oklahoma spine hospital · charge code description charge ub code ub description 000001 su vic 0 ct...

Oklahoma Spine Hospital

Charge Code Description Charge UB Code UB Description

000001 SU VIC 0 CT CR J752D 8.94 272 Sterile Supply

000002 SU VIC 0 CT-1 CR J740D 9.03 272 Sterile Supply

000003 SU VIC 0 CT-1 J946H 1.58 272 Sterile Supply

000004 SU VIC 0 CT2 CR J727D 9.01 272 Sterile Supply

000005 SU VIC 0 CTX CR J764D 8.98 272 Sterile Supply

000006 SU VIC 1 CT CR J753D 10.45 272 Sterile Supply

000007 SU VIC 1 CT1 CR J741D 9.34 272 Sterile Supply

000008 SU VIC 1 CTX CR J765D 8.98 272 Sterile Supply

000009 SU VIC 1 CT 36 J959H 1.66 272 Sterile Supply

000010 SU VIC 2-0 CT1 J945H 1.61 272 Sterile Supply

000011 SU VIC 2-0 CT1 CR J739D 9.00 272 Sterile Supply

000012 SU VIC 2-0 CT2 CR J726D 8.76 272 Sterile Supply

000013 SPONGE COTTON 1/2 X 6 67-82 7.35 272 Sterile Supply

000014 SPONGE COTTON 1/2 X1/2 67-06 9.60 272 Sterile Supply

000015 SU VIC 3-0 SH J416H 1.33 272 Sterile Supply

000016 SU VIC 3-0 SH CR J774D 8.87 272 Sterile Supply

000017 SU PDS 3-0 PS-2 Z497G 4.07 272 Sterile Supply

000018 SU ETHIL 3-0 PS-2 1669H 3.40 272 Sterile Supply

000019 SU SILK 3-0 TIES 30 A304H 2.37 272 Sterile Supply

000020 SU PROLENE 4-0 PS-2 8682H 4.29 272 Sterile Supply

000021 SU VIC 4-0 PS-2 J496H 3.10 272 Sterile Supply

000022 SU VIC 4-0 P-3 J494H 3.44 272 Sterile Supply

000023 SU MONO 4-0 P-3 Y494G 2.42 272 Sterile Supply

000025 SU NURO 4-0 TF CR C584D 15.18 272 Sterile Supply

000026 SU ETHIL 4-0 PS-2 1667H 3.41 272 Sterile Supply

000027 SU SILK TIES 2-0 18 A185H 1.32 272 Sterile Supply

000028 DRAPE IOBAN 35X17 M6650EZ 5.17 272 Sterile Supply

000029 SLEEVE STERILE 89791 / 599 0.43 272 Sterile Supply

000031 BONE WAX 2.5 GRAM 901 3.86 272 Sterile Supply

000039 GLOVE BIOGEL 6 30560 0.99 272 Sterile Supply

000040 GLOVE BIOGEL 7.5 30575 1.01 272 Sterile Supply


000042 SU PROLENE 2-0 FS 8685H 2.30 272 Sterile Supply

000045 SYR 20ML LL B-D 302830 0.17 270 Med-Surg Supplies

000046 SYR 30ML LL B-D BF302832 0.31 270 Med-Surg Supplies

000047 SYR 60ML LL B-D 309653 0.32 272 Sterile Supply

000048 SYR 10ML CONTROL LL 309695 0.68 272 Sterile Supply

000054 NE 25G 3.5 SPINAL 405180 1.27 272 Sterile Supply

000055 NE 22G 3.5 BD/SPIN 405181A 1.48 272 Sterile Supply

000056 NE 22G 5 SPINAL B-D 405148 3.59 272 Sterile Supply

000057 NE 18G 6 SPINAL B-D 408360 3.67 272 Sterile Supply

000058 NE 22G 6 CHIBA B-D 408268 5.30 272 Sterile Supply

000059 NE 20G 3.5 SPINAL B-D 405182A 1.79 272 Sterile Supply

000064 AIRWAY NASAL 32FR 247056 4.81 272 Sterile Supply



000067 PEN SKIN MARKER REG 212MIL 1.52 272 Sterile Supply

000068 SPONGE RAYTEC XRAY 4X4 7317 0.55 272 Sterile Supply

000070 URINAL MALE 4472H14001 0.32 272 Sterile Supply

000074 COLLAR SOFT 79-83500 4.54 274 Prosthetic Dev

000075 DRAPE PEDIATRIC 29492 4.81 272 Sterile Supply

000076 DRAPE U 8474 1.92 272 Sterile Supply

000077 BEDPAN REG CONVENTIONAL DUSTY ROSE 0.91 270 Med-Surg Supplies

000083 TUBE SALEM SUMP 18FR 264986 1.23 272 Sterile Supply


000085 BEDPAN/FRACTURE FBEDPANMAV 0.78 270 Med-Surg Supplies

000086 DRAPE TABLE COVER 8377 1.29 272 Sterile Supply

000087 DRAPE 3/4 SHEET 29350 2.43 272 Sterile Supply

000088 GOWN X-LG 2.31 272 Sterile Supply

000089 DRAPE MAYO STAND COVER 8337 0.79 272 Sterile Supply

Charge Master as of December 19, 2018



000090 DRAPE OVERHEAD TABLE 9385 4.89 272 Sterile Supply

000093 STERI-STRIP 1/2 R1547 3M 0.85 272 Sterile Supply

000098 PACK COLD INSTANT 6X9 0.93 272 Sterile Supply

000100 SWAB BETADINE 3/PK 0.41 272 Sterile Supply

000103 NEBULIZER MICRO MIST W/TUBING 0.91 272 Sterile Supply

000104 TAPE DURAPORE SILK 1 M1538-1 0.57 270 Med-Surg Supplies


000106 TAPE MICROPORE 1PAPER 15301 0.33 270 Med-Surg Supplies

000107 DRESSING TEGADERM 2X2 1624W 0.23 272 Sterile Supply

000108 DRESSING TEGADERM 6X8 1628 1.27 272 Sterile Supply

000109 BANDAGE 6"X5 ECON LF TAN 237000LF 0.93 270 Med-Surg Supplies

000110 BANDAGE ACE 3 2370003LF 6.48 270 Med-Surg Supplies

000111 BANDAGE ACE 4 ELAST W/CLIPS 2370004LF 0.85 270 Med-Surg Supplies

000112 DRESSING KLING 3 2232 0.25 272 Sterile Supply

000113 DRESSING KLING 4 2236 0.28 272 Sterile Supply

000115 DRAIN RESERVOIR JP 0070740 4.40 272 Sterile Supply

000120 TUBE ET 6.5 5-10313 1.67 272 Sterile Supply





000126 DURAPREP 3M 26ML 8630 3.80 270 Med-Surg Supplies

000133 BAG PERSONAL BELONG PC7200 0.11 270 Med-Surg Supplies

000134 DRAIN JP FLAT 7MM SU130-1310 4.97 272 Sterile Supply

000135 DRAIN HEMOVAC MED SUCTION 3 SPRING RESERVOIR 8.37 272 Sterile Supply

000136 STOCKING TED SML REG THIGH 4.77 270 Med-Surg Supplies

000137 STOCKING TED MED REG THIGH 6.74 270 Med-Surg Supplies

000138 STOCKING TED MED LNG THIGH 4.77 270 Med-Surg Supplies

000140 STERI-STRIP 1/4 MR1546 3M 1.03 272 Sterile Supply

000141 STOCKING TED LG REG THIGH 4.77 270 Med-Surg Supplies

000142 TRAY SKIN PREP 4468 3.29 272 Sterile Supply

000143 DRAPE STERI 1020 3M 1.16 272 Sterile Supply

000144 DRAPE STERI BUTT 1000 0.63 272 Sterile Supply

000145 IV JELCO 14GA ANES 4418-22 1.16 272 Sterile Supply

000149 DRAPE STERI 1040 3M 1.82 272 Sterile Supply

000153 CAUTERY TIP CLEANER 31142790 0.41 272 Sterile Supply

000154 IV SET PUMP CLAVE 14687-28 4.75 272 Sterile Supply

000155 DRESSING BIOCLUSIVE BIP0607 0.35 272 Sterile Supply

000157 PACK NEURO SNE47BSPML 71.70 272 Sterile Supply

000166 SLIPPERS TERRY TREADS LG BEIGE NON-SKID 0.65 270 Med-Surg Supplies

000168 KIT NRV RT BLK 183A65 8.11 272 Sterile Supply

000169 KIT NRV RT BLK 18364 8.19 272 Sterile Supply

000170 KIT SUTURE REMOVAL 1.06 272 Sterile Supply

000174 IV START KIT IV4740 LATEX FREE 2.00 272 Sterile Supply

000175 GRADUATE PITCHER H970-00 0.23 270 Med-Surg Supplies

000176 DRESSING KERLIX 6730 CASE 60 0.90 272 Sterile Supply

000177 SYR ASEPTO PP4090 0.64 272 Sterile Supply

000178 IV CATH 18X1.25 RADPQ 381444 1.79 272 Sterile Supply


000180 IV CATH 22X1 RADPQ 381423 1.79 272 Sterile Supply

000181 MASTISOL 2CC 0496-0523-48 1.55 272 Sterile Supply

000183 BLANKET BAIR HUG LO.BODY 525 5.58 270 Med-Surg Supplies

000187 DRAPE MED K-C 77X44 9355 0.48 272 Sterile Supply

000189 DRESSING ABD COMBI 8X8 KC7197D 0.12 272 Sterile Supply

000190 NE 18X6 TUOHY E1860 332160 9.38 272 Sterile Supply

000191 BAG AMBU HUDSON 5372 CS/6 19.14 270 Med-Surg Supplies

000193 GLOVE ORTHO 9 5721317 (NASR) 1.25 272 Sterile Supply

000194 MASK 02 W TUBING ADULT 0.54 272 Sterile Supply

000195 CUFF BP THIGH ADULT DISP 2505 3.85 270 Med-Surg Supplies

000196 CUFF BP LG ADULT DISP 2504 2.96 270 Med-Surg Supplies




000197 CUFF BP MED ADULT DISP 2503 2.59 270 Med-Surg Supplies

000198 CUFF BP SM ADULT DISP 2502 2.59 270 Med-Surg Supplies

000199 SYR CATH TIP 60CC 309620 0.32 272 Sterile Supply

000200 SPECIMEN COL(NUNS CAP)02072 0.35 270 Med-Surg Supplies

000201 TRAY CATH STRAIGHT 15FR 772415 2.13 272 Sterile Supply

000202 GOWN XX-LG KIM-CLARK 95131 4.15 272 Sterile Supply

000203 STOCKINETTE 4X36 STERILE 6.08 270 Med-Surg Supplies

000205 CATHETER SUCTION 18FR KT 37724 0.62 272 Sterile Supply

000208 DRESSING TELFA 3X8 KC1238 0.07 272 Sterile Supply

000209 DRESSING TELFA 3X4 KC1050 0.08 272 Sterile Supply

000211 LOTION REMOVER .5 OZ PKT 8610 0.64 270 Med-Surg Supplies

000212 SPONGE 4X4 2/PK STERILE 2187 0.06 272 Sterile Supply

000214 TAPE MICROFOAM 2 1528-2 2.27 270 Med-Surg Supplies

000215 TAPE MICROFOAM 3 1528-3 3.40 270 Med-Surg Supplies

000218 ELECTRODE PK/5 BX/1000 50007365 0.72 270 Med-Surg Supplies

000219 STAPLER REMOVER SKIN 1.25 272 Sterile Supply


000228 HEADREST SLOTTED PURPLE FP-HEADSL 3.75 270 Med-Surg Supplies

000231 SPONGE 2X2 2/PK STERILE 1806 0.03 272 Sterile Supply

000234 CATH TRIPLE LUMEN 7F. AK-45703-ACDC 76.87 272 Sterile Supply

000235 CATH RADIAL ARTERY RA04020 10.92 272 Sterile Supply

000239 TAPE MICROPORE 2PAPER 15302 0.58 270 Med-Surg Supplies

000240 DRESSING XEROFORM 2X2 BX/25 0.46 272 Sterile Supply

000241 KIT ART LINE MX9505T 8.97 272 Sterile Supply

000242 DRAPE LAPAROTOMY TIBURON 29410 5.20 272 Sterile Supply

000243 DRAPE UTILITY 26X15 0.35 272 Sterile Supply

000244 BAG PRESSURE INFUSER 4005 MEDICHOICE 230500 7.33 270 Med-Surg Supplies

000245 BAND ESMARK 4 LF 836-3412 2.93 270 Med-Surg Supplies

000246 STOCKING TED LG LONG THIGH 4.77 270 Med-Surg Supplies

000247 SPONGE LAP 8X36 419 1.64 272 Sterile Supply

000251 BENZOIN COMPOUND C1544 0.47 272 Sterile Supply

000254 IRRIG NS 3000ML 797208 5.08 272 Sterile Supply

000255 SOL BETADINE 4OZ 29906-004 1.01 270 Med-Surg Supplies

000256 CUP SPECIMEN STERILE 4 OZ 0.29 272 Sterile Supply

000258 STOCKING TED XL REG THIGH 4.77 270 Med-Surg Supplies

000259 DRESSING COBAN 3" CAH35LF 1.09 272 Sterile Supply

000260 DRESSING COBAN 4 1584 3M 1.33 272 Sterile Supply

000263 IRRIG .9% NACL 1000 L071380929 3.00 272 Sterile Supply

000264 IV SET PRIM GRAVITY 12664-28 3.83 272 Sterile Supply

000265 IV BLOOD PLUMSET 14212-28 18.18 272 Sterile Supply

000266 IV SET EXT TWIN 12678-28 2.34 272 Sterile Supply

000267 IV SET SECONDARY 14230-28 0.82 272 Sterile Supply

000268 IV MICROCLAVE HEP LOCK CONNECT 0.80 272 Sterile Supply

000269 IV BLOOD SET Y-TYPE 12435-02 4.28 272 Sterile Supply

000270 STOPCOCK 3-WAY MEDX MX431-1L 0.45 272 Sterile Supply

000271 IV EXT LARGE BORE 12660-28 1.90 272 Sterile Supply


000273 DRAPE MICROSCOPE 5950-120GL (SUB 5950-150GL) 14.75 272 Sterile Supply

000274 DRAPE BAND BG FLORO/BB3630RT 2.22 272 Sterile Supply

000275 DRAPE X-RAY CASSETTE 9954-50 2.05 272 Sterile Supply

000276 CORD BIPOLAR 10-4000 3.45 272 Sterile Supply

000284 SU PDS # 1 XLH Z881G 4.83 272 Sterile Supply

000286 SYR LOR 10CC BBRAUN 332150 2.26 272 Sterile Supply

000287 DRAIN SNYDER 1/8 0073310 26.38 272 Sterile Supply

000288 COLLAR ASPEN ADU/SHORT 983128 48.00 274 Prosthetic Dev


000290 PINS SKULL MAYFIELD 3006-00 24.83 270 Med-Surg Supplies

000291 IRRIGATOR SIMPULSE 0067700 33.18 272 Sterile Supply

000292 HEADREST 7COM/FOAM CF1007 9.21 270 Med-Surg Supplies

000293 SU PROLENE 3-0 PS-2 8687H 4.30 272 Sterile Supply




000294 SU SILK 2-0 PS 1588H 3.52 272 Sterile Supply

000295 SU VIC 3-0 PS-1 J683H 3.57 272 Sterile Supply

000296 SU VIC 4-0 SH CR J773D 8.98 272 Sterile Supply

000297 DRESSING COBAN 2 LF TAN BX/36 0.78 272 Sterile Supply

000298 CAUTERY TIP 2.5 EZ CLEA 0012 4.49 272 Sterile Supply

000299 CAUTERY TIP 4M EZ CLEA 0014A 4.12 272 Sterile Supply

000300 CAUTERY PAD VALLEYLAB 7507A 3.24 272 Sterile Supply

000301 SOFT ROLL 3 SYNTH MCMW03 0.67 272 Sterile Supply

000302 DIAPERS ADULT XL KC60045B 27.43 270 Med-Surg Supplies

000303 SU SILK 0 TIES A306H 1.22 272 Sterile Supply

000304 SU SILK 0 SH K834H 1.14 272 Sterile Supply

000306 NE # 14 FERGUSON 1842-14DC 1.60 272 Sterile Supply

000307 NE 23G 3.5 REGANES RMPS2303 4.06 272 Sterile Supply

000311 CATHETER RR 10FR 0094100 0.78 272 Sterile Supply

000312 TAPE UMBILICAL 30 U11T 1.32 270 Med-Surg Supplies


000314 CAUTERY TIP EX 6COATED 0014 4.94 272 Sterile Supply

000315 COLLAR ASPEN CHILD REG 983124 48.00 274 Prosthetic Dev

000316 SUPPORT LUMBAR 3XLG OC25-803 23.47 270 Med-Surg Supplies

000317 SUPPORT LUMBAR MED OC25-803M 22.68 270 Med-Surg Supplies

000318 SUPPORT LUMBAR LG OC25-803 22.68 270 Med-Surg Supplies

000319 SUPPORT LUMBAR XLG OC25-803 22.68 270 Med-Surg Supplies

000323 DURAGEN PLUS 1X3 DP-5013 482.90 278 Supply/Implants

000324 TRAY PHYS/IND SI/SHT 1386-03 11.45 272 Sterile Supply

000325 TRAY PHYS/IND MARS. 10-2880 14.04 272 Sterile Supply

000326 ADAPTER M/LL DBL MX493 MEDEX 0.49 270 Med-Surg Supplies

000327 EMESIS EME-BAG 40OZ 24/SLEEVE 0.74 270 Med-Surg Supplies

000328 CAUT.COATED BL/INSUL. E1455 6.11 272 Sterile Supply

000329 DRESSING COBAN 4 L/F 2084S 2.34 272 Sterile Supply

000330 DRESSING COBAN 6 L/F 2086S 3.54 272 Sterile Supply

000331 STOCKNETTE IMPERVIOUS 1587 3.63 270 Med-Surg Supplies

000332 STAR SLEEVE REG AR-1606 70.00 272 Sterile Supply

000333 SU ETHILON 3-0 PSL 301691H 3.70 272 Sterile Supply

000334 SU SILK 3-0 SH 30 K832H 1.31 272 Sterile Supply

000336 SU MONO 4-0 PS-1 Y935H 4.14 272 Sterile Supply

000339 KIT RAPID RESPONSE K05L3L4C 94.24 272 Sterile Supply

000341 SUCTION 8FR FRAZIER 003308 2.40 270 Med-Surg Supplies

000342 DRESSING ADAPTIC 3X3 2012 0.28 272 Sterile Supply

000343 DRESSING ADAPTIC 3X16 2014 1.00 272 Sterile Supply

000344 SU VIC 2-0 CT J351H 1.55 272 Sterile Supply

000345 BOWL UTILITY 01232 0.69 270 Med-Surg Supplies

000346 SPONGE LAP 4X18 X-RAY DETEC 23250-407 0.94 272 Sterile Supply

000347 NE 20G 3.5 TUOHY 332168 E2035T 8.70 272 Sterile Supply

000350 DRAIN BLAKE 10FR 1/8 TROCAR 53.09 272 Sterile Supply

000351 DRAIN CHEST DRY SUCTION ATRIUM 3600-100 35.30 272 Sterile Supply

000359 PACK 360 SUPP/ANT SNE47SAPM4 83.37 272 Sterile Supply

000360 PACK MIN EXTREMITY SOP47FTPM3 55.41 272 Sterile Supply

000362 DRESSING TAPE MEDI 6X2 2866S 2.87 272 Sterile Supply

000363 SU SILK 2-0 TIES 30 SA85H 1.79 272 Sterile Supply

000369 BL STRYKER SAW 2296-3-114 37.25 272 Sterile Supply

000370 DRESSING BIOPATCH BLUE JJ4150 9.60 272 Sterile Supply

000373 SU PDS #1 CT1 Z347H 2.31 272 Sterile Supply



000377 SU SURGISEAL SKIN ADH STYLUS 00069090120 9.50 272 Sterile Supply

000378 SU PDS 0 36 Z358T 2.17 272 Sterile Supply

000379 DRESSING MEDIPORE 2X4 3564 0.37 272 Sterile Supply







000383 DRESSING TEGA+ 3586 BX/25 0.73 272 Sterile Supply

000384 DRESSING TEGA+ 3589 1.14 272 Sterile Supply

000385 DRESSING TEGA+ 3590 BX25 1.52 272 Sterile Supply

000386 DRESSING TEGA+ M3591A BX/25 1.87 272 Sterile Supply

000387 SU VIC 2-0 CTX J369H 1.47 272 Sterile Supply

000388 SU VIC 1 CTX J371H 1.47 272 Sterile Supply

000394 IV JELCO 20GA X 1 ANES 4056 1.16 272 Sterile Supply

000395 CATH RADI/ART(SHORT) RA04220 11.96 272 Sterile Supply

000396 SU MONO 3-0 PS-2 27 Y427H 4.82 272 Sterile Supply

000400 SU MONO 4-0 PS2 18'UND Y496G 4.78 272 Sterile Supply

000401 SU ETHIBOND # 1 CX30D 10.07 272 Sterile Supply

000404 SCD ELITE THIGH CUFF 3045 27.01 270 Med-Surg Supplies

000405 KIT WILSON F.W/O HEAD. WF1003 14.85 272 Sterile Supply

000408 TRAY EPI/CATH ARROW MS05501 43.12 272 Sterile Supply

000410 KIT DRESS/CHANGE CVC DT10140 4.55 272 Sterile Supply

000413 KIT JACKSON SPINE TABLE JT1000 18.50 272 Sterile Supply

000414 TRAY CAT FOLEY 16F LF 907316 11.03 272 Sterile Supply

000418 TAPE CLOTH 2 6613 1.62 270 Med-Surg Supplies

000419 TAPE CLOTH 3 7046 2.48 270 Med-Surg Supplies

000420 DRAIN TLS 6640 DRAINAGE SYSTEM 44.26 272 Sterile Supply

000421 SPONGE COTTON 1/2 X 1 67-07 9.60 272 Sterile Supply

000422 SPONGE COTTON 1 X 1 67-12 9.30 272 Sterile Supply

000424 IRRIG STR WATER 1500 7139-36 3.00 272 Sterile Supply

000426 SU FIBER WIRE 2/5 W/NE AR7200 22.00 272 Sterile Supply

000427 SU ARTHX FIB/WIRE #2 AR-7201 35.00 272 Sterile Supply

000429 GL PROT CLASSIC LATEX SURG SZ.6 07072D72N60X 1.17 272 Sterile Supply

000434 GRAFT/ BARD FELT PLEDGET 007969 11.00 278 Supply/Implants

000435 SU ETHIL # 1 CTX 830H 1.56 272 Sterile Supply

000437 SU PROLENE 3-0 SH 8522H 4.96 272 Sterile Supply

000438 SU PROLENE 4-0 SH1 30 8526H 5.10 272 Sterile Supply

000439 SU PROLENE 5-0 RB1 36 8556H 4.49 272 Sterile Supply

000440 SU PROLENE 4-0 RB1 36 8557H 4.47 272 Sterile Supply

000441 SU VIC 3-0 SH UND 18 J864D 10.59 272 Sterile Supply

000443 DRESSING IODOFORM 7831 1.84 272 Sterile Supply

000445 SU PROLENE # 2 TP-1 8825G 4.09 272 Sterile Supply

000449 SU MONO 3-0 PS1 Y936H 4.83 272 Sterile Supply

000450 SU VIC 3-0 PS1 27 J936H 3.19 272 Sterile Supply

000452 SU MONO 3-0 CT-1 36 Y944H 2.18 272 Sterile Supply

000454 BL CLIPPER GEN.PURPOSE CAH4406D 2.29 272 Sterile Supply

000455 NG TUBE ATTACHMENT 9785 2.32 270 Med-Surg Supplies

000457 SU DIS SU/RETRIEVER MED 9893 53.00 272 Sterile Supply

000462 CAUT.TIP 5.7 BAYONET 0029M 26.97 272 Sterile Supply

000463 DRAPE INST.POUCH 3M 1018 1.18 272 Sterile Supply

000464 CATH COUDE 12F 5CC 0102L12 10.60 272 Sterile Supply



000468 LOOPS VESSEL RADPQ BLUE HT9945678A 2.34 270 Med-Surg Supplies

000469 DURAGEN PLUS 1X1 DP5011 295.64 278 Supply/Implants

000470 NE BO/MARROW 11GX 6 BMNJ1115 23.00 272 Sterile Supply

000471 IV PUMP CV MICRODRIP 12663-28 3.79 272 Sterile Supply


000490 CATH EPIDURAL 181A00 16.90 272 Sterile Supply

000492 NE 22 X 3.5 CHIBA 18369 5.56 272 Sterile Supply

000493 NE 22X8 CHI/BAL DRMARS.18376 5.97 272 Sterile Supply

000494 CATH EPI/RADIOP.20X36 26.32 272 Sterile Supply

000497 NE HUBER 20 X 3/4012034 7.82 272 Sterile Supply

000498 OXISENSOR OXIMAX MAX-A 10.73 270 Med-Surg Supplies

000500 DRAIN EX/LUM BAG INS-2100 72.00 272 Sterile Supply

000501 SU ETHIBOND 0 CT1 C/R CX21D 9.04 272 Sterile Supply

000503 KIT STATLOCK CV0220 7.62 272 Sterile Supply




000508 TUBING TUR/IRG 4/LEAD 15239-01 10.44 272 Sterile Supply

000511 GLOVE PROTEXIS 6.0 LATEX/FR 2.08 272 Sterile Supply


000513 GLOVE PROTEXIS 7.0 LF 2D72PT70X 1.66 272 Sterile Supply

000514 GLOVE PROTG/8 DR ANDR.2D72NT80X 0.85 272 Sterile Supply



000517 ANES CUSHION INSRT.LG D28503 24.00 270 Med-Surg Supplies

000519 DRAPE SHOULDER 29367 CARDINAL 25.37 272 Sterile Supply

000520 STAPLER PROXIMATE PXW35 7.00 272 Sterile Supply


000523 DRAIN EX/LUM KIT 31192 590.00 272 Sterile Supply

000532 NEEDLE COUNTER 31142337 4.29 272 Sterile Supply

000533 CATH FEMALE KIT 8FR 0035720 1.60 272 Sterile Supply

000535 IM DURA GUARD PATCH 4X4 DG-0404SN 336.81 278 Supply/Implants

000536 LIGACLIP MUL/CL MED AP.MCM20 47.26 272 Sterile Supply

000537 LIGACLIP MUL/CL LG APP.MCL20 47.78 272 Sterile Supply

000544 SUTURE AID BOOTIES 05-2-003 2.53 270 Med-Surg Supplies

000545 BLANKET MULTI POSITION UP/BODY WINGOUT 62200 6.41 270 Med-Surg Supplies

000546 PACK ARTHROSCOPY SOP47ARPMD 105.02 272 Sterile Supply

000549 SU GOR CV-6 TTC-9 6M02A 27.42 272 Sterile Supply

000550 MASK CPAP NASAL SWIFT HIS/HER 100.00 272 Sterile Supply

000554 CANN ARTHREX 8.25X7 AR-6530 25.00 272 Sterile Supply

000556 SU GOR CV-7 TTC-9 7M02A 27.58 272 Sterile Supply

000557 GLOVE BIOGEL 8 ECLIPSE MARSH. 1.06 272 Sterile Supply

000559 DRAPE U ORTHO LARGE 89311 8.28 272 Sterile Supply

000567 GOWN SURG. LARGE 95111 2.64 272 Sterile Supply

000569 FOOT GARMENT VENAFLOW ELITE 3046 17.81 270 Med-Surg Supplies

000570 ANES INTUB/ STYLET IS14L 1.66 272 Sterile Supply

000573 HEWSON SU/RETRIEVER 7111579 164.50 270 Med-Surg Supplies

000574 ANES BITE GARD BLOCK 1140 0.65 272 Sterile Supply

000575 CATH FOLEY 12FR 5CC 2WAY 100% SILICONE 165812 3.31 272 Sterile Supply

000577 CATH EMBOLECTOMY 4F 120804F 65.48 272 Sterile Supply

000578 TRAY UROLOGIST DIFFICULT 248.66 272 Sterile Supply

000579 TOURQ/CUFF 24'STE.5921024135 25.86 272 Sterile Supply

000580 ANES CIRCUIT L/F WMI6723 6.90 270 Med-Surg Supplies

000581 FOLEY DRAIN BAG LEG DISP 2.61 272 Sterile Supply

000582 CATH FOLEY 14FR 5CC 175814 45.58 272 Sterile Supply

000587 DURASEAL 5CC SEALANT 20-6520 1,105.98 272 Sterile Supply

000592 SCR SYN 3.5 26M 204826 39.00 278 Supply/Implants

000598 NE 1/2 CIRCLE TAPER 216705 4.58 272 Sterile Supply

000599 TOURQ/CUFF 18STE.5921-218-135 17.81 272 Sterile Supply

000602 GLOVE PROTEXIS 7.5 LF 2D72PT75X 1.66 272 Sterile Supply


000604 AQUA.BIPO/SEALER 6.0 231121 599.32 272 Sterile Supply

000605 PREP CHLORA 3M ORNG 260415 0.99 272 Sterile Supply

000606 APPLICATOR SEPP CHLORAPREP 0.46 272 Sterile Supply

000607 PREP CHLORA 10.5M W/ORG TINT 3.39 272 Sterile Supply

000608 PREP CHLORA 26M W/ORG.TINT 6.89 272 Sterile Supply


000610 CATH FOLEY SIL 16FR 265716 1.99 272 Sterile Supply

000611 ANTI REFLUX VALVE 266197 4.45 270 Med-Surg Supplies

000612 PERI BOTTLE 82-231 8OZ 0.38 272 Sterile Supply

000614 SOFT ROLL 6 SYNTH MCMW06 28.83 272 Sterile Supply

000616 SLING ARM M AMBULITE 301504 7.00 270 Med-Surg Supplies

000617 SLING ARM L PROCARE 79-84267 7.00 270 Med-Surg Supplies

000618 SLING ARM XL PROCARE 79-84268 7.00 270 Med-Surg Supplies

000623 REB SUP.SLING MED CSUS.310240 50.50 270 Med-Surg Supplies

000624 REB SUP.SLING LG CSUS 310250 50.50 270 Med-Surg Supplies

000625 NE 21G 4 STIMUPLEX STIMA10 12.79 272 Sterile Supply




000626 NE 22G 2 STIMUPLEX STIMA2250 9.40 272 Sterile Supply

000627 CAUT.MEGA.PENCIL EZ/CLE.0035 5.18 272 Sterile Supply

000631 CANNULA NASAL SALTER W CO2 PORT 4002-25 1.56 272 Sterile Supply

000632 HOOD T4 STRYK SYSTEM 400800 19.61 270 Med-Surg Supplies

000633 NE 18G 3.5 TOUHY 405018 3.48 272 Sterile Supply

000634 NE 18G 5 WEISS B-D 405190 8.79 272 Sterile Supply

000635 BO COMM SEMI-T 1014-14 1,700.00 278 Supply/Implants

000638 GEL PK/STER.SONOSITE 610117 1.19 272 Sterile Supply

000639 PROBE COVER /SONOSITE 610637` 7.38 272 Sterile Supply

000640 CAN STK 20/100/5CR 406630115 27.00 272 Sterile Supply

000643 CAUT.PAD STRYK. 406650205 17.28 270 Med-Surg Supplies

000645 BL STK BO/MILL M/CUT 5400701 290.00 272 Sterile Supply

000646 BL STK BO MILL F/CUT 5400702 290.00 272 Sterile Supply

000647 IRRIG L-R 3000ML 782808 6.13 272 Sterile Supply

000651 COLLAR ASPEN VISTA UNIVERSAL 48.00 274 Prosthetic Dev

000657 NE RX COUDE 18GX 3.5 1051418 BX=10 EACH 19.07 272 Sterile Supply

000665 PEN SKIN MARKER MINI 14511000 (100 PER TUB) 0.22 272 Sterile Supply

000666 TISSEEL 4ML FROZEN 1501262 233.62 272 Sterile Supply

000667 TISSEEL 10ML FROZEN 1501263 573.33 272 Sterile Supply

000670 VERSA-KATH 12' EPI. 156-2112 BX=10 EACH 80.89 272 Sterile Supply

000671 BUR STRY 4M OVAL 1607-2-35 62.43 272 Sterile Supply

000673 ANES BIS SEN/XP QUATRO 1860106 19.25 272 Sterile Supply

000677 GLIDESCOPE GVL LG 0270-0628 18.00 270 Med-Surg Supplies

000678 GLIDESCOPE GVL SM 0270-0626 18.00 270 Med-Surg Supplies

000687 KCI MED DRESG.M8275052-5 44.91 272 Sterile Supply

000688 KCI/CAN W/GEL M8275063/5 (CASE OF 5) 18.56 272 Sterile Supply

000693 COBE SAMP/SPIKE ADP 007016000 5.00 272 Sterile Supply

000694 BL DYON 3.5 FULL RAD.7205305 52.35 272 Sterile Supply

000695 BL DYO FUL/RADIU 4.5 7205306 52.35 272 Sterile Supply

000698 BL DYO ACROMIONI 4M 7205326 57.89 272 Sterile Supply

000699 BL DYO ACROMIONI 5.5 7205327 57.89 272 Sterile Supply

000706 BO DANEK INFUSE 7510050 925.00 278 Supply/Implants

000708 BO DANEK INFUS GRF 7510200 3,325.50 278 Supply/Implants



000714 ROD TSRH 3D 4M PREB 8370040 141.55 278 Supply/Implants





000741 SPONGE 4X4 10/TR 7605 0.51 272 Sterile Supply

000742 CANNULA NASAL O2 001320 / 1104 0.38 270 Med-Surg Supplies


000745 IV EXTENSION MX451-FL 0.40 272 Sterile Supply


000749 TRAY SPI/25GA PORTEX 1559720 29.37 272 Sterile Supply

000750 TEMP STRIP DENOVO BX/100 0.85 270 Med-Surg Supplies

000753 IV BLOOD FILTER PALL SQ40S 7.18 272 Sterile Supply

000754 ESOPHAGEAL/STETHO 18FR 1.84 272 Sterile Supply

000755 NE 18G 3.5 SPINAL B-D 405184A 1.48 272 Sterile Supply

000757 TUBING SUCTION 12' DC34360 1.43 272 Sterile Supply

000758 OPTI-GARD 6135EP2500 4.77 270 Med-Surg Supplies

000759 SUCTION YANKAUER TIP K86 0.38 270 Med-Surg Supplies

000761 TUBING FLUID WARMING 242 9.52 272 Sterile Supply

000764 NE 20G 6 EPID TOUHY 183A28 9.96 270 Med-Surg Supplies

000765 NE 22G X 7 SPINAL 405149 BEAL 4.23 270 Med-Surg Supplies

000766 NE COAXIAL TEMNO BIOP. CT1811 55.97 270 Med-Surg Supplies

000767 NE COAXIAL TEMNO BIOP CT1815 70.41 270 Med-Surg Supplies

000771 NE COAXIAL TEMNO BIOP. CT2015 72.29 270 Med-Surg Supplies

000773 BONE BIOPSY SET (RADIOLOGY) 101072 133.00 270 Med-Surg Supplies




000774 BONE BIOPSY SET (RADIOLOGY) 101073 133.00 270 Med-Surg Supplies

000775 TRAY Z PASS /SHARPS 1145-SMI 2.33 270 Med-Surg Supplies

000776 IM DURA GUARD PATCH 6X8 532.75 278 Supply/Implants

000777 IV EXT T-PORT SMALL BORE 471954 1.56 270 Med-Surg Supplies

000779 CHEST TUBE TROCAR 28FR 32.00 270 Med-Surg Supplies

000783 SOFT ROLL 4" CAST PADDING MCMW04 0.71 270 Med-Surg Supplies

000784 SPONGE K'DIS ( PEANUT) DERMA SCIENCES 2.56 270 Med-Surg Supplies

000785 CATH FOLEY18FR 3-WAY 0174L18 8.55 270 Med-Surg Supplies

000786 CATHETER COUDE 18FR 5CC 0102L18 10.60 270 Med-Surg Supplies

000787 CATHETER COUDE 20FR 5CC 0102L20 10.60 270 Med-Surg Supplies

000790 CATHETER EMBOLECTOMY 5F 120805F 121.23 270 Med-Surg Supplies

000795 GRAFT GELSOFT ST.7MM FEM/POP, 636007 760.00 278 Supply/Implants

000796 CUFF BLOOD PRESSURE BARRIER 0.80 270 Med-Surg Supplies

000805 HEMOCLIP SMALL 523635, A304 17.36 270 Med-Surg Supplies

000806 COVER LIGHT HANDLES DISP. STERIS LB53 1.36 270 Med-Surg Supplies

000808 BLANKET BAIR HUG TORSO 2 PORT 8.91 270 Med-Surg Supplies

000821 DRILL BIT SYN 2.5 31025 126.00 270 Med-Surg Supplies



000900 SU GOR CV-6 TTC13 6MO4A 27.00 270 Med-Surg Supplies

000955 DYONICS RF-S WIRLWIND 90DEG 72202139 184.58 272 Sterile Supply

000956 CAUTERY BLADE INSULATED 6.5" E1455-6 5.86 270 Med-Surg Supplies

000957 CAUTERY BLADE 4" COATED INSULATED E1455-4 7.69 270 Med-Surg Supplies

000959 DRESSING SILVERLON ISLAND 4X10 ID-410 26.82 270 Med-Surg Supplies


000962 BURR STRYKER3.2MM RASP CUTTING 5120-080-030 102.71 270 Med-Surg Supplies

000963 BURR STRYKER 3.0MM AM8 102.71 270 Med-Surg Supplies

000964 BURR STR 3.0MM AM8 EXTENDED 5820-107-430S1 102.71 270 Med-Surg Supplies

000965 BURR STRYKER 2.5MM AM8 MIS 8420-107-025 100.00 270 Med-Surg Supplies

000966 BURR STRYKER 1.7MM AM8 5820-107-530S3 105.77 272 Sterile Supply

000967 BURR STRYKER 4.0MM STRAIGHT FLUTED 5820-018-040 100.00 270 Med-Surg Supplies

000968 BURR STRYKER 4.0MM ROUND CUTTING 5820-010-140 100.00 270 Med-Surg Supplies

000969 BURR STRYKER 5.0MM ROUND CUTTING 5820-010-150 102.71 270 Med-Surg Supplies

000970 BURR STRYKER 6.0MM ACORN 5820-030-060 102.71 270 Med-Surg Supplies

000971 BURR STRYKER 7.5X 7.9MM FLUTED DRUM LNG 5130-020-775 102.71 270 Med-Surg Supplies

000972 BURR STRYKER 9.1X7.9MM FLUTED DRUM XLONG 5160-020-991 132.37 270 Med-Surg Supplies

000973 BL STRYKER CASPAR 6MM 5400-134-6 149.50 272 Sterile Supply





000979 BLADE STRYKER SAG.SAW 2296-3-515 37.25 270 Med-Surg Supplies


000981 PACK BASIC UNIVERSAL W/ DRAPES, MAYO (NASR) 88761 18.55 270 Med-Surg Supplies

000983 PROBE CADWELL DISP MONOPOLAR DIRECT NERVE STIM. 302427-000 47.52 270 Med-Surg Supplies

000986 SU PROLENE 6-0 RB2 30" 8711H 4.96 270 Med-Surg Supplies

000987 SU VIC 2-0 SH CR J775D 10.17 270 Med-Surg Supplies

000990 SU PROLENE 5-0 24 8555H 5.20 270 Med-Surg Supplies

000995 CATH EPIMED BREVI-XL 1552340 66.21 270 Med-Surg Supplies

000996 NE EPIMED 16 G CURVE 105-1416 15.89 270 Med-Surg Supplies

000997 NE EPIMED 16G STRAIGHT 106-1416 14.71 270 Med-Surg Supplies

000998 CPAP, MASK LG ADULT FLOWSAFE, MERCURY 46.08 270 Med-Surg Supplies

000999 CPAP,MASK LG ADULT FLOWSAFE EZ,MERCURY 56.00 270 Med-Surg Supplies

001004 SU VIC 3-30 CT1 J944H 10.02 270 Med-Surg Supplies

001005 SUCTION STRYKER NEPTUNE MANIFOLD 0702-020-001 26.75 270 Med-Surg Supplies

001006 SU 2-0 SILK 30" 623H 1.35 270 Med-Surg Supplies

001007 DRAIN JP FLAT 10MM SU130-1311 4.97 270 Med-Surg Supplies

001009 GRAFT/ BARD PTFE FELT PLEDGET 1X1 007973 19.00 278 Supply/Implants

001010 ADAPTER FIBEROPTIC BRONCHOSCOPE SWIVEL 625191 5.33 270 Med-Surg Supplies

001013 CAN SYK VENOM 20/100MM/ 10 0406-660-125 35.00 270 Med-Surg Supplies




001014 CAN SYK VENOM 20/150MM/ 10 0406-660-225 35.00 270 Med-Surg Supplies

001020 CPAP FACE MASK LG RT040L 27.37 270 Med-Surg Supplies

001021 BO SP/GFT ORTHOBLEND DBM 10C T44150 1,201.75 278 Supply/Implants

001022 BO SP/GFT ORTHOBLEND DBM 5CC T44145 787.50 278 Supply/Implants

001023 NE IV ANGIOCATH 14 G X 5.25 (NASR) 382269 15.52 270 Med-Surg Supplies

001024 SU ART FIBERWIRE 2 W/ NEEDLE AR-7208 576.00 270 Med-Surg Supplies

001025 QUEASE EASE SOOTHING SCENTS PACK/ 30 QE5-MCP30 5.40 270 Med-Surg Supplies

001028 NE PAJUNK SONOPLEX STIM CANNULA 001185-74 14.50 270 Med-Surg Supplies

001029 DRESSING DERMABOND PRINEO CLOSURE CLR222US 72.25 270 Med-Surg Supplies

001033 ANES AIRTRAQ SP SMALL SIZE 2 ATQ-021 79.00 270 Med-Surg Supplies

001036 GL PROTEXIS NEOPRENE 8.5 LATEX FREE/ NASR 2D73DP85 1.32 270 Med-Surg Supplies

001037 TUBE TRACHEAL INTRODUCER SWITZEL TTI-C10 7.08 270 Med-Surg Supplies

001038 GL PROT CLASSIC LATEX SURG 8.0 2D72N80X 0.90 270 Med-Surg Supplies


001040 GL PROT CLASSIC LATEX SURG 7 2D72N70X 0.94 270 Med-Surg Supplies



001045 STRAP OR TABLE DISP SOULE ORTS-01 (ORDER 5 CASES) 3.44 270 Med-Surg Supplies

001046 GL ENCORE ORTHO SIZE 6.5 0.87 270 Med-Surg Supplies

001047 GL ENCORE ORTHO SIZE 7 0.87 270 Med-Surg Supplies




001051 CANN ARTHREX 7X7 AR-6570 25.00 270 Med-Surg Supplies



001054 GL BLUE NEU THERA 7.5 2D72LU75 0.83 270 Med-Surg Supplies

001055 GL BLUE NEU THERA 7 2D72LU70 0.83 270 Med-Surg Supplies



001058 GL BLUE NEU THERA 8 2D72LU80 0.83 270 Med-Surg Supplies

001060 PROBE FRIENDSHIP MONOPOLAR DIRECT STIMULATOR PNM0.8/90 35.00 270 Med-Surg Supplies

001061 PROBE FRIENDSHIP BALL TIP DIRECT NERVE STIM PNG2.3/90 42.00 270 Med-Surg Supplies

001063 TOURQ/ CUFF 18 X 5.5 2 BLADDER 5921-018-145 29.11 270 Med-Surg Supplies

001064 TOURQ/CUFF 24 X 5.5 2 BLADDER 5921-024-145 32.34 270 Med-Surg Supplies

001065 DRESSING SILVERLON ISLAND 4 X 8 ID-48 22.25 270 Med-Surg Supplies

001066 KIT ARROW MULTI LUMEN MAX BARRIER CDC-45703-XP1A 135.23 270 Med-Surg Supplies

001067 GOWN BAIR PAW STANDARD SINGLE 81001 9.92 270 Med-Surg Supplies

001068 GOWN BAIR PAWS X-LARGE SINGLE 81201 14.11 270 Med-Surg Supplies

001069 NE 18G X 3.5" TUOHY 183A07 7.10 270 Med-Surg Supplies

001070 NE 20G X 3.5 WEISS 405186 3.95 270 Med-Surg Supplies

001071 NE 18G X 6" TUOHY 183A021 13.55 270 Med-Surg Supplies

001075 KIT MAK MINI ACCESS MIDLINE 5F MAK501NPD-E 26.00 270 Med-Surg Supplies

001076 ARTHROCARE WAND SUPER TURBOVAC 90 DEG ASHA425001 170.00 270 Med-Surg Supplies

001077 CAN SYK VENOM 18/100MM/10 /0406-860-125 30.00 270 Med-Surg Supplies

001080 GL ORTHO SIZE 9 LATEX POWDER FREE 2D72LT90 1.09 270 Med-Surg Supplies

001081 SLIPPERS TERRY TREADS XL GRAY NON-SKID 58125-GRY 0.67 270 Med-Surg Supplies

001082 CATH SPHENOCATH FLUORO BX/ 10 DT1005GP-1 99.95 270 Med-Surg Supplies

001083 ARTH APOLLORF MP90 ASPIRATING ABLATOR 90 AR-9811 190.00 270 Med-Surg Supplies

001085 CAN SYK ACTIVE TIP 15MM, 100MM 20G 0406-630-135 27.00 270 Med-Surg Supplies

001087 KIT IRRISEPT IRRIGATION SYSTEM 62.01 270 Med-Surg Supplies

001088 CATH EPIDURAL NEO-KATH DR.YATES 200-2430 42.50 270 Med-Surg Supplies

001091 CUFF REG ADULT DISPOSABLE 30509-13 2.40 270 Med-Surg Supplies

001092 CUFF LARGE ADULT DISPOSABLE 30509-14 2.52 270 Med-Surg Supplies

001097 SUTURE PASSER SMITH NEPHEW FIRSTPASS 22-4038 140.00 270 Med-Surg Supplies

001100 KIT ANTI FOG FOAM LATEX FREE 1.27 270 Med-Surg Supplies

001101 SU CHROMIC 4-0 P-3 18" 1654G 5.85 270 Med-Surg Supplies

001102 SU CHROMIC 5-0 P-2 18" 1658G 6.07 270 Med-Surg Supplies

001103 SU 4-0 PLAIN GUT 18" 45CM 1824H 3.01 270 Med-Surg Supplies

001106 ELECTRODE 5SET PRASS PAIRED 18MM 8227304 137.20 270 Med-Surg Supplies




001108 DRAPE IOBAN 23 X 23 INCH (ENT) 6648EZ 7.35 270 Med-Surg Supplies

001109 DRAPE LARGE TOWEL 17 X 23 INCH (ENT) 1010 1.03 270 Med-Surg Supplies

001110 DRAPE SURG FLOUROSCOPE 35" X 43" 1012 5.87 270 Med-Surg Supplies

001111 SU 2-0 SILK 8 X 18 INCH BLACK SH V-20 C012D 7.46 270 Med-Surg Supplies

001112 SU 3-0 SILK 8 X 18 INCH RB-1 CV-23 C053D 10.37 270 Med-Surg Supplies

001113 PROBE SIDE BY SIDE BIPOLAR STIMULATOR PNB 8X2/90 65.00 270 Med-Surg Supplies

001114 LIGHT HANDLES GREEN OR6 548-2RG 1.00 270 Med-Surg Supplies

001116 BLADE ENT INFERIOR TUBINATE 11CM X 2MM 1882040HR 286.80 270 Med-Surg Supplies

001117 MAD NASAL INTRANASAL MUCOSAL ATOMIZATION DEVIC MAD300 5.75 270 Med-Surg Supplies

001121 DURAMATRIX ONLAY PLUS 1 X 1 DMOP11 244.75 270 Med-Surg Supplies

001122 DURAMATRIX ONLAY PLUS 1 X 3 DMOP13 365.20 270 Med-Surg Supplies

001124 KIT ARROWGARD DOUBLE-LUMEN BLUE PLUS CVC AK-42802-CDC & CDC-42802-1A67.92 270 Med-Surg Supplies

001131 RASP SMALL TEAR CROSS CUT 11.0 X 5.0MM 5100037113 126.71 270 Med-Surg Supplies

001134 DARCO SHOE WOMEN MEDIUM MQMB 13.95 270 Med-Surg Supplies

001135 DARCO SHOE WOMEN LARGE MQW3B 13.95 270 Med-Surg Supplies

001149 IRRIGATOR 0.9% SODIUM CHLORIDE 500ML SUB 2F7123 2.93 270 Med-Surg Supplies

001150 CANNULA NASAL OMNILINE PLUS O2 010213 6.81 270 Med-Surg Supplies

001152 BLADE #15C BARD PARKER DR JONES 371716 1.09 270 Med-Surg Supplies

001153 BANDAGE 4IN X 210 WITH VELCO 040 2.37 270 Med-Surg Supplies

001154 DRESSING ARTHREX JUMPSTART AB5-4005 19.00 270 Med-Surg Supplies

001155 SU 0 ETHIBOND MO-6 CX45D 12.42 270 Med-Surg Supplies

001156 VENTRALEX HERNIA PATCH SMALL 4.3CM X 4.3CM 0010301 522.91 270 Med-Surg Supplies

001164 SU 0 ETHIBOND 8X18 CT CR CX1D 9.04 270 Med-Surg Supplies

001165 PHS HERNIA MESH PHSL6 562.38 270 Med-Surg Supplies

001167 NE SPINAL 25G X 5 405140 6.65 270 Med-Surg Supplies

001171 SU 5-0 CHROMIC GUT 18" P-3 687 5.30 270 Med-Surg Supplies

001175 VENTRALEX ST HERNIA PATCH LARGE 3.2IN X 3.2IN 5950009 830.00 270 Med-Surg Supplies

001176 VENTRALEX ST HERNIA PATCH SMALL 5950007 590.00 270 Med-Surg Supplies

001178 BARD FLAT SHEET MARLEX HERNIA MESH 6X6 0112720 73.40 270 Med-Surg Supplies

001180 EXTENSION SET 6IN SMALLBORE NGUYEN 20039E 2.22 270 Med-Surg Supplies

050071 MASK LMA FAST TRACK# 3,4,& 5 (OFR ORDER ONLY) 495.00 272 Sterile Supply

050095 GLOVE EUDERMIC 7.5 376189 2.08 272 Sterile Supply

050122 SORIN SUCTION ASSEMBLY 04137 25.00 272 Sterile Supply

050124 CATHETER RR 16FR 0094160 1.37 272 Sterile Supply

050226 BO SGT PLIF ICW 10X26 171026 1,250.00 278 Supply/Implants

050235 BO SGT ICW 8 X 26 170826 1,250.00 278 Supply/Implants

050253 CATHETER PASSER 38CM.8591-38 98.00 272 Sterile Supply

050267 DJO BACK PAD 11-0813-9-00000 18.78 272 Sterile Supply

050273 DRESSING COVER-ROLL 6 45549 4.99 272 Sterile Supply

050283 COLLAR ASPEN ADULT REG 983130 40.00 274 Prosthetic Dev

050410 TOURNIQUET YELLOW 7.00 270 Med-Surg Supplies

050420 PAIN TAGS STL1960 PAIN MGMT 3 1.80 270 Med-Surg Supplies

050427 PIN ZI/SPI INVIZIA TEMP.FIX 95.00 272 Sterile Supply

050498 IM ARTHX CKS SU/AN AR1928SF2 (BX=5 EACH) 230.00 278 Supply/Implants

050524 DRESSING BIOPATCH 2150 3.34 272 Sterile Supply

050527 EBI SHOULDER PAD 2185D 45.00 272 Sterile Supply

050541 SCR PIONEER ALP ALL SIZES 250.00 278 Supply/Implants

050543 PL PIONEER ALP ALL SIZES 2,000.00 278 Supply/Implants

050544 SCR AESCULAP BUTTRESS ALLSIZES 220.00 278 Supply/Implants

050546 PL AESCULAP BUTTRESS ALL SIZE 895.00 278 Supply/Implants


050637 PAIN TAGS CUSTOM STL1959A MITCHELL 1.47 270 Med-Surg Supplies

050706 IM AES.SPECTRUM 2L CERV CON 1,550.00 278 Supply/Implants

050810 SU MONO 3-0 SH Y416 1.61 272 Sterile Supply

050820 CATH EMBOLEC/LAT/FR 4F A4405 64.81 272 Sterile Supply

050822 SU ETHIBOND 0 MO-6 CX45D 10.56 272 Sterile Supply

050845 SCR CENT STALIF MIDLINE LUM.ALSZ 100.00 278 Supply/Implants

050859 SCR AES S4 ELEMENT ALL SZ 552.50 278 Supply/Implants

050868 ROD AES S4 ELE LUM ALL/SZ 195.00 278 Supply/Implants

050872 SCR AES S4 ELE SET ALL SIZES 50.00 278 Supply/Implants




050877 IM ZI/SPI INVIZIA CERVICAL 1LV CONST 1,240.00 278 Supply/Implants




050905 SCR NUTECH LUMBAR POLY ALL/SZ 600.00 278 Supply/Implants

050927 MED CATH ACC/KIT 8540 25.00 272 Sterile Supply

050928 MED NEURO REFILL 8551 28.00 272 Sterile Supply

050929 KIT SUTURELESS PUMP CON. 8578 150.00 278 Supply/Implants

050933 DURAPREP 3M 6ML 8635 2.60 270 Med-Surg Supplies

050936 CATH MED ASCENDA PUMP 8780 1,100.00 278 Supply/Implants

050938 MED PERSONAL THERAPY MANAGER 8835 795.00 270 Med-Surg Supplies

050943 KIT DUAL MARKING PEN/ LABELS 2.60 272 Sterile Supply

050955 BO NUTECH MORSELIZED ALLOGRAFT+ MATRX LG 2,850.00 278 Supply/Implants

050963 IM KYPHON BO/CEMT MIX.C01B 145.00 278 Supply/Implants

050973 DRAPE ULTRA SOUND 20X28 BX/24 3.13 272 Sterile Supply

050975 CAUTERY PAD MEGADYNE 0855C 2.59 272 Sterile Supply

050981 K-WIRE ACUMED .045 WS-1106ST 19.00 278 Supply/Implants

050988 BO AES PROSPACE TLIF ALL/SZ 2,500.00 278 Supply/Implants

050992 SCR EMI FANG BUTTRESS ALSZ 375.00 278 Supply/Implants

050997 DRILL BIT ACUMED QUICK RELEASE 2.8. 80-0387 164.00 272 Sterile Supply

051022 PL NUTECH 1 LEVEL ALP ALL SIZES 2,000.00 278 Supply/Implants

051024 SCR NUTECH ALP ALL SIZES 250.00 278 Supply/Implants

051054 SCR OMNIA CORAL LUM. ALSZ 900.00 278 Supply/Implants

051062 IM ARTHREX SU/AN AR1934BCF-2 320.00 278 Supply/Implants

051071 DJO COLD THERAPY UNIT 11-0493 72.03 272 Sterile Supply

051118 IM SP/ELE SAPPHIRE CERVICAL 4L CONST. 2,170.00 278 Supply/Implants

051119 PIN SP/ELE SAPPHIRE FIXATION 74.00 272 Sterile Supply

051120 SCR SP/ELE SAPPHIRE ALL SZ 100.00 278 Supply/Implants

051121 DRILL SP/ELE SAPPHIRE ALL SIZE 172.80 272 Sterile Supply




051126 IM AESCULP S4 ELE.1L LUM.CON 2,800.00 278 Supply/Implants



051142 BO ORTHO ALLOQUENT CERV ALL/SZ 620.00 278 Supply/Implants

051166 DRILL BIT ACUMED QUICK RELEASE 3.5 MS-DC35 108.00 272 Sterile Supply

051171 KIT ACCESSORY REPAIR 3550-P4 250.00 272 Sterile Supply

051174 MED ANTENNA EXTERNAL 37092 80.00 272 Sterile Supply

051176 IM MED PRIM RESTOR ADV 97702 12,104.00 278 Supply/Implants

051177 IM MED ITREL 4 37703 7,650.00 278 Supply/Implants

051180 IM MED IPG RESTORE SEN.37714 18,000.00 278 Supply/Implants

051206 ROD NU/SPI S LOC POST/CEVR ALSZ 180.00 278 Supply/Implants

051207 SCR CENTINAL STALIF CER.ALSZ 200.00 278 Supply/Implants

051211 SCR NU/SPI SET S LOC POST/CERV 100.00 278 Supply/Implants

051213 IM SYN ANTEGRA 2LV CONST. 7,421.00 278 Supply/Implants

051217 BO OSTE MATRX 2.5X5CM T42210 1,292.00 278 Supply/Implants

051220 SCR NU/SPI S LOC POST/CERV ALSZ 650.00 278 Supply/Implants

051265 IM ALPHA TRES/LUXE 1L CER CONS 1,240.00 278 Supply/Implants



051268 SCR ALPHA TRESTLE ST/SD ALSZ 100.00 278 Supply/Implants

051274 IM ALPH ZODIAC 1L LUMBAR CONST 2,800.00 278 Supply/Implants

051297 MED NEURO PRIME DUAL PERC 9771PP 18,000.00 278 Supply/Implants

051299 MED NEURO ULTRA SURESCAN PERC 9771UP 17,575.00 278 Supply/Implants

051300 MED NEURO ULTRA KIT BATTERY REPLACE 16,000.00 278 Supply/Implants

051303 BO ALP VIP PLIF EX LONG ALL SZ. 1,250.00 278 Supply/Implants

051309 BO NUTEC NUFIX CORT/DOW ALSZ 2,125.00 278 Supply/Implants

051310 SCR AES ASPACE ARCADIUS ALL SIZES 375.00 278 Supply/Implants

051317 PIN ALPH TREST/LUXE FIX/TEMP 74.00 272 Sterile Supply




051329 IM MED 2X4 DUAL POC/AD 74002 970.00 278 Supply/Implants

051330 GLOVE BIOGEL 8.5 ECLIPSE 1.17 272 Sterile Supply

051347 IM WR/MED GRFT JACKET 86UM4X07 3,688.00 278 Supply/Implants

051359 IM NUTEC SPINE 1L LUMBAR CONST 2,800.00 278 Supply/Implants



051378 ANCHOR MED INJEX 97791 275.00 278 Supply/Implants

051381 KIT KYPHON(THORACIC) KPE1001 3,140.00 272 Sterile Supply

051386 BO NUTECH MORSELIZED ALLOGRAFT + MATRIX SMALL 800.00 278 Supply/Implants

051395 BO NUTECH MORSELIZED ALLOGRAFT W/ NO MATRIX 2,500.00 278 Supply/Implants

051411 ROD OMNIA CORAL LUM ALL SZ 294.00 278 Supply/Implants

051412 DJO BIL.HOSE 11-0674-9-02000 18.03 272 Sterile Supply

051428 SCR NUTECH SET/ LOCKING AL/SZ 50.00 278 Supply/Implants

051452 TUBE ET ENDOFLEX CUFFED 7.5MM 2.26 272 Sterile Supply

051457 PL EMI FANG BUTTRESS ALSZ 895.00 278 Supply/Implants

051484 IM CENTI/PEEK STALIF CER ALSZ 2,400.00 278 Supply/Implants

051497 BIPOLAR BAYONET MED.ANG DISP.1590-00 724.00 272 Sterile Supply

051498 EVAC GLASS CONTAINER S9900-10 40.61 272 Sterile Supply

051542 EBI KNEE PAD STERILE 2050HD 45.00 272 Sterile Supply

051571 BO SGT ASR LASR CORNERSTONE ALZ 620.00 278 Supply/Implants

051578 PL SP/ELE SAPPHIRE 1 LEVEL 840.00 278 Supply/Implants

051579 PL SP/ELE SAPPHIRE 2 LEVEL 950.00 278 Supply/Implants

051580 PL SP/ELE SAPPHIRE 3 LEVEL 1,060.00 278 Supply/Implants

051581 CHLORA PREP BLD CULT 37.56 272 Sterile Supply

051584 SYNTHOSPLINT PRIMACAST 280035 73.50 270 Med-Surg Supplies

051593 BANDAGE PLASTER 3X3 ROLL FAST SETTING JJ7373 10.71 270 Med-Surg Supplies

051594 PLASTER ROLL 4 X 15 307374 15.95 270 Med-Surg Supplies

051630 KIT ACCESSORY REPAIR 355024 50.00 278 Supply/Implants

051632 MED NEURO ACCE/6TOUHY 355028 55.00 272 Sterile Supply

051633 MED NEURO ACCESS.PLUG 355029 150.00 278 Supply/Implants

051634 MED NEURO ACES.SNAP LID 355531 294.00 272 Sterile Supply

051638 KIT ACCESSORY 3550-63 75.00 272 Sterile Supply

051643 KIT ACCESSORY 3655-38 140.00 272 Sterile Supply

051679 BO PIONEER ALIF BIGFOOT ALL/SZ 2,850.00 278 Supply/Implants

051691 PL UNITY ORTHFX ALSZ 433028 2,000.00 278 Supply/Implants

051692 PL UNITY ORTHOFX COVER ALSZ 600.00 278 Supply/Implants

051700 IM ORTHO FIREBIRD 1L LUMBAR CONST 2,800.00 278 Supply/Implants

051701 IM ORTHO FIREBIRD 2L LUMBAR CONST 4,200.00 278 Supply/Implants

051704 BO COMM FIB/SEGMENT 1007-12 650.00 278 Supply/Implants

051706 BO COMM RAD/SEGMENT 1174-12 600.00 278 Supply/Implants

051710 BO COMM 15C FINE/CRUSH 1004-12 260.00 278 Supply/Implants

051717 BO COMM 30C FINE/CRUSH 1112-12 473.00 278 Supply/Implants

051719 BO SGT PREC/GRAF(ALL) 452066 2,850.00 278 Supply/Implants

051725 SCR UNITY ORTHFX ALSZ 100.00 278 Supply/Implants

051740 IM PEEK PILAR ALIF ALL SZ 2,850.00 278 Supply/Implants

051743 PL COVER PILAR ALSZ 600.00 278 Supply/Implants

051746 SCR PILAR SA ALL SZ 100.00 278 Supply/Implants


051774 IM ZI/SPI TMS CERV.TANTALUM ALSZ 995.00 278 Supply/Implants

051777 SCR SP/EL MERCURY LOC CAP 62000000 50.00 278 Supply/Implants

051780 SCR SP/ELE MERCURY MIS ALSZ 900.00 278 Supply/Implants

051795 IM NUV.PEEK COROENT XL(L)ALZ 4,341.40 278 Supply/Implants

051796 IM NUV.PEEK COROENT XLWIDE ALZ 5,756.60 278 Supply/Implants

051809 KIT ANS LTA 11 2.72 272 Sterile Supply

051811 BO AESCULP CESPACE CERV.ALSZ 620.00 278 Supply/Implants

051825 SCR SOVEREIGN BO SCREW ALSZ 100.00 278 Supply/Implants

051836 PL TSRH TI CROSSLINK 811322 400.00 278 Supply/Implants

051842 SCR BUTTRESS 30M 822230 189.00 278 Supply/Implants

051844 IM CABLE ATLAS TIT/DLB 826211 575.00 278 Supply/Implants

051845 IM CABLE ATLAS TIT/SG 826213 450.00 278 Supply/Implants




051852 SCR TSRH 3DX ALL SZ 184.39 278 Supply/Implants

051854 MED PUMP SYNCHRO. 20M 863720 9,520.00 278 Supply/Implants

051855 MED PUMP SYNCHRO.40M 863740 9,520.00 278 Supply/Implants

051857 ROD LEG 5.5 LONG/BLUE 869022 212.76 278 Supply/Implants

051859 DRILL BIT UCSS CANN. ALSZ 605.00 272 Sterile Supply

051860 GUIDEWIRE UCSS NONTHR.873011 103.00 272 Sterile Supply

051867 SCR ATL VIS/VA FX SLF.ALSZ 158.40 278 Supply/Implants

051869 PL MED SPIRE Z ALL SIZES 2,910.00 278 Supply/Implants

051872 IM CAGE PYRAMESH (CERV)ALSZ 3,660.00 278 Supply/Implants

051909 BO SPINALGRAFT AN/RAMP 13M T85313 2,850.00 278 Supply/Implants

051911 BO SP/GFT AN/RAMP 11M T85311 2,850.00 278 Supply/Implants

051919 ROD NUTECH LUMBAR CRVD TI 1 LVL 5.5 X45MM 150.00 278 Supply/Implants

051925 SCR OMNIA CORAL LOCKING ALSZ 50.00 278 Supply/Implants

051945 SCR THEK ATOLL POST CERV ALLSZ 650.00 278 Supply/Implants

051946 SCR THEK ATOLL LOCKING CAP 100.00 278 Supply/Implants

051947 ROD THEK ATOLL POST CERV ALLSZ 180.00 278 Supply/Implants

051948 DRILL THEK ATOLL POST/CERV ALS 72.00 272 Sterile Supply

051963 KIT NUVAS.XLIF DISP.2029950 683.43 272 Sterile Supply

051967 EBI NECK PAD 2030D 45.00 272 Sterile Supply

051973 SCR MED FACET PERC ANCHOR ALSZ PFF0025 3,600.00 278 Supply/Implants

051974 IM PEEK CAGE MED CAPST ALL SIZES 2,500.00 278 Supply/Implants

051975 IM PEEK CLYDESDALE ALL SZ 4,750.00 278 Supply/Implants

051978 SCR NEWPORT LOCK/CAP ALL/SIZE 100.00 278 Supply/Implants

051982 SCR NEWPORT MIS ALL SIZES 900.00 278 Supply/Implants

051988 GUIDEWIRE NEWPORT BLUNT AL/SZ 52.50 272 Sterile Supply

051991 KIT NUVASIVE MAXCESS 3240060 1,381.37 272 Sterile Supply

051997 ROD NEWPORT W/LOCK CAP AL/SZ 344.00 278 Supply/Implants

052015 IM CAGE CAPSTONE CONTROL AL/SZ 3,000.00 278 Supply/Implants

052022 BO COMM PAT/WEDGE 1167-12 710.00 278 Supply/Implants

052025 ROD MED SOLERA COBALT ALL SIZE 200.00 278 Supply/Implants

052028 BO NUV.OSTEO+10C MATX 5013010 2,850.00 278 Supply/Implants

052037 SCR LEGACY 4.5 X 45 75444545 555.26 278 Supply/Implants

052040 SCR LEG 5.0 X 35 75445035 555.26 278 Supply/Implants





052048 SCR LEG.5.5 X 50 75445550 555.26 278 Supply/Implants




052053 SCR LEG. 6.5 X 40 75446540 555.26 278 Supply/Implants


052055 SCR LEG 6.5X 50 75446550 555.26 278 Supply/Implants

052056 SCR LEG 6.5X 55 75446555 555.26 278 Supply/Implants





052061 SCR LEG. 7.5 X 50 75447550 555.26 278 Supply/Implants







052072 SCR MED SOLERA SET/LOCK CAP 100.00 278 Supply/Implants

052074 SCR MED SOLERA LUM ALL SIZES 750.00 278 Supply/Implants

052080 GUIDE WIRE SP/ELE MERCURY ALSZ 52.50 272 Sterile Supply

052081 PL SP/ELE MERCURY CR/LINK ALSZ 400.00 278 Supply/Implants




052082 ROD MED SOLERA CHROMOLY PLUS 200.00 278 Supply/Implants

052083 ROD TRSH 3DX 40MM AND DOWN ALL SIZES 141.55 278 Supply/Implants

052085 ROD SP/ELE MERCURY ALSZ 294.00 278 Supply/Implants

052086 ROD SPINAL ELE MERCURY 400M AND UP 588.00 278 Supply/Implants

052091 ROD ALPH COBALT CHROM ALSZ 195.00 278 Supply/Implants

052092 NE GLOBUS JAMSHIDI 6231025 180.00 272 Sterile Supply

052095 IM PEEK CORNERSTONE PSR ALSZ 1,400.00 278 Supply/Implants

052110 SCR VERTEX SET SCREW 6900300 100.00 278 Supply/Implants

052111 SCR VERTEX MAX SET SCREW 100.00 278 Supply/Implants

052112 DRILL BIT VERTEX MAX 6956010 216.00 272 Sterile Supply

052114 SCR VERTX SEL 3.5X14 6958714 650.00 278 Supply/Implants

052115 SCR VERTEX MAX 3.5X16 6958716 650.00 278 Supply/Implants

052117 SCR VERTEX MAX ALL SIZES 650.00 278 Supply/Implants

052120 SCR VERTEX SELECT ALL SIZES 650.00 278 Supply/Implants

052121 DRILL BIT PRESTIGE 6961241 295.00 272 Sterile Supply

052123 PL VERTEX CR/LK POS/CER ALSZ 400.00 278 Supply/Implants

052125 SCR LEG ILIAC BOLT 70468580 855.00 278 Supply/Implants

052126 SCR LEG ILIAC SET ALL SZ 100.00 278 Supply/Implants

052127 DRILL BIT VISION 7080510 125.00 272 Sterile Supply

052128 PIN ATL/VIS FIX/HOLD 7080902 124.00 278 Supply/Implants

052132 PL ALP TRES/LUX CERV 2 LEVEL 950.00 278 Supply/Implants

052135 SORIN BOWL SET 4250 106.25 272 Sterile Supply

052142 CAN SN 15C 20X10 S/CR 7210278 16.92 272 Sterile Supply

052144 CAUT.PAD ELECTR.S/N 72200015 7.00 270 Med-Surg Supplies

052155 BO SP/GFT MAGNI PL 10CM 7509141 3,400.00 278 Supply/Implants

052156 BO SPINALGRAFT MAGNI PL 5CM 7509145 2,350.00 278 Supply/Implants

052163 SCR LEG/SET 5.5 ALLSZ 7540020 67.33 278 Supply/Implants


052178 ROD VERTEX SELE ALL SZ 180.00 278 Supply/Implants

052179 PL MED VERTEX DOMINO CONNECTOR 3.5/5.5 7750445 617.00 278 Supply/Implants

052180 SCR MED OCCIPITAL CORTICAL ALL/SZS 436.00 278 Supply/Implants

052185 DRILL BIT VERTEX SELEC 2.4 7756010 216.00 272 Sterile Supply

052186 IM VERTEX OFF/CONNECT ALL/SZ 617.00 278 Supply/Implants

052198 IM SOVERIGN SPACER/COVPL ALSZ 8,600.00 278 Supply/Implants

052200 NE NUV.ELECT.SURFACE MOD11 8050015 924.32 272 Sterile Supply

052206 PL TSRH CR/LINK X10 ALSZ 400.00 278 Supply/Implants

052207 PL TSRH X10 CROSLINK 8115536 400.00 278 Supply/Implants



052211 SCR TSRH 3DX SET 8351500 48.19 278 Supply/Implants

052212 SCR TSRH 3DX SM CON.8351520 396.55 278 Supply/Implants

052213 SCR TSRH 3DX LRG CON.8351522 411.94 278 Supply/Implants

052214 SCR TSRH 3DX MED CON.8351521 404.91 278 Supply/Implants


052231 ROD LEG 5.5 COBALT 8690024 550.00 278 Supply/Implants

052232 ROD LEG PRE/BN 30MM 8690030 154.70 278 Supply/Implants

052233 ROD LEG.PR/BNT 40MM 8690040 154.70 278 Supply/Implants

052234 ROD LEG 5.0CM PR/BNT 8690050 232.11 278 Supply/Implants

052235 ROD LEG 60MM 8690060 232.11 278 Supply/Implants

052236 ROD LEG 5.5 70M PR/BN 8690070 232.11 278 Supply/Implants

052237 ROD LEGACY 5.5 80M 8690080 232.11 278 Supply/Implants

052238 ROD LEGACY 90M 8690090 232.11 278 Supply/Implants

052247 IM CAGE PYRAMESH (LUM)ALSZ 5,890.00 278 Supply/Implants

052249 WASHER 17M BUTTRESS 9090117 263.70 278 Supply/Implants

052252 PL SPIRE SPINOUS ALL SIZES 2,910.00 278 Supply/Implants

052253 SCR SPIRE SET (DANAK)9240150 90.00 278 Supply/Implants

052255 PROBE NIM BALL TIP 9450015 177.00 272 Sterile Supply

052257 PROBE BALL TIP 9450051 143.00 272 Sterile Supply

052258 NE MED.PEDI/AC.PROBE 9450069 335.00 272 Sterile Supply

052261 QUARDANT ILLUM.SYST. 9560658 713.00 270 Med-Surg Supplies




052262 KNIFE BAYONETED 156300 422.00 272 Sterile Supply

052265 SCR PYRAMID + ANTERIOR BONE SCREW 98716250 100.00 278 Supply/Implants

052266 PL PYRAMID 3HOLE LORD ALL SIZE 2,350.00 278 Supply/Implants

052267 PL PYRAMID 4HOLE LORD ALL SIZES 2,250.00 278 Supply/Implants

052288 SCR OMNIA MALIBU POLYAXIAL ALL SZS 900.00 278 Supply/Implants

052300 MED NEURO EXT. 1X8 37081-40 681.00 278 Supply/Implants

052315 BO NUTECH SI FIX ALLOGRFT ALZ 6,800.00 278 Supply/Implants

052319 SUCTION LIN 3000CC 65651-530 1.58 270 Med-Surg Supplies

052321 BO SGT 1CC PASTE/GRAFTN T45001 166.50 278 Supply/Implants

052337 SORIN RESV/HEMONETICS 20500 67.50 272 Sterile Supply

052354 ROD FIREBIRD 2LVL ALL SZS 526070 225.00 278 Supply/Implants

052358 SU S/N FOOTPRINT KNOTLESS ANCHOR 4.5 72202901 395.52 278 Supply/Implants

052362 GLOVE RADI RES 8.5 SSR1- 8.5 5.00 270 Med-Surg Supplies

052364 GLOVE RADI .RES 8.0 SSRI- 8.0 5.00 270 Med-Surg Supplies

052368 PL OSTEOMED PRIMALOK SPINOUS ALL SIZES 5,950.00 278 Supply/Implants

052372 MASK LMA SIZE 3 PATIENT CHARGE 25.00 270 Med-Surg Supplies


052374 MASK LMA PROSEAL SZ.3 PATIENT CHARGE 25.00 270 Med-Surg Supplies

052375 MASK LMA PROSEAL SZ 4 PATIENT CHARGE 25.00 270 Med-Surg Supplies


052394 CATH MED ASCENDA PUMP LONG 8781 1,100.00 278 Supply/Implants

052396 IM AES ARCADIUS XP ALIF PEEK ALL SZS 5,000.00 278 Supply/Implants

052399 CLOUD 9 SHEET PATIENT CHARGE 27.00 270 Med-Surg Supplies

052401 MASK LMA FLEXIBLE SZ 3 PATIENT CHARGE 25.00 270 Med-Surg Supplies



052404 BO SP/GFT 5 CC PASTE T45005 675.00 278 Supply/Implants

052409 PLASTER SPLINT 3 X 15 281300 3.09 270 Med-Surg Supplies

052414 LEAD KIT VECTRIS COMPACT 1X8 60CM 977A260 2,592.00 278 Supply/Implants

052425 MEDTRONIC PATIENT PROGRAMMER 97740 975.00 278 Supply/Implants

052426 MEDTRONIC CHARGING SYSTEM 97754 2,342.00 278 Supply/Implants

052427 MEDTRONIC IPG BATTERY 97714 19,000.00 278 Supply/Implants

052428 IM ULRICH CAG/VBR,SM,14MM,ALSZ 5,420.00 278 Supply/Implants

052430 SCR ULRICH VBR SET TI CS2259 60.00 278 Supply/Implants

052433 BO MTF ORTHOFIX TRINITY ELITE MEDIUM ALLOGRAFT 410002 2,250.00 278 Supply/Implants

052435 BO MTF ORTHOFIX TRINITY ELITE XLARGE ALLOGRAFT 410004 5,245.00 278 Supply/Implants

052439 BO SGT CORTICAL WEDGE PLIF 12X26 171226 1,250.00 278 Supply/Implants

052452 BO SPI/ELE LUCENT TIBOND TLIF ALL SIZES 5,000.00 278 Supply/Implants

052453 PL ALPHATEC TRES/LUXE 3 LV 1,060.00 278 Supply/Implants

052462 SU S/N TWINFIX ULTRA ANCHOR 72202897 240.00 278 Supply/Implants

052470 SCR OMNIA MALIBU LOCKING CAP 100.00 278 Supply/Implants

052472 ROD SEA MALIBU OFF SET CONNECT/ CROSS LNK ALL SIZE 400.00 278 Supply/Implants

052499 ROD NUTECH TITANIUM PRE BENT ALL SIZES 300.00 278 Supply/Implants

052501 BO NUTECH DBM 10CC OCMP10 400.00 278 Supply/Implants

052502 BO NUTECH NUCEL SMALL NC-1000 ONLY 900.00 278 Supply/Implants

052523 BL KNIFE #11 1211 B-P 13.55 270 Med-Surg Supplies

052524 BL KNIFE #15 1215 B-P 14.48 270 Med-Surg Supplies

052544 ROD MED MRC AXIAL CONNECTOR DOMINO 77911 ALL SIZES 850.00 278 Supply/Implants

052545 SCR MED MRC SET/ LOCKING CAP 779170005 100.00 278 Supply/Implants

052549 PL TSRH X10 CROSSLINK 8115558 400.00 278 Supply/Implants

052563 ***** RECOVERY CHARGE TC400 ***** 145.00 710 Recovery Room

052568 SCR ORT FIREBIRD ALL SZS, 445650 575.00 278 Supply/Implants

052569 SCR ORT SET FIREBIRD 442001 50.00 278 Supply/Implants

052572 BO ZIMMER TANTALUM TM-400 ALIF ALL SIZES 2,850.00 278 Supply/Implants

052574 BO AES PROSPACE PEEK XP ALL SZS SO443P 1,250.00 278 Supply/Implants

052577 SCR ZIM INVIZIA ALL SZS 07.00118.003 125.00 278 Supply/Implants

052580 MEDTRONIC RECHARGEABLE BATTERY 97713 15,088.00 278 Supply/Implants

052586 MED NEURO ULTRA 565 SURGICAL LEAD 9771US 18,500.00 278 Supply/Implants

052588 IM ORTHO FIREBIRD 3 L LUMBAR CONST. 5,600.00 278 Supply/Implants

052595 SCR MED SOLERA DEGEN SET/ LOCKING 100.00 278 Supply/Implants




052599 MED CATHETER PASSER 8591-60 98.00 270 Med-Surg Supplies

052601 ROD ORT FIREBIRD 4 LVL ALL SZS 522160 375.00 278 Supply/Implants

052602 IM ORT FIREBIRD CROSSLINK ALL SIZES 400.00 278 Supply/Implants

052603 ROD ORT FIREBIRD 1 LEVEL ALL SZS 52-6045 150.00 278 Supply/Implants

052606 IM CABLE AES SONGER DBL 400-651 451.00 278 Supply/Implants

052612 SCR MED SOLERA SAS ALL SIZES 1,200.00 278 Supply/Implants

052614 STYLET GLIDESCOPE (PATIENT CHARGE ONLY) 5.00 270 Med-Surg Supplies

052615 SOLIDIFIER BIO WASTE 1200ML, ISOB1200 1.65 270 Med-Surg Supplies

052625 SCR MED SET TI 6.35 7640020 67.33 278 Supply/Implants

052629 NE ART SCORPION SUREFIRE AR-13991N (BX=5 EACH) 140.00 270 Med-Surg Supplies

052639 ROD MED VERTEX COBALT CHROME TRANSITION 3.5 TO 5.5MM 1,575.00 278 Supply/Implants

052641 NE SPINAL 22X8IN QUINCKE POINT 183174 7.57 278 Supply/Implants

052647 IM PYRAMESH CAGE OVOID XL ALL SIZES 6,567.00 278 Supply/Implants

052648 IM ALPH ARSENAL LUMBAR 1 LEVEL CONST. 2,800.00 278 Supply/Implants



052659 ROD MED 5.5MM TITANIUM 869-021 229.78 278 Supply/Implants

052682 SCR ZI/ SPI VIRAGE POST CERVICAL ALL SIZES 650.00 278 Supply/Implants

052683 ROD ZI/SPI VIRAGE POST CERVICAL ALL SIZES 180.00 278 Supply/Implants

052684 SCR ZI/SPI VIRAGE SET POST CERVICAL 100.00 278 Supply/Implants

052685 MED NEURO TRIAL LEAD SINGLE 600.00 278 Supply/Implants

052686 MED NEURO TRIAL LEAD DOUBLE 1,100.00 278 Supply/Implants

052687 SCR ALPH ARSENAL LUM ALL SIZES 552.50 278 Supply/Implants

052688 SCR ALPH ARSENAL SET/ LOCKING CAP 47027 100.00 278 Supply/Implants

052689 ROD ALPH ARSENAL 500MM AND UP 390.00 278 Supply/Implants

052690 SCR ALPH ARSENAL OFF SET CONNECT ALL SIZES 400.00 278 Supply/Implants

052700 PL MED ILIAC OFF SET CONNECT AL/SZ 7041420 400.00 278 Supply/Implants

052705 IM MED PRESTIGE LP CERV DISC 69724 4,450.00 278 Supply/Implants

052706 DRILL MED PRESTIGE 6972118 125.00 270 Med-Surg Supplies

052708 IM ZI/SPI VEYRON CERV CAGE ALL SIZE 2,800.00 278 Supply/Implants

052709 SCR ZI/SPI VEYRON CERV SD ALL SIZES 100.00 278 Supply/Implants

052755 KIT STRYKER KYPHO CANNULA VERTEPORT CEMENT 03065110000 48.61 278 Supply/Implants

052761 PL ALPH ARSENAL CROSS LINK / VAR. BRIDGE 47006 400.00 278 Supply/Implants

052766 PL SYN ATB 2LV 04.103 4,500.00 278 Supply/Implants

052774 IM MED TRANSVERSE PROCESS HOOK MED 5541343 750.00 278 Supply/Implants

052777 ROD LEG 35MM 8690035 154.70 278 Supply/Implants

052778 NE TARGETING/JAMSHIDI 11G 73701-11 80.00 270 Med-Surg Supplies

052782 ROD MED LEG 100MM 8690100 232.11 278 Supply/Implants

052785 PL SP/ ELE SAPPHIRE 4 LEVEL 1,170.00 278 Supply/Implants

052787 ROD MED SOLERA TITANIUM/ ALLOY ALL SZ 200.00 278 Supply/Implants

052788 BO NUV OSTEOCEL PRO MATRIX MEDIUM 5016005 2,540.00 278 Supply/Implants

052789 SCR PIONEER STREAMLINE POST CERV ALSZ 263500 650.00 278 Supply/Implants

052790 SCR PIONEER SET STREAMLINE POST CERV ALSZ 260000 100.00 278 Supply/Implants

052791 ROD PIONEER STREAMLINE POST CERV ALSZ 230000 180.00 278 Supply/Implants

052794 BO SGT ICW 10X20MM 171020 1,250.00 278 Supply/Implants

052795 BO PIO BIOSET IC DBM 5CC 700.00 278 Supply/Implants

052796 BO PIO BIOSET IC DBM 10CC DBM6710 1,058.00 278 Supply/Implants

052800 IM MED PRESTIGE LP ARTIFICIAL CERV DISC 7X18 6972870 4,450.00 278 Supply/Implants

052801 KIT MED KYPHON EXPRESS INFLATE BONE TAMP K15A 940.00 270 Med-Surg Supplies

052802 KIT MED KYPHON A08E 120.00 270 Med-Surg Supplies

052803 KIT MED KYPHON SIZE 2 F06A 80.00 270 Med-Surg Supplies

052804 KIT MED KYPHON DIAMOND/ BEVEL T34A 700.00 270 Med-Surg Supplies

052814 KIT MED KYPHON EXPRESS INFLATABLE BONE TAMP K15B 940.00 278 Supply/Implants

052815 BO AES CESPACE XP ALL SZS 620.00 278 Supply/Implants

052836 ROD ALPH ARSENAL LUMBAR 48001 195.00 278 Supply/Implants

052841 ROD MED SOLERA TI PRE BENT 35MM 1553201035 154.70 278 Supply/Implants

052844 PL MED ZEVO CERV 37MM 3002037 606.40 278 Supply/Implants

052845 SCR MED ZEVO CERVICAL ALL SIZES 158.40 278 Supply/Implants

052846 SU ART FIBERWIRE W/ NEEDLE AR-7200 18.50 270 Med-Surg Supplies

052854 ROD LEG 65 MM TITANIUM 8690065 232.11 278 Supply/Implants




052857 ROD MED SOLERA PREBENT TITANIUM 100MM 1553201100 232.11 278 Supply/Implants


052869 SCR SYN ATB 30MM 04201030 479.00 278 Supply/Implants

052870 IM ULRICH OBELISC VBR CENTER PIECE ALL SIZES 7,000.00 278 Supply/Implants

052871 PL ULRICH OBELISC VBR END PIECE ALL SIZES 2,200.00 278 Supply/Implants

052872 SCR ULRICH OBELISC VBR LOCKING CS 2901 135.00 278 Supply/Implants


052875 IM PARADIGM COFLEX INTERLAMINAR STABILIZATION ALL SIZES 5,400.00 278 Supply/Implants




052885 ROD MED SOLERA TITANIUM PRE BENT 155320 232.11 278 Supply/Implants





052896 SCR MED VISION ELITE CERV ALL SIZES 158.40 278 Supply/Implants

052902 ROD MED SOLERA PREBENT 5.5MM COBALT 1556000500 200.00 278 Supply/Implants

052903 ROD NUV RELINE MAS TITANIUM LUM ALL SIZES 294.00 278 Supply/Implants

052904 SCR NUV RELINE MAS LUM POLYAXIAL ALL SIZES 1,225.00 278 Supply/Implants

052905 SCR NUV RELINE MAS SET/ LOCK 50.00 278 Supply/Implants


052913 ROD LEG PRE BENT 4.5MM 8690045 232.11 278 Supply/Implants

052916 ROD MED SOLERA PRE BENT TI 70MM 1553201070 232.11 278 Supply/Implants



052937 PL MED VIS/ ATL ELITE CERV 27MM 7200027 606.40 278 Supply/Implants

052940 IM SCENDIA COSMO 1L LUMBAR CONST 2,800.00 278 Supply/Implants

052941 SCR SCENDIA COSMOLOCK PEDICLE ALL SIZES 575.00 278 Supply/Implants

052942 IM OMNIA CALIX-T PC TLIF PEEK ALL SIZES 5,000.00 278 Supply/Implants

052944 IM SCENDIA INTESS PEEK CAGE AL SZS 12-PCT-2612 2,500.00 278 Supply/Implants



052954 BO RTI BIOREADY DBM PUTTY W/CHIPS 1CC, D00301 172.00 278 Supply/Implants

052955 ROD MED MRC SIDE LOADING CONNECTOR ALL SIZES 850.00 278 Supply/Implants

052957 SCR SYN ATB 24MM 04201024 479.00 278 Supply/Implants

052958 BO NOVABONE PUTTY 5CC NB0605 1,047.00 278 Supply/Implants

052960 BO NOVABONE MACROFORM BIOACTIVE 5CC NB4305 1,047.00 278 Supply/Implants

052961 BO NOVABONE MACROFORM BIOACTIVE 10CC NB4310 1,700.00 278 Supply/Implants


052964 IM ORTHOFIX CONSTRUX MINI PTC CERV SPACER ALL SIZES 1,500.00 278 Supply/Implants


052967 MED NEURO ADVANCED DUAL 9771RP 16,000.00 278 Supply/Implants


052971 MESH MED TYREX NEURO ABSORBABLE ANTIBACTERIAL ENVELOPE NMRM6133 995.00 272 Sterile Supply


052974 IM SCENDIA COSMO 2 L LUMBAR CONST 4,200.00 278 Supply/Implants

052975 IM CENT MIDLINE II-TI CAGE ALSZS 8,200.00 278 Supply/Implants

052976 IM SP/ ELEMENTS MAGNUM TI-BOND ALIF PEEK ALL SIZES 8,000.00 278 Supply/Implants

052977 SCR SP/ ELEMENTS MAGNUM TI-BOND ALIF ALL SIZES 250.00 278 Supply/Implants


052986 SU ART ANCHOR CORKSCREW FT III AR-1929SF-3 245.00 278 Supply/Implants

052989 IM ALPH ARSENAL LUMBAR 4 LEVEL CONST 7,000.00 278 Supply/Implants

052992 BO AES TSPACE XP TLIF ALL/SZ 2,500.00 278 Supply/Implants

052993 IM OMNIA MONZA CERVICAL CONST. 2 LEVEL 1,550.00 278 Supply/Implants

052995 IM OMNIA COMPLETE CERVICAL TITANIUM PEEK STAND ALONE ALL/ SZ 2,600.00 278 Supply/Implants


052998 KIT CATH TRIPLE LUMEN CENTRAL VENOUS AK-15703 29.53 270 Med-Surg Supplies

052999 IM OMNIA VU-APOD PRIME ALIF PEEK ALL SIZES 8,000.00 278 Supply/Implants

053000 PL OMNIA VU-APOD PRIME SPIN PLATE ALL SIZES 250.00 278 Supply/Implants





053003 IM AES MODULIFT EXPAND CAGE VBR ALL SIZES 5,500.00 278 Supply/Implants


053006 PL OMNIA MONZA 4 LEVEL ALL SIZES 1,170.00 278 Supply/Implants


053016 ROD OMNIA VALENCIA MI ALL SIZES 294.00 278 Supply/Implants

053017 SCR OMNIA VALENCIA T25 MI LUM ALL SIZES 900.00 278 Supply/Implants

053018 SCR OMNIA VALENCIA LOCKING CAP OM-915-1911 50.00 278 Supply/Implants

053025 PL MED ATL/ VIS ELITE CERV 55MM 7200055 606.40 278 Supply/Implants

053026 BO RTI BIOREADY DBM PUTTY .5CC W/CHIPS D00300 91.00 278 Supply/Implants


053028 PL OMNIA MONZA CERV 2 LEVEL ALL SIZES 950.00 278 Supply/Implants

053029 SCR OMNIA MONZA CERVICAL ALL SIZES 100.00 278 Supply/Implants

053030 IM OMNIA VALENCIA MI CROSSLINK ALL SIZES 400.00 278 Supply/Implants

053032 SCR UCSS 32MM 873-132 634.00 278 Supply/Implants

053033 GUIDEWIRE UCSS TREADED 873004 103.00 270 Med-Surg Supplies

053045 MED NEURO SENSOR SURGICAL 9771SS 20,000.00 278 Supply/Implants

053046 MED NEURO PRIME SURG 9771PS 18,000.00 278 Supply/Implants

053047 MED NEURO SENSOR PERC 9771SP 19,000.00 278 Supply/Implants

053048 IM MED DIVERGANCE ALIF PEEK CAGE ALL SIZES 2,850.00 278 Supply/Implants

053049 PL MED DIVERGANCE COVER ALIF ALL SIZES 2,850.00 278 Supply/Implants

053050 SCR MED DIVERGANCE FIX/ BONE ALL SIZES 200.00 278 Supply/Implants


053063 PL MONZA OMNIA 3 LEVEL OM-116-0359 1,060.00 278 Supply/Implants

053069 BO OMNIA PEEK CERV CALIX AL SZS 620.00 278 Supply/Implants

053070 IM OMNIA PIRANHA CERVICAL 3 LEVEL CONST 1,860.00 278 Supply/Implants

053071 BO OMNIA DBM PUTTY 1CC OM-PUT01P 190.00 278 Supply/Implants

053072 BO OMNIA DBM PUTTY 10CC OM-PUT10P 1,225.00 278 Supply/Implants

053073 IM OMNIA IRIX-A PEEK ALL SZS X080 8,200.00 278 Supply/Implants

053074 SCR OMNIA IRIX-A ALL SZS 5525SD 100.00 278 Supply/Implants

053080 BO OMNIA 10CC VIA GRAFT OM-MAT10 2,850.00 278 Supply/Implants

053083 IM OMNIA PIRANHA CERVICAL 2 LEVEL CONST. 1,550.00 278 Supply/Implants

053084 BO OMNIA DBM PUTTY 5CC OM-PUT05P 612.50 278 Supply/Implants

053086 ROD MED SOLERA PREBENT TI 40MM 1553201040 154.70 278 Supply/Implants

053089 ROD MED SOLERA PRE BENT 30MM 1553201030 154.70 278 Supply/Implants


053093 BO SPINALGRAFT AN/RAMP 19MM A85319 2,850.00 278 Supply/Implants

053095 SCR OMNIA VU-APOD PRIME LOCK AL SZS 33156525 250.00 278 Supply/Implants

053096 MED KIT SURGICAL LIGHT 2762-01-0003 584.00 270 Med-Surg Supplies

053102 IM OMNIA PIRANHA CERVICAL 1 LEVEL CONST. 1,240.00 278 Supply/Implants

053107 IM MED PIVOX CLYDESDALE CAGE ALL SIZES 4,750.00 278 Supply/Implants

053108 ROD MED SOLERA PREBENT 55MM 1553201055 232.11 278 Supply/Implants

053110 IM OMNIA HOLLYWOOD TLIF PEEK ALL SIZES 2,500.00 278 Supply/Implants


053112 IM OMNIA KYPHO OSTEOFLEX BONE CEMENT INTV-CEM 145.00 278 Supply/Implants

053113 KIT OMNIA KYPHO AMENDIA VBRX-15- A-10 OR INTVM-15-DDK 2,080.00 278 Supply/Implants

053114 BO ZIMMER BIOMET INTERGRO DBM 10CC DBMW10 1,225.00 278 Supply/Implants

053115 BO ZIMMER BIOMET INTERGRO DBM 5CC DBMW05 700.00 278 Supply/Implants

053119 ROD MED SOLERA PRE BENT TITANIUM 45MM 1553201045 154.70 278 Supply/Implants

053124 BO ZIMMER PUROS DBM GEL 1CC 84138001 190.00 278 Supply/Implants


053127 SCR SP/ELE MERCURY CANNULATED REDUCTION AL/SZS 63065 900.00 278 Supply/Implants


053131 IM MED BLADE HOOK WIDE LARGE 5541114 800.00 278 Supply/Implants


053137 ROD SCENDIA COSMOLOCK 2LVL AL SZS 225.00 278 Supply/Implants

053139 IM MED HOOK LARGE NARROW 5.5/6.0 5541124 750.00 278 Supply/Implants

053141 IM CTL CERVICAL 1 LEVEL CONST. 1,240.00 278 Supply/Implants

053143 IM CTL CERVICAL 2 LEVEL CONST. 1,550.00 278 Supply/Implants

053144 PIN MED ZEVO PLATE HOLDING 3030003 124.00 270 Med-Surg Supplies




053148 MED KYPHON SYRINGE A08A 75.00 270 Med-Surg Supplies

053149 PL RTI OFFSET CONNECTOR STRAIGHT 26-OFF-CON-S 400.00 278 Supply/Implants

053150 BO SMART MORSELIZED ALLOGRAFT 2,150.00 278 Supply/Implants

053151 IM SMART CANCELLOUS CRUSHED BONE 10CC 700.00 278 Supply/Implants

053152 SCR SCENDIA COSMO LOCKING CAP 11-LCL-0000 50.00 278 Supply/Implants

053160 IM SEASPINE CAMBRIA CERV SPACER TITANIUM PEEK ALL SIZES 2,000.00 278 Supply/Implants

053162 BO OMNIA 1CC VIA GRAFT OM-MAT01 285.00 278 Supply/Implants

053164 BO OMNIA 5CC VIA GRAFT OM-MAT05 1,425.00 278 Supply/Implants

053165 IM MED LEAD SURESCAN SPECIFY MRI 977C165 6,076.00 278 Supply/Implants

053174 SCR OMNIA ILIAC BOLT ALL SIZES 855.00 278 Supply/Implants

053175 PL OMNIA ILIAC CROSS CONNECTOR ALL SIZES 400.00 278 Supply/Implants

053176 SCR OMNIA ILIAC SET ALL SIZES 100.00 278 Supply/Implants

053177 ROD OMNIA VALENCIA MI 400MM AND UP 588.00 278 Supply/Implants

053179 ROD MED MRC 6.35 OPEN 6.35 CLOSED DOMINO CONNECTOR 778146565 850.00 278 Supply/Implants

053180 IM CTL CERVICAL 3 LEVEL CONST 1,860.00 270 Med-Surg Supplies

053183 ROD MED SOLERA CHROMALLOY 100MM 1555501100 232.11 278 Supply/Implants

053184 BO DCI PLIF SPACER PARALLEL ALL SIZES 1,250.00 278 Supply/Implants

053189 SCR OMNIA VALENCIA ILIAC BOLT ALL SIZES 855.00 278 Supply/Implants

053194 BO CERA IFACTOR BONE GRAFT 700-050 1,600.00 278 Supply/Implants

053195 IM ZIM-BIO ARDIS TANTALUM AL SZS 3,400.00 278 Supply/Implants

053199 IM GENSANO XPLUS MEMBRANE 2X3 CM XM-020203 910.00 278 Supply/Implants

053200 IM GENSANO XPLUS MEMBRANE 4X4 CM 1,250.00 278 Supply/Implants

053201 MEDTRONIC SURESCAN PADDLE 977C165 6,076.00 278 Supply/Implants


053208 BO GENSANO CERVICAL SPACER PTT-LCCCS 620.00 278 Supply/Implants

053214 IM OMNIA ENDURAMESH(CERV) CORP SPACER ALL SZS 3,660.00 270 Med-Surg Supplies

053215 PL OMNIA PIRANHA CERV 2 LVL 950.00 278 Supply/Implants

053216 SCR OMNIA PIRANHA CERV ALL SZS 100.00 278 Supply/Implants

053217 IM AES MODULIFT SZ M END CAP MF755T 953.00 278 Supply/Implants

053218 ROD MED SOLERA PREBENT 90MM 1555501090 232.11 278 Supply/Implants


053221 INTRAOPERATIVE MONITORING AIM 500.00 270 Med-Surg Supplies

053222 PL NUV AFFIX II 45MM 7577045 4,275.00 278 Supply/Implants

053223 SCR OMNIA VALENCIA ILIAC SET/ LOCKING 100.00 278 Supply/Implants

053224 CATH MED ASCENDA PUMP 8782 550.00 278 Supply/Implants

053225 IM ZIMMER TIMBERLINE LATERAL HALF PLATE 1 LEVEL CONST. 8,250.00 278 Supply/Implants

053227 BO OMNIA REBAR CERVICAL SPACER ALL SZS SCC-001 620.00 278 Supply/Implants

053229 BO OBEY DEMINERALIZED CANCELLOUS STRIP 50X20X7MM 15A040 1,700.00 278 Supply/Implants

053230 BO OBEY CELERA ALLOGRAFT FLUID 1CC AF-13210 1,425.00 278 Supply/Implants

053232 IM WRIGHT EVOLVE RADIAL HEAD 24MM 2,690.00 278 Supply/Implants

053233 IM WRIGHT EVOLVE RADIAL STEM 6.5MM 3,197.00 278 Supply/Implants

053234 PL ACUMED ELBOW OLECRANON 7 HOLE LEFT 70-0306 1,376.00 278 Supply/Implants

053235 SCR ACUMED NONLOCKING HEXALOBE ALL SIZES 90.00 278 Supply/Implants

053236 SCR ACUMED LOCKING HEXALOBE 3.5MM ALL SIZES 150.00 278 Supply/Implants



053239 DRILL ACUMED QUICK RELEASE 2.0 MM 80-0318 152.00 270 Med-Surg Supplies

053240 DRILL ACUMED QUICK RELEASE 2.3MM 80-0627 160.00 270 Med-Surg Supplies

053242 K-WIRE ACUMED 2.0MM X 9" WS-2009ST 30.00 270 Med-Surg Supplies

053243 GUIDEWIRE MEDTRONIC 75700450 55.00 270 Med-Surg Supplies

053244 BO OBEY FORMA FLEXIBLE SPONGE 12X12X12MM SB-12012 1,047.00 278 Supply/Implants

053245 BO SPI/ ELE CRYSTAL TI-BOND CERVICAL INTERBODY ALL SIZES 2,000.00 278 Supply/Implants

053246 BO OMNIA MORPHEUS BONE GRAFT SUB 6CC 006-MOR 1,197.00 278 Supply/Implants

053247 IM S/N FOOTPRINT KNOTLESS ANCHOR 5.5 72202902 395.52 270 Med-Surg Supplies

053249 BO GENSANO MORSELIZED ALLOGRAFT 2,500.00 278 Supply/Implants

053250 BO GENSANO CANCELLOUS CHIPS 10CC 350.00 278 Supply/Implants

053253 MED KIT ACCESSORY 3550-43 55.00 270 Med-Surg Supplies

053254 BO OBEY FORMA FLEXIBLE SPONGE 14X14X14MM SB-12014 1,700.00 278 Supply/Implants

053255 PL KJM BUTTRESS W/ LOCKING 22MM GBP1-22 2,800.00 278 Supply/Implants

053256 SCR KJM BUTTRESS 5.5 X 24MM GBP1-2455 200.00 278 Supply/Implants




053258 BO OBEY CELERA ALLOGRAFT FLUID 2CC AF-13220 2,850.00 278 Supply/Implants

053259 ROD MALIBU COBALT CHROME 5.5 X 500 AND UP 588.00 278 Supply/Implants

053261 IM MED PRESTIGE LP ARTIFICIAL CERV DISC 6 X18MM 6972860 4,450.00 278 Supply/Implants

053262 IM OMNIA SAVANNAH-T LUMBAR 4 LEVEL CONST. 7,000.00 270 Med-Surg Supplies

053272 SCR OMNIA SAVANNAH CANN LOW TOP PEDICLE ALL SZS OM-10-01 900.00 278 Supply/Implants

053273 SCR OMNIA SAVANNAH SET OM-10-17 50.00 270 Med-Surg Supplies

053274 PL OMNIA SAVANNAH X-LINK ALL SZS 400.00 278 Supply/Implants

053275 ROD OMNIA SAVANNAH CO CR 400MM OM-10707-400 588.00 278 Supply/Implants

053277 PL MED ZEVO CERV. 3301029 606.40 278 Supply/Implants

053278 BO SGT IMPACTED CORTICAL WEDGE 8X20MM 170820 1,250.00 278 Supply/Implants

053279 IM ORTFIX PILLAR SAPTC ALL SZS 39-2214 7,500.00 278 Supply/Implants

053281 IM AES ENNOVATE LUMBAR 1 LEVEL CONST 2,800.00 270 Med-Surg Supplies

053282 SCR AES ENNOVATE ALL SZ 552.50 278 Supply/Implants

053283 SCR AES ENNOVATE SET ALL SZ SY001T 50.00 270 Med-Surg Supplies

053284 IM OMNIA PIRANHA CERVICAL 4 LEVEL CONST 2,170.00 278 Supply/Implants

053285 ROD OMNIA SAVANNAH-T CURVED ROD ALL SIZES 294.00 270 Med-Surg Supplies

053286 IM AES ENNOVATE LUMBAR 2 LEVEL CONST 4,200.00 270 Med-Surg Supplies

053288 PL AMENDIA BUTTRESS 23MM TBP123 895.00 278 Supply/Implants

053289 SCR AMENDIA BUTTRESS 25MM TBS025 375.00 278 Supply/Implants

053290 BO AMENDIA VIA GRAFT-M STEM CELL 10CC VCAM-100000 2,850.00 278 Supply/Implants

053291 BO COMM 15C CANC CUBES 1201-12 260.00 270 Med-Surg Supplies

053292 SCR SEA MALIBU ILIAC BOLT ALL SIZES 900.00 278 Supply/Implants

053293 ROD OMNIA SAVANNAH-T CRO CR 600MM OM-10707-600 588.00 278 Supply/Implants

053294 SCR OMNIA LATERAL CONNECTOR SET 100.00 278 Supply/Implants

053295 BO AMENDIA 5CC DBM CEMO-05P 612.50 278 Supply/Implants

053296 SCR ASTURA OLYMPIC CANNULATED POLYAXIAL ALL SIZES 900.00 278 Supply/Implants

053297 SCR ASTURA OLYMPIC SET ABAA00055 50.00 278 Supply/Implants

053298 ROD ASTURA OLYMPIC ROD LORDOTIC ALL SIZES 294.00 278 Supply/Implants

053299 BO AMENDIA PROVENDA-FLO STEM CELL ALLOGRAFT 1ML BPRF0100 1,425.00 278 Supply/Implants

053300 BO AMENDIA NEVOS SPONGE 14X14X14MM BNES1414 1,700.00 278 Supply/Implants

053301 BO AMENDIA NEVOS DBM FIBER 5CC BNEF0005 612.50 278 Supply/Implants

053302 BO AMENDIA NEVOS SPONGE BNES5027 1,700.00 278 Supply/Implants

053303 IM INTEGRITY FLAREHAWK EXPAND CAGE ALL SIZES 5,000.00 278 Supply/Implants

053304 BO AMENDIA PROVENDA-FLO STEM CELL ALLOGRAFT 2ML BPRF0200 2,850.00 278 Supply/Implants

053305 NE 25G X 5 SPINAL BD BF405140 5.92 270 Med-Surg Supplies

053306 PL SYN 3.5MM LCP 9HOLE 124MM 223.591 560.00 278 Supply/Implants

053307 SCR SYN 3.5MM LOCKING SLF TAP 28MM 212.110 200.00 278 Supply/Implants

053308 DRILL SYN QC 165MM 310.288 147.00 270 Med-Surg Supplies

053309 PL CONN ASTURA LAT ROD TOP LOAD 6.0MM ALSZ 400.00 278 Supply/Implants

053310 ROD ASTURA HEX 6.0 500MM 588.00 278 Supply/Implants

053311 BO AMENDIA NEVOS DBM PUTTY 10CC BNEP0010 1,225.00 278 Supply/Implants

053312 BO AMENDIA NEVOS DBM FIBER 10CC BNEF0010 1,225.00 278 Supply/Implants

053313 SCR SP/ ELEMENTS LOTUS POST CERVICAL ALL SIZES 650.00 278 Supply/Implants

053314 SCR SP/ ELEMENTS LOTUS THREADED CAP POST CERVICAL 32500-000 100.00 278 Supply/Implants

053315 ROD SP/ ELEMENTS LOTUS POST CERVICAL ALL SIZES 180.00 278 Supply/Implants

053317 IM TITAN ENDOSKELETON TO PLIF ALL SIZES 3,000.00 278 Supply/Implants

053318 PL OMNIA PRECISION/USA ALP ALL SIZES 2,600.00 278 Supply/Implants

053319 SCR OMNIA PRECISION/USA ALP ALL SIZES 100.00 278 Supply/Implants

053320 IM MED T2 ALTITUDE EXPANDABLE CAGE CENTERPIECE 25 X 31MM 6,000.00 278 Supply/Implants

053321 SCR MED T2 ALTITUDE 25MM 15 CAP 9402515 385.00 278 Supply/Implants

053322 GUIDE PIN INTEGRITY FLAREHAWK ALL SIZES 199.00 270 Med-Surg Supplies

053323 BO AMENDIA NEVOS DBM PUTTY 5CC BNEP0005 612.50 278 Supply/Implants

053324 IM ASTURA ZION CERVICAL 4 LEVEL CONST. 2,170.00 278 Supply/Implants

053325 DRILL ASTURA ZION CERVICAL ALL SIZES 172.80 272 Sterile Supply


053327 BO SPGFT EXPANSE TISSUE AL SZS T600206 600.00 278 Supply/Implants

053328 IM FIREBIRD OFFSET CONNECTOR AL SZS 400.00 278 Supply/Implants

053329 ROD MED MRC 5.5MM OPEN 5.5MM CLOSED CONNECTOR 779115555 850.00 278 Supply/Implants

053334 IM RTI STREAMLINE TL LUMBAR 1 LEVEL CONST. 2,800.00 278 Supply/Implants

053335 IM MED HOOK LARGE EXTENDED BODY 5541174 750.00 270 Med-Surg Supplies




053336 ROD OMNIA K2M COBALT CHROME 500MM 588.00 278 Supply/Implants


053338 ROD MED SOLERA COBALT 60MM 1555501060 232.11 278 Supply/Implants

053339 IM MED HOOK MEDIUM WIDE BLADE 5541113 800.00 278 Supply/Implants

053340 ROD MED MRC SIDE TO SIDE CONNECTOR 5.5- 5.5 779145555 850.00 278 Supply/Implants



053344 INTRAOPERATIVE MONITORING BRAIN AND NE 500.00 270 Med-Surg Supplies

053345 BRAIN & NERVE MONITORING TC MEP CHARGE 100.00 270 Med-Surg Supplies

053346 IM SPI/ELE CONNECTOR MERCURY TOTAL SPINE AL SZS 60106 400.00 278 Supply/Implants

053347 SCR SPI/ELE ILIAC MERCURY TOTAL SPINE FIX AL SZS 63485 900.00 278 Supply/Implants

053348 SCR AMENDIA AL SZS 108-L-XXXX 900.00 278 Supply/Implants

053349 SCR SET AMENDIA 108-840046 50.00 278 Supply/Implants

053351 NEVRO SENZA IPG NIPG1500 18,375.00 278 Supply/Implants

053352 NEVRO SURGICAL LEAD 70MM LEAD3005-70B 2,500.00 278 Supply/Implants

053353 NEVRO PATIENT REMOTE PTRC1000 1,000.00 270 Med-Surg Supplies

053354 NEVRO CHARGER CHGR1000 1,000.00 270 Med-Surg Supplies

053355 ROD MED MRC 5.5- 5.5 CLOSED/ CLOSED DOMINO CONNECTOR 779125555 850.00 278 Supply/Implants

053357 MED NEURO SURESCAN W/ PADDLE 16,500.00 278 Supply/Implants

053359 ROD STRYKER CP 480MM 48232480 200.00 278 Supply/Implants

053360 SCR STRYKER SET/ BLOCKERS 48230000 50.00 278 Supply/Implants


053362 SCR MED LAMINAR HOOK 7756074 650.00 278 Supply/Implants

053364 SCR ZIMMER TRICOR SI JOINT 50MM 07.02211.015 3,350.00 278 Supply/Implants

053365 SCR ZIMMER TRICOR SI JOINT 45MM 07.02211.014 3,350.00 278 Supply/Implants

053366 PIN ZIMMER TRICOR THREADED 07.02212.035 100.00 278 Supply/Implants

053367 PIN ZIMMER TRICOR EXCHANGE 500MM 07.02212.028 100.00 278 Supply/Implants

053368 PL OMNIA PIRANHA CERV 3 LEVEL ALL SIZES 1,060.00 278 Supply/Implants

053369 SCR ASTURA ZION CERV ALL SZS CBBB40015 100.00 278 Supply/Implants

053370 SCR MED LAG CANNULATED 38MM 873-138 634.00 278 Supply/Implants

053371 MED NEURO PRIME BATTERY W/ ADAPTER 14,049.00 278 Supply/Implants

053372 IM RTI STREAMLINE TL LUMBAR 2 LEVEL CONST. 4,200.00 278 Supply/Implants

053373 BO OMNIA MORPHEUS BONE GRAFT SUB 12CC 012-MOR 1,997.00 278 Supply/Implants

053374 SUTURE PASSER SMITH NEPHEW FIRSTPASS 22-4038 140.00 270 Med-Surg Supplies

053375 SCR MED CANNULATED BALLAST BOLT 8.5 X 70MM 25840018570 1,200.00 278 Supply/Implants

053376 ROD MED MRC DOMINO CLOSED 5.5/ CLOSED 6.35 779125565 850.00 278 Supply/Implants

053377 SCR NUV RELINE-O LUMBAR POLYAXIAL ALL SIZES 600.00 278 Supply/Implants

053378 SCR NUV RELINE-O LUMBAR SET/ LOCKING 13550000 50.00 278 Supply/Implants

053379 ROD NUV RELINE-O TI LORDOTIC ALL SIZES 150.00 278 Supply/Implants

053382 SU SMITH NEPHEW OSTEORAPTOR ANCHOR 2.9 W. UB WHITE/ BLACK 72201996341.12 278 Supply/Implants

053383 SU SMITH NEPHEW OSTEORAPTOR ANCHOR .3 W. UB COBRAID BLUE 72201993 341.12 278 Supply/Implants

053384 SU SMITH NEPHEW OSTEORAPTOR ANCHOR 2.9 W/ 2 UB WHITE/ BLUE 72201995341.12 278 Supply/Implants

053385 PL MED VIS/ ATL ELITE CERV 52.5MM 7200052 606.40 278 Supply/Implants

053386 BO GENSANO APEX DBM PUTTY 5CC DBM-APX-05 612.50 278 Supply/Implants

053389 IM AESCULAP QUINTEX CERVICAL 2 LEVEL CONST 1,550.00 278 Supply/Implants

053390 BO INTEGRITY BIONEST CORTICAL FIBERS LARGE NEST-CF-CR-LG-A 1,225.00 278 Supply/Implants

053391 INTRAOPERATIVE MONITORING NATIONAL 275.00 270 Med-Surg Supplies

053392 BO GENSANO APEX DBM PUTTY 10CC DBM-APX-10 1,225.00 278 Supply/Implants

053393 IM HOOK MED SOLERA 5541133 750.00 278 Supply/Implants

053394 PL MED CROSSLINK 58MM X 10 8116458 400.00 278 Supply/Implants

053395 PL ASTURA OLYMPIC CROSS CONNECTOR ALL SIZES 400.00 278 Supply/Implants

053396 SCR ORT MODULAR NXG AL SZS 77-8640 575.00 278 Supply/Implants

053397 ROD ORT NXG 1 LEVEL AL SZS 52-2040 150.00 278 Supply/Implants

053398 SCR ORT NXG CLOSURE TOP 36-2001 50.00 278 Supply/Implants

053400 PL MED VERTEX AXIAL 3.5/5.5 CONNECTOR 7750348 617.00 278 Supply/Implants

053401 BO SPI/GFT PRECISION ALIF GRAFT FROZEN AL/ SZ 2,850.00 278 Supply/Implants

053402 PL ASTURA ZION CERVICAL 2 LEVEL AL/ SZ 950.00 278 Supply/Implants

053403 ROD MED SOLERA CHROMALLOY 40MM 1555501040 154.70 270 Med-Surg Supplies

053404 IM CTL LUMBAR CONSTR 1 LEVEL 2,800.00 278 Supply/Implants

053405 INSPIRE IV IPG 3028 17,100.00 278 Supply/Implants




053406 INSPIRE STIMULATION LEAD 4063 1,950.00 278 Supply/Implants

053407 INSPIRE PRESSURE SENSING LEAD 4323 3,050.00 278 Supply/Implants

053408 INSPIRE SLEEP REMOTE 2500N 1,400.00 278 Supply/Implants

053410 PATIENT FAN 5" FD05805 10.42 270 Med-Surg Supplies

053411 BO GENSANO DBM SPONGE STRIP DBM-SS-35 1,700.00 278 Supply/Implants

053412 DRILL UCSS 4.0MM 8730007 300.00 270 Med-Surg Supplies

053413 SCR MED UCSS 34MM 873-034 634.00 278 Supply/Implants

053414 SCR MED UCSS 40MM 873-040 634.00 278 Supply/Implants

053415 ULRICH CASSETTE HEAD FOR EXPANDER ALL SIZES 170.00 270 Med-Surg Supplies

053416 SU S/N TWINFIX ULTRA ANCHOR ULTRABRAID 72202618 316.16 278 Supply/Implants

053417 AWL S/N TAPPERED 3.8MM 72202621 39.52 270 Med-Surg Supplies

053418 PL ASTURA ZION CERVICAL 3 LEVEL AL/SZ 1,060.00 278 Supply/Implants

053419 IM SPI/ELE MERCURY PARALLEL OPEN 5.5/ 5.5MM 62364-010 850.00 278 Supply/Implants

053420 ROD INTEGRA NEWPORT MIS CO CH 500MM 588.00 278 Supply/Implants

053421 SU S/N TWINFIX ULTRA ANCHOR5.5MM W/2 UB BLACK BLUE 72202896 230.00 278 Supply/Implants

053423 ROD MED MRC SIDE TO SIDE CONNECTOR 5.5MM- 6.35MM 779146555 850.00 278 Supply/Implants

053424 PL OMNIA PIRANHA CERV 4 LEVEL ALL SIZES 1,170.00 278 Supply/Implants

053425 PL MED VIS/ ATL ELITE 72.5MM 7200172 606.40 278 Supply/Implants

053426 PL OMNIA MONZA CERV 4 LEVEL ALL SIZES 1,170.00 278 Supply/Implants

053428 MED NEURO INTELLIS PERC SCS 9771IP 23,500.00 278 Supply/Implants

053430 INSTRUMENT NEVRO TUNNELING TOOL ACCK3035 155.00 270 Med-Surg Supplies

053432 PIN ASTURA ZION CERV FIXATION 50.00 270 Med-Surg Supplies

053434 IM LDR MOBI-C ARTIFICIAL CERV DISC ALL SIZES 4,950.00 278 Supply/Implants

053435 PIN LDR DISTRACTION MOBI-C CERV DISC ALL SIZES 50.00 270 Med-Surg Supplies

053436 ROD ASTURA OLYMPIC CO CR 500MM 588.00 278 Supply/Implants

053437 SCR ASTURA OLYMPIC ILIAC BOLT ALL SIZES 900.00 278 Supply/Implants

053438 MED NEURO INTELLIS LEADS SINGLE TRIAL 600.00 278 Supply/Implants

053440 IM MED PRESTIGE LP ARTIFICIAL CERV DISC 6X16MM 6972660 4,450.00 278 Supply/Implants

053441 ROD ASTURA OLYMPIC 6.0 CO CR 300MM 588.00 278 Supply/Implants


053443 MED NEURO INTELLIS SURG SCS 9771IS 24,500.00 278 Supply/Implants

053446 MED NEURO INTELLIS LEADS DOUBLE TRIAL 1,100.00 278 Supply/Implants

053449 PL OMNIA ATOLL OCCIPITAL ALL SZS 16-30-25-35 4,300.00 278 Supply/Implants

053450 BO NUT DBM 2CC OCMP2 100.00 278 Supply/Implants

053451 SCR OMNIA ALTUS LUM AL/SZS 9707545 900.00 278 Supply/Implants

053452 SCR OMNIA ALTUS SET 50.00 278 Supply/Implants

053453 ROD OMNIA ALTUS AL/SZS 294.00 278 Supply/Implants

053454 PL OMNIA ALTUS CROSSLINK AL/SZS 400.00 278 Supply/Implants

053455 SCR ASTURA OLYMPIC NON CANNULATED POLYAXIAL AL/SZS 555.00 278 Supply/Implants

053456 PL MED CROSSLINK 8115516 400.00 278 Supply/Implants




053462 MED NEURO ITELLIS REPLACEMENT 97715RP 20,000.00 278 Supply/Implants

053463 COBLATOR PROCISE XP ENDOSCOPIC SUCTION EICA8872-01 266.00 270 Med-Surg Supplies

053465 IM AES ACTIV L SUP, INF PLATE ALLL SIZES SW990K 4,500.00 278 Supply/Implants

053466 IM AES ACTIV L PE-INLAY INSERT AL/SZS SW965 500.00 278 Supply/Implants

053467 MARKER AES MIDLINE ACTIV L FW938SU 80.00 270 Med-Surg Supplies

053469 DRILL BIT VERTEX SELECT 3.2MM 7756131 216.00 270 Med-Surg Supplies

053470 PL MED OCCIPITAL SMALL KEEL 7759970 2,365.00 278 Supply/Implants

053471 ROD MED OCCIPITAL CHROMALOY 3.5MM 7755275 471.64 270 Med-Surg Supplies

053472 CONNECTOR MED MAS EXTENSION 7756069 408.20 270 Med-Surg Supplies

053473 SCR MED MAS SET LOCKING 7753500 100.00 278 Supply/Implants

053474 SCR MED MAS CROSSLINK SET LOCKING 7752529 100.00 278 Supply/Implants

053475 BO ORG 2CC CRUSHED CANCELLOUS MATRIX OCMP2-OCM+DBM 2CC 95.00 278 Supply/Implants

053476 SU S/N TWINFIX ULTRA ANCHOR TI 6.5MM W/ THREE ULTRABRAID 72202900 245.00 278 Supply/Implants


053478 PL MED OFFSET CONNECTOR 70MM 5564370 400.00 278 Supply/Implants


053483 BAG DECANTER 10-102 2.04 270 Med-Surg Supplies




053487 BOSTON SCIENTIFIC SC-1032E STIMULATOR 23,000.00 278 Supply/Implants

053490 ST. JUDE 3660 TRIPOLE SCS 19,800.00 278 Supply/Implants

053491 SU S/N TWINFIX ULTRA 5.5MM W/2 UB 72202895 230.00 278 Supply/Implants

053492 SCR ASTURA POST CERV POLY ALL SIZES 650.00 278 Supply/Implants

053493 SCR ASTURA POST CERV SET LOCKING FBAA00000 100.00 278 Supply/Implants

053494 ROD ASTURA POST CERV ALL SIZES 180.00 278 Supply/Implants

053496 ROD LEG 55MM PRE BENT 8690055 232.11 278 Supply/Implants


053499 DRILL NU/SPI S LOC POST CERVICAL 215.00 270 Med-Surg Supplies

053500 BO AMENDIA NEVOS DBM FIBER PUTTY PLUS 10CC BNFPP0010 1,225.00 278 Supply/Implants

053501 IM HD ALIF TITANIUM PEEK ALL SIZES 8,000.00 278 Supply/Implants

053513 SU SMITH NEPHEW OSTEORAPTOR ANCHOR 2.3 W/ 1UB COBRAID BLACK 72201992341.12 278 Supply/Implants

053514 PL MED ZEVO CERV 75MM 3004075 606.40 270 Med-Surg Supplies

053516 NEVRO SINGLE LEAD TRIAL KIT TLEAD1058-50B 600.00 278 Supply/Implants

053517 ST. JUDE TRIPOLE W/ PADDLE SPINAL CORD STIM 18,000.00 278 Supply/Implants

053518 PL MED OCCIPITAL ADJUSTABLE 7755278 2,365.00 278 Supply/Implants

053520 IM ZIMMER TRINICA CERV 1 LEVEL CONST. 1,240.00 278 Supply/Implants

053521 SCR MED SOLERA DUAL ROD 6.5 X 55MM 55720006555 1,550.00 278 Supply/Implants


053523 PL MED VIS/ ATL ELITE CERV 62.5MM 7200062 606.40 270 Med-Surg Supplies

053524 PL ASTURA ZION CERVICAL 1 LEVEL ALL/ SZ 840.00 270 Med-Surg Supplies

053526 PL ASTURA POST CERV CROSS LINK ALL SIZES 400.00 278 Supply/Implants

053527 PL MED VISION ELITE CERVICAL 21MM 7200021 606.40 278 Supply/Implants

053528 BO AMENDIA NEVOS DBM FIBER PUTTY PLUS 5CC BNFPP0005 612.50 278 Supply/Implants

053529 IM DEPUY SYNEX CORPECTOMY CAGE LUMBAR 04.807.237 6,000.00 278 Supply/Implants

053531 IM MED PRESTIGE LP ARTIFICIAL CERV 7X16MM 6972670 4,450.00 278 Supply/Implants

053532 DRILL MED PRESTIGE 6975015 125.00 270 Med-Surg Supplies

053533 SCR MED SOLERA DUAL ROD 6.5X45MM 55720006545 1,500.00 270 Med-Surg Supplies

053534 SCR MED SOLERA DUAL ROD 7.5X40MM 55720007540 1,550.00 270 Med-Surg Supplies

053537 ROD ASTURA LATERAL ROD CONNECTOR ILIAC ALL SIZES 400.00 278 Supply/Implants

053538 MED NEURO INTELLIS BATTERY REPLACEMENT 20,000.00 278 Supply/Implants

053539 MED NEURO SENSOR REPLACEMENT 9771P 18,000.00 278 Supply/Implants

053541 BO GENSANO APEX DBM PUTTY 2.5CC DBM-APX-02 306.25 278 Supply/Implants

053545 SCR MED SOLERA DUAL ROD 8.5X55MM 55720008555 1,500.00 278 Supply/Implants

053546 ROD MED SOLERA 35MM 1555501035 154.70 278 Supply/Implants

053547 IM MED T2 ALTITUDE EXPANDABLE CAGE 16 X 41-57MM 9391641 9,350.00 278 Supply/Implants

053548 SCR MED T2 ALTITUDE LORDOSIS END CAP 9401615 605.00 278 Supply/Implants

053549 ROD ASTURA POST CERV 400MM CO CR 360.00 278 Supply/Implants

053550 BO OMNIA SUZUKA CERV PEEK CAGE AL SZS 8LR507 620.00 278 Supply/Implants



053555 SCR ARTHREX 4.5 X 40MM AR-9045-40PT 795.00 278 Supply/Implants

053556 K-WIRE ARTHREX 2.0 AR-8956K-01 25.00 270 Med-Surg Supplies

053557 DRILL ARTHREX CANNULATED 3.5 AK-8956C-35PD 175.00 270 Med-Surg Supplies

053558 DRESSING ARTHREX JUMPSTART AB5-4005 19.00 270 Med-Surg Supplies

053559 IM AES MODULIFT SIZE L END CAP ALL SIZES 953.00 278 Supply/Implants


053562 ROD MED SOLERA 90MM TITANIUM 1553201090 232.11 278 Supply/Implants

053563 IM ARTHREX ANATOEMIC PHALANGEAL PROSTHESIS 17MM AR-9500-170 695.00 278 Supply/Implants

053564 SCR ARTHREX QUICKFIX 2.0 X 10MM AR-8930-10 240.00 278 Supply/Implants

053565 ROD ASTURA TRANSITION 4.0-5.5 500MM AL/SZS FCDB40555 588.00 278 Supply/Implants

053567 SPLINT ORTHO GLASS 4 INCH PATIENT CHARGE 8.00 270 Med-Surg Supplies

053568 BO GENSANO APEX DBM PUTTY 1CC DBM-APX-01 190.00 278 Supply/Implants

053569 SCR LEG 7.5 X 30MM 75447530 555.26 278 Supply/Implants



053575 IM AESCULAP QUINTEX CERVICAL 1 LEVEL CONST 1,240.00 278 Supply/Implants


053577 SCR ARTHREX MINI FT 3.5 24MM AR-8730-24H 500.00 270 Med-Surg Supplies

053578 DRILL ARTHREX MINI PROFILE AR-8737-47 150.00 270 Med-Surg Supplies




053579 DRILL BIT ARTHREX CANNULATED 2.7MM AR-8737-35 195.00 270 Med-Surg Supplies

053580 GUIDEWIRE ARTHREX .045 AR-8737-41 31.50 270 Med-Surg Supplies

053581 GUIDEWIRE ARTHREX .062 AR-8941K 21.50 270 Med-Surg Supplies

053582 SCR ARTHREX MINI SCORPION CPR AR-8690DS 950.00 278 Supply/Implants


053584 IM ARTHREX ANATOEMIC PHALANGEAL PROSTHESIS AR-9500-185 695.00 278 Supply/Implants

053586 PL CTL CERVICAL 2 LEVEL ALL SIZES 950.00 278 Supply/Implants

053587 SCR CTL CERVICAL ALL SIZES 100.00 278 Supply/Implants

053588 SPLINT FOOT DROP LARGE RIGHT 40.00 270 Med-Surg Supplies

053589 ROD MED 6.5 CLOSED 5.5 OPEN AXIAL MRC CONNECTOR 778116555 850.00 278 Supply/Implants

053590 SCR ARTHREX 4.5 X 50MM AR-9045-50PT 795.00 278 Supply/Implants


053593 MODULE NUVASIVE NVM5 NEXT GEN EMG 8020015 924.32 270 Med-Surg Supplies

053595 NEVRO BLUE PERC LEAD KIT LEAD1058-70B 500.00 278 Supply/Implants


053598 DRILL ARTHREX 3.2 CANNULATED AR-8737-50 195.00 270 Med-Surg Supplies

053599 SCR ARTHREX 4.0 HEADLESS 24MM AR-8740-24H 422.00 278 Supply/Implants




053603 ROD MED SOLERA 5.5MM COBALT 1555000500 200.00 278 Supply/Implants

053604 BO GENSANO APEX CRUNCH DBM 10CC DBM-APX-10C 1,225.00 278 Supply/Implants

053605 BO GENSANO APEX CRUNCH DBM 5CC DBM-APX-05C 612.50 278 Supply/Implants


053607 ROD MED BALLAST CONNECTOR 70MM 5564370 400.00 278 Supply/Implants

053609 SCR MED T2 ALTITUDE 6.5 X 40MM 9336540 600.00 278 Supply/Implants

053610 PL MED ROASTRAL STAPLE 9330003 1,250.00 278 Supply/Implants

053611 PL MED CAUDAL STAPLE 9330004 1,250.00 278 Supply/Implants

053612 IM MED T2 ALTITUDE CAGE 25MM 9392525 6,000.00 278 Supply/Implants

053613 SCR MED 4 DEGREE END CAP 9402504 605.00 278 Supply/Implants

053614 PL MED VANTAGE 5.5MM 9330055 3,500.00 270 Med-Surg Supplies

053615 SCR MED LOCKING NUT 9330000 260.00 278 Supply/Implants

053616 IM ULRICH UNION CERVICAL 1 LEVEL CONSTRUCT 1,240.00 278 Supply/Implants

053617 IM ONE SURGICAL LUMBAR CONST 1 LEVEL 2,800.00 278 Supply/Implants

053618 ROD MED MRC 5.5 OPEN 6.35 CLOSED DOMINO 778145565 850.00 278 Supply/Implants

053619 BO ALPHATECH CERVICAL SPACER ALL SIZES 620.00 278 Supply/Implants

053620 NATIONAL NIM SPECIALTY PROBE CHARGE 250.00 270 Med-Surg Supplies


053623 SCR ONE SURGICAL CERV AL/SZS 100.00 278 Supply/Implants

053624 PL ONE SURGICAL CERV 3 LVL 1.114 1,060.00 278 Supply/Implants

053626 FIXATION PIN ONE SURGICAL 1.100.2001 74.00 272 Sterile Supply

053627 IM CERV CONST 1 LVL ONE SURGICAL 1,240.00 278 Supply/Implants

053628 BO SEA SPINE ACCELL EVO 3 1CC 02-5000-010 365.70 278 Supply/Implants

053631 BO SEA SPINE ACCELL EVO 3C 10CC 02-6000-100 2,106.00 278 Supply/Implants

053632 BO SEA SPINE ISOTIS STRAND PLUS X SMALL 1CC 02-7100-010 464.55 278 Supply/Implants

053633 BO SEA SPINE ISOTIS STRAND PLUS SMALL 2.5CC 02-7100-025 802.62 278 Supply/Implants

053634 BO SEA SPINE ISOTIS STRAND PLUS MEDIUM 5CC 02-7100-050 1,404.59 278 Supply/Implants

053635 BO SEA SPINE ISOTIS STRAND PLUS LARGE 10CC 02-7100-100 2,608.52 278 Supply/Implants

053636 BO SEA SPINE BALLAST 45 X 11MM 02-8000-060 900.00 278 Supply/Implants

053639 IM ULRICH CAGE VBR SMALL 12MM 5,420.00 270 Med-Surg Supplies

053640 IM CERV CONST 2LVL ONE SURGICAL 1,550.00 278 Supply/Implants

053641 PL ULRICH UNION CERVICAL 2 LEVEL ALL SIZES 950.00 278 Supply/Implants

053643 IM CERVICAL CONST 3 LVL ONE SURGICAL 1,860.00 278 Supply/Implants

053644 SCR INTEGRITY TAURUS CANNULATED ALL SIZES 800.00 278 Supply/Implants

053645 SCR INTEGRITY TAURUS HEAD BODY ASSEMBLY ALL SIZES 100.00 278 Supply/Implants

053646 SCR INTEGRITY TAURUS SET LOCKING LUMBAR 50.00 278 Supply/Implants

053647 ROD INTEGRITY TAURUS LUMBAR ALL SIZES 294.00 278 Supply/Implants

053648 IM INTEGRITY FLAREHAWK SPLIT SHIM ALL SIZES 1,000.00 278 Supply/Implants






053654 SCR UCENTUM POLYAXIAL ALL SZS CS3802 900.00 278 Supply/Implants

053655 SCR UCENTUM LOCKING CS 3801-01 50.00 278 Supply/Implants

053656 ROD UCENTUM PRE BENT ALL SZS CS 8012 294.00 278 Supply/Implants

053659 PL ACUMED LATERAL DISTAL HUMERUS 6 HOLE LEFT PL-LEL6L 1,265.00 278 Supply/Implants

053660 PL ACUMED MEDIAL DISTAL HUMERUS 8 HOLE PL-LEM8 1,265.00 278 Supply/Implants

053661 PLATE TAP ACUMED FOR 3.0 SCREW 80-0659 403.00 278 Supply/Implants

053663 ROD MED 5.5MM TITANIUM CP 1553200500 200.00 278 Supply/Implants

053665 DRILL MED INFINITY 2.4MM G3606010 216.00 270 Med-Surg Supplies

053666 SCR MED INFINITY POST CERV ALL SIZES 650.00 278 Supply/Implants

053667 SCR MED INFINITY SET LOCKING 3600315 100.00 278 Supply/Implants

053668 ROD MED INFINITY POST CERV ALL SIZES 180.00 278 Supply/Implants

053669 PL NUVASIVE DECADE XLIF 2 HOLE ALL SIZES 3,000.00 278 Supply/Implants

053670 SCR NUVASIVE DECADE XLIF BOLT ALL SIZES 855.00 278 Supply/Implants

053671 BO AMENDIA NEVOS DBM PUTTY PLUS BNEPP0010 1,225.00 278 Supply/Implants

053672 SCR ONE SURG LUMBAR AL/SZS 970.6540 552.50 278 Supply/Implants

053673 ROD ONE SURG LUMBAR AL/SZS 923.5045 195.00 278 Supply/Implants

053674 SCR ONE SURG SET LUMBAR 915.1911 100.00 278 Supply/Implants

053676 STENT BOSTON SCIENTIFIC CONTOUR MOO61802240 230.72 270 Med-Surg Supplies

053677 GUIDEWIRE BOSTON SCIENTIFIC SENSOR M0066703080 82.83 270 Med-Surg Supplies

053678 GUIDEWIRE BOSTON SCIENTIFIC COATED PTFE 25.75 270 Med-Surg Supplies

053679 SU S/N TWINFIX ULTRA 4.5MM ANCHOR W/ TWO ULTRABRAID 72202893 230.00 278 Supply/Implants

053682 SUTURE PASSER 2" 72201407 34.32 270 Med-Surg Supplies

053683 MED NEURO EXTENSION KIT 40CM 3708140 681.00 270 Med-Surg Supplies

053685 ROD ASTURA 5.5 COCR 500MM ACCC55500 588.00 278 Supply/Implants

053686 BO AMENDIA ALLOS CERV SPACER BALC0009 AL SZS 620.00 278 Supply/Implants

053688 PL MED VIS/ ELITE CERV 60MM 7200060 606.40 278 Supply/Implants

053689 PL MED INFINITY POST CERV DOMINO 6.0 TO 3.5 3603635 617.00 278 Supply/Implants

053690 IM CTL LUMBAR CONSTR 2 LEVEL 4,200.00 278 Supply/Implants

053691 BO SEA SPINE BALLAST 85 X 11MM 02-8000-115 1,500.00 278 Supply/Implants

053696 INJECTION 0.9% SODIUM CHLORIDE 2.5ML 2.50 270 Med-Surg Supplies

053697 SWANSON FLEXSPAN FLEXIBLE HINGE TOE W/ GROMMETS ALSZS G4260101 1,432.00 278 Supply/Implants

053700 ST. JUDE 3228 CONTROL SYSTEM SCS 19,800.00 278 Supply/Implants

053701 SCR ARTHREX MINI FT 3.5 32MM AR-8730-32H 500.00 278 Supply/Implants

053702 REAMER ARTHREX CIRCULAR 18MM AR-8944MC-18 450.00 270 Med-Surg Supplies

053703 REAMER ARTHREX METATARSAL 18MM AR-8944MR-18 450.00 270 Med-Surg Supplies

053704 REAMER ARTHREX PHALANGEAL 16MM AR-8944PR-16 450.00 270 Med-Surg Supplies


053711 IM ZIMMER VITALITY LUM 1LVL CONST 07.02000 2,800.00 278 Supply/Implants

053712 IM CTL CERVICAL 4 LEVEL CONST 2,170.00 278 Supply/Implants

053713 BO GENSANO CANC CHIPS CRUSHED 10CC CCH-1410 350.00 278 Supply/Implants


053715 ROD MED DOMINO CONNECTOR 5.5MM 778145555 850.00 270 Med-Surg Supplies

053716 GUIDEWIRE MEDTRONIC 8670005 55.00 270 Med-Surg Supplies

053717 ROD MED SOLERA 60MM 1553201060 232.11 278 Supply/Implants

053718 SCR AES ENNOVATE LUMBAR PEDICLE ALL SIZES 800.00 278 Supply/Implants

053719 SCR AES ENNOVATE SET LOCKING CAP SY001TS 50.00 278 Supply/Implants

053720 ROD AES ENNOVATE ALL SIZES 294.00 278 Supply/Implants

053721 IM OMNIA FUJI CERVICAL 2 LEVEL CONSTRUCT 1,550.00 278 Supply/Implants

053723 BO GENSANO CANCELLOUS CHIPS 5CC CCH-41005 175.00 278 Supply/Implants

053726 PL OMNIA FUJI CERVICAL 3 LEVEL ALL SIZES 1,060.00 278 Supply/Implants

053727 SCR OMNIA FUJI CERVICAL FIX ANGLE SELF TAPPING ALL SIZES 100.00 278 Supply/Implants

053728 WIRE SYN KIRSCHNER W/ TROCAR 2.0MM 150MM 292.20 166.00 270 Med-Surg Supplies

053729 PL SYN LCP PROXIMAL HUMERUS 3.5MM 241.901 2,841.00 278 Supply/Implants

053730 SCR SYN 3.5.. LOCKING STARDRIVE 212.118 229.00 278 Supply/Implants

053731 SCR SYN 3.5MM LOCKING STARDRIVE 40MM 212.117 229.00 278 Supply/Implants





053736 SCR SYN CORTEX 28MM 204.828 45.00 278 Supply/Implants





053738 WIRE SYN KIRSCHNER TROCAR 1.25MM 150MM 292.12 166.00 270 Med-Surg Supplies

053744 MED NEURO PADDLE 90CM 977C290 6,076.00 278 Supply/Implants

3040000001 BLADDER SCAN 231.00 920 Other Dx Svs

3040000002 OBS BED DIRECT ADMIT 800.00 762 Observation Room

3040000003 OBSER ROOM PER HOUR 90.00 762 Observation Room

3040000004 Room Private 800.00 110 Room-Board/Pvt

3040000005 Ther/proph/diag iv inf init 731.00 260 Iv Therapy

3040000006 Ther/proph/diag iv inf addon 135.00 260 Iv Therapy

3040000007 Initial observation care, per day 800.00 762 Observation Room

3040000008 Negative Pressure Wound Therapy (Eg, Vacuum Assisted Drainage Collection), Including Topic...358.00 420 Physical Therp

3040000009 PICC Line 5 years and older 3,915.00 360 Or Services

3070000002 OR 1-60 MINUTES 4,620.00 360 Or Services

3070000003 OR EACH ADD 15 MIN 1,100.00 360 Or Services

3070000004 ANESTHESIA BASE RATE 686.00 370 Anesthesia

3070000005 ANESTH EA 15 MIN 174.00 370 Anesthesia

31000001 Recovery Room 1 to 60 Minutes 580.00 710 Recovery Room

31000002 Recovery Room additional 15 minutes 150.00 710 Recovery Room

3160000005 HEART/LUNG RESUSCIT 819.00 450 Emerg Room

3160000008 THER/PROPH/DIAG INJ, 128.00 450 Emerg Room

3160000010 ER ROOM LEVEL 1 120.00 450 Emerg Room

3160000011 ER ROOM LEVEL II 230.00 450 Emerg Room

3160000012 ER ROOM LEVEL III 350.00 450 Emerg Room

3160000013 ER ROOM LEVEL IV 460.00 450 Emerg Room

3220000003 VENIPUNCTURE 21.00 300 Laboratory

3220000004 COLLECTION BLD SPEC 21.00 300 Laboratory

3220000005 TRANSFUSION PLATELET 2,625.49 391 Blood/Admin

3220000006 TRANSFUSION BLOOD 302.00 391 Blood/Admin

3220000008 COL BLOOD/IMPLANT DE 72.00 300 Laboratory

3220000009 COLL BLD VIA IVLINE 199.00 300 Laboratory

3220000010 ARTERIAL PUNCTURE 91.00 300 Laboratory

3220000011 BASIC MET PANEL 81.20 300 Laboratory

3220000012 ELECROLYTE PANEL 67.34 300 Laboratory

3220000013 COMP MET PANEL 101.43 300 Laboratory

3220000014 LIPID PANEL 128.59 300 Laboratory

3220000016 ACUTE HEP PANEL 457.38 300 Laboratory

3220000021 DIGOXIN (LANOXIN) 127.47 300 Laboratory

3220000028 VANCOMYCIN PEAK/VALL 130.06 300 Laboratory

3220000033 URINEWITHMICROSCOPI 30.45 300 Laboratory

3220000034 URINALYSIS 21.56 300 Laboratory

3220000038 ALCOHOL URI/SER/BLD 65.00 300 Laboratory

3220000040 AMONIA PLASMA 139.93 300 Laboratory

3220000041 AMYLASE 62.23 300 Laboratory

3220000044 FECAL OCCULT BLD 31.22 300 Laboratory

3220000046 VITAMIN D3 25-OH 284.27 300 Laboratory

3220000048 INOZIDED CALCIUM I STAT 131.32 300 Laboratory

3220000056 SERUM CALCIUM 49.56 300 Laboratory

3220000057 SERUM CHOLESTEROL 41.79 300 Laboratory

3220000058 CORTISOL SERUM 156.52 300 Laboratory

3220000059 CK TOTAL 62.51 300 Laboratory

3220000061 CK MB & CK TOTAL 110.88 300 Laboratory

3220000062 CREATININE 49.21 300 Laboratory

3220000063 CREATININE EXCLUDING BLOOD 49.70 300 Laboratory

3220000064 VITAMIN B12 144.76 300 Laboratory

3220000066 VITAMIN D 1 25 DIOH 268.90 300 Laboratory

3220000067 ESTRADIOL 268.24 300 Laboratory

3220000068 ESTROGEN 208.32 300 Laboratory

3220000069 FERRITIN 130.90 300 Laboratory

3220000070 FOLIC ACID SERUM 141.19 300 Laboratory

3220000074 I STAT 185.78 300 Laboratory




3220000076 GLUCOSE FASTING 37.73 300 Laboratory

3220000077 GLUCOSE RANDOM 37.73 300 Laboratory

3220000079 GLUCOSE ISTAT 37.73 300 Laboratory

3220000080 FINGERSTICK 22.47 300 Laboratory

3220000081 GGT 69.16 300 Laboratory

3220000086 HEMOGLOBIN A1C 82.95 300 Laboratory

3220000090 IRON 53.48 300 Laboratory

3220000091 IRON BINDING CPCY 83.93 300 Laboratory

3220000092 LACTIC ACID 102.55 300 Laboratory

3220000096 LIPASE SERUM 66.15 300 Laboratory

3220000099 MAGNESIUM 64.33 300 Laboratory

3220000104 B-TYPE NATRIURETIC 325.92 300 Laboratory

3220000106 NICOTINE 823.55 300 Laboratory

3220000122 PARATHYROID HORMONE 396.34 300 Laboratory

3220000128 PHOS INORG SERUM 45.50 300 Laboratory

3220000129 POTASSIUM 44.17 300 Laboratory

3220000130 POTASSIUM ISTAT 44.17 300 Laboratory

3220000131 PREALBUMIN 140.07 300 Laboratory

3220000134 PROLACTIN 186.06 300 Laboratory

3220000135 PROTEIN 35.21 300 Laboratory

3220000144 SODIUM SERUM 46.20 300 Laboratory

3220000145 SODIUM ISTAT 46.20 300 Laboratory

3220000149 TESTERONE FREE 244.58 300 Laboratory

3220000150 TESTOSTERONE 247.87 300 Laboratory

3220000151 T4 TOTAL 65.94 300 Laboratory

3220000152 T4 FREE 86.59 300 Laboratory

3220000153 TSH 161.35 300 Laboratory

3220000156 TRIGLYCERIDE 55.16 301 Lab/Chemistry

3220000157 T3/T4 UPTAKE 62.09 300 Laboratory

3220000158 T3 TOTAL 136.15 300 Laboratory

3220000159 T3 FREE 162.68 300 Laboratory

3220000160 TROPONIN 94.50 300 Laboratory

3220000161 BLOOD UREA NITROGEN 37.94 300 Laboratory

3220000162 URIC ACID 43.40 300 Laboratory

3220000165 HCG URINE QUAL 72.24 300 Laboratory

3220000168 HEMATOCRIT ISTAT 22.75 300 Laboratory

3220000169 HEMATOCRIT 22.75 300 Laboratory

3220000170 HEMOGLOBIN BLOOD 22.75 300 Laboratory

3220000171 CBC/PLATELETS/RDW 74.62 300 Laboratory

3220000172 HEMOGRAM 62.09 300 Laboratory

3220000174 RETICULOCYTE COUNT 38.36 300 Laboratory

3220000175 WBC 24.36 300 Laboratory

3220000176 PLATELET AUTOMATED 42.98 300 Laboratory

3220000177 BLOOD SMEAR INTERPRETATION 184.00 305 Lab/Hemotology

3220000179 D-DIMER 97.72 300 Laboratory

3220000180 FIBRINOGEN 81.55 300 Laboratory

3220000182 BLOOD PLATELET AGGRE 206.29 300 Laboratory

3220000183 ANTI PLATELET MEDICA 206.29 300 Laboratory

3220000184 PROTIME 37.73 300 Laboratory

3220000185 SED RATE WESTERGRN 34.09 300 Laboratory

3220000187 APPT 57.68 300 Laboratory

3220000188 ANA SCREEN 116.06 300 Laboratory

3220000190 CRP QUANT 49.70 300 Laboratory

3220000194 COMP TOT CH50 195.16 300 Laboratory

3220000201 RHEUMATOID QUANT 54.46 300 Laboratory

3220000221 VARICELLA ZOSTER TITER 123.69 300 Laboratory

3220000223 HEP C ANTIBODY 136.99 300 Laboratory

3220000225 HLA B27 240.24 300 Laboratory

3220000228 RED CELL PANEL ADD'L Antibody ID 152.00 300 Laboratory

3220000229 DIRECT ANTIGLOBULIN 51.73 300 Laboratory




3220000230 COOMBS INDIRECT 54.95 300 Laboratory

3220000232 AUTO BLOOD SALVAGE 107.10 300 Laboratory

3220000233 BLOOD TYPING ABO 28.70 300 Laboratory

3220000234 BLOOD TYPING RH 28.70 300 Laboratory

3220000236 FYA ANTIGEN TYPE 152.00 300 Laboratory

3220000237 FYB ANTIGEN TYPE 152.00 300 Laboratory

3220000238 JKA ANTIGEN TYPE 152.00 300 Laboratory

3220000240 K ANTIGEN TYPE 152.00 300 Laboratory

3220000243 M ANTIGEN TYPE 152.00 300 Laboratory

3220000244 N ANTIGEN TYPE 152.00 300 Laboratory

3220000245 S ANTIGEN TYPE 152.00 300 Laboratory

3220000247 C ANTIGEN TYPE 152.00 300 Laboratory

3220000248 E ANTIGEN TYPE 152.00 300 Laboratory

3220000249 DTT SERUM PRETREATME 152.00 300 Laboratory

3220000250 C ANTIGEN TYPE (LC) 152.00 300 Laboratory

3220000255 CROSSMATCH 185.00 300 Laboratory

3220000260 FRESH FROZEN PLASMA THAW 354.00 300 Laboratory

3220000263 CULTURE BLOOD 99.12 300 Laboratory

3220000265 CULT AEROBE 82.74 300 Laboratory

3220000266 ANAEROBE CULTURE 90.93 300 Laboratory

3220000267 ORGANISM IDENTIFICATION 77.56 300 Laboratory

3220000268 CULTURE URINE 77.49 300 Laboratory

3220000270 ORGANISM ID URINE 59.08 300 Laboratory

3220000272 FUNGUS CULTURE 80.71 300 Laboratory

3220000277 CULTURE AFB W/PRESUM 103.74 300 Laboratory

3220000281 CULT SENS MIC 83.02 300 Laboratory

3220000282 GRAM SMEAR 41.02 300 Laboratory

3220000284 C. DIFF A AND B EIA 310.31 300 Laboratory

3220000287 HEPATITIS C VIRUS RNA QUANT PCR 411.32 300 Laboratory

3220000294 CYTOPATH EVAL FNA REPORT 184.00 311 Pathol/Cytology

3220000302 TISSUE EXAM BY PATHOLOGIST III 184.05 310 Pathology Lab

3220000303 TISSUE EXAM LEVEL IV 184.05 310 Pathology Lab

3220000304 TISSUE EXAM LEVEL V 288.30 310 Pathology Lab

3220000306 DECALCIFY TISSUE 55.80 310 Pathology Lab

3220000308 SPECIAL STAINS GROUP 2 85.40 310 Pathology Lab

3220000317 IMMUNOHISTOCHEMISTRY 184.05 310 Pathology Lab

3220000326 BODY FLUID CELL COUNT & DIFF 52.85 300 Laboratory

3220000327 CRYSTAL EXM JOINT 68.67 300 Laboratory

3220000354 MANUAL DIFFERENTIAL 32.97 300 Laboratory

3220000357 RED BLOOD UNIT 475.00 390 Blood/Stor-Proc

3220000359 FRESH FROZEN PLASMA 399.00 383 Blood/Plasma

3220000367 Protien, Electrophoretic Fractionation And Quantitation, Serum 103.11 300 Laboratory

3220000368 Cyckuc Citrullnated Peptide ( CCP), Antibody 124.32 300 Laboratory

3220000386 ODNA 55.00 310 Pathology Lab

3220000387 PRBC 725.00 310 Pathology Lab

3220000396 Culture, Presumptive, Pathogenic Organisms, Screening Only; 63.63 300 Laboratory

3220000397 A1 Type 36.75 300 Laboratory

3220000420 Urinalysis Nonauto W/O Scope 22.47 300 Laboratory

3220000421 Drug Scrn 1+ Class Nonchromo 100.00 300 Laboratory

3220000422 Assay Of Urine Creatinine 49.70 300 Laboratory

3220000424 Assay Of Amitriptyline 107.26 300 Laboratory

3220000425 Assay Of Benzodiazepines 17.85 300 Laboratory

3220000426 Assay Of Ethanol 107.14 300 Laboratory

3220000427 Assay Of Amphetamines 53.57 300 Laboratory

3220000428 Column Chromatography/Mass Spectrometry 173.39 300 Laboratory

3220000429 Assay Of Cocaine 107.14 300 Laboratory

3220000430 Column Chromotography Quant 173.39 300 Laboratory

3220000431 Assay Of Dihydrocodeinone 53.57 300 Laboratory

3220000432 Assay Of Dihydromorphinone 107.14 300 Laboratory

3220000433 Mass Spectrometry Quant 173.39 300 Laboratory




3220000434 Assay Of Meprobamate 53.57 300 Laboratory

3220000435 Assay Of Methadone 107.14 300 Laboratory

3220000436 Assay Of Opiates 53.57 300 Laboratory

3220000437 Assay For Phencyclidine 141.19 300 Laboratory

3220000440 Assay Of Benzodiazepines 17.85 300 Laboratory

3220000442 Assay Of Ethanol 107.14 300 Laboratory

3220000445 Assay Of Cocaine 107.14 300 Laboratory



3220000451 Assay Of Meprobamate 53.57 300 Laboratory

3220000453 Assay Of Methadone 107.14 300 Laboratory


3220000458 Antidepressants, Tricyclic And Other Cyclicals 1 Or 2 107.26 300 Laboratory

3220000460 Amphetamines, 1 Or 2 53.57 300 Laboratory

3220000466 Rare Antisera 412.08 300 Laboratory

3220000467 Beta-2-Transferrin 281.82 300 Laboratory

3220000476 QuantiFERON Gold TB 595.14 300 Laboratory

3220000477 Varicella Zoster Antibody IGM 111.30 300 Laboratory

3220000478 Nicotine Serum / plasma 434.65 300 Laboratory

3310000004 XR NASAL 3V 254.00 320 Dx X-Ray

3310000008 XR SKULL1-3V 303.00 320 Dx X-Ray

3310000010 XR CHEST 1V 252.00 320 Dx X-Ray

3310000011 XR CHEST 2V 272.00 320 Dx X-Ray

3310000013 XR RIB UNI 2V 234.00 320 Dx X-Ray

3310000019 XR SPINE 1V 263.00 320 Dx X-Ray

3310000020 XR C-SP 2-3V 303.00 320 Dx X-Ray

3310000021 XR C-SP 4V 396.00 320 Dx X-Ray

3310000023 XR SCOLI 469.00 320 Dx X-Ray

3310000024 XR T-SP 2V 234.00 320 Dx X-Ray

3310000026 XR T-SP 4V 303.00 320 Dx X-Ray

3310000027 XR T-L 2V 234.00 320 Dx X-Ray

3310000028 XR L-SP 2-3V 303.00 320 Dx X-Ray

3310000029 XR L-SP 4V 396.00 320 Dx X-Ray

3310000030 XR L-SP 6V 396.00 320 Dx X-Ray

3310000032 XR PELVIS 1-2V 234.00 320 Dx X-Ray

3310000034 XR SI JT 1-2V 234.00 320 Dx X-Ray

3310000035 XR SI JT 3V 254.00 320 Dx X-Ray

3310000036 XR SACRUM & COCCYX 2V 234.00 320 Dx X-Ray

3310000037 XR MYELO C-SP 2,538.00 320 Dx X-Ray

3310000039 XR MYELO L-SP 2,538.00 320 Dx X-Ray

3310000040 XR MYELO ENTIRE 2,538.00 320 Dx X-Ray

3310000044 XR SHOULDER 2V 254.00 320 Dx X-Ray

3310000047 XR HUMERUS 2V 254.00 320 Dx X-Ray

3310000048 XR ELBOW 2V 234.00 320 Dx X-Ray

3310000049 XR ELBOW 3V 234.00 320 Dx X-Ray

3310000052 XR WRIST 2V 234.00 320 Dx X-Ray

3310000053 XR WRIST 3V 254.00 320 Dx X-Ray

3310000054 XR HAND 2V 234.00 320 Dx X-Ray

3310000055 XR HAND 3V 254.00 320 Dx X-Ray

3310000056 XR FINGER 2-3V 234.00 320 Dx X-Ray

3310000057 XR HIP UNI 1V 234.00 320 Dx X-Ray

3310000058 XR HIP UNI 2V 254.00 320 Dx X-Ray

3310000059 XR HIP BILAT 2V 354.00 320 Dx X-Ray

3310000062 XR KNEE 1-2V 234.00 320 Dx X-Ray

3310000063 XR KNEE 3V 254.00 320 Dx X-Ray

3310000064 XR KNEE 4V 354.00 320 Dx X-Ray

3310000067 XR TIBFIB 2V 254.00 320 Dx X-Ray

3310000068 XR ANKLE 2V 234.00 320 Dx X-Ray

3310000069 XR ANKLE 3V 234.00 320 Dx X-Ray

3310000070 XR FOOT 2V 234.00 320 Dx X-Ray




3310000071 XR FOOT 3V 254.00 320 Dx X-Ray

3310000074 XR ABD 1V 234.00 320 Dx X-Ray

3310000076 XR ABD 2V 264.00 320 Dx X-Ray

3310000077 XR ABD ACUTE 396.00 320 Dx X-Ray

3310000080 XR NG TUBE 122.00 320 Dx X-Ray

3310000081 XR FLUORO- 426.00 320 Dx X-Ray

3310000082 XR FLUORO+ 442.00 320 Dx X-Ray

3310000087 INJ.FOR MYELOGRAM 483.00 360 Or Services

3310000089 Fluoro guidance and localization spine or paraspinous diagnostic 426.00 320 Dx X-Ray

3310000094 PICC LINE >5 3,915.00 320 Dx X-Ray

3310000098 Myelography Cervical Injection 3,072.00 320 Dx X-Ray

3310000099 Myelography Thoracic Injection 3,072.00 320 Dx X-Ray

3310000100 Myelography Lumbarsacral Injection 3,072.00 320 Dx X-Ray

3310000101 Myelography Injection 2 Or More Region 3,072.00 320 Dx X-Ray

3310000114 XR CHEST 1V 252.00 320 Dx X-Ray

3310000115 XR Chest 2V 272.00 320 Dx X-Ray

3310000118 XR ABD 1V 234.00 320 Dx X-Ray

3310000119 XR ABD 2V 264.00 320 Dx X-Ray

3310000120 XR ABD 3V or more 303.00 320 Dx X-Ray

3310000121 Insertion of Central Line 1,364.40 320 Dx X-Ray

3340000001 MRI ORB/NCK WO 1,921.00 614 Mri Other

3340000004 MRI BRAIN WO 1,921.00 611 Mri Brain

3340000006 MRI BRAIN W&WO 2,784.00 611 Mri Brain

3340000007 MRI C-SP WO 1,921.00 612 Mri Spine

3340000009 MRI T-SP WO 1,921.00 612 Mri Spine

3340000011 MRI L-SP WO 1,921.00 612 Mri Spine

3340000012 MRI L-SP W 2,273.00 612 Mri Spine

3340000013 MRI C-SP W&WO 2,784.00 612 Mri Spine

3340000014 MRI T-SP W&WO 2,784.00 612 Mri Spine

3340000015 MRI L-SP W&WO 2,784.00 612 Mri Spine

3340000016 MRI PELVIS WO 1,921.00 614 Mri Other

3340000018 MRI PELIS W&WO 2,784.00 614 Mri Other

3340000019 MRI UP EXT WO 1,921.00 614 Mri Other

3340000022 MRI UP JNT WO 1,921.00 614 Mri Other

3340000024 MRI UP JNT W&WO 2,784.00 614 Mri Other

3340000025 MRI LOW EXT WO 1,921.00 614 Mri Other

3340000027 MRI LOW EXT W&WO 2,784.00 614 Mri Other

3340000028 MRI LOW JNT WO 2,041.00 614 Mri Other

3370000001 CT HEAD WO 1,019.00 350 Ct Scan

3370000002 CT HEAD W 1,397.00 350 Ct Scan

3370000003 CT HEAD W&WO 1,628.00 350 Ct Scan

3370000004 CT ORBIT WO 1,019.00 350 Ct Scan

3370000006 CT SINUS/FACE 1,019.00 350 Ct Scan

3370000008 CT NECK WO 1,019.00 350 Ct Scan

3370000009 CT NECK W 1,397.00 350 Ct Scan

3370000010 CT NECK W&WO 1,628.00 350 Ct Scan

3370000012 CT CHEST WO 1,019.00 350 Ct Scan

3370000013 CT CHEST W 1,397.00 350 Ct Scan

3370000014 CT CHEST W&WO 1,628.00 350 Ct Scan

3370000015 CTA CHEST 1,764.00 350 Ct Scan

3370000016 CT C-SP WO 1,019.00 350 Ct Scan

3370000017 CT T-SP WO 1,019.00 350 Ct Scan

3370000018 CT T-SP W&WO 1,628.00 350 Ct Scan

3370000019 CT L-SP WO 1,200.00 350 Ct Scan

3370000020 CT L-SP W&WO 1,628.00 350 Ct Scan

3370000021 CT PELVIS WO 1,019.00 350 Ct Scan

3370000022 CT PELVIS W 1,397.00 350 Ct Scan

3370000024 CT UP EXT WO 1,019.00 350 Ct Scan

3370000025 CT LOW EXT WO 1,019.00 350 Ct Scan

3370000028 CT ABD WO 1,019.00 350 Ct Scan




3370000030 CT ABD W&WO 1,628.00 350 Ct Scan

3370000031 CT ABD/PELV WO 1,530.00 350 Ct Scan

3370000032 CT ABD/PELV W 2,413.00 350 Ct Scan

3370000033 CT ABD/PELV W&WO 2,413.00 350 Ct Scan

3370000034 CT RECON 506.00 350 Ct Scan

3370000035 CT GUIDED BX 1,394.00 350 Ct Scan

3370000037 Ct Lumbar Spine W/Contrast 1,245.00 350 Ct Scan

3370000038 Ct Thoracic Spine W/Contrast 1,245.00 350 Ct Scan

3370000039 Ct Cervical Spine W/Contrast 1,245.00 350 Ct Scan

3370000041 CT GUIDED 1,394.00 350 Ct Scan

3400000004 US VEN BI LOW/UP 1,547.00 483 Echocardiology

3400000005 US VEN UNI LOW/UP 738.00 483 Echocardiology

3430000002 COENZYME Q-10 100 MG / 1 cap 4.00 250 Pharmacy

3430000005 Diovan HCT 160/12.5 Tablet 18.85 250 Pharmacy

3430000006 Synthroid 125 mcg Tablet 4.00 250 Pharmacy

3430000007 Melatonin 5 mg Tablet 4.00 250 Pharmacy

3430000008 Hyzaar 100/25 Tablet 13.75 250 Pharmacy

3430000009 Hyzaar 50/12.5 Tablet 10.00 250 Pharmacy

3430000011 Lisinopril HCTZ 20/12.5 Tablet 5.00 250 Pharmacy

3430000012 Lisinopril 40mg Tablet 6.30 250 Pharmacy

3430000013 Viibryd 20 mg Tablet 18.00 250 Pharmacy

3430000014 Lisinopril/HCTZ 10/12.5 Tablet 4.50 250 Pharmacy

3430000015 Synthroid 112 mcg Tablet 4.00 250 Pharmacy

3430000016 GI COCKTAIL 10 ML / 10 ML 40.00 250 Pharmacy

3430000017 Tricor 48mg Tablet 7.75 250 Pharmacy

3430000018 PRADAXA 75 MG 19.00 250 Pharmacy

3430000019 TYLENOL #3 TAB 30/300 1 EA 6.00 250 Pharmacy

3430000021 Tricor 145mg Tablet 20.60 250 Pharmacy

3430000022 ALEVE 220 MG / 1 tab 4.00 250 Pharmacy

3430000023 Butrans 5 mcg Patch 176.00 250 Pharmacy

3430000024 Apidra 10ml Vial 250.00 250 Pharmacy

3430000025 Lunesta 3 mg tablet 39.50 250 Pharmacy

3430000026 Bisoprolol 5 mg tablet 4.00 250 Pharmacy

3430000027 FIBERCON 650MG 4.00 250 Pharmacy

3430000028 JANUMET XR 39.50 250 Pharmacy

3430000030 NIZORAL CREAM 30 GM 110.00 250 Pharmacy

3430000031 AMARYL 4 MG 4.90 250 Pharmacy

3430000032 ALLEGRA 180 MG 4.50 250 Pharmacy

3430000033 RYTHMOL 150 MG 12.00 250 Pharmacy

3430000035 NaCl 10% 25.00 250 Pharmacy

3430000037 Verapamil CR 120mg 10.00 250 Pharmacy

3430000039 Cymbalta 60mg 35.00 250 Pharmacy

3430000040 Accupril 10mg 4.90 250 Pharmacy

3430000041 Cytomel 5mcg 4.00 250 Pharmacy

3430000042 MAGNESIUM SULFATE 1 gm / 2 ML 10.00 636 Drugs/Detail Code

3430000045 Vitamin D-3 2000 units 4.00 250 Pharmacy

3430000048 XALATAN 0.005% EYE DROPS 5 ML 325.00 250 Pharmacy

3430000049 Myers Cocktail 450.00 250 Pharmacy

3430000053 Abilify 5mg 105.00 250 Pharmacy

3430000056 Lotrel 5/20 11.50 250 Pharmacy

3430000058 Prometrium 100mg 5.00 250 Pharmacy

3430000060 Estrogen/Testosterone 1.25/2.5 5.00 250 Pharmacy

3430000061 Hyaluronidase 150 units/ml 172.00 636 Drugs/Detail Code

3430000064 SYMBICORT INHALER 1 EA 510.00 250 Pharmacy

3430000067 SILVER NITRATE STICKS 1 EA 4.00 250 Pharmacy

3430000069 ZOCOR 40 MG 20.00 250 Pharmacy

3430000070 CYMBALTA 20 MG / 1 cap 15.00 250 Pharmacy

3430000071 VITAMIN D 50,000 UNITS 5.75 250 Pharmacy

3430000077 Zyloprim 100mg 4.00 250 Pharmacy

3430000080 Dicyclomine 10 mg capsule 4.00 250 Pharmacy




3430000081 Levothyroxine 88mcg 4.00 250 Pharmacy

3430000084 Nitroglycerin 100mg/250ml 44.00 250 Pharmacy

3430000085 VICTOZA 2-PAK 36 MG / 6 ML 700.00 250 Pharmacy

3430000091 Hydrochlorothiazide 12.5 mg 4.00 250 Pharmacy

3430000092 Magnesium Oxide 400mg 4.00 250 Pharmacy

3430000093 Probiotic 4.00 250 Pharmacy

3430000094 Ketamine 20 mg 20.00 250 Pharmacy

3430000095 Ketamine 50 mg 40.00 250 Pharmacy

3430000096 TPN 1,000.00 250 Pharmacy

3430000097 Apresoline 25mg 4.00 250 Pharmacy

3430000098 Risperdal 1mg 181.50 250 Pharmacy

3430000100 PLAQUENIL 200 MG / 1 tab 4.00 250 Pharmacy

3430000102 Tetracaine 0.5% Eye Drops 40.00 250 Pharmacy

3430000105 Humalog(Novolog) 75/25 150.00 250 Pharmacy

3430000110 Elavil 100 mg 4.00 250 Pharmacy

3430000111 Mirapex 0.5 mg 4.00 250 Pharmacy

3430000112 Metformin 850 mg 4.00 250 Pharmacy

3430000116 Pravachol 20 mg 13.00 250 Pharmacy

3430000117 Zyprexa 5mg 4.00 250 Pharmacy

3430000119 Ancef 3gm IVPB 450.00 250 Pharmacy

3430000120 Hydromorphone 10mg/ml 12.00 250 Pharmacy

3430000123 Sodium Bicarbonate Syringe 21.00 250 Pharmacy

3430000126 NIMBEX VIAL 2 MG / 1 ML 100.00 250 Pharmacy

3430000127 Normal Saline KCL 20meq 88.00 250 Pharmacy

3430000128 ADVAIR DISKUS PWD 500/50 500 mcg / 1 EA 760.00 250 Pharmacy

3430000129 Potassium Chloride 20meq 20.00 636 Drugs/Detail Code

3430000130 Neurontin 600mg 10.00 250 Pharmacy

3430000133 Questran 4 gm 25.00 250 Pharmacy

3430000137 MOTRIN 800 MG / 1 tab 4.00 250 Pharmacy

3430000138 DIAMOX 500 MG / 1 cap 7.00 250 Pharmacy

3430000140 COZAAR 50 MG / 1 tab 9.00 250 Pharmacy

3430000151 FOLIC ACID 1 MG / 1 tab 4.00 250 Pharmacy

3430000154 HYALGAN SYR 20 ML / 2 ML 44.00 636 Drugs/Detail Code

3430000155 K-DUR 10 MEQ / 1 tab 4.00 250 Pharmacy

3430000156 LANTUS INSULN 100 units / 1 ML 400.00 250 Pharmacy

3430000157 EPINEPHRINE 1 MG / 1 ML 17.00 636 Drugs/Detail Code

3430000158 EPINEPHRINE VIAL 30 ML 500.00 250 Pharmacy

3430000159 TORADOL VIAL 60 MG / 1 ML 30.00 636 Drugs/Detail Code

3430000160 GARAMYCIN IVPB 200 MG 30.00 258 Iv Solutions

3430000161 OXYCONTIN CR 10 MG / 1 tab 10.00 250 Pharmacy

3430000163 VANCOMYCIN IVPB 1 gm 100.00 258 Iv Solutions

3430000164 NICOTINE PATCH 21 MG / 1 EA 16.00 250 Pharmacy

3430000165 DECADRON VIAL 10 MG / 1 ML 17.00 636 Drugs/Detail Code

3430000166 MILK/MAGNESIA LIQ 30 ML 4.00 250 Pharmacy

3430000167 DEPO-MEDROL VIAL 80 MG / 1 ML 65.00 636 Drugs/Detail Code

3430000168 LORTAB 7.5/500 8.00 250 Pharmacy

3430000171 NAFCILLIN 2 gm / 1 vial 25.00 250 Pharmacy

3430000173 NORMAL SALINE 1000 ML 88.00 258 Iv Solutions

3430000177 DIFLUCAN IVPB 400 MG / 200 ML 675.00 258 Iv Solutions

3430000179 ANCEF 1 gm / 1 vial 35.00 636 Drugs/Detail Code

3430000181 ROBITUSSIN DM SYRUP 30 ML 6.00 250 Pharmacy

3430000183 NESACAINE MPF 2% VIAL 20 ML 110.00 636 Drugs/Detail Code

3430000185 NEOSTIGMINE 1:1000 VIAL 10 ML 130.00 250 Pharmacy

3430000186 ROBINUL 5ml VIAL 0.2 MG / 1 ML 140.00 250 Pharmacy

3430000187 ROBAXIN IVPB 750 MG / 100 ML 100.00 258 Iv Solutions

3430000190 LUNESTA 1 MG / 1 tab 16.00 250 Pharmacy

3430000191 HEXTEND 6% BAG 500 ML 155.00 258 Iv Solutions

3430000193 EPHEDRINE VIAL 50 MG / 1 ML 140.00 250 Pharmacy

3430000194 D5-1/2NS + KCL 20MEQ 20 MEQ / 1000 ML 88.00 258 Iv Solutions

3430000195 LIDOCAINE 4 % / 5 ML 35.00 250 Pharmacy




3430000196 NEOSYNEPHRINE VIAL 10 MG / 1 ML 13.00 636 Drugs/Detail Code

3430000197 KENALOG VIAL 40 MG / 1 ML 50.00 636 Drugs/Detail Code

3430000198 LTA KIT 1 syringe 68.00 250 Pharmacy

3430000200 DIPRIVAN 20ML VIAL 10 MG / 1 ML 100.00 636 Drugs/Detail Code

3430000201 REGLAN VIAL 10 MG / 2 ML 12.00 636 Drugs/Detail Code

3430000202 PERCOCET 10/325 10 MG / 1 tab 15.00 250 Pharmacy

3430000203 NEURONTIN 300 MG / 1 cap 6.00 250 Pharmacy

3430000205 SOMA 350 MG / 1 tab 16.00 250 Pharmacy

3430000206 CARMEX 1 OZ / 1 EA 5.00 250 Pharmacy

3430000208 MAALOX SUSP 30 ML 10.00 250 Pharmacy

3430000211 FENTANYL AMPULE 250 mcg / 5 ML 30.00 636 Drugs/Detail Code

3430000212 MORPHINE SULFATE 150 MG / 30 ML 70.00 636 Drugs/Detail Code

3430000213 LASIX VIAL 40 MG / 4 ML 10.00 636 Drugs/Detail Code

3430000214 NAROPIN VIAL 0.5% 0.5 % / 1 ML 65.00 250 Pharmacy

3430000215 CYMBALTA 30 MG / 1 cap 16.00 250 Pharmacy

3430000222 Phenol 8% 60.00 250 Pharmacy

3430000223 ROBAXIN 750 MG / 1 tab 5.00 250 Pharmacy

3430000224 TORADOL VIAL 30 MG / 1 ML 15.00 636 Drugs/Detail Code

3430000225 VERSED VIAL 5 MG / 5 ML 55.00 636 Drugs/Detail Code

3430000226 ISOVUE-M 200 41% VIAL 10 ML 62.00 255 Drugs/Incident Rad

3430000227 CLEOCIN IVPB 600 MG / 50 ML 90.00 258 Iv Solutions

3430000228 REGLAN 10 MG / 1 tab 8.00 250 Pharmacy


3430000230 FENTANYL VIAL 100 mcg / 2 ML 20.00 636 Drugs/Detail Code

3430000231 ZANAFLEX 4 MG 8.00 250 Pharmacy

3430000232 LIDOCAINE 1 % / 30 ML 50.00 636 Drugs/Detail Code

3430000233 MORPHINE VIAL 8 MG / 1 ML 10.00 250 Pharmacy

3430000234 NORMAL SALINE 0.9 % / 20 ML 7.00 258 Iv Solutions

3430000236 CHLORASEPTIC SPRAY 20 ML 8.00 250 Pharmacy

3430000237 ISOVUE-M 200 41% VIAL 20 ML 58.00 255 Drugs/Incident Rad

3430000238 SODIUM BICARBONATE 4.2 % / 5 ML 30.00 250 Pharmacy

3430000239 CLEOCIN IVPB 900 MG / 50 ML 95.00 258 Iv Solutions

3430000240 BUFFERED LIDOCAINE 1 % / 1 ML 15.00 636 Drugs/Detail Code

3430000241 AMBIEN 10 MG 15.00 250 Pharmacy

3430000243 KEFLEX 500 MG / 1 cap 13.00 250 Pharmacy

3430000244 XANAX 0.5 MG / 1 tab 10.00 250 Pharmacy

3430000245 MORPHINE VIAL 10 MG / 1 ML 10.00 636 Drugs/Detail Code

3430000246 PRILOSEC 20 MG / 1 cap 20.00 250 Pharmacy

3430000247 Ultiva Syr 50 mcg/2ml 25.00 250 Pharmacy

3430000249 DEMEROL VIAL 25 MG / 1 ML 6.00 636 Drugs/Detail Code

3430000250 RESTORIL 15 MG 5.00 250 Pharmacy

3430000251 BACITRACIN POWDER 50000 units / 1 vial 90.00 250 Pharmacy

3430000252 MARCAINE 0.5% VIAL 10 ML 45.00 250 Pharmacy


3430000254 BETAMETHASONE 12 MG / 1 ML 75.00 250 Pharmacy

3430000255 LIDOCAINE 2% VIAL 20 MG / 5 ML 10.00 636 Drugs/Detail Code

3430000256 DURAMORPH 10 MG / 10 ML 40.00 636 Drugs/Detail Code

3430000257 TRANSDERM-SCOP 1.5 MG 85.00 250 Pharmacy

3430000258 NEXIUM 20 MG / 1 cap 15.00 250 Pharmacy

3430000259 DILAUDID 2 MG / 1 tab 6.00 250 Pharmacy

3430000260 BUPIVACAINE SDV 0.25% 10 ML 20.00 250 Pharmacy


3430000262 DEPO-MEDROL VIAL 40 MG / 1 ML 40.00 636 Drugs/Detail Code

3430000263 TUMS 500 MG 4.00 250 Pharmacy

3430000264 ARTLINE 2 units/ml 500 ML 88.00 258 Iv Solutions

3430000265 GELFOAM 12-7 1 EA 135.00 250 Pharmacy

3430000266 LIDODERM 5% PATCH 1 patch 30.00 250 Pharmacy

3430000267 CELL SAVER 500 ML 88.00 636 Drugs/Detail Code

3430000268 METHADONE 10 MG / 1 tab 6.00 250 Pharmacy

3430000270 VERSED VIAL 2 MG / 2 ML 30.00 636 Drugs/Detail Code




3430000271 NORMAL SALINE FLUSH 3 ML 10.00 250 Pharmacy

3430000272 FIORICET 1 tab 6.00 250 Pharmacy

3430000273 NOVOLIN R 100 units / 1 ML 30.00 250 Pharmacy

3430000274 THROMBIN 5000 units 360.00 250 Pharmacy

3430000275 D5-1/2NS 1000 ML 88.00 258 Iv Solutions

3430000276 MARCAINE/EPI 0.25%/1:200 30 ML 40.00 250 Pharmacy

3430000277 GELFOAM PWD 1 EA 365.00 250 Pharmacy

3430000278 ZOLOFT 50 MG 12.00 250 Pharmacy

3430000279 LABETALOL VIAL 5 MG / 1 ML 50.00 250 Pharmacy

3430000280 THROMBIN 20000 units 1,486.00 250 Pharmacy

3430000281 Aricept 10mg 10.00 250 Pharmacy

3430000282 CEPACOL LOZ 1 tab 4.00 250 Pharmacy

3430000283 BENADRYL 50 MG / 1 ML 8.00 636 Drugs/Detail Code

3430000285 PREVACID 15 MG / 1 cap 10.00 250 Pharmacy

3430000286 TYLENOL 325 MG / 1 tab 4.00 250 Pharmacy

3430000287 NORCO TAB 7.5/325 7.5 MG / 1 tab 8.00 250 Pharmacy

3430000288 MEDROL DOSPAK 4 MG / 1 EA 100.00 636 Drugs/Detail Code

3430000289 URECHOLINE 25 MG / 1 tab 8.00 250 Pharmacy

3430000290 LISINOPRIL 10 MG / 1 tab 6.00 250 Pharmacy

3430000291 CIPRO 500 MG / 1 tab 25.00 250 Pharmacy

3430000292 MAGNESIUM CITRATE 300 ML 10.00 250 Pharmacy

3430000294 HYDROCHLOROTHIAZIDE 25 MG / 1 tab 4.00 250 Pharmacy

3430000295 OXY-IR 5 MG / 1 tab 10.00 250 Pharmacy

3430000296 AMBIEN 5 MG 20.00 250 Pharmacy

3430000297 HUMALOG 100 units / 1 ML 60.00 250 Pharmacy

3430000298 DECADRON 4 MG / 1 vial 10.00 636 Drugs/Detail Code

3430000299 BENADRYL 50 MG / 1 cap 4.00 250 Pharmacy

3430000300 NORCO TAB 10/325 10 MG / 1 tab 8.00 250 Pharmacy

3430000301 LYRICA 25 MG / 1 tab 10.00 250 Pharmacy

3430000302 D5NS 1000 ML 88.00 258 Iv Solutions

3430000303 DECADRON 4 MG / 1 tab 10.00 250 Pharmacy

3430000304 ANCEF IVPB 2 gm 300.00 258 Iv Solutions

3430000306 XOPENEX 1.25 MG / 3 ML 13.00 250 Pharmacy

3430000307 BACTROBAN OINT 22 gm / 1 EA 100.00 250 Pharmacy

3430000308 NORMAL SALINE INHALATION 3 ML 4.00 250 Pharmacy

3430000309 OFIRMEV 1000 MG / 1 vial 140.00 636 Drugs/Detail Code

3430000310 FLEXERIL 10 MG / 1 tab 8.00 250 Pharmacy

3430000311 ULTRAM 50 MG 10.00 250 Pharmacy

3430000312 BACTRIM DS 800 MG 8.00 250 Pharmacy

3430000313 VALIUM SYRINGE 5 MG / 1 ML 6.00 636 Drugs/Detail Code


3430000315 BENADRYL 25 MG / 1 cap 4.00 250 Pharmacy

3430000316 HEPLOCK VIAL 100 units / 1 ML 10.00 250 Pharmacy

3430000317 VALIUM 5 MG / 1 tab 8.00 636 Drugs/Detail Code

3430000318 ALBUTEROL NEBULIZER 2.5 MG / 3 ML 40.00 250 Pharmacy

3430000319 COLACE 100 MG / 1 cap 8.00 250 Pharmacy

3430000320 ZOFRAN VIAL 2 MG / 1 ML 75.00 636 Drugs/Detail Code

3430000321 ZANTAC 150 MG 16.00 250 Pharmacy

3430000322 MIRALAX POWDER 17 gm / 1 packet 10.00 250 Pharmacy

3430000323 PEPCID 20 MG / 1 tab 8.00 250 Pharmacy

3430000324 SALINE FLUSH 10 ML 10.00 258 Iv Solutions

3430000325 SENOKOT-S 8.6 MG 8.00 250 Pharmacy


3430000327 PHENERGAN 25 MG / 1 ML 15.00 636 Drugs/Detail Code

3430000328 DILAUDID VIAL 2 MG / 1 ML 10.00 636 Drugs/Detail Code

3430000331 CARBOCAINE VIAL 1% 30 ML 44.00 250 Pharmacy

3430000334 BENICAR 20 MG / 1 tab 10.00 250 Pharmacy

3430000336 D5W 250 ML 88.00 258 Iv Solutions

3430000338 PYRIDIUM 100 MG / 1 tab 7.00 250 Pharmacy

3430000339 OCEAN NASAL SPRAY 1 EA 11.00 250 Pharmacy




3430000340 Melatonin 3mg 1 tab 10.00 250 Pharmacy

3430000341 IMODIUM 2 MG / 1 tab 4.00 250 Pharmacy

3430000342 FISH OIL 1000 MG / 1 cap 4.00 250 Pharmacy

3430000343 TRIPLE ANTIBIOTIC PACK 1 EA 4.00 250 Pharmacy

3430000344 ANTIVERT 25 MG / 1 tab 4.00 250 Pharmacy

3430000346 PAXIL 20 MG / 1 tab 13.00 250 Pharmacy

3430000348 CELESTONE SOLUSPAN 5ml 6 MG / 1 ML 150.00 636 Drugs/Detail Code

3430000349 PROSCAR 5 MG 13.00 250 Pharmacy

3430000350 CALCIUM GLUCONATE 10ml 1 gm / 1 vial 9.00 636 Drugs/Detail Code

3430000351 FERAGON 324 MG 4.00 250 Pharmacy

3430000352 AVAPRO 150 MG / 1 tab 13.00 250 Pharmacy

3430000356 BUSPAR 10 MG / 1 tab 4.00 250 Pharmacy

3430000357 MAXZIDE 75/50 75 MG 4.00 250 Pharmacy

3430000358 AMOXICILLIN 500 MG / 1 cap 4.00 250 Pharmacy

3430000359 LOPID 600 MG / 1 tab 9.00 250 Pharmacy

3430000363 REQUIP 1 MG / 1 tab 4.00 250 Pharmacy

3430000364 LACTATED RINGERS 1000 ML 88.00 258 Iv Solutions

3430000366 LOMOTIL 2.5 MG 6.00 250 Pharmacy

3430000368 EPINEPHRIN SYRINGE 1 MG / 10 ML 22.00 250 Pharmacy

3430000369 Vancomycin 1.5gm 150.00 250 Pharmacy

3430000370 VERAPAMIL 5 MG / 2 ML 10.00 250 Pharmacy

3430000372 CELEXA 40 MG / 1 tab 11.00 250 Pharmacy

3430000373 LIBRIUM 25 MG / 1 cap 7.00 250 Pharmacy

3430000374 XANAX EXTENDED RELEASE TAB 1 MG / 1 tab 12.00 250 Pharmacy

3430000376 VITAMIN K 10 MG / 1 ML 160.00 636 Drugs/Detail Code

3430000378 DYNAPEN 250 MG / 1 cap 4.00 250 Pharmacy

3430000379 MARINOL 2.5 MG / 1 cap 24.00 250 Pharmacy

3430000381 CLARITIN 10 MG / 1 tab 4.00 250 Pharmacy

3430000382 ZOSYN 3.375 gm / 1 vial 100.00 636 Drugs/Detail Code

3430000384 EXCEDRIN MIGRAINE 1 tab 8.00 250 Pharmacy

3430000386 THORAZINE INJ 25 MG / 1 ML 19.00 636 Drugs/Detail Code

3430000387 MAXALT 10 MG / 1 tab 76.00 250 Pharmacy

3430000390 BUPIVACAINE/EPI 0.25% 30 ML 40.00 250 Pharmacy

3430000391 METHYLENE BLUE 10 ML 32.00 250 Pharmacy

3430000392 TEGRETOL 200 MG / 1 tab 4.00 250 Pharmacy

3430000393 LANOXIN AMP 0.5 MG / 1 ML 15.00 636 Drugs/Detail Code

3430000394 ROMAZICON 0.5 MG / 5 ML 88.00 250 Pharmacy

3430000395 CEFTIN 250 MG / 1 tab 23.00 250 Pharmacy

3430000398 PERCOCET 7.5/325 7.5 MG / 1 tab 12.00 250 Pharmacy

3430000399 CATAPRES 0.1 MG / 1 tab 4.00 636 Drugs/Detail Code

3430000400 CORDARONE 200 MG 30.00 250 Pharmacy

3430000404 ADVAIR DISKUS PWD 250/50 250 mcg / 1 EA 550.00 250 Pharmacy

3430000406 MACROBID 100 MG 17.00 250 Pharmacy

3430000407 LASIX 40 MG / 1 tab 4.00 250 Pharmacy

3430000408 RELISTOR 12 MG / 0.6 ML 415.00 250 Pharmacy

3430000409 LIDOCAINE IVPB 250 ML 66.00 258 Iv Solutions

3430000411 CLEOCIN 150 MG / 1 cap 12.00 250 Pharmacy

3430000413 DIAMOX 250 MG / 1 tab 6.00 250 Pharmacy

3430000416 ISOVUE-M 300 61 % VIAL 15 ML 56.00 255 Drugs/Incident Rad

3430000417 BICITRA 30 ML 4.00 250 Pharmacy

3430000418 OMNISCAN VIAL 287 MG / 20 ML 500.00 250 Pharmacy

3430000420 LEVEMIR 100 units / 1 ML 300.00 250 Pharmacy

3430000424 LIDOCAINE INHALATION KIT 2 % / 1 ML 16.00 250 Pharmacy

3430000426 ARTIFICIAL TEARS 100 Drops 18.00 250 Pharmacy

3430000429 ZOFRAN 4 MG / 1 tab 85.00 636 Drugs/Detail Code

3430000432 RELPAX 40 MG 95.00 250 Pharmacy

3430000433 OPANA ER 5 MG / 1 tab 8.00 250 Pharmacy

3430000437 LOTENSIN 10 MG / 1 tab 6.00 250 Pharmacy

3430000438 MICRONASE 5 MG 4.00 250 Pharmacy

3430000440 CAFFEINE SODIUM BENZONATE VIAL 500 MG / 2 ML 93.00 258 Iv Solutions




3430000441 NUCYNTA 50 MG / 1 tab 9.00 250 Pharmacy

3430000442 SYNTHROID 25 mcg 4.00 250 Pharmacy

3430000443 PREMARIN 0.3 MG 5.00 250 Pharmacy

3430000444 ASCORB ACID 500 MG / 1 tab 4.00 250 Pharmacy

3430000446 VITAMIN D-3 400 units / 1 cap 4.00 250 Pharmacy

3430000448 Vancomycin vial 1 mg 90.00 636 Drugs/Detail Code

3430000449 IMITREX 50 MG / 1 tab 72.00 250 Pharmacy

3430000452 METAMUCIL POWDER 1 EA 4.00 250 Pharmacy

3430000453 CALCIUM CHLORIDE SYRINGE 1 gm / 10 ML 7.00 250 Pharmacy


3430000457 CHANTIX 1 MG / 1 tab 8.00 250 Pharmacy

3430000458 NORFLEX IV 100 MG / 1 ML 90.00 250 Pharmacy

3430000460 DOPAMINE BAG 400 MG / 250 ML 82.00 636 Drugs/Detail Code

3430000461 ZITHROMYCIN 250 MG / 1 tab 200.00 250 Pharmacy

3430000463 AMBIEN CR 12.5 MG 18.00 250 Pharmacy

3430000464 VIBRAMYCIN 50 MG / 1 cap 5.00 250 Pharmacy

3430000468 SEROQUEL 100 MG 10.00 250 Pharmacy

3430000469 AUGMENTIN 875 MG / 1 tab 12.00 250 Pharmacy

3430000471 D5LR 1000 ML 88.00 258 Iv Solutions

3430000472 VESICARE 5 MG 25.00 250 Pharmacy

3430000473 MORPHINE ER 20 MG / 1 cap 12.00 250 Pharmacy

3430000476 SPIRIVA 18 mcg 228.00 250 Pharmacy

3430000477 CARDIZEM VIAL 5 MG / 1 ML 20.00 250 Pharmacy

3430000481 TOBRADEX EYE OINTMENT 0.3% 3 gm / 1 EA 450.00 250 Pharmacy

3430000484 TOPROL 50 MG 4.00 250 Pharmacy

3430000486 NOVOLOG 100 units / 1 ML 150.00 250 Pharmacy

3430000487 NYSTATIN POWDER 100000 U / 1 EA 100.00 250 Pharmacy

3430000488 PHENERGAN GEL 12.5 MG 10.00 250 Pharmacy

3430000489 BUTT PASTE 120 GM 20.00 250 Pharmacy

3430000490 MUCINEX 600 MG / 1 tab 4.00 250 Pharmacy

3430000491 LEVOFLOXACIN IVPB 750 MG / 150 ML 235.00 636 Drugs/Detail Code

3430000493 VASOPRESSIN 20 UNIT / 1 ML 25.00 250 Pharmacy

3430000494 SOLU-CORTEF 100 MG / 2 ML 10.00 636 Drugs/Detail Code

3430000495 UROXATRAL 10 MG 19.00 250 Pharmacy

3430000497 ZEMURON 100 MG / 10 ML 130.00 250 Pharmacy

3430000499 DURAGESIC PATCH 100 mcg / 1 EA 265.00 250 Pharmacy

3430000500 ROBAXIN 500 MG / 1 tab 4.00 250 Pharmacy

3430000501 HEPARIN VIAL 10000 units / 1 vial 8.00 636 Drugs/Detail Code

3430000502 PROTAMINE 50 MG / 5 ML 6.00 636 Drugs/Detail Code

3430000503 COREG 12.5 MG 7.00 250 Pharmacy

3430000504 MORPHINE ER 50 MG / 1 cap 24.00 250 Pharmacy


3430000510 NORVASC 5 MG 10.00 250 Pharmacy

3430000511 HEP LOCK VIAL 10 units / 1 ML 6.00 250 Pharmacy

3430000512 KETAMINE 50 MG / 1 ML 65.00 250 Pharmacy

3430000513 GLUCOSE 4 gm / 1 tab 4.00 250 Pharmacy

3430000514 PHENERGAN 50 MG / 1 vial 17.00 636 Drugs/Detail Code

3430000515 MORPHINE ER 100 MG / 1 tab 21.00 250 Pharmacy

3430000517 RELAFEN 750 MG / 1 tab 5.00 250 Pharmacy

3430000518 ADDERALL 10 MG / 1 tab 8.00 250 Pharmacy

3430000521 LOVENOX 40 MG / 1 syringe 34.00 636 Drugs/Detail Code


3430000523 PAPAVERINE 30 MG / 1 vial 15.00 636 Drugs/Detail Code

3430000525 LEVAQUIN IVPB 500 MG / 100 ML 200.00 258 Iv Solutions

3430000526 BENADRYL CREAM 2% 2 % / 1 EA 22.00 250 Pharmacy

3430000530 ZYRTEC 10 MG / 1 tab 4.00 250 Pharmacy

3430000532 SYNTHROID 100 mcg 4.00 250 Pharmacy

3430000533 PROTONIX 40 MG / 1 tab 20.00 250 Pharmacy

3430000534 LEXAPRO 10 MG / 1 tab 10.00 250 Pharmacy

3430000535 WELLBUTRIN 75 MG / 1 tab 5.00 250 Pharmacy




3430000537 ANCEF IVPB 1 gm 140.00 258 Iv Solutions

3430000541 THORAZINE 25 MG / 1 tab 4.00 250 Pharmacy

3430000543 URECHOLINE 10 MG 4.00 636 Drugs/Detail Code

3430000544 PERCOCET 5/325 5 MG / 1 tab 7.00 250 Pharmacy

3430000545 NARCAN 0.4 MG / 1 ML 25.00 636 Drugs/Detail Code

3430000546 SINGULAIR 10 MG 15.00 250 Pharmacy

3430000547 GLUCOPHAGE 500 MG / 1 tab 4.00 250 Pharmacy

3430000553 LOPRESSOR 50 MG / 1 tab 6.00 250 Pharmacy

3430000554 Myrbetria 25mg 45.00 250 Pharmacy

3430000555 ROBINUL 1ml VIAL 0.2 MG / 1 ML 62.50 250 Pharmacy

3430000556 LIDOCAINE/EPI 1% 20 ML 20.00 250 Pharmacy

3430000561 ULTIVA 2 MG 60.00 250 Pharmacy

3430000562 DIFLUCAN 100 MG / 1 tab 36.00 250 Pharmacy


3430000564 THROMBIN 20000 units 1,415.00 250 Pharmacy

3430000565 LEVAQUIN 500 MG / 1 tab 50.00 636 Drugs/Detail Code

3430000566 ATROPINE 1 MG / 1 ML 5.00 636 Drugs/Detail Code

3430000567 APRESOLINE 20 MG / 1 ML 75.00 636 Drugs/Detail Code

3430000570 TYLENOL 500 MG / 1 tab 4.00 250 Pharmacy

3430000571 GLUCOTROL 5 MG 4.00 250 Pharmacy

3430000574 FLEET ENEMA 1 EA 10.00 250 Pharmacy


3430000576 ELAVIL 25 MG / 1 tab 4.00 250 Pharmacy

3430000577 BREVIBLOC 10 MG / 1 ML 95.00 250 Pharmacy

3430000578 CORTEF 10 MG / 1 tab 4.00 250 Pharmacy

3430000580 D5W 1000 ML 88.00 258 Iv Solutions

3430000581 TOPAMAX 25 MG 10.00 250 Pharmacy

3430000582 DEXTROSE 50 % VIAL 50 ML 36.00 250 Pharmacy

3430000583 WELLBUTRIN XL 150 MG / 1 tab 9.00 250 Pharmacy

3430000584 BYSTOLIC 5 MG / 1 tab 8.00 250 Pharmacy


3430000587 ATIVAN 2 MG / 1 ML 35.00 636 Drugs/Detail Code

3430000591 SKELAXIN 800 MG 13.00 250 Pharmacy

3430000592 DEMEROL PCA 10 MG / 1 ML 50.00 636 Drugs/Detail Code

3430000593 MARCAINE 0.5%/EPI 0.5 % / 30 ML 40.00 250 Pharmacy

3430000594 CRESTOR 40 MG / 1 tab 14.00 250 Pharmacy

3430000595 CLEOCIN VIAL 900 MG / 6 ML 83.00 250 Pharmacy

3430000596 PHENERGAN PO 25 MG 6.00 250 Pharmacy

3430000598 Morphine 15mg tab 4.00 250 Pharmacy


3430000604 GAS-X 80 MG 4.00 250 Pharmacy

3430000605 1/2 NORMAL SALINE 1000 ML 88.00 258 Iv Solutions

3430000608 PROAIR INHALER 1 EA 190.00 250 Pharmacy

3430000609 DIPRIVAN 10 MG / 100 ML 150.00 636 Drugs/Detail Code



3430000614 LYRICA 100 MG / 1 cap 25.00 636 Drugs/Detail Code

3430000615 KLONOPIN 0.5 MG / 1 tab 6.00 250 Pharmacy


3430000618 AFRIN NASAL SPRAY 1 EA 21.00 250 Pharmacy

3430000619 GARAMYCIN 20 MG / 1 vial 10.00 636 Drugs/Detail Code

3430000621 PARAFONE FORTE 500 MG / 1 tab 7.00 250 Pharmacy

3430000622 VASOTEC VIAL 1.25 MG / 1 ML 135.00 250 Pharmacy

3430000623 BACITRACIN OINT 30 gm / 1 EA 20.00 250 Pharmacy

3430000625 D5LR 500 ML 88.00 250 Pharmacy

3430000626 FLOMAX 0.4 MG 12.00 250 Pharmacy

3430000627 OPANA 5 MG / 1 tab 10.00 250 Pharmacy

3430000628 Lidocaine 0.5% + Epi 20.00 250 Pharmacy

3430000629 ASPIRIN CHEWABLE 81 MG / 1 tab 4.00 250 Pharmacy

3430000630 DIPRIVAN 50ML VIAL 10 MG / 1 ML 200.00 636 Drugs/Detail Code




3430000631 NEURONTIN 400 MG / 1 cap 27.00 250 Pharmacy

3430000632 FLONASE NASAL SPRAY 50 mcg / 16 GM 310.00 250 Pharmacy


3430000634 ATIVAN 1 MG / 1 tab 6.00 250 Pharmacy

3430000635 DESERYL 100 MG 4.00 250 Pharmacy

3430000636 DITROPAN 5 MG / 1 tab 6.00 250 Pharmacy

3430000637 SURGICEL FIBRILLAR 1 EA 560.00 250 Pharmacy

3430000638 TALWIN NX TAB 50/0.5 1 EA 6.00 250 Pharmacy

3430000639 PROZAC 20 MG / 1 cap 17.00 250 Pharmacy

3430000641 REMERON 30 MG / 1 tab 11.00 250 Pharmacy

3430000642 LYRICA 75 MG / 1 tab 10.00 250 Pharmacy

3430000643 FERROUS SULFATE 325 MG / 1 tab 4.00 250 Pharmacy

3430000644 DUONEB 3 ML 40.00 250 Pharmacy

3430000647 MAGNESIUM IVPB 4 G / 100 ML 20.00 250 Pharmacy

3430000650 BACLOFEN 10 MG / 1 tab 5.00 636 Drugs/Detail Code

3430000651 OPANA ER 20 MG / 1 tab 30.00 250 Pharmacy

3430000652 TENORMIN 50 MG / 1 tab 6.00 250 Pharmacy

3430000653 MULTIVITAMINS 10.00 250 Pharmacy

3430000654 FIORINAL 1 cap 4.00 250 Pharmacy

3430000655 Ranexa ER 500mg 23.00 250 Pharmacy

3430000656 NORMAL SALINE 0.9 % / 500 ML 44.00 258 Iv Solutions

3430000657 DILAUDID PCA 30 ML 50.00 636 Drugs/Detail Code

3430000658 ANECTINE VIAL 200 MG / 10 ML 20.00 636 Drugs/Detail Code

3430000659 DEMEROL 50 MG / 1 tab 6.00 250 Pharmacy

3430000663 DULCOLAX 10 MG / 1 suppository 4.00 250 Pharmacy

3430000664 BUPRENEX 0.3 MG / 1 ML 16.00 250 Pharmacy

3430000665 DOBUTAMINE BAG 250 MG / 250 ML 50.00 250 Pharmacy

3430000666 INDERAL 20 MG 4.00 250 Pharmacy

3430000667 DEPAKOTE 500 MG / 1 tab 13.00 250 Pharmacy

3430000669 ZYLOPRIM 300 MG / 1 tab 4.00 250 Pharmacy

3430000670 PREDNISONE 5 MG 4.00 636 Drugs/Detail Code

3430000672 ZOVIRAX OINTMENT 5 % 1,530.00 250 Pharmacy

3430000676 NORCO TAB 5/325 1 tab 5.00 250 Pharmacy

3430000677 EFFEXOR 100 MG 10.00 250 Pharmacy

3430000678 SUBOXONE 8/2 8 MG 23.00 250 Pharmacy

3430000679 LIPITOR 20 MG / 1 tab 15.00 250 Pharmacy

3430000682 KCL IVPB 20 MEQ / 100 ML 25.00 258 Iv Solutions

3430000683 LIDOCAINE VISCOUS 300 MG / 15 ML 10.00 250 Pharmacy

3430000684 VALIUM VIAL 5 MG / 1 ML 12.00 636 Drugs/Detail Code

3430000686 OSCAL + D 500 MG / 1 tab 4.00 250 Pharmacy

3430000688 D5NS + KCL 20MEQ 20 MEQ / 1000 ML 88.00 258 Iv Solutions

3430000689 IMDUR 30 MG 7.00 250 Pharmacy

3430000690 CALCIUM CHLORIDE VIAL 1 gm / 10 ML 12.00 250 Pharmacy

3430000693 NICOTINE 14 MG / 1 patch 15.00 250 Pharmacy

3430000694 HESPAN BAG 500 ML 212.00 258 Iv Solutions

3430000695 COMPAZINE 10 MG 4.00 636 Drugs/Detail Code

3430000696 DULCOLAX 5 MG / 1 tab 4.00 250 Pharmacy

3430000698 SUBUTEX 2 MG 20.00 250 Pharmacy

3430000704 HYDROCORTISONE 1% 30gm Oint 1 EA 11.00 250 Pharmacy

3430000710 ECOTRIN 325 MG / 1 tab 4.00 250 Pharmacy

3430000714 LEVSIN 0.125 MG / 1 tab 4.00 250 Pharmacy

3430000717 Klonopin 2mg 5.00 250 Pharmacy

3430000724 CARDIZEM CD 180 MG / 1 cap 6.00 250 Pharmacy

3430000732 LIDOCAINE/EPI 1%/1:100 10 MG / 30 ML 20.00 250 Pharmacy

3430000734 IMITREX 6 MG / 0.5 ML 300.00 250 Pharmacy

3430000735 ZOVIRAX 200 MG / 1 cap 10.00 250 Pharmacy

3430000737 Halcion 0.25mg 18.50 250 Pharmacy

3430000738 CUBICIN 500 MG / 1 vial 1,000.00 636 Drugs/Detail Code

3430000739 Hytrin 5mg 6.00 250 Pharmacy

3430000740 ROBITUSSIN 100 MG / 5 ML 4.00 250 Pharmacy




3430000742 Bridion 200mg/2ml 370.00 250 Pharmacy

3430000744 CIPRO PREMIX 400 MG 125.00 636 Drugs/Detail Code

3430000745 Flagyl 500mg IVPB 30.00 250 Pharmacy

3430000747 Fluzone 2016-17 66.00 250 Pharmacy

3430000748 Vitamin D 5000 units 10.00 250 Pharmacy

3430000749 Oxycontin 30mg 26.00 250 Pharmacy

3430000751 Ativan 2mg 5.00 250 Pharmacy

3430000753 Zyprexa 5mg 5.00 250 Pharmacy

3430000756 ZOCOR 20 MG / 1 tab 18.00 250 Pharmacy

3430000757 ROCEPHIN 2 gm / 1 vial 51.25 636 Drugs/Detail Code

3430000758 Provigil 100mg 8.00 250 Pharmacy

3430000759 Amitiza 8mcg 23.00 250 Pharmacy

3430000760 Calcium Gluconate 1gm IVPB 50.00 250 Pharmacy

3430000761 Calcium Gluconate 2gm IVPB 75.00 250 Pharmacy

3430000762 Phentermine 37.5mg 6.00 250 Pharmacy


3430000764 Morphine 10mg/5ml Liq 5.00 250 Pharmacy

3430000767 HUMULIN-N 100 units / 1 ML 60.00 250 Pharmacy

3430000768 RACEPINEPHRINE 2.25 % 5.00 250 Pharmacy

3430000769 Oxycodone IR 15mg 8.00 250 Pharmacy

3430000770 Diovan 160mg 5.00 250 Pharmacy

3430000773 Percodan 4.8/325 5.00 250 Pharmacy

3430000775 SOLU-MEDROL 125 MG / 2 ML 10.00 636 Drugs/Detail Code

3430000776 Unasyn 3gm 50.00 636 Drugs/Detail Code

3430000777 MOBIC 15 MG / 1 tab 15.00 250 Pharmacy


3430000780 Fentanyl 10 ml 60.00 636 Drugs/Detail Code

3430000781 COUMADIN 2 MG / 1 tab 6.00 250 Pharmacy

3430000783 Amiodarone 150mg Vial 10.00 636 Drugs/Detail Code

3430000784 FENTANYL PCA 30 ML 85.00 636 Drugs/Detail Code

3430000787 HALDOL VIAL 5 MG / 1 ML 17.00 636 Drugs/Detail Code

3430000788 Tresiba 500.00 250 Pharmacy

3430000790 Xanax 2mg 8.00 250 Pharmacy

3430000792 LANOXIN 0.25 MG / 1 tab 4.00 250 Pharmacy

3430000793 Nifedipine ER 30mg 4.00 250 Pharmacy

3430000794 Linzess 290mcg 52.00 250 Pharmacy

3430000795 Zohydro ER 30mg 31.00 250 Pharmacy

3430000799 Sterile Water 5mls 10.00 250 Pharmacy

3430000800 Amlactin Cream 48.00 250 Pharmacy

3430000801 Demadex 20mg 5.00 250 Pharmacy

3430000802 Exparel 1.3% 680.00 636 Drugs/Detail Code

3430000803 Albumin 5% 200.00 250 Pharmacy

3430000804 Keppra 500mg/5ml 12.00 636 Drugs/Detail Code

3430000806 Vancomycin 1.25gm 150.00 636 Drugs/Detail Code

3430000807 KEPPRA 500 MG / 1 tab 4.00 250 Pharmacy

3430000809 VERAPAMIL ER 180 MG / 1 cap 6.00 250 Pharmacy


3430000811 Dotarem 150.00 255 Drugs/Incident Rad

3430000812 LAMACTIL 25 MG / 1 tab 13.00 250 Pharmacy

3430000813 Magnesium 1gm IVPB 20.00 636 Drugs/Detail Code

3430000814 Magnesium 2gm IVPB 45.00 250 Pharmacy

3430000816 Linzess 72 mcg 40.00 250 Pharmacy

3430000817 Vancomycin Oral Solution 50.00 636 Drugs/Detail Code

3430000818 Depakote 125mg 5.00 250 Pharmacy

3430000820 Albumin 250ml 5% 165.00 250 Pharmacy

3430000821 VISTARIL 25 MG / 1 cap 4.00 250 Pharmacy

3430000823 Lidocanine 0.5% 20.00 250 Pharmacy

3430000824 Dilaudid 4mg 5.00 250 Pharmacy

3430000826 Minipress 1mg 8.00 250 Pharmacy

3430000827 AVINZA 30 MG / 1 cap 15.00 250 Pharmacy




3430000828 Sinemet 25/100 5.00 250 Pharmacy

3430000829 Isovue-300 48.00 255 Drugs/Incident Rad

3430000832 VALTREX 500 MG 28.00 250 Pharmacy

3430000833 ACTOS 15 MG / 1 tab 5.00 250 Pharmacy

3430000834 Isovue-370 53.00 255 Drugs/Incident Rad

3430000839 Dakins Solution 60.00 250 Pharmacy

3430000840 ROCEPHIN IVPB 1 G / 50 ML 51.10 258 Iv Solutions

3430000841 Compazine 10 mg injection 20.00 636 Drugs/Detail Code

3430000842 Vancomycin 250mg Cap 36.00 250 Pharmacy

3430000845 Zilretta 2,200.00 636 Drugs/Detail Code

3430000848 GARAMYCIN 80 MG / 2 ML 9.00 636 Drugs/Detail Code

3430000850 NASONEX NASAL SPRAY 50 mcg / 1 EA 366.00 250 Pharmacy

3430000852 Vancomycin 1.75gm 200.00 636 Drugs/Detail Code


3430000854 Belbuca 20.00 250 Pharmacy

3430000856 TYLENOL SUPPOSITORY 650 MG / 1 suppository 4.00 250 Pharmacy

3430000864 ZETIA 10 MG 15.00 250 Pharmacy

3430000866 EMLA CREAM 5 GRAM / 5 GM 38.00 250 Pharmacy

3430000867 NITROSTAT SUBLINGUIAL 0.4 MG / 1 tab 30.00 250 Pharmacy

3430000869 Vancomycin 2gm 200.00 636 Drugs/Detail Code

3430000873 NOVOLOG 70/30 1 ML 122.00 250 Pharmacy

3430000878 PLAVIX 75 MG 16.00 250 Pharmacy

3430000882 AMIDATE AMP 20 MG / 10 ML 65.00 250 Pharmacy

3430000885 Tobramycin Drops 59.00 250 Pharmacy

3430000887 LABETALOL 100 MG / 1 tab 4.00 250 Pharmacy

3430000889 VASOTEC 10 MG / 1 tab 10.00 250 Pharmacy

3430000890 Nortriptyline 25mg 10.00 250 Pharmacy

3430000893 Nortriptyline 10mg 10.00 250 Pharmacy

3430000894 Effexor ER 75mg 10.00 250 Pharmacy

3430000904 GELFOAM 100 1 EA 200.00 250 Pharmacy

3430000905 BSS 1 EA 28.00 250 Pharmacy

3430000906 MURI-LUBE MINERAL OIL 10 ML 10.00 250 Pharmacy

3430000927 JANUVIA 50 MG / 1 tab 29.00 250 Pharmacy

3430000933 NEURONTIN 100 MG 4.00 250 Pharmacy

3430000939 SYNVISC-ONE 1 syringe 119.00 636 Drugs/Detail Code

3430000940 Olanzapine 10mg 115.00 250 Pharmacy

3430000941 LEVOPHED AMP 4 ML 50.00 250 Pharmacy

3430000942 DILANTIN 100 MG / 2 ML 8.00 636 Drugs/Detail Code

3430000943 Omnicef 300mg 5.00 250 Pharmacy

3430000944 CATHFLO 2 MG / 1 vial 350.00 250 Pharmacy

3430000949 NYSTATIN 500000 units / 5 ML 10.00 250 Pharmacy

3430000951 BOTOX DS 100 UN 100 units / 1 vial 25.00 636 Drugs/Detail Code

3430000954 ALTACE 5 MG 10.00 250 Pharmacy

3430000958 DILANTIN 100 MG 4.00 250 Pharmacy

3430000961 GLYCERIN 1 suppository 4.00 250 Pharmacy

3430000962 ESTRADIOL 0.5 MG / 1 tab 5.00 250 Pharmacy

3430000964 ATROPINE 0.4 MG / 1 ML 5.00 636 Drugs/Detail Code

3430000966 Horizant ER 600mg 50.00 250 Pharmacy

3430000970 ADVAIR DISKUS PWD 100/50 100 Microgram / 1 EA 450.00 250 Pharmacy

3430000975 NORFLEX 100 MG / 1 tab 9.00 250 Pharmacy

3430000982 FLAGYL 500 MG 20.00 250 Pharmacy

3430000989 Lactulose 10gm/15ml 5.00 250 Pharmacy

3430000990 THYROID 60 MG / 1 tab 4.00 250 Pharmacy

3430000991 LIDOCAINE 2% JEL 30 gm / 1 EA 50.00 250 Pharmacy

3430000993 AVODART 0.5 MG / 1 capsule 15.00 250 Pharmacy

3430000994 ROBAXIN 1000 MG / 10 ML 70.00 250 Pharmacy

3430000997 PEPCID 20 MG / 2 ML 15.00 250 Pharmacy

3430001002 GLUCAGON 1 MG / 1 vial 320.00 636 Drugs/Detail Code

3430001003 BIAXIN 500 MG 18.00 250 Pharmacy

3430001012 PROTONIX IV 40 MG 120.00 250 Pharmacy




3430001013 CARAFATE 1 G 6.00 250 Pharmacy

3430001015 LIBRIUM 10 MG / 1 cap 4.00 636 Drugs/Detail Code

3430001016 NIACIN 500 MG / 1 tab 4.00 250 Pharmacy

3430001021 LAMACTIL 100 MG / 1 tab 15.00 250 Pharmacy

3430001022 TOPROL XL 25 MG / 1 tab 5.00 250 Pharmacy

3430001027 LOPRESSOR AMP 1 MG / 1 ML 60.00 250 Pharmacy


3430001031 TRILEPTAL 150 MG 7.00 250 Pharmacy

3430001032 RITALIN 10 MG / 1 tab 8.00 250 Pharmacy

3430001034 Restasis 35.00 250 Pharmacy

3430001035 LOTRIMIN CREAM 1 % / 1 EA 7.00 250 Pharmacy

3430001036 Toujeo 535.00 250 Pharmacy

3430001037 AVALIDE 150/12.5 1 tab 13.00 250 Pharmacy

3430001039 ERYTHROCIN 100 MG / 1 syringe 150.00 636 Drugs/Detail Code

3430001046 SOLU-MEDROL 1000 MG 90.00 636 Drugs/Detail Code

3430001051 ALDACTONE 25 MG 4.00 250 Pharmacy

3430001055 SUDAFED 30 MG 4.00 250 Pharmacy

3430001058 ZANTAC 50 MG / 2 ML 20.00 636 Drugs/Detail Code

3430001064 SSD 1 % 30.00 250 Pharmacy

3430001070 TETANUS 75.00 250 Pharmacy

3430001076 MORPHINE VIAL 15 MG / 1 ML 10.00 250 Pharmacy

3430001079 MOTRIN 200 MG / 1 tab 4.00 250 Pharmacy

3430001082 EFFEXOR XR 37.5 MG / 1 cap 15.00 250 Pharmacy

3430001847 POTASSIUM 99mg 99 MG 4.00 250 Pharmacy

3430001864 Cipro Eye Drops 40.00 250 Pharmacy

3430001866 SINEMET CR 25/100 25 MG 37.00 250 Pharmacy

3430001867 VOLTAREN GEL 1 % 175.00 250 Pharmacy

3430001869 DEXILANT 30 MG 23.00 250 Pharmacy

3430001892 Vancomycin 1-2gm 100.00 250 Pharmacy

3430001961 Bupropion ER 100mg / 1 tab 6.75 250 Pharmacy

3430001967 Zosyn 3.375gm Vial 54.00 250 Pharmacy

3430001969 Movantik 25mg 31.00 250 Pharmacy

3430001970 Diltiazem 30mg 4.00 250 Pharmacy

3430001971 Dulera 100/5 685.00 250 Pharmacy

3430001972 Dexamethasone 25.25 250 Pharmacy

3430001973 Pulmicort 2.5mg/2ml 23.60 250 Pharmacy

3430001974 Morphine 4mg Vial 5.00 636 Drugs/Detail Code

3430001975 Albumin 25% 200.00 250 Pharmacy

3430001976 Prevnar 600.00 250 Pharmacy

3430001977 Eliquis 5mg 22.00 250 Pharmacy

3430001978 CARDIZEM 120 MG / 1 cap 8.00 250 Pharmacy

3430001979 D-50-W SYRINGE 36.00 250 Pharmacy

3430001982 OxyContin 15mg 19.00 250 Pharmacy

3430001984 Nucynta ER 50 mg 14.00 250 Pharmacy

3430001985 Metformin 1000mg 4.00 250 Pharmacy

3430001986 Ultram ER 100mg 19.00 250 Pharmacy

3430001987 Synalgos DC 8.00 250 Pharmacy

3430001988 Haldol 2mg Tablet 5.00 250 Pharmacy

3430001990 Marcaine 0.5% Vial 45.00 250 Pharmacy

3430001992 Vancomycin 500mg 34.00 636 Drugs/Detail Code

3430001993 Gentimicin 160 mg IVPB 30.00 636 Drugs/Detail Code

3430001996 MAGNESIUM 250 MG 4.00 250 Pharmacy

3430001998 LUMIGAN EYE DROPS 0.01 % / 50 Drops 500.00 250 Pharmacy

3430001999 Zohydro ER 10mg 28.00 250 Pharmacy

3430002000 Adderall ER 10 mg 20.00 250 Pharmacy

3430002001 Procalamine 3% 122.00 250 Pharmacy

3430002002 XOPENEX INHALER 45 mcg 230.00 250 Pharmacy

3430002004 CRESTOR 10 MG 23.00 250 Pharmacy

3430002007 1/2 + KCL 20 meg 88.00 250 Pharmacy

3460000002 VENT ASSIST 1ST DAY 1,075.00 410 Respiratory Svc




3460000006 EKG 143.00 730 Ekg/Ecg

3460000014 Oxygen Therapy (per hour) 11.00 270 Med-Surg Supplies

3490000001 PT EVALUATION 343.00 424 Pt Evaluation

3490000002 PT RE EVALUATION 189.00 424 Pt Evaluation

3490000003 THERAPEUTIC ACTIVI 155.00 421 Phys Ther Visit

3490000004 NEUROM/PROPRIO BALAN 148.00 421 Phys Ther Visit

3490000005 GAIT TRAINING 126.00 421 Phys Ther Visit

3490000007 THERAPEUTIC EXERCISE 155.00 421 Phys Ther Visit

3490000009 REMOVE TISS ADD 20CM 524.00 420 Physical Therp

3490000010 DEBRID NON SELECTIVE 307.00 421 Phys Ther Visit

3490000012 WOUND VAC TX <50 CM 524.00 420 Physical Therp

3490000013 ADL - TRAINING 154.00 420 Physical Therp

3490000014 Mobility Current Status 0.01 429 Other Phys Therp

3490000015 Mobility Goal Status 0.01 429 Other Phys Therp

3490000016 Mobility D/C Status 0.01 429 Other Phys Therp

3490000017 PT EVALUATION LOW COMPLEXITY 327.32 424 Pt Evaluation

3490000018 PT EVALUATION MODERATE COMPLEXITY 327.32 424 Pt Evaluation

3490000019 PT EVALUATION HIGH COMPLEXITY 327.32 424 Pt Evaluation

3490000020 PT RE-EVALUATION 222.52 424 Pt Evaluation

3550000009 61070, INJECTION SHUNTOGRAM 2,183.00 360 Or Services

3550000011 64633,DESTROY CERV/THOR FA 2,829.00 360 Or Services

3550000012 64634, DESTROY C/TH FACET J 914.00 360 Or Services

3550000014 64636, DESTROY L/S FACET JN 2,829.00 360 Or Services

3550000015 96365, IV INFUSION INITIAL 731.00 260 Iv Therapy

3550000016 96366, IV INF ADDITIONAL 135.00 260 Iv Therapy

3550000021 62310, EPI STEROID INJ C/T 2,829.00 360 Or Services

3550000022 62311, EPI STEROID INJ LUM 2,829.00 360 Or Services

3550000024 63650, PERCUTANEOUS IMP ELE 4,460.00 360 Or Services

3550000025 64400, INJ TRIGEMINAL 913.05 360 Or Services

3550000026 64405, OCCIPITAL NERVE BLOC 2,306.00 360 Or Services

3550000027 64420, INTERCOSTAL NERV BLO 1,930.00 360 Or Services

3550000028 64421, INTERCOSTAL NERV MUL 2,829.00 360 Or Services

3550000029 64479, INJ FORAMEN EPI C/T 2,829.00 360 Or Services

3550000030 64480, INJ FORAMEN EPI C/T 1,459.00 360 Or Services

3550000031 64483, TRANFORAMINAL INJ L 2,829.00 360 Or Services

3550000032 64484, TRAN.INJ.ADD.LEVEL 2,106.00 360 Or Services

3550000033 64490, INJ FACET C/T 1 LEVE 2,829.00 360 Or Services

3550000034 64491, INJ FACET C/T 2 LEVE 914.00 360 Or Services

3550000035 64492, INJ FACET C/T 3 LEVE 914.00 360 Or Services

3550000036 64493, INJ FACET L/S 1 LEVE 2,829.00 360 Or Services

3550000037 64494, INJ FACET L/S 2 LEVE 914.00 360 Or Services

3550000038 64495, INJ FACET L/S 3 LEVE 914.00 360 Or Services

3550000039 64510, INJ STELLATE 2,829.00 360 Or Services

3550000040 64520, INJ SYMPATHETIC 2,829.00 360 Or Services

3550000043 64620, INJ. INTER NERVE 4,283.00 360 Or Services

3550000044 64640, NEUROLYSIS OTHER 2,829.00 360 Or Services

3550000045 64999, UNLISTD PROC NER SYS 913.00 360 Or Services

3550000046 62273, Epidural Blood Patch 2,829.00 360 Or Services

3550000047 27093, INJ HIP ARTHROGRAPHY 806.00 360 Or Services

3550000048 27096, INJ, SI ARTHROGRAPHY 2,614.00 360 Or Services

3550000049 62290, DISKOGRAPHY LUMBAR 800.00 360 Or Services

3550000050 62291, DISKOGRAPHY CERVICAL 800.00 360 Or Services

3550000051 20550, INJ TNDN SHEATH, LIG 2,306.00 360 Or Services

3550000052 20551, INJECTION TENDON 2,306.00 360 Or Services

3550000053 20552, INJ 1 - 2 MUSCLE GRP 2,306.00 360 Or Services

3550000054 20553, INJ 3 PLUS MUSCLE GR 1,930.00 360 Or Services

3550000055 20600, ARTHRO ASPIR &/OR IN 1,930.00 360 Or Services

3550000056 20605, ARTHRCNTSIS INJ INT 1,896.00 360 Or Services

3550000057 20610, ARTHRCNTSIS INJ MAJO 756.00 360 Or Services

3550000058 10022, FNA W/IMAGE 1,728.00 360 Or Services




3550000064 11900, INJ SKIN LESION 536.00 360 Or Services

3550000067 G0260, Injection procedure for sacroiliac joint; 2,829.00 360 Or Services

3550000068 99144, Conscious Sedation 100.00 370 Anesthesia

3550000069 64517 Injection, Anesthetic Agent; Superior Hypogastric Plexus 2,829.00 360 Or Services

3550000070 64450 Injection, Anesthetic Agent; Other Peripheral Nerve Or Branch 1,459.00 360 Or Services

3550000072 77002 Fluoroscopic Guidance For Needle Placement (Eg, Biopsy, Aspiration, Injection, Localizatio...426.00 320 Dx X-Ray

3550000073 77002 add'l levels Fluoroscopic Guidance For Needle Placement (Eg, Biopsy, Aspiration, Injection, Localizatio...50.00 320 Dx X-Ray

3550000074 77003 Fluoroscopic Guidance And Localization Of Needle Or Catheter Tip For Spine Or Paraspinous ...426.00 320 Dx X-Ray

3550000075 77003 add'l levels Fluoroscopic Guidance And Localization Of Needle Or Catheter Tip For Spine Or Paraspinous ...50.00 320 Dx X-Ray

3550000076 72275 Epidurography, Radiological Supervision And Interpretation 1,078.00 320 Dx X-Ray

3550000077 72285 Discography, Cervical Or Thoracic, Radiological Supervision And Interpretation2,500.00 320 Dx X-Ray

3550000078 72285 add'l levels Discography, Cervical Or Thoracic, Radiological Supervision And Interpretation1,450.00 320 Dx X-Ray

3550000079 72295 Discography, Lumbar, Radiological Supervision And Interpretation 2,500.00 320 Dx X-Ray

3550000080 72295 add'l level Discography, Lumbar, Radiological Supervision And Interpretation1,450.00 320 Dx X-Ray

3550000081 62291 add'l levels Injection Procedure For Discography, Each Level; Cervical Or Thoracic650.00 360 Or Services

3550000082 62290 add'l level Injection Procedure For Discography, Each Level; Lumbar 650.00 360 Or Services

3550000083 76942 Ultrasonic Guidance For Needle Placement (Eg, Biopsy, Aspiration, Injection, Localization ...100.00 402 Ultrasound

3550000084 64635 Destruction By Neurolytic Agent, Paravertebral Facet Joint Nerve(S), With Imaging Guidance...2,828.00 360 Or Services

3550000085 64430 Injection, Anesthetic Agent; Pudendal Nerve 2,828.00 360 Or Services

3550000087 99145 Conscious Sedation each 15 minutes 100.00 370 Anesthesia

3550000092 75809 Shuntogram For Investigation Of Previously Placed Indwelling Nonvascular Shunt (Eg, Leveen...354.00 320 Dx X-Ray

3550000094 62264 Percutaneous Lysis Of Epidural Adhesions Using Solution Injection (Eg, Hypertonic Saline, ...4,283.00 360 Or Services

3550000096 62282 Treat Spinal Canal Lesion 4,283.00 360 Or Services

3550000097 64505 N Block Spenopalatine Gangl 1,011.00 360 Or Services

3550000098 64425 N Block Inj Ilio-Ing/Hypogi 1,770.00 360 Or Services

3550000099 20526 Ther Injection Carp Tunnel 1,011.00 360 Or Services

3550000101 Bone Biopsy Trocar/Needle 5,732.00 360 Or Services

3550000103 N Block Inj Sciatic Sng 3,350.00 360 Or Services

3550000104 Implant Neuroelectrodes 26,453.25 360 Or Services

3550000105 Guide Cathet Fluid Drainage 4,330.00 360 Or Services

3550000106 Percutaneous Aspiration Within The Nucleus Pulposus, Intervertebral Disc, Or Paravertebral...2,437.00 360 Or Services

3550000108 Arthrocentesis, Aspiration And/Or Injection, Major Joint Or Bursa (Eg, Shoulder, Hip, Knee...1,056.00 360 Or Services

3550000115 62320 Epi Steroid INJ Crv/ Thrc without imaging 2,535.95 360 Or Services

3550000116 62321 Epi Steroid INJ Crv/ Thrc with imaging (ie, fluoroscopy, CT) 2,535.95 360 Or Services

3550000117 62322 Epi Steroid INJ Lum/Sac without imaging 2,535.95 360 Or Services

3550000118 62323 Epi Steroid INJ Lum/Sac with imaging (ie,fluoroscopy, CT) 2,535.95 360 Or Services

3550000119 62324 Inject Spine w/cath Crv/Thrc without imaging 3,194.65 360 Or Services

3550000120 62325 Inject spine w/cath Crv/Thrc with imaging (ie, fluoroscopy, CT) 3,194.65 360 Or Services

3550000121 62326 Inject spine w/cath Lum/Sac without imaging 3,194.65 360 Or Services

3550000122 62327 Inject spine w/cath Lum/Sac with imaging (ie, fluoroscopy, CT) 3,194.65 360 Or Services

3550000123 99152 Moderate Sedation first 15 minutes 100.00 370 Anesthesia

3550000124 99153 Moderate Sedation each additional 15 minutes 100.00 370 Anesthesia

3550000125 BIOPSY OF SALIVARY GLAND; NEEDLE 1,617.33 360 Or Services

3550000126 62319 Inject Spine W/Cath Lumbar 3,288.40 360 Or Services

3550000127 64622 - Destruction by neurolytic agent - Lumbar 2,828.00 360 Or Services

3550000129 Rotor Pump Study without programming 757.89 360 Or Services

3550000130 Drain cerebrospinal fluid 1,521.57 360 Or Services

3550000131 64623 - Destruction by neurolytic agent addl level - Lumbar 2,828.00 360 Or Services


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