hospital_name,last_updated_on,version,hospital_location,hospital_address,license_number|TX,"To the best of its knowledge and belief, the hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded is true, accurate, and complete as of the date indicated.",additional_generic_notes,,,,,,,,,,
STAT Specialty Hospital of Laredo,10/14/2025,2.0.0,STAT Specialty Hospital of Laredo,"1023 Bob Bullock Loop, Laredo, Texas 78043",100656,TRUE,"STAT Specialty Hospital of Laredo does not have a universal discounted cash price. Only select Evaluation & Management (E/M) codes have specified discounted cash rates, which vary by E/M code tier. For all other descriptions, patients without insurance or who are self-pay are charged the standard gross amount. Please contact billing for specific quotes.",,,,,,,,,,
description,code|1,code|1|type,modifiers,setting,drug_unit_of_measurement,drug_type_of_measurement,standard_charge|gross,standard_charge|discounted_cash,standard_charge|Region_Health_Insurance|HMO|negotiated_dollar,standard_charge|Region_Health_Insurance|HMO|negotiated_percentage,standard_charge|Region_Health_Insurance|HMO|negotiated_algorithm,estimated_amount|Region_Health_Insurance|HMO,standard_charge|Region_Health_Insurance|HMO|methodology,additional_payer_notes|Region_Health_Insurance|HMO,standard_charge|min,standard_charge|max,additional_generic_notes
" Antibody; encephalitis, Eastern equine",86652,CPT,,Both,,,58.91,18,,,,,,,,,
ATROPINE SULFATE INJECTION 0.01mg,J0461,HCPCS,,Both,0.00001,GM,1.42,1,,,,,,,,,
"CLONIDINE HCL, TAB 0.1MG",J8499,HCPCS,,Both,0.0001,GM,7.88,2,,,,,,,,,
"EPINEPHRINE (ADRENALINE), 1MG/ML SDV INJECTION (Per 0.1 mg)",J0165,HCPCS,,Both,0.1,ML,13.26,4,,,,,,,,,
Hydromorphone HCl (Dilaudid) 0.1 mg Injection,J1171,HCPCS,,Both,0.0001,GM,3.06,1,,,,,,,,,
Nitroglycerin / Dextrose 5% 0.1 mg / mL Solution Infusion Bottle 250 mL,J3490,HCPCS,,Both,0.1,ML,226.16,68,,,,,,,,,
"Injection, gadobutrol(gadavist), 0.1 ml",A9585,HCPCS,,Both,0.1,ML,4.34,1,,,,,,,,,
(Polytrim) Polymyxin B Sulfate / Trimethoprim ,J3490,HCPCS,,Both,,,1.1,1,,,,,,,,,
(TYL 3) Acetaminophen / Codeine Tablet,J8499,HCPCS,,Both,,,28,8,,,,,,,,,
(TYL 3) Acetaminophen / Codeine Tablet,J8499,HCPCS,,Both,,,29.4,9,,,,,,,,,
"ALPRAZOLAM (XANAX) ODT, TAB 0.25MG",J8499,HCPCS,,Both,0.00025,GM,23.63,7,,,,,,,,,
0.9% NS 1000 mL with 40 mEq KCl,450,RC,,Both,,,50.3,15,,,,,,,,,
ORAL DEXAMETHASONE PER 0.25MG,J8540,HCPCS,,Both,0.00025,GM,1.18,1,,,,,,,,,
Nitroglycerin (Nitrostat) Sublingual 0.4 mg Tab,J8499,HCPCS,,Both,0.0004,GM,16.28,5,,,,,,,,,
12-LEAD ECG PERFORMED,3120F,HCPCS,,Both,,,512.26,154,,,,,,,,,
20+ CC SYRINGE ONLY,A4213,HCPCS,,Both,,,9.66,3,,,,,,,,,
250 ml N/S Irrigation,450,RC,,Both,,,26.81,8,,,,,,,,,
3 CC STERILE SYRINGE&NEEDLE,A4208,HCPCS,,Both,,,43.43,13,,,,,,,,,
3D RNDR I&R CT MRI US/OTH X REQ POSTPCX,76376,CPT,,Both,,,1855.01,557,,,,,,,,,
"5% dextrose with potassium chloride, 1000 ml",S5012,HCPCS,,Both,,,95.46,29,,,,,,,,,
5% DEXTROSE/NORMAL SALINE,J7042,HCPCS,,Both,,,36.81,11,,,,,,,,,
5% dextrose/water,J7060,HCPCS,,Both,,,12.82,4,,,,,,,,,
5+ CC STERILE SYRINGE&NEEDLE,A4209,HCPCS,,Both,,,48.43,15,,,,,,,,,
A4649CAT,A4649,HCPCS,,Both,,,217.92,65,,,,,,,,,
ABD PAD 5X9 ST1S 20/BX,450,RC,,Both,,,14.79,4,,,,,,,,,
ABD PAD 5X9 ST1S 20/BX,450,RC,,Both,,,14.09,4,,,,,,,,,
ABD Pads,450,RC,,Both,,,0.74,1,,,,,,,,,
Abdominal paracentesis (diagnostic or therapeutic); w/ imaging guidance,49083,CPT,,Both,,,4078,1223,,,,,,,,,
ABLTJ SOF TISS INF TURBS UNI/BI SUPFC INTRAMURAL,30802,CPT,,Both,,,2240.6,672,,,,,,,,,
ABO AND RH BLOOD TYPING DOCUMENTED AS PERFORMED,3293F,HCPCS,,Both,,,225.98,68,,,,,,,,,
ABUTER MASK,A4649,HCPCS,,Both,,,16.14,5,,,,,,,,,
ACCESS DEVICE BD LL 200/CS,450,RC,,Both,,,5.04,2,,,,,,,,,
ACCESS DEVICE BD LL 200/CS,450,RC,,Both,,,4.79,1,,,,,,,,,
ACE WRAP - LT COMPRES BAND >=5,A6450,HCPCS,,Both,,,24.22,7,,,,,,,,,
ACE WRAP (LT COMPRES BAND >=3? <5?/YD),A6449,HCPCS,,Both,,,16.14,5,,,,,,,,,
ACETALDEHYDE BLD,82000,CPT,,Both,,,41.16,12,,,,,,,,,
ACETAMIN 325MG TAB 100/EA,450,RC,,Both,,,46.12,14,,,,,,,,,
"NITROGLYCERIN, SPR 0.4MG",J8499,HCPCS,,Both,0.0004,GM,215.78,65,,,,,,,,,
"TAMSULOSIN HCL (FLOMAX), CAP 0.4MG",J8499,HCPCS,,Both,0.0004,GM,2.63,1,,,,,,,,,
"Sodium Bicarbonate 4.2%, 0.5 mEq / mL Injection",J3490,HCPCS,,Both,0.5,ML,22.78,7,,,,,,,,,
"ALPRAZOLAM (XANAX) OD, TAB 0.5MG",J8499,HCPCS,,Both,0.0005,GM,47.78,14,,,,,,,,,
Benztropine Mesylate (Cogentin) 0.5 mg PO,J8499,HCPCS,,Both,0.0005,GM,2.21,1,,,,,,,,,
ACETAMINOPHEN 120MG SUPP12BXBX,450,RC,,Both,,,40.45,12,,,,,,,,,
ACETAMINOPHEN 120MG SUPP12BXBX,450,RC,,Both,,,38.51,12,,,,,,,,,
Digoxin 0.5mg vial,J1160,HCPCS,,Both,0.0005,GM,24.01,7,,,,,,,,,
ACETAMINOPHEN SUS GRAPE 4OZ,450,RC,,Both,,,20.01,6,,,,,,,,,
ACETAMINOPHEN SUS GRAPE 4OZ,450,RC,,Both,,,19.06,6,,,,,,,,,
acetaminophen/codeine 300/30 soln,450,RC,,Both,,,48.43,15,,,,,,,,,
Racepinephrine (Asthmaefrin) 2.25%/0.5 ml Inh,J7699,HCPCS,,Both,0.5,ML,47.25,14,,,,,,,,,
ACETONE/OTH KETONE BODIES SERUM QUAN,82010,CPT,,Both,,,382,115,,,,,,,,,
RACONIC 0.5ML,J3490,HCPCS,,Both,0.5,ML,11.06,3,,,,,,,,,
COLCHICINE - COLCRYS 0.6mg PO,J8499,HCPCS,,Both,0.0006,GM,108.47,33,,,,,,,,,
"INJECTION, PENICILLIN G POTASSIUM, UP TO 600,000 UNITS",J2540,HCPCS,,Both,600000,UN,68.69,21,,,,,,,,,
ACTIDOSE AQUA 25GM LIQ 120ML,450,RC,,Both,,,124.55,37,,,,,,,,,
ACTIDOSE AQUA 25GM LIQ 120ML,450,RC,,Both,,,118.62,36,,,,,,,,,
ACTIDOSE/SORB 25GM LIQ 120ML,450,RC,,Both,,,121.52,36,,,,,,,,,
ACTIDOSE/SORB 25GM LIQ 120ML,450,RC,,Both,,,115.73,35,,,,,,,,,
"Actin (smooth muscle) antibody (ASMA), each",86015,CPT,,Both,,,121.07,36,,,,,,,,,
ACTIVASE 50MG VL,450,RC,,Both,,,18.19,5,,,,,,,,,
"ACETYLCYSTEINE, VL 1G/ML 30ML 20% PER GRAM",J7608,HCPCS,,Both,1,ML,55.5,17,,,,,,,,,
SODIUM BICARB 8.4% 1mEq / mL - 50 ML SDV,J3490,HCPCS,,Both,1,ML,178.4,54,,,,,,,,,
"Sodium Bicarbonate 8.4%, Presv free 1 mEq/mL Injection 50ml",J3490,HCPCS,,Both,1,ML,139.28,42,,,,,,,,,
"(Levophed) NOREPINEPHRINE BIT, AMP 1 MG/ML 4ML",J3490,HCPCS,,Both,1,ML,131.25,39,,,,,,,,,
ADACEL TDAP VACCINE 10X.5ML,450,RC,,Both,,,2701.15,810,,,,,,,,,
ADACEL TDAP VACCINE 10X.5ML,450,RC,,Both,,,2701.15,810,,,,,,,,,
ADAPTIC NONADH DRESS 3X3,450,RC,,Both,,,180.16,54,,,,,,,,,
ADAPTIC NONADH DRESS 3X3,450,RC,,Both,,,171.57,51,,,,,,,,,
ADENOCARD 3MG/ML SYR 2ML,450,RC,,Both,,,273.12,82,,,,,,,,,
ADENOCARD 3MG/ML SYR 2ML,450,RC,,Both,,,260.11,78,,,,,,,,,
ADENOSINE 3MG/ML VL 2ML,450,RC,,Both,,,31.29,9,,,,,,,,,
ADENOSINE 3MG/ML VL 2ML,450,RC,,Both,,,29.8,9,,,,,,,,,
"ADHESIVE BANDAGE, FIRST-AID",A6413,HCPCS,,Both,,,7.28,2,,,,,,,,,
ADHESIVE DERMABOND SKIN,450,RC,,Both,,,240.25,72,,,,,,,,,
ADHESIVE DERMABOND SKIN,450,RC,,Both,,,228.81,69,,,,,,,,,
ADMIN SET 100,450,RC,,Both,,,28.74,9,,,,,,,,,
ADMIN SET 100,450,RC,,Both,,,27.37,8,,,,,,,,,
ADMIN SET SEC ADULT LL,450,RC,,Both,,,6.74,2,,,,,,,,,
ADMIN SET SEC ADULT LL,450,RC,,Both,,,6.41,2,,,,,,,,,
Adrenocorticotropic hormone (ACTH),82024,CPT,,Both,,,663.75,199,,,,,,,,,
ADRNL IMG CORTEX&/MEDULLA,78075,CPT,,Both,,,5003.93,1501,,,,,,,,,
AFO MULTILIGAMENTUS ANKLE SU,L1906,HCPCS,,Both,,,420,126,,,,,,,,,
"AFO, WALK BOOT TYPE, CUS FAB",L4631,HCPCS,,Both,,,1514.99,454,,,,,,,,,
"ALPRAZOLAM (XANAX) , TAB 1MG",J8499,HCPCS,,Both,0.001,GM,13.13,4,,,,,,,,,
AFRIN NO DRIP SPY 15ML,450,RC,,Both,,,40.26,12,,,,,,,,,
AGGLUTININS FEBRILE EA AG,86000,CPT,,Both,,,120,36,,,,,,,,,
AIRWAY NASO 12FR ADJ FLNG,450,RC,,Both,,,338.54,102,,,,,,,,,
AIRWAY NASO 12FR ADJ FLNG,450,RC,,Both,,,322.41,97,,,,,,,,,
AIRWAY NASO 16FR SOFT PVC ST,450,RC,,Both,,,18.92,6,,,,,,,,,
AIRWAY NASO 16FR SOFT PVC ST,450,RC,,Both,,,18.02,5,,,,,,,,,
AIRWAY NASO 20FR ADJ FLNG,450,RC,,Both,,,338.54,102,,,,,,,,,
AIRWAY NASO 20FR ADJ FLNG,450,RC,,Both,,,322.41,97,,,,,,,,,
AIRWAY NASO 24FR ADJ FLNG,450,RC,,Both,,,338.54,102,,,,,,,,,
AIRWAY NASO 24FR ADJ FLNG,450,RC,,Both,,,322.41,97,,,,,,,,,
AIRWAY NASO 28FR ADJ FLNG,450,RC,,Both,,,338.54,102,,,,,,,,,
AIRWAY NASO 28FR ADJ FLNG,450,RC,,Both,,,322.41,97,,,,,,,,,
AIRWAY NASO 30FR ADJ FLNG,450,RC,,Both,,,338.54,102,,,,,,,,,
AIRWAY NASO 30FR ADJ FLNG,450,RC,,Both,,,322.41,97,,,,,,,,,
AIRWAY NASO 34FR ADJ FLNG,450,RC,,Both,,,338.54,102,,,,,,,,,
AIRWAY NASO 34FR ADJ FLNG,450,RC,,Both,,,322.41,97,,,,,,,,,
AIRWAY NASO ROBERTAZZI 24FR,450,RC,,Both,,,27.35,8,,,,,,,,,
AIRWAY NASO ROBERTAZZI 24FR,450,RC,,Both,,,26.04,8,,,,,,,,,
AIRWAY NASO ROBERTAZZI 26FR,450,RC,,Both,,,27.35,8,,,,,,,,,
AIRWAY NASO ROBERTAZZI 26FR,450,RC,,Both,,,26.04,8,,,,,,,,,
AIRWAY NASO ROBERTAZZI 28FR,450,RC,,Both,,,27.35,8,,,,,,,,,
AIRWAY NASO ROBERTAZZI 28FR,450,RC,,Both,,,26.04,8,,,,,,,,,
AIRWAY NASO ROBERTAZZI 30FR,450,RC,,Both,,,27.35,8,,,,,,,,,
AIRWAY NASO ROBERTAZZI 30FR,450,RC,,Both,,,26.04,8,,,,,,,,,
AIRWAY ORAL KIT6/SET,450,RC,,Both,,,32.81,10,,,,,,,,,
AIRWAY ORAL KIT6/SET,450,RC,,Both,,,31.25,9,,,,,,,,,
AIRWAY ORAL OROPHARYNGEAL LGEA,450,RC,,Both,,,10.13,3,,,,,,,,,
AIRWAY ORAL OROPHARYNGEAL LGEA,450,RC,,Both,,,9.64,3,,,,,,,,,
AIRWAY ORAL OROPHARYNGEAL MDEA,450,RC,,Both,,,10.13,3,,,,,,,,,
AIRWAY ORAL OROPHARYNGEAL MDEA,450,RC,,Both,,,9.64,3,,,,,,,,,
AIRWAY ORAL OROPHARYNGEAL SMEA,450,RC,,Both,,,10.13,3,,,,,,,,,
AIRWAY ORAL OROPHARYNGEAL SMEA,450,RC,,Both,,,9.64,3,,,,,,,,,
AK2 GENE ANALYSIS P.VAL617PHE VARIANT,81270,CPT,,Both,,,769.94,231,,,,,,,,,
ALBUMIN SERUM PLASMA/WHOLE BLOOD,82040,CPT,,Both,,,204,61,,,,,,,,,
ALBUTEROL 2.5MG SOL 25X3ML,450,RC,,Both,,,31.66,9,,,,,,,,,
ALBUTEROL 2.5MG SOL 25X3ML,450,RC,,Both,,,30.15,9,,,,,,,,,
ALBUTEROL COMP CON,J7610,HCPCS,,Both,,,19.53,6,,,,,,,,,
ALBUTEROL COMP UNIT,J7609,HCPCS,,Both,,,201.78,61,,,,,,,,,
ALBUTEROL NON-COMP CON,J7611,HCPCS,,Both,,,19.53,6,,,,,,,,,
ALBUTEROL NON-COMP UNIT,J7613,HCPCS,,Both,,,19.53,6,,,,,,,,,
CLONIDINE HYDROCHLORIDE 1 MG,J0735,HCPCS,,Both,0.001,GM,10.27,3,,,,,,,,,
ALCOHOL ANY SPEC XCPT BRTH,G6040,HCPCS,,Both,,,132.97,40,,,,,,,,,
ALCOHOL BRTH,82075,CPT,,Both,,,600,180,,,,,,,,,
ALCOHOL ISO 70% 16OZ 12/CS,450,RC,,Both,,,11.1,3,,,,,,,,,
ALCOHOL ISO 70% 16OZ 12/CS,450,RC,,Both,,,10.56,3,,,,,,,,,
ALCOHOL OR PEROXIDE PER PINT,A4244,HCPCS,,Both,,,6.45,2,,,,,,,,,
ALCOHOL PREP LG ST 200/BX,450,RC,,Both,,,1.22,1,,,,,,,,,
ALCOHOL PREP LG ST 200/BX,450,RC,,Both,,,1.28,1,,,,,,,,,
ALCOHOL SALIVA TEST QED 10/B,450,RC,,Both,,,449.27,135,,,,,,,,,
ALCOHOL SALIVA TEST QED 10/B,450,RC,,Both,,,427.88,128,,,,,,,,,
ALGER BRUSH COMPLETE,450,RC,,Both,,,501.66,150,,,,,,,,,
ALGER BRUSH COMPLETE,450,RC,,Both,,,477.77,143,,,,,,,,,
ALGINATE DRESSING >48 SQ IN,A6198,HCPCS,,Both,,,50.3,15,,,,,,,,,
ALL TARGETS (N),87150,CPT,,Both,,,113.76,34,,,,,,,,,
ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH,86003,CPT,,Both,,,52.2,16,,,,,,,,,
"Cogentin, Benztropine Mesylate, injection, per 1 mg",J0515,HCPCS,,Both,0.001,GM,510.62,153,,,,,,,,,
DECADRON - DEXAMETHASONE SODIUM PHOS 1MG,J1100,HCPCS,,Both,0.001,GM,29.7,9,,,,,,,,,
ALPHA-1-ANTITRYPSIN TOTAL,82103,CPT,,Both,,,134.4,40,,,,,,,,,
Alpha-fetoprotein (AFP); serum,82105,CPT,,Both,,,288.25,86,,,,,,,,,
DECADRON DEXAMETHASONE ACETATE 1MG,J1094,HCPCS,,Both,0.001,GM,29.7,9,,,,,,,,,
"DIHYDROERGOTAMINE MESYLATE (D.H.E 45) INJ, PER 1MG",J1110,HCPCS,,Both,0.001,GM,116.17,35,,,,,,,,,
"EPINEPHRINE (ADRENALINE), 1MG/ML SDV INJECTION (Per .01 mg)",J0171,HCPCS,,Both,1,ML,13.26,4,,,,,,,,,
ALS ESOPHAGEAL INTUB SUPPLS,A0396,HCPCS,,Both,,,40.36,12,,,,,,,,,
ALS IV DRUG THERAPY SUPPLIES,A0394,HCPCS,,Both,,,1.64,1,,,,,,,,,
AMBU BAG PEDI/ADULT,450,RC,,Both,,,66.7,20,,,,,,,,,
AMIDATE 2MG/ML VL 10X10ML,450,RC,,Both,,,497.6,149,,,,,,,,,
AMIDATE 2MG/ML VL 10X10ML,450,RC,,Both,,,473.9,142,,,,,,,,,
AMINOLEVULINIC ACID DELTA,82135,CPT,,Both,,,118.49,36,,,,,,,,,
AMIODARONE 50MG 3ML VL 10/BX,450,RC,,Both,,,27.41,8,,,,,,,,,
AMIODARONE 50MG 3ML VL 10/BX,450,RC,,Both,,,26.1,8,,,,,,,,,
"FOLIC ACID, TAB 1MG",J8499,HCPCS,,Both,0.001,GM,5.78,2,,,,,,,,,
Ammonia,82140,CPT,,Both,,,1020,306,,,,,,,,,
AMMONIA INH AMP 10/BX,450,RC,,Both,,,17.65,5,,,,,,,,,
AMMONIA INH AMP 10/BX,450,RC,,Both,,,16.8,5,,,,,,,,,
AMMONIA INHALANTS 10/BX,450,RC,,Both,,,15.83,5,,,,,,,,,
AMMONIA INHALANTS 10/BX,450,RC,,Both,,,15.08,5,,,,,,,,,
GLUCAGON HYDROCHLORIDE/1 MG,J1610,HCPCS,,Both,0.001,GM,93.86,28,,,,,,,,,
Hydromorphone HCl (Dilaudid) 1mg/ml Injection,J3490,HCPCS,,Both,1,ML,30.56,9,,,,,,,,,
INJ NALOXONE HYDROCHLORIDE (Narcan) per 1 mg,J2310,HCPCS,,Both,0.001,GM,71.74,22,,,,,,,,,
"Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds) ",J0153,HCPCS,,Both,0.001,GM,90.07,27,,,,,,,,,
AMOXICILLIN 250MG SUS 150ML,450,RC,,Both,,,17.72,5,,,,,,,,,
Amoxicillin 500mg tab,450,RC,,Both,,,2.79,1,,,,,,,,,
Amoxicillin 875mg tab,450,RC,,Both,,,12.48,4,,,,,,,,,
"Amoxicillin for Oral Suspension, USP 200mg/5mL bottle",450,RC,,Both,,,29.09,9,,,,,,,,,
"Injection, Alteplase recombinantm per 1mg(ACTIVASE)",J2997,HCPCS,,Both,0.001,GM,131.25,39,,,,,,,,,
"INJECTION, LANREOTIDE, 1 MG",J1930,HCPCS,,Both,0.001,GM,237.79,71,,,,,,,,,
"INJECTION, NALTREXONE, DEPOT FORM, 1 MG",J2315,HCPCS,,Both,0.001,GM,18.89,6,,,,,,,,,
"Injection, phytonadione (vitamin k), per 1 mg",J3430,HCPCS,,Both,0.001,GM,82.59,25,,,,,,,,,
"Injection, remdesivir, 1 mg",J0248,HCPCS,,Both,0.001,GM,26,8,,,,,,,,,
amoxicillin/clavulanate K+ 400mg/57mg,450,RC,,Both,,,25.96,8,,,,,,,,,
"Injection, remdesivir, 1 mg",J0248,HCPCS,,Both,0.001,GM,27.3,8,,,,,,,,,
AMP F/TH 1/2 JT/PHALANX W/NEURECT LOCAL FLAP,26952,CPT,,Both,,,8113.63,2434,,,,,,,,,
Ampicillin 1 GM Injection,450,RC,,Both,,,34.65,10,,,,,,,,,
Ampicillin 250mg Injection,450,RC,,Both,,,23.42,7,,,,,,,,,
ampicillin 250mg vials,450,RC,,Both,,,179.63,54,,,,,,,,,
"Injection, tenecteplase, 1 mg (TNKase)",J3101,HCPCS,,Both,0.001,GM,1218.44,366,,,,,,,,,
AMPICILLIN SODIUM PER 1.5 GM - UNASYN,J0295,HCPCS,,Both,,,42.6,13,,,,,,,,,
AMYLASE,82150,CPT,,Both,,,572,172,,,,,,,,,
"Analgesics, non-opioid; 1 or 2",80329,CPT,,Both,,,684,205,,,,,,,,,
Analysis test by nucleic acid for Hepatitis C virus,87902,CPT,,Both,,,6178.8,1854,,,,,,,,,
"Injection, testosterone cypionate, 1 mg",J1071,HCPCS,,Both,0.001,GM,2.77,1,,,,,,,,,
Angiotensin i enzyme test,82164,CPT,,Both,,,350.4,105,,,,,,,,,
ANKLE CONTROL ORTHOSI PREFAB,L4350,HCPCS,,Both,,,575.49,173,,,,,,,,,
ANKLE FOOT ORTHOSIS,L1902,HCPCS,,Both,,,666.28,200,,,,,,,,,
ANKLE-GEL STIRRUP REG,450,RC,,Both,,,86.9,26,,,,,,,,,
ANKLE-GEL STIRRUP REG,450,RC,,Both,,,82.76,25,,,,,,,,,
ANKLE-GEL STIRRUP SM,450,RC,,Both,,,86.9,26,,,,,,,,,
ANKLE-GEL STIRRUP SM,450,RC,,Both,,,82.76,25,,,,,,,,,
ANOSC RMVL FB,46608,CPT,,Both,,,3072.5,922,,,,,,,,,
ANTB CHLAMYDIA,86631,CPT,,Both,,,193.58,58,,,,,,,,,
ANTB EPSTEIN-BARR EB VIRUS EARLY AG EA,86663,CPT,,Both,,,365.17,110,,,,,,,,,
ANTB HIV-1,86701,CPT,,Both,,,502.8,151,,,,,,,,,
ANTB HTLV/HIV ANTB CONFIRMATORY TST,86689,CPT,,Both,,,465,140,,,,,,,,,
ANTB INF VIRUS,86710,CPT,,Both,,,232.88,70,,,,,,,,,
ANTB SCR RBC EA SERUM TQ,86850,CPT,,Both,,,281.98,85,,,,,,,,,
ANTB SEVERE AQT RESPIR SYND SARS-COV-2 COVID19,86769,CPT,,Both,,,1020,306,,,,,,,,,
ANTB VARICELLA-ZOSTER,86787,CPT,,Both,,,300,90,,,,,,,,,
ANTIBODY BORDETELLA,86615,CPT,,Both,,,85.47,26,,,,,,,,,
ANTIBODY CYTOMEGALOVIRUS CMV,86644,CPT,,Both,,,347.38,104,,,,,,,,,
ANTIBODY CYTOMEGALOVIRUS CMV IGM,86645,CPT,,Both,,,58.91,18,,,,,,,,,
ANTIBODY EPSTEIN-BARR EB VIRUS NUCLEAR AG EBNA,86664,CPT,,Both,,,300,90,,,,,,,,,
ANTIBODY EPSTEIN-BARR EB VIRUS VIRAL CAPSID VCA,86665,CPT,,Both,,,322.12,97,,,,,,,,,
ANTIBODY FUNGUS NOT ELSEWHERE SPECIFIED,86671,CPT,,Both,,,79.43,24,,,,,,,,,
ANTIBODY HERPES SMPLX NON-SPECIFIC TYPE TEST,86694,CPT,,Both,,,108.1,32,,,,,,,,,
ANTIBODY HERPES SMPLX TYPE 1,86695,CPT,,Both,,,408,122,,,,,,,,,
ANTIBODY HERPES SMPLX TYPE 2,86696,CPT,,Both,,,480,144,,,,,,,,,
ANTIBODY HIV-1&HIV-2 SINGLE RESULT,86703,CPT,,Both,,,102.92,31,,,,,,,,,
ANTIBODY ID RBC ANTIBODIES EA PANEL EA SERUM TQ,86870,CPT,,Both,,,152.99,46,,,,,,,,,
ANTIBODY IDENTIFICATION LEUKOCYTE ANTIBODIES,86021,CPT,,Both,,,258.75,78,,,,,,,,,
ANTIBODY MUMPS,86735,CPT,,Both,,,720,216,,,,,,,,,
ANTIBODY RUBEOLA,86765,CPT,,Both,,,600,180,,,,,,,,,
ANTIBODY VIRUS NOT ELSEWHERE SPECIFIFED,86790,CPT,,Both,,,171.25,51,,,,,,,,,
ANTIBODY WEST NILE VIRUS,86789,CPT,,Both,,,103.64,31,,,,,,,,,
ANTIBODY WEST NILE VIRUS IGM,86788,CPT,,Both,,,318.75,96,,,,,,,,,
"Antibody: Brucella, ",86622,CPT,,Both,,,61.4,18,,,,,,,,,
Antibody: Coxiella burnetii (Q fever),86638,CPT,,Both,,,61.4,18,,,,,,,,,
Antibody: Leptospira,86720,CPT,,Both,,,61.4,18,,,,,,,,,
Antibody; Bartonella,86611,CPT,,Both,,,140.5,42,,,,,,,,,
Antibody; Borrelia burgdorferi (Lyme disease) ,86618,CPT,,Both,,,292.63,88,,,,,,,,,
Antibody; Coccidioides,86635,CPT,,Both,,,360,108,,,,,,,,,
Antibody; Ehrlichia,86666,CPT,,Both,,,67.56,20,,,,,,,,,
"Antibody; encephalitis, Western equine",86654,CPT,,Both,,,58.91,18,,,,,,,,,
"Antibody; enterovirus (eg, coxsackie, echo, polio)",86658,CPT,,Both,,,140.5,42,,,,,,,,,
Antibody; Francisella tularensis,86668,CPT,,Both,,,78.11,23,,,,,,,,,
Antibody; Helicobacter pylori ,86677,CPT,,Both,,,684,205,,,,,,,,,
Antibody; Leishmania,86717,CPT,,Both,,,61.4,18,,,,,,,,,
Antibody; respiratory syncytial virus,86756,CPT,,Both,,,345,104,,,,,,,,,
Antibody; Rickettsia?,86757,CPT,,Both,,,1020,306,,,,,,,,,
Antibody; rotavirus,86759,CPT,,Both,,,226.63,68,,,,,,,,,
Antibody; rubella,86762,CPT,,Both,,,480,144,,,,,,,,,
Antibody; Treponema pallidum,86780,CPT,,Both,,,650,195,,,,,,,,,
ANTIDEPRESSANTS TRICYCLIC OTHER CYCLICALS 1 OR 2,80335,CPT,,Both,,,310.19,93,,,,,,,,,
"Antiepileptics, not otherwise specified; 1-3",80339,CPT,,Both,,,155.1,47,,,,,,,,,
"ANTIFUNGAL CLOTRIMAZOLE, 2%",A9150,HCPCS,,Both,,,16.28,5,,,,,,,,,
Anti-mullerian hormone (AMH),82166,CPT,,Both,,,308.96,93,,,,,,,,,
ANTINEUTROPHIL CYTOPLASMIC ANTB SCREEN EA ANTB,86036,CPT,,Both,,,101.22,30,,,,,,,,,
Antinuclear antibodies (ANA),86038,CPT,,Both,,,411,123,,,,,,,,,
ANTINUCLEAR ANTIBODIES ANA TITER,86039,CPT,,Both,,,521,156,,,,,,,,,
ANTISTREPTOLYSIN O TITER,86060,CPT,,Both,,,186,56,,,,,,,,,
"LOPERAMIDE HCL, LIQ 1MG/7.5ML",A9150,HCPCS,,Both,1,ML,13.13,4,,,,,,,,,
ANTIVERT ?DIMENHYDRINATE 25 TAB,J8499,HCPCS,,Both,,,34.26,10,,,,,,,,,
ANTROM PRESCRIBE,G8895,HCPCS,,Both,,,6.67,2,,,,,,,,,
APLISOL 5TU PPD 10 TEST 1ML,450,RC,,Both,,,255.23,77,,,,,,,,,
APLISOL 5TU PPD 10 TEST 1ML,450,RC,,Both,,,243.08,73,,,,,,,,,
APLISOL 5TU PPD 50 TEST 5ML,450,RC,,Both,,,1021.26,306,,,,,,,,,
APLISOL 5TU PPD 50 TEST 5ML,450,RC,,Both,,,972.63,292,,,,,,,,,
APPLICATION FINGER SPLINT DYNAMIC,29131,CPT,,Both,,,853.45,256,,,,,,,,,
Application of short leg cast (below knee to toes),29405,CPT,,Both,,,622.4,187,,,,,,,,,
"Application, cast; elbow to finger (short arm)",29075,CPT,,Both,,,1118.38,336,,,,,,,,,
"Application, cast; shoulder to hand (long arm)",29065,CPT,,Both,,,1241.5,372,,,,,,,,,
APPLICATOR CAGE #1,450,RC,,Both,,,144.02,43,,,,,,,,,
APPLICATOR CAGE #1,450,RC,,Both,,,137.15,41,,,,,,,,,
APPLICATOR CT 6,450,RC,,Both,,,17.35,5,,,,,,,,,
APPLICATOR CT 6,450,RC,,Both,,,16.52,5,,,,,,,,,
APPROPRIATE EMPIRIC ANTIBIOTIC PRESCRIBED,4045F,HCPCS,,Both,,,1.6,1,,,,,,,,,
LORAZEPAM (ATIVAN) 1 MG TAB,J8499,HCPCS,,Both,0.001,GM,5.78,2,,,,,,,,,
APRON XRAY 24X38 TALL,450,RC,,Both,,,1347.97,404,,,,,,,,,
APRON XRAY 24X38 TALL,450,RC,,Both,,,1283.78,385,,,,,,,,,
AQT HEP PANEL,80074,CPT,,Both,,,1440,432,,,,,,,,,
ARMBOARD 2X4 24/CS,450,RC,,Both,,,87.51,26,,,,,,,,,
ARMBOARD 2X4 24/CS,450,RC,,Both,,,83.33,25,,,,,,,,,
ARMBOARD INFANT 1X4,450,RC,,Both,,,3.71,1,,,,,,,,,
ARMBOARD INFANT 1X4,450,RC,,Both,,,3.53,1,,,,,,,,,
ARMBOARD INFANT 2X9,450,RC,,Both,,,3.03,1,,,,,,,,,
ARMBOARD INFANT 2X9,450,RC,,Both,,,2.89,1,,,,,,,,,
ARMBOARD WRIST 2X6 DISP,450,RC,,Both,,,3.28,1,,,,,,,,,
ARMBOARD WRIST 2X6 DISP,450,RC,,Both,,,3.12,1,,,,,,,,,
ARMSLING LG 6/CS,450,RC,,Both,,,16.8,5,,,,,,,,,
ARMSLING LG 6/CS,450,RC,,Both,,,16,5,,,,,,,,,
ARMSLING MED 6/CS,450,RC,,Both,,,16.8,5,,,,,,,,,
ARMSLING MED 6/CS,450,RC,,Both,,,16,5,,,,,,,,,
ARMSLING SM 6/CS,450,RC,,Both,,,16.8,5,,,,,,,,,
ARMSLING SM 6/CS,450,RC,,Both,,,16,5,,,,,,,,,
ARMSLING XL CLINIC,450,RC,,Both,,,12.32,4,,,,,,,,,
ARMSLING XL CLINIC,450,RC,,Both,,,11.72,4,,,,,,,,,
ARMSLING XS CLINIC,450,RC,,Both,,,12.32,4,,,,,,,,,
ARMSLING XS CLINIC,450,RC,,Both,,,11.72,4,,,,,,,,,
"Arterial puncture, withdrawl of blood for dx",36600,CPT,,Both,,,900,270,,,,,,,,,
ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/US,20606,CPT,,Both,,,590.9,177,,,,,,,,,
ARTHROCENTESIS ASPIR&/INJECTION INTERM JT/BURSA,20605,CPT,,Both,,,1260,378,,,,,,,,,
ARTHROCENTESIS ASPIR&/INJECTION MAJOR JT/BURSA,20610,CPT,,Both,,,1260,378,,,,,,,,,
"Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); with ultrasound guidance, with permanent recording and reporting",20611,CPT,,Both,,,1152,346,,,,,,,,,
"Arthrocentesis, aspiration and/or injection; small joint or ...",20600,CPT,,Both,,,1200,360,,,,,,,,,
"Arthrotomy, including exploration, drainage, or removal of loose or foreign body; interphalangeal",28024,CPT,,Both,,,5973.75,1792,,,,,,,,,
"ARTIFICAL TEARS, DRP OPHTH LUBRICANT",J3490,HCPCS,,Both,,,5.78,2,,,,,,,,,
Melatonin 1mg tab,A9150,HCPCS,,Both,0.001,GM,0.39,1,,,,,,,,,
"Ascorbic acid (Vitamin C), blood",82180,CPT,,Both,,,103.85,31,,,,,,,,,
Aspiration and/or injection of ganglion cyst any location,20612,CPT,,Both,,,762.13,229,,,,,,,,,
ASPIRIN 325MG TAB 100/BT,450,RC,,Both,,,7.1,2,,,,,,,,,
ASPIRIN 325MG TAB 100/BT,450,RC,,Both,,,6.76,2,,,,,,,,,
ASPIRIN 81MG TAB ADULT CHEW,450,RC,,Both,,,6.25,2,,,,,,,,,
ASPIRIN 81MG TAB ADULT CHEW,450,RC,,Both,,,5.94,2,,,,,,,,,
"METOPROLOL TARTRATE, 1MG/ML- 5ML SDV",J3490,HCPCS,,Both,1,ML,36.23,11,,,,,,,,,
NOREPINEPHRINE BITRATE 1MG/ML (Per .01MG),J0171,HCPCS,,Both,1,ML,47.78,14,,,,,,,,,
Assay growth hormone (hgh),83003,CPT,,Both,,,400.08,120,,,,,,,,,
Assay of Acetaminophen,G6039,HCPCS,,Both,,,83.5,25,,,,,,,,,
ASSAY OF ALDOLASE,82085,CPT,,Both,,,97.1,29,,,,,,,,,
ASSAY OF ALDOSTERONE,82088,CPT,,Both,,,251.55,75,,,,,,,,,
ASSAY OF ARSENIC,82175,CPT,,Both,,,199.19,60,,,,,,,,,
ASSAY OF ARSENIC,82175,CPT,,Both,,,189.7,57,,,,,,,,,
ASSAY OF C-PEPTIDE,84681,CPT,,Both,,,357.63,107,,,,,,,,,
Assay of cryoglobulin,82595,CPT,,Both,,,155.28,47,,,,,,,,,
ASSAY OF DIGOXIN,80162,CPT,,Both,,,780,234,,,,,,,,,
ASSAY OF ESTRADIOL,82670,CPT,,Both,,,480.13,144,,,,,,,,,
ASSAY OF ESTROGENS TOTAL,82672,CPT,,Both,,,62.95,19,,,,,,,,,
ASSAY OF ESTRONE,82679,CPT,,Both,,,429,129,,,,,,,,,
ASSAY OF FOLIC ACID RBC,82747,CPT,,Both,,,358,107,,,,,,,,,
ASSAY OF GAMMAGLOBULIN IGA IGD IGG IGM EACH,82784,CPT,,Both,,,810,243,,,,,,,,,
ASSAY OF GASTRIN,82941,CPT,,Both,,,303,91,,,,,,,,,
ASSAY OF GLUCOSIDASE BETA,82963,CPT,,Both,,,154.72,46,,,,,,,,,
ASSAY OF GLYCATED PROTEIN,82985,CPT,,Both,,,167.6,50,,,,,,,,,
Assay of haptoglobin quant,83010,CPT,,Both,,,301.92,91,,,,,,,,,
ASSAY OF HOMOCYSTEINE,83090,CPT,,Both,,,179.2,54,,,,,,,,,
ASSAY OF HYDROXYPROGESTERONE 17-D,83498,CPT,,Both,,,271.7,82,,,,,,,,,
Assay of IgE,82785,CPT,,Both,,,395.04,119,,,,,,,,,
ASSAY OF INSULIN TOTAL,83525,CPT,,Both,,,342,103,,,,,,,,,
ASSAY OF LEAD,83655,CPT,,Both,,,208,62,,,,,,,,,
Assay of lipoprotein(a),83695,CPT,,Both,,,343.68,103,,,,,,,,,
ASSAY OF MERCURY QUANTITATIVE,83825,CPT,,Both,,,170.73,51,,,,,,,,,
ASSAY OF MERCURY QUANTITATIVE,83825,CPT,,Both,,,162.6,49,,,,,,,,,
Assay of metanephrines,83835,CPT,,Both,,,780,234,,,,,,,,,
Assay of nos vitamin,84591,CPT,,Both,,,409.44,123,,,,,,,,,
ASSAY OF PARATHORMONE,83970,CPT,,Both,,,709.25,213,,,,,,,,,
ASSAY OF PHENYTOIN TOTAL,80185,CPT,,Both,,,243.1,73,,,,,,,,,
ASSAY OF PORPHOBILINOGEN URINE QUANTITATIVE,84110,CPT,,Both,,,145,44,,,,,,,,,
ASSAY OF PROGESTERONE,84144,CPT,,Both,,,358.5,108,,,,,,,,,
ASSAY OF PROINSULIN,84206,CPT,,Both,,,266.9,80,,,,,,,,,
ASSAY OF PROSTATE SPECIFIC ANTIGEN COMPLEXED,84152,CPT,,Both,,,119.23,36,,,,,,,,,
ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE,84154,CPT,,Both,,,183.9,55,,,,,,,,,
ASSAY OF PYRIDOXAL PHOSPHATE,84207,CPT,,Both,,,281,84,,,,,,,,,
Assay of Salicylate,G6038,HCPCS,,Both,,,58.57,18,,,,,,,,,
Assay of serotonin,84260,CPT,,Both,,,743.52,223,,,,,,,,,
ASSAY OF SEX HORMONE BINDING GLOBULIN,84270,CPT,,Both,,,228.17,68,,,,,,,,,
ASSAY OF SOMATOMEDIN (IGF),84305,CPT,,Both,,,365.25,110,,,,,,,,,
ASSAY OF THYROGLOBULIN,84432,CPT,,Both,,,276,83,,,,,,,,,
Assay of thyroid activity TBG level,84442,CPT,,Both,,,354.72,106,,,,,,,,,
ASSAY OF TRANSFERRIN,84466,CPT,,Both,,,360,108,,,,,,,,,
ASSAY OF URINE SODIUM,84300,CPT,,Both,,,345.75,104,,,,,,,,,
PREDNISONE ORAL PER 1MG,J7512,HCPCS,,Both,0.001,GM,10.27,3,,,,,,,,,
STADOL (BUTORPHANOL TARTRATE 1 MG),J0595,HCPCS,,Both,0.001,GM,19.37,6,,,,,,,,,
"Tenecteplase (TNKase), 1 mg",J3101,HCPCS,,Both,0.001,GM,161.7,49,,,,,,,,,
"TESTOSTERONE ENANTHATE INJ, 1mg",J3121,HCPCS,,Both,0.001,GM,32.28,10,,,,,,,,,
"VECURONIUM BROMIDE, VL 1MG/ML 10ML",J3490,HCPCS,,Both,1,ML,125,38,,,,,,,,,
VERSED - INJ MIDAZOLAM HYDROCHLORIDE PER 1MG,J2250,HCPCS,,Both,0.001,GM,15.83,5,,,,,,,,,
ZOFRAN (ONDANSETRON HCL INJECTION 1MG),J2405,HCPCS,,Both,0.001,GM,29.7,9,,,,,,,,,
ATOMIC ABSRPJ SPECTROSCOPY EA ANAL,82190,CPT,,Both,,,85.19,26,,,,,,,,,
Zyrtec (Cetirizine) Liquid 1mg/ml,A9150,HCPCS,,Both,1,ML,9.18,3,,,,,,,,,
"Brompheniramine Maleate/Bromfed DM, per 1 mL",J8499,HCPCS,,Both,1,ML,2.1,1,,,,,,,,,
ATROPINE .1MG/ML LS SYR 10ML,450,RC,,Both,,,71.25,21,,,,,,,,,
ATROPINE .1MG/ML LS SYR 10ML,450,RC,,Both,,,67.85,20,,,,,,,,,
ATROPINE 0.1MG/ML SYR 10ML,450,RC,,Both,,,33.42,10,,,,,,,,,
ATROPINE 0.1MG/ML SYR 10ML,450,RC,,Both,,,31.82,10,,,,,,,,,
atropine opth,450,RC,,Both,,,1.4,1,,,,,,,,,
ATROPINE SULF 1% O/S 5ML,450,RC,,Both,,,67.43,20,,,,,,,,,
ATROPINE SULF 1% O/S 5ML,450,RC,,Both,,,64.22,19,,,,,,,,,
Dexamethasone Sodium Phosphate 1mL,J7637,HCPCS,,Both,1,ML,10.71,3,,,,,,,,,
"GAD-BASE MR CONTRAST NOS,1ML",A9579,HCPCS,,Both,1,ML,13.62,4,,,,,,,,,
ATROVENT 0.5 (IPRATROPIUM BROMIDE) NON-COMP,J7644,HCPCS,,Both,,,42.17,13,,,,,,,,,
Augmentin 875 tab,J8499,HCPCS,,Both,,,13.78,4,,,,,,,,,
AUTOMATED LEUKOCYTE COUNT,85048,CPT,,Both,,,267.75,80,,,,,,,,,
"AUTOMATIC BP MONITOR, DIAL",A4670,HCPCS,,Both,,,49.39,15,,,,,,,,,
AVULSION NAIL PLATE PARTIAL/COMP SIMPLE EA ADDL,11732,CPT,,Both,,,689.04,207,,,,,,,,,
AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1,11730,CPT,,Both,,,1365,410,,,,,,,,,
AXILLARY CRUTCH EXTENSION,L0978,HCPCS,,Both,,,1378.18,413,,,,,,,,,
Hyosyne 1 mL PO,J8499,HCPCS,,Both,1,ML,14.81,4,,,,,,,,,
"hypertonic saline solution, 1 ml",J7131,HCPCS,,Both,1,ML,104.93,31,,,,,,,,,
AZITHROMYCIN 200MG/5ML 15ML,450,RC,,Both,,,206.04,62,,,,,,,,,
AZITHROMYCIN 200MG/5ML 15ML,450,RC,,Both,,,196.23,59,,,,,,,,,
AZITHROMYCIN 250MG TAB 30EA,450,RC,,Both,,,271.17,81,,,,,,,,,
AZITHROMYCIN 250MG TAB 30EA,450,RC,,Both,,,258.26,77,,,,,,,,,
AZITHROMYCIN 500MG 10X10ML,450,RC,,Both,,,419.37,126,,,,,,,,,
AZITHROMYCIN 500MG 10X10ML,450,RC,,Both,,,399.4,120,,,,,,,,,
ISOVUE 300 100ML  - PER 1ML,Q9967,HCPCS,,Both,1,ML,7,2,,,,,,,,,
ISOVUE 370 (lopamidol) per 1ml,Q9967,HCPCS,,Both,1,ML,14.36,4,,,,,,,,,
PITOCIN (OXYTOCIN) 1mL (10units/mL),J3490,HCPCS,,Both,1,ML,22.47,7,,,,,,,,,
B1&/JT IMG 3 PHASE STD,78315,CPT,,Both,,,3939.54,1182,,,,,,,,,
B1&/JT IMG TOMOG SPECT,78320,CPT,,Both,,,3939.54,1182,,,,,,,,,
B1&/JT IMG WHBDY,78306,CPT,,Both,,,3234.63,970,,,,,,,,,
BACITRACIN 500/UN O/O 3.5GM,450,RC,,Both,,,430.95,129,,,,,,,,,
BACITRACIN 500/UN O/O 3.5GM,450,RC,,Both,,,410.42,123,,,,,,,,,
bacitracin oint packet 3.5GM,450,RC,,Both,,,430.95,129,,,,,,,,,
bacitracin oint packet 3.5GM,450,RC,,Both,,,410.42,123,,,,,,,,,
BACITRACIN ZINC OINT .9GM,A6250,HCPCS,,Both,,,76.89,23,,,,,,,,,
BACITRACIN ZINC OINT .9GM,450,RC,,Both,,,73.23,22,,,,,,,,,
bactrim DS,450,RC,,Both,,,4.03,1,,,,,,,,,
"LEVALBUTEROL HCL, VL NEB 1.25MG/3ML (Per .5 MG)",J7612,HCPCS,,Both,1.25,ML,19.69,6,,,,,,,,,
Bactroban,J3490,HCPCS,,Both,,,81.48,24,,,,,,,,,
"LEVALBUTEROL HCL, VL NEB 1.25MG/3ML (Per .5 MG)",J7614,HCPCS,,Both,1.25,ML,25.99,8,,,,,,,,,
BAG -  NORMAL SALINE 250ML BAG,450,RC,,Both,,,54.53,16,,,,,,,,,
BAG -  NORMAL SALINE 50ML ,450,RC,,Both,,,17.22,5,,,,,,,,,
BAG - URINARY LEG OR ABDOMEN BAG,A4358,HCPCS,,Both,,,20.18,6,,,,,,,,,
BAG EMESIS 24/BX,450,RC,,Both,,,177.7,53,,,,,,,,,
Bamlan and etesev infusion,M0245,HCPCS,,Both,,,1627.5,488,,,,,,,,,
Bamlanivimab-xxxx infusion,M0239,HCPCS,,Both,,,1627.5,488,,,,,,,,,
BANDAGE - SELF-ADHER BAND W <3?/YD,A6453,HCPCS,,Both,,,3.24,1,,,,,,,,,
BANDAGE ADH  BUGS&DAFFY,450,RC,,Both,,,24.62,7,,,,,,,,,
BANDAGE ADH  BUGS&DAFFY,450,RC,,Both,,,23.45,7,,,,,,,,,
BANDAGE ADH  CHARLIE BRN 3/4,450,RC,,Both,,,24.62,7,,,,,,,,,
BANDAGE ADH  CHARLIE BRN 3/4,450,RC,,Both,,,23.45,7,,,,,,,,,
BANDAGE ADH FLEX 1X3,450,RC,,Both,,,17.83,5,,,,,,,,,
BANDAGE ADH FLEX 1X3,450,RC,,Both,,,16.98,5,,,,,,,,,
BANDAGE ADH FLEX 3/4X3,450,RC,,Both,,,15.16,5,,,,,,,,,
BANDAGE ADH FLEX 3/4X3,450,RC,,Both,,,14.44,4,,,,,,,,,
BANDAGE ADH GLITTER 3/4X3,450,RC,,Both,,,28.01,8,,,,,,,,,
BANDAGE ADH GLITTER 3/4X3,450,RC,,Both,,,26.68,8,,,,,,,,,
BANDAGE ADH SHEER XL 2X4,450,RC,,Both,,,24.56,7,,,,,,,,,
BANDAGE ADH SHEER XL 2X4,450,RC,,Both,,,23.39,7,,,,,,,,,
BANDAGE COHES 1,450,RC,,Both,,,12.26,4,,,,,,,,,
BANDAGE COHES 2,450,RC,,Both,,,6.98,2,,,,,,,,,
BANDAGE COHES 2,450,RC,,Both,,,6.64,2,,,,,,,,,
BANDAGE COHES 3,450,RC,,Both,,,9.7,3,,,,,,,,,
BANDAGE COHES 3,450,RC,,Both,,,9.24,3,,,,,,,,,
BANDAGE COHES 4,450,RC,,Both,,,11.83,4,,,,,,,,,
BANDAGE COHES 4,450,RC,,Both,,,11.26,3,,,,,,,,,
BANDAGE ELAS 2,450,RC,,Both,,,31.66,9,,,,,,,,,
BANDAGE ELAS 2,450,RC,,Both,,,30.15,9,,,,,,,,,
BANDAGE ELAS 3,450,RC,,Both,,,42.44,13,,,,,,,,,
BANDAGE ELAS 3,450,RC,,Both,,,40.43,12,,,,,,,,,
BANDAGE ELAS 4,450,RC,,Both,,,57.84,17,,,,,,,,,
BANDAGE ELAS 4,450,RC,,Both,,,55.09,17,,,,,,,,,
BANDAGE ELAS 6,450,RC,,Both,,,86.1,26,,,,,,,,,
BANDAGE ELAS 6,450,RC,,Both,,,82.01,25,,,,,,,,,
BANDAID,A4649,HCPCS,,Both,,,1.61,1,,,,,,,,,
Bartholin Gland Balloon Word Catheter,450,RC,,Both,,,280.35,84,,,,,,,,,
BASIC METABOLIC PANEL CALCIUM IONIZED,80047,CPT,,Both,,,1554,466,,,,,,,,,
BASIC METABOLIC PANEL CALCIUM TOTAL,80048,CPT,,Both,,,1430,429,,,,,,,,,
BASIN - EMESIS BASIN STERILE,A4649,HCPCS,,Both,,,9.78,3,,,,,,,,,
BASIN EMESIS 9,450,RC,,Both,,,1.04,1,,,,,,,,,
BASIN EMESIS 9,450,RC,,Both,,,0.99,1,,,,,,,,,
BASIN WASH 6.3QT RECT ROSE,450,RC,,Both,,,6.86,2,,,,,,,,,
BASIN WASH 6.3QT RECT ROSE,450,RC,,Both,,,6.53,2,,,,,,,,,
BATTERY AA ALK 24/BX,450,RC,,Both,,,3.03,1,,,,,,,,,
BATTERY AA ALK 24/BX,450,RC,,Both,,,2.89,1,,,,,,,,,
BATTERY AAA ALK 24/BX,450,RC,,Both,,,4.24,1,,,,,,,,,
BATTERY AAA ALK 24/BX,450,RC,,Both,,,4.04,1,,,,,,,,,
BCR/ABL1 MAJOR BREAKPNT QUALITATIVE/QUANTITATIVE,81206,CPT,,Both,,,819.8,246,,,,,,,,,
BED PAN STANDARD,E0275,HCPCS,,Both,,,276,83,,,,,,,,,
BED PAN STANDARD,E0275,HCPCS,,Both,,,276,83,,,,,,,,,
BEDPAN FRACT DUSTY ROSE 34OZEA,450,RC,,Both,,,10.13,3,,,,,,,,,
BEDPAN FRACT DUSTY ROSE 34OZEA,450,RC,,Both,,,9.64,3,,,,,,,,,
Potassium Chloride 10 mEq / 100 mL IV NS 100 mL,J3490,HCPCS,,Both,10,ML,26.24,8,,,,,,,,,
Atarax (Hydroxyzine) 10mg tab,J8499,HCPCS,,Both,0.01,GM,8.66,3,,,,,,,,,
"ATORVASTASTIN, TAB 10MG",J8499,HCPCS,,Both,0.01,GM,5.78,2,,,,,,,,,
BENADRYL ALLERGY LIQ CHILD,450,RC,,Both,,,44.09,13,,,,,,,,,
BENADRYL ALLERGY LIQ CHILD,450,RC,,Both,,,41.98,13,,,,,,,,,
benadryl liquid susp,450,RC,,Both,,,7.28,2,,,,,,,,,
BENTYL ?DICYCLOMINE ?10MG TABLET,J8499,HCPCS,,Both,0.01,GM,1.28,1,,,,,,,,,
"BUSPIRONE HCL, TAB 10MG",J8499,HCPCS,,Both,0.01,GM,0.16,1,,,,,,,,,
Bentyl 10mg/ml (20mg) per dose ,450,RC,,Both,,,215.08,65,,,,,,,,,
BENTYL 10MG/ML AMP 5X2ML,450,RC,,Both,,,1412.37,424,,,,,,,,,
BENTYL 10MG/ML AMP 5X2ML,450,RC,,Both,,,161.41,48,,,,,,,,,
Bentyl 10mg/ml suspension (160ml) ,450,RC,,Both,,,55.66,17,,,,,,,,,
Bentyl 20mg tab ,450,RC,,Both,,,122.56,37,,,,,,,,,
Benzoin - Skin barrier liquid per oz,A4369,HCPCS,,Both,,,10.17,3,,,,,,,,,
CARDIZEM - DILTIAZEM HYDROCHLORIDE 10 MG,J3490,HCPCS,,Both,0.01,GM,3.42,1,,,,,,,,,
Claritin 10mg tab,A9150,HCPCS,,Both,0.01,GM,29.9,9,,,,,,,,,
BETA-2 MICROGLOBULIN,82232,CPT,,Both,,,161.8,49,,,,,,,,,
BETADINE SOL 4OZ,450,RC,,Both,,,11.4,3,,,,,,,,,
BETADINE SOL 4OZ,450,RC,,Both,,,10.86,3,,,,,,,,,
BETADINE/IODINE SWABS/WIPES,A4247,HCPCS,,Both,,,34.83,10,,,,,,,,,
BETADINE/PHISOHEX SOLUTION,A4246,HCPCS,,Both,,,34.83,10,,,,,,,,,
BETAM PHOS/BETAM ACE 6MG 5ML,450,RC,,Both,,,232.97,70,,,,,,,,,
COMPAZINE - PROCHLORPERAZINE 10MG,J0780,HCPCS,,Both,0.01,GM,17.69,5,,,,,,,,,
DICYCLOMINE HCL (BENTYL) SOL 10MG/5ML,J8499,HCPCS,,Both,10,ML,13.26,4,,,,,,,,,
BICILLIN LA 600MU SYR 10/BX,450,RC,,Both,,,2606.77,782,,,,,,,,,
"Bicillin-LA 600,000 mu (per 100,000)",J0561,HCPCS,,Both,,,169.6,51,,,,,,,,,
"Bicillin-LA(per 100,000)",J0561,HCPCS,,Both,,,169.6,51,,,,,,,,,
BILIRUBIN TOT,82247,CPT,,Both,,,366,110,,,,,,,,,
Bilirubin; direct ,82248,CPT,,Both,,,450,135,,,,,,,,,
BioFire Respiratory Panel 2.1 (RP2.1),0202U,HCPCS,,Both,,,3679.76,1104,,,,,,,,,
Flexaril (cyclobenzaprine) 10mg Tab,J8499,HCPCS,,Both,0.01,GM,3.01,1,,,,,,,,,
GEODON - ZIPRASIDONE MESYLATE 10MG,J3486,HCPCS,,Both,0.01,GM,48.27,14,,,,,,,,,
BLD OCLT FECAL HGB DETER IA QUAL FECES 1-3,82274,CPT,,Both,,,273.25,82,,,,,,,,,
BLD OCLT PROXIDASE ACTV QUAL FECES 1 DETER,82270,CPT,,Both,,,1512,454,,,,,,,,,
BLD TYPING RH D,86901,CPT,,Both,,,1020,306,,,,,,,,,
BLD TYPING RH PHEXYPING COMPL,86906,CPT,,Both,,,194.25,58,,,,,,,,,
BLD# COMPL AUTO HHRWP,85027,CPT,,Both,,,408,122,,,,,,,,,
BLD# HEMATOCRIT,85014,CPT,,Both,,,151.48,45,,,,,,,,,
BLD# HGB,85018,CPT,,Both,,,151.48,45,,,,,,,,,
BLD# MNL C-CNT RBC WBC/PLTLT EA,85032,CPT,,Both,,,226.55,68,,,,,,,,,
BLD# RETICULOCYTE MNL,85044,CPT,,Both,,,148.71,45,,,,,,,,,
BLDR IRRIGATION SMPL LVG&/INSTLJ,51700,CPT,,Both,,,1500,450,,,,,,,,,
BLEPHAROTOMY DRG ABSC EYELID,67700,CPT,,Both,,,3516.38,1055,,,,,,,,,
"BLOOD COLLECTION TUBE, VACUUM, FOR DIALYSIS, PER 50",A4770,HCPCS,,Both,,,8.25,2,,,,,,,,,
BLOOD COUNT PLATELET AUTOMATED,85049,CPT,,Both,,,44.8,13,,,,,,,,,
"Blood count; blood smear, microscopic examination w/ manual differential WBC count",85007,CPT,,Both,,,268.81,81,,,,,,,,,
"Blood count; reticulocyte, automated",85045,CPT,,Both,,,1512,454,,,,,,,,,
BLOOD CULTURE - CUL BACT BLD AERC ISOL,87040,CPT,,Both,,,463,139,,,,,,,,,
Blood Culture Adult,87040,CPT,,Both,,,463,139,,,,,,,,,
Blood Culture Pedi,87040,CPT,,Both,,,463,139,,,,,,,,,
BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1-3 SPEC,82272,CPT,,Both,,,1512,454,,,,,,,,,
Blood pregnancy test  HCG,84703,CPT,,Both,,,1020,306,,,,,,,,,
BLOOD SMEAR PERIPHERAL INTERP PHYS W/WRIT REPORT,85060,CPT,,Both,,,155.06,47,,,,,,,,,
Blood Tube Heparin Gel,450,RC,,Both,,,7.51,2,,,,,,,,,
BLOOD TYPE ANTIGEN DONOR REAGENT SERUM EACH,86902,CPT,,Both,,,33.34,10,,,,,,,,,
"Blood typing, serologic; ABO",86900,CPT,,Both,,,1020,306,,,,,,,,,
"Blood, occult, by peroxidase activity (eg, guaiac), qualitat...",82271,CPT,,Both,,,348.74,105,,,,,,,,,
BNP - B TYPE NATRIURETIC PEPTIDE,83880,CPT,,Both,,,1056,317,,,,,,,,,
BOLUS IV LOCK PUSH - INJ HEPARIN SODIUM PER 10 U,J1642,HCPCS,,Both,,,18.56,6,,,,,,,,,
BORDETELLA PARAPERTUSSIS,87798,CPT,,Both,,,566.52,170,,,,,,,,,
BORDETELLA PERTUSSIS,87798,CPT,,Both,,,566.52,170,,,,,,,,,
BORDETELLA PERTUSSIS,87798,CPT,,Both,,,325,98,,,,,,,,,
BP CUFF START KIT DURA 3/EA,450,RC,,Both,,,874.64,262,,,,,,,,,
BP CUFF START KIT DURA 3/EA,450,RC,,Both,,,832.99,250,,,,,,,,,
BP UNIT ADULT DLX,450,RC,,Both,,,208.72,63,,,,,,,,,
BP UNIT ADULT DLX,450,RC,,Both,,,198.78,60,,,,,,,,,
BP UNIT CHILD DLX,450,RC,,Both,,,208.72,63,,,,,,,,,
BP UNIT CHILD DLX,450,RC,,Both,,,198.78,60,,,,,,,,,
BP UNIT LG ADULT DLX,450,RC,,Both,,,239.52,72,,,,,,,,,
BP UNIT LG ADULT DLX,450,RC,,Both,,,228.11,68,,,,,,,,,
BP UNIT THIGH DLX,450,RC,,Both,,,271.6,81,,,,,,,,,
BP UNIT THIGH DLX,450,RC,,Both,,,258.66,78,,,,,,,,,
BRIEF NIGHTINGALE-EXTRA LG,450,RC,,Both,,,35.96,11,,,,,,,,,
BRIEF NIGHTINGALE-EXTRA LG,450,RC,,Both,,,34.25,10,,,,,,,,,
"Inj: Levetiracetam, per 10mg",J1953,HCPCS,,Both,0.01,GM,15.39,5,,,,,,,,,
BRUSH SCRUB EZ W/CHLORHX 30BBX,450,RC,,Both,,,188.53,57,,,,,,,,,
BRUSH SCRUB EZ W/CHLORHX 30BBX,450,RC,,Both,,,179.55,54,,,,,,,,,
BUDDY TAPE,A4649,HCPCS,,Both,,,14.48,4,,,,,,,,,
"Injection, propofol, 10 mg",J2704,HCPCS,,Both,0.01,GM,21.89,7,,,,,,,,,
"KETOROLAC, TAB 10MG (TORADOL)",J8499,HCPCS,,Both,0.01,GM,20.74,6,,,,,,,,,
BURR ALGER .5MM NS 5/BX,450,RC,,Both,,,45.55,14,,,,,,,,,
BURR ALGER .5MM NS 5/BX,450,RC,,Both,,,43.37,13,,,,,,,,,
Lidocaine HCl 1% 10 mg/ml injection,J3490,HCPCS,,Both,10,ML,21.6,6,,,,,,,,,
BX SKIN SUBCUTANEOUS&/MUCOUS MEMBRANE 1 LESION,11100,CPT,,Both,,,1332.5,400,,,,,,,,,
CABLE ECG MULTI-LINK,450,RC,,Both,,,1004.03,301,,,,,,,,,
CABLE ECG MULTI-LINK,450,RC,,Both,,,956.22,287,,,,,,,,,
CABLE TEMP SINGLE 400 SERIES,450,RC,,Both,,,831.04,249,,,,,,,,,
CABLE TEMP SINGLE 400 SERIES,450,RC,,Both,,,791.47,237,,,,,,,,,
CADMIUM,82300,CPT,,Both,,,236.4,71,,,,,,,,,
"LIDOCAINE HCL, INJ 1% 10 mg / mL",J2001,HCPCS,,Both,10,ML,131.78,40,,,,,,,,,
Calamine Topical 8% Strength Lotion ,A6250,HCPCS,,Both,,,37.28,11,,,,,,,,,
"LISINOPRIL(Zestril), TAB 10MG ",J8499,HCPCS,,Both,0.01,GM,18.7,6,,,,,,,,,
CALCIUM CHL 10% L/S 10ML,450,RC,,Both,,,54.64,16,,,,,,,,,
CALCIUM CHL 10% L/S 10ML,450,RC,,Both,,,6.25,2,,,,,,,,,
LOVENOX - INJ ENOXAPARIN SODIUM PER 10MG,J1650,HCPCS,,Both,0.01,GM,44.65,13,,,,,,,,,
"MEDROXYPROGESTERONE (DEPO-PROVERA) , TAB 10MG",J8499,HCPCS,,Both,0.01,GM,26.78,8,,,,,,,,,
MEDROXYPROGESTERONE ACETATE (Provera) 10 MG tab,J8499,HCPCS,,Both,0.01,GM,26.78,8,,,,,,,,,
CALCIUM TOT,82310,CPT,,Both,,,504,151,,,,,,,,,
"MEDROXYPROGESTERONE, TAB 10 MG",J8499,HCPCS,,Both,0.01,GM,55.5,17,,,,,,,,,
Calcium; ionized,82330,CPT,,Both,,,504,151,,,,,,,,,
Calculus; infrared spectroscopy,82365,CPT,,Both,,,92.87,28,,,,,,,,,
Calculus; qualitative analysis,82355,CPT,,Both,,,86.93,26,,,,,,,,,
"Calprotectin, fecal",83993,CPT,,Both,,,103.06,31,,,,,,,,,
"CANISTER, NON-DISPOSABLE, USED WITH SUCTION PUMP, EACH",A7001,HCPCS,,Both,,,13.72,4,,,,,,,,,
CANNULA NASAL ADLT STR TIP,450,RC,,Both,,,2.98,1,,,,,,,,,
CANNULA NASAL ADLT STR TIP,450,RC,,Both,,,2.84,1,,,,,,,,,
CANNULA NASAL O2,A4615,HCPCS,,Both,,,8.09,2,,,,,,,,,
CANNULA NASAL PED 7 TUBE,450,RC,,Both,,,8.43,3,,,,,,,,,
CANNULA NASAL PED 7 TUBE,450,RC,,Both,,,8.02,2,,,,,,,,,
CAPILLARY BLOOD DRAW,36416,CPT,,Both,,,684,205,,,,,,,,,
Montelukast Sodium/Singulair 10 mg tab,J8499,HCPCS,,Both,0.01,GM,4.76,1,,,,,,,,,
CARAFATE 1GM TAB,J8499,HCPCS,,Both,,,65.6,20,,,,,,,,,
Carbamazepine; total,80156,CPT,,Both,,,327.38,98,,,,,,,,,
"Carbamide Peroxide, Ear Drops",A9150,HCPCS,,Both,,,27.3,8,,,,,,,,,
CARBON DIOXIDE,82374,CPT,,Both,,,360,108,,,,,,,,,
Carboxyhemoglobin; quantitative,82375,CPT,,Both,,,211.75,64,,,,,,,,,
CARCINOEMBRYONIC ANTIGEN CEA,82378,CPT,,Both,,,326,98,,,,,,,,,
CARD BPI GTD =BRM PLNR 1 STD REST/STRS,78472,CPT,,Both,,,3032.24,910,,,,,,,,,
Cardene 20mg/200ml,450,RC,,Both,,,667.25,200,,,,,,,,,
CARDIAC MONITOR,A4649,HCPCS,,Both,,,399.51,120,,,,,,,,,
CARDIOPULM RESUSCITATION,92950,CPT,,Both,,,3857.75,1157,,,,,,,,,
CARDIOVERSION ELECTIVE ARRHYT XTRNL,92960,CPT,,Both,,,3368.78,1011,,,,,,,,,
CARDIOVERSION ELECTIVE ARRHYTHMIA INTERNAL SPX,92961,CPT,,Both,,,1954.85,586,,,,,,,,,
Nifedipine (Procardia) 10 mg CAP,J8499,HCPCS,,Both,0.01,GM,9.66,3,,,,,,,,,
cardizem 25mg/5ml vials,450,RC,,Both,,,15.25,5,,,,,,,,,
Casirivi and imdevi infusion and post monitoring,M0243,HCPCS,,Both,,,1627.5,488,,,,,,,,,
CAST BOOT LG,450,RC,,Both,,,31.48,9,,,,,,,,,
CAST BOOT LG,450,RC,,Both,,,29.97,9,,,,,,,,,
CAST BOOT MED,450,RC,,Both,,,31.48,9,,,,,,,,,
CAST BOOT MED,450,RC,,Both,,,29.97,9,,,,,,,,,
CAST BOOT SM,450,RC,,Both,,,31.48,9,,,,,,,,,
CAST BOOT SM,450,RC,,Both,,,29.97,9,,,,,,,,,
CAST BOOT XS,450,RC,,Both,,,33.42,10,,,,,,,,,
CAST BOOT XS,450,RC,,Both,,,31.82,10,,,,,,,,,
CAST CUTTER 115V HEX DRIVE,450,RC,,Both,,,5888.69,1767,,,,,,,,,
CAST CUTTER 115V HEX DRIVE,450,RC,,Both,,,5608.28,1682,,,,,,,,,
CAST FIGURE-OF-8,29049,CPT,,Both,,,1275,383,,,,,,,,,
CAST HAND&LOWER FOREARM GAUNTLET,29085,CPT,,Both,,,1225.13,368,,,,,,,,,
CAST PAD 2,450,RC,,Both,,,93.32,28,,,,,,,,,
CAST PAD 2,450,RC,,Both,,,88.87,27,,,,,,,,,
CAST PAD 3,450,RC,,Both,,,62.21,19,,,,,,,,,
CAST PAD 3,450,RC,,Both,,,59.25,18,,,,,,,,,
CAST PAD 4,450,RC,,Both,,,83.75,25,,,,,,,,,
CAST PAD 4,450,RC,,Both,,,79.76,24,,,,,,,,,
CAST PAD 6,450,RC,,Both,,,79.8,24,,,,,,,,,
CAST PAD 6,450,RC,,Both,,,76,23,,,,,,,,,
CAST SPLINT 2,450,RC,,Both,,,389.9,117,,,,,,,,,
CAST SPLINT 2,450,RC,,Both,,,371.33,111,,,,,,,,,
CAST SPLINT 3,450,RC,,Both,,,498.56,150,,,,,,,,,
CAST SPLINT 3,450,RC,,Both,,,474.82,142,,,,,,,,,
CAST SPLINT 4,450,RC,,Both,,,580.73,174,,,,,,,,,
CAST SPLINT 4,450,RC,,Both,,,553.08,166,,,,,,,,,
CAST SPLINT 5,450,RC,,Both,,,739.54,222,,,,,,,,,
CAST SPLINT 5,450,RC,,Both,,,704.32,211,,,,,,,,,
Cast sup gauntlet plaster,Q4013,HCPCS,,Both,,,187.53,56,,,,,,,,,
CAST SUP LNG ARM SPLINT FBRG,Q4018,HCPCS,,Both,,,408,122,,,,,,,,,
Cast sup lng arm splint plst (11YR+),Q4017,HCPCS,,Both,,,408,122,,,,,,,,,
Cast sup lng arm splnt ped (0-10) fib,Q4020,HCPCS,,Both,,,816,245,,,,,,,,,
Cast sup lng arm splnt ped p,Q4019,HCPCS,,Both,,,960,288,,,,,,,,,
Cast sup lng leg splnt ped f,Q4044,HCPCS,,Both,,,1212,364,,,,,,,,,
Cast sup long arm ped fbrgls,Q4008,HCPCS,,Both,,,1016,305,,,,,,,,,
CAST SUP SHRT LEG FIBERGLASS,Q4038,HCPCS,,Both,,,121.07,36,,,,,,,,,
Cast sup shrt leg ped fbrgls,Q4040,HCPCS,,Both,,,123.89,37,,,,,,,,,
Cast sup shrt leg plaster,Q4037,HCPCS,,Both,,,195.58,59,,,,,,,,,
CAST SUP SHT ARM SPLINT FBRG,Q4022,HCPCS,,Both,,,684,205,,,,,,,,,
Cast sup sht arm splint plst,Q4021,HCPCS,,Both,,,882,265,,,,,,,,,
Cast sup sht arm splnt ped fib,Q4024,HCPCS,,Both,,,684,205,,,,,,,,,
Cast sup sht arm splnt ped plaster,Q4023,HCPCS,,Both,,,684,205,,,,,,,,,
CAST SUP SHT LEG SPLNT FBRGL,Q4046,HCPCS,,Both,,,1212,364,,,,,,,,,
Cast sup sht leg splnt ped f,Q4048,HCPCS,,Both,,,1212,364,,,,,,,,,
"Cast supplies, long leg splint, adult (11 years +), fiberglass",Q4042,HCPCS,,Both,,,1212,364,,,,,,,,,
"Cast supplies, short leg splint, adult (11 years +), plaster",Q4045,HCPCS,,Both,,,668,200,,,,,,,,,
CATH CHEST 10FR STR 10/CS,450,RC,,Both,,,448.18,134,,,,,,,,,
CATH CHEST 10FR STR 10/CS,450,RC,,Both,,,426.83,128,,,,,,,,,
CATH CHEST 12FR STR 10/CS,450,RC,,Both,,,448.18,134,,,,,,,,,
CATH CHEST 12FR STR 10/CS,450,RC,,Both,,,426.83,128,,,,,,,,,
CATH CHEST 16FR STR 10/CS,450,RC,,Both,,,448.18,134,,,,,,,,,
CATH CHEST 16FR STR 10/CS,450,RC,,Both,,,426.83,128,,,,,,,,,
CATH CHEST 24FR STR,450,RC,,Both,,,448.18,134,,,,,,,,,
CATH CHEST 24FR STR,450,RC,,Both,,,426.83,128,,,,,,,,,
CATH KIT 5FR INF CLOSED SYS,450,RC,,Both,,,29.59,9,,,,,,,,,
CATH KIT 5FR INF CLOSED SYS,450,RC,,Both,,,28.18,8,,,,,,,,,
CATH KIT 8FR FEM W/GLOVES,450,RC,,Both,,,24.74,7,,,,,,,,,
CATH KIT 8FR FEM W/GLOVES,450,RC,,Both,,,23.56,7,,,,,,,,,
CATH KIT INTRMT MALE 14FR RR,450,RC,,Both,,,21.65,6,,,,,,,,,
CATH KIT INTRMT MALE 14FR RR,450,RC,,Both,,,20.62,6,,,,,,,,,
CATH TRAY FOLEY 16FR LUBRICT,450,RC,,Both,,,72.64,22,,,,,,,,,
CATH TRAY FOLEY 16FR LUBRICT,450,RC,,Both,,,69.18,21,,,,,,,,,
CATH W/DRAINAGE 2-WAY LATEX,A4314,HCPCS,,Both,,,17.75,5,,,,,,,,,
CATHETER - FOLEY 2 WAY SILICN,A4344,HCPCS,,Both,,,17.75,5,,,,,,,,,
CATHETER W/BAG 3-WAY,A4313,HCPCS,,Both,,,38.73,12,,,,,,,,,
CATHETER W/O BAG 2-WAY LATEX,A4311,HCPCS,,Both,,,48.43,15,,,,,,,,,
"CATHETERIZATION, BLADDER",51701,CPT,,Both,,,1140,342,,,,,,,,,
CATHETERIZE FOR URINE SPEC,P9612,HCPCS,,Both,,,263.42,79,,,,,,,,,
CAUTERY HI-TEMP FINE 10/BX,450,RC,,Both,,,50.69,15,,,,,,,,,
CAUTERY HI-TEMP FINE 10/BX,450,RC,,Both,,,48.28,14,,,,,,,,,
CBC-BLD# COMPL AUTO HHRWP&AUTO DIFFIAL,85025,CPT,,Both,,,1512,454,,,,,,,,,
CC E/M CRITICALLY ILL/INJURED 1ST 30-74 MIN,99291,CPT,,Both,,,9026,2708,,,,,,,,,
CC E/M CRITICALLY ILL/INJURED EA 30 MIN,99292,CPT,,Both,,,3427.08,1028,,,,,,,,,
CCIIV3 VACCINE PRESERVATIVE FREE 0.5 ML IM USE,90661,CPT,,Both,,,186.76,56,,,,,,,,,
CCIIV4 VACCINE PRESERVATIVE FREE 0.5 ML IM USE,90756,CPT,,Both,,,55,17,,,,,,,,,
C-COLLAR PEDI PERFIT 20/CS,450,RC,,Both,,,1017.32,305,,,,,,,,,
C-COLLAR PEDI PERFIT 20/CS,450,RC,,Both,,,968.88,291,,,,,,,,,
C-COLLAR REG PERFIT 20/CS,450,RC,,Both,,,1017.32,305,,,,,,,,,
C-COLLAR REG PERFIT 20/CS,450,RC,,Both,,,968.88,291,,,,,,,,,
C-COLLAR SHORT PERFIT 20/CS,450,RC,,Both,,,1017.32,305,,,,,,,,,
C-COLLAR SHORT PERFIT 20/CS,450,RC,,Both,,,968.88,291,,,,,,,,,
cefazolin 1g vial 6F,450,RC,,Both,,,28.41,9,,,,,,,,,
Cefdinir 3.5cc,J8499,HCPCS,,Both,,,1.24,1,,,,,,,,,
"Ofirmev - Acetaminophen inj, 10mg/mL",J0131,HCPCS,,Both,10,ML,4.9,1,,,,,,,,,
PEPCID AC(FAMOTIDINE) 10MG,A9150,HCPCS,,Both,0.01,GM,6.83,2,,,,,,,,,
Phenylephrine HCl 10 mg / mL Injection 1 mL,J3490,HCPCS,,Both,10,ML,129.28,39,,,,,,,,,
CEFOXITIN SODIUM INJECTION,J0694,HCPCS,,Both,,,64.17,19,,,,,,,,,
"PREDNISOLONE ACETATE; drops, 10mg/mL",J8499,HCPCS,,Both,10,ML,542.33,163,,,,,,,,,
CEFTRIAXONE 1GM VL,450,RC,,Both,,,16.13,5,,,,,,,,,
CEFTRIAXONE 1GM VL,450,RC,,Both,,,15.36,5,,,,,,,,,
CEFTRIAXONE 250MG VL,450,RC,,Both,,,10.07,3,,,,,,,,,
CEFTRIAXONE 250MG VL,450,RC,,Both,,,11.48,3,,,,,,,,,
CEFTRIAXONE 500MG VL,450,RC,,Both,,,13.46,4,,,,,,,,,
CEFTRIAXONE 500MG VL,450,RC,,Both,,,15.4,5,,,,,,,,,
"PREDNISONE ACETATE; drops, 10mg/mL",J8499,HCPCS,,Both,10,ML,542.33,163,,,,,,,,,
"PREDNISONE, TAB 10MG",J8499,HCPCS,,Both,0.01,GM,13.13,4,,,,,,,,,
"Cell count, miscellaneous body fluids (eg, cerebrospinal flu...",89051,CPT,,Both,,,497,149,,,,,,,,,
"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, jt fluid), except blood",89050,CPT,,Both,,,1038,311,,,,,,,,,
CELLDYN LINEARITY CTL 12X3ML,450,RC,,Both,,,2714.99,814,,,,,,,,,
CELLDYN LINEARITY CTL 12X3ML,450,RC,,Both,,,2585.7,776,,,,,,,,,
CENTRAL LINE KIT,450,RC,,Both,,,81.23,24,,,,,,,,,
"CEPACOL, LOZ ",A9150,HCPCS,,Both,,,1.58,1,,,,,,,,,
CEPHALEXIN 125mg/ml 200 ml (KEFLEX),450,RC,,Both,,,402.97,121,,,,,,,,,
CEPHALEXIN 250mg/mL 100mL (KEFLEX),450,RC,,Both,,,300.54,90,,,,,,,,,
"Prescription drug, oral, non chemotherapeuticHydroxycine 10mg tab",J8499,HCPCS,,Both,0.01,GM,8.66,3,,,,,,,,,
CEPHALEXIN 500MG CAPS 100/BT,450,RC,,Both,,,87.8,26,,,,,,,,,
PROPOFOL 10MG,J3490,HCPCS,,Both,0.01,GM,5.2,2,,,,,,,,,
Reglan 10mg Vial,J2765,HCPCS,,Both,0.01,GM,41.56,12,,,,,,,,,
CEPHALOGRAM ORTHODONTIC,70350,CPT,,Both,,,710.22,213,,,,,,,,,
Cepti-Seal,450,RC,,Both,,,14.37,4,,,,,,,,,
CEREBYX(FOSPHENYTOIN SODIUM)750 MG,S0078,HCPCS,,Both,,,167.03,50,,,,,,,,,
CERULOPLASMIN,82390,CPT,,Both,,,107.4,32,,,,,,,,,
CERV COL THERMPLAS FOAM 2 PI,L0172,HCPCS,,Both,,,180,54,,,,,,,,,
CERV FLEXIBLE NON-ADJUSTABLE,L0120,HCPCS,,Both,,,774,232,,,,,,,,,
CERV SEMI-RIG ADJ MOLDED CHN,L0150,HCPCS,,Both,,,811.98,244,,,,,,,,,
"WARFARIN SODIUM, COUMADIN 10MG TAB",J8499,HCPCS,,Both,0.01,GM,3.68,1,,,,,,,,,
CHANGE GASTROSTOMY TUBE PERCUTANEOUS W/O GDNCE,43760,CPT,,Both,,,6658.5,1998,,,,,,,,,
CHEMICAL CAUTERIZATION GRANULATION TISSUE,17250,CPT,,Both,,,1134.51,340,,,,,,,,,
CHEMILUMINESCENT ASSAY,82397,CPT,,Both,,,148.26,44,,,,,,,,,
Cheratussin AC 5 ML,450,RC,,Both,,,20.16,6,,,,,,,,,
ZYRTEC-CETIRIZINE ?10MG TABLET,A9150,HCPCS,,Both,0.01,GM,1.28,1,,,,,,,,,
CALCIUM GLUCONATE INJECTION per 10 ML,J0610,HCPCS,,Both,10,ML,10.32,3,,,,,,,,,
CHLAMYDOPHILA,87486,CPT,,Both,,,480,144,,,,,,,,,
CHLORAPREP APPLCTR 1.5CC ST,450,RC,,Both,,,129.47,39,,,,,,,,,
CHLORAPREP APPLCTR 1.5CC ST,450,RC,,Both,,,123.29,37,,,,,,,,,
DEXTROSE 25% IN WATER 10ML INJECTION,J3490,HCPCS,,Both,10,ML,135.4,41,,,,,,,,,
CHLORHEXIDINE ANTISEPT,A4248,HCPCS,,Both,,,80.71,24,,,,,,,,,
CHLORIDE BLD,82435,CPT,,Both,,,335.46,101,,,,,,,,,
CHLORPROMAZINE HCL INJECTION,J3230,HCPCS,,Both,,,84.17,25,,,,,,,,,
CHOLESTEROL SERUM/WHL BLD TOT,82465,CPT,,Both,,,540,162,,,,,,,,,
CHRMSM COUNT 15-20 CLL 2KARYOTYP BANDING,88262,CPT,,Both,,,2141.63,642,,,,,,,,,
CHROM QUAN COLUMN 1 ANAL NES,82491,CPT,,Both,,,310.25,93,,,,,,,,,
CHYLMD TRACH ASSAY W/OPTIC (Urine),87810,CPT,,Both,,,206.13,62,,,,,,,,,
CILOXAN .3% OPH SOL 5ML,450,RC,,Both,,,645.67,194,,,,,,,,,
CILOXAN .3% OPH SOL 5ML,450,RC,,Both,,,614.92,184,,,,,,,,,
CIPRO 250 MG TAB,450,RC,,Both,,,3.22,1,,,,,,,,,
CIPRODEX OTIC SUS 7.5ML,450,RC,,Both,,,7.28,2,,,,,,,,,
CIPRODEX OTIC SUS 7.5ML,450,RC,,Both,,,1068.31,320,,,,,,,,,
CIPRODEX OTIC SUSP ,J7342,HCPCS,,Both,,,131.78,40,,,,,,,,,
ciproflaxacin opth,450,RC,,Both,,,10.19,3,,,,,,,,,
Ciproflaxin 400mg/200mL Infusion,450,RC,,Both,,,31.5,9,,,,,,,,,
CIPROFLOXACIN .3% O/S 5ML,450,RC,,Both,,,25.47,8,,,,,,,,,
CIPROFLOXACIN .3% O/S 5ML,450,RC,,Both,,,24.26,7,,,,,,,,,
LIDOCAINE 10ML ORAL PO,J3490,HCPCS,,Both,10,ML,51.3,15,,,,,,,,,
CIPROFLOXACIN 500MG TAB 100,450,RC,,Both,,,92.34,28,,,,,,,,,
CIPROFLOXACIN IV,J0744,HCPCS,,Both,,,197.75,59,,,,,,,,,
"CIPROFLOXACIN, DRP OPHTH 0.3% ",J3490,HCPCS,,Both,,,16.28,5,,,,,,,,,
CITRASTAT RX LIME 7OZ,450,RC,,Both,,,42.69,13,,,,,,,,,
CITRASTAT RX LIME 7OZ,450,RC,,Both,,,40.66,12,,,,,,,,,
CITRASTAT RX ORANGE 7OZ,450,RC,,Both,,,42.69,13,,,,,,,,,
CITRASTAT RX ORANGE 7OZ,450,RC,,Both,,,40.66,12,,,,,,,,,
CITRATE OF MAG LEMON 10OZ,450,RC,,Both,,,11.22,3,,,,,,,,,
CITRATE OF MAG LEMON 10OZ,450,RC,,Both,,,10.69,3,,,,,,,,,
CKMB - CREATINE KINASE MB FXJ ONLY,82553,CPT,,Both,,,780,234,,,,,,,,,
CLAFORAN 1GM,450,RC,,Both,,,16.01,5,,,,,,,,,
CLAFORAN 1GM,450,RC,,Both,,,15.25,5,,,,,,,,,
MARCAINE 10ML,J3490,HCPCS,,Both,10,ML,68.69,21,,,,,,,,,
Clave Connector,450,RC,,Both,,,26.18,8,,,,,,,,,
CLAVICLE SPLINT LG,450,RC,,Both,,,27.53,8,,,,,,,,,
CLAVICLE SPLINT LG,450,RC,,Both,,,26.22,8,,,,,,,,,
CLAVICLE SPLINT MED,450,RC,,Both,,,27.53,8,,,,,,,,,
CLAVICLE SPLINT MED,450,RC,,Both,,,26.22,8,,,,,,,,,
CLAVICLE SPLINT SM,450,RC,,Both,,,27.53,8,,,,,,,,,
CLAVICLE SPLINT SM,450,RC,,Both,,,26.22,8,,,,,,,,,
CLAVICLE SPLINT UNIV,450,RC,,Both,,,64.76,19,,,,,,,,,
CLAVICLE SPLINT UNIV,450,RC,,Both,,,61.68,19,,,,,,,,,
CLD DILUENT 10L EMERALD,450,RC,,Both,,,1263.75,379,,,,,,,,,
CLD DILUENT 10L EMERALD,450,RC,,Both,,,1203.57,361,,,,,,,,,
CLD EMERALD CLEANER 960ML,450,RC,,Both,,,1203.05,361,,,,,,,,,
CLD EMERALD CLEANER 960ML,450,RC,,Both,,,1145.76,344,,,,,,,,,
CLD EMERALD LYSE 960ML,450,RC,,Both,,,2402.95,721,,,,,,,,,
CLD EMERALD LYSE 960ML,450,RC,,Both,,,2288.52,687,,,,,,,,,
CLEANER TRANSEPTIC SOL 8.5OZ,450,RC,,Both,,,29.11,9,,,,,,,,,
CLEANER TRANSEPTIC SOL 8.5OZ,450,RC,,Both,,,27.72,8,,,,,,,,,
CLEARVIEW HIV COMPLETE KIT,450,RC,,Both,,,1794.87,538,,,,,,,,,
CLEARVIEW HIV COMPLETE KIT,450,RC,,Both,,,1709.4,513,,,,,,,,,
CLEARVIEW HIV CTL LVL 1&2,450,RC,,Both,,,238.85,72,,,,,,,,,
CLEARVIEW HIV CTL LVL 1&2,86689,CPT,,Both,,,465,140,,,,,,,,,
CLEOCIN - CLINDAMYCIN PHOSP 300MG,S0077,HCPCS,,Both,,,150,45,,,,,,,,,
CLINDAMYCIN 150MG/ML 4ML,450,RC,,Both,,,23.53,7,,,,,,,,,
CLINDAMYCIN 150MG/ML 4ML,450,RC,,Both,,,22.41,7,,,,,,,,,
Clindamycin 300mg tab,450,RC,,Both,,,10.19,3,,,,,,,,,
ROBITUSSIN DM 10 ML Guaifenesin / Dextromethorphan 200-10mg,A9150,HCPCS,,Both,10,ML,8.62,3,,,,,,,,,
"Sterile saline or water, metered dose dispenser, 10 ml",A4218,HCPCS,,Both,10,ML,4.84,1,,,,,,,,,
"STERILE WATER/SALINE, FLUSH 10 ML",A4216,HCPCS,,Both,10,ML,4.84,1,,,,,,,,,
"STERILE WATER/SALINE, FLUSH 100ML (Per 10ML)",A4216,HCPCS,,Both,10,ML,3.5,1,,,,,,,,,
"STERILE WATER/SALINE, FLUSH 50 ML (per 10 ml)",A4216,HCPCS,,Both,10,ML,4.84,1,,,,,,,,,
Levothyroxine 100mcg tab,J8499,HCPCS,,Both,100,GM,5.36,2,,,,,,,,,
CLINITEK STATUS+ PROMO,450,RC,,Both,,,5224.29,1567,,,,,,,,,
CLINITEK STATUS+ PROMO,450,RC,,Both,,,4975.51,1493,,,,,,,,,
CLOFARALINE INJECTION,J9027,HCPCS,,Both,,,193.69,58,,,,,,,,,
CLONIDINE HCL .1MG TAB 100,450,RC,,Both,,,76.1,23,,,,,,,,,
CLONIDINE HCL .1MG TAB 100,450,RC,,Both,,,72.47,22,,,,,,,,,
"Acetylcysteine (ACETADOTE), 100 mg/mL injection",J0132,HCPCS,,Both,100,ML,49.36,15,,,,,,,,,
Allopurinol (Zyloprim) 100mg Tab,J8499,HCPCS,,Both,0.1,GM,1.58,1,,,,,,,,,
"CLOPIDOGREL (PLAVIX) , TAB 75MG",450,RC,,Both,,,13.13,4,,,,,,,,,
CLOPIDOGREL 75MG TABS 30/BT,450,RC,,Both,,,43.05,13,,,,,,,,,
CLOPIDOGREL 75MG TABS 30/BT,450,RC,,Both,,,41,12,,,,,,,,,
CLOROX DISINFECT SPRAY 19OZ,450,RC,,Both,,,26.92,8,,,,,,,,,
CLOROX DISINFECT SPRAY 19OZ,450,RC,,Both,,,25.64,8,,,,,,,,,
CLOROX GERMICIDAL CLNR 32OZ,450,RC,,Both,,,74.34,22,,,,,,,,,
CLOROX GERMICIDAL CLNR 32OZ,450,RC,,Both,,,70.8,21,,,,,,,,,
CLOSED TREATMENT NASAL FRACTURE W/O MANIPULATION,21310,CPT,,Both,,,1745.5,524,,,,,,,,,
"Closed treatment of carpometacarpal dislocation, other than thumb with manipulation, each joing; requiring anesthesia",26675,CPT,,Both,,,5769.38,1731,,,,,,,,,
CLOSED TREATMENT OF DISTAL RADIOULNAR DISLOCATION WITH MANIP...,25675,CPT,,Both,,,5653,1696,,,,,,,,,
Closed treatment of fracture of weight bearing articular por...,27824,CPT,,Both,,,3995,1199,,,,,,,,,
closed treatment of metatarsal fracture;without manipulation,28470,CPT,,Both,,,2854.38,856,,,,,,,,,
Closed treatment of patellar dislocation; without anesthesia,27560,CPT,,Both,,,4673.88,1402,,,,,,,,,
"CLOSED TREATMENT OF PHALANGEAL SHAFT FRACTURE, PROXIMAL OR M...",26720,CPT,,Both,,,2551,765,,,,,,,,,
Closed treatment of radial and ulnar shaft fractures; w/o manipulation,25560,CPT,,Both,,,3575.38,1073,,,,,,,,,
"Closed treatment of radiocarpal or intercarpal dislocation, ...",25660,CPT,,Both,,,5204.75,1561,,,,,,,,,
Closed treatment of tibial shaft fracture (with or without f...,27752,CPT,,Both,,,6843.13,2053,,,,,,,,,
Closed treatment of trimalleolar ankle fracture; with manipulation,27818,CPT,,Both,,,6194.75,1858,,,,,,,,,
Closed treatment of ulnar shaft fracture; w/o manipulation,25530,CPT,,Both,,,3367.88,1010,,,,,,,,,
"Closed treatment,ankle dislocation; req anesthesia, w/ or w/o percutaneous skeletal fixation",27842,CPT,,Both,,,6285.38,1886,,,,,,,,,
CLOSED TX ANKLE DISLOCATION W/O ANESTHESIA,27840,CPT,,Both,,,4767.63,1430,,,,,,,,,
CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/O MANJ,27808,CPT,,Both,,,4311.25,1293,,,,,,,,,
CLOSED TX CALCANEAL FRACTURE W/O MANIPULATION,28400,CPT,,Both,,,3241.63,972,,,,,,,,,
CLOSED TX CARPAL SCAPHOID FRACTURE W/O MNPJ,25622,CPT,,Both,,,3911.25,1173,,,,,,,,,
CLOSED TX KNEE DISLOCATION W/O ANESTHESIA,27550,CPT,,Both,,,6347.38,1904,,,,,,,,,
CLOSED TX MANDIBULAR FRACTURE W/O MANIPULATION,21450,CPT,,Both,,,8047.5,2414,,,,,,,,,
CLOSED TX MONTEGGIA FX DISLOCATION ELBOW W/MNPJ,24620,CPT,,Both,,,7002.88,2101,,,,,,,,,
CLOSED TX NASAL FRACTURE W/O STABILIZATION,21315,CPT,,Both,,,10027.31,3008,,,,,,,,,
CLOSED TX NASAL SEPTAL FRACTURE +-STABILIZATION,21337,CPT,,Both,,,5298,1589,,,,,,,,,
CLOSED TX PATELLAR DISLOCATION W/ANESTHESIA,27562,CPT,,Both,,,6114.5,1834,,,,,,,,,
CLOSED TX PATELLAR FRACTURE W/O MANIPULATION,27520,CPT,,Both,,,4161.13,1248,,,,,,,,,
CLOSED TX RADIAL HEAD/NECK FX W/MANIPULATION,24655,CPT,,Both,,,5597.13,1679,,,,,,,,,
CLOSED TX RADIAL HEAD/NECK FX W/O MANIPULATION,24650,CPT,,Both,,,3363.5,1009,,,,,,,,,
CLOSED TX RADIAL SHAFT FRACTURE W/MANIPULATION,25505,CPT,,Both,,,6412,1924,,,,,,,,,
CLOSED TX RADIAL SHAFT FRACTURE W/O MAN,25500,CPT,,Both,,,3482.75,1045,,,,,,,,,
CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MNPJ,25565,CPT,,Both,,,6645.28,1994,,,,,,,,,
CLOSED TX RIB FRACTURE UNCOMPLICATED EACH,21800,CPT,,Both,,,1467.13,440,,,,,,,,,
CLOSED TX SCAPULAR FRACTURE W/O MANIPULATION,23570,CPT,,Both,,,2962.38,889,,,,,,,,,
CLOSED TX TALUS FRACTURE W/O MANIPULATION,28430,CPT,,Both,,,3046,914,,,,,,,,,
CLOSED TX TARSOMETATARSAL DISLOCATION W/O ANES,28600,CPT,,Both,,,2408.25,722,,,,,,,,,
CLOSED TX TEMPOROMANDIBULAR DISLC COMP 1ST/SBSQ,21485,CPT,,Both,,,9121.63,2736,,,,,,,,,
CLOSED TX TEMPOROMANDIBULAR DISLOCATION 1ST/SBSQ,21480,CPT,,Both,,,1281.13,384,,,,,,,,,
CLOSED TX ULNAR FRACTURE PROXIMAL END W/MANJ,24675,CPT,,Both,,,9035.78,2711,,,,,,,,,
CLOSED TX ULNAR FRACTURE PROXIMAL END W/O MNPJ,24670,CPT,,Both,,,3737,1121,,,,,,,,,
CLOSED TX VERTEBRAL PROCESS FRACTURE,22305,CPT,,Both,,,2451.38,735,,,,,,,,,
CLOSTRIDIUM AG EIA,87324,CPT,,Both,,,463,139,,,,,,,,,
CLOSTRIDIUM TOXIN A W/OPTIC,87803,CPT,,Both,,,98.99,30,,,,,,,,,
CLOSURE LACERATION VESTIBULE MOUTH > 2.5 CM/CPL,40831,CPT,,Both,,,4480.75,1344,,,,,,,,,
"Closure of laceration, vestibule of mouth; 2.5 cm or less",40830,CPT,,Both,,,3540.5,1062,,,,,,,,,
Clotrimazole 1% Cream ,J8499,HCPCS,,Both,,,12.39,4,,,,,,,,,
CLOTTING FACTOR XI PTA,85270,CPT,,Both,,,268.91,81,,,,,,,,,
CLSD TX ACROMIOCLAVICULAR DISLC W/MANIPULATION,23545,CPT,,Both,,,4456,1337,,,,,,,,,
CLSD TX ACROMIOCLAVICULAR DISLC W/O MANIPULATION,23540,CPT,,Both,,,2869.38,861,,,,,,,,,
CLSD TX CLAVICULAR FRACTURE W/MANIPULATION,23505,CPT,,Both,,,4491.5,1347,,,,,,,,,
CLSD TX CLAVICULAR FRACTURE W/O MANIPULATION,23500,CPT,,Both,,,2805.38,842,,,,,,,,,
CLSD TX HUMERAL SHAFT FRACTURE W/O MANIPULATION,24500,CPT,,Both,,,4582.38,1375,,,,,,,,,
CLSD TX SHOULDER DISLC W/MANIPULATION REQ ANES,23655,CPT,,Both,,,5077,1523,,,,,,,,,
CLSD TX SHOULDER DISLC W/MANIPULATION W/O ANES,23650,CPT,,Both,,,4029.75,1209,,,,,,,,,
CLTX ARTCLR FX INVG MTCARPHLNGL/IPHAL JT W/MANJ,26742,CPT,,Both,,,4671,1401,,,,,,,,,
CLTX CARPAL BONE FX W/O MANJ EACH BONE,25630,CPT,,Both,,,3902.13,1171,,,,,,,,,
CLTX CARPL B1 FX W/MNPJ EA B1,25635,CPT,,Both,,,5787.5,1736,,,,,,,,,
CLTX CARPO/METACARPAL FX DISLC THUMB W/MANJ,26645,CPT,,Both,,,5417.38,1625,,,,,,,,,
"CLTX CARPO/METACARPL DISLC THMB MANJ EA W/O ANES;   Closed treatment of carpometacarpal dislocation, other than thumb, with manipulation, each joint; without anesthesia",26670,CPT,,Both,,,4211.88,1264,,,,,,,,,
CLTX DSTL FIBULAR FX LAT MALLS W/MANJ,27788,CPT,,Both,,,5401.75,1621,,,,,,,,,
CLTX DSTL FIBULAR FX LAT MALLS W/O MNPJ,27786,CPT,,Both,,,4077.5,1223,,,,,,,,,
CLTX DSTL PHLNGL FX FNGR/THMB W/MNPJ EA,26755,CPT,,Both,,,4025.38,1208,,,,,,,,,
CLTX DSTL PHLNGL FX FNGR/THMB W/O MNPJ EA,26750,CPT,,Both,,,2363.63,709,,,,,,,,,
CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MNPJ,25600,CPT,,Both,,,4218.13,1265,,,,,,,,,
CLTX DSTL RDL FX/EPIPHYSL SEP +-W/MNPJ,25605,CPT,,Both,,,6988.25,2096,,,,,,,,,
CLTX FEM SHFT FX W/MNPJ +-SKN/SKEL TRACJ,27502,CPT,,Both,,,9715.5,2915,,,,,,,,,
CLTX FX GRT TOE PHLX/PHLG W/MNPJ,28495,CPT,,Both,,,2303.75,691,,,,,,,,,
CLTX FX GRT TOE PHLX/PHLG W/O MNPJ,28490,CPT,,Both,,,1898.63,570,,,,,,,,,
CLTX FX PHLX/PHLG OTH/THN GRT TOE W/MNPJ,28515,CPT,,Both,,,2086.63,626,,,,,,,,,
CLTX FX PHLX/PHLG OTH/THN GRT TOE W/O MNPJ,28510,CPT,,Both,,,1596.75,479,,,,,,,,,
CLTX GREATER HUMERAL TUBEROSITY FX W/O MANJ,23620,CPT,,Both,,,3459.88,1038,,,,,,,,,
CLTX HUMERAL CONDYLAR FX MEDIAL/LAT W/O MANJ,24576,CPT,,Both,,,4374.25,1312,,,,,,,,,
CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/MNPJ,24565,CPT,,Both,,,6767.25,2030,,,,,,,,,
CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/O MANJ,24560,CPT,,Both,,,4136.38,1241,,,,,,,,,
CLTX HUMERAL SHFT FX W/MANIPULATION +-SKEL TRACJ,24505,CPT,,Both,,,6381.38,1914,,,,,,,,,
CLTX IPHAL JT DISLC 1 W/MNPJ W/O ANES,26770,CPT,,Both,,,3541,1062,,,,,,,,,
CLTX IPHAL JT DISLC W/O ANES,28660,CPT,,Both,,,1505.63,452,,,,,,,,,
CLTX MEDIAL MALLS FX W/MANJ W/WO SKN/SKEL TRACJ,27762,CPT,,Both,,,6084.63,1825,,,,,,,,,
CLTX MEDIAL MALLS FX W/O MNPJ,27760,CPT,,Both,,,4306.5,1292,,,,,,,,,
CLTX METAR FX W/MANJ,28475,CPT,,Both,,,3260.38,978,,,,,,,,,
CLTX METATARSOPHLNGL JT DISLC W/O ANES,28630,CPT,,Both,,,2025.88,608,,,,,,,,,
CLTX MTCARPHLNGL DISLC 1 W/MNPJ W/O ANES,26700,CPT,,Both,,,4140.13,1242,,,,,,,,,
CLTX MTCRPL FX 1 W/MNPJ EA B1,26605,CPT,,Both,,,4119.5,1236,,,,,,,,,
CLTX MTCRPL FX 1 W/O MNPJ EA B1,26600,CPT,,Both,,,1635.2,491,,,,,,,,,
CLTX MTCRPL FX W/MNPJ W/XTRNL FIXJ EA B1,26607,CPT,,Both,,,5771.88,1732,,,,,,,,,
CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/MANJ EA,26725,CPT,,Both,,,4305.63,1292,,,,,,,,,
CLTX PROX FIBULA/SHFT FX W/O MNPJ,27780,CPT,,Both,,,3949.5,1185,,,,,,,,,
CLTX PROXIMAL HUMERAL FRACTURE W/O MANIPULATION,23600,CPT,,Both,,,4199.75,1260,,,,,,,,,
CLTX RDL HEAD SUBLXTJ CHLD NURSEMAID ELBW W/MNPJ,24640,CPT,,Both,,,1832.63,550,,,,,,,,,
CLTX RDL SHFT FX&CLTX DISLC DSTL RAD/ULN JT,25520,CPT,,Both,,,7186.63,2156,,,,,,,,,
CLTX SHOULDER DISLC W/FX HUMERAL TUBRST W/MNPJ,23665,CPT,,Both,,,5413.25,1624,,,,,,,,,
CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/MNPJ,24535,CPT,,Both,,,7807.5,2342,,,,,,,,,
CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX+-MNPJ,24530,CPT,,Both,,,4858.5,1458,,,,,,,,,
CLTX TIBIAL FX PROXIMAL W/O MANIPULATION,27530,CPT,,Both,,,1925.03,578,,,,,,,,,
CLTX TIBL SHFT FX W/O MNPJ,27750,CPT,,Both,,,4441.63,1332,,,,,,,,,
CLTX VRT BDY FX W/O MNPJ REQ&W/CSTING/BRACING,22310,CPT,,Both,,,3880.25,1164,,,,,,,,,
CNS DNA/RNA AMP PROBE MULTIPLE SUBTYPES 12-25,87483,CPT,,Both,,,1500.77,450,,,,,,,,,
CNS DNA/RNA AMP PROBE MULTIPLE SUBTYPES 12-25,87483,CPT,,Both,,,2701.4,810,,,,,,,,,
"Cntrl nasal hemorrhage, posterior,w/ posterior nasal packs and/or cautery,any method; subsequent",30906,CPT,,Both,,,3678,1103,,,,,,,,,
CO2 DETECTOR,A4649,HCPCS,,Both,,,24.75,7,,,,,,,,,
CO2 DETECTOR PED,450,RC,,Both,,,59.49,18,,,,,,,,,
CO2 DETECTOR PED,450,RC,,Both,,,56.66,17,,,,,,,,,
COAGJ TM ACTIVATED,85347,CPT,,Both,,,73.13,22,,,,,,,,,
COAGUCHEK XS 5BX PROMO,450,RC,,Both,,,6.07,2,,,,,,,,,
COAGUCHEK XS 5BX PROMO,450,RC,,Both,,,5.78,2,,,,,,,,,
Atenolol 100mg Qty 100 tabs,J8499,HCPCS,,Both,0.1,GM,4.82,1,,,,,,,,,
Azithromycin (Zithromax) 100 mg/5 ml,J8499,HCPCS,,Both,100,ML,105.53,32,,,,,,,,,
"Benzonatate Capsules, per 100mg ",J8499,HCPCS,,Both,0.1,GM,9.66,3,,,,,,,,,
BUPROPION WELLBUTRIN 100MG TAB,J8499,HCPCS,,Both,0.1,GM,13.13,4,,,,,,,,,
COL-CHR/MS QUAL 1 STATIONARY&MOBILE PHASE,82541,CPT,,Both,,,83.49,25,,,,,,,,,
COLD AGGLUTININ TITER,86157,CPT,,Both,,,58.07,17,,,,,,,,,
COLD PACK INSTANT 6X8.75,450,RC,,Both,,,3.15,1,,,,,,,,,
COLD PACK INSTANT 6X8.75,450,RC,,Both,,,3,1,,,,,,,,,
COLLAGEN DRESSING <=16 SQ IN,A6021,HCPCS,,Both,,,24.15,7,,,,,,,,,
COLLECT BLOOD FROM IMPLANT VENOUS ACCESS DEVICE,36591,CPT,,Both,,,298,89,,,,,,,,,
"Collection of blood specimen using established central or peripheral catheter, venous, not otherwise specified",36592,CPT,,Both,,,344.88,103,,,,,,,,,
COLLES SPLINT L/LG W/PAD,450,RC,,Both,,,29.41,9,,,,,,,,,
COLLES SPLINT L/LG W/PAD,450,RC,,Both,,,28.01,8,,,,,,,,,
COLLES SPLINT L/MED W/PAD,450,RC,,Both,,,29.41,9,,,,,,,,,
COLLES SPLINT L/MED W/PAD,450,RC,,Both,,,28.01,8,,,,,,,,,
COLLES SPLINT L/SM W/PAD,450,RC,,Both,,,29.41,9,,,,,,,,,
COLLES SPLINT L/SM W/PAD,450,RC,,Both,,,28.01,8,,,,,,,,,
COLLES SPLINT R/LG W/PAD,450,RC,,Both,,,29.41,9,,,,,,,,,
COLLES SPLINT R/LG W/PAD,450,RC,,Both,,,28.01,8,,,,,,,,,
COLLES SPLINT R/MED W/PAD,450,RC,,Both,,,29.41,9,,,,,,,,,
COLLES SPLINT R/MED W/PAD,450,RC,,Both,,,28.01,8,,,,,,,,,
COLLES SPLINT R/SM W/PAD,450,RC,,Both,,,29.41,9,,,,,,,,,
COLLES SPLINT R/SM W/PAD,450,RC,,Both,,,28.01,8,,,,,,,,,
COLPORRHAPHY SUTURE INJURY VAGINA,57200,CPT,,Both,,,3811.75,1144,,,,,,,,,
"Coly-Mycin S Otic, Ear Drops",450,RC,,Both,,,27.52,8,,,,,,,,,
"CALCIUM CHLORIDE, SYR 10% 100MG/ML ",J3490,HCPCS,,Both,100,ML,84.12,25,,,,,,,,,
COMPLEMENT ANTIGEN EACH COMPONENT,86160,CPT,,Both,,,206.25,62,,,,,,,,,
COMPLEMENT TOTAL HEMOLYTIC,86162,CPT,,Both,,,322.88,97,,,,,,,,,
COMPLETE TTHRC ECHO CONGENITAL CARDIAC ANOMALY,93303,CPT,,Both,,,1406.75,422,,,,,,,,,
COMPOSITE DRSG > 48 SQ IN,A6205,HCPCS,,Both,,,29.06,9,,,,,,,,,
COMPRE CPTR MTN ALYS VIDEO TAPING 3-D KINEMATICS,96000,CPT,,Both,,,1495.28,449,,,,,,,,,
COMPRE METAB PANEL,80053,CPT,,Both,,,1794,538,,,,,,,,,
"Computed tomographic angiography, neck, with contrast materi...",70498,CPT,,Both,,,7009.88,2103,,,,,,,,,
CONCENTRATION INFECTIOUS AGENTS,87015,CPT,,Both,,,344,103,,,,,,,,,
CONFORM BAND N/S W<3,A6442,HCPCS,,Both,,,19.37,6,,,,,,,,,
CONFORM BAND N/S W>=3,A6443,HCPCS,,Both,,,5.09,2,,,,,,,,,
CONFORM BAND S W>=3,A6446,HCPCS,,Both,,,2.61,1,,,,,,,,,
CONT INHALATION TREATMENT EA ADDL HR,94645,CPT,,Both,,,200.51,60,,,,,,,,,
Continuous airway pressure (CPAP) device,E0601,HCPCS,,Both,,,456.02,137,,,,,,,,,
CONTROL NASAL HEMORRHAGE ANTERIOR COMPLEX,30903,CPT,,Both,,,2707.13,812,,,,,,,,,
CONTROL NASAL HEMORRHAGE ANTERIOR SIMPLE,30901,CPT,,Both,,,1512,454,,,,,,,,,
"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method",30905,CPT,,Both,,,3366.5,1010,,,,,,,,,
COOMBS TEST DIRECT,86880,CPT,,Both,,,218.73,66,,,,,,,,,
COOMBS TEST INDIRECT TITER,86886,CPT,,Both,,,88.88,27,,,,,,,,,
Copper,82525,CPT,,Both,,,213.25,64,,,,,,,,,
CORTISOL FREE,82530,CPT,,Both,,,287.13,86,,,,,,,,,
Cortisol; total (Random),82533,CPT,,Both,,,408,122,,,,,,,,,
"CELECOXIB, CAP 100MG",J8499,HCPCS,,Both,0.1,GM,131.78,40,,,,,,,,,
COTTON BALLS MED 2BX/CS,450,RC,,Both,,,1.28,1,,,,,,,,,
COTTON BALLS MED 2BX/CS,450,RC,,Both,,,1.22,1,,,,,,,,,
Cotton Tip Applicator,450,RC,,Both,,,17.35,5,,,,,,,,,
COUDE TIP URINARY CATHETER,A4352,HCPCS,,Both,,,32.49,10,,,,,,,,,
CPAP VENTILATION CPAP INITIATION&MGMT,94660,CPT,,Both,,,801.75,241,,,,,,,,,
C-reactive protein,86140,CPT,,Both,,,504,151,,,,,,,,,
C-reactive protein; high sensitivity (hsCRP),86141,CPT,,Both,,,229.72,69,,,,,,,,,
CREATINE,82540,CPT,,Both,,,47.22,14,,,,,,,,,
CREATINE KINASE ISOENZYMES,82552,CPT,,Both,,,120.67,36,,,,,,,,,
CREATINE KINASE ISOFORMS,82554,CPT,,Both,,,141.16,42,,,,,,,,,
CREATINE KINASE TOT,82550,CPT,,Both,,,468,140,,,,,,,,,
CREATININE BLD,82565,CPT,,Both,,,468,140,,,,,,,,,
CREATININE OTHER SOURCE,82570,CPT,,Both,,,136.11,41,,,,,,,,,
COLACE 100MG TAB,A9150,HCPCS,,Both,0.1,GM,8.87,3,,,,,,,,,
CroFab (Crotalidae Polyvalent Immune Fab) per vial,J3490,HCPCS,,Both,,,17610.35,5283,,,,,,,,,
CRUTCH ALUM ADLT ADJ,E0114,HCPCS,,Both,,,955,287,,,,,,,,,
CRUTCH ALUM ADLT ADJ,450,RC,,Both,,,93.72,28,,,,,,,,,
CRUTCH ALUM ADLT TALL ADJ,E0114,HCPCS,,Both,,,955,287,,,,,,,,,
CRUTCH ALUM ADLT TALL ADJ,450,RC,,Both,,,93.62,28,,,,,,,,,
CRUTCH ALUM CHILD 8/CS,E0114,HCPCS,,Both,,,955,287,,,,,,,,,
CRUTCH ALUM CHILD 8/CS,450,RC,,Both,,,92.17,28,,,,,,,,,
CRUTCH ALUM YOUTH 8/CS,E0114,HCPCS,,Both,,,955,287,,,,,,,,,
CRUTCH ALUM YOUTH 8/CS,450,RC,,Both,,,91.77,28,,,,,,,,,
CRUTCH UNDERARM EACH NO WOOD,E0116,HCPCS,,Both,,,720,216,,,,,,,,,
CRUTCH UNDERARM EACH NO WOOD,E0116,HCPCS,,Both,,,720,216,,,,,,,,,
CRUTCH UNDERARM PAIR NO WOOD,E0114,HCPCS,,Both,,,955,287,,,,,,,,,
CRUTCH UNDERARM PAIR NO WOOD,E0114,HCPCS,,Both,,,955,287,,,,,,,,,
CRUTCH UNDERARM PAIR WOOD,E0112,HCPCS,,Both,,,239,72,,,,,,,,,
CRYOTHERAPY CO2 SLUSH LIQUID N2 ACNE,17340,CPT,,Both,,,582.75,175,,,,,,,,,
CRYSTAL ID LIGHT MICROSCOPY ALYS TISS/ANY FLUID,89060,CPT,,Both,,,780,234,,,,,,,,,
Ct Abd & pelvis W/o Contrast,74176,CPT,,Both,,,12476,3743,,,,,,,,,
CT ABD C-/C+,74170,CPT,,Both,,,7261.96,2179,,,,,,,,,
CT ABD C+ MATRL,74160,CPT,,Both,,,7177,2153,,,,,,,,,
CT ABD C-MATRL,74150,CPT,,Both,,,7177,2153,,,,,,,,,
CT ABDOMEN & PELVIS W/O CONTRST 1/> BODY RE,74178,CPT,,Both,,,12554.73,3766,,,,,,,,,
Ct Abdomen&pelvis W/contrast,74177,CPT,,Both,,,14400.8,4320,,,,,,,,,
CT ANGIO ABD&PELV W/ O&W / DYE,74174,CPT,,Both,,,10368.99,3111,,,,,,,,,
CT ANGIO ABDOMINAL ARTERIES,75635,CPT,,Both,,,7068.81,2121,,,,,,,,,
CT ANGIOGRAPHY ABDOMEN W/CONTRAST/NONCONTRAST,74175,CPT,,Both,,,7170,2151,,,,,,,,,
CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST,71275,CPT,,Both,,,10046,3014,,,,,,,,,
CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST,70496,CPT,,Both,,,7000.13,2100,,,,,,,,,
CT ANGIOGRAPHY LOWER EXTREMITY,73706,CPT,,Both,,,5991.93,1798,,,,,,,,,
CT ANGIOGRAPHY PELVIS W/CONTRAST/NONCONTRAST,72191,CPT,,Both,,,5991.23,1797,,,,,,,,,
CT ANGIOGRPHY W/WO CONTRAST UPPER EXTREMITY,73206,CPT,,Both,,,7114.54,2134,,,,,,,,,
CT BONE MINERAL DENSITY STUDY 1+ SITS APPND,77079,CPT,,Both,,,706.21,212,,,,,,,,,
CT CRV SPI C-/C+,72127,CPT,,Both,,,8304.51,2491,,,,,,,,,
CT CRV SPI C+ MATRL,72126,CPT,,Both,,,6048,1814,,,,,,,,,
CT CRV SPI C-MATRL,72125,CPT,,Both,,,8000.07,2400,,,,,,,,,
CT HEAD/BRN C-/C+,70470,CPT,,Both,,,7507.13,2252,,,,,,,,,
CT HEAD/BRN C+ MATRL,70460,CPT,,Both,,,6804,2041,,,,,,,,,
CT HEAD/BRN C-MATRL,70450,CPT,,Both,,,7429,2229,,,,,,,,,
CT Injection Syringe,450,RC,,Both,,,78.83,24,,,,,,,,,
CT LIMITED/LOCALIZED FOLLOW UP STUDY,76380,CPT,,Both,,,6804,2041,,,,,,,,,
CT LMBR SPI C+ MATRL,72132,CPT,,Both,,,6804,2041,,,,,,,,,
CT LOWER EXTREMITY C-/C+,73702,CPT,,Both,,,6407.7,1922,,,,,,,,,
CT LUMBAR SPINE W/O & W/CONTRAST MATERIAL,72133,CPT,,Both,,,7366.48,2210,,,,,,,,,
CT LUMBAR SPINE W/O CONTRAST MATERIAL,72131,CPT,,Both,,,6804,2041,,,,,,,,,
CT LXTR C+ MATRL,73701,CPT,,Both,,,7770,2331,,,,,,,,,
CT LXTR C-MATRL,73700,CPT,,Both,,,8004,2401,,,,,,,,,
CT MAXLFCL AREA C-/C+,70488,CPT,,Both,,,6249.52,1875,,,,,,,,,
CT MAXLFCL AREA C+ MATRL,70487,CPT,,Both,,,6804,2041,,,,,,,,,
CT ORBIT SELLA/POST FOSSA/EAR C-/C+,70482,CPT,,Both,,,6804,2041,,,,,,,,,
CT ORBIT SELLA/POST FOSSA/EAR C+ MATRL,70481,CPT,,Both,,,6804,2041,,,,,,,,,
CT ORBIT SELLA/POST FOSSA/EAR C-MATRL,70480,CPT,,Both,,,6804,2041,,,,,,,,,
CT PELVIS C-/C+,72194,CPT,,Both,,,7507.13,2252,,,,,,,,,
CT PELVIS C+ MATRL,72193,CPT,,Both,,,6827,2048,,,,,,,,,
CT PELVIS C-MATRL,72192,CPT,,Both,,,7686.67,2306,,,,,,,,,
CT SCAN MAXLFCL AREA C-MATRL - SINUS AREA,70486,CPT,,Both,,,6804,2041,,,,,,,,,
CT SOFT TISS NCK C+ MATRL,70491,CPT,,Both,,,6804,2041,,,,,,,,,
CT SOFT TISS NCK C-MATRL,70490,CPT,,Both,,,6048,1814,,,,,,,,,
CT SOFT TISSUE NECK W/O & W/CONTRAST MATERIAL,70492,CPT,,Both,,,6650.4,1995,,,,,,,,,
CT THORACIC SPINE W/O & W/CONTRAST MATERIAL,72130,CPT,,Both,,,2306.8,692,,,,,,,,,
CT THORAX C-/C+,71270,CPT,,Both,,,6804,2041,,,,,,,,,
CT THORAX C+ MATRL,71260,CPT,,Both,,,6804,2041,,,,,,,,,
CT THORAX W/O CONTRAST MATERIAL,71250,CPT,,Both,,,6804,2041,,,,,,,,,
CT THRC SPI C+ MATRL,72129,CPT,,Both,,,6573.23,1972,,,,,,,,,
CT THRC SPI C-MATRL,72128,CPT,,Both,,,6804,2041,,,,,,,,,
CT UPPER EXT W/DYE,73201,CPT,,Both,,,6804,2041,,,,,,,,,
CT UPPER EXTREMITY W/O & W/CONTRAST MATERIAL,73202,CPT,,Both,,,6804,2041,,,,,,,,,
CT UXTR C-MATRL,73200,CPT,,Both,,,6804,2041,,,,,,,,,
CUL BACT BLD ANAERC ISOL,87075,CPT,,Both,,,684,205,,,,,,,,,
CUL BACT QUAN ANAERC ISOL XCPT UR BLOOD/STOOL,87073,CPT,,Both,,,61.22,18,,,,,,,,,
CUL BACT QUAN COLONY CNT URINE,87086,CPT,,Both,,,465,140,,,,,,,,,
CUL BACT STL AERC ISOL SALMONELLA&SHIGELLA,87045,CPT,,Both,,,953,286,,,,,,,,,
CUL BACT XCPT URINE BLD/STL AERC ISOL,87070,CPT,,Both,,,612,184,,,,,,,,,
CUL CHLAMYDIA ANY SRC,87110,CPT,,Both,,,385.15,116,,,,,,,,,
CUL FNGI MOLD/YEAST PRSMPTV ID SKN HAIR/NAIL,87101,CPT,,Both,,,1020,306,,,,,,,,,
CUL PRSMPTV PTHGNC ORGANISMS SCR,87081,CPT,,Both,,,684,205,,,,,,,,,
Culture Aerobic Identify,87077,CPT,,Both,,,684,205,,,,,,,,,
CULTURE ANAEROBE IDENT EACH,87076,CPT,,Both,,,516,155,,,,,,,,,
CULTURE BACTERIAL URINE,P7001,HCPCS,,Both,,,123.49,37,,,,,,,,,
CULTURE BCT ISOL&PRSMPTV ID ISOLATE EA URINE,87088,CPT,,Both,,,344,103,,,,,,,,,
CULTURE FNGI MOLD/YEAST ISOL PRSMPTV ISOL BLOOD,87103,CPT,,Both,,,214.83,64,,,,,,,,,
CULTURE FNGI MOLD/YEAST PRSMPTV OTH XCPT BLOOD,87102,CPT,,Both,,,568.72,171,,,,,,,,,
CULTURE MYCOPLASMA ANY SOURCE,87109,CPT,,Both,,,153.9,46,,,,,,,,,
CULTURE TUBERCLE/OTH ACID-FAST BACILLI ANY ISOL,87116,CPT,,Both,,,349.74,105,,,,,,,,,
CULTURE TYPE IMMUNOFLUORESC,87140,CPT,,Both,,,41.84,13,,,,,,,,,
CUP 8OZ FOAM WHT DART 25/BX,450,RC,,Both,,,5.28,2,,,,,,,,,
CUP 8OZ FOAM WHT DART 25/BX,450,RC,,Both,,,5.02,2,,,,,,,,,
CUP MEDICINE 1OZ GRADUATED,450,RC,,Both,,,7.58,2,,,,,,,,,
CUP MEDICINE 1OZ GRADUATED,450,RC,,Both,,,7.22,2,,,,,,,,,
CURETTE EAR CHILD PINK 50/BX,450,RC,,Both,,,14.07,4,,,,,,,,,
CURETTE EAR CHILD PINK 50/BX,450,RC,,Both,,,13.4,4,,,,,,,,,
CURETTE EAR OVAL WHT 50/BX,450,RC,,Both,,,14.07,4,,,,,,,,,
CURETTE EAR OVAL WHT 50/BX,450,RC,,Both,,,13.4,4,,,,,,,,,
CURETTE EAR ROUND GRN 50/BX,450,RC,,Both,,,14.07,4,,,,,,,,,
CURETTE EAR ROUND GRN 50/BX,450,RC,,Both,,,13.4,4,,,,,,,,,
CUTTER FINGER RING CHROME,450,RC,,Both,,,224.72,67,,,,,,,,,
CUTTER FINGER RING CHROME,450,RC,,Both,,,214.02,64,,,,,,,,,
CV STRS TST XERS&/OR RX CONT ECG I&R ONLY,93018,CPT,,Both,,,174.41,52,,,,,,,,,
CV STRS TST XERS&/OR RX CONT ECG TRCG ONLY,93017,CPT,,Both,,,407.93,122,,,,,,,,,
CV STRS TST XERS&/OR RX CONT ECG W/SI&R,93015,CPT,,Both,,,843.99,253,,,,,,,,,
CYANOCOBALAMIN,82607,CPT,,Both,,,280.5,84,,,,,,,,,
"Cyclic citrullinated peptide (CCP), antibody",86200,CPT,,Both,,,850,255,,,,,,,,,
DOXYCYCLINE (Vibramycin) 100MG CAP,J8499,HCPCS,,Both,0.1,GM,29.76,9,,,,,,,,,
DOXYCYCLINE (Vibramycin) 100MG CAP,J8499,HCPCS,,Both,0.1,GM,28.34,9,,,,,,,,,
CYCLOPENTOLATE 1% O/S 15ML,450,RC,,Both,,,153.29,46,,,,,,,,,
CYCLOPENTOLATE 1% O/S 15ML,450,RC,,Both,,,145.99,44,,,,,,,,,
CYLINDER O2 E KIT CART FILL,450,RC,,Both,,,1271.89,382,,,,,,,,,
CYP2C19 GENE ANALYSIS COMMON VARIANTS,81225,CPT,,Both,,,2447.42,734,,,,,,,,,
CYTOGENETICS&MOLEC CYTOGENETICS INTERP&REP,88291,CPT,,Both,,,403.18,121,,,,,,,,,
Cytomeg dna quant,87497,CPT,,Both,,,1028.16,308,,,,,,,,,
"Cytopathology, cervical or vaginal",88141,CPT,,Both,,,311.34,93,,,,,,,,,
CYTP SLCTV CELL ENHANCEMENT INTERPJ XCPT C/V,88112,CPT,,Both,,,713,214,,,,,,,,,
"D5LR - 5% dextrose in lactated ringers infusion, up to 1000 cc",J7121,HCPCS,,Both,,,53.97,16,,,,,,,,,
D5W INFUSION,J7070,HCPCS,,Both,,,96.85,29,,,,,,,,,
DAVROCET N - TAB,J3490,HCPCS,,Both,,,10.27,3,,,,,,,,,
DBRDMT MSTDC CAVITY SMPL,69220,CPT,,Both,,,572.62,172,,,,,,,,,
DBRDMT W/RMVL FM FX&/DISLC SKIN&SUBQ TISSUS,11010,CPT,,Both,,,6344.88,1903,,,,,,,,,
DBRDMT W/RMVL FM FX&/DISLC SKN SUBQ T/M/F MUSC,11011,CPT,,Both,,,6868.13,2060,,,,,,,,,
DBRDMT X10SV ECZMT/INFCT SKN UP 10% BDY SURF,11000,CPT,,Both,,,1260,378,,,,,,,,,
D-DIMER - FIBRIN DGRADJ PRODUXS D-DIMER QUAL/SEMIQUAN,85378,CPT,,Both,,,223.5,67,,,,,,,,,
DEBRIDEMENT SKIN FULL THICKNESS,11041,CPT,,Both,,,302.56,91,,,,,,,,,
DEBRIDEMENT SKIN PARTIAL THICKNESS (INVALID AS OF 01/01/2011),11040,CPT,,Both,,,284.1,85,,,,,,,,,
DEBRIDEMENT SUBCUTANEOUS TISSUE&MUSCLE,11043,CPT,,Both,,,534.75,160,,,,,,,,,
"FLUVOXAMIN, TAB 100MG",J8499,HCPCS,,Both,0.1,GM,13.13,4,,,,,,,,,
"GUAIFENESIN (ROBITUSSIN) , LIQ 100MG/5ML",A9150,HCPCS,,Both,100,ML,5.78,2,,,,,,,,,
DEHYDROEPIANDROSTERONE,82626,CPT,,Both,,,252.7,76,,,,,,,,,
Dehydroepiandrosterone-sulfate (DHEA-S),82627,CPT,,Both,,,166.97,50,,,,,,,,,
"IBUPROFEN, SUSP SM 100MG/5ML",A9150,HCPCS,,Both,100,ML,12,4,,,,,,,,,
"IBUPROFEN, SUSP SM 100MG/5ML",A9150,HCPCS,,Both,100,ML,12.6,4,,,,,,,,,
Depomedrol 80mg vial,450,RC,,Both,,,103.09,31,,,,,,,,,
"DERMABOND - ADHESIVE, LIQUID OR EQUAL PER OZ.",A4364,HCPCS,,Both,,,46.12,14,,,,,,,,,
DERMABOND - WOUND CLOSURE BY ADHESIVE,G0168,HCPCS,,Both,,,456,137,,,,,,,,,
DermaBond Mini,A4364,HCPCS,,Both,,,3.03,1,,,,,,,,,
DESTRUCTION BENIGN LESIONS 15/>,17111,CPT,,Both,,,294.56,88,,,,,,,,,
DESTRUCTION BENIGN LESIONS UP TO 14,17110,CPT,,Both,,,1431.25,429,,,,,,,,,
DESTRUCTION PREMALIGNANT LESION 1ST,17000,CPT,,Both,,,1043.25,313,,,,,,,,,
DEXAMETHASONE 10MG/ML VL 1ML,450,RC,,Both,,,9.83,3,,,,,,,,,
DEXAMETHASONE 10MG/ML VL 1ML,450,RC,,Both,,,9.36,3,,,,,,,,,
"Injection, meropenem, per 100 mg",J2185,HCPCS,,Both,0.1,GM,11.09,3,,,,,,,,,
MEPERIDINE HYDROCHL /100 MG,J2175,HCPCS,,Both,0.1,GM,37.76,11,,,,,,,,,
"Dexamethasone, inhalation solution, compounded product, administered through dme, unit dose form, per milligram",J7638,HCPCS,,Both,,,15.68,5,,,,,,,,,
DEXTRAN 75 INFUSION,J7110,HCPCS,,Both,,,177.46,53,,,,,,,,,
DEXTROSE 25% ANSYER 10ML,450,RC,,Both,,,58.88,18,,,,,,,,,
DEXTROSE 25% ANSYER 10ML,450,RC,,Both,,,56.07,17,,,,,,,,,
Nitrofurantoin (Macrodantin) 100mg cap,J8499,HCPCS,,Both,0.1,GM,30.87,9,,,,,,,,,
dextrose 5% and 0.2% normal saline 500ml,450,RC,,Both,,,38.08,11,,,,,,,,,
dextrose 5% and 0.9% normal saline 500ml,450,RC,,Both,,,38.08,11,,,,,,,,,
Dextrose 5% and 45% normal saline with 20 meq potassium 1000ml bag,450,RC,,Both,,,31.42,9,,,,,,,,,
DEXTROSE 50% 18G SYR L/S 50M,450,RC,,Both,,,62.58,19,,,,,,,,,
DEXTROSE 50% 18G SYR L/S 50M,450,RC,,Both,,,59.6,18,,,,,,,,,
"PHENAZOPYRIDINE(AZO STANDARD), 100MG",A9150,HCPCS,,Both,0.1,GM,2.63,1,,,,,,,,,
DIAL A FLOW TUBING,A4649,HCPCS,,Both,,,4.76,1,,,,,,,,,
DIAPER PAMPERS SZ3 UNISEX,450,RC,,Both,,,40.33,12,,,,,,,,,
DIAPER PAMPERS SZ3 UNISEX,450,RC,,Both,,,38.41,12,,,,,,,,,
DIAPER PAMPERS SZ5 UNISEX,450,RC,,Both,,,41.48,12,,,,,,,,,
DIAPER PAMPERS SZ5 UNISEX,450,RC,,Both,,,39.5,12,,,,,,,,,
Remdesivir 100mg,J3490,HCPCS,,Both,0.1,GM,2730,819,,,,,,,,,
THIAMINE HCL 100 MG,J3411,HCPCS,,Both,0.1,GM,16.14,5,,,,,,,,,
"TRANEXAMIC ACID, VL 100MG/ML",J3490,HCPCS,,Both,100,ML,48.31,14,,,,,,,,,
Diazepam 10mg inj,450,RC,,Both,,,15.04,5,,,,,,,,,
Diazepam 5mg tab,450,RC,,Both,,,10.19,3,,,,,,,,,
BAG -  NORMAL SALINE 100ML BAG,A4649,HCPCS,,Both,100,ML,36.81,11,,,,,,,,,
"Infusion, albumin (human), 25%, 100 ml",J3490,HCPCS,,Both,100,ML,843.92,253,,,,,,,,,
Omnipaque 300 -100ml,Q9967,HCPCS,,Both,100,ML,3.71,1,,,,,,,,,
"ORAL MR CONTRAST, PER 100 ML",Q9954,HCPCS,,Both,100,ML,317.69,95,,,,,,,,,
DIGITAL ANALYSIS ELECTROENCEPHALOGRAM,95957,CPT,,Both,,,3416.49,1025,,,,,,,,,
Calcium Gluconate injection 1000 mg/ 10ml,J3490,HCPCS,,Both,1000,ML,105.36,32,,,,,,,,,
TYLENOL 1000MG,J3490,HCPCS,,Both,1,GM,177.56,53,,,,,,,,,
TYLENOL UP TO 1GM (1000MG),A9150,HCPCS,,Both,1,GM,2.97,1,,,,,,,,,
TYLENOL UP TO 1GM (1000MG),A9150,HCPCS,,Both,1,GM,1.98,1,,,,,,,,,
VALTREX (valacyclovir HCl) CAPL 1000MG,J8499,HCPCS,,Both,1,GM,271.92,82,,,,,,,,,
0.9% Sodium Chloride Injection 1000 ml bag,J7030,HCPCS,,Both,1000,ML,73.62,22,,,,,,,,,
SODIUM CHLORIDE BOTTLE 1000 ML,A4649,HCPCS,,Both,1000,ML,16.14,5,,,,,,,,,
DIPHENHYDRAMINE 25MG TAB,450,RC,,Both,,,13.41,4,,,,,,,,,
DIPHENHYDRAMINE 25MG TAB,450,RC,,Both,,,12.77,4,,,,,,,,,
DIPHENHYDRAMINE 50MG 1ML SDVEA,450,RC,,Both,,,5.94,2,,,,,,,,,
DIPHENHYDRAMINE 50MG 1ML SDVEA,450,RC,,Both,,,5.66,2,,,,,,,,,
"Water, distilled, used with large volume nebulizer, 1000 ml",A7018,HCPCS,,Both,1000,ML,70.11,21,,,,,,,,,
DIPHTH TETANUS TOX ACELL PERTUSSIS VACC<7 YR IM,90700,CPT,,Both,,,808,242,,,,,,,,,
DISINFECTANT OPA/28 GL,450,RC,,Both,,,216.59,65,,,,,,,,,
DISINFECTANT OPA/28 GL,450,RC,,Both,,,206.28,62,,,,,,,,,
DISPOSABLE PACK W/BOWEL SYST (VAG SPECULUM),E0352,HCPCS,,Both,,,244.24,73,,,,,,,,,
DISPOSABLE UNDERPADS - CHUCKS PAD - CHUX,A4554,HCPCS,,Both,,,40.29,12,,,,,,,,,
DIVISION SCALENUS ANTICUS RESECTION CERVICAL RIB,21705,CPT,,Both,,,807.08,242,,,,,,,,,
DNA ANTIBODY NATIVE/DOUBLE STRANDED,86225,CPT,,Both,,,236,71,,,,,,,,,
HYDROCODONE AND ACETAMINOPHEN 2.5-108MG/5ML ELIXIR,J3490,HCPCS,,Both,108,ML,69.41,21,,,,,,,,,
BENADRYL 12.5 MG/5 ML ELIXIR,A9150,HCPCS,,Both,12.5,ML,5.78,2,,,,,,,,,
DONNATOL ELIXIR  GRAPE 16OZ,j3490,HCPCS,,Both,,,16.78,5,,,,,,,,,
DONOTUSE-EMERGENCYCODE DUMMY CODE,99281,CPT,,Both,,,1199,360,,,,,,,,,
DONOTUSE-EMERGENCYCODE DUMMY CODE,99282,CPT,,Both,,,2400,720,,,,,,,,,
DONOTUSE-EMERGENCYCODE DUMMY CODE,99283,CPT,,Both,,,5040,1512,,,,,,,,,
DONOTUSE-EMERGENCYCODE DUMMY CODE,99284,CPT,,Both,,,5400,1620,,,,,,,,,
DONOTUSE-EMERGENCYCODE DUMMY CODE,99285,CPT,,Both,,,7553.32,2266,,,,,,,,,
DOPAMINE 400MG/D5W 250ML,450,RC,,Both,,,53.36,16,,,,,,,,,
DOPAMINE 400MG/D5W 250ML,450,RC,,Both,,,50.82,15,,,,,,,,,
DOPPLER - DUP-SCAN LXTR ART/ARTL BPGS UNI/LMTD STD,93926,CPT,,Both,,,3049.75,915,,,,,,,,,
"DOPPLER ECHO FETAL SPECTRAL DISPLAY COMPLETE;  Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete",76827,CPT,,Both,,,1948.41,585,,,,,,,,,
"HYDROCHLOROTHIAZIDE, CAP 12.5MG",J8499,HCPCS,,Both,0.0125,GM,13.13,4,,,,,,,,,
Promethazine HCL 12.5mg SUPP,J8498,HCPCS,,Both,0.0125,GM,77.79,23,,,,,,,,,
DOXYCYCLINE 100MG CAP 50/BT,450,RC,,Both,,,909.62,273,,,,,,,,,
DRAIN CHEST SYS ADLT 6/CS,450,RC,,Both,,,334.67,100,,,,,,,,,
DRAIN CHEST SYS ADLT 6/CS,450,RC,,Both,,,318.72,96,,,,,,,,,
DRAINAGE EXTERNAL AUDITORY CANAL ABSCESS,69020,CPT,,Both,,,3083.13,925,,,,,,,,,
DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA CMPLX,69005,CPT,,Both,,,2800.63,840,,,,,,,,,
"Drainage external ear, abscess or hematoma; simple",69000,CPT,,Both,,,2460.13,738,,,,,,,,,
DRAINAGE FINGER ABSCESS SIMPLE,26010,CPT,,Both,,,3434.63,1030,,,,,,,,,
DRAINAGE LYMPH NODE ABSC/LYMPHADENITIS SMPL,38300,CPT,,Both,,,3662.25,1099,,,,,,,,,
DRAINAGE OF FINGER ABCESS,26011,CPT,,Both,,,5047.63,1514,,,,,,,,,
DRAINAGE SCROTAL WALL ABSCESS,55100,CPT,,Both,,,2720.25,816,,,,,,,,,
DRAPE 18X26 FEN ST BLUE,450,RC,,Both,,,102.06,31,,,,,,,,,
DRAPE 18X26 FEN ST BLUE,450,RC,,Both,,,97.19,29,,,,,,,,,
DRAPE 18X26 NONFEN ST BLUE,450,RC,,Both,,,97.74,29,,,,,,,,,
DRAPE 18X26 NONFEN ST BLUE,450,RC,,Both,,,93.09,28,,,,,,,,,
DRAPE 40X48 TISSUE 2PLY WHT,450,RC,,Both,,,12.32,4,,,,,,,,,
DRAPE 40X48 TISSUE 2PLY WHT,450,RC,,Both,,,11.72,4,,,,,,,,,
DRESSING CHNG TRAY CVP,450,RC,,Both,,,680.84,204,,,,,,,,,
DRESSING CHNG TRAY CVP,450,RC,,Both,,,648.42,195,,,,,,,,,
DRG ABSC CST HMTMA FROM DENTOALVEOLAR STRUXS,41800,CPT,,Both,,,3661.13,1098,,,,,,,,,
DROPERIDOL INJECTION,J1790,HCPCS,,Both,,,4.4,1,,,,,,,,,
DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ LARGE,16030,CPT,,Both,,,2337.5,701,,,,,,,,,
DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ MEDIUM,16025,CPT,,Both,,,1875.75,563,,,,,,,,,
DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ SMALL,16020,CPT,,Both,,,1362,409,,,,,,,,,
DRUG ASSAY ACETAMINOPHEN,80143,CPT,,Both,,,1020,306,,,,,,,,,
DRUG ASSAY CLOZAPINE,80159,CPT,,Both,,,169.26,51,,,,,,,,,
DRUG ASSAY SALICYLATE,80179,CPT,,Both,,,1020,306,,,,,,,,,
DRUG CTL POS/NEG 5ML,450,RC,,Both,,,239.95,72,,,,,,,,,
DRUG CTL POS/NEG 5ML,450,RC,,Both,,,228.52,69,,,,,,,,,
DRUG SCR QUAL MLT DRUG CLASSES CHROM EA PX,80100,CPT,,Both,,,341.83,103,,,,,,,,,
DRUG SCREEN 11 PANEL 25/BX,450,RC,,Both,,,1675.12,503,,,,,,,,,
DRUG SCREEN 11 PANEL 25/BX,G0434,HCPCS,,Both,,,11.19,3,,,,,,,,,
DRUG SCREEN 11 PANEL 25/BX,450,RC,,Both,,,1595.35,479,,,,,,,,,
DRUG SCREEN ANALGESICS NON-OPIOID 3-5,80330,CPT,,Both,,,181.92,55,,,,,,,,,
DRUG SCREEN QUANT DIPROPYLACETIC ACID FREE,80165,CPT,,Both,,,1140,342,,,,,,,,,
Drug screen quant gabapentin,80171,CPT,,Both,,,520.08,156,,,,,,,,,
DRUG SCREEN QUANT VANCOMYCIN,80202,CPT,,Both,,,1764.75,529,,,,,,,,,
DRUG SCREEN QUANTITATIVE ALCOHOLS,80320,CPT,,Both,,,684,205,,,,,,,,,
DRUG SCREEN QUANTITATIVE GENTAMICIN,80170,CPT,,Both,,,494.88,148,,,,,,,,,
DRUG SCREEN QUANTITATIVE LAMOTRIGINE,80175,CPT,,Both,,,94.82,28,,,,,,,,,
DRUG SCREEN QUANTITATIVE LEVETIRACETAM,80177,CPT,,Both,,,95.45,29,,,,,,,,,
DRUG SCREEN QUANTITATIVE OXCARBAZEPINE,80183,CPT,,Both,,,85.89,26,,,,,,,,,
DRUG SCREEN QUANTITATIVE PHENOBARBITAL,80184,CPT,,Both,,,196.75,59,,,,,,,,,
DRUG SCREEN QUANTITATIVE THEOPHYLLINE,80198,CPT,,Both,,,459.2,138,,,,,,,,,
"Drug screen, any number of drug classes from Drug Class List A; any number of non-TLC devices or procedures, (eg, immunoassay) ",80300,CPT,,Both,,,341.83,103,,,,,,,,,
DRUG SCREENING BENZODIAZEPINES 1-12,80346,CPT,,Both,,,1260,378,,,,,,,,,
Drug test def 1-7 classes,G0480,HCPCS,,Both,,,684,205,,,,,,,,,
Drug test presump optical,G0477,HCPCS,,Both,,,62.62,19,,,,,,,,,
DRUG TEST PRSMV INSTRMNT CHEMISTRY ANALYZERS,80307,CPT,,Both,,,756,227,,,,,,,,,
DRUG TEST PRSMV QUAL DIR OPTICAL OBS PER DAY,80305,CPT,,Both,,,493,148,,,,,,,,,
DSTRJ NULYT OTH PRPH NRV/BRANCH,64640,CPT,,Both,,,1687.99,506,,,,,,,,,
DTAP-IPV VACCINE CHILD 4-6 YRS FOR IM USE,90696,CPT,,Both,,,203.88,61,,,,,,,,,
DULCOLAX- BISACODYL supp 10MG,450,RC,,Both,,,7.04,2,,,,,,,,,
ACETAMINOPHEN (TYLENOL) 120 MG SUPP,A9150,HCPCS,,Both,0.12,GM,13.13,4,,,,,,,,,
"Dup of aorta, inferior vena cava, iliac vasculature, or bypass gft; uni or ltd ",93979,CPT,,Both,,,897.92,269,,,,,,,,,
Duplex scan of arterial inflow and venous outflow of abdomin...,93975,CPT,,Both,,,3815,1145,,,,,,,,,
DUP-SCAN AORTA IVC ILIAC VASCL/BPGS COMPLETE,93978,CPT,,Both,,,1508.3,452,,,,,,,,,
DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMT,93976,CPT,,Both,,,2021.65,606,,,,,,,,,
DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY,93925,CPT,,Both,,,3570,1071,,,,,,,,,
DUP-SCAN UXTR ART/ARTL BPGS COMPL BI STUDY,93930,CPT,,Both,,,3280,984,,,,,,,,,
DUP-SCAN UXTR ART/ARTL BPGS UNI/LMTD STD,93931,CPT,,Both,,,2976,893,,,,,,,,,
DUP-SCAN XTR VEINS COMPL BI STD,93970,CPT,,Both,,,3455,1037,,,,,,,,,
DUP-SCAN XTR VEINS UNI/LMTD STD,93971,CPT,,Both,,,3024,907,,,,,,,,,
DUP-SCAN XTRC ART COMPL BI STD,93880,CPT,,Both,,,2500,750,,,,,,,,,
DUP-SCAN XTRC ART UNI/LMTD STD,93882,CPT,,Both,,,2956.56,887,,,,,,,,,
ECG ROUTINE ECG W/LEAST 12 LDS TRCG ONLY W/O I&R,93005,CPT,,Both,,,960,288,,,,,,,,,
ECG ROUTINE ECG W/LEAST 12 LDS W/I&R,93000,CPT,,Both,,,756,227,,,,,,,,,
ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD,93308,CPT,,Both,,,1468.01,440,,,,,,,,,
ECHO TTHRC R-T 2D -+M-MODE REST&STRS CONT ECG,93351,CPT,,Both,,,2157.99,647,,,,,,,,,
ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST,93350,CPT,,Both,,,2464.14,739,,,,,,,,,
ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D,93306,CPT,,Both,,,2485.14,746,,,,,,,,,
"Elastase, pancreatic (EL-1), fecal; qualitative or semi-quantitative",82656,CPT,,Both,,,96.85,29,,,,,,,,,
"Elastase, pancreatic (EL-1), fecal; quantitative",82653,CPT,,Both,,,120.59,36,,,,,,,,,
ELEC ALYS NSTIM PLS GEN SMPL SC/PERPH W/PRGRMG,95971,CPT,,Both,,,694.67,208,,,,,,,,,
ELECTROCAUTERY STICKS,A4649,HCPCS,,Both,,,55.7,17,,,,,,,,,
ELECTRODE SNAP VNL 40MM RND,450,RC,,Both,,,63.13,19,,,,,,,,,
ELECTRODE SNAP VNL 40MM RND,450,RC,,Both,,,60.12,18,,,,,,,,,
ELECTRODE TAB ADGEL LG 100EA,450,RC,,Both,,,41.66,12,,,,,,,,,
ELECTRODE TAB ADGEL LG 100EA,450,RC,,Both,,,39.67,12,,,,,,,,,
"ELECTRODES, PAIR",A4556,HCPCS,,Both,,,102.83,31,,,,,,,,,
ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY,95816,CPT,,Both,,,4317.81,1295,,,,,,,,,
ELECTROLYTE PANEL,80051,CPT,,Both,,,540,162,,,,,,,,,
Acetaminophen / Codeine 120 mg - 12 mg / 5 mL,J8499,HCPCS,,Both,120,ML,48.43,15,,,,,,,,,
EM for Observation or inpatient hospital care,99234,CPT,,Both,,,1560,468,,,,,,,,,
EM for Observation or inpatient hospital care,99235,CPT,,Both,,,2223.47,667,,,,,,,,,
EM for Subsequent observation care,99224,CPT,,Both,,,1500,450,,,,,,,,,
EM for Subsequent observation care,99225,CPT,,Both,,,1710,513,,,,,,,,,
EM for Subsequent observation care,99226,CPT,,Both,,,1950,585,,,,,,,,,
Ema each ig class,86231,CPT,,Both,,,290.16,87,,,,,,,,,
EMER DEPT HI SEVERITY&URGENT EVAL,99284,CPT,,Both,,,5400,1620,,,,,,,,,
EMER DEPT HIGH SEVERITY&THREAT FUNCJ,99285,CPT,,Both,,,7553.32,2266,,,,,,,,,
EMER DEPT LOW TO MODERATE SEVERITY,99282,CPT,,Both,,,2400,720,,,,,,,,,
EMER DEPT MODERATE SEVERITY,99283,CPT,,Both,,,5040,1512,,,,,,,,,
EMER DEPT SELF LIMITED/MINOR,99281,CPT,,Both,,,1199,360,,,,,,,,,
EMERGENCY OB KIT,450,RC,,Both,,,52.64,16,,,,,,,,,
EMERGENCY OB KIT,450,RC,,Both,,,50.13,15,,,,,,,,,
"DILTIAZEM XR (CARDIZEM), CAP 120MG",J8499,HCPCS,,Both,0.12,GM,13.13,4,,,,,,,,,
ENCL/EXC XTRNL THROMBOTIC HEMORRHOID,46320,CPT,,Both,,,2385.9,716,,,,,,,,,
"ENEMA - SUPPOSITORY, ANTIEMETIC RECTAL/SUPP NOS",J8498,HCPCS,,Both,,,42.7,13,,,,,,,,,
ENOXAPARIN 100MG SYR 10X1ML,450,RC,,Both,,,2501.36,750,,,,,,,,,
ENOXAPARIN 100MG SYR 10X1ML,450,RC,,Both,,,2382.24,715,,,,,,,,,
ENVIROCIDE DISINFECTANT 1GL,450,RC,,Both,,,116.25,35,,,,,,,,,
ENVIROCIDE DISINFECTANT 1GL,450,RC,,Both,,,110.71,33,,,,,,,,,
ENVIROCIDE DISINFECTANT 24OZ,450,RC,,Both,,,38.02,11,,,,,,,,,
ENVIROCIDE DISINFECTANT 24OZ,450,RC,,Both,,,36.2,11,,,,,,,,,
Regeneron Casirivi and Imdevi 1200 mg,Q0244,HCPCS,,Both,1.2,GM,0.01,1,,,,,,,,,
Hyoscyamine Sulfate 125mcg/ 5mL PO,J8499,HCPCS,,Both,125,ML,31.99,10,,,,,,,,,
EPINEPHRINE 1:1000 AMP 1ML,450,RC,,Both,,,19.04,6,,,,,,,,,
EPINEPHRINE 1:1000 AMP 1ML,450,RC,,Both,,,18.13,5,,,,,,,,,
Epinephrine 1:1000 ampule,450,RC,,Both,,,26.39,8,,,,,,,,,
EPINEPHRINE 1:1000 MDV 30ML,450,RC,,Both,,,41.84,13,,,,,,,,,
EPINEPHRINE 1:1000 MDV 30ML,450,RC,,Both,,,39.85,12,,,,,,,,,
Epinephrine 1:10000 syringe,450,RC,,Both,,,57.55,17,,,,,,,,,
EPINEPHRINE 1:10MU 20G 1-1/2,450,RC,,Both,,,38.44,12,,,,,,,,,
EPINEPHRINE 1:10MU 20G 1-1/2,450,RC,,Both,,,36.61,11,,,,,,,,,
ERYTHROMYCIN 0.5% 3.5GM OINT,J3490,HCPCS,,Both,,,77.32,23,,,,,,,,,
ERYTHROMYCIN 0.5% 3.5GM OINT,450,RC,,Both,,,73.63,22,,,,,,,,,
Amoxicillin (Amoxil) 125 mg/5 ml Susp,J8499,HCPCS,,Both,125,ML,27.7,8,,,,,,,,,
Erythropoietin,82668,CPT,,Both,,,780,234,,,,,,,,,
ESOPHOGRAM/ CONTRAST X-RAY ESOPHAGUS,74220,CPT,,Both,,,2160.91,648,,,,,,,,,
"Ethyl Chloride Topical Spray, 1 mL/1 spray pump",450,RC,,Both,,,4.2,1,,,,,,,,,
Amoxicillin (Amoxil) 125 mg/5 ml Susp,J8499,HCPCS,,Both,125,ML,29.09,9,,,,,,,,,
EVACUATION SUBUNGUAL HEMATOMA,11740,CPT,,Both,,,648,194,,,,,,,,,
EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 0.6-1.0CM,11441,CPT,,Both,,,2152.75,646,,,,,,,,,
EXC B9 LES MRGN XCP SK TG S/N/H/F/G 0.6-1.0CM,11421,CPT,,Both,,,2121.25,636,,,,,,,,,
EXC B9 LES MRGN XCP SK TG S/N/H/F/G 1.1-2.0CM,11422,CPT,,Both,,,2242,673,,,,,,,,,
EXC B9 LES MRGN XCP SK TG S/N/H/F/G 2.1-3.0CM,11423,CPT,,Both,,,2581.75,775,,,,,,,,,
EXC B9 LES MRGN XCP SK TG T/A/L 3.1-4.0 CM,11404,CPT,,Both,,,1152.51,346,,,,,,,,,
EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.5 CM/<,11420,CPT,,Both,,,1575.75,473,,,,,,,,,
EXC B9 LESION MRGN XCP SK TG T/A/L >4.0 CM,11406,CPT,,Both,,,2942.94,883,,,,,,,,,
EXC B9 LESION MRGN XCP SK TG T/A/L 0.6-1.0 CM,11401,CPT,,Both,,,1910.5,573,,,,,,,,,
EXC B9 LESION MRGN XCP SK TG T/A/L 1.1-2.0 CM,11402,CPT,,Both,,,2122.63,637,,,,,,,,,
EXCISION NAIL MATRIX PERMANENT REMOVAL,11750,CPT,,Both,,,2838.13,851,,,,,,,,,
"Excision of Ganglion, wrist (dorsal or volar); primary",25111,CPT,,Both,,,1898.14,569,,,,,,,,,
EXCISION PILONIDAL CYST/SINUS EXTENSIVE,11771,CPT,,Both,,,409.99,123,,,,,,,,,
EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ <3CM,23075,CPT,,Both,,,3926.58,1178,,,,,,,,,
EXPL PENETRATING WOUND SPX ABDOMEN/FLANK/BACK,20102,CPT,,Both,,,6351.5,1905,,,,,,,,,
EXPLORATION PENETRATING WOUND SPX EXTREMITY,20103,CPT,,Both,,,7495.5,2249,,,,,,,,,
EXT URETH CLMP OR COMPR DVC,A4356,HCPCS,,Both,,,376.93,113,,,,,,,,,
EXTEN SET 6,450,RC,,Both,,,8.8,3,,,,,,,,,
EXTEN SET 6,450,RC,,Both,,,8.38,3,,,,,,,,,
EXTEN SET 8,450,RC,,Both,,,16.19,5,,,,,,,,,
EXTEN SET 8,450,RC,,Both,,,15.41,5,,,,,,,,,
EXTERNAL ECG SCANNING ANALYSIS REPORT,93226,CPT,,Both,,,444.26,133,,,,,,,,,
EXTRACTABLE NUCLEAR ANTIGEN ANTIBODY ANY METHOD,86235,CPT,,Both,,,684,205,,,,,,,,,
EXTRACTOR OTO RHINO 5PK/EA,450,RC,,Both,,,2131.65,639,,,,,,,,,
EXTRACTOR OTO RHINO 5PK/EA,450,RC,,Both,,,2030.14,609,,,,,,,,,
EYE CHART SNELLEN,450,RC,,Both,,,34.44,10,,,,,,,,,
EYE CHART SNELLEN,450,RC,,Both,,,32.8,10,,,,,,,,,
EYE DROPS,J3490,HCPCS,,Both,,,33.43,10,,,,,,,,,
"EYE PATCH, OCCLUSIVE, EACH",A6412,HCPCS,,Both,,,3.75,1,,,,,,,,,
EYEWASH 30ML,450,RC,,Both,,,21.96,7,,,,,,,,,
EYEWASH IRR SOL 4OZ,450,RC,,Both,,,21.96,7,,,,,,,,,
EYEWASH IRR SOL 4OZ,450,RC,,Both,,,20.91,6,,,,,,,,,
EYEWASH STATION OPTIKLENS I,450,RC,,Both,,,669.74,201,,,,,,,,,
EYEWASH STATION OPTIKLENS I,450,RC,,Both,,,637.85,191,,,,,,,,,
Fabric Wrap 1,450,RC,,Both,,,13.34,4,,,,,,,,,
Fabric Wrap 2,450,RC,,Both,,,7.28,2,,,,,,,,,
Fabric Wrap 3,450,RC,,Both,,,9.45,3,,,,,,,,,
Fabric Wrap 4,450,RC,,Both,,,7.28,2,,,,,,,,,
Fabric Wrap 5,450,RC,,Both,,,22.2,7,,,,,,,,,
SOLU-MEDROL IV - METHYLPREDNISOLONE 125mg/2ml ,J3490,HCPCS,,Both,125,ML,158.72,48,,,,,,,,,
FAT/LIPIDS FECES QUALITATIVE,82705,CPT,,Both,,,87.38,26,,,,,,,,,
"FEMALE EXTERNAL URINARY COLLECTION DEVICE; POUCH, EACH",A4328,HCPCS,,Both,,,6.05,2,,,,,,,,,
"VANCOMYCIN, CAP 125MG",J8499,HCPCS,,Both,0.125,GM,47.78,14,,,,,,,,,
"SODIUM POLYSTYRENE (KALEXATE) , SUSP 15G/6ML",J8499,HCPCS,,Both,15,ML,22.87,7,,,,,,,,,
"KETOROLAC TROMETHAMINE, SDV 60MG/2ML - PER 15MG",J1885,HCPCS,,Both,15,ML,28.29,8,,,,,,,,,
Ferritin,82728,CPT,,Both,,,660,198,,,,,,,,,
FETAL NON-STRESS TEST,59025,CPT,,Both,,,829.05,249,,,,,,,,,
FIBRIN DGRADJ PRODUXS D-DIMER QUAN,85379,CPT,,Both,,,1050,315,,,,,,,,,
FIBRIN DGRADJ PRODUXS D-DIMER ULTRSENS,85380,CPT,,Both,,,225.44,68,,,,,,,,,
FIBRINOGEN ANTIGEN,85385,CPT,,Both,,,144.6,43,,,,,,,,,
Fibrinogen: Activity ,85384,CPT,,Both,,,227.52,68,,,,,,,,,
FILTERED NEBULIZER ADMIN SET,A7006,HCPCS,,Both,,,104.93,31,,,,,,,,,
FINE NEEDLE ASPIRATION BX W/US GDN 1ST LESION,10005,CPT,,Both,,,853.86,256,,,,,,,,,
FINE NEEDLE ASPIRATION W/O IMAGING GUIDANCE,10021,CPT,,Both,,,1926.75,578,,,,,,,,,
FINGER COT LG PADDED,450,RC,,Both,,,5.33,2,,,,,,,,,
FINGER COT LG PADDED,450,RC,,Both,,,5.08,2,,,,,,,,,
FINGER COT MED PADDED,450,RC,,Both,,,5.33,2,,,,,,,,,
FINGER COT MED PADDED,450,RC,,Both,,,5.08,2,,,,,,,,,
FINGER COT SM PADDED,450,RC,,Both,,,5.33,2,,,,,,,,,
FINGER COT SM PADDED,450,RC,,Both,,,5.08,2,,,,,,,,,
"Finger orthosis, proximal/distal interphalangeal, w/o joint/spring, extension/flexion, may include soft interface material, pre-fab.  ",L3927,HCPCS,,Both,,,25.66,8,,,,,,,,,
FINGER SPLINT BASEBALL LG,450,RC,,Both,,,5.94,2,,,,,,,,,
FINGER SPLINT BASEBALL LG,450,RC,,Both,,,5.66,2,,,,,,,,,
FINGER SPLINT BASEBALL MED,450,RC,,Both,,,5.94,2,,,,,,,,,
FINGER SPLINT BASEBALL MED,450,RC,,Both,,,5.66,2,,,,,,,,,
FINGER SPLINT BASEBALL SM,450,RC,,Both,,,5.94,2,,,,,,,,,
FINGER SPLINT BASEBALL SM,450,RC,,Both,,,5.66,2,,,,,,,,,
FINGER SPLINT FROG LG PADDED,450,RC,,Both,,,7.52,2,,,,,,,,,
FINGER SPLINT FROG LG PADDED,450,RC,,Both,,,7.16,2,,,,,,,,,
FINGER SPLINT FROG MD PADDEDEA,450,RC,,Both,,,7.52,2,,,,,,,,,
FINGER SPLINT FROG MD PADDEDEA,450,RC,,Both,,,7.16,2,,,,,,,,,
FINGER SPLINT FROG SM PADDED,450,RC,,Both,,,7.52,2,,,,,,,,,
FINGER SPLINT FROG SM PADDED,450,RC,,Both,,,7.16,2,,,,,,,,,
FINGER SPLINT LG CVD PADDED,450,RC,,Both,,,4.91,1,,,,,,,,,
FINGER SPLINT LG CVD PADDED,450,RC,,Both,,,4.68,1,,,,,,,,,
FINGER SPLINT MED CVD PADDED,450,RC,,Both,,,4.91,1,,,,,,,,,
FINGER SPLINT MED CVD PADDED,450,RC,,Both,,,4.68,1,,,,,,,,,
FINGER SPLINT SM CVD PADDED,450,RC,,Both,,,4.91,1,,,,,,,,,
FINGER SPLINT SM CVD PADDED,450,RC,,Both,,,4.68,1,,,,,,,,,
FINGER SPLINT STATIC,29130,CPT,,Both,,,583,175,,,,,,,,,
FINGER SPLINT STAX KIT,450,RC,,Both,,,318.11,95,,,,,,,,,
FINGER SPLINT STAX KIT,450,RC,,Both,,,302.96,91,,,,,,,,,
FINGER SPLINT STRIP 3/4X18,450,RC,,Both,,,5.94,2,,,,,,,,,
FINGER SPLINT STRIP 3/4X18,450,RC,,Both,,,5.66,2,,,,,,,,,
"FINGER SPLINT, STATIC",Q4049,HCPCS,,Both,,,307.15,92,,,,,,,,,
Finger Tourinquet,A4649,HCPCS,,Both,,,22.14,7,,,,,,,,,
"FIORICET, CAP 500-300-40MG",450,RC,,Both,,,152.78,46,,,,,,,,,
FIORICET-BUTALBITAL? TABLET,450,RC,,Both,,,8.56,3,,,,,,,,,
FLAGYL 500MG,S0030,HCPCS,,Both,,,370.06,111,,,,,,,,,
FLEET ENEMA ADULT 4.5OZ,450,RC,,Both,,,7.71,2,,,,,,,,,
FLEET ENEMA ADULT 4.5OZ,450,RC,,Both,,,7.33,2,,,,,,,,,
FLEET GLYCERIN SUPP CHLD 12B,450,RC,,Both,,,22.8,7,,,,,,,,,
FLEET GLYCERIN SUPP CHLD 12B,450,RC,,Both,,,10.33,3,,,,,,,,,
FLEETS ENEMA,A4649,HCPCS,,Both,,,51.09,15,,,,,,,,,
KETOROLAC(TORADOL) 30MG SDV 1ML (PER 15 MG),J1885,HCPCS,,Both,15,ML,8.74,3,,,,,,,,,
FLOWMETER 15L W/MALE ADAPTEREA,450,RC,,Both,,,255.35,77,,,,,,,,,
FLOWMETER 15L W/MALE ADAPTEREA,450,RC,,Both,,,243.18,73,,,,,,,,,
Meloxicam 15mg Tablet,J8499,HCPCS,,Both,0.015,GM,0.21,1,,,,,,,,,
FLUMAZENIL .1MG/ML MDV 5ML,450,RC,,Both,,,27.53,8,,,,,,,,,
FLUMAZENIL .1MG/ML MDV 5ML,450,RC,,Both,,,26.22,8,,,,,,,,,
FLUORESCENT NONNFCT AGT ANTB SCREEN EA ANTIBODY,86255,CPT,,Both,,,445.5,134,,,,,,,,,
FLUORESCENT NONNFCT AGT ANTB TITER EA ANTIBODY,86256,CPT,,Both,,,120.5,36,,,,,,,,,
FLUOR-I-STRIP,A4649,HCPCS,,Both,,,19.53,6,,,,,,,,,
Prednisolone 15 mg / 5 mL Oral Sol,J7510,HCPCS,,Both,15,ML,10.27,3,,,,,,,,,
"TORADOL,(KETOROLAC TROMETHAMINE) PER 15 MG",J1885,HCPCS,,Both,0.015,GM,29.7,9,,,,,,,,,
FOAM DRG > 48 SQ IN W/O BRDR,A6211,HCPCS,,Both,,,42.7,13,,,,,,,,,
FOAM DRG >16<=48 SQ IN W/BDR,A6213,HCPCS,,Both,,,15.83,5,,,,,,,,,
FOLIC ACID 5MG 10ML,450,RC,,Both,,,160.27,48,,,,,,,,,
FOLIC ACID 5MG 10ML,450,RC,,Both,,,152.63,46,,,,,,,,,
"FOLIC ACID, 1mg/mL, injection",450,RC,,Both,,,46.52,14,,,,,,,,,
AFRIN NO DRIP SPY 15ML,A9150,HCPCS,,Both,15,ML,42.27,13,,,,,,,,,
Folic Acid: Serum,82746,CPT,,Both,,,252.63,76,,,,,,,,,
FORCEP FOERSTER SPONGE 9.5,450,RC,,Both,,,149.35,45,,,,,,,,,
FORCEP FOERSTER SPONGE 9.5,450,RC,,Both,,,142.23,43,,,,,,,,,
FORCEP HARTMAN ALLIG EAR 3,450,RC,,Both,,,316.6,95,,,,,,,,,
FORCEP HARTMAN ALLIG EAR 3,450,RC,,Both,,,301.52,90,,,,,,,,,
FORCEP HARTMAN EAR 3.5,450,RC,,Both,,,221.69,67,,,,,,,,,
FORCEP HARTMAN EAR 3.5,450,RC,,Both,,,211.13,63,,,,,,,,,
FORCEP HUNTER SPLNTER 4-1/8,450,RC,,Both,,,105.34,32,,,,,,,,,
FORCEP HUNTER SPLNTER 4-1/8,450,RC,,Both,,,100.32,30,,,,,,,,,
FORCEP JANSEN DRESS 6.5,450,RC,,Both,,,250.13,75,,,,,,,,,
FORCEP JANSEN DRESS 6.5,450,RC,,Both,,,238.22,71,,,,,,,,,
FORCEP KELLY 5.5,450,RC,,Both,,,179.92,54,,,,,,,,,
FORCEP KELLY 5.5,450,RC,,Both,,,171.34,51,,,,,,,,,
FORCEP MAGILL CATH 10,450,RC,,Both,,,91.75,28,,,,,,,,,
FORCEP MAGILL CATH 10,450,RC,,Both,,,87.38,26,,,,,,,,,
FORCEP SPLINTER 4.5,450,RC,,Both,,,126.74,38,,,,,,,,,
FORCEP SPLINTER 4.5,450,RC,,Both,,,120.7,36,,,,,,,,,
Foreign Body Remover,450,RC,,Both,,,15.52,5,,,,,,,,,
FORESKN MNPJ W/LSS PREPUTIAL ADS&STRETCHING,54450,CPT,,Both,,,856.5,257,,,,,,,,,
"FORMOTEROL, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINIS...",J7640,HCPCS,,Both,,,36.86,11,,,,,,,,,
"NEO-SYNEPHRINE, SPR .5% 15ML",A9150,HCPCS,,Both,15,ML,42.42,13,,,,,,,,,
"CLINDAMYCIN HCL, CAP 150MG",J8499,HCPCS,,Both,0.15,GM,2.63,1,,,,,,,,,
FUROSEMIDE 10MG/ML VL 4ML,450,RC,,Both,,,15.23,5,,,,,,,,,
Diflucan 150 mg ,J8499,HCPCS,,Both,0.15,GM,21.11,6,,,,,,,,,
"Injection, medroxyprogesterone acetate (Depo Provera) 150 MG/ML",J1050,HCPCS,,Both,150,ML,330.8,99,,,,,,,,,
GAMMAGLOBULIN IMMUNOGLOBULIN SUBCLASSES,82787,CPT,,Both,,,67.37,20,,,,,,,,,
GARAMYCIN GENTAMICIN INJ,J1580,HCPCS,,Both,,,69.41,21,,,,,,,,,
GAS RELIEF INF DRP 30ML,450,RC,,Both,,,16.74,5,,,,,,,,,
GAS RELIEF INF DRP 30ML,450,RC,,Both,,,15.94,5,,,,,,,,,
GASES BLD PH CALCULATED O2 SATURATION,82803,CPT,,Both,,,649,195,,,,,,,,,
GASES BLD PH ONLY,82800,CPT,,Both,,,193.47,58,,,,,,,,,
GASTRIC TUBE PLMT W/ASPIR & LAVAGE,43753,CPT,,Both,,,1500,450,,,,,,,,,
"Injection, medroxyprogesterone acetate (Depo Provera) 150 MG/ML",J1050,HCPCS,,Both,150,ML,315.05,95,,,,,,,,,
Gastrografin 30ML,450,RC,,Both,,,301.85,91,,,,,,,,,
Gastrografin 30ml,450,RC,,Both,,,287.48,86,,,,,,,,,
GAUZE - KERLIX HYDROGEL DSG<=16 SQ IN,A6231,HCPCS,,Both,,,97.49,29,,,,,,,,,
GAUZE - NON-STERILE GAUZE > 48 SQ IN,A6218,HCPCS,,Both,,,19.53,6,,,,,,,,,
GAUZE - NON-STERILE GAUZE<=16 SQ IN,A6216,HCPCS,,Both,,,19.53,6,,,,,,,,,
GAUZE - NON-STERILE GAUZE>16 BUT <=48 SQ,A6217,HCPCS,,Both,,,19.53,6,,,,,,,,,
GAUZE - STERILE GAUZE <= 16 SQ IN W/BORDER,A6219,HCPCS,,Both,,,19.53,6,,,,,,,,,
Gauze > 48 In No W/sal W/o B,A6224,HCPCS,,Both,,,21.99,7,,,,,,,,,
GAUZE CONFORM 1,450,RC,,Both,,,22.55,7,,,,,,,,,
GAUZE CONFORM 1,450,RC,,Both,,,21.48,6,,,,,,,,,
GAUZE CONFORM 2,450,RC,,Both,,,13.22,4,,,,,,,,,
GAUZE CONFORM 2,450,RC,,Both,,,12.59,4,,,,,,,,,
GAUZE CONFORM 3,450,RC,,Both,,,16.8,5,,,,,,,,,
GAUZE CONFORM 3,450,RC,,Both,,,16,5,,,,,,,,,
GAUZE CONFORM 4,450,RC,,Both,,,20.93,6,,,,,,,,,
GAUZE CONFORM 4,450,RC,,Both,,,19.93,6,,,,,,,,,
GAUZE CONFORM 6,450,RC,,Both,,,21.04,6,,,,,,,,,
GAUZE CONFORM 6,450,RC,,Both,,,20.03,6,,,,,,,,,
GAUZE ROLL 3.4,450,RC,,Both,,,6.07,2,,,,,,,,,
GAUZE ROLL 3.4,450,RC,,Both,,,5.78,2,,,,,,,,,
GAUZE ROLL 4.5,450,RC,,Both,,,9.52,3,,,,,,,,,
GAUZE ROLL 4.5,450,RC,,Both,,,8.55,3,,,,,,,,,
GAUZE ROLL 4.5,450,RC,,Both,,,9.07,3,,,,,,,,,
GELFOAM SZ12 7MM 12/BX,450,RC,,Both,,,453.52,136,,,,,,,,,
GELFOAM SZ12 7MM 12/BX,450,RC,,Both,,,431.91,130,,,,,,,,,
GENERAL HLTH PANEL,80050,CPT,,Both,,,1473.11,442,,,,,,,,,
GENET VIRUS ISOLATE HSV,87255,CPT,,Both,,,497.73,149,,,,,,,,,
GENTAMICIN eye drops(drops),450,RC,,Both,,,169.79,51,,,,,,,,,
"MEDROXYPROGESTERONE ACETATE (Depo-Provera) , SDV 150MG/ML 1ML",J8499,HCPCS,,Both,150,ML,561.5,168,,,,,,,,,
Omnipaque 300 - 150ml,Q9967,HCPCS,,Both,150,ML,4.54,1,,,,,,,,,
GERI-LANTA LIQ 200MG 12OZ,450,RC,,Both,,,11.1,3,,,,,,,,,
GERI-LANTA LIQ 200MG 12OZ,450,RC,,Both,,,10.56,3,,,,,,,,,
GGT - GLUTAMYLTRASE GAMMA,82977,CPT,,Both,,,600,180,,,,,,,,,
"Gliadin (deamidated) (DGP) antibody, each immunoglobulin (Ig) class",86258,CPT,,Both,,,96.85,29,,,,,,,,,
Donnatal Elixir 16.5 mg/5 ml ,J8499,HCPCS,,Both,16.5,ML,16.78,5,,,,,,,,,
Acetaminophen (Tylenol) 160 mg/5 ml Elx Liq,A9150,HCPCS,,Both,160,ML,5.78,2,,,,,,,,,
Fenofibrate 160mg Tablet,J8499,HCPCS,,Both,0.16,GM,6.93,2,,,,,,,,,
GLO STRIPS 1MG 100/BX,450,RC,,Both,,,48.46,15,,,,,,,,,
GLO STRIPS 1MG 100/BX,450,RC,,Both,,,46.14,14,,,,,,,,,
GLOVE EXAM NIT LG PF 200/BX,450,RC,,Both,,,59.18,18,,,,,,,,,
GLOVE EXAM NIT LG PF 200/BX,450,RC,,Both,,,56.36,17,,,,,,,,,
GLOVE EXAM NIT MED PF 200/BX,450,RC,,Both,,,59.18,18,,,,,,,,,
GLOVE EXAM NIT MED PF 200/BX,450,RC,,Both,,,56.36,17,,,,,,,,,
GLOVE EXAM NIT SM PF 200/BX,450,RC,,Both,,,59.18,18,,,,,,,,,
GLOVE EXAM NIT SM PF 200/BX,450,RC,,Both,,,56.36,17,,,,,,,,,
GLOVE SURG LTX 6.5 PF 40PR/B,450,RC,,Both,,,246.79,74,,,,,,,,,
GLOVE SURG LTX 6.5 PF 40PR/B,450,RC,,Both,,,235.04,71,,,,,,,,,
GLOVE SURG LTX 7 PF 40PR/BX,450,RC,,Both,,,246.79,74,,,,,,,,,
GLOVE SURG LTX 7 PF 40PR/BX,450,RC,,Both,,,235.04,71,,,,,,,,,
GLOVE SURG LTX 7.5 PF 40PR/B,450,RC,,Both,,,246.79,74,,,,,,,,,
GLOVE SURG LTX 7.5 PF 40PR/B,450,RC,,Both,,,235.04,71,,,,,,,,,
GLOVES NON-STERILE,A4927,HCPCS,,Both,,,1.61,1,,,,,,,,,
"GLOVES STERILE, PER PAIR",A4930,HCPCS,,Both,,,4.84,1,,,,,,,,,
GLUC BLD GLUC MNTR DEV CLEARED FDA SPEC HOME USE,82962,CPT,,Both,,,283.05,85,,,,,,,,,
GLUC BLD RGNT STRIP,82948,CPT,,Both,,,684,205,,,,,,,,,
GLUC QUAN BLD,82947,CPT,,Both,,,276,83,,,,,,,,,
GLUCAGON 1MG EMERG KIT 1ML,450,RC,,Both,,,1315.17,395,,,,,,,,,
GLUCAGON 1MG EMERG KIT 1ML,450,RC,,Both,,,1252.55,376,,,,,,,,,
Sulfamethoxazole + Trimethoprim 800-160mg PO,J8499,HCPCS,,Both,0.16,GM,4.03,1,,,,,,,,,
GLUCOSE TEST STRIP - BLOOD KETONE TEST OR STRIP,A4252,HCPCS,,Both,,,8.35,3,,,,,,,,,
GLUCOSE TOLERANCE TEST GTT 3 SPECIMENS,82951,CPT,,Both,,,221.13,66,,,,,,,,,
"Glucose, body fluid, other than blood",82945,CPT,,Both,,,474,142,,,,,,,,,
Glycerin Supp,450,RC,,Both,,,21.71,7,,,,,,,,,
GONAD CHORNC QUAN,84702,CPT,,Both,,,1176,353,,,,,,,,,
GONADOTROPIN LUTEINIZING HORMONE,83002,CPT,,Both,,,318.52,96,,,,,,,,,
Gonadotropin; follicle stimulating hormone (FSH),83001,CPT,,Both,,,319.25,96,,,,,,,,,
GOWN ISO YLW 10/BX 5BX/CS,450,RC,,Both,,,64.59,19,,,,,,,,,
GOWN ISO YLW 10/BX 5BX/CS,450,RC,,Both,,,61.51,18,,,,,,,,,
GOWN SURG XL ST W/TWL 20/CS,450,RC,,Both,,,33.11,10,,,,,,,,,
GOWN SURG XL ST W/TWL 20/CS,450,RC,,Both,,,31.53,9,,,,,,,,,
Grey Top Lactic Acid Plasma Test,83605,CPT,,Both,,,570,171,,,,,,,,,
"LOCM 100-199MG/ML IODINE,1ML",Q9965,HCPCS,,Both,199,ML,29.06,9,,,,,,,,,
Haldol 50mg Vial,450,RC,,Both,,,539.62,162,,,,,,,,,
HALOPERIDOL 5MG/ML VL 10ML,450,RC,,Both,,,59.91,18,,,,,,,,,
HALOPERIDOL 5MG/ML VL 10ML,450,RC,,Both,,,57.06,17,,,,,,,,,
HALOPERIDOL DECANOATE INJ,J1631,HCPCS,,Both,,,122.54,37,,,,,,,,,
HANDLG&/OR CONVEY OF SPEC FOR TR FROM PT TO LAB,99001,CPT,,Both,,,28.25,8,,,,,,,,,
HANDLG&/OR CONVEY OF SPEC FOR TR OFFICE TO LAB,99000,CPT,,Both,,,1020,306,,,,,,,,,
"Hbot, full body chamber, 30m",G0277,HCPCS,,Both,,,1261.68,379,,,,,,,,,
Headgear used with positive airway pressure device,A7035,HCPCS,,Both,,,211.6,63,,,,,,,,,
HEEL WARMER INFANT,450,RC,,Both,,,7.04,2,,,,,,,,,
HEEL WARMER INFANT,450,RC,,Both,,,6.7,2,,,,,,,,,
Hemoglobin electrophoresis,83020,CPT,,Both,,,308.88,93,,,,,,,,,
HEMOGLOBIN FETAL (KLEIHAUER-BETKE) ,85460,CPT,,Both,,,133,40,,,,,,,,,
Hemoglobin; glycosylated (A1C),83036,CPT,,Both,,,330,99,,,,,,,,,
HEMOPERFUSION,90997,CPT,,Both,,,564.96,169,,,,,,,,,
HEMOSTAT ABSORB 1/2X2,450,RC,,Both,,,2289.98,687,,,,,,,,,
HEMOSTAT ABSORB 1/2X2,450,RC,,Both,,,2180.93,654,,,,,,,,,
HEP B CORE ANTIBODY IGM,86705,CPT,,Both,,,190.1,57,,,,,,,,,
Heparin assay,85520,CPT,,Both,,,109.96,33,,,,,,,,,
ATIVAN - LORAZEPAM INJECTION 2MG,J2060,HCPCS,,Both,0.002,GM,137.37,41,,,,,,,,,
HEPATC FUNCJ PANEL,80076,CPT,,Both,,,1458,437,,,,,,,,,
HEPATITIS A ANTIBODY HAAB,86708,CPT,,Both,,,212.88,64,,,,,,,,,
HEPATITIS ANTIBODY HAAB IGM ANTIBODY,86709,CPT,,Both,,,208,62,,,,,,,,,
HEPATITIS B CORE ANTIBODY HBCAB TOTAL,86704,CPT,,Both,,,181.25,54,,,,,,,,,
HEPATITIS B SURF ANTIBODY HBSAB,86706,CPT,,Both,,,298.93,90,,,,,,,,,
HEPATITIS B VACCINE ADULT DOSAGE INTRAMUSCULAR,90746,CPT,,Both,,,746.34,224,,,,,,,,,
HEPATITIS C ANTIBODY,86803,CPT,,Both,,,245.25,74,,,,,,,,,
HERPES SIMPLEX 1 AG,87274,CPT,,Both,,,52.5,16,,,,,,,,,
HFO W/O JOINTS PF,L3923,HCPCS,,Both,,,495.66,149,,,,,,,,,
HIBICLENS 4% LIQ 4OZ,450,RC,,Both,,,28.69,9,,,,,,,,,
HIBICLENS 4% LIQ 4OZ,450,RC,,Both,,,27.32,8,,,,,,,,,
HIDA SCAN - HEPATBL DUX SYS IMG GLBLDR,78223,CPT,,Both,,,3470.47,1041,,,,,,,,,
"HLA Class I typing, low resolution; 1 Ag Equivalent B27, each",81374,CPT,,Both,,,1783.92,535,,,,,,,,,
Hla i typing 1 locus hr,81380,CPT,,Both,,,4254,1276,,,,,,,,,
"HLA typing; A, B, or C (eg, A10, B7, B27), single antigen",86812,CPT,,Both,,,443.5,133,,,,,,,,,
HOSPITAL OBSERVATION PER HR,G0378,HCPCS,,Both,,,878,263,,,,,,,,,
HOT WATER BOTTLE,E0220,HCPCS,,Both,,,48.43,15,,,,,,,,,
"Hot water bottle, ice cap or collar, heat and/or cold wrap, any type ",A9273,HCPCS,,Both,,,17.75,5,,,,,,,,,
HPYLORI BREATH ANAL UREASE ACT NON-RADACT ISTOPE,83013,CPT,,Both,,,673.6,202,,,,,,,,,
HPYLORI STOOL AG IA,87338,CPT,,Both,,,207.38,62,,,,,,,,,
HUMULIN R 100U/ML VL 10ML,450,RC,,Both,,,114.09,34,,,,,,,,,
Glimepiride (Amaryl) 2mg Tab,J8499,HCPCS,,Both,0.002,GM,1.47,1,,,,,,,,,
HURRICAINE SPRAY 2OZ CAN,450,RC,,Both,,,190.89,57,,,,,,,,,
HURRICAINE SPRAY 2OZ CAN,450,RC,,Both,,,181.8,55,,,,,,,,,
HYDRALAZINE HCL 20MG/ML 1ML,450,RC,,Both,,,32.57,10,,,,,,,,,
HYDRALAZINE HCL 20MG/ML 1ML,450,RC,,Both,,,31.02,9,,,,,,,,,
"LOPERAMIDE(IMODIUM), CAP 2MG",J8499,HCPCS,,Both,0.002,GM,2.63,1,,,,,,,,,
BICILLIN LA 1.2MMU/2ML SYR,J2510,HCPCS,,Both,2,ML,451.63,135,,,,,,,,,
"Hydralazine, 10 mg",450,RC,,Both,,,0.42,1,,,,,,,,,
CAFFEINE AND SODIUM BENZOATE - 2mL vial - 250mg inj,J0706,HCPCS,,Both,2,ML,215.46,65,,,,,,,,,
Midazolam 10mg per 2ml,J2250,HCPCS,,Both,2,ML,158.27,47,,,,,,,,,
TETRACAINE - PONTOCAINE 1% 2ML IM\IV,J3490,HCPCS,,Both,2,ML,77.96,23,,,,,,,,,
Diastat® Diazepam 2.5 mg Gel Prefilled Rectal DS,J8498,HCPCS,,Both,0.0025,GM,1157,347,,,,,,,,,
HYDROCODONE/APAP 10/325,J8499,HCPCS,,Both,,,26.78,8,,,,,,,,,
Hydrocodone/apap 5/325 tab,450,RC,,Both,,,8.89,3,,,,,,,,,
Hydrocodone/apap 7.5/325 tab,450,RC,,Both,,,18.55,6,,,,,,,,,
Hydrocodone/ibuprofen 7.5/200 tab,450,RC,,Both,,,8.89,3,,,,,,,,,
HYDROCORT .5% CRM 1OZ W/ALOEEA,450,RC,,Both,,,11.95,4,,,,,,,,,
HYDROCORTISONE .5% CRM 1OZ W/ALOEEA,450,RC,,Both,,,14.33,4,,,,,,,,,
"HYDROCORTISONE, CRM 2.5% ",J3490,HCPCS,,Both,,,26.78,8,,,,,,,,,
HYDROGEN PEROX 3% 16OZ 12/CSCS,450,RC,,Both,,,6.01,2,,,,,,,,,
HYDROGEN PEROX 3% 16OZ 12/CSCS,450,RC,,Both,,,5.71,2,,,,,,,,,
HYDROGEN PEROXIDE BOTTLE,A4649,HCPCS,,Both,,,19.37,6,,,,,,,,,
Diazepam (Valium) 2.5mg gel suppository,J8498,HCPCS,,Both,0.0025,GM,860.21,258,,,,,,,,,
Enalapril 2.5mg tab,J8499,HCPCS,,Both,0.0025,GM,1.44,1,,,,,,,,,
HYDROXYZINE HCL INJECTION,J3410,HCPCS,,Both,,,29.7,9,,,,,,,,,
HYGROMETER DIGITAL W/MEMORYEA,450,RC,,Both,,,593.04,178,,,,,,,,,
HYGROMETER DIGITAL W/MEMORYEA,450,RC,,Both,,,564.8,169,,,,,,,,,
Hylands Ear Relief (Drops),450,RC,,Both,,,72.45,22,,,,,,,,,
"GLIPIZIDE ER (GLUCOTROL) , TAB 2.5MG",J8499,HCPCS,,Both,0.0025,GM,5.78,2,,,,,,,,,
"VERAPAMIL HYDROCHLORIDE IV, 2.5 mg/mL",J3490,HCPCS,,Both,2.5,ML,349.65,105,,,,,,,,,
"POTASSIUM CHLORIDE ER, TAB 20MEQ",J8499,HCPCS,,Both,,,5.78,2,,,,,,,,,
I&D ABSC PRITONSILLAR,42700,CPT,,Both,,,2515.75,755,,,,,,,,,
I&D DEEP ABSC/HMTMA SOFT TISSUE NECK/THORAX,21501,CPT,,Both,,,5914.25,1774,,,,,,,,,
I&D EPIDIDYMIS TSTIS&/SCROTAL SPACE,54700,CPT,,Both,,,2660.63,798,,,,,,,,,
I&D HEMATOMA SEROMA/FLUID COLLECTION,10140,CPT,,Both,,,2473.24,742,,,,,,,,,
I&D ISCHIORCT&/PRIRCT ABSC SPX,46040,CPT,,Both,,,6871.38,2061,,,,,,,,,
I&D OF BARTHOLINS GLAND ABSC,56420,CPT,,Both,,,1564.38,469,,,,,,,,,
I&D SHOULDER DEEP ABSCESS/HEMATOMA,23030,CPT,,Both,,,3085.95,926,,,,,,,,,
I&D UPPER ARM/ELBOW DEEP ABSCESS/HEMATOMA,23930,CPT,,Both,,,4577.88,1373,,,,,,,,,
I&D VULVA/PRNL ABSC,56405,CPT,,Both,,,1402,421,,,,,,,,,
"I&D, upper arm or elbow area; bursa",23931,CPT,,Both,,,3705.75,1112,,,,,,,,,
IA INFECTIOUS AGT ANTIBODY QUAL/SEMI 1 STEP METH,86318,CPT,,Both,,,180.9,54,,,,,,,,,
IA INFECTIOUS AGT ANTIBODY SARS-COV-2 COVID-19,86328,CPT,,Both,,,361.8,109,,,,,,,,,
IAAD EIA RSV,87420,CPT,,Both,,,570,171,,,,,,,,,
IAAD EIA STREPTOCOCCUS GROUP A,87430,CPT,,Both,,,348.26,104,,,,,,,,,
IAAD EIA STREPTOCOCCUS GROUP A,87430,CPT,,Both,,,348.26,104,,,,,,,,,
IAAD IA ENTAMOEBA HISTOLYTICA GRP,87337,CPT,,Both,,,77.7,23,,,,,,,,,
IAAD IA ESCHERICHIA COLI 0157,87335,CPT,,Both,,,206.13,62,,,,,,,,,
IAAD IA GIARDIA,87329,CPT,,Both,,,86.31,26,,,,,,,,,
IAAD IA HEPATITIS B SURFACE ANTIGEN,87340,CPT,,Both,,,210.5,63,,,,,,,,,
IAAD IA MULT STEP METHOD NOS EACH ORGANISM,87449,CPT,,Both,,,206.13,62,,,,,,,,,
IAAD IA ROTAVIRUS,87425,CPT,,Both,,,1140,342,,,,,,,,,
IAAD IA SHIGA-LIKE TOXIN,87427,CPT,,Both,,,660,198,,,,,,,,,
IAADI BORDETELLA PRTUSSIS/PARAPRTUSSIS,87265,CPT,,Both,,,209,63,,,,,,,,,
IAADI CRYPTOSPORIDIUM,87272,CPT,,Both,,,86.31,26,,,,,,,,,
IAADI HERPES SMPLX VIRUS TYPE 2,87273,CPT,,Both,,,90.02,27,,,,,,,,,
IAADI VARICELLA ZOSTER VIRUS,87290,CPT,,Both,,,86.31,26,,,,,,,,,
IAADIADOO HIV1 ANTIGEN W/HIV1 & HIV2 ANTIBODIES,87806,CPT,,Both,,,1260,378,,,,,,,,,
IAADIADOO INFLUENZA A/B EACH,87804,CPT,,Both,,,575,173,,,,,,,,,
IAADIADOO NEISSERIA GONORRHOEAE,87850,CPT,,Both,,,90.04,27,,,,,,,,,
IAADIADOO NOT OTHERWISE SPECIFIED,87899,CPT,,Both,,,780,234,,,,,,,,,
IAADIADOO RSV,87807,CPT,,Both,,,2895.6,869,,,,,,,,,
IAADIADOO STREPTOCOCCUS GROUP B,87802,CPT,,Both,,,86.31,26,,,,,,,,,
IAADIADOO STREPTOCOCCUS GRP,87880,CPT,,Both,,,1038,311,,,,,,,,,
IADNA CANDIDA SPECIES AMPLIFIED PROBE TQ,87481,CPT,,Both,,,227.48,68,,,,,,,,,
IADNA CANDIDA SPECIES DIRECT PROBE TQ,87480,CPT,,Both,,,144.43,43,,,,,,,,,
IADNA CHLAMYDIA TRACHOMATIS DIRECT PROBE TQ,87490,CPT,,Both,,,150.6,45,,,,,,,,,
IADNA CYTOMEGALOVIRUS AMPLIFIED PROBE TQ,87496,CPT,,Both,,,227.48,68,,,,,,,,,
IADNA ENTEROVIRUS AMPLIF PROBE & REVRSE TRNSCRIP,87498,CPT,,Both,,,252.74,76,,,,,,,,,
IADNA GARDNERELLA VAGINALIS DIRECT PROBE TQ,87510,CPT,,Both,,,1750.95,525,,,,,,,,,
IADNA HEPATITIS B VIRUS QUANTIFICATION,87517,CPT,,Both,,,428.4,129,,,,,,,,,
IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION,87522,CPT,,Both,,,583.8,175,,,,,,,,,
IADNA HERPES SMPLX VIRUS DIR PRB,87528,CPT,,Both,,,166.14,50,,,,,,,,,
IADNA HERPES SOMPLX VIRUS AMPLIFIED PROBE TQ,87529,CPT,,Both,,,1020,306,,,,,,,,,
IADNA HIV-1 QUANT & REVERSE TRANSCRIPTION,87536,CPT,,Both,,,1462,439,,,,,,,,,
IADNA MULTIPLE ORGANISMS AMPLIFIED PROBE TQ,87801,CPT,,Both,,,1133.29,340,,,,,,,,,
IADNA NEISSERIA GONORRHOEAE AMP PRB,87591,CPT,,Both,,,408,122,,,,,,,,,
IADNA NEISSERIA GONORRHOEAE DIRECT PROBE TQ,87590,CPT,,Both,,,344.63,103,,,,,,,,,
IADNA NEISSERIA GONORRHOEAE QUAN,87592,CPT,,Both,,,756,227,,,,,,,,,
IADNA RESPIRATRY PROBE & REV TRNSCR 12-25 TARGET,87633,CPT,,Both,,,8575.8,2573,,,,,,,,,
IADNA RESPIRATRY PROBE & REV TRNSCR 3-5 TARGETS,87631,CPT,,Both,,,1662.99,499,,,,,,,,,
IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ,87637,CPT,,Both,,,1198.09,359,,,,,,,,,
IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ,87635,CPT,,Both,,,600,180,,,,,,,,,
IADNA SARSCOV2& INF A&B MULT AMPLIFIED PROBE TQ,87636,CPT,,Both,,,997.5,299,,,,,,,,,
IADNA STREPTOCOCCUS GROUP A AMPLIFIED PROBE TQ,87651,CPT,,Both,,,480,144,,,,,,,,,
IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH,87661,CPT,,Both,,,505.47,152,,,,,,,,,
IADNA TRICHOMONAS VAGINALIS DIRECT PROBE TQ,87660,CPT,,Both,,,780,234,,,,,,,,,
IADNA-DNA/RNA GI PTHGN MULTIPLEX PROBE TQ 12-25,87507,CPT,,Both,,,3001.53,900,,,,,,,,,
IADNA-DNA/RNA GI PTHGN MULTIPLEX PROBE TQ 12-25,87507,CPT,,Both,,,3001.53,900,,,,,,,,,
IADNA-DNA/RNA GI PTHGN MULTIPLEX PROBE TQ 1-5,87505,CPT,,Both,,,1015.61,305,,,,,,,,,
IADNA-DNA/RNA GI PTHGN MULTIPLEX PROBE TQ 1-5,87505,CPT,,Both,,,967.25,290,,,,,,,,,
BENTYL - DICYCLOMINE INJECTION 20MG,J0500,HCPCS,,Both,0.02,GM,29.7,9,,,,,,,,,
IBUPROFEN 100MG/5ML SUS120ML,450,RC,,Both,,,35.66,11,,,,,,,,,
IBUPROFEN 100MG/5ML SUS120ML,450,RC,,Both,,,33.96,10,,,,,,,,,
IBUPROFEN 200MG TAB 100/BX,450,RC,,Both,,,14.02,4,,,,,,,,,
IBUPROFEN 200MG TAB 100/BX,450,RC,,Both,,,13.34,4,,,,,,,,,
CELEXA Citalopram Hydrobromide 20MG TABS,J8499,HCPCS,,Both,0.02,GM,113.91,34,,,,,,,,,
IBUPROFEN 600MG TABS 100/BT,450,RC,,Both,,,47.9,14,,,,,,,,,
IBUPROFEN 600MG TABS 100/BT,450,RC,,Both,,,45.62,14,,,,,,,,,
IBUPROFEN CHLD SUS BERRY 4OZEA,450,RC,,Both,,,21.59,6,,,,,,,,,
IBUPROFEN CHLD SUS BERRY 4OZEA,450,RC,,Both,,,20.56,6,,,,,,,,,
"CRESTOR, TAB 20 MG",J8499,HCPCS,,Both,0.02,GM,184.28,55,,,,,,,,,
"DICYCLOMINE (Bentyl) , TAB 20MG",J8499,HCPCS,,Both,0.02,GM,37.28,11,,,,,,,,,
ETOMIDATE 20MG/10ML V 10/B,J3490,HCPCS,,Both,20,ML,22.14,7,,,,,,,,,
"FAMOTIDINE, SDV 20MG/2ML",J3490,HCPCS,,Both,20,ML,11,3,,,,,,,,,
ICE CAP OR COLLAR,97010,CPT,,Both,,,171,51,,,,,,,,,
ICE PACK,A4649,HCPCS,,Both,,,8.09,2,,,,,,,,,
ID BAND ADULT RED 250/BX,450,RC,,Both,,,257.17,77,,,,,,,,,
ID BAND ADULT RED 250/BX,450,RC,,Both,,,244.92,73,,,,,,,,,
ID BAND WHITE 1000/BX,450,RC,,Both,,,241.65,72,,,,,,,,,
ID BAND WHITE 1000/BX,450,RC,,Both,,,230.14,69,,,,,,,,,
IMADM PRQ ID SUBQ/IM NJXS 1 VACC,90471,CPT,,Both,,,324,97,,,,,,,,,
IMITREX 6MG/0.5ML SYRINGE 2/BX,450,RC,,Both,,,2645.48,794,,,,,,,,,
IMITREX 6MG/0.5ML SYRINGE 2/BX,450,RC,,Both,,,1739.83,522,,,,,,,,,
IMM ADMN SARSCOV2 100 MCG/0.5 ML 1ST DOSE,0011A,HCPCS,,Both,,,84.7,25,,,,,,,,,
IMM ADMN SARSCOV2 100 MCG/0.5 ML 2ND DOSE,0012A,HCPCS,,Both,,,141.95,43,,,,,,,,,
IMM ADMN SARSCOV2 30MCG/0.3ML DIL RECON 1ST DOSE,0001A,HCPCS,,Both,,,84.7,25,,,,,,,,,
IMM ADMN SARSCOV2 30MCG/0.3ML DIL RECON 2ND DOSE,0002A,HCPCS,,Both,,,141.95,43,,,,,,,,,
IMMUNIZATION ADMIN EACH ADD,90472,CPT,,Both,,,420,126,,,,,,,,,
Immunization administration through 18 yts of age via any ro...,90460,CPT,,Both,,,85.48,26,,,,,,,,,
IMMUNOASSAY ANALYTE QUAL/SEMIQUAL MULTIPLE STEP,83516,CPT,,Both,,,115.3,35,,,,,,,,,
IMMUNOASSAY ANALYTE QUANT RADIOIMMUNOASSAY,83519,CPT,,Both,,,232.13,70,,,,,,,,,
IMMUNOASSAY ANALYTE QUANTITATIVE NOS,83520,CPT,,Both,,,225.5,68,,,,,,,,,
Immunoassay infectious agent Antibody quant,86317,CPT,,Both,,,359.76,108,,,,,,,,,
IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 125,86304,CPT,,Both,,,357.63,107,,,,,,,,,
IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 15-3,86300,CPT,,Both,,,357.63,107,,,,,,,,,
IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 19-9,86301,CPT,,Both,,,357.63,107,,,,,,,,,
IMMUNOELECTROPHORESIS OTH FLUS CONCENTRATION,86325,CPT,,Both,,,227.64,68,,,,,,,,,
Immunofixation electrophoresis; serum,86334,CPT,,Both,,,247.25,74,,,,,,,,,
IMMUNOFIXJ ELECTROPHORESIS OTHER FLUIDS,86335,CPT,,Both,,,246.54,74,,,,,,,,,
IMMUNOFLUORESCENCE PER SPEC 1ST SINGL ANTB STAIN,88346,CPT,,Both,,,1369.75,411,,,,,,,,,
"Immunoglobulin light chains (ie, kappa, lambda), free, each",83521,CPT,,Both,,,145.07,44,,,,,,,,,
IMPREG GAUZE NO H20/SAL/YARD,A6266,HCPCS,,Both,,,13.94,4,,,,,,,,,
INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE,10060,CPT,,Both,,,1478.25,443,,,,,,,,,
INCISION & DRAINAGE PILONIDAL CYST COMPLICATED,10081,CPT,,Both,,,3503.75,1051,,,,,,,,,
INCISION & DRAINAGE PILONIDAL CYST SIMPLE,10080,CPT,,Both,,,2319.38,696,,,,,,,,,
Incision and Drain Tray,450,RC,,Both,,,0.67,1,,,,,,,,,
"Incision and drainage of penis, deep ",54015,CPT,,Both,,,2112,634,,,,,,,,,
Incision and drainage of vaginal hematoma; non-obstetrical,57023,CPT,,Both,,,2506.8,752,,,,,,,,,
"Incision and drainage, complex, postoperative wound infection",10180,CPT,,Both,,,3161.25,948,,,,,,,,,
INCISION OF ANAL ABSCESS,46050,CPT,,Both,,,3150.32,945,,,,,,,,,
"Incision of thrombosed hemorrhoid, external",46083,CPT,,Both,,,2293.13,688,,,,,,,,,
INCISION&DRAINAGE ABSCESS COMPLICATED/MULTIPLE,10061,CPT,,Both,,,2605.13,782,,,,,,,,,
INCISION&DRAINAGE BURSA FOOT,28001,CPT,,Both,,,2123.52,637,,,,,,,,,
INCISION&REMOVAL FOREIGN BODY SUBQ TISS COMP,10121,CPT,,Both,,,3531.38,1059,,,,,,,,,
INCISION&REMOVAL FOREIGN BODY SUBQ TISS SMPL,10120,CPT,,Both,,,1954.25,586,,,,,,,,,
INCONTINENCE SUPPLY MISCELLANEOUS,A4335,HCPCS,,Both,,,4.84,1,,,,,,,,,
"FUROSEMIDE (LASIX) , TAB 20MG",J8499,HCPCS,,Both,0.02,GM,23.63,7,,,,,,,,,
Indometacin 50 Mg Oral Tab ,450,RC,,Both,,,11.39,3,,,,,,,,,
Furosemide (Lasix) 20mg/2mL Injection,J3490,HCPCS,,Both,20,ML,9.84,3,,,,,,,,,
INDWELLING CATHETER LATEX,A4338,HCPCS,,Both,,,16.14,5,,,,,,,,,
INF AGENT DET NUC ACID CLOSTRIDIUM AMP PROBE,87493,CPT,,Both,,,1020,306,,,,,,,,,
Infant Pulse Oximeter Adhesive Sensor- 300ct/box,A4649,HCPCS,,Both,,,157.5,47,,,,,,,,,
INFCT AGENT DNA/RNA GASTROINTESTINAL PATHOGEN,87506,CPT,,Both,,,1507.87,452,,,,,,,,,
Infectious agent antigen detection .... Cryptococcus neoformans,87327,CPT,,Both,,,49.27,15,,,,,,,,,
Infectious agent antigen detection by enzyme immunoassay tec...,87389,CPT,,Both,,,720,216,,,,,,,,,
Infectious agent antigen detection by immunofluorescent tech...,87280,CPT,,Both,,,68.57,21,,,,,,,,,
"Infectious agent det by nuc acid (DNA/RNA); H Papilloma V (HPV), high-risk type",87624,CPT,,Both,,,280.72,84,,,,,,,,,
Infectious agent detection by nucleic acid (DNA or RNA); pap...,87621,CPT,,Both,,,119.43,36,,,,,,,,,
Infectious agent detection by nucleic acid (DNA or RNA); sev,U0003,HCPCS,,Both,,,523.95,157,,,,,,,,,
"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, methicillin resistant, amplified probe technique",87641,CPT,,Both,,,1440,432,,,,,,,,,
"Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe technique",87491,CPT,,Both,,,756,227,,,,,,,,,
INFECTIOUS AGENT DNA/RNA INFLUENZA 1ST 2 TYPES,87502,CPT,,Both,,,551.57,165,,,,,,,,,
"Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid)",87905,CPT,,Both,,,210,63,,,,,,,,,
INFLUENZA A,87400,CPT,,Both,,,258.55,78,,,,,,,,,
"INFLUENZA A H1N1, VACCINE",G9142,HCPCS,,Both,,,252.16,76,,,,,,,,,
"INFLUENZA A H1N1,ADMIN W COU",G9141,HCPCS,,Both,,,7.93,2,,,,,,,,,
INFLUENZA B,87400,CPT,,Both,,,258.55,78,,,,,,,,,
Influenza Vaccine Quadrivalent,90685,CPT,,Both,,,189.11,57,,,,,,,,,
INFLUENZA VIRUS VACC SPLIT PRSRV FR 3 YEARS + IM,90656,CPT,,Both,,,173.62,52,,,,,,,,,
INFLUENZA VIRUS VACCINE LIVE INTRANASAL,90660,CPT,,Both,,,319.3,96,,,,,,,,,
"Influenza virus vaccine, trivalent, split virus, when admini...",90658,CPT,,Both,,,256.53,77,,,,,,,,,
Infusion Supplies With Pump,A4222,HCPCS,,Both,,,387.44,116,,,,,,,,,
Inderal 20mg Tab,J8499,HCPCS,,Both,0.02,GM,26.78,8,,,,,,,,,
"Infusion, albumin (human), 5%, 50 ml ",P9041,HCPCS,,Both,,,278.25,83,,,,,,,,,
INFUVITE MULT VIT VL 5X2X5ML,450,RC,,Both,,,281.18,84,,,,,,,,,
INFUVITE MULT VIT VL 5X2X5ML,450,RC,,Both,,,267.79,80,,,,,,,,,
METHYLPREDNISOLONE 20 MG INJ,J1020,HCPCS,,Both,0.02,GM,3.76,1,,,,,,,,,
INHALATION SOLUTION FOR DME,J7699,HCPCS,,Both,,,11.36,3,,,,,,,,,
INHALATION TREATMENT - CONTINUOUS 1ST HR,94644,CPT,,Both,,,587.75,176,,,,,,,,,
INITIAL OBSERVATION CARE,99219,CPT,,Both,,,1710,513,,,,,,,,,
Initial observation care,99220,CPT,,Both,,,1950,585,,,,,,,,,
INITIAL TX 1ST DEGREE BURN LOCAL TX,16000,CPT,,Both,,,1512,454,,,,,,,,,
"PEPCID AC, TAB 20MG",A9150,HCPCS,,Both,0.02,GM,13.13,4,,,,,,,,,
INJ HEPARIN SODIUM PER 1000U,J1644,HCPCS,,Both,,,42.51,13,,,,,,,,,
INJ NALBUPHINE HYDROCHLORIDE,J2300,HCPCS,,Both,,,69.41,21,,,,,,,,,
"PREDNISON,TAB 20MG",J8499,HCPCS,,Both,0.02,GM,13.13,4,,,,,,,,,
"INJ PERFLUTREN LIP MICROS,ML",Q9957,HCPCS,,Both,,,176.1,53,,,,,,,,,
SIMETHICONE 20MG/0.3ML,A9150,HCPCS,,Both,20,ML,5.78,2,,,,,,,,,
INJ RETROGRADE URETHROCSTOGRAPY,51610,CPT,,Both,,,773.43,232,,,,,,,,,
INJ TENDON ORIGIN/INSERTION,20551,CPT,,Both,,,1309.39,393,,,,,,,,,
"Inj, anesthetic agent a/o steroid, plantar common digital nerve(s) ",64455,CPT,,Both,,,1174.81,352,,,,,,,,,
"ACETYLCYSTEINE (MUCOMYST) , VL 200MG/ML 4ML",J3490,HCPCS,,Both,200,ML,60.2,18,,,,,,,,,
"AZITHROMYCIN, SUSP RECON 200MG/5ML",J8499,HCPCS,,Both,200,ML,113.19,34,,,,,,,,,
INJECT SI JOINT ARTHRGRPHY&/ANES/STEROID W/IMA,27096,CPT,,Both,,,1686.56,506,,,,,,,,,
INJECTION - UNLISTED THERAPEUTIC PROPH/DX IV/IA NJX/NFS,96379,CPT,,Both,,,294.25,88,,,,,,,,,
INJECTION ANESTHETIC AGENT SCIATIC NRV SINGLE,64445,CPT,,Both,,,1741.88,523,,,,,,,,,
INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES,20552,CPT,,Both,,,1020,306,,,,,,,,,
INJECTION SINGLE/MLT TRIGGER POINT 3/> MUSCLES,20553,CPT,,Both,,,1020,306,,,,,,,,,
"Injection(s); single tendon sheath, or ligament, aponeurosis (eg, plantar ",20550,CPT,,Both,,,1020,306,,,,,,,,,
"FLUCONAZOLE (DIFLUCAN) , TAB 200MG",J8499,HCPCS,,Both,0.2,GM,34.13,10,,,,,,,,,
"IBUPROFEN, 200MG TAB",A9150,HCPCS,,Both,0.2,GM,1.31,1,,,,,,,,,
"INFUVITE, VL ADLT INFUSION Vitamin K 200 mg - 150 mcg/10ML 2VL DOSE",J3490,HCPCS,,Both,200,ML,125.5,38,,,,,,,,,
"Tussin Liquid, GUAIFENESIN; 200 mg/10mL",J3490,HCPCS,,Both,200,ML,6.41,2,,,,,,,,,
"INJECTION, BUPIVICAINE HYDRO",S0020,HCPCS,,Both,,,210,63,,,,,,,,,
"Injection, bamlanivimab and etesevimab, 2100 mg",Q0245,HCPCS,,Both,2100,ML,0.01,1,,,,,,,,,
"Injection, casirivimab and imdevimab, 2400 mg",Q0243,HCPCS,,Both,2.4,GM,0.01,1,,,,,,,,,
ACTIVATED CHARCOAL 25G,J3490,HCPCS,,Both,,,40.36,12,,,,,,,,,
"Injection, octreotide, non-depot form for subcutaneous or intravenous injection, 25 mcg ",J2354,HCPCS,,Both,25,GM,30.29,9,,,,,,,,,
SYNTHROID ( Levothyroxine Sodium ) 25MCG TAB,J8499,HCPCS,,Both,25,GM,55.13,17,,,,,,,,,
"Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml",A9579,HCPCS,,Both,,,16.54,5,,,,,,,,,
ATARAX? Hydroxyzine HCl 25 mg,J8499,HCPCS,,Both,0.025,GM,17.76,5,,,,,,,,,
"INJECTION, INTRA-ARTERIAL",96373,CPT,,Both,,,359.54,108,,,,,,,,,
"INJECTION, INTRAMUSCULAR OR SUBCUTANEOUS",96372,CPT,,Both,,,1512,454,,,,,,,,,
Atenolol 25mg Qty 100 tabs,J8499,HCPCS,,Both,0.025,GM,2.94,1,,,,,,,,,
benadryl 25mg tab,A9150,HCPCS,,Both,0.025,GM,13.38,4,,,,,,,,,
Captopril 25mg tab,J8499,HCPCS,,Both,0.025,GM,14.77,4,,,,,,,,,
"Chlordiazepoxide HCL, 25 mg ",J8499,HCPCS,,Both,0.025,GM,1.34,1,,,,,,,,,
"HYDRALAZINE(APRESOLINE), TAB 25MG",J8499,HCPCS,,Both,0.025,GM,5.78,2,,,,,,,,,
Hydrochlorothiazide (Microzide) 25 mg Tab,J8499,HCPCS,,Both,0.025,GM,0.36,1,,,,,,,,,
"INDOMETHACIN, CAP 25MG",J8499,HCPCS,,Both,0.025,GM,25.5,8,,,,,,,,,
Januvia Sitagliptin Phosphate 25MG,J8499,HCPCS,,Both,0.025,GM,209.5,63,,,,,,,,,
Januvia Sitagliptin Phosphate 25MG,J8499,HCPCS,,Both,0.025,GM,199.52,60,,,,,,,,,
"INJECTION, PENICILLIN G BENZATHINE AND PENICILLIN G PROCAINE...",J0558,HCPCS,,Both,,,90.07,27,,,,,,,,,
Losartan Potassium 25mg Tab,J8499,HCPCS,,Both,0.025,GM,1.32,1,,,,,,,,,
"Meclizine HCL(ANTIVERT), 25MG TAB",J8499,HCPCS,,Both,0.025,GM,20.48,6,,,,,,,,,
"INJECTION, PIPERACILLIN SODI",S0081,HCPCS,,Both,,,3.49,1,,,,,,,,,
METOPROLOL (LOPRESSOR) 25MG TAB,J8499,HCPCS,,Both,0.025,GM,19.17,6,,,,,,,,,
METOPROLOL(LOPRESSOR) 25MG TABS 100/BT,J8499,HCPCS,,Both,0.025,GM,20.13,6,,,,,,,,,
Nicardipine HCl 25 mg / 10 mL Injection SDV,J3490,HCPCS,,Both,25,ML,214.13,64,,,,,,,,,
"INJECTION, SULFAMETHOXAZOLE",S0039,HCPCS,,Both,,,54.37,16,,,,,,,,,
"Promethazine HCL, TAB 25MG",J8499,HCPCS,,Both,0.025,GM,26.78,8,,,,,,,,,
Vistaril (Hydroxyzine) tab per 25mg ,J3490,HCPCS,,Both,0.025,GM,36.06,11,,,,,,,,,
INSERT PLEURAL CATH,32550,CPT,,Both,,,13503.76,4051,,,,,,,,,
INSERT TUNNELED CV CATH - INSJ TUN CTR CVC W/O SUBQ PORT/PMP...,36558,CPT,,Both,,,10251.63,3075,,,,,,,,,
INSERTION WIRE/PIN W/APPL SKELETAL TRACTION SPX,20650,CPT,,Both,,,2622,787,,,,,,,,,
INSJ NON-TUN CTR CVC AGE 5 YR/>,36556,CPT,,Both,,,3014.13,904,,,,,,,,,
INSJ PRPH CVC W/O SUBQ PORT/PMP AGE 5 YR/>,36569,CPT,,Both,,,3169.88,951,,,,,,,,,
INSJ TEMP NDWELLG BLDR CATH COMP,51703,CPT,,Both,,,1619,486,,,,,,,,,
INSJ TEMP NDWELLG BLDR CATH SMPL,51702,CPT,,Both,,,1260,378,,,,,,,,,
Insulin antibodies,86337,CPT,,Both,,,124.58,37,,,,,,,,,
INSULIN RAPID 5 U,S5550,HCPCS,,Both,,,36.5,11,,,,,,,,,
INTEGRILIN .75MG/ML 100ML VL,450,RC,,Both,,,3062.68,919,,,,,,,,,
INTEGRILIN .75MG/ML 100ML VL,450,RC,,Both,,,2916.84,875,,,,,,,,,
INTEGRILIN 2MG/ML 10ML VL,450,RC,,Both,,,980.27,294,,,,,,,,,
INTEGRILIN 2MG/ML 10ML VL,450,RC,,Both,,,933.59,280,,,,,,,,,
INTEREST,1010,HCPCS,,Both,,,3176.25,953,,,,,,,,,
INTERFACE CABLE NELLCOR,450,RC,,Both,,,1765.34,530,,,,,,,,,
INTERFACE CABLE NELLCOR,450,RC,,Both,,,1681.28,504,,,,,,,,,
INTERMITTENT URINARY CATH,A4353,HCPCS,,Both,,,32.28,10,,,,,,,,,
Intial OBS Care,99218,CPT,,Both,,,1500,450,,,,,,,,,
"Intravenous infusion, sotrovimab",M0247,HCPCS,,Both,,,1627.5,488,,,,,,,,,
INTRO NDL/INTRACATH VEIN,36000,CPT,,Both,,,364.4,109,,,,,,,,,
INTRODUCER ENDOTUBE 10/BX,450,RC,,Both,,,449.39,135,,,,,,,,,
INTRODUCER ENDOTUBE 10/BX,450,RC,,Both,,,427.98,128,,,,,,,,,
"Introduction of catheter, superior or inferior vena cava",36010,CPT,,Both,,,6558,1967,,,,,,,,,
INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE,31500,CPT,,Both,,,1373,412,,,,,,,,,
IODINE SOLUTION PREP 1OZ ,A9530,HCPCS,,Both,,,1.18,1,,,,,,,,,
"IODOFORM - PACKING STRIPS/GAUZE , NON-IMPREG",A6407,HCPCS,,Both,,,39.96,12,,,,,,,,,
IPECAC/SIMILAR ADMN EMESIS&OBS STOMACH EMPTIED,99175,CPT,,Both,,,212.75,64,,,,,,,,,
IPRATROPIUM .02% SOL25X2.5ML,450,RC,,Both,,,29.11,9,,,,,,,,,
IPRATROPIUM .02% SOL25X2.5ML,450,RC,,Both,,,27.72,8,,,,,,,,,
Iron,83540,CPT,,Both,,,1020,306,,,,,,,,,
IRON BNDNG CAP,83550,CPT,,Both,,,300,90,,,,,,,,,
IRRIGATION BOTTLE,A4649,HCPCS,,Both,,,21.39,6,,,,,,,,,
IRRIGATION CORPORA CAVERNOSA PRIAPISM,54220,CPT,,Both,,,2534,760,,,,,,,,,
IRRIGATION SYRINGE,A4322,HCPCS,,Both,,,21.39,6,,,,,,,,,
IRRIGATION TRAY,A4320,HCPCS,,Both,,,21.39,6,,,,,,,,,
ISLET CELL ANTIBODY,86341,CPT,,Both,,,124.58,37,,,,,,,,,
ISOLATION GOWN,450,RC,,Both,,,41.06,12,,,,,,,,,
AMOXICILLIN 250MG SUS 150ML,J8499,HCPCS,,Both,250,ML,18.62,6,,,,,,,,,
"AMOXICILLIN, CAP 250MG",J8499,HCPCS,,Both,0.25,GM,26.78,8,,,,,,,,,
"AZITHROMYCIN (ZITHROMAX), TAB 250MG",J8499,HCPCS,,Both,0.25,GM,13.13,4,,,,,,,,,
Calcium Carbonate 250mg Tablet,J8499,HCPCS,,Both,0.25,GM,0.14,1,,,,,,,,,
IV CATH 16X1.25 PROTECTIV+,450,RC,,Both,,,13.83,4,,,,,,,,,
IV CATH 16X1.25 PROTECTIV+,450,RC,,Both,,,13.17,4,,,,,,,,,
IV CATH 18X1.25 PROTECTIV +,450,RC,,Both,,,12.98,4,,,,,,,,,
IV CATH 18X1.25 PROTECTIV +,450,RC,,Both,,,12.36,4,,,,,,,,,
IV CATH 20X1 PROTECTIV + SAF,450,RC,,Both,,,12.93,4,,,,,,,,,
IV CATH 20X1 PROTECTIV + SAF,450,RC,,Both,,,12.31,4,,,,,,,,,
IV CATH 20X1 SAF WNG PUR,450,RC,,Both,,,12.56,4,,,,,,,,,
IV CATH 20X1 SAF WNG PUR,450,RC,,Both,,,11.95,4,,,,,,,,,
IV CATH 22X1 PROTECTIV+ SAF,450,RC,,Both,,,12.93,4,,,,,,,,,
IV CATH 22X1 PROTECTIV+ SAF,450,RC,,Both,,,12.31,4,,,,,,,,,
IV CATH 22X1 SAF WNG PUR,450,RC,,Both,,,12.56,4,,,,,,,,,
IV CATH 22X1 SAF WNG PUR,450,RC,,Both,,,11.95,4,,,,,,,,,
IV CATH 24X.75 PROTECTIV+ S,450,RC,,Both,,,13.83,4,,,,,,,,,
IV CATH 24X.75 PROTECTIV+ S,450,RC,,Both,,,13.17,4,,,,,,,,,
IV CATH 24X0.75 SAF WNG PUR,450,RC,,Both,,,12.56,4,,,,,,,,,
IV CATH 24X0.75 SAF WNG PUR,450,RC,,Both,,,11.95,4,,,,,,,,,
IV CATH ANY SIZE,A4649,HCPCS,,Both,,,217.92,65,,,,,,,,,
IV CATHETER VARIOUS SIZES,450,RC,,Both,,,58.21,17,,,,,,,,,
IV EXTENSION SET,S1015,HCPCS,,Both,,,90,27,,,,,,,,,
IV INFUSION HYDRATION EACH ADDITIONAL HOUR,96361,CPT,,Both,,,714,214,,,,,,,,,
IV INFUSION HYDRATION INITIAL 31 MIN-1 HOUR,96360,CPT,,Both,,,1512,454,,,,,,,,,
IV NFS THER PROPH/DX ADDL SEQUENTIAL NFS >1 HR,96367,CPT,,Both,,,1247,374,,,,,,,,,
IV NFS THERAPY PROPHYLAXIS/DX CONCURRENT NFS,96368,CPT,,Both,,,960,288,,,,,,,,,
iV PUSH ADD DRUG THER PROPH/DX NJX EA SEQL IV PUSH SBST/DRUG,96375,CPT,,Both,,,1406.25,422,,,,,,,,,
IV PUSH THER PROPH/DX NJX IV PUSH SINGLE/1ST SBST/DRUG,96374,CPT,,Both,,,1236,371,,,,,,,,,
IV SET BC 21X3/4 12,450,RC,,Both,,,7.34,2,,,,,,,,,
IV SET BC 21X3/4 12,450,RC,,Both,,,6.99,2,,,,,,,,,
IV SET BC 23X3/4 12,450,RC,,Both,,,6.55,2,,,,,,,,,
IV SET BC 23X3/4 12,450,RC,,Both,,,6.24,2,,,,,,,,,
IV SET BC 25X3/4 12,450,RC,,Both,,,6.55,2,,,,,,,,,
IV SET BC 25X3/4 12,450,RC,,Both,,,6.24,2,,,,,,,,,
IV START KIT,A4649,HCPCS,,Both,,,16.96,5,,,,,,,,,
IV START KIT,450,RC,,Both,,,40.43,12,,,,,,,,,
IV THERAPY 1ST >1 HOUR,96365,CPT,,Both,,,1512,454,,,,,,,,,
"IV THERAPY, EACH ADDL HOUR",96366,CPT,,Both,,,937,281,,,,,,,,,
IV TUBING,A4649,HCPCS,,Both,,,61.81,19,,,,,,,,,
IV TUBING EXTENSION SET,S1015,HCPCS,,Both,,,90,27,,,,,,,,,
IV TUBING PRIMARY,450,RC,,Both,,,61.81,19,,,,,,,,,
Ceftin (Cefuroxime Axetil) 250 mg tab,J8499,HCPCS,,Both,0.25,GM,3.28,1,,,,,,,,,
J0708,J0708,HCPCS,,Both,,,29.7,9,,,,,,,,,
J3490 MOTR,J3490,HCPCS,,Both,,,9.69,3,,,,,,,,,
J3490 VICO,J3490,HCPCS,,Both,,,6.45,2,,,,,,,,,
J3490CARD,J3490,HCPCS,,Both,,,10.27,3,,,,,,,,,
J3490DAV,J3490,HCPCS,,Both,,,10.27,3,,,,,,,,,
J3490TYL,J3490,HCPCS,,Both,,,10.27,3,,,,,,,,,
"CEPHALEXIN(KEFLEX), CAP 250MG",J8499,HCPCS,,Both,0.25,GM,39.95,12,,,,,,,,,
"CEPHALEXIN(KEFLEX), SUSP 250MG/ 5ML ",J8499,HCPCS,,Both,250,ML,16.8,5,,,,,,,,,
JOINT SURVEY SINGLE VIEW 2 OR MORE JOINTS,77077,CPT,,Both,,,2250.65,675,,,,,,,,,
KATZ EXTRACTOR,450,RC,,Both,,,1118.15,335,,,,,,,,,
KAYEXALATE POWDER 16OZ,450,RC,,Both,,,106.03,32,,,,,,,,,
KAYEXALATE POWDER 16OZ,450,RC,,Both,,,100.98,30,,,,,,,,,
KCL in D5NS (potassium chloride in 5% dextrose and sodium chloride injection),J3490,HCPCS,,Both,,,134.4,40,,,,,,,,,
DOBUTAMINE 250 MG/D5W 250 ML,J1250,HCPCS,,Both,250,ML,472.5,142,,,,,,,,,
Kerlix bandges (Any size),450,RC,,Both,,,3.22,1,,,,,,,,,
LEVAQUIN - LEVOFLOXACIN INJECTION 250MG,J1956,HCPCS,,Both,0.25,GM,165.45,50,,,,,,,,,
KETONE BODIES SERUM QUALITATIVE,82009,CPT,,Both,,,195.5,59,,,,,,,,,
KETOROLAC 30MG SDV 1ML,450,RC,,Both,,,8.32,2,,,,,,,,,
KETOROLAC 60MG/2ML VL,450,RC,,Both,,,6.91,2,,,,,,,,,
KETOROLAC 60MG/2ML VL,450,RC,,Both,,,6.58,2,,,,,,,,,
"LEVOFLOXACIN (LEVAQUIN) , TAB 250MG",J8499,HCPCS,,Both,0.25,GM,13.13,4,,,,,,,,,
Heparin Sodium 100 u/ml in 250 ml D5W,J3490,HCPCS,,Both,250,ML,80.8,24,,,,,,,,,
Knee - KO IMMOBILIZER CANVAS LONGIT,L1830,HCPCS,,Both,,,154,46,,,,,,,,,
KNEE IMMOB 16,450,RC,,Both,,,107.81,32,,,,,,,,,
KNEE IMMOB 16,450,RC,,Both,,,102.68,31,,,,,,,,,
KNEE IMMOB 20,450,RC,,Both,,,118.56,36,,,,,,,,,
KNEE IMMOB 20,450,RC,,Both,,,112.9,34,,,,,,,,,
"Knee orthosis, elastic with joints, prefabricated, off-the-shelf",L1812,HCPCS,,Both,,,1101.35,330,,,,,,,,,
KOTEX MAXIPAD REGULAR 24/BX,450,RC,,Both,,,28.32,8,,,,,,,,,
KOTEX MAXIPAD REGULAR 24/BX,450,RC,,Both,,,26.96,8,,,,,,,,,
L0114,L0114,HCPCS,,Both,,,80.71,24,,,,,,,,,
LABETALOL HCL 5MG/ML MDV 20M,450,RC,,Both,,,14.13,4,,,,,,,,,
LABETALOL HCL 5MG/ML MDV 20M,450,RC,,Both,,,13.46,4,,,,,,,,,
BISMUTH 262mg TAB,A9150,HCPCS,,Both,0.262,GM,0.99,1,,,,,,,,,
LACERATION TRAY WEBSTER NH,450,RC,,Both,,,34.13,10,,,,,,,,,
LACTOFERRIN FECAL (QUAL),83630,CPT,,Both,,,141.38,42,,,,,,,,,
LACTOFERRIN FECAL QUALITATIVE,86360,CPT,,Both,,,197,59,,,,,,,,,
LACTOFERRIN FECAL QUANTITATIVE,83631,CPT,,Both,,,127.26,38,,,,,,,,,
LACTULOSE 10GM/15ML SOL 16OZ,450,RC,,Both,,,50.94,15,,,,,,,,,
LACTULOSE 10GM/15ML SOL 16OZ,450,RC,,Both,,,48.51,15,,,,,,,,,
"LOCM 200-299MG/ML IODINE,1ML",Q9966,HCPCS,,Both,299,ML,31.25,9,,,,,,,,,
LANCET 21G SAFETY GRN 200/BX,450,RC,,Both,,,205.02,62,,,,,,,,,
LANCET 21G SAFETY GRN 200/BX,450,RC,,Both,,,195.26,59,,,,,,,,,
LANCET HEEL INCISION 1.2MM,450,RC,,Both,,,228.19,68,,,,,,,,,
LANCET HEEL INCISION 1.2MM,450,RC,,Both,,,217.31,65,,,,,,,,,
"IVERMECTIN, TAB 3MG ",J8499,HCPCS,,Both,0.003,GM,23.63,7,,,,,,,,,
"Laryngoscopy direct, with or without tracheoscopy; for aspiration",31515,CPT,,Both,,,2716,815,,,,,,,,,
LARYNGOSCOPY FLEXIBLE FIBEROPTIC DIAGNOSTIC,31575,CPT,,Both,,,1478,443,,,,,,,,,
LARYNGOSCOPY INDIRECT DIAGNOSTIC SPX,31505,CPT,,Both,,,1090.38,327,,,,,,,,,
LARYNGOSCOPY W/FB REMOVAL,31530,CPT,,Both,,,2539.58,762,,,,,,,,,
LARYNGOSCOPY W/WO TRACHEOSCOPY DX EXCEPT NEWBORN,31525,CPT,,Both,,,3256.38,977,,,,,,,,,
LASIX - FUROSEMIDE INJECTION,J1940,HCPCS,,Both,,,29.7,9,,,,,,,,,
LDH LACTATE DEHYDROGENASE,83615,CPT,,Both,,,600,180,,,,,,,,,
LEADWIRE SET 5 LEAD MIXED,450,RC,,Both,,,812.73,244,,,,,,,,,
LEADWIRE SET 5 LEAD MIXED,450,RC,,Both,,,774.02,232,,,,,,,,,
LEG BAG 500ML MED,450,RC,,Both,,,12.32,4,,,,,,,,,
LEG BAG 500ML MED,450,RC,,Both,,,11.72,4,,,,,,,,,
LEGION PNEUMOPHILIA AG IF,87278,CPT,,Both,,,86.31,26,,,,,,,,,
LENS REMOVER/INSERTER,450,RC,,Both,,,137.53,41,,,,,,,,,
LENS REMOVER/INSERTER,450,RC,,Both,,,130.98,39,,,,,,,,,
LENSES MORGAN MEDI FLOW,450,RC,,Both,,,199.56,60,,,,,,,,,
LENSES MORGAN MEDI FLOW,450,RC,,Both,,,190.05,57,,,,,,,,,
Leukocyte assessment,89055,CPT,,Both,,,684,205,,,,,,,,,
LEUKOCYTE HISTAMINE RELEASE TEST LHR,86343,CPT,,Both,,,89.72,27,,,,,,,,,
Sodium Chloride Inh 3mL 0.9%,J7699,HCPCS,,Both,3,ML,1.53,1,,,,,,,,,
LEVALBUTEROL 0.63MG/3ML SOL,450,RC,,Both,,,686.36,206,,,,,,,,,
LEVALBUTEROL 0.63MG/3ML SOL,450,RC,,Both,,,653.67,196,,,,,,,,,
LEVALBUTEROL 1.25MG/3ML SOL,450,RC,,Both,,,686.36,206,,,,,,,,,
LEVALBUTEROL 1.25MG/3ML SOL,450,RC,,Both,,,653.67,196,,,,,,,,,
LEVALBUTEROL COMP CON,J7607,HCPCS,,Both,,,25.99,8,,,,,,,,,
LEVALBUTEROL COMP UNIT,J7615,HCPCS,,Both,,,25.99,8,,,,,,,,,
LEUPROLIDE ACETATE /3.75 MG,J1950,HCPCS,,Both,0.00375,GM,4167.94,1250,,,,,,,,,
AMIODARONE HCL 30MG,J0282,HCPCS,,Both,0.03,GM,18.93,6,,,,,,,,,
"DULOXETINE DR, CAP 30MG",J8499,HCPCS,,Both,0.03,GM,55.5,17,,,,,,,,,
LEVAQUIN (LEVOFLOXIN) 750MG PO,450,RC,,Both,,,10.75,3,,,,,,,,,
"ISOSORBIDE MN ER, TAB 30MG",J8499,HCPCS,,Both,0.03,GM,7.88,2,,,,,,,,,
LEVAQUIN 500MG TABS 50/BT,450,RC,,Both,,,6.07,2,,,,,,,,,
LEVAQUIN 500MG TABS 50/BT,450,RC,,Both,,,5.78,2,,,,,,,,,
LEVAQUIN 5MG/ML 150ML,450,RC,,Both,,,204.47,61,,,,,,,,,
LEVAQUIN 5MG/ML 150ML,450,RC,,Both,,,194.73,58,,,,,,,,,
Nimodipine 30mg Tab,J8499,HCPCS,,Both,0.03,GM,1.03,1,,,,,,,,,
LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,88305,CPT,,Both,,,879.38,264,,,,,,,,,
"GASTROGAFIN, SOL 30 ML",J8498,HCPCS,,Both,30,ML,131.78,40,,,,,,,,,
"LACTULOSE, SOL 20GM/30ML",J8499,HCPCS,,Both,30,ML,11.03,3,,,,,,,,,
LIDOCAINE 2% (UROJET) JELLY TUBE 30ML(PER GRAM),A4736,HCPCS,,Both,30,ML,60.94,18,,,,,,,,,
Acetaminophen / Codeine 300 mg - 30 mg / 12.5 mL Unit Dose,J8499,HCPCS,,Both,300,ML,25.73,8,,,,,,,,,
LEVOLEUCOVORIN INJECTION,J0641,HCPCS,,Both,,,3.23,1,,,,,,,,,
LEVOPHED 1MG/ML 4ML VL,450,RC,,Both,,,70.95,21,,,,,,,,,
LEVOPHED 1MG/ML 4ML VL,450,RC,,Both,,,67.57,20,,,,,,,,,
"CEFDINIR, CAP 300MG",J8499,HCPCS,,Both,0.3,GM,26.78,8,,,,,,,,,
"CLINDAMYCIN HCL, CAP 300MG",J8499,HCPCS,,Both,0.3,GM,13.13,4,,,,,,,,,
Levsin PO,450,RC,,Both,,,14.81,4,,,,,,,,,
LIDOCAINE,J2001,HCPCS,,Both,,,42.7,13,,,,,,,,,
LIDOCAINE 1% MDV 10ML,450,RC,,Both,,,6.62,2,,,,,,,,,
LIDOCAINE 1% MDV 10ML,450,RC,,Both,,,6.3,2,,,,,,,,,
LIDOCAINE 1% MDV 50ML,450,RC,,Both,,,16.13,5,,,,,,,,,
LIDOCAINE 1% MDV 50ML,450,RC,,Both,,,15.36,5,,,,,,,,,
LIDOCAINE 1% W/EPI 20ML,450,RC,,Both,,,13.77,4,,,,,,,,,
LIDOCAINE 1% W/EPI 20ML,450,RC,,Both,,,13.1,4,,,,,,,,,
LIDOCAINE 1% W/EPI 50ML,450,RC,,Both,,,23.59,7,,,,,,,,,
LIDOCAINE 1% W/EPI 50ML,450,RC,,Both,,,22.47,7,,,,,,,,,
"CLINDAMYCIN HCL, CAP 300MG",J8499,HCPCS,,Both,0.3,GM,12.5,4,,,,,,,,,
"CLINDAMYCIN PHOSPHATE, 300MG/50ML IV solution",J0736,HCPCS,,Both,300,ML,64.95,19,,,,,,,,,
LIDOCAINE 2% 50ML,450,RC,,Both,,,20.98,6,,,,,,,,,
LIDOCAINE 2% 50ML,450,RC,,Both,,,19.98,6,,,,,,,,,
LIDOCAINE 2% JELLY TUBE 30ML,450,RC,,Both,,,58.04,17,,,,,,,,,
LIDOCAINE 2% L/S PFS 5ML,450,RC,,Both,,,19.59,6,,,,,,,,,
LIDOCAINE 2% L/S PFS 5ML,450,RC,,Both,,,18.65,6,,,,,,,,,
LIDOCAINE 2% SDV 5ML,450,RC,,Both,,,13.89,4,,,,,,,,,
LIDOCAINE 2% SDV 5ML,450,RC,,Both,,,13.23,4,,,,,,,,,
LIDOCAINE 2% VISCOUS,J8499,HCPCS,,Both,,,14.37,4,,,,,,,,,
LIDOCAINE 2% VISCOUS 100 (ORAL SOLUTION),J3490,HCPCS,,Both,,,13.69,4,,,,,,,,,
LIDOCAINE 2% W/EPI 50ML,450,RC,,Both,,,29.17,9,,,,,,,,,
LIDOCAINE 2% W/EPI 50ML,450,RC,,Both,,,27.78,8,,,,,,,,,
Lidocaine 2g in 250ml,450,RC,,Both,,,35.66,11,,,,,,,,,
Gabapentin (Neurotin) 300 mg TAB ,J8499,HCPCS,,Both,0.3,GM,1.16,1,,,,,,,,,
LIDOCAINE 4% TOP SOL 50ML,450,RC,,Both,,,28.25,8,,,,,,,,,
"LIDOCAINE 70 MG/TETRACAINE 70 MG, PER PATCH",C9285,HCPCS,,Both,,,114.53,34,,,,,,,,,
Omnipaque 300mg/ml per-1ml,Q9967,HCPCS,,Both,300,ML,3.71,1,,,,,,,,,
ACETAMIN TYLENOL 325 MG,A9150,HCPCS,,Both,0.325,GM,5.7,2,,,,,,,,,
"LIDOCAINE PATCH 5%, 700 mg",450,RC,,Both,,,61.11,18,,,,,,,,,
LIDOCAINE WITH PRILOCAINE 2.5/2.5 30 GRAM TUBE,J3490,HCPCS,,Both,,,123.38,37,,,,,,,,,
"LIGATION, DIVISION, ANDOR EXCISION OF VARICOSE VEIN CLUSTERS",37785,CPT,,Both,,,13064.58,3919,,,,,,,,,
LIGHT SOURCE,A4649,HCPCS,,Both,,,48.85,15,,,,,,,,,
LIMB RESTRAINT FOAM UNIV,450,RC,,Both,,,28.5,9,,,,,,,,,
LIMB RESTRAINT FOAM UNIV,450,RC,,Both,,,27.14,8,,,,,,,,,
LINER SUCT CANISTER 1000CC,450,RC,,Both,,,13.89,4,,,,,,,,,
LINER SUCT CANISTER 1000CC,450,RC,,Both,,,13.23,4,,,,,,,,,
LIPASE,83690,CPT,,Both,,,556,167,,,,,,,,,
LIPID PANEL,80061,CPT,,Both,,,1512,454,,,,,,,,,
LIPOPROTEIN DIR MEAS HIGH DENSITY CHOLESTEROL,83718,CPT,,Both,,,420,126,,,,,,,,,
LIPOPROTEIN DIRECT MEASUREMENT LDL CHOLESTEROL,83721,CPT,,Both,,,163.88,49,,,,,,,,,
LISINOPRIL 20MG,450,RC,,Both,,,1.28,1,,,,,,,,,
ASA ASPIRIN 325MG TAB,A9150,HCPCS,,Both,0.325,GM,1.58,1,,,,,,,,,
"ASPIRIN, 325MG TAB",A9150,HCPCS,,Both,0.325,GM,10.27,3,,,,,,,,,
LITHIUM,80178,CPT,,Both,,,113.63,34,,,,,,,,,
LMA AIRWAY UNIQUE STD SZ3,450,RC,,Both,,,102.72,31,,,,,,,,,
LMA AIRWAY UNIQUE STD SZ3,450,RC,,Both,,,97.83,29,,,,,,,,,
LMA AIRWAY UNIQUE STD SZ4,450,RC,,Both,,,102.72,31,,,,,,,,,
LMA AIRWAY UNIQUE STD SZ4,450,RC,,Both,,,97.83,29,,,,,,,,,
LMA AIRWAY UNIQUE STD SZ5,450,RC,,Both,,,102.72,31,,,,,,,,,
LMA AIRWAY UNIQUE STD SZ5,450,RC,,Both,,,97.83,29,,,,,,,,,
NORCO 5/325 MG  (Hydrocodone Bitartrate and Acetaminophen),J8499,HCPCS,,Both,0.325,GM,38.23,11,,,,,,,,,
TYLENOL 325 MG,J3490,HCPCS,,Both,0.325,GM,48.43,15,,,,,,,,,
Lomotil 2.5 mg tab (Diphenoxylate/Atropine),450,RC,,Both,,,15.88,5,,,,,,,,,
LONG ARM SPLINT SHOULDER HAND,29105,CPT,,Both,,,1455.35,437,,,,,,,,,
LONG LEG SPLINT,29355,CPT,,Both,,,1823,547,,,,,,,,,
LONG LEG SPLINT THIGH ANKLE/TOES,29505,CPT,,Both,,,1379.13,414,,,,,,,,,
LOPERAMIDE (IMODIUM)1 mg / 7.5 mL Liquid 4 oz,450,RC,,Both,,,3.5,1,,,,,,,,,
Omnipaque 350mg/ml per-1ml,Q9967,HCPCS,,Both,350,ML,3.71,1,,,,,,,,,
Tramadol HCl / Acetaminophen 37.5 mg - 325 mg Tab,J8499,HCPCS,,Both,0.0375,GM,2.17,1,,,,,,,,,
Lopermide Tab,450,RC,,Both,,,7.28,2,,,,,,,,,
Omnipaque 370mg/ml per-1ml,Q9967,HCPCS,,Both,370,ML,3.71,1,,,,,,,,,
Lorazepam 1mg tab,450,RC,,Both,,,15.04,5,,,,,,,,,
Omnipaque 370mg/ml per-1ml,Q9967,HCPCS,,Both,370,ML,3.53,1,,,,,,,,,
"ISOVUE-Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml",Q9967,HCPCS,,Both,399,ML,4.54,1,,,,,,,,,
DEXAMETHASONE SOD PHOS (DECADRON) 4MG/ML 1ML SDV (Per MG),J1100,HCPCS,,Both,4,ML,31.14,9,,,,,,,,,
Glimepiride 4mg Tab,J8499,HCPCS,,Both,0.004,GM,17.73,5,,,,,,,,,
LT COMPRES BAND <3?/YD,A6448,HCPCS,,Both,,,15.83,5,,,,,,,,,
LUBE JELLY 3GM FOIL SURGICAL,450,RC,,Both,,,55.61,17,,,,,,,,,
LUBE JELLY 3GM FOIL SURGICAL,450,RC,,Both,,,52.96,16,,,,,,,,,
LUBE JELLY 4OZ FLIP TOP TUBE,450,RC,,Both,,,8.67,3,,,,,,,,,
LUBE JELLY 4OZ FLIP TOP TUBE,450,RC,,Both,,,8.25,2,,,,,,,,,
LUBE STERILE PACKET,A4332,HCPCS,,Both,,,9.69,3,,,,,,,,,
LUMBAR PUNC TRAY ADLT 20X3-1,450,RC,,Both,,,121.71,37,,,,,,,,,
LUMBAR PUNC TRAY ADLT 20X3-1,450,RC,,Both,,,115.9,35,,,,,,,,,
LUMBAR PUNC TRAY ADLT 22X3-1,450,RC,,Both,,,129.71,39,,,,,,,,,
LUMBAR PUNC TRAY ADLT 22X3-1,450,RC,,Both,,,123.52,37,,,,,,,,,
LUMBAR PUNC TRAY IN 22X1-1/2,450,RC,,Both,,,103.45,31,,,,,,,,,
LUMBAR PUNC TRAY IN 22X1-1/2,450,RC,,Both,,,98.52,30,,,,,,,,,
LUMBAR X-RAY 4 VIEWS RADEX SPI LUMBOSAC MINIMUM 4 VIEWS,72110,CPT,,Both,,,3571,1071,,,,,,,,,
Lyme dis dna amp probe,87476,CPT,,Both,,,2421.21,726,,,,,,,,,
LYME DISEASE ANTIBODY,86617,CPT,,Both,,,300,90,,,,,,,,,
Tizanidine (Zanaflex) 4mg tab ,J8499,HCPCS,,Both,0.004,GM,5.99,2,,,,,,,,,
"BACTRIM SULFAMETHOXAZOLE +TMP, SUSP 200-40MG/5ML 475ML",J8499,HCPCS,,Both,40,ML,12.5,4,,,,,,,,,
MACROBID 100MG,450,RC,,Both,,,27.43,8,,,,,,,,,
MAGNESIUM,83735,CPT,,Both,,,600,180,,,,,,,,,
"MAGNESIUM CITRATE, LAX LEMON 10OZ SM",A9150,HCPCS,,Both,,,13.02,4,,,,,,,,,
Depo medrol 40mg/ml IV MDV,J3490,HCPCS,,Both,40,ML,63.58,19,,,,,,,,,
"DIOVAN (VALSARTAN) , TAB 40MG ",J8499,HCPCS,,Both,0.04,GM,79.11,24,,,,,,,,,
"INJECTION, DOPAMINE HCL, 40 MG",J1265,HCPCS,,Both,0.04,GM,24.66,7,,,,,,,,,
"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; C-/C+",73720,CPT,,Both,,,10265.45,3080,,,,,,,,,
Maint Drug Infus Cath Per Wk,A4221,HCPCS,,Both,,,195.17,59,,,,,,,,,
MANNITOL 20% 500ML INJ 24/CS,450,RC,,Both,,,81.62,24,,,,,,,,,
MANNITOL 20% 500ML INJ 24/CS,450,RC,,Both,,,77.73,23,,,,,,,,,
MANNITOL 25% 50ML VL,450,RC,,Both,,,11.16,3,,,,,,,,,
MANNITOL 25% 50ML VL,450,RC,,Both,,,10.63,3,,,,,,,,,
MANNITOL INJECTION,J2150,HCPCS,,Both,,,35.27,11,,,,,,,,,
MANUAL THERAPY 1/> REGIONS,97140,CPT,,Both,,,366.58,110,,,,,,,,,
MARCAINE .25% SDV PF 10ML,450,RC,,Both,,,17.7,5,,,,,,,,,
MARCAINE .25% SDV PF 10ML,450,RC,,Both,,,16.86,5,,,,,,,,,
MARCAINE .5% 50ML MDV,450,RC,,Both,,,24.08,7,,,,,,,,,
MARCAINE .5% 50ML MDV,450,RC,,Both,,,22.93,7,,,,,,,,,
Marcaine 0.25% injection per ml,J3490,HCPCS,,Both,,,1.2,1,,,,,,,,,
"OMEPRAZOLE, CAP 40MG ",J8499,HCPCS,,Both,0.04,GM,5.78,2,,,,,,,,,
MARKER XRAY L/R 1,450,RC,,Both,,,149.96,45,,,,,,,,,
MARKER XRAY L/R 1,450,RC,,Both,,,142.82,43,,,,,,,,,
MASK - NEBULIZER MASK - SPACER WITH MASK,S8101,HCPCS,,Both,,,138,41,,,,,,,,,
MASK - VARIABLE CONCENTRATION MASK - NON-REBREATHER MASK,A4620,HCPCS,,Both,,,76.13,23,,,,,,,,,
MASK GUARDALL FULL VISOR 40C,450,RC,,Both,,,11.1,3,,,,,,,,,
MASK GUARDALL FULL VISOR 40C,450,RC,,Both,,,10.56,3,,,,,,,,,
MASK HORIZONTAL TIE-ON 50BX,450,RC,,Both,,,28.74,9,,,,,,,,,
MASK HORIZONTAL TIE-ON 50BX,450,RC,,Both,,,27.37,8,,,,,,,,,
MASK OXYGEN ADLT NO-REBREATHCS,450,RC,,Both,,,7.33,2,,,,,,,,,
MASK OXYGEN ADLT NO-REBREATHEA,450,RC,,Both,,,7,2,,,,,,,,,
MASK OXYGEN ADLT NO-REBREATHEA,450,RC,,Both,,,7.33,2,,,,,,,,,
MASK OXYGEN ADULT W/7 TUBE,450,RC,,Both,,,4.91,1,,,,,,,,,
MASK OXYGEN ADULT W/7 TUBE,450,RC,,Both,,,4.68,1,,,,,,,,,
MASK PARTICULAT RESP N95 MED,450,RC,,Both,,,124.07,37,,,,,,,,,
MASK PARTICULAT RESP N95 MED,450,RC,,Both,,,118.16,35,,,,,,,,,
MASK PARTICULATE RESP N95 SM,450,RC,,Both,,,124.07,37,,,,,,,,,
MASK PARTICULATE RESP N95 SM,450,RC,,Both,,,118.16,35,,,,,,,,,
MASK PROC EAR LOOP BLU 50/BX,450,RC,,Both,,,24.8,7,,,,,,,,,
MASK PROC EAR LOOP BLU 50/BX,450,RC,,Both,,,23.63,7,,,,,,,,,
MASK PROC EAR LOOP YLW 50/BX,450,RC,,Both,,,36.14,11,,,,,,,,,
MASK PROC EAR LOOP YLW 50/BX,450,RC,,Both,,,34.42,10,,,,,,,,,
MASK TRACH ADULT W/O TUBE,450,RC,,Both,,,7.58,2,,,,,,,,,
MASK TRACH ADULT W/O TUBE,450,RC,,Both,,,7.22,2,,,,,,,,,
MASK WITH EYESHIELD 25/BX,450,RC,,Both,,,134.74,40,,,,,,,,,
MASK WITH EYESHIELD 25/BX,450,RC,,Both,,,128.32,38,,,,,,,,,
Mastisol Adhesive ,450,RC,,Both,,,12.08,4,,,,,,,,,
MASTOTOMY W/EXPL/DRAINAGE ABSCESS DEEP,19020,CPT,,Both,,,6113,1834,,,,,,,,,
Maxitrol,450,RC,,Both,,,846.5,254,,,,,,,,,
Maxtriol ointment,450,RC,,Both,,,1011.26,303,,,,,,,,,
MEAS POST-VOIDING RESIDUAL URINE&/BLADDER CAP,51798,CPT,,Both,,,1261.61,378,,,,,,,,,
MEASLES MUMPS RUBELLA VIRUS VACCINE LIVE SUBQ,90707,CPT,,Both,,,928.3,278,,,,,,,,,
"PILOCARPINE HYDROCHLORIDE, drops; 40 mg/mL",J3490,HCPCS,,Both,40,ML,1069.85,321,,,,,,,,,
PROTONIX - PANTROPRAZOLE 40MG INJ,J2470,HCPCS,,Both,0.04,GM,267,80,,,,,,,,,
MED TRED SLIPPER SOCKS,450,RC,,Both,,,13.01,4,,,,,,,,,
Protonix-Pantoprazole 40mg Tab,J3490,HCPCS,,Both,0.04,GM,94.1,28,,,,,,,,,
Septra (Sulfamethoxazole And Trimethoprim)  200-40 MG / 5 ML Suspension,J8499,HCPCS,,Both,40,ML,13.13,4,,,,,,,,,
SOLU-MEDROL - METHYLPREDNISOLONE 40 MG INJ,J1030,HCPCS,,Both,0.04,GM,7.19,2,,,,,,,,,
"VERAPAMIL HCL, TAB 40MG (100/BT)",J3490,HCPCS,,Both,0.04,GM,168.57,51,,,,,,,,,
"XOFLUZA, TAB 40MG",J8499,HCPCS,,Both,0.04,GM,780.37,234,,,,,,,,,
(MAALOX/MYLANTA ) MILK OF MAGNESIA 400 mg / 5 mL,A9150,HCPCS,,Both,400,ML,9.98,3,,,,,,,,,
MENTAL STATUS ASSESSED,2014F,HCPCS,,Both,,,1.47,1,,,,,,,,,
"ACYCLOVIR (ZOVIRAX) , TAB 400MG",J8499,HCPCS,,Both,0.4,GM,5.78,2,,,,,,,,,
"AMOXICILLIN, SUSP 400MG/5ML 100ML",J8499,HCPCS,,Both,400,ML,8.28,2,,,,,,,,,
"IBUPROFEN, TAB 400MG",A9150,HCPCS,,Both,0.4,GM,1.58,1,,,,,,,,,
Methocarbamol 500 mg tab (Robaxin),450,RC,,Both,,,79.55,24,,,,,,,,,
MAGNESIUM OXIDE 400mg PO,J8499,HCPCS,,Both,0.4,GM,3.15,1,,,,,,,,,
METHOCARBAMOL 750MG 100/BT,450,RC,,Both,,,102.35,31,,,,,,,,,
METHOCARBAMOL 750MG 100/BT,450,RC,,Both,,,97.48,29,,,,,,,,,
"SULFAMETHOXAZOLE+TRIMETHOPRIM,TAB 400MG/80MG",J8499,HCPCS,,Both,0.4,GM,13.13,4,,,,,,,,,
METHOCARBOMAL INJECTION,J2800,HCPCS,,Both,,,29.46,9,,,,,,,,,
TYLENOL 400 MG,J3490,HCPCS,,Both,0.4,GM,88.79,27,,,,,,,,,
METHYLPRED ACE 80MG/ML 1ML,450,RC,,Both,,,44.38,13,,,,,,,,,
METHYLPRED ACE 80MG/ML 1ML,450,RC,,Both,,,42.27,13,,,,,,,,,
TYLENOL 450MG,J3490,HCPCS,,Both,0.45,GM,96.85,29,,,,,,,,,
METHYLPREDNISOLONE INJECTION,J2920,HCPCS,,Both,,,14.35,4,,,,,,,,,
"(VESICARE) SOLIFENACIN SUCCINATE, TAB 5MG",J8499,HCPCS,,Both,0.005,GM,5.78,2,,,,,,,,,
METOCLOPRAMIDE HCL INJECTION,J2765,HCPCS,,Both,,,41.56,12,,,,,,,,,
"APRACLONIDINE HYDROCHLORIDE, 5 mg/mL",J8499,HCPCS,,Both,5,ML,1152.48,346,,,,,,,,,
"BISACODYL EC, TAB 5MG",A9150,HCPCS,,Both,0.005,GM,7.88,2,,,,,,,,,
"CETIRIZINE-PSE HCL,TAB 5MG-120MG",J8499,HCPCS,,Both,0.005,GM,13.13,4,,,,,,,,,
"CYCLOBENZAPRINE (FLEXIRIL) , TAB 5MG",J8499,HCPCS,,Both,0.005,GM,3.68,1,,,,,,,,,
"DIAZEPAM (VALIUM) , TAB 5MG",J8499,HCPCS,,Both,0.005,GM,13.13,4,,,,,,,,,
DILTIAZEM (CARDIZEM) 5MG/ML - 125 MG/25 ML VIAL(MDV),J3490,HCPCS,,Both,5,ML,35.68,11,,,,,,,,,
Diltiazem(Cardizem) HCl 5 mg / mL Injection Single Dose Vial 5 mL(25mg),J3490,HCPCS,,Both,5,ML,35.68,11,,,,,,,,,
METRONIDAZOLE 500MG 100/EA,450,RC,,Both,,,327.85,98,,,,,,,,,
Metronidazole 500mg/100ml inj,S0030,HCPCS,,Both,,,370.06,111,,,,,,,,,
MICROSOMAL ANTIBODIES EACH,86376,CPT,,Both,,,850,255,,,,,,,,,
ELIQUIS (APIXABAN) PER 5 MG,J8499,HCPCS,,Both,0.005,GM,100.59,30,,,,,,,,,
MILK OF MAG SUS 480ML,450,RC,,Both,,,14.13,4,,,,,,,,,
MILK OF MAG SUS 480ML,450,RC,,Both,,,13.46,4,,,,,,,,,
MINERAL OIL,J3490,HCPCS,,Both,,,10,3,,,,,,,,,
"MIRALAX SACHET, PWD 17GM",A9150,HCPCS,,Both,,,12.5,4,,,,,,,,,
"MIRALAX SACHET, PWD 17GM",A9150,HCPCS,,Both,,,13.13,4,,,,,,,,,
MISC/EXPER NON-PRESCRIPT DRU,A9150,HCPCS,,Both,,,9.32,3,,,,,,,,,
"Mitochondrial antibody (eg, M2), each",86381,CPT,,Both,,,267.23,80,,,,,,,,,
MOD SED OTHER PHYS/QHP EACH ADDL 15 MINS,99157,CPT,,Both,,,686.07,206,,,,,,,,,
MOD SED OTHER PHYS/QHP INITIAL 15 MINS <5 YRS,99155,CPT,,Both,,,1147.02,344,,,,,,,,,
MOD SED OTHER PHYS/QHP INITIAL 15 MINS 5/> YRS,99156,CPT,,Both,,,899.22,270,,,,,,,,,
MOD SED SAME PHYS/QHP EACH ADDL 15 MINS,99153,CPT,,Both,,,1200,360,,,,,,,,,
MOD SED SAME PHYS/QHP INITIAL 15 MINS <5 YRS,99151,CPT,,Both,,,687.47,206,,,,,,,,,
MOD SED SAME PHYS/QHP INITIAL 15 MINS 5/> YRS,99152,CPT,,Both,,,1500,450,,,,,,,,,
MONO - HTROPHL ANTIBODIES SCR,86308,CPT,,Both,,,524,157,,,,,,,,,
MONO TEST WAIVED 25/BX,450,RC,,Both,,,420.65,126,,,,,,,,,
MONO TEST WAIVED 25/BX,450,RC,,Both,,,400.62,120,,,,,,,,,
MONONUCLEAR CELL ANTIGEN QUANTITATIVE NOS EA,86356,CPT,,Both,,,110.8,33,,,,,,,,,
"Injection, eptifibatide, 5 mg",J1327,HCPCS,,Both,0.005,GM,57.5,17,,,,,,,,,
"LISINOPRIL, TAB 5MG ",J8499,HCPCS,,Both,0.005,GM,25.5,8,,,,,,,,,
LORTAB 5MG TAB,J3490,HCPCS,,Both,0.005,GM,8.64,3,,,,,,,,,
METOCLOPRAMIDE 5MG/ML ,J8499,HCPCS,,Both,5,ML,16.28,5,,,,,,,,,
MRA ABDOMEN W/WO CONTRAST MATERIAL,74185,CPT,,Both,,,6106.76,1832,,,,,,,,,
MRA HEAD C-MATRL,70544,CPT,,Both,,,6382.63,1915,,,,,,,,,
MRA LXTR C+-MATRL,73725,CPT,,Both,,,6456.69,1937,,,,,,,,,
MRA NCK C-MATRL,70547,CPT,,Both,,,6366.88,1910,,,,,,,,,
MRA NECK W/O &W/CONTRAST MATERIAL,70549,CPT,,Both,,,7970.5,2391,,,,,,,,,
MRCP - Magnetic resonance cholangiopancreatography,S8037,HCPCS,,Both,,,1775.59,533,,,,,,,,,
MRI ABD C-/C+,74183,CPT,,Both,,,10265.45,3080,,,,,,,,,
MRI ABD C-MATRL,74181,CPT,,Both,,,6668.26,2000,,,,,,,,,
MRI ANY JT LXTR C-/C+,73723,CPT,,Both,,,10265.45,3080,,,,,,,,,
MRI ANY JT LXTR C+ MATRL,73722,CPT,,Both,,,9074.6,2722,,,,,,,,,
MRI ANY JT LXTR C-MATRL,73721,CPT,,Both,,,6086.21,1826,,,,,,,,,
MRI ANY JT UXTR C-/C+,73223,CPT,,Both,,,10265.45,3080,,,,,,,,,
MRI ANY JT UXTR C-MATRL,73221,CPT,,Both,,,6086.21,1826,,,,,,,,,
MRI BRN BRN STEM C-/C+,70553,CPT,,Both,,,10265.45,3080,,,,,,,,,
MRI BRN BRN STEM C-MATRL,70551,CPT,,Both,,,6086.21,1826,,,,,,,,,
MRI CH C-MATRL,71550,CPT,,Both,,,6086.21,1826,,,,,,,,,
MRI LOWER EXTREM OTH/THN JT W/O CONTR MATRL,73718,CPT,,Both,,,7814,2344,,,,,,,,,
MRI ORBIT FACE & NECK W/O & W/CONTRAST MATRL,70543,CPT,,Both,,,7173.88,2152,,,,,,,,,
MRI ORBIT FACE &/NECK W/O CONTRAST,70540,CPT,,Both,,,5859.84,1758,,,,,,,,,
MRI ORBIT/FACE/NECK C+,70542,CPT,,Both,,,6074.25,1822,,,,,,,,,
MRI PELVIS C+ MATRL,72196,CPT,,Both,,,9074.6,2722,,,,,,,,,
MRI PELVIS C-MATRL,72195,CPT,,Both,,,8079.63,2424,,,,,,,,,
MRI PELVIS W/O & W/CONTRAST MATERIAL,72197,CPT,,Both,,,7340.5,2202,,,,,,,,,
MRI SPI CANAL&CNTS C-/C+,72157,CPT,,Both,,,10265.45,3080,,,,,,,,,
MRI SPI CANAL&CNTS C-/C+ CRV,72156,CPT,,Both,,,10265.45,3080,,,,,,,,,
MRI SPI CANAL&CNTS C-/C+ LMBR,72158,CPT,,Both,,,12203.69,3661,,,,,,,,,
MRI SPI CANAL&CNTS CRV C-MATRL,72141,CPT,,Both,,,8785.87,2636,,,,,,,,,
MRI SPI CANAL&CNTS LMBR C-MATRL,72148,CPT,,Both,,,8385.37,2516,,,,,,,,,
MRI SPI CANAL&CNTS THRC C-MATRL,72146,CPT,,Both,,,4859,1458,,,,,,,,,
MRI TEMPOROMANDIBULAR JOINT,70336,CPT,,Both,,,1985.67,596,,,,,,,,,
MRI UPPER EXTREMITY OTH THAN JT W/O CONTR MATRL,73218,CPT,,Both,,,5059.63,1518,,,,,,,,,
MRI UXTR OTH/THN JT C-/C+,73220,CPT,,Both,,,10265.45,3080,,,,,,,,,
M-SEDATION BY PHYS OTH/THN HC PROF PERFRMG 5+,99149,CPT,,Both,,,539.65,162,,,,,,,,,
"METOCLOPRAMIDE, TAB 5MG ",J8499,HCPCS,,Both,0.005,GM,13.13,4,,,,,,,,,
Multivitamin (Single vitamin nos) ,A9153,HCPCS,,Both,,,0.96,1,,,,,,,,,
Mycoplasma antibody,86738,CPT,,Both,,,317.76,95,,,,,,,,,
MYCOPLASMA PNEUMONIAE,87581,CPT,,Both,,,360,108,,,,,,,,,
MYELIN BASIC PROTEIN CEREBROSPINAL FLUID,83873,CPT,,Both,,,295.63,89,,,,,,,,,
MYELOGRAPY LUMBOSAC RS&I,72265,CPT,,Both,,,7196.31,2159,,,,,,,,,
MYELOGRAPY THRC RS&I,72255,CPT,,Both,,,3903.42,1171,,,,,,,,,
MYOGLOBIN,83874,CPT,,Both,,,780,234,,,,,,,,,
N BLOCK INJ BRACHIAL PLEXUS,64415,CPT,,Both,,,782.67,235,,,,,,,,,
N BLOCK INJ OCCIPITAL,64405,CPT,,Both,,,1315.22,395,,,,,,,,,
NAIL POLISH REMOVER PAD,450,RC,,Both,,,32.74,10,,,,,,,,,
NAIL POLISH REMOVER PAD,450,RC,,Both,,,31.19,9,,,,,,,,,
NALOXONE 1MG/ML SYR 2ML,450,RC,,Both,,,125.4,38,,,,,,,,,
NALOXONE 1MG/ML SYR 2ML,450,RC,,Both,,,119.43,36,,,,,,,,,
Naphcon-A Opthalmic drops,A9150,HCPCS,,Both,,,11.28,3,,,,,,,,,
NAPROXEN SOD 220MG CPL 100BT,450,RC,,Both,,,62.94,19,,,,,,,,,
NAPROXEN SOD 220MG CPL 100BT,450,RC,,Both,,,59.94,18,,,,,,,,,
"Norvasc (Amlodipine), TAB 5MG",J8499,HCPCS,,Both,5,ML,41.67,13,,,,,,,,,
"NAPROXEN, TAB 500MG",450,RC,,Both,,,12.38,4,,,,,,,,,
NARCAN 2MG INJ,450,RC,,Both,,,264.38,79,,,,,,,,,
NASAL ATOMIZATION DEVICE W/O SYRINGE,450,RC,,Both,,,55.97,17,,,,,,,,,
NASAL ENDOSCOPY DIAGNOSTIC UNI/BI SPX,31231,CPT,,Both,,,3739.25,1122,,,,,,,,,
NASAL SPRAY,A9150,HCPCS,,Both,,,64.08,19,,,,,,,,,
NASO/ORO-GASTRIC TUBE PLMT REQ PHYS&FLUOR GDN,43752,CPT,,Both,,,2332,700,,,,,,,,,
NEBULIZER ADMINISTRATION SET,A7003,HCPCS,,Both,,,77.96,23,,,,,,,,,
NEBULIZER DOME & MOUTHPIECE,A7016,HCPCS,,Both,,,32.28,10,,,,,,,,,
NEBULIZER FOR USE W/ REGULAT,E0580,HCPCS,,Both,,,403.55,121,,,,,,,,,
NEBULIZER MASK NOT USED W OXYGEN,A7017,HCPCS,,Both,,,77.96,23,,,,,,,,,
NEBULIZER MASK USED W NEBULIZER,A7015,HCPCS,,Both,,,77.96,23,,,,,,,,,
NEBULIZER PED MASK 7 TUBE,450,RC,,Both,,,9.89,3,,,,,,,,,
NEBULIZER PED MASK 7 TUBE,450,RC,,Both,,,9.41,3,,,,,,,,,
NEBULIZER TREATMENT AIRWAY INHALATION TREATMENT - PRESS/N-PR...,94640,CPT,,Both,,,347,104,,,,,,,,,
NEBULIZER W/MOUTHPIECE ADULTCS,450,RC,,Both,,,6.01,2,,,,,,,,,
NEBULIZER W/MOUTHPIECE ADULTCS,450,RC,,Both,,,5.71,2,,,,,,,,,
NEBULIZER WITH COMPRESSION,E0570,HCPCS,,Both,,,1092,328,,,,,,,,,
NEEDLE 18X1.5 BLUNT FILL,450,RC,,Both,,,30.44,9,,,,,,,,,
NEEDLE 18X1.5 BLUNT FILL,450,RC,,Both,,,28.99,9,,,,,,,,,
NEEDLE 18X1.5 SAF PREVENT M,450,RC,,Both,,,79.75,24,,,,,,,,,
NEEDLE 18X1.5 SAF PREVENT M,450,RC,,Both,,,75.94,23,,,,,,,,,
NEEDLE 18X1.5 TW 100/BX,450,RC,,Both,,,30.44,9,,,,,,,,,
NEEDLE 18X1.5 TW 100/BX,450,RC,,Both,,,28.99,9,,,,,,,,,
NEEDLE 21X1 SAF PREVENT M,450,RC,,Both,,,79.75,24,,,,,,,,,
NEEDLE 21X1 SAF PREVENT M,450,RC,,Both,,,75.94,23,,,,,,,,,
NEEDLE 22X1.5 TW 100/BX,450,RC,,Both,,,30.44,9,,,,,,,,,
NEEDLE 22X1.5 TW 100/BX,450,RC,,Both,,,28.99,9,,,,,,,,,
NEEDLE 23X1 SAF PREVENT M,450,RC,,Both,,,79.75,24,,,,,,,,,
NEEDLE 23X1 SAF PREVENT M,450,RC,,Both,,,75.94,23,,,,,,,,,
NEEDLE 23X1 TW 100/BX,450,RC,,Both,,,30.44,9,,,,,,,,,
NEEDLE 23X1 TW 100/BX,450,RC,,Both,,,28.99,9,,,,,,,,,
NEEDLE 25X1 SAF PREVENT M,450,RC,,Both,,,79.75,24,,,,,,,,,
NEEDLE 25X1 SAF PREVENT M,450,RC,,Both,,,75.94,23,,,,,,,,,
NEEDLE 25X1 TW 100/BX,450,RC,,Both,,,30.44,9,,,,,,,,,
NEEDLE 25X1 TW 100/BX,450,RC,,Both,,,28.99,9,,,,,,,,,
NEEDLE 25X5/8 SAF PREVENT M,450,RC,,Both,,,79.75,24,,,,,,,,,
NEEDLE 25X5/8 SAF PREVENT M,450,RC,,Both,,,75.94,23,,,,,,,,,
NEEDLE 25X5/8 TW 100/BX,450,RC,,Both,,,30.44,9,,,,,,,,,
NEEDLE 25X5/8 TW 100/BX,450,RC,,Both,,,28.99,9,,,,,,,,,
NEEDLE 27X.5 TW 100/BX,450,RC,,Both,,,30.44,9,,,,,,,,,
NEEDLE 27X.5 TW 100/BX,450,RC,,Both,,,28.99,9,,,,,,,,,
NEEDLE 27X1.5,450,RC,,Both,,,22.8,7,,,,,,,,,
NEEDLE 27X1.5,450,RC,,Both,,,21.71,7,,,,,,,,,
NEEDLE BC 21X1.25 ECL,450,RC,,Both,,,108.06,32,,,,,,,,,
NEEDLE BC 21X1.25 ECL,450,RC,,Both,,,102.91,31,,,,,,,,,
NEEDLE BC 22X1.25 ECLIPSE,450,RC,,Both,,,108.06,32,,,,,,,,,
NEEDLE BC 22X1.25 ECLIPSE,450,RC,,Both,,,102.91,31,,,,,,,,,
NEEDLE INTRAOSSEOUS 18X3CM,450,RC,,Both,,,342.24,103,,,,,,,,,
NEEDLE INTRAOSSEOUS 18X3CM,450,RC,,Both,,,325.94,98,,,,,,,,,
NEEDLE SPINAL 22X3.5 QUINCKE,450,RC,,Both,,,269.96,81,,,,,,,,,
NEEDLE SPINAL 22X3.5 QUINCKE,450,RC,,Both,,,257.1,77,,,,,,,,,
NEEDLE SPINAL 25X3.5 QUINCKE,450,RC,,Both,,,269.96,81,,,,,,,,,
NEEDLE SPINAL 25X3.5 QUINCKE,450,RC,,Both,,,257.1,77,,,,,,,,,
"NEEDLE STERILE, ANY SIZE, EACH",A4215,HCPCS,,Both,,,17.36,5,,,,,,,,,
NEO-SYNEPH REG SPY 15ML,450,RC,,Both,,,27.84,8,,,,,,,,,
NEO-SYNEPH REG SPY 15ML,450,RC,,Both,,,26.5,8,,,,,,,,,
NEO-SYNEPH X/S SPY 15ML,450,RC,,Both,,,28.38,9,,,,,,,,,
NEO-SYNEPH X/S SPY 15ML,450,RC,,Both,,,27.03,8,,,,,,,,,
NEO-SYNEPHRINE - PHENYLEPHRINE HCL INJECTION,J2370,HCPCS,,Both,,,113.25,34,,,,,,,,,
"Prednisolone oral, per 5 mg",J7510,HCPCS,,Both,0.005,GM,13.13,4,,,,,,,,,
NERVE BLOCK ANES OTHER PRPH NRV/BRANCH,64450,CPT,,Both,,,1362,409,,,,,,,,,
NFCT DS CHRNC HCV 6 BIOCHEM ASSAY SRM ALG LVR,81596,CPT,,Both,,,721.9,217,,,,,,,,,
ZOLPIDEM TARTRATE/AMBIEN 5 MG,J8499,HCPCS,,Both,0.005,GM,64.16,19,,,,,,,,,
"NICODERM, Nicotine Patch ",S4990,HCPCS,,Both,,,34.02,10,,,,,,,,,
"(MAXITROL) NEOMY +POLY B +DEX, EYEDROP 0.1% 5ML",J3490,HCPCS,,Both,5,ML,52,16,,,,,,,,,
"(MAXITROL) NEOMY +POLY B +DEX, EYEDROP 0.1% 5ML",J3490,HCPCS,,Both,5,ML,54.6,16,,,,,,,,,
Amoxicil + Clavulanate (Augmentin) 400-57mg/ per 5ml Susp,J8499,HCPCS,,Both,5,ML,18.38,6,,,,,,,,,
N-INVAS EAR/PLS OXIMTRY F/O2 SAT MLT DETERS,94761,CPT,,Both,,,408,122,,,,,,,,,
N-INVAS PHYSIOLOGIC STD XTRC ART COMPL BI STD,93875,CPT,,Both,,,1162.2,349,,,,,,,,,
NITRAZINE PAP W/DISPENSER,450,RC,,Both,,,279.66,84,,,,,,,,,
NITRAZINE PAP W/DISPENSER,450,RC,,Both,,,266.34,80,,,,,,,,,
NITRO STAT- NITROGLYCERIN 2% OINT 1 GRAM,J3490,HCPCS,,Both,,,26.49,8,,,,,,,,,
NITRO-BID 2% OINT 30GM,450,RC,,Both,,,237.89,71,,,,,,,,,
NITRO-BID 2% OINT 30GM,450,RC,,Both,,,226.55,68,,,,,,,,,
"AMOXICILLIN, SUSP 400MG/5ML PER 5 ML",J8499,HCPCS,,Both,5,ML,7.88,2,,,,,,,,,
Atropine sulfate 1% Opth drop sol 5ml,J3490,HCPCS,,Both,5,ML,388.08,116,,,,,,,,,
Betamethasone Sodium Phosphate & Acetate 5mL,J0702,HCPCS,,Both,5,ML,502.43,151,,,,,,,,,
Nitroglycerin 25mg/250ml,450,RC,,Both,,,43.9,13,,,,,,,,,
Nitroglycerin Cardiac Drip ,450,RC,,Both,,,87.8,26,,,,,,,,,
Nitroglycerin Paste,450,RC,,Both,,,237.89,71,,,,,,,,,
"CEFDINIR, SUSP RECON 125MG/5ML- PER 5ML",J8499,HCPCS,,Both,5,ML,154.04,46,,,,,,,,,
NITROSTAT .4MG TABS 25/BT,450,RC,,Both,,,88.04,26,,,,,,,,,
NITROSTAT .4MG TABS 25/BT,450,RC,,Both,,,83.85,25,,,,,,,,,
NJX ANES FACIAL NRV,64402,CPT,,Both,,,1561.63,468,,,,,,,,,
NJX ANES TRIGEMINAL NRV ANY DIV/BRANCH,64400,CPT,,Both,,,1585.4,476,,,,,,,,,
NJX C/P/A CAVERNOSA W/PHARMACOLOGIC AGT,54235,CPT,,Both,,,1120.63,336,,,,,,,,,
NJX RP LOCLZJ NON-IMG PROBE STUDY INTRAVENOUS,78808,CPT,,Both,,,2905.5,872,,,,,,,,,
NONDISPOS CORRUGATED TUBING,A7011,HCPCS,,Both,,,17.75,5,,,,,,,,,
NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL,93922,CPT,,Both,,,2921,876,,,,,,,,,
NON-INVASIVE PHYSIOLOGIC STUDY EXTREMITY 3 LEVLS; Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries,93923,CPT,,Both,,,3024,907,,,,,,,,,
Non-pneum walk boot pre ots,L4387,HCPCS,,Both,,,615.47,185,,,,,,,,,
NON-PNEUM WALK BOOT PREFAB,L4386,HCPCS,,Both,,,1252.23,376,,,,,,,,,
NON-ROUTINE BLOOD DRAW 3/> YRS,36410,CPT,,Both,,,378,113,,,,,,,,,
Norco (Opiate Agonist Hydrocodone Bitartrate/ Acetaminophen 10/ 325 mg) ,450,RC,,Both,,,19.25,6,,,,,,,,,
"CEFDINIR, SUSP RECON 250MG/5ML Per 5 ML",J8499,HCPCS,,Both,5,ML,68.78,21,,,,,,,,,
"Cheratussin Codeine-guaifenesin, PER 5 mL",A9150,HCPCS,,Both,5,ML,25.5,8,,,,,,,,,
"Cheratussin Codeine-guaifenesin, PER 5 mL",A9150,HCPCS,,Both,5,ML,26.78,8,,,,,,,,,
NORMAL SALINE SOLUTION INFUS 250cc,J7050,HCPCS,,Both,,,36.13,11,,,,,,,,,
"Cortisporin (NEOMY +POLY B +DEX, DRP 0.1% 5ML - Per Drop",J3490,HCPCS,,Both,5,ML,23.63,7,,,,,,,,,
NOVOLIN R INSLN 100U/ML 10ML,450,RC,,Both,,,703.83,211,,,,,,,,,
NOVOLIN R INSLN 100U/ML 10ML,450,RC,,Both,,,670.3,201,,,,,,,,,
"NOVOLIN R, PER 5 U ",J1815,HCPCS,,Both,,,8.5,3,,,,,,,,,
"Nystatin (Mycostatin) 1000,000 U/gm",J8499,HCPCS,,Both,,,69.09,21,,,,,,,,,
NYSTATIN CRM 30GM,450,RC,,Both,,,98.11,29,,,,,,,,,
NYSTATIN CRM 30GM,450,RC,,Both,,,93.44,28,,,,,,,,,
"NYSTATIN, CRM 100K U 30GM",A6250,HCPCS,,Both,,,25.5,8,,,,,,,,,
"CYCLOGYL, DRP OPHTH 1% 5ML",J3490,HCPCS,,Both,5,ML,125.5,38,,,,,,,,,
NZM ACTV CELLS/TISS NONRADACT SUBSTRATE EA,82657,CPT,,Both,,,102.54,31,,,,,,,,,
Observation care discharge,99217,CPT,,Both,,,1434,430,,,,,,,,,
Observation or inpatient hospital care,99236,CPT,,Both,,,2866.72,860,,,,,,,,,
OBSTETRIC PANEL,80081,CPT,,Both,,,485.21,146,,,,,,,,,
OCCULT BLOOD TEST SGL SLIDE,450,RC,,Both,,,320.96,96,,,,,,,,,
OCCULT BLOOD TEST SGL SLIDE,450,RC,,Both,,,305.68,92,,,,,,,,,
OFFICE OUTPATIENT NEW 10 MINUTES,99201,CPT,,Both,,,285,86,,,,,,,,,
OFFICE OUTPATIENT NEW 10 MINUTES ,99201,CPT,,Both,,,309.02,93,,,,,,,,,
OFFICE OUTPATIENT NEW 20 MINUTES,99202,CPT,,Both,,,583.07,175,,,,,,,,,
OFFICE OUTPATIENT NEW 30 MINUTES,99203,CPT,,Both,,,874.86,262,,,,,,,,,
OFFICE OUTPATIENT NEW 45 MINUTES,99204,CPT,,Both,,,1484.07,445,,,,,,,,,
OFFICE OUTPATIENT NEW 60 MINUTES,99205,CPT,,Both,,,1937.04,581,,,,,,,,,
OFFICE OUTPATIENT VISIT 10 MINUTES,99212,CPT,,Both,,,293.69,88,,,,,,,,,
OFFICE OUTPATIENT VISIT 15 MINUTES,99213,CPT,,Both,,,588.53,177,,,,,,,,,
OFFICE OUTPATIENT VISIT 25 MINUTES,99214,CPT,,Both,,,908.04,272,,,,,,,,,
OFFICE OUTPATIENT VISIT 40 MINUTES,99215,CPT,,Both,,,1279.32,384,,,,,,,,,
OFFICE OUTPATIENT VISIT 5 MINUTES ,99211,CPT,,Both,,,106.58,32,,,,,,,,,
"GENTAMICIN SULFATE, DRP 0.3% 5ML",J3490,HCPCS,,Both,5,ML,50.09,15,,,,,,,,,
OIL EMULSION DRESS 3X3 50/BX,450,RC,,Both,,,107.69,32,,,,,,,,,
OIL EMULSION DRESS 3X3 50/BX,450,RC,,Both,,,102.56,31,,,,,,,,,
OIL EMULSION DRESS 3X8 24/BX,450,RC,,Both,,,125.59,38,,,,,,,,,
OIL EMULSION DRESS 3X8 24/BX,450,RC,,Both,,,119.6,36,,,,,,,,,
Hydrocodone Bitartrate and Acetaminophen; LORTAB 2.5/108mg per 5mL,J8499,HCPCS,,Both,5,ML,58.17,17,,,,,,,,,
"NYSTATIN, ORAL SUSP 100K/ML 5ML",J8499,HCPCS,,Both,5,ML,131.78,40,,,,,,,,,
"ONDANSTRON, SOL 4MG/5ML PER 5 ML",J8499,HCPCS,,Both,5,ML,25.5,8,,,,,,,,,
"ONDANSTRON, SOL 4MG/5ML PER 5 ML",J8499,HCPCS,,Both,5,ML,25.5,8,,,,,,,,,
OMNIPAQUE 300MG 10X30ML,450,RC,,Both,,,2874.83,862,,,,,,,,,
OMNIPAQUE 300MG 10X30ML,450,RC,,Both,,,2737.93,821,,,,,,,,,
OMNIPAQUE 300MG POLY 10X100M,450,RC,,Both,,,6.07,2,,,,,,,,,
OMNIPAQUE 300MG POLY 10X100M,450,RC,,Both,,,5.78,2,,,,,,,,,
"TETRACAINE, DRP OPHTH 0.5% 5ML",J3490,HCPCS,,Both,5,ML,157.13,47,,,,,,,,,
"TobraDex, DROP OPHTH 0.3-0.1% 5ML",J3490,HCPCS,,Both,5,ML,997.71,299,,,,,,,,,
Lantus per 5 units,J1815,HCPCS,,Both,5,UN,16.91,5,,,,,,,,,
"ALLERGY RELIEF FLONASE, SPRAY KIDS 50MCG",J8499,HCPCS,,Both,,,13.58,4,,,,,,,,,
ONDANSETRON 2MG/ML 2ML VL,450,RC,,Both,,,5.15,2,,,,,,,,,
ONDANSETRON 4 MG,S0119,HCPCS,,Both,,,173.66,52,,,,,,,,,
ONDANSETRON 4MG TAB 30/BT,450,RC,,Both,,,79.3,24,,,,,,,,,
ONDANSETRON 4MG/5ML 50ML,450,RC,,Both,,,866.25,260,,,,,,,,,
Fluticason Propionate 50mcg ,J8499,HCPCS,,Both,50,GM,29.3,9,,,,,,,,,
ONDANSETRON ORAL,Q0162,HCPCS,,Both,,,23.96,7,,,,,,,,,
ANTIVERT - DIMENHYDRINATE INJECTION 50MG,J1240,HCPCS,,Both,0.05,GM,45.51,14,,,,,,,,,
Atenolol 50mg Qty 100 tabs,J8499,HCPCS,,Both,0.05,GM,2.75,1,,,,,,,,,
OPEN TREATMENT ULNAR STYLOID FRACTURE,25652,CPT,,Both,,,7422.98,2227,,,,,,,,,
OPEN TX ACUTE/CHRONIC ELBOW DISLOCATION,24615,CPT,,Both,,,8884.93,2665,,,,,,,,,
OPEN TX ARTICULAR FRACTURE MCP/IP JOINT EA,26746,CPT,,Both,,,4646.53,1394,,,,,,,,,
OPEN TX DISTAL PHALANGEAL FRACTURE EACH,26765,CPT,,Both,,,6351.63,1905,,,,,,,,,
OPEN TX FRACTURE GREAT TOE/PHALANX/PHALANGES,28505,CPT,,Both,,,8607.38,2582,,,,,,,,,
OPEN TX METACARPAL FRACTURE SINGLE EA BONE,26615,CPT,,Both,,,6847.58,2054,,,,,,,,,
OPEN TX PHALANGEAL SHAFT FRACTURE PROX/MIDDLE EA,26735,CPT,,Both,,,7535.75,2261,,,,,,,,,
OPEN TX RADIAL&ULNAR SHAFT FX W/FIXJ RADIUS/ULNA,25574,CPT,,Both,,,8375.81,2513,,,,,,,,,
"Ophthalmic biometry by ultrasound echography, A-scan",76516,CPT,,Both,,,358.08,107,,,,,,,,,
OPHTHALMIC ULTRASOUND DX B-SCAN W/WO A-SCAN,76512,CPT,,Both,,,3140.55,942,,,,,,,,,
OPTX DSTL RADL X-ARTIC FX/EPIPHYSL SEP,25607,CPT,,Both,,,8752.07,2626,,,,,,,,,
BENADRYL - DIPHENHYDRAMINE HCL INJECTION 50MG,J1200,HCPCS,,Both,0.05,GM,29.7,9,,,,,,,,,
Colace Liquid 50mg/5ml bottle (BILL ONCE THIS IS PER BOTTLE),A9150,HCPCS,,Both,50,ML,30.26,9,,,,,,,,,
ORGANIC ACID 1 QUANTITATIVE,83921,CPT,,Both,,,212.1,64,,,,,,,,,
ORTHO GLASS 3,A4590,HCPCS,,Both,,,116.22,35,,,,,,,,,
ORTHO GLASS 4,A4590,HCPCS,,Both,,,173.53,52,,,,,,,,,
"Orthopedic footwear, custom molded shoe, removable inner mold, prosthetic shoe, each",L3250,HCPCS,,Both,,,690,207,,,,,,,,,
"ORTHOPEDIC SHOE ADDITION, CONVERT INSTEP TO VELCRO CLOSURE",L3580,HCPCS,,Both,,,406.08,122,,,,,,,,,
Osmolality: Blood,83930,CPT,,Both,,,159.23,48,,,,,,,,,
Osmolality: Urine,83935,CPT,,Both,,,169.53,51,,,,,,,,,
OSTEOPATH MANJ 1-2 REGIONS,98925,CPT,,Both,,,392.38,118,,,,,,,,,
"Osteotomy; phalanx of finger, each",26567,CPT,,Both,,,3974.83,1192,,,,,,,,,
"Ova and parasites, direct smears, concentration and identification",87177,CPT,,Both,,,1140,342,,,,,,,,,
OXIMETER NON-INVASIVE,E0445,HCPCS,,Both,,,799.03,240,,,,,,,,,
OXYGEN MASK,A4649,HCPCS,,Both,,,29.7,9,,,,,,,,,
OXYGEN PROBE USED W OXIMETER,A4606,HCPCS,,Both,,,175.95,53,,,,,,,,,
OXYGEN SATURATION RESULTS DOCUMENTED & REVIEWED,3028F,HCPCS,,Both,,,72.64,22,,,,,,,,,
Oxytocin 10 Unit/mL IM/IV,450,RC,,Both,,,240.23,72,,,,,,,,,
PACKING NASAL LG W/STRING,450,RC,,Both,,,43.9,13,,,,,,,,,
PACKING NASAL LG W/STRING,450,RC,,Both,,,41.81,13,,,,,,,,,
PACKING STRIP PLAIN 1,450,RC,,Both,,,16.8,5,,,,,,,,,
PACKING STRIP PLAIN 1,450,RC,,Both,,,16,5,,,,,,,,,
PACKING STRIP PLAIN 1/2,450,RC,,Both,,,14.43,4,,,,,,,,,
PACKING STRIP PLAIN 1/2,450,RC,,Both,,,13.74,4,,,,,,,,,
PACKING STRIP PLAIN 1/4,450,RC,,Both,,,13.94,4,,,,,,,,,
PACKING STRIP PLAIN 1/4,450,RC,,Both,,,13.28,4,,,,,,,,,
PACKING STRIP W/IODO 1,450,RC,,Both,,,18.92,6,,,,,,,,,
PACKING STRIP W/IODO 1,450,RC,,Both,,,18.02,5,,,,,,,,,
PACKING STRIP W/IODO 1/2,450,RC,,Both,,,16.56,5,,,,,,,,,
PACKING STRIP W/IODO 1/2,450,RC,,Both,,,15.77,5,,,,,,,,,
PACKING STRIP W/IODO 1/4,450,RC,,Both,,,14.55,4,,,,,,,,,
PACKING STRIP W/IODO 1/4,450,RC,,Both,,,13.86,4,,,,,,,,,
PAD BAND W>=3,A6441,HCPCS,,Both,,,40.83,12,,,,,,,,,
PAD NON-ADH 3X4 ST LTXFR,450,RC,,Both,,,39.42,12,,,,,,,,,
PAD NON-ADH 3X4 ST LTXFR,450,RC,,Both,,,37.54,11,,,,,,,,,
PADDING FOR COMPRSSN BDG,S8430,HCPCS,,Both,,,83,25,,,,,,,,,
PARING/CUTTING BENIGN HYPERKERATOTIC LESION 1,11055,CPT,,Both,,,783,235,,,,,,,,,
PARING/CUTTING BENIGN HYPERKERATOTIC LESION 2-4,11056,CPT,,Both,,,737.75,221,,,,,,,,,
PART AGGLUJ SCR EA ANTB,86403,CPT,,Both,,,198.21,59,,,,,,,,,
PEAK FLOW METER UNIV RANGE,450,RC,,Both,,,53.31,16,,,,,,,,,
PEAK FLOW METER UNIV RANGE,450,RC,,Both,,,50.76,15,,,,,,,,,
PEDIALYTE,J3490,HCPCS,,Both,,,33.43,10,,,,,,,,,
PEDIALYTE 2OZ UNFLAVORED,450,RC,,Both,,,9.41,3,,,,,,,,,
PEDIALYTE 2OZ UNFLAVORED,450,RC,,Both,,,8.95,3,,,,,,,,,
Pedi-Lax Glycerin Supp 1 gm,J8498,HCPCS,,Both,,,2.15,1,,,,,,,,,
Pedi-Lax Glycerin Supp 1 gm,J8498,HCPCS,,Both,,,2.26,1,,,,,,,,,
PENICILLIN G BENZATHINE INJ,J0540,HCPCS,,Both,,,68.69,21,,,,,,,,,
Penicillin G benzathine Inj,J0560,HCPCS,,Both,,,65.42,20,,,,,,,,,
Diclofenac sod (Voltaren) 50mg Tab ,J8499,HCPCS,,Both,0.05,GM,1.96,1,,,,,,,,,
DIPHENHYDRAMINE HCL 50MG,Q0163,HCPCS,,Both,0.05,GM,31.93,10,,,,,,,,,
PENILE VASCULAR STUDY,93980,CPT,,Both,,,2080,624,,,,,,,,,
PENROSE DRAIN,450,RC,,Both,,,34.87,10,,,,,,,,,
"PEPCID - INJECTION, FAMOTIDINE, 20 MG",S0028,HCPCS,,Both,,,97.49,29,,,,,,,,,
"Injection, iron dextran, 50 mg",J1750,HCPCS,,Both,0.05,GM,182.62,55,,,,,,,,,
PEPCID/FAMOTIDINE 20MG TAB,450,RC,,Both,,,21.22,6,,,,,,,,,
PERCUTANEOUS CATHETER ANCHOR,A5200,HCPCS,,Both,,,161.42,48,,,,,,,,,
PERQ REPLACEMENT GTUBE NOT REQ REVJ GSTRST TRC,43762,CPT,,Both,,,1599.36,480,,,,,,,,,
PH BODY FLUID NOT ELSEWHERE SPECIFIED,83986,CPT,,Both,,,61.5,18,,,,,,,,,
PHENAZOPYRIDINE 100MG TABS,450,RC,,Both,,,338.24,101,,,,,,,,,
PHENAZOPYRIDINE 100MG TABS,450,RC,,Both,,,322.13,97,,,,,,,,,
"LOSARTAN POTASSIUM, TAB 50MG",J8499,HCPCS,,Both,0.05,GM,13.13,4,,,,,,,,,
"METOPROLOL SUCC ER, TAB 50MG",J8499,HCPCS,,Both,0.05,GM,57.75,17,,,,,,,,,
Phenergan 25mg Tab,450,RC,,Both,,,7.28,2,,,,,,,,,
Phenergan 50mg Vial,450,RC,,Both,,,59.18,18,,,,,,,,,
PHENYLEPHRINE 10MG/ML 1ML,450,RC,,Both,,,87.08,26,,,,,,,,,
PHENYLEPHRINE 10MG/ML 1ML,450,RC,,Both,,,82.93,25,,,,,,,,,
"PHENYTOIN (Dilantin) , TAB 50MG",J8499,HCPCS,,Both,0.05,GM,13.13,4,,,,,,,,,
Sumatriptan Succ (Imitrex) 50 mg Tab,J8499,HCPCS,,Both,0.05,GM,18.17,5,,,,,,,,,
PHENYTOIN SODIUM INJECTION,J1165,HCPCS,,Both,,,56.5,17,,,,,,,,,
"Phosphatase, alkaline;",84075,CPT,,Both,,,306,92,,,,,,,,,
Phosphorus inorganic (phosphate,84100,CPT,,Both,,,292,88,,,,,,,,,
PHYS DIRION EMS ADVD LIFE SUPPORT,99288,CPT,,Both,,,560.29,168,,,,,,,,,
PHYS SUPVJ PT HOME HLTH AGENCY MO 15-29 MINUTES,99374,CPT,,Both,,,331.68,100,,,,,,,,,
PIC CHEMISTRY CTL LVL 1/2,450,RC,,Both,,,1285.82,386,,,,,,,,,
PIC CHEMISTRY CTL LVL 1/2,450,RC,,Both,,,1224.59,367,,,,,,,,,
PIC MINIPETTE ABAXIS 0.1CC,450,RC,,Both,,,108.97,33,,,,,,,,,
PIC MINIPETTE ABAXIS 0.1CC,450,RC,,Both,,,103.78,31,,,,,,,,,
PIC PANEL BASIC METABOLIC,80048,CPT,,Both,,,1430,429,,,,,,,,,
PIC PANEL CHEM 13 PICCOLO,450,RC,,Both,,,740.93,222,,,,,,,,,
PIC PANEL CHEM 13 PICCOLO,450,RC,,Both,,,740.93,222,,,,,,,,,
PIC PANEL COMPREHENS METABOLBX,450,RC,,Both,,,555.72,167,,,,,,,,,
PIC PANEL COMPREHENS METABOLBX,80053,CPT,,Both,,,1794,538,,,,,,,,,
PIC PAPER THERMAL RESULTS,450,RC,,Both,,,341.75,103,,,,,,,,,
PIC PAPER THERMAL RESULTS,450,RC,,Both,,,325.48,98,,,,,,,,,
PIC PIPET TIPS DISP 0.2CC,450,RC,,Both,,,38.93,12,,,,,,,,,
PIC PIPET TIPS DISP 0.2CC,450,RC,,Both,,,37.08,11,,,,,,,,,
PILLOW VINYL 19X25 TAN 12/CS,450,RC,,Both,,,43.05,13,,,,,,,,,
PILLOW VINYL 19X25 TAN 12/CS,450,RC,,Both,,,41,12,,,,,,,,,
Topamax 50mg Tab,J8499,HCPCS,,Both,0.05,GM,12.67,4,,,,,,,,,
PIPETTES TRANS 5ML 1MLDRAW,450,RC,,Both,,,1.4,1,,,,,,,,,
PIPETTES TRANS 5ML 1MLDRAW,450,RC,,Both,,,1.32,1,,,,,,,,,
"TOPROL-XL Metoprolol Succinate, TAB 50MG",J8499,HCPCS,,Both,0.05,GM,125.5,38,,,,,,,,,
PITRESSIN 20U/ML VL 1ML,450,RC,,Both,,,28.01,8,,,,,,,,,
PITRESSIN 20U/ML VL 1ML,450,RC,,Both,,,26.68,8,,,,,,,,,
Placement of needle for intraosseous infusion,36680,CPT,,Both,,,746.13,224,,,,,,,,,
Plavix 75mg Tab,450,RC,,Both,,,18.19,5,,,,,,,,,
tramadol 50mg tab,J8499,HCPCS,,Both,0.05,GM,46.69,14,,,,,,,,,
"Pleural drainage, percutaneous, with insertion of indwelling catheter; with imaging guidance",32557,CPT,,Both,,,1188.45,357,,,,,,,,,
"Pleural drainage, percutaneous, with insertion of indwelling catheter; without imaging guidance",32556,CPT,,Both,,,1005.92,302,,,,,,,,,
Pneuma/vac walk boot pre ots,L4361,HCPCS,,Both,,,330,99,,,,,,,,,
POLYSOM <6 YRS SLEEP W/CPAP/BILVL VENT 4/> PARAM,95783,CPT,,Both,,,11585.18,3476,,,,,,,,,
POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND,95811,CPT,,Both,,,7791.63,2337,,,,,,,,,
PORPHYRINS URINE QUANTITATION & FRACTIONATION,84120,CPT,,Both,,,252.75,76,,,,,,,,,
POSTOP FOLLOW UP VISIT RELATED TO ORIGINAL PX,99024,CPT,,Both,,,50,15,,,,,,,,,
POST-OP SHOE FEM/LG,450,RC,,Both,,,35.72,11,,,,,,,,,
POST-OP SHOE FEM/LG,450,RC,,Both,,,34.02,10,,,,,,,,,
POST-OP SHOE FEM/MED,450,RC,,Both,,,35.72,11,,,,,,,,,
POST-OP SHOE FEM/MED,450,RC,,Both,,,34.02,10,,,,,,,,,
POST-OP SHOE FEM/SM,450,RC,,Both,,,35.53,11,,,,,,,,,
POST-OP SHOE FEM/SM,450,RC,,Both,,,33.84,10,,,,,,,,,
POST-OP SHOE MALE/LG,450,RC,,Both,,,35.53,11,,,,,,,,,
POST-OP SHOE MALE/LG,450,RC,,Both,,,33.84,10,,,,,,,,,
POST-OP SHOE MALE/MED,450,RC,,Both,,,35.53,11,,,,,,,,,
POST-OP SHOE MALE/MED,450,RC,,Both,,,33.84,10,,,,,,,,,
POST-OP SHOE MALE/SM,450,RC,,Both,,,35.53,11,,,,,,,,,
POST-OP SHOE MALE/SM,450,RC,,Both,,,33.84,10,,,,,,,,,
TRAZADONE 50MG TAB,J8499,HCPCS,,Both,0.05,GM,13.13,4,,,,,,,,,
POTASSIUM CHLORIDE 20 mEq/100mL IV Sol Flex Bag 100mL,450,RC,,Both,,,42.89,13,,,,,,,,,
Zinc Sulfate 50mg Tab,A9152,HCPCS,,Both,0.05,GM,0.22,1,,,,,,,,,
POTASSIUM CHLORIDE INJ - K-DUR,J3480,HCPCS,,Both,,,2.18,1,,,,,,,,,
POTASSIUM SERUM PLASMA/WHOLE BLOOD,84132,CPT,,Both,,,300,90,,,,,,,,,
PowerLoc Port Access Ysite Kit,450,RC,,Both,,,134.93,40,,,,,,,,,
PRALIDOXINE CHLORIDE,J2730,HCPCS,,Both,,,29.7,9,,,,,,,,,
Prealbumin,84134,CPT,,Both,,,170.74,51,,,,,,,,,
"DEXTROSE, SDV 50% 50ML",J3490,HCPCS,,Both,50,ML,47.78,14,,,,,,,,,
PREDNISOLONE 15MG/5ML 240ML,450,RC,,Both,,,72.4,22,,,,,,,,,
PREDNISOLONE 15MG/5ML 240ML,450,RC,,Both,,,68.95,21,,,,,,,,,
LIDOCAINE 4% TOP SOL 50ML,A9150,HCPCS,,Both,50,ML,29.65,9,,,,,,,,,
Omnipaque 240 - 50ml,Q9967,HCPCS,,Both,50,ML,3.71,1,,,,,,,,,
Sodium Chloride 0.9% Mini 50ml Ea,A4649,HCPCS,,Both,50,ML,2.6,1,,,,,,,,,
PREDNISONE 10MG TAB UD 100BX,450,RC,,Both,,,114.3,34,,,,,,,,,
PREDNISONE 10MG TAB UD 100BX,450,RC,,Both,,,108.86,33,,,,,,,,,
Prednisone 15mg/5ml Susp,450,RC,,Both,,,19.36,6,,,,,,,,,
ACETAMINOPHEN (TYLENOL) TABLET 500MG,A9150,HCPCS,,Both,0.5,GM,2.97,1,,,,,,,,,
Acyclovir 500mg/10mL IV,J0133,HCPCS,,Both,500,ML,71.4,21,,,,,,,,,
"AMOXICILLIN, CAP 500MG",J8499,HCPCS,,Both,0.5,GM,5.78,2,,,,,,,,,
PREG HCG CASSETTE WAIVED,450,RC,,Both,,,168.33,50,,,,,,,,,
Pregnenolone,84140,CPT,,Both,,,173.63,52,,,,,,,,,
"AMOXICILLIN+CLAVULANATE POTASSIUM (AUGMENTIN) , TAB 500MG/125MG",J8499,HCPCS,,Both,0.5,GM,26.78,8,,,,,,,,,
"PRESCRIPTION DRUG, GENERIC",S5000,HCPCS,,Both,,,9.75,3,,,,,,,,,
AMPICILLIN 500 MG INJ,J0290,HCPCS,,Both,0.5,GM,29.7,9,,,,,,,,,
"PRESCRIPTION DRUG,BRAND NAME",S5001,HCPCS,,Both,,,10.27,3,,,,,,,,,
PRILOSEC 20MG TABLET,450,RC,,Both,,,33.35,10,,,,,,,,,
PRILOSEC 40MG TABLET,450,RC,,Both,,,66.77,20,,,,,,,,,
PROBE SKIN TEMP DISP 25/BX,450,RC,,Both,,,735.44,221,,,,,,,,,
PROCAINAMIDE 100MGML 10ML VL,450,RC,,Both,,,386.26,116,,,,,,,,,
PROCAINAMIDE 100MGML 10ML VL,450,RC,,Both,,,367.87,110,,,,,,,,,
PROCAINAMIDE 500MG/ML 2ML VL,450,RC,,Both,,,328.36,99,,,,,,,,,
PROCAINAMIDE 500MG/ML 2ML VL,450,RC,,Both,,,312.71,94,,,,,,,,,
PROCAINAMIDE HCL INJECTION,J2690,HCPCS,,Both,,,29.7,9,,,,,,,,,
Procalcitonin (PCT),84145,CPT,,Both,,,1020,306,,,,,,,,,
PROCEDURE GOWN,450,RC,,Both,,,12.32,4,,,,,,,,,
Prochlorperazine 5 mg,S0183,HCPCS,,Both,,,18.53,6,,,,,,,,,
PROFAIR NEBULIZER TREATMENT AIRWAY INHALATION TREATMENT ,94640,CPT,,Both,,,347,104,,,,,,,,,
PROGRAMMED STIMJ & PACG AFTER IV DRUG NFS,93623,CPT,,Both,,,1994.54,598,,,,,,,,,
Prolactin,84146,CPT,,Both,,,754.31,226,,,,,,,,,
PROMETHAZINE 25MG AMP 1ML,450,RC,,Both,,,10.31,3,,,,,,,,,
PROMETHAZINE 25MG AMP 1ML,450,RC,,Both,,,9.82,3,,,,,,,,,
PROMETHAZINE 25MG TAB 100/BT,450,RC,,Both,,,102.3,31,,,,,,,,,
PROMETHAZINE 25MG TAB 100/BT,450,RC,,Both,,,97.42,29,,,,,,,,,
PROMETHAZINE 50MG AMP 1ML,450,RC,,Both,,,14.43,4,,,,,,,,,
PROMETHAZINE 50MG AMP 1ML,450,RC,,Both,,,13.74,4,,,,,,,,,
ANCEF - CEFAZOLIN SODIUM INJECTION 500MG,J0690,HCPCS,,Both,0.5,GM,29.47,9,,,,,,,,,
"AZITHROMYCIN, TAB 500MG",J8499,HCPCS,,Both,0.5,GM,79.28,24,,,,,,,,,
Propanolol 1mg Vial,450,RC,,Both,,,62.28,19,,,,,,,,,
PROPARACAINE,J3490,HCPCS,,Both,,,24.22,7,,,,,,,,,
PROPOFOL 100MG/ML VL 20ML,450,RC,,Both,,,26.27,8,,,,,,,,,
"CALCIUM, TAB 500MG ",A9152,HCPCS,,Both,0.5,GM,0.63,1,,,,,,,,,
PROPOFOL 10MG/ML VL 20ML,450,RC,,Both,,,21.89,7,,,,,,,,,
PROPRANOLOL 1MG SDV 1ML,450,RC,,Both,,,17.17,5,,,,,,,,,
PROPRANOLOL 1MG SDV 1ML,450,RC,,Both,,,16.34,5,,,,,,,,,
Prostate Cancer Screening; Prostate Specific Antigen test (PSA),G0103,HCPCS,,Both,,,238.46,72,,,,,,,,,
Prostate specific antigen (PSA); total ,84153,CPT,,Both,,,650,195,,,,,,,,,
PROTEIN ELECTROP FXJ&QUAN OTH FLUS CONCENTRATION,84166,CPT,,Both,,,251.5,75,,,,,,,,,
PROTEIN ELECTROPHORETIC FRACTJ&QUANTJ SERUM,84165,CPT,,Both,,,107.4,32,,,,,,,,,
PROTEIN TOT XCPT REFRACTOMETRY OTH SRC,84157,CPT,,Both,,,524.1,157,,,,,,,,,
PROTEIN TOTAL XCPT REFRACTOMETRY URINE,84156,CPT,,Both,,,63,19,,,,,,,,,
PROTEIN XCPT REFRACTOMETRY SERUM PLASMA/WHL BLD,84155,CPT,,Both,,,347,104,,,,,,,,,
PROTONIX - PANTROPRAZOLE 40MG,S0164,HCPCS,,Both,,,267.31,80,,,,,,,,,
CEPHALEXIN 500MG CAP (KEFLEX),J8499,HCPCS,,Both,0.5,GM,83.62,25,,,,,,,,,
PROTONIX IV 40MG VL 10/BX,450,RC,,Both,,,365.59,110,,,,,,,,,
PROTONIX IV 40MG VL 10/BX,450,RC,,Both,,,348.18,104,,,,,,,,,
CIPROFLOXACIN 500MG TAB ,J8499,HCPCS,,Both,0.5,GM,2.87,1,,,,,,,,,
PSEUDOEPHEDRINE PO,J3490,HCPCS,,Both,,,4.75,1,,,,,,,,,
PT - PROTHROMBIN TIME,85610,CPT,,Both,,,934,280,,,,,,,,,
PULM STRS TSTG CPLX,94621,CPT,,Both,,,1423.38,427,,,,,,,,,
PULSE OX -N-INVAS EAR/PLS OXIMTRY F/O2 SAT 1 DETER,94760,CPT,,Both,,,457,137,,,,,,,,,
PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST,10160,CPT,,Both,,,1664.5,499,,,,,,,,,
PVP SWABSTICK ST 3S 25/BX,450,RC,,Both,,,30.07,9,,,,,,,,,
PVP SWABSTICK ST 3S 25/BX,450,RC,,Both,,,28.64,9,,,,,,,,,
Pyridium 100mg tab,450,RC,,Both,,,18.19,5,,,,,,,,,
QUELICIN 20MG/ML 10ML,450,RC,,Both,,,86.66,26,,,,,,,,,
QUELICIN 20MG/ML 10ML,450,RC,,Both,,,82.53,25,,,,,,,,,
QUICKVUE RSV 20TEST,450,RC,,Both,,,1279.64,384,,,,,,,,,
QUICKVUE RSV 20TEST,450,RC,,Both,,,176.42,53,,,,,,,,,
Quinupristin/dalfopristin,J2770,HCPCS,,Both,,,225.58,68,,,,,,,,,
"Rabies vaccine, for intramuscular use",90675,CPT,,Both,,,2904.81,871,,,,,,,,,
RACEMIC EPINEPHRINE,J3490,HCPCS,,Both,,,16.14,5,,,,,,,,,
RACEPINEPH 2.25% S-2 30X.5ML,450,RC,,Both,,,297.43,89,,,,,,,,,
RACEPINEPH 2.25% S-2 30X.5ML,450,RC,,Both,,,283.27,85,,,,,,,,,
ERYTHROMYCIN 500MG/IV,J3490,HCPCS,,Both,0.5,GM,103.94,31,,,,,,,,,
RACK TEST TUBE 16MM 60PL WHT,450,RC,,Both,,,76.04,23,,,,,,,,,
RACK TEST TUBE 16MM 60PL WHT,450,RC,,Both,,,72.42,22,,,,,,,,,
INJ ERTAPENEM (INVANZ) 500MG,J1335,HCPCS,,Both,0.5,GM,27.44,8,,,,,,,,,
RADEX ABD 1 ANTEROPOST VIEW,74000,CPT,,Both,,,3024,907,,,,,,,,,
RADEX ABD 1 VIEW,74018,CPT,,Both,,,2142,643,,,,,,,,,
RADEX ABD 2 VIEWS,74019,CPT,,Both,,,2058,617,,,,,,,,,
RADEX ABD 3+ VIEWS,74021,CPT,,Both,,,2389,717,,,,,,,,,
RADEX ABD ANTEROPOST&ADDL OBLQ&CONE VIEWS,74010,CPT,,Both,,,5636.56,1691,,,,,,,,,
RADEX ABD COMPL AQT ABD W/S/E/D VIEWS 1 VIEW CH,74022,CPT,,Both,,,2275,683,,,,,,,,,
RADEX ABD COMPL W/DCBTS&/ERC VIEWS,74020,CPT,,Both,,,8388.89,2517,,,,,,,,,
RADEX ACROMCLAV JTS BI +-W8ED DISTRCJ,73050,CPT,,Both,,,3024,907,,,,,,,,,
RADEX ANKLE 2 VIEWS,73600,CPT,,Both,,,3024,907,,,,,,,,,
RADEX ANKLE COMPL MINIMUM 3 VIEWS,73610,CPT,,Both,,,3024,907,,,,,,,,,
RADEX CALCANEUS MINIMUM 2 VIEWS,73650,CPT,,Both,,,3024,907,,,,,,,,,
RADEX CH 1 VIEW FRNT,71010,CPT,,Both,,,2724,817,,,,,,,,,
RADEX CH 2 VIEWS FRNT&LAT,71020,CPT,,Both,,,2724,817,,,,,,,,,
RADEX CH 2 VIEWS FRNT&LAT OBLQ PRJCJ,71022,CPT,,Both,,,2019.18,606,,,,,,,,,
RADEX CH COMPL MINIMUM 4 VIEWS,71030,CPT,,Both,,,2019.18,606,,,,,,,,,
RADEX CHEST 1 VIEW,71045,CPT,,Both,,,2370,711,,,,,,,,,
RADEX CHEST 2 VIEWS,71046,CPT,,Both,,,3024,907,,,,,,,,,
RADEX CHEST 3 VIEWS,71047,CPT,,Both,,,3024,907,,,,,,,,,
RADEX CHEST 4+ VIEWS,71048,CPT,,Both,,,3024,907,,,,,,,,,
RADEX CLAV COMPL,73000,CPT,,Both,,,3024,907,,,,,,,,,
RADEX ELBW 2 VIEWS,73070,CPT,,Both,,,3024,907,,,,,,,,,
RADEX ELBW COMPL MINIMUM 3 VIEWS,73080,CPT,,Both,,,3024,907,,,,,,,,,
RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 1 VW,72081,CPT,,Both,,,405.64,122,,,,,,,,,
RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 2/3 VW,72082,CPT,,Both,,,3024,907,,,,,,,,,
RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 4/5 VW,72083,CPT,,Both,,,886.2,266,,,,,,,,,
RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 6/> VW,72084,CPT,,Both,,,1032.36,310,,,,,,,,,
RADEX EYE DETCJ FB,70030,CPT,,Both,,,2190,657,,,,,,,,,
RADEX F/ARM 2 VIEWS,73090,CPT,,Both,,,3024,907,,,,,,,,,
RADEX FACIAL B1S < 3 VIEWS,70140,CPT,,Both,,,2394,718,,,,,,,,,
RADEX FACIAL B1S COMPL MINIMUM 3 VIEWS,70150,CPT,,Both,,,2394,718,,,,,,,,,
RADEX FEMUR 2 VIEWS (DELETED CODE),73550,CPT,,Both,,,861.32,258,,,,,,,,,
RADEX Fingers MINIMUM 2 VIEWS,73140,CPT,,Both,,,2274,682,,,,,,,,,
RADEX FOOT 2 VIEWS,73620,CPT,,Both,,,2538,761,,,,,,,,,
RADEX FOOT COMPL MINIMUM 3 VIEWS,73630,CPT,,Both,,,2700,810,,,,,,,,,
RADEX FROM NOSE RECTUM FB 1 VIEW CHLD,76010,CPT,,Both,,,2520,756,,,,,,,,,
RADEX GI TRC UPR +-DLYD FLMS W/KUB,74241,CPT,,Both,,,3024,907,,,,,,,,,
RADEX GI UPR C+ +-GLUC +-DLYD FLMS W/KUB,74247,CPT,,Both,,,7068.81,2121,,,,,,,,,
RADEX HAND 2 VIEWS,73120,CPT,,Both,,,2584,775,,,,,,,,,
RADEX HAND MINIMUM 3 VIEWS,73130,CPT,,Both,,,3024,907,,,,,,,,,
RADEX HIP UNILATERAL WITH PELVIS 1 VIEW,73501,CPT,,Both,,,2571.81,772,,,,,,,,,
RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS,73502,CPT,,Both,,,3024,907,,,,,,,,,
RADEX HIP UNILATERAL WITH PELVIS MINIMUM 4 VIEWS,73503,CPT,,Both,,,3024,907,,,,,,,,,
RADEX HIPS BILATERAL WITH PELVIS 2 VIEWS,73521,CPT,,Both,,,3024,907,,,,,,,,,
RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS,73522,CPT,,Both,,,3024,907,,,,,,,,,
RADEX HUM MINIMUM 2 VIEWS,73060,CPT,,Both,,,3024,907,,,,,,,,,
RADEX KNE 1/2 VIEWS,73560,CPT,,Both,,,2019.18,606,,,,,,,,,
RADEX KNE 3 VIEWS,73562,CPT,,Both,,,3300,990,,,,,,,,,
RADEX KNE COMPL 4/MORE VIEWS,73564,CPT,,Both,,,3024,907,,,,,,,,,
RADEX LXTR INFT MINIMUM 2 VIEWS,73592,CPT,,Both,,,3024,907,,,,,,,,,
RADEX MNDBL COMPL MINIMUM 4 VIEWS,70110,CPT,,Both,,,2538,761,,,,,,,,,
RADEX MNDBL PRTL LESS THAN  < 4 VIEWS,70100,CPT,,Both,,,378.92,114,,,,,,,,,
RADEX NSL B1S COMPL MINIMUM 3 VIEWS,70160,CPT,,Both,,,3024,907,,,,,,,,,
RADEX OF NECK SOFT TISSUE,70360,CPT,,Both,,,3024,907,,,,,,,,,
RADEX ORBITS COMPLETE MINIMUM 4 VIEWS,70200,CPT,,Both,,,3024,907,,,,,,,,,
RADEX PELVIS 1/2 VIEWS,72170,CPT,,Both,,,2111,633,,,,,,,,,
RADEX PELVIS COMPL MINIMUM 3 VIEWS,72190,CPT,,Both,,,2214,664,,,,,,,,,
RADEX RIBS BI 3 VIEWS,71110,CPT,,Both,,,3024,907,,,,,,,,,
RADEX RIBS BI W/POSTEROANT CH MINIMUM 4 VIEWS,71111,CPT,,Both,,,3024,907,,,,,,,,,
RADEX RIBS UNI 2 VIEWS,71100,CPT,,Both,,,2274,682,,,,,,,,,
RADEX RIBS UNI W/POSTEROANT CH 3 VIEWS,71101,CPT,,Both,,,2634,790,,,,,,,,,
RADEX RIBS UNI W/POSTEROANT CH 4 VIEWS,71101,CPT,,Both,,,2634,790,,,,,,,,,
RADEX SACROILIAC JNTS <3 VIEWS,72200,CPT,,Both,,,2940,882,,,,,,,,,
RADEX SACRUM&COCCYX MINIMUM 2 VIEWS,72220,CPT,,Both,,,3024,907,,,,,,,,,
RADEX SCAPULA COMPL,73010,CPT,,Both,,,3024,907,,,,,,,,,
RADEX SHO 1 VIEW,73020,CPT,,Both,,,2279,684,,,,,,,,,
RADEX SHO COMPL MINIMUM 2 VIEWS,73030,CPT,,Both,,,3235,971,,,,,,,,,
RADEX SINUSES PARANSL COMPL MINIMUM 3 VIEWS,70220,CPT,,Both,,,3024,907,,,,,,,,,
RADEX SKL < 4 VIEWS,70250,CPT,,Both,,,2724,817,,,,,,,,,
RADEX SKL COMPL MINIMUM 4 VIEWS,70260,CPT,,Both,,,2724,817,,,,,,,,,
RADEX SPI 1 VIEW SPEC LVL,72020,CPT,,Both,,,3024,907,,,,,,,,,
RADEX SPI CRV 2/3 VIEWS,72040,CPT,,Both,,,3024,907,,,,,,,,,
RADEX SPI CRV COMPL W/OBLQ&FLEXION&/XTN STDS,72052,CPT,,Both,,,3025,908,,,,,,,,,
RADEX SPI CRV MINIMUM 4 VIEWS,72050,CPT,,Both,,,3025,908,,,,,,,,,
RADEX SPI LUMBOSAC 2/3 VIEWS,72100,CPT,,Both,,,3258,977,,,,,,,,,
RADEX SPI LUMBOSAC BENDING MINIMUM 4 VIEWS,72120,CPT,,Both,,,13053.45,3916,,,,,,,,,
RADEX SPI LUMBOSAC COMPL W/BENDING VIEWS,72114,CPT,,Both,,,3024,907,,,,,,,,,
RADEX SPI THRC 2 VIEWS,72070,CPT,,Both,,,3024,907,,,,,,,,,
RADEX SPI THRC 3 VIEWS,72072,CPT,,Both,,,3024,907,,,,,,,,,
RADEX SPI THRC MINIMUM 4 VIEWS,72074,CPT,,Both,,,3024,907,,,,,,,,,
RADEX STERNOCLAVICULAR JT/JTS MINIMUM 3 VIEWS,71130,CPT,,Both,,,2269.69,681,,,,,,,,,
RADEX STERNUM MINIMUM 2 VIEWS,71120,CPT,,Both,,,3024,907,,,,,,,,,
RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH BILAT,70330,CPT,,Both,,,3024,907,,,,,,,,,
RADEX TIBFIB 2 VIEWS,73590,CPT,,Both,,,3024,907,,,,,,,,,
RADEX TMPRMAND JT OPN&CLSD MOUTH UNI,70328,CPT,,Both,,,606.84,182,,,,,,,,,
RADEX TOE MINIMUM 2 VIEWS,73660,CPT,,Both,,,1760,528,,,,,,,,,
RADEX UXTR INFT MINIMUM 2 VIEWS,73092,CPT,,Both,,,2019.18,606,,,,,,,,,
RADEX WRST 2 VIEWS,73100,CPT,,Both,,,3024,907,,,,,,,,,
RADEX WRST COMPL MINIMUM 3 VIEWS,73110,CPT,,Both,,,3164,949,,,,,,,,,
"RADEX, Femur; 2V",73552,CPT,,Both,,,2382,715,,,,,,,,,
"RADEX, sacroiliac joints; 3 or more views",72202,CPT,,Both,,,447.38,134,,,,,,,,,
RADIOLOGIC EXAM BOTH KNEES STANDING ANTEROPOST,73565,CPT,,Both,,,7196.31,2159,,,,,,,,,
RADIOLOGIC EXAM MASTOIDS < 3 VIEWS PER SIDE,70120,CPT,,Both,,,404.4,121,,,,,,,,,
RADIOLOGIC EXAMINATION OSSEOUS SURVEY INFANT,77076,CPT,,Both,,,2271.78,682,,,,,,,,,
"Radiologic examination, osseous survey; limited (eg, for metastases)",77074,CPT,,Both,,,894.88,268,,,,,,,,,
"Radiologic examination, pelvis and hips, infant or child, mi...",73540,CPT,,Both,,,583,175,,,,,,,,,
"Radiologic examination, sinuses, paranasal, less than 3 views",70210,CPT,,Both,,,3024,907,,,,,,,,,
Radiologic examination; pharynx a/o cervical esophagus,74210,CPT,,Both,,,2170.01,651,,,,,,,,,
Radiologic examination; pharynx a/o cervical esophagus,74210,CPT,,Both,,,2278.51,684,,,,,,,,,
RANITIDINE 150MG TABS 100BT,450,RC,,Both,,,50.27,15,,,,,,,,,
RANITIDINE 150MG TABS 100BT,450,RC,,Both,,,47.88,14,,,,,,,,,
RANITIDINE HYDROCHLORIDE INJ,J2780,HCPCS,,Both,,,14.82,4,,,,,,,,,
Rantidine 150mg tab,450,RC,,Both,,,2.69,1,,,,,,,,,
RAPID RHINO NASAL PACKING OR NASAL TAMPON,A4649,HCPCS,,Both,,,288.03,86,,,,,,,,,
RAZOR PREP DBL EDGE 100BX,450,RC,,Both,,,2.25,1,,,,,,,,,
RAZOR PREP DBL EDGE 100BX,450,RC,,Both,,,2.14,1,,,,,,,,,
"Readi-Cat 2 (Barium Sulfate Suspension) (2.1% w/v, 2.0% w/w) 450mL",450,RC,,Both,,,118.85,36,,,,,,,,,
"Readi-Cat 2 (Barium Sulfate Suspension) (2.1% w/v, 2.0% w/w) 900mL",450,RC,,Both,,,237.7,71,,,,,,,,,
"Injection, cefepime hydrochloride, 500 mg",J0692,HCPCS,,Both,0.5,GM,84.28,25,,,,,,,,,
Keppra 500mg tab,J8499,HCPCS,,Both,0.5,GM,1.26,1,,,,,,,,,
"Reglan PO, 10mg",450,RC,,Both,,,5.62,2,,,,,,,,,
LEVAQUIN 500MG IVPB ,J1956,HCPCS,,Both,0.5,GM,79.62,24,,,,,,,,,
REMOVAL DAMAGED SKIN AND UNDERLYING TISSUE,11042,CPT,,Both,,,1502.88,451,,,,,,,,,
REMOVAL EMBEDDED FOREIGN BODY EYELID,67938,CPT,,Both,,,3175.75,953,,,,,,,,,
REMOVAL FOREIGN BODY DEEP THIGH/KNEE,27372,CPT,,Both,,,7813.38,2344,,,,,,,,,
REMOVAL FOREIGN BODY FOOT SUBCUTANEOUS,28190,CPT,,Both,,,3353,1006,,,,,,,,,
REMOVAL FOREIGN BODY INTRANASAL OFFICE PROCEDURE,30300,CPT,,Both,,,3088,926,,,,,,,,,
REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE,20520,CPT,,Both,,,2603.5,781,,,,,,,,,
REMOVAL FOREIGN BODY SHOULDER SUBCUTANEOUS,23330,CPT,,Both,,,1846.53,554,,,,,,,,,
REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT,69209,CPT,,Both,,,1362,409,,,,,,,,,
REMOVAL IMPACTED VAG FB SPX W/ANES OTH/THN LOCAL,57415,CPT,,Both,,,4170.94,1251,,,,,,,,,
Removal of foreign body from pharynx,42809,CPT,,Both,,,2263.5,679,,,,,,,,,
REMOVAL OF FOREIGN BODY OF EAR XTRNL AUD CANAL W/O ANES,69200,CPT,,Both,,,1622.5,487,,,,,,,,,
"Removal of foreign body, external eye; conjunctival superfic...",65205,CPT,,Both,,,1512,454,,,,,,,,,
"Removal of foreign body, foot; deepb",28192,CPT,,Both,,,6147,1844,,,,,,,,,
REMOVAL OF IMPACTED WAX MD,G0268,HCPCS,,Both,,,401.38,120,,,,,,,,,
REMOVAL OF SALIVARY STONE,42330,CPT,,Both,,,3060.63,918,,,,,,,,,
REMOVAL OF SUTURES,S0630,HCPCS,,Both,,,220.51,66,,,,,,,,,
"Removal of tunneled central venous access device, with SQ port or pump, central or peripheral insertion",36590,CPT,,Both,,,2495.88,749,,,,,,,,,
REMOVAL SK TGS MLT FIBRQ TAGS ANY AREA UP&W/15<,11200,CPT,,Both,,,1119.5,336,,,,,,,,,
"Removal, non-biodegradable drug delivery implant",11982,CPT,,Both,,,1362,409,,,,,,,,,
REMOVAL/BIVALVING GAUNTLET BOOT/BODY CAST,29700,CPT,,Both,,,1260,378,,,,,,,,,
REMOVE INTRAUTERINE DEVICE,58301,CPT,,Both,,,1260,378,,,,,,,,,
RENAL FUNCTION PANEL,80069,CPT,,Both,,,410.16,123,,,,,,,,,
Renin,84244,CPT,,Both,,,135.75,41,,,,,,,,,
REPAIR (LACERATION)INTERMEDIATE N/H/F/XTRNL GENT 2.6-7.5 CM,12042,CPT,,Both,,,3689.13,1107,,,,,,,,,
REPAIR COMPLEX EYELID/NOSE/EAR/LIP 1.0 CM/<,13150,CPT,,Both,,,4781.25,1434,,,,,,,,,
REPAIR COMPLEX EYELID/NOSE/EAR/LIP 1.1-2.5 CM,13151,CPT,,Both,,,5381.75,1615,,,,,,,,,
REPAIR COMPLEX EYELID/NOSE/EAR/LIP 2.6-7.5 CM,13152,CPT,,Both,,,6109.38,1833,,,,,,,,,
REPAIR COMPLEX EYELID/NOSE/EAR/LIP EA 5 CM/<,13153,CPT,,Both,,,2453.13,736,,,,,,,,,
REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 1.1 CM-2.5 CM,13131,CPT,,Both,,,4926.63,1478,,,,,,,,,
REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6 CM-7.5 CM,13132,CPT,,Both,,,6079.88,1824,,,,,,,,,
REPAIR COMPLEX F/C/C/M/N/AX/G/H/F EA 5 CM/<,13133,CPT,,Both,,,2257.88,677,,,,,,,,,
REPAIR COMPLEX SCALP/ARM/LEG 1.1 CM-2.5 CM,13120,CPT,,Both,,,4480,1344,,,,,,,,,
REPAIR COMPLEX SCALP/ARM/LEG 2.6 CM-7.5 CM,13121,CPT,,Both,,,5467.25,1640,,,,,,,,,
REPAIR COMPLEX SCALP/ARM/LEG EA 5 CM/<,13122,CPT,,Both,,,1704.38,511,,,,,,,,,
REPAIR COMPLEX TRUNK 1.1 CM-2.5 CM,13100,CPT,,Both,,,4275.88,1283,,,,,,,,,
REPAIR COMPLEX TRUNK 2.6 CM-7.5 CM,13101,CPT,,Both,,,5080.38,1524,,,,,,,,,
REPAIR COMPLEX TRUNK EA 5 CM/<,13102,CPT,,Both,,,1555.63,467,,,,,,,,,
REPAIR INCOMPLETE CIRCUMCISION,54163,CPT,,Both,,,2644.32,793,,,,,,,,,
REPAIR INTERMEDIATE F/E/E/N/L/M&/MUC > 30.0 CM,12057,CPT,,Both,,,7057.75,2117,,,,,,,,,
REPAIR INTERMEDIATE F/E/E/N/L/M&/MUC 12.6-20.0CM,12055,CPT,,Both,,,6048.5,1815,,,,,,,,,
REPAIR INTERMEDIATE F/E/E/N/L/M&/MUC 2.5 CM/<,12051,CPT,,Both,,,3314.5,994,,,,,,,,,
REPAIR INTERMEDIATE F/E/E/N/L/M&/MUC 2.6-5.0 CM,12052,CPT,,Both,,,3757.25,1127,,,,,,,,,
REPAIR INTERMEDIATE F/E/E/N/L/M&/MUC 20.1-30.0CM,12056,CPT,,Both,,,6994.75,2098,,,,,,,,,
REPAIR INTERMEDIATE F/E/E/N/L/M&/MUC 5.1-7.5 CM,12053,CPT,,Both,,,4437.25,1331,,,,,,,,,
REPAIR INTERMEDIATE F/E/E/N/L/M&/MUC 7.6-12.5 CM,12054,CPT,,Both,,,4733.5,1420,,,,,,,,,
REPAIR INTERMEDIATE N/H/F/XTRNL GENT >30.0 CM,12047,CPT,,Both,,,7525.13,2258,,,,,,,,,
REPAIR INTERMEDIATE N/H/F/XTRNL GENT 12.6-20 CM,12045,CPT,,Both,,,5150.28,1545,,,,,,,,,
REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.5CM/<,12041,CPT,,Both,,,3102,931,,,,,,,,,
REPAIR INTERMEDIATE N/H/F/XTRNL GENT 7.6-12.5CM,12044,CPT,,Both,,,4611.38,1383,,,,,,,,,
REPAIR INTERMEDIATE S/A/T/E > 30.0 CM,12037,CPT,,Both,,,5952.88,1786,,,,,,,,,
REPAIR INTERMEDIATE S/A/T/E 12.6-20.0CM,12035,CPT,,Both,,,4970.13,1491,,,,,,,,,
REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<,12031,CPT,,Both,,,3054.88,916,,,,,,,,,
REPAIR INTERMEDIATE S/A/T/E 20.1-30.0 CM,12036,CPT,,Both,,,5414.38,1624,,,,,,,,,
REPAIR INTERMEDIATE S/A/T/E 7.6-12.5 CM,12034,CPT,,Both,,,3993.5,1198,,,,,,,,,
REPAIR LACERATION PALATE </2 CM,42180,CPT,,Both,,,3213.88,964,,,,,,,,,
REPAIR NAIL BED,11760,CPT,,Both,,,3008.88,903,,,,,,,,,
"Repair of anterior abdominal hernia, any approach, initial; less than 3 cm, reducible",49591,CPT,,Both,,,2662.4,799,,,,,,,,,
REPAIR OF TRAUMATIC CORPOREAL TEAR(S),54437,CPT,,Both,,,8163.86,2449,,,,,,,,,
REPAIR TONGUE LACERATION,41250,CPT,,Both,,,3561.5,1068,,,,,,,,,
"Repair, intermediate, wounds of scalp, axillae, trunk and/or...",12032,CPT,,Both,,,3902.38,1171,,,,,,,,,
REPTILASE TEST,85635,CPT,,Both,,,98.5,30,,,,,,,,,
RESCJ/INC SUBVALVULAR TISSUE,33415,CPT,,Both,,,1355.9,407,,,,,,,,,
RESUSCITATOR ADULT W/MASK,450,RC,,Both,,,85.5,26,,,,,,,,,
RESUSCITATOR ADULT W/MASK,450,RC,,Both,,,81.43,24,,,,,,,,,
RESUSCITATOR PED W/MASK,450,RC,,Both,,,80.41,24,,,,,,,,,
RESUSCITATOR PED W/MASK,450,RC,,Both,,,76.58,23,,,,,,,,,
RETURN CHECK FEE,99999,CPT,,Both,,,12.6,4,,,,,,,,,
RHEUMATOID FACTOR QUAL,86430,CPT,,Both,,,109.77,33,,,,,,,,,
RHEUMATOID FACTOR QUANTITATIVE,86431,CPT,,Both,,,307,92,,,,,,,,,
RHINO ROCKET LG SLIM 8/BX,450,RC,,Both,,,95.27,29,,,,,,,,,
RHINO ROCKET LG SLIM 8/BX,450,RC,,Both,,,90.72,27,,,,,,,,,
RHINO ROCKET SLIM SM 8/BX,450,RC,,Both,,,80.77,24,,,,,,,,,
RHINO ROCKET SLIM SM 8/BX,450,RC,,Both,,,76.92,23,,,,,,,,,
RHOGAM 300MCG U/F+ SYR 5/BX,450,RC,,Both,,,2792.36,838,,,,,,,,,
RHOGAM 300MCG U/F+ SYR 5/BX,450,RC,,Both,,,2659.39,798,,,,,,,,,
RHOGAM INJECTION,J2790,HCPCS,,Both,,,275.7,83,,,,,,,,,
RHYTHM ECG 1-3 LDS I&R ONLY,93042,CPT,,Both,,,756,227,,,,,,,,,
RHYTHM ECG 1-3 LDS TRCG ONLY W/O I&R,93041,CPT,,Both,,,216.92,65,,,,,,,,,
RHYTHM ECG 1-3 LDS W/I&R,93040,CPT,,Both,,,960,288,,,,,,,,,
RINGERS LACTATE INFUSION,J7120,HCPCS,,Both,,,125.27,38,,,,,,,,,
Rmvl devital tis 20 cm/<,97597,CPT,,Both,,,1195,359,,,,,,,,,
RMVL EMBEDDED FB VESTIBULE MOUTH SMPL,40804,CPT,,Both,,,2879.25,864,,,,,,,,,
RMVL FB XTRNL AUD CANAL ANES,69205,CPT,,Both,,,1512,454,,,,,,,,,
RMVL FB XTRNL EYE CRNL W/O SLIT LAMP,65220,CPT,,Both,,,1362,409,,,,,,,,,
RMVL FB XTRNL EYE CRNL W/SLIT LAMP,65222,CPT,,Both,,,1512,454,,,,,,,,,
RMVL FB XTRNL EYE EMBEDDED SCJNCL/SCLL NONPRF8,65210,CPT,,Both,,,1260,378,,,,,,,,,
RMVL FECAL IMPACTION/FB SPX UNDER ANES,45915,CPT,,Both,,,4261.88,1279,,,,,,,,,
RMVL FOREIGN BODY MUSCLE/TENDON SHEATH DEEP/COMP,20525,CPT,,Both,,,6240.52,1872,,,,,,,,,
RMVL FOREIGN BODY UPPER ARM/ELBOW SUBCUTANEOUS,24200,CPT,,Both,,,2632.75,790,,,,,,,,,
RMVL IMPACTED CERUMEN SPX 1/BTH EARS,69210,CPT,,Both,,,1512,454,,,,,,,,,
Robinul (Glycopyrrolate) ,J3490,HCPCS,,Both,,,41.95,13,,,,,,,,,
"LEVOFLOXACIN (LEVAQUIN), TAB 500MG",J8499,HCPCS,,Both,0.5,GM,9.98,3,,,,,,,,,
Robitussin DM Destromethorphan,450,RC,,Both,,,20.32,6,,,,,,,,,
Robitussin W/CODEINE 10 ML SUPP ,450,RC,,Both,,,132.2,40,,,,,,,,,
MAGNESIUM SULFATE INJ PER 500MG,J3475,HCPCS,,Both,0.5,GM,34.27,10,,,,,,,,,
ROCURONIUM BR 10MG/ML 5ML,450,RC,,Both,,,36.75,11,,,,,,,,,
ROCURONIUM BR 10MG/ML 5ML,450,RC,,Both,,,35,11,,,,,,,,,
"METFORMIN HCL, TAB 500MG",J8499,HCPCS,,Both,0.5,GM,28.88,9,,,,,,,,,
ROOM AND BOARD - MED/SURG,450,RC,,Both,,,3675,1103,,,,,,,,,
RPR INTERMEDIATE N/H/F/XTRNL GENT 20.1-30.0 CM,12046,CPT,,Both,,,6862.5,2059,,,,,,,,,
RPR LAC TONGUE FLOOR MOUTH > 2.6 CM/CPLX,41252,CPT,,Both,,,4156.25,1247,,,,,,,,,
RPR LIP FULL THKNS VERMILION ONLY,40650,CPT,,Both,,,5802,1741,,,,,,,,,
RPR TUN/NON-TUN CTR VAD CATH W/O SUBQ PORT/PMP,36575,CPT,,Both,,,2214.5,664,,,,,,,,,
RUSSELL VIPER VENOM TIME DILUTED,85613,CPT,,Both,,,124.22,37,,,,,,,,,
SALICYLATE,80196,CPT,,Both,,,166.59,50,,,,,,,,,
SALINE 5CC SYR PF 30/BX,450,RC,,Both,,,94.23,28,,,,,,,,,
SALINE 5CC SYR PF 30/BX,450,RC,,Both,,,89.74,27,,,,,,,,,
SALINE FLUSH SYR 10ML 100/BX,450,RC,,Both,,,257.33,77,,,,,,,,,
SALINE LOCK,A4673,HCPCS,,Both,,,19.37,6,,,,,,,,,
"SALIVA TEST, HORMONE LEVEL; DURING MENOPAUSE",S3650,HCPCS,,Both,,,52.95,16,,,,,,,,,
SARSCOV2 VACCINE 100 MCG/0.5 ML IM USE,91301,CPT,,Both,,,0.01,1,,,,,,,,,
SARSCOV2 VACCINE CHADOX1 5X1010 VP/0.5ML IM USE,91302,CPT,,Both,,,0.01,1,,,,,,,,,
SARSCOV2 VACCINE DIL RECON 30 MCG/0.3 ML IM USE,91300,CPT,,Both,,,0.01,1,,,,,,,,,
SCALPEL #10 SS DISP ST 10/BX,450,RC,,Both,,,38.81,12,,,,,,,,,
SCALPEL #10 SS DISP ST 10/BX,450,RC,,Both,,,36.96,11,,,,,,,,,
SCALPEL #11 SS DISP ST 10/BX,450,RC,,Both,,,38.81,12,,,,,,,,,
SCALPEL #11 SS DISP ST 10/BX,450,RC,,Both,,,36.96,11,,,,,,,,,
SCALPEL #15 SS DISP ST 10/BX,450,RC,,Both,,,38.81,12,,,,,,,,,
SCALPEL #15 SS DISP ST 10/BX,450,RC,,Both,,,36.96,11,,,,,,,,,
SCAPLEL BLADE #11,A4649,HCPCS,,Both,,,8.09,2,,,,,,,,,
SCISSORS BNDG/UTIL 7.5,450,RC,,Both,,,76.28,23,,,,,,,,,
SCISSORS BNDG/UTIL 7.5,450,RC,,Both,,,72.65,22,,,,,,,,,
Scopolamine patch,J3490,HCPCS,,Both,,,193.82,58,,,,,,,,,
"SCREENING PAPANICOLAOU SMEAR; OBTAINING, PREPARING AND CONVE...",Q0091,HCPCS,,Both,,,66.05,20,,,,,,,,,
Scrotoplasty; simple,55175,CPT,,Both,,,4534.7,1360,,,,,,,,,
SEDIMENTATION RATE RBC AUTO,85652,CPT,,Both,,,168,50,,,,,,,,,
SEDIMENTATION RATE RBC NON-AUTO,85651,CPT,,Both,,,684,205,,,,,,,,,
SELF-ADHER BAND W>=3,A6454,HCPCS,,Both,,,7.28,2,,,,,,,,,
Methocarbamol 500 mg tab (Robaxin),J8499,HCPCS,,Both,0.5,GM,83.53,25,,,,,,,,,
SENSOR FINGER W/DB9 CONN 1M,450,RC,,Both,,,924.69,277,,,,,,,,,
SENSOR FINGER W/DB9 CONN 1M,450,RC,,Both,,,924.69,277,,,,,,,,,
SENSOR O2 ADULT 24/CS,450,RC,,Both,,,84.43,25,,,,,,,,,
SENSOR OXI PEDIATRIC 24/CS,450,RC,,Both,,,84.43,25,,,,,,,,,
SEPTOPLASTY/SUBMUCOUS RESECJ W/WO CARTILAGE GRF,30520,CPT,,Both,,,5651.53,1695,,,,,,,,,
Metronidazole (Flagyl) 500 mg/100 ml IV,J3490,HCPCS,,Both,500,ML,27.33,8,,,,,,,,,
SEPTRA DS TABLET,450,RC,,Both,,,1.28,1,,,,,,,,,
SERIAL TONOMETRY SPX W/MLT MEAS INTRAOCULAR PRES,92100,CPT,,Both,,,406.77,122,,,,,,,,,
Set-up portable x-ray equipment,Q0092,HCPCS,,Both,,,307.82,92,,,,,,,,,
SHARPS COLL 18GL RED,450,RC,,Both,,,144.99,43,,,,,,,,,
SHARPS COLL 18GL RED,450,RC,,Both,,,138.08,41,,,,,,,,,
SHARPS COLL 5QT RED HORIZ,450,RC,,Both,,,31.41,9,,,,,,,,,
SHARPS COLL 5QT RED HORIZ,450,RC,,Both,,,29.91,9,,,,,,,,,
SHEATH ULTRASOUND 51X200MM,450,RC,,Both,,,159.66,48,,,,,,,,,
SHEATH ULTRASOUND 51X200MM,450,RC,,Both,,,152.06,46,,,,,,,,,
SHLDER FIG 8 ABDUCT RESTRAIN,L3650,HCPCS,,Both,,,373.09,112,,,,,,,,,
SHORT ARM SPLINT DYNAMIC,29126,CPT,,Both,,,1268.47,381,,,,,,,,,
SHORT ARM SPLINT FOREARM-HAND STATIC,29125,CPT,,Both,,,1014,304,,,,,,,,,
SHORT LEG SPLINT CALF FOOT,29515,CPT,,Both,,,1019,306,,,,,,,,,
SHOULDER IMMOB LG,450,RC,,Both,,,28.44,9,,,,,,,,,
SHOULDER IMMOB LG,450,RC,,Both,,,27.09,8,,,,,,,,,
SHOULDER IMMOB MED,450,RC,,Both,,,28.44,9,,,,,,,,,
SHOULDER IMMOB MED,450,RC,,Both,,,27.09,8,,,,,,,,,
SHOULDER IMMOB SM,450,RC,,Both,,,28.44,9,,,,,,,,,
SHOULDER IMMOB SM,450,RC,,Both,,,27.09,8,,,,,,,,,
SHOULDER IMMOB XS,450,RC,,Both,,,32.14,10,,,,,,,,,
SHOULDER IMMOB XS,450,RC,,Both,,,30.61,9,,,,,,,,,
"SHOULDER SLING OR VEST DESIGN, ABDUCTION RESTRAINER, WITH OR...",A4566,HCPCS,,Both,,,166.75,50,,,,,,,,,
SILVADENE CRM 20GM,450,RC,,Both,,,71.62,21,,,,,,,,,
SILVADENE CRM 20GM,450,RC,,Both,,,68.21,20,,,,,,,,,
SILVADENE CRM 400GM,450,RC,,Both,,,443.74,133,,,,,,,,,
SILVADENE CRM 400GM,450,RC,,Both,,,422.61,127,,,,,,,,,
SILVER NITRATE APPLI,450,RC,,Both,,,168.76,51,,,,,,,,,
SILVER NITRATE APPLI,450,RC,,Both,,,160.71,48,,,,,,,,,
SILVER NITRATE APPLI 100/EA,450,RC,,Both,,,178.15,53,,,,,,,,,
SILVER NITRATE APPLI 100/EA,450,RC,,Both,,,169.67,51,,,,,,,,,
SILVER NITRATE STICKS EACH,A4649,HCPCS,,Both,,,55.7,17,,,,,,,,,
Silver Sulfadizaine Cream 1%,A6250,HCPCS,,Both,,,103.01,31,,,,,,,,,
METRONIDAZOLE 500MG 100/EA,J8499,HCPCS,,Both,0.5,GM,5.92,2,,,,,,,,,
"NAPROXEN, TAB 500MG",A9150,HCPCS,,Both,0.5,GM,2.63,1,,,,,,,,,
Simethicone Drops,450,RC,,Both,,,20.69,6,,,,,,,,,
SIMPLE REPAIR F/E/E/N/L/M >30.0CM,12018,CPT,,Both,,,2541.75,763,,,,,,,,,
SIMPLE REPAIR F/E/E/N/L/M 12.6CM-20.0CM,12016,CPT,,Both,,,2728.38,819,,,,,,,,,
SIMPLE REPAIR F/E/E/N/L/M 2.5CM/<,12011,CPT,,Both,,,1411.63,423,,,,,,,,,
SIMPLE REPAIR F/E/E/N/L/M 2.6CM-5.0CM,12013,CPT,,Both,,,1543.75,463,,,,,,,,,
SIMPLE REPAIR F/E/E/N/L/M 20.1CM-30.0CM,12017,CPT,,Both,,,2079.48,624,,,,,,,,,
SIMPLE REPAIR F/E/E/N/L/M 5.1CM-7.5CM,12014,CPT,,Both,,,1802.75,541,,,,,,,,,
SIMPLE REPAIR F/E/E/N/L/M 7.6CM-12.5CM,12015,CPT,,Both,,,2198,659,,,,,,,,,
SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK >30.0CM,12007,CPT,,Both,,,2915.13,875,,,,,,,,,
SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/<,12001,CPT,,Both,,,1156.88,347,,,,,,,,,
SIMPLE RPR SCALP/NECK/AX/GENIT/TRUNK 7.6-12.5CM,12004,CPT,,Both,,,1641.13,492,,,,,,,,,
SINCALIDE INJECTION,J2805,HCPCS,,Both,,,72.64,22,,,,,,,,,
SKIN SEAL PROTECT MOISTURIZER OINTMENT (NEOSPOIN/TRIP ANT),A6250,HCPCS,,Both,,,7.67,2,,,,,,,,,
SKIN STAPLE REMOVER,450,RC,,Both,,,5.7,2,,,,,,,,,
SKIN STAPLE REMOVER,450,RC,,Both,,,5.43,2,,,,,,,,,
SKIN STAPLE REMOVER PRECISE,450,RC,,Both,,,18.98,6,,,,,,,,,
SKIN STAPLE REMOVER PRECISE,450,RC,,Both,,,18.08,5,,,,,,,,,
SKIN STAPLER,A4649,HCPCS,,Both,,,249.82,75,,,,,,,,,
SKIN STAPLER FIXED PREM 35W,450,RC,,Both,,,60.22,18,,,,,,,,,
SKIN STAPLER FIXED PREM 35W,450,RC,,Both,,,57.35,17,,,,,,,,,
SKIN STAPLER PRECISE 15 ARCU,450,RC,,Both,,,41.84,13,,,,,,,,,
SKIN STAPLER PRECISE 15 ARCU,450,RC,,Both,,,39.85,12,,,,,,,,,
SKIN STAPLER PRECISE 5 ARCU,450,RC,,Both,,,34.26,10,,,,,,,,,
SKIN STAPLER PRECISE 5 ARCU,450,RC,,Both,,,32.63,10,,,,,,,,,
SKN TST TUBERCULOSIS ID,86580,CPT,,Both,,,101.88,31,,,,,,,,,
SLCTV CATH PLMT VEN SYS 1ST ORDER BRANCH,36011,CPT,,Both,,,70.83,21,,,,,,,,,
SLINGS,A4565,HCPCS,,Both,,,201.78,61,,,,,,,,,
SLITTING PREPUCE DORSAL/LAT SPX XCP NB,54001,CPT,,Both,,,2304.38,691,,,,,,,,,
"Smear, primary source with interpretation; Gram or Giemsa st...",87205,CPT,,Both,,,420,126,,,,,,,,,
SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM,12002,CPT,,Both,,,1399,420,,,,,,,,,
SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 12.6-20.0CM,12005,CPT,,Both,,,2121.25,636,,,,,,,,,
SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 20.1-30.0CM,12006,CPT,,Both,,,2563,769,,,,,,,,,
SMR PRIM SRC CPLX SPEC STAIN OVA&PARASITS,87209,CPT,,Both,,,1140,342,,,,,,,,,
SMR PRIM SRC WET MOUNT NFCT AGT,87210,CPT,,Both,,,1020,306,,,,,,,,,
"Smr, prim src, w/ int; spec stain for inclusion bodies or parasites e.g. Malaria......",87207,CPT,,Both,,,251.5,75,,,,,,,,,
So acro/clav can web pre ots,L3670,HCPCS,,Both,,,807,242,,,,,,,,,
SOAP SUDS ENEMA,450,RC,,Both,,,21,6,,,,,,,,,
SODIUM BICARB 4% NEUT 5ML,450,RC,,Both,,,45.48,14,,,,,,,,,
SODIUM BICARB 4% NEUT 5ML,450,RC,,Both,,,43.31,13,,,,,,,,,
"PENICILLIN V POTASSIUM, TAB 500MG",J8499,HCPCS,,Both,0.5,GM,5.78,2,,,,,,,,,
SODIUM BICARB 8.4% SYR 50ML,450,RC,,Both,,,44.75,13,,,,,,,,,
SODIUM BICARB 8.4% SYR 50ML,450,RC,,Both,,,42.62,13,,,,,,,,,
Penicillin-VK 500mg tab,J8499,HCPCS,,Both,0.5,GM,2.47,1,,,,,,,,,
Sotrovimab 500mg,Q0247,HCPCS,,Both,0.5,GM,0.01,1,,,,,,,,,
"SODIUM BICARBONATE, TAB 650M",J8499,HCPCS,,Both,,,13.13,4,,,,,,,,,
TYLENOL 500MG,J3490,HCPCS,,Both,0.5,GM,104.93,31,,,,,,,,,
Sodium Chloride and Potassium Chloride IV 20 MeQ/1000 mL bag,450,RC,,Both,,,35.39,11,,,,,,,,,
Vancomycin 500mg Injection,J3490,HCPCS,,Both,0.5,GM,78.83,24,,,,,,,,,
VANCOMYCIN HCL INJECTION 500MG,J3370,HCPCS,,Both,0.5,GM,78.83,24,,,,,,,,,
Vitamin D 500mg Tablet ,A9152,HCPCS,,Both,0.5,GM,0.24,1,,,,,,,,,
ZITHROMAX - AZITHROMYCIN 500MG,J0456,HCPCS,,Both,0.5,GM,112.19,34,,,,,,,,,
SODIUM SERUM PLASMA OR WHOLE BLOOD,84295,CPT,,Both,,,240,72,,,,,,,,,
SOLU CORTEF SDV 100MG,450,RC,,Both,,,33.11,10,,,,,,,,,
SOLU CORTEF SDV 100MG,450,RC,,Both,,,31.53,9,,,,,,,,,
SOLU MEDROL 125MG PF VL 2ML,450,RC,,Both,,,24.69,7,,,,,,,,,
SOLU MEDROL 125MG PF VL 2ML,450,RC,,Both,,,23.5,7,,,,,,,,,
0.9% Sodium Chloride IV Solution 500 ml,J7040,HCPCS,,Both,500,ML,47.25,14,,,,,,,,,
NORMAL SALINE SOLUTION INFUS - 500 ML=1 UNIT,J7040,HCPCS,,Both,500,ML,36.81,11,,,,,,,,,
"SODIUM CHLORIDE, SOL HYPERTONIC 3% 500ML",J3490,HCPCS,,Both,500,ML,47.88,14,,,,,,,,,
"STERILE WATER/SALINE, 500 ML",A4217,HCPCS,,Both,500,ML,36.81,11,,,,,,,,,
Xifaxan (Rifaximin) 550mg tab,J8499,HCPCS,,Both,0.55,GM,237.1,71,,,,,,,,,
SPACER WITHOUT MASK,S8100,HCPCS,,Both,,,138,41,,,,,,,,,
"Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler",A4627,HCPCS,,Both,,,58.38,18,,,,,,,,,
SPEC COLL 4OZ NS W/LID 20BX,450,RC,,Both,,,12.32,4,,,,,,,,,
SPEC COLL 4OZ NS W/LID 20BX,450,RC,,Both,,,11.72,4,,,,,,,,,
SPEC COLL COMMODE 100/CS,450,RC,,Both,,,6.55,2,,,,,,,,,
SPEC COLL COMMODE 100/CS,450,RC,,Both,,,6.24,2,,,,,,,,,
Specimen collection COVID-19,G2023,HCPCS,,Both,,,120.75,36,,,,,,,,,
Specimen collection for COVID-19,C9803,HCPCS,,Both,,,120.75,36,,,,,,,,,
Specimen Container,450,RC,,Both,,,12.32,4,,,,,,,,,
SPECTINOMYCN DI-HCL INJ,J3320,HCPCS,,Both,,,121.07,36,,,,,,,,,
SPECULA EAR 2.5MM 1000/BX,450,RC,,Both,,,1.32,1,,,,,,,,,
SPECULA EAR 4MM 1000/BX,450,RC,,Both,,,1.32,1,,,,,,,,,
Specula Ear Adult or Pedi,450,RC,,Both,,,2.43,1,,,,,,,,,
SPECULUM,A4649,HCPCS,,Both,,,244.24,73,,,,,,,,,
SPECULUM VAG GRAVES DISP LG,450,RC,,Both,,,190.65,57,,,,,,,,,
SPECULUM VAG GRAVES DISP LG,450,RC,,Both,,,181.57,54,,,,,,,,,
SPECULUM VAG GRAVES DISP MEDBX,450,RC,,Both,,,168.33,50,,,,,,,,,
SPECULUM VAG GRAVES DISP MEDBX,450,RC,,Both,,,160.31,48,,,,,,,,,
SPECULUM VAG GRAVES DISP SM,450,RC,,Both,,,168.33,50,,,,,,,,,
SPECULUM VAG GRAVES DISP SM,450,RC,,Both,,,160.31,48,,,,,,,,,
"Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter)",62272,CPT,,Both,,,2626.5,788,,,,,,,,,
SPINAL TAP FLUID,62270,CPT,,Both,,,2046.13,614,,,,,,,,,
"Spirometer, non-electronic, includes all accessories",A9284,HCPCS,,Both,,,43.88,13,,,,,,,,,
"Spirometer, non-electronic, includes all accessories",A9284,HCPCS,,Both,,,43.88,13,,,,,,,,,
SPLASH GUARD IRRIGATION ST,450,RC,,Both,,,39.38,12,,,,,,,,,
SPLASH GUARD IRRIGATION ST,450,RC,,Both,,,374.85,112,,,,,,,,,
SPLINT,A4570,HCPCS,,Both,,,173.53,52,,,,,,,,,
SPLINT DIGIT,S8450,HCPCS,,Both,,,116.22,35,,,,,,,,,
SPLINT SUPPLIES MISC,Q4051,HCPCS,,Both,,,1212,364,,,,,,,,,
SPLINT WRIST OR ANKLE,S8451,HCPCS,,Both,,,177,53,,,,,,,,,
SPONGE GAUZE 2X2X12P NS,450,RC,,Both,,,8.8,3,,,,,,,,,
SPONGE GAUZE 2X2X12P NS,450,RC,,Both,,,8.38,3,,,,,,,,,
SPONGE GAUZE 4X4X12P NS,450,RC,,Both,,,26.99,8,,,,,,,,,
SPONGE GAUZE 4X4X12P NS,450,RC,,Both,,,25.7,8,,,,,,,,,
SPONGE GAUZE 4X4X12P ST10S,450,RC,,Both,,,7.15,2,,,,,,,,,
SPONGE GAUZE 4X4X12P ST10S,450,RC,,Both,,,6.81,2,,,,,,,,,
SPONGE GAUZE 4X4X12P ST2S,450,RC,,Both,,,20.44,6,,,,,,,,,
SPONGE GAUZE 4X4X12P ST2S,450,RC,,Both,,,19.47,6,,,,,,,,,
SPRAY - HURRICANE SPRAY,J3490,HCPCS,,Both,,,195.88,59,,,,,,,,,
SPTM OBTG SPEC AERSL INDUCED SPX,89220,CPT,,Both,,,221.25,66,,,,,,,,,
SUMATRIPTAN SUCCINATE / 6 MG,J3030,HCPCS,,Both,0.006,GM,8.88,3,,,,,,,,,
STAPLE REMOVAL/REPAIR KIT,A4649,HCPCS,,Both,,,80.71,24,,,,,,,,,
STEP STOOL W/O RAIL 9,450,RC,,Both,,,251.77,76,,,,,,,,,
STEP STOOL W/O RAIL 9,450,RC,,Both,,,239.78,72,,,,,,,,,
Steri Strip All Sizes,A4649,HCPCS,,Both,,,4.32,1,,,,,,,,,
STERILE EYE PAD OR STRIP,A6410,HCPCS,,Both,,,8.09,2,,,,,,,,,
STERILE GAUZE <= 16 SQ IN,A6402,HCPCS,,Both,,,3.16,1,,,,,,,,,
STERILE SALINE - 5% DEXTROSE AND 0.45% SALINE,S5010,HCPCS,,Both,,,320.66,96,,,,,,,,,
"TAMIFLU, SUSP RECON 6MG/ML",J8499,HCPCS,,Both,6,ML,32.03,10,,,,,,,,,
"NIFEDIPINE (PROCARDIA) ER, TAB 60MG",J8499,HCPCS,,Both,0.06,GM,26.78,8,,,,,,,,,
"Clindamycin phosphate (Cleocin) D5W, 600mg/50ml",J3490,HCPCS,,Both,600,ML,122.78,37,,,,,,,,,
IBUPROFEN 600 MG TAB (MOTRIN),A9150,HCPCS,,Both,0.6,GM,9.32,3,,,,,,,,,
"MUCUS RELIEF ER, TAB 600MG",A9150,HCPCS,,Both,0.6,GM,7.88,2,,,,,,,,,
STICKER AWARD BERRY SPECIAL,450,RC,,Both,,,102.35,31,,,,,,,,,
STICKER AWARD BERRY SPECIAL,450,RC,,Both,,,97.48,29,,,,,,,,,
STICKER AWARD DINOSAUR,450,RC,,Both,,,102.35,31,,,,,,,,,
STICKER AWARD DINOSAUR,450,RC,,Both,,,97.48,29,,,,,,,,,
STICKER AWARD SPACESHIP,450,RC,,Both,,,102.35,31,,,,,,,,,
STICKER AWARD SPACESHIP,450,RC,,Both,,,97.48,29,,,,,,,,,
STOCKINETTE 2,450,RC,,Both,,,52.83,16,,,,,,,,,
STOCKINETTE 2,450,RC,,Both,,,50.3,15,,,,,,,,,
STOCKINETTE 3,450,RC,,Both,,,71.38,21,,,,,,,,,
STOCKINETTE 3,450,RC,,Both,,,67.98,20,,,,,,,,,
STOCKINETTE 4,450,RC,,Both,,,80.1,24,,,,,,,,,
STOCKINETTE 4,450,RC,,Both,,,76.29,23,,,,,,,,,
STOCKINETTE 6,450,RC,,Both,,,125.88,38,,,,,,,,,
STOCKINETTE 6,450,RC,,Both,,,119.89,36,,,,,,,,,
STOOL CULTR AEROBIC BACT EA,87046,CPT,,Both,,,1140,342,,,,,,,,,
STOOL EXAM 5LEG BLACK,450,RC,,Both,,,577.22,173,,,,,,,,,
STOOL EXAM 5LEG BLACK,450,RC,,Both,,,549.72,165,,,,,,,,,
STRAIGHT TIP URINE CATHETER,A4351,HCPCS,,Both,,,15.73,5,,,,,,,,,
STRAINER CALCULI 100/CS,450,RC,,Both,,,10.67,3,,,,,,,,,
STRAINER CALCULI 100/CS,450,RC,,Both,,,10.16,3,,,,,,,,,
STRAPPING ANKLE &/FOOT,29540,CPT,,Both,,,1362,409,,,,,,,,,
STRAPPING HAND/FINGER,29280,CPT,,Both,,,1260,378,,,,,,,,,
Strapping Of Elbow Or Wrist,29260,CPT,,Both,,,842.88,253,,,,,,,,,
STRAPPING SHOULDER,29240,CPT,,Both,,,1260,378,,,,,,,,,
STRAPPING TOES,29550,CPT,,Both,,,1362,409,,,,,,,,,
STRAPPING UNNA BOOT,29580,CPT,,Both,,,676.88,203,,,,,,,,,
Strapping; knee,29530,CPT,,Both,,,2040,612,,,,,,,,,
STREP A QUICKVIEW INLINE 25B,87430,CPT,,Both,,,348.26,104,,,,,,,,,
STYLET ENDOTRACH 10FR 25/BX,450,RC,,Both,,,23.96,7,,,,,,,,,
STYLET ENDOTRACH 10FR 25/BX,450,RC,,Both,,,22.81,7,,,,,,,,,
SUBCUTANEOUS INFUSION EACH ADDITIONAL IV PUSH,96376,CPT,,Both,,,853,256,,,,,,,,,
Subcutaneous infusion for therapy or prophylaxis,96371,CPT,,Both,,,255.41,77,,,,,,,,,
ACETAMINOPHEN SUP 650MG,J8498,HCPCS,,Both,0.65,GM,55.5,17,,,,,,,,,
SUCT INSTR YANK BLB W/O VENT,450,RC,,Both,,,4.61,1,,,,,,,,,
SUCT INSTR YANK BLB W/O VENT,450,RC,,Both,,,4.39,1,,,,,,,,,
SUCTION CATH KIT 10FR 50/CS,450,RC,,Both,,,5.7,2,,,,,,,,,
SUCTION CATH KIT 10FR 50/CS,450,RC,,Both,,,5.43,2,,,,,,,,,
SUCTION CATH KIT 12FR 50/CS,450,RC,,Both,,,5.46,2,,,,,,,,,
SUCTION CATH KIT 12FR 50/CS,450,RC,,Both,,,5.2,2,,,,,,,,,
SUCTION CATH KIT 14FR 50/CS,450,RC,,Both,,,5.7,2,,,,,,,,,
SUCTION CATH KIT 14FR 50/CS,450,RC,,Both,,,5.43,2,,,,,,,,,
SUCTION CATH KIT 16FR 50/CS,450,RC,,Both,,,5.58,2,,,,,,,,,
SUCTION CATH KIT 16FR 50/CS,450,RC,,Both,,,5.31,2,,,,,,,,,
SUCTION TUBING USED W PUMP,A7002,HCPCS,,Both,,,129.44,39,,,,,,,,,
"SULFAM + REI, TAB 400-80MG",450,RC,,Both,,,11.31,3,,,,,,,,,
SULFAM/TRI 800/160MG 100/EA,450,RC,,Both,,,50.33,15,,,,,,,,,
SULFAM/TRI 800/160MG 100/EA,450,RC,,Both,,,47.93,14,,,,,,,,,
"TRANEXAMIC ACID, TAB 650MG",J8499,HCPCS,,Both,0.65,GM,78.23,23,,,,,,,,,
"TEMAZEPAM, CAP 7.5MG",J8499,HCPCS,,Both,0.0075,GM,55.13,17,,,,,,,,,
SULFONAMIDE (SYSTEMIC) SULFAMETHOXAZOLE/ TRIMETHOPRIM 200-40MG/ 5mL,450,RC,,Both,,,1145.38,344,,,,,,,,,
SUMATRIPTAN 6MG/0.5ML VL 5BX,450,RC,,Both,,,975.72,293,,,,,,,,,
SUMATRIPTAN 6MG/0.5ML VL 5BX,450,RC,,Both,,,929.25,279,,,,,,,,,
"Injection, bamlanivimab-xxxx, 700 mg",Q0239,HCPCS,,Both,700,ML,0.01,1,,,,,,,,,
Clindamycin pediatric (Cleocin) oral sol 75mg/5ml,J8499,HCPCS,,Both,75,ML,12.29,4,,,,,,,,,
SUPPLIES&MATERIALS PRV BY PHYS >&ABOVE,99070,CPT,,Both,,,300,90,,,,,,,,,
SUPPLY/ACCESSORY/SERVICE,A9900,HCPCS,,Both,,,9.32,3,,,,,,,,,
SURGICAL SHOE/BOOT EACH,L3260,HCPCS,,Both,,,780,234,,,,,,,,,
SURGICAL TRAY/INCISION AND DRAIN,A4550,HCPCS,,Both,,,46.37,14,,,,,,,,,
SURGICAL TRAY/LACERATION KIT,A4550,HCPCS,,Both,,,110.57,33,,,,,,,,,
Surgicel,450,RC,,Both,,,192.31,58,,,,,,,,,
SUTURE 2-0 VICRYL CTD CT-1,450,RC,,Both,,,1065.28,320,,,,,,,,,
SUTURE 2-0 VICRYL CTD CT-1,450,RC,,Both,,,1014.55,304,,,,,,,,,
SUTURE 3-0 ETHILON PS-1,450,RC,,Both,,,2572.55,772,,,,,,,,,
SUTURE 3-0 ETHILON PS-1,450,RC,,Both,,,2450.05,735,,,,,,,,,
SUTURE 3-0 PROLENE PS-1,450,RC,,Both,,,1046.36,314,,,,,,,,,
SUTURE 3-0 PROLENE PS-1,450,RC,,Both,,,996.53,299,,,,,,,,,
SUTURE 3-0 PROLENE PS-2,450,RC,,Both,,,3139.27,942,,,,,,,,,
SUTURE 3-0 PROLENE PS-2,450,RC,,Both,,,2989.77,897,,,,,,,,,
SUTURE 3-0 VICRYL CTD CT-1,450,RC,,Both,,,1062,319,,,,,,,,,
SUTURE 3-0 VICRYL CTD CT-1,450,RC,,Both,,,1011.43,303,,,,,,,,,
SUTURE 3-0 VICRYL CTD PS-2,450,RC,,Both,,,743.13,223,,,,,,,,,
SUTURE 3-0 VICRYL CTD PS-2,450,RC,,Both,,,2382.75,715,,,,,,,,,
SUTURE 3-0 VICRYL CTD PS-2,450,RC,,Both,,,2269.28,681,,,,,,,,,
SUTURE 4-0 ETHILON P-3,450,RC,,Both,,,2337.09,701,,,,,,,,,
SUTURE 4-0 ETHILON P-3,450,RC,,Both,,,2225.8,668,,,,,,,,,
SUTURE 4-0 GUT CHR FS-2,450,RC,,Both,,,1879.28,564,,,,,,,,,
SUTURE 4-0 GUT CHR FS-2,450,RC,,Both,,,1789.79,537,,,,,,,,,
SUTURE 4-0 GUT CHR P-3,450,RC,,Both,,,1315.35,395,,,,,,,,,
SUTURE 4-0 GUT CHR P-3,450,RC,,Both,,,1252.71,376,,,,,,,,,
SUTURE 4-0 GUT CHR RB-1,450,RC,,Both,,,2084.96,625,,,,,,,,,
SUTURE 4-0 GUT CHR RB-1,450,RC,,Both,,,1985.68,596,,,,,,,,,
SUTURE 4-0 PROLENE P-3,450,RC,,Both,,,1073.53,322,,,,,,,,,
SUTURE 4-0 PROLENE P-3,450,RC,,Both,,,1022.41,307,,,,,,,,,
SUTURE 4-0 PROLENE PS-2,450,RC,,Both,,,1074.56,322,,,,,,,,,
SUTURE 4-0 PROLENE PS-2,450,RC,,Both,,,1023.39,307,,,,,,,,,
SUTURE 4-0 VICRYL CTD P-3,450,RC,,Both,,,862.94,259,,,,,,,,,
SUTURE 4-0 VICRYL CTD P-3,450,RC,,Both,,,821.84,247,,,,,,,,,
SUTURE 5-0 ETHILON P-3,450,RC,,Both,,,695.03,209,,,,,,,,,
SUTURE 5-0 ETHILON P-3,450,RC,,Both,,,661.93,199,,,,,,,,,
SUTURE 5-0 ETHILON PS-2,450,RC,,Both,,,756.03,227,,,,,,,,,
SUTURE 5-0 ETHILON PS-2,450,RC,,Both,,,720.03,216,,,,,,,,,
SUTURE 5-0 GUT CHR P-3,450,RC,,Both,,,1346.28,404,,,,,,,,,
SUTURE 5-0 GUT CHR P-3,450,RC,,Both,,,1282.17,385,,,,,,,,,
SUTURE 5-0 PROLENE P-3,450,RC,,Both,,,931.46,279,,,,,,,,,
SUTURE 5-0 PROLENE P-3,450,RC,,Both,,,887.1,266,,,,,,,,,
SUTURE 5-0 PROLENE PS-2,450,RC,,Both,,,863.91,259,,,,,,,,,
SUTURE 5-0 PROLENE PS-2,450,RC,,Both,,,822.76,247,,,,,,,,,
SUTURE 5-0 VICRYL CTD PS-3,450,RC,,Both,,,793.94,238,,,,,,,,,
SUTURE 5-0 VICRYL CTD PS-3,450,RC,,Both,,,756.13,227,,,,,,,,,
SUTURE 6-0 ETHILON P-1,450,RC,,Both,,,788.77,237,,,,,,,,,
SUTURE 6-0 ETHILON P-1,450,RC,,Both,,,751.21,225,,,,,,,,,
SUTURE 6-0 GUT CHR PS-6,450,RC,,Both,,,1326.45,398,,,,,,,,,
SUTURE 6-0 GUT CHR PS-6,450,RC,,Both,,,1263.28,379,,,,,,,,,
SUTURE 6-0 PROLENE P-1,450,RC,,Both,,,1150.36,345,,,,,,,,,
SUTURE 6-0 PROLENE P-1,450,RC,,Both,,,1095.57,329,,,,,,,,,
SUTURE 6-0 PROLENE P-3,450,RC,,Both,,,1157.93,347,,,,,,,,,
SUTURE 6-0 PROLENE P-3,450,RC,,Both,,,1102.79,331,,,,,,,,,
SUTURE 6-0 SILK P-1,450,RC,,Both,,,789.5,237,,,,,,,,,
SUTURE 6-0 SILK P-1,450,RC,,Both,,,751.91,226,,,,,,,,,
SUTURE 6-0 VICRYL CTD P-3,450,RC,,Both,,,839.95,252,,,,,,,,,
SUTURE 6-0 VICRYL CTD P-3,450,RC,,Both,,,799.95,240,,,,,,,,,
SUTURE 6-0 VICRYL CTD S-29,450,RC,,Both,,,2799.15,840,,,,,,,,,
SUTURE 6-0 VICRYL CTD S-29,450,RC,,Both,,,2665.86,800,,,,,,,,,
SUTURE REMOVAL TRAY,A4550,HCPCS,,Both,,,24.48,7,,,,,,,,,
SUTURE REMOVAL TRAY,450,RC,,Both,,,8.32,2,,,,,,,,,
SUTURES ALL TYPES,A4649,HCPCS,,Both,,,20.18,6,,,,,,,,,
SVC PRV BTW 10 PM&8 AM AT 24-HR FAC,99053,CPT,,Both,,,240,72,,,,,,,,,
SWAB BENZOIN TINCTURE 1S,450,RC,,Both,,,32.45,10,,,,,,,,,
SWAB BENZOIN TINCTURE 1S,450,RC,,Both,,,30.89,9,,,,,,,,,
SWAB OR WIPE SKIN BARRIER,A5120,HCPCS,,Both,,,8.09,2,,,,,,,,,
Lyrica 75 mg Tab,J8499,HCPCS,,Both,0.075,GM,4.01,1,,,,,,,,,
SYPHILIS TEST NON TREPONEMAL ANTIBODY QUAL,86592,CPT,,Both,,,384,115,,,,,,,,,
"Syphilis test, non-treponemal antibody; quantitative",86593,CPT,,Both,,,756,227,,,,,,,,,
SYRINGE 10CC LL 100/BX,450,RC,,Both,,,78.29,23,,,,,,,,,
SYRINGE 10CC LL 100/BX,450,RC,,Both,,,74.55,22,,,,,,,,,
SYRINGE 1CC 25X5/8 TB 100/BX,450,RC,,Both,,,59.43,18,,,,,,,,,
SYRINGE 1CC 25X5/8 TB 100/BX,450,RC,,Both,,,56.6,17,,,,,,,,,
SYRINGE 1CC TB 100/BX,450,RC,,Both,,,53.79,16,,,,,,,,,
SYRINGE 1CC TB 100/BX,450,RC,,Both,,,51.22,15,,,,,,,,,
SYRINGE 20CC LL 100/BX,450,RC,,Both,,,190.04,57,,,,,,,,,
SYRINGE 20CC LL 100/BX,450,RC,,Both,,,180.99,54,,,,,,,,,
SYRINGE 3CC LL 100/BX,450,RC,,Both,,,44.27,13,,,,,,,,,
SYRINGE 3CC LL 100/BX,450,RC,,Both,,,42.16,13,,,,,,,,,
SYRINGE 5CC LL 100/BX,450,RC,,Both,,,63.25,19,,,,,,,,,
SYRINGE 5CC LL 100/BX,450,RC,,Both,,,60.23,18,,,,,,,,,
SYRINGE 60CC CATH TIP ST,450,RC,,Both,,,4.61,1,,,,,,,,,
SYRINGE 60CC CATH TIP ST,450,RC,,Both,,,4.39,1,,,,,,,,,
SYRINGE 60CC LL,450,RC,,Both,,,66.05,20,,,,,,,,,
SYRINGE 60CC LL,450,RC,,Both,,,62.9,19,,,,,,,,,
SYRINGE BULB 1OZ ST,450,RC,,Both,,,5.89,2,,,,,,,,,
SYRINGE BULB 1OZ ST,450,RC,,Both,,,5.61,2,,,,,,,,,
SYRINGE TRI-PACK 50/BX,450,RC,,Both,,,3140.97,942,,,,,,,,,
SYRINGE TRI-PACK 50/BX,450,RC,,Both,,,2991.39,897,,,,,,,,,
SYRINGE WITH OR WITHOUT NEEDLE,A4657,HCPCS,,Both,,,9.66,3,,,,,,,,,
T CELLS ABSOLUTE CD4 COUNT,86361,CPT,,Both,,,173.57,52,,,,,,,,,
TACROLIMUS,80197,CPT,,Both,,,520.57,156,,,,,,,,,
Tamiflu 6mg/ml PER ML,450,RC,,Both,,,14.74,4,,,,,,,,,
Tamiflu 75mg Tab,450,RC,,Both,,,92.97,28,,,,,,,,,
Lyrica 75mg Tab,J8499,HCPCS,,Both,0.075,GM,7.02,2,,,,,,,,,
"PLAVIX, TAB 75MG",J8499,HCPCS,,Both,0.075,GM,89.99,27,,,,,,,,,
"TAMIFLU, CAP 75MG",J8499,HCPCS,,Both,0.075,GM,180,54,,,,,,,,,
Tamsulosin 0.4mg Tab,450,RC,,Both,,,31.53,9,,,,,,,,,
"TAMIFLU, CAP 75MG",J8499,HCPCS,,Both,0.075,GM,189,57,,,,,,,,,
TAPE CLOTH/SILK 1,450,RC,,Both,,,57.36,17,,,,,,,,,
TAPE CLOTH/SILK 1,450,RC,,Both,,,54.63,16,,,,,,,,,
TAPE CLOTH/SILK 2,450,RC,,Both,,,57.36,17,,,,,,,,,
TAPE CLOTH/SILK 2,450,RC,,Both,,,54.63,16,,,,,,,,,
TAPE FOAM 2,450,RC,,Both,,,134.01,40,,,,,,,,,
TAPE FOAM 2,450,RC,,Both,,,127.63,38,,,,,,,,,
TAPE FOAM 3,450,RC,,Both,,,134.01,40,,,,,,,,,
TAPE FOAM 3,450,RC,,Both,,,127.63,38,,,,,,,,,
TAPE NON-WATERPROOF,A4450,HCPCS,,Both,,,14.48,4,,,,,,,,,
TAPE PAPER 1,450,RC,,Both,,,34.15,10,,,,,,,,,
TAPE PAPER 1,450,RC,,Both,,,32.51,10,,,,,,,,,
TAPE PAPER 2,450,RC,,Both,,,34.2,10,,,,,,,,,
TAPE PAPER 2,450,RC,,Both,,,32.57,10,,,,,,,,,
TAPE TRANS 1,450,RC,,Both,,,60.22,18,,,,,,,,,
TAPE TRANS 1,450,RC,,Both,,,57.35,17,,,,,,,,,
TAPE TRANS 2,450,RC,,Both,,,54.76,16,,,,,,,,,
TAPE TRANS 2,450,RC,,Both,,,52.14,16,,,,,,,,,
TAPE WATERPROOF,A4452,HCPCS,,Both,,,14.48,4,,,,,,,,,
TB ANTIGEN RESPONSE GAMMA INTERFERON T-CELL SUSP,86481,CPT,,Both,,,1000,300,,,,,,,,,
TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFER,86480,CPT,,Both,,,109.77,33,,,,,,,,,
TCD STD ICRA ART COMPL STD,93886,CPT,,Both,,,1248.49,375,,,,,,,,,
TD TOXOIDS ADSORBED PRSRV FR 7 YR + IM,90714,CPT,,Both,,,806,242,,,,,,,,,
TDAP VACCINE 7 YR + IM,90715,CPT,,Both,,,756,227,,,,,,,,,
TEE R-T IMG 2D IMG ACQUISJ I&R ONLY,93314,CPT,,Both,,,3874.01,1162,,,,,,,,,
TEE R-T IMG 2D W/PROBE PLMT ONLY,93313,CPT,,Both,,,3630.75,1089,,,,,,,,,
TEGADERM DRESS 2-3/8X2.75,450,RC,,Both,,,302.22,91,,,,,,,,,
TEGADERM DRESS 2-3/8X2.75,450,RC,,Both,,,287.83,86,,,,,,,,,
LEVAQUIN 750MG IVPB ,J1956,HCPCS,,Both,0.75,GM,71.96,22,,,,,,,,,
"LEVOFLOXACIN (LEVAQUIN) , TAB 750MG ",J8499,HCPCS,,Both,0.75,GM,57.75,17,,,,,,,,,
TENIVAC PF (TD) SYR 10X.5ML,450,RC,,Both,,,1607.08,482,,,,,,,,,
TENIVAC PF (TD) SYR 10X.5ML,450,RC,,Both,,,1530.54,459,,,,,,,,,
TENOTOMY ELBOW LATERAL/MEDIAL PERCUTANEOUS,24357,CPT,,Both,,,2570,771,,,,,,,,,
"Levofloxacin/Dextrose 5%, 750 mg / 150 mL Inj Bag 150 mL",J3490,HCPCS,,Both,750,ML,262.5,79,,,,,,,,,
TESSALON-BENZONATE 200mg tablet,450,RC,,Both,,,1.28,1,,,,,,,,,
TEST STRIPS OPA/28 50/BT=EA,450,RC,,Both,,,335.02,101,,,,,,,,,
TEST STRIPS OPA/28 50/BT=EA,450,RC,,Both,,,319.07,96,,,,,,,,,
Methocarbamol 750 mg tab (Robaxin),J8499,HCPCS,,Both,0.75,GM,96.93,29,,,,,,,,,
"Testosterone; bioavailable, direct measurement (eg, differential precipitation)",84410,CPT,,Both,,,430.75,129,,,,,,,,,
Testosterone; free,84402,CPT,,Both,,,437.5,131,,,,,,,,,
Testosterone; total ,84403,CPT,,Both,,,443.63,133,,,,,,,,,
TETANUS IMMUNE GLOBULIN INJ,J1670,HCPCS,,Both,,,56.5,17,,,,,,,,,
"METHOCARBAMOL, TAB 750MG",J8499,HCPCS,,Both,0.75,GM,25.5,8,,,,,,,,,
TETRACAINE .5% O/S 15ML,450,RC,,Both,,,58.16,17,,,,,,,,,
TETRACAINE .5% O/S 15ML,450,RC,,Both,,,3.7,1,,,,,,,,,
ONDANSETRON HCL 8 MG ORAL,Q0179,HCPCS,,Both,0.008,GM,6.58,2,,,,,,,,,
"Therapeutic procedure, 1 or more areas, each 15 minutes; gai...",97116,CPT,,Both,,,780,234,,,,,,,,,
THERMOMETER REFRIG/FREEZ,450,RC,,Both,,,382.5,115,,,,,,,,,
THERMOMETER REFRIG/FREEZ,450,RC,,Both,,,364.29,109,,,,,,,,,
Thiamine (Vitamin B-1),84425,CPT,,Both,,,48.93,15,,,,,,,,,
Senna Lax 8.6mg tab,A9150,HCPCS,,Both,0.0086,GM,4.2,1,,,,,,,,,
THIN FILM DRESS 4X4.75,450,RC,,Both,,,379.6,114,,,,,,,,,
THIN FILM DRESS 4X4.75,450,RC,,Both,,,361.52,108,,,,,,,,,
THIN FILM DRESS 6X8,450,RC,,Both,,,186.59,56,,,,,,,,,
THIN FILM DRESS 6X8,450,RC,,Both,,,177.7,53,,,,,,,,,
THORACENTESIS TRAY W/CATH,450,RC,,Both,,,235.76,71,,,,,,,,,
THORACENTESIS TRAY W/CATH,450,RC,,Both,,,224.53,67,,,,,,,,,
"Thoracentesis, needle/catheter, aspiration pleural space; w/o imaging",32554,CPT,,Both,,,1790.16,537,,,,,,,,,
"Thoracentesis, needle/catheter, aspiration pleural space; with imaging",32555,CPT,,Both,,,2385.6,716,,,,,,,,,
THROMBIN TIME PLASMA,85670,CPT,,Both,,,1020,306,,,,,,,,,
"Thrombolysis, cerebral, by intravenous infusion",37195,CPT,,Both,,,1522.72,457,,,,,,,,,
"Thrombolysis, coronary; by intravenous infusion",92977,CPT,,Both,,,710.63,213,,,,,,,,,
Thromboplastin inhibition,85705,CPT,,Both,,,231.12,69,,,,,,,,,
THROMBOPLASTIN TIME PRTL SUBSTIT PLASMA FRCTJ EA,85732,CPT,,Both,,,111.13,33,,,,,,,,,
THROMBOPLASTIN TM PRTL PLSM/WHL BLD,85730,CPT,,Both,,,359,108,,,,,,,,,
THYR HORM UPTK/THYR HORM BNDNG RATIO,84479,CPT,,Both,,,402,121,,,,,,,,,
THYROGLOBULIN ANTIBODY,86800,CPT,,Both,,,850,255,,,,,,,,,
THYROID STIMULATING IMMUNE GLOBULINS TSI,84445,CPT,,Both,,,508.6,153,,,,,,,,,
THYROID UPTAKE SINGLE/MULTIPLE QUANT MEASUREMENT,78012,CPT,,Both,,,913.4,274,,,,,,,,,
THYROXINE FR,84439,CPT,,Both,,,538,161,,,,,,,,,
Thyroxine; total,84436,CPT,,Both,,,438,131,,,,,,,,,
TIMOLOL .5% O/S 5ML,450,RC,,Both,,,30.15,9,,,,,,,,,
TIMOLOL .5% O/S 5ML,450,RC,,Both,,,28.71,9,,,,,,,,,
TISS CUL NON-NEO DISORDERS SKN/OTH SOLID TISS BX,88233,CPT,,Both,,,2026.92,608,,,,,,,,,
TISSUE FACIAL KLEENEX 100/BX,450,RC,,Both,,,6.43,2,,,,,,,,,
TISSUE FACIAL KLEENEX 100/BX,450,RC,,Both,,,6.12,2,,,,,,,,,
"Tissue transglutaminase, each immunoglobulin (Ig) class",86364,CPT,,Both,,,96.85,29,,,,,,,,,
ATORVASTATIN 80MG,J8499,HCPCS,,Both,0.08,GM,25.62,8,,,,,,,,,
TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES,99406,CPT,,Both,,,112.25,34,,,,,,,,,
TOBRADEX OPH SOL 5ML,450,RC,,Both,,,951.59,285,,,,,,,,,
TOBRADEX OPH SOL 5ML,450,RC,,Both,,,906.28,272,,,,,,,,,
Simethicone (Mylicon) 80mg tab,J8499,HCPCS,,Both,0.08,GM,25.1,8,,,,,,,,,
TobraDex? Tobramycin / Dexa 0.3% - 0.1% Ointment 3.5 Gm,J3490,HCPCS,,Both,,,2675.68,803,,,,,,,,,
TOBRAMYCIN .3% O/S 5ML,450,RC,,Both,,,47.79,14,,,,,,,,,
TOBRAMYCIN .3% O/S 5ML,450,RC,,Both,,,45.51,14,,,,,,,,,
TOBRAMYCIN 0.3% EYE DROP,J3490,HCPCS,,Both,,,134.19,40,,,,,,,,,
TOBRAMYCIN SULFATE INJECTION,J3260,HCPCS,,Both,,,49.8,15,,,,,,,,,
Tocopherol alpha (vitamin E assay/level),84446,CPT,,Both,,,113.44,34,,,,,,,,,
Tocopherol alpha (Vitamin E),84446,CPT,,Both,,,58.05,17,,,,,,,,,
TOILET TISSUE COTTONELLE 2PL,450,RC,,Both,,,4.61,1,,,,,,,,,
TOILET TISSUE COTTONELLE 2PL,450,RC,,Both,,,4.39,1,,,,,,,,,
TONGUE BLADE ADULT ST 100/BX,450,RC,,Both,,,20.44,6,,,,,,,,,
TONGUE BLADE ADULT ST 100/BX,450,RC,,Both,,,19.47,6,,,,,,,,,
TONGUE BLADE JR ST 100/BX,450,RC,,Both,,,20.44,6,,,,,,,,,
TONGUE BLADE JR ST 100/BX,450,RC,,Both,,,19.47,6,,,,,,,,,
TONGUE DEPRESSOR,A4649,HCPCS,,Both,,,1.61,1,,,,,,,,,
SOLU-MEDROL - METHYLPREDNISOLONE 80 MG INJ,J1040,HCPCS,,Both,0.08,GM,14.35,4,,,,,,,,,
TOPICAL LIDOCAINE 4%,A6250,HCPCS,,Both,,,13.13,4,,,,,,,,,
Topiramate,80201,CPT,,Both,,,89.52,27,,,,,,,,,
Valsartan 80mg tab ,J8499,HCPCS,,Both,0.08,GM,4.36,1,,,,,,,,,
"XOFLUZA, TAB 80MG",J8499,HCPCS,,Both,0.08,GM,1560.74,468,,,,,,,,,
TOTAL CTL LVL1 5/BX,450,RC,,Both,,,597.71,179,,,,,,,,,
TOTAL CTL LVL1 5/BX,450,RC,,Both,,,569.25,171,,,,,,,,,
TOTAL CTL LVL2 5/BX,450,RC,,Both,,,597.77,179,,,,,,,,,
TOTAL CTL LVL2 5/BX,450,RC,,Both,,,569.3,171,,,,,,,,,
TOURNIQUET 1X18,450,RC,,Both,,,1.04,1,,,,,,,,,
TOURNIQUET 1X18    ,450,RC,,Both,,,1.4,1,,,,,,,,,
"TOURNIQUET FOR DIALYSIS, EACH",A4929,HCPCS,,Both,,,40.03,12,,,,,,,,,
TOWEL MULTI-FOLD WHT9.25X9.5,450,RC,,Both,,,3.82,1,,,,,,,,,
TOWEL MULTI-FOLD WHT9.25X9.5,450,RC,,Both,,,158,47,,,,,,,,,
TOWEL OR BLUE 17X26 ST4S,450,RC,,Both,,,17.83,5,,,,,,,,,
TOWEL OR BLUE 17X26 ST4S,450,RC,,Both,,,16.98,5,,,,,,,,,
TOWEL PROF 13.5X18 3P WHT,450,RC,,Both,,,110.61,33,,,,,,,,,
TOWEL PROF 13.5X18 3P WHT,450,RC,,Both,,,105.34,32,,,,,,,,,
Towellete ,450,RC,,Both,,,2.73,1,,,,,,,,,
TOXIN/ANTITOXIN ASSAY TISSUE CULTURE,87230,CPT,,Both,,,1140,342,,,,,,,,,
Toxoplasma antibody,86777,CPT,,Both,,,345.36,104,,,,,,,,,
TRACH TUBE ENDO 2.5MM MUR NCEA,450,RC,,Both,,,11.22,3,,,,,,,,,
TRACH TUBE ENDO 2.5MM MUR NCEA,450,RC,,Both,,,10.69,3,,,,,,,,,
TRACH TUBE ENDO 3MM MUR NC,450,RC,,Both,,,11.22,3,,,,,,,,,
TRACH TUBE ENDO 3MM MUR NC,450,RC,,Both,,,10.69,3,,,,,,,,,
TRACH TUBE ENDO 4MM MUR NC,450,RC,,Both,,,11.22,3,,,,,,,,,
TRACH TUBE ENDO 4MM MUR NC,450,RC,,Both,,,10.69,3,,,,,,,,,
TRACH TUBE ENDO 5.0MM MUR NCEA,450,RC,,Both,,,11.22,3,,,,,,,,,
TRACH TUBE ENDO 5.0MM MUR NCEA,450,RC,,Both,,,10.69,3,,,,,,,,,
TRACH TUBE ENDO 6 MUR CUF,450,RC,,Both,,,12.68,4,,,,,,,,,
TRACH TUBE ENDO 6 MUR CUF,450,RC,,Both,,,12.08,4,,,,,,,,,
TRACH TUBE ENDO 6.5 MUR CUF,450,RC,,Both,,,12.68,4,,,,,,,,,
TRACH TUBE ENDO 6.5 MUR CUF,450,RC,,Both,,,12.08,4,,,,,,,,,
TRACH TUBE ENDO 7 MUR CUF,450,RC,,Both,,,12.68,4,,,,,,,,,
TRACH TUBE ENDO 7 MUR CUF,450,RC,,Both,,,12.08,4,,,,,,,,,
TRACH TUBE ENDO 7.5 MUR CUF,450,RC,,Both,,,12.68,4,,,,,,,,,
TRACH TUBE ENDO 7.5 MUR CUF,450,RC,,Both,,,12.08,4,,,,,,,,,
TRACH TUBE ENDO 8 MUR CUF,450,RC,,Both,,,12.68,4,,,,,,,,,
TRACH TUBE ENDO 8 MUR CUF,450,RC,,Both,,,12.08,4,,,,,,,,,
TRACH TUBE ENDO 8.5 MUR CUF,450,RC,,Both,,,12.68,4,,,,,,,,,
TRACH TUBE ENDO 8.5 MUR CUF,450,RC,,Both,,,12.08,4,,,,,,,,,
TRACH TUBE ENDO 9 MUR CUF,450,RC,,Both,,,12.68,4,,,,,,,,,
TRACH TUBE ENDO 9 MUR CUF,450,RC,,Both,,,12.08,4,,,,,,,,,
TRACH/LARYN TUBE NON-CUFFED,A7520,HCPCS,,Both,,,51.25,15,,,,,,,,,
TRACHEOSTOMY EMERGENCY CRICOTHYROID MEMBRANE,31605,CPT,,Both,,,2299.13,690,,,,,,,,,
TRACHEOSTOMY EMERGENCY PROCEDURE TRANSTRACHEAL,31603,CPT,,Both,,,41201.03,12360,,,,,,,,,
TRACHEOSTOMY PLANNED SPX,31600,CPT,,Both,,,5698.01,1709,,,,,,,,,
TRACHEOTOMY TUBE CHANGE PRIOR TO FISTULA TRACT,31502,CPT,,Both,,,7085.36,2126,,,,,,,,,
Acyclovir 800MG tab (Zovirax),J8499,HCPCS,,Both,0.8,GM,13.64,4,,,,,,,,,
Ibuprofen  800 mg,J8499,HCPCS,,Both,0.8,GM,10.27,3,,,,,,,,,
"Tranexamic Acid, 100 mg inj",450,RC,,Both,,,16.01,5,,,,,,,,,
MOTRIN 800 MG TABLET,A9150,HCPCS,,Both,0.8,GM,5.51,2,,,,,,,,,
"ASPIRIN, CHEW 81MG",A9150,HCPCS,,Both,0.081,GM,10.14,3,,,,,,,,,
TRANSFERASE ALANINE AMINO,84460,CPT,,Both,,,300,90,,,,,,,,,
TRANSFERASE ASPARTATE AMINO,84450,CPT,,Both,,,356,107,,,,,,,,,
TRAY IRRIGATION 2000CC 20/CS,450,RC,,Both,,,13.94,4,,,,,,,,,
TRAY IRRIGATION 2000CC 20/CS,450,RC,,Both,,,13.28,4,,,,,,,,,
Amoxicillin/Clavulanate 875mg/125mg tab,J8499,HCPCS,,Both,0.875,GM,12.34,4,,,,,,,,,
TREAT FINGER DISLOCATION,26775,CPT,,Both,,,4914.63,1474,,,,,,,,,
TREAT KNUCKLE DISLOCATION,26705,CPT,,Both,,,5269.63,1581,,,,,,,,,
TREAT THUMB DISLOCATION,26641,CPT,,Both,,,4688.38,1407,,,,,,,,,
TREATMENT CLOSED ELBOW DISLOCATION REQ ANES,24605,CPT,,Both,,,5958.88,1788,,,,,,,,,
Treatment Of Ankle Fracture,27810,CPT,,Both,,,6016,1805,,,,,,,,,
Treatment of closed elbow dislocation; without anesthesia,24600,CPT,,Both,,,4675,1403,,,,,,,,,
TRIAGE CARDIAC PANEL 25/BX,450,RC,,Both,,,6.07,2,,,,,,,,,
TRIAGE CARDIAC PANEL 25/BX,82550,CPT,,Both,,,468,140,,,,,,,,,
TRIAGE TOTAL CAL/VER 5X2,450,RC,,Both,,,478.31,143,,,,,,,,,
TRIAGE TOTAL CAL/VER 5X2,450,RC,,Both,,,455.53,137,,,,,,,,,
Albuterol Sulfate 90 mcg Aerosol Metered Dose Inhaler,J3535,HCPCS,,Both,90,GM,355.99,107,,,,,,,,,
"Triamcinolone Acetonide (Kenalog), Crm 0.1%",J3490,HCPCS,,Both,,,28.88,9,,,,,,,,,
Triglycerides,84478,CPT,,Both,,,858,257,,,,,,,,,
TRIIODOTHYRO9 T3 FR,84481,CPT,,Both,,,570,171,,,,,,,,,
TRIIODOTHYRO9 T3 TOT,84480,CPT,,Both,,,684,205,,,,,,,,,
Triiodothyronine T3; reverse,84482,CPT,,Both,,,275.41,83,,,,,,,,,
TRIPLE ANTIBIOTIC OINT .9GM,450,RC,,Both,,,7.67,2,,,,,,,,,
Troleandomycin Oint,J8499,HCPCS,,Both,,,1.43,1,,,,,,,,,
Tropicamide Drops,J8499,HCPCS,,Both,,,7.36,2,,,,,,,,,
TROPONIN QUAL,84512,CPT,,Both,,,408,122,,,,,,,,,
TROPONIN QUAN,84484,CPT,,Both,,,1055,317,,,,,,,,,
TSH - THYR STIMULATING HORM,84443,CPT,,Both,,,774,232,,,,,,,,,
TSTG ANS FUNCJ CARDIOVAGAL INNERVAJ PARASYMP,95921,CPT,,Both,,,1062.47,319,,,,,,,,,
TUBE BC GRN 4ML LITH HEP,450,RC,,Both,,,103.03,31,,,,,,,,,
TUBE BC GRN 4ML LITH HEP,450,RC,,Both,,,103.03,31,,,,,,,,,
TUBE BC LAV 4ML K2EDTA PLAS,450,RC,,Both,,,72.52,22,,,,,,,,,
TUBE BC LAV 4ML K2EDTA PLAS,450,RC,,Both,,,69.07,21,,,,,,,,,
TUBE BC LTBLU 4.5ML SOD CIT,450,RC,,Both,,,116.61,35,,,,,,,,,
TUBE BC LTBLU 4.5ML SOD CIT,450,RC,,Both,,,111.05,33,,,,,,,,,
TUBE BC MINI AMBER SST,450,RC,,Both,,,201.38,60,,,,,,,,,
TUBE BC MINI AMBER SST,450,RC,,Both,,,191.79,58,,,,,,,,,
TUBE BC MINI LAV EDTA,450,RC,,Both,,,181.19,54,,,,,,,,,
TUBE BC MINI LAV EDTA,450,RC,,Both,,,172.56,52,,,,,,,,,
TUBE BC RED 4ML CLOT ACT,450,RC,,Both,,,119.04,36,,,,,,,,,
TUBE BC RED 4ML CLOT ACT,450,RC,,Both,,,113.36,34,,,,,,,,,
TUBE BC RED/GRY 8.5ML SST,450,RC,,Both,,,134.86,40,,,,,,,,,
TUBE BC RED/GRY 8.5ML SST,450,RC,,Both,,,128.44,39,,,,,,,,,
TUBE CHEST 28FR 10/CS,450,RC,,Both,,,43.18,13,,,,,,,,,
TUBE CHEST 28FR 10/CS,450,RC,,Both,,,41.12,12,,,,,,,,,
TUBE CHEST 32FR 10/CS,450,RC,,Both,,,432.17,130,,,,,,,,,
TUBE CHEST 32FR 10/CS,450,RC,,Both,,,411.58,123,,,,,,,,,
TUBE CHEST 36FR 10/CS,450,RC,,Both,,,432.17,130,,,,,,,,,
TUBE CHEST 36FR 10/CS,450,RC,,Both,,,411.58,123,,,,,,,,,
TUBE GAUZE 1,450,RC,,Both,,,65.36,20,,,,,,,,,
TUBE GAUZE 1,450,RC,,Both,,,62.25,19,,,,,,,,,
TUBE GAUZE 5/8,450,RC,,Both,,,51.18,15,,,,,,,,,
TUBE GAUZE 5/8,450,RC,,Both,,,48.74,15,,,,,,,,,
TUBE HLDR BC 100/BX,450,RC,,Both,,,61.79,19,,,,,,,,,
TUBE HLDR BC 100/BX,450,RC,,Both,,,58.84,18,,,,,,,,,
TUBE HLDR BC 250/BX,450,RC,,Both,,,0.24,1,,,,,,,,,
TUBE HLDR BC 250/BX,450,RC,,Both,,,0.23,1,,,,,,,,,
Tube holder ,450,RC,,Both,,,3.1,1,,,,,,,,,
TUBE NASOGASTRIC SUMP 10FR,450,RC,,Both,,,16.61,5,,,,,,,,,
TUBE NASOGASTRIC SUMP 10FR,450,RC,,Both,,,15.82,5,,,,,,,,,
TUBE NASOGASTRIC SUMP 12FR,450,RC,,Both,,,16.61,5,,,,,,,,,
TUBE NASOGASTRIC SUMP 12FR,450,RC,,Both,,,15.82,5,,,,,,,,,
TUBE NASOGASTRIC SUMP 14FR,450,RC,,Both,,,16.61,5,,,,,,,,,
TUBE NASOGASTRIC SUMP 14FR,450,RC,,Both,,,15.82,5,,,,,,,,,
TUBE NASOGASTRIC SUMP 16FR,450,RC,,Both,,,16.61,5,,,,,,,,,
TUBE NASOGASTRIC SUMP 16FR,450,RC,,Both,,,15.82,5,,,,,,,,,
TUBE NASOGASTRIC SUMP 18FR,450,RC,,Both,,,16.61,5,,,,,,,,,
TUBE NASOGASTRIC SUMP 18FR,450,RC,,Both,,,15.82,5,,,,,,,,,
TUBE THORACOSTOMY INCLUDES WATER SEAL,32551,CPT,,Both,,,3345.87,1004,,,,,,,,,
TUBING (OXYGEN) PER FOOT,A4616,HCPCS,,Both,,,1.82,1,,,,,,,,,
TUBING OXYGEN 7 CRUSH RES,450,RC,,Both,,,3.28,1,,,,,,,,,
TUBING OXYGEN 7 CRUSH RES,450,RC,,Both,,,3.12,1,,,,,,,,,
TUBING SUCTION 1/4,450,RC,,Both,,,4.61,1,,,,,,,,,
TUBING SUCTION 1/4,450,RC,,Both,,,7.05,2,,,,,,,,,
TUBING SUCTION 1/4,450,RC,,Both,,,4.39,1,,,,,,,,,
TUBULAR DRESSING,A6457,HCPCS,,Both,,,56.66,17,,,,,,,,,
"AZO STANDARD, TAB 95MG",A9150,HCPCS,,Both,0.095,GM,2.39,1,,,,,,,,,
"TX of tarsal bone fx (except; talus & calcaneus); w/o man, each",28450,CPT,,Both,,,2795.75,839,,,,,,,,,
TX SUPERFICIAL WOUND DEHISCENCE SIMPLE CLOSURE,12020,CPT,,Both,,,3603.25,1081,,,,,,,,,
TX SUPERFICIAL WOUND DEHISCENCE W/PACKING,12021,CPT,,Both,,,2177,653,,,,,,,,,
"Methylergonovine Maleate, up to 0.2 mg, Injection",J2210,HCPCS,,Both,0.0002,GM,246.52,74,,,,,,,,,
Tylenol 120mg sup,450,RC,,Both,,,10.19,3,,,,,,,,,
Levsin (hyoscyamine sulfate) up to 0.25 mg ,J1980,HCPCS,,Both,0.00025,GM,70.88,21,,,,,,,,,
"Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg (Pulmicort)",J7626,HCPCS,,Both,0.0005,GM,138.6,42,,,,,,,,,
"Terbutaline Sulfate, injection, up to 1mg",J3105,HCPCS,,Both,0.001,GM,56.7,17,,,,,,,,,
PRELONE - INJECTION PREDNISOLONE ACETATE UP TO 1 ML,J2650,HCPCS,,Both,1,ML,8.39,3,,,,,,,,,
Tylenol 500mg Tab,450,RC,,Both,,,7.28,2,,,,,,,,,
MORPHINE SULFATE INJECTION UP TO 10MG,J2270,HCPCS,,Both,0.01,GM,29.7,9,,,,,,,,,
ROCURONIUM UP TO 10MG,J3490,HCPCS,,Both,0.01,GM,24.35,7,,,,,,,,,
Triamcinolone acet inj nos up to 10mg (40mg total),J3301,HCPCS,,Both,0.01,GM,26.81,8,,,,,,,,,
TYLENOL W/ CODEINE 1 TSP,J3490,HCPCS,,Both,,,3.72,1,,,,,,,,,
UDS - URINE DRUG SCREEN QUAL 1 DRUG CLASS METH EA DRUG CLASS,G0431,HCPCS,,Both,,,183.86,55,,,,,,,,,
ULTRASOUND 14 WK TABDL 1/1ST GESTATION,76801,CPT,,Both,,,2865.56,860,,,,,,,,,
ULTRASOUND ABDOMINAL R-T W/IMAGE LIMITED,76705,CPT,,Both,,,4003,1201,,,,,,,,,
ULTRASOUND AFTER 1ST TRI 1/1ST GESTATION,76805,CPT,,Both,,,3024,907,,,,,,,,,
ULTRASOUND GEL 5L CLR,450,RC,,Both,,,102.91,31,,,,,,,,,
ULTRASOUND GEL 5L CLR,450,RC,,Both,,,98.01,29,,,,,,,,,
ULTRASOUND GEL 8.5OZ CLR,450,RC,,Both,,,13.89,4,,,,,,,,,
ULTRASOUND GEL 8.5OZ CLR,450,RC,,Both,,,13.23,4,,,,,,,,,
"Ultrasound, pregnant uterus, real time with image documentat...",76814,CPT,,Both,,,430.69,129,,,,,,,,,
"Ultrasound, pregnant uterus, real time with image documentat...",76816,CPT,,Both,,,1854,556,,,,,,,,,
UNDERARM SPRINGASSIST CRUTCH,E0117,HCPCS,,Both,,,166.9,50,,,,,,,,,
UNDERPAD MCK LITE 23X36,450,RC,,Both,,,10.37,3,,,,,,,,,
UNDERPAD MCK LITE 23X36,450,RC,,Both,,,9.87,3,,,,,,,,,
UNLISTED PROCEDURE CASTING/STRAPPING,29799,CPT,,Both,,,1181.75,355,,,,,,,,,
UNLISTED PROCEDURE DENTOALVEOLAR STRUCTURES,41899,CPT,,Both,,,976.13,293,,,,,,,,,
UNLISTED US PROCEDURE,76999,CPT,,Both,,,1155,347,,,,,,,,,
UPPER LIMB ORTHOSIS NOS,L3999,HCPCS,,Both,,,242.13,73,,,,,,,,,
UREA N QUAN,84520,CPT,,Both,,,431,129,,,,,,,,,
URETHROCYSTOGRAPHY RETROGRADE RS&I,74450,CPT,,Both,,,5636.56,1691,,,,,,,,,
URIC ACID BLD,84550,CPT,,Both,,,684,205,,,,,,,,,
URIC ACID OTH SRC,84560,CPT,,Both,,,540,162,,,,,,,,,
URINAL MALE JUG-TYPE,E0325,HCPCS,,Both,,,174,52,,,,,,,,,
URINAL MALE W/COVER CLR,450,RC,,Both,,,7.47,2,,,,,,,,,
URINAL MALE W/COVER CLR,450,RC,,Both,,,7.1,2,,,,,,,,,
URINALYSIS - URNLS DIP STICK/TABLET RGNT AUTO MIC,81001,CPT,,Both,,,690,207,,,,,,,,,
"Urinalysis, microscopic only ",81015,CPT,,Both,,,124.12,37,,,,,,,,,
"Urinary drainage bag, leg or abdomen, latex, w  wo tube, with straps, each",A5112,HCPCS,,Both,,,373.68,112,,,,,,,,,
URINE ALBUMIN QUANTITATIVE,82043,CPT,,Both,,,95.75,29,,,,,,,,,
URINE COLL BAG PED 200ML NS,450,RC,,Both,,,173.06,52,,,,,,,,,
URINE COLL BAG PED 200ML NS,450,RC,,Both,,,164.82,49,,,,,,,,,
URINE CTL DIP 15ML LVL1/2,450,RC,,Both,,,643.56,193,,,,,,,,,
URINE CTL DIP 15ML LVL1/2,450,RC,,Both,,,612.91,184,,,,,,,,,
URINE CUP FEMALE COLLECT DEV CUP,A4327,HCPCS,,Both,,,4.84,1,,,,,,,,,
URINE PREGNANCY TST VIS COLOR CMPRSN METHS,81025,CPT,,Both,,,684,205,,,,,,,,,
URINE SPEC CUP,A4649,HCPCS,,Both,,,4.84,1,,,,,,,,,
URNLS DIP STICK/TABLET RGNT AUTO W/O MIC,81003,CPT,,Both,,,545,164,,,,,,,,,
URNLS DIP STICK/TABLET RGNT NON-AUTO MIC,81000,CPT,,Both,,,510,153,,,,,,,,,
URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MIC,81002,CPT,,Both,,,300,90,,,,,,,,,
"Urography (pyelography), intravenous, with or without KUB, w...",74400,CPT,,Both,,,7068.81,2121,,,,,,,,,
US ABDOMINAL AORTA REAL TIME SCREEN STUDY AAA,76706,CPT,,Both,,,892.92,268,,,,,,,,,
US ABDOMINAL R-T W/IMAGE DOCUMENTATION,76700,CPT,,Both,,,3224,967,,,,,,,,,
US BREAST UNI REAL TIME WITH IMAGE COMPLETE,76641,CPT,,Both,,,2865.56,860,,,,,,,,,
US BREAST UNI REAL TIME WITH IMAGE LIMITED,76642,CPT,,Both,,,1941.41,582,,,,,,,,,
US CHEST REAL TIME W/IMAGE DOCUMENTATION,76604,CPT,,Both,,,2865.56,860,,,,,,,,,
US EXTREMITY NON-VASC REAL-TIME IMG COMPL,76881,CPT,,Both,,,3024,907,,,,,,,,,
US EXTREMITY NON-VASC REAL-TIME IMG LMTD,76882,CPT,,Both,,,1520.97,456,,,,,,,,,
US FETAL NUCHAL TRANSLUCENCY 1ST GESTATION,76813,CPT,,Both,,,1496.65,449,,,,,,,,,
US GUIDANCE NEEDLE PLACEMENT IMG S&I,76942,CPT,,Both,,,2612.5,784,,,,,,,,,
US GUIDE VASCULAR ACCESS,76937,CPT,,Both,,,2671.18,801,,,,,,,,,
US PEL NONOB B-SCAN&/R-T IMG LMTD/F-UP+C97,76857,CPT,,Both,,,2724,817,,,,,,,,,
US PELVIC NONOB REAL-TIME IMG COMPLETE,76856,CPT,,Both,,,3024,907,,,,,,,,,
US PG UTER R-T IMG TRVG,76817,CPT,,Both,,,3024,907,,,,,,,,,
US PREG UTERUS > 1ST TRIMESTER ABDL EA GESTATIO,76810,CPT,,Both,,,3024,907,,,,,,,,,
US PREG UTERUS 14 WK TRANSABDL EACH  ADDL GESTATION,76802,CPT,,Both,,,1170,351,,,,,,,,,
US PREGNANT UTERUS LIMITED 1/> FETUSES,76815,CPT,,Both,,,2300,690,,,,,,,,,
US RETROPERITONEAL R-T W/IMAGE COMPL,76770,CPT,,Both,,,2865.56,860,,,,,,,,,
US RPR B-SCAN&/R-T IMG LMTD,76775,CPT,,Both,,,3024,907,,,,,,,,,
US SCROTUM&CNTS,76870,CPT,,Both,,,3654,1096,,,,,,,,,
US SOFT TISS HEAD&NCK R-T IMG,76536,CPT,,Both,,,3024,907,,,,,,,,,
US TRVG,76830,CPT,,Both,,,3208,962,,,,,,,,,
Uvl pnl 2 sq ft or less,E0691,HCPCS,,Both,,,7636.17,2291,,,,,,,,,
VACUTAINER 21 OR 23 GA,450,RC,,Both,,,8.85,3,,,,,,,,,
VAG DLVR ONLY,59409,CPT,,Both,,,10383.5,3115,,,,,,,,,
VAGINAL SPECULUM,A4649,HCPCS,,Both,,,244.24,73,,,,,,,,,
"Injection, oxytocin, up to 10 units (10units/mL)",J2590,HCPCS,,Both,10,ML,22.47,7,,,,,,,,,
Valproic acid (dipropylacetic acid); total ,80164,CPT,,Both,,,960,288,,,,,,,,,
Valproic Acid/Depacon (Valproate Sodium) Inj 100 mg,450,RC,,Both,,,25.2,8,,,,,,,,,
Fentanyl 100mcg/ (Up to 100MCG),J3010,HCPCS,,Both,,,28.6,9,,,,,,,,,
Valtrex (Acyclovir) up to 800mg,450,RC,,Both,,,19.01,6,,,,,,,,,
FENTANYL CITRATE INJECITON 0.1MG/ (Up to 100MCG),J3010,HCPCS,,Both,0.1,GM,28.6,9,,,,,,,,,
VANCOMYCIN 1GM FT,450,RC,,Both,,,29.9,9,,,,,,,,,
VANCOMYCIN 1GM FT,450,RC,,Both,,,75.83,23,,,,,,,,,
"Inj, hydrocortisone sodium succinate, up to 100 mg",J1720,HCPCS,,Both,0.1,GM,108.82,33,,,,,,,,,
LABETALOL UP TO 100 MG,J3490,HCPCS,,Both,0.1,GM,8.09,2,,,,,,,,,
SOLU-MEDROL - METHYLPREDNISOLONE UP TO 125MG,J2930,HCPCS,,Both,0.125,GM,22.69,7,,,,,,,,,
VASELINE GAUZE 1X36 12/BX,450,RC,,Both,,,66.4,20,,,,,,,,,
VASELINE GAUZE 1X36 12/BX,450,RC,,Both,,,63.23,19,,,,,,,,,
Vasotec/ Enalpril ,J3490,HCPCS,,Both,,,8.66,3,,,,,,,,,
VECURONIUM 10MG 10X10ML,450,RC,,Both,,,520.34,156,,,,,,,,,
VECURONIUM 10MG 10X10ML,450,RC,,Both,,,495.56,149,,,,,,,,,
HYDRALAZINE HCL INJ UP TO 20MG,J0360,HCPCS,,Both,0.02,GM,238.9,72,,,,,,,,,
VENIPUNCTURE,36415,CPT,,Both,,,456,137,,,,,,,,,
VENTOLIN HFA 90MCG INH 18GM,450,RC,,Both,,,319.56,96,,,,,,,,,
VENTOLIN HFA 90MCG INH 18GM,450,RC,,Both,,,304.34,91,,,,,,,,,
SUCCINYCHOLINE CHLORIDE INJ UP TO 20 MG,J0330,HCPCS,,Both,0.02,GM,12.44,4,,,,,,,,,
TYLENOL UP TO 200 MG,J3490,HCPCS,,Both,0.2,GM,44.39,13,,,,,,,,,
VERRUCA-FREEZE CANIST 162ML,450,RC,,Both,,,1914.15,574,,,,,,,,,
VERRUCA-FREEZE CANIST 162ML,450,RC,,Both,,,1822.99,547,,,,,,,,,
Atarax (Hydroxine pamoate) up to 25mg PO,Q0177,HCPCS,,Both,0.025,GM,10.87,3,,,,,,,,,
VICODIN,J3490,HCPCS,,Both,,,16.14,5,,,,,,,,,
VIRUS CENTRIFUGE ENHNCD ID IMFLUOR STAIN EA,87254,CPT,,Both,,,126.79,38,,,,,,,,,
VIRUS TISS CUL INOCULATION CYTOPATHIC EFFECT,87252,CPT,,Both,,,447.88,134,,,,,,,,,
Viscous Lidocaine 10ml bottle,450,RC,,Both,,,12.25,4,,,,,,,,,
"VISION SUPPLY, ACCESSORY AND/OR SERVICE COMPONENT OF ANOTHER...",V2797,HCPCS,,Both,,,327.6,98,,,,,,,,,
MECLIZINE - UP TO 25MG,J3490,HCPCS,,Both,0.025,GM,10.27,3,,,,,,,,,
VISUAL ACUITY SCREENING,99173,CPT,,Both,,,1812,544,,,,,,,,,
VITAL CAPACITY TOTAL SEPARATE PROCEDURE,94150,CPT,,Both,,,334.96,100,,,,,,,,,
VITAMIN A,84590,CPT,,Both,,,58.05,17,,,,,,,,,
VITAMIN B12 INJECTION,J3420,HCPCS,,Both,,,123.49,37,,,,,,,,,
Vitamin C Tab,A9152,HCPCS,,Both,,,0.23,1,,,,,,,,,
VITAMIN D 25 HYDROXY,82306,CPT,,Both,,,1020,306,,,,,,,,,
ROCEPHIN - CEFTRIAXONE SODIUM up to 250MG,J0696,HCPCS,,Both,0.25,GM,61.3,18,,,,,,,,,
"Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed",82652,CPT,,Both,,,308,92,,,,,,,,,
Vitamin K,84597,CPT,,Both,,,58.05,17,,,,,,,,,
VITAMIN K1 10MG AMP,450,RC,,Both,,,82.59,25,,,,,,,,,
VITAMIN K1 10MG AMP,450,RC,,Both,,,78.66,24,,,,,,,,,
VOMIT BAG,A4649,HCPCS,,Both,,,8.88,3,,,,,,,,,
"WALKER, ENCLOSED, FOUR SIDED FRAMED, RIGID OR FOLDING, WHEEL...",E0144,HCPCS,,Both,,,1982.23,595,,,,,,,,,
DILAUDID - HYDROMORPHONE UP TO 4MG,J1170,HCPCS,,Both,0.004,GM,56.5,17,,,,,,,,,
WATER ST PF 10ML VL,450,RC,,Both,,,7.83,2,,,,,,,,,
WATER ST PF 10ML VL,450,RC,,Both,,,7.46,2,,,,,,,,,
"Injection, haloperidol, up to 5 mg",J1630,HCPCS,,Both,0.005,GM,420.88,126,,,,,,,,,
WEARABLE ECG 24 HR W/VIS SUPIMPOS SCAN PHYS R&I,93224,CPT,,Both,,,1212,364,,,,,,,,,
WEDGE EXCISION SKIN NAIL FOLD,11765,CPT,,Both,,,2131.63,639,,,,,,,,,
Wet mounts/ w preparations,Q0111,HCPCS,,Both,,,64.17,19,,,,,,,,,
"Whfo w/o joints pre ots; Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type",L3809,HCPCS,,Both,,,2268,680,,,,,,,,,
"WHFO, NO JOINT, PREFABRICATED",L3807,HCPCS,,Both,,,1531.68,460,,,,,,,,,
"WHFO, RIGID W/O JOINTS",L3808,HCPCS,,Both,,,2268,680,,,,,,,,,
WICK EAR ST 1/16,450,RC,,Both,,,20.56,6,,,,,,,,,
WICK EAR ST 1/16,450,RC,,Both,,,19.57,6,,,,,,,,,
WIPE HYDROGEN PEROXIDE 155EAEA,450,RC,,Both,,,40.94,12,,,,,,,,,
WIPE HYDROGEN PEROXIDE 155EAEA,450,RC,,Both,,,38.98,12,,,,,,,,,
WIPES BABY UNSCENTED 100/BX,450,RC,,Both,,,24.13,7,,,,,,,,,
WIPES BABY UNSCENTED 100/BX,450,RC,,Both,,,22.98,7,,,,,,,,,
WIPES DISNFCT 6X6.75,450,RC,,Both,,,38.81,12,,,,,,,,,
WIPES DISNFCT 6X6.75,450,RC,,Both,,,36.96,11,,,,,,,,,
WOODS LAMP,A4649,HCPCS,,Both,,,23.74,7,,,,,,,,,
WOUND CLEANSER,A6260,HCPCS,,Both,,,137.2,41,,,,,,,,,
Wound Culture Anaerobes/Aerobes,87070,CPT,,Both,,,612,184,,,,,,,,,
WOUND FILLER GEL/PASTE /OZ,A6261,HCPCS,,Both,,,78.46,24,,,,,,,,,
WRIST COCK-UP NON-MOLDED,L3908,HCPCS,,Both,,,639.87,192,,,,,,,,,
"WRIST HAND ORTHOSIS, WITHOUT JOINTS, MAY INCLUDE SOFT INTERF...",L3906,HCPCS,,Both,,,2420.5,726,,,,,,,,,
WRIST&F/A SPLINT L/UNIV,450,RC,,Both,,,58.34,18,,,,,,,,,
WRIST&F/A SPLINT L/UNIV,450,RC,,Both,,,55.56,17,,,,,,,,,
WRIST&F/A SPLINT R/UNIV,450,RC,,Both,,,58.34,18,,,,,,,,,
WRIST&F/A SPLINT R/UNIV,450,RC,,Both,,,55.56,17,,,,,,,,,
X RAY EXAM TRUNK SPINE 2VWS,72080,CPT,,Both,,,3024,907,,,,,,,,,
XEROFORM DRESS 2X2 FOIL,450,RC,,Both,,,126.8,38,,,,,,,,,
XEROFORM DRESS 2X2 FOIL,450,RC,,Both,,,120.75,36,,,,,,,,,
XEROFORM DRESS 5X9 FOIL,450,RC,,Both,,,287.3,86,,,,,,,,,
XEROFORM DRESS 5X9 FOIL,450,RC,,Both,,,273.62,82,,,,,,,,,
VALIUM - DIAZEPAM INJECTION UP TO 5 MG,J3360,HCPCS,,Both,0.005,GM,14.84,4,,,,,,,,,
Xofluza tablet,J8499,HCPCS,,Both,,,506.96,152,,,,,,,,,
"HUMULIN R REG(INSULIN), VL 100U/ML 10ML MDV(UP TO 5 UNITS)",J1815,HCPCS,,Both,5,ML,42.7,13,,,,,,,,,
Demerol up to 50mg,J8499,HCPCS,,Both,0.05,GM,109.79,33,,,,,,,,,
XRAY APRON/GLOVE RACK,450,RC,,Both,,,1394.61,418,,,,,,,,,
XRAY APRON/GLOVE RACK,450,RC,,Both,,,1328.19,398,,,,,,,,,
X-RAY EXAM HIPS BI 5/> VIEWS,73523,CPT,,Both,,,582.13,175,,,,,,,,,
X-RAY EXAM OF FEMUR 1V,73551,CPT,,Both,,,1320,396,,,,,,,,,
XTRNL ECG & 48 HR RECORDING,93225,CPT,,Both,,,311.33,93,,,,,,,,,
Zicam ,A9150,HCPCS,,Both,,,11.03,3,,,,,,,,,
Zika virus igm antibody,86794,CPT,,Both,,,404.4,121,,,,,,,,,
Zinc,84630,CPT,,Both,,,95.68,29,,,,,,,,,
"ZINC OXIDE, OINT 20%",A6250,HCPCS,,Both,,,7.88,2,,,,,,,,,
KETAMINE UP TO 50MG,J3490,HCPCS,,Both,0.05,GM,40.36,12,,,,,,,,,
PHENERGAN - PROMETHAZINE HCL INJECTION UP TO 50MG,J2550,HCPCS,,Both,0.05,GM,29.7,9,,,,,,,,,
Zithromax 200mg/5ml susp,450,RC,,Both,,,22.31,7,,,,,,,,,
"ZITHROMAX AZITHROMYCIN DIHYDRATE, ORAL UP TO 1 GRAM",Q0144,HCPCS,,Both,,,239.46,72,,,,,,,,,
ZITHROMAX IV 500MG 10/BX,450,RC,,Both,,,222,67,,,,,,,,,
ZITHROMAX IV 500MG 10/BX,450,RC,,Both,,,211.43,63,,,,,,,,,
Zofram 4mg/5ml Susp,450,RC,,Both,,,14.65,4,,,,,,,,,
"Acetazolamide Sodium; injection, up to 500 mg",J1120,HCPCS,,Both,0.5,GM,2960.06,888,,,,,,,,,
Zofran 4MG Tab,450,RC,,Both,,,161.54,48,,,,,,,,,
ZOLL ADULT DEFIBRILLATOR PADS,A4649,HCPCS,,Both,,,238.77,72,,,,,,,,,
Magnesium Sulfate Up to 500mg,J7699,HCPCS,,Both,0.5,GM,15.24,5,,,,,,,,,
ZOSYN - PIPERACILLIN/TAZOBACTAM,J2543,HCPCS,,Both,,,80.71,24,,,,,,,,,
"ZOSYN - PIPERACILLIN+TAZOBACTAM, VL 3.375GM ",J2543,HCPCS,,Both,,,79.28,24,,,,,,,,,
ZOSYN 3.375GM VL 10/BX,450,RC,,Both,,,1390.61,417,,,,,,,,,
ZOSYN 3.375GM VL 10/BX,450,RC,,Both,,,1324.39,397,,,,,,,,,
"Injection, orphenadrine citrate, up to 60 mg",J2360,HCPCS,,Both,0.06,GM,169.91,51,,,,,,,,,
MOTRIN UP TO 600MG,J3490,HCPCS,,Both,0.6,GM,0.87,1,,,,,,,,,
Zyvox (linezolid) 600mg/300ml IV bag,450,RC,,Both,,,428.34,129,,,,,,,,,