Acute Care Hospitals

Henderson Hospital

4.0

1050 W Galleria Dr
Henderson, NV 89011

(702) 963-7000 hendersonhospital.com

CCN 290048

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All Procedure Prices

Insurance:

Procedure	CPT	Price
ROD LEGACY 5.5MM X 500MM	27130	$25,211
APPLY FOREARM SPLINT	29125	$276
PLATE VARIAX CLAV SUP MIDSHAFT TI STD 10H 122MM RT	29881	$5,522
Intubation, endotracheal, emergency procedure	31500	$1,131
Tracheotomy tube change prior to establishment of fistula tract	31502	$484
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate pr	31622	$2,035
STENT PROTEGE GPS 6F .035 14X30 80CM	31720	$294
HC ARTERIAL PUNCTURE WITHDRAWAL BLOOD DX	36600	$159
CATH PACIFIC EXTREME PTA BLN 130CM 5X200MM	36620	$396
RAD TX MISC	53900502	$2,310
BASIC RADIATION DOSIMETRY	53900601	$2,119
ISODOSE PLAN SIMP	53900700	$2,119
ISODOSE PLAN COMP	53900908	$2,119
SPECIAL PORT PLAN	53901005	$2,119
SPECIAL DOSIMETRY	53901401	$2,119
TRX DEVICE SIMPLE	53901500	$2,119
TRX DEVICE INTERM	53901609	$2,119
TRX DEVICE COMP	53901708	$2,119
CONTINUING PHYSICS	53901807	$2,119
SPECIAL PHYSICS	53901906	$2,119
UNLISTED PHYSICS/DOSIM/TRX DEV	53902003	$2,310
RAD TX SUPERF/ORTHO VOLT	53902102	$2,119
RAD TX PORT FILMS	53903407	$2,119
RAD TX SPECIAL TREATMENT	53903605	$2,119
PROTON TRX SIMPLE NO COMP	53903803	$2,119
PROTON TRX COMPLEX	53903902	$2,647
HYPERTHERMIA S/F	53904009	$2,119
HYPERTHERMIA DEEP	53904108	$2,119
HYPERTHERMIA <5 INTERSTIT	53904207	$2,119
HYPERTHERMIA >5 INTERSTIT	53904306	$2,119
HYPERTHERMIA INTRACAV PROBES	53904405	$2,119
INTRACAV RAD APPL SIMPLE	53904603	$2,119
INTRACAV RAD APPL INTER	53904702	$2,119
INTRACAV RAD APPL COMP	53904801	$2,119
INTERSTIT RAD ELEMENT COMP	53905105	$2,119
SURFACE APPL RAD ELEM	53905600	$2,119
RADIATION ELEMENT HANDLING	53905709	$2,119
BRACHY UNLISTED PROC	53905808	$2,310
RAD TX SIMULAT SIMPLE LTD	53906004	$1,412
TRX DEVICE SIMPLE LTD	53906301	$1,412
CONTINUING PHYSICS LTD	53906400	$1,412
SPECIAL PHYSICS LTD	53906509	$1,412
RAD TX SUPERF/ORTHO VOLT LTD	53906608	$1,412
PROTON TRX SIMPLE NO COMP LTD	53906806	$2,216
HYPERTHERMIA S/F LTD	53906905	$1,412
INTRACAV RAD APPL SIMPLE LTD	53907200	$1,412
SURFACE APPL RAD ELEM LTD	53907408	$1,412
INFUSE RADIO SOL 3MTH F/UP	53912283	$1,961
INFUSE RADIO SOL 3MTH F/UP LTD	53912291	$1,306
ACETAZOLAMIDE UP TO 500MG	54000930	$610
ACYCLOVIR PER 5MG INJ	54001532	$352
ACYCLOVIR PER 5MG INJ	54001599	$1,078
ACYCLOVIR PER 5MG INJ	54001615	$2,132
ALBUMIN HUMAN 5% 250 ML	54001813	$2,443
ALBUMIN HUMAN 5% PER 50ML	54001839	$668
ALBUMIN HUMAN 25% 50ML	54001854	$2,096
ALBUMIN HUMAN 5% PER 50ML	54001870	$1,184
ALPHA 1 PROT INHIBIT PER 10MG	54002498	$4,644
AMIKACIN SULF PER 100MG	54003215	$4,831
AMIKACIN SULF PER 100MG	54003231	$1,526
AMINOPHYLLINE UP TO 250MG	54003579	$188
AMINOPHYLLINE UP TO 250MG	54003595	$116
AMOBARBITAL SOD UP TO 125MG	54004213	$176
AMPHOTERICIN B 50MG VIAL	54004817	$971
AMPICILLIN SOD 500MG INJ	54004932	$28
AMPICILLIN SOD 500MG INJ	54004957	$44
AMPICILLIN SOD PER 500MG	54004973	$187
AMPICILLIN SOD PER 500MG	54005012	$267
AMPICILLIN SOD 500MG VIAL	54005053	$175
AMP SOD/SULBACT PER 1.5GM	54005111	$310
AMP SOD/SULBACT 1.5GM INJ	54005137	$294
AMP SOD/SULBACT PER 1.5GM	54005152	$446
ASPARAGINASE INJ 10000 UNITS	54006259	$1,373
AZATHIOPRINE 50MG TAB	54007232	$38
AZITHROMYCIN 500MG VIAL	54007372	$475
BENZTROPINE MESYL PER 1MG	54009113	$554
CELESTONE SOLSPN PER 3MG	54009238	$1,175
BUPRENORPHINE PER 0.1MG	54010954	$47
BUTORPHANOL 1MG/ML 1ML VIAL	54011291	$136
BUTORPHANOL TAR PER 1MG	54011317	$284
CAFFEINE CITRATED PER 5MG INJ	54011390	$954
CALC/SAL/SYN UP TO 400UNITS	54011630	$1,442
CALCITRIOL PER 0.1MCG	54011713	$373
CALCIUM GLUC INJ PER 10MG	54012455	$58
CARMUSTINE 100MG VIAL	54013610	$1,561
CEFAZOLIN SODIUM PER 500MG	54014311	$120
CEFAZOLIN SODIUM PER 500MG	54014337	$391
CEFAZOLIN SODIUM 500MG VIAL	54014352	$28
CEFAZOLIN PER 500MG	54014378	$112
CEFEPIME HCL PER 500MG	54014451	$562
CEFEPIME HCL PER 500MG	54014477	$1,173
CEFOTAXIME PER 1GM	54014691	$453
CEFOTAXIME PER 1GM	54014717	$373
CEFOTAXIME PER 1GM	54014774	$247
CEFOTAXIME PER 1GM	54014790	$426
CEFOXITIN SODIUM PER 1GM	54014972	$352
CEFOXITIN SODIUM PER 1GM	54014998	$709
CEFOXITIN SODIUM PER 1GM	54015037	$445
CEFTAZIDIME PER 500MG	54015433	$392
CEFTAZIDIME PER 500MG	54015474	$680
CEFTAZIDIME PER 500MG	54015573	$310
CEFTRIAXONE PER 250MG	54015714	$1,447
CEFTRIAXONE INJ PER 250MG	54015730	$126
CEFTRIAXONE INJ PER 250MG	54015771	$1,495
CEFTRIAXONE INJ PER 250MG	54015797	$286
CEFTRIAXONE INJ PER 250MG	54015813	$538
CEFTRIAXONE PER 250MG	54015839	$759
CEFTRIAXONE PER 250MG	54015870	$666
CEFTRIAXONE PER 250MG	54015896	$1,082
CEFUROXIME SOD PER 750MG	54016035	$124
CEFUROXIME SOD PER 750MG	54016050	$236
CEFUROXIME SOD PER 750MG	54016092	$537
CEFUROXIME SOD PER 750MG	54016118	$150
CEFUROXIME PER 750MG	54016134	$160
CEFUROXIME PER 750MG	54016159	$276
CHLORAMPHENICOL NA UP TO 1GM	54017074	$227
CHLOROTHIAZIDE SOD PER 500MG	54017652	$2,377
CHLORPROMAZINE INJ PER 50MG	54018130	$120
CIPROFLAXIN PER 200MG	54019138	$324
CIPROFLOX PER 200MG	54019153	$1,050
CIPRO/D5W 200MG/100ML IVPB	54019195	$282
CIPROFLAXIN PER 200MG	54019211	$1,520
CODEINE PHOS PER 30MG	54021399	$21
CODEINE PHOS PER 30MG	54021415	$22
CODEINE PHOS PER 30MG	54021456	$23
COLISTIMETHATE PER 150MG VIAL	54022074	$971
COSYNTROPIN 0.25MG VIAL	54022314	$430
CYCLOPHOSPHAMIDE ORAL PER 25MG	54022751	$58
CYCLOSPORINE 100MG CAP (GN)	54022892	$141
CYCLOSPORINE 25MG CAP	54022918	$42
CYCLOSPORIN PAREN PER 250MG	54022959	$731
CYCLOSPORINE MOD 100MG CAP(GN)	54022991	$95
CYCLOSPORINE 25MG CAP	54023015	$34
CYCLOSPORINE ORAL PER 100MG GN	54023072	$4,876
CYTARABINE HCL PER 100MG (GN)	54023197	$390
CYTARABINE HCL PER 100MG GN	54023213	$602
CYTARABINE HCL PER 100MG GN	54023239	$858
CYTARABINE HCL PER 100MG GN	54023296	$1,515
DACARBAZINE PER 100MG VIAL GN	54023312	$551
DACARBAZINE PER 100MG VIAL GN	54023338	$201
DACTINOMYCIN PER 0.5MG	54023353	$2,243
FRAGMIN PER 2500 UNITS	54023379	$346
FRAGMIN PER 2500 UNITS	54023395	$646
DAUNORUBICIN PER 10MG BRAND	54023676	$1,964
DAUNORUBICIN PER 10MG GN	54023692	$2,444
DEFEROXAMINE MESYL 500MG VL	54023718	$373
DEXAMETHASONE PER 0.25MG ORAL	54024179	$1
DEXAMETHASONE PER 0.25MG ORAL	54024195	$2
DEXAMETHASONE PER 0.25MG ORAL	54024211	$1
DEXAMETHASONE PER 0.25MG ORAL	54024237	$2
DEXAMETHASONE PER 0.25MG ORAL	54024252	$1
DEXAMETHASONE PER 0.25MG ORAL	54024278	$2
DEXAMETHASONE PER 0.25MG ORAL	54024294	$31
DEXAMETHASONE PER 0.25MG ORAL	54024310	$36
DEXAMETHASONE PER 0.25MG ORAL	54024450	$298
DEXAMETHASONE INJ PER 1MG	54024518	$2
DEXAMETHASONE INJ PER 1MG	54024559	$453
DEXAMETHASONE INJ PER 1MG	54024575	$1
DIAZEPAM TO 5MG INJ	54025499	$66
DIAZEPAM UP TO 5MG INJ	54025515	$62
DIAZEPAM UP TO 5MG INJ	54025531	$136
DICYCLOMINE UP TO 20MG INJ	54025978	$168
DIGOXIN UP TO 0.5MG INJ	54026455	$84
DIGOXIN UP TO 0.5MG INJ	54026471	$31
DIHYDROERGOTAMINE 1MG/ML AMP	54026539	$169
DIMETHYL SULFOX DMSO 50% 50ML	54027032	$1,103
DIPHENHYDRAMINE 50MG CAP OP CH	54027156	$1
DIPHENHYDRAMINE 50MG/ML VIAL	54027255	$116
DIP/PERT/TET 28-58-10 0.5ML VL	54027495	$87
DIPYRIDAMOLE PER 10MG	54027651	$1,857
DOBUTAMINE PER 250MG INJ	54028550	$1,818
DOLASETRON MESYLATE PER 10MG	54028873	$532
DOPAMINE HCL PER 40MG INJ	54028931	$265
DOPAMINE HCL PER 40MG	54028956	$276
DOPAMINE HCL PER 40MG	54028998	$141
DOPAMINE HCL PER 40MG INJ	54029012	$592
DOPAMINE HCL PER 40MG	54029038	$262
DOPAMINE HCL PER 40MG	54029079	$781
DOPAMINE HCL PER 40MG	54029111	$228
DOPAMINE HCL PER 40MG INJ	54029152	$239
DOXORUBICIN PER 10MG GN	54029657	$1,148
DOXORUBICIN PER 10MG GN	54029673	$4,562
DRONABINOL PER 2.5MG OP CH	54029913	$104
DROPERIDOL INJ UP TO 5MG	54029939	$257
DROPERIDOL UP TO 5MG	54029954	$71
EPOPROSTENOL NA 0.5MG VIAL	54031372	$466
ERYTHRO LACTOB PER 500MG	54032313	$735
ERYTHRO LACTOB PER 500MG	54032339	$607
ESTRADIOL PER 10MG	54032719	$935
ESTROGENS CONJ 25MG VIAL	54033055	$1,202
ETHANOLAMINE OLEATE 100MG AMP	54033311	$651
ETOPOSIDE PER 10MG GN	54033774	$1,984
FENTANYL CITRATE PER 0.1MG	54034533	$71
FENTANYL CITRATE PER 0.1MG	54034558	$35
FENTANYL CITRATE PER 0.1MG	54034574	$959
FENTANYL CITRATE PER 0.1MG	54034590	$1,554
FLUCONAZOLE PER 200MG	54035639	$1,709
FLUCONAZOLE 200MG INJ	54035670	$3,558
FLUCONAZOLE 200MG INJ	54035696	$2,570
FLUOROURACIL INJ PER 500MG	54036439	$229
FLUPHENAZINE DECAN UP TO 25MG	54036637	$612
FOSPHENYTOIN PER 50MG	54037411	$459
FOSPHENYTOIN PER 50MG	54037437	$1,306
FUROSEMIDE PER 20MG	54037650	$76
GANCICLOVIR SODIUM PER 500MG	54037858	$1,338
GENTAMICIN SULF UP TO 80MG	54038179	$189
GENTAMICIN SULF UP TO 80MG	54038211	$215
GENTAMICIN SULF UP TO 80MG	54038237	$206
GENTAMICIN SULF UP TO 80MG	54038252	$90
GENTAMICIN SULF UP TO 80MG	54038278	$236
GENTAMICIN SULF UP TO 80MG	54038435	$125
GLUCAGON HUMAN F KABI 1MG VIAL	54038658	$1,565
GLUCAGON 1MG F KABI KIT	54038674	$1,237
GRANISETRON HCL PER 100MCG	54039276	$3,529
PEDVAXHIB 7.5MCG/0.5ML VL	54041850	$422
HIB PRP-T VACCINE	54041876	$560
HALOPERIDOL DEC PER 50MG	54042072	$1,012
HALOPERIDOL DECAN PER 50MG	54042114	$968
HALOPERIDOL INJ PER 5MG	54042197	$181
HEP B VIR VAC 5MCG/0.5ML VL	54042619	$408
HEP B VIR VAC 10MCG/ML 1ML VL	54042650	$1,091
HEP B VIR VAC 20MCG/ML 1ML VL	54042676	$1,117
HEP B VIR VAC 10MCG/0.5ML VL	54042718	$184
HEP B VACC REC 10MCG/0.5ML SYR	54042775	$367
HEPARIN SOD PER 10 UNITS	54042890	$42
HEPARIN SOD PER 1000 UNITS	54042916	$71
HEPARIN LOCK PER 10 UNITS	54042932	$62
HEPARIN LOC PER 10 UNITS	54042957	$70
HEPARIN PER 1000 UNITS	54042973	$86
HEPARIN PER 1000 UNITS	54042999	$217
HEPARIN PER 1000 UNITS	54043013	$56
HEP B IMM GLOB 0.5ML SYR	54043112	$4,002
HEPATITIS B IMMUNE GLOB 1ML VL	54043138	$2,184
HEP B IMM GLOB 5ML	54043153	$5,780
HYDRALAZINE PER 20MG	54043559	$222
HYDRO SOD SUCC 100MG VL	54044896	$161
HYDRO SOD SUCC PER 100MG	54044912	$724
HYDROCO SOD SUCC UP TO 100MG	54044938	$210
HYDRO SOD SUCC PER 100MG	54044953	$614
HYDROXYZINE UP TO 25MG	54045653	$8
HYOSCYAMINE UP TO 0.25MG	54045976	$242
IDARUBICIN INJ PER 5MG GN	54046271	$5,428
IDARUBICIN PER 5MG GN	54046297	$10,856
IDARUBICIN PER 5MG GN	54046313	$17,061
IFOSFAMIDE PER 1GM	54046339	$2,970
IMIPENEM/CILAS PER 250MG	54046370	$287
IMIPENEM/CILAS PER 250MG	54046396	$1,216
KETOROLAC TROM PER 15MG	54049713	$214
KETOROLAC TROM PER 15MG	54049812	$195
KETOROLAC 15MG/ML 1ML VIAL	54049838	$166
KETOROLAC TROM PER 15MG	54049853	$361
LEUCOVORIN CALCIUM 50MG VIAL	54050976	$2,958
LEUCOVORIN CAL INJ PER 50 MG	54050992	$900
LEUCOVORIN CAL INJ PER 50 MG	54051016	$2,112
LEVOFLOXACIN PER 250MG	54051339	$686
LEVOFLOXACIN PER 250MG	54051354	$742
LEVOFLOXACIN PER 250MG	54051370	$1,508
LINCOMYCIN UP TO 300MG	54052717	$156
LINEZOLID PER 200MG	54052816	$1,622
LORAZEPAM PER 2MG	54053731	$212
LORAZEPAM INJ PER 2MG	54053756	$453
LORAZEPAM INJ PER 2MG	54053798	$1,804
MAG SULFATE PER 500MG	54055058	$27
MAG SULFATE PER 500MG	54055074	$33
MAG SULPHATE PER 500MG INJ	54055116	$52
MAG SULFATE PER 500MG	54055173	$250
MAG SULFATE PER 500MG	54055199	$305
MAG SULFATE PER 500MG	54055215	$332
MAG SULFATE PER 500MG	54055231	$399
MAG SULPHATE PER 500MG INJ	54055272	$80
MANNITOL 25% 50 ML	54055397	$162
M-M-R II VAC VL	54055496	$284
MEDROXYPROG ACET PER 1MG	54055751	$1,808
MEDROXYPROG ACET PER 1MG	54055777	$816
MELPHALAN HCL PER 50MG	54056015	$5,332
MENINGOCOCCAL A C Y W-135	54056031	$1,558
MEPERIDINE HCL PER 100MG	54056338	$24
MEPERIDINE HCL PER 100MG	54056395	$408
MEPERIDINE HCL PER 100MG	54056411	$10
MEPERIDINE HCL INJ PER 100MG	54056494	$422
MEPERIDINE 100MG/ML 1 ML	54056510	$22
MEPIVACAINE HCL PER 10ML	54056718	$284
MEPIVACAINE HCL PER 10ML	54056734	$298
MEPIVACAINE HCL PER 10ML	54056759	$362
MEROPENEM PER 100MG	54056858	$785
MEROPENEM PER 100MG	54056874	$10
MESNA INJ PER 200MG/GN	54056999	$2,688
METHOCARBAMOL UP TO 10ML INJ	54057930	$104
METHOTREXATE 2.5 MG TAB	54057997	$90
METHYLERGONOV MAL UP TO 0.2MG	54058599	$64
METHYLPREDNISOLONE 4MG TAB	54058714	$13
METHYLPREDNISOLONE PER 4MG	54058730	$32
METHYLPREDNISOLONE PER 4MG	54058797	$22
METHYLPREDNISOLONE 4MGDSPK	54058813	$350
METOCLOPRAMIDE UP TO 10MG	54059134	$21
METOCLOPRAMIDE INJ UP TO 10MG	54059159	$90
METOCLOPRAMIDE PER 10MG	54059175	$282
MIDAZOLAM INJ PER 1MG	54060132	$298
MIDAZOLAM INJ PER 1MG	54060157	$696
MIDAZOLAM INJ PER 1MG	54060173	$274
MIDAZOLAM PER 1MG INJ	54060199	$274
MIDAZOLAM INJ PER 1MG	54060215	$649
MIDAZOLAM PER 1MG INJ	54060231	$1,442
MITOMYCIN PER 5MG INJ/GN	54061130	$2,284
MORPHINE SULF PF PER 10 MG	54061833	$1
MORPHINE SULF UP TO 10MG	54061973	$28
MORPHINE SULF UP TO 10MG	54062039	$261
MORPHINE SULF UP TO 10MG	54062054	$250
MORPHINE SULF UP TO 10MG	54062112	$505
MORPHINE SULF UP TO 10MG	54062153	$21
MORPHINE SULF UP TO 10MG	54062179	$13
MORPHINE SULF UP TO 10MG	54062211	$13
MORPHINE SULF PER 10MG	54062252	$479
MYCOPHENOLATE MOFET 250MG CAP	54063276	$58
MYCOPHEN MOF PER 250MG ORAL	54063292	$86
NALBUPHINE 10MG/ML 1ML AMP	54063839	$101
NALBUPHINE PER 10MG	54063854	$116
NALOXONE HCL PER 1MG	54063953	$95
NALOXONE HCL PER 1MG	54063995	$212
NEOSTIGMINE UP TO 0.5MG	54065255	$321
NEOSTIGMINE METHY UP TO 0.5MG	54065271	$96
ONDANSETRON INJ PER 1MG	54067996	$760
ORPHENADRINE CIT UP TO 60MG	54068176	$120
OXACILLIN SODIUM UP TO 250MG	54068390	$48
OXACILLIN SODIUM UP TO 250MG	54068432	$250
OXYTOCIN UP TO 10UNITS	54069315	$71
OXYTOCIN UP TO 10 UNITS	54069356	$72
PAPAVERINE HCL UP TO 60MG	54069554	$128
PAPAVERINE UP TO 60MG	54069570	$310
PARICALCITOL PER 1MCG	54069679	$619
PEN G POT UP TO 600000U INJ	54070131	$242
PEN G POT UP TO 600MU INJ	54070313	$92
PEN G POT UP TO 600MU INJ	54070354	$12
PEN G POT UP TO 600MU INJ	54070370	$74
PENTAZOCINE PER 30MG	54070693	$71
PENTOBARBITAL 50MG/ML 50ML VL	54070834	$514
PERPHENAZINE 4MG TAB OP CH	54071691	$24
PHENOBARB SOD UP TO 120MG	54072178	$76
PHENOBARB SOD UP TO 120MG	54072236	$41
PHENOBARB SOD UP TO 120MG	54072251	$26
PHENTOLAMINE MES UP TO 5MG	54072434	$1,028
PHENYTOIN PER 50MG	54073630	$76
PHENYTOIN SOD PER 50MG	54073697	$79
PHYTONADIONE PER 1MG INJ	54073895	$156
PHYTONADIONE PER 1MG INJ	54073911	$90
PHYTONADIONE PER 1MG	54073937	$87
PIPER/TAZO PER 1.125GM	54074414	$381
ZOSYN INJ PER 1.0GM/0.125GM	54074430	$180
ZOSYN INJ PER 1.0GM/0.125GM	54074455	$528
ZOSYN INJ PER 1.0GM/0.125GM	54074471	$755
PNEUM 23 25MCG/0.5 0.5ML SYR	54074737	$602
PNEUMO 23 VACCINE 2.5ML VL	54074752	$1,228
POT CHL PER 2MEQ INJ	54075411	$54
POT CHL PER 2MEQ INJ	54075478	$518
POT CHL PER 2MEQ INJ	54075494	$674
POT CHL PER 2MEQ INJ	54075510	$1
POT CHL PER 2MEQ INJ	54075536	$410
POTASSIUM PER 2MEQ	54075551	$484
PREDNISOLONE 5MG TAB	54077037	$1
PREDNISOLONE PER 5MG ORAL	54077052	$29
PREDNISOLONE PER 5MG ORAL	54077078	$10
PREDNISOLONE PER 5MG ORAL	54077094	$152
PREDNISOLONE PER 5MG ORAL	54077151	$1,134
PREDNISOLONE 6.7MG/5ML 5ML	54077235	$10
PROCAINAMIDE UP TO 1G INJ	54078134	$474
PROCAINAMIDE UP TO 1G INJ	54078159	$319
PROCHLORPERAZINE 5MG/ML 2ML VL	54078316	$177
PROCHLORPERAZINE PER 5MG OP CH	54078373	$10
PROGESTERONE PER 50MG INJ	54078530	$147
PROMETHAZINE INJ UP TO 50MG	54078811	$50
PROMETHAZINE UP TO 50MG	54078837	$63
PROPRANOLOL UP TO 1MG	54079496	$128
PROPRANOLOL 1MG/ML 1ML AMP	54079512	$98
PROTAMINE SULF PER 10MG INJ	54079611	$123
PROTAMINE SULF PER 10MG INJ	54079652	$897
PYRIDOXINE 100MG/ML 1ML VL	54080478	$66
QUINUPRISTIN/DALFOPR PER 500MG	54080890	$2,420
ROPIVACAINE PER 1MG	54082250	$156
ROPIVACAINE PER 1MG	54082276	$58
ROPIVACAINE PER 1MG	54082292	$518
ROPIVACAINE PER 1MG	54082318	$385
ROPIVACAINE PER 1MG	54082391	$304
SINCALIDE 5MCG VIAL	54083811	$877
SOD FER GLUC COMP PER 12.5MG	54083951	$1,002
STREPTOMYCIN SULF 1GM VIAL	54085659	$98
SUCCINYLCHOLIN CHL UP TO 20MG	54085774	$171
SUCCINYLCHOLINE UP TO 20MG	54085790	$156
SUMATRIPTAN 6MG/0.5ML KIT	54086517	$1,679
TACROLIMUS ORAL PER 1 MG	54086632	$79
TERBUTALINE 1MG/ML 1ML VIAL	54087077	$712
TETANUS IMM GLOBULIN TO 250U	54087416	$888
TET/DIP/TOX 5-2LF UNITS 0.5ML	54087515	$330
TET/DIP/TOX 5-2LFU 5ML	54087572	$324
TET/DIP PED 5-6.6LFU 5ML	54087630	$16
THIOTEPA PER 15MG	54089271	$1,732
TOBRAMYCIN UP TO 80MG INJ	54090170	$107
TOBRAMYCIN UP TO 80MG	54090238	$232
TOBRAMYCIN UP TO 80MG INJ	54090253	$4,378
TOBRAMYCIN UP TO 80MG	54090352	$190
TRIAMCINOLONE PER 10MG	54091475	$161
TRIAMCINOLONE PER 10MG	54091517	$614
TRIMTHBNZAMID UP TO 200MG	54092317	$39
TRIMTHOBNZAMIDE UP TO 200MG	54092333	$56
VANCOMYCIN HCL PER 500MG INJ	54093471	$8
VANCOMYCIN PER 500MG	54093497	$2,940
VANCOMYCIN HCL PER 500MG INJ	54093513	$895
VARICELLA VIRUS VACCINE VIAL	54093554	$1,043
VINBLASTINE SULF PER 1MG	54094172	$665
VINCRISTINE PER 1MG	54094214	$1,148
ZIDOVUDINE PER 10MG INJ	54095252	$430
HEPARIN PER 1000 UNITS	54095815	$82
FUROSEMIDE PER 20MG	54095831	$44
FUROSEMIDE UP TO 20MG	54095856	$73
CYANOCOBALAMIN TO 1000MCG	54096094	$73
GENTAMICIN SULF UP TO 80MG	54096433	$265
HYDROXYZINE UP TO 25MG INJ	54096557	$49
PENTOBARB SOD PER 50MG	54096953	$8
SUCCINYLCHOLIN CHL UP TO 20MG	54097258	$54
MIDAZOLAM INJ PER 1MG	54098579	$4
MIDAZOLAM INJ PER 1MG	54098595	$160
POT CHL PER 2MEQ INJ	54098850	$62
POT CHL PER 2MEQ INJ	54098876	$42
POT CHL PER 2MEQ INJ	54098892	$71
CALCIUM GLUCONATE 10% 10ML	54099148	$44
HEPARIN LOC PER 10 UNITS	54099155	$1
HEPARIN PER 1000 UNITS	54099171	$58
LORAZEPAM PER 2MG	54099429	$1,490
DEXTRAN 40/D5W 10% 500ML BAG	54101506	$2,423
DEXTRAN 40/NS 10-0.9% 500ML BA	54101555	$2,423
D5NS PER 500ML	54102751	$291
D5NS 500ML BAG	54102801	$188
D5W 1000ML BAG	54103155	$270
D5W 500ML BAG	54103205	$250
DOBUTAMINE PER 250MG INJ	54104005	$2,052
DOBUTAMINE PER 250MG INJ 636	54104054	$2,189
HEPARIN PER 1000UNITS	54105507	$275
HEPARIN PER 1000 UNITS	54105655	$23
HEPARIN PER 1000 UNITS	54105705	$779
HEPARIN PER 1000 UNITS	54105754	$158
HEPARIN SOD PER 1000 UNITS	54105804	$434
POT CHL PER 2MEQ INJ	54107206	$628
POT CHL PER 2MEQ INJ	54107354	$506
RINGERS LACTATED 1000ML BAG	54107503	$304
RINGERS LACTATED 500 ML BAG	54107552	$250
SODIUM CHL 0.9% 1000ML BAG	54108055	$318
SODIUM CHL 0.9% 500ML BAG	54108105	$319
SODIUM CHL 0.9% 250ML BAG	54108154	$220
RINGERS LACTATED 250ML BAG	54109756	$194
DOPAMINE HCL PER 40MG	54110150	$260
DEXTROSE 5%-WATER 500ML BAG	54111182	$170
PIPERACIL/TAZO PER 1.125GM	54111497	$265
POT CHL PER 2MEQ INJ	54111521	$265
MOXIFLOXACIN PER 100MG	54111661	$562
VWF PER UNIT (HUMATE-P)>600 VL	54111711	$8
VORICONAZOLE PER 10MG	54111729	$368
POTASSIUM CHL PER 2MEQ	54111760	$619
RASBURICASE PER 0.5MG	54111778	$6,151
AMIODARONE HCL PER 30MG	54111893	$198
PAMIDRONATE DISOD 30MG VL/GN	54111950	$898
ARSENIC TRIOXIDE PER 1MG	54111968	$944
VANCOMYCIN HCL PER 500MG	54111984	$84
VANCOMYCIN HCL PER 500MG INJ	54111992	$87
LEVOFLOXACIN PER 250MG	54112024	$979
CEFTAZIDIME PER 500MG	54112032	$96
DAPTOMYCIN PER 1MG	54112149	$3,479
AZITHROMYCIN 500MG/NS 250ML BD	54112206	$81
AZITHROMYCIN PER 500MG	54112214	$95
VANCOMYCIN PER 500MG	54112222	$222
VANCOMYCIN PER 500MG	54112230	$222
IBUTILIDE FUM PER 1MG	54112248	$686
CILASTATIN IMIP PER 250MG	54112255	$146
VANCOMYCIN PER 500MG	54112289	$84
VANCOMYCIN PER 500MG	54112297	$76
AMPICILLIN SOD PER 500MG INJ	54112305	$100
AMPICILLIN SOD PER 500MG INJ	54112313	$102
AMPICILLIN/SULBACTAM PER 1.5G	54112321	$116
AMPICILLIN/SULBACTAM PER 1.5G	54112339	$152
CEFTAZIDIME PER 500MG	54112362	$128
CEFTRIAXONE SOD 250MG INJ	54112370	$180
CEFTRIAXONE PER 250MG	54112388	$295
CEFUROXIME 750MG/NS 50ML	54112396	$81
PEN G POT UP TO 600MU	54112438	$148
AMPICILLIN SOD 500MG INJ	54112446	$172
CEFOTAXIME PER 1GM	54112453	$174
CEFOTAXIME PER 1GM	54112461	$228
CEFEPIME HCL PER 500MG	54112479	$212
IMIPEN/CILAS PER 250MG	54112487	$208
CEFTAZIDIME PER 500MG	54112495	$211
CEFOXITIN PER 1GM	54112503	$193
PIPERACIL/TAZO PER 1.125G	54112511	$189
PIPERAC/TAZO PER 1.125GM	54112529	$224
OXACILLIN SODIUM UP TO 250MG	54112545	$190
CEFTRIAXONE PER 250MG	54112552	$313
CEFAZOLIN SOD 500MG INJ	54112560	$110
CEFEPIME HCL PER 500MG	54112586	$361
PIPERACIL/TAZO PER 1.125GM	54112602	$212
AMP SOD/SULBACT PER 1.5GM	54112610	$162
PIPERACIL/TAZO PER 1.125GM	54112651	$189
CEFTAZIDIME PER 500MG	54112677	$123
CEFTAZIDIME PER 500MG	54112685	$295
CEFEPIME HCL PER 500MG	54112693	$219
CEFEPIME HCL PER 500MG	54112701	$394
MEROPENEM PER 100MG	54112719	$324
MEROPENEM PER 100MG	54112727	$593
OXACILLIN SODIUM UP TO 250MG	54112974	$167
MORPHINE SULF UP TO 10MG	54113014	$92
OXYTOCIN UP TO 10 UNITS	54113063	$136
OXYTOCIN UP TO 10 UNITS	54113071	$108
AMIODARONE HCL PER 30MG	54113147	$253
AMIODARONE HCL PER 30MG	54113154	$132
FLUCONAZOLE PER 200MG	54113162	$1,610
PAMIDRONATE DISOD PER 30MG GN	54113188	$5,187
OXYTOCIN UP TO 10 UNITS	54113220	$76
OXYTOCIN UP TO 10 UNITS	54113238	$76
MEPERIDINE HCL PER 100MG	54113253	$352
MIDAZOLAM PER 1MG	54113287	$188
LARONIDASE PER 0.1MG	54113303	$3,731
CEFOTAXIME PER 1G 636	54113337	$212
CEFUROXIME PER 750MG	54113352	$316
MAGNESIUM SULPHATE PER 500MG	54113360	$47
AMPICILLIN/NS 500MG/50ML IVPB	54113428	$47
METOCLOPRAMIDE 10MG/NS 50ML PB	54113436	$58
CEFTRIAXONE PER 250MG	54113444	$150
ERTAPENEM SOD PER 500MG	54113451	$390
ONDANSETRON PER 1MG	54113469	$206
PHENYTOIN PER 50MG	54113477	$30
PIPERACIL/TAZO PER 1.125G	54113550	$292
LORAZEPAM PER 2MG	54113600	$640
LORAZEPAM PER 2MG	54113618	$637
MIDAZOLAM PER 1MG INJ	54113626	$304
DOPAMINE HCL PER 40MG	54113642	$152
OXYTOCIN UP TO 10 UNITS	54113675	$135
OXYTOCIN UP TO 10 UNITS	54113683	$422
OXYTOCIN UP TO 10 UNITS	54113741	$176
MEROPENEM PER 100MG	54113824	$393
CEFOXITIN SODIUM PER 1GM	54113832	$244
LORAZEPAM PER 2MG	54113865	$187
MIDAZOLAM PER 1MG	54113881	$100
AMIODARONE PER 30MG	54113907	$256
CEFTRIAXONE SOD PER 250MG	54113915	$828
CEFTRIAXONE SOD PER 250MG	54113923	$43
OXYTOCIN UP TO 10 UNITS	54114012	$493
FENTANYL CITRATE PER 0.1MG	54114095	$115
HEPARIN PER 1000 UNITS	54114269	$66
LORAZEPAM PER 2MG	54114335	$548
AZITHROMYCIN/NS 500MG/250ML GN	54114368	$239
AZITHROMYCN/D5W 500MG/250ML GN	54114376	$263
CEFOXITIN DUPLEX 1GM/50ML IVPB	54114590	$185
CEFOXITIN SODIUM PER 1GM	54114616	$230
VANCOMYCIN PER 500MG	54114632	$146
MAG SULFATE PER 500MG	54114699	$65
HEPARIN PER 1000 UNITS	54114715	$65
MIDAZOLAM PER 1MG	54114723	$212
OXYTOCIN UP TO 10 UNITS	54114772	$60
POTASSIUM CHL PER 2MEQ	54114806	$87
POTASSIUM CHL PER 2MEQ	54114814	$87
MAG SULFATE PER 500MG	54114871	$128
ACYCLOVIR PER 5MG	54114889	$169
CEFAZOLIN PER 500MG	54114905	$136
MAG SULFATE PER 500MG	54114947	$60
AMIODARONE HCL PER 30MG	54114988	$150
CASPOFUNGIN ACET PER 5MG	54114996	$2,472
CASPOFUNGIN ACET PER 5MG	54115001	$1,931
CEFAZOLIN SOD PER 500MG	54115027	$118
FLUCONAZOLE PER 200MG	54115043	$1,622
OXYTOCIN UP TO 10 UNITS	54115050	$140
CEFTRIAXONE SOD PER 250MG	54115076	$242
CEFAZOLIN PER 500MG	54115084	$159
LORAZEPAM PER 2MG	54115100	$292
MIDAZOLAM PER 1MG	54115118	$361
SOD CHL 0.9% ADD-VANT 250ML	54115126	$60
DAPTOMYCIN PER 1MG	54115159	$60
PEN G POT UP TO 600MU	54115167	$124
ZOLEDRONC ACID/RECLAST PER 1MG	54115175	$5,952
PITOCIN/NS 10UNITS/500ML	54115183	$86
DOPAMINE HCL PER 40MG	54115217	$71
INSULIN PER 5 UNITS	54115233	$68
ONDANSETRON PER 1MG	54115241	$172
MILRINONE LACT PER 5MG	54115266	$1,351
CALCIUM GLUC INJ PER 10MG	54115274	$84
OXYTOCIN UP TO 10 UNITS	54115282	$110
CIPROFLOXACIN 200MG/100ML FLEX	54115308	$358
CIPROFLAXACIN PER 200MG	54115316	$188
DOBUTAMINE PER 250MG INJ	54115332	$601
DOPAMINE HCL PER 40MG	54115340	$285
GENTAMICIN SULF UP TO 80MG	54115373	$70
HEPARIN PER 1000 UNITS	54115381	$70
HEPARIN/NS 1000U/500ML PF	54115399	$60
POTASSIUM CHL PER 2MEQ	54115456	$100
POTASSIUM CHL PER 2MEQ	54115464	$100
DEXTRAN/NS 10% 500ML	54115514	$2,665
FENTANYL CITRATE PER 0.1MG	54115563	$84
FENTANYL CITRATE PER 0.1MG	54115571	$86
FENTANYL CITRATE PER 0.1MG	54115589	$87
FENTANYL CITRATE PER 0.1MG	54115597	$92
MORPHINE SULF PF PER 10 MG	54115605	$98
MORPHINE SULF PF PER 10MG	54115613	$98
CALCIUM GLUC INJ PER 10MG	54115639	$98
HEPARIN PER 10 UNITS	54116108	$95
IMIPENEM/CILAS PER 250MG	54116132	$579
LEVETIRACETAM PER 10MG	54116140	$688
ERTAPENEM SOD PER 500MG	54116157	$844
PEN G POT UP TO 600MU	54116199	$123
ONDANSETRON PER 1MG	54116223	$95
FENTANYL CITRATE PER 0.1MG	54116249	$70
ROPIVACAINE PER 1MG	54116272	$180
ROPIVACAINE PER 1MG	54116348	$275
CEFTAZIDIME PER 500MG	54116355	$324
ROPIVACAINE PER 1MG	54116363	$271
OXYTOCIN UP TO 10 UNITS	54116413	$60
CEFTRIAXONE PER 250MG	54116421	$54
BIVALIRUDIN PER 1MG	54116439	$3,262
ALBUMIN HUMAN 25% 50ML BAG	54116454	$458
FLUCONAZOLE PER 200MG	54116462	$373
DOPAMINE HCL PER 40MG	54116512	$134
AMIKACIN SULF PER 100MG	54116520	$146
MAG SULFATE PER 500MG	54116546	$36
TIGECYCLINE PER 1MG	54116678	$751
CEFEPIME PER 500MG	54116686	$441
BIVALIRUDIN PER 1MG	54116694	$2,817
OCTREOTIDE ACET PER 25 MCG	54116728	$1,332
FOSPHENYTOIN PER 50MG	54116736	$84
OXYTOCIN UP TO 10 UNITS	54116777	$358
IRINOTECAN PER 20MG	54116827	$141
IRINOTECAN PER 20MG	54116835	$318
IRINOTECAN PER 20MG	54116843	$1,263
MIDAZOLAM INJ PER 1MG	54116900	$355
INSULIN PER 5 UNITS	54116918	$100
PROMETHAZINE/NS 25MG/50ML	54116926	$60
HEPARIN PER 10 UNITS	54116959	$62
HEPARIN PER 10 UNITS	54116967	$58
MAG SULFATE PER 500MG	54116975	$105
CEFAZOLIN PER 500MG	54116983	$63
MORPHINE SULF UP TO 10MG	54116991	$58
CEFAZOLIN PER 500MG	54117007	$168
MICAFUNGIN SOD PER 1MG	54117031	$458
MICAFUNGIN SOD PER 1MG	54117049	$1,122
TIGECYCLINE PER 1MG	54117056	$437
CEFAZOLIN PER 500MG	54117064	$71
CEFOXITIN/NS 1GM/100ML	54117072	$136
ONDANSETRON PER 1MG	54117114	$194
LORAZEPAM PER 2MG	54117130	$304
HEPARIN LOC PER 10 UNITS	54117163	$65
BANANA BAG ER 1000ML	54117189	$430
FENTANYL CITRATE PER 0.1MG	54117205	$76
FENTANYL CITRATE PER 0.1MG	54117213	$132
ADRENAL EPINEPH INJ PER 0.1MG	54117221	$71
HEPARIN LOC PER 10 UNITS	54117239	$110
HEPARIN LOC PER 10 UNITS	54117247	$110
PIPER/TAZO PER 1.125GM	54117254	$88
PIPER/TAZO PER 1.125GM	54117262	$116
PIPER/TAZO PER 1.125GM	54117270	$146
DOBUTAMINE PER 250MG INJ	54117288	$118
CEFUROXIME SOD PER 750MG	54117346	$136
LORAZEPAM PER 2MG	54117387	$331
MAG SULFATE PER 500MG	54117429	$27
CEFAZOLIN/D5W 500MG/50ML	54117460	$42
CEFAZOLIN SOD PER 500MG	54117551	$49
FENTANYL CITRATE PER 0.1MG	54117585	$50
MIDAZOLAM PER 1MG	54117593	$38
MIDAZOLAM PER 1MG	54117601	$43
FENTANYL CITRATE PER 0.1MG	54117619	$34
VANCOMYCIN PER 500MG	54117791	$18
TIROFIBAN HCL INJ PER 0.25MG	54117981	$2,232
VANCOMYCIN PER 500MG	54118013	$198
CEFAZOLIN PER 500MG	54118047	$15
MORPHINE SULF PER 10MG INJ	54118054	$27
MORPHINE SULF PER 10MG INJ	54118062	$118
MORPHINE SULF PER 10MG INJ	54118070	$242
MORPHINE SULF PER 10MG INJ	54118088	$286
MORPHINE SULF PER 10MG INJ	54118096	$62
CEFTRIAXONE PER 250MG	54118195	$26
CEFTRIAXONE PER 250MG	54118203	$42
VANCOMYCIN HCL 500MG INJ	54118302	$276
VANCOMYCIN PER 500MG	54118369	$263
LEVETIRACETAM PER 10MG	54118385	$35
LEVETIRACETAM PER 10MG	54118393	$227
LEVETIRACETAM PER 10MG	54118401	$325
VANCOMYCIN PER 500MG	54118534	$36
LINEZOLID PER 200MG	54118708	$283
VANCOMYCIN PER 500MG	54118740	$45
VANCOMYCIN PER 500MG	54118765	$43
VANCOMYCIN PER 500MG	54118872	$20
VANCOMYCIN PER 500MG	54118880	$22
CONIVAPTAN PER 1MG	54118948	$2,383
CANGRELOR PER 1MG	54118963	$3,148
AMIODARONE HCL PER 30MG	54119029	$160
ARGATROBAN PER 1MG NONESRD	54119292	$2,273
ARGATROBAN PER 1MG ESRD	54119300	$2,273
ABCIXIMAB INJ 2MG/ML 5ML VIAL	54200050	$10,025
ALTEPLASE PER 1MG	54200456	$35,794
ALTEPLASE PER 1MG	54200506	$17,582
AMIODARONE HCL PER 30MG	54200605	$117
AMPHO B LIPID COMP PER 10MG	54200803	$3,383
FACTOR VIII (ADVATE) PER UNIT	54201058	$22
FACTOR VIII (MONO-P) PER UNIT	54201207	$21
BACLOFEN PER 50MCG FOR TRIAL	54201405	$1,287
BLEOMYCIN SUL 15 UNIT VL BRAND	54201801	$5,368
BLEOMYCIN SULFATE PER 15U GN	54201900	$6,999
BLEOMYCIN SULFATE PER 15U GN	54201959	$2,033
BOTULINUM TOXIN PER UNIT	54202056	$12,225
CARBOPLATIN INJ PER 50MG	54202106	$1,823
CARBOPLATIN INJ PER 50MG	54202155	$4,735
CARBOPLATIN INJ PER 50MG	54202205	$12,099
CIDOFOVIR PER 375MG	54202304	$2,360
CISPLATIN PER 10MG INJ GN	54202403	$3,201
CISPLATIN PER 10MG GN	54202650	$10,038
CISPLATIN PER 10MG INJ GN	54202700	$102
CLADRIBINE PER 1MG	54202809	$7,272
DESMOPRESSIN PER 1MCG	54203351	$679
DESMOPRESSIN PER 1MCG	54203401	$473
DESMOPRESSIN PER 1MCG	54203450	$3,277
DIGOXIN IMMUNE FAB PER VIAL	54204052	$6,022
DOXORUBICIN HCL LIPO PER 10MG	54204250	$19,963
DOXORUBICIN HCL LIPO PER 10MG	54204300	$7,986
ENOXAPARIN SOD PER 10MG INJ	54204409	$608
ENOXAPARIN SOD INJ PER 10MG	54204458	$1,281
ENOXAPARIN SOD INJ PER 10MG	54204508	$950
ENOXAPARIN SOD INJ PER 10MG	54204557	$1,837
ENOXAPARIN SOD INJ PER 10MG	54204607	$894
EPTIFIBATIDE INJ PER 5MG	54204656	$3,853
EPTIFIBATIDE INJ PER 5MG	54204706	$6,976
EPTIFIBATIDE INJ PER 5MG	54204755	$1,158
ETANERCEPT 25MG KIT INJ	54204805	$2,184
FLUDARABINE PHOS 50MG VIAL	54205158	$3,304
FOMEPIZOLE PER 15MG	54205208	$23,290
FOSCARNET SODIUM PER 1000MG	54205307	$2,175
GEMCITABINE HCL PER 200MG	54205406	$6,079
GEMCITABINE HCL PER 200MG	54205455	$1,649
GOSERELIN IMPLANT PER 3.6MG	54205604	$15,942
HEMIN PER 1MG	54205653	$5,972
IBUTILIDE FUM PER 1MG	54206354	$4,039
INFLIXIMAB INJECTION PER 10MG	54207204	$10,302
IRINOTECAN INJ PER 20MG	54207402	$7,667
IRINOTECAN INJ PER 20MG	54207451	$3,650
LEPIRUDIN 50MG VIAL	54207808	$4,245
LEUPROLIDE ACETATE PER 3.75MG	54207956	$10,961
LEUPROLIDE ACETATE PER 3.75MG	54208004	$12,521
LEUPROLIDE ACE DEPOT PER 7.5MG	54208152	$28,538
LEUPROLIDE ACE DEPOT PER 7.5MG	54208202	$32,440
LEUPROLIDE ACE SUSP 7.5MG KIT	54208251	$4,019
LYMPH IMMUNE GLOB PER 250MG	54208509	$2,881
MILRINONE LACT PER 5MG	54208608	$2,908
MILRINONE LACT PER 5MG	54208806	$1,569
MILRNONE PER 5MG	54208855	$2,118
MILRINONE PER 5MG	54208905	$490
MITOXANTRONE HCL PER 5MG	54209101	$13,275
OPRELVEKIN 5MG VL	54209655	$3,494
PALIVIZUMAB PER 50MG	54209853	$18,374
PALIVIZUMAB PER 50MG	54209903	$9,354
PAMIDRONATE DISOD PER 30MG BRD	54209952	$4,897
PAMIDRONATE DISOD PER 30MG GN	54210000	$9,583
RABIES IMM GLOB 150U/ML 10ML	54210208	$2,463
RABIES IG-HT 150UNITS/ML 2ML V	54210257	$2,273
BAYRAB 150UNITS/ML(GN) 2ML	54210307	$2,463
RABAVERT 2.5 UNIT KIT	54210406	$3,080
RABIES VACC HUMAN 2.5U/ML VL	54210455	$2,276
RETEPLASE PER 18.1MG	54210703	$16,476
RHO(D) IMM GLOB PER 50MCG	54210851	$655
RHO(D)IMM GLOB H/SD/PER100IU	54211156	$4,755
RHO(D)IMM GLOB H/SD/PER 100 IU	54211206	$12,961
SARGRAMOSTIM PER 50MCG	54211750	$8,766
SARGRAMOSTIM PER 50MCG	54211800	$4,480
SOMATROPIN PER 1MG	54212006	$3,076
VINORELBINE TART PER 10MG	54213459	$1,129
VINORELBINE TART PER 10MG/BD	54213509	$4,505
ALTEPLASE PER 1MG	54213608	$1,916
ALTEPLASE PER 1MG	54214077	$514
EPOETIN ALFA PER 1000U NONESRD	54214119	$522
EPOETIN ALFA PER 1000U NONESRD	54214127	$863
EPOETIN ALFA PER 1000U NONESRD	54214135	$649
EPOETIN ALFA PER 1000U NONESRD	54214168	$2,305
EPOETIN ALFA PER 1000U NONESRD	54214184	$4,748
EPOETIN ALFA PER 1000U NONESRD	54214192	$7,321
AMPHO B LIPOSOME PER 10MG	54214218	$3,854
MYCOPHENOLATE ORAL PER 250MG	54214366	$5,977
DARBPTN ALFA PER 1MCG NON ESRD	54214374	$2,052
EPIRUBICIN HCL PER 2MG	54214382	$4,530
THYROTROPIN 1.1MG VIAL	54214416	$4,080
CYTARABINE LIPSOME PER 10MG	54214424	$4,722
FULVESTRANT F KABI PER 25MG	54214549	$2,092
DARBPTN ALFA PER 1MCG NON ESRD	54214606	$2,189
BEVACIZUMAB PER 10MG	54214630	$6,664
BEVACIZUMAB PER 10MG	54214648	$15,204
PEMETREXED PER 10MG	54214671	$13,477
OCTREOTIDE NONDEP PER 25MCG	54214697	$1,376
OCTREOTIDE NONDEP PER 25MCG	54214705	$7,274
CETUXIMAB PER 10MG	54214739	$5,386
MESNA PER 200MG	54300819	$224
AMIKACIN SULF PER 100MG	54301957	$464
HYDROXYZINE INJ UP TO 25MG	54302039	$10
DEXAMETHASONE INJ PER 1MG	54302096	$26
DEXAMETHASONE INJ PER 1MG	54302112	$31
MORPHINE SULF PF PER 10MG	54302179	$2,285
NALOXONE HCL PER 1MG	54302195	$109
TRIAMCINOLONE PER 10MG	54302799	$197
BUTORPHANOL TART PER 1MG	54303821	$100
PEGASPARGASE PER SGLE DOSE VL	54304183	$62,108
CYCLOSPORINE ORAL 100MG GN	54304282	$144
VINCRISTINE PER 1MG	54304662	$551
MORPHINE SULF UP TO 10MG	54304688	$11
FLUROROURACIL PER 500MG	54304704	$70
MEPIVACAINE PER 10ML	54305305	$168
MEPERIDINE PER 100MG	54305446	$531
TOBRAMYCIN UP TO 80MG INJ	54306329	$384
HEP-LOCK 10 UNITS/ML 1ML VL	54306584	$2
TEMOZOLOMIDE PER 5MG ORAL	54306907	$1,990
TEMOZOLOMIDE PER 5MG ORAL	54306923	$4,760
MEPIVACAINE PER 10ML	54307020	$58
ONDANSETRON PER 1MG	54307764	$1,796
HEPARIN PER 1000 UNITS	54308002	$44
DROPERIDOL UP TO 5MG	54308143	$81
CASPOFUNGIN ACET PER 5MG	54308622	$7,776
CASPOFUNGIN ACET PER 5MG	54308630	$6,036
HEPARIN PER 10 UNITS	54308721	$52
MDRXYPRGSTRN ACET PER 50MG	54309133	$752
MORPHINE SULF UP TO 10MG	54309489	$168
IRON SUCROSE CPLX PER 1MG	54309901	$1,335
ZOLEDRONIC ACID PER 1MG	54310073	$12,987
SIROLIMUS 1MG TAB	54310255	$162
METHADONE PER 10MG	54310412	$13
DARBPTN ALFA PER 1MCG NON ESRD	54311006	$1,910
PROCHLORPER 5MG TAB/OP CH	54311063	$2
PROMETHAZINE PER 12.5MG OP CH	54311097	$1
HYDROXYZINE 25MG CAP (OP CH)	54311147	$34
CELESTONE PER 3MG	54312236	$56
BETAMETHASONE PER 3MG	54312244	$116
DOXORUBICIN PER 10MG	54312830	$792
CHLORPROMAZINE UP TO 50MG	54313002	$51
PEN G PROCAINE UP TO 600MU	54313028	$168
VANCOMYCIN PER 500MG	54313135	$144
HEPARIN PER 10 UNITS	54313416	$10
MORPHINE SULF UP TO 10MG	54313556	$242
VANCOMYCIN PER 500MG	54313747	$246
MORPHINE SULF UP TO 10MG	54315114	$8
HEPARIN/NA PER 1000 UNITS	54315460	$24
ALTEPLASE PER 1MG	54315478	$2,448
FENTANYL CITRATE PER 0.1MG	54315585	$1
HEPARIN SOD PER 1000 UNITS	54315643	$1
ROPIVACAINE HCL PER 1MG	54315908	$52
CYCLOPHOSPHAMIDE PER 25MG TAB	54316070	$2
TET/DIPH TOX 2-2LFU/0.5ML	54316229	$113
ENOXAPARIN SOD INJ PER 10MG	54316260	$633
ENOXAPARIN SOD PER 10MG	54316278	$762
DIAZEPAM UP TO 5MG INJ	54316484	$24
DIGOXIN IMMUNE FAB PER VIAL	54316518	$4,665
TACROLIMUS PARENTERAL PER 5MG	54316526	$1,504
FONDAPARINUX PER 0.5MG	54316716	$568
ZIPRASIDONE MESYL INJ PER 10MG	54316872	$176
DARBPTN ALFA PER 1MCG NON ESRD	54316971	$1,392
DARBPTN ALFA PER 1MCG NON ESRD	54317235	$1,966
DARBTN ALFA PER 1MCG NON ESRD	54317250	$2,239
LORAZEPAM PER 2MG	54317284	$2
PAPAVERINE UP TO 60MG	54317656	$340
NEOSTIGMINE METHY UP TO 0.5MG	54317680	$321
PIPER/TAZO/D5W 4.5GM/100ML PB	54317938	$512
FUROSEMIDE PER 20MG	54318415	$96
EPOETIN ALFA PER 1000U NONESRD	54319561	$687
PREDNISOLONE PER 5MG ORAL	54319595	$1
FLUCONAZOLE PER 200MG	54319702	$362
PEN G POT UP TO 600MU INJ	54319934	$44
HEP B VACC/DP(A)T-POLIO 0.5ML	54320171	$52
TEMOZOLOMIDE PER 5MG ORAL	54320213	$81
EPOETIN ALFA PER 1000U NONESRD	54320296	$32
DRONABINOL ORAL PER 2.5MG OPCH	54320544	$156
PROMETHAZINE PER 12.5MG OPCH	54320593	$1
DARBPTN ALFA PER 1MCG NON ESRD	54320676	$4,636
HEPARIN PER 10 UNITS	54320833	$1
BIVALIRUDIN PER 1MG	54320866	$7,904
ERTAPENEM SOD PER 500MG	54320874	$150
GLATIRAMER ACETATE 20MG KIT	54320916	$830
HEPARIN PER 1000 UNITS	54321013	$2
MORPHINE SULF UP TO 10MG	54321047	$239
AMIODARONE HCL PER 30MG	54321104	$171
APREPITANT PER 5MG	54321195	$228
APREPITANT PER 5MG	54321203	$1,392
INSULIN PER 5 UNITS	54321351	$60
CAFFEINE CITRATED PER 5MG	54321542	$140
GENTAMICIN UP TO 80MG	54321641	$1
MORPHINE SULF UP TO 10MG	54321740	$1
ACYCLOVIR PER 5MG INJ	54321823	$1
GENTAMICIN UP TO 80MG	54321963	$1
CAFFEINE CITRATE PER 5MG	54322102	$70
PAMIDRONATE DISOD PER 30MG BRD	54322169	$4,920
CYCLOSPOR ORAL PER 100MG/BD	54322201	$76
CYCLOSPOR ORAL PER 100MG/BD	54322227	$1,975
CYCLOSPORINE 100MG CAP BRAND	54322235	$81
CYCLOSPORINE ORAL PER 100MG	54322243	$198
CYCLOSPOR ORAL PER 100MG/BD	54322268	$1,950
CYCLOSPOR ORAL PER 100MG/BD	54322276	$102
DOXORUBICIN PER 10MG BRAND	54322292	$1,257
DOXORUBICIN PER 10MG BRAND	54322300	$188
DOXORUBICIN PER 10MG	54322326	$380
DACARBAZINE PER 100MG BRAND	54322615	$313
IFOSFOMIDE PER 1GM BRAND	54322672	$1,978
IFOSFOMIDE PER 1GM BRAND	54322680	$2,820
MESNA INJ PER 200MG BRAND	54322698	$1,233
MITOMYCIN 5MG VIAL BRAND	54322805	$588
MITOMYCIN PER 5MG INJ BRAND	54322813	$2,546
MITOMYCIN PER 5MG INJ BRAND	54322821	$5,589
OCTREOTIDE NONDEP PER 25MCG	54322896	$87
OCTREOTIDE NONDEP PER 25MCG	54322904	$182
OCTREOTIDE NONDEP PER 25MCG	54322912	$1,382
ETOPOSIDE PER 10MG BRAND	54322961	$226
CEFAZOLIN PER 500MG	54323084	$10
CEFEPIME PER 500MG	54323092	$84
CEFTAZIDIME PER 500MG	54323100	$63
METOCLOPRAMIDE UP TO 10MG	54323142	$1
ROPIVACAINE PER 1MG	54323373	$87
PALONSETRON HCL PER 25MCG	54323639	$1,898
DIPH PERT TET 15-10-5 0.5ML VL	54324074	$208
MORPHINE SULF UP TO 10MG	54324389	$8
OXACILLIN SODIUM UP TO 250MG	54324603	$87
CEFAZOLIN PER 500MG	54324777	$136
AZACITIDINE PER 1MG	54324827	$4,944
FUROSEMIDE INJ UP TO 20MG	54325048	$24
HYDRALAZINE UP TO 20MG	54325055	$24
THIAMINE INJ PER 100MG	54325071	$24
ZIDOVUDINE PER 10MG	54325089	$24
AMPHO B LIPOSOME PER 10MG	54325220	$63
DEXAMETHASONE INJ PER 1MG	54325279	$24
MEROPENEM PER 100MG	54325303	$34
OXACILLIN SODIUM TO 250MG	54325311	$27
CEFAZOLIN PER 500MG	54325568	$171
RISPERIDONE LONG ACT PER 0.5MG	54325725	$2,067
RISPERIDONE LONG ACT PER 0.5MG	54325733	$3,508
OMALIZUMAB PER 5MG	54325857	$3,332
GRANISETRON PER 100MCG	54325881	$98
LEVOFLOXACIN 250MG/10ML SOLN	54326004	$60
HEP B IMMUNE GLOB (>3121IU) VL	54326277	$2,184
HEP B IMMUNE GLOB (>1560IU) VL	54326285	$4,367
FONDAPARINUX SOD PER 0.5MG	54326293	$1,697
FONDAPARINUX SOD PER 0.5MG	54326301	$579
FONDAPARINUX SOD PER 0.5MG	54326319	$579
TET DIP TOX PED 5-6.7LFU 0.5ML	54326327	$135
LORAZEPAM INJ PER 2MG	54326707	$91
THIAMINE INJ PER 100MG	54326814	$59
AMIODARONE HCL PER 30MG	54326921	$95
NATALIZUMAB PER 1MG INJ	54326988	$10,327
MAGNESIUM SULF PER 500MG	54327077	$29
PROPRANOLOL UP TO 1MG	54327085	$162
AMIODARONE HCL PER 30MG	54327341	$269
RISPERIDONE LONG ACT PER 0.5MG	54327663	$3,089
DIGOXIN UP TO 0.5MG	54328042	$1
DARBEPOETIN ALFA PER 1MCG ESRD	54328174	$1,181
PNEUMOVAX 25MCG/0.5ML SYR	54328232	$175
ETANERCEPT PER 25MG	54328315	$2,144
DOXERCALCIFEROL PER 1 MCG	54328356	$115
TIGECYCLINE PER 1MG	54328414	$922
OCTREOTIDE ACET PER 25MCG	54328489	$243
OCTREOTIDE ACET PER 25 MCG	54328497	$1,749
HEPARIN LOC PER 10 UNITS	54328554	$2
FACTOR VIII (RECOMB) PER UNIT	54328596	$22
PARICALCITOL PER 1MCG	54328604	$97
AMINOPHYLLINE UP TO 250MG	54328653	$23
DEFEROXAMINE MESYL 500MG VL	54328679	$480
PEN G PROCAINE UP TO 600MU	54328737	$100
MAG SULPHATE 500MG INJ	54328836	$23
MAG SULPHATE 500MG INJ	54328844	$31
MIDAZOLAM PF 1MG/1ML SYRINGE	54329297	$23
MIDAZOLAM 1MG/ML 1ML	54329305	$23
AMIODARONE PER 30MG	54329404	$140
AMPICILLIN SOD PER 500MG	54329412	$206
AMPICILLIN SOD PER 500MG	54329438	$766
AMPICILLIN SOD 500MG VIAL	54329446	$193
AMP SOD/SULBACT 1.5GM VL	54329453	$516
AMP SOD/SULBACT PER 1.5GM	54329461	$152
AZATHIOPRINE 100MG VL	54329487	$558
CEFTRIAXONE SOD PER 250MG	54329495	$324
CEFTRIAXONE SODIUM 250MG VIAL	54329503	$344
CEFTRIAXONE SOD PER 250MG	54329511	$562
MICAFUNGIN SOD PER 1MG	54329636	$775
DIGOXIN UP TO 0.5MG	54329693	$30
DIPHENHYDRAMINE UP TO 50MG	54329701	$1
MIDAZOLAM PER 1MG	54329776	$1
OCTREOTIDE PER 25MCG	54329784	$50
TOBRAMYCIN UP TO 80MG	54329800	$15
PENTOBARBITAL PER 50MG	54329818	$842
MORPHINE UP TO 10MG	54329826	$10
METOCLOPRAMIDE UP TO 10MG	54330147	$23
DEXAMETHASONE INJ 1MG	54330154	$23
CALCIUM GLUC INJ PER 10MG	54330162	$23
METOCLOPRAMIDE INJ UP TO 10MG	54330519	$34
ACYCLOVIR PER 5MG	54330584	$250
POLIOMYELITIS VAC KILLED 0.5ML	54330659	$380
HEP A VACC 50UNITS/1ML VIAL	54330667	$518
FUROSEMIDE UP TO 20MG	54330691	$24
MIDAZOLAM PER 1MG	54330725	$23
ACYCLOVIR PER 5MG	54330733	$24
HYDRALAZINE UP TO 20MG	54330774	$23
AMINOPHYLLINE UP TO 250MG	54330881	$23
GENTAMICIN UP TO 80MG	54330915	$27
HYDROCORTISONE UP TO 100MG	54330964	$24
BACLOFEN KIT PER 10MG	54331087	$1,298
OXALIPLATIN PER 0.5MG	54331103	$17,697
OXALIPLATIN PER 0.5MG	54331111	$4,902
OXALIPLATIN PER 0.5MG	54331129	$9,804
NESIRITIDE PER 0.1MG	54331152	$5,421
SODIUM CL 0.9% FLUSH 10ML SYRN	54331186	$47
IVIG LYOPHILIZED PER 500MG	54331251	$5,327
IVIG LYOPHILIZED PER 500MG	54331269	$1,524
IVIG LYOPHILIZED PER 500MG	54331277	$6,092
IVIG LYOPHILIZED PER 500MG	54331285	$5,658
IVIG LYOPHILIZED PER 500MG	54331368	$2,661
HYALURON OVINE PER USP UNIT	54331673	$100
HYALURON OVINE PER USP UNIT	54331681	$226
ACETYLCYSTEIN PER 100MG	54331723	$2,149
BACLOFEN KIT PER 10MG	54331764	$5,540
RHO(D) IMMU GLOB 300MCG SYR	54331863	$597
ALBUMIN HUMAN 25% PER 20ML	54332036	$1,830
HYDRALAZINE 1MG/1ML SYR	54332051	$23
PEN G POT 100000U/1ML SYR	54332069	$23
ROPIVACAINE PER 1MG	54332200	$51
MIDAZOLAM PER 1MG	54332275	$10
MORPHINE SULF 1MG/ML 10ML PF	54332341	$52
IVIG NONLYOPHILIZED PER 500MG	54332580	$3,233
POLIO VAC KILLED 0.5ML SYR	54332614	$380
PHENYTOIN PER 50MG	54332648	$22
METOCLOPRAMIDE UP TO 10MG	54332705	$22
NALOXONE HCL PER 1MG	54332721	$22
ONDANSETRON HCL PER 1MG	54332739	$100
PHENOBARB SOD UP TO 120MG	54332754	$22
MORPHINE SULF UP TO 10MG	54332812	$22
POT CHL PER 2MEQ INJ	54332820	$22
MAG SULFATE PER 500MG	54332838	$22
AZITHROMYCIN 500MG/10ML VL GEN	54333117	$601
IVIG NONLYOPHILIZED PER 500MG	54333125	$538
TOBRAMYCIN UP TO 80MG	54333521	$1,699
DOLASETRON MESYLATE PER 10MG	54333562	$147
DOPAMINE HCL PER 40MG	54333968	$28
DOPAMINE HCL PER 40MG	54333976	$95
IVIG NONLYOPHILIZED PER 500MG	54334016	$5,557
CAFFEINE CITRATE PER 5MG	54334115	$71
DOPAMINE PER 40MG	54334123	$95
MITOMYCIN OPHTH SOLN 3ML	54334156	$70
FENTANYL CITRATE PER 0.1MG	54334164	$62
IBANDRONATE SOD PER 1MG	54334263	$1,782
DECITABINE PER 1MG	54334271	$7,402
FENTANYL CITRATE PER 0.1MG	54334461	$212
A-THYMOCYTE GLOB (RABBIT) 25MG	54334479	$2,314
ABATACEPT PER 10MG	54334560	$2,047
ANIDULAFUNGIN PER 1MG	54334701	$548
HEPARIN LOC PER 10 UNITS	54334735	$22
DIP/PERT(ACELL)/TET 0.5ML VL	54334958	$341
EPOETIN ALFA PER 100UNITS ESRD	54334974	$101
EPOETIN ALFA PER 100UNITS ESRD	54334982	$172
EPOETIN ALFA PER 100UNITS ESRD	54334990	$308
EPOETIN ALFA PER 100UNITS ESRD	54335005	$342
EPOETIN ALFA PER 100UNITS ESRD	54335013	$436
EPOETIN ALFA PER 100UNITS ESRD	54335021	$1,622
EPOETIN ALFA PER 100UNITS ESRD	54335039	$111
EPOETIN ALFA PER 100UNITS ESRD	54335047	$3,009
MENINGOCOCCAL/DIPH 16MCG/0.5ML	54335070	$438
FENTANYL CITRATE PER 0.1MG	54335211	$90
FENTANYL CITRATE PER 0.1MG	54335229	$42
HEPARIN LOC PER 10 UNITS	54335419	$23
HEPARIN LOC PER 10 UNITS	54335427	$26
HEPARIN LOC PER 10 UNITS	54335781	$28
HYALURONIDASE PER 1 USP UNIT	54335799	$997
DEXAMETHASONE PER 0.25MG	54335815	$1
HEPARIN/0.2NS 10U/20ML SYR	54335930	$21
CYCLOSPORINE 250MG/5ML VIAL	54336086	$168
INSULIN PER 5 UNITS	54336128	$224
INSULIN PER 5 UNITS	54336136	$262
DARBPTN ALFA PER 1MCG NON ESRD	54336425	$1,585
PHYTONADIONE 1MG/0.5ML SYR	54336698	$21
HEPARIN LOC PER 10 UNITS	54336706	$21
CEFEPIME HCL PER 500MG	54336763	$140
CEFEPIME HCL PER 500MG	54336771	$243
ONDANSETRON PER 1MG	54336789	$30
ONDANSETRON PER 1MG	54336797	$158
CAFFEINE CITRATE PER 5MG	54336896	$177
CAFFEINE CITRATE PER 5MG	54336904	$52
CEFOXITIN (GN) 1GM/20ML VL	54336912	$95
CEFOXITIN SODIUM PER 1GM	54336920	$168
MILRINONE LACT PER 5MG	54336938	$160
DEXAMETHASONE INJ PER 1MG	54336979	$120
HEPARIN LOC PER 10 UNITS	54336987	$21
DICYCLOMINE (GN) 20MG/2ML VL	54337019	$213
FONDAPARINUX SOD PER 0.5MG	54337126	$343
HYDROCORTISONE 100MG/2ML ACT V	54337142	$21
HEPARIN PER 1000 UNITS	54337175	$21
ALBUMIN 5% PER 50ML	54337183	$2,902
ALBUMIN 25% 12.5GM/50ML	54337209	$2,651
DIHYDROERGOTAMINE (GN) 1MG/1ML	54337225	$214
HALOPERIDOL DEC (GN) 50MG/1ML	54337316	$52
HALOPERIDOL LAC (GN) 5MG/1ML	54337332	$208
HALOPERIDOL INJ PER 5MG	54337340	$417
MORPHINE SULF PF PER 10MG	54337530	$479
METHACHOLINE CL PER 1MG	54337548	$276
ONDANSETRON/NS (GN) 1MG/1ML	54337555	$21
HEPARIN LOC PER 10 UNITS	54337563	$51
CARBOPLATIN INJ PER 50MG	54337589	$340
CARBOPLATIN INJ PER 50MG	54337597	$538
CARBOPLATIN (GN) 50MG/5ML VL	54337605	$136
CARBOPLATIN INJ PER 50MG	54337613	$1,080
CYTARABINE (GN) 100MG/5ML VL	54337639	$44
CYTARABINE HCL PER 100MG	54337647	$287
FLUOROURACIL (GN) 500MG/10ML V	54337654	$24
MITOXANTRONE HCL PER 5MG	54337688	$6,411
BLEOMYCIN SULF (GN) 15 UNIT VL	54337712	$470
DACARBAZINE PER 100MG VIAL	54337720	$158
DOXORUBICIN PER 10MG	54337738	$387
FLUDARABINE PHOS (GN) 50MG/2ML	54337746	$1,571
VINCRISTINE PFS 1MG/1ML VL	54337753	$128
ETOPOSIDE PER 10MG	54337779	$352
HEPARIN PER 1000 UNITS	54337910	$21
LEVETIRACETAM PER 10MG	54337951	$244
ARIPIPRAZOLE PER 0.25MG	54337969	$92
IXABEPILONE INJECTION 1MG	54337993	$4,601
IXABEPILONE INJECTION 1MG	54338009	$13,804
RHO(D)IMM GLOB H/SD/PER 100 IU	54338223	$2,594
RHO(D)IMM GLOB H/SD/PER 100 IU	54338231	$15,570
HEPARIN PER 1000 UNITS	54338249	$81
TEMSIROLIMUS PER 1MG	54338306	$5,754
HEPARIN PER 10 UNITS	54338348	$60
MEDROXYPROG ACET PER 1MG	54338496	$329
MEDROXYPROG ACET PER 1MG	54338504	$554
FOSPHENYTOIN PER 50MG	54338678	$27
FOSPHENYTOIN PER 50MG	54338694	$57
AGALSIDASE BETA PER 1MG	54338827	$22,216
VWF PER UNIT (HUMATE-P)<600 VL	54338868	$14
ALBUMIN HUMAN 12.5MG/50ML VIAL	54339072	$459
FACTOR VIII(HELI250) PER UNIT	54339080	$2
FACTOR VIII (HELI500) PER UNIT	54339098	$2
FACTOR VIII(HELI1000) PER UNIT	54339106	$2
FACTOR VIII(HELI2000) PER UNIT	54339114	$2
RHO(D) IMMUNE GLOB PER 100IU	54339122	$499
IFOSFAMIDE PER 1GM	54339155	$382
IFOSFAMIDE PER 1GM	54339163	$948
TREPROSTINIL PER 1MG	54339197	$13,816
TEMOZOLOMIDE PER 5MG ORAL	54339205	$1,164
BENDAMUSTINE PER 1MG	54339320	$8,722
DIPYRIDAMOLE 5MG/ML 2ML AMP	54339403	$21
MICAFUNGIN SOD PER 1MG	54339429	$1,384
DORIPENEM PER 10MG	54339502	$275
ENOXAPARIN/NS 10MG/1ML SYRINGE	54339593	$70
SUCCINYLCHOLIN CHL UP TO 20MG	54339684	$183
BASILIXIMAB 20MG VIAL	54339700	$8,740
IVIG NONLYOPHILIZED PER 500MG	54339775	$5,293
FENTANYL CITRATE PER 0.1MG	54339825	$105
NALBUPHINE PER 10MG	54339874	$79
FENTANYL CITRATE PER 0.1MG	54339940	$71
DIHYDROERGOTAMINE 1MG/1ML VIAL	54339965	$188
INS R/0.45 SOD CHL 5UNITS/50ML	54340005	$127
REGADENOSAN PER 0.1MG	54340054	$1,731
TENECTEPLASE PER 1MG	54340062	$41,997
LEVOLEUCOVORIN PER 0.5MG	54340161	$470
FOSAPREPITANT PER 1MG	54340179	$832
CLEVIDIPINE BUTYRATE PER 1MG	54340237	$1,974
INFLUENZA PEDI 22.5MCG/0.25ML	54340245	$105
METHYLDOPATE 250MG/5ML 5ML VL	54340823	$165
MIDAZOLAM 1MG/1ML SYR	54341201	$16
LEUPROLIDE ACE DEPOT PER 7.5MG	54341433	$6,190
TREPROSTINIL PER 1MG	54341466	$25,583
METHYLERGONOVINE TO 0.2MG	54341482	$76
VANCOMYCIN PER 500MG	54341508	$50
MYCOPHENOLATE 250MG CAP UD	54341581	$79
ALTEPLASE PER 1MG	54341623	$420
ALTEPLASE PER 1MG	54341631	$3,470
VARIZIG 125 IU/1ML VIAL	54341839	$489
ZOSTER VACC LIVE 19400 UNIT	54341870	$766
HEPARIN LOC PER 10 UNITS	54341912	$20
DRONABINOL ORAL PER 2.5MG OPCH	54341946	$128
INFLUENZA VACC 45MCG/0.5ML SYR	54342043	$56
PRALIDOXIME UP TO 1GM	54342068	$410
OCTREOTIDE DEPOT PER 1MG	54342076	$9,834
INSULIN PER 5 UNITS	54342092	$144
MAG SULFATE PER 500MG	54342134	$83
IVIG PRIVIGEN PER 500MG	54342142	$2,056
IVIG PRIVIGEN PER 500MG	54342159	$4,110
IVIG PRIVIGEN PER 500MG	54342167	$8,222
INFLUENZA VACC 45MCG/0.5ML SYR	54342191	$69
TREPROSTINIL PER 1MG	54342217	$5,117
ENOXAPARIN SOD INJ PER 10MG	54342274	$260
ENOXAPARIN SOD INJ PER 10MG	54342282	$300
ENOXAPARIN SOD INJ PER 10MG	54342290	$371
ENOXAPARIN SOD INJ PER 10MG	54342308	$453
ENOXAPARIN SOD INJ PER 10MG	54342316	$444
ENOXAPARIN SOD INJ PER 10MG	54342324	$476
ENOXAPARIN SOD INJ PER 10MG	54342332	$546
ENOXAPARIN SOD INJ PER 10MG	54342340	$579
ENOXAPARIN SOD INJ PER 10MG	54342357	$614
ENOXAPARIN SOD INJ PER 10MG	54342365	$646
ENOXAPARIN SOD INJ PER 10MG	54342373	$682
IRON DEX COMPLEX PER 50MG	54342381	$150
SODIUM HYALURONATE PER DOSE	54342399	$618
INFLUENZA VAC 45MCG/0.5ML SYR	54342431	$96
DEXRAZOXANE PER 250MG	54342563	$2,967
NELARABINE PER 50MG	54342571	$2,156
APREPITANT PER 5MG	54342647	$254
ELLIOTS B SOLUTION PER 1ML	54342662	$236
FENTANYL CITRATE PER 0.1MG	54342670	$28
FENTANYL CITRATE PER 0.1MG	54342688	$16
METHYLENE BLUE PER 1MG	54342985	$66
METHYLENE BLUE PER 1MG	54342993	$38
METHYLENE BLUE PER 1MG	54343009	$56
ATROPINE SULF INJ PER 0.01MG	54343017	$16
ATROPINE SULF INJ PER 0.01MG	54343025	$69
ATROPINE SULF INJ PER 0.01MG	54343033	$16
ATROPINE SULF INJ PER 0.01MG	54343041	$291
ATROPINE SULF INJ PER 0.01MG	54343058	$24
ATROPINE SULF INJ PER 0.01MG	54343066	$18
ATROPINE SULF INJ PER 0.01MG	54343074	$1
ATROPINE SULF INJ PER 0.01MG	54343082	$39
ATROPINE SULF INJ PER 0.01MG	54343090	$16
ATROPINE SULF INJ PER 0.01MG	54343108	$21
HYALURONAN INJ PER 1MG	54343140	$1,071
HYALURONAN INJ PER 1MG	54343157	$3,213
DOCETAXEL PER 1MG	54343165	$6,669
DOCETAXEL PER 1MG	54343173	$1,767
LACOSAMIDE INJ PER 1MG	54343181	$267
PACLITAXEL PROTEIN-BND PER 1MG	54343363	$3,982
ANTI-INHIBITOR(FEIBA VH)PER IU	54343389	$12
LEVETIRACETAM/NS 10MG/2ML SYR	54343454	$16
ETOPOSIDE 50MG CAP	54343520	$238
LEUPROLIDE ACE DEPOT PER 7.5MG	54343538	$5,310
TELAVANCIN PER 10MG	54343645	$287
TELAVANCIN PER 10MG	54343652	$1,689
DEGARELIX PER 1MG	54343686	$4,018
DEGARELIX PER 1MG	54343694	$1,422
PALIPERIDONE PALMITATE PER 1MG	54343702	$1,129
PALIPERIDONE PALMITATE PER 1MG	54343710	$2,254
PALIPERIDONE PALMITATE PER 1MG	54343728	$3,384
OXALIPLATIN PER 0.5MG	54343777	$2,572
OXALIPLATIN PER 0.5MG	54343785	$5,146
ENFUVIRTIDE PER 1MG	54343959	$11,652
PENTOSTATIN PER 10MG	54344007	$8,183
HUMAN SECRETIN PER 1MCG	54344155	$1,891
HEPARIN LOC PER 10 UNITS	54344163	$16
PREVNAR 13 VALENT 0.5ML SYR	54344221	$1,217
FERUMOXYTOL PER 1MG NONESRD	54344288	$1,811
EPOPROSTENOL PER 0.5MG	54344379	$213
EPOPROSTENOL 0.5MG VIAL	54344395	$79
FACTOR IX COMPLEX PER UNIT	54344403	$2
DACLIZUMAB PER 25MG	54344437	$2,267
DIMERCAPROL PER 100MG	54344478	$456
HEP A VACC 1440 UNITS/1ML VIAL	54344486	$360
TETANUS/DIPTH/PERT 0.5ML SYR	54344668	$268
CYTOMEGALOVIRUS PER VIAL	54344684	$4,829
DEXAMETHASONE 0.5MG/5ML	54344924	$16
MORPHINE SULF UP TO 10MG	54344999	$15
CLOFARABINE PER 1MG	54345046	$8,810
MINOCYCLINE PER 1MG	54345111	$560
CLONIDINE 1MG/10ML VIAL	54345160	$265
INSULIN PER 5 UNITS	54345343	$30
MORPHINE SULF UP TO 10MG	54345467	$126
TRIAMCINOLONE ACET PER 1MG	54345509	$516
ADRENAL EPINEPH INJ PER 0.1MG	54345673	$613
ADRENAL EPINEPH INJ PER 0.1MG	54345681	$503
ADRENAL EPINEPH INJ PER 0.1MG	54345731	$306
ADRENAL EPINEPH INJ PER 0.1MG	54345756	$738
ADRENAL EPINEPH INJ PER 0.1MG	54345764	$1
PEN G BENZ/PROC PER 100000	54345772	$269
PEN G BENZ INJ PER 100000U	54345806	$208
PEN G BENZ INJ PER 100000U	54345814	$797
PEN G BENZ INJ PER 100000U	54345822	$886
ESTADIOL VALERATE PER 10MG	54345830	$1,167
TOPOTECAN PER 0.1MG	54345848	$7,526
ANTITHROMBIN RECOM PER 50IU	54345855	$15,578
CROTALIDAE IMMUNE FAB TO 1MG	54345863	$13,166
IMMUNE GLOB/HIZENTRA PER 100MG	54345939	$2,091
EPOETIN ALFA PER 1000U NONESRD	54345954	$1,060
EPOETIN ALFA PER 100UNITS ESRD	54345962	$1,060
DOCETAXEL PER 1MG	54345970	$5,972
DOCETAXEL PER 1MG	54345988	$1,583
IRON SUCROSE CPLX PER 1MG	54346028	$422
PROMETHAZINE 25MG/1ML VIAL	54346051	$14
OCTREOTIDE NONDEP PER 25MCG	54346093	$29
CEFTAROLINE FOSAMIL PER 10MG	54346127	$262
DORIPENEM PER 10MG	54346143	$106
RHO(D) IMM GLOB 50MCG MINI SYR	54346184	$164
INTERFERON A2B PER 1 MILL UNIT	54346267	$594
MIDAZOLAM PER 1MG	54346283	$14
MIDAZOLAM PER 1MG	54346291	$2
IBUPROFEN INJ PER 100MG	54346325	$42
FLUOROURACIL INJ PER 500MG	54346333	$35
LEVOFLOXACIN PER 250MG	54346366	$236
PLERIXAFOR INJ PER 1MG	54346416	$25,219
BENZTROPINE MESYL PER 1MG	54346499	$702
IMIGLUCERASE PER 10 UNITS	54346531	$6,094
PLASMA PROT (HUMAN) 5% 250ML	54346549	$185
SUCCINYLCHOLIN CHL UP TO 20MG	54346887	$95
NEOSTIGMINE METHY UP TO 0.5MG	54346895	$61
IVIG NONLYOPHILIZED PER 500MG	54346945	$3,098
IVIG NONLYOPHILIZED PER 500MG	54346952	$1,550
OXYMORPHONE 1MG/1ML AMP	54346994	$15
BUPRENORPHINE PER 0.1MG	54347075	$23
RETEPLASE PER 18.1MG	54347083	$16,690
HYDROCORT SOD SUC PF 100MG/2ML	54347109	$24
DENOSUMAB PER 1MG	54347257	$3,172
CEFTAROLINE FOSAMIL PER 10MG	54347265	$262
ECALLANTIDE PER 1MG	54347281	$32,087
GEMCITABINE HCL PER 200MG	54347315	$2,062
GEMCITABINE 200MG/5.26ML VIAL	54347323	$412
DOCETAXEL PER 1MG	54347331	$4,586
DOCETAXEL PER 1MG	54347349	$1,217
FOSAPREPITANT PER 1MG	54347414	$984
ACETAMINOPHEN INJ PER 10MG	54347539	$83
LIDOCAINE/TETRA 70-70MG PATCH	54347547	$101
ROTAVIRUS VACCINE SUSP 1ML	54347588	$392
KINRIX VACCINE 0.5ML SYRINGE	54347596	$218
HUMAN PAPILOMVIRUS VACC 0.5ML	54347604	$504
MIDAZOLAM INJ PER 1MG	54347638	$19
RASBURICASE PER 0.5MG	54347695	$11,088
HYDROCORTISONE PF TO 100MG	54347802	$66
HPV VACCINE 2-VALENT 0.5ML	54347836	$492
DIMENHYDRINATE 50MG/1ML VIAL	54347893	$28
HYDRO SOD SUCC PER 100MG	54348057	$110
ROPIVACAINE PER 1MG	54348081	$306
ROPIVACAINE PER 1MG	54348099	$1,756
FENTANYL CITRATE PER 0.1MG	54348115	$23
MORPHINE SULF PF PER 10MG	54348156	$63
TRASTUZUMAB PER 10MG	54348271	$574
PAMIDRONATE DISORD PER 30MG	54348297	$122
TRASTUZUMAB PER 10MG	54348339	$331
NULECIT 12.5MG/5ML	54348354	$14
MELPHALAN 2MG TAB	54348388	$28
ROPIVACAINE HCL PER 1MG	54348412	$39
SIROLIMUS ORAL PER 1 MG	54348479	$49
BRENTUXIMAB VEDOTIN PER 1MG	54348628	$15,720
ANASCORP UP TO 120MG	54348669	$13,946
ACYCLOVIR PER 5MG INJ	54348727	$66
ALBUMIN HUMAN 5% PER 50ML	54348735	$120
GENTAMICIN UP TO 80MG	54348784	$15
HYDROCORTISONE UP TO 100MG	54348792	$23
IVIG NONLYOPHILIZED PER 500MG	54348982	$7,005
IVIG NONLYOPHILIZED PER 500MG	54349089	$464
IVIG NONLYOPHILIZED PER 500MG	54349097	$1,018
BUPIVACAINE LIPOSOME PER 1MG	54349311	$1,468
CYCLOSPORINE ORAL PER 100MG	54349360	$17
METHYLNAL TREXONE PER 0.1 MG	54349618	$472
EVEROLIMUS PER 0.25 MG	54349626	$933
PEN G POT UP TO 600000U INJ	54350947	$23
TOCILIZUMAB INJ PER 1MG	54351234	$5,587
ICATIBANT INJ PER 1MG	54351283	$9,782
INFLUENZA QUAD 60MCG/0.5ML SYR	54351291	$116
INJ FILGRASTIM G-CSF PER 1MCG	54351549	$3,222
INJ FILGRASTIM G-CSF PER 1MCG	54351556	$1,117
INJ FILGRASTIM G-CSF PER 1MCG	54351564	$5,831
INJ BETA INTERFERON PER 1MCG	54351580	$2,736
INJ BETA INTERFERON PER 1MCG	54351598	$2,021
NEOSTIGMINE METHY UP TO 0.5MG	54351804	$62
DENOSUMAB PER 1MG	54351838	$7,290
DEFINITY RT PER 1ML	54352141	$816
POTASSIUM CHL PER 2MEQ	54352372	$18
IVIG NONLYOPHILIZED PER 500MG	54352471	$3,134
MORPHINE SULF PER 10MG INJ	54352786	$263
TESTOSTERON CYP PER 1MG INJ	54352794	$398
TESTOSTERONE ENANTH PER 1MG	54352802	$1,151
PACLITAXEL PER 1MG INJ	54352810	$3,838
PACLITAXEL PER 1MG INJ	54352828	$8,176
MORPHINE SULF PER 10MG INJ	54352836	$438
PACLITAXEL PER 1MG INJ	54352844	$1,966
PACLITAXEL PER 1MG INJ	54352851	$9,694
PROPOFOL INJ PER 10MG	54352869	$357
PROPOFOL INJ PER 10MG	54352877	$432
PROPOFOL INJ PER 10MG	54352885	$86
PACLITAXEL PER 1MG INJ	54352901	$715
PACLITAXEL PER 1MG INJ	54352919	$2,001
PROPOFOL INJ PER 10MG	54352927	$21
PROPOFOL INJ PER 10MG	54352935	$52
PROPOFOL INJ PER 10MG	54352943	$118
PROPOFOL INJ PER 10MG	54352950	$21
PROPOFOL INJ PER 10MG	54352968	$14
PROPOFOL INJ PER 10MG	54352976	$36
PROPOFOL INJ PER 10MG	54352984	$58
PROPOFOL INJ PER 10MG	54352992	$33
PROPOFOL INJ PER 10MG	54353008	$81
PROPOFOL INJ PER 10MG	54353016	$140
PROPOFOL INJ PER 10MG	54353024	$109
PROPOFOL INJ PER 10MG	54353032	$66
PROPOFOL INJ PER 10MG	54353040	$519
ADENOSINE PER 1MG INJ	54353065	$546
ADENOSINE PER 1MG INJ	54353073	$1,112
ADENOSINE PER 1MG INJ	54353198	$183
ADENOSINE PER 1MG INJ	54353206	$661
ADENOSINE PER 1MG INJ	54353214	$50
ADENOSINE PER 1MG INJ	54353222	$846
PROTHROMBIN CMPLEX PER IU	54353230	$10
CYCLOPHOSPHAMIDE ORAL PER 25MG	54353263	$23
CYCLOPHOSPHAMIDE ORAL PER 25MG	54353271	$102
FACTOR VIIA PER 1MCG	54353404	$12
FACTOR VIIA PER 1MCG	54353412	$12
FACTOR VIIA PER 1MCG	54353420	$12
FACTOR IX(PROFILNINE)PER UNIT	54353446	$4
FACTOR IX(BENEFIX)PER UNIT	54353479	$8
ANTITHROMBIN III PER IU	54353495	$22
SUMATRIPTAN 6MG/0.5ML INJ	54353644	$1,294
LORAZEPAM PER 2MG	54353800	$39
CEFTOLOZANE/TAZOBACTAM 50/25MG	54353842	$530
RHO(D) IMMUNE GLOB 300MCG SYR	54353909	$1,790
TBO-FILGRASTIM PER 1MCG	54354089	$1,839
TBO-FILGRASTIM PER 1MCG	54354097	$2,928
ALEMTUZUMAB PER 1MG	54354105	$7,960
PREDNISONE IR ORAL PER 1MG	54354295	$1
PREDNISONE IR ORAL 1MG	54354303	$1
PREDNISONE IR ORAL 1MG	54354311	$1
PREDNISONE IR ORAL 1MG	54354329	$24
PREDNISONE IR ORAL 1MG	54354345	$1
PREDNISONE IR ORAL 1MG	54354352	$81
FILGRASTIM G-CSF BIO PER 1MCG	54354659	$876
NEOSTIGMINE METHY UP TO 0.5MG	54354733	$190
PERAMIVIR PER 1MG	54354824	$1,157
GENTAMICIN SULF UP TO 80MG	54354857	$12
GENTAMICIN SULF UP TO 80MG	54354865	$1
GENTAMICIN UP TO 80MG	54354873	$176
GENTAMICIN UP TO 80MG	54354881	$237
ORITAVANCIN PER 10MG	54355359	$8,289
ISAVUCONAZONIUM PER 1MG	54355391	$1,224
BELATACEPT PER 1MG	54355433	$2,358
ARGATROBAN PER 1MG NONESRD	54355607	$13,008
ARGATROBAN PER 1MG ESRD	54355615	$11,825
METHYLENE BLUE PER 1MG	54355847	$834
IVIG NONLYOPHILIZED PER 500MG	54356076	$3,210
CANGRELOR PER 1MG	54356092	$3,206
CONIVAPTAN PER 1MG	54356100	$504
HEMIN PER 1MG	54356761	$21,461
INSULIN PER 5 UNITS	54356993	$12
DALBAVANCIN PER 5MG	54357009	$3,616
SUCCINYLCHOLIN CHL UP TO 20MG	54357090	$56
CEFAZOLIN PER 500MG	54357116	$16
CEFEPIME HCL PER 500MG	54357124	$37
CEFEPIME HCL PER 500MG	54357132	$69
CEFOXITIN SODIUM PER 1GM	54357157	$34
CEFTAZIDIME PER 500MG	54357165	$32
CEFTRIAXONE PER 250MG	54357173	$16
CEFTRIAXONE PER 250MG	54357181	$26
CEFUROXIME SOD PER 750MG	54357199	$16
MEROPENEM PER 100MG	54357207	$118
CEFAZOLIN PER 500MG	54357280	$23
MEROPENEM PER 100MG	54357314	$34
AMPICILLIN SOD PER 500MG	54357322	$34
AMPICILLIN SOD PER 500MG	54357330	$73
OXACILLIN SODIUM UP TO 250MG	54357348	$53
OXACILLIN SODIUM UP TO 250MG	54357355	$122
DAPTOMYCIN PER 1MG	54357371	$251
ERTAPENEM SOD PER 500MG	54357553	$90
DAPTOMYCIN PER 1MG	54357785	$2,081
FACTOR VIII(WILATE1000)PERUNIT	54357819	$6
C1 ESTERASE BERINERT PER 10U	54357868	$7,158
GLIADEL WAFER 7.7-192.3	54357900	$14,824
IVIG NONLYOPHILIZED PER 500MG	54357975	$1,266
ARGATROBAN PER 1MG NONESRD	54358171	$606
RABIES IG PER 150IU	54358247	$10,893
INJ FILGRASTIM G-CSF PER 1MCG	54358502	$1,109
RITUXIMAB PER 10 MG	54358775	$28,318
RITUXIMAB PER 10 MG	54358783	$6,920
MEROPENEM/VABOR PER 10MG/10MG	54358916	$644
VANCOMYCIN PER 500MG	54358924	$95
EPO ALFA EPBX PER 1000U	54359005	$384
EPO ALFA EPBX PER 100U ESRD	54359047	$384
VANCOMYCIN PER 500MG	54359070	$66
METHYLNAL TREXONE PER 0.1 MG	54359252	$411
COCAINE HCL NASAL PER 1MG	54359294	$518
COCAINE HCL NASAL PER 1MG	54359302	$458
COCAINE HCL NASAL PER 1MG	54359310	$186
MENB-FHBP VACC 2/3 DOSE IM	54359351	$492
EPO ALFA EPBX PER 1000U	54359484	$94
EPO ALFA EPBX PER 100U ESRD	54359492	$94
EPO ALFA EPBX PER 1000U	54359500	$130
EPO ALFA EPBX PER 100U ESRD	54359518	$130
TREPROSTINIL PER 1MG	54359609	$40,095
BCG LIVE INTRAVESICAL PER 1MG	54359815	$2,424
BCG LIVE INTRAVESICAL PER 1MG	54359823	$542
TOCILIZUMAB PER 1MG	54360094	$2,794
ERAVACYCLINE PER 1MG	54360128	$202
EPINEPHRINE PER 0.1MG	54360235	$54
RITUXIMAB-ABBS PER 10MG	54361118	$1,453
RITUXIMAB-ABBS PER 10MG	54361126	$4,582
CAPLACIZUMAB PER 1MG INJ	54361928	$18,189
REMDESIVIR PER 1MG	54363288	$1,354
HEP B VAC 20MCG/0.5ML 1ML	54363460	$316
MENINGOC/DIPH OLIGO 0.5ML VL	54364468	$435
VISAPAQUE 320 PER 1ML	54365671	$349
FIBRINOGEN PER 1MG	54365770	$5
ISOVUE 250 100ML PER 1ML	54366232	$4
ERAVACYCLINE PER 1MG	54366992	$309
PEGFILGRASTIM PER 0.5MG	54367008	$28,498
CEFIDEROCOL PER 10MG	54367156	$583
PNEUMO 20 VALENT VACC 0.5ML	54369269	$653
BORTEZOMIB NOS PER 0.1MG	54370903	$10,428
ERTAPENEM/SWFI 0.5 GM/5 ML	54371042	$62
FLUARIX QUAD 0.5ML SYR	54371729	$68
TENECTEPLASE PER 1MG	54372057	$16,015
CHLOROPROCAINE PER 1MG	54372065	$72
CHLOROPROCAINE PER 1MG	54372073	$355
CHLOROPROCAINE PER 1MG	54372081	$328
CHLOROPROCAINE PER 1MG	54372099	$352
CEFEPIME HCL PER 500MG	54372271	$465
VANCOMYCIN PER 500MG	54372503	$580
CALCIUM GLUC INJ PER 10MG	54373014	$26
CEFEPIME PER 500MG	54373378	$708
SOD FER GLUC COMP PER 12.5MG	54373592	$51
MEROPENEM PER 100MG	54373683	$153
ISOVUE M 200 PER 1ML	54373717	$357
ISOVUE M 200 PER 1ML	54373725	$389
ISOVUE 200 PER 1ML	54373733	$403
ISOVUE 200 200ML PER 1ML	54373741	$2
ISOVUE 250 PER 1ML	54373758	$403
ISOVUE 250 150ML PER 1ML	54373766	$3
ISOVUE 250 200ML PER 1ML	54373774	$2
VISIPAQUE 270 PER 1ML	54373782	$403
VISIPAQUE 270 100ML PER 1ML	54373790	$4
VISIPAQUE 270 150ML PER 1ML	54373808	$3
VISIPAQUE 270 200ML PER 1ML	54373816	$2
IODIXANOL 270 F-K PER 1ML	54373832	$410
IODIXANOL 270 150ML FK PER 1ML	54373840	$3
ISOVUE M 300 PER 1ML	54373857	$98
ISOVUE 300 PER 1ML	54373865	$195
ISOVUE 300 PER 1ML	54373873	$349
ISOVUE 300 PER 1ML	54373881	$460
ISOVUE 300 100ML PER 1ML	54373899	$4
ISOVUE 300 150ML PER 1ML	54373907	$3
ISOVUE 300 200ML PER 1ML	54373915	$2
ISOVUE 370 PER 1ML	54373923	$349
ISOVUE 370 75ML PER 1ML	54373931	$6
ISOVUE 370 100ML PER 1ML	54373949	$4
ISOVUE 370 125ML PER 1ML	54373956	$3
ISOVUE 370 150ML PER 1ML	54373964	$3
ISOVUE 370 200ML PER 1ML	54373972	$2
ISOVUE 370 500ML PER 1ML	54373980	$1
VISIPAQUE 320 PER 1ML	54374004	$406
VISIPAQUE 320 150ML PER 1ML	54374012	$3
VISIPAQUE 320 200ML PER 1ML	54374020	$2
VISIPAQUE 320 500ML PER 1ML	54374038	$1
IODIXANOL 320 F-K PER 1ML	54374046	$349
IODIXANOL 320 F-K PER 1ML	54374053	$406
IODIXANOL320 150ML FK PER 1ML	54374061	$3
IODIXANOL320 200ML FK PER 1ML	54374079	$2
GADIVIST PER 0.1ML	54374095	$147
GADIVIST PER 0.1ML	54374103	$207
GADIVIST PER 0.1ML	54374111	$311
EOVIST PER 1ML	54374129	$310
LUMASON PER 1ML	54374145	$40
CYSTOGRAFIN PER 1ML	54374186	$182
GASTROGRAFIN PER 1ML	54374194	$23
GASTROGRAFIN PER 1ML	54374202	$93
CYSTOGRAFIN PER 1ML	54374517	$182
ALLOPURINOL SODIUM 1MG	54374624	$4,151
ALFENTANIL HYDROCHLORID 500MCG	54374632	$546
ALFENTANIL HYDROCHLORID 500MCG	54374640	$691
AZTREONAM PER 100MG	54374657	$16
AZTREONAM PER 100MG	54374665	$456
AZTREONAM PER 100MG	54374673	$562
AZTREONAM PER 100MG	54374681	$171
AZTREONAM PER 100MG	54374699	$143
AZTREONAM PER 100MG	54374707	$1,083
AZTREONAM PER 100MG	54374715	$782
AZTREONAM PER 100MG	54374731	$430
AZTREONAM PER 100MG	54374749	$300
BUPIVICAINE PER 0.5MG	54374764	$52
BUPIVICAINE PER 0.5MG	54374772	$157
BUPIVICAINE PER 0.5MG	54374806	$157
BUPIVICAINE PER 0.5MG	54374814	$157
BUPIVICAINE PER 0.5MG	54374822	$14
BUPIVICAINE PER 0.5MG	54374830	$21
BUPIVICAINE PER 0.5MG	54374848	$172
BUPIVICAINE PER 0.5MG	54374855	$9
BUPIVICAINE PER 0.5MG	54374889	$34
BUPIVICAINE PER 0.5MG	54374897	$2
BUPIVICAINE PER 0.5MG	54374905	$118
BUPIVICAINE PER 0.5MG	54374913	$128
BUPIVICAINE PER 0.5MG	54374939	$35
BUPIVICAINE PER 0.5MG	54374947	$282
BUPIVICAINE PER 0.5MG	54374954	$228
BUPIVICAINE PER 0.5MG	54374962	$233
BUPIVICAINE PER 0.5MG	54374970	$134
BUPIVICAINE PER 0.5MG	54374988	$136
BUPIVICAINE PER 0.5MG	54374996	$340
BUPIVICAINE PER 0.5MG	54375001	$332
BUPIVICAINE PER 0.5MG	54375019	$239
BUPIVICAINE PER 0.5MG	54375043	$63
BUPIVICAINE PER 0.5MG	54375050	$73
BUPIVICAINE PER 0.5MG	54375068	$340
BUPIVICAINE PER 0.5MG	54375076	$186
BUPIVICAINE PER 0.5MG	54375084	$134
BUPIVICAINE PER 0.5MG	54375118	$488
BUPIVICAINE PER 0.5MG	54375126	$528
BUPIVICAINE PER 0.5MG	54375167	$1,458
BUPIVICAINE PER 0.5MG	54375175	$480
BUPIVICAINE PER 0.5MG	54375191	$858
BUPIVICAINE PER 0.5MG	54375209	$757
METRONIDAZOLE PER 10MG	54375225	$684
METRONIDAZOLE PER 10MG	54375233	$1
METRONIDAZOLE PER 10MG	54375241	$1
METRONIDAZOLE PER 10MG	54375266	$152
METRONIDAZOLE PER 10MG	54375274	$23
METRONIDAZOLE PER 10MG	54375282	$168
NITROGLYCERIN PER 5MG	54375308	$401
NITROGLYCERIN PER 5MG	54375316	$369
NITROGLYCERIN PER 5MG	54375324	$473
NITROGLYCERIN PER 5MG	54375332	$1,452
NITROGLYCERIN PER 5MG	54375357	$98
NITROGLYCERIN PER 5MG	54375399	$507
CLINDAMYCIN PHOSPHATE 300MG	54375415	$110
CLINDAMYCIN PHOSPHATE 300MG	54375431	$66
CLINDAMYCIN PHOSPHATE 300MG	54375456	$172
CLINDAMYCIN PHOSPHATE 300MG	54375464	$177
CLINDAMYCIN PHOSPHATE 300MG	54375472	$101
CLINDAMYCIN PHOSPHATE 300MG	54375480	$95
CLINDAMYCIN PHOSPHATE 300MG	54375514	$916
CLINDAMYCIN PHOSPHATE 300MG	54375522	$199
CLINDAMYCIN PHOSPHATE 300MG	54375548	$150
CLINDAMYCIN PHOSPHATE 300MG	54375589	$277
VASOPRESSIN PER 1 UNIT	54375597	$16
VASOPRESSIN PER 1 UNIT	54375621	$112
VASOPRESSIN PER 1 UNIT	54375639	$709
VASOPRESSIN PER 1 UNIT	54375647	$652
VASOPRESSIN PER 1 UNIT	54375662	$1,178
VASOPRESSIN PER 1 UNIT	54375670	$686
VASOPRESSIN PER 1 UNIT	54375746	$193
VASOPRESSIN PER 1 UNIT	54375753	$2,188
ESMOLOL HYDROCHLORIDE PER 10MG	54375795	$59
ESMOLOL HYDROCHLORIDE PER 10MG	54375829	$206
ESMOLOL HYDROCHLORIDE PER 10MG	54375837	$2,086
ESMOLOL HYDROCHLORIDE PER 10MG	54375845	$1,171
LABETALOL HYDROCHLORIDE 5MG	54375860	$14
LABETALOL HYDROCHLORIDE 5MG	54375878	$24
LABETALOL HYDROCHLORIDE 5MG	54375894	$145
LABETALOL HYDROCHLORIDE 5MG	54375910	$938
LABETALOL HYDROCHLORIDE 5MG	54375936	$484
PHENYLEPHRINE HYDROCHLOR 20MCG	54375944	$16
PHENYLEPHRINE HYDROCHLOR 20MCG	54376009	$71
PHENYLEPHRINE HYDROCHLOR 20MCG	54376017	$15
PHENYLEPHRINE HYDROCHLOR 20MCG	54376058	$105
PHENYLEPHRINE HYDROCHLOR 20MCG	54376074	$146
PHENYLEPHRINE HYDROCHLOR 20MCG	54376090	$70
PHENYLEPHRINE HYDROCHLOR 20MCG	54376124	$58
PHENYLEPHRINE HYDROCHLOR 20MCG	54376140	$101
PHENYLEPHRINE HYDROCHLOR 20MCG	54376157	$173
PHENYLEPHRINE HYDROCHLOR 20MCG	54376199	$52
ISOVUE 300 500ML PER 1ML	54376967	$1
OLANZAPINE INJ PER 0.5MG	54377056	$453
MYCOPHENOLATE MOF PER 10MG	54377072	$282
GLYCOPYROLATE INJ PER 0.1MG	54377569	$110
GLYCOPYROLATE INJ PER 0.1MG	54377577	$31
GLYCOPYROLATE INJ PER 0.1MG	54377601	$62
GLYCOPYROLATE INJ PER 0.1MG	54377619	$79
BUMETAMIDE PER 0.5MG	54377635	$262
BUMETAMIDE PER 0.5MG	54377643	$38
BUMETAMIDE PER 0.5MG	54377650	$91
NICARDIPIN INJ PER 0.1MG	54377692	$815
NICARDIPIN INJ PER 0.1MG	54377718	$143
NICARDIPIN INJ PER 0.1MG	54377742	$182
NICARDIPIN INJ PER 0.1MG	54377767	$1,681
NICARDIPIN INJ PER 0.1MG	54377783	$576
NICARDIPIN INJ PER 0.1MG	54377791	$30
NICARDIPIN INJ PER 0.1MG	54377809	$2,761
FLUPHENAZINE HCL PER 1.25MG	54377825	$208
FLUPHENAZINE HCL PER 1.25MG	54377833	$46
NICARDIPIN INJ PER 0.1MG	54377932	$1,068
GADOBUTROL CONTRAST PER 0.1ML	54378252	$39
GADOBUTROL CONTRAST PER 0.1ML	54378260	$147
GADOBUTROL CONTRAST PER 0.1ML	54378278	$196
GADOBUTROL CONTRAST PER 0.1ML	54378294	$20
GADOBUTROL CONTRAST PER 0.1ML	54378302	$20
GADOBUTROL CONTRAST PER 0.1ML	54378310	$20
GADOBUTROL CONTRAST PER 0.1ML	54378328	$20
BALFAXAR PER IU 20ML	54378435	$4
BALFAXAR PER IU 40ML	54378443	$4
METHYLPREDNISOLONE ACETATE 1MG	54378633	$213
METHYLPREDNISOLONE ACETATE 1MG	54378641	$140
METHYLPREDNISOLONE ACETATE 1MG	54378658	$83
METHYLPREDNISOLONE ACETATE 1MG	54378666	$147
METHPRED SOD SUCCINATE 5MG	54378682	$13
METHPRED SOD SUCCINATE 5MG	54378690	$89
METHPRED SOD SUCCINATE 5MG	54378708	$56
METHPRED SOD SUCCINATE 5MG	54378716	$36
METHPRED SOD SUCCINATE 5MG	54378724	$271
METHPRED SOD SUCCINATE 5MG	54378732	$140
METHPRED SOD SUCCINATE 5MG	54378740	$631
METHPRED SOD SUCCINATE 5MG	54378757	$101
METHPRED SOD SUCCINATE 5MG	54378773	$753
METHPRED SOD SUCCINATE 5MG	54378781	$1,558
HYDROXOCOBALAMIN PER 25MG	54378799	$1,799
CYCLOPHOSPHAMIDE PER 5MG	54378807	$856
CYCLOPHOSPHAMIDE PER 5MG	54378815	$304
CYCLOPHOSPHAMIDE PER 5MG	54378831	$384
METHOTREXATE SOD PER 50MG	54378849	$310
METHOTREXATE SOD PER 50MG	54378856	$760
METHOTREXATE SOD PER 50MG	54378872	$388
METHOTREXATE SOD PER 50MG	54378880	$36
METHOTREXATE SOD PER 50MG	54378898	$701
LEVOTHYROXINE PER 10MCG	54378906	$1,369
LEVOTHYROXINE PER 10MCG	54378914	$538
LEVOTHYROXINE PER 10MCG	54378930	$28
LEVOTHYROXINE PER 10MCG	54378948	$1,261
CEFTRIAXONE PER 250MG	54379151	$5
PANTOPRAZOLE SOD PER 40MG	54379375	$579
PANTOPRAZOLE SOD PER 40MG	54379383	$424
PANTOPRAZOLE SOD PER 40MG	54379391	$444
PANTOPRAZOLE SOD PER 40MG	54379425	$324
PANTOPRAZOLE SOD PER 40MG	54379441	$91
POTASSIUM CHLORIDE PER 2MEQ	54380142	$262
POTASSIUM CHLORIDE PER 2MEQ	54380159	$440
POTASSIUM CHLORIDE PER 2MEQ	54380175	$626
POTASSIUM CHLORIDE PER 2MEQ	54380183	$426
POTASSIUM CHLORIDE PER 2MEQ	54380191	$426
POTASSIUM CHLORIDE PER 2MEQ	54380209	$436
POTASSIUM CHLORIDE PER 2MEQ	54380217	$98
POTASSIUM CHLORIDE PER 2MEQ	54380233	$436
POTASSIUM CHLORIDE PER 2MEQ	54380241	$437
INFLUENZA VAC FLUARIX 0.5ML	54380266	$53
CAPECITABINE ORAL PER 50MG	54380753	$136
LIDOCAINE/EPI PER 1MG	54380761	$182
LIDOCAINE/EPI PER 1MG	54380779	$274
LIDOCAINE/EPI PER 1MG	54380803	$81
LIDOCAINE/EPI PER 1MG	54380829	$28
LIDOCAINE/EPI PER 1MG	54380852	$73
LIDOCAINE/EPI PER 1MG	54380860	$134
LIDOCAINE/EPI PER 1MG	54380878	$176
LIDOCAINE/EPI PER 1MG	54380894	$230
LIDOCAINE/EPI PER 1MG	54380902	$304
LIDOCAINE/EPI PER 1MG	54380910	$28
LIDOCAINE D5W PER 1MG	54380928	$390
LIDOCAINE D5W PER 1MG	54380936	$97
LIDOCAINE D5W PER 1MG	54380944	$189
LIDOCAINE HCL PER 1MG	54380969	$16
LIDOCAINE HCL PER 1MG	54380985	$28
LIDOCAINE HCL PER 1MG	54380993	$16
LIDOCAINE HCL PER 1MG	54381017	$38
LIDOCAINE HCL PER 1MG	54381025	$14
LIDOCAINE HCL PER 1MG	54381041	$8
LIDOCAINE HCL PER 1MG	54381058	$208
LIDOCAINE HCL PER 1MG	54381066	$52
LIDOCAINE HCL PER 1MG	54381074	$27
LIDOCAINE HCL PER 1MG	54381082	$71
LIDOCAINE HCL PER 1MG	54381090	$144
LIDOCAINE HCL PER 1MG	54381116	$236
LIDOCAINE HCL PER 1MG	54381124	$8
LIDOCAINE HCL PER 1MG	54381132	$23
LIDOCAINE HCL PER 1MG	54381140	$116
LIDOCAINE HCL PER 1MG	54381181	$12
LIDOCAINE HCL PER 1MG	54381199	$60
LIDOCAINE HCL PER 1MG	54381207	$69
LIDOCAINE HCL PER 1MG	54381215	$37
LIDOCAINE HCL PER 1MG	54381223	$150
LIDOCAINE HCL PER 1MG	54381264	$184
LIDOCAINE HCL PER 1MG	54381272	$116
LIDOCAINE HCL PER 1MG	54381280	$185
LIDOCAINE HCL PER 1MG	54381298	$255
LIDOCAINE HCL PER 1MG	54381306	$38
LIDOCAINE HCL PER 1MG	54381314	$72
LIDOCAINE HCL PER 1MG	54381322	$78
LIDOCAINE HCL PER 1MG	54381330	$327
HYDROMORPHONE PER 0.1MG	54381355	$7
HYDROMORPHONE PER 0.1MG	54381363	$19
HYDROMORPHONE PER 0.1MG	54381371	$27
HYDROMORPHONE PER 0.1MG	54381389	$28
HYDROMORPHONE PER 0.1MG	54381397	$92
HYDROMORPHONE PER 0.1MG	54381405	$78
HYDROMORPHONE PER 0.1MG	54381413	$184
HYDROMORPHONE PER 0.1MG	54381421	$71
HYDROMORPHONE PER 0.1MG	54381439	$198
HYDROMORPHONE PER 0.1MG	54381447	$160
HYDROMORPHONE PER 0.1MG	54381454	$496
HYDROMORPHONE PER 0.1MG	54381462	$86
HYDROMORPHONE PER 0.1MG	54381470	$91
HYDROMORPHONE PER 0.1MG	54381488	$63
HYDROMORPHONE PER 0.1MG	54381496	$116
HYDROMORPHONE PER 0.1MG	54381504	$71
HYDROMORPHONE PER 0.1MG	54381553	$27
HYDROMORPHONE PER 0.1MG	54381561	$160
HYDROMORPHONE PER 0.1MG	54381579	$62
HYDROMORPHONE PER 0.1MG	54381587	$124
HYDROMORPHONE PER 0.1MG	54381595	$38
HYDROMORPHONE PER 0.1MG	54381603	$105
HYDROMORPHONE PER 0.1MG	54381611	$490
HYDROMORPHONE PER 0.1MG	54381629	$120
HYDROMORPHONE PER 0.1MG	54381652	$285
MRI ORBIT/FACE/NCK W/CON	54600101	$4,976
MRI ORBIT/FACE/NCK W/O CON	54600200	$4,307
MRI ORBIT/FACE/NCK WO/W CON	54600309	$4,162
MRI BRAIN W/O CON	54600507	$4,585
MRI BRAIN W/CON	54600606	$5,510
MRI BRAIN WO/W CON	54600705	$5,786
MRI CHEST W/CON	54600804	$5,212
MRI CHEST W/O CON	54600903	$5,412
MRI CHEST W/WO CON	54601000	$7,207
MRA CHEST W/CON	54601109	$5,101
MRI C-SPINE W/O CON	54601208	$4,770
MRI C-SPINE W/CON	54601307	$6,201
MRI T-SPINE W/O CON	54601406	$3,728
MRI T-SPINE W/CON	54601505	$6,201
MRI L-SPINE W/O CON	54601604	$4,770
MRI L-SPINE W/CON	54601703	$6,201
MRI C-SPINE WO/W CON	54601802	$6,828
MRI T-SPINE WO/W CON	54601901	$6,828
MRI L-SPINE WO/W CON	54602008	$6,828
MRA SPINAL CONTENTS	54602107	$5,407
MRI PELVIS W/CON	54602206	$5,473
MRI PELVIS W/O CON	54602305	$4,770
MRI PELVIS WO/W CON	54602404	$5,743
MRI ABD W/CON	54602602	$4,270
MRI ABD W/O CON	54602701	$4,144
MRI ABD W0/W CON	54602800	$4,528
MRA ABD W/CON	54602909	$5,809
MRI BREAST W/CON BIL	54603501	$2,720
MRI SPECTROSCOPY	54603709	$6,155
MRI BONE MARROW	54603808	$2,681
MRI ORBIT/FACE/NCK W/CON LTD	54603907	$2,681
MRI ORBIT/FACE/NCK W/O CON LTD	54604004	$3,218
MRI ORBIT/FACE/NCK WO/W LTD	54604103	$2,681
MRI BRAIN W/O CON LTD	54604301	$3,268
MRI BRAIN W/CON LTD	54604400	$2,590
MRI BRAIN WO/W CON LTD	54604509	$4,078
MRI CHEST W/O CON LTD	54604707	$2,874
MRI C-SPINE W/O CON LTD	54605001	$3,132
MRI C-SPINE W/CONTRAST LTD	54605100	$2,438
MRI T-SPINE W/O CON LTD	54605209	$2,681
MRI T-SPINE W/CON LTD	54605308	$4,002
MRI L-SPINE W/O CON LTD	54605407	$3,077
MRI L-SPINE W/CON LTD	54605506	$3,696
MRI T-SPINE WO/W CON LTD	54605704	$4,180
MRI L-SPINE WO/W CON LTD	54605803	$4,430
MRI PELVIS WO/W CON LTD	54606009	$2,681
MRI PELVIS W/O CON LTD	54606108	$2,534
MRI PELVIS W/CON LTD	54606207	$2,606
MRI ABD W/CON LTD	54606405	$2,681
MRI ABD W/O CON LTD	54606504	$3,010
MRI ABD W0/W CON LTD	54606603	$2,681
MRI SPECTROSCOPY LTD	54607502	$4,308
MRI TMJ W/O CON LT	54607809	$3,920
MRI TMJ W/WO CON LT	54607908	$3,920
MRI TMJ W/O CONT RT	54608104	$3,920
MRI TMJ W/WO CON RT	54608203	$3,920
MRI EXT UP W/CON LT	54608302	$4,998
MRI EXT UP W/O CON LT	54608401	$5,502
MRI EXT UP WO/W CON LT	54608500	$6,005
MRI EXT UP W/CON RT	54608609	$4,726
MRI EXT UP W/O CON RT	54608708	$5,502
MRI EXT UP WO/W CON RT	54608807	$6,034
MRI EXT UP JOINT W/O CON LT	54608906	$4,828
MRI EXT UP JOINT W/O CON RT	54609003	$4,828
MRI EXT LOW W/CON LT	54609300	$5,998
MRI EXT LOW WO/W CON LT	54609409	$4,585
MRI EXT LOW W/O CON LT	54609508	$5,502
MRI EXT LOW W/CON RT	54609607	$5,998
MRI EXT LOW WO/W CON RT	54609706	$4,585
MRI EXT LOW W/O CON RT	54609805	$5,502
MRI EXT LOW JOINT W/O CON LT	54609904	$5,115
MRI EXT LOW JOINT W/O CON RT	54610001	$5,115
MRI EXT UP WO/W CON BIL	54610506	$12,003
MRI EXT UP JOINT W/O CON BIL	54610605	$9,175
MRI EXT LOW WO/W CON BIL	54610803	$9,175
MRI EXT LOW JOINT W/O CON BIL	54610902	$9,175
MRA HEAD W/O CON	54611108	$3,268
MRA HEAD W/O CON LTD	54611207	$840
MRA HEAD W/CON	54611306	$3,917
MRA HEAD W/WO CON	54611504	$5,312
MRA NECK W/O CON	54611702	$3,163
MRA NECK W/O CON LTD	54611801	$1,470
MRA NECK W/CON	54611900	$3,696
MRA NECK W/CON LTD	54612007	$1,400
MRA NECK WO/W CON	54612106	$4,863
MRI EXT UP W/O CON BIL	54612304	$10,410
MRI EXT UP W/CON BIL	54612403	$9,457
MRI EXT UP JOINT W/ CON BIL	54612502	$9,457
MRI EXT UP JOINT W/ CON LT	54612601	$4,726
MRI EXT UP JOINT W/ CON RT	54612809	$4,998
MRI EXT UP JOINT WO/W CON BIL	54613005	$10,402
MRI EXT UP JOINT WO/W CON LT	54613104	$5,833
MRI EXT UP JNT WO/W CON LT LTD	54613203	$2,731
MRI EXT UP JOINT WO/W CON RT	54613302	$5,833
MRI EXT LOW W/O CON BIL	54613500	$10,410
MRI EXT LOW W/CON BIL	54613609	$9,457
MRI EXT LOW JOINT W/CON BIL	54613708	$9,457
MRI EXT LOW JOINT W/CON LT	54613807	$4,998
MRI EXT LOW JOINT W/CON RT	54614003	$5,198
MRI EXT LOW JOINT WO/W BIL	54614201	$11,672
MRI EXT LOW JOINT WO/W LT	54614300	$5,832
MRI EXT LOW JOINT WO/W RT	54614508	$5,832
MRI GUIDE FOR NDL PLACE S/I	54614706	$2,100
MRI EXT UP JNT W/O CON LT LTD	54671201	$3,049
MRI EXT UP JNT W/O CON RT LTD	54671300	$3,049
MRI EXT LOW W/O CON LT LTD	54671805	$2,534
MRI EXT LOW W/O CON RT LTD	54672100	$2,534
MRI EXT LOW JNT W/O CON LT LTD	54672209	$2,681
MRI EXT LOW JNT W/O CON RT LTD	54672308	$2,634
MRA ABD W/O CON	54672712	$4,973
MRA ABD WO/W CON	54672720	$1,830
MRA CHEST W/O CON	54672753	$4,510
MRA CHEST WO/W CON	54672761	$5,678
MRA EXT LOW W/CON RT	54672860	$5,862
MRA EXT LOW W/CON LT	54672878	$5,862
MRI BREAST W/O CON RT	54672902	$1,087
MRA EXT LOW W/O CON RT	54673041	$5,862
MRA EXT LOW W/O CON LT	54673058	$5,862
MRA PELVIS W/CON LTD	54673165	$5,862
MRA PELVIS W/O CON	54673173	$6,214
GADOTERIDOL PER 1ML	54673314	$303
GADOTERIDOL PER 1ML	54673322	$312
GADOTERIDOL PER 1ML	54673355	$246
GADOTERIDOL PER 1ML	54673363	$260
GADOLINIUM CONT PER 1ML	54673462	$246
GADOLINIUM CONT PER 1ML	54673470	$299
GADOLINIUM CONT PER 1ML	54673488	$303
GADOLINIUM CONT PER 1ML	54673496	$312
GADOLINIUM CONT PER 1ML	54673504	$368
GADOLINIUM CONT PER 1ML	54673512	$330
GADOTERIDOL PER 1ML	54673561	$243
MULTIHANCE CONTRAST PER 1ML	54673827	$398
MULTIHANCE CONTRAST PER 1ML	54673835	$491
MRV HEAD W/CON	54673900	$4,692
MRV HEAD W/O CON	54673918	$3,268
MRCP W/O CON	54673942	$4,144
MRA EXT UP W/WO CON LT	54674007	$4,726
MULTIHANCE CONTRAST PER 1ML	54674098	$283
MULTIHANCE CONTRAST PER 1ML	54674239	$44
MRI IAC W/W/O CONTRAST	54674445	$5,786
MRI IAC W/O CONTRAST	54674452	$4,585
SPIROMETRY W/GRAPHC RECRD	55000095	$539
SPIROMETRY W&WO BRONCH	55000111	$1,364
VITAL CAPACITY TEST	55000137	$286
RESPIRATORY FLOW VOLUME LOOP	55000210	$606
INHAL TX EACH INITIAL	55000269	$302
AEROSOL INHALE PENTAMIDINE	55000277	$1,424
VENTILATOR MGMT INITIAL DAY	55000319	$3,183
VENTILATOR MGMT SUB DAY	55000327	$2,864
CPAP/BIPAP	55000335	$2,839
DEMO EVAL INH TX	55000350	$319
CHEST WALL MANIP INITIAL	55000376	$234
CHEST WALL MANIP SUBSQ	55000384	$210
PULSE OXIMETRY SINGLE	55000459	$392
PULSE OXIMETRY OVERNIGHT	55000475	$387
NASO-TRACH SUCTION	55000509	$294
ARTERIAL BLOOD PUNCTURE	55000517	$159
CARBON MONO QUANT	55000525	$137
BLOOD GAS PH ONLY 300	55000533	$592
BLOOD GASES 300	55000541	$627
BLOOD GASES W/O2 SAT 300	55000558	$942
BLOOD GASES O2 SAT ONLY 300	55000566	$628
GLUCOSE QUANT BY BLOOD DRAW	55000574	$194
ACT CLOT TIME 300	55000590	$374
CPR	55000608	$1,930
CARDIOVERSION EXTERNAL	55000616	$3,434
EKG TRACING	55000624	$638
HFOV VENT FIRST DAY	55000830	$3,183
HFOV VENT SUBSEQUENT	55000848	$3,024
INTUBATION E-TUBE EMERGENCY	55000863	$1,131
EXTREM STDY TCPO2 BIL COMPLETE	55000871	$440
NEWBORN RESUSCITATION 480	55000889	$978
CREATININE 300	55000897	$185
SODIUM 300	55000905	$198
POTASSIUM 300	55000913	$175
IONIZED CALCIUM 300	55000939	$202
BLOOD COUNT HEMATOCRIT	55000954	$141
HEMOGLOBIN 300	55000970	$146
BRONCH DIAGNOSTIC	55000988	$2,035
TRACHEOTOMY TUBE CHANGE	55001267	$484
ART CATH/MNTRG OR TRANS PERC	55001283	$396
NITRIC OXIDE THERAPY INITL DAY	55001556	$3,183
NITRIC OXIDE TX ADDL DAYS	55001564	$19,104
POC BLD GASES W/CALC O2 301	55001614	$645
MDI TREATMENT INITIAL	55001648	$302
SMOKE BEHAVE CHG SYMP 3-10MIN	55001804	$106
SMOKE BEHAVE CHG SYMP >10MIN	55001812	$95
ASSIST AT DELIVERY	55001820	$697
CAPILLARY BLOOD GASES	55001838	$627
SURFACTANT ADMIN ET TUBE	55001861	$113
INHALE TX AEROSOL FIRST HR	55001879	$733
INHALE TX AEROSOL EA ADDL HR	55001887	$692
POC SPUTUM COLLECT	55002018	$192
POC URINE PREG TEST	55002042	$121
SMOKE BEHAVE CHG ASYMP 3-10MIN	55002109	$86
SMOKE BEHAVE CHG ASYMP >10MIN	55002117	$86
POC LACTATE	55002125	$314
6 MINUTE WALK PERFRM TEST	55002133	$201
CHEST TREATMNT W/FLUTTER DEV	55002141	$319
POC PLAVIX (P2Y12) ASSAY TRAP	55002166	$170
PLETHYS LUNG VOL AIRWAY RESIST	55002208	$774
PFT BY GAS	55002216	$788
AIRWY RESIST IMPLS OSCILLOMTRY	55002224	$223
CO MEMBRANE DIFUSE CAPACITY	55002232	$788
MECHANIC CHEST WALL OSCIL/SESS	55002398	$294
HBO TREATMENT PER 30 MIN	55506208	$1,061
HOT/COLD PACK	56000052	$76
PT RE-EVALUATION	56003551	$200
PT WHIRLPOOL 420	56003858	$180
PT ELEC STIM/15MIN ATTEND 420	56004153	$136
PT IONTOPHORESIS 15MIN 420	56004203	$180
PT ULTRASOUND 15MIN 420	56004302	$144
PT THERAPEUTIC EXER 15MIN 420	56004559	$165
PT NEUROMUS RE-ED 15MIN 420	56004609	$153
PT GAIT TRAINING 15MIN 420	56004708	$144
PT MASSAGE THERAPY 15MIN 420	56004757	$140
PT TILT TABLE 15MIN 420	56004807	$58
PT MANUAL THERAPY 15MIN 420	56004906	$209
PT GROUP THERAPEUTIC 420	56004955	$140
PT ORTHROT MGT/TRAIN 15MIN	56005002	$244
PT THERAPEUTIC ACT 15MIN 420	56005101	$171
PT W/C TRAINING 15MIN 420	56005259	$136
PT CHECK ORTHO/PROS 15MIN	56005408	$167
PT N/SELCTV DEBRIDEMENT 420	56005853	$406
PT SENS INTEG TECH 15MIN 420	56005861	$131