charge code description charge amount

4 CATH TRAY TRIPLE LUMEN $218.006 BRUSH FLEX SCOPE CLEANING $8.769 CATH SET ARTERY $36.00

11 CATH TWIN 18-20 16GA $20.1612 CATH TWIN 20-22 18GA $19.9215 CATH TRAY INF CENTRAL VEIN $42.7218 INTRODUCER PERCUTANEOUS 8.5FR $62.7420 TRAY PNEUMOTHORAX $146.2227 BLADE MINI 67 $3.7044 PILLOW ABDUCTION WEDGE MED $68.7246 COLLECTION SET DISP $19.2058 ELECTRODE BALL LOOP 5 MM $26.8872 CLAVICAL STRAP XLARGE $21.1775 ELECTRODE LOOP 10X10CM ROUND $26.4076 SPLINT UNIV KNEE 20" $46.3077 SPLINT UNIV KNEE 24" $50.6478 ELECTRODE LOOP 15X8MM ROUND $26.4079 SPLINT UNIV KNEE 26" $56.3483 SPLINT UNIV KNEE 16" $41.5484 SPLINT UNIV KNEE 18" $43.9485 BLADE SURGICAL CLIPPER $7.5886 ELECTRODE LOOP 20X8MM ROUND $26.4087 SPLINT UNIV KNEE 22" $57.8988 SPLINT UNIV KNEE 28" $50.1893 ELECTRODE LOOP 10X8MM SQUARE $26.4096 VACURETTE 7MM CVD $11.28

101 VACURETTE 10MM CVD $11.28103 TOP ACMI BERKLEY SUCTION $13.44105 SHOE POST OP WOMENS SMALL $22.32106 SHOE POST OP WOMENS MEDIUM $22.32108 SHOE POST OP WOMENS LARGE $22.32109 SHOE POST OP MENS SMALL $22.32110 POST OP SHOE MENS MEDIUM $22.32111 POST OP SHOE MENS LARGE $22.32114 SLING VELPEAU MEDIUM $12.98116 SLING VELPEAU XLARGE $12.98117 SLING VELPEAU LARGE $12.98118 IMMOBILIZER SHOULDER XL $14.42123 IMMOBILIZER SHOULDER LARGE $14.42124 SLING ARM SMALL $10.15125 SLING ARM MEDIUM $10.15126 SLING ARM LARGE $10.15127 SLING ARM XLARGE $10.15141 ARTHO CARTRIDGE SNGL PUMP $176.40142 BONE CEMENT $182.45

144 ARTHO CANNULA SHOULDR INST7X7 $72.75145 CLIP FILSHIE AVALON PK-2 $150.26147 EAR DRESSING KIT $35.04150 SPLINT FIXED ANKLE SMALL $86.00152 SPLINT FIXED ANKLE MEDIUM $54.00153 SPLINT FIXED ANKLE LARGE $86.00157 MARKER ENDOSCOPIC SPOT 5ML $47.76164 TRACTION BOOT LARGE $41.18166 TUBE GASTROSTOMY 12 FR 5CC $88.83170 TUBE GASTROSTOMY 14 FR $78.96171 KIT GASTRIC LAVAGE EASI LAV 34 $98.00173 TRAY PARACENTESIS $102.00175 CATH TRAY GROSHONG $477.75179 TUBE GASTROSTOMY 20 FR MIC $78.96182 TRAY GROSHONG REPAIR 8FR $177.86183 TUBE GASTROSTOMY 24 FR $78.96186 TUBE GASTROSTOMY 18 FR $68.00188 TUBE GASTROSTOMY 28 FR $78.96197 TRAY SPINAL W/MARCAINE $32.64212 AMNIHOOK CURVED MITYHOOK $3.00213 MITYONE M STYLE VACUUM EXTRACT $62.00214 HANDLE DELTA FLO SUCTION $40.87224 BANDAGE SPANDAGE SIZE 6 $2.25225 BANDAGE SPANDAGE SIZE 7 $5.64226 BANDAGE SPANDAGE SIZE 8 $9.36227 BANDAGE SPANDAGE SIZE 9 $12.00229 BANDAGE SPANDAGE SIZE 10 $17.45242 SOLUTION ANTI FOG $10.18244 CATH CONT IRRG 16FR 30CC $55.50245 PACK ARTHROSCOPY $161.84247 CATH CONT IRRG 18FR 30CC $47.93254 BANDAGE ESMARK 4" $5.57257 BANDAGE ESMARK 6" $12.24277 MESH MARLEX PERFIX PLUG LG $324.00278 MESH MARLEX PERFIX PLUG XLG $379.00279 MESH MARLEX PERFIX MED $321.00280 MESH MONIFIL KNIT 6 X 6 IN $121.50288 POLYP TRAP $21.00289 BLANKET EBI KNEE $83.07294 NEEDLE EPIDURAL TOUHY 18GA 6IN $19.20297 CHIPS BONE DRIED 30CC $621.25298 CHIPS BONE DRIED 15CC $511.88304 AMNIHOOK STRAIGHT $3.72306 SPECBOARD $45.60310 PLASTIBELL 1.1 CM $7.32312 PLASTIBELL 1.2 CM $7.68316 PLASTIBELL 1.3 CM $7.32

345 CATH CONT IRRG 20FR 30CC $51.29346 CATH CONT IRRG 22FR 30CC $51.29347 CATH CONT IRRG 24FR 30CC $55.50348 CATH COUDE TIP 20FR 5CC $47.18349 CATH COUDE TIP 16FR 5CC $19.00350 ARGON HAND PENCIL ABC $83.03351 PROBE ARGON FLEX ABC 2.3MM $388.34352 PROBE ARGON LAP ABC 5MM $181.93353 CATH COUDE TIP 18FR 5CC $19.00354 CATH COUDE TIP 22FR 5CC $47.18355 CATH COUNCIL TIP 16FR 5CC $55.16356 CATH COUNCIL TIP 18FR 5CC $54.43360 CATH FOLEY SILICONE 20FR 5CC $9.12361 CATH FOLEY 8FR 3CC $31.39362 CATH FOLEY 10FR 3CC $23.40363 CATH FOLEY 12FR 5CC $22.01364 CATH FOLEY 14FR 5CC $15.50365 CATH FOLEY 16FR 30CC $22.80366 CATH FOLEY 16FR 5CC $15.50367 CATH FOLEY 18FR 5CC $14.60368 CATH FOLEY 20FR 30CC $10.00369 CATH FOLEY 20FR 5CC $14.71370 CATH FOLEY 22FR 5CC $21.99371 CATH FOLEY 24FR 30CC $19.56372 CATH FOLEY 26FR 30CC $24.00377 CATH URET ALL PURPOSE 10FR $1.44378 CATH URET ALL PURPOSE 12FR $2.90379 CATH URET ALL PURPOSE 14FR $4.37397 CATH URET ALL PURPOSE 16FR $1.44399 CATH URET ALL PURPOSE 18FR $4.06404 CATH SUCTION 5/6FR PEDI $1.00409 CANNISTER KIT VAC $141.71411 DRESSING VAC MED 7.1" $86.40412 DRESSING VAC LARGE 10.1" $124.04414 PAD ELECTRODE QUIK COMBO $52.70419 RETRACTOR REDDICK SAYE SCREW $313.25435 CAUTERY SURGICAL HI TEMP $26.16443 DRAIN J.P. FLAT 7MM $12.74444 DRAIN J.P. FLAT 10MM $13.68445 DRAIN J.P. ROUND 15FR $12.03473 CORD BI-POLAR $4.13478 DRAIN PENROSE 1/4 X 18 $1.00480 STOCKINETTE IMPERVIOUS MED $12.00482 DRAIN PENROSE 1/2 X 18 $1.00485 DRAIN PENROSE 3/4 X 18 $1.00488 DRAIN PENROSE 1 X 18 $1.00490 STOCKINETTE IMPERVIOUS LG $13.13

492 HOLDER INSTRUMENT INSTRA MAG $6.34495 DRESSING OPTIFOAM 6X6 $26.00496 IRRIG GLYCINE 3000ML $15.19497 DRESSING OPTIFOAM 4X4 $11.64498 TRAY LUMBAR PUNCTURE INFANT $24.00506 DRESSING SILVA SORB SHEET $29.00508 DRESSING COMP STRATASORB 4X4 $4.60509 IRRIGATION SALINE 0.9% 15ML $1.00512 NEEDLE TRU CUT BIOPSY 18GA $48.96513 DRESSING EXUDERM HYDRO 2X2 $2.00517 DRESSING EXUDERM SACRUM 4X3.6 $12.00518 DRESSING EXUDERM SACRUM 6.5 $26.00519 PAD PREP (OB) $1.88528 TENDERFOOT HEEL DEVICE $9.00543 VISCERA RETAIN (FISH) $81.86545 CORD MONOPOLAR DISP $23.04548 ELECTROSURGICAL TIP CLEANER $1.34553 ELECTROSURGICAL COAG SUCT TUBE $14.70556 COVER EASY 36 X 28 $4.10601 ELECTRODE CUTTING LOOP 24FR $127.50609 LTA KIT ADULT $11.50613 PACK FESS SEPTO CUSTOM $180.20618 BLADE SAGITTAL SAW NARROW THIN $112.33622 LINE GAS SAMPLING C02 120" $1.85623 BRUSH FEM CANAL W/SUCT /IRRIG $28.80625 PACK HIP REPLACEMENT (TOTAL) $561.73627 SYRINGE KIT ACM MIX/CART $183.70630 PACK KNEE (TOTAL) $971.92642 PACK OB CUSTOM $62.76647 SPONGE K DISSECTOR $1.00649 SPONGE TONSIL 1 1/4 EACH $13.63651 J.P. DRAIN KIT $21.65660 IRRIG/SUCT SURGILAV W/TIP $80.42663 CYSTOSCOPY SET $10.20667 MIX EVAC BOWL $100.40671 PACK T & A CUSTOM $183.26679 PAIN CONTROL INF SYSTEM $220.50680 TUBING INSUFLATION W/FILTER $13.37686 CIRCUITS BREATHING ADULT $16.43687 CIRCUIT BREATHING 1 LITER PEDI $7.00689 GASTROSTOMY INTRO KIT 18 FR $245.00693 CIRCUIT BREATHING 2 LITER PEDI $14.06707 IRRIGATION SOD CHL 500 ML $8.00714 IRRIGATION SOD CHL 1000 ML $2.18717 IRRIGATION SOD CHL 1500 ML $3.48719 IRRIGATION SOD CHL P/500ML $11.15731 SECONDARY IRRIGATION SET $6.86

731 STAPLER LINEAR CUTTER 75 X 3.8 $321.95735 IRRIG WTR STERILE BAG 1000ML $7.50736 IRRIG WTR STERILE BAG 1000ML $5.95737 IRRIG WTR STERILE BAG 3000ML $13.15746 IRRIG WTR STERILE BAG 500ML $8.00765 ADAPTER CONNECTOR DBL SWIVEL $14.04770 AIRWAY NASOPHARYNGEAL 24 $13.87771 AIRWAY NASOPHARYNGEAL 24 $9.74772 AIRWAY NASOPHARYNGEAL 32 $9.65773 AIRWAY NASOPHARYNGEAL 34 $9.65774 AIRWAY NASOPHARYNGEAL 36 $29.38775 AIRWAY NASOPHARYNGEAL 28 $9.74776 AIRWAY NASOPHARYNGEAL 30 $9.65777 ANOSCOPE $2.61784 BLANKET FULL BODY CAREQUILT AD $17.59785 BLANKET UPPER BODY CAREDRAPE $22.85789 BANDAGE COMPRSS COMPRLN 4.7 $16.34790 BANDAGE SYSTEM PROFORE $32.04792 BAG BILE $30.17793 DRESSING AQUACEL 2X2 $8.02795 BILIMASK NURSERY $6.29800 NEEDLE REGIONAL BLOCK $7.73801 NEEDLE SPINAL 18GA X 3 1/2 $4.13802 NEEDLE SPINAL 20GA X 3 1/2 $4.13803 NEEDLE SPINAL 22GA X 1 1/2 $4.13804 NEEDLE SPINAL 22GA X 3 1/2 $4.13805 NEEDLE SPINAL 25GA X 3 1/2 $4.13806 NEEDLE SPINAL QUINCKE 22GA X 5 $12.53808 BANDAGE SCOTCHCAST 3 INCH $8.66809 BANDAGE SCOTCHCAST 4 INCH $11.42811 CATH THORACIC $30.84812 WEBRIL ROLL 6 IN X 4 YD $6.70813 CATH THORACIC 28 FR $30.84814 WEBRIL ROLL 2 IN X 4 YD $1.58815 WEBRIL ROLL 3 IN X 4 YD $2.11816 WEBRIL ROLL 4 IN X 4 YD $2.98817 CATH THORACIC 32 FR $16.44818 X-MAS TREE CATH ADAPTER $2.30822 CATH SUCTION 14 FR $1.00823 CATH SUCTION 18 FR $1.00824 CATH TROCAR 8FR $30.70826 CATH TROCAR 12FR $30.70827 CATH TROCAR 16FR $40.46831 SPONGE SUPER AMD #6665 $3.86840 STYLET INTUBATING 5FR PEDI $7.58841 SURGICEL 2 X 14 INCH STERILE $80.44842 TRAP DELEE MUCOUS 10FR $3.50

848 CATH FOLEY 14FR 30CC $15.73849 CATH FOLEY 18 FR 30CC $19.56850 CATH FOLEY 22FR 30CC $16.95858 CATH MALECOT 26FR $23.40861 CATH SUCTION 10 FR $1.00862 CATH SUCTION 5 FR PEDI $1.00864 CATH SUCTION 8 FR PEDI $1.00868 CATH FOLEY SILICONE 16FR 5CC $11.40872 CATH FOLEY SILICONE 22FR 5CC $19.70874 CATH FOLEY SILICONE 24FR 5CC $14.59880 DRAPE IOBAN 2 35CM X 35CM $9.92881 DRAPE IOBAN 2 60CM X 45CM $15.13883 TRAY DRESSING CHANGE W/TEGADRM $9.88884 COVERLET OR DRESSING 3 X 4 IN $1.30886 COVERLET OR DRESSING 4 X 8 IN $2.21891 DRESSING POLYMEM WOUND CARE $11.37893 CRUTCHES ALUM ADULT $30.68894 CRUTCHES ALUM ADULT TALL $30.68895 DRESSING EXERDERM HYDRO 4X4 $9.31896 CRUTCHES ALUM YOUTH $30.68898 DRESSING EXERDERM 4 X 4 LP $7.06904 DRESSING DUODERM 8 X 8 $28.85907 NEEDLE ILLIAC ASPIRATION 16GA $27.00916 ELECTRODE SPIRAL SCALP $8.62918 CARPAL TUNNEL RELEASE KIT $347.06919 NEEDLE MARTIN UTERINE 1/2 CIRC $4.68930 ELECTRODE T.E.N.S. 2 IN SQ $12.75931 PH BRAVO CAPSULE $813.00932 ELECTRODE TENS 3 IN RND $19.08934 CERVICAL ROLL MCKENSIE $23.16936 TRAY EPIDURAL $56.23937 STETH ESOPHOGEAL 12FR $5.21940 LUMBAR ROLL 701 $21.72941 STETH ESOPHOGEAL 18 FR $5.40943 BOOK TREAT BACK PM 802-7* $16.80944 FACIOPLASTY SUPPORT SM $64.53945 BOOK TREAT NECK $15.60947 FACIOPLASTY SUPPORT MED $64.51948 FACIOPLASTY SUPPORT LARGE $64.53953 GAUZE IODOFORM 0.25 IN $8.76954 NON STERILE KLING $1.00955 GAUZE IODOFORM 0.5 IN $7.68956 KLING BANDAGE 3 IN $1.00957 GAUZE IODOFORM 1.0 IN $9.00958 KLING BANDAGE 4 IN $1.27959 GAUZE IODOFORM 2.0 IN $13.08960 KLING BANDAGE 2 IN $1.00

962 KLING BANDAGE 6 IN $1.61964 TRAY LACERATION $11.00967 NEEDLE SPINAL WHIT 22GA $14.98968 NEEDLE SPINAL WHIT 25GAX3 1/3 $14.98969 NEEDLE TONSIL 1/2 CIR TPR $2.63973 OPSITE 5 1/2 X 4 $2.04974 OPSITE 5 1/2 X 10 $6.00975 PASTE STOMAHESIVE $11.14976 OPSITE 4 X 11 $5.02978 SPONGE OPTIPORE $3.17979 LIGACLIP APPLIER MCL 20 LG $114.42980 LIGACLIP APPLIER MED LONG 30 $411.00987 SCALPEL DISP #10 $1.56988 SCALPEL DISP #11 $1.56989 LENS MORGAN $54.74990 SCALPEL DISP #15 $2.00991 TUBING MAXIFLEX SUCTION STERL $1.00993 SIGMOIDOSCOPE $5.57995 SENSOR SKIN TEMP SHER-I-TEMP $4.87997 MESH SURGIPRO OPEN WEAVE 3X5 $94.50

1002 DRESSING CURASORB PLUS 4X4 $9.601007 IRRIGATION SOD CHL 120ML CUP $1.201010 STAPLE TA 55-3.5 (NON-DISP) $114.381014 STAPLE GIA 30 ENDO 3.0-2.5 $186.801036 SYRINGE 60CC TOMMEY TIP $2.331046 STAPLER 15 SHOT PRECISE $12.001048 STAPLER SKIN $19.991049 DRAPE STERI 1010 $4.011051 DRAPE STERI 1020 $3.891052 DRAPE STERI 1021 $4.221071 DRAPE STERI 1050 $8.501074 DRAPE STERI 1092 $4.301075 BLADE SURGICAL SCALPEL NO.10EA $1.001079 BLADE SURGICAL SCALPEL NO.11EA $1.001082 KIT SUTURE REMOVAL $1.441083 BLADE SURGICAL SCALPEL NO.12EA $1.641084 BLADE SURGICAL SCALPEL NO.15EA $1.001086 BLADE SURGICAL SCAPEL NO.15 EA $1.001117 DRESSING PAD TELFA 3IN X 4IN $1.001118 DRESSING PAD TELFA 3IN X 8IN $1.001120 THORA SEAL $107.201122 PUMP SET EZ CAP 1000ML $6.411147 TUBE FEED INFANT 8 FR 42 IN $1.001148 TUBE FEED INFANT 8 FR 15 IN $1.001150 TUBE FEED INFANT 5 FR 15 IN $1.001152 TUBE SALEM SUMP 16 FR $4.101153 TUBE SALEM SUMP 18 FR $4.08

1160 TUBE SPIRAL FLEX 7.0 MM $49.301161 TUBE SPIRAL FLEX TRACH 7.5 MM $49.301162 TUBE SPIRAL FLEX TRACH 8.0 MM $49.301172 TUBE T 18 FR $39.551176 DRAPE TUR UROLOGICAL $11.741205 POUCH COLOSTOMY 4 IN 100CM $5.901220 TRAY LUMBAR PUNCTURE ADULT $30.501228 VESSEL LOOPS PK 2 $2.671236 GELFOAM 50 $38.571239 GELFOAM 100 $55.171240 SPLINT ARTERIAL WRIST/HAND $23.781252 LIGACLIP HEMOCLIP SMALL $6.771253 LIGACLIP HEMOCLIP MED $7.921254 LIGACLIP HEMOCLIP LRG $14.471256 SPONGE NEURO $4.601257 TOURNIQUET CUFF 18" SINGLE $55.581258 TOURNIQUET CUFF 24" SINGLE $52.181260 TOURNIQUET CUFF 34" SINGLE $59.861261 TOURNIQUET CUFF 44" SINGLE $68.641314 CAUTERY PENCIL W/HOLSTER YLLW $8.331315 HEAD POSITIONER SQUARE $10.581316 HEAD REST HOLE IN ONE ROUND $3.741413 CATH BALLIN URET DIL 7FR 40CM $185.281431 CATH BALLN SUPRA RUT 16/22 $81.291441 CATH FLEX TIP URET 5FR 70CM $22.871444 CATH SPIRAL TIP URET 5FR $25.681456 CATH RUTNER WEDGE 5FR $22.441457 CATH STAMEY SUPRAPUPIC $61.941458 GUIDEWIRE .038CM X 145CM $30.791461 FORCEP DOUBLE JAW ALLIGATOR $470.351463 GUIDEWIRE RR STRT 035 145 $71.401465 GUIDEWIRE AMPLATZ X-STIFF .038 $51.421467 SHEATH FLEXO URET ACCESS12/20 $308.441471 SHEATH FLEXO URET ACCESS12/28 $198.281472 SHEATH FLEXO URET ACCESS12/35 $198.281481 STONE EXTRACT HELICAL 3WR 3.2F $298.851485 CONTAINER SPECIMAN 16OZ $1.001487 IRRIGATOR LAP STRYKFLOW II $74.001488 CONTAINER SPECIMAN 32OZ $1.001494 SPONGE LAP 18 X18 $2.741495 SPONGE VISITEC $1.801496 STOCKINETTE TUBULAR 2 IN $1.001498 STOCKINETTE TUBULAR 4 IN $1.581501 ELECTRODE KITTY PREWIRE SM $5.281513 CATH TRAY ARTERIAL LN 18G 6IN $48.781520 PROBE SKIN TEMP OHMEDA $19.201521 PROBE SKIN TEMP SPACE LAB $11.26

1527 CLAMP BABCOCK 10MM ENDO $156.001528 SHEARS MINI 5MM ENDO $135.221530 APPLIER ENDO CLIP 5MM $971.001536 HANDLE ENDO GIA UNIVERSAL $298.851540 ENDO PADDLE RETRACT 12MM $209.301542 ENDO STITCH POLY 3-0 48INCH $53.381544 VACURETTE CURVED 8MM $11.501547 NDL INSUFLATION VERSASTEP 14GA $81.001549 NDL INSUF VERSASTEP 14GA LONG $44.711550 STAPLER PURSTRING 65 $156.001552 SLEEVE VERSASTEP EXPAND 12MM $110.931554 VACURETTE CURVED 12MM $10.341557 SLEEVE VERSASTEP EXPAND LONG $89.741558 STAPLE ENDO GIA ROTIC 30-2.5 $261.501560 STAPLE ENDO GIA ROTIC 60-3.5 $408.031561 STAPLE ENDO GIA ROTIC 60-2.5 $420.281567 STAPLE GIA MULTI 60-3.8 $106.981570 STAPLE MULTI ENDO GIA 30-3.5 $322.231571 STAPLER MULTI ENDO GIA 30-2.5 $420.281572 STAPLER STAT TACK 5MM $302.591575 STAPLER PRO TACK 5MM $515.531577 STAPLER SKIN PREM 35 $52.101578 STAPLER GIA 60 MULTI 3.8 $175.491582 BUTTON FIXATION 17MM $91.111588 STAPLER EEA 31 4.8 MM $583.401589 SUTURE RETRIEVER HEWSON $162.001590 STAPLER EEA 28 4.8 MM $1,803.001591 STAPLER LDS 15W $278.461593 SURGITIE LIGATING LOOP STERILE $51.241595 TROCAR VERSASTEP 12MM LONG $150.891596 OBLATOR 90 DEG 3MM PROBE $286.651597 TROCAR VERSASTEP 5MM LONG $102.581598 TROCAR VERSASTEP 5MM $261.001599 TROCAR VERSASTEP 11MM $125.781601 TROCAR VERSASTEP 12MM $277.001603 CAST ORTHO GLASS 2IN X 1FT $7.871604 CAST ORTHO GLASS 3IN X 1FT $10.871605 SLING ARM XSMALL $10.151608 BLADE BROWN DERMATOME $55.951609 HEMOVAC 19FR W/TROCAR $29.141610 DERMACARRIER 1 1/2/1 $45.941611 DRAPE Z XRAY CASSETTE $9.261612 CONNECTOR STRT TEE W/LUER $1.621620 EPIDISC OTOLOGIC LAMINA 8MM $145.001630 DRILL BIT 3.8MM $115.501631 CAST ORTHO GLASS 4IN X 1FT $13.061632 CAST ORTHO GLASS 5IN X 1FT $16.27

1633 CAST ORTHO GLASS 6IN X 1FT $19.561634 BLADE SPIRAL GIGLI SAW 20 IN $40.321635 SUTURE MAXON 0 T-12 36IN $6.001637 SUTURE MAXON 1 60IN $14.591638 SUTURE MAXON #1 T-60 60IN $14.161643 SUTURE MONOSOF 4-0 C-14 18IN $3.771649 SUTURE TI CRON 1 C-40 30IN $6.341652 SUTURE SURGIGUT 2-0 GS-21 36IN $5.401653 SUTURE SURGIGUT 2-0 V-20 30IN $4.991655 SUTURE CHROMIC 4-0 T-5 27IN $2.931668 EPIFILM OTOLOGIC LAM 2.5X2.5 $309.751670 EYE SHIELD LEFT $3.801671 EYE SHIELD RIGHT $3.801674 SUTURE CHROMIC 2-0 CE-6 27IN $5.421675 SUTURE CHROMIC 5-0 PS-2 27IN $6.341676 SUTURE CHROMIC 3 18IN $3.101680 SUTURE WAX BONE ETHICON 2.5 GM $10.751683 JUHN TYM TAP COLLECT $24.961687 SUSPENSORY SCROTAL SMALL $9.221689 SUSPENSORY SCROTAL MEDIUM $9.001690 SUTURE SILK 4-0 18IN $7.131691 SUSPENSORY SCROTAL LARGE $9.001693 SUSPENSORY SCROTAL XLARGE $21.121704 SUTURE VICRYL 8-0 5IN $55.151706 SUTURE VICRYL 9 5IN $47.921709 SUTURE ETHILON 8-0 12IN $41.601720 SUTURE CHROMIC 5-0 18IN $20.171721 SUTURE CHROMIC 4-0 P-2 18IN $37.441728 SUTURE PROLENE SIZE 6 18L $11.231729 SUTURE PLAIN 6-0 18IN $21.501730 SUTURE ETHILON 6-0 18IN $15.701732 SUTURE CHROMIC 6-0 18IN $12.851741 SUTURE CHROMIC #1 18IN $5.141742 SUTURE CHROMIC 4-0 CV-24 30IN $4.971743 SUTURE SURGIPRO 4-0 CV-23 18IN $6.101745 SUTURE SOFSILK 3-0 V-20 30IN $3.171746 SUTURE SOFSILK 0-0 PRECUT 30IN $3.221748 NASO TAMPON $22.081749 NERVE STIMULATOR $84.601750 OTOWICK POPE MEROCEL $4.611752 THERMASPLINT SINGLE MED $28.561753 TUBE COHEN PK-2 $46.801757 TUBE LASER TRACH 7.0MM $200.181761 SPEARS SURGICAL $3.211765 SPLINT NASAL DOYLE II $76.501769 SUTURE CHROMIC GUT3-0 V-20 30" $2.861782 SUTURE SURGIGUT #1 GS-21 36IN $5.57

1783 SUTURE MONOSOF 3-0 C-14 18IN $2.831784 SUTURE MONOSOF 2-0 C-15 30IN $8.621787 SUTURE CHROMIC GUT0-0GS-21 36" $5.401793 SUTURE ETHIBOND 2-0 CT-2 $4.391803 SUTURE ETHILON 4-0 P-13 18IN $17.461806 SUTURE NOVAFIL 4-0 P-12 18"L $13.221808 SUTURE DEXON 2-0 C-9 27IN $6.861810 SUTURE SILK 0 V-20 30IN $4.151816 TUBING PRIMARY P/B MICRO $23.281817 PAD ATTACHMENT SAFELINC $23.501821 CATH UMBILICAL 5FR $32.811826 SUTURE ETHIBOND 0-0 CT-2 $7.271828 SUTURE MAXON 3-0 T-19 27IN $6.051830 SUTURE TI CRON 2-0 T-56 30IN $6.121834 SUTURE PDS #1 TPI 49IN $10.321842 SUTURE MONOSOF 3-0 C-14 30IN $3.701843 SUTURE MONOSOF 4-0 C-13 18IN $3.671847 SUTURE SOFSILK 1-0 PRECUT 30IN $4.821851 SUTURE DEXON 0 T-12 36IN $6.911855 SUTURE DEXON #1 T-12 36IN $4.101857 SUTURE DEXON #1 TT-20 18IN $5.831860 SUTURE ETHIBOND 1-0 HOS-10 30" $15.341861 SUTURE TI CRON #5 C-20 30"L $9.721877 SUTURE NOVAFIL 3-0 PRE-4 18IN $13.491878 SUTURE NOVAFIL 5-0 PRE-4 18IN $7.341879 SUTURE NOVAFIL 5-0 PRE-2 18IN $9.531880 SUTURE NOVAFIL 6-0 PRE-3 18IN $13.221881 SUTURE CHROMIC GUT5-0 PC-1 18" $13.081889 SUTURE MONOSOF 4-0 P-13 18"L $7.801892 SUTURE CHROMIC GUT2-0 CT-1 36" $6.711899 SUTURE SILK 5-0 18IN $11.601900 SUTURE ETHILON 2-0 C-17 30IN $3.411920 SUTURE DEXON #2 T-12 36IN $5.061921 SUTURE DEXON 2-0 CE-6 36IN $4.821922 PACK CESAREAN BIRTH $238.361925 TUBING POOLE SUCTION $6.361927 SUTURE VICRYL #1 CP-2 $4.421930 SUTURE VICRYL 2-0 CT-1 27IN $3.791935 KIT EXERCISE ROCKWOOD PULLEY $36.001936 SUTURE PLAIN SIZE 4 18"L $7.511937 SUTURE DEXON II 4-0 C-41 18IN $10.251938 SUTURE PLAIN 2-0 GS-23 30IN $5.761942 SUTURE DEXON 4-0 CE-6 30IN $4.681943 SUTURE SURGIGUT 3-0 GS-24 30IN $5.061944 SUTURE SURGIPRO 2-0 GS-22 30IN $5.261945 SUTURE MONOSOF 0-0 C-13 18IN $3.671947 SUTURE SOFSILK 3-0 V-20 30IN $12.46

1948 SUTURE SOFSILK 2-0 V-20 30IN $12.461949 SUTURE CHROMIC 2-0 $4.131950 SUTURE CHROMIC 0 PRECUT 3X18IN $5.141951 SUTURE SOFSILK 2-0 V-20 30IN $3.171955 SUTURE PROLENE SIZE 2 TP-1 $12.101963 SUTURE CHROMIC GUT4-0 P-13 18" $10.151975 SUTURE CHROMIC GUT3-0 V-20 30" $5.021980 SUTURE SURGIPRO SIZE 0 30"L $6.621981 SUTURE SURGIPRO 2-0 GS-26 60IN $10.061982 SUTURE PLAIN GUT 0-0 TIES 90IN $5.401983 SUTURE VICRYL 3-0 CT-1 27IN $3.791984 SUTURE VICRYL 4.0 $4.041985 SUTURE VICRYL 1-0 PRE-4 18IN $10.221988 TUBING NITRO W/PUMP 1187812 $32.402002 SUTURE PDS 2-0 CT-2 27IN $12.382008 SUTURE MONOSOF 5-0 C-13 18IN $7.782010 SUTURE MONOSOF 3-0 C-17 30IN $3.652011 SUTURE MONOSOF 2-0 C-17 30IN $3.652012 SUTURE MONOSOF 4-0 P-24 18IN $7.372015 SUTURE SURGIGUT SIZE 4 30"L $5.232016 SUTURE CHROMIC GUT3-0 C-13 30" $3.982017 SUTURE CHROMIC GUT2-0 C-14 30" $6.142018 SUTURE CHROMIC GUT3-0 P-12 30" $9.652019 SUTURE SOFSILK 2-0 C-14 18IN $3.342020 SUTURE SOFISLK 2-0 PRECUT 30IN $4.822021 SUTURE SOFSILK 0-0 SC-2 30IN $3.632022 SUTURE SOFSILK 3-0 C-14 18IN $3.002023 SUTURE SOFSILK 2-0 C-15 18IN $3.342024 SUTURE SOFSILK 4-0 PRECUT 30IN $4.822025 SUTURE SOFSILK 6-0 P-13 18IN $7.732042 EASY CAP CO2 DETECTOR $22.252043 CATH TROCAR 28FR $44.702044 CATH TROCAR 32FR $44.702046 CATH CONT IRRG 26FR 30CC $46.402047 CATH COUNCIL TIP 20FR 5CC $59.802049 SNARE POLYPECTOMY MEDIUM $36.002079 RETRIEVAL BAL DISTAL INJ 11.5M $365.752080 RETRIEVAL BAL DISTAL INJ 15MM $365.752081 LOCKING DEVICE & BIOPSY CAP $24.242100 STENT BILIARY 7FRX12CM 035 $230.002101 STENT BILIARY 7FRX10CM 035 $183.152102 STENT BILIARY 7FRX7CM 035 $183.152103 STENT BILIARY 7FRX5CM 035 $230.002105 BRUSH CYTOLOGY 035 $206.002107 BASKET TRAPEZOID LITHO 5.0CM $407.932115 FORCEP RADJAW 3 PLU SERR 1.8 $182.652116 CATH ANGIO IV 16GAX5 1/4 $13.37

2117 CATH FOLEY 24FR 5CC $14.082119 CATH TROCAR 24FR $64.602125 PAD ELECTRODE QUIK COMBO $62.902130 LIGACLIP ENDO II MED/LNG $792.002131 ENDO STITCH DISP INST $205.472150 ELECTRODE ULTRACLEAN BLADE 1IN $10.742151 ELECTRODE ULTRACLEAN NEEDLE 6 $14.802152 ELECTRODE ULTRACLEAN BLADE 6IN $14.522155 STAPLER ENDO GIA UNIVERSAL $821.002156 MARKER SKIN W/RLR X-FINE TIP $2.852165 BOOT THERA REGULAR/UNIV. $142.962220 PROTECTOR CORNEAL CROUCH $15.122232 BLADE MINI 64 $2.502238 AMBU BAG ADULT $31.582239 AMBU BAG PEDIATRIC $44.512240 AMBU BAG NEONATE/INFANT $44.512241 CATH BALLARD SUCTION $27.312244 SPIROMETER PEDIATRIC INCENTIVE $19.182247 PAD OXYGEN CANNULA EZ-WRAP $1.652248 PEAK FLOWMETER $24.602249 TRACH CARE KIT $7.372250 HOLDER TRACH TUBE $10.002251 CPT ACAPELLA DH GREEN $85.562254 ADAPTER URETERAL CATH CONN $36.002258 CALCUCATCH $7.932259 STAPLE GIA 30 ENDO 30 2.0 $181.342316 BLADE SAGITTAL HEAVY STRT 12.5 $60.482547 SYRINGE GUAGE ASSEMBLY 60ML $72.152659 MESH VENTRALEX PATCH MED 6.4CM $898.002660 MESH HERNIA 3D MAX MED LEFT $399.002661 MESH HERNIA 3D MAX MED RIGHT $399.002662 MESH HERNIA 3D MAX LARGE LEFT $421.002663 MESH HERNIA 3D MAX LARGE RIGHT $421.002664 MESH VENTRALEX PATCH SM 4.3CM $750.002701 RENT BED-BARIATRIC WIDE P/DAY $63.002729 CABLE AND SLEEVE SET 173928000 $362.602778 RETRIEVAL NET ROTH 2.5MM $170.002786 GUARDS TEETH $3.252795 SCREW ACE LAG 135 X 90 MM $946.752796 PLATE ACE 4 HOLE $765.322798 SCREW ACE BONE 40 MM $104.942799 SCREW ACE BONE 42 MM $104.942820 TUBE GOODE-T EAR 1.15MM $52.562826 TUBE SHEPPARD GROMET W/WIRE $12.962829 DRAPE PROBE CABLE $18.582831 THERABAND RED MEDIUM L2 $8.752832 THERABAND YELLOW THIN L1 $8.88

2876 SPONGE NEURO ST SGL 1/2 X 1/2 $1.942877 SPONGE NEURO ST DBL 1/2 X 1/2 $1.002908 CATH HEMOST POST PROST 22X50CC $40.802909 CATH HEMOST POST PROST 24/50CC $40.802946 WASHER 7.0MM SYNTHES $59.942947 SCREW CANNULATED 4.0 X 36MM $407.042953 SCREW CORTEX SLFTP 3.5 X 14MM $58.802955 SCREW CORTEX SLFTP 3.5 X 20MM $60.002959 SCREW CORTEX SLFTP 3.5 X 16MM $58.802960 SCREW CANC FLLTHRD 4.0 X 20MM $50.402976 STYLET FLEX SLIP 12 FR $6.672989 SUTURE DEXON II 3-0 CE-6 $4.682990 ELECTRODE IONTOPH TRANS QE-MED $18.602995 VALVE GLAUCOMA AHMED $1,488.003014 PACK VAGINAL (KERLIX) STRL $5.503019 KIT PONSKY PEG DELUXE 20FR $173.003056 SUTURE SOFSILK 3-0 30IN $4.823191 MATTRESS-PORT-A-WARM $187.523215 CATH FOLEY SILICONE 18FR 5CC $11.713248 CATH WORD GLAND BARTHOLIN 5CC $43.273250 KNEE IMMOBILIZER INTRAOPERATE $90.653256 PUTTY EXERCISE GREEN $4.183257 PUTTY EXERCISE YELLOW $4.183287 THERABAND BLUE X-HEAVY $5.503288 THERABAND GREEN H L3;50 YRD R $5.003290 THERABAND BLACK SPECIAL HEAVY $12.503292 LENS S SN60AT POST ALL SIZE $150.003294 LENS S SN60WF POST ALL SIZE $150.003351 SUTURE VICRYL SIZE 4 FS2.27" $9.023352 PEDICAP-PEDI END TIDAL CO2 DET $22.253353 HOOKS ELASTIC STAY 5MM $101.883355 RETRACTOR SURGICAL BLADDER SUS $101.883359 TUBE TRACH ORAL RAE MALMED 8.0 $13.013360 NASAL PAC W/O AIRWAY 7.5 $59.803379 SCREW CORTEX SLFTP 3.5 X 12MM $58.803388 SCREW CORTEX SLFTP 2.7 X 22MM $34.803391 SCREW CORTEX SLFTP 2.7 X 16MM $57.003392 SCREW CORTEX SLFTAP 2.7 X 14MM $50.503396 DRILL BIT CANNULATED 2.7MM $921.603405 PUTTY EXERCISE RED $4.183420 SCREW ASNIS 2 GUIDED 6.5X105MM $371.703421 SCREW ASNIS 2 GUIDED 6.5X110MM $371.703426 SCREW CORTEX SLFTP 3.5 X 10MM $53.003427 SCREW CORTEX SLFTP 2.7 X 12MM $56.403431 SCREW CORTX SLFTP 3.5 X 18MM $58.803433 SCREW CORTEX SLFTP 3.5 X 22MM $58.803434 SCREW CORTEX SLFTP 3.5 X 32MM $55.20

3435 SCREW CORTEX SLFTP 3.5 X 26MM $58.803436 SCREW CORTEX SFLTP 3.5 X 28MM $58.803437 SCREW CORTEX SLFTP 3.5 X 30MM $58.803439 SCREW CORTEX SLFTP 3.5 X 34MM $55.203441 SCREW CORTEX SLFTP 3.5 X 38MM $58.803442 SCREW CORTEX SLFTP 3.5 X 40MM $50.503443 SCREW CORTEX SLFTP 3.5 X 45MM $45.603447 SCREW CANC FLLTHRD 4.0 X 14MM $47.403463 SCREW CANC FLLTHRD 4.0 X 50MM $28.203474 POWDER STOMA $12.083479 SCREW CANC SHRTTHRD 4.0 X 50MM $46.203514 ELECTRODE CUTTING LP 26 FR RED $107.453517 ELASTICIZED LOOP 5/8 IN $3.773524 CONNECTOR TUBING Y STERILE $1.373530 WAFER STOMA SURFIT 4 IN $20.813535 DRILL BIT 2.5 MM X 110 MM GOLD $183.603536 DRILL BIT 3.5 MM X 110 MM $163.083537 NEEDLE SPINAL 22GA 8IN QNKE $9.843538 NEEDLE SPINAL 25GA X 6IN QNKE $19.203555 TUBE PROXIMAL EXT CUFFLESS 7.0 $97.903559 WASHER FOR CANC SCREW 13.0MM $63.183561 SCREW CORTEX 4.5 X 14MM $25.803574 PIN GUIDE THREADED $53.503575 SCREW CORTEX SLFTP 2.7 X 20MM $57.003611 LIGATOR MULTI BAND 10 SHOOT $566.973629 STAPLE ENDO GIA ROTIC 30-3.5 $253.883632 PUTTY EXERCISE BLUE 2 OZ $4.183640 PLASTIBELL 1.4 CM $7.323646 INFLATION DEVICE BREEZE RX $133.203649 KIT FIRST FRACTURE THORAC 15/3 $5,391.233656 BAND FALOPE RING $174.003664 TUBE SHILEY TRACH CFLS FEN 6 $89.383668 CANNULA SHILEY TRACH LP/C 6DCT $81.703669 CANNULA SHILEY TRACH LP/C 8DCT $81.703682 TUBE SHILEY TRACH LPC 4 $111.563683 TUBE SHILEY TRACH LPC 6 $111.563685 TUBE SHILEY TRACH LPC 8 $111.563691 SURGICEL FIBRILLAR 1X2 STRL $157.933695 SCREW CANNULATED 4.0 X 40MM $407.043696 SCREW CANNULATED 4.0 X 50MM $407.043715 CANNULA INNER SHILEY TRACH SZ8 $67.823741 SCREW CANNULATED 4.0 X 20MM $372.753745 SCREW CANNULATED 4.0 X 28MM $264.603746 SCREW CANNULATED 4.0 X 30MM $407.043749 SCREW CANNULATED 4.0 X 32MM $407.043750 SCREW CANNULATED 4.0 X 34MM $390.253751 SCREW CANNULATED 4.0 X 38MM $390.25

3753 SCREW CANNULATED 4.0 X 42MM $407.043754 SCREW CANNULATED 4.0 X 44MM $407.043755 SCREW CANNULATED 4.0 X 48MM $407.043757 SCREW CANNULATED 4.0 X 48MM $212.623761 SCREW CANNULATED 4.0 X 40MM $185.633768 SCREW ACE BONE 44 MM $74.253769 SCREW ACE BONE 46 MM $104.943826 NASAL CANNULA W/ETC02 ADULT $9.233881 SUTURE MONOCRYL 4-0 P-12 30IN $22.823891 DRAIN BLAKE 15 FR RND HUBLESS $93.783918 LENS S LI61AO POST ALL SIZES $110.003948 FIBER LASER SLIMLINE 550 $667.283956 STENT BILIARY 10FR 5CM-4560 $260.753957 STENT BILIARY 10FR 7CM-4561 $230.003981 HEMOVAC 15FR W/TROCAR $27.554006 STENT BILIARY 10FR 10CM-#4562 $183.154024 SUTURE MONOSOF 5-0 P-13 18IN $8.204025 SUTURE MONOSOF 5-0 PRE-304 18" $7.874069 ASPIRATOR NASAL BBG $5.964082 BIOPSY DEVICE DONE KYPHX STRL $167.584094 CATH FOLEY SILICONE 10FR 3CC $13.164119 K-WIRE DIA PT .045 X 9IN 2 END $36.004120 K-WIRE DIA PT.062 X 9IN 2 END $39.604129 SUTURE ETHILON 3-0 C-14 18IN $3.964130 SUTURE SURGIPRO 2-0 C-17 30IN $10.584131 SUTURE CHROMIC 3-0 PRECUT 18IN $5.354138 SUTURE SOFSILK 4-0 CV-24 30IN $2.574171 GUIDEWIRE THREADED 1.25/150MM $29.284175 STOMA LOOP OSTOMY ROD 3 1/2" $32.854176 SUTURE MONOSOF 6-0 P-13 18 IN $8.594184 DRAPE MCRSCP NEURO/SPINE ZEISS $52.104200 NUTRN NEPRO 8 OZ $32.564202 ORTHOSIS ANKLE/FOOT LG LT $55.794203 ORTHOSIS ANKLE/FOOT MED LT $55.794208 CRUTCHES ALUM CHILD $57.644209 SUTURE MAXON 3-0 GS-21 5X30 IN $6.054223 K-WIRE DIA PT .035 X 9IN 2 END $39.604224 WIRE ORTHO 1.0 MM X 12 IN $6.404237 SHOE W/WEDGE TOE RELIEF MED $41.304253 BULB IRRIGATOR PATH FINDER $68.454254 CATH TRAY 16 FR CRITICORE $97.724255 CATH TRAY 18 FR CRITICORE $94.744256 COLLECTOR CONT CRITICORE 2000 $38.064259 TRANSDUCER TRANSPAC IV $27.434260 SAFE SET BLOOD SAMPING SYSTEM $29.764269 DRAIN J.P. ROUND 10 FR $11.474272 STONE EXTRACTR FLAT WIRE 2.8FR $237.84

4273 STONE EXTRCTR NIT TIPLES 2.2FR $275.634276 SNARE STENT REMOVAL N-SNARE $52.504277 GUIDEWIRE HI-WIRE .038 STRT TP $59.504278 GUIDEWIRE HI-WIRE .038 ANGL TP $58.304280 DILATOR SET URETHERAL RIGID $307.604282 NUTRN ENSURE VANILLA 8OZ $3.504283 NUTRN ENSURE CHOCOLATE 8OZ $3.504288 NUTRN ENSURE PUDDING VANILLA $3.504289 NUTRN ENSURE PUDDING CHOCOLATE $3.504293 NUTRN GLUCERNA SHAKE CHOCO 8 $1.434294 NUTRN GLUCERNA SHAKE STRAWBRRY $1.434297 NUTRN ENLIVE APPLE 8OZ $2.404298 NUTRN ENLIVE PEACH 8OZ $3.504300 NUTRN TWO CAL HN 8OZ $3.504301 NUTRN JEVITY VAN 8OZ 1.0 CAL $3.504302 NUTRN PULMOCARE VANILLA 8OZ $3.504303 NUTRN ALITRAZ POWDER 2.6OZ $25.944304 NUTRN SUPLENA VANILLA 8OZ $3.454305 NUTRN PEDIASURE VANILLA 8OZ $3.504306 NUTRN PROMOTE VANILLA 8OZ $3.504307 NEEDLE EPIDURAL 22X3.0 TOUHY $20.114309 SUTURE POLYSORB 0 GS-21 30 IN $35.594310 FIBER LASER SLIMLINE 365 $520.634326 SHEATH FLEXO URET ACCESS 12/55 $198.294332 SUTURE MNCRYL 2-0 UR-6 27IN DB $53.834333 CANNULA SAFSET SHIELDED BLUNT $3.434334 RETRIEVAL BAL RX 15.0-18.0MM $365.754344 NEEDLE INSUL REG BLK 22GA X 50 $33.604382 FIBER LASER SLIMLINE 200 $739.504383 FIBER LASER SLIMLINE 1000 $1,145.384384 CATH KIT NEONATE 5FR URO $5.624396 GEL SILVASORB 1.5 OZ $29.004402 WC-UNO-BOOT $10.004404 SLING CVA LARGE $25.204405 SLING CVA MEDIUM $25.204406 LIGASURE RELOAD/INSERT $413.584407 DRESSING OASIS 3X3.5CM STRL $153.814408 DRESSING OASIS 7X10CM STRL $1,586.284409 GEL IODOSORB 40MG STRL $88.004411 SPRAY WOUND CLEANSING 8OZ $18.004414 HEEL GUARD;NS $50.244416 NEEDLE,C-GUT 1/2 CIR TROCAR $4.344431 CDS LAP CHOLE CUSTOM TRAY $1,366.644436 DRESSING MEPILEX XFER 6X8 IN $25.944440 SHOE W/WEDGE TOE RELIEF XLG $48.004443 STENT ENDOSOF 6X24 12 MO $162.504444 STENT ENDOSOF 6X26 12 MO $162.50

4462 SCREW ASNIS 3 CNLTD 6.5 X 70MM $338.634465 SCREW ASNIS 3 CNLTD 6.5 X 85MM $338.624466 SCREW ASNIS 3 CNLTD 6.5 X 90MM $420.004467 SCREW ASNIS 3 CNLTD 6.5 X 95MM $560.004468 SCREW ASNIS 3 CNLTD 6.5 X100MM $420.004469 SCREW ASNIS 3 CNLTD 6.5 X105MM $311.064470 SCREW ASNIS 3 CNLTD 6.5 X110MM $311.064471 SCREW ASNIS 3 CNLTD 6.5 X115MM $414.754472 SCREW ASNIS 3 CNLTD 6.5 X120MM $310.274473 WASHER ASNIS 3 TI $55.504477 DRESSING SILVA SORB CAVITY $31.914493 ANCHOR FAST FIX STRT AB ASSY $1,396.004494 ANCHOR FAST FIX CRVD AB ASSY $1,396.004502 SCREW CORTX SLFTP 3.5 X 60MM $38.404504 SCREW CANC FLLTHRD 4.0 X 60MM $28.204506 PLATE LCP 3.5MM 6 HOLES 85MM $664.324509 CATH FLEXIMA QUICKSTICK 10 FR $180.004512 DRAIN POUCH COOK 300CC STRL $58.564513 MEDIFIL PARTICLES 10ML $72.924525 PLATE LCP 3.5 RECON 6HOLE 84MM $852.254528 DRAPE PACK LAP ABD 3 GOWN $52.304531 SCREW LCKNG STRDRV 3.5 X 10MM $257.284532 SCREW LCKNG STRDRV 3.5 X 12MM $257.284533 SCREW LCKNG STRDRV 3.5 X 16MM $257.284534 PLATE LCP 1/3 TUB 2/COL5HLX57M $357.124535 PLATE LCP 1/3 TUB W/COL6HLX69M $357.124536 DRILL BIT/QC 2.8X165MM $241.924550 PLATE LCP 1/3 TUB 2/COL8HLX93M $382.084551 PLATE LCP 1/3 TUB 2/COL7HLX81M $364.804554 GEL UNTRASOUND AQUASONIC 20GM $3.254556 PLATE LCP 1/3 TUB 2/COL10HX117 $285.254558 SCREW LCKNG STRDRV 3.5 X 14MM $257.284559 SCRE LCKNG STRDRV 3.5 X 18MM $257.284560 SCREW LCKNG STRDRV 3.5 X 20MM $257.284561 SCREW LCKNG STRDRV 3.5 X 22MM $234.504562 SCREW LCKNG STRDRV 3.5 X 24MM $234.504563 SCREW LCKNG STRDRV 3.5 X 26MM $257.284564 SCREW LCKNG STRDRV 3.5 X 28MM $257.284566 SCREW LCKNG STRDRV 3.5 X 32MM $257.284567 SCREW LCKNG STRDRV 3.5 X 34MM $274.244568 SCRE LCKNG STRDRV 3.5 X 36MM $274.244569 SUTURE SURGIPRO 3-0 C-14 18 IN $5.304570 SCREW LCKNG STRDRV 3.5 X 38MM $274.244571 SCREW LCKNG STRDRV 3.5 X 40MM $274.244572 SCREW LCKNG STRDRV 3.5 X 45MM $274.244576 DRILL BIT/QC 2.0X125MM $89.934577 PLATE LCP 3.5 PRO HUM3H SH/90M $2,763.60

4579 DRILL BIT/QC 3 FLUTE 2.7X125MM $243.254583 NEEDLE WILLIAMS CYSTOSCOPIC $33.264589 SUPPORTER ATHLETIC X-LARGE $21.504590 SUPPORTER ATHLETIC LARGE $21.504591 SUPPORTER ATHLETIC MEDIUM $16.084592 SUPPORTER ATHLETIC SMALL $16.064594 PROBE PRASS STIMULATOR STERILE $198.004595 ELECTRODE PAIRED EMG STERILE $160.004597 TUBE EMG ENDOTRACHEAL 7.0MM $484.754598 TUBE EMG ENDOTRACHEAL 8.0MM $484.754600 BAG DRAIN CYSTO TABLE SKYTRON $19.204615 NUTRASHIELD CREAM 12 OZ - WC $16.544616 DRESSING BIOPATCH DISK 1 IN $16.304617 ELECTRODE RESECTION ROLLER 24F $161.184619 MASK NASAL BIPAP SMALL $26.574630 ADHESIVE DERMABOND PEN $58.944637 GUIDEWIRE JAG HYDRA.035X260 ST $236.254638 GUIDEWIRE JAG HYDRA.035X450 ST $236.254640 CREAM ANTIFUNGAL REMEDY 4 OZ $19.084641 NUTRN JEVITY VAN 8OZ 1.2 CAL $3.504666 SUTURE VICRYL #1 0S-6 $6.054667 SUTURE VICRYL #1 0S-4 $6.584668 SUTURE VICRYL 2-0 CP-1 $4.104669 SUTURE VICRYL 2-0 FS-1 $13.064685 HEADREST PILLOW JACKSON TBL $19.034685 HEADREST PILLOW F/JACKSON TBLE $21.604688 IRRIGATION SOD CHL 1000ML-SLN $5.114691 HEADSTRAP BIPAP $13.664693 MASK BIPAP FULL FACE MEDIUM $49.954696 LMA DISPOSABLE SIZE 4,UNIQUE S $23.884697 LMA DISPOSABLE SIZE 5,UNIQUE S $23.884698 STAPLER HEMOROIDECTOMY 33MM $750.454701 DECANTER BAG-A-JET STERILE $5.984703 CIRCUIT BIPAP $20.574707 NUTRN JUVEN POWDER ORANGE 23GM $5.044712 SHOE W/WEDGE TOE RELIEF LARGE $41.304732 VACURETTE 7MM RIGID CVD STRL $11.284733 SUTURE NOVAFIL 6-0 P-13 18IN $13.064738 NUTRN JEVITY CAN 8OZ 1.5 CAL $3.504743 BOOK TREAT NECK SPANISH $15.604750 PLATE LCP 3.5MM 7 HOLES 98MM $400.054758 VALVE LOPEZ W/CAP STERILE $5.164760 DILATOR SET URETHERAL CRVD $350.004761 DILATOR BLLN URET 6X4 INFLATOR $349.564765 SHOE POST OP MENS XLF 440-MXL $22.324768 MASK BIPAP FULL FACE LARGE $50.514776 MASK NASAL BIPAP LARGE $26.57

4803 EYEGARD EYE TAPE $2.404807 BLADE INFERIOR TURBINATE $331.104809 SUTURE VICRYL #1 CT-1 27IN CR $26.954816 E-Z PAP WITH MANOMETER $50.694817 NASAL CANNULA HIGH FLOW $7.984818 HUMIDIFIER HIGH FLOW $7.644825 GUIDE WR THRD ASNIS3 3.2 X 300 $64.754826 GUIDE WR NOTHRD ASNIS3 3.2X300 $64.754827 GUIDE WR CALB ASNIS3 3.2 X 300 $82.504831 MASK BIPAP FULL FACE SMALL $50.514832 FLOSEAL MATRIX SEALANT $291.954833 APPLICATOR ENDOSCOPIC FLOSEAL $114.784849 CATH BALLARD SUCTION 12 FR $34.924857 CHLORAPREP 26ML APPLICATOR $17.044867 TUBE NASAL ENDOTRACH 3.5 CFFD $14.834868 TUBE NASAL ENDOTRACH 4.0 CFFD $16.284869 TUBE NASAL ENDOTRACH 4.5 CFFD $15.624870 TUBE NASAL ENDOTRACH 5.0 CFFD $14.834871 TUBE NASAL ENDOTRACH 5.5 CFFD $14.474872 TUBE NASAL ENDOTRACH 6.0 CFFD $16.284873 TUBE NASAL ENDOTRACH 6.5 CFFD $14.834889 BLADE 72 TYMPANO $35.784897 ORAL CARE SYSTEM Q4 $47.834898 BALLOON TAMPONADE SOS BAKRI $454.004916 GARMENT DVT CALF STANDARD $44.454917 GARMENT DVT CALF LARGE $58.824918 GARMENT DVT CALF BARIATRIC $95.044919 GARMENT DVT FOOT LARGE $56.484921 GARMENT DVT FOOT STANDARD $56.484923 PACK-2 POLY MAJOR ORTHOPEDIC $55.824924 PACK-SEPARATE LITHOTOMY $14.594927 PACK II TURBAN DRAPE EENT $35.594928 PACK III CYSTOSCOPY $24.984934 DRAPE BILATERAL EXTREMITY $26.784936 DRAPE UNDER BUTTOCKS W/POUCH $8.074937 PACK HIP V $84.664938 DRAPE LAP CHOLECYSTECTOMY $30.664939 SHEET LAPAROTOMY T $22.944941 COVER MAYO STAND $3.014944 PACK LAPAROTOMY W/2 REINF GOWN $38.094945 GOWN POLY REINFOR LG X-LONG $8.454955 COBLATOR WOUND EVAC 70 XTRA $367.504963 DRESSING HYDROFERA BLUE 4X4 $16.924964 DRESSING HYDROFERA TUBE 9 MM $7.564973 SHOE W/WEDGE TOE RELIEF SM $34.184979 SUTURE PLAIN 5-0 C-1 $3.104981 TUBE ORAL PRFMD TRACH 3.5 UNCF $7.66

4982 TUBE ORAL PRFMD TRACH 4.0 CFFD $13.014983 TUBE ORAL PRFMD TRACH 4.5 CFFD $13.014984 TUBE ORAL PRFMD TRACH 5.0 CFFD $13.014985 TUBE ORAL PRFMD TRACH 5.5 CFFD $12.344986 DRAPE X-LONG $8.164989 ELEVATOR FOOT W/CALF SUPPORT $56.475001 DRESSING VERSAFOAM 10 X 7.5CM $18.035010 CANNISTER KIT VAC 1000ML $105.675013 TUBE MICROLARYN ENDOTRACH 5.0 $17.115014 TUBE MICROLARYN ENDOTRACH 6.0 $17.115046 EZ CLEANZE SPLASH GUARD $5.405048 LIFT HEEL ADJUST-A-LIFT SMALL $11.765049 LIFT HEEL ADJUST-A-LIFT MEDIUM $11.865050 LIFT HEEL ADJUST-A-LIFT LARGE $11.765051 CONTAINER CALCULI STRAINER $4.205052 CATH SUCTION BALLARD TRACH $26.525070 DRAPE LARGE ARM WRAP ASIP $79.005071 BLADE SAG SAW 1 IN BIOMET HIP $106.405072 BLADE SAG SAW 0.5IN BIOMET KNE $106.405319 CLIPPING DEVICE HEMOSTATIC $418.005327 SHOE FOREFOOT RELIEF W/SHIELD $134.005522 SPONGE LAP 4 X 18 $1.005529 DRAPE ORTHO - U IMPERVIOUS $8.045530 ELASTICIZED LOOP 1 IN $5.005531 FORCEP RAD JAW JUMBO 3.2/240 $51.005545 COBAN COFLEX 6 INCH TAN STERIL $10.375613 MONITOR PAD TABS CHAIR $43.205615 BIOPSY DEVICE MAX CORE 18X30 $94.805624 TUBE SALEM SUMP 10 FR $4.085625 TUBE SALEM SUMP 12 FR $4.035626 TUBE SALEM SUMP 14 FR $3.185650 SPHINCTERTOME HYDRA RX 49-20MM $890.755664 NASO TAMPON 10MM W/O STRING $29.765666 TROCAR FILSHIE CLIP SYSTEM $83.805668 VALVE PASSY MUIR $165.005669 SUTURE VICRYL 4.0 RB-1 27 IN $3.915679 NEEDLE INSUL REG BLK 22GA X 80 $32.685681 INTRODUCER ET TUBE BOUGIE 15FR $15.705684 STONE EXTRCTR NIT TIPLES 1.5FR $308.445688 SHOE FOREFOOT RELIEF W/SHIELD $134.005689 SHOE FOREFOOT RELIEF W/SHIELD $129.005690 SHOE FOREFOOT RELIEF W/SHIELD $150.755726 FEEDER 80ML HABERMAN $29.955729 SUTURE MAX BRAIN PE 2 C-2 38IN $52.805741 NUTRN VIVONEX RTF 8 OZ $14.715743 VACURETT 8MM FLEX-TIP $11.285745 SUTURE NOVAFIL 3-0 C-17 30IN $5.59

5757 CAVILON SPRAY BARRIER 28ML $44.505773 PAIN PUMP SYS ON-1 5ML/HR $306.255788 HOOD T5 BARRIER STERILE $75.145794 NEEDLE SET EZ-IO 40K PLUS $187.255795 NEEDLE SET EZ-IO 3K - 39K PLUS $187.255802 COSEAL SEALANT 4ML $971.305818 STENT ENDOSOF URET 6 X 28 12 M $162.505835 PROTECTOR HEEL ELBOW KNIT PAIR $5.125847 CANNULA NASAL COMFRT FLW INFAN $10.625849 CANNULA NASAL COMFRT FLW PREMI $10.625850 HUMIDIFICATION SYS COMFRT FLW $62.385875 TAPE ADHESIVE ET CLOTH/FOAM $10.255884 BUR ARTHSCPY 4.0 RESECT CUTTER $100.005885 BUR ARTHSCPY 3.5 AGGRESS CUT $100.005886 BUR ARTHSCPY 4.0 AGGRESS CUT $100.005887 BUR ARTHSCPY 5.5 AGGRESS CUT $100.005889 BUR ARTHSCPY 5.5 TOMCAT CUTTER $100.005891 BUR ARTHSCPY 4.0 12 FLUTE BRRL $100.005892 BUR ARTHSCPY 5.5 12 FLUTE BRRL $100.005912 CANNULA NASAL COMFRT FLOW PEDI $10.615919 SUTURE MAX BRAID PE 1/2 CIRCLE $31.635967 ENDO STITCH SURGDAC 2-0 48 SNG $51.245969 TAPE KINESIO 3 IN X 13 FEET $2.545978 TROCAR ADAPT 5MM $52.505980 TROCAR ADAPT 5MM - 10MM UNIV $69.755992 NEWGEL PLUS $52.125993 PUTTY ELASTOMER MIX 50/50 $55.186029 NEEDLE SET EZ-IO BARIATRIC $201.256030 PROTECTOR LIMB FOOT TO THIGH $11.406031 ELECTODE TENS 1.25 IN RND $8.866033 DILATOR CRE ESOPH COLON 8-10 $411.256034 DILATOR CRE ESOPH COLON 10-12 $440.006035 DILATOR CRE ESOPH COLON 12-15 $440.006053 POWDER ARGLAES 5 GRAM $36.706054 DRESSING PURACOL PLUS 2 X 2 $20.596069 BLADE SAG SAW NARROW THIN SHOR $85.986085 KIT PICC 4 FR SINGLE LUMEN $329.006087 KIT PICC 5 FR DUAL LUMEN $332.506089 KIT PICC 6 FR TRIPLE LUMEN $411.256100 NEEDLE GUIDE SITERITE 21 GA $34.566101 NEEDLE GUIDE SITERITE 18 GA $34.566102 MICROINTRODUCER 6 FR X 7 CM $90.006104 NEEDLE EPIDURAL 18 X 3.5 TOUHY $14.406105 CIRCUIT JACKSON - REESE $17.226113 GARMENT DVT THIGH STANDARD $41.026114 GARMENT DVT THIGH LARGE $54.026115 STATLOCK PICC PLUS $15.89

6118 SPLINT FINGER OVAL 8 SZ 2 - 15 $53.526119 SUTURE MONOCRYL 4-0 PS-2 18IN $10.256126 ADAPTER CAP ONE INTUBATED $20.426127 ADAPTER CAP ONE NON-INTUBATED $19.136130 SUTURE ETHIBOND 2-0 SH 30IN GR $12.466133 SUTURE PROLENE 4-0 RB-1 30IN $11.886164 DRESSING PURACOL PLUS 4 X 4 $20.946170 CANNULA INNER SHILEY TRACH SZ6 $66.166182 SENSOR BIS MONITORING QUAPRO $46.806193 TUBE TRACH ORAL RAE MALMED 6.0 $13.016194 TUBE TRACH ORAL RAE MALMED 6.5 $13.016195 TUBE TRACH ORAL RAE MALMED 7.0 $13.016196 TUBE TRACH ORAL RAE MALMED 7.5 $11.046203 STAPLER EEAXL 25 3.5MM X 35CM $753.526216 RETRACTOR FIXED LENGTH LARGE $58.776231 TOURNIQUET CUFF CHILD 12IN SGL $37.606234 CATH IV AUTOGUARD 24GA X 0.56 $6.266235 STAPLER EEA 28 3.5MM $2,015.006253 BUR ARTHSCPY 4.5 TOMCAT ANGLED $100.006255 CLOSURE SYSTEM CT XL $262.506258 SHEAR HARMONIC CVD ACE 36CM $1,008.656259 SHEAR HARMONIC CVD FOCUS 9CM $929.406262 SYSTEM FECAL MANAGEMENT $504.336269 DRILL BIT 2.0 MM $144.006270 DRILL BIT 2.7 MM $132.006278 DRAPE PACK PICC LINE W/GOWN $50.006280 STAPLE PREMIUM TA 55 4.8 $111.056281 STAPLE PREMIUM TA 90 4.8 $121.186318 TUBE DRAINAGE BAG VINYL $37.826319 GUIDE WIRE TSUKAMOTO .35 145 $83.256333 SUTURE VICRYL 0 UR-6 $4.686335 NUTRN ENLIVE MIXED BERRY $2.406339 SHEAR HARMONIC WAVE $573.426343 DRESSING ADHESIVE OPTIFOAM 4X4 $8.576348 COVER BILISOFT PAD LARGE $6.006349 CATH PORT-A-CATH POWERPORT 8FR $813.756421 SUTURE POLYSORB 3-0 C-13 30IN $5.986443 STENT ENDOSOF URET 6 X 20 12 M $156.006444 STENT ENDOSOF URET 6 X 22 12 M $182.816445 STENT ENDOSOF URET 6 X 30 12 M $156.006461 CANNULA NASAL HIGH FLOW 25 FT $10.276471 STAPLER TA 60 3.5 DISPOSABLE $181.756475 STRAP HEAD CHIN FOR BEACH CHR $35.806479 SHEAR HARMONIC CVD ACE 23CM $742.426482 DRILL 1.5 SUBCHONDRAL 4.0 MM $100.006483 FORCEP RAD JAW 4 LG CAPACITY $26.256491 TUBE HOLDER ENDOTRACH FASTENER $21.25

6492 DRILL BIT/QC 3.2MM X 145MM $153.006536 SCREW LCKNG STRDRV 5.0 X 28MM $260.756538 SCREW LCKNG STRDRV 5.0 X 32MM $260.756607 SCREW CANNULATED 7.3 X 85MM $530.256608 SCREW CANNULATED 7.3 X 90MM $530.256609 SCREW CANNULATED 7.3 X 95MM $530.256613 SCREW CORTEX SLFTP 4.5 X 30MM $54.006636 2.0 GUIDE WIRE SPADE PNT 230MM $74.006637 TIP DRILL 2.0 GUIDE WIRE 200MM $127.006638 DRILL BIT QC 4.3MM X 180MM $414.726640 DRILL BIT CANULTD 5.0 X 200MM $723.846644 ENDOLOOP LIGASURE PDS II $286.946652 STAPLER CONTOUR $714.306653 RELOAD CONTOUR $390.536671 NEEDLE ABDOMINAL STRAIGHT 2.5 $4.336676 PROBE SKIN TEMP GIRAFFE OHMEDA $9.756681 DRESSING SORBAVIEW SHIELD SM $2.406695 CATH FOLEY SIL 3WAY 22FR 30CC $56.056707 SUTURE POLYSORB 4-0 C-13 $6.006708 SUTURE POLYSORB 4-0 C-14 $8.356710 SUTURE POLYSORB 3-0 C-14 $8.426727 POSITIONER HAND ALUMINUM LRG $64.006746 SUTURE 0 PDS II CT-1 27 IN $5.286751 DRAIN BLAKE 19 FR RND HUBLESS $111.026753 NASAL PAC W/O AIRWAY 5.5 CM $56.806755 BOUGIE TIP LIGHTED 50FR TAPERD $200.006757 NEEDLE FORAMEN 20GA X 5.0 IN $80.006759 SCREW CANN SET 7.3 X 80MM $509.256764 MESH V-PATCH LARGE 8.0 CM $1,152.006768 SCREW CANN SET 7.3 X 90MM $509.256770 SCREW CANN SET 7.3 X 100MM $509.256771 WAFER STOMA MLDBL CONVEX 1.25 $9.436775 WARMER HEEL INFANT GEL $2.036780 SUTURE POLYSORB 2-0 V-20 30IN $3.776787 SPLINT MURPHY RING SIZE 3 $58.016793 INTERSTIM PERMANANT LEAD 28CM $10,665.006794 INTERSTIM LEAD INTRODUCER KIT $490.006795 SUTURE MONODERM 2-0 2XDE14 30C $69.396797 INTERSTIM PERMANANT BATTERY $35,040.006810 INTERSTIM PATIENT PROGRAMMER $2,082.506811 INTERSTIM PATIENT ANTENNA $160.006816 SUTURE MAXON #1 HGU-46 30 IN $7.306818 NEEDLE INJECT ARTCLTR 25GA 5MM $56.006820 WARMER IV BLOOD FLUID ENFLOW $31.206822 SUTURE POLYSORB 1 GS-21 $4.106823 SUTURE POLYSORB 3-0 GS-21 $3.936830 DRAPE PACK LAVH $38.96

6836 STAPLER GIA 80 MULTI 3.8 $262.456837 STAPLE GIA 80 MULTI 3.8 $156.406843 SLING FINGER THUMB ALL SZS 2-4 $24.386857 LIGASURE IMPACT 10MM X 20CM $1,448.786858 LIGASURE 5MM X 37CM DIVIDER $1,109.706874 SEAL OSTOMY EAKIN SMALL 2 IN $7.776875 FINGER STRAP FLEXION PIP/DIP $3.486877 WAFER STOMA MOLDABLE 1 1/34"45 $4.016878 WAFER STOMA MOLDABLE 2 1/4" 57 $4.016879 WAFER STOMA MOLDABLE 2 3/4" 70 $4.016881 ADAPTER LOW PRESSURE 1 3/4" $1.006882 ADAPTER LOW PRESSURE 2 1/4" $1.006883 ADAPTER LOW PRESSURE 2 3/4" $1.006903 STENT ESOPH PLYFLX 18MM X 12CM $4,287.506917 SUTURE MONOCRYL 3-0 PS-1 27 IN $10.266936 STAPLER SEPTAL ENTACT $330.006940 ELECTRODE BUGBEE 5MM X 58CM $187.206942 GLIDESCOPE BLADE SIZE 1 $47.506943 GLIDESCOPE BLADE SIZE 2 $47.506944 GLIDESCOPE BLADE SIZE 3 $35.726945 GLIDESCOPE BLADE SIZE 4 $35.726949 SENSOR ACOUSTIC RESPIRATION $67.506953 SPHINCIME JAGTOME RX39.025X260 $636.006957 CATH KIT DIALYSIS 23 CM DUAL $671.006958 CATH KIT DIALYSIS 27 CM DUAL $671.006961 CATH KUMAR CHOLANGIOGRAPHY $72.006962 BOOT KEY VASCUALR $7.366966 SUTURE MONOCRYL 0 CT-1 36MM $15.856967 SUTURE PROLENE 6-0 BV-1 9.3MM $58.566969 CATH BALLOON DILITAION 6X4X75 $640.006971 CATH BALLOON DILITAION 8X4X75 $510.006972 CATH BALLOON DILITAION 10X4X75 $510.006973 CATH BALLOON DILITAION 12X4X75 $700.006974 CATH BALLOON DILITAION 14X4X75 $700.006980 SUT PROLENE 7-0 BV-1 3/8IN CIR $22.086981 VESSEL LOOPS RED PK 2 $1.956982 CATH IUPC INTRAUTERINE PRESSUR $72.956993 GUIDEWIRE AMPLATZ XSTIFF 80CM $48.136994 GUIDEWIRE AMPLATZ XSTIFF 180CM $47.456996 SHEATH 6FR 5.5CM LONG VASCULAR $37.506997 SHEATH 7FR 5.5CM LONG VASCULAR $52.506999 VESSEL LOOPS RED MAXI PK 2 $2.157001 KNIFE 15 DEG 5MM I-KNIFE $17.257005 INFLATION DEVICE BASIX COMPAK $66.387006 NEEDLE ANGIOGRAPHY 18GA X 2.75 $5.637007 SUTURE VICRYL 3-0 26MM 1/2"CIR $3.957008 SUTURE PDS 3-0 26MM 1/2" CIRCL $5.48

7009 SUTURE PDS 0 CT-2 26MM 1/2"CIR $5.697010 SUTURE PDS 1 TP-Q 65MM 1/2" CR $10.877015 PATCH VASCULAR XENOSURE BIOLGC $597.007018 TUBE NASAL ENDOTRACH 7.0 CFFD $16.077020 CATH ARTERL EMBLCTMY 4FR 40CM $80.897022 TUBE NASAL ENDOTRACH 8.0 CFFD $16.077024 CATH ARTERL EMBLCTMY 4FR 80CM $80.897025 CATH ARTERL EMBLCTMY 5FR 80CM $80.897026 CATH ARTERL EMBLCTMY 6FR 80CM $80.897040 SUT VICRYL 2-0 26MM 1/2" CIRCL $3.957041 SUT 0 PROL CT-Q 30" 1/2" CRCL $5.207042 SUT 2-0 PROL SH 30" 1/2" CRCL $4.817043 SUT 3-0 PROL SH 30" 1/2" CRCL $5.017044 SUT VICRYL 2-0 36MM 1/2" CIRCL $4.247048 SHUNT KIT CAROTID ARTRY 6 STRT $60.767049 CATH PORT-A-CATH 8F PWR LO PRO $750.007052 CATH DIALYSIS 24CM STRT TEMP $400.007053 CATH DIALYSIS 30CM STRT TEMP $400.007054 CATH DIALYSIS 15CM CRVD TEMP $400.007055 CATH DIALYSIS 20CM CRVD TEMP $400.007065 POLYLOOP SINGLE USE $189.007067 COVER PROBE GLE 6 X 48 IN 1MIL $1.007070 DRESSING MEPITEL ONE 3X4 $11.737071 DRESSING SILVERCEL 4.25X4.25 $19.457077 SUTURE POLYSORB 2-0 V-20 $26.567078 GELPORT LAPROSCOPIC SYSTEM $968.827079 SUTURE POLYSORB 3-0 V-20 $26.847088 CATH DIALYSIS CHRONIC PERITONL $348.007124 CHIPS BONE DRIED 60CC 4-10MM $1,312.007127 TENDON TIBIAL POSTERIOR FROZEN $1,576.007134 ENDO STITCH POLY 2-0 48 INCH $53.387135 CATH DRAIN KIT PLEURX PLEURAL $1,100.007136 CATH DRAIN KIT PLEURX PERITONI $1,100.007137 DRAINAGE KIT PLEURX 1000ML BTL $132.757138 KIT PATIENT STARTER PLEURX $530.007148 PREVENA WOUND MANAGMNT SYSTEM $990.007149 SUTURE PROLENE 5-0 RB-1 $10.297150 SUTURE PROLENE 5-0 RB-2 $10.007153 TOURNIQUET CUFF 18 X 3 IN SNGL $59.157155 GUIDEWIRE HYDRO LNG 180CM .018 $106.477159 RADIESSE VOICE GEL 1 CC INJECT $1,150.007162 SUTURE SILK 4-0 TIES 10X30 IN $5.007164 TRAY CATH MAHURK 12FR X 13CM $378.007165 TRAY CATH MAHURK 12FR X 16CM $378.007166 TRAY CATH MAHURK 12FR X 20CM $388.507169 MATERIAL STRAPPING 2"X10 YRD $77.007183 MATERIAL STRAP WHT 1/2" 10YRD $1.00

7189 CREAM SKIN REPAIR REMEDY 40Z $8.397190 CLEANSER ANTIMICROBIAL REMEDY $6.477191 PASTE PROTECTANT CALAZIME 4 OZ $13.267198 SCREW CANNULATED 7.3 X 70 MM $574.087248 NEEDLE SPINAL WHITE 27 GA X3.5 $13.647250 PACK CATH LAB ANGIO SPECIALS $62.497252 SUT SILK 3-0 TIES $5.137253 SUT SILK 2-0 TIES $5.137255 SUT SILK 3-0 SH NEEDLE $3.457256 SUT SILK 2-0 SH NEEDLE $4.337266 MESH VENTRALIGHT ST 11.4 CIRCL $1,250.007267 MESH VENTRALIGHT ST ECHO 8X10 $3,045.007268 MESH VENTRALIGHT ST 10 X 15 $1,140.007269 MESH VENTRALIGHT ST 15 X 20 $1,969.007271 MESH HERNIA PLUG SMALL $635.327273 MESH VENTRIO ST 11 X 14 CM $1,580.007274 MESH VENTRIO ST 14 X 18 CM $1,750.007275 MESH VENTRIO ST 15 X 27 CM $2,882.257281 NEEDLE BIOPSY TURNER 18 X 15CM $58.347283 TRAY FOLEY CATH 16FR SILICONE $23.327284 TRAY FOLEY CATH 18FR SILICONE $23.327286 SLING LIFT MEDIUM DISPOSABLE $142.547287 SLING LIFT LG 700LB DISPOSABLE $154.107290 GRAFT VAS SML CUFF 6MM/80MM $7,692.007297 TAPE KINESIO ALL COLORS/PER FT $17.307300 BREAST FLANGE XL 32.5 MM $16.407301 FLANGE BREAST CUSTOM 28.5 MM $14.837309 SUT MONOCRYL 0 CT-1 36IN $5.057321 PACK CATH LAB CARDIAC CATH $127.877346 SHEATH BRITE TIP 6FR 23CM $55.757347 SHEATH BRITE TIP 7F 23CM $55.757348 GUIDECATH XB3 6F $224.007350 GUIDECATH XB 3.5 6FR $224.007352 GUIDECATH XB4 6F $224.007354 GUIDECATH XBLAD 3.5 6F $224.007370 GUIDESHEATH FLEX-A ANLO 70C 6F $108.007371 GUIDESHEATH FLEX-A ANL1 70C 6F $108.007376 GUIDESHEATH FLEX-A ANLO 55C 6F $108.007384 PTABALLOON 18LP 4X4 CM $390.007387 PTABALLOON 18LP 4X10 CM $390.007389 PTABALLOON 18LP 5X4 CM $390.007391 PTABALLOON 18LP 5X8 CM $390.007392 PTABALLOON 18LP 5X10 CM $390.007393 PTABALLOON 18LP 5X10 CM $390.007395 PTABALLOON 18LP 6X4 CM $390.007398 PTABALLOON 18LP 7X2 CM $390.007401 PTABALLOON 18LP 7X8 CM $480.00

7404 MESH GRAFT XENMATRIX 10 X 15 $6,764.007405 MESH GRAFT XENMATRIX 15 X 20 $13,519.007406 MESH GRAFT XENMATRIX 19 X 28 $22,400.007407 PTABALLOON 35LP 5X4 CM $260.007408 MESH GRAFT XENMATRIX 19 X 35 $28,044.007410 PTABALLOON 35LP 5X8 CM $260.007414 PTABALLOON 35LP 6X2 CM $260.007415 PTABALLOON 35LP 6X4 CM $260.007425 PTABALLOON 35LP 8X2 CM $260.007426 PTABALLOON 35LP 8X4 CM $260.007427 PTABALLOON 35LP 8X6 CM $260.007431 PTABALLOON 14LP 2.5 X 6 CM $600.007438 PTABALLOON 14LP 2X4 CM $600.007439 PTABALLOON 14LP 2 X6 CM $600.007440 PTABALLOON 14LP 2 X 8 CM $600.007441 PTABALLOON 14LP 2X12 CM $600.007443 PTABALLOON 14LP 2X20 CM $600.007444 PTABALLOON 14LP 3X2 CM $600.007445 PTABALLOON 14LP 3X4 CM $600.007446 PTABALLOON 14LP 3X6 CM $600.007447 PTABALLOON 14LP 3X8 CM $600.007448 PTABALLOON 14LP 3X12 CM $600.007450 PTABALLOON 14LP 3X20 CM $600.007451 PTABALLOON 14LP 4X2 CM $600.007452 PTABALLOON 14LP 4X4 CM $600.007453 PTABALLOON 14LP 4X6 CM $766.507461 PERCATH KUMPE 65C 5F $35.007466 PERCATH COBRA1 65CM $35.007467 PERCATH COBRA2 65CM $35.007469 PERCATH SIM1 IMAGER 65CM $35.007472 PERCATH SIM1 100CM $35.007473 PERCATH SIM2 100CM $35.007476 PERCATH RIM (RC3) 5F $35.007477 PERCATH H1 CATH (DIAGNO) 5F $35.007478 PERCATH SIM2 100CM $35.007479 SHEARS MINI 5MM ENDO SCISSOR $164.707480 POUCH WOUND FISTULA 3.4 X 2.5 $16.437481 ANGIOCATH PIGTAIL 110CM 5F $56.007482 ANGIOCATH 145 PIGTAIL 110CM 5F $56.007483 ANGIOCATH 155 PIGTAIL 110CM 5F $56.007484 ANGIOCATH FR 3.5 5F $56.007485 ANGIOCATH FR4 5F $56.007488 ANGIOCATH FL 3.5 5F $56.007489 ANGIOCATH FL4 5F $56.007491 ANGIOCATH FL5 5F $56.007493 ANGIOCATH AR MODIFIED 5F $56.007496 ANGIOCATH AL1 5F $56.00

7497 ANGIOCATH AL2 5F $56.007498 ANGIOCATH AL3 5F $56.007499 ANGIOCATH MPA1 5F $56.007502 ANGIOCATH IM 5F $56.007505 ANGIOCATH MULTI PK STRAIGHT 5F $151.207506 ANGIOCATH MULTI PK ANGLED 5F $151.207507 ANGIOCATH PIGTAIL 110CM 6F $56.007508 ANGIOCATH 145 PIGTAIL 110CM 6F $56.007509 ANGIOCATH 145 PIGTAIL 110CM 6F $56.007510 ANGIOCATH 155 PIGTAIL 110CM 6F $56.007511 ANGIOCATH FR4 6F $56.007518 ANGIOCATH FL 3.5 6F $56.007519 ANGIOCATH FL 4 6F $56.007520 ANGIOCATH FL 4.5 6F $56.007521 ANGIOCATH FL 5 6F $56.007524 ANGIOCATH AR1 6F $56.007526 ANGIOCATH AL1 6F $56.007527 ANGIOCATH AL2 6F $56.007529 ANGIOCATH MPA1 6F $56.007532 ANGIOCATH IM 6F $56.007533 ANGIOCATH RCB 6F $56.007534 ANGIOCATH LCB 6F $56.007535 ANGIOCATH MULTI STRAIGHT 6F $151.207536 ANGIOCATH MULTI ANGLED 6F $151.207537 ANGIOCATH STEALTH 1.25 SOLID $5,941.257538 ANGIOCATH STEALTH 1.5 CLASSIC $5,941.257539 ANGIOCATH STEALTH 2.0 SOLID $5,941.257540 ANGIOCATH STEALTH 1.5 SOLID $5,941.257542 ARTHWIRE REGALIA WIRE 300CM $340.007543 ARTHWIRE ASTATO WIRE 300CM $340.007544 WIRE MAGIC TORQUE .035 260CM $122.657545 ARTHCATH VIPERWIRE ADV .014 $380.007546 ARTHCATH VIPERSLIDE LUBRICANT $202.507559 INTBALL APEX FLEX 1.5 X 20 $340.007560 INTBALL APEX 2.0 X 8 $340.007561 INTBALL APEX 2.0 X 12 $340.007566 INTBALL APEX 2.5 X 12 $340.007571 INTBALL APEX 3.0 X 12 $340.007575 INTBALL APEX 3.5 X 8 $340.007638 INTERWIRE ASAHI MIR BROS 6 $270.007640 INTERWIRE ASAHI CONFIANZA $270.007646 INTERWIRE EX SPORT 190CM STR $168.757647 INTERWIRE EX SPORT 190CM J $168.757649 INTERWIRE HITORQUE PILOT 150 $168.757650 INTERWIRE WHISPER 109CM STR $168.757651 INTERWIRE WHISPER 190CM J $168.757657 INTERWIRE HITO PILOT 150 190CM $168.75

7658 INTERWIRE HITO PILOT 150 300CM $168.757679 CHLORAPREP 3ML APPLCTR ORANGE $2.637680 CLOSURE MYNX CADENCE 5FR $400.007681 CLOSURE MYNX CADENCE 6/7F $440.007682 SHEATH PINNACLE 4FR 12CM $19.887683 SHEATH PINNACLE 5FR 12CM $19.887684 SHEATH PINNACLE 6FR 12CM $19.887685 SHEATH PINNACLE 7FR 12CM $19.887686 SHEATH PINNACLE 8FR 12CM $19.887687 ACCESS THINWALL NEEDLE 16F $9.207688 STENT BIL WALL FLEX 10X60 CVRD $4,550.007689 CATH ACCESS 4FR MICRO STIFF $79.007691 DIAGWIRE GUIDEWIRE J- .035-145 $13.757692 DIAGWIRE GUIDEWIRE J- .038-260 $13.757694 DIAGWIRE GLIDE .035 180 ANG/ST $155.937695 DIAGWIRE GLIDE .035 260 ANG/ST $166.467697 DIAGWIRE GLIDE .035 260 STR/ST $166.467698 DIAGWIRE GLIDE .035 180 ANGLED $132.417699 DIAGWIRE GLIDE .035 260 ANGLED $147.897701 DIAGWIRE GLIDE .035 260 STR $147.897702 DIAGWIRE TIGERWIRE ANG/FL 300C $210.007703 DIAGWIRE TIGERWIRE ANG/FL 260C $180.007704 DIAGWIRE TIGERWIRE ANG/FL 150C $139.507706 DIAGWIRE TIGERWIRE STR/ST 150C $139.507710 STOCK PACK PACEMAKER $125.877711 CHLORAPREP 10.5 APPL TEAL $9.717828 BALLOON DCB INPACT 4X150X130 $2,853.007838 BALLOON DCB INPACT 5X40X130 $2,328.007840 BALLOON DCB INPACT 5X60X130 $2,328.007846 BALLOON DCB INPACT 5X150X130 $2,853.007858 BALLOON DCB INPACT 6X60X130 $2,328.007860 BALLOON DCB INPACT 6X80X130 $2,328.007864 BALLOON DCB INPACT 6X150X130 $2,853.007878 BALLOON DCB INPACT 7X80X130 $2,328.007957 GUIDEWIRE 2.8 X 300 NONTHRD $232.327965 ANGIOSCULPT PTA BALLOON 5X20 $1,950.007966 ANGIOSCULPT PTA BALLOON 6X20 $1,950.007971 ANGIOSCULPT PTA 5X40 137CM $1,881.257990 GUIDEWIRE 025 X 145 BENTSON $42.688117 CHIPS BONE DRIED 8CC 4-10 MM $236.008122 DESTINATION SHEATH 6F 45CM STR $286.008125 DESTINATION SHEATH 6F 90CM STR $330.008129 DESTINATION SHEATH 7F 90CM STR $330.008135 GUIDECATH 5F 65CM STRAIGHT $160.888136 GUIDECATH 5F100CM STRAIGHT $160.888137 GUIDECATH 5F 65CM ANGLED $160.888138 GUIDECATH 5F 100CM ANGLED $160.88

8139 GUIDECATH 5F 100CM ANGLED $160.888140 GUIDECATH 5F 100CM ANGLED $160.888254 ICAST COVERED STENT 5X22X120 $4,269.218255 ICAST COVERED STENT 6X22X120 $4,269.218259 ICAST COVERED STENT 9X38X120 $4,371.068262 ICAST COVERED STENT 10X38X120 $4,371.068370 GAUZE PACKING STRIP AMD .5 IN $1.838371 GAUZE PACKING STRIP AMD 1 IN $2.058391 GUARDIAN II HEMOSTASIS VALVE $71.448392 BMW WIRE STRAIGHT 190CM $168.758393 BMW WIRE STRAIGHT 300CM $168.758398 ASAHI GRANDSLAM 300 $270.008399 ASAHI GRANDSLAM 300 J $270.008417 NC QUANTUM APEX MR 8 X 2.25 $340.008418 NUTRN ENSURE CLNCL ST CHOCOLAT $1.348419 NUTRN ENSURE CLNCL ST STRBERRY $3.508420 NUTRN ENSURE CLNCL ST VANILLA $3.508422 NC QUANTUM APEX MR 8 X 2.50 $340.008424 ANCHOR SUTURE ABSORB WITH SUT $900.008425 ANCHOR SUTURE ABSORB NO SUTURE $760.008426 NEEDLE SCORPIAN SUTURE ANCHOR $280.008427 CATH FOLEY LF 16FR CRITICORE $48.858428 CATH FOLEY LF 18FR CRITICORE $48.858429 MANIFOLD KIT $63.008431 GLOW AND TELL 30CM TAPE $135.008442 SPIROFLEX THROMB SET ULTRA $3,762.508447 ELECTRODE LOOP 20 X 15CM ROUND $25.898475 3 VALVE MANIFOLD RH OFF $7.508476 72 SALINE SPIKE $5.008477 STOPCOCK 3W MEDUIM PRESSURE $1.258479 30 HIGH PRESSURE CONTRAST LINE $5.008480 12 ML CONTROL SYRYNGE $10.008481 72" CONTRAST SPIKE $5.008482 STOPCOCK HIGH PRESSURE $2.508483 LA6EBU35 $101.258485 LA6EBU375 $101.258487 LA6EBU40 $101.258498 LA6IMA $101.258500 LA6IMASH $101.258501 LA6AL10 $101.258503 LA6AL20 $101.258505 LA6AL75 $101.258506 LA6AR10 $101.258512 LA6JL35 $101.258521 LA6MP1 $101.258542 ENCORE KIT W/INJ-BAPTIST MEM $77.188549 MEDRAD SYRYNGES 150CC $11.00

8555 DRESSING SACRAL 7.2 X 7.2 $16.738556 DRESSING SACRAL 9.2 X 9.2 $26.298560 SNARE STENT REMOVAL 2.4 X 115 $219.388561 EDWARDS THERMODILUTION CATH $153.438562 PRESIGE PLUS CATHETER 185CM $1,350.008563 EAGLE EYE PLATINUM $1,470.008564 SQUEEZE CONTRAST CONTROLLER $14.708565 MINI-SPIKE $5.008574 4F 65CM ANG GLIDE $160.808575 4F 100CM ANG GLIDE $160.808577 ENGAGE 6FR 25CM .035 SHEATHS $66.388580 TUBING HIGH PRESSURE CONTR 10" $5.008581 TUBING HIGH PRESSURE CONTR 60" $9.758586 FLEXOR ANSEL 7FR/70CM/MULTI $123.758587 TRANSDUCER DISP PRESSURE $18.788590 STEALTH CATH 1.25 SOLID MICRO $5,941.258602 EMERALD .025 WIRE $16.258610 MICRO STIFFENED CANNULA 4FR $47.508613 BOOT DELUXE PODUS MEDIUM LARGE $116.718628 ADAPTER SYRINGE CATHETER LL $0.408640 TROCAR VERSAPORT OPTICAL 5MM $75.608645 STENT SUPERA VERITAS 6FR 4X100 $2,966.258647 STENT SUPERA VERITAS 6FR 5X40 $2,966.258649 STENT SUPERA VERITAS 6FR 5X80 $2,966.258650 STENT SUPERA VERITAS 6FR 5X100 $2,966.258651 STENT SUPERA VERITAS 6FR 5X120 $2,966.258652 STENT SUPERA VERITAS 6FR 6X40 $2,966.258654 OMNIFLUSH CATHETERS $52.508656 SWITCH FLOW CONTROL $8.138657 DRAPE RADIAL ARM $14.088662 STENT BIL WALL FLEX 10X40 CVRD $4,550.008668 PML 60" ADULTMLL TO FMLL $2.008671 NEEDLE ARTERIAL 21 GA X 1 IN $8.758672 TORQUE DEVICE TERUMO $18.838673 RADIAL COMPRESSION TR BAND STN $90.008674 RADIAL COMPRESSION TR BAND LNG $90.008675 CATH RADIAL DIAG 5FR X 4.0 TR $101.258676 CATH RADIAL DIAG 5FR X 4.5 TR $101.258677 SHEATH RADIAL 21GA 5FR 10CM $157.508684 DIAGWIRE GUIDEWIRE S .035 145 $27.508687 CATHETER OMNI FLUSH 5FR 65CM $35.008690 CATH DIAG WILLIAMS RT CRV 5FR $20.388691 CATH DIAG WILLIAMS RT CRV 6FR $20.388695 LMA DISPOSABLE SIZE 3 SUPREME $62.508696 LMA DISPOSABLE SIZE 4 SUPREME $62.508697 CATH SUPPORT SEEKER .014 4FR $300.008698 CATH SUPPORT SEEKER .018 4FR $300.00

8699 DRAPE ANGIOGRAPHY FEMORAL $18.358705 CLOSURE VASCULAR ANGIOSEAL 6FR $430.008707 COMPRESSION DEVICE FEMOSTOP $210.008720 TOURNIQUET CUFF 8 in SINGLE $42.088722 CATH KIT DLYSS 16FX19 CM DUAL $910.008723 DRAPE UTILITY XL STERILE $0.618724 BAG BANDED EQUIPMENT COVER $3.068735 CATH SUPPORT SEEKER .035 5FR $300.008736 TRAY PERICARDIOCENTESIS 6 FR $210.008737 TRAY PERICARDIOCENTESIS 8.3 FR $210.008740 GUIDEWIRE SPR STIFF .035 260CM $89.738742 CANNULA CAPNO SMART CO2 LINE $32.658749 NUTRN JUVEN FRUIT PUNCH $5.748751 TURBOWHAWK MS-M $6,125.008755 CATH FLEX TIP URET 4FR 70CM $26.968759 GUIDEWIRE .018 40CM NITINOL $61.658937 SUT VLOC 180 ABSORB 2-0 GS21 $61.758941 STENT SUPERA VERITAS 6FR 6X150 $2,966.258963 NC QUANTUM APEX MR 8 X 3.00 $272.008965 STENT SUPERA VERITAS 6FR 5x120 $2,966.258967 NC QUANTUM APEX MR 8 X 4.00 $340.008968 NC QUANTUM APEX MR 12 X 2.00 $340.008969 NC QUANTUM APEX MR 12 X 2.50 $340.008970 NC QUANTUM APEX MR 12 X 2.75 $340.008971 NC QUANTUM APEX MR 12 X 3.00 $340.008972 NC QUANTUM APEX MR 12 X 3.50 $340.008973 NC QUANTUM APEX MR 12 X 4.00 $340.008975 NC QUANTUM APEX MR 15 X 2.50 $340.008976 NC QUANTUM APEX MR 15 X 2.75 $340.008978 NC QUANTUM APEX MR 15 X 3.50 $340.008981 NC QUANTUM APEX MR 20 X 2.50 $340.008984 NC QUANTUM APEX MR 20 X 3.50 $340.008985 NC QUANTUM APEX MR 20 X 4.00 $340.008989 NC QUANTUM APEX MR 15 X 3.00 $340.009000 GUIDEWIRE INQWIRE .035 80CM ST $46.259002 FILTER IVC FEM OR JUG RETRVBL $2,275.009004 GUIDE WIRE ADVANT .035 260 ANG $390.009009 SUTURE ETHILON MONOFILAMNT 2-0 $8.209032 BALLOON DILATOR 4CM X 6MM $458.009034 SUT SILK 0 30IN BLK $3.489035 INTERLOCK COIL DETACH 6X20 $979.209040 CATHETER MICRO STC .021X130CM $887.409042 GUIDEWIRE MICRO STEER .016X180 $652.809044 2.6FR CXI .018 150CM SUP CATH $380.009045 2.6FR CXI .018 65CM SUP CATH $380.009047 4FR CXI .035 135CM SUP CATH $380.009048 4FR CXI .035 150CM SUP CATH $380.00

9049 4FR CXI .035 90CM SUP CATH $380.009051 INFUSION CATH 5F .035 30P 15CM $215.749108 APEX FLEX 1.5-8 OTW $340.009109 APEX FLEX 1.5-12 OTW $340.009112 APEX FLEX 2.0-8 OTW $340.009113 APEX FLEX 2.0-12 OTW $340.009139 SUT VICRYL 4-0 TF $4.859143 STENT LIFESTAR SLFEXP 9X40X135 $1,250.009148 SLEEVE APPLIED TROCAR 5MM $45.009149 ABDUCTION PILLOW SHLDR FOAM-M $56.709190 MYOSURE TISSUE REMOVAL DEVICE $1,645.009244 6FR RDC 55CM GUIDE CATH $101.259247 OMNILINK ELITE 6X29X135 $1,950.009249 OMNILINK ELITE 6X59X135 $1,950.009251 OMNILINK ELITE 7X39X135 $1,950.009252 OMNILINK ELITE 7X59X135 $1,950.009254 OMNILINK ELITE 8X29X135 $1,950.009256 OMNILINK ELITE 8X59X135 $1,950.009257 OMNILINK ELITE 9X19X135 $1,950.009258 OMNILINK ELITE 9X29X135 $1,950.009268 6FR LCB GUIDE CATH $101.259269 6FR LCBSH GUIDE CATH $101.259272 6FR JR4 GUIDE CATH $101.259277 6FR 3DRC GUIDE CATH $101.259284 6FR RBU 3.5 GUIDE CATH $101.259286 6FR RBU 4.0 GUIDE CATH $101.259292 6FR EBU 3.0 GUIDE CATH $101.259298 DILATOR VASC 10F 20CM .038 $18.009299 CATH LASER ABLATION .9MM RX $5,242.009300 CATH LASER ABLATION .9MM OTW $4,725.009301 CATH LASER ABLATION 1.4MM RX $4,725.009302 CATH LASER ABLATION 1.4MM OTW $4,725.009303 CATH LASER ABLATION 1.7MM RX $4,725.009308 DILATOR VASC 12F 20CM .038 $18.009313 CATH BILIARY DRAIN 8FR 35CM $164.959319 DILATOR VASC 8F 20CM .038 $18.009321 ARMADA .014 1.5X20X150 BALLOON $650.009324 ARMADA .014 1.5X120X150 BALLOO $650.009325 ARMADA .014 2X20X150 BALLOON $650.009326 ARMADA .014 2X400X150 BALLOON $650.009327 ARMADA .014 2X60X150 BALLOON $650.009328 ARMADA .014 2X80X150 BALLOON $650.009330 ARMADA .014 2X200X150 BALLOON $650.009332 ARMADA .014 2.5X40X150 BALLOON $650.009333 ARMADA .014 2.5X60X150 BALLOON $650.009334 ARMADA .014 2.5X80X150 BALLOON $650.009335 ARMADA .014 2.5X120X150 BALLOO $650.00

9336 ARMADA .014 2.5X200X150 BALLOO $650.009338 ARMADA .014 3X40X150 BALLOON $650.009341 ARMADA .014 3X120X150 BALLOON $650.009344 ARMADA .014 4X40X150 BALLOON $650.009348 ARMADA .014 4X200X150 BALLOON $650.009355 SEAL SET MYOSURE $25.009356 CATH BIOPOLAR PACING BLLN 5 FR $225.009380 DRESSING DRAWTEX 4X4 NIN ADHNT $21.559388 CATH LASER ABLATION 2.0MM OTW $4,725.009390 STENT RX XIENCE XP 2.25X12 $2,616.259391 STENT RX XIENCE XP 2.25X15 $2,616.259392 STENT RX XIENCE XP 2.25X18 $2,616.259393 STENT RX XIENCE XP 2.25X23 $2,616.259394 STENT RX XIENCE XP 2.5X8 $2,616.259395 STENT RX XIENCE XP 2.5X12 $2,616.259396 STENT RX XIENCE XP 2.5X15 $2,616.259397 STENT RX XIENCE XP 2.5X18 $2,616.259398 STENT RX XIENCE XP 2.5X23 $2,616.259399 STENT RX XIENCE XP 2.5X28 $2,616.259400 STENT RX XIENCE XP 2.5X33 $2,616.259401 STENT RX XIENCE XP 2.5X38 $2,616.259402 STENT RX XIENCE XP 2.75X8 $2,616.269403 STENT RX XIENCE XP 2.75X12 $2,616.259405 STENT RX XIENCE XP 2.75X18 $2,616.259406 STENT RX XIENCE XP 2.75X23 $2,616.259407 STENT RX XIENCE XP 2.75X28 $2,616.259408 STENT RX XIENCE XP 2.75X33 $2,616.259409 STENT RX XIENCE XP 2.75X38 $2,616.259412 STENT RX XIENCE XP 4.0X15 $2,616.259415 STENT RX XIENCE XP 4.0X28 $2,616.259418 STENT RX XIENCE XP 3.0X8 $2,616.259419 STENT RX XIENCE XP 3.0X12 $2,616.259420 STENT RX XIENCE XP 3.0X15 $2,616.259421 STENT RX XIENCE XP 3.0X18 $2,616.259422 STENT RX XIENCE XP 3.0X23 $2,616.259423 STENT RX XIENCE XP 3.0X28 $2,616.259424 STENT RX XIENCE XP 3.0X33 $2,616.259425 STENT RX XIENCE XP 3.0X38 $2,616.259435 STENT RX XIENCE XP 3.5X12 $2,616.259436 STENT RX XIENCE XP 3.5X15 $2,616.259437 STENT RX XIENCE XP 3.5X18 $2,616.259438 STENT RX XIENCE XP 3.5X23 $2,616.259439 STENT RX XIENCE XP 3.5X28 $2,616.259440 STENT RX XIENCE XP 3.5X33 $2,616.259441 STENT RX XIENCE XP 3.5X38 $2,616.259442 TUBE FEEDING NG DOBBHOF 12FR $24.359464 STENT VISION RX 3.0X18 $1,300.00

9497 BALLOON NC TREK 2.5 X 12 $370.009498 BALLOON NC TREK 2.5 X 15 $370.009533 BALLOON NC TREK 1.5 X 12 $370.009534 BALLOON NC TREK 1.5 X 15 $370.009538 BALLOON NC TREK 2.0 X 12 $370.009539 BALLOON NC TREK 2.0 X 15 $370.009543 BALLOON NC TREK 2.25 X 12 $370.009544 BALLOON NC TREK 2.25 X 15 $370.009547 BALLOON NC TREK 2.5 X 8 $370.009548 BALLOON NC TREK 2.5 X 12 $370.009549 BALLOON NC TREK 2.5 X 15 $370.009550 BALLOON NC TREK 2.5 X 20 $370.009553 BALLOON NC TREK 2.75 X 8 $370.009554 BALLOON NC TREK 2.75 X 12 $370.009558 BALLOON NC TREK 3.0 X 8 $370.009559 BALLOON NC TREK 3.0 X 12 $370.009560 BALLOON NC TREK 3.0 X 15 $370.009561 BALLOON NC TREK 3.0 X 20 $370.009564 BALLOON NC TREK 3.25 X 8 $370.009565 BALLOON NC TREK 3.25 X 12 $370.009566 BALLOON NC TREK 3.25 X 15 $370.009567 BALLOON NC TREK 3.25 X 20 $370.009569 BALLOON NC TREK 3.5 X 8 $370.009570 BALLOON NC TREK 3.5 X 12 $370.009571 BALLOON NC TREK 3.5 X 15 $370.009572 BALLOON NC TREK 3.5 X 20 $370.009578 BALLOON NC TREK 4.0 X 8 $370.009579 BALLOON NC TREK 4.0 X 12 $370.009580 BALLOON NC TREK 4.0 X 15 $370.009581 BALLOON NC TREK 4.0 X 20 $370.009583 BALLOON NC TREK 4.5 X 12 $370.009584 BALLOON NC TREK 4.5 X 15 $370.009591 BALLOON NC TREK MINI RX 1.5X12 $370.009593 BALLOON NC TREK MINI RX 1.5X20 $370.009594 BALLOON NC TREK MINI RX 2.0X8 $370.009595 BALLOON NC TREK MINI RX 2.0X12 $370.009596 BALLOON NC TREK MINI RX 2.0X15 $370.009597 BALLOON NC TREK MINI RX 2.0X20 $370.009600 BALLOON NC TREK MINI RX 2.5X8 $370.009601 BALLOON NC TREK MINI RX 2.5X12 $370.009605 BALLOON NC TREK MINI RX 2.5X30 $370.009606 BALLOON NC TREK MINI RX 3.0X8 $370.009607 BALLOON NC TREK MINI RX 3.0X12 $370.009609 BALLOON NC TREK MINI RX 3.0X20 $370.009626 BALLOON NC TREK MINI RX 5.0X12 $370.009728 BALLO ANGIOSCULPT TT RX 2.5X10 $1,750.009729 BALLO ANGIOSCULPT TT RX 2.5X15 $1,750.00

9731 BALLO ANGIOSCULPT TT RX 3.0X10 $1,750.009734 BALLO ANGIOSCULPT TT RX 3.5X10 $1,750.009760 GLASSES CATARACT $3.759763 TISSEEL SEALANT KIT 4ML VIAL $489.009769 SOLUTION BSS 500ML GLASS $12.509785 SPONGE TONSIL MEDIUM OPC $4.889790 TUBE EAR U JEDMED OPC $55.009792 SUCTION COAGULATION BOVIE 10FR $28.289804 6FR JR 4.0 SH GUIDE CATH $101.259818 SENSOR FLOTRAC 84 IN $530.009833 CATH KIT DLYSS 14.5X19 CM DUAL $589.009839 ANCHOR SUTURE 2.9 X 15.5 MM $760.009841 LASSO 25 DEG TIGHT CURVE RIGHT $320.009843 LASSO 90 DEG TIGHT CURVE $320.009849 VISCOELASTIC HEALON DUET $56.259853 SUT VICRYL PLUS 0 CT-2 27IN $10.809854 GUIDEWIRE HI-TORQUE STEELCORE $168.759862 RADIAL GLIDESHEATH 6FR 10CM $123.759863 CATH JACKY RADIAL 65F 100CM $101.259865 SUT ETHILON 5-0 PC3 $17.009874 ISTENT LT TRABECULAR $2,973.139875 ISTENT RT TRABECULAR $2,973.139897 DILATOR VASC 6F 20CM .038 $18.009907 SUT O PDS CT-1 36" SIZE 0 $16.039908 SUT 1 PDS CT-1 36" SIZE 1 $17.059909 SUT O SILK TIES 30" SIZE 2.0 $13.589910 SUT 3-0 ETHILON NYLON FS-1 $10.459911 SUT 4-0 ETHILON NYLON FS-2 18" $10.309912 SUT O CHROMIC CT-1 36" $20.509913 SUT 3-0 ETHILON NYLON FSLX 30" $11.309914 SUT 2-0 SILK CR 30" $57.909935 BALLOON OTW MINI TREK 1.5 X 12 $370.009945 BALLOON OTW MINI TREK 3.0 X 8 $370.009953 TROCAR VERSAPRT OPTCL 5MM TWIN $92.009954 TROCAR VERSAPRT OPTCL 12MM $179.009955 TROCAR VERSAPORT 5MM X 100 $65.639956 TROCAR VERSAPORT 12MM X 100 $81.659957 STAPLE ENDO GIA RADIAL CONTOUR $790.269958 STAPLE ENDO GIA TAN 2-3 X 60MM $479.989959 STAPLE ENDO GIA PURPL 3-4 60MM $1,010.009963 KIT TOUHY ANGIOPLASTY $40.009965 SUPP CATHTER TWINPASS .014X140 $650.009981 CATH SUPP 4FR CXI .035 150 CM $380.009987 NEEDLE COOK MICROSTICK STIFF $65.259990 TISSUE CORNEA IMPLANT DSAEK $14,286.009992 BASKET TRAPEZOID RX WIRE 3.0 $556.00

10011 CATH DIALYSIS 13FR X 15CM STRT $300.00

10012 CATH DIALYSIS 13FR X 20CM STRT $300.0010020 CATH DRAIN PIGTAIL 8FR 25CM $164.9510030 CATH KIT DIALYSIS 14.5 X 23CM $589.0010035 BALLOON PTA CHOCOLATE 3X40MM $1,700.0010036 BALLOON PTA CHOCOLATE 3X80MM $1,700.0010037 BALLOON PTA CHOCOLATE 3X120MM $1,700.0010038 BALLOON PTA CHOCOLATE 3.5X40MM $1,700.0010040 BALLOON PTA CHOCOLATE 4X40MM $1,700.0010041 BALLOON PTA CHOCOLATE 4X80XMM $1,700.0010042 BALLOON PTA CHOCOLATE 4X120MM $1,700.0010044 BALLOON PTA CHOCOLATE 5X80 MM $1,700.0010051 ATOMIZER INTRANASAL NASAL $13.0510054 STAPLE ENDO GIA TAN 2-3 X 45MM $1,020.7010060 STAPLER HEMOROIDECTOMY 33 X3.5 $808.9610061 DRESSING SILVER FOAM MAX 4 X 4 $8.7810062 DRESSING FOAM MAX 4.5 X 4.5 $14.3510063 DRESSING SILVER FOAM MAX 8X8 $34.6510064 GUIDEWIRE CHOICE PT FLOPPY 300 $191.2510066 PACK ORTHOPEDIC KC $65.7010067 PACK DRAPE ORTHO BAR KC $23.5310068 PACK DRAPE ORTHO U SPLIT KC $35.6010069 PACK DRAPE HIP KC $59.5810084 CONTAMINATION SHIELD $35.0010086 CATHETER JACKY RADIAL 5F 100CM $101.2510087 DRESSING SILVER ROPE .4X14" $16.5010094 CATHETER LANGSTON V2 $278.0010114 SUTURE VICRYL 3.0 SH-1 $5.0010115 SUTURE 4-0 ETHILON PS-2 $9.0010120 SUTURE VICRYL 3-0 FS-2 $7.2510121 SUTURE VICRYL 3-0 27IN FS-1 $7.2010122 SUTURE VICRYL 4-0 27IN FS-1 $7.5010123 SUTURE CHROMIC GUT 2-0 18IN $44.4310124 SUT 2-0 PDS CT-1 27IN $8.0010125 SUTURE CHROMIC GUT 2-0 27IN SH $10.1310126 SUTURE CHROMIC GUT 1 18IN TIES $44.8410127 SUTURE CHROMIC GUT 0 18IN TIES $42.7310128 SUTURE CHROM GUT 4-0 27IN RB-1 $11.2510129 SUTURE VICRYL 0 27IN CT-1 $35.8810130 SCREW LCKNG SLFTP 2.7 X 8MM $282.7210131 SCREW LCKNG SLFT 2.7 X 10MM $282.7210132 SCREW LCKNG SLFT 2.7 X 12MM $282.7210133 SCREW LCKNG SLFT 2.7 X 14MM $282.7210134 SCREW LCKNG SLFT 1.7 X 16MM $282.7210135 SCREW LCKNG SLFT 2.7 X 18MM $282.7210145 GLOVE EDEMA SMALL LEFT $28.7510149 GLOVE EDEMA SMALL RIGHT $14.3810159 NASAL CANNULA ADULT W/ FILTER $7.50

10164 CATH DRAINAGE 8.5 FR X 25CM $203.0410169 SUTURE 3-0 ETHILON PS-2 $11.0010171 WIRE ASAI SOFT INTERVENTIONAL $168.7510176 SUT SILK 1-0 TIES $71.8410177 SUT SILK 3-0 SH NEEDLE 30" $29.9310178 SUT CHROMIC GUT 1-0 CT-1 $14.3810179 SUT CHROMIC GUT 4-0 FS-2 $9.7310180 SUT PROLENE 3-0 PS-2 $13.2510187 BALLOON PTA CHOCOLATE 2.5X40MM $1,700.0010188 BALLOON PTA CHOCOLATE 2.5X80MM $1,700.0010189 BALLOON PTA CHOCOLATE 2.5X120M $1,700.0010190 BALLOON PTA CHOCOLATE 6.0X40MM $1,700.0010191 BALLOON PTA CHOCOLATE 6.0X80MM $1,700.0010198 PAD SET KIT HYPOTHERMIA SMALL $2,060.0010199 PAD SET KIT HYPOTHERMIA LARGE $2,060.0010212 LIT 3 ARM ACCESSORY PACK $400.0010213 SEALS CANNULA 8.5MM 8.5-13MM $90.0010214 SEALS CANNULA 10 12MM $37.5010215 KIT FLUORESCENCE IMAGING PACK $468.0010216 OBTURATOR 8MM BLADELESS $56.2510217 TIP COVER MONO CURVED SCISSOR $50.0010218 DRAPE INSTRUMENT ARM $101.2510219 DRAPE CAMERA ARM $94.5010220 DRAPE CAMERA HEAD $92.2510221 VESSEL SEALER ENDOWRIST ONE $1,190.0010222 SUCTION IRRIG ENDOWRIST ONE $440.0010223 HEMOCLIP POLYMER MEDIUM LARGE $72.3210225 TRAY THORACENTESIS PARACENTESI $57.8910232 WARMER SCOPE ANTI FOG D-HELP $90.0010233 TROCAR APPLIED HASSAN 12MM 130 $112.5010236 BALLOON ARMADA WH 35 4 X 40 $280.0010245 STAPLE ENDO GIA RADIAL BLACK $934.7010247 BALLOON ARMADA WH 35 5 X 40 $280.0010249 BALLOON ARMADA WH 35 5 X 80 $280.0010250 BALLOON ARMADA WH 35 5 X 100 $280.0010253 BALLOON ARMADA WH 35 6 X 40 $280.0010254 BALLOON ARMADA WH 35 6 X 60 $280.0010256 BALLOON ARMADA WH 35 6 X 100 $280.0010257 BALLOON ARMADA WH 35 6 X 120 $280.0010259 BALLOON ARMADA WH 35 7 X 40 $280.0010262 BALLOON ARMADA WH 35 7 X 100 $280.0010265 BALLOON ARMADA WH 35 8 X 40 $280.0010268 BALLOON ARMADA WH 35 10 X 40 $280.0010269 BALLOON ARMADA WH 35 12 X 40 $280.0010270 BALLOON ARMADA WH 35 14 X 40 $280.0010273 BALLOON ARMADA LL 35 6 X 200 $380.0010274 BALLOON ARMADA LL 35 6 X 250 $380.00

10279 KIT 4 ARM ACCESSORY PACK DRAPE $112.5010285 BALLOON ARMADA WH 35 8 X 80 $280.0010287 BALLOON ARMADA LL 35 5 X 150 $380.0010288 BALLOON ARMADA LL 35 5 X 200 $380.0010289 BALLOON ARMADA LL 35 5 X 250 $380.0010290 BALLOON ARMADA LL 35 6 X 150 $380.0010291 BALLOON ARMADA LL 35 7 X 150 $380.0010292 SUT 2-0 ETHILON NYLON FS 18" $5.7010293 SUT 1 PDS CTX 36" $8.4310307 BALLOON NC EUPHOR 2.0 X 8 RX $280.0010308 BALLOON NC EUPHORA 2.0 X 12 RX $280.0010310 BALLOON NC EUPHORA 2.0 X 20 RX $280.0010311 BALLOON NC EUPHORA 2.25 X 8 RX $280.0010318 BALLOON NC EUPHORA 2.5 X 20 RX $280.0010328 BALLOON NC EUPHORA 3.0 X 15 RX $280.0010329 BALLOON NC EUPHORA 3.0 X 20 RX $280.0010339 BALLOON NC EUPHORA 3.5 X 12 RX $280.0010340 BALLOON NC EUPHORA 3.5 X 15 RX $280.0010341 BALLOON NC EUPHORA 3.5 X 20 RX $280.0010347 BOOT FRACTURE LARGE $108.8110348 BOOT FRACTURE MEDIUM $108.8110354 BALLOON NC EUPHORA 4.0 X 20 RX $280.0010357 BALLOON NC EUPHORA 4.5 X 20 RX $280.0010359 STENT RESOLUTE RX 2.25 X 8 $2,415.0010360 STENT RESOLUTE RX 2.25 X 12 $2,415.0010361 STENT RESOLUTE RX 2.25 X 14 $2,415.0010366 SEALS CANNULA 5MM WHITE $42.5010367 PORT SINGLE SITE 8.5MM $285.0010369 STENT RESOLUTE RX 2.5 X 8 $2,415.0010370 STENT RESOLUTE RX 2.5 X 12 $2,415.0010371 STENT RESOLUTE RX 2.5 X 14 $2,415.0010372 STENT RESOLUTE RX 2.5 X 18 $2,415.0010373 STENT RESOLUTE RX 2.5 X 22 $2,415.0010375 STENT RESOLUTE RX 2.5 X 30 $2,415.0010377 STENT RESOLUTE RX 2.75 X 12 $2,415.0010379 STENT RESOLUTE RX 2.75 X 18 $2,415.0010383 STENT RESOLUTE RX 3.0 X 9 $2,415.0010384 STENT RESOLUTE RX 3.0 X 12 $2,415.0010385 STENT RESOLUTE RX 3.0 X 15 $2,415.0010386 STENT RESOLUTE RX 3.0 X 18 $2,415.0010387 STENT RESOLUTE RX 3.0 X 22 $2,415.0010389 STENT RESOLUTE RX 3.0 X 30 $2,415.0010390 STENT RESOLUTE RX 3.0 X 34 $2,415.0010391 STENT RESOLUTE RX 3.0 X 38 $2,415.0010392 STENT RESOLUTE RX 3.5 X 9 $2,415.0010393 STENT RESOLUTE RX 3.5 X 12 $2,415.0010394 STENT RESOLUTE RX 3.5 X 15 $2,415.00

10395 STENT RESOLUTE RX 3.5 X 18 $2,415.0010400 STENT RESOLUTE RX 3.5 X 38 $2,415.0010402 STENT RESOLUTE RX 4.0 X 12 $2,415.0010403 STENT RESOLUTE RX 4.0 X 15 $2,415.0010404 STENT RESOLUTE RX 4.0 X 18 $2,415.0010433 CATHETER RADIAL 6FR TIG $101.2510434 DRESSING VAC ULTRA MEDIUM $230.0010435 CASSETTE VERALINK WOUND VAC $123.7510452 CLOSURE VASCULAR 6/7 FR VASCAD $420.0010457 SHEALTH SLENDER 6FR 10CM $157.5010461 SUT 4-0 ETHILON PC-1 $13.5010464 SUTURE CHROMIC 4-0 PS-4 $16.0010467 RETRACTOR SURGI SLEEVE 2.5-6CM $395.0010472 SUT 2-0 PDS CT-1 8 18IN/PK $58.0010483 TUBE SET ARTHROSCOPY IN / OUT $187.4910486 BAG ENDO SPECIMEN CATCH 5MM $157.5010487 STAPLE ENDO GIA BLACK 4-5 60MM $648.6010489 SENSOR NICOM RELIANT CHEETAH $300.0010490 STATION WASTING BAG 1400ML $16.2510491 STENT PROPEL SINUS $1,390.0010497 FORCEP BIPOLAR MARYLAND S SITE $449.1610500 SUTURE CHROMIC 5-0 G-3 DBL ARM $37.3510503 GUIDE CATH GUIDLINER V2 6FR $870.0010504 DESTINATION SHEATH 6F 65CM STR $274.0010505 STRAPPING MATERIAL 1" X 75 FT $0.4110507 KIT PUSHLOCK ANCHOR 2.9MM $350.0010511 ANGIOSCULPT PTA 5 X 200 137CM $2,187.5010512 ANGIOSCULPT PTA 6 X 200 137CM $2,187.5010515 LMA DISPOSABLE SIZE 5 SUPREME $57.5010516 ELECTRODE CUT LOOP 24 FR THNDR $995.9010517 ELECTRODE BUTTON 12FR THNDRBT $1,045.3810526 TROCAR 12MM OPTICAL BLADELESS $492.1210540 NEEDLE TRU CUT BIOPSY 18GA X 6 $36.6310541 CATH SUPP 2.3FR .014 150CM ANG $380.0010542 CATH SUPP 2.3FR .014 150CM STR $380.0010543 PATCH HEMOSTASIS THROMBIX $50.0010544 SUT ETHILON 2 LR 30" $10.7010545 SUT PROLENE 3-0 FS-1 18" BLUE $6.1410551 SUT VLOC PBT NONABSORB GS21 6" $63.1810552 CLOSURE VASCULAR 6FR PROGLIDE $590.0010553 CATH THROMBECTOMY 3FR X 145CM $3,368.7510554 STENT SUPERA VERITAS 6FR 5X150 $3,316.2510555 STRAPPING MATERIAL 1X75FT BEIG $2.0810556 BALLOON PTA CHOCOLATE 5X120MM $1,700.0010557 BALLOON PTA CHOCOLATE 6X120MM $1,700.0010565 BALLOON PTCA CHOCOLT 3X15MM $1,500.0010567 BALLOON PTCA CHOCOLT 3.5X10MM $1,500.00

10568 BALLOON PTCA CHOCOLT 3.5X15MM $1,500.0010573 GUIDEWIRE .012 X 200CM $1,900.0010574 BALLOON PTA CHOCOLATE 3.5X120 $1,700.0010579 SUT VICRYL 3-0 PS-1 27" $11.7510580 SUT VICRYL 4-0 PS-1 27" $10.6710586 STAPLE ROBOTIC 45 BLUE SI $658.0010587 STAPLE ROBOTIC 45 GREEN SI $658.0010588 SUT SILK 2-0 FS 18" $5.5510589 CATH SUPPORT ANG 135CM NAVICRS $350.0010590 CATH SUPPORT ANG 150CM NAVICRS $350.0010591 GUIDEWIRE .014 X 180 RUNTHROUG $180.0010592 GUIDEWIRE .014 X 300 RUNTHROUG $180.0010593 SEAL STAPLER CANNULA BLUE $50.0010594 SHEATH STAPLER 45 $50.0010597 BALLOON SINUS DIL KIT 5 X 18 $2,625.0010598 BOOT FRACTURE SMALL $108.8110599 BALLOON SINUS DIL KIT 6 X 18 $2,625.0010603 CABLE TEMPORARY PACING 12 DISP $35.0010613 STENT PROPEL SINUS 16MM MINI $1,390.0010614 PULLEY FINGER TRIGGER SOLUTION $39.1310616 PACK ROBOTIC LAVH CUSTOM $893.8210617 PACK ROBOTIC LAP CHOLE CUSTOM $762.8210618 STENT PANCREATIC 4FR X 3CM $340.0010619 STENT PANCREATIC 4FR X 5CM $340.0010621 DRESSING XEROGEL $200.0010637 HEMOCLIP POLYMER LARGE $72.3210641 DRESSING SORBION SACHET 4X5 IN $21.5010651 CEMENT KYPHO W/MIXER $328.0010653 STENT DE ZILVER 6 35 125 6X60 $2,616.0010654 STENT DE ZILVER 6 35 125 6X80 $3,141.0010655 STENT DE ZILVER 6 35 125 6X100 $3,141.0010657 STENT DE ZILVER 6 35 125 7X60 $2,616.0010660 TUBING EPIDURAL PUMP SAPPHIRE $25.2510666 SPLINT METAGRIP $144.0010675 BALLOON DE LUTONIX 6X40X130 $2,888.0010720 SUTURE PROLENE 2-0 CT-2 30" $7.3010722 MOUTHPIECE ISOLITE SMALL $5.0010723 MOUTHPIECE ISOLITE MEDIUM $5.0010724 MOUTHPIECE ISOLITE PEDIATRIC $5.0010730 SNARE CAPTIVATOR II 15MM ROUND $38.4510734 BALLOON PTCA GLIDER 1.5X8.0 $590.0010749 MOUTHPIECE ISOLITE X-SMALL $5.0010761 CATH RADIAL DIAG 5FR X 4.0X110 $101.2510762 CATH RADIAL DIAG 5FR X 4.5X110 $101.2510763 CATHETER JACKY 5F 3.5 110CM $101.2510767 GUIDECATH 6FR MPA 125CM $99.0010786 MESH GRAFT ALLOMAX 7X10 1MM $3,588.00

10790 COVER BILISOFT PAD SMALL $4.5010792 DESTINATION SHEATH 7F 65CM STR $202.5010795 GUIDECATH 6FR JR 4 100CM $99.0010796 GUIDECATH 6FR MPA 1 .070 100CM $99.0010798 SUT VICRYL 4-0 SH 27" VIOLET $5.5010802 STENT SUPERA VERITAS 6FR 6X20 $2,966.2510806 PATCH SOFT TISSUE 1MM 5X10 MM $544.0010811 DRESSING VAC ULTRA LARGE $432.0010824 K-WIRE TROCAR PT 1.25X150MM TI $33.0010825 PROTEIN SUPPLEMENT 15GRAM PK $4.2010829 NEEDLE RF VCD 20G 100MM FMMTIP $120.0010834 STENT DE ZILVER 6 35 125 8X40 $2,056.0010838 SUT PDS 3-0 CT-2 30IN VIOLET $9.0010839 SUT VICRYL 0 TIES 18IN $6.0010840 SUT VICRYL 0 CT-1 36" $5.5010841 SUT PLAIN GUT 3-0 CT 27" $4.7510842 SUT SILK 3-0 FS-1 18" BLACK $5.7510843 SUT SILK 3-0 SH 10" MULTI 5 $17.7510847 SUT VICRYL 3-0 SH 27" MULTI 8 $34.5010848 TUBE FLEX HUMIDVENT $4.0010855 SUT VLOC 180 3-0 V-20 9IN GRN $58.0010856 SUT VLOC 180 0 GS-21 12IN GRN $61.0010860 PROSHIELD SMALL SPLINTING MATL $18.6510866 GLOVE EDEMA RIGHT FULL FINGER $11.0010867 GLOVE EDEMA LEFT FULL FINGER $13.0010872 SUT PROLENE 1 CT-1 30" BLUE $8.0010874 TROCHANTERIC REATTACHMENT DEVI $4,350.0010877 EXTENSION DOC GUIDEWIRE 145CM $169.0010881 NUTRN GLUCERNA 1.5 CAL 8FL OZ $2.0510882 CONTRAST MODULALATION KIT $700.0010883 TUBE SET AIRSEAL TRIPLE LUMEN $197.0010884 TROCAR AIRSEAL 5MM BLUNT 150MM $200.0010885 TROCAR AIRSEAL 8MM OPTIC 120MM $190.0010886 TROCAR AIRSEAL 12MM OPTIC 120M $197.0010888 STENT VIABAHN COVRD 5MM X 5CM $5,591.0010891 STENT VIABAHN COVRD 5MM X 25CM $11,191.0010895 STENT VIAGAHN COVRD 6MM X 25CM $11,191.0010900 STENT VIABAHN COVRD 8MM X 5CM $5,591.0010904 TUBING SET THERMEDX IRRIG COLL $236.0010906 TUBE SET AIRSEAL DUAL LUMEN $174.0010907 TROCAR AIRSEAL 5MM OPTIC 120MM $188.0010908 GRIP CROSSOVER $5.9010915 NC QUANTUM APEX MR 4.5 X 8 $340.0010918 NC QUANTUM APEX MR 5.0 X 15 $340.0010919 STRAP ANKLE DISTRACTOR $101.0010923 CATHETER SPYSCOPE DS DELIVERY $4,638.0010928 TUBE SET DIEGO ENT DEBRIDER $99.00

10929 BLADE BIPOLAR 2.0MM DIEGO $335.0010930 BLADE MONOPOLAR 4.0MM DIEGO $312.0010931 SHAVER BLADE 2.0MM STRT DIEGO $232.0010932 SHAVER BLADE 4.0MM STRT DIEGO $232.0010933 SHAVER BLADE 4.0MM ROTAT DIEGO $401.0010971 GUIDE WIRE WHOLEY .035 X 145CM $187.0010972 GUIDE WIRE WHOLEY .035 X 260CM $216.0010973 CURETTE DERMAL 3MM DISPOSABLE $3.5010974 CURETTE DERMAL 4MM DISPOSABLE $3.5010976 DRESSING SORBACT 4X4 CUTIMED $9.0010977 ELECTRODE CAUTERY 4"BLADE CTD $9.0010984 ABDUCTION PILLOW SHOULDER FOAM $66.0010987 ABDUCTION PILLOW SHLDR FOAM-XL $66.1511000 CATH TRAY FOLEY 16FR TEMP SENS $68.0011001 CIRCUIT NEOPUFF BREATHING $16.0011002 MASK PREMI NEOPUFF BREATHING $15.0011003 MASK INFANT NEOPUFF BREATHING $15.0011006 WRAP NEOWRAP OCCLUSIVE WRAP $6.0011010 CATH LASER ABLATION 2.3MM FLEX $7,866.0011014 THERABAND RED M L2;50 YRD R $5.0011024 CATH THERMODILUTION 6FR 110CM $251.0011026 DRILL BIT ASNIS 3 CANULTD 4.9 $1,162.0011031 ELASTICIZED LOOP 2" X 1FT $3.0011032 ELASTICIZED LOOP 2" X 10YD $3.0011035 NEEDLE INSUL REG BLK 21GAX100 $36.0011046 TOURNIQUET CAT C A T DISPOSABL $65.0011077 STENT DE ZILVER 6 35 125 6X120 $3,492.0011086 STENT SUPERA VERITAS 6FR 5X100 $2,966.2511088 STENT SUPERA VERITAS 6FR 6X100 $2,966.2511090 STENT SUPERA VERITAS 6FR 6X150 $2,966.2511100 CATH ASPIRATION LP 6F X 140 $750.0011101 CATH ASPIRATION LP 5F X 138 $750.0011102 INTRO MICRO SET PEDAL 4FR 7CM $141.7511105 SUCTION CATHETER 5FR HALYARD $34.0011109 KIT RADIAL ACCESS CATHLAB $57.5011113 BLADE SHAVER 2.5MM FULL RADIUS $112.5011115 BLDE AGGRESSIVE 2.5MM CUTTER $112.5011116 HOODED ABRASION BUR 2.0MM $112.5011123 MASK INFANT NEOPUFF BREATHING $14.0011124 GUIDEWIRE SPR STIFF.035 75CM $61.1511125 GUIDEWIRE SPR STIFF.035 145CM $61.1511139 CIRCUIT VENT NEO WATER TRAP $16.0011141 SLING SYSTEM DESARA 45CM LONG $1,590.0011149 PREVENA WOUND MANAGMNT SYSTEM $1,300.0011152 STENT VASCULAR TIGRIS 5X40X120 $2,616.0011155 STENT VASCULAR TIGRI 5X100X120 $2,616.0011161 STENT VASCUALR TIGRIS 7X60X120 $2,616.00

11162 STENT VASCULAR TIGRIS 7X80X120 $2,616.0011163 STENT VASCULAR TIGRI 7X100X120 $2,616.0011167 CANNULA PREEMI RAM NEOTECH $24.0011168 CANNULA NEWBORN RAM NEOTECH $24.0011173 ENVELOPE PACEMAKER MED CANGARO $1,838.0011177 INFLATION DEVICE $63.0011194 SUT 6-0 ETHILON PC-3 $14.0011206 GUIDE WIRE ASAHI SOFT STRT 300 $169.0011207 NEO-TEE INFANT T-PIECE RESUSCT $42.0011210 ELECTRODE CTD BLADE INSUL 2.5 $7.8511230 MINERVA SURGICAL HANDPIECE $1,848.0011231 DRESSING MANUKAHD 4"X5" FIBER $22.1011232 DRESSING MANUKATEX 4"X5" GAUZE $9.3011233 GEL MANUKAPLI .5 OZ $10.1011251 OSETOTOME FLEXIB 6MM X 67MM $1,104.0011252 OSTEOTOME FLEXI 8MM X80MM STRL $1,138.0011253 CATH LASER ABLATION 2.0MM FLEX $7,866.0011266 SUT ETHILON 18" PS-2 NEEDLE $12.3011268 SUT 4-0 ETHILON 18' P-3 $11.5011279 LATERA ABSORBABLE NASAL IMPLNT $2,100.0011280 CARTRIDGE 'SNAP' THERAPY NPWT $252.0011281 DRESSING KIT'SNAP'15CM X 15CM $106.0011283 STRAP'SNAP'NPWT THERAPY MED 21 $26.2511290 STENT PROTEGE GPS 10X20X120 $1,550.0011308 STENT ENTRUST EVRFLX 8X40X120 $1,550.0011311 STENT ENTRUST EVRFLX 8X100X120 $1,550.0011318 THERABAND LATEX FREE L1 YELLOW $3.1511319 THERABAND LATEX FREE L2 L RED $3.2511321 SUCTION CUP LUCAS 3.0 DISPOSBL $74.9511322 RETRIEV WIRE SPECIMEN BAG 10MM $94.0011323 RETRIEV WIRE SPECIMEN BAG 12MM $94.0011348 STENT TRYTON BIFUR 3.5 X 19 $2,048.0011351 PTABALLOON LP 5 35 135 4 20 $260.0011352 PTABALLOON LP 5 35 135 5 20 $260.0011353 PTABALLOON LP 5 35 135 6 20 $260.0011357 PTABALLOON LP 5 35 135 5 4.0 $260.0011360 PTABALLOON LP 5 35 135 5 10.0 $260.0011363 PTABALLOON LP 5 35 135 6 4.0 $260.0011364 PTABALLOON LP 5 35 135 6 6.0 $260.0011365 PTABALLOON LP 5 35 135 6 8.0 $260.0011368 PTABALLOON LP 5 35 135 7 4.0 $260.0011371 HOOD BARRIER FLYTE STERILE $97.0011373 UTERINE MANIPULATOR 3.0CM $200.0011374 UTERINE MANUPULATOR 3.5CM $200.0011375 UTERINE MANIPULATOR 2.5CM $200.0011376 UTERINE MANIPULATOR 4.0CM XLRG $200.0011377 PORT CLOSURE SYSTEM CT 2 II $314.00

11399 BALLOON PTCA MOZEC NC 2.25X10 $191.0011406 BALLOON PTCA MOZEC NC 2.50X8 $191.0011407 BALLOON PTCA MOZEC NC 2.50X10 $191.0011409 BALLOON PTCA MOZEC NC 2.50X15 $191.0011414 BALLOON PTCA MOZEC NC 2.75X8 $191.0011416 BALLOON PTCA MOZEC NC 2.75X13 $191.0011422 BALLOON PTCA MOZEC NC 3.00X8 $191.0011424 BALLOON PTCA MOZEC NC 3.00X13 $191.0011425 BALLOON PTCA MOZEC NC 3.00X15 $191.0011430 BALLOON PTCA MOZEC NC 3.50X8 $191.0011432 BALLOON PTCA MOZEC NC 3.5X13 $191.0011433 BALLOON PTCA MOZEC NC 3.50X15 $191.0011438 BALLOON PTCA MOZEC NC 4.00X8 $191.0011440 BALLOON PTCA MOZEC NC 4.00X13 $191.0011441 BALLOON PTCA MOZEC NC 4.00X15 $191.0011446 BALLOON PTCA MOZEC NC 4.50X8 $191.0011457 ADAPTOR MDI DOSAGE $5.5011459 LIGASURE LAP MARYLAND SEAL INS $1,488.0011463 SLING ARM HEMI $87.5011487 DRESSING OPTI FOAM 4X4 ADHESIV $6.9011497 POUCH CLSTMY HIGH OUTPUT 2.25 $4.4011498 CANNULA CAPNO PEDI W/OXYGEN $32.0011499 CAPNO LINE W/TEE INTUB PATNTS $22.3011500 SHEATH PINNACLE 10FR 10CM STRL $21.2511501 SHEATH PINNACLE 11FR 10CM STRL $21.2511507 SNARE 90 DEG X15MM GOOSE NECK $556.0011508 SNARE 90 DEC X 20MM GOOSE NECK $556.0011511 SNARE 90 DEG X35MM GOOSE NECK $556.0011521 BALLOON DCB STELLAREX 5X60X135 $2,362.5011523 BALLOON DCB STELLAREX5X120X135 $2,616.2511526 BALLOON DCB STELLAREX 6X80X135 $2,362.5011527 BALLOON DCB STELLAREX6X120X135 $2,616.2511528 MESH PELVIC RESTORELLE FLR ANT $3,556.0011535 AIR MENISCUS SYSTEM CURVED $1,785.0011536 PUSHER/SUTURE CUTTER CANNULA $500.0011537 IRRIG SOD CHL 2000ML STRL $15.0011540 KIT MIDLINE CATH 4FR SINGLE PW $429.0011542 SUT MONOCRYL 4-0 SH 27IN TAPER $6.7011544 CATH IVUS VISION PV .035 STRL $1,837.5011548 CATH LITHOPLASTY 5.0 X 60 MM $4,812.0011549 CATH LITHOPLASTY 5.5 X 60 MM $4,812.0011550 CATH LITHOPLASTY 6.0 X 60 MM $4,812.0011552 CATH LITHOPLASTY 7.0 X 60 MM $4,812.0011553 BLADE PLASMA 4.0 RF KNIFE STRL $630.0011555 CATHETER SCORING FLEX PERIPHRL $1,990.0011559 SUT VICRYL 3-0 SH 18" MULTI 8 $37.8511560 KITTNER LAPAROSCOPIC 5MM TIP $20.60

11562 DILATOR BALLN URET 4X6 W/INFLT $622.0011564 CATH BALLOON DILITAION 16X2X75 $580.0011565 CATH BALLOON DILITAION 16X4X75 $580.0011566 CATH BALLOON DILITAION 18X2X75 $580.0011567 CATH BALLOON DILITAION 18X4X75 $580.0011568 CATH BALLOON DILITAION 20X2X75 $670.0011569 CATH BALLOON DILITAION 20X4X75 $670.0011570 CATH BALLOON DILITAION 22X2X75 $770.0011571 CATH BALLOON DILITAION 22X4X75 $770.0011574 STENT VENOUS WALLSENT 18X60X75 $4,151.0011575 STENT VENOUS WALLSENT 18X90X75 $6,338.0011576 STENT VENOUS WALLSENT 20X80X75 $3,734.0011577 STENT VENOUS WALLSENT 22X70X75 $6,338.2211580 APPLCTR ULTRA MIST HEAD-1 USE $108.0011581 CANNULA SLOTTED FAST FIX STRT $284.0011582 CANNULA SLOTTED FAST FIX CRVD $308.0011585 STENT DE ELUNIR RX 2.5X12 $2,250.0011586 STENT DE ELUNIR RX 2.5X15 $2,250.0011587 STENT DE ELUNIR RX 2.5X17 $2,250.0011591 STENT DE ELUNIR RX 2.5X33 $2,250.0011593 STENT DE ELUNIR RX 2.75X12 $2,250.0011596 STENT DE ELUNIR RX 2.75X20 $2,250.0011598 STENT DE ELUNIR RX 2.75X28 $2,250.0011601 STENT DE ELUNIR RX 3.0X12 $2,250.0011602 STENT DE ELUNIR RX 3.0X15 $2,250.0011610 STENT DE ELUNIR RX 3.5X12 $2,250.0011611 STENT DE ELUNIR RX 3.5X15 $2,250.0011612 STENT DE ELUNIR RX 3.5X17 $2,250.0011616 STENT DE ELUNIR RX 3.5X33 $2,250.0011618 STENT DE ELUNIR RX 4.0X12 $2,250.0011621 STENT DE ELUNIR RX 4.0X20 $2,250.0011625 STENT BM NANO CTD 2.5X18 $2,550.0011626 STENT BM NANO CTD 2.5X24 $2,550.0011627 STENT BM NANO CTD 2.5X30 $2,550.0011636 STENT BM NANO CTD 3.0X15 $2,550.0011638 STENT BM NANO CTD 3.0X24 $2,550.0011639 STENT BM NANO CTD 3.0X30 $2,550.0011647 STENT BM NANO CTD 4.0X12 $2,550.0011653 STENT VENOUS WALLSENT 24X70X75 $6,338.2211689 OBTURATR 8MM OPTCL Xi-DA VINCI $67.5011690 OBTURATOR 8MM OPTCL L-DA VINCI $67.5011691 SEAL CANNULA 5-8MM Xi-DA VINCI $45.0011692 SEAL CANNULA 12MM-8MM-DA VINCI $56.2511694 VESSEL SEALER Xi-DA VINCI $1,190.0011697 SEAL STAPLER CANNULA-DA VINCI $50.0011698 DRAPE INSTRMNT ARM Xi-DA VINCI $130.0011699 DRAPE COLUMN Xi-DA VINCI $45.00

11700 BLADE SHAVER 3.5MM DUAL EDGE $186.0011701 EXTERNAL CATH FEMALE PUREWICK $31.0011703 POUCH COLOSTOMY 1PC FLAT WAFER $2.0011704 POUCH UROSTOMY 1PC FLAT WAFER $4.0011705 POUCH COLSTMY 1PC CONVEX WAFER $4.5011706 POUCH UROSTMY 1 PC CONVEX WFR $5.0011707 POUCH HIGH OUTPUT 1PC FLAT WFR $3.9011710 PACK PACEMAKER SUB STRL $108.0011730 SET FOR GRAFT PASS WIRE $304.0011731 DISPS KIT TRAN TIB ACL W/O $290.0011732 FIBERLOOP #2 COATED COLLAGEN $168.7511733 BIO-TRANSFIX ARTHREX ACL 1351B $578.0011737 PLATE 3 HOLE LCP 2.7MM/3.5MM $1,869.0011738 SYRINGE CNTRST ARTERION 150ML $20.0011740 MONITOR LINQ SYSTEM IMPLANT $15,885.0011749 DRAPE PACEMAKER SURGICAL CATH $17.9011758 STENT VASC ACSEAL 4-6MM X 45CM $4,839.0011759 STENT VASC ACSEAL 4-7MM X45 CM $4,839.0011761 STENT VASC PROPTN 4-6MM X 45CM $4,185.0011769 SLING SHOULDER HEMI $111.0011770 PROLARYN VOICE PLUS 1CC INJECT $1,875.0011771 SHEATH SLENDER 5FR 10CM STRL $157.5011784 BULB & BLADDER ASSEMBLY-CLEAN $58.0011788 SHEATH SLENDER 6FR 10CM STRL $211.0011790 GRAFT KIT SUPER HERO1000 STRL $12,600.0011791 SUT 6-0 PROLENE 30" C-1 BLUE $53.0011798 SUT VLOC 2-0 PBT 18"GS-21 $79.0011799 SUT VLOC 2-0 PBT 12" V-20 $70.0011802 TRAY INSERTN UVC CATH NO CATH $110.0011804 VESSEL SEALER EXTEND DA VINCI $1,250.0011806 ENDOWRIST SUCTION IRRIGATOR DV $530.0011816 2.7MM/3.5MM LCP PLAT LAT 6HOLE $1,983.0011817 2.7MM/3.5MM LCP PLAT LAT 7HOLE $1,954.0011821 KNIFE SLIT ANG DBL 2.4MM STRL $20.7511827 GUIDEWIRE .035 260CM ANG/STIFF $118.0011829 DRESSING AVITENE SMALL .75X2 $24.7511830 DRESSING AVITENE LARGE 3X5 $109.0011839 TROCAR 5MM LONG 150MM CANNULA $232.0011841 STENT DE SYNERGY MR 2.25X12 $3,450.0011857 STENT DE SYNERGY MR 2.75X12 $3,450.0011866 STENT DE SYNERGY MR 3.0X16 $3,450.0011867 STENT DE SYNERGY MR 3.0X20 $3,450.0011870 STENT DE SYNERGY MR 3.0X32 $3,450.0011874 STENT DE SYNERGY MR 3.5X16 $3,450.0011892 CANNULAS CARNOFLEX ORAL/NASAL $30.0011894 DRESSING SECURE CHG 3X4 CV $15.5011895 DRESSING SECURE CHG 4X4 PORT $20.00

11896 DRESSING SECURE 2.5X2.75 IV $2.0011898 CATH CENTRAL VENOUS 5FR CUFFED $516.0011906 SUCTION IRRIGATOR SINONASAL $450.0011945 HEMOSTASIS ARISTA AH 1 GRAM S $210.00

731001 WRIST, 2 VIEWS LEFT $253.00731002 WRIST, 2 VIEWS RIGHT $253.00731201 HAND, 2 VIEWS LEFT $253.00731202 HAND, 2 VIEWS RIGHT $253.00731301 HAND MINIMUM 3 VIEWS LEFT $253.00731302 HAND MINIMUM 3 VIEWS RIGHT $253.00736001 ANKLE, 2 VIEWS LEFT $253.00736002 ANKLE, 2 VIEWS RIGHT $253.00736201 FOOT, 2 VIEWS LEFT $253.00736202 FOOT, 2 VIEWS RIGHT $253.00

1100002 R&B MEDICAL PRIVATE $1,391.001100004 R&B SURGICAL PRIVATE $1,391.001120002 R&B OB PRIVATE $1,391.001200001 R&B MEDICAL SEMI-PRIVATE $1,391.001280001 R&B REHABILITATION SEMI-PRI $1,391.001710001 R&B NEWBORN NURSERY LEVEL 1 $783.001720001 R&B NEWBORN CNTG/CARE LEVEL 2 $929.002000001 R&B INTENSIVE CARE $2,563.002000002 R&B ICU: OVERFLOW F/MED PR $1,391.002010000 R&B TELEMETRY SURGICAL $1,391.002020000 R&B TELEMETRY MEDICAL $1,391.002500534 DIPTHERIA/TETANUS ADULT 0.5ML $100.002501436 RT-XOPENEX/LEVALBTRL 0.63MG/3M $7.552501588 RT-PROVENTIL/VNTLN INH 2.5MG/3 $3.502501589 RT-IPRATROPIOM/ATRVNT .5MG/2.5 $10.502501593 RT-RACEPINEPHRINE INH SL 2.25% $16.902501886 INFLUENZA VACCINE,3YRS + $74.002501945 RT-MUCOMYST 20% PER 1CC $20.512502112 RT-XOPENEX/LVLBTRL 1.25MG/3M $8.102502124 RT-DUONEB $6.242502147 RT-ALBUTERAL 10MG INHAL $14.002502151 WC-SANTYL/COLLAGENASE 1/10TH $14.512502152 WC-NEOSPORIN OINTMENT 1/10TH $3.502502154 WC-SILVADENE/SSD 1% CRM 1/10TH $3.502502155 WC-LIDOCAINE 4% TOPICAL 1/10TH $3.502502156 WC-ZINC OXIDE 20% 1/10TH $3.502502165 WC-CLODERM 0.1% 1/10TH $15.972502168 WC-MUPIROCIN OINT 1/10TH $12.472502169 WC-ACETIC ACID .25% 100ML $6.752502170 WC-DAKIN'S SOLUTION 100ML $3.502502456 BROVANA INH S:7.5MCG/ML 2ML VL $18.502502535 TET TOX-DIPHTH-PERTUS 0.5ML SY $134.002502697 PNU-13 VALENT CONJU 0.5 ML SYR $506.00

2502834 INFLUENZA VACCINE HIGH,65YRS+ $95.002600001 IV INFSN,1HR IC $943.002600011 IV INFSN,1HR GIPC $943.002600012 IV INFSN, E+HR GIPC $477.002600013 IV INFSN, E+HR ER $477.002600014 IV INFSN,1HR ER $943.002600015 IV INFSN,ADD SEQ;U/T 1HR GIPC $460.002600016 IV INFSN, CONCURRENT INFUSION $460.002600017 IV INFSN,ADD SEQ;U/T 1 HR ER $460.002600018 IV INFSN,1HR RAD $943.002600020 IV INFSN, E+HR US $477.002601011 IV INFSN,HYDRATION,31M-1H GIPC $943.002601012 IV INFSN,HYDRATION E+HR GIPC $477.002601013 IV INFSN,HYDRATION E+HR ER $477.002601014 IV INFSN,HYDRATION,31M-1HR ER $943.002610005 EPIDURAL PUMP:PAT CONTROL OB $42.002700001 CLOTEST $57.002700008 OXYGEN STANDBY, O2 DAILY $44.002700011 CAST/SPLINT ARM/HAND ADULT $36.002700014 CAST/SPLINT LEG/FOOT CHILD $30.002700016 CAST SPICA CHILD $70.002700023 OXYGEN, HOURLY $73.002700025 FORENSIC EXAM EVIDENCE KIT $50.002700026 FORENSIC EXAM SUPPLY,FILM&DEVL $100.002700027 FORENSIC EXAM SPECULUM W/LGHT $6.502700028 RENT WOUND VAC F/PT PER DAY $143.002700029 CPM RENTAL AND PADS (SUPPLY) $152.002700031 AEROSOL DAILY CHG $124.002710005 CIRCUMCISION TRAY $20.002710007 EYE TRAY IN ER DEPT $4.002710008 EAR/NOSE/THROAT TRAY-ER DEPT $4.002710010 PUMP,ELECTRIC BREAST EQUIP USG $34.002720042 PKU SCREENING KIT (CARD) $80.002790002 RADIANT WARMER/DAILY $66.002790003 RADIANT WARMER PATCH/NSY $1.002790004 BEAR HUGGER-ALL AREAS $29.003000003 GASES,BLD A/COMB (BY CARDIO-P) $323.003000005 COLLECTION OF BLD,VENIPUNCTURE $25.003000008 BLD CNT;CMPLT (CBC), AUTOMATED $76.003000009 URINALYSIS,AUTOMATED W/MICRSPY $72.003000010 ALBUMIN URINE MICROALBU SEMI $63.003000011 AMMONIA $189.003000012 ANTIBODY HIV-1 $147.003000013 BASIC METABOLIC PNL,CALCIUM T $193.003000014 CELL COUNT BDY FLUIDS W/DIFF $173.003000016 NATRIURETIC PEPTIDE $215.003000017 COMPREHENSIVE METABOLIC PANEL $221.00

3000018 CRYSTAL ID,TISSUE ANY BDY FLD $119.003000019 CULTURE BACT;AEROBIC ISOLATE E $165.003000021 DIGOXIN; TOTAL $274.003000022 PHENYTOIN; TOTAL $252.003000026 ELECTROLYTE PANEL $193.003000027 GENTAMICIN $221.003000028 GLUCOSE TOLERANCE TST,3 SPM,1H $221.003000029 GLUCOSE TOLERANCE TST,3 SPM,2H $221.003000030 GLUCOSE TOLERANCE TST,3 SPM,3H $221.003000031 GLUCOSE TOLERANCE,EA BEYOND 3 $213.003000032 GLUCOSE,BDY FLUID,NOT BLOOD $88.003000033 SMEAR,PRI/SRCE W/INTERP;GRAM $80.003000034 HANDLING OF SPECIMEN $40.003000035 BLOOD COUNT; HEMOGLOBIN (HGB) $52.003000036 HEMOGLOBIN; GLYCOSYLATED (A1C) $100.003000037 HEMOGLOBIN,FETAL;ROSETTE $75.003000038 HEPATIC FUNCTION PANEL $241.003000039 CULTURE,BACTERIAL;ANAEROBIC ID $180.003000041 LIPID PANEL $274.003000042 MYOGLOBIN $240.003000043 INFECT AGT DET;NOS,EA ORGANISM $104.003000044 THROMBOPLAST TM,PRTL P/WB $92.003000045 PHENOBARBITAL $260.003000047 URINE PREGNANCY TEST,BY COLOR $145.003000048 PROSTATE SPECIFIC ANTIGEN,TOTA $166.003000050 PROTHROMBIN TIME $72.003000052 SALICYLATE/ANALGESICS,N-OP;1/2 $180.003000053 PSA SCREENING $166.003000054 CONCENTRATION ANY TYPE,INFEC A $67.003000056 CARBAMAZEPINE; TOTAL $286.003000057 THEOPHYLLINE $278.003000059 URINALYSIS,AUTO W/O MICROSCOPY $48.003000060 URINALYSIS,NON-AUTO W/O MICROS $28.003000061 DIPROPYLACETIC(VALPROIC);TTL $133.003000062 VANCOMYCIN $185.003000065 DT-BREATH ALCOHOL $27.003000068 PROTEIN;TOTAL,EX REFRACT,URINE $36.003000069 DT-SAP 10 UDS $40.003000071 DT-UDS COLLECTION:D/SCREEN ONL $20.003000074 SPUTUM,OBTAIN/SPECIMEN,SUCTION $28.003000075 CHLAMYDIA ANTIGEN,EIA $151.003000078 INFCT AGNT DET;INFLUENZA A/B,E $175.003000080 GENERAL HEALTH PANEL $270.003000083 PH,BODY FLUID,EXCEPT BLOOD-CP $64.003000085 GASES,BLOOD,PH ONLY - CP $50.003000086 INFCT AGNT DET;STREPTOCOCCUS,A $175.003000088 DT-HAIR F/DRUG SCREEN TESTING $37.00

3000090 LACTOFERRIN,FECAL;QUALITATIVE $102.003000093 INFECT AGT;SHIGA-LIKE TOXIN $58.003000094 INFECT AGT;SHIGA-LIKE TOXIN $58.003000096 COLL OF BLD, HEEL STICK; OB $25.003000097 COLL OF BLD, HEEL STICK; LAB $25.003000098 OBSTETRIC PANEL $195.003000099 DT-BREATH ALCOHOL CONFIRMATION $10.003000100 DT-OBSERVED COLLECTION,ADD CHG $10.003001000 ACUTE HEPATITIS PANEL $419.003001002 ADRENOCORTICOTROPIC HORMONE $297.003001007 ALBUMIN;SERUM,PLASMA/WHOLE BLD $70.003001008 ALBUMIN;OTHER SRC,QUAN EA $69.003001009 ALDOLASE $75.003001010 ALDOSTERONE $281.003001012 ALPHA-FETOPROTEIN:SERUM $180.003001013 ALPHA-1-ANTITRYPSIN;TOTAL $102.003001014 AMIKACIN $134.003001015 AMINO ACIDS,6+,QUNT EA SPEC $844.003001017 AMINOLEVULINIC ACID, DELTA $122.003001020 ANGIOTENSIN 1,CONVERT ENZYME $140.003001026 ANTI-BDY;BACTERIUM, NES $97.003001027 ANTI-BDY;BLASTOMYCES $152.003001029 ANTI-BDY;BRUCELLA $146.003001031 ANTI-BDY;COCCIDIOIDES $61.003001033 ANTI-BDY;CYTOMEGALOVIRUS,IGG $97.003001034 ANTI-BDY;CYTOMEGALOVIRUS,IGM $97.003001037 ANTI-BDY;HELICOBACTER PYLOR $203.003001040 ANTI-BDY;HERPES SIMPLEX,TYPE 2 $152.003001042 ANTI-BDY;HIV-1&HIV-2 SGL ASSAY $159.003001046 ANTI-BDY;MYCOPLASMA $100.003001047 ANTI-BDY;PARVOVIRUS 2X-86747 $180.003001050 ANTI-BDY;RUBELLA $121.003001053 ANTI-BDY;TOXOPLASMA $97.003001054 ANTI-BDY;TOXOPLASMA,IGM $132.003001055 ANTI-BDY;TREPONEMA PALLIDUM,CT $100.003001059 ANTI-BDY;RICKETTSIA $147.003001060 ANTI-BDY;RUBEOLA $22.003001062 ANTI-BDY;MUMPS $116.003001063 ANTINUCLEAR ANTIBODY $101.003001064 ANTISTREPTOLYSIN O;TITER $80.003001068 BETA 2 GLYCOPROTEIN 1 3X-86146 $292.003001069 BETA-2 MICROGLOBULIN $140.003001072 C-PEPTIDE $132.003001073 C-REACTIVE PROTEIN $107.003001074 IMMUNOASSAY/TUMOR ANQT CA 19-9 $145.003001080 CALCIUM;URINE QUANT,TIMED SPEC $72.003001081 CARBON MONOXIDE;QUANTITATIVE $112.00

3001082 CARDIOLIPIN ANTI-BDY;EA LG CLS $140.003001083 CATECHOLAMINES;FRACTIONATED $285.003001084 CARCINOEMBRYONIC ANTIGEN (CEA) $141.003001086 CERULOPLASMIN $107.003001095 CLOT INHBT/ANTITHRO III REF216 $166.003001096 CLOTTING;FACTOR IX(PTC/CHRIST) $305.003001100 CLOTTING INH;PROTEIN C,ANTIGEN $345.003001101 CLOTTING INH/PROTEIN C,ACTIVTY $357.003001102 CLOTTING INH;PROTEIN S,TOTAL $357.003001106 CLOTTING;FACTOR VIII,VW FACTOR $243.003001109 COMPLEMENT;TOTAL HEMOLYTIC $193.003001110 COMPLEMENT;ANTIGEN, EA COMPONE $75.003001111 COPPER $101.003001112 CORTISOL;TOTAL $163.003001113 CORTISOL;FREE $141.003001114 CREATINE KNS;ISOENZYMES E/3851 $93.003001115 CREATININE;OTHR SOURCE E/3315U $102.003001117 CULTURE,CHLAMYDIA,ANY SOURCE $195.003001120 CULTURE,FUNGI,ID EA ORGAN,YEAS $100.003001122 CULTURE,FUNGI,ID EA ORGAN;MOLD $100.003001123 CULTURE,MYCOBACTERIAL,ID EA IS $102.003001127 CULTURE,TYPING;IMMUNOLOGIC MTH $122.003001132 DEOXYRIBONUCLEIC ACID ANTI-BDY $96.003001133 DEHYDROEPIANDROSTERONE (DHEA) $228.003001134 DEHYDROEPIANDROSTERONE-SULFATE $173.003001137 DIHYDROXYVITAMIN D,1,25- $323.003001141 EPSTEIN-BARR VIRUS,ERLY ANTIGN $243.003001143 EPSTEIN-BARR VIRUS,VIRAL CAPSI $102.003001145 ERYTHROPOIETIN $232.003001146 ESTRADIOL $224.003001147 ESTRIOL $160.003001148 ESTROGENS;TOTAL $263.003001150 ETHYLENE GLYCOL $127.003001152 FACTOR INHIBITOR TEST $405.003001154 FAT/LIPIDS,FECES;QUALITATIVE $119.003001155 FERRITIN $121.003001156 FIBRIN DEGRAD PDTS,D-DIM;QUANT $203.003001162 FOLIC ACID;SERUM $104.003001164 FOLIC ACID;RBC $217.003001165 GONADOTROPIN;FSH $132.003001169 GAMMAGLOBULIN;ADGM $73.003001171 GASTRIN $173.003001176 GONADLTROPIN;LUTEINIZING HORM $132.003001177 GROWTH HORMONE, HUMAN $151.003001178 HAPTOGLOBIN;QUANTITATIVE $129.003001185 HEPATITIS B CORE ANTI-BDY;TOTA $90.003001186 HEPATITIS C ANTI-BDY $151.00

3001188 HEPATITIS A ANTI-BDY $60.003001189 HEPATITIS A ANTI-BDY;IGM $80.003001190 HEPATITIS B CORE ANTI-BDY;IGM $96.003001192 HEPATITIS B SURFACE ANTI-BDY $96.003001193 INFECT AGT;HEPATITIS B SURFACE $98.003001194 HEPATITIS BE ANTI-BDY $90.003001198 HYDROXYINDOLACETIC ACID,5- $230.003001201 HLA TYPING;A,B,C,SNGLE ANTIGEN $179.003001202 HOMOCYSTINE $243.003001204 IMMUNOASSAY ANTIGE,QUANT;CA125 $145.003001207 IMMUNOASSAY ANTIG,QUANT;CA15-3 $145.003001208 IMMUNOASSAY,ANALYTE,QUANT;RADI $173.003001210 MONOCLONAL GAMMOPATHIES,SERUM $180.003001212 INFECT AGT ANTIGEN;ROTAVIRUS $129.003001215 IMMUNOASSAY INF AGT,QUANT;NES $111.003001217 INFECT AGT IMMUNOFLUO;CRYPTOSP $138.003001220 INFECT AGT DNA/RNA;HEPATITIS B $550.003001224 INFECT AGT DNA/RNA;HEP C,QUANT $657.003001226 INFECT AGT GENOTYPE;HEP C VIRU $696.003001228 INSULIN;TOTAL $140.003001229 INTRINSIC FACTOR ANTIBODIES $201.003001230 IRON $22.003001231 IRON BINDING CAPACITY $50.003001234 LACTATE (ACID ACID) $100.003001236 LEAD $88.003001239 LIPASE $67.003001240 LITHIUM $67.003001246 MICROSOMAL ANTIBODIES,EA $132.003001261 MYELIN BASIC PROTEIN,CEREBRO F $201.003001262 MYOGLOBIN, URINE $159.003001264 NORTRIPTYLINE/ANTIDEPRSSNT;1/2 $159.003001266 OLIGOCLONAL IMMUNE $543.003001268 OSMOLALITY;BLOOD $44.003001269 OSMOLALITY;URINE $46.003001273 PARATHORMONE(PARATHYROID HORM) $215.003001278 PHOSPHATASE, ACID; PROSTATIC $127.003001279 PHOSPHATASE,ALKALINE;ISOENZYME $72.003001283 PORPHOBILINOGEN,URINE;QUANT $106.003001285 PREALBUMIN $156.003001286 PRIMIDONE $80.003001288 PROGESTERONE $140.003001289 PROINSULIN $328.003001290 PROLACTIN $141.003001291 PROTEIN;ELECTRO FRACT/QUANT, S $107.003001298 PYRUVATE $144.003001302 RENIN $248.003001303 RHEUMATOID FACTOR;QUANTITATIVE $70.00

3001308 SMEAR,PR SC W/INT FL ACID FAST $58.003001313 CALCULUS;QUAL ANA INFRARED SPE $102.003001317 T CELLS; TOTAL COUNT E/1655 $90.003001318 TACROLIMUS $250.003001319 TESTOSTERONE; FREE $201.003001320 TESTOSTERONE; TOTAL $203.003001321 THROMBIN TIME;PLASMA $119.003001323 THYROGLOBULIN $100.003001329 TOPIRAMATE $132.003001331 TRANSFERRIN $93.003001332 TRIIODOTHYRONINE T3;TOTAL TT-3 $111.003001333 TRIIODOTHYRONINE T3; FREE $263.003001337 TRIIODOTHYRONINE T3; REVERSE $204.003001341 VANILLYLMANDELIC ACID-VMA,URIN $201.003001342 SYPHILIS TEST;QUALITATIVE $96.003001343 VIRUS ISOL;TISSUE CULTURE INOC $180.003001344 VISCOSITY $119.003001345 VITAMIN A $180.003001346 CYANOCOBALAMIN (VITAMIN B-12) $106.003001348 ZINC $101.003001350 CLOTTING FACTOR II ACTIVITY $305.003001351 CLOTTING FACTOR V ACTIVITY $305.003001353 QUANT F/DRUG NES;LAMOTRIGINE $132.003001355 MONOCLONAL GAMMOPATHIES,URINE $285.003001359 ASCORBIC ACID (VITAMIN C) BLD $119.003001361 VITAMIN K $310.003001362 THYROXINE BINDING GLOBULIN TBG $243.003001364 CLOTTING FACTOR VII ACTIVITY $305.003001365 CLOTTING FACTOR X ACTIVITY $305.003001368 CRYPTCOCCUS ANTIGEN, SERUM $122.003001374 CULTURE FUNGI ISOL;O/S NOT BLD $104.003001379 FACTOR VIII(AHG),1 STG E/5961 $221.003001380 RISTOCETIN E/5961 $221.003001381 THROMBOPLAST TM,PRTL E/5961 $221.003001382 VONWILLEBRAND AG E/5961 $236.003001385 CREATINE KINASE; TOTAL E/3851 $93.003001388 ARSENIC E/4080W $119.003001389 THYROXINE TOTAL T4 $48.003001390 FLOW CYTOMETRY,CS,TC,1ST MRKR $334.003001391 QUANT F/DRUG NES;TRILEPTAL $238.003001392 ORGANIC ACID,SNGL,QUANTITATIVE $293.003001393 THIAMINE (VITAMIN B-1) $185.003001394 PYRIDOXAL PHOSPHATE (VIT B-6) $293.003001409 VIRUS ISOL;IDENT NON-IMMNLGC M $97.003001411 IMMUNASSY,ANAL,QNT;NOS E/1077 $343.003001413 THYROID HRMN T3/T4-THBR E/3230 $66.003001414 THYROXINE; TOTAL E/3230 $66.00

3001415 PHOSPHATASE, ALKALINE E/3996 $84.003001416 C-REACTIVE PROTEIN, (hsCRP) $215.003001419 LIPOPRTN,BD;HRFRC/QNT E/S50365 $42.003001420 SPECTROPHTMETRY,A/NOS E/S50365 $36.003001421 APOLIPOPROTEIN,EACH $134.003001423 UNLISTED CHEMISTRY PROCEDURE $46.003001436 ANT-BDY IDNT;LEUKOCYTE E/1866 $502.003001437 ANTINUCLEAR ANT-BDY(ANA)E/1866 $172.003001438 INHIBIN A $350.003001439 CRYOGLOBULIN,QUAL/SEMI-QUANT $57.003001440 T CELLS;ABSOLUTE CD4 COUNT $145.003001442 IMMUNASSY,ANAL,QNT;NOS 3133 $122.003001444 IMMUNOASSAY,ANALYTE,QUANT:NOS $262.003001445 CELL COUNT,MSC BDY FLD E/BLD $60.003001447 AEROBIC SSCPT:FSTDS ORG MIC/PN $330.003001449 CULTURE BACT;AEROBIC ISOLATE E $139.003001457 INFECT AGENT H. PYLORI, STOOL $163.003001464 TOCOPHEROL ALPHA (VT E) E/3530 $90.003001466 THYROID STMLTNG IMMN GL E/3060 $190.003001468 PSA;FREE E/3547 $104.003001470 VASOPRESSIN(ANTIDIRUETIC HORM) $271.003001474 ANTIHMN GLBLN TST ID T E/STBTC $94.003001477 HYDROXYPROGESTERONE, 17-D $67.003001481 FLOW CYTOMETRY,CS,TC,EA + MRKR $50.003001484 FLOW CYTOMETRY,INTRP;16/+MRKRS $331.003001485 ANDROSTENEDIONE $214.003001488 SOMATOMEDIN;INSULIN GRWTH FCTR $334.003001496 INFECT AGT;SHIGA-LIKE TOXIN $132.003001498 SOMATOSTATIN $249.003001501 LIPOPROTEIN,DRCT M;LDL CHLSTRL $84.003001506 INFECT AGT DNA/RNA;NG,DPT $182.003001508 SIROLIMUS $154.003001511 BILE ACIDS, TOTAL $73.003001515 AMPHETAMINE/METHAMPHETAMINE;5+ $145.003001520 INFECT AGENT;CYTOMEGALOVIRUS,Q $613.003001528 PROTEIN;TTL,EX RFCT,U E/1305UR $54.003001533 INFECT AGT DET;HISTOPLASMA SRM $148.003001534 SUSCEPT/STDY;A-MICROB,DM,P/PLT $102.003001552 SEX HORMONE BINDING GLOBULIN $113.003001558 PHENYTOIN; FREE $64.003001563 ANT-BDY;CAMPYLOBACTER $122.003001572 INSULIN ANTIBODIES $153.003001573 MOLEC CYTOGE;ADL KARYOE/S51690 $303.003001576 TB CELL MED IMM MEAS GAMMA INT $294.003001578 CALPROTECTIN, FECAL $193.003001598 HERPES SIMPLEX VIR TYP2 E/2426 $37.003001599 HERPES SIMPLEX VIR TYP1 E/2426 $37.00

3001602 PRETREATMENT SERUM W/PAT RBC'S $38.003001603 PRETREATMENT RBC'S W/ENZYMES $86.003001604 BLD TYPING;ANTIGEN DONOR BLD,E $92.003001605 BLD TYPING;ANTIGEN DONOR BLD,E $120.003001606 BLD TYPING;ANTIGEN DONOR BLD,E $148.003001607 ANTIBODY SCREEN,RBC,E SERUM T $50.003001610 MYCOBACTERIA TUBERCULOSIS,APT $234.003001612 CLT INHBT/ANTI-COA,PRTN S FREE $223.003001613 SICKLING OF RBC, REDUCTION $65.003001614 ANTIBODY; TETANUS $120.003001618 UL HEMATOLOGY/COAGULATION PROC $106.003001620 DEOXYRIBONUCLEIC ACID AB;1 STR $141.003001627 THYROID STIM IMMUNE GLBLN(TSI) $372.003001631 ANTI-BDY;WEST NILE VIRUS $91.003001633 DETECT AGNT MULT DNA AMPLIFIED $323.003001634 PANCREATIC ELASTASE FECAL $242.003001641 ASSAY OF LRH HORMONE $244.003001645 F5 GENE $282.003001646 F2 GENE $212.003001651 PLATELET,AGGRGTN(IN VITRO),EA $144.003001654 AMMONIA E/REF5510 $37.003001655 ASSAY OF URINE SULFATE E/5510 $37.003010005 HELICOBACTER PHYLORI;DRUG ADMN $33.003010010 ACETAMINOPHEN/ANALGESICS;1/2 $284.003010011 ACETONE/KETONE BDY,SERUM QUANT $90.003010013 ALCOHOL (ETHANOL)ANY-EX BREATH $241.003010014 AMYLASE $135.003010015 BILIRUBIN; TOTAL $67.003010016 BILIRUBIN; DIRECT $67.003010018 UREA NITROGEN; QUANTITIVE $88.003010019 CALCIUM; TOTAL $86.003010020 CARBON DIOXIDE (BICARBONATE) $86.003010021 CHLORIDE; BLOOD $88.003010023 CHOLESTEROL,SERUM/WHOLE BLD TL $88.003010024 CPK; MB FRACTION ONLY $305.003010025 CREATINE KINASE(CK),(CPK)TOTAL $104.003010026 CREATININE; BLOOD $88.003010028 GLUTAMYLTRANSFERASE,GAMMA GGT $104.003010029 GLUCOSE,BLD MONIT DVC $42.003010030 GLUCOSE;QUANTITATIVE BLOOD $88.003010031 GONADOTROPIN,CHORIONIC; QUAL $151.003010032 LIPOPROTEIN, HDL CHOLESTEROL $102.003010033 LACTATE DEHYDROGENASE(LD),LDH $88.003010034 MAGNESIUM $129.003010036 BLD OCCULT SCREEN;FECES CONSEC $76.003010037 PH,BODY FLUID, EXCEPT BLOOD $61.003010038 PHOSPHATASE, ALKALINE $104.00

3010039 PHOSPHORUS INORGANIC-PHOSPHATE $86.003010040 POTASSIUM;SERUM,PLASMA/WHL BLD $88.003010041 POTASSIUM; URINE $92.003010042 PROTEIN;TOTAL,EX REFRACT,SERUM $88.003010043 GONADOTROPIN,CHORIONIC;QUANT $228.003010044 RENAL FUNCTION PANEL $206.003010045 SODIUM;SERUM,PLASMA/WHL BLD $88.003010046 SODIUM, URINE $92.003010047 THYROID STIMULATING HORMONE $141.003010048 THYROXINE; FREE $129.003010049 TRANSFERASE;ASPARTATE AMINO $88.003010050 TRANSAMINASE;ALANINE AMINO $88.003010051 TRIGLYCERIDES $104.003010052 TROPONIN,QUANTITATIVE $273.003010054 URIC ACID; BLOOD $88.003010055 CREATININE; CLEARANCE $111.003010056 CHLORIDE;OTHER SOURCE CSF $90.003010061 PAMG-1 CERVICOVAGINAL SEC,QUAL $233.003010062 DRUG SCRN;1DRUG METHOD,INSTRMT $304.003010063 VITAMIN D;25HYDROXY+FRACTIONS $109.003010064 BILIRUBIN,TOTAL,TRANSCUTANEOUS $20.003020010 ANTIBODY ID RBC EA PANEL/SERUM $231.003020012 ANTIGEN RSV $280.003020013 PARTICLE AGGLUTIN SCREEN, EACH $278.003020014 COLD AGGLUTININ; TITER $129.003020015 HETEROPHILE ANTIBODIES; SCREEN $145.003020016 RHEUMATOID FACTOR;QUALITATIVE $102.003020017 SYPHILIS TEST;QUALITATIVE $86.003050012 FIBRINOGEN SPLT PRD,SEMI-QUANT $189.003050013 FIBRINOGEN; ACTIVITY $196.003050014 BLOOD COUNT; HEMATOCRIT (HCT) $52.003050015 BLD COUNT;COMP AUTOMATED & DIF $76.003050016 BLOOD COUNT;PLATELET,AUTOMATED $88.003050017 BLD COUNT;RETICULOCYTE,MANUAL $80.003050018 SEDIMENTATION RATE,NON-AUTOMAT $86.003050019 BLD CT;LEUKOCYTE WBC,AUTOMATED $66.003050021 COAGULATION TIME; ACTIVATED $28.003060010 CLOSTRIDIUM DIFFICILE TOXIN(S) $203.003060011 CULTURE,BACTERIAL EA W/ID, URN $173.003060012 CULTURE,BACTERIAL ANY OTHER SR $187.003060016 CULTURE,BACTERIAL URINE $88.003060017 CULTURE,BACTR,A/S N/BLD,ANAERB $158.003060021 OVA & PARASITES,D/S,CONCENT&ID $129.003060022 SUSCEPTIBILITY STUDIES,MIC/AGA $145.003060023 SMEAR W/INTERP;WET MT INFECT A $76.003060024 INF AGENT ANTIGEN DET, NOS $60.003060025 INF AGENT ANTIGEN DET, NOS $60.00

3060026 INF AGENT ANTIGEN DET, NOS $60.003060028 VAGINITIS SCREEN $228.003060029 INFECT AGT DNA/RNA;AP TECH,EA $114.003100001 CLINICAL PATH CONSULT,W/O REVW $17.003100002 PATH LVL IV-SURG;GRSS/MICRO E $101.003100003 PATH LVL III-SURG;GRSS/MICRO E $101.003100004 PATH LVL V-SURG:GRSS/MICRO E $154.003100005 PATH CNSLT SURG;1ST TB W/FS,1 $101.003100006 PATH:DECALCIFICATION PROCEDURE $32.003100007 PATH SPECIAL STAIN +I&R;GRP 1 $55.003100008 PATH LVLI-SURG;GROSS/EXAM ONLY $32.003100009 PATH CONSULT D/SUR;E+ TB W/FS $32.003100010 PATH LVL VI-SURG;GROSS/MICRO E $154.003100011 PATH CYTOPATHOLOGY F/W/B;SMR&I $48.003100012 PATH LVL II-SURG;GROSS/MICRO E $46.003100013 CYTOPATHOLOGY,C/TECHN,SMEARS&I $46.003100016 PATH MORPHOMETRIC ANALY TI;MAN $146.003100017 PATH IHC/ICC,P/SPCMN;1ST $97.003100018 PATH DUR SRGRY;1TSS BLK,W/FS,1 $63.003100019 PATH SPECIAL STAIN I&R;GII OTH $63.003100021 PATH CONSULT/TRPT MTRL REQ SLD $101.003100022 PATH IN SITU HYBRIDIZATION,E P $306.003100023 PATH MC;IP SITU H,A 100-300 C $281.003100024 PATH MC;DNA PROBE, EA (FISH) $256.003100029 PATH HEMOCHROMATOSIS GENE ANAL $294.003100030 PATH IHC/ICC P/SPCMN;EA+1 STN $89.003100041 PATH IGH, IG HEAVY CHAIN LOCUS $642.003100042 PATH IGK,IG KAPPA LGHT CHN LCS $642.003100043 MORPHOMETRIC ANALYSIS,M,P/S;EA $603.003100045 PATH IN SITU HYBRIDIZATION,E+P $153.003100047 PATH MICROSATELLITE INSTABLE A $546.003100048 PATH MICRODISSECTION;MANUAL $136.003110001 PATH CYTOPATHOLOGY,FNA;1 EV EA $49.003200002 ABDOMEN,COMPL ACUTE SERIES $253.003200004 ABDOMEN,1 VIEW $253.003200005 ABSCESS, FISTULA, OR SINUS STY $582.003200006 ANKLE COMPLETE 3+ VIEWS $253.003200007 ANKLE, 2 VIEWS $253.003200008 KNEE, ARTHROGRAPHY $1,187.003200009 HIP, ARTHROGRAPHY $1,187.003200010 BONE AGE STUDIES $253.003200011 BONE LENGTH STUDIES $426.003200012 OSSEOUS (BONE) SURVEY COMPLETE $489.003200013 OSSEOUS (BONE) SURVEY LIMITED $426.003200014 FLUOROSCOPY U/T 1HR TIME,P $479.003200015 CALCANEUS/HEEL MINIMUM 2 VIEWS $253.003200016 CHOLANGI/PANCREATOGRAPHY IN-OP $582.00

3200019 CLAVICLE, COMPLETE $253.003200020 COLON, AIR CONTRAST W/BARIUM $931.003200021 COLON,CONTRAST ENEMA, W/WO KUB $603.003200022 CYSTOGRAPHY, MINIMUM 3 VIEWS $872.003200024 ELBOW COMPLETE,MINIMUM 3 VIEWS $253.003200025 ELBOW, 2 VIEWS $253.003200028 FACIAL BONES,COMP MIN 3 VIEWS $253.003200029 FEMUR; MINIMUM 2 VIEWS $253.003200030 FINGER(S), MINIMUM 2 VIEWS $253.003200031 FLUORO GUID/LOCAL OF NEEDLE $275.003200032 FLUORO GUID F/NDL PLCMT;RAD $687.003200033 FLUOROSCOPY,U/T 1HR TIME,RM $479.003200035 FOOT COMPLETE, MINIMUM 3 VIEWS $253.003200036 FOOT, 2 VIEWS $253.003200037 FOREARM, 2 VIEWS $253.003200038 FOREIGN BDY EX,NOSE/RECT,1V CH $253.003200039 GI,UPPER W/SM INTEST FLLW-THR $903.003200040 SMALL INTEST, +MULI SERIAL FLM $503.003200041 GI,UPPER W/AIR; W/O KUB $575.003200042 GI,UPPER W/WO DLYD FLM,W/O KUB $503.003200043 HAND MINIMUM 3 VIEWS $253.003200044 HAND, 2 VIEWS $253.003200045 HIPS,BIL,WITH PELVIS WP;3-4 V $426.003200046 HIP,DURING OPERATIVE PROCEDURE $426.003200047 HIP,UNI WITH PELVIS WP;2-3 V $253.003200048 HIP,UNILATERAL W/PELVIS;1 VIEW $253.003200049 HUMERUS, MINIMUM OF 2 VIEWS $253.003200050 HYSTEROSALPINGOGRAPHY,SPVS&INT $1,177.003200052 ACROMIOCLAVICULAR JTS, BILAT $253.003200053 SACROILIAC JOINTS LESS/T 3 VWS $253.003200054 TEMPOROMANDIBULAR JT,O&C BILAT $253.003200055 KNEE,1-2 VIEWS $253.003200056 KNEE, 3 VIEWS $253.003200057 KNEE, COMPLETE 4 OR + VIEWS $253.003200058 KNEE(BOTH),STANDING & ANT/POS $253.003200059 MANDIBLE COMPLETE MIN 4 VIEWS $253.003200060 MANDIBLE PARTIAL LESS/T 4 VIEW $253.003200062 NASAL BONES COMP MIN 3 VIEWS $253.003200063 NECK SOFT TISSUE $253.003200065 ORBITS COMPLETE MIN 4 VIEWS $253.003200066 PELVIS COMPLETE MIN 3 VIEWS $253.003200067 PELVIS 1 OR 2 VIEWS $253.003200068 PORTABLE EXAM IN HOSPITAL $111.003200070 UROGRAPHY INFUSION W/NEPHROTOM $872.003200071 UROGRAPHY IV W/WO KUB OR TOMOG $872.003200072 UROGRAPHY RETROGRADE W/WO KUB $1,144.003200073 RIBS BILAT +P/A CHEST MIN 4 VW $426.00

3200074 RIBS UNIL +P/A CHEST MIN 3 VWS $253.003200075 SACRUM & COCCYX MIN OF 2 VIEWS $253.003200076 SCAPULA COMPLETE $253.003200078 SHOULDER COMPLETE MIN 2 VIEWS $253.003200079 SHOULDER 1 VIEW $253.003200081 SINUSES,PARANASAL,L/T 3 VIEWS $253.003200082 SINUSES,PARANASAL COMP MIN 3 V $253.003200083 SKULL,COMPLETE MIN 4 VWS $426.003200084 SKULL,L/T 4 VIEWS $253.003200087 SPINE,SCOLIOSIS STDY;4/5 VIEWS $426.003200088 SPINE,CERVICAL;6 OR MORE VIEWS $426.003200089 SPINE,CERVICAL 2 OR 3 VIEWS $253.003200090 SPINE,CERVICAL 4 OR 5 VIEWS $426.003200091 SPINE;THORACOLUMBAR JNCTN,2 V $318.003200092 SPINE,LS BENDING, MIN 4 VIEWS $426.003200093 SPINE,LUMBOSACRAL 2/3 VIEWS $253.003200094 SPINE,LUMBOSACRAL MIN 4 VIEWS $426.003200096 SPINE,THORACIC 2 VIEWS $253.003200097 SPINE,THORACIC 3 VIEWS $253.003200098 STERNUM MIN 2 VIEWS $253.003200099 SWALLOW FNCTN W/C&V,BS NO SPCH $503.003200100 TIBIA & FIBULA 2 VIEWS $253.003200101 TOE(S) MINIMUM 2 VIEWS $253.003200103 URETHROCYSTOGRAPHY,RETROGRD-R $1,144.003200104 URETHROCYSTOGRAPHY, VOIDING $872.003200105 UROGRAPHY,ANTEGRD PYEL/NEPH/LO $1,144.003200106 VENOGRAPHY,EXTREMITY UNILAT $4,641.003200108 WRIST, 2 VIEWS $253.003200109 WRIST COMPLETE MIN 3 VIEWS $253.003200111 SHOULDER, ARTHROGRAPHY $1,187.003200112 INJ SHOULDER ARTHRO OR CT/MRI $212.003200113 INJ HIP ARTHRO W/O ANESTHESIA $284.003200121 SWALLOW FNCTN W/C&V,MBS SPEECH $503.003200124 FLUROSCOPIC GDNC CVAD PLMNT $635.003200125 CMBND ENDSCPC CATH BIL/PANC DS $873.003200127 MYELOGRAPHY,LUMBOSACRAL,S&INTP $3,227.003200133 ARTHROCENTESIS/INJ,MJ JT/BURSA $491.003200144 SPINAL PUNCTURE,LUMBAR,DIAG $905.003200145 RAD EXAM, OSSEOUS SRVY,INFANT $426.003200146 INJ SINUS TRACT;DIAG(SINOGRAM) $716.003200150 SPINE LUMBSCRL; CMPLT+BENDNG V $426.003200152 DUAL-ENRGY,BONE DENSITY 1/+;AX $504.003200161 INSRT NON-TNLD CATH,5/+YR,RAD $2,534.003200163 FOOT CMP,MIN 3V;WEIGHT BEARING $253.003200165 AORTOGRPHY,ABD+2 ILIOFEMORAL,C $13,091.003200167 RIBS UNIL; 2 VIEWS $253.003200172 CATH/INTRO S/CM SIS/HYSTEROSAL $635.00

3200184 CHG PERCUT TUBE/DRNGE CTH W/CM $168.003200185 INJ P F/EXTREMITY VENOGRAPHY $661.003200220 KNEE,1-2 VIEWS STANDING $253.003200222 WRIST,ARTHROGRAPHY,S&I $993.003200224 INJ PROC F/WRIST ARTHROGRAPHY $635.003200225 SPNL PNCTR,THER,DRNG FLD,ND/CA $1,092.003200230 MYELOGRAPHY LMBR INJ+S&I;2/+R $3,896.003200232 FEMUR; 1 VIEW $253.003200233 BONE LENGTH SCANOGRAM(LEG MSR) $426.003200236 MANUAL APPL OF STRESS JT RADIO $250.003200238 INJ IV P,1/FRST SUB/DRUG; RAD $280.003200239 ABDOMEN; 3 OR MORE VIEWS $294.003200240 ABDOMEN; 2 VIEWS $253.003200241 INJ,EPIDURAL,BD/CLT PTCH-RAD $1,761.003230002 AORTOGRAPHY,ABD B/SERIALGRAPH $13,091.003230012 ANGIOGRAPHY,EXTREMITY,UNILAT $13,091.003230013 ANGIOGRAPHY,EXTREMITY,BILAT $13,091.003230014 ANGIOGRAPHY,RENAL,UNILT,SEL+FA $6,990.003230015 ANGIOGRAPHY,RENAL,BILAT,SEL+FA $6,990.003230016 ANGIOGRAPHY,VISCERAL,SEL/S-SEL $13,091.003230018 ANGIOGRAPHY,PELVIC,SEL/S-SEL $13,091.003230023 ANGIOGRAPHY,SEL,E+VESSEL A/B E $978.003230026 VENOGRAPHY,EXTREMITY,UNILAT $4,641.003230027 VENOGRAPHY,EXTREMITY,BILATERAL $4,641.003230038 VENOGRAPHY,CAVAL,INFERIOR,W/SG $13,091.003230044 VENOGRAPHY,VEN SINUS/JUGULAR,C $4,641.003230045 ANGIOGRAPHY EXISTING CATH FU/S $497.003230057 ANGIOGRAPHY;IL/FEM,NSEL,B/I,CC $661.003240001 CHEST 4 OR MORE VIEWS $253.003240003 CHEST 1 VIEW $253.003240006 CHEST 2 VIEWS $253.003240007 CHEST 3 VIEWS $253.003350001 CHEMO ADM INFSN 1HR, FRST DRG $1,174.003350002 CHEMO ADM INFSN EA ADD HR $1,174.003350003 CHEMO ADM INFSN 1HR,EA + DRUG $1,174.003400001 RADIOPHARMACEUTICAL THPY,ORAL $704.003410003 ACUTE GI BLOOD LOSS IMAGING $1,645.003410005 BONE &/OR JOINT IMAG LIMITED A $1,573.003410006 BONE &/OR JOINT IMAG WHOLE BDY $1,573.003410007 BONE &/OR JOINT IMAG 3 PHASE S $1,645.003410010 GASTRIC EMPTYING STUDY $1,485.003410011 HEPATOBILIARY DUCTAL SYS IMAG $1,697.003410013 KIDNEY IMAG M W/VF W/O PI, 1 $1,442.003410017 MYOCARDIAL PERF IMAG,TOMO,1R/S $2,838.003410018 MYOCARD PERF IMAG,TOMO,MULTI $4,198.003410019 PARATHYROID PLANAR IMAGING $1,097.003410020 PULMONARY PERF IMAG;PARTICULAT $1,086.00

3410021 PULM PERF IMAG W/VENT,ARSL,1+P $2,129.003410028 THYROID IMAG W/UPTAKE,S OR M U $1,125.003410050 DIA;CARDIOLT/SESTAMIBI U/T 40M $665.003410053 DIA;MAG 3 TECH 99 U/T 15M $752.003410055 DIA;SODIUM IODIDE I-123 400M $715.003410056 DIA;T TC 99M ALBUMIN U/T 10M $188.003410058 DIA;T TC 99M SULFUR U/T 20M $420.003410060 DIA;T TC 99M MEDRONA U/T 30M $240.003410061 DIA;T TC 99M MEBROFE U/T 15M $286.003410064 DIA;TECHNET TC 99M,RBC U/T 30M $253.003410065 DIA;THALLIUM 201 $612.003410069 HEPATOBILIARY DUCTAL S-I W/EF $1,697.003410074 LYMPHATICS & LYMPH NODES IMG $1,652.003410077 KIDNEY IMAG M W/VF W/PI, 1 $1,442.003410082 QUANT PULMONARY PERFUS & VENT $1,804.003410083 MYOCARD PERF IMAG,TOMO,MULTI $4,198.003410084 DIA;IODINE 1-131 SODIUM P/5MLC $345.003500002 CT ABDOMEN WO F/CM&FS $2,358.003500003 CT ABDOMEN W CM $1,984.003500004 CT ABDOMEN W/O CM $1,461.003500005 CT ANGIO,ABD,W CM+NCI&IMAGE PP $2,305.003500008 CT CERVICAL SPINE, W/O CM $1,461.003500009 CT CERVICAL SPINE W CM $1,984.003500010 CT GUIDANCE F/NEEDLE PLCMT S&I $1,984.003500012 CT LOWER EXTREMITY W/O CM $1,461.003500013 CT LOWER EXTREMITY W CM $1,984.003500014 CT LOWER EXTREMITY WO F/CM&FS $2,358.003500015 CT LUMBAR SPINE WO F/CM&FS $2,358.003500016 CT LUMBAR SPINE W CM $1,984.003500017 CT LUMBAR SPINE W/O CM $1,461.003500018 CT PELVIS W CM $1,984.003500019 CT PELVIS W/O CM $1,461.003500020 CT PELVIS WO F/CM&FS $2,358.003500021 CT THORACIC SPINE WO F/CM&FS $2,358.003500022 CT THORACIC SPINE W/O CM $1,461.003500023 CT THORACIC SPINE W CM $1,984.003500024 CT THORAX WO F/CM&FS $2,358.003500025 CT THORAX W CM $1,984.003500026 CT THORAX W/O CM $1,461.003500027 CT UPPER EXTREMITY W/O CM $1,461.003500028 CT UPPER EXTREMITY W CM $1,984.003500029 CT UPPER EXTREMITY WO F/CM&FS $2,358.003500030 INJ IV P, 1/FRST SUB/DRUG; CT $280.003500032 CT ANGIO,CHEST,NC W/CM +NCI $2,305.003500033 CT ANGIO,PELVIS,W/CM +NCI $2,305.003500034 CT ANGIO,LOWER EXT,W/CM +NCI $2,305.003500035 CT A,ABD AORTA/IF LE W/CM +NCI $2,305.00

3500037 BIOPSY OF LIVER,NEEDLE:PERCUTA $2,770.003500046 BIOPSY RENAL;PERCUTANEOUS T/N $2,256.003500047 BIOPSY,LUNG/MEDIASTINUM P/NDL $2,169.003500058 IG FLUID DRNGE CATH;PERI/R-P,P $3,636.003500060 BONE MARROW;BIOPSY,NDL/TROCAR $2,326.003500061 CT,ABDOMEN & PELVIS;WO/CM $1,949.003500062 CT,ABDOMEN & PELVIS; W/CM $2,642.003500063 CT,ABDOMEN & PELVIS;WO F/CM&FS $3,143.003500064 CT ANGIO,PELVIS-ABDOMEN W/CM + $2,305.003500081 MYELOGRAPHY LMBR INJ+S&I;CERV $3,896.003500085 INJ CONTRAST KNEE ARTHOGRAPHY $635.003501035 BIOPSY,BONE,TROC/NDL;DEEP CT $4,020.003510001 CT HEAD/BRAIN WO F/CM&FS $2,358.003510002 CT HEAD/BRAIN W CM $1,984.003510003 CT HEAD/BRAIN W/O CM $1,461.003510004 CT MAXILLFACIAL WO F/CM&FS $2,358.003510006 CT MAXILLOFACIAL W CM $1,984.003510007 CT MAXILLOFACIAL W/O CM $1,461.003510008 CT ORBIT,SELLA,EAR W/O CM $1,461.003510009 CT ORBIT,SELLA,EAR W CM $1,984.003510010 CT ORBIT,SELLA,EAR WO F/CM&FS $2,358.003510011 CT SOFT TISSUE NECK W/O CM $1,461.003510012 CT SOFT TISSUE NECK W CM $1,984.003510013 CT SOFT TISSUE NECK WO F/CM&FS $2,358.003510014 CT ANGIO,NECK,W/CM +NCI $2,305.003510016 CT ANGIOGRAPHY,HEAD,W/CM +NCI $2,305.003510017 ER STROKE ALERT-BRAIN W/O CM $1,461.003520001 CT,HEART,W/O CM,W/QNT EVL CC $167.003520004 CT ANGIOGRAPHY,HEART,CA & BG $2,175.003600003 ARGON BEAM $124.003600004 ARTHRO VIDEO EQUIPMENT $345.003600005 BEAR HUGGER-OR ONLY $67.003600006 BERKLEY SUCTION $44.003600008 BLOOD WARMER $54.003600010 COLONOSCOPE $288.003600011 CO2 LASER $1,012.003600013 DERMATOME $96.003600014 EGD EQUIPMENT CHARGE $566.003600016 ELECTROCAUTERY $112.003600017 ENDOSCRUB UNIT $54.003600022 FLEXIBLE CYSTOSCOPE $212.003600026 HARMONIC SCALPEL $1,061.003600027 HOLMIUM LASER $1,121.003600029 LAPAROSCOPIC VIDEO $346.003600032 ESWL,UNILATERAL: SINGLE PRCDR $9,126.003600038 MICROSCOPE $288.003600043 OR CANCELLATION CHARGE $345.00

3600044 OPERATING RM 30MIN-OR $3,166.003600051 OPERATING RM ADDL 30MIN-OR $691.003600054 ORTHO/PODIATRY REAMER $124.003600055 ORTHO/PODIATRY SAW $109.003600056 ORTHO/PODIATRY/ENT DRILL $97.003600059 PROCTOSCOPE $124.003600061 RESECTOSCOPE $97.003600063 SIGMOIDOSCOPE $288.003600064 SINUS ENDOSCOPE $212.003600065 SMOKE EVAC $117.003600066 SUBSEQUENT PROCEDURE-OR $3,166.003600067 THERMOABLATION $1,121.003600068 TOURNIQUET $42.003600069 URO VIDEO $345.003600070 UROLOGY CYSTOSCOPE $212.003600071 UROLOGY URETEROSCOPE $232.003600077 ROOM SET UP CHARGE-OR $239.003600090 ESWL,BI-LATERAL: DOUBLE PRCDR $18,250.003600091 SONOSURG $1,412.003600092 COLONOSCOPY $2,223.003600093 VASCULAR DOPPLER $89.003600096 HYSTEROSCOPE $212.003600100 OPERATING RM ADD 15MIN-OR $382.003600103 LAPAROSCOPE $258.003600109 NERVE INTEGRITY MONITOR USAGE $770.003600112 FINE NEEDLE ASPRTN;W/IMG GUDNC $1,028.003600116 INTUBATION, ENDOTRACHEAL - OR $503.003600121 N/P WND THRPY(U/T 50SQ CM)-OR $415.003600123 EGD $2,098.003600137 BREAST BIOPSY P+IMG;1+SG-OTHER $5,265.003600141 THROMBOLYSIS,CRNRY;IV INFSN-ER $550.003600152 BIOPSY/EXCIS LYMPH NODE;O,DSN $7,093.003600153 BIOPSY/EXCIS LYMPH NODE;OPEN D $7,092.003600154 INJ,ANES AGENT;LMBR/THRCC RAD $1,693.003601082 OR:N/P WND THRPY (G/T 50SQ CM) $793.003601505 INJ P F/EXTREMITY VENOGRAPHY $661.003601506 INTO OF CATHETER,SUP/INF VENA $661.003601510 INTRO OF CATHETER, AORTA $661.003601514 RE-VAS ILIAC A;W/TL ANGIO $12,691.003601515 RE-VAS W/TL STENT PLMT +AP SV $12,691.003601516 RE-VAS FMRL/POPL A;W/TL ANGIO $12,691.003601517 RE-VAS FMRL/POPL U;W/TL ATHER $26,941.003601518 RE-VAS FMRL/POPL A;W/TL STENT $26,941.003601519 RE-VAS FMRL/POPL A;STENT/ATHER $46,647.003601520 RE-VAS TIB/PERONL A;W/TL ANGIO $12,691.003601521 RE-VAS TIB/PERONL A;W/TL ATHER $26,941.003601522 RE-VAS TIB/PERONL A;W/TL STENT $26,941.00

3601523 RE-VAS TIB/PERONL A;STNT/ATHER $46,647.003601526 SEL CATH PLMT,ART LOW;1ST ORD $661.003601527 SEL CATH PLMT,ART LOW;2ND ORD $661.003601528 SEL CATH PLMT,ART LOW;3RD ORD $661.003601532 SEL CATH PLMT,ART UPP;3RD ORD $661.003601538 INSRT NON-TNLD CATH,5/+YR,CATH $2,534.003601545 RE-VAS TIB/PERONL,E+;W/TL ANGI $12,691.003601546 RE-VAS TIB/PERONL,E+;ATHER $26,941.003601552 TL PERIPH ATHER,O/P;ILIAC,E VE $21,439.003601569 BIOPSY,BONE,TROC/NDL;DEEP $4,020.003601572 INJ TRIGGER PNT;FAC/CHG 1/2MUS $491.003601581 KYPHOPLASTY PERC,1VB;THORACIC $20,573.003601582 KYPHOPLASTY PERC 1VB;LUMBAR $20,573.003601583 KYPHOPLASTY PERC,1VB;EA ADD $20,573.003601591 INSRT PLURAL INDWEL CTH W/CUFF $7,169.003601595 PERICARDIOCENTESIS;INITIAL $1,293.003601597 I/R PERM PACEMAKER W/TE;VENTRI $26,217.003601598 I/R PERM PACEMAKER W/TE;A&V $31,847.003601599 I/R TEMP CARD ELEC/PM CATH,SGL $11,606.003601603 REPOSITION TRANSV PM/ELECTRODE $5,260.003601604 INSERT SINGLE TRANSV E/PPM/C-D $12,071.003601611 INSERT ADDL L VENT LEAD $35,678.003601613 REMOVAL PERM PACEMAKER PUL GEN $5,260.003601614 REM TRANSV PM ELECT;1LEAD,A/V $5,260.003601616 INSERT SNGL/DUAL CHAMB PC-D/PG $78,544.003601618 REMVL 1/2 C PC-D E;THORACOTOMY $5,260.003601619 INSERT/RPST LD 1/2C PC-D & PG $90,033.003601620 IMPLANT P-A CARDIAC E RECORDER $18,124.003601629 INTRO NDL/I-C;EXTREMITY ARTERY $661.003601634 INSERT TNLD CV CATH W/O,5+YR $5,710.003601645 RPL NON-T CI CVC,WO P/P,S/VA $2,636.003601646 RPL TNLD CI CVC,WO P/P,S/VA $5,939.003601649 RPL PI CVC,WO P/P,S/VA $2,636.003601651 RM TUNNELED CV CATH,W/O PORT/P $1,592.003601652 RMVL TNLD CVAD,W P/P,C/P INS $2,636.003601654 RMVL PERICATH MATRL CVD,S/VA $5,939.003601657 INJ CONT,EVAL CVAD,W FL/IM DOC $563.003601660 PRI PERC TRNS MECH THR,ART,INI $9,650.003601661 PERC TRNS MECH THR,ART,SUBSEQ $9,650.003601662 SEC PERC TRNS MECH THR,ART $9,650.003601663 PERC MECH VENOUS THR;FL GDNC $9,650.003601708 EXC PRV PLCD A/C DRNG CATH;GUI $3,774.003601722 RMVL URETERAL STENT,PERC,S&I $4,070.003601724 RMVL NEPHROSTOMY TUBE,W/FL GUI $1,727.003601730 CHANGE NEPHROST/PYELOST TUBE + $3,774.003601736 CHG U-TUBE/U-STNT,VIA ILEAL CO $3,774.003601746 SPINAL PUNCTURE,LUMBAR,DIAG $905.00

3601747 SPNL PNCTR,THER,DRNG FLD,ND/CA $1,092.003601769 DEST JNT NRV,W/I;CERV/THRC,1 L $1,754.003601802 EP EVAL S/D CD LDS,W/TESTING $661.003601815 PLACEMENT IVC FILTER,S&I $10,398.003601848 REMOVE/REPLACE PACEMAKER GEN 1 $22,196.003601866 RMVL PCMKR PG W/RPLCMNT PG;DLS $23,411.003601867 TRANSCATH THRPY,ARTERIAL 1ST D $2,540.003601869 TRANSCATH THRPY,V/A FOLLOWUP D $5,663.003601871 UNLISTED PROC, VASCULAR INJECT $319.003601872 CATH PLMT W/DES;1 MAJOR CA/B $25,055.003601873 CATH PLMT W/DES;EA ADD ARTERY $25,055.003601874 ATHERECTOMY W/DES;1 MAJOR CA/B $25,055.003601876 PER TL REVASCULARIZATION;1 VES $25,055.003601880 PER TL REVAS CHRNC OCCULSION;+ $25,055.003601885 PER TL REVAS;1 VESSEL $19,740.003601898 REM CARDIAC DEFIB GEN W/RPL;1L $74,204.003601901 RMVL/RPLC P/CARDI-DEFIB PG;DLS $74,218.003601902 RMVL/RPLC P/CARDI-DEFIB PG;MLS $74,218.003601903 INSRT TNLD INTRAPERITON CATH $6,893.003601905 TUBE PERICARDIOSTOMY $1,773.003601911 VASC EMBLZTN/OCCLSN;ARTERIAL $26,382.003601913 VASC EMBLZTN/OCCLSN;A/V HEMORR $26,382.003601915 I-VAS US EVAL/INTRVTN S&I;INTL $661.003601916 I-VAS US EVAL/INTRVTN S&I;EA A $661.003601936 PLCMT NEPHROSTOMY CATH+IG RS&I $6,730.003601940 PLCMT URETERAL STENT;P-E TRACT $6,311.003601941 PLCMT URETERAL STENT;NA,W/O SC $6,311.003601945 CATH GUID DRAIN +CATH PLC S&I $537.003601946 RMVL INDWELLING TP CATH W/CUFF $1,360.003601948 TRANSCATH PLMT STNT,OPEN/PC;1V $28,302.003601949 TRANSCATH PLMT STNT,OPEN/PC;+V $12,652.003601951 TRANSLMNL BLLN ANGPLSTY;1ST V $13,048.003601953 TRANSLMNL BLLN ANGPLSTY;1ST A $13,048.003601955 DIAG ANGIOGRAPHY DIALYSIS CIR $1,851.003601956 DIAG ANGIOGRAPHY DC, W/BALLOON $13,048.003601964 DELAYED PLCMNT P/D GRAFT,IST V $4,311.003601965 P A/C FMRL ARTRY ENDOGRAFT,UNI $520.003605013 OPC BLEPHRPLSTY,UP EYELD W/E S $4,266.003605026 OPC INJ D/T SUB,CER/THOR;+IMAG $1,693.003605029 OPC INJ,A/S/E W/IMG;C/T SINGLE $1,761.003605031 OPC INJ,A/S/E W/IMG;L/S SINGLE $1,761.003605032 OPC INJ,A/S/E W/IMG;L/S EA ADD $905.003605033 OPC INJ,PV FCT JT W/IMG,C/T;1 $1,761.003605034 OPC INJ,PV FCT JT W/IMG,C/T;2 $622.003605035 OPC INJ,PV FCT JT W/IMG,C/T;3+ $622.003605036 OPC INJ,PV FCT JT W/IMG,L/S;1 $1,761.003605037 OPC INJ,PV FCT JT W/IMG,L/S;2 $622.00

3605038 OPC INJ,PV PCT JT W/IMG,L/S;3+ $622.003605041 OPC DEST FCT JT NRV,W/I;C/T,1 $4,026.003605042 OPC DEST FCT JT NRV,W/I;C/T,E+ $608.003605043 OPC DEST FCT JT NRV,W/I;L/S,1 $3,010.003605044 OPC DEST FCT JT NRV,W/I;L/S,E+ $1,724.003605045 OPC EXCSN/TP PTERYGIUM;W/GRAFT $4,523.003605046 OPC KERATOPLASTY;ENDOTHELIAL $8,524.003605049 OPC INJ,ANTER CHMBR EYE;AIR/LQ $4,829.003605051 OPC FISTU SCLERA G;TRAB W/SCAR $5,022.003605056 OPC RPSTN INTRAOCULAR LENS,W/I $5,022.003605057 OPC CATARACT REM W/LENS,CMPLX $6,919.003605058 OPC CATARACT REM W/LENS $6,919.003605059 OPC EXCHANGE INTRAOCULAR LENS $5,050.003605060 OPC REM VITREOUS,ANTER;ST W/MV $8,761.003605063 OPC RPR BLEPHAROPTOSIS;MULLERS $4,523.003605064 OPC RPR ECTROPION;EXTENSIVE $4,523.003605067 OPC RM LENS MTRL;ASPIR TEC,1+S $3,286.003605068 OPC INJ D/T SUB,LMB/SCRL;+IMAG $1,761.003605071 OPC INJ,ANES AGT;OCCIPITAL NRV $1,092.003605075 OPC INSRT DRN W/O;INTRNL,T MW $9,048.003605079 OPC REM IMPLANT MTRL,ANTER EYE $5,021.003605088 OPC EXCISION LESION OF EYELID $2,011.003605096 OPC REM LENS MAT;PARS PLANA &V $8,524.003605109 OPC SNIP INCSN LACRIMAL PNCTM $748.003605113 OPC EXCS LESN,CONJUNCTIVA;+1CM $4,528.003605118 OPC INJ,ANES/AGT;IC NERVE,MULT $1,680.003605119 OPC INJ SACROILIAC JT;A/S/O IM $1,891.003605124 OPC INJ,ANES/AGT;INTRCSTL N,1 $1,358.003605131 EXCSN LESION,CORNEA,NOT PTRYGM $3,401.003605135 OPC CANTHOTOMY,INCSN EYELID FD $4,530.003605136 OPC CANTHOPLASTY(RCNS CANTHUS) $4,528.003605137 EXCISION CHALAZION;MULTI,S/LID $2,021.003610002 CIRCUMCISION NEWBORN;CLAMP,O/D $614.003610010 BONE MARROW ASPR W/BPSY SM I/D $1,877.003610013 N/O GASTRIC TUBE PLMT;W/FLUOR $858.003610016 DRAIN FINGER ABSCESS;CMPLCTD $3,505.003610017 BIOPSY BREAST;PERCUT,NC,NO IG $3,370.003700002 MAC-ANESTHESIA LCL +MTRLS; OR $243.003700003 ANES. TIME BASIS 30MIN-OR $876.003700010 ANES. TIME BASIS ADDL 30MIN-OR $258.003700012 ANESTHESIA, SPINAL-OR $335.003700013 ANESTHETIC, LOCAL ER $75.003700018 INTUBATION $195.003700029 ANES. TIME BASIS ADD 15MIN-OR $132.003810001 RBC,LEUKOCYTES,R,STOR&PROC E/U $692.003830001 FRESH FROZEN PLASMA,1DNR,EA UN $554.003870001 CRYOPRECIPITATE, EACH UNIT $344.00

3870002 CRYOPRECIPITATE, 5 UNITS $980.003890001 PLATELETS,PHERESIS,LEU/REDU,EA $2,352.003900001 BLOOD TYPING; ABO $69.003900002 BLOOD TYPING;RH (D) $96.003900003 ANTIHUMAN GLOBULIN/COOMBS;DIR $80.003900004 ANTIBODY SCREEN,RBC,EA SERUM T $312.003900005 IRRADIATION/BLD,EA U BY STBTC $260.003910001 TRANSFUSION,BLD/BLD COMPONENTS $1,537.003990001 COMPATIBILITY TST;SPIN TECH $231.003990002 COMPATIBILITY TST;ANTIGLOBULIN $231.003990003 COMPATIBILITY TST,INCUBATION T $231.004010006 RADIOLOGY EXAM,SURGICAL SPECI $1,124.004010008 MAMM DUCTOGRAM/GALACTOGRAM, 1D $849.004010009 MAMM DUCTOGRAM/GALACTOGRAM, 1+ $849.004010014 MAMMO,DIGITAL,UNILATERAL,ALL V $335.004010015 MAMMO,DIGITAL,BILATERAL,ALL V $355.004010024 TOMOSYNTHESIS,DIGITAL BREAST;U $32.004010025 TOMOSYNTHESIS,DIGITAL BREAST;B $63.004020001 OB/FETAL ULTRASOUND $612.004020002 US GUIDANCE NEEDLE PLMT,S&I $949.004020003 US,ABDOMINAL COMPLETE $642.004020004 US,ABDOMINAL LIMITED $544.004020008 US, CHEST $544.004020012 FETAL BIOPHY PRFL WO NON-ST $416.004020015 US,PELVIS NON-OB COMPLETE $556.004020016 US,PELVIC NON-OB LIMITED OR FU $419.004020017 US,PREGNANT UTERUS EA ADD GEST $544.004020018 US,PREGNANT UTERUS 1/FIRST GES $656.004020019 US,PREGNANT UTERUS LIM/1+FETUS $419.004020020 US, RETROPERITONEAL COMPLETE A $635.004020021 US, RETROPERITONEAL LIMITED $544.004020022 US,SCROTUM AND CONTENTS $560.004020023 US,SOFT TISSUES HEAD & NECK $544.004020024 US,SPINAL CANAL & CONTENTS $544.004020027 ULTRASOUND, TRANSVAGINAL $554.004020028 ULTRASOUND,INFANT HIPS,DYNAMIC $419.004020029 ULTRASOUND,INFANT HIPS,LIM/STA $419.004020030 PUNCTURE ASPIR CYST/BREAST $845.004020031 DUP SCAN I/O FLW ADB,PLV,S;COM $872.004020032 US,PREGNANT UTERUS TRANSVAG $544.004020036 FETAL BIOPHY PRFL WO NON-ST+F $416.004020038 BIOPSY THYROID,PERC CORE NDL $947.004020039 BIOPSY,MUSCLE,PERCUTANEOUS NDL $1,812.004020041 FINE NEEDLE ASPRTN;W/IMG GUDNC $1,028.004020042 BIOPSY/ESCSN LYMPH ND;NDL,SPFL $1,812.004020043 ULTRASOUND GUIDANCE F/VA RAD $146.004020047 PUNCTURE ASPRTN ABSCESS+,US $487.00

4020049 ULTRASOUND,COMPLETE JOINT $603.004020050 ULTRASOUND,JOINT/OTH NV EXTREM $210.004020051 US,DOPPLER VELOCIMETRY,FTL;U A $300.004020053 FINE NEEDLE ASPIR:W/O IMAG GDN $285.004020057 BIOPSY OF LIVER,NEEDLE:PERCUTA $2,770.004020066 ARTHROCENTESIS/INJ,MJ JT/BURSA $491.004020067 BIOPSY SKIN,SUBQ TISSUE,1 LSN $412.004020069 UNLISTED PROCEDURE, INTESTINE $6,129.004020079 US B-SCAN OR RT W/ID;AAA SCRN $317.004020081 BIOPSY RENAL;PERCUTANEOUS T/N $2,256.004020082 ASPIRATION/INJ GANGLION CYST $465.004020083 ULTRASOUND GUIDANCE F/VA CATH $146.004020087 US, RETROPERITONEAL COMPLETE B $635.004020088 BIOPSY,BREAST W/DVCE;1ST L +US $5,477.004020089 BIOPSY,BREAST W/DVCE;EA ADD+US $2,740.004020090 IMAG/G DRAIN B/CATH,SOFT TSS,P $2,548.004020092 BIOPSY,BONE,TROCAR/NDL;S US $1,895.004020093 BIOPSY,ABD/RETROPRTNL MS,P/NDL $2,663.004020094 OB/FETAL US EA ADDL GEST $501.004020095 US,BREAST,UNI W/AXILLA;COMP $442.004020096 US,BREAST,UNI W/AXILLA;LIMT $442.004020097 VESSEL MAP,HEMODLYS ACCESS-VUS $748.004020099 BIOPSY,SALIVARY GLAND,NDL $1,510.004020104 DOPPLER VELOCIMETRY,FETAL;UA $251.004021002 THORACENTESIS,N/C A/PL SP W/IM $1,335.004021004 INJ IV P, 1/FRST SUB/DRUG; US $280.004022002 ABDOMINAL PARACENTESIS;W/US $1,934.004030006 MAMMO,DIGITAL,SCREENING,ALL V $210.004030009 MAMMO,DIGITAL,SCREEN IMPLANTS $355.004030012 TOMOSYNTHESIS,SCREEN D BREAST $63.004100000 RSV COLLECTION CHARGE $187.004100001 INHAL TRMT F/OBSTR-SPTM HHN,IN $196.004100002 INHAL TRMT F/OBSTR-SPTM HHN,SQ $153.004100003 UNLISTED PR:APNEA MNTR DAILY $378.004100004 MANIP CHEST WALL F/LUNG FN:D/E $153.004100005 MANIP CHEST WALL F/LUNG FN:SUB $134.004100007 LV: DET MAL-DISTRIB:INSPRD GAS $379.004100010 NEBULIZER CONTINUOUS 1ST HOUR $627.004100013 MANIP CHEST WALL POST DRN $114.004100014 MANIP CHEST WALL;CPT/PD $166.004100018 VENTILATOR ASSIST/MGMT;SUBQ DY $1,434.004100019 VENTILATOR ASSIST/MGMT;1ST DAY $1,539.004100020 VITAL CAPACITY,TOTAL;PEAK FLOW $107.004100023 INHAL TRMT F/OBSTR-SPTM MDI,IN $196.004100024 EXTRABATION:REMOVAL F/VENTALTR $159.004100025 INHALATION TRT;EZ PAP INITIAL $217.004100026 INHALATION TRT;EZ PAP SUBSEQNT $166.00

4100027 MANIP CHEST WALL;ACAPELLA INIT $153.004100028 MANIP CHEST WALL;ACAPELLA SBSQ $134.004100029 INHAL TRNT F/OBSTR-SPTM MDI,SQ $153.004100030 WEANING PARAMETERS $107.004100032 NEBULIZER CONTINUOUS EA + HOUR $627.004130030 HYPERBARIC OXYGEN, FBC 30MINS $386.004130060 HYPERBARIC OXYGEN, FBC 60MINS $771.004130090 HYPERBARIC OXYGEN, FBC 90MINS $1,156.004130120 HYPERBARIC OXYGEN, FBC 120MINS $1,541.004190002 NEONATAL MONITOR $116.004201010 APP/MOD, ELEC STIM 15M EA $98.004201012 MANUAL THRPY,JT/MOBIL 15MIN EA $139.004201013 APP/MOD ELEC STIM (UNATTENDED) $80.004211002 THRPY PR-AQUATIC W/EX 15MIN EA $163.004211006 FLUIDOTHERAPY $66.004211007 THERAPY PR-GAIT TRAINING 15MIN $129.004211011 THERAPY PR, MASSAGE 15 MIN EA $119.004211012 MAN/TH,MYOFASCIAL REL 15MIN EA $139.004211013 THERAPY PR NEUROMUSC RE-ED 15M $156.004211020 THERAPY ACT DIR PAT CONT 15MIN $141.004211021 THERAPY PR-THERAPY EX 15MIN EA $141.004211022 MANUAL THRPY-TRACTION 15MIN EA $139.004211023 APP/MOD TRACTION MECHANICAL $80.004211024 APP/MOD ULTRASOUND 15MIN EA $112.004241002 PHYSICAL THERAPY RE-EVAL $156.004241003 PT EVAL:LOW 20MINS $332.004241004 PT EVAL:MODERATE 30MINS OUTPAT $343.004241005 PT EVAL:HIGH 45MINS OUTPAT $354.004301003 OT-ORTHO FTTNG/TRNG 1ST 15M $120.004301007 OT-APP/MOD ELEC STIM 15MIN EA $98.004301009 OT-FLUIDOTHERAPY $66.004301012 OT-MANUAL THRPY JT/MOB 15MIN E $139.004301013 OT-THRPY PR MASSAGE 15MIN EA $119.004301015 OT-TH/PR NEUROMUSC RE-ED 15MIN $156.004301016 OT-APP/MOD PARAFFIN BATH $64.004301018 OT-SELF/CARE/HM TRNG DIR:15MN $166.004301021 OT-TH/ACT DIR PAT CONT 15MN EA $141.004301022 OT-APP/MOD ULTRASND 15MIN EA $112.004301028 OT-APP/MOD ELECT STIM(UNATTND) $80.004301029 OT-ORTH/PRS TRN SUBSQNT 15M $123.004311002 OT-THERAPEUTIC PR 15 MINS EACH $141.004331002 OT-THERAPEUTIC PR GROUP $104.004341002 OCCUPATIONAL THERAPY RE-EVAL $156.004341003 OT EVAL:LOW 30MINS OUTPAT $332.004341004 OT EVAL:MODERATE 45MINS OUTPAT $343.004341005 OT EVAL:HIGH 60MINS OUTPAT $354.004421001 TRT SPEECH,LNGG,VC,INDIVIDUAL $198.00

4421002 TRT/SWALLOW DSFNCTN/ORAL FNC $215.004441002 MOTION FLRSCOPIC SWAL BY VIDEO $455.004441003 EVAL SWALLOWING,CLINICAL $455.004441005 EVAL OF SPEECH SOUND PRODCTN $231.004441006 EVAL OF SPEECH SOUND;W/LC & E $468.004441007 BEHAVIOR/QUAL VOICE&RESONANCE $225.004500002 IMMUNIZATION ADMIN,EA ADD VACC $44.004500045 EMERGENCY ROOM LEVEL I $242.004500046 EMERGENCY ROOM LEVEL II $358.004500047 EMERGENCY ROOM LEVEL III $475.004500048 EMERGENCY ROOM LEVEL IV $753.004500049 EMERGENCY ROOM LEVEL V $1,170.004500051 EMERGENCY RM TRIAGE $124.004500160 IMMUNIZATION ADMIN, 1 $122.004500162 INJ SUBQ/IM, THER/DIAG; ER $122.004500163 INJ IV P, 1/FRST SUB/DRUG; ER $280.004500165 INJ TRIGGER PNT;FAC/CHG 1/2MUS $491.004500180 INSRT NON-TNLD CATH,5/+YR,ER $2,534.004500195 INJECT,ANES/PERIPHERAL NERV/BR $626.004500210 INJ,EPIDURAL,BD/CLT PTCH-ER $1,761.004500218 I&D ABSCESS PERITONSILLAR $585.004500224 SUTURE REMOVAL ONLY-ER RM CHG $107.004500225 CLSD TRT DIST/RADI FRAC,W/MA $440.004500226 RPR S SCLP,NCK,TRK,E;2.5-LESS $278.004500229 CLSD TRT RADIAL/ULNAR FRC WO/M $423.004500230 RPR S FACIAL AREAS;2.5CM-LESS $258.004500231 APPL SHORT ARM SPLINT, STATIC $263.004500232 PLCMNT NDL F/INTRAOSSEOUS INFS $214.004500237 CLSD TRT FX,PHALANX/PHALANGES $318.004500239 I&D ABSCESS COMPL/MULTI-ER $475.004500240 DRAINAGE OF SKENE'S GLAND A/C $3,889.004500259 INSERT PICV CATH W/O SP/P 5+YR $2,534.004500264 APPL LOWER LEG SPLINT $263.004500265 CLS TRT POST HIP ARTH-DIS,WO/A $710.004500266 CLSD TRT BIMALLEOLAR ANKLE W M $2,089.004500267 SPINAL PUNCTURE,LUMBAR,DIAG $905.004500269 GASTRIC INTUB&ASPIR/LAVAGE TRT $302.004500270 ARTHROCENTESIS/INJ,MJ JT/BURSA $491.004500501 CNTRL NASAL HEM,ANTR,SIMPLE,AM $201.004500502 APPL LONG LEG SPLINT $212.004500508 RPR,C SCALP,ARMS,LEG;2.6-7.5 $999.004500509 RPR,C SCALP,ARMS,LEG;EA+5CM $301.004500514 I&D ABSCESS SIMPLE/SNGL-ER $457.004500517 RM FB,EXT EYE;CORNEAL,-SL $297.004500518 APPL FINGER SPLINT; STATIC $173.004500520 RPR S FACIAL AREAS;2.6-5.0CM $258.004500521 TUBE THORACOSTOMY+CON DRN,O;ER $1,293.00

4500522 ABDOMINAL PARACENTESIS;W/O US $1,250.004500523 ABDOMINAL PARACENTESIS;W/US $1,934.004500524 DRAIN/ABSCESS,CYST,HEMAT F/DS $321.004500525 RPR,C FACIAL AREAS;2.6-7.5 $999.004500526 RPR,I,NCK,HNDS,FT,E/G;2.6-7.5 $608.004500527 CLSD TRT SHLDR DISLO,W/M;WO AN $531.004500528 CLSD TRT R/H SBLXTN,CHILD,W/MA $531.004500530 RPR,I FACIAL AREAS;2.5CM/LESS $608.004500532 RPR S SCLP,NCK,TRK,E;2.6-7.5 $278.004500533 RPR S SCLP,NCK,TRK,E;7.6-12.5 $418.004500534 RPR S SCLP,NCK,TRK,E;12.6-20.0 $258.004500537 RPR S FACIAL AREAS;5.1-7.5CM $258.004500538 RPR S FACIAL AREAS;7.6-12.5CM $258.004500540 RPR,I,SCLP,AXIL,TRNK,E;2.6-7.5 $608.004500541 RPR,I,SCLP,AXIL,TRNK;7.6-12.5 $608.004500542 RPR,I,SCLP,AXIL,TRNK,E;12.6-20 $999.004500543 RPR,I,NCK,HNDS,FT,E/G;2.5-LESS $608.004500544 RPR,I,NCK,HNDS,FT,E/G;7.6-12.5 $608.004500546 INSERTION TEMP/INDWELL CATH,SI $302.004500547 RPR,I FACIAL AREAS;2.6-5.0CM $608.004500548 RPR,I FACIAL AREAS;5.1-7.5CM $608.004500551 RPR,C SCALP,ARMS,LEG;1.1-2.5 $608.004500552 RPR C HEAD,EXTRM;1.1-2.5CM $608.004500553 RPR C HEAD,EXTRM;2.6-7.5 $1,210.004500554 RPR,C FACIAL AREAS;1.1-2.5CM $999.004500555 RM FOREIGN BDY,INTRANASAL;OFC $302.004500557 AVULSION NAIL PLATE,SMPL;1 $450.004500558 CLSD TRT ELBOW DISLOC;W/O AN $453.004500559 CLSD TRT TEMPOROMAND DIS;1/+ $246.004500563 RPR S FACIAL AREAS;30.0CM + $258.004500564 RPR,I,SCLP,AXIL,TRNK,E;2.5LESS $608.004500568 CLSD TRT I-PHALANGEAL JT DI;WO $331.004500569 APPL LONG ARM SPLINT(SHLD/HND) $253.004500570 EXC NAIL&MATRIX P/C,PERMAN $972.004500571 TELEHEALTH SITE FACILITY FEE $75.004500572 CLS TRT PATELLAR DISLOC;W/O AN $341.004500573 I&D BARTHOLIN'S GLAND ABS-ER $388.004500575 CLS TRT FEMORAL SHAFT FRAC W/M $4,456.004500576 EVACUATION SUBUNGUAL HEMATOMA $188.004500577 RM FB EXTRNL AUDITORY CANAL;WO $166.004500580 THORACENTESIS,N/C A/PL SP WO I $1,335.004500582 BLADDER IRRIG,S,LAVAGE/INSTILL $644.004500584 RM FB, FOOT;SUBCUTANEOUS $1,459.004500586 CP RESUSCITATION - ER $724.004500587 INJ,ANESTH AGNT;TRIGEMINAL NRV $618.004500588 REM CERUMEN W/INST,UNI $166.004500589 RM FB,EXT EYE;CORNEAL,W SLIT L $239.00

4500590 CPAP, INITIATION/MANAGEMENT ER $378.004500591 PUNCTURE ASPRTN ABSCESS+,ER $487.004500592 I&R FB SQT,SIMPLE ER $838.004500593 RM FB,EXT EYE;CONJUNCTIVAL SF $229.004500594 I&D OF PILONIDAL CYST;SIMPLE $487.004500595 CLS TRT METACARPOPHALANGEAL DL $531.004500596 CLS TRT INTERPHALANGEAL JT DL $341.004500598 CHG G TUBE,PERC;W/O I/EG ER $543.004500600 INTUBATION, ENDOTRACHEAL- ER $503.004500601 DRSSNG/DEBRDMT BURN,I/SQ;SMALL $412.004500602 CLS TRT METACARPAL F,1;WM EA B $341.004500603 I&D VULVA OR PERINEAL ABSCESS $579.004500604 CLSD TRT S/T CONDYLAR HF;WO MA $1,179.004500605 THROMBOLYSIS,C,BY IV INFUSION $504.004500606 STRAPPING;SHOULDER(eg,VELPEAU) $173.004500608 WEDGE EXCSN OF SKIN/NAIL FOLD $412.004500611 I&D PERIANAL ABSCESS SUPER F $3,313.004500612 ARTHROCENT,ASP/INJ,IM JT/BURSA $491.004500614 REMOVAL OF INTRAUTERINE DEVICE $555.004500615 CLS TRT S/FRAC,FNGR/THMB;W/M E $510.004500616 EGD,FLEX,TRANSORAL;W/REM FB $2,098.004500617 CONSC SEDATION,< 5 YRS,INT 15M $119.004500618 CONSC SEDATION,> 5 YRS,INT 15M $119.004500619 RMV TISS F/WND,S L/T=20 SQ CNT $412.004500621 CLSD TRT HIP DISLC,TRAUMA;WO A $502.004500624 CNTRL NASAL BLEEDING,POST;INIT $306.004500626 PARING/CUTTING BENIGN LESION;1 $278.004500628 CARDIOVERSION EXTERNAL,IN ER $1,861.004500632 CYSTOURETHROSCOPY $3,272.004500633 CONSCIOUS SEDATION,EA ADTL 15 $119.004500638 RM FB,EXT EYE;EMBEDDED,SC,S NP $297.004500641 CLSD TRT TRIMALLEOLA ANKLE W M $2,089.004500644 RPR C HEAD,EXTRM;EA ADD 5CM/L $834.004500645 CLSD TRT KNEE DISLOCATION;WO A $604.004500646 CLSD TRT PROXIMAL HMRL FRAC;WO $604.004500647 N/O GASTRIC TUBE PLMT;W/FLUOR $858.004500648 DRAIN ABSCESS/PALATE,UVULA $1,023.004500649 CLSD TRT RADIAL SHAFT FRC;WM $2,008.004500651 DEBRIDE-SKN&SBQ 1ST 20SQ CM;ER $798.004500653 REM CERUMEN BY IRRIG/LVG,UNI $159.004500658 REPAIR OF NAIL BED $1,207.004500664 PERICARDIOCENTESIS;INITIAL $1,293.004500668 CLS TRT D-FRACT,FNGR/THMB;MANI $670.004500670 CLS TRT DISTAL FIBULAR FCT;W/M $669.004500678 CONTROL NASAL BLEED,ANTER,CMPX $271.004500680 RPL NON-T CI CVC,WO P/P,S/VA $2,636.004500683 LARYNGOSCOPY,FLEXIBLE;DIAGNSTC $426.00

4500684 CLSD TRT MEDIAL ANKLE FX W/MAN $3,959.004500686 MNTRNG INTERSTITIAL FLUID PRES $1,459.004500692 TRANSCATH THRPY,VENOUS 1ST D $4,910.004500693 CLSD TRT MONTEGGIA F/D ELBOW M $3,166.004500695 N/P WND THRPY(U/T 50SQ CM)-ER $415.004500696 INJ:1/+TRIGGER PNTS,3+MUSC $626.004500699 CHNG CYSTOSTOMY TUBE,SIMPLE $597.004500700 CLSD TRT PSTR MALLEOLUS F/W MA $3,510.004500701 SPNL PNCTR,THER,DRNG FLD,ND/CA $1,092.004500702 EXPLORATION PENETRATING WND;EX $1,490.004500703 CLD TRT FRCTRE WB TIBIA;W ST/M $3,375.004500704 CLD TRT PROX HUMERAL FX,W/MAN $3,375.004500705 DECLOT THROMB AG IMPL VAD/CATH $757.004501163 INJ IV P,EA ADD SEQ NW/DG;ER $269.004501164 INJ IV P,EA ADD SEQ SM/DG;ER $269.004600001 EXPIRED GAS COLLECT,QUANT,1 PR $647.004600002 BRONCHOSPASM RSPN;PFT PRE&POST $242.004600003 SPIROMETRY; PFT SIMPLE $489.004600005 PULSE OX/CONT OVERNIGHT MNTR $378.004600006 CPAP,INITIATION/MANAGEMENT $378.004600009 BIPAP $464.004600010 RESPIRATORY FLOW VOLUME LOOP $168.004600011 BRONCHOSPASM PRVCTN EVL,MD,W/A $720.004600012 PULMONARY STRESS TST; 6MN WALK $310.004600015 THORACIC GAS VLM/RESIST TO AF $647.004600017 DIFFUSING CPCTY(CM,MMBRN) DLCO $102.004600018 EXERCISE TST BRONCHSPSM,S/R/PO $842.004800001 CARDIOVERSION EXTERNAL,RESP $1,861.004800004 ECHOCARD,I/D,W/WO M/REC,F/U-LM $583.004800009 ECHO,TRANSESOPH,I/D,M/REC,IN&R $1,420.004800015 CP RESUSCITATION - RT $724.004800016 INTUBATION, ENDOTRACHEAL - RT $503.004800019 ECHOCRD,I/DC,I/REC WP,W/S&CF $2,613.004800020 ECHOCRD,I/DC,I/REC WP,W/S&CF E $2,988.004800032 PERIPHERAL ARTERIAL REHAB P/S $139.004810005 ENDOLUMINAL IMAGING;S&I,INIT $661.004810006 ENDOLUMINAL IMAGING;S&I, EA + $661.004810007 TC PLMT IC STENT,P,W/WO INTR,S $21,254.004810009 TL CORONARY BALLOON AP,P,SNGL $14,215.004810021 CATH PLMT,CA,INCL IP INJ,S&I $10,267.004810022 CATH PLMT,CA,+INJ W/CP BYPSS G $10,267.004810023 CATH PLMT,CA,+INJ W/RT HEART C $10,267.004810025 CATH PLMT,CA,+INJ W/LF HEART C $10,267.004810026 CATH PLMT,CA,+INJ W/B PG & LHC $10,267.004810027 CATH PLMT,CA,+INJ W/R&L HRT C $10,267.004810028 CATH PLMT,CA,+INJ W/BPG R&L HC $10,267.004810042 INJ D/CARD CATH;SUPRAVALVLR AO $661.00

4810044 INTRA-VAS DPLR/CRNY FLOW,INIT $661.004810045 INTRA-VAS DPLR/CRNY FLOW,ADDTL $661.004810051 HEART CATH;RT,INCL SATS & OP $10,267.004820001 CARDIO STRESS TST:TRACING ONLY $914.005100001 GC NEW PAT 99202 VISIT CHG $142.005100005 GC ESTAB PAT 99211 VISIT CHG $142.005100006 GC ESTAB PAT 99212 VISIT CHG $142.005100007 GC ESTAB PAT 99213 VISIT CHG $142.005100020 I&D ABSCESS SIMPLE/SNGL-GC $457.005100021 I&D ABSCESS COMP/MULTI-GC $475.005100022 EXC NAIL&MATRIX P/C,PERM-GC $972.005100023 REM CERUMEN W/INST,UNI-GC $166.005100024 DEST LSNS,SKIN TAGS;15+-GC $333.005100025 DEST LSNS,SKIN TAGS;U/T 14-GC $415.005100052 GC PREV MED NEW 40-64YRS FAC $179.005100054 GC PREV MED EST 18-39YRS FAC $179.005100055 GC PREV MED EST 40-64YRS FAC $179.005100056 GC PREV MED EST 65+YRS FAC $179.005100057 GC PREVENTIVE MED MEDICARE FAC $144.005100058 GC OBTAIN PAP SMEAR MEDICARE F $35.005100100 INJ SUBQ/IM, THER/DIAG; GC $122.005100101 DEMO/EVAL A/GEN,NEB,IH,IPPB $373.006100001 MRA ABDOMEN W/WO CM $2,792.006100002 MRA CHEST W OR W/O CM $2,695.006100005 MRA HEAD,ARTERY WO CM $2,330.006100006 MRA LOWER EXTR W OR W/O CM $2,695.006100007 MRA NECK WO F/CM&FS $3,556.006100008 MRA NECK W CM $2,695.006100009 MRA NECK W/O CM $2,330.006100010 MRA PELVIS W OR W/O CM $2,695.006100012 MRI ABDOMEN WO F/CM&FS $3,556.006100014 MRI ABDOMEN W/O CM $2,330.006100017 MRI CHEST W/O CM $2,330.006100018 MRI LOWER EXT O/T JT W/O CM $2,330.006100019 MRI LWR EXT ANY JT W CM $2,695.006100020 MRI LWR EXT ANY JT W/O CM F/CM $3,556.006100021 MRI LWR EXT O/T JT W CM $2,695.006100022 MRI LWR EXT ANY JT W/O CM $2,330.006100023 MRI LWR EXT O/T JT W/O CM F/CM $3,556.006100024 MRI ORBIT,FCE,& OR NECK W/O CM $2,330.006100026 MRI ORBIT/FACE/NECK WO/CM F/CM $3,556.006100027 MRI PELVIS WO F/CM&FS $3,556.006100029 MRI PELVIS W/O CM $2,330.006100031 MRI UPPER EXT O/T JT W/O CM $2,330.006100032 MRI UPPER EXT ANY JT W/CM $2,695.006100033 MRI UP EXT ANY/JT W/O CM F/CM $3,556.006100034 MRI UPPER EXT ANY JT W/O CM $2,330.00

6100035 MRI UP EXT O/T JT W/O CM F/CM $3,556.006100040 MRCP - W/O FB CM & FS $2,792.006110001 MRI BRAIN WO F/CM&FS $3,556.006110002 MRI BRAIN W/O CM $2,330.006110003 MRI BRAIN W CM $2,695.006120001 MRI SPINAL CANAL W&W/O CM,CERV $3,556.006120002 MRI SPINAL CANAL W CM,CERVICAL $2,695.006120003 MRI SPINAL CANAL W/O CM,CERVIC $2,330.006120004 MRI SPINAL CANAL W&W/O CM,LUMB $3,556.006120005 MRI SPINAL CANAL W CM,LUMBAR $2,695.006120006 MRI SPINAL CANAL W/O CM,LUMBAR $2,330.006120007 MRI SPNL CNL W&WO CM,FS THORAC $3,556.006120009 MRI SPINAL CANAL W/O CM,THORAC $2,330.006140002 MRI BREAST W W/O CM;BILATERAL $6,117.006360003 LOCM: OMNIPAQUE 350;M/V P/1ML $10.006360006 LOCM: OMNIPAQUE 140 50 P/1ML $26.006360007 LOCM: OMNIPAQUE 350;S/V P/1ML $10.006560001 R&B IPHOSPICE MEDICAL,PRIVATE $1,391.006560003 R&B IPHOSPICE SURG FLR, PRIV $1,391.006560007 R&B IPHOSPICE ICU $2,563.007100001 RECOVERY RM 30MIN-OR $566.007100011 RECOVERY RM ADD 15MIN-OR $167.007210001 BIRTHING ROOM PRIVATE $1,391.007220001 DELIVERY PROCEDURE CHARGE $1,599.007300001 ECG;TRACING ONLY W/O INTER&RPT $232.007320003 FETAL NON STRESS TEST COMPLETE $532.007320005 FETAL HEART MONITOR/EXTERNAL $98.007400007 EEG;+REC AWAKE & ASLEEP W/I $559.007400008 EEG;+REC AWAKE & ASLEEP W/O I $559.007500003 EGD $2,098.007500004 PROCTOSCOPY (RIGID) $2,024.007500005 SIGMOIDOSCOPY (FLEX) $1,608.007500009 COLONOSCOPY; VIDEO ENDOSCOPY $2,223.007500011 INJ SUBQ/IM, THER/DIAG;GASTRO $122.007500018 ERCP;W PLMT OF STENT,EA STENT $10,657.007600001 FORENSIC EXAM FACILITY RM CHG $350.007600002 FORENSIC/MED EXAM W/COLPOSCOPY $233.007600003 FORENSIC/MED EXAM W/O COLPSPY $195.007600004 FORENSIC SA EVAL & MANAG P/HR $106.007600007 INJ,EPIDURAL,BD/CLT P-ER OP $1,761.007600008 CHG G TUBE,PERC;W/O I/EG GIPC $543.007600010 FORENSIC EXAM ANOGENITAL EXAM $150.007600011 FORENSIC EXAM COLPOSCOPY VULVA $150.007610003 BRONCHOSCOPY $2,027.007610007 ERCP $6,791.007610008 ESOPHAGEAL MOTILITY STUDY $1,126.007610009 ESOPHAGUS, ACID REFLUX TEST PR $1,257.00

7610015 TREATMENT RM/1ST V $316.007610019 TREATMENT RM/FU $148.007610025 CHEMO ADM SUBQ/IM N-HORM ANPT $274.007610026 CHEMO ADM IV PUSH 1/F SUB/DRUG $274.007610027 IMMUNIZATION ADMIN, 1 $122.007610029 INJ SUBQ/IM, THER/DIAG; GIPC $122.007610030 INJ IV P, 1/FRST SUB/DRUG;GIPC $280.007610037 ARTHROCENTESIS/INJ,MJ JT/BURSA $491.007610038 PHELBOTOMY,THERAPEUTIC S/P $148.007610044 ELECTROCAUTERY-EQUIPMENT USAGE $102.007610045 ARGON BEAM-EQUIPMENT USAGE $114.007610051 INCISION & DRAINAGE $675.007610062 DECLOT THROMB AG IMPL VAD/CATH $757.007610063 INJECT,ANES/PERIPHERAL NERV/BR $626.007610067 RM TUNNELED CV CATH,W/O PORT/P $1,592.007610073 MISC MINOR PROCEDURE CHG-PACU $173.007610080 INJ IV P,EA ADD SEQ SM/DG;GIPC $269.007610091 DEBRIDE-SKN&SBQ 1ST 20SQ CM;MF $798.007610103 SPINAL PUNCTURE,LUMBAR,DIAG $905.007610113 IRRIGATION IMPLNT VA DEV F/DDS $159.007610123 INSERT PICV CATH W/O SP/P 5+YR $2,534.007610128 IMMUNIZATION ADMIN,EA ADD VACC $44.007610144 RM TUNNELED CV CATH,W/O PORT/P $1,592.007610146 BIOPSY,LUNG/MEDIASTINUM P/NDL $2,169.007610147 BILIARY CATH REM,XRAY D-99212 $66.007610158 INSERT TEMP ID/BLADDER CATH;C $644.007610159 EXC CYSTIC HYGROMA,AX,CER;W/O $7,092.007610160 DIAG BONE MARROW;BIOPSY & ASPR $3,505.007610161 INSERT TEMP ID/BLADDER CATH;C $644.007610162 BIOPSY/EXCIS LYMPH NODE;OPEN D $7,092.007610163 ABLATION,1+RENAL TUMOR,P,UN,RF $11,671.007610164 ARTRL CATH/CANN,SAMPLING,PERC $661.007611001 WC VISIT LEVEL 1 - NEW PT $271.007611002 WC VISIT LEVEL 2 - NEW PT $282.007611003 WC VISIT LEVEL 3 - NEW PT $294.007611004 WC VISIT LEVEL 4 - NEW PT $305.007611007 WC VISIT LEVEL 2-NEW PT W/PROC $282.007611008 WC VISIT LEVEL 3-NEW PT W/PROC $294.007611009 WC VISIT LEVEL 4-NEW PT W/PROC $305.007611010 WC VISIT LEVEL 5-NEW PT W/PROC $317.007611011 WC VISIT LVL 1-ESTABLISHED PAT $271.007611012 WC VISIT LVL 2-ESTABLISHED PAT $282.007611013 WC VISIT LVL 3-ESTABLISHED PAT $294.007611014 WC VISIT LVL 4-ESTABLISHED PAT $305.007611015 WC VISIT LVL 5-ESTABLISHED PAT $317.007611016 WC VISIT LVL 1-EST PAT W/PROC $271.007611017 WC VISIT LVL 2-EST PAT W/PROC $282.00

7611018 WC VISIT LVL 3-EST PAT W/PROC $294.007611019 WC VISIT LVL 4-EST PAT W/PROC $305.007611020 WC VISIT LVL 5-EST PAT W/PROC $317.007611023 WC:DEBRIDE-SKN&SBQ 1ST 20SQ CM $798.007611024 WC:DEBRIDE-MUSCLE 1ST 20SQ CM $1,207.007611025 WC:DEBRIDE-BONE 1ST 20SQ CM $2,650.007611031 WC:UNNA BOOT APPLICATION $361.007611032 WC:I & D ABSCESS SIMPLE/SNGL $457.007611033 WC:INCISION/DRAINAGE H,S,FLUID $2,840.007611035 WC:PARING/CUTTING BEN LESION;1 $278.007611036 WC:TRIM SKIN LESION/CALLUS 2-4 $412.007611037 WC:TRIM NAIL(S) NON-DYSTROPHIC $149.007611038 WC:DEBRIDE NAIL 1-5 $149.007611040 WC:TRIM NAIL(S) DYSTROPHIC MCR $149.007611041 WC:DRSSNG/DEBRDMT BURN,I/SQ;SM $412.007611042 WC:TR SF WD DEHISCENCE,SIMPLE $1,210.007611044 WC:APL RIGID TTL CNTCT LG CAST $630.007611046 WC:SMPL RPR SCALP,ETC 2.5CM/- $278.007611049 WC:NON-SELECTIVE WND DEBRIDE $412.007611050 WC:N/P WND THRPY (U/T 50SQ CM) $415.007611051 WC:N/P WND THRPY (G/T 50SQ CM) $793.007611055 WC:RMV TSS F/WND,S 1ST 20SQ CM $412.007611056 WC:RMV TSS F/WND,S E/A 20SQ CM $309.007611059 WC:AVULSION NAIL PLATE,SMPL;1 $450.007611063 WC:CHEMICAL CAUTERIZ GRN TSSE $412.007611066 WC:UNNA BOOT APPLICATION BILAT $721.007611072 WC:APP LWR LEG CMPRSSN $361.007611073 WC:APP LWR LEG CMPRSSN BILAT $721.007611076 WC:S GRFT BODY;1ST 25SQ CM $3,960.007611080 WC:S GRFT HEAD/EXTRM;1ST 25SQ $3,960.007611087 WC:DEBRIDE NAIL 6 OR MORE $149.007611095 WC:N/P WND THRPY SNAP U/T 50CM $793.007611096 WC:N/P WND THRPY SNAP G/T 50CM $793.007611099 WC:SCNDRY CLOSURE SURG WND,E/C $3,712.007611101 WC:LW FRQ NON-THRML US+TA,P/DY $429.007611102 WC:INCISION/REM FB SQT,SIMPLE $838.007611103 WC:DRNGE FINGER ABSCESS;SMPL $643.007611104 WC:EXCSN;B LESION+MRG;D 4.0+CM $3,370.007611105 WC:DRSSNG/DEBRIDE BURNS,I/S;M $422.007620036 IMMUNIZATION ADMIN, 1 $122.007620037 DELIVERY OF PLACENTA,SP:OB OBS $5,422.007690001 FETAL BIOPHY PRFL W/NST $907.007710030 ADMIN OF FLU VACCINE;GRMC $112.007710031 ADMIN OF PPV VACCINE;GRMC $112.007710033 ADMIN F/TETANUS IMMUNIZATION $112.008090002 CRRT ADDTL NURSING CARE P/DAY $961.009100002 HP-PSYCHIATRIC DIAG INTER EXAM $509.00

9140005 HP-INDIV PSYCHOTHERAPY 20-30MN $328.009140008 HP-INDIV PSYCHOTHERAPY 60MINS $485.009150002 HP-GROUP PSYCHOTHER INITAL $393.009150003 HP-GROUP PSYCHOTHER 1/2HR INIT $387.009150005 HP-GROUP PSYCHOTHER SUBQ $393.009150008 HP-GROUP PSYCHOTHER 1/2HR SUBQ $201.009200002 POLYSOMNOGRAPHY W/CPAP W/TECH $2,886.009200003 POLYSOMNOGRAPHY SLEEP STDY W/T $1,927.009200005 MULTIPLE SLEEP LTNCY/MN TESTNG $1,927.009200022 HOME SLEEP STDY,W/SLEEP TIME $556.009200024 CGM MINIMUM OF 72 HRS;TECH CHG $385.009210001 DUPLEX SCAN LW EXT-ART,UNI/LM $654.009210002 DUPLEX SCAN LW EXT-A,COMP/BILA $654.009210003 DUPLEX SCAN UP EXT-A,COMP/BILA $1,167.009210005 DUPLEX SCAN EXT VEINS,COM/BILA $748.009210006 DUPLEX SCAN EXTRACRANIAL A;C/B $1,668.009210007 DUPLEX SCAN EXT-VEINS,UNI/LIM $654.009210008 DUPLEX SCAN EXTRACRANIAL A;LIM $842.009210010 DUPLEX SCAN UP EXT-A,UNILATERL $544.009210018 DUPLEX SCAN AORTA,IVC,IV;COMPL $556.009210020 DUP SCAN I/O FLW ADB,PLV,S;LIM $416.009400004 INJ SUBQ/IM, THER/DIAG; OB&N $122.009420001 MED NUTR THER;INITAL INDIV 15M $58.009430001 PHYS SR/OP CARDIAC REHAB W/ECG $247.009430002 PHASE III CARDIAC REHAB SERV $5.009430003 MED SPRVSD EX PRGRM-CR $115.009430004 MED SPRVSD EX PRGRM W/MNTR-CR $180.009460001 RENT MATTRESS;AIRLSS/MULTIZONE $55.009600201 ECG;INTERPRETATION/REPORT ONLY $70.009600202 ASSESSMENT & REF F/TBC $125.009600206 TBC:GROUP PSYCHOTHERAPY-1 HOUR $47.009600207 TBC:INDIVID PSYCHOTHRPY 20-30M $67.009600208 TBC:INDIVID PSYCHOTHRPY 45-50M $122.009600210 CD:INDIVID PSYCHTHRPY 45-50MN $122.009600211 TBC:PSYCH/DIAG INTERV EXAM $122.009600212 CD:INDIVID PSYCHTHRPY 20-30MN $67.009600258 ASSESSMENT & REF - MCD F/TBC $125.009600259 TBC:IND PSYCHTHRPY-MCD P/15MIN $31.009600260 TBC:GRP PSYCHTHRPY-MCD P/1HR $47.009600269 CD:INDIVID PSYCHTHRPY 60MN $122.009600270 TBC:INDIVID PSYCHOTHRPY 60MIN $122.009600271 TBC:IND PSYCHTHRPY-MCD P/30MIN $67.009600272 TBC:IND PSYCHTHRPY-MCD P/60MIN $134.009600275 TBC:ADD E&M PSYCHOTHRPY;1ST HR $122.009600500 *IP DISCHARGE 99238<30MIN $193.009600501 *INIT NB 99460 P/DAY,HOSP $247.009600502 *SBSQ NB 99462 P/DAY,HOSP $108.00

9600503 *CIRCUMCISION W/REG BLOCK $388.009600504 *INIT DAY HOSP NEONATE 99477 $914.009600505 *SUBSEQUENT HOSP 99231,LEV 1 $106.009600506 *IC INF PBW2501-5000G SUBQ $306.009600507 *INITIAL HOSPITAL 99221,LV 1 $270.009600510 *INIT OBSERVATION 99218,LV 1 $265.009600514 *OBS CARE DISCHARGE DAY 99217 $194.009600517 *NEONATE CC,INITIAL 99468 $2,103.009600519 *SAME DAY ADMT/DC 99234,LV 1 $367.009600522 *INIT OBSERVATION 99219,LV 2 $360.009600524 *INITIAL HOSPITAL 99222,LV 2 $363.009600534 *INPAT DISCHARGE 99239>30MIN $284.009600536 *INIT NB 99463 ADMT/DSCHG,HOSP $280.009601000 H-INITIAL HOSPITAL 99221,LEV 1 $270.009601001 H-INITIAL HOSPITAL 99222,LEV 2 $363.009601002 H-INITIAL HOSPITAL 99223,LEV 3 $537.009601003 H-SUBSEQUENT HOSP 99231,LEV 1 $106.009601004 H-SUBSEQUENT HOSP 99232,LEV 2 $193.009601005 H-SUBSEQUENT HOSP 99233,LEV 3 $277.009601007 H-INPAT CONSULT 99252,LEV 2 $282.009601008 H-INPAT CONSULT 99253,LEV 3 $306.009601009 H-INPAT CONSULT 99254,LEV 4 $445.009601010 H-INPAT CONSULT 99255,LEV 5 $535.009601011 H-INPAT DISCHARGE 99238,<30MIN $193.009601012 H-INPAT DISCHARGE 99239,>30MIN $284.009601013 H-INIT OBSERVATION 99218,LEV 1 $265.009601014 H-INIT OBSERVATION 99219,LEV 2 $360.009601015 H-INIT OBSERVATION 99220,LEV 3 $492.009601016 H-SAME DAY ADMT/DC 99234,LEV 1 $367.009601017 H-SAME DAY ADMT/DC 99235,LEV 2 $449.009601018 H-SAME DAY ADMT/DC 99236,LEV 3 $578.009601019 H-OBS CARE DISCHARGE DAY 99217 $194.009601020 H-CRITICAL C 99291 1ST 30-74M $723.009601021 H-CRITICAL C 99292 EA + 30MIN $325.009601022 H-SUBSQ,OBSERVATION 99224,LVL1 $111.009601023 H-SUBSQ,OBSERVATION 99225,LVL2 $200.009601024 H-SUBSQ,OBSERVATION 99226,LVL3 $279.009601027 H-ER LEVEL III 99283 $167.009601030 H-CENTRAL LINE PLACEMENT 36556 $340.009601032 H-ARTERIAL LINE PLCMNT 36620 $144.009601033 H-ENDOTRACHEAL INTUBATN 31500 $397.009601034 H-PROLONGED SRVC INPAT;1HR $254.009601058 H-ULTRASOUND GUIDANCE F/VA CTH $38.009601059 H-SMOKING/TOBACCO CSSTN; 3-10M $32.009601061 H-BRONCHOSCOPY;W ALVEOLAR LVG $342.009601063 H-PLURAL DRNG,PERC W/CTH;WO IG $309.009601065 H-ABDOMINAL PARACENTESIS;WO US $186.00

9601067 H-SPINAL PUNCTURE,LUMBAR,DIAG $195.009601069 H-INSTILL,CHEST TUBE/CATH,AGNT $195.009601074 H-INSERT PICV CATH W/O SP/P 5+ $214.009830001 GC NEW PAT 99202 PRO FEE $69.009830002 GC NEW PAT 99203 PRO FEE $92.009830004 GC NEW PAT 99205 PRO FEE $204.009830005 GC ESTAB PAT 99211 PRO FEE $18.009830006 GC ESTAB PAT 99212 PRO FEE $36.009830007 GC ESTAB PAT 99213 PRO FEE $69.009830008 GC ESTAB PAT 99214 PRO FEE $92.009830020 I&D ABSCESS SIMPLE/SNGL-GCP $213.009830021 I&D ABSCESS COMP/MULTI-GCP $395.009830022 EXC NAIL&MATRIX P/C,PERMAN-GCP $383.009830023 REM CERUMEN W/INST,UNI-GCP $74.009830024 DEST LSNS,SKIN TAGS;15+-GCP $187.009830025 DEST LSNS,SKIN TAGS;U/T 14-GCP $152.009830026 ANNUAL DEPRESSION SCREEN,15MIN $47.009830027 GC PREV MED NEW 18-39YRS PRO F $94.009830028 GC PREV MED NEW 40-64YRS PRO F $94.009830029 GC PREV MED NEW 65+YRS PRO F $94.009830030 GC PREV MED EST 18-39YRS PRO F $94.009830031 GC PREV MED EST 40-64YRS PRO F $94.009830033 GC PREVENTIVE MED MEDICARE PRO $55.009830034 GC OBTAIN PAP SMEAR MEDICARE P $39.009900033 TBC:ANGER MANAGEMENT CLASS-SP $20.009900034 TBC:DRUG SCREEN TEST-SP $20.009900035 BIPP - INITAL EVAL $100.009900036 BIPP - GROUP SERVICE (2 HOUR) $30.009900037 BIPP - INDIVIDUAL SERVICE $75.009900038 FORENSIC EXAM AFTER HOURS $39.00

35000261 CT THORAX W/O CM, F/U LOW DOSE $1,461.0035000262 CT THORAX W/O CM, HRES $1,461.0035000263 CT LOW-DOSE F/LUNG CANCER SCRN $1,461.0061000052 MRA HEAD,ARTERY & VENOUS WO CM $4,659.0061000271 MRI PELVIS WO F/CM&FS $3,556.0092100110 VUS:TRANSCUTAN OXIMETRY L/B $334.0096002062 TBC:GROUP PSYCHOTHERAPY-2 HRS $94.0096002063 TBC:GROUP PSYCHOTHERAPY-3 HRS $141.00

450004525 EMERGENCY ROOM LEVEL I W/P $242.00450004625 EMERGENCY ROOM LEVEL II W/P $358.00450004725 EMERGENCY ROOM LEVEL III W/P $475.00450004825 EMERGENCY ROOM LEVEL IV W/P $753.00450004925 EMERGENCY ROOM LEVEL V W/P $1,170.00450005025 EMERGENCY ROOM LEVEL VI W/P $1,591.00960100125 H-INITIAL HOSPITAL 99222,LEV 2 $363.00960100225 H-INITIAL HOSPITAL 99223,LEV 3 $537.00960100325 H-SUBSEQUENT HOSP 99231,LEV 1 $106.00

960100425 H-SUBSEQUENT HOSP 99232,LEV 2 $193.00960100525 H-SUBSEQUENT HOSP 99233,LEV 3 $277.00960102025 H-CRITICAL C 99291 1ST 30-74M $723.000003296A LENS SN6AT TORIC ALL SIZES $634.000003297A LENS ZCT TORIC AMO ALL SIZES $664.00

0004396WC WC-GEL SILVASORB 1/10TH DOSE $4.320004409WC WC-GEL IODOSORB 1/10TH DOSE $6.38

10018A CONCENTRATION ANY TYPE,INFEC A $48.0010018B SMEAR,SPCL STAIN INCLS-BDY/PAR $48.0010647A GAMMAGLOBULIN(IMMUNOGLOB);IgE $38.0010647B ALLERGEN IGE;QNT/SQNT X 23 $854.0010659A GAMMAGLOBULIN(IMMUNOGLOB);IgE $47.0010659B ALLERGEN IGE;QNT/SQNT X 16 $752.0010716A IMMUNOASSAY NOT INFECT;Q/SQ MS $59.4210716B ANTINUCLEAR ANTIBODIES(ANA) $59.4210716C COMPLEMENT;ANTIGEN,EA COMPNT $118.8410716D DEOXYRIBONUCLEIC ACID AB;N/DS $59.4210716E EXTRACTABLE NUCLEAR ANTIGEN,EA $297.1010716F MICROSOMAL ANTIBODIES,EA $59.4210716G RHEUMATOID FACTOR;QUANTITATIVE $59.42

1100002B R&B MED: OVERFLOW F/SURG PRIV $1,391.001100004A R&B SURG: OVERFLOW F/MED PRIV $1,391.00

1868A ANTINUCLEAR ANTIBODIES(ANA) $151.001868B ANTIBODY IDNT;LEUKOCYTE $453.001868C IMMUNOASSAY NOT INFECT;QNT,NOS $151.00

19642A MASS SPECTROMETRY,NES;QNT&QL,E $30.0019642B DRUG SCRN;1DRUG METHOD,INSTRMT $75.0019955A GAMMAGLOBULIN;ADGM $82.9519955B IMMUNOASSAY N/INFC MSM $82.95

2500417GC CLONIDINE/CATAPRES 0.1MG TAB $3.502500491GC DEPO-MEDROL 80MG/1ML INJ $50.30

2500620OPC FENTANYL/SUBLIMAZE 100MCG/2ML $6.722501220WC WC-SILVER NITRATE STICK, EACH $3.502501596WC WC-GENTIAN VIOLET 2% APPLICTN $3.502501628GC KETOROLAC/TORADOL 60MG INJ $12.112501746GC ROCEPHIN/CEFTRIAXONE PER 250MG $10.502501886GC INFLUENZA VACCINE,3YRS + $74.002501965WC WC-LIDOCAINE 1% 20ML MDI P/D $3.502501980A RT-PULMICORT RESPULES 0.25MG $16.02

2502103GC DUO NEB AEROSOL SOLUTION 5.3ML $3.502502486A RT-FORMOTEROL 20MCG/2ML NEBU $21.56

2502944OPC PILOCARPINE HCL 1% 15ML BTL $302.252502947OPC MITOMYCIN 0.2 MG/ML SYR INJECT $178.752502948OPC PHENYLEPHRIN HCI(OPHTH)1.5%1ML $42.002540005JW LOCM,300-399 MG/ML VISIP WAST $8.002540005KX LOCM,300-399 MG/ML VISIP USED $8.002540006JW LOCM,200-299 MG/ML OMNIP WAST $8.00

2540006KX LOCM,200-299 MG/ML OMNIP USED $8.002540009JW LOCM,300-399MG/ML OPTIRAY WAST $8.002540009KX LOCM,300-399MG/ML OPTIRAY USED $8.002540010JW LOCM,300-399MG/ML OPTIRAY WAST $8.002540010KX LOCM,300-399MG/ML OPTIRAY USED $8.002540011JW LOCM,300-399 MG/ML OMNIP WAST $8.002540011KX LOCM,300-399 MG/ML OMNIP USED $8.002600002I IV INFSN,1HR;OBS $943.00

2600002M IV INFSN,1HR;OBS $943.002600002OB IV INFSN,1HR;OBS $943.002600002S IV INFSN,1HR;OBS $943.002600003I IV INFSN,E+HR;OBS $477.00

2600003M IV INFSN,E+HR;OBS $477.002600003OB IV INFSN,E+HR;OBS $477.002600003S IV INFSN,E+HR;OBS $477.00

2731A ANTIBODY;BLASTOMYCES $86.002731B ANTIBODY;COCCIDIOIDES $86.002731C ANTIBODY;HISTOPLASMA 2X-86698 $172.00

3000047GC URINE PREGNANCY TEST, BY COLOR $145.003000054R CONCENTRATION(A/TYPE)INFEC AGT $36.00

3000060GC URINALYSIS,NON-AUTO W/O MICROS $28.003000064A STAT COL FEE F/IN TOWN $15.003000070H DT-SAP 5 HAIR $55.003000081A CALCIUM;IONIZED (BY LAB) $197.00

3000084ER BASIC METABOLIC PNL,CALCIUM-ER $185.003000086S INFCT AGNT W/DOO;STEP,GRP A $175.003001000R ACUTE HEPATITIS PANEL E/2464 $152.003001006R ALBUMIN;URN,MICRO,QN E/3443UR $78.00

3001006R1 MICROALBUMIN 24HR URINE/3441U $74.003001007R1 ALBUMIN;SER,PLSM/WHL BLDE/1550 $50.003001007R2 ALBUMIN;SER,PLM/WHL BLD E/3924 $88.003001008R1 ALBUMIN;OTHER QN,EA E/1550 $50.003001010R1 ALDOSTERONE E/REFS52047 $250.003001012R1 ALPHA-FETOPROTEIN:SERUM E/3028 $138.003001012R2 ALPHA-FETOPROTEIN:SERUM E/3092 $203.003001013R1 ALPHA-1-ANTTRYPSN;TTL E/S50097 $63.003001022R4 ANTIBODY ID;PLATELET ANTIBODY $332.003001022R5 ANTIBODY ID;PLATELET ANTIBODY $362.003001035R1 ANTI-BDY;ANAPLASMA PHAGOCYTOPH $504.003001037R HELICOBACTER PYLR IGG/M/A ABS $530.003001039R ANT-BDY;HERPES SMPLX T-1E/9446 $140.003001040R ANT-BDY;HERPES SMPLX,T-2E/9446 $140.003001050R ANTI-BDY;RUBELLA E/1341 $106.003001055R TREPONEMA PALLIDUM $144.003001056R ANTI-BDY;VARICELLA-ZSTR E/8756 $222.00

3001056R1 ANTI-BDY;VARICELLA-ZOSTER/8761 $104.003001058R ANTI-BDY;BARTONELLA E/8851 $562.00

3001060R ANTBDY;RUBEOLA,MEASLES IGG&IGM $206.003001060R1 ANTI-BDY;RUBEOLA E/1341 $106.003001062R1 ANTI-BDY;MUMPS E/1341 $106.003001063R ANTINUCLEAR ANTBDY(ANA) E/1010 $70.00

3001063R2 ANTINUCLEAR ANT-BDY(ANA)E/1862 $175.003001063R4 ANTINUCLEAR ANT-BDY(ANA)E/5906 $203.003001068R BETA 2 GLYCOPROTEIN I E/9759 $228.00

3001070R1 BLD CNT;LEUKOCYTE,AUTO E/1655 $90.003001071R ANTI-BDY;BORDETELLA PERTUSSIS $213.00

3001080R1 CALCIUM;URN QNT,TMD SPC E/5510 $37.003001082R3 CARDIOLOPIN ATBDY,EA IG X3 $378.003001082R5 CARDIOLIPIN ANTBDY,EA E/9759 $228.003001083R CATECHOLAMINES;FRACTIONATED $246.003001090R CHRMTGRPHY,QUNT,CLMN;1 E/3530 $90.00

3001092R1 CHRMSME ANLY;ALZE20-25E/S51690 $303.003001094R1 CITRATE E/5510 $37.003001104R CLOTTING INHIB/ANTICOAG E/5952 $166.003001109R COMPLEMENT; TOTAL HEMOLYTIC $73.003001113R CORTISOL;FREE $240.00

3001115R1 CREATININE;OTHER SRCE E/3443UR $78.003001115R2 CREATININE;OTHR SRCE E/1305UR $54.003001115R5 CREATININE;OTHER SRCE E/3315UR $81.003001115R7 CREATININE;OTHER SRCE E/5510 $37.003001130R7 CYTOGENECTICS/MOLEC CYT;S51689 $331.003001130R9 CYTOGENECTICS/MOLEC CYT;S51690 $303.003001141R A-B:EPSTEIN-BARR(EA) E/2211 $107.003001142R A-B:EPSTEIN-BARR(EBNA) E/2211 $107.003001143R A-B:EPSTEIN-BARR(VCA) E/2211 $208.00

3001147R1 ESTRIOL E/3092 $203.003001151R2 EXTRACTABLE NUCLEAR ANTIGEN,EA $85.003001151R3 EXTRACTABLE NUCLEAR ANTIGEN,EA $92.003001151R4 EXTRACTABLE NUCLEAR ANTIGEN,EA $92.003001151R7 EXTRACTABLE NUCLEAR ANTIGEN,EA $156.003001158R FIBRINOLYTIC FCTRS/INHI;PLASMI $152.003001167R QUANT F/DRUG NES;LEVETIRACETAM $238.003001168R GAMMAGLOBULIN;IMMGLB SC E/1623 $682.00

3001168R1 GAMMAGLOBULIN;IMMGLB SC E/1931 $223.003001169R1 GAMMAGLOBULIN;ADGM EA E/1623 $174.003001169R2 GAMMAGLOBULIN;ADGM EA E/1550 $100.003001169R3 GAMMAGLOBULIN;ADGM EA E/1931 $113.003001181R HEMOGLOBIN FRACT/QNT E/4984 $93.003001182R HEMOGLOBIN FRACT/QUANT E/4984 $93.003001185R HEPATITIS B CR A/B;TTL E/2464 $152.00

3001185R1 HEPATITIS B CR A/B;TTL E/2461 $75.003001188R HEPATITIS A ANT-BDY E/2464 $152.00

3001190R1 HEPATITIS B CRE A-B;IGM E/2461 $75.003001192R HEPATITIS B SURFACE A/B E/2464 $152.00

3001192R1 HEPATITIS B SURFACE A/B E/2461 $75.003001193R1 INFECT AGT;HEP B SR E/2461 $75.003001197R HETEROPHILE ANTIBODIES;SCREEN $60.003001208R IMMUNOASSY,ANLT,QNT;RAD E/3060 $190.00

3001208R1 IMMUNOASSAY,ANALYTE,QUANT;RADI $331.003001208R11 IMMUN,ANALYTE,QUANT;RAD S50437 $659.003001208R13 IMMUNOASSAY,ANALYTE,QUANT;RADI $270.003001208R15 IMMUN,ANALYTE,QUANT;RAD S51297 $77.00

3001211R INFECT AGT DNA/RNA;CHLAMYDIA $182.003001211R1 INF AGT DNA/RNA;CHLAM E/7438SW $153.003001218R INFECT AGT DET;NOS,EA ORGANISM $201.003001222R INFCT AGT DNA/RNA;HRPS QN X2 $576.003001224R INFCT AGT DNA/RNA;HEPC,QNT5906 $203.003001233R ISLET CELL ANTIBODY $303.003001236R LEAD E/4080W $119.003001243R MERCURY, QUANTITATIVE E/4080W $119.003001244R METANEPHRINES $292.00

3001244R1 METANEPHRINES E/3315UR $81.003001246R1 MICROSOMAL ANTIBODIES,E E/3060 $190.003001246R2 MICROSOMAL ANTIBODIES,EA/3062 $84.003001246R3 MICROSOMAL ANTIBODY,EA E/1016 $88.003001246R4 MICROSOMAL ANTIBODIES,E E/5906 $403.003001247R4 MOLECULAR CYTG;INTERP E/S51686 $130.003001248R6 MOLECULAR CYTGN;DNA/P E/S51686 $260.003001263R NEPHELOMETRY,EA NOS E/1741U $359.00

3001272R1 OXALATE E/5510 $37.003001280R1 PHOSPHATIDYLSERINE 3X-86148 $428.003001280R2 ANTI-PHOSPHATIDYLSERINE E/9759 $228.003001281R2 PLATELET NEUTRALIZATION E/1910 $134.003001297R3 THROMBOPLAST TM;SB/PLSM E/1910 $134.003001302R1 RENIN E/REFS52047 $250.003001303R RHEUMATOID FACTOR;QUANT E/1010 $135.00

3001304R3 RUSSELL VIPER VENOM TM E/1910 $134.003001304R6 RUSSELL VIPER VENOM TM E/9759 $76.003001315R1 T CELLS;ABSLT CD4&CD8+R E/1655 $90.003001320R1 TESTOSTERONE; TOTAL E/3924 $88.003001322R4 THROMBOPLAST TM,PRTL E/1910 $134.003001324R THYROGLOBULIN ANTIBODY E/3060 $190.00

3001324R1 THYROGLOBULIN ANTIBODY E/1016 $88.003001327R3 TISSUE DIS;BN M/BLD C E/S51690 $303.003001330R TOXIN/ANTITOXIN ASSAY,TISSUE C $134.003001335R THYROID STMLTNG HRMN E/3060 $190.003001340R URIC ACID;OTHER SOURCE E/4168 $50.00

3001340R1 URIC ACID;OTHER SOURCE E/5510 $37.003001343R VIRUS ISOL;TISSUE CULTURE INOC $141.003001349R CELIAC IFA 2X-86256 $343.00

3001349R2 FLUORESCENT ANTIBODY TITER $140.00

3001383R2 CHROMOSOME ANA;CT15/20C/S51689 $331.003001384R2 TISS CLTR F/N-NEOPL:LYM S51689 $331.003001388R ARSENIC $100.00

3001390R2 FLOW CYTOMETRY,CS,TC,1M E/1795 $124.003001390R4 FLOW CYTOMTRY,CS,TC,1 M $156.003001393R THIAMINE (VITAMIN B-1) $158.003001406R PSA;TOTAL E/3547 $104.00

3001412R1 INFECT AGT DET;HIV-1 QUANT $128.003001412R3 INFECT AGT DET;HIV-1 QUANT $487.003001413R THYROID HRMN T3/T4 UPTAKE-THBR $14.003001417R ALPHA-1-ANTTRYPSN;PT E/S50097 $63.00

3001428R4 IMMUNOASSAY N/INFC MSM E/5906 $603.003001433R1 PH,BODY FLUID EXCPT BLD E/5510 $37.003001436R ANT-BDY IDNT;LEUKCYT AB E/1862 $175.00

3001436R1 ANT-BDY IDNT;LEUKOCYTE $127.003001436R4 ANT-BDY IDNT;LEUKOCYTE E/5906 $203.003001436R5 ANT-BDY IDNT;LEUKOCYTE $371.003001438R INHIBIN A E/3092 $203.003001441R FLUORSCNT N-IFCT A/ANTI:T,EA A $72.00

3001442R14 IMMUNASSY,ANAL,QNT;NS REF1762 $335.003001460R3 MAGNESIUM E/5510 $37.003001461R PHOSPHORUS INRGNC;URINE E/5510 $37.003001462R POTASSIUM;URINE E/5510 $37.003001463R SOCIUM,URINE E/5510 $37.00

3001476R1 COLUMN CHROM/MS,A NES:QNT,1S/M $135.003001477R HYDROXYPROGESTERONE, 17-D $78.003001481R FLOW CYTOMETRY,CS,TC,E+ E/1795 $2,907.003001484R FLOW CYTOMETRY,INTRP;16+E/1795 $124.00

3001495R2 PROTEIN;WESTERN BLOT W/I&R,EA $347.003001497R2 VOLATILES $24.003001506R INF AGT DNA/RNA;NG,DPTE/7438SW $153.003001507R ACTIVATED PROTEIN C RA $385.00

3001510R1 ANTI-BDY; ENTEROVIRUS $129.003001510R2 ANTI-BDY; ENTEROVIRUS $148.003001512R ANTINUCLEAR ANTIBODIES(ANA) $88.00

3001512R2 FLUORESCENT N-I AB;SCREEN,EA $322.003001512R3 FLRSCNT N-I AB;SCRN,E E/5906 $203.003001537R INFECT AGNT DET/NA,NOS,QNT,E/O $548.00

3001537R2 INFECT AGNT DET/NA,NOS,QNT,E/O $366.003001552R SEX HORMONE BINDING GLB E/3924 $88.003001559R INF AGT GT ANL NA;HIV 1,R/T&P $501.003001628R ANTI-BDY;WEST NILE VIRUS,IGM $91.00

3010026R1 CREATININE;BLOOD I-STAT $88.003010029GC GLUCOSE,BLD MONIT DVC $42.003010043R1 GONADOTROPIN,HCG QUN E/3028 $163.003010043R2 GONADOTROPIN,HCG QUN E/3092 $240.003010052ER TROPONIN,QUANTITATIVE ER $273.00

3010054R URIC ACID:BLOOD E/1010 $84.003020010R ANTBDY RBC EA PNL/SRM E/STBTC $112.003020012S INFCT AGNT W/DOO; RSV SCREEN $280.00

3050014ER BLOOD COUNT;HEMATOCRIT (HCT)ER $52.003060014R CULTURE,BACTERIAL STOOL, AEROB $48.003200055L KNEE,1-2 VIEWS STANDING LEFT $253.003200055R KNEE,1-2 VIEWS STANDING RIGHT $253.003200056L KNEE, 3 VIEWS LEFT $253.003200056R KNEE, 3 VIEWS RIGHT $253.003200124V FLUROSCOPIC GDNC CVAD PLMNT $635.00

3230012OR ANGIOGRAPHY,EXTREMITY,UNILAT $13,091.003230013OR ANGIOGRAPHY,EXTREMITY,BILAT $13,091.003230016OR ANGIOGRAPHY,VISCERAL,SEL/S-SEL $13,091.003600016OB ELECTROCAUTERY-OB $112.003600044OB OPERATING RM 30MIN-OB $3,166.003600044RB OPERATING RM 30MIN-OR $4,381.003600051RB OPERATING RM ADDL 30MIN-OR $691.003600077OB ROOM SET UP CHARGE-OB $239.003600077RB ROOM SET UP CHARGE-OR $239.003600100OB OPERATING RM ADD 15MIN-OB $382.003600100RB OPERATING RM ADD 15MIN-OR $382.003601515OR RE-VAS W/TL STENT PLMT +AP SV $12,691.003601518OR RE-VAS FMRL/POPL A;W/TL STENT $26,941.003601520OR RE-VAS TIB/PERONL A;W/TL ANGIO $12,691.003601526OR SEL CATH PLMT,ART LOW;1ST ORD $661.003601527OR SEL CATH PLMT,ART LOW;2ND ORD $661.003601545OR RE-VAS TIB/PERONL,E+;W/TL ANGI $12,691.003601629OR INTRO NDL/I-C;EXTREMITY ARTERY $661.003601899OR TRANSCATH PLMT STENT;1 ARTERY $28,302.003601915OR I-VAS US EVAL/INTRVTN S&I;INTL $661.003601916OR I-VAS US EVAL/INTRVTN S&I;EA A $661.003601956OR DIAG ANGIOGRAPHY DC, W/BALLOON $13,048.00

36742A ESTRONE $112.0036742B ESTRADIOL $112.0036742C ESTRIOL $112.00

3700003OB ANES. TIME BASIS 30MIN-OB $876.003700003RB ANES. TIME BASIS 30MIN-OR $876.003700010OB ANES. TIME BASIS ADDL 30MIN-OB $258.003700010RB ANES. TIME BASIS ADDL 30MIN-OR $258.003700012OB ANESTHESIA, SPINAL-OB $335.003700029OB ANES. TIME BASIS ADD 15MIN-OB $132.003700029RB ANES. TIME BASIS ADD 15MIN-OR $132.00

37960A CULTURE FUNGI ISOL;0/S NOT BLD $47.5037960B SMEAR,PR SC W/INT FL ACID FAST $47.50

3900001R BLOOD TYPING:ABO E/STBTC $112.003900002R BLOOD TYPING; RH (D) E/STBTC $112.003900004R ANTBDY SRN,RBC,E SRM T E/STBTC $112.00

4020001M MFM-OB/FETAL ULTRASOUND $612.004020012M MFM-FETAL BIOPHY PRFL W/O NST $416.004020018M MFM-US,PREG UTERUS 1/FIRST GES $656.004020019M MFM-US,PREG UTERUS LIM/1+FETUS $419.004020032M MFM-US,PREG UTERUS TRANSVAG $544.004020051M MFM-US,DPPLR VELOCIMETRY,F;UA $300.004020058M MFM-OB/FETAL US EA ADDL GEST $501.004020059M MFM-US,PREG F/M+FETAL T-ABD,1G $899.004020060M MFM-US,PREG UTERUS FU,T-ABD,EA $419.004020061M MFM-US,PREG F/M+FETAL T-ABD,+G $419.004020064M MFM-US,PREG UTERUS 1TRI FNTM;1 $419.004020077M MFM-DPPLR VELOCIMETRY,FTL;MCA $421.004020103M MFM-US GUIDE AMNIOCENTESIS,S&I $541.00

4144A PHENYTONIN; TOTAL $42.504144B PHENYTOIN; FREE $42.50

4201010TA APP/MOD, ELEC STIM 15M EA $98.004201012TA MANUAL THRPY,JT/MOBIL 15MIN EA $139.004201013TA APP/MOD ELEC STIM (UNATTENDED) $80.004210007R THERAPY PR-GAIT TRAINING 15MIN $129.004210013R THERAPY PR NEUROMUSC RE-ED 15M $156.004210020R THERAPY ACT DIR PAT CONT 15MIN $141.004210021R THERAPY PR-THERAPY EX 15MIN EA $141.00

4211002TA THRPY PR-AQUATIC W/EX 15MIN EA $163.004211006TA FLUIDOTHERAPY $66.004211007TA THERAPY PR-GAIT TRAINING 15MIN $129.004211012TA MAN/TH,MYOFASCIAL REL 15MIN EA $139.004211013TA THERAPY PR NEUROMUSC RE-ED 15M $156.004211020TA THERAPY ACT DIR PAT CONT 15MIN $141.004211021TA THERAPY PR-THERAPY EX 15MIN EA $141.004211022TA MANUAL THRPY-TRACTION 15MIN EA $139.004211023TA APP/MOD TRACTION MECHANICAL $80.004211024TA APP/MOD ULTRASOUND 15MIN EA $112.004211025TA APP/MOD WHIRLPOOL $151.004240003R PT EVAL:LOW 20MINS REHAB $332.004240004R PT EVAL:MODERATE 30MINS REHAB $343.004240005R PT EVAL:HIGH 45MINS REHAB $354.004300015R OT-TH/PR NEUROMUSC RE-ED 15MIN $156.004300018R OT-SELF/CARE HM TRNG DIR:15MN $166.004300021R OT-TH/ACT DIR PAT CONT 15MN EA $141.004300025R WHEELCHAIR MNGMT TRNG 15MIN EA $122.004300030R OT-DEVELPMNT COGNITIVE,DPC,15M $88.00

4301012TA OT-MANUAL THRPY JT/MOB 15MIN E $139.004301015TA OT-TH/PR NEUROMUSC RE-ED 15MIN $156.004301021TA OT-TH/ACT DIR PAT CONT 15MN EA $141.004301022TA OT-APP/MOD ULTRASND 15MIN EA $112.004310002R OT-THERAPEUTIC PR 15 MINS EACH $141.00

4311002TA OT-THERAPEUTIC PR 15 MINS EACH $141.00

4331002TA OT-THERAPEUTIC PR GROUP $104.004340003R OT EVAL:LOW 30MINS REHAB $332.004340004R OT EVAL:MODERATE 45MINS REHAB $343.004340005R OT EVAL:HIGH 60MINS REHAB $354.004420001R TRT/SPEECH,LNGG,VC,INDIVIDUAL $198.004420002R TRT/SWALLOW DSFNCTN/ORAL FNC $215.004440002R MOTION FLRSCOPIC SWAL BY VIDEO $455.004440006R EVAL OF SPEECH SOUND;W/LC & E $468.004440007R BEHAVIOR/QUAL VOICE&RESONANCE $225.004500045FT ER LEVEL 1 FASTTRACK $219.00

450004625F ER LEVEL II W/P FASTTRACK $286.004500046FT ER LEVEL II FASTTRACK $286.00

450004725F ER LEVEL III W/P FASTTRACK $392.004500047FT ER LEVEL III FASTTRACK $392.00

450004825F ER LEVEL IV W/P FASTTRACK $487.004500048FT ER LEVEL IV FASTTRACK $487.00

450004925F ER LEVEL V W/P FASTTRACK $614.004500050A EMERGENCY ROOM LEVEL VII CC+30 $771.004500160C IMMUNIZATION ADMIN U/19,1ST V $139.00505026A MONONUCLEAR CELL ANTIGEN,QNT E $71.50505026B NATURAL KILLER(NK) CELLS,TTL C $71.505779MA CULTURE FUNGI ISOL;O/S NOT BLD $44.505779MB SMEAR,PR SC W/INT FL ACID FAST $44.5059792A COMPLEMENT;ANTIGEN,EA COMPNT $108.0059792B DEOXYRIBONUCLEIC ACID AB;N/DS $54.00

6360004A LOCM: OMNIPAQUE 300 50 $30.006360005A LOCM: OMNIPAQUE 240 50 P/1ML $97.006360008A INJECTION: OMNISCAN MRI 15 ML $67.006360009A INJECTION: OMNISCAN 20 ML $88.006360071A INJ OPTISON P/ML $96.00

7100001OB RECOVERY RM 30MIN-OB $566.007100001RB RECOVERY RM 30MIN-OR $566.007100011OB RECOVERY RM ADD 15MIN-OB $167.007100011RB RECOVERY RM ADD 15MIN-OR $167.007610025A CHEMO ADM SUBQ/IM HORM ANPT $274.007610026A CHEMO ADM IV PUSH EA ADD SUB/D $274.007610030A INJ IV P,EA ADD SEQ NW/DG;GIPC $269.007610085IC INSERT PICV CATH W/O SP/P 5+YR $2,534.007610085M INSERT PICV CATH W/O SP/P 5+YR $2,534.007610085S INSERT PICV CATH W/O SP/P 5+YR $2,534.007610116I MSRMNT P-VOIDING/BLDDR US,ICU $158.007610116S MSRMNT P-VOIDING/BLDDR US,SURG $158.007611012M MFM-VISIT LVL 2-EST PT 10MIN $124.007611013M MFM-VISIT LVL 3-EST PT 15MIN $130.007611023A WC:DEBRIDE-SKN&SBQ E/A 20SQ CM $497.007611024A WC:DEBRIDE-MUSCLE E/A 20SQ CM $764.007611025A WC:DEBRIDE-BONE E/A 20SQ CM $1,745.00

7620012I INJ SUBQ/IM,THER/DIAG;OBS $122.007620012M INJ SUBQ/IM,THER/DIAG;OBS $122.007620012OB INJ SUBQ/IM,THER/DIAG;OBS $122.007620012S INJ SUBQ/IM,THER/DIAG;OBS $122.007620013I INJ IV P,1/FRST SUB/DRUG;OBS $280.00

7620013M INJ IV P,1/FRST SUB/DRUG;OBS $280.007620013OB INJ IV P,1/FRST SUB/DRUG;OBS $280.007620013S INJ IV P,1/FRST SUB/DRUG;OBS $280.007621013I INJ IV P,EA ADD SEQ NW/DG;OBS $269.00

7621013M INJ IV P,EA ADD SEQ NW/DG;OBS $269.007621013OB INJ IV P,EA ADD SEQ NW/DG;OBS $269.007621013S INJ IV P,EA ADD SEQ NW/DG;OBS $269.007621014I INJ IV P,EA ADD SEQ SM/DG;OBS $269.00

7621014M INJ IV P,EA ADD SEQ SM/DG;OBS $269.007621014OB INJ IV P,EA ADD SEQ SM/DG;OBS $269.007621014S INJ IV P,EA ADD SEQ SM/DG;OBS $269.007690001M MFM-FETAL BIOPHY PRFL W/NST $907.007710030GC ADMIN OF FLU VACCINE;GC $117.00

87804A INFCT AGNT W/DOO;INFLUENZA A $84.0087804B INFCT AGNT W/DOO;INFLUENZA B $84.0091622A FLUORESCENT N-I AB;SCREEN,EA $1,167.0091622B PROTEIN;WESTERN BLOT W/I&R,EA $778.0091622C PROTEIN;WSTRN BLOT W/I&R,B/OBF $389.0091622D IMMUNOASSAY,ANALYTE,QUANT;RADI $389.0091622E IMMUNOASSAY NOT INFECT;Q/SQ MS $778.0092145A LIPID PANEL E/92145 $50.0092145B LIPOPROTEIN,BLD;QUANT LP #+SC $50.0092145C APOLIPOPROTEIN,EACH E/92145 $50.0092145D LIPOPROTEIN E/92145 $50.0092587A BRCA1,BRCA2 GENE ANAYLSIS;FULL $375.8392587B MOPATH PROCEDURE LEVEL 6 $751.6692587C UNLISTED MOLECULAR PATHOLOGY $375.8392587D PTEN GENE ANALYSIS;FULL SEQ AN $375.8392587E PTEN GEN ANALYSIS;DUPL/DELET V $375.8392587F MOLECULAR PATH PROC, LEVEL 7 $751.6692587G MOPATH PROCEDURE LEVEL 5 $375.83

9830005F GC ESTAB PAT 99211 FAC 1500 $142.009830006F GC ESTAB PAT 99212 FAC 1500 $142.00ABODSA BLOOD TYPING; ABO $38.50ABODSB BLOOD TYPING;RH (D) $38.50FE3001 FORENSIC EXAM: PREGNANCY TEST $20.00FE3002 FORENSIC EXAM: CHLAMYDIA CULTR $51.00FE3003 FORENSIC EXAM: GONORRHEA CULTR $30.00FE3005 FORENSIC EXAM: DS,GHB,ROHYPNOL $58.00FE3006 FORENSIC EXAM: VENIPUNCTURE $20.00FE3007 FORENSIC EXAM:HANDLING OF SPEC $20.00FE3008 FORENSIC EXAM: VAGINITIS SRN $48.00

FE3011 FORENSIC EXAM:GC/CHLAMYDIA DNA $76.00FE3012 FORENSIC EXAM:UA W/O MICROS $30.00FE3013 FORENSIC EXAM:UA WITH MICROS $44.00LC3001 LAB CONTRACT-ON SITE CHG $100.00

LENS-SLC LENS,SPCL ORDR -COST OF STNDRD -$139.00PC99204 PALLIATIVE 99204 45MIN OP;NEW $331.00PC99205 PALLIATIVE 99205 50MIN OP;NEW $432.00PC99212 PALLIATIVE 99212 10MIN OP;ESTB $109.00PC99213 PALLIATIVE 99213 15MIN OP;ESTB $184.00PC99214 PALLIATIVE 99214 25MIN OP;ESTB $270.00PC99215 PALLIATIVE 99215 40MIN OP;ESTB $363.00PC99220 PALLIATIVE 99220 70MN OBS;INIT $492.00PC99221 PALLIATIVE 99221 30MIN IP;INIT $270.00PC99222 PALLIATIVE 99222 50MIN IP;INIT $363.00PC99223 PALLIATIVE 99223 70MIN IP;INIT $537.00PC99225 PALLIATIVE 99225 25MN OBS;SUBS $200.00PC99231 PALLIATIVE 99231 15MIN IP;SUBS $106.00PC99232 PALLIATIVE 99232 25MIN IP;SUBS $193.00PC99233 PALLIATIVE 99233 35MIN IP;SUBS $277.00PC99285 PALLIATIVE 99285 ER LEVEL V $468.00PC99306 PALLIATIVE 99306 35MIN NH;INIT $428.00PC99308 PALLIATIVE 99308 15MIN NH;SUBS $177.00PC99309 PALLIATIVE 99309 25MIN NH;SUBS $234.00PC99310 PALLIATIVE 99310 35MIN NH;SUBS $348.00REF1012 IMMUNASSY,ANAL,QNT;NOS $413.00

REF1045C GAMMAGLOBULIN;ADGM $324.00REF10715 ALLERGEN IGE;QNT/SQNT $700.00REF1101 FLUORESCENT N-I AB;TITER, EA $80.00REF1106 FLUORESCENT N-I AB;TITER, EA $88.00REF1107 FLUORESCENT N-I AB;TITER, EA $80.00

REF11073 IMMUNOASSAY NOT INFECT;Q/SQ MS $276.00REF14839 HELICOBACTER PHYLORI;BREATH A $179.00REF15064 FLUORESCENT N-I AB;SCREEN,EA $86.00

REF15064T FLUORESCENT N-I AB;TITER, EA $25.00REF1530 COMPLEMENT;FUNCTIONAL ACT,EA $158.00

REF15780 RUSSELL VIPER VENOM TIME;DILUT $115.00REF16262 QUANT F/DRUG NES;LACOSAMIDE $173.00REF16283 SPECTROPHOTOMETRY,A/NOS $275.00REF1629 GAMMAGLOBULIN;IMMUNOG SUBCLASS $149.00

REF16538 JAK2 GENE ANALYSIS,(V617F) $500.00REF16963 IMMUNOASSAY INF AGT,QUANT;NES $922.00REF17306 VITAMIN D;25HYDROXY +F;TTL $226.00REF17911 MTHFR GENE ANALYSIS, VARIANTS $310.00REF18831 MASS SPECTROMETRY & TM,QL/QN,E $366.00REF20103 ANTI-BDY;EHRLICHIA $396.00REF2161 ANTI-BDY;PROTOZOA, NES $56.00REF2351 DEOXYRIBONUCLEASE,ANTIBODY $65.00

REF267 THYROGLOBULIN ANTIBODY $67.00REF2802 ALLERGEN IGE;QNT/SQNT COW MILK $44.00REF2813 ALLERGEN IGE;QNT/SQNT PEANUT $44.00REF2814 ALLERGEN IGE;QNT/SQNT SOYBEAN $44.00REF2826 ALLERGEN IGE;QNT/SQNT PORK IgE $44.00REF2827 ALLERGEN IGE;QNT/SQNT BEEF $44.00REF2854 ALLERGEN IGE;QNT/SQNT GLUTEN $44.00REF3138 IMMUNASSY,ANAL,QNT;NOS $205.00REF3241 EXTRACTABLE NUCLEAR ANTIGEN,EA $83.00

REF34144 IMMUNASSY,ANAL,QNT;NOS $163.00REF34179 INFECT AGT DNA/RNA;AP TECH,EA $321.00REF36573 PHOSPHOLIPID NEUTRALATN;HEXGNL $102.00REF37053 FLUORESCENT N-I AB;SCREEN,EA $150.00REF37092 FLUORESCENT N-I AB;SCREEN,EA $96.00REF37273 INFECT AGNT DET/NA;HEPATITIS C $325.00REF37438 IMMUNASSY,ANAL,QNT;NOS $115.00REF37673 ANTIBODY;RUBELLA $160.00REF37852 ZONISAMIDE $99.00REF38568 EXTRACTABLE NUCLEAR ANTIGEN,EA $61.00REF3982 CHEMILUMINESCENT ASSAY $298.00REF4125 DRUGS OF ABUSE, SERUM $462.00

REF43020A CUSTOM ETHRIDGE ALLERGEN PANEL $286.00REF4333UR URIC ACID;OTHER SOURCE $104.00REF4490UR OPIATES, 1 OR MORE $114.00

REF4875 SELENIUM $138.00REF5019 AI;PLATELET IMMUNOGLOB ASSAY $255.00REF5695 IAAD;ENTAMOEBA HISTOLYTICA GRP $75.00REF5920 IMMUNOASSAY NOT INFECT;Q/SQ MS $251.00REF6646 ANTIBODY;BORRELIA BURGDORFERI $250.00

REF70242 SUSCEPTIBILITY STUDIES,ADM,P/A $154.00REF7083 GAMMAGLOBULIN;ADGM $201.00REF7581 INFECT AGT DNA/RNA;HERPES S V $537.00

REF791584 ALCOHOL BIOMARKERS;1 OR 2 $108.00REF8168 ANTI-BDY;WEST NILE VIRUS,IgM $92.00REF8593 BORRELIA BURGDORFERI CONFIRM T $200.00REF8821 IMMUNOASSAY NOT INFECT;Q/SQ MS $138.00REF8863 ANTI-BDY;BARTONELLA $66.00REF8929 ALLERGEN IGE;QNT/SQNT CLAM IgE $44.00

REF8941C ANTIBODY;BORRELIA BURGDORFERI $234.00REF90129 IMMUNASSY,ANAL,QNT;NOS $300.00REF90559 VERY LONG CHAIN FATTY ACIDS $275.00REF90827 ANTI-BDY;PROTOZOA, NES $138.00

REF90830-2 SUSCEPTIBILITY STUDIES,MIC/AGA $154.00REF91065 BCR/ABL-1 GENE MAJOR BP $363.00REF92414 ISLET CELL ANTIBODY $895.00REF92491 HELICOBACTER PHYLORI;BREATH P $179.00REF92790 MASS SPECTROMETRY,NES;QNT&QL,E $130.00

REF92888 VITAMIN D;25HYDROXY +F;D2,D3,T $212.00REF93870 INFECT AGT DNA/RNA;AP TECH,EA $385.00REF94646 EXTRACTABLE NUCLEAR ANTIGEN,EA $88.00REF9861 ANTIBODY;HAEMOPHILUS INFLUENZA $138.00REFF79G ALLERGEN IGG S-QNT,EA $44.00

REFP43020B ALLERGEN IGE;QNT/SQNT CNTRL TX $960.00REFS40845 COLUMN CHROM/MS,A NES;QNT,1S/M $141.00REFS49461 CULTURE,PRESUMP,PATH/ORGAN,SCR $104.00REFS49590 ORGANIC ACIDS;TOTAL,QUANT,EA S $300.00REFS49825 RIBOFLAVIN (VITAMIN B-2) $156.00REFS49882 PARTICLE AGGLUTINATION;SR,EA A $90.00REFS51244 SPERM AB $93.00REFS51481 MECONIUM 5 DRUG TC:S51481 $120.00REFS51514 ANTIBODY;HEPATITIS,DELTA AGENT $261.00REFS51585 IMMUNE COMPLEX ASSAY $105.00REFS52014 IMMUNASSY,ANAL,QNT;NOS $78.00REFS52015 IMMUNASSY,ANAL,QNT;NOS $114.00REFS52032 IMMUNASSY,ANAL,QNT;NOS $150.00REFS52096 IMMUNOASSAY NOT INFECT;Q/SQ MS $86.00REFS52345 ANTI-BDY;ASPERGILLUS 4X-86606 $160.00REFS52399 PROCALCITONIN (PCT) $245.00REFS52492 ANTIBODY;JC(J.CUNNINGHAM)VIRUS $1,475.00

RT1007 SS-A&SS-B IGG AUTOABS 86235X2 $170.00S51263A TRANSFERASE;ASPARTATE AMINO $40.00S51263B CHOLESTEROL,SERUM/WHOLE BLD TL $40.00S51263C GLUCOSE;QUANTITATIVE BLOOD $40.00S51263D TRIGLYCERIDES $40.00S51263E NEPHELOMETRY,EA ANALYTE NES $40.00S51263F HAPTOGLOBIN;QUANTITATIVE $40.00S51263G APOLIPOPROTEIN,EACH $40.00S51263H BILIRUBIN; TOTAL $40.00S51263I GLUTAMYL TRANSFERASE,GAMMA GGT $40.00S51263J TRANSAMINASE;ALANINE AMINO $40.00S52424A ANTIBODY;HERPES SMPLX TYPE 1 $110.00S52424B ANTI-BDY;HERPES SIMPLEX,TYPE 2 $110.00

ST503 COLD AGGLUTININ; TITER $104.00ST505 COOMBS TEST INDIRECT QUAL $17.00

WILDCODE1 VOLATILES(EG,ACETIC ANHYDRIDE) $40.00