DESCRIPTION CURRENT PRICE LABORATORY

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DESCRIPTION CURRENT PRI LABORATORY .BLOOD BANK HANDLING 161.20 $ .CBC W/AUTO DIFF 299.50 $ .CBC-HEMOGRAM 172.00 $ .URINALYSIS COMPLETE 148.20 $ .URINALYSIS DIPSTICK 93.60 $ ABG INCLUDES ANY COMBINATION 354.90 $ ABG O2 SATURATION ONLY 248.00 $ ACETAMINOPHEN LEVEL 296.40 $ ACETONE, SERUM 88.00 $ AEROBIC C&S 450.00 $ ALANINE AMINO ALT - RL 114.00 $ ALANINE AMINO ALT (SGPT) 148.20 $ ALBUMIN 100.10 $ ALCOHOL (ETHANOL) 296.40 $ ALKALINE PHOSPHATASE 118.30 $ ALLERGEN SPECIFIC IgE QUANT OR SEMIQUANT 572.00 $ AMYLASE 231.40 $ ANAER ID/SUSC 177.00 $ ANEMIA PROFILE B #042077 349.00 $ ANTI HG COOMBS INDIRECT 171.60 $ ANTIGEN TESTING 221.00 $ ANTITHROMBIN III ACTIVITY 185.90 $ BASIC PANEL 523.00 $ BB ANTIBODY SCREEN RBC EACH SERUM TECH 171.60 $ BB BLOOD BANK-CROSSMATCH 180.00 $ BB CROSSMATCH AHG 146.90 $ BB PRBC LISA 771.23 $ BB RH FACTOR 78.00 $ BILIRUBIN DIRECT 201.50 $ BILIRUBIN TOTAL 191.10 $ BLOOD TYPING ABO 85.80 $ BNP 454.74 $ BODY FLUID C&S 347.00 $ BUN 148.20 $ C.DIFF CULT 129.00 $ CALCITONIN 251.00 $ CALCIUM 148.20 $ CBC HEMOGRAM W/O DIFF 236.60 $ CD4/CD8 RATIO 400.40 $ C-DIFFICILE 218.00 $ CHEM8 STAT 249.60 $ CHLAMYDIA GEN/PROBE 322.40 $ CHLAMYDIA URINE(PCR) 248.00 $ CHOLESTEROL 162.50 $ CHOLESTEROL HDL 202.80 $ CK TOTAL 209.30 $ CKMB 162.50 $

Transcript of DESCRIPTION CURRENT PRICE LABORATORY

Page 1: DESCRIPTION CURRENT PRICE LABORATORY

DESCRIPTION CURRENT PRICE

LABORATORY

.BLOOD BANK HANDLING 161.20$

.CBC W/AUTO DIFF 299.50$

.CBC-HEMOGRAM 172.00$

.URINALYSIS COMPLETE 148.20$

.URINALYSIS DIPSTICK 93.60$

ABG INCLUDES ANY COMBINATION 354.90$

ABG O2 SATURATION ONLY 248.00$

ACETAMINOPHEN LEVEL 296.40$

ACETONE, SERUM 88.00$

AEROBIC C&S 450.00$

ALANINE AMINO ALT - RL 114.00$

ALANINE AMINO ALT (SGPT) 148.20$

ALBUMIN 100.10$

ALCOHOL (ETHANOL) 296.40$

ALKALINE PHOSPHATASE 118.30$

ALLERGEN SPECIFIC IgE QUANT OR SEMIQUANT 572.00$

AMYLASE 231.40$

ANAER ID/SUSC 177.00$

ANEMIA PROFILE B #042077 349.00$

ANTI HG COOMBS INDIRECT 171.60$

ANTIGEN TESTING 221.00$

ANTITHROMBIN III ACTIVITY 185.90$

BASIC PANEL 523.00$

BB ANTIBODY SCREEN RBC EACH SERUM TECH 171.60$

BB BLOOD BANK-CROSSMATCH 180.00$

BB CROSSMATCH AHG 146.90$

BB PRBC LISA 771.23$

BB RH FACTOR 78.00$

BILIRUBIN DIRECT 201.50$

BILIRUBIN TOTAL 191.10$

BLOOD TYPING ABO 85.80$

BNP 454.74$

BODY FLUID C&S 347.00$

BUN 148.20$

C.DIFF CULT 129.00$

CALCITONIN 251.00$

CALCIUM 148.20$

CBC HEMOGRAM W/O DIFF 236.60$

CD4/CD8 RATIO 400.40$

C-DIFFICILE 218.00$

CHEM8 STAT 249.60$

CHLAMYDIA GEN/PROBE 322.40$

CHLAMYDIA URINE(PCR) 248.00$

CHOLESTEROL 162.50$

CHOLESTEROL HDL 202.80$

CK TOTAL 209.30$

CKMB 162.50$

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CMV IgG 338.00$

COMP PANEL 622.00$

COMPLEX O & P STAIN 215.00$

CREATININE 176.80$

CREATININE URINE 97.00$

CULTURE ANAEROBIC RL 266.50$

CULTURE ANAEROBIC SC 392.00$

CULTURE-LOWER RESP 254.00$

CULTURE-THROAT 55.00$

DAT(COOMBS) 156.00$

DAU 5-PART 158.60$

DAU COLLECTION 31.20$

DDIMER CARDIAC TEST RL 214.50$

DILANTIN FREE RL 309.40$

DRUG SCREEN-FDLE/COC 84.50$

DRUG SCREEN-QUAL 176.80$

EBV NUCLEAR ANTIGEN 105.00$

EBV VCA IgG 105.00$

EBV VCA IgM 105.00$

ELECTROLYTES 354.90$

EPSTEIN BARR AB TITER 122.20$

ESTRIOL 260.00$

ESTRONE 234.00$

FINGER STICK 31.20$

FREE T4 207.00$

FREE T-4 269.10$

GAMMA GT 29.00$

GASTROCCULT 40.30$

GASTROCCULT 83.00$

GENTAMICIN LEVEL 198.90$

GIARDIA SPEC ANTIBODY 176.80$

GLUCOSE 162.50$

GLUCOSE POC 162.50$

GTT 2 HOUR 169.00$

GTT 3 HOUR 169.00$

GTT 4 HOUR 219.70$

GTT 5 HOUR 219.70$

H PYLORI 198.90$

H PYLORI ANTIGEN 202.00$

H1N1 FLU A-RL 540.80$

HANDLING FEE 33.00$

HAPTO GLOBIN LEVEL 166.40$

HCT OP 25.00$

HCV QUAL RNA-RL 546.00$

HEAVY METALS PROFILE 698.10$

HEMATOCRIT 32.50$

HEMATOPATH CONSULTATION ,SMEAR 115.70$

HEMOGLOBIN 75.40$

HEMOGLOBIN A1C 142.00$

HEPA B SURF AB 114.00$

HEPATIC FUNCTION 399.10$

HERPES AB-IgG-TYPEI&II 228.00$

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HERPES SIMPLEX CULTURE 227.50$

HERPES SIMPLEX/GENITAL 169.00$

HOMOCYSTINE RL 210.60$

HSV 1&2 SP AB IgG 282.10$

IMMUNOASSAY FOR ANALYTE OTHER THAN INFEC 170.00$

IMMUNOELECT SERUM 136.50$

IMMUNOELECTRO URINE 126.10$

INDIRECT COOMBS TEST 136.50$

INFLUENZA A 69.00$

INFLUENZA A & B 360.10$

INFLUENZA B 69.00$

IRON BINDING CAPACITY 102.00$

IRON TOTAL 112.00$

KETONE BODIES-SERUM 207.00$

KIDNEY STONE ANALYSIS 231.40$

KOH FUNGUS SMEAR-RL 111.80$

KOH-FUNGUS SMEAR 78.00$

LACTATE ARTERIAL 213.20$

LACTATE VENOUS 213.20$

LACTIC ACID RL 213.20$

LDH ISOENZYMES 144.30$

LEGIONELLA AG 198.90$

LH 88.00$

LIPASE- 256.10$

LIPID PROFILE 236.60$

LUPUS ANTICOAG 522.60$

LUPUS PROFILE 140.40$

MAGNESIUM 228.00$

METANEPHRINES 205.40$

MICROALBUMIN URINE 124.00$

MONO TEST 154.70$

MRSA SCREENING CULTURE 115.70$

MYOGLOBIN SERUM 253.50$

MYSOLIN LEVEL 475.80$

NA SERUM 161.20$

OCCULT BLOOD-FECES 100.10$

PACKED RBC 859.00$

PAP SMEAR W/MAT INDX 208.00$

PARATHYROID HORMONE 442.00$

PHENOBARBITAL 296.40$

PHOSPHORUS 137.80$

PHOSPHORUS URINE 126.10$

PINWORM PREP 99.00$

PLASMA CATECHOLAMINES 241.80$

PLATELET COUNT 209.30$

PORPHYRIN URINE QUANT 282.10$

POTASSIUM 162.50$

POTASSIUM URINE 126.10$

PREGNANCY (URINE) 118.30$

PREGNANCY SERUM 118.30$

PREGNANCY-U 25.00$

PROLACTIN 63.00$

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PROSTATIC SPEC ANTIGEN 150.00$

PROTEIN (TOTAL) 137.80$

PROTEIN C 470.60$

PROTEIN ELECTROPHORESIS 46.00$

PROTEIN IMMUNO ELECT 224.90$

PROTEIN S RL 813.80$

PROTEIN/CREATININE RATIO 94.00$

PSA 168.00$

PT/INR 171.00$

PTT 194.00$

RAPID RSV ANTIGEN 189.00$

RAPID STREP 154.70$

RA-RL 64.00$

RENAL PROFILE 448.50$

RENIN ACTIVITY PLASMA 209.30$

RENIN PLASMA 161.00$

RETICULOCYTE SEPARATION 153.40$

RH PHENOTYPING COMPLETE 171.60$

RSV 67.60$

SALICYLATE SERUM 185.00$

SED RATE 155.61$

SENSITIVITY GRAM NEG 67.00$

SENSITIVITY GRAM POS 75.00$

SENSITIVITY ORGANISM 85.80$

SENSITIVITY STREP 67.00$

SEROTONIN SERUM 257.40$

SERUM ACETONE LABCORP 105.00$

SERUM IGG 66.30$

SERUM OS MOLALITY 51.00$

SERUM PREGNANCY QUAL 173.00$

SICKLING OF RBC REDUCTION 124.00$

SJOGRENS ANTIBODIES 215.80$

SMEAR ACID FAST 141.70$

SMEAR EOSINOPHIL NASAL DO NOT USE 91.00$

SODIUM 224.90$

SODIUM 113.00$

SPECIFIC GRAVITY 100.10$

SULFONYLUREA 336.70$

T4 TOTAL 40.00$

TEGRETOL EPOXIDE RL 135.00$

TESTOSTERONE FREE AND WEEKLY BOUND 136.00$

TESTOSTERONE TOTAL 124.00$

THEOPHYLLINE LEVEL RL 296.40$

THROAT CULTURE-SCREENIN 96.00$

THROMBIN TIME 131.30$

THYROID PANEL W/ TSH 118.00$

TOBRAMYCIN LEVEL 172.90$

TRANSFERASE ASPARTATE AMINO (AST) 148.20$

TRANSFERASE ASPARTATE AMINO (AST) RL 148.20$

TRIGLYCERIDES 209.30$

TROPONIN QUANTITATIVE 214.50$

TSH 207.00$

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UREA/URINE 24 HR 180.70$

URIC ACID 158.60$

URINE CHLORIDE 126.10$

URINE CYSTINE 161.20$

URINE FATS 36.00$

URINE FOR CHLAMYDIA PCR 131.00$

URINE FOR GC PCR 144.00$

VENIPUNCTURE 43.00$

VENIPUNCTURE LAB CORP 43.00$

VENIPUNCTURE QUEST 43.00$

VIRAL LOAD 761.80$

VITAMIN B-12 184.00$

VITAMIN D25 267.00$

VMA 187.20$

WBC MAN DIFF 130.00$

WET PREP 111.80$

ZARONTIN TEST 280.80$

RADIOLOGY

A C JOINTS X-RAY 395.20$

ABDOMEN 2 VIEWS 317.20$

ABDOMEN 3 VIEWS OR MORE 343.20$

ABDOMEN AP X-RAY 423.80$

ABDOMEN X-RAY SERIES 657.80$

ACROMIO-CLAV JOINTS X-R 237.90$

ANKLE AP & LAT X-RAY 343.20$

ANKLE LMT LEFT 343.20$

ANKLE LMT RIGHT 343.20$

ANKLE ROUTINE LEFT 401.70$

ANKLE ROUTINE RIGHT 401.70$

BILATERAL HIP 572.00$

BONE SURVEY 1,159.60$

C-ARM FLUOROSCOPY 1,080.30$

CERVICAL AP & LAT X-RAY 451.10$

CERVICAL COMPLETE X-RAY 501.80$

CERVICAL INC FLEX/EX 358.80$

CHEST 1 VIEW X-RAY 380.00$

CHEST X-RAY PA & LAT 445.00$

CLAVICLE LEFT 474.50$

CLAVICLE RIGHT 474.50$

ELBOW COMPLETE X-RAY 332.00$

ELBOW L 352.30$

ELBOW RIGHT 352.30$

FACIAL BONES COMPLETE X 474.50$

FEMUR LEFT 474.50$

FEMUR RIGHT 474.50$

FINGERS L 2ND 264.00$

FINGERS LEFT 343.20$

FINGERS RIGHT 343.20$

FOOT COMPLETE LEFT 395.20$

FOOT COMPLETE RIGHT 395.20$

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FOREARM L 474.00$

FOREARM R 451.10$

HAND LEFT 395.20$

HAND RIGHT 395.20$

HIP LEFT 564.00$

HIP RIGHT 564.00$

HUMERUS LEFT 434.20$

HUMERUS RIGHT 434.20$

KNEE LMT LEFT 370.50$

KNEE LMT RIGHT 370.50$

KNEE ROUTINE LEFT 536.90$

KNEE ROUTINE RIGHT 536.90$

LUMBAR LIMITED 526.50$

LUMBOSACRAL COMPLETE 765.70$

MANDIBLE COMPLETE 526.50$

MASTOIDS 582.40$

NASAL BONES 474.50$

NECK LAT SOFT TISSUE 305.50$

ORBIT BILATERAL 443.30$

ORBIT LEFT 443.30$

ORBIT RIGHT 443.30$

OS CALCIS HEEL 259.00$

OS CALSIS-HEEL LEFT 370.50$

OS CALSIS-HEEL RIGHT 370.50$

PELVIS X-RAY 403.00$

PORTABLE X-RAY 463.00$

RIBS BILATERAL 698.10$

RIBS UNILAT LEFT 474.50$

RIBS UNILAT RIGHT 499.00$

SACRUM & COCCYX 501.80$

SACRUM-ILIAC JOINTS 423.80$

SCAPULA LEFT 395.20$

SCAPULA RIGHT 395.20$

SHOULDER LEFT 440.70$

SHOULDER RIGHT 440.70$

SINUSES COMPLETE 594.10$

SKULL AP & LAT 474.50$

SKULL SERIES 652.60$

SPINE SCOLIOSIS SERIES 352.30$

SPINE SINGLE VIEW 189.80$

STERNUM X-RAY 370.50$

TEMP/MAND JOINT 429.00$

THORACIC X-RAY 553.80$

THORACOLUMBAR SPINE 325.00$

TIB FIB LEFT 474.50$

TIBFIB RIGHT 474.50$

TOE LEFT 343.20$

TOE RIGHT 343.20$

WRIST LEFT 451.10$

WRIST RIGHT 451.10$

ULTRASOUND

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NERVE BLOCK AXILLARY 1,138.80$

NERVE BLOCK BRACHIAL PLEXUS 1,138.80$

NERVE BLOCK CERVICAL PLEXUS 1,138.80$

NERVE BLOCK OTHER PERIPHERAL BRANCH/NERV 1,138.80$

US ABDOMEN COMPLETE 1,156.00$

US ABDOMEN LIMITED 422.50$

US ABDOMEN ULTRASOUND 770.00$

US ABDOMINAL 585.00$

US ABDOMINAL AORTA SCREENING 845.00$

US AORTA 856.70$

US AORTA DUPLEX SCAN 1,053.00$

US ARTERIAL LOWER EXTREMITY BILATERIAL 1,144.00$

US ARTERIAL LOWER EXTREMITY UNILATERAL 793.00$

US ARTERIAL STUDIES BILATERAL SINGLE 422.50$

US ARTERIAL UPPER EXTREMITY UNILATERAL 659.10$

US ARTERIOGRAM SUBCLAVIAN 496.00$

US BLADDER ULTRASOUND 422.50$

US BREAST ULTRASOUND, COMPLETE 449.00$

US BREAST ULTRASOUND, LIMITED 409.50$

US C-ARM FLUORO EXT 515.00$

US CAROTID ARTERIES DUPLEX SCAN BILAT 1,082.90$

US CHEST ULTRASOUND 396.50$

US CHOLANGIOGRAM T-TU 802.00$

US ECHOCARDIOGRAM 2D 1,575.60$

US ECHOCARDIOGRAM 2D W/COLOR FLOW DOPP 868.40$

US GALLBLADDER 455.00$

US PELVIC 856.70$

US PELVIC ULTRASOUND 599.00$

US PREGNANCY 1ST TRIMESTER 383.50$

US PREGNANCY 2ND AND 3RD TRIMESTER 520.00$

US RENAL (KIDNEY) 363.00$

US SCROTUM 487.50$

US SOFT TISSUE - EXTREMETIES 715.00$

US SONOGRAM ABD 705.90$

US SONOGRAM GALL BLADDER 681.20$

US THYROID 781.30$

US TRANSVAGINAL ULTRASOUND 599.00$

US TRANSVAGINAL-NON OB 856.70$

US TRANSVAGINAL-OB 858.00$

US ULTRASONIC GUIDANCE 292.50$

US UPPER EXTREMITY ARTERIAL BILATERAL 1,144.00$

US VENOUS EXTREMITY BILAT 907.00$

US VENOUS EXTREMITY UNILATERAL 549.00$

US VENOUS IMAGING EXTREMITY-LEFT 1,040.00$

US VENOUS IMAGING EXTREMITY-RIGHT 1,040.00$

CT SCAN

CT HEAD W/O CONTRAST 1,411.80$

CT HEAD W/CONTRAST 1,634.10$

CT HEAD W&W/O CONTRAST 2,176.20$

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CT SCAN HEAD 1,454.00$

CT W/WO HEAD 2,831.00$

CT ORB/SELLA/P-FOSSA W/O 1,470.30$

CT ORB/SELLA/P-FOSSA W/ 1,705.60$

CT ORB/SELLA/P-FOSSA W& 2,057.90$

CT MAXILLO W/O CONTRAST 1,423.50$

CT MAXILLO FACIAL W/CON 1,682.20$

CT MAXILLO FACE W&W/O 2,057.90$

CT NECK W/O CONTRAST 1,470.30$

CT NECK W/CONTRAST 1,710.80$

CT NECK W&W/O CON 2,057.90$

CT THORAX W/O CONTRAST 1,705.60$

CT THORAX W/CONTRAST 2,057.90$

CT THORAX W & W/O CONTR 2,421.90$

CT CERVICAL SP W/O CONT 2,353.00$

CT CERVIVAL SP W/CONTRA 2,763.80$

CT CERVICAL SP W&W/O CO 3,264.30$

CT THORACIC W/O CONTRAS 2,034.50$

CT THORACIC SPINE W/CON 2,353.00$

CT THORAIC SPINE W&W/O 3,264.30$

CT LUMBAR SP W/O CONTR 2,353.00$

CT LUMBAR SPINE W/CONTR 2,587.00$

CT LUMBAR SPINE W & W/O 3,292.90$

CT PELVIS W/O CONTRAST 2,057.90$

CT PELVIS W/CONTRAST 1,730.30$

CT PELVIS W&W/O CONTRAS 2,557.10$

CT UPR EXT W/O CONTRAST 1,470.30$

CT UPPER EXTREMITY W/CO 1,705.60$

CT UPPER EXTREMITY W & 2,046.20$

CT LOWER EXTREMITY W/O 1,462.50$

CT LOWER EXTREMITY W/CO 1,699.10$

CT LOWER EXTREMITY W & 2,057.90$

CT ABD W/O CONTRAST 1,940.90$

CT ABD W/CONTRAST 2,553.20$

CT ABD W & W/O CONTRAST 2,559.70$

CT BONE DENSITY STUDY 2,587.00$

CT CORONAL 847.60$

CT TEMP/MAND W/O CONTRA 1,423.50$

CT TEMP/MAND W/CONTRAST 1,682.20$

CT TEMP/MAND W&W/O CONT 2,057.90$

BLOOD

ANTIBODY ELUTION 358.80$

ANTIBODY ID PANEL 354.90$

BB BLOOD PROCESSING/STORAG 725.40$

BLOOD TRANSFUSION SERVI 1,539.20$

RBC ANTIGENS OTHER THAN ABO OR RH(D) 128.70$

RUBELLA ANTIBODIES IGM 136.50$

RESPIRATORY THERAPY

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3RD MEDICATION 79.30$

AEROSOL INITIAL 157.30$

ARTERIAL PUNCTURE, WITHDRAWAL OF BLOOD 78.00$

ASST INTUBATION 224.90$

BIPAP 500.50$

CHEST PHISIOTHERAPY INTIAL 179.40$

CHEST PHISIOTHERAPY SUB 85.80$

CPAP SETUP 500.50$

HEMOGLOBIN 33.80$

HUMIDIFIER (DAILY) 119.60$

INCENT SPIRO TRTMT INITIAL 131.30$

MDI TREATMENT EACH 115.70$

METHEMOGLOBIN 58.50$

NEB, MDI, IPPB EDUCATION ONLY 128.70$

NEBUL TREATMENT EACH 104.00$

OXIMETRY (BLOOD PO-2) 37.70$

OXYGEN ER 50.70$

OXYGEN PER 24HR 734.00$

OXYGEN PRN (PER 24HR) 530.40$

OXYGEN-PORT/HOUR 33.80$

PEAK FLOW INITIAL 68.90$

PEAK FLOW SUB 41.60$

PFT 296.40$

PULMONARY STRESS TEST 171.60$

PULSE OXIMETER MULTIPLE DETERMINATIONS 180.70$

PULSE OXIMETRY CONT OVERNIGHT MONITORING 674.70$

PULSE OXIMETRY SINGLE DETERMINATION 674.70$

SIMPLE SPIROMETRY TEST 171.60$

SPUTUM INDUCTION 41.60$

TELEMETRY DAILY 494.65$

TELEMETRY SET UP 239.79$

VENTILATOR - SET UP/STAT 709.80$

VENTILATOR PER HOUR 179.40$

PHYSICAL THERAPY

PT RE EVALUATION 253.50$

PT TRACTION 62.40$

PT WHIRLPOOL THERAPY 81.50$

PT DEBRID FULL THICK EA ADDTL 20 sq cm 291.20$

PT TENS (AS ADD MODALITY) 74.10$

PT MANUAL FOR YOUR NECK 13.40$

PT MANUAL FOR YOUR BACK 19.50$

PT HAND SPLINTS 149.50$

PT DEBRIDEMENT FULL THICK 552.50$

PT DEBRIDEMENT SUBCUTANEOUS <= 20sq cm 552.50$

PT FCE 156.00$

PT ELECTRODE 127.40$

PT THER EXERCISE 15 MIN 137.00$

PT WHEELCHAIR MGMT 158.60$

PT BALANCE 128.70$

PT DEBRID SELECT <=20SQ CM 292.50$

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PT DEBRIDE SELECT >20 SQ C 130.00$

PT DEBRIDE NON-SELECT PER 260.00$

PT RESTING/EXTENSION SPLINT 543.40$

PT PARAFFIN 71.50$

PT ORTHOTIC/PROST INITIAL EACH 15 MINS 146.90$

PT ORTHOTIC/PROST ESTAB EACH 15 M 182.00$

PT E STIM 107.90$

PT INITIAL EVAL LOW COMPLEXITY 377.00$

PT HOT/COLD PACKS 57.20$

PT ULTRASOUND 15 MIN 79.30$

PT MASSAGE 107.90$

PT GAIT TRAINING 173.00$

PT ADL SELF CARE 15 MIN 133.90$

PT WHIRLPOOL 136.50$

PT DRESSING CHANGE 71.50$

PT IONTOPHORESIS 15 MIN 124.80$

PT THER ACT 15 MIN 141.00$

PT NEUROMUSC RE-ED 15 MIN 128.70$

PT MANUAL THER TECHNIQUES 115.70$

PT INITIAL EVAL MOD COMPLEXITY 377.00$

PT INITIAL EVAL HIGH COMPLEXITY 377.00$

OCCUPATIONAL THERAPY

OT INITIAL EVAL LOW 364.00$

OT RE-EVAL 240.50$

OT HEAT/COLD PACKS 42.90$

OT ULTRASOUND 15 MIN 65.00$

OT THER EXER 15 MIN 131.00$

OT ELECTRODES 98.00$

OT E STIM 79.30$

OT IONTOPHORESIS 15 MINS 96.00$

OT NEUROMUSC RE-ED 15 MINS 128.70$

OT DEBRIDE(SELECT)<=20SQ.C 292.50$

OT WHIRLPOOL 85.80$

OT CONTRAST BATH 70.20$

OT MANUAL THERAPY TECHNIQUE 115.70$

OT ADL SELF CARE 15 MIN 141.00$

OT RESTING/EXTENSION SPLINT 543.40$

OT PARAFFIN 71.50$

OT ORTHOTIC/PROST INITIAL EA 15 M 146.90$

OT ORTHOTIC/PROST ESTAB EACH 15 M 182.00$

OT DRESSING CHANGE 57.20$

OT GEL CAPS - SUPPLIES 9.10$

OT SCAR CONFORMER - SUPPLI 114.40$

OT ELBOW ORTHOSIS DYNAMIC 694.20$

OT ELBOW ORTH CUSTOM 494.00$

OT THER ACT 15 MIN 141.00$

OT INITIAL EVAL MOD 364.00$

OT INITIAL EVAL HIGH 400.00$

POST-OFFER EMPLOYMENT SCREEN 116.00$

POST-OFFER EMPLOYMENT SCREEN-NO SHOW 55.25$

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SPEECH THERAPY

ST SPEECH TREATMENT INDIVIDUAL 308.10$

ST SPEECH THER INITIAL EVA 265.20$

ST SWALLOWING/FEEDING 349.00$

ST SPEECH RE-EVAL 128.70$

ST SPEECH EVAL 224.90$

ST ASSESS OF APHASIA 405.60$

ST EVALUATE SWALLOWING 390.00$

ST SPEECH COGNI SKILLS DEV 143.00$

EMERGENCY ROOM

ADM/IMMUN TOXOID EACH ADDITIONAL 192.40$

ADM/IMMUNI/TOXOID </= 18 YO EACH ADDT 165.10$

ADM/IMMUNIZ/TOXOID SUBC/IM 212.00$

ADM/IMMUNIZATION/TOXOID </= 18 YO 192.40$

ADM/THERA DRUG, IV INJ - PUSH 212.00$

ADM/THERA DRUG,SUBC/IM 212.00$

ARTHROCENT SHDLR,HIP,KN 237.90$

BURN,DRESSING-LARGE 501.80$

BURN,DRESSING-MEDIUM 491.40$

BURN,DRESSING-SMALL 481.00$

BURN,INITIAL TX 1ST DEG 460.20$

CARDIAC MONITOR E/R 743.00$

CARDIAC MONITOR PER DAY 678.60$

CAST SHORT ARM 460.20$

CAST SHORT LEG 534.30$

CATHERTERIZATION,SIMPLE 235.30$

CLOSED TRET OF FRACTURE OTHER GREAT TOE 510.00$

CLOSED TX METACAR W/O A 427.70$

CRITICAL CARE 1ST HR 2,357.00$

CRITICAL CARE ADDL 30 M 1,072.50$

DEBRID, SKIN PARTIAL 384.80$

DEBRIDEMENT 370.50$

DESTRUCTION BENIGN LESIONS 552.50$

DIS/A-C SEP W/MANIP 481.00$

DIS/A-C SEP W/O MANIP 427.70$

DIS/ELBOW CLOSED W/O AN 562.90$

DIS/ELBOW,CLOSED W/ANES 2,779.40$

DIS/FINGER/CLOSED W/ MANIPULATION 1,352.00$

DIS/FINGER/CLOSED W/ANE 2,779.40$

DIS/FINGER/CLOSED W/O A 427.70$

DIS/GREAT TOE 640.90$

DIS/HIP SPONTANEOUS W/O 562.90$

DIS/HIP,SPONTANEOUS W/A 2,779.40$

DIS/HIP,TRAUMATIC W/ANE 2,779.40$

DIS/HIP,TRAUMATIC W/O A 562.90$

DIS/RADIAL HEAD-SUBLUXA 562.90$

DIS/SHOULDER,CLOSED W/O 427.70$

DIS/THUMB W/MANIPULATIO 562.90$

Page 12: DESCRIPTION CURRENT PRICE LABORATORY

DIS/T-M JOINT 438.10$

DRAINAGE OF GUM LESSION 540.00$

EMERGENCY CARE I 254.80$

EMERGENCY LEVEL I 508.00$

EMERGENCY LEVEL II 794.00$

EMERGENCY LEVEL III 952.00$

EMERGENCY LEVEL IV 1,425.00$

EMERGENCY LEVEL V 2,158.00$

EXC BEN LESION 1.1 - 2 1,276.60$

EXCISION OF NAIL 829.40$

EXPLORE WOUND, EXTREMIT 427.70$

FOREIGN BODY - CORNEA 821.60$

FOREIGN BODY MOUTH SIMPLE 552.50$

I&D ABSCESS COMP 1,314.30$

I&D ABSCESS COMPLEX 1,248.00$

I&D ABSCESS SIMPLE 550.00$

I&D BARTHOLIN'S CYST 616.20$

I&D DEEP ABCESS SHOULDER 1,625.00$

I&D HEMATOMA 958.10$

I&D MOUTH 438.10$

I&D PILONIDAL CYST 481.00$

I&D SUBUNGUAL HEMATOMA 224.90$

I&D THROMB.HEMORRHOID 609.70$

IMPACTED CERUME EARS INST 213.20$

IMPACTED CERUME EARS IRRIGATION 213.20$

INJ SINGLE OR MULTIPLE TRIGGER POINTS 290.00$

IV CONCURRENT INFUSION 227.50$

IV HYDRATION INFUSION EACH ADDT HOUR 110.50$

IV HYDRATION INITIAL 31 - 60 MINS 299.00$

IV INFUSION (NEW DRUG) SEQUENT = < 1 HR 156.00$

IV INFUSION THER EACH ADDT HOUR 116.00$

IV INFUSION THERAPY INITIAL 16 - 60 MINS 572.00$

IV PUSH ADDITIONAL DOSE SAME DRUG 116.00$

IV PUSH SEQUENT - EA. ADDIT NEW SUBSTA 156.00$

LAC COMPLEX EACH ADD'TL 5 CM OR LESS 780.00$

LAC/COMP-1.0 TO 2.5 CM 972.40$

LAC/COMP-1.1 TO 2.5 CM 982.80$

LAC/COMP-1.1 TO 2.5 CM 2,468.70$

LAC/COMP-2.6 TO 7.5 CM 1,004.90$

LAC/COMP-2.6 TO 7.5 CM 1,015.30$

LAC/COMP-2.6 TO 7.5 CM 1,015.30$

LAC/COMP-2.6 TO 7.5 CM 2,480.40$

LAC/INTER-12.6 TO 20 CM 790.40$

LAC/INTER-12.6 TO 20 CM 2,497.30$

LAC/INTER-12.6 TO 20 CM 855.40$

LAC/INTER-2.6 TO 5.0 CM 683.80$

LAC/INTER-2.6 TO 7.5 CM 683.80$

LAC/INTER-2.6 TO 7.5 CM 683.80$

LAC/INTER-20.1 TO 30 CM 855.40$

LAC/INTER-20.1 TO 30 CM 855.40$

LAC/INTER-5.1 TO 7.5 CM 737.10$

LAC/INTER-7.6 TO 12.5 C 737.10$

Page 13: DESCRIPTION CURRENT PRICE LABORATORY

LAC/INTER-7.6 TO 12.5 C 737.10$

LAC/INTER-7.6 TO 12.5 C 790.40$

LAC/INTER-UP TO 2.5 CM 630.50$

LAC/INTER-UP TO 2.5 CM 630.50$

LAC/INTER-UP TO 2.5 CM 630.50$

LAC/SIMP-12.6 TO 20 CM 790.40$

LAC/SIMP-12.6 TO 20 CM 790.40$

LAC/SIMP-2.6 TO 5.0 CM 652.60$

LAC/SIMP-2.6 TO 7.5 CM 718.00$

LAC/SIMP-20.1 TO 30 CM 855.40$

LAC/SIMP-5.1 TO 7.5 CM 683.80$

LAC/SIMP-7.6 TO 12.5 CM 737.10$

LAC/SIMP-7.6 TO 12.5 CM 737.10$

LAC/SIMP-UP TO 2.5 CM 630.50$

LAC/SIMP-UP TO 2.5 CM 630.50$

NAIL AVULSION 552.50$

NOSE PACKING, SIMPLE 267.80$

NOSE PACKING,COMPLEX 299.00$

PLSTR CST/SPL LEG ADULT 245.70$

PUNCTURE ASPIRATION OF ABSCESS 650.00$

REM FB EYE-CONJ-COMPLEX 575.90$

REM.FOREIGN BODY SIMPLE 409.50$

REM/DEVITALIZED TISS/WO 256.10$

REM/F/B,MUSCLE 838.50$

REM/F/B-NOSE 309.40$

REM/FOREIGN BDY SIMP-TI 414.70$

REMOV F/B SUBCUT: SIMPLE 547.30$

REMOVAL FB EYE CONJUNCTIVAL 547.30$

REMOVAL FB EYE CORNEAL 308.10$

REMOVAL FOREIGN BDY EAR 215.80$

REMOVAL FOREIGN BDY,ARM 845.00$

REMOVAL FOREIGN BDY,COM 1,349.40$

REMOVE F/B EYELID 418.60$

REMOVE F/B FOOT 837.20$

REPAIR LIP 2,492.10$

REPAIR OF NAIL BED 504.40$

SKIN TISSUE PROCEDURE 405.60$

SPLINT, FINGER 279.50$

SPLINT, LONG ARM 507.00$

SPLINT, LONG LEG 526.50$

SPLINT, SHORT ARM 487.50$

SPLINT, SHORT LEG 513.50$

STRAPPING, ANKLE 321.10$

STRAPPING, KNEE 341.90$

STRAPPING, TOES 309.40$

TD 7YRS/OLDER 240.50$

WEDGE EXC FOR INGROWN N 435.50$

EMERGENCY ROOM - PROFESSIONAL

AVUL NAIL PLATE SIMPLE 1,045.20$

COMPLEX DRAINAGE,WOUND 941.20$

Page 14: DESCRIPTION CURRENT PRICE LABORATORY

DRAINAGE OF HERMATOMA/F 1,045.20$

INCISION & DRAINAGE ABS 1,190.80$

INCISION & DRAINAGE ABS 2,632.50$

INCISION & DRAINAGE,SIM 640.90$

INCISION &DRAINAGE PILO 2,585.70$

PUNCTURE ASPIRATION OF 643.50$

REM.NAIL PLATE,ADD-ON 176.80$

REMOVAL FOREIGN BDY SIM 705.90$

REMOVAL FOREIGN BODY CO 2,232.10$

EKG

EKG 341.00$

EEG (LSH) 560.30$

EKG 24 HOUR HOLTER 419.90$

OBSERVATION

OBS BED HOURS 281.00$

OUTPATIENT CARE 469.30$

OUTPATIENT SERVICES

ADM/IMMUNIZATION/TOXOID 136.50$

ADM/IMMUNIZATION/TOXOID </= 18 YO 136.50$

ADM/IMMUNIZATION/TOXOID </= 18 YO EA ADD 111.80$

ADM/IMMUNIZATION/TOXOID EACH ADDT 111.80$

ADM/INJECTION JOINTS 111.80$

ADM/THER DRUG,ANTIB,INT 111.80$

ADM/THER DRUG,INT/ART I 111.80$

ADM/THER DRUG,IV INJ 111.80$

ADM/THERA DRUG,SUBC/INT 111.80$

BURN DRESSING-SMALL 253.50$

CAST FOREARM 416.00$

DRAINAGE OF SKIN ABSCES 477.10$

EXCISION OF NAIL 955.50$

IRRIGATION DRUG DELIVERY DEVICE 110.50$

O/P CLINIC LEVEL III NEW PATIENT 30 MIN 372.00$

O/P CLINIC LEVEL I EST PATIENT 5 MINS 72.00$

O/P CLINIC LEVEL I NEW PATIENT 10 MIN 231.00$

O/P CLINIC LEVEL II EST PATIENT 10 MINS 91.00$

O/P CLINIC LEVEL II NEW PATIENT 20 MIN 281.00$

O/P CLINIC LEVEL III EST PATIENT 15 MINS 169.00$

O/P CLINIC LEVEL IV NEW PATIENT 45 MIN 436.00$

O/P CLINIC LEVEL V EST PATIENT 40 MINS 364.00$

O/P CLINIC LEVEL V NEW PATIENT =>60 MIN 559.00$

O/P CLINIC VISIT LEVEL 4 EST PT 25MINS 273.00$

REMOVAL FOREIGN BODY-EY 630.50$

SPLINT, SHORT LEG 517.40$

SPLINT,SHORT ARM 491.40$

Page 15: DESCRIPTION CURRENT PRICE LABORATORY

PHARMACY

ACET/COD (TYLENOL#4) 300MG/60MG TAB 5.10$

ACET/COD (TYLENOL/COD)120MG/12MG 5ML 5.85$

ACET/COD(TYLENOL #3) 300MG/ 30MG TAB 3.85$

ACETAMINOPHEN (TYLENOL) 160MG/5 ML SUSP 8.05$

ACETAMINOPHEN (TYLENOL) 160MG/5 ML SUSP 8.67$

ACETAMINOPHEN (TYLENOL) 325 MG CAPLET 0.32$

ACETAMINOPHEN (TYLENOL) 325 MG SUPP 6.24$

ACETAMINOPHEN (TYLENOL) 325 mg SUPP 3.85$

ACETAMINOPHEN(TYLENOL ES) 500 MG TAB 3.85$

ACETAMINOPHEN(TYLENOL) 120 MG SUPP 6.63$

ACETAMINOPHEN(TYLENOL) 650 MG SUPP 4.40$

ACETIC ACID 0.25% IRRIGATION SOLUTION 16.62$

ACETYLCYSTEINE 20% VIAL 200 MG/ML 37.80$

ACETYLCYSTEINE (MUCOMYST) 20% 30 ML VIAL 1,400.00$

ACETYLCYSTEINE(MUCOMYST)20%4ML INH VIAL 84.41$

ACTIV CHARC/SORB(ACTIDOSE/SOR)50GM/96GM 189.15$

ACTIV CHARCOAL (ACTIDOSE) 25 GM /120 ML 80.20$

ACYCLOVIR (ZOVIRAX) 200 MG CAP 9.17$

ACYCLOVIR (ZOVIRAX) 50MG/ML 20ML VIAL 150.00$

ACYCLOVIR (ZOVIRAX) IV IN NS 150.00$

ADENOSINE (ADENOCARD) 12 MG /4 ML SYR 156.00$

ADENOSINE (ADENOCARD) 6MG/2ML VIAL 13.79$

ADENOSINE(ADENOCARD) 6 MG / ML SYR 216.20$

ADMINISTRATION FEE (INJECTION CHARGE) 11.00$

ADRENALIN (EPINEPHrine) 1MG/1ML VIAL 14.96$

ADVAIR DISKUS 500/50 MCG BLISTERS 1,088.96$

ALBUTEROL (VENTOLIN) HFA 8 G INH 240.95$

ALBUTEROL (VENTOLIN) INH SOL 0.083% 5.82$

ALBUTEROL (VENTOLIN)2.5 MG /3ML VIAL NEB 4.80$

ALBUTEROL MDI(VENTOLIN)90 MCG/PUFF 270.09$

ALBUTEROL SULFATE INH SOL, 0.021% 5.82$

ALENDRONATE(FOSAMAX) 70 MG TAB 122.93$

ALLOPURINOL(ZYLOPRIM) 100 MG TAB 5.58$

ALPRAZolam (XANAX) 0.25 MG TAB 3.85$

ALPRAZolam (XANAX) 0.5 MG TAB 4.14$

AMANTADINE SYRUP 100MG/10ML (STOCKED-NF) 16.05$

AMIODARONE (CORDARONE) 200 MG TAB 20.28$

AMIODARONE HCL(CORDARONE)150MG/3 ML VIAL 11.00$

AMITIZA (LUBIPROSTONE) 24 MCG CAPSULE 44.52$

AMITRYPTILINE (ELAVIL) 100 MG TAB 15.24$

AMITRYPTILINE (ELAVIL) 25 MG TAB 3.85$

amLODIPine (NORVASC) 5 MG TAB 9.85$

AMMONIA INHALANT AMP 3.85$

AMOX/CLAV (AUGMENTIN)875 MG/125 MG TAB 29.70$

AMOX/CLAV(AUGMENTIN) 500MG/125MG TAB 22.70$

AMOXICILLIN (AMOXIL) 250 MG CAP 1.49$

AMOXICILLIN(AMOXIL) 250 MG / 5 ML SUSP 10.62$

AMOXICILLIN/CLAV 200MG/28.5MG/5ML SUSP 36.90$

AMPICILLIN (OMNIPEN) 1 GM VIAL 51.85$

AMPICILLIN / SUBLACT (UNASYN) 3 GM VIAL 55.55$

Page 16: DESCRIPTION CURRENT PRICE LABORATORY

AMPICILLIN 2 GM VIAL 92.14$

AMPICILLIN 500 MG VIAL 26.43$

AMPICILLIN/SUBLACT (UNASYN) 1.5 GM VIAL 46.41$

ANTI-ITCH CREAM 1% HYDROCORTISONE 5.85$

ANTIPYRINE/BENZO(AURALGAN)10ML OTIC DROP 71.70$

ANZEMET (DOLASETRON MESYL)100MG/5ML VIAL 237.87$

ARANESP (DARBEPOETIN) 60 MCG/0.3ML SYR 2,105.44$

ASPIRIN 325 MG EC DR TAB 3.85$

ASPIRIN 81 MG CHEWABLE TAB 3.85$

ASPIRIN 81 MG EC TAB 3.85$

ASPIRIN SUPPOSITORIES 600 MG 9.06$

ASPIRIN SUPPOSITORY 300 MG 8.74$

ATENOLOL(TENORMIN) 25 MG TAB 4.28$

ATORVASTATIN (LIPITOR) 20 MG TAB 3.85$

ATORVASTATIN (LIPITOR) 80 MG TAB 11.64$

ATORVASTATIN (LIPITOR)10 MG TAB 3.00$

ATROPINE (0.1 MG / ML) 1 MG / 10 ML SYR 59.80$

ATROPINE 0.4 MG/ML VIAL 26.25$

ATROPINE 1 MG / ML VIAL 41.25$

ATROPINE 8 MG / 20 ML VIAL 210.60$

ATROPINE SULFATE 1% EYE DROP 2 ML 153.75$

azaTHIOprine 50 MG TAB 14.07$

AZITHROMYCIN (ZITHROMAX) 250 MG TAB 25.29$

AZITHROMYCIN (ZITHROMAX) 500 MG VIAL 53.49$

AZITHROMYCIN (ZITHROMAX) 600 MG TAB 102.75$

AZITHROMYCIN IV 500MG ADD-VANTAGE VIAL 70.99$

AZITHROMYCIN(ZITHROMAX) 300 MG/15ML SUSP 69.76$

AZITHROMYCIN(ZMAX) 200MG/5ML 30ML SUSP 34.86$

AZTREONAM 1 GM 20 ML VIAL 179.70$

BACITRACIN 50,000 UNITS VIAL 79.85$

BACLOFEN 10MG TAB 3.85$

BACTERIOSTATIC SODIUM CHL 0.9% 10ML VIAL 11.00$

BELLADONNA /OPIUM (16.2 / 30 MG) SUPP 151.31$

BELLADONNA /PB (DONNATAL) 10 ML ELIXIR 107.60$

BENZOIN TINCTURE(TINCT OF BENZ)CMPD 2OZ 3.85$

BENZONATATE(TESSALON PERLES) 100MG CAP 4.37$

BENZTROPINE MESYLATE INJ SOLN 1MG/1ML 264.37$

BETAMETHASONE(CELESTONE)6MG/1ML 5ML VIAL 48.00$

BISACODYL (DULCOLAX) 10 MG SUPP 3.85$

BISACODYL (DULCOLAX) 5 MG TAB 3.85$

BLOXIVERZ 0.5 MG / 1 ML PER 10 ML VIAL 474.00$

BRILINTA (TICAGRELOR) 90MG TABLET 39.90$

BUDESONIDE RESPULES(PULMICORT) 0.5MG INH 41.05$

BUDESONIDE(PULMICORT)0.25MG/2ML RESUPULE 35.35$

BUDESONIDE(PULMICORT)INH SUS 0.25 MG/2ML 30.24$

BUDESONIDE(PULMICORT)INH SUS 0.5 MG 48.10$

BUMETANIDE (BUMEX) 0.25 MG/ML VIAL 15.15$

BUMETANIDE(BUMEX) 1 MG TAB 16.02$

BUPIVICAINE(MARCAINE) 0.5% 30ML VIAL 13.10$

BUPIVICAINE(SENSORCAINE) 0.5% 10 ML VIAL 32.83$

BUPIVICAINE/EPI(SENSORCAIN)0.5%30ML VIAL 15.12$

BUPRENORPHINE 2MG SUBLINGUAL TABLET 27.18$

Page 17: DESCRIPTION CURRENT PRICE LABORATORY

buPROPion (WELLBUTRIN)150MG TAB SR 12HR 4.22$

busPIRone (BUSPAR) 15 MG TAB 12.12$

BYSTOLIC (NEBIVolol) 5MG TABLET 26.60$

BYSTOLIC ORAL TABLET 10MG 28.62$

CALCITRIOL 0.25MCG CAPSULE 7.68$

CALCIUM 500 MG (CITRICAL) /VIT D TAB 3.85$

CALCIUM ACETATE (PHOSLO) 667MG CAPSULE 6.12$

CALCIUM CARBONATE (TUMS) 500MG 500TABs 0.40$

CALCIUM CHLORIDE 1 GM 100 MG / ML SYR 38.23$

CALCIUM GLUCONATE 10 % 100 MG / ML IVPB 38.88$

CALCIUM GLUCONATE 100 MG/ML 10 ML VIAL 38.88$

CAPTOPRIL(CAPOTEN) 25 MG TAB 11.17$

carBAMazepine (TEGretol ) 200 MG TAB 9.50$

CARBAMIDE (CERUMENEX)6.5% EAR SOL 13.80$

CARBIDOPA / LEVODOPA ORAL TAB 25MG-100MG 3.85$

CARBIDOPA/LEVODOPA 25MG/250MG TAB 6.68$

CARBIDOPA/LEVODOPA 50-200M EXT RELEASE 10.45$

CARVEDILOL(COREG) 12.5 MG TAB 12.82$

CARVEDILOL(COREG) 3.125 MG TAB 12.60$

CATHFLO ACTIVASE (ALTEPLASE) 2MG VIAL 679.24$

ceFAZolin (ANCEF) 1 GM VIAL 7.92$

ceFAZolin (ANCEF)1 GM/50 ML D5W PREMIX 30.25$

ceFAZolin 1 GRAM 15.67$

ceFAZolin INJ 1 GRAM 15.67$

ceFAZolin/DEXTROSE(ANCEF)2GM/50ML PREMIX 52.56$

CEFDINIR(OMNICEF) 300 MG CAP 30.68$

CEFEPIME(MAXIPIME) 1 GM VIAL 111.84$

CEFEPIME(MAXIPIME) 2 GM VIAL 65.74$

cefTRIAXone (ROCEPHIN) 1 GM VIAL 230.00$

cefTRIAXone (ROCEPHIN) 1GM VIAL 230.00$

cefTRIAXone (ROCEPHIN) 500 MG VIAL 11.00$

cefTRIAXone 1GM VIAL/LIDOcaine 230.00$

cefTRIAXone/D5W(ROCEPHIN)1GM/50ML PREMIX 83.55$

cefTRIAXzone (ROCEPHIN) 1 GM ADD VIAL 24.55$

CEFUROXIME (CEFTIN) ORAL TABLET 250MG 10.92$

CeleCOXIB(CELEBREX) 100 MG CAP 26.20$

CELECOXIB(CELEBREX) 200 MG CAP 50.54$

CEPHALEXIN (KEFLEX) 250 MG / 5 ML SUSP 5.85$

CEPHALEXIN(KEFLEX) 250 MG CAP 4.07$

CETIRIZINE (zyrTEC) 10 MG TAB 3.85$

chlordiazePOXIDE (LIBRIUM) 10 MG CAP 3.85$

CHLORHEXIDINE GLUCONATE 0.12% MOUTHRINSE 0.13$

CHLORHEXIDINE GLUCONATE 0.12% ORAL RINSE 62.40$

CHLORTHALIDONE 25MG TABLET 13.77$

CHOLESTYRAMINE PWD FOR SUSP 4GM/9GM 20.16$

CIPROFLOXACIN(CIPRO) 500 MG TAB 30.60$

CIPROFLOXACIN(CIPRO)/D5W400MG/200ML PRMX 21.24$

CLARITHROMYCIN (BIAXIN) 500 MG TAB 36.81$

CLEOCIN/ D5W(CLINDAMYCIN)600MG/50ML PRMX 115.12$

CLEOCIN/D5W(CLINDAMYCIN)900MG 50ML PREMX 99.68$

CLINDAMYCIN (CLEOCIN) 150 MG CAP 3.85$

CLINDAMYCIN (CLEOCIN) 600 MG 4 ML VIAL 20.88$

Page 18: DESCRIPTION CURRENT PRICE LABORATORY

CLINIC CLEOCIN PEDIACTRIC SOL 75MG / 5ML 21.96$

clonazePAM (klonoPIN) 0.5 MG TAB 4.83$

clonazePAM (KlonoPIN) 1 MG TABLET 5.40$

cloNIDine (CATAPRES) 0.1 MG TAB 3.85$

cloNIDine (CATAPRES) 0.1 MG TD PATCH 165.61$

cloNIDine (CATAPRES) 0.2 MG TD PATCH 398.89$

cloNIDine (CATAPRES) 0.3 MG TD PATCH 608.12$

CLOPIDOGREL(PLAVIX) 75 MG TAB 26.17$

CLORAZEPATE (TRANXENE) 7.5MG TABLET 17.04$

CLOTRIMAZOLE(LOTRIMIN AF)14.17GM CREAM 31.74$

COLCHICINE (COLCRYS) 0.6 MG TAB 66.90$

COLLAGENASE (SANTYL) 30 GM OINT 983.04$

CurX (BENZALKONIUM) 45 GM GEL TUBE 306.00$

CurX ANTIMICROBIAL GEL 5 GM TUBE 1.50$

CYCLOBENZAPRINE HCL (FLEXERIL) 10 MG TAB 7.25$

CYCLOPENTOLATE(CYCLOGEL) 1 % EYE DROPS 174.75$

cycloSPORINE 100 MG CAPSULE 32.98$

cycloSPORINE 25 MG CAPSULE 8.25$

DALIRESP (ROFLUMILAST) 500MCG TAB 77.19$

DANTROLENE SOD(DANTRIUM) 20 MG IV 5.82$

DAPTOmycin(CUBICIN) 500 MG VIAL 2,016.00$

DEMEROL (MEPERIDINE) 25MG/ ML 10CT SYR 32.69$

DEXAMETHASONE (DECADRON) 4 MG/1 ML VL 15.84$

DEXAMETHASONE (PF) 10 MG / ML 1 ML VIAL 37.80$

DEXAMETHASONE ORAL SOLN 1MG/10ML SYR 1.59$

DEXAMETHASONE ORAL SOLN 1MG/ML 5ML SYR 6.43$

DEXAMETHASONE(DECADRON) 0.5 MG TAB 5.82$

DEXAMETHASONE(DECADRON) 10 MG / ML 11.00$

DEXAMETHASONE(DECADRON) 4 MG TAB 4.10$

DEXAMETHASONE(DECADRON) 4MG/1ML 5ML VIAL 11.86$

DEXTROSE (PEDIATRIC) 25% 2.5 GM/10 ML 49.90$

DEXTROSE 50 % 25 GM (0.5 G/ML) 50 CC SYR 125.00$

DIAZEPAM (VALIUM) TAB 5 MG 3.85$

DIAZEPAM(VALIUM) 10 MG / 2 ML SYR 103.95$

DICLOFENAC (VOLTAREN) 1% TOPICAL GEL 246.69$

DICLOXACILLIN 250 MG CAP 7.52$

DICYCLOMINE (BENTYL) 10 MG CAP 3.58$

DICYCLOMINE(BENTYL) 20MG/2ML AMP 362.55$

DIGOXIN(LANOXIN) 0.125 MG TAB 15.36$

DIGOXIN(LANOXIN) 0.5 MG / 2 ML AMP 39.60$

DILTIAZEM (CARDIZEM) 25 MG/ 5 ML VIAL 15.69$

DILTIAZEM (CARDIZEM) 30 MG TAB 3.85$

DILTIAZEM CD (CARDIZEM) 120 MG CAP 8.98$

DILTIAZEM CD (CARDIZEM) 180 MG CAP 3.85$

DIPHENHYD(BENADRYL)12.5 MG/5 ML 473ML 3.85$

DIPHENHYDRAMINE (BENADRYL)50 MG/1ML VIAL 11.00$

DIPHENHYDRAMINE(BENADRYL) 12.5MG/5ML SOL 5.85$

DIPHENHYDRAMINE(BENADRYL) 25 MG CAP 0.41$

DIPHENHYDRAMINE(BENADRYL) 50 MG CAP 3.85$

DIPHNXYLTE/ATROP(LOMOTIL)2.5MG/0.025 TAB 3.85$

DIPTH/TET/PERT(CHILD)(DTAP)0.5ML VIAL 247.00$

DIVALPROEX (DEPAKOTE) 250MG DR TABLET 104.10$

Page 19: DESCRIPTION CURRENT PRICE LABORATORY

DIVALPROEX ER(DEPAKOTE) 250 MG TAB 11.78$

DOBUTamine 250 MG/20 ML 20 ML VIAL 33.40$

DOCUSATE 100 MG / 10 ML CUPS* 5.12$

DOCUSATE(COLACE) 100 MG CAP 0.26$

DONEPEZIL(ARICEPT) 5 MG TAB 4.66$

DOPamine 200 MG 40 MG/ML VIAL 11.00$

DOPAMINE HCL 200 MG 40MG/1ML 5 ML VIAL 17.50$

DOPamine/D5W 200 MG /250 ML PREMIX 64.80$

DOPAMINE/DEXTROSE 400MG/500 ML PREMIX 92.40$

DOXAZOSIN 1MG TABLET 6.06$

DOXAZOSIN ORAL TABLET 4MG 8.46$

DOXEPIN (SINEquan) 25 MG CAP 3.85$

DOXYCYCLINE HYCLATE 100MG CAPSULE 19.69$

DOXYCYCLINE HYCLATE(VIBRAMYCIN)100MG TAB 17.10$

DOXYCYCLINE MONOHYDRATE 100MG CAPSULE 9.90$

DRONABINOL (MARINOL) 5MG CAPSULE [SK-NF] 73.56$

DROPERIDOL (2.5 MG/ML) 5 MG/2 ML AMP 14.55$

DULERA 200 MCG/ 5 MCG ORAL INHALATION 944.08$

DULoxetine (CYMBALTA) 20 MG CAP 48.99$

DULoxetine (CYMBALTA) 30 MG CAP 35.55$

ELIQUIS (APIXABAN) 2.5 MG TABLET 46.62$

ELIQUIS (APIXABAN) ORAL TABLET 5MG 46.56$

ENALAPRIL(VASOTEC ) 5 MG TAB 9.26$

ENALAPRILAT(VASOTEC)1.25 MG/ML VIAL 21.60$

ENEMEEZ MINI ENEMA RECTAL ENEMA 283MG 15.39$

ENOXAPARIN (LOVENOX) 30 MG / 0.3 ML SYR 43.00$

ENOXAPARIN(LOVENOX ) 100 MG / ML SYR 142.80$

ENOXAPARIN(LOVENOX) 40 MG / 0.4 ML SYR 178.45$

ENTRESTO 24MG-26MG TABLET 48.54$

ENTRESTO ORAL TABLET 97MG-103MG 55.59$

ePHEDrine SULFATE 50 MG/ML:2 ML VIAL 78.10$

EPINEPHrine (1:1000) 1 MG/ML AMPULE 17.50$

EPINEPHrine (ADRENALIN CL) 1 MG/ML SOL 53.02$

EPINEPHrine 0.1 MG/1 ML (1:10,000) SYR 43.20$

EpiPen AUTO-INJECT 0.3 MG (ADULT) 745.76$

EpiPen Jr (Epinephrine) 0.15 MG (Child) 1,500.00$

EPOETIN ALFA(PROCRIT)10,000 U/1 ML 1,070.90$

ERAXIS(aniDULAFUNGIN) 100MG VIAL 864.00$

ERGOCALCIFEROL ORAL SOLUTION 8000IU/1ML 5.85$

ERTAPENEM / NS 1 GM / 100 ML 509.36$

ERTAPENEM SOD.(INVanz) 1 GM VIAL 447.35$

ERTAPENEM(INVanz)INJ 1 GM 509.36$

ERYTHROMYCIN 0.5% 1 GM EYE OINT 74.49$

ERYTHROMYCIN ETHYL SUCCINATE 200 MG/5 ML 564.08$

ESCITALOPRAM (LEXAPRO) 10 MG TAB 26.28$

ESMOLOL HCL (BREVIBLOC)100MG/10ML VIAL 52.50$

ESOMEPRAZOLE (NexIUM) 40 MG VIAL 232.95$

ESTRADIOL (ESTRACE) 1 MG TAB 4.08$

ETHYL CHLORIDE SPRAY 133.50$

ETOMIDATE(AMIDATE) 20 MG/10 ML VIAL 46.65$

EYE WASH 118 ML SOL 19.02$

FAMOTIDINE (PEPCID) 10MG/ML 2ML VIAL 5.67$

Page 20: DESCRIPTION CURRENT PRICE LABORATORY

FAMOTIDINE (PEPCID) 20MG ORAL TABLET 3.85$

FENOFIBRATE (TRICOR) 145 MG TAB 33.48$

FENOFIBRATE (TRICOR) 48 MG TAB 11.46$

fentaNYL (DURAGESIC) 75 MCG / HR PTCH 266.88$

fentaNYL (DURAGESIC)100 MCG / HR PTCH 354.20$

fentaNYL (DURAGESIC)12 MCG/HR PATCH 101.50$

fentaNYL (DURAGESIC)25 MCG/HR PTCH 117.00$

fentaNYL (SUBLIMAZE) 100 MCG/2 ML INJ 11.00$

fentaNYL 50 MCG /1ML 5ML AMPULE 2.81$

FERROUS SULFATE 324 MG TAB 3.85$

FLEET ENEMA 4.5 OZ 7.74$

FLEET ENEMA MINERAL OIL 11.94$

FLUCAINE OPTHALMIC SOLUTION 226.00$

FLUCONAZOLE (DIFLUCAN) 100 MG TAB 58.25$

FLUCONAZOLE(DIFLUCAN) 200MG/100ML PREMIX 35.10$

FLUMAZENIL(ROMAZICON) 0.5 MG / 5 ML VL 48.85$

FLUORESCEIN(FUL-GLO) 0.6 MG EYE STRIPS 3.85$

fluOXETINE(PROzac) 10 MG CAP 14.52$

fluOXETINE(PROzac) 20 MG CAP 15.10$

FLUTICASONE NASAL SPRAY 0.05MG/1ACT 31.62$

FLUTICASONE PROPIONATE 0.05% 30GM CREAM 171.85$

FOLIC ACID(FOLATE) 1 MG TAB 3.85$

FONDAPARINUX (ARIXTRA) 2.5 MG SYR 259.65$

FOSFOMYCIN TROMETH.(MONUROL) 3GM 1SACHET 359.10$

FUROSEMIDE (LASIX) 20 MG TAB 3.85$

FUROSEMIDE (LASIX) 40 MG TAB 3.85$

FUROSEMIDE (LASIX) 40 MG/4 ML VIAL 36.50$

GABAPENTIN (NEURONTIN) 100 MG CAP 3.85$

GABAPENTIN (NEURONTIN) 300 MG CAP 9.96$

GEMFIBROZIL (LOPID) 600 MG TAB 26.58$

GENTAMICIN 3 MG/ML 5 ML EYE DROPS 119.35$

GENTAMICIN SULFATE TOPICAL OINTMENT 0.1% 246.90$

GENTAMYCIN 80 MG / 2 ML (IV) VIAL 23.26$

GENTAMYCIN SULFATE 0.3% EYE OINT 108.18$

GENTAMYCIN(GARAMYCIN) 80MG/2ML VIAL 23.25$

GLUCAGON 1 MG KIT 823.70$

GLUTOSE 15 GM ORAL GEL 31.42$

glyBURIDE (DIABETA) 5 MG TAB 3.85$

GLYCERIN ADULT SUPP 3.85$

GLYCERIN SOLUTION 6 oz BOTTLE 57.24$

GLYCERIN SUPPOSITORIES ADULT 3.30$

GLYCERINE SUPPOSITORY PEDIATRIC 3.85$

GLYCOPYRROLATE(ROBINUL)0.2MG/ML 1ML VIAL 99.00$

guaiFENesin DM(ROBITUSSIN)10MG/100MG 5ML 5.85$

guaiFENesin ER(Mucinex) 600 mg TAB 6.01$

guaiFENesin(ROBITUSSIN) 300MG/15 ML SOL 5.85$

HALOPERIDOL (HALDOL) 5MG/1ML AMPULE 40.48$

HALOPERIDOL(HALDOL) 1 MG TAB 3.85$

HALOPERIDOL(HALDOL)INJ 5MG/ML INJ 44.22$

HEPARIN 100 UNITS / ML 5 ML FLUSH SYR 22.26$

HEPARIN 25,000 UNITS 5% DEX 500 ML IVPB 66.00$

HEPARIN INJ SOLUTION 5000U/1ML VIAL 12.42$

Page 21: DESCRIPTION CURRENT PRICE LABORATORY

HEPARIN SODIUM 5,000 UNITS/ML INJ 14.80$

HEPATITIS B (RECOMB)VAC 10 MCG/0.5 ML 140.20$

HEPATITIS B (RECOMBINANT) 20 MCG/ML VAC 282.83$

HUMULIN R (INSULIN R) 100U/1ML 3 ML VIAL 98.13$

HYDRCOD./CHLOR(TUSSIONEX)10/8MG 5ML SUSP 21.98$

hydroCHLOROthiazide (HCTZ) 25 MG TAB 3.85$

HYDROCOD./ACET(LORTAB)7.5/325MG 15ML SOL 19.45$

HYDROcodone/APAP(LORTAB) 7.5/500 MG TAB 3.85$

HYDROcodone/APAP(LORTAB)5/500 MG TAB 3.85$

HYDROcodone/APAP(Norco) 7.5MG/325MG TAB 5.31$

HYDROcodone/APAP(Norco)5MG/325MG TAB 3.85$

HYDROCORTISONE (ANUCORT-HC) 25 MG SUPP 135.88$

HYDROCORTISONE (ANUSOL)2.5 % 20 GM CREAM 29.40$

HYDROCORTISONE (CORTEF) 10 MG TAB 6.41$

HYDROCORTISONE ANTI-ITCH 1%: 1.5G PACK 2.10$

HYDROCORTISONE ANTI-ITCH 1%: 1.5G PACK 2.10$

HYDROCORTISONE CREAM 1% (28G) 6.90$

HYDROGEN PEROXIDE 473 ML TOP SOL 1.78$

HYDROmorphone (DILAUDID) 2 MG / ML AMP 11.00$

HYDROmorphone (DILAUDID) 2 MG TAB 4.26$

HYDROMORPHONE (DILAUDID) 2MG/ML 1ML VIAL 10.37$

HYDROXYCHLOROQUINE SULFATE TABLET 200MG 26.34$

hydrOXYzine (VISTARIL) 10MG TABLET 1.71$

hydrOXYzine (VISTARIL) 25 MG/ML VIAL 22.50$

hydrOXYzine HCL 10 MG/5 ML: 118 ML SYRUP 5.85$

hydrOXYzine(VISTARIL) 25 MG CAP 1.79$

hyrdALAZINE (APRESOLINE) 20 MG/ML VIAL 86.40$

hyrdALAZINE (APRESOLINE) 25 MG TAB 3.85$

hyrdALAZINE HCL 10MG TABLET 3.20$

IBUPROFEN (MOTRIN) 100 MG/5 ML SUSP 5.85$

IBUPROFEN (MOTRIN) 400 MG TAB 3.85$

IBUPROFEN (MOTRIN) 600 MG TAB 3.85$

IBUPROFEN (MOTRIN) 800 MG TAB 3.85$

IBUPROFEN(MOTRIN) CHILD 100MG/5 ML SUSP 5.85$

IMIPENEM/CILASTIN(PRIMAXIN) 250MG IV 35.87$

INFLUENZA (QUAD) 65yo > SYRINGE 183.85$

INFLUENZA (QUAD) 65yo>SYR 2018-19 278.70$

INFLUENZA >3 Y/O QUADVAL MDV (2018-2019) 101.28$

INFLUENZA QUAD 3YO > PF SYR (2018-2019) 112.64$

INFLUENZA QUAD 6-35 MONTH/O SYR 2018-19 112.64$

INFLUENZA VAC (QUAD) - 3YO > SYRINGE 31.86$

INFLUENZA VAC PED (QUAD) 6 - 35 MN SYR 31.85$

INFLUENZA VACCINE VIAL 60 MCG/ 0.5 ML 93.82$

INSULIN 70 / 30 (NovoLIN) 100 U / ML 11.00$

INSULIN HumaLOG(LISPRO)100 UNITS/ ML10ML 1.70$

INSULIN novoLOG 70/30 100 U/ML10ML 3.30$

INSULIN R (NOVOLIN R) 100U/ML 10ML VIAL 0.99$

INTRALIPID 20 % 500 ML 218.27$

INVANZ(ERTAPENEM) ADD 1 GM VIAL 506.78$

IPRATRO/ALBUTEROL(DUONEB)0.5/3MG/3ML NEB 13.25$

IPRATROPIUM (ATROVENT) 0.02% INH SOL 7.92$

IPRATROPIUM (ATROVENT) HFA 12.9 G INH 1,032.60$

Page 22: DESCRIPTION CURRENT PRICE LABORATORY

IPRATROPIUM / ALBUTEROL 0.5 MG / 3MG 13.25$

ISOPROP ALC(RUBBING ALC) 70% 473 ML SOL 14.34$

ISOPROTERENOL (ISUPREL) INJ 1 MG 1,047.82$

IsoSORBIDE (Isordil) DInitrate 30 MG TAB 7.86$

ISOSORBIDE DINIT(ISORDIL) 5 MG TAB 5.91$

ISOSORBIDE MONO ER(IMDUR) 30 MG TAB 10.06$

K EFFERVESCENT(POTASSIUM EFF.) 25mEq TAB 7.52$

KAYEXALATE(KIONEX) 15 GM / 60 ML SUSP 67.50$

KCL (POT. CL)20MEQ D5 1/2 NS 1000ML IV 16.68$

KCL(POT. CL) 20 MEQ/NS 1000ML IV 22.25$

KCL(POT.CL ) 20 MEQ D5W 1000 ML IVBP 16.80$

KETAMINE HCL(KETALAR) 50 MG / ML VIAL 43.20$

KETOROLAC(TORADOL) 30 MG / ML VIAL 36.00$

KETOROLAC(TORADOL) 60 MG / 2 ML VIAL 20.74$

KETOROLAC(TORADOL)10 MG TAB 12.94$

LABETALOL (TRANDATE) 200 MG TAB 4.77$

LABETALOL(NORMODYNE) 5MG/1ML 20ML VIAL 5.11$

LACTOBACILLUS GG(CULTURELLE) 10 BILL CAP 3.30$

LACTULOSE(CEPHULACE ) 10 GM / 15 ML CUP 5.85$

LANSOPRAZOLE DR 30MG CAP 33.97$

LANTUS(INSULIN GLARGINE)100U/ML10ML VIAL 3.30$

LEVALBUTEROL 1.25 MG / 3 ML 12.00$

LEVALBUTEROL(XOPENEX) 0.63 MG / 3 ML 40.23$

levETIRAcetam(KEPPRA) 250 MG TAB 15.52$

levoFLOXacin 750 MG / 5% DEXTROSE 150 ML 53.63$

levoFLOXacin(LEVAQUIN)250 MG TAB 90.71$

LEVOTHYROXINE 88MCG TABLET 3.35$

LEVOTHYROXINE ORAL TABLET 112MCG 4.06$

LEVOTHYROXINE(SYNTHROID) 25 MCG TAB 3.85$

LEVOTHYROXINE(SYNTHROID) 50 MCG TAB 3.85$

LIDOCAINE (LIDODERM) 5% 50 MG/GM PATCH 56.16$

LIDOCAINE (XYLOCAINE) 2 % 5 ML VIAL 20.52$

LIDOCAINE (XYLOCAINE)1% 5 ML VIAL 24.41$

LIDOCAINE 1 % 50 ML VIAL 16.63$

LIDOCAINE 1% 10 ML VIAL 24.41$

LIDOCAINE 1% 10 MG/ML 30 ML VIAL 11.00$

LIDOCAINE 1% 5ML PF-AMPULE 0.78$

LIDOCAINE 2 % 50 ML VIAL 21.96$

LIDOCAINE 4 MG / ML 1 G/250 ML D5W PRMIX 43.30$

LIDOCAINE 5% AND DEXTR 7.5% 2 ML AMP 49.70$

LIDOCAINE HCL 1% (10 MG/ML) 50 MG SYR 36.40$

LIDOCAINE HCL 2% (20 MG/ML)100 MG SYR 18.50$

LIDOCAINE HCL(XYLOCAINE)40 MG/ML:5 ML 25.42$

LIDOCAINE VISCOUS 2 % 15 ML CUP 5.85$

LIDOCAINE(XYLCAINE)2%-EPI 1:100K 20ML VL 27.40$

LIDOCAINE(XYLOCAINE) 2% 10 ML VIAL 21.60$

LIDOCAINE(XYLOCAINE) JELLY 5 ML TUBE 46.80$

LIDOCAINE/ EPI 1% 1:100,000W 30 ML VIAL 30.24$

LIDOCAINE/PRILOCAINE(EMLA)2.5% 5GM CREAM 48.24$

LIMBREL 500MG-50MG CAP 83.88$

LINEZOLID (ZYVOX) 600 MG TAB 728.86$

LINEZOLID(ZYVOX) 600 MG / 300 ML IVPB 749.80$

Page 23: DESCRIPTION CURRENT PRICE LABORATORY

LINEZOLID(ZYVOX)100 MG/5 ML 150 ML SUSP. 583.11$

LISINOPRIL (PRINIVIL) 2.5 MG TAB 4.10$

LISINOPRIL (PRINIVIL)10 MG TAB 7.44$

LISINOPRIL(PRINIVIL) 40 MG TAB 4.62$

LOPERAMIDE(IMODIUM) 2 MG CAP 5.25$

LORATADINE (CLARITIN) 10 MG TAB 4.21$

LORazepam (ATIVAN) 1 MG TAB 3.85$

LORazepam (ATIVAN) 2 MG/ML SYRINGE 18.30$

LORazepam (ATIVAN) 4MG/ML 1ML VIAL 12.32$

LOSARTAN POTASSIUM ORAL TABLET 50MG 13.60$

LYRICA (PREGABALIN) 50MG CAPSULE 49.80$

MAG HYD/ALUM HYD/SIMETH(MAALOX)SUSP CUPS 7.35$

MAGIC MOUTH WASH COMPOUND VERSION 1 37.25$

MAGNESIUM CIT 1.745 GM / OZ / 296 ML BTL 7.07$

MAGNESIUM OXIDE 400 MG TAB 3.85$

MAGNESIUM SULF. 1 GM / D5W 100 ML IVPB 45.15$

MAGNESIUM SULFATE SALTS 2.64$

MARCAINE 7.5 MG SPINAL 2 ML AMPULE 27.22$

MARCAINE(BUPIVACAINE HCL) 0.25% VIAL 19.66$

MECLIZINE (ANTAIVERT) TABLET 12.5MG 16.80$

MECLIZINE(ANTIVERT ) 25 MG TAB 5.21$

MED PASS 2 OZ NO SUGAR ADDED VANILLA 3.30$

MED PASS 4 OZ NO SUGAR ADDED VANILLA 3.30$

medrxyPROGSTRone(DEPO-MEDROL)150MG/ML VL 362.52$

MEGESTROL (MEGACE) 40 MG TAB 6.27$

MEGESTROL (MEGACE) 400 MG/10 ML SUSP 25.48$

MELOXICAM (MOBIC) 7.5 MG TAB 18.58$

MEMANTINE (NAMENDA) 5 MG TAB 5.72$

MEPERIDINE (DEMEROL) 100 MG/ML SYR 31.60$

MEPERIDINE (DEMEROL) 25MG/1ML VIAL 7.48$

MEPERIDINE (DEMEROL) 50 MG TAB 8.57$

MEPERIDINE (DEMEROL) 50 MG/ML SYR 33.70$

MEPERIDINE (DEMEROL) 75 MG / ML SYR 15.80$

MERCAPTOPURINE 50 MG TABLET [CYTOTOXIC] 22.80$

MEROPENEM (MERREM) 500 MG VIAL 130.00$

MERREM (MEROPENEM) 1 GM VIAL 362.12$

metFORMIN(GLUCOPHAGE) 500 MG TAB 3.85$

metFORMIN(GLUCOPHAGE) 850 MG TAB 8.82$

METHADONE 10 MG TAB 3.85$

METHOCARBAMOL(ROBAXIN) 500 MG TAB 3.85$

METHOCARBAMOL(ROBAXIN)100MG/ML 10ML VIAL 356.85$

methylPREDNISolone 125MG/2ML ACT-O-VIAL 64.58$

methyLPREDNISolone 40MG/ML ACT-O-VIAL 39.00$

methylPREDNISolone(MEDROL) 4 MG TAB 12.92$

METOCLOPRAMIDE (REGLAN) 5MG/1ML 2ML SYR 6.66$

METOCLOPRAMIDE(REGLAN) 10 MG TAB 0.78$

METOCLOPRAMIDE(REGLAN) 5MG/ML 2ML VIAL 11.00$

METOLAZONE ORAL TABLET 5MG 16.14$

METOPROLOL (TOPROL XL) 100 MG TAB 11.18$

METOPROLOL (TOPROL XL) 25 MG TAB 7.43$

METOPROLOL TARTRATE (LOPRESSOR) 25MG TAB 1.45$

METOPROLOL(LOPRESSOR)5 MG / 5 ML VIAL 11.00$

Page 24: DESCRIPTION CURRENT PRICE LABORATORY

metroNIDAZOLE (FLAGYL )250 MG TAB 3.85$

metroNIDAZOLE / D5W 500MG/100ML RECON 12.96$

metroNIDAZOLE/NS(FLAGYL)500MG/100ML IVPB 11.55$

MIDAZOLAM (VERSED) 5 MG / ML 10 ML VIAL 11.00$

MIDAZOLAM(VERSED)1 MG/ML 5 ML VIAL 11.00$

MIDAZOLAM(VERSED)10 MG/2 ML VIAL 11.00$

MIDODRINE HYDROCHLORIDE 2.5MG TABLET 8.58$

MIDODRINE HYDROCHLORIDE ORAL TABLET 5MG 7.89$

MIGHTY SHAKE 3.30$

MILK OF MAGNESIA(MOM) 30ML SUSP CUPS 5.85$

MINOCYCLINE HCL 100MG CAP 20.38$

MIRTAZAPINE(REMERON) 15 MG TAB 20.36$

MODAFINIL (PROVIGIL) 100MG TABLET 132.00$

MONTELUKAST(SINGULAIR) 10 MG TAB 33.47$

MORPHINE 2 MG / 1 ML SYRINGE 13.20$

MORPHINE 4 MG /1 ML SYRINGE 13.20$

MORPHINE SULF 10 MG SYR 11.00$

MORPHINE SULF 15 MG ER TAB 5.89$

MORPHINE SULFATE 10 MG/ 5 ML SOL 30 CUPS 9.78$

MORPHINE SULFATE 4MG/1ML VIAL 13.55$

MOXIFLOXACIN (AVELOX) 400 MG/250 ML PRMX 250.90$

MOXIFLOXACIN HCL (AVELOX) 400 MG TAB 80.74$

MULTAQ (DRONEDARONE) 400MG TABLET [NF] 71.40$

MULTIVITAMIN TABLET 3.85$

MUPIROCIN(BACTROBAN) 2% 22GM OINT 67.50$

MVI-12 (INFUVITE) 10 ML [2 5 ML VIALS] 116.10$

MYCAMINE 100MG IV POWDER VIAL 897.60$

NAFCILLIN 2 GM VIAL 155.77$

NALBUPHINE(NUBAINE)10 MG AMP 23.65$

NALOXONE(NARCAN) 0.4 MG / ML VIAL 102.89$

NAPROXEN(NAPROSYN)500 MG TABLET 3.85$

NAROPIN(ROPIVACAINE)0.5 % 150 MG / 30 ML 45.50$

NEO/ POLY/DEX(NEODECADRON) 5ML EYE SUSP 220.00$

NEO/POL/BAC/HC(CORTISPORIN)3.5GM EYE OIN 292.72$

NEO/POLY SULF/DEXA 3.5 GM EYE OINT 109.23$

NEO/POLY/BAC(NEOSPORIN) 3.5GM EYE OINT 236.43$

NEO/POLY/HC (CORTISPORIN)10 ML EAR DROPS 154.05$

NEO/POLY/HC (CORTISPORIN)10ML EAR DROPS 138.65$

NEO/POLY/HC(COTISPORIN) 7.5 ML EYE SUSP 565.88$

NEPRO DRINK FOR PEOPLE ON DIALYSIS 25.09$

NEUPRO (ROTIGOTINE) TD PATCH ER 3MG/24HR 129.32$

NEUPRO (ROTIGOTINE) TD PATCH ER 8MG/24HR 129.30$

NF-RENAGEL 800 MG TABLET 27.60$

NICOTINE(NICODERM) 14 MG PATCH 17.10$

NICOTINE(NICODERM) 21 MG PATCH 11.40$

NICOTINE(NICODERM) 7 MG PATCH 17.10$

NIFEdipine ER(PROCARDIA)30 MG TAB 3.94$

niMODipine 30MG CAPSULE (STOCKED NF) 20.64$

NITROFURANTOIN BID (MACROBID) 100MG CAP 14.12$

NITROFURANTOIN(MACRODANTIN)100 MG CP 20.28$

NITROGLYCERIN 0.4 MG / HR PATCH 17.45$

NITROGLYCERIN IV SOL 50 MG / 250 ML D5W 51.65$

Page 25: DESCRIPTION CURRENT PRICE LABORATORY

NITROGLYCERIN(NITROBID) 2% 1GM OINT PKG 11.58$

NITROGLYCERIN(NITRODUR) 0.2 MG/HR 11.40$

NITROGLYCERIN(NITROST)0.4 MG SL TAB 3.85$

NovoLIN NPH (INSULIN NPH)100 U/ML 10ML 11.00$

NovoLOG (INSULIN ASPART)100 U/ML10ML VIA 3.30$

NS (NACL 0.9%) 100ML ADDV BAG 17.20$

NYSTATIN 15 GM CREAM 96.25$

NYSTATIN(MYCOSTATIN)100,000 U /GM POWDER 151.03$

NYSTATIN(MYCOSTATIN)500000U/5ML SUSP CUP 7.06$

OFLOXACIN(OCUFLOX)0.3 % 3 MG/ML EYE SOL 123.75$

OLANZapine(ZyPREXA) 10 MG TAB 79.29$

OMEPRAZOLE(PriLOSEC) 20 MG CAP 17.53$

ONDANSETRON ODT(ZOFRAN ODT) 4 MG TAB 122.61$

ONDANSETRON(ZOFRAN) 4 MG / 2 ML VIAL 8.28$

OR EMERGENCY KIT 50.00$

ORAL ELEC-LYTE SOL(PEDIALYTE)1000 ML 5.85$

OSELTAMIVIR (TAMIFLU) 30MG CAP 85.08$

OSELTAMIVIR(TAMIFLU) 75 MG CAP 94.56$

OXYBUTYNIN ER (DITROPAN) 5 MG TAB 20.15$

oxyCODO/APAP(PERCOCET)5 MG/325 MG TAB 8.31$

OxyCODONE IR(ROXICODONE) 5 MG TAB 3.85$

OxyCONTIN (OxyCODONE ER) 10MG TABLET 27.17$

OXYMETAZOLIN(AFRIN) 0.05% NASAL SPRAY 26.34$

PANTOPRAZOLE (PROTONIX) 20MG DR TABLET 23.92$

PANTOPRAZOLE I.V.(PROTONIX)40 MG VIAL 36.00$

PANTOPRAZOLE SOD DR (PROTONIX) 40 MG TAB 2.06$

PARoxetine(PAXIL) 20 MG TAB 1.59$

PEDIA LAX(FLEETS FOR CHILDREN)66ML ENEMA 5.50$

PEDIACTRIC ELECTOLYTE 11.10$

PENICILLIN G BENZ (BICILLIN LA)1.2MU SYR 576.27$

PENICILLIN G POT(PFIZERPEN) 5 MU VIAL 75.60$

PENICILLIN V POTASSIUM(PEN VK) 250MG TAB 4.38$

PHENAZOPYRIDINE(PYRIDIUM) 100 MG TAB 3.85$

PHENAZOPYRIDINE(PYRIDIUM) 95 MG TAB 3.85$

PHENobarital 32.4MG TABLET 2.67$

PHENobarital(LUMINAL)65 MG / ML 1ML VIAL 105.60$

PHENYLEPHRINE HCL 10 MG / ML 86.40$

PHENYTOIN ER (DILANTIN)100 MG CAP 4.08$

PHENYTOIN(DILANTIN) 50 MG / ML 5 ML VIAL 11.88$

PHENYTOIN(DILANTIN) 50 MG /ML 2 ML VIAL 8.28$

PHOSPHA (K-PHOS) 250 MG NEUTRAL TAB (NF) 6.60$

PHYTONADIONE(VITAMIN K) 10 MG AMP 175.30$

PHYTONADIONE(VITAMIN K) 5 MG TAB 317.30$

PIPERACILLIN / TAZO(ZOSYN) 3.375 GM VIAL 68.04$

PIPERACILLIN/ TAZOBACTAM 2GM-0.25GM VIAL 87.00$

PNEUMOCOCCAL(PNEUMOVAX) 0.5 ML VACCINE 368.75$

POLIOVIRUS VACCINE IA (IPOL) 5 ML VIAL 171.90$

POLYETHYL.GLYCOL(MIRALAX)17GM PD SACHET 16.69$

POLYSPORIN OINTMENT 0.9 g FOIL PACK 3.30$

POLYVINYL ALC(ARTIFICIAL TEARS) 15ML SOL 26.28$

POTASSIUM CHL(KLOR-CON) ER 10 MEQ TAB 9.15$

POTASSIUM CHLOR ER(KLOR-CON) 20MEQ TAB 4.08$

Page 26: DESCRIPTION CURRENT PRICE LABORATORY

POVIDONE IODINE(BETADINE) 118 ML SOL 11.40$

POVIDONE IODINE(BETADINE)10% 473 ML SOL 50.52$

POVIDONE/IODINE 10% OINT 30 GM 42.35$

PRADAXA (DABIGATRAN) ORAL CAPSULE 75MG 44.52$

PRAMIPEXOLE (MIRAPEX) 0.5MG TABLET 5.28$

PRAVASTATIN(PRAVACHOL ) 20 MG TAB 14.97$

prednisoLONE 3 MG / ML ORAL SOL 12.90$

predniSONE 20 MG TAB 1.70$

predniSONE 20 MG TAB 1.70$

predniSONE 5 MG TAB 3.85$

PRIMIDONE 50MG TABLET 4.76$

PRISTIQ (DESVENLAFAXINE) 50MG ER 68.40$

PROBENECID (BENEMID) 500 MG TAB 5.90$

PROCHLORPERAZINE MALEATE 5 MG TAB 3.85$

PROCHLORPERAZINE(COMPAZINE) 25 MG SUPP 80.39$

PROCHLORPERAZINE(COMPAZINE)10MG/2ML VIAL 122.10$

PROMETHAZINE(PHENERGAN) 12.5 MG SUPP 106.23$

PROMETHAZINE(PHENERGAN) 25 MG / ML VIAL 6.19$

PROMETHAZINE(PHENERGAN) 25 MG TAB 3.85$

PROMETHAZINE(PHENERGAN)25 MG SUPP 106.23$

PROMETHAZINE(PHENERGEN) 25 MG / ML AMP 11.00$

PROPOFOL (DIPRIVAN) 10 MG / ML 20 ML VL 43.20$

PROPOFOL 200 MG/ 20 ML VIAL 41.04$

PROSCAR (FINASTERIDE) 5MG TABLET 2.42$

PROTAMINE SUL 50 MG IV 5 ML VIAL 84.24$

PROTONIX (PANTOprazole) 40MG GRANULES 94.69$

PSEUDOEPHEDRINE HCL(Sudafed)30MG/5ML SOL 5.85$

PSEUDOEPHEDRINE(SUDAFED) 30 MG TAB 3.85$

QUETiapine(SEROquel) 25 MG TAB 23.98$

QUINUPRISTIN/DALFOPRSTIN 150MG/350MG INJ 475.39$

RACEPINEPHRINE 2.25% INH SOL 12.46$

RAMIPRIL (ALTACE) 2.5 MG CAP 10.83$

RAMIPRIL (ALTACE)10 MG CAP 3.85$

raNITIdine(ZANTAC ) 150 MG TAB 3.85$

raNITIdine(ZANTAC) 25MG/ML 2ML VIAL 85.07$

REFRESH (ARTIFICIAL TEARS) OPTHALMIC UD 2.06$

RELISTOR SUBQ SOLN 12MG/0.6ML SYRINGE 872.00$

risperiDONE(risperDAL) 0.5 MG TAB 23.59$

RIVASTIGMINE 6MG CAPSULE 25.46$

ROCURONIUM BROMIDE(ZEMURON)100 MG/10 ML 54.00$

rOPINIRole (REQUIP) 0.25 MG TABLET 3.54$

ROPINIROLE HYDROCHLORIDE ORAL TABLET 2MG 15.00$

ROSUVASTATIN CALCIUM ORAL TABLET 20MG 8.62$

SAVAYSA (EDOXABAN) 60MG ORAL TABLET 80.76$

SCOPOLAMINE(TRANSDERM SCOP) 1.5MG PATCH 129.01$

SENNA-LAX(SENNOSIDES) 8.6 MG TAB 3.85$

SENSORCAINE 0.5% 50 ML MULTIDOSE VIAL 87.84$

SERTRALINE (ZOLOFT) 50 MG TAB 3.85$

SEVELAMER CARBONATE 800MG TAB 59.49$

SEVOFLURANE 250 ML INHALATION ANESTHETIC 5.85$

SILDENAFIL (REVATIO) 20 MG TABLET 8.34$

SILVADENE 1% CREAM 25 GM TUBE 53.94$

Page 27: DESCRIPTION CURRENT PRICE LABORATORY

SILVER NITRATE 75% APPLICATOR 3.85$

SIMETHICONE(MYLICON)20MG / 0.3 ML DROP 47.94$

SIMETHICONE(MYLICON)80 MG TAB 3.85$

SIMVASTATIN(ZOCOR) 10 MG TAB 3.85$

SIMVASTATIN(ZOCOR) 20 MG TAB 3.85$

SLO NIACIN 500 MG TAB 3.85$

SMX/TMP DS(BACTRIM DS)800MG/160MG TAB 3.85$

SMX/TMP(BACTRIM) 800MG/160MG/ 20ML CUP 29.62$

SMX/TMP(BACTRIM) 80MG/16MG VIAL 25.30$

SODIUM BICARB 4.2 % 0.5 MEQ / ML 10 ML 64.30$

Sodium Bicarb vial 50 ml 56.74$

SODIUM BICARBONATE 650 MG TABLET 3.85$

SODIUM BICARBONATE 8.4% 1mEq/ml 50ml SYR 44.65$

SODIUM CHL 10 ML SYR FLUSH 3.30$

SODIUM CHL 3 ML SYR FLUSH 3.30$

SODIUM CHLORIDE 0.9% INJ 10 ML VIAL 11.00$

SODIUM CHLORIDE 1 GM TABLET 4.30$

SODIUM CHLORIDE INH SOL.0.9% 3 ML VIAL 5.85$

SODIUM CHLORIDE SOLUTION 0.9% 3 ML 5.82$

SODIUM CHLORIDE(SALINE)O.65% NASAL SPRAY 14.34$

SODIUM NITROPRUSSIDE 25MG/1ML 2 ML VL 1,031.20$

SOTALOL HCL TABLET 80MG 13.92$

SPIRONALACTONE(ALDACTONE) 25 MG TAB 3.85$

SSD (SILVADENE) 1% 400 GM CREAM 317.97$

STERILE WATER 10 ML VIAL 11.00$

STERILE WATER 100 ML 25.56$

SUCCINYLCHOLINE(ANECTINE)200MG/10ML VIAL 160.14$

SUCRALFATE (CARAFATE) 1 GM TAB 3.85$

SULFACETAMIDE(SULAMYD)10% 15ML EYE SOL 287.54$

SUMAtriptan SUCC.(IMITREX)6MG/0.5ML VIAL 408.79$

Surgical Lubricant(KY JELLY)120.49G TUBE 18.27$

SURGILUBE(K-Y JELLY) 3GM PACKET 3.85$

SYMBICORT INH AER LIQ 160MCG-4.5MCG 1,067.24$

SYMBICORT INH AER LIQ 80MCG-4.5MCG 927.76$

TAMIFLU 6MG/1ML POWDER FOR SUSPENSION 18.22$

TAMSULOSIN(FLOMAX) 0.4 MG CAP 2.84$

TAZICEF (cefTAZidime) 1GM INJECTION 30.24$

TEFLARO (CEFTAROLINE) 400MG VIAL 842.18$

TEFLARO(CEFTAROLINE FOSAMIL) 600 MG VIAL 732.48$

TEMAZEPAM(RESTORIL) 15 MG CAP 5.19$

TEST LANTUS MEDICATION 1.79$

TET/DIP/TOX/ACEL/PERT ADULT 0.5 ML VIAL 228.10$

Tetanus and Diphtheria Toxoids adsorbed 115.00$

TETANUS TOXOID CONJUGATE 0.5 MG 164.00$

TETRACAINE 5 MG / 1 ML 0.5% OPTH SOLN 66.16$

TETRACAINE HCL 0.5% 15ML EYE SOL 0.24$

TETRAVISC(TETRACAINE) 0.5% 5ML EYE DROPS 150.85$

THIAMINE (VIT B 1)100 MG / ML 2 ML VIAL 74.65$

TIOTROPIUM(SPIRIVA)18MCG CAP HANDI-HALER 103.96$

TOLTERODINE (DETROL) 2MG TABLET [SK-NF] 20.38$

traMADol (ULTRAM) 50 MG TAB 3.85$

traZODone HYDROCHLORIDE 50 MG TABLET 3.85$

Page 28: DESCRIPTION CURRENT PRICE LABORATORY

TRIAMCINOLONE ACETONIDE 0.1% 15 GM 33.48$

TRIAMCINOLONE(KENALOG) 40 MG / ML VIAL 65.22$

TRIAMTERENE/HCTZ(DYAZIDE)37.5 MG/25 MG 3.85$

TRIFLUOPERAZINE HCL 5MG TABLET 9.74$

TRIPHRO(NEPHRO) MULTI - VITAMIN CAP 4.04$

TRIPLE-ANTIB.(NEOSPORIN) 0.9 GM OINT PKG 3.85$

TUBERCULIN PPD (TUBERSOL) 0.1 ML VIAL 48.75$

TYGACIL (TIGECYCLINE) 50MG VIAL 273.01$

ULORIC (FEBUXOSTAT) 40MG TABLET 64.86$

valACYclovir (VALTREX) 500MG TABLET 35.81$

VALSARTAN (DIOVAN) 160 MG TAB 29.99$

VALSARTAN (DIOVAN) 40 MG TAB 23.32$

VANCOMYCIN (VANCOCIN ) 1 GM ADD-VIAL 30.25$

VANCOMYCIN (VANCOCIN) 1 GM VIAL 105.86$

VANCOMYCIN 25MG/ML 20ML ORAL SUSP VIAL 26.45$

VANCOMYCIN HCL 750MG ADD-VANTAGE 60.34$

VANCOMYCIN(VANCOCIN )500 MG VIAL 57.88$

VANCOMYCIN(VANCOCIN) 125 MG CAP 156.50$

VASELINE(PETROLEUM JELLY) 5 GM FOIL PKG 3.85$

VASOPRESSIN(PITRESSIN) 20 U / ML VIAL 307.00$

VENCLEXTA ORAL TABLET 100MG (STOCKED NF) 446.02$

VENLAXAFINE (EFFEXOR) 75MG TAB 11.44$

VENLAXAFINE ER(EFFEXOR) 37.5 MG TAB 3.85$

VERAPAMIL 2.5 MG / ML 2 ML VIAL 192.90$

VERAPAMIL 2.5 MG/ML 4 ML SYRINGE 461.30$

VERAPAMIL ER (CALAN)120 MG TAB 6.29$

VERAPAMIL ER(CALAN) 180 MG TAB 7.20$

VERAPAMIL HCL 120MG TAB 4.50$

VERAPAMIL HCL 240 MG SR TAB 9.81$

VIMPAT (LACOSAMIDE) 100MG ORAL TABLET 83.00$

VIT B-12(CYANOCOBALAMIN) 1000MCG/ML VIAL 52.44$

VITAMIN B-1 (THIAMINE) 100 MG TAB 3.85$

VITAMIN B12 500MCG TABLET 1.90$

VITAMIN B-6(PYRIDOXINE)100 MG TAB 3.85$

VITAMIN C (ASCORBIC ACID) 500 MG TAB 3.85$

VITAMIN C 250 MG TAB 3.85$

VITAMIN D ORAL TABLET 400IU 3.52$

WARFARIN(COUMADIN) 1 MG TAB 12.35$

WARFARIN(COUMADIN) 10 MG TAB 21.03$

WARFARIN(COUMADIN) 2.5 MG TAB 3.85$

XARELTO (RIVAROXABAN) 15 MG TABLET 79.09$

XARELTO(RIVAROXABAN) 10 MG TAB 75.53$

XYLOCAINE (LIDOCAINE) 1% 10ML AMP 3.72$

XYLOCAINE (LIDOCAINE) 1% 20 MG/2 ML VIAL 14.69$

XYLOCAINE(LIDOCAINE)2% 20MG/1ML 20 ML VL 11.00$

ZINC OXIDE (CALMOSEPTINE) OINT 30.00$

ZINC OXIDE 20% OINTMENT 28.68$

ZOLPIDEM (AMBIEN) 10 MG TAB 42.00$

ZOLPIDEM (AMBIEN) 5 MG TAB 27.71$

MEDICAL/SURGICAL SUPPLY

Page 29: DESCRIPTION CURRENT PRICE LABORATORY

18FR FOLEY CATH 30CC 36.00$

3 WAY 16FR FOLEY CATHETER 30CC 77.70$

3 WAY 18FR FOLEY CATHETER 30CC 41.94$

3 WAY 18FR FOLEY CATHETER 30CC UM*** 41.70$

3M BARRIER CREAM 44.94$

ABDUCTION PILLOW HIP 199.95$

ABG KIT AUTOSTICK 13.37$

ACCUCHECK 11.00$

ACE 2 3.30$

ACE 2 PROFESSIONAL PODUCTS 3.30$

ACE 3 3.30$

ACE 4 3.30$

ACE 4 PROFESSIONAL PRODUCTS 10.73$

ACE 6 10.36$

ADAPTER PLUG, CLAVE PORT 12.67$

ADAPTIC 3X3 3.63$

ADAPTIC 3X8 12.71$

ADULT O2 MASK 8.20$

AMBU-BAG PED 93.23$

ANDESEN 11 TUBE 72.78$

ANDUSEN 10 TUBE 72.78$

ANKLE AIR BRACE L OR R 167.50$

ANKLE AIR BRACE LEFT LRG 162.00$

ANKLE AIR BRACE LEFT MED 162.00$

ANKLE AIR BRACE LEFT PED 162.00$

ANKLE AIR BRACE RIGHT LRG 162.00$

ANKLE AIR BRACE RIGHT MED 162.00$

ANKLE AIR BRACE RIGHT PED 162.00$

APRON, PULLOVER POLY HW BLUE 3.30$

ARM BOARD ADULT 3.63$

ARM BOARD PEDIATRIC 3.63$

ARM SLING DEEP PKET LG 33.00$

ARM SLING DEEP PKET MED 33.00$

ARM SLING DEEP PKET SM 33.00$

ARM SLING LG 54.42$

ARM SLING MED 30.90$

ARM SLING SM 30.90$

ARM SLING SMALL PROCARE 40.50$

ARM SLING UNIVERSAL PROCARE 47.70$

ARM SLING XL 30.90$

ARM SLING XL PROCARE 41.70$

BABY BOTTLE 14.24$

BABY DIAPER S,M,L 3.30$

BABY POWDER 3.63$

BABY SIPPY CUP 44.34$

BANDAGE ESMARK 4X12 26.10$

BANDAGE ESMARK 6X12 33.00$

BANDAID - EX LRG FABRIC 2x4 3.63$

BARRIER STERILE 3.30$

BASIC PACK DYNJP1015 352.17$

BEDPAN 10.78$

BEDPAN BARIATRIC 35.70$

Page 30: DESCRIPTION CURRENT PRICE LABORATORY

BEDPAN FRACT BARIATRIC 47.70$

BEDPAN FRACTURE 10.78$

BETADINE 7.00$

BETADINE SOLUTION 4 OZ 14.30$

BILE BAG 87.73$

BIOPATCH DRESSING 4150 65.22$

BIOPSY/SKIN/PUNCH 107.00$

BIPAP 410.00$

BLADE #69 BEAVER 47.30$

BLADE DERMATONE BROWN 38.61$

BLADE SURGICAL #10 3.30$

BLADE SURGICAL #15 3.30$

BONE WAX 13.64$

BOOT LARGE 389.75$

BOOT MEDIUM 389.75$

BOOT PEDIATRIC 389.75$

BOOT SMALL 389.75$

BOOT XLARGE 389.75$

BRACE, CERVICAL COLLAR 400.16$

BULB SYRINGE 1OZ 8.53$

BULB SYRINGE 3OZ 8.53$

BURITROL (MINI DRIP) 24.57$

CALMOSEPTINE 2.5oz TUBE 39.00$

CALMOSEPTINE 3.5gm 3.30$

CALMOSEPTINE 4oz TUBE 59.70$

CAPS, M-GEL KNIT DIGITAL 21.66$

CARAFE 3.63$

C-ARM DRAPE/OEM MINI 75.51$

CASTING, PLASTER 5 16.89$

CATH IV 14Gx1.25 16.77$

CATH FOLEY 18FR 5CC BARDIA SILICONE 16.25$

CATH IV 16GX1 25 16.38$

CATH IV 16GX1.75 17.62$

CATH IV 18GX1 25 16.11$

CATH IV 20GX1 16.11$

CATH IV 20GX1.75 18.20$

CATH IV 22GX1 16.11$

CATH IV 24GX0 75 16.11$

CATHETER COUDE 14fr 10cc 45.30$

CATHETER COUDE 16fr 10cc 45.30$

CATHETER COUDE 18fr 10cc 45.30$

CATHETER COUDE 20fr 10cc 45.30$

CATHETER FOLEY 5CC 12FR 9.68$

CATHETER FOLEY 5CC 14FR 9.75$

CATHETER FOLEY 5CC 16FR 9.75$

CATHETER FOLEY 5CC 18FR 9.75$

CATHETER FOLEY TRAY COMP 14fr 74.52$

CATHETER FOLEY TRAY COMP 16fr 74.52$

CATHETER FOLEY TRAY COMP 18fr 74.52$

CATHETER ROBINSON 10FR 6.50$

CATHETER ROBINSON 12FR 6.44$

CATHETER ROBINSON 14FR 6.44$

Page 31: DESCRIPTION CURRENT PRICE LABORATORY

CATHETER ROBINSON 16FR 6.44$

CATHETER ROBINSON 18FR 14.80$

CATHETER SUCTION 10fr 5.40$

CATHETER SUCTION 12fr 5.72$

CATHETER SUCTION 14fr 5.72$

CATHETER SUCTION 16fr 5.72$

CATHETER SUCTION 18fr 5.40$

CATHETER SUCTION 5fr 5.72$

CATHETER SUCTION 8fr 6.18$

CATHETER, MALE 32MM 10.08$

CATHETER, MALE 36MM 10.08$

CATHETER, MALE REG 29MM 10.08$

CATHETER, ROBINSON 12FR NO LATEX 3.30$

CAUTERY, PENCIL, FRM UM 55.44$

CLAMP, CURVED TAIL CLOSURE DUOLOCK 15.60$

COBAN 1 TAN 3.30$

COBAN 2 COLORPACK LATEX 9.94$

COBAN 2 , LATEX FREE 9.01$

COBAN 3 13.26$

COBAN 3 , LATEX FREE 12.98$

COBAN 4 26.16$

COBAN 6 TAN 49.92$

COLLAR CERVICAL HRD PED ADJUSTABLE 56.10$

COLLAR CERVICAL LRG 33.90$

COLLAR CERVICAL MEDIUM 33.90$

COLLAR CERVICAL SMALL 33.90$

COLLAR CERVICAL UNIVERSAL 33.90$

COLLAR CERVICAL X LARGE 33.90$

COLLAR CERVICALADULT ADJUSTABLE 44.70$

COMB 3.63$

COMFORT EASE ELECTRODE 10.00$

COMMODE COLLECTOR 3.63$

CONDITIONER CAP, RINSE FREE 22.50$

CONDITIONER NO RINSE 7.67$

CONNECTOR 5-1 STERILE 3.30$

COVER, BOOT IMPERVIOUS REG 8.88$

COVER, BOOT IMPERVIOUS XL 8.84$

CPM KNEE DEVICE 126.50$

CRASH CART - CODE 220.00$

CRUTCHES FOREARM 199.75$

CRUTCHES PEDIATRIC 104.23$

CRUTCHES REGULAR ADULT 87.73$

CRUTCHES TALL 87.73$

CRUTCHES YOUTH 87.73$

CUSHION DONUT FOAM 18 89.70$

DEODORANT 3.63$

DERMA BOND 150.80$

DIAPER, LARGE 7.15$

DIAPER, XL 59X66 3.30$

DIAPERS PULL UP LARGE 3.30$

DIAPERS PULL UP MEDIUM 3.30$

DIAPERS PULL UP X. LARGE 3.30$

Page 32: DESCRIPTION CURRENT PRICE LABORATORY

DIAPERS PULL UP XXLARGE 3.30$

DISC/PORT FOR W.V. DRESSING 99.00$

DISP OB KIT 2030 51.30$

DNU 379.75$

DNU ARM SLING DEEP PKET XL 33.00$

DNU DRESSING KCI BLACK LG 447.35$

DONUT RING CUSHIN FOAM 18 89.70$

DONUT RING CUSHIN INFLATABLE 53.70$

DRAIN PENROSE .25X12 3.27$

DRAIN PENROSE .50X12 3.50$

DRAIN PENROSE .75X12 4.55$

DRAIN SPONGES 2X2X2 STERILE 3.30$

DRAIN SPONGES 4X4X2 STERILE 3.30$

DRAINAGE BAG 21.13$

DRAPE 1010 18.54$

DRAPE 1092 51.00$

DRAPE SHEET3/4 9349 4.29$

DRAPE SPLIT W/ADH 77X108 39.00$

DRAPE TIBURON HAND 29427 85.53$

DRAPE, MICRO-COVER ZEISS 126.40$

DRESSING ALGINATE 4 X 5 SACRAL 58.74$

DRESSING ALGINATE 7.2 X 7.8 SACRAL PINK 56.70$

DRESSING ALLEVYN LIFE 66801069 33.62$

DRESSING AQUASORB (HYDROGEL) 3.75X3.75 46.20$

DRESSING COVERSITE 650459715100 11.21$

DRESSING DUODERM 4X4 46.50$

DRESSING DUODERM 4X5 87.05$

DRESSING DUODERM THIN 35.35$

DRESSING DUODERM(HYDROCOLLOID) 4X4 27.00$

DRESSING DUODERM, EXTRA THIN 40.00$

DRESSING FOAM MED SQ 200.00$

DRESSING HYDROCEL 7X7 SACRAL 68.94$

DRESSING HYDROCOLLOID FILM 4X4 BACKING 27.00$

DRESSING KCI FOAM SMALL WHITE 77.84$

DRESSING KCI C1157WHITE LG 371.25$

DRESSING KCI LG 106.70$

DRESSING KCI VERS/FOAM SM 77.82$

DRESSING MEPILEX 3 X 3 27.54$

DRESSING MEPILEX 4 X 4 35.94$

DRESSING MEPILEX 7.2 X 7.2 83.94$

DRESSING NU-DERM 4x4 46.74$

DRESSING NU-DERM BORDER 25.81$

DRESSING PICC LINE 80.40$

DRESSING SORBALGON 49210000 9.91$

DRESSING TEGADERM 1624 3.30$

DRESSING TEGADERM 4.5 X 4.5 10.34$

DRESSING, BLACK FOAM SM 185.00$

DRESSING, FILM (FOR DEVON) 27.00$

DRESSING, HYDROCELL 3X3 (LIKE MEPILEX) 19.44$

DRESSING, MED SQ (FOR DEVON) 175.00$

DRESSING, OPTIFOAM 3X3 (LIKE MEPILEX) 22.75$

DRESSING, OPTIFOAM 4X4 (LIKE MEPILEX) 26.97$

Page 33: DESCRIPTION CURRENT PRICE LABORATORY

DRESSING, OPTIFOAM 6X6 (LIKE MEPILEX) 52.50$

DRESSING, SMALL OVAL (FOR DEVON) 159.50$

DRESSING, XL SQ (FOR DEVON) 225.00$

DUDODERM HYDRO 69.35$

DYNAHEX 4 OZ 16.77$

EAR WICK SPONGE STERILE 25.50$

EDEMA ISOTONER GLOVE 25.00$

EGGCRATE MATTRESS 109.73$

ELECTRODE (GROUNDING PA 50.82$

ELECTRODE ESU TIP CLEANER 7.02$

EMESIS BAG 6.86$

EMESIS BAG UM 3.30$

EMESIS BASIN 3.30$

ENEMA KIT (SOAP SUDS) 10.40$

ENSURE 8oz 8.12$

ENT TRAY 41.80$

ET TUBE MURPHY CUFF 6.5 16.19$

ET TUBE MURPHY CUFF SIZE 4 16.19$

ET TUBE MURPHY CUFF SIZE 4.5 16.19$

ET TUBE MURPHY CUFF SIZE 5.0 12.94$

ET TUBE MURPHY CUFF SIZE 6 16.19$

ET TUBE MURPHY CUFF SIZE 7 16.19$

ET TUBE MURPHY CUFF SIZE 8 16.19$

ET TUBE MURPHY N CUFF SIZE 4 12.94$

ET TUBE MURPHY NO CUFF 3.5 11.57$

ET TUBE MURPHY SIZE 7.5 16.19$

ET TUBE MURPHY W/CUFF SIZE 5.5 16.19$

ET TUBE W/STYLET 5 19.50$

ET TUBE W/STYLET 5.5 19.50$

ET TUBE W/STYLET 6 19.50$

ET TUBE W/STYLET 6.5 19.50$

ET TUBE W/STYLET 7 19.50$

ET TUBE W/STYLET 7.5 19.50$

ET TUBE W/STYLET 8 19.50$

ET TUBE W/STYLET 8.5 19.50$

ET TUBE W/STYLET 9 19.50$

ETCO2 MONITOR CAP 61.38$

EXTENSION SET 14.89$

EXTREMITY SHEET 59.10$

EYE PAD 3.30$

EYE TRAY 74.80$

EZYWRAP 4 10.73$

FEEDING TUBE DECLOGGER #911 31.50$

FEEDING TUBE DECLOGGER #922 31.50$

FEEDING TUBE PED 5FR 8.13$

FEEDING TUBE PED 8FR 9.43$

FEMALE CATH KIT 41.70$

FEMALE CATH KIT-MEDLINE 31.50$

FIXODENT .75OZ 18.85$

FLEXI FECAL MGMT SYSTEM 418000 1,597.33$

FLEXI SEAL COLLECTION BAGS 411102 75.00$

FOLEY BAG LEG MEDIUM 21.13$

Page 34: DESCRIPTION CURRENT PRICE LABORATORY

FOLEY BAG LEG STRAP 9.17$

FOLEY CATH SECURE PLUS 25.03$

FOLEY STABILIZATION DEVICE 31.14$

GAUZE DRAIN SPONGES 4X4X2 STERILE 3.30$

GEL CAPS - SUPPLIES 16.00$

GEL FOAM 211.80$

GLOVE NITRILE BIOGEL SYN PF SIZE 8 18.52$

GLOVE NITRILE BIOGEL SYN PF SIZE 8 5 18.52$

GLOVE NITRILE BIOGEL SYN PF SIZE 8 5 18.52$

GLOVE NITRILE BIOGEL SYN PF SIZE 7 5 18.52$

GLOVE SURGICAL BIOGEL SYN PF SIZE 7 18.52$

GLOVE, ISOTONER MEDIUM 109.73$

GLOVES SURG. SZ. 5.5 3.63$

GLOVES BIOGEL 912 7.5 18.52$

GLOVES NITRIDERM LATEX 5.5 10.39$

GLOVES NITRIDERM LFPF 6 10.39$

GLOVES NITRIDERM LFPF 7.5 10.39$

GLOVES NITRIDERM LFPF 8 9.86$

GLOVES NITRIDERM LFPF 8.5 9.86$

GLOVES NITRIDERM LFPF SIZE 6.5 10.39$

GLOVES NITRIDERM LFPF SIZE 7 10.39$

GLOVES PERRY 7.5 10.39$

GLOVES SURGICAL NEOLON LF PF SIZE 8.5 12.74$

GLOVES SURGICAL SIZE 6 3.63$

GLOVES SURGICAL SIZE 6.5 3.63$

GLOVES SURGICAL SIZE 7 3.63$

GLOVES, COMPRESSION FOREARM LENGTH 84.60$

GLOVES, SENSICARE PFLF 5.5 15.58$

GLOVES, SURGICAL, 6 BIOGEL PF UNDERGLOVE 20.22$

GLOVES, SURGICAL, 6.5 BIOGEL LF PF 20.74$

GLOVES, SURGICAL, 7 BIOGEL LF PF 20.74$

GLOVES, SURGICAL, 8.5 BIOGEL LF PF 20.80$

GLUCERNA 11.90$

GOWN SURGEONS LARGE 9515 27.45$

GOWN SURGICAL SIZE XL 15.15$

GOWN, PREV PLUS 2XL NON27457XXL 31.11$

GOWN, PREV PLUS L NON27457 29.89$

GOWN, PREV PLUS M NON27457M 22.14$

GOWN, PREV PLUS XL NON27457XL 31.11$

GOWN, PREV PLUS XLNG XXL DYNJP2303P 40.62$

GOWNS SURGICAL SIZE XXL 27.45$

GOWNS SURGICAL SIZE XXXL 35.28$

HAND EXERCISER YELLOW 57.00$

HEEL LIFT LARGE 1/4 4998 82.23$

HEEL LIFT SMALL 1/4 82.23$

HEEL/ELBOW PROTECTORS PROCARE 79-81600 41.70$

HEMOCLIPS MEDIUM 30.25$

HEXAGEN (BENZALKONIUM CL) 30G TUBE 205.15$

HIBICLENS-SCRUB BRUSH 8.65$

HOOD, WHITE REGULAR 3M TYCHEM QC 168.35$

HYPAFIX (BX) 29.70$

ICE BAG REFILLABLE 12.68$

Page 35: DESCRIPTION CURRENT PRICE LABORATORY

ICE/HOT PACK NURSING ONLY 12.67$

IMMOBILIZER, HEAD, MULTI-GRIP ADULT 41.70$

INTERDRY 10 X144 336.25$

IODINE SWABS 3.30$

IRRIGATION TRAY 23.05$

IRRIGATOR IGLOO WOUND 9.75$

ISOLATION GOWN EA 3.30$

ISOLATION GOWN IMPERV - PLASTIC EACH 76.94$

ISOLATION GOWN IMPERV - PLASTIC MCKESSON 87.00$

IV BLOOD ADMIN #12259-02 100.38$

IV BLOOD ADMIN #14212-28 56.76$

IV CONCURRENT INFUSION 227.50$

IV EXTENSION SET 30-SL 16.90$

IV HYDRATION INFUSION EACH ADDT HOUR 85.00$

IV HYDRATION INITIAL 31 - 60 MINS 230.00$

IV INFUSION THER EACH ADDT HOUR 85.00$

IV INFUSION THERAPY INITIAL 16 - 60 MINS 440.00$

IV INFUSION THERAPY SEQUENT = < 1 HR 120.00$

IV PMI W/A FLOW 23.98$

IV PRIMARY PIGGYBACK 30.50$

IV PRIMARY SET 28.86$

IV PUSH < 16 MINS 120.00$

IV PUSH ADDITIONAL DOSE SAME DRUG 85.00$

IV PUSH SEQUENT - EA. ADDIT NEW SUBSTA 120.00$

IV SECONDARY TUBING 3.30$

IV START KIT 9.10$

IV STATLOCK 50.40$

IV3000 STANDARD 15.60$

IVAC PUMP PER DAY 47.63$

KANGAROO PUMP RENTAL 81.62$

KERLIX 2 3.30$

KERLIX ROLL 4 9.69$

KLEENEX SMALL 3.30$

KLING 2 3.30$

KLING 3 3.30$

KLING 4 3.30$

KLING 6 8.93$

KNEE IM MEDIUM 136.40$

KNEE IM X LARGE 136.40$

KNEE IMM DLX 16 UNIVERSAL 120.73$

KNEE IMM DLX 20 UNIVERSAL 126.23$

KNEE IMM DLX 22 UNIVERSAL 135.03$

KNEE IMM DLX 24 UNIVERSAL 142.73$

KNEE IMM LARGE 136.40$

KNEE IMM SMALL 136.40$

KNEE IMM TRICOT FOAM L 20 131.73$

KNEE IMM TRICOT FOAM MED 20 131.73$

KNEE IMM TRICOT FOAM SMALL 20 131.73$

KNEE IMM TRICOT FOAM XL 20 131.73$

KNEE PACK ARTHROSCOPY DYNJS0811 274.90$

K-WIRE 2-0 67.50$

LACERATION TRAY 36.30$

Page 36: DESCRIPTION CURRENT PRICE LABORATORY

LACT RINGER 500 ML 7953 60.00$

LAVACUATOR 32 63.95$

LAVACUATOR TUBE M/A 63.95$

LEG BAG KIT 47.70$

LEMON GLYCERIN SWAB 3.63$

LEVINE TUBE STOMACH 12fr 5.85$

LEVINE TUBE STOMACH 14fr 5.85$

LEVINE TUBE STOMACH 16fr 5.85$

LEVINE TUBE STOMACH 18fr 5.85$

LIQUID CORN STARCH POWD 12.09$

LOTION 3.63$

LS SUPPORT LARGE 120.12$

LS SUPPORT MEDIUM 120.12$

LS SUPPORT SMALL 120.12$

LS SUPPORT X LARGE 120.12$

LUMBAR PUNCT TRAY-PEDS 96.80$

LUMBAR PUNCTURE TRAY 104.23$

MARKING PENS STERILE 6.50$

MASK SIMPLE OXYGEN PED 9.04$

MASTISOL ADHESIVE 8.31$

MATCOMBAT TOURNIQUET 199.75$

MAYO COVER 10.85$

MED PASS 2 OZ BUTTER PECAN 3.30$

MED PASS 2 OZ ORIGINAL VANILLA 3.30$

MED PASS 4 OZ BUTTER PECAN 3.30$

MED PASS 4 OZ ORIGINAL VANILLA 3.30$

MEDELA QK CONN TUBE W/PAD 81.00$

MEDELA TUBING W/QK CONN 85.25$

MEDELA WOUND CANNISTER 150ML 104.50$

MEDELA WOUND CANNISTER 300ML 85.25$

MEDELA Y CONN 99.00$

MEDELA, DRESSING, L 200.00$

MEDELA, DRESSING, MED 175.00$

MEDELA, FILM 48.00$

MEDIHONEY WND & BURN DRESS GEL .5TUBE 41.70$

MEPILEX 16-295390 35.40$

MICRO SPONGE SPEARS 8.91$

MOUTHWASH 3.63$

NASAL AIRWAY - ALL SIZES 24.38$

NASAL CANNULA PEDIATRIC 9.00$

NASAL CANNULA SALTER LAB 4707-7-7-25 9.00$

NEBUL CIRCUIT HANDHELD 25.00$

NEEDLE COUNTER 10 COUNT 9.96$

NEEDLE COUNTER 30 COUNT 9.96$

NEEDLE ELECTRODE/BOVIE 32.89$

NEEDLE HUBER #20 38.80$

NITRO TUBING 75.96$

NO RINSE, SHMPO & BODY WASH 14.04$

NUGUAZE IODOFOAM 1 30.69$

NUGUAZE IODOFOAM 1/2 30.36$

NUGUAZE IODOFOAM 1/4 26.40$

NUGUAZE PLAIN 1 26.40$

Page 37: DESCRIPTION CURRENT PRICE LABORATORY

NUGUAZE PLAIN 1/2 26.40$

NUGUAZE PLAIN 1/4 27.56$

OB PAD 3.30$

OSC SAW BLADE 10X18.5X.4 290.00$

OSTEOSET 5CC BONE FILE 1,433.85$

PAD CPM 121.00$

PEDOMETER #2 58.00$

PICCLINE KIT 79.26$

PINCAPS 0.028 8.58$

PINCAPS 0.035 8.58$

PLEUREVAC 430.22$

PORTABLE WHIRLPOOL 131.84$

POSEY, BED PAD SENSOR 8283 128.70$

POSEY, CHAIR BELT SENSOR 8360 200.15$

POTTY LINERS 104.22$

POUCH UROSTOMY 25.80$

POUCH, COLOSTOMY 22.10$

POUCH, DRAIN SURE FIT 4 COLOSTOMY 19.44$

POUCH, UROSTOMY 30.00$

PUMP BREAST 267.45$

PUMP TUBING W/SENSOR 430.65$

QUICK ANCHOR MITEK 2124 770.00$

RAZOR 3.63$

REACHER 32 LONG A665-00-9 66.60$

REACHER LONG LIGHTWEIGHT 26 48.54$

RESTING HAND WITH FINGER SEPARATORS 377.79$

RN, PLUS, (STRAP) 150.00$

ROD TENDON HUNTER 3MM 4,997.30$

ROD TENDON HUNTER 4MM 4,997.30$

SAFESECURE FOLEY TUBE HOLDER 41.70$

SCALPEL #10 16.25$

SCALPEL #11 14.30$

SCALPEL #15 16.21$

SCD CALF LEG LARGE WRAPS 534.83$

SCD CALF LEG WRAPS 277.75$

SCRUB SPONGE LONG HANDLE 23.34$

SENSI CARE #3 BARRIER CREA 92.94$

SENSI CARE BODY CREAM 41.70$

SENSOR O'2 ADULT LNCS 70.00$

SENSOR O'2 INFANT 104.50$

SENSOR O'2 INFANT LNCS 82.50$

SENSOR O'2 PEDIATRIC 93.33$

SENSOR O'2 PEDIATRIC LNCS 82.38$

SENSOR PAD(RN PLUS) 165.00$

SHAMPOO 3.63$

SHAVE CREAM MINI 7.15$

SHOE POST OP FEMALE LARGE BLK 41.70$

SHOE POST OP FEMALE MEDIUM BLK 41.70$

SHOE POST OP FEMALE SMALL BLK 41.70$

SHOE POST OP MALE LARGE BLK 41.70$

SHOE POST OP MALE MEDIUM BLK 41.70$

SHOE POST OP MALE SMALL BLK 40.02$

Page 38: DESCRIPTION CURRENT PRICE LABORATORY

SHOE POST OP MALE XLARGE BLK 41.70$

SHOEHORN 17 THERAFIN EZ SLIDE 47.94$

SHOELACE FLEXOLACE BLACK 61.74$

SHOELACE FLEXOLACE WHITE 99.88$

SHOULDER PACK FOR BEACH CHAIR 88108 311.68$

SHOULDER PACK, ARTHROSCOPY DYNJS3065 266.39$

SHOULDER PULLEY 74.16$

SKIN BARRIER PASTE CRITIC AID 30.96$

SKIN STAPLER #15 132.45$

SKIN STAPLER #5 41.25$

SKIN STAPLER 35W 054887 132.45$

SKIN-PREP SWAB NO-STING 3ML 7.67$

SLING & SWATHE 82.23$

SLIPPERS LARGE 8.25$

SLIPPERS MEDIUM 8.25$

SLIPPERS XL 8.25$

SLIPPERS XXLRG 8.25$

SOCK-AID 57.60$

SOD CHLOR IRR FLEX 3000ML 44.76$

SODI/CHLOR 0.45% 500 ML 60.00$

SODI/CHLOR 0.9% 1000 ML FOR IRR 7138-09 59.40$

SODIUM CHL 10 ML SYR SWAB FLUSH 3.85$

SOL 1/2NS-1000ml, 7985-09, 2B1314X 60.00$

SOL 100ml AD, 0553-18 60.00$

SOL 50ml AD, 0553-11 35.78$

SOL D5.20-1000ml, 7924-09, 2B1094X 60.00$

SOL D5.33-1000ml, 7925-09 60.00$

SOL D5.45-1000ml,7926-09, 2B1074X 60.00$

SOL D5LR-1000ml, 7929-09, 2B2074X 60.00$

SOL D5NS-1000ml, 7941-09, 2B1064X 60.00$

SOL D5W-1000ml, 7922-09, 2B0064X 60.00$

SOL D5W-100ml AD, 0551-18 35.78$

SOL D5W-100ml, 7923-23, 2B0087 60.00$

SOL D5W-250ml AD, 7100-02 60.00$

SOL D5W-250ml, 7922-02, 2B0062Q 60.00$

SOL D5W-500ml, 7922-03, 2B0063Q 30.00$

SOL D5W-ADV, 7100-67 60.00$

SOL LR 7953-03 60.00$

SOL LR-1000ml, 7953-09, 2B2324X 60.00$

SOL NACL IRR 500ML , 6138-03, 2F7123 30.00$

SOL NACL100ml 7984-23, 2B1307, ABB1307U 60.00$

SOL NACL-250ml, 7983-02, 2B1322Q 60.00$

SOL NACL-ADV 100ML, 7101-69 60.00$

SOL NS 250ML 7101-02 60.00$

SOL NS 500ML 7983-03, 2B1323Q, JB1323 60.00$

SOL NS-1000ml, 7983-09, 2B1324X 60.00$

SOL STERILE WATER 6139-03, 2F7113 30.00$

SPECIMEN CONT STERILE 3.30$

SPECIMEN CONTAINER 10.40$

SPECIMEN MIDSTRM KIT 3.30$

SPLINT C-SPLINT OPTION-HAND BA 210.00$

SPLINT EWHO RIGID W/O JOINTS 380.00$

Page 39: DESCRIPTION CURRENT PRICE LABORATORY

SPLINT FINGER KNUCKLE BENDER 90.00$

SPLINT FINGER ORTHOSIS-BIVALVE 180.00$

SPLINT FLEX GLOVE W/ELASTIC 65.00$

SPLINT IP GUTTER 85.00$

SPLINT MALLET FINGER 85.00$

SPLINT SOFT SAM 4 X 36 155.37$

SPLINT SOFT SAM MULTI 63.00$

SPLINT STATIC PROG WRIST HAND 405.00$

SPLINT THUMB SPICA 285.00$

SPLINT THUMB SPICA H/F ORTH/TR 210.00$

SPLINT TIP PROTECTOR 85.00$

SPLINT WHFO DORSAL BLOCKING 380.00$

SPLINT WHFO DYNAMIC FLEXOR 445.00$

SPLINT WHFO RADIAL/ULNAR GUTTER 285.00$

SPLINT WHFO WRIST SUPPORT 420.00$

SPLINT WRIST LF 58.62$

SPLINT WRIST RT 58.62$

SPLINT, FINGER ALUMINUM 16.08$

SPLINT, SAM 12 116.82$

SPLINT, SAM 15 100.49$

SPLINT, SAM 9 93.50$

SPLINT, WRIST UNIV L 57.00$

SPLINT, WRIST UNIV R 57.00$

SPONGES 2X2X2 STERILE 3.30$

SPONGES 4X4X10 STERILE 3.30$

SPONGES 4X4X2 3.30$

SPONGES X-RAY DECT 4X8 8.09$

STAPLE REMOVER SKIN 27.28$

STAPLE SKIN ROYAL 132.45$

STERI DRAPE 1010 20.48$

STERI STRIP 1/2 11.17$

STERI STRIP 1/4 11.17$

STERI STRIP 1/8 11.17$

STOCKINETTE 6 18.07$

STOCKINETTE, IMPERVIOUS 6 X30 19.76$

STOMAHESIVE, WAFER 2.25 50.40$

STOMAHESIVE, WAFER HYDRO 46.74$

STYLET, LARGE, ADULT #1000 M52294 25.14$

STYLET, MEDIUM, CHILD #750 M52293 25.14$

STYLET, SMALL, NEONETAL #500 M52292 25.14$

SUCTION TUBE .25X10 8.57$

SUCTION TUBE .25X6 9.13$

SURGICEL 2X14 #1951 209.75$

SURGICEL DRESS/1951 425.60$

SURGIPAD 5X9 3.30$

SUTURE 5-0 TEVEDEK 7-733 43.14$

SUTURE ANCHOR, MICRO MINI 2-0 ETHIBOND V 920.15$

SUTURE CHROMIC 2/0 G-123 14.41$

SUTURE CHROMIC 4.0 U203H 58.38$

SUTURE CHROMIC 5-0 1636G 105.39$

SUTURE CHROMIC 6/0 1635G 105.38$

SUTURE CHROMIC 7-0 1744G 95.37$

Page 40: DESCRIPTION CURRENT PRICE LABORATORY

SUTURE CHROMIC GUT 4-0 G-121 H 54.36$

SUTURE CHROMIC GUT 6-0 1641G 34.98$

SUTURE CHROMIC S-172 3/0 14.41$

SUTURE DERMALON 1851-28 9/0 122.16$

SUTURE DEXON PLUS 5/0 9536-21 54.84$

SUTURE DEXON PLUS 5612-31 4/0 20.00$

SUTURE DEXON PLUS 5618-41 3/0 49.98$

SUTURE ETHIBOND #1 X-425H 18.98$

SUTURE ETHIBOND 2.0 C-X46G 77.00$

SUTURE ETHIBOND 3.0 1669H 57.66$

SUTURE ETHIBOND 3.0 X872H 40.20$

SUTURE ETHIBOND 4.0 871H 39.78$

SUTURE ETHIBOND 5.0 698G 59.97$

SUTURE ETHILON #2 825G 72.00$

SUTURE ETHILON 10-0 2830G/2870G 281.65$

SUTURE ETHILON 2-0 PS-2 593H 72.24$

SUTURE ETHILON 4-0 P-3 699G 63.00$

SUTURE ETHILON 5/0 698G 64.44$

SUTURE ETHILON 6/0 1698G 64.50$

SUTURE ETHILON 7-0 1696G 78.48$

SUTURE ETHILON 8-0 2808G 187.48$

SUTURE ETHILON NYLON 3.0 633G 37.98$

SUTURE ETHILON NYLON 4-0 1667G 69.96$

SUTURE ETHILON NYLON 5-0 1666G 69.96$

SUTURE ETHILON P-3 5-0 58.98$

SUTURE MONCRYL 4-0 J463G 72.05$

SUTURE MONOCRYL 4-0 Y-494 83.05$

SUTURE MONOSOF 9.0 N-2532 193.75$

SUTURE NYLON 1667 4/0 30.00$

SUTURE NYLON 2808 8/0 104.56$

SUTURE NYLON 3/0 663G 73.31$

SUTURE NYLON 697 6/0 30.00$

SUTURE PDS 6-0 Z432H 38.28$

SUTURE PDS-II 6.0 Z117H 165.15$

SUTURE PLAIN 5/0 686G 101.75$

SUTURE PLAIN 6-0 1916G 105.39$

SUTURE PLAIN 842 3/0 16.67$

SUTURE PLAIN 843 2/0 11.44$

SUTURE PROLENE 4-0 P-3 8699G 85.98$

SUTURE PROLENE 5-0 8698G 81.96$

SUTURE PROLENE 6.0 8714H 72.66$

SUTURE PROLENE 6/0 8695G 76.06$

SUTURE REMOVAL KIT 7.67$

SUTURE SURG STEEL 0.18 3.30$

SUTURE SURG STEEL 2 DS-24 44.88$

SUTURE SURG STEEL 2/0 18 76.78$

SUTURE SURG STEEL 3/0 76.78$

SUTURE SURGICAL STEEL #1 3.30$

SUTURE SURGICAL STEEL 4-0 539G 126.00$

SUTURE TEVDEK 3-0 7-590 38.28$

SUTURE TEVDEK 4-0 7-732 56.65$

SUTURE TEVDEK 6-0 7-853 40.86$

Page 41: DESCRIPTION CURRENT PRICE LABORATORY

SUTURE TEVDEK STRANDS 3/0 7-913 38.28$

SUTURE TICRON 4/0 3047-31 17.77$

SUTURE VICRYL 3-0 J-497G 69.48$

SUTURE VICRYL 3-0 PLUS VCP285G 35.75$

SUTURE VICRYL 4-0 J494G 23.33$

SUTURE VICRYL 5.0 VCP493G UNDYED 84.90$

SUTURE VICRYL 5-0 VCP 463G VIOLET 70.95$

SUTURE VICRYL 6/0 J212H 27.66$

SUTURE VICRYL J-495 5-0 21.66$

SUTURE, MONOCRYL 5-0 Y493G 77.88$

SUTURE, VICRYL PLUS, 3-0,LIGAPAK 44.46$

SUTURE, VICRYL PLUS, 3-0,LIGAPAK 44.46$

SUTURE, VICRYL PLUS, 4-0, LIGAPAK 44.46$

SWAB FLUSH CAP 3.85$

SYRINGE 30ML 3.30$

SYRINGE 35ML 3.30$

SYRINGE 60CC LUER TIP 3.30$

TED HOSE KNEE LARGE 57.75$

TED HOSE KNEE MEDIUM 57.75$

TED HOSE KNEE SMALL 57.75$

TED HOSE KNEE XL 57.75$

TED HOSE THIGH HI LG LONG 65.70$

TED HOSE THIGH HI MED LONG 65.70$

TED HOSE THIGH HI XL LONG 65.70$

TED HOSE THIGH LARGE 78.71$

TED HOSE THIGH MEDIUM 78.71$

TED HOSE THIGH SMALL 78.71$

TED HOSE THIGH XL 78.71$

TELFA DRESSING 3 X 4 3.30$

TELFA LIKE 2X3 PADS, CURAD 3.30$

TELFA LIKE 3X4 PADS, CURAD 3.30$

TEMP. INDICATOR 3.30$

TENDON SPAC 24cmX5mm 647.46$

THERABAND - BLUE 25.00$

THERABAND - GREEN 25.00$

THERABAND - RED 25.00$

THERABAND - YELLOW 25.00$

THERAPUTTY 15.00$

TLSO BACK BRACE 1,776.49$

TOOTHBRUSH 3.63$

TOOTHETTE SWAB W/ANTISEPTIC RINSE 9.04$

TOOTHPASTE 3.63$

TOURNIQUET CUFF 15 DIS 136.95$

TOURNIQUET CUFF 18 DIS 121.44$

TOURNIQUET CUFF 24 DIS 142.21$

TRACH TUBE 270.00$

TRIPLE-ANTIB. OINT NEOSPORIN 308 3.30$

TUBE SALEM SUMP 10FR 25.68$

TUBE SALEM SUMP 12FR 25.68$

TUBE SALEM SUMP 14FR 25.68$

TUBE SALEM SUMP 16FR 25.68$

TUBING O2 7' 3.30$

Page 42: DESCRIPTION CURRENT PRICE LABORATORY

UNDERPAD 10.08$

URINAL 3.63$

URINAL, FEMALE, STAND TO PEE 12.93$

URINARY EXTENSION TUBE 18 12.68$

URINE COLLECTOR PEDS 3.30$

VESSEL LOOP 17.71$

VICRYL SUTURE 5-0 J500G 72.96$

WASH BASIN 3.30$

WASHCLOTH BARRIER CREAM 28.14$

WASHCLOTH HD UNSCENTED 21.84$

WASHCLOTH UNSCENTED 23.70$

WEBRIL II 2 7.40$

WEBRIL II 3 9.74$

WEBRIL II 4 STERILE 12.60$

WEDGE 2'X2'X10 148.23$

WHIRLPOOL ADDITIVES 240.00$

WIPE DISPOSABLE 10.27$

WOUND CLEANSER BIOLEX 60.00$

WOUND IRRIGATOR 9.75$

WOUND VAC CANNISTER 125.00$

WOUND VAC CANNISTER FOR DEVON 137.50$

WOUND VAC HALO PUMP 205.00$

WOUND VAC, DEVON 205.00$

WRIST HAND ORTHOSIS,WRIST EXTENSION CONT 190.00$

WRIST WRAP, NEOPRENE BLK UNIV 77.94$

WRIST, SPLINT L UNIVERSAL 53.70$

WRIST, SPLINT R UNIVERSAL 53.70$

XEROFORM 1X8 3.63$

XEROFORM 2X2 7.73$

XEROFORM 4X4 9.74$

XEROFORM 5X9 6.37$

XEROFORM 5X9 GENERIC 3.30$

XEROFORM PETROLATUM 5X9 12.94$

XLR8 PORT DRESSING 99.00$

X-RAY CASSETT COVER/DRAPE 7.28$

Y CONNECTOR FOR W.V. DRESSING 48.00$

YANKAUR SUCTION TIP 6.76$

YANKAUR SUCTION W/TIP 20.46$

HOSPITAL ROOM AND BOARD

ROOM AND BOARD-SB (SNF) SEMI-PRIVATE 2,568.00$

ROOM AND BOARD-ACUTE SEMI-PRIVATE 2,568.00$

RESPITE CARE

RESPITE CARE I 1-4 HOURS 91.00$

RESPITE CARE I PER HOUR 11.70$

RESPITE CARE II 1-4 HOURS 104.00$

RESPITE CARE II PER HOUR 16.90$

RESPITE CARE III 1-4 HOURS 117.00$

Page 43: DESCRIPTION CURRENT PRICE LABORATORY

RESPITE CARE III PER HOUR 22.10$

RESPITE CARE IV 1-4 HOURS 130.00$

RESPITE CARE IV PER HR 27.30$

RESPITE CARE V 1-4 HOURS 143.00$

RESPITE CARE V PER HR 32.50$

Page 44: DESCRIPTION CURRENT PRICE LABORATORY

CURRENT PRICE