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Jerold Phelps Community Hospital Standard Charges Listing – March 2022
Service | Procedure Code | Charge |
---|---|---|
INVESTIGATION OF TRANSFSION REACTION /SO | BB | 339.10 |
RH FACTOR | BB | 121.65 |
ABO BLOOD TYPE | BB | 79.10 |
ANTIBODY DETECTION /SO | BB | 25.60 |
ANTIGEN SCREENING OF PATIENT BLOOD, ABO | BB | 98.00 |
ANTIGEN SCREENING OF DONOR BLOOD, RH (D) | BB | 98.00 |
RED BLOOD CELLS LEUKOREDUCED | BB | 567.30 |
PLATELETS PHERESIS | BB | 1,371.30 |
Rbc leukoreduced irradiated | BB | 878.70 |
NO CHARGE | CL | 0.00 |
NO SHOW CHARGE | CL | 44.10 |
OCCULT BLOOD FECES | CL | 86.75 |
EX BEN SCP/NK/HD/FT <.5CM | CL | 239.70 |
GLUCOSE BY REAGENT STRIP | CL | 27.40 |
HEMOGLOBIN | CL | 42.20 |
SVN INITIAL TREATMENT | CL | 246.70 |
SVN SUBSEQUENT (EA) | CL | 60.80 |
PREGNANCY TEST URINE | CL | 103.75 |
UA DIP WO/MICRO | CL | 29.80 |
AVIATION PHYSICAL CASH ON DOS | CL | 100.00 |
DMV PHYSICAL CASH ON DOS | CL | 150.00 |
INSURANCE EXAM | CL | 273.85 |
HOME VISIT NEW PT LOW | CL | 171.05 |
HOME VISIT NEW PT MODERATE | CL | 246.70 |
HOME VISIT NEW PT MOD-HI | CL | 405.10 |
HOME VISIT NEW PT HIGH | CL | 566.20 |
HOME VISIT NEW PT HI UNSTABLE | CL | 687.55 |
HOME VISIT EST PT LIMITED | CL | 136.30 |
HOME VISIT EST PT LOW-MOD | CL | 208.20 |
HOME VISIT EST PT MOD-HI | CL | 319.60 |
VISITING NURSE EST PT UNSTABLE | CL | 443.65 |
INJ THER/PRO/DX INTRA-ART | CL | 96.70 |
IMMUN ADMIN 1ST EA/COMBO | CL | 122.75 |
IMMUN ADMIN ADDL EA/COMBO | CL | 43.50 |
IMMUN ADMIN INFLUENZA | CL | 104.10 |
IMMUN ADMIN VACCINE FOR CHILDREN | CL | 28.70 |
PRO SVC ALLERGN TX WO EXT | CL | 44.75 |
PRO SVC ALLERGEN > 2 | CL | 44.75 |
INJ SC/SQ/IM FLU VAC SPLIT 3+ YRS | CL | 68.20 |
INJECTION-SC/SQ OR IM | CL | 68.20 |
TELEHEALTH FACILITY FEE | CL | 55.15 |
VACCINE SCHOOL SPECIAL | CL | 31.10 |
RAPID STREP SCREEN | CL | 182.20 |
SKIN TEST TUBERCULOSIS | CL | 102.00 |
SPORTS PHYS/CASH DOS ONLY | CL | 21.00 |
REMOVE FB FROM EYE PRO FEE | CL | 130.10 |
RESPIRATORY FIT TEST NURSE ONLY | CL | 83.80 |
DMV 2ND VISIT CASH ON DOS | CLMD | 52.50 |
Medicare RHC AIR | CLMD | 0.00 |
ARTHRO ASP/INJ INTRMD JNT | CLMD | 182.20 |
ARTHRO ASP/INJ MAJ JNT/BR | CLMD | 215.60 |
ARTHROCENT ASP/INJ SM JNT | CLMD | 176.00 |
ASPIRATE/INJ GANGLION CYST | CLMD | 162.00 |
AVULS NAILPLT PART/COMP S | CLMD | 194.50 |
EVAC SUBUNGUAL HEMATOMA | CLMD | 89.40 |
APPL CAST SHRT ARM EBW/FN | CLMD | 255.30 |
COLPO W/BX CERVIX/ECC | CLMD | 742.15 |
COLPOSCOPY/VAGINOSCOPY | CLMD | 519.10 |
DEBRIDEMNT NAIL 6 OR MORE | CLMD | 132.10 |
DEBRIDE SKIN | CLMD | 169.75 |
DEB MUSC/FASCIA 20SQ CM< | CLMD | 629.00 |
DEBRIDE SKIN/SUB TISSUE | CLMD | 230.60 |
DEBRIDEMENT OF NAIL 1 - 5 | CLMD | 53.40 |
DEST LESION ANY METH 1ST | CLMD | 143.90 |
DEST LESION 2-14 EACH | CLMD | 33.50 |
PROLONGED OFFICE/OP E/M EA 15M | CLMD | 79.30 |
DEST WART ANY METH 1-14 | CLMD | 161.20 |
E/M OFFICE EST HI MDM 40-54 MIN | CLMD | 346.90 |
E/M OFFICE EST MOD MDM 30-39 MIN | CLMD | 216.90 |
E/M OFFICE EST LOW MDM 20-29 MIN | CLMD | 149.95 |
E/M OFFICE EST STRT FWD 10-19 MIN | CLMD | 116.50 |
E/M EST PT MINIMAL PROB | CLMD | 81.90 |
E/M OFFICE NEW HI MDM 60-74 MIN | CLMD | 535.20 |
E/M OFFICE NEW MOD MDM 45-59 MIN | CLMD | 396.45 |
E/M OFFICE NEW LOW MDM 30-44 MIN | CLMD | 277.50 |
E/M OFFICE NEW STRT FWD 15-29 MIN | CLMD | 213.20 |
MDCR VIRTUAL VISIT | CLMD | 244.70 |
REP WND FCE/MUC 2.5< | CLMD | 431.15 |
ENDOMETRIAL BIOPSY | CLMD | 490.70 |
EST PT PRE EXAM/UNDR 1 YR | CLMD | 174.70 |
EST PT PREV EXAM/ 1-4 YRS | CLMD | 216.90 |
EST PT PREV EXAM/ 5-11 YR | CLMD | 228.00 |
EST PT PREV EXAM/12-17 YR | CLMD | 246.70 |
EST PT PREV EXAM/18-39 YR | CLMD | 332.00 |
EST PT PREV EXAM/40-64 YR | CLMD | 376.65 |
EST PT PREV EXAM/65 & OVR | CLMD | 412.70 |
SKIN FULL GRFT FACE/GEN/HF PRO FEE | CLMD | 2,284.40 |
EX BEN SCP/NK/HD/FT0.6-1. | CLMD | 397.70 |
EX BN LS FCE/MUC MEM <0.5 | CLMD | 370.45 |
EX BN LS/TRK/ARM/LEG .6-1 | CLMD | 379.20 |
EX BN LS/TRK/ARM/LEG >4.0 | CLMD | 654.20 |
EX BN LS/TRK/ARM/LG 1.1-2 | CLMD | 385.25 |
EX BN LS/TRK/ARM/LG 2.1-3 | CLMD | 494.45 |
EX BN LS/TRK/ARM/LG 3.1-4 | CLMD | 546.30 |
EX ML LES/FACE 1.1-2CM | CLMD | 664.00 |
EX ML TRK/ARM/LG 1.1-2C | CLMD | 526.50 |
ADJNT TIS TRANSFR/REARRANGE TRUNK 10.1-3 | CLMD | 1,931.00 |
EX BN LS/TRK/ARM/LG <0.5C | CLMD | 272.60 |
EX NAL/MTRX PRT/CMPL PERM | CLMD | 413.80 |
EXC F/E/E/N/L MAL+MRG 0.5CM< | CLMD | 524.00 |
EXC F/E/E/N/L MAL+MRG 0.6-1 | CLMD | 577.00 |
EXC MLG LES FACE 2.1-3CM | CLMD | 817.60 |
I&D ABSCESS;CMPLCTD/MULTP | CLMD | 491.70 |
I&D ABSCESS SIMPLE/SINGLE | CLMD | 272.60 |
INC/REM FB SUBCUT TISSUE | CLMD | 379.20 |
INJ TRIG PNT 3+ MUS GRP | CLMD | 276.40 |
INJ TEND SHTH/LIG/APNEURO | CLMD | 276.40 |
Single tendon origin/insertion | CLMD | 276.60 |
INJ TRIG PNT 1 OR 2 MUSCL | CLMD | 276.40 |
IUD INSERTION | CLMD | 209.50 |
TELEHEALTH MDCR 99202 | CLMD | 212.10 |
TELEHEALTH MDCR 99203 | CLMD | 277.50 |
TELEHEALTH MDCR 99204 | CLMD | 396.45 |
TELEHEALTH MDCR 99205 | CLMD | 535.20 |
TELEHEALTH MDCR 99212 | CLMD | 116.50 |
TELEHEALTH MDCR 99213 | CLMD | 149.95 |
TELEHEALTH MDCR 99214 | CLMD | 216.90 |
TELEHEALTH MDCR 99215 | CLMD | 346.90 |
INSERT DRUG IMPLANT DEVICE | CLMD | 280.40 |
REMOVE INSERT DRUG IMPLANT | CLMD | 372.00 |
REMOVE DRUG IMPLANT DEVICE | CLMD | 191.00 |
INCS THROMBOSED HEMOR EXT | CLMD | 518.60 |
ANOSCOPY DIAG | CLMD | 246.70 |
NP INT PREVENT EXAM 1-4YR | CLMD | 259.00 |
NP INT PREV EXAM 12-17 YR | CLMD | 348.15 |
NP INT PREV EXAM 18-39 YR | CLMD | 400.30 |
NP INT PREV EXAM 40-64 YR | CLMD | 453.50 |
NP INT PREV EXAM 5-11 YRS | CLMD | 317.20 |
NP INT PREV EXAM 65 & OVR | CLMD | 442.30 |
NP INT PREV EXAM/UNDR 1 YR | CLMD | 323.10 |
CTL HEMORRAGE NASAL ANTER | CLMD | 284.90 |
PARING/CUT BEN LESION SGL | CLMD | 66.95 |
PHLEBOTOMY THERAPEUTIC | CLMD | 95.45 |
REM FB EAR CABAK WO/ANEST | CLMD | 293.30 |
REMOV IMPACTED EAR WAX IRRIGATION UNILAT | CLMD | 41.10 |
REM IMPAC CERUM/UNL/BILAT | CLMD | 135.15 |
REM SKN TGS MULT FIBR 15< | CLMD | 176.00 |
DSTRJ LESION PENIS SIMPLE CRYOSURGERY | CLMD | 365.00 |
REP SC/TRK/AX/NK/EX <2.5 | CLMD | 429.90 |
DESTRUCTN MALIGNANT LESION T/A/L 0.5 CM< | CLMD | 252.00 |
REP WND FCE/MU 2.6-5.0 CM | CLMD | 480.70 |
SHAVE SKIN LESION 0.6-1.0 CM TRNK/ARM/LG | CLMD | 317.50 |
SHV EP/DM FC/MUC MEM <0.5 | CLMD | 166.10 |
SHV EP/DM LS/TR/AR/LG<0.5 | CLMD | 185.20 |
SHAVE SKIN LESION 0.6-1.0 CM | CLMD | 321.00 |
SKIN SUB GRAFT TRNK/ARM/LEG PRO FEE | CLMD | 214.00 |
TYMPANOMETRY | CLMD | 64.50 |
WEDGE EXCISION SKN/NAL FO | CLMD | 177.35 |
ADV CARE PLAN FAMILY/PT, ADDL 30M | CLMD | 203.70 |
ADV CARE PLAN FAMILY/PT, FIRST 30M | CLMD | 233.10 |
TRIM NONDYSTROPHIC NAILS | CLMD | 60.80 |
REM IUD | CLMD | 429.90 |
CATH INSRT FOLEY SIMPLE | CLMD | 185.90 |
TANGNTL BX SKIN SINGLE LES | CLMD | 277.85 |
TANGNTL BX SKIN EA ADDL | CLMD | 149.95 |
PUNCH BX SKIN SINGLE LES | CLMD | 349.55 |
PUNCH BX SKIN EA ADDL | CLMD | 172.00 |
INCISIONAL BX SKIN SINGLE LES | CLMD | 423.40 |
INCISIONAL BX SKIN EA ADDL | CLMD | 202.90 |
DEBR SKIN | CLMD | 111.50 |
REM SHORT ARM/LEG CAST | CLMD | 198.25 |
FOLLOW-UP GLOBAL SVC | CLMD | 0.00 |
TELEHEALTH PHP 99202 | CLMD | 212.10 |
TELEHEALTH PHP 99203 | CLMD | 277.50 |
TELEHEALTH PHP 99204 | CLMD | 396.45 |
TELEHEALTH PHP 99205 | CLMD | 535.20 |
TELEHEALTH PHP 99212 | CLMD | 116.50 |
TELEHEALTH PHP 99213 | CLMD | 149.95 |
TELEHEALTH PHP 99214 | CLMD | 216.90 |
TELEHEALTH PHP 99215 | CLMD | 346.90 |
AUDIOLGC FNCTN SCRNG AIR | CLMD | 42.20 |
WELCOME TO MEDICARE EXAM | CLMD | 509.30 |
MCARE 1ST YEARLY WELLNESS | CLMD | 412.70 |
MCARE EA AD YEARLY EXAM | CLMD | 435.30 |
DRAIN EXTERNAL EAR LESION | CLMD | 590.90 |
PUNCT/ASP ABCS/HEM/BUL/CY | CLMD | 305.70 |
SNF E/M INITIAL LOW CMPLX | CLMD | 153.60 |
SNF E/M INITIAL MOD CMPLX | CLMD | 215.60 |
SNF E/M INITIAL HI CMPLX | CLMD | 261.50 |
SNF SUBSEQUENT HI CMPLX | CLMD | 230.60 |
SNF E/M H&E SUBQ LOW | CLMD | 85.60 |
SNF E/M H&E SUBQ MODER | CLMD | 116.50 |
SNF E/M H&E SUBQ DETAILED | CLMD | 169.75 |
SNF DISCHARG MGMNT <30MIN | CLMD | 159.90 |
SNF DISCHARG MGMNT >30MIN | CLMD | 199.50 |
SNF ANNUAL ASSESSMENT | CLMD | 169.75 |
PRE-EMPLOYMENT PHYSICAL CONTRACTED | CLMD | 157.50 |
EMPLOYEE PHYSICAL | CLMD | 149.95 |
CT HEAD W/O CONTRAST | CT | 893.05 |
CT HEAD W/CONTRAST | CT | 1,984.50 |
CT HEAD W W/O CONTRAST | CT | 1,984.50 |
CT EYE/EAR/FOSSA W/O CONTRAST | CT | 893.05 |
CT EYE/EAR/FOSSA W/CONTRAST | CT | 1,984.50 |
CT EYE/EAR/FOSSA W W/O CONTRAST | CT | 1,984.50 |
CT MAXILLOFACIAL W/O CONTRAST | CT | 893.05 |
CT MAXILLOFACIAL W/CONTRAST | CT | 1,984.50 |
CT MAXILLOFACIAL W W/O CONT | CT | 1,984.50 |
CT SOFT TISS NECK W/O CONTRAST | CT | 893.05 |
CT SOFT TISS NECK W/CONTRAST | CT | 1,984.50 |
CT SOFT TISS NECK W W/O CONTRAST | CT | 1,984.50 |
CT ANGIO HEAD | CT | 1,984.50 |
CT ANGIO NECK | CT | 1,984.50 |
CT THORAX W/CONTRAST | CT | 1,984.50 |
CT THORAX W W/O CONTRAST | CT | 1,984.50 |
CT ANGIO CHEST | CT | 1,984.50 |
CT C-SPINE W/O CONTRAST | CT | 893.05 |
CT C-SPINE W/CONTRAST | CT | 2,072.70 |
CT C-SPINE W W/O CONTRAST | CT | 3,175.20 |
CT T-SPINE W/O CONTRAST | CT | 893.05 |
CT T-SPINE W/CONTRAST | CT | 1,984.50 |
CT T-SPINE W W/O CONTRAST | CT | 1,984.50 |
CT L-SPINE W/O CONTRAST | CT | 893.05 |
CT L-SPINE W/CONTRAST | CT | 1,984.50 |
CT L-SPINE W W/O CONTRAST | CT | 3,175.20 |
CT PELVIS W/O CONTRAST | CT | 893.05 |
CT PELVIS W/CONTRAST | CT | 1,984.50 |
CT PELVIS W W/O CONTRAST | CT | 1,984.50 |
CT UPPER EXT W/O CONTRAST | CT | 893.05 |
CT UPPER EXT W/CONTRAST | CT | 1,984.50 |
CT UPPER EXT W W/O CONTRAST | CT | 1,984.50 |
CT LOWER EXT W/O CONTRAST | CT | 893.05 |
CT LOWER EXTREM W/CONT | CT | 1,984.50 |
CT LOWER EXT W W/O CONTRAST | CT | 1,984.50 |
CT ABDOMEN W/O CONTRAST | CT | 893.05 |
CT ABDOMEN W/CONTRAST | CT | 1,984.50 |
CT ABDOMEN W W/O CONTRAST | CT | 1,984.50 |
CT ANGIO ABD/PELV W W/O CONTRAST | CT | 1,984.50 |
CT ABD PELV W/O CONTRAST | CT | 1,984.50 |
CT ABD PELV W/CONTRAST | CT | 1,984.50 |
CT ABD &/OR PELV W W/O CONTRAST | CT | 3,175.20 |
CT HEART W/O CONTRAST W/CA TEST | CT | 496.15 |
CT ANGIO ABD ARTERIES | CT | 1,984.50 |
CT HEAD/NECK 3D ADDL | CT | 0.00 |
CT BODY 3D ADDL | CT | 0.00 |
CT LTD F/U HEAD/NECK | CT | 496.15 |
CT LTD F/U OTHR THAN HEAD/NECK | CT | 496.15 |
CT BONE DENSITY PERIPHERAL | CT | 496.15 |
CT LOW DOSE CANCER SCREEN | CT | 496.15 |
CT THORAX W/O CONTRAST | CT | 893.05 |
CT SINUS W W/O CONTRAST | CT | 1,984.50 |
CT SINUS W/CONTRAST | CT | 1,984.50 |
CT SINUS W/O CONTRAST | CT | 893.05 |
CT GUIDE NEEDLE PLACE | CT | 0.00 |
CT HEAD W/O CONTRAST PRO FEE | CTMD | 307.15 |
CT HEAD W/CONTRAST PRO FEE | CTMD | 431.60 |
CT HEAD W W/O CONTRAST PRO FEE | CTMD | 511.90 |
CT EYE/EAR/FOSSA W/O CONTRAST PRO FEE | CTMD | 619.50 |
CT EYE/EAR/FOSSA W/CONTRAST PRO FEE | CTMD | 732.40 |
CT EYE/EAR/FOSSA W W/O CONTRAST PRO FEE | CTMD | 798.00 |
CT MAXILLOFACIAL W/O CONTRAST PRO FEE | CTMD | 370.15 |
CT MAXILLOFACIAL W/CONTRAST PRO FEE | CTMD | 446.30 |
CT MAXILLOFACIAL W W/O CONTRAST PRO FEE | CTMD | 543.40 |
CT SOFT TISS NECK W/O CONTRAST PRO FEE | CTMD | 514.50 |
CT SOFT TISS NECK W/CONTRAST PRO FEE | CTMD | 627.40 |
CT SOFT TISS NECK W W/O CONTRAST PRO FEE | CTMD | 737.65 |
CT ANGIO HEAD PRO FEE | CTMD | 779.65 |
CT ANGIO NECK PRO FEE | CTMD | 777.00 |
CT THORAX W/CONTRAST PRO FEE | CTMD | 611.65 |
CT THORAX W W/O CONTRAST PRO FEE | CTMD | 732.40 |
CT ANGIO CHEST PRO FEE | CTMD | 798.00 |
CT C-SPINE W/O CONTRAST PRO FEE | CTMD | 490.90 |
CT C-SPINE W/CONTRAST PRO FEE | CTMD | 606.50 |
CT C-SPINE W W/O CONTRAST PRO FEE | CTMD | 716.65 |
CT T-SPINE W/O CONTRAST PRO FEE | CTMD | 480.40 |
CT T-SPINE W/CONTRAST PRO FEE | CTMD | 611.65 |
CT T-SPINE W W/O CONTRAST PRO FEE | CTMD | 721.90 |
CT L-SPINE W/O CONTRAST PRO FEE | CTMD | 477.80 |
CT L-SPINE W/CONTRAST PRO FEE | CTMD | 606.40 |
CT L-SPINE W W/O CONTRAST PRO FEE | CTMD | 716.65 |
CT PELVIS W/O CONTRAST PRO FEE | CTMD | 388.50 |
CT PELVIS W/CONTRAST PRO FEE | CTMD | 601.15 |
CT PELVIS W W/O CONTRAST PRO FEE | CTMD | 690.40 |
CT UPPER EXT W/O CONTRAST PRO FEE | CTMD | 477.80 |
CT UPPER EXT W/CONTRAST PRO FEE | CTMD | 590.65 |
CT UPPER EXT W W/O CONTRAST PRO FEE | CTMD | 737.65 |
CT LOWER EXT W/O CONTRAST PRO FEE | CTMD | 480.90 |
CT LOWER EXT W/CONTRAST PRO FEE | CTMD | 601.15 |
CT LOWER EXT W W/O CONTRAST PRO FEE | CTMD | 727.15 |
CT ABDOMEN W/O CONTRAST PRO FEE | CTMD | 399.00 |
CT ABDOMEN W/CONTRAST PRO FEE | CTMD | 614.30 |
CT ABDOMEN W W/O CONTRAST PRO FEE | CTMD | 698.30 |
CT ANGIO ABD/PELV W W/O CONTRAST PRO FEE | CTMD | 1,034.30 |
CT ABD PELV W/O CONTRAST PRO FEE | CTMD | 535.50 |
CT ABD PELV W/CONTRAST PRO FEE | CTMD | 826.90 |
CT ABD &/OR PELV W W/O CONTRAST PRO FEE | CTMD | 939.80 |
CT HEART W/O CONTRAST W/CA TEST PRO FEE | CTMD | 267.80 |
CT ANGIO ABD ARTERIES PRO FEE | CTMD | 1,015.90 |
CT HEAD/NECK 3D ADDL PRO FEE | CTMD | 63.00 |
CT LTD F/U HEAD/NECK PRO FEE | CTMD | 388.50 |
CT LTD F/U OTHR THAN HEAD/NECK PRO FEE | CTMD | 388.50 |
CT GUIDE NEEDLE PLACE PRO FEE | CTMD | 330.80 |
CT BONE DENSITY PERIPHERAL PRO FEE | CTMD | 301.90 |
CT LOW DOSE CANCER SCREEN PRO FEE | CTMD | 672.00 |
CT THORAX W/O CONTRAST PRO FEE | CTMD | 480.40 |
CT SINUS W W/O CONTRAST PRO FEE | CTMD | 543.40 |
CT SINUS W/CONTRAST PRO FEE | CTMD | 446.30 |
CT SINUS W/O CONTRAST PRO FEE | CTMD | 370.15 |
ECG-12 LEADS TRACING ONLY | ED | 723.50 |
ECG-1-3 LEAD TRACING ONLY | ED | 101.65 |
PEAK FLOW MEASURE | ED | 119.00 |
POS AIRWAY PRESSURE CPAP | ED | 512.70 |
SVN INITIAL TREATMENT | ED | 360.60 |
VENIPUNCTURE, ED | ED | 42.20 |
IMMUN ADMIN ADDL EA COMBO | ED | 66.95 |
IV PLC OF NDL W/CAP ONLY | ED | 218.15 |
INFUSION HYDRATION > 1 HR | ED | 719.70 |
INFUSION HYDRATION < 1 HR | ED | 1,397.35 |
IV PUSH ADDL-SAME DRUG | ED | 214.50 |
GLUCOSE BY REAGENT STRIP | ED | 27.40 |
IV PUSH ADDL-NEW DRUG | ED | 233.00 |
IV PUSH SINGLE-INIT DRUG | ED | 300.00 |
INJ THER-PROP-DX SQ-IM | ED | 241.60 |
INFUSION CONCURRENT LINE >1 HR | ED | 262.35 |
INFUSION 2ND LINE <1 HR | ED | 151.20 |
INFUSION THER/DX <1 HOUR | ED | 645.45 |
INFUSION THER/DX 1-8HR EA | ED | 474.50 |
I&D PILONIDAL CYST SIMPLE | ED | 752.20 |
I&D ABSCESS SIMPLE/SINGLE | ED | 403.95 |
I&D ABSCESS/CYST COMPLEX | ED | 506.75 |
DRIANAGE OF GLAND ABCESS | ED | 433.55 |
INC/REM FB SUBCUT SIMPLE | ED | 525.20 |
INC/REM FB SUBCUT COMPLEX | ED | 1,901.45 |
NG TUBE INSERTION | ED | 1,236.30 |
CD TRT FX PHLNG SHFT W/M | ED | 1,076.50 |
RPLC GASTRO TUBE NO REV/GUID | ED | 638.40 |
REPAIR LAC TONGUE FLOOR MOUTH >2.6CM | ED | 1,993.45 |
REP LAC SCP/NK/TNK <2.5CM | ED | 914.25 |
REP LAC SCP/NK/TNK2.5-7.5 | ED | 1,013.40 |
REPAIR FINGER TENDON | ED | 2,972.80 |
REP LAC SCP/NK 7.6-12.5CM | ED | 551.40 |
REPAIR TONGUE LACERATION <2.5CM | ED | 264.00 |
REP LAC SIMPLE 12.6-20 CM | ED | 929.05 |
REP LAC FAC/MUC <2.5CM | ED | 654.20 |
REPAIR SIMPLE F/E/E/N/L 2.6-5CM | ED | 371.70 |
REP LAC FAC/MUC 5.1-7.5CM | ED | 361.85 |
REP LAC FAC/MUC 7.6-12.5C | ED | 551.40 |
REMOVAL OF NAIL BED | ED | 706.00 |
LAY CLS TK/EXT <2.5 CM | ED | 649.10 |
LAY CLS TK/EXT 2.6-7.5 CM | ED | 649.10 |
REPR INTERM SCALP/AX/TRNK/EXT | ED | 1,330.80 |
LAY CLS TK/EXT 7.6-12.5CM | ED | 648.00 |
LAY CLS TK/EXT 12.6-20 CM | ED | 606.60 |
LAY CLS NK/HND/FT<2.5CM | ED | 551.40 |
LAY CLS FC/MUC5.1-7.5 CM | ED | 665.80 |
LAY CLS NK/HND/FT2.6-7.5CM | ED | 636.40 |
INJ TEND SHTH/LIG/APNEURO | ED | 627.50 |
LAY CLS FC/MUC<2.5CM | ED | 551.40 |
LAY CLS FC/MUC2.6-5.0CM | ED | 551.40 |
INJ TRIG PNT 1 OR 2 MUSCL | ED | 693.75 |
REMOVE FOREARM FB | ED | 3,349.40 |
CD TRT DSL SHLDR W/M WO/A | ED | 1,076.50 |
DRAINAGE OF ARM BURSA | ED | 3,715.45 |
REM FB INTRANASAL | ED | 289.55 |
CONTROL OF NOSEBLEED | ED | 284.90 |
CONTROL OF NOSEBLEED | ED | 400.30 |
INTUBATE ET EMERGENT | ED | 2,318.95 |
DX LARYNGOSCOPY EXCL NB | ED | 2,800.40 |
LAV PERITON/ABD PARA INTL | ED | 2,098.10 |
ANOSCOPY W/REMVL FOREIGN BODY | ED | 1,736.50 |
SPINAL PUNCT LUMBAR DX | ED | 1,363.70 |
REM FB CORNEAL WO/SLITLMP | ED | 592.20 |
INCS THROMBOSED HEMOR EXT | ED | 596.30 |
REMOV FB EYE CORNEA W SLIT LAMP | ED | 763.05 |
ABD PARACENTESIS W/IMAGING | ED | 1,748.30 |
REM FB EAR CABAK WO/ANEST | ED | 233.85 |
REM IMPACT CERUMEN UN/BIL | ED | 124.00 |
EXC BEN LES INC MAR HEAD/FT/GENIT <.5CM | ED | 926.10 |
EXC TR EXT B9+MARG 1.1-2 CM | ED | 1,188.50 |
REMOVE IMPACTED EAR WAX UNI | ED | 169.75 |
EXC B9 LESION MRGN S,N,H,F,G 2.1-3 PR F | ED | 3,033.05 |
REMOVAL OF SKIN TAGS ED | 340.40 | |
LARYNGOSCOPY INDIRECT DIAGNOSTIC SPX | ED | 410.00 |
AVUL NAIL PRTL/COMPLT SING | ED | 341.60 |
DRESS/DEBRID PT-THICK BURN LG | ED | 684.70 |
DRS/DBD BURN W/O ANS SML | ED | 364.25 |
CD TRT DSL ELBOW WO/A | ED | 515.00 |
DRESS/DEBRID BURN W/O ANESTH | ED | 254.00 |
INITIAL TX 1ST DEGREE BURN LOCAL TX | ED | 459.00 |
DESTRUCTION B9 LESION UP TO 14 | ED | 443.20 |
AMPUTATION OF FINGER/THUMB | ED | 2,233.20 |
DEBR ECZEM/INFCT SKN 10% | ED | 507.90 |
CD TRT FX DIS RAD/EP WO/M | ED | 605.90 |
CLSD TX TIBIAL FX W/MANIP | ED | 459.10 |
I&D HEMAT/SEROMA/FLD | ED | 1,619.00 |
CD TRT FX RADIUS/ULNA | ED | 557.45 |
CLSD TX FX ULNAR STYLOID | ED | 578.40 |
OPN TRT FX DIST PHLNG EA | ED | 3,695.10 |
TREAT LOWER LEG FRACTURE | ED | 3,173.20 |
TREAT WRIST BONE FX | ED | 2,683.50 |
TREAT WRIST BONE FX | ED | 2,683.50 |
CLOSED TX ANKLE FX W/MANIP | ED | 2,683.50 |
CLOSED TX ANKLE DISLOC W/O ANES | ED | 592.30 |
TX CLOSED HEEL FX | ED | 592.30 |
EXCISION OLECRANON BURSA | ED | 7,229.15 |
CLSD TX RESET DISLOCATED JAW | ED | 620.80 |
CENTRAL LINE PLACEMENT>5 | ED | 2,769.80 |
INS NON-TUNNEL CATH VENOUS <5Y | ED | 3,322.25 |
CLOSED TX METATARSAL FX W/MANI | ED | 515.00 |
CD TRT FX TRIMALLEOAR | ED | 459.10 |
CLOSED TX BIMALLEOLAR ANKLE FX W/MANJ | ED | 3,480.00 |
I&D ABCESS PERITONSILLAR | ED | 464.65 |
REM OF FOREIGN BODY FR PHARYNX | ED | 909.60 |
THROAT SURGERY PROCEDURE UNSPEC | ED | 865.50 |
DRAINAGE ABSCESS MOUTH ROOF LESION | ED | 535.50 |
REMOVAL OF FOOT FOREIGN BODY SUBQ | ED | 1,553.00 |
DENTAL PROC DENTOALVEOLAR STRUCTURES | ED | 529.00 |
CD TX DISTAL FINGER FX | ED | 566.00 |
ARTHR/ASP/INJ INT JNT/BRS | ED | 647.20 |
ARTHROCENTESIS ASPIR/INJ MAJOR JT/BURSA | ED | 652.80 |
DRAIN/INJ JOINT/BURSA W ULTRASOUND GUIDE | ED | 690.00 |
CLSD TX TOE DISLOC WO ANES | ED | 659.90 |
REP CMLX FC/HND/GN1.1-2.5 | ED | 684.70 |
REP CMLX FC/HND/GN2.6-7.5 | ED | 623.00 |
REPAIR COMPLEX TRUNK 2.6-7.5 CM | ED | 1,345.65 |
REPAIR COMPX SCALP/ARM/LEG 2.6-7.5CM | ED | 970.00 |
LAY CLS FC/MUC 736-12.5 CM | ED | 425.10 |
LAY CLS FC/MUC20.1-30 CM | ED | 551.40 |
REP LAC SIMPLE 20.1-30 CM | ED | 833.50 |
DIAGNOSTIC ANOSCOPY SPX | ED | 289.00 |
APPL SPLINT LONG LEG | ED | 613.20 |
CL TX SCAPULAR FX W/MANIP | ED | 3,618.40 |
CLSD TX CLAVICLE FX W/MANIP | ED | 692.40 |
CD TRT FX METACARP EA WOM | ED | 619.60 |
CD TRT FX METACP W/M EA | ED | 665.80 |
TREAT THUMB FX W MANI | ED | 3,556.00 |
CD TRT FX NAS BN W/O STBN | ED | 2,274.30 |
CD TRT SUBLX RAD HEAD W/M | ED | 712.30 |
UPPER ARM ELBOW SURG UNLISTED | ED | 595.40 |
CD TRT DSL PATELLAR WO/A | ED | 567.00 |
CLTX TIBIAL FX W/WO MANI SKELETAL TRACJ | ED | 7,185.20 |
REPAIR NAIL BED EA | ED | 1,241.00 |
TX FX RADIUS & ULNA | ED | 1,534.70 |
CONTROL THROAT BLEEDING SIMPLE | ED | 493.10 |
REM FB EYE EXT CNJT SUPER | ED | 289.55 |
SHV EP/DM LS/TR/AR/LG<0.5 | ED | 338.05 |
APPL SPLINT SHT LEG | ED | 403.95 |
APPL SPLINT SHT ARM STATI | ED | 403.95 |
APPL SPLINT LONG ARM | ED | 302.40 |
CATH INSRT BLADDR NONINDW | ED | 313.80 |
CATH INSERT FOLEY SIMPLE | ED | 692.35 |
CATH INSRT FOLEY COMPLEX | ED | 233.25 |
CHANGE OF BLADDER TUBE | ED | 463.10 |
VAGINAL DELIVERY ONLY | ED | 1,028.00 |
DRAIN BLADDER BY NEEDLE | ED | 1,558.95 |
DELIVER PLACENTA | ED | 6,557.30 |
CARDIOVERSION ELECTIVE EX | ED | 829.90 |
CARDIOPULMONARY RESUS | ED | 898.10 |
THOROCOSTOMY TUBE PLACED | ED | 1,001.50 |
THORACENTESIS | ED | 1,752.80 |
THORACENTESIS W/IMAGING GUIDANCE | ED | 1,350.60 |
APPL SPLINT FNGR STATIC | ED | 198.25 |
CL TX FINGER FX W MANIP | ED | 458.45 |
CD TRT DSL IPJNT W/M WO/A | ED | 706.00 |
I&D DEEP ABSC BURSA THIGH/KNEE | ED | 6,554.40 |
CLSD TX PST HIP DISCLOC W/O ANES | ED | 578.90 |
REMOV FB DEEP THIGH/KNEE | ED | 6,087.10 |
CD TRT DSL SHLDR W/M W/A | ED | 2,868.90 |
EVAC SUBUNGUAL HEMATOMA | ED | 179.80 |
CD TRT FX TOE DISLOC W/O ANESTH | ED | 659.10 |
CD TRT FX PHLNX/NG W/M | ED | 706.00 |
TX BIG TOE FRACTURE | ED | 2,689.10 |
DEBR SKN & SUBQ TISSUE | ED | 838.65 |
DEBR/REM FB SKIN/SQ/MUS/BONE | ED | 2,585.20 |
NEG PRESS WND TX =50 SQ CM | ED | 864.00 |
EXPL PENETRATING WOUND ABD/BACK | ED | 4,131.70 |
EXPLOR PENETRATING WOUND EXTREMITY | ED | 1,247.95 |
NEG PRESSURE WOUND TX <=50sqcm | ED | 458.90 |
NEG PRESSURE WOUND TX >50sqcm | ED | 839.00 |
TANGNTL BX SKIN SINGLE LES (SHV,SCOOP) | ED | 486.30 |
TANGNTL BX SKIN EA ADDL | ED | 258.00 |
PUNCH BX SKIN SINGLE LES | ED | 486.30 |
PUNCH BX SKIN EA ADDL | ED | 258.00 |
INCISIONAL BX SKIN SINGLE LES | ED | 865.50 |
INCISIONAL BX SKIN EA ADDL | ED | 458.65 |
CD TRT FX HUM CONDYL W/MANIP | ED | 659.10 |
CLTX SHLDR DISLOC W MANIP | ED | 2,684.40 |
INSERT PICC CATH | ED | 2,166.50 |
CD TRT FX SHOULDER DISL W/MANIP | ED | 3,173.20 |
INSERT TUNNELED CV CATH | ED | 7,139.30 |
INTRAOSSEOUS NEEDLE PLACE | ED | 1,038.10 |
REMOVE IUD | ED | 710.90 |
DRAINAGE OF GUM LESION | ED | 649.10 |
RMVL DEVITAL TIS 20CM< | ED | 1,072.80 |
DRAINAGE ABCESS FINGER SIMPLE | ED | 802.40 |
DRAINAGE EYELID ABSCESS | ED | 746.45 |
DRAINAGE OF FINGER ABSCESS COMPLICATED | ED | 3,715.00 |
INCISION ANAL ABCESS | ED | 998.50 |
DRAIINAGE OF MOUTH LESION, SIMPLE | ED | 706.00 |
CLOSD MOUTH LAC RPR >2.5CM | ED | 1,279.30 |
I&D PILONIDAL CYST SIMPLE | ED | 752.20 |
CD TRT FX LAT MAL W/M | ED | 592.30 |
CLTX PROX FIBULA SHAFT FX W MANIJ PRO FE | ED | 3,556.40 |
EX BN LS/TRK/ARM/LG 3.1-4 | ED | 3,517.00 |
UA DIP WO/MICRO | ED | 29.80 |
I&D VULVA/PERINEAL ABSCESS | ED | 436.55 |
REPAIR OF VAGINA | ED | 5,009.80 |
O2 SAT MEAS SNGL READ | ED | 59.55 |
REP CMLX FC/HND/GN AD<5CM | ED | 623.00 |
RPR WOUND, LESION EA ADDL <5CM | ED | 951.60 |
TRANSFUSE BLOOD/BLD PROD | ED | 2,238.30 |
DRAIN EXTERNAL EAR LESION | ED | 661.15 |
DRAIN OUTER EAR CANAL LESION | ED | 661.15 |
OCCULT BLOOD FECES | ED | 86.75 |
PREGNANCY TEST | ED | 83.10 |
RAPID STREP SCREEN | ED | 115.35 |
ED VISIT LEVEL 1 | ED | 387.90 |
ED VISIT LEVEL 2 | ED | 1,218.90 |
ED VISIT LEVEL 3 | ED | 2,279.15 |
ED VISIT LEVEL 4 | ED | 3,317.20 |
ED VISIT LEVEL 5 | ED | 6,006.40 |
ED VISIT LEVEL 6 CC SVCS | ED | 10,403.70 |
ED VISIT CC SVCS ADL 30MN | ED | 895.70 |
ED NURSE ONLY - NO CHG | ED | 0.00 |
INJECT TRIGGER POINTS 3+ MUSCLES | ED | 644.90 |
MOD SED SAME PHYS >5 YRS 1st 30M | ED | 231.55 |
MOD SED SAME PHYS>5 YRS EA ADDL 15M | ED | 115.80 |
MOD SED PHYS/QHP INITIAL 15 MINS 5/> YRS | ED | 200.00 |
MOD SED OTHER PHYS/QHP EACH ADDL 15 MINS | ED | 160.00 |
PUNCT/ASP ABCS/HEM/BUL/CY | ED | 199.50 |
NERVE BLOCK INJ TRIGEMINAL | ED | 652.80 |
INJ ANES/STEROID INTRCOSTAL NRV SNG LVL | ED | 1,641.20 |
INJ/ANES OTHR PERIPHERAL | ED | 644.90 |
DIAGNOSTIC ANOSCOPY SPX SEP PROC PRO FEE | ED | 104.00 |
ECG-12 LEAD INTP REPORT ONLY | EDMD | 69.50 |
I&D ABSCESS SIMPLE/SINGLE | EDMD | 283.80 |
I&D ABSCESS/CYST COMPLEX | EDMD | 568.70 |
DRAINAGE OF GLAND ABCESS | EDMD | 287.50 |
INC/REM FB SUBCUT SIMPLE | EDMD | 400.30 |
INC/REM FB SUBCUT COMPLEX | EDMD | 867.20 |
NG TUBE INSERTION | EDMD | 364.25 |
CD TRT FX PHLNG SHFT W/M | EDMD | 1,050.50 |
RPLC GASTRO TUBE NO REV/GUID PRO FEE | EDMD | 110.30 |
RPR LAC TONGUE FLOOR MOUTH >2.6CM PRO FE | EDMD | 949.30 |
REP LAC SCP/NK/TNK <2.5CM | EDMD | 429.90 |
REP LAC SCP/NK/TNK2.5-7.5 | EDMD | 519.10 |
REPAIR FINGER TENDON | EDMD | 1,486.40 |
REP LAC SCP/NK 7.6-12.5CM | EDMD | 643.00 |
REPAIR TONGUE LACERATION <2.5CM PRO FEE | EDMD | 966.20 |
REP LAC SIMPLE 12.6-20 CM | EDMD | 678.90 |
REP LAC FAC/MUC <2.5CM | EDMD | 519.10 |
REP LAC FAC/MUC 2.6-5.0CM | EDMD | 608.30 |
REP LAC FAC/MUC 5.1-7.5CM | EDMD | 564.90 |
REP LAC FAC/MUC 7.6-12.5C PRO FEE | EDMD | 786.70 |
REMOVAL OF NAIL BED PRO FEE | EDMD | 495.50 |
LAY CLS TK/EXT <2.5 CM | EDMD | 469.60 |
LAY CLS TK/EXT 2.6-7.5 CM | EDMD | 604.60 |
REPR INTERM SCALP/AX/TRNK/EXT PRO FEE | EDMD | 799.40 |
LAY CLS TK/EXT 7.6-12.5CM | EDMD | 681.30 |
LAY CLS TK/EXT 12.6-20 CM PRO FEE | EDMD | 862.60 |
LAY CLS NK/HND/FT<2.5 CM | EDMD | 520.30 |
LAY CLS NK/HND/FT2.6-7.5C | EDMD | 618.20 |
LAY CLS NK/HND/FT7.6-12.5 | EDMD | 688.90 |
LAY CLS FC/MUC<2.5 CM | EDMD | 618.20 |
LAY CLS FC/MUC2.6-5.0 CM | EDMD | 579.80 |
LAY CLS FC/MUC5.1-7.5 CM PRO FEE | EDMD | 682.60 |
INJ TRIG PNT 1 OR 2 MUSCL | EDMD | 276.40 |
INJ TEND SHTH/LIG/APNEURO PRO FEE | EDMD | 276.40 |
REMOVE FOREARM FB PRO FEE | EDMD | 1,166.45 |
CD TRT DSL SHLDR W/M WO/A | EDMD | 790.35 |
DRAINAGE OF ARM BURSA PRO FEE | EDMD | 455.40 |
REM FB INTRANASAL PRO FEE | EDMD | 386.60 |
CTL HEMORRAGE NASAL ANTER | EDMD | 284.90 |
CTL HEMORRHAGIC NASAL POSTERIOR | EDMD | 413.80 |
INTUBATE ET EMERGENT | EDMD | 443.65 |
DX LARYNGOSCOPY EXCL NB PRO FEE | EDMD | 569.50 |
LAV PERITON/ABD PARA INTL | EDMD | 427.50 |
ANOSCOPY W/REMVL FOREIGN BODY PRO FEE | EDMD | 243.15 |
SPINAL PUNCT LUMBAR DX PRO FEE | EDMD | 828.80 |
REM FB CORNEAL WO/SLITLMP | EDMD | 298.60 |
INCS THROMBOSED HEMOR EXT PRO FEE | EDMD | 316.20 |
REMOV FB EYE CORNEA W SLIT LAMP PRO FEE | EDMD | 171.40 |
ABD PARACENTESIS W/IMAGING PRO FEE | EDMD | 310.90 |
REM FB EAR CABAK WO/ANEST PRO FEE | EDMD | 343.15 |
REM IMPACT CERUMEN UN/BIL PRO FEE | EDMD | 135.15 |
EXC BEN LES HEAD/FT/GENIT <.5CM PRO FEE | EDMD | 236.15 |
EXC TR EXT B9+MARG 1.1-2 CM PRO FEE | EDMD | 465.30 |
REMOVE IMPACTED EAR WAX UNI | EDMD | 41.10 |
EXC B9 LESION MRGN S,N,H,F,G 2.1-3 | EDMD | 445.05 |
REMOVAL OF SKIN TAGS EDMD | 216.60 | |
LARYNGOSCOPY INDIRECT DIAGN SPX PRO FEE | EDMD | 122.50 |
ARTERIAL CATH PERCUTANEOU | EDMD | 162.35 |
AVUL NAIL PRTL/CMPLT SING | EDMD | 194.50 |
DRESS/DEBRID PT-THICK BURN LG PRO FEE | EDMD | 463.10 |
DRS/DED BURN W/O ANS SML | EDMD | 265.25 |
DRESS/DEBRID BURN W/O ANESTH | EDMD | 501.80 |
INTL TRMT 1DEG BURN/LOCAL | EDMD | 198.25 |
DESTRUCTION B9 LESION UP TO 14 PRO FEE | EDMD | 326.20 |
AMPUTATION OF FINGER/THUMB PRO FEE | EDMD | 1,911.10 |
DEBR ECZEM/INFCT SKN 10% | EDMD | 115.35 |
CD TRT FX DIS RAD/EP WO/M | EDMD | 889.50 |
CLSD TX TIBIAL FX W/MANIP PRO FEE | EDMD | 1,897.50 |
I&D HEMAT/SEROMA/FLD | EDMD | 468.30 |
CD TRT FX TIB SHFT WO/M | EDMD | 993.50 |
CD TRT FX RADIUS/ULNA | EDMD | 1,622.70 |
CLSD TX FX ULNAR STYLOID PRO FEE | EDMD | 884.40 |
OPN TRT FX DIST PHLNG EA | EDMD | 1,193.00 |
TREAT LOWER LEG FRACTURE | EDMD | 1,466.90 |
CD TRT DSL ELBOW WO/A PRO FEE | EDMD | 1,142.15 |
TREAT WRIST BONE FX PRO FEE | EDMD | 1,342.30 |
CLOSED TX ANKLE FX W/MANIP PRO FEE | EDMD | 728.25 |
CLOSED TX ANKLE DISLOC W/O ANES PRO FEE | EDMD | 1,053.80 |
TX CLOSED HEEL FRACTURE PRO FEE | EDMD | 1,008.10 |
EXCISION OLECRANON BURSA PRO FEE | EDMD | 1,005.30 |
CLSD TX RESET DISLOCATED JAW PRO FEE | EDMD | 90.40 |
INS NON-TUNNEL CATH VENOUS <5Y PRO FEE | EDMD | 244.80 |
CLOSED TX METATARSAL FX W/MANI PRO FEE | EDMD | 580.00 |
CD TRT FX TRIMALLEOAR W/M PRO FEE | EDMD | 1,829.50 |
CLOSED TX BIMALLEOLAR ANKLE FX W/MANJ PF | EDMD | 1,097.00 |
CD TRT FX HUM/PROX W/MAN | EDMD | 1,430.75 |
NON-ROUTINE BL DRAW 3/> YRS | EDMD | 23.55 |
I&D ABCESS PERITONSILLAR | EDMD | 540.20 |
REM OF FOREIGN BODY FR PHARYNX PRO FEE | EDMD | 346.30 |
THROAT SURGERY PROCEDURE UNSPEC PRO FEE | EDMD | 270.20 |
DRAINAGE ABSCESS MOUTH ROOF LESION PRO F | EDMD | 283.50 |
REMOVAL OF FOOT FOREIGN BODY SUBQ | EDMD | 338.00 |
DENTAL PROC DENTOALVEOLAR STRUCTURES PF | EDMD | 500.00 |
CD TX DISTAL FINGER FX PRO FEE | EDMD | 771.80 |
ARTHR/ASP/INJ SM JNT/BRS | EDMD | 205.75 |
ARTHR/ASP/INJ INT JNT/BRS | EDMD | 234.30 |
ARTHR/ASP/INJ MJR JNT/BRS | EDMD | 215.60 |
DRAIN/INJ JOINT/BURSA W ULTRASOUND GUIDE | EDMD | 194.50 |
CLSD TX TOE DISLOC WO ANES PRO FEE | EDMD | 378.65 |
CD TRT FX DIST PHLNG WO/M | EDMD | 970.00 |
REP CMLX FC/HND/GN1.1-2.5 PRO FEE | EDMD | 723.50 |
REP CMLX FC/HND/GN2.6-7.5 PRO FEE | EDMD | 1,122.35 |
REPAIR COMPLEX TRUNK 2.6-7.5 CM PRO FEE | EDMD | 724.40 |
REP CMLX LD/N/E/L1.1-2.5 | EDMD | 910.50 |
REP CMLX SCLP/LIMB2.6-7.5 | EDMD | 950.10 |
LEG SURGERY PROCEDURE PRO FEE | EDMD | 385.90 |
LAY CLS FC/MUC 7.6-12.5 CM | EDMD | 1,088.90 |
REP LAC SIMPLE 20.1-30 CM PRO FEE | EDMD | 708.50 |
APPL SPLINT LONG LEG | EDMD | 268.90 |
CL TX SCAPULAR FX W/MANIP PRO FEE | EDMD | 1,073.85 |
CLSD TX CLAVICLE FX W/MANIP PRO FEE | EDMD | 1,191.90 |
CD TRT FX METACARP EA WOM PRO FEE | EDMD | 788.35 |
CD TRT FX METACP W/M EA PRO FEE | EDMD | 1,050.50 |
TREAT THUMB FX W MANI PRO FEE | EDMD | 1,028.00 |
CD TRT FX NAS BN W/O STBN | EDMD | 587.20 |
CD TRT SUBLX RAD HEAD W/M | EDMD | 367.90 |
UPPER ARM ELBOW SURGERY UNLISTED PRO FEE | EDMD | 374.90 |
CD TRT DSL PATELLAR WO/A PRO FEE | EDMD | 995.95 |
CLTX TIBIAL FX W/WO MANI SKEL TRAC PR FE | EDMD | 1,575.00 |
CD TRT FX RAD SHFT WO/M | EDMD | 1,496.40 |
REPAIR NAIL BED EA | EDMD | 360.60 |
TX FX RADIUS & ULNA PRO FEE | EDMD | 1,164.25 |
REM FB EYE EXT CONJ EMBED | EDMD | 277.50 |
CONTROL THROAT BLEEDING SIMPLE | EDMD | 786.70 |
REM FB EYE EXT CNJT SUPER | EDMD | 256.50 |
SHV EP/DM LS/TR/AR/LG<0.5 PRO FEE | EDMD | 104.20 |
APPL SPLINT SHT LEG | EDMD | 174.70 |
APPL SPLINT SHT ARM STATI | EDMD | 179.80 |
APPL CAST SHT LEG | EDMD | 233.00 |
APPL SPLINT LONG ARM | EDMD | 210.65 |
CATH INSERT FOLEY SIMPLE | EDMD | 185.90 |
CHANGE OF BLADDER TUBE PRO FEE | EDMD | 154.10 |
VAGINAL DELIVERY ONLY | EDMD | 4,077.80 |
DRAIN BLADDER BY NEEDLE PRO FEE | EDMD | 111.15 |
DELIVER PLACENTA | EDMD | 252.00 |
CARDIOVERSION ELECTIVE EX | EDMD | 495.50 |
CARDIOPULMONARY RESUS | EDMD | 650.40 |
CD TRT FX MED MALLOS WO/M | EDMD | 891.90 |
ED MD EMS DIRECTED ALS | EDMD | 482.00 |
THOROCOSTOMY TUBE PLACED PRO FEE | EDMD | 695.00 |
THORACENTESIS W/O IMAGING GUIDANCE | EDMD | 738.40 |
THORACENTESIS W/IMAGING GUIDANCE PRO FEE | EDMD | 319.75 |
APPL SPLINT FNGR STATIC | EDMD | 119.00 |
CD TRT FX PHL SHFT WOM EA | EDMD | 473.25 |
CL TX FINGER FX W MANIP PRO FEE | EDMD | 1,347.50 |
CD TRT DSL IPJNT W/M WO/A | EDMD | 758.20 |
I&D DEEP ABSC BURSA THIGH/KNEE PRO FEE | EDMD | 1,439.90 |
CLSD TX PST HIP DISCLOC W/O ANES PRO FEE | EDMD | 1,182.10 |
REMOV FB DEEP THIGH/KNEE PRO FEE | EDMD | 1,098.00 |
CD TRT DSL SHLDR W/M W/A | EDMD | 1,278.45 |
EVAC SUBUNGUAL HEMATOMA | EDMD | 89.40 |
CD TRT FX TOE DISLOC W/O ANESTH | EDMD | 346.90 |
CD TRT FX PHLNX/NG W/M | EDMD | 428.70 |
TX BIG TOE FRACTURE PRO FEE | EDMD | 1,140.00 |
PARTIAL AMPUTATION OF TOE | EDMD | 1,799.90 |
DEBR SKN & SUBQ TISSUE | EDMD | 230.60 |
DEBR/REM FB SKIN/SQ/MUS/BONE | EDMD | 1,564.60 |
EXPL PENETRATING WOUND ABD/BACK PRO FEE | EDMD | 1,438.60 |
EXPLOR PENETRATING WOUND EXTRMTY PRO FEE | EDMD | 1,040.90 |
TANGNTL BX SKIN SINGLE LES PRO FEE | EDMD | 113.60 |
TANGNTL BX SKIN EA ADDL PRO FEE | EDMD | 65.10 |
PUNCH BX SKIN SINGLE LES PRO FEE | EDMD | 142.30 |
PUNCH BX SKIN EA ADDL PRO FEE | EDMD | 77.20 |
INCISIONAL BX SKIN SINGLE LES PRO FEE | EDMD | 173.15 |
INCISIONAL BX SKIN EA ADDL PRO FEE | EDMD | 92.60 |
CD TRT FX HUM SHFT WO/M | EDMD | 890.70 |
CD TRT FX HUM CONDYLAR W/MANIP | EDMD | 1,604.20 |
CLTX SHLDR DISLOC W MANIP PRO FEE | EDMD | 1,116.90 |
INSERT PICC CATH PRO FEE | EDMD | 244.15 |
CD TRT FX SHOULDER DISL W/MANIP PRO FEE | EDMD | 1,466.90 |
INSERT TUNNELED CV CATH PRO FEE | EDMD | 793.10 |
INTRAOSSEOUS NEEDLE PLACE | EDMD | 462.20 |
REMOVE IUD PRO FEE | EDMD | 183.80 |
DRAINAGE OF GUM LESION | EDMD | 552.60 |
RMVL DEVITAL TIS 20CM< | EDMD | 137.60 |
DRAINAGE ABCESS FINGER SIMPLE PRO FEE | EDMD | 422.40 |
DRAINAGE EYELID ABSCESS PRO FEE | EDMD | 326.35 |
DRAINAGE OF FINGER ABSCESS COMPLICTD PF | EDMD | 478.00 |
INCISION ANAL ABCESS PRO FEE | EDMD | 519.10 |
DRAIINAGE OF MOUTH LESION, SIMPLE | EDMD | 427.50 |
CLOSD MOUTH LAC RPR >2.5CM PRO FEE | EDMD | 683.05 |
MOD SED SAME PHYS <5 YRS | EDMD | 190.80 |
I&D PILONIDAL CYST SIMPLE PRO FEE | EDMD | 434.00 |
CD TRT FX LAT MAL W/M PRO FEE | EDMD | 1,550.90 |
CLTX PROX FIBULA SHAFT FX W MANIJ | EDMD | 1,085.70 |
EX BN LS/TRK/ARM/LG 3.1-4 PRO FEE | EDMD | 546.30 |
INJECTION THERAPEUTIC | EDMD | 146.30 |
I&D VULVA/PERINEAL ABSCESS PRO FEE | EDMD | 390.25 |
REPAIR OF VAGINA | EDMD | 906.30 |
APPL SPLINT SHT ARM DYNAM | EDMD | 261.50 |
REP CMLX FC/HND/GN AD<5CM PRO FEE | EDMD | 366.80 |
RPR WOUND, LESION EA ADDL <5CM PRO FEE | EDMD | 422.40 |
DRAIN EXTERNAL EAR LESION | EDMD | 590.90 |
DRAIN OUTER EAR CANAL LESION PRO FEE | EDMD | 650.50 |
CENTRAL LINE PLCMT > 5 YR | EDMD | 743.20 |
ED VISIT PROBLEM FOCUSED | EDMD | 171.05 |
ED VISIT EXPANDED | EDMD | 231.65 |
ED VISIT EXPANDED/MODER | EDMD | 346.90 |
ED VISIT DETAILED | EDMD | 519.10 |
ED VISIT COMPREHENSIVE | EDMD | 773.00 |
ED CC SVCS 30-74 MIN | EDMD | 770.55 |
ED CC SVCS ADDL 30 MIN ++ | EDMD | 385.25 |
MEDICAL SCREENING EXAM | EDMD | 74.35 |
INJECT TRIGGER POINTS 3+ MUSCLES PRO FEE | EDMD | 187.55 |
MOD SED SAME PHYS >5 YRS 1st 30M PRO FEE | EDMD | 158.70 |
MOD SED SAME PHYS>5 YR EA AD 15M PRO FE | EDMD | 80.00 |
OBSERV DISCH DIFF DAY | EDMD | 168.60 |
OBSRV H&P LOW CMPLX | EDMD | 210.65 |
OBSRV H&P MOD CMPLX | EDMD | 286.25 |
OBSRV H&P HIGH CMPLX | EDMD | 358.10 |
HSP CARE INITIAL LOW | EDMD | 261.50 |
HSP CARE INITIAL / MODERATE | EDMD | 351.90 |
HSP CARE INITIAL / HIGH | EDMD | 432.40 |
OBSERVATION SUBS LOW | EDMD | 115.35 |
OBSERVATION SUBS MODERATE | EDMD | 176.00 |
OBSERVATION SUBS HIGH | EDMD | 260.15 |
HSP CARE SUBQ/FOCUSED/LOW | EDMD | 131.50 |
HSP CARE SUBQ/EXPNDED/MOD | EDMD | 187.10 |
HSP CARE SUBQ / HIGH | EDMD | 254.00 |
OBS/ HSP ADM/DIS SAME DAY LOW | EDMD | 369.20 |
OBS/ HSP ADM/DIS SAME DAY MOD | EDMD | 501.80 |
OBS/ HSP ADM/DIS SAME DAY HIGH | EDMD | 562.40 |
HSP DISCHARG MGMT/MD/<30 | EDMD | 221.90 |
HSP DISCHARG MGMT/MD/>31 | EDMD | 277.50 |
PUNCT/ASP ABCS/HEM/BUL/CY | EDMD | 343.15 |
NERVE BLOCK INJ TRIGEMINAL | EDMD | 226.80 |
NERVE BLOCK INJECTION FACIAL | EDMD | 574.80 |
NERVE BLOCK INJ OCCIPITAL | EDMD | 200.80 |
CHEMODENERVATE MUSC MIGRAIN | EDMD | 356.20 |
INJ ANES/STERD INTRCOSTL NRV 1 LVL PR F | EDMD | 162.80 |
INJ/ANES OTHR PERIPHERAL PRO FEE | EDMD | 306.00 |
LIPASE /SO | LAB | 140.20 |
DOT Drug Testing - DATCO | LAB | 99.25 |
ORGANISM ID AEROBIC EACH /SO | LAB | 32.15 |
SENSITIVITY/SUSCEPTIBILTY ON CULTURE /SO | LAB | 34.35 |
LEUKOCYTE ALK PHOS /SO | LAB | 29.30 |
CULTURE TYPE IMMUN NOT FLUORES /SO | LAB | 20.60 |
ORGANISM ID ANAEROBIC EACH /SO | LAB | 32.15 |
LIPID PANEL | LAB | 256.50 |
PSA TOTAL | LAB | 241.60 |
TSH | LAB | 340.75 |
CADMIUM ASSAY /SO | LAB | 78.80 |
DRUG SCREEN QUAN LAMOTRIGINE /SO | LAB | 45.05 |
HGB A1C | LAB | 194.50 |
ALCOHOL BLOOD | LAB | 218.15 |
LIPASE | LAB | 140.20 |
MAGNESIUM | LAB | 133.90 |
TROPONIN QUANTITATIVE | LAB | 386.60 |
RENAL PANEL | LAB | 236.70 |
OB PANEL | LAB | 395.30 |
T4, FREE | LAB | 194.50 |
LDL DIRECT | LAB | 188.40 |
HS-CRP /SO | LAB | 262.70 |
NUCLEAR ANTIGEN ANTIBODY /SO | LAB | 61.00 |
CYTOLOGY URINE /SO | LAB | 87.70 |
PROTEIN/CREAT RATIO /SO | LAB | 12.50 |
LDH /SO | LAB | 24.85 |
LEISHMANIA AB /SO | LAB | 48.30 |
MICROBE SUSCEPTIBLE ENZYME /SO | LAB | 18.90 |
URINE BACTERIA CULTURE /SO | LAB | 32.15 |
METHYLMALONIC ACID /SO | LAB | 58.30 |
ALK PHOS ISOENZYMES /SO | LAB | 88.00 |
GLIADIN AB IgG IgA 2nd test /SO | LAB | 39.30 |
GRAM STAIN /SO | LAB | 14.50 |
WBC SMEAR STOOL / Q | LAB | 14.50 |
GLIADIN AB IgG IgA /SO | LAB | 39.30 |
HAPTOGLOBIN /SO | LAB | 42.80 |
FUNGI IDENT MOLD /SO | LAB | 35.10 |
CELIAC DIAGNOSTIC PNL /SO | LAB | 39.30 |
ALDOLASE /SO | LAB | 33.00 |
ALKALOIDS NOS /SO | LAB | 32.25 |
FOLATES RBC /SO | LAB | 157.90 |
COMPLEMENT C3C /SO | LAB | 40.85 |
COMPLEMENT CH50 /SO | LAB | 69.15 |
COMPLEMENT C4 /SO | LAB | 58.90 |
CA19-9 /SO | LAB | 70.90 |
SHBG /SO | LAB | 73.90 |
SODIUM 24 URINE /SO | LAB | 16.60 |
PTH BIOINTACT /SO | LAB | 140.50 |
ANTI-DNA /SO | LAB | 46.75 |
COL CHROMOTOGRAPHY QUAL/QUAN /SO | LAB | 71.25 |
TOTAL/DIRECT BILI FXNTD /SO | LAB | 93.05 |
H PLORI IGA AAB /SO | LAB | 49.40 |
AMH /SO | LAB | 47.60 |
TISSUE TRANSGLUTAM ABS /SO | LAB | 39.30 |
MERCURY /SO | LAB | 55.35 |
ALPHA 1 ANTITRUPSIN /SO | LAB | 45.40 |
CORTISOL 24 URINE /SO | LAB | 56.90 |
M. TUBERCULO DNAAMP PROBE /SO | LAB | 119.40 |
ANTITHROMBIN III PAN /SO | LAB | 40.30 |
PROTEIN C /SO | LAB | 53.40 |
LUPUS ANTICOAG EVAL /SO | LAB | 32.60 |
CARDIOLIPIN AB SCREEN /SO | LAB | 86.65 |
ZONISAMIDE(ZONEGRAN) /SO | LAB | 45.10 |
ERYTHROPOIETIN /SO | LAB | 63.95 |
RENIN /SO | LAB | 74.80 |
POTASSIUM 24 URINE /SO | LAB | 14.70 |
HSV I IGG /SO | LAB | 44.90 |
HSV II IGG /SO | LAB | 65.90 |
VAP IM CHOLESTEROL /SO | LAB | 93.35 |
VITAMIN A /SO | LAB | 39.50 |
VITAMIN B6 /SO | LAB | 95.60 |
VITAMIN D 1 25-DIHYDROXY /SO | LAB | 131.00 |
HERPES SIMPLEX NES ANTBDY /SO | LAB | 48.95 |
VIT B1 THIAMINE /SO | LAB | 72.25 |
URIC ACID 24 URINE /SO | LAB | 16.20 |
CHROMOGRANIN A /SO | LAB | 70.90 |
ASSAY OF URINE, UREA NIT /SO | LAB | 16.20 |
FIBRIROGEN /SO | LAB | 39.90 |
APOLIPOPROTEIN A-1 /SO | LAB | 58.10 |
CHLAMYDIA PENUMONIAE /SO | LAB | 119.40 |
MYCOPLASMA PNEUMONIAE /SO | LAB | 45.05 |
DRUG ASSAY EVEROLIMUS /SO | LAB | 46.75 |
ZINC /SO | LAB | 38.75 |
CLOTTING FACTOR VIII VW MEASURE /SO | LAB | 78.10 |
CYSTIC FIBROSIS SCREEN /SO | LAB | 124.00 |
IGA /SO | LAB | 31.70 |
IGG /SO | LAB | 31.70 |
IGM /SO | LAB | 31.70 |
ANTIEPILEPTIC LEVEL ETHOSUXIMIDE /SO | LAB | 13.70 |
CULTURE BACT ANAEROBIC EXCEPT BLOOD /SO | LAB | 32.25 |
ARSENIC /SO | LAB | 64.60 |
MOLECULAR PATH 2 HUNTINGTON'S /SO | LAB | 377.10 |
IgG 1, 2, 3 or 4 EACH S/O | LAB | 21.10 |
H. PYLORI ANTIGEN /SO | LAB | 48.95 |
CP AB /SO | LAB | 44.05 |
A1C /SO | LAB | 194.50 |
GENTAMICIN ASSAY PEAK /SO | LAB | 55.80 |
GENTAMICIN ASSAY TROUGH /SO | LAB | 55.80 |
MAGNESIUM RBC /SO | LAB | 133.90 |
ACTH /SO | LAB | 131.50 |
B-2 MICROGLOBULIN /SO | LAB | 55.00 |
UA MICRO ONLY | LAB | 47.15 |
ASSAY OF LIPOPROTEIN (A) /SO | LAB | 44.05 |
CERULOPLASMIN /SO | LAB | 36.55 |
FECAL FAT /SO | LAB | 17.35 |
GASTRIN /SO | LAB | 60.00 |
T3 REVERSE / Q | LAB | 53.70 |
ASSAY OF PROGRESTERONE 17-D S/O | LAB | 71.30 |
FOLIC ACID RBC | LAB | 157.90 |
HEP B GENOTYPE DNA /SO | LAB | 876.10 |
5 HIAA URINE /SO | LAB | 43.90 |
COPPER SERUM /SO | LAB | 42.20 |
MUMPS /SO | LAB | 44.40 |
ALPHA 1 ANTITRYPSIN PHENOTYPE /SO | LAB | 49.25 |
IGF1 /SO | LAB | 72.35 |
SUGARS SINGLE QUAL /SO | LAB | 18.80 |
FLOW CYTOMETRY TC 1 MARKER /SO | LAB | 39.65 |
FLOW CYTOMETRY EA ADDL MARKER /SO | LAB | 10.30 |
CATECHOLAMINES /SO | LAB | 85.95 |
KAPPA LAMBDA LIT CHN /SO | LAB | 46.30 |
ESTRONE /SO | LAB | 84.95 |
B-2 GLYCOPROTEIN /SO | LAB | 86.65 |
PHOSPHOLIPID ANTIBODY /SO | LAB | 54.70 |
T4 FREE BY DIALYSIS /SO | LAB | 194.50 |
TRANSFERRIN /SO | LAB | 43.50 |
TRICHOMMONAS AMP PROBE /SO | LAB | 112.60 |
COLD AGGLUTININ TITER S/O | LAB | 24.20 |
CULTURE TYPING GLC/HPLC /SO | LAB | 42.65 |
MICROBE SUSCEPTIBLE DIFFUSE /SO | LAB | 16.20 |
MICROBE SUSCEPTIBLE DISK /SO | LAB | 23.40 |
MOLECULAR CYTOGENETICS 25-99 CELLS S/O | LAB | 105.95 |
MRSA SCREEN RT PCR /SO | LAB | 119.40 |
HEPARIN ASSAY | LAB | 38.35 |
CYTOGENETICS DNA PROBE EA S/O | LAB | 53.55 |
CALCULUS INFRARED SPECTROSCOPY /SO | LAB | 43.90 |
SMR PRIM SRC FLUORESC&/AFS BCT FNGI /SO | LAB | 18.30 |
MICOBACTERIA CULTURE ACID FAST /SO | LAB | 36.80 |
INFECTIOUS AGENT, CORONOVIRUS, AMP PROBE | LAB | 133.40 |
SKIN FUNGI CULT MOLD, YEAST /SO | LAB | 26.20 |
CANDIDA DNA DIR PROBE /SO | LAB | 68.30 |
GARDNER VAG DNA DIR PROBE /SO | LAB | 68.30 |
TRICHOMONAS VAGIN DIR PROBE /SO | LAB | 68.30 |
CANDIDA DNA AMP PROBE /SO | LAB | 119.40 |
GARDNER VAG DNA QUANT /SO | LAB | 142.10 |
TOXIN/ANTITOXIN ASSAY TISSUE /SO | LAB | 67.15 |
AB EPSTEIN BARR NUCLEAR AG /SO | LAB | 52.10 |
AB EPSTEIN-BARR VIRAL CAPSID /SO | LAB | 61.75 |
SMEAR COMPLX STAIN OVA PARASIT /SO | LAB | 61.10 |
AB CYTOMEGALOVIRUS /SO | LAB | 48.95 |
AB CYTOMEGALOVIRUS IGM /SO | LAB | 57.35 |
AB HEP DELTA AGENT /SO | LAB | 58.40 |
HEPATITIS BE ANTIBODY /SO | LAB | 39.40 |
CHLAMYDIA CULTURE ANY SOURCE /SO | LAB | 66.70 |
CULT TYPE IMMUNOFLUORESC EA ANTISERM /SO | LAB | 19.00 |
HEATITIS B IADNA QUANT /SO | LAB | 145.75 |
AB EPSTEIN-BARR VIRUS EARLY ANT EA S/O | LAB | 32.80 |
HPV IADNA HIGH RISK TYPES /SO | LAB | 119.40 |
HPV TYPES 16 & 18 ONLY /SO | LAB | 119.40 |
HUMAN EPIDIDYMIS PROTEIN 4 HE4 /SO | LAB | 70.90 |
ONCO OVARIAN BIOCHEM ASSAY 2 PROTEIN /SO | LAB | 718.00 |
STOOL CULTR AEROBIC BACT EACH /SO | LAB | 32.15 |
SHIGA LIKE TOXIN IAAD EIA /SO | LAB | 40.85 |
DRUG SCREEN QUANT MYCOPHENOLATE /SO | LAB | 61.45 |
CYTOPATH CELL ENHANCE TECHNIQ SLCTV /SO | LAB | 77.50 |
ELASTASE PANCREATIC FECAL QUAL /SO | LAB | 39.30 |
H PYLORI BREATH ANAL UREASE /SO | LAB | 229.20 |
HLA I LOW RES ONE ANTIGEN EQUIV EACH /SO | LAB | 247.55 |
CALCIUM URINE QUANT TIMED SPECIMEN /SO | LAB | 20.55 |
CLOSTRIDIUM DIFF AMPLIFIED PROBE /SO | LAB | 119.40 |
ASSAY OF CALPROTECTIN FECAL /SO | LAB | 66.30 |
ASSAY OF PREGNENOLONE /SO | LAB | 70.40 |
AB VIRUS NOT ELSEWHERE CLASSIFIED /SO | LAB | 43.85 |
ASSAY OF CRYOFIBRINOGEN /SO | LAB | 39.00 |
ASSAY OF CRYOGLOBULIN SEMI QUANT /SO | LAB | 22.00 |
IADNA AMP PROBE TQ EACH NOT SPECIFD /SO | LAB | 119.40 |
ISLET CELL ANTIBODY /SO | LAB | 67.30 |
HEP DELTA AGENT ANTIBODY /SO | LAB | 58.40 |
CRYOGLOBULIN QUAL SEMI-QUANT /SO | LAB | 22.00 |
CHLAMYDIA ANTIBODY /SO | LAB | 40.30 |
CHLAMYDIA IGM ANTIBODY /SO | LAB | 21.10 |
ASSAY OF CAROTENE S/O | LAB | 23.05 |
ALPHA FETOPROTEIN L3 S/O | LAB | 161.00 |
GLUCOSE TOLERANCE EA ADDL AFTER 3 SPECIM | LAB | 19.20 |
BILE ACID /SO | LAB | 58.30 |
POTASSIUM,URINE /SO | LAB | 14.70 |
TISSUE EXAM BY PATHOLOGIST LVL 1 /SO | LAB | 48.15 |
TISSUE EXAM BY PATHOLOGIST LVL II /SO | LAB | 87.70 |
TISSUE EXAM BY PATHOLOGIST LVL III /SO | LAB | 123.20 |
TISSUE EXAM BY PATHOLOGIST LVL IV /SO | LAB | 123.20 |
TISSUE EXAM BY PATHOLOGIST LVL V /SO | LAB | 593.80 |
TISSUE EXAM BY PATHOLOGIST LVL VI /SO | LAB | 1,491.00 |
CHLORIDE,URINE /SO | LAB | 17.10 |
CARBON DIOXIDE BLOOD ASSAY /SO | LAB | 16.60 |
CHLORIDE, BLOOD /SO | LAB | 15.65 |
CHEMILUMINESCENT ASSAY /SO | LAB | 48.10 |
B CELLS TOTAL COUNT S/O | LAB | 94.30 |
ASSAY NONENDOCRINE RECEPTOR S/O | LAB | 91.45 |
QUANTITATION OF TX DRUG NES /SO | LAB | 51.40 |
BETA 2 MICROGLOBULIN /SO | LAB | 55.00 |
ANTIBODY HELMINTH NOS S/O | LAB | 32.50 |
DEOXYCORTISOL S/O | LAB | 73.20 |
SYPHILIS TEST NON-TREP ANTIBX QUAL S/O | LAB | 10.70 |
RESP VIRUS 12-25 TARGETS S/O | LAB | 1,040.00 |
M.PNEUMON DNA AMP PROBE S/O | LAB | 87.75 |
INSULIN ANTIBODIES S/O | LAB | 53.55 |
DRUG ASSAY ADALIMUMAB S/O | LAB | 96.40 |
M GENITALIUM AMP PROBE S/O | LAB | 87.75 |
HSV CULTURE,SOFP /SO | LAB | 115.25 |
INFLUENZA DNA AMP PROBE | LAB | 264.10 |
STREP A DNA AMP PROBE | LAB | 107.50 |
DETECT AGNT MULT DNA AMPLI | LAB | 215.05 |
AQUAPORIN-4 ANTB CBA EA S/O | LAB | 30.35 |
VOLTAGE-GTD CA CHNL ANTB EA S/O | LAB | 64.40 |
THYROGLOBULIN W/O TGAB /SO | LAB | 54.70 |
INFLUENZA A&B AG,EIA /SO | LAB | 40.85 |
NT-PRO BNP | LAB | 687.55 |
ASSAY OF CALCITONIN /SO | LAB | 91.20 |
CULTURE SCREEN /SO | LAB | 22.60 |
SODIUM SERUM | LAB | 91.80 |
EHRLICHIA ABS /SO | LAB | 34.70 |
LIPO PROFILE TEST /SO | LAB | 58.10 |
COLLAGEN CROSSLINKS NTX /SO | LAB | 63.60 |
MCARE SCREENING PSA | LAB | 241.60 |
HSV 1/2 IGG /SO | LAB | 44.90 |
CA 15-3 /SO | LAB | 70.90 |
PREALBUMIN /SO | LAB | 49.70 |
AMINO ACID ANALYSIS /SO | LAB | 57.45 |
SIROLIMUS/RAPAMYCIN /SO | LAB | 46.75 |
CYTOMEGALOVIRUS DNA /SO | LAB | 145.75 |
CHROMIUM,PLASMA /SO | LAB | 69.05 |
COBALT,BLOOD /SO | LAB | 96.80 |
NO CHARGE | LAB | 0.00 |
TSH /SO | LAB | 340.75 |
UA DIP W/O MICROSCOPIC | LAB | 29.80 |
CMP /SO | LAB | 235.40 |
LIPID PANEL /Q | LAB | 35.20 |
TOTAL PSA /SO | LAB | 241.60 |
PHOSPHORUS/PHOSPHATE /SO | LAB | 98.00 |
THYROID STIMUL IMM /SO | LAB | 173.05 |
OB PANEL /SO | LAB | 254.75 |
ASSAY OF VIT E TOCOPHEROL ALPHA /SO | LAB | 48.30 |
PLATELET ANTIBODIES IDENTIFICATION S/O | LAB | 45.90 |
ANCA SCREEN /SO | LAB | 51.25 |
TOXICOLOGY DRUG SCREEN, MULT CLASSES, /S | LAB | 680.60 |
DRUG SCREEN PRESUMPTIVE OPT INST | LAB | 84.30 |
FTA S/O | LAB | 33.10 |
C-REACTIVE PROTEIN HS /SO | LAB | 262.70 |
ASSAY LIPOPROTEIN PLA2 /SO | LAB | 128.30 |
MURAMIDASE S/O | LAB | 46.85 |
HEP B CORE TOTAL/HBC IG /SO | LAB | 41.10 |
KIT DRAW FROM PATIENT | LAB | 58.80 |
KIT DRAW FROM EMPLOYEE | LAB | 0.00 |
KIT - URINE COLLECTION | LAB | 58.80 |
BRCA1&2 SEQ & FULL DUP/DEL /SO | LAB | 6,209.30 |
BARTONELLA HENSELEA /SO | LAB | 34.70 |
GENE ANALYSIS HEMOCHROMATOSIS /SO | LAB | 222.40 |
HLA II TYPING 1 LOC HR /SO | LAB | 420.85 |
VIRUS TISSUE INOCULATION /SO | LAB | 88.75 |
VIRUS INOCULATION SHELL STAIN /SO | LAB | 66.60 |
Liver Fibrosis Panel / SO | LAB | 199.05 |
VANCOMYCIN /SO | LAB | 46.10 |
LYME WEST BLOT /SO | LAB | 238.90 |
RUBEOLOA TITER /SO | LAB | 43.85 |
ASSAY OF PROTEIN SERUM INHOUSE | LAB | 15.55 |
C-REACTIVE PROTEIN INHOUSE | LAB | 21.90 |
ASSAY OF VASOPRESSIN /SO | LAB | 115.50 |
ALLERGEN IGE, EA ALLERGEN /SO | LAB | 17.75 |
ASSAY OF MYOGLOBIN / SO | LAB | 33.90 |
DHEA /SO | LAB | 86.00 |
PORPHOBILINOGEN ASSAY, RANDOM /SO | LAB | 28.80 |
ANGIOTENSION CONV ENZY/SO | LAB | 49.70 |
HEPATITIS A, TOTAL /SO | LAB | 42.10 |
HEPATITIS Be AG EIA /SO | LAB | 39.20 |
URINE PORPHYRINS, FRACT, /SO | LAB | 50.10 |
HIV-1 RNA QUANT BDNA /SO | LAB | 289.60 |
THYROXINE FREE /SO | LAB | 194.50 |
KETONES PANEL /SO | LAB | 15.00 |
ALDOSTERONE ASSAY /SO | LAB | 138.70 |
PROTEIN TOTAL XCPT REFRACTOMETRY / SO | LAB | 12.50 |
QUEST MISC LIVER FIBROSIS TEST /SO | LAB | 0.00 |
GLUCOSE,SYNOVIAL FLUID /SO | LAB | 13.45 |
SJOGREN'S ANTIBODY-SS-A /SO | LAB | 61.00 |
SM ANTIBODY NUCLEAR ANTIGEN /SO | LAB | 61.00 |
HSV 1/2 DNA PCR /SO | LAB | 119.40 |
ASSAY OF ANDROSTENEDIONE /SO | LAB | 110.70 |
CARBOXYHEMOGLOBIN /SO | LAB | 41.90 |
LACTIC ACID/LACTATE | LAB | 216.90 |
IMMUNOASSAY ANALYTE QUANT RADIOIMMUNOA | LAB | 52.90 |
RETICULOCYTE COUNT | LAB | 203.20 |
CRP-HS | LAB | 262.70 |
INFLUENZA | LAB | 99.10 |
ANIBODY FUNGUS /SO | LAB | 41.70 |
D DIMER | LAB | 338.30 |
VISCOSITY,SERUM /SO | LAB | 39.80 |
DIHYDROTESTOSTERONE / SO | LAB | 76.90 |
ASSAY OF ESTROGENS / SO | LAB | 84.80 |
ASSAY OF ESTRIOL / SO | LAB | 63.50 |
FATTY ACIDS NONESTERIFIED | LAB | 49.30 |
IGE /SO | LAB | 56.00 |
ASSAY OF G6PD ENZYME /SO | LAB | 32.90 |
ASSAY OF GLYCATED PROTEIN /SO | LAB | 51.30 |
Human growth hormone level S/O | LAB | 43.80 |
HEMOGLOBIN CHROMOTOGRAPHY /SO | LAB | 61.50 |
HLA CLASS II LOW RES /SO | LAB | 415.90 |
OXALATE URINE /SO | LAB | 12.40 |
ASSAY PH BODY FLUID NOS /SO | LAB | 12.20 |
MAGNESIUM URINE | LAB | 12.40 |
ASSAY OF HISTAMINE /SO | LAB | 101.45 |
CITRATE URINE /SO | LAB | 12.40 |
INTRINSIC FACTOR /SO | LAB | 51.30 |
COXSACKIE AB /SO | LAB | 44.30 |
QUANTIFERON GOLD /SO | LAB | 210.95 |
LACTOFERRIN FECAL (QUANT) | LAB | 51.60 |
CARDIO IQ (TM) LIPO, ION /SO | LAB | 107.30 |
CARDIO IQ (TM) HDL CHOL /SO | LAB | 27.95 |
MASS SPECTROMETRY QUAL/QUAN /SO | LAB | 66.50 |
MUCIN SYNOVIA FLUID ROPES TEST /SO | LAB | 20.00 |
ASSAY MYELOPEROXIDASE | LAB | 133.50 |
PHOSPHORUS URINE /SO | LAB | 17.65 |
17-HYDROXYPREGNENOLONE LEVEL /SO | LAB | 77.60 |
ASSAY OF PROSTAGLNDIN EACH /SO | LAB | 115.80 |
WESTERN BLOT TEST /SO | LAB | 58.00 |
PROTEIN WESTERN BLOT OTHR FLUID S/O | LAB | 73.00 |
ASSAY OF SELENIUM /SO | LAB | 86.90 |
SUGARS SINGLE QUANT / SO | LAB | 30.30 |
SULFATE URINE /SO | LAB | 16.20 |
ASSAY OF VITAMIN NOS /SO | LAB | 47.05 |
VITAMIN K LEVEL /SO | LAB | 46.75 |
CALCIUM IONIZED /SO | LAB | 46.50 |
VIT D 25-HYDROXY | LAB | 100.70 |
GIARDIA AG STOOL /SO | LAB | 40.85 |
CRYPTOSPORIDIUM OR INFECTIOUS AGENT /SO | LAB | 22.75 |
CRYPTOSPORIDIUM AG IF /SO | LAB | 40.85 |
ENTAMOEB HIST GRP AG IA /SO | LAB | 40.85 |
CLOTTING FACTOR VIII AHG 1 STAGE /SO | LAB | 60.90 |
CLOTTING FACTOR VIII VW FACTOR ANTGN /SO | LAB | 78.10 |
CLOTTING FACTR VIII VW MULTIMETRIC /SO | LAB | 78.10 |
BLOOD CLOTTING FACTOR X /SO | LAB | 73.10 |
Factor inhibitor test | LAB | 33.80 |
FIBRIN DEGRADATION PRODUCTS /SO | LAB | 24.30 |
RBC SICKLE CELL TEST /SO | LAB | 18.80 |
ALLERGEN SPEC IGG QUAN/SEMIQUAN EA /SO | LAB | 21.60 |
FLUORESCENT ANTIBODY SCREEN /SO | LAB | 41.10 |
IMMUNOFIXATION ELECTROPHORESIS SERUM /SO | LAB | 76.15 |
IMMUNODIFFUSION OUCHTERLONY S/O | LAB | 31.45 |
NK CELLS TOTAL CT /SO | LAB | 128.40 |
NEUTRALIZATION TEST VIRAL /SO | LAB | 57.55 |
PARTICLE AGGLUT ANTBDY SCRN / SO | LAB | 31.80 |
Aspergillus antibody screen S/O | LAB | 46.10 |
BACTERIUM ANTIBODY S/O | LAB | 39.45 |
SARS COV2 COV19 ANTIBODY IGG | LAB | 89.30 |
BLASTOMYCES ANTIBODY S/O | LAB | 39.55 |
BORDETELLA ANTIBODY S/O | LAB | 34.70 |
AB CANDIDA /SO | LAB | 40.85 |
ANTIBODY COCCIDIOIDES S/O | LAB | 35.30 |
AB COXIELLA BURNET II Q FEVER /SO | LAB | 41.90 |
CRYPTOCOCCUS ANTIBODY / SO | LAB | 44.10 |
GIARDIA LAMBLIA AB /SO | LAB | 50.10 |
HISTOPLASMA ANTIBODY S/O | LAB | 38.30 |
IgG ANTIBODY NOS /SO | LAB | 42.10 |
RICKETTSIA ANTIBODY /SO | LAB | 66.20 |
TOXOPLASMA ANTIBODY /SO | LAB | 48.95 |
TOXOPLASMA ANTIBODY IGM /SO | LAB | 49.05 |
Anti human globulin RBC titer | LAB | 14.30 |
Blood typing, RBC Ag not ABO/Rh ea. | LAB | 10.60 |
FSHD1 Southern Blot Test S/O | LAB | 721.50 |
BLOOD FUNGUS CULTURE S/O | LAB | 56.40 |
Culture, mycoplasma, any source S/O | LAB | 40.45 |
MACROSCOPIC EXAM PARASITE /SO | LAB | 14.50 |
PINWORM EXAM /SO | LAB | 14.50 |
VARICELLA ZOSTER AG IF /SO | LAB | 40.85 |
ANTIBODY DETECTION NOS IF /SO | LAB | 44.40 |
ASPERGILLUS AG IA S/O | LAB | 36.80 |
HISTOPLASMA CAPSUL AG IA / SO | LAB | 36.80 |
IADNA BARTONELLA AMP PROBE TECHNIQ /SO | LAB | 119.40 |
HCV RNA QUAL /SO | LAB | 119.40 |
VANCOMYCIN In-House | LAB | 83.00 |
DRUG SCREEN V /SO | LAB | 289.90 |
TPMT GENE ANALYSIS COM VARIANTS S/O | LAB | 458.90 |
SNRPN METHYLATION GENE ANALYSIS S/O | LAB | 140.80 |
CELL COUNT (BODY FLUID) /SO | LAB | 18.80 |
HEP B CORE ANTI IGM /SO | LAB | 40.10 |
HEP B SURFACE ANTIB /SO | LAB | 36.55 |
HEPATITIS C ANTIBODY /SO | LAB | 48.50 |
CALCIUM /SO | LAB | 71.95 |
LEVETIRACETAM DRUG SCREEN /SO | LAB | 52.30 |
C. DIFF TOXIN, EIA/SO | LAB | 40.85 |
PCR AG DETECT NOS IIA MULT /SO | LAB | 40.85 |
BLOOD SMEAR INTERPRETATION /SO | LAB | 70.50 |
CBC W/AUTO DIFF | LAB | 179.80 |
CYTOPATH C/V THIN LAYER /SO | LAB | 68.95 |
UA AUTO WO/MICRO | LAB | 126.50 |
CYTOPATH C/V THIN LAYER RESCREEN /SO | LAB | 90.15 |
CRYSTALS- SYNOVIAL FLUI /SO | LAB | 24.40 |
CBC W/MANUAL DIFF | LAB | 127.75 |
ESR | LAB | 80.65 |
HEMATOCRIT | LAB | 73.20 |
HEMOGLOBIN | LAB | 83.10 |
CBC W/O DIFFERENTIAL | LAB | 142.60 |
P.T.T | LAB | 215.60 |
PTT S/O | LAB | 15.80 |
PLATELET CT SEPARATE PROC | LAB | 215.60 |
RBC AUTOMATED /SO | LAB | 10.30 |
PREGNANCY TEST URINE | LAB | 104.10 |
PROTIME W/INR /SO | LAB | 189.65 |
PROTHROMBIN TIME | LAB | 189.65 |
IMMUNODIFFUSION NES /SO | LAB | 47.80 |
IMMUNFIX ELEC SERUM /SO | LAB | 82.50 |
IMMUNOFIXATN ELEC URIN /SO | LAB | 99.90 |
URINE, DIP STICK W/MICRO, NON-AUTO | LAB | 68.20 |
RETICULOCYTE/SO | LAB | 203.20 |
SEMEN ANALYSIS POST /SO | LAB | 41.10 |
CYSTIC FIBROSIS SCREEN /SO | LAB | 1,534.20 |
UA W/ MICROSCOPIC | LAB | 147.55 |
HEPATITIS C BY RIBA /SO | LAB | 52.70 |
STREPTOCOCCUS PNEUMONIAE IgG AB /SO | LAB | 51.05 |
CULTURE, BLOOD /SO | LAB | 35.10 |
ESTRADIOL (E2) /SO | LAB | 95.05 |
CHLAMYDIA DNA,SDA /SO | LAB | 119.40 |
CULTURE-FUNGUS /SO | LAB | 28.60 |
DNA ANTIBODY SINGLE STRAND /SO | LAB | 41.20 |
GC DNA,SDA /SO | LAB | 119.40 |
PROTEIN C INHIBIT /SO | LAB | 47.10 |
HERPES CULTURE /SO | LAB | 51.35 |
HERPES SIMP QUANT DNA OR RNA | LAB | 125.00 |
TISSUE KOH FOR FUNGI /SO | LAB | 47.15 |
KOH PREP WET MOUNT FUNGUS | LAB | 47.15 |
PROTHROMBIN GENE /SO | LAB | 181.00 |
CYSTATIN C /SO | LAB | 51.05 |
ASSAY OF LDH ENZYMES /SO | LAB | 43.60 |
JAK2 GENE /SO | LAB | 318.50 |
FACTOR V LEIDEN /SO | LAB | 208.00 |
BLOOD OCCULT FECAL HGB IA QUAL 1-3 /S0 | LAB | 62.75 |
ANTITHROMBIN III ANTIGEN /SO | LAB | 36.80 |
OCCULT BLOOD FECES | LAB | 41.10 |
PROTEIN S CLOT INHIBIT /SO | LAB | 52.20 |
OVA & PARASITES /SO | LAB | 30.25 |
BLOOD OCCULT FECAL HGB IA QUAL 1-3 | LAB | 62.75 |
RAPID STREP SCREEN | LAB | 182.20 |
MTHFR GENE ANALYSIS /SO | LAB | 180.10 |
SKIN TEST TUBERCULOSIS | LAB | 54.70 |
CULTURE URINE /SO | LAB | 27.50 |
WET MOUNT | LAB | 57.10 |
ACETOMINOPHEN | LAB | 410.10 |
ALBUMIN | LAB | 94.30 |
AMMONIA- BLOOD | LAB | 225.55 |
AMYLASE /SO | LAB | 195.90 |
AMYLASE | LAB | 195.90 |
VITAMIN B12 | LAB | 51.50 |
BILIRUBIN TOTAL | LAB | 93.05 |
BILIRUBIN- DIRECT | LAB | 95.45 |
CALCIUM- BLOOD | LAB | 71.95 |
CA 27.29 (BR27.29) /SO | LAB | 70.90 |
CEA /SO | LAB | 64.50 |
CHOLESTEROL- TOTAL | LAB | 49.60 |
CORTISOL TOTAL /SO | LAB | 55.45 |
CPK ISOENZYMES /SO | LAB | 169.75 |
CPK ISOENZYMES | LAB | 169.75 |
CPK /SO | LAB | 158.70 |
CPK | LAB | 158.70 |
CKMB - CREATINE KINASE MB FRACTION /SO | LAB | 39.30 |
CREATININE | LAB | 104.10 |
CREATININE/ URINE /SO | LAB | 19.60 |
CREATININE URINE | LAB | 19.60 |
DIGOXIN | LAB | 268.90 |
DRUG ASSAY CYCLOSPORINE /SO | LAB | 61.45 |
ELECTROLYTE PANEL | LAB | 140.20 |
ESTROGEN TOT /SO | LAB | 73.80 |
FERRITIN /SO | LAB | 46.40 |
FOLIC ACID /SO | LAB | 50.00 |
FSH /SO | LAB | 63.20 |
T3 FREE /SO | LAB | 57.65 |
GLUCOSE QUANT | LAB | 68.20 |
GLUCOSE TOL 3 SPECIMENS | LAB | 260.15 |
RAY'S MARKET DRUG SCREEN | LAB | 48.40 |
HCG, QUANTITATIVE | LAB | 57.35 |
IRON TOTAL /SO | LAB | 22.10 |
IRON TOTAL/IRON BIND /SO | LAB | 29.80 |
INSULIN /SO | LAB | 38.90 |
C PEPTIDE /SO | LAB | 70.90 |
T3 BY RIA /SO | LAB | 48.25 |
VARICELLA ZOSTER IGG /SO | LAB | 43.85 |
TETANUS ANTITOXID /SO | LAB | 51.15 |
LITHIUM /SO | LAB | 22.50 |
HEPATIC PANEL | LAB | 167.30 |
LUTEINIZING HORMONE(LH) /SO | LAB | 63.00 |
OSMOLALITY(SERUM) /SO | LAB | 22.50 |
OSMOLALITY (URINE) /SO | LAB | 23.20 |
PHOSPHATASE ALKALINE | LAB | 88.00 |
PHOSPHATE INORGANIC | LAB | 98.00 |
POTASSIUM | LAB | 98.00 |
PROGESTERONE /SO | LAB | 71.00 |
PROCALCITONIN (PCT) /SO | LAB | 91.20 |
PROLACTIN /SO | LAB | 65.95 |
PROTEIN TOTAL/ SERUM /SO | LAB | 15.55 |
PROTEIN ELECTRO SERUM /SO | LAB | 36.55 |
SALYCILATES | LAB | 247.75 |
SGOT | LAB | 42.20 |
SGPT | LAB | 47.15 |
STONE ANALYSIS /SO | LAB | 39.40 |
T4 /SO | LAB | 23.40 |
TEGRETOL- CARBAMAZEPHN /SO | LAB | 49.60 |
C REACTIVE PROTEIN /SO | LAB | 21.90 |
TESTOSTERONE TOTAL ADULT MALE /SO | LAB | 87.85 |
TESTOSTERONE TOTAL LC/MS/MS /SO | LAB | 87.85 |
PROTEIN TOTAL 24HR URIN /SO | LAB | 12.50 |
TRIGLYCERIDES | LAB | 65.80 |
UREA NITROGEN (BUN) QUANT | LAB | 88.00 |
DHEA SULFATE /SO | LAB | 75.70 |
HEPATITIS A ANTIB IGM /SO | LAB | 38.35 |
VMA /SO | LAB | 52.70 |
VALPROIC ACID /SO | LAB | 46.10 |
CA 125 /SO | LAB | 70.90 |
MICRO ALBUMIN /SO | LAB | 19.70 |
DRUG SCRN QUANT OXCARBAZEPIN /SO | LAB | 45.10 |
MICROALBUMIN URINE /SO | LAB | 19.70 |
ANTINUCLEAR ANTIBODY/SO | LAB | 41.20 |
ANA TITER /SO | LAB | 38.00 |
CROSS MATCH EACH UNIT | LAB | 532.70 |
DETECT DNA /SO | LAB | 145.75 |
HEPATITIS B SURF AG /SO | LAB | 35.10 |
DRUG SCREEN/MULTI DRG CLS | LAB | 289.90 |
HEPATITIS PANEL/SO | LAB | 161.30 |
HIV 1\2 AB SCREEN /SO | LAB | 46.60 |
HLA B27 /SO | LAB | 87.85 |
HIV-1&2, AG & ANTIBODY /SO | LAB | 81.90 |
LYME DISEASE ANTIBODY /SO | LAB | 58.00 |
LYME DISEAS ANTIBDY IGM /SO | LAB | 52.70 |
LEAD BLOOD /SO | LAB | 41.20 |
MONONUCLEOSIS TEST | LAB | 105.50 |
PTH /SO | LAB | 140.50 |
PREGNANCY TEST SERUM QUAL | LAB | 152.50 |
H. PYLORI AB /SO | LAB | 51.35 |
GIARDIA ANTIGEN /SO | LAB | 40.85 |
RUBELLA /SO | LAB | 48.95 |
RHEUMATOID FACTOR /SO | LAB | 19.30 |
RPR /SO | LAB | 14.50 |
MYELIN BASIC PROTEIN CSF ANALYSIS /SO | LAB | 58.60 |
OLIGOCLONAL IMMUNE BANDS /SO | LAB | 75.50 |
PROTEIN E-PHORESIS/URINE/CSF /SO | LAB | 60.70 |
HEP C RNA QUANT /SO | LAB | 145.75 |
THYROGLOBULIN AB /SO | LAB | 54.20 |
AFP /SO | LAB | 57.10 |
DIRECT ANTIGLOBULIN TEST /SO | LAB | 18.30 |
PSA FREE RATIO /SO | LAB | 62.60 |
HEP C GENOTYPE LIPA /SO | LAB | 876.10 |
EHRLICA CANIS AB /SO | LAB | 41.10 |
MALARIA SMEAR /SO | LAB | 20.40 |
HOMOCYSTINE TOTAL /SO | LAB | 57.45 |
FLOW CYTOMETRY INTERP 16/> MARKERS /SO | LAB | 245.10 |
GASES-PH PCO2 PO2 & SAT | LAB | 724.70 |
METANEPHRINES TOTAL /SO | LAB | 57.65 |
COMPREHENSIVE METAB PANEL | LAB | 235.40 |
BASIC METABOLIC PANEL | LAB | 198.25 |
DILANTIN (PHENYTOIN) | LAB | 268.90 |
PHENOBARBITAL /SO | LAB | 42.20 |
ASO TITER /SO | LAB | 24.85 |
ARTERIAL PUNC/BLOOD WTHDR | LAB | 93.05 |
VENIPUNCTURE | LAB | 42.20 |
CHP BLOOD DRAW | LAB | 38.65 |
CENTRAL LINE BLOOD DRAW | LAB | 39.80 |
GLUCOSE POST GLUCOSE DOSE | LAB | 71.95 |
T CELLS CD4&CD8 ABSOLUTE COUNT S/O | LAB | 123.30 |
T CELLS TOTAL COUNT S/O | LAB | 99.00 |
T LYMPHOCYTE CD4 /SO | LAB | 91.15 |
GGT /SO | LAB | 24.50 |
URIC ACID /SO | LAB | 15.40 |
CREATININE CLEARANCE 24 /SO | LAB | 32.15 |
BCR/ABL1 GENE MAJOR BP S/O | LAB | 430.40 |
BCR/ABL1 GENE MINOR BP S/O | LAB | 380.20 |
THYROID PEROXIDASE AB /SO | LAB | 49.50 |
CULTURE AEROBIC /SO | LAB | 29.35 |
AMMONIA /SO | LAB | 225.55 |
TESTOSTERONE FREE /SO | LAB | 86.70 |
HCV RNA QUANT R-T PCR /SO | LAB | 145.75 |
TACROLIMUS /SO | LAB | 46.75 |
CULTURE STOOL /SO | LAB | 32.15 |
CULTURE THROAT /SO | LAB | 29.35 |
DRUG TEST DEF 1-7 CLASSES /SO | LAB | 315.40 |
T3 UPTAKE /SO | LAB | 22.00 |
Semen Count Not Billable /SO | LAB | 0.00 |
HEPATIC PANEL /SO | LAB | 167.30 |
MAMM DX UNILATERAL | MAMM | 363.85 |
MAMMOGRAPHY SCREENING BILAT W/CAD | MAMM | 367.40 |
IMMUN ADMIN 1ST EA COMBO | MM | 122.75 |
BANDG- ACE ELASTIC 4" | MM | 36.10 |
BANDG- ACE ELASTIC 3" | MM | 26.10 |
BANDG- ACE ELASTIC 6" | MM | 26.10 |
SOL- IV, D5, 1000ML | MM | 43.00 |
SOL- IV, 3% NACL, 500ML | MM | 43.00 |
SOL- IV, D5, 500ML | MM | 42.00 |
SOL- IV, D5, 100ML | MM | 36.00 |
SOL- IV, 9% NACL, 1000ML | MM | 47.00 |
SOL- IV, 9% NACL, 500ML | MM | 43.00 |
SOL- IV, 9% NACL, 100ML | MM | 37.00 |
SOL-IV, 45% NACL, 1000ML | MM | 47.00 |
SOL- IV, 9% NACL, 250ML | MM | 33.00 |
SOL-IV, D5,.45NACL 1000ML | MM | 45.00 |
SOL-IV,D5/.9NACL EA 1L | MM | 44.00 |
SOL-IV, LR, 1000ML | MM | 44.00 |
SOL-IV, D5, LR, 1000ML | MM | 14.00 |
SALINE SOL 10CC FOR MDI | MM | 13.70 |
CATH-FOLEY, 18FR, 05CC | MM | 80.65 |
CATH-FOLEY, 16FR, 05CC | MM | 80.65 |
CATH FOLEY 14F 05CC | MM | 80.65 |
CATH-FOLEY, 8FR, 03CC | MM | 80.65 |
CATH-FOLEY, 12FR, 05CC | MM | 80.65 |
DERMADOND | MM | 55.15 |
PLEUR- EVAC | MM | 805.15 |
CRUTCH- ADULT TALL | MM | 197.10 |
CRUTCH- ADULT | MM | 197.10 |
CRUTCH- YOUTH | MM | 197.10 |
SANDAL-CAST LARGE | MM | 106.65 |
SANDAL- CAST MEDIUM | MM | 106.65 |
SANDAL-CAST SMALL | MM | 106.65 |
CAST- FIBERGLASS 4" | MM | 66.95 |
BANDG-TUBULAR GZ SZ2 /YD | MM | 5.05 |
BANDG-TUBULAR GZ SZ 1/YD | MM | 11.25 |
SANDL-CAST X-LARGE | MM | 106.65 |
BAG- FOLEY 2000ML | MM | 37.20 |
CATH- FEMALE KIT | MM | 37.20 |
BAG-LEG URINARY | MM | 59.55 |
STRAP-CATH LEG | MM | 98.00 |
SPLINT-CRDBD/FOAM 12" | MM | 13.70 |
SPLINT-CLAVICLE SMALL | MM | 30.90 |
SPLINT-CLAVICLE LARGE | MM | 30.90 |
SPLINT-CLAVICLE X-LARGE | MM | 30.90 |
SPLINT-COLLES LG LEFT | MM | 55.90 |
SPLNT-COLLES LG RIGHT | MM | 99.10 |
SPLNT-COLLES SM LEFT | MM | 99.10 |
SPLNT-COLLES SM RIGHT | MM | 99.10 |
SPLNT-COLLES WRIST | MM | 99.10 |
SPLNT-COLLES MED LEFT | MM | 99.10 |
RIB BELT UNIVERSAL | MM | 26.50 |
BRACE-WRIST UNIV RIGHT | MM | 109.10 |
BRACE-WRIST UNIV LEFT | MM | 109.10 |
SPLINT-FINGER PLAIN 4.25 | MM | 11.25 |
BANDG-ROLL GAUZE 4" STL | MM | 22.40 |
BANDG-ROLL GAUZE 2" STL | MM | 8.70 |
BANDG-CONFORM 4" PER YARD | MM | 11.25 |
BANDG-CONFORM 3" PER YARD | MM | 11.25 |
BANDG-CONFORM 2" PER YARD | MM | 11.25 |
SPONGE-GAUZE 4X4 TRAY | MM | 11.05 |
DRESS- TELFA 3"X8" | MM | 8.70 |
DRESS-TELFA 3X4 | MM | 22.40 |
DRESS- TELFA 2"X3" | MM | 8.70 |
DRESS- XSPAN SIZE 4/YD | MM | 8.70 |
DRESS- XEROFORM 1"X8" | MM | 10.00 |
DRESS- XEROFORM 5"X9" | MM | 16.20 |
DRESS-TRANSPARENT 2X3 | MM | 22.40 |
DRESS-NONADHERING 3"X16" | MM | 11.25 |
DRESS-NONADHERING 3"X3" | MM | 8.70 |
DRESS-NONADHEARING 3"X8" | MM | 13.70 |
DRESS-TRANS 10CMX14CM | MM | 16.20 |
PACKING- IODOFORM 1/4" | MM | 53.40 |
PACKING- PLAIN 1/2" | MM | 26.10 |
CATH- MALE EXTERNAL | MM | 8.70 |
SPLINT-ANKLE STIRRUP LARGE | MM | 214.50 |
BANDG-TUBULAR GZ SZ3/YD | MM | 13.70 |
STOCKINETTE | MM | 13.70 |
PLASTER SPLINT | MM | 28.60 |
PACKING | MM | 53.40 |
DRESSING-XPAND | MM | 8.70 |
DRESSING-TELFA | MM | 22.40 |
PADDING-CAST | MM | 20.00 |
BANGAGE-TUBULAR GZ | MM | 13.70 |
DRESSING-NONADHEARING | MM | 22.40 |
SANDAL-CAST | MM | 106.65 |
IMMOB-SHOULDER UNIV | MM | 73.20 |
SLING-ARM LARGE | MM | 66.95 |
RIB BELT FEMALE XL | MM | 30.90 |
SOL-IRRIGATION H2O STL 1L | MM | 30.00 |
SOL-IRRIGATION STL NACL1L | MM | 34.00 |
OCULAR IRRIG LENS MORGAN | MM | 194.50 |
DRESS-DUODERM 4X4 | MM | 64.50 |
DRESS-HYDROCOLLOID 3X3 | MM | 39.80 |
DRESS-DUODERM 6X6 | MM | 16.80 |
DRESSING- ALLEVYN LIFE 5 1/6 X 5 1/6 | MM | 31.50 |
DRESSING-ALLEVYN 5X5 | MM | 38.65 |
NACL FLUSH 10ML | MM | 6.60 |
ADHESIVE-SKIN | MM | 99.10 |
DRESS-MEPILEX SACRUM FOAM 9.2X9.2 | MM | 27.60 |
BRACE-ANKLE STIRRUP UNIV | MM | 50.50 |
FINGER SPLINT | MM | 8.05 |
ELECTRODE-ONESTEP PEDS | MM | 246.80 |
BIOPATCH DISK | MM | 50.80 |
SOL-IV D10W 250ML | MM | 44.00 |
BLANKET-BAIR HUGGER | MM | 38.65 |
DRESSING-SILICONE BORDERED FOAM 7.2X7.2 | MM | 31.50 |
QUICK TRACH 4.0 | MM | 215.05 |
QUICK TRACH PEDS 2.0 | MM | 215.05 |
COLLAR-CERVICAL SOFT MEDIUM | MM | 39.00 |
CAST ARM SHRT FBRGL >11YO | MM | 93.05 |
CAST LEG SHRT FBRGL >10YO | MM | 157.35 |
CAST LEG SHRT PLSTR >11YO | MM | 80.65 |
SPLINT ARM LONG FBRGL <11 | MM | 70.80 |
SPLINT ARM LONG FBRGL >11 | MM | 188.40 |
SPLINT ARM SHRT FBRGL <11 | MM | 104.10 |
SPLINT ARM SHRT FBRGL >11 | MM | 98.00 |
SPLINT LEG LONG FBRGL >11 | MM | 115.35 |
SPLINT LEG SHRT FBRGL <11 | MM | 126.50 |
SPLINT LEG SHRT FBRGL >11 | MM | 143.90 |
SPLINT LEG SHRT PLSTR >11 | MM | 41.10 |
PEDIALYTE | MM | 27.60 |
RIB BELT UNISEX L | MM | 38.65 |
RIB BELT MENS XL | MM | 38.65 |
DRESS-SILICONE FOAM 4X4 | MM | 24.70 |
DRESSING- HYDROPHILIC FOAM 4X4 | MM | 6.30 |
MEDIPORE TAPE 4" | MM | 44.10 |
TEGADERM 3.5 X 4.5 | MM | 21.00 |
TEGADERM 4X4 | MM | 7.80 |
COLLAR-CERVICAL SOFT LARGE | MM | 33.10 |
COLLAR-CERVICAL SOFT SM/LONG | MM | 39.00 |
CATH-FOLEY SILICONE COUDE TIP 14FR | MM | 80.65 |
ARM SLING LG | MM | 22.70 |
SLING-ARM MEDIUM | MM | 21.20 |
SLING CHILD | MM | 19.85 |
SOL-IRRIGATION NACL 500ML | MM | 34.00 |
TEGADERM DRESSING | MM | 17.75 |
WALKING BOOT LARGE | MM | 137.90 |
WALKING BOOT SMALL | MM | 137.90 |
WALKING BOOT MEDIUM | MM | 137.90 |
MEDIPORE TAPE 2" | MM | 32.05 |
DRESS-HYDROCOLLOID 4X4 | MM | 21.00 |
DRESS-HYDROCOLLOID 8X8 | MM | 30.90 |
KNEE ORTHO PRE FAB OTS W JOINTS SM | MM | 273.00 |
KNEE ORTHO PRE FAB OTS W JOINTS LG | MM | 273.00 |
KNEE ORTHO PRE FAB OTS W JOINTS MED | MM | 273.00 |
KNEE ORTHO PRE FAB OTS W JOINTS XL | MM | 273.00 |
KO IMMOB CANVAS LONG PREFAB OFFSHELF | MM | 273.00 |
U SHAPED CALLUS CUSHION | MM | 13.80 |
SEMI PVT BED ACUITY LVL 1 | NUR | 3,247.80 |
SEMI PVT BED ACUITY LVL 2 | NUR | 4,871.65 |
OBS BED CHARGE PER HOUR | OBS | 215.60 |
E/M NEW PT LIMITED | OPMD | 171.05 |
E/M NEW PT EXPANDED | OPMD | 213.20 |
E/M NEW PT DETAILED | OPMD | 277.50 |
E/M NEW PT COMP/MOD | OPMD | 396.45 |
E/M NEW PT COMP/COMPLEX | OPMD | 535.20 |
E/M EST PT LIMITED | OPMD | 116.50 |
E/M EST PT EXPANDED | OPMD | 149.95 |
E/M EST PT DETAILED | OPMD | 216.90 |
E/M EST PT COMPREHNS | OPMD | 346.90 |
Covid Vacc Adm 1st dose Pfizer age 12+ | OPPR | 40.00 |
Covid Vacc Adm 2nd dose Pfizer age 12+ | OPPR | 40.00 |
ECG-12 LEADS TRACING ONLY | OPPR | 723.50 |
ECG-1-3 LEAD TRACING ONLY | OPPR | 36.10 |
Covid Vacc Adm 3rd dose Pfizer age 12+ | OPPR | 40.00 |
Covid Vacc Adm booster Pfizer age 12+ | OPPR | 40.00 |
Covid Vacc Adm 1st dose Pfizer age 5-11 | OPPR | 40.00 |
Covid Vacc Adm 2nd dose Pfizer age 5-11 | OPPR | 40.00 |
IV PUSH-SNGL OR INTL DRUG | OPPR | 233.00 |
E/M HBC NURSE ONLY | OPPR | 386.60 |
E/M HBC FOCUSED-MINOR | OPPR | 280.05 |
E/M HBC EXPANDED-MODERATE | OPPR | 267.70 |
E/M HBC DETAILED-MODERATE | OPPR | 239.20 |
SKIN SUB GRAFT TRNK/ARM/LEG | OPPR | 4,287.00 |
I&D ABSCESS SIMPLE/SINGLE | OPPR | 379.20 |
STRAPPING UNNA BOOT | OPPR | 360.00 |
SKIN FULL GRFT FACE/GEN/HF | OPPR | 4,266.70 |
INFUSION/HYDRATE <1HOUR | OPPR | 698.70 |
INFUSION THER/DX <1 HOUR | OPPR | 645.45 |
INFUSION THER/DX >1HR-8HR | OPPR | 474.50 |
INFUSION/HYDRATE >1 HR | OPPR | 140.20 |
THORACENTESIS | OPPR | 1,071.55 |
IMMUN ADMIN 1ST EA/COMBO | OPPR | 104.10 |
IMMUN ADMIN ADDL EA/COMBO | OPPR | 39.80 |
TRANSFUSE BLOOD/BLD PROD | OPPR | 2,238.30 |
INJ THER/PROP/DX SQ/IM | OPPR | 241.60 |
TUMS ANTACID | PHAR | 0.00 |
POLYETHYLENE GLYCOL | PHAR | 34.00 |
PREDNISOLONE 1% 10 ML | PHAR | 188.00 |
SHINGRIX VACCINE INJ | PHAR | 234.00 |
PEDIARIX | PHAR | 168.00 |
VFC-PEDIARIX | PHAR | 0.00 |
DTAP/HEP B/IPV | PHAR | 169.00 |
VFC- INFANRIX PED | PHAR | 0.00 |
REMDESIVIR 100 MG PWVL | PHAR | 950.00 |
Humulin R IVPB | PHAR | 23.00 |
KEDRAB | PHAR | 750.00 |
IMOVAX | PHAR | 701.00 |
VISIPAQUE CT CONTRAST ZERO CHARGE 340B | PHAR | 0.00 |
OMNIPAQUE CT CONTRAST ZERO CHARGE 340B | PHAR | 0.00 |
Magnesium Sulfate 1 GM/ 2 ml IM/ IVP | PHAR | 18.00 |
MAGNESIUM 1 GM/ 2 ML IVPB | PHAR | 26.00 |
CALCIUM 500 MG TAB | PHAR | 4.00 |
ZINC OXIDE 20% | PHAR | 23.00 |
Ammonia Inhalants | PHAR | 10.00 |
AMIODARONE HCL 200MG TAB | PHAR | 9.00 |
LIDOCAINE 2% PREFILLED 100MG /5ML | PHAR | 36.00 |
GUAIFENESIN DM 5ML SUS | PHAR | 9.00 |
ISENTRESS | PHAR | 90.00 |
RABAVERT | PHAR | 650.00 |
LABETALOL HCL 5MG INJ | PHAR | 100.00 |
XYLOCAINE VISC BOTTLE | PHAR | 32.10 |
CALCIUM GLUC PER 10ML INJ | PHAR | 68.00 |
MAGNESIUM 300MG TAB | PHAR | 4.30 |
ACETAZOLAMIDE 500 MG PWVL | PHAR | 150.00 |
Sodium Bicarbonate Drip | PHAR | 80.00 |
BELBUCA | PHAR | 33.00 |
BENZTROPINE 1MG/ML | PHAR | 99.00 |
LOSARTAN 25 MG | PHAR | 3.00 |
NEUPOGEN 300MCG | PHAR | 574.00 |
ACETAMINOPHEM 120MG SUPP | PHAR | 9.00 |
ERYTHROMYCIN SULF 2-600MG | PHAR | 83.50 |
METOPROLOL <5MG IV | PHAR | 30.00 |
WARFARIN 5MG | PHAR | 5.25 |
TRUVADA | PHAR | 10.00 |
CEFOTETAN IVPB 2 GM | PHAR | 97.00 |
CEFOTETAN IM 2 GM | PHAR | 89.00 |
NEULASTA 6MG INJ | PHAR | 4,983.00 |
LEVAQUIN PER 250MG IV | PHAR | 17.00 |
PHAR | 17.00 | |
HEPATITIS B IMMUNE GLOBULIN 1ML | PHAR | 250.00 |
HEPATITIS B IMMUNE GLOBULIN 5ML | PHAR | 813.43 |
XOPENEX UD INHL | PHAR | 36.00 |
PROTONIX 40MG IV | PHAR | 39.00 |
ZOSYN 1G/0.125G 1.125 IV | PHAR | 77.00 |
FLUCONAZOLE 100 MG | PHAR | 12.00 |
PEN G 5 MILLION | PHAR | 84.00 |
ONDANSETRON HCL IV PER MG | PHAR | 15.00 |
ONDANSETRON HCL TAB 4MG | PHAR | 5.00 |
XARELTO TAB 15 MG | PHAR | 65.00 |
IRON SUCROSE 200MG | PHAR | 0.80 |
ZOLEDRONIC EA 5MG INJ | PHAR | 144.00 |
TRAMADOL 50MG | PHAR | 13.00 |
PIPERACILLIN IVPB 3.375 GM | PHAR | 40.00 |
AMIODARONE HCL 30MG INJ | PHAR | 4.30 |
ACETAMINOPHEN 300MG SUPP | PHAR | 7.50 |
PSEUDOEPHEDRN HCL/ACTF TB | PHAR | 4.30 |
EPINEPHRINE 1ML INJ 1:1K | PHAR | 97.00 |
EPINEPHRINE IM 1 MG/ML | PHAR | 77.00 |
ALBUTEROL INHALER | PHAR | 109.00 |
PROAIR | PHAR | 195.00 |
HYPERRAB | PHAR | 960.00 |
HYPERRAB 3ML | PHAR | 2,857.00 |
ALCAINE O/S 4 DROPS | PHAR | 14.00 |
SPIRONOLCTN/ADLACTONE TB | PHAR | 5.00 |
ActHIB | PHAR | 54.00 |
AMOXICILLIN 250MG CAP | PHAR | 5.00 |
AMOXICILIN 125MG/5CC SUS | PHAR | 28.00 |
AMOXICILLIN 250MG/5CC SUS | PHAR | 33.00 |
AMOXICILLIN 500MG CAP | PHAR | 8.00 |
MOXIFLOXACIN 0.5% | PHAR | 117.00 |
AMPICILLIN IVPB 2 GM | PHAR | 35.00 |
AMPICILLIN IM/IVP 2 GM | PHAR | 27.00 |
AMPICILLIN SOD 1 GM IVP | PHAR | 43.00 |
PHAR | 43.00 | |
AMPICILLIN 1GM IM | PHAR | 43.00 |
Azithromycin 200m/5ml | PHAR | 143.00 |
AZITHROMYCIN 200/5 [30ML] | PHAR | 60.00 |
COVID-19 [ADULT] VACC PFIZER 1 DOSE | PHAR | 0.00 |
COVID-19 [ADULT] VACC PFIZER 2ND DOSE | PHAR | 0.00 |
COVID-19 [ADULT] VACC PFIZER 3RD DOSE | PHAR | 0.00 |
COVID-19 [PED] VACC PFIZER 1ST DOSE | PHAR | 0.00 |
COVID-19 [PED] VACC PFIZER 2ND DOSE | PHAR | 0.00 |
SUCCINYLCHNE 20MG INJ | PHAR | 100.00 |
CEPHALEXIN 250MG/100ML PO | PHAR | 97.00 |
CEPHALEXIN 250MG/5ML PO | PHAR | 3.30 |
ASA SUPPOSITOR 600 MG | PHAR | 17.00 |
ASCORBIC ACID | PHAR | 3.00 |
ASA 325MG TAB | PHAR | 4.30 |
LORAZEPAM/ATIVAN 1MG TAB | PHAR | 4.00 |
ATROPINE 0.1MG INJ | PHAR | 61.00 |
DIPHENHYDRMN HCL 25MG CAP | PHAR | 3.00 |
DIPHENHYDRAMIN 50MG | PHAR | 31.00 |
PHAR | 31.00 | |
DIPHENHYDRAMINE 12.5 MG/5ML | PHAR | 5.00 |
PEN G BENZ/LA 100,000 units | PHAR | 317.00 |
CALCIUM CHLR 10%<10ML INJ | PHAR | 61.00 |
CAPTOPRIL 25MG TAB | PHAR | 20.00 |
DILTIAZEM 5MG INJ IVP | PHAR | 36.00 |
DILTIAZEM HCL/CARD 30MG T | PHAR | 13.00 |
DILTIAZEM 5 MG/ML IVPB | PHAR | 42.00 |
CLONIDINE HCL/CAP .1MG TB | PHAR | 6.00 |
CLINDAMYCIN 300MG INJ | PHAR | 21.00 |
PHAR | 21.00 | |
CLINDAMYCN 600MG IVPB | PHAR | 16.00 |
CLINDAMYCIN IM 600 MG | PHAR | 32.00 |
DILAUDID 2MG TAB | PHAR | 4.30 |
Dicyclomine 20mg | PHAR | 7.00 |
MAGNESIUM OXIDE 400MG TABLET | PHAR | 13.00 |
BENZTROPINE 1 MG TAB | PHAR | 9.00 |
DOCUSATE SOD/COL 100MG TB | PHAR | 5.00 |
PROCHLORPERAZINE 10MG TAB | PHAR | 12.00 |
PROCHLORPRZN/COMPZ SUP 25 | PHAR | 64.00 |
PROCHLORPERAZINE <=10MG I | PHAR | 96.00 |
PROCHLORPERAZINE IM/IVP 5 MG/ML | PHAR | 96.00 |
EFFER-K 20 mEq | PHAR | 6.75 |
CORTISPORIN 1 SQUIRT | PHAR | 6.50 |
Crotalidae Crofab | PHAR | 5,772.00 |
DEXAMETH/DECRON 4 MG TAB | PHAR | 4.30 |
DEXAMTH <4MG/ML INJ | PHAR | 14.00 |
DEXAMETHASONE PER 1MG INJ | PHAR | 4.30 |
DEXAMETHASONE 10MG INJ | PHAR | 30.00 |
VALPROIC ACID/DEPKN 250MG | PHAR | 4.30 |
DEPO MEDROL 40MG INJ | PHAR | 71.00 |
DEPO MEDROL 20MG INJ | PHAR | 7.50 |
DEPO MEDROL 80MG INJ | PHAR | 96.00 |
MEDROXYPROGSTRNE 1 MG | PHAR | 205.00 |
TRAZODONE HCL 50MG | PHAR | 7.00 |
MEDROXYPROGESTERONE 5 mg | PHAR | 16.00 |
NITRO/D5W 50 MG/250ML | PHAR | 87.00 |
BUPRENORPHINE 2 MG | PHAR | 10.00 |
LINEZOLID 600 MG TAB | PHAR | 278.00 |
ASPIRIN 325 MG | PHAR | 5.00 |
DIGOXIN .125MG TAB | PHAR | 18.00 |
DIGOXIN .25MG TAB | PHAR | 21.00 |
DIGOXIN .5MG TAB | PHAR | 4.30 |
DIGOXIN <.5MG INJ | PHAR | 40.00 |
FOSPHENYTOIN SOD 100MG INJ | PHAR | 123.00 |
FOSPHENYOIN IM 50 PE/ML | PHAR | 115.00 |
PHENYTOIN SODIUM 100MG TB | PHAR | 10.00 |
HYDROMORPHONE HCL 0.5 MG/ML | PHAR | 33.00 |
HYDROMORPHONE 1MG/ML | PHAR | 37.00 |
HYDROMORPHONE 2MG/ML | PHAR | 31.00 |
FOSPHENYTOIN 100MG/10ML | PHAR | 55.00 |
DONNATAL ELIXIR 5CC | PHAR | 32.00 |
DOPAMINE 400MG INJ | PHAR | 86.00 |
DOXAZOSIN 4MG TAB | PHAR | 16.00 |
BISACODYL 10MG SUPP | PHAR | 6.00 |
BISACODYL TAB 5 MG | PHAR | 4.00 |
AMITRIPYLINE HCI | PHAR | 9.00 |
EPINEPHRINE 1-10000MINIJT | PHAR | 97.00 |
ERYTHROMYCIN OPTH OINT 4G | PHAR | 98.00 |
ERYTHROMYCIN 250MG TAB | PHAR | 69.00 |
FERROUS SULFT/FE SUF 325M | PHAR | 4.00 |
METRONIDAZOLE 500 MG | PHAR | 30.00 |
VFC- FLUMIST 2021-22 | PHAR | 0.00 |
FLUARIX QUAD 2021-2022 | PHAR | 98.00 |
FLU VACCINE INJ MEDICARE | PHAR | 0.00 |
FLU VACCINE HI DOSE INJ MDCR | PHAR | 0.00 |
FLU VACCINE INJ | PHAR | 90.00 |
FOLIC ACID 1MG TAB | PHAR | 5.00 |
FLU VACCINE CASH | PHAR | 25.00 |
PROVENTIL INHAL 5 MG | PHAR | 177.00 |
PROVENTIL 2.5 MG | PHAR | 11.00 |
BUDESONIDE 1 MG | PHAR | 22.00 |
GENTAMICIN SULF <80MG IM/IVP | PHAR | 17.00 |
GENTAMICIN SULF <80MG IVPB | PHAR | 17.00 |
GENTAMICIN SULF OPTH <5ML | PHAR | 90.00 |
GLUCAGON 1MG INJ | PHAR | 316.00 |
GLUCOTROL 10 MG | PHAR | 9.00 |
Glutose 15gms | PHAR | 31.00 |
HALOPERIDOL LACTAT<5MGINJ | PHAR | 20.00 |
HALDOL 2MG TAB | PHAR | 9.00 |
HEPARIN SOD PER 5000 INJ | PHAR | 29.00 |
HEPARIN 10000 UNITS | PHAR | 36.00 |
HEPATITUS B ADULT INJ | PHAR | 238.70 |
HCTZ 50MG TAB | PHAR | 4.30 |
Hydrocortisone Supp 25mg | PHAR | 94.00 |
INDERAL 10MG TAB | PHAR | 9.00 |
INDOCIN 25MG CAP | PHAR | 7.00 |
INSULIN N PER 5 UNITS | PHAR | 16.00 |
INSULIN R PER 5 UNITS | PHAR | 9.00 |
SODIUM POLY SULF 15GM SUS | PHAR | 99.00 |
KEFLEX 250MG/5CC 100CC LQ | PHAR | 94.00 |
KEFLEX 500MG TAB | PHAR | 15.00 |
CEFAZOLIN 1 GM IVPB | PHAR | 19.00 |
PHAR | 19.00 | |
CEFAZOLIN 1 GM IM | PHAR | 19.00 |
TRIAMCINOLONE /10MG INJ | PHAR | 64.00 |
LACTULOSE 15 ML SOL | PHAR | 11.00 |
FUROSEMIDE 40 MG TABLET | PHAR | 5.00 |
BUPRENORPHINE SUBL 8 MG | PHAR | 7.00 |
LASIX 40MG TAB | PHAR | 4.00 |
FUROSEMIDE <20MG IVPB | PHAR | 34.00 |
FUROSEMIDE <20MG IM/IVP | PHAR | 32.00 |
LIDOCAINE 50CC INJ | PHAR | 24.70 |
ATORVASTATIN 10 MG TAB | PHAR | 6.00 |
LOMOTIL 2.5MG TAB | PHAR | 12.00 |
METOPROLOL TARTRATE TAB | PHAR | 9.00 |
METOPROLOL ER | PHAR | 11.75 |
MAALOX 30CC LIQUID | PHAR | 7.00 |
MAGNESIUM SULF 500MG INJ | PHAR | 29.00 |
MAGNESIUM SULFATE IM/IVP 5 GM | PHAR | 20.00 |
MAG CITRATE 10 OZ LIQUID | PHAR | 11.80 |
BUPIVACAINE W/EPI 0.5% (10ML) | PHAR | 37.00 |
BUPIVICAINE .5% 1CC INJ | PHAR | 94.00 |
BUPIVACAINE INJ 0.5 % | PHAR | 26.00 |
MILK OF MAGNESA 30ML LQUD | PHAR | 22.00 |
PIPERACILLIN/TAZOBACTAM 2.25 MG IVPB | PHAR | 40.00 |
EPINEPHRINE .4 UD INH SOL | PHAR | 13.00 |
MORPHINE SULFATE IVPB 4 MG | PHAR | 32.00 |
MORPHINE SULFATE IM/IVP 4MG/ML | PHAR | 33.00 |
MORPHINE SULFATE IM/IVP 10 MG/ML | PHAR | 33.00 |
MORPHINE SULFATE IVPB 10 MG/ML | PHAR | 33.00 |
MORPHINE SULFATE SOL 20MG/5ML | PHAR | 91.00 |
MMR VACCINE | PHAR | 205.00 |
IBUPROFEN 200MG TAB | PHAR | 5.00 |
IBUPROFEN 600MG TAB | PHAR | 6.00 |
MULTIVITAMIN CONCRTE INJ | PHAR | 121.00 |
MYLANTA <30CC | PHAR | 5.00 |
NAPROSYN 250MG TAB | PHAR | 11.00 |
NALOXONE 1 MG IVPB | PHAR | 166.00 |
NEOSPORIN 1/32 OZ TOPICAL | PHAR | 4.30 |
NEOSPORIN OPTH SOL | PHAR | 147.00 |
NICARDIPINE IVP 25 MG / 10 ml | PHAR | 75.00 |
NITROGLYCERIN 50MG INJ | PHAR | 49.30 |
NITROGLYCERIN TAB | PHAR | 4.30 |
NITROGLYCERIN 2% OINTMENT | PHAR | 25.00 |
ORPHENADRINE CIT<=60MG IN | PHAR | 96.00 |
OPHTHAINE OPHTHALMIC 15ML | PHAR | 135.00 |
PEN VK 250MG/5CC 100ML | PHAR | 54.00 |
PEN VK 500MG TAB | PHAR | 13.00 |
PEN VK 250MG | PHAR | 5.00 |
PERCOCET -5 TAB | PHAR | 15.00 |
PERMETHRIN 5% CREAM | PHAR | 45.00 |
PHENERGAN 25MG SUPPOSITOR | PHAR | 12.90 |
PHENERGAN 25MG TAB | PHAR | 4.30 |
POLY B/SULF/TRI | PHAR | 46.00 |
LIDOCAINE 5% PATCH | PHAR | 18.00 |
POTASSIUM CL 10MEQ TAB | PHAR | 9.00 |
POTASSIUM CL EA 2 MEQ INJ | PHAR | 38.00 |
PREDNISONE 20MG TAB | PHAR | 6.00 |
POTASSIUM CHLORIDE IVPB 10 MEQ PREMIX | PHAR | 40.00 |
PREDNISONE 10MG TAB | PHAR | 4.30 |
PREDNISONE 5MG TAB | PHAR | 5.00 |
FLU ZONE (HIGH DOSE) | PHAR | 140.00 |
LIDOCAINE 2% (SYRING) | PHAR | 16.00 |
GENTAMICIN 0.3% OPTH OINNT | PHAR | 145.00 |
ISOSORBIDE 10MG | PHAR | 10.00 |
LIDOCAINE/EPI 2% | PHAR | 35.00 |
VERAPAMIL 80MG | PHAR | 9.00 |
PROTAMINE SULFATE 250MG/25ML | PHAR | 140.00 |
CEFTAZIDIME 1GM IVPB | PHAR | 41.00 |
KENALOG 0.1% CREAM | PHAR | 32.00 |
CEFTAZIDIME 1 GM IM | PHAR | 33.00 |
PROCARDIA 30MG TAB | PHAR | 12.00 |
LEVOTHYROXINE 100MG | PHAR | 18.00 |
SUDOGEST | PHAR | 4.00 |
PROPRANOLOL 10MG | PHAR | 7.00 |
PROMETHAZINE TAB 25 MG | PHAR | 13.00 |
PREDNISOLONE 1% | PHAR | 169.00 |
PROMETHAZINE HCL<50MG IVPB | PHAR | 25.00 |
PILOCARPINE 1% | PHAR | 200.00 |
VECURONIUM BROMIDE IV | PHAR | 56.80 |
NORVASC 5MG TAB | PHAR | 18.00 |
PHYSOSTGMINE | PHAR | 195.00 |
ALBUTERAL/IPRATROPIUM NEB | PHAR | 21.00 |
SODIUM BICARBONATE 8.4% | PHAR | 72.00 |
PENICILLIN VK 250MG | PHAR | 10.00 |
AFRIN | PHAR | 29.00 |
DOXYCYCLINE 100MG | PHAR | 101.00 |
LITHIUM 300MG | PHAR | 15.00 |
BENAZEPRIL 5MG | PHAR | 3.50 |
METFROMIN 500MG | PHAR | 4.00 |
METOCLOPRAMIDE 5MG | PHAR | 6.00 |
PYRIDIUM 100MG TAB | PHAR | 4.30 |
PYRIDIUM 200MG TAB | PHAR | 22.00 |
HYDROcodone/Apap 10/325 | PHAR | 20.00 |
ALBUTEROL UD / MG INH SOL | PHAR | 21.00 |
OFLOXAXIN | PHAR | 274.00 |
NEXPLANON | PHAR | 1,770.00 |
NYSTATIN CREAM | PHAR | 90.00 |
NICOTINE PATCH 21MG | PHAR | 20.00 |
NAFCILIIN | PHAR | 80.00 |
MANNITOL | PHAR | 29.00 |
MAGNESIUM CITRATE | PHAR | 14.00 |
REGLAN 10MG TAB | PHAR | 4.30 |
HEPARIN 5,000 | PHAR | 29.00 |
METOCLOPRAMIDE <=10MG INJ | PHAR | 20.00 |
POTASSIUM CL 20 MEQ | PHAR | 3.00 |
LIDOCAINE W/D5W | PHAR | 50.00 |
PITOCIN | PHAR | 17.00 |
POTASSIUM CHLORIDE ORAL SOLUTION 20MEQ | PHAR | 15.00 |
RESTORIL 15MG TAB | PHAR | 10.00 |
PEN VK SUSP 125MG | PHAR | 49.00 |
PERMETHRIN CREAM | PHAR | 250.00 |
ETOMIDATE 2MG >10ML | PHAR | 45.00 |
PROMTHAZINE SUPP 25MG | PHAR | 92.00 |
RhoGam | PHAR | 260.00 |
SODIUM BICARB 4.2 | PHAR | 45.00 |
BACTERIOSTATIC H20 | PHAR | 18.00 |
BACTERIOSTATIC SODIUM CHLORIDE | PHAR | 8.00 |
GUAIFENESIN AC 5ML SUS | PHAR | 3.00 |
GUAIFENESIN AC 30ML SUS | PHAR | 9.70 |
SULF/TRIM 800/160MG TAB | PHAR | 7.00 |
SULF/TRIM 200/40MG/5MLSUS | PHAR | 30.00 |
Simethicone 80mg tablet | PHAR | 4.00 |
SILVADENE 1%<50GM TOPICAL | PHAR | 65.00 |
SODIUM BICARB 4% | PHAR | 53.00 |
POTASSIUM CHLORIDE 40 MeQ PER 20 ML | PHAR | 15.00 |
LIDOCAINE 2% 20 ML | PHAR | 17.00 |
SULFACETAMD SOD 10% | PHAR | 186.00 |
SOLU-CORTEF 100 MG IVPB | PHAR | 76.00 |
SOLU-CORTEF 100 MG IM/IVP | PHAR | 76.00 |
SOLU-MEDROL <=40MG INJ | PHAR | 69.60 |
SOLU-MEDROL <=125MG INJ | PHAR | 61.00 |
POTASSIUM CHLORIDE 40 mEq/20ml | PHAR | 40.00 |
DOXYCYCLINE 100MG TAB | PHAR | 22.00 |
CIMETIDINE 300MG INJ | PHAR | 28.90 |
TEGRETOL 200MG TAB | PHAR | 13.00 |
ATENOLOL 50MG TAB | PHAR | 12.00 |
TAMSULOSIN 0.4MG | PHAR | 28.00 |
TD VACC PRSV FREE 7 YRS & OLDER | PHAR | 137.00 |
DIPTHERIA & TETNS TXD INJ >7 PRESERV FRE | PHAR | 151.00 |
TDAP VACCINE | PHAR | 163.00 |
OLANZAPINE 5 MG | PHAR | 6.00 |
MULTI VIT TAB | PHAR | 3.00 |
CHLORPROMAZINE 50 MG | PHAR | 146.00 |
THYROID 60MG TAB | PHAR | 4.30 |
CLINDAMYCIN 150MG PO | PHAR | 10.00 |
TYLENOL 325MG TAB | PHAR | 4.00 |
TYLENOL 650MG TAB | PHAR | 4.30 |
TYLENOL 5CC LIQUID | PHAR | 16.00 |
TYLENOL W/CODEINE 30MG TB | PHAR | 7.00 |
VALIUM 5MG TAB | PHAR | 5.40 |
CEFTRIAXONE SOD 250MG | PHAR | 82.00 |
PHYTONADIONE IM 1 MG/0.5ML | PHAR | 59.00 |
VITAMIN K PER MG INJ | PHAR | 33.00 |
DIAZEPAM TAB 10 MG | PHAR | 11.00 |
VANCOMYCIN 1GM | PHAR | 112.00 |
VANCOMYCIN IVPB 250-1000 MG | PHAR | 43.00 |
MIDAZOLAM 50MG/10 ml IVPB | PHAR | 41.00 |
MIDAZOLAM IM/IVP 5 MG | PHAR | 19.00 |
MIDAZOLAM IM/IVP 1 MG | PHAR | 17.00 |
VICODIN PO | PHAR | 4.30 |
THIAMINE 100MG INJ | PHAR | 49.00 |
XYLOCAINE 1% 1CC INJ | PHAR | 27.00 |
LIDOCAINE /EPI 1 % (50 mL) MDV | PHAR | 4.00 |
XYLOCAINE 1% W/EPI | PHAR | 19.00 |
NITROGLYCERIN | PHAR | 12.00 |
XYLOCAINE 2% 10mL INJ | PHAR | 35.00 |
XYLOCAINE 2% W/EPI 1CC IN | PHAR | 0.00 |
XYLOCAINE/W EPI 1% | PHAR | 34.00 |
XYLOCAINE VISC | PHAR | 13.00 |
XYLOCAINE JELLY 30GM | PHAR | 20.40 |
XYLOCAINE JELLY 1GM | PHAR | 14.00 |
CHARCOAL ACIVT 50GM 8OZ | PHAR | 98.00 |
CHARCOAL ACT WITH SORBITAL 50GM 8OZ | PHAR | 124.00 |
CORTISPORIN OINTMENT 15GM | PHAR | 283.00 |
CIPROFLOXACIN 500MG TAB | PHAR | 6.00 |
BACITRACIN TOPICAL | PHAR | 29.00 |
IMODIUM 2MG TAB | PHAR | 6.00 |
KETOROLAC TROMTH 15MG INJ | PHAR | 49.00 |
AUGMENTIN 500MG TAB | PHAR | 29.00 |
OTIC SOL/AURALGAN GTTS | PHAR | 19.00 |
AUGMENTIN 250MG SUSP | PHAR | 220.00 |
AUGMENTIN 250/5 [100ML] | PHAR | 160.00 |
MECLIZINE HCL 25MG TAB | PHAR | 12.00 |
PREDNISONE 5CC ELIX | PHAR | 11.00 |
PREDNISONE 30 CC ELIX | PHAR | 5.40 |
RANITIDINE HCL 50MG INJ | PHAR | 35.00 |
PHAR | 35.00 | |
LOTENSION 10MG TAB | PHAR | 12.00 |
RANITIDINE IM/IVP 25 MG | PHAR | 35.00 |
Naproxen 500mg | PHAR | 11.00 |
METRONIDAZOLE 500MG TAB | PHAR | 28.00 |
PRILOSEC 20MG TAB | PHAR | 11.80 |
ADENOSINE 6MG INJ | PHAR | 45.00 |
AZITHROMYCIN 250MG TAB | PHAR | 16.00 |
HEP A VACCINE | PHAR | 181.00 |
LORAZEPAM 1MG IVPB | PHAR | 23.00 |
LORAZEPAM IM/IVP 2 MG/ML | PHAR | 16.00 |
Levofloxacin 750mg/150 ml PREMIX | PHAR | 27.00 |
IBUPROFEN 100MG/ML 5ML | PHAR | 12.00 |
SUMATRIPTAN SUCC 6MG INJ | PHAR | 177.00 |
IPRATROPIUM BROMIDE UD | PHAR | 6.00 |
NYSTATIN CREAM 1M | PHAR | 24.70 |
FAMOTIDINE 20MG TAB | PHAR | 17.00 |
BACLOFEN 10MG TAB | PHAR | 8.00 |
GLUCOPHAGE 500MG TAB | PHAR | 5.40 |
MACROBID 100MG CAP | PHAR | 27.00 |
GABAPENTIN 300MG | PHAR | 5.00 |
GABAPENTIN 100 MG CAP | PHAR | 10.00 |
ASA 81MG TAB | PHAR | 4.00 |
MELATONIN | PHAR | 5.00 |
ACYCLOVIR 200MG CAP | PHAR | 17.00 |
KETAMINE 500MG INJ | PHAR | 50.00 |
KETAMINE 50 MG/ML IVPB | PHAR | 42.00 |
XOLAIR 225MG SQ | PHAR | 2,100.00 |
NITROFURANTOIN MONO/MACRO 100 MG CAP | PHAR | 30.00 |
PROPOFOL 10 ML INJ | PHAR | 31.00 |
PROPOFOL 100ML | PHAR | 73.00 |
PROPOFOL 50ML | PHAR | 65.00 |
PNEUMOCOCCAL VAC INJ | PHAR | 273.00 |
PNEUMO 23 VACCINE INJ MEDICARE | PHAR | 0.00 |
FENTANYL CIT <100MCG INJ | PHAR | 357.00 |
PHAR | 357.00 | |
PNEUMO 13 VACC INJ MEDICARE | PHAR | 0.00 |
AZITHROMYCIN 500MG IV | PHAR | 94.00 |
VANCOMYCIN 1.5 GM | PHAR | 165.00 |
PARAGUARD IUD | PHAR | 125.00 |
LISINOPRIL 5MG TAB | PHAR | 12.00 |
LISINOPRIL 10MG TAB | PHAR | 4.30 |
GEODON 20MG | PHAR | 204.00 |
HEPATITUS B CHILD INJ | PHAR | 129.00 |
PROLIA 60 MG INJ | PHAR | 2,453.00 |
SKYLA 13.5 MG | PHAR | 1,501.00 |
PARAGARD | PHAR | 1,595.00 |
MEROPENEM 100 MG IV | PHAR | 81.00 |
MEROPENEM IVP 500 MG | PHAR | 42.00 |
PULMICORT/BUDESONIDE NEB | PHAR | 312.50 |
SPIRIVA | PHAR | 376.70 |
INFED 50MG | PHAR | 155.00 |
AMOXICILLIN 875 MG | PHAR | 4.30 |
CEPHALEXIN 250 MG | PHAR | 10.00 |
DIVALPROEX SODIUM | PHAR | 19.00 |
ENALAPRIL | PHAR | 20.00 |
FLUOXETINE | PHAR | 22.00 |
LEVOFLOXACIN 500 MG | PHAR | 52.00 |
AMPICILLIN/SULBACTAM 1.5 GM IVPB | PHAR | 53.00 |
PHAR | 53.00 | |
AMPICILLIN/SULBACTAM 1.5 GM IM | PHAR | 53.00 |
AMPICILLIN/SULBACTAM 3 GM | PHAR | 80.00 |
AMPICILLIN/SULBACTAM 3 GM IVPB | PHAR | 90.00 |
BUMETANIDE 2.5 MG IM/IVP | PHAR | 31.00 |
BUMETANIDE 1 MG | PHAR | 6.00 |
CEFTRIAXONE 1 GM | PHAR | 153.00 |
CEFTRIAZONE IM 1000 MG | PHAR | 145.00 |
CEFTRIAXONE 2 GM | PHAR | 198.00 |
CEFTRIAXONE IM 2000 MG | PHAR | 93.00 |
CEFTRIAXONE 500 MG | PHAR | 45.00 |
DOBUTAMINE 250 MG | PHAR | 41.00 |
FLUMAZENIL .5 MG | PHAR | 48.00 |
ENALAPRILAT 1.25 MG | PHAR | 36.00 |
FUROSEMIDE 40 MG | PHAR | 5.00 |
HEPARIN FLUSH | PHAR | 9.00 |
SOLU-CORTEF 250 MG | PHAR | 74.90 |
SOLU-MEDROL 1 GRAM | PHAR | 166.00 |
SOLU-CORTEF 500 MG | PHAR | 213.00 |
PROMETHAZINE 25MG IM | PHAR | 17.00 |
CEFUROXIME TAB 500 MG | PHAR | 43.00 |
ACETAMINOPHEN SUPP 650 MG | PHAR | 10.00 |
AMOXICILLIN POT CLAV 400 MG | PHAR | 22.50 |
NASAL SPRAY | PHAR | 8.60 |
FENTANYL CITRATE 50 MCG IVPB | PHAR | 12.00 |
FENTANYL CITRATE 50 MCG IM/IVP | PHAR | 23.00 |
KETORLAC 30 MG/ML | PHAR | 44.00 |
EMLA 2.5% CREAM | PHAR | 17.00 |
ENEMA | PHAR | 11.80 |
ENEMA MINERAL OIL | PHAR | 20.00 |
ESTROGEN/PREMARIN | PHAR | 937.00 |
eye wash | PHAR | 141.00 |
FAMOTIDINE 40mg/4ML INJ | PHAR | 25.00 |
FENTANYL 250 MCG | PHAR | 26.00 |
HPV VACCINE | PHAR | 246.10 |
CAPSAICIN CREAM | PHAR | 74.00 |
DTAP | PHAR | 132.00 |
KETORLAC 60MG | PHAR | 34.00 |
PANTOPRAZOLE TAB 40 MG | PHAR | 5.00 |
NOREPINEPHRINE 4 MG | PHAR | 105.00 |
DICLOXACILLIN 250MG | PHAR | 15.00 |
ARTIFICIAL TEARS | PHAR | 28.00 |
MICONAZOLE NITRATE 2% CREAM | PHAR | 24.06 |
ENOXAPARIN 10MG INJ | PHAR | 36.00 |
LUPRON 7.5 MG INJ | PHAR | 3,189.00 |
NICARDIPINE IVP | PHAR | 18.00 |
CLOPIDOGRE/PLAIV 75MG TAB | PHAR | 29.00 |
BENZOCAINE SPRAY | PHAR | 5.00 |
HYDROXYZIN HCL CAP 25MG | PHAR | 6.00 |
LANSOPRAZOL/PREVACD 30MG | PHAR | 10.00 |
HYDROXYZINE 50MG/ML | PHAR | 97.00 |
AUGMENTIN 875MG TAB | PHAR | 28.00 |
AZITHROMYCIN 250MG Z-PAC | PHAR | 42.00 |
CYANOBALAMIN <=1000 MCG I | PHAR | 49.00 |
TENECTEPLASE (TNK) 50MGIV | PHAR | 8,173.00 |
LIDOCAINE LOCAL 1-2CC INJ | PHAR | 18.00 |
PHENOBARBITAL | PHAR | 165.00 |
PHENOBARBITAL 130MG/ML | PHAR | 138.00 |
TH CLINDAMYCIN 6 PK | PHAR | 12.90 |
NORCO | PHAR | 11.00 |
Daptomycin 750 MG | PHAR | 1,040.00 |
COSYNTROPIN 0.25 MG | PHAR | 200.00 |
ELIQUIS 5 MG | PHAR | 37.00 |
VARICELLA VACC-PT > 19Y/O | PHAR | 264.00 |
VFC- VARICELLA | PHAR | 0.00 |
AZITHROMICIN 750MG IV | PHAR | 134.00 |
CLOVE OIL | PHAR | 18.00 |
VANCOMYCIN INJ 750 MG | PHAR | 80.00 |
Caspofungin 5mg | PHAR | 622.00 |
CATHFLO ACTIVASE | PHAR | 283.00 |
DTAP-IPV | PHAR | 208.00 |
TRUVADA | PHAR | 150.00 |
ROCURONIUM 10 MG | PHAR | 62.00 |
POTASIUM CHLORIDE 10MEG/100ML | PHAR | 36.40 |
CELESTONE INJ PER 3MG | PHAR | 52.00 |
POTASIUM CHLORIDE 10MEQ/50ML | PHAR | 16.00 |
FERRLECIT 12.5 MG | PHAR | 168.00 |
CEFTAZIDIME 500MG | PHAR | 55.00 |
HPV-GARDASIL | PHAR | 438.00 |
BEXSERO | PHAR | 352.00 |
DIHYDROERGOTAMINE 1 MG INJ | PHAR | 315.00 |
PRIMAXIN 500MG | PHAR | 164.00 |
NITROGLYCERIN SPRAY | PHAR | 340.00 |
NITRO 25MG/250ML | PHAR | 106.00 |
ONDANSETRON ODT 8MG | PHAR | 157.00 |
ACETYLCYSTEINE INJ 200MG/ML | PHAR | 346.00 |
ACETYLCYSTEINE INH | PHAR | 67.00 |
WARFARIN 5MG | PHAR | 9.00 |
SILVADENE CREAM | PHAR | 77.00 |
OMEPRAZOLE 20MG CAP | PHAR | 25.00 |
MULTI-VIT | PHAR | 3.50 |
RANITIDINE 150MG TAB | PHAR | 5.00 |
ACETAMINOPHEN 500MG TAB | PHAR | 4.30 |
ACETYLCYSTEINE INH SOL | PHAR | 49.00 |
CALMOSEPTINE OINTMENT | PHAR | 27.60 |
DOCUSATE SODIUM 250MG | PHAR | 6.00 |
PROCAINAMIDE 100MG/ML INJ | PHAR | 211.00 |
SODIUM BICARB 8.4% | PHAR | 72.00 |
VERAPAMIL 2.5MG INJ | PHAR | 161.00 |
GENTAMYCIN 0.3% OINT | PHAR | 38.00 |
HCTZ 25MG | PHAR | 4.00 |
HYDROMORPHONE 2MG TAB | PHAR | 10.00 |
HEPARIN 5000U INJ | PHAR | 17.00 |
HEPATITIS A PED/ADOLESCENT | PHAR | 132.00 |
MENINGOCOCCAL MPSV4 | PHAR | 230.00 |
IPOL Polio Vaccine | PHAR | 85.00 |
Neo/Poly/HC Suspension | PHAR | 169.00 |
Neo/Poly/Bac Ointment | PHAR | 102.00 |
PITOCIN 10UN/ML | PHAR | 17.00 |
PREVNAR 13 | PHAR | 485.00 |
INSULIN LANTUS PER 5 UNITS | PHAR | 23.00 |
HUMULIN R | PHAR | 16.00 |
FLUCONAZOLE 150MG | PHAR | 19.00 |
TRANEXAMIC ACID | PHAR | 165.00 |
FLUORESCEIN SODIUM STRIP | PHAR | 5.00 |
ARISTADA 1064MG | PHAR | 5,968.00 |
Paroxetine 20mg | PHAR | 26.00 |
Oseltamivir 75mg | PHAR | 80.00 |
Oseltamivir 30MG | PHAR | 34.00 |
PHENYTOIN SUSP 125MG | PHAR | 29.00 |
AMIODARONE 150MG/3ML | PHAR | 32.00 |
NALOXONE 0.4MG IVPB | PHAR | 102.00 |
NALOXONE IM/IVP 0.4 MG | PHAR | 102.00 |
Ceftaroline 600mg vial | PHAR | 270.00 |
LEVOFLOXACIN 500MG TAB | PHAR | 87.00 |
POTASSIUM 20MEQ/15ML | PHAR | 11.00 |
STERILE WATER | PHAR | 17.00 |
LILETTA IUD 52MG | PHAR | 1,030.00 |
CYCLOPENTOLATE HCL OPTH SOL 2% | PHAR | 32.00 |
CYCLOBENZAPRINE 10 MG | PHAR | 6.00 |
Ertapenem 1GM IVPB | PHAR | 315.00 |
Ertapenem 1GM IM/IVP | PHAR | 178.00 |
CEFEPIME 2 GM IVPB | PHAR | 36.00 |
CEFEPIME 2GM IVP | PHAR | 36.00 |
VFC-KINRIX | PHAR | 0.00 |
VFC- DTAP | PHAR | 0.00 |
VFC- ACTHIB- HAEMOPHILUS B (HIB) | PHAR | 0.00 |
VFC- ACTHIB DTAP-IPV-HIB | PHAR | 132.00 |
VFC- INFLUENZA VAC | PHAR | 0.00 |
VFC- ROTAVIRUS | PHAR | 0.00 |
NIFEDIPINE CAP 30MG | PHAR | 17.00 |
DECAVAC INJ | PHAR | 180.00 |
Ethyl Chloride fine stream | PHAR | 131.00 |
EPINEPHRINE 1MG/ML | PHAR | 39.00 |
EPI-PEN 0.3 MG | PHAR | 358.00 |
EPI-PEN JR | PHAR | 358.00 |
BOTOX 100 U | PHAR | 940.00 |
BOTOX 200 U | PHAR | 1,803.00 |
VFC- MENINGOCOCCAL B | PHAR | 0.00 |
VFC- PREVNAR 13 | PHAR | 0.00 |
VFC- BOOSTRIX | PHAR | 0.00 |
VFC- M-M-R | PHAR | 0.00 |
VFC- KINRIX | PHAR | 272.00 |
VFC- PENTACEL | PHAR | 255.00 |
VFC- HEPATITIS A | PHAR | 0.00 |
VFC- HEPATITITS B | PHAR | 0.00 |
VFC- MENACTRA | PHAR | 0.00 |
VFC- POLIOMYELITIS | PHAR | 0.00 |
VFC-GARDASIL 9 | PHAR | 0.00 |
VFC- HEPATITIS B | PHAR | 0.00 |
Prednisilone 15mg/5ml | PHAR | 8.00 |
Zinc 50mg | PHAR | 3.00 |
MUPIROCIN 2% OINT | PHAR | 103.00 |
METOLAZONE 2.5MG TAB | PHAR | 20.00 |
LEVETIRACETAM 50O MG | PHAR | 5.00 |
LEVETIRACETAM IVP 500 MG/ 5 ML | PHAR | 18.00 |
LEVETIRACETAM IVPB 500 MG/ 5 ML | PHAR | 28.00 |
VANCOCIN CAPS 125MG | PHAR | 18.00 |
BACLOFEN | PHAR | 29.00 |
AZITROMYCIN SUS 200MG/5ML | PHAR | 147.70 |
LOPERAMIDE 2MG | PHAR | 12.00 |
NICOTINE PATCH 14 MH | PHAR | 5.00 |
PEDIA-LAX | PHAR | 34.00 |
PEROXYL | PHAR | 0.00 |
THERA-TAB (MULTI-VIT0 | PHAR | 0.00 |
DOCUSATE TAB 100 MG | PHAR | 5.00 |
VITAMIN D3 5000IU | PHAR | 4.00 |
VITAMIN D3 2000IU | PHAR | 4.00 |
PROBIOTIC | PHAR | 5.00 |
OYSTER SHELL CALCIUM | PHAR | 5.00 |
SENNA | PHAR | 4.00 |
LORATADINE TAB 10 MG | PHAR | 6.00 |
SILVER NITRATE STICK | PHAR | 5.00 |
SODIUM CHLORIDE INHAL 9% | PHAR | 4.00 |
SODIUM CHLORIDE INHAL 3% | PHAR | 7.00 |
LIDOCAINE SYRINGE 1% | PHAR | 14.00 |
ORAJEL | PHAR | 49.00 |
SODIUM CHLORIDE 1GM TAB | PHAR | 6.00 |
NYSTATIN TOPICAL POWDER | PHAR | 25.00 |
APLIGRAF | PHAR | 2,993.00 |
PT EVAL LOW COMPLEX 20MIN | PT | 260.60 |
PT EVAL MOD COMPLEX 30MIN | PT | 318.50 |
PT EVAL HIGH COMPLEX 45MIN | PT | 405.20 |
PT GAIT TRNG/STAIR /15MIN | PT | 90.60 |
MAN THERAPY 1+ REGIONS, EA 15 MIN | PT | 87.20 |
PT RE-EVAL EST PLAN CARE | PT | 162.10 |
PT NEURO MSCL RE-ED /15MI | PT | 102.90 |
PT THERAPU EX /15MIN | PT | 102.90 |
PT ULTRASOUND ATTN / 15MI | PT | 49.60 |
PT ELEC STIM ATTN / 15MIN | PT | 91.80 |
THERAPEUTIC ACTV EA 15MIN | PT | 71.95 |
MOBILITY CURRENT STATU CM | PT | 0.00 |
MOBILITY GOAL STATUS CL | PT | 0.00 |
MOBILITY GOAL STATUS CK | PT | 0.00 |
CURRENT MOBIL STAT CJ | PT | 0.00 |
MOBILITY GOAL STATUS CI | PT | 0.00 |
Self Care / Home Mngmt Training | PT | 71.95 |
ST EVAL DYSPHAGIA | PT | 400.30 |
ST DYSPHAGIA INDIVID | PT | 247.75 |
Individual Psychotherapy 16-37 mins | SLS | 325.00 |
Individual Psychotherapy 38-52 mins | SLS | 350.00 |
Individual Psychotherapy 53-67 mins | SLS | 375.00 |
Family psychotherapy w/o patient present | SLS | 375.00 |
Family psychotherapy w/ patient present | SLS | 375.00 |
Group Psychotherapy | SLS | 295.00 |
Telehealth Fee SLS | SLS | 50.00 |
SKILLED NURSING BED CHG | SNF | 568.83 |
SNF BED HOLD / LOA | SNF | 568.83 |
EVAL FOR SPEECH DEVICE RX EA ADDL 30 MIN | ST | 163.60 |
SPEECH SOUND LANG COMPREHENSION | ST | 607.00 |
BEHAVRAL & QUALIT ANALYS VOICE | ST | 281.20 |
EVAL FOR NONSPEECH DEVICE RX | ST | 278.80 |
TX SWALLOWING DYSFUNCTION | ST | 268.90 |
COGNITIVE SKILLS DEVELOPMENT | ST | 83.10 |
CONGITIVE TEST BY HC PRO | ST | 367.90 |
THER SERV NONSPEECH DEVICE | ST | 223.00 |
USE OF SPEECH DEVICE SERVICE | ST | 346.90 |
EVAL SWALLOWING FUNCTION | ST | 229.20 |
EVAL FOR SPEECH DEVICE RX 1ST HR | ST | 396.45 |
ORAL SPEECH DEVICE EVAL | ST | 225.55 |
EVAL FOR NONSPEECH DEV RX ADD 30 MIN | ST | 101.65 |
TEAM CONFERENCE FACE-TO-FACE NON PHYS | ST | 119.10 |
Medical team conf w/ nonphys, 30min more | ST | 108.75 |
SWING BED CHARGE | SWB | 743.20 |
SWB BED HOLD / LOA | SWB | 743.20 |
RIBS UNILAT 2V MIN L | XR | 171.30 |
RIBS UNILAT 2V+ R | XR | 171.30 |
RIBS BILAT MIN 3V | XR | 327.30 |
ABD COMP W/PA CHEST | XR | 327.30 |
ABDOMEN 1 VW | XR | 171.30 |
ABDOMEN 2 VW | XR | 327.35 |
ABDOMEN 3 OR MORE VW | XR | 327.35 |
ACROMIOCLAVICULAR JTS/BIL | XR | 171.30 |
ELBOW COMP 3V BILAT | XR | 342.50 |
CHEST 1 VW | XR | 171.30 |
CHEST 2 VW | XR | 171.30 |
CHEST 3 VW | XR | 171.30 |
CHEST 4 OR MORE VW | XR | 327.35 |
ANKLE COMP 3V+ R | XR | 171.30 |
ANKLE COMP 3V+ L | XR | 171.30 |
ANKLE LTD 2V L | XR | 171.30 |
ANKLE LTD 2V R | XR | 171.30 |
ANKLE LTD 2V BILAT | XR | 342.50 |
BONE AGE STUDIES | XR | 327.30 |
BONE SURVEY COMP W/LNG BO | XR | 327.30 |
POST PROCEDURE PLACEMENT XRAY | XR | 0.00 |
CLAVICLE COMP L | XR | 171.30 |
CLAVICLE COMP R | XR | 171.30 |
ELBOW COMP 3V+ L | XR | 171.30 |
ELBOW COMP 3V+ R | XR | 171.30 |
ELBOW LTD 2V L | XR | 171.30 |
ELBOW LTD 2V R | XR | 171.30 |
SHOULDERS 2V+ BILAT | XR | 342.50 |
ANKLE COMP 3V+ BILAT | XR | 342.50 |
ELBOW 2VW BILATERAL | XR | 342.50 |
FACIAL BONES COMPL/3V MIN | XR | 327.30 |
FACIAL BONES 1 OR 2 VIEWS | XR | 171.30 |
ORBITS/4V MIN | XR | 327.30 |
FINGERS 2V+ L | XR | 171.30 |
FINGERS 2V+ R | XR | 171.30 |
FEMUR MIN 2 V RT | XR | 171.30 |
FEMUR MIN 2 V LT | XR | 171.30 |
FOOT 2V BILATERAL | XR | 342.50 |
FOOT COMP 3V+ R | XR | 171.30 |
FOOT COMP 3V+ L | XR | 171.30 |
FOOT 3V BILATERAL | XR | 342.50 |
FOOT 2V R | XR | 171.30 |
FOOT 2V L | XR | 171.30 |
UPPER EXTREMITY INFANT R | XR | 327.30 |
FOREARM 2V R | XR | 171.30 |
FOREARM 2V L | XR | 171.30 |
FOREIGN BODY CHILD 1 V | XR | 171.30 |
FOREARM 2V BILAT | XR | 342.50 |
HAND 3V+ L | XR | 171.30 |
HAND 3V+ R | XR | 171.30 |
HAND 3V+ BILATERAL | XR | 342.50 |
HAND 2V L | XR | 327.30 |
HAND 2V R | XR | 327.30 |
HAND 2V BILATERAL | XR | 654.60 |
HIPS BILAT W PELVIS 2 V | XR | 327.30 |
HIPS BILAT W PELVIS 3-4 V | XR | 327.30 |
HIP UNILAT 2-3 V LT | XR | 171.30 |
HIP UNILAT 2-3 V RT | XR | 171.30 |
HUMERUS 2V+ L | XR | 171.30 |
HUMERUS 2V+ R | XR | 171.30 |
HIP & PELVIS UNILAT 1 VW L | XR | 171.30 |
HIP & PELVIS UNILAT 1 VW R | XR | 171.30 |
KNEE 3V R | XR | 171.30 |
KNEE 3V L | XR | 171.30 |
KNEE 3V BILATERAL | XR | 342.50 |
KNEE/PATELLA 1-2V L | XR | 171.30 |
KNEE 1-2V R | XR | 171.30 |
KNEE 1-2V BILATERAL | XR | 342.50 |
KNEE/PATELLA 1-2V L | XR | 171.30 |
KNEE/PATELLA 1-2V R | XR | 171.30 |
MANDIBLE PRTL/1-3V L | XR | 171.30 |
MANDIBLE PRTL 1-3V R | XR | 171.30 |
MANDIBLE PRTL 1-3V BILAT | XR | 342.50 |
NASAL BONES/3V MIN | XR | 171.30 |
NECK/SOFT TISSUE | XR | 171.30 |
CALCANEUS 2V+ L | XR | 171.30 |
CALCANEUS 2V+ R | XR | 171.30 |
CALCANEUS 2V BILAT | XR | 342.50 |
SINUSES/PARANASAL 3V MIN | XR | 171.30 |
SINUSES/PARANASAL 1 OR 2V | XR | 171.30 |
PELVIS AP 1-2V | XR | 327.30 |
RIBS BILAT W/PA CHEST 4V | XR | 327.30 |
RIBS UNILAT W/PA CXR 3V L | XR | 327.30 |
RIBS UNILAT W/PA CXR 3V R | XR | 327.30 |
SACROILIAC JNTS MIN 3V | XR | 327.30 |
SI JOINTS LESS THAN 3 VWS | XR | 327.30 |
SACRUM/COCCYX MIN 2V | XR | 171.30 |
SCAPULA COMP L | XR | 327.30 |
SCAPULA COMP R | XR | 327.30 |
SHOULDER COMP 2V+ L | XR | 171.30 |
SHOULDER COMP 2V+ R | XR | 171.30 |
SHOULDER LTD 1V L | XR | 171.30 |
SHOULDER LTD 1V R | XR | 171.30 |
SKULL COMP 4V | XR | 327.30 |
SKULL LTD/1-3V | XR | 327.30 |
SPINE CERVICAL AP/LAT | XR | 171.30 |
SPINE SINGLE VIEW | XR | 171.30 |
C-SPINE FLEXION / EXTENSION ONLY | XR | 171.30 |
SPINE CERVICAL COMP 4V+ | XR | 327.30 |
SPINE CERVICAL W/FLEX EXT | XR | 327.30 |
SPINE LUMBOSACRAL AP/LAT | XR | 327.30 |
SPINE LUMBOSACRAL BEND ONLY | XR | 315.55 |
SPINE LUMBOSACRAL W/BEND | XR | 327.30 |
SPINE LUMBOSACRAL W/OBL | XR | 327.30 |
SPINE, ENTIRE, 1VW | XR | 171.30 |
SPINE THORACIC AP/LAT | XR | 327.30 |
SPINE THORACIC W/SWIMMER | XR | 327.30 |
STERNUM MIN 2V | XR | 171.30 |
TMJ JOINTS BILATERAL | XR | 171.30 |
SPINE THORACOLUMBAR 2V | XR | 171.30 |
TIBIA/FIBULA 2V R | XR | 171.30 |
TIBIA/FIBULA 2V L | XR | 171.30 |
LOWER EXTREM-INFANT L | XR | 171.30 |
LOWER EXTREM-INFANT R | XR | 171.30 |
TOES 2V+ L | XR | 171.30 |
TOES 2V+ R | XR | 171.30 |
TIBIA/FIBULA 2V BILAT | XR | 342.50 |
TOE 2V BIG DIGIT L | XR | 171.30 |
TOE 2V BIG DIGIT R | XR | 171.30 |
TOES 2V+ BILAT | XR | 342.50 |
WRIST COMP 3V+ R | XR | 171.30 |
WRIST COMP 3V+ L | XR | 171.30 |
WRIST LTD 2V BILAT | XR | 342.50 |
WRIST LTD 2V R | XR | 171.30 |
WRIST LTD 2V L | XR | 171.30 |
WRIST COMP 3V+ BILATERAL | XR | 342.50 |
KNEE COMP 4V L | XR | 327.30 |
KNEE COMP 4V R | XR | 327.30 |
KNEE COMP 4V BILATERAL | XR | 654.50 |
KNEE BILAT STANDING AP | XR | 171.30 |
UPPER EXTREMITY INFANT L | XR | 327.30 |
FINGER 2ND DIGIT L | XR | 171.30 |
FINGER 3RD DIGIT L | XR | 171.30 |
FINGER 4TH DIGIT L | XR | 171.30 |
FINGER 5TH DIGIT L | XR | 171.30 |
FINGER THUMB L | XR | 171.30 |
FINGER 2ND DIGIT R | XR | 171.30 |
FINGER 3RD DIGIT R | XR | 171.30 |
FINGER 4TH DIGIT R | XR | 171.30 |
FINGER 5TH DIGIT R | XR | 171.30 |
FINGER THUMB R | XR | 171.30 |
RIBS UNILATERAL 2V MIN LT PRO FEE | XRMD | 33.10 |
RIBS UNILAT 2V MIN RT PRO FEE | XRMD | 33.10 |
RIBS BILAT MIN 3V PRO | XRMD | 41.70 |
ABD COMP W/PA CHEST PRO FEE | XRMD | 45.70 |
ABDOMEN 1 VW PRO FEE | XRMD | 33.10 |
ABDOMEN 2 VW PRO FEE | XRMD | 33.10 |
ABDOMEN 3 OR MORE VW PRO FEE | XRMD | 38.75 |
ACROMIOCLAVICULAR JTS/BIL PRO FEE | XRMD | 33.10 |
ELBOW COMP 3V BILAT PRO FEE | XRMD | 49.70 |
CHEST 1 VW PRO FEE | XRMD | 33.10 |
CHEST 2 VW PRO FEE | XRMD | 33.10 |
CHEST 3 VW PRO FEE | XRMD | 39.70 |
CHEST 4 OR MORE VW PRO FEE | XRMD | 45.70 |
ANKLE COMP 3V+ RT PRO FEE | XRMD | 33.10 |
ANKLE COMP 3V LT PRO FEE | XRMD | 33.10 |
ANKLE LTD 2V LT PRO FEE | XRMD | 33.10 |
ANKLE LTD 2V RT PRO FEE | XRMD | 33.10 |
ANKLE LTD 2V BILAT PRO FEE | XRMD | 66.20 |
BONE AGE STUDIES PRO | XRMD | 33.10 |
BONE SURVEY SOMP W/LNG BO PRO FEE | XRMD | 76.45 |
RADIOLOGIST FEE 71010 | XRMD | 41.40 |
POST PROCEDURE PLACEMENT XRAY PRO FEE | XRMD | 0.00 |
RADIOLOGIST FEE 71020 | XRMD | 49.70 |
CLAVICLE COMP LT PRO FEE | XRMD | 33.10 |
CLAVICLE COMP RT PRO FEE | XRMD | 33.10 |
ELBOW COMP 3V+ LT PRO FEE | XRMD | 33.10 |
ELBOW COMP 3V+ RT PRO FEE | XRMD | 33.10 |
ELBOW LTD 2V LT PRO FEE | XRMD | 33.10 |
ELBOW LTD 2V RT PRO FEE | XRMD | 33.10 |
SHOULDERS 2V+ BILAT PRO FEE | XRMD | 53.60 |
ANKLE COMP 3V+ BILAT PRO FEE | XRMD | 99.25 |
ELBOW 2VW BILATERAL PRO FEE | XRMD | 45.70 |
FACIAL BONES COMPL/3V MIN PRO FEE | XRMD | 37.70 |
FACIAL BONES 1 OR 2 VIEWS PRO FEE | XRMD | 33.10 |
ORBITS 4V MIN PRO | XRMD | 40.70 |
FINGERS 2V+ L PRO FEE | XRMD | 33.10 |
FINGERS 2V+ R PRO FEE | XRMD | 33.10 |
FEMUR MIN 2 V RT PRO FEE | XRMD | 33.10 |
FEMUR MIN 2 V LT PRO FEE | XRMD | 33.10 |
FOOT 2V BILATERAL PRO FEE | XRMD | 87.40 |
FOOT COMP 3V+ R PRO FEE | XRMD | 33.10 |
FOOT COMP 3V+ L PRO FEE | XRMD | 33.10 |
FOOT 3V BILATERAL PRO FEE | XRMD | 95.25 |
FOOT 2V RT PRO FEE | XRMD | 33.10 |
FOOT 2V LT PRO FEE | XRMD | 33.10 |
UPPER EXTREM INFANT R PRO | XRMD | 33.10 |
FOREARM 2V RT PRO FEE | XRMD | 33.10 |
FOREARM 2V LT PRO FEE | XRMD | 33.10 |
FOREIGN BODY CHILD 1V PRO | XRMD | 33.10 |
FOREARM 2V BILAT PRO FEE | XRMD | 47.70 |
HAND 3V+ LT PRO FEE | XRMD | 33.10 |
HAND 3V+ RT PRO FEE | XRMD | 33.10 |
HAND 3V+ BILATERAL PRO FEE | XRMD | 49.70 |
HAND 2V LT PRO FEE | XRMD | 33.10 |
HAND 2V R PRO | XRMD | 33.10 |
HAND 2V BILATERAL PRO FEE | XRMD | 47.70 |
HIPS BILAT W PELVIS 2 V PRO FEE | XRMD | 66.20 |
HIPS BILAT W PELVIS 3-4 V PRO FEE | XRMD | 42.70 |
HIP UNILAT 2-3 V LT PRO FEE | XRMD | 33.10 |
HIP UNILAT 2-3 V RT PRO FEE | XRMD | 33.10 |
HUMERUS 2V+ LT PRO FEE | XRMD | 33.10 |
HUMERUS 2V+ RT PRO FEE | XRMD | 33.10 |
HIP & PELVIS UNILAT 1 VW LT PRO FEE | XRMD | 33.10 |
HIP & PELVIS UNILAT 1 VW RT PRO FEE | XRMD | 33.10 |
KNEE 3V RT PRO FEE | XRMD | 33.10 |
KNEE 3V LT PRO FEE | XRMD | 33.10 |
KNEE 3V BILATERAL PRO FEE | XRMD | 107.20 |
KNEE/PATELLA 1-2V LT PRO-FEE | XRMD | 33.10 |
KNEE/PATELLA 1-2V RT | XRMD | 33.10 |
KNEE 1-2V BILATERAL PRO FEE | XRMD | 95.25 |
KNEE 1-2V L PRO | XRMD | 33.10 |
KNEE/PATELLA 1-2V R PRO | XRMD | 33.10 |
MAMM DX UNILATERAL PRO FEE | XRMD | 121.30 |
MAMMOGRAPHY SCREEN BILAT W/CAD PRO FEE | XRMD | 128.80 |
MANDIBLE PRTL 1-3V L PRO FEE | XRMD | 33.10 |
MANDIBLE PRTL 1-3V R PRO FEE | XRMD | 33.10 |
MANDIBLE PRTL 1-3V BILAT PRO FEE | XRMD | 51.60 |
NASAL BONES/3V MIN PRO FEE | XRMD | 33.10 |
NECK/SOFT TISSUE PRO FEE | XRMD | 33.10 |
CALCANEUS 2V+ LT PRO FEE | XRMD | 33.10 |
CALCANEUS 2V+ RT PRO FEE | XRMD | 33.10 |
CALCANEUS 2V BILAT PRO FEE | XRMD | 91.30 |
SINUSES/PARANASAL 3V MIN PRO FEE | XRMD | 35.70 |
SINUSES/PARANASAL 1 OR 2V PRO FEE | XRMD | 33.10 |
PELVIS AP 1-2V PRO FEE | XRMD | 33.10 |
RIBS BILAT W/PA CHEST 4VN PRO FEE | XRMD | 46.60 |
RIBS UNILAT W/PA CXR 3V LT PRO FEE | XRMD | 38.65 |
RIBS UNILAT W/PA CXR 3V RT PRO FEE | XRMD | 38.65 |
SACROILIAC JNTS MIN 3V PRO FEE | XRMD | 33.10 |
SI JOINTS LESS THAN 3 VWS PRO FEE | XRMD | 33.10 |
SACRUM/COCCYX MIN 2V PRO FEE | XRMD | 33.10 |
SCAPULA COMP LT PRO FEE | XRMD | 33.10 |
SCAPULA COMP R PRO | XRMD | 33.10 |
SHOULDERS 2V+ LT PRO FEE | XRMD | 33.10 |
SHOULDERS 2V+ RT PRO FEE | XRMD | 33.10 |
SHOULDER LTD 1V LT PRO FEE | XRMD | 33.10 |
SHOULDER LTD 1V RT PRO FEE | XRMD | 33.10 |
SKULL COMP 4V PRO | XRMD | 49.70 |
SKULL LTD/1-3V PRO FEE | XRMD | 35.70 |
SPINE CERVICAL AP/LAT PRO FEE | XRMD | 33.10 |
SPINE SINGLE VIEW PRO FEE | XRMD | 33.10 |
C-SPINE FLEXION / EXTENSION ONLY PRO FEE | XRMD | 33.10 |
SPINE CERVICAL COMP 4V+ PRO FEE | XRMD | 44.70 |
SPINE CERVICAL W/FLEX EXT PRO | XRMD | 51.60 |
SPINE LUMBOSACRAL AP/LAT PRO FEE | XRMD | 33.10 |
SPINE LUMBOSACRAL BEND ONLY PRO FEE | XRMD | 114.15 |
SPINE LUMBOSACRAL W/BEND PRO FEE | XRMD | 46.60 |
SPINE LUMBOSACRAL W/OBL PRO FEE | XRMD | 44.70 |
SPINE, ENTIRE, 1VW PRO FEE | XRMD | 37.70 |
SPINE THORACIC AP/LAT PRO FEE | XRMD | 33.10 |
SPINE THORACIC W/SWIMMER PRO FEE | XRMD | 33.10 |
STERNUM MIN 2V PRO FEE | XRMD | 33.10 |
TMJ JOINTS BILATERAL PRO FEE | XRMD | 34.80 |
SPINE THORACOLUMBAR 2V PRO FEE | XRMD | 33.10 |
TIBIA/FIBULA 2V RT PRO FEE | XRMD | 33.10 |
TIBIA/FIBULA 2V LT PRO FEE | XRMD | 33.10 |
LOWER EXTREM-INFANT L PRO FEE | XRMD | 33.10 |
LOWER EXTREM-INFANT R PRO FEE | XRMD | 33.10 |
TOES 2V+ L PRO FEE | XRMD | 33.10 |
TOES 2V+ R PRO FEE | XRMD | 33.10 |
TIBIA/FIBULA 2 V BILAT PRO FEE | XRMD | 95.25 |
TOE 2V BIG DIGIT L PRO FEE | XRMD | 33.10 |
TOE 2V BIG DIGIT R PRO FEE | XRMD | 33.10 |
TOES 2V+ BILAT PRO FEE | XRMD | 66.20 |
WRIST COMP 3V+ RT PRO FEE | XRMD | 33.10 |
WRIST COMP 3V+ LT PRO FEE | XRMD | 33.10 |
WRIST LTD 2V BILAT PRO FEE | XRMD | 49.70 |
WRIST LTD 2V R PRO | XRMD | 33.10 |
WRIST LTD 2V L PRO FEE | XRMD | 33.10 |
WRIST COMP 3V+ BILAT PRO FEE | XRMD | 49.70 |
KNEE COMP 4V LT PRO FEE | XRMD | 33.10 |
KNEE COMP 4V RT PRO FEE | XRMD | 33.10 |
KNEE COMP 4V BILATERAL PRO FEE | XRMD | 66.20 |
KNEE BILAT STANDING AP PRO FEE | XRMD | 66.20 |
UPPER EXTREM INFANT L PRO | XRMD | 33.10 |
FINGER 2ND DIGIT L PRO FEE | XRMD | 33.10 |
FINGER 3RD DIGIT L PRO FEE | XRMD | 33.10 |
FINGER 4TH DIGIT L PRO FEE | XRMD | 33.10 |
FINGER 5TH DIGIT L PRO FEE | XRMD | 33.10 |
FINGER THUMB L PRO FEE | XRMD | 33.10 |
FINGER 2ND DIGIT R PRO FEE | XRMD | 33.10 |
FINGER 3RD DIGIT R PRO FEE | XRMD | 33.10 |
FINGER 4TH DIGIT R PRO FEE | XRMD | 33.10 |
FINGER 5TH DIGIT R PRO FEE | XRMD | 33.10 |
FINGER THUMB R PRO FEE | XRMD | 33.10 |