Charge Code Description Price998 R & B OBS DTX $6,227.00999 R & B MED MAN WITHDR $6,227.00

1000 R & B MED SUP WTHDRL $6,227.001002 R & B SEMI PVT $6,227.001003 R & B TWO SOUTH $6,227.001004 R & B I C U $9,221.001005 R & B REHAB $6,227.001006 R & B DETOX PVT $6,827.001007 R & B PVT $6,827.001008 R & B PVT MED NEC $6,827.001009 R & B ALC MED SURG $1,500.001010 R & B ALC PSYCH $1,500.001011 OBSERVATION TWO NORT $0.001012 OBSERVATION TWO DAVI $0.001013 OBSERVATION TWO SOUT $0.001014 OBSERVATION I C U $0.001015 OBSERVATION QUANNACU $0.001016 23 HR NO CHARGE $0.001017 CANISTER W GEL $136.751018 DSG VAC WND CARE SYS $123.051019 HO ABD CNTRL HIP JT $3,733.901020 AD LWR EXT THI N MOL $951.051021 ADD TO PELVIC EXT $1,250.501022 ADD TO SOF1 ABV KNEE $968.751023 HUMERAL FX BRACE $1,761.201024 HUM FX BRACE SOCK $396.201030 OBSERVATION ER 1 HR $9,221.001031 OBSERVATION ER 2 HRS $4,610.501032 OBSERVATION ER 3 HRS $3,073.671033 OBSERVATION ER 4 HRS $2,305.251034 OBSERVATION ER 5 HRS $1,844.201035 OBSERVATION ER 6 HRS $1,536.831036 OBSERVATION ER 7 HRS $1,317.281037 OBSERVATION ER 8 HRS $1,152.621038 OBSERVATION ER 9 HRS $1,024.551039 OBSERVATION ER 10 HR $922.101040 OBSERVATION ER 11 HR $838.271041 OBSERVATION ER 12 HR $768.421042 OBSERVATION ER 13 HR $709.311043 OBSERVATION ER 14 HR $658.641044 OBSERVATION ER 15 HR $614.731045 OBSERVATION ER 16 HR $576.311046 OBSERVATION ER 17 HR $542.411047 OBSERVATION ER 18 HR $512.281048 OBSERVATION ER 19 HR $485.311049 OBSERVATION ER 20 HR $461.05

1050 OBSERVATION ER 21 HR $439.091051 OBSERVATION ER 22 HR $419.141052 OBSERVATION ER 23 HR $400.911053 OBSERVATION ER 24 HR $384.211055 OBS DIRECT 1 HOUR $6,570.251056 OBS DIRECT 2 HOURS $3,285.151057 OBS DIRECT 3 HOURS $2,190.051058 OBS DIRECT 4 HOURS $1,642.551059 OBS DIRECT 5 HOURS $1,314.051060 OBS DIRECT 6 HOURS $1,095.051061 OBS DIRECT 7 HOURS $938.601062 OBS DIRECT 8 HOURS $821.301063 OBS DIRECT 9 HOURS $730.001064 OBS DIRECT 10 HOURS $657.051065 OBS DIRECT 11 HOURS $597.301066 OBS DIRECT 12 HOURS $547.501067 OBS DIRECT 13 HOURS $505.351068 OBS DIRECT 14 HOURS $469.301069 OBS DIRECT 15 HOURS $438.001070 OBS DIRECT 16 HOURS $410.601071 OBS DIRECT 17 HOURS $392.301072 OBS DIRECT 18 HOURS $365.001073 OBS DIRECT 19 HOURS $345.801074 OBS DIRECT 20 HOURS $328.501075 OBS DIRECT 21 HOURS $312.901076 OBS DIRECT 22 HOURS $298.601077 OBS DIRECT 23 HOURS $285.651078 OBS DIRECT 24 HOURS $273.751080 IV HYDRATION 1ST HR $818.401081 IV HYDR EA ADDL HR $57.651082 IV INFUS UP TO 1 HR $756.301083 IV INFUS EA ADDL HR $348.101084 SUBSEQ IV INFUS 1HR $57.651085 IM INJECTION $55.951086 IVP INJ INITIAL $114.751087 IVP NEW DRUG $116.001088 IVP EA ADDL SAME SUB $60.901089 CAMI WALKER BOOT $879.651090 MEAS BLADDER CAPACIT $155.851091 LARYNGSCOPE REMOV FB $4,246.701092 BLOOD TRANSFUSION $1,077.501093 REMOVAL FB CORNEA $490.051094 TELEMETRY MOB $176.151095 CONCURRENT INFUSION $58.301096 IMMUNIZATION ADMIN $61.101098 INTER REPROG PMAKER $106.901099 FLU VACCINE $61.10

1100 ETOH/SUB ABUSE 15-30 $75.401101 ETOH SUB ABUSE 15-30 $75.401102 ETOH SUB ABUSE 15-30 $75.403007 CATERACT REM IOL IMP $0.003510 CHEMO TX IV PUSH $307.953889 HALO 18MM $4,746.253890 HALO 22MM $4,746.253891 HALO 25MM $4,746.253892 HALO 28MM $4,746.253893 HALO 31MM $4,746.253894 HALO BALLOON 47 5MM $1,267.603895 HALO 90MM $3,747.403896 HALO ULTR $4,746.253897 HALO CAP SMALL $1,018.703898 HALO CAP MEDIUM $1,018.703899 HALO GUIDEWIRE $456.453900 HALO 60MM $39.353901 ABSTACK 30 $1,616.153902 ENDO AVITIENE 10MM $386.355029 SURGIMEND 10CM X15CM $10,867.505030 6.5 MM TWIST DRILL $1,097.405031 SURGMND20CM X25CM X2 $26,775.005032 TRANSVER CONNECT ADJ $5,762.155033 DISTAL RAD INSTR KIT $3,143.705035 TECNIS MULTIFOLAR LE $2,819.255443 VISCERA RETAINER $131.555444 IVAS CURETTE 11G $1,389.155445 NATURA STOMAHESIVE $10.705513 2NDRY FIX W/SWIVLOCK $2,702.705514 WALKER ADULT 2BUTTON $161.006002 REC RM FIRST HALF HR $352.206005 OR 0.5 HOURS $1,632.056006 OR 1 HOUR $2,289.706007 OR 1.5 HOURS $3,258.356008 OR 2 HOURS $4,227.056009 OR 2.5 HOURS $5,195.706010 OR 3 HOURS $6,164.406011 OR 3.5 HOURS $7,133.106012 OR 4 HOURS $8,101.856013 OR 4.5 HOURS $9,070.456014 OR 5 HRS $10,039.206021 CARDIOVERSION $1,195.056022 IMMUNIZATION ADMIN $44.006025 MONITR INT FLD PRES $3,951.556031 REC ROOM 1 HOUR $631.806032 REC ROOM 1.5 HOURS $704.556033 REC ROOM 2 HOURS $880.65

6034 REC ROOM 2.5 HOURS $1,056.706035 REC ROOM 3 HOURS $1,232.856036 REC ROOM 3.5 HOURS $1,409.006037 REC ROOM 4 HOURS $1,585.156038 REC ROOM 4.5 HOURS $1,761.206039 REC ROOM 5 HOURS $1,937.406040 REC ROOM 5.5 HOURS $2,113.556041 REC ROOM 6 HOURS $2,289.706042 REC ROOM 6.5 HOURS $2,465.756043 REC ROOM 7 HOURS $2,641.856044 REC ROOM 7.5 HOURS $2,818.006045 REC ROOM 8 HOURS $2,994.106046 REC ROOM 8.5 HOURS $3,170.256047 REC ROOM 9 HOURS $3,346.406048 REC ROOM 9.5 HOURS $3,522.556049 REC ROOM 10 HOURS $3,698.656050 REC ROOM 10.5 HOURS $3,874.756051 REC ROOM 11 HOURS $4,050.906052 REC ROOM 11.5 HOURS $4,227.056053 REC ROOM 12 HOURS $4,403.156054 REC ROOM 12.5 HOURS $4,579.256055 REC ROOM 13 HOURS $4,755.406056 REC ROOM 13.5 HOURS $4,931.556057 REC ROOM 14 HOURS $5,107.656058 REC ROOM 14.5 HOURS $5,283.756059 REC ROOM 15 HOURS $5,459.906065 OR MINOR FST HALF HR $351.556066 OR MINOR 1 HR $528.356070 OR MINOR 3 HRS $1,232.856071 OR MINOR 3.5 HRS $1,409.006072 OR MINOR 4 HRS $1,585.156073 OR MINOR 4.5 HRS $1,761.206074 OR MINOR 5 HRS $1,937.406075 OR MINOR 5.5 HRS $2,113.556076 OR MINOR 6 HRS $2,289.706077 OR MINOR 6.5 HRS $2,465.756078 OR MINOR 7 HRS $2,641.856095 ARTHROSCOPY KNEE $5,766.356096 VENTRALEX HER PAT M $813.706097 VENTRALEX HER PAT SM $972.256099 ALLOGRAFT KNEE $14,836.706110 EPIDURAL $0.006136 TR ROOM 14.5 HRS $5,283.756138 INFUSION CHEMOTHERAP $434.306139 TISSUE EXPANDER $5,173.656141 BALL TIP WIRE $473.306142 BLADE HELICAL $2,087.10

6143 NAIL FEMORAL $8,157.256144 STEERABLE STYLETTE $858.606145 TRIAL LEAD KIT $9,955.556146 TRANSMITTER TRIAL $1,541.106147 NEUROSTIMULTR ANALYS $300.856148 SIX SHOT MLTIBAN LIG $1,021.456150 COMPLEX PROG 1ST HR $131.606156 SI JOINT INJECTION $270.256159 NS CMPLX PRG 1ST HR $104.106160 OR 5.5 HRS $11,007.906161 OR 6 HRS $11,976.606163 MSR IV PUSH INITIAL $86.506164 RESTOR LENS $1,531.556170 PERIATEX MESH 8 X 6 $2,335.506171 PERIATEX MESH 12 X 8 $4,020.256172 I CLIP RESRB FIX X20 $1,512.356173 PERC IDISC ANNULOPLA $3,420.056174 PERC IDISC ANNL ADDL $2,137.606175 MSR IVINFU INIT <1HR $756.306176 MSR IV INF EA AD HR $59.606177 INJ METHYLENE BLUE $8.106179 SCLERA $1,531.556180 16G RX EPI NEDL RACZ $52.606181 16G RX COUDE RACZ CA $56.656182 19G PN STM KATH RACZ $290.956183 19G BREVI XL RACZ $237.356184 PULSE GEN MEDTR DUAL $26,380.706185 ERCP RETRIEVAL BALLO $574.306186 ERCP GLO TIP CATHETE $382.906187 ERCP CTN CANNULAT II $1,225.206188 ERCP JACWIRE $3,434.456189 PLATES PERIART RECON $1,678.556190 MESH HERN PROLENE LG $1,212.506191 MESH HER PROLENE MED $1,212.506192 CORAL BLK BN GRF SUB $2,393.006193 WRIGHT SZ3 RADIALHEA $1,830.206194 KYPHOPLASTY EXPR SYS $15,745.706195 KYPHOPLASTY CEMENT $1,546.106196 MONARC SUBFASC HAMMO $3,047.756197 PERIGEE SYSTEM $4,885.556198 PULSE GEN MEDTRONIC $20,813.506199 IFLO 100 ML $829.556200 IFLO 270 ML $829.556202 FLO SEAL HEMOS MATRX $612.606203 AMPLATZ DILATOR $819.356204 KIT NERVE INTRODUCER $1,072.056205 KIT INTERSTIM UR3625 $3,043.90

6206 LEAD URIN INTERSTIM $10,414.406207 INTERSTIM II 3058 $35,703.956208 PROGRAM UR INTERSTIM $4,556.306209 NAVICATH $727.456210 INVANCE MALE SLING $15,698.306211 MSR IV PUSH ADDL NEW $86.506212 SYNCH II INTR PUMP $37,170.006213 IND INTRATHECAL CATH $2,538.506214 PARIETEX ING HER MSH $629.006215 N S PUMP REFILL $359.906218 MSR IVINFU HYD EA HR $59.606219 MSR EA ADDL IV SUBS $93.956220 INSERT SUPRAPUB TUBE $4,817.506221 CHEMOTHERAPY EA HOUR $86.506222 IV ADD SEQ OVER 1 HR $86.506223 CHEMO EA SEQUENTIAL $176.406224 OR 6.5 HRS $12,945.356234 CHEMOTX IV PU EA DRU $176.406238 MSR IV INF HYD <1HR $264.356239 MSR IV PUSH EACH ADD $60.906240 MSR INJECTION IV $59.606247 DEBRIDE SKIN AND TIS $652.456300 PRE ASSESM NO CHARGE $0.006301 ADVANCE MALE SLING $18,720.456302 LEAD CARD DEFIB DUAL $21,058.656303 DUAL CHAMB CARDIODEF $82,320.156304 ALLOMATRIX 5CC BONE $3,522.556305 BEADS 25CC W BONE PU $4,364.856306 EXT FIXATION DEVICE $29,769.306307 ALLOMATRIX C 5CC BON $3,886.256308 SEPRAFILM 5"X6" $918.906309 SEPRA FILM PK POUCH $2,251.356310 EXPRESS MINI SHUNT $3,809.656311 TOE JOINT NPC MD $3,063.056312 PRIMATRIX 1CM X 1CM $991.906313 ARTHREX PUSHLOCK 2.9 $1,239.806315 ARTHR DISP KIT PUSH $638.156316 ARTHREX LASSO $510.506317 ARTHREX SUT LASSO SD $102.106318 ARTHREX OPES ASP ABL $638.156320 ARTHREX TIGERTAPE 2M $164.106321 ARTHREX FIB TAPE 2MM $164.106322 ARTHREX SCORPION NED $510.506323 ARTHREX #2 TIGER STK $167.756324 ARTHREX BIO SWIVELOC $1,385.706325 KYPHOPLASTY ADDL LEV $10,410.806326 RHIZOTOMY TRAY $8,481.80

6327 RPR WOUND DEHISCENCE $3,546.906328 PERMACOL 1 SQ CM MSH $67.456330 MILD KIT $9,116.306332 NEUROTHERM TOUHY NDL $36.456333 NEUROTHERM EPID CAT $182.306334 MINI ARC SLING $6,267.706335 CRYOTHERAPY PROSTATE $20,420.506336 LIND RING TORQUE WIR $125.806337 KYPH CURET T TIP #2 $1,987.406338 KYPH BONE BIOP DEV $753.606339 GEL ONE 3 ML $2,734.906340 SNGL CHMBR CARD DEFI $68,665.106341 COAPTITE $964.856342 FLEX IRIS RETRACTOR $320.906343 CAPSULAR TENSION RIN $652.756344 HOLMIUM YAG LASER UR $5,457.356345 GREENLIGHT LASER URO $6,016.706346 CRYOTHERAPY PROC URO $20,420.506347 LITHOTRIPSY PROCEDUR $5,469.756348 IMPLANTABLE PORT $1,732.106349 LIGA SURE 10 $1,614.156350 LIGA SURE 15 $1,157.606351 LIGA SURE 43 $2,537.606353 FIBER WIRE $113.056354 ABSORBA TACK 5MM $1,620.306355 DURASPHERE 1 ML $820.456356 CINCH LEAD ANCHOR $273.456357 6" NEEDLE $218.756358 SCS ACCESSORY KIT $1,185.156359 URET INTES DIV STENT $546.956360 STONE BASKET $780.356361 REF 4500 CYTO BRUSH $441.206362 STONETOME RBF 3515 $1,422.106363 C FLEX BIL DBL PIG $244.356364 AMBIO DRY 2 $2,066.356365 TAT CHOLANGIOGRAM CA $235.106366 ENDO SHEARS #176643 $114.606367 RENAL ACCESS COBRA C $92.606368 EVICEL SM KIT $2,370.056369 EVICEL TIP APPLIC 35 $180.256370 TISSEEL FIBRIN SEALA $465.856371 REVEAL XT 9529 $14,238.806372 CONSCIOUS SEDATION $306.356373 CON SEDAT EA ADDL 15 $306.356374 STRYKER DRIL BIT 180 $521.456375 STRYKER DRIL BIT 340 $1,180.756376 STRYKER ENDCAP T2 PR $644.85

6377 ENERGEN ICD GENERATO $60,775.306378 X STOP 12 $15,903.006379 X STOP 14 $15,903.006380 VERTEPORT X4 MANIFOL $998.456381 ENDO CATCH $241.856382 ENDOGIA UNIVERSAL $340.856383 ENDOSCOPIC PEANUT $71.006384 MEDTRONIC PER T MGR $2,760.906385 CORNEAL GRAFT $12,502.356386 CRAWFORD BICAN INTUB $219.906387 CRAWFORD HOOKS $312.556388 ARTHR COOLCUT BA ELE $399.356389 ARTHREX 4.0 RND BURR $204.906390 VULC LIG CHISEL CURV $465.356391 NATURA STOMA HESIVE $11.556392 BARD MESH PLUG XL $1,069.656393 GAMMA TUBE CLIP $143.606394 LOCKING SCREW 5MM $708.206395 LONG NAIL KIT $8,984.656396 PLATE 7 HOLE $3,621.756397 LOCKING SCREW 3.5MM $603.606398 PLATE 6 HOLE $5,376.306399 LOCKING SCREW 4.0 $517.806400 SPEED SCREW $1,614.906401 SUTURE CARTRIDGE $600.806402 HEMIPATELLAR TENDON $17,798.506403 OLECRANON PLATE $4,963.156404 BONE SCREW $308.506405 LONG LOCKING SCREW $686.806406 VITOSS FOAM PACK $5,226.706407 OMEGA PLUS LAG SCREW $1,169.506408 OMEGA BARREL HIP $1,812.806409 SELF TAP CORTIC SCRE $91.206410 LOCKING SCREW 3.0MM $325.556411 LOCK RECON PLATE 8 H $1,953.456412 OMEGA LAG SCREW $1,169.506413 SELF TAP CORTIC SCRE $104.156414 MEDLN SILICONE DRAIN $15.156416 COV LIGASURE IMPACT $2,537.556417 EPIDUR NEEDLE 14G 6" $208.356418 BS EXTRACTOR PRO X-L $479.256419 ARTH KNOT PUSHER SUT $434.106420 OLYM DISP HOT BX FOR $114.606421 OLYM DISP INJECTOR N $81.006422 DISP ELEC SURG SNARE $31.806423 SOFT SILK SCREW 1.5 $481.656424 ANCHORAGE FIXATION P $659.80

6425 VOLAR NAR 9 HOLE PLA $3,219.356426 DEP SUP QUICK ANCH P $1,489.856427 TECNIS ZM800 $3,108.206428 TECNIS ZCBOO IOL $520.906429 CRYSTALENS IOL $3,108.206430 CRYSTALENS HD IOL $3,802.806431 RESTOR IOL $3,108.206432 TORIC IOL $1,719.056433 RADIO FREQ CANNULA $98.406434 DEROYAL KNEE IMMOBI $66.006435 CATHETER PASSER $340.356436 DISP SUCTION IRRIGAT $529.056437 12MM VERSA STEP PLUS $200.806438 BLUNT PORT PLUS 5MM- $189.256439 INSUFFLAT NEEDLE 14G $59.756440 5MM VERSA STEP $160.906441 SHOULDER IMMOBILIZER $29.856442 ARTHROSCOPY PUMP TUB $211.856443 CRUTCHES ALUMINUM $35.356444 VERSYS HIP ENDO FEM $11,391.056445 4 HOLE FIBULAR PLATE $2,272.306446 FEMERAL STEM $5,542.706447 5.0 PRECIS ROUND BUR $642.506448 BONE MILL DISP MEDIU $13.906449 UROVAC BLADD EVAC $119.106450 DISPO SURGICAL CABLE $104.156451 7FR SAFESHEATH II IN $173.606452 OCTRODE LEAD KIT 60C $2,819.256453 EON MINI 1 PG 16 CHA $61,518.506454 STRYKER TOT KNEE $32,705.456456 ABDOMINAL BINDER $44.806457 PRESC NEURO DRILL 3M $467.606459 TRIGGER FLEX BIPOLAR $2,604.656460 4.9 CANNULATED DRILL $1,209.856461 ANIS THREAD GUIDE PI $356.056462 COFLEX SITE 14 $18,232.556463 LEAD MRICS COMPACT $10,453.306464 INS REST ULTRA MRICS $71,871.156465 INSR MRICS CHARGER $8,300.156466 PROGRAMMER MRICS $4,132.706467 CATHETER PASSER 38CM $340.356468 PROX HUMERAL NAIL LG $6,681.406469 TEFLON TUBE HUMERAL $691.356470 GUIDE WIRE SMOTH TIP $502.156471 9 HOLE PLATE $2,440.056472 GUID WIRE 1.4 X 150 $110.506473 NON LOCKING SCREW $232.45

6474 CATHETER 8780 $3,638.256475 OMEG ST BAR PLT 8-12 $2,248.406476 OM STD BAR PL 2-6 HO $1,778.306477 OM SHT BARREL PLATES $1,778.306478 OMEG COMPRESSN SCREW $286.156479 SLF TAP 4.5 HX CORT $89.406480 OMG STD LAG SCR 13MM $1,147.156481 3.2 DRILL OMEGA $460.906482 K WIRE STRYKER $62.456483 PUNCTURE CLOS DEVICE $59.556484 DRILL AO $511.506485 TIBIAL NAIL $5,450.256486 BAIR HUGGER BLANKET $19.106487 SURGICAL SHOE $19.456488 MONO TRIAX WRIST KI $4,984.206489 RUSH PIN NAIL $294.356490 COAPTITE INJ IMPLANT $875.156491 ABDUCTION PILLOW $69.156492 INCENTIVE SPIROMETER $11.006493 MRI COMP SPIN CORD S $72,599.606494 REST MODULAR HIP STM $10,045.556495 REST MODULR HIP BODY $14,020.506496 REST MODULAR HIP SLE $531.806497 UNITR ENDOPRO HD COM $2,468.706501 3 HOLE PLATE $2,682.756502 MED VEC SUR MRI LEAD $9,955.556503 MEDT ACCESSORY KIT $1,157.606504 REDDICK CHOLAGIO CAT $429.806505 MENISCAL CINCH W PE $853.356506 I STENT $8,268.756507 SMALL CROSS LINKS $975.706508 6.0 X 100 ROD $998.856509 6.0 ANGLED CONNECTOR $1,157.606510 6.0 CONNECTORS $1,157.606511 BREAK OFF NUTS $711.106512 6.5 MM X 45 SCREWS $2,811.356513 ZN HY HERN RPR DV 15 $3,969.006514 1 PG TEMPLATE KIT $549.056515 BLUE PERC LEAD KIT $6,849.856516 RISE SPACER 8X22MM $18,742.506517 5.5 ROD $1,376.756518 7.5X45MM MESA 2 SCRE $7,362.506519 6.5X50MM MESA 2 SCRE $7,362.506520 REAM SHFT MOD TRINK $805.656521 AO DRILL 230 MM $502.156522 PROCLAIM ELITE 5 W/C $74,190.556523 PROCLAIM ELITE 7 W P $74,190.55

6524 HUMERAL POLY INSERT $4,912.956525 HUMERAL CUP $6,140.056526 HUMER CENTER GLENOSP $6,140.056527 HUMERAL STEM $15,880.306528 PERIPHERAL SCREW $615.856529 GLENOID BASE PLATE $6,755.906530 PILOT WIRE $134.306531 HEADLESS PIN $795.406532 3.1 MM DRILL $358.306533 REELX 4.5 KNOTLESS $1,696.756534 CINCHLOCK SS KNOTLES $1,607.456535 CHAMP SLINGSHOT SUTU $1,154.306536 FORCE FIBER $63.006537 PIVOT CINCH LK DRILL $595.356538 SHLDR TRAY RENTAL $1,575.006539 EXTERNAL PULSE GENER $1,732.506540 INGEV LEAD MRI 52CM $1,890.006541 INGEV MRI LEAD 45CM $1,890.006542 ACCOLADE MRI DR PMAK $19,845.006543 KIT FIBULA DISTAL ST $8,347.506544 STAND CORTICAL SCREW $267.756545 FEMORL BONE CEM KIT $916.656546 CMT MIXING SYSTEM $359.106547 CLEARIFY VISUAL SYST $128.206548 SPACEMKR PRO SYSTEM $128.956549 VERS 12MM BL TROCAR $171.506550 SPHENO CATH $239.706551 SUPERIOR SUI KIT $2,535.006552 VERTIF INST PLAT KIT $2,085.006553 SUP INDIR DECOM IMPL $31,485.006813 MX STR SHRT EXT TUBE $590.356814 STR SHT EXT TUB W VE $1,345.756815 AUTOPLEX WO NEEDLES $2,127.706816 A PLEX W VPLEX WO NE $2,691.456817 SPINEPLX 20GM TWIN $806.506818 VERTAPLEX 20 GM TWIN $1,027.006819 VERTAPLEX HV 20 GM $1,180.756820 10G 10MM IVAS SYSKIT $3,820.156821 10G 10MM BALLOON CAT $2,951.906822 10G15MM IVAS SYS KIT $3,820.156823 10G15MM IVAS BAL CAT $2,951.906824 10G20MM IVAS SYS KIT $3,820.156825 10G20MM BALLOON CATH $2,951.906826 8G 10MM IVAS SYS KI $3,820.156827 8G 15MM IVAS SYS KIT $3,820.156828 10G HAND DRILL $202.606829 IVAS 10G ACCESS CANU $185.10

6830 IVAS 8G ACC CANNULA $189.256831 IVAS 8G BEVEL STYLET $143.806832 IVAS 8G HAND DRILL $254.406833 IVAS 8G VERT CEM CAN $171.156834 10G VERT LNG STY NEE $171.156835 10G VERT CEMENT CANN $168.806836 10G VERT SHRT STYLET $159.106837 11G VERTE CEMENT CAN $205.256838 8G BIOPSY KIT $269.356839 IVAS 10G BONE BIOPSY $267.406840 CARTRIDGE 5CC $2,431.006841 CARTRIDGE 10CC $4,167.456842 CARTRIDGE 10CC 2 PK $4,167.456844 MIX TIPS LUER 3PK $607.756845 MALYUGIN RING $2,604.656846 BS ALTRUA 60 GEN 606 $18,058.956847 BS ADVANTIO K063 GEN $17,364.356848 PACING LEAD 52CM4470 $1,910.056849 PACING LEAD MOD 4465 $1,910.056850 UNI POLAR PRESS FIT $11,576.256852 ROTICULAT AUTO STAPL $653.606853 20FGASTRFEEDING TUBE $366.056854 TR GRAFT PERICARD PA $955.006855 AHMED GLAUCOMA VALVE $1,811.256856 ACARE SPEED LOC 6500 $1,719.056857 ACARE SPEED LOC 7500 $1,719.056858 PURSTRING AUTO SUTUR $732.556859 CLINIC VISIT ALL LEV $290.656860 BARD MESH PLUG SM $1,795.706861 ENDO DISP BIOP FORCP $25.556862 HEWSON SUTURE RETRIE $382.006863 TSRH ROD $1,572.056864 TSRH CONNECTOR SM $4,407.056865 8X22 CAPSTN PEEK SPA $14,149.556866 TSRH SET SCREW $534.506867 TSRH SCREW $2,234.206868 LG BLK PST OP SHOE M $69.656869 SPIN CAN 1.25 X 90MM $145.856870 WLF PUMP TUB FLD CNT $215.306871 BI TIP FLEXTRODE $2,431.006872 XEROFORM $2.656873 IRR CONT SPIKE ADAPT $5.156874 T4 HOOD $83.956875 ZIM COMP VAC CEM MIX $641.856876 RECIPROCATOR BLADE $114.356877 OSCILLATOR BLADE $66.106878 IOBAN 2 23 X 23 $34.90

6879 INT HNDPC SET C HF T $100.706880 PLATE 8H VARIAX $3,989.256881 L 8 HOLE HUM PLT AXS $5,231.406882 4.5MM CANNUL SCREWS $93.856883 3.1 DRILL BIT $308.856884 2.5 DRILL BIT $362.556885 4.3 DRILL BIT $3,894.806886 3.2 DRILL BIT $513.456887 K WIRE LONG $84.556888 TA STAPLERS $294.506889 SCREWDRIVER BLADE $836.106890 OLIVE WIRE $88.506891 2.7 OVERDRILL BIT $442.606892 SPEED GUIDER BIT $1,996.906893 2.6 DRILL BIT $902.956894 SCREW 2.7 CANNULATED $442.606895 VAR SUP CLAV PL R SH $4,024.156896 2.0 STAND DRILL BIT $442.606897 BRD VENTR HERN PA LG $2,289.306898 ESOPH BAL DILAT CATH $850.856899 MEDTRONIC ACCES KIT $1,041.856900 BLOOD TRANSFUSION $1,823.256901 MULTILEAD TRIAL CABL $727.656902 EON MINI LE CHARG SY $4,615.456903 EON PAT PROGRAMMER $4,768.256904 DISPOS FRAME FIXATOR $1,898.506905 12H RECON LOCK PLATE $2,213.256906 12 HOLE PLATE $6,567.506907 MED SP STIM LD TRIAL $4,827.256908 MD INJX BIWNG ANC TR $955.006910 OM THR TIP GD PN 230 $137.706911 GUARDUS OVERTUBE $645.956912 SIMPL HV CEMENT W GE $1,305.806913 10 HOLE PLATE $2,272.306914 3.5MM DRILL BIT $316.756915 TSRH MED CONNECTOR $4,497.656916 NON CEMENT TOTAL HIP $18,191.256917 ENDO BABCOCK 10MM $142.906918 AVIATION PLATE 14MM $7,578.306919 AVIATOR VASD SCR 14M $1,853.206920 AVIATOR FIXATION PIN $785.956921 AVIATOR DRILL 12MM $1,305.956922 EXCHANGE PIN $429.956923 GUIDE PIN 3.2MM $215.006924 CANNUL DRILL BIT 7.0 $2,067.206925 ARM SLING $26.906926 SI BONE IMPLANT $11,890.45

6927 MULTI LUMEN CVC KIT $249.156928 CELL SAVE SERV 2-4HR $909.556929 CELL SAVER EA ADD HR $99.206930 ENDOTAK RELIANCE G $17,529.756931 SHORT GAMMA NAIL $4,938.906932 INSUFL TUBING LAPRA $20.506933 PIN CLAMP EX FIX LEG $1,979.606934 CALCANIEOUS XFIX PIN $476.056935 GREEN ROD HOLDER $1,826.856936 BLUNT PINS 5X180 $453.906937 PIN ROD HOLDER $1,941.956939 ROD 8 X 450 $1,031.906940 STRAIGHT ROD HOLDER $422.956941 ROD 8 X 200 $976.506942 EX FIX DRILL BIT 4.0 $305.406943 EX FIX PIN 380 $265.706944 TRULIGN CRYST IOL $3,142.106945 TRIAL SPINAL CORD ST $7,938.006946 PERM SPINAL CRD STIM $89,302.506947 MACROPLASTIQUE $1,637.206948 UROPL RIGID ENDO NED $99.206949 AMNIOTIC MEMBRANE $1,967.956950 ALCON ANTER VIRT PRO $628.406951 ENDOV SAFETY PEG KIT $975.706952 ESSENTIO DR IS1 $17,529.756953 RFDE SI SIMPLIC III $594.656954 MACKOOL CAT HOOK KIT $446.506955 MDM LINER CEMENT LES $1,653.756956 MDM X3 INSERT FOR MD $1,653.756957 STRYKER 5 HOLE PLATE $1,476.756958 BONE PUTTY 5 ML STER $5,512.756959 STRYKER 2 HOLE PLATE $8,711.956960 TRIAL LEAD N STIM 60 $5,391.206961 6" INSERT NEEDLE KIT $549.056962 PAT REMOTE KI $4,931.506963 N300 LEAD ANCHOR KIT $820.256964 PERCUTA LEAD INTRODU $248.056965 6 HOLE CLAVICLE PLAT $3,449.306966 MONOSTENT $413.456967 DAL MIL CABLE SLEEVE $1,077.556968 DAL MIL CABL GRIP LG $1,559.806969 45 BALL ELECTRODE $380.356970 SAGITTAL BLADE $211.306971 PULSE IRRIGATOR $155.256972 INFUSE KIT II BMP LG $18,419.456973 MASTERGRAFT MATRIX $3,902.856974 B DESGN ING HERN GRF $959.15

6975 DIST FIB 3 HOLE PLAT $2,164.106976 DEL SYS DIST BICP RP $3,827.256977 DS KIT FOR TENO SCRW $878.856978 HYDROSET $10,093.156979 BL TIP BAL TROC 12MM $220.506980 SURGIMEND 10 X10 X1 $6,300.006981 AVIATOR TEMP PIN $748.556982 AVIATOR DRILL 12MM $1,243.756983 HENSLER BONE PRESS $2,835.006984 AVIATOR PLATE 30MM $7,760.756985 AVIATOR SCREWS 14MM $1,764.956986 ROTHNET FB STANDARD $296.106987 TIGER WIRE $62.456988 TUNNELER $308.706989 RT INTERMED PLATE $5,109.306990 OMEGA K WIRE $124.906991 BIOCOMP INTER SCREW $740.256992 SURGIMEND 25 X 40 $53,550.006994 STRYKER TOTAL HIP $14,962.506995 HUMERAL CUP $5,847.656996 HUMERAL FX STEM $16,694.056997 PERIPHERAL SCREW $586.556998 HUMER CUP TRIAL ADAP $1,074.706999 CONCENTR GLENOSPHERE $5,847.657000 CENT SCREW TOT SHOUL $586.557001 INTRAOCULAR LENS $0.007002 GLENOID BASEPLATE $6,434.207003 HUMERAL INSERT $4,679.007004 PILOT WIRE $127.907005 3.1 MM DRILL BIT $341.757006 OBTRYX II SYS HALO $4,365.907007 UP LITE W CAPIO SLIM $6,891.907008 TFCC INSTR KIT $1,102.507009 K-LES TIGHTROP W DRV $4,709.257010 FEMORAL KNE CMT MOLD $8,914.507011 TIB KNEE CEMT MOLD $4,252.507012 .86MM GD WR TROC TIP $99.207013 2.MM DRIL BIT CALIBR $878.857014 28MM MCRO COMPRES FI $1,329.307015 .86MM GUIDEWR TROCAR $116.557016 SCP COM KNEE KIT 5CC $13,230.007018 BREV RAD OPAQUE EPI $208.557019 ZIP WIRE $183.957020 SENSOR STRT TIP WIRE $206.457021 CUTTING LOOP .35 MM $353.907022 SPED GUID DRL 2MMX30 $1,184.407023 VOLAR DR PLAT RT 11 $5,468.40

7024 BICO HEMOSTAS PROBE $449.007025 NEUROMEND $6,120.457026 KAHOOK DUAL BLADE $1,338.757027 CORTOSS 5CC CART CMT $1,687.607028 BALLEON SYSTEM $2,362.507029 MIX TIP 3 PK $491.407030 DELIVERY GUN $1,420.257031 PICO NEG WOUND DSG $693.007032 AUTFIX COMPRES SCREW $1,765.057035 I FU EXCHANG PIN 3.2 $367.507036 I FUS BLNT PIN 3.2 $204.757037 1 FUS GD PIN 3.2 $204.757038 I FUS CANNUL DR 7.0M $1,968.757039 I FUSE 3D $11,324.257040 TAUT OP CHOLANG CATH $168.507041 REVITA 6X6 CM GRAFT $13,200.007215 ENDO STITCH SUT DEV $345.457216 ENDO GIA 60 MM MED $674.138001 0.45% NS 1000 ML $7.908003 DEXTROSE 500 ML $18.908006 SODIUM CHLORIDE INJ $8.108008 D5%W 0.45%NS 500 ML $18.908009 D5%W 0.45%NS 1000 ML $8.108010 DEX. NACL. KCL 1000M $8.608011 D5%W 0.2%NS 500 ML $7.708012 D5% 0.2%NS 1000 ML $7.908013 D5%W LR 500 ML $18.908014 D5%W LR 1000 ML $7.908015 D5% 0.9%NS 500 ML $8.108016 D5%W 0.9%NS 1000 ML $7.908018 DEXTROSE WATER 50ML $6.808019 DEXTROSE WATER 100ML $6.808021 DEXTROSE WATER 250ML $7.508022 DEXTROSE WATER 500ML $7.908023 DEXTROSE WATER 1000M $11.008024 EMPTY CONTAINER 100M $0.008025 EVACUATED CONTAINER $17.108026 EVACUATED CONTAINER $18.808027 EVACUATED CONTAINER $19.708029 LACTATED RINGERS 500 $18.908030 LACTATED RINGERS 100 $18.908031 SODIUM CHL 50ML NS 0 $6.808032 SODIUM CHL 100ML NS $6.808034 SODIUM CHL 500ML NS $8.708035 SODIUM CHL 1000ML NS $9.408036 PROCLAM. (3%AMINO. 3 $75.758037 RINGERS 1000ML $14.40

8040 SODIUM CHLORIDE 0.9% $8.208041 D51/2NS + 40MEQ KCL $10.708042 NS + 20MEQ KCL $8.508043 D5W + 20MEQ KCL $8.308044 D5NS + 20 MEQ KCL $10.308045 D5NS +40MEQ KCL $11.208046 D51/4NS + 20MEQ KCL $10.809001 ABBOCATH 16 X 2 $0.009002 ABBOCATH 18 X 2 INCH $11.559003 ABBOCATH 20 X 1/4 IN $11.559004 ABDOMINAL SUPPORT $58.109006 ACE BANDAGE $7.359008 ACURA COUNT NEEDLE P $11.559010 ADMINISTRATION SET I $27.509011 ADMISSION KIT $13.709014 ARM IMMOBILIZER $25.359015 ARM IMMOBILIZER, SMA $25.359016 ARM SLING $13.709017 ARM SLING, ADULT MED $13.709018 ARM SLING ADULT SMAL $13.709019 ARM SLING BLACK CLOT $15.859020 ARM SLING PEDIATRIC $15.859021 BAG BILE $30.609022 BAG BLOOD WARMING $46.459024 BANDAGE: ACE 2" $4.209025 BANDAGE: ACE 3" $4.209026 BANDAGE: ACE 4" $4.209027 BANDAGE: ACE 6" $4.209028 BANDAGE: KLING 3" $4.209029 BANDAGE: KLING 4" $4.209030 BANDAGE: KLING 6" $4.209031 BANDAGE: KLUNG 2" $4.209032 BASIN. EMESIS DISP. $4.209033 BELT PELVIC TRACTION $71.809040 BIOPSY NEEDLE $79.209041 BLADE RETRIEVER $48.609042 BLOOD COLLECTION SET $13.709043 BLOOD COMPONENT SET $11.559044 BLOOD, ARTERIAL/GAS $11.559045 BONE CEMENT $236.709046 BONE CEMENT- CARTRID $83.509047 BONE SCREW $0.009048 BOOT: CAST WEATHERPR $44.309049 BOVIE (GROUND PAD & $36.909050 BRACE, KNEE UNIVERSA $123.659051 BRACE- KNEE LARGE $125.759052 BRACE - KNEE MEDIUM $125.75

9053 BRACE - KNEE SMALL $125.759054 BRACE - KNEE X LARGE $125.759055 BRACE -NASAL $44.309056 BRONSON BOOT $32.759059 CANNULAE $4.209061 CAST BOOT $62.309062 CATH. & GLUV SET 14 $7.359063 CATH. FOLEY 2 WAY 16 $42.209064 CATH. FOLEY 2 WAY 18 $42.209065 CATH. FOLEY 2 WAY 20 $42.209066 CATH. FOLEY 2 WAY 20 $42.209067 CATH. FOLEY 2 WAY 20 $42.209068 CATH. FOLEY 2 WAY 22 $42.209070 CATH. FOLEY 2 WAY 22 $42.209071 CATH. FOLEY 2 WAY 24 $42.209072 CATH. FOLEY 2 WAY 24 $42.209073 CATH. FOLEY 2 WAY 26 $42.209074 CATH. FOLEY 2 WAY 26 $42.209075 CATH. FOLEY 2 WAY 28 $42.209076 CATH. FOLEY 2 WAY 28 $42.209077 CATH. FOLEY 3 WAY 18 $42.209078 CATH FOLEY 3 WAY 20 $42.209079 CATH. FOLEY 3 WAY 22 $42.209080 CATH. FOLEY 3 WAY 24 $42.209081 CATH. FOLEY 3 WAY 26 $42.209082 CATH. FOLEY 3 WAY 28 $42.209083 CATH. SUBCLAVIAN (DE $50.709084 CATHETER FOGARTY (OR $69.659085 CATHETER FOGARTY *3F $197.559086 CATHETER FOGARTY *4F $181.759087 CATHETER STRAIGHT RU $9.509088 CATHETER STRAIGHT RU $9.509089 CATHETER STRAIGHT RU $9.509090 CATHETER STRAIGHT SZ $9.509091 CATHETER STRAIGHT SZ $9.509092 CATHETER STRAIGHT SZ $9.509093 CATHETER STRAIGHT SZ $9.509094 CATHETER STRAIGHT SZ $9.509095 CATHETER STRAIGHT SZ $9.509096 CATHETER STRAIGHT SZ $9.509097 CATHETER STRAIGHT SZ $9.509098 CATHETER STRAIGHT SZ $9.509099 CATHETER SUCTION SZ $7.359100 CATHETER SUCTION SZ $7.359101 CATHETER SUCTION SZ $7.359102 CATHETER SUCTION SZ $7.359103 CATHETER SUCTION SZ $7.35

9104 CATHETER CHOLANGIOGR $65.509105 CATHETER TROCAR (CHE $55.959106 CATHETER, URETHRAL C $34.909108 CATHETER, TRAY #6006 $39.059109 CATHETER, URETHRAL S $13.709110 CAUTERY ERASER HEMOS $34.909111 CAUTERY SURICAL (SUR $48.609112 CAUTERY. OP-TEMP $34.909113 CERVICAL COLLAR $21.109114 CERVICAL COLLAR FOAM $27.509115 CERVICAL COLLAR FOAM $27.509116 CERVICAL COLLAR: FOA $27.509117 CERVICAL COLLAR: PHI $174.359119 CERVICAL HALTER (SKI $42.209120 COLOSTOMY: BELT #120 $36.909121 COLOSTOMY: LOOP LOC $222.959122 COLOSTOMY: ERFILL #1 $50.709123 COLOSTOMY: REFILL #1 $88.709124 COLOSTOMY: REFILL #1 $139.459125 COLOSTOMY: REFILL #1 $139.459126 COLOSTOMY: REFILL #1 $181.759127 COLOSTOMY: RING PLAS $13.709128 COLOSTOMY: RING PLAS $13.709129 COLOSTOMY: RING PLAS $13.709130 COLOSTOMY: RING PLAS $13.709131 COLOSTOMY: SURE FIT $46.459132 COMPRESSION SET ( TU $697.459134 CRUTCHES $33.409135 CRUTCHES: ADULT #42/ $55.959136 CRUTCHES: ADULT # 46 $55.959137 CRUTCHES: CUSHION TI $55.959138 CRUTCHES: PEDIATRIC $55.959139 CRUTCHES: UNDERARM P $55.959140 CYSTO IRRIGATION SET $21.109141 CYTOLOGY BRUSH $39.059142 DERMATONE BLAD $39.059154 DISCARD-A-PAD $7.359155 DISPOZ- A-BAG: MEDIU $19.009156 DRAIN: PENROSE 4 X 6 $4.209157 DRAIN: PENROSE LATEX $4.209159 DRAIN: PENROSE LATEX $4.209160 DRAIN:PENROSE LATEX $4.209162 DRAINAGE SET, CLOSED $25.359168 DRESSING: ADAPTIC $7.359169 DRESSING: ADAPTIC 3 $7.359173 ENEMA: BAGS (FLEET) $7.359174 EPSILON ULTRA SONIC $544.25

9175 EXT SET .22 MICRON F $25.359176 EXT. SET 30 FOR SYRI $21.109177 EYE GARTER $4.209179 FAZIOPLAST $30.609181 FLATUS EVACUATION $4.209182 FOLEY SIL COATED 2 W $42.209183 FOLEY SIL COATED 2 W $42.209184 FOLEY SIL COATED 2 W $42.209185 FOLEY SIL COATED 2 W $42.209186 FOLEY SILCONE 2 WAY $42.209187 FOLEY SILCONE 2 WAY $42.209188 FOLEY SILCONE 2 WAY $42.209189 FOLEY SILCONE 2 WAY $42.209190 FOLEY SILCONE 2 WAY $42.209191 FULLER SHIELD $25.359192 GAUZE, VASELINE $53.859193 GAUZE, VASELINE PACK $90.809194 GIGLI SAW $27.509203 GRAFT-ST $0.009204 GRAFT-ST. VASCULAR ( $1,255.459205 HANDLE,SUCTION, YANK $11.559206 HEMOSTATIC ERASER $34.909207 HIP PACK, SPECIAL $278.959208 HUDSON MASK, MULTI V $11.559210 PACKS (OPHTHALMIC) I $557.959211 PACKS (UNIPAC) I-A $484.009212 IMMOBILIZERS-KNEE $97.159213 IMMOBLIZERS-SHOULDER $21.109214 IMMOBILIZERS-WRIST $62.309215 INSPIRON CIRCUITS, I $19.009217 INSPIRON MASK OXYGEN $0.009218 INSPIRION NEBULIZER, $15.859219 IRRIGATION SET (ABBO $55.959220 IRRIGATION SET MARSA $162.809221 IRRIGATION TRAY PIST $7.359222 IRRIGATION TRAY, SEA $7.359223 JEJUNOSTOMY SET (NEE $69.659224 K-PAD (DUO THERM 112 $55.959225 K-WIRE, STAINLESS $365.809226 KARAYA GUM WASHER 1 $27.509227 KARAYA GUM WASHER 1" $27.509228 KARAYA GUM WASHER 2 $27.509229 KARAYA GUM WASHER 2" $27.509230 KARAYA GUM WASHER 3" $27.509231 KLING BANDAGE $4.209237 LAP PAD ( SPONGE) 20 $4.209238 LIGA CLIP $17.60

9239 LIMB RESTRAINT "CAST $19.009240 LINERS, SUCTION (MED $13.709241 LINERS, SUCTION (MED $13.709242 LOTION $4.209243 LUKI-LUBE $9.509248 MASK, OXYGEN DISP. 1 $4.209250 MASK, TRACH (AEROSOL $11.559252 MICROPHAK (CRYOWIK E $183.859253 MICROSPONGE $9.509254 MINISET VEIN INFUSIO $4.209255 MINISET VEIN INFUSIO $7.359256 MINISET VEIN INFUSIO $7.359257 MINISET VEIN INFUSIO $7.359259 MINISET VEIN INFUSIO $4.209260 MINISET VEIN INFUSIO $4.209261 MISTY NEBULIZER #201 $9.509262 MODESS $4.209263 MONTGOMERY STRAP $112.059264 MOUTHWASH $4.209265 NEB. W/FLO 2 2% $25.359266 NEBULIZER, MISTY W/M $9.509267 NEBULIZER, MISTY W/T $7.359270 OR CATHERER PHILLIPS $39.059271 OR DRESSING $4.209278 PENROSE PACK $9.509279 PINS (OR) STERILE SA $4.209280 PLUER-EVAC $306.459284 PROSTHESIS CUP (ACET $488.259285 PROTRUSIO SHELL IN T $836.909286 QUIK CATH 18 G X 1 1 $7.359287 QUIK CATH 208 $7.359291 RESPIREY #158A $23.209292 RESTRICTOR SET W/LVC $69.659293 RIORDAN FIXATION PIN $25.359294 SCREW (COMPRESSION S $27.509295 SCREW (MALLEOLAR) $48.609297 SHIRLEY WOUND $13.709298 SHOULDER DRESSING UN $25.359299 SHOULDER IMMOBLIZER $25.359300 SHOULDER IMMOBILIZER $25.359301 SHROUD KIT (MORTUARY $13.709302 SILCONE COATED 2 WAY $42.209303 SITZ BATH (DISPOSABL $15.859304 SKIN STAPLE EXTRACTO $25.359305 SKIN TRACTION KIT, A $44.309306 SKIN TRACTION KIT, P $44.309307 SKIN TRACTION KIT-JU $44.30

9308 SLING $19.009309 SLIPPERS-FOAM:LARGE, $7.359310 SLIPPERS-FOAM: MEDIU $7.359315 SPECIL SUTURES $7.359316 SPECIAL SUTURES (OPH $77.109318 SPLINT `C` 4 X 15 $69.659319 SPLINT `C` 4 X 30 $69.659320 SPLINT ARM UNIV. WRI $55.959321 SPLINT CLAVICLE LARG $39.059322 SPLINT CLAVICLE MEDI $39.059323 SPLINT CLAVICLE SMAL $39.059324 SPLINT CLAVICLE X LA $39.059325 SPLINT FINGER $7.359326 SPLINT FINGER 1 X 18 $11.559327 SPLINT FINGER 1/2 X $11.559328 SPLINT FINGER 3/4 X $11.559329 SPLINT FINGER PEDIAT $60.209330 SPLINT FOREARM $62.309331 SPONGE PEANUT $7.359332 SPONGE: COVER NON-ST $25.359333 SPONGE: GAUZE 4X4 12 $7.359334 STANDARD ADMINISTRAT $9.509335 STANDARD MINI DRIP I $9.509336 STAPLE FRACTURE $34.909337 STAPLES $158.509338 STAPLES 30-4. 8 INTE $292.709339 STAPLES SM 12W SKIN $158.509340 STAPLES SM 25W $158.509341 STEINMAN PIN $23.209342 STERI-STRIP $7.359343 STERI-STRIP LCE. R-1 $7.359344 STERI-TRIP MED. R-15 $7.359348 STERILE WATER FOR IR $0.009349 STINT URETERAL DOUBL $627.659351 STOCKINGS: THIGH-HI $27.509352 STOCKINGS: THIGH-HI $27.509353 STOCKINGS: THIGH-HI $27.509354 STOCKINGS: THIGH-HI $27.509355 STOCKINGS: THIGH-HI $27.509356 STOCKINGS: THIGH-HI $27.509357 STOCKINGS: THIGH-HI $27.509358 STOCKINGS: THIGH-HI $27.509359 STOCKINGS: THIGH-HI $27.509360 STRIP BRACE 5" X 30" $44.309361 STRIP REINFORCING TR $116.259362 STRIP REINFORCING TR $116.259363 STRIP REINFORCING TR $116.25

9364 STRIP REINFORCING TR $125.759368 SUCTION TUBE ORTHO S $39.059369 SUSPENSORY: LARGE $30.609370 SUSPENSORY: MEDIUM $30.609371 SUSENSORY: X-LARGE $30.609372 SUTURE: REMOVAL TRAY $7.359373 SWIVEL: ADAPTOR (POR $39.059374 T-SIZE 8 $25.359375 T-SIZE 10 $25.359376 T-SIZE 12 $25.359377 T-SIZE 14 $25.359378 T-SIZE 16 $25.359379 T- SIZE 18 $25.359380 TAPE: DERMICEL $7.359381 TAPE: DERMICEL 1" #5 $7.359382 TAPE: DERMICEL 2" #5 $7.359383 TAPE: DERMICEL 3" #5 $7.359384 TAPE: MICROFOAM #152 $34.909385 TAPE: MICROFOAM (PAT $34.909386 TAPE: MICROPORE 1" $4.209387 TAPE: MICROPORE 2" $4.209390 TRAY:LUMBAR PUNTURE- $112.059391 TRAY: LUMBAR PUNTURE $112.059392 TRAY: MANOMETER $27.509393 TRAY: THOROCENTESIS $146.909394 TRAY:THOROCENTESIS W $104.609395 TRAY:TRACHEOSTOMY CL $27.509396 TUBE: TRACHESTOMY (C $193.359397 TUBE: ANDERSON AN-10 $13.709398 TUBE: ANDERSON AN-20 $60.209399 TUBE: ANDERSON AN-21 $60.209400 TUBE: CONNECTING 9' $7.359401 TUBE: FEEDING SET IS $9.509402 TUBE: FEEDING SIZE 1 $4.209403 TUBE: FEEDING SIZE 5 $4.209404 TUBE: FEEDING SIZE 8 $4.209405 TUBE: FEEDING VIVONE $67.609406 TUBE:LEVINE SIZE 10 $21.109407 TUBE: LEVINE SIZE 12 $21.109408 TUBE: LEVINE SIZE 14 $21.109409 TUBE:LEVINE SIZE 16 $21.109410 TUBE: LEVINE SIZE 18 $21.109411 TUBE: LEVINE SIZE 18 $21.109412 TUBE: LEVINE SIZE 20 $21.109413 TUBE: LEVINE SIZE 22 $21.109414 TUBE: LEVINE SIZE 8 $21.109415 TUBE: OXYGEN CONNECT $4.20

9416 TUBE:RECTAL #22 $15.859417 TUBE:RECTAL #26 $15.859418 TUBE:RECTAL #28 $15.859419 TUBE:RECTAL #30 $15.859420 TUBE:STOMACH #12 $4.209421 TUBE:STOMACH #14 $4.209422 TUBE:STOMACH #16 $4.209423 TUBE:STOMACH #18 $4.209424 TUBING,CORRUGATED 72 $7.359427 URINEMETER $83.509428 UROGATE IRRIGATION S $55.959429 VAGINAL IRRIGATION $11.559430 VEIN STRIPPERS $34.909432 VENTILATOR, VOLUME S $55.959433 VESSEL LOOP (DISPOSA $19.009434 VITRECTOMY SYSTEM II $592.859435 X-RAY COVERS (CASETT $13.709436 Y TYPE ADMINISTRATIO $23.209437 Y TYPE IRRIGATION SE $34.909455 SODIUM CHLORIDE 0.9% $0.009458 TYPE BLOOD ADM. SET $13.709466 MESH 3D MAX $750.459467 FOUR SHOOT MULTI LIG $850.709468 CAM WALKER $255.20

10004 GUEST TRAYS $9.2510006 PERSONAL SERVICES $0.0011001 KETOGENIC STEROIDS 1 $93.4011002 KETROSTEROIDS 17 $105.7011003 OH CORTICOSTEROIDS $187.3511004 HIAA URINE 5 $137.8511005 NUCLEODIDASE 5 $84.5011006 MANUAL PLATELET CNT $50.1511007 METABOLIC PANEL-BASI $90.5011008 BLOOD TYPE & RH $0.0011009 ACETAMINOPHEN $216.5011010 ACETONE (QUAL) SERUM $41.3511011 METABOLIC PANEL-COMP $114.5011012 ACID PHOSPHATASE TOT $96.9011013 SHELL INNOCULAT VZV $204.2011014 ACTH $413.3011015 ALBUMIN $53.0011016 AFB SMEAR $49.2511017 CHLAMYDIA CULTURE $220.1511018 ALCOHOL $104.6011019 ALDOSTERONE $436.0011020 ALKLINE PHOSPHATASE $57.6511021 CHLAMYDIA DNA PROBE $58.10

11022 AMMONIA $155.8511023 AMPHETAMINE METHAMPH $147.3011024 AMYLASE $69.3511025 ANA $119.4511026 ANTI DNA $147.0011027 ACTIN (SM MUSCLE) AB $147.9511028 THYROGLOBULIN AB $197.3511029 ANTI THYROID MICROSO $155.6011030 ANTIMITOCHONORIAL AN $147.9511031 ANTIPARIETAL ANTIBOD $147.9511032 ASO TITER $78.0511033 APOLIPOPROTEIN A-1 & $105.7011034 BREWERS YEAST ALLERG $30.8011035 SP CONCENTRAT. PREP $71.4511036 VITAMIN B12 $161.2011037 UR PHOSPHORUS RANDOM $73.1011038 GMMP METABOLITE $309.0511039 BARBITURATES $147.3011040 BENZODIAZEPINES $197.8511041 B-HCG SUBUNIT,QUANT. $161.0011042 GTG METABOLITE $309.0511043 BILIRUBIN, TOTAL SER $53.7011044 BLEEDING TIME $48.2011045 BLOOD GAS (PH, PCO2, $207.0511046 GTT-4TH SPEC. $8.8011047 C-REACTIVE PROTEIN $79.2011048 C-DIFFICILE TOXIN $121.5511049 CA 125 $222.6011050 CALCIUM $55.1011051 CANNABINOIDS $48.4511052 CARBAMAZEPINE $125.4511053 CARBON DIOXIDE CONTE $39.2511054 PRO-PREDICTR 6MP $0.0011055 RACEMOSUS ALLERGEN $53.4011056 CATECHOLAMINES FRACT $183.1511057 CEA $202.9511058 CELL COUNT W/DIFF (C $46.0011059 CBC & DIFF $83.1011060 GTT 1 HOUR $57.2011061 CERULOPLASMIN SERUM $80.6511062 CHLAMYDIA DIRECT AG $197.2511063 CHLORIDE (BLOOD, URI $66.9011064 CHOLESTEROL. TOTAL $46.5011065 CKMB $154.9011066 ANTI HISTONE AB $73.1011067 COCAINE $147.3011068 COLD AGGLUTININS $62.15

11069 GC DNA PROBE $63.3511070 COMPLEMENT C 3 $128.4511071 COMPLEMENT C 4 $128.4511072 COMPLEMENT TOT. CH50 $217.4011073 CBC WITHOUT DIFF $83.1011075 CORONARY RISK PANEL $96.9011076 CORTISOL $174.4011077 CORTISOL FREE URINE $178.7511078 CK $70.4511079 CREATININE $54.8011080 CREATININE CLEARANCE $101.0511081 CRYOGLOBULIN, QUAL. $69.2511082 CULTURE AFB $115.6511083 CULTURE BLOOD DEFINI $112.7011084 BODY FLUID CULT W/GS $0.0011085 CULTURE CSF W/GR STN $0.0011086 CULTURE EYE AND EAR $67.8511087 CULTURE FUNGI $89.9011088 CULTURE GC $70.8511089 CULTURE OTHER $92.2011090 CULTURE SPUTUM W/GS $0.0011091 CULTURE STOOL $0.0011092 CULTURE THROAT $92.2011093 CULTURE VAGINAL/URET $92.2011094 CULTURE VIRAL $272.2011095 CULTURE WOUND $92.2011096 CULTURE YEAST $44.0011097 CYTOMEGALO VIRUS CUL $156.7011098 CMV IGG AB $154.0511099 CMV IGM AB $103.9011100 HGB & HCT $0.0011101 DEPAKENE (VALPROIC A $144.9011102 FINGERSTICK GLUCOSE $35.2011103 DIFFERENTIAL $51.0511104 DIGITOXIN $90.6511105 DIGOXIN $142.0511106 DILANTIN $141.8011108 DRUG SCREEN TOXIC UR $0.0011109 EBV CAPSID ANTBDY & $194.1511110 EBV EARLY ANTIBODY & $140.3011111 EBV NUCLEAR ANTIBODY $163.7011112 ELECTROLYTES $100.4511113 ELECTROPHORESIS HEMO $0.0011114 EOSINOPHIL COUNT $44.5011115 EBV PANEL $0.0011116 EBV CAPSID AG -LGM $88.9511117 ESTRADIOL $298.95

11118 ESTRIOL $258.7011119 FAT (FECAL) $116.2511120 STREP EXOENZYME AB $97.3011121 FEB AGGLUT, EACH ANT $51.0511122 FERRITIN $145.7511123 FIBRINOGEN $90.8511124 FOLATE (FROZEN) $157.3011125 FSH $198.8511126 GASTROCCULT $44.0011127 SKIN CULTURE $92.2011128 GENTAMICIN $175.3011129 GGTP $76.9511130 GLUCOSE (2 HR. P P ) $105.7011131 GTT-5TH SPEC $8.8011132 GLUCOSE QUANTITATIVE $41.9011133 FESCUE GRASS ALLERGN $30.8011134 GLUCOSE TOL 3 HR (4 $137.7511135 GLUCOSE TOL 4 HR (5 $137.7511136 GLUCOSE TOL 5 HR (3 $137.7511137 GLUCOSE TOL 6 HR (3 $108.2511138 GLYCOHEMOGLOBIN $103.8011139 GRAM STAIN $45.5511140 HAPTOGLOBIN $134.6011141 LIPID PANEL $143.3511142 BANANA ALLERGEN $53.4011143 HEMATOCRIT $25.3511144 OAT ALLERGEN $53.4011145 HEPATIC FUNCTION PAN $102.1511146 HEPATITIS A ANTIBODY $120.4511147 HEPATITIS B CORE AG $128.9511148 HEPATITIS B SURFACE $115.4511149 HEPATITIS B SURF AG $110.4511150 HEPATITIS C ANTIBODY $154.9011151 HEPATITIS ACUTE PNL $0.0011152 HERPES IGG I & II $0.0011153 HETEROPHILE $55.3511154 EBV NUCLEAR AG -LGM $149.6511155 KEPPRA/LEVETIRACETAM $193.2011156 IMMUNOGLOBULIN IGA $99.5011157 IGE $225.4011158 IMMUNOGLOBULINS IGG $99.5011159 IMMUNOGLOBULIN IGM $99.5011160 IMMUNOFIXATION BLD $253.2511161 IMMUNOFIXATION URINE $301.2011162 IMMUNOGLOBIN PANEL, $0.0011163 TISSUE CULTURE W/GS $0.0011164 PEANUT ALLERGEN $53.40

11165 INSULIN $122.3511166 TIBC $93.5011167 IRON, SERUM (TOTAL) $69.3011168 LDH $70.4511169 LDH ISOENZYMES $93.6011170 STRAWBERRY ALLERGEN $53.4011171 LEGIONELLA IGM $163.7511172 LAP $92.0011173 LH $198.2011174 LIDOCANE $114.5011175 LIPASE $62.1511176 LIPOPROTEIN ELECTROP $0.0011177 LITHUM $77.5011178 LYME TITRE CSF $44.0011179 LYME TITRE SERUM $137.4011180 LYME WESTERN BLOT $0.0011181 MAGNESIUM $71.6511182 METHADONE $149.2511183 TOMATO ALLERGEN $53.4011184 MYCOPLASMA PNEUMO. A $0.0011185 NASAL SMEAR FOR EOSI $57.2011186 BLASTOCYSTIS $44.0011187 DISOPYRAMIDE/NORPACE $176.1511188 OCCULT BLOOD-STOOL $25.5011189 OPIATES $147.3011190 PREALBUMIN $59.7511191 OVA & PARA, FECAL: D $105.7011192 PARTIAL THROMBOPLAST $68.6011193 RAST PROFILE (MULT A $0.0011194 PH $63.3511195 PHENCYCLIDINE $147.3011196 PHENOBARBITAL $122.6011197 PHOSPHORUS $50.7511198 PINWORM $64.1011199 PLATELET COUNT $47.7511200 PO2 $65.1511201 PORPHOBILINOGEN, QUA $26.4511202 PORPHYRINS QUANTITAT $105.7011203 POTASSIUM $49.1011204 PREGNANCY TEST- SERU $80.3011205 PREGNANCY TEST URINE $80.3011206 STRIATED MUSCLE AB $124.4511208 PRIMIDONE $111.0011209 PROCAINAMIDE + NAPA $135.5511210 IMMUNO/INFECTIOUS AB $53.7011211 PROGESTERONE $223.2511212 PROLACTIN $207.35

11213 PROSTATIC ACID PHOSP $75.7011214 RADIOPHARM TECHNIQUE $79.6511215 PSA $196.7511216 PR E-PHORESIS SERUM $114.8511217 PROTEIN ELECTROPHORE $82.7511218 PROTEIN TOTAL (SERUM $45.1011219 PROTEIN (ALBUMIN) 24 $61.9011220 LIGHT CHAIN PROTEIN $239.0011221 PROTHROMBIN CONSUMPT $42.2011222 PT/INR $50.1511223 PTH (FROZEN) INTACT $0.0011224 PWRM $255.4011225 QUINIDINE $107.4011226 RHEUMATOID FACTOR $60.7011227 RBC-CSF $19.4011228 RED CELL FRAGILITY T $82.7511229 RENAL CALCULI- STONE $84.5011230 FLOURESCENT TITRE EA $73.9511231 RENIN (FROZEN) (EDTA $235.3011232 RETICULOCYTE $47.5011233 RMSF IGG $0.0011234 RUBELLA $154.0511235 RUBEOLA ANTIBODY IGG $137.8011236 SALICYATES $75.9511237 SEDIMENTATION RATE $54.2511238 SEMEN ANALYSIS COMPL $290.6511239 SEMEN FOR MICROSCOPI $290.6511240 ANTIBIOTIC SENS PER $62.1511241 SERUM OSMOLALITY $70.7011242 SERVICE CHARGE-TRANS $19.1011243 SGOT (AST) $55.3011244 SGPT (ALT) $56.6511245 SICKLE CELL PREPARAT $42.1511246 SMEARS FOR PARASITES $64.1011247 SMEARS STAINED, ANY $40.4511248 SODIUM $51.4511249 SPECIFIC GRAVITY $15.8511250 SPECIMEN COLLECT FEE $6.1011251 CELIAC DISEASE AB $0.0011253 KIDNEY STONE ANALYS. $137.7511254 SKELETAL MUSCLE ABS $29.0511255 PSA MONITORING $196.7511256 SUGAR, QUALITATIVE $6.1011257 ALCOHOL METHYL $123.0011258 NEONATAL BILIRUBIN $44.0011259 T3UPTAKE $69.2511260 T3RIA $151.70

11261 T4 $73.5511262 TESTOSTERONE $276.3011263 THEOPHYLLIN $146.8011264 THYROID PANEL (T3U, $0.0011265 THYROXINE, FREE $96.4511266 TOBRAMYCIN TROUGH $177.1511267 TOURNIQUET TEST $15.8511268 TOXOPLASMOSIS IGG AB $154.0511269 TOXOPLASMOSIS IGM AB $95.0511270 TRICYCLIC ANTIDEPRES $147.3011271 TRICYCLIC ANTIDEPRES $145.2511272 B BURGDORFERI IGG $140.9011273 TRYOSINE $42.2011274 TSH $179.7011275 TRANSFERRIN $149.6511276 TYPE/RH & AB SCREEN $0.0011277 UREA CLEARANCE $51.0511278 UREA NITROGEN $42.1511279 BUN 24 HR URINE $41.3511280 URIC ACID $50.1511281 URIC ACID CRYSTALS $47.1511282 URINALYSIS $36.9011283 URINE CULTURE $86.5511284 OSOMOLALITY URINE $72.8511285 URINE, BILIRUBIN $44.0011286 UROBILINOGEN QUALITA $21.1011287 UROBILINOGEN QUANTIT $47.5011288 VANCOMYCIN $139.0511289 RENIN ACTIVITY $135.5511290 VDRL (RPR) $45.5511291 VMA 24 HOUR URINE $161.9511292 VOL MEASURE URINE $28.1511293 ZINC $78.7011294 BORRELIA BURGDORFERI $0.0011295 LDL DIRECT $102.0011296 THROAT CULTURE-R/O S $70.8511297 VARICELLA ZOSTER IGM $223.6511298 RUBELLA SCREEN-IGG $86.2511299 HEMOGLOBIN $25.3511300 ABO $40.4511301 R H $31.8511302 ANTIBODY SCREEN GEL $122.3511303 HPV DNA LOW/HIGH RIS $0.0011304 HPV DNA LOW/HIGH RIS $366.6011305 PAPILLOMAVIRUS DNA $0.0011306 ARCH R BINDING $317.0011307 HGE $70.80

11308 HUMAN GRANUL (HGE) $0.0011309 URINE COLLECTION $7.0511310 OSTEOCALCIN, HUMAN $284.9511311 IMMUNO QUANT RIA $396.2011312 WESTERN BLOT $396.2011313 PARANEOPLASTIC PRO $0.0011314 IMMUNOASSAY QUANT. $396.2011315 VITAMIN A $124.0011316 HOMOCHROM DNA MUTATE $0.0011319 HEPATITIS C DIRECT $73.1011320 IMMUNOASSAY NONAB $93.6011321 HEP B DNA QNT VIRAL $0.0011322 CHEMILUMINSCENT $65.1511323 GLUTETHIMIDE $111.0011326 ARSENIC FRACTIONATE $302.9011327 DEXAMETHASONE SUPRES $99.5011328 TOTAL CARBAMAZEPINE $83.9511329 HCV RNA QUANT $605.8011330 15-20 CELL KARYOTYPE $1,302.0511331 TISSUE CULTURE $219.8511332 CHROM ANYSIS BM/HEM $0.0011333 TISSUE CULTURE $132.1011334 ADDITIONAL KARYOTYPE $128.8011335 ANALYSIS 20-25 CELLS $638.9011336 LIPOPROTEIN TRIGLYCE $35.2011337 LIPOPROTEIN SEPARATE $69.1511338 HLA TYPING A,B,C $0.0011339 CARBA METABOLITE $106.5511340 HSV 1,2 TYPE SPECFIC $0.0011341 HERPES SIMPLEX TYPE1 $81.0011342 HERPES SIMPLEX TYPE2 $118.9011343 RETICULIN IGA AB $128.9511344 RAST ALLERGEN EACH $52.1511345 GM1 AB IGG $125.0011346 GM1 AB IGM $125.0011347 CHLAMYDIA TRA AB IGM $55.5011348 CHLAMYDIA TRA AB IGG $55.5011349 Q FVR PHASE 1 IGG/M $60.7011350 Q FVR PHASE 2 IGG/M $60.7011351 WESTERN BLOT $220.1511352 WESTERN BLOT MAG AB $140.9011353 CYTOPATHOLGY CER/VAG $44.0011354 HPV II DNA $100.4511355 HUMAN PAPILLO II DNA $0.0011356 SMITH ANTIBODY $109.2011357 IMMUNE BINDNG TO C1Q $260.6511358 PNUEM IGG AB 12 SERO $0.00

11359 PNEUMOCOCCAL AB EACH $148.8011360 LIVR/KIDNEY MICRO AB $123.2511361 DIRECT COOMBS IGG $35.2011362 DIRECT COOMBS C3 $35.2011363 GAMMAGLOBULIN EACH $57.2011364 ALBUMIN CSF $53.0011365 NEPHELOMETRY $121.4511366 CSF/SERUM IGG INDEX $0.0011367 CSF LYME INDEX EACH $173.4511368 CSF/SERUM LYME INDEX $0.0011369 IMMUNFIXATION 24HR $239.0011370 RETICULIN IGG AB $128.9511371 RETICULIN AB IGG/IGA $0.0011372 CELIAC PANEL #1 $0.0011373 CELIAC PANEL #2 $0.0011374 GLUTAMIC DECARB AB $117.8011375 LYME FLUID IGG WB $228.9511376 LYME FLUID IGM WB $228.9511377 LYME FLUID IGG/IGM $0.0011378 MA TA COMBINED AUTAB $676.2511379 VOLTAGE GATED 34057 $500.6011380 CHROMOGRANIN A $222.6011381 IMMUNO ELECTRO BLOOD $239.0011382 SMITH ANTIBODIES $111.0011383 RNP ANTIBODIES $111.0011384 INHIBIN A $162.8011385 CLOZAPINE/METABOLITE $136.5011386 H PYLORI IGA $62.1511387 CLAM ALLERGEN $53.4011388 OYSTER ALLERGEN $30.8011389 SCALLOP(BLUE MUSSEL) $30.8011390 ESTRADIOL, 17-BETA $291.8511391 BLOOD C/S FOR FUNGUS $159.4511392 PR E-PHORESIS UR/CSF $190.8511393 IMMUNO ELECTRO 24HR $239.0011394 METANEPHRINES PLASMA $315.2011395 RUSSELL VIPER TIME $62.1511396 CHLAMYDIA TMA $375.5511397 GC/CHLAMYDIA BY TMA $0.0011398 DIHYDRTESTOSTERONE $276.2011399 HORSE DANDER ALLERGN $30.8011400 SUGAR CANE RAST ALL $63.0511401 UREAPLASMA AGAR $44.0011402 WB-2 CONFIRMATORY $186.7011403 ALPRAZOLAM (XANAX) $114.5011404 SUBSTANCE P LEVEL $428.0011405 VASO ENDOTHEL GRWTH $211.70

11406 FCM CD SLAMBDA $137.1511407 LEUK/LYMPH PANEL BM $0.0011408 SEROTONIN, BLOOD $109.2011409 TSH-3RD GENERATION $109.2011410 WEST NILE VIRUS RNA $686.8511411 HSV CULTURE RAPID $87.1511413 HSV DNA PCR $375.5511414 GLYCOPROTEIN IGG $62.1511415 GLYCOPROTEIN IGM $62.1511416 GLYCOPROTEIN IGA $62.1511417 BETA-2-GLYCOPROT PNL $0.0011418 HLA TYPING EACH $356.7011419 HLA A LOCUS BLOOD $0.0011420 HEPATITIS E IGM $76.5011421 IMMNOASAY NON-ANTIBY $53.7011422 TISSUE TRANSGLUTAMIN $0.0011423 ASPERGILLUS EACH ID $36.1011424 ASPERGILLUS ALLERGEN $53.4011425 FLUID BUN $73.9511426 EOSINOPHIL SMEAR UR $35.2011427 24HR CYSTINE $88.0511428 CELIAC AB PANEL #4 $0.0011429 IMMUNE COMPLEX ASSAY $150.1011430 IMMUNE COMPLEX #1 $0.0011431 METHYLDOPA LEVEL $197.7011432 24 HR KIDNEY PROFILE $79.2011433 NEOCEREBELLAR PANEL $0.0011434 PROTEIN WB, EACH $307.9011435 IMMUNO RIA, EACH $307.9011437 EHRLICHIA HGE IGM AB $62.1511438 EHRLICHIA HGE IGG AB $62.1511439 EHRLICHIA HGE PANEL $0.0011440 BARLEY ALLERGEN $53.4011441 RYE ALLERGEN $30.8011442 COW DANDER ALLERGEN $30.8011443 PIGWEED ALLERGEN $53.4011444 RABBIT DANDER ALLERG $30.8011445 RAT DANDER ALLERGEN $30.8011446 ANTI NUERONAL AB(HU) $133.5511447 RIBOSOMAL P ABS. $138.5511448 PHOSPHATIDYLE AB IGA $158.5011449 WEST NILE VIRUS CSF $686.8511450 WEST NILE VIRUS IGG $107.4011451 WEST NILE VIRUS IGM $107.4011452 WEST NILE PL IGG/IGM $0.0011453 CO IG1 TRIAD PANEL $0.0011454 CO GM1 IGG $378.65

11455 CO GM1 IGA $378.6511456 CO GM1 IGM $378.6511457 CEFUROXIME LEVEL EA. $177.8511458 AMPICILLIN LEVEL $137.4011459 ANTI YO ANTIBODY $249.4011460 SALMONELLA/SHIGELLA $100.9011461 CAMPYLOBACTER,STOOL $100.9011462 YERSINIA/STOOL $100.9011463 SENSITIVITY E EACH $50.8511464 INFLUENZAE A VIRUS $154.9011465 INFLUENZAE B VIRUS $154.9011466 AMIODARONE LEVEL $146.4011467 DESMETHYLAMODARONE $193.2011468 HSV I IGG AB $141.1011469 HSV II IGG AB $207.1011470 MAG IGM AB EACH $138.5511471 INFLUENZAE B VIR ID $154.9011472 GENPROBE GC & CHLAM $0.0011473 CHICKEN FEATHERS ALL $31.7011474 DUCK FEATHERS ALLERG $53.4011475 GOOSE FEATHERS ALLER $31.7011476 HSV TYPE I ID $31.7011477 HSV TYPE II ID $167.7511478 HSV TYPING $0.0011479 TISSUE CULTURE & ID $278.9011480 ADDITIONAL STAINS $216.1511486 ENZYME ACTIVITY EACH $220.1511487 ALAD-PBG-D $0.0011488 HEMOCHROM DNA MUTATN $0.0011489 HOUSE DUST ALLERGEN $53.4011490 HEP B DNA QUAL $220.1511491 PORPHOBILINOGEN 24HR $53.7011492 HYPERSENS PNEUM EACH $128.2011493 HYPERSENS PNEUMO PNL $0.0011494 LEPTOSPIRA CUL/STAIN $0.0011495 LEPTOSPIRA CULTURE $96.9011496 LEPTOSPIRA GR STAIN $96.9011497 METHYL/HYDRO/FOLATE $0.0011502 ACETYCHOL RECEP $224.9511503 ACETYLCHOL MODULATE $139.6511504 ANTI MUSK ANTIBODY $0.0011505 IMMUNOASSAY (RIA) EA $443.8011507 STAT PROTEIN 24HR $96.9011508 STAT CREATININE CLR $103.9011509 STAT CREATININE 24HR $68.6011510 CMT EVALUATION 280 $0.0011519 PREGNENOLONE $221.25

11520 LAMBS QUARTER ALLRGN $53.4011521 PRIVET ALLERGEN $30.8011522 SHEEP SORREL WEED $53.4011523 TIMOTHY GRASS ALLRGN $53.4011524 DMD/BMD DNA DELETION $0.0011530 HUNTINGTON'S DISEASE $0.0011531 HCV RNA HEPTAMAX $570.5511534 MTHFR DNA MUTATION $994.4011535 PROTEIN C RESISTANCE $165.1511536 COPPER URINE $132.7511537 CHESTNUT ALLERGEN $40.0511538 RAGWEED(GIANT) ALLGN $53.4011539 TAY-SACHS LEUKOCYTE $177.4511540 WBC AUTOMATED $53.2511541 TETANUS ANTIBODY $154.5011542 INFLUENZA A & B AB $0.0011543 INFLUENZA A AB $83.6511544 INFLUENZA B AB $83.6511545 MUSK ANTIBODY $0.0011546 IMMUNOASSAY RIA $510.5011549 URINE EOSINOPHILES $38.7011550 FLOW CYTOMETRY EACH $68.2511551 ACUTE LEUKEMIA PANEL $0.0011552 B12/FOLATE (REF) $0.0011553 VITAMIN B12 $161.2011554 FOLIC ACID $157.3011555 PARAINFLUENZAE CULT $0.0011556 CARDIOLIPIN IGM $89.3511557 FETAL FIBRONECTIN $616.4011558 ALPHA & BETA EVALUAT $162.4511559 PANCREATIC POLYPEPTD $139.6511560 DM1 DNA 6538 $0.0011565 NEUTRA AB/BIFN 11336 $0.0011566 VIRAL NEUTRALIZATION $303.8511567 NITROBLUE TETRAZOLIM $114.5011568 *TISSUE CULTURE $303.8511569 GQ1 AB IGG $178.3511570 GENTAMICIN TROUGH $175.3011571 LATEX ALLERGEN $53.4011572 CHOLINASE.&DIBUCAINE $0.0011573 CHOLINESTERASE SERUM $50.1511574 DIBUCAINE NUMBER $77.3511575 24HR URINE CYSTINE $106.5011576 PTT-LA SCREEN $55.5011577 STACLOT-LA $144.4011578 DRVVT CONFIRMATION $144.4011579 CADASIL COMPLETE $0.00

11580 24HR BENCE JONES QNT $0.0011581 FREE KAPPA BENCE JON $122.8011582 FREE LAMBDA BENCE JO $122.8011583 24HR UR PROTEIN $39.1511584 IMMUNOFIX ELECTROPH $239.0011585 AMERICAN BEECH ALLER $30.8011586 ELM ALLERGEN $53.4011587 RED TOP ALLERGEN $53.4011588 HCV RNA PROG TO GENO $458.3011589 FETAL HGB BY RID $39.9511590 MUMPS AB IGM $62.1511591 URINE TOXICOLOGY SC $0.0011592 CMV DNA QUAL PCR $256.8511593 MYOSITIS ASSESS PNL $0.0011594 IMMUNOASSAY NON AB $183.4511595 NUCLEAR ANTIGEN AB $183.4511596 CHROM ANALYSIS 11575 $0.0011597 CYTOGENETIC DNA PROB $145.2511598 CYTOGENETICS 100-300 $412.8511599 CYTOGENETICS $145.2511600 PLATELET INDIRECT AB $191.9011601 PLATELET AB PANEL $0.0011602 IMMUNE CMP C1Q & C3B $0.0011603 MURAMIDASE/LYSOZYME $98.3511604 DIPTH ANTITOXOID AB $66.8511605 DENGUE FEVER AB $0.0011606 BILE ACIDS $72.6511607 HBV DNA PCR HYBRID $405.0511608 CATECHOLAMINE/CREAT $0.0011609 CATECHOLAMINE ASSAY $183.1511610 HISTAMINE SERUM $131.6011611 HISTAMINE URINE PNL $0.0011612 HISTAMINE URINE $151.5011613 BRUCELLA ABORTUS PNL $0.0011614 BRUCELLA ABORTUS IGG $68.5511615 BRUCELLA ABORTUS IGM $68.5511616 HERPES SIMPLEX CULTU $278.9011617 LEISHMANIA AB IFA $105.7011618 TRYPANOSOMA PANEL $0.0011619 TRYPANOSOMA IGG $61.9511620 TRYPANOSOMA IGM $61.9511621 CADASIL DNA 421 $0.0011626 VANCOMYCIN TROUGH $144.9011627 IMIPRAMINE $88.7511628 ORCHARD GRASS ALLERG $53.4011629 COCKLERBUR ALLERGEN $53.4011630 MUGWORT ALLERGEN $53.40

11631 AFP QUAD SCREEN $0.0011632 *ALPHA FETOPROTEIN $86.1511633 *ESTRIOL $123.9511634 *IMMUNOASSAY RIA $66.3511635 *HCG QUANTITATIVE $77.0011638 TESTOSTERONE F/W BD $0.0011639 ALBUMIN $53.0011640 *SEX HORMONE BINDING $111.5011641 TESTOSTERONE ASSAY $276.3011642 VAP CHOLESTEROL $0.0011643 *TRIGLYCERIDES $61.6011644 ASSAY OF LIPOPROTEIN $138.5511645 EACH PATHOGEN $100.9011646 HELMINTH ANTIBODY $42.1511647 TOXOCARA PANEL $0.0011648 ID YEAST $53.5011649 ID ANAEROBIC $41.8011650 AFB PROBE ID $103.4011651 AFB INDENTIFICATION $56.5011652 HIV-1 PHENOTYPE COMP $0.0011653 PHENOTYPE DNA HIV/CL $2,503.9511654 PHENO,DNA HIV CLT AD $133.5511655 C-TELOPEPTIDE, SERUM $195.2511656 TRICHINELLA IGG AB $77.7511657 GAMMAGLOBIN IGM EACH $47.6511658 HERPES VIRUS-8 AB $121.4511659 CD-57 COUNT #1962 $58.7011660 RAPAMYCIN LEVEL $146.8011661 COMPLEMENT C2 $61.6511663 AMP PROBE TECH. EA $180.1011665 MOLECULAR GEL ELECTR $20.6011666 IMUGEN BABESIA PCR $0.0011667 IMUGEN LYME $0.0011668 IMUGEN HGE PCR $0.0011669 TYPHUS IGG/IGM ABS $207.1011670 WEIL FELIX GROUP $0.0011671 CARBAMAZEPINE FREE $100.8511673 JC VIRUS PCR QNT $561.7011674 ALK PHOS BONE SPEC $55.3511675 HPV ANAL CONDYLOMA $446.2011676 PEDIATRIC MIXED PNL $0.0011677 PRIMIDONE & PHENO $0.0011678 HCV QUAL PCR QNT $406.8511679 *HIV1 RNA QN -ULTRA $910.4011680 CYTOTOXIC CD8 #2069 $65.2511681 LE PREP $8.8011682 SS DNA $62.30

11683 LYME AB IGM 3814 $87.3011684 CRYPTOSPORIDIUM AG $93.6011685 NEUTRALIZATION VIRAL $344.1511686 NITROB TETRAZ DYE T $344.1511687 TISSUE CULTURE ADD $344.1511688 NABFERON TO ATHENA $0.0011689 CYSTINE 24HR URINE $73.3011690 IMUGEN TBD-3 $0.0011691 INFECTIOUS AGENT EA $160.4511694 AMPLIFIED TECH EACH $375.5511695 LACTOFERRIN, STOOL $209.9511696 FISH CML-ALL BCR-ABL $0.0011697 CYTOGENTIC DNA PR EA $172.8511698 SITU HYDRIDIZATION $160.3011699 CYTOGENTIC INTER/REP $41.8511700 CCP CYCLIC PEPTIDE $144.6011701 SALMON ALLERGEN $53.4011702 FLOUNDER ALLERGEN $30.8011703 CYSTIC FIBROSIS SCRN $0.0011707 LEUK/LYMPH #12659 $0.0011708 FLOW CYTOMETRY EACH $59.4511709 BL SMEAR W/INTERP $59.4511710 TRYPTOPHAN LEVEL $206.2511712 CRYOGLOBULINS QUANT $69.2511713 ETHYLENE GLYCOL $128.7511714 ORGANIC ACIDS URINE $346.5011715 EPITHELIUM ALLERGEN $29.0511716 TURKEY ALLERGEN $29.0511717 BOX ELDER ALLERGEN $53.4011718 COTTONSEED ALLERGEN $29.0511719 ORRIS ROOT ALLERGEN $29.0511720 GUM ARABIC ALLERGEN $40.3511721 PYRETHRUM ALLERGEN $40.3511722 TRIGLYCERIDES $61.6011723 LABORATORY MISC $0.0011724 METANEPHRINES FRACT $181.1511725 PORPHOBILINOGEN QUAN $59.8511726 GASTRIN SERUM $188.7011727 VASOACTIVE INTEST PO $378.1011728 H PYLORI IGG $135.5511729 DHEA SULFATE $237.9511730 INSULIN SERIES 7 SP $0.0011731 INSULIN SPECIMEN 1 $58.7011732 ANTI RI $0.0011733 WB INTERP & REPORT $177.9011734 FLUORS NONMINFEC AB $177.9011735 HB VIRUS QUANT 8369 $408.95

11736 FCM CD 56 $137.1511737 INTER 16/MORE MARKER $20.4011738 THYROGLOBULIN $171.8011739 CSF LYME AB IGM WBLT $97.7011740 JC/BK VIRUS DNA PCR $277.4011741 11-EPOXIDE LEVEL $120.3511742 CARBMAZEP 10-11 EXP $0.0011743 VIT B12 BINDING CAP $73.7511744 INSULIN SPECIMEN 2 $58.7011745 INSULIN SPECIMEN 3 $58.7011746 INSULIN SPECIMEN 4 $58.7011747 INSULIN SPECIMEN 5 $58.7011748 INSULIN SPECIMEN 6 $58.7011749 INSULIN SPECIMEN 7 $58.7011750 INSULIN SPECIMEN 8 $58.7011751 INSULIN SPECIMEN 9 $58.7011752 INSULIN SERIES 2 SP. $0.0011753 INSULIN SERIES 3 SP. $0.0011754 INSULIN SERIES 4 SP. $0.0011755 INSULIN SERIES 5 SP. $0.0011756 INSULIN SERIES 6 SP $0.0011757 INSULIN SERIES 8 SP. $0.0011758 INSULIN SERIES 9 SP. $0.0011759 SACCHAROMYES CER PNL $0.0011760 SACCHAROMYES CER IGA $72.6511761 SACCHAROMYES CER IGG $72.6511762 DRUG PROF/CONF 1902 $0.0011763 DRUG SCRN QUALITATE $147.3011764 CONFIRMATION GCMS $70.5511765 BUCKWHEAT ALLERGEN $30.8011766 COCONUT ALLERGEN $52.1511767 LETTUCE ALLERGEN $30.8011768 PEA ALLERGEN $30.8011769 TEA ALLERGEN $52.1511770 TSH RECEP.BINDING AB $559.9511771 TEICHOIC ACID AB SCR $128.2011772 BLASTOMYCES DER AB $0.0011773 ID BLASTOMYCES $29.7511774 CF BLASTOMYCES $29.7511775 FCM CD19 $137.1511776 FCM CD SKAPPA $137.1511777 FCM CD4 $137.1511778 FCM CD 8 $137.1511779 FCM CD2 $137.1511780 FCM CD7 $137.1511781 FCM CD20 $137.1511782 FCM CD3 $137.15

11783 FCM CD45 $137.1511784 THYR PEROXIDASE AB $74.9011785 PROTEIN S ANTIGEN $59.4511786 CMV DNA QUANT PCR $447.4011788 SEROTONIN RELEASE AS $69.3011789 AMPLIFIED TECH EACH $375.5511790 INFECTIOUS AGENT EA $160.4511792 MDMA & METABOLITE SC $0.0011793 DRUG CONFIRMATION EA $68.0011794 DRUG CONFIRAMTION EA $68.0011795 HBV GENOTYPING 10529 $0.0011801 NEUTROPHIL FUNCTION $604.8511802 SALMONELLA AB TYPHI $0.0011803 SALMONELLA AB EACH $41.9511804 SALMONELLA AB EACH $41.9511805 HCV RNA GENO 5761 $180.1011806 IBD ANCA AB $77.0011807 IBD ASCA DNASE PATEN $163.6511808 IBD ASCA IFA PATTERN $163.6511809 IBD ASCA IGA AB $121.1011810 IBD ASCA IGG AB $121.1011811 IBD OMPC IGA AB $164.3511812 IBD DIAGNOSTIC-II $0.0011813 EASTERN EQUINE ENCEP $89.5011814 ACYLCARNITINE PROFIL $293.4511815 BETA HYDROXY BUTRYIC $104.2011816 SQUID ALLERGEN $53.4011817 MACADAMIA NUT ALLRGN $30.8011818 PLATELET AUTO AB $0.0011819 PLATELET AB SCREEN $191.9011820 PLATELET ANTIBODY $189.7511821 IMMUNOGLOBULIN ASSAY $63.8011822 IMMUNOGLOBULIN ASSAY $63.8011823 PROTEIN ELECTROPHOR $0.0011824 PROTEIN ELECTRO U/UR $0.0011825 URINE ELECTROPHORSIS $0.0011826 ASSAY OF PROTEIN SER $18.7511827 ASSAY OF PROTEIN UR $18.7511828 ASSAY OF PROTEIN UR $37.6011829 URINE PROTEIN $19.0511830 BURPRENORPHINE/NALON $339.7011831 TISS TRANSGLUTIN IGA $93.6011832 TISS TRANSGLUTIN IGG $93.6011833 CASEIN AB IGE ALLERG $53.4011834 CASEIN AB IGG ALLERG $58.7011835 RAST TESTING $25.6011836 NORTHEAST REGION IGE $0.00

11837 DANDELION ALLERGEN $53.4011838 RUSSIAN THISTLE $53.4011839 ROUGH MARSHELDER $53.4011840 FIRE BRUSH (KOCHIA) $53.4011841 NETTLE ALLERGEN $53.4011842 MOLD ALLERGEN $40.8511843 ENTEROVIRUS PCR/CSF $273.0511844 GLYCOPROTN IIB/IIIA $168.8011845 CHROM FISH BM 14542 $0.0011846 CYTOGENIC DNA PROBE $240.7011847 CYTOGENTICS 100-300 $240.7011848 CHROM FISH BM 14498 $0.0011849 CYTOGENIC DNA PROBE $211.4011850 CYTOGENICS 100-300 $211.4011851 CHROM FISH BM 14507 $0.0011852 CYTOGENICS DNA PROBE $278.1011853 CYTOGENICS 100-300 $278.1011854 CHROM FISH BM 14499 $0.0011855 HSV -6 IGG/IGM PANEL $0.0011856 HSV-6 IGG AB $83.6511857 HSV-6 IGM AB $83.6511858 ATAXIA COMP EVAL $0.0011859 SPRUE AB PANEL $0.0011860 IMMUNOASSAY $44.8511861 IMMUNOASSAY (RIA) $66.3511862 FLUORESCENT AB TITER $61.8011863 URINE ALCOHOL $70.5511864 DHEAS UNCONJUGATED $129.4511865 AS-1 RBC LOW VOL $799.5011866 AS-3 RBC LR $987.1011867 AS-5 RBC LR $987.1011868 CPDA-1 RBC LR $616.4011869 PLT PHER LR BAG 2 $2,517.9511870 CPD RBC $987.1011871 AS-1 RBC $799.5011872 AS-3 RBC $799.5011873 AS-5 RBC $799.5011874 AUTO RBC $616.4011875 DIRECT RBC $616.4011876 EUGLOBULIN CLOT LYS $111.6011877 VIT A & BETA CAROTEN $0.0011878 BETA CAROTENE $41.1011879 VITAMIN C $98.5511880 VITAMIN B2 $90.2511881 COENZYME Q10 $220.8011882 PESTACIDE PANEL $185.0511883 AS-1 LEUKOREDUCE RBC $987.10

11884 CPD LEUKOREDUCED RBC $987.1011885 NICOTINE SCREEN UR $143.8011886 KAPPA & LAMBDA QUANT $0.0011887 NEPHELOMETRY EACH $125.0011888 NEPHELOMETRY EACH $118.5511889 AS-1 PHER RBC LR BG2 $987.1011890 PLT PHER LR BAG 3 $2,135.5511891 PLT PHER LR IRR BAG3 $2,135.5511892 AS-3 RBC LOW VOL $616.4011893 ECHINOCOCCUS AB $98.3011894 17OH PROGESTERONE $168.4511895 FACTOR XIII ACTIVITY $57.7011896 24HR UR COPPER LEVEL $129.5511898 GRAM STAIN $40.4511899 MYCOPHENOLIC ACID $146.4011900 STREP PNEUMONIAE SEN $0.0011901 KIRBY BAUER SENS $59.6511902 PENICILLIN MIC $38.2511903 CEFTRIAXONE MIC $38.2511904 MEROPENEM MIC $38.2511905 BODY FLUID C & S $180.5011906 DIRECT GRAM STAIN $45.5511907 SPUTUM CULTRUE $105.7011908 DIRECT GRAM STAIN $41.0511909 CSF CULTURE $118.9011910 CONCENT INFECT AGENT $71.4511911 GRAM STAIN PREP $45.5511912 TISSUE CULT & SENS $180.5011913 DIRECT GRAM STAIN $41.0511914 KIRBY BAUER SENSITIV $59.6511915 MIC EACH ANTIMICROBL $38.2511916 ANAEROBIC SENSITIVTY $0.0011917 PENICILLIN MIC $21.1511918 AMPICILLIN/CA MIC $21.1511919 CLINDAMYCIN MIC $21.1511920 CEFOTETAN MIC $21.1511921 METRONIDAZOLE MIC $21.1511922 IMIPENEM MIC $21.1511923 PIPERICILLIN TAZOBAC $21.1511924 MICROSCAN SENSI N/UR $0.0011925 ORGANISM IDENTIFICAT $44.8511926 ORGANISM SUSCEPTIBLY $50.6011927 MIC ANTIFUNGAL TEST $0.0011928 FLUCONAZOLE MIC $21.1511929 KETOCONAZOLE MIC $21.1511930 5-F-C MIC $21.1511931 AMPHOTERICIN B MIC $21.15

11932 ITRACONAZOLE MIC $21.1511933 VORICONAZOLE MIC $21.1511934 MICROSCAN SENS URINE $0.0011935 ORGANISM IDENTIFICAT $44.8511936 ORGANISM SUSCEPTIBTY $50.6011937 IDB DIFFERENIAL PNL $0.0011938 WBC AB ANCA IBD $161.0011939 ASCA IGA $52.1511940 ASCA IGG $52.1511941 DEOXYCORTICOS $124.3511942 URINE PORPHYRINS $38.2511943 URINE LEAD $53.9511944 HSV I PCR $375.5511945 NEUROKININ A $376.4511946 DIRECT AFB PROBE $159.5511947 FECAL GLOBIN BY IMMC $104.4011948 FLUID CHOLESTEROL $57.2011950 ARIPIPRAZOLE $174.3511951 11 DEOXYCORTISOL $130.4511952 EHRLICHIA IGM AB $50.6511953 MICROSCAN 1 SENS $50.6011954 MICROSCAN 2 SENS $50.6011955 MICROSCAN 3 SENS $50.6011956 MICROSCAN SENES $50.6011957 MICROSCAN OR 1 SENS $50.6011958 MICROSCAN OR 2 SENS $50.6011959 MICROSCAN OR 3 SENS $50.6011960 ORGANISM ID $44.8511961 ORGANISM ID $44.8511962 ORGANISM ID $44.8511963 ORGANISM 2 ID $86.4011964 ORGANISM 2 ID $86.4011965 ORGANISM 2 ID $44.8511966 ORGANISM 2 SUSCEPT $50.6011967 ORGANISM 3 SUSCEPT $50.6011968 ORGANISM 2 SUSCEPT $50.6011969 ORGANISM 3 SUSCEPT $50.6011970 MIC 2ND ANTIMICROB $38.2511971 KB SENS ISOATE 2 $101.1011972 KB SENS ISOLATE 3 $101.1011973 MIC 3RD ANTIMICROB $38.2511974 ORGANISM 2 ID $44.8511975 ORGANISM 3 ID $44.8511976 ORGANISM 3 ID $44.8511977 ORGANISM 3 ID $44.8511978 ORGANSIM 2 ID $44.8511979 ORGANSIM 3 ID $86.40

11980 ORGANISM 3 ID $44.8511981 AEROBIC CULTURE $92.2011982 VINEGAR ALLERGEN $30.8011983 PORK ALLERGEN $30.8011984 POTATO ALLERGEN $30.8011985 MUSTARD ALLERGEN $52.1511986 CHEESE ALLERGEN $30.8011987 CRYOFIBRINOGEN $23.4011988 B PERTUSIS IGG TOXIN $30.7011989 B PERTUSIS IGA TOXIN $30.7011990 B PERTUSIS IGM TOXIN $30.7011991 B PERTUSIS IGG FILAM $30.7011992 B PERTUSIS IGA FILAM $30.7011993 B PERTUSIS IGM FILAM $30.7011994 B PERTUSIS AB PANEL $0.0011995 RANDOM UR FOR MG $0.0011996 ASSAY OF CREATININE $23.2511997 ASSAY OF MAGNESIUM $29.8011998 CV2 ANTIBODY $388.3011999 HOME CARE PHLEB TRAV $0.0012000 AMOXICILLIN IGE RAST $30.8012001 RED CELLS PACKED $799.5012002 COOMBS TEST DIRECT $57.4512003 COOMBS TEST INDIRECT $38.7012004 CROSSMATCH (SAL,ALB, $191.3012005 CRYOPRECIPITATE $281.8012006 FRESH FROZEN PLASMA $273.0512007 PANDYS $9.5012008 PATH CONSULTATION $0.0012009 PLATELET CONCENTRATE $195.2512010 THAWED F24 $287.0512011 FRESH FROZEN PLASMA $0.0012012 RH SCREEN $26.4512013 RH TITRE $38.7012014 TESTS REFERRED TO OT $116.2512015 TRANSFUSTION REACTIO $248.2512016 WHOLE BLOOD $261.5012017 SINGLE DONOR PHORESI $2,135.5512018 RBC LEUKO. POOR FILT $406.0012019 AGUNI $48.2512020 ANTIBODY PANEL $212.2512021 ELUATE $191.3012022 IRRADIATE PRODUCT $0.0012023 PLATELET FILTERS 50 $253.6012024 PLATELET FILTERS 100 $0.0012025 RBC FILTER 100 $0.0012026 RBC FILTER 50 $126.75

12027 CROSSMATCH (WARM) $191.3012997 CATHFLO ACTIVASE 1MG $275.5013001 BLOOD SMEAR INTERPRE $70.4513003 CLIN. CONSULTATION C $230.7013004 CLIN CONSULTATION LI $111.0013005 CONSULTATION ON REFE $79.2013006 DECALCIFICATION PROC $40.4513007 FINE NEEDLE ASPIRATE $176.1513008 FULL CONSULT. SLIDES $98.6013009 INVESTIGATION OF TRA $248.2513010 LRG SRG SPE GRS & MI $493.1513011 NECROPSY (AUTOPSY) W $1,084.9513012 NECROPSY (AUTOPSY) W $986.3013013 NECROSY STILLBORN OR $1,025.0013014 NECROPSY (AUTOPSY) L $848.8513015 SPECIAL STAINS - GRO $88.0513016 SPECIAL STAINS - GRO $70.4513017 CYTOLOGY $114.5013018 SPUTUM AND BODY FLUI $88.0513019 SUR SP <3 GRS & MICR $220.1513020 SUR SPEC WTHOUT IND $317.0013021 SURGICAL SPECIMAN GR $52.8013022 URINE - PAP $96.9013023 VAGINAL CERVICAL (PA $51.0513024 VAGINAL CERVICAL W E $51.0513025 BM BIOPSY/CLOT $0.0013026 CYT BRON BRUSHING $0.0013027 CYT FLUID OTHER $126.7513028 CYT GYN 1 SLIDE $0.0013029 CYTO GYN 2 SLIDE $0.0013030 CYTO ENDOSCOPIC $0.0013031 CYTO BRON PCP $0.0013032 CYTOLOGY $0.0013033 INTRAOPERAT. CONSULT $121.7513034 CYTOLOGY TOUCH PREP $187.3513035 FINE NEEDLE ASP $0.0013036 FROZEN SECTION $0.0013037 THIN PREP REQUIRING $44.0013038 KIDNEY IMAG SPECT $924.7013039 THYROID IMAGE MULT W $669.2513040 PARATHYROID IMAGE $924.7013041 LYMPH SYSTEM IMAGING $924.7013042 GASTR EMPT STUD MLTD $924.7013043 TESTICUL IMAGING FLO $669.2513100 TENECTEPLASE INJ 50 $422.0514000 VENIPUNCTURE (P.I.) $17.6014001 AFP. TUMOR MARKER $179.50

14002 AMIODARONE $0.0014004 AMOXAPINE $153.2014005 AMYLASE ISOENZYMC $111.0014006 ANTI-ENA $0.0014007 GLOBERULAR BASE MEMB $138.5514009 CARDIOLIPIN AB $0.0014010 BETA-HCG (LOW LEVEL) $161.0014011 CA 15-3 $222.6014012 CLOMIPRAMINE $172.3514013 COXSACKIE TYPE A $161.1514014 CYTOPLASMIC NEUTROPH $0.0014015 CULTURE MOUTH $79.2014016 DOXEPIN $114.5014017 RAST DUST PROFILE $0.0014018 ECHOVIRUS AB $0.0014019 ERP & PGR, ICC FROZE $317.0014020 FLECAINIDE $150.4514021 FLUOXETINE $99.5014022 INFECTIOUS AGENT $132.1014023 HEAVY METALS, URINE $0.0014024 HEP B SURFACE AB QUA $167.3014025 CULTURE SURGICAL $0.0014026 IBUPROFEN $139.0514027 GTT-6TH SPEC $8.8014028 LYMAPHOCYTE MITOGEN $278.2514029 MALATHION $152.3514030 GTT 7TH SPEC $8.8014031 MEXILETINE $143.0014032 RAST MOLD PROFILE $0.0014033 MUMPS AB IGG $147.9514034 NATURAL KILLER CELLS $144.4014035 RAST ALLERGEN (1 ALL $96.9014038 PORPHYRIN,FRACT $105.7014039 PROTEIN C $147.9514040 PROTEIN S $0.0014041 RAJI CELL $260.6514042 RED CELL MAGNESIUM $72.1514043 RSV $172.5514044 SJOGRENS ANTIBODY $0.0014046 T-LYMPH SUBSETS NO 2 $144.4014047 T CELLS HELPER & SUP $502.7514048 TEICHOIC ACID AB $150.2514049 THC QUANT $116.2514050 TRAZODONE $118.9014051 RAST TREE PROFILE $0.0014052 TSH RECEPTOR ANTIBOD $311.7014053 VARICELLA ZOSTER IGG $62.15

14054 VISCOSITY $89.8014055 VIT D (1,25 DI-OH) $411.8014056 VENIPUNCTURE $36.5014057 17OH-PREGNENOLONE $244.1514058 24 HR URINE URIC ACI $63.5514059 24HR UR AMYLASE $86.9514060 24HR UR CALCIUM $71.9014061 24HR UR CHLORIDE $50.1514062 24HR UR CITRATE $297.5014063 24HR UR CREATININE $65.2014064 24HR UR GLUCOSE $60.2014065 24HR UR POTASSIUM $51.8514066 24HR UR SODIUM $54.5514067 AMYLASE TIMED 24/2HR $86.9514068 2HR UR CALCIUM $75.7014069 2HR UR CREATININE $55.3514070 A1-AT PHENOTYPING $158.9014071 ACETYLCHOLBINDING AB $139.6514072 ACID PHOS TOTAL $107.0514073 AFB BLD/BONE MAR $115.4514075 AFB STOOL $0.0014076 AFP MATERNIAL $179.5014077 AFP $242.6514078 ALBUMIN FLUID $55.1514079 ALDOLASE $103.8014080 ALK PHOS ISO $0.0014081 ALPHA-1 ANTITRYP $143.7014082 ALTERNARIA RAST $53.4014083 ALUMINUM LEVEL $179.5014084 AMIKACIN PEAK $148.9014085 AMIKACIN TROUGH $148.9014086 AMINO ACID SCREEN $93.7514087 AMINOLEVULINIC ACD $331.8514088 AMITRIPTYLINE $178.2514089 AMYLASE FLUID $83.6514090 ANAEROBIC CULT $164.0014091 ANDROSTENEDIONE $313.1514092 ANGIO CONV ENZYME $156.1514093 ANTI-DIURETIC HORM $318.3514094 ANTI-JO-1 $148.9014095 ANTISCLERODERMA $127.8514096 ANTITHROMBIN III $239.3014097 BLOOD C&S (PLUS) $164.0014098 BLODY FLUID ANA $107.4014099 BODY FLUID, CRYSTALS $68.5514100 BONE MARROW C&S $88.6514101 BRONCH C&S $147.15

14102 BUFF COAT COND $55.1514103 C PEPTIDE $222.6014104 CA 27-29 $222.6014105 CALCITONIN $286.5014106 CARBOXYHEMOGLOBIN $131.9014107 CARNITINE T&F $0.0014108 CAROTENE $100.4514109 CAT DANDER RAST $53.4014110 CATECHOLAMINES BLD $244.4014111 CD4/CD8 RATIO PROF $299.4514112 CEA PERITONEAL FLUID $147.5014113 CERVICAL C&S $92.2014114 CHL URINE BY LCR $126.7514115 CHLAMYDIA AB $143.8014116 CHOLINESTERSE RBC $90.6514117 CHROM ANALYSIS $0.0014118 CHROMIUM $90.4014119 LEUK\LYMPHOMA PROF $0.0014120 CLO TEST H PYLORI $86.4014121 CLONAZEPAM $160.6514122 CLOZARIL $197.8514123 COCCIDIOIDES AB $99.0014124 COPPER SERUM $132.7514125 CPK ISOENZYMES $0.0014126 CPK MB FRACTION $37.4514127 CRYPTOCOCCAL AG BL $118.8514128 CRYPTOCOCCAL AG SF $257.7014129 CRYPTOSPORIDIUM ST $120.4514130 CSF GLUCOSE $73.5514131 CSF PROTEIN $73.5514132 CSF-IMUGEN LYME $0.0014133 CULTURE GRAM STAIN $40.4514134 CULTURE AFB SMEAR $57.4514135 CVP TIP CULTURE $92.2014136 CYCLOSPORA EXAM $169.1114137 D-DIMER $86.9514138 D FARINAE ALLERGN $53.4014139 DEHYDROEPIANDROST $291.0514140 DHT SERUM $193.2014141 DIAZEPAM (VALIUM) $181.4014142 DIRECT BILIRUBIN $53.7014143 DIRECT FLU AG A $192.9014144 DNA ANTIBODY (DS) $147.0014145 DRUG SCREEN BLOOD $0.0014146 EBV AB VCA IGM $194.1514147 ENT AMOEBIC AB $110.0514148 ESTROGEN LEVEL $232.00

14149 EYE CULTURE $100.4514150 FACTOR DEF SC PTT $88.5514151 FACTOR II $222.5014152 FACTOR IX $234.2014153 FACTOR SCR P/T $88.5514154 FACTOR V $215.7514155 FACTOR VII $214.1514156 FACTOR VIII $189.3014157 FACTORX $234.8014158 FACTOR XI $232.5514159 FACTOR XII $232.5514160 FDP $120.4514161 FEBRILE AGGLUTIN $0.0014162 FECAL FAT QUAL $71.9014163 FETAL MATERNAL SCREE $107.4014164 FLUID POTASSIUM $64.2514165 FLUID PROTEIN $75.5014166 FLUID SODIUM $44.0014167 FLUID TRIGLYCERIDE $61.6014168 FOOD RAST PANEL $0.0014169 FRAGILE X CHROMOSOME $0.0014170 PSA TOTAL AND FREE $0.0014171 FRUCTOSAMINE $161.2014172 FTA-ABS $141.6014173 FUNGUS ID $123.8014174 G6PD QUANTITATIVE $130.2514175 GC URINE BY LCR $220.5514176 GENTAMYCIN PEAK $175.3014177 GIARDIA ANTIGEN $93.6014178 GLIADIN AB IGA/IGG $0.0014179 GLUCAGON PLASMA $146.1014180 GLUCOLA 1 HOUR $50.8514181 GLUCOSE FLUID $73.5514182 GLUTEN ALLERGEN $53.4014183 GOLDENROD ALLERGEN $53.4014184 GRASS PANEL #2 $0.0014185 GRP B STREP CUL $65.2014186 H PYLORI IGM $147.9514187 HAIRY CELL LEUKEMIA $644.1014188 HANDLING CHARGE $36.4514189 HDL CHOLESTEROL $14.9014191 HEP BE AB $138.7014192 HEP C RNA QUANT $458.3014193 HEP DELTA AB $163.3014194 HEP C GENOTYPING $1,541.1014195 HEPATITIS A PROFILE $211.5014196 HEPATITIS C QUAL $458.30

14197 HEPATITIS C RIBA $219.1514198 HERPES IGM 1 AB $154.0514199 HISTOPLASMA AB $0.0014200 HIV VIRAL ANTIBODY $0.0014201 HIV WESTERN BLOT CON $174.3514202 HLA-B27 $276.0514203 HOMOCYSTEINE $286.0514204 HORMODENDRUM ALL $30.8014205 HUMAN GROWTH HORMON $178.3514206 IGG SUBCLASSES $0.0014207 IGG-CSF $228.9514208 IMMEDIATE SPIN CROSS $191.3014209 INDIA INK PREP $65.2014210 INSULIN ANTIBODIES $0.0014211 INTRINSIC FACTOR AB $161.2014212 IONIZED CALCIUM $132.1014213 WET MOUNT SMEAR $63.3514214 LACTIC ACID $92.5014215 LACTOSE TOLERANCE $0.0014216 GC TMA $375.5514217 LIPOPROTEIN (A) $138.5514218 LUPUS ANTICOAG PROF $0.0014219 MERCURY LEVEL $174.0014220 METHYMALONIC ACID $236.0014221 MICROALBUMIN UR $81.0014222 SPECIAL STAIN $64.1014223 MILK ALLERGEN $53.4014224 MIXED VENOUS BLOOD G $150.1014225 MYCO/UREAPLASMA $72.1514226 MYELIN BASIC PROT $158.5014227 MYOGLOBIN SERUM $158.5014228 N-TELOPEPTIDE, URINE $0.0014229 NEURONTIN $193.2014230 NEUROPATHY PANEL $0.0014231 NIDA COLLECTION $99.5514232 NIDA SUBST ABUSE $160.2514233 NORTRIPTYLINE $174.3514234 NOSE CULTURE $100.4514235 NUT MIX GR RAST $0.0014236 OB GLUCOSE TOLERANCE $132.1014237 ORANGE ALLERGEN $30.8014238 PAPILLOMAVIRUS DNA $375.5514239 PARACENTESIS C&S $100.4514240 PARVOVIRUS $160.8014241 PH FLUID $52.8014242 PKU $11.4014243 PLATELET AB DIRECT $191.90

14244 PLT BOUND AB & C3 $105.7014245 PNEUMOCOCCAL AB $111.0014246 RANDOM UR AMYLASE $64.8014247 RANDOM UR CALCIUM $64.5014248 RANDOM UR CREATININE $58.7014249 RANDOM UR POTASSIUM $53.1514250 RANDOM UR PROTEIN $75.5014251 RANDOM UR SODIUM $53.7014252 RAPID A STREP SCREEN $0.0014253 RBC FOLATE $169.4514254 SLIDE REVIEW/MORPH $36.9014255 RICE ALLERGEN $30.8014256 TYPHUS IGG/IGM ABS $0.0014257 ROTAVIRUS AG $172.5514258 RSV ANTIGEN $225.4014259 RUBELLA AB IGM $154.0514260 RUBEOLA IGM $158.9014261 SCABIES/KOH PREP $0.0014262 SEAFOOD GR 19 $0.0014263 SENSITIVITY E TEST $0.0014264 SEX BINDING GLOBULIN $232.4514265 SOY ALLERGEN $53.4014266 STOOL FOR WBC $59.8514267 STOOL PH $50.1514268 STOOL MUSCLE FIBER $127.1514269 STOOL REDUCING SUB $123.8014270 T HELPER/CD4 IND $286.5014271 T3 FREE $181.1514272 TACROLIMUS $212.4514273 TESTOSTERONE FREE $0.0014274 THIN PREP PAP $216.7514275 THORACENTISIS C&S $100.4514276 THROXIN BIND GLOB $158.2014277 TORCH IGG/IGM PANEL $0.0014278 TRICHROME STAIN $85.3514279 TROPONIN I $145.6014280 TROUGH ANTIBIOTIC $199.0014281 PR E-PHORESIS UR/CSF $190.8514282 UR MYOGLOBIN $127.4514283 UR PREGNANEDIOL $151.9014284 UR AMINO ACID SCREEN $93.7514285 UR MAGNESIUM $92.0014286 UR PHOSPHATE 24HR $55.3514287 URINE DRUG SCREEN $122.8014288 URINE ELECTROLYTES $0.0014289 UA AUTO W/MICRO $94.1014290 URINE OXALATE $125.45

14291 URINE FAT QUAL $12.5514292 V ZOSTER AB IGM $99.9014293 VAGINAL C&S $100.4514294 VALPROIC ACID FREE $175.6514295 VANCOMYCIN PEAK $144.9014296 VDRL CSF ONLY $63.8014297 VITAMIN B1 PLASMA $227.1514298 VITAMIN B6 $264.2014299 YEAST ALLERGEN $53.4014300 TOTAL IRON /TIBC $0.0014302 THYROID/TSH $0.0014303 B12/FOLATE $0.0014304 PSA FREE $196.7514305 CARDIAC PROFILE $0.0014306 URINE SODIUM $51.9514307 URINE POTASSIUM $46.0514308 RANDOM URINE CHLORID $35.8014309 COMP AND LIVER PANEL $0.0014310 CPK FRACTION $0.0014311 CPK TOTAL $38.7014312 MB FRACTION $38.7014313 CODFISH ALLERGEN $53.4014314 CORN MAIZE ALLERGEN $53.4014315 EGG YOLK $53.4014316 MILK $53.4014317 ORANGE $53.4014318 CRAB ALLERGEN $53.4014320 SOYBEAN $53.4014321 WHEAT ALLERGEN $53.4014323 HEAVY METALS GROUP $234.9514324 RMSF IGG/IGM AB $207.1014325 ORGANISM ID AEROBIC $86.4014326 ORGANISM ID AEROBIC $86.4014327 CHLORDIAZEPOXIDE $193.2014328 LEGIONELLA CULTURE $40.3514329 URINE AFB $0.0014330 AFB CULTURE $170.3514331 CONC INFECTIOUS AGEN $84.5014334 CREATININE, FLUID $44.0014335 APTT FOR PANEL $189.3014336 VON WILLEBRAND FR $120.9514337 VON WILLEBRAND AG $189.3014338 CAPILLARY CHARGE $31.7014339 ERYTHROPOIETIN $201.0514340 THY STIM IMMUNOG $544.0514341 TUMOR NECROSIS FR $388.3014342 M.I.C. $35.35

14343 IGF-1 $295.9014344 INTERLEUKIN-6 $337.6014345 VON WILLEBRAND SCREE $0.0014346 HEPARIN PROTOCOL APT $64.1514347 TTG IGA ANTIBODY $219.8014348 FEBRILE AGGLUTIN EA $35.8514349 BETA-2 MICROGLOBULIN $173.1014350 FLUID CELL COUNT $70.4514351 17ALPHA HYDROXYPROGE $290.6514352 HEPATITIS B SURFACE $114.8514353 RBC MAGNESIUM $71.6514354 CHLAMYDIA DNA PCR $125.9514355 GC DNA,PCR $125.9514356 CA 19-9 ANTIGEN $222.6014357 DESIPRAMINE $78.4514358 HEP B COMP PROFILE 2 $0.0014359 HBB SURFACE AG $110.4514360 HBB CORE AB TOTAL $128.9514361 HB CORE AB IGM $125.8514362 AB TO BHV SURFACE AG $114.8514363 COMPLEMENT 5 $49.2514364 ENTEROVIRUS CULTURE $0.0014365 HEP B SURF AG NEUT $49.2514367 VARICELLA IGM $99.9014368 COMPLEMENT C1 ESTERA $99.9014369 C1 ESTERASE FUNC. $138.5514370 HBV DNA QUANT $0.0014371 CHEMILUMINESCENT ASS $111.6014375 HALOPERIDOL $40.9514377 HIV RNA QNT BY PCR $910.4014378 VITAMIN D 25-HYDROXY $316.6014379 T3 TOTAL $151.7014380 FREE T3 BATTERY $0.0014381 HEPATITIS BE ANTIGEN $123.2514382 CONFIRMATORY HIV 1 B $118.0014383 INFLUENZA VIRUS CULT $0.0014384 LAMOTRIGINE (LAMICTA $193.2014385 EHRLICHIA (HGE) $0.0014386 EHRLICHIA IFA $154.9014387 IGF BINDING PROTEIN $82.7514388 PROGRESSIVE TOXOPLAS $88.0514389 PAINFUL NEUROPATHY P $0.0014395 PROTEIN WESTERN BLOT $229.8014396 IMMUNOASSAY RIA $229.8014397 PSA ULTRA SENSITIVE $196.7514398 POLIOVIRUS AB NEUTRA $0.0014399 NEUTRALIZATION STRAI $216.15

14400 NEUTRALIZATION STRAI $216.1514401 NEUTRALIZATION STRAI $216.1514402 POLIO ID 1 $278.9014403 POLIO ID 2 $278.9014404 POLIO ID 3 $278.9014405 VONWILLEBRAND FACTOR $266.7514406 MYOBACTERIAL IDENTIF $66.9514407 L/S RATIO LUNG MATUR $132.1014408 ASPERGILLUS MIXED ID $0.0014409 LYMPHOCYTES SUBSET P $0.0014410 T CELL TOTAL COUNT $403.5514411 T CELL ABSOLUTE COUN $502.7514412 STEM CELL $192.4014414 ANTI MYELOPEROXIDASE $161.0014415 ANTI PANCA $243.9514416 ANTI CARDIOLIPIN IGG $55.5014417 ANTI CARDIOLIPIN IGM $55.5014418 SEROTYPING CHARGE $53.6014419 SEROLOGY GROUPING 1 $30.8014420 SEROLOGY GROUPING 2 $30.8014421 SEROLOGY GROUPING 3 $30.8014422 VARICELLA ZOSTER VIR $0.0014423 RISTOCETIN COFACTOR $189.3014424 MID MOLECULE PTH PRO $0.0014425 PTH CALCIUM $55.1014426 PTH CREATININE $30.8014427 PTH RIA $250.1014428 PTH PHOSPHORUS $28.1514429 HTLV-I/II ABS $206.0514430 HTLV-I/II, CONFIRM $246.6014431 HIV-1/HIV-2 SEROLOGY $146.8014432 HIV-2 AB IMMUNOBLOT $108.2514433 HIV-2 IGG ANTIBODIES $207.1014434 NON-GYN CYTOLOGY $74.9014435 MAG ANTIBODIES $0.0014436 LEPTOSPIRA ANTIBODY $135.7514437 FRAN, TULARENSIS AB $63.3514438 TOPIRAMATE $127.5514439 DOG DANDER ALLERGN $53.4014440 COCKROACH ALLERGEN $53.4014441 CYANIDE $118.0014442 CHOCOLATE ALLERGEN $53.4014443 METHOTREXATE $83.1514444 INTERLEUKIN-2 REC $78.8014445 H PYLORI ANTIGEN $185.7514447 ACETYLCHOLINESTERASE $67.8514448 GROUP B STREP AG $106.50

14449 PENICILLIUM NOTATUM $53.4014450 HIV-1 ULTRA SENSE $910.4014451 THROMBIN TIME $35.2014452 CYSTICERCOSIS $160.4514453 ZINC PROTOPORPHYRIN $59.8514454 ETHOSUXIMIDE, SERUM $99.5014455 CRP HIGHLY SENSITIVE $284.4514456 OXCARBAZEPINE $193.2014457 NEURON-SPECIFIC ENOL $200.7514458 GLYCATED ALBUMIN $143.1014459 ACETYLCHOL BLOCK AB $139.6514460 ADMARK APOE GENOTYPE $0.0014461 ONION ALLERGEN $30.8014462 GARLIC ALLERGEN $30.8014463 BEEF ALLERGEN $30.8014464 FECAL FAT FRACTIONAT $105.1514465 CANDI $53.4014466 VITAMIN B1 (THIAMINE $227.1514467 SERTRALINE (ZOLOFT) $170.8014468 LYME DISEASE DNA PCR $444.2514469 RHEUMATOID FAC FLUID $62.8014470 BORRELIA BURGDORFERI $583.0014471 FLUPHENAZINE $110.4514472 24HR UREA NITROGEN $29.0514473 METABOLIC URINE SCRE $503.7014474 HTLV I $89.7014475 HTLVII $149.8514481 INTERPRETATION & REP $61.6514482 HIV-1 AMPLIFIED PROB $352.2014483 HUMAN HERPESVIRUS IG $92.4514484 HUMAN HEPERVIRUS IGM $92.4514485 24HR UR MICROALBUMIN $61.9014486 CREATININE, URINE $55.3514487 NONINFECTIOUS AB $128.9514488 WESTERN BLOT & REPRT $139.1514489 ADENOVIRUS CULTURE $158.5014490 T4 $73.5514491 BORDETELLA CULTURE $40.4514492 BORDETELLA SMEAR $53.2514493 STREP PNEUMONIA $26.4514494 NEISSERIA MENINGITID $26.4514495 N.MENINGITIDIS GR CO $26.4514496 H. INFLUENZAE TYPE B $26.4514497 GOUP B STREP AG $26.4514498 BARTONELLA HENSELAE $36.1014499 BARTONELLA QUINTANA $36.1014500 BARTONELLA HENSELAE $36.10

14501 BARTONELLA QUINLANA $36.1014502 FT4 $96.4514503 HTLV-I/-II, PROGRESS $0.0014504 HIV-1 GENOTYPING, PR $2,754.3514505 HUMAN HERPESVIRUS 6 $0.0014506 MICROALBUMIN W/CREAT $0.0014507 BABESIA MICROTI AB $0.0014508 BORDETELLA CULT/SM $0.0014509 BACTI ANTIGENS $0.0014510 BARTONELLA ANTIBODY $0.0014511 FREE T4 BY DIALYSIS, $0.0014512 LYME TEST, CSF $0.0014513 LYME IGG AB FLUID $160.4514514 LYME AB IGM $54.5514515 AFB SENSITIVITY $0.0014516 ETHAMBUTOL $44.9514517 ISONIAZID SUSCEPT $44.9514518 PYRAZINAMIDE $44.9514519 RIFAMPIN $44.9514520 STREPTOMYCIN $44.9514521 RESPIRATORY VIRUS CU $0.0014522 INFLUENZA VIRUS CUL $160.2514523 ID EACH VIRUS TYPE $30.8014524 GALOP AUTOANTIBODY $0.0014525 GALOP IGA $138.5514526 GALOP IGG $138.5514527 GALOP IGM $138.5514528 PTH, N-TERMINAL SPEC $0.0014529 PTH $441.5014530 CALCIUM $80.1014531 ENTEROVIRUS, ECHO 4 $52.8014532 ENTEROVIRUS, ECHO 7 $52.8014533 ENTEROVIRUS, ECHO 9 $52.8014534 ENTEROVIRUS, ECHO 11 $52.8014535 ENTEROVIRUS, ECHO 30 $52.8014536 THYROID ANTIBODY GRO $0.0014537 UREA PLASMA AGAR CUL $40.4514539 INFLUENZAE A AND B D $0.0014540 DIRECT FLU AG B $167.3014541 FREE PHENYTOIN $125.4514542 BAHIA GRASS $53.4014543 BENT GRASS $53.4014544 BERMUDA GRASS $53.4014545 JOHNSON GRASS $53.4014546 PERENNIAL RYE GRASS $53.4014547 HAZELNUT ALLERGEN $53.4014548 HICKORY ALLERGEN $53.40

14549 MAPLE ALLERGEN $53.4014550 OAK ALLERGEN $53.4014551 WALNUT ALLERGEN $53.4014552 WHITE ASH ALLERGEN $53.4014553 WHITE PINE ALLERGEN $53.4014554 WILLOW ALLERGEN $53.4014555 LOBSTER ALLERGEN $53.4014556 SHRIMP ALLERGEN $53.4014557 TUNA ALLERGEN $53.4014558 ALMOND ALLERGEN $53.4014559 BRAZIL NUT ALLERGEN $30.8014560 COCONUT ALLERGEN $52.1514566 FACTOR V DNA MUTATIO $0.0014570 FACTOR II MUTATION $307.3514571 LEGIONELLA IGG AB $163.7514572 LEGIONELLA AG $93.6014573 LEGIONELLA URINARY A $0.0014574 AFP AMNIOTIC $105.7014575 ARSENIC $202.9514576 VITAMIN E $151.7014577 OLIGOCLONAL PROTEINS $215.1014578 PLT NEUTRALIZATION $83.0014579 ANTI-CARDOLIP IGA $62.1514580 TISSUE CULTURE FRAGX $214.6014587 RPR $47.2014588 CMV, IGM $34.7514589 HSV2, IGM $154.0514590 HSVI, IGM $141.1014591 RUBELLA, IGM $87.1514592 TOXOPLASMA IGM $77.5014593 TOLERANCE TEST $77.9014594 EACH ADDITIONAL $17.6014595 HGB CHROMATOGRAPHY $168.5014596 SINGLE CHROMOTOGRAPH $193.2014597 CK $69.6514598 CK ELECTROPHORESIS $93.6014599 INHIBITOR ASSAY $124.0014600 INHIBITOR TEST $152.9514601 INSULIN ANTIBODIES $149.6514602 TOTAL ALK PHOS $55.3514603 ELECTROPHORESIS $93.6014604 AFB CULTURE $70.0014605 AFB STOOL $32.9514606 HIV VIRAL AB SCREEN $53.5014607 HIV CONFIRMATORY $117.5514621 DRUG SCREEN QUANT $167.3014622 CSF LYME AB IGG WBLT $97.70

14623 FCM CD5 & TECH COMP $137.1514624 EASTERN MIXED PNL $30.8014625 HEAVY METAL BLOOD $54.5514626 GLIADIN AB $93.6014627 CARNITINE TOTAL & FR $87.6014628 RAST DUST PROFILE $53.4014629 RAST MOLD PROFILE $53.4014632 MYCOPLASMA PNEUMONIA $141.7014633 HISTOPLASMA AB $68.2514634 TESTOSTERONE ASSAY $272.3514635 TOTAL TESTOSTERONE $276.3014636 PLATELET NEUTRALIZAT $81.8514637 PROTHROMBIN TIME $56.7514638 RUSSELL VIPER VENOM $62.1514639 THROMBIN TIME PLASMA $35.2014640 PTT $74.9514641 FDS PTT $74.9514642 CARDIOLIPIN IGG $178.3514643 ASSAY OF PARATHORMON $441.5014644 ASSAY OF CALCIUM $55.1014645 ASSAY OF CREATININE $53.2514646 ASSAY OF PHOSPHORUS $50.7514647 COLLAGEN CROSSLINKS $199.9014648 ASSAY OF URINE CREAT $55.3514649 NUCLEAR ANTIGEN ANTI $108.7014650 MATA ANTIBODY $533.8014651 RI ANTIBODY $407.1514652 CAR ANTIBODY $388.3014653 FECAL LYTES OSMOTIC $0.0014654 STOOL NA $51.0514655 STOOL CHLORIDE $51.0514656 HALIBUT ALLERGEN $30.8014658 SPINO-CEREBELLAR DNA $0.0014659 BETA-2 TRANSFERRIN $191.2014660 ANA SCREEN EIA W/REF $53.8514661 PANCREATIC ELASTAS-1 $343.0514662 PROPAFENONE $85.0514663 PENICILLIN V RAST $30.8014664 PENCILLIN G RAST $30.8014665 AMPICILLIN RAST $30.8014666 ERYTHROMYCIN RAST $67.7014667 CEPHALOSPORIN RAST $67.7014668 TETRACYCLINE RAST $67.7014669 SULFAMETHOXAZOL RAST $67.7014670 CASHEW NUT RAST $53.4014671 PISTACHIO NUT RAST $47.6014672 SSDNA IGG ANTIBODY $53.95

14673 BORDETELLA PERT PNL $0.0014674 BORDETELLA IGA PT AB $60.7014675 BORDETELLA IGG PT AB $60.7014676 BORDETELLA IGM $62.0514677 LEMS AUTOANTIBODY $417.5014678 MULTIFOCAL NEUROPATH $0.0014679 IMMUNOASSAY ANALYTE $195.6514685 MALARIA SCREEN $57.1014686 BABESIA DETECTION $131.2014689 PYRUVATE ACID $53.3514698 FRAGILE X DNA PROBE $0.0014699 CREATININE W/GFR $44.0014700 MAG-SGPG IGM AB $57.7014701 WESTERN BLOT TEST $59.3514702 HU ANTIBODY WB $136.8014703 RI ANTIBODY WB $81.5514704 MOTOR/SENS PNL 53002 $0.0014705 MANGANESE LEVEL $109.6014706 CADMIUM $175.1014707 FLM TO STONY BROOK $191.4014708 L/S TO STONY BROOK $255.2014709 GAMMAGLOBULIN IGE $176.2014710 RESP ALLEGREN REGN 1 $0.0014711 DIURETICS THIAZIDE $123.8014712 PEACH ALLERGEN $30.8014713 PM-SCL ANTIBODY $79.9514714 PECAN ALLERGEN $47.6014715 PLATELIA ASPER. AG $154.4014716 PROMETHEUS TPMT ENZY $368.8014720 NORCLOZAPINE $160.6514722 HLA TYPING CELIAC $258.4014723 MERCURY TOTAL/ORGANC $76.3514725 PEMPHIGUS AB SCREEN $53.7014726 PEMPHIGOID AB TITER $53.7014727 HONEYBEE ALLERGEN $53.4014728 ACE CSF $156.1514729 ARYLSULFATASE A $197.1514730 SELENIUM LEVEL $113.8514731 BETA GALACTOSIDASE $197.1514732 PARVOVIRUS B19 DNA $366.6014733 HEMOGLOBIN PLASMA $47.6514734 IMMUNOGLOBULIN D $95.4014735 ZIC4 AUTOANTIBODY $388.3014736 AFP-TRIPLE SCREEN $570.8514737 DIALYSIS PANEL $0.0014738 MALT ALLERGEN $30.8014739 SD PHERSIS LR $2,135.55

14740 SD PLT PHERESIS LRI $2,540.6014741 RED CELL IRRADIDATED $616.4014742 RED CELL LR $616.4014743 RED CELLS LRI $616.4014744 GONADOTR RELEASG HOR $376.4514745 CARDIOLIPIN IGA $178.3514751 PKDX SEQUENCING ALYS $0.0014752 HLA-DR DQ CLASS II $315.8514753 D.PTERONYSSINUS RAST $53.4014754 MUCOR RACERMOSUS $53.4014755 CEDAR ALLERGEN $53.4014756 CHLAMYDIA PSITTACI $0.0014757 CHLAMYDIA IGG $62.1514758 CHLAMYDIA IGA $62.1514759 CHLAMYDIA IGM AB $60.7014760 CHLAMYDIA PN AB PNL $0.0014761 CANDIDA AB/ATG PNL $0.0014762 CANDIDA ALBICANS AB $62.2014763 CANDIDA ALBICANS ATG $91.4014764 CANDIDA IGM AB $62.2014765 FIBROSPECT PROMETHUS $0.0014766 ALPHA MACROGLOBIN $154.7514767 TISSUE INHIB METALPR $189.3014768 HYALURONIC ACID $165.7014769 BLUE MUSSELL RAST $30.8014770 HIV VIRTUAL PHENOTYP $581.0514771 HIV 1 GENOTYPE $1,147.6514772 CARNITINE TOTAL $81.3514773 ADENOVIRUS ANTIBODY $25.8514774 CELIAC HLA TYPING $0.0014780 URINE HEMOGLOBIN $40.1514781 CRYOPRECIPITATE $281.8014782 RETICULIN AB IGA $80.1014783 IGA SUBCLASSES $0.0014784 ASSAY OF GAMMA IGM $97.1014785 IGG 1,2,3,OR 4 EACH $171.8014786 NONINFECTIOUS AB $66.3514787 WESTERN BLOT & REPT $139.1514788 BABESIA MICROTI AB $0.0014789 HGE (ANAPLASMA PHAG) $0.0014790 EHRLICHIA HGE IGM AB $30.6014791 EHRLICHIA HGE IGG AB $30.6014792 HME HUMAN MONOCYTIC $61.2014793 EHRLICHIA HGE HME $0.0014794 CYCLOSPORINE LEVEL $80.5014795 NAB NEUTRALIZING AB $1,130.3514796 LUPUS ANTICOAGULANT $0.00

14797 PT REFERENCE $50.1514798 METANEPHRINE URINE $32.8514799 HLA-DQ CLASS II DNA $0.0014800 AS-3 RBC IRRADIDATED $616.4014801 RETICULIN IGG AB W/ $128.9514802 B HENSELAE IGM $25.8514803 B QUINTANA IGG $60.7014804 B QUINTANA IGM $25.8514805 B HENSELAE IGG $60.7014806 IGA FHA AB $60.7014807 IGG FHA AB $60.7014808 HEPARIN INDUCED THRM $0.0014809 HEPARIN INDUCED PLTS $283.6514810 SEROTONIN RELEASE AS $283.6514811 CORTISONE SERUM $200.9514812 TTG IGG ANTIBODY $93.6014813 AMPHIPHYSIN AB WB $263.8514814 FECAL CAL-INFLAMTRY $306.0514815 RANDOM UR BUN $21.1514816 MANGANESE $109.6014817 BRUCELLA IGG AB $36.1514818 BRUCELLA IGM AB $36.1514819 PYRUVIC ACID $48.4014820 SELENIUM $113.8014821 VITAMIN B2 $90.2514827 BRUCELLA IGG IGM AB $0.0014828 HLA CELIAC DISEASE $0.0014829 HEPARIN ANTI-XA $162.4014830 THIN PREP W/HIGH HPV $210.5514840 TPMT GENOTYPE $1,101.3014841 T CELL TOTAL/RATIO $482.1514842 CD4 CD8 W/RATIO $209.4514843 EBV RT PCR CSF $217.1014844 GMB IGG $78.1014845 IMUGEN TBD-4 $0.0014846 AMPLIFIED TECH EACH $375.5514847 INFECTIOUS AGENT EA $160.4514850 HEP-IND PLT AB $193.6514851 SRA $398.2014852 HEP-IND THROMBOCYTO. $0.0014853 INFLUENZA H1N1 PCR $0.0014854 H1N1 GENE PCR $182.7514855 OPIATE CONFIRMATION $55.7014856 MARIJUANA CONFIRM $186.5014857 MDMA LEVEL $162.4014858 *IFNB TISSUE CULTURE $234.0014859 *IFNB NEUTRALIZATION $217.70

14860 *INFB NEUTRALIZ. AB $0.0014861 GRH $376.4514862 *CD-57 FCM $229.7014863 BENZODIAZEPINE GCMS $125.2514864 GQ1B AB $352.5514865 CO-GM1 ANTIBODY $262.9514866 CO-GM1 ASIALO AB $262.9514867 CO-GD1B AB $262.9514868 ANTI MAG AB $303.5514869 ANTI-SGPG AB $303.5514870 APHER FROZEN PLASMA $273.0514871 THAWING OF APF $47.6514872 THAWED APHER PLASMA $0.0014873 IODINE LEVEL $193.2014874 BUPRENORPHINE CONFIR $0.0014875 TOXIGENIC C.DIFF PCR $392.4514876 OXYCODONE CONFIRMAT. $147.3014877 HYDROCODONE CONF. $220.9014878 AAT PHENOTYPE $151.0014879 PLASMINOGEN ACT INH $176.8514880 TISSUE PLASMINOGEN $181.9014881 PROINSULIN LEVEL $184.0014882 URINE SULFATE 24 HR $49.6014883 RICKETTSIA AB PANEL $0.0014884 PLT GLYCOPROTEIN AB $191.9014885 ANTIBODY TITER $60.7014886 PROPOXYPHENE SCREEN $147.3014887 ENDOMYSIAL AB SCREEN $51.1514888 CP2D RBC LEUKO RED $987.1014890 ENDOMYSIAL IGA SCRN $125.9014891 ECHOVIRUS PCR $366.6014892 ADENOVIRUS PCR $366.6014893 YEAST SENSITIVITY $468.5014894 TRH $297.5514895 VMA RANROM UR $161.9514896 VMA RANDOM UR W/CR $0.0014897 HPV DNA HIGH RISK $366.6014898 MBL $135.3514899 UREA BREATH TEST $703.5514900 THINPREP W/HPV REFLX $211.6014901 SLA AUTOANTIBODY $135.2514902 LKM-1 AB IGG $152.0014903 BACT,VAGINOSIS PNL $0.0014904 HPV DNA HIGH RISK $366.6014905 CANDIDA DNA PROBE $90.0014906 T. VAGINALIS DNA $90.0014907 G.VAGINALIS DNA $90.00

14908 SUREPATH PAP $211.6014909 CHYMOTRIPSIN, STOOL $111.5514910 PROCALCITONIN $192.8514911 SUREPATH, HPV DNA $0.0014912 SUREPATH W/REF HPV $211.6014913 TRYPYOPHAN, LC/MS $190.8514914 DIPHTH/TETANUS AB $0.0014915 QUANTIFERON TB GOLD $647.3514916 BK VIRUS DNA-PCR QNT $447.4014917 TYSABRI AB $355.4514918 HISTAMINE RELEASE $103.5514919 AMH $135.2514920 PLAVIX P450 GENOTYPE $0.0014922 URINE OXYCODONE $143.8014923 METAMPHETAMINE URIN $143.8014924 HLA B-27 DNA TYPING $0.0014926 MI-2 AUTO AB $187.3514927 NEIS. GONORRHOEAE AB $60.7014929 FFP (CP2D) $273.0514930 CHLAMTDOPHILA AB $0.0014931 CHLAM. PNEUM IGA $60.7014932 CHLAM. PNEUM. IGG $60.7014933 CHLAM. PNEUM IGM $60.7014934 FFP (CP2D) $0.0014935 CANDIDA ALBICANS IGG $52.1514936 KAPPA/LAMBDA 24 UR $0.0014937 BACTERIAL ID/SENS $0.0014938 URINE ID/SENSITIVITY $0.0014939 BACTERIAL ISOLATE ID $0.0014940 LEUK/LYMPHOMA FLCYT $0.0014941 ETOH URINE TO QUEST $143.8014942 CD57,CD3,CD8,FCM $0.0014943 HBV DRUG RESISTANCE $1,147.1514944 FRAGILE X CHROMOSOME $0.0014945 *VYSIS INSUFFICIENT $0.0014946 RESULTS RECEIVED $0.0014947 ANTIBODY SCREEN $122.3514948 BONE ALK.PHOSPHATASE $54.0514949 1:1 PTT IMM MIX $88.5514950 BUPRENORPHINE CONF $135.5514951 BERYLLIUM $229.4014952 LYME DNA PCR QUEST $366.6014953 *MICROSOMAL AB $152.0014955 SYCAMORE IGE $53.4014956 DERMATOPHAGOIDES F. $53.4014957 WHITE MULBERRY $53.4014958 PAPRIKA RAST $52.15

14959 BLACK PEPPER, RAST $52.1514960 BASIL, RAST $52.1514961 STONE ANA NON-KIDNEY $137.7514962 SHELL INNOCUL HSV $204.2014963 VARICELLA/HERPES CX $0.0014964 THYME RAST $52.1514965 CHILI PEPPER RAST $52.1514966 MUSHROOM RAST $52.1514967 FENNEL RAST $52.1514968 CHIVE RAST $52.1514969 PARSLEY RAST $52.1514970 PROTEIN, FLUID $31.8014971 SOTALOL BLOOD $143.0014972 COTTONWOOD IGE $53.4014973 RBC FRAGILITY $91.4014974 NEUTROPHIL FUNCTION, $188.6014975 LYME C6 AB TOTAL $177.9014976 LEPTIN $141.1014977 MYELOPEROXIDASE AB $154.5014978 PROTEINASE-3 AB $154.5014979 URINE TOX. SCREEN $149.3014980 PNEUMOCOCCAL IGG EA $153.9514981 STREP.PNEUM 23 SEROT $0.0014982 IMMUNOFIX PROF URINE $0.0014983 DERMATOPHAGOIDES PT. $52.1514984 LIPASE FLUID $60.7014985 QUININE $119.4514986 HEMOGLOBIN A2 $200.7014987 MARIJUANA SCREEN, S $89.7014989 MYASTHENIA RIA $138.6514990 LEGIONELLA AB SERUM $0.0014991 B CELLS, TOTAL $387.1014992 NK CELLS TOTAL $387.1014993 LYMPH SUBSET PANEL1 $0.0014994 R. TYPHII IGM TITER $202.1514995 R. TYPHII IGG TITER $199.9014996 RMSF IGM TITER $199.9014997 RMSF IGG TITER $198.5014999 ETG, URINE $186.2515000 PNH NY $274.7015001 EKG $528.3515004 CINNAMON IGE RAST $91.2015445 NICKEL, PLASMA $211.5515446 ISLET AB TITER $204.2515447 SHELLFISH PANEL $0.0015448 GANGLIOSIDE AB PANEL $0.0015449 ANGIOTENSIN II $210.40

15500 STREP PNEU. URIN AG $94.9015501 CSF ACE $150.8515502 PARECHOVIRUS PCR,CSF $360.2015503 METHEMOGLOBIN $36.0015505 ANTIMICROB.SUSC. PNL $107.0515508 URIC ACID, URINE $49.0515509 URIC ACID RAND URINE $0.0015510 CABBAGE ALLERGEN $52.1515511 CARROT ALLERGEN $52.1515512 WHITE BEAN ALLERGEN $49.7015513 GRAPE ALLERGEN $52.1515514 VITAMIN B3 (NIACIN) $121.1515515 ANCA SCREEN $155.5015516 P-ANCA TITER $155.5015517 C-ANCA TITER $155.4515518 ATYPICAL PANCA TITER $155.5015519 ASCA ABS $0.0015520 IBD DIFF. PANEL $0.0015521 CHOM ANAL. NO GROWTH $212.2015522 ENDOMYSIAL IGA TITER $124.4515523 THAWED AFF PLASMA $210.3015524 LEUKO REDUCED AS3 $1,580.1015525 LRI AS3 $969.5015526 RNA POLYMERASE AB 3 $133.7015527 THC CONFIRMATION $186.5015528 THC CONFIRMATIONW/RA $0.0015529 HSV TYPE 1 AB $136.3015530 HSV TYPE 2 $199.9015531 HSV 1/2 AB IGM $0.0015532 HSV 1 IGM TITER $136.3015533 HSV 2 IGM TITER $136.3015534 ASSAY AMMONIA URINE $150.5015535 CALCIUM URINE $62.2515536 CITRATE URINE $287.1515537 ASSAY OF SULFATE UR $49.0515538 ASSAY POTASSIUM URIN $44.3515539 ASSAY OF PH URINE $34.5515540 STONE RISK PROFILE $0.0015541 EOSINOPHIL SMEAR, NA $49.0515542 ALPHA GLOBIN MUTATIO $2,320.1515543 ALPHA SUBUNIT $141.1015544 AS3 LEUKOREDUCED PHE $615.8515550 PLATELET AB SCREEN $0.0015551 NAP1-BI STRAIN $366.6015552 C. DIFFICILE/EPI ASS $0.0015553 N-TELOPEPTIDE, SERUM $195.2515554 P190 $0.00

15555 P210 $0.0015557 MYASTHENIA PANEL 2 $0.0015558 MYASTHENIA PANEL 3 $0.0015559 TPMT RBC ENZYME ACTI $188.6015560 QNT HPLC 6 METHYL-TH $185.3015561 TPMT RBC ENZYME ACTI $0.0015562 AC3 APH RBC $987.1015563 LAMB IGE (F88) $52.1515564 ACCUTYPE IL28B (NY) $326.2515565 ANTIBODY, BRUCELLA $60.7015566 BRUCELLA ABS AGGLUT $0.0015567 ANALYSIS 45 CELLS $1,552.3515568 MOSAICISM CYTOREPORT $0.0015569 COBALT, BLOOD $226.9015570 RISPERIDONE $186.5015571 AQP4G $150.8015572 FLUORESCENT AB EACH $150.8015573 PARANEOPLASTIC AB CB $0.0015574 ANNA3 AB TITER $166.6515575 PCA-2 AB TITER $166.6515576 STRIATED M AB TITER $166.6515577 ACHOLINE REC MODULAT $226.2015578 INFLUENZA A DNA PCR $850.9515579 INFLUENZA B DNA PCR $207.6515580 INFLUENZA A/B BY PCR $0.0015581 WALNUT IGE REF COMPO $53.4015582 *RJUG R1 $53.4015583 RJUG R3 $53.4015584 WALNUT COMPONENT PNL $0.0015585 CASHEW NUT IGE RFLX $53.4015586 CASHEW NUT COMPONENT $53.4016001 BILIARY SCAN $1,688.8516002 BONE SCAN WB $2,013.1016003 BRAIN FLOW $915.0516005 GALIUM SCAN $733.9016006 MUGA SCAN $1,915.3016010 RENAL SCAN $1,374.0516017 THYROID SCAN $340.7516018 BONE SCAN(3) PHASE $2,081.7516020 MUGA WITH 1ST PASS $532.7016022 LUNG VENT WITH AEROS $532.7016023 THYROID IMAGING ONLY $319.6516027 GI BLEEDING SCAN $1,805.0016028 BONE IMAGING MULT AR $924.7016029 BONE SCAN, TOMO SPEC $924.7016032 LIVER SPECT W VASC F $924.7016033 LIV/SPL IMAG W VASC $763.20

16034 LIVER GB STUDY W SER $924.7016035 NM PERFUSION LUNG $2,358.8016036 VENT PERFUS STUDY $2,273.3516037 KIDNEY FLOW FUNCT ST $1,782.5016039 TC99M MEDRONATE $114.8016040 IODINE I-123 SOD IOD $216.9516041 TC99M PERTECHNETATE $109.9516042 TCPPM PENTETATE $127.6016043 TC99M MEBROFONIN $114.8016044 TC99M PYROPHOSPHATE $250.1516045 TC99M SULFUR COLLOID $178.6516046 KINEVAV SINCALIDE $108.4516047 TC99M MAA $165.8516048 GASTR EMPT SB MLTD $454.1016049 TC99 SESTAMIBI BM $242.4516175 JAK2 V617F MUTATION $567.0016400 GREEN PEPPER ALLERGE $52.1516401 OREGANO ALLERGEN $52.1516402 BUPRENORPHINE $149.3016403 WHEY ALLERGEN, RAST $52.1516404 MTB COMPLEX BY TMA $360.2016405 E-TEST FDA CLEARED $140.3516406 E-TEST NON FDA APPR. $140.3516407 THAW.PRE-POOLED CRYO $0.0016408 THAWED CRYOPRECIP $226.7016409 PRE POOLED CRYOPREC $0.0016410 P-ANCA TITER $154.5016411 METHYLPHENIDATE $140.5016412 CREATINE, 24 URINE $47.5016413 HU AB TITER $123.7016414 MAG-SGPS IGM, EIA $132.8516415 MAG AB IGM, EIA $132.8516416 PURKINJE AB TITER $175.0016417 HSV1 DNA QT PCR $439.6516418 HSV2 DNA QT PCR $439.6516419 AMYLASE URINE RANDOM $83.6516420 LIPASE URINE RANDOM $62.1516421 RPR TITER $55.5516422 TISSUE CX CHRMH $268.6016423 CHROMOSOME CARIOTYP $1,302.0516424 CHROMOSOME ANALYSIS $0.0016425 LISTERIA AB $59.6516426 ISONIAZID HPLC $140.5016427 HSP 70 $207.2016428 PROMETHEUS IBD $0.0016429 CHEMILUMINESCENT ASS $111.6016430 IMMUNOASSAY ANALYTE $135.25

16435 *C-REACTIVE PROTEIN $54.0516436 IMMUNOFL. STUDY EACH $302.3016437 BENZODIAZEPINES $149.2516439 DRUG SCREEN SERUM, 9 $189.6516440 TYPHUS IGM TITER $202.1516441 RMSF IGG TITER $202.1516442 NEURONAL RI AB $125.9016443 HU YO AND RI ANTIBO $0.0016444 YO AB WESTERN BLOT $139.1516445 RI AB WB $139.1516446 RI AB TITER $175.0016447 BORD.PERTUSSIS DNA $360.2016448 BORD.PARAPERTUSSIS $360.2016449 BORDETELLA BY PCR $0.0016450 BACTERIUM ANTIBODY $35.2016451 VIRAL RESP. CULTURE $200.6516452 *HPVDNA HI RISK QNS $0.0016453 MYCOB. DIRECT PROBE $206.0016454 MAI COMPLEX DIR PROB $206.0016455 MTB COMPLEX DIR PROB $206.0016456 UR HISTO ATG F/U $193.7016457 BRAIN NATRIURETIC PE $363.2016458 5 NUCLEOTIDASE $110.7516459 CENTROMERE ANTIBODY $110.0516460 C1 ESTERASE INHIB. $128.4516461 ESTRONE $267.1016462 HANG DROP PREP $86.2516463 FLUID LDH $70.4516464 INDIRECT COOMBS $61.1516465 TOTAL UR HYDROXYPROL $144.4016466 FREE UR HYDROXYPROL $242.3516467 REVERSE T3 $287.0516468 ANTI-PANCA ATYPICAL $161.0016470 MRSA SURVEILLANCE $102.6016471 PTH RELATED PEPTIDE $360.5516472 APPLE ALLERGEN $30.8016473 BIRCH ALLERGEN COMM $53.4016474 CLADOSPORIUM ALLRGN $53.4016475 CHICKEN MEAT ALLERGN $30.8016476 D.PTERONYSSIUM ALLRG $53.4016477 EGG WHITE ALLERGEN $53.4016478 ENGLISH PLAN ALLERGN $53.4016479 COXSACKIE B1 $62.1516480 COXSACKIE B2 $62.1516481 COXSACKIE B3 $62.1516482 COXSACKIE B4 $62.1516483 COXSACKIE B5 $62.15

16484 COXSACKIE B6 $62.1516485 COXSACKIE B1-B6 AB $0.0016486 GANGLIOSIDE AB PANEL $0.0016487 COXIELLA BOURNETI AB $0.0016488 ASILIO GM1 AB IGG $138.5516489 ASILIO GM1 AB IGM $138.5516490 GM1 AB PANEL IGM/IGG $0.0016491 GD1A AB IGG $138.5516492 GD1A AB IGM $138.5516493 GD1B AB IGG $138.5516494 GD1B AB IGM $138.5516495 HLA SINGLE ANTIGEN $635.8016496 HERPES/VARICELLA CX $0.0016497 UR HYDROXYPROLINE #1 $0.0016498 JUNE GRASS ALLERGEN $53.4016499 FREE HYDROXYPROLINE $137.4016500 IRON LIVER TISSUE $228.9516501 PHOSPHATIDYL AB PNL $0.0016502 PHOSPHATIDYLE AB IGG $171.8016503 PHOSPHATIDYLE AB IGM $171.8016504 COMMON RAGWEED ALRGN $53.4016505 SINEMET LEVEL $306.4516506 SULFATIDE ABS. PANEL $0.0016507 SULFATIDE IGG $297.6516508 SULFATIDE IGM $297.6516509 C DIFF TOXIN B $211.4016510 CHLAMYDIA URINE LCR $116.2516511 URINE GC/CHLAMYDIA $0.0016512 PROZAC LEVEL $167.3016513 HISTOLOGY $0.0016514 RENAL PANEL $105.7016515 GLUCOSE TOL 2HR $137.7516516 IGG SUBCLASS 1 $103.9016517 IGG SUBCLASS 2 $103.9016518 IGG SUBCLASS 3 $103.9016519 IGG SUBCLASS 4 $103.9016520 LIBS ANTIBODY ID $898.2516521 PROTEIN S ACTIVITY $152.9516522 COCAINE CONF BY GCMS $99.0016527 CYSTIC FIBROSIS DNA $0.0016528 CENTROMERE AB TITER $73.1016529 PROTEIN C ACTIVITY $147.9516530 BILIRUBIN TOT & DIR $0.0016531 AMINO ACID ANALY QNT $776.7016532 PACKED RBC BUFFY $987.1016533 WASHED PACKED CELLS $723.3516534 WASHED FROZEN PC $923.70

16535 PLT IRRAD/LEUKO RED $356.6016536 RBC IRRADIATED $843.1516537 PLATELET IRRADIATED $218.8016538 RBC IRRADIATED/BUFFY $969.5016539 SD PLATELET LR $2,517.9516540 SD BCR/IRRADIATED $2,540.6016541 PROTEIN/CREAT RATIO $0.0016542 PLATELET BUFFY REMOV $309.5516543 ALLERGEN TEST $53.4016544 HEP. INDUCED PLT AB $220.8516545 GLUCAGON $73.3016546 ANTITHROMBIN III ATG $113.0016547 HLA TYPING NACROLEPS $258.4016548 THYROID STIM IMMUNO $247.0516549 CORTISOL FREE SERUM $187.2016550 CORTISOL BIND GLOB $187.9516551 CYTOGENETICS DNA PRO $225.4016552 CYTOGENETICS 100-300 $323.8016553 CYTOGENETICS REPORT $17.8516554 CORN SUGAR IGE ALLER $54.1016555 FREE KAPPA/LAMBDA $0.0016556 FREE KAPPA $121.4516557 FREE LAMBDA $121.4516558 FISH UROVYSION BL CA $0.0016559 DNA PROBE CHROMOS 7 $294.1516560 DNA PROBE CHROMSO 3 $294.1516561 DNA PROBE CHROMOS 17 $294.1516562 DNA PROBE CHROM 9P21 $294.1516563 MT DNA EVALUATION $0.0016572 SENSE E TEST #2 $0.0016573 SENSE E TEST #3 $0.0016574 ANTIBIOTIC SENSV #2 $62.1516575 ANTIBIOTIC SENS #3 $62.1516578 FIBROGEN QNT NEPHELM $33.9516579 ZONISAMIDE LEVEL $134.9516580 FATTY ACID PROF PERX $206.2516581 LYMPH SUBSET PNL #4 $502.7516582 CPD LEUKORED IRRAD $987.1016583 FREE T3 BY DIALYSIS $0.0016584 TPMT METABOLITE $222.6516585 TMT METABOLITE $222.6516586 THIOPURINE METABOLIT $0.0016587 NEUTRO OXIDATE BURST $0.0016588 CELL ACTIVITY ANION $169.0516589 CELL ACTIVITY H2O2 $169.0516590 PLT PHER LR BAG 3 $2,135.5516591 RBC PHERESIS (ACDA) $799.50

16592 ISLET CELL AB SCREEN $204.2516593 FRESH FROZEN F24 $273.0516594 THAWING OF F24 $47.6516595 FRESH FROZEN F24 $0.0016596 EGGPLANT ALLERGEN $30.8016597 SESAME SEED ALLERGEN $53.4016598 MYOSITIS/PLUS JO-1 $0.0016599 IMMUNOASSAY NON-AB $121.5016600 NUCLEAR AB $121.5016601 CATFISH ALLERGEN IBT $41.7516602 SOLUBLE LIVER AG $87.3516603 ANTIMYOCARDIAL AB SC $53.7016604 VITAMIN K $236.3516605 FLUID LYME IMUGEN $0.0016606 LYME IGA AB FLUID $160.4516607 LYME IGM AB FLUID $163.7516608 LYME DNA PCR IMUGEN $0.0016610 AG DETECT NOS EACH $93.6016611 LYME DIS DNA AMP PRB $156.5016612 HME HUMAN MONOCYTIC $128.9516613 IMUGEN EHRLICHIA $0.0016614 COMPARISON LYME AB $0.0016615 LYME IGG AB SERUM $160.4516616 LYME IGA AB SERUM $160.4516617 LYME IGM AB SERUM $160.4516618 LYME G39/40 AG SERUM $160.4516619 LYME 49736 AG SERUM $160.4516620 ADDITONAL LYME AG FL $0.0016621 G39/40 AG FLUID $66.9016622 49376 AG FLUID $66.9016623 HIV WB CONFIRMATORY $86.3516624 ALPHA SUBUNIT HCG $117.7516625 PANCREASTATIN $376.4516626 HSV II DNA $375.5516627 HSV I & II DNA $0.0016628 LEUKEMIA\LYMPHOMA 35 $0.0016629 FCM FIRST MARKER $66.1516630 CELL SURFACE CYTO $49.4016631 FLOW CYTO INTERP $99.2016632 FCM CD10 $137.1516633 FCM CD11C $137.1516634 FCM CD23 $137.1516635 FCM CD38 $137.1516636 FCM CD64 $137.1516637 FMC 7 $137.1516638 1 ADDITIONAL MARKER $49.4016639 2 ADDITIONAL MARKERS $0.00

16640 3 ADDITIONAL MARKERS $0.0016641 ADDITIONAL FC MARKER $49.4016642 ADDITIONAL FC MARKER $49.4016643 ADDITIONAL FC MARKER $49.4016644 ADDITIONAL FC MARKER $49.4016645 ADDITIONAL FC MARKER $49.4016646 HEP C AB W/REFX RIBA $62.0516647 JAK2 DNA MUTATN PCR $0.0016655 UA AUTO W/O MICRO $52.6016656 SD PLTS LR BAG 3 $2,517.9516657 AS-1 LR IRR BAG 2 $616.4016658 BUTALBITAL SERUM $51.1016659 HIV-2 AB SCREEN $111.4016660 FIBRINOGEN ANTIGEN $37.9516661 TRYPTASE LEVEL $138.5516665 INFLUENZAE A & B $0.0016666 DRVVT 1:1 MIX $40.8516667 LYMPHOCYTE PANEL #3 $0.0016668 T-CELLS TOTAL $387.1016669 T-CELL ABSOLUTE $502.7516670 CHILDREN FOOD SC IGE $64.9516671 TPMT GENOTYPE $0.0016676 VZV RAPID CULTURE $87.1516677 SD PLTS BCR/IRR 5DAY $613.5516679 CHRONIC URTICURIA PL $0.0016680 LUEKOCYTE HIST REV $28.6016681 LEUKOCYTE CD23 AB ID $161.0016682 ADRENAL AB SCREEN $128.9516683 AFP AND AFP-L3 $79.5016684 RYE GRAIN ALLERGEN $30.8016685 IFNB AB NEUTRA ASSAY $451.8016686 STRONGYLOIDES AB IGG $86.9016687 **ORGANOPHOSPHATE $188.6016688 CAFFEINE SERUM $146.4016693 MUTATION ID $58.5516694 TAY SACHS DISEASE $0.0016695 HEXOSAMINIDASE A & T $0.0016696 HEMOSAMINIDASE T $160.8016697 HEMOSAMINIDASE A $160.8016698 CU INDEX $223.4016699 VOLATILES $142.7516700 MULTIPLE MYELOMA $0.0016701 DNA PROBE EACH $205.2016702 ANALYZE 100-300 CELL $205.2016703 INTERP AND REPORT $205.2016704 HEMATOLOGIC MALIGANT $0.0016705 BONE MARROW, BLOOD $114.60

16706 ANALYZE 20-25 CELLS $555.6016707 ADDITIONAL KAROTYPES $111.9516708 INTERP AND REPORT $90.0016709 MICROSPORIDIUM DET $0.0016710 MIXING STUDIES $0.0016711 BASELINE PT $17.5516712 BASELINE PTT $26.7016713 IMMEDIATE PT MIX $48.3016714 MIXING STUDIES PTTLA $28.8516715 RBC-BCR AND IRRAD $784.1516716 ALPHA 1 ANTITRIP MUT $0.0016717 YELLOW JACKET RAST $53.4016718 YELLOW HORNET RAST $53.4016719 WHITE FACES HORNET $53.4016720 PAPER WASP RAST $53.4016721 PTH PROFILE W/CA $0.0016722 ASSAY OF CALCIUM $74.8016723 BETA-GLOBULIN COMP $0.0016730 RAST CARROT ALLERGEN $53.4016731 GREEN BEAN ALLERGEN $53.4016732 SD PLTS BCR BAG 3 $2,517.9516733 HANTAVIRUS IGM AB $62.1516734 HANTAVIRUS IGG AB $62.1516735 TIN LEVEL $234.9516736 VZV DNA PCR $375.5516737 WESTERN BLOT CONF $174.3516738 ENTAMOEBA HISTO AG $67.3516739 AS-3 RBC LR IRR $969.5016740 AS-3 RBC $616.4016741 AS-3 RBC LOW VOLUME $799.5016742 MITO MYOPATHY MTDNA $0.0016749 FRESH FROZEN PLASMA $273.0516750 FRESH FROZEN PLASMA $0.0016751 HERPES 6 AB IGG/IGM $0.0016752 HERPES 6 AB IGG $62.1516753 HERPES 6 AB IGM $62.1516754 BASE WBC HIST RELEAS $28.7016755 WBC HISTAMINE POST $28.7016756 BASLINE HISTAMINE $131.6016757 STIMULATED HISTAMINE $131.6016758 RHIZOPUS ALLERGEN $53.4016759 RAGWEED(SHORT) IGE $53.4016760 CP2 RED BLOOD CELLS $799.5016761 THYROTROPIN BINDING $60.2016762 GLYCOMARK (R) $120.4016763 RBC LEUKORED IRR $784.1516764 AS3 RBC LR LOW VOL $616.40

16765 PARANEOPLASTIC PROF $0.0016766 IMMUNOASSAY NON AB $272.3016767 PROTEIN WESTERN BLOT $272.3016768 IMMUNOASSAY RIA $272.3016769 SHIGA TOXINS EIA $89.7016770 FREE KAPPA/LAMBDA $0.0016771 **JAK2 V617F $0.0016772 JAK2 EXON 12 & 13 $574.3516774 RBC LEUKORED IRR $616.4016775 BUPRENORPHINE SCREEN $260.1516776 BUPRENORPHINE CONF $0.0016777 MPL W515 AND S505 $0.0016783 NOROVIRUS RAPID AG $183.8016784 IMMUNOFIXATION BLD $239.0016785 STONE RISK PROFILE 3 $0.0016786 ASSAY OF CA URINE $64.5016787 ASSAY OF CITRATE UR $297.5016788 ASSAY OF MAGNESIUM $71.6516789 ASSAY OF OXALATE UR $118.3516790 ASSAY OF PHOSPHOROUS $55.3516791 ASSAY OF SODIUM UR $51.9516792 ASSAY OF URIC ACID $50.8516793 TPMT $186.5016794 AS-3 APHER LR RBC $616.4016795 MITOCHONDRIA M2 AB $57.7016796 URINE TOX EACH $61.3516797 AS-3 APHER BAG 2 $616.4016798 TOTAL HYDROXYPROLINE $149.6516799 CHROMATIN ANTIBODY $136.1516996 TIAGABINE (GABITRIL) $170.8016997 RUSSELL VIPER DILUTE $59.8516998 DR/DQ MULTIPLE AG $461.5016999 HLA TYPING A,B,C EA. $461.5017000 FLOW CYTOMETRY EACH $18.1017001 ABDOMEN: 2 VIEWS $524.8017002 ABDOMEN: ONE VIEW $404.5517003 ACROMIOCLAVICULAR JO $410.9017006 ANKLE 2 VIEWS $406.2517009 BARIUM ENEMA $884.5517010 BARIUM ENEMA AIR CON $607.6517013 BONE AGE $169.0517014 BONE LENGTH $200.7517019 FLUOROSCOPY 1 HOUR $733.5517020 CHEST PA AND LATERAL $520.6017024 CLAVICLE $388.1017027 ELBOW 3 VIEWS $416.9017029 ESOPHGRAM $643.15

17031 EXTREMITIES POST RED $140.9017032 FACIAL BONES 3 VIEWS $550.5517033 FEMUR 1 VIEW $335.1517034 FINGER 2 VIEWS $342.8017036 FOOT 3 VIEWS $404.0517037 FOREARM $391.1017040 GASTROGRAFIN ENEMA $884.5517041 GASTROINTESTINAL SER $918.8017042 HAND 3 VIEWS $414.8017043 HANDS & WRISTS ARTHR $323.4517044 HIP-AP.LAT 1 VIEW $421.6017045 HUMERUS 2 VIEWS $397.2017046 RETROGRAD URETHRAGRM $451.8017047 INTRAVENOUS PYELOGRA $868.0017048 KNEE 3 VIEWS $502.3517049 SPINE: LUMBOSACRAL W $822.9017052 MANDIBLE 4 VIEWS $489.7017054 METASTATIC SURVEY $776.4517056 NASAL BONES $441.1017057 NECK $401.1517058 NEPHROTOMOGRAM $451.8017061 ORBIT 4 VIEWS $197.2517062 CHEST 3 VIEWS $510.9517066 PELVIS $388.2017067 PELVIS WITH HIP $335.1517070 RETORGRADE PYELOGRAM $1,031.2517071 RETRO CYSTOGRAM VOID $756.3017072 RIBS: BILATERAL $569.6017073 RIBS: UNILATERAL $448.6017074 SACRO-ILAC JTS 3VIEW $428.2017076 SCAPULAR $435.0517077 SCOLIOSIS SERIES $835.0517079 SHOULDER 2 VIEWS $434.7017081 SINOGRAM $439.4517082 SINUSES $597.9017083 SKULL 4 VIEWS $571.9017084 SKULL, LIMITED $406.4517085 SMALL BOWEL $866.3017086 SPINE CERVICAL W/OBL $743.6017087 SPINE: CERVICAL $604.4017088 SPINE: COCCYX $434.2017089 SPINE:ENT A P W SKUL $528.3517090 SPINE: FLEX OR EXT $743.6017091 SPINE: LUMBOSACRAL $540.5017092 SPINE: SACRUM/COCCYX $434.2017093 SPINE: THORACIC $344.7517094 STERNO-CLAVICULAR JO $158.50

17095 STERNUM $431.5517097 THUMB $123.2517098 TIBIA-FIBULA $399.6517099 TM JOINTS $514.2017100 TOE $344.0017104 VENOGRAM BIL $1,116.8017105 VOIDING CYSTOGRAM $451.8017106 WRIST 3 VIEWS $425.9017109 X-RAYS DONE @ BEDSID $102.4017113 X-RAY SPECIMEN $203.6517114 CHEST PA $401.7517115 EPIDUROGRAM $1,673.1517352 DEXA BONE DENSITY ST $1,322.7517392 LFPRT CONTRAST INJ $176.1517393 FLURO C ARM 1ST HR $733.5517394 FLURO C ARM FOR ESI $563.3517396 MYELOGRAM INJECTION $44.0017397 MYELOGRAM L-S $1,643.1517398 MYELOGRAM CERVICAL $1,702.4517400 OPTIRAY 320 PHAR REF $0.0017401 MAMMO DIG DIAG BILAT $1,167.4517402 MAMMO DIGITAL SCREEN $1,013.1517403 MAMMO DIG DIAG UNILA $920.7017404 SITZMARKS CAPSULES $61.2017405 RIGHT HAND 3 VIEWS $414.8017406 LEFT HAND 3 VIEWS $414.8017407 BILAT HANDS 3 VIEWS $414.8017408 RIGHT WRIST 3 VIEWS $425.9017409 LEFT WRIST 3 VIEWS $425.9017410 BILAT WRISTS 3 VIEWS $425.9017411 RIGHT ELBOW 3 VIEWS $391.1017412 LEFT ELBOW 3 VIEWS $391.1017413 BILAT ELBOWS 3 VIEWS $391.1017414 RIGHT FOREARM 2 VIEW $391.1017415 LEFT FOREARM 2 VIEWS $391.1017416 BILAT FOREARMS 2 VWS $391.1017417 RIGHT HUMERUS 2 VIEW $397.2017418 LEFT HUMERUS 2 VIEWS $397.2017419 BILATERAL HUMERUS $397.2017420 RT SHOULDER 2 VIEWS $434.7017421 LEFT SHOULDER 2 VIEW $434.7017422 BILATERAL SHOULDER $434.7017423 RIGHT CLAVICLE $388.1017424 LEFT CLAVICLE $388.1017425 BILATERAL CLAVICLES $388.1017426 RIGHT FOOT 3 VIEWS $404.0517427 LEFT FOOT 3 VIEWS $404.05

17428 BILAT FEET 3 VIEWS $404.0517429 RIGHT HEEL 2 VIEWS $288.2517430 LEFT HEEL $404.0517431 BILAT HEELS 2 VIEWS $404.0517432 RIGHT ANKLE 3 VIEWS $406.2517433 LEFT ANKLE 3 VIEWS $406.2517434 BILAT ANKLES 3 VIEWS $406.2517435 RIGHT TIB/FIB 2 VIEW $399.6517436 LT TIBIA FIBULA 2 VW $399.6517437 BILAT TIBIA/FIBULAS $399.6517438 RIGHT KNEE 3 VIEWS $502.3517439 LEFT KNEE 3 VIEWS $502.3517440 BILAT KNEES 3 VIEWS $502.3517441 RIGHT FEMUR 1 VIEW $335.1517442 LEFT FEMUR 1 VIEW $335.1517443 BILAT FEMURS 2 VIEWS $335.1517444 RIGHT HIP $421.6017445 LEFT HIP C PELVIS $421.6017446 BILATERAL HIPS $421.6017448 BILAT RIBS 3 VIEWS $448.6017450 RIGHT ORBIT 4 VIEWS $197.2517451 LEFT ORBIT 4 VIEWS $197.2517452 BILAT ORBITS 4 VIEWS $197.2517453 PELVIS ATTN RT HIP $335.1517454 PELVIS ATTN LEFT HIP $335.1517455 PELVIS/HIPS 5 VIEWS $507.1517456 RT RIBS UNILAT 3 VWS $448.6017457 LT RIBS UNILAT 2 VW $448.6017458 RIGHT SCAPULA $435.0517459 LEFT SCAPULA $435.0517460 BILATERAL SCAPULAS $435.0517461 RT SACRO ILIAC JT 3 $428.2017462 LT SACRO ILIAC JT 3V $428.2017463 BL SACRO ILLIAC 3 VW $428.2017464 RT STERNO CLAVIC 3VW $158.5017465 LT STERNO CLAVIC 3 V $158.5017466 BL STERNO CLAV JT 3V $158.5017467 BRST TOMO SYN SCR BL $100.3017468 BRST TOMO UNI DIAG $100.3017469 BRST TOMO BILAT DIAG $100.3017470 ABDOMEN XR 3T VIEWS $576.4517471 CHEST X-R 4 VIEWS $576.4518000 NON-CHARGEABLE ITEM $0.0018001 US ABDOMINAL AORTA $863.2518006 ECHOCARDIOGRAM $528.3518007 US OB LIMITED $539.7018009 US LIVER $877.95

18011 US PELVIC NON OB COM $777.8518012 US OB COMPLETE $990.1518013 US RENAL BILATERAL $863.2518014 US RENAL $938.7518015 US RETRAPERITONEAL $528.3518016 US SPLEEN $877.9518018 THYROID $664.4518023 ULTRASOUND GUIDANCE $852.4018024 ULTRASOUND DUIDANCE $399.8018025 US SCROTUM AND CONTE $719.7018027 US TRANSVAGINAL $747.0518028 VEN DOPP LIMITED EXT $1,289.4018029 DUPLEX ART LOW EXT L $1,170.4518032 DUPLEX ART UP EXT LI $1,142.3518033 DUPLEX ART UP EXT BL $1,677.0018034 DUPLEX ART LOW EXT B $1,760.7018036 VEN DOPP COMP BILAT $704.5518037 DUPLEX CAROTID BILAT $1,607.7018038 US ABDOMEN COMPL $1,031.7518039 US KID TRANSPL C DUP $528.3518041 US TRANSRECTAL $528.3518042 US FETAL BPP W/O STR $528.3518044 US OB REPEAT F/U $396.2018045 US OB MULT GESTATION $1,061.5518046 US PELVIC NON OB LIM $918.1018048 US BREAST EVAL 4Q/AX $590.8518052 US CHEST $528.3518053 US ABDOMEN SINGLE OR $877.9518054 US RETROPERIT LIM $938.7518056 US KNEE NON VASC $640.4018057 US KNEE BL NON VA LI $640.4018058 US TRANSVAGINAL OB $396.2018059 VEN DOPP VEN INSUFF $270.6018060 US BREAST EVAL LIMIT $590.8518061 ABD DOPPLER RENAL AR $754.1018319 COAG. CONSULT LEVEL $109.3518405 THROMBIN 1:1 MIX $70.7018880 MDMA SCREEN IA $83.4518881 MDMA CONFIRMATIOM $172.3518882 HEROIN SCREEN IA $83.4518883 HEROIN CONFIRMATION $123.9019006 ABDOMEN:WITHOUT CONT $2,338.4019007 ABDOMEN:WITH CONTRAS $2,748.5519008 ABDOMEN:BOTH $3,542.0519009 BRAIN:WITHOUT CONTRA $2,338.4019010 BRAIN: WITH CONTRAST $2,748.5519011 BRAIN:BOTH $3,542.05

19012 CHEST:WITHOUT CONTRA $2,338.4019013 CHEST:WITH CONTRAST $2,748.5519014 CHEST:BOTH $3,542.0519015 PELVIS:WITHOUT CONTR $2,338.4019016 PELVIS:WITH CONTRAST $2,748.5519017 PELVIS:W W/O $3,542.0519018 SINUSES:WITHOUT CONT $2,338.4019019 SINUSES:WITH CONTRAS $2,748.5519020 SINUSES:W W/O $3,542.0519021 SOFT TISSUE NECK W/O $2,338.4019022 SOFT TISSUE NECK:WIT $2,748.5519023 ST TISSUE NECK W W/O $3,542.0519024 C-SPINE:WITHOUT CONT $2,338.4019025 T-SPINE:WITHOUT CONT $2,338.4019026 L-SPINE:WITHOUT CONT $2,338.4019027 LOWER EXT:WITHOUT CO $2,338.4019028 LOWER EXT:WITH CONTR $3,542.0519029 LOWER EXT: W/WO $3,542.0519030 UPPER EXT: WITHOUT C $2,338.4019031 UPPER EXT:WITH CONTR $2,748.5519032 UPPER EXT: W W/O $3,542.0519033 ORBITS:WITHOUT CONTR $2,338.4019034 ORBITS:WITH CONTRAST $2,748.5519035 ORBITS:W W/O $3,542.0519036 CT 3D RECONSTRUCTION $1,710.2519037 CT BIOPSY $1,673.1519038 CT ABSCESS DRAINAGE $1,673.1519039 CT H RES CHEST $1,673.1519040 NCTPIT LIM $0.0019041 CT ANGIO HEAD $3,812.0019042 CT ANGIO NECK $3,812.0019043 CT ANGIO PELVIS $3,812.0019044 CT ANGIO AORTA W/RO $3,812.0019045 CT ANGIO ABDOMEN $3,812.0019046 CT ANGIO THORAX $3,812.0019047 CT ANGIO LOWER EXT $3,812.0019048 CT ABD PELVIS W/O CO $4,692.6519049 CT ABD PELVIS W W/O $7,740.4019050 CT ABD PELVIS W CONT $5,519.4519051 CT C SPINE W CONTRA $2,748.5519052 CT C SPINE W/WO CONT $3,542.0519053 CT L SPINE W CONTRAS $2,748.5519054 CT L SPINE W/WO CONT $3,542.0519055 CT MAXO FACIAL W CON $2,748.5519056 CT MAXO FACIAL W/WO $3,542.0519057 CT T SPINE W CONTRAS $2,748.5519058 CT T SPINE W/WO CONT $3,542.05

19059 CT ANGIO ABD/PELVIS $3,812.0019150 CYSTIC FIBROSIS NY $138.9019151 FACTOR V MUTATION $362.1519152 HEMOCHROMATOSIS DNA $652.4519153 HLA-B27 TYPING $1,592.2019154 HLA TYPING CELIAC $0.0019155 HLA II TYP LOCUS HR $1,113.3519156 JAK2 V617F, QUAL $548.3519157 LYME PCRFLUID IMUGEN $0.0019158 TTG AB PANEL $0.0019159 QFEVER PHASE2 TITER $57.8019160 LEGIONELA PN.TOTALAB $0.0019161 INFLUENZA A/B RT-PCR $812.4019162 STREPTOZYME TITER $61.3519163 HLA-A CLASS I DNA $163.9519164 FRAGILE X $913.6019165 PLT PH LR PAS-C BAG1 $2,540.6019166 PLT PH L/R BAG 2 $2,540.6019167 PLT PH LR BAG 3 $2,540.6019168 HLA CROSSMATCH UNIT $838.8019169 BETA-GLOBIN GENE $2,044.8519170 HEMOGLOBIN PHENOTYPE $126.6519171 HBPATHY THALASSEMIA $0.0019172 METAPNEUMOVIRUS $108.3519173 HGB C-Z ELECTROPHOR $126.6519174 QNT OF HGB BY HPLC $179.6019175 HGB STABILITY $34.7019176 RBC AUTOMATED $29.6519177 FERRITIN (THALA) $135.5019178 HEMOGLOBIN (THALA) $23.5019179 HCT (TTHALA) $23.5019180 ARTERIAL LACTIC ACID $92.5019181 BCR-ABL1 GENE REARR $580.8019182 CYTOGENETICS COMM $0.0019183 PROGENEOMIC MIC ARRA $604.8519184 WBC AB ID $143.7519185 FLUOROSCENT AB SCREE $115.1019186 ASPERGILUS AG $87.0519187 SMA CARRIER SCREEN $875.1519188 DENGUE FEVER IGG $83.3519189 DENGUE FEVER IGM $0.8519190 GC/CLAMYDIA BY PCR $0.0019191 CHLAMYDIA BY PCR $375.5519192 GC PCR $375.5519193 24 HR THAWED PLASMA $260.0519194 COCAINE CONF URINE $144.6519195 RSV BY DFA $83.45

19196 LIPOPROTEIN BY NMR $198.7019197 24 HR UR ALDOSTERONE $405.4519198 AS-3 LR IRRAD $969.5019199 PNH WITH FLAER $486.2019200 MRSA NASAL BY PCR $384.3519201 GALACTOSE ALPHA $96.0519202 CALPROTECTIN $187.3519203 CHLAMYDIA TRAC IGA $55.5019204 CLAMYDIA AB PANEL $0.0019205 CRYPTOCOCCAL AGTITER $55.5019206 TBD4M $0.0019207 HEPATITIS E IGG $76.5019208 HEPATITIS E ABS $0.0019209 NMO IGG AB $530.9019210 NMO ANTIBODY (IGG) $0.0019211 INHIBIN B $102.0019212 DCP $688.8019213 STRATIFY JCV AB $0.0019214 JCV AB INHIBITION $811.3019215 TOBRAMYCIN PEAK $177.1519216 NSE CSF $198.7019217 HSV2 IGG INHIBITION $211.8519218 STRIATED MUSCL TITER $132.0019219 LASA $128.2519220 HEA DNA TESTING CHA $2.1019221 GELATIN IGE (C74) $55.5519222 BLASTOMYCES AB, ID $55.5019223 HERPES SIMPLEX DFA $119.2019224 HERPES SIMPLEX RAPID $214.1519225 V ZOSTER RAPID CX $214.1519226 VARICELLA ZOSTER AG $96.0519230 CCP AB IGA, IGG $144.6019231 SOMATOSTATIN $200.3019232 AMPHETAMINE BY GC/MS $148.3019233 NMDA RECEPTOR AB $463.8519234 AAT-1 MUTATION ANAL $120.8519235 HBV PCR W/R VIR.LOAD $408.9519236 AS3 RBC ACDA LR IRR $1,016.4019237 AS3 RBC LR IRR BAG2 $1,016.4019238 IMMUNE CELL FUNCTION $1,297.0519239 ADENOSINE DEAMINASE $77.5519240 AUTO WHOLE BLOOD $1,829.0519241 24HR THAWED PLASMA $287.0519242 LACOSAMIDE $130.7519243 EVEROLIMUS $148.1519245 VGKC AB TO ATHENA $437.6019246 GANGLIONIC ACHR AB $437.60

19247 FUNGITELL (1-3)-B-D- $382.0019248 HSV6 DNA RT PCR $398.6019249 ECHINOCOCCUS WB $171.7019250 STOOL POTASSIUM $63.2019251 BRCA1&2 SEQ & COM DU $2,361.5519252 BRCA1&2 UNCOM DUP/DE $625.1019253 HANTAVIRUS ABS $0.0019254 SIN NOMBRE VIRUA IGG $62.1519255 SIN NOMBRE VIRUS IGM $62.1519256 PITYROSPORUM ORB.IGE $55.5519257 CYSTATIN C $123.8519258 LACTIC ACID CSF $82.5519259 BK VIRUS DNA URINE $447.4019260 LEUKOCYTE ALC PHOSP $94.9019261 LIBS IRRAD CHARGE $38.0019262 LIBS CMV TESTING CHA $45.5019263 LIBS HGS TESTING CHA $15.1519264 LIBS AG CHRG EACH $144.3019265 WASHED RBC $1,884.0019266 CEA PLEURAL FLUID $147.5019267 CHIKUNGUNYA IGG $60.0019268 CHIKUNGUNYA IGM $60.0019270 THIOPURINE METABOLIT $197.9019271 ALPHA-GALACTOSIDASE $448.1019272 APOLIPOPROTEIN $47.4519273 ASSAY OF BILIRUBIN $55.5519274 ASSAY OF CHOLESTEROL $48.6019275 ASSAY OF GLUCOSE $44.0019276 ASSAY OF GGT $79.8519277 ASSAY OF HAPTOGLOBIN $137.7519278 ASSAY OF AST $59.0019279 ASSAY OF ALT $59.0019280 ASSAY OF TRIGLYCERID $63.7019281 NASH FIBROSURE $0.0019282 ENTEROVIRUS RNA QUAL $335.0519283 RAST ALLERGEN IGG EA $47.6019284 HIV-1 AB $97.2519285 HIV-2 AB $148.1519286 HIV-1/2 DIFF $0.0019287 DEGLY RBC LR IRR $2,180.9519288 DEGLYC RBC LR IRR $2,180.9519289 NORTHEAST MIXED PNL $0.0019290 HEAVY METALS 24 UR $0.0019291 SINGLE UNIT OF CRYO $281.8019292 FECAL LEUK STAIN $40.8019293 OVA1 $902.9519294 LIPD PANEL CARDIO IQ $127.95

19295 LIPOPROTEIN QUANT $194.1519296 APOLIPOPROTEIN B $147.9519297 LIPOPROTEIN A $123.6519298 ADVANCED LIPID PANEL $0.0019299 EBV DNA PCR $408.9519300 CHIKUNGUNYA SCREEN $0.0019301 CHIKUNGUNYA IGG TITE $63.7019302 CHIKUNGUNYA IGM TITE $63.7019303 TYPE AND SCREEN GEL $0.0019304 ANTIBODY SCREEN $122.3519305 CARDIOLIPIN AB PANEL $0.0019306 MYCOBACTERIUM MIC $100.7019307 RANDOM URINE IODINE $164.1519308 AMYLASE ISOENZYME $63.6519309 AMYLASE ISO3 PNL $0.0019310 DEXAMETHASONE $154.7519311 INTERLEUKIN EACH $117.7519312 HELMINTHOSPORIUM HAL $53.4019313 PINE NUT ALLERGEN $53.4019314 METHYLATED SEPTIN 9 $292.2519315 HIV AG/AB 4TH GEN $219.0519316 HIV-1 RNA QL TMA $941.8519317 ARAH2 $57.1519318 ARAH1 $57.1519319 ARAH3 $57.1519320 ARAH9 $57.1519321 ARAH8 $57.1519322 PEANUT COMPONENT PNL $0.0019323 BILIRUBIN TOTAL $57.1519324 GGT HEPASCORE $82.1519325 HYALURONIC ACID $188.1019326 ALPHA-2-MACROGLOB $128.5519327 LIVER FIBROSIS PANEL $0.0019328 RIA NONAB TO MAYO $165.3519329 FLUOR AB SCREEN MAYO $165.3519330 FLUOR AB TITER MAYO $165.3519331 GAD65 AB $165.3519332 PORPHYRINS TOTAL $203.6019333 NOREPINEPHRINE PLASM $203.6019335 PROSTAGLANDINS D2 $228.2519336 OMEGA3,6 FATTY ACIDS $211.0519337 TOTAL VITAMIND 25-OH $316.6019338 CRYPTOCOCCUS AB $92.6519339 ACHR GANGL NEUR AB $139.5019340 NEURONAL VGKC AUTOAB $139.5019341 N-TYPE CA CHANNEL AB $139.5019342 P/Q CA CHANNEL AB $139.50

19343 STRIATED MUSCLE AB $139.5019344 AGNA-1 $128.9519345 AMPHIPHYSIN-PARANEOP $128.9519346 ANNA-1 $128.9519347 ANNA-2 $128.9519348 ANNA-3 $128.9519349 CRMP-5-IGG $128.9519350 PCA-1 $128.9519351 PCA-2 $128.9519352 PCA-TR $128.9519353 ADAMTS 13 ACTIVITY $346.5019354 ADAMTS 13 INHIBITOR $201.3519355 CRMP-5 IGG WB $203.6019356 PARANEOLP AUTOAB WB $203.6019357 NMO/AQP4-IGG CBA $128.9519358 AMPCS $128.9519359 GABCS $128.9519360 NMDCS $128.9519361 AMPIS $128.9519362 GABIS $128.9519363 NMDIS $128.9519364 PARANEOPLASTIC AB EV $0.0019365 WATERMELON ALLERGEN $52.1519366 RED KIDNEY BEAN IGE $52.1519367 LIVER FIBROSIS FIBRO $0.0019368 B. MIYAMOTOI IGM $150.8519369 B. MIYAMOTOI IGG $150.0519370 BORRELIA MIYAMOTOI S $0.0019371 PARASITE ID $48.8019372 HIV1 RNA QT RFLX $910.4019373 THAWED APHERESIS PLA $273.0519374 OLANZAPINE LEVEL $203.6019375 CPDA-1 RBC LR IRR $784.1519376 AFP-L3 FRAC + AFPTOT $566.3519377 DCP $566.3519378 HEPATOCELL CA PANEL $0.0019379 CARDIO LIPOPROT FRAC $183.0019380 CALRETICULIN MUTATIO $863.2519381 REFLEXED LYME WB $0.0019382 LYME 49736 AG WB $169.0519383 LYME 39/40 AG WB $169.0519384 INTERLEUKIN-1 BETA $146.4519385 HAZELNUT TREE IGE $47.6019386 CARNITINE SERUM $291.9519388 CARNITINE SERUM $0.0019389 WEST NILE ABS CSF $0.0019390 PHENYLALANINE $113.15

19391 TYROSINE $117.8519392 PHENYLALANINE TYROSI $0.0019393 PORPHYRINS FR RANDUR $142.9019394 HLAII TYP 1 LOCUS LR $1,094.6519395 GC/CHLAMYDIA RECTAL $0.0019396 LEPTOSPIRA DNA QUAL $395.3019397 LP-PLA2 (PLAC) $412.8019398 C. DIFFICILE TOXINS $106.7519399 C. DIFFICILE GDH AG $106.7519400 SLOW GROW AFB MIC $173.2019401 ALPHA-LACTALBUMIN $53.4019402 BETA-LACTOGLOBULIN $53.4019403 MILK COMPONENT PANEL $0.0019404 OVALBUMIN IGE $53.4019405 OVOMUCOID IGE $53.4019406 EGG COMPONENT PANEL $0.0019407 HCV NS5A DRUG RESIST $2,326.4519408 THAWED PLASMA $287.0519409 THAWED PLAZMA <24HR $287.0519410 THAWED PLSM CRYO RED $281.8019411 THAWED POOLED CRYO $0.0019412 RBC BCR, LR $987.1019413 RBC BCR AND IRR $987.1019414 PACKED RBC'S $987.1019415 SINGLE DONOR PLT BCR $2,135.5519416 SD PLATELETS BCR IRR $2,540.6019417 SDP BCR, IRR VARYELD $2,540.6019418 SDP BCR IRR LOWYELD $2,540.6019419 CRYO SINGLE THAWED $226.7019420 ANTI IGE R AB $0.0019421 SDP APHERESIS PASBCR $2,135.5519422 PACKED RBC IRRADIATE $843.1519423 ORGANIC ACIDS UR QNT $0.0019424 ANTI IGE IGG $116.6019425 HCV NS3 DRUG RESIST $2,326.4519426 EPICOCCUM IGE $53.4019427 FUSARIUM MON IGE $53.4019428 PHOMA BETAE IGE $53.4019429 STEMPHYLIUM BOTR IGE $53.4019430 SWEET GUM IGE $53.4019431 DRECSHLERA IGE $53.4019432 RISOPHUS NIGR IGE $53.4019433 LYMPH PROLIFERATION $476.6519434 GOAT EPITHELIA IGE $53.4019435 BIOTIN $152.7519436 CALCIUM RANDOM URINE $68.0519437 CREATININE RANDOM UR $79.15

19438 CALCIUM CREAT URRAND $0.0019439 EN ANTIGEN ANTIBODY $224.8519440 IMMUNOASSAY NON AB $109.7519441 LYMPH MITOGEN RESPON $490.3019442 LACTIC ACID $92.5019443 LACTIC ACID $92.5019444 VW CB ASSAY $162.7019445 OXYCODONE W/O CONF $147.3019446 PNCYS JIROVECII PCR $439.1519447 HAEMOPHILUS INFLUENC $198.4019448 WEED ALLERY PANEL 1 $0.0019449 HAZELNUT IGE W/RFL $47.6019450 HAZNUT COMPONENT EAC $16.1019451 HAZELNUT COMPONENTS $0.0019452 TREPONEMA PALLIDUM $166.6519453 GIP, PCR FECES $3,576.8019454 PINEAPPLE ALLERGEN $52.1519455 POSACONAZOLE LEVEL $209.6019456 PARANEOPL AB WB $0.0019457 IMMUNOFIXATION CSF $301.2019458 OCTOPUS ALLERGEN $53.4019459 TROUT ALLERGEN $53.4019460 RESP VIRAL PANEL $3,601.8519461 SYPHILLIS AB CASCADI $166.6519462 RPR /REFLEX TO TITER $54.2519463 T PALLIDYM AGL $166.6519464 FELBAMATE $171.9519465 BEECH ALLERGEN IGE $53.4019466 MULBERRY TREE IGE $53.4019467 INFLIXIMAB LEVEL $576.4019468 INFLIXIMAB CONC/AB $0.0019469 ZIKA VIRUS PCR SERUM $485.1019470 ZIKA VIIRUS PCR URIN $485.1019471 ZIKA VIRUS PCR S/U $0.0019472 RHEUMATOID FACTORIGA $108.8019473 RHEUMATOID FACTORIGG $108.8019474 RHEUMATOID FACTORIGM $108.8019475 HEP B CORE AB IGM $91.6019476 MRSA WOUND BY PCR $384.3519477 COXIELA BURNETII DNA $272.9519478 COFFEE ALLERGEN IGE $52.1519479 VANILLA ALLERGEN IGE $52.1519480 COPEPTIN $165.2419481 NS5A GTYPE 3 DRRES $2,326.4519482 ISOPROPYL ALCOHOL $123.0019483 GALECTIN 3 $265.5019484 AMPHETAMINES URINE $387.90

19485 ENA AG AB TO ANY $139.5119486 WB FOR ENA AG AB $204.4719504 AMPHIPHYSIN WB MAYO $203.6019505 VZV PCR QUANT $386.0019506 21-HYDROXYLASE AB $192.9019507 DRUG SCREEN W CONF $173.2519508 CORTICOTR REL HORM $258.3019509 FLUORESCENT AB EA $128.9019510 ISLET CELL AB $211.6019511 RIA NONANTIBODY $159.4019512 IMMUNOASSAY QN NONAB $149.6019513 ESTROGENS FRACTIONAT $251.2519514 OPIATES URINE $195.3019515 BENZODIAZEPINES URIN $195.3019516 CULTURE IF EACH $75.0019517 RAPID RESP VIRUSES $0.0019518 ZINC TRANSP 8 AB $261.8019519 QUANTIFERON TB PLUS $646.9519520 SRP AUTOANTIBODY $187.3519521 JO1 AUTOANTIBODY $187.3519522 PL7 AB $120.4219523 PL12 ANTIBODY $120.4219524 KU ANTIBODY $120.4219525 EJ ANTIBODY $120.4219526 OJ ANTIBODY $120.4219528 BUPROPION $175.2219934 CHIKUNGUNYA PCR $319.1020001 ANES CASES BY 1ST HA $264.2020002 ANEST, ANEST EACH AD $132.1020003 ANESTHESIA SUPPLIES $372.8020008 EPIDURAL ANESTHESIA $170.8020009 PAIN MGMT PROC FIRST $880.6520012 ANESTHESIA W MRI $352.2020013 RADIO FREQ ABL NEEDL $211.4020014 ARTHROCARE PROBE $4,861.1020015 PERC DISCECTO PROBE $7,397.3520016 PERC DISCECTOMY WAND $5,706.5020017 VERTEBROPLASTY KIT $3,022.3020018 ANULOPLASTY PROBE WN $4,315.1020019 CENT VENOUS CATH KIT $109.2020020 UNV FLD DSP SYRINGE $317.0020021 PO PAIN RELIEF SYSTM $662.4520022 N STIM TRANSMITTER $5,261.7020023 NS PULSE GENERATOR $70,657.6520024 NS PROGRAMMER $5,261.7020025 NS EXTENSION $3,940.7520026 NS ELECTRODE LEAD $11,295.05

20637 RITONAVIR 100 MG TAB $30.8020638 AMINO ACID DEX INJ $167.2520639 AMINO ACID DEXT INJ $0.8020640 ASENAPINE 5MG SUBLIN $72.0021001 MRI CONTRAST MATERIA $421.7521002 MRI LUMBAR SPINE W/C $5,011.6021003 MRI LUMBAR SPINE W/O $4,524.5521009 MRI BRAIN W CONTRAST $4,652.8021010 MRI BRAIN W/O CONTRA $4,434.5021011 MRI CERV SPINE W/CON $4,503.1521012 MRI CERV SPINE W/O C $4,500.6021013 MRI CHEST W/O CONTRA $3,546.5521015 MRI FACIAL BONES W/O $4,444.4521026 MRI ORBIT W/O CONTRA $4,444.4521028 MRI PELVIS W CONTRAS $4,297.5521034 MRI TMJ W/O CONTRAST $4,304.1521036 MRI THORACIC SPINE W $4,928.7021037 MRI THOR SPINE W/O C $4,316.0021045 MRA CAROTID WO CTRST $4,103.1021051 MRI PELVIS W/O CONTR $4,027.6021053 MRI PELVIS W/W SEQ $6,352.2521056 MRI LUMBAR SPINE W/W $6,524.4021059 MRI THORACIC SPINE W $6,484.0521062 MRI CERV SPINE W/W S $5,809.1521065 MRI BRAIN W/WO SEQ $6,537.6521067 MRI NECK SOFT TISS W $4,913.5021068 MRI NECK SOFT TISS W $4,444.4521070 MRI NECK SOFT TISS W $6,336.1021072 MRI SHOULDER WO CONT $3,904.7021074 MRI ELBOW WO CONTRAS $3,904.7021075 MRI WRIST WO CONTRAS $3,904.7021078 MRI HUMERUS WO CONTR $4,159.7021080 MRI FOREARM WO CONTR $4,159.7021082 MRI HIP WO CONTRAST $4,337.5021084 MRI ANKLE WO CONTRAS $4,337.5021086 MRI FEMUR WO CONTRAS $4,042.4521088 MRI TIB/FIBULA WO CO $4,042.4521090 MRI ABD ORGANS W CON $1,937.4021091 MRI MRCP $4,403.6021093 MRI ABD ORGANS W/W S $6,390.0021095 MRI CHEST W CONTRAST $4,276.8021097 MRI CHEST W/W SEQ $5,404.3521098 MRI FOOT WO CONTRAST $4,042.4521099 MRI HEEL WO CONTRAST $4,042.4521101 MRI KNEE W/O CONTRAS $4,337.5021107 MRI FACIAL BONES W C $4,913.5021109 MRI FACIAL BONES W/W $6,336.10

21113 MRI WRIST W CONTRAST $4,266.1521115 MRI WRIST W/W SEQ $4,930.8521119 MRI ELBOW W CONTRAST $4,266.1521123 MRI ELBOW W/W SEQ $4,930.8521129 MRI SHOULDER W/CONTR $4,266.1521133 MRI SHOULDER W/W SEQ $4,930.8521137 MRI FOREARM W CONTRA $4,333.8021141 MRI FOREARM W/W SEQ $5,932.1521145 MRI HUMERUS W CONTRA $4,263.2021149 MRI HUMERUS W/W SEQ $5,932.1521151 MRI HIP W CONTRAST $4,782.6021155 MRI ANKLE W CONTRAST $4,782.6021157 MRI HIP W/W SEQ $6,137.6021159 MRI KNEE W/W SEQ $6,137.6021161 MRI ANKLE W/WO SEQ $6,137.6021165 MRI KNEE W CONTRAST $4,782.6021177 MRI FEMUR W CONTRAST $4,333.8021179 MRI TIB FIB W CONTRA $1,937.4021187 MRI FEMUR W/W SEQ $6,024.0521189 MRI TIB FIB W/W SEQ $6,024.0521192 MRI ORBIT W CONTRAST $4,913.5021194 MRI ORBIT W/W SEQ $6,336.1021196 MRI HAND W CONTRAST $4,159.7021198 MRI HAND W/W SEQ $6,024.0521199 MRI HAND W/O CONTRAS $4,042.4521201 MRI HEEL W CONTRAST $4,333.8021203 MRI FOOT W CONTRAST $1,937.4021205 MRI HEEL W/W SEQ $6,024.0521207 MRI FOOT W/W SEQ $6,024.0521208 MRI BREAST UNI W/WO $1,937.4021209 MRI BREAST BILA W/WO $6,126.1521210 MRA ABDOMEN W CONTRA $4,264.1021212 PRE ASSESM NO CHARGE $0.0021213 MRA LOW EXT W/WO CON $3,991.9521214 MRA LOW EXT W/O CONT $3,831.9521215 MRA NECK W/WO CONTRA $6,011.5521216 MRA HEAD W/WP CONTRA $4,654.5022001 AEROSOL TENT $126.7522003 ARTERIAL BLOOD GASES $137.1522006 COUGH AND DEEP BREAT $0.0022007 DRUG NEBULIZ INIT $70.4522009 HIGH DENSITY NEBULIZ $212.4022012 INCENTIVE INSTRUCTIO $35.2022018 OXYGEN ( PER DAY) $158.5022019 OXYGEN INTENSIVE CAR $158.5022022 PEAK FLOW $248.5022024 POSTURAL DRAINAGE $58.10

22025 POSTURAL DRAINAGE & $88.0522027 PULSE OXIMETRY $132.3022028 PULSE OXIMETRY CONTI $132.3022029 RESP. THER. BASIC PU $96.9022030 RESP. THER. COMP. PU $264.2022031 PULSE OX SERIAL MEAS $44.0022032 SPUTUM INDUCTION $112.7022033 SWAN GANZ ASSIT $0.0022040 VENTILATOR SET-UP $0.0022041 VENTILATOR-CONTINUOU $652.9522043 VITAL CAPACITY $35.2022050 THERAPEUTIC EXERCISE $70.4522051 CPAP BIPAP $176.1522052 DRUG NEBULIZER $212.4022100 BUPIVICA/EPI INJ .5% $29.7022101 MORPH SUL20MG/ML ORL $7.0522102 FENOFIBRATE 145MG TB $17.2022103 NACL FOR INHAL 15ML $2.8022104 PREGABALIN 50MG CAP $30.9022105 PREGABALIN 75 MG CAP $30.9022106 PREGABALIN 100 MG CA $30.9022107 TENOFOVIR 300 MG TAB $143.5022108 FOMEPIZOLE INJ 1GM/M $3,699.6022109 TRAVOPR .004% OPTHAL $661.9022110 BRINZOLAMIDE 1% OPTH $555.1022111 BIMATOPROST.03%OPTHA $403.9022112 OLOPATADINE .1%OPTHA $1,046.2022113 KETORALAC .1% OPTHAL $944.3022114 NAPHAZ/PHENIR OPTHAL $27.0022115 LOTEPREDN .5% OPTHAL $855.8022116 MAG INJ 2GM/50ML IVP $13.1322117 OLMESART MEDOX 20MG $6.3022118 LEVOTHYROXINE 75MCG $4.4022119 INSULIN PEN NEDL 31G $1.5022120 SCOPOLAM 1.5MG TDPAT $76.7022121 LIDOCAINE MPF INJ.5% $13.9022122 DAPTOMYCIN INJ 500MG $3.2122123 WARFARIN SOD 1MG TAB $7.4022124 PALIPERIDONE SR 3MG $141.4022125 VALACYCLOVIR 500MG T $45.2022126 PREDNISOLONE ORAL 15 $7.2022127 HYDROACTIVE GEL 30GM $25.8022128 LIDOCAINE 5% PATCH $65.4022131 MORPHINE SULF PF INJ $25.4622400 MESALAMIN 100MG SUP $139.4022401 MIDAZOLAM INJ 100MG/ $162.0022402 FELODIPINE ER 5MG TA $5.45

22403 SOTALOL 5 MG TAB $40.7022404 SUNBLOCK SPF 30 $67.1022405 TIGECYCLINE INJ 50MG $563.4022406 CLINDAMYCIN 300MG/50 $25.5022407 CLINDAMYCIN 600MG/50 $38.4022408 CLINDAMYCIN 900MG/50 $47.0022409 EXENATIDE INJ 250MCG $2,626.7022410 EXENATIDE INJ 250MCG $2,626.7022411 DORZOLAMIDE/TIMOLOL $367.8022412 ALCOHOL 5%D5W 1000ML $30.6022413 ATOVAQUONE 750MG/5ML $90.8022414 QUININ SULF 324MGCAP $22.0022415 LORAZEPAM 2MG TABLET $0.8022416 LORAZEPAM INJ 4MG/ML $4.2022417 AMOXIC SUSP400MG/5ML $14.7022418 VARENICLINE .5MG TAB $27.1022419 VARENICLINE 1MG TAB $27.1022420 DOXAZOSIN 2MG TAB $11.3022421 MORPHINE-PF INJ 10MG $37.4422422 HEPARIN SOD INJ 5000 $15.6022423 NIMODIPINE 30MG CAP $27.5022424 TRAMADOL 50 MG TAB $2.5022700 IMM GLOB IV 0.5 GM $277.6022701 LEVOFLOXACIN 750MG T $75.2022702 LEVOFLOX INJ 750MG/ $21.6022703 AZELASTIN NAS SP 137 $315.7022704 MOMETASONE NAS SPR50 $411.7022705 FLUTICAS/SALMET 100/ $1,092.5022706 BUPROPION EXT REL150 $163.4022707 GLIMEPIRIDE 2 MG TAB $5.2022709 ASP/DIPYRID 25MG/200 $33.8022710 DEFEROXAMINE INJ 2GM $28.4322711 RACEPINEPH INH 2.25 $5.4022712 TRIMETHOBENZ 300MGCP $4.9022713 BUDESONIDE INH RSP.5 $36.9022714 TIOTROP BROM INH 18M $61.2022715 CHLORPROMAZ 10MG TAB $12.6022716 CA VIT D 500MG/200MG $0.8022717 AQUAPHOR HEALING OIN $25.4022718 IPRATROP HFA INHAL17 $1,397.2022719 GUAIFENESIN SR600 TA $1.6022720 REMELTEON 8MG TAB $46.7022721 ROPINIROLE 1 MG TAB $7.5022722 DULOXETINE 30 MG CAP $23.1022723 MODAFINIL 100 MG TAB $66.2022724 FERRIC GLUC CPLX SUC $114.5022725 CALC ACET 667MG GEL $3.10

22726 OFLOXACIN .3%OTIC SL $462.8022727 CHOLESTYRAMIN 4GM PK $10.1022728 DORZOLAMIDE/TIMOLOL $150.7022800 ETHYL CHLORIDE TOPIC $104.5022801 SAFE TUSSIN COUGH SY $0.9522802 MIRTZAPINE SOL TAB 1 $7.1022803 MIRTZAPINE SOL TAB 3 $15.8022804 FLEET PHOS-SODA 45ML $9.8022805 DPHNHYDR LID VSC MLX $161.4022806 ZIPRASIDONE CAP 20 M $52.8022807 ZIPRESIDONE CAP 40 M $26.9022808 ROFECOXIB TAB 25 MG $13.7522809 INSULIN GLARGINE INJ $0.8022810 .9% NOR SAL FLSH 5ML $0.8022811 METOPROLOL 25 MG TAB $0.8022812 TERAZOSIN 1MG CAP $4.8022813 LANSOPRAZOLE 30MG SO $49.8022814 HYDROCHLORTHIAZ 12.5 $1.3022815 FLUTICASONE 220 MCG $1,401.2022816 KETOCONAZOLE 2%CREAM $92.7022817 NAFCILLIN 2 GM INJ $85.0022818 OLANZAPINE IM 10 MG $160.9022819 MEMANTINE 5 MG TAB $26.7022820 ACETYLCYSTEINE INJ $22.6022821 CALCITRIOL.25MCG CAP $3.0022822 SEVELAMAR 800MG TAB $25.4022823 LOREZEPAM INJ 2MG/ML $11.5522824 TRIAMCINOLONE INJ 40 $34.6022825 CALCIUM ACETATE 667 $1.0522828 NITROGLYCERIN 2%OINT $8.3022830 SENNA DOCUS 8.6/50MG $1.0522832 BETAXOLOL .25% OPHTH $1,117.9022833 CLOBETASOL PROP .05% $384.7022834 FLUTICASONE SALMETER $890.3022835 CEFUROXIM AXETIL 250 $295.9022836 RHO D IMMUNE GLOB IN $378.4022837 BUMETANIDE 1 MG TAB $3.3022838 ACAMPROSATE 333 MG T $5.3022839 LEVETIRACETAM 500 MG $28.3022840 LOPINAVIR/ROTONAVIR $30.7022841 ROPIVACA PF INJ .5% $78.2022900 INFLIXIMB INJ 10 MG $420.4022903 FLTICS HFA 110MCG IN $902.1022904 SOD BICARB 8.4% 50ML $34.9022905 HEP LCK FLSH 500U 50 $2.0022906 METHLPHNIDAT ER 10MG $35.8022907 SPINAL TRAY LIDOCN5% $51.00

22909 LORAZEPAM INTEN ORAL $4.8022910 PHENOBARB 60 MG TAB $0.8022911 HYALURONIDASE INJ150 $200.9022912 LOSARTAN/HCTZ100-12. $10.2022913 LOSARTAN/HCTZ 100-25 $10.2022914 FEXOFENADINE 180MG T $2.2022915 ORAL ELECT SOL 177ML $0.8022916 LIDOCAINE SYR 50MG/5 $32.3022917 DEXTROSE 25% SYRINGE $30.1022918 CLOZAPIN ORL DISIN25 $9.0022919 CLOZAPN ORL DIS 100M $57.6022920 BUPRENORPHINE SL 2MG $12.4022921 ESZOPICLONE 1 MG TAB $35.0022922 SOD CHLOR PF INJ 10% $132.3022923 HYALURONIDASE 1500 U $150.0022924 PHENOL SOLUTION $3.6023001 TRIAMCINOLONE CREAM $33.3023003 TRIAMCINOLONE LOTION $270.0023004 TRIAMCINOLONE OINT 0 $16.7023007 TRIAMTERENE CAPS 50M $34.5023010 TOBRAMYC DEXAM OPTHA $285.1023011 TRIAZOLAM TABS 0.125 $3.9023012 LEVONORGESTREL .75MG $108.0023013 TRIFLUOPERAZINE CONC $10.9523014 TRIFLUOPERAZINE HCL $8.7023015 TRIFLUOPERAZINE HCL $2.1023016 TRIFLUOPERAZINE HCL $4.6023017 TRIFLUOPERAZINE HCL $7.6023021 TRIFLURIDINE OPTH SO $668.8023022 TRIHEXYPHENIDYL HCL $0.8023023 TRIMETHOBENZAMIDE CA $2.6523024 TRIMETHOBENZAMIDE CA $1.8023025 TRIMETHOBENZAMIDE IN $138.8023026 TRIMETHOBENZAMIDE SU $1.9023029 TROPICAMIDE OPHTH SO $14.0023031 TUBERCULIN PPD 5 TU $32.0023032 VIT B&C COMPLEX TAB $0.8023033 NICOTIN POLAC 2MGLOZ $1.5023034 MTHYLPHENID 10MG TAB $3.2023035 ELETRIPTAN 40MG TAB $53.7023036 TET/DIPH/PER.5ML INJ $393.2023037 BUPIVAC .75% DEX INJ $8.0023039 TUSSAR SF SYRUP $5.4023044 TYLENOL W/CODEINE #3 $0.8023045 TYLENOL W/CODEINE EL $4.4023056 VANCOMYCIN HCL INJ 5 $25.2023061 VASOPRESSIN INJ 20U/ $63.70

23062 VECURONIUM BROMIDE I $180.0023068 VERAPAMIL HCL INJ 5M $104.2023069 VERAPAMIL HCL TABS 1 $2.3023070 VERAPAMIL HCL TABS 8 $1.2023071 VERAPAMIL INJ. 5 MG/ $58.1023072 VERAPAMIL HCL SR TAB $7.6023073 VERAPAMIL HCL SR TAB $7.5023074 VICON C CAPS $0.8023076 VIDARABINE OPHTH OIN $124.2523081 VISCOAT INJ. 0.5 ML $383.0523086 VITAMINS THERA. W/MI $0.8023093 WARFARIN SOD. CRYST. $11.5023094 WARFARIN SOD. CRYST. $8.0023095 WARFARIN SOD. CRYST. $7.7023096 WARFARIN SOD. CRYST. $8.3023097 ADMIN OF PP VACCINE $179.6523099 BACTERIOSTATIC WATER $4.2023101 WATER, STERILE,FOR I $21.2023103 WHITE PETROLATUM 1 O $4.6023104 WHITE PETROLATUM 5 G $0.8023114 ZIDOVUDINE CAPS 100 $6.0023116 ZINC OXIDE OINTMENT $9.8023123 WITCH HAZEL $5.6023124 OFLOXACIN TABS 200 M $27.5023125 OFLOXACIN TABS 400 M $34.3523126 OFLOXACIN IV 400 MG $181.9523127 PAROXETINE TABS 20 M $8.2023129 CLINDAMYCIN 900 MG $14.9023131 CEFOXITIN 2GM IVPB $22.9523132 ERYTHROMYCIN 250 MG $25.4523133 AMLODIPINE TAB 5MG $23.5023136 GENTAMICIN CREAM 15 $148.1023137 AZITHROMYCIN CAP 250 $23.3023138 CLARITHROMYCIN TAB. $18.0023139 CLONIDINE PATCH 0.1 $236.9023140 CROMOLYN INHALER $450.7523141 DILTIAZEM C.D. CAP 1 $1.1023142 DILTIAZEM S.R. CAP 6 $4.7523143 METHYLPHENIDATE TAB. $1.9023145 PYRIDOXINE INJ 100 M $54.7023146 OVCON-50 TAB $8.7023147 POVIDONE IODINE OPHT $46.3023149 IMMUNE SERUM GLOBULI $71.9523150 TOBRADEX OPHTH. SOLN $43.7023151 PHENYLEPHRINE OPHTH. $42.9523152 IBUPROFEN SUSPENSION $2.8023153 CIPROFLOXACIN 400MG $5.30

23154 LOPERAMIDE CAPSULES $4.1023155 METHOTREXATE TABLETS $10.7023156 OFLOXACIN OPTHALMIC $425.3023157 SUMATRIPTAN INJECTIO $685.6023158 TERAZOCIN TABLETS 2 $10.6023159 TIMENTIN IVPB 3.1 GM $48.0023160 ZOLPIDEM TABLETS 5 M $13.8023161 ZOLPIDEM TABLETS 1 $13.9023162 ZOSTRIX $58.1023163 ZOVIRAX $67.6023164 DIGOXIN IMMUNE FAB $13,100.4023165 MESALAMINE 400 MG TA $0.4523166 HEPATITIS B VACCINE $82.5023167 PROCAN SR 750 MG TAB $4.1023168 AMVISC PLUS 0.8ML $547.2023169 NIZATIDINE CAPSULES, $14.4523170 CISAPRIDE TABLETS, 1 $6.2023171 FERROSEQUELS $2.0023172 HYALURONATE SYRINGE $1,399.9523173 HYDROCORTISONE CREAM $32.9023174 OFLOXAVIN TABLETS 30 $32.6523175 ROCURONIUM INJECTION $18.2023176 CAFFENE AND SODIUM B $65.6023178 ONDASETRON INJ 4 MG/ $0.4323179 DOBUTAMINE 500 MG/25 $22.5523182 BALANCED SALT SOL. 5 $98.9023183 ETOMIDATE INJ. 20 MG $22.4023184 MAXITROL OPTH. OINT. $701.6023185 PILOCARPINE OPTH SOL $302.4023186 PROVISC $384.2023187 CEFTAZIDIME IVPB 2GM $9.9023188 HEMORRHOIDAL SUPPOSI $1.2023189 HUMULIN 70/30 INJECT $0.8023190 IPRATROPIUM SOLUTION $5.7023191 LIDOCAINE INJECTION, $13.7023192 NICARDIPINE INJECTIO $185.0523193 OVRAL TABLETS $8.9023194 PENTOBARBITAL CAPSUL $4.2523195 TRIAMCINOLONE CREAM $16.7023196 CEFONICID IVPB 2GM $359.7523197 CLINDAMYCIN IVPB 600 $10.9523198 MORPHINE INJ 5MG/10M $94.9023199 OFLOXACIN IVPB 400MG $190.1523201 AMIODARONE INJ 150 M $1.0223202 AUGMENTIN TAB 250MG $8.5523203 BUPIVACAINE INJ 0.25 $6.9023204 DIVALPROEX TAB 125 M $2.40

23205 DIVALPROEX TAB 250 M $5.2023206 DIVALPROEX TAB 500 M $9.6023207 FLUVOXAMINE MALEATE $7.7023208 FLUVOXAMINE MALEATE $15.8523209 ISOSORBIDE MONOTAB 6 $1.6023210 LISINOPRIL TAB 5 MG $2.7023211 LISINOPRIL TAB 10 MG $2.8023212 LOSARTAN TAB 25 MG $5.0023213 MAG SULF INJ 50% 5GM $5.9623214 MOLINDONE TAB 10 MG $5.3523215 MOLINDONE TAB 25 MG $8.0523216 NEFAZODONE TAB 100 M $5.9523217 PREDNISOLONE LIQUID $12.2023218 PYRAZINAMIDE TAB 500 $18.9023219 RISPERIDONE TAB 1 MG $41.0023220 RISPERIDONE TAB 2 MG $68.6023221 RISPERIDONE TAB 3 MG $80.5023222 VENLAFAXINE TAB 25 M $5.8023223 VENLAFAXINE TAB 37.5 $7.8523224 VENLAFAXINE TAB 50 M $7.8523225 VENLAFAXINE TAB 75 M $11.2523228 TMP DOPAMINE INJV200 $69.5523231 TMP THIAMINE INJ 100 $30.6523232 TICLOPIDINE TAB 250 $4.9523233 TMP OFLOXACIN IV 200 $95.0523234 QUINAPRIL HCL TAB 10 $17.4023235 TMP ISOTRETINOIN CAP $47.6023236 TMP CEFACLOR CAP 250 $10.8023237 CALCIUM CITRATE TAB $1.8023238 TMP EPOETIN INJ 4000 $197.3523239 TMP FLUTAMIDE CAP 12 $12.4023240 TMP HYDROXYUREA CAP $4.9023241 TMP PINOLINE TAB 18. $3.3523242 TMP MAG GLUC ELIX 54 $0.8023244 TMP PIMOZIDE TAB 2 M $5.5023245 TMP LAC HYDRIN LOTIO $54.2023246 TMP RANITIDINE TAB 1 $5.3023247 TMP RANITIDINE TAB 3 $22.3023248 TMP DOXAZOSIN MES TA $5.5023249 TMP DOXAZOSIN MES TA $5.5023250 TMP DOXAZOSIN MES TA $5.7023251 TMP BECLOMETHASONE $253.2523253 NTG TRANSDERMAL 15 M $7.2023254 PHARMACY ITEM $11.4523255 PHARMACY ITEM $23.0023256 PHARMACY ITEM $34.4523257 PHARMACY ITEM $46.00

23258 PHARMACY ITEM $57.4523259 PHARMACY ITEM $1.0523260 PHARMACY IV ITEM $46.0023261 PHARMACY IV ITEM $91.8523262 PHARMACY IV ITEM $137.8023263 PHARMACY IV ITEM $183.8023264 PHARMACY IV ITEM $229.7023265 PHARMACY IV ITEM $275.6523266 NON FORMULARY MED $321.6523267 NON FORMULARY MED $367.5023268 NON FORMULARY MED $413.5023269 PHARMACY IV ITEM $459.5023270 TMP AMLODIPINE BESYL $23.5023271 NITROGLYCERINE OINT $13.3523274 NON FORMULARY ITEM 4 $91.8523275 NON FORMULARY ITEM 5 $114.8023276 NON FORMULARY ITEM 6 $137.8023277 NON FORMULARY ITEM 7 $160.8023278 NON FORMULARY ITEM 8 $183.8023279 PERCOCET TABLET $4.1023281 ENALAPRIL 1.25 MG/1M $6.1023282 MYAMBUTOL TAB 400 MG $2.8023283 NON-FORMULARY ITEM $459.5023284 ALBUTEROL SYRUP 2 MG $1.9023285 AUGMENTIN TAB 500 MG $11.3023286 AZTREONAM INJ 2 GM $208.8023287 BACITRACIN OPTH OINT $355.3023288 CEFOTAXIME INJ 1 GM $7.9023292 DAKIN'S SOLUTION $34.5023293 DIMERCAPROL INJ 100M $192.5023294 EMLA CREAM 30 GM $24.1023295 FAMOTIDINE INJ 20 MG $1.6023296 FAT EMULSION 20% 500 $79.5023297 FLUCONAZOLE IVPB 200 $21.6023298 FLUOCINONIDE CREAM 0 $136.7023299 FLUOCINONIDE OINTMEN $212.3023301 LORAZEPAM INJ 2MG/ML $3.5023302 NITROGLYCERIN IV 50 $69.6023303 PAPAVARINE HCL INJ 3 $128.8023304 SEVOFLURANE 25 ML $2.7023305 SIMETHICONE TAB 80MG $0.8023306 TRIAMCINOLONE ACETON $564.1023307 UNASYN IVPB 1.5 GM $27.3023308 UNASYN IVPB 3GM $28.7023310 SODIUM CHLORIDE 0.9% $1.0523311 VITAMIN E CAP 400 IU $0.8023312 PSEUDOEPHEDRINE TAB $0.80

23313 TMP VITAMINS THERAPE $4.9523314 TMP DILTIAZEM CD 300 $10.3023317 DOBUTAMINE INJ 250MG $20.0023318 DOPAMINE INJ 400 MG/ $6.8023319 DILTIAZEM CD CAPSULE $8.0023320 AVAILABLE FOR USE $0.0023321 AVAILABLE FOR USE $0.0023322 FIORICET TABLETS $5.0023323 NALDECON DX ADULT SY $1.5023324 FAMOTIDINE IVPB 20MG $1.5023325 LAMIVUDINE TABLET 15 $24.9023326 NIFEDIPINE ER TABLET $8.7023327 NIFEDIPINE ER TABLET $15.9523328 NIFEDIPINE ER TABLET $18.1523329 OLANZAPINE TABLET 5 $39.6023330 OLANZAPINE TABLET 7. $48.2023331 OLANZAPINE TABLET 10 $39.6023332 SAQUINAVIR CAPSULES $11.4523333 SORBITOL SOLUTION, 7 $6.7023334 VARICELLA VIRUS VACC $232.5023336 CHOLERA VACCINE 0.5M $44.5023337 ACEL-IMMUNE 0.5ML IN $289.7523338 DIPTH &TETANUS TOX A $49.1023339 HEPATITIS A VACCINE $281.2023340 HEPATITIS A VACCINE $409.7523341 MENINGOCOCCAL VACCIN $369.2023342 POLIO VIRUS VACCINE $267.8023343 RABIES VACCINE 1 ML $1,282.9023344 TYPHOID VACCINE 0.50 $16.2523345 YELLOW FEVER VACCINE $287.0023347 TETRAMUNE 0.5 ML INJ $345.4523348 ATROPINE SULF SYRING $45.6023349 BUSPIRONE TAB 5 MG $2.3023350 CLARITHROMYCIN TAB 5 $22.5523351 FLEET ENEMA 4.5 OZ D $3.5023352 FLEET LARGE VOLUME E $45.8023353 FLEET OIL ENEMA 4.5 $6.2023355 SIMVASTATIN TAB 10MG $8.3023356 NON FORMULARY ITEM $574.3023357 NON FORMULARY ITEM $689.1523358 NON FORMULARY ITEM $918.9023359 NON FORMULARY ITEM $1,148.6523360 ATROVASTIN TAB 10 MG $37.7023361 FENTANYL TRANSDERMAL $63.8023362 FENTANYL TRANSDERMAL $79.1023363 FENTANYL TRANSDERMAL $461.0023364 FENTANYL TRANSDERMAL $611.90

23366 LIDOCAINE INJ 4% 4ML $25.4023367 LORATADINE TAB 10MG $2.5023368 METHADONE TAB 10 MG $1.1023369 MORPHINE SULFATE SOL $1.2523370 POTASSIUM CHL SR CAP $2.1023372 SILVER SULFADIAZINE $33.2023373 TRAMADOL CAP 50 MG $5.2523374 QUINAPRIL TAB 5 MG $17.4023375 ADENOSINE SYR 3 MG/M $20.5023376 ATENOLOL TAB 25 MG $2.4023377 CARVEDILOL TAB 3.125 $17.8023378 CARVEDILOL TAB 12.5 $6.3023379 DIPTH-TETANUS-PERTUS $53.4523380 TORSEMIDE TAB 20 MG $2.5023381 DANTROLENE CAP 25 MG $3.2023383 ASPIRIN 81 MG ENTERI $0.8023384 METFORMIN TAB 500 MG $3.5023385 HALOPERIDOL DEC. INJ $298.8023386 SUMATRIPTAN TAB 25 M $107.9023387 HEPATITIS A VACC ADU $250.0023388 MAG SULF INJ 40 GM/1 $0.3723389 MORRHUATE SOD INJ 50 $8.4023391 TROGLITAZONE TAB 200 $20.6023392 SALINE EYE DROPS $16.2523393 METHYLPREDNISOLONE S $150.8023394 TETRAMUNE $498.6023395 METROPROLOL ER TAB 5 $3.7023396 BUPROPION SR TAB 100 $24.9023397 BUPROPION SR TAB 150 $26.7023398 AZITHROMYCIN INJ 500 $21.6023399 IRBESARTAN TAB 75 MG $8.8023400 IRBESARTAN TAB 150 M $9.2023401 VICODIN ES TAB $6.8023402 BECLOMETHASONE AQ 84 $564.9523403 QUETIAPINE TAB 25 MG $0.8023404 QUETIAPINE TAB 100 M $24.0023405 QUETIAPINE TAB 200 M $45.3023406 MIRTAZAPINE TAB 15 $13.7523407 RABIES VACCINE ADSOR $947.6023408 GABAPENTIN CAP 100 M $1.7023409 GABAPENTIN CAP 300 M $0.8023410 LEVOFLOXACIN TAB 250 $52.6023411 LEVOFLOXACIN TAB 500 $50.5023412 LEVOFLOXACIN 250 MG/ $25.2023413 LEVOFLOXACIN 500 MG/ $10.8023415 FLUPHENAZINE CONC 5 $8.6023416 LANSOPRAZOLE CAP 15 $21.25

23417 LANSOPRAZOLE CAP 30 $21.8523418 NUGAUZE IODOFORM 2 I $10.8023419 PROPOFOL EMULSION IN $1.1323420 VENLAFAXINE XR CAP 3 $12.5023421 VENLAFAXINE XR CAP 7 $12.6023422 SUSPENSORY LARGE $30.9523423 SUSPENSORY X LARGE $30.9523425 AEROCHAMBER FOR INHA $130.9023427 DIVALPROEX SPRINKLES $4.2023428 HEPATITIS B VACC 5 M $85.8023429 LOTRISONE CREAM 15 G $168.0023430 ENOXAPARIN INJECTION $29.7823431 MEASELES VIRUS VACCI $36.0023432 CALCITONIN SAL NASAL $192.2023433 MULTIVITAMIN CONC IN $55.5023434 PAROXETINE TABLET 10 $22.2023435 CLOPIDOGREL TABLET 7 $13.1023436 POTASSIUM INJ 20 MEQ $0.9623437 PRAVASTATIN TABLET 2 $9.8023438 FINASTERIDE TABLET 5 $9.4023439 RABIES IMMUNE GLOBUL $2,556.4023440 RABIES IMMUNE GLOBUL $11,668.3023441 RISPERIDONE SOLN 1 M $45.8023442 TRAZODONE TABLET 100 $4.2023443 SERTRALINE TABLET 25 $8.6023444 ISOSULFAN BLUE 1% 50 $243.5023445 ALBUTEROL INHALER 17 $78.0023446 ALENDRONATE TAB 10 M $11.9023447 BRIMONIDINE OPTH SOL $166.7523448 CLOTRIMAZOLE CR 1% 1 $16.8023449 CROMOLYN SOD NASAL S $66.5523450 CYCLOBENZAPRINE TAB $3.6023451 DESMOPRESSIN .01% NA $1,676.6023453 EPOETIN INJ/1000UNIT $96.2123454 FILGRASTIM INJ 300 M $3.7823455 FILGRASTIM INJ 480 M $3.7623457 INDINAVIR CAP 400 MG $9.1023458 ISOSULFAN BLUE 1% 50 $3,183.9023459 LATANOPROST OPTH SOL $733.6023460 MONTELUKAST TAB 10 M $17.0023461 OXYCODONE CR TAB 10 $14.9023462 PLAIN PACKING 2 INCH $10.8023463 SOD CHLORIDE IRRAG 1 $9.8023464 AMOXICILLIN TAB 875 $2.6023465 ATROPINE OPTHAL SOLN $133.8023466 ATORVASTATIN TAB 40 $53.8023467 AUGMENTIN TAB 875 MG $14.70

23468 ANALGESIC TOPICAL OI $22.7023470 CHERRY SYRUP $3.1023471 CHLORAMPHENICOL 0.5% $24.3523472 CITALOPRAM TAB 20 MG $34.1023474 DENTAL ADHESIVE CREA $50.9023476 DIMETAPP ELIXIR $1.0523478 DONNATAL ELIXIR $155.3023479 FENTANYL ORALET 100 $200.6523480 FENTANYL ORALET 400 $215.0523481 FLUMAZENIL INJ 0.5 M $24.4023482 GLIPIZIDE TAB 5 MG $0.8023483 HYDROCORTISONE SS IN $0.0423484 KERI LOTION 2 OZ $20.3023485 KETOCONAZOLE SHAM 2% $80.0023486 LIDOCAINE INJ 1% MDV $0.8023488 MIDAZOLAM SYRUP 2 MG $6.5023489 MINERAL OIL $0.8023490 OCTREOTIDE INJ 50 MC $8.1023491 OCTREOTIDE INJ 100 M $5.8523492 PLAIN PACKING 1/4" $10.8023493 PHENYLEPHRINE O.S. 2 $121.9023494 TIMOLOL O.S. 0.25% $45.0023495 TIMOLOL O.S. 0.5% $18.1023496 VANCOMYCIN HCL INJ 1 $28.8523498 CLIMETIDINE LIQ 300 $6.2023499 DONEPEZIL TAB 5 MG $0.8023500 DOXEPIN CAP 10 MG $1.9023501 EPOETIN INJ/1000UNIT $96.2123502 HYDROCHLORTHIAZIDE T $0.8023503 LITHIUM CARBONATE TA $1.6023504 MEDROXYPROGESTERONE $3.0523505 MIDAZOLAM INJ 1 MG/1 $0.6823506 CARBIDOPA/LEVODOPA S $4.7023507 TAMSULOSIN CAP 0.4 M $12.6023508 HEXACHLOROPHENE LIQU $95.1023509 GABAPENTIN CAP 400 M $0.8023510 MIRTAZAPINE TAB 30 M $14.2023511 TOLTERODINE TAB 2 MG $26.4023512 ZAFIRLUKAST TAB 20 M $9.0023513 GLIPIZIDE TAB CR 5 M $2.2023514 CALCIUM 250 MG/VIT D $1.8023515 TERAZOSIN CAP 5 MG $4.8023516 AMOXICILLIN ORAL SUS $6.3523517 DUOVISC VISCOELASTIC $684.9023518 LIDOCAINE INJ 1% MDV $0.8023519 LIDOCAINE/EPI INJ 1% $0.8023520 MICONAZOLE NIT VAG S $0.26

23521 MIDAZOLAM INJ 5 MG/M $0.8623523 RAPACURONIUM INJ 20 $212.0523524 RISPERDONE TAB 0.5 M $38.6023525 ACETIC ACID 0.25% IR $18.9023526 AMLODIPINE TAB 10 MG $6.8023527 CELECOXIB CAP 100 MG $27.8023528 GABAPENTIN TAB 600 M $7.6023529 GABAPENTIN TAB 800 M $9.1023530 ISOSORBIDE MONONITRA $1.5023532 COLLAGEN SPONGE $224.1523533 ROSIGLITAZONE TAB 4 $16.2023534 RIMANTIDINE TAB 100 $9.7023535 OSELTAMIVIR CAP 75 M $54.7023536 METHADONE DISP TAB 4 $0.8023537 FLUTICASONE NASAL IN $253.0023538 INSULIN LISPRO INJ $0.1623539 MUPIROCIN OINTMENT 2 $33.7023540 LEVOTHYROXINE TAB 12 $4.4023541 TRAZODONE TAB 150 MG $8.4023542 FENTANYL INJ 100 MCG $6.3023543 RAMIPRIL CAP 1.25 MG $18.2023544 RAMIPRIL CAP 2.5 MG $5.4023545 RAMIPRIL CAP 5 MG $5.7023546 LINEZOLID TAB 600 MG $549.0023547 LINEZOLID INJ 600 MG $96.0023548 FLU VACCINE $44.5023549 ADMINISTR OF FLU VAC $14.6523550 COCAINE HCL TOP.SOL. $669.4023551 D51/2NS+10MEQ KCL 10 $10.7023552 D51/2NS+30MEQ KCL 10 $10.7023553 EPOETIN ALFAINJ/1000 $96.2123554 ZIDOVUDINE/LAMIVUDIN $46.6023555 ENOXAPARIN SODIUM 60 $29.8023556 ENOXAPARIN SODIUM 80 $29.8023557 ENOXAPARIN SODIUM 10 $29.8023558 ARTIFICIAL SALIVA LI $15.5023559 TIROFIBAN HCL 12.5 M $37.2823560 PANTOPRAZOLE SODIUM $12.2023561 PHENOBARBITAL 30 MG $4.0023562 STAVUDINE 40 MG CAPS $24.9023563 NELFINAVIR 350 MG TA $14.6023564 CALCITONIN-SAL INJ 2 $9,731.0023565 CELESTONE SOLUSPAN I $18.5523566 PRIMAXIN IV INJ 500 $58.7523567 DEXAMETHASONE INJ 4 $2.1523568 PHENYTOIN SODIUM INJ $2.2523570 ENOXAPRIN INJECTION $29.77

23571 MIDAZOLAM INJ 1MG/1M $1.1523572 NALOXONE 2MG/2ML SYR $59.4023574 OXACILLIN SODIUM INJ $10.8823575 NEOSTIGMINE INJ 1MG/ $0.7523576 PROTAMINE SULFATE IN $8.8423577 IPECAC 30 ML $13.6523580 TRIAMCINOLONE INJ 40 $8.4323582 WATER, STERILE, FOR $12.5023588 LEVALBUTEROL 0.63 MG $20.1023589 LEVALBUTEROL 1.25 MG $20.1023590 FENTANYL CITRATE LOZ $44.1023591 MANNITOL INJ 20%SOLN $62.8023592 CLOTRIMAZOLE/BETAMET $92.2023593 CLONIDINE INJ 100 MC $90.0023594 PANTOPREZOLE INJ 40 $18.0023595 CARVEDILOL TAB 6.25 $17.8023596 TOPIRAMATE TAB 25 MG $21.8023597 TOPIRAMATE TAB 100 M $59.4023598 POLYETHELENE GLYCOL $3.4023599 STERILE WATER FOR IN $9.5023600 CLONIDINE PATCH 0.2M $167.5023601 DICYCLOMINE SYRUP 10 $4.5023602 DEXTROMETHORPHAM HBR $1.8023603 DEXTROMETHORPHAN POL $33.5523604 NALMEFENE INJ 2 MG/2 $165.8523605 VANCOMYCIN CAP 125 M $93.9023606 MORPHINE SULFATE INJ $4.7923607 AZITHROMYCIN TAB 600 $296.6023608 CHLORDIAZ/CLIDINIUM $15.4023609 FOSINOPRIL TAB 10 MG $0.8023610 ALBUTEROL/PRATROPIUM $6.8023611 PIOGLITAZONE TAB 30 $71.3023612 PIOGLITAZONE TAB 45 $77.3023613 AZITHROMYCIN SUSP 10 $174.4023614 AZITHROMYCIN SUSP 20 $87.2023615 AMOXOCILLIN/CLAV SUS $331.4523616 AMOXICILLIN/CLAV SUS $485.4023617 DO NOT USE $0.0023619 BOTULINUM TOXIN TYPE $21.6023620 DROTRECOGIN INJ 5MG $1,445.5523621 DROTRECOGIN INJ 20MG $5,781.8523623 FOLGARD TABLET $1.0523624 MORPHINE SULFATE $1.0323625 ZIPRASIDONE $89.4023626 FAMOTIDINE $5.2023627 ALENDRONATE 70MG TAB $61.5023628 NAFCILLIN 1 GM INJ $43.80

23629 DICLOXACILLIN 250MG $2.0023630 ARIPIPREZOLE 10MG TA $96.3023631 ARIPIPRAZOLE 15MG TA $96.2023632 TRIMETHOBE 100MG SUP $2.4023633 ALUM/MAGNES 30ML SUS $9.8023634 BRIMONIDINE .15%OPTH $614.0023635 N/S FOR IRRIG 4LITER $33.4023636 ST H2O IRRIG 1LITER $9.1023637 ESCITALOPRAM 10MG TA $13.1023638 OXCARBAZEPINE 150MG $4.5023639 10%DEXTRAN 40 D5W500 $95.5023640 INDOCYANINE GR INJ25 $410.1023641 FAMCICLOVIR 500MG TA $38.1023642 PENCICLOVIR 1% CREAM $2,923.2023643 KCL IVPB 10 MEQ/100M $10.4023644 ERTAPENEM 1GM INJ $421.4023645 PROPOFOL INJ 100 ML $1.1323646 HYDROMORPHONE INJ 2M $0.5223648 THIAMIN INJ200MG/2ML $9.3023649 METOPROLOL ER 25MGTA $3.7023650 KETOROLAC INJ 15MG/M $7.4023651 FLUTAC/SALME 250-50I $1,418.2023652 SALMET DISKUS 50 MCG $1,395.1023653 SIMVASTATIN 40 MGTAB $14.8023654 ERYTHROMY BASE 500MG $63.0023655 0.45% NS +20MEQ KCL $22.3023656 PIPER BUTOX PYRET KT $24.8023657 DIPHENHYDRAMI 2% CRM $12.0023658 CLINDAMYCIN IN 300MG $11.4523659 SUCRALFATE 1GM/10ML $36.5023660 .9NACL LCK FLUSH 3ML $2.6523661 .9%NACL LCK FLSH 10M $0.8023662 SENNA 8.6 MG TAB $0.8023663 BUPRENORPHIN/NAL 2MG $15.4023664 BUPRENORP/NAL 8MG/2M $27.6523665 LIDOC/EPI/TETRAC LIQ $36.4523666 LANSOPRAZO 30MG ORAL $21.8523668 PAMIDRONATE INJ 30MG $67.7023669 LEVOTHYROX 112MCG TA $4.4023670 LEVOTHYROX 88MCG TAB $4.4023671 EZETIMIBE 10MG TAB $41.4023672 DIVALPROEX EXT 250MG $12.1023673 DIVALPROEX EXT 500MG $21.2023674 OXYBUTYNIN EXT 5MG T $22.9023675 NITROFURANT MAC 100M $15.3023676 RIVASTIGMINE 1.5MG C $12.7023677 RIVASTIGMINE 3MG CAP $14.00

23678 DESMOPR ACE INJ 4MCG $53.5823679 RESPERID LA INJ 25MG $3,490.2023680 RESPERID LA INJ 37.5 $5,235.5023681 RESPERID LA INJ 50MG $6,980.8023682 DEHYD ALC INJ 98%1ML $34.6023683 FONDAPARINUX INJ 2.5 $32.8023684 TOLTERODIN ER 2MG CA $44.2023685 NEVIRAPINE 200MG TAB $54.4023686 EFAVIRENZ 200MG CAP $39.2023687 CLOTRIMAZOLE 10MG TR $4.3023688 PAROXETINE CONTR REL $16.7023689 OLANZAPINE ZYDIS 5MG $53.9023690 OLANZAPINE ZYDIS 10M $79.4023691 BENAZEPRIL 10MG TAB $2.9023692 CANDESART CILEX 16MG $9.9023693 BUPIVICA EPINEPH.25% $30.2023694 GLIMEPIRIDE 4MG TAB $4.6523695 POVIDONE IOD SOL 60M $4.2023696 HYDROGEN PEROX 120ML $2.4023697 CEFEPIME INJ 1GM $20.5023698 MG SULF INJ 1GM/100 $13.3023699 IMIPENEM CILASTAT IV $92.3023700 CAPSAICIN.025% CREAM $29.8023701 DESENEX 2% POWD 45GM $12.5023702 MEXILETINE 150MG CAP $7.6023703 MEXILETINE 200MG CAP $9.1023704 RISPERID ORAL DIS TA $17.2023705 TOBRAMYCIN INJ 1.2GM $630.0023706 CONTACT LENS SOLUTIO $13.7523707 PHENYTOIN EXT REL 30 $4.0023708 PHENYTOIN 50MG CHEW $4.4023710 NON FORMULARY MEDICA $23.0023711 NON FORMULARY MED $34.4523712 NON FORMULARY MED $46.0023713 NON FORMULARY MED $57.4523714 NON FORMULARY MED $0.8023715 NON FORMULARY MED $229.7023716 NON FORMULARY MED $275.6523717 NON FORMULARY MED $321.6523718 NON FORMULARY MED $367.5023719 NON FORMULARY MED $413.5023720 NON FORMULARY MED $91.8523721 NON FORMULARY MED $114.8023722 NON FORMULARY MED $160.8023723 NON FORMULARY MED $459.5023724 BACITRACIN OPTH OINT $170.9023725 NON FORMUL BULK MED $33.40

23726 CARBAMIDE PEROX OTIC $15.3023727 FLUOCINONIDE CREAM $50.8023728 FLUCOCINONIDE OINT $50.8023729 NON FORMULARY MED $574.3023730 NON FORMULARY MED $574.3023731 NON FORMULARY MED $918.9023732 NON FORMULARY MED $1,148.6523733 INSULIN LISPRO INJ $1.0523734 AMANTADINE HCL $2.3023736 MANNITOL INJ $16.0023737 PHENLEPHRINE OPTHAL $144.0023738 SENNA/DOCUSATE SODIU $0.8023739 SILVER SULFADIAZINE $194.9023740 ROSUVASTATIN 5MG TAB $26.8023741 VALPRO SOD INJ 100MG $4.8023742 FORMOTEROL 20 MCG/2M $58.3023743 TETRACAINE INJ 1% $273.4023744 AMPHET SALT CMP 10MG $6.2023745 AMPHET EXT REL SALT $18.4023920 REMOVAL FULL ARM OR $220.1524001 A AND D OINTMENT 2 O $10.2024002 A AND D OINTMENT 5 G $0.8024003 ACETAMINOPHEN DROPS $0.8024004 ACETAMINOPHEN ELIXIR $5.8024005 ACETAMINOPHEN SUPPR $1.7024006 ACETAMINOPHEN SUPPR $2.4024007 ACETAMINOPHEN SUPPR $1.8024008 ACETAMINOPHEN TABS 3 $0.8024009 ACETAZOLAMIDE INJ 50 $144.0024010 ACETAZOLAMIDE SR CAP $12.9024011 ACETAZOLAMIDE TABS 2 $8.6024012 ACETONE PADS $0.8024013 ACETYLCHOLINE IO SOL $712.1024014 ACETYLCYSTEINE 20% 1 $43.7024015 ACETYLCYSTEINE 20% 3 $36.8024018 ACTIFED TABS $1.8024019 ACYCLOVIR CAPS 200 M $4.6024020 ACYCLOVIR INJ 500 MG $67.7024021 ACYCLOVIR OINTMENT 5 $5,266.8024022 ADENOSIN INJ 6 MG/2M $21.6224023 AGORAL, PLAIN $2.4024024 ALBUTEROL INH SOLN 2 $2.4024025 ALBUTEROL INH SOLN 2 $8.7024026 ALBUTEROL INHALER 6. $124.7524027 ALBUTEROL SULFATE TA $1.9024028 ALCOHOL, RUBBING $10.6524029 ALFENTANIL INJ 500MC $55.80

24030 ALLOPURINAL TABS 100 $0.8024031 ALLOPURINOL TABS 300 $2.3024032 ALPRAZOLAM TABS 0.25 $2.1024033 ALPRAZOLAM TABS 0.5 $18.8024034 ALTEPLASE INJ 100 MG $316.8124035 ALUMINUM HYDROX GEL $1.0524036 AMANTADINE HCL CAPS $10.4024038 AMIKACIN SULFATE INJ $293.2024039 AMINOCAPROIC ACID TA $10.8024040 AMINOCAPROIC ACID IN $1.2024041 AMINOPHYLLINE INJ 50 $12.6024043 AMIODARONE TABS 200 $1.8024044 AMITRITYLINE HCL TAB $0.8024046 AMITRIPTYLINE HCL TA $1.9024047 AMITRIPTYLINE HCL TA $1.7024049 AMMONIA, AROMATIC, I $1.2024051 AMOXAPINE TABS 50 MG $3.5024052 AMOXICILLIN CAPS 250 $0.8024053 AMOXICILLIN OS 125MG $24.7024054 AMOXICILLIN OS 250MG $2.2024055 AMOXICILLIN OS 250MG $0.8024056 AMPICILLIN CAPS 250 $0.8024057 AMPICILLIN CAPS 500 $1.0524061 AMPICILLIN IVPB 1 GM $10.6024062 AMPICILLIN IVPB 2 GM $11.9324068 ARTIFICIAL TEARS 15 $17.5024069 ASCORBIC ACID INJ 50 $18.1524070 ASCORBIC ACID TABS 5 $0.8024071 ASCRIPTIN TABS $0.8024072 ASPIRIN SUPPR 125 MG $1.0524073 ASPIRIN SUPPR 300 MG $4.4024074 ASPIRIN SUPPR 600 MG $4.5024075 ASPIRIN TABS 325 MG $1.5024076 ASPIRIN TABS 81 MG $0.8024077 ASPIRIN, ENTERIC COA $0.8024078 ATENOLOL TABS 50 MG $2.7024079 ATRACURIUM IV 700MG/ $363.5524080 ATRACURIUM BS INJ 10 $45.4024081 ATROPINE SULF OPTH S $4.0024082 ATROPINE SULF SYR .5 $7.2024083 ATROPINE SULF SYR 1 $32.4024084 ATROPINE SULFATE INJ $0.6624085 ATROPINE SULFATE INJ $8.2524086 ATROPINE SULFATE TAB $1.5024087 AURALGAN OTIC SOLN. $51.6024088 AVEENO OATMEAL BATH $25.1024089 AZTREONAM IVPB 1 GM $104.40

24090 BACITRACIN INJ 50,00 $39.9024091 BACITRACIN OINTMENT $15.9024092 BACITRACIN OINTMENT $0.8024093 BACLOFEN TABS 10 MG $1.5024094 BALANCED SALT SOLN 1 $28.3024097 BELLADONNA AND OPIUM $100.4024098 BEN GAY OINTMENT 3 O $28.8024099 BENZALKONIUM CHL SOL $88.3524100 BENZOCAINE GEL 10% 1 $15.1024101 BENZOIN TINCTURE #10 $37.8024102 BENZOIN TINCTURE COM $16.6024103 BENZTROPINE MESYLATE $1.2024104 BENZTROPINE MESYLATE $1.5024105 BENZOYL PEROXIDE GEL $20.7024106 BENZOYL PEROXIDE GEL $65.0524107 BENZTROPINE MESY INJ $251.9024108 BENZTROPINE MESYLATE $3.6024109 BETAMETHASONE VAL CR $83.9024110 BETAMETHASONE VAL CR $22.9024111 BETAXOLOL HCL OPTH S $184.3024112 BETAXOLOL OPHTH SUSP $130.1524114 BETHANECHOL CHLORIDE $6.8524115 BETHANECHOL CHLORIDE $20.1024116 BICITRA LIQUID 30 ML $10.7024117 BISACODYL SUPPR 10 M $0.8024118 BISACODYL TAB 5 MG $0.8024119 BLISTEX OINTMENT 0. $3.7024120 BRETYLIUM TOSY INJ 5 $2.3024121 BROMOCRIPTINE MESY C $24.7024122 BROMOCRIPTINE MESY T $12.4024123 BUPIVICAINE INJ .25% $57.4524124 BUPIVICAINE INJ .5% $7.7024125 BUPIVICAINE INJ .75% $36.5024126 BUPROPION HCL TABS 7 $2.2024127 BUPROPION HCL TABS 1 $5.9024128 BUSPIRONE TABS 10 MG $4.0024129 BUTORPHANOL TARTR IN $57.4524130 CAFERGOT SUPPOSITORI $36.6524131 CAFERGOT TABS $7.3524133 CALADRYL LOTION $14.2024135 CALCIUM CARBONATE TA $0.9024136 CALCIUM CHLORIDE INJ $69.6024137 CALCIUM GLUCONATE IN $32.9024138 CALCIUM GLUCONATE TA $1.0024139 CANDIDA 1:500 0.1ML $3.0024140 CAPTOPRIL TABS 12. 5 $4.7024141 CAPTOPRIL TABS 25MG $5.60

24142 CARBACHOL I O SOLN 0 $121.2024143 CARBAMAZEPINE TABS 2 $4.8024146 CASCARA SAGRADA FLUI $1.0524147 CEFAZOLIN INJ 1 GM $11.2524149 CEFAZOLIN INJ 500 MG $7.2024152 CEFONICID INJ 1 GM $179.8524153 CEFONICID IVPB 1 GM $186.8524154 CEFOXITIN IVPB 1 GM $33.7024155 CEFTAZIDIME IVPB 1 G $9.3524156 CEFTRIAXONE SODIUM I $44.5024157 CEFTRIAXONE SODIUM I $2.1524158 CEFTRIAXONE SODIUM I $1.9824159 CEFUROXIME TAB 250MG $13.2024160 CEFUROXIME TABS 500 $24.0024161 CEPACOL LOZENGES $0.9524162 CEPHALEXIN CAPS 250 $2.1024163 CEPHALEXIN CAPS 500 $4.1024164 CEPHALEXIN OS 250MG/ $86.3024165 CERUMENEX OTIC DROPS $73.8024166 CETACAINE SPRAY $217.2024167 CETAPRED OPHTH SOLN $523.8024168 CHARCOAL CAP 260MG $1.5024169 CHARCOAL ACTIVATED/S $50.1024170 CHLORAL HYDRATE CAPS $1.8024171 CHLORAL HYDRATE LIQ $3.4524173 CHLORAMPHENICOL OPHT $67.4524174 CHLORAMPHENICOL SOLN $22.8024175 CHLORASEPTIC LOZENGE $0.8024176 CHLORASEPTIC SPRAY $5.8024177 CHLORDIAZEPOXIDE HCL $1.8024178 CHLORDIAZEPOXIDE HCL $2.0024179 CHLORDIAZEPOXIDE HCL $2.4024181 CHLORPHENIRAMINE MAL $1.8024184 CHLORPROMAZINE HCL I $1.8924185 CHLORPROMAZINE HCL T $66.7024186 CHLORPROMAZINE HCL T $22.9024187 CHLORPROMAZINE HCL T $41.5024189 CHLORPROPAMIDE TABS $2.4024190 CHLORPROPAMIDE TABS $4.7524194 CHLORZOXAZONE TABS 5 $3.4524195 CHOLESTYRAMINE POWDE $13.6524196 CIMETIDINE INJ 300 M $5.7024197 CIMETIDINE INJ 300 M $38.5024205 CITRATE OF MAGNESIA $5.8024206 CLINDAMYCIN HCL CAPS $2.2024207 CLINDAMYCIN PHOS INJ $29.1524208 CLOMIPRAMINE HCL CAP $33.70

24209 CLOMIPRAMINE HCL CAP $33.7024210 CLONAZEPAM TABS 0.5 $2.2024211 CLONAZEPAM TABS 1 MG $2.7024212 CLONIDINE HCL TABS 0 $0.8024213 CLONIDINE HCL TABS 0 $0.8024214 CLOTRIMIAZOLE CREAM $173.5524215 CLOTRIMAZOLE SOLN 1% $136.9024216 CLOTRIMAZOLE VAGINAL $4.6024217 CLOZAPINE TABS 100 M $10.3024218 CLOZAPINE TABS 25 MG $4.0024219 COCAINE SOLUTION 10% $47.2524221 CODEINE SULFATE TABS $2.8024222 COLBENEMID TABS $2.4524223 COLCHICINE TABS 0. 6 $25.1024224 COLLAGENASE OINTMENT $853.2024225 COLLODION $36.5024226 COLLYRIUM EYE LOTION $9.7024227 COLYMYCIN- OTIC SUSP $417.0024230 CORTISPORIN OTIC SUS $107.6024231 COSYNTROPIN INJ .25 $383.7024232 CROMOLYN SOD NEB SOL $20.4024233 CYANIDE ANTIDOTE KIT $1,379.0024234 CYANOCOBALAMIN INJ 1 $26.2024235 CYCLANDELATE CAPS 40 $1.5024236 CYCLOMYDRIL OPHTH SO $100.2024237 CYCLOPENTOLATE OPTH $95.8024240 CYPROHEPTADINE HCL T $1.5024241 DACRIOSE OPHTHALMIC $1.5524242 DANTROLENE SODIUM IN $319.1024243 DARVOCET N-100 TABS $2.0024245 CIPRO FLOX 500MG TAB $9.5024246 DESIPRAMINE HCL TABS $4.5024247 DESIPRAMINE HCL TABS $5.5024248 DESIPRAMINE HCL TABS $2.6524249 DESITIN OINTMENT $11.9024250 DEXAMETHASONE INJ 10 $0.4724253 DEXAMETHASONE OPHTH $21.6524254 DEXAMETHASONE OPTH S $34.4524255 DEXAMETHASONE TABS 0 $0.8024256 DEXAMETHASONE TABS 0 $0.8024257 DEXAMETHASONE TABS 4 $3.6024258 DEXTRANOMER BEADS 60 $342.1024260 DEXTROSE SYRINGE 50% $28.8024261 DIAZEPAM INJ 10 MG/2 $49.2024262 DIAZEPAM TABS 10 MG $2.5524263 DIAZEPAM TABS 2 MG $0.8024264 DIAZEPAM TABS 5 MG $0.80

24265 DIBUCAINE OINTMENT 3 $19.0024266 DICLOFENAC TABS 50 M $2.8024267 DICLOFENAC TABS 75 M $2.0024268 DICYCLOMINE HCL CAPS $1.8024269 DICYCLOMINE INJ 10 M $151.3024270 DIETHYLSTILBESTROL T $1.5024271 DIGOXIN CAPS 0.05 MG $1.5024272 DIGOXIN CAPS 0.1 MG $2.4024273 DIGOXIN ELIXIR, PED. $42.0024274 DIGOXIN INJ 0.5 MG/2 $19.8024275 DIGOXIN TABS 0. 125 $6.9024276 DIGOXIN TABS 0.25 MG $5.0024277 DILTIAZEM CONT DIFF $1.2024278 DILTIAZEM CONT DIFF $6.2024279 DILTIAZEM HCL INJ 25 $1.5024280 DILTIAZEM HCL TABS 3 $3.0024281 DILTIAZEM HCL TABS 6 $4.7024282 DILTIAZEM HCL SR CAP $3.8524284 DIMETAPP ELIXIR $1.5024285 DIMETAPP EXTENTABS $1.0524286 DIPHENHYDRAMINE HCL $0.8024287 DIPHENHYDRAMINE HCL $0.8024288 DIPHENHYDRAMINE HCL $0.8024289 DIPHENHYDRAMINE HCL $3.8024290 DIPIVEFRIN HCL OP SO $10.2024291 DIPTH TET PERTUSS VA $115.9524292 DIPYRIDAMOLE TABS 25 $3.2024293 DIPYRIDAMOLE TABS 50 $2.2024295 DISOPYRAMIDE PHOS CA $2.9524296 DISOPYRAMIDE PHOS CA $10.1024297 DISOPYRAMIDE PHOS CR $3.5524298 DISOPYRAMIDE PHOS CR $17.0024299 DISULFIRAM TABS 250 $29.7024300 ULTRACET 37.5/325MG $9.9024301 VALSARTAN 80 MG TAB $14.5024302 DOCUSATE SODIUM CAPS $0.8024303 DOCUSATE SODIUM SYRU $0.2024304 DOME-PASTE BANDAGE $36.1024305 DOMEBORO POWDER PACK $2.4024306 DONNAGEL LIQUID $3.1024308 DONNATAL ELXIR 5 ML $8.9024309 DONNATAL TABS $7.6024310 DOPAMINE HCL IV 400 $4.6624311 DOPAMINE HCL INJ 200 $9.6024312 DOXEPIN HCL CAPS 25 $2.5024313 DOXEPIN HCL CAPS 50 $3.1024317 DOXYCYCLINE HYCLATE $16.60

24318 DOXYCYCLINE INJ 100 $94.8024319 DROPERIDOL INJ 2.5 M $8.7024320 DYAZIDE CAPS $1.4024321 DYCLONINE HCL SOLN 0 $224.6024322 EDROPHONIUM CHL INJ $19.2024324 ENALAPRIL TABS 5 MG $4.6024326 EPHEDRINE SULFATE IN $177.3024327 EPINEPHRINE INJ 1:10 $0.3324328 EPINEPHRINE TOP.SOL $751.7024329 EPINEPHRINE OPHTH SO $198.2524330 EPINEPHRINE RACE INH $59.5024331 EPINEPHRINE SUSP 1:2 $38.2024332 EPINEPHRINE SYR 1:10 $1.6424333 ERGOCALCIFEROL CAPS $3.6024335 ERGOTAMINE TARTRATE $5.1524336 ERYTHROMYCIN E. S. O $3.8524337 ERYTHROMYCIN ES OS 2 $67.7024339 ERYTHROMYCIN IVPB 50 $274.1024340 ERYTHROMYCIN OPHTH O $57.0024341 ERYTHROMYCIN TABS 25 $39.4024342 ESMOLOL INJECTION 10 $26.3024344 ESTROGENS, CONJ TABS $20.2024345 ESTROGENS, CONJ TABS $5.8024347 ETHAMBUTOL HCL TABS $2.6524351 EUCERIN 4 OZ $19.5024354 FERROUS GLUCONATE TA $0.8024355 FERROUS SULF ELIX 22 $9.4024356 FERROUS SULFATE TABS $0.8024357 FIORINAL TABS $1.5024358 FLECAINIDE TAB 100MG $9.3024359 FLUCONAZOLE TABS 100 $135.6024360 FLUMAZENIL INJ 1MG/1 $552.6024365 FLUORESCEIN SODIUM O $0.8024366 FLUORI METHANE SPRAY $81.3024367 FLUORIDE TABS 1 MG $1.8024368 FLUOROMETHOLONE OP S $71.9024369 FLUOROURACIL INJ 500 $9.0024370 FLUOXETINE CAPS 20 M $7.4024371 FLUOXYMESTERONE TABS $12.9024372 FLUPHENAZINE DEC INJ $111.6024373 FLUPHENAZINE HCL ELI $2.8024374 FLUPHENAZINE HCL INJ $65.9024375 FLUPHENAZINE HCL TAB $1.7024376 FLUPHENAZINE HCL TAB $2.7024377 FLUPHENAZINE HCL TAB $2.1024378 FLUPHENAZINE HCL TAB $4.0024379 FLURAZEPAM HCL CAPS $1.80

24381 FLURBIPROFEN OPHTH S $129.6024382 FOLIC ACID INJ 5 MG/ $16.2024383 FOLIC ACID TABS 1 MG $0.8024384 FUROSEMIDE INJ 100 M $4.1424385 FUROSEMIDE INJ 20 MG $14.8024386 FUROSEMIDE INJ 40 MG $5.2024387 FUROSEMIDE TABS 20 M $1.5024388 FUROSEMIDE TABS 40 M $1.7024389 GAVISCON TABS $0.8024390 GELATIN SPONGE ABSOR $149.9024391 GELATIN SPONGE, AB S $40.5524392 GELATIN SPONGE, ABSO $100.3024394 GENTAMICIN INJ 80 MG $4.0024395 GENTAMICIN IVPB 80 M $12.3024396 GENTAMICIN OINTMENT $148.1024397 GENTAMICIN OPHTH OIN $106.3024398 GENTAMICIN OPHTH SOL $57.5024400 GLUCAGON INJ 1 MG $1,010.9024401 GLUCOSE 4GM CHEWABLE $0.8024402 GLUCOSTIX $0.0024403 GLYBURIDE TABS 2.5 M $1.4024404 GLYBURIDE TABS 5 MG $1.6024405 GLYCERIN $5.0024406 GLYCERIN SUPPOSITORI $0.8024407 GLYCERIN SUPPOSITORI $0.8024408 GLYCOPYRROLATE INJ 0 $48.8024409 GLYOXIDE LIQUID $6.9024411 GUAIFENESIN AC SYRUP $1.9024412 GUAIFENESIN DM SYRUP $2.0024413 GUAIFENESIN SYRUP $1.6024414 GUANABENZ ACETATE TA $3.2024415 HALOPERIDOL CONC 2 M $1.5024416 HALOPERIDOL CONC 2 M $0.4624417 HALOPERIDOL DEC INJ $313.4024418 HALOPERIDOL INJ 5 MG $21.5024419 HALOPERIDOL TABS 0.5 $0.8024420 HALOPERIDOL TABS 1 M $1.4024421 HALOPERIDOL TABS 10 $5.4024422 HALOPERIDOL TABS 2 M $1.9024424 HALOPERIDOL TABS 5 M $3.1024425 HEMA-COMBISTIX $2.1524426 HEMORRHOIDAL CREAM W $7.6524427 HEMORRHOIDAL OINTMEN $8.7024428 HYDROCORTISONE SUPPO $2.4024429 HEMMORRHOIDAL SUPPR $64.5024430 HEPARIN INJ 1,000 UN $4.9024431 HEPARIN INJ 10,000 U $1.44

24434 HEPARIN LOCK FLUSH S $3.0024435 HEPATITIS B IMMUNE G $2,880.8024436 KETOROLAC TABLETS 1 $8.9024437 HETASTARCH INJ. 6% 5 $54.0024438 HEXACHLOROPHENE CLNS $186.5024439 HOMATROPINE OPHTH SO $63.9524440 HYALURONATE INJ 10MG $457.4024442 HYDRALAZINE HCL INJ $33.8024443 HYDRALAZINE HCL TABS $1.2024444 HYDRALAZINE HCL TABS $1.5024445 HYDROCHLOROTHIAZIDE $1.5024446 HYDROCORTISONE CREAM $10.3024447 HYDROCORTISONE CREAM $15.2024448 HYDROCORTISONE ENEMA $38.3024449 HYDROCORTISONE OINTM $15.2024450 HYDROCORTISONE S S I $71.6024451 LACTOBACILLIS $0.8024453 HYDROCORTISONE TABS $3.2024455 HYDROMORPHONE TABS 2 $1.4024456 HYDROXYZINE HCL INJ $40.0524457 HYDROXYZINE HCL SYRU $1.3024458 HYDROXYZINE HCL TABS $2.0024459 HYDROXYZINE HCL TABS $1.2024460 HYDROXYZINE HCL TABS $1.4024461 IBUPROFEN TABS 200 M $0.8024462 IBUPROFEN TABS 400MG $0.8024463 IBUPROFEN TABS 600MG $0.8024464 IMIPRAMINE HCL TABS $0.8024465 IMIPRAMINE HCL TABS $1.3024466 IMIPRAMINE HCL TABS $3.2524467 IMIPRAMINE HCL INJ 1 $16.7524468 INDOMETHACIN CAPS 25 $1.2024473 INSULIN, HUMAN, NPH $0.8024474 INSULIN, HUMAN, REGU $0.8024483 IOPANOIC ACID TABS 5 $4.6024485 IPRATHOPIUM BROMIDE $191.2524486 IRON DEXTRAN INJ 50M $50.0524487 ISOETHARINE HCL INH $0.0024488 ISOETHARINE MESY INH $169.5524489 ISOFLURANE 100ML $91.2024490 ISONIAZID TABS 100MG $0.8024491 ISONIAZID TABS 300MG $3.8024492 ISOPROTERNOL INHALER $170.9524493 ISOPROTERNOL INJ 1:5 $6,444.4024494 ISOPROTERNOL MISTOME $164.6524495 ISOSORBIDE DIN SL TA $0.8024496 ISOSORBIDE DIN SR TA $7.10

24497 ISOSORBIDE DIN TABS $1.0524498 ISOSORBIDE DIN TABS $3.6024526 IV D5W 250CC W/25,00 $50.6024539 KAOLIN-PECTIN SUSP 3 $1.2024540 KERI-LOTION 13 OZ $42.2024541 KETAMINE HCL INJ 50M $12.8024542 KETO-DIASTIX $0.9524543 KETOCONAZOLE TABS 20 $23.3024544 KETOROLAC TROMETH IN $9.0024547 LABETALOL HCL INJ 5M $12.2024548 LABETALOL HCL TABS 2 $2.4024549 LACRI-LUBE OPHTH OIN $35.1024550 LACTINEX TABS $1.5024551 LACTULOSE SYRUP $2.8024552 LAMB'S WOOL $15.9524553 LARYNG-O-JET KIT $73.2524555 LEUCOVORIN CALCIUM T $14.5024556 LEVOBUNOLOL HCL OP S $72.5024557 LEVODOPA CAPS 250MG $3.7024558 LEVOTHYROXINE SOD IN $176.8524559 LEVOTHYROXINE SOD TA $1.6024560 LEVOTHYROXINE SOD TA $1.8024561 LIDOCAINE INJ 0.5% 5 $0.8024562 LIDOCAINE INJ 0.5% 5 $27.3524563 LIDOCAINE INJ 1% 30M $4.1024564 LIDOCAINE INJ 1% 30M $7.9024565 LIDOCAINE INJ 1% W/E $8.9024566 LIDOCAINE INJ 1.5% 2 $32.7024567 LIDOCAINE INJ 2 GM $29.1524568 LIDOCAINE INJ 2 GM/2 $17.5024569 LIDOCAINE INJ 2% 30M $0.8024570 LIDOCAINE INJ 2% W/E $0.8024571 LIDOCAINE INJ 4% LAR $15.6024572 LIDOCAINE JELLY 2% 3 $25.2024573 LIDOCAINE JELLY UROJ $23.1024574 LIDOCAINE SYRINGE 2% $14.4024575 LIDOCAINE VISCOUS 2% $39.6024576 LINDANE LOTION 1% 2O $375.2024577 LINDANE SHAMPOO 1% 2 $410.6024578 LIOTHYRONINE TABS 25 $2.0024579 LIOTHYRONINE TABS 5 $1.5024580 LITHIUM CARBONATE SR $2.3024581 LITHIUM CARBONATE TA $0.8024582 LITHIUM CIT SYRUP 30 $5.4024583 LOMOTIL LIQUID $21.0024584 LOMOTIL TABS $10.2024586 LORAZEPAM TABS 0.5MG $0.80

24587 LORAZEPAM TABS 1MG $2.6024588 LOVASTATIN TABS 20 M $7.1024589 LOXAPINE SUCCINATE C $5.5024590 LOXAPINE SUCCINATE C $4.8524591 LOXAPINE SUCCINATE C $14.4524592 LOXAPINE SUCCINATE C $3.0524593 LOXAPINE SUCCINATE C $11.4524594 M.V.I.-12 $49.7024595 MAALOX PLUS ORAL SUS $2.9524596 MAGNESIUM CHLORIDE S $0.8024597 MAGNESIUM SULF INJ 5 $5.7024598 MAGNESIUM SULFATE(EP $11.2524600 MAXITROL OPHTH SUSP $406.9024601 MEASLES MUMPS RUBELL $268.8024602 MEAT TENDERIZER $0.0024603 MECLIZINE HCL TABS 1 $2.1024604 MEDROXPROGESTERONE T $7.7524605 MEGESTROL ACETATE TA $4.1024607 MEPERIDINE INJ 25MG $20.7024610 MEPERIDINE TABS 50MG $5.1524613 METAPROTERENOL INHAL $148.8524614 METAPROTERENOL SYRUP $0.8024616 METHADONE TABS 5MG $0.8024618 METHOCARBAMOL TABS 5 $1.5024619 METHOCARBAMOL TABS 7 $2.0024620 METHOHEXITAL SODIUM $5.1024621 METHOTREXATE INJ. 50 $25.8024622 METHOXAMINE INJ 20MG $168.3524623 METHYLDOPA TABS 250M $0.8024624 METHYLDOPATE INJ 250 $144.0024625 METHYLENE BLUE 1% 10 $604.1024626 METHYLERGONOVINE INJ $92.6024628 METHYLPREDNISOLONE A $38.0024629 METHYLPREDNISOLONE A $66.0024630 METHYLPREDNISOLONE S $21.6024631 METHYLPREDNISOLONE S $83.9024632 METHYLPREDNISOLONE S $20.8024633 METOCLOPRAMIDE HCL T $0.8024635 METOCLOPRAMIDE HCL I $12.1024636 METOLAZONE TABS 10MG $4.6524637 METOLAZONE TABS 2.5M $9.8024638 METOLAZONE TABS 5MG $11.2024639 METOPROLOL TART INJ $9.7024640 METOPROLOL TARTRATE $0.8024641 METRONIDAZOLE IVPB 5 $6.5024642 METRONIDAZOLE TABS 2 $1.7024643 MEXILETINE HCL CAPS $7.35

24644 MEXILETINE HCL CAPS $8.7024645 MEZLOCILLIN IVPB 3 G $102.1024646 MEZLOCILLIN IVPB 4 G $129.9024647 MICONAZOLE NIT VAG C $34.4024648 MICROFIBRILLAR COL H $276.5524649 MICROFIBRILLAR COLL $150.7024650 MICROFIBRILLAR COLL $348.3024653 MILK OF MAG/CASCARA $2.3024654 MILK OF MAGNESIA, CO $1.4024655 MINERAL OIL 16 OZ $3.1024656 MINERAL OIL, STER LI $6.5024657 MISOPROSTOL TABS 200 $4.3024658 MITOMYCIN INJ. 5 MG $530.8824659 MIVACURIUM CHL INJ 2 $48.9524662 MORPHINE SULFATE SR $5.0024663 MULTIPLE ELECTROLYTE $4.7024664 MULTIPLE TRACE ELEME $23.9024665 MUMPS SKIN TEST ANTI $36.3524666 MUPIROCIN OINTMENT 2 $150.6024667 MYCOLOG II CREAM 15G $335.8024668 MYCOLOG II OINTMENT $335.8024669 NADOLOL TABS 40 MG $21.7024670 NALOXONE INJ 0. 4MG/ $71.2024672 NALTREXONE HCL TABS $8.2024673 NAPROXEN TABS 250MG $2.4024674 NEODECADRON OPHTH OI $45.2524675 NEOMYCIN SULFATE TAB $5.9024676 NEOSPORIN CREAM 15 G $17.3024677 NEOSPORIN OINTMENT 1 $12.9024678 NEOSPORIN OINTMENT 1 $0.8024679 NEOSPORIN OPHTH OINT $145.4024680 NEOSPORIN OPHTH SOLN $183.8024682 NEUTRAPHOS POCKETS 1 $2.0024683 NIACINAMIDE TABS 50M $1.5024684 NICOTINE POLACRILEX $0.8024685 NICOTINE TRANSDERMAL $6.4024686 NICOTINE TRANSDERMAL $8.6024687 NICOTINE TRANSDERMAL $8.6024688 NIFEDIPINE CAPS 10MG $3.8024689 NIFEDIPINE CAPS 20MG $5.0024690 NIFEDIPINE SR TABS 3 $5.3024691 NITROFURANTOIN CAPS $4.1024692 NITROFURAZONE SOL DR $101.2524693 NITROGLYC TRNSDERML $6.5024694 NITROGLYC TRNSDERML $5.6024695 NITROGLYC TRNSDERML $5.7024696 NITROGLYCERIN CR CAP $1.80

24697 NITROGLYCERIN CR CAP $3.0024699 NITROGLYCERIN INJ 5M $48.8024700 NITROGLYCERIN OINTME $45.5524701 NITROGLYCERIN SL TAB $0.9524702 NITROGLYCERIN SL TAB $4.5024704 NITROPRUSSIDE SOD IN $1,080.0024705 NOREPINEPHRINE BIT I $72.8024706 NORFLOXACIN TAB 400M $18.3524707 NORMAL SERUM ALBUMIN $208.3024708 NORTRIPYLINE HCL CAP $0.8024709 NORTRIPTYLINE HCL CA $4.4024710 NORTRIPTYLINE HCL CA $17.3024711 NUGAUZE, IODOFORM, 1 $12.6024712 NUGAUZE, IODOFORM, 1 $11.0024713 NUGAUZE, IODOFORM, 1 $10.8024714 NUGAUZE, PLAIN, 1" $10.8024715 NUGAUZE, PLAIN 1/2" $10.8024717 NYSTATIN CREAM 15 GM $52.5024718 NYSTATIN OINTMENT 15 $50.4024719 NYSTATIN SUSP 100,00 $5.0024720 NYSTATIN TOPICAL POW $82.4024722 OMEPRAZOLE CAP 20 MG $27.6024723 OXACILLIN SODIUM CAP $5.2524725 OXACILLIN SODIUM INJ $10.6024729 OXAZEPAM CAPS 10 MG $1.3024730 OXAZEPAM CAPS 15 MG $3.6024731 OXYBUTYNIN CHLORIDE $1.8024733 OXYMETAZOLINE NASAL $15.8024734 OXYTOCIN INJ 10U/ML $5.3024735 PANCRELIPASE CAPS $9.2024736 PANCURONIUM BRO INJ $17.0024739 PEDIAZOLE SUSP 100ML $107.8024740 PEG W/ELECTROLYTES $206.9024741 PEN G BENZ LA INJ 1, $47.2124743 PEN V POT O S 250MG/ $29.9024745 PENICILLIN G POT INJ $126.5024747 PENICILLIN G PROC IN $119.5024748 PENICILLIN V POT TAB $3.5024752 PENTOXIFYLLINE TABS $4.4024754 PERICOLACE CAPS $1.8024755 PERICOLACE SYRUP $2.9524756 PEROXIDE $2.1024757 PERPHENAZINE TABS 16 $11.7024758 PERPHENAZINE TABS 2 $5.9024759 PERPHENAZINE TABS 4 $8.0024761 PHENAZOPYRIDINE TABS $8.1024762 PHENELZINE TABS 15 M $8.70

24763 PHENOBARBITAL ELIXIR $3.2024764 PHENOBARBITAL INJ 65 $78.5024765 PHENOBARBITAL TABS 1 $1.0524767 PHENTOLAMINE MESY IN $1,604.9024768 PHENYLEPHRINE HCL IN $21.6024769 PHENYLEPHRINE NASAL $11.4024770 PHENYLEPHRINE NASAL $12.7024773 PHENYLEPHRINE OPTH S $15.9524774 PHENYTOIN SODIUM CAP $5.1024776 PHENYTOIN SODIUM INJ $1.3024777 PHENYTOIN SODIUM O S $12.3024778 PHOSPHO-SODA 3 OZ $8.4524779 PHOSPHOLINE IOD OPTH $233.9524780 PHOSPHOLINE IOD OPTH $263.6024781 PHYSOSTIGMINE S INJ $140.9024782 PHYTONADIONE INJ 10M $17.3624783 PHYTONADIONE TABS 5M $211.5024784 PILOCARPINE OPHTH SO $23.4024785 PHYSOSTIGMINE S OPSO $24.4024786 PILOCARPINE OPHTH SO $18.8524787 PILOCARPINE OPHTH SO $19.2524788 PLACEBO TABS $1.5024789 PNEUMOCOCCAL VACCINE $360.7024790 POLIO ORAL VACCINE 0 $52.2024791 POLYMXIN B SULF INJ $40.5024792 POTASSIUM BICARB TAB $6.8524793 POTASSIUM C LIQ 10% $55.8024794 POTASSIUM CHL INJ 40 $0.8024795 POTASSIUM CHL POWDER $32.2024796 POTASSIUM CHL SR TAB $15.8024797 POTASSIUM IODIDE SOL $38.9024798 POTASSIUM PHOS INJ 4 $3.5024799 POVIDONE IOD ANTISEP $33.4024800 POVIDONE IOD SURG SC $25.9024801 POVIDONE IOD SURG SC $59.7524802 POVIDONE IOD WHRIL S $78.7024803 POVIDONE IODINE DOUC $7.8024804 POVIDONE IODINE OINT $9.9024805 POVIDONE IODINE OINT $0.8024806 POVIDINE IODINE SOLN $14.0024807 POVIDINE IODINE SOLN $45.0524808 POVIDONE IODINE SPRA $39.0524809 PRALIDOXIME CHL INJ $312.1024813 PREDNISOLONE OPHTH S $166.0024814 PREDNISONE TABS 10MG $0.0824815 PREDNISONE TABS 1MG $0.8024816 PREDNISONE TABS 20MG $0.04

24817 PREDNISONE TABS 5MG $0.1624818 PRIMIDONE TABS 250MG $5.6524819 PRIMIDONE TABS 50MG $2.0024820 PROBENECID TABS 500M $3.4024821 PROCAINAMIDE HCL CAP $1.5024823 PROCAIN. HCL CAPS 37 $1.5024824 PROCAINAMIDE HCL SR $1.8024825 PROCAINAMIDE HCL SR $2.1024826 GEMFIBROZIL CAPSULES $6.9024827 PROCAINAMIDE INJ 1GM $374.4024829 PROCHLORPERAZINE INJ $66.6024830 PROCHLORPERAZINE SUP $36.8024831 PROCHLORPERAZINE SUP $7.8524832 PROCHLORPERAZINE SYR $4.7524833 PROCHLORPERAZINE TAB $2.9024834 PROCHLORPERAZINE TAB $1.8024835 PROCTOFOAM-HC $512.9024836 PROMETHAZINE HCL INJ $6.6024838 PROPANTHELINE TABS 1 $3.8524839 PROPOFOL INJ 20ML $0.4324840 PROPOXYPHENE CAPS 65 $1.0524841 PROPRANOLOL HCL INJ $36.2024842 PROPRANOLOL HCL TABS $0.8024843 PROPRANOLOL HCL TABS $1.5024844 PROPRANOLOL HCL TABS $2.1024845 PROPYLTHIORACIL TABS $2.7024848 TMP PSEUDOEPHEDRINE $1.5024849 PSEUDOEPHEDRINE HCL $0.8024850 PSYLLIUM HYDROPHILIC $1.3024851 PYRIDOXINE HCL TABS $0.8024852 QUINIDINE GLUC. INJ $64.7024853 QUINIDINE GLUCONATE $4.9524854 QUINIDINE SULFATE TA $1.0524855 QUININE SULFATE TABS $2.2024856 RIFAMPIN CAPS 300MG $6.0024857 RUBELLA VIRUS VACC, $37.6524858 SALINE NASAL DROPS 2 $6.4024859 SARNA LOTION 7.5ML $28.5024860 SCOPOLAMINE OPTH SOL $64.2524861 SEBUTONE SHAMPOO 4 O $15.0524863 SELENIUM SULFIDE LOT $47.6024864 SEPTRA DS TABS $10.3024865 SEPTRA INJ 10ML $45.1024866 SEPTRA SUSP $1.7024867 SERTRALINE HCL TAB 1 $8.1024868 SERTRALINE HCL TAB 5 $40.1024869 SILVER NITRATE STICK $2.00

24871 SILVER SULFADIAZINE $23.4024872 SILVER SULFADIAZINE $49.6024873 SIMETHICONE DROPS 40 $0.8024874 SIMETHICONE TABS 80M $1.5024875 SINEMET 10/100 TABS $2.1024876 SINEMET 25/100 TABS $0.8024877 SINEMET 25/250 TABS $2.8024878 SODIUM ACETATE INJ 4 $0.8024879 SODIUM BICARB SYR 4. $38.9024880 SODIUM BICARB SYR 8. $38.0024881 SODIUM BICARBONATE P $1.0524882 SODIUM BICARBONATE T $0.8024883 SODIUM CHL CONC INJ $0.8024884 SODIUM CHL STER FOR $3.3024885 SODIUM CHLORIDE TAB $0.8024886 SODIUM PHOS INJ 45MM $58.1024887 SODIUM POLYSTY SULF $33.8024888 SODIUM TETRADECYL IN $281.3024889 SORBUTUSS SYRUP $1.8024891 SPIRONOLACTONE TABS $1.3024893 DESFLURANE $2.4024895 SUCCINYLCHLINE IN 20 $6.9024896 SUCRALFATE TABS 1 GM $2.3024897 SULFACETAMIDE OPTH S $167.0024898 SULFASALAZINE TABS 5 $0.8024902 SUNBLOCK LOTION SPF $10.7024903 SURGICEL 2" X 14" $238.7024904 SURGICEL 4" X 8" $289.0524905 SURGILUBE 3GM $0.8024906 SURGILUBE 4.25 OZ $71.8024907 TALWIN NX TABS 50MG $7.8524908 TAMOXIFEN CITRATE TA $1.7024910 CHARCOAL ACTIVATED 2 $50.1024914 TERBUTALINE SULF INJ $14.4024915 TERBUTALINE SULFATE $3.7024917 TERFENADINE TABS 60 $7.2024920 TETANUS & DIP TOXS A $120.9024922 TETANUS IMMUNE GLOBU $1,907.6024924 TETANUS TOXOID ADSOR $144.8024927 TETRACAINE HCL OPTH $36.8024930 TETRACYCLINE HCL CAP $23.6024931 TETRACYCLINE HCL CAP $1.5024935 TETRAHYDROZOLINE HCL $5.2024939 THEOPHYLLINE ANH SR $1.7024940 THEOPHYLLINE ANH SR $1.2024941 THEOPHYLLINE SOLN $10.6024943 THIAMINE HCL INJ 100 $4.60

24944 THIAMINE HCL TABS 10 $0.8024951 THIOPENTAL INJ 500MG $208.3524952 THIORIDAZINE HCL TAB $3.2024953 THIORIDAZINE HCL TAB $1.6024954 THIORIDAZINE HCL TAB $2.3024955 THIORIDAZINE HCL TAB $2.6524957 THIOTHIXENE CAPS 10M $15.3024958 THIOTHIXENE CAPS 1MG $3.5024959 THIOTHIXENE CAPS 2MG $7.1024960 THIOTHIXENE CAPS 5MG $10.9024961 THIOTHIXENE CONC 5MG $5.4024964 THROMBIN, TOPICAL, 5 $258.4024965 OXCARBAZEP 600MG TAB $14.7024966 THYMOL IODIDE 15 GM $32.9024969 THYROID TABS 30MG $2.7024971 THYROID TABS 60MG $1.0524973 HYLAN INTRART INJ 8M $97.4624974 DEXTRAN 70/DEXTROSE $11.3524975 CALC CHLOR 10% SYRIN $32.4024976 PIPERACILLIN/TAZOBAC $18.4524977 PIPERACILLIN/TAZOBAC $20.5024980 TIMOLOL OPHTH SOLN 0 $63.0524981 TIMOLOL OPHTH SOLN 0 $75.1024985 TOBRAMYCIN INJ 80MG/ $7.1024986 TOCAINIDE HCL TABS 4 $6.4024987 TOCAINIDE HCL TABS 6 $8.1524989 TOLNAFTATE CREAM 1% $18.8024990 TOLNAFTATE POWDER 1% $11.1024991 TRANYLCYPROMINE TABS $10.8024992 TRAZODONE HCL TABS 5 $0.8024993 ENALAPRIL TAB 2.5MG $4.4024994 VICODIN TAB $1.4524995 FLUOXETINE CAP 10MG $55.4024996 ESCITALOPRAM 20MG TA $13.7024997 LAMOTRIGINE 25MG TAB $46.0024998 LAMOTRIGINE 100MG TA $52.5024999 WARFARIN SOD 7.5MG T $11.1025000 TIAGABINE 4MG TABLET $23.8025001 PRE/POST BRONC SPIRO $629.4025002 BASIC PULOMARY SCREE $248.5025004 BRONCHOSPASM EVAL. $148.8025005 CARDIO. COMPL. FUNCT $528.3525006 CARDIO. PULM. BRONCH $319.6525007 COMP PULM FUNCTION $0.0025009 COMPLETE PFT PRE & P $0.0025010 DIFFUSION $326.3025011 FLOW VOLUME LOOP $106.55

25014 RESP.FLOW VOLUME LOO $96.9025015 SLOW VITAL CAPACITY $117.0525016 VITAL CAPACITY, TOTA $96.9025018 LUNG VOLUME $341.4525020 WALK EVAL W MON, MCR $44.0025600 INDIGOTIN INJ 8MG/ML $618.8025601 FAMOTID INJ20MG/50ML $17.3025603 MORPHIN SULF INJ 5MG $3.5025604 ONDANSETRON 4MG TAB $90.3025605 MEPERDINE INJ 25MG/M $21.4025606 NALTREXONE INJ 380MG $12.4025607 QUETIAP EXT REL 50MG $29.6025608 QUETIAP EXT REL 200 $58.4025609 HYDROMORPH INJ 1MG/M $9.2025610 GADOPENT DIMEGLUM IN $14.9025611 LOVERSOL 300 INJ $1.3025612 FELODIPINE ER 2.5MG $4.7025613 OXYCODONE IR 5MG TAB $1.6025614 FERRIC SUBSULFATE SO $323.9025615 ONDANSETRON ODT 4 MG $69.3025616 PHENYLEPHRINE INJ 10 $33.6025617 SUCCINYLCH INJ 200MG $135.2025618 EPHEDRINE INJ 50MG/5 $246.8025999 CEFEPIME INJ 2 GM $35.2026000 CYANOCOBALAM 1000MCG $0.8026001 MORPH SULF ORL 10MG/ $3.8026002 MORPH SULF ORL 5MG/ $6.6526003 BENZONATAT 100MG PER $7.5026004 DULOXETINE 20MG CAP $26.7026005 ROPINIROLE .25MG TAB $7.5026007 ROPIVACAINE PF INJ.2 $139.1026009 HYDROCODONE/IBUPROFE $3.4026010 SITAGLIPTIN 100 MG T $54.1026011 GLIPIZIDE ER 2.5MG T $4.1026012 CARVEDILOL CR 10 MG $33.0026014 GENTIAN VIOLET 1% SO $12.2026015 FENTANYL 12MCG PATCH $60.9026016 MICROFIB COL HEM POW $588.6526017 ALBUTEROL SULF HFA $79.4026018 SOD CHLOR VIAL 50ML $8.3026020 ZOLEDRONIC ACID INJ $780.3626021 MORPH SULF INJ 100MG $23.0026022 MILRINONE INJ 40MG/ $56.8026023 INFLUENZA A H1N1 VAC $0.9526024 LORAZEPAM INJ 2MG/ML $3.2026025 HYDROMORPHO INJ .2MG $0.8026026 CLOTRIMAZ/BETAMET CR $130.70

26027 CEFDINIR 300 MG CAPS $15.3026028 IBUPROFEN INJ 100MG/ $27.6026029 RITUXIMAB INJ 100MG/ $3,382.3026030 DRONEDARONE 400MG TA $14.6026031 WARFARIN 3 MG TABLET $8.0026032 WARFARIN 4MG TABLET $8.0026033 WARFARIN 6 MG TABLET $10.7026034 ATOMOXETINE 10 MG CA $47.4026035 ATOMOXETINE 40 MG CA $51.5026036 CARDENE IV INJ 20 MG $1.8026037 SUBOXONE FILMTAB 2MG $17.2026038 SUBOXONE FILMTAB 8MG $30.8026039 IBUPROFEN INJ 800 MG $60.2026040 ILOPERIDONE 1 MG TAB $70.6026041 ILOPERIDONE 4 MG TAB $70.6026042 DESVENLAFAXINE EXT R $41.9026043 TAPENTADOL 50 MG TAB $22.9026044 PYR CONST PLT 2LV 40 $6,355.1026045 SLF TAP SC 4.0X14 PY $1,434.0526046 SL TP SC 4.35X14MM P $1,566.3526047 DBM PUTTY 100 1ML $952.1026048 CERV INTRBOD 13X16X7 $9,292.5026049 TEMP FIX PIN CERVICA $418.1526050 PYR CERV DRIL 2.3X12 $911.9026051 HI PRF BONE DRL 3.2 $444.8026052 REVITA 2X2 CM GRAFT $3,600.0027006 ER VISIT LEVEL I $573.6027007 ER VISIT LEVEL II $775.4527008 ER VISIT LEVEL III $1,124.9027009 ER VISIT LEVEL IV $1,503.7027010 ER VISIT LEVEL V $2,004.0527011 ER CRITICAL CARE $2,716.5027020 SMP RPR WOUND DEHIS $449.0527021 SMPL REPR WOUND DEHI $690.3027022 SMPL REPR >30.0 CM F $449.0527023 SMPL REPR 20.1-30.CM $449.0527024 SMPL REPR 12.6-20.CM $449.0527025 SMPL REPR 7.6-12.5CM $490.7027026 SMPL REPR 5.1-7.5CM $449.0527027 SMPL REPR 2.6-5.0CM $500.1027028 SMPL REPR 2.5CM OR< $472.7527029 SMPL REPR >30.CM SCL $449.0527030 SMPL REPR 20.1-30.CM $517.3527031 SMPL REPR 12.6-20.CM $467.5027032 SMPL REPR 7.6-12.5CM $449.7527033 SMPL REPR 2.6-7.5CM $468.5027034 SMPL REPR 2.5CM OR< $449.05

27035 BLOOD TRANSFUSION ER $1,077.5027036 SPLINT, SHORT LEG $351.0527037 SPLINT, SHORT ARM $392.3027039 SPLINT, LONG LEG $474.0027041 CLINIC NEW PATIENT $330.7527042 REMOVAL FB COMPLICAT $1,203.1527043 REMOVAL FB SIMPLE $397.3027044 I&D ABSCESS COMPL OR $369.6027045 I&D POSTOP WOUND INF $680.1027046 I&D HEMATOMA/FLUID $680.1027047 I&D ABSCESS SMPL/SIN $414.8527048 CARDIOVERSION EXTERN $1,031.1027049 TET DIPH IM INJ $79.2027051 REMOVAL NAIL PLATE R $333.5027052 NASAL CAUTERIZ PACKI $432.1027053 NASAL CAUTERIZ PACKI $407.3527054 PUNCTURE ASPIRATION $860.2027055 CPR $888.2027056 REM FB EYE LT $490.0527058 REM IMPACTED EAR WAX $193.0027059 DRESS DEBRIDE W/O AN $431.2027060 REM FB EAR W/O ANEST $310.0527061 REM FB EAR W/O ANEST $310.0527062 CLINIC ESTAB PATIENT $155.6027064 CL TX DIST FIB FX MA $611.7327067 APPLY LONG ARM SPLIN $415.0027069 EXC DEBRID 20SQ CM - $441.0527074 IMMUNIZATION ADM $61.1027076 NASO/ORO G TUBE PLAC $349.9027082 REMOVAL FECAL IMP OR $1,246.7027083 FETAL NON STRESS TES $127.0527084 CLOSED FX TX W/O MAN $306.3527085 STRAPPING SHOULDER R $321.6527086 STRAPPING SHOULDER L $448.1527087 REM IMPACTED EAR WAX $193.0027088 LUMBAR PUNCTURE DIAG $1,588.7527090 CLOSED TX DISLOCATE $483.3027091 REMOVE FB SLIT LAMP $490.0527094 ET INTUBATION $842.3527097 AEROSOL VAPOR INHAL $96.9027099 CLOSED FX TX W/O MAN $306.3527100 REM FB EYELID $520.7027103 CLOSED TX ELBOW DISL $577.9027106 CLOSED TX SHLDR DISL $459.5027107 CLOSED TX SHLDR DISL $459.5027108 EXC NAIL $738.1527109 DRAIN HEMATOMA SUBUN $226.25

27110 CLOS RED FX HUM W MA $401.2527111 CLOS RED FX HUM W MA $401.2527112 SPLINT FINGER $333.0527113 STRAPPING TOES $303.4027114 INIT VENT SUPPORT $887.5027116 I&D MOUTH AND TONGUE $689.1527117 REM FB NASAL $312.4027123 RED FX FING $306.3527124 RED FX W/ANES $459.5027126 DEBRIDE SKIN REM FB $776.4527128 REPAIR NAIL BED $448.7527129 INTERREPR 2.6-7.5CM $464.5027132 INTRACATH IN VEIN $38.2527136 TOE FRACTURE $906.6027139 INTER RPR 2.5CM OR<S $456.4027141 ELBOW RX NURSEMAID $407.3527143 INTER REPR 2.6-7.5CM $485.3027144 KNEES BILATERAL $169.0527145 BLADDER IRRIGATION $407.3527146 SUBSEQ IV INFUS 1 HR $57.6527148 PULSE OXIMETRY $44.0027151 INTER RPR 2.6-5.0CM $545.1027152 INTR RPR 2.5 CM OR< $513.0527155 IV INFUSION $35.2027156 INFUSION $35.2027158 CLOS RED FX METACARP $483.9527161 CLOSED RED HIP DISLO $594.1027163 ARTHROCENTESIS JT BU $428.8027166 ARTHROCENTESIS MJJT $1,065.6027168 NON INDWELL CATHETER $193.3527169 REPAIR COMPLEX WOUND $355.2527170 INDWELLING CATHETER $286.6527171 CLOSE WOUND DERMABON $185.2527173 CLOSURE WND LAYERED $454.7527174 INJ EPID BLD OR PTCH $918.9027175 I&D RECTAL ABSCESS $1,955.7527176 ABDOM PARACENTESIS $646.2527177 CL TX HUMERAL FX $537.9027178 CL RED FINGER DISLOC $479.7527179 EPISIOTOMY $2,778.2527180 SHORT ARM CAST $243.5027181 REPAIR TENDON $3,391.8527182 SHORT LEG CAST $496.2527184 CL RED THUMB $482.4527185 CONS SEDATION $306.3527186 CLOS TX ANKLE FX $480.9027187 CL RED ARM FX $480.90

27188 CLOS TX RADIAL FX $534.9027189 CLOSED REDUCT ELBOW $2,482.5027190 VENTILATION MECH $887.5027191 INSERT CENT VEN CATH $4,764.8527192 LAYER REP 7.6-12.5CM $599.7527193 LAYER REP 12.6-20.CM $554.6027194 INTERPORE IMPLANT500 $4,459.5027195 CL RED HIP DIS W ANE $2,482.5027198 CLSD RED JAW DISLOC $447.2027199 RED HIP DSLOC W ANES $1,434.5027200 REPAIR TENDON $1,694.4027202 RED THUMB DISLOCATIO $252.5027203 INC CRYCOTHYROID MEM $1,663.5527204 CLSD RED DISLOC KNEE $439.9027206 CLOSURE OF SKIN $178.5027208 CL RED FINGER FRACT $462.9527209 CL REDUCT ANKLE FX $249.8527210 CL REDUCT FX FINGER $382.3027211 THROMBOLY COR IV INF $706.3527212 THROMB CEREB IV INFU $326.3027213 RPR EXTENSOR TENDON $1,676.2527214 CL REDUCT DIS FIB FX $249.8527216 I&D PILONIDAL CYST $447.4027219 CLS RED TIB/FIB FX $253.4527220 TRIGGER POINT INJECT $252.2527221 ARTHROPLASTY $3,698.1527222 STRAIGHT CATH C&S $38.2527223 RABIES VACCINE IM $204.9527224 CL VISIT EST PT LVL4 $191.2027225 IM INJECTION $55.9527226 IV INFUS UP TO 1 HR $756.3027227 IV INFUS EA AD <8HRS $348.1027228 IV INJECTION $114.7527229 IV INJECTION $114.7527230 IM INJECTION $55.9527231 IV INFUS UP TO 1 HR $756.3027232 IV INF EA ADD < 8 HR $348.1027234 TYPHOID VAC INJ IM $51.0527235 HEPATIT A VAC IM IN $51.0527236 THORACENTESIS ER $744.1027237 AMP FINGER W V-Y FLP $2,294.8027239 REP ACQUIR A-V FISTU $3,812.1527240 RED TOE FRACTURE $757.2027241 RED RADIAL HEAD FX $243.3527242 IV HYDRATION 1ST HR $818.4027243 IV HYDRATION ADDL HR $57.6527244 CYSTOSTO TUBE CHANGE $412.25

27245 CLOSED REDUCT FINGER $246.4027246 LARYNGOSCOPY $1,833.8027247 IV PUSH NEW DRUG $116.0027248 IV PUSH NEW DRUG $116.0027249 EXTERNAL PACEMAKER $305.2027250 GASTRIC LAVAGE $696.0027251 I D BARTHOLINS CYST $524.8527252 IVP EA ADDL SAME SUB $60.9027253 EA ADDL IV SUBSTANCE $93.9527254 BI PAP $431.8027255 CLINIC NEW PATIENT $253.2527257 CL VISIT EST PT LVL4 $191.2027261 EXC DEBRIDE 20 SQCM+ $441.0527262 RPL GASTROSTOMY TUBE $1,864.2527264 TX FIRST DEGREE BURN $214.4527267 SUTURE MUSCLE $886.3527268 INTRAOSS NEEDLE PLAC $462.4527269 COL VENOUS BLD VENIP $36.5027270 INTRAOSSEOUS NEEDLE $462.4527271 DPT VACCINE $79.2027272 DPT VACCINE $79.2027273 INS CENT VENOUS CATH $2,610.3027274 CL RED BIMALLEOLAR F $353.6527275 SUTURE ARTERY $127.3027276 I&D PERIANAL ABSCESS $1,309.1527277 REP LAC 7.6-12.5 CM $766.2527278 REP LAC 20.1-30.0CM $766.5527279 BIOPSY NAIL BED $1,041.3027280 IRRIGATE VAD $127.5027281 RPR EXTENSOR TENDON $3,674.1027282 MEAS BLADDER CAPACIT $155.8527283 LARYNGOSCO REMOVE FB $4,246.7027284 SHAVE DERMAL LESION $224.7027285 RHINO ROCK NAS TMP M $47.3527286 RHINO ROCK NAS TMP L $54.0527287 CENTRAL LINE KIT $122.9527288 RECTAL TEMP PROBE $6.9527289 TEMP SETTING FOLEY $155.4527290 ARTICSUN COOLPADS UN $7,119.3527291 ARTICSUN COOL PADS S $7,119.3527292 ARTICSUN COOL PADS M $7,119.3527293 RABIES VACCINE IM $204.9527294 CRIT CARE EA ADDL 30 $352.0527297 CLINIC VISIT ALL LEV $290.6527298 TISSUE REARRANGE <10 $4,306.8027299 TISSUE REARRANGE 10. $4,306.8027300 BAIR HUGGER FULL BOD $67.60

27301 CENTRAL LINE 3 LUMEN $158.5027302 CHEST TUBE $360.0027303 EYE TRAY $245.1527304 FOLEY $42.2027305 AMBU $27.7527306 TRAY, LUMBAR PUNCTUR $104.1527307 TRAY, THORACENTESIS $188.1027308 4C2416 BLOOD WARMER $73.9527309 REMOVAL OF CAST $320.0027310 IMMOB KNEE CUTAWAY $56.3527311 IMMOB SHLDR W FOAM $28.8027312 CRUTCHES ALUM ADULT $35.3527313 CHEMO $449.5027314 CHEMO EA SEQUESTRIAL $176.4027316 PERICARDIOCENTESIS $1,549.6027317 CLOS RED ANKLE DISLO $816.3527318 O RED DIST PHLANX FX $6,213.3027319 CL RED TIB SHAFT FX $3,991.3527321 APPLY UNNA BOOT $388.9027322 SHORT LEG CAST $496.2527323 CL TX SHOULDER DISLO $3,463.1027324 INTERME RPR FOREHEAD $372.1027325 CMPLX LAC LIP REPAIR $1,353.9027327 IRR IMPACTED CERUMEN $204.6027812 GRAFIXPL PRIME 3X4CM $4,050.0028002 BURN DRESSING-ARM CH $63.3528003 BURN DRESSING ABDDOM $84.5028004 BURN DRESSING ABDOME $73.9528005 BURN DRESSING ARM AD $84.5028006 BURN DRESSING CHEST $84.5028007 BURN DRESSING CHEST $73.9528008 BURN DRESSING HEAD A $84.5028009 BURN DRESSING HEAD C $63.3528010 BURN DRESSING LEG AD $95.0528011 BURN DRESSING LEG CH $84.5028012 CAST FIBERGLS $554.4028013 CAST FIBERGLS LONG L $306.4528014 CAST FIBERGLS SHORT $158.5028015 CAST FIBERGLS SHORT $211.4028016 CAST PLASTER LONG AR $103.5028017 CAST PLASTER LONG LE $131.1028018 CAST PLASTER SHORT A $75.9028019 CAST PLASTER SHORT L $96.6028024 CRASH CART (CODE 66) $1,585.1528029 EENT TRAY $105.7028030 ELECTRO SHOCK THERAP $940.9528038 ICSN-THRMBOSED HEMOR $0.00

28041 NASAL PKG TRAY POSTE $137.4028042 NASAL PKG TRAY VASOL $52.8028046 PELVIC TRAY $211.4028049 RECTAL TRAY $62.1028051 REDUCTION OF NASAL F $132.1028055 SUTURE TRAY- LARGE $138.0028056 SUTURE TRAY-MEDIUM $158.5028057 SUTURE TRAY-SMALL $69.0028058 TELEMETRY $176.1529015 BLADDER IRRIGATION $407.3529034 CL METATARSAL FX W/M $419.1529048 CLSD DISTAL FIB FX W $590.0029078 DRNG OF ABCSS OF PAL $1,147.4529089 ENUCLEATION-THROMBOS $440.2529155 INSERTION OF TEMP PA $7,544.3529174 INTRMED REP NK, HD, $130.1029181 LACER. RPR<2. 5CM FL $219.6529205 PUNCTURE ASPIRATION, $860.2029214 RMVL FOREIGN BDY, EM $133.8029217 RMVL FRGN BDY CNEA W $490.0529227 RPR ACHILLES TENDON $1,188.8029248 STRAPPING ANKLE/FT $300.7029249 STRAPPING KNEE $322.7031001 ACTIVITIES-DAILY LIV $144.9531002 AMBULATION $119.4031003 COLD PACK/HOT PACK $93.1531004 CPM $105.7031005 ELCT STIM ATND-EA 15 $160.1531008 MASSAGE $63.8031010 PT RE-EVALUATION $209.4031012 FUNCTIONAL ACTIVITIE $140.9531013 MANU TCHNQS-EA 15 MN $161.0531014 PARAFFIN $122.1031015 INITIAL EVAL LOW $308.5031017 NEURO RE-ED $153.5031018 THERAPEUTIC EXERCISE $157.9531019 ELCT STIM UNATTENDED $124.1531020 MECHANICAL TRACTION $102.1531021 ULTRA-SND-EA 15 MIN $136.9531023 WHIRLPOOL $197.8531025 PROSTHETIC TRAINING $79.2031031 SPEECH INIT EVALUATI $414.7531033 SPEECH INDIV THERAPY $191.4031035 SPEECH LANGUAGE EVAL $330.7531038 SPEECH LANG TREATMEN $165.3531052 BIOFEEDBACK 15 MINUT $241.2031054 WRIST GAUNTLET MOLDE $165.60

31055 DYNAMIC SPLINT W/DOR $220.8031056 COCK UP SPLINT $165.6031057 HAND BASED THUMB SPL $138.0031058 THUMB SPLINT (SPIKA) $186.3031059 RESTING SPLINT $165.6031061 CARRY CURRENT STATUS $0.0031062 CARRY GOAL STATUS $0.0031063 CARRY DC STATUS $0.0031064 SELF CARE CUR STATUS $0.0031065 SELF CARE GOALSTATUS $0.0031066 SELF CARE DC STATUS $0.0031067 OTHER PT CURR STATUS $0.0031068 OTHER PT GOAL STATUS $0.0031069 OTHER PT DC STATUS $0.0031073 MOBILITY CURR STATUS $0.0031074 MOBILITY GOAL STATUS $0.0031075 MOBILITY DC STATUS $0.0031076 BODY POS CURR STATUS $0.0031077 BODY POS GOAL STATUS $0.0031078 BODY POS DC STATUS $0.0031079 SUB PT CURR STATUS $0.0031080 SUB PT GOAL STATUS $0.0031081 SUB PT DC STATUS $0.0031082 WHEEL CHAIR MANAGEME $157.9532004 OCCUP. THERAPY EVALU $363.5532005 OCCUPAT THER REEVAL $168.5532011 HOT/COLD PACKS $93.1532012 CONTRAST BATHS $122.1032013 THER EXRCS-EA 15 MIN $51.0532015 FUNCTIONAL ACTIVITIE $140.9532016 MASSAGE $63.8032017 MANU TCHNQS-EA 15 MN $161.0532018 ULTRA SND-EA 15 MIN $136.9532019 ELCT STIM ATND EA 15 $72.1532020 ELCT STIM UNATTENDED $61.6532021 FINGER EXTENSION SPL $63.3532027 SLF CR MGMT TRAINING $144.9536009 OPEN DISCUSSION GRP. $31.7036010 OTHER: SPECIFY $31.7036014 SOCIAL GROUP $31.7038003 OTHER $0.0040001 PHYS THERAPY RE EVAL $168.5540002 IONTOPHORESIS 15MIN $63.3540004 AQUATIC THER W EXERC $125.0040005 PHYS PERFORMANCE TST $528.3540006 BIOFEEDBACK TRAINING $127.6040007 FITNESS CONSULT 15MI $31.85

40009 INITIAL EVAL MOD $293.8040010 INIT EVAL HIGH $293.8042021 ACTIVITIES OF DAILY $51.0542023 PARAFFIN $122.1045002 OTHER $0.0055002 GROUP THERAPY $330.7555003 FAMILY THERAPY, CLIE $330.7555004 INDIVIDUAL THERAPY $330.7555006 INTITIAL ASSESS NEW $352.2055007 FAMILY THERAPY, CLIE $330.7555009 INIT ASSESS ESTAB PT $330.7555010 D GROUP THERAPY $330.7555011 D FAMILY THERAPY CLI $330.7555012 D INDIVIDUAL THERAPY $330.7555013 D INITIAL ASSESS NEW $352.2055014 D INIT ASSESS EST PT $330.7555015 D PSYCH EVALUATION $406.2555016 D MED EVAL 15 MINUTE $406.2555210 PSYCH EVALUATION $406.2555211 MED EVAL SOMATO $406.2555212 IND THERAPY BRIEF D $330.7555213 IND THERAPY BRIEF A $330.7555214 INTAKE 30 MIN A $352.2055215 INTAKE 30 MIN D $352.2055216 INTAKE 15 MIN A $352.2055217 INTAKE 15MIN D $352.2055218 MED EVAL 30 MIN D $406.2555219 MED EVAL 30 MIN A $406.2555220 SCREENING A $330.7555221 SCREENING D $330.7555222 COMPLEX CARE D $406.2555223 BRIEF INTERVENTION A $330.7555224 BRIEF INTERVENTION D $330.7555225 COMPLEX CARE A $406.2555226 PEER COUNSELING A $330.7555227 PEER COUNSELING D $330.7555228 OUTREACH A $330.7555229 OUTREACH D $330.7555230 NO SERVICE $0.0055231 COLLATERAL VISIT A $330.7555232 COLLATERAL VISIT D $330.7555233 D GROUP THERAPY BC $330.7555234 GROUP THERAPY BC $330.7555235 D INIT ASSESS NEW BC $352.2055236 INIT ASSESS NEW BC $352.2055237 D IND THERAPY BC $330.7555238 INDIVID THERAPY BC $330.75

55239 MED EVAL 30MIN A BC $406.2555240 MED EVAL 30 MIN D BC $406.2555241 PSYCH EVAL D BC $406.2555242 PSYCH EVAL A BC $406.2555244 D INIT AS EST PT BC $330.7560002 OPD VISIT WITH CONSU $88.0560010 TET/DIPH IM INJ $79.2060011 CYSTOMETRICS SIMPLE $836.6060012 CYSTOMETRICS COMPLEX $413.4060013 CHANGE GAST TUBE $501.9560014 CLINIC NEW PATIENT L $211.4060015 IMMUNIZATION ADM $61.1060019 BLOOD COLL/VEN ACCES $44.0060020 OUTPATIENT VISIT $213.0560022 INTRACATH IN VEIN $35.2060023 CL RED HIP W CON SED $252.5060025 INDWELLING CATHETER $286.6560026 IV HYDRATION 1ST HR $264.3560027 IV HYDRATION ADDL HR $57.6560028 MMR VACCINE $98.4560029 REMOVAL VAD $1,466.2560030 CL TR HIP ARTHROPLAS $465.0060031 REDUCE NASAL FX $3,851.9560032 I & D MOUTH ABCESS $720.9560033 ETOH SUB ABUSE 15-30 $75.4060034 ETOH SUB ABUSE 15-30 $376.6060035 ETOH SUB ABUSE 15-30 $75.4060036 ETOH SUB ABUSE 15-30 $376.6060037 ETOH SUB ABUSE 15-30 $75.4060038 ETOH SUB ABUSE >30MI $376.6061001 MNT INDV FL UP EA 15 $44.0061002 MNT INITIAL $0.0061003 MNT INDV INIT EA 15 $44.0061082 DIETARY EVAL CORF $0.0061083 DIETARY CONSULT CORF $0.0070005 ADAPTER, LUER-LOC FE $4.2070015 BASIN, EMESIS DISPOS $4.2070045 CATHETER & GLOVE SET $2.7670055 CATHETER, ARTERIAL L $42.2070065 CATHETER, DESERET SU $69.6570070 CATHETER PLUG $4.2070075 CATHETER, SWAN GANZ $418.3570080 CATHETER, TEXAS $4.2070085 CATHETER TRAY, BI-LU $376.1570095 CATHETER TRAY CLOSED $34.9070105 CATHETER URETHRAL $9.5070115 COMBINE PAD (PKG OF $4.20

70125 DISPOZ-A-BAG (LEG BA $7.3570145 DRAINAGE BAG, 4 LITE $60.2070155 DRAINAGE SET, CLOSED $27.5070165 DRAIN, WOUND SHIRLEY $42.2070175 ELECTRODES, EXTERNAL $278.9570185 ENEMA BAG $9.5070195 ENEMA DISPOSABLE $2.7670205 ENEMA, OIL RETENTION $4.8370215 ENEMA PEDIATRIC $4.8370225 EYE MOISTURE CHAMBER $21.1070235 FAZIOPLAST BAGS $34.9070245 FEEDING SET, KANGARO $23.2070255 FOOT DROP STOP $151.0570265 FULLER SHIELD $27.5070275 GAUZE, VASELINE 3 X $4.2070285 GAUZE PACKING, VASEL $9.5070315 YANKAUER SUCTION HAN $4.2070325 INTRODUCER, 8.5 FR. $174.3570335 LINER, SUCTION VAC 1 $9.5070345 LINER, SUCTION VAC 2 $11.5570365 LUKI TUBE SPECIMEN T $9.5070375 MONTGOMERY STRAP $4.2070395 PITCHER W/CUP & LINE $4.2070405 PLEUR-EVAC CHEST DRA $532.5570415 SUCTION SET W/TUBING $269.5070418 TRACH. DISP. INNER C $12.6070420 TRACHESTOMY SUCTION $80.2570425 TRANSDUCER W/MONITOR $286.4070435 URINEMETER, DRAINAGE $44.3070445 AIRWAY, NASOPHARYNGE $30.6070455 AIRWAY, NASOPHARYNGE $30.6070465 AIRWAY, NASOPHARYNGE $30.6070475 AIRWAY, NASOPHARYNGE $30.6070485 AIRWAY, NASOPHARYNGE $30.6070495 BAG, BILE $44.3070505 BAG, FLATUS EVACUATI $4.2070515 BAG, VAGINAL IRRIGAT $15.8570525 BANDAGE, ACE 2" ELAS $4.2070535 BANDAGE, ACE 3" ELAS $4.2070545 BANDAGE, ACE 4" ELAS $4.2070555 BANDAGE, ACE 6" ELAS $7.3570565 BANDAGE, KLING 2" $4.2070575 BANDAGE, KLING 3" $4.2070585 BANDAGE, KLING 4" $4.2070595 BANDAGE, KLING 6" $4.2070605 CATHETER, FOLEY SIZE $42.2070615 CATHETER, FOLEY SIZE $42.20

70625 CATHETER, FOLEY SIZE $42.2070635 CATHETER FOLEY SIZE $19.0070645 CATHETER FOLEY SIZE $42.2070655 CATHETER FOLEY SIZE $42.2070665 CATHETER FOLEY SIZE $42.2070675 CATHETER FOLEY SIZE $42.2070685 CATHETER FOLEY SIZE $19.0070695 CATHETER FOLEY SIZE $42.2070705 CATHETER FOLEY SIZE $19.0070715 CATHETER FOLEY SIZE $19.0070725 CATHETER FOLEY SIZE $19.0070735 CATHETER FOLEY SIZE $19.0070745 CATHETER FOLEY SIZE $19.0070755 CATHETER FOLEY SIZE $19.0070765 CATHETER, STRAIGHT R $23.2070775 CATHETER, STRAIGHT R $23.2070785 CATHETER, STRAIGHT R $23.2070795 CATHETER, STRAIGHT R $23.2070805 CATHETER, STRAIGHT R $23.2070815 CATHETER, STRAIGHT R $23.2070825 CATHETER, STRAIGHT R $23.2070835 CATHETER, STRAIGHT R $23.2070845 CATHETER, STRAIGHT R $23.2070855 CATHETER, STRAIGHT R $23.2070865 CATHETER, STRAIGHT R $23.2070875 CATHETER, STRAIGHT R $23.2070885 CATHETER, SUCTION SI $4.2070895 CATHETER, SUCTION SI $4.2070905 CATHETER, SUCTION SI $4.2070915 COLOSTOMY BELT $36.9070925 SUR-FIT POUCH 2-3/4" $139.4570935 SUR-FIT POUCH 4" FLA $130.0070945 SUR-FIT STOMAHESIVE $21.1070955 SUR-FIT STOMAHSIVE W $30.6070965 COLOSTOMY LOOP OSTOM $97.1570975 COLOSTOMY POUCHES 3" $300.1070985 COLOSTOMY POUCHES 2- $300.1070995 COLOSTOMY POUCHES 2" $300.1071005 COLOSTOMY POUCHES 1- $300.1071015 COLOSTOMY POUCHES 1- $300.1071025 STOMAHESIVE $15.8571035 COLOSTOMY IRRIGATION $151.0571045 COLOSTOMY IRRIGATION $123.6571055 SUR-FIT IRRIGATION S $108.8571065 SUR-FIT IRRIGATION S $95.0571075 POST-OP COLOSTOMY/IL $153.2071085 DRAIN PENROSE 3/4 X $4.20

71095 DRAIN, PENROSE 3/4 X $4.2071105 DRAIN, PENROSE 3/4 X $4.2071115 DRAIN, PENROSE 3/8 X $4.2071125 DRAIN, PENROSE 3/8 X $4.2071135 DRAIN, PENROSE 1 X 1 $4.2071145 DRAIN, T SIZE 8 $55.9571155 DRAIN, T SIZE 10 $55.9571165 DRAIN, T SIZE 12 $55.9571175 DRAIN, T SIZE 14 $55.9571185 DRAIN, T SIZE 16 $55.9571195 DRAIN, T SIZE 18 $55.9571205 DRESSING, ADAPTIC 3X $4.2071215 DRESSING, ADAPTIC 3 $11.5571225 DRESSING, HYDROACTIV $27.5071235 DRESSING, HYDROACTIV $81.3571245 DRESSING, HYDROACTIV $19.0071255 DRESSING, XEROFLO ST $15.8571265 STERILE WATER FOR IR $4.2071275 STERILE WATER FOR IR $9.5071285 STERILE WATER FOR IR $46.4571295 SODIUM CHLORIDE FOR $2.7671305 SODIUM CHLORIDE FOR $22.7771315 1.5% GLYCINE FOR IRR $48.6071325 TUR IRRIG. SET V4537 $27.5071335 UNIVERSAL IRRIG. SET $30.6071345 IRRIGATION TRAY W/PI $7.3571355 PERITON DIALS SOL. W $19.0071365 PERITON DIALSY SOL.W $21.1071375 PERITONEAL DIALYSIS $257.9071385 SPONGE NON-STERILE 4 $30.6071395 SPONGE COVER NON-STE $15.8571405 SPONGE,DRAIN,STERILE $7.3571415 SPONGE,GAUZE 4X4 12P $4.2071425 SPONGE,GAUZE 4X4, 16 $4.2071435 STOCKINGS, TED THIGH $27.5071445 STOCKINGS, TED THIGH $27.5071455 STOCKINGS, TED THIGH $27.5071465 STOCKINGS, TED THIGH $27.5071475 STOCKINGS. TED THIGH $27.5071485 STOCKINGS, TED THIGH $27.5071495 STOCKINGS, TED THIGH $27.5071505 STOCKINGS, TED THIGH $27.5071515 STOCKINGS, TED THIGH $27.5071525 STOCKINGS TED THIGH $27.5071535 STOCKINGS TED THIGH $27.5071545 STOCKINGS TED KNEE H $11.5571555 STOCKINGS, TED KNEE $11.55

71565 STOCKINGS TED KNEE H $11.5571570 STOPCOCK, THREE-WAY $9.5071572 STOPCOCK, THREE-WAY $11.5571575 SUSPENSORY, X-LARGE $46.4571585 SUSPENSORY, LARGE $46.4571595 SUSPENSORY, MEDIUM $46.4571605 SUSPENSORY, SMALL $46.4571615 TAPE, MICROFOAM 4" $34.9071625 TRAY, LUMBAR PUNCTUR $176.4571635 TRAY, LIMBAR PUNCTUR $118.3071645 TRAY, MANOMETER CVP $55.9571655 TRAY, THORACENTESIS $188.1071665 TRAY, THORACENTESIS $135.2571675 TRAY, TRACHEOSTOMY C $13.7071685 TUBE, FEEDING ENTERA $100.4571695 TUBE,TRACHEOSTOMY CU $395.1571705 TUBE,TRACHEOSTOMY CU $395.1571715 TUBE,TRACHEOSTOMY CU $395.1571725 TUBE,TRACHESTOMY CUF $395.1571735 TUBE,TRACHEOSTOMY CU $381.4571745 TUBE,TRACHESTOMY CUF $381.4571755 TUBE,TRACHESTOMY CUF $381.4571765 TUBE,TRACHESTOMY CUF $381.4571775 ABDOMINAL BINDER, UN $71.8071785 BRACE, KNEE UNIVERSA $108.8571795 CANE, WOOD $36.9071805 CERVICAL HALTER $13.7071815 ARM IMMOBILIZER, SMA $36.9071825 ARM IMMOBILIZER, MED $36.9071835 ARM IMMOBILIZER, LAR $36.9071845 ARM SLING, PEDIATRIC $7.3571855 ARM SLING, ADULT SMA $7.3571865 ARM SLING, ADULT MED $7.3571875 ARM SLING, ADULT LAR $7.3571885 CASTBOOT, SMALL $34.9071895 CASTBOOT, MEDIUM $34.9071905 CASTBOOT, LARGE $34.9071915 CERVICAL COLLAR, FOA $19.0071925 CERVICAL COLLAR, FOA $19.0071935 CERVICAL COLLAR, FOA $19.0071945 CERVICAL COLLAR, PHI $95.0571955 CERVICAL COLLAR, PHI $95.0571965 CERVICAL COLLAR, PHI $95.0571975 CERVICAL COLLAR PHIL $95.0571985 CRUTCHES, PEDIATRIC $58.1071995 CRUTCHES, ADULT MEDI $58.1072005 CRUTCHES, ADULT LARG $58.10

72015 CRUTCH, HAND GRIPS $7.3572025 CRUTCH, TIPS $4.2072035 CRUTCH, UNDERARM PAD $7.3572045 SPLINT, ARM PEDI RIG $108.8572055 SPLINT, ARM PEDI LEF $108.8572065 SPLINT, WRIST/ARM UN $58.1072075 SPLINT, CLAVICLE SMA $27.5072085 SPLINT, CLAVICLE MED $27.5072095 SPLINT, CLAVICLE LAR $27.5072105 SPLINT, CLAVICLE X-L $27.5072115 SPLINT, BUCKS TRACTI $46.4572125 SPLINT, BUCKS TRACTI $46.4572135 SPLINT, BUCKS TRACTI $46.4572145 ABG KIT W/PROTECTED $7.5972155 CANNULA, NASAL $4.2072165 FACE TENT, VINYL $11.5572175 INCENTIVE SPIROMETER $38.6472185 MASK, AEROSOL ADULT $7.3572195 MASK, AEROSOL CHILD $4.2072205 MASK, MULTI-VENT $13.7072215 MASK, OXYGEN $4.2072225 MASK, OXYGEN NON-REB $13.7072235 MASK, OXYGEN REBREAT $11.5572245 MASK, PEDIATRIC OXYG $7.3572255 MASK, TRACHEOSTOMY $11.5572265 NEBULIZER (HDN BOTTL $23.2072275 NEBULIZER, MISTY W/A $11.5572285 NEBULIZER, W/TEE ADA $15.8572295 RESUSCITATOR (AMBU), $116.2572305 RESPIREX RESPIRATORY $25.3572315 STERILE WATER FOR IN $9.6572325 TENT CANOPY $13.8072335 TENT CANOPY, PEDIATR $35.1972345 UNIVERSAL MANIFOLD & $21.1072355 #1613 VENTILATOR CIR $20.0172365 #1627 VENTILATOR CIR $21.3972375 VOLUME VENT CIRCUIT $34.9072385 BEDPAN, FRACTURE DIS $7.3572395 DEODORANT (BAN 1.5 O $10.3572405 MATTRESS, EGG CRATE $20.0172415 MATTRESS, EGG CRATE $45.5472416 MATTRESS, THERAPEUTI $105.7072425 MODESS $9.5072435 PROTECTOR, HEEL/ELBO $21.1072445 RESTRAINT, LIMB HOLD $19.0072455 SHAMPOO (WELLA BALSA $10.3572465 SHAVING CREAM $7.35

72475 SHROUD KIT $9.5072485 SITZ BATH, DISPOSABL $11.5572495 SLIPPERS, X-LARGE $7.3572505 SLIPPERS, LARGE $7.3572515 SLIPPERS, FOAM, MEDI $7.3572525 SPECIPAN $4.2072605 PAMPERS, SMALL $12.4272606 LEAD LEVEL $129.4572615 PAMPERS, MEDIUM $12.4272625 PAMPERS, LARGE $42.7872635 PAMPERS, ADULT $13.8072645 TUBE, CONNECTING SUC $4.2072655 TUBE, FEEDING SIZE 5 $4.2072665 TUBE, FEEDING SIZE 8 $9.5072675 TUBE, FEEDING VIVONE $137.4072685 TUBE, LEVINE SIZE 8 $34.9072695 TUBE, LEVINE SIZE 10 $34.9072705 TUBE, LEVINE SIZE 12 $34.9072715 TUBE, LEVINE SIZE 14 $34.9072725 TUBE, LEVINE SIZE 16 $34.9072735 TUBE, LEVINE SIZE 18 $34.9072745 TUBE, LEVINE SIZE 20 $34.9072755 TUBE, LEVINE SIZE 22 $34.9072765 TUBE, RECTAL #28 $30.6072775 TUBE, SALEM SUMP 16 $13.7072785 TUBE, SALEM SUMP 18 $13.7072795 TUBING, 72" CORR-A-F $9.5072805 TUBING, CONNECTING O $4.2072815 CAUTERY, SURGICAL AC $48.6072816 CORAL GRAN BONE GFT $722.1572825 SKIN STAPLE EXTRACTO $15.8572835 SUTURE REMOVAL TRAY $4.2072845 SPONGE, RAYTEC, 10/P $4.2072846 MATTRESS, SPENCO $30.6073000 PACK, DELIVERY ER $86.6573002 STAPLER, SKIN $38.0073003 TROCAR 15 MM $348.7073004 GIA 30 35 $593.9573005 BLUNTPORT $431.1573006 ENDOCLIP 5MM $951.0573007 TA 30 48 RELOAD $536.8573008 TA 30 35 $321.2073009 TA 60 STAPLER $327.5573010 TA 30 STAPLER $321.2073011 GIA 60 STAPLER $361.3573012 GIA 60 RELOAD $1,747.9073013 TROCAR S11 $443.80

73014 TROCAR S12 $462.9073016 CATHETER, TAUT CHOLA $0.0073017 ENDOSCOPE DEFOGGER $31.7073018 SPIKE ADAPTER $12.6073019 NEURO SPONGE $0.0073020 NEZHAT DORSEY TUBING $0.0073021 TUBING INSUFFLATION $46.4573022 CAMERA DRAPE $24.8473023 CONSTAVAC $215.5073024 DURAPREP $33.8073025 STERIDRAPE $41.4073027 DERMATOME BLADE $112.0573028 BOVIE PAD $25.3573029 BLAKE DRAIN $141.5573030 J VAC 150 MM $101.4573031 INTRODUCER KIT $114.1573032 INTRODUCER KIT $0.0073033 CORCIS INTROQUER SYS $0.0073034 PACING LEAD $0.0073035 BAXTER SHEATH INTROD $0.0073036 CORCIS INTRODUCER SY $0.0073037 GU BIOPSDY NEEDLE $253.6073038 BOVIE ENDOSCOPIC COR $0.0073039 DOUBLE J STENT $507.2073040 CATHETER OLIVE TIP $46.4573041 CATHETER WHISTLE $61.2073042 CATHETER CONE TIP $61.2073043 STENT PIGTAIL $0.0073044 TUR SET U4537 $27.5073045 CPI WRENCH KIT $221.8573046 CATHETER FILAFORM $61.2073047 LEUEEN INFLATOR GAUG $317.0073048 LUBRIGLIDE GUIDEWIRE $139.4573049 BALLN URTRL DILATION $441.7073050 SEGURA BASKET $500.9073051 ELECATH 5 FRENCH PAC $329.7073052 PHILLIPS FOLLOWER $84.5073053 CPT VISTA T SINGLE $8,862.0073054 CPT SR MACEL 1130 $11,191.1073055 TELTRONIC TEMPORARY $494.5073056 TELTRONICS TEMPORARY $0.0073057 TA 90 48 STAPLER $331.8573058 TA 90 3S RELOAD $348.7073059 TA 90 48 RELOAD $676.2573060 GIA 30 3S RELOAD $395.1573061 GIA 30 25 RELOAD $395.1573062 TA 90 354 STAPLER $331.85

73063 TA 60 48 RELOAD $676.2573064 TAGO 35 RELOAD $54.9073065 TA 60 48 STAPLER $327.5573066 STRYKER SUCTION IRRI $380.4573067 BAIR HUGGER UPPER BO $31.7473068 BAIR HUGGER FULL BOD $67.6073069 TA 30 48 STAPLER $0.0073070 SURGICLIP MED. 9.75 $355.0573071 SURGICLIP SM 9.0 $355.0573072 PERI PACK $33.8073073 HIP PACK $158.5073074 TWO GOWN PACK $24.8473075 EEA 31 $864.4073076 EEA 25 $864.4073077 EEA 28 $864.4073078 ONE GOWN PACK $25.3573079 CYSTO PACK $38.0073080 LAPAROTOMY PACK $65.5073081 EXTREMITY DRAPE $26.2273082 BASIC PACK $33.8073085 ARTHROSCOPY PACK $179.6573086 CHOLECYSTECTOMY PACK $107.8073089 MAYO COVER $6.3073091 PEANUT SPONGE $19.0073095 MICROBIOLOGY BRUSH $116.2573096 HOT TEMP CAUTERY $54.9073097 SUCTION TUBING $4.2073098 CYTOLOGY BRUSH $67.6073099 MARLEX MESH 1X4 $803.1573100 MARLEX MESH 2x4 $1,109.5573101 MARLEX MESH 10x4 $1,796.5073102 IA PACK $488.2573103 UNIPACK $500.9073104 MICROSPONGE $14.7573105 OPTHALMIC KNIFE $60.7573106 COLOGEN SHIELD $196.5573107 EYE SUTURE $105.7073108 WETFIELD ERASER $33.8073110 SITE PHACOPACK $443.8073111 CYSTOTOME $19.0073112 U SHAPE CANULA $27.5073113 TIP CLEANER $4.2073114 EYE TRAY $245.1573115 BEAVER BLADE 376900 $42.2073116 BEAVER BLADE 377515 $27.5073117 BEAVER BLADE 376600 $107.8073118 BEAVER BLADE 375521 $95.05

73119 BEAVER BLADE 375520 $95.0573120 CARDIOVASCULAR SUTUR $63.3573121 SOFT JAW INSERT $61.2073122 PARALLEL JAW SPRING $29.5573123 DISPOSA LOOP $12.6073124 LIFEPORT INTRODUCER $0.0073125 PORT A CATH $999.6573126 PTFE VASCULAR PATCH $989.1073127 POLYPECTOMY SNARE $211.4073128 PTFE VASCULAR GRAFT $2,694.7073129 PTFE VASCULAR GRAFT $2,694.7073130 PTFE VASCULAR GRAFT $2,694.7073131 GELSOFT VASCULAR GRA $2,014.1573132 GELSOFT VASCULAR GRA $2,014.1573133 BARBED STAPLE $143.7073134 KIRSCHNER WIRE $27.5073135 WOODRUFF SCREW $156.4073136 RUSH ROD SMALL $748.1573137 RUSH ROD MEDIUM $348.7073138 RUSH ROD LARGE $748.1573139 CANCELLOUS SCREW $853.3073140 CORTICAL SCREW $708.2073141 MALLEOLAR SCREW $124.7573142 RIORDAN PIN $67.6073143 KNOWLES PIN $266.3073144 AMBI PLATE 6 SLOT $567.1873145 AMBI PLATE 8 SLOT $1,077.9573146 AMBI PLATE 5 SLOT $549.2473147 AMBI PLATE 4 SLOT $792.6073148 AMBI LAG SCREW $492.4573149 RICHARDS 45 BONE SCR $67.6073150 65 CANNULATED SCREW $412.1073151 ARTHROSCOPIC CUTTER $462.9073152 DISPOSABLE ORTHO HOO $112.0573153 AMBI PLATE 10 SLOT $815.5873154 AMBI SUPRACONDULAR O $0.0073155 AMBI PLATE 14 SLOT $1,063.9873156 AMBI SUPRACONDULAR P $943.9273157 AMBI HIP SCREW CLIP $187.6873158 AMBI COMPRESSING SCR $12.4273159 PIN COVER $0.0073160 ABDUCTION PILLOW $285.3573161 STAINLESS STEEL MIDI $190.1573162 TITANIUM 1/3 TUBULAR $247.2573163 TITANIUM DRILL BIT 2 $171.2073164 TITANIUM CORTICAL SC $126.7573165 STAINLESS STEEL 1.7 $0.00

73167 TITANIUM PURTIAL THR $57.0573168 TITANIUM CANCELLOUS $57.0573169 TITANIUM CORTICAL SC $54.9073170 4.5 CORTICAL SCREW $602.3073171 STAINLESS STEEL DHS $0.0073172 DARCO POSTOP SHOE $97.3573173 PULSAVAC KIT $342.4573176 AUSTIN MOORE ENDOPRO $1,506.9573177 AUSTEN MOORE LARGE $1,597.7573178 SAW BLADE $59.1573179 LEG HOLDER PAD $76.1073180 COBAN $19.0073181 ORTHO CONSTAVAC $215.5073182 TIBIA BOLT $0.0073183 GIGLI SAW $92.9073184 ECT SCREW $238.7073185 THREADED KIRSCHNER W $12.6073186 STEINMANN PIN $422.6573187 FEMORAL CANAL RESTRI $475.5573188 VACUUM MIXING FILTER $0.0073189 VACUUM MIXING BOWL $0.0073190 VACUUM MIXING SYSTEM $682.6573191 ZIMMER PALACOS CEMEN $1,066.9073192 BONE CEMENT INJECTOR $1,418.1573193 FEMORAL BRUSH $101.4573194 SUPER BOWL CEMENT 2N $0.0073195 SUPER BOWL CEMENT SE $0.0073196 XRAY COVER $25.3573197 MASSIE PLATE $450.1573198 MASSIE NAIL $932.0573199 STAINLESS STEEL 2.5 $0.0073200 ANGLED ARTHROSCOPINC $0.0073201 LAPROSCOPIC HERNIA K $912.1873202 LAMAITRE VASCULATOME $682.6573203 FLORESTER VESSEL OCC $278.9573300 PHY THERAPY $0.0073320 SPEECH THERAPY $0.0073330 QUANNACUT $0.0075005 S9902 EVAUATED CONTA $4.2075015 S9901 EVACUATED CONT $7.3575025 S9900 EVACUATED CONT $7.3575035 ADULT IV SET W/1 INJ $7.3575045 MEASURED VOL SOL ADM $15.8575055 MEAS VOL SOL ADM SET $21.1075065 ADULT IV SET Y TYPE $11.5575075 ADULT IV SET W/O FIL $9.5075085 MINI DRIP IV SET W/O $11.55

75095 IV SECOND SET W/PROT $9.5075105 PALL BLOOD TRANSFUSI $52.4475115 RC50 LEUKOCYTE BLOOD $146.9075125 RC100 LEUKOCYTE BLOO $369.8075135 PL100 PLATELET LEUKO $439.6575145 BLOOD COLLECTION SET $7.3575155 4C2100 BLOOD COMPONE $15.8575165 4C2416 BLOOD WARMER $73.9575175 EXTENSION SET 33" V5 $4.2075185 IV FILTER .22 MICRON $13.7075195 IV CATHETER 16G X 2- $4.2075205 IV CATHETER 18G X 1- $4.2075215 IV CATHETER 20G X 1- $4.2075225 IV CATHETER 22G X 1 $4.2075235 IV CATHETER TWO LUME $34.9075245 IV CATHETER TWO LUME $34.9075255 INFUSION SET NONCORI $21.1075265 INFUSION SET NONCORI $21.1075275 INFUSION SET NONCORI $21.1075285 INFUSION SET NONCORI $21.1075295 NEEDLE, NON-CORING 2 $21.1075305 MINISET VEIN INFUSIO $4.2075315 MINISET VEIN INFUSIO $4.2075325 MINISET VEIN INFUSIO $4.2075335 MINISET VEIN INFUSIO $4.2075345 MINISET INFUSION 25G $4.2075346 STATACK 3.2 MM $443.8075347 STATACK 5.0 MM $443.8075348 SURETAC II $443.8075349 K-WIRE TITANIUM $581.1575350 ORTHOFX EXT. FIXATOR $5,000.0575351 CANNULATED SCREW 4.0 $558.0075352 CANNULATED SCREW 6.5 $878.8575353 LAG SCREW $2,116.7075354 GUIDE WIRE URETERAL $179.6575355 PROTECTED NEEDLE $4.2075356 SYMBO COMP MESH 15CM $1,653.7575365 N2030 PRN (IV CATH P $4.2075375 IV ADD-ON HALFSET V7 $58.1075385 PRIMARY IV SET W/FIL $73.9575395 NITROGLYCERIN IV SET $102.4075405 PRIMARY IV SET W/BAC $60.2075415 CLAVE ACCESS DEVICE $19.0075425 CLAVE CONNECTOR $14.7575435 CLAVE EXTENSION SET $21.1076000 GUN STAPLING EQUIPME $951.0576001 STAPLE RELOADS $317.00

76250 CATARACT SUPPLIES $2,219.2076251 INTRAOCCULAR LENS $1,585.1576500 COLONOSCOPY/ENDOSCOP $2,250.9076750 J STENT $1,046.2076751 LITHOTRIPTOR PROBES $1,109.5576752 URETEROSCOPY SUPPLIE $2,536.1576753 BALLOON LAP HERNIA $369.8076754 CATH. CYSTIC DUCT $528.3576755 ARTHRO ABLATION CATH $686.8576756 CENTRAL LINE 3 LUMEN $158.5076757 PICC CATHETER $744.3076758 CATH. EPIDURAL $317.0076759 CATH, EMBOLECTOMY $348.7076760 GUIDEWIRE, ENDO $306.4576761 PMKR GUIDEWIRE $369.8076762 TOT HIP CEMENTED ZIM $21,135.2076763 TOT HIP NON-CMNTD ZM $21,135.2076764 TOTAL KNEE CMNTD ZIM $28,428.5076765 TOT. KNEE CRUCI.SACR $17,964.9576766 BIPOLAR HIP $20,078.4576767 PMKR LEAD TEMP 6FR $439.6576768 MESH, SURGIPRO 3X5 $1,637.9576769 MESH, SURGIPRO 6X6 $2,377.7076770 MESH, COMPOSIX 8X10 $3,943.8576771 MESH, COMPOSIX 12X12 $5,917.9076772 MESH, COMPOSIX 10X14 $5,243.6576773 MESH, KUGEL OVAL SM $1,690.8576774 MESH, KUGEL OVAL MD $2,496.0076775 MESH, KUGEL OVAL LG $3,163.9576776 MESH, KUGEL CIRCLE $1,386.5076777 MESH, PLUG MEDIUM $545.3076778 MESH, PLUG LARGE $817.9076779 MESH, PLUG X-LARGE $951.0576780 MESH, PROLENE SYSTEM $900.3576781 PMKR PULSAR MAX DR $23,227.5576782 PMKR DISCOVERY II DR $23,227.5576783 PMKR MERIDIAN DR $17,330.9076784 PMKR INSIGNIA DR $29,568.1576785 IMPLNT BREAST SALINE $1,902.1076786 IMPLNT BREAST SILICN $5,063.6076787 PMKR INTRODUCER 7FR $208.8576788 PMKR INTRODUCER 8FR $158.5076789 PMKR INTRODUCER 9FR $158.5076790 PMKR INTRODUCER 10FR $158.5076791 PMKR LEAD PERMANENT $1,910.0576792 PMKR DISCOVERY II SR $19,402.1076793 PMKR MERIDIAN SR $13,949.25

76794 PMKR INSIGNIA SR $27,031.9576795 KIT SUPRAPUBIC CYST. $528.3576796 APLIGRAFT, PER SQ.CM $5,437.5576797 TA 30 48 $321.2076798 TA 60 35 $321.2076799 TA 60 48 $321.2076800 TA 90 35 $321.2076801 TA 90 48 $321.2076802 GIA 60 $593.9576803 GIA 80 $593.9576804 TA RELOAD 30 35 $536.8576805 TA RELOAD 60 35 $676.2576806 TA RELOAD 90 35 $676.2576807 GIA 80 RELOAD $1,747.9076808 SURGICLIP M 11.5 $355.0576809 SURGICLIP M 9.75 $355.0576810 CEEA 55 $693.2076811 CEEA 25 $693.2076812 CEEA 28 $693.2076813 CEAA 31 $693.2076814 ENDO GIA II RLD 3025 $551.5576815 ENDO GIA II RLD 3035 $551.5576816 ENDO GIA II RLD 4552 $551.5576817 ENDO GIA II RLD 4535 $551.5576818 ENDO GIA II RLD 3020 $551.5576819 ENDO CLIP 10 MM $951.0576820 ENDO STITCH RELOAD $568.5576821 INTRAOCULR LNS IMPLT $774.9076822 AMBI PLATE $4.5576823 PMKR PULSAR MAX IIDR $21,135.2076824 WOUND VAC THERAP SYS $260.3576825 WOUND CARE SUPPLIES $260.3577000 LAP COLI KIT $3,614.1077001 LAP HERNIA KIT $5,072.4577250 ARTHROSCOPIC CUTTERS $380.4577251 CABLE SYSTEM $2,060.6577252 CANNULATED SCREW 3.5 $672.1577253 TOTAL HIP SUPPLIES $0.0077254 ENDO PROSTHESIS HIP $8,454.0577255 HIP SURGERY ORIF SUP $3,170.2577256 TOTAL KNEE SUPPLIES $0.0077502 PMKR PULSAR MAX DR $19,402.1077750 VASCULARTOME $1,363.1077751 VENA CAVA FILTERS $5,341.2577752 VENOUS ACCESS KIT $1,991.0077753 MESH KUGEL OVAL XL $7,326.9077754 PROCD SURG MESH 8X10 $3,277.45

77755 PROCD SURG MSH 10X14 $8,095.4078050 SWANN GANZ CATHETER $1,902.1078060 CHEST TUBE INSERTION $2,007.8078070 PMKR LEAD TMP 5FR $439.6578071 WRIST SPLINT $113.3578072 AIR CUSHION WHEELCHA $1,830.2078073 ORTHOSIS KAFO $7,808.2578100 MISC SURG SUPPLIES $0.0095080 NYS SURCHARGE $0.00

147893 HGE $0.00172162 ORTHO TRI-CYCLEN 28 $151.10272490 APPL LONG LEG CAST $656.60277176 PERC PLACE GASTRO TU $1,422.75277177 VAGINAL DELIVERY $752.00277178 CL RED RADIAL FX $482.45277182 CL RED TOE DISLOC $246.40277183 INS CHEST TUBE W WAT $793.50277184 IRRIGATE VAD $127.50277186 DRAIN CHEST TUBE $5,007.50412015 SYMBYAX 6MG/25MG $53.60712000 LORAZEPAM $0.00712001 BARIUM SULFATE SUSP $15.80712002 CHLORDIAZEPOXIDE HCL $0.00712003 CLONAZEPAM 0MG $0.00712004 DIATRIZOATE MEGLU SO $2.90712005 PHARMACY NON CHARGE $0.00712006 NON FORMULARY $15 CH $0.00712007 PATIENT OWN MEDS $0.00712008 PHYSICIAN SAMPLE $0.00712009 REMOVE NITROPATCH $0.00712010 WARFARIN $0.80712011 TESTOSTERONE 1% GEL $44.90712012 CARBAMAZEPINE 100 MG $1.90712013 DABIGATRAN 75 MG $26.00712014 DABIGATRAN 150 MG $26.00712015 SYMBYAX 6MG/25MG $43.40712016 LOESTRIN FE TAB $3.10712017 RASAGILINE 1 MG $93.90712018 VITAMIN D 1000 UNITS $0.80712019 PRESERVISION TAB $0.80712020 RANOLAZINE SR 500 MG $22.40712021 VALPROIC 250MG/5ML $2.30712022 FEBUXOSTAT 80 MG $39.60712023 DESLORATADINE 5MG $24.20712024 SYMBICORT 80-4.5 $737.50712025 PANCRELIPASE 21000 $21.60712026 INSULIN DETEMIR $0.80

712027 NEPAFENAC 0.1% SOLN $977.90712028 DIFLUPREDNATE 0.05% $671.60712029 RISEDRONATE 35 MG $306.90712030 MAGNESIUM OXIDE 400 $0.80712031 OMEGA 3 ACID $6.20712032 BRIMONIDONE 0.1% $1,727.60712034 NIACIN CR 500 MG $12.70712035 METHYLPHENIDATE SA $18.70712036 LISDEXAMFETAMINE $36.50712037 NATEGLINIDE 120 MG $13.40712038 ASA/ACETA/CAFFEINE $0.80712039 LETROZOLE 2.5 MG $84.20712040 SOD CL HYPERTONIC 2% $54.70712041 NORTREL 7/7/7 $3.50712042 AMBRISENTAN 5 MG $1,165.00712043 LUBIPROSTONE 8 MCG $22.30712044 PYRIDOSTIGMINE 60 MG $4.40712045 RIVASTIGMINE 4.6 MG $82.30712046 PRIMIDONE 50 MG $1.50712047 NEBIVOLOL 5 MG $17.50712048 CARBIDOPA 25 MG $100.50712049 SILDENAFIL 20 MG $171.70712050 ARIPIPRAZOLE 2 MG $96.20712051 TERIPARATIDE 20 MCG $12,335.40712052 MICROGESTIN FE $3.10712053 DUTASTERIDE $23.80712054 LIOTHYRONINE $6.90712055 ZINC SULFATE $0.80712056 HYDROXYCHLOROQUINE $12.20712057 DESMOPRESSIN $28.40712058 BETAXOLOL 0.5% $369.80712059 AMILORIDE 5 MG $0.80712060 DEMECLOCYCLINE 300MG $51.20712061 SULIFENACIN 5 MG $46.30712062 MOXIFLOXACIN $183.80712063 ATRIPLA $342.90712064 CILOSTAZOL $5.50712065 TACROLIMUS $6.70712066 MYCOPHENOLATE $11.90712067 MYCOPHENOLATE $23.80712068 CEFUROXIME $21.00712069 LIDOCAINE $13.10712070 ABACAVIR/LAMIVUDINE $155.00712071 METFORMIN $3.60712072 PROPAFENONE $2.80712073 LURASIDONE $146.80712074 OLSALAZINE $48.80

712075 RALTEGRAVIR $90.00712076 METHYLPHENIDATE SA $80.30712077 METHIMAZOLE $1.30712078 TRUVADA $210.90712079 DARIFENACIN $45.70712080 CICLESONIDE $1,009.70712081 TEMAZEPAM $2.20712082 TIZANIDINE $8.10712083 ATAZANAVIR $173.90712084 CETIRIZINE $0.80712085 RITONAVIR $48.75712086 YAZ TABLET $20.90712087 PRASUGREL 10 MG $49.50712088 INDAPAMIDE $2.50712089 BICALUTAMIDE $55.10712090 CALCIUM CARB CHEW $0.80712091 RIVASTIGMINE $82.30712092 FENOFIBRATE $7.10712093 LISDEXAMFETAMINE $36.50712094 PROPRANOLOL ER $6.20712095 ALFUZOSIN $18.30712096 FENOFIBRATE $18.00712097 DICLOFENAC $164.50712098 ZIAC $23.30712099 METHENAMINE $6.30712100 CINACALCET $96.80712101 ZENCHENT $4.80712102 CARTEOLOL $63.80712103 ACEBUTOLOL $3.20712104 ESTRADIOL $1.70712105 ANASTROZOLE $39.90712106 FENOFIBRATE $1.80712107 CIPRODEX $850.00712109 SULINDAC $2.90712110 CENESTIN $13.10712111 AVIANE $3.80712112 HYDROXYUREA $2.70712113 SACCHAROMYCES $2.00712114 KETOROLAC $6.50712115 GLATIRAMER $649.20712116 MESALAMINE $10.90712117 PRENATAL $0.80712118 MESALAMINE CR $21.80712119 HYOSCYAMINE $2.60712120 SYMBICORT $1,248.60712121 TAZAROTENE $1,434.70712122 FLUCONAZOLE $30.60

712123 COLESEVELAM $13.10712124 NITROFURANTOIN $5.90712125 PINDOLOL $3.90712126 TRI-SPRINTEC $118.00712127 ZOLEDRONIC $2,880.00712128 PARICALCITOL $36.50712129 CARBAMAZAPINE $19.50712130 CEFIXIME $63.50712131 OXYCODONE $37.00712132 SAFETUSSIN $1.70712133 PALIPERIDONE SR $141.40712134 TESTOSTERONE $464.90712135 AMPHETAMINE $18.40712136 MYCOPHENOLATE $19.50712137 TACROLIMUS $13.40712138 SOD. HYALURONATE $829.10712139 HYALURONAN $1,720.80712140 CARBAMAZEPINE SR $4.90712141 MOXIFLOXACIN $81.70712142 ALISKIREN $29.60712143 PERIGUARD $13.50712144 CHLORHEXIDINE $0.80712145 CYCLOSPORINE $33.50712146 COMBIGAN $634.80712147 COLBETASOL $12.40712148 PROPAFENONE $14.60712149 CAPECITABINE $117.30712150 ALISKIREN $23.40712151 PROGESTERONE $12.20712152 TELMISARTAN $25.90712153 VITAMIN D $0.80712154 LOESTRIN FE $3.10712155 METFORMIN $0.80712156 FENOFIBRATE $6.00712157 MONETASONE $266.30712158 BIMATOPROST $982.50712159 KETOROLAC $200.60712160 COMPOUND W $21.50712161 FEXOFENADINE $1.70712162 ORTHO TRI-CYCLEN $172.20712163 LACTOSE $0.80712164 FLUVASTATIN $38.70712165 CARISPRODOL $1.80712166 ENTACAPONE $27.80712167 FINGOLIMOD $985.30712168 METFORMIN $3.20712169 CALCIUM $0.80

712170 LOESTRIN 24 FE $268.60712171 ARIPIPRAZOLE $127.40712172 CABERGOLINE $110.00712173 VENT 24 HOUR ORAL $60.00712174 REPAGLINIDE $11.00712175 LIDOCAINE (BUFFERED) $49.50712176 MORPHINE-PF $4.30712177 AMIODARONE $124.90712178 AMIODARONE $166.10712179 NALOXONE $427.40712180 FESOTERODINE $39.80712181 ACARBOSE $3.50712182 HYOSCYAMINE CR $8.30712183 LEVETIRACETAM SR $19.30712184 ZOLPIDEM CR $18.30712185 SODIUM $34.00712186 SILVASORB $91.70712187 FOSAMPRENAVIR $69.50712188 BOSENTAN $697.90712189 TRIZIVIR $155.60712190 DARUNAVIR $70.00712191 HYDROCODONE/ACETA $2.00712192 HYDROCODONE/ACETA $2.60712193 HYDROCODONE/ACETA $3.60712194 SAXAGLIPTIN $50.40712195 ENTECAVIR $164.70712196 VINCRISTINE $20.70712197 CYCLOPHOSPHAMIDE $21.60712198 BRIMONIDINE $98.00712199 CEFADROXIL $10.80712200 POLIGRIP $10.60712201 PRAMIPEXOLE $8.80712202 PRAMIPEXOLE SR $71.70712203 GLYCOPYRROLATE $3.90712204 OXYCODONE $10.70712205 COLESEVELAM $78.80712206 PROTRIPTYLINE $12.20712207 PREGABALIN $28.10712208 NORETHINDRONE $86.80712209 SODIUM CHLORIDE $8.10712210 MOMETASON $758.70712211 EXEMESTANE $60.70712212 FEBUXOSTAT $39.60712213 CARBAMAZEPINE SR $5.90712214 RISPERIDONE $28.00712215 ECONAZOLE $1,304.10712216 DESONIDE $963.40

712217 ACETAMINOPHEN $1.57712218 BISOPROLOL $4.10712219 MIDODRINE $7.20712220 OPTI-FREE $11.70712221 LINAQLIPTIN $52.30712222 EPINEPHRINE $0.75712223 VORICONAZOLE $167.10712224 SORAFENIB $576.90712225 IRON SUCROSE $1.80712226 BALZIVA $134.50712227 RABEPRAZOLE $34.40712228 TAZAROTENE $1,434.70712229 MILNACIPRAN $22.90712230 PREMPRO $24.80712231 ESOMEPRAZOLE $30.10712232 PRAMIPEXOLE $8.80712233 TACLONEX $3,733.20712235 PRAMIPEXOLE $8.80712236 AMBRISENTAN $1,165.00712237 DARUNAVIR $48.60712238 DARUNAVIR $101.40712239 RIZATRIPTAN $99.60712240 CLINDAMYCIN $311.00712241 MEGESTROL $89.90712242 ADVAIR HFA $764.90712243 CLOBETASOL $1,184.90712244 AUGMENTIN $55.40712245 AUGMENTIN $105.50712246 MELOXICAM $9.50712247 POLYETHYLENE $20.90712248 SELEGILINE $8.90712249 MILNACIPRAN $11.50712250 MILNACIPRAN $22.90712251 LO LOESTRIN FE $506.60712252 MARAVIROC $93.40712254 TADALAFIL $250.20712255 PYRIDOSTIGMINE $47.20712256 TINIDAZOLE $38.00712257 TIMOLOL $1,241.30712258 CHLORTHALIDONE $6.90712259 POTASSIUM $5.90712260 CLINDAMYCIN $360.50712261 TRETINOIN $301.30712262 EFFERDENT $0.80712263 SAXAGLIPTIN $50.40712264 IMATINIB $337.10712265 MEGESTROL $1.80

712266 RALOXIFENE $7.80712267 ZIAC $4.10712268 SEVELAMER $20.30712269 HALOBETASOL $574.10712270 MERCAPTOPURINE $24.50712271 OXYCODONE $21.30712272 SPRINTEC $122.80712273 RIVAROXABAN $53.70712274 COLESTIPOL $3.70712275 LUBIPROSTONE $22.30712276 CEREFOLIN $8.20712277 LEVALBUTEROL $245.60712278 CARVEDILOL $6.40712279 FENOFIBRATE $2.40712280 NEPHROVITE $1.40712281 EPINASTINE $321.00712282 NABUMETONE $4.60712283 PALIPERIDONE $41.14712284 PALIPERIDONE $41.14712285 PALIPERIDONE $41.14712286 PALIPERIDONE $41.14712287 PALIPERIDONE $41.14712288 TRYPAN BLUE $182.00712289 BETAMETHASONE $317.00712290 SALINE $9.20712291 OPTI-FREE $28.40712292 INDAPAMIDE $2.00712293 HALLS COUGH DROPS $0.80712294 DEXLANSOPRAZOLE $24.90712295 DILTIAZEM $5.00712296 DEXLANSOPRAZOLE $33.90712297 ROFLUMILAST $43.30712299 BENZOYL $60.80712300 POVIDONE IODINE $37.00712302 PANCRELIPASE $22.20712303 COENZYME $2.80712304 LANSOPRAZOLE $34.40712305 ANAGRELIDE $29.80712306 AMIKACIN $22.10712307 AZELASTINE $581.70712308 PRAZOSIN $5.40712309 ESGIC $5.90712310 BUDESONIDE $56.50712311 LEVOTHYROXINE $4.40712312 MINOCYCLINE $5.10712313 GOLD BOND $16.00712314 ARTIFICIAL $26.80

712316 SEA BOND $0.80712317 SILODOSIN $31.40712318 EPLERENONE $41.00712319 CEVIMELINE $5.80712320 SOFT CONTACT $7.50712322 OMEPRAZOLE $1.90712323 MAGNESIUM $0.80712324 NEVIRAPINE SR $100.80712325 HUMALOG MIX $0.80712326 ITRACONAZOLE $41.70712327 ERGOCALCIFEROL $4.40712328 PALIPERIDONE $141.40712331 FLUTICASONE $83.00712332 ZINC OXIDE $8.00712333 LEVONORGESTREL $482.10712334 DRONABINOL $17.70712335 ORTHO $362.10712336 AMINO ACID/DEX $120.30712337 AMINO ACID/DEX W E $149.60712338 AMINO ACID/DEX INJ $153.40712339 DOCUSATE CALCIUM $0.80712340 PRAZOSIN $6.90712341 METHYLCELLULOSE $0.80712342 DORZOLAMIDE $200.40712343 PYRIDOSTIGMINE $115.20712344 MAGNESIUM $0.80712345 LEVOTHYROXINE $380.10712346 CEFTAROLINE $691.60712347 DIFLORASONE $1,258.00712348 VISIVITES $0.80712349 GALANTAMINE $9.20712350 DARIFENECIN $31.20712351 AZELAIC $1,241.50712352 DICLOFENAC $156.50712353 SODIUM CHLORIDE $57.50712354 CENTRUM $0.80712355 DOFETILIDE $37.40712356 BIOTIN $0.80712357 MOXIFLOXACIN $239.60712358 GANCICLOVIR $1,264.50712359 TOBRAMYCIN $771.70712360 BISOPROLOL $3.60712361 ACTOPLUS MET XR $38.30712362 TERBINAFINE $39.20712363 DRONABINOL $36.80712364 SELEGILINE $258.80712365 SENSITIVE $5.00

712366 FERREX 28 $3.10712367 ZOVIA 1/50E $265.10712368 LIRAGLUTIDE $1,106.10712369 VILAZODONE $32.60712370 LIOTHYRONINE $9.10712371 PILOCARPINE $295.70712372 BEYAZ $755.30712373 MEDROXYPROGESTERONE $0.80712374 THALIDOMIDE $998.60712375 METHSCOPALAMINE $8.30712376 NABUMETONE $3.90712377 JOLESSA $5.30712378 TESTOSTERONE $69.50712379 STALEVO $27.50712380 PRAMIPEXOLE $10.00712381 PIMOZIDE $5.50712382 MOMETASONE $233.50712383 MINOXIDIL $26.00712384 DORNASE ALFA $413.70712385 PANCRELIPASE $16.80712386 DICLOFENAC $44.70712387 METRONIDAZOLE $741.40712388 HEMATOGEN FA $2.00712389 IBANDRONATE $416.20712390 MOMETASONE $266.30712391 TESTOSTERONE $73.90712392 SALICYLIC $22.70712393 STALEVO $27.50712394 CONJUGATED $20.20712395 PROPRANOLOL ER $7.10712396 0.9%NS + 40K $33.90712397 CISATRACURIUM $99.00712398 OCTREOTIDE $357.80712399 OMEPRAZOLE $22.20712400 DULERA $758.70712401 BIOTRUE $24.40712402 MEDROXYPROGESTERONE $293.20712403 ABACAVIR $30.10712404 TIMOLOL $5.10712405 NICOTINE $1.20712406 BENZOYL $741.50712407 BACITRACIN $63.70712409 WITCH HAZEL $19.50712410 MIRTAZAPINE $10.20712411 LORAZEPAM $134.90712412 TEMAZEPAM $2.60712413 FLUDROCORTISONE $2.20

712414 D5%W + 40 MEQ KCL $9.25712415 CEFDINIR $298.50712416 BUMETADINE $1.90712418 TREPROSTINIL $2,124.20712419 GIANVI $303.90712420 MINOCYCLINE $10.20712421 LEVOTHYROXINE $4.40712422 CLIMARA $190.10712423 MEN-PHOR $18.90712424 NISOLDIPINE $49.40712425 SALICYCLIC $50.90712426 ACYCLOVIR $607.90712427 INSULIN PUMP $18,585.00712428 STALEVO $27.50712429 STALEVO $27.50712430 ROTIGOTINE $80.70712431 PROGESTERONE $6.40712433 BUDESONIDE $851.00712434 OLOPATADINE $812.60712435 DONEPEZIL $54.30712436 SILODOSIN $31.40712437 AMLODIPINE/VALSARTAN $16.40712438 FOLGARD $0.80712439 DAPSONE $1,143.30712440 MESALAMINE $15.30712441 INSULIN $306.20712442 INSULIN $402.40712443 LISDEXAMFETAMINE $36.50712444 PROMETHAZINE $0.80712445 TESTOSTERONE $2,010.00712446 ETIDRONATE $25.90712447 MEDROXYPROGESTERONE $1.40712448 TERCONAZOLE $97.90712449 ATOMOXETINE $42.70712450 AZELASTINE $312.20712451 PIOGLITAZONE $16.00712452 TRI-LEGEST FE $171.50712453 DIDANOSINE DR $23.60712454 NAPROXEN $0.80712455 THERATEARS $33.30712456 BENZOYL $59.30712457 BENZOYL $59.30712458 EDARBYCLOR $23.00712459 EDARBYCLOR $23.00712460 SALONPAS $1.80712461 TROLAMINE $14.70712462 FLUOCINONIDE $291.50

712463 TERBUTALINE $16.30712464 ZONISAMIDE $6.60712465 OLOPATADINE $671.90712466 RIVAROXABAN $53.70712467 ISOSORBIDE $1.50712468 INSULIN $0.80712469 PUMP $594.00712470 RASAGILINE $93.90712471 SODIUM CHLORIDE $44.30712472 ARTHROTEC $10.10712473 ROPINIROLE $7.50712474 ROPINIROLE $7.80712475 SOMATROPIN $100.00712476 OCUVITE $0.80712477 RIFAXIMIN $48.10712478 BROMFENAC $867.20712479 BESIFLOXACIN $391.50712480 COLCHICINE/PROBENEC $2.90712481 TROSPIUM SR $20.20712482 SODIUM $27.90712483 CYCLOPHOSPHAMIDE $11.80712484 SIMCOR $11.60712485 MEPIVACAINE $0.80712486 METAXALONE $17.70712487 METYROSINE $1,251.40712488 TIGER BALM $18.00712489 PROBIOTIC $2.60712490 RIVASTIGMINE $82.30712491 PANCRELIPASE $11.20712492 OSTEO BI-FLEX $0.80712493 CALMOSEPTINE $16.55712494 ONDANSETRON $0.80712495 DILTIAZEM $29.80712496 EPINEPHRINE $741.00712497 MINOXIDIL $49.00712498 ESTRADIOL $1,241.20712499 FLUOCINOLONE $668.30712500 FLUOCINOLONE $660.90712501 APIXABAN $26.60712502 TRIMETHOPRIM $2.00712503 ARTIFICIAL $14.20712504 VISINE $23.20712505 ORSYTHIA $3.80712506 DOCUSATE $6.70712507 AXITINIB $904.90712508 OXYMORPHONE SR $25.40712509 OXYMORPHONE $6.10

712510 DEXMETHYLPHENIDATE $23.20712511 FLUOXETINE $16.00712512 LOTEPREDNOL $966.20712513 JALYN $23.80712514 TRINESSA $118.00712515 TACROLIMUS $1,929.60712516 AMLODIPINE/OLMESART $23.50712517 FLUOCINONIDE $714.60712518 SCAR $78.00712519 URSODIOL $22.10712520 TICAGRELOR $22.40712521 DARUNAVIR $202.70712522 SUBOXONE FILMTB 12MG $61.60712523 LACTOBACILLUS $0.80712524 HYDROCORTISONE $436.70712525 LUTEIN $0.80712526 FOOT $14.90712527 PROPYLENE $41.40712528 IPRATROPIUM $1,448.30712529 LUTEIN $0.80712530 RILUZOLE $112.10712531 MESALAMINE $14.00712532 FOLBIC $2.70712533 PANTOTHENIC $0.80712534 MAGNESIUM $0.80712535 DEFERIPRONE $229.10712536 FINASTERIDE $8.10712537 NICOTINE $1.50712538 PANCRELIPASE $5.60712539 POLIDENT $0.80712540 POTASSIUM $13.10712541 GRANULEX $29.10712542 RIFAXIMIN $142.10712543 CIPROFLOXACIN $75.10712544 SODIUM $0.80712545 FROVATRIPTAN $216.80712546 NORETHINDRONE $7.90712547 METHYLPREDNISOLONE $4.30712548 WITCH HAZEL $0.80712549 PREPARATION H $34.70712550 TRI-PREVIFEM $4.20712551 GELFOAM $227.10712552 MEROPENEM $72.00712553 MIRABEQRON $46.10712554 TROSPIUM $8.50712555 LACTOSE $0.80712556 ACEBUTOLOL $4.00

712557 CLEAR CARE $25.60712558 GLUCOSAMINE $0.80712559 ACETAMINOPHEN CR $0.80712560 CLOTRIMAZOLE $224.20712561 METHYLFOLATE $20.10712562 ROTIQOTINE $80.70712563 FENOFIBRATE $20.70712564 METRONIDAZOLE $1,649.60712565 OPCON-A $11.70712566 STOMAHESIVE $27.70712567 CILOSTAZOL $5.50712568 DERMAFIX $18.80712569 FLUTICASONE $436.80712570 MESALAMINE $33.70712571 EXENATIDE ER $427.70712572 TRIAMCINOLONE $36.30712573 VERAPAMIL $21.60712574 DOFETILIDE $37.40712575 CENTRUM $0.80712576 LAMOTRIGINE SR $92.40712577 LAMOTRIGINE SR $138.50712578 SRONYX $3.80712579 D5LR + 20 MEQ KCL $34.70712580 JANUMET XR $27.10712581 LINACLOTIDE $50.90712582 VORICONAZOLE $39.10712583 KETOTIFEN $36.60712584 TADALAFIL $42.70712585 INTERFERON $6,233.20712586 SALICYCLIC ACID 2% $13.60712587 SALICYCLIC ACID 2% $19.60712588 NASAL DILATOR $33.70712589 MINASTRIN $22.80712590 ZOLMITRIPTAN $166.20712591 LOSARTAN $9.20712592 LEVOTHYROXINE $2.40712593 WHEAT DEXTRIN $0.80712595 FENOFIBRATE $7.10712596 DICLOFENAC $24.30712598 IPRATROPIUM 0.03% NA $335.00712599 TUCKS HEMORR OINT $13.10712600 SALICYCLIC ACID 0.5% $16.60712601 SOAP & CLEANSERS $16.00712602 SAXAGLIPTIN/METFORMI $50.40712603 GENERESS FE $21.00712604 COAR TAR 2% OINTMENT $21.60712605 HYALURONATE 20MG/2ML $1,223.70

712606 SOD FLUORIDE 1.1% $22.90712607 THEOPHYLLINE XR 300 $14.40712608 INSULIN PEN NEEDLE $1.50712609 BELLADONN/PHENO $28.00712610 ROSUVASTATIN 40 MG $4.30712611 SIROLIMUS 2 MG TAB $221.00712612 TELMISARTAN 80 MG $31.00712613 CLOBETASOL0.05% FOAM $1,922.30712614 BETAMETH DIP 0.05% L $143.90712615 OMEGA-3 FATTY ACID $0.80712616 CASPOPUNQIN 50 MG $33.84712617 CASPOFUNQIN 70 MG $25.46712618 L-METHYLFOLATE FORTE $12.30712619 SOFOSBUVIR 400 MG $3,600.00712620 RIBAVIRIN 200 MG $24.90712621 ELINEST TABLET $3.30712622 METOPROLOL ER 200 MG $11.30712624 CICLESONIDE 160 MCG $987.10712625 AZITHROMYCIN 1% DROP $742.40712626 MVI 5 ML UD $0.80712627 NUEDEXTA $70.40712628 CHLORHEXIDINE 4% LIQ $2.90712629 CICLOPIROX 1% SHAMPO $280.80712630 MEHTYLCELL POWDER $27.10712631 PANCRELIPASE 36K UNI $33.70712632 NEFAZODONE 150MG $14.60712633 BIOTIN 300 MCG TAB $0.80712634 GILDESS 1.5/30 $22.70712635 GILDESS FE 1.5/30 $3.10712638 FLURANDRENOLIDE $2,090.90712639 HYALURONATE 88MG/4ML $5,132.20712640 DEFERASIROX 500 MG $608.00712641 ROTIGOTINE 8 MG/24HR $80.70712642 REFRESH OPTIVE ADV $26.50712643 VENLAFAXINE ER 150MG $13.70712644 VORTIOXETINE 10 MG $46.00712645 NATEGLINIDE 60 MG $12.90712646 METRONIDAZOLE POWDER $145.40712647 ACYCLOVIR 400 MG TAB $6.50712648 CEFIXIME 200 MG TAB $140.60712649 TIZANIDINE 4 MG TAB $4.40712650 AVEENO LOTION $15.80712651 DIMETHICONE 1.3% LOT $16.60712652 NITROFURANTOIN 100MG $19.80712653 VILAZODONE 10 MG TAB $32.60712654 VILAZODONE 20 MG TAB $32.60712655 CAMRESE TABLET $8.90

712656 PHENYLEPHRINE 2.5% $324.00712657 CARBAMAZEPINE SR 200 $5.90712658 MEMANTINE SR 21 MG $55.80712659 BIOTIN 10 MG TABLET $0.80712660 DEXTROAMPHETAMINE 5M $24.50712661 DEXTROAMPHETA 10 MG $20.60712662 CLORAZEPATE 3.75 MG $6.10712663 ACLIDINIUM 400 MCG $936.00712664 ARIPIPRAZOLE 10 MG $20.47712665 CANAGLIFLOZIN 300 MG $59.30712666 SIMBRINZA $585.80712667 SYEDA TABLET $8.20712668 MENANTINE SR 7 MG $55.80712669 CETYLPYRIDINIUM $14.30712670 FENOFIBRATE MICRO $5.90712671 SEVELAMER CARBONATE $61.00712672 ISOSORBIDE DINITRATE $2.90712673 MEMANTINE SR 28 MG $55.80712674 PRAMIPEXOLE SR 0.375 $71.70712675 PANTOPRAZOLE 20 MG $17.20712676 JUNEL 1/20 TABLET $4.10712677 PRENATAL 0.8 MG TAB $0.80712678 IPRATROPIUM 0.06% $287.10712679 ESTRADIOL 1 MG TAB $19.60712680 ESOMEPRAZOLE 20 MG $30.10712681 LEVETIRALETAM 500MG/ $28.40712682 LEVETIRACETAM 500MG $2.30712683 CIPROFLOXACIN 200MG $43.90712684 CICLESONIDE 80MCG IN $987.10712685 BENZOCAINE 20% GEL $40.90712686 PAROXETINE 10MG/5ML $24.20712687 APRACLONIDINE 0.5% $260.30712688 OLANZAPINE 2.5 MG $42.70712689 PRESERVISION LUTEIN $0.80712690 FLUOCINOLONE 0.01% $540.00712691 MACITENTAN 10 MG TAB $1,158.40712692 MOMETASONE 0.1% CREA $152.90712693 CEFPODOXIME 100 MG $20.20712694 LEVOMILNACIPRAN 80MG $47.10712695 LEVOCETIRIZINE 5 MG $9.20712696 PIRBUTEROL 200 MCG $481.40712697 RANITIDINE 15 MG/ML $2.20712698 MICROGESTIN FE 1/20 $3.10712699 BROMOCRIPTINE 0.8 MG $15.10712700 ACYCLOVIR 800 MG TAB $0.80712701 PRENATAL PLUS PNV $0.80712702 FENTANYL 1000 MCG/20 $3.06

712703 LENALIDOMIDE 25 MG $2,591.30712704 FIXODENT XTRA HOLD $16.60712705 HYDROMORPHONE 0.5MG $9.70712706 FENTANYL INJ 2500/50 $64.10712707 DIPHENHYDRAMINE/ZINC $12.00712708 PRAMOXINE 1% RECTAL $19.40712709 SALICYLIC ACID 2% $11.10712710 TAFLUPROST 0.0015% $25.60712711 PSYLLIUM HUSK FIBER $2.40712712 LEVOMILNACIPRAN 40 M $47.10712713 DEXMEDETOMIDINE $4.40712714 DULOXETINE 60 MG $29.90712715 OCELLA TABLET $8.20712716 LACOSAMIDE 100 MG $51.80712717 GOLD BOND MAX POWDER $9.90712718 WHITE PETROLATUM 5GM $0.80712719 CRANBERRY 500 MG $1.20712720 LINACLOTIDE 145 MCG $50.90712721 HYDROGEN PEROXIDE 3% $0.80712722 PAZOPANIB 200 MG $392.30712723 CALCIUM CITRATE 200 $0.80712724 ARMODAFINIL 250 MG $95.50712725 BIOTENE ORALBALANCE $16.90712726 TRIAMCINOLONE 0.1% $43.70712727 LIDOCAINE/DEXTRISE $16.40712728 MEDROXYPROGESTERONE $1.50712729 PRAMIPEXOLE 0.75 MG $8.80712730 LEFLUNOMIDE 10 MG $18.90712731 SALINE LOCK FLUSH $0.80712732 MELATONIN 5 MG TAB $0.80712733 ABIRATERONE 250 MG $326.60712735 PERMETHRIN 5% CREAM $371.30712736 HYDROCOR/PRAMOX $216.80712737 TESTOSTERONE 30MG/AC $1,858.00712738 FLECAINIDE 50 MG $6.00712739 ARTIFICIAL TEARS 1.4 $16.70712740 BIOTIN 5 MG CAP $0.80712741 TACROLIMUS 0.03% $781.40712742 DIMETHYL FUMARATE DR $468.40712743 IBRUTINIB 140 MG CAP $517.40712744 DAPSONE 250 MG TAB $2.40712745 VORTIOXETINE 5 MG $46.00712746 SCAR TREATMENT GEL $52.20712747 DOXAZOSIN SR 8 MG $11.25712748 DOXAZOSIN SR 4 MG $10.70712749 QUASENSE TABLET $5.30712750 HYOCYAMINE 0.125 MG $2.60

712751 CANAGLIFLOZIN 100 MG $59.30712752 SITAGLIPTIN 25 MG $54.10712753 BENZOYL PEROXIDE 2.5 $37.20712754 ROTIGOTINE 4 MG PATC $80.70712755 MELOXICAM 15 MG TAB $16.00712756 CARBIDOPA/LEVODOPA $11.50712757 DEXMEDETOMIDE/NS $94.50712758 METHYL SALICYLATE $26.10712759 LEVONORGESTREL 1.5 $109.70712760 PERMETHRIN 1% LOTION $22.50712761 BUPIVACAINE LIPOSOME $1,168.00712762 JUNEL FE 1/20 TABLET $3.10712763 DOXYCLCLINE HYCLATE $125.60712764 SALICYCLIC ACID 2% W $18.20712765 MILNACIPRAN 25 MG $22.90712766 DASATINIB 50 MG TAB $911.30712767 TOPIRAMATE SR 200 MG $121.50712768 FISH OIL 1200 MG CAP $0.80712769 GLYCOPYRROLATE 2 MG $6.60712770 SALICYCLIC 0.5% PAD $11.60712771 AMOXICILLIN 500 MG $1.30712772 INFLUENZA QUAD VACC $128.50712773 INFLUENZA HIGH DOSE $337.10712774 METHIMAZOLE 10 MG $2.30712775 FLUTICASONE/VILANTER $487.10712776 FLUTICASONE/VILANTER $1,264.50712777 VIORELE TABLET $6.40712778 FLUTICASONE HFA 44 $673.90712779 HYDROGEN PEROXIDE $12.20712780 REPAGLINIDE 1 MG $28.50712781 MEMANTINE SR 14 MG $55.80712782 FLUNISOLIDE HFA 80MC $564.60712783 GELUSIL CHEW TAB $0.80712784 FLUNISOLIDE 0.025% $215.80712785 LOSEASONIQUE TAB $8.90712786 IMIQUIMOD 5% CREAM $55.20712787 PODOPHYLLUM 25% $367.50712788 ROTIGOTINE 1 MG/24 $80.70712789 ENZALUTAMIDE 40 MG $346.40712790 STRIBILD $389.00712791 MELATONIN 3 MG TAB $0.80712792 CARVEDILOL CR 20 MG $24.50712793 RANITIDINE 75 MG TAB $0.80712794 RILPIVIRINE 25 MG TA $133.80712795 ETODOLAC 400 MG TAB $5.50712796 COMPLERA TAB $337.40712797 EVEROLIMUS 5 MG TAB $1,493.80

712798 SENNA 176 MG/5ML $0.80712799 GOLD BOND XTRA STR $10.30712800 LUTEIN 40 MG CAP $2.90712801 SAXAGLIPTIN/METFORMI $25.20712802 BUDESONIDE 0.25MG/2M $31.40712803 DOCOSANOL 10% CREAM $55.70712804 NORETHINDRONE 0.35 M $3.90712805 L-METHYL-MC-TAB $8.80712806 SACUBITRIL/VALSARTAN $30.50712807 BECLOMETHASONE 80 MC $0.80712808 MEXILETINE 250 MG $10.50712809 DIVALPROEX DR 125MG $6.40712810 TIOTROPIUM/OLODATERO $1,431.60712811 ANAGRELIDE 1 MG $72.20712812 NEPAFENAC 0.3% OPH $990.30712813 FENTANYL PCA $66.70712814 BIMATOPROST 0.01% $709.10712815 ARMOUR THYROID 90MG $4.20712816 BROMFENAC SOD 0.07% $960.00712817 PITAVASTATIN 2 MG $35.50712818 UMECLIDINIUM/VILANT $354.40712819 LENALIDOMIDE 5 MG $2,591.30712820 MORPHINE SULFATE (PF $7.60712821 CLOBETASOL PROPRIONA $1,558.50712822 AMMONIUM LACTATE 12% $61.50712823 HYDROMORPHONE PF INJ $372.60712824 CAMPHOR/EUCA/MENTHOL $13.70712825 MORPHINE INJ 4 MG/ML $6.80712826 DEXMEDETOMIDINE $441.00712827 CEFAZOLIN 2 GM IVPB $10.30712828 OLMESARTAN/HCTZ $26.40712829 METANX CAPSULE $10.10712830 HYDROCORTISONE 1% LO $20.70712831 METHYLPREDNISOLONE $4.30712832 TABLET CUTTER $15.30712833 LURASIDONE 80 MG TAB $146.80712835 QUETIAPINE 50 MG $19.70712836 ELUXADOLINE 75 MG $75.30712837 DROXIDOPA 200 MG $207.50712838 DROXIDOPA 100 MG $103.80712839 PRESERVISION AERDS $0.80712840 COCOA BUTTER LOTION $11.90712841 ESTRADIOL 0.05MG/HR $69.60712842 NORTREL 1/35 - 28 DA $3.20712843 ISOTRETINOIN 40 MG $84.70712844 CARBAMAZEPINE SR TAB $12.10712845 ARMOUR THYROID 15 MG $2.30

712846 ARMOUR THYROID 180 M $4.10712847 TOPIRAMATE 15 MG $7.20712848 ARANELLE TABLET $4.20712850 ACET INFANT SUSP $2.70712851 DALBAVANCIN INJ 500 $55.25712853 YASMIN 28 TABLET $8.20712854 HYDROCORTISONE VAL $268.60712855 POVIDONE-IODINE 10% $21.50712856 TOLTERODINE SR 4 MG $28.60712857 ALPRAZOLAM 1 MG $3.50712858 NIACIN ER 100 MG TAB $0.80712859 COENZYME Q10 30 MG $1.20712860 TOFACITINIB 5 MG TAB $268.80712861 SACUBITRIL/VALSARTAN $30.50712862 SACUBITRIL/VALSARTAN $30.50712863 PRIMIDONE 250 MG TAB $1.50712864 DAPAGLIFLOZIN 5 MG $59.10712865 DAPAGLIFLOZIN 10 MG $59.10712866 METHYLPHENIDATE SR $32.20712867 MEMANTINE/DONEPEZIL $55.50712868 MEMANTINE/DONEPEZIL $55.50712869 ROCURONIUM INJ 50MG/ $105.00712870 AMPHET SALT CPD XR $25.60712871 ARIPIPRAZOLE ER INJ $10.57712872 PRASUGREL 5 MG TAB $55.10712873 HAIR/SKIN/NAIL TAB $0.80712874 FLECAINIDE 100 MG $10.70712875 CARBO/LEVO CR 23.75 $11.50712876 BREXPIPRAZOLE 3 MG $139.80712877 ARIPIPRAZOLE ER $10.57712878 ARIPIPRAZOLE ER INJ $10.57712879 SUGAMMADEX INJ $359.10712880 DESOXIMETASONE 0.05% $187.30712881 DESOXIMETASONE 0.25% $174.80712882 GALANTAMINE SR 16 MG $18.30712883 TROPICAMIDE 1% OPHTH $30.00712884 SILVER ALGINATE $27.00712885 THYROID 32.5 MG TAB $0.80712886 DENTAL ADHESIVE PLUS $13.10712887 BARIUM SULFATE 2.1% $10.60712888 LIDOCAINE-MPF 2% $10.30712889 BUDESONIDE NASAL $57.30712890 OLODATEROL 2.5 MCG $762.60712891 RIBAVIRIN 200 MG CAP $14.10712892 ELBASVIR/GRAZOPREVIR $936.00712893 UMECLIDINIUM 62.5 $254.60712894 MOMETASONE 0.1% $171.10

712895 PENICILLIN VK 500 MG $3.50712896 DULAGLUTIDE INJ $570.35712897 BUTAL/ASA/CAFF $19.50712898 FERREX 150 PLUS $3.80712899 LENALIDOMIDE 10 MG $2,591.30712900 METHYLPHENIDATE ER $16.80712901 TAB-O-VITE $0.80712902 PRESERVISION AREDS 2 $0.80712903 CANAGLIFLOZIN/MET $29.60712904 FLUOXETINE 20 MG/5ML $14.70712905 MORPHINE 250 MG/10 M $1.02712906 TRIAMCINOLONE OPTH $13.54712907 HYDROCORTISONE $33.00712908 INSULIN GLARGINE $466.40712909 DOXYCYCLINE 20 MG $2.30712910 SOFT CONTACT SOLN $8.30712911 MORPHINE SULF POWDER $0.80712912 ROPINIROLE 5 MG $7.80712913 SOD CHLOR 0.45 GM $1.80712914 BACLOFEN POWDER $0.80712915 BUPIVACAINE POWDER $0.80712916 FENTANYL POWDER $17.50712917 SODIUM CHLORIDE COMP $1.50712918 STERILE WATER INJ $0.80712919 HYDROMORPHONE POWDER $1.30712920 CLONIDINE POWDER $612.00712921 ARTIFICIAL TEAR OINT $11.60712923 CARBOXYMETHYLCELLULO $20.60712924 BUTALBITAL/ACETA $4.70712925 ZIPRASIDONE(BRAND) $69.20712926 FOOT CARE PRODUCT $12.00712927 NAPHAZOLINE/GLYCERIN $12.30712928 MICAFUNGIN INJ $6.73712929 METHYLPHENIDATE ER $33.60712930 NALOXEGOL OXALATE $42.60712931 PHENYL/COCOA BUTTER $1.40712932 A.E.R. WITCH HAZEL $7.40712933 DOLUTEGRAVIR 50 MG $208.80712934 ETRAVIRINE 200 MG $81.40712935 ALLEGRA D 12 HOUR $7.30712936 TIOTROPIUM 2.5 MCG $1,546.10712938 COENZYME Q10 50 MG $0.80712939 COENZYME Q10 100MG $1.40712940 PIMAVANSERIN 17 MG $166.70712941 CARBIDOPA/LEVODOPA C $9.10712942 ORPHENADRINE SR $7.00712943 LISINOPRIL 20 MG TAB $3.20

712944 ALTAVERA TABLET $3.30712945 BLISOVI FE 1.5/30 $3.10712946 LEVOMILNACIPRAN SR $47.10712947 BREXPIPRAZOLE 2 MG $139.80712948 FLAXSEED OIL 1000 MG $0.80712949 ALPHA-LIPOIC ACID $0.80712950 ARIPIPRAZOLE ER INJ $20.47712951 ACARBOSE 50 MG TAB $2.90712952 SOD HYALURONATE 16.8 $7.39712953 LYSINE 500 MG CAP $0.80712954 VIEKIRA PAK $892.70712955 LIDOCAINE 1%-10 ML $7.60712956 NIFEDIPINE ER 90 MG $8.70712957 RHO D IMMUNE GLOBULI $199.10712958 MEROPENEM 500 MG INJ $21.60712959 VASOPRESSIN INJ $602.10712960 BROMFENAC 0.075% $972.00712961 LORATADINE/PSEUDO $3.80712962 B COMPLEX/C/FOLIC $1.30712963 NIFEDIPINE ER 90 MG $7.70712964 TERCONAZOLE 0.4% $155.20712965 FLUCONAZOLE 150 MG $40.80712966 OXYCODONE IR 20 MG $3.30712967 OXYCODONE ER 40 MG $29.70712968 ZINC 50 MG TABLET $0.80712969 BUPROPRION XL 450 $53.60712970 L-METHYLFOLATE $8.60712971 ALVIMOPAN 12 MG CAP $594.30712972 MENTHOL/ZINC OXIDE $15.10712973 METHYLPHENIDATE ER $32.90712974 MELATONIN 1 MG CAP $0.80712975 CYCLOSPORINE 100 MG $41.90712976 SALICYLIC ACID/UREA $14.40712977 BUPROPION ER 300 MG $14.30712978 TRIUMEQ TABLET $346.70712979 THYROID 65 MG TABLET $1.40712980 MINOXIDIL 2% TOP SOL $58.20712981 PROPRANOLOL ER 160MG $11.70712982 DROXIDOPA 300 MG CAP $311.30712983 THROMBIN EPISTAXIS $276.70712984 FLUVOXAMINE 100 MG $18.90712985 THROMBIN SPRAY KIT $263.60712986 LEDIPASVIR/SOFOSBUVI $4,050.00712987 TRICALM HYDROGEL $27.00712988 MIBELAS 24 FE 1/20 $17.90712989 CLINDAMYCIN 100 MG $211.00712990 PEG 3350 BULK $28.60

712991 FILGRASTIN-SNDZ $987.70712992 CEFPODOXIME 200 MG $18.80712993 CIPROFLOXACIN 0.2% $25.10712994 DOXYCYCLINE 25MG/5ML $68.30712995 HEPATITIS B VACCINE $211.80712996 RIBOFLAVIN 100 MG TA $0.80712997 LITHIUM ER 300 MG TA $1.40712998 SUPREP BOWEL PREP $174.50712999 LACTASE 3000 UNIT $0.80713000 POLYMYXIN/TRIMETHOPR $273.80713001 GABAPENTIN ER 300 MG $46.60713002 GLATIRAMER 40 MG INJ $0.80713003 MIRABEGRON ER 50MG $46.10713004 VANCOMYCIN ORAL SOLN $8.90713005 AZELASTINE/FLUTICASO $675.40713006 PREDNISONE DR $316.00713007 TRI-ESTARYLLA TAB $4.20713008 LEFLUNOMIDE 20 MG $147.50713009 POLYETHYLENE GLYCOL $27.00713010 CROMOLYN 4% OPTHAL $111.60713011 GUANFACINE 2 MG TAB $4.70713012 MESALAMINE DR 800 MG $23.30713013 PIPERACILLIN/TAZ 4.5 $46.80713014 DIMETHICONE 1.2% GEL $17.50713015 ALYACAN 1/35 TABLET $9.10713016 MAVYRET 100/40 MG TA $565.70713017 ARTIFICIAL TEAR $26.00713018 WOUND DRESSING GEL $54.40713019 CHLORZOXAZONE 500 MG $3.20713020 ALOGLIPTIN 25 MG $46.30713021 OLMESARTAN MEDOXOMIL $15.40713022 DIAZEPAM INJ 50MG/10 $131.30713023 LANSOPRAZOLE 30 MG $17.00713024 ALOGLIPTIN/METFORMIN $23.10713025 CLONIDINE HCL 0.3MG/ $553.40713026 MINOCYCLINE 50 MG TA $10.30713027 TAPENTADOL ER 100 MG $45.60713028 TIOTROPIUM 1.25 MCG/ $1,546.10713029 HYDROCORTISONE 2.5% $43.80713030 HONEY WOUND DRESSING $55.00713031 IXAZOMIB 2.3 MG $12,110.40713032 NALOXONE NASAL $0.80713033 OSELTAMIVIR 6 MG/ML $8.20713034 PSYLLIUM PACKET $1.30713035 CEFEPIME INJ 2 GM $36.00713036 TACROLIMUS ER 1 MG $17.00713037 TACROLIMUS ER 5 MG $84.80

713038 LIDOCAINE 5% OINT $950.00713039 OSELTAMIVIR 30 MG $42.50713040 VANCOMYCIN ORAL SUSP $16.40713041 RISPERIDONE 0.25MG $35.20713042 CARIPRAZINE 1.5 MG $144.10713043 LIQUID FIBER $0.80713044 METHYLPHENIDATE 18MG $28.00713045 PANCRELIPASE 25,000 $26.70713046 DASETTA 7/7/7 TAB $3.90713047 ARFORMOTEROL 15 MCG/ $61.80713048 BECLOMETHASONE HFA $864.90713049 PAMPRIM TABLET $0.80713050 DESOGEN $3.90713051 ARIPIPRAZOLE 1MG/ML $21.20713052 MVI + MINERALS LIQUI $1.50713053 BREXIPIPRAZOLE 0.5 $139.80713054 CICLOPIROX 8% SOLN $505.70713055 PAROXETINE CR 37.5MG $18.00713056 METRONIDAZOLE 0.75% $458.50713057 BETRIXABAN 40 MG $54.00713058 CALCIPOTRIEINE 0.005 $1,085.70713059 CYANOCOBALAMIN 5000 $0.80713060 POMALIDOMIDE 1 MG $2,949.70713061 ZOLPIDEM CR 6.25 MG $27.50713062 CONIVAPTAN INJ 20 MG $2,456.80713063 DIAZEPAM RECTAL GEL $1,092.20713064 TOPIRAMATE 200 MG $1.30713065 LEVETIRACETAM 750 MG $12.80713066 LEVETIRACETAM 250 MG $10.30713067 LEVETIRACETAM 1000 $24.40713068 DIPHENHYDRAMINE $0.80713069 GLYCOPYRROLATE/FORM $1,315.20713070 GABAPENTIN ER $46.60713071 NITROGLYCERIN 0.4% $2,306.70713072 CICLOPIROX 0.77% $153.30713073 GENVOYA $370.80713074 CYRED TABLET $3.80713075 PANCRELIPASE 10,000 $12.10713076 PSYLLIUM 0.52 GM $0.80713077 MIDAZOLAM INJ 5 MG/M $4.30713078 OLOPATADINE 0.7% $701.00713079 ARIPIPRAZOLE ER675MG $10.57713080 ARIPIPRAZOLE ER $10.57713081 OXYBUTYNIN ER 15MG $19.20713082 ARMOUR THYROID 120 M $7.40713083 CRANBERRY $0.80713084 AMPHETAMINE SALT $5.10

713085 NEFAZODONE 200 MG $14.90713086 PAROXETINE CR 25MG $19.60713087 BABY WIPES $12.00713088 SILDENAFIL 25 MG $254.60713089 SOLIFENACIN 10 MG $46.30713090 GALANTAMINE 8 MG $19.20713091 AMINO ACID 5/DEX20 $141.10713092 AA 5%/DEX 20%+E INJ $142.40713093 FLUVASTATIN 40 MG $15.00713094 FENOFIBRATE 50 MG $9.80713095 FLUTICASONE/UMECLID $915.80713096 DICLOFENAC POTASSIIU $272.20713097 BICTEGRAVIR/EMTICI $370.80713098 XYLITOL 550 MG DISK $0.80713099 ALENDRONATE 70 MG/75 $171.70713100 DESMOPRESSIN 0.1 MG $9.10713101 AMILORIDE/HCTZ 5/50M $3.50713102 PLECANATIDE 3 MG $49.40713103 ARTIFICIAL TEARS OIN $11.65713104 ABEMACICLIB 150 MG $754.20713105 AMIKACIN INJ 500 MG $44.10713106 FE FUMARATE W B12/VI $1.30713107 SOFT CONTACT LENS $19.10713108 LIDO/PHENYL 1/1.5% $86.90713109 ALBENDAZOLE 200 MG $873.60713110 DORZOLAMIDE/TIMOLOL $8.50713111 NORGESTIMATE/ESTRADI $4.20713112 VALBENAZINE 80 MG $776.90713113 MOMETASONE HFA 200 $809.60713114 CLOMIPHENE 50 MG $20.80713115 NETARSUDIL 0.02% $898.60713116 LIOTHYRONINE 10 MCG/ $1,386.00713117 TIMOLOL GEL FORMING $653.20713118 FOLIC ACID 400 MCG $0.80713119 K-PHOS NEUTRAL $2.50713120 RIFAMUTIN 150 MG $52.50713121 EMTRICITABINE/TENOFO $210.90713122 BUPRENORPHINE/NALOXO $62.20713123 DOXYCYCLINE HYCLATE $6.80713124 BALSAM PERU/CASTOR O $59.50713125 CLINDAMYCIN 2% $391.00713126 DOXYCYCLINE MONO $7.70713127 GALANTAMINE ER 8MG $38.40713128 SPIRONOLACTONE 100 M $4.30713129 BUPRENORPHINE 8 MG $37.60713130 ESTRADIO VALERATE $432.90713131 PIMECROLIMUS 1% $1,076.60

713132 ESTROGENS/METHYLTEST $14.40713133 ROPINIROLE ER 8 MG $53.20713134 VITAMIN E OIL $13.10713135 COAL TAR SHAMPOO $15.10713136 PSYLLIUM POWDER $57.30713137 CALCIUM/VITAMIN D $0.80713138 HYDROCOR VAL 0.2% OI $715.80713139 TRIAMCINOLONE ACE $249.10713140 SELEGILINE TD 6MG $197.90713141 ETONOGES/ESTRA $585.50713142 BENOZOCAINE/MENTHOL $16.30713143 POTASSIUM CITRATE $7.40713144 DABIGATRAN 110 MG $26.00713145 BUDESONIDE 90 MCG $635.50713146 RIOCIGUAT 1.5 MG $413.50713147 SITAGLIPTIN/METFORMI $27.10713148 CARBOXYMETHYL CELL $28.40713149 ESKETAMINE 28MG/DEV $1,062.00713150 NORGESTIMATE/ESTRA $4.90713151 ESKETAMINE 28MG/DEV $1,062.00713152 HYPROMELLOSE 0.3% $30.60713153 ICOSAPENT $9.10713154 BREXPIPRAZOLE 1 MG $139.80713155 SERTRALINE 20 MG/ML $3.30713156 INSULIN LISPRO $84.07713157 METHOHEXITAL INJ $101.55713158 MIDAZOLAM $81.40721472 ARTHROTEC $7.70721773 INFLUENZA HIGH DOSE $232.40

4040001 LVL II GRSS-MCRO EXM $105.704040002 LVL III GRS-MCRO EXM $132.104040003 PATH CNSLT DRNG SURG $2.054040004 PATH CNSLT FRZN SCTN $273.054040005 EACH ADDL FRZN SCTN $105.704040006 SLD PREP, CNSLT-RPT $246.604040007 CYTPTH-BDY FLD-CNCTR $126.754040008 FNA-SUPERFICIAL TISS $281.804040009 FNA-DP TSS, RAD GUID $308.104040010 FNA-IMMED EVAL/ADQCY $202.604040011 BLD MRW-SMEAR INTRP $153.204040012 BN MARROW-NDL BIOPSY $220.154040013 BLD BNK-AUTH NONSTND $220.154040014 IHC AB EA ADL P SPEC $368.254040015 IHC INIT SING AB PRO $434.404040016 IHC P SPEC EA MUL ST $293.254240002 INJECT, KNEE $176.154240003 ARTHROGRAM, HIP $542.50

4240004 INJ, HIP ARTHRO $176.154240005 ARTHROGRAM, ANKLE $612.604240006 INJECT, ANKLE ARTHRO $176.154240007 MAMMO, DX - UNILAT $264.204240009 MAMMO, SCREENING $352.204240010 HIP 1 VIEW C PELVIS $335.154240011 HIP BILAT 2 VW C PEL $528.354240012 DISKOGRAP CERV OR T $2,151.804240013 DISKOGRAPHY, LUMBAR $2,151.804240014 DISKOGR THOR/CERV $2,151.804240017 VERTEBRAL FX ASSESSM $222.854310001 MRA BRAIN WO CNTRST $4,148.204400003 CPAP $660.404430001 SWALLOW EVALUATION $414.759999999 NO CHARGE REFERRAL $0.00