI-ANKLE W/WO CO-LT PLF 610 0 3003.41 4273 

7000961 MRI-ANKLE W/WO CO-RT PLF 610 0 3003.41 4273 

7000979 MRI-UPEXT JOINT W/CON LT PLF 610 0 2299.83 4273 

7000987 MRI-UPEXT JNT W/CON RT PLF 610 0 2299.83 4273 

7000995 MRI-UPEXT JOINT W/O CON LT PLF 610 0 1839.86 4273 

7001001 MRI-UPEXT JOINT W/O CON RT PLF 610 0 1839.86 4273 

7001019 MRI-UPEXT W/WO CON LT PLF 610 0 3003.41 4273 

7001027 MRI-UPEXT W/WO CON RT PLF 610 0 3003.41 4273 

7001035 MRI-LOEX NO JT WO LT PLF 610 0 1839.86 4273 

7001043 MRI-LOEX NO JT WO RT-PLF 610 0 1839.86 4273 

7001050 MRI-LOEX NO JT W LT-PLF 610 0 2299.83 4273 

7001068 MRI-LOEX NO JT W RT-PLF 610 0 2299.83 4273 

7001076 MRI-LOEX NO JT W/WO LT-PLF 610 0 3003.41 4273

7001084 MRI-LOEX NO JT W/WO RT-PLF 610 0 3003.41 4273 

7002009 MRA-LO EX W/WO CO-LT PLF 616 0 2060.06 4273 

7002017 MRA-LO EX W/WO CO-RT PLF 616 0 2060.06 4273 

7002025 MRA-LOWER EXT W/WO BILAT PLF 616 0 3190.4 4273 

7002033 MRA-UP EX W/WO CO-LT PLF 618 0 775.62 4273 

7002041 MRA-UP EX W/WO CO-RT PLF 618 0 775.62 4273 

7002058 MRA-CHEST W/WO CONTR PLF 618 0 1897.94 4273 

7002066 MRA-HEAD W/O CONTR PLF 615 0 1373.37 4273 

7002074 MRA-HEAD W/CONTRAST PLF 615 0 1373.37 4273 

7002082 MRA-HEAD W/WO CONTR PLF 615 0 2687.53 4273 

7002090 MRA-NECK W/O CONTR PLF 615 0 1373.37 4273 

7002108 MRA-NECK W/WO CONTR PLF 615 0 2687.53 4273 

7002116 MRA-AB W/WO CONTRAST PLF 618 0 2536.31 4273 

7002124 MRA-PELVIS W/WO CONT PLF 610 0 1373.37 4273 

7500010 VIT A & D OINTMENT 250 0 0 4300 

7500028 ZYPREXA 5MG ODT TAB LN 250 0 0 4300 

7500036 ACEBUTOLOL HCL 200 M CAP 250 0 0 4300 

7500044 ACETAZOLAMIDE SODIUM 500 MG VIAL 636 0 0 4300 

7500051 ACETAZOLAMIDE 250 MG TAB 250 0 0 4300 

7500069 GLUCOPHAGE 500MG.XR SR TAB 250 0 0 4300 

7500077 PROTONIX 40MG I.V. VIAL 250 0 0 4300 

7500085 OXAZEPAM 10MG. CAP 250 0 0 4300 

7500093 ACETAMINOPHEN 160 MG SUSP 250 0 0 4300 

7500101 DUONEB 3ML U.D. SOLN 250 0 0 4300 

7500119 POLYCITRA PACKETS 250 0 0 4300 

7500127 ACETIC ACID 1000CC IRRIG 250 0 0 4300 

7500135 BETHANECHOL CHLORIDE 10 MG TAB 250 0 0 4300 

7500143 ACETAMINOPHEN 325 MG SUPP 250 0 0 4300 



7500176 ACETAMINOPHEN 500 MG TAB 250 0 0 4300 

7500184 ACETAMINOPHEN 325 MG TAB 250 0 0 4300 

7500192 ACETYLCYSTEINE 200 M 20% 6GM VIAL 250 0 0 4300 

7500200 ACETONE LIQUID 250 0 0 4300 

7500218 ACETYLCHOLINE CHLORI 30 MG/30ML KIT 250 0 0 4300 

7500226 SODIUM PHOSPHATE VIAL 250 0 0 4300 

7500234 PECTIN/ACIDOPHILUS CAP 250 0 0 4300 

7500242 ACYCLOVIR 200 MG CAP 250 0 0 4300 

7500259 ACYCLOVIR 0 OINTMENT 250 0 0 4300 

7500267 ACYCLOVIR SODIUM 500 VIAL 636 0 0 4300 

7500275 ALBUTEROL SULFATE 4 T SR 12 250 0 0 4300 

7500283 ALBUTEROL SULFATE 2 TAB 250 0 0 4300 

7500291 ALBUTEROL SULFATE 2 SYRUP 250 0 0 4300 

7500309 ALBUTEROL SO4 U.D. SOLN 636 0 0 4300 

7500317 ALBUTEROL 90 MCG AER 250 0 0 4300 

7500325 ADENOSINE 6 MG/2ML VL 636 0 0 4300 

7500333 ISOPROPYL ALCOHOL 0 SOLN 250 0 0 4300

7500341 ROCALTROL .25MCG CAP 250 0 0 4300 

7500358 ALLOPURINOL 300 MG TAB 250 0 0 4300 

7500366 ALLOPURINOL 100 MG TAB 250 0 0 4300 

7500374 VITAMIN E 50 U DROPS 250 0 0 4300 

7500382 ALPRAZOLAM 0.5 MG TAB 250 0 0 4300 

7500390 ALPRAZOLAM 0.25 MG TAB 250 0 0 4300 

7500408 ALPRAZOLAM 1 MG TAB 250 0 0 4300 

7500416 OLANZAPINE 10MG. ODT TAB LN 250 0 0 4300 

7500424 ATOVAQUONE 5ML SUSP 250 0 0 4300 

7500432 ALBUTEROL SOL 20ML SOLN 250 0 0 4300 

7500440 MAG CARB/AL HYDROX/A SUSP 250 0 0 4300 

7500457 CALCIUM ACETATE/AL PACKET 250 0 0 4300 

7500465 ACAMPROSATE 333MG. EC TAB 250 0 0 4300 

7500473 AMANTADINE HCL 100 M CAP 250 0 0 4300 

7500481 AMINOCAPROIC ACID 25 VIAL 250 0 0 4300 

7500499 AMINOCAPROIC 500MG TAB 250 0 0 4300 

7500507 AMINOPHYLLINE 250 MG VIAL 636 0 0 4300 

7500515 AMITRIPTYLINE HCL 25 TAB 250 0 0 4300 



7500549 AMMONIA AMP 250 0 0 4300 

7500556 AMOXICILLIN TRIHYDRA CAP 250 0 0 4300 

7500564 AMOXICILLIN TRIHYDRA SUS REC 250 0 0 4300 

7500572 AMOXICILLIN TRIHYDRA SUS REC 250 0 0 4300 

7500580 AMOXICILLIN TRIHYDRA CAP 250 0 0 4300 

7500598 BSS EYE SOLUTION 15ML SOLN 250 0 0 4300 

7500606 AMPHOTERICIN B 50 MG VIAL 636 0 0 4300 

7500614 XOPENEX 0.63/3ML VIAL 250 0 0 4300 

7500622 AMPICILLIN TRIHYDRAT SUS REC 250 0 0 4300 

7500630 XOPENEX 1.25/3ML SOLN 250 0 0 4300 

7500648 AMPICILLIN SODIUM 50 MG VIAL 636 0 0 4300 

7500655 AMPICILLIN SODIUM 1 GM ADDV 636 0 0 4300 

7500663 AMPICILLIN TRIHYDRAT CAP 250 0 0 4300 

7500671 AMPICILLIN SODIUM 25 VIAL 636 0 0 4300 

7500689 AMPICILLIN SODIUM 2 GM ADDV 636 0 0 4300 

7500697 AMPICILLIN SODIUM 1 GM VIAL 636 0 0 4300 

7500705 AMPICILLIN SODIUM 125MG VIAL 636 0 0 4300 

7500713 AMPICILLIN SODIUM 2 GM VIAL 636 0 0 4300 

7500721 HYDROCORTISONE ACETA SUPP 250 0 0 4300 

7500739 PRAM HC/BALSAM/ZNOX/ OINT 250 0 0 4300 

7500747 RESOR/BALSAM/BIS SG/ SUPP 250 0 0 4300 

7500754 ABILIFY 15MG. TAB 250 0 0 4300 

7500762 ASCORBIC ACID 500 MG TAB 250 0 0 4300 

7500770 ABILIFY 5MG. TAB 250 0 0 4300 

7500788 ASPIRIN 300 MG SUPP 250 0 0 4300 

7500796 ASPIRIN 600 MG SUPP 250 0 0 4300 

7500804 ASPIRIN 325 MG ECTAB 250 0 0 4300

7500820 ASPIRIN 325 MG TAB 250 0 0 4300 

7500838 ATENOLOL 50 MG TAB 250 0 0 4300 

7500846 PILOCARPINE HCL 0 DROPS 250 0 0 4300 

7500853 ATROPINE SULFATE 0 OINT 250 0 0 4300 

7500861 ACET/COD #2 TAB 250 0 0 4300 

7500879 ANASTRAZOLE 1MG. TAB 250 0 0 4300 

7500887 ATROPINE SULFATE 0 DROPS 250 0 0 4300 

7500895 ATROPINE SULFATE 0.1 SYRINGE 636 0 0 4300 

7500903 AMOX TR/POTASSIUM CL SUS REC 250 0 0 4300 

7500911 AMOX TR/POTASSIUM CL TAB 250 0 0 4300 

7500929 AMOX TR/POTASSIUM CL SUS REC 250 0 0 4300 

7500937 ANTIPYRINE/BENZOCAIN DROPS 250 0 0 4300 

7500945 BACITRACIN OINT U.D. PACKET 250 0 0 4300 

7500960 BACITRACIN ZINC 500 OINT 250 0 0 4300 

7500978 BACLOFEN 10 MG TAB 250 0 0 4300 

7500986 BECLOMETHASONE DIPRO SPRAY 250 0 0 4300 

7500994 METHYL SALICYLATE/ME OINT 250 0 0 4300 

7501000 BENZOIN COMPOUND TINCT 250 0 0 4300 

7501018 BENZONATATE 100 MG CAP 250 0 0 4300 

7501026 BENZTROPINE MESYLATE 2 MG AMP 636 0 0 4300 

7501034 BENZTROPINE MESYLATE 1 MG TAB 250 0 0 4300 

7501042 BETAMET ACET/BETAMET 6 MG VIAL 636 0 0 4300 

7501059 BETAMETHASONE VALERA CREAM 250 0 0 4300 

7501067 BETAMETHASONE VALERA OINT 250 0 0 4300 

7501075 BETAMETHASONE VALERA OINT 250 0 0 4300 

7501083 BETAXOLOL HCL 0 DROPS 250 0 0 4300 

7501091 BETAMETHASONE VALERA CREAM 250 0 0 4300 

7501109 BISACODYL 5 MG EC TAB 250 0 0 4300 

7501117 BISACODYL 10 MG SUPP 250 0 0 4300 

7501125 ANTIVENIN LACTRODECT BOX KIT 250 0 0 4300 

7501133 LUMIGAN EYE DROPS DROPS 250 0 0 4300 

7501141 SOD/POTASS/CAL/MAGNE SOLN 250 0 0 4300 

7501158 BROMOCRIPTINE MESYLA TAB 250 0 0 4300 

7501166 PULMICORT 0.25 INH 250 0 0 4300 

7501174 RHINOCORT AQUA 8.6GM SPRAY 250 0 0 4300 

7501182 BUMETANIDE 0.5 MG TAB 250 0 0 4300 

7501190 PULMICORT 0.25MG/2ML INH 250 0 0 4300 

7501208 BUMETANIDE 0.25 MG VIAL 250 0 0 4300 

7501216 BUPIVACAINE HCL 5 MG VIAL 250 0 0 4300 

7501224 BUPIVACAINE HCL 2.5 VIAL 250 0 0 4300 

7501232 BUPIVACAINE HCL 7.5 VIAL 250 0 0 4300 

7501240 BUPIVACAINE HCL 5 MG VIAL 250 0 0 4300 

7501257 BUPIVACAINE HCL/EPIN VIAL 250 0 0 4300 

7501265 BUPIVACAINE.25% 50ML VIAL 250 0 0 4300 

7501273 BUSPIRONE HCL 10 MG TAB 250 0 0 4300 

7501281 BUSPIRONE HCL 5 MG TAB 250 0 0 4300 

7501299 BUMETANIDE 1MG. TAB 250 0 0 4300

7501307 CALCIUM CHLORIDE 100 VIAL 250 0 0 4300 

7501315 CANDESARTAN 4MG. TAB 250 0 0 4300 

7501323 CALCIUM CARBONATE 50 CHWTAB 250 0 0 4300 

7501331 CANDESARTAN 16MG. TAB 250 0 0 4300 

7501356 CAPSAICIN 0 CREAM 250 0 0 4300 

7501364 CAPTOPRIL 25 MG TAB 250 0 0 4300 

7501372 CAPTOPRIL 50 MG TAB 250 0 0 4300 

7501380 CAPTOPRIL 12.5 MG TAB 250 0 0 4300 

7501398 CARBAMAZEPINE 200 MG TAB 250 0 0 4300 

7501406 CARBAMAZEPINE 100 MG CHWTAB 250 0 0 4300 

7501414 CARB/LEVO 25-100 ER SR TAB 250 0 0 4300 

7501422 CARBIDOPA/LEVODOPA 0 TAB 250 0 0 4300 



7501455 CARBACHOL .15 ML VIAL 250 0 0 4300 

7501471 CARISOPRODOL 350 MG TAB 250 0 0 4300 

7501489 CEFAZOLIN SODIUM 1 G VIAL 636 0 0 4300 

7501497 CEFAZOLIN SODIUM/D5W 1 GM IVPB 636 0 0 4300 

7501505 CEFAZOLIN 1GM ADV. ADDV 636 0 0 4300 

7501513 CEFOTAXIME SODIUM 2 GM VIAL 636 0 0 4300 

7501521 CEFOTAXIME SODIUM 1 GM VIAL 636 0 0 4300 

7501539 CEFOTETAN DISODIUM 2 GM VIAL 250 0 0 4300 

7501547 CEFOTETAN DISODIUM 1GM VIAL 250 0 0 4300 

7501554 CEFOTETAN 1GM PREMIX FZ PBCK 250 0 0 4300 

7501562 CEFTRIAXONE SODIUM 500 MG VIAL 636 0 0 4300 

7501570 CEFTRIAXONE SODIUM 1 GM VIAL 636 0 0 4300 

7501588 CEFTRIAXONE SODIUM 2 GM VIAL 636 0 0 4300 

7501596 CEFUROXIME AXETIL TAB 250 0 0 4300 

7501604 CEFOXITIN 1GM VIAL 636 0 0 4300 

7501612 CELECOXIB 200MG. CAP 250 0 0 4300 

7501620 CEPHALEXIN MONOHYDRA CAP 250 0 0 4300 

7501638 CEPHALEXIN MONOHYDRA CAP 250 0 0 4300 

7501646 CEFTRIAXONE 1GM ADV. TAB 636 0 0 4300 

7501653 CEFTRIAXONE 1GM ADDV 636 0 0 4300 

7501661 CEFTRIAXONE 2GM ADV. 636 0 0 4300 

7501679 CHARCOAL/SORBITOL SO SUSP 250 0 0 4300 

7501687 ACTIVATED CHARCOAL 5 SUSP 250 0 0 4300 

7501695 DUOVISC KIT 250 0 0 4300 

7501703 CHLORAMBUCIL 2 MG TAB 250 0 0 4300 

7501711 CHLORAL HYDRATE 500 SYRUP 250 0 0 4300 

7501729 CHLORDIAZEPOXIDE HCL CAP 250 0 0 4300 

7501737 CHLORDIAZEPOXIDE HCL CAP 250 0 0 4300 

7501745 CHLOROPROCAINE HCL 20 ML VIAL 636 0 0 4300 

7501752 CHLORPROMAZINE HCL 25 MG INJ 636 0 0 4300 

7501760 CHLORPROMAZINE HCL 50 MG INJ 636 0 0 4300 

7501778 CHLORPROMAZINE HCL 25MG TAB 636 0 0 4300 

7501786 CHLOROPROCAINE 3% 20 ML VIAL 636 0 0 4300

7501794 CHOLESTYRAMINE/SUCRO PACKET 250 0 0 4300 

7501802 CHLOROTHIAZIDE 500MG VIAL 636 0 0 4300 

7501810 CHOL SAL/MAGNESIUM S TAB 250 0 0 4300 

7501828 CILOSTAZOL 100MG. TAB 250 0 0 4300 

7501836 CIPROFLOXACIN HCL 25 TAB 250 0 0 4300 

7501844 CLINDAMYCIN PHOSPHAT VIAL 250 0 0 4300 



7501877 CLINDAMYCIN HCL 150 CAP 250 0 0 4300 

7501885 CLONAZEPAM 0.5 MG TAB 250 0 0 4300 

7501893 CLONAZEPAM 1 MG TAB 250 0 0 4300 

7501901 CLONIDINE HCL 0.3 MG PAT TDW 250 0 0 4300 

7501919 CLONIDINE HCL 0.1 MG TAB 250 0 0 4300 



7501943 CLORAZEPATE DIPOTASS TAB 250 0 0 4300 

7501950 CLOTRIMAZOLE/BETAMET CREAM 250 0 0 4300 

7501968 CLOTRIMAZOLE 0 CREAM 250 0 0 4300 

7501976 CLOTRIMAZOLE 10 MG TROCHE 250 0 0 4300 

7501984 COCAINE HCL 0 SOLN 250 0 0 4300 

7501992 CODEINE SULFATE 15 M TAB 250 0 0 4300 

7502016 COLCHICINE 0.6 MG TAB 250 0 0 4300 

7502024 COLLODION LIQUID 250 0 0 4300 

7502032 HELITENE 1GM. EACH 250 0 0 4300 

7502057 CORTISONE 25MG. TAB 250 0 0 4300 

7502065 COLESTID 1GM. TAB 250 0 0 4300 

7502073 NEOMY SULF/GRAMICID DROPS 250 0 0 4300 

7502081 NEOMY SULF/POLYMYX B DROPS 250 0 0 4300 

7502099 COSYNTROPIN 0.25 MG VIAL 636 0 0 4300 

7502107 CROMOLYN SODIUM 20 M INH 250 0 0 4300 

7502115 SOD THIOSULF/SOD NIT KIT 250 0 0 4300 

7502123 CYANOCOBALAMIN 1000 VIAL 636 0 0 4300 

7502131 RESTASIS DROPPER 258 0 0 4300 

7502149 CYCLOBENZAPRINE HCL TAB 250 0 0 4300 

7502156 CYCLOPENTOLATE HCL 0 DROP 250 0 0 4300 

7502164 DAPSONE 25 MG TAB 250 0 0 4300 

7502172 DANTROLENE SODIUM 20 VIAL 250 0 0 4300 

7502180 DANTROLENE SODIUM 25 CAP 250 0 0 4300 

7502198 CARBAMIDE PEROXIDE 0 DROPS 250 0 0 4300 

7502206 BENZOCAINE/LANOLIN/A AER 250 0 0 4300 

7502214 DEFEROXAMINE MESYLAT VIAL 636 0 0 4300 

7502222 DESIPRAMINE HCL 10 M TAB 250 0 0 4300 

7502230 DESIPRAMINE HCL 25 M TAB 250 0 0 4300 

7502248 DESMOPRESSIN ACETATE AMP 636 0 0 4300 

7502255 DEXAMETHASONE 2MG. TABS 636 0 0 4300 

7502263 DEXAMETHASONE 0.5 MG TAB 636 0 0 4300 

7502271 DEXAMETHASONE 4 MG TAB 636 0 0 4300

7502289 DEXAMETHASONE SOD PH 4 MG VIAL 636 0 0 4300 


7502305 DEXAMETHASONE10MG/ML VIAL 636 0 0 4300 

7502313 DEXTROSE 50%-WATER 0 SYRINGE 250 0 0 4300 

7502321 DIAZEPAM 5 MG TAB 250 0 0 4300 

7502339 DIAZEPAM 2 MG TAB 250 0 0 4300 

7502347 DIAZEPAM 5 MG SYRINGE 636 0 0 4300 

7502354 DIAZOXIDE 300 MG INJ 636 0 0 4300 

7502362 DIBUCAINE 1 APPL OINT 250 0 0 4300 

7502370 DICLOFENAC SODIUM 50 TAB 250 0 0 4300 

7502388 DICLOFENAC SODIUM 75 TAB 250 0 0 4300 

7502396 DICLOXACILLIN SODIUM CAP 250 0 0 4300 

7502404 DICYCLOMINE HCL 10 M CAP 250 0 0 4300 

7502412 DIGOXIN 2.5ML SOL 250 0 0 4300 

7502420 DIGOXIN IMMUNE FAB 3 VIAL 250 0 0 4300 

7502438 DIGOXIN 250 MCG TAB 250 0 0 4300 

7502446 DIGOXIN 250 MCG INJ 636 0 0 4300 

7502461 DIGOXIN 125 MCG TAB 250 0 0 4300 

7502479 DILTIAZEM HCL 30 MG TAB 250 0 0 4300 

7502487 DILTIAZEM HCL 60 MG TAB 250 0 0 4300 

7502495 DIMENHYDRINATE 50 MG TAB 250 0 0 4300 

7502503 DIMETHYL SULFOXIDE SOLN 250 0 0 4300 

7502511 DINOPROSTONE 20 MG SUPVAG 250 0 0 4300 

7502529 DIPHENHYDRAMINE HCL VIAL 636 0 0 4300 

7502537 DIPHENHYDRAMINE HCL CAP 636 0 0 4300 

7502545 DIPHENHYDRAMINE HCL CREAM 250 0 0 4300 

7502552 DIPHENHYDRAMINE HCL CAP 636 0 0 4300 

7502560 DIPIVEFRIN HCL 0 DROPS 250 0 0 4300 

7502578 DIPYRIDAMOLE 25 MG TAB 250 0 0 4300 

7502586 DISOPYRAMIDE PHOSPHA SR CAPS 250 0 0 4300 

7502594 DISOPYRAMIDE PHOSPHA SR CAPS 250 0 0 4300 

7502602 DOBUTAMINE HCL 12.5 VIAL 636 0 0 4300 

7502610 DOCUSATE SODIUM 250 CAP 250 0 0 4300 

7502628 DOCUSATE SODIUM 100 CAP 250 0 0 4300 

7502636 BELLADONNA ALKALOIDS ELIXIR 250 0 0 4300 

7502644 BELLADONNA ALKALOIDS TAB 250 0 0 4300 

7502651 ANTISPASMODIC 5ML ELIXIR 250 0 0 4300 

7502669 DOPAMINE HCL 40 MG VIAL 636 0 0 4300 

7502677 DOPAMINE HCL/DEXTROS PREMIX 636 0 0 4300 

7502685 DOPAMINE 200MG/250ML PREMIX 636 0 0 4300 

7502693 DOXEPIN HCL 25 MG CAP 637 0 0 4300 



7502727 XIGRIS 5MG. VIAL 250 0 0 4300 

7502735 XIGRIS 20MG. VIAL 250 0 0 4300 

7502743 DOXYCYCLINE HYCLATE VIAL 250 0 0 4300 

7502750 DOXYCYCLINE HYCLATE TAB 250 0 0 4300

7502768 DULOXETINE 30MG. CAP EC 250 0 0 4300 

7502776 DULOXETINE 20MG. CAP EC 250 0 0 4300 

7502784 ERYTHROMYCIN ETHYL SUSP 250 0 0 4300 

7502792 ERYTHROMYCIN ETHYLSU TAB 250 0 0 4300 

7502800 ENALAPRIL 2.5 MG TAB 250 0 0 4300 

7502818 ENALAPRIL MALEATE 20 TAB 250 0 0 4300 

7502826 ENALAPRIL MALEATE 5 TBA 250 0 0 4300 

7502834 ENALAPRIL MALEATE 10 TAB 250 0 0 4300 

7502842 ENOXAPARIN 100MG 1ML SYRINGE 636 0 0 4300 

7502859 ENOXAPARIN 80MG. SYRINGE 636 0 0 4300 



7502883 EPINEPHRINE 0.1 MG 1ML SYRINGE 636 0 0 4300 

7502891 EPINEPHRINE 1 MG INJ 636 0 0 4300 

7502909 EPINEPHRINE 30ML MDV VIAL 636 0 0 4300 

7502917 EPINEPHRINE 11.25 MG NEB 250 0 0 4300 

7502925 EPINEPHRINE 0 SOLN 250 0 0 4300 

7502933 INVANZ 1GM. VIAL 636 0 0 4300 

7502941 ERYTHROMYCIN LACTOBI 500 MG VIAL 636 0 0 4300 

7502958 ERYTHROMYCIN LACTOBI 500 MG ADDV 636 0 0 4300 

7502974 ERYTHROMYCIN BASE 33 ECTAB 250 0 0 4300 

7502982 ERYTHROMYCIN BASE 33 ECTAB 250 0 0 4300 

7502990 ESTRADIOL 1 MG TAB 250 0 0 4300 

7503006 ERYTHROMYCIN BASE 25 TAB 250 0 0 4300 

7503014 ENALAPRIL 1.25MG/ML VIAL 250 0 0 4300 

7503022 ERYTH EYE OINT. 250 0 0 4300 

7503048 ESMOLOL HCL 10 MG VIAL 250 0 0 4300 

7503055 ESTRADIOL CYPIONATE 25 MG VIAL 636 0 0 4300 

7503063 ESTROGENS CONJUGATED TAB 250 0 0 4300 


7503089 ESTROGENS CONJUGATED VIAL 636 0 0 4300 

7503097 ETHACRYNIC ACID 50 M TAB 250 0 0 4300 

7503105 ETHACRYNATE SODIUM 5 VIAL 250 0 0 4300 

7503113 ESOMEPRAZOLE INJ. VIAL 250 0 0 4300 

7503121 ETHYL CHLORIDE SPRAY 250 0 0 4300 

7503139 LEXAPRO 10MG TAB 250 0 0 4300 

7503147 EZETIMIBE 10MG. TAB 250 0 0 4300 

7503154 ESMOLOL RTU 250ML PREMIX 250 0 0 4300 

7503162 FAMOTIDINE 20 MG TAB 250 0 0 4300 

7503170 FENT/ROPIV EPIDURAL INJBAG 250 0 0 4300 

7503188 FENTANYL CITRATE 0.0 INJ 636 0 0 4300 

7503196 FENTANYL CITRATE 250 MCG AMP INJ 636 0 0 4300 

7503204 FERRIC SUBSULFATE SOLN 250 0 0 4300 

7503212 SLOW FE 160MG. SR TAB 250 0 0 4300 

7503220 FERROUS SULFATE 325 TAB 250 0 0 4300 

7503238 TRICOR 48MG. TAB 250 0 0 4300 

7503246 ACETAMINOPHEN/CAFFEI TAB 250 0 0 4300

7503253 ASPIRIN/CAFFEINE/BUT CAP 250 0 0 4300 

7503279 FLUNISOLIDE 0 SPRAY 250 0 0 4300 

7503287 FLUCYTOSINE 250MG. CAP 250 0 0 4300 

7503303 FLUOXETINE 5ML U.D. SOLN 250 0 0 4300 

7503311 FLUOXETINE HCL 20 MG CAP 250 0 0 4300 

7503329 FLUPHENAZINE HCL 2.5 TAB 250 0 0 4300 

7503337 FLUPHENAZINE HCL 2.5 VIAL 250 0 0 4300 

7503345 FLUPHENAZINE HCL 5 M TAB 250 0 0 4300 

7503352 FLUPHENAZINE DECANOA VIAL 636 0 0 4300 

7503360 FLOVENT HFA 44MCG. AER 250 0 0 4300 



7503394 FLURBIPROFEN SODIUM DROPS 250 0 0 4300 

7503402 FOLIC ACID 5 MG VIAL 250 0 0 4300 

7503410 FOLIC ACID 1 MG TAB 250 0 0 4300 

7503428 FUROSEMIDE 20 MG TAB 250 0 0 4300 

7503436 FUROSEMIDE 10 MG VIAL 636 0 0 4300 





7503485 FUROSEMIDE 10 MG SOLN 250 0 0 4300 

7503493 FONDAPARINUX 2.5MG SYRINGE 636 0 0 4300 

7503501 GEMFIBROZIL 600 MG TAB 250 0 0 4300 

7503519 GENTAMICIN SULFATE 0 DROPS 250 0 0 4300 

7503527 GENTAMICIN SULFATE 0 OINT 250 0 0 4300 

7503535 GENTAMICIN SULFATE 1 VIAL 636 0 0 4300 

7503543 GENTAMICIN SULFATE 0 CREAM 250 0 0 4300 

7503550 GENTAMICIN SULFATE 4 VIAL 636 0 0 4300 

7503568 GLIPIZIDE 10 MG TAB 250 0 0 4300 

7503576 GLIPIZIDE 5 MG TAB 250 0 0 4300 

7503584 COPAXONE 20 MG KIT 636 0 0 4300 

7503592 GLYBURIDE 5 MG TAB 250 0 0 4300 

7503600 GLYBURIDE 2.5 MG TAB 250 0 0 4300 

7503618 GLYCERIN 0 SUSP 250 0 0 4300 

7503626 GLYCERIN ADULT SUPP 250 0 0 4300 

7503634 GLYCOPYRROLATE 0.2 M VIAL 250 0 0 4300 

7503642 GUAIFENESIN 200 MG SYRUP 637 0 0 4300 

7503659 GUAIFENESIN S.F. SYRUP 637 0 0 4300 

7503667 GUAIFEN/COD 10ML SYRUP 637 0 0 4300 

7503675 HALOPERIDOL ORAL 5ML PO CON 637 0 0 4300 

7503683 ACTHIB VIAL 250 0 0 4300 

7503691 HALOPERIDOL 2 MG TAB 250 0 0 4300 

7503709 HALOPERIDOL 0.5 MG TAB 250 0 0 4300 

7503717 HALOPERIDOL DECANOAT VIAL 636 0 0 4300 

7503725 HALOPERIDOL 5 MG TAB 250 0 0 4300 

7503733 HALOPERIDOL 1 MG TAB 250 0 0 4300

7503741 HALOPERIDOL LACTATE VIAL 636 0 0 4300 

7503758 HYDROCHLOROTHIAZIDE TAB 250 0 0 4300 

7503766 HEPARIN SODIUM PORCI 1000U 1 ML VL 636 0 0 4300 

7503774 HEPARIN SODIUM PORCI 10000U VIAL 636 0 0 4300 

7503782 HEPARIN SODIUM PORCI 5000U VIAL 636 0 0 4300 

7503790 HEPARIN SODIUM PORCI 100U/10ML VIAL 636 0 0 4300 

7503808 HEP-LOCK 10U/1ML VIAL 636 0 0 4300 

7503816 HEPARIN SODIUM PORCI 1000U/10ML VL 636 0 0 4300 

7503824 HEPATITIS B IMMUNE G 1 ML VIAL 636 0 0 4300 

7503832 HEP B VIR VACC RECOM VIAL 250 0 0 4300 

7503840 HEP B VIR VACC RECOM SYRINGE 250 0 0 4300 

7503857 HEALON 5 SYRINGE 250 0 0 4300 

7503865 HYDRALAZINE HCL 10 M TAB 250 0 0 4300 

7503873 HYDRALAZINE HCL 20 M VIAL 636 0 0 4300 

7503881 HYDRALAZINE HCL 25 M TAB 250 0 0 4300 

7503899 HYDROCORTISONE 0 CREAM 250 0 0 4300 

7503907 HYDROCORTISONE 0 OINT 250 0 0 4300 

7503915 HYDROCORTISONE 0 CREAM 250 0 0 4300 

7503923 HYDROCORTISONE VALER CREAM 250 0 0 4300 

7503931 HYDROCORTISONE SOD S VIAL 636 0 0 4300 

7503949 HYDROCORTISONE 0 OINT 250 0 0 4300 

7503956 HYDROCOD BIT/HOMATRO SYRUP 250 0 0 4300 

7503964 HYDROCORTISONE SOD S 500 MG VIAL 636 0 0 4300 

7503972 HYDROGEN PEROXIDE 0 SOLN 250 0 0 4300 

7503980 HYDROMORPHONE HCL 2 TAB 250 0 0 4300 

7503998 HYDROMORPHONE HCL 2 MG VIAL 636 0 0 4300 

7504004 HYDROMORPH HP 50MG INJ 636 0 0 4300 

7504012 HYDROXYZINE HCL 10 MG TAB 250 0 0 4300 

7504020 HYDROXYUREA 500 MG CAP 250 0 0 4300 

7504038 HYDROXYZINE HCL 25 M TAB 250 0 0 4300 

7504046 HYDROXYZINE HCL 50 M TAB 250 0 0 4300 

7504053 HYDROXYCHLOROQUINE S TAB 250 0 0 4300 

7504061 NABUMETONE 500 MG TAB 250 0 0 4300 

7504079 IBUPROFEN 600 MG TAB 250 0 0 4300 



7504103 IC-GREEN 25MG.KIT VIAL 250 0 0 4300 

7504111 IMIPRAMINE HCL 10 MG TAB 250 0 0 4300 

7504129 IMIPRAMINE HCL 25 MG TAB 250 0 0 4300 

7504137 IMMUNE GLOBULIN 3GM. VIAL 636 0 0 4300 

7504145 IBUBROFEN U.D. SUSP. 250 0 0 4300 

7504152 INDIGOTINDISULFONATE INJ 250 0 0 4300 

7504160 INDOMETHACIN SR 75MG SR CAPS 250 0 0 4300 

7504178 INDOMETHACIN 25 MG CAP 250 0 0 4300 

7504186 M.S.ELIX 5ML U.D. SOLN 250 0 0 4300 

7504202 INSULIN REGULAR HUMA VIAL 636 0 0 4300 

7504210 6NSULIN NPH HUMAN RE VIAL 636 0 0 4300

7504236 HUMALOG 75/25 VIAL 636 0 0 4300 

7504244 SPORANOX 100MG. CAP 250 0 0 4300 

7504251 POVIDONE-IODINE 0 SWAB 250 0 0 4300 

7504269 POVIDONE-IODINE 0 SOAP 250 0 0 4300 

7504277 POVIDONE-IODINE 0 SOLN 250 0 0 4300 

7504285 POTASSIUM IODIDE/IOD SOLN 250 0 0 4300 

7504293 IRON DEXTRAN COMPLEX 100MG 2ML VIAL 636 0 0 4300 

7504301 IRBESARTAN 150MG. TAB 250 0 0 4300 

7504319 IPRATROPIUM HFA AER 250 0 0 4300 

7504327 ISOFLURANE LIQUID 250 0 0 4300 

7504335 ISONIAZID 100 MG TAB 250 0 0 4300 

7504343 ISOSORBIDE DINITRATE TAB 250 0 0 4300 

7504350 ISOSORBIDE DINITRATE TAB 250 0 0 4300 

7504376 POTASSIUM CHLORIDE 1 TAB SR 250 0 0 4300 

7504384 POTASSIUM CHLORIDE 2 TAB SR 250 0 0 4300 

7504392 POTASSIUM CHLORIDE 2 250 0 0 4300 

7504400 TORADOL 10MG.TAB 250 0 0 4300 

7504418 KETOCONAZOLE 200 MG TAB 250 0 0 4300 

7504426 KEPPRA 250MG. TAB 250 0 0 4300 

7504434 LABETALOL HCL 100 MG TAB 250 0 0 4300 

7504442 LABETALOL HCL 5 MG CARPUJECT 250 0 0 4300 

7504459 LABETALOL 5MG/ML 20M VIAL 250 0 0 4300 

7504467 LANOLIN OINT 250 0 0 4300 

7504475 RHO(D) IMMUNE GLOBUL 1500U VIAL 636 0 0 4300 

7504491 LEUCOVORIN CALCIUM 5 TAB 250 0 0 4300 

7504509 LEVOTHYROXINE SODIUM TAB 250 0 0 4300 





7504558 LEVOTHYROXINE SODIUM VIAL 250 0 0 4300 

7504566 LIDOCAINE HCL 20 MG SYRINGE 250 0 0 4300 

7504574 LIDOCAINE 2% 20ML VIAL 250 0 0 4300 

7504582 LIDODERM PATCH 5% PATCH 250 0 0 4300 

7504590 LIDOCAINE 1% 50ML VIAL 250 0 0 4300 

7504608 LIDOCAINE HCL/EPINEP VIAL 250 0 0 4300 

7504616 LIDOCAINE HCL 0 JELLY 637 0 0 4300 

7504624 LIDOCAINE HCL 10 MG INJ 250 0 0 4300 

7504632 LIDOCAINE HCL/D5W 4 DRIP 250 0 0 4300 

7504640 LIDOCAINE HCL 40 MG INJ 250 0 0 4300 



7504673 LIDOCAINE HCL 20 MG VIAL 636 0 0 4300 


7504699 LIDOCAINE HCL 40 MG SOLN 250 0 0 4300 

7504707 LINDANE 0 SHAMPOO 250 0 0 4300 

7504715 LINDANE 0 LOTION 250 0 0 4300

7504723 LIDOCAINE HCL/D7.5W INJ 250 0 0 4300 

7504731 LIOTHYRONINE SODIUM TAB 250 0 0 4300 

7504749 PRINIVIL 2.5 MG TAB 250 0 0 4300 

7504756 LISINOPRIL 20 MG TAB 250 0 0 4300 



7504780 LITHIUM CARBONATE 30 TAB 250 0 0 4300 

7504798 LITHIUM CITRATE 8 ME SOLN 250 0 0 4300 

7504806 DIPHENOXYLATE HCL/AT TAB 250 0 0 4300 

7504814 LINEZOLID 600MG. TAB 250 0 0 4300 

7504822 LOPERAMIDE HCL 1 MG LIQUID 250 0 0 4300 

7504830 LOPERAMIDE HCL 2 MG CAP 250 0 0 4300 

7504848 LORAZEPAM 0.5 MG TAB 250 0 0 4300 

7504855 LORAZEPAM 2 MG VIAL 636 0 0 4300 

7504863 LORAZEPAM 2 MG TAB 250 0 0 4300 

7504871 LORAZEPAM 1 MG TAB 250 0 0 4300 

7504889 LOVASTATIN 20 MG TAB 250 0 0 4300 

7504897 MAGNESIUM SULFATE 4 VIAL 636 0 0 4300 

7504905 MAGNESIUM SULFATE CRYSTAL 250 0 0 4300 

7504913 MAGNESIUM CITRATE SOLN 250 0 0 4300 

7504921 MAGNESIUM 4GM 100ML INFUS 636 0 0 4300 

7504939 MAGNESIUM CHLORIDE 6 SR TAB 250 0 0 4300 

7504947 MANNITOL 25% VIAL 636 0 0 4300 

7504954 DEXAMETHASONE 0 DROPS 250 0 0 4300 

7504962 TRIPLE ANTI OINT U.D OINT 250 0 0 4300 

7504970 NEO/POLYMYX B SULF/D DROPS 250 0 0 4300 

7504988 NEO/POLYMYX B SULF/D OINT 250 0 0 4300 

7504996 HCTZ/TRIAMTERENE 0 TAB 250 0 0 4300 

7505001 METHYLDOPA 250 MG TAB 250 0 0 4300 

7505019 MECLIZINE HCL 12.5 M TAB 250 0 0 4300 

7505027 MECLIZINE HCL 25 MG TAB 250 0 0 4300 

7505035 MEGESTROL 10ML U.D. SUSP 250 0 0 4300 

7505043 MEGESTROL ACETATE 40 TAB 250 0 0 4300 

7505050 MELPHALAN 2 MG TAB 636 0 0 4300 

7505068 MEMANTINE 5MG. TAB 250 0 0 4300 

7505076 MEPERIDINE HCL 50 MG SYRINGE 636 0 0 4300 


7505092 MEPERIDINE HCL 100 M SYRINGE 636 0 0 4300 


7505118 MEPIVACAINE HCL 10 M VIAL 636 0 0 4300 

7505126 MEPERIDINE HCL 10 MG PCA 636 0 0 4300 

7505134 MEPERIDINE HCL 50 MG TAB 250 0 0 4300 

7505142 MELOXICAM 7.5MG TAB 250 0 0 4300 

7505159 MAALOX 30ML UD SUSP 250 0 0 4300 

7505167 MESALAMINE SUPPS 250 0 0 4300 

7505209 METHACHOLINE CHLORID VIAL 636 0 0 4300 

7505217 METHADONE HCL 5 MG TAB 250 0 0 4300

7505225 METHENAMINE 1GM TAB 250 0 0 4300 

7505233 METHOCARBAMOL 500 MG TAB 250 0 0 4300 

7505241 METHOTREXATE SODIUM 2.5 MG TAB 636 0 0 4300 

7505258 METHYLDOPATE INJ. 250 MG VIAL 636 0 0 4300 

7505266 METHYLERGONOVINE MAL .2 MG INJ 636 0 0 4300 

7505274 METHYLERGONOVINE MAL TAB 250 0 0 4300 

7505282 METHYLENE BLUE 0 INJ 636 0 0 4300 

7505290 METHYLPHENIDATE HCL TAB 250 0 0 4300 

7505308 ISOSULFAN BLUE 0 VIAL 250 0 0 4300 

7505316 METOCLOPRAMIDE HCL 1 TAB 250 0 0 4300 

7505324 METOCLOPRAMIDE HCL 10 MG VIAL 636 0 0 4300 

7505332 METOPROLOL 25MG. TAB 250 0 0 4300 

7505340 METOLAZONE 2.5 MG TAB 250 0 0 4300 

7505357 METOPROLOL TARTRATE INJ 250 0 0 4300 

7505365 METOPROLOL TARTRATE TAB 250 0 0 4300 

7505373 TOPROL XL 25MG. TAB 250 0 0 4300 

7505381 METRONIDAZOLE/SODIUM 500 MG PB 250 0 0 4300 

7505399 METRONIDAZOLE 250 MG TAB 250 0 0 4300 

7505407 METRONIDAZOLE 500 MG TAB 250 0 0 4300 

7505415 MEXILETINE HCL 200 M CAP 250 0 0 4300 

7505423 MICONAZOLE NITRATE 0 CRM 250 0 0 4300 

7505431 MICONAZOLE NITRATE 0 CREAM 250 0 0 4300 

7505449 MICONAZOLE NITRATE 1 SUPP VAG 250 0 0 4300 

7505456 MIDAZOLAM HCL 5 MG VIAL 636 0 0 4300 

7505464 MIDAZOLAM SYR 2MG/ML SYRUP 250 0 0 4300 

7505472 MIDAZOLAM 5MG/5ML VIAL 636 0 0 4300 

7505480 MINERAL OIL 250 0 0 4300 

7505498 MINERAL OIL ENEMA 250 0 0 4300 

7505506 MINERAL OIL 250 0 0 4300 

7505522 MAGNESIUM HYDROXIDE SUSP 250 0 0 4300 

7505530 METHYLPREDNISOLONE S VIAL 250 0 0 4300 

7505548 METHYLPREDNISOLONE 4 MG TAB 636 0 0 4300 

7505555 METHYLPREDNISOLONE S 40 MG VIAL 636 0 0 4300 

7505563 METHYLPREDNISOLONE S VIAL 250 0 0 4300 

7505571 METHYLPREDNISOLONE S 125 MG VIAL 636 0 0 4300 

7505589 METHYLPREDNISOLONE A VIAL 636 0 0 4300 

7505597 METHYLPREDNISOLONE A VIAL 636 0 0 4300 

7505605 MOEXIPRIL 7.5MG TAB 250 0 0 4300 

7505613 MORPHINE SULFATE 10 SYRINGE 636 0 0 4300 

7505621 MORPHINE SULFATE 4 M SYRINGE 636 0 0 4300 

7505639 MORPHINE SULFATE 2 M SYRINGE 636 0 0 4300 

7505647 MORPHINE SULFATE 1 M 30 MG PCA 636 0 0 4300 

7505654 MORPHINE SULFATE 30 SR TAB 250 0 0 4300 

7505662 MORPHINE 100MG/100ML KIT ADDV 636 0 0 4300 

7505670 MORPHINE 15MG. IMR TAB 250 0 0 4300 

7505688 MOXIFLOXACIN 3ML DROPS 250 0 0 4300 

7505696 MULTIVITAMINS THERAP TAB 250 0 0 4300

7505704 MULTIVITAMINS THERAP 250 0 0 4300 

7505712 VITAMIN B COMP W-C TAB 250 0 0 4300 

7505720 MULTIVITAMINS THER W TAB 250 0 0 4300 

7505738 MUPIROCIN OINT UD OINT 250 0 0 4300 

7505746 MUPIROCIN 0 OINT 250 0 0 4300 

7505753 SODIUM CL IRRIG SOLN IRRIG 250 0 0 4300 

7505761 SODIUM CL IRRIG SOLN IRRIG 250 0 0 4300 

7505779 SODIUM CHLORIDE 0.9% PGGYBCK 250 0 0 4300 

7505787 SODIUM CHLORIDE 1 G TAB 250 0 0 4300 

7505795 SODIUM CL FOR INHALA INH 250 0 0 4300 

7505803 SODIUM CHLORIDE 0 SPRAY 250 0 0 4300 

7505811 SODIUM CHLORIDE 4 ME VIAL 250 0 0 4300 

7505829 SODIUM CHLORIDE 0.9% VIAL 250 0 0 4300 

7505837 NADOLOL 40 MG TAB 250 0 0 4300 

7505845 NAFCILLIN SODIUM 2 G ADDV 250 0 0 4300 

7505852 NAFCILLIN SODIUM 1 GM VIAL 250 0 0 4300 

7505860 NAFCILLIN SODIUM 2 GM VIAL 250 0 0 4300 

7505878 NAFCILLIN SODIUM 1 G ADDV 250 0 0 4300 

7505886 NALOXONE HCL 0.4 MG SYRINGE 636 0 0 4300 

7505894 NALOXONE HCL 0.4 MG INJ 636 0 0 4300 

7505902 NATEGLINIDE 120MG.TAB 250 0 0 4300 

7505910 NAPROXEN 500 MG TAB 250 0 0 4300 



7505944 NEOMY SULF/BACITRAC OINT 250 0 0 4300 

7505951 NEOMY SULF/BACITRA/P TAB 250 0 0 4300 

7505969 NEOMY SULF/BACITRA/P OINT 250 0 0 4300 

7505977 NEOMY SULF/POLYMYXIN INJ 250 0 0 4300 

7505985 NEOMYCIN SULFATE 500 TAB 250 0 0 4300 

7505993 NEOMY SULF/POLYMYX B DROPS 250 0 0 4300 

7506009 NEOSTIGMINE METHYLSU VIAL 636 0 0 4300 

7506017 NEVIRAPINE SUSP 250 0 0 4300 

7506025 NIASPAN 500MG. SR TAB 250 0 0 4300 

7506033 NICOTINE POLACRILEX GUM 250 0 0 4300 

7506041 NIFEDIPINE 10 MG CAP 250 0 0 4300 

7506058 NIFEDIPINE 30 MG TAB 250 0 0 4300 

7506066 URINE PHENAPHTHAZINE ROLL 250 0 0 4300 

7506074 NITROFURANTOIN MACRO CAP 250 0 0 4300 

7506082 NORTRIPTYLINE HCL 10 CAP 250 0 0 4300 

7506090 NORTRIPTYLINE HCL 25 CAP 250 0 0 4300 

7506108 NITROPRUSSIDE 2ML VIAL 250 0 0 4300 

7506116 NITROGLYCERIN 5 MG VIAL 250 0 0 4300 

7506124 NITROGLYCERIN 2.5 MG SR CAPS 250 0 0 4300 

7506132 NITROGLYCERIN 6.5 MG SR CAPS 250 0 0 4300 

7506140 NITROGLYCERIN 0.3 MG SL TAB 250 0 0 4300 

7506157 NITROGLYCERIN 0.4 MG SL TAB 250 0 0 4300 

7506165 NITROGLYCERIN 0.6 MG SL TAB 250 0 0 4300

7506173 NITROGLYCERIN SPRAY 250 0 0 4300 

7506181 NITROGLYCERIN 0.4 MG PAT 24 HR 250 0 0 4300 

7506199 NITROGLYCERIN 0.1 MG PATCH 250 0 0 4300 



7506223 NITROGLYCERIN 0INT 250 0 0 4300 

7506231 NITRO OINT UD 250 0 0 4300 

7506249 NYSTATIN/TRIAMCIN CREAM 250 0 0 4300 

7506256 NYSTATIN 100 MU CREAM 250 0 0 4300 

7506264 NYSTATIN 100 MU POWDER 250 0 0 4300 

7506272 NYSTATIN 100 MU OINT 250 0 0 4300 

7506280 NYSTATIN 100 MU TAB 250 0 0 4300 

7506298 SOD CHLORIDE/NAHCO3/ SOLN 250 0 0 4300 

7506306 OLANZAPINE 20MG. ZYD TAB LN 250 0 0 4300 

7506314 BENICAR 20MG. TAB 250 0 0 4300 

7506322 OPIUM/BELLADONNA ALK SUPP 250 0 0 4300 

7506330 OLANZAPINE 10MG IM VIAL 250 0 0 4300 

7506348 OXACILLIN SODIUM 1 G ADDV 636 0 0 4300 

7506355 OXACILLIN SODIUM 2 G ADDV 636 0 0 4300 

7506363 OXACILLIN SODIUM 2 G VIAL 636 0 0 4300 

7506371 OXAZEPAM 15 MG CAP 250 0 0 4300 

7506389 DITROPAN XL 5MG TAB XL 250 0 0 4300 

7506397 OXYBUTYNIN CHLORIDE TAB 250 0 0 4300 

7506405 OXYMETAZOLINE HCL 0 SPRAY 250 0 0 4300 

7506413 OXYTOCIN 10 U VIAL 636 0 0 4300 

7506421 AMYLASE/LIPASE/PROTE TAB 250 0 0 4300 

7506439 PALONOSETRON HCL INJ .25 MG VIAL 636 0 0 4300 

7506447 FLOXIN OTIC 5ML DROPS 250 0 0 4300 

7506454 PAXIL CR 12.5MG. TAB 250 0 0 4300 

7506462 PEN G 2 M.U. FZ PIGG 636 0 0 4300 

7506470 PEN G 3 M.U. FZ PIGG 636 0 0 4300 

7506488 PENICILLIN G POTASSI 5 MILLION VIAL 636 0 0 4300 

7506496 PENICILLIN V POTASSI SUS REC 250 0 0 4300 

7506504 PENICILLIN G BENZATH 2,400,00 UN 636 0 0 4300 

7506512 PENICILLIN G POTASSI VIAL 636 0 0 4300 

7506520 PENIC G BENZ 1.2MU SYRINGE 636 0 0 4300 

7506538 ACTICIN 5% CR/60GM CREAM 250 0 0 4300 

7506546 PERMETHRIN 1% 2OZ LIQUID 250 0 0 4300 

7506553 PHENOBARB 5ML ELIXIR 250 0 0 4300 

7506561 PANTOPRAZOLE 40MG. EC TAB 250 0 0 4300 

7506579 PENTOXIFYLLINE 400 M SR TAB 250 0 0 4300 

7506587 OXYCODONE HCL/ACETAM TAB 250 0 0 4300 

7506595 PERPHENAZINE 2 MG TAB 250 0 0 4300 



7506629 PETROLATUM WHITE JELLY 250 0 0 4300 

7506637 LANOLIN/MIN OIL/PETR OINT 250 0 0 4300

7506645 PHENAZOPYRIDINE HCL TAB 250 0 0 4300 

7506652 PHENELZINE SULFATE 1 TAB 250 0 0 4300 

7506660 PHENOBARB 65MG. 1ML VIAL 636 0 0 4300 

7506678 PHENOBARB 130MG 1ML VIAL 636 0 0 4300 

7506686 PHENOBARB TAB 16.2MG TAB 250 0 0 4300 

7506694 PHENTOLAMINE MESYLAT VIAL 636 0 0 4300 

7506702 PHENYLEPHRINE HCL 10 MG 1 ML INJ 636 0 0 4300 

7506710 CEPASTAT LOZENGES 250 0 0 4300 

7506728 PHENYLEPHRINE HCL 0 SPRAY 250 0 0 4300 

7506736 PHENYLEPHRINE HCL DROPS 250 0 0 4300 

7506744 PHENYLEPHRINE HCL SPRAY 250 0 0 4300 

7506751 PHENYTOIN 50 MG CHEW TAB 250 0 0 4300 

7506769 PHENYTOIN SODIUM EXT CAP 250 0 0 4300 

7506777 PHENYTOIN SODIUM 50 VIAL 636 0 0 4300 

7506785 NA PHOS M-B/NA PHOS SOLN 250 0 0 4300 

7506793 PHYSOSTIGMINE SALICY TAB 250 0 0 4300 

7506801 PHYTONADIONE 5 MG 250 0 0 4300 

7506819 PHYTONADIONE 2 MG INJ 636 0 0 4300 

7506827 PHYTONADIONE 10 MG INJ 636 0 0 4300 

7506835 PILOCARPINE HCL 0 DROPS 250 0 0 4300 

7506843 PILOCARPINE HCL DROPS 250 0 0 4300 

7506850 PIPERACILLIN 3GM VIAL 250 0 0 4300 

7506868 PIPERACILLIN 4GM VIAL 250 0 0 4300 

7506876 POLY VITAMIN DROPS 250 0 0 4300 

7506884 PNEUMOCOCCAL 23-VAL VIAL 636 0 0 4300 

7506892 SODIUM POLYSTYRENE SUSP 250 0 0 4300 

7506900 TUBERCULIN PURIF.PRO VIAL 250 0 0 4300 

7506918 MIRALAX POWDER PACKET 250 0 0 4300 

7506926 PRAMIPEXOLE 0.25MG TAB 250 0 0 4300 

7506934 PRAZOSIN 1MG. CAP 250 0 0 4300 

7506942 PRAZOSIN 5MG CAP 250 0 0 4300 

7506959 PRALIDOXIME CHLORIDE 1 GM VIAL 636 0 0 4300 

7506967 PREDNISONE 1 MG TAB 636 0 0 4300 

7506975 ORAPRED U.D. SOLN 250 0 0 4300 


7506991 PREDNISOLONE ACETATE DROPS 250 0 0 4300 



7507023 PREDNISONE 5MG TABS 636 0 0 4300 

7507031 PREDNISOLONE 5ML 15 MG SYRUP 636 0 0 4300 

7507049 PRIMIDONE 250 MG TAB 250 0 0 4300 


7507064 PROBENECID 500 MG TAB 250 0 0 4300 

7507072 PROCAINE 10% 2ML 200 MG INJ 250 0 0 4300 

7507098 PROCHLORPERAZINE MAL SUPP 250 0 0 4300 

7507106 PROCHLORPERAZINE MAL 10 MG TAB 636 0 0 4300 

7507114 PROCHLORPERAZINE MAL 5 MG TAB 636 0 0 4300

7507122 PROCHLORPERAZINE EDI 10 MG VIAL 636 0 0 4300 

7507130 PROCAINAMIDE HCL 100 1 GM VIAL 636 0 0 4300 

7507148 PROMETHAZINE HCL 25 INJ 636 0 0 4300 

7507155 PROMETHAZINE HCL 25 TAB 636 0 0 4300 

7507163 PROMETHAZINE HCL 25 SUPP 250 0 0 4300 

7507171 PROPARACAINE HCL DROPS 250 0 0 4300 

7507189 PROPOXYPHENE NAPSYLA TAB 250 0 0 4300 

7507197 PROPRANOLOL LA 60MG. CAP 250 0 0 4300 

7507205 PROPRANOLOL LA 80MG. CAP 250 0 0 4300 

7507213 PROPRANOLOL HCL 20 M TAB 250 0 0 4300 

7507221 PROPRANOLOL HCL 1 MG VIAL 636 0 0 4300 

7507239 PROPRANOLOL HCL 80 MG TAB 250 0 0 4300 

7507247 PROPRANOLOL HCL 10 MG TAB 250 0 0 4300 

7507254 PROPYLTHIOURACIL 50 MG TAB 250 0 0 4300 

7507262 PROTAMINE SULFATE 10 VIAL 636 0 0 4300 

7507288 PSEUDOEPHEDRINE HCL TAB 250 0 0 4300 

7507296 PSEUDOEPHEDRINE HCL SYRUP 250 0 0 4300 

7507304 PSYLLIUM SEED PACKET 250 0 0 4300 

7507312 PYRIDOXINE HCL 50 MG TAB 250 0 0 4300 

7507320 ACCUPRIL 5MG. TAB 250 0 0 4300 

7507338 QUINIDINE GLUCONATE VIAL 250 0 0 4300 

7507346 QUINIDINE SULFATE 20 TAB 250 0 0 4300 

7507353 QUINIDINE GLUCONATE SR TAB 250 0 0 4300 

7507361 QUININE SULFATE 325 MG CAP 250 0 0 4300 

7507379 RABIES VACCINE IM 2.5 U/V VIAL 636 0 0 4300 

7507387 RABIES VACCINE 636 0 0 4300 

7507395 RISPERADAL CONSTA 25 MG SYRINGE 636 0 0 4300 

7507403 RISPERADAL CONS 37.5 SYRINGE 636 0 0 4300 

7507411 RISPERADAL CONS 50MG SYRINGE 636 0 0 4300 

7507429 RANITIDINE HCL 150 M TAB 250 0 0 4300 

7507437 RIFAXIMIN 200MG. TAB 250 0 0 4300 

7507445 RIFAMPIN 300 MG CAP 250 0 0 4300 

7507452 EXELON 1.5MG CAP 250 0 0 4300 

7507460 SALMETEROL DISKUS 250 0 0 4300 

7507478 SCOPOLAMINE HYDROBRO PATCH 250 0 0 4300 

7507486 PHENYLEPHRINE HCL/PH SOLN 250 0 0 4300 

7507494 DEXTROMETHORPHAN HBR LIQUID 250 0 0 4300 

7507502 SENNOSIDES A&B CALCI TAB 250 0 0 4300 

7507510 SILDENAFIL 50MG. TAB 250 0 0 4300 

7507528 SILVER SULFADIAZINE CREAM 250 0 0 4300 

7507536 THERMAZINE 50GM CREAM 250 0 0 4300 

7507544 SILVER NITRATE EACH 250 0 0 4300 

7507551 SILDENAFIL 25MG. TAB 250 0 0 4300 

7507569 SIMETHICONE 80 MG CHEWTAB 250 0 0 4300 

7507577 SIMETHICONE 40 MG DROPS 250 0 0 4300 

7507585 ZOCOR 40MG. TAB 250 0 0 4300 

7507593 SODIUM BICARBONATE SYRINGE 250 0 0 4300

7507601 SODIUM BICARBONATE SYRINGE 250 0 0 4300 

7507619 SODIUM BICARBONATE 6 TAB 250 0 0 4300 

7507627 EYE STREAM 30ML IRRIG 250 0 0 4300 

7507635 SULFACETAMIDE SODIUM OINT 250 0 0 4300 

7507643 SODIUM BICARBONATE SYRINGE 250 0 0 4300 

7507650 SULFACETAMIDE SODIUM DROPS 250 0 0 4300 

7507668 SORBITOL SOLUTION SOLN 250 0 0 4300 

7507676 SPIRONOLACTONE 25 MG TAB 250 0 0 4300 

7507684 SUCCINYLCHOLINE CHLO VIAL 636 0 0 4300 

7507692 SULFAMETHOXAZOLE/TRI TAB 250 0 0 4300 

7507700 SULFAMETHOXAZOLE/TRI VIAL 250 0 0 4300 

7507718 SULFAMETHOXAZOLE/TRI SUSP 250 0 0 4300 

7507726 SULFAMETHOXAZOLE/TRI TAB 250 0 0 4300 

7507734 SULFASALAZINE 500 MG TAB 250 0 0 4300 

7507742 SULINDAC 200 MG TAB 250 0 0 4300 

7507759 TAMOXIFEN CITRATE 10 MG TAB 250 0 0 4300 

7507767 POLYVINYL ALCOHOL DROPS 250 0 0 4300 

7507783 TEMAZEPAM 15 MG CAP 250 0 0 4300 

7507791 TELITHROMYCIN 400MG. TAB 250 0 0 4300 

7507809 TERBUTALINE SULFATE TAB 250 0 0 4300 

7507817 TERBUTALINE SULFATE 1 MG VIAL 636 0 0 4300 

7507825 TERCONAZOLE CREAM 250 0 0 4300 

7507833 TET/DIP P.F. SYRINGE 636 0 0 4300 

7507841 TETANUS TOXOID ADSOR VIAL 250 0 0 4300 

7507858 TETANUS IMMUNE GLOBU 250 U SYRINGE 636 0 0 4300 

7507866 TETRACYCLINE HCL 250 MG CAP 250 0 0 4300 

7507874 TETRACAINE HCL DROPS 250 0 0 4300 

7507890 THEOPHYLLINE ANHYDRO TAB 250 0 0 4300 

7507908 THEOPHYLLINE ANHYDRO TAB 250 0 0 4300 

7507916 MESALAMINE 400 MG EC TAB 250 0 0 4300 

7507924 THEOPHYLLINE ANHYDRO T SR 12 250 0 0 4300 

7507932 THIAMINE HCL 100 MG TAB 250 0 0 4300 

7507940 THIAMINE HCL 100 MG VIAL 636 0 0 4300 

7507957 THIOPENTAL SODIUM 50 SYRINGE 250 0 0 4300 

7507965 THIORIDAZINE HCL 25 TAB 250 0 0 4300 

7507973 THIORIDAZINE HCL 10 TAB 250 0 0 4300 

7507981 THIOTHIXENE 1 MG CAP 250 0 0 4300 

7507999 THIOTHIXENE 5MG. CAP 250 0 0 4300 

7508005 THROMBIN/FIBRINOGEN/KIT 250 0 0 4300 

7508013 THROMBIN 5 MU VIAL 250 0 0 4300 

7508021 FLOSEAL KIT 250 0 0 4300 

7508039 THYROID 30 MG TAB 250 0 0 4300 

7508047 TIAGABINE 4MG. TAB 250 0 0 4300 

7508054 TIMENTIN 3.1GM ADDV 250 0 0 4300 

7508062 TIMOLOL MALEATE DROPS 250 0 0 4300 

7508070 TIMOLOL MALEATE DROPS 250 0 0 4300 

7508088 TIZANIDINE 4MG. TAB 250 0 0 4300

7508096 TOBRAMYCIN SULFATE 4 80 MG VIAL 636 0 0 4300 

7508104 TOBRAMYCIN SULFATE OINT 250 0 0 4300 

7508112 TOBRAMYCIN SULFATE DROPS 250 0 0 4300 

7508120 TOBRA POWDER 1.2GM VIAL 250 0 0 4300 

7508138 TIOTROPIUM BROMIDE CAP 250 0 0 4300 

7508146 TOLBUTAMIDE 500 MG TAB 250 0 0 4300 

7508153 TOLNAFTATE POWDER 250 0 0 4300 

7508161 TOLNAFTATE CREAM 250 0 0 4300 

7508179 DEMADEX 20MG TAB 250 0 0 4300 

7508187 TRAZODONE HCL 50 MG TAB 250 0 0 4300 

7508195 TRIAMCINOLONE ACETON 200 MG VIAL 636 0 0 4300 

7508203 TRIAMCINOLONE ACETON CREAM 250 0 0 4300 

7508211 TRIAMCINOLONE ACETON OINT 250 0 0 4300 

7508229 NASACORT AQ SPRAY 250 0 0 4300 

7508237 TRYPAN BLUE OPTH SOL SYRINGE 250 0 0 4300 

7508245 TRIAZOLAM 0.125 MG TAB 250 0 0 4300 

7508252 TRIFLUOPERAZINE HCL TAB 250 0 0 4300 

7508260 TRIHEXYPHENIDYL HCL TAB 250 0 0 4300 

7508278 TRIHEXYPHENIDYL HCL TAB 250 0 0 4300 

7508294 TRIMETHOBENZAMIDE HC 200 MG SYRINGE 636 0 0 4300 

7508310 TROPICAMIDE DROPS 250 0 0 4300 

7508328 TROPICAMIDE DROPS 250 0 0 4300 

7508336 AMPICILLIN SODIUM/SU 1.5 GM ADDV 636 0 0 4300 

7508344 DIVALPROEX 250MG ER TAB 250 0 0 4300 

7508351 DIVALPROEX SODIUM 50 TAB 250 0 0 4300 


7508377 VASOPRESSIN 10U 0.5M VIAL 250 0 0 4300 

7508385 VANCOMYCIN 1GM ADDV 636 0 0 4300 

7508393 VANCOMYCIN HCL 500 M ADDV 636 0 0 4300 

7508401 VANCOMYCIN HCL 1 GM VIAL 636 0 0 4300 

7508419 VERAPAMIL HCL 80 MG TAB 250 0 0 4300 

7508427 VASOPRESSIN 20 U VIAL 250 0 0 4300 

7508435 VECURONIUM BROMIDE 1 VIAL 250 0 0 4300 

7508443 VERAPAMIL HCL 2.5 MG VIAL 250 0 0 4300 

7508450 VERAPAMIL HCL 240 MG ER TAB 250 0 0 4300 

7508468 VORICONAZOLE I.V. 200 MG VIAL 636 0 0 4300 

7508476 VORICONAZOLE 200MG.TAB 250 0 0 4300 

7508484 WITCH HAZEL LEAF PADS 250 0 0 4300 

7508492 WARFARIN SODIUM 2.5 TAB 250 0 0 4300 

7508500 WARFARIN SODIUM 2 MG TAB 250 0 0 4300 


7508526 WATER FOR INJ. BACTE VIAL 250 0 0 4300 

7508534 WATER FOR INJECTION VIAL 250 0 0 4300 

7508542 STERILE WATER 10ML VIAL 250 0 0 4300 

7508559 ZIDOVUDINE 100 MG CAP 250 0 0 4300 

7508567 ZIPRASIDONE IM 200 MG VIAL 636 0 0 4300 

7508575 ZINC OXIDE OINT 250 0 0 4300

7508583 ISOPROPYL ALCOHOL SOLN 250 0 0 4300 

7508591 CALCITONIN SALMON SY 400 U VIAL 636 0 0 4300 

7508609 CEFUROXIME SODIUM 1.5 GM VIAL 636 0 0 4300 

7508617 CEFUROXIME SODIUM 75 VIAL 636 0 0 4300 

7508625 COD LIVER OIL/ZINC OINT 250 0 0 4300 

7508633 D-AMPHETAMINE SULFAT SR CAPS 250 0 0 4300 

7508641 DOBUTAMINE HCL/D5W 1 INJ 636 0 0 4300 

7508658 EPHEDRINE SULFATE 50 INJ 250 0 0 4300 

7508666 HYDROXYZINE HCL 10 ML SYRUP 250 0 0 4300 

7508674 ISOPROTERENOL HCL 0.INJ 250 0 0 4300 

7508682 KETAMINE HCL 50 MG VIAL 250 0 0 4300 

7508690 MEDROXYPROGESTERONE TAB 250 0 0 4300 

7508708 ERY E-SUCC/SULFISOXA SUS REC 250 0 0 4300 

7508716 PROPOFOL 10MG 20ML VIAL 250 0 0 4300 

7508732 FLUCONAZOLE 100 MG TAB 250 0 0 4300 

7508740 DIHYDROERGOTAMINE ME 1 MG INJ 250 0 0 4300 

7508757 ADVAIR 100/50 DISK 250 0 0 4300 

7508765 ADVAIR 250/50 DISK 250 0 0 4300 

7508773 ADVAIR 500/50 DISK 250 0 0 4300 

7508781 PIROXICAM 10 MG CAP 250 0 0 4300 

7508799 SODIUM POLYSTYRENE S ENEMA 250 0 0 4300 


7508815 ACETYLCYSTEINE 400 MG VIAL 250 0 0 4300 

7508823 CEFTAZIDIME PENTAHYD 1 GM VIAL 636 0 0 4300 

7508831 ARGATROBAN 250MG/2.5ML SD VIAL 250 0 0 4300 

7508849 NALBUPHINE HCL 10 MG INJ 636 0 0 4300 

7508856 FLUCONAZOLE/SODIUM C 200 MG PB 250 0 0 4300 

7508864 FLUCONAZOLE/DEXTROSE 200 MG IVPB 258 0 0 4300 

7508872 NAPROXEN SODIUM 550 MG TAB 250 0 0 4300 

7508880 NITROGLYCERIN/D5W GLS BOT 250 0 0 4300 

7508898 KETOROLAC 15 MG VIAL 636 0 0 4300 

7508906 KETOROLAC TROMETHAMI VIAL 636 0 0 4300 

7508914 CLONAZEPAM 2 MG TAB 250 0 0 4300 

7508922 KETOROLAC TROMETHAMI VIAL 636 0 0 4300 

7508930 MENINGOCOCCAL VAC A VIAL 250 0 0 4300 

7508948 METRONIDAZOLE 0 GEL 250 0 0 4300 

7508955 MORPHINE SULFATE 100 TAB 250 0 0 4300 

7508963 OMEPRAZOLE 20 MG EC CAP 250 0 0 4300 

7508971 SODIUM ACETATE 2 MEQ VIAL 250 0 0 4300 

7508989 TRIAMCINOLONE ACETON CREAM 250 0 0 4300 


7509003 FLUDROCORTISONE ACET .1 MG TAB 250 0 0 4300 

7509011 MORPHINE SULFATE 1 M 250 0 0 4300 

7509029 MORPHINE SULFATE 10 MG INJ 636 0 0 4300 

7509037 MEASLES MUMPS&RUBELL VIAL 250 0 0 4300 

7509045 RUBELLA VACCINE VIAL 250 0 0 4300 

7509052 TRIAMCINOLONE ACETON PASTE 250 0 0 4300

7509060 AMIODARONE HCL 200 MG TAB 250 0 0 4300 

7509078 CAFFEINE/SODIUM BENZ VIAL 250 0 0 4300 

7509086 CHERRY FLAVOR SYRUP 250 0 0 4300 

7509094 CLOMIPRAMINE HCL 25 CAP 250 0 0 4300 

7509102 DOXAPRAM HCL 20 MG VIAL 250 0 0 4300 

7509110 ESTROGENS CONJUGATED CREAM 250 0 0 4300 

7509128 ETOMIDATE 2 MG VIAL 250 0 0 4300 

7509136 HEP NA PORCINE/NA CH 1000UN/NS 500M 250 0 0 4300 

7509144 INSUL NPH HU REC/INS VIAL 636 0 0 4300 

7509151 POTASSIUM IODIDE 1 GM SOLN 250 0 0 4300 

7509169 POVIDONE-IODINE SOLN 250 0 0 4300 

7509177 ZYVOX 600MG INJ 636 0 0 4300 

7509185 KETOCONAZOLE CREAM 250 0 0 4300 

7509193 MAGNESIUM OXIDE 140 CAP 250 0 0 4300 

7509201 MEPIVACAINE HCL 20 M VIAL 636 0 0 4300 

7509219 PROPAFENONE HCL 150 TAB 250 0 0 4300 

7509227 RABIES IMMUNE GLOBUL 150U VIAL 636 0 0 4300 

7509235 CEFTRIAXONE SODIUM 250 MG VIAL 636 0 0 4300 

7509243 ACETAMINOPHEN 80 MG CHWTAB 250 0 0 4300 

7509250 AZTREONAM 2 GM VIAL 250 0 0 4300 

7509268 BUPIVACAINE HCL/DEXT INJ 250 0 0 4300 

7509276 BUPROPION HCL 75 MG TAB 250 0 0 4300 

7509284 CLOZAPINE 100 MG TAB 250 0 0 4300 

7509292 CLOZAPINE 25 MG TAB 250 0 0 4300 

7509300 ESTAZOLAM 1 MG TAB 250 0 0 4300 

7509318 INDAPAMIDE 2.5 MG TAB 250 0 0 4300 

7509326 LACTULOSE 10 GM SOLN 250 0 0 4300 

7509334 MORPHINE SULFATE 15 SR TAB 250 0 0 4300 

7509342 NADOLOL 20 MG TAB 250 0 0 4300 

7509359 NIFEDIPINE 60 MG TAB 250 0 0 4300 

7509367 IBUPROFEN 100 MG SUSP 250 0 0 4300 

7509375 FENTANYL 25 MCG/1 PATCH 250 0 0 4300 

7509383 FENTANYL 50 MCG/1 PATCH 250 0 0 4300 

7509391 FLUMAZENIL 0..5 MG 5 ML VIAL 250 0 0 4300 

7509409 CHLORPROMAZINE HCL 10 MG TAB 636 0 0 4300 

7509417 ACYCLOVIR 800 MG TAB 250 0 0 4300 

7509425 LEVOBUNOLOL HCL DROPS 250 0 0 4300 

7509433 AMPICILLIN SODIUM/SU 3 GM VIAL 636 0 0 4300 

7509441 DILTIAZEM HCL 240 MG CAP 250 0 0 4300 

7509458 DILTIAZEM HCL 180 MG CAP 250 0 0 4300 

7509466 DOXAZOSIN MESYLATE 1 TAB 250 0 0 4300 

7509474 DOXAZOSIN MESYLATE 2 TAB 250 0 0 4300 

7509482 CARBIDOPA/LEVODOPA TAB 250 0 0 4300 

7509490 SERTRALINE HCL 50 MG TAB 250 0 0 4300 

7509508 BENAZEPRIL HCL 10 MG TAB 250 0 0 4300 

7509516 SERTRALINE HCL 25 MG TAB 250 0 0 4300 

7509524 FENTANYL 100 MCG/1 PATCH 250 0 0 4300

7509532 ISOSORBIDE MONONITRA T SR 24 250 0 0 4300 

7509540 AZATHIOPRINE 50 MG TAB 636 0 0 4300 


7509565 IPRATROPIUM BROMIDE SPRAY 250 0 0 4300 

7509573 HEP NA PORCINE/NACL 12500 UN/250 ML 250 0 0 4300 

7509581 VALSARTAN 80 MG TAB 250 0 0 4300 

7509607 D-AMPHETAMINE SULFAT TAB 250 0 0 4300 

7509615 LIDOCAINE/PRILOCAINE CREAM 250 0 0 4300 

7509623 HEPATITIS A VIRUS VA VIAL 250 0 0 4300 


7509649 IPRATROPIUM BROMIDE SOLN 250 0 0 4300 

7509656 CLARITHROMYCIN 250 MG TAB 250 0 0 4300 

7509664 TERAZOSIN HCL 1 MG CAP 250 0 0 4300 

7509672 LORATADINE 10 MG TAB 250 0 0 4300 

7509680 TIMOLOL MALEATE/DORZ DROPS 250 0 0 4300 

7509698 ACETAZOLAMIDE 500 MG SR CAPS 250 0 0 4300 

7509706 PROGESTERONE 50 MG VIAL 636 0 0 4300 

7509714 ONDANSETRON 4 MG TAB 636 0 0 4300 

7509722 RALOXIFENE HCL 60 MG TAB 250 0 0 4300 

7509730 QUETIAPINE FUMARATE TAB 250 0 0 4300 

7509748 VENLAFAXINE HCL 37.5 C SR 24 250 0 0 4300 

7509755 DESMOPRESSIN ACETATE 40 MCG VIAL 636 0 0 4300 


7509771 OXYCODONE HCL 5 MG TAB 250 0 0 4300 

7509789 CARVEDILOL 12.5 MG TAB 250 0 0 4300 

7509797 HYDROXYPROPYL METHYL DROPS 250 0 0 4300 


7509813 GUAIFENESIN/P-EPHED SR TAB 250 0 0 4300 

7509821 OCTREOTIDE ACETATE 15000 MCG VIAL 636 0 0 4300 

7509839 OCTREOTIDE ACETATE 100 MCG INJ 636 0 0 4300 

7509854 IMMU GLOBULIN GAMMA 10 ML VIAL 636 0 0 4300 

7509862 AZITHROMYCIN 200MG/5 SUS REC 250 0 0 4300 

7509870 FAMCICLOVIR 250 MG TAB 250 0 0 4300 

7509888 AZITHROMYCIN 100MG SUS REC 250 0 0 4300 

7509896 ESTRADIOL 0.05 MG/24 PATCH 250 0 0 4300 

7509904 SELEGILINE HCL 5 MG TAB 250 0 0 4300 

7509912 LITHIUM CARBONATE 45 SR TAB 250 0 0 4300 

7509920 IOPAMIDOL VIAL 250 0 0 4300 

7509938 PIPERACILL NA/TAZOBA 2.25 GM VIAL 636 0 0 4300 

7509946 HYALURONATE SODIUM 1 SYRINGE 250 0 0 4300 

7509953 IMIPENEM/CILASTATIN 500 MG VIAL 636 0 0 4300 

7509961 ERYTHROMYCIN BASE 25 TAB 250 0 0 4300 

7509979 GLIMEPIRIDE 2 MG TAB 250 0 0 4300 

7509995 CEFADROXIL MONOHYDRA 500 MG CAP 250 0 0 4300 

7510001 CITALOPRAM HYDROBROM TAB 250 0 0 4300 

7510019 AMOX TR/POTASSIUM CL SUSP 250 0 0 4300 

7510027 ROPIVACAINE HCL 2 MG INJ 636 0 0 4300

7510035 VITAMIN E 200 CAP 250 0 0 4300 

7510043 LAMOTRIGINE 100 MG TAB 250 0 0 4300 

7510050 LAMICTAL 25MG. TAB 250 0 0 4300 

7510068 MIRTAZAPINE 15 MG TAB 250 0 0 4300 

7510076 ATROPINE SULFATE 1 MG VIAL 250 0 0 4300 

7510084 HEPATITIS A VIRUS VA VIAL 250 0 0 4300 

7510092 CALCIUM GLUCONATE 10 ML VIAL 636 0 0 4300 

7510100 MONTELUKAST SODIUM 5 TAB 250 0 0 4300 

7510118 ATENOLOL 25 MG TAB 250 0 0 4300 

7510126 RISPERIDONE 5ML SOLN 250 0 0 4300 

7510134 RISPERIDONE 1 MG SOLN 250 0 0 4300 

7510142 FOSINOPRIL SODIUM 10 MG TAB 250 0 0 4300 

7510159 CEFTRIAXONE 1GM/D5W 50ML IVPB 636 0 0 4300 

7510167 GLYBURIDE MICRONIZED TAB 250 0 0 4300 

7510175 HYDROCORTISONE 10 MG TAB 250 0 0 4300 

7510183 ATORVASTATIN CALCIUM TAB 250 0 0 4300 

7510191 AMPHOTERICIN B LIPID 100 MG VIAL 636 0 0 4300 

7510209 LAMIVUDINE 150 MG TAB 250 0 0 4300 

7510217 FINASTERIDE 5 MG TAB 250 0 0 4300 

7510225 MAG HYDROX/AL HYDROX SUSP 250 0 0 4300 

7510233 PAROXETINE HCL 20 MG TAB 250 0 0 4300 

7510241 LYTES/CARBOXYMETHYLC SOLN 250 0 0 4300 

7510258 MORPHINE SULFATE 20 SOLN 250 0 0 4300 

7510266 FLUVOXAMINE MALEATE 50 MG TAB 250 0 0 4300 

7510274 INSULIN LISPRO 100 U VIAL 636 0 0 4300 

7510282 ZAFIRLUKAST 20 MG TAB 250 0 0 4300 




7510324 METFORMIN HCL 850 MG TAB 250 0 0 4300 


7510340 MILRINONE LACTATE/200 MCG/ML D5W PB 250 0 0 4300 

7510357 FLUTICASONE PROPIONA SPRAY 250 0 0 4300 

7510365 TAMSULOSIN HCL 0.4 M C SR 24 250 0 0 4300 

7510373 DESMOPRESSIN/NA PHOS SPRAY 250 0 0 4300 

7510381 BRIMONIDINE TARTRATE DROPS 250 0 0 4300 

7510399 LEVOFLOXACIN 500 MG TAB 250 0 0 4300 

7510407 LEVAQUIN 750MG. IV BAG 250 0 0 4300 

7510415 BENZTROPINE MESYLATE .5 MG TAB 250 0 0 4300 

7510423 AMLODIPINE 10 MG TAB 250 0 0 4300 

7510431 LORAZEPAM 4 MG VIAL 636 0 0 4300 


7510456 OYST CAL 500 TAB 250 0 0 4300 

7510464 CALCIUM CARBONATE/VI TAB 250 0 0 4300 

7510472 RISPERIDONE 3 MG TAB 250 0 0 4300 

7510480 CELECOXIB 100 MG CAP 250 0 0 4300 

7510498 BENAZEPRIL HCL 5 MG TAB 250 0 0 4300

7510506 SUMATRIPTAN SUCCINAT TAB 250 0 0 4300 

7510514 NELFINAVIR MESYLATE TAB 250 0 0 4300 

7510522 ZIDOVUDINE 10 MG INJ 636 0 0 4300 

7510530 ZIDOVUDINE 10 MG SYRUP 250 0 0 4300 

7510548 DINOPROSTONE 10 MG SUPVAG 250 0 0 4300 

7510555 BUTORPHANOL TARTRATE 1 MG VIAL 636 0 0 4300 

7510563 CEFUROXIME AXETIL 12 SUSP 250 0 0 4300 

7510571 PREVACID 30MG. IV 250 0 0 4300 

7510589 LANSOPRAZOLE 30 MG CAP 250 0 0 4300 

7510597 LEVOBUNOLOL HCL DROPS 250 0 0 4300 

7510605 PREVACID SOLUTAB MG M TAB 250 0 0 4300 

7510613 CHONDRO SU A/HYALUR SYRINGE 250 0 0 4300 

7510621 ALBUTEROL SULFATE/IP AER 250 0 0 4300 

7510639 CLOPIDOGREL BISULFAT TAB 250 0 0 4300 

7510654 DEMECLOCYCLINE HCL 1 TAB 250 0 0 4300 

7510662 CARVEDILOL 3.125 MG TAB 250 0 0 4300 

7510670 PRAVASTATIN SODIUM 1 TAB 250 0 0 4300 

7510688 RAMIPRIL 2.5 MG CAP 250 0 0 4300 

7510696 TOLTERODINE TARTRATE TAB 250 0 0 4300 

7510704 ASPIRIN 81 MG TAB 250 0 0 4300 

7510712 NITROFURANTOIN/NITRO CAP 250 0 0 4300 

7510720 HYDROMORPHONE HCL 10 MG INJ 636 0 0 4300 

7510738 PROMETHAZINE HCL 12. SUPP 250 0 0 4300 

7510746 LEVOFLOXACIN/DEXTROS PB 636 0 0 4300 

7510753 DICLOFENAC SODIUM DROPS 250 0 0 4300 

7510761 GABAPENTIN 100 MG CAP 250 0 0 4300 

7510779 LATANOPROST DROPS 250 0 0 4300 

7510795 CLINDAMYCIN PHOSPHAT PB 250 0 0 4300 

7510803 LEVOFLOXACIN/DEXTROS PB 636 0 0 4300 

7510811 ENOXAPARIN SODIUM 40 SYRINGE 636 0 0 4300 

7510829 PIPERACILL NA/TAZOBA 3.375 GM VIAL 636 0 0 4300 

7510837 QUINAPRIL HCL/MAG CA TAB 250 0 0 4300 

7510845 MISOPROSTOL 100 MCG TAB 250 0 0 4300 

7510852 IBUTILIDE FUMARATE 1 MG 10 ML VIAL 636 0 0 4300 

7510860 SUMATRIPTAN SUCCINAT 6 MG VIAL 636 0 0 4300 

7510878 VARICELLA VIRUS VACC VIAL 250 0 0 4300 

7510894 METOCLOPRAMIDE SOLN 250 0 0 4300 

7510902 GUAIFEN DM 10ML UD SYRUP 250 0 0 4300 

7510910 DOCUSATE 10ML UD LIQUID 250 0 0 4300 

7510928 FERROUS SULFATE 5 ML LIQUID 250 0 0 4300 

7510936 POTASSIUM 10% 15ML LIQUID 250 0 0 4300 

7510944 LIDOCAINE 2% UD 20ML SOLN 250 0 0 4300 

7510951 METFORMIN HCL 500 MG TAB 250 0 0 4300 

7510969 ZINC SULFATE 220 MG CAP 250 0 0 4300 

7510977 ALUMINUM HYDRATE 30M SUSP 250 0 0 4300 

7510985 PHENYTOIN 4ML UD SUSP 250 0 0 4300 

7510993 NYSTATIN 5ML SUSP 250 0 0 4300

7511009 LIPITOR 40 MG TAB 250 0 0 4300 

7511017 GUAIFENESIN 600 MG SR TAB 250 0 0 4300 

7511025 OLANZAPINE 10 MG TAB 250 0 0 4300 

7511033 HYALURONATE SODIUM 8 G F 20 16 MG 636 0 0 4300 

7511041 SUCRALFATE 1 G TAB 250 0 0 4300 

7511058 SUCRALFATE 10MG SUSP 250 0 0 4300 

7511066 TAMIFLU 75MG CAP 250 0 0 4300 

7511074 TERAZOSIN HCL 5 MG CAP 250 0 0 4300 

7511082 BACTERIOSTATIC SODIU VIAL 250 0 0 4300 

7511090 METHADONE HCL 10 MG TAB 250 0 0 4300 


7511124 ISRADIPINE 2.5 MG CAP 250 0 0 4300 

7511132 OLANZAPINE 5 MG TAB 250 0 0 4300 

7511140 IPRATROPIUM BROMIDE SPRAY 250 0 0 4300 

7511157 POTASSIUM CHLORIDE 10 MEQ PB 636 0 0 4300 

7511165 VENLAFAXINE HCL 75 M C SR 24 250 0 0 4300 

7511173 CLINDAMYCIN PHOSPHAT PB 250 0 0 4300 

7511181 SEVOFLURANE LIQUID 250 0 0 4300 

7511199 ROPIVACAINE HCL 2 MG INFUS 636 0 0 4300 

7511207 FLUPHENAZINE HCL 5 M PO CON 250 0 0 4300 

7511215 CLINDAMYCIN PHOSPHAT CRM 250 0 0 4300 

7511223 ONDANSETRON HCL 2 MG VIAL 636 0 0 4300 

7511231 DORZOLAMIDE HCL DROPS 250 0 0 4300 

7511249 CANASA 500 MG SUPP 250 0 0 4300 

7511256 TRAMADOL HCL 50 MG TAB 250 0 0 4300 

7511264 SENNA/DOCUSATE SODIUM TAB 250 0 0 4300 

7511272 SODIUM MORRHUATE 50 VIAL 250 0 0 4300 


7511298 ASPIRIN 81 MG IVPB 250 0 0 4300 

7511306 CEFTRIAXONE 2GM/D5W 50ML 636 0 0 4300 

7511314 ANAGRELIDE HCL 0.5 MG CAP 250 0 0 4300 

7511322 TIMOLOL MALEATE SOL GEL 250 0 0 4300 


7511348 HYOSCYAMINE SULFATE SL TAB 250 0 0 4300 

7511355 NICOTINE 7 MG/24 PATCH 250 0 0 4300 



7511389 CEFUROXIME SODIUM 1.5 GM ADDV 636 0 0 4300 

7511397 MONTELUKAST SODIUM 1 TAB 250 0 0 4300 

7511405 METHIMAZOLE 10 MG TAB 250 0 0 4300 



7511439 AZITHROMYCIN 500 MG VIAL 636 0 0 4300 

7511447 CITRIC ACID/SODIUM SOLN 250 0 0 4300 

7511454 ROCURONIUM BROMIDE 1 VIAL 250 0 0 4300 

7511462 VITAMIN E 400 UN CAP 250 0 0 4300 

7511470 CLONIDINE HCL 100 MC VIAL 636 0 0 4300



7511504 HYOSCYAMINE SULFATE DROPS 250 0 0 4300 

7511512 WELLBUTRIN XL 150MG. TAB 250 0 0 4300 

7511520 TRIAMCINOLONE ACETON 40 MG VIAL 636 0 0 4300 

7511538 GLIPIZIDE 5 MG TAB OS 250 0 0 4300 

7511546 DETROL LA 2MG CAP 250 0 0 4300 

7511553 MEXILETINE 150 MG CAP 250 0 0 4300 

7511561 BLOOD SUGAR DIAGNOST STRIP 250 0 0 4300 

7511579 ERGOTAMINE TARTRATE/ TAB 250 0 0 4300 

7511587 NATRECOR 1.5MG VIAL 636 0 0 4300 


7511603 HALOPERIDOL DECANOAT 100 MG VIAL 636 0 0 4300 

7511611 ACET/CODEINE # 3 TAB 250 0 0 4300 

7511629 LOSARTAN POTASSIUM 5 TAB 250 0 0 4300 

7511637 AMIODARONE HCL 50 MG VIAL 636 0 0 4300 

7511645 MEDROXYPROGESTERONE 150 MG VIAL 636 0 0 4300 

7511652 CHLORPROMAZINE HCL 1 TAB 250 0 0 4300 

7511660 CEFTAZIDIME PENTAHYD 1 GM ADDV 636 0 0 4300 

7511678 CEFTAZIDIME PENTAHYD 2 GM VIAL 636 0 0 4300 

7511686 DONEPEZIL HCL 5 MG TAB 250 0 0 4300 

7511694 AZITHROMYCIN 250 MG TAB 250 0 0 4300 

7511702 FLUOXETINE HCL 10 MG CAP 250 0 0 4300 

7511710 DEPAKOTE 125MG SPRIN CAP 250 0 0 4300 

7511728 NEFAZODONE HCL 100 M TAB 250 0 0 4300 

7511736 WARFARIN SODIUM 5 MG VIAL 250 0 0 4300 

7511744 CLARITHROMYCIN 250 M SUS REC 250 0 0 4300 

7511751 BISMUTH SUBSALICYLAT SUSP 250 0 0 4300 

7511769 PENICILLIN 500 AFTHR TAB 250 0 0 4300 

7511777 DILTIAZEM HCL 120 MG C SR 24 250 0 0 4300 

7511785 ZOLPIDEM TARTRATE 5 TAB 250 0 0 4300 

7511793 AMLODIPINE 2.5MG TAB 250 0 0 4300 

7511801 AMLODIPINE 5MG. TAB 250 0 0 4300 

7511819 SOTALOL HCL 80 MG TAB 250 0 0 4300 

7511835 ALENDRONATE 70 MG TAB 250 0 0 4300 

7511843 ENOXAPARIN SODIUM 30 SYRINGE 636 0 0 4300 

7511850 IMIPENEM/CILASTATIN 500 MG ADDV 636 0 0 4300 

7511868 VENLAFAXINE HCL 25 M TAB 250 0 0 4300 

7511876 RIFAMPIN 600 MG VIAL 250 0 0 4300 

7511884 NOREPINEPHRINE BITAR VIAL 250 0 0 4300 

7511892 MIDAZOLAM HCL 1 MG VIAL 636 0 0 4300 


7511918 SIMVASTATIN 10 MG TAB 250 0 0 4300 

7511934 ASPIRIN/DIPYRIDAMOLE CAP 250 0 0 4300 

7511959 TOPIRAMATE 100 MG TAB 250 0 0 4300 

7511967 TOPIRAMATE 25 MG TAB 250 0 0 4300 

7511975 LUBRIDERM LOTION 250 0 0 4300

7511983 FLUVASTATIN SODIUM 2 CAP 250 0 0 4300 

7512007 CASTOR OIL 250 0 0 4300 

7512015 ALPROSTADIL 500 MCG INJ 250 0 0 4300 

7512023 DILTIAZEM HCL 300 MG C SR 24 250 0 0 4300 

7512031 SCOPOLAMINE HYDROBRO VIAL 250 0 0 4300 

7512049 TRAZODONE HCL 100 MG TAB 250 0 0 4300 

7512056 RAMIPRIL 5 MG CAP 250 0 0 4300 

7512064 BISOPROLOL FUMARATE TAB 250 0 0 4300 

7512072 PIOGLITAZONE HCL 15 TAB 250 0 0 4300 

7512080 DISULFIRAM 250 MG TAB 250 0 0 4300 

7512098 METOPROLOL TARTRATE TAB 250 0 0 4300 

7512106 QUETIAPINE FUMARATE TAB 250 0 0 4300 

7512114 RISPERIDONE 0.5 MG TAB 250 0 0 4300 

7512122 NALTREXONE HCL 50 MG TAB 250 0 0 4300 

7512130 ZIPRASIDONE HCL 20 M CAP 250 0 0 4300 

7512148 ZIPRASIDONE HCL 40 M CAP 250 0 0 4300 

7512155 GLIPIZIDE 2.5 MG TAB 250 0 0 4300 

7512163 ISOSORBIDE MONONITRA T SR 24 250 0 0 4300 

7512171 AMILORIDE HCL 5 MG TAB 250 0 0 4300 

7512189 FLECAINIDE ACETATE 5 TAB 250 0 0 4300 


7512205 PIOGLITAZONE HCL 45 TAB 250 0 0 4300 

7512213 QUETIAPINE 200 MG TAB 250 0 0 4300 

7512221 METOPROLOL XL 50MG TAB 250 0 0 4300 


7512247 SERTRALINE HCL 100 M TAB 250 0 0 4300 

7512254 ACARBOSE 25 MG TAB 250 0 0 4300 

7512262 DILTIAZEM HCL 5 MG VIAL 250 0 0 4300 

7512270 CARBOPROST TROMETHAM 250 MCG INJ 250 0 0 4300 

7512288 NAPH MB-DB/K PH MBDB PACKET 250 0 0 4300 


7512304 LANSOPRAZOLE 15 MG CAP 250 0 0 4300 

7512312 VALPROIC ACID 5ML UD CUP 250 0 0 4300 

7512320 PAPAIN/UREA 0.83 MMU OINT 250 0 0 4300 

7512338 AMIKACIN 250MG 2ML VIAL 636 0 0 4300 

7512346 CALCITONIN SALMON SPRAY 250 0 0 4300 

7512353 IRON POLYSACCHARIDES CAP 250 0 0 4300 

7512387 INFLIXIMAB 100 MG VIAL 636 0 0 4300 


7512403 ANTIVENIN CROTALIDA VIAL 250 0 0 4300 

7512411 CLOTRIMAZOLE CREAM 250 0 0 4300 

7512429 RISPERIDONE 1 MG TAB 250 0 0 4300 

7512437 CIPROFLOXACIN LACTAT 400 MG PB 636 0 0 4300 

7512445 ACTIGALL 300 MG CAP 250 0 0 4300 

7512452 CHLORASEPTIC SPRAY SOLN 250 0 0 4300 

7512460 HYOSCYAMINE 0.375 MG TAB 250 0 0 4300 

7512478 ADVIL 200 MG TAB 250 0 0 4300

7512486 LANTUS INSULIN VIAL 636 0 0 4300 

7512494 LORAZEPAM 2 MG PO CONC 250 0 0 4300 

7512502 ACTIVASE 100MG VIAL 636 0 0 4300 

7512510 ACETAMINOPHEN 5ML UD SOLN 250 0 0 4300 

7512528 DIPHENHYDRAMINE 10UD ELIXIR 636 0 0 4300 

7512536 PHENYTOIN 100MG IV VIAL 636 0 0 4300 

7512544 ENECTEPLASE 50MG. KIT 636 0 0 4300 

7512551 METOPROLOL SUCCINATE T SR 24 250 0 0 4300 

7512569 DILTIAZEM 5ML VIAL 250 0 0 4300 

7512577 PHOSLO TAB 250 0 0 4300 

7512585 HYDROXYZINE 50MG/IML VIAL 636 0 0 4300 

7512593 AMMONIUM LACTATE LOTION 250 0 0 4300 

7512601 CYANOCOBOLAMIN 500MG TAB 250 0 0 4300 

7512619 TRILEPTAL 300MG TAB 250 0 0 4300 

7512627 LACTULOSE 30ML UD SOLN 250 0 0 4300 

7512643 LITHOBID 300 MG SR TAB 250 0 0 4300 

7512650 MAGNESIUM SULF 50% 1 GM VIAL 636 0 0 4300 

7512668 MIDAZOLAM 100MG/100ML KIT 636 0 0 4300 

7512676 BSS EYE SOL 500 ML SOLN 250 0 0 4300 

7512684 CATHFLOALTE PLASE 2MG VIAL 250 0 0 4300 

7512692 ACET/COD 12.5ML ELIXIR 250 0 0 4300 

7512700 FAMOTIDINE 10 MG VIAL 250 0 0 4300 

7512718 MIRAPEX 0.125 MG TAB 250 0 0 4300 

7512726 MAG OXIDE 400 MG TAB 250 0 0 4300 

7512734 LOVENOX 60MG SYRINGE 636 0 0 4300 

7512742 ETHANOLAMINE OLEATE 100 MG 2ML INJ 636 0 0 4300 

7512759 ROPINIROLE .25MG 250 0 0 4300 

7512767 MELOXICAM 7.5MG 250 0 0 4300 

7512775 EPLERENONE 25MG 250 0 0 4300 

7512783 ALBUTEROL HFA 250 0 0 4300 

7512791 DICLOXACILLIN TO GO 250 MG CAP 250 0 0 4300 

7512809 EDROPHONIUM 10 MG/ML VIAL 150 MG 250 0 0 4300 

7512817 FLUORESCEIN OPTH STRIP 250 0 0 4300 

7512825 GLUCAGON 1 MG VIAL 636 0 0 4300 

7512833 GLYCERIN LIQUID 250 0 0 4300 

7512841 ISOSORBIDE DIN 40MG SR TAB 250 0 0 4300 

7512858 MORPHINE 60 MG SR TAB 250 0 0 4300 

7512866 NAPROXEN TO GO 375 PACK TAB 250 0 0 4300 

7512874 PREGABALIN 25 MG CAP 250 0 0 4300 

7512882 PROPOFOL 1% 100ML BOTTLE 250 0 0 4300 

7512890 LEVOFLOXACIN 250 MG TAB 250 0 0 4300 

7512908 OLANZAPINE 2.5 MG TAB 250 0 0 4300 

7512916 HEPATITIS B IMM GLOB 5ML VIAL 636 0 0 4300 

7512924 CYCLOBENZAPRINE 10 RX TO GO TAB 250 0 0 4300 

7512932 OXYCODONE/APAP RX TO GO ED TAB 250 0 0 4300 

7512940 IBUPROFEN RX TO GO 600MG TAB 250 0 0 4300 

7512957 SULFAMETHOX/TMP DS RX TO GO TAB 250 0 0 4300

7512965 PRAMIPEXOLE .25MG TAB 250 0 0 4300 

7512973 AMOXICILLIN 500 MG RX TO GO CAP 250 0 0 4300 

7512981 CEPHALEXIN 500 MG RX TO GO CAP 250 0 0 4300 

7512999 OVRAL 0.5/50 TAB GENERIC TAB 250 0 0 4300 

7513005 CODEINE/APAP #3 RX TO GO TAB 250 0 0 4300 

7513047 ROPINIROLE 0.25 MG TAB 250 0 0 4300 

7513054 EPLERENONE 25 MG TAB 250 0 0 4300 

7513062 TRAVOPROST 0.004% 2.5 ML DROPS 250 0 0 4300 

7513070 EDETATE CALCIUM 1000MG AMP INJ 636 0 0 4300 

7513088 TRIAMCINOLONE 0.1% OIN 80G 250 0 0 4300 

7513096 CYPROHEPTADINE 4 MG TAB 250 0 0 4300 

7513104 VALACYCLOVIR 500 MG TAB 250 0 0 4300 

7513112 SCOT TUSSIN 100MG/5ML LIQUID 250 0 0 4300 

7513120 PODOPHYLLUM RESIN 30 GM POWDER 250 0 0 4300 

7513138 VANCOMYCIN 500 MG VIAL 636 0 0 4300 

7513146 EPINEPHRINE 1MG/10ML SYR 636 0 0 4300 

7513153 HYDROXYZINE PAM 25 MG CAP 250 0 0 4300 

7513179 ORA SWEET SF SYRUP 250 0 0 4300 

7513187 ORA PLUS SUSP VEHICLE SYRUP 250 0 0 4300 

7513195 POVIDONE-IOD 10% OINT 30GM 250 0 0 4300 

7513203 HYPERHEP 0.5ML/SYRINGE 250 0 0 4300 

7513229 CAFFEINE 200 MG TAB 250 0 0 4300 

7513237 NYSTATIN CREAM 30GM TUBE 250 0 0 4300 

7513245 CHLOROXYLENOL LIQ BOTTLE 250 0 0 4300 

7513252 CANDIDA SKIN TEST 250 0 0 4300 

7513278 EMOLLIENT(RADIAGEL) 85GM GEL 250 0 0 4300 

7513286 HYDROCERIN CREAM 454GM 250 0 0 4300 

7513294 HYDROCERIN CREAM 120GM 250 0 0 4300 

7513310 BUMETANIDE 1 MG/4ML VIAL 250 0 0 4300 

7513328 BUMETANIDE 2.5MG/10ML VL 250 0 0 4300 

7513336 PRENATAL VITAMIN TAB 250 0 0 4300 

7513344 MINERAL OIL 10ML VIAL 250 0 0 4300 

7513351 VISINE A EYE DROPS 15ML 250 0 0 4300 

7513369 VITAMIN D 400 UNIT TAB 250 0 0 4300 

7513377 ASCORIC ACID 1 GM/2ML AMP INJ 250 0 0 4300 

7513385 CEFAZOLIN 2 GM INJ 636 0 0 4300 

7513393 KCL 2 MEQ/ML INJ VL 15ML VIAL 636 0 0 4300 

7513401 KCL 2 MEQ/ML INJ VL 10ML VIAL 636 0 0 4300 

7513419 KCL 2 MEQ/ML INJ VL 5 ML VIAL 636 0 0 4300 

7513427 KCL 2 MEQ/ML INJ VL 20 ML VIAL 636 0 0 4300 

7513435 TRACE METALS VIT 10 ML VL 250 0 0 4300 

7513443 MVI ADULT INJ VIAL 250 0 0 4300 

7513450 POTASSIUM PHOSPH 45 MM VL 250 0 0 4300 

7513468 POTASSIUM ACET 40MEQ VIAL 250 0 0 4300 

7513476 TETRACAINE 2% SOLN 30 ML 250 0 0 4300 

7513484 STERILE WATER IRRIG LITER 250 0 0 4300 

7513492 DEXTROSE 25% WATER 10ML INJ SYRINGE 250 0 0 4300

7513500 POVIDONE-IODINE 10% SOLN 250 0 0 4300 

7513518 MAGNESIUM 1GM/100ML D5W INFUS 636 0 0 4300 

7513526 FLUORESCEIN 10% INJ AMP 250 0 0 4300 

7513534 TIMOLOL 0.25% GFS 2.5 ML SOL GEL 250 0 0 4300 

7513542 BOTULINUM TOXIN 100 U VIAL 636 0 0 4300 

7513559 MIDODRINE 5 MG TAB 250 0 0 4300 

7513567 ERGOCALCIFEROL 50M U CAP 250 0 0 4300 

7513575 KALETRA TAB 250 0 0 4300 

7513583 COMBIVIR TABLET 250 0 0 4300 

7513591 ACETYLCYSTEINE 200MG/ML INJ 250 0 0 4300 

7513609 OXYBUTYNIN 3.9 MG/PATCH 250 0 0 4300 

7513617 SUBOXONE 2MG/0.5MG SL TAB 250 0 0 4300 

7513625 BUPRENORPHINE 2 MG TAB 250 0 0 4300 

7513633 EPTIFIBATIDE 75MG/100ML VIAL 636 0 0 4300 

7513641 EPTIFIBATIDE 20MG/10ML VIAL 636 0 0 4300 

7513658 RISPERIDONE 2 MG M TAB 250 0 0 4300 

7513666 PIPERACILLIN/TAZO 2.25 GM IVPB 250 0 0 4300 

7513674 STERILE WATER INJ VL 50ML 250 0 0 4300 

7513765 BUPIVACAINE W/EPI 0.25% VL 250 0 0 4300 

7513773 E.E.S 200 MG/5ML SUSP 100ML 250 0 0 4300 

7513823 METRONIDAZOLE 250MG IV BAG PB 250 0 0 4300 

7513831 FLUCONAZOLE 100MG/D5W 50ML PB 636 0 0 4300 


7513856 CALCIUM GLUC 23 MEQ INJ 50 ML VIAL 636 0 0 4300 


7513872 CILOSTAZOL 50 MG TAB 250 0 0 4300 

7513880 PANTOPRAZOLE 20 MG TAB 250 0 0 4300 

7513898 ALBUTEROL 2.5 MG/0.5ML NEB 250 0 0 4300 

7513906 BARIUM (PHARMACY NO CHARGE) SUSP 250 0 0 4300 

7513922 ROSUVASTATIN 10 MG TAB 250 0 0 4300 

7513930 DIATR MEGLU/DIATRIZOATE SODIUM SOLN 250 0 0 4300 

7513948 SODIUM HYPOCHLORITE-DAKINS ML 270 0 0 4300 

7513963 PHYTONADIONE 1 MG/0.5ML SYR 636 0 0 4300 

7513971 DEXTROSE TABS CHEWABLE 250 0 0 4300 

7513989 HALOPERIDOL LACT 5MG/ML VIAL 250 0 0 4300 

7513997 QUETIAPINE 50 MG TAB 250 0 0 4300 

7514003 MAGNESIUM 20 GM/500ML INFUS 250 0 0 4300 

7514011 LACTAID TABLETS 250 0 0 4300 

7514029 FIBER TABLET 250 0 0 4300 

7514037 RX TO GO PENICILLIN 500G TAB 250 0 0 4300 

7514052 BACTROBAN 2% 15GM CREAM 250 0 0 4300 

7514078 AZACTAM 1GM VIAL 250 0 0 4300 

7514094 HEPARIN 100U/ML 5ML VIAL 636 0 0 4300 

7514102 ALTACE 1.25MG CAP 250 0 0 4300 

7514110 K-PHOS 5ML 22MEQ INJ VIAL 250 0 0 4300 

7514136 OXACILLIN 16M VIAL 636 0 0 4300 

7514144 CHLORHAXIDINE GLUCONATE LIQ SCRUB 250 0 0 4300

7514151 ERTAPENEM 1GM ADDV 636 0 0 4300 

7514169 GLYCOPYRROLATE 1MG TAB 250 0 0 4300 

7514177 FLORASTOR 250MG CAP 250 0 0 4300 

7514185 PEPTO BISMOL TAB 250 0 0 4300 

7514193 UNASYN 1.5GM VIAL 250 0 0 4300 

7514201 LORAZEPAM INTENSOL ORAL SYRINGE 250 0 0 4300 

7514219 MORPHINE 20MG/ML ORAL SYRINGE SOLN 250 0 0 4300 

7514227 MIRACLE MOUTHWASH #1 FORMULA ML 250 0 0 4300 

7514235 MICONAZOLE 2% (BAZA) CREAM 250 0 0 4300 

7514243 CEPHALEXIN 250MG SUSP 250 0 0 4300 

7514250 DIPYRIDAMOLE 10MG INJ VIAL 636 0 0 4300 

7514268 VERAPAMIL 40MG TAB 250 0 0 4300 

7514276 VANCOMYCIN 1GM/250ML IVPB 636 0 0 4300 

7514284 FLUVIRON 5ML MULTI VIAL 636 0 0 4300 

7514292 FLUVIRON 0.5ML 2009 10 SINGLE VIAL 636 0 0 4300 

7514300 PENICILLIN VK 250MG TAB 250 0 0 4300 

7514318 ROPINIROLE 1MG TAB 250 0 0 4300 

7514326 GAMUNEX 1GM/10ML VIAL 636 0 0 4300 

7514334 LEVETIRACETAM 500MG/5ML VIAL 636 0 0 4300 

7514342 NACL 5ML FLUSH SYRINGE 250 0 0 4300 

7514359 ANEBESOL MAX STRENGTH GEL 250 0 0 4300 

7514367 NACL 0.9% 3ML FLUSH SYRINGE 250 0 0 4300 

7514375 NACL 0.9% 10ML FLUSH SYRINGE 250 0 0 4300 

7514383 GAMMAGARD 2.5GM VIAL 636 0 0 4300 

7514391 EPINEPHRINE 1MG/ML PRESFREE 1ML AMP 636 0 0 4300 

7514409 CYTOGAM 2.5GM/50ML VIAL 636 0 0 4300 

7514417 BRIMONIDINE 0.2% EYE DROPS 250 0 0 4300 

7514425 FISH OIL CAP 250 0 0 4300 

7514433 MORPHINE SULFATE INJ 250MG/10ML VL 636 0 0 4300 

7514441 MINOCYCLINE 100MG CAP 250 0 0 4300 

7514458 TRIAMCINOLONE 0.5% OINT 250 0 0 4300 

7514474 ROBITUSSIN S/F COUGH SYP 10ML 250 0 0 4300 

7514482 VITAMIN B12 100MCG TAB 250 0 0 4300 

7514490 AMPHADASE 150U/ML SDV VIAL 636 0 0 4300 

7514516 PENICILLIN G PROCAINE 2ML 1.2 MIL 636 0 0 4300 

7514524 CIPROFLOXIN 200MG/100ML PREMIX PB 636 0 0 4300 

7514532 ADACEL INJ .5ML SYRINGE VIAL 636 0 0 4300 

7514540 RECLAST INJ 5MG/100ML INFUS 636 0 0 4300 

7514557 PILOCARPINE 5MG TAB 250 0 0 4300 

7514565 ALBUTEROL INHALATION NEB 1.25MG/3ML 250 0 0 4300 

7514573 PRIVIGEN 10% LIQUID 5GM/50ML VIAL 636 0 0 4300 

7514581 LTA 360 PRE-ATTACHED 4% SOLN 250 0 0 4300 

7514599 NEVANAC 0.1% OPTHALMIC SUSPENSION 250 0 0 4300 

7514607 QUINAPRIL 20MG TAB 250 0 0 4300 

7514615 MORPHINE ORAL NEONATE 0.1MG/ML SOLN 250 0 0 4300 

7514623 GAMMAGARD LIQUID 500 MG 636 0 0 4300 

7514631 FONDAPARINUX 7.5MG/0.6ML SYRINGE 636 0 0 4300

7514649 PYRAZINAMIDE 500MG TAB 250 0 0 4300 

7514656 ETHAMBUTOL 400MG TAB 250 0 0 4300 

7514664 STREPTOMYCIN 1GM VIAL 636 0 0 4300 

7514672 PYRIDOSTIGMINE 60MG TAB 250 0 0 4300 

7514680 JANUVIA 100MG TAB 250 0 0 4300 

7514698 PALIPERIDONE 3 MG TAB 250 0 0 4300 



7514722 LITHIUM CARBONATE 300 MG CAPS 250 0 0 4300 

7514730 SUMATRIPTAN 50 MG TAB 250 0 0 4300 

7514748 KALETRA 100 25 MG TAB 250 0 0 4300 

7514755 FOMEPIZOLE 1 GM/ML 1.5 ML VIAL 636 0 0 4300 

7514763 TRUSOPT 2% EYE DROPS 250 0 0 4300 

7514771 ARIPIPRAZOLE 30 MG TAB 250 0 0 4300 

7514789 FENTANYL PATCH 12 MCG/HOUR 250 0 0 4300 


7514805 VICODIN 5/500 MG TAB 250 0 0 4300 

7514813 VENOFER 20MG/ML INJ VIAL 636 0 0 4300 

7514821 RANEXA 500 MG TAB 250 0 0 4300 

7514839 AZITHROMYCIN 200 MG/5 ML ORAL SYRNG 250 0 0 4300 

7514847 PEDIAZOLE 200-600 MG/5 ML ORAL 250 0 0 4300 

7514854 AMOXICILLIN 250 MG/5 ML ORAL SYRGE 250 0 0 4300 

7514862 AUGMENTIN 250 MG/5 ML ORAL SYRINGE 250 0 0 4300 

7514870 AZITHROMYCIN 100 MG/5 ML ORAL SYRIN 250 0 0 4300 

7514888 AMOXICILLIN 125 MG/5 ML ORAL SYRING 250 0 0 4300 

7514896 AUGMENTIN 125 MG/5ML ORAL SYRINGE 250 0 0 4300 

7514904 AUGMENTIN 400 MG/5ML ORAL SYRINGE 250 0 0 4300 

7514920 CEFUROXIME 125 MG/5 ML ORAL SYRINGE 250 0 0 4300 

7514938 CEPHALEXIN 250 MG/5ML ORAL SYRINGE 250 0 0 4300 

7514946 E.E.S 200 MG/5 ML ORAL SYRINGE 250 0 0 4300 

7514953 E.E.S 400 MG/5ML ORAL SYRINGE 250 0 0 4300 

7514961 SANTYL OINTMENT 30 GM 250 0 0 4300 

7514979 EDECRIN 25 MG TAB 250 0 0 4300 


7514995 RELENZA 5 MG DISKHALER 250 0 0 4300 

7515000 GI COCKTAIL SOLUTION 250 0 0 4300 

7515018 PRAVASTATIN 20 MG TAB 250 0 0 4300 

7515026 BONIVA 3 MG/3ML INJ KIT 636 0 0 4300 

7515034 FLUOXETINE 20MG/5ML U/D SOLN 636 0 0 4300 

7515042 SODIUM BICARBONATE 8.4% VIAL 250 0 0 4300 

7515067 CITALOPRAM 10 MG TAB 250 0 0 4300 

7515083 TAMIFLU 30 MG CAP 250 0 0 4300 

7515091 TAMIFLU 45 MG CAP 636 0 0 4300 

7515109 NACL 0.9% 20 ML VIAL 636 0 0 4300 

7515117 METHYLENE BLUE 1% 1 ML VIAL 636 0 0 4300 

7515125 VECURONIUM 20 MG VIAL 636 0 0 4300 

7515133 MORPHINE ORAL NEONATE 0.4MG/ML 250 0 0 4300

7515141 FOSPROPOFOL 1050MG/30ML 250 0 0 4300 

7515158 HAVRIX HEP A VAC INJ 1440 UNITS 636 0 0 4300 

7515166 CHOLECALCIFEROL(VITAMIN D) 1000 UN 250 0 0 4300 

7515174 NACL 0.9% FOR INJ-PRIMARY 250 0 0 4300 

7515182 STERILE WATER FOR INJ-PRIMARY 250 0 0 4300 

7515190 DAKINS SOLUTION 0.5%(FULL STRENGTH) 270 0 0 4300 

7515208 DAKINS SOLUTION.25%(1/2 STRENGTH) 270 0 0 4300 

7515216 DAKINS SOLUTION .125%(1/4 STRENGTH) 270 0 0 4300 

7515224 LACTULOSE ENEMA 200GM/1000ML 250 0 0 4300 

7515232 HYDROGEN PEROXIDE SOLUTION 1.5% 636 0 0 4300 

7515240 SILVADENE 50 GM/SWFI 1000ML 250 0 0 4300 

7515257 SILVADENE 50GM/NACL 1000ML 250 0 0 4300 

7515265 DOMEBORO 1 PCKT/500ML NACL 250 0 0 4300 

7515273 DOMEBORO 1 PCKT/500ML WATER 250 0 0 4300 

7515281 NEOSTIGMINE 10 MG/10 ML VIAL 636 0 0 4300 

7515299 ATROPINE 1 MG/10 ML INJ 636 0 0 4300 

7515307 LIDOCAINE 5% OINT 250 0 0 4300 



7515331 VENLAFAXINE 12.5 MG TAB 250 0 0 4300 

7515349 ROSUVASTATIN 5 MG TAB 250 0 0 4300 

7515364 QUETIAPINE 12.5 MG TAB 250 0 0 4300 

7515372 PYRIDOXINE 25 MG TAB 250 0 0 4300 

7515380 ASCORBIC ACID(VIT C) 250 MG 250 0 0 4300 

7515398 ATENOLOL 12.5 MG TAB 250 0 0 4300 

7515406 BENAZEPRIL 2.5 MG TAB 250 0 0 4300 

7515414 BISOPROLOL 2.5 MG TAB 250 0 0 4300 



7515448 GLYBURIDE 1.25 MG TAB 250 0 0 4300 

7515455 LEVOTHYROXINE 12.5 MG TAB 250 0 0 4300 

7515463 LISINOPRIL 1.25 MG TAB 250 0 0 4300 

7515471 METHOCARBAMOL 250 MG TAB 250 0 0 4300 

7515489 OXYBUTYNIN 2.5 MG TAB 250 0 0 4300 

7515497 ARIPIPRAZOLE 2.5 MG TAB 250 0 0 4300 

7515505 TETRACAINE 0.5% EYE DROPS 250 0 0 4300 

7515513 TROPICAMIDE 1% EYE DROPS 250 0 0 4300 

7515521 ERYTHROMYCIN EYE OINT. 3.5 GM 250 0 0 4300 

7515539 HYDROXYZINE PAMOATE 50 MG CAP 250 0 0 4300 

7515547 FLUCONAZOLE 50 MG TAB 250 0 0 4300 

7515554 CAPTOPRIL 6.25 MG TAB 250 0 0 4300 


7515570 CHOLECALCIFEROL 200 UN TAB 250 0 0 4300 

7515588 IRBESARTAN 75 MG TAB 250 0 0 4300 

7515596 HYOSCYAMINE .125 MG TABS 250 0 0 4300 

7515604 PEPTO BISMOL 30 ML 250 0 0 4300 

7515612 SILDENAFIL CITRATE 12.5 MG TAB 250 0 0 4300

7515620 BUSPIRONE 2.5 MG TAB 250 0 0 4300 

7515638 SIMETHICONE 40 MG CHWTAB 250 0 0 4300 

7515646 FONDAPARAINUX 5 MG INJ 636 0 0 4300 

7515653 FONDAPARAINUX 10 MG INJ 636 0 0 4300 

7515679 PREDNISONE 2.5 MG TAB 636 0 0 4300 

7515687 PROMETHAZINE 12.5 MG TAB 636 0 0 4300 

7515695 TRAZODONE 25 MG TAB 250 0 0 4300 

7515703 POTASSIUM CHLORIDE SR 5 MEQ 250 0 0 4300 

7515711 NABUMETONE 250 MG TAB 250 0 0 4300 

7515729 NADOLOL 10 MG TAB 250 0 0 4300 

7515737 OXCARBAZEPINE 150 MG TAB 250 0 0 4300 

7515745 OXCARBAZEPINE 75 MG TAB 250 0 0 4300 


7515760 SOTALOL 40 MG TAB 250 0 0 4300 

7515778 TIZANIDINE 2 MG TAB 250 0 0 4300 

7515786 AVEENO BATH 250 0 0 4300 

7515794 MITOMYCIN 500 MCG EYE SURG 636 0 0 4300 

7515802 ALBUMIN 25% 50 ML VIAL 636 0 90 4300 

7515810 ALBUMIN 5% 250 ML VIAL 636 0 100.6 4300 

7515828 VALPROATE SODIUM 500 MG/5 ML INJ 250 0 0 4300 

7515836 SORBITOL 70% 480 ML BOTTLE 250 0 0 4300 

7515844 MORPHINE 100 MG ADDV VIAL INJ 250 0 0 4300 

7515851 MIDAZOLAM 50MG/10ML VIAL 636 0 0 4300 

7515869 HYDROMORPHONE 1 MG/ML 1 ML SYRINGE 636 0 0 4300 

7515877 OSELTAMIVIR 12MG/ML SUSP 25 ML BTL 250 0 0 4300 

7515885 PODOPHYLLYM 25% SOLN 15 ML 250 0 0 4300 

7515893 FUROSEMIDE 40MG/4ML ORAL SOLUTION 250 0 0 4300 

7515901 PEDIATRIC CODE CART 270 0 0 4300 

7515919 ADULT CODE CART 270 0 0 4300 

7515927 GASTROVIEW (MD GASTROVIEW) 120 ML 636 0 0 4300 

7515935 BACLOFEN 5 MG TAB 250 0 0 4300 

7515943 OLMESARTAN 10 MG TAB 250 0 0 4300 

7515950 THEOPHYLLILNE SR 100 MG TAB 250 0 0 4300 

7515968 PHYTONADIONE 2.5 MG TAB 250 0 0 4300 

7515976 TORSEMIDE 10 MG TAB 250 0 0 4300 

7515984 CEFTAZIDIME 2 GM ADDV 636 0 0 4300 

7515992 UNASYN 3 GM ADDV 636 0 0 4300 

7516008 MORPHINE 5 MG/ML INJ 636 0 0 4300 

7516016 VANCOMYCIN 250 ML/5ML ORAL 636 0 0 4300 

7516024 SODIUM THIOSULFATE 12.5GM/50 ML INJ 250 0 0 4300 

7516032 ADACEL DIPTHERIA, PERTUSSIS TET 636 0 0 4300 

7516040 DAPTACEL DIPTHERIA, PERTUSSIS, TET 250 0 0 4300 

7516057 CLOPIDOGREL 300 MG TAB 250 0 0 4300 

7516065 HEPATITUS A VACCINE 720 ELU/.5 ML 636 0 0 4300 

7516073 VANCOMYCIN 250 MG CAP 250 0 0 4300 

7516081 LIDOCAINE 1% INJ 10 ML 250 0 0 4300 

7516099 MIDAZOLAM 10MG/5 ML UD CUP 250 0 0 4300

7516115 BACITRACIN 50 MU INJ VIAL 250 0 0 4300 

7516131 DRONEDARONE 400 MG TAB 250 0 0 4300 

7516149 AMINOPHYLLINE 500 MG/20 ML INJ 636 0 0 4300 

7516156 PANCRELIPASE 5,000 UNITS 250 0 0 4300 

7516164 PRASUGREL 5 MG TAB 250 0 0 4300 

7516172 PRASUGREL 10 MG TAB 250 0 0 4300 

7516180 LIDOCAINE 1% W/EPI 1:100,000 250 0 0 4300 

7516198 REGADENOSON INJ .4 MG/5ML 636 0 0 4300 

7516206 HYDROXOCOBALAMIN 2.5 GM/VIAL 250 0 0 4300 

7516214 TRAVOPROST Z 0.004% 250 0 0 4300 

7516222 HEP SODIUM LOCK 10U/ML SDV 10ML INJ 636 0 0 4300 

7516230 VANCOMYCIN 125 MG/2.5 ML ORAL 636 0 0 4300 

7516248 EDROPHONIUM/ATROPINE 10 MG/.14 MG 250 0 0 4300 

7516255 VANCOMYCIN 250MG/5ML ORAL 636 0 0 4300 

7516263 DABIGATRAN 150 MG CAP 250 0 0 4300 

7516271 DABIGATRAN 75 MG CAP 250 0 0 4300 

7516289 NICARDIPINE 25 MG/10 ML VIAL 250 0 0 4300 

7516297 QUININE 324 MG CAP 250 0 0 4300 

7516305 HYDROCORTISONE SOD SUCCINATE 636 0 0 4300 

7516313 HYDROCORTISONE SOD SUCCINATE 100 MG 636 0 0 4300 

7516321 SULFAMETHOXAZOLE W/TMP SUSP 20 ML 250 0 0 4300 

7516339 MTHYLPRED SODIUM SUCCINATE 1000 MG 636 0 0 4300 

7516347 FERROUS SULFATE SR 45 MG 250 0 0 4300 

7516354 QUETIAPINE XR 50 MG TAB 250 0 0 4300 



7516388 INFLUENZA 2011 12 INJ MDV 10 ML 636 0 0 4300 

7516396 INFLUENZA 2011 12 INJ MDV 10 ML 636 0 0 4300 

7516404 INFLUENZA 2011 12 VAC .5 ML DOSE 636 0 0 4300 

7516412 INFLUENZA 2011 12 VAC .5 ML INJ 636 0 0 4300 

7516420 MISOPROSTOL 200 MCG TAB 250 0 0 4300 

7516438 ASENAPINE 10 MG TAB 250 0 0 4300 

7516446 ASENAPINE 5 MG TAB 250 0 0 4300 

7516453 CEFEPIME 1 GM VIAL 636 0 0 4300 

7516461 PNEUMOC 13 VAL CONJ DIP CR .5 ML IN 636 0 0 4300 

7516479 HEPATITIS B VIRUS VAC 10MCG/ML VL 636 0 0 4300 

7516487 ABATACEPT 250 MG VIAL 636 0 0 4300 

7516495 PANTOPRAZOLE 40 MG PACKET 250 0 0 4300 

7516503 THROMBIN BOVINE/GELATIN BOVINE 5 ML 270 0 0 4300 

7516511 THROMBIN BOVINE/GELATIN BOVINE 10ML 270 0 0 4300 

7516529 DEXMEDETOMIDINE 200 MCG/2ML 250 0 0 4300 

7516537 CEFEPIME 2 GM VIAL 636 0 0 4300 

7517550 ARIPIPRAZOLE 2 MG TAB 250 0 0 4300 

7517576 MORPHINE PF 0.2 MG/0.2 ML INJ 636 0 0 4300 

7517584 TRANEXAMIC ACID 1000 MG/10ML 250 0 0 4300 

7517592 LEVOTHYROXINE 100 MCG VIAL 250 0 0 4300 

7517600 MIDAZOLAM 10 MG/10 ML VIAL 636 0 0 4300

7517618 TETANUS AND DIPTHERIA TOX .5 ML INJ 636 0 0 4300 

7517626 LORAZEPAM 4 MG/ML VIAL INJ 636 0 0 4300 

7517634 LORAZEPAM 2 MG/0.5 ML VIAL INJ 636 0 0 4300 

7517642 CEFDINIR 250/5ML U/D ORAL 250 0 0 4300 

7517659 CEFDINIR 250/5ML BOTTLE 60 ML 250 0 0 4300 

7517667 CEFDINIR 300 MG CAP 250 0 0 4300 

7517675 PREDNISOLONE SODIUM PHOSPHATE 636 0 0 4300 

7517683 AZITHROMYCIN 500MG ADDV VIAL 636 0 0 4300 

7519804 BUPIVACAINE LIPOSOME 636 0 0 4300 

7519812 MILK OF MAGNESIA 2400MG/30ML CUP 250 0 0 4300 

7519820 BESIFLOXACIN 0.6% OPTH SOLN 250 0 0 4300 

7519838 FIDAXOMICIN 200 MG TAB 250 0 0 4300 

7519846 FACTOR VIII, ANTIHEMOPHILIC 636 0 0 4300 

7519853 FACTOR IX, HUMAN RECOMBINANT 636 0 0 4300 

7519861 ZOSYN 4.5 GM VIAL 636 0 0 4300 

7519879 HYDROXOCOBALAMIN 5 GM/VIAL 250 0 0 4300 

7519887 INFLUENZA 2012 2013 VACCINE .5 ML 636 0 0 4300 

7519895 LORTAB LIQUID 5 334MG/10ML U/D 250 0 0 4300 

7519903 ROPIVACAINE 5 MG/ML 20 ML AMP 636 0 0 4300 

7519911 CALMOSEPTINE OINTMENT 250 0 0 4300 

7519929 VANCOMYCIN 125 MG CAP 250 0 0 4300 

7519937 ARIPIPRAZOLE 9.75 MG/1.3 ML INJ 636 0 0 4300 

7519945 PALIPERIDONE 234 MG VIAL 636 0 0 4300 

7519952 PALIPERIDONE 156 MG VIAL 636 0 0 4300 

7519960 GLUCOSE(DEXTROSE) GEL ORAL 250 0 0 4300 

7519978 INFLUENZA 2012 2013 VAC .5 ML INJ 636 0 0 4300 

7519986 RIFAXAMIN 550 MG TAB 250 0 0 4300 

7519994 MORPHINE 250 MG ADDV VIAL 636 0 0 4300 

7520000 MIRACLE MOUTHWASH DUKE 250 0 0 4300 

7520018 COMBIVENT RESPIMAT 100 20 MCG 250 0 0 4300 

7520026 BIMATOPROST 0.01% 250 0 0 4300 

7520034 ATORVASTATIN 20 MG TAB 250 0 0 4300 

7520042 PENCICLOVIR 1% CREAM 250 0 0 4300 

7520059 SULFAMETHOXAZOLE/TRIMETHOPRIM IV 250 0 0 4300 

7520067 KETAMINE 10 MG/ML IV 250 0 0 4300 

7520075 DENTAL ADHESIVE CREAM 250 0 0 4300 

7520083 HYALURONATE SODIUM 48 MG SYRINGE 636 0 0 4300 

7520091 RIVAROXABAN 20 MG TAB 250 0 0 4300 



7520133 APIXABAN 2.5 MG TAB 250 0 0 4300 

7520141 MULTIVITAMIN/MULTIMINERAL LIQUID 250 0 0 4300 

7520158 INFLUENZA 2013 14 .5 ML INJ DOSE 636 0 0 4300 

7521123 APIXABAN 5 MG TAB 250 0 0 4300 

7550023 CULT SKIN SUBST HUMA DISK 250 0 0 4300 

7550031 ETHYL ALCOHOL INJ 250 0 0 4300 

7550049 HYDROCORTISONE POWDER 250 0 0 4300

7550056 ACETAMINOPHEN 100 MG DROPS 250 0 0 4300 

7550064 REPAGLINIDE 0.5 MG TAB 250 0 0 4300 

7550072 HYDROCORTISONE CREAM 250 0 0 4300 

7550080 MESALAMINE 4 G ENEMA 250 0 0 4300 

7550098 MERCAPTOPURINE 50 MG TAB 250 0 0 4300 

7550106 PYRIDOXINE HCL 100 M VIAL 636 0 0 4300 

7550114 HYDROCORTISONE 100 MG ENEMA 250 0 0 4300 

7550122 EPINEPHRINE 0.3 MG PEN IN 250 0 0 4300 

7580004 FLEET BAGENEMA 270 0 0 4300 

7580012 FLEET 4.5 ENEMA 270 0 0 4300 

7580020 FLEET PREP KIT #1 270 0 0 4300 

7599996 NON FORMULARY MED 250 0 0 4300 

7600018 AMINO ACIDS 7% INJ 250 0 0 4310 

7600026 AA 5%/ELECTROLYTE-TP INJ 250 0 0 4310 

7600034 AMINO ACIDS 3.5%/D5W INJ 250 0 0 4310 

7600042 AMINO ACIDS 10% INJ 250 0 0 4310 

7600059 AMINO ACIDS 3.5%/D25 INJ 250 0 0 4310 

7600091 DEXTROSE 10%-WATER INJ 258 0 0 4310 



7600125 DEXTROSE 5%-0.25% SA INJ 258 0 0 4310 



7600158 POTASSIUM CHLORIDE/D INJ 250 0 0 4310 

7600166 DEXTROSE 5% 1/4 N.S. INJ 258 0 0 4310 





7600216 DEXTROSE 5%-LACTATED INJ 258 0 0 4310 

7600224 DEXTROSE 5%-NORMAL S INJ 258 0 0 4310 



7600257 DEXTROSE 5%-WATER PGGYBCK 258 0 0 4310 


7600273 DEXTROSE 5%-WATER ADDV 258 0 0 4310 



7600307 N.S./20MEQ POT CHL INJ 250 0 0 4310 

7600315 N.S./40MEQ POT CHL INJ 250 0 0 4310 

7600323 OXYTOCIN PREMIX 30 UNITS PREMIX 258 0 0 4310 

7600331 DEXTROSE 5% 250ML BT ADDV 258 0 0 4310 

7600349 CONTAINER EMPTY 270 0 0 4310 

7600356 CONTAINER EVAC BOT 250ML 270 0 0 4310 

7600364 CONTAINER EMPTY 270 0 0 4310 

7600372 CONTAINER EMPTY 1000 270 0 0 4310 

7600380 CONTAINER EMPTY 250 270 0 0 4310

7600398 CONTAINER EMPTY 500 270 0 0 4310 

7600406 HETASTARCH/NA CHLOR INJ 250 0 0 4310 

7600455 FAT EMULSIONS 0 250 0 0 4310 

7600463 FAT EMULSIONS 0 250 0 0 4310 

7600471 RINGERS SOLUTION LAC INJ 258 0 0 4310 

7600505 SODIUM CHLORIDE 0.9% PGGYBCK 258 0 0 4310 

7600513 SODIUM CHLORIDE 0.45 INJ 258 0 0 4310 

7600521 SODIUM CHL 1000 ML INJ 636 0 0 4310 

7600539 SODIUM CHLORIDE 0.9% INJ 258 0 0 4310 

7600547 SODIUM CHLORIDE 0.9% ADDV 258 0 0 4310 

7600554 SODIUM CHLORIDE 0.9% 250 ML PGGYBCK 258 0 0 4310 

7600588 MANNITOL 20% 500 ML INJ 258 0 0 4310 

7600596 WATER FOR INJECTION INJ 250 0 0 4310 

7600604 WATER FOR INJECTION 250 0 0 4310 

7600612 MAGNESIUM SULFATE INFUS 258 0 0 4310 

7600661 7 HIGH PRESSURE SET" 270 0 0 4310 

7600679 BLOOD I.V. SET 270 0 0 4310 

7600687 SURGICAL IV SET 270 0 0 4310 

7600695 IV FILTER SET 270 0 0 4310 

7600711 BLOOD PUMP SET #4602 270 0 0 4310 

7600729 SECONDARY SET 270 0 0 4310 

7600745 PRIMARY IV SET 270 0 0 4310 

7600794 DEXTROSE 5% 250ML GLS BOTTLE 258 0 0 4310 

7600802 NACL 0.9% 250 ML ADDV 258 0 0 4310 

7600810 D5%W-1/2NS 250ML BAG INJ 258 0 0 4310 

7600836 D5%W 1/2NS 500ML BAG INJ 258 0 0 4310 

7600844 LMD 10% W/5% DEXTROSE 500ML INJ 258 0 0 4310 

7601016 STERILE WATER INJ 1000 ML INJ 258 0 0 4310 

7601024 NACL 0.9% 250ML GLASS BOTTLE 258 0 0 4310 

7601032 DILTIAZEM DRIP KIT VIAL 250 0 0 4310 

7601040 METRONIDAZOLE 125MG PB 250 0 0 4310 

7601057 0.9% NACL 250ML EXCEL PGGYBCK 258 0 0 4310 

7601065 0.9% NACL 50ML PAB PGGYBCK 258 0 0 4310 

7601073 0.9% NACL 100ML PAB 258 0 0 4310 

7601081 D5W 50ML PAB 258 0 0 4310 

7601099 D5W 250ML EXCEL PGBK 258 0 0 4310 

7601107 D5W 100ML PAB 258 0 0 4310 

7601110 D5W 400ML 258 0 0 4310 

7601115 AZITHROMYCIN 500MG/250ML IVPB 636 0 0 4310 

7601123 DOXYCYCLINE 100MG/250ML IVPB 250 0 0 4310 

7601131 ERTAPENAM 1GM/100ML IVPB 636 0 0 4310 

7601149 NAFCILLIN 1GM/100ML IVPB 250 0 0 4310 

7601156 CEFOXITIN 1GM/50ML IVPB 636 0 0 4310 

7601164 UNASYN 1.5GM/100ML NACL IVPB 636 0 0 4310 

7601172 UNASYN 3GM/100ML NACL IVPB 636 0 0 4310 

7601180 CEFTAZIDIME 2 GM/100 ML IVPB 636 0 0 4310 

7601198 VANCOMYCIN 500 MG/100 ML IVPB 636 0 0 4310

7601206 FLUCONAZOLE 400 MG/200 ML IVPB 636 0 0 4310 

7601214 ZOSYN 3.375 GM/100 ML IVPB 636 0 0 4310 

7601222 AMPICILLIN 1 GM/100 ML 636 0 0 4310 

7601230 CEFUROXIME 1.5 GM/100 ML IVPB 636 0 0 4310 

7601248 AMPICILLIN 2GM/100ML IVPB 636 0 0 4310 

7601255 PENICILLIN G 2.5MIL UNITS/100ML IVP 636 0 0 4310 

7601263 PENICILLIN G 5MILLION UNITS/100ML 636 0 0 4310 

7601271 MAGNESIUM 2 GM/50ML IVPB 636 0 0 4310 

7601289 PENICILLIN G 5 MILLION UNITS/250 ML 636 0 0 4310 

7601297 MORPHINE 1000 MG/100ML 636 0 0 4310 

7601305 MORPHINE 500 MG/50 ML 636 0 0 4310 

7601313 .45% SODIUM CHLORIDE/20 MEQ KCL IV 250 0 0 4310 

7601321 AZACTAM 1 GM/50 ML D5W 250 0 0 4310 

7601339 LIPOSYN III 20% INJECTION 500 ML 636 0 0 4310 

7601347 HYDROMORPHONE 25MG/100ML DRIP IVPB 636 0 0 4310 

7601354 HYDROMORPHONE 100MG/100ML DRIP IVPB 636 0 0 4310 

7601362 CEFTAZIDIME 1GM/100ML D5W IV 636 0 0 4310 

7601370 NITROGLYCERIN 50 MG/250 ML BTL INJ 250 0 0 4310 

7601388 NOREPINEPHRINE 4 MG/1000 ML D5W KIT 250 0 0 4310 

7601396 DILTIAZEM 125 MG/125 ML MIX 250 0 0 4310 

7601404 LORAZEPAM 240 MG/120 ML D5W MIX 636 0 0 4310 

7601412 LORAZEPAM 40MG/400 ML KIT 636 0 0 4310 

7601420 LORAZEPAM 40MG/400 ML MIX 636 0 0 4300 

7601438 MIDAZOLAM 100MG/100ML D5W MIX 636 0 0 4300 

7601446 PHENYTOIN 500MG/100ML NACL KIT 250 0 0 4300 

7601461 NITROGLYCERIN 25MG/D5W 250 ML 250 0 0 4300 

7601479 VECURONIUM 100 MG/100 ML D5W KIT 250 0 0 4300 

7601487 AMIODARONE 150 MG/100 ML D5W KIT 636 0 0 4300 

7601495 AMIODARONE 450 MG/250 ML D5W KIT 636 0 0 4300 

7601503 PROPOFOL 1% INFUSION (10 MG/ML) 250 0 0 4300 

7601511 NICARDIPINE .1 MG/ML D5W 200 ML 250 0 0 4300 

7601529 CLINDAMYCIN 600 MG/D5W 100 ML 250 0 0 4300 

7601537 CLINDAMYCIN 900MG/D5W 100 ML 250 0 0 4300 

7601545 FLUCONAZOLE 400MG/200 ML NACL IVPB 636 0 0 4300 

7601552 FLUCONAZOLE 50MG/25ML NACL IVPB 636 0 0 4300 

7601560 FLUCONAZOLE 100MG/50 ML NACL IVPB 636 0 0 4300 

7601578 FLUCONAZOLE 150MG/75ML NACL IVPB 636 0 0 4300 

7601586 HEPARIN 25,000 UN/500 ML BAG 636 0 0 4300 

7601594 CEFEPIME 1 GM/50 ML D5W 636 0 0 4300 


7601610 D5W 250 ML VISIV 250 0 0 4300 

7601628 AMIODARONE 360 MG/200 ML D5W PREMIX 636 0 0 4300 

7601701 CEFAZOLIN 2 GM/50 ML D5W 636 0 0 4310 

7601719 HEPARIN 25,000 UN/500 ML D5W BAG 636 0 0 4310 

7601727 LACTATED RINGERS 500 ML 636 0 0 4310 

7601735 .45% NACL 500 ML 250 0 0 4310 

7601743 ACETAMINOPHEN 10 MG/ML IV 250 0 0 4310

7690001 RED CAP LUER LOCK MED SUPPLY 270 0 0 4300 

7690019 INTUBATION KIT 270 0 0 4310 

7690027 IV EQUIPMENT 1 SET 270 0 0 4310 

7690191 CONTAINER EMPTY IV 100ML 270 0 0 4310 

7690506 CONTAINER EMPTY IV 100ML 270 0 0 4310 

7690514 EMPTY IV BAG 250ML 270 0 0 4310 

7690522 EMPTY IV BAG 250ML 270 0 0 4310 

7690530 CONTAINER EMPTY BAG LITER 270 0 0 4310 

7690548 CONTAINER EMPTY BAG 500 ML 270 0 0 4310 



7690571 CONTAINER EVAC BOT 1000 ML 270 0 0 4310 

7700057 EVAL SPEECH & LANGUAGE (PROC) 444 0 430.14 4371 

7700107 SPEECH & LANGUAGE TX (PROC) 440 0 304 4371 

7700156 SWALLOW EVAL (PROC) 444 0 415.88 4371 

7700206 SWALLOW TX (PROC) 440 0 284.8 4371 

7700255 AAC EVAL NON-SPEECH GEN (PROC) 444 0 447.5 4371 

7700354 AAC EVAL SPEECH GEN 1ST HR 444 0 458 4371 

7700404 AAC 30 ADD'L MIN 440 0 197 4371 

7700453 VIDEO FLUORO EVAL (PROC) 444 0 523.33 4371 

7700461 DEVELOPMENT COG SKILLS PER 15 MIN 440 0 57.52 4371 

7700479 TREATMENT SP/LANG, GRP 440 0 49.76 4371 

7700487 AC THER SVC, SPEECH GEN 440 0 300.55 4371 

7700495 EVAL VOICE PROSTHETIC DEVICE 444 0 421 4371 

7790009 SPEECH STROKE SCREEN 999 0 0 4371 

7790017 SPEECH OUTPT VISIT 999 0 0 4371 

7790025 SPEECH INPT VISIT 999 0 0 4371 

7790033 SPEECH IP-NO CHARGE 999 0 0 4371 

7790041 SP/CANCELLED VISIT 999 0 0 4371 

7790058 SP/CANCELLED-DSCHGD 999 0 0 4371 

7790066 SP-ABSENT 999 0 0 4371 

7790744 DVELOPMNT, COGNITIVE SKILL PER 15 M 440 0 57.52 4371 

7790769 AAC THER SVC, SPEECH-GEN 440 0 300.55 4371 

7790785 EVAL, AAC THERAPY NON SPEECH EA ADD 444 0 141.87 4371 

7800055 SPEECH & LANGUAGE EVAL (PROC) DLS 444 0 430.14 4372 

7800105 SPEECH & LANGUAGE TX (PROC) 440 0 304 4372 

7800154 SWALLOW EVAL (PROC) DLS 444 0 415.88 4372 

7800204 SWALLOW TX (PROC) DLS 440 0 284.8 4372 

7800212 DVLOPMT COGNITIVE SKILLS PER 15 MIN 440 0 57.52 4372 

7800220 TREATMENT SP/LANG, GROUP DLS 440 0 49.76 4372 

7800238 AAC THER SVC, SPEECH-GEN DLS 440 0 300.55 4372 

7800246 EVAL, VOICE PROSTHETIC DEVICE DLS 444 0 421 4372 

7800261 MOTION FLUORO EVAL(MBS) DLS 444 0 523.33 4372 

7800709 EVAL AAC NON SPEECH EA ADD'L 30 MIN 444 0 141.87 4372 

7890007 SP-STROKE SCREEN DLS 999 0 0 4372 

7890015 SP OUTPT VISIT DLS 999 0 0 4372 

7890023 SP-CANCEL-DISCH DLS 999 0 0 4372

7890031 SP-CANCEL VISIT DLS 999 0 0 4372 

7890049 SP-ABSENT DLS 999 0 0 4372 

7900053 PLFD SPEECH & LANGUAGE EVAL (PROC) 444 0 430.14 4373 

7900103 SPEECH & LANGUAGE TX (PROC) PLF 440 0 304 4373 

7900152 SWALLOW EVAL (PROC) PLF 444 0 415.88 4373 

7900202 SWALLOW TX (PROC) PLF 440 0 284.8 4373 

7900251 AAC EVAL NON SPEECH (PROC) PLF 444 0 447.5 4373 

7900350 AAC EVAL SPEECH 1ST HR PLF 444 0 458 4373 

7900400 AAC 30 ADD'L MINUTES PLF 440 0 197 4373 

7900509 AAC THER SERVICE (PROC) PLF 440 0 300.55 4373 

7900517 DVLPMT , COGITIVE SKILLS PER 15 PLF 440 0 57.52 4373 

7900673 EVAL, AAC NON SPEECH EA ADD'L 30 MN 444 0 141.87 4373 

7990005 SP-STROKE SCREEN PLF 999 0 0 4373 

7990013 SP-OUTPAT VISIT PLF 999 0 0 4373 

7990021 SP-CANCEL VISIT PLF 999 0 0 4373 

7990039 SP-CANCEL-DISCH PLF 999 0 0 4373 

7990047 SP-ABSENT PLF 999 0 0 4373 

8000051 SPINAL ANESTHESIA 1ST 1/2 HR 370 0 127.47 4350 

8000069 SPINAL ANES EA ADD'L 15 MIN 370 0 15.39 4350 

8000101 MONITORED ANESTHESIA 1ST 1/2 HR 370 0 191.19 4350 

8000119 MONITORED ANESTHESIA EA ADD'L 15MIN 370 0 26.08 4350 

8000200 OB EPIDURAL ANES 370 0 718.72 4350 

8000218 OB SPINAL ANESTHESIA EA ADD'L 15MIN 370 0 15.39 4350 

8000226 OB SPINAL ANESTHESIA 1ST 1/2 HR 370 0 112.82 4350 

8000259 GENERAL ANESTHESIA 1ST 1/2 HR 370 0 382.39 4350 

8000267 GENERAL ANESTHESIA EA ADD'L 15 MIN 370 0 52.15 4350 

8000358 IV REGIONAL BLOCK 1ST 1/2 HR 370 0 63.73 4350 

8000366 IV REGIONAL BLOCK EA ADD'L 15 MIN 370 0 8.69 4350 

8000408 OR EPIDURAL ANES 1ST 1/2 HR 370 0 254.93 4350 

8000416 OR EPIDURAL ANES EA ADD'L 15 MIN 370 0 34.77 4350 

8000424 PRE OP PAIN BLOCK 710 0 725.69 4350 

8200057 EVALUATION (PROC) DLS 424 0 172.6 4372 

8200107 RE-EVALUATION (PROC) DLS 424 0 91.86 4372 

8201006 GAIT TRAINING PER 15 MIN DLS 420 0 58.47 4372 

8201055 THERAPEUTIC EX PER 15 MIN DLS 420 0 67.74 4372 

8201105 ULTRASOUND PER 15 MIN DLS 420 0 28.14 4372 

8201204 PARAFIN (PROC) DLS 420 0 17.62 4372 

8201303 E-STIM, MANUAL ATTEND/15 MIN DLS 420 0 43.62 4372 

8201352 ESTIM INTER UNATTENDED (PROC) DLS 420 0 116 4372 

8201402 TENS (PROC) DLS 420 0 32.14 4372 

8201451 ADL PER 15 MIN DLS 420 0 76.09 4372 

8201469 THERAPEUTIC PROCEDURE GROUP DLS 420 0 45.48 4372 

8201477 CHCKOT ORTH PROS PER 15 MIN DLS 420 0 109.27 4372 

8201501 IONTOPHORESIS PER 15 MIN DLS 420 0 43.62 4372 

8201550 MECHANICAL TRACTION (PROC) DLS 420 0 34.33 4372 

8201600 NEURO MUSC RE-ED PER 15 MIN DLS 420 0 70.51 4372 

8201659 MANUAL THER TECHN PER 15 MIN DLS 420 0 63.1 4372

8201709 PROSTETIC TRAIN PER 15 MIN DLS 420 0 114.5 4372 

8201758 THERAPEUTIC ACTIVITY PER 15MIN DLS 420 0 84.43 4372 

8202251 KNEE STRAPPING (PROC)DLS 420 0 133.91 4372 

8202301 ANKLE/FOOT STRAPPING (PROC) DLS 420 0 121.74 4372 

8202459 HIP STRAPPING (PROC) DLS 420 0 180.95 4372 

8202657 CONTRAST BATHS PER 15 MIN DLS 420 0 33.4 4372 

8202855 WHEELCHAIR MGMT PER 15 MIN DLS 420 0 63.1 4372 

8203499 DLSN FOWOJT L3933 274 0 257.42 4372 

8203523 THERAPEUTIC PROCEDURE, GROUP 420 0 45.48 4372 

8203531 CHECKOUT, ORTH/PROS USE, PER 15 MIN 420 0 109.27 4372 

8205007 DLSN PT VASOPNEUMATIC DEVICE 420 0 30.61 4372 

8280257 DLSN ELECTRODES 270 0 14.4 4372 

8280307 DLSN PUTTY 270 0 5.15 4372 

8280356 DLSN TENS UNIT 270 0 51.5 4372 

8280406 DLSN THERABAND 270 0 5.15 4372 

8280455 DLSN GAUZE 2X2 270 0 6.2 4372 

8280505 DLSN GAUZE 4X4 270 0 7.2 4372 

8280554 DLSN KERLIX ROLLS 270 0 22.65 4372 

8280604 DLSN KERLIX SPONGE 270 0 3.1 4372 

8280653 DLSN TELFA 8X3 270 0 18.55 4372 

8280703 DLSN PADS ABD 10X8 270 0 8.25 4372 

8290009 DLSN-STROKE SCREEN 999 0 0 4372 

8290017 DLSN-OUTPATIENT VISIT 999 0 0 4372 

8290025 DLSN-OP NO CHARGE 999 0 0 4372 

8290033 DLSN-ABSENT 999 0 0 4372 

8290041 DLSN/CANCELLED VISIT 999 0 0 4372 

8290058 DLSN/CANCELLED-DSCHG 999 0 0 4372 

8300055 EVALUATION (PROC) PLF 424 0 172.6 4373 

8300105 PLFD RE-EVALUATION (PROC) 424 0 91.86 4373 

8301004 GAIT TRAINING PER 15 MIN PLF 420 0 58.47 4373 

8301053 THERAPEUTIC EXERCISE PER 15MIN PLF 420 0 67.74 4373 

8301103 ULTRASOUND PER 15 MIN PLF 420 0 28.14 4373 

8301152 WHIRLPOOL (PROC) PLF 420 0 40.81 4373 

8301202 PARAFIN (PROC) PLF 420 0 17.62 4373 

8301301 ELECTRICAL STIM(ATTENDED)15MIN PLF 420 0 43.62 4373 

8301350 ELECTRICAL STIM(UNATTENDED)) PLF 420 0 116 4373 

8301400 TENS APPLICATION PLF 420 0 32.14 4373 

8301459 SELF CARE HOME MGMT(ADL) PER 15 MIN 420 0 76.09 4373 


8301558 MECHANICAL TRACTION (PROC) DLS 420 0 34.33 4373 

8301608 NEURO MUSC RE-EDUC PER 15 MIN PLF 420 0 70.51 4373 

8301657 MANUAL THERAPY PER 15 MIN PLF 420 0 63.1 4373 

8301707 PROSTHETIC TRAINING PER 15 MIN PLF 420 0 114.5 4373 

8301756 THERAPEUTIC ACTIVITY PER 15MIN PLF 420 0 84.43 4373 

8301806 PHYS PERFTEST(FTE) PER 15 MIN PLF 420 0 65.88 4373 

8302309 ANKLE/FOOT STRAPPING (PROC) PLF 420 0 121.74 4373 

8302812 THERAPEUTIC PROCEDURE GROUP PLF 420 0 45.48 4373

8302820 CHCKOT ORTH PROS PER 15 MIN PLF 420 0 109.27 4373 

8302853 WHEELCHAIR MGMT PER 15 MIN PLF 420 0 63.1 4372 

8303109 ORTHOTIC TRAINING PER 15 MIN PLF 420 0 132 4373 

8303257 PLFD ELBOWORTHO L3702 274 0 348.36 4373 

8303265 PLFD EWHORTHO L3763 274 0 877.83 4373 

8303273 PLFD EWHFOWOJT L3765 274 0 1546.95 4373 

8305005 PLFD PT VASOPNEUMATIC DEVICE 420 0 30.61 4373 

8380255 PLFD ELECTRODES 270 0 14.4 4373 

8380305 PLFD PUTTY 270 0 5.15 4373 

8380354 PLFD TENS UNIT 270 0 51.5 4373 

8380404 PLFD THERABAND 270 0 5.15 4373 

8380453 PLFD GAUZE 2X2 270 0 6.2 4373 

8380503 PLFD GAUZE 4X4 270 0 7.2 4373 

8380552 PLFD KERLIX ROLLS 270 0 22.65 4373 

8380602 PLFD KERLIX SPONGE 270 0 3.1 4373 

8380651 PLFD TELFA 8X3 270 0 18.55 4373 

8380701 PLFD PADS ABD 10X8 270 0 8.25 4373 

8390007 PLFD STROKE SCREEN 999 0 0 4373 

8390015 PLFD-OUTPATIENT VISIT 999 0 0 4373 

8390023 PLFD-OP NO CHARGE 999 0 0 4373 

8390031 PLFD-ABSENT 999 0 0 4373 

8390049 PLFD/CANCELLED VISIT 999 0 0 4373 

8390056 PLFD/CANCELLED-DSCHG 999 0 0 4373 

8400053 EVALUATION (PROC) 424 0 172.6 4371 

8400103 RE-EVALUATION (PROC) 424 0 91.86 4371 

8401002 GAIT TRAINING PER 15 MIN 420 0 58.47 4371 

8401051 THERAPEUTIC EX PER 15 MIN 420 0 67.74 4371 

8401101 ULTRASOUND PER 15 MIN 420 0 28.14 4371 

8401150 WHIRLPOOL (PROC) 420 0 40.81 4371 

8401200 PARAFIN (PROC) 420 0 17.62 4371 

8401309 E-STIM,MANUAL ATTEND PER 15 MIN 420 0 43.62 4371 

8401358 E-STIM INTER UNATTEND (PROC) 420 0 116 4371 

8401408 TENS (PROC) 420 0 32.14 4371 

8401457 ADL-15 PER 15 MIN 420 0 76.09 4371 

8401507 IONTOPHORESIS PER 15 MIN 420 0 37.12 4371 

8401556 MECHANICAL TRACTION (PROC) 420 0 34.33 4371 

8401606 NEURO-MUSC RE-EDUCAT PER 15 MIN 420 0 70.51 4371 

8401655 MANUAL THER TECHNIQUE PER 15 MIN 420 0 63.1 4371 

8401705 PROSTHETIC TRAINING/15 MIN 420 0 114.5 4371 

8401754 THERAPEUTIC ACTIVITY PER 15 MIN 420 0 84.43 4371 

8401903 SHORT ARM SPLINT STA 420 0 146.09 4371 

8402257 KNEE STRAPPING (PROC) 420 0 133.91 4371 

8402307 ANKLE/FOOT STRAPPING (PROC) 420 0 121.74 4371 

8402455 HIP STRAPPING (PROC) 420 0 180.95 4371 

8402851 W/C MOB/MANAGE PER 15 MIN 420 0 63.1 4371 

8403107 ORTHOTIC FIT & TRAIN PER 15M MIN 420 0 132 4371 

8403206 WHFOJTL L3806 274 0 548.03 4371

8403214 WHFOWOJT L3808 274 0 509.69 4371 

8403461 HFOWOJT L3913 274 0 326.76 4371 

8480105 CPM SET UP 420 0 67.74 4371 

8480154 CPM PADS 270 0 53.55 4371 

8480204 CPM RENTAL 270 0 25.75 4371 

8480253 ELECTRODES 270 0 14.4 4371 

8480303 PUTTY 270 0 5.15 4371 

8480352 TENS UNIT 270 0 51.5 4371 

8480402 THERABAND 270 0 5.15 4371 

8480451 GAUZE 2X2 270 0 6.2 4371 

8480501 GAUZE 4X4 270 0 7.2 4371 

8480550 KERLIX 4-1/2" 270 0 22.65 4371 

8480600 KERLIX SPONGE 270 0 3.1 4371 

8480659 TELFA 8X3 270 0 18.55 4371 

8480709 PADS ABO 10X8 270 0 8.25 4371 

8480758 CERV COLLAR-FORM FIT 274 0 23.18 4371 

8480766 VASOPNEUMATIC DEVICE 420 0 30.61 4371 

8480774 FLUIDOTHERAPY 420 0 40.81 4372 

8490005 PT STROKE SCREEN 999 0 0 4371 

8490013 DKH/INPATIENT VISIT 999 0 0 4371 

8490021 DKH/IP NO CHG 15 999 0 0 4371 

8490039 DKH/CANCELLED VISIT 999 0 0 4371 

8490047 DKH/CANCELLED-DSCHGD 999 0 0 4371 

8490054 DKH/OUTPATIENT VISIT 999 0 0 4371 

8490062 DKH/OP NO CHG 15 999 0 0 4371 

8490070 DKH/ABSENT 999 0 0 4371 

8600058 OT EVALUATION (PROC) 434 0 180.01 4371 

8600108 OT RE-EVALUATION (PROC) 434 0 121.57 4371 

8601007 OT EXERCISE PER 15 MIN 430 0 67.74 4371 

8601056 OT THERAPEUTIC ACTIVITY/15 MIN 430 0 84.43 4371 

8601106 OT ULTRASOUND PER 15 MIN 430 0 28.14 4371 

8601155 OT WHIRLPOOL (PROC) 430 0 40.81 4371 

8601205 OT PARAFIN (PROC) 430 0 17.62 4371 

8601304 OT ESTIM,MANUAL ATT PER 15 MIN 430 0 43.62 4371 

8601353 OT ESTIM,INTER UNATT (PROC) 430 0 116 4371 

8601403 OT TENS (PROC) 430 0 32.14 4371 

8601452 OT ADL-15 PER 15 MIN 430 0 76.09 4371 

8601502 OT IONTOPHORESIS PER 15 MIN 430 0 37.12 4371 

8601601 OT NEUR-MUSC RE-ED PER 15 MIN 430 0 70.51 4371 

8601650 OT MANUAL THER TECH PER 15 MIN 430 0 63.1 4371 

8601700 OT PROSTHETIC TRAIN/15 MIN 430 0 114.5 4371 

8602302 OT ANKLE/FOOT STRAPPING (PROC) 430 0 121.74 4371 

8602450 OT HIP STRAPPING (PROC) 430 0 180.95 4371 

8602658 OT CONTRAST BATHS/15 MIN 430 0 33.4 4371 

8602765 OT COGNITIV RE-TRAIN/15 MIN 430 0 57.52 4371 

8602807 OT SENSORY INT TECH/15 MIN 430 0 61.24 4371 

8602856 OT W/C MOB/MANAGE/15 MIN 430 0 63.1 4371

8602906 OT AQUATIC REHAB/15 MIN 430 0 74.23 4371 

8603102 OT ORTHOTIC FIT&TRN PER 15 MIN 430 0 132 4371 

8603201 OT WHFOJT L3806 274 0 548.03 4371 

8603219 OT WHFOWOJT L3808 274 0 509.69 4371 

8603250 OT ELBOWORTHO L3702 274 0 348.36 4371 

8603441 OT WHOWOJT L3906 274 0 582.98 4371 

8603466 OT HFOWOJT L3913 274 0 326.76 4371 

8603474 OT HOWOJT L3919 274 0 326.76 4371 

8603482 OT HFO1+JT L3921 274 0 387.54 4371 

8603490 OT FOWOJT L3933 274 0 257.42 4371 

8603524 MOLDED INSERT PREFAB 274 0 301.68 4371 

8603706 OT-VASOPNEUMATIC DEVICE 430 0 30.61 4371 

8603714 OT-FLUIDOTHERAPY 430 0 40.81 4371 

8680050 ELECTRODES 270 0 14.4 4371 

8680308 PUTTY 270 0 5.15 4371 

8680407 THERABAND 270 0 5.15 4371 

8680456 OT-GAUZE 2X2 270 0 8.25 4371 

8680506 OT GAUZE 4X4 270 0 7.2 4371 

8680555 OT-KERLIX RLS 4-1/2 270 0 22.65 4371 

8680605 OT-KERLIX SPONGE 270 0 3.1 4371 

8680654 OT-TELFA 8X3 270 0 18.55 4371 

8680704 OT-PADS ABO 10X8 270 0 8.25 4371 

8680811 WHO, NON TORSION JOINTS L3764 274 0 1595.28 4371 

8680829 EO, ADJ POS LOCK, ACT CTL L3740 274 0 2661.16 4371 

8680837 EO, EXT/FLEX ASSIST L3730 274 0 1991.56 4371 

8680845 EWHO, NON TORSION JOINTS 274 0 1529.44 4371 

8680860 EWHFO, NON TORSION L3766 274 0 2184.14 4371 

8680878 SO, ABD POS, W/O JOINTS L3674 274 0 1802.52 4371 

8690000 OT STROKE SCREEN 999 0 0 4371 

8690018 OT INPATIENT VISIT 999 0 0 4371 

8690026 OT-CANCELLED VISIT 999 0 0 4371 

8690034 OT-CANCELLED-DSCHGD 999 0 0 4371 

8690042 OT ABSENT 999 0 0 4371 

8690059 OT DKH/OP NO CHG 999 0 0 4371 

8690067 OT DKH/IP NO CHG 999 0 0 4371 

8690075 OT OUTPAT VISITS 999 0 0 4371 

8700056 DLSN OT EVALUATION (PROC) DLS 434 0 180.01 4372 

8700106 DLSN OT RE-EVALUATION (PROC) DLS 434 0 121.57 4372 

8701005 THERAPEUTIC PROCEDURE PER 15 MIN 430 0 67.74 4372 

8701054 THERAPEUTIC ACTIVITY/15 MIN DLS 430 0 84.43 4372 

8701104 ULTRASOUND PER 15 MIN DLS 430 0 28.14 4372 

8701153 WHIRLPOOL (PROC) DLS 430 0 40.81 4372 

8701203 PARAFIN (PROC) DLS 430 0 17.62 4372 

8701302 ELECTRICAL STIM ATTENDED 15 MIN DLS 430 0 43.62 4372 

8701351 ELECTRICAL STIM UNATTENDED DLS 430 0 116 4372 

8701401 TENS APPLICATION DLS 430 0 32.14 4372 

8701450 SELF CARE/HOME MGMT ADL 15 MIN DLS 430 0 76.09 4372


8701609 NEURO MUSC RE-EDUCATION / 15 MIN 430 0 70.51 4372 

8701658 MANUAL THERAPY PER 15 MIN DLS 430 0 63.1 4372 

8701708 PROSTHETIC TRAIN PER 15 MIN DLS 430 0 114.5 4372 

8701807 PHYS PERF TEST(FTE) PER 15 MIN DLS 434 0 65.88 4372 

8702250 KNEE STRAPPING (PROC) DLS 430 0 133.91 4372 

8702300 ANKLE/FOOT STRAP (PROC) DLS 430 0 121.74 4372 

8702458 HIP STRAPPING (PROC) DLS 430 0 180.95 4372 

8702706 COMM/WORK REINTEG PER 15MIN DLS 430 0 61.24 4372 

8702755 DEVELOP COGN SKILL PER 15MIN DLS 430 0 57.52 4372 

8702805 SENSORY INT TECH PER 15 MIN DLS 430 0 61.24 4372 

8702854 WHEELCHAIR MGMT PER 15 MIN DLS 430 0 63.1 4372 

8703274 DLSN OT EWHFOWOJT L3765 274 0 1546.95 4372 

8703472 DLSN OT HOWOJT L3919 274 0 326.76 4372 

8703480 DLSN OT HFO1+JT L3921 274 0 387.54 4372 

8705006 DLSN OT VASOPNEUMATIC DEVICE 430 0 30.61 4372 

8780058 DLSN OT ELECTRODES 270 0 14.4 4372 

8780306 DLSN OT PUTTY 270 0 5.15 4372 

8780405 DLSN OT THERABAND 270 0 5.15 4372 

8780454 DLSN OT GAUZE 2X2 270 0 6.2 4372 

8780504 DLSN OT GAUZE 4X4 270 0 7.2 4372 

8780553 DLSN OT KERLIX ROLLS 270 0 22.65 4372 

8780603 DLSN OT KERLIX SPONGE 270 0 3.1 4372 

8780652 DLSN OT TELFA 8X3 270 0 18.55 4372 

8780702 DLSN OT PADS ABD 10X8 270 0 8.25 4372 

8790008 OT DLSN STROKE SCREEN 999 0 0 4372 

8790024 OT DLSN-CANCELLED VISIT 999 0 0 4372 

8790032 OT DLSN-CANCELLED DISCHGD 999 0 0 4372 

8790040 OT DLSN-ABSENT 999 0 0 4372 

8790065 OT DLSN-OP NO CHG 999 0 0 4372 

8790073 OT DLSN-OUTPAT VISIT 999 0 0 4372 

8800054 PLFD OT EVALUATION (PROC) PLF 434 0 180.01 4373 

8800104 PLFD OT RE-EVALUATION (PROC) PLF 434 0 121.57 4373 

8801003 THERAPEUTIC PROCEDURE PER 15 MIN 430 0 67.74 4373 

8801052 THERAPEUTIC ACTIVITY/15 MIN PLF 430 0 84.43 4373 

8801102 ULTRASOUND PER 15 MIN PLF 430 0 28.14 4373 

8801201 PARAFFIN(PROC) PLF 430 0 17.62 4373 

8801300 ELECTRICAL STIM ATTENDED /15 MIN 430 0 43.62 4373 

8801359 ELECTRICAL STIM UNATTENDED(PROC) 430 0 116 4373 

8801409 TENS APPLICATION PLF 430 0 32.14 4373 

8801458 SELF CARE HOME MGMT ADL /15 MIN 430 0 76.09 4373 

8801508 IONTOPHORESIS PER 15 MIN PLF 430 0 37.12 4373 

8801607 NEURO MUSC RE-ED PER 15 MIN PLF 430 0 70.51 4373 

8801656 MANUAL THERAPY /15 MIN PLF 430 0 63.1 4373 

8801706 PROSTHETIC TRAIN PER 15 MIN PLF 430 0 114.5 4373 

8802258 KNEE STRAPPING (PROC) PLF 430 0 133.91 4373 

8802308 ANKLE/FOOT STRAPPING (PROC) PLF 430 0 121.74 4373

8802456 HIP STRAPPING (PROC) PLF 430 0 180.95 4373 

8802803 SENSORY INTEGR TECH/15 MIN PLF 430 0 61.24 4373 

8802852 WHEELCHAIR MGMT PER 15 MIN PLF 430 0 63.1 4373 

8803215 PLFD OT WHFOWOJT L3808 274 0 509.69 4373 

8803256 PLFD OT ELBOWORTHO L3702 274 0 348.36 4373 

8803447 PLFD OT WHOWOJT L3906 274 0 582.98 4373 

8803462 PLFD OT HFOWOJT L3913 274 0 326.76 4373 

8803470 PLFD OT HOWOJT L3919 274 0 326.76 4373 

8803488 PLFD OT HFO1+JT L3921 274 0 387.54 4373 

8803496 PLFD OT FOWOJT L3933 274 0 257.42 4373 

8805004 PLFD OT VASOPNEUMATIC DEVICE 430 0 30.61 4373 

8880056 PLFD OT ELECTRODES 270 0 14.4 4373 

8880304 PLFD OT PUTTY 270 0 5.15 4373 

8880403 PLFD OT THERABAND 270 0 5.15 4373 

8880452 PLFD OT GAUZE 2X2 270 0 6.2 4373 

8880502 PLFD OT GAUZE 4X4 270 0 7.2 4373 

8880551 PLFD OT KERLIX ROLLS 270 0 22.65 4373 

8880601 PLFD OT KERLIX SPONGE 270 0 3.1 4373 

8880650 PLFD OT TELFA 8X3 270 0 18.55 4373 

8880700 PLFD OT PADS ABD 10X8 270 0 8.25 4373 

8890006 OT PLFD-STROKE SCREEN 999 0 0 4373 

8890022 OT PLFD-CANCELLED VISIT 999 0 0 4373 

8890030 OT PLFD-CANCELLED DSCHGD 999 0 0 4373 

8890048 OT PLFD-ABSENT 999 0 0 4373 

8890063 OT PLFD-OP NO CHG 999 0 0 4373 

8890071 OT PLFD-OUTPAT VISIT 999 0 0 4373 

9001009 INDIV THERAPY 45 MIN 914 0 493.35 4470 

9001256 GROUP THERAPY 915 0 138.49 4470 

9001454 THERAPY&MED EVAL-MD 45 50 914 0 138 4470 

9001702 INJECTION SC, IM 940 0 74.34 4470 

9002130 FAMILY PSYCHOTHERAPY 914 0 378.53 4470 

9002148 MULTIPLE FAMILY GRP PSYCHOTHERAPY 914 0 145.77 4470 

9002155 TELEPHONE TRIAGE NON BILLABLE 099 0 0 4470 

9002163 SUPERVISION TIME NON BILLABLE 099 0 0 4470 

9002171 INTERACTIVE INTERVIEW 914 0 217.5 4470 

9002189 FAMILY PSYCHOTHERAPY W/O PATIENT 914 0 141.25 4470 

9002197 PREPARE RPT OF PATIENT HX, TXN 914 0 131.25 4470 

9003005 LEVEL I MD 914 0 108.14 4470 

9003013 LEVEL II MD 914 0 161.13 4470 

9003021 LEVEL III MD 914 0 201.09 4470 

9003047 LEVEL IV MD 914 0 282.3 4470 

9003054 LEVEL V MD 914 0 384.27 4470 

9003062 LEVEL I APRN 914 0 108.14 4470 

9003070 LEVEL II APRN 914 0 161.13 4470 

9003088 LEVEL III APRN 914 0 201.09 4470 

9003096 LEVEL IV APRN 900 0 282.3 4470 

9003104 LEVEL V APRN 914 0 384.27 4470

9003112 INITIAL PSYCH EVAL MD 900 0 567.33 4470 

9003120 INITIAL PSYCH EVAL PSYCHOLOGIST 914 0 561.81 4470 

9003138 EMERG PSYCH EVAL NON CR MD 1ST 60 459 0 398.77 4470 

9003146 EMERG PSYCH EVAL NON CR NON MD 1ST 459 0 398.77 4470 

9003153 EMERG PSYCH EVAL NON CR MD EA ADDL 459 0 199.38 4470 

9003161 EMERG PSYCH EVAL NON CR NON MD EA 459 0 199.38 4470 

9003179 EMERG PSYCH EVAL CR MD 1ST 60 MIN 459 0 398.77 4470 

9003187 EMERG PSYCH EVAL CR NON MD 1ST 60 459 0 398.77 4470 

9003195 EMERG PSYCH EVAL CR MD EA ADDL 30 459 0 199.38 4470 

9003203 EMERG PSYCH EVAL CR NON MD EA ADDL 459 0 199.38 4470 

9003211 IND THERAPY 30 MIN W/MED EVAL MD 914 0 255.66 4470 

9003229 IND THERAPY 30 MINW/MED EVAL APRN 914 0 255.66 4470 

9003237 INITIAL PSYCH EVAL APRN 914 0 567.33 4470 

9003500 INITIAL PSYCH EVAL LCSW/LPC 914 0 561.84 4470 

9003518 INDIVIDUAL THERAPY 30 MIN 914 0 454.93 4470 

9003526 INDIVIDUAL PSYCHOTHERAPY 60 MIN 914 0 295.9 4470 

9004003 EAP PREVENTATIVE COUNSELING INDIV 914 0 288 4470 

9100058 AEROSOL SUPPLIES 270 0 30.65 4360 

9100108 AEROSOL INITIAL TREATMENT 410 0 57.34 4360 

9100116 AEROSOL SUBSEQUENT TREATMENT 410 0 57.34 4360 

9100207 ARTERIAL PUNCTURE 300 0 40.9 4360 

9100306 CHEST PHYSIOTHE INIT TREATMENT 410 0 83.65 4360 

9100314 CHEST PHYSIOTHE SUBS TREATMENT 410 0 83.65 4360 

9100504 INDUCED SPUTUM INIT TREATMENT 410 0 57.34 4360 

9100512 INDUCED SPUTUM SUBSE TREATMENT 410 0 57.34 4360 

9100702 MDI INITIAL TREATMENT 410 0 57.34 4360 

9100710 MDI SUBSEQUENT TREATMENT 410 0 57.34 4360 

9100801 OXYGEN 270 0 37.65 4360 

9100819 OXYGEN SUPPLIES 270 0 21 4360 

9100900 VITAL CAPACITY 460 0 62.5 4360 

9101007 SVN SUPPLIES 270 0 14 4360 

9101015 SVN INITIAL TREATMENT 410 0 57.34 4360 

9101023 SVN SUBSEQUENT TREATMENT 410 0 57.34 4360 

9101106 VENTILATOR 1ST DAY 410 0 636.07 4360 

9101114 VENT SUBSEQUENT DAYS 410 0 636.07 4360 

9101304 BIPAP/CPAP 410 0 207.64 4360 

9101312 BIPAP/CPAP SUPPLIES 270 0 77.9 4360 

9101403 PULSE OXIMETRY W/EXE 460 0 303.56 4360 

9101411 PULSE OXIMETRY OVERN 460 0 235.91 4360 

9101502 FLUTTER VALVE 270 0 129.55 4360 

9101510 FLUTTER VALVE INITIA 410 0 83.65 4360 

9101528 FLUTTER VALVE SUBSEQ 410 0 83.65 4360 

9105008 INHALATION TEACH&EVA 460 0 70.46 4360 

9105305 SMOKING CESSATION ED 410 0 71.04 4360 

9200155 PLETHYSOMOGRAPHY 460 0 213.72 4340 

9200353 LUNG VOLUME (TGV) 460 0 390.23 4340 

9200452 BEDSIDE FVL 460 0 128.7 4340

9200551 M V V 460 0 665.18 4340 

9200650 METHACHOLINE EVAL 460 0 1129.6 4340 

9200858 ARTERIAL PUNCT-PUL KIT 270 0 14.4 4340 

9200957 DLCO 460 0 625.5 4340 

9201054 SPIROMETRY 460 0 199.21 4340 

9201153 SPRIOMETRY W/BRONCHO 460 0 286.03 4340 

9201252 PULSE OXIMETRY 460 0 514.18 4340 

9201351 PULSE OX W/EXERCISE 460 0 303.56 4340 

9201450 INHALATION TEACH&EVA 460 0 70.46 4340 

9290016 PROVOCHOLINE PER 1MG 636 0 21.45 4340 

9300013 MOBILITY CURRENT STATUS 420 0 0.01 4371 

9300021 MOBILITY GOAL STATUS 420 0 0.01 4371 

9300039 MOBILITY D/C STATUS 420 0 0.01 4371 

9300047 BODY POS CURRENT STATUS 420 0 0.01 4371 

9300054 BODY POS GOAL STATUS 420 0 0.01 4371 

9300062 BODY POS D/C STATUS 420 0 0.01 4371 

9300070 CARRY CURRENT STATUS 420 0 0.01 4371 

9300088 CARRY GOAL STATUS 420 0 0.01 4371 

9300096 CARRY D/C STATUS 420 0 0.01 4371 

9300104 SELF CARE CURRENT STATUS 420 0 0.01 4371 

9300112 SELF CARE GOAL STATUS 420 0 0.01 4371 

9300120 SELF CARE D/C STATUS 420 0 0.01 4371 

9300138 OTHER PT/OT CURRENT STATUS 420 0 0.01 4371 

9300146 OTHER PT/OT GOAL STATUS 420 0 0.01 4371 

9300153 OTHER PT/OT D/C STATUS 420 0 0.01 4371 

9300161 SUB PT/OT CURRENT STATUS 420 0 0.01 4371 

9300179 SUB PT/OT GOAL STATUS 420 0 0.01 4371 

9300187 SUB PT/OT D/C STATUS 420 0 0.01 4371 



















9300500 SWALLOW CURRENT STATUS 440 0 0.01 4371

9300518 SWALLOW GOAL STATUS 440 0 0.01 4371 

9300526 SWALLOW D/C STATUS 440 0 0.01 4371 

9300534 MOTOR SPEECH CURRENT STATUS 440 0 0.01 4371 

9300542 MOTOR SPEECH D/C STATUS 440 0 0.01 4371 

9300559 LANG COMP CURRENT STATUS 440 0 0.01 4371 

9300567 LANG COMP GOAL STATUS 440 0 0.01 4371 

9300575 LANG COMP D/C STATUS 440 0 0.01 4371 

9300583 LANG EXPRESS CURRENT STATUS 440 0 0.01 4371 

9300591 LANG EXPRESS GOAL STATUS 440 0 0.01 4371 

9300609 LANG EXPRESS D/C STATUS 440 0 0.01 4371 

9300617 ATTEN CURRENT STATUS 440 0 0.01 4371 

9300625 ATTEN GOAL STATUS 440 0 0.01 4371 

9300633 ATTEN D/C STATUS 440 0 0.01 4371 

9300641 MEMORY CURRENT STATUS 440 0 0.01 4371 

9300658 MEMORY GOAL STATUS 440 0 0.01 4371 

9300666 MEMORY D/C STATUS 440 0 0.01 4371 

9300674 VOICE CURRENT STATUS 440 0 0.01 4371 

9300682 VOICE GOAL STATUS 440 0 0.01 4371 

9300690 VOICE D/C STATUS 440 0 0.01 4371 

9300708 SPEECH LANG CURRENT STATUS 440 0 0.01 4371 

9300716 SPEECH LANG GOAL STATUS 440 0 0.01 4371 

9300724 SPEECH LANG D/C STATUS 440 0 0.01 4371 

9300732 MOTOR SPEECH GOAL STATUS 440 0 0.01 4371 













9300864 SWALLOW CURRENT STATUS 440 0 0.01 4371 











9300971 SWALLOW GOAL STATUS 440 0 0.01 4371















































9301433 LANG EXPRESS GOAL STATUS 440 0 0.01 4371















































9301904 VOICE CURRENT STATUS 440 0 0.01 4371















































9302373 MOBILITY GOAL STATUS 430 0 0.01 4371















































9302845 CARRY CURRENT STATUS 420 0 0.01 4371










































9303272 OTHER PT/OT STATUS 420 0 0.01 4371 





9303322 OTHER PT/OT GOAL STATUS 420 0 0.01 4371







9303397 SUB PT/OT STATUS 420 0 0.01 4371 








































9303801 CARRY D/C STATUS 430 0 0.01 4371















































9304288 SUB PT/OT GOAL STATUS 430 0 0.01 4371









9445065 DKH AIM PAYMENT 0 0 1000 

9500059 GUEST TRAY 991 0 5.5 5600 

9500109 GUEST MEAL SPECIAL 991 0 0 5600 

9700014 SELF PAY DISCOUNT 0 0 5050 

9700022 STATE MLIA ALLOWANCE 0 0 5130 

9700071 CARE PAYMENT ALLOWANCE 0 0 5210 

9700154 RETURNED CHECK FEE ALLOWANCE 0 0 5850 

9700204 ESCHEAT SOC SMALL CREDIT BALANCE 0 0 2400 

9700402 COMBINED ACCOUNT BALANCE ALLOWANCE 0 0 1215 

9700436 ONE CALL MEDICAL ALLOWANCE 0 0 5210 

9700550 MBSC ALLOWANCE 0 0 5210 

9700683 NIPPON LIFE ALLOWANCE 0 0 5210 

9700717 CAREPAYMENT ADD ON ALLOWANCE 0 0 5210 

9700808 REFUND 0 0 1212 

9700816 VOIDED REFUND 0 0 1212 

9701004 MEDICARE ALLOW 0 0 5090 

9701020 MCR IP PART B ONLY ALLOW 0 0 5090 

9701038 PSYCH UNTD BEHAVE MED ALLOW 0 0 5170 

9701046 TRAILBLAZER ALLOW 0 0 5090 

9701053 PSYCH MHN MED AV ALLOW 0 0 5170 

9701061 MEDICARE APPEALS ALLOW 0 0 5090 

9701103 MEDICARE MANAGED CARE ALLOWANCE 0 0 5090 

9701111 FALLON SENIOR PLAN ALLOW 0 0 5090 

9701129 BLUE CHIP ALLOW 0 0 5090 

9701137 TUFTS MEDICARE PREF ALLOW 0 0 5090 

9701145 HEALTHNET SMARTCHOICE ALLOW 0 0 5090 

9701152 AMER PROG TODAY OPTION ALLOWANCE 0 0 5090 

9701160 EVERCARE MEDICARE ALLOW 0 0 5090 

9701178 CONNECTICARE MEDICARE ALLOW 0 0 5090 

9701186 HEALTHNET PEARL MEDICARE ALLOW 0 0 5090 

9701194 AETNA MEDICARE ADVANTAGE ALLOWANCE 0 0 5090 

9701202 MEDICARE SECONDARY ALLOW 0 0 5090 

9701301 CIGNA MEDICARE ADVANTAGE ALLOWANCE 0 0 5090 

9701319 AARP MEDICARE COMPLETE ALLOWANCE 0 0 5090 

9701400 H/L MCR PRO FEE OTHER 0 0 5090 

9701434 WORKERS COMP OF RI ALLOWANCE 0 0 5210 

9701509 SUPP STATE ALLOWANCE 0 0 5130 

9701517 H/L MCR ABN NOT SIGNED MCAID SUPP 0 0 5090 

9701525 H/L MCR ABN SIGNED MCAID SUPP 0 0 5010

9701533 SUPP BLUE CROSS ALLOWANCE 0 0 5170 

9701566 SUPP TRICARE ALLOWANCE 0 0 5210 

9701590 SUPP COMMERCIAL ALLOWANCE 0 0 5210 

9701780 RAC MEDICARE RECY ALLOWANCE 0 0 5090 

9701798 FIRST COAST MCR PART B ALLOW 0 0 5090 

9701806 H/L MEDICARE TIMELY FILING 0 0 5090 

9701814 H/L MEDICARE REGISTRATION ERROR 0 0 5090 

9701822 H/L MEDICARE OTHER 0 0 5090 

9701830 H/L MEDICARE NON CREDENTIAL 0 0 5090 

9701848 H/L MEDICARE CLINICAL ERROR 0 0 5090 

9701855 H/L MEDICARE NO AUTH ON FILE 0 0 5090 

9701863 H/L MEDICARE MEDICAL NECESSITY 0 0 5090 

9701871 H/L MEDICARE DAYS DENIED 0 0 5090 

9701889 H/L MEDICARE AUTH/SVC MISMATCH 0 0 5090 

9701897 H/L MEDICARE NON COVERED SERVICE 0 0 5090 

9701905 H/L MEDICARE ADMINISTRATION 0 0 5090 

9701913 H/L MEDICARE PATIENT/MEMBER 0 0 5090 

9701921 H/L MEDICARE RAC MED NEC 0 0 2387 

9701939 H/L MEDICARE RAC DRG CHANGE 0 0 2387 

9701947 H/L MCR 1 DAY STAY PRE PAY DENIAL 0 0 5090 

9701954 H/L MCR 1 DAY STAY POST PAY DENIAL 0 0 5090 

9701962 H/L MCR PRO FEE MEDICAL NECESSITY 0 0 5090 

9701970 H/L MCR PRO FEE TIMELY FILING 0 0 5090 

9701988 H/L MCR PRO FEE NO AUTH 0 0 5090 

9701996 H/L MCR PRO FEE CREDENTIAL ISSUE 0 0 5090 

9702002 MEDICAID ALLOWANCE 0 0 5130 

9702044 PSYCH BEHAVORAL HLTH ALLOWANCE 0 0 5130 

9702085 STATE AGENCIES ALLOWANCE 0 0 5130 

9702093 LMHA ALLOWANCE 0 0 5130 

9702101 HEALTHNET MCD MCO ALLOWANCE 0 0 5130 

9702119 BLUE CARE FAMILY PLAN ALLOWANCE 0 0 5130 

9702127 COMM HLTH NETWORK MCD ALLOWANCE 0 0 5130 

9702135 PREFERRED ONE/FIRST CHOICE ALLOW 0 0 5130 

9702143 AETNA BETTER HLTH ALLOWANCE 0 0 5130 

9702150 AMERICHOICE UNHLTHCARE ALLOWANCE 0 0 5130 

9702200 OUT OF STATE MEDICAID ALLOWANCE 0 0 5130 

9702218 RHODE ISLAND MEDICAID ALLOWANCE 0 0 5210 

9702234 COVENTRY HEALTH ALLOWANCE 0 0 5210 

9702259 MASS MEDICAID ALLOWANCE 0 0 5130 

9702267 NEW YORK MEDICAID ALLOWANCE 0 0 5130 

9702283 FIRST HEALTH ALLOWANCE 0 0 5210 

9702309 CHARTER OAK COMM HLTH ALLOWANCE 0 0 5210 

9702317 CHARTER OAK AMERICHOICE ALLOWANCE 0 0 5210 

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9940644 UMR PAYMENT 0 0 1000 

9940651 ULTRABENEFITS PAYMENT 0 0 1000 

9940669 STOP SHOP HEALTHCARE STRAT PAYMENT 0 0 5210 

9940677 MEDICAL MUTUAL PAYMENT 0 0 5210 

9940685 NIPPON LIFE PAYMENT 0 0 1000 

9940693 RURAL CARRIERS BENE PLAN PYMT 0 0 1000 

9940701 HEALTH PLANS INC PYMT 0 0 1000 

9940719 PSYCH MHN/PSH CARVEOUT PAYMENT 0 0 1000 

9940727 PSYCH VALUE BEHAVIORAL PAYMENT 0 0 1000 

9940735 DIVERSIFIED ADMIN PAYMENT 0 0 1000 

9940743 DIVERSIFIED GROUP BROKERAGE PAYMENT 0 0 1000 

9940750 GUARDIAN LIFE PAYMENT 0 0 1000 

9940768 HEALTHNET (PHS) PAYMENT 0 0 1000 

9940776 HEALTHNET/HEALTHNET PAYMENT 0 0 1000 

9940784 KANAWHA HEALTHCARE SOLUTIONS PYMT 0 0 1000 

9940792 MAIL HANDLERS BENEFIT FUND PAYMENT 0 0 1000 

9940826 MEGA LIFE (STUDENT INS) PAYMENT 0 0 1000 

9940834 MEGA LIFE & HEALTH PAYMENT 0 0 1000 

9940842 MOHEGAN TRIBAL PAYMENT 0 0 1000 

9940867 SRC AETNA COMPANY PAYMENT 0 0 1000 

9940875 TIME INSURANCE COMPANY PAYMENT 0 0 1000 

9940883 TR PAUL PAYMENT 0 0 1000 

9940891 UNICARE/CIGNA PAYMENT 0 0 1000 

9940909 UTICA NATIONAL PAYMENT 0 0 1000 

9940917 WAUSAU INSURANCE PAYMENT 0 0 1000 

9940925 PRIMARILY CARE PAYMENT 0 0 1000 

9940933 BENEMAX PAYMENT 0 0 1000 

9940941 LONDON HEALTH ADMIN PAYMENT 0 0 1000

9940958 SEVEN CORNERS PAYMENT 0 0 1000 

9940966 IMG PAYMENT 0 0 1000 

9940974 GEHA PAYMENT 0 0 1000 

9940982 MID WEST LIFE PYMT 0 0 1000 

9941006 PSYCH BEACON HLTH STRATEGIES PMT 0 0 1000 

9941014 CONNECTICARE PAYMENT 0 0 1000 

9941022 FALLON COMM HLTH PAYMENT 0 0 1000 

9941030 HARVARD PILGRIM PAYMENT 0 0 1000 

9941048 PSYCH MHN (FOXWOODS) PAYMENT 0 0 1000 

9941055 NASE PAYMENT 0 0 1000 

9941063 TUFTS HEALTH PLAN PAYMENT 0 0 1000 

9941071 WELLCARE PAYMENT 0 0 1000 

9941089 COVENTRY HEALTH PAYMENT 0 0 1000 

9941097 FIRST HEALTH PAYMENT 0 0 1000 

9941105 HARVARD PILGRIM ACCESS AMERICA 0 0 1000 

9941113 MAIN SENSE PAYMENT 0 0 1000 

9941121 CHESTERFIELD RESOURCES PAYMENT 0 0 1000 

9941139 EMPLOYEE BENEFIT CONCEPTS PAYMENT 0 0 1000 

9941147 AFTRA PAYMENT 0 0 1000 

9941170 COMMERCIAL INS/REGIST TO ENTER PMT 0 0 1000 

9941188 COMMERCIAL/COMMERCIAL PAYMENT 0 0 1000 

9941287 SSMF PAYMENT 0 0 1000 

9942004 AUTO INSURANCE PAYMENT 0 0 1000 

9942020 LIABILITY OTHER PAYMENT 0 0 1000 

9942038 LIBERTY MUTUAL AUTO PAYMENT 0 0 1000 

9942046 GEICO AUTO PAYMENT 0 0 1000 

9942053 ALLSTATE AUTO INS PAYMENT 0 0 5210 

9942509 TCORS AUTO PAYMENT 0 0 1000 

9943028 WORKERS COMP PAYMENT 0 0 1000 

9943036 WORKERS COMP DKH PAYMENT 0 0 1000 

9943044 PRIME HEALTH PAYMENT 0 0 1000 

9943051 WORKERS COMP OF RI 0 0 1000 

9943069 ONE CALL MEDICAL PAYMENT 0 0 1000 

9943077 BROADSPIRE SERVICES WC PYMT 0 0 1000 

9943085 CHARTIS INSURANCE WC PAYMENT 0 0 1000 

9943093 LIBERTY MUTUAL WC PAYMENT 0 0 1000 

9943101 EMC INSURANCE WC PAYMENT 0 0 1000 

9943119 ONE BEACON WC PAYMENT 0 0 1000 

9943507 TCORS WC PAYMENT 0 0 1000 

9944000 TRICARE PAYMENT 0 0 1000 

9944018 CHAMPVA PAYMENT 0 0 1000 

9944026 TRICARE SECONDARY PAYMENT 0 0 1000 

9945015 EBPA PAYMENT 0 0 1000 

9945023 DKH CIGNA PAYMENT 0 0 1000 

9945031 MERITAIN HEALTH PAYMENT 0 0 1000 

9945056 DKH ORTHONET PAYMENT 0 0 1000 

9945064 DKH AIM PAYMENT 0 0 1000

9945072 PSYCH DKH CIGNA BEHAV PAYMENT 0 0 1000 

9948001 PYMT PRO FEE COMMERCIAL 0 0 1000 

9950007 SAGA PAYMENT 0 0 1000 

9950106 PSYCH ADVANCE BEHAVIORAL HLTH PMT 0 0 1000 

9960014 HAVEN HEALTH PAYMENT 0 0 1000 

9960022 HOLY SPIRIT PAYMENT 0 0 1000 

9960030 MATULAITIS PAYMENT 0 0 1000 

9960048 PIERCE MEMORIAL PAYMENT 0 0 1000 

9960055 VILLA MARIA PAYMENT 0 0 1000 

9960063 VILLAGE MANOR PAYMENT 0 0 1000 

9960071 WESTVIEW PAYMENT 0 0 1000 

9960089 SNF OTHER PAYMENT 0 0 1000 

9960097 REGENCY HGTS SNF PAYMENT 0 0 1000 

9961004 BCCG PAYMENT TRANSFER 0 0 1000 

9962002 DEARY MAMMO FUND (CMD) PAYMENT 0 0 1000 

9962507 SAFETY NET FOUNDATION PAYMENT 0 0 1000 

9963000 HOMECARE PT PAYMENT TRANSFER 0 0 7570 

9963018 HOMECARE NON DKH PAYMENT 0 0 1000 

9964008 HOSPICE PAYMENT TRANSFER 0 0 7620 

9964016 HOSPICE NON DKH PAYMENT 0 0 1000 

9968009 US BUTTON CORPORATION PAYMENT 0 0 1000 

9968017 FRITO LAY PAYMENT 0 0 1000 

9968025 US COSMETICS PAYMENT 0 0 1000 

9968033 C&M CORPORATION PAYMENT 0 0 1000 

9968041 FACTORY MUTUAL PAYMENT 0 0 1000 

9968058 MPI LABEL SYSTEMS PAYMENT 0 0 1000 

9968066 UNITED SERVICES PAYMENT 0 0 1000 

9968074 ZZ NORAMPAC PAYMENT 0 0 1000 

9968082 ZZ NATIONAL CHROMIUM PAYMENT 0 0 1000 

9968090 ZZ INTERNATIONAL PAPER PYMT 0 0 1000 

9968108 ZZ QUIKRETE PAYMENT 0 0 1000 

9968116 ZZ UNITED NATURAL FOODS PYMT 0 0 1000 

9968124 ZZ BST PAYMENT 0 0 1000 

9968132 ZZ SEALAND ENVIRO PAYMENT 0 0 1000 

9968140 ZZ SELF EMPLOYED PAYMENT 0 0 1000 

9968157 ZZ BGR RADIATOR PAYMENT 0 0 1000 

9968165 ZZ CH NICKERSON PAYMENT 0 0 1000 

9968173 ZZ DELTA RUBBER PAYMENT 0 0 1000 

9968181 ZZ FLEET SAFETY SVCS PAYMENT 0 0 1000 

9968199 ZZ LOOS CORPORATION PYMT 0 0 1000 

9968207 ZZ MIDLAND SALES PAYMENT 0 0 1000 

9968215 ZZ MOOSUP FIRE DEPT PYMT 0 0 1000 

9968223 ZZ NEW ENGLAND PLASMA PYMT 0 0 1000 

9968231 ZZ PAQUETTE ELECTRIC PYMT 0 0 1000 

9968249 ZZ WELLNESS 2000 PAYMENT 0 0 1000 

9968256 ZZ ENSIGN BICKFORD PAYMENT 0 0 1000 

9968264 ZZ HYDE SCHOOL BEHAVIOR HLTH PYMT 0 0 1000

9968272 ZZ OHM UNSPECIFIED PYMT 0 0 1000 

9968280 ZZ STERLING ONECO FIRE DEPT PAYMENT 0 0 1000 

9968298 MISC SCHOOL BEHAVIORAL HEALTH 0 0 1000 

9970005 UNAPPLIED CASH FY 08 PAYMENT 0 0 1000 

9980004 ADMIN REVIEW PAYMENT 0 0 1000 

3103 MED/SURG BLOOD ADMIN 391 0 0 3090 

6817 EMERGENCY ROOM-HOSPITAL EVENTS 0 0 6780 

13094 MED/SURG, PRIVATE 111 0 0 3090 

13508 NURSERY, SICK BABY 170 0 0 3500 

59014 ENDO VISIT 999 0 0 3720 

59022 IV THERAPY VISIT 999 0 0 3720 

59030 ACU VISIT 999 0 0 3720 


63628 EB PRESCRIPTION DRUGS 0 0 0 

100065 CRYOSURGERY RENAL 1ST 1/2 HOUR 360 0 0 3600 

100073 LITHOTRIPSY OR 1ST 1/2 HR 360 0 0 3600 

100081 PROSTATE ABLATION OR 1ST 1/2HR 360 0 0 3600 

100164 CRYOSURGERY PROSTATE 1ST 1/2HR 360 0 0 3600 

130096 PHY FEE-NO CHG 450 0 0 3780 

140457 BLADDER IRRIGATION-SIMPLE LAVAGE 456 0 0 3780 

180000 NO CHARGE PO 360 0 0 3600 

210005 POSTOP PAIN CO SC,IM 710 0 0 3650 

210054 POSTOP IVP 710 0 0 3650 

210104 POSTOP IVP EA ADD'L 710 0 0 3650 

210302 IV THERAPY 1ST HOUR 710 0 0 3650 

210310 IV THERAPY ADD HRS 710 0 0 3650 

300046 OR C-SECTION 1ST 1/2HR, 1 PERSON 722 0 0 3510 

300095 OR C-SECTION 1ST 1/2 HR, 3 PEOPLE 722 0 0 3510 

300103 OR C-SECTION EA ADDL 15MIN, 3PEOPLE 722 0 0 3510 

300152 NERVE CONDUCTION SENSORY 920 0 0 4200 

300376 OCYTOCIN CHALLENGE 720 0 0 3510 

300517 NST/FETAL MONITOR 920 0 0 3510 

300954 PNEUMOGRAM 460 0 0 3510 

301051 VACCINE INJECTION 940 0 0 3510 

301465 IVP SEQ SAME DAY >30 MIN 260 0 0 3510 

302109 MCH-SPEC PROC RM 1-1/2 HRS 720 0 0 3510 

400051 SMEAR DIAPHRAM SCRAP 310 0 0 3090 

461893 COBALT, RANDOM URINE 300 0 0 4010 

500256 ACU-E&M LEVEL 5 761 0 0 3720 

500504 ACU-SPEC PROC RM 1/2 HR 361 0 0 3720 

500603 ACU-SPEC PROC RM-1 1/2 HRS 361 0 0 3720 

500652 ACU-SPEC PROC RM 2 HRS 361 0 0 3720 

500850 MRI KEN UPEX NOJTW/WO RT 610 0 0 4275 

501015 COLONOSCOPY 750 0 0 3720 

501064 GASTROSCOPY 750 0 0 3720 

501114 BRONCHOSCOPY 761 0 0 3720 

501155 DUODENSCOPY 360 0 0 3720

501205 LARYNGOSCOPY 361 0 0 3720 

501254 TEE PROBE 361 0 0 3720 

501353 SIGMOIDOSCOPY 750 0 0 3720 

501403 POLYPECTOMY 750 0 0 3720 

501551 SPEC PROC MISC-LAZER 361 0 0 3720 

502161 VISIT3 IV TX ADD HRS 260 0 0 3720 

502203 VISIT 4 IV THER INIT 260 0 0 3720 

502211 VISIT4 IV TX ADD HRS 260 0 0 3720 

502302 IV TX ADD'L SEQ < 1 HR 260 0 0 3720 

502666 IVP SEQ SAME DRUG >30 MIN 940 0 0 3720 

502807 IV START 260 0 0 3720 

502815 PERIPHERAL DRESSING CHANGE 269 0 0 3720 

502823 CENTRAL LINE DRESSING CHANGE 269 0 0 3720 

502831 SQ PORT ACCESSING 269 0 0 3720 

502849 SQ PORT DE ACCESSING 269 0 0 3720 

502864 BLOOD DRAW W/IV START 269 0 0 3720 

502872 MIDLINE EVALUATION/INSERTION 269 0 0 3720 

502880 PICC LINE REMOVAL 269 0 0 3720 

504035 ENTEROSCOPY 750 0 0 3720 

504076 BONE MARROW ASPIRATION 360 0 0 3720 

504084 G TUBE REPLACEMENT 361 0 0 3720 

504092 PEG BUTTON CHANGE 361 0 0 3720 

504126 PILL CAM ENDOSCOPY 750 0 0 3720 

505016 MED/SURG ROUTINE 270 0 0 3720 

560334 MRI KEN ELBOW WO CON LT 610 0 0 4275 

580159 NO SHOW N/C 940 0 0 3720 

600205 C-ARM PAIN MGT

1000090 SITE ASSESSMENT 260 0 0 4320 

1000108 SITE ASSESSMENT W OR W/O FLUSH 269 0 0 4320 


1000124 CENTRAL LINE DRESSING CHANGE 269 0 0 4320 

1000132 SQ PORT ACCESSING 269 0 0 4320 

1000140 SQ PORT DE ACCESSING 269 0 0 4320 

1000173 PPD PLANTING/READING 269 0 0 4320 

1000181 BLOOD DRAW W/IV STARTS 269 0 0 4320 

1000207 MIDLINE EVALUATION/INSERTION 269 0 0 4320 

1000223 PICC EVALUATION 269 0 0 4320 

1000231 MIDLINE EVALUATION 269 0 0 4320 

1000249 PICC LINE REMOVAL 269 0 0 4320 

1100080 IV START 260 0 0 4320 


1300359 FACILITY FEE-RECHECK 450 0 0 3780 

1300607 ED-LWBS 450 0 0 3780 

1300714 NES PHY FEE-BRIEF 981 0 0 2120 

1300771 NES PHY FEE-RECHECK 981 0 0 2120 

1300789 NES URGENT-MINIMAL 450 0 0 2120 

1300797 NES URGENT-BRIEF 450 0 0 2120 

1300805 NES URGENT-LIMITED 450 0 0 2120 

1300813 PHY INTERMED 456 0 0 3780 

1300854 PHY INTERMED 456 0 0 2120 

1300862 PHY COMPREHENSIVE 456 0 0 2120 

1300870 PHY EXTENDED 456 0 0 2120 

1300904 PHY FEE-MINIMAL 981 0 0 2120 

1300912 PHY FEE-BRIEF 981 0 0 2120 

1300920 PHY FEE-LIMITED 981 0 0 2120 

1300938 PHY FEE-INTERMEDIATE 450 0 0 2120 

1300946 PHY FEE-EXTENDED 450 0 0 2120 

1300953 PHY FEE-RECHECK 981 0 0 2120 

1300961 PHY FEE-NO CHG 450 0 0 2120 

1300979 PHY FEE-COMPREHENSIVE 450 0 0 2120 

1300987 PHY FEE-RECHECK 450 0 0 2120 

1301589 I&D CMPL POST-OP ABS 450 0 0 3780 

1301597 DEBR SKN UPTO 10%TBS 450 0 0 3780 

1301621 DEBR SKIN FULL THICK 450 0 0 3780 

1301647 BX SKIN SUBC SINGLE 450 0 0 3780 

1301654 BX SKIN SUBC MULTI 450 0 0 3780 

1301662 EXC BEN SCALP..0.5CM 450 0 0 3780 

1301670 REM SKIN TAGS;UPTO15 450 0 0 3780 

1301688 EXC BENIGN O.6-1.0CM 450 0 0 3780 

1301696 DEBR NAILS 1-5 450 0 0 3780 

1301860 SMPL FACE20.1-30.0CM 450 0 0 3780 

1301878 SMPL FACE >30.0 CM 450 0 0 3780 

1301944 LYR BODY SC >30.0 CM 450 0 0 3780 

1301985 LY NECK EXTS 12.6-20 450 0 0 3780

1301993 LY NECK EXTS 20.1-30 450 0 0 3780 

1302009 LYR NECK EXTS >30 CM 450 0 0 3780 

1302058 LYR FACE 12.6-20.0 450 0 0 3780 

1302066 LYR FACE 20.1-30.0 450 0 0 3780 

1302074 LYR FACE >30.0 CM 450 0 0 3780 

1302082 CMPLX TRNK 1.1-2.5CM 450 0 0 3780 

1302090 CMPLX TRNK 2.6-7.5 450 0 0 3780 

1302108 CMPLX SC EXTS1.1-2.5 450 0 0 3780 

1302132 CMPLX FACE EXTS

1302991 TX COCCYGEAL FX 450 0 0 3780 

1303015 HIP DISLOCW/O ANES 450 0 0 3780 

1303031 CL TX POST HIP W/ANE 450 0 0 3780 

1303056 PATELLAR FX W/O M 450 0 0 3780 

1303072 KNEE FX W OR W/O MAN 450 0 0 3780 

1303106 TIB SHAFT FX W/O MAN 450 0 0 3780 

1303163 BIMALLEOLAR FX W/O M 450 0 0 3780 

1303221 ARTHROTOMY MTP JOINT 450 0 0 3780 

1303247 REMOVAL FB FOOT DEEP 450 0 0 3780 

1303254 REMOVAL FB FOOT COMP 450 0 0 3780 

1303262 REP EXT TENDON FOOT 450 0 0 3780 

1303288 CALCANEAL FX W/MANIP 450 0 0 3780 

1303312 CL TR FX GR TOE WO M 450 0 0 3780 

1303338 FX PHALANX W/O M 450 0 0 3780 

1303379 CAST SHORT ARM 450 0 0 3780 

1303387 CAST-FINGER 450 0 0 3780 

1303478 RMVL CAST/BIVALVE 450 0 0 3780 

1303486 RMVL FUL ARM/LEG CST 450 0 0 3780 

1303536 EPISTAXIS POST SUBSQ 450 0 0 3780 

1303551 CHANGE TRACH TUBE 450 0 0 3780 

1303569 LARYNGPY INDRCT W/FB 450 0 0 3780 

1303601 LARYN DIR OP W/FB RE 450 0 0 3780 

1303619 TRACH ER TRSTRACH 450 0 0 3780 

1303627 TRACH ED CRICOTHYD 450 0 0 3780 

1303643 THORACENTESIS W/TUBE 450 0 0 3780 

1303668 THORA MAJ W/CARDI MA 450 0 0 3780 

1303692 REM TRIPLE LUMEN CAT 450 0 0 3780 

1303767 LAC VESTIBULE 2.5 CX 450 0 0 3780 

1303783 UNLISTED PROC TONGUE 450 0 0 3780 

1303825 I+D ABSCESS;PARAPHAR 450 0 0 3780 

1303841 RML FB PHARYNX EXS 450 0 0 3780 

1303866 EGD W/REM FOREIGN BO 450 0 0 3780 

1303874 EGD W/BY SGL OR MULT 450 0 0 3780 

1303908 EGD W/REMOVAL OF FB 450 0 0 3780 

1303940 CHANGE CYSTO TUBE 450 0 0 3780 

1303957 CATH URETHRA SMPL 450 0 0 3780 

1304013 CAUT CERV-INIT OR RP 450 0 0 3780 

1304021 CAUTERIZA OF CERVIX 450 0 0 3780 

1304047 INJ ANES;INTERCO,SGL 450 0 0 3780 

1304120 BLEPHAR-I&D ABSC EYE 450 0 0 3780 

1304260 ECG 1-3 LEAD INT&REP 450 0 0 3780 

1304278 VENT ASSIST&MNG 1STD 450 0 0 3780 

1304286 PULSE OX/EAR SINGLE 460 0 0 3780 

1304294 PULSE OX/EAR-MULTI 460 0 0 3780 

1304302 DLS TIBI W/WO AN W/M 450 0 0 3780 

1304351 PROCTO W/OR WO/ COLL 450 0 0 3780 

1304377 ANOSC W/ REMOVAL FB 450 0 0 3780

1304385 EXCIS OF X THORB HEM 450 0 0 3780 

1304393 EXCIS OF ANUS,SIMPLE 450 0 0 3780 

1304419 IPECAC FOR EMESIS 450 0 0 3780 

1304427 ASP OF BLADDER BY NEEDLE 450 0 0 3780 

1304435 PRIAPISM;TX BY FISTU 450 0 0 3780 

1304450 UNLSTD MALE GENITAL 450 0 0 3780 

1304468 COLPOR-SUTURE VAGINA 450 0 0 3780 

1304476 REM IMPACT VAG FB AN 450 0 0 3780 

1304484 REM OF INTRAUT DEVIC 450 0 0 3780 

1304500 DELIVERY OF PLACENTA 450 0 0 3780 

1304518 INJ EPIDU;LUMBAR SAC 450 0 0 3780 

1304641 ANOG EXAM W/COLP MAG 450 0 0 3780 

1304666 STRAPPING-SHOULDER 450 0 0 3780 

1304674 STRAPPIN ELBOW/WRIST 450 0 0 3780 

1304708 DRAIN LYMPH NODE ABSCESS; SIMPLE 450 0 0 3780 

1304716 DRAIN ABCESS, PALATE, UVULA 450 0 0 3780 

1304740 I&D UPPER ARM AREA; BURSA 450 0 0 3780 

1304757 TXT TARSAL B1 FX XPC TALUS W/O MNPJ 450 0 0 3780 

1304963 INCISION OF THROMBOSED HEMORRHOI,EX 450 0 0 3780 

1305101 SIMPLE LAC BODY, SCALP > 30 CM 450 0 0 3780 

1390251 UNIV RIB BELT 274 0 0 3780 

1400357 PC-FAC FEE-RECHECK 456 0 0 3780 

1400506 PC CRITICAL CA 1STHR 456 0 0 3780 

1400514 PC CRIT CAR EA 30MIN 456 0 0 3780 

1400605 PC-NES PHY FEE-MINIMAL 981 0 0 2120 

1400613 PC-NES PHY FEE-BRIEF 981 0 0 2120 

1400621 PC-NES PHY FEE-LIMITED 981 0 0 2120 

1400639 PC-NES PHY FEE-INTERMEDIATE 981 0 0 2120 

1400647 PC-NES PHY FEE-EXTENDED 981 0 0 2120 

1400654 PC-NES PHY FEE-COMPREHENSIVE 981 0 0 2120 

1400704 PC-NES URGENT-MINIMAL 456 0 0 2120 

1400712 PC-NES URGENT-BRIEF 456 0 0 2120 

1400720 PC-NES URGENT-LIMTED 456 0 0 2120 

1400738 PC-NES PHY FEE-RECHECK 456 0 0 2120 

1401603 DEBR SKIN FULL THICK 456 0 0 3780 

1401629 BX SKIN SUBC SINGLE 456 0 0 3780 

1401637 BX SKIN SUBC MULTI 456 0 0 3780 

1401652 EXC BEN SCALP..0.5CM 456 0 0 3780 

1401660 EXC BENIGN 0.6-1.0CM 456 0 0 3780 

1401843 SMPL FACE20.1-30.0CM 456 0 0 3780 

1401850 SMPL FACE >30.0 CM 456 0 0 3780 

1401868 TX SUPERFIC WND SMPL 456 0 0 3780 

1401918 LYR BDY SC 20.1-30.0 456 0 0 3780 

1401926 LYR BODY SC >30.0 CM 456 0 0 3780 

1401967 LY NECK EXTS 12.6-20 456 0 0 3780 

1401975 LY NECK EXTS 20.1-30 456 0 0 3780 

1401983 LYR NECK EXTS >30 CM 456 0 0 3780

1402023 CL INTE FACE7.6-12.5 456 0 0 3780 

1402031 LYR FACE 12.6-20.0 456 0 0 3780 

1402049 LYR FACE 20.1-30.0 456 0 0 3780 

1402056 LYR FACE >30.0 CM 456 0 0 3780 

1402064 CMPLX TRNK 1.1-2.5CM 456 0 0 3780 

1402072 CMPLX TRNK 2.6-7.5 456 0 0 3780 

1402080 CMPLX SC EXTS1.1-2.5 456 0 0 3780 

1402114 CMPLX FACE EXTS

1402759 THUMB FX W/MAN 456 0 0 3780 

1402767 METACAR DIS W/M WO/A 456 0 0 3780 

1402809 IP JOINT FX W/O MAN 456 0 0 3780 

1402858 AMPU FINGER/THB W/C/ 456 0 0 3780 

1402866 TX COCCYGEAL FX 456 0 0 3780 

1402874 HIP DISLOC W/O FIXTN 456 0 0 3780 

1402882 HIP DISLOC W/O ANES 456 0 0 3780 

1402890 POST HIP DISLC W/O A 456 0 0 3780 

1402908 CL TX DIS FEM FXWO/M 456 0 0 3780 

1402916 PATELLAR FX W/O M 456 0 0 3780 

1402924 TIB PLATEAU FX W/O M 456 0 0 3780 

1402932 KNEE FX W OR W/O MAN 456 0 0 3780 

1402940 KNEE DISLOC W/O ANES 456 0 0 3780 

1402965 TIB SHAFT FX W/O MAN 456 0 0 3780 

1402973 M MALLEOLUS FX W/O M 456 0 0 3780 

1402981 PROX FIB/SHFT W/O M 456 0 0 3780 

1402999 DIST FIB FX W/O M 456 0 0 3780 

1403005 BIMALLEOLAR FX W/O M 456 0 0 3780 

1403013 BIMALLEOLAR FX W/MAN 456 0 0 3780 

1403021 TRIMALLEOLAR FX WO M 456 0 0 3780 

1403047 ANKLE DISLOC W/O ANE 456 0 0 3780 

1403054 ANKLE DISLOC W/ANES 456 0 0 3780 

1403062 ARTHROTOMY MTP JOINT 456 0 0 3780 

1403088 REMOVAL FB FOOT DEEP 456 0 0 3780 

1403096 REMOVAL FB FOOT COMP 456 0 0 3780 

1403104 CALCANEAL FX W/O M 456 0 0 3780 

1403112 TALUS FX W/O M 456 0 0 3780 

1403120 METATARSAL FX W/O M 456 0 0 3780 

1403138 CL TR FX GR TOE WO M 456 0 0 3780 

1403153 FX PHALANX W/O M 456 0 0 3780 

1403195 CAST SHORT ARM 456 0 0 3780 

1403203 CAST-FINGER 456 0 0 3780 

1403245 STRAPPING-SHOULDER 456 0 0 3780 

1403252 STRAPPIN ELBOW/WRIST 456 0 0 3780 

1403260 CAST LONG LEG 456 0 0 3780 

1403302 RMVL CAST/BIVALVE 456 0 0 3780 

1403310 RMVL FUL ARM/LEG CST 456 0 0 3780 

1403369 ET INTUBATION 456 0 0 3780 

1403377 CHANGE TRACH TUBE 456 0 0 3780 

1403385 LARYNG IND RECT DIAG 456 0 0 3780 

1403393 LARYNGPY INDRCT W/FB 456 0 0 3780 

1403401 LARYN DIR FOR ASPIRA 456 0 0 3780 

1403419 LARYN D/R DX NO NEWB 456 0 0 3780 

1403427 LARYN DIR OP W/FB RE 456 0 0 3780 

1403435 TRACH ER TRSTRACH 456 0 0 3780 

1403443 TRACH ED CRICOTHYD 456 0 0 3780 

1403450 THORACENTESIS FOR ASP INT OR SUBSQ 456 0 0 3780

1403468 THORACENTESIS W/TUBE 456 0 0 3780 

1403476 TUBE THOR W/SEAL (HEMOTX) 456 0 0 3780 

1403484 THORA MAJ W/CARDI MA 456 0 0 3780 

1403500 INS/RE TEM ELE/PM CA 456 0 0 3780 

1403518 TRANSFSN BLOOD/COMPT 391 0 0 3780 

1403526 INS CNT'L VEN CATH>5 456 0 0 3780 

1403534 REM TRIPLE LUMEN CAT 456 0 0 3780 

1403542 ARTERIAL BLD DRAW DX 456 0 0 3780 

1403559 PLMT INTRAOSSEOUS 456 0 0 3780 

1403583 CHEILOPLASTY > V.HGT 456 0 0 3780 

1403609 LAC VESTIBULE 2.5 CX 456 0 0 3780 

1403633 DENTOGLVEOLAR STRUCT 456 0 0 3780 

1403658 RML FB PHARYNX EXS 456 0 0 3780 

1403666 CONT OROPHAR HEM SIM 456 0 0 3780 

1403682 CHG GASTROSTOMY TUBE W/O IMG/GUID 456 0 0 3780 

1403690 PROCTO W/OR WO/ COLL 456 0 0 3780 

1403716 INCIS DRAIN PERIA AB 456 0 0 3780 

1403732 EXCIS OF X THORB HEM 456 0 0 3780 

1403757 ANOSC W/ REMOVAL FB 456 0 0 3780 

1403765 EXCIS OF ANUS,SIMPLE 456 0 0 3780 

1403773 PERIT ABD PARA OR PE 456 0 0 3780 

1403781 ASP OF BLADDER BY NEEDLE 456 0 0 3780 

1403815 CMPT CATH/BALLOON 456 0 0 3780 

1403823 I&D SCROTAL ABSCESS 456 0 0 3780 

1403849 REM IMPACT VAG FB AN 456 0 0 3780 

1403856 CAUTERIZA OF CERVIX 456 0 0 3780 

1403864 CAUT CERV-INIT OR RP 456 0 0 3780 

1403872 REM OF INTRAUT DEVIC 456 0 0 3780 

1403880 VAG DELIV W/POSTPART 456 0 0 3780 

1403898 LUMBAR TAP/DX 456 0 0 3780 

1403914 INJ ANES;INTERCO SGL 456 0 0 3780 

1403971 BLEPHAR-I&D ABSC EYE 456 0 0 3780 

1404102 IV TX CONCURR INF 260 0 0 3780 

1404151 GASTRIC LAVAGE 456 0 0 3780 

1404169 NASO W/ENDO (DIAG) 456 0 0 3780 

1404177 CPR 456 0 0 3780 

1404193 CARDIOVERSION,EXTERN 456 0 0 3780 

1404201 ECG 1-3 LEAD INT/REP 456 0 0 3780 

1404219 VENT ASSIST&MNG 1STD 456 0 0 3780 

1404227 PULSE OX/EAR SINGLE 460 0 0 3780 

1404235 PULSE OX/EAR MULTI 460 0 0 3780 

1404243 ANOG EXAM W/COLP MAG 456 0 0 3780 

1404250 IPECAC FOR EMESIS 456 0 0 3780 

1404284 CATH FOR COLLECT OF SPEC-STR CATH 300 0 0 3780 

1404300 MONITOR FOR COMPARTMENT SYNDROME 456 0 0 3780 

1404482 STRAPPING HIP 456 0 0 3780 

1404557 SIMPLE LAC BODY, SCALP>30CM 456 0 0 3780

1800150 JAMSHIDI NEEDLE 270 0 0 3750 

2000016 MED SURG/SUP-MS 270 0 0 3800 

2000024 MED/SURG SUPP ICU 270 0 0 3800 

2000032 ACE BANDAGE 270 0 0 3800 

2000040 BIOPSY NEEDLE 270 0 0 3800 

2000057 BLOOD GAS KIT 270 0 0 3800 

2000073 CUSTOM DSG TRAY 270 0 0 3800 

2000081 COBAN 270 0 0 3800 

2000099 IRRIGATION TRAY 270 0 0 3800 

2000107 SLING 270 0 0 3800 

2000115 DRAIN SALEM SUMP 270 0 0 3800 

2000131 VASELINE GAUZE 270 0 0 3800 

2000149 ZEROFOAM GAUZE 270 0 0 3800 

2000156 ANTIEMBOLISM HOSE 270 0 0 3800 

2000172 CAST BOOT 270 0 0 3800 

2000180 CLEAN CATCH URINE CO 270 0 0 3800 

2000206 KLING 270 0 0 3800 

2000214 STERI STRIPS 270 0 0 3800 

2000222 URINE LEG BAG 270 0 0 3800 

2000248 LUMBAR PUNCTURE TRAY 270 0 0 3800 

2000321 MED/SURG ROUTINE-PIP 270 0 0 3800 

2000347 MED/SURG SUPPLY-MCH 270 0 0 3800 

2000354 MED/SURG SUPPLY-NSY 270 0 0 3800 

2000362 ROUTINE M&S OR 270 0 0 3800 

2001675 PICC 5FR KIT 270 0 0 3800 

2100758 ELA-DUAL PCMKER 275 0 0 3800 

2100766 ST JUDE-DUAL PCMKER 275 0 0 3800 

2100774 MEDTRONI-DUAL PCMKER 275 0 0 3800 

2100782 ELA-SINGLE PCMKER 275 0 0 3800 

2100790 ST JUDE-SINGLE PCMKE 275 0 0 3800 

2100808 MEDTRO-SINGLE PCMKER 275 0 0 3800 

2100816 GUIDANT-ENTRA DUAL 275 0 0 3800 

2100824 MEDTR-ENPULSE PCMKER 275 0 0 3800 

2100832 MEDTRONIC-ENRYTHYM PCMKR 275 0 0 3800 

2100857 ELA-PCMKER LEAD 275 0 0 3800 

2100865 ST JUDE-PCMKER LEAD 275 0 0 3800 

2100873 MEDTRON-PCMKER LEAD 275 0 0 3800 

2100907 DUAL PACEMAKER 275 0 0 3800 

2100915 SINGLE PACEMAKER 275 0 0 3800 

2100923 PACEMAKER LEAD 275 0 0 3800 

2102002 LOOP MONITOR 278 0 0 3800 

2200103 OXYGEN SUPPLIES-ACU 270 0 0 3721 

2201028 CYTOLOGY BRUSH 270 0 0 3711 

2201036 DUAL PORT ADAPTOR 270 0 0 3721 

2201127 I-NEEDLE (LONG) 270 0 0 3711 

2201150 J-TUBE 270 0 0 3711 

2201168 20G TUOHY NEEDLE 270 0 0 3711

2201218 POST-OP SHOE 270 0 0 3721 

2201267 T-LOOP ELECTRODE 270 0 0 3711 

2201531 BALLOON EXTRACT TX12 270 0 0 3711 

2201648 STIFCOR BX NEEDLE 270 0 0 3711 

2201655 STIF CORE BRON NEEDL 270 0 0 3711 

2201705 PICC LINE CATH 278 0 0 3721 

2201721 STAT LOCK 270 0 0 3721 

2201838 PROBE INJ GOLD 10FR 270 0 0 3711 

2202539 LUMBAR PUNCTURE TRAY 270 0 0 3721 

2400117 EPIDURAL TRAY 270 0 0 3800 

2500346 ACL SUTURE TI-CRON 278 0 0 3800 

2505006 ART BANANA KNIFE 270 0 0 3800 

2505105 ART BIO-FASTAK 278 0 0 3800 

2505121 ART BIO-SUTURE TAK 278 0 0 3800 

2505345 ART C-REAMER 10MM 278 0 0 3800 

2505360 ART C-REAMER 8mm 278 0 0 3800 

2505386 ART C-REAMER 9mm 278 0 0 3800 

2505444 ART ESU PROBE/HNDL 991 0 0 3800 

2505725 ART OATS SET 10mm 278 0 0 3800 

2505741 ART OATS SET 6MM 278 0 0 3800 

2505766 ART OATS set 8mm 278 0 0 3800 

2506228 ART TUBING PATIENT 270 0 0 3800 

2515047 ENT EAR CANAL STRIP 270 0 0 3800 

2515245 ENT NASAL THERMSPLNT 270 0 0 3800 

2515500 ENT STIM PROBE 270 0 0 3800 

2515799 ART 5.5MMBIO CORK SUTURE ANC W/NEED 278 0 0 3800 

2520062 EXFIX EBI FIXA 04200 270 0 0 3800 

2520088 EXFIX EBI FIXA 04300 270 0 0 3800 

2520146 EXFIX MON OFFSET CLMP 270 0 0 3800 

2520229 EXFIX MON SNGL CLMP 270 0 0 3800 

2520260 EXFIX SYN CLAMPS 270 0 0 3800 

2520286 EXFIX SYN ROD 200 270 0 0 3800 

2520302 EXFIX SYN ROD 220 270 0 0 3800 

2520328 EXFIX SYN ROD 240 270 0 0 3800 

2520344 EXFIX SUN SCHANZ SCW 270 0 0 3800 

2525004 EYE ADAPT MALE/MALE 270 0 0 3800 

2525087 EYE CORNEAL PUNCH 7.75 270 0 0 3800 

2525103 EYE CORNEAL PUNCH 8.0 270 0 0 3800 

2525129 EYE CORNEAL TISSUE 278 0 0 3800 

2525145 EYE CORNEAL TRESPHINE 7.5 270 0 0 3800 

2525467 EYE LENS GLIDE 276 0 0 3800 

2525483 EYE MEROCEL DRAIN 276 0 0 3800 

2525509 EYE PACK ANT VITRECT 270 0 0 3800 

2525525 EYE PACK ANT VITRECTOMY 270 0 0 3800 

2525541 EYE PACK AQUALASE 270 0 0 3800 

2525582 EYE PACK MICROCEAL 270 0 0 3800 

2525608 EYE PACK POSTERIOR,VENTU 270 0 0 3800

2525640 EYE RETROBULBAR NDL 270 0 0 3800 

2525665 EYE SCLERAL BUCK ALL 270 0 0 3800 

2525681 EYE SPHERE 270 0 0 3800 

2535201 LAP ENDOLOOP 270 0 0 3800 

2535425 LAP VERES NDL 150MM 270 0 0 3800 

2540185 MESH PERFIX, LG 278 0 0 3800 

2540201 MESH PERFIX, MED 278 0 0 3800 

2546026 MIS U DRAPE 270 0 0 3800 

2546109 MIS VACUSTAT BULLDOG 270 0 0 3800 

2550168 ORT CONSTAVAC CBC II 270 0 0 3800 

2550184 ORT CONSTAVAC DRN 1/4 270 0 0 3800 

2550200 ORT CONSTAVAC DRN 1/8 270 0 0 3800 

2550408 ORT DALL-MILE PL 10 270 0 0 3800 

2550424 ORT DALL-MILE PL 12 270 0 0 3800 

2550440 ORT DALL-MILE PL 6.5 270 0 0 3800 

2550663 ORT GRAFT BONEPLAST 270 0 0 3800 

2551182 ORT MITEK FASTIN RC 278 0 0 3800 

2551265 ORT MITEK ROT CUFF 278 0 0 3800 

2551422 ORT SAW BL HALL 262 270 0 0 3800 

2551448 ORT SAW BL HALL 264 270 0 0 3800 

2551786 ORT STEIN PIN SM 3/16 270 0 0 3800 




2551901 ORT STEIN PIN THD 1/8 270 0 0 3800 







2552404 URO STENT URET 4.8 X 26 278 0 0 3800 

2552537 TIER 1 MISC JOINT IMPLANT 278 0 0 3800 

2553030 COLLAGEN IMPLANT URINARY 2.5 CC 278 0 0 3800 

2560001 SHAVER 2.0MM 270 0 0 3800 

2560027 SHAVER 2.0MM FULL RA 270 0 0 3800 

2560043 SHAVER BURR OV.6MM 270 0 0 3800 

2560068 SHAVER BURR OVA4.0MM 270 0 0 3800 

2560084 SHAVER BURR SHER 4.5 270 0 0 3800 

2560100 SHAVER CUDA 3.5 270 0 0 3800 

2560126 SHAVER CUDA MERL 4.2 270 0 0 3800 

2565422 STAPLE POLY ROTIC 270 0 0 3800 

2565505 STAPLE ROTIC 55&3.5 278 0 0 3800 

2565547 STAPLE ROTIC 55-4.8 278 0 0 3800 

2565562 STAPLE ROTIC 55-4.8 278 0 0 3800 

2570000 SYN L Pl DCP NR 10 H 270 0 0 3800 

2570067 SYN L Pl DCP BR 06 H 270 0 0 3800

2570083 SYN L Pl DCP BR 07 H 270 0 0 3800 

2570109 SYN L Pl DCP BR 08 H 270 0 0 3800 

2570125 SYN L Pl DCP BR 09 H 270 0 0 3800 

2570141 SYN L Pl DCP BR 10 H 270 0 0 3800 

2570166 SYN L Pl DCP BR 12 H 270 0 0 3800 

2570182 SYN L Pl DCP BR 14 H 270 0 0 3800 

2570208 SYN L Pl DCP NR 04 H 270 0 0 3800 

2570224 SYN L Pl DCP NR 05 H 270 0 0 3800 

2570240 SYN L Pl DCP NR 06 H 270 0 0 3800 

2570265 SYN L Pl DCP NR 07 H 270 0 0 3800 

2570307 SYN L Pl DCP NR 12 H 270 0 0 3800 

2570323 SYN L Pl L-BUTT LT 270 0 0 3800 

2570349 SYN L Pl L-BUTT RT 270 0 0 3800 

2570364 SYN L Pl SPOON 5 H 270 0 0 3800 

2570380 SYN L Pl SPOON 6 H 270 0 0 3800 

2570406 SYN L Pl T- 8 H 270 0 0 3800 

2570463 SYN L Pl T-BUTT 04 H 270 0 0 3800 

2570562 SYN L SCR MAL 25-70 270 0 0 3800 

2571065 SYN MN SCR 1.5 6-20 270 0 0 3800 

2571081 SYN MN SCR 2.0 6-20 270 0 0 3800 

2571107 SYN MN SCR 2.7 6-22 270 0 0 3800 

2571149 SYN SM 3.5 RECON 05 H 270 0 0 3800 

2571164 SYN SM 3.5 RECON 06 H 270 0 0 3800 

2571180 SYN SM 3.5 RECON 07 H 270 0 0 3800 

2571206 SYN SM 3.5 RECON 08 H 270 0 0 3800 

2571248 SYN SM 3.5 RECON 10 H 270 0 0 3800 

2571263 SYN SM 4.5 RECON 06 H 270 0 0 3800 

2571289 SYN SM 4.5 RECON 08 H 270 0 0 3800 

2571305 SYN SM 4.5 RECON 10 H 270 0 0 3800 

2571420 SYN SM PI CALCAN 60 270 0 0 3800 

2571446 SYN SM PL CALCAN 70 270 0 0 3800 

2571461 SYN SM PL CALCAN Y 270 0 0 3800 

2571883 SYN SM SC CAN FL THD 270 0 0 3800 

2571909 SYN SM SC CAN PT THD 270 0 0 3800 

2571925 SYN SM SC COR SLF TP 270 0 0 3800 

2575181 TOT JOINT DEVICE IMPLANT 278 0 0 3800 

2580025 URO BAL DIL URO MAX10 270 0 0 3800 

2580264 URO CATH SILC 8/10 270 0 0 3800 

2580280 URO CATH SILC 18/5CC 270 0 0 3800 

2580348 URO CATH SUPRABLCYSTOSCO 278 0 0 3800 

2581007 URO PROSTH PENILE NON-IN 278 0 0 3800 

2581023 URO PROTH PENILE INFLAT 278 0 0 3800 

2581668 URO URET ACCS CATH 270 0 0 3800 

2590016 IMPLANTABLE JOINT DEVICE 278 0 0 3800 

2590024 MISC IMPLANTABLE SCREW/ANCHOR 278 0 0 3800 

2591014 TKA 3-M STYLE SAW BLADE 270 0 0 3800 

2591089 TKA TRIATHLON PS TIBIAL INSERT 278 0 0 3800

2600153 AMNIO SUPPLIES 270 0 0 3800 

2902757 INTRATHECAL ADMIN 331 0 0 3700 

2902864 CHEMO UNSPECIFIED 335 0 0 3700 

2903508 FLU VACCINE ADMIN 771 0 0 3700 

2903706 ONCOLOGY E&M LEVEL 3 510 0 0 3700 

3000965 DELIVERY ROOM TWINS 720 0 0 3510 

3002003 ONC IV THER 1ST HR 260 0 0 3700 

3002011 ONC IV THER ADD'L HR 260 0 0 3700 

3002052 IV TX ADD'L SQ < 1 HR 260 0 0 3700 

3002102 IV TX CONCURR INF 260 0 0 3700 

3002169 IV TX HYDRA ADD'L HR 260 0 0 3700 

3002201 ONC INJECTED SC,IM 940 0 0 3700 

3002250 IV PUSH INITIAL 940 0 0 3700 

3002300 IVP EA ADD'L SEQ 940 0 0 3700 

3002318 IVP SEQ SAME DRUG >30 MIN 940 0 0 3700 

3002508 CHEMO INFUSD 1ST HR 335 0 0 3700 

3002516 CHEMO INFUSD AD'L HR 335 0 0 3700 

3002607 CHEM INF SEQ 1ST HR 335 0 0 3700 

3002656 CHEMO CNS REQ SPINAL 331 0 0 3700 

3002706 CHEMO IVP INITIAL 331 0 0 3700 

3002714 CHEMO IVP EA ADD'L 280 0 0 3700 

3002755 INTRATHECAL ADMIN 331 0 0 3700 

3002805 CHEMO SC/IM NON-HORM 335 0 0 3700 

3002854 CHEMO SC/IM HORMONAL 335 0 0 3700 

3002862 CHEMO UNSPECIFIED 335 0 0 3700 

3003001 BLOOD ADMIN-ONCOLOGY 391 0 0 3700 

3003118 PORT FLUSH ONLY 280 0 0 3700 

3003506 FLU VACCINE ADMIN 771 0 0 3700 

3003555 PNEUMON VACCINE ADMIN 771 0 0 3700 

3090008 CARMUSTINE 100 MG 636 0 0 4290 

3090057 DACARBAZINE 200 MG 636 0 0 4290 

3090073 CLADRIBINE 1 MG 636 0 0 4290 

3090115 DOCETAXEL 80 MG 636 0 0 4290 

3090131 ALDESLEUKIN 22 MMU 636 0 0 4290 

3090149 INTERFERON ALFA-2B R 636 0 0 4290 

3090172 INTERFERON ALFA-2A R 636 0 0 4290 

3090180 THIOTEPA 15 MG 636 0 0 4290 

3090313 LEUCOVORIN CALCIUM 1 636 0 0 4290 

3090453 CARBOPLATIN 150 MG 636 0 0 4290 

3090479 CYTARABINE 100 MG 636 0 0 4290 

3090537 GEMCITABINE HCL 1 G 636 0 0 4290 

3090560 PENTOSTATIN 10 MG 636 0 0 4290 

3090610 ZOLADEX 10.8MG. 636 0 0 4290 

3090693 INTRON 5MMU 636 0 0 4290 

3090701 INTRON 10MMU 636 0 0 4290 

3090719 INTRON 3MMU 636 0 0 4290 

3090735 ELOXATIN 100MG. 636 0 0 4290

3090743 FASLODEX 50MG/ML 636 0 0 4290 

3090776 DEPOCYT 50MG 5ML 636 0 0 4290 

3090800 PLENAXIS 100MG. 636 0 0 4290 

3090875 ALEMTUZUMAB 30MG 636 0 0 4290 

3090909 ABRAXANE 100MG 636 0 0 4290 

3090917 CARBOPLATIN 450 MG/45ML VL 636 0 0 4290 

3090941 ROFERON-A 3MM U/0.5ML KIT 636 0 0 4290 

3090958 LEUPROLIDE 30 MG DEPOT 4MO 636 0 0 4290 

3090966 DAUNORUBICIN 20 MG VIAL 636 0 0 4290 

3091121 EPINEPHRINE 1MG/ML PRES FREE 1ML AM 636 0 0 4290 

3303906 PULSE OXIMETRY MULTI 460 0 0 4130 

3340106 SUPERVISED LEVEL III PULMONARY 940 0 0 4130 

3340304 P/R MANIP-CHEST CUP 410 0 0 4130 

3350220 CR PHASE IV-PLFD 460 0 0 4130 

3500014 NEEDLE OCULOELECTROMYOGRAPHY 920 0 0 4200 

3500022 NDL ELECTROMYOGRAPHY 1 EXTREMITY 920 0 0 4200 

3500030 NDL ELECTROMYOGRAPHY, 2 EXTREMITIES 922 0 0 4200 

3500048 NDL ELECTROMYOGRAPHY, 3 EXTREMITIES 0 0 4200 

3500055 NDL ELECTROMYOGRAPHY 4 EXTREMITIES 922 0 0 4200 

3500063 NDL ELECTROMYOGRAPHY LARYNX 922 0 0 4200 

3500071 NDL ELECTROMYO HEMIDIAPHRAGM 922 0 0 4200 

3500089 NDL ELECTROMYO CRANIAL NERVE UNI 922 0 0 4200 

3500097 NDL ELECTROMYO CRANIAL NERVE BILAT 922 0 0 4200 

3500105 NDL ELECTROMYO THORACIC PARASPINAL 922 0 0 4200 

3500113 NDL ELECTROMYO LMTD STUDY 922 0 0 4200 

3500121 NDL ELECTROMYO SINGLE FIBER 922 0 0 4200 

3500139 MOTOR W/O F WAVE 1 TO 2 SITES 922 0 0 4200 

3500147 MOTOR WITH F WAVE 1 TO 2 SITES 922 0 0 4200 

3500162 MOTOR & OR SENSORY NERVE CONDUCTION 922 0 0 4200 

3500188 H FLEX, GASTROC/SOLEUS 922 0 0 4200 

3500196 H FLEX OTHER 920 0 0 4200 

3500204 CURRNT PERCEPTION THRESH PER LIMB 920 0 0 4200 

3502218 H FLEX, GASTROC/SOLEUS BILATERAL 922 0 0 4200 

3502226 MOTOR W/O F WAVE EACH ADD'L 922 0 0 4200 

3502234 MOTOR W/F WAVE EACH ADD'L 922 0 0 4200 

3502242 EEG EXTENDED MONITORING 41 60 MIN 920 0 0 4200 

3502309 MOTOR W/O F WAVE 3 TO 4 STUDIES 922 0 0 4200 



3502333 MOTOR WITH F WAVE 3 TO 4 STUDIES 922 0 0 4200 



4100152 QUINIDINE 300 0 0 4010 

4100343 AMPHETAMINE 300 0 0 4010 

4100350 COCAINE 300 0 0 4010 

4100368 TETRAHYDROCANNABINOL 300 0 0 4010 

4100376 BARBITURATES 300 0 0 4010

4100384 BENZODIAZEPINES 300 0 0 4010 

4100392 PCP 300 0 0 4010 

4100400 OPIATES 300 0 0 4010 

4100962 CARDIAC PANEL 300 0 0 4010 

4101200 ARTHRITIS PANEL 300 0 0 4010 

4102067 BLOOD GAS W/TEMP 300 0 0 4010 

4102141 HEPATITIS C AB 300 0 0 4010 

4102158 HEP B CORE IGM 300 0 0 4010 

4102166 HEP B SURFACE AG 300 0 0 4010 

4102174 HEP B SURFACE AB 300 0 0 4010 

4102224 HEPATITIS A AB, TOTAL 300 0 0 4010 

4112165 ITEL NON BILLABLE OBS PER HR 099 0 0 3140 

4200366 LE PREP 300 0 0 4010 

4300018 LYME EIA (IGG & IGM) 310 0 0 4010 

4300042 H.PYLORI AB 300 0 0 4010 

4300133 ROTAVIRUS 300 0 0 4010 

4300141 CHLAMYDIA DNA PROBE 300 0 0 4010 

4300158 GC DNA PROBE 300 0 0 4010 

4300224 AFFIRM 300 0 0 4010 

4300448 CHLAMYDIA 300 0 0 4010 

4300455 TRICHOMONAS 300 0 0 4010 

4300463 GARDNERELLA 300 0 0 4010 

4300471 CANDIDA SPECIES 300 0 0 4010 

4300596 TRICHOMONAS (AFFIRM) 300 0 0 4010 

4300604 GARDNERELLA (AFFIRM) 300 0 0 4010 

4300612 CANDIDA SPECIES (AFF 300 0 0 4010 

4314340 RECESSIVE HSP EVAL ATHENA 652 300 0 0 4010 

4400149 FIBRINOGEN 300 0 0 4010 

4400248 PROTHROMBIN TIME 300 0 0 4010 

4400255 PTT 300 0 0 4010 

4500245 RA SCREEN 300 0 0 4010 

4601282 TICK ID & LYME/ PCR 300 0 0 4010 

4602371 LIPASE 300 0 0 4010 

4602512 HEPATITIS PNL,ACUTE 300 0 0 4010 

4602793 HEPATITIS BE AG 300 0 0 4010 

4602934 CSF HERPES, PCR 300 0 0 4010 

4603213 TETANUS TITER 300 0 0 4010 

4603221 RETROVIRAL SEROLOGY 300 0 0 4010 

4603387 LYME BY PCR (UCONN) 300 0 0 4010 

4603437 YO AUTOANTIBODY 300 0 0 4010 

4603445 HU AUTOANTIBODY 300 0 0 4010 

4603668 DIRECT LDL 300 0 0 4010 

4603700 NUCL.MOL.ISOLATION 300 0 0 4010 

4603718 NUCL.MOL.ENZ.DIGEST. 300 0 0 4010 

4603726 NUCL.MOL.SEPARATION 300 0 0 4010 

4603734 NUCL.MOL.NUCL. ACID 300 0 0 4010 

4603742 NUCL.MOL.AMPLIFICATION 300 0 0 4010

4603775 KENNEDY DISEASE DNA 300 0 0 4010 

4603783 APOLIPO.E GENOTYPE 300 0 0 4010 

4603825 T PROTEIN,24HR UR 300 0 0 4010 

4603841 MOL.ENZYMATIC DIGEST 300 0 0 4010 

4603858 MOLECULAR ISOLATION 300 0 0 4010 

4603866 MOLECULAR SEPARATION 300 0 0 4010 

4603916 LEMS AUTOANTIBODY 300 0 0 4010 

4604054 MYTONIC DYST. DNA 300 0 0 4010 

4604237 CHARCOT MARIE TOOTH 300 0 0 4010 

4604260 CSF EBV BY PCR 300 0 0 4010 

4604294 PRESS.PALSY NEUR.DNA 300 0 0 4010 

4604419 METHADONE 300 0 0 4010 

4604708 MA TA AUTOANTIBODY 300 0 0 4010 

4604971 HUNTINGTON'S DISEASE 300 0 0 4010 

4605051 LEMS (RIA) 300 0 0 4010 

4605150 HU(WB) 300 0 0 4010 

4605168 YO (WB) 300 0 0 4010 

4605176 RI (WB) 300 0 0 4010 

4605192 MA2 (WB) 300 0 0 4010 

4605366 MAG ELISA 300 0 0 4010 

4605374 GQ1B AUTOANTIBODY 300 0 0 4010 

4605382 MOL.AMPLIFICATION PC 300 0 0 4010 

4605481 ISOLATION OR EXTRACT 300 0 0 4010 

4605499 AMPLIFICATION 300 0 0 4010 

4605515 GALOP AUTOANTIBODY 300 0 0 4010 

4605523 SULFATIDE IGG 300 0 0 4010 

4605531 SULFATIDE IGM 300 0 0 4010 

4605580 SPINAL MUSCULAR ATRO 300 0 0 4010 

4605598 NEUTRALIZATION TEST 300 0 0 4010 

4605606 NITROBLUE TETRA.DYE 300 0 0 4010 

4605614 TISSUE CULTURE 300 0 0 4010 

4605622 CO-ASIALO GM1 300 0 0 4010 

4605630 CO-GD1B 300 0 0 4010 

4605648 CO-GM1 IGG 300 0 0 4010 

4605655 SGPG ELISA 300 0 0 4010 

4605739 TAU/AB42 INTERPRETAT 300 0 0 4010 

4605747 CO SGPG 300 0 0 4010 

4605754 MOL.ISOLATION/EXTRAC 300 0 0 4010 

4605762 MOL.AMPLIFICATION 300 0 0 4010 

4605770 MOL.ENZ.DIGESTION 300 0 0 4010 

4605788 MOL.SEP.BY GEL ELECT 300 0 0 4010 

4605820 NUCLEIC ACID PROBE 300 0 0 4010 

4605838 DOT/SLOT BLOT PROD. 300 0 0 4010 

4605846 NUCLEIC ACID AMPLIFI 300 0 0 4010 

4605861 PROTEIN 14-3-3 300 0 0 4010 

4605903 MT DNA ENCEPHALOMYOP 300 0 0 4010 

4605911 NUCLEIC ACID ISO/EXT 300 0 0 4010

4605929 MUTATION ID ALLELE S 300 0 0 4010 

4605945 MUTATION ID BY SEQUE 300 0 0 4010 

4605952 THIN LAYER ANALYSIS 300 0 0 4010 

4605960 CHRON.DEMYELIN.NEURO 300 0 0 4010 

4606026 DOT/SLOT BLOT PROD. 300 0 0 4010 

4606042 OPMD INTERPRETATION 300 0 0 4010 

4606133 NUCLEIC ACID TRANSFE 300 0 0 4010 

4606141 ALPHA-GLOBULIN GENE 300 0 0 4010 

4606232 TETANUS AB 300 0 0 4010 

4606364 FSHD DNA DEL. TEST 300 0 0 4010 


4606711 ISOLATION/EXTRACT NA 300 0 0 4010 


4606737 REVERSE TRANSCRIPTIO 300 0 0 4010 

4607263 CADISIL DNA TEST 300 0 0 4010 

4607552 MERRF MTDNA MUTATION 300 0 0 4010 

4607784 CV2 AUTOANTIBODY 300 0 0 4010 

4607883 WESTERN BLOT/BAND ID 300 0 0 4010 

4607891 IMMUNOASSAY 300 0 0 4010 

4607966 HSV AMP PROBE TECH 300 0 0 4010 

4608113 MUTATION SCANNING 300 0 0 4010 

4608378 HIGH RISK HPV DNA 300 0 0 4010 


4608527 CYTOGENETICS INTERPR 310 0 0 4010 


4608709 IM ASSAY/AB TO INF A 300 0 0 4010 



4608915 AMP.NA,MULTIPLX RXN 300 0 0 4010 

4608923 DMD/BMD DELETION INT 300 0 0 4010 

4608931 RET PROTO ONCOGENE M 300 0 0 4010 

4608949 MUTATION ID BY SEQ 300 0 0 4010 

4609194 FAM.ADENOMATOUS POLY 300 0 0 4010 

4609236 MELAS MUTATION INTER 300 0 0 4010 

4609244 ATAXIA PROF INTERP 300 0 0 4010 

4609319 DYSTONIA INTERP. 300 0 0 4010 


4609335 HERED SPASTIC PARAPL 300 0 0 4010 

4609350 TRANSTHYRETIN DNA SE 300 0 0 4010 

4609426 RECOMBX CAR 300 0 0 4010 

4609442 DMD/BMD DNA CARRIER 300 0 0 4010 

4609459 TAU CSF ANALYSIS 300 0 0 4010 

4609467 AB42 CSF ANALYSIS 300 0 0 4010 

4609640 NARP MTDNA EVAL INTP 300 0 0 4010 

4609715 GAUCHER'S DISEASE 300 0 0 4010 

4609723 FAMILIAL DYSAUTONOMI 300 0 0 4010 

4609798 CYTO & MOL. INTERPRE 310 0 0 4010

4609970 MEN2/FMTC MUTATIONS 300 0 0 4010 

4610374 COMPLETE CMT EVAL 300 0 0 4010 

4610382 MUSK ANTIBODY TEST 300 0 0 4010 

4610390 NEUROFIBROMATOSIS 300 0 0 4010 


4610655 PS-1(PRESINILLIN-1) 300 0 0 4010 

4610713 CHOREA,HUNTINGTON'S 300 0 0 4010 

4610747 APRATAXIN 300 0 0 4010 

4610796 MITOCHONDRIAL MYOP. 300 0 0 4010 

4611182 AMP.OF NUCLEIC ACID 300 0 0 4010 

4611190 MOL.ISO. OR EXTRACTI 300 0 0 4010 

4611208 ENZ.DIGESTION 300 0 0 4010 

4611489 NIEMANN PICK DISEASE 300 0 0 4010 

4611505 CONNEXIN32 DNA SEQUE 300 0 0 4010 

4611554 MUT.ID BY SEQUENCING 300 0 0 4010 

4611604 MASS SPECTROMETRY 300 0 0 4010 

4611620 IMMUNOASSAY,NOT SPEC 300 0 0 4010 

4611802 AMYLOIDOSIS EVAL. 300 0 0 4010 

4611869 CYTOGENETIC INTERP. 300 0 0 4010 

4611901 IMMUNOASSAY,QUANT,RA 300 0 0 4010 

4611919 MOLEC.DIAG.INTERP. 300 0 0 4010 

4611968 NEOSENSORY NEURO.PNP 300 0 0 4010 

4611976 IMMUNOASSAY,RIA 300 0 0 4010 

4611984 PROTEIN,WB TEST 300 0 0 4010 

4611992 FXTAS DNA TEST 300 0 0 4010 

4612115 HEP B GENOTYPE 300 0 0 4010 

4612131 NUCLEIC ACID ISO/EXT 300 0 0 4010 

4612149 NUCL.MOL.SEPARATION 300 0 0 4010 

4612156 NUCL.MOL.AMPLIFICATION 300 0 0 4010 

4612180 ISO/EXTRACTION NA 300 0 0 4010 

4612198 ENZYMATIC DIGESTION 300 0 0 4010 



4612222 SIGNAL AMP.NUCLEIC A 300 0 0 4010 

4612446 HIGH RES SEP & ID 300 0 0 4010 

4612453 FAM HEMI MIGRAIN INT 300 0 0 4010 

4612487 HIGH RES CHROMOSOME 300 0 0 4010 

4612578 FISH, WILLIAMS 300 0 0 4010 

4612586 RETTS SYNDROME 300 0 0 4010 

4612594 ARX DNA SEQUENCING 300 0 0 4010 

4612602 NORRIE DISEASE DNA 300 0 0 4010 

4612610 SCN1A DNA SEQUENCING 300 0 0 4010 

4612628 TUBEROUS SCLEROSIS 300 0 0 4010 

4612636 AMP. 1ST 2 NA SEQUENCING 300 0 0 4010 

4612644 EPILEPSY EVAL PROG 300 0 0 4010 

4612651 DM2 DNA TEST 300 0 0 4010 

4612669 NEUROPATHY EVAL, MULT 300 0 0 4010

4612685 CX 26 DNA SEQUENCING 300 0 0 4010 

4612693 SM. FIBER PAIN AXON 300 0 0 4010 

4612701 MULTIFOCAL NEUR EVAL 300 0 0 4010 

4612719 CONGEN. HYPMYELINATIO 300 0 0 4010 

4612768 SCHISTOSOMIASIS 300 0 0 4010 

4612776 HEP B SURF. AG 300 0 0 4010 

4612784 GIARDIA AG 300 0 0 4010 

4612792 CRYPTOSPORIDIA AG 300 0 0 4010 

4612818 HEP C AB 300 0 0 4010 

4612859 LYMPHOGRANULOMA VENEREUM 300 0 0 4010 

4612966 SIGNAL AMP NUCL ACID 300 0 0 4010 

4613246 OSMS, FECES 300 0 0 4010 

4613360 HIGH RESOLUTION SEP & ID 300 0 0 4010 

4613493 CORTISOL, SALIVARY 300 0 0 4010 

4613501 METHSUXIMIDE 300 0 0 4010 

4613618 11 DEOXYCORTISOL 300 0 0 4010 

4613782 MUTATION IDENTIFICATION 300 0 0 4010 

4613790 SEPARATION AND IDENTIFICATION 300 0 0 4010 

4613808 ISOLATION/EXTRACTION 300 0 0 4010 

4614228 URORISK PANEL 300 0 0 4010 

4614277 MUTATION ID BY ENZ. LIGATION 300 0 0 4010 

4614293 HIGH RESOLUTION SEPARATION & ID 300 0 0 4010 

4614301 NUC ACID ISOL-ATHENA 652 300 0 0 4010 

4614319 NUC ACID AMPL ATHENA 652 300 0 0 4010 

4614327 MUTATION ID ATHENA 652 300 0 0 4010 

4614335 SEP & ID ATHENA 652 300 0 0 4010 

4614343 RECESSIVE HSP EVAL ATHENA 652 300 0 0 4010 

4614525 ISOLATION/EXTRACTION NUCLEIC ACID 300 0 0 4010 

4614533 ENZYME DIGESTION 300 0 0 4010 

4614541 AMPLIFICATION, NUCLEIC ACID 2 300 0 0 4010 

4614558 AMPLIFICATION, NUCLEIC ACID>2 300 0 0 4010 

4614566 SEPARATION/ID HIGH RESOLUTION 300 0 0 4010 

4614582 MUTATION ID BY ENZYME 300 0 0 4010 

4614657 DKH DRUG SCREEN 300 0 0 4010 

4614665 DKH DRUG SCREEN 300 0 0 4010 

4614681 ATHENA ISOL AND EXTRACT 300 0 0 4010 

4614699 ATHENA AMPLIFICATION 300 0 0 4010 

4614707 ATHENA MUTATION ID 300 0 0 4010 

4614723 ATHENA SEP AND ID 300 0 0 4010 

4615142 LDH QUEST 300 0 0 4010 

4615159 TESTOSTERONE QUEST 300 0 0 4010 

4615183 TROPONIN QUEST 300 0 0 4010 

4615191 SGPT QUEST 300 0 0 4010 

4615209 SGOT QUEST 300 0 0 4010 

4615217 FOLATE QUEST 300 0 0 4010 

4615225 LIPASE QUEST 300 0 0 4010 

4615233 AMMONIA QUEST 300 0 0 4010

4617353 PCR BY IMUGEN 300 0 0 4010 

4617379 A PHAGOCYTOPHILUM, PCR 300 0 0 4010 

4617395 LYME, PCR 300 0 0 4010 

4617478 E CHAFFEENSIS, PCR 300 0 0 4010 

4618807 TAPENTADOL, QUANT, URINE 098 0 0 4010 

4700126 CHROMOSOME (UCONN) 310 0 0 4010 

4700175 PKU SCREEN 300 0 0 4010 

4700233 CMV (URINE) 300 0 0 4010 

4700258 SSB ANTI-LA TITER 300 0 0 4010 

4700498 HSV ON CSF BY PCR 300 0 0 4010 

4700514 ATAXIA PROF INTERP 300 0 0 4010 

4700548 SMEAR ECC 310 0 0 4010 

4700555 SMEAR DIAPHRAM SCRAP 310 0 0 4010 

4700563 ST EVAL FNA/ADEQUACY 310 0 0 4010 

4700571 SMEAR NGYN 310 0 0 4010 

4700589 CYTO BRONCH SPUTUM 310 0 0 4010 

5050018 MED/SURG ROUTINE 270 0 0 370 

5500012 PLATELETS, 5 UNITS 390 0 0 4100 

5500038 CELLS,WBC-REDUCED,4U 390 0 0 4100 

5500053 PLTS,WBC-REDU,IRR,2U 390 0 0 4100 

5500061 PLTS,WBC-REDU,IRR,3U 390 0 0 4100 

5500087 CELLS,WBC REDU,IR,2U 390 0 0 4100 

5500095 ALBUMIN 25%/50ML 2UN 390 0 0 4100 

5500103 FRSH FRZ PLASMA,2UNI 390 0 0 4100 

5500111 CRYOPRECIP, 2 UNITS 390 0 0 4100 

5500137 CELLS,WBC/REDUCED,6U 390 0 0 4100 

5500145 CELLS,WBC REDUCED,3U 390 0 0 4100 

5500178 AUTOLOGOUS PROCESS 391 0 0 4100 



5500244 CRYOPRECIP. 3 UNITS 390 0 0 4100 

5500269 13080 UNITS FACTOR 8 636 0 0 4100 




5500319 ALBUMIN 5%/250ML 390 0 0 4100 

5500376 PLTS,WBC REDU,IRR,6U 390 0 0 4100 

5500384 SEPACELL FILTERS (2) 270 0 0 4100 

5500392 PLATELETS, TEN UNITS 390 0 0 4100 

5500400 SEPACELL FILTER (1) 270 0 0 4100 

5500418 2 PLT INFUSION SETS 270 0 0 4100 

5500426 CRYOPRECIP. 4 UNITS 390 0 0 4100 

5500434 WBC FILTER/PLATELET 270 0 0 4100 

5600069 MRI KEN L SPINE W WO CONTRAST 612 0 0 4275 

5600192 MRI KEN SHLDR ARTHRO LT 610 0 0 4275 

5600200 MRI KEN SHLDR ARTHRO RT 610 0 0 4275 

5600804 MRI KEN UPEX NO JT WO LT 610 0 0 4275

5600812 MRI KEN UPEX NO JT WO RT 610 0 0 4275 

5600929 MRI KEN LOEX NOJT W/O LT 610 0 0 4275 

5600945 MRI KEN LOEX NO JT W LT 610 0 0 4275 

5800057 SLEEP STUDY REQUEST 270 0 0 4100 

5800107 S.S. SCREEN (UNAT.4) 270 0 0 4100 

5800156 S.S. SCREEN (ATT.4) 270 0 0 4100 

5977707 EEG MISC 922 0 0 4140 

6000764 E.R. EKG 730 0 0 4120 

6090518 INJ REGADENOSON, .1 MG 636 0 0 4120 

6107908 GALLBLADDER SERIES 320 0 0 4210 

6108708 PORTABLE RADIOGRAPHY 320 0 0 4210 

6108955 CONSULT-OUTSIDE FILM 320 0 0 4210 

6109003 VENOGRAM BILATERAL 320 0 0 4210 

6110050 MAMMO DIAG BILAT 401 0 0 4210 

6110258 MAMMO-UNILAT/BIOPSY 320 0 0 4210 

6110407 MAMMO DIAG UNI-LT 401 0 0 4210 

6110415 MAMMO DIAG UNI-RT 401 0 0 4210 

6110464 MAMMO PADS 621 0 0 4210 

6110472 LOC NEEDLES 270 0 0 4210 

6110480 STEREO TRAY 270 0 0 4210 

6111603 VENOGRAM UNILAT-LT 761 0 0 4210 

6111652 VENOGRAM UNILAT-RT 761 0 0 4210 

6112809 MAMMO SCREEN 403 0 0 4210 

6114201 VENOGRAM INS-LT 761 0 0 4210 

6114219 VENOGRAM INS-RT 761 0 0 4210 

6116164 MAMMO NEEDLE LOC ADD'L UNIL-RT 401 0 0 4211 

6116172 GREENFIELD FILTER REMOVAL 761 0 0 4211 

6116180 GREENFIELD FILTER REMOVAL PROC 761 0 0 4211 

6116198 GREENFIELD FILTER INTRODUCTION 761 0 0 4211 

6170005 PORTABLE RADIOGRAPHY 320 0 0 4211 

6170039 RIGHT KNEE-WO-OTIS-IMPLANT 320 0 0 4210 

6170047 LEFT KNEE-WO-OTIS-IMPLANT 320 0 0 4210 

6170054 RIGHT KNEE-WO-OTIS IMPLANT 320 0 0 4210 

6191001 VISIP320MG-LOCM@50ML 636 0 0 4210 

6191050 VISIP320-LOCM@100ML 636 0 0 4210 

6191100 VISIP320-LOCM@150ML 636 0 0 4210 

6191159 OMNIP180-LOCM@20ML 636 0 0 4210 

6191209 OMNIP300-LOCM@50ML 636 0 0 4210 

6191258 OMNIP300-LOCM@100ML 636 0 0 4210 

6191308 OMNIP300-LOCM@150ML 636 0 0 4210 

6191357 OMNIP350-LOCM@50ML 636 0 0 4210 

6191407 OMNIP350-LOCM@100ML 636 0 0 4210 

6191456 OMNIP350-LOCM@125ML 636 0 0 4210 

6192025 MAMMO PAD 098 0 0 4211 

6192058 BIOP SOFT TIS KNEE/THIGH SUPERFSCL 320 0 0 4210 

6200257 1ST PASS BLOOD POOL 340 0 0 4240 

6201008 GALLIUM STUDY SCAN 340 0 0 4240

6201305 PLANAR CARDIAC RE&EX 340 0 0 4240 

6201404 PLANAR CARDIAC REST 340 0 0 4240 

6202808 GALLIUM TOM W SPECT 340 0 0 4240 

6203301 MYOCARD INFARC SPECT 340 0 0 4240 

6203400 MYOCARDIAL PERF W.M. 340 0 0 4240 

6203509 MYOCARDIAL PERF E.F. 340 0 0 4240 

6204002 LIVER WITH SPECT 340 0 0 4240 

6204564 THALLIUM 1 MCI 343 0 0 4240 

6204572 THALLIUM 1 MCI RE INJECTION 343 0 0 4240 

6204614 PORT INJECTION FOR PATENCY 0 0 4240 

6290050 PERSANTINE 1.0-10.0 636 0 0 4240 

6290100 PERSANTINE 10.1-20.0 636 0 0 4240 

6290159 PERSANTINE 20.1-30.0 636 0 0 4240 

6290209 PERSANTINE 30.1-40.0 636 0 0 4240 

6290258 PERSANTINE 40.1-50.0 636 0 0 4240 

6290308 PERSANTINE 50.1-60.0 636 0 0 4240 

6290654 2 DOSES MYOVIEW 343 0 0 4240 

6290852 INDIUM DOSAGE 343 0 0 4240 

6291009 TECHNESIUM 20 343 0 0 4240 

6291058 TECHNESIUM 25 343 0 0 4240 

6301105 ECHO-2D LIMITED BUBBLE STUDY 480 0 0 4251 

6301709 DOPPLER ECHO LIMITED 480 0 0 4251 

6305502 PORTABLE ULTRASOUND 402 0 0 4250 

6307359 RENAL CYST/PELV PROC 761 0 0 4250 

6307904 NEEDLE BIOPSY 761 0 0 4250 

6307953 NEEDLE LOC (US)/PROC 761 0 0 4250 

6307961 NEEDLE LOC FULL (US) 761 0 0 4250 

6307979 NEEDLE LOC (US) 402 0 0 4250 

6307987 NEEDLE LOC PROC 761 0 0 4250 

6310510 US-GUIDED DRAINAGE 402 0 0 4250 

6311104 NEPHROSTOMY LOCALIZA 402 0 0 4250 

6320055 ARTERIES LOW EXT UNI 921 0 0 4250 

6320105 ARTERIES UPP EXT UNI 921 0 0 4250 

6320501 LEVEL II OB-US 402 0 0 4250 

6370001 PORTABLE ULTRASOUND 402 0 0 4251 

6390090 DEFINITY CONT-PERFLU PER ML 636 0 0 4250 

6400105 PET/CT-COLON 404 0 0 4220 

6400204 PET/CT-ESOPH 404 0 0 4220 

6400303 PET/CT-HEAD 404 0 0 4220 

6400402 PET/CT-NECK 404 0 0 4220 

6400501 PET/CT-LUNG 404 0 0 4220 

6400600 PET/CT-LYMPHOMA 404 0 0 4220 

6400709 PET/CT-WHOLE BODY 404 0 0 4220 

6401202 PET/CT-BREAST 404 0 0 4220 

6401301 PET/CT-THYROID 404 0 0 4220 

6401400 PET-MYOCARD-DIAGNOST 404 0 0 4220 

6401905 PET/CT-SKULL-TO-THIGH 404 0 0 4220

6500052 MRI-SPECIAL 352 0 0 4270 

6500201 MRI-BONE MARROW 610 0 0 4270 

6500904 MRI-MYOCARDIUM 610 0 0 4270 

6502256 MRI-RIGHT KNEE WO OTIS IMPLANT 320 0 0 4270 

6590053 MRI-GADO-15ML 636 0 0 4270 

6590103 MRI-GADO-20ML 636 0 0 4270 

6590152 MRI-GADO-30ML 636 0 0 4270 

6590202 MRI-GADO-40ML 636 0 0 4270 

6600159 MRA-SPINE W/WO CONTR 618 0 0 4270 

6600308 MRA-NECK W/CONTRAST 615 0 0 4270 

6600357 MRA-AB W/WO CONTR 618 0 0 4270 

6700926 CT I.A.M. W/WO CONTR 351 0 0 4260 

6701049 CT LOW EX W/WO CO-LT 352 0 0 4260 

6701056 CT LOW EX W/WO CO-RT 352 0 0 4260 

6701601 CT POST FOSSA W/CONT 351 0 0 4260 

6701619 CT POST FOSSA W/WO C 351 0 0 4260 

6701627 CT POST FOSSA WO CON 351 0 0 4260 

6701700 CT RETROP W/WO CONTR 352 0 0 4260 

6701718 CT RETROPERI W/CONTR 352 0 0 4260 

6701726 CT RETROPERI W/O CON 352 0 0 4260 

6701825 CT SAC/COCC W/WO CON 352 0 0 4260 

6701924 CT SI JTS W/WO CONTR 352 0 0 4260 

6702211 CT UP EX W/WO CO-RT 352 0 0 4260 

6702302 CT-3D WIZARD 350 0 0 4260 

6702401 CT-ANGIO AORTA 352 0 0 4260 

6706006 CT-KIDNEY CYST ASP 352 0 0 4260 

7000508 MRI-SHLDR ARTHRO LT PLF 610 0 0 4273 

7000516 MRI-SHLDR ARTHRO RT PLF 610 0 0 4273 

7500812 RHO(D) IMMUNE GLOBUL VIAL 636 0 0 4300 

7500952 BACITRACIN 500 U OINT 250 0 0 4300 

7501349 MISCELLANEOUS MEDICA 250 0 0 4300 

7501463 CARBOPLATIN 450 MG 250 0 0 4300 

7502008 COLCHICINE 0.5 MG VIAL 636 0 0 4300 

7502040 CORTICOTROPIN 80 U 636 0 0 4300 

7502453 DIGOXIN 100 MCG CAP 250 0 0 4300 

7502966 ERYTHROMYCIN LACTOBI 636 0 0 4300 

7503030 ESMOLOL HCL 250 MG INJ 250 0 0 4300 

7503261 FLUNISOLIDE 250 MCG 250 0 0 4300 

7503295 FLUOROMETHOLONE 0 DROPS 250 0 0 4300 

7504194 INSULIN ZINC EXTEND 636 0 0 4300 

7504228 INSULIN ZINC HUMAN R 636 0 0 4300 

7504368 ATTAPULGITE 750 MG 250 0 0 4300 

7504483 RHO(D) IMMUNE GLOBUL 600 U VIAL 636 0 0 4300 

7505175 METAPROTERENOL SULFA 250 0 0 4300 



7505514 MIVACRON 2MG/ML 5ML VIAL 250 0 0 4300

7507080 PROCAINAMIDE 500MG. SR TAB 250 0 0 4300 

7507775 TEGASEROD 6MG. 250 0 0 4300 

7507882 THEOPHYLLINE/DEXTROS 400 MG INJ 636 0 0 4300 

7508286 TRIMETHOBENZAMIDE HC 250 0 0 4300 

7508302 TRIMETHOBENZAMIDE HC SUPP 250 0 0 4300 

7508724 FERROUS SULFATE 75 MG DROPS 250 0 0 4300 

7509599 MESNA 100 MG 250 0 0 4300 

7509847 SANDOSTATIN 20MG LAR 636 0 0 4300 

7509987 PIPERACILL NA/TAZOBA 636 0 0 4300 

7510647 FELODIPINE 2.5MG. TAB 250 0 0 4300 

7510787 ROSIGLITAZONE MALEAT TAB 250 0 0 4300 

7510886 INTERFERON ALFA-2A R 250 0 0 4300 

7511108 LEUPROLIDE ACETATE 3 250 0 0 4300 

7511827 ALENDRONATE SODIUM 1 250 0 0 4300 

7511926 DAUNORUBICIN HCL 5 M 250 0 0 4300 

7511942 ROSIGLITAZONE MALEAT TAB 250 0 0 4300 

7511991 AMINO ACIDS 8% 0 250 0 0 4300 

7512361 BETAXOLOL HCL DROPS 250 0 0 4300 

7512379 CEFOTETAN DISODIUM 1GM 250 0 0 4300 

7512635 NEPHROCAPS 250 0 0 4300 

7513161 IPECAC SYRUP 30ML BOTTLE 250 0 0 4300 

7513211 NEUTRA PHOS-K PWD PACKET 250 0 0 4300 

7513302 LEUCOVORIN 50 MG VIAL 636 0 0 4300 

7514466 ATENOLOL 0.5MG/ML INJ 250 0 0 4300 

7514508 TORISEL KIT-25MG 636 0 0 4300 

7514912 BACTRIM SUSP 5 ML ORAL SYRINGE 250 0 0 0 

7515059 DANTROLENE 50 MG CAP 636 0 0 4300 

7515075 H1N1 VACCINE 636 0 0 4300 

7515356 ROSIGLITAZONE 2 MG TAB 250 0 0 4300 

7515661 E E S 200 MG/5ML 250 0 0 4300 

7516107 CEFAZOLIN 2 GM/100ML IVPB 636 0 0 4300 




7550015 ISOMETHEPTENE/APAP/D 250 0 0 4300 

7550130 FLEET BAGENEMA 270 0 0 4300 

7579998 PRE ADMIN SERVICES-IVIG 636 0 0 4300 

7600067 ASCORBATE SODIUM 500 258 0 0 4310 

7600075 ALCO/DEXT 5-5% 258 0 0 4310 

7600083 CEFAZOLIN SODIUM 10 258 0 0 4310 





7600489 ZNSO4 HEP/NAI/CU/MAN 258 0 0 4310 

7600497 MULTIVITAMINS 258 0 0 4310 

7600562 POTASSIUM PHOS M-BAS 258 0 0 4310

7600570 POTASSIUM ACETATE 2 258 0 0 4310 

7600620 IV EQUIPMENT 258 0 0 4310 

7600638 MALE ADAPTER 258 0 0 4310 

7600646 IV ADMINISTRATION SE 258 0 0 4310 

7600653 IV ADMIN EXTENSION S 258 0 0 4310 

7600703 NITRO PLUMB SET 270 0 0 4310 

7600737 PRIMARY IV SET 270 0 0 4310 

7600786 CLAVE CONNECTOR 11956 270 0 0 4310 

7601636 METRONIDAZOLE 500 MG IV 250 0 0 4300 

7601644 FLUCONAZOLE 200 MG IV 636 0 0 4300 

7601750 MAGNESIUM 20 GM/500 ML 250 0 0 4300 

7690035 MALE ADAPTOR PLUG - 11391 270 0 0 4310 

7690043 IV ADMINISTRATION SET-CLAM ML 270 0 0 4310 

7690050 EXT SET RESEAL 11957 270 0 0 4310 

7690068 DIAL A FLOW W/EXT 19140 270 0 0 4310 

7690076 MACRO SET 11961 270 0 0 4310 

7690084 7 HIGH PRESSURE SET SS-461 270 0 0 4310 

7690092 BLOOD IV SET TYPE Y - 12434 270 0 0 4310 

7690100 SURGICAL IV SET 12664 270 0 0 4310 

7690118 PUMP FILTERED SET 12030 270 0 0 4310 

7690126 NITROGLYCERIN PLUMSET-11878 270 0 0 4310 

7690134 BLOOD IV SET - 4602 270 0 0 4310 

7690142 SECONDARY SET 32IN 11953 270 0 0 4310 

7690159 FLTR SET HIGH-PRES 12273 1SET 270 0 0 4310 

7690167 IV SET PRIMARY 11962 270 0 0 4310 

7690175 CLAVE CONNECTOR - 11956 270 0 0 4310 

7690183 EPIDURAL PUMP TUBING #13514 270 0 0 4310 

7690589 PCA PUMP SET 270 0 0 4310 

7700065 RE-EVAL COMPX SPEECH&LANG CTCARE 444 0 0 4380 

7700305 AAC THER SERVICE NON SPEECH (PROC) 440 0 0 4380 

7790074 DEVELOPMENT, COG SKILLS PER 15 MIN 440 0 0 4371 

7790751 TREATMENT, SP/LANG, GRP 440 0 0 4371 

7790777 EVAL, VOICE PROSTHETIC DEVICE 444 0 0 4371 

7800063 RE-EVAL CMPLX SP&LANG CT CARE DLS 444 0 0 4380 

7800253 AAC EVAL NON SPEECH (PROC) DLS 444 0 0 4380 

7800303 AAC THER NON SPEECH (PROC)DLS 440 0 0 4380 

7800352 AAC EVAL SPEECH 1ST HR DLS 444 0 0 4380 

7800402 AAC 30 ADD'L MIN DLS 440 0 0 4380 

7800501 AAC THER SERVICE (PROC) DLS 440 0 0 4380 

7900061 PLFD RE-EVAL CMPLX SP&LANG CT CARE 444 0 0 4380 

7900301 AAC THER NON SPEECH (PROC) PLF 440 0 0 4380 

8000150 ICU MONITORED 1ST 1/2 HR 370 0 0 4350 

8000168 ICU MONITORED ANES EA ADD'L 15 MIN 370 0 0 4350 

8000309 INTERSCALENE BLOCK 370 0 0 4350 

8012809 H/L MEDICAID B/D ALLOWANCE 0 0 5130 

8200156 DLSN RE-EVAL COMPLEX CT CARE (PROC) 424 0 0 4370 

8201154 WHIRLPOOL (PROC) DLS 420 0 0 4370

8201253 DLSN MOIST HEAT/CRYO (PROC) 420 0 0 4370 

8201808 FUNCTIONAL CAPACITY PER 15 MIN DLS 420 0 0 4370 

8201907 DLSN SHORT ARM SPLINT STATIC (PROC) 420 0 0 4370 

8201956 DLSN SHORT ARM SPLINT DYNAMIC (PROC 420 0 0 4370 

8202004 DLSN FINGER SPLINT STATIC (PROC) 420 0 0 4370 

8202053 DLSN FINGER SPLINT DYNAMIC (PROC) 420 0 0 4370 

8202103 LOW BACK STRAPPING (PROC) DLS 420 0 0 4372 

8202152 SHOULDER STRAPPING (PROC) DLS 420 0 0 4372 

8202202 ELBOW/WRIST STRAPPING (PROC) DLS 420 0 0 4372 

8202350 HAND/FINGER STRAPPING (PROC) DLS 420 0 0 4372 

8202400 THORAX/CHEST STRAPPING (PROC) DLS 420 0 0 4372 

8202509 TOES STRAPPING (PROC) DLS 420 0 0 4370 

8202558 UNNA BOOT STRAPPING (PROC) DLS 420 0 0 4370 

8202707 COMM/WORK REINTEGRAT PER 15MIN DLS 420 0 0 4370 

8202756 DEVELOP COG SKILLS PER 15 MIN DLS 420 0 0 4370 

8202806 SENSORY INTEG TECH PER 15 MIN 420 0 0 4370 

8202905 AQUATIC THERAPY DLS 420 0 0 4372 

8202954 WC DEBRIDE >20CM (PROC) DLS 420 0 0 4370 

8203002 WC DEBRIDE

8203465 DLSN HFOWOJT L3913 274 0 0 4370 

8203473 DLSN HOWOJT L3919 274 0 0 4370 

8203481 DLSN HFO1+JT L3921 274 0 0 4370 

8203507 DLSN FOWJT L3935 274 0 0 4370 

8203515 DLSN ADDOPERJOINT L3956 274 0 0 4370 

8203549 VASOPNEUMATIC DEVICE 420 0 0 4372 

8208506 HOUSEKEEPING-PAPER PRODUCTS 0 0 8500 

8280752 DLSN CERV COLLAR FORM FIT 274 0 0 4370 

8280802 DLSN UNIVERSAL CERVICAL COLLAR 274 0 0 4370 

8280851 DLSN COLLAR W/OPEN TRACHEA 274 0 0 4370 

8280901 DLSN UNIVERSAL KNEE SPLINT 274 0 0 4370 

8280950 DLSN UNIVERSAL RIB BELT 274 0 0 4370 

8300154 PLFD RE-EVAL CMPLX CT CARE (PROC) 424 0 0 4373 

8301251 PLFD MOIST HEAT/CRYO (PROC) 420 0 0 4370 

8301905 PLFD SHORT ARM SPLINT STATIC (PROC) 420 0 0 4370 

8301954 PLFD SHORT ARM SPLINT DYNAMIC(PROC) 420 0 0 4370 

8302002 PLFD FINGER SPLINT STATIC (PROC) 420 0 0 4370 

8302051 PLFD FINGER SPLINT DYNAMIC (PROC) 420 0 0 4370 

8302101 LOW BACK STRAPPING (PROC) PLF 420 0 0 4373 

8302150 SHOULDER STRAPPING (PROC) PLF 420 0 0 4373 

8302200 ELBOW/WRIST STRAPPING (PROC) PLF 420 0 0 4373 

8302259 KNEE STRAPPING (PROC) PLF 420 0 0 4373 

8302358 HAND/FINGER STRAPPING (PROC) PLF 420 0 0 4373 

8302408 THORAX/CHEST STRAPPING (PROC) PLF 420 0 0 4373 

8302457 HIP STRAPPING (PROC) PLF 420 0 0 4373 

8302507 TOES STRAPPING (PROC) PLF 420 0 0 4370 

8302556 UNNA BOOT STRAPPING (PROC) PLF 420 0 0 4370 

8302655 CONTRAST BATHS PER 15 MIN PLF 420 0 0 4370 

8302705 COMM/WORK REINTEGRATION/15 MIN PLF 420 0 0 4370 

8302754 DEVELOP COGNITIVE SKILLS/15MIN PLF 420 0 0 4370 

8302804 SENSORY INTEG TECH PER 15 MIN PLF 420 0 0 4370 

8302903 AQUATIC REHAB PER 15 MIN PLF 420 0 0 4370 

8302952 WC DEBRIDE >20CM (PROC) PLF 420 0 0 4370 

8303000 WC DEBRIDE

8303356 PLFD WHFOADDSPREXT L3835 274 0 0 4370 

8303364 PLFD WHFOADSPGS L3840 274 0 0 4370 

8303372 PLFD WHFOADDTHMP L3845 274 0 0 4370 

8303380 PLFD WHFOADDASST L3850 274 0 0 4370 

8303398 PLFD WHFOADDMPFLX L3855 274 0 0 4370 

8303406 PLFD WHFOADMPFLIP L3860 274 0 0 4370 

8303414 PLFD ADDTOUEJWE,EA L3890 274 0 0 4370 

8303422 PLFD WHFODYNHINGE L3900 274 0 0 4370 

8303430 PLFD WHFODYNHNGCABLE L3901 274 0 0 4370 

8303448 PLFD WHOWOJT L3906 274 0 0 4370 

8303455 PLFD WHOWRTHSPICA L3907 274 0 0 4370 

8303463 PLFD HFOWOJT L3913 274 0 0 4370 

8303471 PLFD HOWOJT L3919 274 0 0 4370 

8303489 PLFD HFO1+JT L3921 274 0 0 4370 

8303497 PLFD FOWOJT L3933 274 0 0 4370 

8303505 PLFD FOWJT L3935 274 0 0 4370 

8303513 PLFD ADDTOPERJOINT L3956 274 0 0 4370 

8380750 PLFD CERVICAL COLLAR FORM FIT 274 0 0 4370 

8380800 PLFD UNIVERSAL CERVICAL COLLAR 274 0 0 4370 

8380859 PLFD COLLAR W/OPEN TRACHEA 274 0 0 4370 

8380909 PLFD UNIVERSAL KNEE SPLINT 274 0 0 4370 

8380958 PLFD UNIVERSAL RIB BELT 274 0 0 4370 

8400152 RE-EVAL COMPLEX CT CARE (PROC) 424 0 0 4370 

8401259 MOIST HEAT/CRYO (PROC) 420 0 0 4370 

8401804 FUNCTIONAL CAPACITY PER 15 MIN 420 0 0 4370 

8401952 SHORT ARM SPLINT DYN 420 0 0 4370 

8402000 FINGER SPLINT STATIC 420 0 0 4370 

8402059 FINGER SPLINT DYNAMI 420 0 0 4370 

8402109 LOW BACK STRAPPING (PROC) 420 0 0 4371 

8402158 SHOULDER STRAPPING (PROC) 420 0 0 4371 

8402208 ELBOW/WRIST STRAPPING (PROC) 420 0 0 4371 

8402356 HAND/FINGER STRAPPING (PROC) 420 0 0 4371 

8402406 THORAX/CHEST STRAP (PROC) 420 0 0 4370 

8402505 TOES STRAPPING (PROC) 420 0 0 4370 

8402554 UNNA BOOT STRAPPING (PROC) 420 0 0 4370 

8402653 CONTRAST BATHS PER 15 MIN 420 0 0 4370 

8402703 COMM/WORK REINTEGRAT PER 15 MIN 420 0 0 4370 

8402752 DEVELOP COGN SKILLS PER 15 MIN 420 0 0 4370 

8402802 SENSORY INTEG TECH PER 15 MIN 420 0 0 4370 

8402901 AQUATIC REHAB/15 MIN 420 0 0 4371 

8402950 WC DEBRID >20CM (PROC) 420 0 0 4371 

8403008 WC DEBRID

8403263 EWHORTHO L3763 274 0 0 4370 

8403271 EWHFOWOJT L3765 274 0 0 4370 

8403289 WHFOSHOPPON L3800 274 0 0 4370 

8403297 WHFOLGOPPONENS L3805 274 0 0 4370 

8403305 WHFOADDTHUMB L3810 274 0 0 4370 

8403313 WHFOADD2NDMP L3815 274 0 0 4370 

8403321 WHFOADDIPEXTMP L3820 274 0 0 4370 

8403339 WHFOADDMPEXTST L3825 274 0 0 4370 

8403347 WHFOADDMPAST L3830 274 0 0 4370 

8403354 WHFOADDSPREXT L3835 274 0 0 4370 

8403362 WHFOADDSPRGSWVL L3840 274 0 0 4370 

8403370 WHFOADDTHMP L3845 274 0 0 4370 

8403388 WHFOADDASST L3850 274 0 0 4370 

8403396 WHFOADDMPFLX L3855 274 0 0 4370 

8403404 WHFOADOMPFLXIP L3860 274 0 0 4370 

8403412 ADDTOUEJWE,EA L3890 274 0 0 4370 

8403420 WHFODYNHINGE L3900 274 0 0 4370 

8403438 WHFODYNHNGCABLE L3901 274 0 0 4370 

8403446 WHOWOJT L3906 274 0 0 4370 

8403453 WHOWRTHSPICA L3907 274 0 0 4370 

8403479 HOWOJT L3919 274 0 0 4370 

8403487 HFO1+JT L3921 274 0 0 4370 

8403495 FOWOJT L3933 274 0 0 4370 

8403503 FOWJT L3935 274 0 0 4370 

8403511 ADDTOPERJOINT L3956 274 0 0 4370 

8480055 PHYS THER SUPPLIES 420 0 0 4370 

8480808 UNIVERSAL CERV COLLA 274 0 0 4370 

8480857 COLLAR W/OPEN TRACH 274 0 0 4370 

8480907 UNIV KNEE SPLINT 274 0 0 4370 

8480956 UNIV RIB BELT 274 0 0 4370 

8481004 WHFOJT L3806 274 0 0 4370 

8481012 WHFOWOJT L3808 274 0 0 4370 

8481020 REPLSTRAP L4002 274 0 0 4370 

8481038 REPAIRTIME L4205 274 0 0 4370 

8481046 REPAIRMINOR L4210 274 0 0 4370 

8481053 ELBOWORTHO L3702 274 0 0 4370 

8481061 EWHORTHO L3763 274 0 0 4370 

8481079 EWHFOWOJT L3765 274 0 0 4370 

8481087 WHFOSHOPPON L3800 274 0 0 4370 

8500050 EVAL SPEECH & LANGUA 274 0 0 4370 

8500100 SPEECH & LANGUAGE TX 274 0 0 4370 

8500159 SWALLOW EVAL 274 0 0 4370 

8500209 SWALLOW TX 274 0 0 4370 

8500258 AAC EVAL NON-SP GEN 274 0 0 4370 

8500308 AAC THER SERV NON SP 274 0 0 4370 

8500357 AAC EVAL SPEECH GEN 274 0 0 4370 

8500407 AAC 30 ADDIT'L MIN 274 0 0 4370

8500456 VIDEO FLUORO EVAL I 274 0 0 4370 

8600157 OT RE-EVAL CPLX CT CARE (PROC) 434 0 0 4390 

8601254 OT HEAT/CRYO (PROC) 430 0 0 4390 

8601809 OT FCE PER 15 MIN 434 0 0 4390 

8601908 OT SHORT ARM SPL ST 430 0 0 4390 

8601957 OT SHORT ARM SPL DY 430 0 0 4390 

8602005 OT FINGER SPLINT ST 430 0 0 4390 

8602054 OT FINGER SPLINT DY 430 0 0 4390 

8602104 OT LOW BACK STRAPPING (PROC) 430 0 0 4371 

8602153 OT SHOULDER STRAPPING (PROC) 430 0 0 4371 

8602203 OT ELBOW/WRIST STRAPPING (PROC) 430 0 0 4371 

8602252 OT KNEE STRAPPING (PROC) 430 0 0 4390 

8602351 OT HAND/FINGER STRAP (PROC) 430 0 0 4371 

8602401 OT THORAX/CHEST STRAP(PROC) 430 0 0 4371 

8602500 OT TOES STRAPPING (PROC) 430 0 0 4390 

8602559 OT UNNA BOOT STRAP (PROC) 430 0 0 4390 

8602708 OT COMM/WORK REINTEG/15 MIN 430 0 0 4390 

8602757 OT DEVELOP COGN SKILL/15 MIN 430 0 0 4390 

8602955 OT WC DEBRID >20CM (PROC) 430 0 0 4371 

8603003 OT WC DEBRID

8603557 JOINT JACK 274 0 0 4390 

8603565 RING PIP PREFAB 274 0 0 4390 

8680753 CERV COLLAR-FORM FIT 274 0 0 4390 

8680803 UNIVERSAL CERV COLLA 274 0 0 4390 

8680852 COLLAR W/OPEN TRACH 274 0 0 4390 

8680902 UNIV KNEE SPLINT 274 0 0 4390 

8680951 UNIV RIB BELT 274 0 0 4390 

8681009 OT SUPPLIES 274 0 0 4390 

8700155 DLSN OT RE-EVAL CPLX CT CARE (PROC) 434 0 0 4390 

8701252 HEAT/CYRO (PROC) DLS 430 0 0 4372 

8701906 DLSN OT SHORT ARM SPLINT STA (PROC) 430 0 0 4390 

8701955 DLSN OT SHORT ARM SPLINT DYN (PROC) 430 0 0 4390 

8702003 DLSN OT FINGER SPLINT STATIC (PROC) 430 0 0 4390 

8702052 DLSN OT FINGER SPLINT DYNAMIC(PROC) 430 0 0 4390 

8702102 LOW BACK STRAPPING (PROC) DLS 430 0 0 4372 

8702151 SHOULDER STRAPPING (PROC) DLS 430 0 0 4372 

8702201 ELBOW/WRIST STRAP (PROC) DLS 430 0 0 4372 

8702359 HAND/FINGER STRAP (PROC) DLS 430 0 0 4372 

8702409 THORAX/CHEST STRAP (PROC) DLS 430 0 0 4390 

8702508 TOES STRAPPING (PROC) DLS 430 0 0 4390 

8702557 UNNA BOOT STRAPPING (PROC) DLS 430 0 0 4372 

8702656 CONTRAST BATH PER 15 MIN DLS 430 0 0 4390 

8702763 COGN RE-TRAIN PER 15 MIN DLS 430 0 0 4390 

8702904 AQUATIC REHAB PER 15 MIN DLS 430 0 0 4390 

8702953 WC DEBRIDE >20CM (PROC) DLS 430 0 0 4390 

8703001 WC DEBRIDE

8703407 DLSN OT WHFOADMPFLXI L3860 274 0 0 4390 

8703415 DLSN OT ADDUEJWE,EA L3890 274 0 0 4390 

8703423 DLSN OT WHFODYNHINGE L3900 274 0 0 4390 

8703431 DLSN OT WHFODYHNGCBL L3901 274 0 0 4390 

8703449 DLSN OT WHOWOJT L3906 274 0 0 4390 

8703456 DLSN OT WHOWRTHSPICA L3907 274 0 0 4390 

8703464 DLSN OT HFOWOJT L3913 274 0 0 4390 

8703498 DLSN OT FOWOJT L3933 274 0 0 4390 

8703506 DLSN OT FOWJT L3935 274 0 0 4390 

8703514 DLSN OT ADDOPERJOINT L3956 274 0 0 4390 

8780751 DLSN OT CERVICAL COLLAR FORM FIT 274 0 0 4390 

8780801 DLSN OT UNIV CERIVICAL COLLAR 274 0 0 4390 

8780850 DLSN OT COLLAR W/OPEN TRACHEA 274 0 0 4390 

8780900 DLSN OT UNIV KNEE SPLINT 274 0 0 4390 

8780959 DLSN OT UNIVERSAL RIB BELT 274 0 0 4390 

8800153 RE-EVAL COMPLEX CTCARE(PROC) PLF 434 0 0 4390 

8801151 WHIRLPOOL (PROC) PLF 430 0 0 4390 

8801250 PLFD OT HEAT/CYRO (PROC) 430 0 0 4390 

8801805 PHYS PERF TEST FTE 15 MIN PLF 434 0 0 4390 

8801904 PLFD OT SHORT ARM SPLINT STAT(PROC) 430 0 0 4390 

8801953 PLFD OT SHORT ARM SPLINT DYNA(PROC) 430 0 0 4390 

8802001 PLFD OT FINGER SPLINT STATIC (PROC) 430 0 0 4390 

8802050 PLFD OT FINGER SPLINT DYNAMIC(PROC) 430 0 0 4390 

8802100 LOW BACK STRAPPING (PROC) PLF 430 0 0 4390 

8802159 SHOULDER STRAPPING (PROC) PLF 430 0 0 4390 

8802209 ELBOW/WRIST STRAPPING(PROC) PLF 430 0 0 4373 

8802357 HAND/FINGER STRAPPING(PROC) PLF 430 0 0 4373 

8802407 THORAX/CHEST STRAP (PROC) PLF 430 0 0 4390 

8802506 TOES STRAPPING (PROC) PLF 430 0 0 4373 

8802555 UNNA BOOT STRAPPING (PROC) PLF 430 0 0 4390 

8802654 CONTRAST BATH PER 15 MIN PLF 430 0 0 4390 

8802704 COMM/WORK REINTEG PER 15MIN PLF 430 0 0 4390 

8802753 PLFD OT DEVELOP COGN SKILLS/15 MIN 430 0 0 4390 

8802761 DEV OF COGNITIVE SKILLS / 15 MIN 430 0 0 4390 

8802902 AQUATIC REHAB PER 15 MIN PLF 430 0 0 4390 

8802951 WC DEBRIDE >20CM (PROC) PLF 430 0 0 4390 

8803009 WC DEBRIDE

8803306 PLFD OT WHFOADDTHUM L3810 274 0 0 4390 

8803314 PLFD OT WHFOADD2NDMP L3815 274 0 0 4390 

8803322 PLFD OT WHFADIPMP L3820 274 0 0 4390 

8803330 PLFD OT WHFADMPEXT L3825 274 0 0 4390 

8803348 PLFD OT WHFOADDMPAST L3830 274 0 0 4390 

8803355 PLFD OT WHFOADSPREXT L3835 274 0 0 4390 

8803363 PLFD OT WHFOADSPGSW L3840 274 0 0 4390 

8803371 PLFD OT WHFOADDTHMP L3845 274 0 0 4390 

8803389 PLFD OT WHFOADDASST L3850 274 0 0 4390 

8803397 PLFD OT WHFOADDMPFLX L3855 274 0 0 4390 

8803405 PLFD OT WHFOADMPFLXI L3860 274 0 0 4390 

8803413 PLFD OT ADDUEJWE,EA L3890 274 0 0 4390 

8803421 PLFD OT WHFODYNHINGE L3900 274 0 0 4390 

8803439 PLFD OT WHFODYHNGCBL L3901 274 0 0 4390 

8803454 PLFD OT WHOWRTHSPICA L3907 274 0 0 4390 

8803504 PLFD OT FOWJT L3935 274 0 0 4390 

8803512 PLFD OT ADDOPERJT L3956 274 0 0 4390 

8880759 PLFD OT CERVICAL COLLAR FORM FIT 274 0 0 4390 

8880809 PLFD OT UNIVERSAL CERVICAL COLLAR 274 0 0 4390 

8880858 PLFD OT COLLAR W/OPEN TRACHEA 274 0 0 4390 

8880908 PLFD OT UNIVERSAL KNEE SPLINT 274 0 0 4390 

8880957 PLFD OT UNIVERSAL RIB BELT 274 0 0 4390 

9000050 MISSED APPOINTMENT 990 0 0 4470 

9000100 CANCELLATION 990 0 0 4470 

9000159 INITIAL IP CONSULT 914 0 0 4470 

9000209 FOLLOW-UP IP CONSULT 914 0 0 4470 

9001058 INDIV THER 20-30 MIN 914 0 0 4470 

9001108 FAMILY PSYCHOTHERAPY 914 0 0 4470 

9001157 GROUP THERAPY BY DR 914 0 0 4470 

9001207 GROUP THERAPY BY PRN 914 0 0 4470 

9001306 GROUP THERAPY-DBT 915 0 0 4470 

9001355 EMERGENCY PSYCH EVAL NON CR 459 0 0 4470 

9001405 EMER PSYCH EVAL-CREDENTIALED 459 0 0 4470 

9001504 THERAPY&MED EVA-APRN 45 50 914 0 0 4470 

9001603 MEDS EVAL BY MD 914 0 0 4470 

9001652 MEDS EVAL BY APRN 914 0 0 4470 

9001751 INITIAL M.D. EVAL 900 0 0 4470 

9001801 INITIAL APRN EVAL 900 0 0 4470 

9001850 INIT PSYCHOTHER EVAL 914 0 0 4470 

9002007 MISSED APPOINTMENT 990 0 0 4470 

9002015 CANCELLATION 990 0 0 4470 

9002023 PROF FEE EMERG PSYCH EVAL 985 0 0 4470 

9002031 PROF FEE INDIV THERAPY 20 30 MIN 985 0 0 4470 

9002049 PROF FEE INDIV THERAPY 45 50 MIN 985 0 0 4470 

9002056 PROF FEE INDIV THERAPY W/MED EVAL 985 0 0 4470 

9002064 PROF FEE INDIV 20 30 MIN W/MED EVAL 985 0 0 4470 

9002072 PROF FEE INDIV 75 80 MIN 985 0 0 4470

9002080 PROF FEE FAMILY PSYCHOTHERAPY 985 0 0 4470 

9002098 PROF FEE MULTIPLE GRP THERAPY 985 0 0 4470 

9002106 PROF FEE GRP THERAPY NON FAMILY 985 0 0 4470 

9002114 IND THERAPY 20-30 MIN W/MED EVAL MD 914 0 0 4470 

9002122 IND THERAPY 75-80 MINUTES 914 0 0 4470 

9002205 IND THERAPY 20/30 MED EVAL APRN 914 0 0 4470 

9003039 LEVEL IV MD 510 0 0 0 

9100405 CROUPETTE SUPPLIES 270 0 0 4360 

9100413 CROUPETTE TREATMENT 410 0 0 4360 

9100603 IPPB TREATMENT INIT 410 0 0 4360 

9100611 IPPB SUBSEQUENT TREATMENT 410 0 0 4360 

9101205 BEDSIDE FVL 460 0 0 4360 

9101213 PRE/POST FVL 460 0 0 4360 

9105206 ARTERIAL BLOOD GAS 410 0 0 4360 

9200056 ROUTINE PFT 460 0 0 4340 

9200254 PFT-COMPLETE 460 0 0 4340 

9200759 PRE/POST FVL 460 0 0 4340 

9201559 ART BLOOD GAS-PFT 460 0 0 4340 

9290057 LVL1 1.25MG PROVOCHO 636 0 0 4340 


9290156 LVL3 2.5MG PROVOCHOL 636 0 0 4340 

9290206 LVL4 5.0MG PROVOCHOL 636 0 0 4340 



9446998 OXFORD HEALTH PAYMENT 0 0 5210 

9700105 RETURNED CHECK NSF ALLOWANCE 0 0 1000 

9700253 PATIENT CASH TRANSFER ALLOWANCE 0 0 1210 

9700303 INSURANCE CASH TRANSFER ALLOWANCE 0 0 1210 

9704214 CIGNA ALLOWANCE 0 0 0 

9704222 CNA INSURANCE COMPANIES ALLOWANCE 0 0 0 

9704230 COMMONWEALTH SERVICE CENTER ALLOWAN 0 0 0 

9704248 CONN GENERAL ALLOWANCE 0 0 0 

9704255 CONNECTICARE ALLOWANCE 0 0 0 

9704263 CONSOLIDATED HEALTH ALLOWANCE 0 0 0 

9704271 CT CARPENTERS HEALTH FUND ALLOWANCE 0 0 0 

9704685 UNITED HEALTHCARE ALLOWANCE 0 0 5210 

9704693 US HEALTHCARE INS ALLOWANCE 0 0 5210 

9704701 UTICA NATIONAL ALLOWANCE 0 0 5210 

9704933 SSMF ALLOWANCE 0 0 0 

9704941 LBC BCCG ALLOWANCE 0 0 0 

9709205 SMALL BALANCE ALLOWANCE 0 0 5290 

9710005 POS PROMPT PAY DISCOUNT 0 0 5050 



9710245 MEDIBLUE ALLOWANCE 0 0 5210 

9720020 STATE MLIA ALLOWANCE 0 0 5210 

9730144 BC VALUE OPTIONS ALLOW 0 0 1000

9742503 TCORS AUTO ALOOWANCE 0 0 5210 

9743501 TCORS WC ALLOWANCE 0 0 5210 

9748047 ALLOW PROF FEE COMMERCIAL 0 0 5210 

9800202 B/D ESCHEAT SOC UNCLAIMED CASH 0 0 2400 

9804030 CIGNA B/D ALLOWANCE 0 0 5210 

9804055 OXFORD HEALTH B/D ALLOWANCE 0 0 5210 

9804105 HEALTHNET (FOXWOODS) B/D ALLOWANCE 0 0 5210 

9804188 US HEALTHCARE B/D ALLOWANCE 0 0 5210 

9804303 AETNA B/D ALLOWANCE 0 0 5210 

9804592 UNITED HEALTHCARE B/D ALLOWANCE 0 0 5210 

9804766 HEALTHNET (PHS) B/D ALLOWANCE 0 0 5210 

9806308 HOMECARE PT B/D ALLOWANCE 0 0 5210 

9806407 HOSPICE B/D ALLOWANCE 0 0 5210 

9809203 SMALL BALANCE B/D ALLOWANCE 0 0 5290 

9814039 CIGNA B/D PAYMENT 0 0 9900 

9814054 OXFORD HEALTH B/D PAYMENT 0 0 9900 

9814104 HEALTHNET (FOXWOOD) B/D PAYMENT 0 0 9900 

9814187 US HEALTHCARE B/D PAYMENT 0 0 9900 

9814302 AETNA B/D PAYMENT 0 0 9900 

9814401 CHAMPUS/TRICARE B/D PAYMENT 0 0 9900 

9814518 EBPA B/D PAYMENT 0 0 9900 

9814591 UNITED HEALTHCARE B/D PAYMENT 0 0 9900 

9814765 HEALTHNET (PHS) B/D PAYMENT 0 0 9900 

9819004 BCCG B/D PAYMENT TRANSFER 0 0 2510 

9819012 HOSPICE B/D PAYMENT TRANSFER 0 0 9900 

9819020 HOMECARE PT B/D PMT TRANSFER 0 0 9900 

9900739 CAREPAYMENT ADD ON AR PAYMENT 0 0 1000 

9910266 BLUE CROSS OF MA PAYMENT 0 0 1000 

9910308 BLUE CROSS SUPPLEMENTAL PAYMENT 0 0 1000 

9910407 AARP-UNITED HLTHCARE SUPPL PAYMENT 0 0 1000 

9910423 AETNA SUPPLEMENTAL PAYMENT 0 0 1000 

9910449 AMER PROGRESSIVE SUPPLEMENTAL PMT 0 0 1000 

9910464 BANKERS LIFE SUPPLEMENTAL PAYMENT 0 0 1000 

9910480 CELTIC LIFE SUPPLEMENTAL PAYMENT 0 0 1000 

9910506 CHAMPVA SUPPLEMENTAL PAYMENT 0 0 1000 

9910522 COMBINED INS SUPPLEMENTAL PAYMENT 0 0 1000 

9910548 EBPA SUPPLEMENTAL PAYMENT 0 0 1000 

9910563 HEALTHNET SUPPLEMENTAL PAYMENT 0 0 1000 

9910589 MONUMENTAL LIFE SUPPLEMENTAL PMT 0 0 1000 

9910605 MUTUAL OF OMAHA SUPPLEMENTAL PMT 0 0 1000 

9910621 STIRLING/STIRLING SUPPLEMENTAL PMT 0 0 1000 

9910647 TRICARE SUPPLEMENTAL PAYMENT 0 0 1000 

9910662 UNITED AMERICAN SUPPLEMENTAL PMT 0 0 1000 

9910688 UNITED HLTHCARE SUPPLEMENTAL PMT 0 0 1000 

9910704 UNITED TEACHERS SUPPLEMENTAL PMT 0 0 1000 

9910720 USAA LIFE SUPPLEMENTAL PAYMENT 0 0 1000 

9910746 MAILHANDLERS SUPPLEMENTAL PAYMENT 0 0 1000

9910993 COMMERCIAL SUPPLEMENTAL PAYMENT 0 0 1000 

9940859 NATIONAL HEALTH INS - NASE PAYMENT 0 0 1000 

9941212 AIM-CIGNA PAYMENT 0 0 1000 

9941352 AMALGAMATED LIFE PAYMENT 0 0 1000 

9941428 AMERIHEALTH PAYMENT 0 0 1000 

9941493 APWU AMER POSTAL WORKERS PAYMENT 0 0 1000 

9941568 ASSOCIATION & SOCIETY PAYMENT 0 0 1000 

9941634 ASSURANT HEALTH PAYMENT 0 0 1000 

9941709 BCI-BENEFIT CONCEPTS PAYMENT 0 0 1000 

9941774 BENEFIT PLANNERS PAYMENT 0 0 1000 

9941840 BENESIGHT PAYMENT 0 0 5210 

9941915 CBA PAYMENT 0 0 5210 

9941980 CHRISTIAN BROTHERS PAYMENT 0 0 5210 

9942129 CIGNA/CIGNA PAYMENT 0 0 0 

9942194 CNA INSURANCE COMPANIES PAYMENT 0 0 0 

9942269 COMMONWEALTH SERVICE CENTER PAYMENT 0 0 0 

9942335 CONN GENERAL PAYMENT 0 0 0 

9942400 CONNECTICARE PAYMENT 0 0 0 

9942475 CONSOLIDATED HEALTH PAYMENT 0 0 0 

9942541 CT CARPENTERS HEALTH FUND PAYMENT 0 0 0 

9942616 DIFINITY HEALTH PAYMENT 0 0 0 

9942681 DIVERSIFIED ADMIN PAYMENT 0 0 0 

9942756 DIVERSIFIED GROUP BROKERAGE PAYMENT 0 0 0 

9942822 EMPLOYER SERVICE CENTER PAYMENT 0 0 5210 

9942897 FORTIS HEALTH PAYMENT 0 0 5210 

9942962 GOLDEN RULE PAYMENT 0 0 5210 

9943176 GUARDIAN LIFE INS PAYMENT 0 0 1000 

9943242 HEALTH ADVANTAGE PAYMENT 0 0 1000 

9943317 HEALTH CHOICE PAYMENT 0 0 1000 

9943382 HEALTHCARE VALUE MGMT PAYMENT 0 0 1000 

9943457 HEALTHNET (FOXWOODS) PAYMENT 0 0 1000 

9943523 HEALTHNET (PHS) PAYMENT 0 0 5210 

9943598 HEALTHNET/HEALTHNET PAYMENT 0 0 5210 

9943663 HMC PPO PAYMENT 0 0 5210 

9943739 HUMANA INSURANCE PAYMENT 0 0 5210 

9943804 INTERACTIVE BENEFIT CORP PAYMENT 0 0 5210 

9943879 IRONWORKERS PAYMENT 0 0 5210 

9943945 JOHN ALDEN INS PAYMENT 0 0 5210 

9944083 LOCAL 371 AMAL WELF/TRUST PAYMENT 0 0 1000 

9944158 MAIL HANDLERS BENEFIT PLAN PAYMENT 0 0 1000 

9944224 MANAGED HEALTH NETWORK PAYMENT 0 0 1000 

9944299 MEDSPAN, INC PAYMENT 0 0 1000 

9944364 MEGA LIFE (STUDENT INS) PAYMENT 0 0 5210 

9944430 MEGA LIFE & HEALTH PAYMENT 0 0 5210 

9944505 MOHEGAN TRIBAL PAYMENT 0 0 5210 

9944646 N E DIRECT HEALTH PAYMENT 0 0 5210 

9944711 NASE PAYMENT 0 0 5210

9944786 NATIONAL HEALTH INS NASE PAYMENT 0 0 5210 

9944851 NE HEALTH CARE EMP WEL FD PAYMENT 0 0 5210 

9944927 NEW ENGLAND PAYMENT 0 0 5210 

9945007 WAUSAU INSURANCE PAYMENT 0 0 5210 

9945114 EMPLOYEE HEALTH DKH PAYMENT 0 0 1000 

9945130 SRC AETNA COMPANY PAYMENT 0 0 5210 

9945205 STIRLING & STIRLING PAYMENT 0 0 5210 

9945270 TIME INSURANCE PAYMENT 0 0 5210 

9945346 TR PAUL PAYMENT 0 0 5210 

9945411 TRAVELERS PAYMENT 0 0 5210 

9945486 UNICARE/CIGNA PAYMENT 0 0 5210 

9945551 UNITED HEALTHCARE PAYMENT 0 0 5210 

9945577 MUTUAL OF OMAHA INS PAYMENT 0 0 5210 

9945627 UNITED HEALTH/UNITED HEALTH PAYMENT 0 0 5210 

9945692 US HEALTHCARE INS PAYMENT 0 0 5210 

9945767 UTICA NATIONAL PAYMENT 0 0 5210 

9945833 WALMART PAYMENT 0 0 5210 

9945973 WELLCARE PAYMENT 0 0 5210 

9945981 COMM INS/COMM INS PAYMENT 0 0 5210 

9946997 COMM INS/REGISTRA TO ENTE PAYMENT 0 0 5210 

9947003 HEAVEN HEALTH PAYMENT 0 0 5210 

9947011 HOLY SPIRIT PAYMENT 0 0 0 

9947029 MATULAITIS PAYMENT 0 0 0 

9947037 PIERCE MEMORIAL PAYMENT 0 0 0 

9947045 VILLA MARIA PAYMENT 0 0 0 

9947052 VILLAGE MANOR PAYMENT 0 0 0 

9947060 WESTVIEW PAYMENT 0 0 0 

9948019 CHAMPUS/TRICARE PAYMENT 0 0 0 

9948027 CHAMP VA PAYMENT 0 0 0 

9948035 SSMF PAYMENT 0 0 0 

9948043 PYMT PROF FEE COMMERCIAL 0 0 1000 

9949009 LBC BCCG PAYMENT 0 0 0 

462096 DIHYDROTESTOSTERONE 300 0 0 4010 


751625 VANCOMYCIN 250 MG/5 ML ORAL 636 0 0 4300 

828038 NUTRITIONAL SERV-PUBLICATIONS 0 0 8030 

1302884 OP TX FX HAND W/INT. FIX 450 0 0 3780 

1304856 CLS TX FX DISTAL RADIAL W/MAN 450 0 0 3780 

1404367 CLS TX FX DISTAL RADIAL W/MAN 456 0 0 3780 

2000198 CRUTCHES 270 0 0 3800 

2202497 M & S SUPPLIES-ACU 270 0 0 3721 

2500064 ACL BREAK-AWAY PIN* 278 0 0 3800 

2500221 ACL HI-STRENGTH PIN* 278 0 0 3800 

2505063 BIO-CORKSCREW FT 5.5MM 278 0 0 3800 

2505089 ART BIOCORK W/NDL 6.5 278 0 0 3800 

2505600 ART OATS 05mm 270 0 0 3800 

2505626 ART OATS 06mm 270 0 0 3800

2505642 ART OATS 07mm 270 0 0 3800 

2505667 ART OATS 08MM 270 0 0 3800 

2505683 ART OATS 09mm 270 0 0 3800 

2505709 ART OATS 10mm 270 0 0 3800 

2506160 ART TENOSCREW TI4.75 270 0 0 3800 

2506186 ART TENOSCREW TI5.5 270 0 0 3800 

2506269 ART VULC 90 DEG HP 270 0 0 3800 

2506285 ART VULC LIG CHIS CV 270 0 0 3800 

2506301 ART VULC LIG CHIS HK 270 0 0 3800 

2515005 ENT CAUTERY HI TEMP* 270 0 0 3800 

2515633 CRUTCHES-BARIATRIC 270 0 0 3800 

2525186 EYE FLUID FILTER 0.2* 270 0 0 3800 

2525202 EYE FO ENDO ILLUMINATOR* 270 0 0 3800 

2535284 LAP SURGIWAND 270 0 0 3800 

2546182 MIS VESSEL LOOP BLUE* 270 0 0 3800 

2551844 ORT STEIN PIN SM 5/64* 270 0 0 3800 

2580520 URO FASCIAL DILAT 05.0* 270 0 0 3800 





2581387 URO STERILE CORD* 270 0 0 3800 

2591006 TKA DURACON AP LIPPED TIBIAL INSERT 278 0 0 3800 

3002151 IV TX HYDRAT 31-60 MIN 260 0 0 3700 

4500427 CRP 300 0 0 4010 

4613543 IA - 2 AB 300 0 0 4010 

4615167 CRP QUEST 300 0 0 4010 

7507270 PROTIRELIN 500 MCG 636 0 0 4300 

8201857 DLSN SPECIAL PROCEDURE (PROC) 420 0 0 4370 

8202608 DLSN UNLST CASTING/STRAPPING (PROC) 420 0 0 4370 

8301855 PLFD SPECIAL PROCEDURE (PROC) 420 0 0 4370 

8302606 PLFD UNLISTED CAST/STRAPPING (PROC) 420 0 0 4370 

8401853 SPECIAL PROCEDURE 420 0 0 4370 

8402604 UNLST CASTING/STRAP(PROC) 420 0 0 4370 

8601858 OT SPECIAL PROCEDURE 430 0 0 4371 

8602609 OT UNLST CAST/STRAP (PROC) 430 0 0 4390 

8701856 DLSN OT SPECIAL PROCEDURE (PROC) 430 0 0 4390 

8702607 DLSN OT UNLST CAST/STRAPPING (PROC) 430 0 0 4390 

8801854 PLFD OT SPECIAL PROCEDURE (PROC) 430 0 0 4390 

8802605 PLFD OT UNLST CAST/STRAPPING (PROC) 430 0 0 4390 

9700006 SELF PAY DISCOUNT ALLOWANCE 0 0 5050 

9700055 PERSONAL PAYMENT PAYROLL 0 0 1210 

9703927 UNASSIGNED 0 0 5170 

9704925 UNASSIGNED 0 0 5210 

9705922 UNASSIGNED 0 0 5250 

9709106 RETURNED CHECK FEE ADJUSTMENT 0 0 5850 

9709809 CHARITY MEDICARE B/D-DED ADJ 0 0 9880

9709817 CHARITY MEDICARE B/D-COINS ADJ 0 0 9880 

9709825 CHARITY MEDICARE B/D-N/C ADJ 0 0 9880 

9709841 STATE MEDICARE B/D-DED ADJ 0 0 9880 

9709858 STATE MEDICARE B/D-COINS ADJ 0 0 9880 

9709866 STATE MEDICARE B/D-N/C ADJ 0 0 9880 

9720970 MAINE MEDICAID ALLOWANCE 0 0 5210 

9800004 SELF PAY B/D O/P ALLOWANCE 0 0 5050 

9800053 SELF PAY PAYROLL DEDUCTION ADJ 0 0 1210 

9800103 B/D RETURNED CHECK NSF 0 0 1000 

9800152 B/D RETURNED CHECK FEE 0 0 5850 

9800251 B/D PATIENT CASH TRANSFER 0 0 9900 

9800301 B/D INSURANCE CASH TRANSFER 0 0 9900 

9801101 MEDICARE MGD CARE B/D O/P ALLOW 0 0 5090 

9801119 MEDICARE MGD CARE B/D I/P ALLOW 0 0 5090 

9804402 CHAMPUS/TRICARE B/D ALLOWANCE 0 0 5210 

9804519 EBPA B/D ALLOWANCE 0 0 5210 

9809807 CHARITY B/D MEDICARE-DED ADJ 0 0 9880 

9809815 CHARITY B/D MEDICARE-COINS ADJ 0 0 9880 

9809823 CHARITY B/D MEDICARE-N/C ADJ 0 0 9880 

9809849 STATE B/D MEDICARE-DED ADJ 0 0 9880 

9809856 STATE B/D MEDICARE-COINS ADJ 0 0 9880 

9809864 STATE B/D MEDICARE-N/C ADJ 0 0 9880 

9809989 TFR MEDICARE B/D I/P COST REPORT 0 0 9880 

9809997 TFR MEDICARE B/D O/P COST REPORT 0 0 9880 

9810003 SELF PAY B/D PAYMENT 0 0 9900 

9811100 MEDICARE MANAGED CARE B/D PYMT 0 0 9900 

9819996 TFR MEDICARE B/D COST REPORT 0 0 9880 

9940800 MEDICAL CLAIMS SERVICE PAYMENT 0 0 1000 

9940818 MEDSPAN, INC. PAYMENT 0 0 1000

CPT4 MOD CRVUI COLD# CRSTS1 PMSTS CIGL# COGL# CMMITM 

0 10000010 A A 30909990 30909990 

G0008 0 A A 30909990 30909990 

G0009 0 A A 30909990 30909990 

0 14000010 A A 32009990 32009990 

0 A A 32009990 32009990 

0 16000010 A A 34009990 34009990 

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0 17000010 A A 34609990 34609990 

0 18000010 A A 35009990 35009990 

0 A A 76207350 10001000 

0 12000010 A A 31409990 31409990 

30 21000005 A A 36009990 36009990 

15 21000005 A A 36009990 36009990 

60 21000005 A A 36009990 36009990 

30 A A 36009990 36009990 

0 A A 36009990 36009990 56005 

0 A A 36009990 36009990 71001 

0 A A 36009990 36009990 71005 

90 21000005 A A 36009990 36009990 

45 A A 36009990 36009990 

0 A A 36009990 36009990 71003 

0 A A 36009990 36009990 

0 A A 36009990 36009990 

30 21000105 A A 36009990 36009990 

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15 22000004 A A 36509990 36509990 

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0 23000003 A A 35109990 35109990 

59514 15 23000005 A A 35109990 35109990 

59514 60 23000005 A A 35109990 35109990 

15 23000007 A A 35109990 35109990 

59514 30 23000005 A A 35109990 35109990 

59000 0 23000011 A A 35109990 35109990 

59514 0 A A 35109990 35109990 

59514 0 A A 35109990 35109990 

59025 0 23000041 A A 35109990 35109990 

92585 0 23000055 A A 35109990 35109990 

54150 0 23000066 A A 35109990 35109990 

36510 0 23000070 A A 35109990 35109990 

36600 0 23000079 A A 35109990 35109990 

36416 0 23000080 A A 35109990 35109990 

59412 0 A A 35109990 35109990 

84030 91.67 A A 35109990 35109990 

81220 36.05 A A 35109990 35109990 

88720 0 23000085 A A 35109990 35109990

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0 23000100 A A 35109990 35109990 

0 23000110 A A 35109990 35109990 

0 23000130 A A 35109990 35109990 

36430 0 A A 35109990 35109990 

0 A A 35109990 35109990 

99211 0 A A 35109990 35109990 

99212 0 A A 35109990 35109990 

99213 0 A A 35109990 35109990 

99214 0 A A 35109990 35109990 

99215 0 A A 35109990 35109990 

0 A A 35109990 35109990 

0 A A 35109990 35109990 

0 23000300 A A 35109990 35109990 

G0378 0 A A 30909990 30919990 

G0379 0 A A 30909990 30919990 

96372 0 A A 32009990 32009990 

96360 0 A A 30909990 30919990 

96361 0 A A 30909990 30919990 

96374 0 A A 30909990 30919990 

96375 59 0 A A 30909990 30919990 

96376 0 A A 30909990 30919990 

96366 0 A A 30909990 30919990 

96365 0 A A 30909990 30919990 

96367 0 A A 30909990 30919990 

96368 0 A A 30909990 30919990 

51701 0 A A 30909990 30919990 

51702 0 A A 30909990 30919990 

51703 0 A A 30909990 30919990 

36430 0 A A 30909990 30919990 

96372 0 A A 30909990 30919990 

36430 0 A A 30909990 30919990 

0 A A 30909990 30919990 

0 A A 30909990 30909990 

G0378 0 A A 31409990 31419990 

G0379 0 A A 31409990 31419990 

96360 0 A A 31409990 31419990

96361 0 A A 31409990 31419990 

96374 0 A A 31409990 31419990 

96375 59 0 A A 31409990 31419990 

96376 0 A A 31409990 31419990 

96366 0 A A 31409990 31419990 

96365 0 A A 31409990 31419990 

96367 0 A A 31409990 31419990 

96368 0 A A 31409990 31419990 

51701 0 A A 31409990 31419990 

51702 0 A A 31409990 31419990 

51703 0 A A 31409990 31419990 

36430 0 A A 31409990 31419990 

96372 0 A A 31409990 31419990 

36430 0 A A 31409990 31419990 

0 A A 31409990 31409990 

G0378 0 A A 34009990 34019990 

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96367 0 A A 34009990 34019990 

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36430 0 A A 34009990 34019990 

0 A A 34009990 34019990 

36430 0 A A 34009990 34009990 

G0378 0 A A 34609990 34619990 

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96360 0 A A 34609990 34619990 

96361 0 A A 34609990 34619990 

96374 0 A A 34609990 34619990 

96375 59 0 A A 34609990 34619990 

96376 0 A A 34609990 34619990 

96366 0 A A 34609990 34619990 

96365 0 A A 34609990 34619990 

96367 0 A A 34609990 34619990 

96368 0 A A 34609990 34619990 

96372 0 A A 34609990 34619990 

0 A A 34609990 34619990 

G0378 0 A A 32009990 32009990 

0 A A 32009990 32009990 

99211 0 49000010 A A 37209990 37209990 

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99213 0 49000030 A A 37209990 37209990 

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90 49000073 A A 37209990 37209990 

0 49000085 A A 37209990 37209990 

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96375 59 0 49000273 A A 37209990 37209990 

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36593 0 A A 37209990 37209990 

36591 0 A A 37209990 37209990 

36592 0 A A 37209990 37209990 

36593 0 A A 37209990 37209990 

0 A A 37209990 37209990 

36430 0 49000260 A A 37209990 37209990 

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0 49000280 A A 37209990 37209990 

15 49000230 A A 37209990 37209990 

95117 0 A A 37209990 37209990 

0 A A 37209990 37209990 

0 A A 37209990 37209990 

0 A A 37209990 37209990 

G9141 0 A A 37209990 37209990 

0 A A 37209990 37209990 

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0 A A 37209990 37209990 

0 A A 37209990 37209990 

0 A A 37209990 37209990 

0 A A 37209990 37209990 

0 49099990 A A 37209990 37209990 

0 49099991 A A 37209990 37209990 

0 A A 37209990 37209990 

0 A A 37209990 37209990

0 A A 37209990 37209990 

0 A A 37209990 37209990 

0 49200001 A A 37209990 37209990 

Q9966 0 A A 37209990 37209990 

0 49599995 A A 37109990 37109990 

0 49599996 A A 37109990 37109990 

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0 A A 37109990 37109990 

0 A A 37109990 37109990 

0 A A 37109990 37109990 

0 A A 37109990 37109990 

0 A A 37109990 37109990 

0 A A 37109990 37109990 

0 A A 37109990 37109990 

0 A A 37109990 37109990 

96523 0 A A 37109990 37109990 

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96374 59 0 A A 37109990 37109990 

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36430 0 A A 37109990 37109990 

0 A A 37109990 37109990 

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91110 0 A A 37109990 37109990 

0 A A 37109990 37109990 

0 A A 37109990 37109990 

0 A A 37109990 37109990 

0 A A 37109990 37109990 

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11623 0 A A 37309990 37309990 

11624 0 A A 37309990 37309990 

11626 0 A A 37309990 37309990

11640 0 A A 37309990 37309990 

11641 0 A A 37309990 37309990 

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93922 0 A A 37309990 37309990 

93922 0 A A 37309990 37309990 

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29581 RT 0 A A 37309990 37309990 

29581 LT 0 A A 37309990 37309990 

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11055 0 A A 37309990 37309990 

36589 0 A A 37309990 37309990 

11750 0 A A 37309990 37309990 

29445 0 A A 0 37309990 

0 A A 37309990 37309990 69349 

0 A A 37309990 37309990 69650 

0 A A 37309990 37309990 69651 

0 A A 37309990 37309990 69346 

0 A A 37309990 37309990 10530 

0 A A 37309990 37309990 10528 

0 A A 37309990 37309990 10432 

0 A A 37309990 37309990 10422 

0 A A 37309990 37309990 10418 

0 A A 37309990 37309990 10428 

0 A A 37309990 37309990 10420 

0 A A 37309990 37309990 69286

0 A A 37309990 37309990 69287 

0 A A 37309990 37309990 10412 

0 A A 37309990 37309990 1014 

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0 A A 37309990 37309990 51232 

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0 A A 37309990 37309990 

0 A A 37309990 37309990 

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0 A A 37309990 37309990 51348 

85610 QW 0 A A 48759990 48759990 

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0 59000100 A A 35119990 35119990 

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G0431 124.702 31125111 A A 40109990 40109990 

G0431 124.702 31125112 A A 40109990 40109990 

G0431 124.702 31125113 A A 40109990 40109990 

G0431 124.702 31125114 A A 40109990 40109990 

G0431 124.702 31125115 A A 40109990 40109990 

G0431 124.702 31125116 A A 40109990 40109990 

G0431 124.702 31125117 A A 40109990 40109990 

82550 52.53 31125503 A A 40109990 40109990 

0 31125530 A A 40109990 40109990 

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82575 77.25 31125602 A A 40109990 40109990 

82570 38.11 31125651 A A 40109990 40109990 

82570 41.2 31127343 A A 40109990 40109990 

82800 86.52 31128051 A A 40109990 40109990 

82374 40.17 31128408 A A 40109990 40109990 

82803 158.62 31128903 A A 40109990 40109990 

82977 74.16 31129760 A A 40109990 40109990 

84156 66.95 31130339 A A 40109990 40109990 

82436 41.2 31130340 A A 40109990 40109990 

83002 189.52 31133036 A A 40109990 40109990 

82340 54.59 31133424 A A 40109990 40109990 

84146 196.73 31133515 A A 40109990 40109990 

80061 95.79 31133556 A A 40109990 40109990 

82436 40.17 31134414 A A 40109990 40109990 

83690 59.74 31600707 A A 40109990 40109990 

82570 43.26 31135569 A A 40109990 40109990 

80051 149.35 31135863 A A 40109990 40109990 

83615 48.41 31136203 A A 40109990 40109990 

0 31136428 A A 40109990 40109990 

0 31136429 A A 40109990 40109990 

82951 131.84 31136430 A A 40109990 40109990 

82952 40.17 31136431 A A 40109990 40109990 

80178 62.83 31137250 A A 40109990 40109990 

83735 54.59 31137359 A A 40109990 40109990 

83735 59.74 31137360 A A 40109990 40109990

83930 55.62 31139306 A A 40109990 40109990 

84153 180.25 31140601 A A 40109990 40109990 

G0103 180.25 31140602 A A 40109990 40109990 

84075 52.53 31140759 A A 40109990 40109990 

84100 40.17 31141005 A A 40109990 40109990 

84105 41.2 31141006 A A 40109990 40109990 

84132 38.11 31141401 A A 40109990 40109990 

84132 32.96 31141402 A A 40109990 40109990 

80051 54.59 31141450 A A 40109990 40109990 

80053 88.58 31141451 A A 40109990 40109990 

80053 88.58 31141452 A A 40109990 40109990 

80048 72.1 31141453 A A 40109990 40109990 

80048 72.1 31141454 A A 40109990 40109990 

80076 86.52 31141456 A A 40109990 40109990 

80069 88.58 31141457 A A 40109990 40109990 

84155 48.41 31141559 A A 40109990 40109990 

84156 45.32 31141560 A A 40109990 40109990 

84157 30.9 31141807 A A 40109990 40109990 

80196 96.82 31142425 A A 40109990 40109990 

80400 297.67 31142513 A A 40109990 40109990 

84295 41.2 31142953 A A 40109990 40109990 

84295 32.96 31142954 A A 40109990 40109990 

82945 40.17 31143233 A A 40109990 40109990 

84133 33.99 31143290 A A 40109990 40109990 

82947 38.11 31143308 A A 40109990 40109990 

82784 95.79 31143310 A A 40109990 40109990 

82784 95.79 31143311 A A 40109990 40109990 

82784 95.79 31143312 A A 40109990 40109990 

86431 93.73 31143313 A A 40109990 40109990 

84133 33.99 31144215 A A 40109990 40109990 

82945 40.17 31144447 A A 40109990 40109990 

84450 41.2 31144553 A A 40109990 40109990 

84460 43.26 31144652 A A 40109990 40109990 

84478 48.41 31144751 A A 40109990 40109990 

82950 47.38 31144884 A A 40109990 40109990 

84520 41.2 31145204 A A 40109990 40109990 

82565 41.2 31145205 A A 40109990 40109990 

0 31145206 A A 40109990 40109990 

82570 38.11 31145207 A A 40109990 40109990 

84550 38.11 31145501 A A 40109990 40109990 

82947 38.11 31145626 A A 40109990 40109990 

84105 41.2 31145634 A A 40109990 40109990 

84300 40.17 31151426 A A 40109990 40109990 

82150 74.16 31152200 A A 40109990 40109990 

83880 276.04 31152222 A A 40109990 40109990 

83001 189.52 31152275 A A 40109990 40109990 

84300 40.17 31152952 A A 40109990 40109990

83986 40.17 31153532 A A 40109990 40109990 

82945 40.17 31154818 A A 40109990 40109990 

82150 52.53 31154909 A A 40109990 40109990 

86141 131.84 31155206 A A 40109990 40109990 

83935 55.62 31155559 A A 40109990 40109990 

82533 135.96 31156619 A A 40109990 40109990 

83090 184.37 31156620 A A 40109990 40109990 

84403 263.68 31156621 A A 40109990 40109990 

82533 135.96 31156622 A A 40109990 40109990 

82533 135.96 31156623 A A 40109990 40109990 

82533 135.96 31156624 A A 40109990 40109990 

82533 135.96 31156625 A A 40109990 40109990 

82533 158.62 31156626 A A 40109990 40109990 

82533 158.62 31156627 A A 40109990 40109990 

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82803 158.62 31167398 A A 40109990 40109990 

82803 158.62 31167430 A A 40109990 40109990 

84157 31.93 31171713 A A 40109990 40109990 

81003 18.54 31172003 A A 40109990 40109990 

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82952 40.17 31172006 A A 40109990 40109990 

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82952 40.17 31172008 A A 40109990 40109990 

82952 40.17 31172009 A A 40109990 40109990 

82952 40.17 31172010 A A 40109990 40109990 

82947 38.11 31172011 A A 40109990 40109990 

82950 47.38 31172012 A A 40109990 40109990 

82951 131.84 31172015 A A 40109990 40109990 

82952 40.17 31172016 A A 40109990 40109990 

0 31172019 A A 40109990 40109990 

0 31172020 A A 40109990 40109990 

0 31172021 A A 40109990 40109990 

0 31172022 A A 40109990 40109990 

0 31172023 A A 40109990 40109990 

0 31172024 A A 40109990 40109990 

0 31172026 A A 40109990 40109990 

0 31172027 A A 40109990 40109990 

82951 131.84 31172028 A A 40109990 40109990 

82952 40.17 31172029 A A 40109990 40109990 

0 31172030 A A 40109990 40109990 

0 31172525 A A 40109990 40109990 

82150 74.16 31175267 A A 40109990 40109990 

82553 93.73 31177351 A A 40109990 40109990 

84560 40.17 31181811 A A 40109990 40109990 

82247 30.9 31181812 A A 40109990 40109990 

83615 48.41 31191919 A A 40109990 40109990 

84560 45.32 31195555 A A 40109990 40109990

81050 41.2 31196140 A A 40109990 40109990 

83721 76.22 31610133 A A 40109990 40109990 

84540 36.05 31145202 A A 40109990 40109990 

80053 193.64 31110838 A A 40109990 40109990 

86160 0 A A 40109990 40109990 

86304 0 A A 40109990 40109990 

86160 0 A A 40109990 40109990 

84134 0 A A 40109990 40109990 

84144 0 A A 40109990 40109990 

86701 0 A A 40109990 40109990 

83880 0 A A 40109990 40109990 

86762 0 A A 40109990 40109990 

84480 0 A A 40109990 40109990 

84481 0 A A 40109990 40109990 

83970 0 A A 40109990 40109990 

G0431 0 A A 40109990 40109990 

80047 QW 0 A A 40109990 40109990 

85014 QW 0 A A 40109990 40109990 

82565 QW 0 A A 40109990 40109990 

84484 0 A A 40109990 40109990 

0 A A 40109990 40109990 

82248 0 A A 40109990 40109990 

82330 0 A A 40109990 40109990 

82803 0 A A 40109990 40109990 

82803 0 A A 40109990 40109990 

0 31200003 A A 40109990 40109990 

85610 32.96 31200100 A A 40109990 40109990 

85730 45.32 31200101 A A 40109990 40109990 

85384 83.43 31200102 A A 40109990 40109990 

85362 62.83 31200103 A A 40109990 40109990 

0 31200104 A A 40109990 40109990 

85002 47.38 31200105 A A 40109990 40109990 

85027 52.53 31220147 A A 40109990 40109990 

0 31220148 A A 40109990 40109990 

85018 23.69 31222227 A A 40109990 40109990 

83030 62.83 31230303 A A 40109990 40109990 

85007 11.186 31234180 A A 40109990 40109990 

85025 62.83 31250152 A A 40109990 40109990 

85027 88.58 31250167 A A 40109990 40109990 

85041 28.84 31250202 A A 40109990 40109990 

85048 26.78 31250301 A A 40109990 40109990 

85018 26.78 31250509 A A 40109990 40109990 

85014 26.78 31250558 A A 40109990 40109990 

88319 122.57 31250616 A A 40109990 40109990 

85048 30.9 31251517 A A 40109990 40109990 

85048 81.514 31251518 A A 40109990 40109990 

0 31251520 A A 40109990 40109990

0 31251522 A A 40109990 40109990 

0 31251524 A A 40109990 40109990 

85651 44.29 31251526 A A 40109990 40109990 

85651 50.47 31251527 A A 40109990 40109990 

85048 26.78 31253503 A A 40109990 40109990 

85049 45.32 31255805 A A 40109990 40109990 

85049 23.69 31255806 A A 40109990 40109990 

85045 41.2 31256407 A A 40109990 40109990 

89190 19.57 31261589 A A 40109990 40109990 

89190 62.83 31262629 A A 40109990 40109990 

86038 133.9 31263510 A A 40109990 40109990 

86225 179.22 31263536 A A 40109990 40109990 

86225 194.67 31263551 A A 40109990 40109990 

89050 95.79 31263635 A A 40109990 40109990 

89050 50.47 31264641 A A 40109990 40109990 

86039 194.67 31265531 A A 40109990 40109990 

0 31265532 A A 40109990 40109990 

89051 0 31266687 A A 40109990 40109990 

80055 187.46 31267421 A A 40109990 40109990 

0 31274350 A A 40109990 40109990 

89050 97.85 31274355 A A 40109990 40109990 

89050 97.85 31274360 A A 40109990 40109990 

85060 0 31285060 A A 40109990 40109990 

89051 72.1 31290554 A A 40109990 40109990 

0 A A 40109990 40109990 

80048 112.27 31200155 A A 40109990 40109990 

85025 62.83 31250152 A A 40109990 40109990 

85027 88.58 31250167 A A 40109990 40109990 

80055 187.46 31267421 A A 40109990 40109990 

85048 30.9 31251517 A A 40109990 40109990 

85048 81.514 31251518 A A 40109990 40109990 

85025 0 A A 40109990 40109990 

86403 181.28 31300058 A A 40109990 40109990 

87081 206 31312366 A A 40109990 40109990 

87449 97.85 31312456 A A 40109990 40109990 

87071 110.21 31312531 A A 40109990 40109990 

87206 58.71 31322340 A A 40109990 40109990 

87220 40.17 31336217 A A 40109990 40109990 

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87081 58.71 31343622 A A 40109990 40109990 

87081 58.71 31343623 A A 40109990 40109990 

87081 58.71 31343627 A A 40109990 40109990 

87329 122.57 31343640 A A 40109990 40109990 

87101 139.05 31343689 A A 40109990 40109990 

87206 51.5 31343800 A A 40109990 40109990 

87073 95.79 31350001 A A 40109990 40109990 

87169 153.47 31350002 A A 40109990 40109990

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87046 28.84 31350005 A A 40109990 40109990 

87077 64.89 31350006 A A 40109990 40109990 

87077 64.89 31350007 A A 40109990 40109990 

87077 64.89 31350008 A A 40109990 40109990 

87077 30.9 31350009 A A 40109990 40109990 

87077 30.9 31350010 A A 40109990 40109990 

87076 32.96 31350011 A A 40109990 40109990 

87076 32.96 31350012 A A 40109990 40109990 

87076 32.96 31350013 A A 40109990 40109990 

87076 32.96 31350014 A A 40109990 40109990 

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87106 25.75 31350017 A A 40109990 40109990 

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87081 58.71 31362931 A A 40109990 40109990 

87081 58.71 31362932 A A 40109990 40109990 

86641 167.89 31367213 A A 40109990 40109990 

86641 128.75 31367214 A A 40109990 40109990 

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87400 48.89 31368315 A A 40109990 40109990 

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87177 246.17 31370133 A A 40109990 40109990 

87102 146.26 31370612 A A 40109990 40109990 

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87071 103 31370851 A A 40109990 40109990 

87081 69.01 31370869 A A 40109990 40109990 

87081 58.71 31370877 A A 40109990 40109990 

87045 95.79 31370886 A A 40109990 40109990 

87046 95.79 31370887 A A 40109990 40109990 

87427 97.85 31370888 A A 40109990 40109990 

87071 112.27 31370893 A A 40109990 40109990 

87040 98.88 31370901 A A 40109990 40109990 

87088 72.1 31370919 A A 40109990 40109990 

87071 84.46 31370927 A A 40109990 40109990

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87040 384.19 31370968 A A 40109990 40109990 

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87186 70.04 31370983 A A 40109990 40109990 

87040 257.5 31370992 A A 40109990 40109990 

87116 225.57 31371016 A A 40109990 40109990 

86756 124.63 31371245 A A 40109990 40109990 

87077 111.24 31372102 A A 40109990 40109990 

87177 56.65 31372107 A A 40109990 40109990 

87071 72.1 31372109 A A 40109990 40109990 

87071 78.28 31372110 A A 40109990 40109990 

87071 98.88 31372113 A A 40109990 40109990 

87071 98.88 31372114 A A 40109990 40109990 

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87071 122.57 31379002 A A 40109990 40109990 

87071 32.96 31379003 A A 40109990 40109990 

87070 86.52 31380769 A A 40109990 40109990 

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87172 43.26 31383052 A A 40109990 40109990 

87168 53.56 31384761 A A 40109990 40109990 

87324 191.58 31385741 A A 40109990 40109990 

86787 131.84 31385750 A A 40109990 40109990 

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87070 77.25 A A 40109990 40109990 

87081 59.74 31343620 A A 40109990 40109990 

87427 243.08 31370920 A A 40109990 40109990 

87046 35.02 31370889 A A 40109990 40109990 

87400 48.89 A A 40109990 40109990 

87081 58.7 A A 40109990 40109990 

87147 0 A A 40109990 40109990 

87147 0 A A 40109990 40109990 

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87493 59 0 A A 40109990 40109990 

119.48 31400112 A A 40109990 40109990 

86901 32.96 31417228 A A 40109990 40109990 

86900 23.69 31417229 A A 40109990 40109990 

86900 0 31417230 A A 40109990 40109990 

86901 0 31417231 A A 40109990 40109990 

243.08 31417884 A A 40109990 40109990 

199.82 31418791 A A 40109990 40109990 

158.62 31419872 A A 40109990 40109990 

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86900 119.48 31430077 A A 40109990 40109990 

86886 61.8 31431315 A A 40109990 40109990

86886 61.8 31441413 A A 40109990 40109990 

86886 61.8 31451511 A A 40109990 40109990 

86922 47.38 31455621 A A 40109990 40109990 

0 31455622 A A 40109990 40109990 

0 31455623 A A 40109990 40109990 

0 31455624 A A 40109990 40109990 

0 31455625 A A 40109990 40109990 

0 31455626 A A 40109990 40109990 

0 31455640 A A 40109990 40109990 

0 31455641 A A 40109990 40109990 

0 31455642 A A 40109990 40109990 

86886 78.28 31460256 A A 40109990 40109990 

86970 114.33 31460686 A A 40109990 40109990 

86870 232.78 31460967 A A 40109990 40109990 

J2790 305.91 31461304 A A 40109990 40109990 

86880 43.26 31462500 A A 40109990 40109990 

86850 62.83 31462609 A A 40109990 40109990 

86850 44.29 31462625 A A 40109990 40109990 

86885 57.68 31465297 A A 40109990 40109990 

86077 0 31486077 A A 40109990 40109990 

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86900 0 A A 40109990 40109990 

86901 0 A A 40109990 40109990 

86850 0 A A 40109990 40109990 

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86880 0 A A 40109990 40109990 

86870 0 A A 40109990 40109990 

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86921 0 A A 40109990 40109990 

86870 0 A A 40109990 40109990 

86870 0 A A 40109990 40109990 

86850 0 A A 40109990 40109990 

86850 0 A A 40109990 40109990 

86880 0 A A 40109990 40109990 

86905 0 A A 40109990 40109990 

86905 0 A A 40109990 40109990 

86902 0 A A 40109990 40109990 

86902 0 A A 40109990 40109990 

86902 0 A A 40109990 40109990 

0 31500101 A A 40109990 40109990 

81001 59.74 31510001 A A 40109990 40109990 

0 31510002 A A 40109990 40109990 

81001 59.74 31510003 A A 40109990 40109990 

81003 9.27 31510019 A A 40109990 40109990 

81015 26.78 31510027 A A 40109990 40109990

81003 18.54 31510043 A A 40109990 40109990 

81003 25.75 31510050 A A 40109990 40109990 

81003 18.54 31510068 A A 40109990 40109990 

89125 42.23 31510076 A A 40109990 40109990 

85379 126.69 31510080 A A 40109990 40109990 

81025 79.31 31510092 A A 40109990 40109990 

81003 18.54 31510142 A A 40109990 40109990 

81000 29.87 31510241 A A 40109990 40109990 

81003 9.27 31522220 A A 40109990 40109990 

82270 38.11 31522709 A A 40109990 40109990 

81003 9.27 31533334 A A 40109990 40109990 

81002 29.87 31542244 A A 40109990 40109990 

86762 146.26 31550056 A A 40109990 40109990 

84315 33.99 31555006 A A 40109990 40109990 

83986 11.33 31560063 A A 40109990 40109990 

86308 61.8 31560949 A A 40109990 40109990 

86156 97.85 31560956 A A 40109990 40109990 

84703 79.31 31562453 A A 40109990 40109990 

89160 19.57 31563293 A A 40109990 40109990 

86592 47.38 31564107 A A 40109990 40109990 

89321 122.57 31593007 A A 40109990 40109990 

89060 66.95 31593015 A A 40109990 40109990 

89320 139.05 31593205 A A 40109990 40109990 

86618 176.13 31300032 A A 40109990 40109990 

87510 203.94 31354001 A A 40109990 40109990 

87660 203.94 31354000 A A 40109990 40109990 

87480 203.94 31354002 A A 40109990 40109990 

87591 203.94 31343632 A A 40109990 40109990 

87590 203.94 31343631 A A 40109990 40109990 

86787 116.39 31385750 A A 40109990 40109990 

86677 148.32 31312455 A A 40109990 40109990 

82731 581.95 31122222 A A 40109990 40109990 

86759 136.99 31343628 A A 40109990 40109990 

86738 119.48 31370811 A A 40109990 40109990 

83605 0 A A 40109990 40109990 

80170 133.9 A A 40109990 40109990 

80200 135.96 A A 40109990 40109990 

84112 0 A A 40109990 40109990 

85378 126.67 A A 40109990 40109990 

82390 110.21 31600001 A A 40109990 40109990 

82627 227.63 31600011 A A 40109990 40109990 

86304 44.3 31600016 A A 40109990 40109990 

84445 519.12 31600017 A A 40109990 40109990 

82482 125.66 31600018 A A 40109990 40109990 

80182 125.66 31600019 A A 40109990 40109990 

82652 313.12 31600020 A A 40109990 40109990 

85303 220.42 31600023 A A 40109990 40109990

381.1 31600024 A A 40109990 40109990 

80158 247.2 31600038 A A 40109990 40109990 

80154 231.75 31600040 A A 40109990 40109990 

85245 220.42 31600043 A A 40109990 40109990 

84681 213.21 31600059 A A 40109990 40109990 

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82525 155.53 31600499 A A 40109990 40109990 

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86280 331.66 31600597 A A 40109990 40109990 

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85441 29.87 31600601 A A 40109990 40109990 

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86431 93.73 31600637 A A 40109990 40109990 

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82088 375.95 31600688 A A 40109990 40109990 

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84620 183.34 31600723 A A 40109990 40109990 

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86160 141.11 31600730 A A 40109990 40109990 

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82131 206 31600854 A A 40109990 40109990 

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82491 131.84 31610276 A A 40109990 40109990 

87252 83.43 31610277 A A 40109990 40109990 

86617 91.67 31610278 A A 40109990 40109990 

86617 91.67 31610279 A A 40109990 40109990 

86753 115.36 31610281 A A 40109990 40109990 

86753 121.54 31610282 A A 40109990 40109990 

86003 62.83 31610283 A A 40109990 40109990 

86003 62.83 31610284 A A 40109990 40109990 

86003 62.83 31610285 A A 40109990 40109990 

86003 62.83 31610286 A A 40109990 40109990 

86003 62.83 31610287 A A 40109990 40109990 

86003 62.83 31610288 A A 40109990 40109990 

86003 62.83 31610289 A A 40109990 40109990 

86003 62.83 31610290 A A 40109990 40109990 

86003 62.83 31610291 A A 40109990 40109990 

86003 62.83 31610292 A A 40109990 40109990 

86003 62.83 31610293 A A 40109990 40109990

86003 62.83 31610294 A A 40109990 40109990 

83520 187.46 31610296 A A 40109990 40109990 

85460 112.27 31610298 A A 40109990 40109990 

86255 122.57 31610299 A A 40109990 40109990 

80201 141.11 31610305 A A 40109990 40109990 

83919 147.29 31610308 A A 40109990 40109990 

87338 608.73 31610309 A A 40109990 40109990 

84166 143.17 31610311 A A 40109990 40109990 

84156 74.16 31610312 A A 40109990 40109990 

86723 276.04 31610313 A A 40109990 40109990 

82105 63.24 31610316 A A 40109990 40109990 

84702 43.94 31610317 A A 40109990 40109990 

82677 91.16 31610318 A A 40109990 40109990 

83516 105.06 31610319 A A 40109990 40109990 

G0431 55.62 31610320 A A 40109990 40109990 

80101 38.11 31610321 A A 40109990 40109990 

82735 200.85 31610322 A A 40109990 40109990 

87270 128.75 31610326 A A 40109990 40109990 

83519 158.62 31610327 A A 40109990 40109990 

87350 117.42 31610328 A A 40109990 40109990 

86707 119.48 31610329 A A 40109990 40109990 

86817 580.92 31610335 A A 40109990 40109990 

83519 208.06 31610336 A A 40109990 40109990 

86255 166.86 31610338 A A 40109990 40109990 

82104 148.32 31610339 A A 40109990 40109990 

84311 363.59 31610340 A A 40109990 40109990 

83516 167.89 31610341 A A 40109990 40109990 

87535 490.28 31610342 A A 40109990 40109990 

82530 196.73 31610343 A A 40109990 40109990 

83519 175.1 31610344 A A 40109990 40109990 

86359 327.54 31610346 A A 40109990 40109990 

85048 30.9 31610347 A A 40109990 40109990 

86360 299.73 31610348 A A 40109990 40109990 

88184 87.55 31610349 A A 40109990 40109990 

G0431 200.85 31610350 A A 40109990 40109990 

82491 148.32 31610351 A A 40109990 40109990 

86316 169.95 31610356 A A 40109990 40109990 

86705 131.84 31610357 A A 40109990 40109990 

84311 89.61 31610358 A A 40109990 40109990 

87281 183.34 31610359 A A 40109990 40109990 

83519 172.01 31610360 A A 40109990 40109990 

83519 164.8 31610361 A A 40109990 40109990 

85025 208.06 31610362 A A 40109990 40109990 

83883 111.24 31610464 A A 40109990 40109990 

86671 126.69 31610465 A A 40109990 40109990 

86602 103 31610466 A A 40109990 40109990 

86671 126.69 31610467 A A 40109990 40109990

86606 133.9 31610468 A A 40109990 40109990 

86671 126.69 31610469 A A 40109990 40109990 

86671 126.69 31610470 A A 40109990 40109990 

86671 126.69 31610471 A A 40109990 40109990 

86671 126.69 31610472 A A 40109990 40109990 

84182 351.23 31610476 A A 40109990 40109990 

80299 201.88 31610478 A A 40109990 40109990 

83937 268.83 31610479 A A 40109990 40109990 

82131 196.73 31610480 A A 40109990 40109990 

82139 773.53 31610481 A A 40109990 40109990 

82139 1093.86 31610482 A A 40109990 40109990 

86003 48.41 31610483 A A 40109990 40109990 

86003 48.41 31610484 A A 40109990 40109990 

86003 48.41 31610485 A A 40109990 40109990 

86003 48.41 31610486 A A 40109990 40109990 

86003 48.41 31610487 A A 40109990 40109990 

86003 48.41 31610488 A A 40109990 40109990 

86003 48.41 31610489 A A 40109990 40109990 

86003 48.41 31610490 A A 40109990 40109990 

80299 152.44 31610491 A A 40109990 40109990 

82131 221.45 31610493 A A 40109990 40109990 

80154 224.54 31610494 A A 40109990 40109990 

81220 41.2 31610499 A A 40109990 40109990 

82491 135.96 31610500 A A 40109990 40109990 

86609 131.84 31610501 A A 40109990 40109990 

86609 131.84 31610502 A A 40109990 40109990 

86609 131.84 31610503 A A 40109990 40109990 

86609 131.84 31610504 A A 40109990 40109990 

86609 131.84 31610505 A A 40109990 40109990 

86609 131.84 31610506 A A 40109990 40109990 

86784 47.38 31610507 A A 40109990 40109990 

81240 41.2 31610510 A A 40109990 40109990 

82105 172.01 31610514 A A 40109990 40109990 

82491 74.16 31610515 A A 40109990 40109990 

82491 74.16 31610516 A A 40109990 40109990 

82491 74.16 31610517 A A 40109990 40109990 

84443 225.57 31610526 A A 40109990 40109990 

84597 303.85 31610527 A A 40109990 40109990 

82491 261.62 31610528 A A 40109990 40109990 

86003 128.75 31610529 A A 40109990 40109990 

86648 180.25 31610530 A A 40109990 40109990 

83701 154.5 31610531 A A 40109990 40109990 

83700 83.43 31610532 A A 40109990 40109990 

81291 43.26 31610541 A A 40109990 40109990 

81256 165.83 31610542 A A 40109990 40109990 

87015 87.55 31610543 A A 40109990 40109990 

87207 87.55 31610547 A A 40109990 40109990

83840 135.96 31610549 A A 40109990 40109990 

86790 180.25 31610550 A A 40109990 40109990 

86790 143.17 31610551 A A 40109990 40109990 

0 31610555 A A 40109990 40109990 

82607 167.89 31610559 A A 40109990 40109990 

82746 167.89 31610560 A A 40109990 40109990 

82728 143.17 31610561 A A 40109990 40109990 

84600 126.69 31610563 A A 40109990 40109990 

81241 0 31610564 A A 40109990 40109990 

81220 0 31610566 A A 40109990 40109990 

86654 72.1 31610568 A A 40109990 40109990 

86651 72.1 31610569 A A 40109990 40109990 

86652 72.1 31610570 A A 40109990 40109990 

86653 72.1 31610571 A A 40109990 40109990 

0 31610572 A A 40109990 40109990 

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88230 1053.69 31610578 A A 40109990 40109990 

88237 1141.24 31610579 A A 40109990 40109990 

88261 1437.88 31610580 A A 40109990 40109990 

88280 203.94 31610581 A A 40109990 40109990 

88285 155.53 31610582 A A 40109990 40109990 

0 31610583 A A 40109990 40109990 

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86648 143.17 31610585 A A 40109990 40109990 

86609 141.11 31610587 A A 40109990 40109990 

86609 141.11 31610588 A A 40109990 40109990 

86609 141.11 31610589 A A 40109990 40109990 

86609 141.11 31610590 A A 40109990 40109990 

82784 100.94 31610591 A A 40109990 40109990 

82784 100.94 31610592 A A 40109990 40109990 

82784 100.94 31610593 A A 40109990 40109990 

82785 100.94 31610594 A A 40109990 40109990 

82787 146.26 31610595 A A 40109990 40109990 

82787 146.26 31610596 A A 40109990 40109990 

82787 146.26 31610597 A A 40109990 40109990 

82787 146.26 31610598 A A 40109990 40109990 

81220 37.08 31610601 A A 40109990 40109990 

84311 324.45 31610602 A A 40109990 40109990 

83516 128.75 31610603 A A 40109990 40109990 

87536 869.32 31610604 A A 40109990 40109990 

84311 211.15 31610605 A A 40109990 40109990 

85303 218.36 31610607 A A 40109990 40109990 

85306 251.32 31610608 A A 40109990 40109990 

86038 122.57 31610609 A A 40109990 40109990 

86255 122.57 31610610 A A 40109990 40109990

86255 122.57 31610611 A A 40109990 40109990 

86255 122.57 31610612 A A 40109990 40109990 

86160 122.57 31610613 A A 40109990 40109990 

86160 122.57 31610614 A A 40109990 40109990 

86235 182.31 31610615 A A 40109990 40109990 

86235 182.31 31610616 A A 40109990 40109990 

86235 182.31 31610617 A A 40109990 40109990 

86235 182.31 31610618 A A 40109990 40109990 

83520 114.33 31610619 A A 40109990 40109990 

86235 182.31 31610620 A A 40109990 40109990 

86376 148.32 31610621 A A 40109990 40109990 

86255 122.57 31610622 A A 40109990 40109990 

86255 122.57 31610623 A A 40109990 40109990 

86225 141.11 31610624 A A 40109990 40109990 

86255 122.57 31610625 A A 40109990 40109990 

86431 57.68 31610626 A A 40109990 40109990 

83088 232.78 31610627 A A 40109990 40109990 

82570 18.54 31610628 A A 40109990 40109990 

87798 318.27 31610629 A A 40109990 40109990 

86160 36.05 31610630 A A 40109990 40109990 

86148 210.12 31610631 A A 40109990 40109990 

86148 210.12 31610632 A A 40109990 40109990 

82150 126.69 31610633 A A 40109990 40109990 

82664 126.69 31610634 A A 40109990 40109990 

86644 146.26 31610638 A A 40109990 40109990 

86645 155.53 31610639 A A 40109990 40109990 

86603 132.87 31610640 A A 40109990 40109990 

86631 165.83 31610641 A A 40109990 40109990 

83925 158.62 31610642 A A 40109990 40109990 

86359 341.96 31610643 A A 40109990 40109990 

86360 425.39 31610644 A A 40109990 40109990 

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84220 172.01 31610646 A A 40109990 40109990 

87798 475.86 31610647 A A 40109990 40109990 

86141 107.12 31610648 A A 40109990 40109990 

86677 148.32 31610649 A A 40109990 40109990 

86677 177.16 31610650 A A 40109990 40109990 

88312 146.26 31610651 A A 40109990 40109990 

82787 184.37 31610652 A A 40109990 40109990 

82787 191.58 31610653 A A 40109990 40109990 

82784 95.79 31610654 A A 40109990 40109990 

86666 157.59 31610655 A A 40109990 40109990 

86666 157.59 31610656 A A 40109990 40109990 

86336 112.27 31610657 A A 40109990 40109990 

87081 172.01 31610660 A A 40109990 40109990 

85240 52.53 31610661 A A 40109990 40109990 

85335 47.38 31610662 A A 40109990 40109990

85732 19.57 31610663 A A 40109990 40109990 

86757 196.73 31610664 A A 40109990 40109990 

86757 196.73 31610665 A A 40109990 40109990 

82705 136.99 31610666 A A 40109990 40109990 

84600 166.86 31610667 A A 40109990 40109990 

G0431 150.38 31610668 A A 40109990 40109990 

82378 64.89 31610669 A A 40109990 40109990 

86300 73.13 31610670 A A 40109990 40109990 

84275 73.13 31610671 A A 40109990 40109990 

86316 73.13 31610672 A A 40109990 40109990 

81220 0 31610673 A A 40109990 40109990 

86750 100.94 31610674 A A 40109990 40109990 

85305 114.33 31610675 A A 40109990 40109990 

85306 148.32 31610676 A A 40109990 40109990 

82542 164.8 31610677 A A 40109990 40109990 

82491 298.7 31610678 A A 40109990 40109990 

82379 172.01 31610679 A A 40109990 40109990 

82379 172.01 31610680 A A 40109990 40109990 

82491 148.32 31610681 A A 40109990 40109990 

83701 176.13 31610682 A A 40109990 40109990 

82943 154.5 31610683 A A 40109990 40109990 

82523 151.41 31610685 A A 40109990 40109990 

82570 41.2 31610686 A A 40109990 40109990 

84165 88.58 31610688 A A 40109990 40109990 

84166 189.52 31610689 A A 40109990 40109990 

86140 38.11 31610690 A A 40109990 40109990 

80188 131.84 31610691 A A 40109990 40109990 

82785 148.32 31610693 A A 40109990 40109990 

G0431 112.27 31610694 A A 40109990 40109990 

87206 129.78 31610696 A A 40109990 40109990 

87081 129.78 31610697 A A 40109990 40109990 

86038 119.48 31610698 A A 40109990 40109990 

84307 322.39 31610699 A A 40109990 40109990 

82491 172.01 31610700 A A 40109990 40109990 

87517 392.43 31610701 A A 40109990 40109990 

85613 131.84 31610702 A A 40109990 40109990 

85300 139.05 31610703 A A 40109990 40109990 

85303 177.16 31610704 A A 40109990 40109990 

85306 182.31 31610705 A A 40109990 40109990 

85384 86.52 31610706 A A 40109990 40109990 

85307 155.53 31610707 A A 40109990 40109990 

85420 70.04 31610708 A A 40109990 40109990 

86376 148.32 31610709 A A 40109990 40109990 

87621 112.27 31610710 A A 40109990 40109990 

86147 206 31610711 A A 40109990 40109990 

86147 206 31610712 A A 40109990 40109990 

82784 97.85 31610713 A A 40109990 40109990

82784 95.79 31610714 A A 40109990 40109990 

82042 41.2 31610715 A A 40109990 40109990 

82040 38.11 31610716 A A 40109990 40109990 

82787 129.78 31610717 A A 40109990 40109990 

82787 129.78 31610718 A A 40109990 40109990 

82787 129.78 31610719 A A 40109990 40109990 

82787 129.78 31610720 A A 40109990 40109990 

84030 206 31610721 A A 40109990 40109990 

86148 210.12 31610722 A A 40109990 40109990 

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87798 318.27 31610725 A A 40109990 40109990 

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87798 318.27 31610727 A A 40109990 40109990 

0 31610729 A A 40109990 40109990 

82232 160.68 31610730 A A 40109990 40109990 

86784 100.94 31610731 A A 40109990 40109990 

82507 260.59 31610732 A A 40109990 40109990 

84403 263.68 31610733 A A 40109990 40109990 

84402 260.59 31610734 A A 40109990 40109990 

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80299 139.05 31610736 A A 40109990 40109990 

83883 110.21 31610737 A A 40109990 40109990 

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G0431 388.31 31610740 A A 40109990 40109990 

86160 122.57 31610741 A A 40109990 40109990 

83520 324.45 31610742 A A 40109990 40109990 

82664 280.16 31610743 A A 40109990 40109990 

84702 153.47 31610745 A A 40109990 40109990 

82677 247.2 31610746 A A 40109990 40109990 

86021 292.52 31610748 A A 40109990 40109990 

86812 210.12 31610751 A A 40109990 40109990 

83150 239.99 31610753 A A 40109990 40109990 

82570 18.54 31610754 A A 40109990 40109990 

86706 126.69 31610755 A A 40109990 40109990 

84488 83.43 31610756 A A 40109990 40109990 

87230 165.83 31610757 A A 40109990 40109990 

83519 225.57 31610761 A A 40109990 40109990 

83520 166.86 31610762 A A 40109990 40109990 

87158 46.35 31610763 A A 40109990 40109990 

83925 158.62 31610764 A A 40109990 40109990 

82941 144.2 31610772 A A 40109990 40109990 

86160 148.32 31610773 A A 40109990 40109990 

83835 294.58 31610774 A A 40109990 40109990 

86774 167.89 31610775 A A 40109990 40109990 

87799 431.57 31610777 A A 40109990 40109990 

83516 734.21 31610778 A A 40109990 40109990

86060 90.64 31610780 A A 40109990 40109990 

86671 166.86 31610783 A A 40109990 40109990 

86671 166.86 31610784 A A 40109990 40109990 

86255 166.86 31610785 A A 40109990 40109990 

83519 267.8 31610786 A A 40109990 40109990 

86431 119.48 31610787 A A 40109990 40109990 

83883 56.65 31610788 A A 40109990 40109990 

83883 56.65 31610789 A A 40109990 40109990 

83883 56.65 31610790 A A 40109990 40109990 

83883 56.65 31610791 A A 40109990 40109990 

83883 56.65 31610792 A A 40109990 40109990 

82491 136.99 31610793 A A 40109990 40109990 

86147 0 31610794 A A 40109990 40109990 

83925 170.98 31610795 A A 40109990 40109990 

82491 148.32 31610799 A A 40109990 40109990 

86787 131.84 31610800 A A 40109990 40109990 

86787 131.84 31610801 A A 40109990 40109990 

82570 18.54 31610802 A A 40109990 40109990 

83921 48.41 31610803 A A 40109990 40109990 

86735 143.17 31610804 A A 40109990 40109990 

86735 179.22 31610805 A A 40109990 40109990 

87476 357.41 31610808 A A 40109990 40109990 

82785 167.89 31610816 A A 40109990 40109990 

86677 91.67 31610817 A A 40109990 40109990 

84146 235.87 31610825 A A 40109990 40109990 

82785 167.89 31610826 A A 40109990 40109990 

82784 90.64 31610828 A A 40109990 40109990 

82784 90.64 31610829 A A 40109990 40109990 

86609 90.64 31610830 A A 40109990 40109990 

82784 90.64 31610831 A A 40109990 40109990 

86648 80.34 31610832 A A 40109990 40109990 

86684 80.34 31610833 A A 40109990 40109990 

82787 90.64 31610834 A A 40109990 40109990 

82787 90.64 31610835 A A 40109990 40109990 

82787 90.64 31610836 A A 40109990 40109990 

82787 90.64 31610837 A A 40109990 40109990 

80164 55.62 31610839 A A 40109990 40109990 

82379 175.1 31610840 A A 40109990 40109990 

82016 69.01 31610841 A A 40109990 40109990 

87491 357.41 31610844 A A 40109990 40109990 

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81220 0 31610851 A A 40109990 40109990 

87496 400.67 31610852 A A 40109990 40109990 

82175 119.48 31610853 A A 40109990 40109990 

82175 119.48 31610854 A A 40109990 40109990 

86682 187.46 31610856 A A 40109990 40109990 

82542 257.5 31610857 A A 40109990 40109990

86146 260.59 31610858 A A 40109990 40109990 

86146 260.59 31610859 A A 40109990 40109990 

86146 260.59 31610860 A A 40109990 40109990 

88271 199.82 31610861 A A 40109990 40109990 

88275 180.25 31610862 A A 40109990 40109990 

86280 160.68 31610864 A A 40109990 40109990 

82271 26.78 31610865 A A 40109990 40109990 

85301 88.58 31610867 A A 40109990 40109990 

82541 162.74 31610868 A A 40109990 40109990 

82486 246.17 31610869 A A 40109990 40109990 

85540 100.94 31610871 A A 40109990 40109990 

86226 108.15 31610872 A A 40109990 40109990 

80150 119.48 31610882 A A 40109990 40109990 

80150 121.54 31610883 A A 40109990 40109990 

82105 172.01 31610884 A A 40109990 40109990 

86658 119.48 31610885 A A 40109990 40109990 

86658 119.48 31610886 A A 40109990 40109990 

86658 119.48 31610887 A A 40109990 40109990 

83840 350.2 31610889 A A 40109990 40109990 

85247 334.75 31610893 A A 40109990 40109990 

81220 144.2 31610894 A A 40109990 40109990 

81220 0 31610897 A A 40109990 40109990 

84311 154.5 31610899 A A 40109990 40109990 

86753 235.87 31610900 A A 40109990 40109990 

86336 112.27 31610901 A A 40109990 40109990 

82105 172.01 31610902 A A 40109990 40109990 

85576 53.56 31610903 A A 40109990 40109990 

81220 0 31610904 A A 40109990 40109990 

86256 29.87 31610907 A A 40109990 40109990 

82646 129.78 31610911 A A 40109990 40109990 

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86200 220.42 31610918 A A 40109990 40109990 

86336 58.73 31610919 A A 40109990 40109990 

85520 196.73 31610920 A A 40109990 40109990 

86713 124.63 31610921 A A 40109990 40109990 

86713 148.32 31610922 A A 40109990 40109990 

86336 342.99 31610923 A A 40109990 40109990 

86038 196.73 31610925 A A 40109990 40109990 

84238 357.41 31610930 A A 40109990 40109990 

87901 2093.99 31610931 A A 40109990 40109990 

87903 4418.7 31610932 A A 40109990 40109990 

87904 1177.29 31610933 A A 40109990 40109990 

87254 256.47 31610934 A A 40109990 40109990 

0 31610935 A A 40109990 40109990 

84143 228.66 31610936 A A 40109990 40109990 

83915 126.69 31610937 A A 40109990 40109990

86765 179.22 31610938 A A 40109990 40109990 

84270 211.15 31610939 A A 40109990 40109990 

86666 103 31610940 A A 40109990 40109990 

86666 103 31610941 A A 40109990 40109990 

85635 189.736 31610942 A A 40109990 40109990 

87522 799.28 31610943 A A 40109990 40109990 

85384 119.48 31610945 A A 40109990 40109990 

86694 231.75 31610946 A A 40109990 40109990 

86694 146.26 31610947 A A 40109990 40109990 

82570 48.41 31610950 A A 40109990 40109990 

87109 180.25 31610951 A A 40109990 40109990 

85730 72.1 31610952 A A 40109990 40109990 

85613 103 31610955 A A 40109990 40109990 

84482 232.78 31610956 A A 40109990 40109990 

86635 278.1 31610958 A A 40109990 40109990 

84238 297.67 31610960 A A 40109990 40109990 

0 31610963 A A 40109990 40109990 

82651 263.68 31610964 A A 40109990 40109990 

86337 325.48 31610965 A A 40109990 40109990 

83498 276.04 31610971 A A 40109990 40109990 

86336 236.9 31610972 A A 40109990 40109990 

84252 64.89 31610974 A A 40109990 40109990 

87015 64.89 31610976 A A 40109990 40109990 

87207 48.41 31610977 A A 40109990 40109990 

87902 2093.99 31610978 A A 40109990 40109990 

86361 320.33 31610992 A A 40109990 40109990 

86631 347.11 31610994 A A 40109990 40109990 

85660 55.62 31610997 A A 40109990 40109990 

87798 588.13 31610998 A A 40109990 40109990 

86747 153.47 31610999 A A 40109990 40109990 

87536 660.23 31611000 A A 40109990 40109990 

87522 471.74 31611002 A A 40109990 40109990 

83519 264.71 31611004 A A 40109990 40109990 

86762 146.26 31611008 A A 40109990 40109990 

86762 189.52 31611009 A A 40109990 40109990 

88346 279.13 31611010 A A 40109990 40109990 

82523 28.95 31611011 A A 40109990 40109990 

82373 164.8 31611012 A A 40109990 40109990 

83080 249.26 31611013 A A 40109990 40109990 

82017 172.01 31611014 A A 40109990 40109990 

86003 46.35 31611015 A A 40109990 40109990 

86003 46.35 31611016 A A 40109990 40109990 

86003 46.35 31611017 A A 40109990 40109990 

86003 46.35 31611018 A A 40109990 40109990 

86003 46.35 31611019 A A 40109990 40109990 

86003 46.35 31611020 A A 40109990 40109990 

86003 46.35 31611021 A A 40109990 40109990

86671 151.41 31611022 A A 40109990 40109990 

86671 151.41 31611023 A A 40109990 40109990 

82088 375.95 31611024 A A 40109990 40109990 

83519 123.6 31611026 A A 40109990 40109990 

83918 515 31611027 A A 40109990 40109990 

86817 580.92 31611028 A A 40109990 40109990 

86336 112.27 31611029 A A 40109990 40109990 

83970 335.78 31611030 A A 40109990 40109990 

82310 59.74 31611031 A A 40109990 40109990 

85705 94.76 31611034 A A 40109990 40109990 

86695 118.45 31611035 A A 40109990 40109990 

86696 176.13 31611036 A A 40109990 40109990 

82492 563.41 31611038 A A 40109990 40109990 

88273 261.62 31611040 A A 40109990 40109990 

88271 192.61 31611041 A A 40109990 40109990 

88230 1052.66 31611043 A A 40109990 40109990 

88275 258.53 31611044 A A 40109990 40109990 

88237 318.27 31611045 A A 40109990 40109990 

0 31611046 A A 40109990 40109990 

82384 258.53 31611047 A A 40109990 40109990 

82570 41.2 31611048 A A 40109990 40109990 

88262 1013.52 31611049 A A 40109990 40109990 

86235 182.31 31611050 A A 40109990 40109990 

86235 182.31 31611051 A A 40109990 40109990 

81220 0 31611052 A A 40109990 40109990 

81220 0 31611053 A A 40109990 40109990 

86334 923 31611055 A A 40109990 40109990 

80299 79.52 31611056 A A 40109990 40109990 

83519 232.78 31611057 A A 40109990 40109990 

86148 210.12 31611058 A A 40109990 40109990 

86622 90.64 31611063 A A 40109990 40109990 

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86658 118.45 31611066 A A 40109990 40109990 

86658 118.45 31611067 A A 40109990 40109990 

86658 118.45 31611068 A A 40109990 40109990 

86658 118.45 31611069 A A 40109990 40109990 

86658 118.45 31611070 A A 40109990 40109990 

86658 118.45 31611071 A A 40109990 40109990 

86658 118.45 31611072 A A 40109990 40109990 

86658 118.45 31611073 A A 40109990 40109990 

86658 118.45 31611074 A A 40109990 40109990 

86658 118.45 31611075 A A 40109990 40109990 

86658 118.45 31611076 A A 40109990 40109990 

86658 118.45 31611077 A A 40109990 40109990 

86658 118.45 31611078 A A 40109990 40109990 

86658 118.45 31611079 A A 40109990 40109990 

86658 118.45 31611080 A A 40109990 40109990

86658 118.45 31611081 A A 40109990 40109990 

86658 118.45 31611082 A A 40109990 40109990 

86658 118.45 31611083 A A 40109990 40109990 

86658 118.45 31611084 A A 40109990 40109990 

86658 118.45 31611085 A A 40109990 40109990 

83519 156.56 31611086 A A 40109990 40109990 

87476 295.61 31611087 A A 40109990 40109990 

85041 25.75 31611088 A A 40109990 40109990 

85018 19.57 31611089 A A 40109990 40109990 

85014 19.57 31611090 A A 40109990 40109990 

86727 128.75 31611091 A A 40109990 40109990 

86727 128.75 31611092 A A 40109990 40109990 

80299 161.71 31611093 A A 40109990 40109990 

86403 63.86 31611094 A A 40109990 40109990 

86403 53.56 31611095 A A 40109990 40109990 

86403 53.56 31611096 A A 40109990 40109990 

86403 53.56 31611097 A A 40109990 40109990 

86403 53.56 31611098 A A 40109990 40109990 

86403 53.56 31611099 A A 40109990 40109990 

86403 53.56 31611100 A A 40109990 40109990 

86403 53.56 31611101 A A 40109990 40109990 

86403 53.56 31611102 A A 40109990 40109990 

87529 357.41 31611103 A A 40109990 40109990 

87798 456.29 31611104 A A 40109990 40109990 

82088 375.95 31611109 A A 40109990 40109990 

86606 103 31611110 A A 40109990 40109990 

86331 62.83 31611111 A A 40109990 40109990 

87260 109.18 31611112 A A 40109990 40109990 

87252 265.74 31611113 A A 40109990 40109990 

87496 409.94 31611114 A A 40109990 40109990 

83789 41.2 31611115 A A 40109990 40109990 

87252 196.73 31611116 A A 40109990 40109990 

83883 254.41 31611117 A A 40109990 40109990 

83883 254.41 31611118 A A 40109990 40109990 

84238 282.22 31611119 A A 40109990 40109990 

84238 375.95 31611120 A A 40109990 40109990 

86255 349.17 31611121 A A 40109990 40109990 

82626 444.96 31611122 A A 40109990 40109990 

84376 109.18 31611123 A A 40109990 40109990 

87252 225.57 31611124 A A 40109990 40109990 

86403 157.59 31611125 A A 40109990 40109990 

87476 153.47 31611126 A A 40109990 40109990 

87476 153.47 31611127 A A 40109990 40109990 

86617 363.59 31611128 A A 40109990 40109990 

86695 167.89 31611129 A A 40109990 40109990 

86696 167.89 31611130 A A 40109990 40109990 

86617 363.59 31611131 A A 40109990 40109990

81220 0 31611132 A A 40109990 40109990 

86698 100.94 31611134 A A 40109990 40109990 

85597 360.5 31611135 A A 40109990 40109990 

0 31611136 A A 40109990 40109990 

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84244 325.48 31611138 A A 40109990 40109990 

86671 258.53 31611140 A A 40109990 40109990 

83519 258.53 31611141 A A 40109990 40109990 

86816 605.64 31611143 A A 40109990 40109990 

81257 0 31611144 A A 40109990 40109990 

82523 338.87 31611145 A A 40109990 40109990 

85410 258.53 31611146 A A 40109990 40109990 

80074 368.74 31611148 A A 40109990 40109990 

87556 567.53 31611149 A A 40109990 40109990 

86648 57.68 31611150 A A 40109990 40109990 

86609 66.95 31611151 A A 40109990 40109990 

82787 79.31 31611152 A A 40109990 40109990 

82787 79.31 31611153 A A 40109990 40109990 

82787 79.31 31611154 A A 40109990 40109990 

82787 79.31 31611155 A A 40109990 40109990 

82785 66.95 31611156 A A 40109990 40109990 

82784 66.95 31611157 A A 40109990 40109990 

82784 66.95 31611158 A A 40109990 40109990 

82784 66.95 31611159 A A 40109990 40109990 

86684 57.68 31611160 A A 40109990 40109990 

86774 57.68 31611161 A A 40109990 40109990 

87254 134.93 31611162 A A 40109990 40109990 

87252 134.93 31611163 A A 40109990 40109990 

82544 728.21 31611164 A A 40109990 40109990 

85290 371.83 31611165 A A 40109990 40109990 

85385 61.8 31611167 A A 40109990 40109990 

G0431 161.71 31611168 A A 40109990 40109990 

87116 304.88 31611169 A A 40109990 40109990 

87206 87.55 31611170 A A 40109990 40109990 

82003 117.42 31611172 A A 40109990 40109990 

83925 140.08 31611173 A A 40109990 40109990 

86226 237.93 31611174 A A 40109990 40109990 

82491 229.69 31611175 A A 40109990 40109990 

83516 139.05 31611176 A A 40109990 40109990 

82016 83.43 31611177 A A 40109990 40109990 

83919 567.53 31611178 A A 40109990 40109990 

82544 567.53 31611179 A A 40109990 40109990 

86817 716.88 31611180 A A 40109990 40109990 

87186 387.28 31611181 A A 40109990 40109990 

87497 627.27 31611182 A A 40109990 40109990 

84120 151.41 31611183 A A 40109990 40109990 

87491 235.87 31611184 A A 40109990 40109990

87591 211.15 31611185 A A 40109990 40109990 

83789 238.96 31611186 A A 40109990 40109990 

83874 81.37 31611187 A A 40109990 40109990 

0 31611191 A A 40109990 40109990 

83520 124.63 31611192 A A 40109990 40109990 

83519 503.67 31611193 A A 40109990 40109990 

84060 90.64 31611194 A A 40109990 40109990 

87801 421.27 31611195 A A 40109990 40109990 

87476 263.68 31611196 A A 40109990 40109990 

80102 108.15 31611197 A A 40109990 40109990 

86147 153.47 31611198 A A 40109990 40109990 

87621 134.88 31611199 A A 40109990 40109990 

86768 86.52 31611200 A A 40109990 40109990 

87015 61.8 31611201 A A 40109990 40109990 

82131 100.94 31611202 A A 40109990 40109990 

87529 397.58 31611203 A A 40109990 40109990 

86695 91.67 31611204 A A 40109990 40109990 

86696 145.23 31611205 A A 40109990 40109990 

86695 87.55 31611206 A A 40109990 40109990 

86696 130.81 31611207 A A 40109990 40109990 

86757 309 31611208 A A 40109990 40109990 

83527 223.51 31611209 A A 40109990 40109990 

86628 72.1 31611210 A A 40109990 40109990 

86628 72.1 31611211 A A 40109990 40109990 

86628 72.1 31611212 A A 40109990 40109990 

82164 129.78 31611213 A A 40109990 40109990 

80299 223.51 31611214 A A 40109990 40109990 

87798 263.68 31611215 A A 40109990 40109990 

86355 275.01 31611216 A A 40109990 40109990 

86357 285.31 31611217 A A 40109990 40109990 

87449 392.43 31611219 A A 40109990 40109990 

86790 147.29 31611221 A A 40109990 40109990 

86790 147.29 31611222 A A 40109990 40109990 

86677 110.21 31611223 A A 40109990 40109990 

86403 181.28 31611224 A A 40109990 40109990 

0 31611226 A A 40109990 40109990 

81220 36.05 31611227 A A 40109990 40109990 

82180 301.79 31611228 A A 40109990 40109990 

83520 99.91 31611229 A A 40109990 40109990 

83018 131.912 31611231 A A 40109990 40109990 

88347 246.17 31611233 A A 40109990 40109990 

85247 424.36 31611234 A A 40109990 40109990 

0 31611235 A A 40109990 40109990 

82492 238.96 31611236 A A 40109990 40109990 

84206 332.69 31611237 A A 40109990 40109990 

84255 194.67 31611238 A A 40109990 40109990 

0 31611239 A A 40109990 40109990

0 31611240 A A 40109990 40109990 

0 31611241 A A 40109990 40109990 

0 31611242 A A 40109990 40109990 

0 31611243 A A 40109990 40109990 

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83520 370.8 31611245 A A 40109990 40109990 

84630 157.59 31611246 A A 40109990 40109990 

80101 426.42 31611247 A A 40109990 40109990 

84478 48.41 31611248 A A 40109990 40109990 

83701 232.78 31611249 A A 40109990 40109990 

82542 176.13 31611251 A A 40109990 40109990 

86355 327.54 31611252 A A 40109990 40109990 

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88271 275.01 31611254 A A 40109990 40109990 

88273 246.17 31611255 A A 40109990 40109990 

87497 486.16 31611257 A A 40109990 40109990 

86353 296.64 31611258 A A 40109990 40109990 

82397 86.52 31611259 A A 40109990 40109990 

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82145 105.06 31611263 A A 40109990 40109990 

0 31611264 A A 40109990 40109990 

87265 90.64 31611265 A A 40109990 40109990 

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87254 83.43 31611271 A A 40109990 40109990 

87253 64.89 31611272 A A 40109990 40109990 

83925 55.62 31611273 A A 40109990 40109990 

87206 79.31 31611274 A A 40109990 40109990 

87116 242.05 31611275 A A 40109990 40109990 

0 31611276 A A 40109990 40109990 

83516 98.88 31611277 A A 40109990 40109990 

82105 215.27 31611278 A A 40109990 40109990 

87149 206 31611279 A A 40109990 40109990 

83520 172.01 31611280 A A 40109990 40109990 

83925 108.15 31611282 A A 40109990 40109990 

83950 368.74 31611286 A A 40109990 40109990 

G0431 36.05 31611287 A A 40109990 40109990 

81220 36.05 31611293 A A 40109990 40109990 

82139 562.38 31611294 A A 40109990 40109990 

83520 280.16 31611295 A A 40109990 40109990 

83516 122.57 31611296 A A 40109990 40109990 

83516 122.57 31611297 A A 40109990 40109990 

87798 489.25 31611298 A A 40109990 40109990 

86335 167.89 31611299 A A 40109990 40109990 

84166 108.15 31611300 A A 40109990 40109990 

84157 21.63 31611301 A A 40109990 40109990 

84403 320.33 31611302 A A 40109990 40109990 

84270 304.88 31611303 A A 40109990 40109990

82040 25.75 31611304 A A 40109990 40109990 

86793 93.73 31611305 A A 40109990 40109990 

81270 36.05 31611306 A A 40109990 40109990 

83690 72.1 31611307 A A 40109990 40109990 

84588 193.64 31611308 A A 40109990 40109990 

83930 44.29 31611309 A A 40109990 40109990 

86021 84.46 31611310 A A 40109990 40109990 

86666 0 31611311 A A 40109990 40109990 

82540 26.78 31611312 A A 40109990 40109990 

82775 128.75 31611313 A A 40109990 40109990 

88230 297.67 31611316 A A 40109990 40109990 

88262 357.41 31611317 A A 40109990 40109990 

88289 90.64 31611318 A A 40109990 40109990 

88368 768.38 31611320 A A 40109990 40109990 

86615 95.79 31611321 A A 40109990 40109990 

83805 100.94 31611322 A A 40109990 40109990 

83018 41.2 31611323 A A 40109990 40109990 

80154 230.72 31611324 A A 40109990 40109990 

88273 157.59 31611326 A A 40109990 40109990 

88291 1777.78 31611327 A A 40109990 40109990 

88365 320.33 31611337 A A 40109990 40109990 

80299 262.65 31611342 A A 40109990 40109990 

81220 25.75 31611343 A A 40109990 40109990 

0 A A 40109990 40109990 

0 A A 40109990 40109990 

0 A A 40109990 40109990 

0 A A 40109990 40109990 

0 A A 40109990 40109990 

83883 103 A A 40109990 40109990 

0 A A 40109990 40109990 

0 A A 40109990 40109990 

80194 131.84 31611352 A A 40109990 40109990 

82239 110.21 31611351 A A 40109990 40109990 

86741 85.49 31611350 A A 40109990 40109990 

86403 64.89 31611349 A A 40109990 40109990 

86255 741.6 31611348 A A 40109990 40109990 

82172 97.85 31611346 A A 40109990 40109990 

87186 211.15 31611345 A A 40109990 40109990 

86790 95.79 31610217 A A 40109990 40109990 

86790 95.79 31610218 A A 40109990 40109990 

82784 90.64 31610827 A A 40109990 40109990 

85730 85.49 31610873 A A 40109990 40109990 

85300 85.49 31610874 A A 40109990 40109990 

85303 90.64 31610875 A A 40109990 40109990 

85305 90.64 31610876 A A 40109990 40109990 

85306 90.64 31610877 A A 40109990 40109990 

86684 175.1 31611353 A A 40109990 40109990

80103 111.24 31610855 A A 40109990 40109990 

88184 136.99 31611355 A A 40109990 40109990 

86609 134.93 31610728 A A 40109990 40109990 

87798 618 31611356 A A 40109990 40109990 

80299 112.27 31610080 A A 40109990 40109990 

83516 144.2 31611363 A A 40109990 40109990 

86255 206 31611362 A A 40109990 40109990 

83088 283.25 31611361 A A 40109990 40109990 

83632 515 31611360 A A 40109990 40109990 

84181 165.83 31610986 A A 40109990 40109990 

86255 381.1 31610985 A A 40109990 40109990 

84315 36.05 31611358 A A 40109990 40109990 

84999 165.83 31611357 A A 40109990 40109990 

G0431 195.7 31611359 A A 40109990 40109990 

84302 135.96 31610878 A A 40109990 40109990 

84999 135.96 31610879 A A 40109990 40109990 

82438 40.17 31610880 A A 40109990 40109990 

83735 150.38 31610881 A A 40109990 40109990 

82491 140.08 31610224 A A 40109990 40109990 

84150 618 31611364 A A 40109990 40109990 

86316 139.05 31610782 A A 40109990 40109990 

87591 199.82 31611367 A A 40109990 40109990 

87491 199.82 31611366 A A 40109990 40109990 

80299 247.2 31611365 A A 40109990 40109990 

88184 154.5 31611369 A A 40109990 40109990 

87186 247.2 31611368 A A 40109990 40109990 

87340 93.73 31600740 A A 40109990 40109990 

83858 213.21 A A 40109990 40109990 

81220 452.17 A A 40109990 40109990 

82533 162.74 A A 40109990 40109990 

86817 444.96 A A 40109990 40109990 

83497 163.77 A A 40109990 40109990 

85730 72.1 A A 40109990 40109990 

82570 41.2 A A 40109990 40109990 

86331 183.34 A A 40109990 40109990 

83835 319.3 A A 40109990 40109990 

84591 155.53 A A 40109990 40109990 

G0431 234.84 A A 40109990 40109990 

87555 454.23 A A 40109990 40109990 

83516 626.24 A A 40109990 40109990 

86817 361.53 A A 40109990 40109990 

81220 22.66 A A 40109990 40109990 

80299 92 A A 40109990 40109990 

86480 303 A A 40109990 40109990 

86341 395 A A 40109990 40109990 

83630 329 A A 40109990 40109990 

82610 284 A A 40109990 40109990

84378 184 A A 40109990 40109990 

80299 500 A A 40109990 40109990 

84442 48 A A 40109990 40109990 

82633 81 A A 40109990 40109990 

80299 284 A A 40109990 40109990 

86235 144 A A 40109990 40109990 

87799 984 A A 40109990 40109990 

83036 125 A A 40109990 40109990 

82507 455 A A 40109990 40109990 

82677 84 A A 40109990 40109990 

86606 26 A A 40109990 40109990 

83018 263 A A 40109990 40109990 

83887 134 A A 40109990 40109990 

86618 657 A A 40109990 40109990 

85306 947 A A 40109990 40109990 

82542 471 A A 40109990 40109990 

82306 244.11 A A 40109990 40109990 

86709 253 A A 40109990 40109990 

81275 0 A A 40109990 40109990 

87798 309.21 A A 40109990 40109990 

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83516 70.22 A A 40109990 40109990 

83516 70.22 A A 40109990 40109990 

83516 70.22 A A 40109990 40109990 

83516 70.22 A A 40109990 40109990 

83516 70.22 A A 40109990 40109990 

86235 70.22 A A 40109990 40109990 

86235 70.22 A A 40109990 40109990 

86235 70.22 A A 40109990 40109990 

87621 134.88 A A 40109990 40109990 

86160 216.42 A A 40109990 40109990 

87177 23.04 A A 40109990 40109990 

87209 21.26 A A 40109990 40109990 

82542 297.37 A A 40109990 40109990 

85610 67.25 A A 40109990 40109990 

85730 67.25 A A 40109990 40109990 

80184 60.3 A A 40109990 40109990 

86038 22.61 A A 40109990 40109990 

86039 13.16 A A 40109990 40109990 

0 A A 40109990 40109990 

86641 44.68 A A 40109990 40109990 

87449 48.05 A A 40109990 40109990 

G0431 457.89 A A 40109990 40109990 

G0431 178.95 A A 40109990 40109990 

82145 253.82 A A 40109990 40109990 

86255 71.42 A A 40109990 40109990 

83519 310.53 A A 40109990 40109990

86343 355.26 A A 40109990 40109990 

83069 47.88 A A 40109990 40109990 

83986 40.24 A A 40109990 40109990 

82340 40.24 A A 40109990 40109990 

84560 40.24 A A 40109990 40109990 

82507 40.24 A A 40109990 40109990 

84300 40.24 A A 40109990 40109990 

84392 40.24 A A 40109990 40109990 

84105 40.24 A A 40109990 40109990 

83735 40.24 A A 40109990 40109990 

84133 40.24 A A 40109990 40109990 

82570 40.24 A A 40109990 40109990 

83945 40.24 A A 40109990 40109990 

82010 170 A A 40109990 40109990 

83540 162.37 A A 40109990 40109990 

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84157 0 A A 40109990 40109990 

84202 0 0 A A 40109990 40109990 

84244 0 A A 40109990 40109990 

84255 0 A A 40109990 40109990 

84255 0 A A 40109990 40109990 

84260 0 A A 40109990 40109990 

84270 0 A A 40109990 40109990 

84402 0 A A 40109990 40109990 

84403 0 A A 40109990 40109990 

84482 0 A A 40109990 40109990 

85732 0 A A 40109990 40109990 

86063 0 A A 40109990 40109990 

86235 0 A A 40109990 40109990 

86255 0 A A 40109990 40109990 

86317 0 A A 40109990 40109990 

86382 0 A A 40109990 40109990 

86671 0 A A 40109990 40109990 

86702 0 A A 40109990 40109990 

86762 0 A A 40109990 40109990

86765 0 A A 40109990 40109990 

86765 0 A A 40109990 40109990 

86780 0 A A 40109990 40109990 

87536 0 A A 40109990 40109990 

86001 0 A A 40109990 40109990 

86001 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86001 0 A A 40109990 40109990 

86001 0 A A 40109990 40109990 

86001 0 A A 40109990 40109990 

86001 0 A A 40109990 40109990 

86001 0 A A 40109990 40109990 

86001 0 A A 40109990 40109990 

86001 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86003 0 A A 40109990 40109990 

86790 115.36 31800003 A A 40109990 40109990 

86710 143.17 31800006 A A 40109990 40109990 

86710 142.14 31800007 A A 40109990 40109990 

86603 115.36 31800008 A A 40109990 40109990 

86756 115.36 31800009 A A 40109990 40109990

86790 115.36 31800010 A A 40109990 40109990 

86790 115.36 31800011 A A 40109990 40109990 

86756 148.32 31800012 A A 40109990 40109990 

86735 133.9 31800014 A A 40109990 40109990 

87252 265.74 31800019 A A 40109990 40109990 

86765 131.84 31800021 A A 40109990 40109990 

86658 118.45 31800037 A A 40109990 40109990 

86780 135.96 31800048 A A 40109990 40109990 

87252 265.74 31800050 A A 40109990 40109990 

86592 52.53 31800051 A A 40109990 40109990 

86720 135.96 31800055 A A 40109990 40109990 

86612 32.96 31800057 A A 40109990 40109990 

86606 133.9 31800058 A A 40109990 40109990 

83655 30.9 31800062 A A 40109990 40109990 

87106 314.15 31800075 A A 40109990 40109990 

86235 182.31 31800095 A A 40109990 40109990 

86255 231.75 31800099 A A 40109990 40109990 

82355 126.69 31800105 A A 40109990 40109990 

82128 143.17 31800106 A A 40109990 40109990 

82105 172.01 31800107 A A 40109990 40109990 

86618 175.1 31800200 A A 40109990 40109990 

86256 148.32 31800203 A A 40109990 40109990 

86765 131.84 31800350 A A 40109990 40109990 

86611 103 31800497 A A 40109990 40109990 

84630 114.33 31810039 A A 40109990 40109990 

86235 228.66 31811429 A A 40109990 40109990 

86648 604.61 31811736 A A 40109990 40109990 

86304 194.67 31823745 A A 40109990 40109990 

84275 236.9 31823746 A A 40109990 40109990 

83520 114.33 31823747 A A 40109990 40109990 

82105 200.85 31823748 A A 40109990 40109990 

84702 153.47 31823749 A A 40109990 40109990 

82677 247.2 31823750 A A 40109990 40109990 

86300 194.67 31823758 A A 40109990 40109990 

82677 66.95 31830127 A A 40109990 40109990 

81220 94.76 31610147 A A 40109990 40109990 

83520 176.13 31610148 A A 40109990 40109990 

86688 214.24 31610155 A A 40109990 40109990 

81220 36.05 31610157 A A 40109990 40109990 

81220 0 31610280 A A 40109990 40109990 

88188 109.18 31610909 A A 40109990 40109990 

87077 111.24 31680001 A A 40109990 40109990 

87076 148.32 31680000 A A 40109990 40109990 

82491 0 A A 40109990 40109990 

36415 0 31900001 A A 40109990 40109990 

0 31900003 A A 40109990 40109990 

0 31943210 A A 40109990 40109990

P9603 0 31943300 A A 40109990 40109990 

P9604 0 31943301 A A 40109990 40109990 

P9604 0 31943350 A A 40109990 40109990 

0 31944325 A A 40109990 40109990 

36415 25.75 31993249 A A 40109990 40109990 

36416 47.38 31993355 A A 40109990 40109990 

36415 16.48 31993421 A A 40109990 40109990 

36415 16.48 31993422 A A 40109990 40109990 

36415 47.38 31993454 A A 40109990 40109990 

36415 0 A A 40109990 40109990 

81220 0 A A 40109990 40109990 

P9036 0 32400670 A A 41009990 41009990 

P9033 0 32415550 A A 41009990 41009990 

P9040 0 32415553 A A 41009990 41009990 

43 32423451 A A 41009990 41009990 

P9010 0 32433340 A A 41009990 41009990 

86890 0 32433342 A A 41009990 41009990 

86905 0 32441348 A A 41009990 41009990 

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86813 0 32445785 A A 41009990 41009990 

86816 551 32445786 A A 41009990 41009990 

P9016 0 32460032 A A 41009990 41009990 

P9047 0 32460081 A A 41009990 41009990 

P9019 0 32460107 A A 41009990 41009990 

P9023 217 32460111 A A 41009990 41009990 

P9012 0 32460123 A A 41009990 41009990 

P9017 0 32460131 A A 41009990 41009990 

P9034 0 32460156 A A 41009990 41009990 

J7195 0 A A 41009990 41009990 

P9031 0 A A 41009990 41009990 

72141 0 A A 42759990 42759990 

72142 0 A A 42759990 42759990 

72156 0 A A 42759990 42759990 

72148 0 A A 42759990 42759990 

72149 0 A A 42759990 42759990 

70540 0 A A 42759990 42759990 

70542 0 A A 42759990 42759990 

70543 0 A A 42759990 42759990 

72146 0 A A 42759990 42759990 

72147 0 A A 42759990 42759990 

72157 0 A A 42759990 42759990 

73221 LT 0 A A 42759990 42759990 

73221 RT 0 A A 42759990 42759990 

73222 LT 0 A A 42759990 42759990 

73222 RT 0 A A 42759990 42759990 

73223 LT 0 A A 42759990 42759990 

73223 RT 0 A A 42759990 42759990

73721 LT 0 A A 42759990 42759990 

73721 RT 0 A A 42759990 42759990 

73722 LT 0 A A 42759990 42759990 

73722 RT 0 A A 42759990 42759990 

73723 LT 0 A A 42759990 42759990 

73723 RT 0 A A 42759990 42759990 

73221 LT 0 A A 42759990 42759990 

73221 RT 0 A A 42759990 42759990 

73222 LT 0 A A 42759990 42759990 

73222 RT 0 A A 42759990 42759990 

73223 LT 0 A A 42759990 42759990 

73223 RT 0 A A 42759990 42759990 

73221 LT 0 A A 42759990 42759990 

73221 RT 0 A A 42759990 42759990 

73222 LT 0 A A 42759990 42759990 

73222 RT 0 A A 42759990 42759990 

73223 LT 0 A A 42759990 42759990 

73223 RT 0 A A 42759990 42759990 

73721 LT 0 A A 42759990 42759990 

73721 RT 0 A A 42759990 42759990 

73722 LT 0 A A 42759990 42759990 

73722 RT 0 A A 42759990 42759990 

73723 LT 0 A A 42759990 42759990 

73723 RT 0 A A 42759990 42759990 

73218 LT 0 A A 42759990 42759990 

73218 RT 0 A A 42759990 42759990 

73718 LT 0 A A 42759990 42759990 

73718 RT 0 A A 42759990 42759990 

74181 0 A A 42759990 42759990 

74182 0 A A 42759990 42759990 

74183 0 A A 42759990 42759990 

71550 0 A A 42759990 42759990 

71551 0 A A 42759990 42759990 

71552 0 A A 42759990 42759990 

70540 0 A A 42759990 42759990 

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70543 0 A A 42759990 42759990 

70551 0 A A 42759990 42759990 

70552 0 A A 42759990 42759990 

70553 0 A A 42759990 42759990 

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70551 0 A A 42759990 42759990 

70553 0 A A 42759990 42759990 

73721 LT 0 A A 42759990 42759990 

73721 RT 0 A A 42759990 42759990 

73723 LT 0 A A 42759990 42759990 

73723 RT 0 A A 42759990 42759990

73722 RT 0 A A 42759990 42759990 

73722 LT 0 A A 42759990 42759990 

74181 0 A A 42759990 42759990 

70540 0 A A 42759990 42759990 

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72195 0 A A 42759990 42759990 

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72197 0 A A 42759990 42759990 

70336 50 0 A A 42759990 42759990 

70336 LT 0 A A 42759990 42759990 

70336 RT 0 A A 42759990 42759990 

73219 LT 0 A A 42759990 42759990 

73219 RT 0 A A 42759990 42759990 

73220 LT 0 A A 42759990 42759990 

77059 0 A A 42759990 42759990 

77058 LT 0 A A 42759990 42759990 

77058 RT 0 A A 42759990 42759990 

0159T 0 A A 42759990 42759990 

C8907 0 A A 42759990 42759990 

76376 0 A A 42759990 42759990 

73719 LT 0 A A 42759990 42759990 

73719 RT 0 A A 42759990 42759990 

73720 LT 0 A A 42759990 42759990 

73720 RT 0 A A 42759990 42759990 

76498 0 A A 42759990 42759990 

76498 0 A A 42759990 42759990 

73725 LT 0 A A 42759990 42759990 

72158 0 A A 42759990 42759990 

73221 LT 0 A A 42759990 42759990 

73220 RT 0 A A 42759990 42759990 

70551 0 A A 42759990 42759990 

73725 RT 0 A A 42759990 42759990 

73725 50 0 A A 42759990 42759990 

71555 0 A A 42759990 42759990 

70544 0 A A 42759990 42759990 

70545 0 A A 42759990 42759990 

70546 0 A A 42759990 42759990 

70547 0 A A 42759990 42759990 

70549 0 A A 42759990 42759990 

72198 0 A A 42759990 42759990 

72198 0 A A 42759990 42759990 

73222 LT 0 A A 42759990 42759990 

73222 RT 0 A A 42759990 42759990 

73221 LT 0 A A 42759990 42759990 

73221 RT 0 A A 42759990 42759990 

73223 LT 0 A A 42759990 42759990

73223 RT 0 A A 42759990 42759990 

A9579 0 A A 42759990 42759990 

76770 17.469 A A 42539990 42539990 

76705 9.311 A A 42539990 42539990 

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93971 0 A A 42539990 42539990 

76819 11.66 A A 42539990 42539990 

76645 18.622 A A 42539990 42539990 

76645 LT 9.311 A A 42539990 42539990 

76645 RT 9.311 A A 42539990 42539990 

93880 14.873 A A 42539990 42539990 

76604 6.674 A A 42539990 42539990 

93976 9.888 A A 42539990 42539990 

93975 14.75 A A 42539990 42539990 

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58340 8.034 A A 42539990 42539990 

76831 13.967 A A 42539990 42539990 

76801 12.813 A A 42539990 42539990 

76810 10.959 A A 42539990 42539990 

76805 16.315 A A 42539990 42539990 

76810 10.959 A A 42539990 42539990 

76805 9.311 A A 42539990 42539990 

76810 10.959 A A 42539990 42539990 

76816 9.311 A A 42539990 42539990 

76815 8.116 A A 42539990 42539990 

76817 9.311 A A 42539990 42539990 

76856 17.469 A A 42539990 42539990 

76830 9.311 A A 42539990 42539990 

76857 9.311 A A 42539990 42539990 

93971 LT 9.806 A A 42539990 42539990 

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93970 13.06 A A 42539990 42539990 

93970 13.06 A A 42539990 42539990 

76770 17.469 A A 42539990 42539990 

76870 11.66 A A 42539990 42539990 

76536 11.66 A A 42539990 42539990 

G0389 0 A A 42539990 42539990 

77082 0 A A 42119990 42119990 

77080 0 A A 42119990 42119990 

76536 0 A A 42539990 42539990 

95810 15.316 50000300 A A 44609990 44609990 

95810 52 15.316 A A 44609990 44609990 

95811 18.046 50000350 A A 44609990 44609990 

95811 52 18.046 A A 44609990 44609990 

95805 18.622 50000375 A A 44609990 44609990

95805 52 18.622 A A 44609990 44609990 

95805 18.622 A A 44609990 44609990 

95811 52 18.046 A A 44609990 44609990 

95811 18.046 A A 44609990 44609990 

95807 52 10.92 A A 44609990 44609990 

95806 0 A A 44609990 44609990 

95782 0 A A 44609990 44609990 

95782 52 0 A A 44609990 44609990 

95783 0 A A 44609990 44609990 

95783 52 0 A A 44609990 44609990 

0 A A 44609990 44609990 

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0 A A 44609990 44609990 

95819 12.69 30000022 A A 41409990 41409990 

95816 12.69 30000090 A A 41409990 41409990 

95824 11.289 30000095 A A 41409990 41409990 

95822 10.176 30000100 A A 41409990 41409990 

95812 0 A A 41409990 41409990 

95951 0 A A 41409990 41409990 

95953 0 A A 41409990 41409990 

95816 52 0 A A 41409990 41409990 

93005 1.112 33000019 A A 41209990 41209990 

93005 76 1.112 A A 41209990 41209990 

93270 6.386 33000030 A A 41209990 41209990 

93271 0 A A 41209990 41209990 

93272 0 A A 41209990 41209990 

93272 0 A A 41209990 41209990 

93272 0 A A 41209990 41209990 

93272 0 A A 41209990 41209990 

93272 0 A A 41209990 41209990 

93272 0 A A 41209990 41209990 

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93225 6.386 33000068 A A 41209990 41209990 

93226 0 A A 41209990 41209990 

93227 0 A A 41209990 41209990 

93227 0 A A 41209990 41209990 

93227 0 A A 41209990 41209990 

93227 0 A A 41209990 41209990 

93227 0 A A 41209990 41209990 

93227 0 A A 41209990 41209990 

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93017 6.283 33000084 A A 41209990 41209990 

93017 6.448 33000087 A A 41209990 41209990 

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93041 0.577 33000092 A A 41209990 41209990 

93786 1.741 33000101 A A 41209990 41209990 

93015 0 A A 41209990 41209990

93016 0 A A 41209990 41209990 

93018 0 A A 41209990 41209990 

93005 1.112 33001229 A A 41209990 41209990 

93005 0 A A 41209990 41209990 

0 A A 60506299 10001000 

J3490 0.082 37300506 A A 41209990 41209990 

J3490 0.731 37300507 A A 41209990 41209990 

J1250 0.67 37303501 A A 41209990 41209990 

J3490 0.082 37303502 A A 41209990 41209990 

J3490 0.082 37303503 A A 41209990 41209990 

J3490 0.082 37303504 A A 41209990 41209990 

J3490 0.082 37303505 A A 41209990 41209990 

J1245 0.072 35303720 A A 41209990 41209990 

70250 3.502 34010009 A A 42119990 42119990 

70260 5.768 34010017 A A 42119990 42119990 

70220 5.768 34010025 A A 42119990 42119990 

70130 6.221 34010033 A A 42119990 42119990 

70160 3.502 34010041 A A 42119990 42119990 

70110 5.85 34010058 A A 42119990 42119990 

70330 5.85 34010066 A A 42119990 42119990 

70030 3.502 34010074 A A 42119990 42119990 

70200 5.85 34010082 A A 42119990 42119990 

70150 5.85 34010090 A A 42119990 42119990 

70360 3.502 34010132 A A 42119990 42119990 

71010 3.543 34011007 A A 42119990 42119990 

71020 3.79 34011015 A A 42119990 42119990 

71022 6.18 34011023 A A 42119990 42119990 

71010 3.543 34011031 A A 42119990 42119990 

71101 LT 4.656 34011050 A A 42119990 42119990 

71101 RT 4.656 34011051 A A 42119990 42119990 

71111 6.18 34011056 A A 42119990 42119990 

71120 4.656 34011064 A A 42119990 42119990 

71130 4.656 34011072 A A 42119990 42119990 

71030 6.18 34011080 A A 42119990 42119990 

71035 3.79 34011098 A A 42119990 42119990 

71010 3.543 34011114 A A 42119990 42119990 

71020 3.79 34011130 A A 42119990 42119990 

72040 2.884 34012005 A A 42119990 42119990 

72040 2.884 34012006 A A 42119990 42119990 

72052 5.356 34012013 A A 42119990 42119990 

72050 5.356 34012021 A A 42119990 42119990 

72050 5.356 34012025 A A 42119990 42119990 

72072 3.502 34012039 A A 42119990 42119990 

72070 2.966 34012055 A A 42119990 42119990 

72100 4.079 34012062 A A 42119990 42119990 

72114 7.004 34012088 A A 42119990 42119990 

72220 3.502 34012096 A A 42119990 42119990

77082 3.543 34012100 A A 42119990 42119990 

72010 10.465 34012104 A A 42119990 42119990 

72090 8.158 34012112 A A 42119990 42119990 

72170 3.502 34012120 A A 42119990 42119990 

77074 10.465 34012138 A A 42119990 42119990 

72202 5.85 34012146 A A 42119990 42119990 

9.27 34012153 A A 42119990 42119990 

72100 4.079 34012161 A A 42119990 42119990 

72020 2.802 34012187 A A 42119990 42119990 

72069 3.502 34012195 A A 42119990 42119990 

72110 7.004 34012203 A A 42119990 42119990 

72110 7.004 34012211 A A 42119990 42119990 

73140 LT 2.348 34012230 A A 42119990 42119990 

73140 RT 2.348 34012231 A A 42119990 42119990 

72114 7.004 34012238 A A 42119990 42119990 

77075 2.802 34012248 A A 42119990 42119990 

73140 LT 2.348 34021007 A A 42119990 42119990 

73140 RT 2.348 34021008 A A 42119990 42119990 

73130 LT 2.925 34021023 A A 42119990 42119990 

73130 RT 2.925 34021024 A A 42119990 42119990 

73130 50 3.378 34021025 A A 42119990 42119990 

73130 LT 2.348 34021056 A A 42119990 42119990 

73130 RT 2.348 34021057 A A 42119990 42119990 

73110 LT 2.925 34021064 A A 42119990 42119990 

73110 RT 2.925 34021065 A A 42119990 42119990 

73110 50 4.244 34021066 A A 42119990 42119990 

73090 LT 2.925 34021090 A A 42119990 42119990 

73090 RT 2.925 34021091 A A 42119990 42119990 

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73060 RT 3.502 34021123 A A 42119990 42119990 

73030 LT 4.079 34021148 A A 42119990 42119990 

73030 RT 4.079 34021149 A A 42119990 42119990 

73030 50 4.903 34021150 A A 42119990 42119990 

73050 4.656 34021162 A A 42119990 42119990 

73000 LT 2.348 34021189 A A 42119990 42119990 

73000 LT 2.348 34021190 A A 42119990 42119990 

73010 LT 3.502 34021205 A A 42119990 42119990 

73010 RT 3.502 34021206 A A 42119990 42119990 

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73660 RT 2.348 34021222 A A 42119990 42119990 

73630 LT 2.925 34021247 A A 42119990 42119990 

73630 RT 2.925 34021248 A A 42119990 42119990 

73630 50 4.244 34021249 A A 42119990 42119990 

73650 LT 2.348 34021262 A A 42119990 42119990 

73650 RT 2.348 34021263 A A 42119990 42119990 

73610 LT 2.925 34021288 A A 42119990 42119990 

73610 RT 2.925 34021289 A A 42119990 42119990

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73590 RT 3.502 34021331 A A 42119990 42119990 

73610 50 3.502 34021290 A A 42119990 42119990 

73560 LT 3.502 34021346 A A 42119990 42119990 

73560 RT 3.502 34021347 A A 42119990 42119990 

73560 50 4.985 34021348 A A 42119990 42119990 

73564 LT 4.656 34021361 A A 42119990 42119990 

73564 RT 4.656 34021362 A A 42119990 42119990 

73564 50 6.88 34021363 A A 42119990 42119990 

73550 LT 3.502 34021387 A A 42119990 42119990 

73550 RT 3.502 34021388 A A 42119990 42119990 

73520 6.18 34021402 A A 42119990 42119990 

73510 LT 3.914 34021411 A A 42119990 42119990 

73510 RT 3.914 34021412 A A 42119990 42119990 

73510 LT 3.914 34021429 A A 42119990 42119990 

73510 RT 3.914 34021430 A A 42119990 42119990 

73080 LT 3.502 34021452 A A 42119990 42119990 

73080 RT 3.502 34021453 A A 42119990 42119990 

77072 2.348 34021469 A A 42119990 42119990 

73540 50 4.656 34021477 A A 42119990 42119990 

73030 LT 4.079 34021486 A A 42119990 42119990 

73030 RT 4.079 34021487 A A 42119990 42119990 

73030 50 4.903 34021488 A A 42119990 42119990 

73564 LT 4.656 34021494 A A 42119990 42119990 

73564 RT 4.656 34021495 A A 42119990 42119990 

73564 50 5.562 34021496 A A 42119990 42119990 

73550 50 4.202 34021389 A A 42119990 42119990 

73590 50 4.202 34021332 A A 42119990 42119990 

77075 7.004 34031005 A A 42119990 42119990 

77073 3.708 34031013 A A 42119990 42119990 

74000 3.502 34031039 A A 42119990 42119990 

74020 4.779 34031047 A A 42119990 42119990 

74220 4.656 34031062 A A 42119990 42119990 

74246 11.66 34031070 A A 42119990 42119990 

74270 13.967 34031088 A A 42119990 42119990 

74020 4.779 34031112 A A 42119990 42119990 

74250 9.311 34031120 A A 42119990 42119990 

74249 16.274 34031138 A A 42119990 42119990 

74305 5.562 34031146 A A 42119990 42119990 

74300 9.311 34031153 A A 42119990 42119990 

74000 3.502 34031179 A A 42119990 42119990 

74420 7.457 34031204 A A 42119990 42119990 

74420 7.457 34031205 A A 42119990 42119990 

74430 6.139 34031229 A A 42119990 42119990 

74455 8.364 34031237 A A 42119990 42119990 

74415 13.967 34031286 A A 42119990 42119990 

74280 16.274 34031294 A A 42119990 42119990

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74000 0 A A 42119990 42119990 

0 A A 42119990 42119990 

75820 0 A A 42119990 42119990 

75820 0 A A 42119990 42119990 

75820 0 A A 42119990 42119990 

75820 0 A A 42119990 42119990 

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77031 38.069 34041220 A A 42119990 42119990 

20.93 34041221 A A 42119990 42119990 

20.93 34041222 A A 42119990 42119990 

6.18 34041223 A A 42119990 42119990 

6.18 34041224 A A 42119990 42119990 

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77032 20.147 34041227 A A 42119990 42119990 

19290 LT 3.172 34041232 A A 42119990 42119990 

19290 RT 3.172 34041233 A A 42119990 42119990 

19291 LT 3.172 34041234 A A 42119990 42119990 

19291 RT 3.172 34041235 A A 42119990 42119990 

G0204 14.832 34041240 A A 42119990 42119990 

G0206 RT 9.476 34041241 A A 42119990 42119990 

G0206 LT 9.476 34041242 A A 42119990 42119990 

G0202 12.978 34041243 A A 42119990 42119990 

77002 0 A A 42119990 42119990 

G0202 0 A A 42119990 42119990 

19103 59 20.93 A A 42119990 42119990 

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77051 0 A A 42119990 42119990 

76080 0 A A 42119990 42119990 

20501 0 A A 42119990 42119990 

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73615 RT 15.409 34041279 A A 42119990 42119990 

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73085 RT 17.469 34041287 A A 42119990 42119990 

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73580 RT 15.409 34041295 A A 42119990 42119990 

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73525 RT 17.469 34041303 A A 42119990 42119990 

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73115 RT 15.409 34041321 A A 42119990 42119990 

73040 LT 17.469 34041328 A A 42119990 42119990 

73040 RT 17.469 34041329 A A 42119990 42119990 

G0206 RT 0 A A 42119990 42119990 

G0204 0 A A 42119990 42119990 

36598 0 A A 42119990 42119990 

49446 0 A A 42119990 42119990

49450 0 A A 42119990 42119990 

49440 0 A A 42119990 42119990 

49440 0 A A 42119990 42119990 

49451 0 A A 42119990 42119990 

49441 0 A A 42119990 42119990 

G0202 52 0 A A 42119990 42119990 

76098 3.502 34041368 A A 42119990 42119990 

76098 3.502 34041369 A A 42119990 42119990 

76098 3.502 34041370 A A 42119990 42119990 

76080 12.36 34041376 A A 42119990 42119990 

74740 13.967 34041400 A A 42119990 42119990 

74425 LT 12.978 34041419 A A 42119990 42119990 

74425 RT 12.978 34041420 A A 42119990 42119990 

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74475 RT 35.061 34041436 A A 42119990 42119990 

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72240 25.626 34041467 A A 42119990 42119990 

72265 25.626 34041483 A A 42119990 42119990 

72255 25.626 34041491 A A 42119990 42119990 

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74480 LT 35.061 34041658 A A 42119990 42119990 

74480 RT 35.061 34041659 A A 42119990 42119990 

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75980 35.061 34041764 A A 42119990 42119990 

75989 19.158 34041766 A A 42119990 42119990 

15.285 34041771 A A 42119990 42119990 

20.6 34041772 A A 42119990 42119990 

15.285 34041797 A A 42119990 42119990 

20.6 34041798 A A 42119990 42119990 

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20.6 34051085 A A 42119990 42119990 

15.285 34051086 A A 42119990 42119990 

20.6 34051087 A A 42119990 42119990 

76000 15.285 34051128 A A 42119990 42119990 

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75860 39.346 34051144 A A 42119990 42119990 

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70210 2.348 34061127 A A 42119990 42119990 

76010 5.85 34061135 A A 42119990 42119990 

75982 31.889 34061184 A A 42119990 42119990 

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1.566 34061318 A A 42119990 42119990 

1.566 34061319 A A 42119990 42119990 

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24220 RT 1.772 34061335 A A 42119990 42119990 

1.566 34061342 A A 42119990 42119990 

1.566 34061343 A A 42119990 42119990 

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1.566 34061367 A A 42119990 42119990 

1.566 34061368 A A 42119990 42119990 

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50392 RT 49.11 34061418 A A 42119990 42119990 

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50398 RT 19.117 34061741 A A 42119990 42119990 

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0 A A 42119990 42119990 

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0 34304000 A A 42119990 42119990 

0 A A 42119990 42119990 

0 A A 42119990 42119990 

0 A A 42119990 42119990 

0 A A 42119990 42119990 

0 A A 42119990 42119990 

J3300 0 A A 42119990 42119990 

J3490 0 A A 42119990 42119990 

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78215 20.971 35091032 A A 42409990 42409990 

78580 16.686 35091065 A A 42409990 42409990 

78701 30.282 35091073 A A 42409990 42409990 

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78579 18.581 35091230 A A 42409990 42409990 

78278 26.821 35091248 A A 42409990 42409990 

78582 33.372 35091255 A A 42409990 42409990 

78290 18.581 35091263 A A 42409990 42409990 

78262 18.581 35091271 A A 42409990 42409990 

78315 30.282 35091289 A A 42409990 42409990 

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78300 11.742 35091305 A A 42409990 42409990 

78761 18.581 35091313 A A 42409990 42409990 

78320 29.128 35091321 A A 42409990 42409990 

78710 29.128 35091339 A A 42409990 42409990 

78607 46.391 35091354 A A 42409990 42409990 

78451 78.77 35091361 A A 42409990 42409990 

78452 78.77 35091371 A A 42409990 42409990 

78205 26.821 35091412 A A 42409990 42409990 

0 35091563 A A 42409990 42409990 

0 35091574 A A 42409990 42409990 

78264 37.08 35091585 A A 42409990 42409990 

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78807 85.696 35091041 A A 42409990 42409990 

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78805 71.853 35091042 A A 42409990 42409990 

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78012 0 A A 42409990 42409990 

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78452 78.77 A A 42409990 42409990 

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78070 14.91 A A 42409990 42409990 

78598 0 A A 42409990 42409990 

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78452 26 0 A A 42409990 42409990 

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78597 0 A A 42409990 42409990 

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A9502 7.498 35303780 A A 42409990 42409990 

A9569 21.836 35303800 A A 42409990 42409990 

A9512 0.247 35303830 A A 42409990 42409990 

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A9539 2.225 35303870 A A 42409990 42409990 

A9541 1.277 35303880 A A 42409990 42409990 

A9537 2.843 35303890 A A 42409990 42409990 

A9503 1.277 35303920 A A 42409990 42409990

A9538 2.554 35303930 A A 42409990 42409990 

A9516 0 A A 42409990 42409990 

A9500 0 A A 42409990 42409990 

J3490 2.39 35400005 A A 42409990 42409990 

A9505 0 A A 42409990 42409990 

A9505 0 A A 42409990 42409990 

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2.637 36068610 A A 42519990 42519990 

2.307 36068611 A A 42519990 42519990 

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8.034 36068952 A A 42519990 42519990 

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5.274 36069573 A A 42519990 42519990 

5.315 36069702 A A 42519990 42519990 

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40.17 36069583 A A 42519990 42519990 

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76810 10.959 36069601 A A 42519990 42519990 

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8.075 36069630 A A 42519990 42519990 

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13.514 36069811 A A 42519990 42519990 

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0 A A 42519990 42519990 

0 A A 42519990 42519990 

0 A A 42519990 42519990 

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76942 0 A A 42519990 42519990 

76942 0 A A 42519990 42519990 

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76885 9.311 36069670 A A 42519990 42519990 

76886 5.191 36069675 A A 42519990 42519990 

76942 8.034 36069682 A A 42519990 42519990 

76942 8.034 36069690 A A 42519990 42519990 

76937 2.142 36069691 A A 42519990 42519990 

22.413 36069692 A A 42519990 42519990 

23.69 36069701 A A 42519990 42519990 

0 A A 42519990 42519990 

75989 0 A A 42519990 42519990 

0 A A 42519990 42519990 

93976 0 A A 42519990 42519990 

93975 0 A A 42519990 42519990 

76536 0 A A 42519990 42519990 

96374 3.873 36100010 A A 42519990 42519990 

Q9957 5.768 36303720 A A 42519990 42519990 

A7043 0 A A 42519990 42519990 

A7042 0 A A 42519990 42519990 

A4300 0 A A 42519990 42519990

C1751 0 A A 42519990 42519990 

0 A A 42519990 42519990 

78815 PI 46.556 A A 42209990 42209990 

78815 PS 46.556 A A 42209990 42209990 

78816 PI 46.556 A A 42209990 42209990 

78816 PS 46.556 A A 42209990 42209990 

78814 46.556 20000151 A A 42209990 42209990 

78608 42.292 20000160 A A 42209990 42209990 

78608 42.292 20000161 A A 42209990 42209990 

78459 42.055 20000170 A A 42209990 42209990 

78491 39.428 20000171 A A 42209990 42209990 

78492 39.428 20000172 A A 42209990 42209990 

78815 PI 0 A A 42209990 42209990 

78815 PS 0 A A 42209990 42209990 

78816 PI 0 A A 42209990 42209990 

78816 PS 0 A A 42209990 42209990 

A9552 7.869 20100010 A A 42209990 42209990 

74181 15.357 45101003 A A 42709990 42709990 

74182 18.519 45101004 A A 42709990 42709990 

74183 34.052 45101005 A A 42709990 42709990 

72141 15.182 45101037 A A 42709990 42709990 

72142 18.715 45101045 A A 42709990 42709990 

72156 34.969 45101334 A A 42709990 42709990 

71550 15.182 45101052 A A 42709990 42709990 

71551 18.519 45101053 A A 42709990 42709990 

71552 33.485 45101054 A A 42709990 42709990 

70540 14.914 45101078 A A 42709990 42709990 

70542 18.468 45101079 A A 42709990 42709990 

70543 34.052 45101080 A A 42709990 42709990 

70551 15.182 45101086 A A 42709990 42709990 

70552 19.168 45101094 A A 42709990 42709990 

70553 34.969 45101326 A A 42709990 42709990 

70553 34.969 45101095 A A 42709990 42709990 

70551 13.957 A A 42709990 42709990 

73222 LT 0 A A 42709990 42709990 

73222 RT 0 A A 42709990 42709990 

73221 LT 0 A A 42709990 42709990 

70553 34.969 45101096 A A 42709990 42709990 

73221 RT 0 A A 42709990 42709990 

73223 LT 0 A A 42709990 42709990 

73223 RT 0 A A 42709990 42709990 

73721 LT 14.914 45101104 A A 42709990 42709990 

73721 RT 14.914 45101105 A A 42709990 42709990 

73723 LT 21.991 45101106 A A 42709990 42709990 

73723 RT 21.991 45101107 A A 42709990 42709990 

73722 RT 18.705 45101108 A A 42709990 42709990 

73722 LT 18.705 45101109 A A 42709990 42709990

72148 17.757 45101136 A A 42709990 42709990 

72149 19.065 45101144 A A 42709990 42709990 

72158 34.969 45101359 A A 42709990 42709990 

74181 15.357 45101160 A A 42709990 42709990 

70540 13.184 45101169 A A 42709990 42709990 

70542 14.914 45101170 A A 42709990 42709990 

70543 34.052 45101171 A A 42709990 42709990 

70540 13.184 45101177 A A 42709990 42709990 

70542 14.914 45101178 A A 42709990 42709990 

70543 34.052 45101179 A A 42709990 42709990 

72195 15.357 45101185 A A 42709990 42709990 

72196 18.519 45101186 A A 42709990 42709990 

72197 34.052 45101187 A A 42709990 42709990 

72146 17.757 45101201 A A 42709990 42709990 

72147 19.065 45101219 A A 42709990 42709990 

72157 34.969 45101342 A A 42709990 42709990 

70336 50 15.1 45101227 A A 42709990 42709990 

70336 LT 15.1 45101228 A A 42709990 42709990 

70336 RT 15.1 45101229 A A 42709990 42709990 

73221 LT 14.914 45101253 A A 42709990 42709990 

73221 RT 14.914 45101254 A A 42709990 42709990 

73222 LT 18.705 45101255 A A 42709990 42709990 

73222 RT 18.705 45101256 A A 42709990 42709990 

73223 LT 34.052 45101257 A A 42709990 42709990 

73223 RT 34.052 45101258 A A 42709990 42709990 

73222 LT 18.705 45101259 A A 42709990 42709990 

73222 RT 18.705 45101260 A A 42709990 42709990 

73721 LT 14.914 45101271 A A 42709990 42709990 

73721 RT 14.914 45101272 A A 42709990 42709990 

73722 LT 18.705 45101273 A A 42709990 42709990 

73722 RT 18.705 45101274 A A 42709990 42709990 

73723 LT 34.052 45110279 A A 42709990 42709990 

73723 RT 34.052 45110280 A A 42709990 42709990 

73221 LT 14.914 45101305 A A 42709990 42709990 

73221 RT 14.914 45101306 A A 42709990 42709990 

73222 LT 18.705 45101307 A A 42709990 42709990 

73222 RT 18.705 45101308 A A 42709990 42709990 

73223 LT 34.052 45101309 A A 42709990 42709990 

73223 RT 34.052 45101310 A A 42709990 42709990 

73221 LT 14.914 45101311 A A 42709990 42709990 

73221 RT 14.914 45101312 A A 42709990 42709990 

73222 LT 18.705 45101313 A A 42709990 42709990 

73222 RT 18.705 45101314 A A 42709990 42709990 

73223 LT 34.052 45101315 A A 42709990 42709990 

73223 RT 34.052 45101316 A A 42709990 42709990 

73218 LT 14.914 45101321 A A 42709990 42709990 

73218 RT 14.914 45101322 A A 42709990 42709990

73219 LT 18.468 45101323 A A 42709990 42709990 

73219 RT 18.468 45101324 A A 42709990 42709990 

73220 LT 34.052 45101327 A A 42709990 42709990 

73220 RT 34.052 45101328 A A 42709990 42709990 

77059 32.754 45101362 A A 42709990 42709990 

77058 LT 18.705 45101365 A A 42709990 42709990 

77058 RT 18.705 45101366 A A 42709990 42709990 

0159T 0.742 A A 42709990 42709990 

73721 LT 0 A A 42709990 42709990 

73721 RT 0 A A 42709990 42709990 

C8907 0 A A 42709990 42709990 

76376 0 A A 42709990 42709990 

76376 4.965 45101400 A A 42709990 42709990 

73721 LT 14.914 45110281 A A 42709990 42709990 

73721 RT 14.914 45110282 A A 42709990 42709990 

73722 LT 18.705 45110287 A A 42709990 42709990 

73722 RT 18.705 45110288 A A 42709990 42709990 

73723 LT 34.052 45110289 A A 42709990 42709990 

73723 RT 34.052 45110290 A A 42709990 42709990 

73718 LT 14.914 45110295 A A 42709990 42709990 

73718 RT 14.914 45110296 A A 42709990 42709990 

73719 LT 18.705 45110297 A A 42709990 42709990 

73719 RT 18.705 45110298 A A 42709990 42709990 

73720 LT 34.052 45110303 A A 42709990 42709990 

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76498 15.357 45110500 A A 42709990 42709990 

76498 15.357 45101098 A A 42709990 42709990 

70551 0 A A 42709990 42709990 

A9579 0.191 A A 42709990 42709990 

73725 LT 21.991 45301017 A A 42709990 42709990 

73725 RT 21.991 45301018 A A 42709990 42709990 

73725 50 25.729 A A 42709990 42709990 

C8936 LT 12.422 45301029 A A 42709990 42709990 

C8936 RT 12.422 45301030 A A 42709990 42709990 

71555 18.798 45301046 A A 42709990 42709990 

70544 15.357 45301055 A A 42709990 42709990 

70545 15.079 45301056 A A 42709990 42709990 

70546 30.097 45301057 A A 42709990 42709990 

70547 15.357 45301059 A A 42709990 42709990 

70549 30.364 45301060 A A 42709990 42709990 

74185 12.422 45301064 A A 42709990 42709990 

72198 16.429 45301073 A A 42709990 42709990 

74160 7.931 46000089 A A 42609990 42609990 

74170 9.847 46000097 A A 42609990 42609990 

74150 6.798 46000071 A A 42609990 42609990 

72126 8.364 46000295 A A 42609990 42609990 

72125 7.931 46000196 A A 42609990 42609990

71250 6.798 46000905 A A 42609990 42609990 

71260 7.931 46000055 A A 42609990 42609990 

71270 9.28 46000063 A A 42609990 42609990 

71250 6.798 46000048 A A 42609990 42609990 

72129 8.364 46000303 A A 42609990 42609990 

72128 7.931 46000204 A A 42609990 42609990 

70487 7.365 46000592 A A 42609990 42609990 

70486 7.076 46000246 A A 42609990 42609990 

70488 9.054 46000378 A A 42609990 42609990 

70470 7.365 46000030 A A 42609990 42609990 

70460 6.232 46000022 A A 42609990 42609990 

70450 5.099 46000014 A A 42609990 42609990 

70481 7.365 46000162 A A 42609990 42609990 

70480 7.076 46000527 A A 42609990 42609990 

73701 LT 6.798 46000585 A A 42609990 42609990 

73701 RT 6.798 46000586 A A 42609990 42609990 

73700 LT 5.665 46000155 A A 42609990 42609990 

73700 RT 5.665 46000156 A A 42609990 42609990 

76380 4.635 46000610 A A 42609990 42609990 

72132 8.364 46000311 A A 42609990 42609990 

72131 7.076 46000139 A A 42609990 42609990 

70491 6.798 46000287 A A 42609990 42609990 

70490 5.665 46000568 A A 42609990 42609990 

70492 7.931 46000188 A A 42609990 42609990 

70481 7.365 46000576 A A 42609990 42609990 

70480 7.076 46000238 A A 42609990 42609990 

70482 9.219 46000352 A A 42609990 42609990 

72193 7.931 46000113 A A 42609990 42609990 

72194 9.28 46000121 A A 42609990 42609990 

72192 6.798 46000105 A A 42609990 42609990 

70481 7.365 46000170 A A 42609990 42609990 

70480 7.076 46000543 A A 42609990 42609990 

70482 9.053 46000550 A A 42609990 42609990 

72193 8.364 46000451 A A 42609990 42609990 

72192 7.076 46000444 A A 42609990 42609990 

72132 8.364 46000485 A A 42609990 42609990 

72131 7.076 46000477 A A 42609990 42609990 

70487 7.076 46000212 A A 42609990 42609990 

70486 7.076 46000329 A A 42609990 42609990 

70488 9.054 46000337 A A 42609990 42609990 

70480 7.076 46000253 A A 42609990 42609990 

70482 9.054 46000394 A A 42609990 42609990 

70481 7.365 46000600 A A 42609990 42609990 

70486 7.076 46000402 A A 42609990 42609990 

73202 LT 7.931 46000520 A A 42609990 42609990 

73200 LT 5.665 46000361 A A 42609990 42609990 

73200 RT 5.665 46000362 A A 42609990 42609990

73201 RT 6.798 46000388 A A 42609990 42609990 

73201 LT 6.798 46000387 A A 42609990 42609990 

74175 10.115 46000098 A A 42609990 42609990 

74174 0 A A 42609990 42609990 

71275 10.115 46000065 A A 42609990 42609990 

73706 10.115 46001020 A A 42609990 42609990 

73206 10.115 46001010 A A 42609990 42609990 

70496 10.115 46000033 A A 42609990 42609990 

75635 10.115 46001000 A A 42609990 42609990 

70498 10.115 46000189 A A 42609990 42609990 

72191 10.115 46000125 A A 42609990 42609990 

77012 9.62 46000865 A A 42609990 42609990 

49180 7.962 46000709 A A 42609990 42609990 

50200 LT 7.962 46000684 A A 42609990 42609990 

50200 RT 7.962 46000685 A A 42609990 42609990 

77012 LT 9.62 46000635 A A 42609990 42609990 

77012 RT 9.62 46000636 A A 42609990 42609990 

77012 9.62 46000642 A A 42609990 42609990 

47000 7.962 46000691 A A 42609990 42609990 

77012 9.62 46000147 A A 42609990 42609990 

32405 3.1 46000675 A A 42609990 42609990 

48102 7.962 46000717 A A 42609990 42609990 

77012 9.62 46000667 A A 42609990 42609990 

77012 9.62 46000659 A A 42609990 42609990 

77012 9.62 46000882 A A 42609990 42609990 

20220 0.567 46000894 A A 42609990 42609990 

50020 LT 3.399 46000858 A A 42609990 42609990 

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75989 LT 3.801 46000736 A A 42609990 42609990 

75989 RT 3.801 46000737 A A 42609990 42609990 

50390 LT 7.962 46000872 A A 42609990 42609990 

50390 RT 7.962 46000873 A A 42609990 42609990 

47000 7.962 46000808 A A 42609990 42609990 

75989 3.801 46000741 A A 42609990 42609990 

3.399 46000790 A A 42609990 42609990 

75989 3.801 46000725 A A 42609990 42609990 

48000 3.399 46000816 A A 42609990 42609990 

75989 3.801 46000766 A A 42609990 42609990 

75989 3.801 46000774 A A 42609990 42609990 

49020 2.781 46000824 A A 42609990 42609990 

49020 2.781 46000840 A A 42609990 42609990 

75989 3.801 46000758 A A 42609990 42609990 

73201 LT 6.798 46000262 A A 42609990 42609990 

73201 RT 6.798 46000263 A A 42609990 42609990 

49040 2.781 46000832 A A 42609990 42609990 

75989 3.801 46000782 A A 42609990 42609990 

73701 50 8.158 46000587 A A 42609990 42609990

75989 0 A A 42609990 42609990 

49421 0 A A 42609990 42609990 

75989 0 A A 42609990 42609990 

32550 0 A A 42609990 42609990 

75989 0 A A 42609990 42609990 

32552 0 A A 42609990 42609990 

32550 0 A A 42609990 42609990 

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42400 0 A A 42609990 42609990 

77012 0 A A 42609990 42609990 

77012 LT 0 A A 42609990 42609990 

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74177 0 A A 42609990 42609990 

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27096 0 A A 42609990 42609990 

64493 0 A A 42609990 42609990 

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20205 0 A A 42609990 42609990 

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76380 0 A A 42609990 42609990 

76376 0 A A 42609990 42609990 

0 A A 42609990 42609990 

Q9963 0 A A 42609990 42609990 

J3490 0 A A 42609990 42609990 

A7043 0 A A 42609990 42609990 

A7042 0 A A 42609990 42609990 

A4300 0 A A 42609990 42609990 

0 A A 42609990 42609990 

74000 3.502 A A 42129990 42129990 

74020 4.779 A A 42129990 42129990 

74020 4.779 A A 42129990 42129990 

74020 4.779 A A 42129990 42129990 

73050 4.656 A A 42129990 42129990 

73050 4.656 A A 42129990 42129990 

73610 RT 3.502 A A 42129990 42129990 

73610 LT 2.925 A A 42129990 42129990 

73610 50 3.502 A A 42129990 42129990 

72050 5.356 A A 42129990 42129990 

72052 5.356 A A 42129990 42129990 

72020 2.802 A A 42129990 42129990 

72040 2.884 A A 42129990 42129990 

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72050 5.356 A A 42129990 42129990 

71020 3.79 A A 42129990 42129990 

71010 3.543 A A 42129990 42129990 

71035 3.79 A A 42129990 42129990

71035 5.686 A A 42129990 42129990 

71035 3.79 A A 42129990 42129990 

71021 5.686 A A 42129990 42129990 

71022 6.18 A A 42129990 42129990 

71020 3.79 A A 42129990 42129990 

71030 6.18 A A 42129990 42129990 

73000 LT 2.348 A A 42129990 42129990 

73000 RT 2.348 A A 42129990 42129990 

72072 3.502 A A 42129990 42129990 

72070 2.966 A A 42129990 42129990 

73080 LT 3.502 A A 42129990 42129990 

73080 RT 3.502 A A 42129990 42129990 

73070 LT 2.348 A A 42129990 42129990 

73070 RT 2.348 A A 42129990 42129990 

72010 10.465 A A 42129990 42129990 

70150 5.85 A A 42129990 42129990 

70140 3.502 A A 42129990 42129990 

73550 50 4.202 A A 42129990 42129990 

73550 LT 3.502 A A 42129990 42129990 

73030 50 4.903 A A 42129990 42129990 

73030 50 4.903 A A 42129990 42129990 

72200 3.502 A A 42129990 42129990 

70220 5.768 A A 42129990 42129990 

77075 2.802 A A 42129990 42129990 

70260 5.768 A A 42129990 42129990 

70250 3.502 A A 42129990 42129990 

70360 3.502 A A 42129990 42129990 

71130 4.656 A A 42129990 42129990 

71120 4.656 A A 42129990 42129990 

70330 5.85 A A 42129990 42129990 

70328 3.502 A A 42129990 42129990 

73660 LT 2.348 A A 42129990 42129990 

73660 RT 2.348 A A 42129990 42129990 

73092 LT 3.049 A A 42129990 42129990 

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73110 LT 2.925 A A 42129990 42129990 

73110 RT 2.925 A A 42129990 42129990 

73100 LT 2.348 A A 42129990 42129990 

73100 RT 2.348 A A 42129990 42129990 

73110 50 4.244 A A 42129990 42129990 

73550 RT 3.502 A A 42129990 42129990 

73140 LT 2.348 A A 42129990 42129990 

73140 RT 2.348 A A 42129990 42129990 

73140 LT 2.348 A A 42129990 42129990 

73140 RT 2.348 A A 42129990 42129990 

73630 LT 2.925 A A 42129990 42129990 

73630 RT 2.925 A A 42129990 42129990

73620 LT 2.348 A A 42129990 42129990 

73620 RT 2.348 A A 42129990 42129990 

73630 50 4.244 A A 42129990 42129990 

73090 LT 2.925 A A 42129990 42129990 

73090 RT 2.925 A A 42129990 42129990 

73130 LT 2.925 A A 42129990 42129990 

73130 RT 2.925 A A 42129990 42129990 

73120 LT 2.348 A A 42129990 42129990 

73120 RT 2.348 A A 42129990 42129990 

77072 2.348 A A 42129990 42129990 

73130 50 3.378 A A 42129990 42129990 

73650 LT 2.348 A A 42129990 42129990 

73650 RT 2.348 A A 42129990 42129990 

73520 6.18 A A 42129990 42129990 

73510 LT 3.914 A A 42129990 42129990 

73510 RT 3.914 A A 42129990 42129990 

73510 LT 3.914 A A 42129990 42129990 

73510 RT 3.914 A A 42129990 42129990 

73510 LT 3.914 A A 42129990 42129990 

73510 RT 3.914 A A 42129990 42129990 

73540 50 4.656 A A 42129990 42129990 

73060 LT 3.502 A A 42129990 42129990 

73060 RT 3.502 A A 42129990 42129990 

73560 50 4.985 A A 42129990 42129990 

73560 LT 3.502 A A 42129990 42129990 

73560 RT 4.656 A A 42129990 42129990 

73564 LT 4.656 A A 42129990 42129990 

73564 RT 4.656 A A 42129990 42129990 

73564 50 6.88 A A 42129990 42129990 

73564 50 5.562 A A 42129990 42129990 

73564 LT 4.656 A A 42129990 42129990 

73564 RT 4.656 A A 42129990 42129990 

73565 4.656 A A 42129990 42129990 

77075 7.004 A A 42129990 42129990 

73592 LT 2.348 A A 42129990 42129990 

73592 RT 2.348 A A 42129990 42129990 

73590 50 4.202 A A 42129990 42129990 

73590 LT 3.502 A A 42129990 42129990 

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72100 4.079 A A 42129990 42129990 

72110 7.004 A A 42129990 42129990 

72110 7.004 A A 42129990 42129990 

72114 7.004 A A 42129990 42129990 

72100 4.079 A A 42129990 42129990 

72114 7.004 A A 42129990 42129990 

G0204 14.832 A A 42129990 42129990 

G0206 LT 9.476 A A 42129990 42129990

G0206 RT 9.476 A A 42129990 42129990 

G0202 12.978 A A 42129990 42129990 

70110 5.85 A A 42129990 42129990 

70100 3.502 A A 42129990 42129990 

70130 6.221 A A 42129990 42129990 

70120 4.12 A A 42129990 42129990 

77074 10.465 A A 42129990 42129990 

70160 3.502 A A 42129990 42129990 

73130 LT 2.348 A A 42129990 42129990 

73130 RT 2.348 A A 42129990 42129990 

76010 5.85 A A 42129990 42129990 

70200 5.85 A A 42129990 42129990 

70030 3.502 A A 42129990 42129990 

70210 2.348 A A 42129990 42129990 

72170 3.502 A A 42129990 42129990 

71111 6.18 A A 42129990 42129990 

71101 LT 4.656 A A 42129990 42129990 

71101 RT 4.656 A A 42129990 42129990 

72220 3.502 A A 42129990 42129990 

72202 5.85 A A 42129990 42129990 

73010 LT 3.502 A A 42129990 42129990 

73010 RT 3.502 A A 42129990 42129990 

73030 LT 4.079 A A 42129990 42129990 

73030 RT 4.079 A A 42129990 42129990 

73030 LT 4.079 A A 42129990 42129990 

73030 RT 4.079 A A 42129990 42129990 

73020 LT 2.348 A A 42129990 42129990 

73020 RT 2.348 A A 42129990 42129990 

G0206 LT 0 A A 42129990 42129990 

G0206 RT 0 A A 42129990 42129990 

G0204 0 A A 42129990 42129990 

G0202 52 0 A A 42129990 42129990 

G0202 52 0 A A 42129990 42129990 

G0202 0 A A 42129990 42129990 

74000 3.502 A A 42139990 42139990 

74020 4.779 A A 42139990 42139990 

74020 4.779 A A 42139990 42139990 

74020 4.779 A A 42139990 42139990 

74020 4.779 A A 42139990 42139990 

73050 4.656 A A 42139990 42139990 

73610 LT 2.925 A A 42139990 42139990 

73610 RT 2.925 A A 42139990 42139990 

73610 50 3.502 A A 42139990 42139990 

72050 3.543 A A 42139990 42139990 

72052 5.356 A A 42139990 42139990 

72020 2.802 A A 42139990 42139990 

72040 2.884 A A 42139990 42139990

72040 2.884 A A 42139990 42139990 

72050 5.356 A A 42139990 42139990 

71020 3.79 A A 42139990 42139990 

71010 3.543 A A 42139990 42139990 

71035 3.79 A A 42139990 42139990 

71035 5.686 A A 42139990 42139990 

71035 3.79 A A 42139990 42139990 

71021 5.686 A A 42139990 42139990 

71022 6.18 A A 42139990 42139990 

71020 3.79 A A 42139990 42139990 

71030 6.18 A A 42139990 42139990 

73000 LT 2.348 A A 42139990 42139990 

73000 RT 2.348 A A 42139990 42139990 

72072 3.502 A A 42139990 42139990 

72070 2.966 A A 42139990 42139990 

73080 3.502 A A 42139990 42139990 

73080 RT 3.502 A A 42139990 42139990 

73070 LT 2.348 A A 42139990 42139990 

73070 RT 2.348 A A 42139990 42139990 

72010 10.465 A A 42139990 42139990 

70150 5.85 A A 42139990 42139990 

70140 3.502 A A 42139990 42139990 

73550 50 4.202 A A 42139990 42139990 

73550 3.502 A A 42139990 42139990 

73030 50 4.903 A A 42139990 42139990 

73030 50 4.903 A A 42139990 42139990 

72200 3.502 A A 42139990 42139990 

70220 5.768 A A 42139990 42139990 

77075 2.802 A A 42139990 42139990 

70260 5.768 A A 42139990 42139990 

70250 3.502 A A 42139990 42139990 

70360 3.502 A A 42139990 42139990 

71130 4.656 A A 42139990 42139990 

71120 4.656 A A 42139990 42139990 

70330 5.85 A A 42139990 42139990 

70328 3.502 A A 42139990 42139990 

73660 LT 2.348 A A 42139990 42139990 

73660 RT 2.348 A A 42139990 42139990 

73092 LT 3.049 A A 42139990 42139990 

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73110 LT 2.925 A A 42139990 42139990 

73110 RT 2.925 A A 42139990 42139990 

73100 LT 2.348 A A 42139990 42139990 

73100 RT 2.348 A A 42139990 42139990 

73110 50 4.244 A A 42139990 42139990 

73550 RT 3.502 A A 42139990 42139990 

73140 LT 2.348 A A 42139990 42139990

73140 RT 2.348 A A 42139990 42139990 

73630 LT 2.348 A A 42139990 42139990 

73140 RT 2.348 A A 42139990 42139990 

73660 LT 2.925 A A 42139990 42139990 

73630 RT 2.348 A A 42139990 42139990 

73620 LT 2.348 A A 42139990 42139990 

73620 RT 2.348 A A 42139990 42139990 

73630 50 4.244 A A 42139990 42139990 

73630 LT 2.925 A A 42139990 42139990 

73090 RT 2.925 A A 42139990 42139990 

73120 LT 2.925 A A 42139990 42139990 

73130 RT 2.925 A A 42139990 42139990 

73120 LT 2.348 A A 42139990 42139990 

73120 RT 2.348 A A 42139990 42139990 

77072 2.348 A A 42139990 42139990 

73130 50 2.348 A A 42139990 42139990 

73650 LT 2.348 A A 42139990 42139990 

73650 RT 2.348 A A 42139990 42139990 

73520 6.18 A A 42139990 42139990 

73510 LT 3.914 A A 42139990 42139990 

73510 RT 3.914 A A 42139990 42139990 

73510 LT 3.914 A A 42139990 42139990 

73510 RT 3.914 A A 42139990 42139990 

73510 LT 3.914 A A 42139990 42139990 

73510 RT 3.914 A A 42139990 42139990 

73540 50 4.656 A A 42139990 42139990 

73060 LT 3.502 A A 42139990 42139990 

73060 RT 3.502 A A 42139990 42139990 

73560 50 4.985 A A 42139990 42139990 

73560 LT 3.502 A A 42139990 42139990 

73560 RT 3.502 A A 42139990 42139990 

73564 LT 4.656 A A 42139990 42139990 

73564 RT 4.656 A A 42139990 42139990 

73564 50 6.88 A A 42139990 42139990 

73564 50 5.562 A A 42139990 42139990 

73564 LT 4.656 A A 42139990 42139990 

73564 RT 4.656 A A 42139990 42139990 

73565 4.656 A A 42139990 42139990 

77075 7.004 A A 42139990 42139990 

73592 LT 2.348 A A 42139990 42139990 

73592 RT 2.348 A A 42139990 42139990 

73590 4.202 A A 42139990 42139990 

73590 LT 3.502 A A 42139990 42139990 

73590 RT 3.502 A A 42139990 42139990 

72100 4.079 A A 42139990 42139990 

72110 7.004 A A 42139990 42139990 

72110 7.004 A A 42139990 42139990

72114 7.004 A A 42139990 42139990 

72100 4.079 A A 42139990 42139990 

72114 7.004 A A 42139990 42139990 

G0204 14.832 A A 42139990 42139990 

G0206 LT 9.476 A A 42139990 42139990 

G0206 RT 9.476 A A 42139990 42139990 

G0202 12.978 A A 42139990 42139990 

70110 5.85 A A 42139990 42139990 

70100 3.502 A A 42139990 42139990 

70130 6.221 A A 42139990 42139990 

70120 4.12 A A 42139990 42139990 

77074 10.465 A A 42139990 42139990 

70160 3.502 A A 42139990 42139990 

73130 LT 2.348 A A 42139990 42139990 

73130 RT 5.85 A A 42139990 42139990 

76010 5.85 A A 42139990 42139990 

70200 5.85 A A 42139990 42139990 

70030 3.502 A A 42139990 42139990 

70210 2.348 A A 42129990 42129990 

72170 3.502 A A 42139990 42139990 

71111 6.18 A A 42139990 42139990 

71101 LT 4.656 A A 42139990 42139990 

71101 RT 4.656 A A 42139990 42139990 

72220 3.502 A A 42139990 42139990 

72202 5.85 A A 42139990 42139990 

73010 LT 3.502 A A 42139990 42139990 

73010 RT 3.502 A A 42139990 42139990 

73030 LT 4.079 A A 42139990 42139990 

73030 RT 4.079 A A 42139990 42139990 

73030 LT 4.079 A A 42139990 42139990 

73030 RT 4.079 A A 42139990 42139990 

73020 LT 2.348 A A 42139990 42139990 

73020 RT 2.348 A A 42139990 42139990 

G0206 LT 0 A A 42139990 42139990 

G0206 RT 0 A A 42139990 42139990 

G0204 0 A A 42139990 42139990 

G0202 52 0 A A 42139990 42139990 

G0202 52 0 A A 42139990 42139990 

G0202 0 A A 42139990 42139990 

74181 0 A A 42739990 42739990 

74182 0 A A 42739990 42739990 

74183 0 A A 42739990 42739990 

72141 0 A A 42739990 42739990 

72142 0 A A 42739990 42739990 

72156 0 A A 42739990 42739990 

71550 0 A A 42739990 42739990 

71551 0 A A 42739990 42739990

71552 0 A A 42739990 42739990 

70540 0 A A 42739990 42739990 

70542 0 A A 42739990 42739990 

70543 0 A A 42739990 42739990 

70551 0 A A 42739990 42739990 

70552 0 A A 42739990 42739990 

70553 0 A A 42739990 42739990 

70553 0 A A 42739990 42739990 

70551 0 A A 42739990 42739990 

70553 0 A A 42739990 42739990 

73721 LT 0 A A 42739990 42739990 

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73723 LT 0 A A 42739990 42739990 

73723 RT 0 A A 42739990 42739990 

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73722 LT 0 A A 42739990 42739990 

72148 0 A A 42739990 42739990 

72149 0 A A 42739990 42739990 

72158 0 A A 42739990 42739990 

74181 0 A A 42739990 42739990 

70540 0 A A 42739990 42739990 

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70542 0 A A 42739990 42739990 

70540 0 A A 42739990 42739990 

70542 0 A A 42739990 42739990 

70543 0 A A 42739990 42739990 

72195 0 A A 42739990 42739990 

72196 0 A A 42739990 42739990 

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72146 0 A A 42739990 42739990 

72147 0 A A 42739990 42739990 

72157 0 A A 42739990 42739990 

70336 50 0 A A 42739990 42739990 

70336 LT 0 A A 42739990 42739990 

70336 RT 0 A A 42739990 42739990 

73221 LT 0 A A 42739990 42739990 

73221 RT 0 A A 42739990 42739990 

73222 LT 0 A A 42739990 42739990 

73222 RT 0 A A 42739990 42739990 

73223 LT 0 A A 42739990 42739990 

73223 RT 0 A A 42739990 42739990 

73721 LT 0 A A 42739990 42739990 

73721 RT 0 A A 42739990 42739990 

73722 LT 0 A A 42739990 42739990 

73722 RT 0 A A 42739990 42739990 

73723 LT 0 A A 42739990 42739990 

73723 RT 0 A A 42739990 42739990

73221 LT 0 A A 42739990 42739990 

73221 RT 0 A A 42739990 42739990 

73222 LT 0 A A 42739990 42739990 

73222 RT 0 A A 42739990 42739990 

73223 LT 0 A A 42739990 42739990 

73223 RT 0 A A 42739990 42739990 

73221 LT 0 A A 42739990 42739990 

73221 RT 0 A A 42739990 42739990 

73222 LT 0 A A 42739990 42739990 

73222 RT 0 A A 42739990 42739990 

73223 LT 0 A A 42739990 42739990 

73223 RT 0 A A 42739990 42739990 

73218 LT 0 A A 42739990 42739990 

73218 RT 0 A A 42739990 42739990 

73219 LT 0 A A 42739990 42739990 

73219 RT 0 A A 42739990 42739990 

73220 LT 0 A A 42739990 42739990 

73220 RT 0 A A 42739990 42739990 

77059 0 A A 42739990 42739990 

77058 LT 0 A A 42739990 42739990 

77058 RT 0 A A 42739990 42739990 

0159T 0 A A 42739990 42739990 

C8907 0 A A 42739990 42739990 

70551 0 A A 42739990 42739990 

73718 LT 0 A A 42739990 42739990 

73718 RT 0 A A 42739990 42739990 

73219 LT 0 A A 42739990 42739990 

73219 RT 0 A A 42739990 42739990 

73220 LT 0 A A 42739990 42739990 

73220 RT 0 A A 42739990 42739990 

73721 LT 0 A A 42739990 42739990 

73721 RT 0 A A 42739990 42739990 

73722 LT 0 A A 42739990 42739990 

73722 RT 0 A A 42739990 42739990 

73723 LT 0 A A 42739990 42739990 

73723 RT 0 A A 42739990 42739990 

73222 LT 0 A A 42739990 42739990 

73222 RT 0 A A 42739990 42739990 

73221 LT 0 A A 42739990 42739990 

73221 RT 0 A A 42739990 42739990 

73223 LT 0 A A 42739990 42739990 

73223 RT 0 A A 42739990 42739990 

73718 LT 0 A A 42739990 42739990 

73718 RT 0 A A 42739990 42739990 

73719 LT 0 A A 42739990 42739990 

73719 RT 0 A A 42739990 42739990 

73720 LT 0 A A 42739990 42739990

73720 RT 0 A A 42739990 42739990 

73725 LT 0 A A 42739990 42739990 

73725 RT 0 A A 42739990 42739990 

73725 50 0 A A 42739990 42739990 

C8936 LT 0 A A 42739990 42739990 

C8936 RT 0 A A 42739990 42739990 

71555 0 A A 42739990 42739990 

70544 0 A A 42739990 42739990 

70545 0 A A 42739990 42739990 

70546 0 A A 42739990 42739990 

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70549 0 A A 42739990 42739990 

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G8984 GO 0 A A 43719990 43719990 

G8984 GO 0 A A 43719990 43719990 

G8984 GO 0 A A 43719990 43719990 

G8984 GO 0 A A 43719990 43719990 

G8984 GO 0 A A 43719990 43719990 

G8984 GO 0 A A 43719990 43719990 

G8985 GO 0 A A 43719990 43719990 

G8985 GO 0 A A 43719990 43719990 

G8985 GO 0 A A 43719990 43719990 

G8985 GO 0 A A 43719990 43719990 

G8985 GO 0 A A 43719990 43719990 

G8985 GO 0 A A 43719990 43719990 

G8986 GO 0 A A 43719990 43719990 

G8986 GO 0 A A 43719990 43719990 

G8986 GO 0 A A 43719990 43719990 

G8986 GO 0 A A 43719990 43719990 

G8987 GO 0 A A 43719990 43719990

G8986 GO 0 A A 43719990 43719990 

G8987 GO 0 A A 43719990 43719990 

G8987 GO 0 A A 43719990 43719990 

G8987 GO 0 A A 43719990 43719990 

G8987 GO 0 A A 43719990 43719990 

G8987 GO 0 A A 43719990 43719990 

G8987 GO 0 A A 43719990 43719990 

G8988 GO 0 A A 43719990 43719990 

G8988 GO 0 A A 43719990 43719990 

G8988 GO 0 A A 43719990 43719990 

G8988 GO 0 A A 43719990 43719990 

G8988 GO 0 A A 43719990 43719990 

G8988 GO 0 A A 43719990 43719990 

G8989 GO 0 A A 43719990 43719990 

G8989 GO 0 A A 43719990 43719990 

G8989 GO 0 A A 43719990 43719990 

G8989 GO 0 A A 43719990 43719990 

G8989 GO 0 A A 43719990 43719990 

G8989 GO 0 A A 43719990 43719990 

G8990 GO 0 A A 43719990 43719990 

G8990 GO 0 A A 43719990 43719990 

G8990 GO 0 A A 43719990 43719990 

G8990 GO 0 A A 43719990 43719990 

G8990 GO 0 A A 43719990 43719990 

G8990 GO 0 A A 43719990 43719990 

G8991 GO 0 A A 43719990 43719990 

G8991 GO 0 A A 43719990 43719990 

G8991 GO 0 A A 43719990 43719990 

G8991 GO 0 A A 43719990 43719990 

G8991 GO 0 A A 43719990 43719990 

G8991 GO 0 A A 43719990 43719990 

G8992 GO 0 A A 43719990 43719990 

G8992 GO 0 A A 43719990 43719990 

G8992 GO 0 A A 43719990 43719990 

G8992 GO 0 A A 43719990 43719990 

G8992 GO 0 A A 43719990 43719990 

G8992 GO 0 A A 43719990 43719990 

G8993 GO 0 A A 43719990 43719990 

G8993 GO 0 A A 43719990 43719990 

G8993 GO 0 A A 43719990 43719990 

G8993 GO 0 A A 43719990 43719990 

G8993 GO 0 A A 43719990 43719990 

G8993 GO 0 A A 43719990 43719990 

G8994 GO 0 A A 43719990 43719990 

G8994 GO 0 A A 43719990 43719990 

G8994 GO 0 A A 43719990 43719990 

G8994 GO 0 A A 43719990 43719990

G8994 GO 0 A A 43719990 43719990 

G8994 GO 0 A A 43719990 43719990 

G8995 GO 0 A A 43719990 43719990 

G8995 GO 0 A A 43719990 43719990 

G8995 GO 0 A A 43719990 43719990 

G8995 GO 0 A A 43719990 43719990 

G8995 GO 0 A A 43719990 43719990 

G8995 GO 0 A A 43719990 43719990 

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29550 15 48300132 D D 43739990 43739990 

29580 15 48300133 D D 43909990 43909990 

97034 15 48300139 D D 43909990 43909990 

97537 15 48300140 D D 43909990 43909990 

97532 15 48300141 D D 43909990 43909990 

97532 15 48300116 D D 43909990 43909990 

97113 15 48300144 D D 43909990 43909990 

97598 15 48300149 D D 43909990 43909990 

97597 15 48300150 D D 43909990 43909990 

97602 15 48300151 D D 43739990 43739990 

97760 15 48300138 D D 43909990 43909990 

L3806 90 48300004 D D 43909990 43909990 

L4002 45 48300024 D D 43909990 43909990 

L4205 30 48300025 D D 43909990 43909990 

L4210 30 48300026 D D 43909990 43909990 

L3763 90 48300001 D D 43909990 43909990 

L3765 90 48300002 D D 43909990 43909990 

L3800 90 48300003 D D 43909990 43909990 

L3805 90 48300028 D D 43909990 43909990

L3810 90 48300006 D D 43909990 43909990 

L3815 90 48300007 D D 43909990 43909990 

L3820 90 48300008 D D 43909990 43909990 

L3825 90 48300009 D D 43909990 43909990 

L3830 90 48300010 D D 43909990 43909990 

L3835 90 48300011 D D 43909990 43909990 

L3840 90 48300029 D D 43909990 43909990 

L3845 90 48300012 D D 43909990 43909990 

L3850 90 48300013 D D 43909990 43909990 

L3855 90 48300014 D D 43909990 43909990 

L3860 90 48300015 D D 43909990 43909990 

L3890 90 48300033 D D 43909990 43909990 

L3900 90 48300016 D D 43909990 43909990 

L3901 90 48300034 D D 43909990 43909990 

L3907 90 48300017 D D 43909990 43909990 

L3935 90 48300022 D D 43909990 43909990 

L3956 90 48300023 D D 43909990 43909990 

L0120 0 48300085 D D 43909990 43909990 

L0120 0 48300086 D D 43909990 43909990 

L0140 0 48300087 D D 43909990 43909990 

L1830 0 48300088 D D 43909990 43909990 

L0210 0 48300090 D D 43909990 43909990 

0 43300013 D D 44709990 44709990 

0 43300021 D D 44709990 44709990 

99255 4 43310008 D D 44709990 44709990 

99233 0 43310010 D D 44709990 44709990 

90804 1.21 43320023 D D 44709990 44709990 

90847 0 43320030 D D 44709990 44709990 

90853 0 43320041 D D 44709990 44709990 

90853 0 43320045 D D 44709990 44709990 

90853 0.59 43320050 D D 44709990 44709990 

90801 2.8 43320064 D D 44709990 44709990 

90801 2.8 43320073 D D 44709990 44709990 

90807 2.02 43320081 D D 44709990 44709990 

90862 0.95 43320098 D D 44709990 44709990 

90862 0.95 43320110 D D 44709990 44709990 

90801 2.8 43320163 D D 44709990 44709990 

90801 2.8 43320166 D D 44709990 44709990 

90801 2.8 43320171 D D 44709990 44709990 

0 43300013 D D 44709990 44709990 

0 43300021 D D 44709990 44709990 

90801 0 D D 44709990 44709990 

90804 0 D D 44709990 44709990 

90806 0 D D 44709990 44709990 

90807 0 D D 44709990 44709990 

90805 0 D D 44709990 44709990 

90808 0 D D 44709990 44709990

90847 0 D D 44709990 44709990 

90849 0.59 D D 44709990 44709990 

90853 0.59 D D 44709990 44709990 

90805 1.37 D D 44709990 44709990 

90808 2.79 D D 44709990 44709990 

90805 1.37 D D 44709990 44709990 

0 D D 0 0 

0 40000069 D D 43609990 43609990 

94640 0.42 40000080 D D 43609990 43609990 

94640 0.45 40000126 D D 43609990 43609990 

94640 76 0.42 40000127 D D 43609990 43609990 

94375 0.85 40000270 D D 43609990 43609990 

94060 1.52 40000271 D D 43609990 43609990 

0 40100037 D D 43609990 43609990 

60 47000004 D D 43409990 43409990 

60 47000013 D D 43409990 43409990 

94060 372.86 47000096 D D 43409990 43409990 

0 47100105 D D 43409990 43409990 

J7674 40.17 47200010 D D 43409990 43409990 

J7674 5.15 47200015 D D 43409990 43409990 

J7674 5.15 47200020 D D 43409990 43409990 

J7674 5.15 47200025 D D 43409990 43409990 

J7674 5.15 47200030 D D 43409990 43409990 

J7674 5.15 47200035 D D 43409990 43409990 

0 D D 52105010 52105220 

0 D D 10001000 10001000 

0 D D 12101300 12101300 

0 D D 12101300 12101300 

0 D D 52105010 52105220 

0 D D 52105010 52105220 

0 D D 52105010 52105220 

0 D D 52105010 52105220 

0 D D 52105010 52105220 

0 D D 52105010 52105220 

0 D D 52105010 52105220 

0 D D 52105010 52105220 

0 D D 52105010 52105220 

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0 D D 52105010 52105220 

0 D D 52105010 52105220 

0 D D 52905010 52905220 

0 D D 50505010 50505220 

0 D D 50505010 50505220 

0 D D 50505010 50505220 

0 D D 52105010 52105220 

0 D D 52105010 52105220 

0 D D 10001000 10001000

0 D D 52105010 52105220 

0 D D 52105010 52105220 

0 D D 52105010 52105220 

0 D D 24002090 24002090 

0 D D 52105010 52105220 

0 D D 52105010 52105220 

0 D D 52105010 52105220 

0 D D 52105010 52105220 

0 D D 52105010 52105220 

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0 D D 52105010 52105220 

0 D D 52105010 52105220 

0 D D 52105010 52105220 

0 D D 52905010 52905220 

0 D D 10001000 99009430 

0 D D 10001000 99009430 

0 D D 10001000 99009430 

0 D D 10001000 99009430 

0 D D 10001000 99009430 

0 D D 10001000 99009430 

0 D D 10001000 99009430 

0 D D 10001000 99009430 

0 D D 10001000 99009430 

0 D D 25102090 99009430 

0 D D 76206680 99009430 

0 D D 75706680 99009430 

0 D D 10001000 10001000 

0 D D 10001000 10001000 

0 D D 10001000 10001000 

0 D D 10001000 10001000 

0 D D 10001000 10001000 

0 D D 10001000 10001000 

0 D D 10001000 10001000 

0 D D 10001000 10001000 

0 D D 10001000 10001000 

0 D D 10001000 10001000 

0 D D 10001000 10001000 

0 D D 10001000 10001000 

0 D D 10001000 10001000 

0 D D 10001000 10001000 

0 D D 10001000 10001000 

0 D D 10001000 10001000 

0 D D 10001000 10001000 

0 D D 10001000 10001000 

0 D D 10001000 10001000 

0 D D 10001000 10001000 

0 D D 10001000 10001000

0 D D 10001000 10001000 

0 D D 10001000 10001000 

0 D D 10001000 10001000 

0 D D 10001000 10001000 

0 D D 10001000 10001000 

0 D D 10001000 10001000 

0 D D 10001000 10001000 

0 D D 10001000 10001000 

0 D D 10001000 10001000 

0 D D 10001000 10001000 

0 D D 52105010 52105220 

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0 D D 52105010 52105220 

0 D D 52105010 52105220 

0 D D 52105010 52105220 

0 D D 52105010 52105220 

0 D D 52105010 52105220 

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0 D D 52105010 52105220 

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0 D D 52105010 52105220 

0 D D 52105010 52105220 

0 D D 52105010 52105220 

0 D D 10001000 10001000 

0 D D 10001000 10001000 

0 D D 10001000 10001000 

0 D D 10001000 10001000 

0 D D 10001000 10001000 

0 D D 52105010 52105220 

0 D D 52105010 52105220 

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0 D D 52105010 52105220 

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0 D D 52105010 52105220 

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0 D D 10001000 10001000 

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0 D D 10001000 10001000 

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0 D D 52105010 52105220 

0 D D 52105010 52105220 

0 D D 52105010 52105220

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0 D D 52105010 52105220 

0 D D 52105010 52105220 

0 D D 52105010 52105220 

0 D D 10001000 10001000 

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0 D D 52105010 52105220 

0 D D 52105010 52105220 

0 D D 52105010 52105220 

0 D D 10001000 10001000 

0 D D 52105010 52105220 

82651 0 I I 40109990 40109990 

J3490 0 I I 43009990 43009990 

J3370 0 I I 43009990 43009990 

0 I I 80308170 10001000 

26735 0 26600307 I I 37809990 37809990 

25605 0 I I 37809990 37809990 

25605 0 I I 37809990 37809990 

0 27000316 I I 38009990 38009990 

0 27300249 I I 37219990 37219990 

0 27580894 I I 38009990 38009990 51011 

0 27580895 I I 38009990 38009990 50490 

C1713 0 I I 38009990 38009990 50828 

C1713 0 I I 38009990 38009990 50974 

0 I I 38009990 38009990 51179 

0 I I 38009990 38009990 51083

0 I I 38009990 38009990 51180 

0 I I 38009990 38009990 51184 

0 I I 38009990 38009990 51181 

0 I I 38009990 38009990 51178 

0 I I 38009990 38009990 51187 

0 I I 38009990 38009990 50705 

0 I I 38009990 38009990 51015 

0 I I 38009990 38009990 51081 

0 I I 38009990 38009990 51188 

0 I I 38009990 38009990 51017 

0 I I 38009990 38009990 28280 

0 27530321 I I 38009990 38009990 50662 

0 27530318 I I 38009990 38009990 51114 

0 27570025 I I 38009990 38009990 50586 

0 I I 38009990 38009990 50714 

0 I I 38009990 38009990 50434 

0 I I 38009990 38009990 

0 I I 38009990 38009990 

0 I I 38009990 38009990 

0 I I 38009990 38009990 

0 I I 38009990 38009990 

0 27560066 I I 38009990 38009990 50169 

C1776 0 I I 38009990 38009990 6642 1 

96360 0 28000218 I I 37009990 37009990 

86140 0 I I 40109990 40109990 

86341 0 I I 40109990 40109990 

0 I I 40109990 40109990 

J2725 0 37001183 I I 43009990 43009990 

97139 15 41200126 I I 43709990 43709990 

29799 15 41200148 I I 43709990 43709990 

97139 15 41300124 I I 43709990 43709990 

29799 15 41300148 I I 43709990 43709990 

97139 15 41000124 I I 43709990 43709990 

29799 15 41000148 I I 43709990 43709990 

97139 15 48000112 I I 43719990 43719990 

29799 15 48000134 I I 43909990 43909990 

97139 15 48200112 I I 43909990 43909990 

29799 15 48200134 I I 43909990 43909990 

97139 15 48300112 I I 43909990 43909990 

29799 15 48300134 I I 43909990 43909990 

0 I I 50505010 50505220 

0 I I 12101300 12101300 

0 I I 51705010 51705220 

0 I I 52105010 52105220 

0 I I 52505010 52505220 

0 I I 58505850 58505850 

0 I I 98809400 98809400

0 I I 98809400 98809400 

0 I I 98809400 98809400 

0 I I 98809400 98809400 

0 I I 98809400 98809400 

0 I I 98809400 98809400 

0 I I 52105010 52105220 

0 I I 99009430 50505220 

0 I I 99009430 12101300 

0 I I 10001000 10001000 

0 I I 58505850 58505850 

0 I I 99009430 99009430 

0 I I 99009430 99009430 

0 I I 99009430 50905220 

0 I I 99009430 50905010 

0 I I 52105010 52105220 

0 I I 52105010 52105220 

0 I I 99009430 98809400 

0 I I 99009430 98809400 

0 I I 99009430 98809400 

0 I I 99009430 98809400 

0 I I 99009430 98809400 

0 I I 99009430 98809400 

0 I I 98809400 98809400 

0 I I 98809400 98809400 

0 I I 10001000 99009430 

0 I I 10001000 99009430 

0 I A 98809400 98809400 

0 I I 10001000 10001000 

0 I I 10001000 10001000

CBDSC MTDQTY YTDQTY 

MED/SURG, SEMI-PRIVATE 534 534 

INFLUENZA VIRUS INJ 15ADMIN 

15 

PNEUMONIA INJECT ADMIN 7 7 

PSYCHIATRIC UNIT182 182 

PSYCHIATRIC EXEMPT 129UNIT 

129 

ICU, SEMI-PRIVATE 72 72 

INFLUENZA INJECTION 0 ADMIN 0 

PNEUMONIA INJECT ADMIN 0 0 

OB/GYN, SEMI-PRIVATE 151 151 

NURSERY 127 127 

MED SUPPLS DEPT SPECIAL 0 0 

ITEL, SEMI-PRIVATE191 191 

OR 1ST 1/2 HR, 1 PERSON 1 1 

OR EA ADDL 15MIN, 1PERSON1 1 

OR 1ST 1/2 HR, 2 PEOPLE 327 327 

OR EA ADDL 15MIN, 737 2PEOPLE 737 

SHAPE MATCH TECH 0FEES 

0 

CRYOSURG TECHNICAL 1 FEES 1 

HOLMIUM LASER TECH 1 FEES 1 

OR 1ST 1/2 HR, 3 PEOPLE 13 13 

OR EA ADDL 15MIN, 95 3PEOPLE 95 

LASER ABLATION TECH 0 FEES 0 

ESWL TECHNICAL FEE6 6 

HOLMIUM LASER STAND 0 BY 0 

PROC DISCONT WO ANES 0 0 

PROC DISCONT W/ANES 0 0 

RECOVERY ROOM 251 1ST 15MIN 251 

RECOVERY RM EA ADDL 709 15MIN709 

DELIVERY ROOM 40 40 

OR C-SEC EA ADDL 15MIN,1P 0 0 

OR C-SEC 1ST 1/2HR, 172PEOP 

17 

PACU-MCH/15 MIN143 143 


AMNIOCENTESIS 0 0 

OR CSECTION TWINS 01ST 1/2 0 

OR CSECTION TWINS 0ADD 15 0 

FETAL NON STRESS TEST 50 50 

NEWBORN HEARING 50SCRN 

50 

CIRCUMCISION 15 15 

CATH OF UMBILICAL 0 0 

ARTERIAL BLOOD DRAW 0 0 

COLLECTION-CAPILLARY 0 0 

VERSION 0 0 

PKU SCREEN 53 53 

CYSTIC FIBROSIS TEST 53 53 

TRANS BILI CHECK 49 49

IMMUN ADMIN INJ

ITEL IV TX HYDRA ADD'L 224 HR 224 

ITEL IV PUSH INITIAL24 24 

ITEL IVP EA DDD'L SEQ 15 15 

ITEL IVP SEQ SAME RX>30 35 35 

ITEL IV THERAPY ADD'L 6 HR 6 

ITEL IV THERAPY 1ST 2HR 

2 

ITEL IV TX ADD'L SQ 30 9 9 

ICU IV THERAPY ADD'L 0 HR 0 

ICU IV THERAPY 1ST HR 0 0 

ICU IV TX ADD'L SQ < 01 HR 0 

ICU IV TX CONCURR INF 0 0 

ICU INJECTION SC, IM1 1 

ICU OBSERVATION BLOOD 1 ADM 1 

ICU NON BILL OBS PER 0 HR 0 

ICU TRNSFSN BLOOD/COMPT 2 2 

MCH OBSERVATION 103 PER HOUR103 

MCH DIRECT OBSERVATION 1 1 

MCH IV TX HYDRA 310TO 60 0 

MCH IV TX HYDRA ADD'L 0 HR 0 

MCH IV PUSH INITIAL1 1 

MCH IVP EA ADD'L SEQ0 0 

MCH IVP SEQ SAME RX>30MIN 1 1 

MCH IV THERAPY ADD'L 0 HR 0 

MCH IV THERAPY 1ST 0HR 

0 

MCH IV TX ADD'L SQ 0

ACU-E&M LEVEL 3 0 0 


ACU-SPEC PROC RM 10 HR 0 



ISCHEMIC EXER TEST0 0 

PORT OR PICC FLUSH 4ONLY 

4 

PICC LINE INSERTION0 0 

VISIT 1 IV THER INIT75 75 

VISIT1 IV TX ADD HRS44 44 

VISIT 2 IV THER INIT 0 0 



IV TX HYDRAT 31-60 MIN 0 0 

IV TX HYDRA ADD'L HR0 0 

INJECTION SC,IM 0 0 

POSTOP INJECT SC, IM0 0 

IV PUSH INITIAL 1 1 

IVP EA ADD'L SEQ 0 0 

POSTOP IVP INITIAL 4 4 

POSTOP IVP AD'L SEQ3 3 

INJECTION, VACCINE10 10 

DECLOTTING CENTRAL 0 LINES 0 

VENOUS DRAW THROUGH 0 PORT0 

BLOOD DRAW / CENTRAL 0 LINE 0 

CATHFLO ACTIVASE HI-TECH 2 2 

ACU FLOOR RECOVERY/HOUR 351 351 

BLOOD ADMIN-ACU 6 6 

PHLEBOTOMY 15 15 

AUTOL. BLOOD TRANSF. 0 0 

INJ EPIDU/BLOOD CLOT 0 0 

RECOVERY ROOM 172 172 

IMMUNOTHERAPY INJECTION 1 1 

PARA/THORACENTESIS 0 0 

LUMBAR PUNC/SPINAL 1 TAP 1 

EPIDURAL L SPINE INJECT 0 0 

H1N1 IMMUN ADMIN0 0 

NERVE/JOINT INJECT 01 SITE 0 

NERVE/JOINT INJ 2 SITES 0 0 





CANCELLED N/C 0 0 

NO SHOW N/C 0 0 

ENDO VISIT 0 0 

IV THERAPY VISIT 168 168

ACU VISIT 5 5 

ENDO DUAL VISIT 0 0 

SPEC PROC RM PM 10HR 

0 

OMNIPAQUE 240 PER 0ML 

0 

CONSULT RET GI N/C0 0 

CONSULT INT GI N/C 0 0 



COLONOSCOPY 261 261 

GASTROSCOPY 95 95 

BRONCHOSCOPY 1 1 

LARYNGOSCOPY 0 0 

TEE PROBE 0 0 

SIGMOIDOSCOPY 2 2 

POLYPECTOMY 60 60 

PORT OR PICC FLUSH 0ONLY 

0 



POSTOP IVP INITIAL 1 1 

POSTOP IVP AD'L SEQ0 0 

ACU FLOOR RECOVERY 0 PER HR 0 

BLOOD ADMIN GASTRO 0 0 

G TUBE REPLACEMENT 1 1 

PEG BUTTON CHANGE0 0 

PILL CAM ENDOSCOPY2 2 

CANCELLED N/C 0 0 




BONE MARROW ASPIRATION 2 2 

E&M EST PATIENT (BRIEF) 2 2 

E&M EST PATIENT(LIMITED) 29 29 

E&M EST PATIENT(INTER) 21 21 

E&M EST PATIENT(EXTENDED) 58 58 

E&M EST PATIENT(COMPLEX) 6 6 

SKIN TAG REMOVAL=15 0 LES 0 

SKIN TAG RMVL EA ADDL 0 10 0 

UNNA BOOT 0 0 

SELECTIVE DEBRIDE 120 CM 1 

NON SELECTIVE DEBRIDEMENT 0 0 

ART DOPPLER MULTI 0LVEL BI 0 

FINGERSTICK 0 0 

PUNTURE ASPIRATN ABSCESS 0 0 

I&D POST OP WOUND0 0 

NEG PRESS(VACUUM) 17WD50 SQ 1 CM 1

I&D, ABSCESS, SIMPLE0 0 

I&D, ABSCESS, COMPLEX 0 0 

I&D, HEMATOMA 0 0 

DEBRIDE, PART THICKNESS 0 0 

DEBRIDE, FULL THICKNESS 0 0 

DEBRIDE, SUB-Q TISSUE 0 0 

DEBRIDE, SUB-Q, MUSCLE 0 0 

DEBRIDE,SUB Q,MUSCLE,BONE 0 0 

PARING OF BENIGN LESION 0 0 

PARING BENIGN LESION 0 2-4 0 

PARING BENIGN LESION, 0 >4 0 

BIOPSY SINGLE LESION0 0 

BIOPSY,SKIN, ADD'L LESION 0 0 

SIMPLE REPAIR SUPER 0 2.5-7 0 

SIMPLE REPAIR 7.5-12.5 0 CM 0 

DEBRIDEMENT OF NAILS, 0 1-5 0 

DEBRIDEMENT OF NAILS, 0 6+ 0 

AVULSION OF NAIL PLATE 0 0 

AVULSION OF ADD'L NAIL 0 0 

EXCISION OF NAIL & MATRIX 0 0 

SKIN SUB APPLY UP TO 0 25CM 0 

SKIN SUB APP ADD 250 SQ CM 0 

APLIGRAF PER SQ CM0 0 

ELECTRIC CAUTER 1ST 0 LESIO 0 

WOUND CAUTERY, CHEMICAL 0 0 

EX BENGN TNK ARM LEG 0

EX MAL LES FACE 4.0 0 CM 0 

DEBRIDE SUB Q EA ADD 0 20 0 

DEBRIDE SUB Q MUS/FAC 0 20 0 

DEB SUB Q MUS/FAC/BONE 0 20 0 

BILAT ABI UPR LOWR 21-2 LV 2 

UNILAT ABI UPR LWR 01-2 LV 0 

BILAT ABI UPR LWR 2ND 0 PRO 0 

MLCW RT LWR EXTREMITY 0 0 

MLCW LT LWR EXTREMITY 1 1 

MLCW BILAT 8 8 

UNNA BOOT RT LWR 0EXTREM 

0 

UNNA BOOT LT LWR 0EXTREM 

0 

UNNA BOOT BILAT 0 0 

EXC BENIGN LES TRUNK 0 2.1 0 

EXC BENIGN LES TRUNK 0 3.1 0 

EXC BENIGN LES TRUNK>4.0 0 0 

EXC BENIGN LES SCALP 0 2.1- 0 

EXC BENIGN LES SCALP 0 3.1 0 

EXC BENIGN LES SCALP 0 >4.0 0 

EXC BENIGN LES FACE4.0CM 0 0 

EXC MAL LES TRK/ARM 0 1.1-2 0 

CUT SINGLE BENIGN LESION 1 1 

RMV TUN CVA CATH 0W/O SUBQ 0 

EXC NAIL, MATRIX, PAR/COM 0 0 

APPLY RIGID CONTACT 0 LEG 0 

OPTILOCK 5 X 5 DRESSING 7 7 

PROMOGRAM MATRIX 2 DRESSING2 

PRISMA MATRIX W/SILVER 0 0 

INTERDRY AG SHEET 0 0 

DUODERM XTRA THIN 0 4 X 4 0 

DUODERM GCF 4 X 40 0 

MEPILEX FOAM 4 X 839 39 

MEPLIEX AG 4 X 4 SLVR 11 FM 11 

MEPLIEX BORDER 314 X 3 14 

MEPILEX BORDER 417 X 4 17 

MEPILEX BORDER 6 X 16 

1 

MELGISORB ROPE 1.12 X 12.5 2

MELGISORB AG 6 X 61 1 

MEPITEL 2 X 3 0 0 

MEPITEL 3 X 4 0 0 

MEPITEL 4 X 7.2 0 0 

COBAN 3M LITE COMP 2 WRAP 2 

COBAN 4 X 5 YD 0 0 

HYDRO 9 MM TUNNEL 13 DRESSNG13 

MEDIHONEY HCS 4.52X 4.5 2 

MEDIHONEY CAL ALG 0.75X12 

0 

COBAN 3M COMPRESSION 13 WRAP 13 

ELASTO-GEL PLUS TAPE 0 4X4 0 

STIMULEN COLLAGEN 5POWDER 

5 

MATRIX SKIN SUB PER 105 SQ CM 105 

HYDROGEL GOLD DUST 4 FILLER 4 

PROTHROMBIN TIME 303 303 

ANTI COAG CLINIC 303 VISIT 303 

CARDIOVERSION PROC3 3 

CARDIO QUICK COMBO 3 PADS 3 

SPEC PROC RM-1/2 HR0 0 

SPEC PROC RM-1 HR 2 2 

SPEC PROC RM-1 1/20HRS 

0 

SPEC PROC RM- 2 HRS0 0 

MONITORED ANES 1ST 3 1/2 HR 3 

MON ANES EA ADD'L 015 MIN 0 

INSERT TEMP PACEMAKER 1 1 

ICU NURSING TIME PER 7 HOUR 7 

BLOOD DRAW/CENTRAL 1 LINE 1 

BLOOD DRAW THRU SQ 0 PORT 0 

PICC INSERTION 1 1 

CATHFLO ACT HITECH 0LINES 

0 

PICC LINE REPOSITION0 0 

SQ PORT FLUSH 0 0 

AUTOLO BLOOD TRANSFUSION 0 0 

IV TEAM VISIT 2 2 

HICKMAN CATHETER 0REPAIR 

0 

E & M LEVEL 1 0 0 

E & M LEVEL 2 0 0 

E & M LEVEL 3 0 0 

E & M LEVEL 4 0 0 

E & M LEVEL 5 0 0 

BLOOD ADMINISTRATION 0 0 

PHLEBOTOMY 0 0 


IV PUSH SEQ SAME DRUG>30 0 0 

IV PUSH EA ADD'L SEQ0 0 

INJECTION SC, IM 0 0 

IV TX HYDRA 31 TO 600 MIN 0


VACCINE INJECTION 1 1 

IMMUNO THERAPY INJECTION 0 0 

IV THERAPY 1ST HR 0 0 

IV THERAPY ADD'L HR0 0 

IV TX ADD'L SEQ < 1 HR 0 0 

IV TX CONCUR INF 0 0 

PICC 4 FR KIT 1 1 

MIDLINE CATHETER 0 0 

MAXIMUM BARRIER KIT 1 1 

4 FR INTRODUCER 0 0 

PICC 5 FR KIT 0 0 

PICC 4 FR MST KIT 1 1 

PICC 5 FR MST KIT 0 0 

HICKMAN REPAIR KIT0 0 

FACILITY FEE-MINIMAL 22 22 

FACILITY FEE-BRIEF 54 54 

FACILITY FEE-LIMITED 444 444 

FACILITY FEE-INTERME 546 546 

FACILITY FEE-EXTEND 448 448 

FACILITY FEE-NO CHRG1 1 

CRITICAL CARE 1ST-HR 30 30 

CRITICAL CA EA 30 MN0 0 

LWBS-TRIAGE ONLY 6 6 

NES PHY FEE-MINIMAL 0 0 

NES PHY FEE-LIMITED 239 239 

NES PHY FEE-INTERMED 173 173 

NES PHY FEE-EXTENDED 53 53 

NES PHY SEE NOTE* 0 0 

NES PHY FEE-COMPREHE 7 7 

I&D ABSCESS SIMPLE2 2 

I&D ABSCESS COMPLEX 2 2 

I&D PILONIDAL CYST S0 0 

I&D PILONIDAL CYST C0 0 

RMVL SUBC FB SMPL0 0 

RMVL SUBC FB CMPLX0 0 

I&D HEMATOMA SEROMA 0 0 

PUNC ASP ABSC CYST0 0 

DEBR W/OPEN FX/DIS0 0 

DEBRIDE OPEN FX/BONE 0 0 

DEBR SKN & SUBC TISS 1 1 

AVUL NAIL PLATE SMPL 1 1 

EVAC SUBUNGUAL HEMAT 2 2 

EXC NAIL MATRIX INGE 0 0 

REPAIR NAIL BED 0 0 

WDG EXC NAIL FOLD0 0 

SMPL BODY SC

SMPL BODY SC 2.6-7.58 8 

SMPL BDY SC 7.6-12.51 1 

SMPL BDY SC 12.6-201 1 

SMPL BDY SC 20.1-300 0 

SMPL BODY SC >30.00 0 

SMPL FACE < 2.5 5 5 

SMPL FACE 2.6-5.0 CM1 1 


SMPL FACE 7.6-12.5CM0 0 

SMPL FACE12.6-20.0CM 0 0 

TX SUPERFIC WND SMPL 0 0 

LYR BDY SCALP

RADIAL SHFT FX W/MAN 0 0 

FX CARE W/MAN ULNA 0 0 

ULNAR SHFT FX W/MAN 0 0 

DISTAL RADIUS FX W/O 0 0 

DISTAL RADIUS FX W/M 1 1 

NAVICULAR FX W/O MAN 0 0 

CARPAL BONE FX W/MAN 0 0 

DSTL RADIOULNAR W/M 0 0 

I&D ABSC FINGER SMPL 0 0 

I&D ABS FINGER CMPLX 0 0 

REP EXT TEN HAND PRI 0 0 

METACARPAL FX W/MAN 0 0 

THUMB DISLOC W/MAN 0 0 

METACAR DIS W/M WO 0 A 0 

IP JNT DISL W/M WO 0A 

0 

PHALANGEAL FX W/O 0M 

0 

PHALANGEAL FX W/MAN 0 0 

IP JOINT FX W/MAN 0 0 

DIST PHALANX FX W/M0 0 

CLS TX TIB/FIB FXW/M0 0 

CL TX DIS FEM FXWO/M 0 0 

IP JT DIS W/M W/O A0 0 

AMP FINGER SGL W/FLA 0 0 

AMPU FINGER/THB W/C/ 0 0 

HIP DISLOC W/O FIXTN0 0 

POST HIP DISLC W/O A0 0 

CL TX FEM SHT FX;W/M0 0 

TIB PLATEAU FX W/O 0M 

0 

KNEE DISLOC W/O ANES 0 0 

PATELLAR DSLOC W/O 0 A 0 

M MALLEOLUS FX W/O 0 M 0 

CL TX MED MAL FX W/M 0 0 

PROX FIB/SHFT W/O M0 0 

DIST FIB FX W/O M 0 0 

DIST FIB FX W/MAN 0 0 

BIMALLEOLAR FX W/MAN 0 0 

TRIMALLEOLAR FX WO 0 M 0 

ANKLE DISLOC W/O ANE 0 0 

TRIMALLEOLAR FX W/MA 0 0 

ANKLE DISLOC W/ANES 0 0 

REMOVAL FB FOOT SUBC 0 0 

CALCANEAL FX W/O M0 0 

TALUS FX W/O M 0 0 

METATARSAL FX W/O 0M 

0 

FX TOE/PHANLANX W/MA 0 0 

FX PHALANX W/M 0 0 

MTP JNT DIS W/O ANES 0 0

RML FB EXT EYE/CONJL 0 0 

RML EMBED CONJCTL 0FB 

0 

RML FB CORN W/O SLIT 0 0 

RML FB CORN W/SLIT0 0 

RML FB EYELID 0 0 

CANTHOTOMY 0 0 

DRAIN X EAR ABS/HEMA 0 0 

DRAIN X AUD CANAL 0AB 

0 

RML FB EXT AUD W/O 0 A 0 

RML IMPLD CERUMEN1 1 

INJ PROPHYLACTIC 112 DX 112 

IV INJECT INITIAL 379 379 


IM ANTIBIOTIC 9 9 

GASTRIC LAVAGE 1 1 

NASO W/ENDO (DIAG) 0 0 

CPR 1 1 

DLS TIBIA FX W/MAN0 0 

LARYN,FLEX FIBER;DX0 0 

PERICARDIOCEN INITIA 0 0 

INS/RE TEM ELE/PM CA 0 0 

ANOSCOPY BY BRUSH/WA 0 0 

PERIT ABD PARA OR PE 0 0 

I&D SCROTAL ABSCESS0 0 

VAG DELIV IN ED 0 0 

THROMBOL,CORONARY,IV 0 0 

IV THERAPY 1ST HOUR 130 130 

VACCINE INJ EA ADD'L0 0 

VACCINE INJECTION24 24 

IV TX HYDRAT 31-6076 MIN 76 

IV TX HYDRA ADD'L 596 HR 596 

IV TX ADD'L SQ < 1 HR 29 29 

IV TX CONCURR INF 5 5 

IV THERAPY ADD'L HR 41 41 

TEMP TRANSCUT PACING 0 0 

CARDIOVERSION EXTERN 0 0 

EKG RHYTHM STRIP 0 0 

CHEM CAUT GRAN TISSU 0 0 

MASTOTOMY, DEEP ABSCS 0 0 

DEBR SKIN PART THICK 0 0 

IVP SEQ SAME DRUG 114>30 MIN114 

CATH COLLECT SPEC-STR 49 CAT 49 

MTR FOR COMPARTMENT 0 SYNDR0 

AMP FGR/THUMB/SEC 0 SGL 0 

PERCUTAN CHOLECYSTOSTOMY 0 0 

RPR FLEX TENDN PRIM 0 WO GT 0 

I&D INTRAORAL, SUBLING 0 AB 0

SHAVING SKIN LESION 0

PC FACILITY FEE-MIN4 4 

PC FACILITY FEE-BRIE29 29 

PC FACILITY FEE-LIM289 289 

PC FACILITY FEE-INTE23 23 

PC FACILITY FEE-EXT 1 1 

PC-FAC FEE-NO CHRG0 0 

PC LWBS-TRIAGE ONLY 1 1 

I&D ABSCESS SIMPLE3 3 

I&D ABSCESS COMPLEX 1 1 

I&D PILONIDAL CYST S0 0 

I&D PILONIDAL CYST C0 0 

RMVL SUBC FB SMPL1 1 

RMVL SUBC FB CMPLX1 1 

I&D HEMATOMA SEROMA 0 0 

PUNC ASP ABSC CYST0 0 

DEBR SKN UPTO 10%TBS 0 0 

DEBR SKIN PART THICK 0 0 

DEBR SKN & SUBC TISS 0 0 

REM SKIN TAGS;UPTO15 0 0 

DEBR NAILS 1-5 0 0 

AVUL NAIL PLATE SMPL 0 0 

EVAC SUBUNGUAL HEMAT 3 3 

EXC NAIL MATRIX INGE 0 0 

REPAIR NAIL BED 0 0 

WDG EXC NAIL FOLD0 0 

SMPL BODY SC 30.00 0 

SMPL FACE < 2.5 11 11 



SMPL FACE 7.6-12.5CM0 0 


LYR BDY SCALP

CMPLX SC EXTS EA ADD 0 0 

CMPLX FACE EXTS2.6-7 0 0 

CMPL NOS/LIPS1.1-2.50 0 

BURNS-SML W/O ANES 0 0 

BURNS-MED W/O ANES 0 0 

CHEM CAUT GRAN TISSU 0 0 

EXPL WOUND EXTREMITY 0 0 

RMVL MUSC FC SMPL0 0 

REM FB MUS/TEND COMP 0 0 

ARTHROCENTESIS-SML 0 0 

ARTHROCENTESIS-INTM 0 0 

ARTHROCENTESIS-LRG0 0 

TX NASAL FX W/O STAB 0 0 

ELBOW DSL W/O ANES 0 0 

NURSEMAIDS SUB W/M 0 0 

FX RADIAL HEAD W/O 0M 

0 

ULNAR SHFT FX W/MAN 0 0 

DISTAL RADIUS FX W/O 0 0 

DISTAL RADIUS FX W/M 0 0 

DSTL RADIOULNAR W/M 0 0 

I&D ABSC FINGER SMPL 0 0 

I&D ABS FINGER CMPLX 0 0 

REP EXT TEN HAND PRI 0 0 

METACARPAL FX WO/MAN 0 0 

METACARPAL FX W/MAN 0 0 

IP JNT DISL W/M WO 0A 

0 

PHALANGEAL FX W/O 0M 

0 

PHALANGEAL FX W/MAN 0 0 

IP JOINT FX W/MAN 2 2 

PHALANX DISTAL FX WO 0 0 

DIST PHALANX FX W/M0 0 

IP JT DIS W/M W/O A2 2 

PATELLAR DSLOC W/O 1 A 1 

TRIMALLEOLAR FX W/MA 0 0 

REMOVAL FB FOOT SUBC 0 0 

FX TOE/PHANLANX W/MA 0 0 

FX PHALANX W/M 0 0 

MTP JNT DIS W/O ANES 0 0 

IP JNT DIS W/O ANES0 0 

SPLINT LONG ARM 1 1 

SPLINT SHORT ARM15 15 

SPLINT FINGER STATIC8 8 

CAST SHORT LEG 0 0 

SPLINT LONG LEG 0 0 

SPLINT SHORT LEG 7 7 

RMVL FB NASAL 0 0 

EPISTX ANT SIMPLE 0 0

EPISTX ANT CMPLX PKG 0 0 

EPISTX POST INITIAL 0 0 

PERICARDIOCEN INITIA 0 0 

CHEILOPLASTY LIP 0 0 

CHEILOPLASTY < V.HGT 0 0 

LAC VESTIBULE 2.5 CM0 0 

LAC MOU/TONG < 2.50 0 

DRAIN ABSCESS CYST0 0 

I&D PERITONSLR ABSC0 0 

UNLTED PROC;NASO-PHA 0 0 

L&D LSCHIO/PERI ABSC 0 0 

INC THRMBSCL HEM/EXT 0 0 

ANOSCOPY BY BRUSH/WA 0 0 

CATH URETHRA SMPL0 0 

INSER TEMP FOLEYCATH 0 0 

I&D BARTHOLIN GLD/AB 0 0 

INJ ANES TRIGEMINAL0 0 

INJ ANES PERIPHERAL1 1 

RML FB EXT EYE/CONJL 0 0 

RML EMBED CONJCTL 0FB 

0 

RML FB CORN W/O SLIT 0 0 

RML FB CORN W/SLIT1 1 

RML FB EYELID 0 0 

DRAIN X EAR ABS/HEMA 0 0 

DRAIN X AUD CANAL 0AB 

0 

RML FB EXT AUD W/O 0 A 0 

RML IMPLD CERUMEN0 0 

VACCINE INJECTION24 24 

VACCINE INJ EA ADD'L0 0 



IV THERAPY 1ST HOUR2 2 

IV THERAPY ADD'L HR0 0 

IV TX ADD'L SQ < 1 HR0 0 

INJ PROPHYLACTIC DX 23 23 

IM ANTIBIOTIC 6 6 

IV INJECT INITIAL 1 1 


TEMP TRANSCUT PACING 0 0 

DRAIN ABCESS,PALATE,UVULA 0 0 

IVP SEQ SAME DRUG 1>30 MIN 1 

I&D UPPER ARM; BURSA 0 0 

RPR FLEX TNDN PRIM 0WO GRF 0 

I&D INTRAORAL, SUBLING 0 AB 0 

SHAVING SKIN LESION 0

SUTURE REMOVAL-DKH 0 0 

REMOVAL FB UPPER ARM 0 SUBQ 0 

FINE NEEDLE ASP W/O 0 IMAGE 0 

REPR LAC2.6 0 0 

I&D VULVA OR PERI AB 0 0 

THROM. CEREBRAL, BY 0 IV 0 

IRRIGATE IMPLANTED 0VAD 

0 

CLOSED TX TIBIA SHAFT 0 FX 0 

ENDOMETRIAL SAMPLE(BIOP) 0 0 

VENIPUNCTURE ED 7 7 

STRAPPING KNEE 0 0 

STRAPPING ANKLE OR 0 FOOT 0 

FINGER SPLINT STATIC0 0 

SEDATION(MODERATE) 0 0 

BLD STICK/HEEL, FING, 0 EAR 0 

VENI BY MD FOR DIAG/THER 0 0 

EXC BENIGN 1.1 TO 2.0 0 CM 0 

BLADDER IRRI SIMPLE 0LAVAG 

0 

PREG MONOCLONAL 7URINE 

7 

SPFCL WOUND DEHISC 0 W/PACK 0 

ANESTHESIA CONSULT 0 N/C 0 

BONE MARROW TRAY2 2 

CATH TRAY STRAIGHT0 0 

PARA/THORACENTESIS 0 0 

CATHETER TRAY FOLEY 0 0 

VOLDYNE 0 0 

URINE DRAINAGE BAG0 0 

MED/SURG ROUTINE 0M&S 

0 

MED/SURG SUPPLY-TEL 0 0 

MED/SURG SUPPLY-ICU 0 0 

CARDIOVERSION COMBO 0 PADS 0 

G-TUBE REPLACEMENT 1 1 

PEG BUTTON 0 0 

PEG KIT 1 1 

POLYPECTOMY SNARE 45 45 

SCLEROSING NEEDLE3 3 

BALLOON DIALATOR 2 2 

DILATOR KIT 1 1 

ESOPHAGEAL BANDER0 0 

PULM BIOP FORCEP W/NEEDLE 0 0 

HOT BIOPSY FORCEPS0 0 

BIOPSY FORCEP 115 115 

PICC 4FR KIT 0 0 


PICC 4FR MST KIT 0 0 

PICC 5FR MST KIT 0 0

MIDLINE CATHETER 0 0 

EPIDURAL TRAY 0 0 

ROTH BASKET 0 0 

PROBE INJ GOLD 7FR0 0 

SPOT MARKERS 4 4 

RESOLUTION CLIP 11 11 


PARATHORA TRAY 0 0 

LUMBAR PUNCTURE 0TRAY 

0 

MAXIMUM BARRIER KIT 0 0 

TRY STRL ESI PK(JEFF 0GRP) 

0 

PULMONARY STANDARD 1 FORCEP1 

PULM BIOP W/NEEDLE 0 20G 0 

PULM RAIAL JAW 4 FORCEP 0 0 

OXYGEN SETUP-ONC0 0 

OXYGEN-ONC 0 0 

ACL BIO TRANSFX 40MM 0 0 

ACL BIO TRANSFX 50MM 0 0 

ACL BONE PLUG 0 0 

ACL CAN SCREW 10X35 0 0 



ACL CAN SCREW 9X350 0 

ACL DRILL PASSER 0 0 

ACL G/PIN 2,4 NITINOL 0 0 

ACL G/PIN 2,4 SUTR EYE 0 0 

ACL PTLA GRAFT DRILL0 0 

ACL RND SCREW 10X28 0 0 

ACL RND SCREW 11X28 0 0 

ACL RND SCREW 8X280 0 

ACL RND SCREW 9X280 0 

ACL TRANSFX SP KIT 0 0 

ART BIOCORK W/FIB 05.0 

0 

ART BIOCORK W/FIB 06.5 

0 

ART BIOTENO SCR 4.75 0 0 

ART BIOTENO SCR 4x10 0 0 

ART BIOTENO SCR 5.50 0 





ART CANNULA 6x7 1 1 

ART CANNULA 8.25x7 41 41 

ART CANNULA 8.25x90 0 

ART DRILL TIP 2.4 0 0 

ART ESU PROBE/HNDL5 5 

ART FASTFIX CURVED5 5

ART FASTFIX KNT PSHR2 2 

ART FASTFIX STRAIGHT 2 2 

ART FWIRE #2 2 STRANDS 1 1 

ART FWIRE #2 BLUE W/NDL 0 0 

ART FWIRE #5 STRAND/BLUE 5 5 

ART FWIRE LOOP NDL 0PN 

0 

ART ABLATION WAND 16 90 DEG 16 

ART SH AGRESS 2.5MM 0 MINI 0 

ART SH TOMCAT 3.5MM 0 0 

ART SH TOMCAT 4.0MM 2 2 

ART SH TOMCAT 4.0MM 0 ANGLE 0 

ART SH RESECT 2.5MM 0 MINI 0 

ART SH RESECT 3.5MM9 9 

ART SHAV RESECT 4.0MM 4 4 

ART SHAV FULL RAD 5.5 0 0 

ART SHAV TOMCAT 10 5.0MM 10 

ART SH BUR 6 FLUTE 24.0MM 

2 

ART SH BUR 6 FLUTE 135.5MM 

13 

ART SH BUR ROUND 4.0MM 0 0 

ART STAR SLEEVE 10 10 

ART SUT LASSO 25 LT6 6 

ART SUT LASSO 25 RT4 4 

ART SUT LASSO 90 DEG 2 2 

ART SUT PASS WIRE 0 0 

ART SUT RETRVR LG 0 0 

ART SUT RETRVR MD0 0 

ART MAIN PUMP TUBING 0 0 

ART PUMP TUBING SINGLE 0 0 

ART FIBERWIRE #2 0 0 

ASNIS 4.0 DRILL 1.4 1 1 



ASNIS 4.0 SCRW 10-706 6 

ASNIS 4.0 THD G/WIRE 4 4 

ASNIS 4.0 WASHER 2 2 




ASNIS 5.0 SCW 20-800 0 


ASNIS 5.0 WASHER 0 0 






ASNIS 6.5 SCRW 40-120 7 7


ASNIS 6.5/8.0 WASHER 1 1 

ASNIS 8.0 SCRW 40-120 0 0 

ENT CAUTERY LO TEMP* 0 0 

ENT EAR TUBE ACTIVENT 0 0 

ENT EAR TUBE MIRCON 0 0 

ENT EAR TUBE T 0 0 

ENT EAT TUBE REUTER 6 BOB 6 

ENT GEL FILM 2 2 

ENT MEROCEL NASAL 0PK 

0 

ENT MICRO DRAPE OPMI 0 0 

ENT MYRINGOTMY BLADE 3 3 

ENT NASAL SPLINT 1 1 

ENT NIM ENDO TUBE 0#6 

0 


1 


0 

ENT NIM SUBDER ELECT 0 0 

ENT PHENOL APPLICATOR 0 0 

ENT SEPTAL BUTTON0 0 

ENT SHAVER BLADE 2.0 4 4 

ENT SHAVER BLADE 4.0 1 1 

ENT SHAVER BLADE T&A 0 0 

ENT SHAVER STR SHOT 0 0 

ENT SUCTION CAUTERY* 0 0 

ENT VARI STIM 0 0 

ENT COBLATOR EVAC0 0 

ENT COBLATOR REFLEX 8 45 8 

ENT COBLATOR REFLEX 2 55 2 

ENT PRASS MONOPOLAR 0 PROBE0 

LAP IRRIG/SUCTION15 15 

LAP SHAFT 14 14 

LAP HANDLE 15 15 

MAXTRAX ANKLE BOOT 0 0 

LG BIOPSY FORCEP 46 46 

ESSURE LEFT 0 0 

ESSURE RIGHT 0 0 

CRYO PROBE 1 1 

ARGON GAS 6000 PSI1 1 

HELIUM GAS 6000 PSI1 1 

ENT PRASS STIM 0 0 

URO PERIGEE SLING 0 0 

URO MONARC SLING0 0 

200 MICRON FIBER 0 0 




980 SIDE FIBER 0 0

LAP UNIV TROCAR SLVE 14 5MM 14 

ART PUSHLOCK 4.5X18.5 0 MM 0 

URO URETAL STENT 4.8 0 X 26 0 

URO APOGEE SLING 0 0 

EXFIX EBI DRILL 2.0 0 0 

EXFIX EBI DRILL 2.7 0 0 

EXFIX EBI FIXA 041030 0 

EXFIX EBI PIN 0 0 

EXFIX MON DRILL 2.20 0 

EXFIX MON PIN 0 0 

EXFIX MON ROD 15x200 0 0 

EXFIX MON ROD 15x250 0 0 

EXFIX MON TRIAX CLMP 0 0 

EYE ANT CHAMB MAINTAINER 0 0 

EYE CONFORMER 0 0 

EYE CORNEAL PROTECT 0 0 

EYE DRAPE INCISE POUCH 0 0 

EYE HEMOS ERAS 18GA* 0 0 

EYE HEMOS ERAS 23GA 0 0 

EYE I&A CANNULA 0 0 

EYE TORIC LENS 11 11 

EYE IOL STANDARD 82 82 

EYE MULTIFOCAL LENS 4 4 

EYE KNIFE 15 DEGREE1 1 

EYE KNIFE 3.5 ANGLE0 0 

EYE KNIFE 5.7 0 0 

EYE KNIFE FEATHER 1 1 

EYE KNIFE GRIESHABER 0 0 

EYE KNIFE KELLAN 1 1 

EYE KNIFE, 4.0 ANGLED 0 0 

EYE LACRIMAL INT CRWFRD 0 0 

EYE PACK INFINITY FMS 81 81 

EYE RETRCTOR IRIS 0 0 

EYE SPHERE-SILICONE0 0 

EYE VARI CAUTERY* 0 0 

GYN DERMABOND PEN 1 1 

GYN FALOP BAND (2)1 1 

GYN HYST BAG URO 15 CAT 15 

GYN HYST ROLL BALL 022 

0 

GYN HYST Y TUBE 0 0 

GYN HYSTCOPE LOOP 022 

0 

GYN HYSTCOPE TUBING 0 0 

GYN INTERCEED 0 0 

GYN LOOP ELEC T-STYL 0 0 

GYN STAC VAC TUB SM/LG 0 0 

GYN THERMAL ABLATOR 0 0 

GYN UTERIN MANIPUL 0 0

GYN VAG PACKING* 0 0 

LAP CHOLE CATH KUMAR 2 2 

LAP END LINCUT 45 3 3 

LAP END LINCUT 45DLU 6 6 

LAP ENDO CLOSE 0 0 

LAP ENDO RETRACT 0 0 

LAP ENDOCLIP 10MM6 6 

LAP ENDOCLIP 5MM 7 7 

LAP ENDOCLOSE 0 0 

LAP ENDODISSECT 0 0 

LAP ENDODISSECTOR0 0 

LAP ENDOPOUCH 6 6 

LAP ENDORETRACT 0 0 

LAP ENDOSCISSOR 2 2 

LAP TROCAR 12MM31 31 

LAP TROCAR 5MM 33 33 

LAP TROCAR 7/8MM0 0 

LAP TROCAR HASSON5 5 

LAP VERES NDL 120MM 16 16 


MESH DULEX OVAL 0 0 

MESH DULEX RECTANGUL 0 0 

MESH KUG COMP 7X9OVL 0 0 

MESH KUGEL LG OVAL0 0 

MESH KUGEL MD OVAL 0 0 

MESH KUGEL SM OVAL 0 0 

MESH KUGEL XLG OVAL 0 0 

MESH MARLE 10X14 0 0 

MESH MARLEX 1X4 0 0 

MESH PERFIX, X-LG 0 0 

MESH SURGIPRO 3X59 9 

MESH SURGPRO 6X62 2 

MESH VENTRALEX MED 1 1 

MESH VENTRALEX SMALL 13 13 

MIS A-LINE TRANS KIT0 0 

MIS BAIR HUGGER ALL0 0 

MIS BILE BAG* 0 0 

MIS CATH EMBBOLECTOMY 0 0 

MIS CATH FOLEY 8 8 

MIS CATH FOLEY BAG*0 0 

MIS CATH FOLEY KIT 2 2 

MIS CATH TRIPLE LUMEN 0 0 

MIS CHOLANG CATH*0 0 

MIS CORNWALL SYRINGE* 0 0 

MIS CYSTO TUBING* 0 0 

MIS DERMATOME BLADE 0 0 

MIS DISP VEIN STRIPP0 0

MIS DRAIN BAKER JEJUN 0 0 

MIS DRAIN HEMOVAC0 0 

MIS DRAIN J P 4 4 

MIS DRAIN SALEM SUMP* 0 0 

MIS DRAIN T TUBE 10FR* 0 0 

MIS DRAIN T TUBE 12FR* 0 0 

MIS DRAPES C/ARM*0 0 

MIS ESU SMOKE/P FILTER* 0 0 

MIS ESU SMOKE/PENCIL 8 8 

MIS ESU SMOKE/TUBING 8 8 

MIS FRED ANTIFOG* 0 0 

MIS GEL FOAM 100 0 0 

MIS GEL FOAM 12 -7*0 0 

MIS GIGLI SAW BLADE0 0 

MIS HICKMAN DUAL 0 0 

MIS HICKMAN SINGLE0 0 

MIS HOLLISTER KIT 0 0 

MIS LEVEEN SHUNT 0 0 

LIGASURE V 3 3 

MIS LIGASURE MAX 1 1 

MIS LIGASURE STD 2 2 

MIS LIGASURE XTD 0 0 

MIS LVL I ANES 0 0 

MIS MICROSCOPE DRAPE* 0 0 

MIS PUDDLE VAC 4 4 

MIS SQ PORT DBL LMN0 0 

MIS SQ PORT SNGL LMN 0 0 

MIS SURGICEL 4X8 2 2 

MIS TAPE UMBILICAL0 0 

MIS THOROCEAL 0 0 

MIS TRACH TUBE 0 0 

MIS TRU-CUT NEEDLE0 0 

MIS U-DRAPE* 0 0 

MIS URIMETER* 0 0 

MIS VEIN PIK 0 0 

MIS VEIN STRIPPER DISPO 0 0 

MIS VENA CAVA CLIPS0 0 

MIS VESSSEL LOOP RED* 0 0 

APLIGRAF PER SQ CM0 0 

ORT BLADE INDI TOME 10 10 

ORT CAST ARM LONG0 0 

ORT CAST ARM SHORT1 1 

ORT CAST HIP SPICA 0 0 

ORT CAST LEG LONG 0 0 

ORT CAST LEG SHORT0 0 

ORT CAST SPLINT ARM2 2 

ORT CAST SPLINT LEG5 5

ORT CRV-TC CART MED 0 0 

ORT CRV-TC NDL MED* 0 0 

ORT CURV-TECH CART 0 LG 0 

ORT CURV-TECH NDL 0LG* 

0 

ORT DALL-MILE CBL BD 0 0 

ORT DALL-MILE CBL SS 0 1.6 0 

ORT DALL-MILE CBL VI 0 0 

ORT DALL-MILE G/C LG0 0 

ORT DALL-MILE G/C MD 0 0 

ORT DALL-MILES CBL 0SS 2.0 0 

ORT DALL-MILES G/C 05MM 

0 

ORT DALL-MILES PL 8"0 0 

ORT FLEX OSTEO CRV 012 

0 

ORT FLEX OSTEO CRV 015 

0 

ORT FLEX OSTEO FLT 010 

0 


0 


0 

ORT FLEX OSTEOTOMES 0 0 

ORT FLEXI LUM 0 0 

ORT GRAFT CAN/CORT0 0 

ORT GRAFT DBM 10CC0 0 



ORT GRAFT PRO-OS 15CC 0 0 

ORT GRAFT PRO-OS 30CC 0 0 

ORT GRAFT PRO-OS 500 0 0 

ORT JURGAN BALL .045* 0 0 

ORT JURGAN BALL .062* 0 0 

ORT JURGAN BALL 3/32* 0 0 



ORT JURGAN BALL X003* 0 0 

ORT JURGAN BALL X006* 0 0 

ORT KNEE IMMOB 18"0 0 



ORT KNEE IMMOBILIZER 0 13" 0 

ORT K-WIRE SMTH .035* 0 0 




ORT K-WIRE THD .0620 0 

ORT LAMIN PILLOW*0 0 

ORT MINI C/ARM DRAPE* 0 0 

ORT MITEK GII 0 0 

ORT MITEK MICRO 0 0 

ORT MITEK MINI 0 0

ORT MITEK SUPER 0 0 

ORT PLATE HUMERAL 0I/R 

0 

ORT QUICK STICK CMP 0 SYN 0 

ORT REDI DRAPE 0 0 

ORT RUSH PIN 0 0 

ORT SAW BL HALL 1380 0 

ORT SAW BL HALL 2393 3 

ORT SAW BL MS-1230 0 




ORT SAW BL STRY 1050 0 







ORT SIDEWNDR DRL 3.2 0 0 

ORT SIDEWNDR DRL 4.3 0 0 

ORT SIDEWNDR DVICE0 0 

ORT SPECIMEN SOCK*0 0 

ORT STEIN PIN SM 1/81 1 

ORT STEIN PIN SM 3/32* 0 0 

ORT STOCK IMPERV 12"* 0 0 



ORT UNI WRIST SPLT 0RIGHT 

0 

ORT WATER PIK 18 18 

ORT WATER PIK IM* 0 0 

ORT UNI WRIST SPLT 0LEFT 

0 

ORT WATER PIK SHRT0 0 

MITEK SUTURE GRASPER 2 60 2 

ORT SAW B1 PRECISION 3 CART 3 

STAPLE LIN CUT 45 0 0 

ACL ENDOBUTTON CL 1ULTRA 

1 

GYN ERS KIT 2 2 

ACL ENDO CANNULTD 1 DL 4.5 1 

SINGLE PACEMAKER 0 0 

DUAL PACEMAKER 7 7 

LOOP MONITOR IMPLANT 0 0 

PACEMAKER LEAD 8 8 

URO STENT URET 4.80X 24 0 


URO GLIDE WIRE .0350 0 

URO CYSTO INJ NEEDLE 1 5 FR 1 

TIER 1 DRILL 2 2

TIER 1 INSERTS 1 1 

TIER 1 NAILS/RODS 0 0 

TIER 1 PLATES 1 1 

TIER 1 SCREWS/ANCHORS 5 5 

TIER 1 SHELLS 1 1 

TIER 1 STEMS 1 1 

TIER 1 WIRES 0 0 

TIER 2 DRILL 4 4 





TIER 2 SHELLS 1 1 



TIER 3 DRILL 15 15 




TIER 3 SCREW/ANCHOR 70 70 

TIER 3 SHELL 0 0 



TIER 1 MISC ORTHO CONSUME 0 0 



TIER 1 MISC OTHER CONSUME 0 0 





TIER 1 HEAD 1 1 

TIER 2 HEADS 0 0 

TIER 3 HEADS 0 0 

TIER 1 ALLOGRAFT 0 0 



TIER 1 URETHRAL STENTS 0 0 

ENT SPEAR TIP BLADE0 0 

URO SLING MINIARC 0 0 

HARMONIC SCALPEL 0DIS HOOK 0 

HARMONIC HAND SWITCH 0 ADAP0 

HARMONIC SCALPEL 0ACE 

0 

HARMONIC BLADE WRENCH 0 0 

SUPRALOOP 0 0 

ORT PEEK ANCHOR 3.5 21 21 

ORT PEEK ANCHOR 5.55 5

TKA X3 TRIATHLON CS 0 INS 0 

TOPAZ WAND 0 0 

ASNIS MICRO 1.7 CAN 3 DRILL 3 

MORCELLATOR CUTTER 0 12 MM 0 

ASNIS MICRO 2.0 CAN 4 SCREW 4 

ASNIS MICRO .8X1004K WIRE 4 

INTRIDUCER KIT 6 FR1 1 

TISSUE EXPANDER(BREAST) 4 4 

ALLODERM PER CM 4 4 

NEPTUNE MANIFOLD 444 PORT 44 

NEPTUNE MANIFOLD 5SGL PORT 5 

ART PUSHLOCK 4.5 X 924 MM 9 

CONTOUR URETERAL 0STENT 

0 

BREAST IMPLANT 0 0 

TIER 1 URO SLING 0 0 



LAP TROCAR 5MM XL0 0 

MIS EZ CLEAN CAUTERY 0 TIP 0 

GREENFIELD FILTER 0 0 

GREENFLD FIL PLAT GUIDE 0 0 

GREENFIELD FLTR OTH 0 GUIDE 0 

GREENFIELD REMOVAL 0 SET 0 

GREENFLD FILTR ACCESS 0 KIT 0 

GREENFIELD FILTER TRAY 0 0 

NEPHROSTOMY KIT 0 0 

GYN RUMI UTER MANIP 2 TIP 2 

GYN RUMI II UTER MANIP 1 KO 1 

POWER PORT VVE MRI 0 8FR 0 

ENT SINUFOAM DRESSING 4 4 

TIER 4 ORTHO IMPLANT 1 1 

PORT DUAL LUMEN HICK 0 0 

PORT DUAL LUMEN SUBQ 0 0 

PORT SGL LUMEN HICKM 0 0 

PORT SGL LUMEN SUB-Q 0 0 

HYDROSET 3CC 0 0 




MIS POWER PORT DUO 0 9.5 FR 0 

VITAGEL 17 17 

VITAGEL PLASMA SEPARATOR 17 17 

ART SUREFIRE SCORPION 2 NDL 2 

SONICBEAT-35CM(SB-0535PC) 0 0 

THUNDERBEAT 35CM 2TB0535PC2 

PACEMAKER-AIGIS 0 0 

POWER PORT VVE MRI 6 LGE 8F 6

BALLOON SINUPLASTY0 0 

ART 6.5 PEEK ZIP ANCHOR 11 11 

TOURNIQUET 3 3 

TROCHANTERIC LONG 0 NAIL 0 

BEADED CABLE & SLEEVE 0 0 

END CAP 0 0 

U-BLADE LAG SCREW 0SET TI 0 

DISTAL DRILL 0 0 

GUIDE WIRE BALL 1 1 

SIDEWINDER 0 0 

SIDEWINDER DRILL 0 0 

CANCELLOUS BONE SCREW 0 0 

TRIDENT HEMI SOLID 0BACK 

0 

TRITANIUM HEMI SOLID 3 BACK 3 

TRIDENT HEMI CLUSTER 0 0 

TRITANIUM HEMI CLUSTER 0 0 

ACCOLADE TMZF HIP 3STEM 

3 

ACCOLADE HFX 1 1 

NEUTRAL HOOD 4 4 

TRIDENT 0 X3 INSERT0 0 

TRIDENT 0 INSERT 0 0 

TRIATHLON TS BASEPLATE 0 0 

TRIATHLON TS PLUS TIBIAL 0 0 

TRIATHLON CEMENTED 0 STEM 0 

SHAVER FULL RAD 0 0 

STAPLE CONTOU 3.5 1DLU 

1 

STAPLE CONTOU 4.7 0DLU 

0 

STAPLE CONTOUR 3.51 1 

STAPLE GIA 80 DLU3.80 0 

STAPLE GIA 80 IN 3.80 0 

STAPLE ILS 21MM EEA0 0 



STAPLE ILS 33 1 1 

STAPLE LIGACLIP LG 0 0 

STAPLE LIGACLIP MED3 3 

STAPLE LIGACLIP SM 0 0 


STAPLE LIN CUT 55DLU0 0 


STAPLE LIN CUT 80DLU0 0 

STAPLE LINEAR 30 0 0 

STAPLE LINEAR 30DLU0 0 

STAPLE LINEAR 60 0 0 

STAPLE LINEAR 60DLU3 3 

STAPLE LINEAR 90-4.80 0 

STAPLE POLYROTIC 2000 0

STAPLE PURSESTRING0 0 

STAPLE PURSTRING 1 1 

STAPLE ROTIC 55-3.50 0 

STAPLE SKIN* 0 0 

STAPLE TA 90 0 0 

SYN L DRILL 3.2 0 0 

SYN L DRILL 4.5 0 0 

SYN L PL DCP NR 08 H0 0 

SYN L PL T-4 H 0 0 

SYN L PL T-6 H 0 0 

SYN L SCR CANC 55-80 0 

SYN L SCR CANC 85-110 0 0 

SYN L SCR CANC FL THD 0 0 

SYN L SCR CORT 14-70 0 

SYN L WASHER* 0 0 

SYN L WASHER SPIKED0 0 

SYN L SCR CORT 14-70* 

0 

SYN MN DRILL 1.5 0 0 



SYN MN K-WIRE 0.6*0 0 



SYN MN PLATE 1/4 TUB 0 3H 0 






SYN MN PLATE L 2.0 LT 0 0 

SYN MN PLATE L 2.0 RT 0 0 

SYN MN PLATE L 2.7 LT 0 0 

SYN MN PLATE L 2.7 RT 0 0 

SYN MN PLATE STR 3H0 0 



SYN MN PLATE T 2.0 0 0 

SYN MN PLATE T 2.7 0 0 

SYN MN WASHER SPIKED 0 0 

SYN SM 3.5 RECON 090 H 0 

SYN SM DRILL 2.5 0 0 

SYN SM DRILL 3.5 0 0 

SYN SM K-WIRE 1.25 0 0 

SYN SM K-WIRE 1.6 0 0 

SYN SM K-WIRE 20. 0 0 

SYN SM PL CLVR 03 H0 0 

SYN SM PL CLVR 04 H0 0

SYN SM PL LCDCP 05 H0 0 






SYN SM PL T-OBL 3/30H 

0 


0 


0 

SYN SM PL T-RT 3 H 0 0 

SYN SM PL T-RT 4 H 0 0 

SYN SM PLATE 1/3 TUB 0 2H 0 







SYN SM WASHER 0 0 

SYN SM WASHER SPIKED 0 0 

TOT BONE CEMENT 0 0 

TOT BONE CEMENT 15 W/TOB 15 

TOT BONEDRY FEM WICK 3 3 

TOT BUR 3MM 0 0 

TOT BUR 4MM 0 0 

TOT BUR EGG 0 0 

TOT CEMENT MIX KIT14 14 

TOT HEWSON SUT PASS 6 6 

TOT IM BRUSH 0 0 

TOT KNIFE SLIT BLADE0 0 

TOT SAW BL STRY 250 0 

TOT SAW BL STRY 328 8 

TOT STERI-SHLD HELM 72 72 

TOT SUPER SUCKER 0 0 

URO AMPLATZ DILATORS 0 0 

URO BAL DIL URO MAX4 0 0 

URO BALL TIP ELECTRODE 0 0 

URO CATH ALCOC 220 0 

URO CATH ALCOC 240 0 

URO CATH CARSON 0-TIP 0 0 

URO CATH CONE 10 2 2 

URO CATH CONE 8 0 0 

URO CATH COUDE (ALL) 0 0 

URO CATH COUNCIL 16 0 0 

URO CATH COUNCIL 20 0 0 

URO CATH MALECOT 0ALL 

0 

URO CATH SILC 20/30CC* 0 0

URO CATH SILIC 22/3WAY* 0 0 

URO CATH WHISTLE 4FR 0 0 

URO CATH WHISTLE 5FR* 0 0 

URO CATH WHISTLE 6FR 4 4 

URO DEV-URINARY W/SLING 0 0 

URO EHL PROBE 3.3-1050 0 0 



URO EHL PROBE 9 0 0 

URO GD WIRE .038 6 6 

URO GD WIRE RING TORQ 0 0 

URO GD WIRE SENSOR1 1 

URO GD WIRE STIFF 0 0 

URO GLIDE WIRE .0381 1 

URO LEVEEN INFLATOR 0 0 

URO LEVEL I IRRIGATION 11 11 

URO LIDOCAINE BRISTO 0 0 

URO LONE STAR RETR0 0 

URO LONE STAR STAYS 0 0 

URO MAL REENTRY2 0 0 

URO NDL FASCIAL INCIS 0 0 

URO NEPH KAYE TAMP 0 0 

URO NEPH LAWSON RETR 0 0 

URO NEPH VTC CATH 012FR 

0 

URO NEPHRO MAX 0 0 

URO OCCLUS BAL CATH 0 0 

URO OPT UREETHTOME 0 0 

URO OPT URETHTOME 0 1/2 0 

URO PUP STENT 0 0 

URO S/P CATH INTRODU 0 0 

URO SAPS 0 0 

URO SLING GYNECARE 0 TVT 0 

URO SLING MID URETHRAL 0 0 

URO STENT POSITIONER 0 0 

URO STENT PRC END/PYE 0 0 

URO STENT PUP 0 0 

URO STENT PUSHER/POSITIO 0 0 

URO STENT TAIL 30 0 0 



URO STENT URET 6X20 0 0 

URO STENT URET 6x220 0 




URO STONE BSKT 0-TIP 0 0 

URO STONE BSKT SEG 13 

1

URO STONE BSKT SEG 14 

1 

URO STONE CONE RET0 0 

URO STONE GRASP TRICP 0 0 

URO SURSEAL II 1 1 

URO TOOMEY SYRINGE* 0 0 

URO TURP BALL 24 0 0 


URO TURP KNIFE 24FR0 0 

URO TURP LOOP 24 0 0 

URO TURP LOOP 27 8 8 

URO TURP STAMEY PERC 0 0 

URO URET ACCS SHEATH 0 0 

URO URET DUAL LUMEN 0 0 

URO URETERAL STENT0 0 

URO UROST TUBE ADAP* 0 0 

SPECIAL ORDERS 0 0 

TKA TRIATHL CR FEM 0CEMENT 

0 

TKA TRIATHL PS FEM 0CEMENT 

0 

TKA TRIA CR PA FEM 11BEADED 

11 

TKA TRIA ASYM+B13 1PATELLA 

1 

TKA ASYM ALL POLY 10 PATELLA 10 

TKA TRIA CR TIBIAL INSERT 1 1 

TKA TRIA CR TRIBIAL 10INSX3 

10 

TKA TRIA PS TIBIAL INS 0 X3 0 

TKA TRIA PRIM TIB BP 11CRUC 

11 

THA TRI HEMI SOLID SHELL 0 0 

THA HEMI CL CEM-LESS 0 SHEL 0 

THA VITALOCK CLUSTER 0 SHEL 0 

THA TRIDENT CROSSFIRE 0 INS 0 

THA TRIDENT ALUMN 0ID HEAD 0 

THA TRID 10DEG X3 ID 0 HEAD 0 

THA V40 ALUMNA HEAD 0 32MM 0 

THA V40 CORCR LFIT 1HEAD 

1 

THA V40 BIOLOX DELTA 2 HD36 2 

THA TI SLEEVE ALUMNA 0 HEAD 0 

THA ALUMNA HEAD V40 0 36MM 0 

THA ANA HEADV40 COCR 0 LFIT 0 

THA ANA C/TAPER BIO 0 D-HEA 0 

THA ANA V40 BIO DELTAHEAD 0 0 

THA CANC BONE SCREW 0 6.5 0 

THA MERID PA HIPSTEM#6/14 0 0 

THA CITATION TMZF 0HA#2 LT 0 

THA ACCOLADE TMZE 0HIPSTEM 

0 

THA ACCO PLUS TMZF 0 HIPSTE 0 

THA ARTISAN BONE PLUG 0 0 

THA CEMENT PLUG SIZED 1 1 

THA UNIVER DISTAL SPACER 0 0

THA ACCOLADE C CS 0127NK 

0 

THA ACCOLADE C CS 0132NK 

0 

THA DEFI CEMENTED 0HIPSTEM 

0 

THA RELIANCE DIST CENTRAL 1 1 

THA RELIANCE PF HIP 1STEM 

1 

THA UHR BIPOLAR 260 0 

THA UNITRAX MODU 2ENDOHEAD2 

THA UNITR V40 TAPERSLEEVE 0 0 

THA TRID ECC X3 HEAD 2 36MM 2 

THA DALLM CBL/SLVSET2MMSS 0 0 

THA DALLM BEAD CBLSET2MMV 0 0 

THA DALL MED GRIP&22MMCBL 0 0 

GAMMA TROCHA LOCKING 2 NAIL2 

GAMMA LAG SCREW2 2 

GAMMA CROSS SCREW2 2 

GAMMA SET SCREW 0 0 

GAMMA CAP SCREW0 0 

GAMMA KIRSCHNER 2WIRE 

2 

GAMMA DRILL 0 0 

GAMMA GUIDE WIRE 1BALL TIP 1 

OMEGA STANDARD LAG 0 SCREW 0 

OMEGA SUPER LAG SCREW 0 0 

OMEGA COMPRESSION 0 SCREW 0 

OMEGA 3.6 BONE DRILL 0 0 

OMEGA CORT SELF-TAP 0 SCREW 0 

OMEGA STD BARREL 02 HOLE 0 

OMEGA STD BARREL 03HOLE 

0 


0 


0 


0 


0 


0 


0 

GELFOAM 0 0 

PACK C-SECTION 17 17 

GYN INTERCEED 0 0 

MCH MIS CATH FOLEY 17 17 

MCH STAPLE CRICKET1 1 

ONC IV THER 1ST HR68 68 

ONC IV THER ADD'L 38 HR 38 

INI PLACE PUMP/CASSETTE 19 19 

REFILL/MAIN PUMP/CASSETTE 4 4 

EACH ADDITIONAL VACCINE 0 0 

IV TX ADD'L SQ < 1182 HR 182 

SINGLE VACCINE ADMIN 1 1 

LUMBAR PUNCTURE 0 0 

BONE MARROW ASPIRATION 1 1

BONE MARROW BIOPSY 1 1 



IV TX HYDRAT 31 6025 MIN 25 

IV TX HYDRA ADD'L 51 HR 51 

ONC INJECTED SC, 100 IM 100 


IVP EACH ADD'L SEQ 7 7 

IVP SEQ SAME DRUG>30 0 MIN 0 

GLUSOCE CHECK 0 0 

INSER FOLEY CATH 0 0 

LEVEL I NV 2 2 

CHEMO INFUSD 1ST 130 HR 130 

CHEMO INFUSD AD'L 44HR 

44 

CHEMO INF SEQ 1ST 44 HR 44 

CHEMO SPINAL INC LUMBAR 0 0 

CHEMO IVP INITIAL 1 1 

CHEMO IVP EA ADD'L 22 22 

CHEMO SC/IM NON-HORM 12 12 

CHEMO SC/IM HORMONAL 3 3 

BLOOD ADMIN-ONCOLOGY 20 20 

PORT FLUSH ONLY 55 55 

PNEUMON VACCINE 0ADMIN 

0 

CONSULT ONLY ONC 0N/C 

0 

EKG ONCOLOGY 2 2 

CHEMOTHERAPY VISIT 144 144 

NON CHEMOTHERAPY 258 VISIT 258 

VENOUS DRAW THROUGH 28 PORT 28 

CHEMO PUMP RENTAL 15 15 

CHEMO SPILL KIT 1 1 

CHEMO PUMP KIT 15 15 

ONCOLOGY OXYGEN 4 4 

ONCOLOGY E&M LEVEL 0 3 0 

CONSULT ONLY ONC 0N/C 

0 

BLEOMYCIN 15 UNIT 2VIAL 

2 

DOXORUBICIN 10MG 40VIAL 

40 

FLUDARABINE 50 MG 0VIAL 

0 

VINCRISTINE 1MG/ML 6 2MLVIA 6 

VINBLASTINE 10 MG 0VIAL 

0 

DOCETAXEL 1 MG INJECTION1300 

DOXORUBICIN LIPOSOME 0 20MG0 

RITUXIMAB 100MG/ML 64 VIAL 64 

TRASTUZUMAB 440 718 MG VIAL 718 

VINORELBINE 10 MG 0VIAL 

0 

CARBOPLATIN 10MG/ML 104 VIAL104 

CYCLOPHOSPHAMIDE 0100 MG 0 

IRINOTECAN 40 MG 126 SDV VIAL 126

ETOPOSIDE 20 MG/ML 450 VIAL 450 

FLUOROURACIL 50244 MG/ML VL244 

GEMCITABINE 200101 MG VIAL 101 

METHOTREXATE 25MG/ML 0 VIAL0 

INTRON A 18 MM UNITS/VIAL 0 0 

EPOETIN 2,000 U/ML 0VL 

0 

EPOETIN 3,000 U/ML 0VIAL 

0 

EPOETIN 4,000 U/ML 0VIAL 

0 

EPOETIN 10,000 U/ML 50 VIAL 50 

EPOETIN 20,000 U/ML 160 VIAL 160 

CISPLATIN 10 MG 125 125 

MITOXANTRONE 20MG/10ML 0 VL0 

MITOMYCIN 5 MG VIAL 2 2 

MITOMYCIN 20 MG VIAL 0 0 

ONDANSETRON 2 MG/ML 192 MDV 192 

TOPOTECAN .1 MG 8 8 

PAMIDRONATE 30 MG 0 VIAL 0 

PAMIDRONATE 90 MG 0 VIAL 0 

EPIRUBICIN 50 MG/25ML 100 VIA 100 

FERRLECIT 62.5MG/5ML 190 INJ 190 

ZOLEDRONIC ACID 4 MG 8 VIAL 8 

GOSERELIN ACET 3.60MG SYR 0 

LEUPROLIDE ACET 22.5MG 0 SY 0 

DOLASETRON 100 MG 0 VIAL 0 

NEULASTA 6MG/0.6ML 37 SYRNGE37 

FILGRASTIM 300 MCG/ML 5 VL 5 

FILGRASTIM 480 MCG/ML 10 VL 10 

OXALIPLATIN 50 MG 4500VIAL 

4500 

BORTEZOMIB 3.5 MG 245VIAL 

245 

PEMETREXED 500 MG 0 VIAL 0 

BEVACIZUMAB 100660 MG VIAL 660 

CETUXIMAB 100 MG 0VIAL 

0 

AZACITIDINE 100 MG 0VIAL 

0 

EPOETIN 40,000 UNIT/ML 280 VL 280 

FULVESTRANT 250 MG 0 SYRING 0 

PACLITAXEL 6 MG/ML, 118 5ML V 118 

MESNA 1 GM/10ML VIAL 0 0 

OCTREOTIDE 20MG LAR 0 DEPOT 0 

ABRAXANE 100 MG 2100 IV VIAL 2100 

CYCLOPHOSPHAMIDE 110100 MG110 

CYCLOPHOSPHAMIDE 40100 MG 40 

CYTARABINE 100 MG0 0 

DACARBAZINE 100 MG0 0 

MITOMYCIN 5 MG 56 56 

VINCRISTINE 1MG/ML 0 1MLVIA 0 

LEUCOVORIN 50MG 257 VIAL 257 

VECTIBIX 5CC 100MG 0VIAL 

0

ARANESP 200MG 1.4ML 0 0 

IFOSFAMIDE 100MG 0INJ VIAL 0 

TORISEL KIT-25MG 0 0 

DACOGEN 50MG VIAL 400 400 

COSMEGEN 0.5MG VIAL 0 0 

EPOGEN 10000 UNITS 0VIAL 

0 

EPOGEN 4000 UNITS0 0 

SANDOSTATIN LAR DEPOT 0 30 0 

BENDAMUSTINE 1 MG0 0 

EPOGEN 2000 UNITS/ML 0 0 



IXABEPILONE 1 MG 0 0 

ROMIPLOSTIM 10 MICROGRAMS 

225 225 

ROMIPLOSTIM 500 MCG 0 INJ 0 

CAD CASSETTE W/IV 25 SOLUTIO 25 

LEVOLEUCOVORIN 500 MG VIAL 0 

AZACITIDINE 1 MG WASTE 0 0 

BEVACIZUMAB 10MG 0WASTE 

0 

CISPLATIN 10 MG WASTE 0 0 

CARBOPLATIN 50MG 0WASTE 

0 

CYCLOPHASPHAMIDE 0WASTE 

0 

CYCLOPHOSPHAMIDE 0WASTE 

0 

CYCLOPHOSPHAMIDE 0WASTE 

0 

DOCETAXEL 1MG WASTE 0 0 

DOXORUBICIN HCL 10MG 0 WAST 0 

DOXORUBICIN HCL 100 WASTE 0 

GEMCITABINE HCL 200 0 WASTE 0 

RITUXIMAB 100MG VL 0 WASTE 0 

TOPOTECAN .1MG WASTE 0 0 

ALTIMA 10 MG WASTAGE 0 0 

ANZEMET 10 MG WASTAGE 0 0 

BENDAMUSTINE 1MG 0 WASTE 0 

BLEOMYCIN 15 UNITS 0WASTE 

0 

COSMEGEN .5MG VL 0WASTE 

0 

CYTARABINE 100MG 0WASTE 

0 

DACARBAZINE 100MG 0 WASTE 0 

DACOGEN 1MG WASTAGE 0 0 

ELLENCE 2MG WASTAGE 0 0 

ELOXATIN .5 MG WASTE 0 0 

EPOETIN 1000 UTS WASTAGE 0 0 

EPOETIN 1000 UNITS 0WASTE 

0 


0 


0 


0 


0 


0

EPOGEN 1000 UNITS 0WASTAGE 

0 


0 


0 


0 

ERBITUX 10MG WASTAGE 0 0 

ETOPOSIDE 10MG WASTAGE 0 0 

FASLODEX 25MG WASTE 0 0 

FERRLECIT IV 12.5MG 0WASTE 

0 

FLUDARABINE PHOSPHAT 0 WAST0 

FLUOROURACIL 500MG 0 WASTE 0 

IFOSFAMIDE 1GRAM 0WASTE 

0 

IRINOTECAN HCL 20 WASTE 0 0 

IXABEPILONE 1MG VL 0WASTE 

0 

LEUCOVORIN 50 MG 0WASTE 

0 

LEVOLEUCOVORIN .5MG 0 WASTE0 

LUPRON DEPOT 7.5MG 0 WASTE 0 

MESNA 200 MG WASTE 0 0 

MITOMYCIN 5MG WASTE 0 0 

MITOMYCIN .25 MG WASTE 0 0 

INJ INTERFERON ALFA 0 2B 0 

FERUMOXYTOL 11020 MG INJ 1020 

PEMETREXED 100MG 510VL INJ 510 

RASBURICASE .5 MG 0VL INJ 0 

HEPARIN SOD PER 10000 UN 0 

DENOSUMAB 1201440 MG VIAL 1440 

INJ, DENOSUMAB, 1 MG 0 0 

BENDAMUSTINE 25200 MG VIAL 200 

FOSAPREPITANT DIMEGLUMINE 

150 150 

OPRELVEKIN 5 MG VIAL 0 0 

LEUPROLIDE ACETATE 0 30 MG 0 

LEUPROLIDE ACETATE 3 22.5 3 

LEUPROLIDE ACETATE 0 45 MG 0 

LEUPROLIDE ACETATE 0 7.5 MG 0 

LEUPROLIDE ACETATE 0 SUSP 0 

ERIBULIN 1 MG/2 ML0 0 

CARFILZOMIB 60 MG 0VIAL 

0 

PERTUZUMAB 420 MG 84 VIAL 84 

TEMOZOLOMIDE 1000 MG VIAL 0 

VINBLASTINE 1 MG/ML 0 0 

DEXRAZOXANE 500 MG 0 VIAL 0 

DARBEPOETIN 40 MCG/ML 0 VL 0 

HEPARIN 50,000UN/5ML 100 VIAL100 

CR PHASE IV-PUTNAM69 69 

CARD REHAEB PSE II NO 0 ECG 0 

SUPERVISED PH III CARDIAC 3 3 

CARDIAC PHASE II 133 133 

GLUCOSE REAGENT 49 STRP 49

GLUCOSE STRIP SUBSEQ 49 49 

PULM REHAB LEVEL 14 4 14 

PULMONARY EVAL 3 3 

P/R MD INT DOSE INHL 0 0 

P/R ONE TO ONE WALK 4 MONTR 4 

P/R ONE TO ONE STAIRS 0 0 

P/R GRP ACTIVITY 24 24 

CR PHASE IV-PLAINFIELD 17 17 

CARDIAC EVAL 6 6 

BLINK REFLEX, ORBI OCULI 0 0 

REPETITIVE STIM NEURO 5 JXN 5 

SENSORY 1 TO 2 SITES0 0 

SENSORY 3 TO 4 STUDIES 1 1 





SENSORY 13 OR MORE7 7 

LEVEL 4 GROSS/MICRO 733 733 

BM SMEAR INTERPRE4 4 

LEVEL 1 GROSS EXAM4 4 

LEVEL 2 GROSS/MICRO7 7 



LEVEL 6 GROSS/MICRO5 5 

DECALCIFICATION 29 29 

SPECIAL STAIN GP I 71 71 

SPECIAL STAIN GP II27 27 

MD COMPLETE CONSULT 0 0 

CONSULT DURING SURG 0 0 

FIRST FROZEN SECTION 2 2 

ADDITIONAL FROZEN0 0 

PAP SCREEN 0 0 

PAP SMEAR MD 0 0 

PAP DIAGNOSTIC 0 0 

SMEAR TZANK 0 0 

SMEAR SEMEN 1 1 

SMEAR BREAST DISC 1 1 

CYTO THINPREP SCREEN 559 559 

THIN PREP MD 73 73 

CYTO THINPREP DIAG35 35 

CYTO GASTRIC BRUSH0 0 

CYTO BREAST CYST 0 0 

CYTO BREAST ASPIRATE 2 2 

CYTO BRONCH BRUSH1 1 

CYTO CSF 2 2 

CYTO OVARY CYST 2 2

CYTO SPUTUM 0 0 

CYTO URINE 6 6 

CYTO FINE NEEDLE ASP 2 2 

CYTO PERITONEAL FLD1 1 

CYTO PLEURAL FLUID2 2 

CYTO THYROID ASP 8 8 

CYTO BRONCH WASH1 1 

NONGYN MISCELLANEOUS 1 1 

CYTO LUNG FNA 0 0 

CYTO PERICARDIAL 0 0 

CYTO GASTRIC WASH0 0 

IMMUNOHISTOCHEMISTRY 0 0 

HER-2/NEU 6 6 

ESTROGEN RECEPTOR4 4 

REFERRED BLOCKS 0 0 

UNLISTED PROCEDURE 0 0 

HER-2/NEU 0 0 

REFERRED SLIDES 0 0 

MD COMPLETE CONSULT 0 0 

CONSULT DURING SURG 1 1 

SMEAR ECC 0 0 

SMEAR DIAPHRAM SCRAP 0 0 

ST EVAL FNA/ADEQUACY 1 1 

SMEAR NGYN 0 0 

CYTO POST BRONCH 0SPUTUM 

0 

MANUALLY QUANTITATIVE 4 4 

IN SITU HYBRIDIZATION 0 0 

MD REVIEW TOUCH PREP 2 2 

ISH PROBE 0 0 

GENE REARRANGEMENT 0 0 

BCR/ABL MJR BRKPT 081207 

0 

BCR/ABL MJR BRKPT 081206 

0 

AUTO FISH 0 0 

EVAL OF FNA ADE,EA 0PASS 

0 

FLOW CYTOMETRY, 1ST 0 MARK 0 

TOUCH PREP, EA ADD 0SITE 

0 

IHC, COMPUTER ASSISTED 0 0 

ARCHIVE TISS, MOLECULAR 0 0 

IN SITU HY(FISH),EA PROBE 0 0 

INSITU(QUANT),EA, COMP 0 0 

INSITU HYBRID(QUANT), 0 MAN 0 

IMMUNOHISTCHEM 70 W/CHARGES 70 

DIRECT IMMUNOFLOURESCENSE 6 6 

FLOW CYTOMETRY 0 0 


CEA 53 53 

FERRITIN 259 259

DIGOXIN 44 44 

GENTAMYCIN BASELINE 1 1 

PHENOBARBITAL 5 5 

FOLIC ACID 151 151 

TEGRETOL 25 25 

GLYCOHEMOGLOBIN 984 984 

T3 UPTAKE 88 88 

T4 (THYROXINE) 107 107 

TSH 1813 1813 

GENTAMYCIN PEAK 0 0 

VALPROIC ACID 55 55 

DILANTIN 48 48 

VITAMIN B12 371 371 

ACETOMINOPHEN130 130 

TOBRAMYCIN PEAK 0 0 

FREE T4 365 365 

TOBRAMYCIN BASELINE 0 0 

HCG BETA SUBUNIT74 74 

THEOPHYLLINE 1 1 

VANCOMYCIN,RANDOM 2 2 

VANCOMYCIN TROUGH 36 36 

VANCOMYCIN PEAK 4 4 

UREA NITROGEN 24HR0 0 

PREG TOXEMIA PANEL0 0 

METHEMOGLOBIN 0 0 

TROPONIN I LEVEL 0 0 

FACTORY MUTUAL PNL 0 2 0 

POTASSIUM,PLASMA4 4 


FLUID APPEARANCE 0 0 

FLUID PH 2 2 

GENTAMYCIN,RANDOM 0 0 

TOBRAMYCIN,RANDOM 0 0 

LDL,DIRECT 46 46 

GLUCOSE 1HR,NON-FASTING 46 46 

ACETONE (BLOOD) 1 1 

MICROALB.RANDOM 210UR 

210 

MICROALB.24HR UR 0 0 

ALBUMIN (BLOOD) 66 66 

FLUID ALBUMIN 1 1 

ALCOHOL 183 183 

HDL 8 8 

AMMONIA (BLOOD)33 33 

AMYLASE 88 88 

FIBRONECTIN 0 0 

CSF CHLORIDE 0 0 

BILIRUBIN, TOTAL, NEONAT 15 15

BILIRUBIN TOTAL 25 25 

BILIRUBIN DIRECT 15 15 

BILIRUBIN, INDIRECT0 0 

IRON 291 291 

TIBC 0 0 

UIBC 269 269 

CALCIUM 61 61 

FLUID CHLORIDE 0 0 

CARBON MONOXIDE 8(CO) 

8 

CALCIUM URINE RANDOM 0 0 

CHLORIDE (CL) 3 3 

CHOLESTEROL 20 20 

PCP (TDAS) 0 0 

BENZO (TDAS) 0 0 

COCAINE (TDAS) 0 0 

AMPT (TDAS) 0 0 

THC (TDAS) 0 0 

OPIATES (TDAS) 0 0 

BARBITURATES (TDAS) 0 0 

CPK 986 986 

IRON/TIBC 0 0 

IRON SATURATION 0 0 

CREATININE CLEARANCE 13 13 

CREAT JP DRAINAGE 0 0 

CREATININE RANDOM 88 UR 88 

PH BLOOD 1 1 

BICARBONATE (HCO3)3 3 

BLOOD GASES 69 69 

GGTP 47 47 

PROTEIN 24HR URINE 24 24 

CHLORIDE UR RANDOM 4 4 

LUTEINIZING HORMONE 39 39 

CALCIUM 24HR URINE2 2 

PROLACTIN 81 81 

HDL PANEL 2319 2319 

CHLORIDE 24HR URINE 0 0 

LIPASE 214 214 

CREATININE 24HR UR9 9 

ELECTROLYTES & MG0 0 

LDH 152 152 

LACTOSE TOL FASTING1 1 

LACTOSE TOL 1/2 HR1 1 

LACTOSE TOL 1HR 1 1 

LACTOSE TOL 2 HR 1 1 

LITHIUM LEVEL 30 30 

MAGNESIUM 373 373 

MAGNESIUM,UR.RANDOM 0 0

OSMOLALITY SERUM8 8 

PSA DIAGNOSTIC 86 86 

PSA SCREENING 256 256 

ALKALINE PHOS 21 21 

PHOSPHOROUS 154 154 

PHOSPHORUS,RANDOM 0 UR 0 

POTASSIUM (K),SERUM 49 49 

POTASSIUM (K),FLUID0 0 

LYTES 182 182 

COMP.METABOL.PNL 1716NF 

1716 

COMP.METABOL.PNL 1243FST 

1243 

BASIC METABOL.PNL 1083NF 

1083 

BASIC METABOL FSTING 650 650 

HEPATIC FUNCTION 575 PNL 575 

RENAL FUNCTION PANEL 20 20 

TOTAL PROTEIN 10 10 

PROTEIN UR RANDOM 36 36 

CSF PROTEIN 7 7 

SALICYLATE 136 136 

COSTISOL STIMULATION 0 0 

SODIUM (NA),SERUM8 8 

SODIUM (NA),FLUID 0 0 

GLUCOSE 24HR URINE0 0 

POTASSIUM 24HR URINE 0 0 

GLUCOSE FASTING147 147 

IGG 19 19 

IGA 32 32 

IGM 20 20 

RA FACTOR,QUANT72 72 

POTASSIUM RANDOM 0 UR 0 

FLUID GLUCOSE 5 5 

SGOT 506 506 

SGPT 555 555 

TRIGLYCERIDES 7 7 

GLUCOSE 2HHP 0 0 

BUN 303 303 

CREATININE 364 364 

BUN/CREA RATIO 0 0 

CREATININE,FLUID 0 0 

URIC ACID 262 262 

GLUCOSE RANDOM25 25 

PHOSPHOROUS 24HR 1UR 

1 

SODIUM URINE RANDOM 12 12 

AMYLASE RANDOM URINE 0 0 

B NATRIURETIC PEPTIDE 0 0 

FSH SERUM 58 58 

SODIUM 24HR URINE3 3

GASTRIC PH 0 0 

CSF GLUCOSE 7 7 

FLUID AMYLASE 0 0 

CRP,HIGH SENSITIVITY 140 140 

OSMOLALITY URINE 9 9 

CORTISOL,SUPPRESSION 0 0 

HOMOCYSTEINE 22 22 

TESTOSTERONE 62 62 

CORTISOL AM 23 23 

CORTISOL PM 4 4 

CORTISOL BASELINE 2 2 

CORTISOL 1/2HR 2 2 

CORTISOL 1HR 2 2 

CORTISOL BASELINE,DX 0 0 

CORTISOL,POST SUPPRE 0 0 

BLOOD GASES CORD 0VEN 

0 

BLOOD GASES CORD 0ART 

0 

FLUID TOTAL PROTEIN3 3 

CHALLENGE URINE 0 0 

GLUCOSE 1HR GTT 4 4 






GLUCOSE FASTING 10 10 

GLUCOSE 1HR POST GLUCOLA 4 4 

GLUCOSE 2 HR 14 14 

GLUCOSE 3HR 14 14 

CHALLENGE FST.URINE 0 0 

GLUCOSE FASTING PREG 15 15 

GLUCOSE 1/2HR GTT3 3 

GLUCOSE FASTING GTT 4 4 

GLU CHALLENGE FST 0 0 

GLU CHALLENGE 1 HR0 0 


GLUCOSE 2 HR 0 0 


GLUCOSE 3HR PREG 0 0 

GLUCOSE 3HR W/URINE 0 0 


AMYLASE 24HR URINE0 0 

CKMB 128 128 

URIC ACID(NOT BLOOD) 0 0 

FLUID BILIRUBIN 0 0 

FLUID LDH 3 3 

URIC ACID 24HR URINE 1 1

TIME & VOLUME URINE 22 22 

DLDL 0 0 

UREA,URINE,RANDOM0 0 


C3 0 0 

CA 125 0 0 

C4 0 0 

PREALBUMIN 0 0 

PROGESTERONE 0 0 

HIV 0 0 

NT BNP 181 181 

RUBELLA ICG 0 0 

T3 TOTAL 0 0 

T3 FREE 0 0 

INTACT PTH 0 0 

URINE DRUG SCREEN 190 190 

CHEM 8 + METABOLIC 0 LAB 0 

CHEM 8 + HEMATOCRIT 0 LAB 0 

CREATININE, BLOOD, 0LAB 

0 

TROPONIN LAB 495 495 

BILIRUBIN, UNCONJUGATED 0 0 

BILIRUBIN, CONJUGATED 55 55 

IONIZED CALCIUM 17 17 

VENOUS BLOOD GASES 1 1 

CAPILLARY BLOOD GASES 3 3 

SLIDE/ONCOLOGY 8 8 

PROTHROMBIN TIME 2568 2568 

PTT 227 227 

FIBRINOGEN 69 69 

FDP 1 1 

INR 0 0 

BLEEDING TIME 0 0 

HEMOGRAM 242 242 

HEMOGRAM 0 0 

H + H 0 0 

FETAL HGB SCREEN 5 5 

WRIGHT STAIN 0 0 

CBC/AUTO DIFF 0 0 

CBC/MANUAL DIFF 0 0 

RBC COUNT 0 0 

WBC COUNT 5 5 

HEMOGLOBIN 159 159 

HEMATOCRIT 169 169 

PEROXIDASE STAIN 0 0 

WBC & DIFFERENTIAL0 0 

WBC & MANUAL DIFF0 0 

DIFFERENTIAL/AUTO 985 985

DIFFERENTIAL/MANUAL 797 797 

SMEAR REVIEW 176 176 

SED RATE WESTERGREN 0 0 

SED RATE WESTERGREN 397 397 

ABSOLUTE EOS CT 0 0 

PLATELET COUNT 20 20 

PLATELET CT/NA CITR0 0 

RETICULOCYTES 83 83 

NASAL SMEAR FOR EOS 0 0 

EOSINOPHIL SMEAR 3 3 

ANA SCREEN 2 2 

DNA SCREEN 0 0 

DNA TITER 0 0 

FLUID RBC 10 10 

FLUID WBC 10 10 

ANA TITER 0 0 

ANA PATTERN 0 0 

FLUID DIFFERENTIAL 0 0 

OBSTETRIC PANEL 0 0 

SPINAL FLUID PANEL21 21 

CSF RBC 13 13 

CSF WBC 13 13 

MD SMEAR REVIEW 0 0 

CSF DIFFERENTIAL 10 10 

MIXING STUDIES 0 0 

GRISWOLD RUB. OCC. 0H 

0 

CBC/AUTO DIFF 4791 4791 

CBC/MANUAL DIFF111 111 

OBSTETRIC PANEL 67 67 

WBC & DIFFERENTIAL 40 40 

WBC & MANUAL DIFF1 1 

CBC-ONCOLOGY 0 0 

BACTERIAL AG, CSF 0 0 

H PYLORI CULTURE 0 0 

LEGIONELLA AG,URINE 14 14 

BRONCHIAL CULTURE0 0 

ACID FAST STAIN 0 0 

KOH PREP 2 2 

GRAM STAIN 241 241 

VANCO RESIST.ENTERO 0 0 

METH.RESIST.STAPH 39SC 

39 

GP.B STREP SCREEN47 47 

GIARDIA CRYPTO AG 0 0 

FUNGUS SKIN 0 0 

CYCLOSPORA SP STAIN0 0 

ANAEROBIC ISOLATION 96 96 

MACRO PARASITE EXAM 0 0

TISSUE HOMOGENOUS 2 2 

STOOL ADD.PATH. 2 0 0 

DEFINITIVE ID AER 1333 333 

DEFINITIVE ID AER.237 37 

DEFINITIVE ID AER.3 4 4 

DEFINITIVE IS AER.4 1 1 

DEFINITIVE IS AER.5 0 0 

DEF.ID ANAEROBIC 11 1 





DEF. ID FUNGUS 1 0 0 

DEF.ID FUNGUS 2 0 0 


DEF.ID FUNGUS 4 0 0 


BETA STREP GROUPING 96 96 





THROAT SCREEN PEDS 81 81 

RAPID GROUP A STREP 29 29 

CRYPTOCOCCUS AG 0 0 

C.NEOFORMANS AG(CSF) 0 0 

INFLUENZA A/EIA 0 0 

INFLUENZA A 23 23 

ENVIRONMENTAL-NH0 0 

ENVIRONMENTAL-DKH0 0 

GRAM STAIN 0 0 

WET PREP 0 0 

OVA & PARASITES 0 0 

FUNGUS CULTURE 5 5 

MYCOPLASMA IGM 0 0 

COLONY COUNT 738 738 

RAPID RETROVIRAL 5 5 

CSF CULTURE 7 7 

GC SCREEN 0 0 

BETA STREP SCREEN139 139 

SALM/SHIG STOOL CULT 55 55 

CAMPY STOOL CULT55 55 

SHIGA TOXIN STOOL CU 0 0 

GENITAL CULTURE 5 5 

BLOOD CULTURE 317 317 

URINE CULTURE 739 739 

RESP CULTURE 45 45

WOUND CULTURE124 124 

BLOOD CULTURE #3 0 0 

SENSITIVITY,MIC 388 388 

KB SUSCEPTIBILITY 11 11 

SINGLE KB SENSITIVIT0 0 

E-TEST SENSITIVITY 2 2 

BLOOD CULTURE #2 0 0 

TB CULTURE W/SMEAR 0 0 

RESP.SYNCYTIAL VIRUS 11 11 

AEROBIC ISOLATE ID 0 0 

PARASITE/ISOLATE ID0 0 

CATH TIP CULTURE 0 0 

GASTRIC ASP CULTURE0 0 

EYE CULTURE 3 3 

EAR CULTURE 2 2 

TRICHROME STAIN 0 0 

MISC. CULTURE 0 0 

ENVIRONMENTAL-OTHER 0 0 

THROAT CULTURE 18 18 

ANTHRAX CULTURE 0 0 

PINWORM PREP 2 2 

TICK ID DKH 0 0 

C.DIFFICILE TOXIN 0 0 

VARICELLA ZOSTER IMM 0 0 

CRYPTOSPORIDIA AG15 15 

GIARDIA AG 15 15 

BRONCHIAL BRUSH, QUANT 0 0 

CHROM. FOR MRSA 4 4 

SHIGA TOXIN, STOOL55 55 

YERSINIA CULTURE 2 2 

INFLUENZA B 23 23 

GROUP B STREP SCREENN 0 SEN 0 

CULTURE TYPING IMMUNO 13 13 

COAGULASE TEST 0 0 

C DIFF TOXIN B 68 68 

NAP1 0 0 

TYPE & CROSS,1 UNIT0 0 

RH 179 179 

BLOOD TYPING ABO164 164 

TYPE CHECK 17 17 

RH CHECK 17 17 

TYPE & CROSS 4 UNITS0 0 



SPEC ANTIGEN TYPING1 1 

CORD BLOOD TYPING54 54 

ANTI HU GLOB TITER0 0

ANTI TITER-ALBUMIN0 0 

ANTI TITER-SALINE 0 0 

CROSSMATCH, AHG 0 0 

XM W/O TS 0 0 

4 UNIT COMPATIBILITY 0 0 







ANTIBODY TITER 0 0 

COLD AGG ABSORBTION 0 0 

ANTIBODY IDENTIFICAT 7 7 

RHOGAM 7 7 

DIRECT COOMBS 12 12 

ANTIBODY SCREEN182 182 

TYPE AND SCREEN 0 0 

DU, CORD BLOOD 6 6 

BLOOD BK MD SERVICE 0 0 

TRANSFUSION REACTION 0 0 

ABO TYPE 0 0 

RH 0 0 

ANTIBODY SCREEN 0 0 

DU 0 0 

DAT, ANTI-IGG 0 0 

DAT, BROAD SPECTRUM 0 0 

ANTIBODY ID 0 0 

FFP/CRYO, THAWING, 8EA UNT 8 

CROSSMATCH, IMMED 132 SPIN 132 

CROSSMATCH, 37C INCUB 12 12 

ANTIBODY ID PANEL 20 0 

ANTIBODY ID PANEL 30 0 



DAT, C3B 0 0 

SPCL ANTIGEN TYPE 2, 0 PAT 0 

SPCL ANITGEN TYPE 3, 0 PAT 0 

SPECIAL ANTIGEN TYPE 38 1 38 

SPECIAL ANTIG TYPE 2, 0 UNT 0 

SPECIAKL ANTI TYPE 3, 0 UNT 0 

FIBRIN CLOT 0 0 

URINALYSIS 447 447 

MACROSCOPIC URINE0 0 

URINALYSIS/CIC 1022 1022 

BILIRUBIN, URINE 0 0 

URINE MICROSCOPIC0 0

PH URINE 0 0 

SPEC.GRAVITY URINE0 0 

GLUCOSE, URINE 0 0 

FAT URINE 0 0 

D-DIMER 61 61 

PREG MONOCLONAL 83URIN 

83 

KETONES - URINE 0 0 

PROTEIN,URINE 0 0 

OCCULT BLOOD URINE0 0 

OCCULT BLOOD FECES 41 41 

NITRATE URINE 0 0 

REDUCING SUB - URINE 0 0 

RUBELLA SCREEN 34 34 

FLUID SPEC.GRAVITY0 0 

PH FECES 0 0 

MONO TEST 48 48 

COLD AGGLUTININS 3 3 

PREG MONOCLONAL 17SERU 

17 

FECAL FIBER 0 0 

RPR 130 130 

SEMEN POST VAS 4 4 

FLUID CRYSTALS 3 3 

SEMEN FERTILITY 1 1 

LYME EIA (IGG & IGM)0 0 

GARDNERELLA 174 174 

TRICHOMONAS 174 174 

CANDIDA SPECIES 174 174 

GC DNA 264 264 

CHLAMYDIA DNA 264 264 

VARICELLA ZOSTER IMM 0 0 

H.PYLORI AB IGG 36 36 

FIBRONECTIN 7 7 

ROTAVIRUS 1 1 

MYCOPLASMA IGM16 16 

LACTIC ACID 20 20 

GENTAMYCIN(ONCE DAILY) 0 0 

TOBRAMYCIN(ONCE DAILY) 0 0 

AMNISURE 9 9 

D-DIMER(DIC) 1 1 

CERULOPLASMIN 3 3 

DHEA SULFATE 19 19 

CA 125 12 12 

THYROID STIM.IMMUNO 2 2 

CHOLINESTERASE ,RBC0 0 

NORTRIPTYLINE 0 0 

VIT D 125 DIHYROXY47 47 

PROTEIN C,ANTIGENIC0 0

TESTOSTERONE T & F0 0 

CYCLOSPORINE, BLOOD 6 6 

ALPRAZOLAM (XANAX) 0 0 

RISTOCETIN COFACTOR 1 1 

C PEPTIDE 3 3 

TRAZADONE - DESYREL 0 0 

CHORIONIC GONADOTROP 1 1 

HETEROPHILE AGGLUT. 0 0 

CA 15-3 0 0 

PROTEIN S, ANTIGENIC0 0 

CYSTINE, 24HR URINE1 1 

SUCROSE HEMOLYSIS0 0 

LIDOCAINE 0 0 

IGG INDEX & SYN RATE 0 0 

APOLIPOPROTEIN A1/B 0 0 

SCLERODERMA ANTIBODY 3 3 

ACETYLCHOLINE RECEPT 1 1 

MERCURY, BLOOD 3 3 

CADMIUM,URINE 0 0 

PORPHOBILINOGEN 24HR 0 0 

PORPHYRINS 24HR URIN 0 0 

RBC,FOLIC ACID 0 0 

CA19-9 15 15 

CITRATE, 24HR URINE1 1 

RBC PROTOPORPHYRIN 0 0 

ALCOHOL (URINE) 1 1 

ANTI-CARDIOLIPIN AB0 0 

STREPTOZYME 0 0 

ANTI-DNASE (STREP)0 0 

TULAREMIA ANTIBODY 0 0 

LYSOZYME SERUM 0 0 

MEXILETINE 0 0 

LEAD URINE 24HR 0 0 

ANDROSTENEDIONE 0 0 

ANTI-GLIADIN AB 56 56 

ANTI RETICULIN AB 0 0 

ENDOMYSIAL ANTIBODY 0 0 

IMMUNOFIXATION 26 SERUM 26 

MYOGLOBIN RANDOM 0 UR 0 

MAGNESIUM 24HR URINE 1 1 

ANTI HISTONE AB 0 0 

CANNABINOIDS (URINE) 0 0 

PLASMINOGEN,PLASMA 0 0 

DHEA 1 1 

ANTI NEUT CYTO PROF 8 8 

THIOTHIXENE 0 0 

VIT B1/THIAMINE 3 3

ECHOVIRUS AB 0 0 

HLA A,B TYPING DNA0 0 

BETA 2 MICROGLOBULIN 13 13 

METHANOL 0 0 

ANTI-PARIETAL CELL 1 1 

MANGANESE BLOOD0 0 

HYDROXYPROLINE TOTAL 0 0 

HEP DELTA AB HDV 0 0 

HEP C AB 132 132 

ZINC PROTOPORPHYRIN 3 3 

THYROGLOBULIN 9 9 

PERPHENAZINE 0 0 

PRE-ALBUMIN 5 5 

FACTOR XIII ACTIVITY0 0 

MAGNESIUM RBC 25 25 

RHYTHMOL PROPAFENONE 0 0 

INHALENT TOXIN PANEL 0 0 

DUST PANEL (RAST) 0 0 

INTRINSIC FACTOR AB1 1 

MOLD (PANEL) 0 0 

FRUCTOSAMINE 2 2 

METHYLPHENIDATE 0 0 

HGB FREE PLASMA 0 0 

TOXOPLASMA IGM 5 5 

TOXOPLASMA IGG 5 5 

CLOMIPRAMINE/NORCLOM 0 0 

DRUG ABUSE MECONIUM 2 2 

TRIFLUOPERAZINE 0 0 

IMMUNOFIXATION URINE 8 8 

PROZAC 0 0 

THROMBIN TIME 1 1 

VITAMIN E 1 1 

T4 FREE BY DIALYSIS 1 1 

NAPROXEN 0 0 

ETHYLENE GLYCOL 0 0 

ANTI-NEUT CYTO AB 0 0 

VISTARIL 0 0 

ZINC 24HR URINE 0 0 

HEMOGLOBIN ELECTROPH 70 70 

BABESIA MICROTI 3 3 

CLOZARIL 1 1 

FREDRICKSON CLASSIFI 0 0 

POLIO VIRUS AB 0 0 

MESORIDAZINE 0 0 

ANTI HU ANTIBODY 1 1 

DRUGS OF ABUSE 9 9 

HERPES SIMPLEX II 0 0

FLUPHENAZINE 0 0 

COPPER, 24HR URINE0 0 

ADH,PLASMA 1 1 

BORDETELLA PERTUSSIS 0 0 

MULTIPLE SCLEROSIS 02 

0 

CHLAMYDIA CULT 0 0 

CHLAMYDIA CULT 0 0 

WELLBUTRIN 0 0 

TOXOCARA AB SCREEN0 0 

AMINO ACID SC-URINE 0 0 

PROTEIN BOUND GLUCOS 0 0 

COMPLEMENT C2 0 0 

HISTAMINE 24HR URINE 0 0 

LSD, URINE 0 0 

FELBAMATE (FEBATOL) 0 0 

LIBRIUM 0 0 

DILANTIN FREE 0 0 

PM1 ANTIBODY SERUM0 0 

RBC OSMO FRAGILITY0 0 

TSH RECEPTOR AB 2 2 

TEMAZEPAM 0 0 

SELENIUM (URINE) 0 0 

SELENIUM (SERUM) 1 1 

COCAINE, RANDOM UR 0 0 

BORATE (URINE) 0 0 

CPK ELECTROPHORESIS 0 0 

ANTI GLOMULAR MEMBRA 1 1 

17-KETOSTERIODS URIN 0 0 

TRILISATE 0 0 

DIPHENHYDRAMINE 0 0 

FLECAINIDE/TAMBACOR 2 2 

COPPER (RBC) 0 0 

COPPER SERUM 0 0 

PYRUVATE 0 0 

NEURONTIN LEVEL 3 3 

PLATELET AB PROFILE1 1 

HANTAAN VIRUS 0 0 

IRON 24HR URINE 0 0 

RISPERDOL LEVEL 0 0 

BIOTINIDASE ACTIVITY0 0 

MYELIN BASIC PROTEIN 1 1 

ZOLOFT, SERUM 0 0 

ARSENIC, BLOOD 3 3 

PURKINJE CELL AB(YO) 0 0 

FRAGILE X DNA 1 1 

VIRAL ISOLATION UMAS 0 0 

IGG 26 26

IGA 26 26 

IGM 26 26 

PORPHYRINS, RANDOM 0 U 0 

PROCAINAMIDE NAPA0 0 

TRANSFERRIN 14 14 

LDH ISOENZYMES 0 0 

ANTIMITOCHONDRIAL 3 AB 3 

MALARIA SMEAR 0 0 

HERPES SIMPLEX IGM0 0 

HERPES TYPE I 0 0 

ANTI-JO-1 ANTIBODY0 0 

ASCARIASIS AB 0 0 

EFFEXOR/VENLAFAXINE 0 0 

FIBRONECTIN AGGREGAT 0 0 

3-A-ANDROSTANEDIOL-G 0 0 

HLA-DRB,DQB1 TYPING 0 0 

PHYTANIC ACID, SERUM 0 0 

FILARIASIS 0 0 

VISCERAL LARVA MIGRA 0 0 

STRONGYLOIDES AB 0 0 

ANTI EXTRACT.NUC.AG6 6 

HEINZ BODIES STAIN 0 0 

FACTOR 8 VW FACTOR2 2 

FACTOR IX ACTIVITY 0 0 

FACTOR VII ACTIVITY0 0 

PORPHOBILINOGEN RAND 0 0 

ANTI THROMBIN 3 11 11 

FACTOR VIII 3 3 

FACTOR V 1 1 

B.PERTUSSIS CULTURE1 1 

CIDAL TROUGH LEVEL0 0 

U UREALYTICUM/M HOMI 1 1 

ACTH 6 6 

ACID PHOS,PROSTATIC0 0 

T3 FREE 48 48 

T3 TOTAL 16 16 

INSULIN 14 14 

C1Q BINDING ASSAY 0 0 

ALPHA I ANTITRYPSIN5 5 

ZINC SERUM 3 3 


RAJI CELL ASSAY 0 0 


ESTROGEN TOTAL 5 5 

HAPTOGLOBIN 14 14 

RHEUMATOID FACTOR 0 QU 0 

HEMOSIDERIN RAND 0UR 

0

RETROVIRAL SEROLOGY 207 207 

FEBRILE AGGLUTININS0 0 

5HIAA URINE 24HR 0 0 

AMINOLEVULINIC ACID 0 0 

VISCOSITY BODY FLUID2 2 

THORAZINE LEVEL 0 0 


OXALATE 24HR URINE1 1 

VASO INTESTINAL PEP0 0 

ALDOLASE 3 3 

AMINO ACID SC-PLASMA 1 1 

ANTI MICROSOMAL 21 AB 21 

ANTI-THYROGLOBULIN 18 18 

ESTRADIOL E2 NONPREG 10 10 

B12 BINDING CAPACITY 0 0 

IONIZED CALCIUM 0 0 

NORPACE 0 0 

SUB ABUSE PANEL 0 0 

17 KETOGENIC STEROID 0 0 

BETA CAROTENE 0 0 

CHOLINESTERASE 0 0 

CLONOPIN/CLONAZEPAM 0 0 

CRYOGLOBULINS 5 5 

HLA B27 0 0 

HYDROXYPROLINE FREE 0 0 

ELAVIL 0 0 

MELLARIL 0 0 

ANTI SMOOTH MUSCLE 3 3 

ALDOSTERONE 10 10 

CATECHOLAMINE,FRAC/U 2 2 

VMA QUANTITATIVE 1 1 

METANEPHRINE FRACT. 1 1 

CORTISOL FREE, URINE 1 1 

17 KETOSTEROIDS TOT0 0 

HUMAN GROWTH HORMONE 0 0 

PTH C TERM MIDREGION 0 0 

COMPLEMENT CH50 1 1 

LACTIC ACID 0 0 

LEAD ADULT 8 8 

COMP C1Q NONBINDING 1 1 

HEAVY METALS 24HR 0UR 

0 

MERCURY URINE 24HR0 0 

EBV AB SCREEN 22 22 

DOXEPIN/SINEQUAN0 0 

ALK PHOS ISOENZYMES 2 2 

ANGIO-CONVERT ENZYME 6 6 

PROGESTERONE 14 14

PTH N TERM INTACT 0 0 

SEROTONIN-SERUM 0 0 

VITAMIN A 3 3 

XYLOSE TOLERANCE 0 0 

IMIPRAMINE 0 0 

CATECHOLAMINE,FRAC/P 1 1 

C ESTERASE INHIBITOR0 0 

CYANIDE,BLOOD 0 0 

CRYOFIBRINOGEN 0 0 

HEPATITIS A AB 9 9 

THYROID AB GROUP 0 0 

SOMATOMEDIN C 0 0 

ALUMINUM 1 1 

HEP B SURFACE AG 41 41 

FAT FECES/LIPIDS 72H0 0 

HEP B SURFACE AB 0 0 

IGG SUBCLASSES 3 3 

HEP B CORE AB 1 1 

DESIPIRAMINE 1 1 

GASTRIN 0 0 

ZARONTIN 4 4 

VITAMIN D (25 OH) 0 0 

ARSENIC,URINE 0 0 

HISTAMINE, BLOOD 0 0 

HEPATITIS BE AG & AB0 0 

ESTRONE 0 0 

HALDOL 0 0 

LUNG MATURITY PROF 0 1 0 

OLIGOCLONAL BANDS2 2 

TOCAINIDE 0 0 

L/S RATIO 0 0 

CALCITONIN,SERUM 2 2 

PNEUMONITIS HYPERSEN 0 0 

17 HYDROXYCORTICOST 0 0 

ERYTHROPOIETIN 3 3 

ESTROGEN/PROG RECEPT 0 0 

GLUCOSE 6 PHOSPHATE 4 4 

HYDROXYZINE,SERUM0 0 

EPI FLUOR AB TISSUE0 0 

LAMOTEIGINE, SERUM5 5 

PAXIL/PAROXETINE 0 0 

ATROPINE, RAN URINE0 0 

URINE CYTOLOGY MPNJ 0 0 

AMINO ACID, QUANT0 0 

TOXOPLASMOSIS CSF0 0 

TEGRETOL EPOXIDE 0 0 

HEXOSAMINIDASE A 2ACT 

2

HTLV I/II AB 0 0 

FATTY ACID/LONGCHAIN 0 0 

MYCOPLASMA IGG 0 0 

MYCOPLASMA IGM 0 0 

AMBIEN (ZOLPIDEM)0 0 

HEPATITIS C RIBA 0 0 

RAST ALLERGEN 1 128 128 












AMIODARONE/DESETHYL. 1 1 

LORAZEPAM,SERUM 1 1 

LYMPH SUBSET PROF 0II 

0 

RAST TEST W/ALLERGEN 0 0 

BETA-GLUCOSIDASE ACT 0 0 

HEP C RNA, QUAL 0 0 


P24 ANTIGEN 0 0 

CMV EARLY AG/CULTURE 0 0 

HEP B SURFACE AB/EH0 0 

CA 19-9 0 0 

C PEPTIDE,URINE 0 0 

HEMOSAMINIDASE A&B 0 0 

ALDOSTERONE,URINE0 0 

ESTROGEN,URINE 0 0 

T3 FREE BY DIALYSIS 0 0 

METHOTREXATE 0 0 

BARBITURATES, ID 0 0 

MOLYBDENUM,RBC 0 0 

ANABOLIC STEROIDS0 0 

DIBUCAINE NUMBER0 0 

LYME EIA/CSF 0 0 

FACTOR II 1 1 

FACTOR X 0 0 

FACTOR XI 0 0 

FACTOR XII 0 0 

LEUK/LYMPHOMA EVAL 0 0 

LIPOPROTEIN (A) 1 1 

PREGNENOLONE 0 0

BARBITURATES,SERUM0 0 

BARBITURATES,URINE0 0 

IBUPROFEN 0 0 

ESSENT. FATTY ACIDS0 0 

PORPHYRINS,PLAS.(TOT 0 0 

IGD 0 0 

BETA 2 MICROGLOB,UR 0 0 

MYELIN ASSOC. GLYCOP 0 0 

MYCOPLASMA CULTURE 0 0 

HGB A2 & F BY COLUMN 0 0 

XANTHINE 0 0 

THALLIUM,SERUM 2 2 

CADMIUM,BLOOD 2 2 

H.INFLUENZAE B VAC.R 0 0 

HEP C RNA, QUANT28 28 

METHYLMALONIC ACID 37 37 

OXYCODONE,SERUM0 0 

CYSTINE,SERUM 0 0 

PSA, FR 27 27 

RI AUTOANTIBODY 0 0 

ACT.PROTEIN C RESIST 12 12 

HLA A,B,C TYPING DNA0 0 

CYCLIC AMP,URINE 0 0 

SPECIAL SEROLOGY 0 0 

EHRLICHIA AB 0 0 

ELECTROPHOR,24HR 2UR 

2 

IMMUNOFIX,24HR UR0 0 

CHROMOSOME KARYOTYPE 0 0 

IMURAN LEVEL 0 0 

STOOL CULTURE,VIBRIO 0 0 

FUNGUS,BLOOD CULT0 0 

ISLET CELL ANTIBODY0 0 

CYSTINE & HOMOCYSTEI 0 0 

LEGIONELLA CULT&FA0 0 

LEGIONELLA AB (IFA)0 0 

CARISOPRODOL 0 0 

VIRAL CULT,CSF 0 0 

CSF CULT RO ENTEROVI 0 0 

CSF CULT RO HSV 0 0 

CSF CULT RO CMV 0 0 

HISTOPLASMOSIS AG,UR 0 0 

HYDROCARBONS & VOLAT 0 0 

ORGANIC ACIDS,URINE 0 0 

Q FEVER ANTIBODY,IFA 0 0 

TB CULT./DUPONT/UMAS 0 0 

BONE MARROW CULTURE 0 0 

SENSITIVITY UMASS 0 0

ORG ID AEROBIC UMASS 0 0 

ORG ID ANAEROBIC 0 0 

PNEUMOCYSTIS CARINII 0 0 

ANTI SPERM AB IGG 0 0 

ANTI SPERM AB IGA 0 0 

ANTISPERM AB IGM 0 0 

T CELL CLONALITY INT0 0 

TYPHUS FEVER AB IGG0 0 

TYPHUS FEVER AB IGM0 0 

ALK PHOS BONE SPECIF 0 0 

HGB/THAL INTERPRET. 0 0 

FLOW CYTOMETRY EA 0 CE 0 

BABESIA MORPHOLOGY 0 0 

CHROMIUM,SERUM 0 0 

CODEINE,SERUM QUANT. 0 0 

NICOTINE,SERUM 0 0 

ITERLEUKIN 2 0 0 

LISTERIA AB,SERUM 0 0 

CA27.29 MARKER 33 33 

SULFONYLUREA PNL,SER 0 0 

SULFONYLUREA SCR. 0UR 

0 

BRUCELLA CANIS IGG0 0 

PREDNISONE 0 0 

GLIPIZIDE 0 0 

TRYPTASE 1 1 

ALA-D,ERYTHROCYTES -1 -1 

UPG-S,ERYTHROCYTES -1 -1 

HISTOPL.MYCELIAL AB0 0 

HISTOPL.YEAST AB 0 0 

A1 ANTITRYPSIN,STOOL 0 0 

IODINE,URINE 0 0 

ADENOVIRUS,CSF 0 0 

LYME WB IGG 0 0 

LYME WB IGM 0 0 

BABESIA AB IGG 0 0 

BABESIA AB IGM 0 0 

IBT RAST ALLERGEN 176 76 









IBT RAST ALLERGEN 32 10 32 

IBT RAST ALLERGEN 28 11 28

IBT RAST ALLERGEN 24 12 24 

SGPG 0 0 

FETAL HGB QUANT. 1 1 

ANTI-RETICULIN, IGA20 20 

TOPAMAX(TOPIRAMATE) 3 3 

ORGANIC ACIDS,PLASMA 0 0 

HELICOBACTER AG,STOO 0 0 

URINE ETP,RANDOM5 5 

TOTAL PROT,UR,RANDOM 5 5 

LISTERIA AB,CSF 0 0 

AFP 0 0 

HCG 0 0 

ESTRIOL 0 0 

METHOTREXATE 0 0 

TETRAHYDROCANNABINOL 0 0 

CARBOXY-THC 0 0 

FLUORIDE 0 0 

CHLAMYDIA,DIRECT AG 0 0 

IGF BINDING PROTEIN3 1 1 

HEPATITIS BE AG 1 1 

HEPATITIS BE AB 1 1 

NARCOLEPSY ASSOC AG 0 0 

TRYPSINOGEN,SERUM0 0 

ANTI-OVARIAN ANTIBOD 0 0 

A1 ANTITRYPSIN PHENO 0 0 

ARYLSULPHATASE A ACT 0 0 

FK506 31 31 


FREE CORTISOL,BLOOD 0 0 

DEXAMETHASONE 0 0 

T CELLS,TOTAL CT. 0 0 

WBC 0 0 

ABS. CD4 &CD8 0 0 


LSD CONFIRM. BY GCMS 0 0 

LUVOX LEVEL 0 0 

CHROMOGRANIN-A 0 0 

HEP B CORE AB, IGM1 1 

ADENOSINE DEAMINASE 0 0 

PNEUMOCYSTIS CARINII 0 0 

ALPHA SUBUNIT 0 0 

GLUT.ACID DECARBX 0AB 

0 

COZ PLASTIC OCC HEAL 0 0 

ALPHA 1 ACID GLYCOPR 0 0 

MICROPOLYSPORA FAENI 0 0 

THEROACTINOMYCES 0SPP 

0 

ALTERIA ALTERNATA0 0

ASPERGILLUS FUMIGAT. 0 0 

AUREOBASIDIUM PULLUL 0 0 

PENICILLIUM NOTATUM 0 0 

PHOMA HERBARUM 0 0 

TRICHODERMA VIRIDE0 0 

CAR (WB) 0 0 

BUPIVACAINE/MARCAINE 0 0 

OSTEOCALCIN 0 0 

AMINO ACID,SINGLE 0ID 

0 

AMINO ACID PANEL,SER 0 0 

AMINO ACID PANEL,UR 0 0 

ASPERGILLUS,IGE 0 0 

CLADOSPORIUM,IGE 0 0 

PENICILLIUM,IGE 0 0 

CHAETOMIUM,IGE 0 0 

MOUSE DROPPINGS,IGE 0 0 

RAT DROPPINGS,IGE 0 0 

PIGEON DROPPINGS,IGE 0 0 

COCKROACH,IGE 0 0 

PROPOXYPHENE 0 0 

METHIONINE 0 0 

BENZODIAZEPINES,SERU 0 0 

CYSTIC FIBROSIS GENE 70 70 

FORMIC ACID 0 0 

PNEUMO.IGG TYPE 10 0 



PNEUMO.IGG TYPE 19F 0 0 

PNEUMO.IGG TYPE 23F 0 0 


TRICHINELLA TITER 0 0 

FACTOR II MUTATION 13G 

13 

AFP 0 0 

NORFLUNITRAZEPAM0 0 

7-AMINOFLUNITRAZEPAM 0 0 

FLUNITRAZEPAM 0 0 

TSH (3RD GENERATION) 0 0 

VITAMIN K1 0 0 

METANEPHRINES,PLASMA 0 0 

LATEX SPECIFIC IGE 0 0 

DIPHTHERIA AB 0 0 

ULTRACENTRIFUGATION 0 0 

LIPOPROTEIN PROFILE0 0 

5,10MTHFR C677T INTE 26 26 

HEMOCHROMATOSIS 5ANAL 

5 

PARASITE CONCENTRA. 0 0 

SP.STAIN FOR PARASIT0 0

METHADONE,UR 0 0 

HEPATITIS E IGM 0 0 

HEPATITIS E IGG 0 0 

EPM1 0 0 


FOLATE 0 0 

FERRITIN 0 0 

BENZENE 0 0 

FACTOR 5 LEIDEN 8 8 

HLAB INTERPRETATION 0 0 

WESTERN EQUINE ENCEP 1 1 

CALIF.EQUINE ENCEPH1 1 

EASTERN EQUINE ENCEP 1 1 

ST LOUIS EQUINE ENCE 1 1 

WEST NILE,SER,ACUTE1 1 

WEST NILE,SER,CONVAL 0 0 

WEST NILE,CSF,ACUTE1 1 

WEST NILE,CSF,CONVAL 0 0 

TISSUE CULT.NON-NEOP -1 -1 

TISSUE CULT.NEOPLAST 0 0 

CHROMOSOME ANAL.5CEL -1 -1 

CHR.ANAL.ADD.KARYOTY -1 -1 

ADD.CELLS COUNTED-1 -1 

FRAGILE X CHROMOSOME -1 -1 

CHROMOSOMAL/LEUKEMIA 0 0 

DIPHTHERIA TOXOID 0AB 

0 

PNEUMO TYPE 3 AB 0 0 

PNEUMO TYPE 7F AB0 0 

PNEUMO TYPE 9N AB0 0 

PNEUMO TYPE 14 AB0 0 

IGM (HIS) 0 0 

IGA (HIS) 0 0 

IGG (HIS) 0 0 

IGE (HIS) 0 0 

IGG SUBCLASS 1 (HIS)0 0 




HLA DR4 0 0 

PROSTAGLANDIN D20 0 

IGA TRANSGLUTAMINASE 38 38 


PHOSPHOGLYCERATE 0KIN 

0 

PROTEIN C,FUNCTIONAL 11 11 

PROTEIN S,FUNCTIONAL 11 11 

ANA AB/LUPUS PROF0 0 

SMOOTH MUSCLE AB0 0

PARIETAL CELL AB 0 0 

MITOCHONDRIAL AB0 0 

C3/ LUPUS PROF 0 0 

C4 / LUPUS PROF 0 0 

SS-B AB/LUPUS PROF0 0 

SS-A AB/LUPUS PROF0 0 

SM AB EIA/LUPUS PROF 0 0 

SM/RNP AB LUPUS PROF 0 0 

RIBOSOMAL P PROTEIN 0 0 

SCL-70 AB/LUPUS PROF 0 0 

THYROID PEROXIDASE0 0 

MYOCARDIAL AB/LUPUS 0 0 

RETICULIN AB/LUPUS0 0 

DNA AB/LUPUS PROF0 0 

STRIATED MUSCLE AB0 0 

RHEUMATOID FACTOR/LU 0 0 

N-METHYLHISTAMINE0 0 

CREATININE,24HR UR0 0 

EHRLICHIOSIS,PCR 0 0 

COMPLEMENT AG,EACH 0 0 

IGG PHOSPHATIDYLSERI 0 0 

IGM PHOSPHATIDYLSERI 0 0 

TOTAL AMYLASE 0 0 

PANCREATIC ISOENZYME 0 0 

CMV AB,IGG 14 14 

CMV AB,IGM 13 13 

ADENOVIRUS AB 0 0 

CHLAMYDIA GROUP AB 0 0 

OPIATES,QUANTITATIVE 0 0 

CD3% 2 2 

CD3/CD4(HELPER)ABS2 2 

ABS.LYMPH CT. 2 2 

PYRUVATE KINASE,RBC 0 0 

TROPHERYMA WHIPPELII 0 0 

CARDIO CRP/SENSITIVE 0 0 

H.PYLORI,IGM 1 1 

H.PYLORI,IGA 7 7 

MICROSPORIDIA,STOOL 0 0 

IGA SUBCLASSES 1 0 0 

IGA SUBCLASSES 2 0 0 

IGA TOTAL 0 0 

HGE IGG TITER 0 0 

HGE IGM TITER 0 0 

INHIBIN A 0 0 

H.PYLORI CULTURE 0 0 

FACTOR VIII 0 0 

FACTOR 8 INHIBITOR0 0

SUBSTITUTION PLASMA 0 0 

RMSF IGG 0 0 

RMSF IGM 0 0 

STOOL EXAMINATION1 1 

ISOPROPYL ALCOHOL0 0 

ECSTASY (MDMA) 0 0 

CEA 0 0 

CA27-29 0 0 

LASA-P 0 0 

H2N ONCOGENE 0 0 

ATAXIA PROF.INTERP.0 0 

MALARIA ANTIBODIES0 0 

PROTEIN S TOTAL 0 0 

PROTEIN S FREE 0 0 

ECSTASY,URINE 0 0 

MACROAMYLASE 0 0 

CARNITINE TOTAL 1 1 

CARNITINE,FREE 1 1 

KEPPRA/LEVETIRACETAM 17 17 

CHYLOMICRONS 0 0 

GLUCAGON 1 1 

PYRILINKS D,DEOXYPYR 0 0 

CREATININE (PYRILINK0 0 

PROTEIN ELECTRO,SERU 47 47 

PROTEIN ELECTRO,UR0 0 

C REACTIVE PROTEIN 203 203 

PRIMIDONE 4 4 

IGE 13 13 

DOT DRUG SCREEN 0 0 

LEGIONELLA FLUOR.ST. 0 0 

LEGIONELLA CULTURE0 0 

ANA/FLUID 0 0 

SOMATOSTATIN 0 0 

PCB(POLYCHLOR.BIPHEN 0 0 

HEP B DNA BY PCR 3 3 

LUPUS ANTICOAGULANT 18 18 

ANTI THROMBIN 3 0 0 

PROTEIN C,FUNCTIONAL 0 0 

PROTEIN S,FUNCTIONAL 0 0 

FIBRINOGEN 0 0 

APC RESISTANCE 0 0 

PLASMINOGEN 0 0 

LIV-KIDNEY MICROS AB 0 0 

HPV DNA/RNA AMPLIFIC 0 0 

ANTI CARDIOLIPIN IGG 15 15 

ANTI CARDIOLIPIN IGM 15 15 

IGG,CSF (CSFI) 2 2

IGG,SERUM (CSFI) 2 2 

ALBUMIN,CSF (CSFI) 2 2 

ALBUMIN,SERUM (CSFI) 2 2 

IGG SUBCLASS 1 0 0 




PHENYLALANINE,PLASMA 0 0 

PHOSSERINE AB (IGG)0 0 

PHOSSERINE AB (IGM)0 0 

HTLV I/II PCR 0 0 

HTLV I DNA 0 0 

HTLV II DNA 0 0 

CHAGAS DISEASE SEROL 0 0 

B2 MICROGLOBULIN,CSF 0 0 

TRICHINOSIS AB,IGG 0 0 

CITRATE,SERUM 0 0 

TESTOSTERONE,TOTAL 38 38 

TESTOSTERONE,FREE38 38 

IMMUNOGLOB.PCR CHAIN 0 0 

RAPAMYCIN(RAPAMUNE) 0 0 

KAPPA CHAIN 24HR UR 0 0 

LAMBDA CHAINS 24HR 0 U 0 

KAPPA & LAMBDA LT 0CH 

0 

THIAZIDE DIURETIC SC0 0 

C3A 0 0 

INTERLEUKIN 6 0 0 

LDL SUBPARTICLES 0 0 

HCG 0 0 

ESTRIOL 0 0 

PROTEINASE 3 AB 2 2 

HLA B27 6 6 

HOMOVANILLIC ACID0 0 

CREATININE 0 0 

HEPATITIS B S AB 44 44 

TRYPSIN,FECES 0 0 

C.DIFFICILE AB 0 0 

PARATHYROID H REL 1PR 

1 

IGF-II 0 0 

BACTERIAL AG DETECT. 0 0 

MORPHINE,FREE,SERUM 0 0 

OXCARBAZEPINE/TRILEP 5 5 

C1 ESTERASE INHIBIT0 0 

METANEPHRINES,PLASMA 5 5 

TETANUS ANTITOXOIDAB 1 1 

CSF FOR EBV BY PCR 0 0 

PROTEIN 14-3-3 0 0

ANTI-STREPTOLYSIN O3 3 

S.CEREVISIAE IGG 1 1 

S.CEREVISIAE IGA 1 1 

P-ANCA, IFA 1 1 

BRAIN NATRIUR PEPTID 0 0 

RHEUMATOID FACTOR,FL 0 0 

KAPPA/LAMBDA IGA 0NEP 

0 

KAPPA/LAMBDA IGG 0NEP 

0 

KAPPA/LAMBDA IGM 0NEP 

0 

LT. CHAINS KAPPA 0 0 

LT. CHAINS LAMBDA 0 0 

ZONISAMIDE 1 1 

ANTICARDIOLIPIN AB0 0 

TOTAL OPIATES 0 0 

OLANZAPINE 0 0 

VARICELLA AB IGG,EIA1 1 

VARICELLA AB IGM,EIA0 0 

CREAT.URINE,RANDOM0 0 

METHYLMALONIC ACID 0 0 

MUMPS AB,IGM 0 0 

MUMPS AB,IGG 29 29 

LYME,DNA,PCR,BLOOD0 0 

IGE 0 0 

H.PYLORI AB IGG 0 0 

PROLACTIN 0 0 

IGE 0 0 

IGA 0 0 

IGM 0 0 

PNEUMOCOCCAL ABS0 0 

TETANUS AB IGG 0 0 

DIPHTHERIA AB IGG 0 0 

HEMOPHILUS INFLU B0 0 

IGG1 SUBCLASS 0 0 




VALPROIC ACID,FREE0 0 

CARNITINE,URINE 0 0 

ACYLCARNITINE,URINE 0 0 

C.TRACHOMATIS AMP0 0 

N.GONORRHOEAE AMP 0 0 

PROMYELOCYTIC LEUKEM 0 0 

CMV DNA,PCR 0 0 

ARSENIC,HAIR 0 0 

ARSENIC,NAILS 0 0 

STRONGYLOIDES AB IGG 0 0 

GAMMA HYDROXYBUTRIC 0 0

IGG B2 GLYCOPROTEIN6 6 

IGM B2 GLYCOPROTEIN 6 6 

IGA B2 GLYCOPROTEIN6 6 

DNA PROBE,EACH 3 3 

IN SITU HYBRIDIZATIO1 1 

RHEUMATOID FACTOR,FL 0 0 

GASTRIC OCCULT BLOOD 0 0 

ANTITHROMBIN III,AG0 0 

QUETIAPINE LEVEL 0 0 

CELEBREX 0 0 

LEUKOCYTE ALK.PHOS. 0 0 

DNA,SINGLE STRANDED 0 0 

AMIKACIN,TROUGH 0 0 

AMIKACIN,PEAK 0 0 

AFP,DIANON 0 0 

POLIO TYPE 1 0 0 



METHADONE,SERUM1 1 

VON WILLEBRAND MULTI 1 1 

BABESIOSIS DNA,PCR0 0 

NEOCOMPLETE PARANEOP 0 0 

PHOSPHOFRUCTOKINASE 0 0 

E.HISTOLYTICA AB EIA0 0 

INHIBIN A (UCONN) 0 0 

ALPHA FETOPROTEIN0 0 

PLT AGG,EA. AGENT 0 0 

MTHFR A1298C MUTATIO 0 0 

ANTI MITOCHOND.TITER 0 0 

HYDROCODONE 0 0 

GRANULOCYTE AB 0 0 

SOURCE 0 0 

CYCLIC CITRULLINE AB 19 19 

INHIBIN A 0 0 

HEPARIN ANTI XA 2 2 

LEGIONELLA IGM 0 0 

LEGIONELLA AB 0 0 

INHIBIN A 0 0 

CENTROMERE AB 2 2 

SOLUBLE TRANSFERRIN 2 2 



EA.ADD.DRUG RESISTAN 0 0 

HERPES SIMPLEX CULT 17 17 

HSV TYPING 3 3 

17 OH PREGNENOLONE 0 0 

5'NUCLEOTIDASE 0 0

RUBEOLA AB,IGG 28 28 

SEX HORMONE BIND 3GLB 

3 

HGE IGG AB 0 0 

HGE IGM AB 0 0 

REPTILASE 0 0 

HEPTIMAX HCV RNA PCR 0 0 

FIBRINOGEN,FUNCTIONL 0 0 

HSV IGM AB 13 13 

HSV IGM AB TITER 0 0 

CREATININE,URINE 24H 0 0 

UREAPLASMA,URINE0 0 

PTT(LAC)SCREEN 0 0 

LUPUS ANTICOAGULANT 0 0 

REVERSE T3 17 17 

COCCIDIOIDES AB(IGG) 0 0 

INTERLEUKIN 2 RECPT0 0 

EHRLICHIOSIS AB(G&M) 0 0 

DIHYDROTESTOSTERONE 0 0 

INSULIN AUTOANTIBODY 0 0 

17-OH-PROGESTERONE 0 0 

INHIBIN B 1 1 


CONC/INFECT.AGENTS0 0 

SP.STAIN/PARASITES0 0 

HEPATITIS C GENOTYPE 5 5 

LYMPH SUBSET V 5 5 

CHLAMYDIA AB PROF1 1 

SICKLE CELL SCREEN 0 0 

MONOCYTIC EHRLICHIA 0 0 

FIFTH'S DISEASE 10 10 


HCV RNA,BDNA,QUANT. 0 0 

SEROTONIN RELEASE0 0 

RUBELLA AB IGG 0 0 

RUBELLA AB IGM 0 0 

TISSUE I.F. SKIN 0 0 

N TELOPEPTIDE (NTX)8 8 

CARB DEF TRANSFERRIN 0 0 

HEXOSAMINIDASE A 1 1 

ACYLCARNITINE,QUANT. 0 0 

EGG WHITE ALLERGEN0 0 

COW MILK ALLERGEN0 0 

PEANUT ALLERGEN 0 0 

D FARINAE MITE ALLER 0 0 

ALTERNARIA TENUIS 0 0 

DOG DANDER ALLERGEN 0 0 

CAT DANDER ALLERGEN 0 0

SACCHAROMYCES IGG 1 AB 1 

SACCHAROMYCES IGA 1 AB 1 

ALDOST.ACTH RESP.EA. 0 0 

LEPTIN LEVEL 0 0 

ORGANIC ACIDS,QUAN,U 0 0 

NARCOLEPSY PANEL 0 0 

HEPARIN ASSOC ABS 2 2 

PTH INTACT 47 47 

CALCIUM (PTH INTACT) 0 0 

THROMBOPLASTIN INHIB 0 0 

HSV 1 IGG TYPE SPEC0 0 

HSV 2 IGG TYPE SPEC0 0 

PROPREDICTR 6MP 1 1 

CHROM.IN SITU HYBRID 0 0 

MOL. CYTOGENETICS0 0 

TISS.NON NEOPLASTIC0 0 

INTERPHASE IN SITU H0 0 

TISS.NEOPLASTIC 0 0 

CHROMOSOMES,FISH0 0 

CATECHOLAMINE,UR1 1 

CREATININE,UR RANDOM 1 1 

CHROMOSOME ANALYSIS 1 1 

ANTI SSA ANTIBODY14 14 

ANTI SSB ANTIBODY14 14 

PS-1 GENE 0 0 

PLASMINOGEN ACT INH1 0 0 

BETA 2 TRANSFERRIN0 0 

ZELDOX(ZIPRASIDONE) 0 0 

GAD-65 AB 0 0 

IGA PHOSPHATIDYLSERI 0 0 

BRUCELLA IGG 0 0 

BRUCELLA IGM 0 0 

TYPE2 COXSACKIE A AB 0 0 




TYPE10 COXSACKIE A0 0 

TYPE16 COXSACKIE A0 0 

TYPE 4 ECHOVIRUS AB0 0 



TYPE 11 ECHOVIRUS AB 0 0 

TYPE30 ECHOVIRUS AB 0 0 

POLIO VIRUS 1,CF 0 0 



COXSACKIE B1 AB 0 0

COXSACKIE B2 AB 0 0 





IGG,ANTI-IGA AB 0 0 

LYME DNA PCR,URINE0 0 

RBC 70 70 

HEMOGLOBIN 70 70 


LCM IGG AB 0 0 

LCM IGM AB 0 0 

BETAPACE LEVEL 0 0 

H.INFLUENZAE TYPE B0 0 

STREP.PNEUMONIAE0 0 

N.MENINGITIDIS GP A0 0 

N.MENINGITIDIS GP B0 0 

N.MENINGITIDIS GP C0 0 

N.MENINGITIDIS GP Y0 0 

N.MENINGITIDIS GPW13 0 0 

GP B STREPTOCOCCUS0 0 

E.COLI AG 0 0 

CSF HSV 1 1 

ENTEROVIRUS,PCR 0 0 

ALDOSTERONE,PLASMA 2 2 

ASPERGILLUS 0 0 

GEL DIFF.EA AG/AB 0 0 

ADENOVIRUS CULTURE 0 0 

ADENOVIRUS TISS INOC 0 0 

CMV DNA,QL,PCR 0 0 

TPMT MUTATION ANALYS 2 2 

VIRAL CULTURE,COMPRE 6 6 

FREE KAPPA,SERUM10 10 

FREE LAMBDA,SERUM10 10 

ACHR BLOCKING AB 0 0 

ACHR MODULATING 0AB 

0 

SKELETAL MUSCLE AB0 0 

DHEA,URINE 0 0 

REDUCING SUBST.FECES 0 0 

ENTEROVIRUS CULTURE 0 0 

CRYPTOCOCCUS AG,SERU 0 0 

LYME,PCR,FLUID 0 0 

LYME,PCR,CSF 0 0 

LYME WB IGG/IGM,CSF 0 0 

HSV I,IGG 13 13 

HSV II,IGG 13 13 

LYME WB IGG/IGM FLD. 0 0

PLASMINOGEN ACT INH1 0 0 

HISTOPLASMA AB ID 0 0 

HEXAGONAL PH.NEUT. 0 0 

HISTOPLASMA AB PROF 0 0 

BABESIA AB/IGG/IGM0 0 

RENIN ACTIVITY,PLASM0 0 

SPOROTHRIX AB 0 0 

21-HYDROXYLASE AB0 0 

NARCOLEPSY ASSOC. 0AG 

0 

ALPHA THALASSEMIA0 0 

N-TELOPEPTIDE (NTX)0 0 

ALPHA-2-ANTIPLASMIN 0 0 

HEPATITIS PNL,ACUTE 80 80 

M.TUBERCULOSIS,DNA0 0 

DIPHTHERIA AB 0 0 

PNEUMOCOCCAL AB0 0 





IGE 0 0 

IGG 0 0 

IGM 0 0 

IGA 0 0 

H.INFLUENZA TYPE B0 0 

TETANUS AB 0 0 

CMV,RAPID CULTURE1 1 

CMV CONVENTIONAL 1CUL 

1 

ACYLGLYCINES 0 0 

FACTOR XIII,FUNCTION0 0 

FIBRINOGEN AG 0 0 

COCAINE,BLOOD 0 0 

TB CULTURE 0 0 

ACID FAST/FLUOR.SMR 0 0 

ACETAMINOPHEN 1 1 

HYDROCODONE 1 1 

DNA,SINGLE STRANDED 0 0 

ROPIVACAINE 0 0 

IGG TRANSGLUTAMINASE 7 7 

ACYLCARNITINE,PLASMA 0 0 

ORGANIC ACIDS,URINE 0 0 

ACYLGLYCINE ANALYSIS 0 0 

HLA DR,DQ CLASS II 0 0 

YEAST SENSITIVITY 0 0 

CMV DNA,QN,PCR,REAL 0 0 

PORPHYRINS,UR RANDOM 0 0 

C.TRACHOMATIS RNA0 0

N.GONORRHOEAE RNA 0 0 

CORTISONE,SERUM 0 0 

MYOGLOBIN 1 1 

T OR B CELL CLONAL R0 0 

SOLUBLE LIVER AG AB0 0 

INTERLEUKIN 5 0 0 

ACID PHOSPHATASE,TOT 0 0 

C.PNEUMONIAE/PSITTAC 0 0 

LYME SKIN BIOPSY 0 0 

SUB ABUSE PANEL 54 54 

CARDIOLIPIN IGA AB 0 0 

HPV DNA HIGH RISK267 267 

SALMONELLA AB 0 0 

CONCENTRATION,INF.AG 8 8 

TRYPTOPHAN 0 0 

HSV 1&2,DNA,PCR 1 1 

HSV 1 IGM,IFA,CSF 0 0 

HSV 2 IGM,IFA,CSF 0 0 

HSV 1 IGG,CSF 0 0 

HSV 2 IGG,CSF 0 0 

RICKETTSIA CONORII 0 0 

INSULIN,FREE 3 3 

CANDIDA IGG AB 0 0 

CANDIDA IGA AB 0 0 

CANDIDA IGM AB 0 0 

ANGIOTENSIN CONV 0CSF 

0 

KETAMINE&META SCREEN 0 0 

PARVO B19 DNA,PCR0 0 

B CELLS,TOTAL CT. 0 0 

NATURAL KILLER(NK)0 0 

NORWALK LIKE VIRUS0 0 

DENGUE FEVER IGG AB 0 0 

DENGUE FEVER IGM AB 0 0 

H.PYLORI AB(IGG) 0 0 

S.PNEUMONIAE AG 0 0 

BCR/ABC QUANT. 0 0 

CYSTIC FIBROSIS TEST0 0 

VITAMIN C 0 0 

C1 INHIB.FUNCTIONAL0 0 

BERYLLIUM 0 0 

IMMUNOFLUOR,INDIR,AB 0 0 

VWF PROTEASE W/RF 0IN 

0 

VWF INHIBITOR 0 0 

CLARITIN LEVEL 0 0 

PROINSULIN 0 0 

SELENIUM,BLOOD 0 0 

ANTICARDIOLIPIN AB0 0

HYPERCOAG. NON-PREG 0 0 

HOLD/CHEMISTRY 8 8 

HOLD/BLOOD BANK 0 0 

HYPERCOAG.PNL HOLD 0 0 

HYPERCOAG.PNL.PREG. 0 0 

MYELIN BASIC PROT.AB 0 0 

ZINC,PLASMA 0 0 

TRAMADOL 0 0 

TRIGLYCERIDES(VAP)6 6 

HIGH RES.FRACT.LIPO. 6 6 

THC,DELTA-9,SERUM0 0 

B CELLS,TOTAL CT. 0 0 

FISH DIGEORGE 1 1 

DNA PROBE,EA. 1 1 

CHROMOSOME,HYBRID. 1 1 

CMV QUANT. PCR 0 0 

LEUK.HISTAMINE REL.0 0 

CHEMILUMINESCENT 0ASY 

0 

VGKC AB 0 0 

AMPHETAMINE 0 0 

PARKINSON EVAL PANEL 0 0 

B.PERTUSSIS AG,DFA3 3 

PINK1 DNA SEQ.TEST0 0 

VIRUS ISOLATION,P.ID0 0 

TISSUE CULT.DEF.ID 0 0 

OXYCODONE,URINE,GCMS 2 2 

FLUOR./AFB SMR. 8 8 

TB CULTURE 8 8 

TB CULTURE W/SMR 0 0 

GASTRIC PARIETAL AB0 0 

AFP 0 0 

NUCLEIC ACID PROBE 0I 

0 

ASIALO GM1 AB(IGM)0 0 

MORPHINE,URINE 0 0 

HER2,ELISA 0 0 

FENTANYL & METAB.UR 0 0 

UTG1A128 GENETIC VAR 0 0 

AMINO ACIDS, QUANT. 0 0 

PROTHROMBIN AB (G&M) 0 0 

ANNEXIN V IGG AB 0 0 

ANNEXIN V IGM AB 0 0 

EBV DNA QUAL. 0 0 

IMMUNOFIXATION, CSF 0 0 

ELECTROPHORESIS, CSF 0 0 

PROTEIN, TOTAL, CSF0 0 

TESTOSTERONE, TOTAL 0 0 

SEX HORMONE BNG GLOB 0 0

ALBUMIN 0 0 

YERSINIA AB 1 1 

JANUS KINASE 2 2 2 

LIPASE, URINE, RANDOM 0 0 

ARGIN-VASOPRES, URINE 0 0 

OSMOLALITY, URINE 0 0 

MYELOPEROXIDASE AB 2 2 

EHRLICHIOSIS AB 0 0 

CREATINE, SERUM 0 0 

GALACTOSE I-PHOS URI 0 0 

TISSUE CULT NON NEOP 0 0 

CT 15 TO 20 CELLS/KA0 0 

CHROMOSOME ADD 0HIGH 

0 

UROVYSION 0 0 

AB, BORDETELLA 0 0 

CARISOPRODOL/MEPROBA 0 0 

BROMIDE 0 0 

ALPRAXOLAM, URINE0 0 

CHROMOSOME INSITU 0 HY 0 

FISH, SUBTELOMERE 0INT 

0 

HPV TYPING IN SITU 0 0 

LEXAPRO 0 0 

GALACTOSEMIA GENE 0 AN 0 

AUTOSOMAL DOMINENT 0 ATAXIA0 

LYME WB, SERUM 0 0 

CONGEN VEN THROMOSIS 0 PROF0 

HERPES VIRUS 6 AB 0 0 

HSV DNA DETECTOR 0 0 

KAPPA/LAMBDA LT CHAINS 0 UR 0 

PARASITE PROFILE 0 0 

IBD DETECTION 0 0 

QUINIDINE 0 0 

BILE ACIDS, TOTAL 1 1 

N. MENINGITIDIS IGG0 0 

MENINGITIS AG PANEL 0 0 

NEUROMYELITIS OPTICA 0 0 

APOLIPOPROTEIN B 0 0 

YEAST SENS TO FULCON 0 0 

HERPES VIRUS 6 IGG 0 0 

HERPES VIRUS 6 IGM0 0 

IGG 0 0 

APTT 0 0 

ANTITHROMBIN, PLASMA 0 0 

PROTEIN C ACTIVITY 0 0 

PROTEIN S ACTIVITY 0 0 

PROTEIN S AG, FREE 0 0 

H. INFLUENZAE TYPE 0B IGG 0

TISSUE PREP 0 0 

CD38 0 0 

NEISSERI GONORRHOEAE 0 0 

B.PERTUSSIS DNA 0 0 

NEFAZODONE 0 0 

ACTIN AB IGG 0 0 

IGA ENDOMYSIAL AB0 0 

HISTAMINE, PLASMA0 0 

PLACENTAL LACTOGEN0 0 

WB, CSF 0 0 

FLUORESCENT AB, CSF0 0 

SP.GRAVITY, FLUID 0 0 

OSMO, FECES 0 0 

FIP1L1-PDGGRA GENE0 0 

SODIUM, FECES 0 0 

POTASSIUM, FECES 0 0 

CHLORIDE, FECES 0 0 

MAGNESIUM, FECES 0 0 

RITALIN, URINE 0 0 

PROSTAGLANDINS D2, 0 UR 0 

CA72-4 0 0 

N.GONORRHOEAE 0 0 

C.TRACHOMATIS 0 0 

CELEXA 0 0 

CD 57 LYMPHOCYTE CT 0 0 

ANTIMICROBIAL SUSC0 0 

BSAG 2 2 

METHSUXIMIDE 0 0 

THALASSEMIA, BETA 0DNA 

0 

CORTISOL, SALIVARY 0 0 

HLA TYPING, CELIAC 5 5 

5HIAA, RANDOM URINE 1 1 

PTT, ACTIVATED 1 1 

CREAT. RANDOM, URINE 1 1 

TEICHOIC ACID AB W/REFLEX 0 0 

METANEPHRINE,RANDOM 0 URINE0 

NIACIN 0 0 

ULTRAM, URINE 0 0 

TB DIRECT DETECT DNA 0 AMP 0 

TYSABRI AB 0 0 

HLA DQB1 CLASS II DNA 0 0 

THALLASEMIA, BETA, 0DNA 

0 

MYCOPHENOLIC ACID0 0 

QUANTIFERON GOLD4 4 

IA - 2 AB 0 0 

LACTOFERRIN, STOOL0 0 

CYSTATIN C 0 0

GLYCOMARK 0 0 

STREPTOMYCIN 0 0 

THYROXIN BINDING CAPACITY 0 0 

DEOXYCORTICOSTERONE 0 0 

ALDACTONE/SPIRONOLACTONE 0 0 

CHROMATIN ANTIBODY 0 0 

BK VIRUS DNA, QN, PCR 0 0 

HA1C WITH MPG 0 0 

CITRATE URINE, RANDOM 0 0 

ESTRIOL 0 0 

ASPERGILLUS ANTIBODY 0 0 

TIN 0 0 

NICOTINE/COTININE, 1URINE 

1 

LYME DISEASE C6 ANTIBODY 0 0 

PRO S ANTIGEN TL AND 0 FREE 0 

ATOMOXETINE 0 0 

VITAMIN D 498 498 

HEPATITIS A AB, IGM14 14 

KRAS 0 0 

INFLUENZA A RNA 0 0 

SWINE FLU H1 GENE 0 0 

PL-7 AUTOABS 0 0 

PL-12 AUTOABS 0 0 

MI-2 AUTOABS 0 0 

KU AUTOABS 0 0 

EJ AUTOABS 0 0 

OG AUTOABS 0 0 

SRP AUTOABS 0 0 

JO-1 AUTOABS 0 0 

REFLEX HPV DNA 22 22 

COMPLEMENT-C5 0 0 

OVA AND PARASITES35 35 

TRICHROME 35 35 

ABILIFY 0 0 

PT-QUEST 0 0 

PTT-LA 0 0 



ANA TITER 19 19 

ANA PATTERN 0 0 

CRYPTOCOCCUS AG, CSF 0 0 

LEGIONELLA AG, URINE 0 0 

BUPRENORPHINE, URINE 4 4 

COTININE, URINE 0 0 

AMPHETAMINES, UR 0QUANT 

0 


T3 ANTIBODY 0 0

LIDOCAINE AUTO ABS0 0 

FREE HEMOGLOBIN, URINE 0 0 

PH, URINE 0 0 

CALCIUM, URINE 0 0 

URIC ACID, URINE 0 0 

CITRATE, URINE 0 0 

SODIUM, URINE 0 0 

SULFATE, URINE 0 0 

PHOSPHORUS, URINE0 0 

MAGNESIUM, URINE0 0 

POTASSIUM, URINE 0 0 

CREATININE, URINE 0 0 

CALCIUM OXALATE, URINE 0 0 

BETA-HYDROXYBUTYRATE 0 0 

IRON, LIVER TISSUE 0 0 

CREATININE, URINE, QUEST 0 0 

EARLY ALZHEIMERS EVAL 0 0 

LEFLUNOMIDE 0 0 

ANTI NEURON NUC AB 0 TYPE 1 0 



ANTI GLIAL NUC AN TYPE 0 1 0 

PURKINJE CELL CYTO 0AB T 1 0 

PURKINJE CELL CYTO 0AB T 2 0 

PURKINJE CELL CYTO 0AB TTR 0 

AMPHIPHYSIS AB 0 0 

CRMP 5 IG G 0 0 


P/Q TYPE CA CHANNEL 0 AB 0 

N TYPE CA CHANNEL 0AB 

0 

ACH REC BINDING AB0 0 

ACHR GANGLION NEURONAL 0 AB0 

NEURON (V-G)K+ CHANNEL 0 AB 0 

RETOVIRAL SEROLOGY0 0 

TAY SACHS MUTATION 0 ANALYS 0 

PRO-BNP NT 0 0 

TARTRATE RESIST ACID 0 PHOS 0 

CYMBALTA 0 0 

THYROTROPIN 0 0 

CODEINE ALLERGEN 0 0 

PORPHYRINS, FECAL, 0QUAL 

0 

XYLENE PANEL 0 0 

COMPLETE MYOTONIA 0 EVAL 0 

17 OH PROGESTERONE 4 4 


5HIAA UR, 24 HR 2 2 

ACETYLCHOLINE MODULATE 0 AB 0

CHROMAGRANIN A 3 3 

CMV DNA QUANT RT 5PCR 

5 

DNA (DS) AB, CRITHIDIA 13 13 

ENDOMYSIAL AB SCREEN 13 13 

RBC FOLATE 6 6 

H PYLORI AG, STOOL12 12 

HERPES SIMPLEX CULTURE 0 0 

HYDROCODONE URINE 0 0 

INSULIN LIKE GROW FAC 3 1 3 

LEAD, BLOOD 0 0 

LEPTIN LEVEL 0 0 

LYME, PCR, FLUID 0 0 

U UREALYTICUM/H HOM 0 CULT 0 

RENIN ACTIVITY, PLASMA 5 5 

QUETIAPINE (SEROQUAL) 0 0 

ANCA SCREEN 0 0 

SCA5 DNA TEST ATHENA 0 0 


MIRAS SPEC POLG 1 ATHENA 0 0 

SIL1 DNA TEST ATHENA 0 0 

SCA13 SELECT EXON ATHENA 0 0 


SETX DNA TEST ATHENA 0 0 

TTPA DNA TEST ATHENA 0 0 

PTT LA 0 0 

HEXAGONAL PHASE CONF 0 0 

DRVVT SCREEN 0 0 

DRVVT 1:1 MIX 0 0 

DRVVT CONFIRMATION 0 0 

LACTOFERRIN, STOOL0 0 

LYME DISEASE, C6 AB'S 0 0 

HOMOCYSTEINE 0 0 


CHOLINESTERASE, SERUM 0 0 

THYROXINE BINDING 0GLOB 

0 

ESTRIOL 0 0 

SODIUM QUEST 0 0 

PEDIATRIC LEAD LEVEL 0 0 

RH PHENO TYPING COMPLETE 0 0 

RBC AG, OTHER ABO 0OR D EA 0 

DAT, EA ANTISERA 0 0 

ELUTION, EACH 0 0 

ANTIBODY SCREEN, EA 0 MEDIA 0 

AB ID/EA PANEL & MEDIA 0 0 

AB ID/EA SEL REAGENT 0 CELL 0 

PRETREAT W/ENZYM 0PER CELL 0 

PRE RX RBC'S W/CHEM/RX 0 0

INCU SERUM & DRUGS, 0 EA 0 

DIFF/AUTO ADS OF SER, 0 EA 0 

INCU W/INHI, PER ALIQUOT 0 0 

DILUTION OF SERUM/ALIQUOT 0 0 

INDIRECT TITER, PER 0AB 

0 

SEP DENSITY GRAD, RETICS 0 0 

AG SCRN W/PT SERUM/UNIT 0 0 

ANTIGEN TP/UNT, NOT 0 LABEL 0 

GLIADIN(DEAM PEP)AB, 0 IGG 0 

GLIADIN(DEAM PEP)AB, 0 IGA 0 

FTA-ABS 0 0 

IODINE, RANDOM URINE 0 0 

BUPRENORPHINE 0 0 

NALOXONE 0 0 

PSA, POST PROSTATECTOMY 0 0 

ESTRIOL 0 0 

BULLOUS PEMP (BP230 0 IGG) 0 

MYCOBACTERIUM, BLOOD 0 CULT0 

IGM ANTIBODY CAPTURE 420 420 

IGG ANTIBODY CAPTURE 420 420 

IGA ANTIBODY CAPTURE 420 420 

IGG IMMUNOBLOT 420 G39/40 420 

IGG IMMUNOBLOT 420 49736 420 

BABESIA, AMP PROBE 212TECH 

212 

A PHAGO, AMP PROBE 212 TECH 212 

LYME, AMP PROBE TECH 5 5 

BABESIA ANTIBODY 3 3 

BABESIA BLOT IGG 3 3 

BABESIA BLOT IGM 3 3 

A PHAGOCYTOPHILUM, 4 IGM 4 

A PHAGOCYTOPHILUM, 4 IGG 4 

HME IGG 0 0 

E CHAFFEENSIS, AMP 2PR TCH 2 

ACUTE TICK BORNE PANEL 0 3 0 

ACUTE TICK BORNE PANEL 0 4 0 

C-TELOPEPTIDE 1 1 

NALOXENE, QUANT, URINE 0 0 


COENZYME Q10 0 0 

LYME DISEASE C6 AB'S, 0 TTL 0 

BK VIRUS DNA 12 12 

TRICHOMONAS VAGINALIS 0 CUL 0 

BILE ACIDS FRACT & TOTAL 0 0 

CALPROTECTIN, STOOL 2 2 

IA-2 ANTIBODY 0 0 

HE4, OVARIAN CANC 1MONITOR 

1 

VZA DNA, QL PCR 0 0

ANTI MULLERIAN HORMONE 0 0 

TSH ANTIBODY 0 0 

CYSTIC FIBROSIS SCREEN 0 0 

HEMOCHROMATOSIS 0ANALYSIS 

0 

FACTOR II MUTATION 0GENE 

0 

SILVER, URINE 0 0 

SILVER, BLOOD 0 0 

LEAD, BLOOD(OSHA)0 0 

CHROMIUM, RBC 0 0 

H PYLORI AB, IGG 0 0 

TAPENTADOL, QUANT, 0 URINE 0 

ACCUTYPE IL28B 0 0 

DPD GENE MUTATION0 0 

LEAD, URINE 0 0 

CREAT, URINE 0 0 

CA 125, ROMA 1 1 

HE4, ROMA 1 1 

DYE TEST 0 0 

IGM ELISA, TOXO 0 0 

PART AGGLUTINATION, 0 TOXO 0 

CHLAMYDIA ANTIBODY, 0 LGV 0 

CHLAMYDIA ANTI, IGM, 0 LGV 0 

ARSENIC, RANDOM URINE 0 0 

COBALT, RANDOM URINE 0 0 

CREATININE, RANDOM 0 URINE 0 

MERCURY, RANDOM 0URINE 

0 

LEAD, RANDOM URINE 0 0 

CADMIUM, RANDOM 0URINE 

0 

THALLIUM, RANDOM 0URINE 

0 

VZV IMMUNITY SCREEN 27 27 

WEST NILE IGG, SERUM0 0 

WEST NILE IGM, SERUM 0 0 

A1AT PHENOTYPE 0 0 

ACETONE 0 0 

ACYLCARN PROFILE, PLASMA 0 0 

ACTH, PLASMA 0 0 

BETA 2 MICRO, SERUM0 0 

ACTIN (SMOOTH) ANTIBODY 0 0 

ACHR BINDING ABS, SERUM 0 0 

ACHR BLOCKING ABS, 0SERUM 

0 

ACHR MODULATING 0ANTIBODY 

0 

ACTIVATED PROTEIN 0S RESIS 0 

ANTI-DS DNA ANTIBODIES 0 0 

ANTISCLERODERMA 70 0 ANTIBO 0 

AMIKACIN PEAK, SERUM 0 0 

BETA-HYDROXYBUTYRATE 0 0 

ACYLCARNITINE PROFILE 0 0

ALDOLASE 0 0 

ALDOLASE 0 0 

ALPHA 1 ANTITRYPSIN, 0 SER 0 

AFP, SERUM, TUMOR 0MARKER 

0 

AMINO ACID, PROF, QN, 0 PLA 0 

ANDROSTENEDIONE 0 0 

ANGIOTENSIN-CONVERT 0 ENZYM0 

APLIPOPROTEIN A-1 0 0 

APOLIPOPROTEIN B 0 0 

ARSENIC, BLOOD 0 0 

BILE ACIDS 0 0 

ARIPIPRAZOLE 0 0 

5 HIAA, QUANT, 24HR 0 URINE 0 

ANTIGLOMERULAR BM 0 AB 0 

ANTIPARIETAL CELL ANTI 0 0 

ANTI-TSH AUTOANTIBODY 0 0 

ANTI-MULLERIAN HORMONE 0 0 

ANTIMYELOPEROXIDASE(MPO) 0 0 

ANTIPROTEINASE 3(PR-3)ABS 0 0 

ALK PHOS, TOTAL 0 0 

ALK PHOS ISOENZYME0 0 

ALK PHOS, BONE SPECIFIC 0 0 

ANTITHROMBIN ACTIVITY 0 0 

ANTITHROMBIN ANTIGEN 0 0 

ANTISTREPTOLYSIN O 0AB 

0 

ANTICARDIOLIPIN AB, 0IGA 

0 

ANTICARDIOLIPIN AB, 0IGG 

0 

ANTICARDIOLIPIN AB, 0IGM 

0 

ANTI-DNASE B STREP 0ANTI 

0 

ANTIHISTONE ANTIBODIES 0 0 

ANTI-JO-1 0 0 

ANTIPANCREATIC ISLET 0 CELL 0 

ANTITHYROGLOBULIN 0 AB 0 

BK QUANT PCR PLASMA/SERUM 0 0 

ANTIEXTRACTABLE NUCLEAR 0 0 

ANTINEUTROPHIL CYTO 0 AB 0 

BARTONELLA ANTIBODY 0 PANEL 0 

BPERTA + BPERTG 0 0 

CA ENCEPHALITIS AB0 0 

EAST EQUINE ENCEPH 0 AB 0 

ST LOUIS ENCEPHALITIS 0 AB 0 

WEST EQUINE ENCEPH 0 AB 0 

ANTI CENTRO B ANTIBODY 0 0 

LAMOTRIGINE(LAMICTAL)SER 0 0 

LEVETIRACETAM(KEPPRA), 0 S 0 

IMMUNO D QUANT, SERUM 0 0 

IMMUNOGLOBULIN E, 0 TOTAL 0

INSULIN 0 0 

LD, BODY FLUID 0 0 

LACTOFERRIN 0 0 

LEAD, BLOOD, ADULT0 0 

LEAD, BLOOD, PEDIATRIC 0 0 

L/S RATIO 0 0 

LIPOPROTEIN(A) 0 0 

IODINE, SERUM OR PLASMA 1 1 

PG, A F 0 0 

LIPID-ASSOC SIALIC ACID 0 0 

IMMUNOFIXATION, URINE 0 0 

ANSULIN ANTIBODIES0 0 

INTRINSIC FAC ABS, SERUM 0 0 

LEGIONELLA PNEUMO 0 ABS 0 

L. PNEUMO SEROGP 10 UR AG 0 

HLA B 27 DISEASE ASSOC 0 0 

IL28B POLYMORPHISM 0 GENO 0 

ALBUMIN, SERUM 0 0 

ALBUMIN, CSF 0 0 

ARSENIC, 24 HR URINE0 0 

CREATININE, 24 HR URINE 0 0 

IMMUNOGLOBULIN, 0QN 

0 

IGG, SUBCLASS 0 0 

HISTAMINE, PLASMA0 0 

HOMOCYST(E)INE, PLASMA 0 0 

IGF-BP3 0 0 

INHIBIN B 0 0 

LEAD, 24 HR URINE 0 0 

MERCURY, 24 HR URINE 0 0 

HYDRO + METABOLITES, 0 U 0 

HYDROCODONE & METABOLITE 0 0 

IGF-1 0 0 

HEPARIN ANTI-XA 0 0 

HGB SOLUBILITY 0 0 

HEPARIN INDUCED PLATELET 0 0 

IND ANTIPLAT ALLOANTIBODY 0 0 

IMMUNOFIX ELECTROPHORO 0 0 

INHIBIN A, ULTRASENSITIVE 0 0 

HELICOBACTER PYLORI, 0 IGA 0 

HELICOBACT PYLORI, 0IGM AB 0 

HSV, IGM I/II COMBINATION 0 0 

HEP B CORE AB, TOT 0 0 

HEP B CORE AB, IGM0 0 


HEP BE AB 0 0 

HEPATITIS A AB, IGM0 0 

HSV CULTURE AND TYPING 0 0

HEP BE AG 0 0 

HISTOPLASMA ANTIGEN, 0 URIN 0 

HCV GENOTYPING NON 0 REFLEX 0 

HSV 1/2 PCR 0 0 

PHENOBARBITAL, SERUM 0 0 

PRIMIDONE 0 0 

VANCOMYCON TROUGH, 0 SERUM0 

ZONISAMIDE(ZONEGRAN), 0 SER 0 

PORPHOBILINOGEN, 0QN, RAND 0 

PREALBUMIN 0 0 

PROGESTERONE 0 0 

PROINSULIN 0 0 

ZINC, PLASMA, OR SERUM 0 0 

PROTEIN C ANTIGEN 0 0 

PROTEIN C FUNCTIONAL 0 0 

PROTEIN S, TOTAL 0 0 

PROTEIN S, FREE 0 0 

PROTEIN S FUNCTIONAL 0 0 

PNEUMOCYSTIS SMEAR, 0 DFA 0 

NICOTINE METABOLITE, 0 URIN 0 

PHENOBARBITAL, SERUM 0 0 

PHENYTOIN, FREE, SERUM 0 0 

MTHFR 0 0 

OLANZAPINE(ZYPREXA) 0 0 

OXCARBAZEPINE(TRILEPTAL) 0 0 

MITOCHONDRIAL (M2) 0 ANTI 0 

NMO IGG AUTOANTIBODIES 0 0 

MAGNESIUM, RBC 0 0 

MAGNESIUM, URINE0 0 

MERCURY, BLOOD 0 0 

METANEPHRINES,FRAC,QN,24H 0 0 

METANEPHRINES,FRAC,FREE 0 0 

METHADONE(DOLOPHINE)SERUM 

0 0 

MYELIN BASIC PROTEIN, 0 CSF 0 

MYOGLOBIN, SERUM0 0 

MYOGLOBIN, URINE 0 0 

OLIGOCLONAL BANDING 0 0 

ORGAN ACID ANALY URINE 0 0 

METHYLMALONIC ACID, 0 SERUM 0 

OXYCODONE AND METABOLITE 0 0 

OXYCODONE AND METABOLITE 0 0 

OXALATE, QUANT, 24-HOUR 0 0 

PH, STOOL 0 0 

LYSOZYME, SERUM 0 0 

PLATELET AUTOANTIBODY 0 0 

PNEUMO IMMUNITY 014 TYPE 0 

LIVER-KIDNEY MICROSOMAL 0 0

MUMPS ANTIBODIES, 0IGG 

0 

MYCOPLASMA PNEUMON 0 IGG AB0 

MYCOPLASMA PNEUMO 0 IGM AB0 

PARVOVIRUS B19, HUMAN, 0 0 

PARASITE EXAM, BLOOD 0 0 

NOROVIRUS, RT-PCR0 0 

0 0 

ETHOSUX(ZARONTIN) 0SERUM 

0 

CYSTIC FIBROSIS PROFILE 0 0 

FACTOR II, DNA ANALYSIS 0 0 

FACTOR V LEIDEN MUTATION 0 0 

FRAGILE X, PCR REFLEX 0 0 

CYSTINE, QUAN, URINE 0 24HR 0 

GABAPENTIN(NEURO)SERUM 0 0 

C-TELOPEPTIDE, SERUM 0 0 

COPPER, SERUM 0 0 

CORTISOL, URINARY FREE 0 0 

DEXAMETHASONE, SERUM 0 0 

FELBAMATE(FELBATOL), 0 SERU 0 

URINE CREATININE ASSAY 0 0 

CRYOGLOBULIN, QL, SERUM 0 0 

DHEA, SERUM 0 0 

DHEA-SULFATE 0 0 


ERYTHROPOIETIN(EPO)SERUM 0 0 

ESTRADIOL 0 0 

ESTROGENS, TOTAL 0 0 

FECAL FAT, QUALITATIVE 0 0 

ASSAY OF FOLIC ACID 0RBC 

0 

GASTRIN SERUM 0 0 

GLUCOSE, BODY FLUID0 0 

ASSAY OF G6PD ENZYME 0 0 

FRUCTOSAMINE 0 0 

HAPTOGLOBIN 0 0 

ASSAY OF 5 HIAA 0 0 

GAD 65 AUTOANTIBODY 0 0 

FECAL REDUCING SUBSTANCES 0 0 

FREE T4 BY DIAL/MASS 0 SPEC 0 

C-PEPTIDE SERUM 0 0 

HCG, BETA, QNT, SERUM 0 0 


FACTOR II ACTIVITY 0 0 

AUTOMATED RBC COUNT 0 0 

FACTOR VIII ACTIVITY0 0 

FACTOR X ACTIVITY 0 0 

FACTOR IX ACTIVITY 0 0 

FDP, PLASMA 0 0

FETOMATERNAL HEMO 0 SCREEN 0 

DILUTE RUSSEL VIPER 0VENOM 

0 

DRVVT MIX 0 0 

COMPLEMENT C3, SERUM 0 0 

COMPLEMENT C4, SERUM 0 0 

COMPLEMENT, TOTAL(CH50) 0 0 

ENDOMYSIAL ANTIBODY 0 IGA 0 

GROWTH HORMONE 0ANTIBODIES 

0 

DIPHTHERIA ANTIOXOID 0 AB 0 

C6 PEPTIDE B BURGDORFERI 0 0 

CYTOMEGALOVIRUS(CMV)AB 0 0 

CYTOMEGALOVIRUS(CMV)IGM 0 0 

EPSTEIN BARR ANTIBODY 0 0 

EPSTEIN BARR NUCLEAR 0 ANTI 0 

H PYLORI IGG, ABS 0 0 

HCV ANTIBODY 0 0 

HCV ANTIBODY VERIFICATION 0 0 

INFECTIOUS AGENT CONCEN 0 0 

FLOURESCENT/ACID AGENT 0 0 

VIRUS INOCULATION 0TISSUE 

0 

VIRUS INOCU SHELL VIA 0 0 

H PYLORI STOOL AG, 0EIA 

0 

ENTEROVIRUS RT PCR0 0 

HCV RNA PCR QUALITATIVE 0 0 

HCV GENOTYPING NON 0 REFLEX 0 

GLIADIN IGG/IGA AB 0PROF 

0 

FREE K + L LT CHAINS, 0QN 

0 

FREE K+L CHAINS, QN 0URINE 

0 

CANDIDA ANTI IGG, IGA, 0 0 

CHLAMYDIA ANTIBODY 0 0 

CHLAMYDIA ANTIBODY 0 IGM 0 

COXSACKIE VIRUS GRP 0 A AB 0 

EPSTEIN BARR CAPSID 0 VCA 0 

CADMIUM, BLOOD 0 0 

CALCITONIN, SERUM0 0 

CATECHOLAMINES, PLASMA 0 0 

CATECHOLAMINES, UR, 0 FREE 0 

CERULOPLASMIN 0 0 

CHLORIDE, 24 HR URINE 0 0 

BUPROPOIN(WELBUTRIN) 0 0 

CITALOPRAM(CELEXA)0 0 

CHROMIUM, PLASMA0 0 

CITRIC ACID(CITRATE)URINE 0 0 

CANNABINOID CONFIRMATION 0 0 

CLOMIPRAMINE, SERUM 0 0 

COLD ACG TITER, QUANT 0 0 

C1 ESTERASE INHIB, SERUM 0 0

C1 ESTERASE INHIB, FUNC 0 0 

CCP ANTIBODIES IGG/IGA 0 0 

CA 27.29 0 0 

CA 15 3 0 0 

CA 19 9 0 0 

CA 125 0 0 

CHROMOGRANIN A 0 0 

CHLAMYDIA CULTURE0 0 

CULTURE TYPING 0 0 

CHLAMYDIA TRACH DNA 0 AMP 0 

N GONORRHOEAE DNA 0 AMP 0 

TISSUE CULTURE LYMPHOCYTE 0 0 

CHROMOSOME ANALYSIS 0 15 20 0 

CYTO/MOLECULAR REPORT 0 0 

CK TOTAL 0 0 

CK ISOENZYMES 0 0 

CALPROTECTIN, FECAL0 0 

ALK PHOS TOTAL 0 0 

ALK PHOS ISOENZYME0 0 

HAEMOPHILUS INFLUENZAE 0 B 0 

HLA CLASS 2 LOW RESOL 0 0 

HLA CLASS 2 LOW RESOLTION 0 0 

HLA CLASS 2 HIGH RESOLUT 0 0 

10 DRUG-BUNDLE 0 0 

MECONIUM 5 PANEL0 0 

9 DRUG BUNDLE 0 0 

TOPIRAMATE(TOPIMAX)SERUM 0 0 

VANCOMYCIN TROUGH, 0 SERUM 0 

HERED HEMOCHROMA,DNA 0 0 

VITAMIN D, 25 HYDROXY 0 0 

CATECHOLAMINES, PLASMA 0 0 

THIOPURINE METHYTRANSFER 0 0 

TRAZODONE, SERUM0 0 

ZONISAMIDE(ZONEGRAN)SERUM 

0 0 

LACOSAMIDE 0 0 

NALOXONE SCREEN, TTL 0 URIN 0 

VIT B12 UNSAT BINDING 0 CAP 0 

THALLIUM 0 0 

HEMOGLOBIN CHROMO 0 0 

T-TRANSGLUT(TTG)IGA 0 0 

T-TRANSGLUTAMI(TTG)IGG 0 0 

TRYPTASE 0 0 

LEPTIN, SERUM 0 0 

LIPOPROTEIN BLD HR 0FRACTI 

0 


VITAMIN B2, WHOLE 0BLOOD 

0 

VITAMIN B1(THIAMINE)BLOOD 0 0

THYROID STIM IMMUNO 0 0 

VITAMIN E, SERUM 0 0 

TRANSFERRIN 0 0 

TRIGLYCERIDES 0 0 

TRIIODOTHYRONINE(T3) 0 0 

TRIIODOTHYRON, FREE, 0 SER 0 

VANILLYL ACID, 24 HR 0URN 

0 

VITAMIN A, SERUM 0 0 

ZINC, PLASMA OR SERUM 0 0 

VWF ACTIVITY 0 0 

VON WILLEBRAND(VWF) 0 AG 0 

HEXAGONAL PHASE PHOS 0 0 

RBC SICKLE CELL TEST0 0 

THROMBIN TIME 0 0 

VISCOSITY, SERUM 0 0 

ANTINUC ANTIBODIES, 0 IFA 0 

BETA2 GLYCOPROTEIN0 0 

NDNA SCREEN 0 0 

ANTI HU ANTIBODIES0 0 

PARANEOPLASTIC PROFILE 0 1 0 

HUMAN EPI PROT 4, SERIAL 0 0 

B CELLS TOTAL COUNT0 0 

NK CELLS TOTAL COUNT 0 0 

T CELLS TOTAL COUNT0 0 

TCELL ABSOLUTE CT/RATIO 0 0 

HELPER T LYMPH CD40 0 

MICROSOMAL ANTIBODY 0 0 

THYROID PEROXIDASE(TBO)AB 0 0 

VDRL, CSF 0 0 

HEP A (RFLX TO IGM)0 0 

HEP A AB, IGM 0 0 

TOXOPLASMA GONDII 0 AB, IGG 0 

TOXOPLASMA GONDII 0 AB, IGM 0 

VARICELLA-ZOSTER AB, 0 IGM 0 

VARICELLAZOSTER V 0AB, IGG 0 

WEST NILE VIRUS AB 0IGM 

0 

WEST NILE VIRUS ANTIBODY 0 0 

THYROGLOBULIN ANTIBODY 0 0 

HCV AB W/RFLX TO VERIFIC 0 0 

HCV ANTIBODY VERIFICATION 0 0 

OVARIAN MALIGNANCY 0 RISK 0 

STOOL CULTURE, VIBRIO 0 0 

ORGANISM ID, BACTERIA 0 0 

TRICHOMONAS CULTURE 0 0 

FUNGUS(MYCOLOGY) 0CULTURE 

0 

ORGANISM ID, YEAST0 0 

ORGANISM ID, MOLD0 0

UREAPLASMA MYCOPLASMA 0 HOM 0 

MYCOBACTERIA CULTURE 0 0 

OVA AND PARASITE SMEARS 0 0 

FLOURESCENT STAIN/ACID 0 0 

FUNGUS STAIN 0 0 

SMEAR COMPLEX STAIN 0 0 

VIRAL CULTURE, GENERAL 0 0 

VIRUS INOCULATION 0TISSUE 

0 

VIRUS INNOCULATION 0 SHELL 0 

VIRAL CULT, RAPID, RESPIR 0 0 

GENET VIRUS ISOLATE 0 HSV 0 

VIRUS,VARICELLA ZOSTER 0 AG 0 

HBSAG SCREEN 0 0 

CMV QUANT DNA PCR(PLASMA) 0 0 

HBV REAL TIME PCR, 0QUANT 

0 

HCV RT PCR QUANT(NONGRAPH 0 0 

VZV REAL TIME PCR 0 0 

CRYPTOCOCCUS ANTIGEN 0 0 

SIROLIMUS(RAPAMUNE)BLOOD 0 0 

TACROLIMUS(FK506)BLOOD 0 0 

PTHRP(PTH RELATED 0PEPTID 

0 

QUETIAPINE(SEROQUEL) 0 0 

RISPERIDONE(RISPERDAL) 0 0 

TAY SACHS, BIO CHEM, 0 SERU 0 

PTH, INTACT 0 0 

PSA TOTAL 0 0 

PSA, ULTRA, W/O SERIAL 0 0 

PSA FREE 0 0 

PROTEIN, BODY FLUID0 0 

PROTOPORPHYRIN FEP/ZPP 0 0 

RENIN ACTIVITY, PLASMA 0 0 

SELENIUM, BLOOD 0 0 

SELENIUM, SERUM/PLASMA 0 0 

SEROTONIN, WHOLE 0BLOOD 

0 

SEX HORM BINDING GLOB 0 0 

TESTERONE FREE 0 0 

TESTOSTERONE TOTAL 0 0 

REVERSE T3, SERUM 0 0 

PTT-LA MIX 0 0 

STREPTOZYME 0 0 

SJOGRENS AB,ANTI SS 0 A/SS 0 

RETICULIN IGA ANTIBODIES 0 0 

TETANUS ANTITOXOID 0 IGG 0 

RABIES NEUT ABS TITRAT 0 0 

SACCHAROMYCES CEREVISIAE 0 0 

HIV-2 ANTIBODY SCREEN 0 0 

RUBELLA ANTIBODIES, 0 IGG 0

RUBEOLA ANTIBODIES, 0 IGG 0 

RUBEOLA ANTIBODIES, 0 IGM 0 

T PALLIDUM AB (FTA-AB) 0 0 

RNA, REAL TIME PCR0 0 

POTATO WHITE, IGG 0 0 

ORANGE, IGG 0 0 

LAMB'S QUARTER, IGE0 0 

BLUEGRASS KENTUCKY, 0 IGE 0 

MUGWORT, IGE 0 0 

PLANTIAN ENGLISH, IGE 0 0 

PINE WHITE, IGE 0 0 

YEAST BAKERS, IGE 0 0 

GLUTEN, IGE 0 0 

TOMATO, IGE 0 0 

POTATO WHITE, IGE 0 0 

CHICKEN, IGE 0 0 

PORK, IGE 0 0 

BEEF, IGE 0 0 

RICE, IGE 0 0 

BLUE CHEESE MOLD, 0IGE 

0 

APPLE, IGE 0 0 

OAT, IGE 0 0 

BANANA, IGE 0 0 

ST4RAWBERRY, IGE 0 0 

GRAPE. IGE 0 0 

BROCCOLI, IGE 0 0 

BARLEY WHOLE GRAIN, 0 IGE 0 

CARROT, IGE 0 0 

PEANUT, IGE 0 0 

CARMINE/RED DYE-COCHINEAL 0 0 

CASHEW NUT, IGE 0 0 

ORANGE, IGE 0 0 

MACADAMIA NUT, IGE 0 0 

PECAN NUT, IGE 0 0 

EGG YOLK, IGE 0 0 

CASEIN, IGE 0 0 

PEACH, IGE 0 0 

TURKEY, IGE 0 0 

PEAR, IGE 0 0 

BLUEBERRY, IGE 0 0 

GREEN PEA, IGE 0 0 

GREEN BEAN, IGE 0 0 

WHEY, IGE 0 0 

WALNUT FOOD, IGE 0 0 

YOGURT, IGE 0 0 

GARLIC, IGE 0 0 

SHRIMP, IGE 0 0

COCONUT, IGE 0 0 

ONIONS, IGE 0 0 

PINEAPPLE, IGE 0 0 

BRAZIL NUT, IGE 0 0 

TUNA, IGE 0 0 

MELON HONEYDEW, 0IGE 

0 

GREEN BELL PEPPER, 0IGE 

0 

CUCUMBER, IGE 0 0 

CRAB, IGE 0 0 

LETTUCE, IGE 0 0 

CHEESE CHEDDAR, IGE0 0 

PISTACHIO NUT, IGE 0 0 

ALMOND, IGE 0 0 

WATERMELON, IGE 0 0 

KIWI FRUIT, IGE 0 0 

BREWER'S YEAST, IGE0 0 

SCALLOP, IGE 0 0 

BING CHERRY, IGE 0 0 

PLUM, IGE 0 0 

LOBSTER, IGE 0 0 

WHEAT, IGE 0 0 

GLUTEN, IGG 0 0 

WHEAT, IGG 0 0 

EGG WHITE, IGG 0 0 

SOYBEAN, IGG 0 0 

TOMATO, IGG 0 0 

EGG YOLK, IGG 0 0 

PEANUT, IGG 0 0 

WHEAT, IGE 0 0 

MILK(COW), IGE 0 0 

SOYBEAN, IGE 0 0 

EGG WHITE, IGE 0 0 

CORN, IGE 0 0 

CAT HAIR/DANDER, IGE 0 0 

DOG HAIR/DANDER, IGE 0 0 

ASPERGILLUS FUMIGATUS 0 0 

D PTERONYSSINUS, IGE 0 0 

D FARINAE, IGE 0 0 

TIMOTHY, IGE 0 0 

COCKROACH GERMAN, 0 IGE 0 

PENICILLIN NOTATUM, 0 IGE 0 

CLADOSPORIUM HERBARU, 0 IGE 0 

ALTERNARIA TENIUS, 0IGE 

0 

OAK WHITE, IGE 0 0 

SYCAMORE AMERICAN, 0 IGE 0 

PIGWEED ROUGH, IGE0 0 

BERMUDA GRASS, IGE0 0

MUCOR RACEMOSUS, 0 IGE 0 

MAPLE/BOX ELDER, IGE 0 0 

ASH WHITE, IGE 0 0 

BIRCH WHITE, IGE 0 0 

RAGWEED SHORT/COMMON, 0 IGE 0 

HONEY BEE, IGE 0 0 

HORNET WHITE FACE, 0 IGE 0 

YELLOW JACKET, IGE 0 0 

WASP, IGE 0 0 

HORNET YELLOE, IGE0 0 

CANDIDA ALBICANS, 0IGE 

0 

HELMINTH HALO, IGE0 0 

FUSARIUM MONILIFORME, 0 IGE 0 

AUREOBASIDIUM PULLUL, 0 IGE 0 

PHOMA BETAE, IGE 0 0 

EPICOCCUM PURPURASCE, 0 IGE 0 

STEMPHYLIUM BOTRYOSU, 0 IGE 0 

HORMLDENDRUM HORDEI, 0 IGE 0 

ALDER SMOOTH, IGE0 0 

BEECH AMERICAN, IGE0 0 

CEDAR WHITE, IGE 0 0 

ELM AMERICAN/WHITE, 0 IGE 0 

WALNUT POLLEN, IGE0 0 

WILLOW BLACK, IGE 0 0 

HICKORY WHITE, IGE0 0 

WHITE POPLAR, IGE 0 0 

OYSTER, IGE 0 0 

HAZELNUT/FILBERT, IGE 0 0 

DOG EPITHELIA, IGE 0 0 

BAHIA GRASS, IGE 0 0 

COCKROACH AMERICAN, 0 IGE 0 

HAZELNUT TREE, IGE0 0 

WHITE MULBERRY, IGE 0 0 

CEDAR MOUNTAIN, IGE 0 0 

SHEEP SORREL(DOCK), 0 IGE 0 

NETTLE, IGE 0 0 

SWEET VERNAL, IGE 0 0 

ORCHARD GRASS, IGE0 0 

RED TOP, IGE 0 0 

JOHNSON GRASS, IGE0 0 

COTTONWOOD TREE, 0IGE 

0 

DOCKWEED YELLOW, 0IGE 

0 

PARAINFLUENZA TY III0 0 

INFLUENZA TYPE A AB0 0 

INFLUENZA TYPE B AB0 0 

ADENOVIRUS AB/CF 0 0 

RESPIRATORY SYNC CF0 0

PARAINFLUENZA TYPE 0 I 0 

PARAINFLUENZA TYPEII 0 0 

RESP SYNCYTIAL PANEL 0 0 

MUMPS AB IGG 0 0 

CSF VIRAL STUDIES 0 0 

RUBEOLA AB-IGM 0 0 

COXSACKIE AB PANEL0 0 

FLUORESCENT TREP AB 0 0 

VIRAL WOUND SWAB0 0 

CSF VDRL 1 1 

LEPTOSPIRA 1 1 

BLASTOMYCOSIS 0 0 

ASPERGILLOSIS TITER0 0 

LEAD-CHILD 159 159 

FUNGUS SENDOUT 0 0 

SSA ANTI-RO TITER 0 0 

PEMPHIGUS PEMPHIGOID 0 0 

STONE ANALYSIS 11 11 

CYSTIC FIBROSIS SCR 0 0 

ALPHA FETO PROTEIN9 9 

LYME ELISA UCONN 0 0 

RABIES ANTIBODY 1 1 

RUBEOLA/MEASLES 0 0 

CAT SCRATCH FEVER 3 3 

ZINC,RBC 0 0 

SCLERODERMA IMMCO 0 0 

HUMORAL IMMUNITY 0 IBT 0 

CA-125 (DIANON) 0 0 

LASA-P (DIANON) 0 0 

DM/70K (DIANON) 0 0 

AFP (DIANON) 0 0 

HCG (DIANON) 0 0 

ESTRIOL UNCONJUGATED 0 0 

CA15-3 (DIANON) 0 0 

ESTRIOL (UCONN) 0 0 

ATAXIA PROFILE 0 0 

SULFATIDE ANTIBODY0 0 

HTLV-2 0 0 

MELAS MUTATION INTER 0 0 

HSV DNA DETECTOR, 0PCR 

0 

MARKER, FLOW CYTOMETER 0 0 

AEROBIC ISOLATE ID 0 0 

ANAEROBIC/ISOLATE 0ID 

0 

LIPID PEROXIDASE 6 6 

STAT TEST 0 0 

HOLD EXTRA TUBE121 121 

HOME VISIT 0 0

SPE COLL TRAVEL/MILE 0 0 

SPE COLL TRAVEL/FLAT 0 0 

SPE COLL TRAVEL/FLAT 944 944 

NURSING HOME VISIT0 0 

VENI, EVENING 546 546 

VENI CAPILLARY 10 10 

VENI ROUTINE DAYS 7708 7708 

VENI BY ED 0 0 

VENIPUNCTURE NIGHT 506 506 

VENI BLOOD DRAW SVC 1 ONLY 1 


IRRAD.PLTS,SGL DONOR/UNIT 0 0 

PLTS,WBC-REDU,IRR,PER 0 UNI 0 

CELLS,WBC/REDU,IR,PER 5 UNI 5 

PLATELET INFUS. SET0 0 

PROCESSING & STORAGE 0 0 

DESTRUCTION OF BLOOD 0 0 

PHENOTYPE ROUTINE0 0 

PHENOTYPE OFF HOURS 0 0 

HLA TYPING 0 0 

HLA TYPING (DR) 0 0 

CELLS,WBC REDUCD,PER 93 UNIT 93 

ALBUMIN 25%/50ML0 0 

PLATELETS, PER UNIT0 0 

SOLVENT DET.PLASMA/UNIT 0 0 

CRYOPRECIP. PER UNIT 0 0 

FRSH FRZ PLASMA PER 6 UNIT 6 

PLATELET SGL DONOR/UNIT 0 0 

FACTOR 9 PER UNIT 0 0 

PLATELETS, 1 UNT, LEUK 0 RE 0 

MRI KEN CSPINE WO 0CONTRAS 

0 

MRI KEN CSPINE W CONTRAST 0 0 

MRI KEN CSPINE W WO 0 CONT 0 

MRI KEN LSPINE WO 11CONTR 

11 

MRI KEN L SPINE W CONTR 0 0 

MRI KEN NECK W O CONTRAST 0 0 

MRI KEN NECK W CONTRAST 0 0 

MRI KEN NECK W WO 0CONTR 

0 

MRI KEN D SPINE WO 2CONT 

2 

MRI KEN D SPINE W CONTR 0 0 

MRI KEN D SPINE W WO 0 CONT 0 

MRI KEN SHLDR WO CONT 8 LT 8 

MRI KEN SHLDR WO CONT 4 RT 4 

MRI KEN SHLDR W CON 0 LT 0 

MRI KEN SHLDR W CON 0 RT 0 

MRI KEN SHLDR W WO 0 CO LT 0 

MRI KEN SHLDR W WO 0 CO RT 0

MRI KEN KNEE WO CONT 9 LT 9 

MRI KEN KNEE WO CONT 12 RT 12 

MRI KEN KNEE W CONT 0 LT 0 

MRI KEN KNEE W CONT 0 RT 0 

MRI KEN KNEE W WO 0CO LT 0 

MRI KEN KNEE W WO 0CONT RT 0 

MRI KEN WRIST WO CONT 0 LT 0 

MRI KEN WRIST WO CON 1 RT 1 

MRI KEN WRIST W CON 0 LT 0 

MRI KEN WRIST W CON 0 RT 0 

MRI KEN WRIST W WO 0 CO LT 0 

MRI KEN WRIST W WO 0 CO RT 0 

MRI KEN ELBOW WO 0CON LT 0 

MRI KEN ELBOW WO 0CON RT 0 

MRI KEN ELBOW W CON 0 LT 0 

MRI KEN ELBOW W CON 0 RT 0 

MRI KEN ELBOW W/WO 0 CON LT 0 

MRI KEN ELBOW W/WO 0 CON RT0 

MRI KEN ANKLE WO CON 1 LT 1 

MRI KEN ANKLE WO CON 1 RT 1 

MRI KEN ANKLE W CONT 0 LT 0 

MRI KEN ANKLE W CON 0 RT 0 

MRI KEN ANKLE W/WO 0 CON LT 0 

MRI KEN ANKLE W/WO 0 CO RT 0 

MRI KEN UPEX NO JT 0WO LT 0 

MRI KEN UPEX NO JT 0WO RT 0 

MRI KEN LO EX NO JT 0WO LT 0 

MRI KEN LO EX NO JT 1WO RT 1 

MRI KEN ABDOMEN W/O 0 CONT 0 

MRI KEN ABDOMEN W/CONT 0 0 

MRI KEN ABDOMEN W/WO 0 CONT 0 

MRI KEN CHEST W/O 0CONT 

0 

MRI KEN CHEST W/CONTRAST 0 0 

MRI KEN CHEST W W/O 0 CONT 0 

MRI KEN FACE W/O CONTRAST 0 0 

MRI KEN FACE W/CONTRAST 0 0 

MRI KEN FACE W W/O 0 CONT 0 

MRI KEN HEAD W/O CONTRAST 0 0 

MRI KEN HEAD W/CONTRAST 0 0 

MRI KEN HEAD W W/O 0 CONT 0 

MRI KEN IAC'S W W/O 0 CONT 0 

MRI KEN IAC'S WO CONTRAST 0 0 

MRI KEN PIT/SELLA W 0W/O 

0 

MRI KEN HIP WO CONT 0 LT 0 

MRI KEN HIP W/O CONT 1 RT 1 

MRI KEN HIP W W/O 0CONT LT 0 

MRI KEN HIP W W/O 0CONT RT 0

MRI KEN HIP W/CONT 0 RT 0 

MRI KEN HIP W/CONT 0 LT 0 

MRI KEN MRCP 0 0 

MRI KEN ORBITS W/O 0CONT 

0 

MRI KEN ORBITS W/CONT 0 0 

MRI KEN ORBITS W W/O 0 CONT 0 

MRI KEN PELVIS W/O 0CONT 

0 

MRI KEN PELVIS W/CONT 0 0 

MRI KEN PELVIS W W/O 0 CONT 0 

MRI KEN TMJ BILAT 0 0 

MRI KEN TMJ UNI LT 0 0 

MRI KEN UNILAT RT 0 0 

MRI KEN UPEX NO JT 0W LT 0 

MRI KEN MRI UPEX NO 0 JTWRT 0 

MRI KEN UPEX NOJT W/WO 0 LT 0 

MRI KEN BREASTS W 0W/O CON 0 

MRI KEN BRST UNI W 0W/O LT 0 

MRI KEN BRST UNI W 0W/O RT 0 

MRI KEN MAMMO CAD 0 0 

MRI KEN BRST W/O CONTRAST 0 0 

3D RECONSTRUCTION 0 KEN 0 

MRI KEN LOEX NO JT 0W LT 0 

MRI KEN LOEX NO JT 0W RT 0 

MRI KEN LOEX NOJT W 0 W/OLT 0 

MRI KEN LOEX NOJT W 0 W/O R 0 

MRV KEN WO CONTRAST 0 0 

MRV KEN W W/O 0 0 

MRA KEN LOEX W W/O 0 CON LT 0 

MRI KEN L SPINE W WO 0 CON 0 


MRI KEN UPEX NO JT 0W/WO R 0 

MRI KEN PIT/SELLA W/O 0 CON 0 

MRA LEN LOEX W W/O 0 CON RT 0 

MRA KEN LOEX W W/O 0 BILAT 0 

MRA KEN CHEST W W/O 0 CONT 0 

MRA KEN HEAD W W/O 0 CONT 0 

MRA KEN HEAD W/CONTRAST 0 0 

MRA KEN HEAD W/O 0CONTRAST0 

MRI KEN NECK W/O CONT 0 0 

MRA KEN NECK W W/O 0 CONT 0 

MRA KEN AB W W/O 0CONT 

0 

MRA KEN PELVIS W W/O 0 CONT 0 

MRI KEN UPEXT JNT W/CO 0 LT 0 

MRI KEN UPEXT JNT W/CO 0 RT 0 

MRI KEN UPEXT JNT W/O 0 LT 0 

MRI KEN UPEXT JNT W/O 0 RT 0 

MRI KEN UPEXT W W/O 0 LT 0

MRI KEN UPEXT W/WO 0 CON RT 0 

MRI KEN GADO PER ML 0 0 

ABD AORTA ULTRASOUND 3 3 

ABD LTD ONE ORGAN5 5 

ABDOMINAL ULTRASOUND 27 27 

AV FITTULA /PSEUDO 0ANEURY 

0 

BIOPHYSICAL PROFILE0 0 

BREAST ULTRAS BILAT0 0 

BREAST US UNILAT-LT0 0 

BREAST US UNILAT-RT0 0 

CAROTID DUPLEX W 12 C/F 12 

CHEST PLEURAL EFFUS0 0 

COLOR DOPP ABD LTD0 0 

COLOR DOPPLER ABDOM 0 0 

ECHO EXT. NON VAS 2 2 

HYSTERO PROCEDURE0 0 

HYSTEROSONOGRAPHY 0 0 

OB-1ST TRI 1 FETUS 1 1 

OB-1ST TRI ADD FETUS 0 0 

OB-2ND TRI 1 FETUS 0 0 

OB-2ND TRI ADD FETUS 0 0 

OB-3RD TRI 1 FETUS 0 0 

OB-3RD TRI ADD FETUS 0 0 

OB- FOLLOW UP 0 0 

OB-LIMITED 0 0 

OB-TRANSVAGINAL 1 1 

PELVIC ULTRASOUND55 55 

PELVIC-NON OB TRANSV 53 53 

PELVIS LTD OR APPEND 1 1 

PERIVASC-ARM-UNIL 0LT 

0 

PERIVASC-ARM-UNIL 1RT 

1 

PERIVASC-LEG-UNIL LT4 4 

PERIVASC-LEG-UNIL-RT 2 2 

PERIVASC-ARM-BILAT0 0 

PERIVASC-LEG-BILAT 0 0 

RENAL ULTRASOUND17 17 

TESTICLE 3 3 

THYROID ULTRASOUND 19 19 

PLF US MEDICARE EXAM 0 AAA 0 

BONE DENSITY FX EVAL 0 0 

BONE DENSITY (DEXA) 42 42 

HEAD OR NECK ULTRASOUND 1 1 

FULL NIGHT POLYSOMNOGRAM 

49 49 

POLYSOMNOGRAM < 06 HRS 0 

TITTRATION POLYSOMNOGRAM 

30 30 

TITRATION POLYSOMNO

M.S.L.T. < 6 HRS 0 0 

MAIT. OF WAKEFULNESS 0 0 

SPLIT NIGHT POLYSOMNO

PRO FEE STRESS MD SUPERVS 0 0 

PRO FEE STRESS TEST 181REPOR 

181 

EKG P.A.T. 26 26 

EKG P.A.T. PLAINFIELD1 1 

MED STAFF COR SAL REC 0 0 

ALBUTEROL S04 U.O.0 0 

ALBUTEROL INH HFA0 0 

DOBUTAMINE 28 28 

ATROPINE BRISTO-JECT 13 13 

LOPRESSOR 5MG 25 25 

AMINOPHYLLIN 40 40 

CARDIZEM 25MG 2 2 

PERSANTINE PER 10MG 78 78 

SKULL AP & LAT 0 0 

SKULL 0 0 

SINUSES 2 2 

MASTOIDS 0 0 

NASAL BONES 3 3 

MANDIBLE 1 1 

TMJ BILATERAL 0 0 

ORBITS/FOREIGN BODY 6 6 

ORBITS 2 2 

FACIAL BONES 0 0 

SOFT TISSUE NECK 4 4 

CHEST AP OR LATERAL 10 ONLY 10 

CHEST PA & LAT 563 563 

CHEST W OBLIQUES 0 0 

CHEST ER PORTABLE 126 126 

RIBS ONE SIDE-LEFT23 23 

RIBS ONE SIDE-RIGHT14 14 

RIBS BILATERAL, R&L3 3 

STERNUM 3 3 

STERNOCLAVICULAR 0JTS 

0 

CHEST/DECUBITIS R&L1 1 

CHEST DECUB ONLY 0 0 

CHEST HOUSE PORTABLE 49 49 

CHEST, P.A.T. 0 0 

CERV SPINE TWO VIEW1 1 

CERV SPINE OBL ONLY0 0 

CERV SPINE - W/OBL28 28 

CERV SPINE W FLEX EX0 0 

CERV SPINE - TRAUMA 36 36 

DORSAL SPINE 23 23 

DORSAL SPINE 2 VIEWS 0 0 

LS SPINE ROUTINE 75 75 

LUMBAR SP W FLEX EXT 0 6 VW 0 

SACROCOCCYGEAL SPINE 4 4

BONE DENSITY FX EVAL 1 1 

ENTIRE SPINE SURVEY0 0 

SCOLIOSIS FULL STUDY2 2 

PELVIS 1 OR 2 VIEWS15 15 

METASTATIC SERIES 0 0 

SACROILIAC JOINTS 0 0 

JOINT ASP/INJ W/FLOURO 0 0 

LS SPINE-SHOOT-THRU 0 2VIEW 0 

CERV SPINE LAT ONLY0 0 

SCOLI F/UP (SCREEN)2 2 

LS SPINE W UPRIGHT 14VIEWS 

1 

LS SPINE W OBLIQUES 19 4VIEW 19 

FINGER 2 OR MORE-LT1 1 

FINGER 2 OR MORE-RT 2 2 

LS SPINE&OBL&FLEX&EX 0 6VW 0 

SKELETAL SURVEY 0 0 

FINGER,SINGLE-LEFT27 27 

FINGER,SINGLE-RIGHT 27 27 

HAND LEFT 24 24 

HAND RIGHT 36 36 

HAND-BILATERAL 9 9 

NAVICULAR VIEWS-LT0 0 

NAVICULAR VIEWS-RT0 0 

WRIST LEFT 24 24 

WRIST RIGHT 26 26 

WRIST-BILATERAL 0 0 

FOREARM-LEFT 5 5 

FOREARM-RIGHT 4 4 

HUMERUS-LEFT 6 6 

HUMERUS-RIGHT 5 5 

SHLDR NO TRAUMA-LT 5 5 

SHLDR NO TRAUMA-RT 5 5 

SHOULDER NO TRAUMA-BILAT 2 2 

AC JTS, W&WO WTS R&L 0 0 

CLAVICLE-LEFT 4 4 

CLAVICLE-RIGHT 2 2 

SCAPULA-LEFT 0 0 

SCAPULA-RIGHT 3 3 

TOE-LEFT 3 3 

TOE-RIGHT 5 5 

FOOT LEFT 38 38 

FOOT RIGHT 42 42 

FOOT-BILATERAL 5 5 

HEEL(OS CALC)-LEFT 3 3 

HEEL(OS CALC)-RIGHT1 1 

ANKLE LEFT 36 36 

ANKLE RIGHT 41 41

LOWER LEG-LEFT 7 7 

LOWER LEG-RIGHT 8 8 

ANKLE-BILAT 0 0 

KNEE NO TRAUMA-LEFT 12 12 

KNEE NO TRAUMA-RIGHT 21 21 

KNEE NO TRAUMA-BILAT 7 7 

KNEE W/OBLIQ-LEFT33 33 

KNEE W/OBLIQ-RIGHT 31 31 

KNEE W/OBLIQUE-BILAT 2 2 

FEMUR-LEFT 3 3 

FEMUR-RIGHT 3 3 

HIP (PELV INCL)BILAT6 6 

HIP (PELVIS INCL)-LT18 18 

HIP (PELVIS INCL)-RT37 37 

HIP RECHECK-LEFT 3 3 

HIP RECHECK-RIGHT 5 5 

ELBOW W/OBLIQ LEFT 13 13 

ELBOW W/OBLIQ RIGHT 15 15 

HAND/WRIST BONE AGE 0 0 

HIPS PEDIATRIC BILAT0 0 

SHLDR TRAUMA-LEFT17 17 

SHLDR TRAUMA-RIGHT 33 33 

SHOULDER TRAUMA-BILAT 0 0 

KNEE W/PATELLA-LEFT 1 1 

KNEE W/PATELLA-RIGHT 1 1 

KNEE W/PATELLA-BILAT 0 0 

FEMUR-BILAT 0 0 

LOWER LEG-BILAT 1 1 

LONG BONE SURVEY 0 0 

BONE LENGTH 0 0 

ABDOMEN (KUB/FLAT) 52 52 

ABDOMEN FLAT&UPRIGHT 43 43 

BARIUM SWALLOW15 15 

GI SERIES 7 7 

BE 3 3 

ABDOMEN W/ DECUBITIS 6 6 

SMALL BOWEL SERIES1 1 

GI WITH SMALL BOWEL 2 2 

T TUBE CHOLANGIOGRAM 0 0 

OR CHOLANGIOGRAM0 0 

OR SCOUT FILM 0 0 

RETRO PYELOGRAM 0 0 

RETRO PYELOGRAM 0 0 

CYSTOGRAPHY 0 0 

VOID CYSTO URETHROG 0 0 

IVP WITH TOMOGRAPHY 0 0 

BE DOUBLE CONTRAST 2 2

CYSTO SCOUT FILM 0 0 

ABD/KUB PORTABLE 0 0 

STEROID INJ UNDER FLOURO 7 7 

VENOGRAPHY ARM/LEG 0 0 




CORE BREAST BIO 12 12 

CORE BREAST BIO 3 3 

COR BRST BIO PROC-LT 12 12 

COR BRST BIO PROC-RT 3 3 

CORE BIO CLIP PLA-LT 12 12 

CORE BIO CLIP PLA-RT3 3 

NEEDLE LOC-LEFT 1 1 

NEEDLE LOC-RIGHT 1 1 

NEEDLE LOC PROC-LT1 1 

NEEDLE LOC PROC-RT1 1 

NDLE LOC ADDL LES-LT 0 0 

NDLE LOC ADDL LES-RT 0 0 

MAMMO DIAG DIGITAL 41 41 

MAMMO DIAG DIGITAL-RIGHT 20 20 

MAMMO DIAG DIGITAL-LEFT 35 35 

DKH MAMMO SCREEN 358 DIGITAL 358 

FLOURO GUIDE FOR NEEDLE 0 0 

DKH MAMMO SCREEN 2 IMPLANTS2 

COR BRST BIO PROC ADD'L 0 0 

ICAD SCREENING MAMMO 723 723 

ICAD DIAGNOSTIC MAMMO 74 74 

SINUS TRACT PROCEDURE 0 0 

SINUS TRACT INJECTION 0 0 

MAMMO DIAG EXTRA 43 VIEWS LT43 

ANKLE-ARTH W/RAD-LT 0 0 

ANKLE-ARTH W/RAD 0RT 

0 

ELBOW ARTH W/RAD-LT 0 0 

ELBOW ARTH W/RAD-RT 0 0 

KNEE-ARTHROGRAM-LT 0 0 

KNEE-ARTHROGRAM-RT 0 0 

HIP-ARTHROGRAM-LT1 1 

HIP-ARTHROGRAM-RT1 1 

WRIST-ARTHRO-LT 1 1 

WRIST-ARTHRO-RT 0 0 

SHLDR-ARTHROGRAM-LT 3 3 

SHLDR-ARTHROGRAM-RT 5 5 

MAMMO DIAG EXTRA 38 VIEWS RT38 

MAMMO DIAG XTRA 8VIEW BILA 8 

PORT INJ FOR PATENCY 0 0 

CONV TO GASTRO JEJUN 0 TUBE 0

GASTRO TUBE REPLACEMENT 1 1 

INSERT GASTRO JEJUNOSTOMY 0 0 

GASTRO TUBE PLACEMENT 0 0 

JEJUN TUBE RE PLACEMENT 0 0 

JEJUN TUBE PLACEMENT 0 0 

MAMMO SCREEN DIGITAL 4 RT 4 

BIOPSY SPECIMEN 0 0 

MAMMO SPECIMEN 14 LEFT 14 

MAMMO SPECIMEN RIGHT 4 4 

ABSCESSOGRAM 0 0 

HYSTEROSALPINGOGRAM 0 W/RAD0 

NEPHROSTOGRAM-LT2 2 

NEPHROSTOGRAM-RT1 1 

NEPHR TUBE CHGE-LT0 0 

NEPHR TUB CHGE-RT0 0 

PERCUT NEPHROS-LT0 0 

PERCUT NEPHROS-RT0 0 

TOMOGRAPHY 0 0 

CERVICAL MYELO W/RAD 0 0 

LUMBAR MYELO W/RAD 0 0 

DORSAL-MYELO W/RAD 0 0 

LUMBAR PUNC 2 2 

URETERAL STENT PL-LT 0 0 

URETERAL STENT PL-RT 0 0 

DRAINAGE CATH CHANGE 0 0 

BILIARY DRAINAGE 0 0 

DRAINAGE-ABDOMEN0 0 

C-ARM OR < 1 HR 22 22 

C-ARM OR > 1 HR 14 14 

C-ARM ACU < 1 HR 0 0 

C-ARM ACU > 1 HR 0 0 

FLOURO GUIDE FOR SPINE 7 IN 7 

C-ARM ICU > 1 HR 0 0 

C-ARM ICU < 1 HR 0 0 

C-ARM PACEMAKER 1 1 

FLOURO CHARGE 0 0 

FLUORO CHRG W RAD/CASE 2 XA 2 

HICK CATH/TRIP LUMEN 0 0 

MAMMO NED LOC ADD'L 0 BILAT 0 

KNEES STANDING-BILAT 1 1 

ORBITS-WATER VIEW0 0 

NOSE TO RECTUM/FB2 2 

PERCUTAN IN/EX DRAIN 0 0 

LUMBAR PUNC/INSERT 2 2 

WRST-ARTH PRO/INS-LT 1 1 

WRST-ARTH PRO/INS-RT 0 0 

SHLDR-ARTH PRO/INS-LT 3 3

SHLDR-ARTH PRO/INS-RT 5 5 

ELBW ARTH PRO/INS-LT 0 0 

ELBW ARTH PRO/INS-RT 0 0 

HIP-ARTH PRC/INS-LT1 1 

HIP-ARTH PRC/INS-RT1 1 

KNEE-ARTH PRO/INS-LT 0 0 

KNEE-ARTH PRO/INS-RT 0 0 

ANKLE-ARTH PRO/IN-LT 0 0 

ANKLE-ARTH PRO/IN-RT 0 0 

PERC NEPH PROC-LT 0 0 

PERC NEPH PROC-RT0 0 

HYSTERO PLACE/INSERT 0 0 

ABSCESS INJ VIA CATH0 0 

DRAINAGE-ABDOMEN-PRO 0 0 

NEPHROST PROC-LT 1 1 

NEPHROST PROC-RT 1 1 

NEPHRO TUBE CHG-LT0 0 

NEPHRO TUBE CHG-RT0 0 

CHEST W APICAL VIEW1 1 

CHEST INS & EXP LAT3 3 

BA SWALLOW-MODIFIED 5 5 

CHEST PA INS & EXP 5 5 

BONE DENSITY (DEXA) 77 77 

CERV SPINE PORT LAT0 0 

PORT INJECTION PROC0 0 

PORT INJECTION W/RAD 0 0 

MAMMO DUCTOGR-LT 0 0 

MAMMO DUCTOGR-RT 1 1 

ABDOMEN WITH LATERAL 0 0 

MAMMO DUCT MULTI-LT 0 0 

MAMMO DUCT MULTI-RT 0 0 

MANDIBLE (LIMITED)0 0 

MASTOIDS (LIMITED)0 0 

FACIAL BONES (LTD) 0 0 

TMJ UNILATERAL 0 0 

SI JOINTS-2 VIEWS 2 2 

SHOULDER 1 VIEW LT0 0 

SHOULDER 1 VIEW RT0 0 

ELBOW (2 VIEWS) LT 3 3 

ELBOW (2 VIEWS) RT3 3 

UPPER EXT LT 0 0 

UPPER EXT RT 1 1 

WRIST RT (2 VIEWS) 0 0 

WRIST LT (2 VIEWS) 0 0 

HAND LT (2 VIEWS) 0 0 

HAND RT (2 VIEWS) 0 0 

MAMMO DUCT-PROC-LT 0 0

MAMMO DUCT PROC-RT 1 1 

HIP-2 VIEWS LT 2 2 

HIP-2 VIEWS RT 3 3 

LOWER EXTR INFANT 0LT 

0 

LOWER EXTR INFANT 0RT 

0 

FOOT LT (2 VIEWS) 0 0 

FOOT RT (2 VIEWS) 0 0 

STRESS VIEWS (S) 0 0 

ABDOMEN LATERAL & 0 AP 0 

MAMMO NED LOC UNIL 0 0 

COR BRST BIO PROC BILAT 0 0 

CORE BIO CLIP PLA BILAT 0 0 

CORE BREAST BIO BILATERAL 0 0 

NEPH TUBE REMOVE 0W/FLOURO0 

VENOGRAM FOR IVC0 0 

DKH MAMMO DIAG W/IMPLANTS 

0 0 

PICC LINE INSERT W/O 2 PORT 2 

CENTRAL LINE INSR W/PORT 0 0 

CENTRL LINE INSR W/O 0 PORT 0 

MAMMO SCREEN DIGITAL 2 LT 2 

HYSTERISALGM W/O 0RADIOLOG 

0 

FL-GUIDE CENTRAL VENOUS 1 L 1 

IVP 0 0 

CORE BRST CLIP-LT 12 12 

CORE BRST CLIP-RT 3 3 

OMNIPAQUE 180 PER 0ML 

0 

OMNIPAQUE 3002118 PER ML 2118 

OMNIPAQUE 350 24228 PER ML 24228 

VISIPAQUE 320 PER 1030 ML 1030 

DIGITIZED NC MAMMO 0 0 

LOC NEEDLES 0 0 

STEREO TRAY 0 0 

NEPHROSTOMY KIT 0 0 

CYSTO CONRAY SUPPLY 0 0 

DI SUPPLY TRAY 56 56 

TRIESENCE INJ PER MG 80 80 

VOLUMEN PER BOTTLE 0 0 

BRAIN SCAN 0 0 

BONE SCAN 11 11 

LIVER & SPLEEN SCAN0 0 

LUNG SCAN PERFUSION 0 ONLY 0 

KID IMAG W/VAS FLOW 0 0 

KID IMAG W/FUNCTION 0 0 

KIDNEY IMAGING ONLY 0 0 

KID IMAG COM V&F STU 0 0 

THYROID ISOTOPE SCAN 0 0 

BLOOD FLOW STUDIES7 7

MYO-IMAGING-INFARCT 0 0 

GATED HEART - MUGA7 7 

HIDA SCAN WITH CCK2 2 

VENTILATION STUDY0 0 

GI BLEEDING SCAN 0 0 

LUNG SCAN P & V 7 7 

MECKEL'S DIVERT SCAN 0 0 

G.I. REFLUX SCAN 0 0 

BONE SCAN 3 PHASE7 7 

RADIONUCLIDE V.C.U.G 0 0 

BONE SCAN LIMITED 0 0 

TESTICULAR WITH FLOW 0 0 

BONE SCAN SPECT 0 0 

KIDNEY WITH SPECT 0 0 

BRAIN WITH SPECT 0 0 

CARD SPECT RST OR EX 1 1 

CARD SPECT RST & EX 77 77 

LIVER WITH SPECT 0 0 

EJECT FRACTION-SPC78 78 

WALL MOTION & SPECT 78 78 

GASTRIC-EMPTYING 2 2 

LYMPHATIC IMAGING0 0 

WHITE BC SPECT 0 0 

WHITE BC WHOLE BODY 0 0 

WHITE BC LIMITED 0 0 

THYROID- I123 SCAN 0ONLY 

0 

THYROID - 123 UPTAKE 0 ONLY 0 

THYROID I123 SCAN & 2 UPTAK 2 

TALLIUM SPECT RST & 0 EX 0 

THALLIUM SPECT RST 0OR EX 0 

THYROID PARA SCAN0 0 

LUNG SCAN SPLIT W/P&V 0 0 

SPECT 0 0 

PROF FEE CARDIAC SPECT 1 1 

PRO FEE CARDIAC SPECT 77 77 

PROF FEE MUGA STUDY 7 7 

HIDA SCAN 1 1 

LUNG SCAN PERF W/SPT 0 FUNC 0 

KINEVAC 0 0 

1 DOSE MYOVIEW155 155 

1 DOSE CERETEC -40 -40 

TECHNESIUM 6-10 0 0 

ALBUMIN 7 7 

PENTETATE 7 7 

SULFUR COLLOID 2 2 

TC-99M ISOTOPE 3 3 

MEDRONATE 18 18

PYROPHOSPHATE 7 7 

I 123 - 200 2 2 

SESTAMIBI ISOTOPE 0 0 

SOD CHLORIDE 100ML0 0 

THALLIUM 1 MCI 0 0 

THALLIUM 1 DOSE RE 0INJECT 

0 

NEONATAL HEAD 0 0 

THYROID ULTRASOUND 28 28 

BREAST US UNILAT-LT 46 46 

BREAST US UNILAT-RT 45 45 

BREAST ULTRAS BILAT 16 16 

ECHOCARDIOGRAM 2D+M 0 0 

ECHO-2D LIMITED 5 5 

DOBUTAMINE-STRESS 24 EC 24 

STRESS & REST ECHO40 40 

ABDOMINAL ULTRASOUND 86 86 

COLOR DOPPLER ABDOM 0 0 

COLOR DOPP ABD LTD0 0 

DOPPLER ECHO 3 3 

PELVIS LTD OR APPEND 10 10 

RENAL ULTRASOUND43 43 

ABD AORTA ULTRASOUND 20 20 

COLOR DOPP AORTA+VC 0 0 

OB-2ND TRI 1 FETUS0 0 

OB-FOLLOW UP 0 0 

FOLLOWUP LEV 2 OB-US 0 0 

PELVIC ULTRASOUND 59 59 

US-CYST ASPIRATION 1GUIDE 

1 

US-CYST ASPI PROC 1 1 

US-PELVIS-CYST-PROC0 0 

TESTICLE 11 11 

CHEST PLEURAL EFFUS1 1 

BIOPHYSICAL PROFILE0 0 

CHEST-ULTRASOUND1 1 

US INTRA PERI CATHETER 0 0 

US INTRAPERI CATH PROC 0 0 

US INTRAPERI CATH REMOVAL 0 0 

US INTRAPERI CATH REMOVE 0 0 

US PLEURAL TUNNEL 0CATH RV 0 

US PLUER TUNNEL CATH 0 RMV 0 

US MEDICARE AAA SCREEN 0 0 

PRO FEE DOPPLER 185 ECHO ROUT185 

PROF FEE CONTRAST 0ADMIN 

0 

INJ BICEP TENDON SHEATH 0 0 

HYSTEROSONOGRAPHY 0 0 

HYSTERO-PROCEDURE0 0 

ECHO EXT. NON VAS14 14

COLOR FLOW DOPPLER 3 3 

PERIVASCU-LEG-BILAT 24 24 

PERIVASC-LEG-UNIL 29 LT 29 

PERIVASC-LEG-UNIL-RT 18 18 

PERIVASCU-ARM-BILAT 0 0 

PERIVASC-ARM-UNIL 2LT 

2 

PERIVASC-ARM-UNIL-RT 5 5 

CAROTID DUPLEX W 52 C/F 52 

PELVIC-NON OB TRANSV 55 55 

OB-TRANSVAGINAL 6 6 

TRANSESOPHAGEAL ECHO 3 3 

AMNIOCENTESIS W/ULTR 0 0 

BREAST CYST ASP PRO0 0 

FNA WITH IMAGING GUIDANCE 8 8 

RENAL CYS/PEL PRO-LT 0 0 

RENAL CYS/PEL PRO-RT 0 0 

OB-LIMITED 0 0 

OB-1ST TRI 1 FETUS 6 6 

OB-1ST TRI ADD FETUS 0 0 

OB-2ND TRI ADD FETUS 0 0 

OB-3RD TRI 1 FETUS0 0 

OB-3RD TRI ADD FETUS 0 0 

PARACENTESIS GUIDE0 0 

PARACENTESIS PROC 0W/O GDE 0 

NEEDLE LOC(US)-LT GUIDE 1 1 

NEEDLE LOC(US)-RT GUIDE 1 1 

NEEDLE LOC-PROC-LT1 1 

NEEDLE LOC PROC-RT1 1 

NEEDLE BIOPSY-LT GUIDE 0 0 

NEEDLE BIOPSY-RT GUIDE 0 0 

DOPPLER ECHO ROUTINE 185 FUL 185 

DOPPLER ECHO ROUTINE 0 W/CO 0 

AB PARA W/IMAGE GUIDE 0 0 

PRO FEE ECHO 2D + M1 1 

PRO FEE 2D LIMITED 7 7 

US-BIO-MISCELLANEOUS 0 GDE 0 

US-BIOPSY PROC-LIVER 3 3 

US-BIOPSY-LIVER GUIDE 3 3 

US-BIOPSY PROC-ABD0 0 

US-BIO PRO BREAST 11 LT 11 

US-BIOPSY-BREAST GUIDE 19 19 

US-BIO PRO-BREAST RT 8 8 

US-BIO-PROC BREAST 0BILAT 

0 

US-BIOPSY PRO-KIDNEY 0 0 

US-BIOPSY-KIDNEY GUIDE 0 0 

US-BIOPSY PROC-LUNG 0 0 

US-BIOPSY-LUNG GUIDE 0 0

US-BIOPSY PROC-PANCR 0 0 

US-BIOPSY-PANCREAS 0 GUIDE 0 

US-BIOPSY PROC-RETRO 0 0 

US-BIOPSY-RETROPER 0GUIDE 

0 

US-BIOP PROC-LUNG 0ADD'L 

0 

US-GUIDED PROC-DRAIN 0 0 

US-BIOPSY-LYMPH NODE 1 GDE 1 

US-GUIDED DRAINAGE 0 GUIDE 0 

US-BIOPSY PROC-LYMPH 1 NODE 1 

US-BIOPSY-ABD GUIDE0 0 

US-BIO-PROC-BREAST 1ADD'L 

1 

US-CORE BIOPSY THYROID 0 0 

US-BIOPSY-THYROID 6GUIDE 

6 

US-BIOP PROC THYROID 2 ADDL 2 

BREAST CYST ASPIRA 2GUIDE 

2 

US-BIOPSY PROC-BONE 0 DEEP 0 

US BIOP PROC NECK OR 0 THOR 0 

US BIOP PROC SOFT TISSUE 0 0 

US BIOP PROC BONE 0SPRFICL 

0 

AV FIST OR PSEUDO ANEURSM 0 0 

US-BIOPSY-BONE DEEP 0 GUIDE 0 

US BIOP BONE SUPERFICIAL 0 0 

US-BIOPSY-NECK OR THORAX 0 0 

US-BIOPSY-SOFT TISSUE 0 GDE 0 

ARTERIES LOW EXT-LT0 0 

ARTERIES LOW EXT-RT0 0 

ARTERIES UPP EXT-LT0 0 

ARTERIES UPP EXT-RT0 0 

ABD LTD ONE ORGAN16 16 

U S-INFANT HIPS 2 2 

U S-INFANT HIPS-LTD0 0 

THORACENTESIS GUIDE 0 0 

ULTRASOUND GUIDANCE 2 2 

CENTRL LINE PLACEMNT 1 1 

CENTRAL LINE PROC 0 0 

THORACENTESIS PROC0 0 

US-PLEURAL TUNNEL 0CATH PR 0 

US-PLEURAL TUNNEL 0CATH 

0 

US-BREAST CLIP PLACEMENT 19 19 

VASCULAR STUDY LIMITED 0 0 

VASCULAR STUDY COMPLETE 1 1 

HEAD OR NECK ULTRASOUND 4 4 

IV START INJECTION 0 0 

DEFINITY CONT-PERFLU 58 58 

US VACUUM DRAIN BTL/TUBE 0 0 

US PLEURAL CATHETER 0 SPLY 0 

US PERITONEAL CATHETER 0 0

US-MIDLINE CATHETER 0 0 

PICC KIT 0 0 

PET/CT SKULL TO THIGH 9 INI 9 

PET/CT SKULL TO THIGH 9 SUB 9 

PET/CT WHOLE BODY 0MEL INI 0 

PET/CT WHOLE BODY 0MEL SUB 0 

PET/CT-LIMITED AREA0 0 

PET-BRAIN-METAB EVAL 0 0 

PET-BRAIN-PERFU EVAL 0 0 

PET-MYOCAR META EVAL 0 0 

PET-CARD-REST-OR-STR 0 0 

PET-CARD FULL MULTI 0 0 

PET/CT SK TO TH INI NOPR 0 0 

PET/CT SK TO TH SUB 0NOPR 

0 

PET/CT WHOLE MEL IN 0 NOPR 0 

PET/CT WHOLE MEL SUB 0 NOPR 0 

PET-FDG-ISOTOPE 18 18 

MRI-ABDOMEN W/O 2CONT 

2 

MRI-ABDOMEN W/CONTRA 0 0 

MRI-ABDOMEN W/WO 8 CON 8 

MRI-C SPINE W/O CONT 28 28 

MRI-C SPINE W CONTRA 2 2 

MRI-C SPINE W/WO CON 7 7 

MRI-CHEST W/O CONTR 0 0 

MRI-CHEST W/CONTRAST 0 0 

MRI-CHEST W/WO CONTR 2 2 

MRI-FACE W/O CONTRAS 0 0 

MRI-FACE W/CONTRAST 0 0 

MRI-FACE W/WO CONTR 0 0 

MRI-HEAD W/O CONTRAS 28 28 

MRI-HEAD W CONTRAST 0 0 

MRI-HEAD W/WO CONTRA 61 61 

MRI-IAC'S W/WO CONTRAST 17 17 

MRI-IACS-WO 0 0 

MRI-UPEXT JOINT W/CON 0 LT 0 

MRI-UPEXT JOINT W/CON 0 RT 0 

MRI-UPEXT JNT W/O 0CON LT 0 

MRI-PIT/SELLA W/WO 1 CO 1 

MRI-UPEXT JNT W/O 0CON RT 0 

MRI-UPEXT W W/O CONT 0 LT 0 

MRI-UPEXT W W/O CONT 1 RT 1 

MRI-HIP WO CONTR-LT 0 0 

MRI-HIP WO CONTR-RT 2 2 

MRI-HIP W&WO CON-LT 0 0 

MRI-HIP W&WO CON-RT 3 3 

MRI-HIP-W/CONT-RT1 1 

MRI-HIP-W/CONT-LT1 1

MRI-LS SPINE W/O CON 43 43 

MRI-LS SPINE W/CONT 1 1 

MRI-LS SPINE W/WO 6CO 

6 

MRI-MRCP 4 4 

MRI-NECK W/O CONTRAST 0 0 

MRI-NECK W/CONTRAST 0 0 

MRI-NECK W/WO CONTRA 2 2 

MRI-ORBITS W/O CONTR 0 0 

MRI-ORBITS W/CONTR0 0 

MRI-ORBITS W/WO CONT 0 0 

MRI-PELVIS W/O CONTR 0 0 

MRI-PELVIS W/CONTRAS 0 0 

MRI-PELVIS W/WO CONT 5 5 

MRI-D SPINE W/O CONT 3 3 

MRI-D SPINE W CONTRA 0 0 

MRI-D SPINE W/WO CON 4 4 

MRI-TMJ BILAT 0 0 

MRI-TMJ UNILAT-LT 0 0 

MRI-TMJ UNILAT-RT 0 0 

MRI-SHLDR WO CON-LT 8 8 

MRI-SHLDR WO CON-RT 8 8 

MRI-SHLDR W CON-LT0 0 

MRI-SHLDR W CON-RT0 0 

MRI-SHLDR W/WO CO-LT 0 0 

MRI-SHLDR W/WO CO-RT 0 0 

MRI-SHLDR-ARTHRO-LT 3 3 

MRI-SHLDR-ARTHRO-RT 5 5 

MRI-KNEE WO CON-LT 19 19 

MRI-KNEE WO CON-RT 13 13 

MRI-KNEE W CONT-LT0 0 

MRI-KNEE W CONT-RT0 0 

MRI-KNEE W/WO CO-LT 0 0 

MRI-KNEE W/WO CO-RT 0 0 

MRI-WRIST WO CON-LT 2 2 

MRI-WRIST WO CON-RT 0 0 

MRI-WRIST W CON-LT1 1 

MRI-WRIST W CON-RT0 0 

MRI-WRIST W/WO CO-LT 0 0 

MRI-WRIST W/WO CO-RT 1 1 

MRI-ELBOW WO CON-LT 1 1 

MRI-ELBOW WO CON-RT 2 2 

MRI-ELBOW W CON-LT 0 0 

MRI-ELBOW W CON-RT 0 0 

MRI-ELBOW W/WO CO-LT 0 0 

MRI-ELBOW W/WO CO-RT 0 0 

MRI-UPEX NO JT WO-LT 0 0 

MRI-UPEX NO JT WO-RT 0 0

MRI-UP EX NO JT W-LT0 0 

MRI-UP EX NO JT W-RT 0 0 

MRI-UPEX NOJT W/WO-LT 0 0 

MRI-UPEX NOJT W/WO-RT 0 0 

MRI-BREASTS W/WO 6CON 

6 

MRI-BRST-UNI W/WO-LT 0 0 

MRI-BRST-UNI W/WO 1RT 

1 

MRI-MAMMO-CAD 7 7 

MRI-LEFT KNEE WO SHAPEMAT 0 0 

MRI-RT KNEE WO SHAPEMATCH 0 0 

MRI BREASTS W/O CONTRAST 0 0 

3D RENDER W/INTER 4CT MRI 4 

3D RECONSTRUCTION0 0 

MRI-ANKLE WO CON-LT 3 3 

MRI-ANKLE WO CON-RT 0 0 

MRI-ANKLE W CONT-LT 0 0 

MRI-ANKLE W CONT-RT 0 0 

MRI-ANKL W/WO CO-LT 0 0 

MRI-ANKL W/WO CO-RT 0 0 

MRI-LOEX NO JT WO-LT 0 0 

MRI-LOEX NO JT WO-RT 5 5 

MRI-LO EX NO JT W-LT0 0 

MRI-LO EX NO JT-W-RT 0 0 

MRI-LOEX NOJT W/WO-LT 1 1 

MRI-LOEX NOJT W/WO-RT 2 2 

MRV-WO CONTRAST0 0 

MRV-W&WO 0 0 

MRI PIT/SELLA W/O CONTRAS 0 0 

MRI-GADO PER ML 2844 2844 

MRA-LO EX W/WO CO-LT 0 0 

MRA-LO EX W/WO CO-RT 0 0 

MRA-LOWER EXT W/WO-BILAT 0 0 

MRA-UP EX W/WO CO-LT 0 0 

MRA-UP EX W/WO CO-RT 0 0 

MRA-CHEST W/WO CONTR 0 0 

MRA-HEAD W/O CONTR 26 26 

MRA-HEAD W/CONTRAST 0 0 

MRA-HEAD W/WO CONTR 0 0 

MRA-NECK W/O CONTRA 0 0 

MRA-NECK W/WO CONTRA 12 12 

MRA-AB W/WO CONTRAST 2 2 

MRA-PELVIS W/WO CONT 0 0 

CT ABDOMEN W CONTRAS 8 8 

CT ABDOMEN W&W/O 1 CON 1 

CT ABDOMEN W/O CONT 1 1 

CT C SPINE W/CONTRAS 0 0 

CT CERVICAL SPINE W/O 37 37

CT CHEST HIGH RESOLU 0 W/O 0 

CT CHEST W CONTRAST 50 50 

CT CHEST W&W/O CONT 0 0 

CT CHEST W/O CONTRAS 45 45 

CT D SPINE W/CONTRAS 0 0 

CT DORSAL SPINE 1 1 

CT FACIAL/MAND W/CONTRAST 1 1 

CT FACIAL/MAND W/O 10 CON 10 

CT FACIAL/MAND W/WO 0 CONTR0 

CT HEAD W & W/O CONT 6 6 

CT HEAD W CONTRAST 4 4 

CT HEAD W/O CONTRAST 201 201 

CT I.A.M. W/CONTRAST 0 0 

CT I.A.M. W/O CONTRA 0 0 

CT LO EXT W /CON-LT0 0 

CT LO EXT W/CON RT0 0 

CT LO EXT WO CON-LT4 4 

CT LO EXT WO CON-RT5 5 

SCANOGRAM-LEGS 0 0 

CT LUMBAR SP W/CON0 0 

CT LUMBAR SPINE W/O 5 CONTR 5 

CT NECK W/CONTRAST 12 12 

CT NECK W/O CONTRAST 2 2 

CT NECK W/WO CONTRAS 0 0 

CT ORBITS W/CONTRAST 0 0 

CT ORBITS W/O CONT3 3 

CT ORBITS W/WO CONTR 0 0 

CT PELVIS W / CONTRAST 0 0 

CT PELVIS W&W/O CONT 0 0 

CT PELVIS W/O CONTRA 3 3 

CT PITUITARY W/CONT 0 0 

CT PITUITARY W/O CON 0 0 

CT PITUITARY W/WO 0CONTR 

0 

CT SAC/COCC W/CONTRA 0 0 

CT SAC/COCC W/O CONT 0 0 

CT SI JTS W/CONTRAST 0 0 

CT SI JTS W/O CONTRA0 0 

CT SINUS W/CONTRAST 0 0 

CT SINUS W/O CONTRAS 27 27 

CT SINUS W/WO CONTRA 0 0 

CT TEMP BNS W/O CONT 4 4 

CT TEMP BNS W/WO 0CON 

0 

CT TEMP BONES W/CONT 0 0 

CT TM JOINTS 0 0 

CT UP EX W/WO CO-LT 0 0 

CT UP EX WO CON-LT2 2 

CT UP EX WO CON-RT2 2

CT UP EXT W/ CON-RT0 0 

CT UP EXT W/CON-LT0 0 

CT-ANGIO ABDOMEN0 0 

CT ANGIO ABD&PELVIS 3 W&W/O3 

CT-ANGIO CHEST 50 50 

CT-ANGIO EXTR LOWER 0 0 

CT-ANGIO EXTR UPPER0 0 

CT-ANGIO HEAD 3 3 

CT-ANGIO LEGS RUNOFF 0 0 

CT-ANGIO NECK 3 3 

CT-ANGIO PELVIS 0 0 

CT-BIOPSY ABD MASS0 0 

CT-BIOPSY ABD PROC.0 0 

CT-BIOPSY KID PRO-LT0 0 

CT-BIOPSY KID PRO-RT0 0 

CT-BIOPSY KIDNEY-LT0 0 

CT-BIOPSY KIDNEY-RT0 0 

CT-BIOPSY LIVER 0 0 

CT-BIOPSY LIVER PROC0 0 

CT-BIOPSY LUNG 2 2 

CT-BIOPSY LUNG PROC. 2 2 

CT-BIOPSY PANC. PROC 0 0 

CT-BIOPSY PANCREAS0 0 

CT-BIOPSY RETRO 0 0 

CT-BONE BIOPSY 3 3 

CT-BONE BIOPSY PROC 3 3 

CT-KID ABS/DR PRO-LT0 0 

CT-KID ABS/DR PRO-RT 0 0 

CT-KIDN ABCESS/DR-LT 0 0 

CT-KIDN ABCESS/DR-RT 0 0 

CT-KIDNEY CYST PRO-LT 0 0 

CT-KIDNEY CYST PRO-RT 0 0 

CT-LIVER ABS/DR PROC 0 0 

CT-LIVER ABSCESS/DR0 0 

CT-LUNG AB PUN/DR 0PR 

0 

CT-LUNG ABSCESS/DRA 0 0 

CT-PANC ABS DRA PROC 0 0 

CT-PANCREAS ABS/DR0 0 

CT-PERITON ABS/DRAIN 0 0 

CT-PERITON DRAIN PRO 0 0 

CT-RETRO ABS DRA PRO 0 0 

CT-RETRO ABS/DR 0 0 

CT-SHLDR/ARTHRO-LT0 0 

CT-SHLDR/ARTHRO-RT0 0 

CT-SUB/DI ABS DRA PR0 0 

CT-SUB/DIA ABS/DRAIN 0 0 

CT LOWER EXT BILAT 0W/CONT 

0

CT INTRAPERI CATHETER 0 0 

CT INTRAPERI CATH PROC 0 0 

CT INTRA PERI CATH REMOVL 0 0 

CT INTRAPERI CATH RMV 0 PRC 0 

CT PLEURAL TUNNEL 0CATH RV 0 

CT PLEURAL TUNNEL 0CATH RV 0 

CT PLEURL TUNNL CATH 0 PROC 0 

CT PLEURAL TUNNEL 0CATH 

0 

CT BIOPSY NECK PROC0 0 

CT BIOPSY NECK 0 0 

CT KIDNEY ASPIR LT 0 0 

CT KIDNEY CYST ASPIR 0 RT 0 

CT AB & PELVIS W/CONTRAST 138 138 

CT AB AND PELVIS W/O 73 CONT 73 

CT AB & PELVIS W W/O 3 CONT 3 

CT-SI JOINT INJECTION0 0 

CT LUMBAR FACET INJECTION 0 0 

CT-SI JOINT NEEDLE GUIDE 0 0 

CT BONE BX DEEP VERT 0 BODY 0 

CT GUIDANCE 0 0 

CT CHEST LIMITED STUDY 0 0 

3D RECONSTRUCTION 0 CHARTE 0 

CT GUIDED CELIAC PLEXUS 0 0 

GASTROVIEW PER 1013 ML 1013 

READICAT PER BOTTLE 306 306 

CT VACUUM BTL/DRAIN 0 TUBE 0 

CT PLEURAL CATHETER 0 SPLY 0 

CT PERITONEAL CATHETER 0 0 

CT BONE BIOPSY KIT 1 1 

ABDOMEN (KUB/FLAT) 4 4 

ABDOMEN FLAT & UPRIGHT 2 2 


ABDOMEN W/ DECUBITIS 0 0 



ANLLE RIGHT 4 4 


ANKLE BILAT 0 0 

CERV SPINE TRAUMA0 0 

CERV SPINE W/OBL 4 4 

CERV SPINE LAT ONLY0 0 

CERV SPINE OBL ONLY0 0 





CHEST DECUB ONLY 0 0





CHEST P A T 0 0 

CHEST / DECUBITIS R 0& L 0 

CLAVICLE LEFT 0 0 

CLAVICLE RIGHT 0 0 



ELBOW W/OBLIQ LEFT1 1 

ELBOW W/ OBLIQUE 1RIGHT 

1 

ELBOW(2 VIEWS)LT 0 0 

ELBOW(2 VIEWS) RT 0 0 



FACIAL BONES(LTD) 0 0 

FEMUR BILAT 0 0 

FEMUR LEFT 0 0 

SHOULDER NO TRAUMA 1 BILAT 1 

SHOULDER TRAUMA 0BILAT 

0 

SI JOINTS 2 VIEWS 0 0 

SINUSES 2 2 

SKELETAL SURVEY 0 0 

SKULL 0 0 




0 

STERNUM 0 0 



TOE LEFT 1 1 

TOE RIGHT 2 2 





WRIST LT (2 VIEWS) 0 0 

WRIST RT (2 VIEWS) 0 0 

WRIST BILATERAL 0 0 

FEMUR RIGHT 1 1 

FINGER 2 OR MORE LT0 0 

FINGER 2 OR MORE RT0 0 

FINGER SINGLE LEFT 2 2 

FINGER SINGLE RIGHT3 3 

FOOT LEFT 8 8 

FOOT RIGHT 4 4

FOOT LT(2 VIEWS) 0 0 

FOOT RT(2 VIEWS) 0 0 

FOOT BILATERAL 1 1 

FOREARM LEFT 0 0 

FOREARM RIGHT 0 0 

HAND LEFT 2 2 


HAND LT(2 VIEWS) 0 0 

HAND RT(2 VIEWS) 0 0 


HAND BILATERAL 2 2 

HEEL (OS CALC) LEFT 0 0 

HEEL(OS CALC) RIGHT0 0 

HIP(PEL INCL) BILAT 1 1 

HIP(PELVIS INCL) LT 1 1 

HIP(PELVIS INCL)RT 1 1 

HIP RECHECK LEFT 0 0 

HIP RECHECK RIGHT 0 0 

HIP 2 VIEWS LT 4 4 

HIP 2 VIEWS RT 9 9 

HIPS PEDIATRIC BILAT0 0 

HUMERUS LEFT 0 0 

HUMERUS RIGHT 0 0 

KNEE NO TRAUMA BILAT 1 1 

KNEE NO TRAUMA LEFT 3 3 

KNEE NO TRAUMA RIGHT 4 4 

KNEE W/OBLIQ LEFT 0 0 

KNEE W/OBLIQ RIGHT1 1 

KNEE W/OBLIQUE BILAT 0 0 

KNEE W/PATELLA BILAT 0 0 

KNEE W/PATELLA LEFT0 0 

KNEE W/PATELLA RIGHT 0 0 

KNEES STANDING BILAT 1 1 



0 


0 

LOWER LEG BILAT 0 0 

LOWER LEG LEFT 2 2 

LOWER LEG RIGHT 0 0 

LS SPINE ROUTINE 216 VIEWS 16 


LS SPINE W UPRIGHT 04VIEW 

0 

LS SPINE&OBL&FLEX&EX 0 6VW 0 

LS SPINE SHOOT THRU0 0 

LUMBAR SP W FLEX EXT 0 6 VW 0 


MAMMO DIAG DIGITAL 0 LEFT 0

MAMMO DIAG DIGITAL 0 RIGHT 0 

DDC MAMMO SCREEN 167 DIGITAL 167 

MANDIBLE 0 0 

MANDIBLE(LIMITED) 0 0 

MASTOIDS 0 0 

MASTOIDS(LIMITED) 0 0 



NAVICULAR VIEWS LT0 0 

NAVICULAR VIEWS RT0 0 


ORBITS 0 0 


ORBITS WATER VIEW0 0 


RIBS BILATERAL R & L0 0 

RIBS ONE SIDE LT 4 4 

RIBS ONE SIDE RT 1 1 

SACROCOCCYGEAL SPINE 0 0 


SCAPULA LT 0 0 

SCAPULA RT 0 0 

SHLDR NO TRAUMA LT6 6 

SHLDR NO TRAUMA RT 5 5 

SHLDR TRAUMA LT 0 0 

SHLDR TRAUMA RT 1 1 



MAMMO DIAG EXTRA 0 VIEW LT 0 

MAMMO DIAG EXTRA 0 VIEW RT 0 

MAMMO DIAG EXTRA 0 VIEWS BI 0 

MAMMO SCREEN DIG 0 RT DNLSN0 

MAMMO SCREEN DIG 1 LT DNLSN 1 

MAMMO SCREEN IMPLANT 1 DNLS1 

ABDOMEN (KIB/FLAT) 12 12 

ABDOMEN FLAT & UPRIGHT 0 0 


ABDOMEN W/DECUBITIS 0 0 




ANKLE RIGHT 8 8 

ANKLE BILAT 0 0 

CERV SPINE TRAUMA0 0 

CERV SPINE W/OBL 7 7 

CERB SPINE LAT ONLY0 0 

CERV SPINE OBL ONLY0 0





CHEST DECUB ONLY 0 0 





CHEST P A T 0 0 

CHEST / DECUBITIS R 0& L 0 

CLAVICLE LEFT 1 1 

CLAVICLE RIGHT 1 1 



ELBOW W OBLIQUE LEFT 3 3 

ELBOW W/OBLIQ RIGHT 3 3 

ELBOW (2 VIEWS) LT 0 0 

ELBOW(2 VIEWS)RIGHT 0 0 



FACIAL BONES (LTD) 0 0 

FEMUR BILAT 0 0 

FEMUR LEFT 0 0 

SHOULDER NO TRAUMA 1 BILAT 1 

SHOULDER TRAUMA 0BILAT 

0 

SI JOINTS 2 VIEWS 0 0 

SINUSES 2 2 

SLELETAL SURVEY 0 0 

SKULL 0 0 




0 

STERNUM 2 2 



TOE LEFT 3 3 

TOE RIGHT 1 1 





WRIST LT(2 VIEWS) 0 0 

WRIST RT(2 VIEWS) 0 0 

WRIST BILATERAL 0 0 

FEMUR RIGHT 1 1 

FINGER 2 OR MORE LT1 1

FINGER 2 OR MORE RT0 0 

FINGER, SINGLE LEFT5 5 

FINGER SINGLE RIGHT0 0 

FOOT LEFT 13 13 

FOOT RIGHT 14 14 

FOOT LT(2 VIEWS) 0 0 

FOOT RT(2 VIEWS) 0 0 

FOOT BILATERAL 0 0 

FOREARM LEFT 2 2 

FOREARM RIGHT 0 0 

HAND LEFT 2 2 


HAND LT (2 VIEWS) 0 0 

HAND RT (2 VIEWS) 0 0 


HAND BILATERAL 1 1 

HEEL (OS CALS) LEFT 2 2 

HEEL(OS CALC) RIGHT1 1 

HIP(PELV INCL) BILAT3 3 

HIP(PELVIS INCL) LT 3 3 

HIP(PELVIS INCL) RT 7 7 

HIP RECHECK LEFT 0 0 

HIP RECHECK RIGHT 0 0 

HIP 2 VIEWS LT 0 0 

HIP 2 VIEWS RT 1 1 

HIPS PEDIATRIC BILATERAL 0 0 

HUMERUS LEFT 1 1 

HUMERUS RIGHT 1 1 

KNEE NO TRAUMA BILAT 1 1 

KNEE NO TRAUMA LEFT 3 3 

KNEE NO TRAUMA RIGHT 5 5 

KNEE W/OBLIQ LEFT11 11 

KNEE W/OBLIQ RIGHT 10 10 

KNEE W/OBLIQ BILAT0 0 

KNEE W/PATELLA BILAT 0 0 

KNEE W/PATELLA LEFT0 0 

KNEE W/PATELLA RIGHT 0 0 

KNEES STANDING BILAT 0 0 



0 


0 

LOWER LEG BILAT 0 0 

LOWER LEG LEFT 1 1 

LOWER LEG RIGHT 2 2 

LS SPINE ROUTINE 224 VIEWS 24 


LS SPINE W UPRIGHT 04VIEW 

0

LS SPINE&OBL&FLEX&EX 0 6 VW 0 

LS SPINE SHOOT THRU 0 2VIEW 0 

LUMBAR SP W FLEX EXT 0 0 


MAMMO DIAG DIGITAL 0 LT 0 

MAMMO DIAG DIGITAL 0 RIGHT 0 

PDC MAMMO SCREEN 192 DIGITAL192 

MANDIBLE 0 0 

MANDIBLE(LIMITED) 0 0 

MASTOIDS 0 0 

MASTOIDS(LIMITED) 0 0 



NAVICULAR VIEWS LT0 0 

NAVICULAR VIEWS RT0 0 


ORBITS 0 0 


ORBITS WATER VIEW0 0 


RIBS BILATERAL R&L 0 0 

RIBS ONE SIDE LEFT 6 6 

RIBS ONE SIDE RIGHT1 1 

SACROCCYGEAL SPINE1 1 


SCAPULA LEFT 1 1 

SCAPULA RIGHT 0 0 

SHLDR NO TRAUMA LT3 3 

SHLDR NO TRAUMA RT 3 3 

SHLDR TRAUMA LEFT1 1 

SHLDR TRAUMA RIGHT 4 4 



MAMMO DIAG EXTRA 0 VIEW LT 0 

MAMMO DIAG EXTRA 0 VIEWS RT0 

MAMMO DIAG EXTRA 0 VIEW BIL 0 

MAMMO SCREEN DIG 2 RT PDC 2 

MAMMO SCREEN DIG 0 LT PDC 0 

PDC MAMMO SCREEN 2 IMPLANTS2 

MRI-ABDOMEN W/O 0CONT PLF 0 

MRI-ABDOMEN W/CONT 0 PLF 0 

MRI-ABDOMEN W/WO 0 CON PLF0 

MRI-C SPINE W/O CONT 4 PLF 4 

MRI-C SPINE W CONTRA 0 PLF 0 

MRI-C SPINE W/WO CON 2 PLF 2 

MRI-CHEST W/O CONTR 0 PLF 0 

MRI-CHEST W/CONTRAST 0 PLF 0

MRI-CHEST W/WO CONTR 0 PLF 0 

MRI-FACE W/O CONTRAS 0 PLF 0 

MRI-FACE W/CONTRAST 0 PLF 0 

MRI-FACE W/WO CON 0 PLF 0 

MRI-HEAD W/O CONTR 0 PLF 0 

MRI-HEAD W/CONTRAST 0 PLF 0 

MRI-HEAD W/WO CONT 3 PLF 3 

MRI-IAC W/WO CONT 1 PLF 1 

MRI-IAC'S WO CONTRAST 0 PLF 0 

MRI PIT/SELLA W/WO 0 PLF 0 

MRI-HIP WO CONT LT 0PLF 

0 

MRI-HIP WO CONT RT 0 PLF 0 

MRI-HIP W&WO CON 1LT 

1 

MRI-HIP W&WO CON 0RT PLF 0 

MRI-HIP W/CONT RT 0PLF 

0 

MRI-HIP-W/CONT LT 0PLF 

0 

MRI-LS SPINE W/O CON 7 PLF 7 

MRI-LS SPINE W/CONT 0 PLF 0 

MRI-LS SPINE W/WO 1CO PLF 1 

MRI MRCP PLF 0 0 

MRI-NECK W/O CONTRAST 0 PLF 0 

MRI-NECK W/CONTRAST 0 PLF 0 

MRI-NECK W W/O CON 0 PLF 0 

MRI-ORBITS W/O CON 0 PLF 0 

MRI-ORBITS W/CONTRAST 0 PLF 0 

MRI-ORBITS W W/O CON 0 PLF 0 

MRI-PELVIS W/O CONT 0 PLF 0 

MRI-PELVIS W/CONT 0PLF 

0 

MRI-PELVIS W W/O CONT 0 PLF 0 

MRI-D SPNE W/O CONT 0 PLF 0 

MRI-D SPINE W / CONT 0 PLF 0 

MRI-D SPINE W W/O 1CON PLF 1 

MRI-TMJ BILAT PLF 0 0 

MRI-TMJ UNILAT LT PLF 0 0 

MRI-TMJ UNILAT RT PLF 0 0 

MRI-SHLDR W/O CON 2LT PLF 2 

MRI-SHLDR WO CON 0RT PLF 0 

MRI-SHLDR W CON LT 0 PLF 0 

MRI-SHLDR W CON RT 0 PLF 0 

MRI-SHLDR WW/O CON 0 LT PLF 0 

MRI-SHLDR WW/O CON 0 RT PLF 0 

MRI-KNEE WO CONT 3LT PLF 3 

MRI-KNEE WO CON RT 0 PLF 0 

MRI-KNEE W CONT LT 0PLF 

0 

MRI-KNEE W CONT RT 0 PLF 0 

MRI-KNEE W W/O CONT 0 PLF 0 

MRI-KNEE W W/O CONT 0 RT PL 0

MRI WRIST WO CON 0LT PLF 0 

MRI-WRIST WO CON 0RT PLF 0 

MRI-WRIST W CON LT 0PLF 

0 

MRI-WRIST W CON RT 0 PLF 0 

MRI-WRIST W/WO CO 0 LT PLF 0 

MRI-WROST W/WO CP 0 RT PLF 0 

MRI-ELBOW WO CON 0LT PLF 0 

MRI-ELBOW WO CON 0RT PLF 0 

MRI-ELBOW W CON LT 0 PLF 0 

MRI-ELBOW W CON RT 0 PLF 0 

MRI-ELBOW W/WO CO 0 LT PLF 0 

MRI-ELBOW W/WO CO 0 RT PLF 0 

MRI-UPEX NO JT WO 0LT PLF 0 

MRI-UPEX NO JT WO 0RT PLF 0 

MRI-UP EX NO JT W-LT 0 PLF 0 

MRI-UP EX NO JT W-RT 0 PLF 0 

MRI-UPEX NOJT W/WO 0 LT PLF 0 

MRI-UPEX NOJT W/WO 0 RT PLF 0 

MRI-BREASTS W/WO 0CON PLF 0 

MRI-BRST UNI W/WO 0LT PLF 0 

MRI-BRST-UNI W/WO 0RT PLF 0 

MRI-MAMMO-CAD 0 0 

MRI BREASTS W/O CON 0 PLF 0 

MRI PIT/SELLA W/O CON 0 PLF 0 

MRI-LOEX NO JT WO-LT 1 PLF 1 

MRI-LOEX NO JT WO-RT 0 PLF 0 

MRI-LO EX NO JT W-LT 0 PLF 0 

MRI-LO EX NO JT-W-RT 0 PLF 0 

MRI-UPEX NOJT W/WO-LT 0 PLF 0 

MRI-UPEX NOJT W/WO-RT 0 PLF 0 

MRI-ANKLE WO CON-LT 0 PLF 0 

MRI-ANKLE WO CON-RT 0 PLF 0 

MRI-ANKLE W CONT-LT 0 PLF 0 

MRI-ANKLE W CONT-RT 0 PLF 0 

MRI-ANKLE W/WO CO-LT 0 PLF 0 

MRI-ANKLE W/WO CO-RT 0 PLF 0 

MRI-UPEXT JNT W/CON 0 LT PL 0 

MRI-UPEXT JNT W/CO 0 RT PLF 0 

MRI-UPEXT JNT W/O 0LT PLF 0 

MRI-UPEXT JNT W/O 0RT PLF 0 

MRI-UPEXT W/WO CON 0 LT PLF 0 

MRI-UPEXT W/WO CON 0 RT PLF 0 

MRI-LOEX NO JT WO 0LT PLF 0 

MRI-LOEX NO JT WO 0RT-PLF 

0 

MRI-LOEX NO JT W LT-PLF 0 0 

MRI-LOEX NO JT W RT-PLF 0 0 

MRI-LOEX NO JT W/WO 0 LT-PL 0

MRI-LOEX NO JT W/WO 0 RT-PL 0 

MRA-LO EX W/WO CO-LT 0 PLF 0 

MRA-LO EX W/WO CO-RT 0 PLF 0 

MRA-LOEX W/WO BILAT 0 PLF 0 

MRA-UP EX W/WO CO-LT 0 PLF 0 

MRA-UP EX W/WO CO-RT 0 PLF 0 

MRA-CHEST W/WO CONTR 0 PLF 0 

MRA-HEAD W/O CONTR 0 PLF 0 

MRA-HEAD W/CONTRAST 0 PLF 0 

MRA-HEAD W/WO CONTR 0 PLF 0 

MRA-NECK W/O CONTR 0 PLF 0 

MRA-NECK W/WO CONTR 0 PLF 0 

MRA-AB W/WO CONTRAST 0 PLF 0 

MRA-PELVIS W/WO CONT 0 PLF 0 

VITAMINS A AND D OINT 0 57G 0 

OLANZAPINE 5 MG ZYDIS 11 TAB 11 

ACEBUTOLOL 200 MG 0CAP 

0 

ACETAZOLAMIDE 5000 MG VIAL 0 

ACETAZOLAMIDE 2508 MG TAB 8 

METFORMIN ER 50051 MG TAB 51 

PANTOPRAZOLE 40152 MG VIAL 152 

OXAZEPAM 10 MG CAP 0 0 

ACETAMINOPHEN 160MG/5ML 0 L0 

ALBUTEROL/IPRATROPIUM 872 NEB 872 

POLYCITRA K GENERIC 0 PACKE 0 

ACETIC ACID 1000CC 0IRRIG 

0 

BETHANECHOL 10 MG 0 TAB 0 

ACETAMINOPHEN 325 3 MG SUPP3 



ACETAMINOPHEN 388 500 MG TAB388 

ACETAMINOPHEN 1104 325 MG TAB 1104 

ACETYLCYSTEINE 20% 06GM VL 0 

ACETONE LIQUID BOTTLE 0 0 

ACETYLCHOLINE CHLORI 2 30 2 

SODIUM PHOSPH 45 0MM VIAL 0 

LACTOBACILLUS ACIDOPH 781 CAP781 

ACYCLOVIR 200 MG CAP 0 0 

ACYCLOVIR 5 % OINT 015 GM 0 

ACYCLOVIR 500 MG VIAL 0 0 

ALBUTEROL 4 MG ER 0TAB 

0 

ALBUTEROL SULFATE 02 MG TA 0 

ALBUTEROL SULF 2MG/5ML 0 SO 0 

ALBUTEROL 2.5MG/3ML 468 NEB 468 

ALBUTEROL HFA INHALER 54 AER 54 

ADENOSINE 6 MG/2ML 6 INJ 6 

ISOPROPYL ALCOHOL 070% 

0

CALCITRIOL 0.25 MCG 5 CAP 5 

ALLOPURINOL 300 MG 25 TAB 25 

ALLOPURINOL 100 MG 9 TAB 9 

AQUASOL E 50 UNIT/ML 0 DROP 0 

ALPRAZOLAM 0.5 MG 30TAB 

30 

ALPRAZOLAM 0.25107 MG TAB 107 

ALPRAZOLAM 1 MG 25 TAB 25 

OLANZAPINE 10 MG 47 ZYDIS TA 47 

ATOVAQUONE 750 SUSP 11 11 

ALBUTEROL SULF 5MG/ML 3 SOL 3 

GAVISCON LIQUID GENERIC 0 0 

DOMEBORO PACKET0 0 

ACAMPROSATE 333 MG 0 EC TAB 0 

AMANTADINE 100 MG 15 CAPSULE15 

AMINOCAPROIC 5 GM/20ML 0 VL 0 

AMINOCAPRO ACID 500MG 0 TAB0 

AMINOPHYLLINE 2500MG/10ML 

0 

AMITRIPTYLINE 25 MG 0 TAB 0 



AMMONIA AROMATIC 0 INHALANT0 

AMOXICILLIN 500 MG 5CAPSUL 

5 

AMOXICILLIN 250MG/5ML 5 SUS 5 

AMOXICILLIN 125MG/5ML 1 SUS 1 

AMOXICILLIN 250 MG 0CAP 

0 

BSS EYE SOLUTION 15ML 40 SOL 40 

AMPHOTERICIN B 500MG VIAL 0 

LEVALBUTEROL 1.2511 MG NEB 11 

AMPICILLIN 250 MG/5ML 0 SUS 0 

LEVALBUTEROL 0.6319 MG NEB 19 

AMPICILLIN 500 MG VIAL 1 1 

AMPICILLIN 1 GM ADDV 0 VIAL 0 

AMPICILLIN 250 MG CAP 0 0 

AMPICILLIN SODIUM 1250 VL 12 

AMPICILLIN 2 GM ADDV 0 VIAL 0 

AMPICILLIN 1 GM VIAL 12 12 

AMPICILLIN 125 MG VIAL 0 0 

AMPICILLIN 2 GM VIAL 8 8 

HYDROCORTISONE 250 MG SUPP 0 

TUCKS HEMMRD OINT 0 TUBE 0 

TUCKS SUPPOSITORY 0SUPP 

0 

ARIPIPRAZOLE 15 MG 77TAB 

77 

ASCORBIC ACID 50039 MG TAB 39 

ARIPIPRAZOLE 5 MG 43 TAB 43 

ASPIRIN 300 MG SUPPOSITOR 3 3 

ASPIRIN 600 MG SUPP7 7 

ASPIRIN EC 325 MG 152 ECTAB 152

ASPIRIN 325 MG TAB1 1 

ATENOLOL 50 MG TAB 53 53 

PILOCARPINE 4% EYE 0DROPS 

0 

ATROPINE SULF 1% EYE 0 OINT 0 

TYLENOL # 2 TAB 0 0 

ANASTROZOLE 1 MG 0TAB 

0 

ATROPINE SULF 1% EYE 2 DROP 2 

ATROPINE SULF 0.5150 MG ABBO150 

AMOX/CLAV 125/5ML 0 SUSP 75 0 

AMOX/CLAV 250/1250 MG TAB 0 

AMOX/CLAV 250/5ML 1 SUSP 75 1 

ANTIPYRINE/BENZOCAIN 1 OTIC 1 

BACITRACIN 500 PACKET 20 20 

BACITRACIN OINT 28GM 6 TUBE 6 

BACLOFEN 10 MG TAB 16 16 

BECLOMETHASONE 0.042% 0 NAS0 

METHYL SALIC/MENTHOL 3 30GM3 

BENZOIN COMPOUND 0 30 ML BT 0 

BENZONATATE 100 53 MG CAP 53 

BENZTROPINE 2MG/2ML 4 AMP 4 

BENZTROPINE 1 MG 90 TAB 90 

BETAMETHASONE 6MG/ML 10 INJ10 

BETAMETH VAL 0.1% 0CR 15GM 0 

BETAMETHASONE VAL 0 0.1% OI 0 

BETAMETHASONE VAL 0 0.1% OI 0 

BETAXOLOL 0.5% EYE 0DROP 

0 

BETAMETH VAL 0.1% 0CR 45GM 0 

BISACODYL 5 MG EC 85 TAB 85 

BISACODYL 10 MG SUPP 7 7 

BLACK WIDOW ANTIVENIN 0 SDV 0 

BIMATOPROST 0.03% 0EYE DRO 0 

BSS PLUS EYE SOLN 5000 ML 0 

BROMOCRIPTINE 2.50MG TAB 0 

BUDESONIDE 0.25MG/2ML 6 NEB 6 

BUDESONIDE AQ NAS 0SPR 8.6 0 

BUMETANIDE 0.5 MG 0TAB 

0 

BUDESONIDE 0.5MG/2ML 14 NEB 14 

BUMETANIDE 0.5MG/2ML 0 VIAL 0 

BUPIVICAINE 0.5% SDPF 18 VIA 18 

BUPIVICAINE 0.25% SDPF 2 VL 2 

BUPIVACAINE HCL/PF 0VIAL 

0 

BUPIVACAINE 5MG/ML-50ML 73 V73 

BUPIVICAINE W/EPI 36 0.5% VL 36 

BUPIVACAINE 2.5MG/ML 11 50ML11 

BUSPIRONE 10 MG 188 TAB 188 

BUSPIRONE 5 MG TAB9 9 

BUMETANIDE 1 MG TAB 3 3

CALCIUM CHLORIDE 10% 0 VIAL 0 

CANDESARTAN 4 MG 1TAB 

1 

CALCIUM CARB 50044 MG CHWTA44 

CANDESARTAN 16 MG 0 TAB 0 

CAPSAICIN 0.025% CR 060 GM 0 

CAPTOPRIL 25 MG TAB1 1 

CAPTOPRIL 50 MG TAB0 0 

CAPTOPRIL 12.5 MG 38 TAB 38 

CARBAMAZEPINE 200 39MG TAB 39 

CARBAMAZEPINE 100 MG CHWT 10 

CARBIDOPA/LEV 25/100 0 SR T 0 

CARBIDOPA/LEV 25/100 12 TAB 12 

CARBIDOPA/LEV 25/250 0 TAB 0 

CARBIDOPA/LEV 10/100MG 0 TA 0 

CARBACHOL 0.01% OCULAR 0 0 

CARISOPRODOL 35016 MG TAB 16 

CEFAZOLIN 1 GM VIAL 18 18 

CEFAZOLIN 1 GM/D5W 376 50ML 376 

CEFAZOLIN 1 GM VIAL 0 ADDV 0 

CEFOTAXIME 2 GM VIAL 0 0 

CEFOTAXIME 1 GM VIAL 2 2 

CEFOTETAN DISODIUM 0 2 GM 0 

CEFOTETAN 1 GM VIAL 0 0 

CEFOTETAN 2 GM FZ 050 ML 0 

CEFTRIAXONE 500 MG 0 VIAL 0 

CEFTRIAXONE 1 GM 20 VIAL 20 

CEFTRIAXONE 2 GM VIAL 0 0 

CEFUROXIME 250 MG 11TAB 

11 

CEFOXITIN 1 GM VIAL 10 10 

CELECOXIB 200 CAP 9 9 

CEPHALEXIN 500 MG 19CAP 

19 

CEPHALEXIN 250 MG 0CAP 

0 

CEFPODOXIME 200 MG 0 TAB 0 

CEFTRIAXONE 1 GM ADDV 0 VIA 0 

CEFTRIAXONE 2 GM ADDV 0 VL 0 

CHARCOAL/SORB 50GM/240ML 2 2 

CHARCOAL ACTIV 50GM/240ML 0 0 

DUOVISC VISCOELASTIC 93 SYST 93 

CHLORAMBUCIL 2 MG 0 TAB 0 

CHLORAL HYDRATE 5000 MG UD 0 

CHLORDIAZEPOXIDE 50 MG CAP 0 

CHLORDIAZEPOXIDE 17 25 MG CA 17 

CHLOROPROCAINE -MPF 0 2% VL 0 

CHLORPROMAZINE 25 0 MG AMP 0 

CHLORPROMAZINE 50 9 MG AMP 9 

CHLORPROMAZINE 81 25 MG TAB81 

CHLOROPROCAINE 3% 0 20ML VL 0

CHOLESTYRAMINE 4GM 2 PCKT 2 

CHLOROTHIAZIDE 5000 MG VIA 0 

TRILISATE 500MG TAB 0 GENER 0 

CILOSTAZOL 100 MG 0TAB 

0 

CIPROFLOXACIN 25053MG TAB 53 

CLINDAMYCIN 300MG/2ML 4 VL 4 

CLINDAMYCIN 600MG/4ML 0 VIA 0 

CLINDAMYCIN 900MG/6ML 0 VL 0 

CLINDAMYCIN 150 MG 13 CAP 13 

CLONAZEPAM 0.5 MG 86 TAB 86 

CLONAZEPAM 1 MG 26 TAB 26 

CLONIDINE 0.3MG/240 HR PAT 0 

CLONIDINE 0.1 MG TAB 57 57 



CLORAZEPATE 3.75 MG 0 TAB 0 

LOTRISONE CR GENERIC 2 15GM 2 

CLOTRIMAZOLE 1% VAG 0 CR 45 0 

CLOTRIMAZOLE 10 MG 0 TROCHE 0 

COCAINE HCL 4% TOP 4SOLN 

4 

CODEINE SULF 15 MG 0TAB 

0 

COLCHICINE 0.6 MG TAB 6 6 

COLLODION FLEXIBLE 0SOLN 

0 

HELITENE 1 GM MICROFIBRIL 0 0 

CORTISONE ACET 25 0MG TAB 0 

COLESTIPOL 1 GM TAB0 0 

NEOSPORIN EYE SOLN 0 GENERI 0 

CORTISPORIN EAR SUSP 1 GNRC 1 

COSYNTROPIN 0.25 MG 3 VIAL 3 

CROMOLYN 20MG/2ML 0 U/D NEB0 

CYANIDE ANTIDOTE KIT 0 0 

CYANOCOBALAMIN 36 1 MG VIAL 36 

CYCLOSPORINE 0.05% 0 DROPET 0 

CYCLOBENZAPRINE 120 10 MG TAB120 

CYCLOPENTOLATE 1% 4EYE DRO 4 

DAPSONE 25 MG TAB0 0 

DANTROLENE 20 MG 0VIAL 

0 

DANTROLENE 25 MG 0CAP 

0 

CARBAMIDE PEROXIDE 2 6.5% E 2 

DERMOPLAST SPRAY 342 OZ CAN 34 

DEFEROXAMINE 500 8MG VIAL 8 

DESIPRAMINE 10 MG 0TAB 

0 

DESIPRAMINE 25 MG 0TAB 

0 

DESMOPRESSIN 4 MCG/ML 0 AMP0 

DEXAMETHASONE 216 MG TABS 16 

DEXAMETHASONE 0.50 MG TAB 0 

DEXAMETHASONE 304 4 MG TAB 304

DEXAMETHASONE 492 4MG/ML VIAL 492 

DEXAMETHASONE 1892 20MG VIAL 1892 

DEXAMETHASONE 630 10MG/ML VIA 630 

DEXTROSE 50%-WATER 22 ABBOJ 22 

DIAZEPAM 5 MG TAB 108 108 

DIAZEPAM 2 MG TAB0 0 

DIAZEPAM 10MG/2ML 60 CARPUJC60 

DIAZOXIDE 300MG/20ML 0 AMP 0 

DIBUCAINE 1% OINT 41 30 GM 41 

DICLOFENAC 50 MG EC 0 TAB 0 

DICLOFENAC 75 MG EC 0 TAB 0 

DICLOXACILLIN 250 MG 2 CAP 2 

DICYCLOMINE 10 MG 13CAP 

13 

DIGOXIN 250 MCG/2.5ML 0 SOL 0 

DIGOXIN IMMUNE FAB 0 40MG V 0 

DIGOXIN 250 MCG TAB 8 8 

DIGOXIN 500 MCG AMPULE 16 16 

DIGOXIN 125 MCG TAB 18 18 

DILTIAZEM 30 MG TAB 43 43 

DILTIAZEM 60 MG TAB 36 36 

DIMENHYDRINATE 50MG 1 TAB 1 

DIMETHYL SULFOXIDE 0 50 ML 0 

DINOPROSTONE 20 MG 0 VAG SU 0 

DIPHENHYDRAMINE 99 50 MG VIA99 

DIPHENHYDRAMINE 50 0 MG CAP 0 

ANTI-ITCH 2-0.1% CREAM 0 0 

DIPHENHYDRAMINE 94 25 MG CAP94 

DIPIVEFRIN 0.1% EYE 0DROP 

0 

DIPYRIDAMOLE 25 MG 0 TAB 0 

DISOPYRAMIDE PHOSPHA 0 150 0 

DISOPYRAMIDE CR 1000 MG CA 0 

DOBUTAMINE 250 MG/20ML 0 VL0 

DOCUSATE SODIUM 179 250 MG CA 179 

DOCUSATE 100 MG 345 CAP 345 

DONNATAL ELIXER GENERIC 0 0 

DONNATAL TABS GENERIC 0 TAB 0 

DONNATAL ELIX 5ML 92ORAL LI 92 

DOPAMINE 40MG/ML 0 5 ML VIA 0 

DOPAMINE 400MG/D5W 20 500ML 20 

DOPAMINE 200MG/D5W 10 250ML 10 

DOXEPIN 25 MG CAP20 20 



DROTRECOGIN ALFA 05 MG VL 0 

DROTRECOGIN ALFA 020 MG VL 0 

DOXYCYCLINE 100 MG 54 VIAL 54 

DOXYCYCLINE 100 MG 16 TAB 16

DULOXETINE 30 MG 113 CAP EC 113 

DULOXETINE 20 MG 32 CAP 32 

ERYTHROMYCIN 400MG/5ML 0 LI 0 

ERYTHROMYCIN ETHYLSU 0 400M 0 

ENALAPRIL 2.5 MG TAB 0 0 

ENALAPRIL 20 MG TAB3 3 



ENOXAPARIN 100 MG 450SYRINGE450 


ENOXAPARIN 120 MG 0SYRINGE 

0 

ENOXAPARIN 150 MG 0SYRINGE 

0 

EPINEPHRINE .1 MG900 900 

EPINEPHRINE .1 MG 3 3 


RACEPINEPHRINE 2.25% 3 AMP 3 

EPINEPHRINE 0.1% NASAL 0 SO 0 

ERTAPENEM 1 GM 152 INJ VIAL 152 

ERYTHROMYCIN LACT 0500MG V 0 

ERYTHROMYCIN LACT 0500MG V 0 

ERYTHROMYCIN EC 333 0 MG TA 0 

ERYTHROMYCIN 333 0RX TO GO 0 

ESTRADIOL 1 MG TAB10 10 

ERYTHROMYCIN EC 250 0 MG TA 0 

ENALAPRILAT 2.5 MG/2ML 26 VL 26 

ERYTHROMYCIN 0.5% 60OINT EY 60 

ESMOLOL 100 MG/10ML 2 VIAL 2 

ESTRADIOL CYPIONATE 0 25 MG 0 

ESTROGENS,CONJ 0.625 4 MG T 4 

ESTROGENS,CONJ 0.35 MG TAB 5 

ESTROGENS,CONJ 250MG VIAL 0 

ETHACRYNIC ACID 500MG TAB 0 

ETHACRYNATE SODIUM 0 50MG V0 

ESOMEPRAZOLE 40 MG 0 VIAL 0 

ETHYL CHLORIDE SPRAY 0 BTL 0 

ESCITALOPRAM 10131 MG TAB 131 

EZETIMIBE 10 MG TAB 13 13 

ESMOLOL 2,500 MG/250ML 0 DR 0 

FAMOTIDINE 20 MG 95 TAB 95 

FENTA/ROPIVA 2 MCG/0.2% 52 I 52 

FENTANYL 100 MCG 732 INJ AMP 732 

FENTANYL CIT 250183 MCG AMP 183 

FERRIC SUBSULFATE SOLN 0 0 

FERROUS SULF SR 160MG 0 TAB 0 

FERROUS SULFATE 231 325 MG TA231 

FENOFIBRATE 48 MG 42TAB 

42 

FIORICET TAB GENERIC 57 TAB 57

FIORINAL CAP GENERIC 2 CAP 2 

FLUNISOLIDE 0.025% 0NASAL 

0 

FLUCYTOSINE 250 MG 0 CAP 0 

FLUOXETINE 20MG/5ML 0 U/D 0 

FLUOXETINE 20 MG 57 CAP 57 

FLUPHENAZINE 2.5 MG 19 TAB 19 

FLUPHENAZINE 2.5 MG/ML 0 VL 0 

FLUPHENAZINE 5 MG 0TAB 

0 

FLUPHENAZINE DEC 1251 MG V 1 

FLUTICASONE 44 MCG 0 INHALE 0 

FLUTICASONE 110 MCG 0 INHAL 0 

FLUTICASONE 220 MCG 4 INHAL 4 

FLURBIPROFEN 0.03% 0EYE DR 0 

FOLIC ACID 1 MG/0.2ML 14 VIA 14 

FOLIC ACID 1 MG TAB 161 161 

FUROSEMIDE 20 MG 50TAB 

50 

FUROSEMIDE 20MG/20ML 83 VIAL83 


63 

FUROSEMIDE 100MG/10ML 75 VIA75 

FUROSEMIDE 40MG/4ML 234 VIAL234 


20 

FUROSEMIDE 10MG/ML 0 LIQUID 0 

FONDAPARINUX 2.5 MG 0 SYRG 0 

GEMFIBROZIL 600 MG 3 TAB 3 

GENTAMICIN 0.3% EYE 0 DROP 0 

GENTAMICIN SULF 0.3% 1 EYE 1 

GENTAMICIN 10 MG/ML 8 VIAL 8 

GENTAMICIN 0.1% CR 015 GM 0 

GENTAMICIN SULF 40/ML 46 VIA 46 

GLIPIZIDE 10 MG TAB21 21 

GLIPIZIDE 5 MG TAB 0 0 

GLATIRAMER 20 MG/ML 0 INJ 0 

GLYBURIDE 5 MG TAB 11 11 

GLYBURIDE 2.5 MG TAB 6 6 

GLYCERIN 0 SUSP 0 0 

GLYCERIN SUPP ADULT 0 0 

GLYCOPYRROLATE 0.2 98 MG VIA 98 

GUAIFENESIN SYRUP 6U/D CUP 6 

GUAIFENESIN/DM SF 0SYRUP 

0 

ROBITUSSIN AC 10 ML 16 U/D 16 

HALOPERIDOL 10 MG/5ML 0 U/D 0 

ACTHIB 10 MCG/0.5ML 0 VIAL 0 

HALOPERIDOL 2 MG TAB 2 2 

HALOPERIDOL 0.5 MG 0 TAB 0 

HALOPERIDOL DEC 50MG/ML 0 V 0 

HALOPERIDOL 5 MG 219 TAB 219 

HALOPERIDOL 1 MG TAB 3 3

HALOPERIDOL LAC 535 MG/ML V 35 

HYDROCHLOROTHIAZIDE 94 25 MG94 

HEPARIN 1000 UNITS/ML 0 VIA 0 

HEPARIN 10,000 UNIT 0 VIAL 0 

HEPARIN 5000 UNIT 2315 VIAL 2315 

HEPARIN FLUSH 100 U/10ML 0 0 

HEPARIN 10 UNIT/ML 0FLUSH 

0 

HEPARIN 1000 U/10ML 0 FLUSH 0 

NABI HB INJ VIAL 0 0 

HEPATITIS B VACC 5 MCG/VL 0 0 

ENGERIX B 10MCG/0.5ML 0 INJ 0 

HYALURONATE 23 MG/ML 0 SYR 0 

HYDRALAZINE 10 MG 11TAB 

11 

HYDRALAZINE 20MG/ML 2 SDV 2 

HYDRALAZINE 25 MG 34TAB 

34 

HYDROCORTISONE 1% 2 CR 30 G 2 

HYDROCORTISONE 0.5% 0 OINT 0 

HYDROCORTISONE 0.5% 1 CR 28 1 

HYDROCORTISONE VAL 0 0.2% C 0 

SOLU CORTEF 100 MG 0 VIAL 0 

HYDROCORTISONE 1% 0 OINT 28 0 

HYCODAN SYRUP GENERIC 0 0 

SOLU CORTEF 500 MG 0 VIAL 0 

HYDROGEN PEROXIDE 0 3% SOLN 0 

HYDROMORPHONE 174 2 MG TAB174 

HYDROMORPHONE 35 2 MG/ML VIA 35 

HYDROMORPHONE 50MG/5ML 0 AM 0 

HYDROXYZINE HCL 104 MG TAB 4 

HYDROXYUREA 500 MG 0 CAP 0 

HYDROXYZINE 25 MG 99TAB 

99 

HYDROXYZINE 50 MG 0TAB 

0 

HYDROXYCHLOROQUINE 2 S 200 2 

NABUMETONE 500 MG 0 TAB 0 

IBUPROFEN 600 MG 214 TAB 214 



INDOCYANINE GREEN 025 MG V 0 

IMIPRAMINE 10 MG TAB 0 0 

IMIPRAMINE 25 MG 24 TAB 24 

CARIMUNE NANOFILT 0 3 GM IV 0 

IBUPROFEN 100 MG/5ML 56 CUP 56 

INDIGO CARMINE 0.8% 4 AMPUL 4 

INDOMETHACIN 75 MG 0 SR CAP 0 

INDOMETHACIN 25 MG 4 CAP 4 

MORPHINE 10/5ML U/D 3 CUP 3 

INSULIN REG HUMAN 0100U/ML 

0 

NOVOLIN N INSULIN VIAL 0 0

HUMALOG MIX 75/250 INSULIN 0 

ITRACONAZOLE 100 MG 0 CAP 0 

POVIDONE-IODINE SWABS 0 0 

POVIDONE-IODINE 7.5% 0 SCRU 0 

POVIDONE-IODINE 10% 0 SOLN 0 

POTASSIUM IODIDE 10 GM/ML 0 

IRON DEXTRAN 100MG/2ML 0 VL 0 

IRBESARTAN 150 MG 0TAB 

0 

IPRATROPIUM HFA INHALER 3 3 

ISOFLURANE LIQUID 100 0 ML 0 

ISONIAZID 100 MG TAB 0 0 

ISOSORBIDE DIN 10 MG 0 TAB 0 


POTASSIUM CHLOR 10 4 MEQ TA 4 

POTASSIUM CHLOR 270 20 MEQ TA270 

POTASSIUM CHLO 253MEQ PCK 3 

KETOROLAC 10 MG TAB 4 4 

KETOCONAZOLE 200 0MG TAB 0 

LEVETIRACETAM 250 197MG TAB197 

LABETALOL 100 MG 36 TAB 36 

LABETALOL 20 MG CARPUJECT 20 20 

LABETALOL 5 MG/ML 13MDV VL 13 

LANOLIN OINT 30GM0 0 

WINRHO SDF 1,500 UNITS 0 VL 0 

LEUCOVORIN 5 MG TABS 0 0 

LEVOTHYROXINE 1500MCG TAB 0 

LEVOTHYROXINE 5044 MCG TAB 44 

LEVOTHYROXINE 100 33MCG TAB33 


LEVOTHYROXINE 125 18MCG TAB18 

LEVOTHYROXINE 2000MG VIAL 0 

LIDOCAINE HCL 2% ABBOJECT 1 1 

LIDOCAINE HCL 2% 203 ML VL 3 

LIDOCAINE 5% PATCH96 96 

LIDOCAINE HCL 1% 50ML 45 VIA 45 

LIDOCAINE 2% W/EPI 5VIAL 

5 

LIDOCAINE 2% JELLY 10 5 ML 10 

LIDOCAINE HCL/PF INJ 48 48 

LIDOCAINE 0.4%/D5W 1 500ML 1 

LIDOCAINE 4% -PF 5 ML 1 AMP 1 


38 


0 

LIDOCAINE 2% -MPF 240 SDV VL 240 

LIDOCAINE 0.5% -MPF, 19 SDV 19 

LIDOCAINE 4% TOPICAL 1 SOLN 1 

LINDANE 1% SHAMPOO 0 0 

LINDANE 1% LOTION0 0

LIDOCAINE 5%/D7.5W 0 VIAL 0 

LIOTHYRONINE 5 MG 0TAB 

0 

LISINOPRIL 2.5 MG TAB 24 24 

LISINOPRIL 20 MG 133 TAB 133 

LISINOPRIL 10 MG TAB 58 58 

LISINOPRIL 5 MG TAB52 52 

LITHIUM CARB 300 MG 0 TAB 0 

LITHIUM CITRATE 300MG/5ML0 0 

LOMOTIL TAB GENERIC 0 TAB 0 

LINEZOLID 600 MG TAB 0 0 

LOPERAMIDE 1 MG/5ML 0 LIQD 0 

LOPERAMIDE 2 MG CAP 7 7 

LORAZEPAM 0.5 MG 153TAB 

153 

LORAZEPAM 2 MG/ML 161 VIAL 161 

LORAZEPAM 2 MG TAB 0 0 

LORAZEPAM 1 MG 148 TAB 148 

LOVASTATIN 20 MG 44 TAB 44 

MAGNESIUM SULF 5 0GM VIAL 0 

EPSOM SALT 1 LB CARTON 0 0 

CITRATE OF MAGNESIA 7 300 M 7 

MAGNESIUM SULF 4GM/100ML 

32 32 

MAGNESIUM CL 64 56 MG TAB 56 

MANNITOL 25% 50 ML 12 VIAL 12 

DEXAMETHASONE 0.1% 0 EYE DR 0 

TRIPLE ANTIBIOT OINT 3 PCKT 3 

MAXITROL EYE SUSP 0GENERIC 

0 

NEO/POLYMYX B SULF/D 92 OINT 92 

MAXZIDE-25MG GENERIC 0 TAB 0 

METHYLDOPA 250 MG 0 TAB 0 

MECLIZINE 12.5 MG TAB 0 0 

MECLIZINE 25 MG TAB 28 28 

MEGESTROL 400MG/10ML 0 SUSP0 

MEGESTROL 40 MG TAB 0 0 

MELPHALAN 2 MG TAB 0 0 

MEMANTINE 5 MG TAB 28 28 

MEPERIDINE 50 MG 10 SYRINGE 10 

MEPERIDINE 75 MG SYRINGE 0 0 

MEPERIDINE 100 MG 0SYRINGE 

0 

MEPERIDINE 25 MG 11 SYRINGE 11 

MEPIVACAINE 1% -MPF,SDV 0 0 

MEPERIDINE 300MG/30ML 12 PCA12 

MEPERIDINE 50 MG TAB 0 0 

MELOXICAM 7.5 MG 4TAB 

4 

MAALOX SUSP 30 ML 17U/D CUP 17 

MESALAMINE 1000 MG 0 SUPP 0 

METHACHOLINE 1000MG VIAL 0 

METHADONE 5 MG TAB 0 0

METHENAMINE 1 GM 0TAB 

0 

METHOCARBAMOL 500 4 MG TAB4 

METHOTREXATE 2.5 MG 0 TAB 0 

METHYLDOPATE 250MG/5ML 0 VL0 

METHYLERGONOVINE 5 0.2 MG A 5 

METHYLERGONOVINE 1 0.2MG TA1 

METHYLENE BLUE 200 100MG AMP 200 

METHYLPHENIDATE 128 5 MG TAB128 

ISOSULFAN BLUE 1% 4VIAL 

4 

METOCLOPRAMIDE 28 10 MG TAB28 

METOCLOPRAMIDE 51 10MG/2ML 51 V 

METOPROLOL 25 MG 279TAB 

279 

METOLAZONE 2.5 MG 8 TAB 8 

METOPROLOL 5 MG/5ML 148 INJ A148 

METOPROLOL 100 MG 29 TAB 29 

METOPROLOL 25 MG 87XL TAB 87 

METRONIDAZOLE 500MG 140 IV BA 140 

METRONIDAZOLE 250 28 MG TAB 28 

METRONIDAZOLE 5009 MG TAB 9 

MEXILETINE 200 MG 0CAP 

0 

MICONAZOLE 7 VAG 1CR 45 GM 1 

MICONAZOLE NITRATE 0 2% CR 0 

MICONAZOLE 7 VAG 2SUPP 

2 

MIDAZOLAM 5 MG/ML 0 VIAL 0 

MIDAZOLAM 5MG/2.5ML 0 SYRUP0 

MIDAZOLAM 5MG/5ML 945 SDV 945 

MINERAL OIL LAXATIVE 0 30 M 0 

MINERAL OIL ENEMA 0133 ML 0 

MINERAL OIL- HEAVY0 0 

MILK OF MAGNESIA CONC 0 10M 0 

SOLU MEDROL 1 GM 0VIAL 

0 

METHYLPREDNISOLONE 2 4 MG T 2 

METHYLPREDNIS 40 128 MG VIAL 128 

METHYLPRED SUCC 500MG 2 VL 2 

METHYLPREDNIS 125 242MG VIAL242 

METHYLPREDN 80 MG 1 DEPOT V 1 

METHYLPREDN 40 MG 3 DEPOT V 3 

MOEXIPRIL 7.5 MG TAB 0 0 

MORPHINE 10 MG/ML 115 CARPUJC 115 

MORPHINE 4 MG/ML 493CARPUJEC 

493 

MORPHINE 2 MG/ML 229CARPUJEC 

229 

MORPHINE 30MG PCA 30 PUMP SY30 

MORPHINE SR 30 MG 3TAB 

3 

MORPHINE 100MG/100ML 0 KIT 0 

MORPHINE IR 15 MG 2TAB 

2 

MOXIFLOXACIN 0.5% 0EYE DRO 0 

MULTIVITAMIN TAB 83 PLAIN 83

MULTIVITAMIN ORAL 0LIQ 

0 

VITAMIN B COMP W/VIT 0 C TA 0 

MULTIVITAMIN W/MINERAL 16 TA16 

MUPIROCIN 2% OINT 0U/D PCK 0 

MUPIROCIN 2% OINT 0TUBE 

0 

SODIUM CL 0.9% IRRIG 0 500M 0 

SODIUM CL IRRIG SOLN 0 00 0 

NACL 0.9% 50 ML 78 PVC 78 

SODIUM CHLORIDE 24 1 GM TAB 24 

SODIUM CL 0.9% INH 3 ML V 3 

SODIUM CL 0.65% NASAL 3 3 

SODIUM CHLORIDE 23.4% 0 VIA 0 

NACL 0.9% 10 ML VIAL 0 0 

NADOLOL 40 MG TAB0 0 

NAFCILLIN 2 GM ADDV 0 VIAL 0 

NAFCILLIN 1 GM VIAL 28 28 

NAFCILLIN 2 GM VIAL2 2 

NAFCILLIN 1 GM ADDV 0 VIAL 0 

NALOXONE 1MG/ML 4SYRINGE 

4 

NALOXONE 0.4 MG/ML 0 AMP 0 

NATEGLINIDE 120 MG 0 TAB 0 

NAPROXEN 500 MG 26 TAB 26 

NAPROXEN 375 MG TAB 8 8 

NAPROXEN 250 MG TAB 0 0 

CORTISPORIN EYE OINT 0 GNRC 0 

TRIPLE ANTIB OINT 30GM 0 TB 0 

TRIPLE ANTIBIOTIC EYE 0 OIN 0 

NEOSPORIN G.U. IRRIGANT 0 0 

NEOMYCIN SULF 5000MG TAB 0 

NEOMYCIN/POLY/HC 0EYE DROP 0 

NEOSTIGMINE 5MG/10ML 330 VIAL 330 

NEVIRAPINE 50MG/5ML 0 SUSP 0 

NIACIN 500 MG SR TAB 22 22 

NICOTINE 2 MG GUM81 81 

NIFEDIPINE 10 MG CAP 4 4 

NIFEDIPINE 30 ER TAB0 0 

NITRATEST PAPER-URINE 0 TES 0 

NITROFURANTOIN MACRO 13 50MG 13 

NORTRIPTYLINE 10 MG 0 CAP 0 

NORTRIPTYLINE 25 MG 5 CAP 5 

NITROPRUSSIDE 50MG/ML 0 VIA 0 

NITROGLYCERIN 50MG/10ML 0 V 0 

NITROGLYCERIN SR 2.5 0 MG C 0 

NITROGLYCERIN ER 6.5 0 MG C 0 

NITROGLYCERIN 0.3MG 13 TB SL 13 

NITROGLYCERIN 0.466 MG SL T 66 

NITROGLYCERIN SL 0.6 0 MG 0

NITROGLYCERIN 0.4MG 0 SL SP 0 

NITROGLYCERIN 0.4 MG 2 PATC 2 




NITROGLYCERIN 2% OINT 2 30G 2 

NITROGLYCERIN 2% 191 OINT PCK191 

NYSTATIN/TRIAMCIN 030GM TU 0 

NYSTATIN CREAM 151GM TUBE 1 

NYSTATIN 100000 POWDER 24 24 

NYSTATIN OINT 15 GM 0 TUBE 0 

NYSTATIN 100MU VAG 0 TAB 0 

PEG-3350 ELECTR ORAL 5 SOLN 5 

OLANZAPINE 20 MG 13 ZYDIS TA 13 

OLMESARTAN 20 MG 17TAB 

17 

OPIUM/BELLADONNA 1 ALK SUPP 1 

OLANZAPINE 10 MG VIAL 8 8 

OXACILLIN 1 GM ADDV 0 VIAL 0 

OXACILLIN 2 GM ADDV 0 VIAL 0 

OXACILLIN 2 GM IV VIAL 0 0 

OXAZEPAM 15 MG CAP 0 0 

OXYBUTYNIN XL 5 MG 0 TAB 0 

OXYBUTYNIN 5 MG 23 TAB 23 

OXYMETAZOLINE 0.5% 10 NASAL 10 

OXYTOCIN 10 U/ML 61 VIAL 61 

PANCRELIPASE CAPSULE 0 TAB 0 

PALONOSETRON 0.25/5ML 610 VIA610 

OFLOXACIN 0.3% EAR 3DROPS 

3 

PAROXETINE CR 12.52MG TAB 2 

PEN G POT 2MM UNITS/D5W 0 5 0 

PEN G POT 3MM UNITS/D5W 150 150 5 

PENICILLIN G POT 5MM 126 VIAL 126 

PENICILLIN VK 250MG/5ML 0 0 

PENICILL G BENZ 1000000 UN 0 

PENICILLIN G POT INJ 0VIAL 

0 

PENICILL G BENZ 1000000 UN 0 

PERMETHRIN 5% CREAM 1 60 GM1 

PERMETHRIN 1% 60ML 0 BOTTLE 0 

PHENOBARBITAL 20MG/5ML 0 UD0 

PANTOPRAZOLE 40762 MG TAB 762 

PENTOXIFYLLINE 40013MG TAB 13 

PERCOCET 5/325 GENERIC 464 TA 464 

PERPHENAZINE 2 MG 0TAB 

0 


0 


0 

PETROLATUM,WHITE 228 GM 2 

EYE LUBRICANT OINT 13.5GM 

1

PHENAZOPYRIDINE 13 100 MG TA 13 

PHENELZINE 15 MG TAB 0 0 

PHENOBARBITAL 65 MG 0 VIAL 0 

PHENOBARBITAL 1300 MG VIAL 0 

PHENOBARBITAL 16.26 MG TAB 6 

PHENTOLAMINE 5 MG 0 VIAL 0 

PHENYLEPHRINE 10 MG 8 INJ A 8 

CEPASTAT LOZENGE34 34 

PHENYLEPHRINE 0.5% 0 NASAL 0 

PHENYLEPHRINE 2.5% 94 EYE SO 94 

PHENYLEPHRINE 0.25% 0 NASAL 0 

PHENYTOIN 50 MG CHEW 2 TAB 2 

PHENYTOIN ER 100 45 MG CAP 45 

PHENYTOIN 250 MG 30 VIAL 30 

FLEET PHOSHA SODA 0LIQ 45M 0 

PHYSOSTIGMINE 1 MG 0 AMP 0 

PHYTONADIONE 5 MG 27 TAB 27 

VITAMIN K 1MG/0.5ML 0 AMP 0 

VITAMIN K 10 MG/ML 20 IV AMP 20 


0 


0 

PIPERACILLIN 3 GM VIAL 0 0 

PIPERACILLIN 4 GM VIAL 0 0 

MULTIVITAMINS PEDI 0DRP BT 0 

PNEUMOCOCCAL-23 17VACC 25MC 17 

SPS 15 GM/60ML SUSPENSION 4 4 

TUBERCULIN PPD 5 T 1UNITS 

1 

PEG-3350 U/D PACKET 63 17 GM 63 

PRAMIPEXOLE 0.25 14 MG TAB 14 

PRAZOSIN 1 MG CAP1 1 

PRAZOSIN 5 MG CAP0 0 

PRALIDOXIME 1 GM VIAL 0 0 

PREDNISONE 1 MG TAB 6 6 

PREDNISOLONE 15 MG/5ML 0 0 

PREDNISONE 50 MG 40 TAB 40 

PREDNISOLONE ACET 31% 5ML 3 



PREDNISONE 5 MG TAB 26 26 

PREDNISOLONE 15MG/5ML 0 U/D0 

PRIMIDONE 250 MG 2TAB 

2 

PRIMIDONE 50 MG TAB 2 2 

PROBENECID 500 MG 0TAB 

0 

PROCAINE 10% INJ AMP 0 INJ 0 

PROCHLORPERAZINE 125 SUPP 1 

PROCHLORPERAZINE 210 MG TA 2 

PROCHLORPERAZINE 05 MG TAB 0

PROCHLORPERAZINE 110 MG VI 1 

PROCAINAMIDE 1GM/10ML 0 VIA 0 

PROMETHAZINE 25 36 MG AMP 36 

PROMETHAZINE 25 MG 4 TAB 4 

PROMETHAZINE 25 MG 0 SUPP 0 

PROPARACAINE 0.5% 15EYE DRO 15 

DARVOCET N-100 TAB 0 GENERI 0 

PROPRANOLOL LA 602 MG CAP 2 

PROPRANOLOL LA 800 MG CAP 0 

PROPRANOLOL 20 MG 25 TAB 25 

PROPRANOLOL 1 MG/ML 0 VIAL 0 



PROPYLTHIOURACIL 50 0 MG TA 0 

PROTAMINE SULF 10MG/ML 0 VL 0 

PSEUDOEPHEDRINE 30 2 MG TAB 2 

PSEUDOEPHEDRINE HCL 0 30 0 

METAMUCIL PACKET10 10 

PYRIDOXINE 50 MG TAB 0 0 

QUINAPRIL 5 MG TAB0 0 

QUINIDINE GLUC 80MG/ML 0 VL 0 

QUINIDINE SULF 2000MG TAB 0 

QUINIDINE GLUC 3240 MG SR 0 

QUININE SULF 325 MG 0 CAP 0 

RABIES VACC IM 2.514 U/VIAL 14 

RABAVERT RABIES VACC 0 0 

RISPERIDONE CONSTA 0 25MG K 0 

RISPERIDONE CONSTA 0 37.5 M 0 

RISPERIDONE CONSTA 0 50MG K 0 

RANITIDINE HCL 150 0TAB 

0 

RIFAXIMIN 200 MG TAB 0 0 

RIFAMPIN 150 MG CAP 0 0 

RIVASTIGMINE 1.5 MG 0 CAP 0 

SALMETEROL DISKUS 0INHALER 

0 

SCOPOLAMINE HYDROBRO 32 1.5 32 

SCOT TUSSIN ORIGINAL 0 SOLN 0 

SCOT TUSSIN DM SUGAR 0 FREE 0 

SENNOSIDES 8.6 TAB 239 239 

SILDENAFIL 50 MG TAB 0 0 

SILVER SULFADIAZ 1% 0CR 40 0 

SILVER SULFADIAZ 1% 6CR 50 6 

SILVER NITRATE APPLICATOR 1 1 

SILDENAFIL 25 MG TAB 0 0 

SIMETHICONE 80 MG 18CHEWTAB18 

SIMETHICONE 40 MG 1LIQUID 

1 

SIMVASTATIN 40 MG 1TAB 

1 

NA BICARB INFANT 4.2% 0 ABB 0

NA BICARB PEDI 8.4% 2ABBOJ 

2 

SODIUM BICARB 6500MG TAB 0 

EYE STREAM NON SURG 6 30 ML 6 

SULFACETAMIDE 10% 0OINT EY 0 

NA BICARBONATE 7.5% 0 ABBOJ 0 

SULFACET NA 10% EYE 0 DROPS 0 

SORBITOL SOLUTION 070% ORA 0 

SPIRONOLACTONE 25 21MG TAB 21 

SUCCINYLCHOLINE 170 20MG/ML 170 V 

SULFAMETHOX/TMP 27DS TAB 27 

SULFAMETHOX/TMP 05 ML VIAL 0 

SULFAMETHOXAZOLE 0W/TMP SU0 

SULFAMETH/TMP 400/80MG 0 TA0 

SULFASALAZINE 500 MG 0 TAB 0 

SULINDAC 200 MG TAB 15 15 

TAMOXIFEN 10 MG TAB 0 0 

ARTIFICIAL TEARS 15 4ML 

4 

TEMAZEPAM 15 MG CAP 3 3 

TELITHROMYCIN 4000MG TAB 0 

TERBUTALINE 2.5 MG 0TAB 

0 

TERBUTALINE 1 MG/ML 0 SDV 0 

TERCONAZOLE 7 VAG 0CREAM 

0 

TETANUS AND DIPH TOX 0 0.5M 0 

TETANUS TOX ADSB 0.5ML 3 VL 3 

TETANUS IMM GLOB 0250U/SYR 

0 

TETRACYCLINE 250 MG 0 CAP 0 

TETRACAINE 0.5% EYE 86 DROPS 86 

THEOPHYLLINE 300 MG 0 TAB 0 

THEOPHYLLINE 400 MG 0 SR TA 0 

MESALAMINE EC 4000MG TAB 0 

THEOPHYLLINE SR 2000 MG TA 0 

THIAMINE 100 MG TAB 61 61 

THIAMINE 100 MG VIAL 32 32 

THIOPENTAL 500 MG 0CARPUJC 

0 

THIORIDAZINE 25 MG 0TAB 

0 

THIORIDAZINE 10 MG 0TAB 

0 

THIOTHIXENE 1 MG CAP 0 0 

THIOTHIXENE 5 MG CAP 0 0 

TISSEEL VH KIT 0 0 

THROMBIN-JMI 5,0001 U VIAL 1 

FLOSEAL KIT 0 0 

ARMOUR THYROID 300 MG TAB 0 

TIAGABINE 4 MG TAB0 0 

TICARCILLIN/CLAV 3.1GM 0 VL 0 

TIMOLOL MALEATE 0.5% 3 DROP 3 

TIMOLOL 0.25% EYE DROPS 0 0 

TIZANIDINE 4 MG TAB1 1

TOBRAMYCIN 80 MG/2ML 11 VIAL11 

TOBRAMYCIN 0.3% EYE 0 OINT 0 

TOBRAMYCIN 0.3% EYE 3 DROPS 3 

TOBRAMYCIN SULF 1.2 0 GM VL 0 

TIOTROPIUM 18 MCG 19INHALER19 

TOLBUTAMIDE 500 MG 0 TAB 0 

TOLNAFTATE 1% POWDER 0 45 G 0 

TOLNAFTATE 1% CR 15GM 0 TUB 0 

TORSEMIDE 20 MG TAB 0 0 

TRAZODONE 50 MG 98 TAB 98 

KENALOG 40 MG/ML 0INJ MDV 0 

TRIAMCINOLONE 0.1% 2 CR 15G 2 

TRIAMCINOLONE 0.1% 1 OINT 1 1 

TRIAMCINOLONE 55MCG 0 NASAL0 

TRYPAN BLUE 1 SYRINGE 1 1 

TRIAZOLAM 0.125 MG 0 TAB 0 

TRIFLUOPERAZINE 1 MG 0 TAB 0 

TRIHEXYPHENIDYL 2 MG 0 TAB 0 

TRIHEXYPHENIDYL 5 MG 0 TAB 0 

TRIMETHOBENZ 100 1MG/ML SY 1 

TROPICACYL 0.5% EYE 0DROPS 

0 

TROPICAMIDE 1% EYE 93 DROPS 93 

AMPICILLIN/SULB 1.5GM 0 VIA 0 

DIVALPROEX 250 MG 5ER TAB 5 

DIVALPROEX EC 50017 MG TAB 17 

DIVALPROEX EC 25017 MG TAB 17 

VASOPRESSIN 20 U/ML 0 VIAL 0 

VANCOMYCIN 1 GM ADDV 0 VL 0 

VANCOMYCIN 500 MG 0 ADDV VL 0 

VANCOMYCIN 1 GM 188 VIAL 188 

VERAPAMIL 80 MG TAB 0 0 

VASOPRESSIN 10 UNIT 2 VIAL 2 

VECURONIUM 10 MG 1VIAL 

1 

VERAPAMIL 5MG/2ML 0 VIAL 0 

VERAPAMIL SR 240 11 MR TAB 11 

VORICONAZOLE 200 MG 0 VIAL 0 

VORICONAZOLE 200 MG 0 TAB 0 

WITCH HAZEL PADS40 40 

WARFARIN 2.5 MG TAB 31 31 

WARFARIN 2 MG TAB41 41 


BACTERIOSTATIC WATER 0 VIAL 0 

STERILE WATER INJ VL 4 20ML 4 

STERILE WATER INJ 19 FLIPTOP 19 

ZIDOVUDINE 100 MG 0CAP 

0 

ZIPRASIDONE 20 MG 0VIAL 

0 

ZINC OXIDE 20% OINT 330GM 

3

ISOPROPYL ALCOHOL 070% GAL 0 

CALCITONIN 400 U/2ML 0 VIAL 0 

CEFUROXIME 1.5 GM 0VIAL 

0 

CEFUROXIME 750 MG 0VIAL 

0 

ZINC OXIDE 40% OINT.(DESI 5 5 

D-AMPHETAMINE 100MG SR CA 0 

DOBUTAMINE 250MG/D5W 0 250M0 

EPHEDRINE 50 MG/ML 36 AMP 36 

HYDROXYZINE 10 MG/5ML 0 LIQ 0 

ISOPROTERENOL 0.2MG/ML 0 AM0 

KETAMINE 500MG/10ML 0 VIAL 0 

MEDROXYPROGEST 2.5 2 MG TAB 2 

PEDIAZOLE 200/600MG 0 GENER 0 

PROPOFOL 1% SINGLE 549 USE VI 549 

FLUCONAZOLE 100 MG 13 TAB 13 

DIHYDROERGOTAMINE 0 1 MG AM0 

ADVAIR DISKUS 100/50 3 3 



PIROXICAM 10 MG CAP 0 0 

SOD POLYSTYRENE 30GM 0 ENEM0 

VERAPAMIL SR 180 MG 2 TAB 2 

ACETYLCYSTEINE 4000MG/4ML 

0 

CEFTAZIDIME 1 GM VIAL 0 0 

ARGATROBAN 250MG/2.5ML 0 SD0 

NALBUPHINE 10 MG/ML 24 AMP 24 

FLUCONAZOLE 200MG/NS 0 100M0 

FLUCONAZOLE 200MG/D5W 0 1000 

NAPROXEN SODIUM 550 MG TA 5 

NITROGLYCERIN 50MG 0 IV BTL 0 

KETOROLAC 15 MG/ML 34 AMP VL34 

KETOROLAC 60 MG/2ML 264 VIAL264 

CLONAZEPAM 2 MG TAB 0 0 

KETOROLAC 30 MG 1020 VIAL 1020 

MENOMUNE-A/C/Y/W-135 0 VIAL0 

METRONIDAZOLE 0.75% 0 VAG G 0 

MORPHINE SR 100 MG 0 TAB 0 

OMEPRAZOLE 20 MG 0EC CAP 0 

SODIUM ACETATE 400MEQ SDV 0 

TRIAMCINOLONE ACET 1 0.1% C 1 


FLUDROCORTISONE 66 0.1 MG TA66 

MORPHINE SULFATE 01 M 0 

MORPHINE SULF/PF 18 1MG/ML A18 

MEASLES/MUMPS/RUBELLA 1 VAC1 

RUBELLA VACCINE 0.5ML/VIA 0 0 

TRIAMCIN ACET 0.1% 0PASTE 

0

AMIODARONE 200 MG 16 TAB 16 

CAFFEINE/SOD BENZ 0500MG V 0 

CHERRY FLAVOR SYRUP 0 0 

CLOMIPRAMINE 25 MG 0 CAP 0 

DOXAPRAM 20 MG/ML 0 VIAL 0 

ESTROGENS,CONJ 0.625 0 CREA 0 

ETOMIDATE 20MG/10ML 3 3 

HEPARIN 1,000 UNITS/NS 0 50 0 

NOVOLIN 70/30 INSULIN 0 0 

POTASS IODIDE 1 GM/ML-30M 27 27 


LINEZOLID 600 MG IV 0BAG 

0 

KETOCONAZOLE 2% CREAM 0 15G0 

MAGNESIUM OXIDE 140 0 MG CA 0 

MEPIVACAINE 2% -MPF,SDV 0 0 

PROPAFENONE 150 MG 0 TAB 0 

RABIES IMM GLOB 300U/2ML 34 34 

CEFTRIAXONE 250 MG 64 VIAL 64 

ACETAMINOPHEN 800MG CHEWT0 

AZTREONAM 2 GM VIAL 0 0 

MARCAINE 0.75% PF 0SPINAL 

0 

BUPROPION 75 MG 33 TAB 33 

CLOZAPINE 100 MG TAB 5 5 

CLOZAPINE 25 MG TAB 0 0 

ESTAZOLAM 1 MG TAB0 0 

INDAPAMIDE 2.5 MG 2TAB 

2 

LACTULOSE 10 GM/15ML 0 SOLN 0 

MORPHINE SR 15 MG 8TAB 

8 


NIFEDIPINE ER 60 MG 3TAB 

3 

IBUPROFEN 100 MG/5ML 0 SUSP 0 

FENTANYL 25 MCG PATCH 8 8 

FENTANYL 50 MCG PATCH 0 0 

FLUMAZENIL 0.5MG/5ML 2 VL 2 

CHLORPROMAZINE 10 MG TAB 0 

ACYCLOVIR 800 MG TAB 0 0 

LEVOBUNOLOL 0.5% 0EYE DROP 0 

AMPICILLIN/SULB 3114 GM VIAL 114 

DILTIAZEM XR 240 MG 17 CAP 17 

DILTIAZEM CD 180 MG 26 CAP 26 

DOXAZOSIN 1 MG TAB0 0 

DOXAZOSIN 2 MG TAB 63 63 

CARBID/LEV SR 50/200MG 0 TA 0 

SERTRALINE 50 MG 28 TAB 28 

BENAZEPRIL 10 MG 25 TAB 25 

SERTRALINE 25 MG TAB 7 7 

FENTANYL 100 MCG PATCH 2 2

ISOSORBIDE MONO 40 ER 60MG T40 

AZATHIOPRINE 50 MG 10 TAB 10 

VERAPAMIL SR 120 MG 0 TAB 0 

IPRATROPIUM 0.06% 0NASAL S 0 

HEPARIN 12,500 UNITS/250M 13 13 

VALSARTAN 80 MG 61 TAB 61 

DEXTROAMPHETAMINE 0 5 MG TA0 

EMLA CREAM GENERIC 2 5 GM 2 

HEPATITIS A VACC 250U/VL 

0 

ESTROGENS,CONJ 0.90 MG TAB 0 

IPRATROPIUM 0.5 MG 1 NEB 1 

CLARITHROMYCIN 250 2 MG TAB 2 

TERAZOSIN 1 MG CAPSULE 4 4 

LORATADINE 10 MG 40 TAB 40 

COSOPT EYE DROPS 10 6 ML 6 

ACETAZOLAMIDE SR 500 0 MG C 0 

PROGESTERO OIL 50MG/ML 0 VL 0 

ONDANSETRON 4 MG 280TAB 

280 

RALOXIFENE 60 MG TAB 3 3 

QUETIAPINE 25 MG 65 TAB 65 

VENLAFAXINE XR 37.53 MG CA 3 

DESMOPRESSIN 4 MCG/ML 0 INJ 0 

DIVALPROEX EC 125 MG 0 TAB 0 

OXYCODONE 5 MG 337 TAB 337 

CARVEDILOL 12.5 MG 116TAB 

116 

GONAK 2.5% EYE SOLUTION 0 0 

LIDOCAINE 1% -MPF 17 SDV 17 

ENTEX PSE 600/120MG 0 GENER 0 

OCTREOTIDE 1 MG/ML 0 VIAL 0 

OCTREOTIDE 100 MCG/ML 0 AMP 0 

BAYGAM 10 ML VIAL0 0 

AZITHROMYCIN 600 MG 0 BOTTL 0 

FAMCICLOVIR 250 MG 0 TAB 0 

AZITHROMYCIN 300MG 1 BOTTLE 1 

ESTRADIOL 0.05MG/24HR 0 PAT 0 

SELEGILINE 5 MG TAB0 0 

LITHIUM CARB ER 4501 MG TA 1 

ISOVUE-M 300 (61%) 0VIAL 

0 

PIPERACILL/TAZO 2.25 116 GM V 116 

PROVISC 10 MG/ML DISP 0 SYR 0 

PRIMAXIN 500 MG INJ 2 VIAL 2 

ERYTHROMYCIN 250 0MG TAB 0 

GLIMEPIRIDE 2 MG 102 TAB 102 

CEFADROXIL 500 MG 0CAP 

0 

CITALOPRAM 20 MG 85TAB 

85 

AMOX/CLAV 400MG/5ML 0 SUSP 0 

ROPIVACAINE 10MG/ML 0 20ML 0

VITAMIN E 200 UNIT 0CAP 

0 

LAMOTRIGINE 100 MG 57 TAB 57 

LAMOTRIGINE 25 MG 31TAB 

31 

MIRTAZAPINE 15 MG 38TAB 

38 

ATROPINE 1 MG/ML 500SDV 

500 

HEPATITIS A VACC 50U/VL 0 0 

CALCIUM GLUC 1 GM/10ML 12 VL12 

MONTELUKAST 5 MG 0CHEW TAB0 

ATENOLOL 25 MG TAB 73 73 

RISPERIDONE 1 MG/ML 8 SOLN 8 

RISPERIDONE 1MG/ML 0 SOLN 0 

FOSINOPRIL 10 MG TAB 0 0 

CEFTRIAXONE 1GM/D5W 892 50ML 892 

GLYBURIDE 3 MG TAB0 0 

HYDROCORTISONE 104 MG TAB 4 

ATORVASTATIN 10 MG 89 TAB 89 

AMPHOTER B LIPID 100MG 0 VL 0 

LAMIVUDINE 150 MG 0TAB 

0 

FINASTERIDE 5 MG TAB 31 31 

MYLANTA 30ML CUP 127GENERIC127 

PAROXETINE 20 MG 85 TAB 85 

SALIVA SUBSTITUE 0 0 

MORPHINE SULF 20MG/ML 0 LIQ 0 

FLUVOXAMINE 50 MG 0 TAB 0 

NOVOLOG INSULIN VIAL 0 0 

ZAFIRLUKAST 20 MG 0TAB 

0 

AUGMENTIN 875MG 39TAB GENER 39 

AMOX/CLAV 500/125MG 7 TAB 7 


METFORMIN 850 MG 0TAB 

0 

OXYCODONE SR 20 MG 47 TAB 47 

MILRINONE 20MG/100ML 0 IV 0 

FLUTICASONE 50MCG 15NASAL S 15 

TAMSULOSIN 0.4 MG 127CAP 

127 

DESMOPRESSIN 10MCG 1 NASAL 1 

BRIMONIDINE 0.15% 0EYE 5ML 0 

LEVOFLOXACIN 50014 MG TAB 14 

LEVOFLOXACIN 750MG 30 IV BAG 30 

BENZTROPINE 0.5 MG 0 TAB 0 

AMLODIPINE 10 MG 26 TAB 26 

LORAZEPAM 40 MG/10ML 0 VIAL 0 

BUPROPION 100 MG 0TAB 

0 

CALCIUM CARB 50012 MG TAB 12 

CALCIUM 600MG/VIT 14D TAB 14 

RISPERIDONE 3 MG TAB 6 6 

CELECOXIB 100 MG CAP 5 5 

BENAZEPRIL 5 MG TAB0 0

SUMATRIPTAN 25 MG 0 TAB 0 

NELFINAVIR 250 MG 0TAB 

0 

ZIDOVUDINE 10 MG/ML 0 INJ 0 

ZIDOVUDINE 10 MG/ML 0 SYRUP 0 

DINOPROSTONE 10 MG 5 VAG SU 5 

BUTORPHANOL 1MG/ML 12 SDV VL 12 

CEFUROXIME 125MG/ML 0 SUSP 0 

LANSOPRAZOLE 30 MG 0 VIAL 0 

LANSOPRAZOLE 30 MG 0 CAP 0 

LEVOBUNOLOL 0.25% 0EYE DRO 0 

LANSOPRAZOLE 30 MG 0 M TAB 0 

VISCOAT SYRINGE 0 0 

COMBIVENT INHALER 214.7 GM 2 

CLOPIDOGREL 75 MG 63TAB 

63 

DEMECLOCYCLINE 1500 MG TAB 0 

CARVEDILOL 3.125 MG 71 TAB 71 

PRAVASTATIN 10 MG 7TAB 

7 

RAMIPRIL 2.5 MG CAP0 0 

TOLTERODINE 1 MG TAB 0 0 

ASPIRIN 81 MG CHEWABLE 281 TA281 

MACROBID GENERIC 30100MG CA30 

HYDROMORPHONE 10MG/ML 0 AMP 0 

PROMETHAZINE 12.50MG SUPP 0 

LEVOFLOXACIN 25015 MG IV BA 15 

DICLOFENAC 0.1% EYE 0 DROP 0 

GABAPENTIN 100 MG 33CAP 

33 

LATANOPROST EYE DROP 2 2.5M 2 

CLINDAMYCIN 600MG/50ML 18 IV18 

LEVOFLOXACIN 500172 MG IV BA172 


PIPERACILL/TAZO 3.375G 654 AD 654 

QUINAPRIL 10 MG TAB 0 0 

MISOPROSTOL 100 MCG 4 TAB 4 

IBUTILIDE 1 MG/10ML 0 VIAL 0 

SUMATRIPTAN 6MG/0.5ML 1 SDV 1 

VARIVAX VACCINE 0.5ML/VIA 0 0 

METOCLOPRAMIDE 10MG/10ML0 0 

GUAIFENESIN/DM SYRUP 53 U/D 53 

DOCUSATE 100MG/10ML 3 U/D 3 

FERROUS SULF 300MG/5ML 0 UD 0 

KCL 10% U/D CUP 20MEQ/15M 16 16 

LIDOCAINE % VISC SOLN 48 20M 48 

METFORMIN 500 MG 130TAB 

130 

ZINC SULFATE 220 MG 0 CAP 0 

AMPHOJEL 30ML U/D 0CUP 

0 

PHENYTOIN 100 MG/4ML 0 CUP 0 

NYSTATIN 500000 U/5ML 49 CUP 49

ATORVASTATIN 40205 MG TAB 205 

GUAIFENESIN 600 MG 37 SR TAB 37 

OLANZAPINE 10 MG 61 TAB 61 

SYNVISC 16MG/2ML 0SYRINGE 

0 

SUCRALFATE 1 GM TAB 17 17 

SUCRALFATE 1 GM/10ML 67 U/D 67 

OSELTAMIVIR 75 MG 0CAP 

0 

TERAZOSIN 5 MG CAP1 1 

BACTERIOSTATIC NACL 0 FLUSH 0 

METHADONE 10 MG 131TAB 

131 

AMVISC PLUS 16MG/ML 0 0 

ISRADIPINE 2.5 MG CAP 0 0 

OLANZAPINE 5 MG TAB 35 35 

IPRATROPIUM 0.03% 0NASAL S 0 

POTASSIUM CL 10MEQ/100ML 

215 215 

VENLAFAXINE XR 7589 MG CAP 89 

CLINDAMYCIN 900MG/50ML 26 IV26 

SEVOFLURANE LIQ ANESTH 0 IN 0 

ROPIVACAINE 0.2% 100ML 0 BT 0 

FLUPHENAZINE 5MG/ML 0 CONC. 0 

CLINDAMYCIN 2% VAG 0 CREAM 0 

ONDANSETRON 42572 MG/2ML SDV 2572 

DORZOLAMIDE 2% DROPS 0 5ML 0 

MESALAMINE 500MG 0SUPP 

0 

TRAMADOL 50 MG TAB 93 93 

SENNA-S TAB 76 76 

SODIUM MORRHUATE 0 5% VIAL 0 

DEXAMETHASONE 285 4 MG/ML VL 285 

ASPIRIN 81 MG EC 286 TAB 286 

CEFTRIAXONE 2GM/D5W 560 50ML 560 

ANAGRELIDE 0.5 MG 0CAP 

0 

TIMOLOL 0.5% GEL/SOLUTION 0 0 


215 

HYOSCYAMINE 0.1250MG TAB 0 

NICOTINE PATCH 7 MG1 1 

NICOTINE PATCH 1418 MG 18 

NICOTINE PATCH 21MG 109 PATCH109 

CEFUROXIME 1.5 GM 0ADDV VL 0 

MONTELUKAST 10 MG 37 TAB 37 

METHIMAZOLE 10 MG 9 TAB 9 

OXYCODONE SR 10124 MG TAB 124 

OXYCODONE SR 40 MG 0 TAB 0 

AZITHROMYCIN 500 103 MG VIAL 103 

BICITRA 30 ML U/D 10 CUP 10 

ROCURONIUM 10MG/ML 69 VIAL 69 

VITAMIN E 400 UNIT 0CAP 

0 

CLONIDINE 100 MCG/ML 0 VIAL 0

BUPROPION SR 100 MG 0 TAB 0 

BUPROPION SR 15018 MG TAB 18 

HYOSCYAMINE 0.1250MG DROP 0 

BUPROPION XL 15012 MG TAB 12 

TRIAMCINOLONE ACET 12 40MG I 12 

GLIPIZIDE ER 5 MG TAB 0 0 

TOLTERODINE LA 2 MG 12 CAP 12 

MEXILETINE 150 MG 0CAP 

0 

BLOOD SUGAR DIAG 0STRIP 

0 

CAFERGOT GENERIC 1/100 0 TA 0 

NESIRITIDE 1.5 MG VIAL 0 0 

CARBAMAZEPINE XR 0100MG TB 0 

HALOPERIDOL DEC 100MG/ML0 0 

ACETAMINOPHEN/COD 75 #3 TAB75 

LOSARTAN 50 MG TAB 42 42 

AMIODARONE 50 MG/ML 0 VIAL 0 

MEDROXYPROGEST 150 150 MG SDV 150 

CHLORPROMAZINE 100 2 MG TAB2 

CEFTAZIDIME 1 GM ADDV 0 VIA 0 

CEFTAZIDIME 2GM ADDV 0 VL 0 

DONEPEZIL 5 MG TAB 22 22 

AZITHROMYCIN 25068 MG TAB 68 

FLUOXETINE 10 MG 13 CAP 13 

DIVALPROEX 125 MG 0SPRKL C 0 

NEFAZODONE 100 MG 0 TAB 0 

WARFARIN 5 MG VIAL0 0 

CLARITHROMYCIN 250MG/5ML0 0 

PEPTO BISMOL GENERIC 0 SUSP 0 

PENICILLIN VK 500 MG 4 TABL 4 


ZOLPIDEM 5 MG TAB96 96 

AMLODIPINE 2.5 MG 31TAB 

31 

AMLODIPINE 5 MG TAB 81 81 

SOTALOL 80 MG TAB36 36 

ALENDRONATE 70 MG 0 TAB 0 


PRIMAXIN 500 MG ADDV 0 VL 0 

VENLAFAXINE 25 MG 2TAB 

2 

RIFAMPIN 600 MG VIAL 0 0 

NOREPINEPHRINE 1MG/ML 1 SDV 1 

MIDAZOLAM 2MG/2ML 1520 SDV1520 



2 

AGGRENOX CAP GENERIC 5 5 

TOPIRAMATE 100 MG 30 TAB 30 

TOPIRAMATE 25 MG 69TAB 

69 

DRY SKIN LOTION 480ML 1 BTL 1

FLUVASTATIN 20 MG 0CAP 

0 

CASTOR OIL LIQUID 0 0 

ALPROSTADIL 500 MCG 0 AMP 0 


SCOPOLAMINE 0.4 MG/ML 0 VIA 0 

TRAZODONE 100 MG 164TAB 

164 

RAMIPRIL 5 MG CAP34 34 

BISOPROLOL 5 MG TAB 0 0 

PIOGLITAZONE 15 MG 26 TAB 26 

DISULFIRAM 250 MG 0TAB 

0 

METOPROLOL 50 MG 112TAB 

112 

QUETIAPINE 100 MG 22TAB 

22 

RISPERIDONE 0.5 MG 37TAB 

37 

NALTREXONE 50 MG 0TAB 

0 

ZIPRASIDONE 20 MG 3CAP 

3 

ZIPRASIDONE 40 MG 0CAP 

0 

GLIPIZIDE ER 2.5 MG 0TAB 

0 

ISOSORBIDE MONO 46 ER 30MG T46 

AMILORIDE 5 MG TAB0 0 

FLECAINIDE 50 MG TAB 0 0 

DIVALPROEX ER 500 115 MG TAB 115 

PIOGLITAZONE 45 MG 0 TAB 0 

QUETIAPINE 200 MG 113TAB 

113 

METOPROLOL XL 5039 MG TAB 39 

LEVOTHYROXINE 1123MCG TAB 3 

SERTRALINE 100 MG 53TAB 

53 

ACARBOSE 25 MG TAB0 0 

DILTIAZEM 125MG/25ML 6 VIAL 6 

CARBOPROST 250 MCG 4 AMP 4 

NEUTRA-PHOS PACKET 0 GENERI 0 


80 

LANSOPRAZOLE 15 MG 0 CAP 0 

VALPROATE 250 MG/5ML 0 CUP 0 

PAPAIN/UREA OINT 30 0 GM 0 

AMIKACIN 500 MG/2 0ML VIAL 0 

CALCITONIN NASAL SPR 2 3.7M 2 

IRON POLYSACCH 1503 CAPSUL 3 

INFLIXIMAB 100 MG 800 VIAL 800 

HYALURONATE 14MG/ML 0 SYRG 0 

ANTIVENIN,CROTALIDAE 0 FAB 0 

CLOTRIMAZOLE 1% CR 0 30 GM 0 

RISPERIDONE 1 MG 69 TAB 69 

CIPROFLOXACIN 400MG/200ML 36 36 

URSODIOL 300 MG CAP 3 3 

PHENASEPTIC MOUTH 2 SPRAY 2 

HYOSCYAMINE ER 0.375MG 0 TA 0 

IBUPROFEN 200 MG 12 TAB 12

LANTUS 100 UNITS/ML 0 VIAL 0 

LORAZEPAM 2 MG/ML 1 PO SOLN 1 

ALTEPLASE 100 MG 200 VIAL 200 

ACETAMINOPHEN 160/5ML 66 U/D66 

DIPHENHYDRAMINE 16 25MG LIQ 16 

PHENYTOIN 100MG/2ML 0 INJ 0 

TENECTEPLASE 1MG 0INJECTIO 

0 

METOPROLOL XL 100 17MG TAB 17 

DILTIAZEM 25MG/5ML 35 VIAL 35 

CALCIUM ACETATE 667MG 18 TAB18 

HYDROXYZINE 50 MG/ML 2 VIAL 2 

AMMONIUM LACTATE 0 12% LOTI0 

CYANOCOBALAMIN 47 500 MCG TA 47 

OXCARBAZEPINE 300 33MG TAB 33 

LACTULOSE 30 ML U/D 35 CUP 35 

LITHIUM CARB 300 MG 0 ER TA 0 

MAGNESIUM SULF 196GM VIAL 96 

MIDAZOLAM 100MG/100ML 0 KIT0 

BSS EYE SOLUTION 500ML 91 91 

ALTEPLASE 2 MG VIAL 12 12 

TYLENOL/CODEINE LIQ 11 12.5M 11 

FAMOTIDINE 20 MG 151 VIAL 151 

PRAMIPEXOLE 0.12512MG TAB 12 

MAGNESIUM OXIDE 1400 MG TA14 


ETHANOLAMINE 5% AMPULE 0 0 

ROPINIROLE .25MG 0 0 

MELOXICAM 7.5MG 0 0 

EPLERENONE 25MG 0 0 

ALBUTEROL HFA 0 0 

DICLOXACILLIN TO GO 0 250 M 0 

EDROPHONIUM 10 MG/ML 0 VIAL0 

FLUORESCEIN OPTH 13 STRIP 13 

GLUCAGON 1 MG VIAL 1 1 

GLYCERIN LIQUID 0 0 

ISOSORBIDE DIN 40MG 0 SR TA 0 

MORPHINE 60 MG SR 0TAB 

0 

NAPROXEN TO GO 375 0 PACK 0 

PREGABALIN 25 MG 11 CAP 11 

PROPOFOL 1% 100ML 20 BOTTLE 20 

LEVOFLOXACIN 250 MG 3 TAB 3 

OLANZAPINE 2.5 MG 8TAB 

8 

HEPATITIS B IMM GLOB 0 5ML 0 

CYCLOBENZAPRINE 100 RX TO 0 

OXYCODONE/APAP 25 RX TO GO E25 

IBUPROFEN RX TO GO 0 600MG 0 

SULFAMETHOX/TMP 0DS RX TO 0

PRAMIPEXOLE .25MG 0TAB 

0 

AMOXICILLIN 500 MG 0RX TO 0 

CEPHALEXIN 500 MG 0RX TO G 0 

OVRAL 0.5/50 TAB GENERIC 8 8 

CODEINE/APAP #3 RX 0TO GO 0 

ROPINIROLE 0.25 MG 7TAB 

7 

EPLERENONE 25 MG 0TAB 

0 

TRAVOPROST 0.004% 02.5 ML 0 

EDETATE CALCIUM 1000MG 0 AM0 

TRIAMCINOLONE 0.1% 1 OIN 80 1 

CYPROHEPTADINE 4 MG 0 TAB 0 

VALACYCLOVIR 50014 MG TAB 14 

SCOT TUSSIN 100MG/5ML 0 0 

PODOPHYLLUM RESIN 0 30 GM 0 

VANCOMYCIN 500 MG 61 VIAL 61 

EPINEPHRINE .1 MG 0 0 

HYDROXYZINE PAM 34 25 MG CAP34 

ORA SWEET SF SYRUP0 0 

ORA PLUS SUSP VEHICLE 0 SYR 0 

POVIDONE-IOD 10% OINT 0 30G 0 

HYPERHEP 0.5ML/SYRINGE 0 0 

CAFFEINE 200 MG TAB0 0 

NYSTATIN CREAM 30GM 0 TUBE 0 

CHLOROXYLENOL LIQ 0BOTTLE 

0 

CANDIDA SKIN TEST 0 0 

EMOLLIENT(RADIAGEL) 0 85GM 0 

HYDROCERIN CREAM 1454GM 

1 

HYDROCERIN CREAM 1120GM 

1 

BUMETANIDE 1 MG/4ML 2 VIAL 2 

BUMETANIDE 2.5MG/10ML 0 VL 0 

PRENATAL VITAMIN TAB 3 3 

MINERAL OIL 10ML VIAL 1 1 

VISINE A EYE DROPS 15ML 0 0 

VITAMIN D 400 UNIT 0TAB 

0 

ASCORIC ACID 1 GM/2ML 0 AMP 0 

CEFAZOLIN 2 GM INJ0 0 

KCL 2 MEQ/ML INJ VL 015ML 

0 

KCL 2 MEQ/ML INJ VL 010ML 

0 

KCL 2 MEQ/ML INJ VL 855 ML 85 

KCL 2 MEQ/ML INJ 100 VL 20 ML 100 

TRACE METALS VIT 100 ML VL 0 

MVI ADULT INJ VIAL10 10 

POTASSIUM PHOSPH 045 MM VL 0 

POTASSIUM ACET 40MEQ 0 VIAL 0 

TETRACAINE 2% SOLN 0 30 ML 0 

STERILE WATER IRRIG 0LITER 

0 

DEXTROSE 25% WATER 0 10ML I 0


MAGNESIUM 1GM/100ML 34 D5W34 

FLUORESCEIN 10% INJ 0 AMP 0 

TIMOLOL 0.25% GFS 2.5 0 ML 0 

BOTULINUM TOXIN 1000 U VIA 0 

MIDODRINE 5 MG TAB 23 23 

ERGOCALCIFEROL 50M 1 U CAP 1 

KALETRA TAB 0 0 

COMBIVIR TABLET 0 0 

ACETYLCYSTEINE 200MG/ML 0 I 0 

OXYBUTYNIN 3.9 MG/PATCH 0 0 

SUBOXONE 2MG/0.5MG 76 SL TAB76 

BUPRENORPHINE 2 MG 0 TAB 0 

EPTIFIBATIDE 75MG/100ML 0 0 

EPTIFIBATIDE 20MG/10ML 0 VI 0 

RISPERIDONE 2 MG 65 M TAB 65 

PIPERACILLIN/TAZO 2.25 0 GM 0 

STERILE WATER INJ VL 0 50ML 0 

BUPIVACAINE W/EPI 420.25% V 42 

E.E.S 200 MG/5ML SUSP 0 100 0 

METRONIDAZOLE 250MG 0 IV BA 0 

FLUCONAZOLE 100MG/D5W 0 50M0 

FLUCONAZOLE 150MG/D5W 0 75M0 

CALCIUM GLUC 23 MEQ 0 INJ 0 

FLUCONAZOLE 50MG/D5W 0 25ML 0 

CILOSTAZOL 50 MG TAB 2 2 

PANTOPRAZOLE 20 MG 2 TAB 2 

ALBUTEROL 2.5 MG/0.5ML 0 NE 0 

BARIUM (PHARMACY 0NO CHARG0 

ROSUVASTATIN 10 MG 0 TAB 0 

DIATR MEGLU/DIATRIZOATE 0 S 0 

SODIUM HYPOCHLORITE-DAKIN 0 0 

PHYTONADIONE 1 MG/0.5ML 50 S50 

DEXTROSE TABS CHEWABLE 0 0 

HALOPERIDOL LACT 5MG/ML 0 0 

QUETIAPINE 50 MG TAB 6 6 

MAGNESIUM 20 GM/500ML 12 12 

LACTAID TABLETS 0 0 

FIBER TABLET 12 12 

RX TO GO PENICILLIN 0500G 

0 

BACTROBAN 2% 15GM 0 CREAM 0 

AZACTAM 1GM VIAL 0 0 

HEPARIN 100U/ML 10550 5ML VIAL 10550 

ALTACE 1.25MG CAP20 20 

K-PHOS 5ML 22MEQ 5INJ VIAL 5 

OXACILLIN 16M VIAL0 0 

CHLORHAXIDINE GLUCONATE 0 0

ERTAPENEM 1GM ADDV 0 0 

GLYCOPYRROLATE 1MG 0 TAB 0 

FLORASTOR 250MG 26 CAP 26 

PEPTO BISMOL TAB 2 2 

UNASYN 1.5GM VIAL23 23 

LORAZEPAM INTENSOL 1 ORAL 1 

MORPHINE 20MG/ML0 0 

MIRACLE MOUTHWASH 0 ML 0 

MICONAZOLE 2% CREAM 7 7 

CEPHALEXIN 250MG 0SUSP 

0 

DIPYRIDAMOLE 10MG 0 INJ VL 0 

VERAPAMIL 40MG TAB 0 0 

VANCOMYCIN 1GM/250ML 0 IVPB0 

FLUVIRON 5ML MULTI 0 VIAL 0 

FLUVIRON 0.5ML 09 10 0 VIAL 0 

PENICILLIN VK 250MG 0 TAB 0 

ROPINIROLE 1MG TAB 39 39 

GAMUNEX VIAL 0 0 

LEVETIRACETAM 10MG 400 400 

NACL 5ML FLUSH SYRINGE 0 0 

ANEBESOL MAX STRENGTH 3 GEL 3 

NACL 0.9% 3ML FLUSH0 0 

NACL 0.9% 10ML FLUSH 0 0 

GAMMAGARD 2.5GM 0VIAL 

0 


CYTOGAM 2.5GM/50ML 0 VIAL 0 

BRIMONIDINE 0.2% EYE 4 DROP 4 

FISH OIL CAP 29 29 

MORPHINE SULF 250MG/1OML 0 0 

MINOCYCLINE 100MG 0 CAP 0 

TRIAMCINOLONE 0.5% 0 OINT 0 

ROBITUSSIN S/F COUGH 0 10ML 0 

VITAMIN B12 100MCG 0 TAB 0 

AMPHADASE 150U/ML 1 SDV 1 

PENICILLIN G PROCAINE 0 2ML 0 

CIPROFLOXIN 200MG/100ML 0 0 

ADACEL INJ .5ML SYRINGE 0 0 

RECLAST INK 5MG/100ML 30 30 

PILOCARPINE 5MG TAB 0 0 

ALBUTEROL INH NEB 01.25MG 

0 

PRIVIGEN 10% LIQ 5GM/50ML 0 0 

LTA 360 PRE-ATTACHED 1 4% 1 

NEVANAC 0.1% OPTHALMIC 0 0 

QUINAPRIL 20MG TAB0 0 

MORPHINE ORAL NEO 97 .1MG/ML 97 

GAMMAGARD LIQUID 560 500 MG560 

FONDAPARINUX 7.5MG/0.6ML 0 0

PYRAZINAMIDE 500MG 0 TAB 0 

ETHAMBUTOL 400MG 0 TAB 0 

STREPTOMYCIN 1GM 0VIAL 

0 

PYRIDOSTIGMINE 60MG 0 TAB 0 

JANUVIA 100MG TAB0 0 

PALIPERIDONE 3 MG 0TAB 

0 


4 


0 

LITHIUM CARBON 3000 MG CAP 0 

SUMATRIPTAN 50 MG 0 TAB 0 

KALETRA 100 25 MG 0TAB 

0 

FOMEPIZOLE 1 GM/ML 0 1.5ML 0 

TRUSOPT 2% EYE DROPS 1 1 

ARIPIPRAZOLE 30 MG 0TAB 

0 

FENTANYL PATCH 120MCG/HR 

0 

PREGABALIN 100 MG 23CAP 

23 

VICODIN 5/500 MG 213 TAB 213 

VENOFER 20MG/ML 9200 INJ 9200 

RANEXA 500 MG TAB88 88 

AZITH 200 MG/5 ML ORAL 0 0 

PEDIAZOLE 200-600 MG/5ML 0 0 

AMOX 250 MG/5 ML 0ORAL 

0 

AUGMENTIN 250 MG/5ML 0 ORAL0 

AZITHROMYCIN 100 MG/5ML 0 0 

AMOX 125 MG/5 ML 0ORAL 

0 



CEFUROXIME 125 MG/5 0 ML OR 0 

CEPHALEXIN 250 MG/5ML 0 ORL 0 

E E S 200 MG/5 ML ORAL 0 0 

E E S 400 MG/5ML ORAL 0 0 

SANTYL OINTMENT 300 GM 0 

EDECRIN 25 MG TAB 0 0 

PREGABALIN 50 MG 67 CAP 67 

RELENZA 5 MG DISKHALER 0 0 

GI COCKTAIL SOLUTION 9 9 

PRAVASTATIN 20 MG 224TAB 

224 

BONIVA 3 MG/3ML INJ 0 KIT 0 

FLUOXETINE 20MG/5ML 0 U/D 0 

SODIUM BICOARBONATE 31 8.4%V31 

CITALOPRAM 10 MD 18TAB 

18 

TAMIFLU 30 MG CAP0 0 

TAMIFLU 45 MG CAP0 0 

NACL 0.9% 20 ML VIAL0 0 

METHYLENE BLUE 1% 201 ML VL 20 

VECURONIUM 20 MG 0VIAL 

0 

MORPHINE ORAL NEO 0 .4MG/ML0

FOSPROPOFOL 1050MG/30ML 0 0 

HAVRIX HAP A VAC INJ 0 1440 0 

CHOLECALCIFERAL VITAMIN 19 D 19 

NACL 0.9% FOR INJ-PRIMARY 0 0 

STERILE H2O FOR INJ-PRIM 9 9 

DAKINS SOLUTION 0.5% 0 FULL 0 

DAKINS SOLUTION .25%(1/2) 3 3 

DAKINS SOLUTION .125% 0 1/4 0 

LACTULOSE ENEMA 200GM0 0 

HYDROGEN PEROXIDE 0 SOL 1.5 0 

SILVADENE 50GM/SWFI 0 1000 0 

SILVADENE 50GM/NACL 0 1000 0 

DOMEBORO 1 PKT/500ML 0 NACL0 

DOMEBORO 1 PKT/500ML 0 H2O 0 

NEOSTIGMINE 10MG/10ML 0 VL 0 

ATROPINE 1 MG/10 ML 0 INJ 0 

LIDOCAINE 5% OINT 0 0 

VALSARTAN 20 MG TAB 0 0 


VENLAFAXINE 12.5 MG 0 TAB 0 

ROSUVASTATIN 5 MG 0TAB 

0 

QUETIAPINE 12.5 MG 0TAB 

0 

PYRIDOXINE 25 MG TAB 0 0 

ASCORBIC ACID(VIT C)250MG 0 0 

ATENOLOL 12.5 MG TAB 0 0 

BENAZEPRIL 2.5 MG TAB 0 0 

BISOPROLOL 2.5 MG 0TAB 

0 

GLIPIZIDE 1.25 MG TAB 0 0 

GLIPIIZDE 2.5 MG TAB0 0 

GLYBURIDE 1.25 MG 0TAB 

0 

LEVOTHYROXINE 12.50 MG TAB 0 

LISINOPRIL 1.25 MG TAB 0 0 

METHOCARBAMOL 250 0 MG TAB0 

OXYBUTYNIN 2.5 MG 0TAB 

0 

ARIPIPRAZOLE 2.5 MG 0 TAB 0 

TETRACAINE 0.5% EYE 0 DROPS 0 

TROPICAMIDE 1% EYE 0 DROPS 0 

ERYTHROMYCIN EYE 0OINT 3.5 0 

HYDROXYZINE PAMOATE 24 50 MG24 

FLUCONAZOLE 50 MG 0 TAB 0 

CAPTOPRIL 6.25 MG TAB 0 0 

CARBAMAZEPINE 50 0MG TAB 0 

CHOLECALCIFEROL 2000 UN TB 0 

IRBESARTAN 75 MG TAB 0 0 

HYOSCYAMINE .125 MG 0 TABS 0 

PEPTO BISMOL 30 ML 50 50 

SILDENAFIL CITRATE 12.5 0 0

BUSPIRONE 2.5 MG TAB 0 0 

SIMETHICONE 40 MG 0CHWTAB 

0 

FONDAPARAINUX 5 MG 0 INJ 0 

FONDAPARAINUX 100MG INJ 0 

PREDNISONE 2.5 MG 0TAB 

0 

PROMETHAZINE 12.50MG TAB 0 

TRAZODONE 25 MG TAB 0 0 

POTASSIUM CHLORIDE 0 SR 5 M 0 

NABUMETONE 250 MG 0 TAB 0 


OXCARBAZEPINE 1506MG TAB 6 

OXCARBAZEPINE 75 MG 0 TAB 0 

PRIMIDONE 25 MG TAB 0 0 

SOTALOL 40 MG TAB0 0 

TIZANIDINE 2 MG TAB0 0 

AVEENO BATH 0 0 

MITOMYCIN 500 MCG 0 EYE SRG 0 

ALBUMIN 25% 50 ML 8VIAL 

8 

ALBUMIN 5% 250 ML 0VIAL 

0 

VALPROATE SODIUM 0500MG/5M0 

SORBITOL 70% 480 ML 0 BTL 0 

MORPHINE 100MG ADDV 0 VL IN 0 

INJ, MIDAZOLAM HYDR 0 1 MG 0 

INJ, HYDRO UP TO 134 4 MG 134 

OSELTAMIVIR 12MG/ML 0 SUSP 0 

PODOPHYLLYM 25% SOLN 0 15 M 0 

FUROSEMIDE 40MG/4ML 0 ORAL 0 

PEDIATRIC CODE CART0 0 

ADULT CODE CART 0 0 

GASTROVIEW(MD GASTROVIEW) 0 0 

BACLOFEN 5 MG TAB0 0 

OLMESARTAN 10 MG 0TAB 

0 

THEOPHYLLILNE SR 100MG TB 0 

PHYTONADIONE 2.5 MG 0 TAB 0 

TORSEMIDE 10 MG TAB 0 0 

INJ CEFTAZIDIME PER 050 MG 0 

INJ AMPI SOD/SULB PER 0 1.5 0 

INJ MORPHINE UP TO 010 MG 0 

INJ, VANCOMYCIN HCL 0 500MG 0 

INJ SODIUM THIO 12.5GM/50 0 0 

ADACEL DPT, .5 ML 35 INJ 35 

DAPTACEL DPT, .5 ML 0INJ 

0 

CLOPIDOGREL 300 MG 4 TAB 4 

HEP A VAC 720 ELU/.5 0 ML 0 

VANCOMYCIN 250 MG 0 CAP 0 

LIDOCAINE 1% INJ 10 41ML 

41 

MIDAZOLAM 10 MG/5ML 0 UD CP0

BACITRACIN 50 MU INJ 4 VIAL 4 

DRONEDARONE 400 MG 6 TAB 6 

AMINOPHYLLINE 500MG/20ML 0 0 

PANCRELIPASE 5,0001UNITS 

1 

PRASUGREL 5 MG TAB0 0 

PRASUGREL 10 MG 19 TAB 19 

LIDO 1% W/EPI 1:100,000 0 0 

REGADENOSON INJ 100 .4 MG/5ML 100 

HYDROXOCOBALAMIN 0 2.5GM/VL0 

TRAVOPROST Z 0.004%6 6 

HEPARIN SODIUM 120 INJ PER 10 120 

VANCOMYCIN 125MG/2.5 23 ML 23 

ENLON PLUS INJ 10MG/.14MG 0 0 

VANCOMYCIN 250MG/5ML 49 ORAL 49 

DABIGATRAN 150 MG 0 CAP 0 

DABIGATRAN 75 MG 0CAP 

0 

NICARDIPINE 25 MG/10ML 0 VL 0 

QUININE 324 MG CAP0 0 

HYDROCOR SOD SUCCINATE 0 0 

HYDRO SOD SUCCINATE 24 100MG24 

SULFAMETHOXAZOLE 0W/TMP 200 

METHYLPRED SOD SUCC 40 1000 40 

FERROUS SULFATE SR 045 MG 0 

QUETIAPINE XR 50 MG 0 TAB 0 

QUETIAPINE XR 15025 MG TAB 25 

QUETIAPINE XR 20042 MG TAB 42 

FLU 2011 12 INJ MDV 010 ML 0 

FLU 2011 12 INJ MDV 010 ML 0 

FLU 2011 12 VAC .5 ML 0 0 

FLU 2011 12 VAC .5 ML 0 0 

MISOPROSTOL 200 MCG 26 TAB 26 

ASENAPINE 10 MG TAB 0 0 

ASENAPINE 5 MG TAB0 0 

INJ, CEFEPIME HYDRO 0 500MG 0 

PREVNAR 13 INJ 0 0 

RECOMBIVAX HB INJ 0 0 

ANATACEPT 10 MG 150 INJ 150 

PANTOPRAZOLE 40 MG 5 PACKET 5 

THROMBIN BOVINE/GEL 0 BOV 0 

THROMBIN BOVINE/GEL 0 BOV 0 

DEXMEDETOMIDINE 0200MCG/2M0 

CEFEPIME 2 GM VIAL0 0 

ARIPIPRAZOLE 2 MG TAB 2 2 

MORPHINE 0.2 MG/0.2ML 0 INJ 0 

TRANEXAMIC ACID 1000MG/10 42 42 

LEVOTHYROXINE 1000MCG VL 0 

MIDAZOLAM 10MG/10 0 ML VIAL 0

TET DIPTH TOX .5 ML 23INJ 

23 

LORAZEPAM 4 MG/ML 0 VIAL 0 

LORAZEPAM 2 MG/0.5 0 ML VL 0 

CEFDINIR 250/5ML U/D 0 ORAL 0 

CEFDINIR 250/5ML BLT 0 60ML 0 

CEFDINIR 300 MG CAP0 0 

PREDNISOLONE SODIUM 28 PHOS28 

AZITHROMYCIN 500 MG 0 ADD 0 

BUPIVACAINE LIPOSOME 0 0 

MILK OF MAG 2400MG/30ML 17 17 

BESIFLOXACIN .6% OPTH 99 SOL 99 

FIDAXOMICIN 200 MG 0 TAB 0 

FACTOR VIII, ANTIHEMOPHIL 0 0 

FACTOR IX, HUMAN RECOMBIN 0 0 

ZOSYN 4.5 GM VIAL68 68 

HYDROXOCOBALAMIN 0 5GM/VIAL0 

INLUENZA 12 13 VACC 0 .5 ML 0 

LORTAB LIQ 5 334MG/10ML 1 1 

ROPIVACAINE 5MG/ML 6600 20 ML 6600 

CALMOSEPTINE OINTMENT 4 4 

VANCOMYCIN 125 MG 0 CAP 0 

ARIPIPRAZ 9.75MG/1.3MLINJ 0 0 

PALIPERIDONE 234 MG 0 VIAL 0 

PALIPERIDONE 156 MG 0 VIAL 0 

GLUCOSE(DEXTROSE)GEL 0 ORAL 0 

FLU 2012 2013 VAC .50 ML 0 

RIFAXAMIN 550 MG 12 TAB 12 

MORPHINE 250 MG 15 ADDV VIAL15 

MIRACLE MOUTHWASH 0 DUKE 0 

COMBIVENT RESPIMAT 1 100 20 1 

BIMATOPROST 0.01%2 2 

ATORVASTATIN 20 MG 43 TAB 43 

PENCICLOVIR 1% CREAM 0 0 

SULFAMETHOX/TRIMETHOPRIM 0 0 

KETAMINE 10 MG/ML 27 IV 27 

DENTAL ADHESIVE CREAM 0 0 

HYALUR SODIUM 48 MG 0 SYR 0 

RIVAROXABAN 20 MG 8 TAB 8 



APIXABAN 2.5 MG TAB0 0 

MULTIVIT/MINERAL LIQUID 0 0 

FLU 2013 14 .5 ML INJ 69 69 

APIXABAN 5 MG TAB10 10 

APLIGRAF SKIN SUBSTITUTE 0 0 

ETHYL ALCOHOL 98% 0INJ VIA 0 

HYDROCORTISONE PWD 0 COMPDG 0

ACETAMINOPH 100MG/ML 0 DROP0 

REPAGLINIDE 0.5 MG 0TAB 

0 

HYDROCORTIS 2.5% CR 1 RCTL 1 

MESALAMINE 4 GM/60ML 0 ENEM0 

MERCAPTOPURINE 50 MG TAB 0 

PYRIDOXINE 100 MG 0VIAL 

0 

HYDROCORTISONE 1000 MG ENE 0 

EPINEPHRINE 0.3MG 0AUTO-IN 

0 

FLEET BAGENEMA 0 0 

FLEET 4.5 ENEMA 22 22 

FLEET PREP KIT #1 0 0 

NON FORMULARY MED 0 0 

AMINO ACIDS 7% IV SOLN 0 0 

AA 5%/D25%W IV SOLN 0 1000M 0 

AMINO ACIDS 3.5%/D5W 0 INJ 0 

AMINO ACIDS 10% IV 0SOLN 

0 

AA 3.5%/D25W IV SOLN 0 0 

DEXTROSE 10%W/ 250ML 6 IV 6 

DEXTROSE 10%W/ IV 01000ML 

0 

DEXTROSE 20%W IV 500 0 ML 0 

DEXTROSE 5% 1/4NS 1000ML 

1 

DEXTROSE 5% 1/4NS 0500ML 

0 

DEXTROSE 5% 1/4NS 0250 ML 0 

D5W-1/4NS KCL 40MEQ/1000M 0 0 

D5W-1/4NS 20MEQ/1000ML 0 0 

D5W-1/2NS 1000ML 57IV SOLN 57 

D5W-1/2NS KCL40 MEQ/1000M 

16 16 

D5-1/2NS KCL 20 MEQ/L 21 IV 21 

DEXTROSE 50%-WATER 0 500 ML 0 

DEXTROSE 5%-LR 1000 45 ML IV 45 

DEXTROSE 5%-NS IV 98 1000ML 98 

D5W-NS 20 MEQ KCL/LITER 11 11 

D5W 1000 ML IV BAG15 15 

D5W 250 ML PVC IV 42BAG 

42 

D5W 50 ML PVC IV 22 BAG 22 

D5W 250 ML ADDV 137 IV BAG 137 

D5W 100 ML PVC 106 IV BAG 106 

D5W 500 ML IV BAG37 37 

NS KCL 20 MEQ/LITER 42IV 

42 

NS KCL 20 MEQ/LITER 30IV 

30 

OXYTOCIN-NS 30 UNITS/500M 96 96 

D5W 100 ML ADDV 256 IV BAG 256 

CONTAINER EVAC BOT 0 1000 M 0 

CONTAINER EVAC BOT 0 250ML 0 


CONTAINER EMPTY BAG 0 LITER 0 

CONTAINER EMPTY BAG 0 250 0

CONTAINER EMPTY BAG 0 500 M 0 

HETASTARCH 6%/NS 0500ML 

0 

FAT EMULSION 20% IV 0 200ML 0 

FAT EMULSION 10% IV 0 500ML 0 

LACTATED RINGERS 691 1000 ML 691 

NACL 0.9% 100 ML 248 IVPB 248 

NACL 0.45% 1000 ML 26BAG 

26 

NACL 0.9% 1000 ML 1025 IV BAG 1025 

NACL 0.9% 500 ML 437 BAG 437 

NACL 0.9% 100 ML 142ADDV 

142 

NACL 0.9% 25084000 ML PVC 84000 

MANNITOL 20% IV BAG 0 500ML 0 

STERILE WATER INJ 1000 ML 0 

WATER FOR INJ 250 ML 0 GLS 0 

MAGNESIUM SULF 160 40GM/LITER 160 

7 HIGH PRESSURE SET" 0 0 

BLOOD I.V. SET 0 0 

SURGICAL IV SET 0 0 

IV FILTER SET 0 0 

BLOOD PUMP SET #4602 0 0 

SECONDARY SET 0 0 

PRIMARY IV SET 0 0 

DEXTROSE 5% 250ML 0GLS BTL 0 

NACL 0.9% 250 ML 82 ADDV 82 

D5%W-1/2NS 250ML 0BAG INJ 0 

D5%W 1/2NS 500ML 0BAG INJ 0 

LMD 10% W/5% DEXTROSE 0 500 0 

STERILE WATER INJ 1000 ML 0 

NACL 0.9% 250ML GLASS 0 BTL 0 

DILTIAZEM DRIP KIT VIAL 0 0 

METRONIDAZOLE 125MG 0 PB 0 

0.9% NACL 250ML EXCEL 0 0 

0.9% NACL 50ML PAB 29 PB 29 

0.9% NACL 100ML PAB 15 15 

D5W 50ML PAB 0 0 

D5W 250ML EXCEL PGBK 0 0 

D5W 100ML PAB 2 2 

D5W 400ML 18 18 

AZITHROMYCIN 500MG/250ML 0 0 

DOXYCYCLINE 100MG/250ML 0 0 

ERTAPENAM 1GM/100ML 0 IVPB 0 

NAFCILLIN 1GM/100ML 0 IVPB 0 

CEFOXITIN 1GM/50ML 17 IVPB 17 

UNASYN 1.5GM/100ML 0 NACL 0 

UNASYN 3GM/100ML 0NACL 

0 

CEFTAZIDINE 2 GM/100 148 ML 148 

VANCOMYCIN 500 MG/100 0 ML 0

FLUCONAZOLE 400 MG/200 0 ML 0 

ZOSYN 3.375 GM/100 0ML 

0 

AMPICILLIN 1 GM/100 0 ML 0 

CEFUROXIME 1.5 GM/100 0 ML 0 

AMPICILLIN 2GM/100ML 0 IVPB 0 

PENICI G 2.5MIL UNITS/100 0 0 

PENICI G 5MIL UNITS/100ML 0 0 

MAGNESIUM 2 GM/50ML 92 IVPB92 

PENICILLIN G5 MILL UN/250 0 0 

MORPHINE 1000 MG/100 0 ML 0 

MORPHINE 500 MG/50 0 ML 0 

.45% SODIUM CHL/20 18MEQ KL 18 

AZACTAM 1 GM/50 ML 0 D5W 0 

LIPOSYN III 20% INJ 500ML0 0 

HYDROMORPHONE 25MG/100ML 

0 0 

HYDROMORPHONE 100MG/100ML0 0 

INJ CEFTAZIDIME PER 4500MG 

4 

NITRO 50MG/250 BTL 0INJ 

0 

NOREPINEPHRINE 4MG/1000 0 0 

DILTIAZEM 125MG/125ML 0 MIX 0 

INJ, LORAZEPAM, 2MG0 0 

INJ, LORAZEPAM 2 MG0 0 

INJ LORAZEPAM 2 MG0 0 

INJ MIDAZOLAM HYDRO/1MG 0 0 

PHENYTOIN 500MG/100ML 0 KIT 0 

NITRO 25MG/D5W 250 3 ML 3 

VECURONIUM 100MG/100 0 INJ 0 

AMIODARONE INJ, 30 10MG 

10 

AMIODARONE INJ 300MG 

0 

PROPOFOL 1% INF(10 0MG/ML) 

0 

NICARDINE .1 MG D5W 0 200ML 0 

CINDAMYCIN 600MG/D5W 0 100 0 

CLINDAMYCIN 900MG/D5W 0 1000 

INJ FLUCONAZOLE 2000 MG 0 




HEPARIN 25000 UN/500ML 0 BG 0 

CEFEPIME 1 GM/50 ML 0 D5W 0 


D5W 250 ML VISIV 0 0 

AMIODARONE 360MG/200MLD5W 

12 12 

CEFAZOLIN 2 GM/50 192ML D5W192 

HEPARIN 25,000 UN/500 25 ML 25 


.45 NACL 500 ML 0 0 

ACETAMINOPHEN 436 10 MG/ML 436 IV

RED CAP LUER LOCK MED 0 SUP 0 

INTUBATION KIT 0 0 

IV EQUIPMENT 1 SET0 0 

CONTAINER EMPTY IV 0 100ML 0 

CONTAINER EMPTY 13 IV 100ML 13 

EMPTY IV BAG 250ML0 0 

EMPTY IV BAG 250ML0 0 

CONTAINER EMPTY BAG 0 LITER 0 

CONTAINER EMPTY 10 BAG 500 M10 



CONTAINER EVAC BOT 0 1000 M 0 

EVAL SPEECH & LANGU(PROC) 11 11 

SPEECH & LANG TX (PROC) 33 33 

SWALLOW EVAL (PROC) 20 20 

SWALLOW TX (PROC) 33 33 

AAC EVAL NON-SP GEN(PROC) 0 0 

AAC EVAL SP GEN 1ST 0HR 

0 

AAC 30 ADD'L MIN 0 0 

VIDEO FLUORO EVAL 5(PROC) 

5 

DVLPMT COG SKILLS PER 0 15 0 

TREATMENT SP/LANG, 0 GRP 0 

AC THER SVC SPEECH 0GEN 

0 

EVAL VOICE PROSTHETIC 0 DEV 0 

SPEECH STROKE SCREEN 0 0 

SPEECH OUTPT VISIT76 76 

SPEECH INPT VISIT 43 43 

SPEECH IP-NO CHARGE 1 1 

SP/CANCELLED VISIT 0 0 

SP/CANCELLED-DSCHGD 0 0 

SP-ABSENT 0 0 

DVLPT, COG SKILL PER 64 15 M 64 

AAC THER SVC, SPEECH-GEN 0 0 

EVAL NON SPEECH EA 0ADD'L 

0 

SPEECH&LANG EVAL(PRO 0 DLS 0 

SPEECH&LANG TX(PROC) 0 0 

SWALLOW EVAL (PROC) 0 DLS 0 

SWALLOW TX (PROC) 0DLS 

0 

DVLPMT COG SKILL PER 0 15 M 0 

TREATMENT SP/LANG, 0 GROUP 0 

AAC THER SVC, SPEECH-GEN 0 0 

EVAL VOICE PROS DEVICE 0 0 

MOTION FLUORA EVAL 0 (MBS) 0 

EVAL NON SPEECH ADD'L 0 30 0 

SP-STROKE SCREEN DLS 0 0 

SP OUTPT VISIT DLS 0 0 

SP-CANCEL-DISCH DLS0 0

SP-CANCEL VISIT DLS0 0 

SP-ABSENT DLS 0 0 

PLFD SPEECH&LANG 3EVAL(PRO 

3 

SPEECH&LANG TX(PROC) 30 PLF 30 

SWALLOW EVAL (PROC) 1 PLF 1 

SWALLOW TX (PROC) 1PLF 

1 

AAC EVAL NON SP(PROC 0 PLF 0 

AAC EVAL SP 1ST HR 0PLF 

0 

AAC 30 ADD'L MIN PLF0 0 

AAC THER SERV (PROC) 0 PLF 0 

DVLPT,COG SKILL 15MIN 48 PLF 48 

EVAL NON SPEECH EA 0ADD'L 

0 

SP-STROKE SCREEN PLF 0 0 

SP-OUTPAT VISIT PLF51 51 

SP-CANCEL VISIT PLF 0 0 

SP-CANCEL-DISCH PLF0 0 

SP-ABSENT PLF 0 0 

SPINAL ANES 1ST 1/2 41HR 

41 

SPINAL ANES EA ADDL 194 15MIN 194 

MONITORED ANES 419 1ST 1/2 HR419 

MONITORED AN EA 110 ADDL 15MI 110 

OB EPIDURAL ANES39 39 

OB SPINAL EA ADDL 15 0 MIN 0 

OB SPINAL ANES 1ST 01/2 HR 0 

GENERAL ANES 1ST 156 1/2 HR 156 

GENERAL ANE EA ADDL 583 15MIN583 

IV RGNL BLOCK 1ST 17 1/2 HR 17 

IV RGN BLOCK EA ADDL 13 15MI 13 

OR EPIDURAL AN 1ST 61/2 HR 6 

OR EPIDURAL EA ADDL 16 15MIN 16 

PRE OP PAIN BLOCK26 26 

EVALUATION (PROC) 74DLS 

74 

RE-EVALUATION (PROC) 4 DLS 4 

GAIT TRAINING/15 MIN 12 DLS 12 

THERAPEUTIC EX/15MIN 716 DLS 716 

ULTRASOUND/15 MIN 57 DLS 57 

PARAFIN (PROC) DLS0 0 

E-STIM MAN ATT/15MIN 1 DLS 1 

ESTIM INTER UNAT(PRO 15 DLS 15 

TENS (PROC) DLS 4 4 

ADL PER 15 MIN DLS 0 0 

THER PROC GROUP DLS 0 0 

CHCKOT ORTH/PROS 015 DLS 0 

IONTOPHORESIS/15 MIN 0 DLS 0 

MECHAN TRACTION(PROC 15 DLS 15 

NEURO MUSC RE-ED/15M 122 DLS122 

MANUAL THER TECH/15M 358 DLS 358

PROSTETIC TRAIN/15MI 0 DLS 0 

THERAP ACTIVITY/15MI 0 DLS 0 

KNEE STRAPPING (PROC 0 DLS 0 

ANKLE/FOOT STR(PROC) 0 DLS 0 

HIP STRAPPING (PROC) 0 DLS 0 

CONTRAST BATHS/15MIN 0 DLS 0 

WHEELCHAIR MGMT/15 0 MIN 0 

DLSN FOWOJT L39330 0 

THER PROC, GROUP 0 0 

CHCKOUT, ORTH/PROS 0 PER 15 0 

DLSN PT VASOPNEUMO 76 DEVICE76 

DLSN ELECTRODES 0 0 

DLSN PUTTY 0 0 

DLSN TENS UNIT 0 0 

DLSN THERABAND 0 0 

DLSN GAUZE 2X2 0 0 

DLSN GAUZE 4X4 0 0 

DLSN KERLIX ROLLS 0 0 

DLSN KERLIX SPONGE0 0 

DLSN TELFA 8X3 0 0 

DLSN PADS ABD 10X80 0 

DLSN-STROKE SCREEN0 0 

DLSN-OUTPATIENT 643 VISIT 643 

DLSN-OP NO CHARGE3 3 

DLSN-ABSENT 0 0 

DLSN/CANCELLED VISIT 0 0 

DLSN/CANCELLED-DSCHG 0 0 

EVALUATION (PROC) 71PLF 

71 

PLFD RE-EVALUATION 3(PROC) 

3 

GAIT TRAINING/15 10 MIN PLF 10 

THERAPEUTIC EXERCISE/15 681 681 

ULTRASOUND PER 118 15MIN PLF118 

WHIRLPOOL (PROC) PLF 0 0 

PARAFIN (PROC) PLF 0 0 

ELECT STIMULATION 0PER 15 0 

ELECTRICAL STIM(UNATTEND) 120 120 

TENS APPLICATION PLF 1 1 

SLF CARE HOME MGMT 2 ADL/15 2 

IONTOPHORESIS/15 MIN 0 DLS 0 

MECHANICAL TRAC(PROC) 28 DLS 28 

NEURO MUSC RE-ED/15M 138 PLF138 

MAN THER PER 15407 MIN PLF 407 

PROSTHET TRAIN/15MIN 0 PLF 0 

THERAPEUTIC ACT PER 0 15 0 

PHYS PERFTEST FTE 15 0 MIN 0 

ANKLE/FOOT STRAP(PROC)PLF 0 0 

THERA PROCEDURE GROUP 0 PLF 0

CHCKOT ORTH PROS 0PER 15 0 

WHEELCHAIR MGMT 0/15 MIN 0 

ORTHOTIC TRAINING 0/ 15MIN 0 

PLFD ELBOWORTHO L3702 0 0 

PLFD EWHORTHO L3763 0 0 

PLFD EWHFOWOJT L3765 0 0 

PLFD PT VASOPNEUMO 54 DEVICE54 

PLFD ELECTRODES 0 0 

PLFD PUTTY 0 0 

PLFD TENS UNIT 0 0 

PLFD THERABAND 0 0 

PLFD GAUZE 2X2 0 0 

PLFD GAUZE 4X4 0 0 

PLFD KERLIX ROLLS 0 0 

PLFD KERLIX SPONGE0 0 

PLFD TELFA 8X3 0 0 

PLFD PADS ABD 10X80 0 

PLFD STROKE SCREEN0 0 

PLFD-OUTPATIENT 688 VISIT 688 

PLFD-OP NO CHARGE6 6 

PLFD-ABSENT 0 0 

PLFD/CANCELLED VISIT 0 0 

PLFD/CANCELLED-DSCHG 0 0 

EVALUATION (PROC) 233 233 

RE-EVALUATION (PROC) 0 0 

GAIT TRAINING PER 256 15 MIN 256 

THERAPEUTIC EX 1181 PER 15 MIN1181 

ULTRASOUND PER 15 37MIN 

37 

WHIRLPOOL (PROC) 0 0 

PARAFIN (PROC) 0 0 

E-STIM,MANUAL ATTEND/15MI 13 13 

E-STIM INTER UNATTEN(PROC 83 83 

TENS (PROC) 2 2 

ADL-15 PER 15 MIN 0 0 

IONTOPHORESIS PER 015 MIN 0 

MECHANICAL TRACTION(PROC) 4 4 

NEURO-MUSC RE-EDUCAT/15MI 

81 81 

MANUAL THER TECHNIQ/15MIN 

381 381 

PROSTHETIC TRAINING/15MIN 0 0 

THERAPEUTIC ACTIVITY/15MI 297 297 

SHORT ARM SPLINT STA(PROC 0 0 

KNEE STRAPPING (PROC) 0 0 

ANKLE/FOOT STRAPPING(PROC 0 0 

HIP STRAPPING (PROC) 0 0 

W/C MOB/MANAGE PER 0 15 MIN0 

ORTHOTIC FIT & TRAIN/15MI 0 0 

WHFOJTL L3806 0 0

WHFOWOJT L3808 0 0 

HFOWOJT L3913 0 0 

CPM SET UP 11 11 

CPM PADS 11 11 

CPM RENTAL 40 40 

ELECTRODES 0 0 

PUTTY 0 0 

TENS UNIT 0 0 

THERABAND 0 0 

GAUZE 2X2 0 0 

GAUZE 4X4 0 0 

KERLIX 4-1/2" 0 0 

KERLIX SPONGE 0 0 

TELFA 8X3 0 0 

PADS ABO 10X8 0 0 

CERV COLLAR-FORM 0FIT 

0 

VASOPNEUMATIC DEVICE 53 53 

FLUIDOTHERAPY 0 0 

PT STROKE SCREEN 0 0 

DKH/INPATIENT VISIT 365 365 

DKH/IP NO CHG 15 4 4 

DKH/CANCELLED VISIT0 0 

DKH/CANCELLED-DSCHGD 0 0 

DKH/OUTPATIENT 796 VISIT 796 

DKH/OP NO CHG 1512 12 

DKH/ABSENT 0 0 

OT EVALUATION (PROC) 91 91 

OT RE-EVALUATION (PROC) 1 1 

OT EXERCISE PER 15 MIN 8 8 

OT THERAPEUTIC ACTIV/15MI 126 126 

OT ULTRASOUND PER 1315 MIN 13 

OT WHIRLPOOL (PROC) 0 0 

OT PARAFIN (PROC) 0 0 

OT ESTIM,MANUAL ATT/15MIN 1 1 

OT ESTIM,INTER UNATT(PROC 1 1 

OT TENS (PROC) 0 0 

OT ADL-15 PER 15 112 MIN 112 

OT IONTOPHORESIS/15 0 MIN 0 

OT NEUR-MUSC RE-ED/15 110 MIN110 

OT MANUAL THER 210 TECH/15MIN 210 

OT PROSTHETIC TRAIN/15MIN 0 0 

OT ANKLE/FOOT STRAP(PROC) 0 0 

OT HIP STRAPPING (PROC) 0 0 

OT CONTRAST BATHS/15 0 MIN 0 

OT COGNITIV RE-TRAIN/15MI 0 0 

OT SENSORY INT TECH/15MIN 0 0 

OT W/C MOB/MANAGE/15 0 MIN 0

OT AQUATIC REHAB/15 0 MIN 0 

OT ORTHOTIC FIT&TRN/15MIN 0 0 

OT WHFOJT L3806 0 0 

OT WHFOWOJT L38080 0 

OT ELBOWORTHO L3702 0 0 

OT WHOWOJT L39060 0 

OT HFOWOJT L3913 1 1 

OT HOWOJT L3919 0 0 

OT HFO1+JT L3921 0 0 

OT FOWOJT L3933 0 0 

MOLDED INSERT PREFAB 0 0 

OT-VASOPNEUMATIC 26DEVICE 

26 

OT-FLUIDOTHERAPY 0 0 

ELECTRODES 0 0 

PUTTY 0 0 

THERABAND 0 0 

OT-GAUZE 2X2 0 0 

OT GAUZE 4X4 0 0 

OT-KERLIX RLS 4-1/2 0 0 

OT-KERLIX SPONGE 0 0 

OT-TELFA 8X3 0 0 

OT-PADS ABO 10X8 0 0 

WHO, NON TORSION 0JOINTS 

0 

EO,ADJ POS LOCK, ACTV 0 CL 0 

EO, EXT/FLEX ASSIST 0L3730 

0 

EWHO, NON TORSION 0 JOINTS 0 

EWHFO, NON TORSION 0 L3766 0 

SO, ABD POS, W/O JOINTS 0 0 

OT STROKE SCREEN 0 0 

OT INPATIENT VISIT68 68 

OT-CANCELLED VISIT0 0 

OT-CANCELLED-DSCHGD 0 0 

OT ABSENT 0 0 

OT DKH/OP NO CHG 1 1 

OT DKH/IP NO CHG 7 7 

OT OUTPAT VISITS201 201 

DLSN OT EVALUATION 19 (PROC) 19 

DLSN OT RE-EVAL (PROC)DLS 1 1 

THERA PROCEDURE 54 PER 15MIN54 

THERAP ACT/15 MIN 4DLS 

4 

ULTRASOUND/15 MIN 19 DLS 19 

WHIRLPOOL (PROC) DLS 0 0 

PARAFIN (PROC) DLS15 15 

ELECT STIM ATTEND PER 0 15 0 

ELECT STIM UNATTENDED 1 DLS 1 

TENS APPLICATION DLS 0 0 

SELF CARE HME MGMT 1 15 MIN 1

IONTOPHORESIS PER 015 MIN 0 

NEUR MUS RE ED PER 915 MIN 9 

MANUAL THERAPY 259 PER 15 MIN259 

PROSTETIC TR/15MIN 0DLS 

0 

PHYS PERF (FTE)/15 MIN 0 0 

KNEE STRAP(PROC) DLS 0 0 

ANKLE/FOOT STRAP(PROC) 0 0 

HIP STRAP (PROC) DLS0 0 

COMM/WORK REINTEG 0 PER 15 0 

DEVE COGN SK/15MIN 0 DLS 0 

SENSORY INT TECH PER 0 15 0 

WHEELCHAIR MGMT 0PER 15MIN0 

DLSN OT EWHFOWOJT 0 L3765 0 

DLSN OT HOWOJT L3919 0 0 

DLSN OT HFO1+JT L3921 1 1 

DLSN OT VASONEUMO 0 DEVICE 0 

DLSN OT ELECTRODES0 0 

DLSN OT PUTTY 0 0 

DLSN OT THERABAND0 0 

DLSN OT GAUZE 2X2 0 0 

DLSN OT GAUZE 4X4 0 0 

DLSN OT KERLIX ROLLS0 0 

DLSN OT KERLIX SPONGE 0 0 

DLSN OT TELFA 8X3 0 0 

DLSN OT PADS ABD 10X80 0 

OT DLSN STROKE SCREEN 0 0 

OT DLSN-CANCELLED 0VISIT 

0 

OT DLSN-CANCELLED 0DISCHGD 

0 

OT DLSN-ABSENT 0 0 

OT DLSN-OP NO CHG0 0 

OT DLSN-OUTPAT VISIT 153 153 

PLFD OT EVALUATION 22 (PROC) 22 

PLFD OT RE-EVAL (PROC) 1 1 

THERA PROCEDURE 149 /15 MIN 149 

THERAP ACT/15 MIN 5PLF 

5 

ULTRASOUND/15 MIN 24 PLF 24 

PARAFFIN(PROC) PLF1 1 

ELECT STIM ATTENDED/15MIN 0 0 

ELECTRICAL STIM UNATTEND 11 11 

TENS APPLICATION PLF 0 0 

SELF CARE HOME MGMT 5 ADL15 5 

IONTOPHORESIS/15MIN 4 PLF 4 

NEUR MUSC RE ED / 58 15 MIN 58 

MANUAL THERAPY 123 PER 15 MIN123 

PROSTH TRAIN/15MIN 0 PLF 0 

KNEE STRAP (PROC) PLF 0 0 

ANKLE/FOOT STRAPPING 0 PROC 0

HIP STRAP (PROC) PLF0 0 

SENSORY INT TECH / 015 MIN 0 

WHEELCHAIR MGMT 0PER 15MIN0 

PLFD OT WHFOWOJT 0L3808 

0 

PLFD OT ELBOWORTHO 0 L3702 0 

PLFD OT WHOWOJT L3906 0 0 

PLFD OT HFOWOJT L3913 0 0 

PLFD OT HOWOJT L3919 0 0 

PLFD OT HFO1+JT L3921 0 0 

PLFD OT FOWOJT L3933 0 0 

PLFD OT VASOPNEUMO 41 DEVICE41 

PLFD OT ELECTRODES0 0 

PLFD OT PUTTY 0 0 

PLFD OT THERABAND0 0 

PLFD OT GAUZE 2X2 0 0 

PLFD OT GAUZE 4X4 0 0 

PLFD OT KERLIX ROLLS0 0 

PLFD OT KERLIX SPONGE 0 0 

PLFD OT TELFA 8X3 0 0 

PLFD OT PADS ABD 10X80 0 

OT PLFD-STROKE SCREEN 0 0 

OT PLFD-CANCELLED 0VISIT 

0 

OT PLFD-CANCELLED 0DSCHGD 

0 

OT PLFD-ABSENT 0 0 

OT PLFD-OP NO CHG1 1 

OT PLFD-OUTPAT VISIT 193 193 

INDIV THERAPY 45365 MIN 365 

GROUP THERAPY 52 52 

THERAPY&MED EVAL-MD 0 45 50 0 

INJECTION SC, IM 4 4 

FAMILY PSYCHOTHERAPY 40 40 

MUL FAMILY GRP THERAPY 0 0 

TELE TRIAGE NON BILLABLE 0 0 

SUPERVISION TIME NON 0 BILL 0 

INTERACTIVE INTERVIEW 0 0 

FAM THERAPY W/O PATIENT 8 8 

PREPARE PATIENT HIST 2 RPT 2 

LEVEL I MD 0 0 

LEVEL II MD 0 0 

LEVEL III MD 0 0 

LEVEL IV MD 167 167 

LEVEL V MD 0 0 

LEVEL I APRN 0 0 

LEVEL II APRN 0 0 

LEVEL III APRN 17 17 

LEVEL IV APRN 225 225 

LEVEL V APRN 0 0

INITIAL PSYCH EVAL MD 2 2 

INI PSYCH EVAL PSYCHOLOGI 7 7 

EMERG PSYCH EVAL NON 0 1ST 0 

EMER PSYCH EVL NONCR 93 NON 93 

EMER PSYCH EVAL NON 0 CR MD 0 

EMER PSYCH EVAL NON 17 CR NO 17 

EMER PSYCH EVAL CR 8MD 

8 

EMER PSYCH EVAL CR 15NON MD15 

EMERG PSYCH EVAL CR 0 MD EA 0 

EMER PSYCH EVAL CR 26NON MD26 

IND THER 30 MIN W/MED 0 MD 0 

IND THERAPY 30W/MED 0 APRN 0 

INITIAL PSYCH EVAL 13 APRN 13 

INITAL PSYCH EVAL LCSW 16 16 

INDIV THERAPY 30 MIN 48 48 

IND PSYCHOTHERAPY 060 MIN 0 

EAP PREV COUNSELING 0 INDIV 0 

AEROSOL SUPPLIES 4 4 

AEROSOL INITIAL TREATMENT 4 4 

AEROSOL SUBSEQUENT 0 0 

ARTERIAL PUNCTURE17 17 

CHEST PHYSIOTHE INIT 0 0 

CHEST PHYSIOTHE SUBS 0 0 

INDUCED SPUTUM INIT 1 1 

INDUCED SPUTUM SUBSE 0 0 

MDI INITIAL TREATMENT 138 138 

MDI SUBSEQUENT 150 TREATMANT 150 

OXYGEN 278 278 

OXYGEN SUPPLIES 37 37 

VITAL CAPACITY 18 18 

SVN SUPPLIES 147 147 

SVN INITIAL TREATMENT 365 365 

SVN SUBSEQUENT 637 TREATMENT 637 

VENTILATOR 1ST DAY4 4 

VENT SUBSEQUENT DAYS 4 4 

BIPAP/CPAP 30 30 

BIPAP/CPAP SUPPLIES 13 13 

PULSE OXIMETRY W/EXE 0 0 

PULSE OXIMETRY OVERN 1 1 

FLUTTER VALVE 11 11 

FLUTTER VALVE INITIA 11 11 

FLUTTER VALVE SUBSEQ 8 8 

INHALATION TEACH&EVA 18 18 

SMOKING CESSATION 10ED 

10 

PLETHYSOMOGRAPHY 36 36 

LUNG VOLUME (TGV) 36 36 

BEDSIDE FVL 1 1

M V V 0 0 

METHACHOLINE EVAL5 5 

ARTERIAL PUNCT-PUL 0KIT 

0 

DLCO 36 36 

SPIROMETRY 2 2 

SPRIOMETRY W/BRONCHO 39 39 

PULSE OXIMETRY 0 0 

PULSE OX W/EXERCISE 10 10 

INHALATION TEACH&EVA 1 1 

PROVOCHOLINE PER 321MG 

32 

MOBILITY CURRENT STATUS 4 4 

MOBILITY GOAL STATUS 10 10 

MOBILITY D/C STATUS4 4 

BODY POS CURRENT 0STATUS 

0 

BODY POS GOAL STATUS 0 0 

BODY POS D/C STATUS 0 0 

CARRY CURRENT STATUS 0 0 

CARRY GOAL STATUS0 0 

CARRY D/C STATUS 1 1 

SELF CARE CURRENT 0STATUS 

0 

SELF CARE GOAL STATUS 0 0 

SELF CARE D/C STATUS 1 1 

OTR PT/OT STATUS 0 0 

OTHER PT/OT GOAL STATUS 0 0 

OTHER PT/OT D/C STATUS 0 0 

SUB PT/OT CURRENT 0STATUS 

0 

SUB PT/OT GOAL STATUS 0 0 

SUB PT/OT D/C STATUS 0 0 





0 







2 



OTR PT/OT CURRENT 0STATUS 

0 




0 



SWALLOW CURRENT 1STATUS 

1

SWALLOW GOAL STATUS 4 4 

SWALLOW D/C STATUS 1 1 

MOTOR SPEECH CURRENT 0 STAT 0 

MOTOR SPEECH D/C 0STATUS 

0 

LANG COMP CURRENT 0 STATUS 0 

LANG COMP GOAL STATUS 0 0 

LANG COMP D/C STATUS 0 0 

LANG EXPRESS CURRENT 0 STAT 0 

LANG EXPRESS GOAL 0STATUS 

0 

LANG EXPRESS D/C STATUS 0 0 

ATTEN CURENT STATUS 0 0 

ATTEN GOAL STATUS0 0 

ATTEN D/C STATUS 0 0 

MEMORY CURRENT STATUS 0 0 

MEMORY GOAL STATUS 0 0 

MEMORY D/C STATUS0 0 

VOICE CURRENT STATUS 0 0 

VOICE GOAL STATUS 2 2 

VOICE D/C STATUS 0 0 

SPEECH LANG CUR STATUS 0 0 

SPEECH LANG GOAL STATUS 0 0 

SPEECH LANG D/C STATUS 0 0 

MOTOR SPEECH GOAL 0 STATUS 0 


MOBILITY CURRENT 26 STATUS 26 












3 


5 


2 


0 


0 


0 






SWALLOW GOAL STATUS 0 0





LANG CAMP GOAL STATUS 0 0 










0 


0 


0 


0 


0 


0 


























1 


0 


1 


0


0 


0 







ATTEN CURRENT STATUS 0 0 






































VOICE CURRENT STATUS 0 0
















SPEECH LANG CURRENT 0 STAT 0 









SPECH LANG GOAL STATUS 0 0 






















MOBILITY GOAL STATUS 0 0









MOBILITY D/C STATUS 12 12 









0 


1 


2 


0 


1 


1 


0 


0 


0 


0 


0 


0 



















CARRY CURRENT STATUS 1 1




















1 


0 


0 


0 


0 


0 












OTHER PT/OT CURRENT 0 STATU 0 


OTHER PT/OT CURRENT 0 STAT 0 




OTHER PT/OT STATUS1 1 





OTHER PT/OT GOAL STATUS 0 0







SUB PT/OT STATUS 0 0 


0 


0 


0 


0 


0 


































CARRYD/C STATUS 0 0 

CARRY D/C STATUS 0 0



3 


3 


3 


3 


1 


0 


















OTHER PT/TO CURRENT 0 STAT 0 














0 


0 


0 


0 


0 


0 




SUB PT/OT GOAL STATUS 0 0









DKH AIM PMT 0 0 

GUEST TRAY 20 20 

GUEST MEAL SPECIAL0 0 

SELF PAY DISCOUNT -392 -392 

STATE MLIA ALLOWANCE -827 -827 

CARE PAYMENT ALLOWANCE 0 0 

RETURNED CK FEE ALLOW 2 2 

ESCH SOC SM CR BAL1 1 

COMB ACCT BAL ALLOW -18 -18 

ONE CALL MEDICAL ALLOW -5 -5 

MBSC ALLOWANCE 0 0 

NIPPON LIFE ALLOWANCE 0 0 

CAREPYMT ADD ON AR 0 ALLOW 0 

REFUND 0 0 

VOIDED REFUND 0 0 

MEDICARE ALLOW-5284 -5284 

MCR IP PART B ONLY 0ALLOW 

0 

PSY UNTD BEHAVE -37 MED ALLOW-37 

TRAILBLAZER ALLOW0 0 

PSYCH MHN MED AV 0ALLOW 

0 

MEDICARE APPEALS -1 ALLOW -1 

MEDICARE MAN CARE -4 ALLOW -4 

FALLON SENIOR PLAN -4ALLOW 

-4 

BLUE CHIP ALLOW -7 -7 

TUFTS MCR PREFERRED 0 ALLOW 0 

HLTHNT SMARTCHOICE 0 ALLOW 0 

AMER PROG T/OPTION 0 ALLOW 0 

EVERCARE MEDICARE -3ALLOW 

-3 

CONNECTICARE MCR -516ALLOW-516 

HEALTHNET PEARL MCR 0 ALLOW 0 

AETNA MEDICARE ADV -29 ALLOW-29 

MEDICARE SECONDARY -48 ALLOW-48 

CIGNA MEDICARE ADV -1 ALLOW -1 

AARP MED COMPLETE -829 ALLOW-829 

H/L MCR PRO FEE OTHER 0 0 

WORKERS COMP OF RI 0 ALLOW 0 

SUPP STATE ALLOW-220 -220 

H/L MCR ABN N/S MCAID -82 SUP -82 

H/L MCR ABN SIGNED -6MCAID 

-6

SUPP BLUE CROSS -237 ALLOW -237 

SUPP TRICARE ALLOW0 0 

SUPP COMM ALLOW-3 -3 

RAC MEDICARE RECY 0ALLOW 

0 

FIRST COAST MCR-B -396 ALLOW -396 

H/L MDCRE TIMELY FILING -5 -5 

H/L MDCRE REG ERROR 0 0 

H/L MEDICARE OTHER0 0 

H/L MEDICARE NON CREDENTI 0 0 

H/L MDCR CLINICAL -1 ERROR -1 

H/L MDCRE NO AUTH 0ON FILE 0 

H/L MEDICARE MEDICAL -130 NEC-130 

H/L MDCRE DAYS DENIED 0 0 

H/L MDCRE AUTH/SVC 0 MISMTC 0 

H/L MDCRE NON COVERED -208 SVC -208 

H/L MDCRE ADMINISTRATION 0 0 

H/L MDCRE PATIENT/MEMBER 0 0 

H/L MEDICARE RAC MED -1 NEC -1 

H/L MCR RAC DRG CHANGE 0 0 

H/L MCR 1 DAY PRE PAY 0 DNL 0 

H/L MCR 1 DAY POST 0PAY DL 0 

H/L MCR PRO FEE MED -2 NEC -2 

H/L MCR PRO FEE TIMELY -1 FL -1 

H/L MCR PRO FEE NO 0AUTH 

0 

H/L MCR PRO FEE CREDENTL -15 -15 

MEDICAID ALLOWANCE -441 -441 

PSYCH BEHAVORAL HLTH 0 ALLW 0 

STATE AGENCIES ALLOW -3 -3 

LMHA ALLOW 0 0 

HEALTHNET MCD MCO 0 ALLOW 0 

BLUE CARE FAMILY ALLOW 0 0 

COMM HLTH NETWK 0MCD ALLOW0 

PREF ONE/FST CHC ALLOW 0 0 

AETNA BETTER HLTH 0ALLOW 

0 

AMERICHOICE UNHLTHC 0 ALLOW0 

OUT OF STATE MEDICAID -9 ALL -9 

RI MEDICAID ALLOWANCE -4 -4 

COVENTRY HEALTH ALLOWANCE 

-5 -5 

MASS MEDICAID ALLOW -17 -17 

NEW YORK MEDICAID -1ALLOW 

-1 

FIRST HEALTH ALLOWANCE 0 0 

CHARTER OAK CHN ALLOW 0 0 

CH OAK AMERICHOICE 0 ALLOW 0 

CH OAK AETNA B/HLTH 0 ALLOW 0 

MEDIBLUE ALLOWANCE -20 -20 

TCORS AUTO ALLOWANCE 0 0 

SAFETY NET FOUND ALLOW 0 0

MIC MEDICAID INTGRTY 0 ALLW 0 

H/L MCAID TIMELY -39 FILING -39 

H/L MCAID REG ERROR 0 0 

H/L MEDICAID OTHER0 0 

H/L MEDICAID NON CREDENTI 0 0 

H/L MDCD CLINICAL ERROR 0 0 

H/L MEDICAID NO AUTH -64 -64 

H/L MEDICAID MEDICAL 0 NEC 0 

H/L MEDICAID DAYS DENIED 0 0 

H/L MCAID AUTH/SVC 0 MISMAT 0 

H/L MEDICAID NON COVERED 0 0 

H/L MCAID ADMINISTRATION 0 0 

H/L MCAID PATIENT/MEMBER 0 0 

H/L MIC MEDICAID INTGTY 0 0 

MAINE MEDICAID ALLOWANCE -1 -1 

BLUE CROSS ANTHEM -2027ALLOW-2027 

BLUE CROSS/BC ALLOW -14 -14 

ALLOW PROF FEE BLUE -11 CROSS -11 

PSYCH BC ANTHEM -122 BEH ALLOW -122 

PSYCH BC MAGELLAN 0ALLOW 

0 

PSY BC UNTD BEHAV 0ALLOW 

0 

PSYCH BC VAL BEHAV 0ALLOW 

0 

PSYCH BC VAL OPT ALLOW 0 0 

PSY BC MGD HLTH NTWK 0 ALLW 0 

TCORS WC ALLOWANCE 0 0 

H/L B/C TIMELY FILING0 0 

H/L B/C REG ERROR 0 0 

H/L BLUE CROSS OTHER 0 0 

H/L BLUE CROSS NON 0CRED 

0 

H/L BL CR CLINICAL ERROR 0 0 

H/L B/C NO AUTH ON -6FILE 

-6 

H/L BCBS MEDICAL NECESSIT 0 0 

H/L BLUE CROSS DAYS -1 DENY -1 

H/L B/C AUTH/SVC MISMATCH 0 0 

H/L B/C NON COVERED 0 SVC 0 

H/L B/C ADMINISTRATION 0 0 

H/L B/C PATIENT/MEMBER 0 0 

H/L BC PRO FEE TIMELY -1 FLE -1 

H/L BC PRO FEE NO AUTH 0 0 

H/L BC PRO FEE CREDENTIAL 0 0 

H/L BC PRO FEE OTHER 0 0 

PSY CIGNA BEHAV HLTH -19 ALLW-19 

AIM CIGNA ALLOW 0 0 

AMALGAMATED LIFE 0ALLOW 

0 

CIGNA ALLOWANCE -750 -750 

CIGNA/CIGNA ALLOW0 0 

CONN GENERAL ALLOW 0 0

GOLDEN RULE ALLOW -38 -38 

GREAT WEST LIFE INS -73ALLOW 

-73 

HEALTH ADVANTAGE 0ALLOW 

0 

HEALTH CHOICE ALLOW 0 0 

HEALTHNET FOXWOODS -187 ALLOW -187 

INTERACTIVE BENEFIT -11 ALLOW -11 

JOHN ALDEN INS ALLOW 0 0 

N E DIRECT HEALTH ALLOW 0 0 

NEW ENGLAND INS ALLOW 0 0 

OXFORD HEALTH ALLOW -387 -387 

OXFORD/OXFORD ALLOW 0 0 

ORTHONET ALLOW-18 -18 

US HEALTHCARE ALLOW 0 0 

FOXWOODS BOLLORE -19ALLOW 

-19 

PSYCH VALUE OPTIONS -2 ALLOW -2 

PSYCH UNITED BEHAV -71 ALLOW -71 

AARP ALLOW 0 0 

AETNA ALLOWANCE -474 -474 

AETNA ALLOWANCE-1 -1 

ALLIED BENEFIT ALLOW0 0 

AMERIHEALTH ALLOW0 0 

APWU AM POSTAL WKR -1 ALLOW-1 

ASSOC & SOCIETY ALLOW 0 0 

ASSURANT HEALTH ALLOW -4 -4 

BCI BENEFIT CONCPTS 0 ALLOW 0 

BENEFIT PLANNERS ALLOW 0 0 

BENESIGHT ALLOW 0 0 

CBA ALLOWANCE 0 0 

CHRISTIAN BROTHERS 0 ALLOW 0 

CNA INSURANCE ALLOW 0 0 

COMMONWEALTH SERV 0 ALLOW0 

CONSOLIDATED HEALTH -2 ALLOW-2 

CT CARPENTERS HLTH 0ALLOW 

0 

DEFINITY HEALTH ALLOW 0 0 

EMPLOYER SERV CTR 0ALLOW 

0 

FORTIS HEALTHCARE 0ALLOW 

0 

GROUP BENEFIT SERV -1ALLOW 

-1 

HEALTHCARE VALUE 0ALLOW 

0 

HMC PPO ALLOW 0 0 

HUMANA INSURANCE -2 ALLOW -2 

IRONWORKERS ALLOW0 0 

LOCAL 371 AMAL WELF -8 ALLOW -8 

MUTUAL OF OMAHA 0ALLOW 

0 

NE HLTHCR EMP WELF 0 ALLOW 0 

STIRLING & STIRLING 0ALLOW 

0 

TRAVELERS ALLOWANCE 0 0 

UNITED HLTHCARE -699 ALLOW -699

UNTDHLTH/UNTDHLTH -1 ALLOW -1 

WALMART ALLOWANCE 0 0 

HEALTH PARTNERS ALLOW -3 -3 

MVP OF NY ALLOW -6 -6 

UMR ALLOWANCE -1 -1 

ULTRABENEFITS ALLOW -36 -36 

STOP SHOP HEALTH ALLOWANC 0 0 

MEDICAL MUTUAL ALLOWANCE 0 0 

PSYCH MHN/PHS ALLOW 0 0 

PSYCH VALUE BEHAV 0ALLOW 

0 

DIVERSIFIED ADMIN ALLOW 0 0 

DIVERSIFIED GRP BRKG 0 ALLW 0 

GUARDIAN LIFE ALLOW0 0 

HEALTHNET (PHS) ALLOW 0 0 

HEALTHNET/HEALTHNET 0 ALLOW0 

KANAWHA HLTHCR SOLUT 0 ALLW0 

MAILHANDLERS BENEFIT -6 ALLW -6 

H/L COMM TIMELY FILING -3 -3 

H/L COMM REG. ERROR 0 0 

H/L COMMERCIAL OTHER 0 0 

H/L COMMERCIAL NON 0 CRED 0 

H/L COMM CLINICAL 0ERROR 

0 

H/L COMM NO AUTH -1ON FILE -1 

H/L COMMERCIAL MED 1 NECESS 1 

H/L COMMERCIAL DAYS -2 DENY -2 

H/L COMM AUTH/SVC 0 MISMTCH0 

H/L COMM NON COVERED -1 SVC -1 

H/L COMM ADMINISTRATION 0 0 

H/L COMM PATIENT/MEMBER 0 0 

H/L COMM PRO FEE CRDTL 0 0 

H/L COM PRO FEE OTHER 0 0 

H/L COM PRO FEE MED -2 NEC -2 

H/L COM PRO FEE TIMELY -8 FL -8 

H/L COM PRO FEE NO 0AUTH 

0 

SAGA ALLOWANCE 0 0 

PSY ADVANCE BEHAV 0ALLOW 

0 

H/L BC PRO FEE MED 0NEC 

0 

H/L SAGA TIMLEY FILING 0 0 

H/L SAGA REG ERROR0 0 

H/L SAGA OTHER 0 0 

H/L SAGA NON CREDENTIAL 0 0 

H/L SAGA CLINICAL ERROR 0 0 

H/L SAGA NO AUTH ON 0 FILE 0 

H/L SAGA MEDICAL NEC 0 0 

H/L SAGA DAYS DENIED 0 0 

H/L SAGA AUTH/SVC 0MISMATC 

0 

H/L SAGA NON COVERED 0 SVC 0

H/L SAGA ADMINISTRATION 0 0 

H/L SAGA PATIENT/MEMEBER 0 0 

H/L MCR AUTO REVIEW 0 DENY 0 

H/L MCR CERT AUDIT 0DENIAL 

0 

SNF CONTR COMM -130 ALLOW -130 

OCC HEALTH ALLOWANCE 0 0 

BCCG ALLOWANCE-14 -14 

DEARY MAMMO FUND -48 ALLOW-48 

HOMECARE PT ALLOWANCE -1 -1 

HOMECARE NON DKH 0 ALLOW 0 

HOSPICE ALLOWANCE -4 -4 

HOSPICE NON DKH ALLOW 0 0 

MISC SCHOOL BEHAVE 0 HLTH 0 

PSYCH BEACON HLTH -1ALLOW 

-1 

CONNECTICARE ALLOW -298 -298 

FALLON COMM HLTH -15ALLOW 

-15 

HARVARD PILGRIM -52 ALLOW -52 

PSYCH MHN-FOXWOODS -8 ALLOW-8 

NASE ALLOWANCE 0 0 

TUFTS HEALTH PLAN -17ALLOW 

-17 

WELLCARE ALLOWANCE 0 0 

COMMERCIAL INS ALLOW -31 -31 

COMM / COMM ALLOW 0 0 

AUTO INSURANCE ALLOW -9 -9 

ALLSTATE AUTO INS ALLOW 0 0 

LIABILITY OTHER ALLOW 0 0 

RURAL CARRIERS BENE -5 ALLOW -5 

SSMG ALLOWANCE 0 0 

WORKERS COMP ALLOW -102 -102 

WORKERS COMP DKH -3ALLOW 

-3 

PRIME HEALTH ALLOW0 0 

TRICARE ALLOWANCE -155 -155 

CHAMPVA ALLOW -4 -4 

EBPA ALLOWANCE 0 0 

EMPLOYEE HEALTH -21 DKH ALLOW-21 

MERITAIN HEALTH ALLOW 0 0 

DKH CIGNA ALLOWANCE -502 -502 

GEHA ALLOWANCE -1 -1 

DKH ORTHONET ALLOW 0 0 

DKH AIM ALLOW 0 0 

PIP DKH CIGNA BEHAV 0 ALLOW 0 

MEGA LIFE (STUDENT) -10 ALLOW-10 

MEGA LIFE & HEALTH 0ALLOW 

0 

MOHEGAN TRIBAL ALLOW -7 -7 

HARVARD PILGRIM -24 ACCESS AL-24 

SRC AETNA COMPANY -1 ALLOW -1 

TIME INSURANCE ALLOW 0 0

TR PAUL ALLOWANCE0 0 

UNICARE/CIGNA ALLOWANCE -16 -16 

UTICA NATIONAL ALLOWANCE 0 0 

WAUSAU INSURANCE 0ALLOW 

0 

ADMINISTRATIVE ALLOWANCE -6 -6 

MEDICAID HUSKY -2069 A ALLOW -2069 

MEDICAID HUSKY B -55 ALLOW -55 

CHARTER OAK HUSKY -63ALLOW 

-63 

BC OF MA ALLOWANCE -208 -208 

TRICARE SECONDARY 0ALLOW 

0 

BC OF RI ALLOWANCE -69 -69 

OUT OF STATE BC -360 ALLOWANCE -360 

MEDICAID FAM PLAN 0ALLOW 

0 

PSY BEAC HLTH MCR 0ALLOW 

0 

MAIN SENSE ALLOWANCE 0 0 

CHESTERFIELD ALLOWANCE -6 -6 

EE BENE CONCEPTS ALLOW -2 -2 

UNITED HEALTH OF NE -1 ALLOW -1 

NEIGHBOR HEALTH RI 0ALLOW 

0 

BMC ALLOWANCE -2 -2 

FALLON MASSHEALTH -1 ALLOW -1 

NEIGH MASSHEALTH -1ALLOW 

-1 

NETWORK HEALTH MASS 0 ALLOW0 

AFTRA ALLOWANCE 0 0 

CHARITY ALLOWANCE -77 -77 

H/L MED DENY 30 DAY 0 REAMT 0 

ESCHEAT SOC UNCLAIMED 2 2 

SMALL BALANCE W/O -368 -368 

NAT'L HEALTHQUEST -1ALLOW 

-1 

POSPROMPT PAY -297 DISCOUNT -297 

HEALTH PLANS INC ALLOW 0 0 

MID WEST LIFE ALLOW -4 -4 

PART B REBILL ALLOWANCE 7 7 

LONDON HEALTH ADMIN 0 ALLOW0 

SEVEN CORNERS PAYMENT 0 0 

IMG ALLOWANCE 0 0 

STATEMENT PROMPT -1660PAY DISC -1660 

ALLOW PRO FEE COMMERCIAL -9 -9 

CHARITY MED B/D DED 0 W/O 0 

CHARITY MED B/D COINS -6 W/O -6 

CHARITY MED B/D NONCOV -1 WO-1 

STATE MED B/D DEDUCT -4 W/O -4 

STATE MED B/D COINS -313 W/O -313 

STATE MED B/D NON 0COV W/O 0 

ZZ HYDE BEHVR HLTH 0ALLOW 

0 

PRIMARILY CARE ALLOWANCE 0 0 

BENEMAX ALLOWANCE 0 0

TFR FROM B/D TO A/R3 3 

TFR FROM A/R TO -784 B/D -784 

SELF PAY B/D I/P ALLOW 0 0 

SELF PAY B/D DISCOUNT 0 0 

B/D COMBINED ACCT 0BALANCE 

0 

B/D REFUND 0 0 

B/D VOIDED REFUND0 0 

MEDICARE B/D O/P ALLOW 0 0 

MEDICARE B/D I/P ALLOW 0 0 

B/D PART B REBILL ALLOW 0 0 

SUPP STATE B/D O/P 0ALLOW 

0 

SUPP STATE B/D I/P ALLOW 0 0 

SUPP BL CROSS BD OP 0 ALLOW 0 

SUPP BL CROSS BD IP 0ALLOW 

0 

SUPP TRICARE BD OP 0ALLOW 

0 

SUPP TRICARD BD IP 0ALLOW 

0 

SUPP COMMRCL BD OP 0 ALLOW 0 

SUPP COMMRCL BD IP 0 ALLOW 0 

RAC MEDICARE BD IP 0ALLOW 

0 

RAC MEDICARE BD OP 0 ALLOW 0 

H/L MEDICARE BD OP 0ALLOW 

0 

H/L MEDICARE BD IP 0ALLOW 

0 

H/L MCR RAC MED NEC 0 BD OP 0 

H/L MCR RAC MED NEC 0 BD IP 0 

H/L MCR RAC DRG BD 0OP 

0 

H/L MCR RAC DRG BD 0IP 

0 

H/L BD MCR AUTO REV 0 DENY 0 

H/L BD MCR CERT AUDIT 0 DEN 0 

MEDICAID B/D O/P ALLOW -2 -2 

MEDICAID B/D I/P ALLOW 0 0 

MEDICAID MGD CR BD 0 OP ALL 0 

MEDICAID MGD CR BD 0 IP ALL 0 

MIC MEDICAID BD IP 0ALLOW 

0 

MIC MEDICAID BD OP 0ALLOW 

0 

H/L MEDICAID BD OP 0ALLOW 

0 

H/L MEDICAID BD IP ALLOW 0 0 

BLUE CROSS B/D O/P -2ALLOW 

-2 

BLUE CROSS B/D I/P ALLOW 0 0 

H/L BLUE CROSS BD OP 0 ALLW 0 

H/L BLUE CROSS BD IP 0 ALLW 0 

COMMERCIAL B/D O/P -3 ALLOW -3 

COMMERCIAL B/D I/P 0ALLOW 

0 

H/L COMM B/D O/P ALLOW 0 0 

H/L COMM B/D I/P ALLOW 0 0 

SAGA B/D O/P ALLOW0 0 

SAGA B/D I/P ALLOW0 0 

H/L SAGA B/D O/P ALLOW 0 0

H/L SAGA B/D I/P ALLOW 0 0 

SNF B/D O/P ALLOW 0 0 

BCCG B/D ALLOWANCE -1 -1 

ADMINISTRATIVE BD 0OP ALLW 0 

ADMINISTRATIVE BD 0IP ALLW 0 

CHARITY B/D O/P ALLOW -1 -1 

CHARITY B/D I/P ALLOW 0 0 

ESCHEAT SOC B/D UNCLAIMED 0 0 

RETURN CHECK B/D FEE 0 ADJ 0 

ZZ HYDE BEHVR B/D ALLOW 0 0 

SMALL BAL B/D O/P W/O 0 0 

SMALL BAL B/D I/P W/O 0 0 

CHARITY B/D MDCRE-DED 0 W/O 0 

CHARITY B/D MED-COINS 0 W/O 0 

CHARITY B/D MDCR-N/C -1 W/O -1 

STATE B/D MDCR-DED 0 W/O 0 

STATE B/D MDCR-COINS 0 W/O 0 

STATE B/D MDCR-N/C 0 W/O 0 

ESCHEAT SOC B/D SM 0CR BAL 0 

SELF PAY B/D PAYMENT -116 -116 

CAREPAYMENT B/D PAYMENT 6 6 

CAREPYMT ADD ON BD 0 PYMT 0 

MED BUR ECONOMICS -6 PMT -6 

CENTURY FIN SERV PMT 0 0 

MARCAM ASSOCIATES -102 PMT -102 

MBSC PAYMENT -12 -12 

TCORS B/D PAYMENT-4 -4 

MERCHANTS ASSOC -62 OF FL PMT-62 

MEDICARE B/D PAYMENT 2 2 

SUPP STATE B/D PAYMENT 0 0 

SUPP BLUE CROSS B/D 0 PMT 0 

SUPP TRICARE B/D PAYMENT 1 1 

SUPP COMMRCL B/D 0PYMT 

0 

RAC MEDICARE B/D PAYMENT 0 0 

MEDICAID B/D PAYMENT -2 -2 

MEDICAID MGD CARE 0B/D PMT 0 

B/D PART B REBILL PAYMENT 0 0 

MIC MEDICAID B/D PAYMENT 0 0 

BLUE CROSS B/D PAYMENT 1 1 

COMMERCIAL B/D PAYMENT 7 7 

SAGA B/D PAYMENT 0 0 

SNF B/D PAYMENT 0 0 

BCCG B/D PAYMENT-2 -2 

PERSONAL B/D PYRL -6 DED PMT -6 

ZZ HYDE BEHVR B/D PYMT 0 0 

DUE TO MEDICARE 0 0 

BAD DEBT PASS THRU 0PMTS 

0

PHYS PRAC ATHENA CASH 0 0 

MEDICAL OFFICE CHECKING 0 0 

N/A CITIBANK CIGNA0 0 

DEPARTMENT CHANGE 0 FUNDS 0 

FUND RAISING REIMB0 0 

EMP.BENE LIFE R CODERRE 0 0 

ATHENA UNPOSTED CASH 0 ADJ 0 

DKH UNPOSTED CASH 0 ADJ 0 

DKMG UNPOSTED ADJUSTMENTS 

0 0 

ACCTS REC MENTAL HEALTH 0 0 

A/R PRIM CARE SERV0 0 

A/R HOMECARE 0 0 

A/R GERIATRICS 0 0 

A/R DIABETES MGMNT 0 0 

A/R PED CENTER 0 0 

A/R OB SERVICES 0 0 

A/R INFECTIOUS DISEASE 0 0 

A/R ONCOLOGY 0 0 

A/R CARDIAC SPECT 0 0 

A/R PULMONARY SERVICES 0 0 

OTHER PAYABLES 0 0 

LIABILITY LITIGATION0 0 

MD REC-WILTERDINK 0LOAN 

0 

HOMECARE TOWN RECEIVABLE 0 0 

INVENTORY ADJ 0 0 

ACCRUED INTEREST INCOME 0 0 

INVENTORY-STORES 0 0 

PREPAID A/P EXPENSES 0 0 

SPEC PURP EXP UNR 0 0 

OTHER RECEIVABLES0 0 

PHYS LOAN RECEIVABLES 0 0 

CHATTERJEE LOAN 0 0 

MISC INCOME -SAFETY/SEC 0 0 

MISC INCOME-HOSPICE 0 0 

REC FROM HOMEMAKERS 0 0 

DUE FROM CREDIT UNION 0 0 

PHY SRVS LLC RECEIVABLE 0 0 

DUE FROM DKMG 0 0 

BUILDINGS 0 0 

LAND/LAND IMPROVEMENTS 0 0 

MOV EQUIP CURR YR 0ADDTS 

0 

CONST IN PROGRESS/BLDGS 0 0 

FED INCOME TAXES WITHHELD 0 0 

SOCIAL SECURITY TAXES 0 0 

BENEF PAY-OTH DEDUCTIONS 0 0 

BENEFITS PAY-DEP CARE 0 FSA 0 

BENEFITS PAY-HLTHCARE 0 FSA 0

ST INCOME TAXES WITHHELD 0 0 

ANNUITIES DEDS-EMPLOYEES 0 0 

PHYS SHORTAGE AREA 0 INCENT 0 

DUE TO MEDICAID 0 0 

QUARTERLY DSH PAYMENT 0 0 

BCCG SERVICES LIABILITY 0 0 

MISC INCOME-ADMIN0 0 

MISC INCOME 0 0 

LITIGATION RESERVE0 0 

GRANTS - SENIOR RESOURCES 0 0 

MISC INC-DIAB MGMT0 0 

MISC INC-PRIM CARE 0PLFD 

0 

GRANTS-BCCG 0 0 

MISC INC-OCCUP THERAPY 0 0 

GRANTS-WELLNESS 0 0 

MISC INCOME-GRANTS 0 0 

DK BLUE CROSS O/P ALLOWS 0 0 

MEDICAID I/P ALLOW0 0 

MEDICAID HOSP O/P 0ALLOW 

0 

BREAST FEEDING GRANT 0 0 

GRANTS WIC 0 0 

DK COMMERCIAL O/P 0ALLOWS 

0 

INFECT PREVENT GRANT 0 0 

FALL PREVENTION GRANT 0 0 

MATERIALS MGMT REBATES 0 0 

GRANTS - NCA 0 0 

GRANTS NURTURING 0FAMILIES 

0 

CITY/TOWN ALLOW HOSP 0 O/P 0 

CITY/TOWN ALLOW HOSP 0 I/P 0 

ADMIN ADJUST HOSP 0O/P 

0 

MISCELLANEOUS GRANTS 0 0 

DSH 0 0 

EDUCATION RESOURCES 0 0 

DSH-STATE OF CONNECTICUT 0 0 

GRANTS - MDT 0 0 

GRANTS-OUTREACH 0 0 

GRANTS-HEALTHY START 0 0 

GRANTS BIOTERRORISM 0 0 

GRANTS MENTAL HEALTH 0 0 

WELLNESS-VACCINES0 0 

EDUC RES-OTHER 0 0 

DAY HOSPITAL-NATCHAUG 0 0 

PROGRAM INCOME-GERIATRICS 0 0 

PROGRAM INCOME-WELLNESS 0 0 

CAFETERIA SALES EMPLOYEES 0 0 

PROGRAM INCOME-INTEG 0 MED 0 

CAFETERIA SALES OTHER 0 0

CAFETERIA SALES CAFE 0 0 

CAFETERIA SALES VENDING 0 0 

RENTAL INCOME OTHER 0 0 

RENTAL INCOME-PUTNAM 0 MAB 0 

COMMON EXP INC PUTNAM 0 CON0 

RENTAL INCOME-PLNFLD 0 MAB 0 

RENTAL INCOME-DANLSN 0 MAB 0 

OR IMPLANTS REBATES 0 0 

RENTAL INCOME-HILLSIDE 0 0 

MISC INCOME-CASE MNMGT 0 0 

MED REC TRANSCRIPTION 0 FEE 0 

DI MED REC TRNSCRPT 0 FEES 0 

PHARMACE REBATES0 0 

PHAR REBATES EMPL 0BENEFTS 

0 

PHARMACE SALES OTHER 0 0 

MISC INC-EMER DEPT0 0 

MISC INCOME 0 0 

MISC INCOME-PHARMACY 0 0 

MISC INCOME - MIS 0 0 

MISC INCOME PHYSICIAL 0 MED 0 

MISC INC SPEECH THERAPY 0 0 

MISC INC PEDIATRIC CENTER 0 0 

GAIN ON DISPOSAL OF 0 ASSET 0 

MISC INCOME-ACCOUNTING 0 0 

MISC INCOME-HOMECARE 0 0 

CASH VARIATIONS 0 0 

DONATIONS HOSPICE 0SP NEED 0 

DONATIONS-CHAPLAINCY 0 PRGM0 

INTEREST INCOME-INVSTMNTS 0 0 

INTEREST INCOME- A/R 0 0 

INTEREST INCOME-LOANS 0 0 

MISC INCOME-HOSPICE 0 0 

OP INVSTMNT INTRST 0INCOME 

0 

OP INVSTMNT DIVDND 0 INCOME 0 

ENDOWMENT-INTEREST 0 INCOME0 

ENDOW - FISCAL AGENT 0 FEE 0 

TRUST/BEQUEST INCOME 0 0 

NON OPERATING INC-OTHER 0 0 

PAT SERV ADM-HSPTAL 0 EVENT 0 

MISC INC HEALTH RCD 0 INIT 0 

MEANINGFUL USE 0 0 

EDUC RES CONTRACTED 0 SRVCS 0 

MED STAFF COORD-MTGS/CONF 0 0 

EDUC RES MISC EXPENSE 0 0 

EDUC RES - JOB SKILL 0TRNG 

0 

MED SURG-FURNISHINGS 0 0 

MED SURG-EQUIP RENTAL 0 0

RENTAL INCOME LLC 0-VAN 

0 

PSY I/P OFF EQUIP NON 0 SAL 0 

PSYCH I/P EQUIP RENTAL 0 0 

NON MEDICAL SUPPLIES 0 0 

MED LIBR SAL RECOVERIES 0 0 

MED STAFF - SAL RECOVERY 0 0 

I.C.U.-M&S SUPPLIES0 0 

MATERNAL CHILD MD 0 FEES 0 

ICU EQUIP RENTAL 0 0 

MCH-MED SURG SUPPLIES 0 0 

MCH-EQUIPMENT RENTAL 0 0 

MCH-REPAIRS/MAINT 0EQUIP 

0 

O.R. SALARY RECOVERIES 0 0 

OR IMPLANTS GEN 0 0 

O.R.-MED SURG SUPPLIES 0 0 

O.R. IMPLANTS TRAMA 0 0 

OPER ROOM-EQUIP RENTAL 0 0 

R.R.-M&S SUPPLIES 0 0 

OPER ROOM SPEC SUPPLIES 0 0 

PROFESSIONAL FEES 0 0 

INTEG MED FEES 0 0 

INTEGRATIVE MED MISC 0 SUPP 0 

EQUIPMENT RENTAL0 0 

OR JOINT IMPLANTS 0 0 

ACU EQUIPMENT RENTAL 0 0 

OPERATING RM PACMAKRS,ACC 0 0 

C.S.S. STERILIZATION 0SUPL 

0 

MED SURG SUPPLIES0 0 

ER SALARY RECOVERIES 0 0 

EMERGENCY MISC EXPENSE 0 0 

ER -EQUIPMENT RENTAL 0 0 

INTEG MED-WELLNESS 0 EXPENS 0 

EMERGENCY RM-HOSP 0 EVENTS 0 

LAB FEES CONTRACTED 0 0 

SALARY RECOVERIES 0 0 

0 0 

REPAIRS & MAINTENANCE 0 0 

PROF FEES LICENSING0 0 

MED SUPPLS DEPT SPECIAL 0 0 

PET SCAN FEES 0 0 

LAB MED SUPLS CHEMISTRY 0 0 

LAB-FEES LICENSING 0 0 

LAB FEES OUTSIDE LAB0 0 

LABORATORY-R/M PLANT 0 0 

LABORATORY-M&S SUPPLIES 0 0 

LAB FEES QUEST 0 0 

LABORATORY FEES - UMASS 0 0

LABORATORY - UTILITIES 0 0 

CARDIA REHAB N/M SUPPLIES 0 0 

EKG(NICS)-MD FEES CONTRAC 0 0 

LAB MED SUPLS HISTOLOGY 0 0 

C/P REHAB-FOOD BEV0 0 

DUES & MEMBERSHIP0 0 

REPAIRS & MAINTENANCE 0 0 

NUCLEAR MED PROF 0FEES 

0 

LAB-NON MEDICAL SUPPLIES 0 0 

EMG O/S LAUNDRY 0 0 

EMG M&S SUPPLIES 0 0 

DI-FILM/STORAGE MEDIA 0 0 

DIAG IMAGING-M&S 0SUPPLIES 

0 

RADIOLOGY-FEES CONSULT 0 0 

RADIOLOGY-DEPT FOOD 0 BEV 0 

ULTRASOUND-R/M MED 0 EQUIP 0 

ULTRASOUND-LICENSING 0 FEES 0 

MRI-DRUGS 0 0 

ULTRASOUND CONTRACT 0 SRVCS0 

RADIOLOGY DRUGS PUTNAM 0 0 

PHARMACY-DRUGS 0 0 

PHARMACY EQUIPMENT 0 RENTAL0 

PHARMACY-PROP TAXES/LEASE 0 0 

PHARMACY-OFFICE SUPPLIES 0 0 

PHYS MED - DEPT FOOD 0 BEV 0 

PHYS MED-TONER 0 0 

PHYS MED SALARY RECOVERIE 0 0 

PHYS THER-MEETINGS/CONF 0 0 

PHYS MED REP & MAINT 0 0 

PHARMACY ONCOLOGY 0 DRUGS 0 

CONTRACT PHYSICIAN 0 OTHER 0 

SL DISORDER JOB SKILL 0 TRN 0 

PHARM SOFTWARE LICENSING 0 0 

CAT SCAN DRUGS 0 0 

PHYS MED PUT MED 0SUPPLIES 

0 


HC ADMIN-MISCELLANEOUS 0 0 

HC ADMIN-BOOKS/MAGS 0 0 

SOFTWARE FEES 0 0 

HC ADMIN MOBILE TELEPHONE 0 0 

H/C NURSING-EQUIP 0LEASE 

0 

HC NSG-CONTRACTED 0 SERVS 0 

HC NSG JOB SKILL TRAINING 0 0 

HC PROF FEES/CONTRACT 0 SRV 0 

NEUR - MED/SUR SUPP 0 0 

NEUROLOGY-OFFICE 0SUPPLIES 

0 

HC HOSPICE-DRUGS 0 0

HC HOSPICE MED SP 0MED/SUR 

0 

HC HOSPICE BOOKS/MAGS 0 0 

HC HOSPICE-JOB SKILL 0 TRAI 0 




RHEUMATOLOGY M&S 0 SUPPLIES0 

RHEUMATOLOGY DRUGS 0 0 

RHEUMOTOLOGY BNFT 0 SAL REC 0 

RHEUMOTOLOGY PR 0FE TRANSC0 

NEPHROLOGY SAL RECOVERIES 0 0 

NEUROLOGY BNFT SAL 0 RECOVE 0 

NEURO-FEES TRANSCRIPTION 0 0 

OTHER NON SALARY 0 0 

CONSULTING PLANNING 0 FEES 0 

DIAB MGMT S&W NUTRITION 0 0 

PED CENTER-OFFICE SUPPL 0 0 

PED CTR ANSWERING 0SERV 

0 

PED CTR MED/SURG SUPPLIES 0 0 

PHYS PRAC ADMIN-DUES/MEMB 0 0 

P/P ADMIN - TEL MOBILE 0 0 

OPER OF PLANT PLMBG/ELECT 0 0 

OB SERV MOBILE TELEPHONE 0 0 

OB SERV-M&S SUPPLIES 0 0 

MISC INCOME OB SERVICES 0 0 

PULM SERV-DEPT FOOD 0 BEV 0 

PULM SERV-MOBILE TELEPHON 0 0 

DIAB MGMT SALARY 0RECOV 

0 

APC LIC/PROF FEES 0 0 


WIC GRANT-MOBILE 0PHONE 

0 

BIOTERRORISM MBLE 0TELEPH 

0 

NURTRING FAM-TEL MOBILE 0 0 

OPER OF PLANT-CONTRC 0 SERV 0 

NURTR FAM-JOB SKILL 0 TRNG 0 

EQUIPMENT LEASE 0 0 

DIABETES TRANSCRIPTION 0 0 

CONTRACTED FEES 0 0 

NUTRITN SERV-PUBLICATIONS 0 0 

NUTR SERV-CANNED 0GOODS 

0 

WORKERS COMP RESERVE 0 0 

PHY PRAC NON MED 0SUPPLIES 

0 


NON MEDICAL EQUIPMENT 0 0 

S&W FACILITIES MAINTAIN 0 0 


MAINT/PLANT 0 0

OPER OF PLANT-GAS0 0 

NON MEDICAL SUPPLIES 0 0 

SAF/SEC DUES & MEMBERSHIP 0 0 

REPAIRS/MAINT-R/M 0PLANT 

0 

PLFD BLDG UTILITIES 0COMMN 

0 

DANIELSON BLDG-CONDO 0 FEES 0 

DANIELSON BLDG-ELECTRICIT 0 0 

JOB SKILL TRAINING 0 0 

HOUSEKEEPING-PAPER 0 PROD 0 

HOUSEKEEPING-CLEANSERS 0 0 

HOUSEKEEPING-FURNISHINGS 0 0 

FINANCE NON MED SUPPLIES 0 0 

LATE CHARGES 0 0 

CORP COMM SPONSORSHIP 0 0 

ACCOUNTING-BANK FEES 0 0 

ACCOUNTING-HOSPITAL 0 EVENT 0 

ACCOUNTING-OFFICE 0SUPPLIE 

0 

ACCTNG JOB SKILL TRAINING 0 0 

MEDICAL RECORDS - 0OFF SUP 0 

ACCTNG NON MED SUPPLIES 0 0 

MD SERVS SFTWARE 0LCNSNG 

0 

OPER OF PLANT GRNDS 0 MAINT 0 

OPER OF PLANT GRNDS 0 UTIL 0 

MED RECORDS NON MED 0 SUPP 0 

MARK STRAT PLANNING 0 0 

MED REC MISC EXP 0 0 

M.I.S. I/T SUPPLS & PARTS 0 0 

CARE PAYMENT FEES0 0 

BILLING FEES CONTR 0SERV 

0 

BILLING CONSULT/PLAN 0 FEES 0 

BILLING-BILLING FEES0 0 

M.I.S.-R/M OTHER EQUIP 0 0 

COMM-OTH NON SAL 0TEL LOCA 0 

M.I.S.-SFTWARE LCNG/MAINT 0 0 

CARE PAYMENT FUNDED 0 FEES 0 

IMPLEMENTATION FEES 0 0 


QI/RM-SUPP MISC 0 0 

LEGAL FEES/PROF FEES 0 0 

HR OTHR NONSAL HSPTL 0 EVNT 0 

ADMIN-SALARY RECOVERIES 0 0 

ADMIN MD FEES CONTR 0 OTHER 0 

ADMIN NON-MED SUPP 0 MISC 0 

ADMIN MOBILE TELEPHONE 0 0 

ADMIN-MTNGS & CONFS 0 0 

ADMIN-FEES CONSULT/PLAN 0 0 

MTL MGMT-NON-MED 0 SUP POST0

MTL MGT NO MED SPCL 0 POST 0 

MATERIALS MGMT-FREIGHT 0 0 

MATERIALS MGMT-OFF 0 SUPLS 0 

ADMIN HOSPITAL EVENTS 0 0 

MAT MGMT EQUIPMENT 0 LEASE 0 

LEGAL/PROF FEES 0 0 

PHYSICIAN RECRUITMENT 0 0 

ADMIN-GAS & UTILITIES 0 0 

MEETINGS & CONFERENCES 0 0 

PASTORAL CARE-JR VOLUNTR 0 0 

CORP COMM-HSPTL EVENTS 0 0 

CORP COMM OUTSIDE 0 PRINTNG0 

CORP COMM ADVERTISING 0 0 

FUND RAISING 0 0 

EMPLOYEE BENEF-WORK 0 COMP 0 

EMPLOYEE BENEF-TPA 0 FEES 0 

EMPLOYEE BENEF-DENTAL 0 CLM 0 

EMPLOYEE BENEF-VISION 0 CLM 0 

EMPL BENE-COBRA CONTRIB 0 0 

EMPL BENE SHORT TERM 0 DISA 0 

EMPL BENE SOCIAL SECURITY 0 0 

EMPL BNFT LFE CONTRIBUTN 0 0 

EMPL BNFT STD CONTRIBUTON 0 0 

EMP BFT LTD CONTRIBUTION 0 0 

EMP BNFT HLT INS CONTRIB 0 0 

EMP BFT VISION CONTRIBUT 0 0 

EMP BFT DENTAL CONTRIBUT 0 0 

EMPL BENEF-HLTH INS 0 CLAIM 0 

BAD DEBT PHYS PRAC 0RECY 

0 

INSURANCE-AUTO 0 0 

BAD DEBT COLL FEE HOSP 0 0 

BAD DEBT COL FEE PHYS 0 SER 0 

INSURANCE-MALPRACTICE 0 0 

PRESCRIPTION DRUGS0 0 

EMPLOY BEN WELLNESS 0 0 

EMPLOY BEN LTD 0 0 

PASTORAL CARE OT NON 0 SAL 0 

FUND RAISING PHOTO 0 SUPPLS 0 

HUMAN RESOURCES0 0 

SELF PAY PMT -2998 -2998 

SELF PAY MED BUR PMT 0 0 

SELF PAY PMT -35 -35 

NON COVERED LENS 0PAYMENT 

0 

SELF PAY OPT OUT INS0 0 

SELF PAY CR PHASE -424 PYMT -42 

SELF PAY PMT 0 0 

CONTRACT PAYMENT -50 -50

PERSONAL PYMT (P/R -37DED) 

-37 

TCORS PYMNT 0 0 

MBSC PAYMENT 0 0 

CARE PAYMENT -153 -153 

CAREPYMT ADD ON 17 PYMT 17 

CARE PAYMENT RECOURSE 0 PYT 0 

STATE PENDING PAYMENT 0 0 

STATE SPENDDOWN -1 PMT -1 

SAGA PENDING PAYMENT 0 0 

MEDICARE PMT -5501 -5501 

MEDICARE INPT B PMT 0 0 

TRAILBLAZER PAYMENT 0 0 

MEDICARE APPEALS -1 PYMT -1 

HN SMARTCHOICE PMT 0 0 

FALLON SENIOR PMT-5 -5 

BLUE CHIP MEDICARE -7PMT 

-7 

TUFTS MCR PREF PMT0 0 

AMER PROG T/OPTION 0 PMT 0 

EVERCARE MEDICARE -1PMT 

-1 

CONNECTICARE MEDICARE -233 PMT -233 

HEALTHNET PEARL MCR 0 PMT 0 

AETNA MEDICARE ADV -28 PMT -28 

MEDICARE MGD CARE 12 PMT 12 

CIGNA MEDICARE ADV -1 PMT -1 

AARP MED COMPLETE -482 PAYMENT -482 

PSYCH NHM MED AV 0PAYMENT 

0 

PSYCH UNTD BEHV MED 24 PYMT 24 

MEDIBLUE PAYMENT -21 -21 

PSYCH BEAC HLTH MEDI 0 PAY 0 

MEDICARE SECONDARY 27 PMT 27 

SUPP STATE PAYMENT -129 -129 

SUPP BLUE CROSS -406 PYMT -406 

SUPP AARP/UHC PAYMENT -447 -447 

SUPP UMR PMT -2 -2 

SUPP AETNA PAYMENT 0 0 

SUPP OXFORD HEALTHCARE -28 -28 

SUPP AMER PROGRESS 1 PYMT 1 

SUPP CT CARPENTERS 0LCL 24 0 

SUPP BANKERS LIFE -1 PYMT -1 

SUPP CELTIC LIFE PYMT 0 0 

SUPP CHAMPVA PAYMENT -5 -5 

SUPP COMBINE INS PYMT 0 0 

SUPP EBPA PAYMENT0 0 

SUPP HEALTHNET PYMT 0 0 

SUPP MONUMENTAL -3LIFE PYMT-3 

SUPP MUTUAL OF OMAHA -12 PYMT -12 

SUPP STIRLING & STIR -76 PYMT -76

SUPP TRICARE PAYMENT -91 -91 

SUPP UNITED AMERICAN -1 PYMT-1 

SUPP UNITED HEALTHCR -31 PYMT-31 

SUPP UNITED TEACHERS -3 PYMT -3 

SUPP USAA LIFE PAYMENT -3 -3 

SUPP MAILHANDLERS -6PYMT 

-6 

SUPP WAUSAU PAYMENT 0 0 

SUPP CIGNA PAYMENT -43 -43 

SUPP MERITAIN PMT0 0 

SUPP OTH/ST MEDICAID -1 PMT -1 

SUPP COMMRCL NOT -72LIST PYM-72 

PART B REBILL PYMT 2 2 

RAC MEDICARE RECY 0PMT 

0 

FIRST COAST MCR-B -369 PMT -369 

MEDICAID PAYMENT -249 -249 

MEDICAID HUSKY -1408 A PAYMENT -1408 

STATE MLIA PAYMENT -528 -528 

MEDICAID HUSKY B -26 PAYMENT -26 

PSYCH BEHAV HLTH PAYMENT 0 0 

MEDICAID FAMILY PLAN 1 PAY 1 

STATE AGENCIES PMT. -5 -5 

LMHA PAYMENT 0 0 

HEALTHNET MCD PMT0 0 

BC FAMILY PLAN MCD 0 PMT 0 

COMM HLTH NTWK MCD 0 PMT 0 

PR ONE/FIRST CHC MCD 0 PMT 0 

AETNA BETTER HLTH 0PMT 

0 

AMERICHOICE UNHLTHC 0 PMT 0 

UNITED HEALTH OF NE -1 PYMT -1 

NEIGHBORHOOD RI PAYMENT 1 1 

OUT OF ST MEDICAID -1PMT 

-1 

BMC PAYMENT -1 -1 

FALLON MASSHEALTH -1 PAYMENT-1 

NEIGHBOR MASSHEALTH -1 PYMT-1 

NETWORK MASSHEALTH 0 PMT 0 

MASS MEDICAID PMT -24 -24 

NEW YORK MEDICAID 0PMT 

0 

MAINE MEDICAID PAYMENT -1 -1 

RI MEDICAID PAYMENT -1 -1 

CHARTER OAK CHN PAYMENT 0 0 

CH OAK AMERICHOICE 0 PMT 0 

CH OAK AETNA B/HLTH 0 PMT 0 

CHARTER OAK HUSKY -24PAYMENT 

-24 

MIC MEDICAID INTGRTY 0 PMT 0 

BLUE CROSS ANTHEM -1835PMT 

-1835 

BLUE CROSS/BC PAYMENT -14 -14 

BLUE CROSS OF MA -252 PAYMENT-252

BLUE CROSS OF RI PAYMENT -88 -88 

OUT OF STATE BC -382 PAYMENT -382 

PSY BC ANTHEM BHV -38HLT PMT-38 

PSYCH BC MAGELLAN 0PMT 

0 

PSYCH BC UNITED BEHAV 0 PMT 0 

PSYCH BC VAL BEHAV 0PMT 

0 

PSYCH BC VAL OPT PMT 0 0 

PSY BC MGD HLTH NTWK 0 PYMT 0 

PYMT PRO FEE BLUE -21 CROSS -21 

PSY CIGNA BEHAV HLTH -17 PMT -17 

AIM CIGNA PAYMENT0 0 

AMALGAMATED LIFE 0PYMNT 

0 

CIGNA PAYMENT -557 -557 

CIGNA/CIGNA PMT 0 0 

CONN GENERAL PYMNT 0 0 

GOLDEN RULE PAYMENT -3 -3 

GREAT WEST LIFE INS -62PYMNT 

-62 

HEALTH ADVANTAGE 0PYMNT 

0 

HEALTH CHOICE PAYMENT 0 0 

HEALTHNET FOXWOODS -153 PMT-153 

INTERACTIVE BENEFIT -9PMT 

-9 

JOHN ALDEN INS PAYMENT 0 0 

N E DIRECT HEALTH PMT 0 0 

NEW ENGLAND INS PMT 0 0 

OXFORD HEALTH PMT 40 40 

OXFORD/OXFORD PAYMENT 0 0 

ORTHONET PMT -14 -14 

US HLTCARE INC PYMT0 0 

FOXWOODS BOLLORE -17PAYMENT 

PSYCH VALUE OPTIONS -2 PMT -2 

PSYCH UNITED BEHAV 19 PMT 19 

AARP PAYMENT 0 0 

AETNA PMT -248 -248 

AETNA/AETNA PAYMENT 1 1 

ALLIED BENEFIT PAYMENT 0 0 

AMERIHEALTH PAYMENT 0 0 

APWU AMER POSTAL -1WKR PYMT -1 

ASSOC & SOCIETY PYMT 0 0 

ASSURANT HEALTH PMT 3 3 

BCI BENEFIT CONCPT 0PMT 

0 

BENEFIT PLANNERS PMT 0 0 

BENESIGHT PAYMENT0 0 

CBA PYMT 0 0 

CHRISTIAN BROTHERS 0 PMT 0 

CNA INSURANCE CO PMT 0 0 

COMMONWEALTH SER 0 CTR PMT0 

CONSOLIDATED HLTH -2PMT 

-2

CT CARPENTERS HLTH 0PMT 

0 

DEFINITY HEALTH PMT0 0 

EMPLOYER SERV CTR 0PMT 

0 

FORTIS HEALTHCARE 0PMT 

0 

GROUP BENEFIT SERV -1PMT 

-1 

HEALTHCARE VAL MGMT 0 PMT 0 

HMC PPO PAYMENT 0 0 

HUMANA INS PMT 0 0 

IRONWORKERS PAYMENT 0 0 

LOCAL 371 AMAL WELF 0 PMT 0 

MUTUAL OF OMAHA 0INS PMT 0 

NE HEALTH CARE EMP 0 PMT 0 

STIRLING & STIRLING 0PMT 

0 

TRAVELERS PAYMENT0 0 

UNITED HEALTHCARE -534PMT 

-534 

UNTDHLTH/UNTDHLTH -1 PMT -1 

WALMART PAYMENT0 0 

HEALTH PARTNERS PMT -3 -3 

MVP OF NY PMT -2 -2 

UMR PAYMENT -1 -1 

ULTRABENEFITS PMT -29 -29 

STOP SHOP HEALTHCARE 0 PYMT 0 

MEDICAL MUTUAL PAYMENT 0 0 

NIPPON LIFE PAYMENT 0 0 

RURAL CARR BENE PLAN -4 PYMT -4 

HEALTH PLANS INC PYMT 0 0 

PSYCH MHN/PSH CARVE 0 PMT 0 

PSYCH VALUE BEHAVIOR 0 PMT 0 

DIVERSIFIED ADMIN -2 PMT -2 

DIVERSIFIED GRP BRKG 1 PMT 1 

GUARDIAN LIFE PAYMENT 0 0 

HEALTHNET (PHS) PAYMENT 0 0 

HEALTHNET/HEALTHNET 0 PMT 0 

KANAWHA HLTCR SOLUT 0 PMT 0 

MAIL HANDLERS BEN -2PMT 

-2 

MEGA LIFE STUDENT -9PMT 

-9 

MEGA LIFE & HLTH PMT 0 0 

MOHEGAN TRIBAL PAYMENT 5 5 

SRC AETNA CO PAYMENT 4 4 

TIME INSURANCE CO 0PMT 

0 

TR PAUL PAYMENT 0 0 

UNICARE/CIGNA PAYMENT -16 -16 

UTICA NATIONAL PAYMENT 0 0 

WAUSAU INSURANCE 0PAYMENT0 

PRIMARILY CARE PAYMENT 0 0 

BENEMAX PAYMENT0 0 

LONDON HEALTH ADMIN -4 PYMT-4

SEVEN CORNERS PAYMENT 0 0 

IMG PAYMENT 0 0 

GEHA PAYMENT -1 -1 

MID WEST LIFE PYMT-2 -2 

PSYCH BEACON HLTH -1PMT 

-1 

CONNECTICARE PMT18 18 

FALLON COMM HLTH -7PMNT 

-7 

HARVARD PILGRIM -43 PMNT -43 

PSYCH MHN-FOXWOODS -7 PMT -7 

NASE PAYMENT 0 0 

TUFTS HEALTH PLAN -9PMNT 

-9 

WELLCARE PAYMENT0 0 

COVENTRY HEALTH PAYMENT 2 2 

FIRST HEALTH PAYMENT 0 0 

HARVARD PILGRIM -24 ACCESS AM-24 

MAIN SENSE PAYMENT 0 0 

CHESTERFIELD RES PYMT -4 -4 

EE BENEFIT CONCEPT -2PYMTS 

-2 

AFTRA PAYMENT 0 0 

COMMERCIAL INS PMNT -19 -19 

COMMERCIAL/COMMERCIAL 0 PMT 0 

SSMF PAYMENT 0 0 

AUTO INSURANCE PMT -26 -26 

LIABILITY OTHER PAYMENT -1 -1 

LIBERTY MUTUAL AUTO 0 PYMT 0 

GEICO AUTO PAYMENT -1 -1 

ALLSTATE AUTO INS PYMT 0 0 

TCORS AUTO PAYMENT 0 0 

WORKERS COMP PAYMENT -109 -109 

WORKERS COMP DKH -3PMT 

-3 

PRIME HEALTH PAYMENT 0 0 

WORKERS COMP OF RI 0 0 

ONE CALL MEDICAL PAYMENT -6 -6 

BROADSPIRE SVCS WC 0 PYMT 0 

CHARTIS INS WC PYMT 0 0 

LIBERTY MUTUAL WC 0PAYMENT 

0 

EMC INSURANCE WC 0PAYMENT 

0 

ONE BEACON WC PAYMENT 0 0 

TCORS WC PAYMENT0 0 

TRICARE PAYMENT-114 -114 

CHAMPVA PAYMENT-4 -4 

TRICARE SECONDARY -3PAYMENT-3 

EBPA PAYMENT 0 0 

DKH CIGNA PMT -504 -504 

MERITAIN HEALTH PAYMENT 0 0 

DKH ORTHONET PMT0 0 

DKH AIM PMT 0 0

PSYCH DKH CIGNA BEH 0 PMT 0 

PYMT PROF FEE COMMERCIAL -4 -4 

SAGA PAYMENT 0 0 

PSYCH ADVANCE BEHAV 0 PMT 0 

HAVEN HEALTH PAYMENT 0 0 

HOLY SPIRIT PAYMENT0 0 

MATULAITIS PAYMENT 0 0 

PIERCE MEMORIAL PAYMENT -6 -6 

VILLA MARIA PAYMENT 0 0 

VILLAGE MANOR PAYMENT 0 0 

WESTVIEW PAYMENT0 0 

SNF OTHER PAYMENT -1 -1 

REGENCY HGTS SNF -26 PMT -26 

BCCG PAYMENT TRANSFER -16 -16 

DEARY MAMMO FUND -101 PYMT-101 

SAFETY NET FOUND PYMT 0 0 

HOMECARE PT PYMT 0TFR 

0 

HOMECARE NON DKH 0 PAYMENT0 

HOSPICE PAYMENT TFR -4 -4 

HOSPICE NON DKH PAYMENT 0 0 

US BUTTON CORP PAYMENT 0 0 

FRITO LAY PAYMENT0 0 

US COSMETICS PAYMENT 0 0 

C&M CORPORATION 0PYMT 

0 

FACTORY MUTUAL PAYMENT -1 -1 

MPI LABEL SYSTEMS PYMT 0 0 

UNITED SERVICES PAYMENT 0 0 

ZZ NORAMPAC PAYMENT 0 0 

ZZ NATL CHROM PAYMENT 0 0 

ZZ INTL PAPER PAYMENT 0 0 

ZZ QUIKRETE PAYMENT 0 0 

ZZ UNTD NAT FOODS 0PYMT 

0 

ZZ BST PAYMENT 0 0 

ZZ SEALAND ENVIRO 0PYMT 

0 

ZZ SELF EMPLOYED PAYMENT 0 0 

ZZ BGR RADIATOR PAYMENT 0 0 

ZZ CH NICKERSON PYMT 0 0 

ZZ DELTA RUBBER PYMT 0 0 

ZZ FLEET SAFETY SVCS 0 PYMT 0 

ZZ LOOS CORPORATION 0 PYMT 0 

ZZ MIDLAND SALES PAYMENT 0 0 

ZZ MOOSUP FIRE DEPT 0 PYMT 0 

ZZ NE PLASMA PAYMENT 0 0 

ZZ PAQUETTE ELEC PAYMENT 0 0 

ZZ WELLNESS 2000 PAYMENT 0 0 

ZZ ENSIGN BICKFORD 0PYMT 

0 

ZZ HYDE SCHL BEHVR 0PYMT 

0

ZZ OHM UNSPECIFIED 0PYMT 

0 

ZZ STERLING ONECO 0FIRE PY 0 

MISC SCHOOL BEHAVE 0 HLTH 0 

UAAPPLIED CASH FY -1 08 PYMT -1 

ADMIN REVIEW PAYMENT 0 0 

MED/SURG BLOOD ADMIN 0 0 

EMERGENCY RM-HOSP 0 EVENTS 0 

MED/SURG, PRIVATE0 0 

NURSERY, SICK BABY0 0 


IV THERAPY VISIT 0 0 

ACU VISIT 0 0 


PRESCRIPTION DRUGS0 0 

CRYOSURG RENAL 1ST 0 1/2 HR 0 

LITHOTRIPSY OR 1ST 01/2 HR 0 

PROS ABLATION OR 1ST 0 1/2 0 

CRYOSURG PROSTA 1ST 0 1/2HR 0 

PHY FEE-NO CHG 0 0 

BLADDER IRRI-SIMPLE 0 LAVAG 0 

NO CHARGE PO 0 0 






OR C-SECT 1ST 1/2HR,1PERS 0 0 

OR C-SECT 1ST 1/2HR, 0 3PEO 0 


NERVE CONDUCTION 0SENSORY 

0 

OCYTOCIN CHALLENGE 0 0 

NST/FETAL MONITOR0 0 

PNEUMOGRAM 0 0 

VACCINE INJECTION 0 0 

IVP SEQ SAME DAY >30 0 MIN 0 

MCH-SPEC PROC RM 01-1/2 HR 0 


COBALT, RANDOM URINE 0 0 


ACU-SPEC PROC RM 01/2 HR 0 

ACU-SPEC PROC RM 1-1/2 0 HR 0 

ACU-SPEC PROC RM 20 HRS 0 

MRI KEN UPEX NOJT W/WO 0 RT 0 

COLONOSCOPY 0 0 

GASTROSCOPY 0 0 

BRONCHOSCOPY 0 0 

DUODENSCOPY 0 0

LARYNGOSCOPY 0 0 

TEE PROBE 0 0 

SIGMOIDOSCOPY 0 0 

POLYPECTOMY 0 0 

SPEC PROC MISC-LAZER 0 0 




IV TX ADD'L SEQ < 1 HR 0 0 


IV START 0 0 

PERIPHERAL DRESSING 0 CHANG 0 

CENTRAL LINE DRESSING 0 0 

SQ PORT ACCESSING 0 0 

SQ PORT DE ACCESSING 0 0 

BLOOD DRAW W/IV START 0 0 

MIDLINE EVAL/INSERT0 0 

PICC LINE REMOVAL 1 1 

ENTEROSCOPY 0 0 

BONE MARROW ASPIRATION 0 0 

G TUBE REPLACEMENT 0 0 

PEG BUTTON CHANGE0 0 

PILL CAM ENDOSCOPY0 0 

MED/SURG ROUTINE0 0 



C-ARM PAIN MGT

SITE ASSESSMENT 0 0 

SITE ASSESSMENT WW/O 0 FLSH 0 


CENTRAL LN DRESSNG 0 CHANGE 0 

SQ PORT ACCESSING 0 0 

SQ PORT DE ACCESSING 0 0 

PPD PLANTING/READING 0 0 

BLOOD DRAW W/IV STARTS 0 0 

MIDLINE EVAL/INSERTION 0 0 

PICC EVALUATION 0 0 

MIDLINE EVALUATION0 0 

PICC LINE REMOVAL 0 0 

IV START 0 0 


FACILITY FEE-RECHECK0 0 

ED-LWBS 0 0 

NES PHY FEE-BRIEF 0 0 

NES PHY FEE-RECHECK0 0 

NES URGENT-MINIMAL 0 0 

NES URGENT-BRIEF 0 0 

NES URGENT-LIMITED0 0 

PHY INTERMED 0 0 

PHY INTERMED 0 0 

PHY COMPREHENSIVE0 0 

PHY EXTENDED 0 0 

PHY FEE-MINIMAL 0 0 

PHY FEE-BRIEF 0 0 

PHY FEE-LIMITED 0 0 

PHY FEE-INTERMEDIATE 0 0 

PHY FEE-EXTENDED 0 0 

PHY FEE-RECHECK 0 0 

PHY FEE-NO CHG 0 0 

PHY FEE-COMPREHENSIVE 0 0 

PHY FEE-RECHECK 0 0 

I&D CMPL POST-OP ABS 0 0 

DEBR SKN UPTO 10%TBS 0 0 

DEBR SKIN FULL THICK0 0 

BX SKIN SUBC SINGLE0 0 

BX SKIN SUBC MULTI0 0 

EXC BEN SCALP..0.5CM0 0 

REM SKIN TAGS;UPTO15 0 0 

EXC BENIGN O.6-1.0CM0 0 

DEBR NAILS 1-5 0 0 


SMPL FACE >30.0 CM0 0 

LYR BODY SC >30.0 CM0 0 

LY NECK EXTS 12.6-2 0 0

LY NECK EXTS 20.1-3 0 0 

LYR NECK EXTS >30 CM0 0 

LYR FACE 12.6-20.0 0 0 

LYR FACE 20.1-30.0 0 0 

LYR FACE >30.0 CM 0 0 

CMPLX TRNK 1.1-2.5CM 0 0 

CMPLX TRNK 2.6-7.5 0 0 

CMPLX SC EXTS1.1-2.50 0 

CMPLX FACE EXTS

TX COCCYGEAL FX 0 0 

HIP DISLOCW/O ANES0 0 

CL TX POST HIP W/ANE 0 0 

PATELLAR FX W/O M0 0 

KNEE FX W OR W/O MAN 0 0 

TIB SHAFT FX W/O MAN 0 0 

BIMALLEOLAR FX W/O 0 M 0 

ARTHROTOMY MTP JOINT 0 0 

REMOVAL FB FOOT DEEP 0 0 

REMOVAL FB FOOT COMP 0 0 

REP EXT TENDON FOOT 0 0 

CALCANEAL FX W/MANIP 0 0 

CL TR FX GR TOE WO M0 0 

FX PHALANX W/O M 0 0 

CAST SHORT ARM 0 0 

CAST-FINGER 0 0 

RMVL CAST/BIVALVE0 0 

RMVL FUL ARM/LEG CST 0 0 

EPISTAXIS POST SUBSQ0 0 

CHANGE TRACH TUBE0 0 

LARYNGPY INDRCT W/FB 0 0 

LARYN DIR OP W/FB RE 0 0 

TRACH ER TRSTRACH0 0 

TRACH ED CRICOTHYD0 0 

THORACENTESIS W/TUBE 0 0 

THORA MAJ W/CARDI 0MA 

0 

REM TRIPLE LUMEN CAT 0 0 

LAC VESTIBULE 2.5 CX0 0 

UNLISTED PROC TONGUE 0 0 

I+D ABSCESS;PARAPHAR 0 0 

RML FB PHARYNX EXS0 0 

EGD W/REM FOREIGN 0 BO 0 

EGD W/BY SGL OR MULT 0 0 

EGD W/REMOVAL OF 0FB 

0 

CHANGE CYSTO TUBE0 0 

CATH URETHRA SMPL0 0 

CAUT CERV-INIT OR RP0 0 

CAUTERIZA OF CERVIX0 0 

INJ ANES;INTERCO,SGL 0 0 

BLEPHAR-I&D ABSC EYE 0 0 

ECG 1-3 LEAD INT&REP 0 0 

VENT ASSIST&MNG 1STD 0 0 

PULSE OX/EAR SINGLE0 0 

PULSE OX/EAR-MULTI0 0 

DLS TIBI W/WO AN W/M 0 0 

PROCTO W/OR WO/ COLL 0 0 

ANOSC W/ REMOVAL 0FB 

0

EXCIS OF X THORB HEM 0 0 

EXCIS OF ANUS,SIMPLE 0 0 

IPECAC FOR EMESIS 0 0 

ASP OF BLADDER BY NEEDLE 0 0 

PRIAPISM;TX BY FISTU0 0 

UNLSTD MALE GENITAL 0 0 

COLPOR-SUTURE VAGINA 0 0 

REM IMPACT VAG FB 0AN 

0 

REM OF INTRAUT DEVIC 0 0 

DELIVERY OF PLACENTA 0 0 

INJ EPIDU;LUMBAR SAC 0 0 

ANOG EXAM W/COLP 0MAG 

0 

STRAPPING-SHOULDER 0 0 

STRAPPIN ELBOW/WRIST 0 0 

DRAUB LYMPH NODE 0ABSCESS 

0 

DRAIN ABCESS,PALATE,UVULA 0 0 

I&D UPPER ARM AREA; 0 BURSA 0 

TX TRSL FX TALUS W/O 0 MNPJ 0 

INCISION THROMBOSED 0 HEM 0 

SMPL LAC BODY, SCALP>30CM 0 0 

UNIV RIB BELT 0 0 

PC-FAC FEE-RECHECK0 0 



PC-NES PHY FEE-MINIMAL 0 0 

PC-NES PHY FEE-BRIEF0 0 

PC-NES PHY FEE-LIMITED 0 0 

PC-NES PHY FEE-INTERMED 0 0 

PC-NES PHY FEE-EXTENDED 0 0 

PC-NES PHY FEE-COMPREHENS 0 0 

PC-NES URGENT-MINIMAL 0 0 

PC NES URGENT-BRIEF0 0 

PC-NES URGENT-LIMITED 0 0 

PC-NES PHY FEE-RECHECK 0 0 

DEBR SKIN FULL THICK0 0 

BX SKIN SUBC SINGLE0 0 

BX SKIN SUBC MULTI0 0 

EXC BEN SCALP..0.5CM0 0 

EXC BENIGN 0.6-1.0CM0 0 


SMPL FACE >30.0 CM0 0 

TX SUPERFIC WND SMPL 0 0 

LYR BDY SC 20.1-30.00 0 

LYR BODY SC >30.0 CM0 0 



LYR NECK EXTS >30 CM0 0

CL INTE FACE7.6-12.50 0 

LYR FACE 12.6-20.0 0 0 

LYR FACE 20.1-30.0 0 0 

LYR FACE >30.0 CM 0 0 

CMPLX TRNK 1.1-2.5CM 0 0 

CMPLX TRNK 2.6-7.5 0 0 

CMPLX SC EXTS1.1-2.50 0 

CMPLX FACE EXTS

THUMB FX W/MAN 0 0 

METACAR DIS W/M WO/A 0 0 

IP JOINT FX W/O MAN0 0 

AMPU FINGER/THB W/C/ 0 0 

TX COCCYGEAL FX 0 0 

HIP DISLOC W/O FIXTN0 0 

HIP DISLOC W/O ANES0 0 

POST HIP DISLC W/O A0 0 

CL TX DIS FEM FXWO/M 0 0 

PATELLAR FX W/O M0 0 

TIB PLATEAU FX W/O 0M 

0 

KNEE FX W OR W/O MAN 0 0 

KNEE DISLOC W/O ANES 0 0 

TIB SHAFT FX W/O MAN 0 0 

M MALLEOLUS FX W/O 0 M 0 

PROX FIB/SHFT W/O M0 0 

DIST FIB FX W/O M 0 0 

BIMALLEOLAR FX W/O 0 M 0 

BIMALLEOLAR FX W/MAN 0 0 

TRIMALLEOLAR FX WO 0 M 0 

ANKLE DISLOC W/O ANE 0 0 

ANKLE DISLOC W/ANES 0 0 

ARTHROTOMY MTP JOINT 0 0 

REMOVAL FB FOOT DEEP 0 0 

REMOVAL FB FOOT COMP 0 0 

CALCANEAL FX W/O M0 0 

TALUS FX W/O M 0 0 

METATARSAL FX W/O 0M 

0 

CL TR FX GR TOE WO M0 0 

FX PHALANX W/O M 0 0 

CAST SHORT ARM 0 0 

CAST-FINGER 0 0 

STRAPPING-SHOULDER 0 0 

STRAPPIN ELBOW/WRIST 0 0 

CAST LONG LEG 0 0 

RMVL CAST/BIVALVE0 0 

RMVL FUL ARM/LEG CST 0 0 

ET INTUBATION 0 0 

CHANGE TRACH TUBE0 0 

LARYNG IND RECT DIAG 0 0 

LARYNGPY INDRCT W/FB 0 0 

LARYN DIR FOR ASPIRA 0 0 

LARYN D/R DX NO NEWB 0 0 

LARYN DIR OP W/FB RE 0 0 

TRACH ER TRSTRACH0 0 

TRACH ED CRICOTHYD0 0 

THORACENT ASP INT 0OR SUBS 0

THORACENTESIS W/TUBE 0 0 

TUBE THOR W/SEAL (HEMOTX) 0 0 

THORA MAJ W/CARDI 0MA 

0 

INS/RE TEM ELE/PM CA 0 0 

TRANSFSN BLOOD/COMPT 0 0 

INS CNT'L VEN CATH>5 0 0 

REM TRIPLE LUMEN CAT 0 0 

ARTERIAL BLD DRAW 0DX 

0 

PLMT INTRAOSSEOUS0 0 

CHEILOPLASTY > V.HGT 0 0 

LAC VESTIBULE 2.5 CX0 0 

DENTOGLVEOLAR STRUCT 0 0 

RML FB PHARYNX EXS0 0 

CONT OROPHAR HEM 0SIM 

0 

CHG GASTRO TUBE W/O 0 IMG/G 0 

PROCTO W/OR WO/ COLL 0 0 

INCIS DRAIN PERIA AB0 0 

EXCIS OF X THORB HEM 0 0 

ANOSC W/ REMOVAL 0FB 

0 

EXCIS OF ANUS,SIMPLE 0 0 

PERIT ABD PARA OR PE 0 0 

ASP OF BLADDER BY NEEDLE 0 0 

CMPT CATH/BALLOON0 0 

I&D SCROTAL ABSCESS0 0 

REM IMPACT VAG FB 0AN 

0 

CAUTERIZA OF CERVIX0 0 

CAUT CERV-INIT OR RP0 0 

REM OF INTRAUT DEVIC 0 0 

VAG DELIV W/POSTPART 0 0 

LUMBAR TAP/DX 0 0 

INJ ANES;INTERCO SGL 0 0 

BLEPHAR-I&D ABSC EYE 0 0 


GASTRIC LAVAGE 0 0 

NASO W/ENDO (DIAG) 0 0 

CPR 0 0 

CARDIOVERSION,EXTERN 0 0 

ECG 1-3 LEAD INT/REP0 0 

VENT ASSIST&MNG 1STD 0 0 

PULSE OX/EAR SINGLE0 0 

PULSE OX/EAR MULTI0 0 

ANOG EXAM W/COLP 0MAG 

0 

IPECAC FOR EMESIS 0 0 

CATH COLLECT SPEC-STR 0 CAT 0 

MTR FOR COMPARTMENT 0 SYNDR0 

STRAPPING HIP 0 0 

SMPL LAC BADY, SCALP>30CM 0 0

JAMSHIDI NEEDLE 0 0 

MED SURG/SUP-MS 0 0 

MED/SURG SUPP ICU0 0 

ACE BANDAGE 0 0 

BIOPSY NEEDLE 0 0 

BLOOD GAS KIT 0 0 

CUSTOM DSG TRAY 0 0 

COBAN 0 0 

IRRIGATION TRAY 0 0 

SLING 0 0 

DRAIN SALEM SUMP 0 0 

VASELINE GAUZE 0 0 

ZEROFOAM GAUZE 0 0 

ANTIEMBOLISM HOSE0 0 

CAST BOOT 0 0 

CLEAN CATCH URINE 0CO 

0 

KLING 0 0 

STERI STRIPS 0 0 

URINE LEG BAG 0 0 


1 

MED/SURG ROUTINE-PIP 0 0 

MED/SURG SUPPLY-MCH 0 0 

MED/SURG SUPPLY-NSY 0 0 

ROUTINE M&S OR 0 0 


ELA-DUAL PCMKER 0 0 

ST JUDE-DUAL PCMKER 0 0 

MEDTRONI-DUAL PCMKER 0 0 

ELA-SINGLE PCMKER 0 0 

ST JUDE-SINGLE PCMKE 0 0 

MEDTRO-SINGLE PCMKER 0 0 

GUIDANT-ENTRA DUAL 0 0 

MEDTR-ENPULSE PCMKER 0 0 

MEDCRONIC-ENRYTHYM 0 PCMKR0 

ELA-PCMKER LEAD 0 0 

ST JUDE-PCMKER LEAD0 0 

MEDTRON-PCMKER LEAD 0 0 

DUAL PACEMAKER 0 0 

SINGLE PACEMAKER 0 0 

PACEMAKER LEAD 0 0 

LOOP MONITOR 0 0 

OXYGEN SUPPLIES-ACU 0 0 

CYTOLOGY BRUSH 0 0 

DUAL PORT ADAPTOR0 0 

I-NEEDLE (LONG) 0 0 

J-TUBE 0 0 

20G TUOHY NEEDLE 0 0

POST-OP SHOE 0 0 

T-LOOP ELECTRODE 0 0 

BALLOON EXTRACT TX12 0 0 

STIFCOR BX NEEDLE 0 0 

STIF CORE BRON NEEDL 0 0 

PICC LINE CATH 0 0 

STAT LOCK 0 0 

PROBE INJ GOLD 10FR0 0 


0 

EPIDURAL TRAY 0 0 

ACL SUTURE TI-CRON0 0 

ART BANANA KNIFE 1 1 

ART BIO-FASTAK 0 0 

ART BIO-SUTURE TAK0 0 

ART C-REAMER 10MM0 0 



ART ESU PROBE/HNDL0 0 

ART OATS SET 10MM0 0 

ART OATS SET 6MM 0 0 

ART OATS SET 8MM 0 0 

ART TUBING PATIENT0 0 

ENT EAR CANAL STRIP0 0 

ENT NASAL THERMSPLNT 0 0 

ENT STIM PROBE 0 0 

5.5 BIO CORK SUTURE 0 ANCHR 0 



EXFIX MON OFFSET CLMP 0 0 

EXFIX MON SNGL CLMP 0 0 

EXFIX SYN CLAMPS 0 0 

EXFIX SYN ROD 200 0 0 



EXFIX SUN SCHANZ SCW 0 0 

EYE ADAPT MALE/MALE 0 0 

EYE CORNEAL PUNCH 07.75 

0 

EYE CORNEAL PUNCH 08.0 

0 

EYE CORNEAL TISSUE0 0 

EYE CORNEAL TRESPHINE 0 7.5 0 

EYE LENS GLIDE 0 0 

EYE MEROCEL DRAIN0 0 

EYE PACK ANT VITRECT 0 0 

EYE PACK ANT VITRECTOMY 0 0 

EYE PACK AQUALASE0 0 

EYE PACK MICROCEAL0 0 

EYE PACK POSTERIOR,VENTU 0 0

EYE RETROBULBAR NDL 0 0 

EYE SCLERAL BUCK ALL 0 0 

EYE SPHERE 0 0 

LAP ENDOLOOP 0 0 


MESH PERFIX, LG 1 1 

MESH PERFIX, MED 0 0 

MIS U DRAPE 0 0 

MIS VACUSTAT BULLDOG 0 0 

ORT CONSTAVAC CBC 0II 

0 

ORT CONSTAVAC DRN 0 1/4 0 

ORT CONSTAVAC DRN 0 1/8 0 

ORT DALL-MILE PL 100 0 

ORT DALL-MILE PL 120 0 

ORT DALL-MILE PL 6.50 0 

ORT GRAFT BONEPLAST 0 0 

ORT MITEK FASTIN RC0 0 

ORT MITEK ROT CUFF0 0 



ORT SPECIMEN SOCK0 0 

ORT SPECIMEN SOCK0 0 

ORT STEIN PIN SM 7/64 0 0 










TIER 1 MISC JOINT IMPLANT 0 0 

COLLAGEN IMPLANT 0URINARY 

0 

SHAVER 2.0MM 0 0 

SHAVER 2.0MM FULL 0RA 

0 

SHAVER BURR OV.6MM 0 0 

SHAVER BURR OVA4.0MM0 0 

SHAVER BURR SHER 4.5 0 0 

SHAVER CUDA 3.5 0 0 

SHAVER CUDA MERL 04.2 

0 

STAPLE POLY ROTIC 0 0 

STAPLE ROTIC 55&3.50 0 




STAPLE TA 90 0 0

SYN L PL DCP BR 07 H0 0 



































TOT JOINT DEVICE IMPLANT 0 0 

TOT KNIFE SLIT BLADE0 0 


0 


0 

URO CATH SUPRABLCYSTOSCO 0 0 

URO PROSTH PENILE 0NON-IN 

0 

URO PROTH PENILE INFLAT 0 0 


IMPLANTABLE JOINT 0DEVICE 

0 

MISC IMPLANT SCREW/ANCHOR 0 0 

TKA 3-M STYLE SAW BLADE 0 0 

TKA TRIA PS TIBIAL INSERT 0 0

AMNIO SUPPLIES 0 0 

INTRATHECAL ADMIN0 0 

CHEMO UNSPECIFIED0 0 

FLU VACCINE ADMIN0 0 

ONCOLOGY E&M LEVEL 0 3 0 

DELIVERY ROOM TWINS 0 0 

ONC IV THER 1ST HR 0 0 

ONC IV THER ADD'L HR 0 0 

IV TX ADD'L SQ < 1 HR0 0 



ONC INJECTED SC,IM0 0 




CHEMO INFUSD 1ST HR 0 0 

CHEMO INFUSD AD'L 0HR 

0 

CHEM INF SEQ 1ST HR0 0 

CHEMO CNS REQ SPINAL 0 0 

CHEMO IVP INITIAL 0 0 

CHEMO IVP EA ADD'L0 0 

INTRATHECAL ADMIN0 0 

CHEMO SC/IM NON-HORM 0 0 

CHEMO SC/IM HORMONAL 0 0 

CHEMO UNSPECIFIED0 0 

BLOOD ADMIN-ONCOLOGY 0 0 

PORT FLUSH 0 0 

FLU VACCINE ADMIN0 0 

PNEUMON VACCINE 0ADMIN 

0 

CARMUSTINE 100 MG 0 VIAL 0 

DACARBAZINE 100 MG 0 VIAL 0 

CLADRIBINE 1 MG/ML 0 VIAL 0 

DOCETAXEL 80 MG VIAL 0 0 

ALDESLEUKIN 22MMU 0 VIAL 0 

INTRON A (10MM UNITS/ML) 0 0 

ROFERON-A 9MM U/0.5ML 0 KIT 0 

THIOTEPA 15 MG VIAL0 0 

LEUCOVORIN 100 MG 0VIAL 

0 

CARBOPLATIN 150 MG 0 VIAL 0 

CYTARABINE 100 MG 0VIAL 

0 

GEMCITABINE 1 GM VIAL 0 0 

PENTOSTATIN 10 MG 0VIAL 

0 

ZOLADEX 10.8 MG SYRINGE 0 K 0 

INTRON A 5MM UNITS 0 INJ PE 0 

INTRON A 10 MMU VIAL 0 0 

INTRON A 3MM UNITS 0 INJ PE 0 

OXALIPLATIN 100 MG 0VIAL 

0

FULVESTRANT 125 MG 0 SYRING 0 

CYTARABINE LIPOSOME 0 50MG 0 

ABARELIX 100 MG VIAL 0 0 

ALEMTUZUMAB 30 MG 0 VIAL 0 

ABRAXANE 100MG 0 0 

CARBOPLATIN 450 MG/45ML 0 V 0 

ROFERON-A 3MM U/0.5ML 0 KIT 0 

LEUPROLIDE 30 MG DEPOT 0 4M 0 

DAUNORUBICIN 20 MG 0 VIAL 0 

EPINEPHRINE 1MG PRES 0 FREE 0 

PULSE OXIMETRY MULTI 0 0 

SUPERVISED LVL III PULM 0 0 

P/R MANIP-CHEST CUP 0 0 

CR PHASE IV-PLFD 0 0 

NDL OCULOELECTROMYOGRAPHY 

0 0 

NDL ELECTROMY 1 EXTREMITY 0 0 




NDL ELECTROMYO LARYNX 0 0 

NDL ELECTROMYO HEMIDIAGRM 0 0 

NDL ELECTRO CRANIAL 0 UNI 0 

NDL ELECTRO CRANIAL 0 BILAT 0 

NDL ELECTRO THOR PARASPNL 0 0 

NDL ELECTROMYO LMTD 0 STUDY 0 

NDL ELECTROMYO SNGL 0 FIBER 0 

MOTOR W/O F WAVE 01 TO 2 0 

MOTOR WITH F WAVE 0 1 TO 2 0 

MTR & OR SENSE NERVE 0 COND 0 

H FLEX, GASTROC/SOLEUS 0 0 

H FLEX OTHER 0 0 

CURRENT PREC THRESH 0 LIMB 0 

H FLEX GASTROC/SOL 0BILAT 

0 

MOTOR W/O F WAVE 0EA ADD'L 0 

MOTOR W/F WAVE EACH 0 ADD'L 0 

EEG EXTEND MONITOR 0 41 60 0 







VALPROIC ACID 0 0 

AMPHETAMINE 0 0 

COCAINE 0 0 

TETRAHYDROCANNABINOL 0 0 

BARBITURATES 0 0

BENZODIAZEPINES 0 0 

PCP 0 0 

OPIATES 0 0 

CARDIAC PANEL 0 0 

ARTHRITIS PANEL 0 0 

BLOOD GAS W/TEMP0 0 

HEPATITIS C AB 0 0 

HEP B CORE IGM 0 0 

HEP B SURFACE AG 0 0 


HEPATITIS A AB, TOTAL 0 0 

ITEL NON BILL OBS PER 0 HR 0 

FLUID RBC 0 0 

CSF DIFFERENTIAL 0 0 

H PYLORI CULTURE 0 0 

GP.B STREP SCREEN 0 0 



TISSUE HOMOGENOUS 0 0 








REC HSP EVAL ATHENA 0 652 0 

ANTI TITER-SALINE 0 0 



COLD AGGLUTININS 0 0 

TICK ID & LYME/ PCR0 0 

LEAD ADULT 0 0 

IMIPRAMINE 0 0 

HEPATITIS BE AG 0 0 

CSF HERPES, PCR 0 0 

TETANUS TITER 0 0 


LYME BY PCR (UCONN) 0 0 

YO AUTOANTIBODY 0 0 

HU AUTOANTIBODY 0 0 

CYSTINE,SERUM 0 0 

NUCL.MOL.ISOLATION0 0 

NUCL.MOL.ENZ.DIGEST. 0 0 

NUCL.MOL.SEPARATION 0 0 

NUCL.MOL.NUCL. ACID 0 0 

NUCL.MOL.AMPLIFICATION 0 0

KENNEDY DISEASE DNA 0 0 

APOLIPO.E GENOTYPE0 0 

T PROTEIN,24HR UR 0 0 

MOL.ENZYMATIC DIGEST 0 0 

MOLECULAR ISOLATION 0 0 

MOLECULAR SEPARATION 0 0 

LEMS AUTOANTIBODY0 0 

MYTONIC DYST. DNA0 0 

CHARCOT MARIE TOOTH 0 0 

CSF EBV BY PCR 0 0 

PRESS.PALSY NEUR.DNA 0 0 

METHADONE 0 0 

MA TA AUTOANTIBODY 0 0 

HUNTINGTON'S DISEASE 0 0 

LEMS (RIA) 0 0 

HU(WB) 0 0 

YO (WB) 0 0 

RI (WB) 0 0 

MA2 (WB) 0 0 

MAG ELISA 0 0 

GQ1B AUTOANTIBODY0 0 

MOL.AMPLIFICATION 0PC 

0 

ISOLATION OR EXTRACT 0 0 

AMPLIFICATION 0 0 

GALOP AUTOANTIBODY 0 0 

SULFATIDE IGG 0 0 

SULFATIDE IGM 0 0 

SPINAL MUSCULAR ATRO 0 0 

NEUTRALIZATION TEST 0 0 

NITROBLUE TETRA.DYE 0 0 

TISSUE CULTURE 0 0 

CO-ASIALO GM1 0 0 

CO-GD1B 0 0 

CO-GM1 IGG 0 0 

SGPG ELISA 0 0 

TAU/AB42 INTERPRETAT 0 0 

CO SGPG 0 0 

MOL.ISOLATION/EXTRAC 0 0 

MOL.AMPLIFICATION0 0 

MOL.ENZ.DIGESTION0 0 

MOL.SEP.BY GEL ELECT 0 0 

NUCLEIC ACID PROBE0 0 

DOT/SLOT BLOT PROD. 0 0 

NUCLEIC ACID AMPLIFI 0 0 

PROTEIN 14-3-3 0 0 

MT DNA ENCEPHALOMYOP 0 0 

NUCLEIC ACID ISO/EXT0 0

MUTATION ID ALLELE 0S 

0 

MUTATION ID BY SEQUE 0 0 

THIN LAYER ANALYSIS0 0 

CHRON.DEMYELIN.NEURO 0 0 

DOT/SLOT BLOT PROD. 0 0 

OPMD INTERPRETATION 0 0 

NUCLEIC ACID TRANSFE 0 0 

ALPHA-GLOBULIN GENE 0 0 

TETANUS AB 0 0 

FSHD DNA DEL. TEST 0 0 


ISOLATION/EXTRACT 0NA 

0 


REVERSE TRANSCRIPTIO 0 0 

CADISIL DNA TEST 0 0 

MERRF MTDNA MUTATION 0 0 

CV2 AUTOANTIBODY0 0 

WESTERN BLOT/BAND 0 ID 0 

IMMUNOASSAY 0 0 

HSV AMP PROBE TECH0 0 

MUTATION SCANNING0 0 

HIGH RISK HPV DNA 0 0 


CYTOGENETICS INTERPR 0 0 


IM ASSAY/AB TO INF A0 0 



AMP.NA,MULTIPLX RXN 0 0 

DMD/BMD DELETION 0INT 

0 

RET PROTO ONCOGENE 0 M 0 

MUTATION ID BY SEQ0 0 

FAM.ADENOMATOUS 0POLY 

0 

MELAS MUTATION INTER 0 0 

ATAXIA PROF INTERP0 0 

DYSTONIA INTERP. 0 0 


HERED SPASTIC PARAPL 0 0 

TRANSTHYRETIN DNA 0SE 

0 

RECOMBX CAR 0 0 

DMD/BMD DNA CARRIER 0 0 

TAU CSF ANALYSIS 0 0 

AB42 CSF ANALYSIS 0 0 

NARP MTDNA EVAL INTP 0 0 

GAUCHER'S DISEASE 0 0 

FAMILIAL DYSAUTONOMI 0 0 

CYTO & MOL. INTERPRE 0 0

MEN2/FMTC MUTATIONS 0 0 

COMPLETE CMT EVAL0 0 

MUSK ANTIBODY TEST0 0 

NEUROFIBROMATOSIS0 0 


PS-1(PRESINILLIN-1) 0 0 

CHOREA,HUNTINGTON'S 0 0 

APRATAXIN 0 0 

MITOCHONDRIAL MYOP. 0 0 

AMP.OF NUCLEIC ACID0 0 

MOL.ISO. OR EXTRACTI 0 0 

ENZ.DIGESTION 0 0 

NIEMANN PICK DISEASE 0 0 

CONNEXIN32 DNA SEQUE 0 0 

MUT.ID BY SEQUENCING 0 0 

MASS SPECTROMETRY0 0 

IMMUNOASSAY,NOT 0SPEC 

0 

AMYLOIDOSIS EVAL. 0 0 

CYTOGENETIC INTERP. 0 0 

IMMUNOASSAY,QUANT,RA 0 0 

MOLEC.DIAG.INTERP.0 0 

NEOSENSORY NEURO.PNP 0 0 

IMMUNOASSAY,RIA 0 0 

PROTEIN,WB TEST 0 0 

FXTAS DNA TEST 0 0 

HEP B GENOTYPE 0 0 

NUCLEIC ACID ISO/EXT0 0 

NUCL.MOL.SEPARATION 0 0 

NUCL.MOL.AMPLIFICATION 0 0 

ISO/EXTRACTION NA0 0 

ENZYMATIC DIGESTION 0 0 



SIGNAL AMP.NUCLEIC 0 A 0 

HIGH RES SEP & ID 0 0 

FAM HEMI MIGRAIN 0INT 

0 

HIGH RES CHROMOSOME 0 0 

FISH, WILLIAMS 0 0 

RETTS SYNDROME 0 0 

ARX DNA SEQUENCING 0 0 

NORRIE DISEASE DNA0 0 

SCN1A DNA SEQUENCING 0 0 

TUBEROUS SCLEROSIS0 0 

AMP. 1ST 2 NA SEQUENCING 0 0 

EPILEPSY EVAL PROG0 0 

DM2 DNA TEST 0 0 

NEUROPATHY EVAL, MULT 0 0

CX 26 DNA SEQUENCING 0 0 

SM. FIBER PAIN AXON0 0 

MULTIFOCAL NEUR EVAL 0 0 

CONGEN. HYPMYELINATIO 0 0 

SCHISTOSOMIASIS 0 0 

HEP B SURF. AG 0 0 

GIARDIA AG 0 0 

CRYPTOSPORIDIA AG0 0 

HEP C AB 0 0 

LYMPHOGRANULOMA 0 VENEREUM 0 

SIGNAL AMP NUCL ACID 0 0 

OSMS, FECES 0 0 

HIGH RESOLUTION SEP 0 & ID 0 

CORTISOL, SALIVARY 0 0 

METHSUXIMIDE 0 0 

11 DEOXYCORTISOL 0 0 

MUTATION IDENTIFICATION 0 0 

SEPARATION & IDENTIFY 0 0 

ISOLATION/EXTRACTION 0 0 

URORISK PANEL 0 0 

MUTATION ID BY ENZ 0LIGA 

0 

HIGH RESULTION SEP 0& ID 0 

NUC ACID ISOL-ATHENA 0 652 0 

NUC ACID AMPL ATHENA 0 652 0 

MUTATION ID ATHENA 0 652 0 

SEP & ID ATHENA 6520 0 

REC HSP EVAL ATHENA 0 652 0 

ISO/EXTRACT NUCLEIC 0 ACID 0 

ENZYME DIGESTION 0 0 

AMPLI, NUCLEIC ACID 02 

0 

AMPLI, NUCLEIC ACID 0> 2 0 

SEPARATION/ID HIGH 0RESOLU 

0 

MUTATION ID BY ENZYME 0 0 

DKH DRUG SCREEN 0 0 

DKH DRUG SCREEN 0 0 

ATHENA ISOL AND EXTRACT 0 0 

ATHENA AMPLIFICATION 0 0 

ATHENA MUTATION ID0 0 

ATHENA SEP AND ID 0 0 

LDH QUEST 0 0 

TESTOSTERONE QUEST 0 0 

TROPONIN QUEST 0 0 

SGPT QUEST 0 0 

SGOT QUEST 0 0 

FOLATE QUEST 0 0 

LIPASE QUEST 0 0 

AMMONIA QUEST 0 0

PCR BY IMUGEN 0 0 

A PHAGOCYTOPHILUM, 0 PCR 0 

LYME, PCR 0 0 

E CHAFFEENSIS, PCR 0 0 

TAPENTADOL, QUANT, 0 URINE 0 

CHROMOSOME (UCONN) 0 0 

PKU SCREEN 0 0 

CMV (URINE) 0 0 

SSB ANTI-LA TITER 0 0 

HSV ON CSF BY PCR 0 0 

ATAXIA PROF INTERP0 0 

SMEAR ECC 0 0 


ST EVAL FNA/ASEQUACY 0 0 

SMEAR NGYN 0 0 

CYTO BRONCH SPUTUM 0 0 

MED/SURG ROUTINE0 0 

PLATELETS, 5 UNITS 0 0 

CELLS,WBC-REDUCED,4U 0 0 

PLTS,WBC-REDU,IRR,2U 0 0 

PLTS,WBC-REDU,IRR,3U 0 0 

CELLS,WBC REDU,IR,2U 0 0 

ALBUMIN 25%/50ML 02UN 

0 

FRSH FRZ PLASMA,2UNI 0 0 

CRYOPRECIP, 2 UNITS0 0 

CELLS,WBC/REDUCED,6U 0 0 

CELLS,WBC REDUCED,3U 0 0 

AUTOLOGOUS PROCESS 0 0 



CRYOPRECIP. 3 UNITS0 0 

13080 UNITS FACTOR 08 

0 

6540 UNITS FACTOR 80 0 



ALBUMIN 5%/250ML0 0 

PLTS,WBC REDU,IRR,6U 0 0 

SEPACELL FILTERS (2)0 0 

PLATELETS, TEN UNITS0 0 

SEPACELL FILTER (1) 0 0 

2 PLT INFUSION SETS0 0 

CRYOPRECIP. 4 UNITS0 0 

WBC FILTER/PLATELET0 0 

MRI KEN LSPINE W WO 0 CONTR 0 

MRI KEN SHLDR ARTHRO 0 LT 0 

MRI KEN SHLDR ARTHRO 0 RT 0 

MRI KEN UPEX NO JT 0WO LT 0

MRI KEN UPEX NO JT 0WO RT 0 

MRI KEN LOEX NOJT W/O 0 LT 0 

MRI KEN LOEX NO JT 0W LT 0 

SLEEP STUDY REQUEST 0 0 

S.S. SCREEN (UNAT.4)0 0 

S.S. SCREEN (ATT.4) 0 0 

EEG MISC 0 0 

E.R. EKG 0 0 

INJ REGADENOSON, .1 0 MG 0 

GALLBLADDER SERIES0 0 

PORTABLE RADIOGRAPHY 0 0 

CONSULT-OUTSIDE FILM 0 0 

CONSULT-OUTSIDE FILM 0 0 

MAMMO DIAG BILAT0 0 

NEEDLE LOC-RIGHT 0 0 

MAMMO DIAG UNI-LT0 0 

MAMMO DIAG UNI-RT0 0 

MAMMO PADS 0 0 

LOC NEEDLES 0 0 

STEREO TRAY 0 0 



MAMMO SCREEN 0 0 

VENOGRAM INS-LT 0 0 

VENOGRAM INS-RT 0 0 

MAMMO NED LOC ADDL 0 UNI-RT0 

GREENFIELD FILTER REMOVAL 0 0 

GREENFIELD FILTER REMOVAL 0 0 

GREENFIELD FILTER INTRO 0 0 

PORTABLE RADIOGRAPHY 0 0 

RT KNEE-WO-OTIS-IMPLANT 0 0 

LT KNEE-WO-OTIS-IMPLANT 0 0 

RT KNEE-WO-OTIS IMPLANT 0 0 

VISIP320MG-LOCM@50ML 0 0 

VISIP320-LOCM@100ML 0 0 

VISIP320-LOCM@150ML 0 0 

OMNIP180-LOCM@20ML0 0 



OMNIP300-LOCM@150ML 0 0 



OMNIP350-LOCM@125ML 0 0 

MAMMO PAD 0 0 

BIO SOFT TIS KNEE/THIGH 0 0 

1ST PASS BLOOD POOL 0 0 

GALLIUM STUDY SCAN0 0

PLANAR CARDIAC RE&EX 0 0 

PLANAR CARDIAC REST 0 0 

GALLUIM TOM W SPECT 0 0 

MYOCARD INFARC SPECT 0 0 

MYOCARDIAL PERF W.M. 0 0 

MYOCARDIAL PERF E.F. 0 0 

LIVER WITH SPECT 0 0 

THALLIUM 1 MCI 0 0 

THALLIUM 1 MCI RE INJECT 0 0 

PORT INJ FOR PATENCY 0 0 

PERSANTINE 1.0-10.00 0 






2 DOSES MYOVIEW 0 0 

INDIUM DOSAGE 0 0 

TECHNESIUM 20 0 0 

TECHNESIUM 25 0 0 

ECHO-2D LIMITED BUBBLE 0 ST 0 

DOPPLER ECHO LIMITED 0 0 

PORTABLE ULTRASOUND 0 0 

RENAL CYST/PELV PROC 0 0 

NEEDLE BIOPSY 0 0 



NEEDLE LOC (US) 0 0 

NEEDLE LOC PROC 0 0 

US-GUIDED DRAINAGE0 0 

NEPHROSTOMY LOCALIZA 0 0 

ARTERIES LOW EXT UNI 0 0 

ARTERIES UPP EXT UNI 0 0 

LEVEL II OB-US 0 0 

PORTABLE ULTRASOUND 0 0 

DEFINITY CON-PERFL 0PER ML 0 

PET/CT-COLON 0 0 

PET/CT-ESOPH 0 0 

PET/CT-HEAD 0 0 

PET/CT-NECK 0 0 

PET/CT-LUNG 0 0 

PET/CT-LYMPHOMA 0 0 

PET/CT-WHOLE BODY0 0 

PET/CT-BREAST 0 0 

PET/CT-THYROID 0 0 

PET-MYOCARD-DIAGNOST 0 0 

PET/CT-SKULL-TO-THIGH 0 0

MRI-SPECIAL 0 0 

MRI-BONE MARROW0 0 

MRI-MYOCARDIUM 0 0 

MRI-RIGHT KNEE WO 0OT IMPL 0 

MRI-GADO-15ML 0 0 




MRA-SPINE W/WO CONTR 0 0 

MRA-NECK W/CONTRAST 0 0 

MRA-AB W/WO CONTR 0 0 

CT I.A.M. W/WO CONTR 0 0 

CT LOW EX W/WO CO-LT 0 0 

CT LOW EX W/WO CO-RT 0 0 

CT POST FOSSA W/CONT 0 0 

CT POST FOSSA W/WO 0 C 0 

CT POST FOSSA WO CON 0 0 

CT RETROP W/WO CONTR 0 0 

CT RETROPERI W/CONTR 0 0 

CT RETROPERI W/O CON 0 0 

CT SAC/COCC W/WO 0CON 

0 

CT SI JTS W/WO CONTR 0 0 

CT UP EX W/WO CO-RT 0 0 

CT-3D WIZARD 0 0 

CT-ANGIO AORTA 0 0 

CT-KIDNEY CYST ASP 0 0 

MRI-SHLDR ARTHRO LT 0 PLF 0 

MRI-SHLDR ARTHRO RT 0 PLF 0 

WINRHO SDF 5,000 UNITS 0 VL 0 

BACITRACIN EYE OINT 03.5GM 

0 

CANDESARTAN 16 MG 0 TAB 0 

CARBACHOL 0.01% OCULAR 0 0 

COLCHICINE 1MG/2ML 0 VIAL 0 

CORTICOTROPIN 80 U/ML 0 VIA 0 

DIGOXIN 100 MCG CAPS 0 0 

ERYTHROMYCIN 1 GM 0 ADDV VL 0 

ESMOLOL 2.5 GM AMPULE 0 0 

AEROBID INHALER 7 GM 0 0 

FLUOROMETHOLONE 00.1% DROP0 

HUMULIN U INSULIN0 0 

INSULIN ZINC HUMAN 0 R 100 0 


WINRHO SDF 600 UNITS 0 VIAL 0 

METAPROTERENOL 0.4% 0 NEB U 0 

METAPROTERENOL INHALER 0 0 

METAPROTERENOL 0.6% 0 NEB 0 

MIVACURIUM 10MG/5ML 0 VIAL 0

PROCAINAMIDE SR 500 MG TA 0 

TEGASEROD 6 MG TAB0 0 

THEOPHYLLINE 400MG/D5W 0 50 0 

TRIMETHOBENZAMIDE 0 HC 0 

TRIMETHOBENZAMIDE 0 HC SUPP0 

FERR SULF INF DRP 15MG/.6 0 0 


OCTREOTIDE 100 MCG/ML 0 AMP 0 

PIPERACILL/TAZO 2.25G 0 ADD 0 

FELODIPINE 2.5 ER TAB 0 0 

ROSIGLITAZONE 4 MG 0 TAB 0 

VARIVAX VACCINE 0.5ML/VIA 0 0 

METHADONE 10 MG 0TAB 

0 

ALENDRONATE 10 MG 0 TAB 0 


0 


FLUVASTATIN 20 MG 0CAP 

0 

BETAXOLOL 0.25% EYE 0 DROP 0 

CEFOTETAN 1 GM ADD 0 VIAL 0 

NEPHROCAP CAPSULES 0 0 

IPECAC SYRUP 30ML 0BOTTLE 

0 

NEUTRA PHOS-K PWD 0 PACKET 0 

LEUCOVORIN 50 MG 0VIAL 

0 

ATENOLOL 0.5MG/ML 0 INJ 0 

TORISEL KIT-25MG 0 0 

BACTRIM SUSP 5 ML 0ORAL 

0 

DANTROLENE 50 MG 0CAP 

0 

H1N1 VACCINE 0 0 


E E S 200 MG/5ML 0 0 

INJECTION, CEFAZOLIN 0 500 0 



BENDAMUSTINE 25 MG 0 VIAL 0 

MIDRIN GENERIC CAP0 0 

FLEET BAGENEMA 0 0 

PRE ADMIN SERV-IVIG0 0 

AA 3.5%/D25W IV SOLN 0 0 

ALCOHOL 5%/D5W IV 01000 ML 0 

ALCOHOL 5%/D5W IV 01000 ML 0 


0 


0 


0 


0 



NACL 0.9% 250 ML PVC 0 0

NACL 0.9% 250 ML PVC 0 0 

MAGNESIUM SULF 40GM/LITER0 0 




NITRO PLUMB SET 0 0 

SECONDARY SET 0 0 

CLAVE CONNECTOR 11956 0 0 

METRONIDAZOLE 5000 MG IV 0 

FLUCONAZOLE 200 MG 0 INJ 0 

MAGNESIUM 20 GM/500 0 ML 0 

MALE ADAPTOR PLUG 0 - 11391 0 

IV ADMINISTRATION 0SET-CLA 

0 

EXT SET RESEAL 119570 0 

DIAL A FLOW W/EXT 019140 

0 

MACRO SET 11961 0 0 

7 HIGH PRESSURE SET 0SS-46 

0 

BLOOD IV SET TYPE Y 0- 124 0 

SURGICAL IV SET 12664 0 0 

PUMP FILTERED SET 12030 0 0 

NITROGLYCERIN PLUMSET-118 0 0 

BLOOD IV SET - 46020 0 

SECONDARY SET 32IN 011953 

0 

FLTR SET HIGH-PRES 12273 0 0 

IV SET PRIMARY 119620 0 

CLAVE CONNECTOR - 011956 

0 

EPIDURAL PUMP TUB 0#13514 

0 

PCA PUMP SET 0 0 

REEVAL CMPX SP&LANG 0 CTCAR 0 

AAC THER SERV NON 0SP(PROC 

0 

DVLPMT, COG SKILLS 015 MIN 0 

TREATMENT, SP/LANG, 0 GRP 0 

EVAL VOICE PROS DEVICE 0 0 

REEVAL CMPX SP CTCAR 0 DLS 0 

AAC EVAL NON SP(PROC 0 DLS 0 

AAC THER NON SP(PROC 0 DLS 0 

AAC EVAL SP 1ST HR DLS 0 0 

AAC 30 ADD'L MIN DLS 0 0 

AAC THER SERV (PROC) 0 DLS 0 

PLFD REEVAL CMPX SP 0 CTCAR 0 

AAC THER NON SP(PROC 0 PLF 0 

ICU MONITORED 1ST 01/2 HR 0 

ICU MONITOR EA ADDL 0 15MIN 0 

INTERSCALENE BLOCK0 0 

H/L MEDICAID B/D ALLOW 0 0 

DLSN RE-EVAL CPLX CTC(PRO 0 0 

WHIRLPOOL (PROC) DLS 0 0

DLSN MOIST HEAT/CRYO(PROC 0 0 

FUNCTIONAL CAP/15MIN 0 DLS 0 

DLSN SHORT ARM SP 0ST(PROC 

0 

DLSN SHORT ARM SP 0DY(PROC 

0 

DLSN FINGER SPLIN ST(PROC 0 0 

DLSN FINGER SPLINT 0DY(PRO 

0 

LOW BACK STRAP(PROC) 0 DLS 0 

SHOULDER STRAP(PROC) 0 DLS 0 

ELBOW/WRIST STR(PROC 0 DLS 0 

HAND/FINGER STR(PROC 0 DLS 0 

THORAX/CHEST ST(PROC 0 DLS 0 

TOES STRAPPING (PROC) 0 DLS 0 

UNNA BOOT STRA(PROC) 0 DLS 0 

COMM/WORK REINT/15MI 0 DLS 0 

DEVELOP COGN SKILLS/15MIN 0 0 

SENSORY INT TEC/15MI 0 0 

AQUATIC THERAPY DLS 0 0 

WC DEBRIDE>20CM(PROC 0 DLS 0 

WC DEBRIDE

DLSN HFOWOJT L39130 0 

DLSN HOWOJT L39190 0 

DLSN HFO1+JT L39210 0 

DLSN FOWJT L3935 0 0 

DLSN ADDOPERJOINT 0L3956 

0 

VASOPNEUMATIC DEVICE 0 0 

HOUSEKEEPING-PAPER 0 PRODTS 0 

DLSN CERV COLLAR FORM 0 FIT 0 

DLSN UNIV CERVICAL 0COLLAR 

0 

DLSN COLLAR W/OPEN 0 TRACH 0 

DLSN UNIVERSAL KNEE 0 SPLIN 0 

DLSN UNIVERSAL RIB 0BELT 

0 

PLFD RE-EVAL CPLX CTC(PRO 0 0 

PLFD MOIST HEAT/CRYO(PROC 0 0 

PLFD SHORT ARM SP 0ST(PROC 

0 

PLFD SHORT ARM SP 0DY(PROC 

0 

PLFD FINGER SPLINT ST(PRO 0 0 

PLFD FINGER SPLINT DY(PRO 0 0 

LOW BACK STRAP(PROC) 0 PLF 0 

SHOULDER STRAP(PROC) 0 PLF 0 

ELBOW/WRIST STRA(PROC)PLF 0 0 

KNEE STRAPPING (PROC 0 PLF 0 

HAND/FINGER STRA(PROC)PLF 0 0 

THORAX/CHEST STRAPPING 0 0 

HIP STRAPPING (PROC) 0 PLF 0 

TOES STRAPPING(PROC) 0 PLF 0 

UNNA BOOT STRAP(PROC)PLF 0 0 

CONTRAST BATHS/15MIN 0 PLF 0 

COMM/WORK REINT/15MIN 0 PLF0 


SENSORY INT TEC/15MIN 0 PLF 0 

AQUATIC REHAB/15 MIN 0 PLF 0 

WC DEBRIDE>20CM(PROC)PLF 0 0 

WC DEBRIDE

PLFD WHFOADDSPREXT 0 L3835 0 

PLFD WHFOADSPGS L3840 0 0 

PLFD WHFOADDTHMP 0 L3845 0 

PLFD WHFOADDASST 0L3850 

0 

PLFD WHFOADDMPFLX 0 L3855 0 

PLFD WHFOADMPFLIP 0 L3860 0 

PLFD ADDTOUEJWE,EA 0 L3890 0 

PLFD WHFODYNHINGE 0 L3900 0 

PLFD WHFODYNHGNCBL 0 L3901 0 

PLFD WHOWOJT L39060 0 

PLFD WHOWRTHSPICA 0 L3907 0 

PLFD HFOWOJT L39130 0 

PLFD HOWOJT L39190 0 

PLFD HFO1+JT L39210 0 

PLFD FOWOJT L39330 0 

PLFD FOWJT L3935 0 0 

PLFD ADDOTOPERJT L3956 0 0 

PLFD CERV COLLAR FORM 0 FIT 0 

PLFD UNIV CERVICAL 0COLLAR 

0 

PLFD COLLAR W/OPEN 0 TRACH 0 

PLFD UNIVERSAL KNEE 0 SPLIN 0 

PLFD UNIV RIB BELT 0 0 

RE-EVAL COMPLX CTCARE(PRO 0 0 

MOIST HEAT/CRYO (PROC) 0 0 

FUNCTIONAL CAPACITY/15MIN 0 0 

SHORT ARM SPLINT DYN(PROC 0 0 

FINGER SPLINT STATIC(PROC 0 0 

FINGER SPLINT DYNAMI(PROC 0 0 

LOW BACK STRAPPING 0 (PROC) 0 

SHOULDER STRAPPING 0 (PROC) 0 

ELBOW/WRIST STRAPPIN(PROC 0 0 

HAND/FINGER STRAPPIN(PROC 0 0 

THORAX/CHEST STRAP 0 (PROC) 0 

TOES STRAPPING (PROC) 0 0 

UNNA BOOT STRAPPING(PROC) 0 0 

CONTRAST BATHS PER 0 15 MIN 0 

COMM/WORK REINTEGRAT/15MI 

0 0 


SENSORY INTEG TECH/15 0 MIN 0 

AQUATIC REHAB PER 015 MIN 0 

WC DEBRID >20CM (PROC) 0 0 

WC DEBRID

EWHORTHO L3763 0 0 

EWHFOWOJT L3765 0 0 

WHFOSHOPPON L38000 0 

WHFOLGOPPONENS 0L3805 

0 

WHFOADDTHUMB L3810 0 0 

WHFOADD2NDMP L3815 0 0 

WHFOADDIPEXTMP L3820 0 0 

WHFOADDMPEXTST L3825 0 0 

WHFOADDMPAST L3830 0 0 

WHFOADDSPREXT L3835 0 0 

WHFOADDSPRGSWVL 0 L3840 0 

WHFOADDTHMP L3845 0 0 

WHFOADDASST L3850 0 

WHFOADDMPLFX L3855 0 0 

WHFOADOMPFLXIP L3860 0 0 

ADDTOUEJWE,EA L3890 0 0 

WHFODYNHINGE L39000 0 

WHFODYNHNGCABLE 0L3901 

0 

WHOWOJT L3906 0 0 

WHOWRTHSPICA L3907 0 0 

HOWOJT L3919 0 0 

HFO1+JT L3921 0 0 

FOWOJT L3933 0 0 

FOWJT L3935 0 0 

ADDTOPERJOINT L3956 0 0 

ORTHOTIC FIT & TRAIN/15MI 0 0 

UNIVERSAL CERV COLLAR 0 0 

COLLAR W/OPEN TRACH 0 0 

UNIV KNEE SPLINT 0 0 


WHFOJT L3806 0 0 

WHFOWOJT 33808 0 0 

REPLSTRAP L4002 0 0 

REPARITIME L4205 0 0 

REPAIRMINOR L42100 0 

ELBOWORTHO L37020 0 

EWHORTHO L3763 0 0 

EWHFOWOJT L3765 0 0 

WHFOSHOPPON L38000 0 

EVAL SPEECH & LANGUA 0 0 

SPEECH & LANGUAGE 0TX 

0 

SWALLOW EVAL 0 0 

SWALLOW TX 0 0 

AAC EVAL NON-SP GEN 0 0 

AAC THER SERV NON 0SP 

0 

AAC EVAL SPEECH GEN0 0 

AAC 30 ADDIT'L MIN 0 0

VIDEO FLUORO EVAL I0 0 

OT REEVAL CPLX CTCARE(PRO 0 0 

OT HEAT/CRYO (PROC) 0 0 

OT FCE PER 15 MIN 0 0 

OT SHORT ARM SPL ST(PROC) 0 0 

OT SHORT ARM SPL DY(PROC) 0 0 

OT FINGER SPLINT ST(PROC) 0 0 

OT FINGER SPLINT DY(PROC) 0 0 

OT LOW BACK STRAPPIN(PROC 0 0 

OT SHOULDER STRAPPIN(PROC 0 0 

OT ELBOW/WRIST STRAP(PROC 0 0 

OT KNEE STRAPPING 0(PROC) 

0 

OT HAND/FINGER STRAP(PROC 0 0 

OT THORAX/CHEST STRAP(PRO 0 0 

OT TOES STRAPPING 0(PROC) 

0 

OT UNNA BOOT STRAP 0 (PROC) 0 

OT COMM/WORK REINTEG/15MI 

0 0 

OT DEVELOP COGN SKILL/15M 0 0 

OT WC DEBRID >20CM 0 (PROC) 0 

OT WC DEBRID

JOINT JACK 0 0 

RING PIP PREFAB 0 0 

CERV COLLAR-FORM 0FIT 

0 

UNIVERSAL CERV COLLAR 0 0 

COLLAR W/OPEN TRACH 0 0 

UNIV KNEE SPLINT 0 0 


OT SUPPLIES 0 0 

DLSN OT REEVAL CPLX 0 CTCAR 0 

HEAT/CYRO (PROC) DLS 0 0 

DLSN OT SH ARM SP ST(PROC 0 0 

DLSN OT SH ARM SP DY(PROC 0 0 

DLSN OT FINGER SP ST(PROC 0 0 

DLSN OT FINGER SP DY(PROC 0 0 

LOW BACK STRA(PRO0 0 

SHOULDER STRAPPING(PROC) 0 0 

ELBOW/WRIST STRAP 0(PROC) 

0 

HAND/FNGR STR(PROC) 0 DLS 0 

THORAX/CHEST STRAP 0 (PROC) 0 

TOES STRAP (PROC) DLS 0 0 

UNNA BOOT ST(PROC) 0 DLS 0 

CONTRAST BATH/15MIN 0 DLS 0 

COGN RE-TRAIN/15MIN 0 DLS 0 

AQUATIC REHAB PER 015 MIN 0 

WC DEBR>20CM(PROC) 0 DLS 0 

WC DEBR

DLSN OT WHFOADMPFLXIL3860 0 0 

DLSN OT ADDUEJWE,EA 0 L3890 0 

DLSN OT WHFODYNHINGEL3900 0 0 

DLSN OT WHFODYHGNCBLL3901 0 0 

DLSN OT WHOWOJT L3906 0 0 

DLSN OT WHOWRTHSPICAL3907 0 0 

DLSN OT HFOWOJT L3913 0 0 

DLSN OT FOWOJT L3933 0 0 

DLSN OT FOWJT L39350 0 

DLSN OT ADDOPERJT 0L3956 

0 

DLSN OT CERV COLLAR 0 FORM 0 

DLSN OT UNIV CERV COLLAR 0 0 

DLSN OT COLLAR W/OPEN 0 TRA 0 

DLSN OT UNIV KNEE SPLINT 0 0 

DLSN OT UNIV RIB BELT 0 0 

RE-EVAL CPLX CTCA 0PLF 

0 

WHIRLPOOL (PROC) PLF 0 0 

PLFD OT HEAT/CYRO 0(PROC) 

0 

PHYS PERF TEST FTE 15 0 MIN 0 

PLFD OT SH ARM SP ST(PROC 0 0 

PLFD OT SH ARM SP DY(PROC 0 0 

PLFD OT FINGER SP ST(PROC 0 0 

PLFD OT FINGER SP DY(PROC 0 0 

LOW BACK STR(PROC) 0 PLF 0 

SHOULDER STR(PROC) 0 PLF 0 

ELBOW/WRIST STRAPPING 0 PLF 0 

HAND/FNGR STR(PROC) 0 PLF 0 

THORAX/CHEST STRAP 0 PLF 0 

TOES STRAP (PROC) PLF 0 0 

UNNA BOOT STR(PROC) 0 PLF 0 

CONTRAST BATH/15MIN 0 PLF 0 

COMM/WORK REINTEG 0 PER 15 0 

PLFD OT DEV COGN SK/15MIN 0 0 

DEV COGNITIVE SKILLS 0 /15M 0 

AQUATIC REHAB/15 MIN 0 PLF 0 

WC DEBR>20CM(PROC) 0 PLF 0 

WC DEBR

PLFD OT WHFOADDTHUM 0 L38100 

PLFD OT WHFOADD2NDMPL3815 

0 0 

PLFD OT WHFADIPMP 0 L3820 0 

PLFD OT WHFADMPEXT 0 L3825 0 

PLFD OT WHFOADDMPASTL3830 0 0 

PLFD OT WHFOADSPREXTL3835 0 0 

PLFD OT WHFOADSPGSW 0 3840 0 

PLFD OT WHFOADDTHMP 0 L38450 

PLFD OT WHFOADDASST 0 L3850 0 

PLFD OT WHFOADDMPFLXL3855 0 0 

PLFD OT WHFOADMPFLXIL3860 0 0 

PLFD OT ADDUEJWE,EA 0 L3890 0 

PLFD OT WHFODYNHNG 0 L3900 0 

PLFD OT WHFODYHNGCBLL3901 0 0 

PLFD OT WHOWRTHSPICAL3907 0 0 

PLFD OT FOWJT L39350 0 

PLFD OT ADDOPERJT 0L3956 

0 

PLFD OT CERV COLLAR 0 FORM 0 

PLFD OT UNIV CERV COLLAR 0 0 

PLFD OT COLLAR W/OP 0 TRACH 0 

PLFD OT UNIV KNEE SPLINT 0 0 

PLFD OT UNIV RIB BELT 0 0 

MISSED APPOINTMENT 0 0 

CANCELLATION 0 0 

INITIAL IP CONSULT 0 0 

FOLLOW-UP IP CONSULT 0 0 

INDIV THER 20-30 MIN0 0 

FAMILY PSYCHOTHERAPY 0 0 

GROUP THERAPY BY DR 0 0 

GROUP THERAPY BY PRN 0 0 

GROUP THERAPY-DBT0 0 

EMERG PSYCH EVAL NON 0 CR 0 

EMER PSYCH EVAL-CREDENTLD 0 0 

THERAPY&MED EVA-APRN 0 45 0 

MEDS EVAL BY MD 0 0 

MEDS EVAL BY APRN0 0 

INITIAL M.D. EVAL 0 0 

INITIAL APRN EVAL 0 0 

INIT PSYCHOTHER EVAL 0 0 

MISSED APPOINTMENT 0 0 

CANCELLATION 0 0 

PROF FEE EMERG PSYCH 0 EVAL 0 

PRO FEE INDIV 20 300MIN 

0 

PRO FEE INDIV 45 500MIN 

0 

PRO FEE INDIV THER 0W/MED 

0 

PRO FEE INDIV 20 300W/MED 

0 

PROF FEE INDIV 75 800 MIN 0

PRO FEE FAMILY THERAPY 0 0 

PROF FEE MUL GRP THERAPY 0 0 

PRO FEE GRP THER NON 0 FAM 0 

IND THER 20/30 MED 0W/MD 

0 

IND THERAPY 75-80 MIN 0 0 

IND THER 20/30 MED 0APRN 

0 

LEVEL IV MD 0 0 

CROUPETTE SUPPLIES0 0 

CROUPETTE TREATMENT 0 0 

IPPB TREATMENT INIT0 0 

IPPB SUBSEQUENT TREATMENT 0 0 

BEDSIDE FVL 0 0 

PRE/POST FVL 0 0 

ARTERIAL BLOOD GAS0 0 

ROUTINE PFT 0 0 

PFT-COMPLETE 0 0 

PRE/POST FVL 0 0 

ART BLOOD GAS-PFT0 0 

LVL1 1.25MG PROVOCHO 0 0 


LVL3 2.5MG PROVOCHOL 0 0 

LVL4 5.0MG PROVOCHOL 0 0 



UNITED HLTCARE ALLOW 0 0 

RETURNED CK NSF ALLOW 0 0 

PATIENT CASH TRANS 0ALLOW 

0 

INS CASH TRANSFER ALLOW 0 0 











H/L COMMERCIAL ONCOLOGY 0 0 


SMALL BALANCE ALLOWANCE 0 0 

POS-PROMPT PAY DISCOUNT 0 0 

STATEMENT PROMPT 0PAY DISC 0 

STATEMENT PROMPT 0PAY DISC 0 

MEDIBLUE ALLOWANCE 0 0 

STATE MLIA ALLOWANCE 0 0 

PSYCH BC VAL OPT PMT 0 0

TCORS AUTO ALLOWANCE 0 0 

TCORS WC ALLOWANCE 0 0 

ALLOW PROF FEE COMMERCIAL 0 0 

B/D ESCH SOC UNCLM 0 CASH 0 

CIGNA B/D ALLOWANCE 0 0 

OXFORD HEALTH B/D 0ALLOW 

0 

HLTHNT (FOXWOODS) 0 B/D ALL 0 

US HEALTHCARE B/D 0ALLOW 

0 

AETNA B/D ALLOWANCE 0 0 

UNITED HLTHCARE B/D 0 ALLOW 0 

HLTHNT (PHS) B/D ALLOW 0 0 

HOMECARE PT B/D ALLOW 0 0 

HOSPICE B/D ALLOWANCE 0 0 

SMALL BALANCE B/D 0ALLOW 

0 

CIGNA B/D PAYMENT0 0 

OXFORD HEALTH B/D 0PAYMENT 

0 

HLTNT (FOXWOOD) B/D 0 PYMT 0 

US HEALTHCARE B/D 0PAYMENT 

0 

AETNA B/D PAYMENT0 0 

CHAMPUS/TRICARE B/D 0 PYMT 0 

EBPA B/D PAYMENT 0 0 

UNITED HLTHCARE B/D 0 PYMT 0 

HEALTHNET (PHS) B/D 0 PYMT 0 

BCCG B/D PAYMENT 0TRANSFER 

0 

HOSPICE B/D PYMT TRANSFER 0 0 

HOMECARE PT B/D PMT 0 TRANS 0 

CAREPYMT ADD ON AR 0 PYMT 0 

BLUE CROSS OF MA PAYMENT 0 0 

MISC MEDICARE MCO 0 PMT 0 


















MISC MEDICARE MCO 0 PMT 0


NATIONAL HLTH-NASE 0 PYMT 0 

WELLCARE PMT 0 0 





















AETNA ALLOWANCE 0 0 



WORKERS-DKH COMP 0 PMT 0 





CHAMPUS/TRICARE ALLOW 0 0 







CHAMPVA PYMT 0 0 




EBPA/CBA ALLOWANCE 0 0 




EBPA/CBA ALLOWANCE 0 0





EMPLOYEE HLTH DKH 0PYMT 

0 

















H/L COMM PATIENT ACCTNG 0 0 






H/L COMM ADMINISTRATION 0 0 

H/L COMM PATIENT/MEMBER 0 0 


PYMT PROF FEE COMMERCIAL 0 0 




VANCOMYCIN 250MG/5ML 0 ORAL0 

NUTRIT SERV-PUBLICATIONS 0 0 

OP TX FX HAND W/INT. 0 FIX 0 

CLS TX FX DIS RADIAL 0W/MN 

0 

CLS TX FX DSTL RAD W/MAN 0 0 

CRUTCHES 0 0 

M & S SUPPLIES-ACU0 0 

ACL BREAK-AWAY PIN* 0 0 

ACL HI-STRENGTH PIN* 0 0 

BIOCORKSCREW FT 5.5MM 0 0 

ART BIOCORK W/NDL 06.5 

0 

ART OATS 05MM 0 0 

ART OATS 06MM 0 0





ART TENOSCREW TI4.75 0 0 

ART TENOSCREW TI5.50 0 

ART VULC 90 DEG HP0 0 

ART VULC LIG CHIS CV0 0 

ART VULC LIG CHIS HK0 0 

ENT CAUTERY HI TEMP* 0 0 

CRUTCHES-BARIATRIC0 0 

EYE FLUID FILTER 0.2*0 0 

EYE FO ENDO ILLUMINATOR* 0 0 

LAP SURGIWAND 0 0 

MIS VESSEL LOOP BLUE* 0 0 

ORT STEIN PIN SM 5/64* 0 0 

URO FASCIAL DILAT 05.0* 0 0 





URO STERILE CORD* 0 0 

TKA DURAC AP LIP TIB 0 INSE 0 


CRP 0 0 

IA - 2 AB 0 0 

CRP QUEST 0 0 

PROTIRELIN 500 0 0 

DLSN SPECIAL PROC (PROC) 0 0 

DLSN UNLST CAST/STRAP(PRO 0 0 

PLFD SPEC PROCEDURE(PROC) 0 0 

PLFD UNLST CAST/STRAP(PRO 0 0 

SPECIAL PROCEDURE 0(PROC) 

0 

UNLST CASTING/STRAP(PROC) 0 0 

OT SPECIAL PROCEDUR(PROC) 0 0 

OT UNLST CAST/STRAP(PROC) 0 0 

DLSN OT SPECIAL PROC(PROC 0 0 

DLSN OT UNLS CAST/STR(PRO 0 0 

PLFD OT SPECIAL PROCEDURE 0 0 

PLFD OT UNLS CAST/STR(PRO 0 0 

SELF PAY DISC ALLOW0 0 

PERS PAYMENT PAYROLL 0 0 

UNASSIGNED 0 0 



RETURN CHECK FEE ADJ 0 0 

CHARITY MDCR B/D-DED 0 ADJ 0

CHARITY MED B/D-COINS 0 ADJ 0 

CHARITY MDCR B/D-N/C 0 ADJ 0 

STATE MDCR B/D-DED 0 ADJ 0 

STATE MDCR B/D-COINS 0 ADJ 0 

STATE MDCR B/D-C=N/C 0 ADJ 0 

MAINE MEDICAID ALLOWANCE 0 0 

SELF PAY B/D O/P ALLOW 0 0 

SELF PAY P/R DEDUCTION 0 AD 0 

B/D RETURNED CHECK 0 NSF 0 

B/D RETURNED CHECK 0 FEE 0 

B/D PATIENT CASH TRANSFER 0 0 

B/D INS CASH TRANFER 0 0 

MDCR MGD CARE BD 0OP ALLOW0 

MDCR MGD CARE BD 0IP ALLOW 0 

CHAMPUS/TRICARE B/D 0 ALLOW 0 

EBPA B/D ALLOWANCE 0 0 

CHARITY B/D MDCR-DED 0 ADJ 0 

CHARITY B/D MED-COINS 0 ADJ 0 

CHARITY B/D MDCR-N/C 0 ADJ 0 

STATE B/D MDCR-DED 0 ADJ 0 

STATE B/D MDCR-COINS 0 ADJ 0 

STATE B/D MDCRE-N/C 0 ADJ 0 

T-MED B/D I/P COST REPORT 0 0 

T-MED B/D O/P COST 0REPORT 

0 

SELF PAY B/D PAYMENT 0 0 

MEDICARE MGD CARE 0 B/D PMT 0 

TFR MEDICARE B/D COST 0 RPT 0 

MEDICAL CLAIMS SERV 0 PYMT 0 

MEDSPAN, INC. PYMT0 0

chrg# cdsc cdept csrv cupr crev# 3095 med/surg, semi ... - CT.gov

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