EHS-Active Charge Master-1-24-20...EHS-Active Charge Master-1-24-20 ... &0

Charge # Description Rev CodeCPT/ HCPCS

Charge Amt Status

42000001 (TRANSCUTAN) NEUROSTIM 420 64550 $ 299.94 ACTIVE

250006800.45% NS 1000ML W/20MEQ (1/2 NS-20MEQ POT CHL 1000ML)

258 J7030 $ 30.00 ACTIVE

250002580.9% SODIUM CHLORIDE 3ML PREFILLED SALINE FLUSH SYRINGE

250 A4216 $ 14.00 ACTIVE

30100129 1 25-DIHYDROXYVITAMIN D 301 82652 $ 513.36 ACTIVE

27200001 10 FRENCH SHEATH 15-716B 272 C1894 $ 212.80 ACTIVE

2580000510% LMD IN 5% DEXTROSE 500ML / DEXTRAN 40 IN DEXTROSE INJ 500ML

258 J7060 $ 280.00 ACTIVE

2580000610% LMD IN 5%DEXTROSE 500ML/DE

258 J7060 $ 322.00 ACTIVE

30100216 17-KETOSTEROIDS TOTAL 301 83586 $ 170.64 ACTIVE

272001994.0MM ACROMIOBLASTER 7205668

272 A4649 $ 140.00 ACTIVE

272008874FR INT KIT MINI GW-POUCH/SHEATH

272 A4649 $ 112.00 ACTIVE

272008455.5MM PEDIPORT W/ LOCKING TROCAR

272 C1751 $ 1,376.88 ACTIVE

27200180 5FR POLLACK CATHETER 272 A4649 $ 32.46 ACTIVE

30100201 5-HYDROXYINDOLEACETIC ACID 301 83497 $ 171.96 ACTIVE

25901724 A&D ONINTMENT 2OZ 270 A6250 $ 64.00 ACTIVE

63600003 ABBOKINASE 5MU VIAL 636 J3365 $ 15,755.60 ACTIVE

32000001 ABD AORTAGRAM 320 75625 $ 6,708.00 ACTIVE

48100087ABD AORTAGRAM - NON SELECTIVE

481 75625 $ 6,708.00 ACTIVE

48100086ABD AORTAGRAM W/ BILATERAL RUNOFF

481 75630 $ 8,306.00 ACTIVE

32000002 ABD W/RUN OFFS 320 75630 $ 8,306.00 ACTIVE

27000561 ABDOMINAL BINDER UNIV 270 L0625 $ 500.00 ACTIVE

27000524 ABDOMINAL PAD 270 A4649 $ 3.10 ACTIVE

36000190ABDOMINAL PARACENTESIS (DIAGNOSTIC OR THERAPEUTIC); WITH IMAGING GUIDANCE

360 49083 $ 3,403.00 ACTIVE

36000189ABDOMINAL PARACENTESIS (DIAGNOSTIC OR THERAPEUTIC); WITHOUT IMAGING GUIDANCE

360 49082 $ 3,403.00 ACTIVE

48100114ABLATION OF ADDITIONAL MECHANISM OF SVT OR VT

481 93655 $ 48,028.75 ACTIVE

32000053 ABSCSS FIST SIN TRACT 320 76080 $ 2,656.50 ACTIVE

27000756 ACE WRAP 6" 270 A6449 $ 34.10 ACTIVE

25000011 ACETADOTE 20% INJECTION 250 J0132 $ 28.00 ACTIVE

25900029 ACETAMINOPH 160MG/5ML LIQ 259 J3490 $ 30.00 ACTIVE

25000029 ACETAMINOPHEN 1000MG IV 250 J0131 $ 59.00 ACTIVE

25900031 ACETAMINOPHEN 120MG SUPP. 250 J8498 45 ACTIVE

25900032 ACETAMINOPHEN 325MG SUPP. 250 J8498 45 ACTIVE

25900033 ACETAMINOPHEN 325MG TAB 250 A9150 $ 30.00 ACTIVE

25900030 ACETAMINOPHEN 500 MG TAB 250 J0131 $ 30.00 ACTIVE

25700002ACETAMINOPHEN 500MG TAB (MAPAP ES)

250 A9150 $ 30.00 ACTIVE

25900034 ACETAMINOPHEN 650MG SUPP 250 J8498 $ 45.00 ACTIVE

Charge Master List


Charge Amt Status

Charge Master List

25700001ACETAMINOPHEN SUSP. 160MG/5ML PRECISIONDOSE

250 A9150 $ 30.00 ACTIVE

25900036 ACETAMINOPHEN W/COD #4 250 J8499 $ 14.00 ACTIVE

25901937ACETAMINOPHEN/CODEINE 120-12MG/5ML ORAL SOL

250 J3490 $ 45.00 ACTIVE

30100003 ACETONE BLOOD 301 82010 $ 108.96 ACTIVE

30100004 ACETONE SERUM QUALITATIVE 301 82009 $ 60.24 ACTIVE

30700001 ACETONE URINE NON AUTO 307 81002 $ 41.76 ACTIVE

30100005ACETYLCHOLINE RECEPTOR ANTIBODY

301 84238 $ 341.32 ACTIVE

25901933ACETYLCYSTEINE (MUCOMYST) 10% INH 100MG 30ML VIAL

250 J7608 $ 112.00 ACTIVE

25900041 ACETYLCYSTEINE 10PC 250 J7608 $ 202.00 ACTIVE

25900773 ACETYLCYSTEINE 20% 30ML 250 J7608 $ 184.50 ACTIVE

30100296 ACID PHOSPHATASE (TOTAL) 301 84060 $ 98.52 ACTIVE

30600085ACID-FAST BACILLUS SMEAR & FUNGAL STAIN

306 87206 $ 71.88 ACTIVE

30600001ACID-FAST BACILLUS SMEAR AND CULTURE

306 87116 $ 144.00 ACTIVE

32000054ACROMIOCLAVICULAR AC JOINTS W/WO WEIGHTS - 2 VIEW

320 73050 $ 818.52 ACTIVE

25901306ACTIDOSE WITH SORBITAL 50GM 240ML

250 J3490 $ 338.00 ACTIVE

30500002 ACTIVATED CLOTTING TIME 305 85347 $ 56.76 ACTIVE

30100007 ACUTE HEPATITIS PANEL 301 80074 $ 635.16 ACTIVE

27200883 ACUTRAK2 7.5 LONG DRILL 270 C1713 $ 9,315.00 ACTIVE

27000584 ADAPTER CATHETER 270 A4300 $ 52.00 ACTIVE

27000637 ADAPTER VALVE LL 270 A4649 $ 132.00 ACTIVE

32000003 ADD PERIPH S&I ADD FAMILY 320 75964 $ 4,945.92 ACTIVE

32000004 ADD VIS S&I 320 75968 $ 4,945.92 ACTIVE

48100112 ADDITIONAL A FIB ABLATIONS 481 93657 $ 41,671.40 ACTIVE

25400001 ADENOSINE 90MG/30ML VIAL 636 J0153 $ 710.10 ACTIVE

30200005 ADENOVIRUS ANTIBODY 302 86603 $ 171.60 ACTIVE

36000366

ADJACENT TISSUE TRANSFER OR REARRANGEMENT, ANY AREA; DEFECT 30.1 SQ CM TO 60.0 SQ CM

360 14301 $ 45,499.50 ACTIVE

42000004 ADL TRAIN EA 15 450 97535 $ 251.16 ACTIVE

77100001 ADMIN HEPATITIS B VACCNE 771 G0010 $ 144.90 ACTIVE

77100002 ADMIN INFLUENZA VACCINE 771 G0008 $ 411.96 ACTIVE

77100003ADMIN PNEUMOCOCCAL VACCNE

771 G0009 $ 277.88 ACTIVE

30100006ADRENOCORTICOTROPIC HORMONE

301 82024 $ 363.86 ACTIVE

25900058 ADVAIR DISKUS 250/50 250 J3535 $ 2,040.00 ACTIVE

25900059 ADVAIR DISKUS 500/50 250 J3535 $ 2,680.00 ACTIVE

25900061 ADVIL 200MG TABLET 250 A9150 $ 30.00 ACTIVE

25901316 ADVIL SUSP. 100MG/5ML 4 OZ 250 A9150 $ 30.00 ACTIVE

27000761 AERO CHAMBER 270 A4627 $ 13.50 ACTIVE

25900064 AFRIN 0.05 PC SPRY 15ML 250 J3490 $ 46.00 ACTIVE

30900019 AG DETECT NOS IA MULT 306 87449 $ 44.40 ACTIVE

30600064 AGENT NOS ASSAY W/OPTIC 306 87899 $ 192.84 ACTIVE

27000015 AIRWAY NASAL 28FR (11267) 270 A7034 $ 100.00 ACTIVE



Charge Amt Status

Charge Master List


27200813 AIRWAYS NASAL (ALL) 272 A7034 $ 336.00 ACTIVE

27200812 AIRWAYS ORAL (ALL) 272 A7044 $ 204.00 ACTIVE

30100022 ALANINE AMINOTRANSFERASE 301 84460 $ 70.68 ACTIVE

30100011 ALBUMIN (SERUM) 301 82040 $ 66.00 ACTIVE

30100010 ALBUMIN (URINE) 301 82042 $ 93.36 ACTIVE

25900071ALBUTEROL (MCR) INHALER UNIT DOSE 1MG

250 J7609 $ 446.00 ACTIVE

25901201ALBUTEROL (VENTOLIN) INHALR 90MCG/ACT INH

250 J7613 $ 592.50 ACTIVE

25000032ALBUTEROL INH 0.5% 2.5MG 0.5ML VIAL

250 J7613 $ 32.50 ACTIVE

25900072ALBUTEROL SULFATE 0.083% 3ML-NEBULIZER

250 J7613 $ 30.00 ACTIVE

25901774ALBUTEROL UP TO 2.5MG & IPRATROPIUM BROMIDE UP TO 0.5MG

259 J7620 $ 24.00 ACTIVE

25901319ALBUTEROL/IPRABROMIDE 0.5-3MG/3ML

250 J7620 $ 82.50 ACTIVE

30100632 ALCOHOL (ETHANOL) 301 80320 $ 112.80 ACTIVE

27000754ALCOHOL ISOPROPYL 70% 4OZ BTL

250 A4244 $ 5.25 ACTIVE

27000755ALCOHOL, ISOPROPYL 70% 16OZ (473ML) BTL

250 A4244 $ 5.25 ACTIVE

30000013 ALDOLASE 301 82085 $ 129.48 ACTIVE

30100015 ALDOSTERONE 301 82088 $ 392.84 ACTIVE

30100017 ALKALINE PHOSPHATASE 301 84075 $ 69.00 ACTIVE

30100016ALKALINE PHOSPHATASE ISOENZYMES

301 84080 $ 197.16 ACTIVE

30600002ALL POTASSIUM HYDROXIDE (KOH) PREPARATIONS

306 Q0112 $ 69.78 ACTIVE

30200174ALLERGEN SPECIFIC IGE QUANTITATIVE/SEMIQUANTITATIVE

302 86003 $ 69.60 ACTIVE

30100574 ALLERGY SKIN TEST 301 95028 $ 222.74 ACTIVE

25900083 ALLOPURINOL 100MG TAB 250 J8499 $ 16.00 ACTIVE

30100019 ALPHA-1-ANTITRYPSIN (TOTAL) 301 82103 $ 179.16 ACTIVE

30000041ALPHA-FETOPROTEIN AMNIOTIC FLUID

301 82106 $ 223.68 ACTIVE

30100009ALPHA-FETOPROTEIN TUMOR MARKER

301 82105 $ 223.68 ACTIVE

25901234ALPRAZOLAM (XANAX) 0.5MG TAB

250 J8499 $ 30.00 ACTIVE

25900086 ALPRAZOLAM .25MG TAB 250 J8499 $ 24.00 ACTIVE

25900087 ALPRAZOLAM 0.5MG TAB 250 J8499 $ 44.00 ACTIVE

25901854 ALPRAZOLAM 1MG TAB 250 J8499 $ 45.00 ACTIVE

30100021 ALPRAZOLMAM-XANAX 301 80299 $ 223.68 ACTIVE

63600025ALTEPLASE (CATHFLO ACTIVASE) 2MG VIAL

636 J2997 $ 813.80 ACTIVE

25900094 AMBIEN 10 MG TAB 250 J8499 $ 57.00 ACTIVE

25900095 AMBIEN 5MG TAB 250 J8499 $ 57.00 ACTIVE

27000587 AMBU BAG 270 S8999 $ 400.00 ACTIVE

30100023 AMIKACIN 301 80150 $ 201.00 ACTIVE

30100024AMINO ACIDS MX QUALITATE EACH SPECIMEN

301 82128 $ 184.92 ACTIVE

30100025AMINOLEVULINIC ACID DELTA (ALA)

301 82135 $ 219.36 ACTIVE


Charge Amt Status

Charge Master List

25000875AMIODARONE 150MG (50MG/3ML) 3ML SDVIAL

636 J0282 $ 70.00 ACTIVE

63600149 AMIODARONE 360MG/200ML IV 636 J0282 $ 93.36 ACTIVE

63600150 AMIODARONE 450MG/9ML VIAL 636 J0282 $ 9.66 ACTIVE

63600151 AMIODARONE 900MG/18ML 636 J0282 $ 34.00 ACTIVE

25900306AMIODARONE CORDARONE 200MG TABLET

250 J8499 $ 54.00 ACTIVE

25901419AMITRIPTYLINE (ELAVIL) 10MG TABS

250 J8499 $ 18.40 ACTIVE

25901420AMITRIPTYLINE (ELAVIL) 25MG TABS

250 J8499 $ 30.00 ACTIVE

25900843AMLODIPINE (NORVASC) 5 MG TAB

250 J8499 $ 52.00 ACTIVE

25900105 AMLODIPINE 10MG TAB 250 J8499 $ 68.00 ACTIVE

30100028 AMMONIA 301 82140 $ 194.28 ACTIVE

25900107 AMMONIA INHALANT 250 J7699 $ 32.00 ACTIVE

27000696 AMNIOFIX PARTICULATE 40MG 250 C1762 $ 2,902.00 ACTIVE

25901323AMOXICILLIN (AMOXIL) 125MG/5ML OS

259 J8499 $ 96.60 ACTIVE

25900145AMOXICILLIN + CLAVULANATE POTASSIUM (AUGMENTIN) 875 MG TAB

259 J8499 $ 94.50 ACTIVE

25901946AMOXICILLIN +CLAVULANATE 400MG 5ML OS

250 J3490 $ 24.00 ACTIVE

25901322 AMOXICILLIN 250 MG. CAP. 250 J8499 $ 24.00 ACTIVE

25901855 AMOXICILLIN 250MG/5ML 150ML 250 J8499 $ 24.00 ACTIVE



25100039 AMOXICILLIN 500MG CAP 259 J8499 $ 24.00 ACTIVE

25900143AMOXICILLIN+CLAV POTAS (AUGMENTIN) 500/125MG TAB

250 J8499 $ 76.50 ACTIVE

25901324 AMOXIL 250MG/5ML 100ML 250 J8499 $ 228.00 ACTIVE

30100029 AMPHETAMINE 301 82145 $ 183.54 ACTIVE

63600185 AMPICILLIN 250MG VIAL 636 J0290 $ 33.68 ACTIVE

63600190 AMPICILLIN/SULBACTAM 1.5GM 636 J0290 $ 33.68 ACTIVE

63600191 AMPICILLIN/SULBACTAM 3GM 636 J0290 $ 33.68 ACTIVE

30100031AMPLICATION OF PATIENT NUCLEIC ACID

301 83900 $ 379.96 ACTIVE

36000238

AMPUTATION FINGER/THUMB ANY JOINT/PHALAN SINGLE INCLUDING NEURECTOMIES W/DIRECT CLOSURE

360 26951 $ 33,190.50 ACTIVE

36000298AMPUTATION, TOE; INTERPHALANGEAL JOINT

360 28825 $ 18,346.50 ACTIVE

30100032 AMYLASE 301 82150 $ 86.40 ACTIVE

30100071 ANABOLIC STEROIDS; 1 OR 2 301 80327 $ 40.20 ACTIVE

30100059 ANALGESICS NON-OPIOID 1-2 301 80329 $ 221.28 ACTIVE

30100114 ANALGESICS, NON-OPIOID; 3-5 301 80330 $ 221.28 ACTIVE

25000003 ANCEF 1GRM 50ML IV 636 J0690 $ 12.24 ACTIVE

30100038 ANDROSTENEDIONE 301 82157 $ 267.26 ACTIVE

37100001

ANESTHESIA FOR CARDIAC CATHETERIZATION INCLUDING CORONARY ANGIOGRAPHY AND VENTRICULOGRAPHY

371 1920 $ 3,814.48 ACTIVE


Charge Amt Status

Charge Master List

37000008

ANESTHESIA FOR NERVES/MUSCLES/TENDONS/FASCIA/BURSAE OF UPPER ARM/ELBOW; TENODESIS

370 1716 $ 2,416.00 ACTIVE

32000006 ANGIO BI-LAT CAROTID 320 75680 $ 14,808.78 ACTIVE

32000007ANGIO BI-LAT CAROTID/CEREBRAL

320 75671 $ 14,808.78 ACTIVE

27200007 ANGIO CATH 3.5 X 20MM 272 C1725 $ 21.50 ACTIVE

27200660 ANGIO JET 150ML 272 C1757 $ 339.00 ACTIVE

36000016ANGIO JET A-V GRAFT THROMBECTO

360 36870 $ 1,287.00 ACTIVE

32300014ANGIO THROUGH EXISTING CATHETER

323 75898 $ 3,794.08 ACTIVE

32000008 ANGIO UNI-LAT CAROTID 320 75676 $ 14,808.78 ACTIVE

32000009ANGIO UNI-LAT CAROTID/CEREBRAL

320 75665 $ 14,808.78 ACTIVE

32300010 ANGIOG PUMONARY BIL SEL 323 75743 $ 18,890.70 ACTIVE

27200702ANGIOPLASTY HEMOSTASIS VALVE

272 A4649 $ 282.50 ACTIVE

30100039ANGIOTENSIN I CONVERTING ENZYME

301 82164 $ 194.64 ACTIVE

32000056 ANKLE 2 VIEWS 320 73600 $ 1,300.00 ACTIVE

32000055 ANKLE 3V OR MORE 320 73610 $ 1,505.00 ACTIVE

32200001 ANKLE ARTHROGRAPHY 322 73615 $ 2,618.56 ACTIVE

27400007ANKLE WALKER, MAXTRAX W/AIR LG

270 L4360 $ 596.10 ACTIVE

27800030 ANS CHARGING SYSTEM 270 C1820 $ 8,553.02 ACTIVE

27800799 ANS PATIENT PROGRAMMER 270 L8681 $ 21.50 ACTIVE

27800797ANS STIMULATOR CHARGING SYSTEM

270 L8689 $ 35.95 ACTIVE

30200013ANTI MITOCHONDRIAL ANTIBODY

302 86256 $ 160.68 ACTIVE

30200017 ANTI PLATELET ANTIBODIES 302 86023 $ 166.08 ACTIVE

30600003ANTIBIOTIC SENSITIVE MICROTITER MINIMUM INHIBITORY CONCENTRATION

306 87186 $ 115.32 ACTIVE

30000001ANTIBODY HERPES SIMPLEX NON SPECIFIC TYPE TEST

302 86694 $ 191.88 ACTIVE

30200004 ANTIBODY IDENTIFICATION 302 86870 $ 260.82 ACTIVE

30200008ANTIBODY IDENTIFICATION; LEUKOCYTE ANTIBODIES

302 86021 $ 55.77 ACTIVE

30000002ANTIBODY LYMPHOCYTIC CHORIOMENINGITIS VIRUS

300 86727 $ 171.60 ACTIVE

30200026ANTIBODY SCREEN RED BLOOD CELLS EACH SERUM TECHNIQUE

302 86850 $ 117.24 ACTIVE

30000003 ANTIBODY WEST NILE VIRUS 302 86789 $ 191.88 ACTIVE

30000004ANTIBODY WEST NILE VIRUS (IMMUNOGLOBIN-M)

302 86788 $ 224.64 ACTIVE

30100547 ANTIBODY; ACTINOMYCES 302 86602 $ 37.68 ACTIVE

30200006ANTIGEN SCREEN WITH REAGENT SERUM/UNIT

302 86905 $ 51.00 ACTIVE

30100040 ANTI-HISTONE ANTIBODY 301 83516 $ 153.72 ACTIVE

30200027ANTIHUMAN GLOBULIN TEST (COOMBS TEST) DIRECT EACH ANTISERUM

302 86880 $ 71.88 ACTIVE

30200014ANTINUCLEAR ANTIBODY TEST (ANA)

302 86038 $ 161.16 ACTIVE

30200015 ANTINUCLEAR ANTIBODY TITER 302 86039 $ 148.80 ACTIVE


Charge Amt Status

Charge Master List

30200029

ANTI-SACCHAROMYCES CEREVISIAE ANTIBODIES IMMUNOGLOBIN-G/IMMUNOGLOBIN-A (FUNGAL

302 86671 $ 163.44 ACTIVE

30200028 ANTISTREPTOLYSIN-O SCREEN 302 86063 $ 76.92 ACTIVE

30200032 ANTISTREPTOLYSIN-O TITER 302 86060 $ 97.32 ACTIVE

30500003 ANTITHROMBIN III ANTIGEN 305 85301 $ 144.12 ACTIVE

25900112ANUCORT (HEMORR W/ HC SUPP) R/S

250 J8498 $ 49.50 ACTIVE

27200183 ANVIL GRASPER 10AG 272 A4649 $ 2,389.86 ACTIVE

27200856 AO DRILL BIT 3.5 272 A4649 $ 1,946.00 ACTIVE

32000010 AORTIC ARCH 320 75650 $ 14,808.78 ACTIVE

27200189 AORTIC CANNULA 24FR L211024 272 A4649 $ 64.00 ACTIVE

48100061 AORTIC ROOT INJECTION 481 93567 $ 1,600.34 ACTIVE

44000001 APHASIA ASSESSMENT 1 HOUR 440 96105 $ 1,062.60 ACTIVE

76100002APLIGRAF APPL OF PRODUCT ADDL 25 SQ CM

761 15341 $ 3,620.74 ACTIVE

76100003APLIGRAF APPLICATION OF PRODUCT INITIAL

761 15340 $ 3,620.74 ACTIVE

42000005 APLY FINGER SPLNT STAT 450 29130 $ 769.78 ACTIVE

42000007 APLY SHRT ARM SPLT DYN 450 29126 $ 769.78 ACTIVE

30100042 APOLIPOPROTEIN A 301 82172 $ 253.08 ACTIVE

36000333

APP OF SKIN SUBSTITUTE GRAFT, TOTAL WOUND SURFACE AREA UP TO 100SQCM; FIRST 25SQCM OR < WOUND SURFACE AREA

360 15275 $ 4,950.00 ACTIVE

36000063APPENDECTOMY RUPTURED APPENDIX W/ ABSCESS OR GENERALIZED PERITONITIS

360 44960 $ 27,417.90 ACTIVE

45000133APPLICATION OF SHORT ARM SPLINT (FOREARM TO HAND)STATIC

450 29125 $ 2,052.00 ACTIVE

36000293APPLICATION OF SHORT LEG CAST (BELOW KNEE TO TOES)

360 29405 $ 1,405.90 ACTIVE

45000141APPLICATION, FINGER SPLINT; STATIC

450 29130 $ 550.00 ACTIVE

45000142APPLICATION, LONG LEG SPLINT (THIGH TO ANKLE/TOES)

450 29505 $ 500.00 ACTIVE

27200691 APPLICATOR MALLEABLE 272 A4649 $ 847.50 ACTIVE

27200744APPLIER CLIP SURGICLIP M-9.75 AUTO BLUE

272 A4649 $ 565.00 ACTIVE

42000008 APPLY DENIS-BROWNE SPL 450 29590 $ 769.78 ACTIVE

42000009 APPLY FINGER SPLNT DYN 450 29131 $ 769.78 ACTIVE

42000010 APPLY LONG ARM SPLINT 450 29105 $ 769.78 ACTIVE

42000011 APPLY LONG LEG SPLINT 450 29505 $ 769.78 ACTIVE

42000012 APPLY SHORT LEG SPLINT 450 29515 $ 769.78 ACTIVE

27000020 AQUACEL RIBBON 3/4 X 18 270 A6197 $ 280.00 ACTIVE

27000769 AQUAGEL 270 A6196 $ 12.50 ACTIVE

42000013 AQUATIC EXERCISE EA 15 450 97113 $ 206.08 ACTIVE

25900118 ARICEPT 5 MG TAB 250 J8499 $ 136.50 ACTIVE

30100044 ARSENIC 301 82175 $ 252.96 ACTIVE

30100427 ART PUNC WITHDRAW BLD DX 410 36600 $ 904.50 ACTIVE

92100001 ARTERIAL 1-LEV/BI-LATERAL 921 93922 $ 1,200.50 ACTIVE


Charge Amt Status

Charge Master List

27200008ARTHERECTOMY SILVERHAWK DS

272 C1714 $ 16,223.90 ACTIVE

27200615ARTHREX ARTHROSCOPY PUMP TUBING

272 A7002 $ 662.00 ACTIVE

27200673 ARTHREX CANNULA 272 C1713 $ 1,695.00 ACTIVE

45000086

ARTHROCENTESIS ASPIRATION INJ INTERMEDIATE JOINT/BURSA (TEMPOROMANDIBULAR/ACROMIOCLAVICULAR/WRIST/ELBOW/ANKLE) W/O US GUID

450 20605 $ 1,944.00 ACTIVE

36100015

ARTHROCENTESIS ASPIRATION/INJECTION MAJOR JOINT/BURSA (SHOULDER HIP KNEE SUBACROMIAL BURSA) W/O US GUIDANCE

361 20610 $ 2,410.00 ACTIVE

45000087

ARTHROCENTESIS ASPIRATION/INJECTION SMALL JOINT/BURSA (FINGERS/TOES) W/O US GUIDANCE

450 20600 $ 1,836.00 ACTIVE

45000131

ARTHROCENTESIS, ASPIRATION/INJECTION, MAJOR JOINT/BURSA (SHOULDER/HIP/KNEE/SUBAC BURSA); W/O US GUIDE

450 20610 $ 2,394.00 ACTIVE

36000329ARTHRODESIS, ANKLE, OPEN PROCEDURE

360 27870 $ 53,351.50 ACTIVE

36000347ARTHRODESIS, GREAT TOE; METATARSOPHALANGEAL JOINT

360 28750 $ 29,201.00 ACTIVE

36000354

ARTHRODESIS, MIDTARSAL OR TARSOMETATARSAL, MULTIPLE OR TRANSVERSE; WITH OSTEOTOMY (EG, FLATFOOT CORRECTION)

360 28735 $ 40,553.50 ACTIVE

36000307ARTHRODESIS, TIBIOFIBULAR JOINT, PROXIMAL OR DISTAL

360 27871 $ 33,695.00 ACTIVE

36000353 ARTHRODESIS; SUBTALAR 360 28725 $ 40,373.50 ACTIVE

36000017

ARTHROPLASTY ACETABULAR AND PROXIMAL FEMORAL PROSTHETIC REPLACE(TOTAL HIP ARTHROPLASTY) W/OR W/O AUTOGRAFT OR ALLOGRAFT

360 27130 $ 14,112.80 ACTIVE

36000050

ARTHROPLASTY KNEE CONDYLE, PLATEAU MEDIAL, & LATERAL COMPARTMENTS W/OR W/O PATELLA RESURFACING (TOTAL KNEE ARTHROPLASTY)

360 27447 $ 70,730.50 ACTIVE

36000092

ARTHROSCOPY KNEE REMOVAL OF FB (OSTEOCHONDRITIS DISSECANS FRAGMENTATION CHONDRAL FRAGMENTA

360 29874 $ 27,957.00 ACTIVE

36000231

ARTHROSCOPY KNEE W/ MENISCECTOMY (MEDIAL & LATERAL)INC SHAVING/DEBRID/CHONDROPLASTY

360 29880 $ 29,260.00 ACTIVE


Charge Amt Status

Charge Master List

36000061ARTHROSCOPY SHOULDER W/ROTATOR CUFF REPAIR

360 29827 $ 54,989.00 ACTIVE

36100011ARTHROSCOPY SHOULDER; REPAIR OF SLAP LESION

361 29807 $ 53,946.50 ACTIVE

36000375

ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOINTS), SURGICAL; SYNOVECTOMY, PARTIAL

360 29895 $ 23,343.00 ACTIVE

36000320

ARTHROSCOPY, ANKLE (TIBIOTALAR/FIBULOTALAR JOINTS), SURG; DEBRIDEMENT, EXTENSIVE

360 29898 $ 29,159.50 ACTIVE

36000321

ARTHROSCOPY, ANKLE, EXCISION OF OSTEOCHONDRAL DEFECT OF TALUS/TIBIA, INCL DRILLING OF THE DEFECT

360 29891 $ 34,793.50 ACTIVE

36000271

ARTHROSCOPY, KNEE W/MENIS (MED OR LAT) INC DEB SHAVING/ARTICULAR (CHONDROP)

360 29881 $ 25,381.00 ACTIVE

36000186

ARTHROSCOPY, KNEE, DEBRIDEMENT/SHAVING OF ARTICULAR CARTILAGE (CHONDROPLASTY)

360 29877 $ 32,336.00 ACTIVE

36000256

ARTHROSCOPY, SHOULDER DECOMP OF SUBACROMIAL W/PARTIAL ACROMIOPLASTY & CORACOACROMIAL LIGAMENT

360 29826 $ 9,226.50 ACTIVE

36000255

ARTHROSCOPY, SHOULDER DISTAL CLAVICULECTOMY INC ARTICULAR SURFACE (MUMFORD PROCEDURE)

360 29824 $ 34,681.50 ACTIVE

36000261ARTHROSCOPY, SHOULDER, SURGICAL; DEBRIDEMENT, LIMITED

360 29822 $ 29,499.50 ACTIVE

36000326ARTHROSCOPY, SUBTALAR JOINT, SURGICAL; W/DEBRIDEMENT

360 29906 $ 36,071.50 ACTIVE

36000292ARTHROTOMY ANKLE, INC EXPLORATION, DRAINAGE, OR REMOVAL OF FB

360 27610 $ 15,528.80 ACTIVE

36000291

ARTHROTOMY W/EXPLORATION,DRAINAGE,REMOVAL OF LOOSE OR FB;INTERTARSAL OR TARSOMETATARSAL JOINT

360 28020 $ 18,698.00 ACTIVE

36000327

ARTHROTOMY W/EXPLORATION/DRAINAGE/REMOVAL OF FB; INTERPHALANGEAL JOINT, EA.

360 26080 $ 20,178.00 ACTIVE

36000373

ARTHROTOMY, WITH EXPLORATION, DRAINAGE, OR REMOVAL OF LOOSE OR FOREIGN BODY; METACARPOPHALANGEAL JOINT, EACH

360 26075 $ 16,464.50 ACTIVE

30100046ASCORBIC ACID OR VITAMIN C (BLOOD)

301 82180 $ 131.76 ACTIVE

36000105 ASP/INJ THYROID CYST 360 60300 $ 2,830.36 ACTIVE


Charge Amt Status

Charge Master List

30100047ASPARTATE AMINOTRANSFERASE

301 84450 $ 69.00 ACTIVE

30200033 ASPERGILLUS ANTIBODY 302 86606 $ 200.76 ACTIVE

27000001ASPIRATION CATHETER (MEDTRONIC VASCULAR)

270 C1887 $ 2,674.00 ACTIVE

25900128 ASPIRIN 325MG TAB 250 G8598 $ 24.00 ACTIVE

25900130 ASPIRIN 81 MG COATED 250 A9150 $ 8.00 ACTIVE

25901334 ASPIRIN BABY 81MG TAB 250 A9150 $ 24.00 ACTIVE

30100440 ASSAY OF SELENIUM 301 84255 $ 94.56 ACTIVE

30100623 ASSAY OF SIALIC ACID 301 84275 $ 179.16 ACTIVE

30100206 ASSAY OF SOMATOMEDIN 301 84305 $ 78.75 ACTIVE

30600100 ASSAY TEST FOR BLOOD FECAL 300 82274 $ 56.00 ACTIVE

25000055 ATROPINE 0.4MG/ML AMP 636 J0461 $ 70.00 ACTIVE

25900139 ATROPINE 1% OPHTH SOL 15 ML 250 J7636 $ 92.00 ACTIVE

25900140ATROVENT 0.02% 2.5ML UNIT DOSE VIAL

250 J7644 $ 20.00 ACTIVE

25901346 AURALGAN OTIC GTTS 10ML 250 J3490 $ 280.50 ACTIVE

30200034AUTOLOGOUS BLOOD OR COMPONENT

302 86890 $ 689.08 ACTIVE

30500017AUTOMATED COMPLETE BLOOD COUNT (CBC)

305 85027 $ 86.16 ACTIVE

30100438 AUTOMATED SEDIMENT RATE 305 85652 $ 36.00 ACTIVE

25900155 AVITENE 1GM JAR 250 J8499 $ 1,881.40 ACTIVE

45000044AVULSION OF NAIL PLATE PARTIAL OR COMPLETE SIMPLE SINGLE

450 11730 $ 2,862.00 ACTIVE

25000872 AZITHROMYCIN 250 Q0144 $ 62.78 ACTIVE

25000004 AZITHROMYCIN 200MG/5ML 15ML 250 J0456 $ 62.78 ACTIVE

30100048 B TYPE NATRIURETIC PEPTIDE 301 83880 $ 471.12 ACTIVE

25900161 BACITRACIN 500U/GM 3.5GM 250 J3490 $ 69.00 ACTIVE

25901953BACITRACIN 500UN 14GM TOP OINTMENT

250 J3490 $ 24.00 ACTIVE

25901957BACITRACIN ZINC +POLYMYXIN B OPHTH OINMT

250 J3490 $ 12.50 ACTIVE

25900672BACLOFEN (LIORESAL) 10MG TABLET

259 J8499 $ 24.00 ACTIVE

30100600BACTERIAL VAGINOSIS SIGLIDASE

306 87905 $ 45.24 ACTIVE

25900165 BACTERIOSTATC H2O 30ML VL 250 A4216 $ 14.00 ACTIVE

25900166 BACTROBAN 2% 15GM CREAM 250 A4216 $ 360.00 ACTIVE

25900169 BACTROBAN NASL2% 1GM OINT 250 A6250 $ 92.00 ACTIVE

27000023 BAG BEDI URINE (16398) 270 A4357 $ 16.00 ACTIVE

27000477 BAG COLOSTOMY 270 A5061 $ 508.00 ACTIVE

27000632 BAG DECANTER 270 A4649 $ 116.00 ACTIVE

27200013 BAG DECANTERS 272 A4649 $ 16.00 ACTIVE

27200635BAG DISPOSABLE 1400 ML RELIEF VALVE/SPIKE

272 A4357 $ 447.00 ACTIVE

27000024 BAG DRAINAGE URINE 270 A4357 $ 22.00 ACTIVE

27000025 BAG FOLEY DRAIN 270 A4358 $ 500.00 ACTIVE

27200773 BAG ICE LARGE 272 A9270 $ 35.40 ACTIVE

27000026 BAG URINEMETER W FOLEY 270 A4358 $ 428.00 ACTIVE

27000027 BAG URINEMETER W/O FOLEY 270 A4358 $ 232.00 ACTIVE

27000029BAG UROLOGY COLLECTION CF505406

270 A4358 $ 570.00 ACTIVE


Charge Amt Status

Charge Master List

27000028 BAG UROLOGY DRAIN CF507505 270 A4358 $ 428.00 ACTIVE

27200914BAG, BANDED W/RUBBER BAND & TAPE 101CMX101CM

272 A4649 $ 28.80 ACTIVE

27000746BAG, PAT DRWSTRNG 20X20X4 WHT

270 A9270 $ 2.40 ACTIVE

27000030 BANDAGE ACE 2 270 A6448 $ 21.90 ACTIVE




27000530 BANDAGE COBAN 6'' 270 A6455 $ 116.00 ACTIVE

27000036 BANDAGE ELASTIC 2 270 A6448 $ 20.00 ACTIVE

27000522 BANDAGE ESMARK ALL 270 A6413 $ 120.00 ACTIVE

27000037 BANDAGE KERLIX 270 A6446 $ 72.00 ACTIVE

27000038 BANDAGE KLING 2IN (10572) 270 A6446 $ 16.00 ACTIVE

27000039 BANDAGE KLING 3" 270 A6446 $ 48.00 ACTIVE

27000040 BANDAGE KLING 4"""" 270 A6446 $ 28.00 ACTIVE

27000041 BANDAGE KLING ALL 270 A6446 $ 24.00 ACTIVE

27900050 BANDAGE REG ALL SIZES 272 A6413 $ 9.60 ACTIVE

27000042 BANDAGE STERI STRIP 1/2X4 270 A4450 $ 44.00 ACTIVE

27000770 BANDAGE STRECH 3X75 270 A6446 $ 9.00 ACTIVE

27200899 BANDAGE, COBAN ELAS TAN 1 272 A6453 $ 9.00 ACTIVE

30100049 BARBITURATES (NESDONAL) 301 82205 $ 170.66 ACTIVE

32000057 BARIUM ENEMA W/WO KUB 320 74270 $ 7,187.00 ACTIVE

25901858BARIUM SULFATE BERRY SMOOTHIE 2.1%/2.0% CONTRAST 450ML OS

250 J8499 $ 8.08 ACTIVE

30200035BARTONELLA HENSELAE ANTIBODY (IMMUNOGLOBIN-G)

302 86611 $ 135.72 ACTIVE

30100602 B-CELL TOTAL COUNT 302 86355 $ 139.74 ACTIVE

27000558 BEDPANS, FRACTURE 271 E0276 $ 382.32 ACTIVE

51000009BEHAVIORAL WEIGHT LOSS-3 MONTHS

510 G0447 $ 1,320.00 ACTIVE

51000010BEHAVIORAL WEIGHT LOSS-6 MONTHS

510 G0447 $ 3,080.00 ACTIVE

25901956BELLADONNA EARACHE DROPS 10ML OTIC SOLN

250 J3490 $ 12.50 ACTIVE

27000771BELT STRAP SLEEVE GARMENT OR COVERING ANY TYPE

270 A4467 $ 28.25 ACTIVE

25900174 BENADRYL 12.5MG/5ML ELIX 250 Q0163 $ 14.00 ACTIVE

25900175 BENADRYL 25MG CAPSULE 250 Q0163 $ 24.00 ACTIVE

25900179 BENICAR 20MG TAB 250 J8499 $ 27.00 ACTIVE

25000579 BENTYL 20MG/2ML 636 J0500 $ 14.26 ACTIVE

25901859 BENZOCAINE 20% SPRAY 250 J8499 $ 5.15 ACTIVE

25901948 BENZOCAINE 6MG LOZENGE 250 J8499 $ 5.25 ACTIVE

30000005BETA 2 GLYCOPROTEIN I ANTIBODY (IMMUNOGLOBIN-A)

302 86146 $ 64.24 ACTIVE

30100054 BETA-2 MICROGLOBULIN 301 82232 $ 215.64 ACTIVE

25900187 BETADINE ANTSPT SOL 10%24 259 A4246 $ 30.00 ACTIVE

25901355 BICITRA 30ML 250 J3490 $ 24.00 ACTIVE

25900197 BICITRA SUGAR FREE SOL 15 ML 250 J8499 $ 14.50 ACTIVE

32000011 BI-LAT EXTREMITY U/L S&I 320 75716 $ 8,984.00 ACTIVE

30100055 BILE ACIDS (TOTAL) 301 82239 $ 228.36 ACTIVE

32000058 BILE STONE EXTRACTION 320 74327 $ 2,701.74 ACTIVE

36000142 BILI DCT STNE REM PRQ 360 47544 $ 18,766.04 ACTIVE


Charge Amt Status

Charge Master List

32000059 BILI DRN PRC 320 75980 $ 4,303.60 ACTIVE

36000018BILI ENDOSCOP PERQ T TUBE W/DIL STRICT W/ST

360 47556 $ 12,793.98 ACTIVE

30100056 BILIRUBIN DIRECT 301 82248 $ 66.84 ACTIVE

30100058 BILIRUBIN TOTAL 301 82247 $ 66.84 ACTIVE

27000043 BINDER ABDOMINAL LG (16241) 270 L0625 $ 176.00 ACTIVE

27000044 BINDER ABDOMINAL MED (16242) 270 L0625 $ 176.00 ACTIVE

27000045 BINDER ABDOMINAL XLG (16273) 270 L0625 $ 336.00 ACTIVE

27000046BINDER ABDOMINAL XXLG (16274)

270 L0625 $ 336.00 ACTIVE

25901860BIOFLEXOR PAIN REL TOP GEL 2.25OZ JAR

250 J8499 $ 5.25 ACTIVE

36000126BIOPSY ABDOMINAL OR RETROPERITONEAL MASS, PERCUTANEOUS NEEDLE

360 49180 $ 4,318.02 ACTIVE

36000127BIOPSY BREAST PERCUT NEEDLE CORE NOT USING IMAGING GUIDANCE

360 19100 $ 3,316.60 ACTIVE

36000108 BIOPSY LIVR NDL W/MJR PRO 360 47001 $ 5,600.00 ACTIVE

36000109 BIOPSY LUNG MEDIASTNM 360 32405 $ 6,106.58 ACTIVE

36000107BIOPSY OF LIVER, NEEDLE; PERCUTANEOUS

360 47000 $ 6,106.58 ACTIVE

40200055BIOPSY OR EXCISION OF LYMPH NODES

360 38505 $ 5,203.17 ACTIVE

36000102BIOPSY PROSTATE NEEDL/PUNCH SIN/MUTIPLE

360 55700 $ 6,880.00 ACTIVE

36000149 BIOPSY SOFT TISS NEC THOR 360 21550 $ 6,229.66 ACTIVE

36000308

BIOPSY SOFT TISSUE OF LEG/ANKLE AREA; DEEP (SUBFASCIAL OR INTRAMUSCULAR)

360 27614 $ 20,195.00 ACTIVE

36000110 BIOPSY SPIN CORD PERQ NDL 360 62269 $ 6,106.52 ACTIVE

36000356BIOPSY, BONE, OPEN; DEEP (EG, HUMERAL SHAFT, ISCHIUM, FEMORAL SHAFT)

360 20245 $ 18,306.00 ACTIVE

25900198 BISACODYL 10MG SUPP 250 J8498 $ 8.00 ACTIVE

25900199 BISACODYL 5MG TAB 250 J8499 $ 8.00 ACTIVE

27200196 BIT DRILL 2.5MM 310.25 272 C1713 $ 888.00 ACTIVE

27000739 BIT DRILL 2.6MMX70MM 270 C1713 $ 3,190.00 ACTIVE

27200625 BIT DRILL HELIX NUVASIVE 272 C1713 $ 6,090.00 ACTIVE

27200558 BITE BLOCK 272 A4649 $ 128.00 ACTIVE

25400003 BIVALIRUDIN 250MG VIAL 636 J0583 $ 162.08 ACTIVE

27200200BLADE 4.0 AGGRESSIVE PLUS 375-544-000

272 A4649 $ 684.00 ACTIVE

27000641 BLADE CLIPPER SURG DISP 272 A4649 $ 128.00 ACTIVE

27200649 BLADE FULL RADIUS 5.5MM 272 A4550 $ 3,129.00 ACTIVE

27200648 BLADE INCISOR 4.5MM 272 A4649 $ 140.00 ACTIVE

27200911 BLADE MICRO DUAL CUT 272 A4649 $ 824.70 ACTIVE

27200688 BLADE MYRINGOTOMY 272 A4649 $ 847.50 ACTIVE

27200826 BLADE SURGICAL (#10 15 & 20) 272 A4649 $ 72.00 ACTIVE

27200647 BLADE TWINFIX 5.0 272 A4649 $ 6,126.00 ACTIVE

27000640BLANKET BAER HUGGER UPPER/LOWER BODY

270 A4467 $ 368.00 ACTIVE

30200040 BLASTOMYCES ANTIBODY 302 86612 $ 172.08 ACTIVE

30100428 BLD GASES W/02 SAT 301 82805 $ 945.24 ACTIVE


Charge Amt Status

Charge Master List

30500006 BLEEDING TIME 305 85002 $ 60.12 ACTIVE

31000002BLOOD BANK SERUM TRANSFUSION REACTION

302 86078 $ 328.92 ACTIVE

27000744BLOOD COLLECTION BLUE TUBE BLD VAC 4.5ML LT BLU

270 A4649 $ 31.00 ACTIVE

27000442BLOOD COLLECTION GREEN TUBE VAC/HEMOGARD PLUS GRN 4ML

270 A4649 $ 27.00 ACTIVE

27000438BLOOD COLLECTION LAVENDER TUBE VAC/HEMOGARD+EDTA LAV 4ML

270 A4649 $ 37.00 ACTIVE

27000440BLOOD COLLECTION TIGER TOP TUBE 8.5ML

270 A4649 $ 57.00 ACTIVE

30000039BLOOD COUNT; AUTOMATED DIFFERENTIAL WBC COUNT

300 85004 $ 86.16 ACTIVE

30600004 BLOOD CULTURE BACTERIAL 306 87040 $ 137.64 ACTIVE

30500005BLOOD SMEAR MICROSCOPIC EXAMINATION WITHOUT MANUAL WBC DIFFERENTIAL

305 85008 $ 45.84 ACTIVE

30500004BLOOD SMEAR WITH MANUAL WHITE BLOOD CELL DIFFERENTIAL

305 85007 $ 45.84 ACTIVE

39000007 BLOOD SPLIT UNIT SPEC AMT 390 P9011 $ 4,356.00 ACTIVE

30200042BLOOD TYPE ANTIGEN SERUM/UNIT

302 86904 $ 196.08 ACTIVE

30200044 BLOOD TYPING ABO 302 86900 $ 39.84 ACTIVE

30200051BLOOD TYPING- RH PHENOTYPING COMPLETE

302 86906 $ 103.22 ACTIVE

30200049 BLOOD TYPING RH-D 302 86901 $ 39.84 ACTIVE

30000037

BLOOD TYPING; ANTIGEN TESTING OF DONOR BLOOD USING REAGENT SERUM, EACH ANTIGEN TEST

302 86902 $ 76.20 ACTIVE

30100060 BLOOD UREA NITROGEN 301 84520 $ 52.68 ACTIVE

30100398BLOOD UREA NITROGEN RANGE (URINE)

301 84540 $ 66.72 ACTIVE

30100001

BLOOD, OCCULT; FECES, CONSECUTIVE COLLECTED SPECIMENS FOR COLORECTAL CANCER SCREEN

301 82270 $ 52.56 ACTIVE

30900016 BODY FLUID PROTEIN 309 84157 $ 48.84 ACTIVE

32000060 BONE AGE STUDIES 320 77072 $ 1,113.00 ACTIVE

36000306BONE GRAFT, ANY DONOR AREA; MAJOR OR LARGE

360 20902 $ 28,934.84 ACTIVE

36000305BONE GRAFT, ANY DONOR AREA; MINOR OR SMALL (EG, DOWEL OR BUTTON)

360 20900 $ 21,639.82 ACTIVE

32000061 BONE LENGTH STUDIES 320 77073 $ 1,745.00 ACTIVE

36000101BONE MARROW BIOPSY ASPIRATION

360 38220 $ 5,203.17 ACTIVE

31000003BONE MARROW SMEAR INTERPRETATION

305 85097 $ 579.60 ACTIVE

27000048 BOOT CALF GARMENT SM-REG 270 L3260 $ 358.00 ACTIVE

27100021 BOOT PODOUS UNIV 271 L4396 $ 1,844.00 ACTIVE

27200906 BOWL, SOLUTION STR 32OZ 272 A4649 $ 21.45 ACTIVE

27000049 BRACE ANKLE LARGE 274 L4350 $ 314.85 ACTIVE

27000050 BRACE ANKLE MEDIUM 274 L4350 $ 304.00 ACTIVE


Charge Amt Status

Charge Master List

27000051 BRACE ANKLE SMALL 274 L4350 $ 304.00 ACTIVE

27000052 BRACE ANKLE SUPPORT XLG 274 L4350 $ 517.00 ACTIVE

27000053 BRACE CLAVICLE LARGE 270 L3650 $ 56.00 ACTIVE

27000054 BRACE CLAVICLE MEDIUM 270 L3650 $ 56.00 ACTIVE

27000055 BRACE CLAVICLE SMALL 270 L3650 $ 56.00 ACTIVE

27000056 BRACE CLAVICLE X LARGE 270 L3650 $ 56.00 ACTIVE

27000057 BRACE CLAVICLE XSMALL 270 L3650 $ 50.00 ACTIVE

32000012 BRACH S&I 320 75962 $ 4,945.92 ACTIVE

31200020BRCA1 GENE FULL DUP/DEL ALYS

312 81166 $ 2,260.13 ACTIVE

31200019 BRCA1 GENE FULL SEQ ALYS 312 81165 $ 2,121.60 ACTIVE

31200022BRCA2 GENE FULL DUP/DEL ALYS

312 81167 $ 2,121.60 ACTIVE

31200021 BRCA2 GENE FULL SEQ ALYS 312 81216 $ 2,221.44 ACTIVE

36000106 BREAST CYST ASPIRATION 360 19000 $ 2,824.30 ACTIVE

25901357 BRETHINE 2.5MG TAB 250 J8499 $ 29.00 ACTIVE

25000675BREVITAL SODIUM (METHOHEXITAL) 500MG VIAL

250 J3490 $ 716.00 ACTIVE

27000583 BRIEF ADULT 270 A4520 $ 52.00 ACTIVE

27000582 BRIEF INFANT/PEDI 270 A4520 $ 52.00 ACTIVE

46000010

BRONCHODILATION RESPONSIVENESS SPIROMETRY PRE&POST-BRONCHODILATOR ADMIN

460 94060 $ 318.24 ACTIVE

30200053BRUCELLA ABORTUS AGGLUTININS

302 86000 $ 93.12 ACTIVE

30200052 BRUCELLA ANTIBODY 302 86622 $ 119.04 ACTIVE

27000007 BUBBLE HUMIDIFIER 270 E0555 $ 38.10 ACTIVE

25901829 BUDESONIDE 0.5MG/2ML SUSP 250 J7634 $ 116.48 ACTIVE

25901929 BUMETANIDE 0.5MG TAB 250 J8499 $ 10.50 ACTIVE

25000005 BUMETANIDE 1MG 250 J3490 $ 8.10 ACTIVE

25200001 BUMEX 1MG TAB 250 J8499 $ 16.00 ACTIVE

25000646BUPIVACAINE (MARCAINE) 0.5% + EPI 50ML

250 J3490 $ 68.00 ACTIVE

25000006BUPIVACAINE (SENSORCAINE) MPF 0.5% 10ML SDVIAL

250 J3490 $ 66.00 ACTIVE

25901960BUPIVACAINE/DW 0.75% SPINAL 2ML AMP

250 J3490 $ 68.00 ACTIVE

25901230BUPROPION (WELLBUTRIN) ER SR 100MG TAB

250 J8499 $ 78.00 ACTIVE

27200559BUR 4.0MM BARREL 6-FLUTE 375-941-000

272 A4649 $ 724.00 ACTIVE

27200910BURR 4.0MM OVAL SOLID CARBIDE MEDIUM

272 A4649 $ 180.00 ACTIVE

27200666 BURR/BLADE 272 A4649 $ 678.00 ACTIVE

25900206 BUSPAR 10MG TABLET 250 J8499 $ 37.50 ACTIVE

63600153 BUTORPHANOL 1MG/1ML VIAL 636 J0595 $ 11.98 ACTIVE

36000104 C OR T ADD LEVEL 360 64472 $ 3,986.36 ACTIVE

30100061 C- PEPTIDE 301 84681 $ 277.56 ACTIVE

32000064 CA SCREEN BARIUM ENEMA 320 G0120 $ 5,209.96 ACTIVE

32000065 CALCANEOUS 2V OR MORE 320 73650 $ 888.00 ACTIVE

30100063 CALCITONIN (SERUM) 301 82308 $ 357.24 ACTIVE

30100065 CALCIUM (SERUM) 301 82310 $ 67.76 ACTIVE

25901167CALCIUM CARBONATE (TUMS) CHEW ES 750MG TAB

250 J8499 $ 16.00 ACTIVE

25800096CALCIUM CHLORIDE 10% 1G (100MG/ML) 10ML ABJT SYG

250 J3490 $ 72.70 ACTIVE


Charge Amt Status

Charge Master List

25800097CALCIUM GLUCONATE 10% (100MG/ML) 10ML SDVIAL

258 J0610 $ 25.23 ACTIVE

30100064 CALCIUM IONIZED 301 82330 $ 182.40 ACTIVE

30200099CALIFORNIA EQUINE ENCEPHALITIS

302 86651 $ 48.84 ACTIVE

30200061 CANCER ANTIGEN 125 302 86304 $ 277.56 ACTIVE

30200059 CANCER ANTIGEN 15-3 302 86300 $ 277.56 ACTIVE

30200062 CANCER ANTIGEN 19.9 302 86301 $ 277.56 ACTIVE

30200064 CANDIDA ANTIBODY 302 86628 $ 160.08 ACTIVE

31000004 CANDIDA DNA DIR PROBE 310 87480 $ 111.40 ACTIVE

27100020 CANNISTER SUCTION 271 A7000 $ 76.00 ACTIVE

27000635 CANNULA DISP INNER 270 A4623 $ 188.00 ACTIVE

27000692 CANNULA DISP THRD 8.5X72MM 270 A4550 $ 480.00 ACTIVE

27000693 CANNULA DISP THRD 8.5X72MM 270 A4550 $ 480.00 ACTIVE

27100026CANNULA ETCO2 ADULT 7' O2 2 CO2 TUBING F

271 A4615 $ 14.50 ACTIVE

27000668 CANNULA OXYGEN NASAL 7FT 271 A4615 $ 24.00 ACTIVE

27000059 CANNULA TRACH INNER 10 270 A4623 $ 76.00 ACTIVE




27000749 CAP, BOUF LF SB 24" BLU 270 A9270 $ 1.05 ACTIVE

25900224 CARAFATE 1 GM TABLET 250 J8499 $ 24.00 ACTIVE

30100074 CARBAMAZEPINE TOTAL 301 80156 $ 194.16 ACTIVE

30100075CARBOXYHEMOGLOBIN (QUANTITATIVE)

301 82375 $ 164.28 ACTIVE

30100080 CARCINOEMBRYONIC ANTIGEN 301 82378 $ 252.84 ACTIVE

30200065 CARDIOLIPIN ANTIBODY 302 86147 $ 128.80 ACTIVE

34100001 CARDIOLITE 1 DAY PROTOCOL 341 78461 $ 7,752.30 ACTIVE

36000004CARDIOPULMONARY RESUSCITATION

360 92950 $ 1,931.90 ACTIVE

45000146CARDIOPULMONARY RESUSCITATION

450 92950 $ 1,931.90 ACTIVE

48100081CARDIOVERSION, ELECTRICAL CONVERSION OF ARRHYTHMIA; EXTERNAL

481 92960 $ 3,838.12 ACTIVE

25900232 CARDIZEM 30MG TABLET 250 J8499 $ 24.00 ACTIVE

25900238 CARDIZEM CD 300MG CAP 250 J8499 $ 55.20 ACTIVE

25900244 CARISOPRODOL 350MG TABLET 250 J8499 $ 14.00 ACTIVE

27200909 C-ARM DRAPE 41 X 74 INCH 272 A4649 $ 2,442.30 ACTIVE

25900245 CARMEX LIP OINT 7GM 250 A9150 $ 6.00 ACTIVE

30100076 CARNITINE 301 82379 $ 224.88 ACTIVE

30100077 CAROTENE (SERUM) 301 82380 $ 123.00 ACTIVE

48100084CAROTID ANGIOGRAM - UNILATERAL

481 36222 $ 19,621.53 ACTIVE

36000086CARPAL TUNNEL RELEASE MEDIAN NERVE

360 64721 $ 22,128.50 ACTIVE

25900307CARVEDILOL (COREG) 12.5MG TAB

259 J8499 $ 40.00 ACTIVE

27000062 CAST ARM LONG 270 Q4005 $ 140.00 ACTIVE

27000063 CAST ARM SHORT 270 Q4009 $ 68.00 ACTIVE

27000479 CAST BOOT 274 L3260 $ 1,520.00 ACTIVE

27000064 CAST LEG LONG 270 Q4041 $ 143.20 ACTIVE

27000065 CAST LEG SHORT 270 Q4045 $ 60.00 ACTIVE


Charge Amt Status

Charge Master List

27000480 CAST SHOE 274 L3260 $ 500.00 ACTIVE

27000544 CAST SHOE LG 270 L3260 $ 272.00 ACTIVE

27000066CAST SPLINT ONESTP 3""""X12"""

270 A4649 $ 16.00 ACTIVE

27000067 CASTING TAPE 2IN 270 A4649 $ 14.00 ACTIVE




30100078CATECHOLAMINES BLOOD FRACTION

301 82384 $ 193.20 ACTIVE

30100079CATECHOLAMINES TOTAL (URINE)

301 82382 $ 327.60 ACTIVE

27200739CATH 1.5 MM 120MM 150CM 014 PTA DILATATION

272 C1726 $ 1,890.00 ACTIVE


272 C1726 $ 1,890.00 ACTIVE

27200717CATH 1.5MM 20MM 150CM 014 PTA DILATATION

272 C1726 $ 1,890.00 ACTIVE

27200719CATH 2 MM 120MM 150CM 014 PTA DILATATION

272 C1726 $ 1,890.00 ACTIVE


272 C1726 $ 1,890.00 ACTIVE


272 C1726 $ 1,890.00 ACTIVE


272 C1726 $ 1,890.00 ACTIVE


272 C1726 $ 1,890.00 ACTIVE


272 C1726 $ 1,890.00 ACTIVE


272 C1726 $ 1,890.00 ACTIVE


272 C1726 $ 1,890.00 ACTIVE


272 C1726 $ 1,890.00 ACTIVE


272 C1726 $ 1,890.00 ACTIVE


272 C1726 $ 1,890.00 ACTIVE


272 C1726 $ 1,890.00 ACTIVE


272 C1726 $ 1,890.00 ACTIVE


272 C1726 $ 1,890.00 ACTIVE


272 C1726 $ 1,890.00 ACTIVE


272 C1726 $ 1,890.00 ACTIVE


272 C1726 $ 1,890.00 ACTIVE


272 C1726 $ 1,890.00 ACTIVE


272 C1726 $ 1,890.00 ACTIVE


272 C1726 $ 1,890.00 ACTIVE


272 C1726 $ 1,890.00 ACTIVE


272 C1726 $ 1,890.00 ACTIVE


Charge Amt Status

Charge Master List


272 C1726 $ 1,890.00 ACTIVE


272 C1726 $ 1,890.00 ACTIVE

27000074 CATH ALL PURPOSE 16FR 272 A4338 $ 16.00 ACTIVE

27000071 CATH ALL PURPOSE 8FR 272 A4351 $ 16.00 ACTIVE

27000072 CATH ALL PURPOSE-10FR 272 A4351 $ 16.00 ACTIVE











27200675 CATH ARMADA 14 272 C1726 $ 1,804.00 ACTIVE

27200697 CATH ARTERIAL 272 A4301 $ 152.00 ACTIVE

27900023 CATH ASPIRATION 272 C1757 $ 1,450.00 ACTIVE

27800035 CATH BALLOON PEG 272 C1726 $ 650.00 ACTIVE

27900030 CATH BERN 272 C1725 $ 1,356.00 ACTIVE

27200588 CATH BRONCHO ANY SIZE 272 C1725 $ 608.00 ACTIVE

27000481 CATH CHOLANGIGRAM 272 C1726 $ 550.00 ACTIVE

27000083 CATH CHOLANGIO LAP 272 A4338 $ 30.00 ACTIVE

27900036 CATH CROSSER 272 C1725 $ 1,400.00 ACTIVE

27900014 CATH DIAGNOSTIC 272 C1887 $ 678.00 ACTIVE

27900048CATH EMBOLECTOMY WITH INFLATION PORT 5.5FR 80CM T

272 C1757 $ 837.00 ACTIVE

27000523 CATH EXTERNAL MALE ALL 270 A4326 $ 52.00 ACTIVE

27200897 CATH F4 INF 3DRC 100CM 272 A4351 $ 57.00 ACTIVE

27200896 CATH F4 INF IM 100CM 272 A4351 $ 57.00 ACTIVE

27200895 CATH F4 INF JL 4 100CM 272 A4351 $ 57.00 ACTIVE

27200889 CATH F4 INF JR 4 100CM 272 A4351 $ 57.00 ACTIVE

27000084 CATH FEMALE KIT 272 A4311 $ 34.00 ACTIVE

27000482 CATH FEMALE SPEED 272 A4353 $ 100.00 ACTIVE

27000085 CATH FILIFORM 272 A4351 $ 30.00 ACTIVE

27000086 CATH FOLEY 18FR 5CC COUDE 272 A4338 $ 42.00 ACTIVE

27000087 CATH FOLEY 2 W 10FR 272 A4338 $ 56.00 ACTIVE

27000095 CATH FOLEY 2 W 18FR 30CC 272 A4338 $ 56.00 ACTIVE


27000110 CATH FOLEY 22FR 30CC COUDE 272 A4338 $ 62.00 ACTIVE

27000088 CATH FOLEY 2-W-12FR 270 A4338 $ 16.00 ACTIVE

27000089 CATH FOLEY 2-W-12FR30CC 272 A4338 $ 62.00 ACTIVE










Charge Amt Status

Charge Master List







27000117 CATH FOLEY COUDE 24-5 272 A4346 $ 86.00 ACTIVE

27000118 CATH FOLEY TRAY 16FR 272 A4311 $ 63.00 ACTIVE

27000119 CATH FOLEY TRAY 18FR 272 A4311 $ 64.00 ACTIVE

27200027 CATH FRONTRUNNER XP 272 C2628 $ 8,982.82 ACTIVE

27000120 CATH INFANT KIT 270 A4311 $ 52.00 ACTIVE

27000121 CATH KIT FLEX-TIP EPI 270 A4649 $ 72.00 ACTIVE

27200219 CATH LIBERTE MONORAIL ALL 272 C1725 $ 1,890.00 ACTIVE

27200028 CATH MICROGUIDE XP 272 C1887 $ 674.00 ACTIVE

27200685 CATH MPA ALL SIZES 272 A4340 $ 186.50 ACTIVE

27200029 CATH PACK 272 A4649 $ 430.00 ACTIVE

27200225 CATH PERITONEAL DIAL 272 C1752 $ 312.34 ACTIVE

48100094CATH PLACEMENT IN MAMERY (FOR IM ANGIO)

481 36216 $ 63,246.86 ACTIVE

48100095CATH PLACEMENT IN SUBCLAVIAN

481 36215 $ 53,874.98 ACTIVE

48100001 CATH PLACEMENT W/O LHC 481 93508 $ 24,040.52 ACTIVE

48100096CATH PLACMENT NOS SEL AORTA - CAROTID,VERTEBRAL,ANGIO

481 36221 $ 19,623.53 ACTIVE

27200226 CATH PROTECTIVE 8.0MM 272 A4649 $ 16.00 ACTIVE

27000483 CATH RACZ KIT& NEEDLE 270 A4649 $ 300.00 ACTIVE

27000124 CATH RED LATEX 22FR 272 A4351 $ 92.00 ACTIVE

27000125 CATH RED LATEX 24FR 272 A4351 $ 92.00 ACTIVE

27900016 CATH SLIP BEACON 272 A4351 $ 69.00 ACTIVE

27000484 CATH STRAIGHT 270 A4649 $ 484.00 ACTIVE

27000559 CATH SUCTION 270 A4628 $ 52.00 ACTIVE

27200228 CATH SUPRA PUBIC 272 C2627 $ 225.40 ACTIVE

27200659 CATH TERUMO 272 C1887 $ 1,674.00 ACTIVE

27000129 CATH VENOUS 272 A4301 $ 152.00 ACTIVE

27000130 CATH WHISTLE TIP 26FR 272 A4351 $ 106.00 ACTIVE




27000128 CATH, PVC W/TROCAR 14FR 270 A4338 $ 428.00 ACTIVE

27200888 CATH4F INF PIG 145 MOD 110CM 272 A4351 $ 147.00 ACTIVE

36000195

CATHETER ASPIRATION (SEPARATE PROCEDURE); NASOTRACHEAL CLEARANCE OF AIRWAYS

360 31720 $ 719.38 ACTIVE

27200250 CATHETER BALLOON 5837 272 C1726 $ 2,080.00 ACTIVE

27200791 CATHETER DIALYSIS 272 C1752 $ 8,372.00 ACTIVE

27000486 CATHETER EPIDURL SET 272 A4550 $ 75.00 ACTIVE

27800741CATHETER FLEX SINUS GUIDE GC000

272 C1887 $ 1,266.00 ACTIVE

27800742CATHETER FLEX SINUS GUIDE GC070

272 C1887 $ 1,266.00 ACTIVE

27800740CATHETER FLEX SINUS GUIDE GC110RF

272 C1887 $ 1,266.00 ACTIVE


Charge Amt Status

Charge Master List

27000134CATHETER FOLEY (NO LATEX) 16FR

272 A4351 $ 106.00 ACTIVE

27200251CATHETER GASTRIC BALLOON SUCTION B2020

272 C1726 $ 1,443.96 ACTIVE

27200918CATHETER GUIDE-6F GUIDING CATHETER 100CM, XBLAD3.5 SH

272 C1887 $ 1,485.00 ACTIVE

27200916CATHETER IV PROTECT PLUS 20GX1IN

272 C1725 $ 29.85 ACTIVE

27200249 CATHETER MULTILUMEN 272 A4649 $ 56.00 ACTIVE

48100088CATHETER PLACEMENT - ABDOMINAL AORTAGRAM

481 36245 $ 78,551.82 ACTIVE

27800739CATHETER SOLO PRO SINUS BALLOON BC0516SP

272 C1887 $ 1,748.00 ACTIVE

27000762 CATHETER SUCTION 10FR 272 A4624 $ 14.00 ACTIVE

27000465 CATHETER SUCTION 12FR 272 A4624 $ 14.00 ACTIVE

27000136CATHETER SUCTION 18FR (10846)

272 A4624 $ 16.00 ACTIVE

27000660 CATHETER SUCTION INLINE 272 A4624 $ 15.00 ACTIVE

27200833 CATHETER SUCTION PEDI 272 A4624 $ 24.00 ACTIVE

27000579CATHETER URETETAL WHISTEL TIP

270 A4353 $ 360.00 ACTIVE

27200847

CATHETER, ELECTROPHYSIOLOGY, DIAGNOSTIC/ABLATION, 3D OR VECTOR MAPPING

272 C1732 $ 39,660.00 ACTIVE

27200050CATHETER, TRANSLUMINAL ATHERECTOMY, ROTATIONAL

272 C1724 $ 69,000.00 ACTIVE

27000743 CAUTERY TUBE PEN 270 A4649 $ 135.00 ACTIVE

30500085 CD 4 COUNT 302 86361 $ 99.18 ACTIVE

30100625 C-DIFF DNA (CDIFF BY PCR) 306 87493 $ 129.99 ACTIVE

25000873 CEFOTETAN 2 GRAM 250 S0074 $ 172.00 ACTIVE

25900253 CEFTIN 250MG TABLET 250 J8499 $ 46.00 ACTIVE

25900259 CELEXA 20MG TAB 250 J8499 $ 45.00 ACTIVE

30900001CELL COUNT MISCELLANEOUS FLUID (NO BLOOD)

309 89051 $ 73.44 ACTIVE

30900021 CELL SEPARATION 302 86972 $ 79.50 ACTIVE

25901947 CEPHALEXIN 125MG 5ML OS 250 J3490 $ 18.00 ACTIVE

25900262 CEPHALEXIN 250MG CAPSULE 259 J8499 $ 18.00 ACTIVE

25900263 CEPHALEXIN 500MG CAP 259 J8499 $ 54.00 ACTIVE

32000066 CEPHALOGRAM ORTHODONTIC 320 70350 $ 478.80 ACTIVE

30100082 CERULOPLASMIN 301 82390 $ 143.16 ACTIVE

32000063 CERV SPINE (6+V) 4V & FLEX/EXT 320 72052 $ 2,687.00 ACTIVE

32000186 CERV SPINE 2-3 VIEWS 320 72040 $ 1,591.50 ACTIVE

32000062 CERV SPINE 4-5 VIEWS 320 72050 $ 2,140.00 ACTIVE

27000137 CERVICAL COLLAR (MED) (16244) 274 L0120 $ 66.00 ACTIVE

27000138 CERVICAL COLLAR LG 274 L0120 $ 152.00 ACTIVE

27400001 CERVICAL COLLAR SM 270 L0120 $ 12.44 ACTIVE

27000139 CERVICAL COLLAR XL 274 L0120 $ 176.00 ACTIVE

27000140 CERVICAL COLLAR XTR SMALL 274 L0120 $ 124.00 ACTIVE

27000778

CERVICAL, SEMI-RIGID, ADJUSTABLE MOLDED CHIN CUP (PLASTIC COLLAR WITH MANDIBULAR/OCCIPITAL PIECE)

270 L0150 $ 294.21 ACTIVE


Charge Amt Status

Charge Master List

32000014CHANGE PRQ TUBE/DRG CATH C+MNTR RS&I

320 75984 $ 1,070.36 ACTIVE

25900268 CHAR. W/SORBITOL 25GM L 250 J3490 $ 280.00 ACTIVE

25900269 CHARCOAL ACTIVATED 25GM 250 J3490 $ 156.00 ACTIVE

42000014 CHECKOUT ORTHOTIC 15M 450 97762 $ 218.40 ACTIVE

30100083 CHEMILUMINESCENT 301 82397 $ 188.28 ACTIVE

32400010 CHEST 1 VIEW 320 71045 $ 1,078.50 ACTIVE

32000234 CHEST 2 VIEW 320 71046 $ 1,471.50 ACTIVE

32400011 CHEST 2V W AP LORDOTIC 324 71047 $ 1,882.00 ACTIVE

32400012CHEST 2V W OBLIQUES(TOTAL4V)

324 71048 $ 2,004.00 ACTIVE

27000141CHEST TUBE EVACUATION SYSTEM (THORACLEX)

270 A7041 $ 424.00 ACTIVE

27000142 CHEST TUBE STRAIGHT 24FR 270 A7041 $ 70.00 ACTIVE




30200072CHLAMYDIA IMMUNOGLOBIN-G ANTIBODY

302 86631 $ 157.68 ACTIVE

30200073CHLAMYDIA IMMUNOGLOBIN-M ANTIBODY

302 86632 $ 169.08 ACTIVE

30600007CHLAMYDIA TRACHOMATIS DIRECT DNA PROBE

306 87491 $ 126.00 ACTIVE

27200863 CHLORAPREP 3ML WITH TINT 272 A4248 $ 16.05 ACTIVE

25900271 CHLORASEPTIC SPRAY 45ML 250 J3490 $ 54.00 ACTIVE

25901373CHLORDIAZ/CLIDIN.BROMIDE CAP

250 J8499 $ 30.00 ACTIVE

25900275 CHLORDIAZEPOXIDE10MG CAPS 250 J8499 $ 8.00 ACTIVE

30100085 CHLORIDE 301 82435 $ 61.32 ACTIVE

30100084 CHLORIDE 24HR URINE 301 82436 $ 69.00 ACTIVE

30100086 CHLORIDE BODY FLUID 301 82438 $ 65.16 ACTIVE

25000018 CHLORPROMAZINE 25MG/1ML 636 J3230 $ 70.95 ACTIVE

36000019 CHNG PRQ BILIARY DRG CATH 360 47525 $ 7,676.48 ACTIVE

32000068CHOLANGIO&/OR PANCREATGRM

320 74300 $ 2,242.00 ACTIVE

32000069 CHOLANGIOGRAM T-TUBE 320 74305 $ 2,638.00 ACTIVE

32000015CHOLANGIOGRAPHY PERQ TRANSHEPA

320 74320 $ 4,468.00 ACTIVE

32000071 CHOLECYSTOGRAPHY ORAL 320 74290 $ 1,121.82 ACTIVE

34100003CHOLESCINITRAPHY W/KENEVAC DEL

341 78223 $ 3,769.78 ACTIVE

30100092 CHOLINESTERASE SERUM 301 82480 $ 105.00 ACTIVE

30100093 CHOLYLGLYCINE 301 82240 $ 354.36 ACTIVE

30100094CHROMATOGRAPHY QUANTITATIVE COLUMN

301 82491 $ 209.30 ACTIVE

31100001CHROMOSOME ANALYSIS 20-25 CELLS

311 88264 $ 1,062.60 ACTIVE

31100002 CHROMOSOME COUNT 5 CELLS 311 88261 $ 2,221.80 ACTIVE

30600102 CHYLMD TRACH DNA QUANT 306 87492 $ 160.41 ACTIVE

30600111 CHYLMD TRCH DIR PROBE DNA 306 87490 $ 74.28 ACTIVE

32000072 CINE/VIDEO 320 76120 $ 1,402.10 ACTIVE

32000073 CINE/VIDEO COMPLEMENT 320 76125 $ 680.40 ACTIVE

25900281 CIPRODEX 0.3%/1% 7.5ML OTIC 250 J7342 $ 928.00 ACTIVE

25900282 CIPROFLOXACIN 250MG TAB 250 J8499 $ 102.00 ACTIVE


Charge Amt Status

Charge Master List

25000277CIPROFLOXACIN 400MG 200ML IVFL

636 J0744 $ 3,826.00 ACTIVE

25900283 CIPROFLOXACIN 500MG TAB 259 J8499 $ 96.00 ACTIVE

25900493 CIPROFLOXACIN OTIC 0.3%/5ML 250 J3490 $ 68.13 ACTIVE

27000653 CIRCUIT BIPAP 270 A4618 $ 372.00 ACTIVE

27200814CIRCUITS ANESTHESIA BREATHING

272 A4618 $ 468.00 ACTIVE

36000072

CIRCUMCISION SURG EXCISION OTHER THAN CLAMP DEVICE OR DORSAL SLIT > THAN 28 DAYS OLD

360 54161 $ 10,306.50 ACTIVE

25900664CITALOPRAM (ESCITALOPRAM) 10MG TAB

259 J8499 $ 56.00 ACTIVE

30100095 CITRATE 301 82507 $ 370.68 ACTIVE

25900286 CITRATE OF MAGNESIA 300ML 250 J3490 $ 69.00 ACTIVE

25900289 CLARITIN 10MG TABLET 250 J8499 $ 60.00 ACTIVE

25901379CLARITIN ELIXIR 5MG/5ML PER 5ML

250 J3490 $ 16.00 ACTIVE

32000074 CLAVICLE COMPLETE 320 73000 $ 1,334.00 ACTIVE

27000595CLEANSER WOUND/SKIN CARRAKLENZ

270 A6260 $ 156.00 ACTIVE

25901938 CLEOCIN 600MG/50ML IV 250 J3490 $ 30.00 ACTIVE

25000019 CLEOCIN 900MG 50ML IV 250 J3490 $ 32.55 ACTIVE

25000020 CLEOCIN 900MG 6ML SDVIAL 250 J3490 $ 10.50 ACTIVE

25000021CLEOCIN ADDV 900MG 6ML SDVIAL

250 J3490 $ 10.50 ACTIVE

25900292CLINDAMYCIN (CLEOCIN) 150MG CAP

259 J8499 $ 60.00 ACTIVE

25000022CLINDAMYCIN (CLEOCIN) ADDV 600MG 4ML SDVIAL

250 J3490 $ 15.80 ACTIVE

25000023 CLINDAMYCIN 300MG/2ML VIAL 250 J3490 $ 28.50 ACTIVE

25901945 CLINDAMYCIN 600MG 50ML IV FL 259 J3490 $ 34.88 ACTIVE

25000024 CLINDAMYCIN 600MG/4ML 250 J3490 $ 19.20 ACTIVE

25000025 CLINDAMYCIN 900MG/6ML 250 J3490 $ 32.55 ACTIVE

25900626CLONAZEPAM (KLONOPIN) 0.5MG TAB

259 J8499 $ 24.00 ACTIVE

25900627CLONAZEPAM (KLONOPIN) 1MG TAB

250 J8499 $ 24.00 ACTIVE

25900297 CLONIDINE 0.1MG TAB 259 J8499 $ 50.48 ACTIVE

25900917CLOPIDOGREL (PLAVIX) 75MG TAB

250 G9531 $ 99.00 ACTIVE

45000154

CLOSED TREATMENT OF DISTAL PHALANGEAL FRACTURE, FINGER OR THUMB; WITH MANIPULATION, EACH

450 26755 $ 13,363.50 ACTIVE

36000316

CLOSED TREATMENT OF FX, PHALANX/GES, OTHER THAN GREAT TOE; W/O MANIPULATION, EA

360 28510 $ 6,192.00 ACTIVE

45000062CLOSED TREATMENT OF PATELLAR DISLOCATION WITHOUT ANESTHESIA

450 27560 $ 17,401.50 ACTIVE

45000090CLOSED TREATMENT OF RADIAL SHAFT FX; W/O MANIPULATION

450 25500 $ 4,233.60 ACTIVE


Charge Amt Status

Charge Master List

45000140CLOSED TREATMENT, METACARPAL FX, SINGLE; W/ MANIPULATION, EACH BONE

450 26605 $ 8,217.00 ACTIVE

45000094CLOSED TX OF DISTAL ANKLE FX; W/ MANIPULATION

450 27788 $ 19,764.00 ACTIVE

45000095CLOSED TX OF DISTAL ANKLE FX; W/O MANIPULATION

450 27786 $ 14,688.00 ACTIVE

45000126CLOSED TX OF FINGER DISLOCATION, SINGLE, W/ MANIP W/ ANES

450 26775 $ 17,766.00 ACTIVE

45000102CLOSED TX OF FINGER JOINT DISLOCATION SINGLE W/MANP & W/O ANESTHESIA

450 26770 $ 13,086.00 ACTIVE

45000091

CLOSED TX OF FX, PHALANX/PHALANGES, OTHER THAN GREAT TOE; W/O MANIP, EA

450 28510 $ 9,192.00 ACTIVE

45000134CLOSED TX OF RADIAL SHAFT FRACTURE; W/MANIPULATION

450 25505 $ 23,399.50 ACTIVE

45000093

CLOSED TX PHALANGEAL SHAFT FX PROXIMAL/MIDDLE PHALANX, FINGER/THUMB; W/MAN W/OR W/O SKIN/SKELETAL TRACTION; EA

450 26725 $ 15,588.00 ACTIVE

45000103CLOSED TX SHOULDER DISLOCATION W/MANP W ANESTHESIA

450 23655 $ 20,736.00 ACTIVE

45000104CLOSED TX SHOULDER DISLOCATION W/MANP W/O ANESTHESIA

450 23650 $ 14,832.00 ACTIVE

45000114

CLOSED TXOF FX, PHALANX/PHALANGES, OTHER THAN GREAT TOE; W/ MANIPULATION, EACH

450 28515 $ 7,344.00 ACTIVE

30600005CLOSTRIDIUM DIFFICILE TOXIN ENZYME IMMUNOASSAY

306 87324 $ 159.84 ACTIVE

27200031CLOSURE DEVICE VASCULAR ALL

272 C1760 $ 10,000.00 ACTIVE

30500013CLOT INHIBING PROTEIN C ACTIVITY

305 85303 $ 184.44 ACTIVE

30500012CLOT INHIBITING ANTITHROMBIN III

305 85300 $ 158.04 ACTIVE

27000758CLOTH, SURGICAL SCRUB 2% CHLORAHEXADINE

270 A4248 $ 38.70 ACTIVE

30500014 CLOTTING FACTOR V 305 85220 $ 235.32 ACTIVE

30500015 CLOTTING FACTOR VII 305 85230 $ 238.68 ACTIVE

30500009 CLOTTING FACTOR VIII 305 85245 $ 305.88 ACTIVE

30500016 CLOTTING FACTOR VIII ANTIGEN 305 85244 $ 272.28 ACTIVE

30500019CLOTTING FACTOR VIII VON WILLEBRAND FACTOR ANTIGEN

305 85246 $ 305.88 ACTIVE

30500010CLOTTING FACTOR VIII VON WILLEBRAND FACTOR MX

305 85247 $ 305.88 ACTIVE

30500011 CLOTTING FACTOR XIII 305 85290 $ 217.80 ACTIVE

30100585 CMV QUANT DNA PCR (PLASMA) 306 87497 $ 158.64 ACTIVE

46000003 CO DIFFUSING CAPACITY 460 94720 $ 676.20 ACTIVE

30100100 CO2 (BICARBONATE) 301 82374 $ 65.16 ACTIVE

30500082 COAG TIME OTHER METHODS 305 85348 $ 53.88 ACTIVE

30100101 COCAINE QUANTITATIVE 301 80353 $ 201.00 ACTIVE


Charge Amt Status

Charge Master List

30200074 COCCIDIOIDES ANTIBODY 302 86635 $ 153.00 ACTIVE

27000146COCKUP WRIST/FOREARM LARGE

270 L3908 $ 348.00 ACTIVE

42000015 COGN SKILLS DEV 420 97127 $ 247.66 ACTIVE

27000002 COIL PUSHER 16 270 A4649 $ 42.00 ACTIVE

30100220COL CHROMOTOGRAPHY QUAL/QUAN

301 82542 $ 289.08 ACTIVE

30200075 COLD AGGLUTININS TITER 302 86157 $ 107.52 ACTIVE

27000147 COLLAR CERV MED 270 L0120 $ 28.00 ACTIVE

27000148 COLLAR CERVCL LG SERPENT 270 L0120 $ 92.00 ACTIVE

27000149 COLLAR PLASTIC LG 270 L0120 $ 86.00 ACTIVE

27000150 COLLAR PLASTIC MED 270 L0120 $ 86.00 ACTIVE

27000488 COLLAR SOFTIZE 274 L0120 $ 98.85 ACTIVE

30000048COLLECTION BLOOD SPECIMEN (EG,FINGER,HEEL,EAR STICK)

300 36416 $ 30.00 ACTIVE

27000752COLLECTOR, SPECIMEN COMMODE WHT 27OZ

270 A4649 $ 8.70 ACTIVE

27000751COLLECTOR, SPECIMEN POLP/STONE

270 A4649 $ 53.25 ACTIVE

27000151 COLLR CERV MED SERPENTINE 270 L0120 $ 92.00 ACTIVE

32000075 COLON BARIUM ENEMA W/AIR 320 74280 $ 9,652.00 ACTIVE

36000295COLONOSCOPY FLEX; W/REM OF TUMOR/POLYP/LESION BY SNARE TECHNIQUE

360 45385 $ 7,128.90 ACTIVE

45000060

COLONOSCOPY FLEXIBLE DIAGNOSTIC INC COLLECTION OF SPECIMEN BY BRUSHING/WASHING

360 45378 $ 9,861.00 ACTIVE

75000004 COLONOSCOPY WITH BIOPSY 360 45380 $ 10,698.50 ACTIVE

36000303COLONOSCOPY, FLEX; W/DIRECTED SUBMUCOSAL INJ ANY SUBSTANCE

360 45381 $ 10,189.00 ACTIVE

36000344COLORECTAL CANCER SCREEN ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK

360 G0121 $ 9,428.50 ACTIVE

36000350COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL AT HIGH RISK

360 G0105 $ 9,414.00 ACTIVE

36000351COLORECTAL CANCER SCREENING; FLEXIBLE SIGMOIDOSCOPY

360 G0104 $ 2,832.00 ACTIVE

32000076 COMB ENDO CATH BILI/PANC 320 74330 $ 2,809.60 ACTIVE

30200077COMPATABILITY TEST EACH UNIT USING THE ANTIGLOBULIN TECHNIQUE

302 86922 $ 219.96 ACTIVE

30200281COMPATIBILITY TEST EACH UNIT; ELECTRONIC

302 86923 $ 2,270.00 ACTIVE

25900304 COMPAZINE 10MG TAB 250 J8499 $ 41.40 ACTIVE

30100433COMPLEMENT COMPONENT TOTAL (CH50)

302 86162 $ 193.20 ACTIVE

30200058COMPLEMENT; ANTIGEN, EACH COMPONENT, C 2-5 OR FACTOR B

302 86160 $ 159.96 ACTIVE

32000050

COMPLETE ACUTE ABDOMEN SERIES, INC SUPINE, ERECT, AND/OR DECUBITUS VIEWS, SINGLE VIEW CHEST

320 74022 $ 2,106.50 ACTIVE


Charge Amt Status

Charge Master List

30500008COMPLETE BLOOD COUNT WITH AUTOMATED DIFFERENTIAL (CBC)

305 85025 $ 103.56 ACTIVE

30200076 COMPLETE EACH INCUBATION 302 86921 $ 149.96 ACTIVE

30100104COMPREHENSIVE METABOLIC PANEL (CMP)

301 80053 $ 140.88 ACTIVE

27000573 COMPRES HOT/COLD 270 A9273 $ 12.45 ACTIVE

40100001COMPUTER MAMMOGRAM COMPUTER A

401 77052 $ 426.50 ACTIVE

30600008CONCENTRATION (ANY TYPE) OF INFECTIOUS AGENTS

306 87015 $ 89.04 ACTIVE

27000152 CONNECTING TUBE NEPH DRAIN 270 A7048 $ 74.00 ACTIVE

27000153CONNECTOR 5 IN 1 TUBING (10806)

270 A4649 $ 16.00 ACTIVE

27200256 CONNECTOR FLEX 272 A4649 $ 56.00 ACTIVE

27200257 CONNECTOR OXY SUPPLY TU 272 A4649 $ 56.00 ACTIVE

27000154CONTAINER SPECIMEN MUSCOUS 40C (15426)

270 A4649 $ 16.00 ACTIVE

41000026CONTINUOUS BREATHING TREATMENT 1ST HOUR

410 94644 $ 506.80 ACTIVE

41000027CONTINUOUS BREATHING TREATMENT EACH ADD'L HOUR

410 94645 $ 304.08 ACTIVE

42000016 CONTRAST BATHS EA 15 450 97034 $ 201.62 ACTIVE

45000151CONTROL NASAL HEMORRHAGE ANTERIOR COMPLEX ANY METHOD

450 30903 $ 810.96 ACTIVE

45000065

CONTROL NASAL HEMORRHAGE POSTERIOR W/NASAL PACKS AND/OR CAUTERY ANY METHOD INITIAL

450 30905 $ 300.00 ACTIVE

45000105

CONTROL NASAL HEMORRHAGE, ANTERIOR, SIMPLE (LIMITED CAUTERY AND/OR PACKING) ANY METHOD

450 30901 $ 2,916.00 ACTIVE

27000759CONVERTORS UNDER-BUTTOCKS DRAPES

270 A4649 $ 13.00 ACTIVE

30100105 COPPER 301 82525 $ 165.48 ACTIVE

27200040CORDIS CYPHER STENT COATED/COVERED W/DELIVERY SYST 3.0 X 18 CXS18300

272 C1874 $ 32,000.00 ACTIVE

25900308 COREG 25MG TABLETS 250 J8499 $ 40.00 ACTIVE

25900309 COREG 3.125 MG TAB 259 J8499 $ 37.50 ACTIVE

25900311 COREG 6.25MG TAB 250 J8499 $ 27.00 ACTIVE

48100066CORONARY ANGIOGRAM ONLY (NO VALVE CROSS)

481 93454 $ 74,005.50 ACTIVE

48100067CORONARY SVG (BYPASS GRAFT) W IMA ANGIO

481 93455 $ 81,353.50 ACTIVE

36000150

CORRECTION HALLUX VALGUS(BUNIONECTOMY) W/SESAMOIDECTOMY/RESECTION OF PROXIMAL PHALANX BASE WHEN PERFORMED

360 28292 $ 25,273.50 ACTIVE

36000311

CORRECTION, HAMMERTOE (EG, INTERPHALANGEAL FUSION, PARTIAL OR TOTAL PHALANGECTOMY)

360 28285 $ 18,864.00 ACTIVE


Charge Amt Status

Charge Master List

30100106 CORTISOL FREE (URINE) 301 82530 $ 222.84 ACTIVE

30100107 CORTISOL TOTAL 301 82533 $ 217.32 ACTIVE

25900324 COUMADIN 1MG TABLET 250 J8499 $ 24.00 ACTIVE

27200893COVER, MAYO STAND REINF 23" X54"

272 A4649 $ 13.00 ACTIVE

27200894COVER, TABLE STD RE-INF STR 44X90

272 A4649 $ 19.00 ACTIVE

30200089 COXSACKIE TYPE A ANTIBODY 302 86658 $ 173.64 ACTIVE

25200076 COZAAR 100MG TAB 252 J8499 $ 32.00 ACTIVE



41000003CPAP/BIPAP INITIATION AND MANAGEMENT

410 94660 $ 969.10 ACTIVE

41000005 CPT INITIAL 410 94667 $ 750.00 ACTIVE

41000020 CPT SUBQ 410 94668 $ 506.80 ACTIVE

27200699 CRADLE ARM LAMINECTOMY 272 E0190 $ 226.00 ACTIVE

27200642CRE ESOPHAGEAL DILATATION BALLOON

272 C1726 $ 6,435.00 ACTIVE

30200054 C-REACTIVE PROTEIN 302 86140 $ 69.00 ACTIVE

30200056C-REACTIVE PROTEIN HIGH SENSITIVITY

302 86141 $ 172.68 ACTIVE

30100111 CREATINE 301 82540 $ 61.80 ACTIVE

30100112 CREATINE CLEARANCE 301 82575 $ 126.12 ACTIVE

30100096 CREATINE KINASE TOTAL 301 82550 $ 86.76 ACTIVE

30100097 CREATINE KINASE-MB TRIAGE 301 82553 $ 153.96 ACTIVE

30100109CREATINE PHOSPHOKINASE ISOENZYME (CK MB)

301 82552 $ 178.56 ACTIVE

30100116 CREATININE (FLUID) 301 82570 $ 69.00 ACTIVE

30100113 CREATININE BLOOD 301 82565 $ 68.28 ACTIVE

45000081CRITICAL CARE E/M FIRST 30-74MINS

450 99291 $ 5,152.44 ACTIVE

30200091 CROSS MATCH EACH UNIT (SPIN) 302 86920 $ 219.96 ACTIVE

27000324CRUTCHES LARGE UNDERARM OTHER THAN WOOD ADJUSTABLE

271 E0114 $ 285.00 ACTIVE

27000326CRUTCHES PEDI (CHILD) STANDARD

271 E0114 $ 285.00 ACTIVE

27000325CRUTCHES SMALL UNDERARM OTHER THAN WOOD ADJUSTABLE

271 E0114 $ 285.00 ACTIVE

27300001CRUTCHES STANDARD MEDIUM SIZE PAIR

271 E0114 $ 350.00 ACTIVE

30100120 CRYOGLOBULIN (QUALITATIVE) 301 82595 $ 86.16 ACTIVE

39000002 CRYOPRECIPITATE EACH UNIT 390 P9012 $ 547.40 ACTIVE

30600010 CRYPTOSPORIDIUM ANTIGEN 306 87272 $ 159.84 ACTIVE

30900003CRYSTAL IDENTIFICATION ANY FLUID (NO URINALYSIS)

309 89060 $ 95.40 ACTIVE

35000002CT 3D RENDER W/O POST PROCESS

350 76377 $ 3,088.50 ACTIVE

35000003CT 3D RENDER W/POST PROCESS

350 76376 $ 1,096.50 ACTIVE

35200034CT ABD & PELVIS W AND W/O CONTRAST

352 74178 $ 16,931.50 ACTIVE

35200033 CT ABD & PELVIS W/CONTRAST 352 74177 $ 14,962.50 ACTIVE

35200002 CT ABD W/O - W/CONTRAST 352 74170 $ 12,582.00 ACTIVE


Charge Amt Status

Charge Master List

35200031 CT ABD/PELVIS W/O CONTRAST 352 74176 $ 9,631.00 ACTIVE

35200004 CT ABDOMEN W/CONTRAST 352 74160 $ 11,059.00 ACTIVE

35200003 CT ABDOMEN W/O CONT 352 74150 $ 7,196.50 ACTIVE

35000004 CT BONE DENSITY STUDY AXIAL 350 77078 $ 3,438.00 ACTIVE

35100003 CT BRAIN W W/O CONTR 351 70470 $ 9,197.00 ACTIVE

35100001 CT BRAIN W/CONTRAST 351 70460 $ 7,771.00 ACTIVE

35100002 CT BRAIN W/O CONTRAST 351 70450 $ 5,567.00 ACTIVE

35200005 CT CER SPINE W/CONTRAST 352 72126 $ 10,989.00 ACTIVE

35200006 CT CERV SPINE W/O CONT 352 72125 $ 8,356.00 ACTIVE

35200007 CT CERV SPINE WO- W/CONTR 352 72127 $ 9,355.50 ACTIVE

35200008 CT CHEST W/CONTRAST 352 71260 $ 10,990.00 ACTIVE

35200009 CT CHEST W/O CONTRAST 352 71250 $ 8,235.50 ACTIVE

35200010 CT CHEST W/O THEN W/CON 352 71270 $ 13,179.50 ACTIVE

35000001 CT DRAIN W/CATH PLACEMT 350 75989 $ 5,844.00 ACTIVE

35000005 CT ELECTRON BEAM TOMO 350 S8092 $ 1,259.02 ACTIVE

35000006 CT GUIDANCE TISS ABLATION 350 77013 $ 3,055.52 ACTIVE

35000007 CT GUIDE NDL PLACEMENT 350 77012 $ 5,999.50 ACTIVE

35200011 CT LOWER EXTREM W/O CON 352 73700 $ 8,184.00 ACTIVE

35200012 CT LOWER EXTREM WO- W/CON 352 73702 $ 13,092.00 ACTIVE

35200013 CT LUMB SPINE W/CONTRAST 352 72132 $ 10,954.50 ACTIVE

35200014 CT LUMB SPINE W/O CONTR 352 72131 $ 8,184.00 ACTIVE

35200015 CT LUMB SPINE W/O- W/CON 352 72133 $ 12,972.50 ACTIVE

35200016 CT LWR EXTREM W/CONTRAST 352 73701 $ 10,817.50 ACTIVE

35100005 CT MAXILLOFACIAL W/CON 351 70487 $ 8,083.00 ACTIVE

35100004 CT MAXILLOFACIAL W-W/O 351 70488 $ 9,829.00 ACTIVE

35100006 CT MAXILLOFACIALW/O CONT 351 70486 $ 6,712.00 ACTIVE

35100007 CT NECK W CONTRAST 351 70491 $ 11,300.00 ACTIVE

35100008 CT NECK W- W/O CONTRAST 351 70492 $ 13,317.50 ACTIVE

35100009 CT NECK W/O CONTRAST 351 70490 $ 8,872.50 ACTIVE

35100011 CT ORBIT/SELLA/IAC W 351 70481 $ 13,213.50 ACTIVE

35100012 CT ORBIT/SELLA/IAC WO 351 70480 $ 8,872.50 ACTIVE

35100010 CT ORBIT/SELLA/IAC W-WO 351 70482 $ 14,462.50 ACTIVE

35200017 CT PELVIS W/CONTRAST 352 72193 $ 10,817.50 ACTIVE

35200018 CT PELVIS W/O CONTRAST 352 72192 $ 7,024.00 ACTIVE

35200019 CT PELVIS WO- W/CONT 352 72194 $ 12,476.50 ACTIVE

35000009 CT RECONST AORTA 350 G0288 $ 4,246.96 ACTIVE

35000008 CT SINUS LTD/LO F/U STUDY 350 76380 $ 5,227.50 ACTIVE

35000010 CT STEREOTACTIC LOC 350 77011 $ 3,487.26 ACTIVE

35200020 CT THOR SPINE W/CONTRAST 352 72129 $ 10,989.50 ACTIVE

35200021 CT THOR SPINE W/O CONT 352 72128 $ 8,184.00 ACTIVE

35200022 CT THOR SPINEW/O- W/CON 352 72130 $ 12,972.50 ACTIVE

35000011 CT UNLISTED PROCEDURE 350 76497 $ 3,004.40 ACTIVE

35200023 CT UPPER EXTREM W/CONT 352 73201 $ 10,664.00 ACTIVE

35200024 CT UPPER EXTREM W/O CON 352 73200 $ 8,169.00 ACTIVE

35200025 CT UPPER EXTREMWO-W CON 352 73202 $ 5,115.60 ACTIVE

35200001 CT VERTEBROPLASTY 352 72292 $ 2,415.00 ACTIVE

35200026 CTA ABD AW RUNOFF WO/W 352 75635 $ 18,235.00 ACTIVE

35200036

CTA ABD/PELVIS WITH CONTRAST INCLUDING NON CONTRAST IF PERFORMED AND POST PROCESING

352 74174 $ 18,674.00 ACTIVE


Charge Amt Status

Charge Master List

35200027CTA ABDOMEN W/O W CONTRAST

352 74175 $ 14,723.00 ACTIVE

35200028CTA CHEST (NONCORONARY) W/CONTRAST; INC W/O CONTRAST IF PERFORMED

352 71275 $ 14,398.50 ACTIVE

35100016 CTA HEAD W-W/O CONTRAST 351 70496 $ 14,175.00 ACTIVE

35200037

CTA HEART,WITHOUT CONTRAST MATERIAL,WITH QUANTITATIVE EVALUATION OF CORONARY CALCIUM

352 75571 $ 4,816.50 ACTIVE

35900001 CTA LWR EXTR WO/W CON-W 359 73706 $ 16,845.00 ACTIVE

35100017 CTA NECK W/O & W CONTRAST 351 70498 $ 14,089.50 ACTIVE

35200029 CTA PELVIS WO-W CONTRAST 352 72191 $ 14,603.50 ACTIVE

35200030 CTA UP EXTREM WO/W CONTR 352 73206 $ 5,670.00 ACTIVE

36000122

CUBITAL TUNNEL RELEASE/NEUROPLASTY/TRANSPOSITION ULNAR NERVE AT ELBOW

360 64718 $ 30,723.00 ACTIVE

27200806 CUFF BLOOD PRESSURE (ALL) 272 A4663 $ 168.00 ACTIVE

27200259CUICK COMBO REDI PAK 11996-000017

272 A4649 $ 632.00 ACTIVE

30600019 CULTURE ANAEROBIC BACTERIA 306 87075 $ 126.24 ACTIVE

30600022CULTURE BACTERIAL ANY OTHER SOURCE

306 87070 $ 114.84 ACTIVE

30600104CULTURE BACTERIAL QUANTITATIVE AEROBIC

306 87071 $ 34.98 ACTIVE

30600020 CULTURE CAMPYLOBACTER 306 87046 $ 125.88 ACTIVE

30600045CULTURE CHLAMYDIA, ANY SOURCE

306 87110 $ 261.24 ACTIVE

30600012 CULTURE EPIDERMAL FUNGUS 306 87101 $ 102.72 ACTIVE

30600025CULTURE FUNGI ISOLATION (BLOOD)

306 87103 $ 245.52 ACTIVE

30600011CULTURE FUNGI ISOLATION (NOT BLOOD)

306 87102 $ 102.72 ACTIVE

30600105CULTURE PRESUMPTIVE PATHOGENIC ORGANISMS SCREENING ONLY

306 87081 $ 88.32 ACTIVE

30600013 CULTURE TYPE SALMONELLA 306 87147 $ 69.00 ACTIVE

30600015CULTURE URINE BACTERIA ISOLATION

306 87088 $ 107.88 ACTIVE

27000753 CUP, MED GRAD 1OZ 270 A9270 $ 12.00 ACTIVE

27000622 CUSHION DONUT O RING 270 E0190 $ 230.00 ACTIVE

27200260 CUTTER 45MM LINEAR 6TB45 272 A4649 $ 2,908.00 ACTIVE

27200907CUTTING LOOP 27FR EXTENDED LENGTH

272 A4649 $ 625.05 ACTIVE

48200001 CV STRESS W/ECG TRACE 482 93017 $ 1,912.68 ACTIVE

30100121 CYANIDE 301 82600 $ 258.60 ACTIVE

30200094CYCLIC CITRULLINATED PEPTIDE

302 86200 $ 172.68 ACTIVE

25900339CYCLOBENZAPHRINE (FLEXERIL) 10MG TAB

250 J8499 $ 22.00 ACTIVE

25901864CYCLOPENTOLATE 40MG/2ML OPTH

250 J3490 $ 68.48 ACTIVE

30600041 CYCLOSPORA STAIN 306 87207 $ 79.92 ACTIVE

30100122 CYLOSPORINE LEVEL 301 80158 $ 240.72 ACTIVE

25200113 CYMBALTA 60MG CAP 250 J8499 $ 56.00 ACTIVE

30100072 CYSTATIN C 301 82610 $ 222.24 ACTIVE


Charge Amt Status

Charge Master List

36000242 CYSTECTOMY PARTIAL SIMPLE 360 51550 $ 5,015.40 ACTIVE

32000077 CYSTOGRAM 3V OR MORE 320 74430 $ 1,782.00 ACTIVE

36000358

CYSTOPLASTY OR CYSTOURETHROPLASTY, PLASTIC OPERATION ON BLADDER AND/OR VESICAL NECK (ANTERIOR Y-PLASTY, VESICAL FUNDUS RESECTION), ANY

360 51800 $ 52,486.50 ACTIVE

36000380

CYSTOURETHROSCOPY (INCLUDING URETERAL CATHETERIZATION); WITH REMOVAL OF URETERAL CALCULUS

360 52320 $ 12,848.00 ACTIVE

36100013CYSTOURETHROSCOPY (SEPARATE PROCEDURE)

361 52000 $ 2,183.11 ACTIVE

36100012CYSTOURETHROSCOPY W/ BIOPSY(S)

361 52204 $ 7,441.50 ACTIVE

36000278

CYSTOURETHROSCOPY W/ URETEROSCOPY/PYELOSCOPY; W/REMOVAL OR MANIPULATION OF CALCULUS

360 52352 $ 18,393.00 ACTIVE

36000264

CYSTOURETHROSCOPY W/CALIBRATION AND/OR DILATION OF URETHRAL STRICTURE/STENOSIS, W/W/O MEATOTOMY, W/W/O INJECTION FOR CYSTOGRAPHY

360 52281 $ 8,004.00 ACTIVE

36000263CYSTOURETHROSCOPY W/DIRECT VISION INTERNAL URETHROTOMY

360 52276 $ 13,922.50 ACTIVE

36000253

CYSTOURETHROSCOPY W/FULGURATION (INC CRYOSURGERY/LASER SURGERY) &/OR RESECTION OF; SMALL BLADDER TUMOR(S) 0.5-2.0CM

360 52234 $ 12,942.00 ACTIVE

36000054

CYSTOURETHROSCOPY W/FULGURATION (INCLUDING CRYOSURGERY/LASER SURGERY) TX OF MINOR (<0.5 CM) LESION(S) W/OR W/O BX

360 52224 $ 10,729.50 ACTIVE

36000313

CYSTOURETHROSCOPY W/REMOVAL OF FB/CALCULUS/URETERAL STENT FROM URETHRA/BLADDER; SIMPLE

360 52310 $ 7,902.00 ACTIVE

36000276

CYSTOURETHROSCOPY W/URETERAL CATH W/OR W/O IRRIGA/INSTILLATION/URETEROPYELOGRAPHY

360 52005 $ 6,926.50 ACTIVE

36000360

CYSTOURETHROSCOPY, WITH FULGURATION (INCLUDING CRYOSURGERY OR LASER SURGERY) AND/OR RESECTION OF; LARGE BLADDER TUMOR(S)

360 52240 $ 20,484.00 ACTIVE


Charge Amt Status

Charge Master List

36000379

CYSTOURETHROSCOPY, WITH FULGURATION (INCLUDING CRYOSURGERY OR LASER SURGERY) AND/OR RESECTION OF; MEDIUM BLADDER TUMOR(S) (2.0 TO 5.0 C

360 52235 $ 15,028.50 ACTIVE

36000312CYSTOURETHROSCOPY, WITH INTERNAL URETHROTOMY; MALE

360 52275 $ 12,583.66 ACTIVE

36000288

CYSTOURETHROSCOPY, WITH URETEROSCOPY AND/OR PYELOSCOPY; WITH LITHOTRIPSY (URETERAL CATHETERIZATION IS INCLUDED)

360 52353 $ 19,697.50 ACTIVE

30100549CYTOGENETICS & MOLECULAR CYTOGENETICS, INTERPRETATION & REPORT

311 88291 $ 151.68 ACTIVE

31100003 CYTOLOGY BRUSHINGS 311 88104 $ 257.60 ACTIVE

30200095 CYTOMEGALOVIRUS ANTIBODY 302 86644 $ 191.88 ACTIVE

30200096CYTOMEGALOVIRUS IMMUNOGLOBIN-M ANTIBODY

302 86645 $ 224.64 ACTIVE

31100017CYTOPATH C/V AUTO FLUID REDO

311 88175 $ 98.13 ACTIVE

31100004CYTOPATHOLOGY SMEARS (OTHER SOURCE)

311 88160 $ 193.20 ACTIVE

30200277

CYTOPATHOLOGY, CERVICAL/VAGINAL, PRESERVATIVE FLUID, AUTO THIN LAYER PREP; MANUAL SCREEN

311 88142 $ 75.03 ACTIVE

25800016 D5 1/2NS 30MEQ 1000ML 258 J3480 $ 2,676.00 ACTIVE

25800027 D5W 250ML IV SOLN. 258 J7060 $ 146.00 ACTIVE

25000139DANTRIUM 20MG VIAL (DANTROLENE SOD)

250 J3490 $ 1,168.00 ACTIVE

30500023D-DIMERS AND FIBRIN DEGRADATION PRODUCTS QUANTITATIVE

305 85379 $ 150.42 ACTIVE

48100068DE STENT EACH ADDITIONAL VESSEL

481 G0291 $ 1,600.34 ACTIVE

42000002DEBRDMNT/NON-SEL STERL 15 MIN

420 97602 $ 1,027.82 ACTIVE

42000017 DEBRIDE SELECT W/O ANES <=2 450 97597 $ 1,027.82 ACTIVE

42000018 DEBRIDE SELECT W/O ANES 20+ 450 97598 $ 1,027.82 ACTIVE

36000083

DEBRIDEMENT BONE (EPIDERMIS/DERMIS/SUBCUT TISSUE/MUSCLE/FASCIA) FIRST 20 SQ CM OR LESS

360 11044 $ 3,608.85 ACTIVE

76100005DEBRIDEMENT SKIN - FULL THICKNESS

761 11041 $ 1,118.10 ACTIVE

76100007DEBRIDEMENT SKIN - SUBCUTANEOUS

761 11042 $ 1,841.50 ACTIVE

36000367

DEBRIDEMENT, MUSCLE AND/OR FASCIA (INCLUDES EPIDERMIS, DERMIS, AND SUBCUTANEOUS TISSUE, IF PERFORMED); FIRST 20 SQ CM OR LESS

360 11043 $ 8,018.50 ACTIVE


Charge Amt Status

Charge Master List

25000141 DEBROX EAR WAX 6.5% 0.5 OZ 250 A9150 $ 54.00 ACTIVE

31200001 DECALCIFICATION PROCEDURE 312 88311 $ 161.42 ACTIVE

36100009

DECLOTTING BY THROMBOLYTIC AGENT OF IMPLANTED VASCULAR ACCESS DEVICE OR CATHETER

361 36593 $ 1,148.55 ACTIVE

25900366 DEPAKOTE 250MG EC TABLET 250 J8499 $ 24.00 ACTIVE

25900367 DEPAKOTE 500MG 250 J8499 $ 54.00 ACTIVE

27200698 DERMACARRIER 272 C1781 $ 395.50 ACTIVE

36000335 DERMAPURE, PER SQ CM 360 Q4152 $ 50.00 ACTIVE

25000716DESFLURANE (SUPRANE) INH LIQ 240ML

250 J3490 $ 76.00 ACTIVE

30100544DETECT AGNT MULT DNA AMPLIFIED TECHNIQUE

306 87801 $ 150.00 ACTIVE

42000019 DEV TESTING EXT W/I&R 450 96111 $ 4,385.64 ACTIVE

42000020 DEV TESTING LTD W/I&R 450 96110 $ 1,116.16 ACTIVE

27200662 DEVICE EVERCROSS 272 C1725 $ 4,212.00 ACTIVE

32000078DEXA APPENDICULAR (PERIPHERAL) SKELETON

320 77081 $ 378.44 ACTIVE

32000079 DEXA AXIAL SKELETON 320 77080 $ 1,984.50 ACTIVE

32000080DEXA VERTEBRAL FRACTURE ASSESS

320 77082 $ 488.32 ACTIVE

63600195DEXAMETHASONE (DECADRON) INHALATION SOLUTION PER MILLIGRAM

636 J7638 $ 13.50 ACTIVE

25000033 DEXAMETHASONE 1MG 30ML OS 250 J8540 $ 42.08 ACTIVE

25900375DEXAMETHASONE 1MG TAB PER .25MG

259 J8540 $ 24.00 ACTIVE

25800031 DEXTROSE 10% 500ML IV 250 J3490 $ 20.00 ACTIVE

25800033 DEXTROSE 25% 10ML 250 J3490 $ 54.00 ACTIVE

25800036DEXTROSE 5%/LACTATED RINGERS/2

258 J7121 $ 434.00 ACTIVE

25901958 DEXTROSW 50% 10ML SYRINGE 250 J3490 $ 85.00 ACTIVE

30100124 DHEA 301 82626 $ 336.96 ACTIVE

30100125 DHEA-SULFATE 301 82627 $ 296.52 ACTIVE

94200001 DIAB O/P SELF-MGT GRP 30M 942 G0109 $ 81.20 ACTIVE

94200002 DIAB O/P SELF-MGT IND 30M 942 G0108 $ 394.80 ACTIVE

44000003 DIAGNOSTIC LARYNGOSCOPY 440 31575 $ 1,020.74 ACTIVE

25900382 DIAZEPAM 5MG TAB 259 J8499 $ 30.00 ACTIVE

25901220DICLOFENAC (VOLTAREN) 75MG TABLET

250 J8499 $ 28.00 ACTIVE

25901866 DICLOFENAC 100MG TAB 250 J8499 $ 8.30 ACTIVE

25900385 DICYCLOMINE 10MG CAPSULE 250 J8499 $ 8.00 ACTIVE

25900386 DICYCLOMINE HCL 20MG TAB 250 J8499 $ 8.00 ACTIVE

51000007 DIETARY CONSULT 510 97802 $ 220.00 ACTIVE

25900387 DIFLUCAN 100MG TABLET 250 J8499 $ 96.00 ACTIVE

25900388 DIFLUCAN 150 MG TABLET 250 J8499 $ 340.00 ACTIVE

25900389 DIFLUCAN 50 MG TAB 250 J8499 $ 138.00 ACTIVE

30100127 DIGOXIN 301 80162 $ 177.00 ACTIVE

25901931DIGOXIN (DIGITEX) 250MCG (0.25MG) TABLET

250 J8499 $ 10.50 ACTIVE

30100128 DIHYDROCODEINONE 301 82646 $ 492.66 ACTIVE

25900390 DILANTIN 100MG CAPSULE 250 J8499 $ 24.00 ACTIVE

32000081 DILATION NEPHROSTOMY 320 74485 $ 2,552.90 ACTIVE


Charge Amt Status

Charge Master List

25901954DIPHENHYDRAMINE 2% TOP CREAM

250 J3490 $ 24.00 ACTIVE

25901867DIPHENOXELATE/ATROPINE 2.5MG TAB

250 J8499 $ 24.00 ACTIVE

25900399 DIPYRIDAMOLE 50MG TABLET 250 J8499 $ 10.00 ACTIVE

76200002DIRECT ADMISSION PATIENT FOR HOSPITAL OBS

762 G0379 $ 2,403.45 ACTIVE

32000082 DISKOGRAM CERV THOR 320 72285 $ 5,503.00 ACTIVE

32000083 DISKOGRAM LUMBAR 320 72295 $ 4,713.50 ACTIVE

31100005 DNA ANALYSIS 311 88182 $ 463.68 ACTIVE

30200097DNA ANTIBODY/NATIVE/DOUBLE STRAND

302 86225 $ 183.24 ACTIVE

30200098DNA ANTIBODY/NATIVE/SINGLE STRAND

302 86226 $ 161.40 ACTIVE

63600154 DOBUTAMINE 250MG/20ML 636 J1250 $ 57.08 ACTIVE

63600184 DOBUTAMINE 250MG/250ML IV 636 J1250 $ 64.12 ACTIVE

25900405 DOCUSATE SODIUM 100MG CAP 250 J8499 $ 8.00 ACTIVE

25900410 DONNATAL 16.2MG ELIXIR 259 J8499 $ 264.00 ACTIVE

48000003DOP ECHO COLOR FLO VEL MAPG

480 93325 $ 1,159.20 ACTIVE

40200001DOP ECHO FTL PLSD SPECTRAL DIS

402 76828 $ 1,159.20 ACTIVE

40200002DOP ECHO FTL SPECTRAL DISPLAY

402 76827 $ 1,288.00 ACTIVE

48000005DOP ECHO P-W&/OR CONT W/SPECTR

480 93321 $ 1,159.20 ACTIVE

25000030 DOPAMINE 200MG 5ML VIAL 250 J1265 $ 45.00 ACTIVE

25000176 DOPAMINE 800MG/250ML D5W 250 J1265 $ 234.00 ACTIVE

92100014 DOPPLER INTCRAN ARTS COMP 921 93886 $ 1,754.90 ACTIVE

40200062DOPPLER VELOCIMETRY, FETAL; UMBILICAL ARTERY

402 76820 $ 2,466.00 ACTIVE

27200263DOUBLE DRY SUCTION CHEST DRAIN

272 C1729 $ 196.40 ACTIVE

25900414 DOXEPIN 10MG CAPSULE 250 J8499 $ 8.00 ACTIVE

25000180 DOXYCYCLINE 100MG VIAL 250 J3490 $ 198.00 ACTIVE

25900417 DOXYCYCLINE100MG TABL 250 J8499 $ 190.00 ACTIVE

27200654 DRAIN BLAKE 19FR 272 A7048 $ 1,305.00 ACTIVE

27000156 DRAIN BLAKE 19FR 270 A7048 $ 600.00 ACTIVE

27000157 DRAIN JACK PRATT 10MM 270 A7048 $ 550.00 ACTIVE

27000158 DRAIN JACK PRATT 7MM 270 A7048 $ 550.00 ACTIVE

27000160 DRAIN PENROSE 12 X 1 270 A7048 $ 28.00 ACTIVE

27000161 DRAIN PENROSE 12 X 1/2 270 A7048 $ 28.00 ACTIVE



27000164 DRAIN PENROSE 18 X 1 270 A7048 $ 28.00 ACTIVE




27000168 DRAIN PLEUR-EVAC 270 A7041 $ 50.00 ACTIVE

36000257DRAINAGE OF OVARIAN CYST(S), UNILATERAL/BILATERAL; ABDOMINAL APPROACH

360 58805 $ 20,880.50 ACTIVE


Charge Amt Status

Charge Master List

36000132DRAINAGE, LYMPH NODE ABSCESS/LYMPHADENITIS; SIMPLE

360 38300 $ 14,209.86 ACTIVE

36000130DRAINAGE, PERIVESICAL/PREVESICAL SPACE ABSCESS

360 51080 $ 11,983.44 ACTIVE

27200627DRAPE ABDOMINAL LAPARO STERILE

272 A4467 $ 102.00 ACTIVE

27200667 DRAPE CLEARVIEW 272 A4467 $ 678.00 ACTIVE

27200665 DRAPE EXTREMITY 272 A4467 $ 678.00 ACTIVE

27200701 DRAPE MICROSCOPE 272 A4467 $ 452.00 ACTIVE

27200678 DRAPE PROBE COVER 272 A4649 $ 1,017.00 ACTIVE

27000633 DRAPE SURG STERI DRAPE 270 A4467 $ 124.00 ACTIVE

27000634 DRAPE SURG STERI DRAPE 1010 270 A4467 $ 108.00 ACTIVE

27000173 DRESSING 2X2 STERILE 272 A6402 $ 8.00 ACTIVE

27000177 DRESSING ADAPTIC 3X3 272 A6223 $ 9.25 ACTIVE

27000178 DRESSING ADAPTIC 3X8 272 A6223 $ 23.85 ACTIVE

27000019 DRESSING AQUACEL 4X4 270 A6197 $ 70.00 ACTIVE

27200776 DRESSING AQUACEL AG 4X4 272 A6209 $ 174.90 ACTIVE

62300001DRESSING AQUACEL W/HYDROFIBER .75X18

623 A6197 $ 270.00 ACTIVE

62300002DRESSING AQUACEL W/HYDROFIBER 9.5X 11.5

623 A6197 $ 242.00 ACTIVE

27100022 DRESSING BIO PATCH 271 A6219 $ 212.00 ACTIVE

27000034 DRESSING COBAN 2" 272 A6453 $ 18.74 ACTIVE

27000035 DRESSING COBAN 3" 272 A6454 $ 4.95 ACTIVE

27000180 DRESSING DRAIN SPONGE 270 A4649 $ 120.00 ACTIVE

62300003DRESSING DUODERM EXTRA THIN 2X8

623 A6234 $ 84.00 ACTIVE

62300004DRESSING DUODERM EXTRA THIN 4X6

623 A6234 $ 82.00 ACTIVE

27000592DRESSING FOAM ADHESIVE OPTIFOAN 4 X 4

272 A6212 $ 188.00 ACTIVE

27000591DRESSING FOAM EXUDER ODORSHIELD

272 A6209 $ 272.00 ACTIVE

27000182 DRESSING GAUZE TUBE P-APP 270 A6457 $ 8.45 ACTIVE

27000169 DRESSING GELFOAM 270 A6212 $ 92.00 ACTIVE

62300006DRESSING GRANUFORM ALL SIZES

623 A6550 $ 508.50 ACTIVE

27000170DRESSING HYDOCLLOID 4.5 X 7.5 OVAL

270 A6235 $ 146.00 ACTIVE

27000495 DRESSING KERLIX ROLL 272 A6445 $ 384.00 ACTIVE

27000185 DRESSING OPSITE 2X3 272 A6258 $ 0.90 ACTIVE

27200797 DRESSING SPANDEX (ALL) 272 A6210 $ 204.00 ACTIVE

27200808DRESSING SURESITE/TEGADERM TRANSPARENT 6 X 8

272 A6259 $ 172.00 ACTIVE

27000171DRESSING SURGICAL ISLAND 4 X 8

270 A6235 $ 22.00 ACTIVE

27000172 DRESSING TAGADERM 10X12 C 272 A6204 $ 132.00 ACTIVE

27000195 DRESSING TEGADERM 4X4 272 A6203 $ 12.60 ACTIVE

27000197 DRESSING TELFA 2X3 272 A6219 $ 16.00 ACTIVE



27200771 DRESSING UNNA 4" 270 A6456 $ 108.45 ACTIVE

62300005 DRESSING VASELINE 623 A6222 $ 190.00 ACTIVE


Charge Amt Status

Charge Master List

27000205 DRESSING XEROFORM 1/8 272 A6222 $ 15.00 ACTIVE

27000206 DRESSING XEROFORM 5X9 272 A6223 $ 18.10 ACTIVE

45000084DRESSING/DEBRIDEMENT PART-THICKNESS APPLICATION BURNS-LESS 5% BODY

450 16020 $ 2,826.00 ACTIVE

27800584DRILL 2.0MM X 102MM WL 50MM AO-SHAFT

272 C1713 $ 4,170.00 ACTIVE

27000435DRILL BONE GRAFT 10MM PART# BG-8020-5

272 A4649 $ 7,560.00 ACTIVE

27000738DRILL BONE GRAFT 8MM PART#BG8010S

272 C1713 $ 7,520.00 ACTIVE

36000111 DRN OF RETROPER ABCS 360 49060 $ 6,858.60 ACTIVE

36000133 DRN PAN PSUDOCYST PRQ 360 48511 $ 8,880.82 ACTIVE

27000174 DRSNG 4X4 10S 270 A6413 $ 52.00 ACTIVE

27000175 DRSNG 4X4 2S 270 A6413 $ 48.00 ACTIVE

27000176 DRSNG 4X4 NON STERILE LF 270 A6216 $ 5.40 ACTIVE

27000179 DRSNG AEROFORM STRIP 5X9 270 A6212 $ 28.00 ACTIVE

27000181 DRSNG GZ IODINE 270 A6224 $ 112.00 ACTIVE

27000183 DRSNG KERLIX FLUFF 270 A6403 $ 32.20 ACTIVE

27000184 DRSNG NASAL PK VASE 270 A6223 $ 66.00 ACTIVE

27000186 DRSNG OPSITE 5X7 272 A6259 $ 120.00 ACTIVE

27000187 DRSNG SPAND SZ 1-2 272 A6243 $ 52.00 ACTIVE




27000191 DRSNG SPANDAG P/40 272 A6244 $ 90.00 ACTIVE

27000192 DRSNG SURGICEL 2X3 272 A6203 $ 550.00 ACTIVE

27000193 DRSNG SURGICEL 4X8 272 A6204 $ 550.00 ACTIVE

27000194 DRSNG SURGIPAD EA 272 A6203 $ 16.00 ACTIVE

27000196 DRSNG TELFA 1.5X2 272 A6219 $ 32.00 ACTIVE

27000200 DRSNG VAS GZ 1/2 272 A6223 $ 28.00 ACTIVE

27000201 DRSNG VAS GZ 1/36 272 A6224 $ 28.00 ACTIVE

27000202 DRSNG VAS GZ 3X18 272 A6224 $ 28.00 ACTIVE



30100132DRUG SCREEN METHYLXANTHINE CLASS (EACH)

301 G0434 $ 502.32 ACTIVE

30000045 DRUG SCREEN PANEL 301 80305 $ 151.20 ACTIVE

30000007DRUG SCRN QUANT OXCARBAZEPIN

300 80183 $ 176.76 ACTIVE

30100098DRUG TEST PRESUMPTIVE CHEMISTRY ANLYZR

301 80307 $ 287.32 ACTIVE

30000044

DRUG TEST PRESUMPTIVE, ANY NUMBER DRUG CLASSES; ANY DEVICES OR PROC(IMMUNOASSAY), CAPABLE OF BEING READ BY

300 G0477 $ 4,472.00 ACTIVE

30100110

DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND

301 G0481 $ 164.42 ACTIVE


Charge Amt Status

Charge Master List

30100115

DRUG TEST(S), DEFINITIVE, UTILIZING DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL IS

301 G0659 $ 323.25 ACTIVE

27200646 DUET TRS 60 272 A4649 $ 16,485.00 ACTIVE

25901707DULOXETINE DR (CYMBALTA) 30MG CAPSULE

250 J8499 $ 54.00 ACTIVE

27000207 DUODERM 4 X 4 272 A6212 $ 146.00 ACTIVE

27000012 DUODERM CGF 4X4 DRESSING 270 A6212 $ 64.00 ACTIVE

27000013DUODERM EXTRA THIN CGF SPOTS

270 A6212 $ 60.00 ACTIVE

92100004 DUP ABD/PELVIC/RETRO PERI 921 93975 $ 9,070.50 ACTIVE

92100016 DUP SCN EXTCRANI ARTS LTD 921 93882 $ 5,022.00 ACTIVE

92100006 DUPLEX ABD/PELV/RETRO LTD 921 93976 $ 1,780.66 ACTIVE

92100008DUPLEX DOPP L EXT ARTERIAL BILATERAL

921 93925 $ 9,070.50 ACTIVE

92100005DUPLEX DOPP L EXT ARTERIAL UNILA

921 93926 $ 6,201.00 ACTIVE

92100011DUPLEX DOPP VENOUS IMAG UPP/LOW EXT BILATERAL

921 93970 $ 9,070.50 ACTIVE

92100013

DUPLEX DOPP VENOUS IMAG UPP/LOW EXT UNILAT INC RESPONSES TO COMPRESSION/ MANEUVERS

921 93971 $ 4,765.50 ACTIVE

92100009 DUPLEX UPPER EXTREM BILAT 921 93930 $ 2,470.44 ACTIVE

92100010 DUPLEX(UPPER)EXTR UNILAT 921 93931 $ 1,702.40 ACTIVE

25900421 DURAGESIC 25 MCG/HR PATCH 250 J3490 $ 357.00 ACTIVE

25900420 DURAGESIC 75MCG PATCH 250 J3490 $ 606.00 ACTIVE

27100013 DURAPREP 26ML 271 A4245 $ 340.00 ACTIVE

27100012 DURAPREP 6ML 271 A4649 $ 176.00 ACTIVE

36000020EACH ADDITIONAL STENT VESSEL

360 37206 $ 881.00 ACTIVE

25901868 EARACHE DROPS 10ML 250 J3490 $ 14.00 ACTIVE

30200063 EASTERN EQUINE ENCEPHALITIS 302 86652 $ 48.84 ACTIVE

73000001 ECG 12 LEAD TRACE ONLY 730 93005 $ 676.20 ACTIVE

73100001 ECG 24H W/VIS SCN ANA RPT 731 93226 $ 730.94 ACTIVE

73100002 ECG MON-24 HRS RECORDING 731 93225 $ 1,355.62 ACTIVE

48000024 ECHO C/2D 483 93306 $ 3,083.50 ACTIVE

40200003 ECHO FTL CV SYS R-T REC 402 76825 $ 1,288.00 ACTIVE

40200004ECHO FTL CV SYS R-T REC REPEAT

402 76826 $ 1,159.20 ACTIVE

48000021ECHO TRANSESOPHAGEAL 2D W/PROBE IMAGE ACQUISITION INTERPRETATION & REPORT

480 93312 $ 4,553.08 ACTIVE

48000017

ECHO TRANSESOPHAGEAL CONGENITAL ANOMALIES W/PROBE IMAGE INTEPRETATION & REPORT

480 93315 $ 4,553.08 ACTIVE

48000020ECHO TRANSTHORACIC 2D FOLLOW-UP/LIMITED STUDY

480 93308 $ 1,159.20 ACTIVE

48000018

ECHO TRANSTHORACIC REAL-TIME 2D CARDIOVASCULAR STRESS TEST INTERPRETATION & REPORT

480 93350 $ 2,437.54 ACTIVE


Charge Amt Status

Charge Master List

48300001

ECHOCARDIOGRAPHY, TRANSTHORACIC(2D), INC M-MODE REC, WHEN PERFORMED, DURING REST/CARDIO STRESS TEST; W/INT AND REP; INC MONITORING W/SU

483 93351 $ 11,952.00 ACTIVE

48000019ECHOCARDIOGRAPHY, TRANSTHORACIC, 2D; COMPLETE

480 93307 $ 2,437.54 ACTIVE

74000001 EEG ROUTINE 740 95816 $ 1,700.16 ACTIVE

74000002 EEG UP TO 1 HR 740 95812 $ 1,812.86 ACTIVE

25900430 EFFEXOR XR 75MG CAP 250 J8499 $ 76.00 ACTIVE

75000005EGD DIAGNOSTIC; FLEXIBLE TRANSORAL

361 43235 $ 6,544.50 ACTIVE

36000067

EGD FLEX TRANSORAL W/FUNDOPLASTY PARTIAL/COMPLETE INC DUODENOSCOPY

360 43210 $ 22,871.50 ACTIVE

36000232EGD FLEXIBLE TRANSORAL W/BX SINGLE OR MULTIPLE

360 43239 $ 7,398.00 ACTIVE

36000270

EGD FLEXIBLE, TRANSORAL W/REMOVAL OF TUMOR/POLYP/LESION BY SNARE TECHNIQUE

360 43251 $ 10,445.50 ACTIVE

73000003 EKG HOLTER MONITOR FOR 24 730 93224 $ 602.14 ACTIVE

32000085 ELBOW 2 VIEWS 320 73070 $ 1,316.00 ACTIVE

32000084 ELBOW 3V OR MORE 320 73080 $ 1,505.00 ACTIVE

32200002 ELBOW ARTHROGRAPHY 322 73085 $ 4,724.00 ACTIVE

48000006ELEC ALYS PACG CVDFB 2 CHMBR W

480 93289 $ 431.48 ACTIVE

42000022 ELECTRIC STIM(UNATT) 450 97014 $ 226.82 ACTIVE

73000004ELECTROCARDIOGRAM, ROUTINE ECG W/12 LEADS; W/INTERPRETATION & REPORT

730 93000 $ 976.00 ACTIVE

45000004 ELECTROCONVERSION HRT EXT 450 92960 $ 3,838.12 ACTIVE

27200710ELECTRODE BLADE 5.1 COATED INSULATED HEXLOC

272 A4556 $ 68.48 ACTIVE

27200709 ELECTRODE BLADE LONG 40 272 A4556 $ 65.08 ACTIVE

27200711ELECTRODE BLADE PTFE-COATED 6.5"

272 A4556 $ 107.36 ACTIVE

27000671ELECTRODE ELECTROSURGICAL PATIENT RETURN

270 A4556 $ 140.00 ACTIVE

27200708 ELECTRODE NEEDLE STD 40 272 A4556 $ 20.12 ACTIVE

27200784 ELECTRODES 270 A4556 $ 52.00 ACTIVE

27000709 ELECTRODES RESTING EKG TAB 270 A4556 $ 17.00 ACTIVE

25901949 ELECTROLYTE PEDI 1QT BTL 250 B4103 $ 15.22 ACTIVE

92000005ELECTRONIS ANALYSIS OF IMPLANTED NEUROSTIMULATOR PULSE GENERATOR

920 95972 $ 1,092.00 ACTIVE

48100060ELECTROPHYSIOLOGIC COMPHSV EVAL-SVT- W/ ABLATION

481 93653 $ 55,432.55 ACTIVE

27200782 ELECTROSURGICAL PENCIL 272 A4649 $ 184.00 ACTIVE

27000763 END TITAL CO2 DETECTOR 270 A4649 $ 10.15 ACTIVE


Charge Amt Status

Charge Master List

32000086 ENDO BILI DUCT 320 74328 $ 2,380.00 ACTIVE

32000087 ENDO CATH PANCRETIC DUCT 320 74329 $ 2,338.00 ACTIVE

48100014 ENDOMYOCARDIAL BX 481 93505 $ 9,587.98 ACTIVE

44000004ENDOSCOPY SWALLOW TEST (FEES)

440 92612 $ 4,623.92 ACTIVE

36000287ENDOSCOPY, WRIST, W/ RELEASE OF TRANSVERSE CARPAL LIGAMENT

360 29848 $ 9,988.30 ACTIVE

36000023ENDOVASC EXTEN PROSTH ADD'L

360 34711 $ 2,870.00 ACTIVE

36000024ENDOVASC EXTEND PROSTH INIT

360 34709 $ 9,268.00 ACTIVE

25000187 ENOXAPARIN 60MG/0.6ML SRG 636 J1650 $ 102.00 ACTIVE

36000056ENTEROLYSIS (FREEING OF INTESTINAL ADHESION) (SEPARATE PROCEDURE)

360 44005 $ 45,746.40 ACTIVE

27200285 EON PATIENT PROGRAMMER 272 C1787 $ 11,014.92 ACTIVE

48100111 EP STUDY -SVT - NO ABLATION 481 93620 $ 76,921.20 ACTIVE

48100071EP STUDY/ TRASPTL, A FIB, PULM VEIN ABLT

481 93656 $ 82,943.52 ACTIVE

27200548 E-PACK PROCEDURE KIT #7836E 272 33512 $ 2,609.06 ACTIVE

32000088 EPIDUROGRAM 320 72275 $ 5,548.00 ACTIVE

30200003EPSTEIN-BARR NUCLEAR ANTIGEN ANTIBODY

302 86664 $ 203.88 ACTIVE

30200100EPSTEIN-BARR VIRAL CAPSID ANTIGEN ANTIBODY IMMUNOGLOBIN-G

302 86665 $ 128.80 ACTIVE

30200105EPSTEIN-BARR VIRUS EARLY ANTIGEN

302 86663 $ 174.96 ACTIVE

27000208 EQUALIZER WALKER LG (16218) 270 L4386 $ 688.00 ACTIVE

27000209EQUALIZER WALKER MED (16216)

270 L4386 $ 688.00 ACTIVE

45000143ER TEMP FOLEY CATHETER INSERTION

450 51702 $ 1,343.00 ACTIVE

75000007 ERCP 750 43260 $ 8,384.00 ACTIVE

75000008ERCP W/BIOPSY SINGLE OR MULTIPLE

750 43261 $ 12,576.00 ACTIVE

75000013ERCP W/SPHINCTEROTOMY/PAPILLOTOMY

750 43262 $ 11,482.19 ACTIVE

25901428 ERTHYROMYCIN 250MG TAB 250 J8499 $ 16.00 ACTIVE

25900447 ERYTHROMYCIN 500MG TAB 250 J8499 $ 30.00 ACTIVE

25900446 ERYTHROMYCIN 5MG/GM OINT 250 A6250 $ 124.00 ACTIVE

30100136 ERYTHROPOIETIN (EPO) 301 82668 $ 250.56 ACTIVE

25000198 ESMOLOL HCI 10MG/1ML 10ML 250 J3490 $ 326.00 ACTIVE

25901861 ESOMEPRAZOLE 20MG CAP 250 J8499 $ 7.07 ACTIVE

36000337ESOPHAGOSCOPY, FLEXIBLE, TRANSORAL; W/REMOVAL OF FB

360 43215 $ 7,162.50 ACTIVE

32000089 ESOPHAGUS 320 74220 $ 4,243.50 ACTIVE

42000021 E-STIM EA 15 450 97032 $ 251.92 ACTIVE

30100137 ESTRADIOL (E2) 301 82670 $ 372.48 ACTIVE

30100138 ESTRIOL 301 82677 $ 322.44 ACTIVE

30100139 ESTROGEN FRACTIONATED 301 82671 $ 430.68 ACTIVE

30100140 ESTROGENS (TOTAL) 301 82672 $ 289.32 ACTIVE

30100141 ESTRONE 301 82679 $ 186.76 ACTIVE


Charge Amt Status

Charge Master List

25900458 ETHYL CHLORIDE 250 J3490 $ 324.00 ACTIVE

30100142 ETHYLENE GLYCOL 301 82693 $ 198.72 ACTIVE

25901940 ETOMIDATE 40MG/20ML VIAL 250 J3490 $ 13.84 ACTIVE

30000052 EUGLOBULIN LYSIS 300 85360 $ 112.08 ACTIVE

45000106EVACUATION OF SUBUNGUAL HEMATOMA

450 11740 $ 1,692.00 ACTIVE

44400002 EVAL FNX SWALL 120 450 92610 $ 6,877.92 ACTIVE

44400006 EVAL MTN FLUOR SWA 120 450 92611 $ 6,877.92 ACTIVE

44400009 EVAL SP/COM DVC 1ST HR 450 92607 $ 1,597.12 ACTIVE

44400010 EVAL SP/COM DVC ADL 30 450 92608 $ 360.64 ACTIVE

44400011 EVAL SP/LANG/COM 120 450 92506 $ 2,588.88 ACTIVE

27900039 EVICEL APPLICATOR 270 A4649 $ 1,950.00 ACTIVE

27200676 EVICEL KIT W/PRESSURE 272 C9250 $ 10,395.00 ACTIVE

44000012 EXAM NEUROBEHAVIOR HR 450 96116 $ 1,610.00 ACTIVE

32000090 EXAM OF MIDDLE EAR 320 70134 $ 734.38 ACTIVE

36000025EXCH PREV PLCD ABSC/CYST DRAIN CATH W/GDE

360 49423 $ 7,676.48 ACTIVE

36100014EXCISION OF CHEST WALL TUMOR INCLUDING RIBS

361 19260 $ 12,505.80 ACTIVE

36000239EXCISION OF HYDROCELE BILATERAL

360 55041 $ 26,726.50 ACTIVE

36000260EXCISION OF HYDROCELE; UNILATERAL

360 55040 $ 17,705.50 ACTIVE

36000348EXCISION OF LESION OF SPERMATIC CORD (SEPARATE PROCEDURE)

360 55520 $ 23,561.50 ACTIVE

36100016EXCISION OF SPERMATOCELE W/ OR W/O EPIDIDYMECTOMY

361 54840 $ 15,475.00 ACTIVE

36000267

EXCISION OF VARICOCELE/LIGATION OF SPERMATIC VEINS FOR VARICOCELE; SEPERATE PROCEDURE

360 55530 $ 18,416.50 ACTIVE

45000049EXCISION OTHER BENIGN LESION INCLUDING MARGINS EXCEPT SKIN TAG

450 11440 $ 600.00 ACTIVE

36000302EXCISION TUMOR SOFT TISSUE NECK/ANTERIOR THORAX, SUBCUT; <3CM

360 21555 $ 14,990.00 ACTIVE

36000272EXCISION TUMOR SOFT TISSUE OF UPPER ARM/ELBOW AREA, SUBCUT <3CM

360 24075 $ 15,437.50 ACTIVE

36100022EXCISION TUMOR SOFT TISSUE PELVIS/HIP AREA, SUBCUT; <3CM

361 27047 $ 17,748.00 ACTIVE

36000315

EXCISION, BENIGN LESION INC MARGINS, EXCEPT SKIN TAG, TRUNK/ARMS/LEGS; DIAM 3.1-4.0CM

360 11404 $ 8,388.00 ACTIVE

36100025

EXCISION, BENIGN LESION INC MARGINS, EXCEPT SKIN TAG, TRUNK/ARMS/LEGS; EXCISED DIAMETER 0.5CM OR <

361 11400 $ 4,176.00 ACTIVE

36100026

EXCISION, BENIGN LESION INC MARGINS, EXCEPT SKIN TAG, TRUNK/ARMS/LEGS; EXCISED DIAMETER 0.6 TO 1.0CM

361 11401 $ 5,384.00 ACTIVE


Charge Amt Status

Charge Master List

36100027

EXCISION, BENIGN LESION INC MARGINS, EXCEPT SKIN TAG, TRUNK/ARMS/LEGS; EXCISED DIAMETER 1.1 TO 2.0CM

361 11402 $ 5,922.00 ACTIVE

36000341

EXCISION, BENIGN LESION INCL MARGINS, EXCEPT SKIN TAG, SCALP/NECK/HANDS/FEET/GENITALIA; EXCISED DIAM >4CM

360 11426 $ 14,274.00 ACTIVE

36000372

EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), SCALP, NECK, HANDS, FEET, GENITALIA; EXCISED DIAM

360 11421 $ 600.00 ACTIVE

36000339

EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG, TRUNK, EXTREM; DIAMETER >4.0CM

360 11406 $ 12,218.50 ACTIVE

36100024EXCISION, LESION INC MARGINS EXCEPT SKIN TAG TRUNK/ARMS/LEGS; 2.1-3.0CM

361 11403 $ 7,285.00 ACTIVE

36000370 EXCISION, OLECRANON BURSA 360 24105 $ 17,335.50 ACTIVE

36000338EXCISION, OTHER BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG, FACE 3.1-4CM

360 11444 $ 11,219.50 ACTIVE

36000369

EXCISION, TUMOR, SOFT TISSUE OF FOOT OR TOE, SUBCUTANEOUS; LESS THAN 1.5 CM

360 28043 $ 13,128.50 ACTIVE

36000309EXCISION, TUMOR, SOFT TISSUE OF PELVIS/HIP AREA, SUBC 3 CM OR>

360 27043 $ 23,279.50 ACTIVE

36000273

EXCISION/CURETTAGE OF BONE CYST/BENIGN TUMOR OF HEAD/NECK OF RADIUS/OLECRANON PROCESS

360 24120 $ 24,749.50 ACTIVE

36000154EXCSN BREAST LESION; OPEN; SINGLE LESION

360 19125 $ 13,791.26 ACTIVE

45000077EXCSN NAIL/NAIL MATRIX PART/COMP PERM RMV

450 11750 $ 350.00 ACTIVE

48200002EXERCISE/PHARMACOLOGICAL STRESS WITHOUT TRANSPORT

482 93015 $ 4,989.00 ACTIVE

25000871 EXPAREL 1.3% 200MG/20ML 250 J3490 $ 62.00 ACTIVE

36000280EXPLORATION OF EPIDIDYMIS, W/ WO BX

360 54865 $ 18,590.50 ACTIVE

36000323EXPLORATION OF PENETRATING WOUND (SEPARATE PROCEDURE); EXTREMITY

360 20103 $ 18,072.00 ACTIVE

36000059

EXPLORATORY LAPAROTOMY EXPLORATORY CELIOTOMY W/ OR W/OUT BX (SEPARATE PROCEDURE)

360 49000 $ 32,212.00 ACTIVE

32000017 EXT CAROTID BI-LAT 320 75662 $ 14,808.78 ACTIVE

32000018 EXT CAROTID UNI-LAT 320 75660 $ 4,945.92 ACTIVE


Charge Amt Status

Charge Master List

27200003

EXTENSION DRAINAGE TUBING, ANY TYPE, ANY LENGTH, WITH CONNECTOR/ADAPTOR, FOR USE WITH URINARY LEG BAG OR UROSTOMY POUCH, EACH

272 A4331 $ 10.74 ACTIVE

27000765EXTENSION SET CARESITE 35 INCH T

270 S1015 $ 10.26 ACTIVE

30200018EXTRACTABLE NUCLEAR ANTIGEN, ANTIBODY TO, ANY METHOD

302 86235 $ 239.16 ACTIVE

25901862 EYE WASH 118ML 250 J3490 $ 5.00 ACTIVE

32000092 EYE XRAY FOR FB 320 70030 $ 905.00 ACTIVE

27000003EZ BENT TIP RETRIEVAL SHEATH 6 FRENCH

272 C1884 $ 18,000.00 ACTIVE

76100008 F/U VISIT LEVEL 1 761 99211 $ 567.40 ACTIVE




76100012 F/U VISIT LEVEL 5 761 99215 $ 1,177.00 ACTIVE

31000009

F5 (COAGULATION FACTOR V) (EG, HEREDITARY HYPERCOAGULABILITY) GENE ANALYSIS, LEIDEN VARIANT

310 81241 $ 366.85 ACTIVE

45000148 FAC FEE FOLLOW UP 450 99024 $ 1,000.00 ACTIVE

45000005 FAC FEE LEVEL I 450 99281 $ 2,400.00 ACTIVE

45000007 FAC FEE LEVEL II 450 99282 $ 5,000.00 ACTIVE

45000009 FAC FEE LEVEL III 450 99283 $ 13,000.00 ACTIVE

45000011 FAC FEE LEVEL IV 450 99284 $ 15,000.00 ACTIVE

45000013 FAC FEE LEVEL V 450 99285 $ 18,000.00 ACTIVE

32000093 FACIAL BONE 3V OR MORE 320 70150 $ 1,986.00 ACTIVE

32000094 FACIAL BONES <3 VIEWS 320 70140 $ 1,420.50 ACTIVE

30100255 FACTOR V LEIDEN MUTATION 1 301 83891 $ 238.00 ACTIVE




45000057FACTOR VIII (ANTIHEMOPHILIC FACTOR HUMAN) PER IU

450 J7190 $ 100.00 ACTIVE

25900466 FAMOTIDINE 20MG TAB 259 J8499 $ 46.00 ACTIVE

25000026 FAMOTIDINE 20MG/50ML IV 250 S0028 $ 13.80 ACTIVE

30100591 FAT GLOBULES URINE 300 89125 $ 17.64 ACTIVE

30100144FATS/LIPIDS FECES QUALITATIVE

301 82705 $ 67.92 ACTIVE

30100088 FATTY ACIDS, NONESTERIFIED 301 82725 $ 225.24 ACTIVE

30100057 FECAL BILIRUBIN (QUALITATIVE) 301 82252 $ 60.72 ACTIVE

30100143FECAL FATS/LIPIDS QUANTITATIVE

301 82710 $ 224.04 ACTIVE

27100023 FECAL MGMNT KIT 271 A4649 $ 6,552.00 ACTIVE

27100024 FECAL MGMNT POUCH 271 A4330 $ 452.00 ACTIVE

44000005FEES W/LARYNGEAL SENSE TEST

440 92616 $ 7,753.76 ACTIVE

48100039FEM/POP REVASC ANGIOPLASTY UNILATERAL

481 37224 $ 29,627.23 ACTIVE


Charge Amt Status

Charge Master List

48100042 FEM/POP REVASC STENT/ATHER 481 37227 $ 71,835.92 ACTIVE

48100040FEM/POP REVASC W/ ATHERE/ANGIO

481 37225 $ 51,568.52 ACTIVE

48100041 FEM/POP REVASC W/STENT 481 37226 $ 51,568.52 ACTIVE

36000026 FEM-POP ATHERECTOMY 360 35493 $ 29,141.00 ACTIVE

25900470 FENTANYL 100MCG/HR PATCH 250 J3490 $ 684.00 ACTIVE

25900471 FENTANYL 50MCG/HR. P 250 J3490 $ 402.00 ACTIVE

30100146 FERRITIN 301 82728 $ 181.80 ACTIVE

25900475 FERROUS SULFATE TAB 325 250 J8499 $ 30.00 ACTIVE

30500022FIBRIN DEGRADATION PRODUCTS AND D-DIMERS QUALITATIVE

305 85378 $ 116.64 ACTIVE

30500020 FIBRINOGEN ACTIVITY 305 85384 $ 116.64 ACTIVE

30200245 FIBRINOGEN ANTIGEN 305 85385 $ 173.52 ACTIVE

30500021FIBRINOGEN DEGRADATION SPLIT PRODUCTS

305 85362 $ 91.80 ACTIVE

30000053FIBRINOLYTIC FACTORS AND INHIBITORS; ALPHA-2 ANTIPLASMIN

305 85410 $ 102.72 ACTIVE

30000054FIBRINOLYTIC FACTORS AND INHIBITORS; PLASMINOGEN, EXCEPT ANTIGENIC ASSAY

305 85420 $ 87.12 ACTIVE

27000666 FILTER ANTI-REFLUX 270 A7013 $ 250.00 ACTIVE

27000659 FILTER BACTERIA 270 A7013 $ 104.00 ACTIVE

27000767 FINGER STICK LANCET 270 A4259 $ 8.00 ACTIVE

32000096 FINGER(S) 2V OR MORE 320 73140 $ 1,487.50 ACTIVE

25901301 FIORICET TAB 250 J8499 $ 24.00 ACTIVE

25900478 FLAGYL 250MG TABLET 250 J8499 $ 69.00 ACTIVE

25900479 FLAGYL 500MG TABLET 250 J8499 $ 84.00 ACTIVE

25900481 FLECAINIDE 50MG TABLET 250 J8499 $ 18.00 ACTIVE

25900482 FLEET ENEMA 250 J3490 $ 205.50 ACTIVE

25900486 FLOMAX 0.4MG CAPSULE 250 J8499 $ 45.00 ACTIVE

25900487 FLONASE 0.05% NASAL SPRAY 250 J3490 $ 960.00 ACTIVE

25900488 FLORINEF 0.1MG TABLET 250 J8499 $ 22.00 ACTIVE

31100006FLOW CYTOMETRY CELL SURFACE MARKER

311 88185 $ 135.52 ACTIVE

31100008FLOW CYTOMETRY FIRST MARKER

311 88184 $ 866.18 ACTIVE

31100009FLOW CYTOMETRY INTERPERTATION

311 88187 $ 501.20 ACTIVE

25901939 FLUCAINE OPTH SOL 5ML 250 J3490 $ 74.56 ACTIVE

27200890FLUID MANAGEMENT PACK, ENDOSCOPY

272 A4649 $ 342.60 ACTIVE

25901941 FLUMAZENIL 1MG/10ML 250 J3490 $ 12.08 ACTIVE

32000097FLUOR GUIDE NDL PLACE/ASP/BX

320 77002 $ 1,255.80 ACTIVE

25901942FLUORESCEIN +BENOXINATE OPHTH 0.25% SOLN

250 J3490 $ 24.00 ACTIVE

27000691 FLUORESCEIN DROPS 5ML 270 J3490 $ 20.00 ACTIVE

30200016FLUORESCENT NONINFECTIOUS AGENT ANTIBODY; SCREEN, EACH ANTIBODY

302 86255 $ 160.68 ACTIVE

25000207 FLUOR-I-STRIP 9MG STRIP 250 A9150 $ 24.00 ACTIVE

32000019 FLUORO <1 HOUR 320 76000 $ 2,257.50 ACTIVE

32000020 FLUORO >1 HOUR 320 76001 $ 7,134.00 ACTIVE

32000098 FLUORO GUIDE CVA DEVICE 320 77001 $ 1,092.68 ACTIVE


Charge Amt Status

Charge Master List

32000099 FLUOROSCOPIC GUIDEI 320 77003 $ 1,552.88 ACTIVE

30100148 FOLATE RED BLOOD CELL 301 82747 $ 231.00 ACTIVE

27000211FOLEY CATH 22FR 75CC RIB BALLOON

270 L4386 $ 1,712.00 ACTIVE

25900500 FOLIC ACID 1MG TABLET 250 J8499 $ 30.00 ACTIVE

30100150 FOLIC ACID SERUM 301 82746 $ 196.08 ACTIVE

30100153FOLLICLE STIMULATING HORMONE (FSH)- GONADOTROPIN

301 83001 $ 247.80 ACTIVE

45000147 FOLLOW UP VISIT 450 99027 $ 150.00 ACTIVE

32000102 FOOT 2 VIEW 320 73620 $ 1,232.00 ACTIVE

32000104 FOOT 3V OR MORE 320 73630 $ 1,386.00 ACTIVE

27400008FOOT DROP SPLINT, RECUMBENT POSITIONING DEVICE, PREFABRICATED

274 L4398 $ 226.14 ACTIVE

27200668 FORCEPS PULMONARY 272 A4649 $ 2,511.00 ACTIVE

32000105 FOREARM 2 VIEWS 320 73090 $ 1,232.00 ACTIVE

25000211 FORTAZ 1GM VIAL 250 J0713 $ 156.00 ACTIVE

30200109 FRESH FROZEN PLASMA (450ML) 302 86927 $ 383.18 ACTIVE

39000004FRESH FROZEN PLASMA 1 DONOR (EACH UNIT)

390 P9017 $ 817.88 ACTIVE

30200239 FROZEN BLOOD FREEZING EA 302 86930 $ 519.70 ACTIVE

30100152FRUCTOSAMINE/GLYCATED PROTEIN

301 82985 $ 201.12 ACTIVE

32000106 FULL BODY 1 VIEW CHILD 320 76010 $ 851.20 ACTIVE

36000332FULL THICKNESS GRAFT, FREE, INC DIRECT CLOSURE OF DONOR SITE; 20 SQ CM OR <

360 15240 $ 41,471.50 ACTIVE

30600042 FUNGUS IDENTIFICATION (MOLD) 306 87107 $ 196.42 ACTIVE

30600043 FUNGUS/YEAST IDENTIFICATION 306 87106 $ 137.64 ACTIVE

25900507 FUROSEMIDE 20MG TAB 259 J8499 $ 8.00 ACTIVE

25900508 FUROSEMIDE 40MG TABLET 259 J8499 $ 24.00 ACTIVE

25901540GABAPENTIN 100MG CAPSULE (NEURONTIN)

259 J8499 $ 30.00 ACTIVE

25901869GADODIAMIDE (OMNISCAN) 287MG 15ML BTL

250 A9579 $ 221.90 ACTIVE

25901870GADODIAMIDE (OMNISCAN) 287MG 20ML VIAL

250 A9579 $ 257.35 ACTIVE

42000023 GAIT TRAINI EA 15MIN 450 97116 $ 246.40 ACTIVE

32000107 GALACTOGRAM 1 DUCT 403 77053 $ 1,358.84 ACTIVE

30000049 GALECTIN-3 301 82777 $ 301.70 ACTIVE

30100156GAMMAGLOBULIN SUBUNITS IMMUNOGLOBIN-G1 2 3 4

301 82787 $ 106.92 ACTIVE

30100170GAMMA-GLUTAMYL TRANSPEPTIDASE/TRANSFERASE

301 82977 $ 96.00 ACTIVE

25901442 GARAMYCIN OPHTH OINT 3.5 GM 250 J3490 $ 193.20 ACTIVE

25000294GARAMYCN GENTAMICIN TO 80MG

636 J1580 $ 1,836.00 ACTIVE

31000006GARDNERELLA VAGINALIS, DNA DIR PROBE

310 87510 $ 111.40 ACTIVE

30600044 GAS LIQUID CHROMATOGRAPHY 306 87143 $ 167.04 ACTIVE

27200902GAS SAMPLING LINE W/M/M/ CONN 10'

272 A4649 $ 722.30 ACTIVE


Charge Amt Status

Charge Master List

30100628 GASES BLOOD PH ONLY 301 82800 $ 132.00 ACTIVE

30100163 GASTRIC ACID FREE & TOTAL 301 82930 $ 80.52 ACTIVE

30900004 GASTRIC INTUBATION ANALYSIS 309 89130 $ 268.64 ACTIVE

75900001 GASTRIC LAVAGE 759 91105 $ 1,079.56 ACTIVE

30100164 GASTRIC OCCULT BLOOD 301 82271 $ 63.84 ACTIVE

30100165 GASTRIN 301 82941 $ 235.08 ACTIVE

25800095 GASTROVIEW 30ML 250 J3490 $ 115.50 ACTIVE

27200002 GAUZE >16 <=48 SQ IN W/BORDR 272 A6220 $ 28.00 ACTIVE

27000574 GAUZE 2X2 NONSTERILE; EA 270 A6216 $ 2.10 ACTIVE

30100166 GENERAL HEALTH PANEL 301 80050 $ 531.00 ACTIVE

30600096GENETIC VIRUS ISOLATE HERPES SIMPLEX VIRUS

306 87255 $ 125.43 ACTIVE

25000009GENTAMICIN (GARAMYCIN) PEDI 20MG 2ML SDVIAL

636 J1580 $ 77.25 ACTIVE

25901863GENTAMICIN 0.3% OPTH DROPS 5ML

250 J3490 $ 40.93 ACTIVE

25000012 GENTAMICIN 80MG 50ML IV 636 J1580 $ 57.33 ACTIVE

25000013GENTAMICIN 80MG/100ML 0.9% NACL

636 J1580 $ 77.25 ACTIVE

25000010 GENTAMICIN 80MG/20ML IV 636 J1580 $ 57.33 ACTIVE

30100167 GENTAMICIN PEAK 301 80170 $ 218.40 ACTIVE

30200112 GIARDIA ANTIBODY 302 86674 $ 196.20 ACTIVE

30600046 GIARDIA ANTIGEN 306 87329 $ 81.76 ACTIVE

30100171 GLIADIN ANTIBODY 301 83520 $ 207.24 ACTIVE

27200886GLOVE SURGICAL ESTEEM PI PF ANY SZ D-STAT SUB

272 A4930 $ 75.00 ACTIVE

27200885GLOVE, SURGICAL, LTX, ENCORE, ACCLAIM, PF, 7

272 A4930 $ 15.90 ACTIVE

27000610 GLOVES BIOGEL (ALL) 272 A4930 $ 108.00 ACTIVE

27000768 GLOVES NON STERILE 270 A4927 $ 8.00 ACTIVE

27000577 GLOVES STERILE (ALL SZS) 272 A4930 $ 8.00 ACTIVE

25900526 GLUCOPHAGE 500MG TAB 250 J8499 $ 24.00 ACTIVE

30100174 GLUCOSE 2HR POSTPRANDIAL 301 82950 $ 63.24 ACTIVE

30100175GLUCOSE BLOOD REAGENT STRIP-FINGER STICK

301 82948 $ 60.48 ACTIVE

30100177GLUCOSE CEREBROSPINAL FLUID

301 82945 $ 52.44 ACTIVE

30100179GLUCOSE QUANTITATIVE; VENOUS BLOOD

301 82947 $ 52.44 ACTIVE

30100184GLUCOSE TOLERANCE TEST 3HR 1ST 3 SPEC

301 82951 $ 171.60 ACTIVE

30100185GLUCOSE TOLERANCE TEST ADDED SAMPLE

301 82952 $ 52.32 ACTIVE

30900022GLUCOSE, BLOOD BY GLUCOSE MONITORING DEVICE(S) FOR HOME USE

301 82962 $ 39.36 ACTIVE

30100178GLUCOSE-6-PHOSPHATE DEHYDROGENASE

301 82955 $ 129.24 ACTIVE

25900529 GLUCOTROL 10MG TABLET 250 J8499 $ 16.00 ACTIVE

25900530 GLUCOTROL 5MG TABLET 250 J8499 $ 24.00 ACTIVE

25901871 GLUTOSE 15 O/GEL 37.5GM TUBE 250 A9150 $ 8.75 ACTIVE

25901516GLYBURIDE (MICRONASE) 5MG TAB

250 J8499 $ 30.00 ACTIVE

25900535 GLYCERIN ADULT SUPP 250 J8498 $ 37.50 ACTIVE

25900004 GLYCERIN PEDI SUPP 250 J8498 $ 37.50 ACTIVE


Charge Amt Status

Charge Master List

25800071 GLYCINE 1.5% 3000ML 258 J3490 $ 104.48 ACTIVE

25901872 GOLYTELY 4,000ML SOLN 250 J3490 $ 47.68 ACTIVE

27100014 GOWNS ISOLATION 271 A4649 $ 48.00 ACTIVE

27000626 GOWNS SURGICAL 270 A4467 $ 120.00 ACTIVE

27000627 GOWNS SURGICAL XL (KC) 270 A4467 $ 224.00 ACTIVE

30600047 GRAM STAIN 306 87205 $ 57.00 ACTIVE

25901448 GRANULEX SPRAY 2 OZ 250 J3490 $ 391.00 ACTIVE

27200664 GRASPER REPOSABLE 272 A4649 $ 2,790.00 ACTIVE

91500001 GROUP PSYCHOTHERAPY 915 90853 $ 277.69 ACTIVE

25901873GUAIFENESIN +DEXTROMETHORPHAN (ROBITUSSIN DM) OS 100/10MG

250 J3490 $ 5.50 ACTIVE

25900541 GUAIFENESIN 100MG/5ML SYR 259 J3490 $ 64.00 ACTIVE

25000222GUAIFENESIN DM 200MG/20MG/10ML 10ML UD

250 J3490 $ 14.00 ACTIVE

25901874GUAIFENESIN+DEXTROMETH 600/30MG TAB

250 J8499 $ 5.50 ACTIVE

27000212 GUIDE WIRE 3.2MM 270 C1769 $ 1,012.00 ACTIVE

27200901

GUIDE WIRE HI-TORQUE BALANCE MIDDLEWIGHT UNIVERSAL .014 STRAIGHT TIP 3.0CM X 190CM

272 C1769 $ 150.00 ACTIVE

27000213GUIDEWIRE .021 SWANZ STRAIGHT F (CA10053)

270 C1769 $ 150.00 ACTIVE

27000214 GUIDEWIRE THREADED 1.1MM 270 C1769 $ 392.00 ACTIVE

27200900GUIDING CATHETER 6F .070 XB LAD 3.5 100CM

272 C1714 $ 720.00 ACTIVE

30100569 H PYLORI BREATH TESTING 301 83013 $ 898.08 ACTIVE

30100570 H PYLORI DRUG ADMIN 301 83014 $ 104.76 ACTIVE

30200115 HAEMOPHILUS INFLUENZA 302 86684 $ 211.20 ACTIVE

25900546 HALDOL 0.5MG TAB 250 J8499 $ 24.00 ACTIVE

25000746 HALDOL 1MG TAB 250 J8499 $ 24.00 ACTIVE

36000297

HALLUX RIGIDUS CORRECTION W/CHEILECTOMY, DEBRID & CAPSULAR RELEASE OF FIRST METATARSOPHALANGEAL JOINT; W/IMPLANT

360 28291 $ 11,831.00 ACTIVE

25900551 HALOPERIDOL 5MG TABLET 250 J8499 $ 30.00 ACTIVE

32000109 HAND 2 VIEWS 320 73120 $ 1,249.50 ACTIVE

32000108 HAND 3V OR MORE 320 73130 $ 1,454.50 ACTIVE

27200651HANDLE EXTRA LONG ENDO 61A ULTRA

272 A4649 $ 4,812.00 ACTIVE

30000008HANDLE SPECIMEN IN OTHER FACILITY-LAB

300 99001 $ 280.00 ACTIVE

30000050HANDLING/CONVEYANCE OF SPECIMEN FOR TRANSFER TO A LABORATORY

300 99000 $ 20.00 ACTIVE

30100186 HAPTOGLOBIN 301 83010 $ 167.64 ACTIVE

30100181 HBA1C GLYCOHEMOGLOBIN 301 83036 $ 129.48 ACTIVE

41300001 HBO 413 99183 $ 1,072.62 ACTIVE

41300002 HBO PER 30 MINUTE 413 C1300 $ 1,072.62 ACTIVE

30100525 HBV DNA 306 87517 $ 158.64 ACTIVE

30100053HCG - BETA HUMAN CHORIONIC GONADOTROPHIN QUANTITATIVE

301 84702 $ 200.76 ACTIVE


Charge Amt Status

Charge Master List

30500079 HCT SPUN 305 85013 $ 84.00 ACTIVE

30100187HDL CHOLESTEROL DIRECT MEASURE

301 83718 $ 109.20 ACTIVE

91400005HEALTH AND BEHAVIORAL INTERVENTION EA 15 MIN

914 96152 $ 277.69 ACTIVE

30100188HEAVY METAL QUANTITATIVE (BLOOD)

301 83015 $ 251.28 ACTIVE

30600049HELICOBACTER PYLORIC ANTIGEN

306 87338 $ 191.76 ACTIVE

30200116HELICOBACTOR PYLORI ANTIBODY

302 86677 $ 132.28 ACTIVE

30500024 HEMATOCRIT 305 85014 $ 31.56 ACTIVE

36000286

HEMIPHALANGECTOMY/INTERPHALANGEAL JOINT EXCISION,TOE,PROXIMAL END PHALANX, EACH

360 28160 $ 13,322.00 ACTIVE

80100001 HEMODIALYSIS TREATMENT 801 90935 $ 4,171.80 ACTIVE

30500026 HEMOGLOBIN 305 85018 $ 31.56 ACTIVE

30100190 HEMOGLOBIN (PLASMA) 301 83051 $ 97.44 ACTIVE

30100194HEMOGLOBIN ELECTROPHORESIS

301 83021 $ 240.72 ACTIVE

30200117HEMOLYSINS AND AGGLUTININS (INCUBATED)

302 86941 $ 161.40 ACTIVE

45000066HEMORRHOIDECTOMY INTERNAL AND EXTERNAL SINGLE COLUMN/GROUP

450 46255 $ 3,682.20 ACTIVE

30100191 HEMOSIDERIN (QUALITATIVE) 301 83070 $ 63.24 ACTIVE

27200329 HEMOSPLIT CATHETER 19CM 272 C1750 $ 4,272.04 ACTIVE

25901852 HEPARIN 1000 UNIT/ML 1ML VIAL 636 J1644 $ 9.20 ACTIVE

25000230 HEPARIN 25 000U/500ML D5W 636 J1644 $ 262.00 ACTIVE

63600183 HEPARIN 25,000/250ML IV 636 J1644 $ 35.40 ACTIVE

63600192 HEPARIN FLUSH 30U 3ML 636 J1642 $ 14.00 ACTIVE

63600156 HEPARIN FLUSH 500UNITS/5ML 636 J1642 $ 5.50 ACTIVE

27000217 HEPARIN LOCK 270 J1642 $ 60.00 ACTIVE

25000233HEPARIN LOCK FLUSH 100 U/ML 1ML VIAL

636 J1642 $ 14.00 ACTIVE

25000235HEPARIN LOCK FLUSH 500U/5ML SYR

636 J1642 $ 10.00 ACTIVE

32000111 HEPATIC VENOGRAM 320 75889 $ 6,955.00 ACTIVE

30200119 HEPATITIS A ANTIBODY TOTAL 302 86708 $ 165.12 ACTIVE

30200120HEPATITIS A IMMUNOGLOBIN-M ANTIBODY

302 86709 $ 150.12 ACTIVE

30200125 HEPATITIS B ANTIBODY TEST 302 86707 $ 154.20 ACTIVE

30200121 HEPATITIS B CORE ABIGM 302 86705 $ 156.96 ACTIVE

30200122HEPATITIS B CORE ANTIBODY (TOTAL)

302 86704 $ 143.16 ACTIVE

30600055HEPATITIS B E-ANTIGEN ENZYME IMMUNOASSAY

306 87350 $ 153.72 ACTIVE

30600052HEPATITIS B NUCLEIC ACID AMPLIFICATION PROBE

306 87516 $ 467.88 ACTIVE

30200128HEPATITIS B SURFACE ANTIBODY

302 86706 $ 143.16 ACTIVE

30600053HEPATITIS B SURFACE ANTIGEN ENZYME IMMUNOASSAY

306 87340 $ 137.76 ACTIVE

63600045 HEPATITIS B VACCINE 636 90746 $ 794.00 ACTIVE

30200126 HEPATITIS C ANTIBODY 302 86803 $ 190.20 ACTIVE


Charge Amt Status

Charge Master List

30600057 HEPATITIS C GENOTYPE 306 87902 $ 953.52 ACTIVE

30600056HEPATITIS C NUCLEIC ACID AMPLIFICATION PROBE

306 87521 $ 467.88 ACTIVE

30600050HEPATITIS C VIRUS B-DNA RNA QUANTIFICATION

306 87522 $ 571.20 ACTIVE

34000001

HEPATOBILIARY SYSTEM IMAGING, INC GALLBLADDER WHEN PRESENT; W/PHARMACOLOGIC INTERVENTION, INC QUANT MEAS; WHEN PERFORMED

340 78227 $ 22,294.00 ACTIVE

30200130HERPES SIMPLEX TYPE 2 ANTIBODY

302 86696 $ 193.20 ACTIVE

30200131HERPES SIMPLEX TYPE I ANTIBODY

302 86695 $ 175.80 ACTIVE

30200244HERPES SIMPLEX VIRUS AMPLIFIED PROBE TECHNIQUE

306 87529 $ 129.99 ACTIVE

30100199HERPES SIMPLEX VIRUS WESTERN BLOT ANALYSIS

301 84182 $ 350.52 ACTIVE

30600136HERPS SIMPLEX VIRUS QUANTIFICATION

306 87530 $ 158.64 ACTIVE

25800039 HESPAN 6% 500ML 250 J3490 $ 516.00 ACTIVE

30200153HETEROPHILE ANTIBODIES; SCREENING

302 86308 $ 69.00 ACTIVE

30200132 HETEROPHILE ANTIBODY TITER 302 86309 $ 86.16 ACTIVE

30100193 HGB ELECTROPHORESIS 301 83020 $ 171.60 ACTIVE

25900556 HIBICLENS 4% TOPICAL 259 A4248 $ 57.45 ACTIVE

30100195HIGH RESOLULTION LIPOPROTEIN FRACTIONATION AND QUANTIFICATION

301 83701 $ 235.20 ACTIVE

32000113 HIP DURING SURGERY 320 73530 $ 1,391.60 ACTIVE

32000225 HIP UNI W/PELVIS 2-3 VIEWS 320 73502 $ 2,092.50 ACTIVE

32000228HIP UNILAT W/PELVIS 1VIEW RADIOLOGICAL

320 73501 $ 1,265.50 ACTIVE

32000115 HIPS BIL 2V W PELV 320 73521 $ 1,898.50 ACTIVE

32000118 HIPS BIL 3-4 V W PELV 320 73522 $ 2,191.50 ACTIVE

30200133 HISTOPLASMA ANTIBODY 302 86698 $ 166.56 ACTIVE

30700015 HISTOPLASMA CAPSULATUM 306 87385 $ 44.40 ACTIVE

30200134 HIV 1 ANTIBODY 302 86701 $ 118.44 ACTIVE

30600059HIV 1 B-DNA RNA QUANTIFICATION

306 87536 $ 1,134.60 ACTIVE

30600060HIV-1 DNA PCR AMPLIFIED PROBE

306 87535 $ 467.88 ACTIVE

30200135HIV-1/HIV-2 ANTIBODY SINGLE ASSAY

302 86703 $ 182.76 ACTIVE

27200500 HME FILTER 272 A7507 $ 16.00 ACTIVE

30100196 HOMOCYSTEINE 301 83090 $ 224.88 ACTIVE

30100198 HOMOVANILLIC ACID (HVA) 301 83150 $ 268.92 ACTIVE

27000218 HOSE AE IMPER LRG 270 A6533 $ 624.00 ACTIVE

27000219 HOSE AE IMPERV MED 270 A6533 $ 158.00 ACTIVE

27000220 HOSE AE IMPERV SM 270 A6533 $ 158.00 ACTIVE

27000221 HOSE AE IMPERV WS-MD-LN 270 A6533 $ 286.00 ACTIVE

27000222 HOSE AE TED TH-LG-LN 270 A6533 $ 396.00 ACTIVE

27000223 HOSE AE TED TH-LG-RG 270 A6533 $ 396.00 ACTIVE

27000224 HOSE AE TED TH-LG-SH 270 A6533 $ 90.00 ACTIVE

27000225 HOSE AE TED TH-MD-LN 270 A6533 $ 396.00 ACTIVE

27000226 HOSE AE TED TH-MD-RG 270 A6533 $ 396.00 ACTIVE


Charge Amt Status

Charge Master List

27000227 HOSE AE TED TH-MD-SH 270 A6533 $ 396.00 ACTIVE

27000228 HOSE AE TED TH-SM-LN 270 A6533 $ 396.00 ACTIVE

27000229 HOSE AE TED TH-SM-RG 270 A6533 $ 90.00 ACTIVE

27000230 HOSE AE TED TH-SM-SH 270 A6533 $ 90.00 ACTIVE

27000231 HOSE AE TED WS-LG-LN 270 A6530 $ 224.00 ACTIVE

27000232 HOSE AE TED WS-LG-RG 270 A6530 $ 130.00 ACTIVE

27000233 HOSE AE TED WS-SM-LN 270 A6530 $ 130.00 ACTIVE

27000234 HOSE AE TED WS-SM-RG 270 A6530 $ 130.00 ACTIVE

27000235 HOSE AE TED WS-XLG-LN 270 A6530 $ 130.00 ACTIVE

27000236 HOSE AE TED WS-XLG-RG 270 A6530 $ 224.00 ACTIVE

27000237 HOSE KNEE HI/LARGE LONG 270 A6530 $ 28.00 ACTIVE

27000238 HOSE KNEE HI/LARGE REG 270 A6530 $ 28.00 ACTIVE

27000239 HOSE KNEE HI/MEDIUM LONG 270 A6530 $ 28.00 ACTIVE

27000240 HOSE KNEE HI/MEDIUM REG 270 A6530 $ 28.00 ACTIVE

27000241 HOSE KNEE HI/SMALL LONG 270 A6530 $ 28.00 ACTIVE

27000242 HOSE KNEE HI/SMALL REG 270 A6530 $ 28.00 ACTIVE

27000243 HOSE KNEE HI/X-LARGE LONG 270 A6530 $ 28.00 ACTIVE

27000244 HOSE KNEE HI/X-LARGE REG 270 A6530 $ 28.00 ACTIVE

27000603 HOSE TED KNEE HIGH (ALL) 270 A6533 $ 244.00 ACTIVE

27000601HOSE TED THIGH LENGTH X-LARGE BARIATRIC

270 A6533 $ 196.00 ACTIVE

27000602HOSE TED THIGH LENGTH XX-LARGE BARIATRIC

270 A6533 $ 648.00 ACTIVE

27000245 HOSE THIGH LG LNG WBLT 270 A6533 $ 202.00 ACTIVE

27000246 HOSE THIGH LG REG WBLT 270 A6533 $ 202.00 ACTIVE

27000247 HOSE THIGH MED LNG WBLT 270 A6533 $ 202.00 ACTIVE

27000248 HOSE THIGH MED REG WBLT 270 A6533 $ 202.00 ACTIVE

27000249 HOSE THIGH SM LNG WBLT 270 A6533 $ 202.00 ACTIVE

27000250 HOSE THIGH XLG LNG WBLT 270 A6533 $ 202.00 ACTIVE

27000251 HOSE THIGH XLG REG WBLT 270 A6533 $ 202.00 ACTIVE

98700007HOSPITAL DISCHARGE DAY MANAGEMENT; UP TO 30 MIN

987 99238 $ 1,781.75 ACTIVE

42000024 HOT/COLD PACKS 450 97010 $ 165.40 ACTIVE

25900559 HUMALOG 30UNITS/3ML 250 J3490 $ 802.00 ACTIVE

30200114HUMAN GROWTH HORMONE ANTIBODY (HGH)

302 86277 $ 209.88 ACTIVE

30100516HUMAN GROWTH HORMONE HGH

301 83003 $ 61.74 ACTIVE

30200136HUMAN LEUKOCYTE ANTIGEN B27

302 86812 $ 199.64 ACTIVE

30200137

HUMAN T-LYMPHOTROPHIC VIRUS/HUMAN IMMUNODEFICIENCY VIRUS CONFIRMATORY ANTIBODY

302 86689 $ 258.12 ACTIVE

32000116 HUMERUS 2V OR MORE 320 73060 $ 1,282.50 ACTIVE

25200012HUMULIN R (REGULAR) INSULIN 10ML

250 J1815 $ 780.00 ACTIVE

25900264HURRICAINE (CETACAINE) SPRAY PER DOSE

250 J3490 $ 854.00 ACTIVE

25000721HYDRALAZINE (APRESOLINE) 10MG TAB

250 J8499 $ 24.00 ACTIVE

25901875HYDRALAZINE (APRESOLINE) 50MG TAB

250 J8499 $ 24.00 ACTIVE

63600152 HYDRALAZINE 20MG/1ML SDVIAL 636 J0360 $ 23.94 ACTIVE

25900567 HYDRALAZINE HCL 25MG TAB 250 J8499 $ 24.00 ACTIVE

25900568 HYDRALAZINE HCL 50MG TAB 250 J8499 $ 24.00 ACTIVE


Charge Amt Status

Charge Master List

45000018HYDRATION IV INFUS INIT 31MINS-1HR

450 96360 $ 1,267.50 ACTIVE

45000017HYDRATION IV INFUSION ADD TO 8

450 96361 $ 277.88 ACTIVE

25900553HYDROCHLOROTHIAZIDE HCTZ 12.5MG CAP

259 J8499 $ 10.00 ACTIVE

25901453HYDROCHLORTHIAZIDE 25MG TAB

250 J8499 $ 24.00 ACTIVE

25900573 HYDROCODONE/APAP 10/500MG 250 J8499 $ 10.00 ACTIVE

25901963HYDROCODONE/APAP 7.5MG/325MG 15ML ORAL SOL

250 J8499 $ 12.00 ACTIVE

25900575 HYDROCORTISNE 1% 30GM CRM 250 A6250 $ 78.00 ACTIVE

25901454HYDROCORTISONE 1% CREAM 1OZ

250 A6250 $ 48.00 ACTIVE

25901876HYDROCORTISONE CREAM 0.9GM PACKET

250 A6250 $ 5.25 ACTIVE

25901456 HYDROGEN PEROXIDE 40Z LIQ 250 J3490 $ 60.00 ACTIVE

25000243HYDROMORPHONE (DILAUDID) 2MG/1ML SDVIAL UP TO 4MG

636 J1170 $ 414.00 ACTIVE

63600181HYDROMORPHONE 1MG/ML SYRINGE

636 J1170 $ 212.00 ACTIVE

27000750HYDRO-SURG WOUND IRRIGATOR

270 A4649 $ 4,799.70 ACTIVE

30100200 HYDROXYCORTICOSTEROID 301 83491 $ 233.64 ACTIVE

25000034HYDROXYZINE 10MG/5ML ORAL SYRUP

250 J8499 $ 85.56 ACTIVE

25901877 HYDROXYZINE 25MG TAB 250 J8499 $ 30.00 ACTIVE

25900579 HYDROXYZINE PAM 25MG PO 250 J8499 $ 30.00 ACTIVE

25900661HYOSCYAMINE (LEVSIN) 0.125MG TABLET

250 J8499 $ 30.00 ACTIVE

25000031HYPERTONIC SALINE 3% 500ML IV FL

250 J7131 $ 13.78 ACTIVE

32000117 HYSTEROSALPINGOGRAM 320 74740 $ 2,648.80 ACTIVE

36000368

HYSTEROSCOPY, SURGICAL; WITH ENDOMETRIAL ABLATION (EG, ENDOMETRIAL RESECTION, ELECTROSURGICAL ABLATION, THERMOABLATION)

360 58563 $ 12,704.00 ACTIVE

76100013I&D COMPLEX POST OP INFECTION

761 10180 $ 12,053.66 ACTIVE

36000265I&D OF EPIDIDYMIS, TESTIS, SCROTAL SPACE (ABSCESS/HEMATOMA)

360 54700 $ 11,190.00 ACTIVE

76100016I&D OF HEMATOMA SEROMA OR FLUID

761 10140 $ 7,678.50 ACTIVE

36000299

I&D OF ISCHIORECTAL/PERIRECAL ABSCESS (SEPARATE PROCEDURE)

360 46040 $ 20,460.00 ACTIVE

27000252 IAB LINEAR 7.5 34CC (C10433) 272 A4301 $ 10,550.00 ACTIVE

27000253 IAB LINEAR 7.5 40CC (C10434) 272 A4301 $ 10,550.00 ACTIVE

27000254 IAB STATLOCK 272 A4301 $ 5,294.00 ACTIVE

25901459 IBUPROFEN 400MG TAB 259 J8499 $ 24.00 ACTIVE

25901950 IBUPROFEN 50MG 1.25ML OS 259 J3490 $ 24.00 ACTIVE

25400002 IBUTILIDE 1MG/10ML VIAL 636 J1742 $ 482.60 ACTIVE

63600048 IBUTILIDE FUMARATE 1MG 636 J1742 $ 482.72 ACTIVE


Charge Amt Status

Charge Master List

48100072ICAR CATHETER ABLATION ATRIOVENTR NODE FUNCTION

481 93650 $ 73,900.26 ACTIVE

48000034ICD EVAL S/D ICD LEADS AT INITIAL IMPLANT

480 93640 $ 14,381.36 ACTIVE

48000035ICD PULSE GENERATOR TESTING S/D ICD

480 93641 $ 27,559.98 ACTIVE

27000255 ICE PACK STAY DRY LG (16256) 270 A9273 $ 52.00 ACTIVE

30600018IDENTIFY CULTURED AEROBIC BACTERIA

306 87077 $ 107.64 ACTIVE

30600061IDENTIFY EACH ANAEROBIC ORGANISM

306 87076 $ 107.64 ACTIVE

48100018ILIAC ANGIO WITH LEFT HEART CATH (NON-SELECTIVE)

481 G0278 $ 53,830.57 ACTIVE

48100056 ILIAC REVASC W /STENT ADD ON 481 37223 $ 2,567.00 ACTIVE

48100054 ILIAC REVASC W/STENT 481 37221 $ 48,600.00 ACTIVE

48100055 ILIAC REVASC. ADD ON 481 37222 $ 3,336.00 ACTIVE

36000138IMAGE CATH FLUID COLXN VISC; PERCUTANEOUS

360 49405 $ 8,880.82 ACTIVE

36000135 IMAGE CATH FLUID PERI/RETRO 360 49406 $ 8,880.82 ACTIVE

30100202 IMIPRAMINE 301 80174 $ 202.86 ACTIVE

27000257 IMMOB ARM LARGE 270 L3702 $ 38.00 ACTIVE

27000258 IMMOB ARM MEDIUM 270 L3702 $ 46.00 ACTIVE

27000259 IMMOB ARM SMALL 270 L3702 $ 260.00 ACTIVE

27000260 IMMOB ARM XLG 270 L3702 $ 50.00 ACTIVE

27000261 IMMOB KNEE POST/OP LGE 274 L1830 $ 650.00 ACTIVE

27000262 IMMOB KNEE POST/OP MED 274 L1830 $ 650.00 ACTIVE

27000263 IMMOB KNEE POST/OP SML 274 L1830 $ 650.00 ACTIVE

27000264 IMMOB KNEE POST/OP XLRG 274 L1830 $ 114.00 ACTIVE

27000256 IMMOB KNEE POST/OP XXL 2 270 L1830 $ 114.00 ACTIVE

27000265 IMMOB KNEE POST/OP XXLG 274 L1830 $ 112.00 ACTIVE

27000266 IMMOB SHLDR MED 270 L3660 $ 650.00 ACTIVE

27000267 IMMOB SHLDR SM 270 L3660 $ 650.00 ACTIVE

27000268 IMMOB SHLDR X- LRG 270 L3660 $ 650.00 ACTIVE

27000269 IMMOB SHLDR XL 270 L3660 $ 650.00 ACTIVE

27000270 IMMOB ULTRASLING LARGE 270 L3670 $ 52.00 ACTIVE

27000271 IMMOB ULTRASLING MEDIUM 270 L3670 $ 366.00 ACTIVE

27000272 IMMOB ULTRASLING SMALL 270 L3670 $ 50.00 ACTIVE

27400005 IMMOBILIZER KNEE LG 274 L1830 $ 430.00 ACTIVE

27000273IMMOBILIZER SHOULDER ELASTIC (16227)

270 L3660 $ 80.00 ACTIVE

27000274IMMOBILIZER SHOULDER LG (16228)

270 L3660 $ 80.00 ACTIVE

27000275IMMOBILIZER SHOULDER MED FEMALE (16230)

270 L3660 $ 150.00 ACTIVE

27000276IMMOBILIZER SHOULDER MED MALE (16229)

270 L3660 $ 176.00 ACTIVE

27000277IMMOBILIZER SHOULDER XLG FEMALE (16302)

270 L3660 $ 204.00 ACTIVE

27000278IMMOBILIZER SHOULDER XLG MALE (16301)

270 L3660 $ 204.00 ACTIVE

27000279IMMOBILIZER SLINE & SWATHE AR

270 L3671 $ 86.00 ACTIVE

30200138 IMMUNE COMPLEX ASSAY 302 86332 $ 324.96 ACTIVE

77100006IMMUNIZ ADMIN 1 VACC SINGL/COMBO

771 90471 $ 277.88 ACTIVE


Charge Amt Status

Charge Master List

30200139IMMUNOASSAY IMMUNOELECTROPHORESIS (SERUM)

302 86320 $ 359.04 ACTIVE

30200140IMMUNOASSAY IMMUNOELECTROPHORESIS (URINE)

302 86325 $ 298.20 ACTIVE

30200209

IMMUNOASSAY, INFECTIOUS AGENT ANTIBODY, QUANTITATIVE, NOT OTHERWISE SPECIFIED

302 86317 $ 55.55 ACTIVE

31200004IMMUNOCYTHOCHEMISTRY EACH ANTIBODY

312 88342 $ 336.34 ACTIVE

30200141IMMUNOFIXATION ELECTROPHORESIS (SERUM)

302 86334 $ 297.96 ACTIVE

30100553 IMMUNOFIXATION URINE 302 86335 $ 108.69 ACTIVE

31000001IMMUNOFLUORESCENT STUDY, EACH ANTIBODY; DIRECT METHOD

312 88346 $ 492.66 ACTIVE

30100159 IMMUNOGLOBIN-E 301 82785 $ 219.48 ACTIVE

30100157 IMMUNOGLOBULINS IGA IGG IGM 301 82784 $ 124.08 ACTIVE

27200333 IMP 1.8MM PIN 22MM 201.972 272 C1713 $ 616.06 ACTIVE

27200362IMP BARD FIRM LUBRISTENT 030724

272 C2617 $ 1,698.08 ACTIVE

27600001 IMP RESTOR CATARACT LENS 276 V2632 $ 7,693.42 ACTIVE

27000280IMPED CONT ENDOMETRIAL ABLATION DISP DEVICE KIT

270 A4264 $ 10,344.00 ACTIVE

36000234IMPLANTATION OF MESH FOR HERNIA REPAIR OR FOR CLOSURE

360 49568 $ 14,018.50 ACTIVE

41000006 INCENT SPIRO INITIAL 410 G0237 $ 276.92 ACTIVE

41000030 INCENTIVE SPIROMETRY INITIAL 410 94664 $ 539.53 ACTIVE

41000031INCENTIVE SPIROMETRY INSTRUCTION

410 94799 $ 263.08 ACTIVE

36000192INCISION & DRAINAGE DEEP ABSCESS, BURSA/HEMATOMA THIGH/KNEE REGION

360 27301 $ 26,064.00 ACTIVE

36000251INCISION & DRAINAGE, LEG/ANKLE; DEEP ABSCESS/HEMATOMA

360 27603 $ 20,139.50 ACTIVE

51000024INCISION & REMOVAL OF FB SKIN SIMPLE SUB TISSUE

361 10120 $ 5,349.50 ACTIVE

45000108INCISION AND DRAINAGE OF ABSCESS COMPLICATED/ MULTIPLE

450 10061 $ 9,252.00 ACTIVE

45000080INCISION AND DRAINAGE OF ABSCESS SIMPLE/ SINGLE

450 10060 $ 5,022.00 ACTIVE

45000107INCISION AND DRAINAGE OF PILONIDAL CYST COMPLICATED

450 10081 $ 8,766.00 ACTIVE

36100028INCISION AND REMOVAL OF FB, SUBCUTANEOUS TISSUES; COMPLICATED

361 10121 $ 9,558.00 ACTIVE

36000296INCISION, EXTENSOR TENDON SHEATH, WRIST (EG, DEQUERVAINS DISEASE)

360 25000 $ 5,210.52 ACTIVE

25900596INDERAL (PROPRANOLOL) 10MG TAB

250 J8499 $ 24.00 ACTIVE

25900597INDERAL (PROPRANOLOL) 20MG TABS

250 J8499 $ 30.00 ACTIVE


Charge Amt Status

Charge Master List

25900598INDERAL (PROPRANOLOL) 40MG TAB

250 J8499 $ 18.40 ACTIVE

30600062 INDIA INK PREP 306 87210 $ 151.34 ACTIVE

25000255 INDIGO CARMINE 0.8PC AMP 250 J3490 $ 932.00 ACTIVE

91400001INDIVIDUAL PSYCHOTHERAPY 30 MINUTES

914 90832 $ 1,159.20 ACTIVE

25900602 INDOCIN 25MG CAPS 250 J8499 $ 24.00 ACTIVE

32000021 INF VENA CAVA GRAM 320 75825 $ 6,607.50 ACTIVE

30000006INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY TECHNIQUE,[EIA], [ELISA], [IMCA]

300 87427 $ 740.00 ACTIVE

30000020

INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA), NOT OTHERWISE SPECIFIED; QUANTIFICATION, EACH ORGANISM

300 87799 $ 238.00 ACTIVE

30000017

INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); CANDIDA SPECIES, AMPLIFIED PROBE TECHNIQUE

300 87481 $ 194.50 ACTIVE

30000018

INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); GARDNERELLA VAGINALIS, QUANTIFICATION

300 87512 $ 232.00 ACTIVE

30000019

INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); TRICHOMONAS VAGINALIS, AMPLIFIED PROBE TECHNIQUE

300 87661 $ 194.95 ACTIVE

30600065INFECTIOUS AGENT DETECTION BY NUCLEIC ACID DNA

306 87798 $ 467.88 ACTIVE

27200917INFLATION DEVICE. BASIXCOMPAK .30ATM/BAR .20ML

272 A4649 $ 175.05 ACTIVE

27000774INFUSION PUMP, IMPLANTABLE, NON-PROGRAMMABLE

270 E0782 $ 12,932.31 ACTIVE

27200915INFUSION SET 3 NDL FREE VALVE

272 S1015 $ 161.10 ACTIVE

98700002

INITIAL HOSP CARE,COMPREHENSIVE HX; COMPREHENSIVE EXAM; MED DECISION MOD COMPLEX

987 99222 $ 3,369.25 ACTIVE

98700003

INITIAL HOSP CARE,COMPREHENSIVE HX;COMPREHENSIVE EXAM;MED DECISION HIGH COMPLEX

987 99223 $ 4,990.75 ACTIVE

98700001

INITIAL HOSPITAL CARE, DETAIL/COMPREHENSV HX;DETAIL/COMPREHENSV EXAM;MED DEC STRTFWD/LOW

987 99221 $ 2,494.00 ACTIVE

45000129INITIAL TX, FIRST DEGREE BURN, WHEN NO MORE THAN LOCAL TREATMENT IS REQUIRED

450 16000 $ 2,394.00 ACTIVE


Charge Amt Status

Charge Master List

63600007INJ ADENOSINE 6MG/2ML VIAL PER 1MG

636 J0153 $ 540.00 ACTIVE

36000159 INJ AIR/CON PERIT CAV 360 49400 $ 1,986.10 ACTIVE

25000225 INJ AMIDATE 20MG/10 ML VIAL 250 J3490 $ 273.84 ACTIVE

25100031 INJ AMPICILLIN 1GM VIAL 636 J0290 $ 131.00 ACTIVE

48100002INJ AORTOGRAPHY DURING HEART C

481 93544 $ 1,600.34 ACTIVE

36000160 INJ ARTHRO ANKLE 360 27648 $ 1,779.46 ACTIVE

36000161 INJ ARTHRO ELBOW 360 24220 $ 1,888.20 ACTIVE

36000162 INJ ARTHRO HIP 360 27093 $ 2,193.64 ACTIVE

36000163 INJ ARTHRO KNEE 360 27370 $ 1,847.78 ACTIVE

36000164 INJ ARTHRO SHOULDER 360 23350 $ 1,738.58 ACTIVE

36000165 INJ ARTHRO TMJ 360 21116 $ 1,801.64 ACTIVE

36000166 INJ ARTHRO WRIST 360 25246 $ 1,924.50 ACTIVE

25000297INJ ATARAX (HYDROXYZINE) TO 25MG

250 J3410 $ 114.00 ACTIVE

25000722 INJ ATROPINE 0.4 MG VIAL 636 J0461 $ 136.50 ACTIVE

25000723INJ ATROPINE 1MG/10ML ABBOJECT

636 J0461 $ 456.00 ACTIVE

25000262 INJ AZITHROMYCIN 500MG 636 J0456 $ 417.00 ACTIVE

25901820INJ BICILLIN LA PER 100 000 UNITS

636 J0561 $ 285.00 ACTIVE

25000726 INJ BUMEX 1MG 4ML VIAL 250 J3490 $ 106.50 ACTIVE

25100006INJ BUPIVACAINE 0.25% 30ML VIAL

250 J3490 $ 76.50 ACTIVE

25100007INJ BUPIVACAINE 0.5% (150MG) +EPI 30ML VIAL

250 J3490 $ 154.50 ACTIVE

36000168 INJ C1 C2 MYELOGRAM 360 61055 $ 5,577.26 ACTIVE

30200280 INJ CANDIDA SKIN TEST 302 86485 $ 48.65 ACTIVE

25000728 INJ CARDIZEM 25MG/5ML VIAL 250 J3490 $ 402.00 ACTIVE

25100014INJ CEFAZOLIN 1 GM VIAL PER 500MG

636 J0690 $ 227.00 ACTIVE

25000270 INJ CEFEPIME HCL 500MG VIAL 636 J0692 $ 195.00 ACTIVE

25000389 INJ CEFOXITIN 2 MG VIAL 636 J0694 $ 342.00 ACTIVE

25000271 INJ CEFOXITIN SODIUM 1GM VIAL 636 J0694 $ 205.50 ACTIVE

25200126INJ CEFTRIAXONE (ROCEPHIN) ADDV 1GM 20ML SDVIAL

636 J0696 $ 141.50 ACTIVE

63600186 INJ CEFTRIAXONE 2GM VIAL 636 J0696 $ 126.27 ACTIVE

25000730 INJ CEFTRIAXONE 500MG VIAL 636 J0696 $ 270.00 ACTIVE

25200015INJ CELESTONE 6MG/1ML 30MG/5ML VIAL

636 J0702 $ 320.00 ACTIVE

36000167INJ CERVICAL/THORACIC TRANSFORAMINAL EPIDURAL, WITH IMAGING GUIDANCE

360 64479 $ 4,614.74 ACTIVE

25200026 INJ CLAFORAN 500MG VIAL 636 J0698 $ 144.00 ACTIVE

25000863INJ CLINDAMYCIN PHOSPHATE 300 MG

250 S0027 $ 131.00 ACTIVE

25000864INJ CLINDAMYCIN PHOSPHATE 300MG-NOT COV BY MCR

250 S0077 $ 131.00 ACTIVE

63600130 INJ CLONIDINE HCL 1MG VIAL 636 J0735 $ 609.50 ACTIVE

25000494 INJ COMPAZINE 10MG/2ML VIAL 636 J0780 $ 112.50 ACTIVE

48100003 INJ CORONARIES 481 93545 $ 1,600.34 ACTIVE

48100004 INJ CORONARIES S&I 481 93555 $ 1,020.74 ACTIVE

25000136 INJ D50W 50ML SYRINGE 250 J3490 $ 585.00 ACTIVE

36000156 INJ DACRYOCYSTOGRAM 360 68850 $ 985.60 ACTIVE


Charge Amt Status

Charge Master List

25000142INJ DECADRON 10MG/ML PER 1MG

636 J1100 $ 388.00 ACTIVE

25000844INJ DECADRON 4MG/1ML (PER 1MG)VIAL

250 J1100 $ 28.50 ACTIVE

25000153INJ DEPO MEDROL 40MG/ML VIAL

636 J1030 $ 114.00 ACTIVE

25901812INJ DEPO MEDROL 80MG/ML VIAL

636 J1040 $ 93.75 ACTIVE

25000158INJ DEXAMETHASONE 4MG VIAL PER 1MG

636 J1100 $ 28.00 ACTIVE

45000136

INJ DIAG/THERAP NOT INC NEUROLYTIC SUBST. INCL NEEDLE/CATH PLACEMENT; LUMBAR/SACRAL W/IMAGING GUIDANCE

450 62323 $ 4,972.00 ACTIVE

36100019

INJ DIAGNOSTIC/THERAPEAUTIC AGENT PARAVERT FACET JOINT W/IMAG GUID;LUMBAR/SACRAL; SECOND LEVEL

361 64494 $ 2,592.00 ACTIVE

36100018

INJ DIAGNOSTIC/THERAPEAUTIC AGENT PARAVERT FACET JOINT W/IMAG GUID;LUMBAR/SACRAL; SINGLE LEVEL

361 64493 $ 4,500.00 ACTIVE

25000162INJ DIAZEPAM/VALIUM UP TO 5MG

250 J3360 $ 181.50 ACTIVE

25000283 INJ DIGOXIN TO 0.5MG AMP 636 J1160 $ 60.00 ACTIVE

25000286 INJ DIPHENHYDRAM UP TO 50MG 636 J1200 $ 114.00 ACTIVE

36000169 INJ DISKOGRAM CERV 360 62291 $ 4,411.20 ACTIVE

36000170 INJ DISKOGRAM LUMB 360 62290 $ 4,995.20 ACTIVE

36000171 INJ DUCT GALACTOGRAM 360 19030 $ 1,818.20 ACTIVE

25000186 INJ ENOXAPARIN 100MG/1.0 ML 636 J1650 $ 871.50 ACTIVE

25000190 INJ EPHEDRINE 50MG/ML AMP 250 J3490 $ 959.00 ACTIVE

25000191 INJ EPINEPHRINE 0.1MG/ML 250 J0171 $ 550.00 ACTIVE

25000192INJ EPINEPHRINE 1MG/ML 30 ML VIAL

250 J0171 $ 207.00 ACTIVE

25100019 INJ ETOMIDATE 20MG/20ML 250 J3490 $ 273.84 ACTIVE

36000173 INJ FACET LS ADDL LVL 360 64476 $ 3,986.36 ACTIVE

25000205INJ FENTANYL 0.05MG/ML 2ML AMP

250 J3010 $ 304.00 ACTIVE

25000290INJ FLUCONAZOLE 200MG 100ML IV

250 J1450 $ 804.00 ACTIVE

25000216INJ FUROSEMIDE 40MG VIAL PER 20MG

250 J1940 $ 159.00 ACTIVE

25000215 INJ FUROSEMIDE UP TO 20MG 250 J1940 $ 194.00 ACTIVE

63600043 INJ GLUCAGON 1MG VIAL 636 J1610 $ 1,233.00 ACTIVE

25000226 INJ HALOPERIDOL 5MG/ML VIAL 250 J1630 $ 136.50 ACTIVE

25000231 INJ HEPARIN 5000 UNITS/ML VIAL 636 J1644 $ 96.00 ACTIVE

25901600 INJ HUMULIN 70/30 INSULIN VIAL 636 J1815 $ 780.00 ACTIVE

25901452 INJ HUMULIN NPH INSULIN VIAL 636 J1815 $ 819.00 ACTIVE

25100073INJ INSULIN NOVOLOG (PLAIN) PER DOSE

636 J1815 $ 60.00 ACTIVE


Charge Amt Status

Charge Master List

48100005 INJ INTERNAL MAMMARY 481 93564 $ 1,600.34 ACTIVE

25000783 INJ ISOPTIN 2.5MG/ML 2ML 250 J3490 $ 85.00 ACTIVE

25000784 INJ ISUPREL 1ML AMP 250 J3490 $ 114.00 ACTIVE

25000342 INJ KENALOG 40MG/ML 1ML VIAL 636 J3301 $ 270.00 ACTIVE

25901305 INJ KETAMINE 500MG /10ML VIAL 250 J3490 $ 229.50 ACTIVE

25000347 INJ KETOROLAC 30MG PER 15MG 636 J1885 $ 90.00 ACTIVE

25200114INJ KETOROLAC 60MG/2ML PER 15MG VIAL

636 J1885 $ 48.00 ACTIVE

25000806INJ LABETALOL NORMODYNE 100MG/20ML

250 J3490 $ 570.40 ACTIVE

25000356 INJ LEVOFLOXACIN 250MG 50ML 636 J1956 $ 357.00 ACTIVE

25000358 INJ LEVOPHED 4MG/4ML VIAL 250 J3490 $ 320.00 ACTIVE

63600159INJ LIDOCAINE (XYLOCAINE) 1% 10MG 30ML SDVIAL

636 J2001 $ 8.63 ACTIVE

63600160INJ LIDOCAINE (XYLOCAINE) 1% 10MG 5ML SDAMPUL

636 J2001 $ 8.63 ACTIVE

63600161INJ LIDOCAINE (XYLOCAINE) 2% 20MG/ML 50ML MDVIAL

636 J2001 $ 10.80 ACTIVE

25000842INJ LIDOCAINE (XYLOCAINE) MPF 1% 10MG/ML 5ML SDVIAL

636 J2001 $ 198.00 ACTIVE

25000364INJ LIDOCAINE +D5 (XYLOCAINE) 2GM/500ML IV

636 J2001 $ 70.00 ACTIVE

63600162 INJ LIDOCAINE 1% + EPI 10ML 636 J2001 $ 5.60 ACTIVE

25000639INJ LIDOCAINE 1% + EPI 20ML VIAL

636 J2001 $ 159.00 ACTIVE

25000361 INJ LIDOCAINE 1% 10ML VIAL 636 J2001 $ 180.00 ACTIVE

63600163 INJ LIDOCAINE 1% 20ML VIAL 636 J2001 $ 6.15 ACTIVE

25000645INJ LIDOCAINE 2% 100MG/5ML SYRINGE

636 J2001 $ 32.00 ACTIVE

63600164 INJ LIDOCAINE 2% 20ML 636 J2001 $ 6.15 ACTIVE

25000372 INJ LINCOCIN 300MG/ML VIAL 636 J2010 $ 165.60 ACTIVE

25901772 INJ LOVENOX 120MG/1.2ML 636 J1650 $ 976.00 ACTIVE

25100020 INJ LOVENOX 30 MG/0.3ML 636 J1650 $ 244.00 ACTIVE

25000378 INJ LOVENOX 40MG/0.4ML 636 J1650 $ 325.00 ACTIVE

48100006 INJ LT VENT OR ATRIAL ANGIO 481 93543 $ 1,600.34 ACTIVE

36000174INJ LUMBAR/SACRAL TRANSFORAMINAL EPIDURAL, WITH IMAGING GUIDANCE

360 64483 $ 4,614.74 ACTIVE

25800042 INJ MANNITOL 25% IN 50ML 636 J2150 $ 114.00 ACTIVE

25000845INJ MARCAINE 0.25%/EPI 20ML VIAL

250 J3490 $ 99.00 ACTIVE

25000384 INJ MARCAINE 0.5% 30ML 250 J3490 $ 96.00 ACTIVE

25000390 INJ MEPERIDINE 50MG 636 J2175 $ 48.00 ACTIVE

25200059 INJ MERREM 1 GM VIAL 636 J2185 $ 644.00 ACTIVE

25000308INJ METHYLPREDNISOLONE (SOLUMEDROL) SOD SUCCINATE 125MG VIAL

636 J2930 $ 114.00 ACTIVE

25000307INJ METHYLPREDNISOLONE (SOLUMEDROL) SOD SUCCINATE 40MG

636 J2920 $ 114.00 ACTIVE

25000401INJ METOCLOPRAMIDE UP TO 10MG/ML

636 J2765 $ 472.00 ACTIVE

25901511 INJ METOPROLOL 5MG/5ML VIAL 259 J3490 $ 166.50 ACTIVE


Charge Amt Status

Charge Master List

25000800INJ MIDAZOLAM 2MG/2ML VIAL PER 1MG

636 J2250 $ 295.50 ACTIVE

25000311 INJ MORPHINE SULF TO 10MG 636 J2270 $ 114.00 ACTIVE

36000176 INJ MYELOGRAM 360 62284 $ 2,532.32 ACTIVE

25000430INJ NALOXONE 0.4MG/ML PER 1MG

636 J2310 $ 387.00 ACTIVE

36000177 INJ NEPHROGRAM 360 50394 $ 1,811.60 ACTIVE

25000448 INJ NORCURON 10MG VIAL 250 J3490 $ 81.00 ACTIVE

76000035INJ OF ANESTHETIC AGENT PARAVERTEBRAL FACET JOINT W/IMAGE GUID; FIRST LEVEL

760 64490 $ 1,463.22 ACTIVE

25901294INJ ONDANSETRON PER 1MG VIAL

636 J2405 $ 97.88 ACTIVE

25000450INJ ORPHENADRINE (NORFLEX) UP TO 60MG/2ML

636 J2360 $ 869.00 ACTIVE

25000810 INJ OXYTOCIN 10 UNIT VIAL 636 J2590 $ 322.00 ACTIVE

36000178 INJ PARAVERT C/T JNT 360 64470 $ 4,614.74 ACTIVE

36000179 INJ PARAVRT L/S 1 LVL 360 64475 $ 4,614.74 ACTIVE

25000466 INJ PEPCID 20MG VIAL 250 S0028 $ 136.50 ACTIVE

25000659INJ PIPERACILLIN/TAZOBACTAM 3.375GM

636 J2543 $ 258.00 ACTIVE

63600102 INJ PNEUMOVAX 23 0.5ML VIAL 250 J3490 $ 486.00 ACTIVE

30200208 INJ PPD SKIN TEST APLISOL 302 86580 $ 96.00 ACTIVE

25000489 INJ PRIMAXIN PER 250MG IV VIAL 636 J0743 $ 265.50 ACTIVE

25000770 INJ PROCAINAMIDE TO 1GM 636 J2690 $ 324.00 ACTIVE

25000498INJ PROMETHAZINE UP TO 50 MG VIAL

636 J2550 $ 66.00 ACTIVE

25000500INJ PROPOFOL 10MG/ML 20ML VIAL

636 J2704 $ 273.00 ACTIVE

25000505 INJ PROTONIX 40 MG VIAL 636 C9113 $ 382.50 ACTIVE

25000510 INJ RANITIDINE 50MG/2ML VIAL 636 J2780 $ 60.00 ACTIVE

25000523 INJ ROBINUL 0.2MG/ML 1ML VIAL 636 J7643 $ 151.50 ACTIVE

25200024 INJ ROCEPHIN 1GM PER250MG 636 J0696 $ 138.50 ACTIVE

25000528 INJ ROMAZICON 5MLVIAL 250 J3490 $ 964.50 ACTIVE

36000157 INJ RTRO URETHCYSTOG 360 51610 $ 2,035.60 ACTIVE

36000158 INJ SACROILIAC JT 360 27096 $ 2,588.38 ACTIVE

25000843INJ SENSORCAINE 0.25% WITH EP 20ML VIAL

250 J3490 $ 195.00 ACTIVE

25000546INJ SODIUM BICARB 50MEQ 50ML VIAL

250 J3490 $ 714.00 ACTIVE

25000559 INJ SOLU-CORTEF 100MG 2ML 636 J1720 $ 96.00 ACTIVE

36000115 INJ STELLATE GANGLION 360 64510 $ 4,614.74 ACTIVE

25901735INJ SUCCINYLCHOLINE CHLORIDE 10ML

636 J0330 $ 64.00 ACTIVE

25000578 INJ TDAP 0.5ML 636 90715 $ 751.50 ACTIVE

25200052 INJ TEFLARO 600MG VIAL 636 J0712 $ 394.00 ACTIVE

25000581 INJ THROMBINAR 5000 UNITS 250 J3490 $ 1,161.00 ACTIVE

25000605 INJ VANCOMYCIN 1GM VIAL 636 J3370 $ 540.00 ACTIVE

25000335 INJ VANCOMYCIN 500MG VIAL 636 J3370 $ 315.00 ACTIVE

25000612 INJ VASOPRESSIN 20 UNITS 250 J3490 $ 80.00 ACTIVE

25000613 INJ VASOTEC IV 1.25MG/ML VIAL 250 J3490 $ 95.00 ACTIVE


Charge Amt Status

Charge Master List

48100007 INJ VEIN GRAFT VISUALIZATION 481 93540 $ 1,600.34 ACTIVE

25000617 INJ VERAPAMIL 5MG/2ML VIAL 250 J3490 $ 79.50 ACTIVE

25000830 INJ VERCURONIUM 10MG/ML 250 J3490 $ 95.60 ACTIVE

25900007 INJ VITAMIN K 10MG/ML AMP 250 J3430 $ 159.00 ACTIVE

25000833INJ XYLOCAINE 2% W/EPI 20 ML VIAL

636 J2001 $ 159.00 ACTIVE

36100017INJ, ANESTH AGENT; OTH PERIPHERAL NERVE/BRANCH

361 64450 $ 2,247.50 ACTIVE

36000246INJ, ANESTHETIC AGENT; SCIATIC NERVE, SINGLE

360 64445 $ 3,720.00 ACTIVE

25100053INJ. PROPOFOL 10MG/ML 50ML VIAL

636 J2704 $ 576.00 ACTIVE

48100051 INJ. VENT/ATRIAL ANGIO 481 93565 $ 1,600.34 ACTIVE

36000184 INJ-CONTRAST VENOGRAM 360 36005 $ 3,833.64 ACTIVE

76000034INJECTION OF ANESTHETIC AGENT GREATER OCCIPITAL NERVE

760 64405 $ 748.58 ACTIVE

36000183INJECTION PROC, CYSTOGRAPHY/VOIDING URETHROCYSTOGRAPHY

360 51600 $ 2,348.52 ACTIVE

36000182

INJECTION PROC, URETEROGRAPHY/URETEROPYELOGRAPHY THROUGH URETEROSTOMY/CATHETER

360 50684 $ 2,227.00 ACTIVE

36000374

INJECTION PROCEDURE FOR CHOLANGIOGRAPHY, PERCUTANEOUS, COMPLETE DIAGNOSTIC PROCEDURE INCLUDING IMAGING GUIDANCE (EG, ULTRASOUND AND/OR

360 47532 $ 10,818.00 ACTIVE

36000180INJECTION SALIVARY; SIALOGRAPHY

360 42550 $ 1,690.08 ACTIVE

45000096INJECTION SINGLE TENDON SHEATH,OR LIGAMENT(PLANTAR"FASCIA")

450 20550 $ 2,034.00 ACTIVE

45000128INJECTION SINGLE/MULTIPLE TRIGGER POINT 3> MORE MUSCLES

450 20553 $ 2,232.00 ACTIVE

36000181INJECTION SINUS TRACT; DIAGNOSTIC (SINOGRAM)

360 20501 $ 1,439.98 ACTIVE

51000001INJECTION TRIGGER POINT-TECH

510 20552 $ 138.00 ACTIVE

36100021INJECTION(S),DIAGNOSTIC OR THERAPEUTIC AGENT,PARAVERTEBRAL FACET

361 64495 $ 2,625.00 ACTIVE

36000371INJECTION, ANESTHETIC AGENT; AXILLARY NERVE

360 64417 $ 3,544.50 ACTIVE

36000244INJECTION, ANESTHETIC AGENT; BRACHIAL PLEXUS, SINGLE

360 64415 $ 3,383.50 ACTIVE

36000318INJECTION, ANESTHETIC AGENT; ILIOINGUINAL, ILIOHYPOGASTRIC NERVES

360 64425 $ 4,842.00 ACTIVE

36000172

INJECTION, DX/THERAPEUTIC SUBSTANCE, EPIDURAL/SUBARACHNOID; LUMBAR/SACRAL

360 62322 $ 4,614.74 ACTIVE


Charge Amt Status

Charge Master List

63600196INJECTION, VITAMIN B-12 CYANOCOBALAMIN, UP TO 1000 MCG

636 J3420 $ 56.25 ACTIVE

36000116INS OR REPL OF SPINAL NEUROSTI

360 63685 $ 79,680.51 ACTIVE

36000027INS/REPLC PPM DUAL W/VENT & AT

481 33208 $ 69,356.09 ACTIVE

36000028INS/REPLC PPM GENERATOR ONLY D

360 33213 $ 71,185.22 ACTIVE

36000029INS/REPLC PPM GENERATOR ONLY S

360 33212 $ 62,051.62 ACTIVE

36000030INS/REPLC PPM SGL W/VENT ELECT

481 33207 $ 63,662.08 ACTIVE

36000031INSER OF INTRA-AORTIC BALL ASS

360 33967 $ 1,020.74 ACTIVE

36000033INSERT 1 CHMBR PACING CARDIO D

481 33206 $ 58,442.58 ACTIVE

36000034INSERT 2 CHMBR PACING CARDIO D

360 33240 $ 64,067.82 ACTIVE

36000035 INSERT LEAD PACE-DEFIB DUAL 481 33217 $ 27,370.44 ACTIVE

36000036 INSERT LOOP RECORDER 481 33282 $ 42,302.16 ACTIVE

36000037 INSERT LV PACING LEAD 481 33224 $ 57,193.06 ACTIVE

36000038INSERT OR REPOS OF ELEC LEAD F

480 33249 $ 1,20,508.40 ACTIVE

32000023INSERT PACEMAKER FLUOR AND RA

320 71090 $ 1,020.74 ACTIVE

48100008 INSERT SWAN-GANZ 481 93503 $ 10,249.66 ACTIVE

48100036INSERTION OF CENTRAL VENOUS LINE SURGERY

360 36561 $ 17,236.50 ACTIVE

36000039INSERTION OF HEART ELECTRODE

481 33210 $ 28,450.74 ACTIVE

36100001INSERTION OF INDWELLING TUNNELED PLEURAL CATHETER WITH CUFF

361 32550 $ 11,236.57 ACTIVE

48100069INSERTION OF NON TUNNELED CENTRAL VENOUS LINE

481 36556 $ 6,317.00 ACTIVE

45000152INSERTION OF NON-INDWELLING BLADDER CATHETER

450 51701 $ 1,520.55 ACTIVE

45000082

INSERTION TUNNELED CENTRALLY; CENTRAL VENOUS ACCESS DEVICE, W/SUBC PORT; AGE 5OR>

450 36561 $ 2,767.50 ACTIVE

36000040INSJ ELTRD 1 CHMBR 1 ELTRD PRM

360 33216 $ 50,232.00 ACTIVE

36000041INSJ ELTRD CAR VEN SYS TM INSJ

481 33225 $ 53,753.49 ACTIVE

36000042INSJ IPR CANNULA/CATH F/DRG/DIAL TEMP

360 49420 $ 22,511.02 ACTIVE

36000044INSRT INTRAPERITL CANN/CATH DRAIN/DIALY

360 49421 $ 18,647.58 ACTIVE

36000185 INSRT URET STNT DRN 360 50393 $ 16,206.06 ACTIVE

27200644INSTRUMENT BIOPSY MAXCORE 18G X 20CM

272 A4215 $ 1,899.00 ACTIVE

30100205 INSULIN 301 83525 $ 152.40 ACTIVE

30200146 INSULIN ANTIBODIES 302 86337 $ 285.48 ACTIVE

48100093INTERNAL MAMMARY ARTERIOGRAM

481 75756 $ 3,440.40 ACTIVE

27200921INTRA CARDIAC ECHO CATHETER

272 C1759 $ 22,000.00 ACTIVE

48100113 INTRACARDIAC ECG (ICE) 481 93662 $ 12,581.47 ACTIVE


Charge Amt Status

Charge Master List

48100064

INTRACARDIAC ELECTROPHYSIOLOGIC 3-DIMENSIONAL MAPPING (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)

481 93613 $ 14,456.02 ACTIVE

92000001INTRACUTANEOUS (INTRADERMAL) TESTS WITH ALLERGENIC EXTRACTS

920 95024 $ 195.22 ACTIVE

32000120 INTRALUMINAL DILATE 320 74360 $ 1,841.62 ACTIVE

48100083

INTRAVASCULAR DOPPLER VELOCITY AND/OR PRESSURE DERIVED CORONARY FLOW RSV MEASUREMENT CORONARY VESSEL OR GRAFT - ADDL VESSEL

481 93572 $ 1,697.76 ACTIVE

48100082

INTRAVASCULAR DOPPLER VELOCITY AND/OR PRESSURE DERIVED CORONARY FLOW RSV MEASUREMENT CORONARY VESSEL OR GRAFT DURING CORONARY ANGIOGRA

481 93571 $ 4,283.42 ACTIVE

48100098INTRAVASCULAR STENT (EA ADDITIONAL VEIN)

481 37239 $ 25,419.12 ACTIVE

48100097INTRAVASCULAR STENT (INITIAL VEIN)

481 37238 $ 51,568.52 ACTIVE

30200147INTRINSIC FACTOR BLOCKING ANTIBODY

302 86340 $ 201.00 ACTIVE

36000187 INTRO LONG GI TUBE 360 44500 $ 2,118.26 ACTIVE

36000046INTRO OF CATH RIGHT HEART OR

360 36013 $ 1,513.40 ACTIVE

36000047INTRO OF NEEDLE OR INTRACATH

360 36140 $ 1,239.70 ACTIVE

36000048INTRO PERQ TRANSHEP STENT INT/EXT BILI

360 47511 $ 12,793.98 ACTIVE

36000049INTRO PRQ TRANSHEPATC CATH BILIARY DRG

360 47510 $ 13,981.24 ACTIVE

27000282INTRODUCER 6FR-8FR - PERIPHERAL

270 C1894 $ 510.00 ACTIVE

27000283 INTRODUCER LEAD 270 C1892 $ 444.00 ACTIVE

27200110 INTRODUCER/SHEATH CAROTID 272 C1766 $ 1,583.52 ACTIVE

45000132INTRODUCTION OF NEEDLE OR INTRACATHETER, VEIN

450 36000 $ 486.00 ACTIVE

41000022INTUBATION ENDOTRACHEAL ASSIST BY RT

410 31500 $ 861.20 ACTIVE

45000052INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE

450 31500 $ 750.00 ACTIVE

25000340 INVANZ 1GM VIALS 636 J1335 $ 556.00 ACTIVE

25200077 IODOSORB GEL TOPICAL 1.4 OZ 250 J3490 $ 88.00 ACTIVE

42000025 IONTOPHORESIS EA 15 450 97033 $ 276.44 ACTIVE

63600157IOPAMIDOL (ISOVUE M200) 41% 200MG 20ML

636 Q9966 $ 221.35 ACTIVE


636 Q9967 $ 162.06 ACTIVE


636 Q9967 $ 214.68 ACTIVE

63600189 IOPAMIDOL 300MG 150ML BTL IV 636 Q9967 $ 382.20 ACTIVE


Charge Amt Status

Charge Master List

96000011IP CONSULT COMPREHENSIVE/HIGH COMPLEX 110MINS

960 99255 $ 5,112.00 ACTIVE

96000010IP CONSULT COMPREHENSIVE/MOD COMPLEX 80MINS

960 99254 $ 4,248.00 ACTIVE

96000009IP CONSULT DETAILED/LOW COMPLEX 55MINS

960 99253 $ 2,925.00 ACTIVE

96000008IP CONSULT EXPANDED FOCUS/STRAIGHTFORWARD 40MINS

960 99252 $ 1,899.00 ACTIVE

96000007IP CONSULT PROBLEM FOCUS/STRAIGHTFORWARD 20MINS

960 99251 $ 1,242.00 ACTIVE

25901347IRBESARTAN (AVAPRO) 75MG TAB

250 J8499 $ 36.00 ACTIVE

25901878IRBESARTAN +HCTZ 150/12.5MG TAB

250 J8499 $ 5.25 ACTIVE

25901879IRBESARTAN +HCTZ 300/12.5MG TAB

250 J8499 $ 5.25 ACTIVE

25901930IRBESARTAN 150MG TABLET (AVAPRO)

250 J8499 $ 24.00 ACTIVE

30100208 IRON 301 83540 $ 86.28 ACTIVE

30100209 IRON BINDING CAPACITY TEST 301 83550 $ 116.52 ACTIVE

30900018IRRADIATION OF BLOOD PRODUCT EACH UNIT

302 86945 $ 78.51 ACTIVE

25900589 ISOSORBIDE (IMDUR) 30MG TAB 250 J8499 $ 30.00 ACTIVE

63600193 ISOVUE 370-100ML 636 Q9967 $ 238.25 ACTIVE

25300001 ISOVUE 61% 50ML 636 Q9967 $ 450.70 ACTIVE

30100210 I-STAT BLOOD GASES 301 82803 $ 312.84 ACTIVE

30500060I-STAT PANEL CRITICAL BLOOD ANALYSIS

305 85041 $ 40.20 ACTIVE

30100212 I-STAT POTASSIUM 301 84132 $ 61.32 ACTIVE

30100213 I-STAT SODIUM 301 84295 $ 64.20 ACTIVE

25800003 IV 1/2 NS 1000ML BAG 258 J7030 $ 615.00 ACTIVE

25800004 IV 1/2 NS 500ML BAG 258 J7040 $ 585.00 ACTIVE

27000284 IV CATH PROTECTIV 16G X 1 1/4 272 A4649 $ 40.00 ACTIVE


27000286 IV CATH PROTECTIV 20G X 1 272 A4649 $ 84.00 ACTIVE


27000288 IV CATH PROTECTIV 22G X 1 272 A4649 $ 44.00 ACTIVE

27000289 IV CATH PROTECTIV 24G X 3/4 272 A4649 $ 44.00 ACTIVE

25800020 IV D5 LR 1000ML BAG 258 J7121 $ 480.00 ACTIVE

25800022 IV D5NS 1000 ML BAG 258 J7030 $ 675.00 ACTIVE

25800025 IV D5W 1000ML BAG 258 J7070 $ 440.00 ACTIVE



25000738IV DOBUTAMINE 500MG/250ML D5W BAG

258 J3490 $ 690.00 ACTIVE

25000175 IV DOPAMINE 400MG/250ML 250 J1265 $ 544.50 ACTIVE

25800049 IV LACT RINGERS 1000 ML BAG 258 J7120 $ 520.00 ACTIVE

25800081IV LACTATED RINGERS 500ML BAG

258 J7120 $ 290.00 ACTIVE

25800052 IV NS 1000ML BAG 258 J7030 $ 607.50 ACTIVE


Charge Amt Status

Charge Master List





25800057 IV NS MINI BAG PLUS 50 ML 258 J7050 $ 622.50 ACTIVE

48100099 IVC FILTER INSERTION 481 37191 $ 23,461.99 ACTIVE

32000123 IVP W NEPHROTOMOGRAM 320 74415 $ 2,462.60 ACTIVE

32000124 IVP W-W/O TOMOGRAM 320 74400 $ 5,236.50 ACTIVE

45000026IVPB DRIP INF ADD SEQUENTIAL INF OF NEW DRUG/SUBS UP TO 1 HR

450 96367 $ 277.88 ACTIVE

45000028IVPB DRIP INF CONCURRENT INFUSION

450 96368 $ 447.30 ACTIVE

45000027 IVPB DRIP INF EACH ADD HR 450 96366 $ 464.52 ACTIVE

45000029 IVPB DRIP INF INIT 1HR 450 96365 $ 1,267.50 ACTIVE

27200113 IVUS ATLANTIS PV CATHETER 272 C1753 $ 20,500.00 ACTIVE

48000008 IVUS -CORO-EA ADDL VESSEL 480 92979 $ 1,406.24 ACTIVE

48000009 IVUS -CORO-INITIAL VESSEL 480 92978 $ 6,583.68 ACTIVE

48100106IVUS RADILOGIC S & I ADDITIONAL VESSEL

481 75946 $ 292.68 ACTIVE

48100105IVUS RADILOGIC S & I INITIAL VESSEL

481 75945 $ 472.12 ACTIVE

48100103IVUS, NON CORONARY, DX OR INTV (VENEOUS)

481 37250 $ 1,661.98 ACTIVE

48100104IVUS, NON CORONARY,DX OR INTV ADDITIONAL VESSEL

481 37251 $ 1,035.16 ACTIVE

32000125 JNT ANY STRES V 320 77071 $ 454.84 ACTIVE

27100001JUGS OMNI SUCTION CANISTER 16000CC

271 A7002 $ 259.90 ACTIVE

30100502KAPPA/ LAMBDA FLC FREE LIGHT CHAINN SERUM

301 83883 $ 181.32 ACTIVE

25900619 K-DUR 10MEQ SA TAB 250 J8499 $ 24.00 ACTIVE

25900620 K-DUR 20MEQ SA TAB 250 J8499 $ 30.00 ACTIVE

25900624 KEPPRA 250MG TABLETS 250 J8499 $ 46.00 ACTIVE

25900625 KEPPRA 500 MG TAB 250 J8499 $ 37.50 ACTIVE

25000345KEPPRA 500MG/5ML 5ML (LEVETIRACETAM)

636 J1953 $ 430.00 ACTIVE

30000047KEPPRA/LEVETIRACETAM LEVEL TEST

301 80177 $ 176.76 ACTIVE

25901880KETOCONAZOLE 2% CREAM 30GM TUBE

250 J3490 $ 112.58 ACTIVE

30100215KETOGENIC STEROIDS FRACTION

301 83582 $ 189.00 ACTIVE

34100089

KIDNEY IMAGING W/ VASCULAR FLOW FUNCTION AND W/O PHARMACOLOGICAL INTERVENTION

341 78707 $ 11,513.50 ACTIVE

27000614 KIT ABG 270 A4649 $ 96.00 ACTIVE

27200674 KIT ANGIO JET 272 A4649 $ 4,212.00 ACTIVE

27200634KIT CATH 6FR D LUMEN CT PICC FULL SW

272 A4649 $ 2,940.00 ACTIVE

27200795 KIT ENEMA 270 A4458 $ 52.00 ACTIVE

27200626 KIT ESOPHYX 2 272 A4649 $ 25,000.00 ACTIVE

27200789 KIT EYE IRRIGATION 270 A4649 $ 80.00 ACTIVE

27200679KIT GRAFT ACCESSORY OUTFLOW

272 A4649 $ 17,955.00 ACTIVE

27200633 KIT INTRODUCER 272 A4649 $ 819.00 ACTIVE

27200775 KIT IRRIGATION PISTON 270 A4322 $ 52.00 ACTIVE


Charge Amt Status

Charge Master List

27200759 KIT IV START 272 A4649 $ 28.00 ACTIVE

27200774 KIT LACERATION 272 A4550 $ 160.00 ACTIVE

27100016 KIT LTA 271 A4649 $ 224.00 ACTIVE

27000563 KIT MIDSTREAM COLLECTION 270 A4649 $ 52.00 ACTIVE

27000293KIT MIDSTREAM COLLECTOR (16496)

272 A4649 $ 16.00 ACTIVE

27000615 KIT NEBULIZER INC MASK 270 A7015 $ 44.00 ACTIVE

27200778 KIT PARACENTESIS 272 A4649 $ 72.00 ACTIVE

27200788 KIT PELVIC EXAM 272 A4649 $ 404.00 ACTIVE

27000475KIT SUCTION CATHETER (ALL SIZES)

272 A4624 $ 40.50 ACTIVE

27200779 KIT SUTURE REMOVAL 272 A4550 $ 84.00 ACTIVE

27200777 KIT THORACENTESIS 272 A4550 $ 924.00 ACTIVE

27200800 KIT TRACH CARE 272 A4629 $ 52.00 ACTIVE

32000126 KNEE 1 OR 2V 320 73560 $ 1,133.50 ACTIVE

32000127 KNEE 3 VIEWS 320 73562 $ 1,641.50 ACTIVE

32000128 KNEE 4V OR MORE 320 73564 $ 1,914.50 ACTIVE

32200003 KNEE ARTHROGRAPHY 322 73580 $ 5,510.00 ACTIVE

27000519 KNEE BRACES,HINGED 274 L1810 $ 479.12 ACTIVE

32000129 KNEES STANDING AP 320 73565 $ 1,573.00 ACTIVE

32000024KYHOPLASTY RADIOLOGICAL S&I

320 72291 $ 1,514.92 ACTIVE

36000051 KYPHOPLASTY LUMBAR 360 22514 $ 48,811.84 ACTIVE

27200426KYPHOPLASTY LUMBAR TRAY KPT1505

272 A4550 $ 10,990.00 ACTIVE

36000052 KYPHOPLASTY THORACIC 360 22513 $ 48,811.84 ACTIVE

34100004 LABELED RED CELL SEQUESTR 341 78140 $ 3,723.32 ACTIVE

25901881 LABETALOL 100MG TAB 250 J8499 $ 5.25 ACTIVE

25901882LACRI LUBE (REFRESH) OINTMT 3.5GM TUBE

250 J3490 $ 46.50 ACTIVE

30100218 LACTATE (LACTIC ACID) 301 83605 $ 142.44 ACTIVE

30100221 LACTATE DEHYDROGENASE 301 83615 $ 156.36 ACTIVE

30100223LACTATE DEHYDROGENASE ISOENZYME

301 83625 $ 170.64 ACTIVE

30100219 LACTOGEN PLACENTAL (HPL) 301 83632 $ 269.64 ACTIVE

25900633 LACTULOSE 10G/15ML 250 J8499 $ 280.00 ACTIVE

25901936LACTULOSE ORAL SOLUTION 20GM/30ML

250 J3490 $ 56.00 ACTIVE

25901883 LAMOTRIGINE 200MG TAB 250 J8499 $ 5.25 ACTIVE

30000014LAMOTRIGINE SERUM (LAMICTAL)IMMUNOASSAY

300 80175 $ 73.65 ACTIVE

25900640 LANOXIN 0.125MG TABLET 250 J8499 $ 24.00 ACTIVE

25000352 LANTUS INSULIN 1 UNIT/10ML 636 J1815 $ 14.00 ACTIVE

27800840 LAP BAND 270 A4649 $ 24,000.00 ACTIVE

36100004 LAP BAND ADJUSTMENT 361 S2083 $ 880.00 ACTIVE

36000275LAP, ESOPHAGOGASTRIC FUNDOPLASTY

360 43280 $ 56,219.50 ACTIVE

36000342LAPAROSCOPIC INGUINAL HERNIA REPAIR

360 49650 $ 18,325.54 ACTIVE

36000237LAPAROSCOPY CHOLECYSTECTOMY

360 47562 $ 34,384.00 ACTIVE

36000343LAPAROSCOPY PROCEDURE, HERNIOPLASTY, HERNIORRHAPHY, HERNIOTOMY

360 49659 $ 17,325.54 ACTIVE


Charge Amt Status

Charge Master List

36000229LAPAROSCOPY SURG CHOLECYSTECTOMY W/COMMON DUCT EXPLORE

360 47564 $ 58,162.00 ACTIVE

36000235LAPAROSCOPY SURGICAL APPENDECTOMY

360 44970 $ 31,404.50 ACTIVE

36000236LAPAROSCOPY SURGICAL CHOLECYSTECTOMY W/CHOLANGIOGRAPHY

360 47563 $ 37,315.50 ACTIVE

36000259

LAPAROSCOPY, ABDOMEN, PERITONEUM & OMENTUM, DX, W/ W/O SPECIMEN COLLECTION BY BRUSHING OR WASHING (SEPARATE PROC)

360 49320 $ 17,021.50 ACTIVE

36000304LAPAROSCOPY, COLECTOMY, PARTIAL, W/ANASTOMOSIS

360 44204 $ 76,336.50 ACTIVE

36000258

LAPAROSCOPY, W/FULGURATION OR EXCISION OF LESIONS OF OVARY, PELVIC VISCERA/PERITONEAL SURFACE METHOD

360 49322 $ 36,679.00 ACTIVE

27200881 LARGE ROCKER SHOE - LONG 274 L4386 $ 10,107.75 ACTIVE

44400001 LARYNGEAL FUNCTION STUDY 444 92520 $ 912.82 ACTIVE

44000006LARYNGOSCOPIC SENSORY TEST

440 92614 $ 3,979.92 ACTIVE

44000007LARYNGOSCOPY WITH STROBOSCOPY

440 31579 $ 3,039.68 ACTIVE

30100225LDL CHOLESTEROL DIRECT MEASURE

301 83721 $ 127.20 ACTIVE

30100226 LEAD 301 83655 $ 161.40 ACTIVE

48100062LEFT HEART / RIGHT HEART CATH W/ CORONARIES

481 93460 $ 73,557.50 ACTIVE

48100059LEFT HEART CATH LEFT VENTRICULOGRAPHY ART/GRFT ANGIO

481 93459 $ 61,860.36 ACTIVE

48100058LEFT HEART CATH W/ CORONARIES

481 93458 $ 50,382.50 ACTIVE

48100074LEFT HEART CATHETERIZATION; LEFT VENTRICULOGRAPHY, IMAGING SUPERVISION & INTERP

481 93452 $ 42,353.50 ACTIVE

27000686 LEG BAG LG. 32OZ 270 A4649 $ 10.56 ACTIVE

30200148 LEGIONELLA ANTIBODY 302 86713 $ 204.00 ACTIVE

30600071LEGIONELLA PNEUMOPHILA ANTIGEN DIRECT FLUORESCENT ANTIBODY

306 87278 $ 187.20 ACTIVE

30900014 LEPTOSPIRA 302 86720 $ 48.84 ACTIVE

51000027LESION BIOPSY EACH ADD'L-TECH

510 11101 $ 780.60 ACTIVE

51000026LESION BIOPSY SUBCUTANEOUS TISS/MUCUOUS MEM SINGLE

510 11100 $ 1,518.00 ACTIVE

30100227 LEUCINE AMINOPEPTIDASE 301 83670 $ 122.16 ACTIVE

30500029LEUKOCYTE ALKALINE PHOSPHATASE WITH CT

305 85540 $ 114.72 ACTIVE

30900005 LEUKOCYTE COUNT (FECAL) 309 89055 $ 57.00 ACTIVE

30100436LEUKOCYTE COUNT AUTOMATED

305 85048 $ 33.84 ACTIVE


Charge Amt Status

Charge Master List

39000003LEUKOCYTE POOR RED BLOOD CELL (EACH UNIT)

390 P9016 $ 1,893.36 ACTIVE

25901239LEVALBUTEROL (XOPENEX) 0.63MG 0.63MG SOL

250 J7614 $ 36.00 ACTIVE

25901240 LEVALBUTEROL 1.25MG/3ML INH 250 J7614 $ 36.00 ACTIVE

25900647 LEVAQUIN 250 MG TABLET 250 J8499 $ 214.00 ACTIVE

25900650 LEVAQUIN 500MG TABLET 250 J8499 $ 171.00 ACTIVE

25900648 LEVAQUIN 750MG TAB 250 J8499 $ 52.00 ACTIVE

25000355 LEVAQUIN 750MG/150ML 636 J1956 $ 772.00 ACTIVE

25000357LEVOFLOXACIN (LEVAQUIN) 500MG 100ML IV

636 J1956 $ 481.50 ACTIVE

25901755LEVOTHYROXINE (SYNTHROID)75MCG (0.075MG) TAB

259 J8499 $ 24.00 ACTIVE

25901295LEXISCAN 0.4MG/5ML (PER 0.1MG)

636 J2785 $ 1,890.00 ACTIVE

30100228 LIDOCAINE 301 80176 $ 195.84 ACTIVE

25000362 LIDOCAINE 1% 2ML 636 J2001 $ 210.00 ACTIVE

25000365 LIDOCAINE 2% 20MG/ML 636 J2001 $ 214.00 ACTIVE

25901487 LIDOCAINE 4% TOP APP 250 J3490 $ 192.00 ACTIVE

25900668LIDOCAINE HCL ORAL 2% VISCOUS

259 J3490 $ 184.00 ACTIVE

25901935 LIDOCAINE VISCOUS 2% 15ML 250 J3490 $ 69.00 ACTIVE

25901884LIDOCAINE/PRILOCAINE CREAM 30GM

250 J3490 $ 127.50 ACTIVE

25901885LIDOCAINE/PRILOCAINE CREAM 5GM

250 J3490 $ 16.43 ACTIVE

30100229 LIPASE 301 83690 $ 91.80 ACTIVE

25900673 LIPITOR 10 MG TABLET 250 J8499 $ 60.00 ACTIVE

25900674 LIPITOR 20MG TABS 259 J8499 $ 86.00 ACTIVE

30100231 LIPOPROTEIN 301 83695 $ 172.68 ACTIVE

30100081LIPOPROTEIN,BLOOD;ELECTROPHORETIC SEPARATION AND QUANTITATION

301 83700 $ 150.12 ACTIVE

30100066LIPOPROTEIN-ASSOCIATED PHOSPHOLIPASE A2 (LP-PLA2

301 83698 $ 555.72 ACTIVE

25901257LISINOPRIL (PRINVIL, ZESTRIL) 5MG TAB

259 J8499 $ 24.00 ACTIVE

25901256 LISINOPRIL (ZESTRIL) 20MG TAB 259 J8499 $ 28.00 ACTIVE

25901886LISINOPRIL +HYDROCHLOROTHIAZIDE 20/12.5MG TAB

250 J8499 $ 5.25 ACTIVE

25901887 LISINOPRIL 2.5MG TAB 250 J8499 $ 7.59 ACTIVE

30100233 LITHIUM 301 80178 $ 88.20 ACTIVE

27000731 LITHO MACHINE RENTAL 271 E1399 $ 21,000.00 ACTIVE

36000148

LITHOLAPAXY OF CALCULUS BY ANY MEANS IN BLADDER/REMOVAL OF FRAGMENTS COMPLICATED/LARGE >2.5CM

360 52318 $ 24,890.00 ACTIVE

27200920LITHOTOMY DRAPES LITHOTOMY SHT

272 A4649 $ 25.00 ACTIVE

45000058LITHOTRIPSY EXTRACORPOREAL SHOCK WAVE

790 50590 $ 29,746.00 ACTIVE


Charge Amt Status

Charge Master List

79000001

LITHOTRIPSY EXTRACORPOREAT SHOCK WAVE AND LITHO MACHINE RENTAL

790 50590 $ 50,746.00 ACTIVE

34100005 LIVER & SPLEEN IMAGE/FLOW 341 78216 $ 6,226.50 ACTIVE

30100301 LONG CHAIN FATTY ACIDS 301 82726 $ 240.72 ACTIVE

27200706 LOOP VESSEL MINI WHITE 272 A4649 $ 19.66 ACTIVE

27200707 LOOP VESSEL MINI WHITE 2 PK 272 A4649 $ 19.54 ACTIVE

27200712 LOOPS BLUE MICRO MINI 2 PACK 272 A4649 $ 22.60 ACTIVE

25901934LOPERAMIDE 1MG/5ML ORAL SOL 120ML

250 J3490 $ 24.00 ACTIVE

25900684 LOPERAMIDE 2MG CAP 250 J8499 $ 16.00 ACTIVE

25900686 LOPID 600MG TABLET 250 J8499 $ 24.00 ACTIVE

25000376 LOPRESSOR 1MG/ML AMPUL 250 J3490 $ 176.00 ACTIVE

25900688 LOPRESSOR 50MG TABLET 250 J8499 $ 24.00 ACTIVE

63600165LORAZEPAM (ATIVAN) 2MG 1ML SDVIAL

636 J2060 $ 24.00 ACTIVE

25900690 LORAZEPAM .5MG TAB 250 J8499 $ 16.00 ACTIVE

25900691 LORAZEPAM 1MG TAB 250 J8499 $ 22.00 ACTIVE

25901944 LORAZEPAM 2MG 30ML OS 250 J3490 $ 24.00 ACTIVE

25900583LOSARTAN + HYDROCHLOROTHIAZIDE (HYZAAR) 50/12.5MG TAB

250 J8499 $ 40.00 ACTIVE

25901888LOSARTAN + HYDROCHLORROTHIAZIDE (HYZAAR) 100/25MG TAB

250 J8499 $ 7.59 ACTIVE

25900697LOTENSIN 20MG TAB (BENAZEPRIL)

250 J8499 $ 28.00 ACTIVE

25900703 LOTRIMIN 1% LOTION 30ML 250 J3490 $ 326.60 ACTIVE

25900705 LOTRISONE CREAM 15GM 250 J3490 $ 424.50 ACTIVE

25901269LOVASTATIN (ZOCOR) 20MG TABLET

250 J8499 $ 76.50 ACTIVE

32000091LOWER EXTREM INFANT 2OR MORE V <1YR

320 73592 $ 638.40 ACTIVE

48100063LT AND RT HEART CATH - W/ CORONORIES & GRAFTS

481 93461 $ 75,145.00 ACTIVE

48100076LT HEART CATH - TRANSEPTAL PUNTURE THROUGH SEPTUM

481 93462 $ 44,550.95 ACTIVE

32000026 LT PULMONARY ANGIO 320 75741 $ 6,468.98 ACTIVE

25000379LTA 360 KIT (LIDOCAINE HYDROCHLORIDE TOPICAL SOL USP 4%)

250 J3490 $ 64.00 ACTIVE

27200755 LUBRICATING JELLY 272 A4332 $ 52.00 ACTIVE

32000130 LUMB SPINE 2 OR 3 VIEWS 320 72100 $ 1,677.00 ACTIVE

32000131 LUMB SPINE 4+ VIEWS 320 72110 $ 2,344.00 ACTIVE

32000132 LUMB SPINE BEND VW ONLY 320 72120 $ 1,932.00 ACTIVE

32000133LUMB SPINE COMP W/BEND V 6+VIEWS

320 72114 $ 2,993.00 ACTIVE

30100234 LUTHERIZING HORMONE ( LH) 301 83002 $ 246.84 ACTIVE

30200150 LYME DISEASE ANTIBODY 302 86618 $ 227.04 ACTIVE

30600072LYME DISEASE PCR AMPLIFICATION PROBE

306 87476 $ 467.88 ACTIVE

32000134 LYMPHANGIO PELV/ABD BIL 320 75807 $ 3,507.72 ACTIVE

32000135 LYMPHANGIO PELV/ABD UNIL 320 75805 $ 3,507.72 ACTIVE

32000136 LYMPHANGIOGRAPHY EXT BIL 320 75803 $ 3,507.72 ACTIVE

32000137 LYMPHANGIOGRAPHY EXT UNI 320 75801 $ 2,511.60 ACTIVE


Charge Amt Status

Charge Master List

25901502 MAALOX 30ML 250 J3490 $ 30.00 ACTIVE

25901889MAG-AL-SIMETHICONE RS 200-200-20MG

250 J3490 $ 5.70 ACTIVE

30100236 MAGNESIUM 301 83735 $ 89.28 ACTIVE

63600166 MAGNESIUM 500MG/2ML VIAL 636 J3475 $ 5.70 ACTIVE

25900720 MAGNESIUM OXIDE 400MG TAB 250 J8499 $ 24.00 ACTIVE

25000382 MAGNESIUM SULFATE 2GM/50ML 636 J3475 $ 174.00 ACTIVE

27200754MAHURKAR TRIPLE LUMEN CATHETER 12FR / CH X 16CM

272 C1752 $ 360.00 ACTIVE

40100002 MAMMO SCREEN CONVERT DIAG 401 77055 $ 1,152.76 ACTIVE

40100003MAMMO SCREEN CONVERT DIAGN BIL

401 77056 $ 1,152.76 ACTIVE

40300001 MAMMO SCRN DIG W COMP 403 77051 $ 427.50 ACTIVE

32000138 MAMMOGRAPHY BREAST LOC 320 77032 $ 1,152.76 ACTIVE

30500078 MAN DIFF WBC CNT BUFFY CT 305 85009 $ 60.84 ACTIVE

32000139 MANDIBLE 4V OR MORE 320 70110 $ 1,815.00 ACTIVE

32000140 MANDIBLE PARTIAL <4 VIEWS 320 70100 $ 3,500.00 ACTIVE

41000010 MANIP CW LUNG FUNC SUBSEQ 410 94668 $ 222.62 ACTIVE

63600167 MANNITOL 20% 250ML IV 636 J2150 $ 53.88 ACTIVE

63600168 MANNITOL 20% 500ML 636 J2150 $ 47.35 ACTIVE

30500030 MANUAL PLATELET COUNT 305 85032 $ 57.48 ACTIVE

42000026 MANUAL TECH EA 15M 450 97140 $ 266.00 ACTIVE

27000652 MASK BIPAP 272 A7034 $ 132.00 ACTIVE

27000616 MASK FACE TENT W/TUBING 270 A7030 $ 132.00 ACTIVE

27000650MASK NON-REBREATHABLE (NRB)

270 A4620 $ 52.00 ACTIVE

27000651 MASK OXYGEN 271 A4620 $ 15.00 ACTIVE

27000649 MASK VENTI 270 A4620 $ 76.00 ACTIVE

27100025 MASK, FOG FREE W/EAR LOOP 271 A4620 $ 4.35 ACTIVE

27000757 MASK, LARYNGEAL DISP CLEAR 270 A7521 $ 137.10 ACTIVE

30200270MASS SPECTROMETRY AND TANDEM MASS SPECTROMETRY

301 83789 $ 124.25 ACTIVE

27000554 MASTISOL LIQUID ADHESIVE 272 A4364 $ 120.00 ACTIVE

32000141 MASTOIDS COMP 3V OR > 320 70130 $ 938.00 ACTIVE

32000142 MASTOIDS LESS THAN 3V 320 70120 $ 800.80 ACTIVE

27000593MAXORB EXTRA CALCIUM ALGINATE

270 A6196 $ 250.00 ACTIVE

27000594MAXORB EXTRA CMC/ALGINATE 4 X 8

270 A6197 $ 356.00 ACTIVE

30100103 MC DRUG TEST 301 G0480 $ 287.32 ACTIVE

41000028 MDI TREATMENT INITIAL 410 94640 $ 449.61 ACTIVE

41000029 MDI TREATMENT SUBQ 410 94640 $ 224.80 ACTIVE

42000027 MECH TRACT 15 450 97012 $ 252.76 ACTIVE

36000349

MECHANICAL REMOVAL OF OBSTRUCTIVE MATERIAL FROM GASTROSTOMY, DUODENOSTOMY, JEJUNOSTOMY, GASTRO-JEJUNOSTOMY

750 49460 $ 10,761.50 ACTIVE

25900727 MECLIZINE HCL 25MG TABLET 259 J8499 $ 8.00 ACTIVE


Charge Amt Status

Charge Master List

94200006MED NUTRITION INDIVIDUAL RE-ASSESSMENT EA 15 MINUTES

942 97803 $ 280.00 ACTIVE

94200007MED NUTRITION THERAPY INTIAL ASSESSMENT EA 15 MINUTES

942 97802 $ 308.00 ACTIVE

94200008 MED NUTRTION GROUP 30MIN 942 97804 $ 156.46 ACTIVE

25900728 MEDROL DOS PAK 4MG TAB 250 J8499 $ 523.50 ACTIVE

27200118MEDTRONIC REVEAL LOOP RECORDER

272 C1764 $ 46,950.00 ACTIVE

63600169 MEFOXIN 2GM 50ML IV 636 J0694 $ 57.18 ACTIVE

25901890 MELATONIN 1MG CAP 250 J8499 $ 5.05 ACTIVE

46000004 MEMBRANE DIFFUS CAPAC 460 94725 $ 737.38 ACTIVE

25000798MEPERIDINE (DEMEROL) 25MG 1ML

636 J2175 $ 48.00 ACTIVE

25000392MEPERIDINE HCL (DEMEROL) 75MG/1.5ML VIAL (50MG/1ML)

636 J2175 $ 316.00 ACTIVE

63600170MEPIVACAINE (CARBOCAINE) 2% 20ML SDVIAL

636 J0670 $ 15.60 ACTIVE

30100239 MEPROBAMATE 301 83805 $ 183.54 ACTIVE

30100240 MERCURY 301 83825 $ 135.24 ACTIVE

27200645 MESH COMPOSITE 7X9 272 C1781 $ 16,000.00 ACTIVE

30100089 METABOLIC PANEL IONIZED CA 301 80047 $ 164.76 ACTIVE

30100241 METANEPHRINES (BLOOD) 301 83835 $ 157.78 ACTIVE

25901891 METAXOLONE 800MG TABLET 250 J8499 $ 5.25 ACTIVE

30100244 METHADONE 301 80358 $ 140.88 ACTIVE

30100247METHEMOGLOBIN QUANTITATIVE

301 83050 $ 98.40 ACTIVE

25000394METHERGINE 0.2MG/ML INJECTION

636 J2210 $ 56.00 ACTIVE

25901029METHOCARBAMOL (ROBAXIN) 500MG TABLET

250 J8499 $ 10.00 ACTIVE

25901030METHOCARBAMOL (ROBAXIN) 750MG TAB

250 J8499 $ 24.00 ACTIVE

25000155METHYL ACETATE (DEPO-MEDROL) 80 MG

636 J1040 $ 26.43 ACTIVE

25000395 METHYLENE BLUE 1% 10ML 636 Q9968 $ 110.00 ACTIVE

30100099METHYLENEDIOXYAMPHETAMINES (MDA, MDEA, MDMA)

301 80359 $ 4,470.00 ACTIVE

30100248 METHYLMALONIC ACID 301 83921 $ 254.52 ACTIVE

25900740 METOCLOPRAMIDE 10MG TAB 250 J8499 $ 24.00 ACTIVE

25100024 METOPROLOL 25MG TAB 250 J8499 $ 16.00 ACTIVE

25900182METOPROLOL SUCCINATE ER 25MG TABLET

259 J8499 $ 22.00 ACTIVE

25000403 METRONIDAZ 500MG/NS 100ML 250 S0030 $ 244.00 ACTIVE

48200004MICRO T WAVE ALTERATIONS WITHOUT TRANSPORTATION

482 93025 $ 1,170.40 ACTIVE

30500001 MICROALBUMIN (URINE) 301 82043 $ 77.04 ACTIVE

30200151MICROSOMAL ANTIBODIES (EACH)

302 86376 $ 135.24 ACTIVE

63600171MIDAZOLAM (VERSED) 5MG/5ML VIAL

636 J2250 $ 15.32 ACTIVE

25000621MIDAZOLAM (VERSED) 5MG/ML 10ML OS

250 J3490 $ 2,914.00 ACTIVE

25900751 MILK MAGNESIA ORAL 20ML 250 J3490 $ 16.00 ACTIVE

25901517 MILK OF MAGNESIA 30ML 250 J3490 $ 24.00 ACTIVE

25900756MIRALAX POWDER UNIT DOSE PKG

250 J3490 $ 44.00 ACTIVE


Charge Amt Status

Charge Master List

25900759 MIRAPEX 1MG TAB 250 J8499 $ 54.00 ACTIVE

63600172MMR II, MEASLES MUMPS RUBELLA VACC 0.5ML MDVIAL

636 90707 $ 384.25 ACTIVE

25900761 MOBIC 7.5 MG TABS 250 J8499 $ 37.50 ACTIVE

37000010MODERATE SEDATION 5YRS OR OLDER 1ST 15M

370 99152 $ 628.00 ACTIVE

37000011MODERATE SEDATION EACH ADDT'L 15MIN

370 99153 $ 556.50 ACTIVE

37000009MODERATE SEDATION UNDER 5YRS 1ST 15M

370 99151 $ 1,202.50 ACTIVE

36000153MODERATE SEDATION; 5+YRS, EA ADDTNL 15MINS

360 99157 $ 590.00 ACTIVE

36000151MODERATE SEDATION; 5+YRS, FIRST 15MINS

360 99156 $ 1,200.00 ACTIVE

30100262 MOLECULAR DIAGNOSTICS 301 83902 $ 154.56 ACTIVE

30100264MOLECULAR DX AMPLIFICATION PATIENT NUCLEIC ACID EACH MULTIPLEX REACTION

301 83901 $ 193.20 ACTIVE

30100263MOLECULAR DX ENZYMATIC DIGESTION

301 83892 $ 96.60 ACTIVE

30100251 MOLECULAR DX EXTRACTION 301 83890 $ 305.90 ACTIVE

30100259

MOLECULAR DX MUTATION IDENTIFICATION SEQUENCING SINGLE SEGMENT EACH SEGMENT

301 83904 $ 309.12 ACTIVE

30100260MOLECULAR DX NUCEIC ACID PROBE (EACH)

301 83896 $ 96.60 ACTIVE

30200230 MONO SPOT TEST 302 86723 $ 48.84 ACTIVE

25901063MONTELUKAST (SINGULAIR) 10MG TAB

250 J8499 $ 69.00 ACTIVE

27600003 MORGAN LENS 276 V2797 $ 51.95 ACTIVE

25000414 MORPHINE 15MG 1ML SDVIAL 636 J2270 $ 100.00 ACTIVE

25000415 MORPHINE 2MG/ML 1ML CARP 636 J2270 $ 42.00 ACTIVE

25000416 MORPHINE 4MG/1ML VIAL 636 J2270 $ 380.00 ACTIVE

63600182 MORPHINE 5MG SYRINGE 636 J2270 $ 42.00 ACTIVE

25000420 MORPHINE SULFATE (PF) 10MG 636 J2270 $ 135.00 ACTIVE

31200017 MORPHOMETRIC ANALYSIS 312 88360 $ 623.64 ACTIVE

27200879 MOTOR STRUT -SHORT 272 A4649 $ 28,034.10 ACTIVE

25900767 MOTRIN 400MG TABLET 259 J8499 $ 22.50 ACTIVE



61800001 MRA ABD W CON 618 C8900 $ 4,482.24 ACTIVE

61800003 MRA ABD W/O CON 618 C8901 $ 4,211.76 ACTIVE

61800002 MRA ABD W-W/O CON 618 C8902 $ 6,053.60 ACTIVE

61800004 MRA CHEST W CON 618 C8909 $ 4,482.24 ACTIVE

61800006 MRA CHEST W/O CON 618 C8910 $ 4,173.12 ACTIVE

61800005 MRA CHEST W-W/O CON 618 C8911 $ 6,053.60 ACTIVE

61600001 MRA EXT LOW W CON 616 C8912 $ 4,482.24 ACTIVE

61600003 MRA EXT LOW W/O CON 616 C8913 $ 4,173.12 ACTIVE

61600002 MRA EXT LOW W-W/O CON 616 C8914 $ 6,053.60 ACTIVE

61500004 MRA HEAD W CONTRAST 615 70545 $ 2,981.50 ACTIVE

61500001 MRA HEAD W/O CONTRAST 615 70544 $ 16,626.00 ACTIVE

61500003 MRA NECK W/O CON 615 70547 $ 16,610.50 ACTIVE

61500002 MRA NECK W-W/O CONTRACT 615 70549 $ 27,502.50 ACTIVE

61800007 MRA PELV W CON 618 C8918 $ 4,482.24 ACTIVE


Charge Amt Status

Charge Master List

61800009 MRA PELV W/O CON 618 C8919 $ 4,173.12 ACTIVE

61800008 MRA PELV W-W/O CON 618 C8920 $ 6,053.60 ACTIVE

61800010MRA PELVIS; W OR W/O CONTRAST

618 72198 $ 4,173.12 ACTIVE

61500006 MRA, NECK W/CONTRAST 615 70548 $ 3,730.50 ACTIVE

61500005MRA,HEAD W AND W/O CONTRAST

615 70546 $ 3,663.50 ACTIVE

61000022 MRI- ABD W/O CONTRAST 610 74181 $ 15,949.00 ACTIVE

61000004 MRI ABDOMEN W/CONTRAST 610 74182 $ 21,811.50 ACTIVE

61000005 MRI ABDOMEN W/WO CONTRAST 610 74183 $ 24,331.50 ACTIVE

61000006 MRI BONE MARROW 610 77084 $ 4,440.38 ACTIVE

61100001 MRI BRAIN WITH CONTRAST 611 70552 $ 15,354.50 ACTIVE

61000027 MRI CHEST W CONTRAST 610 71551 $ 18,266.50 ACTIVE

61000007 MRI CHEST W/O CON 610 71550 $ 17,247.50 ACTIVE

61000008 MRI CHEST W/WO CONTRAST 610 71552 $ 27,917.50 ACTIVE

61000009MRI EXP UPPER OTHER THAN JT W/WO CONTRAST

610 73220 $ 23,954.50 ACTIVE

61000010 MRI EXT LOW JNT W/CON 610 73722 $ 18,307.50 ACTIVE

61000011 MRI EXT LOW NO JNT W/CON 610 73719 $ 19,401.00 ACTIVE

61000012 MRI EXT UPP JNT W/CON 610 73222 $ 18,154.50 ACTIVE

61000013 MRI EXT UPP JNT W/O CON 610 73221 $ 11,299.50 ACTIVE

61000014 MRI EXT UPP NO JNT W/CON 610 73219 $ 19,365.50 ACTIVE

61000015 MRI EXT UPP NO JNT W/O 610 73218 $ 16,972.00 ACTIVE

61000016 MRI GUIDE VISCL TISS ABLT 610 77022 $ 4,440.38 ACTIVE

61000018 MRI JOINT LOWER EXT W/WO 610 73723 $ 22,605.50 ACTIVE

61000017MRI LOWER EXT OTHER THAN JOINT W/WO CONTRAST

610 73720 $ 24,109.00 ACTIVE

61000001 MRI ORBIT FACE NEC W/O 610 70540 $ 16,954.50 ACTIVE

61000019 MRI ORBIT FACE NECK W/WO 610 70543 $ 23,597.00 ACTIVE

61200001 MRI PELVIS W/WO CONTRAST 610 72197 $ 24,280.00 ACTIVE

61000020MRI UPPER EXT JOINT W/WO CONTRAST

610 73223 $ 22,502.50 ACTIVE

61000026MRI, HEAD + NECK + ORBITS, W/ CONTRAST

610 70542 $ 4,029.00 ACTIVE

61100002 MRI-BRAIN W/O & W CONT 611 70553 $ 18,114.50 ACTIVE

61100003 MRI-BRAIN W/O CONTRAST 611 70551 $ 11,028.50 ACTIVE

61000023MRI-EXT LOWER JOINT WO CONTRAST

610 73721 $ 11,282.00 ACTIVE

61000024MRI-LOWER EXT OTHER THAN JOINT WO CONTRAST

610 73718 $ 16,972.00 ACTIVE

61200002 MRI-PELVIS W/CONTRAST 610 72196 $ 19,727.00 ACTIVE

61200003 MRI-PELVIS W/O CONTRAST 610 72195 $ 17,263.50 ACTIVE

61200004 MRI-SPINE CERV W/O & W C 612 72156 $ 18,217.00 ACTIVE

61200005MRI-SPINE CERVICAL W CONTRAST

612 72142 $ 15,526.50 ACTIVE

61200006 MRI-SPINE CERVICAL W/O 612 72141 $ 10,704.00 ACTIVE

61200007 MRI-SPINE LUMB W/O&W C 612 72158 $ 18,164.50 ACTIVE

61200008 MRI-SPINE LUMBAR W CONT 612 72149 $ 15,339.00 ACTIVE

61200009 MRI-SPINE LUMBER W/O CONT 612 72148 $ 10,653.00 ACTIVE

61200010 MRI-SPINE THORACIC W CONT 612 72147 $ 15,423.50 ACTIVE

61200011 MRI-SPINE THORACIC W/O 612 72146 $ 10,704.00 ACTIVE

61000025 MRI-TEMPORAL MANDBLR TMJ 610 70336 $ 15,351.50 ACTIVE

61200012 MRI-THORACIC W/O&W CONT 612 72157 $ 18,266.50 ACTIVE


Charge Amt Status

Charge Master List

31000008

MTHFR (5,10-METHYLENETETRAHYDROFOLATE REDUCTASE) (EG, HEREDITARY HYPERCOAGULABILITY) GENE ANALYSIS, COMMON VARIANTS (EG, 677T, 1298C)

310 81291 $ 206.02 ACTIVE

25900771MUCINEX 600MG EXTENDED RELEAS

250 J8499 $ 10.00 ACTIVE

92000002 MULT SLEEP LATENCY TEST 920 95805 $ 21,276.50 ACTIVE

25000681MULTAQ 400MG TABLET (DRONEDARONE)

250 J8499 $ 48.00 ACTIVE

25901892 MULTI VITAMIN 250 J8499 $ 5.25 ACTIVE

30200154 MUMPS ANTIBODY 302 86735 $ 174.00 ACTIVE

25901893MUPIROCIN (BACTROBAN) 2% OINTMT 22GM TUBE

250 A6250 $ 24.30 ACTIVE

30100267MUTATION IDENTIFICATION BY ENZYMATIC LIGATION

301 83914 $ 189.98 ACTIVE

25901943 MVI ADULT INJ 5ML VIAL 250 J3490 $ 32.20 ACTIVE

30000010MYCOBACTERIAL IDENTIFICATION (EACH ISOLATE)

306 87118 $ 175.32 ACTIVE

30600073MYCOBACTERIUM TUBERCULOSIS NUCLEIC ACID AMPLIFICATION TEST (NAAT)

306 87556 $ 500.16 ACTIVE

30200156 MYCOPLASMA ANTIBODY 302 86738 $ 176.52 ACTIVE

30100268 MYELIN BASIC PROTEIN 301 83873 $ 141.68 ACTIVE

32000144 MYELOGRAPHY 2+ REGIONS 320 72270 $ 6,122.00 ACTIVE

32000145 MYELOGRAPHY CERVICAL 320 72240 $ 4,729.50 ACTIVE

32000146 MYELOGRAPHY LUMBOSACRAL 320 72265 $ 4,421.50 ACTIVE

32000143 MYELOGRAPHY POST FOSSA 320 70010 $ 4,944.58 ACTIVE

32000147 MYELOGRAPHY THORACIC 320 72255 $ 4,697.50 ACTIVE

30100069 MYELOPEROXIDASE (MPO) 301 83876 $ 610.32 ACTIVE

34100088

MYOCARDIAL PERFUSION IMAGING W/SPECT EJECTION FRACTION REST AND/OR STRESS

341 78452 $ 23,450.50 ACTIVE

30100269 MYOGLOBIN 301 83874 $ 172.20 ACTIVE

30600103 N.GONORRHOEAE DNA QUANT 306 87592 $ 158.64 ACTIVE

34100006 N/M THYROID UPTAKE W/ SCAN 341 78006 $ 2,514.20 ACTIVE

25200007NALBUPHINE 10MG/ML 10ML MDV

636 J2300 $ 74.26 ACTIVE

63600173 NALOXONE 2MG/2ML SYRINGE 636 J2310 $ 57.57 ACTIVE

25901531 NAPROSYN EC 500MG TAB 250 J8499 $ 37.50 ACTIVE

25000434NAROPIN (ROPIVACAINE HCL) 5MG MG/ML 0.5% 30ML SDV

636 J2795 $ 192.00 ACTIVE

32000148 NASAL BONES MIN 3 VI 320 70160 $ 1,556.50 ACTIVE

30900006 NASAL SMEAR EOSINOPHILS 309 89190 $ 69.48 ACTIVE

36000188NASAL/OROGASTRIC W/TUBE PLMT

360 43752 $ 1,273.79 ACTIVE

47100001 NASOPHARYNGOSCOPY 471 92511 $ 4,456.48 ACTIVE

27000772NEBULIZER ADMINISTRATION SET

270 A7003 $ 24.00 ACTIVE

41000001 NEBULIZER TREATMENT INITIAL 410 94640 $ 539.53 ACTIVE

41000019 NEBULIZER TREATMENT SUBSQ 410 94640 $ 269.77 ACTIVE


Charge Amt Status

Charge Master List

32000149 NECK SOFT TISSUE 320 70360 $ 1,335.00 ACTIVE

27200898NEDDLE, MERIT ADVANCE. ONE WALL 18G. 7.0CM 2 3/4" . SELDINGER SHIELD SMOOTH

272 A4215 $ 393.75 ACTIVE

27200861 NEEDLE BONE MARROW VITOSS 272 C1830 $ 3,120.00 ACTIVE

92200001 NEEDLE EMG 1 EXTREM 922 95860 $ 805.00 ACTIVE

92200002 NEEDLE EMG 2 EXTREM 922 95861 $ 866.18 ACTIVE

92200003 NEEDLE EMG 3 EXTREM 922 95863 $ 1,014.30 ACTIVE

92200004 NEEDLE EMG 4 EXTREM 922 95864 $ 1,362.06 ACTIVE

27200785 NEEDLE HUBER/GRIPPER 272 A4649 $ 44.00 ACTIVE

27200823 NEEDLE HYPODERMIC (ALL) 272 A4215 $ 24.00 ACTIVE

27200652 NEEDLE INSULATED ALL SIZES 272 A4215 $ 1,119.00 ACTIVE

27200700NEEDLE PERCUTANEOUS ENTRY THINWALL 18GA/7CM

272 A4215 $ 113.00 ACTIVE

27000302NEEDLE PORT A CATH 20G X 1 1/4 (13914)

270 A4301 $ 114.00 ACTIVE

27000303NEEDLE PORT A CATH 20G X 3/4 (13790)

270 A4301 $ 110.00 ACTIVE

27000304NEEDLE PORT A CATH 20G X 3/4 (13790)

270 A4301 $ 100.00 ACTIVE

27200669 NEEDLE RADIAL JAW 272 A4215 $ 847.50 ACTIVE

27000608 NEEDLE SPINAL 18-19 GA X 3.5 272 A4215 $ 60.00 ACTIVE

27000606 NEEDLE SPINAL 18-20GA 6-8" 272 A4215 $ 344.00 ACTIVE

27000607 NEEDLE SPINAL 22 GA 5-7" 272 A4215 $ 488.00 ACTIVE

27000305 NEEDLE SPINAL 25G X 3.5 (10351) 270 A4215 $ 48.00 ACTIVE

27200824 NEEDLE SPINAL 25GA X 3.5 272 A4215 $ 140.00 ACTIVE

27200587 NEEDLE TRU CUT BIOPSY 272 A4215 $ 244.00 ACTIVE

27200794 NEEDLE W/SYRINGE 272 A4657 $ 52.00 ACTIVE

27200904 NEEDLE, BLUNT FILL 18GX1.5 272 A4215 $ 2.10 ACTIVE

42000029 NEG PRESS WOOUND TX > 50CM 450 97606 $ 1,027.82 ACTIVE

29100001NEG PRESSURE THERAPY UNIT DAILY RATE

291 E2402 $ 744.00 ACTIVE

30600074NEISSERIA GONORRHOEAE DIRECT DNA PROBE

306 87590 $ 126.00 ACTIVE

30600101NEISSERIA GONORRHOEAE, AMPLIFIED PROBE TECHNIQUE

306 87591 $ 129.99 ACTIVE

25000437NEO SYNEPHRINE 10MG/ML 5ML VIAL (PHENYLEPHRINE)

636 J2370 $ 60.00 ACTIVE

25900800 NEOMYCIN 500MG TAB 250 J8499 $ 52.50 ACTIVE

25901894 NEOMYCIN OTIC SOLN BTL 250 J3490 $ 408.10 ACTIVE

25000438 NEOMYCIN/POLYMYXIN/HC 10ML 250 J3490 $ 172.00 ACTIVE

25900802 NEOSPORIN OINTMENT .94GM 250 A6250 $ 36.00 ACTIVE

25900803 NEOSPORIN OINTMENT 15GM 250 A6250 $ 106.50 ACTIVE

25000439 NEOSTIGMIN 11000/ML INJ 636 J2710 $ 248.00 ACTIVE

25000440 NEOSTIGMINE 0.5MG INJ 636 J2710 $ 78.00 ACTIVE

25900797NEO-SYNEPHINE 1% NASAL SPRAY

250 J3490 $ 28.00 ACTIVE

42000031 NEUROMUSC RE-ED EA 15 450 97112 $ 260.40 ACTIVE

25900806 NEURONTIN 300 MG CAPS 250 J8499 $ 27.00 ACTIVE

25900807 NEURONTIN 400MG CAP 250 J8499 $ 30.00 ACTIVE

25901895 NEURONTIN 600MG CAP 250 J8499 $ 27.00 ACTIVE

25901896 NEURONTIN 800MG TAB 250 J8499 $ 27.00 ACTIVE

36000279NEUROPLASTY/TRANSPOSITION; ULNAR NERVE WRIST

360 64719 $ 20,600.00 ACTIVE


Charge Amt Status

Charge Master List

76100018 NEW PATIENT LEVEL 1 761 99201 $ 567.40 ACTIVE



76100021 NEW PATIENT LEVEL 4 761 99204 $ 1,177.00 ACTIVE

76100022 NEW PATIENT LEVEL 5 761 99205 $ 1,500.36 ACTIVE

25901951 NICARDIPINE 20MG 200ML IV FL 250 J3490 $ 201.50 ACTIVE

25901897 NICARDIPINE 25MG/10ML IV 250 J3490 $ 63.65 ACTIVE

25900820 NICOTINE 21MG PATCH 259 S4990 $ 230.00 ACTIVE

25900961NIFEDIPINE (PROCARDIA) 30MG TABLET

250 J8499 $ 45.00 ACTIVE

25200040 NITRO-BID 2% OINT U/D PKG 250 A6250 $ 16.00 ACTIVE

25901898 NITROBID OINT 30GM 250 A6250 $ 85.18 ACTIVE

25900719NITROFURANTOIN (MACROBID) 50MG CAP

250 J8499 $ 24.00 ACTIVE

46000005 NITROGEN WASHOUT 460 94350 $ 908.04 ACTIVE

25901899 NITROGLYCERIN 25MG/250ML IV 250 J3490 $ 50.50 ACTIVE

25901959 NITROGLYCERIN 50MG/250ML IV 250 J3490 $ 19.22 ACTIVE

25000691NITROSTAT 0.4MG S.L. TAB (NITROGLYCERIN)

250 J8499 $ 28.00 ACTIVE

30100603 NK CELL TOTAL COUNT 302 86357 $ 139.74 ACTIVE

34100008 NM ABSCSS LOC WB 341 78806 $ 27,338.00 ACTIVE

34100009 NM ADRENAL IMAGING 341 78075 $ 4,396.00 ACTIVE

34100011 NM BONE DENSITY 1+SITES 341 78350 $ 504.00 ACTIVE

34100012 NM BONE SCAN THREE PHASE 341 78315 $ 17,237.00 ACTIVE

34100013 NM BONE SCAN W SPEC 341 78320 $ 11,309.50 ACTIVE

34100014 NM BONE SCAN WHOLE BODY 341 78306 $ 12,502.50 ACTIVE

34100015 NM BONESCAN LIMITED 341 78300 $ 8,944.50 ACTIVE

34100016 NM BONESCAN MX AREAS 341 78305 $ 11,442.50 ACTIVE

34100017 NM BOWEL IMAGING-MECKELS 341 78290 $ 12,335.00 ACTIVE

34100018 NM BRAIN CISTERNOGRAM 341 78630 $ 16,854.50 ACTIVE

34100019 NM BRAIN CMPL STATIC 341 78605 $ 3,825.36 ACTIVE

34100020 NM BRAIN CMPL W FLOW 341 78606 $ 5,771.70 ACTIVE

34100021 NM BRAIN CMPL W SPECT 341 78607 $ 17,497.50 ACTIVE

34100022 NM BRAIN CSF SHUNT EVAL 341 78645 $ 2,758.00 ACTIVE

34100023 NM BRAIN FLOW ONLYY 341 78610 $ 5,771.70 ACTIVE

34100024 NM BRAIN LTD 341 78600 $ 3,825.36 ACTIVE

34100025 NM BRAIN LTD W FLOW 341 78601 $ 3,825.36 ACTIVE

34100026 NM CSF FLOW W SPECT 341 78647 $ 5,771.70 ACTIVE

34100027 NM CSF LEAKAGE DETECTION 341 78650 $ 5,771.70 ACTIVE

34100028 NM CSF VENTRICULOGRAPHY 341 78635 $ 5,771.70 ACTIVE

34100030 NM GALLIUM SCAN MULT 341 78801 $ 4,057.20 ACTIVE

34100031 NM GALLIUM SCAN SPEC 341 78803 $ 10,075.86 ACTIVE

34100029 NM GALLIUM TUMOR LOCLTD 341 78800 $ 3,326.26 ACTIVE

34100032 NM GASTRIC EMPTYING STDY 341 78264 $ 14,363.50 ACTIVE

34100033NM GASTROESOPHAGEAL REFLX

341 78262 $ 2,923.76 ACTIVE

34100034 NM GI BLEEDING SCAN 341 78278 $ 17,338.00 ACTIVE

34100035 NM GI PROTEIN LOSS 341 78282 $ 2,923.76 ACTIVE

34100036 NM HEART 1ST PASS ADD ON 341 78496 $ 2,343.60 ACTIVE

34100037 NM HEART 1ST PASS MULTI 341 78483 $ 4,522.00 ACTIVE

34100038 NM HEART 1ST PASS SINGLE 341 78481 $ 3,500.00 ACTIVE


Charge Amt Status

Charge Master List

34100039 NM HEART BLOOD POOL SPECT 341 78494 $ 3,889.20 ACTIVE

34100040 NM HEART GATED MX STDY 341 78473 $ 4,831.40 ACTIVE

34100041 NM HEART GATED SINGLE 341 78472 $ 11,411.50 ACTIVE

34100042 NM HEART MI PLANAR 341 78466 $ 3,397.10 ACTIVE

34100043 NM HEART MI W EF 341 78468 $ 3,397.10 ACTIVE

34100044 NM HEART MI W SPECT 341 78469 $ 3,397.10 ACTIVE

34100045 NM HEART MP SNGLE PLANAR 341 78460 $ 7,752.30 ACTIVE

34100046 NM HEART MP W EF 341 78480 $ 1,763.38 ACTIVE

34100047 NM HEART MP WALL MOTION 341 78478 $ 1,778.00 ACTIVE

34100050 NM HRT MP MX W SPECT 341 78465 $ 7,752.30 ACTIVE

34100051 NM HRT MP SINGLE W SPEC 341 78464 $ 7,752.30 ACTIVE

25500014 NM I 123 IODINE 250 A9516 $ 540.96 ACTIVE

34100052 NM KIDNEY STUDY BIL 341 78708 $ 8,612.50 ACTIVE

34100054 NM LIVER & SPLEEN STATIC 341 78215 $ 9,625.50 ACTIVE

34100053 NM LIVER (SPECT) W FLOW 341 78206 $ 3,843.28 ACTIVE

34100057 NM LIVER IMAGING (SPECT) 341 78205 $ 10,432.50 ACTIVE

34100058 NM LIVER IMAGING STATIC 341 78201 $ 3,368.12 ACTIVE

34100059 NM LIVER W/VASCULAR FLOW 341 78202 $ 9,951.50 ACTIVE

34100060 NM LUNG PERF 341 78580 $ 11,835.00 ACTIVE

34100092NM LUNG PERFUSION AND VENTILATION

341 78582 $ 4,418.00 ACTIVE

34100091 NM LUNG VENTILATION ONLY 341 78579 $ 11,835.00 ACTIVE

34100066 NM OCTREOSCAN 341 78399 $ 3,102.40 ACTIVE

34100067 NM PARATHYROID IMAGING 341 78070 $ 14,910.50 ACTIVE

34100068 NM RENAL SCAN W/SPECT 341 78710 $ 3,404.80 ACTIVE

25500016 NM RP MYOVIEW 10MCI REST 255 A9502 $ 1,349.18 ACTIVE

34100073 NM SPLEEN IMAGING ONLY 341 78185 $ 3,075.10 ACTIVE

34100074 NM TESTIC IMG W/VASC FLW 341 78761 $ 9,625.50 ACTIVE

34100077 NM THYROID IMAGING ONLY 341 78010 $ 11,400.00 ACTIVE

34100076 NM THYROID METASTSS LTD 341 78015 $ 3,326.26 ACTIVE

34100078 NM THYROID METS W BODY 341 78018 $ 4,033.40 ACTIVE

34100079 NM THYROID UPTAKE MX 341 78001 $ 17,400.00 ACTIVE

34100080 NM THYROID UPTAKE SINGLE 341 78000 $ 1,307.32 ACTIVE

34100081 NM TUMOR LOC WB SNGL DAYG 341 78802 $ 5,506.26 ACTIVE

34200001 NM TX THYROID SUPPW/EVAL 342 79005 $ 3,044.72 ACTIVE

34100082 NM VENOGRAM BILAT 341 78458 $ 2,270.94 ACTIVE

34100007 NM VENOGRAM UNILAT 341 78457 $ 2,103.50 ACTIVE

34100083 NM VP SHUNT PATENCY TEST 341 78291 $ 2,923.76 ACTIVE

34100084NM WBC LABEL LOCAL/ABSCESS/LTD

341 78805 $ 22,338.00 ACTIVE

34100085 NM WHOLE BODY 2+ DAYS 341 78804 $ 10,075.86 ACTIVE

30100067NMR LIPOPROTEIN PROFILE (LDL-P AND HDL-P)

301 83704 $ 420.72 ACTIVE

36000053NON CORONARY STENT PLACEMENT

360 37205 $ 881.00 ACTIVE

48100092NON SEL COMMON ILLIAC SUBCLAVIAN ANGIO

481 75710 $ 9,308.68 ACTIVE

92100018 NONINVAS ART W/STRESS BIL 921 93924 $ 1,700.16 ACTIVE

92100017 NON-INVAS EXT ART MX BIL 921 93923 $ 1,597.12 ACTIVE

44000008 NONSPEECH GEN DEVICE EVAL 440 92605 $ 322.00 ACTIVE

44000009NONSPEECH GEN DEVICE SERVICE

440 92606 $ 322.00 ACTIVE

25900839 NORCO 10-325 TAB 250 J8499 $ 24.00 ACTIVE


Charge Amt Status

Charge Master List

25900840 NORCO 5-325 TAB 250 J8499 $ 16.00 ACTIVE

25900841 NORCO 7.5MG/325MG TABLET 250 J8499 $ 22.00 ACTIVE

30100275 NORTRIPTYLINE 301 80182 $ 228.62 ACTIVE

25000669NOVOLOG 100 UNITS/ML (1 UNIT/.01 ML)

250 J1815 $ 14.00 ACTIVE

25900848 NOVOLOG MIX 100 UNITS/10ML 636 J1815 $ 14.00 ACTIVE

25800050NS 0.45% 1000ML W/POTASSIUM CHL 20MEQ

258 J3480 $ 30.00 ACTIVE

25800051 NS 0.9% 1000ML/KCL 20MEQ 258 J3480 $ 164.00 ACTIVE

30100276 N-TELOPEPTIDE (SERUM) 301 82523 $ 249.12 ACTIVE

30600076 NUCLEIC ACID PROBE 306 87149 $ 267.36 ACTIVE

30100524 NUCLEOTIDASE 5 301 83915 $ 148.68 ACTIVE

94200009 NUTRIT CNSL DIETICIAN 942 S9470 $ 460.46 ACTIVE

25900849 NYSTATIN CREAM 15GM TUBE 250 A6250 $ 54.00 ACTIVE

25000455NYSTATIN ORAL SUSP 5000U/5ML UD CUP

250 J3490 $ 14.00 ACTIVE

25900850 NYSTATIN PWD 100 000 U/1GM 250 J3490 $ 302.00 ACTIVE

25901965 NYSTATIN PWD 15GM 250 J3490 $ 302.00 ACTIVE

40200005 OB US DETAILED SNGL FETUS 402 76811 $ 8,841.50 ACTIVE

40200006 OB US LIMITED FETUS(S) 402 76815 $ 4,109.50 ACTIVE

76200003 OBSERVATION PER HOUR 762 G0378 $ 3,000.00 ACTIVE

76200025 OBSERVATION PER HOUR <8HRS 762 G0378 $ 3,000.00 ACTIVE

25900854OFLOXACIN 0.3% OPHTH SOLN 10ML BTL

250 J3490 $ 496.80 ACTIVE

30100277 OLIGOCLONAL BANDS 301 83916 $ 328.68 ACTIVE

25901794OMEPRAZOLE (PRILOSEC, NEXIUM) 20MG CAP

259 J8499 $ 24.00 ACTIVE

25000015OMNIPAQUE 240MG/10ML (IOHEXOL)

636 Q9966 $ 266.00 ACTIVE


636 Q9966 $ 266.00 ACTIVE

25000457OMNIPAQUE 240MG/50ML VIAL (IOHEXOL)

636 Q9966 $ 298.00 ACTIVE

25000458OMNIPAQUE 300MG/100ML VIAL (IOHEXOL)

636 Q9967 $ 260.00 ACTIVE


636 Q9967 $ 266.00 ACTIVE


636 Q9967 $ 274.00 ACTIVE

25900858ONDANSETRON (ZOFRAN) 4MG ODTAB

250 S0119 $ 240.00 ACTIVE

63600174 ONDANSETRON 40MG/20ML VIAL 636 J2405 $ 13.78 ACTIVE

25000572ONDANSETRON 4MG/5ML 50ML OS BTL

250 S0119 $ 150.00 ACTIVE

27000311 ON-Q 400ML PAIN PUMP 270 E0781 $ 1,925.28 ACTIVE

96000006OP CONSULT COMPREHENSIVE/HIGH COMPLEX 80MINS

960 99245 $ 5,661.00 ACTIVE

96000005OP CONSULT COMPREHENSIVE/MOD COMPLEX 60MINS

960 99244 $ 4,644.00 ACTIVE

96000004OP CONSULT DETAILED/LOW COMPLEX 40MINS

960 99243 $ 3,105.00 ACTIVE

96000003OP CONSULT EXPANDED PROBLEM/STRAIGHTFORWARD 30MIN

960 99242 $ 2,268.00 ACTIVE


Charge Amt Status

Charge Master List

96000002OP CONSULT PROBLEM FOCUSED/STRAIGHTFORWARD 15MIN

960 99241 $ 1,206.00 ACTIVE

48100028OPEN ANGIOPLASTY - EACH ADDITIONAL

481 37208 $ 1,522.00 ACTIVE

36000361

OPEN TREATMENT OF CALCANEAL FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED;

360 28415 $ 57,995.50 ACTIVE

36000123

OPEN TREATMENT OF CLAVICULAR FX INCLUDES INTERNAL FIXATION WHEN PERFORMED

360 23515 $ 21,639.82 ACTIVE

36000284

OPEN TREATMENT,DISTAL TIBIOFIBULAR JOINT (SYNDESMOSIS) DISRUPTION, INCLUDES INTERNAL FIXATION, WHEN PERFORMED

360 27829 $ 84,831.80 ACTIVE

36000289

OPEN TX OF FRACTURE,WT BEARING ARTICULAR SURFACE/PORTION OF DISTAL TIBIA (EG, PILON OR TIBIAL PLAFOND),WITH IF

360 27827 $ 56,722.00 ACTIVE

36000043

OPEN TX PROXIMAL HUMERAL (SURGICAL/ANATOMICAL NECK) FX INCLUDES INTERNAL FIXATION TUBOROSITY REPAIR

360 23615 $ 39,072.71 ACTIVE

11900001OPEN TX TRIMALLEOLAR ANKLE FX WITH OR WITHOUT INTERNAL FIXATION

360 27822 $ 44,268.50 ACTIVE

32000150 OPTIC FORAMINA 320 70190 $ 890.40 ACTIVE

25901966OPTIMARK 330.9MG/ML 15ML VIAL

250 A9579 $ 99.82 ACTIVE

63600175 OPTIRAY 300/50ML 636 Q9967 $ 46.53 ACTIVE

27000312 OR COBAN DRESSING 4"" 270 A6454 $ 184.00 ACTIVE

41000034 ORAL CARE PROCEDURE BY RT 410 31720 $ 539.53 ACTIVE

25500013ORAL MAGNETIC RESONANCE CONTRAST PER 100 ML

255 Q9954 $ 48.75 ACTIVE

44000010ORAL SPEECH DEVICE EVALUATION

440 92597 $ 1,899.80 ACTIVE

25000470ORAVERSE, REGITINE 5MG SDVIAL

636 J2760 $ 712.00 ACTIVE

32000151 ORBITS 4V OR MORE 320 70200 $ 2,020.50 ACTIVE

36000277ORCHIECTOMY, SIMPLE; SCROTAL OR INGUINAL APPROACH

360 54520 $ 16,903.50 ACTIVE

36000032ORCHIOPEXY INGUINAL APPROACH W/OR W/O HERNIA REPAIR

360 54640 $ 25,033.50 ACTIVE

30100280ORGANIC ACIDS QUALITATIVE (EACH)

301 83919 $ 219.36 ACTIVE

36000268ORIF FINGER DISLOCATION, SINGLE

360 26715 $ 29,650.50 ACTIVE

36000274 ORIF OF BIMALL ANKLE FX 360 27814 $ 36,231.50 ACTIVE

36000245ORIF OF DISTAL FIBULA FX (LAT MALLEOLUS)

360 27792 $ 33,914.50 ACTIVE

36000262ORIF OF DISTAL RADIAL FX OR EPIPHYSEAL SEPARATION

360 25607 $ 38,148.00 ACTIVE


Charge Amt Status

Charge Master List

36000269ORIF OF HUMERAL SUPRACONDYLAR/TRANSCONDYLAR FX

360 24545 $ 48,349.00 ACTIVE

36100020ORIF OF METACARPAL FX, SINGLE, EA BONE

361 26615 $ 28,106.00 ACTIVE

36000310ORIF OF METATARSAL FRACTURE, WHEN PERFORMED, EA

360 28485 $ 28,079.50 ACTIVE

42000032 ORTHO FIT/TRAIN EA 15 450 97760 $ 259.00 ACTIVE

25900218 OSCAL 600/400MG TAB 250 J8499 $ 8.00 ACTIVE

25901900OSELTAMIVIR (TAMIFLU) 30MG CAP

250 J8499 $ 21.68 ACTIVE

30100283 OSMOLALITY URINE 301 83935 $ 90.84 ACTIVE

32000152 OSSEOUS SURVEY 320 77075 $ 4,177.00 ACTIVE

32000153 OSSEOUS SURVEY INFANT 320 77076 $ 982.10 ACTIVE

32000154 OSSEOUS SURVEY LIMITED 320 77074 $ 3,065.50 ACTIVE

36000240OSTECTOMY OF STERNUM PARTIAL

360 21620 $ 7,873.80 ACTIVE

36000252

OSTECTOMY, PARTIAL, EXOSTECTOMY/CONDYLECTOMY, MT HEAD, EA METATARSAL HEAD

360 28288 $ 22,409.50 ACTIVE

27000314 OSTEOGENIC STIMULATOR 270 E0748 $ 36,225.00 ACTIVE

29000001OSTEOMED 2.3 CANNULATED DRILL

270 C1713 $ 2,400.00 ACTIVE

36000364OSTEOTOMY, TARSAL BONES, OTHER THAN CALCANEUS OR TALUS;

360 28304 $ 31,318.00 ACTIVE

36000355

OSTEOTOMY, WITH OR WITHOUT LENGTHENING, SHORTENING OR ANGULAR CORRECTION, METATARSAL; MULTIPLE (EG, SWANSON TYPE CAVUS FOOT PROCEDURE)

360 28309 $ 46,331.50 ACTIVE

36000362

OSTEOTOMY; CALCANEUS (EG, DWYER OR CHAMBERS TYPE PROCEDURE), WITH OR WITHOUT INTERNAL FIXATION

360 28300 $ 33,732.50 ACTIVE

36000357

OSTEOTOMY; MULTIPLE, WITH REALIGNMENT ON INTRAMEDULLARY ROD (EG, SOFIELD TYPE PROCEDURE)

360 27712 $ 57,455.50 ACTIVE

43400001 OT EVAL 15 MIN 434 97003 $ 302.68 ACTIVE

43400002 OT RE-EVAL 15 MIN 434 97004 $ 302.68 ACTIVE

30600079 OTHER METHOD IDENTIFICATION 306 87158 $ 92.88 ACTIVE

30000038OVA AND PARASITES DIRECT SMEAR CONCENTRATION AND IDENTIFICATION

306 87177 $ 118.68 ACTIVE

27000657 OXIMETER PULSE DISP 270 E0445 $ 144.00 ACTIVE

25900401OXYBUTYNIN (DITROPAN) 5MG TAB

250 J8499 $ 24.00 ACTIVE

27000776OXYGEN PROBE FOR USE WITH OXIMETER DEVICE

270 A4606 $ 46.15 ACTIVE

41000035OXYGEN THERAPY INITIAL SETUP

410 94799 $ 506.80 ACTIVE

41000036 OXYGEN THERAPY PER DAY 410 94799 $ 304.08 ACTIVE

30100287 OXYLATE 301 83945 $ 173.40 ACTIVE

25901901 OXYMETAZOLINE 0.05% NS 30ML 250 J3490 $ 5.25 ACTIVE


Charge Amt Status

Charge Master List

27000618 PACK ARTHROSCOPY 270 A4649 $ 1,044.00 ACTIVE

27000620 PACK BASIC SET-UP 270 A4649 $ 148.00 ACTIVE

27200714 PACK CATH LAB 272 A4301 $ 558.00 ACTIVE

27200686 PACK CYCTOSCOPY 272 A4649 $ 203.40 ACTIVE

27200628 PACK LAPAROTOMY T-SHEET 272 A4467 $ 186.00 ACTIVE

27200903PACK, HEAVY DUTY LOWER EXTREMITY

272 A4649 $ 917.05 ACTIVE

27200908 PACK, OBSTETRICAL 272 A4649 $ 237.00 ACTIVE

30000042 PACKED RBC 381 P9021 $ 460.00 ACTIVE

27000500 PACKING GAUZE IODOFORM 1 272 A6266 $ 464.00 ACTIVE

27000323 PACKING NUGZ 1"""" PL 270 A6407 $ 5.30 ACTIVE

27000327 PACKING NUGZ 2 270 A6402 $ 52.00 ACTIVE

27200793 PAD EYE PATCH STERILE 272 A6410 $ 62.00 ACTIVE

27000745 PAD, ALCOHOL PREP STR MED 270 A4245 $ 0.15 ACTIVE

27200891 PAD, FOAM DECUB 33X72X2" 272 A6213 $ 217.20 ACTIVE

27000329 PADDING CAST 2 N/S 270 A4580 $ 14.00 ACTIVE

27000330 PADDING CAST 4 STERILE 270 A4580 $ 24.00 ACTIVE

27000331 PADDING CAST 6 N/S 270 A4580 $ 28.00 ACTIVE

27200696 PAIN BLOCK TRAY 272 A4550 $ 169.50 ACTIVE

30100051 PANEL BASIC METABOLIC 301 80048 $ 112.80 ACTIVE

30100134 PANEL ELECTROLYTE 301 80051 $ 93.48 ACTIVE

30100192 PANEL HEPATIC FUNCTION 301 80076 $ 108.96 ACTIVE

30100230 PANEL LIPID 301 80061 $ 178.56 ACTIVE

30100349 PANEL RENAL FUNCTION 301 80069 $ 115.80 ACTIVE

42000033 PARAFFIN BATH 15 450 97018 $ 203.70 ACTIVE

30100338 PARATHYROID PTH INTACT 301 83970 $ 475.80 ACTIVE

45000092PARING/CUTTING BENIGN HYPERKERATOTIC LESION (EG, CORN/CALLUS); SINGLE LESION

450 11055 $ 828.00 ACTIVE

76100023PARING/CUTTING BENIGN LESION/2-4 LESIONS

761 11056 $ 580.50 ACTIVE

76100024PARINT/CUTTING BENIGN LESION/ > 4 LESIONS

761 11057 $ 751.64 ACTIVE

36000121PARTIAL EXCISION BONE PHALANX OF TOE

360 28124 $ 17,272.00 ACTIVE

30500037PARTIAL THROMBOPLASTIN TIME

305 85730 $ 80.04 ACTIVE

30500039PARTIAL THROMBOPLASTIN TIME (PLASMA/ WHOLE BLOOD)

305 85732 $ 86.16 ACTIVE

30200092PARTICLE AGGLUTINATION; SCREEN, EACH ANTIBODY

302 86403 $ 138.48 ACTIVE

30200165PARVOVIRUS B19 ANTIBODY IMMUNOGLOBIN-G

302 86747 $ 200.40 ACTIVE

27000676 PASTE SKIN BARRIER 270 A4649 $ 56.50 ACTIVE

27000436 PATIENT SOCKS 270 A9270 $ 15.00 ACTIVE

48100079

PCI ACUTE/SUBTOTAL OCCLUSION MYOCARDIAL INFARCTION, CORONARY ARTERY OR CORONARY ARTERY BYPASS GRAFT

481 92941 $ 40,568.52 ACTIVE

29400001PEAK EXPIRATORY FLOW RATE METER, HAND HELD

270 A4614 $ 267.60 ACTIVE

46000006 PEAK FLOW STUDY 460 94010 $ 215.20 ACTIVE

32000027 PELVIC VESSEL 320 75736 $ 16,461.99 ACTIVE

32000157 PELVIS 1 OR 2 VIEWS 320 72170 $ 1,317.50 ACTIVE


Charge Amt Status

Charge Master List

25000463PENICILLIN G POTASS 5,000,000UN VIAL

636 J2540 $ 90.00 ACTIVE

25000700PENICILLIN V POTASS 125MG 5ML ORAL SOL

250 J3490 $ 24.00 ACTIVE

25901712 PEPTO BISMOL 12 OZ 250 A9150 $ 36.00 ACTIVE

25900893 PEPTO-BISMOL 262MG CHEW 250 J8499 $ 8.00 ACTIVE

48000010PERC COR ATHERECTOMY W/WO PTCA

480 92995 $ 45,573.84 ACTIVE

48000011PERC COR ATHERECTOMY W/WO PTCA

480 92996 $ 45,573.84 ACTIVE

32000028 PERC PLACET OF IVC FILTER S&I 320 75940 $ 5,296.36 ACTIVE

48100078PERC. CORONARY INTV OF/THROUGH A BYPASS GRAFT

481 92937 $ 45,568.52 ACTIVE

36000118PERCUT IMPL OF NEUROSTIM ELECT

360 63650 $ 41,724.92 ACTIVE

48100108

PERCUTANEOUS CORONARY INTERVENTION - WITH DES - EACH ADDITIONAL BRANCH OF A MAJOR CORONARY ARTERY

481 C9601 $ 21,236.50 ACTIVE

36000314

PERCUTANEOUS SKELETAL FIXATION OF FRACTURE GREAT TOE, PHALANX OR PHALANGES, WITH MANIPULATION

360 28496 $ 13,993.00 ACTIVE

48100038

PERCUTANEOUS TRANSCATHETER PLACEMENT OF DRUG ELUTING STENT(S) W/CORONARY ANGIOPLASTY WHEN PERFORMED; SINGLE MAJOR COR

481 C9600 $ 40,568.52 ACTIVE

48100077

PERCUTANEOUS TRANSCATHETER PLACEMENT OF INTRACORONARY STENT(S), WITH CORONARY ANGIOPLASTY WHEN PERFORMED; EACH ADDITIONAL

481 92929 $ 40,568.52 ACTIVE

48000012PERCUTANEOUS TRANSLUMINAL CORONARY THROMBECTOMY MECHANICAL

480 92973 $ 7,298.14 ACTIVE

48100109

PERCUTANEOUS TRANSLUMINAL REVASCULARIZATION OF ACUTE TOTAL/SUBTOTAL OCCLUSION DURING ACUTE MYOCARDIAL INFA

481 C9606 $ 71,835.92 ACTIVE

48100037

PERCUTANOUS TRANSCATHETER PLCMNT OF INTRACORONARY STENT(S) W/ ANGIOPLASTY WHEN PERFORMED EA ADDITIONAL

481 92928 $ 57,276.00 ACTIVE

32000029 PERI ATHERECTOMY S&I 320 75992 $ 5,998.86 ACTIVE

48100035 PERICARDIAL WINDOW 481 33025 $ 3,319.82 ACTIVE

48100033 PERICARDIOCENTISIS 481 33010 $ 3,794.08 ACTIVE

30500007 PERIPHERAL BLOOD SMEAR 305 85060 $ 243.94 ACTIVE

32000158 PERITONEOGRAM 320 74190 $ 3,507.72 ACTIVE

25000468 PERMETHRIN CREAM 250 A6250 $ 316.00 ACTIVE


Charge Amt Status

Charge Master List

32000030 PERQ BILIARY DRAINAGE S&I 320 75982 $ 3,909.08 ACTIVE

25901569 PERSANTINE 25MG TABS 250 J8499 $ 16.00 ACTIVE

36000376PHALANGECTOMY, TOE, EACH TOE

360 28150 $ 13,962.50 ACTIVE

32000160 PHARYNGEAL SPEECH EVAL 320 70371 $ 1,544.42 ACTIVE

32000161 PHARYNX OR ESOPH CERV 320 74210 $ 1,097.60 ACTIVE

32000162 PHARYNXLARYNX W FLUORO 320 70370 $ 1,128.40 ACTIVE

25900900PHENAZOPYRIDINE (PYRIDIUM, AZO) 95MG TAB

250 J8499 $ 24.00 ACTIVE

25901902 PHENAZOPYRIDINE 100MG TAB 250 J8499 $ 5.25 ACTIVE

25900903 PHENERGAN 12.5MG R/S 250 J8498 $ 45.00 ACTIVE

25901572PHENERGAN 6.25MG + CODEINE 10MG PER 5ML

250 J3490 $ 24.00 ACTIVE

30100292 PHENOBARBITAL 301 80184 $ 183.60 ACTIVE

25900907 PHENOBARBITAL 100MG TAB 250 J8499 $ 8.00 ACTIVE

25200008PHENOL EZ OTIC ANESTH COTTON SWAB

250 J3490 $ 176.00 ACTIVE

63600176 PHENYLEPHRINE 10MG/ML 636 J2370 $ 9.18 ACTIVE

25900391PHENYTOIN (DILANTIN) 100MG 2ML (50MG/ML) SDVIAL

250 J3490 $ 124.25 ACTIVE

25901964PHENYTOIN (DILANTIN) 250MG 5ML

250 J3490 $ 124.25 ACTIVE

30100294 PHENYTOIN (FREE) 301 80186 $ 183.48 ACTIVE

25900912 PHISOHEX 3% LIQUID 148ML 250 A6250 $ 216.00 ACTIVE

94000013 PHLEBOTOMY (THERAPEUTIC) 940 99195 $ 386.40 ACTIVE

30100298 PHOSPHORUS SERUM 301 84100 $ 63.24 ACTIVE

30100299 PHOSPHORUS URINE 301 84105 $ 69.36 ACTIVE

42000034 PHYS PERFORM TEST 15M 450 97750 $ 284.36 ACTIVE

42400006PHYSICAL THERAPY EVAL: HIGH COMPLEXITY

424 97163 $ 4,140.50 ACTIVE

42400004PHYSICAL THERAPY EVAL: LOW COMPLEXITY

424 97161 $ 828.10 ACTIVE

42400005PHYSICAL THERAPY EVAL: MODERATE COMPLEXITY

424 97162 $ 2,070.25 ACTIVE

36000201 PICC INSERT W/OUT SQ PORT 360 36569 $ 23,513.00 ACTIVE

36000202 PICC INSERT W/SQ PORT 5YRS> 360 36571 $ 12,060.50 ACTIVE

27100002 PILLOW ABDUCTION 271 E0190 $ 1,988.00 ACTIVE

27000734 PIN ANCHORAGE FIXATION 270 C1713 $ 1,976.00 ACTIVE

30600080 PINWORM EXAM 306 87172 $ 57.00 ACTIVE

30100302 PKU BLOOD 301 84030 $ 73.32 ACTIVE

36000055 PLACE CATHETER IN AORTA 360 36200 $ 4,520.88 ACTIVE

36000057 PLACE CATHETER IN VEIN 360 36010 $ 4,520.88 ACTIVE

36000045PLACEMENT NEPHROSTOMY CATHETER

360 50432 $ 14,242.06 ACTIVE

48100107PLACEMENT OF CATHETER VENEOUS

481 36011 $ 10,796.86 ACTIVE

48100119PLACEMENT OF OCCLUSIVE DEVICE INTO EITHER A VENOUS OR ARTERIAL ACCESS SITE

481 G0269 $ 25,412.65 ACTIVE

63600011PLASBUMIN 25 (ALBUMIN, HUMAN) 25%USP 100ML

636 P9047 $ 882.00 ACTIVE

30500086PLASMINOGEN ACTIVATOR INHIBITOR TYPE 1 (PAI-1)

305 85415 $ 229.20 ACTIVE

30500031PLATELET AGGREGATION USING ADP

305 85576 $ 298.92 ACTIVE

30200012PLATELET ANTIBODY IDENTIFICATION

302 86022 $ 244.92 ACTIVE


Charge Amt Status

Charge Master List

30500033 PLATELET NEUTRALIZATION 305 85597 $ 239.64 ACTIVE

39000005PLATELET PHERESIS (EACH UNIT)

390 P9034 $ 4,651.28 ACTIVE

39000006PLATELET RICH PLASMA (EACH UNIT)

390 P9020 $ 3,220.00 ACTIVE

30500050 PLATELETS 305 85049 $ 59.64 ACTIVE

31100012 PLEURAL FLUID CYTOLOGY 311 88108 $ 257.60 ACTIVE

36000365

PLIT-THICKNESS AUTOGRAFT, TRUNK, ARMS, LEGS; FIRST 100 SQ CM OR LESS, OR 1% OF BODY AREA OF INFANTS AND CHILDREN (EXCEPT 15050)

360 15100 $ 36,994.00 ACTIVE

45600001PLUS 30 EACH ADDL CRITICAL MIN W/99291

450 99292 $ 2,747.50 ACTIVE

77100007PNEUMOCOCCAL CONJUGATE VACCINE 13 VALENT PCV13

771 90670 $ 401.00 ACTIVE

77100005PNEUMOCOCCAL VACCINE 23 VALENT PPSV23 ADMIN

771 90732 $ 462.00 ACTIVE

92000003 POLYSOM GT 4 PARAM GT 6HR 920 95810 $ 30,165.00 ACTIVE

92000004 POLYSOM W/CPAP 920 95811 $ 33,099.00 ACTIVE

30100303PORPHOBILINOGEN 24HR (URINE)

301 84110 $ 112.56 ACTIVE

30100305 PORPHYRINS (PLASMA) 301 82492 $ 247.94 ACTIVE

30100304 PORPHYRINS FRACTION (URINE) 301 84120 $ 196.20 ACTIVE

27200656 PORT APPLIER 272 A4223 $ 5,406.00 ACTIVE

26000001 PORTACATH BLOOD DRAW 260 36591 $ 400.62 ACTIVE

94000004PORTACATH FLUSH/DRSG CHANGE

940 96523 $ 1,267.00 ACTIVE

27100003 POSITIONER SHOULDER 271 A4566 $ 2,456.00 ACTIVE

27400002 POST OP BRACE 270 L1832 $ 1,458.74 ACTIVE

30100308POTASSIUM (CEREBROSPINAL FLUID)

301 84999 $ 128.80 ACTIVE

25000479POTASSIUM 10 MEQ IN 100ML NS (

258 J3480 $ 194.00 ACTIVE

30100307 POTASSIUM 24HR (URINE) 301 84133 $ 57.48 ACTIVE

25901903POTASSIUM 25MEQ EFFERVESCENT TABLET

250 J8499 $ 15.25 ACTIVE

25901472POTASSIUM CHL 10% 20MEQ 15ML OS

250 J3490 $ 24.00 ACTIVE

25901904POTASSIUM CHL 10% 40MEQ 30ML OS

250 J3490 $ 73.25 ACTIVE

25800058POTASSIUM CHLORIDE 20MEQ/100ML 100ML BAG

258 J3480 $ 586.00 ACTIVE

30600070POTASSIUM HYDROXIDE TISSUE EXAM

306 87220 $ 57.00 ACTIVE

25901853 PRASUGREL 10MG TAB 250 J8499 $ 120.20 ACTIVE

25900933 PRAVACHOL 20MG TAB 250 J8499 $ 76.50 ACTIVE

25901905PRAVASTATIN (PRAVACHOL) 40MG TAB

250 J8499 $ 5.25 ACTIVE

30100311 PREALBUMIN 301 84134 $ 194.52 ACTIVE

25900936PREDNISOLONE 1% 5ML OPHTHALMIC

250 J3490 $ 176.00 ACTIVE

25900938PREDNISOLONE SYRUP 15MG/5ML 5ML UNIT DOSE

250 J7510 $ 246.00 ACTIVE

25900941 PREDNISONE 5MG TAB 250 J8499 $ 24.00 ACTIVE

25900359PREDNISONE DELTASONE 20MG TAB

250 J7512 $ 24.00 ACTIVE


Charge Amt Status

Charge Master List

30700004 PREGNANCY TEST (URINE) 307 81025 $ 103.32 ACTIVE

30100312PREGNANCY TEST SERUM QUALITATIVE

301 84703 $ 100.32 ACTIVE

30100313 PREGNANEDIOL 301 84135 $ 255.24 ACTIVE

30100314 PREGNANETRIOL 301 84138 $ 252.60 ACTIVE

30100087 PREGNENOLONE 301 84140 $ 275.64 ACTIVE

25900948 PREPARATION H OINT/APPL. 250 A6250 $ 106.00 ACTIVE

30200167

PRETREATMENT OF RBCS FOR USE IN RBC ANTIBODY DETECTION INCUBATION WITH CHEMOKIN

302 86970 $ 560.00 ACTIVE

30200168

PRETREATMENT OF SERUM FOR USE IN RED BLOOD CELL ANTIBODY IDENTIFICATION BY RED C

302 86978 $ 1,120.00 ACTIVE

30200240 PRETX SERUM RBC AB INHIB 302 86977 $ 311.62 ACTIVE

25000488PRIMAXIN 500MG IN 100ML NS (PR

636 J0743 $ 630.00 ACTIVE

30100315 PRIMIDONE LEVEL 301 80188 $ 221.28 ACTIVE

42000035 PROC THER GP 15 450 97150 $ 282.64 ACTIVE

30100316 PROCAINAMIDE W METABOLITES 301 80192 $ 223.32 ACTIVE

30100108 PROCALCITONIN 301 84145 $ 31.26 ACTIVE

98100061PROF APPLICATION SURGICAL BOOT/SHOE, EACH

981 L3260 $ 500.00 ACTIVE

98100023

PROF ARTHROCENTESIS ASPIRATION INJ INTERMEDIATE JOINT/BURSA (TEMPOROMANDIBULAR/ACROMIOCLAVICULAR/WRIST/ELBOW/ANKLE) W/O US GUID

981 20605 $ 256.60 ACTIVE

98100038

PROF ARTHROCENTESIS ASPIRATION/INJECTION MAJOR JOINT/BURSA (SHOULDER HIP KNEE SUBACROMIAL BURSA) W/O US GUIDANCE

981 20610 $ 928.80 ACTIVE

98100039

PROF ARTHROCENTESIS ASPIRATION/INJECTION SMALL JOINT/BURSA (FINGERS/TOES) W/O US GUIDANCE

981 20600 $ 244.05 ACTIVE

98100075PROF AVULSION OF NAIL PLATE PARTIAL OR COMPLETE SIMPLE SINGLE

981 11730 $ 1,625.40 ACTIVE

98100035PROF CARDIOPULMONARY RESUSCITATION

981 92950 $ 1,556.65 ACTIVE

98500001

PROF CARDIOVASCULAR STRESS TEST USING TREADMILL/BICYCLE CONTINUOUS ECG MONITORING, INTER/REPORT ONLY

985 93018 $ 740.00 ACTIVE

98100100PROF CLOSED TREATMENT OF PATELLAR DISLOCATION WITHOUT ANESTHESIA

981 27560 $ 4,500.00 ACTIVE

98100074PROF CLOSED TREATMENT OF RADIAL SHAFT FX; W/O MANIPULATION

981 25500 $ 980.00 ACTIVE

98100059PROF CLOSED TX OF DISTAL ANKLE FX; W MANIPULATION

981 27788 $ 5,900.10 ACTIVE


Charge Amt Status

Charge Master List

98100060PROF CLOSED TX OF DISTAL ANKLE FX; W/O MANIPULATION

981 27786 $ 4,387.35 ACTIVE

98100063PROF CLOSED TX OF FINGER DISLOCATION, SINGLE, W/ MANIP W/ ANES

981 26775 $ 5,307.90 ACTIVE

98100076

PROF CLOSED TX OF FX, PHALANX/PHALANGES, OTHER THAN GREAT TOE; W/O MANIP, EA

981 28510 $ 6,426.00 ACTIVE

98100083PROF CLOSED TX OF RADIAL SHAFT FRACTURE; W/MANIPULATION

981 25505 $ 7,689.45 ACTIVE

96000012

PROF CLOSED TX OF TEMPOROMANDIBULAR DISLOCATION; INITIAL OR SUBSEQUENT

960 21480 $ 2,538.00 ACTIVE

98100065

PROF CLOSED TX PHALANGEAL SHAFT FX PROXIMAL/MIDDLE PHALANX, FINGER/THUMB; W/MANIPULATION W/OR W/O SKIN/SKELETAL TRACTION; EA

981 26725 $ 8,217.00 ACTIVE

98100115PROF CONTROL NASAL HEMORRHAGE ANTERIOR COMPLEX ANY METHOD

981 30903 $ 304.08 ACTIVE

98100104

PROF CONTROL NASAL HEMORRHAGE POSTERIOR W/NASAL PACKS AND/OR CAUTERY ANY METHOD INITIAL

981 30905 $ 175.00 ACTIVE

98100057PROF CRITICAL CARE E/M FIRST 30-74MINS

981 99291 $ 5,152.44 ACTIVE

98100071

PROF ECHO, TRANSTHORACIC, REAL-TIME W/IMAGE DOC INC M-MODE, WHEN PERFORMED, COMP W/SPEC DOPPLER/COLOR FLOW DOPPLETE, WITH SPE

981 93306 $ 3,666.50 ACTIVE

98100109PROF ER TEMP FOLEY CATHETER INSERTION

981 51702 $ 575.00 ACTIVE

98100093

PROF EXCISION OTHER BENIGN LESION FACE/EARS/EYELIDS/NOSE/LIPS/MUCOUS MEMBRANE DIAMETER 0.5 CM/<

981 11440 $ 248.00 ACTIVE

98100094PROF EXCSN NAIL/NAIL MATRIX PART/COMP PERM RMV

981 11750 $ 125.75 ACTIVE

98100004PROF FEE ER DEPT HI SEV LEVEL IV

981 99284 $ 11,000.00 ACTIVE

98100005PROF FEE ER DEPT HIGH SEV LEVEL V

981 99285 $ 12,000.00 ACTIVE

98100001PROF FEE ER DEPT LIMITED LEVEL I

981 99281 $ 8,000.00 ACTIVE

98100002PROF FEE ER DEPT MOD LEVEL II

981 99282 $ 9,000.00 ACTIVE

98100003PROF FEE ER DEPT MOD LEVEL III

981 99283 $ 10,000.00 ACTIVE

98100108PROF HEMORRHOIDECTOMY INTERNAL AND EXTERNAL SINGLE COLUMN/GROUP

981 46255 $ 1,050.00 ACTIVE


Charge Amt Status

Charge Master List

98100112PROF INCISION & REMOVAL OF FB SKIN SIMPLE SUB TISSUE

981 10120 $ 2,248.65 ACTIVE

76200015PROF INITIAL OBS CARE LOW SEVERITY/30MINS

982 99218 $ 2,481.75 ACTIVE

98100089PROF INITIAL OBS CARE LOW SEVERITY/30MINS

982 99218 $ 2,481.75 ACTIVE

98100091PROF INITIAL OBS HIGH SEVERITY/70MINS

982 99220 $ 4,577.00 ACTIVE

76200020PROF INITIAL OBS MODERATE SEVERITY/50MINS

982 99219 $ 3,347.00 ACTIVE

98100090PROF INITIAL OBS MODERATE SEVERITY/50MINS

982 99219 $ 3,347.00 ACTIVE

98100085

PROF INJ DIAG/THERAP NOT INC NEUROLYTIC SUBST. INCL NEEDLE/CATH PLACEMENT; LUMBAR/SACRAL W/IMAGING GUIDANCE

981 62323 $ 6,264.00 ACTIVE

98100084PROF INJ, ANESTH AGENT; OTH PERIPHERAL NERVE/BRANCH

981 64450 $ 1,231.20 ACTIVE

98100056PROF INJECTION SINGLE TENDON SHEATH,OR LIGAMENT(PLANTAR"FASCIA")

981 20550 $ 283.65 ACTIVE

98100040PROF INJECTION SINGLE/MULTIPLE TRIGGER POINT 1 OR 2 MUSCLE

981 20552 $ 283.65 ACTIVE

98100041PROF INJECTION SINGLE/MULTIPLE TRIGGER POINT 3> MORE MUSCLES

981 20553 $ 327.00 ACTIVE

98100106

PROF INSERTION TUNNELED CENTRALLY; CENTRAL VENOUS ACCESS DEVICE, W/SUBC PORT; AGE 5OR>

981 36561 $ 1,100.00 ACTIVE

98100105PROF INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE

981 31500 $ 375.00 ACTIVE

98100048PROF MOD SED <5YRS 1ST 15MINS

981 99151 $ 1,202.50 ACTIVE

98100049PROF MOD SED 5+YRS 1ST 15MIN

981 99152 $ 628.00 ACTIVE

98100050PROF MOD SED EACH ADDT'L 15MIN

981 99153 $ 556.50 ACTIVE

76200009PROF OBSERV & D/C SAME DAY DISCHARGE LOW COMPLEX

762 99234 $ 683.10 ACTIVE

76200012PROF OBSERV & D/C SAME DAY MODERATE COMPLEXITY

762 99235 $ 4,182.75 ACTIVE

76200013PROF OBSERVATION & D/C SAME DAY HIGH COMPLEXITY

762 99236 $ 1,111.10 ACTIVE

98100088PROF OBSERVATION CARE DISCHARGE

982 99217 $ 1,789.00 ACTIVE

98100073PROF PARING/CUTTING BENIGN HYPERKERATOTIC LESION (EG, CORN/CALLUS); SINGLE LESION

981 11055 $ 2,466.00 ACTIVE

98100066PROF PLUS 30 EACH ADDL CRITICAL MIN W/99291

981 99292 $ 3,009.00 ACTIVE

98100036PROF REMOVAL FB EXT EYE CORNEAL W/SLIT LAMP

981 65222 $ 1,020.30 ACTIVE

98100051PROF REMOVAL FB, INTRANASAL; OFF TYPE PROC

981 30300 $ 750.00 ACTIVE


Charge Amt Status

Charge Master List

98100053PROF REMOVAL FB; EXTERNAL AUDITORY CANAL; W/O GENERAL ANESTHESIA

981 69200 $ 2,430.00 ACTIVE

98100087PROF REMOVAL IMPACTED CARUMEN REQUIRING INSTRUMENTAL

981 69210 $ 107.60 ACTIVE

98100044PROF REMOVAL IMPACTED CERUMEN IRRIGATION/LAVAGE UNI

981 69209 $ 65.05 ACTIVE

98100110PROF REMOVAL OF FB EXT EYE CORNEAL W/O SLIT LAMP

981 65220 $ 217.05 ACTIVE

98100042PROF REMOVAL OF FB EXTERNAL EYE CONJUNCTIVAL SUPERFICIAL

981 65205 $ 285.85 ACTIVE

98100043PROF REMOVAL OF FB FOOT SUBCUTANEOUS

981 28190 $ 350.00 ACTIVE

98100111PROF REMOVAL OF FOREIGN BODY EAR W/ANESTHESIA

981 69205 $ 669.68 ACTIVE

96000014

PROF REMOVAL OF TUNNELED CENTRAL VENOUS CATHETER, WITHOUT SUBCUTANEOUS PORT OR PUMP

960 36589 $ 10,945.25 ACTIVE

98100113PROF REPAIR COMPLEX FACE/NECK/AXILLAE/GENITALIA/HANDS/FEET 2.6-7.5 CM

981 13132 $ 4,500.00 ACTIVE

98100114PROF REPAIR COMPLEX FACE/NECK/AXILLAE/GENITALIA/HANDS/FEET ADD ON

981 13133 $ 1,200.00 ACTIVE

98100098

PROF REPAIR COMPLEX FOREHEAD/CHEEKS/CHIN/MOUTH/NECK/AXILLAE/GENITALIA/HANDS/FEET 1.1-2.5 CM

981 13131 $ 4,500.00 ACTIVE

98100046PROF REPAIR COMPLEX SCALP/ARMS/LEGS; 2.6-7.5CM

981 13121 $ 4,202.10 ACTIVE

98100072PROF REPAIR INTERM WOUNDS SCALP/AXILLAE/TRUNK/EXTREMITIES 2.6-7.5CM

981 12032 $ 1,010.95 ACTIVE

98100095PROF REPAIR INTERMEDIATE OF SCALP/AXILLAE/TRUNK/EXTREMITIES (EXC HANDS&FEET) 2.5CM<

981 12031 $ 682.40 ACTIVE

98100097

PROF REPAIR INTERMEDIATE WOUNDS OF NECK/HANDS/FEET AND/OR EXTERNAL GENITALIA 7.6 CM TO 12.5 CM

981 12044 $ 980.00 ACTIVE

98100096

PROF REPAIR INTERMEDIATE WOUNDS OF NECK/HANDS/FEET/EXTERNAL GENITALIA 2.5<

981 12041 $ 980.00 ACTIVE

98100077

PROF REPAIR INTERMEDIETE OF SCALP/AXILLAE/TRUNK/OR EXTREM (EXCL HANDS&FEET) 7.6-12.5

981 12034 $ 739.80 ACTIVE

98100107

PROF REPAIR LACERATION 2.5CM<; FLOOR OF MOUTH/ANTERIOR TWO-THIRDS OF TONGUE

981 41250 $ 1,125.00 ACTIVE

98100116 PROF REPAIR OF NAIL BED 981 11760 $ 248.50 ACTIVE


Charge Amt Status

Charge Master List

45000157

PROF REPAIR, COMPLEX, SCALP, ARMS, AND/OR LEGS; EACH ADDITIONAL 5 CM OR LESS (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE

960 13122 $ 4,274.50 ACTIVE

98100029PROF SERV APPLICATION OF FINGER SPLINT STATIC

981 29130 $ 300.00 ACTIVE

98100027PROF SERV APPLICATION OF LONG ARM SPLINT (SHOULDER TO HAND)

981 29105 $ 300.00 ACTIVE

98100030PROF SERV APPLICATION OF LONG LEG SPLINT (THIGH TO ANKLE OR TOES)

981 29505 $ 312.00 ACTIVE

98100028PROF SERV APPLICATION OF SHORT ARM SPLINT (FOREARM TO HAND)STATIC

981 29125 $ 300.00 ACTIVE

98100031PROF SERV APPLICATION OF SHORT LEG SPLINT (CALF TO FOOT)

981 29515 $ 300.00 ACTIVE

98100082

PROF SERV CLOSED TREATMENT OF METACARPAL FRACTURE, SINGLE; WITH MANIPULATION, EACH BONE

981 26605 $ 7,166.00 ACTIVE

98100025

PROF SERV CLOSED TX OF FINGER JOINT DISLOCATION SINGLE W/MANP & W/O ANESTHESIA

981 26770 $ 1,888.00 ACTIVE

98100062PROF SERV CLOSED TX SHOULDER DISLOCATION W/MANP W ANES

981 23655 $ 980.00 ACTIVE

98100024PROF SERV CLOSED TX SHOULDER DISLOCATION W/MANP W/O ANESTHESIA

981 23650 $ 940.00 ACTIVE

98100032PROF SERV CONTROL OF NASAL HEMORRHAGE SIMPLE ANY METHOD

981 30901 $ 225.00 ACTIVE

98100022

PROF SERV DRESSING/DEBRIDEMENT PART-THICKNESS BURNS-LESS 5% BODY

981 16020 $ 840.00 ACTIVE

98100033

PROF SERV ELECTROCARDIOGRAM(ECG) 12LEADS INTERPRETATION & REPORT ONLY

985 93010 $ 300.00 ACTIVE

98100010PROF SERV EVACUATION OF SUBUNGUAL HEMATOMA

981 11740 $ 518.50 ACTIVE

98100007PROF SERV INCISION AND DRAINAGE (I & D) MULTIPLE

981 10061 $ 762.00 ACTIVE

98100008PROF SERV INCISION AND DRAINAGE OF PILONIDAL CYST COMPLICATED

981 10081 $ 1,068.00 ACTIVE

98100006PROF SERV INCISION AND DRAINAGE SIMPLE/ SINGLE

981 10060 $ 1,300.00 ACTIVE

98100021PROF SERV INITIAL TX 1ST DEGREE BURN - LOCAL

981 16000 $ 590.00 ACTIVE

98100009PROF SERV PUNCTURE ASPIRATION OF ABSCESS HEMATOMA, BULLA, OR CYST

981 10160 $ 1,000.00 ACTIVE

98100018PROF SERV REPAIR INTEMD NECK/HAND/FT/GENIT 2.6-7.5CM

981 12042 $ 980.00 ACTIVE


Charge Amt Status

Charge Master List

98100019PROF SERV REPAIR INTEMD WOUND 2.5 CM OR LESS

981 12051 $ 900.00 ACTIVE

98100020PROF SERV REPAIR INTEMD WOUND 2.6 TO 5.0CM

981 12052 $ 1,200.00 ACTIVE

98100045PROF SERV REPAIR INTERM FACE/EARS/EYELIDS/NOSE/LIPS/MUCOUS MEMBRANES 5.1-7.5CM

981 12053 $ 1,137.90 ACTIVE

98100086

PROF SERV REPAIR INTERM FACE/EARS/EYELIDS/NOSE/LIPS/MUCOUS MEMBRANES 7.6-12.5 CM

981 12054 $ 1,251.82 ACTIVE

98100037

PROF SERV REPAIR INTERMEDIETE OF SCALP/AXILLAE/TRUNK/OR EXTREM (EXCL HANDS&FEET) 12.6-20CM

981 12035 $ 980.00 ACTIVE

98100058PROF SERVICES PRVD 10PM-8AM @ 24-HOUR FAC

981 99053 $ 1,200.00 ACTIVE

98100026PROF SESRV CLOSED TX OF TOE FX OTHER THAN GREAT TOE W/MANP EACH

981 28515 $ 288.00 ACTIVE

98100014PROF SIMPLE REPAIR FACE AREA 2.5<

981 12011 $ 557.60 ACTIVE

98100015PROF SIMPLE REPAIR FACE AREA 2.6CM-5CM

981 12013 $ 583.00 ACTIVE

98100016PROF SIMPLE REPAIR FACE AREA 5.1-7.5CM

981 12014 $ 682.40 ACTIVE

98100017PROF SIMPLE REPAIR FACE AREA 7.6-12.5CM

981 12015 $ 826.90 ACTIVE

98100011PROF SIMPLE REPAIR SCALP/NECK/EXTREM 2.5CM OR <

981 12001 $ 454.80 ACTIVE

98100012PROF SIMPLE REPAIR SCALP/NECK/EXTREM 2.6-7.5CM

981 12002 $ 554.20 ACTIVE

98100080PROF SIMPLE REPAIR SCALP/NECK/EXTREM 20.1-30CM

981 12006 $ 2,970.00 ACTIVE

98100013PROF SIMPLE REPAIR SCALP/NECK/EXTREM 7.6-12.5CM

981 12004 $ 653.45 ACTIVE

98100034PROF SIMPLE REPAIR SCALP/NECK/GEN/TRUNK/EXT 12.6-20

981 12005 $ 285.05 ACTIVE

98100052PROF SPINAL PUNCTURE, LUMBAR, DIAGNOSTIC

981 62270 $ 1,037.50 ACTIVE

98100101PROF STRAPPING ELBOW OR WRIST

981 29260 $ 175.00 ACTIVE

98100064PROF STRAPPING; ANKLE AND/OR FOOT

981 29540 $ 400.00 ACTIVE

98100102 PROF STRAPPING; HAND/FINGER 981 29280 $ 150.00 ACTIVE

98100103 PROF STRAPPING; KNEE 981 29530 $ 240.00 ACTIVE

76200024PROF SUBS OBS CARE HIGH/35MINS

982 99226 $ 2,589.00 ACTIVE

98200002PROF SUBS OBS CARE HIGH/35MINS

982 99226 $ 2,589.00 ACTIVE

76200022PROF SUBS OBS CARE LOW/15MINS

982 99224 $ 983.75 ACTIVE

98100092PROF SUBS OBS CARE LOW/15MINS

982 99224 $ 983.75 ACTIVE


Charge Amt Status

Charge Master List

76200023 PROF SUBS OBS MOD/25MINS 982 99225 $ 1,796.00 ACTIVE

98200001 PROF SUBS OBS MOD/25MINS 982 99225 $ 1,796.00 ACTIVE

98100055

PROF SUTURE REMOVAL BY PHYSICIAN OTHER THAN PHYSICIAN WHO ORIGINALLY CLOSED WOUND

981 S0630 $ 300.00 ACTIVE

98100099PROF TREATMENT, CLOSED ELBOW DISLOCATION; W/O ANESTHESIA

981 24600 $ 687.00 ACTIVE

98100081PROF WOUND CLOSURE UTILIZING TISSUE ADHESIVE(S) ONLY

981 G0168 $ 1,587.60 ACTIVE

30100317 PROGESTERONE 301 84144 $ 278.16 ACTIVE

38100002

PROGRAMMED STIMULATION AND PACING AFTER INTRAVENOUS DRUG INFUSION (LIST SEPARATELY IN ADDT TO PRIMARY PROC)

481 93623 $ 3,876.00 ACTIVE

30000032 PROINSULIN 301 84206 $ 80.07 ACTIVE

30100319 PROLACTIN 301 84146 $ 258.36 ACTIVE

45000032PROLONGED TX/PROPH/DX IV INF > 8 HOURS REQ PUMP

450 C8957 $ 1,148.55 ACTIVE

25901587 PROMETHAZINE 25MG SUPP. 250 J8498 $ 69.00 ACTIVE

25901952PROMETHAZINE DM 6.25 5ML ORAL SOL 120ML BOTTLE

250 J3490 $ 24.00 ACTIVE

25900971 PROMETHAZINE HCL 25MG TAB 250 J8499 $ 24.00 ACTIVE

25900972 PROPARACAINE OPTH. 0.5% 250 J3490 $ 122.00 ACTIVE

25901906 PROPOFOL 200MG/20ML VIAL 250 J3490 $ 53.17 ACTIVE

25900973 PROSCAR 5MG TABLET 250 J8499 $ 69.00 ACTIVE

30100321PROSTATE CANCER SCREENING PROSTATE SPECIFIC ANTIGEN (TOTAL)

301 84153 $ 245.28 ACTIVE

30100335PROSTATE SPECIFIC ANTIGEN - MEDICARE

301 G0103 $ 245.28 ACTIVE

30000012PROSTATE SPECIFIC ANTIGEN FREE

300 84154 $ 245.28 ACTIVE

36000300

PROSTATECTOMY (INC CONTROL OF POSTOP BLEEDVASECTOMY/MEATOTOMY/URETHRAL CALIBRATION/DILATION) 1-2 STAGES

360 55821 $ 21,890.00 ACTIVE

30100295 PROSTATIC ACID PHOSPHATASE 301 84066 $ 128.76 ACTIVE

42000036 PROSTH TRAIN EA15MIN 450 97761 $ 239.40 ACTIVE

25000503 PROTAMINE 250 MG/25 ML VIAL 636 J2720 $ 216.00 ACTIVE

30100322 PROTEIN 24 HOUR (URINE) 301 84156 $ 48.84 ACTIVE

30100437 PROTEIN C ANTIGEN 305 85302 $ 160.20 ACTIVE

30100323PROTEIN ELECTROPHORESIS SERUM

301 84165 $ 143.16 ACTIVE

30500035 PROTEIN S (FREE) 305 85306 $ 204.36 ACTIVE

30000015 PROTEIN S (TOTAL) 305 85305 $ 154.80 ACTIVE

30100327 PROTEIN TOTAL 301 84155 $ 48.84 ACTIVE

30500036 PROTHROMBIN TIME 305 85610 $ 52.44 ACTIVE

25900974 PROTONIX 20MG TAB 250 J8499 $ 48.00 ACTIVE

25200004PROTONIX 40MG TAB (PANTOPRAZOLE SODIUM)

250 S0164 $ 76.00 ACTIVE


Charge Amt Status

Charge Master List

30200007 PROTOZOA ANTIBODIES 302 86753 $ 45.87 ACTIVE

25900980 PROZAC 10MG CAP 250 J8499 $ 98.00 ACTIVE

25900981 PROZAC 20MG CAPSULE 250 J8499 $ 60.00 ACTIVE

48100080PRQ CARD REVASC CHRONIC TOTAL OCCLUSION - FIRST MAIN VESSEL

481 92943 $ 50,568.52 ACTIVE

48100075 PRQ CARD STENT/ATH/ANGIO 481 92933 $ 55,370.62 ACTIVE

48100085PRQ TRLUML CORONARY ANGIOPLASTY ONE ART/BRANCH

481 92920 $ 29,627.23 ACTIVE

91400004PSYCHIATRIC DIAGNOSTIC EVALUATION WITH NO MEDICAL SERVICES

914 90791 $ 478.41 ACTIVE

91400002PSYCHOLOGICAL TESTING PER HOUR

914 96101 $ 804.32 ACTIVE

42000030PT NEG PRESS WOUND TX <50 CM

420 97605 $ 558.44 ACTIVE

42000037 PT SENS INTEGRATIN EA 15M 420 97533 $ 235.20 ACTIVE

48100053 PTA - ILLIAC ARTERY REVASC 481 37220 $ 29,627.23 ACTIVE

36000058 PTA AORTA 360 35472 $ 27,102.58 ACTIVE

36000060 PTA BRACH ARTERY 360 35475 $ 27,102.58 ACTIVE

36000062 PTA FEM/POP ARTERIES 360 35474 $ 27,102.58 ACTIVE

36000064 PTA ILIAC ARTERY 360 35473 $ 27,102.58 ACTIVE

36000066 PTA RENAL & VISCERAL 360 35471 $ 27,102.58 ACTIVE

48100073

PTCA 3.00MMX15MM DRUG ELUTING INTRACORONARY STENT(S), WITH CORONARY ANGIOPLASTY WHEN PERFORMED; SINGLE MAJOR CORONARY ARTERY OR BRANCH

481 C9600 $ 14,000.00 ACTIVE

27200919PTCA BALLOON CATHETER 3.00MMX15MM - MOZEC

272 C1726 $ 4,500.00 ACTIVE

48000013 PTCA EACH ADDL VESSEL 480 92944 $ 37,110.42 ACTIVE

48000014 PTCA SINGLE VESSEL 480 92982 $ 37,110.42 ACTIVE

48000015 PTCA W/STENT EA ADDL VESSEL 480 92938 $ 55,370.62 ACTIVE

48000016 PTCA W/STENT PLACEMENT 480 92980 $ 55,370.62 ACTIVE

46000002PULMONARY FUNTION TEST FVC SPIROMETRY

460 94010 $ 260.10 ACTIVE

41000018 PULMONARY REHABILITATION 410 G0424 $ 315.99 ACTIVE

46000008 PULSE OXIMETRY MULTIPLE 460 94761 $ 244.72 ACTIVE

46000009 PULSE OXIMETRY SINGLE 460 94760 $ 170.66 ACTIVE

46000007 PULSE OX-OVERNIGHT CONT 460 94762 $ 657.02 ACTIVE

27100008 PUMP INFUSION (IV) 271 A4224 $ 196.00 ACTIVE

36000124PUNCTURE ASPIRATION CYST BREAST EACH ADDITIONAL

360 19001 $ 1,255.80 ACTIVE

45000109PUNCTURE ASPIRATION OF ABSCESS, HEMATOMA, BULLA, OR CYST

450 10160 $ 4,914.00 ACTIVE

45000059

PYELOPLASTY (FOLEY Y-PYELOPLASTY) PLASTIC OPERATION ON RENAL PELVIS SIMPLE

360 50400 $ 60,297.00 ACTIVE

30100342 PYRUVATE 301 84210 $ 173.76 ACTIVE

27000006QUICK CROSS CATHETER LEVEL I

270 C1751 $ 1,755.60 ACTIVE

27200913QUIKCLOT, INTERVENTIONAL, WITHOUT SLIT GAUZE

272 A6222 $ 1,266.30 ACTIVE


Charge Amt Status

Charge Master List

30100344 QUINIDINE (RANDOM) 301 80194 $ 194.64 ACTIVE

63600187RABIES IMMUNE GLOBULIN (HUMAN) 150IU 1ML VIAL

636 90675 $ 1,462.00 ACTIVE

63600148 RABIES VACCINE 636 90675 $ 1,462.00 ACTIVE

25900996 RACEPINEPHRINE 2.25% SOL 250 J7699 $ 48.00 ACTIVE

32000232RAD EXAM, ENTIRE SPINE THO/LUM/CERV/SAC INC SKULL IF PERF 1VIEW

320 72081 $ 981.00 ACTIVE

32000231RAD EXAM, ENTIRE SPINE THO/LUM/CERV/SAC INC SKULL IF PERF 2-3VIEWS

320 72082 $ 1,584.00 ACTIVE

33000001RAD EXAM, ENTIRE SPINE THO/LUM/CERV/SAC INC SKULL IF PERF 4-5VIEWS

320 72083 $ 1,908.00 ACTIVE

33000002RAD EXAM, ENTIRE SPINE THO/LUM/CERV/SAC INC SKULL IF PERF MIN 6VIEWS

320 72084 $ 2,223.00 ACTIVE

32000226RADIOLOGIC EXAMINATION FEMUR 1 VIEW

320 73551 $ 1,406.50 ACTIVE

32000227RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS

320 73552 $ 1,641.00 ACTIVE

32200004RADIOLOGIC EXAMINATION HIP ARTHOGRAPHY

322 73525 $ 4,877.00 ACTIVE

32000233RADIOLOGIC EXAMINATION, ABDOMEN; 1 VIEW

320 74018 $ 1,130.00 ACTIVE

33000003RADIOLOGIC EXAMINATION, ABDOMEN; 2 VIEWS

320 74019 $ 1,677.50 ACTIVE

32000235RADIOLOGIC EXAMINATION, ABDOMEN; 3V OR MORE

320 74021 $ 1,781.00 ACTIVE

32000119

RADIOLOGIC EXAMINATION, HIP, UNILATERAL, WITH PELVIS WHEN PERFORMED; MINIMUM OF 4 VIEWS

320 73503 $ 2,574.50 ACTIVE

32000230RADIOLOGICAL EXAM PELVIS COMPLETE MIN 3VIEWS

320 72190 $ 1,930.00 ACTIVE

25900997 RAMIPRIL 5MG CAP 250 J8499 $ 36.00 ACTIVE

25901907RANITIDINE (ZANTAC) 300MG TAB

250 J8499 $ 5.40 ACTIVE

30000051 RAPID FLU SWAB TEST A&B 306 87502 $ 350.00 ACTIVE

30600067RAPID INFLUENZA SWAB ASSAY W/OPTIC

306 87804 $ 198.60 ACTIVE

30100346 RECEPTOR ASSAY ESTROGEN 301 84233 $ 447.58 ACTIVE

30500040 RED BLOOD CELL 305 85041 $ 40.20 ACTIVE

30200002RED BLOOD CELL ANTIBODY ELUTION (EACH)

302 86860 $ 228.62 ACTIVE

39200001RED BLOOD CELL PROCESSING & STORAGE

391 P9021 $ 10,437.00 ACTIVE

38100001 RED BLOOD CELLS, EACH UNIT 381 P9021 $ 10,437.00 ACTIVE

36000021

REDUCTION OF TORSION OF TESTIS SURGICAL W/OR W/O FIXATION OF CONTRALATERAL TESTIS

360 54600 $ 23,842.50 ACTIVE

42400003 RE-EVAL 15 MIN 450 97002 $ 395.92 ACTIVE

37000005 REG/SPINAL ANES 60 MIN 370 1936 $ 4,832.00 ACTIVE

37000006 REG/SPINAL ANES ADD 30 MN 370 1936 $ 2,416.00 ACTIVE

25000513 RELISTOR 12MG/0.6ML VIAL 636 J2212 $ 540.00 ACTIVE

48100116 REM/REPLACE BI V PACEMAKER 481 33229 $ 56,564.26 ACTIVE

48100117REM/REPLACE ICD GENERATOR ONLY

481 33230 $ 71,118.96 ACTIVE


Charge Amt Status

Charge Master List

48100118REM/REPLACE ICD/PPM (3+ LEADS)

481 33231 $ 99,590.33 ACTIVE

25901005REMERON (NOT SOLTAB) 15MG TAB

250 J8499 $ 76.00 ACTIVE

25901006 REMERON 30MG TAB 250 J8499 $ 84.00 ACTIVE

32000163 REMOVAL FB ESOPHI 320 74235 $ 993.30 ACTIVE

45000098REMOVAL FB FROM EXTERNAL AUDITORY CANAL; W/O GENERAL ANESTHESIA

450 69200 $ 4,225.00 ACTIVE

45000097REMOVAL FB, INTRANASAL; OFFICE TYPE PROCEDURE

450 30300 $ 5,400.00 ACTIVE

45000122REMOVAL IMPACTED CERUMEN REQUIRING INSTRUMENTATION, UNILATERAL

450 69210 $ 1,692.00 ACTIVE

45000123REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE, UNILATERAL

450 69209 $ 720.00 ACTIVE

36000068 REMOVAL LOOP RECORDER 481 33284 $ 9,787.50 ACTIVE

36000281 REMOVAL OF ANKLE IMPLANT 361 27704 $ 29,626.00 ACTIVE

76000001REMOVAL OF FB EXT EYE CORNEAL W/O SLIT LAMP

450 65220 $ 790.83 ACTIVE

45000099REMOVAL OF FB EXTERNAL EYE CONJUNCTIVAL SUPERFICIAL

450 65205 $ 2,268.00 ACTIVE

45000100REMOVAL OF FB FOOT SUBCUTANEOUS

450 28190 $ 6,948.00 ACTIVE

45000121REMOVAL OF FB, EXTERNAL EYE; CORNEAL, WITH SLIT LAMP

450 65222 $ 2,682.00 ACTIVE

96000013REMOVAL OF FB, SHOULDER; SUBCUTANEOUS

960 23330 $ 4,084.00 ACTIVE

36100008REMOVAL OF FOREIGN BODY EAR W/ANESTHESIA

361 69205 $ 5,289.50 ACTIVE

45000145REMOVAL OF FOREIGN BODY EAR W/ANESTHESIA

450 69205 $ 3,709.86 ACTIVE

36000345

REMOVAL OF IMPLANT; DEEP (EG, BURIED WIRE/PIN/SCREW/METAL BAND/NAIL/ROD/PLATE)

360 20680 $ 20,959.50 ACTIVE

36000336

REMOVAL OF IMPLANT; SUPERFICIAL (BURIED WIRE/PIN/ROD) (SEPARATE PROCEDURE)

360 20670 $ 7,239.00 ACTIVE

36000065REMOVAL OF INFLATABLE PENILE PROSTHESIS W/O REPLACEMENT OF PROSTHESIS

360 54406 $ 11,391.15 ACTIVE

36000069REMOVAL OF INTRA-AORTIC BALLOON ASSIST INCLUDING REPAIR OF FEMORAL ARTERY

360 33971 $ 2,688.00 ACTIVE

36000120REMOVAL OF NEPHROSTOMY TUBE WITH FLUOROSCOPY

360 50389 $ 4,875.36 ACTIVE

36100023 REMOVAL OF PEG TUBE 361 49999 $ 1,200.00 ACTIVE

36000070REMOVAL OF PERMANENT PACEMAKER

360 33233 $ 35,563.45 ACTIVE

45000124

REMOVAL OF SUTURES; BY PHYSICIAN OTHER THAN THE PHYSICIAN WHO ORIGINALLY CLOSED WOUND

450 S0630 $ 300.00 ACTIVE


Charge Amt Status

Charge Master List

36100003REMOVAL OF TUNNELED CENTRAL VENOUS DEVICE WITH SUBCUTANEOUS PORT OR PUMP

361 36590 $ 3,364.43 ACTIVE

36000378REMOVAL, SUBCUTANEOUS CARDIAC RHYTHM MONITOR

360 33286 $ 9,787.50 ACTIVE

36000290REMOVAL, UNDER ANESTHESIA, OF EXTERNAL FIXATION SYSTEM

360 20694 $ 17,406.00 ACTIVE

48100049REMVL PERM PM PLS GEN W/REPL PLSE GEN 2 LEAD SYS

481 33228 $ 82,135.95 ACTIVE

48100110REMVL PERM PM PLS GEN W/REPL PLSE GEN SINGLE LEAD

481 33227 $ 68,450.74 ACTIVE

32000034 RENAL AND VISC S AND I 320 75966 $ 4,446.82 ACTIVE

48100017RENAL ANGIO WITH LEFT HEART CATH (NON-SELECTIVE)

481 G0275 $ 47,512.51 ACTIVE

36000112 RENAL BIOPSY NEEDLE 360 50200 $ 6,106.58 ACTIVE

36000113 RENAL CYST ASPIRATION 360 50390 $ 6,106.58 ACTIVE

30100350 RENIN 301 84244 $ 183.54 ACTIVE

45000073REPAIR COMPLEX FACE/NECK/AXILLAE/GENITALIA/HANDS AND/OR FEET 1.1-2.5CM

450 13131 $ 13,900.75 ACTIVE

45000150REPAIR COMPLEX FACE/NECK/AXILLAE/GENITALIA/HANDS AND/OR FEET ADD ON

450 13133 $ 4,500.00 ACTIVE

45000101REPAIR COMPLEX SCALP/ARMS/LEGS; 2.6-7.5CM

450 13121 $ 13,878.00 ACTIVE

36000143REPAIR INITIAL INCISIONAL OR VENTRAL HERNIA REDUCIBLE

360 49560 $ 12,236.57 ACTIVE

36100010REPAIR INITIAL INGUINAL HERNIA AGE 5YRS OR > REDUCIBLE

360 49505 $ 27,177.00 ACTIVE

36000359

REPAIR INITIAL INGUINAL HERNIA, AGE 5 YEARS OR OLDER; INCARCERATED OR STRANGULATED

360 49507 $ 30,491.50 ACTIVE

45000139

REPAIR INTEMD FACE/EARS/EYELIDS/NOSE/LIPS/MUCOUS MEMBRANES 7.6-12.5 CM

450 12054 $ 11,850.00 ACTIVE

35000012REPAIR INTERM FACE/EARS/EYELIDS/NOSE/LIPS/MUCOUS MEMBRANES 5.1-7.5CM

450 12053 $ 11,322.00 ACTIVE

45000070REPAIR INTERMEDIATE OF SCALP/AXILLAE/TRUNK/EXTREMITIES (EXC HANDS&FEET) 2.5CM<

450 12031 $ 792.45 ACTIVE

45000071

REPAIR INTERMEDIATE OF SCALP/AXILLAE/TRUNK/EXTREMITIES (EXCL HANDS&FEET) 2.6-7.5CM

450 12032 $ 1,010.95 ACTIVE

45000034

REPAIR INTERMEDIATE WOUNDS OF NECK/HANDS/FEET AND/OR EXTERNAL GENITALIA 7.6 CM TO 12.5 CM

450 12044 $ 8,400.00 ACTIVE


Charge Amt Status

Charge Master List

45000063

REPAIR INTERMEDIATE WOUNDS OF NECK/HANDS/FEET/EXTERNAL GENITALIA 2.5<

450 12041 $ 7,800.50 ACTIVE

45000112

REPAIR INTERMEDIATE, WOUNDS OF FACE/EAR/EYELID/NOSE/LIPS /MUCOUS MEMBRANES; 2.6-5.0 CM

450 12052 $ 10,584.00 ACTIVE

45000111

REPAIR INTERMEDIATE, WOUNDS OF FACE/EARS/EYELIDS/NOSE/LIPS/MUCOUS MEMBRANES; 2.5 CM <

450 12051 $ 8,892.00 ACTIVE

45000085

REPAIR INTERMEDIETE OF SCALP/AXILLAE/TRUNK/OR EXTREM (EXCL HANDS&FEET) 12.6-20CM

450 12035 $ 12,456.00 ACTIVE

45000072

REPAIR INTERMEDIETE OF SCALP/AXILLAE/TRUNK/OR EXTREM (EXCL HANDS&FEET) 7.6-12.5

450 12034 $ 1,072.30 ACTIVE

45000083REPAIR LACERATION 2.5CM<; FLOOR OF MOUTH/ANTERIOR TWO-THIRDS OF TONGUE

450 41250 $ 3,823.50 ACTIVE

36000324

REPAIR OF COLLATERAL LIGAMENT, METACARPOPHALANGEAL/INTERPHALANGEAL JOINT

360 26540 $ 33,515.50 ACTIVE

45000155 REPAIR OF NAIL BED 450 11760 $ 280.94 ACTIVE

36000089REPAIR OF TUNICA VAGINALIS HYDROCELE (BOTTLE TYPE)

360 55060 $ 19,938.50 ACTIVE

36000233REPAIR RECURRENT INCISIONAL OR VENTRAL HERNIA REDUCIBLE

360 49565 $ 40,122.50 ACTIVE

36000317

REPAIR RECURRENT INGUINAL HERNIA, ANY AGE; INCARCERATED OR STRANGULATED

360 49521 $ 37,277.50 ACTIVE

36000129REPAIR UMBILICAL HERNIA >5 YRS REDUCIBLE

360 49585 $ 11,236.57 ACTIVE

45000149

REPAIR, COMPLEX, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS AND/OR FEET; 2.6 CM TO 7.5 CM

450 13132 $ 13,297.67 ACTIVE

45000156

REPAIR, COMPLEX, SCALP, ARMS, AND/OR LEGS; EACH ADDITIONAL 5 CM OR LESS (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)

450 13122 $ 4,274.50 ACTIVE

45000110

REPAIR, INTERMEDIATE, WOUNDS OF NECK, HANDS, FEET AND/OR EXTERNAL GENITALIA; 2.6 CM TO 7.5 CM

450 12042 $ 8,150.00 ACTIVE

36000319REPAIR, PRIMARY, DISRUPTED LIGAMENT, ANKLE; BOTH COLLATERAL LIGAMENTS

360 27696 $ 28,943.50 ACTIVE

36000285REPAIR, PRIMARY, DISRUPTED LIGAMENT, ANKLE; COLLATERAL

360 27695 $ 83,870.80 ACTIVE


Charge Amt Status

Charge Master List

36000330REPAIR, PRIMARY, OPEN/PERCU; RUPTURED ACHILLES TENDON

360 27650 $ 34,055.50 ACTIVE

36000346REPAIR, SECONDARY, ACHILLES TENDON, W/ OR W/O GRAFT

360 27654 $ 35,211.00 ACTIVE

36000322

REPAIR, SECONDARY, DISRUPTED LIGAMENT, ANKLE, COLLATERAL (EG, WATSON-JONES PROCEDURE)

360 27698 $ 33,209.50 ACTIVE

36000243

REPAIR, TENDON/MUSCLE, UPPER ARM/ELBOW, EACH TENDON/MUSCLE, PRIMARY/SECONDARY

360 24341 $ 38,744.00 ACTIVE

30000046

REPEAT COLLECTION OF BLOOD SPECIMEN USING ESTABLISHED CENTRAL/PERIPHERAL CATHETER VENOUS

459 36592 $ 150.00 ACTIVE

76100029

REPLACEMENT, CATHETER ONLY, OF CENTRAL VENOUS ACCESS DEVICE, W/SUBCUTANEOUS PORT/PUMP, CENTRAL/PERIPHERAL INSERTION SITE

761 36578 $ 2,113.20 ACTIVE

36000073REPOS/REPLC PPM OR AICD LEAD

481 33215 $ 19,062.24 ACTIVE

25901014 REQUIP 0.25MG TABS 250 J8499 $ 40.00 ACTIVE

25901016 REQUIP 2MG TABLET 250 J8499 $ 40.00 ACTIVE

41000024RESPIRATORY ASSESSMENT BY RT

410 94664 $ 899.20 ACTIVE

41000025RESPIRATORY EDUCATION BY RT

410 98960 $ 506.80 ACTIVE

46000012RESPIRATORY FLOW VOLUME LOOP

460 94375 $ 400.90 ACTIVE

30600081RESPIRATORY SYNCYTIAL VIRUS ANTIGEN ENZYME IMMUNOASSAY

306 87420 $ 166.92 ACTIVE

34100095RESTING STRESS WITHOUT TRANSPORTATION

341 78451 $ 11,725.26 ACTIVE

25901018 RESTORIL 15MG CAPS 250 J8499 $ 24.00 ACTIVE

30500080 RETIC0 CT FLO CYTOMETRY 305 85045 $ 53.28 ACTIVE

30100526RETICULOCYTE CELLULAR HEMOGLOBIN

305 85046 $ 74.28 ACTIVE

30500042 RETICULOCYTE COUNT MANUAL 305 85044 $ 57.48 ACTIVE

27200694 RETRIEVAL OF STONE BASKET 272 A4649 $ 6,048.00 ACTIVE

27200892 RETRIEVER, ROTH POLYP 272 A4649 $ 5,500.00 ACTIVE

36000074REVIS &/OR REINSERT TRANSHEPATIC TUBE

360 47530 $ 7,358.56 ACTIVE

36000075REVJ SKN POCKET 1/2 CHMBR PACG

360 33223 $ 13,527.42 ACTIVE

36000076REVJ/RELOCATION SKN POCKET PM

360 33222 $ 13,527.42 ACTIVE

30200179RHEUMATOID FACTOR QUALITATIVE

302 86430 $ 75.60 ACTIVE

30200181RHEUMATOID FACTOR QUANTITATIVE

302 86431 $ 75.60 ACTIVE

73000002 RHYTHM EKG 1-3 LEAD TRACING 730 93041 $ 260.82 ACTIVE


Charge Amt Status

Charge Master List

73000005RHYTHM EKG 1-3 LEAD TRACING WITH INTERPERTATION

730 93040 $ 285.95 ACTIVE

32000165 RIBS BILAT 3 VIEWS 320 71110 $ 1,781.50 ACTIVE

32000164 RIBS BILAT W/PA CHEST 320 71111 $ 2,261.50 ACTIVE

32000166RIBS UNI & PA CHEST MIN 3VIEWS

320 71101 $ 1,730.00 ACTIVE

32000167 RIBS UNILAT 2 VIEWS 320 71100 $ 1,455.50 ACTIVE

30200182 RICKETTSIA ANTIBODIES 302 86757 $ 258.12 ACTIVE

25901022 RIFADIN 150MG CAP 250 J8499 $ 38.00 ACTIVE

25901023 RIFADIN 300MG CAP 250 J8499 $ 48.00 ACTIVE

48100065 RIGHT HEART CATH 481 93451 $ 30,430.48 ACTIVE

48100010 RIGHT HEART CATHETERIZATION 481 93501 $ 24,040.52 ACTIVE

27900008 RIGIFLEX II ABD 272 C1726 $ 425.00 ACTIVE

25901027 RISPERDOL 1MG TAB 250 J8499 $ 129.00 ACTIVE

25901961 RIZATRIPTAN ODT 10MG 250 J8499 $ 12.00 ACTIVE

36000077RMVL 1/2 CHMBR PACG CVDFB ELTR

360 33244 $ 16,168.46 ACTIVE

25000524 ROBINUL 0.4MG 2ML SDVIAL 636 J7643 $ 180.00 ACTIVE

25901607 ROBITUSSIN DAC 5ML 250 J8499 $ 16.00 ACTIVE

25000527ROCEPHIN (CEFTRIAXONE) 250MG VIAL

636 J0696 $ 177.18 ACTIVE

25901908ROCURONIUM (10MG/ML) 50MG/5ML VIAL

250 J3490 $ 13.50 ACTIVE

30600082ROTAVIRUS ANTIGEN ENZYME IMMUNOASSAY

306 87425 $ 159.84 ACTIVE

30000011 ROUTINE VENIPUNCTURE 300 36415 $ 36.00 ACTIVE

36000078RPR 1 ELTRDS 1 CHMBR PRM PM/1

360 33218 $ 53,130.00 ACTIVE

36000079RPR 2 ELTRDS 2 CHMBR PRM PM/2

360 33220 $ 90,160.00 ACTIVE

36000080RPSG PREV IMPLTED CAR VEN SYS

481 33226 $ 53,769.48 ACTIVE

30600114 RSV ASSAY W/OPTIC 306 87807 $ 159.84 ACTIVE

30600137 RSV CULTURE 306 87081 $ 88.32 ACTIVE

48100011 RT & LT HEART CATH 481 93526 $ 24,040.52 ACTIVE

32000036 RT PULMONARY ANGIO 320 75746 $ 6,468.98 ACTIVE

48100052 RT. & LF. HEART CATH 481 93453 $ 54,382.50 ACTIVE

30200186RUBELLA ANTIBODY IMMUNOGLOBIN-G

302 86762 $ 191.88 ACTIVE

30200187 RUBEOLA ANTIBODY 302 86765 $ 171.72 ACTIVE

30500043RUSSELL VIPER VENOM DILUTED TEST

305 85613 $ 127.68 ACTIVE

32200005 SACROILIAC JNT ARTHROGRAM 322 73542 $ 2,618.56 ACTIVE

32000170 SACROILIAC JNTS <3 VIEWS 320 72200 $ 1,352.00 ACTIVE

32000171 SACROILIAC JNTS >3 VIEWS 320 72202 $ 1,574.00 ACTIVE

32000172 SACRUM & COCCYX 2+ VIEWS 320 72220 $ 1,335.00 ACTIVE

30100351 SALICYLATE 301 80196 $ 150.42 ACTIVE

25901045 SANTYL OINTMENT 30GM 250 A6250 $ 684.00 ACTIVE

32000173 SCAPULA COMPLETE 320 73010 $ 1,436.50 ACTIVE

40300002 SCREENING MAMMOGRAM 403 77057 $ 1,152.76 ACTIVE

30600099SCREENING TEST FOR BLOOD FECAL

306 G0328 $ 56.00 ACTIVE

36000266 SCROTAL EXPLORATION 360 55110 $ 20,318.50 ACTIVE


Charge Amt Status

Charge Master List

36000377

SECONDARY CLOSURE OF SURGICAL WOUND OR DEHISCENCE, EXTENSIVE OR COMPLICATED

360 13160 $ 39,613.00 ACTIVE

30500018 SEDIMENT RATE 305 85651 $ 51.24 ACTIVE

36000081 SELECT CATH 1ST ORDER 360 36215 $ 53,874.98 ACTIVE

36000082SELECT CATH 1ST ORDER ABD ADD FAMILY

360 36245 $ 78,551.82 ACTIVE

36000084 SELECT CATH 2ND ORDER 360 36216 $ 63,246.86 ACTIVE

36000085 SELECT CATH 2ND ORDER ABD 360 36246 $ 8,075.76 ACTIVE

36000087 SELECT CATH 3RD ORDER 360 36217 $ 8,075.76 ACTIVE

36000088 SELECT CATH 3RD ORDER ABD 360 36247 $ 8,075.76 ACTIVE

36000090 SELECT CATH ADD VESSEL 360 36218 $ 8,075.76 ACTIVE

36000091 SELECT CATH ADD VESSEL ABD 360 36248 $ 8,075.76 ACTIVE

32000037 SELECTED BI-LAT RENALS 320 75724 $ 14,808.78 ACTIVE

32000038 SELECTED UNI-LAT RENALS 320 75722 $ 14,808.78 ACTIVE

48100090SELECTIVE - UNILATERAL RENAL ANGIO

481 36251 $ 15,418.84 ACTIVE

48100089SELECTIVE BILATERAL RENAL ANGIO

481 36252 $ 19,621.53 ACTIVE

32000110SELECTIVE CATH PLACEMENT, EXT CAROTID, UNI W/ANGIOGRAPHY

320 36227 $ 5,809.50 ACTIVE

48100091SELECTIVE COMMON ILLIAC ANGIO

481 75736 $ 16,461.99 ACTIVE

32000039SELECTIVE PELVIC VESSEL ADD S&I

320 75774 $ 6,468.98 ACTIVE

32000174 SELLA TURCICA 320 70240 $ 566.72 ACTIVE

30900009 SEMEN ANALYSIS MOT&CT 309 89310 $ 31.89 ACTIVE

25901048 SENOKOT S TABLET 250 J8499 $ 24.00 ACTIVE

30600084 SENSITIVITY 1-12 DISKS 306 87184 $ 91.92 ACTIVE

25000535 SENSORCAINE 0.25PC 10ML 250 J3490 $ 210.00 ACTIVE

25000539 SENSORCAINE 0.5PC VL 10ML 250 J3490 $ 230.00 ACTIVE

25000541 SENSORCAINE EPI .25% 50ML 250 J3490 $ 260.00 ACTIVE

25000537SENSORCAINE MPF 0.5% 30ML VIAL

250 J3490 $ 96.00 ACTIVE

25000543SENSORCAINE-MPF 0.75% 10ML VIAL

250 J3490 $ 486.00 ACTIVE

30100352SEPARATION AND IDENTIFICATION

301 83909 $ 189.98 ACTIVE

25901055 SEROQUEL 25MG TAB 250 J8499 $ 36.00 ACTIVE

30100353 SEROTONIN 301 84260 $ 413.16 ACTIVE

27000336SET ADD-ON BURETROL (ALARIS (10309)

270 S1015 $ 92.00 ACTIVE

27000343 SET INF BUTTERFLY 23G X 3/4 12 272 A4212 $ 17.85 ACTIVE

27200760 SET IV BLOOD TUBING Y 272 S1015 $ 580.00 ACTIVE

27200762 SET IV CONTINUE FLOW 272 S1015 $ 140.00 ACTIVE

27200764 SET IV PRIMARY 2 VALVE 272 S1015 $ 652.00 ACTIVE

27200766 SET IV PRIMARY 3 VALVE 272 S1015 $ 550.00 ACTIVE

27200763 SET IV SECONDARY 272 S1015 $ 96.00 ACTIVE

27200768 SET IV TUBING EXTENSION 272 S1015 $ 208.00 ACTIVE

27200761 SET IVE BURETTE 60 DROP 272 S1015 $ 1,864.00 ACTIVE

27200765 SET J LOOP 272 S1015 $ 244.00 ACTIVE

27200769 SET PCA TUBING 272 A4649 $ 212.00 ACTIVE


Charge Amt Status

Charge Master List

25000707 SEVOFORANE 90 MIN 250 J7699 $ 3,416.00 ACTIVE

27200716 SHEATH AVANTI 6FR 5.5CM 272 A4270 $ 101.70 ACTIVE

27200715 SHEATH AVANTI 6FR 7.5CM 272 A4270 $ 101.70 ACTIVE

27200637SHEATH PRELUDE 8 FR 4CM MARKER TIP

272 A4270 $ 615.00 ACTIVE

27200629 SHEET T THYROID STERILE 272 A4467 $ 207.00 ACTIVE

27000347 SHOE POST OP MEN-LG 270 L3260 $ 96.00 ACTIVE

27000348 SHOE POST OP MEN-MED 270 L3260 $ 96.00 ACTIVE

27000349 SHOE POST OP MEN-SM 270 L3260 $ 96.00 ACTIVE

27000766 SHOE POST OP PEDIATRIC 270 L3260 $ 96.00 ACTIVE

27000350 SHOE POST OP WOMEN -SM 270 L3260 $ 96.00 ACTIVE

27000351 SHOE POST OP WOMEN-LG 270 L3260 $ 96.00 ACTIVE

27000352 SHOE POST OP WOMEN-MED 270 L3260 $ 96.00 ACTIVE

27000353 SHOE POST OP XLG MALE 270 L3260 $ 96.00 ACTIVE

27000748SHOECOVER, LF N/SKID UNIV BLU EACH

270 A9270 $ 2.85 ACTIVE

32000176 SHOULDER 1 VIEW 320 73020 $ 1,111.50 ACTIVE

32000175 SHOULDER 2V OR MORE 320 73030 $ 1,385.00 ACTIVE

32200006 SHOULDER ARTHROGRAPHY 322 73040 $ 4,825.50 ACTIVE

27000502 SHOULDER PADDING OSI KIT 270 L3671 $ 628.00 ACTIVE

27000777

SHOULDER SLING OR VEST DESIGN, ABDUCTION RESTRAINER, WITH OR WITHOUT SWATHE CONTROL, PREFABRICATED

270 A4566 $ 38.95 ACTIVE

32000177 SIALOGRAPHY 320 70390 $ 1,755.60 ACTIVE

30500045 SICKLE CELL TEST 305 85660 $ 73.44 ACTIVE

75000011

SIGMOIDOSCOPY FLEX W/ REMOVAL OF TUMOR/POLYP/OTHER LESION BY HOT BX FORCEPS

750 45333 $ 5,278.00 ACTIVE

75000012

SIGMOIDOSCOPY FLEX; DIAGNOSTIC INC COLL OF SPECIMEN BY BRUSHING/WASHING

750 45330 $ 4,252.10 ACTIVE

27000476 SILVADENE CREAM 400GM 270 A6250 $ 432.00 ACTIVE

25901909SILVER GEL (ELTA) ANTIMICROBIAL WOUND GEL 1.5OZ 45ML TUBE

250 A6250 $ 64.25 ACTIVE

25901056 SILVER NITRATE STICK EACH 250 J3490 $ 69.00 ACTIVE

25901910 SILVER NITRATE SWAB 250 J3490 $ 12.25 ACTIVE

25901911SILVER SULFADIAZENE CREAM 85 GM

250 A6250 $ 61.28 ACTIVE

25901057SILVER SULFADIAZINE 1% CREAM 20GM

250 A6250 $ 622.00 ACTIVE

25901912SILVER SULFADIAZINE, THERMAZENE (SILVADENE) 1% CREAM 25GM TUBE

250 A6250 $ 20.40 ACTIVE

25901058SIMETHICONE INFANT DROPS 20MG/0.3ML 30ML BTL

250 J3490 $ 68.00 ACTIVE

45000088SIMPLE REPAIR FACE AREA 2.5CM<

450 12011 $ 2,844.00 ACTIVE

45000115SIMPLE REPAIR FACE AREA 2.6-5CM

450 12013 $ 2,988.00 ACTIVE

45000116SIMPLE REPAIR FACE AREA 5.1-7.5CM

450 12014 $ 3,852.00 ACTIVE

45000117SIMPLE REPAIR FACE AREA 7.6-12.5CM

450 12015 $ 4,842.00 ACTIVE


Charge Amt Status

Charge Master List

45000125SIMPLE REPAIR SCALP/NECK/EXTREM 2.5CM OR <

450 12001 $ 2,286.00 ACTIVE

45000118SIMPLE REPAIR SCALP/NECK/EXTREM 2.6-7.5CM

450 12002 $ 3,024.00 ACTIVE

45000130SIMPLE REPAIR SCALP/NECK/EXTREM 20.1-30CM

450 12006 $ 6,012.00 ACTIVE

45000113SIMPLE REPAIR SCALP/NECK/EXTREM 7.6-12.5CM

450 12004 $ 3,762.00 ACTIVE

45000138

SIMPLE REPAIR SUPERFICIAL WOUNDS SCALP/NECK/AXILLAE/GENITALIA/TRUNK/EXTREMITIES 12.6-20.0 CM

450 12005 $ 2,844.00 ACTIVE

27200692 SIMPULSE SOLO SYSTEM 272 A4628 $ 1,186.50 ACTIVE

25901268SIMVASTATIN (ZOCOR) 10MG TAB

259 J8499 $ 69.00 ACTIVE

32000178SINGLE VIEW SPINE SPECIFY LEVEL

320 72020 $ 1,043.50 ACTIVE

32000179 SINUS PARANASAL <3 VIEW 320 70210 $ 1,420.50 ACTIVE

32000180 SINUS PARANASAL MIN 3V 320 70220 $ 1,781.00 ACTIVE

27000590 SKIN PASTE SOOTHE AND COOL 270 A6250 $ 136.00 ACTIVE

32000181 SKULL <4 VIEWS 320 70250 $ 1,712.00 ACTIVE

32000182 SKULL COMP > 4 VIEWS 320 70260 $ 2,158.50 ACTIVE

74000003 SLEEP EEG AWAKE/ASLEEP 740 95819 $ 1,700.16 ACTIVE

27000674 SLEEVES SCD ALL SIZES 270 A4649 $ 1,216.00 ACTIVE

27000503 SLING ARM LARGE 274 A4565 $ 41.25 ACTIVE

27000504 SLING ARM MEDIUM 274 A4565 $ 64.05 ACTIVE

27000505 SLING ARM SMALL 274 A4565 $ 53.70 ACTIVE

27000021 SLING ARM XLG 270 A4565 $ 93.20 ACTIVE

27000747SLIPPER, TERRY RYL BLU XLG ADLT

270 A9270 $ 11.90 ACTIVE

32000183 SM BOWEL SERIES 320 74250 $ 4,996.00 ACTIVE

31100013SMEARS OTHER EXTENDED STUDY (>5)

311 88162 $ 202.86 ACTIVE

77000002SMOKING/TOBACCO CESSATION COUNSE 3-10MINS

942 99406 $ 116.92 ACTIVE

77000001SMOKING/TOBACCO CESSATION COUNSEL >10 MIN

942 99407 $ 200.00 ACTIVE

27000008 SNARE SYSTEM 3920060- ALL 270 C1773 $ 3,819.20 ACTIVE

27000760 SO.CHL 0.9% IRR 500ML BTL 250 A4217 $ 9.73 ACTIVE

25901913SO.CHL 5% OPHTH OINTMT 3.5GM 1/8OZ TUBE

250 A6250 $ 29.48 ACTIVE

30100356SODIUM (CEREBROSPINAL FLUID)

301 84302 $ 64.80 ACTIVE

30100355 SODIUM 24HR (URINE) 301 84300 $ 64.80 ACTIVE

25000545SODIUM BICARBONATE 4.2% 10ML

250 J3490 $ 54.00 ACTIVE

25000547SODIUM BICARBONATE 8.4% PEDI S

250 J3490 $ 456.00 ACTIVE

25800062 SODIUM CHL 0.9% 25ML IV FL 258 J7050 $ 130.00 ACTIVE

25000668SODIUM CHLORIDE 0.45% 250ML BAG

258 J2912 $ 18.00 ACTIVE

25900010 SODIUM CHLORIDE 0.9% 10ML 250 A4216 $ 36.00 ACTIVE

25000179SODIUM CHLORIDE 0.9% 10ML FLUSH SYRINGE

272 A4216 $ 16.00 ACTIVE


Charge Amt Status

Charge Master List

25901914 SODIUM CHLORIDE 0.9% 20ML 258 J7050 $ 36.00 ACTIVE

25000553 SODIUM CHLORIDE 3000ML 250 J3490 $ 100.00 ACTIVE

25901932SODIUM CHLORIDE 5% SOLUTION (0.5FL. OZ)

258 J7042 $ 42.00 ACTIVE

25000557 SODIUM NITROPRUSSIDE 50MG 250 J3490 $ 98.00 ACTIVE

25901070 SODIUM POLYSTYRENE 15GM 250 J3490 $ 64.00 ACTIVE

25000027SOLUMEDROL 1GM (8-125MG DOSES) MDVIAL

636 J2930 $ 61.28 ACTIVE

25000028SOLUMEDROL 500MG (4-125MG DOSES) MDVIAL

636 J2930 $ 61.28 ACTIVE

27000576SOLUTION SODIUM CHLORIDE IRRIGATION 1000ML

259 A4217 $ 88.00 ACTIVE

25901851SOLUTION SODIUM CHLORIDE IRRIGATION 250ML BTL

250 J7050 $ 50.00 ACTIVE

25901962 SOTALOL 120MG 250 J8499 $ 12.00 ACTIVE

31200010 SPECIAL STAINS GROUP I (EACH) 312 88312 $ 336.00 ACTIVE

31200011SPECIAL STAINS GROUP II (EACH)

312 88313 $ 238.28 ACTIVE

27000628SPECIMEN CONTAINERS 4 OZ STERILE

270 A4649 $ 24.00 ACTIVE

32000184 SPECIMEN SURGICAL 320 76098 $ 787.50 ACTIVE

30100041SPECTROPHOTOMETRY, ANALYTE NOT ELSEWHERE SPECIFIED

301 84311 $ 97.20 ACTIVE

27000474SPECULUM SIGMOIDOSCOPE DISPOSABLE

270 A4649 $ 759.00 ACTIVE

36000117SPINAL PUNCTURE LUMBAR; DIAGNOSTIC

360 62270 $ 2,922.30 ACTIVE

45000144SPINAL PUNCTURE, LUMBAR, DIAGNOSTIC

450 62270 $ 2,430.00 ACTIVE

27200489 SPINE CATH 272 C1755 $ 13,106.80 ACTIVE

32000192 SPINE SURVEY ENTIRE 320 72010 $ 3,372.50 ACTIVE

25901072 SPIRIVA 18MCG INHALER 250 J7699 $ 888.00 ACTIVE

27000363 SPLINT ARM LONG 270 Q4018 $ 648.00 ACTIVE

27000506 SPLINT ARM SHORT 270 Q4022 $ 2,144.25 ACTIVE

27100010 SPLINT FINGER S/M 271 Q4049 $ 95.85 ACTIVE

27000370 SPLINT FINGER/TOE 270 L3927 $ 424.00 ACTIVE

27000371 SPLINT HAND 270 L3908 $ 1,052.00 ACTIVE

27000372 SPLINT LEG LONG 270 Q4042 $ 2,772.00 ACTIVE

27000373 SPLINT LEG SHORT 270 Q4046 $ 2,084.00 ACTIVE

27000375 SPLINT NASAL SEPTAL 270 Q4051 $ 478.00 ACTIVE

27000378 SPLINT WRIST LEFT SM 270 E1805 $ 46.00 ACTIVE

27000381 SPLINT WRIST RIGHT SML 270 A4570 $ 46.00 ACTIVE

36000363

SPLIT-THICKNESS AUTOGRAFT, TRUNK, ARMS, LEGS; EACH ADDITIONAL 100 SQ CM, OR EACH ADDITIONAL 1% OF BODY AREA OF INFANTS AND CHILDREN, OR

360 15101 $ 5,802.50 ACTIVE

36000334

SPLIT-THICKNESS AUTOGRAFT; FIRST 100SQCM OR <, OR 1% OF BODY AREA OF INFANT/CHILD (EXCEPT 15050)

360 15120 $ 36,017.50 ACTIVE

27000382 SPONGE GUAZE 4X4 2 PK (16436) 272 A6402 $ 8.45 ACTIVE

27000494 SPONGE LAPARATOMY 270 A6403 $ 24.00 ACTIVE


Charge Amt Status

Charge Master List

27000642 SPONGE X-RAY DETECT 4X4 270 A4649 $ 52.00 ACTIVE

27000383SPONGE XRAY DETECTABLE 10/PK (10227)

272 A6402 $ 2.80 ACTIVE

27000638 SPUTUM COLLECT SYSTEM DISP 270 A4649 $ 56.00 ACTIVE

41000033 SPUTUM COLLECTION BY RT 410 31720 $ 719.38 ACTIVE

30900007 SPUTUM COLLECTION SIMPLE 309 89220 $ 328.92 ACTIVE

25901074 SSD AF 1% CREAM 50GM 250 A6250 $ 232.00 ACTIVE

30200191 ST LOUIS ENCEPHALITIS 302 86653 $ 175.80 ACTIVE

30100361 STADOL/BUTORPHANOL 301 83925 $ 1,542.38 ACTIVE

27800923STAPLE LOADING UNIT 45 2.5 ENDO GIA RELOAD (TR45W)

272 A4649 $ 2,467.29 ACTIVE

27000385 STAPLE REMOVER SKIN (10843) 270 A4550 $ 32.00 ACTIVE

27200693 STAPLER HEMORRHOID 272 A4649 $ 7,560.00 ACTIVE

27200772 STAPLER SKIN PRECISION 272 A9270 $ 292.00 ACTIVE

27000773STATIONARY OXYGEN CONTENTS, GASEOUS

270 E0441 $ 158.91 ACTIVE

27200148 STENT ACCULINK STRAIGHT 272 C1876 $ 20,000.00 ACTIVE

27200643 STENT WALL ESOPH 28X155MM 272 A4649 $ 36,663.00 ACTIVE

32000193 STEREO LOCALIZ BREAST 320 77031 $ 3,152.38 ACTIVE

27000389 STERI STRIPS 272 A4450 $ 11.85 ACTIVE

27200703 STERILE TALC 4 GRAM 272 A4649 $ 1,092.00 ACTIVE

25000566 STERILE WATER 10ML VIAL 250 A4216 $ 154.00 ACTIVE

25901915 STERILE WATER 20ML 250 A4216 $ 5.70 ACTIVE

25800064 STERILE WATER 3000ML 258 A4217 $ 184.00 ACTIVE

25901916 STERILE WATER 500ML BOTTLE 250 A4217 $ 10.03 ACTIVE

25000634STERILE WATER IRRIGATION 500ML

250 A4217 $ 70.00 ACTIVE

32000194 STERNOCLAVIC 3V MORE 320 71130 $ 1,728.00 ACTIVE

32000195 STERNUM 2+ VIEWS 320 71120 $ 1,403.50 ACTIVE

27000507 STOCKINETTE 270 A6457 $ 568.00 ACTIVE

27000508 STOCKINETTE IMPREVIOUS 270 A4649 $ 1,476.00 ACTIVE

30100362STONE ANALYSIS - CALCULUS INFRARED SPECTROSCOPY

301 82365 $ 171.96 ACTIVE

30600091STOOL CULTURE BACTERIAL ISOLATION

306 87045 $ 125.88 ACTIVE

27200165 STOP COCKS 272 A4649 $ 24.00 ACTIVE

27800652 STPL ENDOCLIP 320 DISP 272 A4649 $ 3,000.00 ACTIVE

45000050 STRAPPING ELBOW OR WRIST 450 29260 $ 350.00 ACTIVE

45000046 STRAPPING HAND OR FINGER 450 29280 $ 300.00 ACTIVE

45000054 STRAPPING KNEE 450 29530 $ 450.00 ACTIVE

42000047 STRAPPING SHLDR (VELPEAU) 420 29240 $ 769.78 ACTIVE

45000120STRAPPING; ANKLE AND/OR FOOT

450 29540 $ 936.00 ACTIVE

30100542 STREP B ASSAY W/OPTIC 306 87802 $ 44.40 ACTIVE

30600092STREPTOCOCCUS-A ASSAY WITH DIRECT OBSERVATION

306 87880 $ 198.36 ACTIVE

27200787 STRIP ACCUCHECK TEST 272 A4253 $ 52.00 ACTIVE

40200054 SUBCLAVIAN VENOGRAM 402 76937 $ 1,558.00 ACTIVE

36000093SUBQ RMVL 1/2 CHMBR PACG CVDFB

360 33241 $ 16,168.46 ACTIVE


Charge Amt Status

Charge Master List

98700006

SUBSEQ HOSP CARE,DETAILED INTERVL HX; DETAILED EXAM;MED DECISION HIGH COMPLEX

987 99233 $ 2,571.25 ACTIVE

98700005

SUBSEQ HOSP CARE,EXPAND PROB FOCUS INT HX;EXPAND PROB EXAM;MED DEC MOD COMPLEX

987 99232 $ 1,779.25 ACTIVE

98700004

SUBSEQ HOSP CARE:PROB FOCUS INT HX;PROB FOCUS EXAM;MED DEC STRTFWD/LOW COMPLEX

987 99231 $ 967.25 ACTIVE

27200496SUCTION CATHETER 14/12FR DYND41902

270 A4624 $ 16.00 ACTIVE

41000021 SUCTION PROCEDURE BY RT 410 31720 $ 629.45 ACTIVE

27000159SUCTION RESERVOIR 100CC SILICONE

270 A4649 $ 550.00 ACTIVE

25901084SULFA/TRIM (BACTRIM) 800/160MG TAB

250 S0039 $ 58.00 ACTIVE

25901085 SULFASALAZINE 500MG TABLET 250 J8499 $ 14.00 ACTIVE

25901917 SUMATRIPTAN 100MG TAB 250 J8499 $ 10.15 ACTIVE

25900594 SUMATRIPTAN 25MG TAB 250 J8499 $ 10.25 ACTIVE

63600111 SUMATRIPTAN 6MG/0.5ML 636 J3030 $ 122.20 ACTIVE

32000040 SUP VENA CAVA GRAM 320 75827 $ 6,660.00 ACTIVE

31200008SURGICAL PATHOLOGY CONSULTANT EACH ADDED SECTION

312 88332 $ 161.42 ACTIVE

31200009SURGICAL PATHOLOGY CONSULTANT WITH 1 FROZEN SECTION

312 88331 $ 328.92 ACTIVE

31200012SURGICAL PATHOLOGY GROSS AND MICROBIOLOGY LEVEL I

312 88300 $ 161.42 ACTIVE

31200005SURGICAL PATHOLOGY GROSS AND MICROBIOLOGY LEVEL II

312 88302 $ 228.62 ACTIVE

31200003SURGICAL PATHOLOGY GROSS AND MICROBIOLOGY LEVEL IV

312 88305 $ 470.12 ACTIVE

31200006SURGICAL PATHOLOGY GROSS AND MICROBIOLOGY LEVEL V

312 88307 $ 611.80 ACTIVE

31200007SURGICAL PATHOLOGY GROSS AND MICROBIOLOGY LEVEL VI

312 88309 $ 808.22 ACTIVE

36000331

SURGICAL PREPARATION/CREATION OF RECIPIENT SITE BY EXCISION OR INCISIONAL RELEASE ; FIRST 100 SQ CM OR 1% OF BODY AREA OF INFANT/CHILD

360 15004 $ 13,914.00 ACTIVE

27000516 SUSPENSORY ALL 270 A4649 $ 384.00 ACTIVE

27000735 SUTURE 0 PROLENE CT-1 270 A4649 $ 64.00 ACTIVE

27000540SUTURE 3-0 CHROMIC GUT SH 6 PER BOX

270 A4649 $ 2,848.00 ACTIVE

27000727 SUTURE 3-0 ETHYLON CT1 272 A4649 $ 63.50 ACTIVE

27000543 SUTURE 4-0 ETHILON PS-2 272 A4649 $ 148.00 ACTIVE

27000711 SUTURE 4-0 NYLON 270 A4649 $ 498.90 ACTIVE

27000538 SUTURE 4-0 PROLENE PS-2 270 A4649 $ 176.00 ACTIVE

27000541 SUTURE 4-0 VICRYL PS-2 270 A4649 $ 164.00 ACTIVE


Charge Amt Status

Charge Master List

27000539 SUTURE 5-0 PROLENE PS-3 272 A4649 $ 60.00 ACTIVE

27200705 SUTURE BOOTIE YELLOW 270 A4649 $ 32.54 ACTIVE

27000404 SUTURE ER 270 A4649 $ 206.00 ACTIVE

27000707 SUTURE ETHILON 3-0 PS2 272 A4649 $ 70.35 ACTIVE

36000328SUTURE OF 1 NERVE; ULNAR MOTOR

360 64836 $ 42,335.50 ACTIVE

36000282SUTURE OF INFRAPATELLAR TENDON; PRIMARY

360 27380 $ 30,505.50 ACTIVE

36000283SUTURE OF QUADRICEPS/HAMSTRING MUSCLE RUPTURE; PRIMARY

360 27385 $ 28,012.50 ACTIVE

27000405 SUTURE OR 270 A4649 $ 496.00 ACTIVE

27200851 SUTURE PASSER DISPOSABLE 272 A4550 $ 3,900.00 ACTIVE

27200713 SUTURE PROLENE BV BV 272 A4649 $ 158.20 ACTIVE

27200798 SWABSTICK BENZION 272 A5120 $ 32.00 ACTIVE

27200799 SWABSTICK POVIDINE/IODINE 272 A5120 $ 12.00 ACTIVE

32000196 SWALLOW FUNC W/CINE 320 74230 $ 1,390.62 ACTIVE

25901828SYMBICORT 160/4.5 MCG INHALER

250 J7699 $ 1,426.40 ACTIVE

36000250

SYNOVECTOMY, TENDON SHEATH, RADICAL (TENOSYNOVECTOMY), FLEXOR TENDON, PALM/FINGER, EACH TENDON

360 26145 $ 26,570.50 ACTIVE

30100266 SYNOVIAL MUCIN (FLUID) 301 83872 $ 78.12 ACTIVE

25901690 SYNTHROID 0.025MG TABS 250 J8499 $ 24.00 ACTIVE

25901633 SYNTHROID 0.05MG TAB 250 J8499 $ 24.00 ACTIVE

30200193 SYPHILIS TEST (QUANTITATIVE) 302 86593 $ 58.68 ACTIVE

30200185SYPHILIS TEST (RAPID PLASMA REAGIN)

302 86592 $ 57.00 ACTIVE

27000567 SYRINGE 10CC 272 A4209 $ 48.00 ACTIVE


27200820 SYRINGE 22GA X 1.5 272 A4209 $ 24.00 ACTIVE





27000562 SYRINGE ASEPTO 272 A4320 $ 48.00 ACTIVE

27200862SYRINGE BONE MARROW ASPIRATION 20CC

272 C1830 $ 3,656.00 ACTIVE

27000417 SYRINGE BULB ASEPTO (10125) 270 A4322 $ 16.00 ACTIVE

27000565 SYRINGE INSULIN 272 A4657 $ 48.00 ACTIVE

27000675SYSTEM GASTRIC LAVGE CLOSED 34FR

270 A4649 $ 3,032.00 ACTIVE

30000036 T CELL ACTIVATION 302 86356 $ 99.18 ACTIVE

30100367 T3 (REVERSE) 301 84482 $ 210.12 ACTIVE

30100364 T3 FREE 301 84481 $ 225.84 ACTIVE

30100368 T3 TOTAL 301 84480 $ 189.00 ACTIVE

30100366 T3 UPTAKE 301 84479 $ 86.16 ACTIVE

30100370 T4 FREE 301 84439 $ 120.24 ACTIVE

30100371 T4 TOTAL 301 84436 $ 91.56 ACTIVE

30100372 TACROLIMUS 301 80197 $ 183.12 ACTIVE

25901097 TAM FLU 75MG CAP 250 J8499 $ 84.00 ACTIVE

25000571TAMIFLU 45MG CAP (OSELTAMIVIR PHOS)

250 J8499 $ 108.00 ACTIVE


Charge Amt Status

Charge Master List

27100011 TAPE 4 INCHES MEDIPORE 271 A4452 $ 420.00 ACTIVE

30100571 TB QUANTIFERON GOLD 302 86480 $ 229.56 ACTIVE

48100012TC PLACEMENT INTRACORONARY DRUG ELUTING STENT SINGLE VESSEL

481 G0290 $ 78,498.22 ACTIVE

30200194 T-CELLS CD4 & CD8 302 86360 $ 470.12 ACTIVE

30200195 T-CELLS TOTAL COUNT 302 86359 $ 470.12 ACTIVE

34300001TECHNETIUM TC-99 SESTAMIBI DIAGNOSTIC PER STUDY DOSE GENERIC

341 A9500 $ 515.20 ACTIVE

48000022TEE F/CGEN CAR ANOMAL COMPL

480 93303 $ 2,437.54 ACTIVE

48000023TEE F/CGEN CAR ANOMAL F-UP/LMT

480 93304 $ 1,159.20 ACTIVE

25901105 TEGRETOL 200MG TABLET 250 J8499 $ 24.00 ACTIVE

36000200TEMP FOLEY CATHETER INSERTION

450 51702 $ 1,343.00 ACTIVE

45000021 TEMPORARY EXTERNAL PACING 450 92953 $ 1,806.00 ACTIVE

45000074TENDON SHEATH INCISION (TRIGGER FINGER)

361 26055 $ 16,036.50 ACTIVE

63600188 TENECTEPLASE 50MG VIAL IV 636 J3101 $ 11,860.00 ACTIVE

36000352

TENOLYSIS, FLEXOR OR EXTENSOR TENDON, LEG AND/OR ANKLE; MULTIPLE TENDONS (THROUGH SEPARATE INCISION[S])

360 27681 $ 28,349.50 ACTIVE

25901641 TENORMIN 50MG TABS 250 J8499 $ 24.00 ACTIVE

36000340TENOTOMY, PERCUTANEOUS, TOE; SINGLE TENDON

360 28010 $ 10,782.00 ACTIVE

63600123 TERBUTALINE 1MG/ML 636 J3105 $ 12.00 ACTIVE

25901114 TESSALON PERLE 100MG CAP 250 J8499 $ 24.00 ACTIVE

30100375 TESTOSTERONE (FREE) 301 84402 $ 244.72 ACTIVE

30100374TESTOSTERONE BINDING GLOBULIN

301 84270 $ 289.80 ACTIVE

30100376 TESTOSTERONE TOTAL 301 84403 $ 344.16 ACTIVE

63600115TETANUS (TD; TENIVAC) VACC 0.5ML SDVIAL

636 90714 $ 59.83 ACTIVE

25901926TETRACAINE 0.5% OPHTHALMIC SOLN 2ML

250 J3490 $ 100.00 ACTIVE

25901927TETRACAINE 0.5% OPTH DROPS 5ML

250 J3490 $ 100.00 ACTIVE

25901928TETRACAINE 035% OPTH SOL 4ML

250 J3490 $ 100.00 ACTIVE

25901116 TETRACAINE HCL 0.5% 15ML 250 J3490 $ 100.00 ACTIVE

25901645 TETRACYCLINE 250MG CAP 250 J8499 $ 24.00 ACTIVE

25901121 THEO-DUR 200MG TABLET SA 250 J8499 $ 8.00 ACTIVE

30100379 THEOPHYLLINE 301 80198 $ 188.52 ACTIVE

42000038 THER ACT 15MIN 450 97530 $ 261.96 ACTIVE

42000039THER MASSAGE EA 15 PERCUSSION

450 97124 $ 234.94 ACTIVE

45000022THER PROPH/DX INJ INTRA ARTICU

450 96373 $ 566.28 ACTIVE

45000023 THER PROPH/DX INJ SUBQ/IM 450 96372 $ 355.60 ACTIVE

44000013 THER SVC SP DEV W/MOD 450 92609 $ 801.78 ACTIVE

42000040 THERAP EXE EA 15MIN 450 97110 $ 266.58 ACTIVE

27200884 THERMOMETER, ORAL AXILLARY 272 A4931 $ 547.00 ACTIVE


Charge Amt Status

Charge Master List

63600177 THIAMINE 200MG/2ML VIAL 636 J3411 $ 24.83 ACTIVE

30100413 THIAMINE VITAMIN B-1 301 84425 $ 283.08 ACTIVE

32000199 THOR- SPINE 2 VIEWS 320 72070 $ 1,506.00 ACTIVE

32000200 THOR- SPINE 3 VIEWS 320 72072 $ 1,643.50 ACTIVE

32000201 THOR- SPINE 4+ VIEWS 320 72074 $ 1,865.50 ACTIVE

36000194THORACENTESIS W IMAGE GUIDANCE

360 32555 $ 3,403.00 ACTIVE

36000139

THORACENTESIS, NEEDLE OR CATHETER, ASPIRATION OF THE PLEURAL SPACE; WITHOUT IMAGING GUIDANCE

360 32554 $ 2,434.32 ACTIVE

32000042 THORACIC AORTAGRAM 320 75605 $ 6,711.50 ACTIVE

32000202 THOR-LUMB SPINE 2 VIEWS 320 72080 $ 1,607.50 ACTIVE

27200170 THROMBECTOMY CATHETER 272 C1757 $ 1,868.20 ACTIVE

48000001 THROMBOLYSIS COR IV INF 480 92977 $ 2,135.00 ACTIVE

30900013 THROMBOPLASTIN INHIBITION 305 85705 $ 128.40 ACTIVE

30100382 THYROGLOBULIN 301 84432 $ 214.08 ACTIVE

30200200 THYROGLOBULIN ANTIBODY 302 86800 $ 212.04 ACTIVE

30100381THYROID BINDING GLOBULIN (TBG)

301 84442 $ 197.16 ACTIVE

36000114 THYROID BIOPSY NEEDLE 360 60100 $ 2,830.36 ACTIVE

30100383THYROID STIMULATING HORMONE

301 84443 $ 224.04 ACTIVE

30100396THYROID STIMULATING IMMUNOGLOBIN

301 84445 $ 678.12 ACTIVE

48100047 TIB/PERO REVAS ADD ON 481 37232 $ 1,150.50 ACTIVE

48100050TIB/PERO REVASC STENT & ATHERO/ANGIO

481 37235 $ 1,086.50 ACTIVE

48100046TIB/PERO REVASC W STENT & ATHERO

481 37231 $ 75,835.92 ACTIVE

48100043TIB/PERO REVASC W/ANGIOPLASTY

481 37228 $ 54,568.62 ACTIVE

48100044TIB/PERO REVASC W/ATHER/ANGIO

481 37229 $ 71,835.92 ACTIVE

48100048TIB/PERO REVASC W/ATHERO ADD ON

481 37233 $ 775.00 ACTIVE

48100045 TIB/PERO REVASC W/STENT 481 37230 $ 71,835.92 ACTIVE

48100057TIB/PERO REVASC W/STENT W/STENT UNI EA.

481 37234 $ 1,086.50 ACTIVE

32000203 TIBIA & FIBULA TWO VIEWS 320 73590 $ 1,266.50 ACTIVE

48100115 TILT TABLE EVALUATION 481 93660 $ 17,152.60 ACTIVE

25901918 TIMOLOL 0.5% OPTH SOL 250 J3490 $ 15.15 ACTIVE

31100014TISSUE CULTURE NEO-BLOOD BONE MARROW

311 88237 $ 1,062.60 ACTIVE

36000249TISSUE GRAFTS, OTHER (EG, PARATENON, FAT, DERMIS)

360 20926 $ 22,002.00 ACTIVE

31200018TISSUE IN SITU HYBRIDIZATION, INTERPRETATION & REPORT

312 88365 $ 121.34 ACTIVE

32000204 TMJ BILATERAL 320 70330 $ 2,258.00 ACTIVE

32000205 TMJ UNILATERAL 320 70328 $ 828.80 ACTIVE

30100386 TOBRAMYCIN 301 80200 $ 215.04 ACTIVE

25901136 TOBRAMYCIN 0.3% OPTH OIN 250 J3490 $ 564.00 ACTIVE

30100419 TOCOPHEROL ALPHA VITAMIN E 301 84446 $ 189.00 ACTIVE

32000206 TOE(S) 2V OR MORE 320 73660 $ 1,334.00 ACTIVE

32000207 TOMOGRAM 320 76100 $ 4,450.00 ACTIVE


Charge Amt Status

Charge Master List

27100015 TONGUE DEPRESSOR (STERILE) 271 A4649 $ 24.00 ACTIVE

25901139 TOPAMAX 25 MG TAB 250 J8499 $ 36.00 ACTIVE

30100388 TOPIRAMATE 301 80201 $ 158.88 ACTIVE

25901143 TORADOL 10MG TABLET 250 J8499 $ 33.00 ACTIVE

76100028TOTAL CONTACT CAST APPLICATION

761 29445 $ 1,568.12 ACTIVE

30100293 TOTAL PHENYTOIN 301 80185 $ 176.76 ACTIVE

30100091 TOTAL SERUM CHOLESTEROL 301 82465 $ 58.08 ACTIVE

27200912 TOURNIQUETS LATEX 42" DISP 272 A4649 $ 4.10 ACTIVE

30100434TOXOPLASMA ANTIBODY IMMUNOGLOBIN-G

302 86777 $ 191.88 ACTIVE

30100435TOXOPLASMA ANTIBODY IMMUNOGLOBIN-M

302 86778 $ 192.12 ACTIVE

41000032 TRACH CARE PROCEDURE BY RT 410 31720 $ 899.22 ACTIVE

27400006TRACHEOSTOMY TUBE COLLAR/HOLDER, EACH

270 A7526 $ 38.10 ACTIVE

94200010 TRAIN & EDUCATE OPPS/PHP 942 G0177 $ 2,410.52 ACTIVE

25800094TRANEXAMIC ACID 1000 MG/10ML

258 J3490 $ 285.60 ACTIVE

36000094 TRANSCATH IV STENT OPEN 360 37207 $ 1,525.00 ACTIVE

32000043TRANSCATH IV STENT S&I EACH VE

320 75960 $ 4,945.92 ACTIVE

36000095 TRANSCATH STENT CCA W/EPS 360 37215 $ 1,060.50 ACTIVE

36000096TRANSCATH STENT CCA W/O EPS

360 37216 $ 1,177.50 ACTIVE

32000045TRANSCATH TX EMBOLIATION S&I

320 75894 $ 5,776.40 ACTIVE

36000097TRANSCATH TX EMBOLIZATION COILING

360 37204 $ 1,020.00 ACTIVE

25901146 TRANSDERM SCOP.1.5MG/72HR 250 J3490 $ 163.50 ACTIVE

30100389 TRANSFERRIN 301 84466 $ 170.16 ACTIVE

39100001TRANSFUSION BLOOD OR BLOOD COMPONENTS

391 36430 $ 1,790.00 ACTIVE

36000241TRANSURETHRAL ELECTROSURGICAL RESECTION OF PROSTATE COMPLETE

360 52601 $ 44,342.50 ACTIVE

25901149TRAVATAN 0.004% 2.5ML OPTH SOL

250 J3490 $ 648.00 ACTIVE

27000427TRAY ADULT LUMBAR PUNCTURE

270 A4550 $ 444.00 ACTIVE

27200677 TRAY CIAGLIA RHINO 272 A4550 $ 9,450.00 ACTIVE

27000578 TRAY DRESSING CVC 272 A4649 $ 204.00 ACTIVE

27000510 TRAY FOLEY CATHETER W/LUB 272 A4649 $ 3,340.00 ACTIVE

27000428TRAY LUMBAR PUNCTURE PEDI/INFANT (10809)

272 A4550 $ 248.00 ACTIVE

27000629 TRAY SHAVE PREP 270 A4550 $ 56.00 ACTIVE

27200586TRAY SPINAL ANESTHESIA BF405671

272 A4550 $ 190.00 ACTIVE

27000511 TRAY TRACH W/TUBE 272 A4550 $ 1,216.00 ACTIVE

27200780 TRAY URETHRAL CATH 14FR 272 A4550 $ 92.00 ACTIVE

27200905TRAY, FOLEY CATH, 14FR, LUBR, PVP, DRAIN BAG

272 A4315 $ 283.35 ACTIVE

25901152 TRAZODONE HCL 50MG TAB 259 J8499 $ 10.00 ACTIVE


Charge Amt Status

Charge Master List

42000045 TREATMENT WHIRLPOOL 15 MIN 420 97022 $ 308.00 ACTIVE

30200276TREPONEMA PALLIDUM ANTIBODIES

302 86780 $ 49.02 ACTIVE

25901955TRIAMCINOLONE ACETONIDE 0.025% TOP CREAM

250 J3490 $ 12.50 ACTIVE

31000007TRICHOMONAS VAGINALIS DIR PROBE

310 87660 $ 111.40 ACTIVE

45000127 TRIGGER POINT INJECTION 1-2 450 20552 $ 1,962.00 ACTIVE

30100392 TRIGLYCERIDES 301 84478 $ 76.56 ACTIVE

48100023 TRLUML PERIP ATHRC ILIAC ART 481 0238T $ 45,327.58 ACTIVE

27200657TROCAR BLADELESS OBTURATOR

272 A4649 $ 1,842.00 ACTIVE

27200624TROCAR ENDO ULTRA VERES NDL 120MM

272 A4649 $ 223.00 ACTIVE

27000646 TROCAR EXCEL 270 A4649 $ 2,264.00 ACTIVE

27000643TROCAR EXCEL 12MM LONG BLADELESS STABILITY SLEEV

270 A4649 $ 4,236.00 ACTIVE

27000645 TROCAR EXCEL 12MM SLEEVE 270 A4649 $ 1,720.00 ACTIVE

27000644TROCAR EXCEL/PISTONGRIP 12MM

270 A4649 $ 2,468.00 ACTIVE

27200680 TROCAR SEALANT TIP 272 A4649 $ 5,733.00 ACTIVE

27200704 TROCAR THORACOPORT 11.5MM 272 A4649 $ 169.50 ACTIVE

25901919TROPICAMIDE 1% OPTH SOL 15ML

250 J3490 $ 23.18 ACTIVE

30100394 TROPONIN 1 TRIAGE 301 84484 $ 149.64 ACTIVE

27000647 TUBE CALIBRATION GASTRIC 270 B4087 $ 4,788.00 ACTIVE

27000512 TUBE CHEST (ANY) 272 A4649 $ 548.00 ACTIVE

27200811 TUBE ENDOTRACHEAL 272 A7520 $ 80.00 ACTIVE

27200532 TUBE ENDOTRACHEAL ADAPTER 272 A7520 $ 597.65 ACTIVE

27000434 TUBE FEED ENTERNAL 10FR 270 B4082 $ 125.58 ACTIVE

27000437 TUBE FEED WEIGHTED 270 B4081 $ 125.58 ACTIVE

27000520 TUBE FEEDING INTERNAL 270 B4088 $ 268.00 ACTIVE

27000441 TUBE LEVIN 16FL 270 B4083 $ 41.86 ACTIVE

27200832 TUBE NASOGASTRIC W STYLET 272 B4081 $ 56.00 ACTIVE

27000779TUBE NASOGASTRIC WITHOUT STYLET

272 B4082 $ 48.00 ACTIVE

27000513 TUBE PULL PEG 270 B4082 $ 6,416.00 ACTIVE

27000528 TUBE SALEM SUMP 14 FR 270 B4082 $ 56.00 ACTIVE



27000636 TUBE TRACH (ALL SZ) 270 A4605 $ 2,240.00 ACTIVE

27000450 TUBE TRACH ANY SIZE 272 A7520 $ 452.00 ACTIVE

25000596TUBERSOL (TUBERCULIN PROTEIN)

250 J3490 $ 68.00 ACTIVE

27000560 TUBING DISPOSABLE 270 A4649 $ 52.00 ACTIVE

27000564 TUBING NASAL 7FT 270 A4615 $ 52.00 ACTIVE

27000672TUBING NON-CONNECTING 3/16 X 6

270 A7002 $ 40.00 ACTIVE

27000656 TUBING OXYGEN 7FT 270 A4616 $ 10.00 ACTIVE

27000670 TUBING PUMP STRYKER 270 A7002 $ 2,188.00 ACTIVE

27200756TUBING SUCTION W/YANKAUER TIP

272 A4628 $ 80.00 ACTIVE

25901168TUSSIONEX 5ML ORAL SUSP PER 5ML

250 J3490 $ 24.00 ACTIVE


Charge Amt Status

Charge Master List

45000076TX CLOSED ELBOW DISLOC; W/O ANES

450 24600 $ 3,500.00 ACTIVE

44000014 TX SP/LANG/COM 120 450 92507 $ 772.80 ACTIVE

44000021 TX SP/LANG/COM GP 120 450 92508 $ 1,545.60 ACTIVE

44000026 TX SWALL/ORAL FNX 120 450 92526 $ 3,091.20 ACTIVE

45000024 TX/PROPH/DX INJ IV PUSH ADD 450 96375 $ 566.28 ACTIVE

45000078TX/PROPH/DX INJ IV PUSH SAME DRUG

450 96376 $ 566.28 ACTIVE

45000025 TX/PROPH/DX INJ IV PUSH SGL/IN 450 96374 $ 821.80 ACTIVE

25901920TYLENOL MAPAP 650MG 20.3ML O/S

250 J3490 $ 5.50 ACTIVE

25901173 TYLENOL W/COD 30 MG #3 TAB 250 J8499 $ 36.00 ACTIVE

36100007 TYMPANOGRAM TEST 361 92567 $ 316.25 ACTIVE

40200007 U/S GUIDANCE PARENTESIS 402 76942 $ 2,915.00 ACTIVE

32000208 UGI W AIR CON 320 74246 $ 6,143.00 ACTIVE

32000209 UGI W AIR CON KUB 320 74247 $ 6,759.50 ACTIVE

32000210 UGI W AIR CON SM BOWEL 320 74249 $ 8,797.00 ACTIVE

32000211 UGI W KUB 320 74241 $ 5,633.00 ACTIVE

32000212 UGI W SM BOWEL 320 74245 $ 8,216.00 ACTIVE

32000214 UGI W/O KUB 320 74240 $ 5,460.00 ACTIVE

25901177 ULTRAM 50MG TAB 250 J8499 $ 60.00 ACTIVE

42000041 ULTRASOUND EA 15 450 97035 $ 234.10 ACTIVE

40200060

ULTRASOUND,BREAST,UNILATERAL,REAL TIME WITH IMAGE DOCUMENTATION,INCLUDING AXILLA WHEN PERFORMED;COMPLETE

402 76641 $ 2,151.50 ACTIVE

63600178 ULTRAVIST 300/100ML 636 Q9967 $ 60.70 ACTIVE

63600179 ULTRAVIST 300/50ML 636 Q9967 $ 53.10 ACTIVE

27000571 UNDERPAD DISPOSABLE 270 A4554 $ 52.00 ACTIVE

32000046 UNI-LAT EXTREMITY U/L S&I 320 75710 $ 9,308.68 ACTIVE

32000213 UNLISTED DX X RAY PROC 320 76499 $ 1,425.20 ACTIVE

34100086 UNLISTED GU PROC DX NM 341 78799 $ 3,633.00 ACTIVE

42000050 UNLISTED MODALITY PT 450 97039 $ 259.00 ACTIVE

36000098UNLISTED PROCEDURE VASCULAR S

360 37799 $ 10,374.00 ACTIVE

36000294UNLISTED PROCEDURE, MALE GENITAL SYSTEM

360 55899 $ 1,978.30 ACTIVE

42000042 UNLISTED PT PROC 450 97799 $ 352.26 ACTIVE

42000048 UNNA BOOT APPLICATION 420 29580 $ 769.78 ACTIVE

41000014 UPDRAFT TRMT INITIAL 410 94640 $ 251.16 ACTIVE

36000099UPG PM SYS CONV 1 CHMBR SYS 2

360 33214 $ 96,350.80 ACTIVE

27400003UPP EXT FX ORTHOSIS HUMERAL

270 L3980 $ 2,234.96 ACTIVE

32000215 UPPER EXTREM INF 2+VIEW 320 73092 $ 454.84 ACTIVE

25000874UREA 45% TOPICAL CREAM 255GM TUBE

250 A6250 $ 15.20 ACTIVE

30100493 UREA NITROGEN CLEARANCE 301 84545 $ 88.20 ACTIVE

25900193URECHOLINE (BETHANECHOL) 25MG TAB

250 J8499 $ 37.50 ACTIVE

25901667 URECHOLINE 10MG TAB 250 J8499 $ 24.00 ACTIVE


Charge Amt Status

Charge Master List

36000247

URETERAL ENDOSCOPY THROUGH URETEROTOMY, W/W/OUT IRRIGATION/INSTILLATION/URETEROPYELOGRAPHY W/W/OUT CATH & DILATION

360 50972 $ 6,545.04 ACTIVE

36000248URETEROTOMY W/EXPLORATION/DRAINAGE (SEPARATE PROCEDURE)

360 50600 $ 8,004.00 ACTIVE

32000217 URETHROCYSTOGRAM 320 74450 $ 3,784.50 ACTIVE

32000218 URETHROCYSTOGRAM VOID 320 74455 $ 3,901.00 ACTIVE

36000071URETHROPEXY (MARSHALL-MARCHETTI-KRANTZ BURCH) SIMPLE

360 51840 $ 34,349.50 ACTIVE

36000254

URETHROPLASTY, TRANSPUBIC OR PERINEAL, 1-STAGE, FOR RECONSTRUCTION/REPAIR OF PROSTATIC/MEMBRANOUS URETHRA

360 53415 $ 59,265.50 ACTIVE

30100401 URIC ACID BLOOD 301 84550 $ 60.24 ACTIVE

30100402 URIC ACID URINE 301 84560 $ 63.24 ACTIVE

27000556 URINAL 271 E0325 $ 19.50 ACTIVE

30700014URINALYSIS MICROSCOPIC ONLY

307 81015 $ 40.68 ACTIVE

30700006URINALYSIS QUALITATIVE/SEMIQUANTITATIVE NOT IMMUNOASSAYS

307 81005 $ 28.92 ACTIVE

30700008URINALYSIS, DIP STICK/TABLET REAGENT; AUTOMATED WITH MICROSCOPYURINALYSIS

307 81001 $ 42.24 ACTIVE

30700003URINALYSIS, DIP STICK/TABLET REAGENT; AUTOMATED, W/O MICROSCOPY

307 81003 $ 29.88 ACTIVE

30600014 URINE COLONY COUNT 306 87086 $ 107.64 ACTIVE

31000005 URINE CYTOLOGY 311 88112 $ 322.50 ACTIVE

30100090 URINE DRUG SCREEN 301 80306 $ 205.68 ACTIVE

27000515 URINE METER W/BAG 270 A4358 $ 1,104.00 ACTIVE

30700009URINE VOLUME MEASURE (24 HR)

307 81050 $ 43.68 ACTIVE

30100405UROBILINOGEN URINE (QUALITATIVE)

301 84578 $ 53.64 ACTIVE

32000219 UROGRAM RETRO 320 74420 $ 6,229.00 ACTIVE

40200011US ABD (SINGLE ORGAN) LIMITED

402 76705 $ 4,434.50 ACTIVE

40200016 US ABDOMEN COMPLETE 402 76700 $ 5,942.50 ACTIVE

40200017 US BIO PROFILE W NONSTRES 402 76818 $ 5,908.00 ACTIVE

40200018 US BIO PROFILE WO NOSTRES 402 76819 $ 1,366.40 ACTIVE

40200061US BREAST, UNI, REAL TIME W/IMAGE DOC, INC AXILLA WHEN PERFORMED; LIMITED

402 76642 $ 1,600.00 ACTIVE

92100002 US CAROTID DOPPLER 921 93880 $ 7,840.50 ACTIVE

40200020 US CHEST 402 76604 $ 4,263.00 ACTIVE

40200024 US ECHO PROSTATE VOL STDY 402 76873 $ 8,042.00 ACTIVE

40200025 US ENCEPHALOGRAM 402 76506 $ 1,472.10 ACTIVE


Charge Amt Status

Charge Master List

40200026US EXTREMITY NON-VASC COMPLETE

402 76881 $ 5,631.50 ACTIVE

40200059US EXTREMITY NON-VASC LIMITED/ANATOMICAL SPECIFIC

402 76882 $ 1,475.60 ACTIVE

40200027 US FU STDY 402 76970 $ 883.40 ACTIVE

40200028 US GUIDANCE INTRA-OP 402 76998 $ 1,097.60 ACTIVE

40200033 US OB AFTR 1ST TRI 1 GEST 402 76805 $ 6,915.50 ACTIVE

40200035 US OB FU/REEVAL EA FETUS 402 76816 $ 1,083.60 ACTIVE

40200036 US OB TRANSVAGINAL 402 76817 $ 4,726.50 ACTIVE

40200037 US PELV LTD FU NON OB 402 76857 $ 2,282.00 ACTIVE

40200049 US PELVIC COMPE NON OB 402 76856 $ 5,308.00 ACTIVE

40200038 US PERICARDIOCENT 402 76930 $ 1,232.00 ACTIVE

40200039US PREGANT UTERUS 1ST TRIMEST

402 76801 $ 6,027.50 ACTIVE

40200050 US- RETROPER KIDNEY CMPL 402 76770 $ 5,463.00 ACTIVE

40200041 US RETROPERIT (AORTA) LTD 402 76775 $ 2,778.50 ACTIVE

40200044US SOFT TISSUE HEAD AND NECK

402 76536 $ 8,439.50 ACTIVE

40200045 US TESTICULAR SCROTUM 402 76870 $ 3,223.50 ACTIVE

40200051 US- TRANSRECTAL PROSTATE 402 76872 $ 4,523.00 ACTIVE

40200047 US TRANSVAGINAL 402 76830 $ 5,921.50 ACTIVE

45000153VAGINAL DELIVERY ONLY (WITH OR WITHOUT EPISIOTOMY AND/OR FORCEPS)

450 59409 $ 26,317.47 ACTIVE

30100123 VALPROIC ACID 301 80164 $ 180.60 ACTIVE

25901922 VALSARTAN (DIOVAN) 40MG TAB 250 J8499 $ 20.00 ACTIVE

25900396VALSARTAN + HCTZ (DIOVAN) 80/12.5MG TAB

250 J8499 $ 30.00 ACTIVE

25901194 VALTREX 500MG TAB 250 J8499 $ 84.00 ACTIVE

25000609 VANCOMYCIN 750MG VIAL 636 J3370 $ 70.00 ACTIVE

30100407 VANCOMYCIN PEAK 301 80202 $ 180.60 ACTIVE

30100420VANILLYLMANDELIC ACID (RANDOM URINE)

301 84585 $ 206.64 ACTIVE

30200203 VARICELLA ZOSTER ANTIBODIES 302 86787 $ 171.72 ACTIVE

36000228VASECTOMY UNILATERAL OR BILATERALINCLUDING POSTOP SEMEN EXAMINATION(S)

360 55250 $ 19,669.00 ACTIVE

30100411VASOACTIVE INTESTINAL PEPTIDE

301 84586 $ 225.56 ACTIVE

42000043 VASOPNEUMATIC DEVICE 450 97016 $ 252.20 ACTIVE

25901199 VASOTEC 5MG TABLET 250 J8499 $ 30.00 ACTIVE

36000301VASOVASOSTOMY, VASOVASORRHAPHY

360 55400 $ 24,962.50 ACTIVE

27200178 VENA CAVA FILTER G2 272 C1880 $ 28,000.00 ACTIVE

30000009

VENIPUNCTURE, AGE 3 YEARS OR OLDER, NECESSITATING THE SKILL OF A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL (

300 36410 $ 175.00 ACTIVE

32000220 VENOGRAM EXT BIL 320 75822 $ 6,627.50 ACTIVE

32000221 VENOGRAM EXT UNI 320 75820 $ 5,561.50 ACTIVE

48100102VENOGRAPHY, CAVAL, INFERIOR W SERIOLOGRAPHY

481 75825 $ 6,607.50 ACTIVE


Charge Amt Status

Charge Master List

48100101VENOGRAPHY, EXTREMITY, BILATERAL S & I

481 75822 $ 6,627.50 ACTIVE

48100100VENOGRAPHY, EXTREMITY, UNILATERAL S & I

481 75820 $ 5,561.50 ACTIVE

48100013 VENT & ATRIAL ANGIO S&I 481 93556 $ 1,020.74 ACTIVE

41000017 VENT MANAGEMENT 1ST DAY 410 94002 $ 7,801.00 ACTIVE

41000016 VENT MGMNT SUBSEQUENT 410 94003 $ 1,648.52 ACTIVE

27000764 VENTILATOR CIRCUIT 270 A4618 $ 72.00 ACTIVE

25900214 VERAPAMIL 80MG TAB 250 J8499 $ 24.00 ACTIVE

32000047 VERT HEAD&NECK 320 75685 $ 14,808.78 ACTIVE

40200058 VESSEL MAPPING 402 G0365 $ 2,500.00 ACTIVE

25901208 VIGAMOX 0.5% OPHTH SOL 250 J3490 $ 58.00 ACTIVE

30200205 VIRUS ANTIBODY NES 302 86790 $ 171.72 ACTIVE

30600028 VIRUS INOCULATION TISSUE 306 87252 $ 202.86 ACTIVE

30600097VIRUS ISOLATION ENHANCED (SHELL VIAL)

306 87254 $ 72.45 ACTIVE

32000048 VISCERAL W/FLUSH 320 75726 $ 7,242.00 ACTIVE

30500049 VISCOSITY 305 85810 $ 155.64 ACTIVE

92200005 VISUAL EVOKED POTENT TEST 922 95930 $ 1,738.80 ACTIVE

30100415 VITAMIN A 301 84590 $ 154.80 ACTIVE

25901213 VITAMIN A&D OINT. 2 OZ. TUBE 257 A6250 $ 64.00 ACTIVE

25901127VITAMIN B1 THIAMINE 100MG TAB

250 J8499 $ 24.00 ACTIVE

30100416 VITAMIN B-12 301 82607 $ 201.00 ACTIVE

25900814 VITAMIN B3 NIACIN 500MG CAP 250 J8499 $ 24.00 ACTIVE

30100414 VITAMIN B-6 301 84207 $ 374.64 ACTIVE

25900125VITAMIN C ASCORBIC ACID 500MG TAB

250 J8499 $ 24.00 ACTIVE

30100062 VITAMIN D 25 OH 301 82306 $ 394.68 ACTIVE

25901923VITAMIN D3 CHOLECALCIFEROL 400IU TAB

250 J8499 $ 24.00 ACTIVE

30000055 VITAMIN K 300 84597 $ 182.88 ACTIVE

25000473VITAMIN K1 PHYTONADIONE 1MG/0.5ML

250 J3430 $ 159.00 ACTIVE

30100421 VOLATILES 301 84600 $ 214.44 ACTIVE

27000009VORTX - 18 DIAMOND SHAPE FIBERED PLATINUM COILS

270 C1729 $ 370.00 ACTIVE

27000460 WALKER BOOT LOW TOP 274 L4387 $ 584.00 ACTIVE

27200672 WAND TURBO VAC 272 A4649 $ 1,696.00 ACTIVE

25901222 WARFARIN 5MG TAB 250 J8499 $ 24.00 ACTIVE

27000599 WASH PERINEAL 270 A4649 $ 72.00 ACTIVE

27000575 WATER STERILE 1000ML 272 A4217 $ 88.00 ACTIVE

25901921 WATER, STERILE 250ML IV 250 A4217 $ 6.20 ACTIVE

42000044 WC MGT TRAIN EA 15MIN 450 97542 $ 224.00 ACTIVE

41000023 WEANING / EXTUBATION 410 31500 $ 750.00 ACTIVE

27000461WEBRIL NONSTERILE CAST PADDING

270 A4649 $ 16.00 ACTIVE

96000001WEDGE EXCISION OF SKIN OF NAIL FOLD (MATRIXECTOMY)

960 11765 $ 484.65 ACTIVE

25901228 WELLBUTRIN SR 150MG 250 J8499 $ 37.50 ACTIVE

30100422 WESTERN BLOT (HU SCREEN) 301 84181 $ 227.04 ACTIVE

30200207WESTERN EQUINE ENCEPHALITIS

302 86654 $ 175.80 ACTIVE


Charge Amt Status

Charge Master List

30600093WET MOUNTS INCLUDING PREPARATIONS OF VAGINAL CERVICAL OR SKIN SPECIMEN

306 Q0111 $ 69.78 ACTIVE

25901924WHITE PETROLATUM/LIGHT MINERAL OIL O/O 3.5GM

250 A6250 $ 11.25 ACTIVE

39000001WHOLE OR RED BLOOD CELLS LEUKOCYTES REDUCED FROZEN DEGLYCEROL WASHED EACH UN

390 P9054 $ 3,825.36 ACTIVE

27000609 WIPES ALOE VERA 270 A4649 $ 252.00 ACTIVE

27200636WIRE GUIDE HYDROPHYLIC 035DIA/180 CM

272 C1769 $ 747.00 ACTIVE

27200869WIRE WITH OLIVE DIA 2.0X450 MM

272 C1713 $ 1,212.75 ACTIVE

42000046 WORK REINTG TRAIN 15 450 97537 $ 225.18 ACTIVE

45000003WOUND CLOSURE TISSUE ADHESIVE ONLY

450 G0168 $ 798.00 ACTIVE

32000223 WRIST 2 VIEWS 320 73100 $ 1,401.50 ACTIVE

32000222 WRIST 3V OR MORE 320 73110 $ 1,692.50 ACTIVE

32200007 WRIST ARTHROGRAPHY 322 73115 $ 2,618.56 ACTIVE

27000775WRIST HAND FINGER ORTHOSIS (WHFO), WITHOUT JOINT(S), PREFABRICATED

270 L3809 $ 664.18 ACTIVE

27400009WRIST HAND FINGER ORTHOSIS (WHFO), WITHOUT JOINT(S), PREFABRICATED

274 L3807 $ 664.18 ACTIVE

25901235 XANAX 1MG TAB 250 J8499 $ 30.00 ACTIVE

25000869XARELTO RIVAROXABAN 10MG TAB

259 J8499 $ 54.80 ACTIVE

25901675 XENADERM OINTMENT 30GM 250 A6250 $ 59.00 ACTIVE

36000100XPOSE FOR ENDOPROSTH FEMORL BI-LAT

360 34812 $ 9,940.00 ACTIVE

32000224 XR GB/PAN INTRAOP ADD SET 320 74301 $ 1,358.84 ACTIVE

25901244 XYLOCAINE 2% JELLY 30GM 250 A6250 $ 327.00 ACTIVE

30100423XYLOSE ABSORBTION TEST BLOOD/URINE

301 84620 $ 157.92 ACTIVE

30000043 Y SET TUBING 272 S1015 $ 30.00 ACTIVE

25901246 ZANAFLEX 4MG TABS 250 J8499 $ 37.50 ACTIVE

25901248 ZANTAC 150MG TABLET 250 J8499 $ 60.00 ACTIVE

25901255 ZESTRIL 10MG TABLET 250 J8499 $ 24.00 ACTIVE

25901696ZIDOVUDINE (RETROVIR) 300MG TAB

250 J8499 $ 17.30 ACTIVE

30100424 ZINC 301 84630 $ 151.80 ACTIVE

25901261 ZINC OXIDE OINTMENT 30GM 250 A6250 $ 14.00 ACTIVE

25901266 ZITHROMAX 250MG TAB 250 Q0144 $ 118.00 ACTIVE

25000654ZITHROMAX 500MG IN 250ML NS (P

250 Q0144 $ 484.00 ACTIVE

25901267ZITHROMAX ORAL 200MG/5ML 30ML

250 Q0144 $ 439.50 ACTIVE

25901925 ZOLMITRIPTAN 5MG ODT 250 J8499 $ 15.48 ACTIVE

25901272 ZOLOFT 100MG TABLET 250 J8499 $ 60.00 ACTIVE

63600180ZOSTER SHINGLES VACC 0.65ML SDVIAL

636 90736 $ 424.00 ACTIVE

25901278 ZOVIRAX 200MG CAPS 250 J8499 $ 45.00 ACTIVE

25901282 ZOVIRAX 400MG TAB 250 J8499 $ 121.50 ACTIVE

25901290 ZYRTEC-D 12HR TAB 250 J8499 $ 16.00 ACTIVE

Documents

EHS-Active Charge Master-1-24-20...EHS-Active Charge Master-1-24-20 ... &0