Updated 12/21/2023 Item Number Item Description Charge Amount 30237-8900-6 SIPULEUCEL-T-LACTATED RINGERS 50 MILLION CELL/250 ML IV SUSP $406,916.25 69488-003-01 LUTETIUM LU 177 DOTATATE 10 MCI/ML (370 MBQ/ML) IV SOLN $326,950.00 69488-003-70 LUTETIUM LU 177 DOTATATE 10 MCI/ML (370 MBQ/ML) IV SOLN $326,950.00 67979-002-01 HISTRELIN 50 MG (65 MCG/DAY) IMPL KIT $308,054.31 0187-0010-50 SODIUM BENZOATE-SOD PHENYLACET 10-10 % IV SOLN $296,794.55 69488-010-61 LU-177 VIPIVOTIDE TETRAXETAN 27 MCI/ML (1,000 MBQ/ML) IV SOLN $276,250.00 0169-7013-01 TRETTEN 2,500 UNIT IV SOLR $265,850.00 0169-7113-11 TRETTEN 2,500 UNIT IV SOLR $265,850.00 50633-210-11 GLUCARPIDASE 1,000 UNIT IV SOLR $238,212.00 13811-705-50 SODIUM BENZOATE-SOD PHENYLACET 10-10 % IV SOLN $237,250.00 HC62809041 GENRTR PULSE OPTIMIZER SMART MINI IPG G200042 $216,666.00 0003-2328-22 IPILIMUMAB 200 MG/40 ML (5 MG/ML) IV SOLN $209,048.84 75987-080-10 PEGLOTICASE 8 MG/ML IV SOLN $173,323.93 72694-515-01 CALASPARGASE PEGOL-MKNL 750 UNIT/ML IV SOLN $167,596.72 57894-061-03 USTEKINUMAB 90 MG/ML SUBCUTANEOUS SYRG $165,731.28 50419-208-01 RADIUM RA 223 DICHLORIDE 1,100 KBQ/ML(30 MICROCURIE/ML) IV SOLN $158,485.86 72694-954-01 PEGASPARGASE 750 UNIT/ML INJ SOLN $158,093.85 79952-110-01 LONCASTUXIMAB TESIRINE-LPYL 10 MG IV SOLR $156,824.20 0008-0100-01 INOTUZUMAB OZOGAMICIN 0.9 MG (0.25 MG/ML INITIAL) IV SOLR $139,602.71 99988-000-42 NM SIR-SPHERES Y-90 RESIN MICROSPHERES $116,967.50 50242-150-01 OCRELIZUMAB 30 MG/ML IV SOLN $115,679.07 99988-000-34 NM YTTRIUM Y-90 IBRITUMOMAB (ZEVALIN) <=40MCI $113,750.00 HC62809058 STENT ENDOPRSTH THOR(TAG®GORE®) $112,000.00 47335-177-95 TILDRAKIZUMAB-ASMN 100 MG/ML SUBCUTANEOUS SYRG $106,708.16 HC62808514 CLIP DELIVERY SYSTEM MITRACLIP $104,998.00 99988-000-43 NM THERASPHERE Y-90 GLASS MICROSPHERES $104,000.00 66302-014-01 DINUTUXIMAB 3.5 MG/ML IV SOLN $102,506.37 47783-101-01 ECALLANTIDE 10 MG/ML (1 ML) SUBCUTANEOUS SOLN $101,835.38 50242-105-01 POLATUZUMAB VEDOTIN-PIIQ 140 MG IV SOLR $101,400.00 75987-130-15 TEPROTUMUMAB-TRBW 500 MG IV SOLR $100,565.40 0003-7125-11 NIVOLUMAB-RELATLIMAB-RMBW 240-80 MG/20 ML IV SOLN $89,012.82 0024-5823-15 CABAZITAXEL 10 MG/ML (FIRST DILUTION) IV SOLN $83,308.36 0024-5824-11 CABAZITAXEL 10 MG/ML (FIRST DILUTION) IV SOLN $83,308.36 57894-060-03 USTEKINUMAB 45 MG/0.5 ML SUBCUTANEOUS SYRG $82,865.64 50242-245-01 PERTUZUMAB-TRASTUZUMAB-HY-ZZXF 1,200 MG-600MG- 30000 UNIT/15ML SUBCUTANEOUS SOLN $82,595.47 0169-7205-01 NOVOSEVEN RT 5 MG (5,000 MCG) IV SOLR $80,600.00 0169-7215-11 NOVOSEVEN RT 5 MG (5,000 MCG) IV SOLR $80,600.00 HC62806963 SENSOR PULMONARY ARTERY PRESS IMPL WIRELESS SYS $80,324.00 HC44502946 REVAS FEMPOP TLA&STENT&ATHER-B $78,782.00 0074-9694-03 LEUPROLIDE (PEDIATRIC 3 MONTH) 30 MG IM SYKT $72,981.35 0074-3473-03 LEUPROLIDE ACETATE (6 MONTH) 45 MG IM SYKT $72,309.19 99999-035-68 EPIFIX SKIN GRAFT ( 7X7 CM ) $71,285.50 59572-775-01 LUSPATERCEPT-AAMT 75 MG SUBCUTANEOUS SOLR $71,220.63 0173-0898-03 DOSTARLIMAB-GXLY 50 MG/ML IV SOLN $70,122.26 HC62226915 KIT ABALATION (MAZE) $69,999.00 HC62808886 STENT THORACIC SG AC CONFORM(TAG®GORE®) $69,194.00 HC62809066 DEVICE OCCLUDE AMPLATZER $67,900.00 71104-944-01 ALPROLIX 3,000 UNIT IV SOLR $67,275.00 HC62807417 STENT ENDOPRSTH TAA AF $66,499.00 25682-007-01 SEBELIPASE ALFA 2 MG/ML IV SOLN $66,365.00 0074-3779-03 LEUPROLIDE (PEDIATRIC 3 MONTH) 11.25 MG IM SYKT $66,262.37 51144-050-01 BRENTUXIMAB VEDOTIN 50 MG IV SOLR $65,507.00 50242-917-01 ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) IV SOLN $64,016.16 71336-1000-1 PATISIRAN (LIPID COMPLEX) 2 MG/ML IV SOLN $63,602.50 HC44503068 REVAS TIB/PERO TLA&STNT&ATHR-B $63,564.00 HC62806849 STENT ENDOPRSTH TAA AE $62,999.00 61755-008-01 CEMIPLIMAB-RWLC 50 MG/ML IV SOLN $62,462.72 99999-033-30 BOTULISM IMMUNE GLOBULIN INJECTION $62,075.00 0008-4510-01 GEMTUZUMAB OZOGAMICIN 4.5 MG (1 MG/ML INITIAL CONC) IV SOLR $61,216.09 HC62807748 M: GENRTR NRSTM HI FREQU RE-CHRG&CHRGR $60,990.00 68727-745-01 DAUNORUBICIN-CYTARABINE LIPOS 44-100 MG IV SOLR $60,125.00 68727-745-02 DAUNORUBICIN-CYTARABINE LIPOS 44-100 MG IV SOLR $60,125.00 HC62808530 GENERATOR PULSE NEUROSTIM(INSPIRE®) $59,849.00 HC62808365 DEVICE CLOSURE LAA (WATCHMAN) $59,499.00 HC62807243 STENT ENDOPRSTH TAA AD $59,499.00 0074-5015-01 RISANKIZUMAB-RZAA 60 MG/ML IV SOLN $59,386.60 HC44504611 THROMBECT MECH PERC&/THROMBOLYSIS INF CRANI BI $58,843.00 57894-450-01 TECLISTAMAB-CQYV 90 MG/ML SUBCUTANEOUS SOLN $58,675.50 68727-745-05 DAUNORUBICIN-CYTARABINE LIPOS 44-100 MG IV SOLR $58,662.50 69097-870-67 LANREOTIDE 120 MG/0.5 ML SUBCUTANEOUS SYRG $57,802.29 HC44702835 COMP EP EVAL W/INDUC&ABLAT 3D MAP ECHO S&I PVI AFIB $57,526.00 HC44503290 ATHER'TRLUML ILIAC EAVES W/S&I-B $57,454.00 0173-0896-01 BELANTAMAB MAFODOTIN-BLMF 100 MG IV SOLR $57,372.06 50242-085-25 ALTEPLASE 100 MG IV SOLR $57,202.34 50242-085-27 ALTEPLASE 100 MG IV SOLR $57,202.34 HC44502888 REVASC FEM POP W/TLA&ATHER-BI $56,770.00 57894-503-01 DARATUMUMAB-HYALURONIDASE-FIHJ 1,800 MG-30,000 UNIT/15 ML SUBCUTANEOUS SOLN $56,718.58 HC44504041 EMBOLIZE TUMOR/ORGAN/INFARCT W/S&I $56,381.00 HC45401601 MRI GUIDED US STEREOTACT ABLAT INTRACRAN LESION $56,160.00 HC44504058 EMBOLIZE VES HEMORRG/LYMPH EXTRAVW/S&I $55,999.00 HC62807987 STENT ENDOPRSTH TAA AC $55,999.00 HC44703056 TAVR/TAVI W/ PROSTH; TRANSAPICAL EXP (LT THORAC) $55,500.00 HC44703809 EV REPAIR STENT PLACE COARCT AORTA ACROSS MAJOR SIDE BRANCHES $55,244.00 HC44703189 OPEN REPAIR INFRARENAL AAA; FAILED ENDOGRAFT; AORTO-BIFEM PRO $55,081.00 HC44703171 OPEN REPAIR INFRARENAL AAA; FAILED ENDOGRAFT; AORTO-BI-ILIAC PRO $55,081.00 50242-260-01 PERTUZUMAB-TRASTUZUMAB-HY-ZZXF 600 MG-600 MG- 20000 UNIT/10ML SUBCUTANEOUS SOLN $55,061.50 HC44703163 OPEN REPAIR INFRARENAL AAA; FAILED ENDOGRAFT; TUBE PRO $54,615.00 HC44703106 TEVAR W/ LT SUBCLAV; INITIAL ENDO& DIST EXTS CELIAC $54,529.00 HC62807185 DIVERTER FLOW NEUROVASC(PIPELINE FLX 35)F $54,179.00 HC44702934 REPAIR VISC AORTA FEVAR(PROX&DIST);4 PROSTH $54,166.00 68403-1100-6 BOTULISM IMMUNE GLOBULIN,HUMAN 100 MG IV SOLR $53,700.00 HC44502912 REVASC FEM POP W/TLA&STENT-BI $53,666.00 HC44703460 REPAIR AORTA ASCENDING ENDOVSC STENT GRAFT $53,618.00 HC44501005 INSERTION-TIPS $53,277.00 HC44702926 REPAIR VISC AORTA FEVAR(PROX&DIST);3 PROSTH $52,945.00 HC62808134 G130136 KIT STENTS ENDOPRSTH ASC AORTA $52,499.00 HC62806930 STENT ENDOPRSTH TAA AB $52,499.00 HC62808118 STENT ENDOPRSTH TAA IDE G040175 $52,499.00 HC62806641 DIVERTER FLOW NEUROVASC(PIPELINE LG)E $52,482.00 0003-2327-11 IPILIMUMAB 50 MG/10 ML (5 MG/ML) IV SOLN $52,262.34 60923-284-10 ETEPLIRSEN 50 MG/ML IV SOLN $52,000.00 HC44503035 REVAS TIB/PERO W/TLA&STENT-BI $51,258.00 HC44702918 REPAIR VISC AORTA FEVAR(PROX&DIST);2 PROSTH $51,205.00 HC44503001 REVAS TIB/PERO W/TLA & ATHER-BI $51,158.00 64406-008-01 NATALIZUMAB 300 MG/15 ML IV SOLN $51,062.99 HC44702900 REPAIR VISC AORTA FEVAR(PROX&DIS);1 PROSTH $50,800.00 64764-300-20 VEDOLIZUMAB 300 MG IV SOLR $50,136.00 HC44703353 EV REPAIR INFRARENAL AORTA&/ILIAC GRAFT AORTO-BI-ILIAC ~RUPT $50,044.00 HC44503266 ATHER'TRLUML BRACH EAVES W/S&I-B $49,982.00 HC62807177 DIVERTER FLOW NEUROVASC(PIPELINE FLX 16)D $49,769.00 HC44703114 TEVAR; INITIAL ENDO & DIST EXTS TO CELIAC $49,674.00 HC44703338 EV REPAIR INFRARENAL AORTA&/ILIAC GRFT AORTO-UNI-ILIAC ~RUPT $49,602.00 HC44503217 ATHER' TRLUML RENAL ART&S&I-BI $49,471.00 58468-0225-1 CAPLACIZUMAB-YHDP 11 MG INJ KIT $49,348.00 58468-0227-1 CAPLACIZUMAB-YHDP 11 MG INJ SOLR $49,348.00 HC44504033 EMBOLIZE ARTERIAL(ANY MALFORMTN)W/S&I $49,338.00 HC44702827 COMP EP EVAL W/INDUC&ABLAT 3D MAP TX VT $49,308.00 HC44703049 TAVR/TAVI W/ PROSTH; TRANSAORTIC EXP (STERNO) $49,070.00 HC62808068 STENT ENDOPRSTH AAA AA $48,999.00 HC62808076 STENT ENDOPRSTH TAA AA $48,999.00 HC44503183 REVAS TIB/PER EA+TLA&ATH&STN-B $48,981.00 50242-109-01 RITUXIMAB-HYALURONIDASE,HUMAN 1600 MG/13.4 ML (120 MG/ML) SUBCUTANEOUS SOLN $48,854.57 HC62802988 DEVICE FLOW DIVERSION PIPELINE $48,649.00 0074-3683-03 LEUPROLIDE (4 MONTH) 30 MG IM SYKT $48,205.43 HC62806633 DIVERTER FLOW NEUROVASC(PIPELINE SM)C $47,949.00 50242-070-01 OBINUTUZUMAB 1,000 MG/40 ML IV SOLN $47,454.94 HC44703817 EV REPAIR STENT PLACE COARCT AORTA NOT CROSSING MAJOR SIDE BRANCHES $47,208.00 HC44502763 REVASC ILIAC W/TLA & STENT-BI $47,204.00 68727-712-01 LURBINECTEDIN 4 MG IV SOLR $46,865.00 0026-3948-25 JIVI 3,000 (+/-) UNIT IV SOLR $46,800.00 0026-4948-01 JIVI 3,000 (+/-) UNIT IV SOLR $46,800.00 HC62805270 DEVICE EMBOLIZATION NEURO(PIPELINE) $46,549.00 HC44703015 TAVR/TAVI W/ PROSTH; OPEN FEM ARTERY $46,495.00 HC62808639 OXYGENATOR ECMO CIRCUIT CARDIOHELP $46,199.00 HC44501864 REVISION-TIPS $45,933.00 HC44702892 REPAIR VISC AORTA FEVAR; 4+PROSTH $45,902.00 0003-3734-13 NIVOLUMAB 240 MG/24 ML IV SOLN $45,846.06 HC62806245 SYSTEM PERFUSION VENOUS(ANGIOVAC) $45,499.00 HC44503662 VERT/THOR CAROTID STENT 1ST LT $45,391.00 HC44503670 VERT/THOR CAROTID STENT 1ST RT $45,391.00 50242-120-47 TENECTEPLASE 50 MG INJ SOLR (MHS) $45,031.61 50242-918-01 ATEZOLIZUMAB 840 MG/14 ML (60 MG/ML) IV SOLN $44,811.31 58468-0040-1 AGALSIDASE BETA 35 MG IV SOLR $44,804.18 HC44702884 REPAIR VISC AORTA FEVAR; 3 PROSTH $44,358.00 HC44703031 TAVR/TAVI W/ PROSTH; OPEN ILIAC ARTERY $44,163.00 48818-001-01 PRALATREXATE 20 MG/ML (1 ML) IV SOLN $44,118.88 HC44502938 REVAS FEMPOP TLA&STENT&ATHER-L $43,770.00 HC44502920 REVAS FEMPOP TLA&STENT&ATHER-R $43,770.00 HC62808217 DEVICE NEUROVASC PULSERIDER H160002 $43,749.00 44206-439-40 IMMUN GLOB G(IGG)-PRO-IGA 0-50 10 % IV SOLN $43,542.20 44206-439-93 IMMUN GLOB G(IGG)-PRO-IGA 0-50 10 % IV SOLN $43,542.20 99999-035-67 EPIFIX SKIN GRAFT ( 5X6 CM ) $43,374.50 0944-2514-02 IGG-HYALURONIDASE,RECOMBINANT 30 GRAM /300 ML (10 %) SUBCUTANEOUS SOLN $43,304.63 HC44702876 REPAIR VISC AORTA FEVAR; 2 PROSTH $43,198.00 HC44703619 TRANSCATH INTRACARD SHUNT(TIS) STENT ICF CONGENTL INCLUDE IMAGI; 1ST SHUNT (FONTANE) $42,940.00 0002-7678-01 RAMUCIRUMAB 10 MG/ML IV SOLN $42,895.13 50242-108-01 RITUXIMAB-HYALURONIDASE,HUMAN 1400 MG/11.7 ML (120 MG/ML) SUBCUTANEOUS SOLN $42,747.78 HC44503159 REVAS TIB/PER EA+V TLA&STENT-B $42,636.00 HC44504157 SEL CATH IC CAROTID &ANG IC W/SI BI $42,509.00 25682-001-01 ECULIZUMAB 300 MG/30 ML IV SOLN $42,399.44 HC44703023 TAVR/TAVI W/ PROSTH; OPEN AXILLARLY ARTERY $42,075.00 HC44702868 REPAIR VISC AORTA FEVAR;1 PROSTH $42,037.00 HC62808050 STENT ENDOPRSTH AAA Y $41,999.00 HC44504025 EMBOLIZE VENOUS (ANY MALFORMTN)W/S&I $41,799.00 55513-190-01 PEGFILGRASTIM 6 MG/0.6 ML SUBCUTANEOUS SYRG $41,716.94 55513-192-01 PEGFILGRASTIM 6 MG/0.6 ML SUBCUTANEOUS SYIN $41,716.94 25682-025-01 RAVULIZUMAB-CWVZ 100 MG/ML IV SOLN $41,626.01 HC44501880 STENT PLAC INTRACRANIAL $41,527.00 0078-0825-81 OCTREOTIDE,MICROSPHERES 30 MG IM SSRR $41,509.91 HC44501583 PTA INTRACRANIAL $41,355.00 0944-2719-30 IMMUN GLOB G(IGG)-GLY-IGA OV50 30 GRAM/300 ML (10 %) SUBCUTANEOUS SOLN $41,242.50 HC44702819 COMP EP EVAL W/INDUC&ABLAT 3D MAP TX SVT $41,090.00 HC25001413 TRAUMA ACTVTN I CMPREN $40,926.00 HC44502821 REVAS ILIAC EA+VES W/TLA&STENT-B $40,751.00 49702-240-15 CABOTEGRAVIR-RILPIVIRINE 600 MG/3 ML- 900 MG/3 ML IM SPSR $40,564.60 72903-853-01 MIRVETUXIMAB SORAVTANSINE-GYNX 5 MG/ML IV SOLN $40,430.00 50242-037-06 TENECTEPLASE 50 MG INJ SOLR (MHS) $40,422.59 64193-425-02 FEIBA NF 1,750-3,250 UNIT IV SOLR $39,975.00 HC62808597 CATH LITHOTRIPSY CORONARY TRANSLUM INTRAVASC $39,854.00 51144-003-01 TISOTUMAB VEDOTIN-TFTV 40 MG IV SOLR $39,741.00 HC44703221 PERC LT ATRIAL APPEND CLOSURE (LARIAT) $39,640.00 HC44504173 SEL CATH VERTEBRAL &ANG VRT W/SI BI $39,599.00 15054-1060-4 LANREOTIDE 60 MG/0.2 ML SUBCUTANEOUS SYRG $39,572.00 HC44503126 REVASC TIB/PERO EA+VES W/TLA-B $39,284.00 0078-0690-61 OFATUMUMAB 1,000 MG/50 ML IV SOLN $39,219.05 HC44703312 EV REPAIR INFRARENAL AORTA DEPLOY GRAFT A-A ~RUPT $38,741.00 HC44500544 PERC DILATATION INTRACRANIAL VASOSPASM EA ADD VES DIFF TERRITORY+ $38,673.00 HC44703585 TMVR PERC REPAIR MITRAL VALVE 1ST PROSTHESIS $38,646.00 55513-956-01 PANITUMUMAB 400 MG/20 ML (20 MG/ML) IV SOLN $38,532.39 HC62228895 SYSTEM FLOWTRIEVER® $38,499.00 HC44703700 PERC TRANSCATH INTRATRIAL SEPTAL SHUNT $38,447.00 50242-145-01 PERTUZUMAB 420 MG/14 ML (30 MG/ML) IV SOLN $38,314.82 HC44703007 TAVR/TAVI W/ PROSTH; PERC FEM ARTERY $37,914.00 HC44703379 EV REPAIR ILIAC GRFT ILIO-ILIAC AORTIC BI DIST UNILAT ~RUPT $37,491.00 HC44700433 INSERT/REPLC SYSTM T-ICD DUAL W/LDS $37,448.00 0026-3787-75 KOGENATE FS 3,000 (+/-) UNIT IV SOLR $37,440.00 HC44502045 TRANSCATH EMBOLIZ PERC-CNS $37,161.00 HC44703122 TEVAR; PLCMT PROX EXT PROTH; INITIAL $37,077.00 HC44703718 TTVR PERC REPAIR TRICUSPID VALVE 1ST PROSTHESIS $36,981.00 50242-087-01 ADO-TRASTUZUMAB EMTANSINE 160 MG IV SOLR $36,542.22 HC44701662 PERC CLOSURE OF VSD W/IMPLANT $36,521.00 HC44502052 TRANSCATH EMBOLIZ PERC-NON CNS $36,498.00 0074-3346-03 LEUPROLIDE (3 MONTH) 22.5 MG IM SYKT $36,153.98 HC44504140 SEL CATH CC/INOM &ANGIO IC W/S&I BI $36,118.00 HC25002676 TRAUMA ACT' I W/O CC SERVICE $35,856.00 13533-800-40 IMMUNE GLOBUL G-GLY-IGA AVG 46 40 GRAM/400 ML (10 %) INJ SOLN $35,552.40 13533-800-41 IMMUNE GLOBUL G-GLY-IGA AVG 46 40 GRAM/400 ML (10 %) INJ SOLN $35,552.40 HC44703270 PPVI PERC TRANSCATH PV IMPLANT W/STENTING $35,513.00 HC44703346 EV REPAIR INFRARENAL AORTA&/ILIAC GRFT AORT-BI-ILIAC NONRUPT $35,363.00 HC44500601 CAROTID STENT W/EMBOL PROT LT $35,023.00 HC44500619 CAROTID STENT W/EMBOL PROT RT $35,023.00 HC44502698 CAROTID STENT W/O EMBO PROT LT $35,023.00 HC44502706 CAROTID STENT W/O EMBO PROT RT $35,023.00 68982-850-05 IMMUN GLOBG(IGG)-MALT-IGA OV50 10 % IV SOLN $35,022.00 99207-240-05 EDETATE CALCIUM DISODIUM 200 MG/ML INJ SOLN $35,005.52 HC62806831 STENT ENDOPRSTH AAA W $34,999.00 HC62806922 STENT ENDOPRSTH TAA W $34,999.00 HC62808738 KIT THROMBECTOMY/EMBOLECTOMY Z $34,983.00 0944-3046-10 ADVATE 3,000 (+/-) UNIT IV SOLR $34,905.00 0944-3046-11 ADVATE 3,000 (+/-) UNIT IV SOLR $34,905.00 HC44700441 INSERT/REPLC SYSTM T-ICD SNGL W/LD $34,902.00 0310-1730-30 BENRALIZUMAB 30 MG/ML SUBCUTANEOUS SYRG $34,780.72 0006-3026-01 PEMBROLIZUMAB 25 MG/ML IV SOLN $34,721.44 0006-3026-02 PEMBROLIZUMAB 25 MG/ML IV SOLN $34,721.44 0006-3026-04 PEMBROLIZUMAB 25 MG/ML IV SOLN $34,721.44 HC44701415 PLCMT CORON CATH;R&L HRT&GRFT $34,656.00 73090-421-01 SILTUXIMAB 400 MG IV SOLR $34,489.26 HC47200811 SRS LINR ACCL TX 1 SESSN,CMPLT(CRANIAL) $34,488.00 HC47200837 SRS ROBOTIC TX 1 SESSN, CMPLT(CRANIAL) $34,488.00 70020-1911-1 IXABEPILONE 45 MG IV SOLR $34,444.80 70020-1911-2 IXABEPILONE 45 MG IV SOLR $34,444.80 HC44703601 TRANSCATH ATRIAL SEPT(TAS)CONGENTL INCLED ALL IMAG(RASHKIND) $34,352.00 HC44502730 REVASC ILIAC W/TLA INITL VES-BI $34,291.00 HC62808720 KIT THROMBECTOMY/EMBOLECTOMY Y $34,283.00 HC44502854 REVASC FEM POP W/TLA-BI $34,063.00 HC44703916 TMVI W/ PROSTH; PERC SEPTAL PUCNCT $33,641.00 HC44505014 PERC PULM ARTERY REVASC W/STENT INITL; ABNRML NTV BILAT $33,641.00 HC44700698 PERC BALLOON VALVPLSTY MITRAL $33,556.00 HC44503050 REVAS TIB/PERO TLA&STNT&ATHR-L $33,451.00 HC44503043 REVAS TIB/PERO TLA&STNT&ATHR-R $33,451.00 HC44504553 PLCMT URET STENT PERC(NEPH/URET'GRM,S&I)NEW ACCES BI $33,312.00 HC44703320 EV REPAIR INFRARENAL AORTA&/ILIAC GRFT AORT-UNIILIAC NONRUPT $33,270.00 50474-700-62 CERTOLIZUMAB PEGOL 400 MG (200 MG X 2 VIALS) SUBCUTANEOUS KIT $33,147.92 50474-710-79 CERTOLIZUMAB PEGOL 400 MG/2 ML (200 MG/ML X 2) SUBCUTANEOUS SYKT $33,147.92 0024-5151-74 RASBURICASE 7.5 MG IV SOLR $32,910.67 0024-5151-75 RASBURICASE 7.5 MG IV SOLR $32,910.67 HC46502118 ABLAT RENAL TUMOR(S) PERC CRYO $32,840.00 HC46502126 ABLATION RENAL TUMOR(S) PERC; CRYO LT $32,840.00 HC46502134 ABLATION RENAL TUMOR(S) PERC; CRYO RT $32,840.00 HC44701399 PLCMT CORON CATH;LT HRT&GRAFTS $32,804.00 HC44703924 TMVR/TMVI W/PROTH; VIA CORONARY SINUS $32,680.00 HC44703551 REVASCULARIZATION LITHOTRIPSY INTRAVASC W/STENT & ATHERECT $32,635.00 25010-210-27 ETHACRYNATE SODIUM 50 MG IV SOLR $32,595.29 HC38420196 ECMO/ECLS INSJ OF CENTRAL CANNULA 6 YRS & OLDER $32,556.00 HC38420188 ECMO/ECLS INSJ OF CENTRAL CANNULA BIRTH-5 YRS $32,556.00 HC44702280 PERC COR CHRON REVAS ATHR/STNT/A;SNGL-LC $32,524.00 HC44702272 PERC COR CHRON REVAS ATHR/STNT/A;SNGL-LD $32,524.00 HC44702264 PERC COR CHRON REVAS ATHR/STNT/A;SNGL-LM $32,524.00 HC44702298 PERC COR CHRON REVAS ATHR/STNT/A;SNGL-RC $32,524.00 HC44702306 PERC COR CHRON REVAS ATHR/STNT/A;SNGL-RI $32,524.00 HC44702736 PERC COR CHRONC REVAS ATHR/DES/A;SNGL-LC $32,524.00 HC44702728 PERC COR CHRONC REVAS ATHR/DES/A;SNGL-LD $32,524.00 HC44702710 PERC COR CHRONC REVAS ATHR/DES/A;SNGL-LM $32,524.00 HC44702744 PERC COR CHRONC REVAS ATHR/DES/A;SNGL-RC $32,524.00 HC44702751 PERC COR CHRONC REVAS ATHR/DES/A;SNGL-RI $32,524.00 HC44703148 TEVAR; PLCMT OF DISTAL EXTS PROTH(S) DELAYED $32,427.00 73607-011-11 ARTESUNATE 110 MG IV SOLR $32,370.00 0169-7202-01 NOVOSEVEN RT 2 MG (2,000 MCG) IV SOLR $32,240.00 0169-7212-11 NOVOSEVEN RT 2 MG (2,000 MCG) IV SOLR $32,240.00 HC44504629 THROMBECT MECH PERC&/THROMBOLYSIS INF CRANI LT $32,225.00 HC44504637 THROMBECT MECH PERC&/THROMBOLYSIS INF CRANI RT $32,225.00 HC44702488 PERC COR ATHR+STENT(DES)ANGIOP; SNGL-LC $32,208.00 HC44702470 PERC COR ATHR+STENT(DES)ANGIOP; SNGL-LD $32,208.00 HC44702462 PERC COR ATHR+STENT(DES)ANGIOP; SNGL-LM $32,208.00 HC44702496 PERC COR ATHR+STENT(DES)ANGIOP; SNGL-RC $32,208.00 HC44702504 PERC COR ATHR+STENT(DES)ANGIOP; SNGL-RI $32,208.00 HC44702033 PERC COR ATHR+STENT/ANGIOP; SNGL-LC $32,208.00 HC44702025 PERC COR ATHR+STENT/ANGIOP; SNGL-LD $32,208.00 HC44702017 PERC COR ATHR+STENT/ANGIOP; SNGL-LM $32,208.00 HC44702041 PERC COR ATHR+STENT/ANGIOP; SNGL-RC $32,208.00 HC44702058 PERC COR ATHR+STENT/ANGIOP; SNGL-RI $32,208.00 HC44502979 REVAS TIB/PERO W/TLA 1ST VES-BI $32,160.00 HC44702686 PERC COR AMI REVAS ATHR/DES/ANGP;SNGL-LC $31,917.00 HC44702678 PERC COR AMI REVAS ATHR/DES/ANGP;SNGL-LD $31,917.00 HC44702660 PERC COR AMI REVAS ATHR/DES/ANGP;SNGL-LM $31,917.00 HC44702694 PERC COR AMI REVAS ATHR/DES/ANGP;SNGL-RC $31,917.00 HC44702702 PERC COR AMI REVAS ATHR/DES/ANGP;SNGL-RI $31,917.00 HC44702231 PERC COR AMI REVAS ATHR/STNT/ANG;SNGL-LC $31,917.00 HC44702223 PERC COR AMI REVAS ATHR/STNT/ANG;SNGL-LD $31,917.00 HC44702215 PERC COR AMI REVAS ATHR/STNT/ANG;SNGL-LM $31,917.00 HC44702249 PERC COR AMI REVAS ATHR/STNT/ANG;SNGL-RC $31,917.00 HC44702256 PERC COR AMI REVAS ATHR/STNT/ANG;SNGL-RI $31,917.00 HC44504991 PERC PULM ARTERY REVASC W/STENT INITL; NRML NTV BILAT $31,719.00 HC44701407 PLCMT CORON CATH;R&L HRT CATH $31,687.00 HC44503282 ATHER'TRLUML ILIAC EAVES W/S&I-L $31,543.00 HC44503274 ATHER'TRLUML ILIAC EAVES W/S&I-R $31,543.00 HC44502870 REVASC FEM POP W/TLA&ATHER-LT $31,539.00 HC44502862 REVASC FEM POP W/TLA&ATHER-RT $31,539.00 HC62803317 STENT ENDOPRSTH AAA V $31,499.00 58394-637-03 BENEFIX 3,000 UNIT IV SOLR $31,395.00 HC44504942 PERC DILAT EXIST TRACT UROLOGIC PX W/IMAGE &TUBE PLC; NEW ACCESS RNL COL-BIL $31,241.00 71104-806-01 ELOCTATE 2,000 UNIT IV SOLR $30,940.00 HC44701621 INSRT ICD W/EXSTNG MULTI LEADS $30,759.00 HC44505006 PERC PULM ARTERY REVASC W/STENT INITL; ABNRML NTV UNILAT $30,758.00 HC44504587 PLCMT URET STENT PERC(NEPH/URET'GRM,S&I) NEW ACCES SEP CATH BI $30,558.00 50242-053-06 RITUXIMAB 10 MG/ML IV CONC $30,534.40 HC38420311 INSERT LEFT HEART VENT BY THORACIC INC ECMO/ECLS $30,521.00 50242-077-01 TRASTUZUMAB-HYALURONIDASE-OYSK 600 MG-10,000 UNIT/5 ML SUBCUTANEOUS SOLN $30,389.06 HC44701654 REMV&REPLC SYSTM ICD LEAD MULTI $30,383.00 0310-3040-00 ANIFROLUMAB-FNIA 300 MG/2 ML (150 MG/ML) IV SOLN $30,352.08 0074-3663-03 LEUPROLIDE (3 MONTH) 11.25 MG IM SYKT $30,339.66 0944-2700-07 IMMUN GLOB G(IGG)-GLY-IGA OV50 10 % INJ SOLN $30,271.80 0944-2700-13 IMMUN GLOB G(IGG)-GLY-IGA OV50 10 % INJ SOLN $30,271.80 HC44702975 INSERT/REPLC SYSTM ICD PERM&SUBQ LD $30,082.00 55513-150-01 BLINATUMOMAB 35 MCG IV SOLR $30,076.48 55513-160-01 BLINATUMOMAB 35 MCG IV KIT $30,076.48 HC47200324 PLC BRACHY CATH W/PART MAST BIL $29,907.00 HC44700680 PERC BALLOON VALVPLSTY AORTIC $29,903.00 HC44502904 REVASC FEM POP W/TLA&STENT-LT $29,816.00 HC44502896 REVASC FEM POP W/TLA&STENT-RT $29,816.00 HC44504769 THROMBECT &/THROMBOLYSIS DIALYSIS CIRC WS&I,PHARM INJ; &PTA,STENT(S)OF PDS $29,805.00 HC44502797 REVASC ILIAC EA+VES W/TLA-BI $29,764.00 68727-900-01 ASPARAGINASE ERWINIA-RYWN 10 MG/0.5 ML IM SOLN $29,575.00 68727-900-03 ASPARAGINASE ERWINIA-RYWN 10 MG/0.5 ML IM SOLN $29,575.00 HC44700714 PERC CLOSURE OF ASD W/IMPLANT $29,397.00 HC44701837 PERC COR ANGIOP/ATHRECT; SNGL CA/BR-LC $29,300.00 HC44701829 PERC COR ANGIOP/ATHRECT; SNGL CA/BR-LD $29,300.00 HC44701811 PERC COR ANGIOP/ATHRECT; SNGL CA/BR-LM $29,300.00 HC44701845 PERC COR ANGIOP/ATHRECT; SNGL CA/BR-RC $29,300.00 HC44701852 PERC COR ANGIOP/ATHRECT; SNGL CA/BR-RI $29,300.00 55513-222-01 ROMIPLOSTIM 500 MCG SUBCUTANEOUS SOLR $29,277.17 HC47200357 PLC MAMMOSITE AFTER DOS BIL $29,242.00 HC44504827 TRANSLUMINAL BALO ANGIOP ARTERY W/S&I:INTL BILAT $29,187.00 HC44503092 REVASC TIB/PERO EA+VES W/TLA-B $29,034.00 0944-2513-02 IGG-HYALURONIDASE,RECOMBINANT 20 GRAM /200 ML (10 %) SUBCUTANEOUS SOLN $28,869.75 HC44504983 PERC PULM ARTERY REVASC W/STENT INITL ; NRML NTV UNILAT $28,836.00 50633-120-11 DIGOXIN IMMUNE FAB 40 MG IV SOLR $28,743.00 50633-121-11 DIGOXIN IMMUNE FAB 40 MG IV SOLR $28,743.00 24338-050-08 CARMUSTINE IN POLIFEPROSAN 7.7 MG IMPL WAFR $28,626.43 50242-044-06 ALTEPLASE 50 MG IV SOLR $28,601.17 50242-044-13 ALTEPLASE (FOR STROKE) INFUSION (50 MG VIAL) $28,601.17 HC44700706 PERC BALLOON VALVPLSTY PULM $28,589.00 HC44703304 EV REPAIR INFRARENAL AORTA DEPLOY GRAFT A-A NON-RUPT $28,517.00 HC44700813 PLACEMENT COIL SEPTUM $28,374.00 HC44502995 REVAS TIB/PERO W/TLA & ATHER-LT $28,363.00 HC44502987 REVAS TIB/PERO W/TLA & ATHER-RT $28,363.00 HC44503027 REVAS TIB/PERO W/TLA&STENT-LT $28,265.00 HC44503019 REVAS TIB/PERO W/TLA&STENT-RT $28,265.00 HC44702587 PERC CABG REVAS ATHR/DES/ANGIOP; SNGL-LC $27,918.00 HC44702579 PERC CABG REVAS ATHR/DES/ANGIOP; SNGL-LD $27,918.00 HC44702561 PERC CABG REVAS ATHR/DES/ANGIOP; SNGL-LM $27,918.00 HC44702595 PERC CABG REVAS ATHR/DES/ANGIOP; SNGL-RC $27,918.00 HC44702603 PERC CABG REVAS ATHR/DES/ANGIOP; SNGL-RI $27,918.00 HC44702132 PERC CABG REVAS ATHR/STENT/ANG; SNGL-LC $27,918.00 HC44702124 PERC CABG REVAS ATHR/STENT/ANG; SNGL-LD $27,918.00 HC44702116 PERC CABG REVAS ATHR/STENT/ANG; SNGL-LM $27,918.00 HC44702140 PERC CABG REVAS ATHR/STENT/ANG; SNGL-RC $27,918.00 0078-0818-81 OCTREOTIDE,MICROSPHERES 20 MG IM SSRR $27,720.81 HC44504280 VERTEBRAL AUGMNT 1BODY W/GUIDE;LUMBAR $27,637.00 HC44700383 INSERT PACER DUAL CHAMBER $27,585.00 HC44700144 COMP EP EVAL W/ INDUC ARRHYTHM $27,500.00 0944-2718-20 IMMUN GLOB G(IGG)-GLY-IGA OV50 20 GRAM/200 ML (10 %) SUBCUTANEOUS SOLN $27,495.00 63459-104-50 RITUXIMAB-ABBS 10 MG/ML IV SOLN $27,480.38 HC44702389 PERC COR DES STENT(S)/ANGIOP; SNGL-LC $27,160.00 HC44702371 PERC COR DES STENT(S)/ANGIOP; SNGL-LD $27,160.00 HC44702363 PERC COR DES STENT(S)/ANGIOP; SNGL-LM $27,160.00 HC44702397 PERC COR DES STENT(S)/ANGIOP; SNGL-RC $27,160.00 HC44702405 PERC COR DES STENT(S)/ANGIOP; SNGL-RI $27,160.00 67457-833-06 PEGFILGRASTIM-JMDB 6 MG/0.6 ML SUBCUTANEOUS SYRG $27,137.50 70114-101-01 PEGFILGRASTIM-CBQV 6 MG/0.6 ML SUBCUTANEOUS SYRG $27,137.50 HC44701936 PERC COR STENT(S)/ANGIOP; SNGL CA/BR-LC $27,128.00 HC44701928 PERC COR STENT(S)/ANGIOP; SNGL CA/BR-LD $27,128.00 HC44701910 PERC COR STENT(S)/ANGIOP; SNGL CA/BR-LM $27,128.00 HC44701944 PERC COR STENT(S)/ANGIOP; SNGL CA/BR-RC $27,128.00 HC44701951 PERC COR STENT(S)/ANGIOP; SNGL CA/BR-RI $27,128.00 HC44703783 RT & LT HRT CATH CONGEN DEFECT INCLUDE IMAGE; ABNRML NATIVE CONNECT $27,120.00 49702-253-15 CABOTEGRAVIR-RILPIVIRINE 400 MG/2 ML- 600 MG/2 ML IM SPSR $27,043.12 HC44503258 ATHER'TRLUML BRACH EAVES W/S&I-L $27,000.00 HC44503241 ATHER'TRLUML BRACH EAVES W/S&I-R $27,000.00 0078-0331-84 BASILIXIMAB 20 MG IV SOLR $26,840.97 HC44701373 PLCMT CORON CATH;GRAFTS&RT HRT $26,831.00 HC44701647 REMV&REPLC SYSTM ICD LEAD DUAL $26,785.00 HC44503209 ATHER' TRLUML RENAL ART&S&I-LT $26,781.00 HC44503191 ATHER' TRLUML RENAL ART&S&I-RT $26,781.00 HC44701613 INSRT ICD W/EXSTNG DUAL LEAD $26,755.00 HC62806716 DEVICE REVSC/THROMBCT(CAPTUR/SOLITAIR/TREVO)E $26,739.00 HC44701381 PLCMT CORON CATH;LT HRT CATH $26,670.00 HC44504066 REVAS OTHR PERIPH1ST ART W/STNT W-S&I $26,662.00 HC44703544 REVASCULARIZATION LITHOTRIPSY INTRAVASC & ATHERECT $26,624.00 HC44703577 EV REPAIR NON-AORTOILIAC DEPLOY GRAFT ILIAC CATH UNILAT NON-RUPT $26,554.00 HC44503233 ATHER' TRLUML ABD AORTA W/S&I $26,480.00 HC62808209 STENT NEUROVASC CODMAN ENTRPRS H060001 $26,414.00 HC38420220 ECMO/ECLS REPOS CENTRAL PERPH CANNULA BIRTH-5YRS $26,388.00 HC44703098 PERC CLOSURE OF PDA TRANSCATH $26,374.00 0002-7623-01 PEMETREXED DISODIUM 500 MG IV SOLR $26,279.50 HC62806740 KIT LIQ EMBOL ANEURYSM(ONYX HD-500)H060003 $26,232.00 HC44504272 VERTEBRAL AUGMNT 1BODY W/GUIDE;THORACIC $26,212.00 HC62808944 BONE GRAFT FILLER VOID 18ML(CERAMENT®BONESUPPORT®) $26,179.00 HC44504165 SEL CATH SUBC/INOM &ANG VRT W/SI BI $26,164.00 HC44703775 RT & LT HRT CATH CONGEN DEFECT INCLUDE IMAGE;NRML NATIVE CONNECT $26,115.00 69468-151-04 URIDINE TRIACETATE 10 GRAM ORAL GRPK $26,084.50 69468-151-10 URIDINE TRIACETATE 10 GRAM ORAL GRPK $26,084.50 HC44701605 REMV&REPL PACER MULTI LEAD SYS $26,029.00 67457-187-50 ALLOPURINOL SODIUM 500 MG IV SOLR $25,915.89 HC44503175 REVAS TIB/PER EA+TLA&ATH&STN-L $25,788.00 HC44503167 REVAS TIB/PER EA+TLA&ATH&STN-R $25,788.00 0002-8400-01 TERIPARATIDE 20 MCG/DOSE (600MCG/2.4ML) SUBCUTANEOUS PNIJ $25,782.96 HC44703536 REVASCULARIZATION LITHOTRIPSY INTRAVASC W/STENT $25,765.00 HC47200381 PLC MAMMOSITE ON DOS BIL $25,761.00 HC44502755 REVASC ILIAC W/TLA & STENT-LT $25,754.00 HC44502748 REVASC ILIAC W/TLA & STENT-RT $25,754.00 HC44703767 LT HRT CATH CONGEN DEFECTS INCLUDE IMAG; NRML/ABNRML NATIVE CONNECT' $25,614.00 HC44703361 EV REPAIR ILIAC GRFT ILIO-ILIAC AORTC BI DIST UNILAT NONRUPT $25,572.00 HC62807193 STENT NEUROVASC WINGSPAN H050001 $25,532.00 61314-866-01 PEGFILGRASTIM-BMEZ 6 MG/0.6 ML SUBCUTANEOUS SYRG $25,515.95 0069-0324-01 PEGFILGRASTIM-APGF 6 MG/0.6 ML SUBCUTANEOUS SYRG $25,512.50 HC62211834 DEVICE THROMBECT MECH NEURO D $25,375.00 HC62808191 STENT NEUROVASC NEUROFORM ATLAS H020002 $25,375.00 0143-9533-01 ALLOPURINOL SODIUM 500 MG IV SOLR $25,350.00 HC44504751 THROMBECT &/THROMBOLYSIS DIALYSIS CIRC WS&I,PHARM INJ;&PTA OF PDS $25,339.00 HC44701332 RT & LT HEART CATH;LT VENT S&I $25,247.00 HC44504884 TRANSLUMINAL BALO ANGIOP VEIN W/S&I:INTL BILAT $25,200.00 HC62217369 KIT DEVICE RETRIEVAL NEURO FB S $25,199.00 HC62806823 STENT ENDOPRSTH AAA S $25,199.00 HC62807201 STENT NEUROVASC LVIS MICROVENTION H130005 $25,199.00 HC44700490 INSRT ICD W/EXISTNG SNGL LEAD $25,173.00 HC44700508 INSRT/RPLC DUAL ICD GENERATOR $25,173.00 HC44701191 UPGRADE W/ ADD LV LEAD $25,169.00 55513-032-01 DARBEPOETIN ALFA IN POLYSORBAT 500 MCG/ML INJ SYRG $25,155.00 HC44703825 PTA NATIVE/RECURRENT COARCTATION AORTA $25,111.00 55513-112-01 TEZEPELUMAB-EKKO 210 MG/1.91 ML (110 MG/ML) SUBCUTANEOUS SYRG $25,007.77 0026-3786-65 KOGENATE FS 2,000 (+/-) UNIT IV SOLR $24,960.00 HC44703080 TAVR/TAVI; BYPASS OPEN CENTRAL A&V(AORTA,RA,PA)+ $24,946.00 0310-4611-50 DURVALUMAB 50 MG/ML IV SOLN $24,910.73 HC91200138 R&B NICU-NURSERY LEVEL IV $24,903.00 HC44703759 RT HRT CATH CONGEN DEFECTS INCLUDE IMAG;ABNRML NATIVE CONNECT' $24,886.00 51144-030-01 ENFORTUMAB VEDOTIN-EJFV 30 MG IV SOLR $24,882.00 HC47200845 SRS ROBOTIC FX EA 1-5 SESS,CMPLT $24,828.00 HC44504132 SEL CATH CC/INOM &ANGIO EXCC W/S&I BI $24,796.00 HC62808712 STENT COAT/COVRD W/O DEL SYS V $24,769.00 55513-132-01 TRASTUZUMAB-ANNS 420 MG IV SOLR $24,753.17 HC44701365 PLCMT CORON CATH;RT HRT CATH $24,709.00 0006-3025-00 BEZLOTOXUMAB 25 MG/ML IV SOLN $24,700.00 0006-3025-01 BEZLOTOXUMAB 25 MG/ML IV SOLN $24,700.00 42023-157-01 ETHACRYNATE SODIUM 50 MG IV SOLR $24,700.00 68682-012-50 ETHACRYNATE SODIUM 50 MG IV SOLR $24,693.50 HC44501237 OCCL BALLOON TEMP HEAD/NECK $24,604.00 HC47200829 SRS LINR ACCL FX 1-5 SESSNS,CMPLT $24,572.00 HC44703742 RT HRT CATH CONGEN DEFECTS INCLUDE IMAG;NRML NATIVE CONNECT $24,511.00 HC62228796 SYSTEM ENDOAVF WAVELINQ™ $24,499.00 HC44702991 REMV&REPLC SUBQ ICD GEN ONLY $24,345.00 HC44701639 REMV&REPLC SYSTM ICD LEAD SINGL $24,345.00 HC44504520 PLCMT URET STENT PERC(NEPH/URET'GRM,S&I)PRE-EXIST BI $24,292.00 HC25001421 TRAUMA ACTVTN II INTRM $24,283.00 HC44504322 ABLATION LIVER TUMOR(S) PERC; CRYO $24,147.00 67457-845-50 TRASTUZUMAB-DKST 420 MG IV SOLR $24,032.19 67457-847-44 TRASTUZUMAB-DKST 420 MG IV SOLR $24,032.19 HC44503605 PLCMNT IVC FILTER /S&I/IMAGE $23,988.00 HC44701597 REMV&REPL PACER DUAL LEAD SYS $23,978.00 HC62808852 KIT CATH INDIGO 12 THROMB 12FR HTORQ[PENUMBRA] $23,835.00 HC44703072 TAVR/TAVI; BYPASS OPEN PERIPH A&V(F/I/A)+ $23,833.00 59572-711-01 LUSPATERCEPT-AAMT 25 MG SUBCUTANEOUS SOLR $23,740.21 HC44503829 SEL CATH IC CAROTID &ANG IC W/SI LT $23,620.00 HC44503837 SEL CATH IC CAROTID &ANG IC W/SI RT $23,620.00 HC44703197 OPEN ILIAC FOR ILIAC OR AORTIC ENDOGRAFT, UNI $23,589.00 HC62808654 DEVICE ENDOSCOPE UGI IMAGING ILLUM DISP $23,547.00 63833-825-02 C1 ESTERASE INHIBITOR 500 UNIT (10 ML) IV KIT $23,534.49 HC44701738 PERC COR ANGIOPLST; SNGL CA/BRCH-LC $23,521.00 HC44701720 PERC COR ANGIOPLST; SNGL CA/BRCH-LD $23,521.00 HC44701712 PERC COR ANGIOPLST; SNGL CA/BRCH-LM $23,521.00 HC44701746 PERC COR ANGIOPLST; SNGL CA/BRCH-RC $23,521.00 HC44701753 PERC COR ANGIOPLST; SNGL CA/BRCH-RI $23,521.00 99999-035-66 EPIFIX SKIN GRAFT ( 4X4 CM ) $23,510.50 HC44701316 PERC IMPLANT NEURO ELEC; PERIP $23,442.00 68982-850-04 IMMUN GLOBG(IGG)-MALT-IGA OV50 10 % IV SOLN $23,348.00 0024-0656-01 ISATUXIMAB-IRFC 20 MG/ML IV SOLN $23,304.45 0069-0249-01 RITUXIMAB-PVVR 10 MG/ML IV SOLN $23,296.00 0944-3045-10 ADVATE 2,000 (+/-) UNIT IV SOLR $23,270.00 0944-3045-11 ADVATE 2,000 (+/-) UNIT IV SOLR $23,270.00 HC44700375 INSERT PACER VENT SNGL CHAMBER $23,129.00 63833-617-02 HUMATE-P 1,000-2,400 UNIT IV SOLR $23,088.00 63833-627-01 HUMATE-P 1,000-2,400 UNIT IV SOLR $23,088.00 HC44701183 UPGRADE PACER SNGL-DUAL $23,070.00 HC44501765 REM & REPLAC URETERAL STENT BI $23,045.00 0003-3756-14 NIVOLUMAB 120 MG/12 ML IV SOLN $22,922.95 63833-387-02 KCENTRA 1,000 UNIT (800-1240 UNIT) IV SOLR $22,890.40 63833-397-01 KCENTRA 1,000 UNIT (800-1240 UNIT) IV SOLR $22,890.40 HC44703478 PERC CLOSURE LAA (WATCHMAN) $22,871.00 50242-088-01 ADO-TRASTUZUMAB EMTANSINE 100 MG IV SOLR $22,838.92 HC62802657 VALVE HANCOCK II MEDTRONIC $22,785.00 HC44504082 REVAS OTHR PERIPH1ST VEIN W/STNT W-S&I $22,771.00 HC44502524 PERC DILATATION INTRACRANIAL VASSOSPASM INITIAL VESSEL -LT $22,557.00 HC44502532 PERC DILATATION INTRACRANIAL VASSOSPASM INITIAL VESSEL -RT $22,557.00 HC25002700 TRAUMA ACT' I W/O P-H ALERT $22,542.00 HC62807722 M: BODY VERTEBRAL REPLACEMENT $22,540.00 HC44503142 REVAS TIB/PER EA+V TLA&STENT-L $22,443.00 HC44503134 REVAS TIB/PER EA+V TLA&STENT-R $22,443.00 HC74200056 OR TIME INITIAL HR LEVEL 6 (MCAL 1ST HOUR) $22,441.00 HC44504124 ABLAT PULM TUMOR(S) PERC UNILAT W/IMG GUID; CRYO $22,385.00 0024-5860-01 CLOFARABINE 1 MG/ML IV SOLN $22,126.65 13533-318-05 RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML IM SOLN $22,116.06 13533-318-50 RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML IM SOLN $22,116.06 HC62807771 M: HIP FEM MODULAR COMPONENT $22,074.00 0037-0066-06 MESALAMINE 4 GRAM/60 ML RECTAL ENEM $22,046.31 0069-0305-01 TRASTUZUMAB-QYYP 420 MG IV SOLR $22,042.02 0069-0306-01 TRASTUZUMAB-QYYP 420 MG IV SOLR $22,042.02 HC46502910 PERC AV FISTULA UE SEPRT ACCESS ART & VEIN VASC & IMAG $21,901.00 HC46502902 REVASC LITHOTRIP ARTHERECTOMY TIBIA/PERONEAL ENDOVASC W/STENT $21,901.00 99999-035-69 EPIFIX SKIN GRAFT ( 6X16 CM ) $21,840.00 13533-618-10 RABIES IMMUNE GLOBULIN (PF) 150 UNIT/ML IM SOLN $21,789.24 13533-618-11 RABIES IMMUNE GLOBULIN (PF) 150 UNIT/ML IM SOLN $21,789.24 44206-438-20 IMMUN GLOB G(IGG)-PRO-IGA 0-50 10 % IV SOLN $21,771.10 44206-438-92 IMMUN GLOB G(IGG)-PRO-IGA 0-50 10 % IV SOLN $21,771.10 HC44701324 LEFT HEART CATH; LT VENT,W/S&I $21,730.00 50242-103-01 POLATUZUMAB VEDOTIN-PIIQ 30 MG IV SOLR $21,728.59 HC91200137 R&B NICU-NURSERY LEVEL III $21,683.00 HC44701589 REMV&REPL PACER SINGL LEAD SYS $21,642.00 HC44700367 INSERT PACER ATRIAL SNGL CHAMB $21,634.00 0173-0892-42 MEPOLIZUMAB 100 MG/ML SUBCUTANEOUS SYRG $21,614.71 HC62808704 STENT COAT/COVRD W/O DEL SYS U $21,538.00 HC44703528 REVASCULARIZATION LITHOTRIPSY INTRAVASC $21,471.00 HC44701357 PLCMT CORON CATH;BYPASS GRAFTS $21,425.00 66658-231-01 PALIVIZUMAB 100 MG/ML IM SOLN $21,384.22 HC44700136 COMP EP EVAL W/O IND ARRHYTH $21,359.00 57894-501-00 AMIVANTAMAB-VMJW 50 MG/ML IV SOLN $21,339.82 57894-501-01 AMIVANTAMAB-VMJW 50 MG/ML IV SOLN $21,339.82 HC44703411 TRANSCATH DELIVERY ENHANCED FIXATION DEVICE $21,259.00 HC44502813 REVAS ILIAC EA+VES W/TLA&STENT-L $21,216.00 HC44502805 REVAS ILIAC EA+VES W/TLA&STENT-R $21,216.00 0173-0881-01 MEPOLIZUMAB 100 MG SUBCUTANEOUS SOLR $21,207.62 HC44501823 REMOVE URETERAL STENT BIL $21,125.00 HC44900041 ABLATE BONE TUMOR(S) PERQ W/CT;RF $21,123.00 HC44901049 ABLATE BONE TUMOR(S) PERQ W/CT;CRYO $21,100.00 HC46502894 REVASC LITHOTRIP ARTHERECTOMY TIBIA/PERONEAL ENDOVASC $21,041.00 HC62228440 DEVICE REVASC/THROMBCT(EMBOTRAP) $21,000.00 HC62807409 STENT ENDOPRSTH AAA P $21,000.00 HC44503860 SEL CATH VERTEBRAL &ANG VRT W/SI LT $20,973.00 HC44503878 SEL CATH VERTEBRAL &ANG VRT W/SI RT $20,973.00 58394-636-03 BENEFIX 2,000 UNIT IV SOLR $20,930.00 HC45400918 MR UP EXT JNT W&W/O CONT BILAT $20,900.00 0074-3799-02 ADALIMUMAB 40 MG/0.8 ML SUBCUTANEOUS SYKT $20,831.95 0074-4339-02 ADALIMUMAB 40 MG/0.8 ML SUBCUTANEOUS PNKT $20,831.95 HC44500007 ABLATION RENAL TUMOR(S) PERC; RF $20,794.00 HC44500015 ABLATION RENAL TUMOR(S) PERC; RF LT $20,794.00 HC44500023 ABLATION RENAL TUMOR(S) PERC; RF RT $20,794.00 59572-962-10 ROMIDEPSIN 10 MG/2 ML IV SOLR $20,791.23 59572-984-01 ROMIDEPSIN 10 MG/2 ML IV SOLR $20,791.23 50633-110-12 CROTALIDAE POLYVAL IMMUNE FAB INJ SOLR $20,787.00 50242-061-01 BEVACIZUMAB 25 MG/ML IV SOLN $20,720.44 HC44503118 REVASC TIB/PERO EA+VES W/TLA-L $20,679.00 HC44503100 REVASC TIB/PERO EA+VES W/TLA-R $20,679.00 HC46502886 REVASC LITHOTRIP TIBIA/PERONEAL ENDOVASC W/STENT $20,612.00 59676-610-01 TRABECTEDIN 1 MG IV SOLR $20,535.00 0009-7224-01 LYMPHOCYTE,ANTI-THYMO IMM GLOB 50 MG/ML IV SOLN $20,469.67 0009-7224-02 LYMPHOCYTE,ANTI-THYMO IMM GLOB 50 MG/ML IV SOLN $20,469.67 HC44700037 CATH ABLAT AV NODE HEART BLOCK $20,408.00 HC44700359 INSERT LV LEAD AT INIT IMPLNT+ $20,398.00 67457-675-02 CALCITONIN (SALMON) 200 UNIT/ML INJ SOLN $20,358.65 42023-205-01 CALCITONIN (SALMON) 200 UNIT/ML INJ SOLN $20,351.50 HC38420295 ECMO/ECLS REMOVAL OF CENTRAL CANNULA 6 YRS & OLDER $20,348.00 HC62808845 KIT CATH INDIGO 12 THROMB 8FR XTORQ[PENUMBRA] $20,335.00 HC44503597 SEL CATH&RENAL ANGIO2NDW/S&I-B $20,289.00 5985700305 HUMAN REGENERATIVE TISSUE MTRX 2 X 3 CM TOPICAL SHEE $20,280.00 0944-2700-06 IMMUN GLOB G(IGG)-GLY-IGA OV50 10 % INJ SOLN $20,181.20 0944-2700-12 IMMUN GLOB G(IGG)-GLY-IGA OV50 10 % INJ SOLN $20,181.20 HC44703627 TRANSCATH INTRACARD SHUNT(TIS) STENT CONGENTL INCLUDE IMAGE; EA ADDL+ $20,162.00 HC38420287 ECMO/ECLS REMOVAL OF CENTRAL CANNULA BIRTH-5 YRS $20,125.00 HC44504595 PLCMT URET STENT PERC(NEPH/URET'GRM,S&I) NEW ACCES SEP CATH LT $20,055.00 HC44504603 PLCMT URET STENT PERC(NEPH/URET'GRM,S&I) NEW ACCES SEP CATH RT $20,055.00 HC44703064 TAVR/TAVI; BYPASS PERC PERIPH A&V(FEM)+ $19,973.00 HC46501086 INSERT PERITONEAL CATH TUNNELED W/PORT $19,967.00 HC44701340 PLCMT CORONARY CATH(ANGIO/S&I) $19,960.00 HC44504116 PERC TRNSCTH RENAL SYMP DENRV W/IMG BI $19,858.00 HC44700904 PTA PULMONARY ARTERY SNGL $19,776.00 HC46502878 REVASC LITHOTRIP TIBIA/PERONEAL ENDOVASC $19,753.00 HC62210687 SYSTEM MICRODELIVERY FOR STENT $19,744.00 HC74200049 OR TIME INITIAL HR LEVEL 5 (MCAL 1ST HOUR) $19,740.00 HC44504355 PLCMT STNT BIL PERC EA(CHOLANG,BLN DIL,S&I)EXIST ACC $19,733.00 HC25002684 TRAUMA ACT' II W/O CC SERVICE $19,676.00 HC44703395 PLACMNT DELAY DISTL/PROX EXTSN INFRARENL AA ILIAC:INT'L VSSL $19,658.00 99999-038-94 POLIHEXANIDE (PURAPLY AM) 6X9 CM EACH TOPICAL SHEET $19,656.00 HC62808837 KIT CATH INDIGO 7 LIGHT XTORQ PLUS[PENUMBRA] $19,635.00 HC62802970 STENT NEUROVASCULAR O $19,600.00 HC45400561 MR UP EXT(NON JNT) W&W/O BIL $19,553.00 HC44503803 SEL CATH CC/INOM &ANGIO IC W/S&I LT $19,524.00 HC44503811 SEL CATH CC/INOM &ANGIO IC W/S&I RT $19,524.00 HC44703155 OPEN ILIAC FOR ENDOGRAFT OR OCCLUSION, UNI $19,462.00 HC62806955 WAND ASPIRATION/IRRIG NEUROVASC $19,442.00 HC38420238 ECMO/ECLS ECLS REPOS CENTRAL CNULA 6YRS & OLDER $19,331.00 HC38420329 REMOVAL LEFT HEART VENT BY THORACIC INCIS ECMO/ECLS $19,331.00 63459-391-20 BENDAMUSTINE 100 MG IV SOLR $19,316.70 HC62807862 STENT EXTENDER ENDOGRAFT TAA O $19,250.00 HC44503639 LIGATION INFERIOR VENA CAVA $19,242.00 HC44504744 THROMBECT &/THROMBOLYSIS DIALYSIS CIRC WS&I,PHARM INJ $19,241.00 99999-038-98 POLIHEXANIDE (PURAPLY) 6X9 CM EACH TOPICAL SHEET $19,155.50 HC44504298 VERTEBRAL AUGMNT 1BODY W/GUIDE;EA ADD'L L $19,150.00 HC44702785 PERC COR CHRON REVAS ATHR/DES/A;ADDL-LC+ $19,137.00 HC44702777 PERC COR CHRON REVAS ATHR/DES/A;ADDL-LD+ $19,137.00 HC44702769 PERC COR CHRON REVAS ATHR/DES/A;ADDL-LM+ $19,137.00 HC44702793 PERC COR CHRON REVAS ATHR/DES/A;ADDL-RC+ $19,137.00 HC44702801 PERC COR CHRON REVAS ATHR/DES/A;ADDL-RI+ $19,137.00 HC44702330 PERC COR CHRON REVAS ATHR/STNT/A;ADDL-LC+ $19,137.00 HC44702322 PERC COR CHRON REVAS ATHR/STNT/A;ADDL-LD+ $19,137.00 HC44702314 PERC COR CHRON REVAS ATHR/STNT/A;ADDL-LM+ $19,137.00 HC44702348 PERC COR CHRON REVAS ATHR/STNT/A;ADDL-RC+ $19,137.00 HC44702355 PERC COR CHRON REVAS ATHR/STNT/A;ADDL-RI+ $19,137.00 0003-3774-12 NIVOLUMAB 100 MG/10 ML IV SOLN $19,102.46 HC44502722 REVASC ILIAC W/TLA INITL VES-LT $19,046.00 HC44502714 REVASC ILIAC W/TLA INITL VES-RT $19,046.00 HC44504488 ENDOVASC INFUS CRANIAL(NON-THROMB)INIT'L TRRT $18,974.00 HC44702538 PERC COR ATHR+STENT(DES)ANGIOP; ADDL-LC+ $18,933.00 HC44702520 PERC COR ATHR+STENT(DES)ANGIOP; ADDL-LD+ $18,933.00 HC44702512 PERC COR ATHR+STENT(DES)ANGIOP; ADDL-LM+ $18,933.00 HC44702546 PERC COR ATHR+STENT(DES)ANGIOP; ADDL-RC+ $18,933.00 HC44702553 PERC COR ATHR+STENT(DES)ANGIOP; ADDL-RI+ $18,933.00 HC44702082 PERC COR ATHR+STENT/ANGIOP; ADDL-LC+ $18,933.00 HC44702074 PERC COR ATHR+STENT/ANGIOP; ADDL-LD+ $18,933.00 HC44702066 PERC COR ATHR+STENT/ANGIOP; ADDL-LM+ $18,933.00 HC44702090 PERC COR ATHR+STENT/ANGIOP; ADDL-RC+ $18,933.00 HC44702108 PERC COR ATHR+STENT/ANGIOP; ADDL-RI+ $18,933.00 HC44502847 REVASC FEM POP W/TLA-LT $18,925.00 HC44502839 REVASC FEM POP W/TLA-RT $18,925.00 HC46500971 INS TUN VEN ACS DEV W/PORT<5YR $18,862.00 0955-1746-01 CLOFARABINE 1 MG/ML IV SOLN (MCH) $18,850.00 65219-380-30 ALLOPURINOL SODIUM 500 MG IV SOLR $18,850.00 HC46501029 INS VEN ACS DEV 2SITES W/PORT $18,812.00 HC44501906 THROMBECTOMY MECH PRIM ART LT(NONCOR/CRNL) $18,803.00 HC44501914 THROMBECTOMY MECH PRIM ART RT(NONCOR/CRNL) $18,803.00 HC45400223 MR LO EXT(NON JNT)W&W/O CON BI $18,773.00 HC44504850 TRANSLUMINAL BALO ANGIOP ARTERY W/S&I:ADDL + BILAT $18,731.00 HC44503563 SEL CATH&RENAL ANGIO1STW/S&I-B $18,700.00 HC46500989 INS TUN CV ACCESS DEV W/PORT 5YRS+ $18,671.00 HC38420162 ECMO/ECLS INSERT PERIPH CANNULA OPEN BIRTH-AGE 5 $18,537.00 HC38420170 ECMO/ECLS INSJ OF PRPH CANNULA 6 YRS&OLDER OPEN $18,537.00 HC62200076 ABLATION DEVICE(CARDIAC TISS) $18,484.00 HC47200183 IMRT TX PLAN $18,388.00 HC44504181 SEL CATH EX CAROTID&ANG EC W/SI BI+ $18,325.00 76075-101-01 CARFILZOMIB 60 MG IV SOLR $18,285.93 HC44504736 ACCESS DIALYSIS CIRCUIT EVAL->VENA CAVA WS&I: PDS PTA,STENT(S) $18,261.00 49411-052-08 AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLN $18,205.63 HC62806005 CATH EP/ABLAT NOT COOL-TIP/3D/V MAP AT $18,200.00 HC62807631 M: COLLAR STEM HIP $18,200.00 HC62808092 STENT EXTENDER ENDOGRAFT AAA AD $18,200.00 HC44503498 PHLEBCT VEIN/EXT >20 STAB-LT $18,164.00 HC44503480 PHLEBCT VEIN/EXT >20 STAB-RT $18,164.00 55513-207-01 BEVACIZUMAB-AWWB 25 MG/ML IV SOLN $18,140.82 HC46502431 PLCMT CATH NEPHURET PERC(NEPH/URET'GRM,S&I)NEW ACC BI $18,105.00 99988-000-23 NM IN-111 PENTETREOTIDE (OCTREOSCAN) $18,039.00 HC47201173 TRANSPERINEAL PLCMNT BIODEGRADABLE MATERIAL $18,026.00 HC62800800 RECORDER CARDIAC EVENT(MEDTRONIC LINQ) $18,008.00 HC44703734 INSERT PERC VAD INC S&I TRANSSEPTL PUNC; LEFT HEART $17,989.00 HC44703247 INSERT ELECTRODE DEFIBRILLATOR SUBQ $17,930.00 HC91400496 R&B ICU PEDS - INTENSIVE PPE ISOLATION $17,928.00 HC74200031 OR TIME INITIAL HR LEVEL 4 (MCAL 1ST HOUR) $17,919.00 HC44502961 REVAS TIB/PERO W/TLA 1ST VES-LT $17,867.00 HC44502953 REVAS TIB/PERO W/TLA 1ST VES-RT $17,867.00 0003-4522-11 ELOTUZUMAB 400 MG IV SOLR $17,863.04 HC46501706 BX/RMVL LYMPH NODE(S)-OPEN BI $17,803.00 HC44700409 INSERT/EXTRAC/RET/REPOS D TV LEADS $17,799.00 59923-604-02 FLUDARABINE 50 MG/2 ML IV SOLN $17,784.00 13533-800-24 IMMUNE GLOBUL G-GLY-IGA AVG 46 20 GRAM/200 ML (10 %) INJ SOLN $17,776.20 13533-800-25 IMMUNE GLOBUL G-GLY-IGA AVG 46 20 GRAM/200 ML (10 %) INJ SOLN $17,776.20 HC44701886 PERC COR ANGIOP/ATHRECT; ADDL CA/BR-LC+ $17,742.00 HC44701878 PERC COR ANGIOP/ATHRECT; ADDL CA/BR-LD+ $17,742.00 HC44701860 PERC COR ANGIOP/ATHRECT; ADDL CA/BR-LM+ $17,742.00 HC44701894 PERC COR ANGIOP/ATHRECT; ADDL CA/BR-RC+ $17,742.00 HC44701902 PERC COR ANGIOP/ATHRECT; ADDL CA/BR-RI+ $17,742.00 HC44504199 SEL CATH EA IC CRTD/VERT&ANG W/SI BI+ $17,699.00 55513-730-01 DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLN $17,661.48 HC91200136 R&B NICU-NURSERY LEVEL II $17,636.00 62935-453-45 LEUPROLIDE ACETATE (6 MONTH) 45 MG SUBCUTANEOUS SYRG $17,615.85 62935-454-44 LEUPROLIDE ACETATE (6 MONTH) 45 MG SUBCUTANEOUS SYRG $17,615.85 55292-811-55 DACTINOMYCIN 0.5 MG IV SOLR $17,605.51 HC91000208 R&B TRAUMA ICU $17,586.00 15054-0043-1 IRINOTECAN LIPOSOMAL 4.3 MG/ML IV DISP $17,543.50 HC46500005 ABLATION LIVER TUMOR(S) PERC; RF $17,533.00 HC26000059 DELIVERY VAGINAL TWINS $17,533.00 HC44504561 PLCMT URET STENT PERC(NEPH/URET'GRM,S&I)NEW ACCES LT $17,531.00 HC44504579 PLCMT URET STENT PERC(NEPH/URET'GRM,S&I)NEW ACCES RT $17,531.00 HC46501482 REPLC TUNNELED CV ACS DEV W/PUMP $17,507.00 HC62229000 CATH THROMBECTOMY AZ $17,500.00 0944-3054-02 ADVATE 1,500 (+/-) UNIT IV SOLR $17,452.50 HC44701571 INSRT PACER ONLY;EXST MULTI LD $17,390.00 HC44504926 PERC DILAT EXIST TRACT UROLOGIC PX W/IMAGE &TUBE PLC; NEW ACCESS RNL COL-LT $17,359.00 HC44504934 PERC DILAT EXIST TRACT UROLOGIC PX W/IMAGE &TUBE PLC; NEW ACCESS RNL COL-RT $17,359.00 HC44504348 PLCMT CATH BIL DRN PERC(CHOLANG,S&I)INT/EXT $17,339.00 HC62219258 DEVICE DELIVERY SUTURE INCL LARIAT $17,325.00 HC44503936 PLCMNT GRAFT FEM-FEM-AAA REP+ $17,318.00 HC44505022 PERC PULM ARTERY REVASC W/STENT INITL; EA ADDL LESION+ $17,302.00 HC44504371 PLCMT STNT BIL PERC EA&CATH(CHOLANG,BLN DIL,S&I)NEW ACC $17,259.00 HC45400314 MR LOW EXT(JNT)W&W/O CONT BIL $17,216.00 43598-309-20 CLOFARABINE 1 MG/ML IV SOLN $17,168.32 HC62802996 RECORDER CARDC EVNT(BIOTRONIK BIOMNTR 2AF) $17,150.00 23155-261-41 CARMUSTINE 100 MG IV SOLR $17,143.04 HC23001118 PERC IMPLANT'N NEUROSTIM ELEC $17,138.00 HC46500997 INS TUN VEN ACS DEV W/SQ PUMP $17,121.00 HC23000326 IMPLNT/REV/REPOS TUN EPI CATH $17,091.00 HC91400096 R&B PEDIATRIC INTENSIVE CARE $17,037.00 HC44501989 THROMBECTOMY VENOUS LT $17,006.00 HC44501997 THROMBECTOMY VENOUS RT $17,006.00 HC44505030 THROMBECTOMY VENOUS MECHANICAL (VENA CAVA'S) $17,006.00 73594-9310-1 FERRIC DERISOMALTOSE 100 MG IRON/ML IV SOLN $16,993.28 HC46501078 INSERT PERITONEAL CATH TUNNELED W/IMAGING $16,972.00 HC44503720 THROMBOLYSIS ART OTHER NONCOR/CRNL+S&I1ST DAY $16,960.00 HC44702439 PERC COR DES STENT(S)/ANGIOP; ADDL-LC+ $16,924.00 HC44702421 PERC COR DES STENT(S)/ANGIOP; ADDL-LD+ $16,924.00 HC44702413 PERC COR DES STENT(S)/ANGIOP; ADDL-LM+ $16,924.00 HC44702447 PERC COR DES STENT(S)/ANGIOP; ADDL-RC+ $16,924.00 HC44702454 PERC COR DES STENT(S)/ANGIOP; ADDL-RI+ $16,924.00 HC44701977 PERC COR STENT(S)/ANGIOP; ADDL CA/BR-LD+ $16,924.00 HC44701969 PERC COR STENT(S)/ANGIOP; ADDL CA/BR-LM+ $16,924.00 HC44701993 PERC COR STENT(S)/ANGIOP; ADDL CA/BR-RC+ $16,924.00 HC44702009 PERC COR STENT(S)/ANGIOP; ADDL CA/BR-RI+ $16,924.00 HC44701985 PERC COR STENT(S)/ANGIOP; ADDL CA/BR-LC+ $16,906.00 HC44702637 PERC CABG REVAS ATHR/DES/ANGPL; ADDL-LC+ $16,889.00 HC44702629 PERC CABG REVAS ATHR/DES/ANGPL; ADDL-LD+ $16,889.00 HC44702611 PERC CABG REVAS ATHR/DES/ANGPL; ADDL-LM+ $16,889.00 HC44702645 PERC CABG REVAS ATHR/DES/ANGPL; ADDL-RC+ $16,889.00 HC44702652 PERC CABG REVAS ATHR/DES/ANGPL; ADDL-RI+ $16,889.00 HC44702181 PERC CABG REVAS ATHR/STENT/ANG; ADDL-LC+ $16,889.00 HC44702173 PERC CABG REVAS ATHR/STENT/ANG; ADDL-LD+ $16,889.00 HC44702165 PERC CABG REVAS ATHR/STENT/ANG; ADDL-LM+ $16,889.00 HC44702199 PERC CABG REVAS ATHR/STENT/ANG; ADDL-RC+ $16,889.00 HC44702207 PERC CABG REVAS ATHR/STENT/ANG; ADDL-RI+ $16,889.00 HC44500486 ASP/DECOMP PERC DISKECTOMY $16,880.00 HC62806021 CATH EP/ABLAT NOT COOL-TIP/3D/V MAP AS $16,800.00 HC62807268 STENT COV W/DEL SYS PVD M $16,800.00 HC62806815 STENT ENDOPRSTH AAA M $16,800.00 HC46502944 PERC AV FISTULA UE SINGLE ACCESS BOTH ART & VEIN VASC & IMAG $16,770.00 0944-7553-02 VONVENDI 1,300 (+/-) UNIT RANGE IV SOLR $16,731.00 HC25001439 TRAUMA ACTVTN III LMTD $16,708.00 57894-502-20 DARATUMUMAB 20 MG/ML IV SOLN $16,644.94 51144-020-01 ENFORTUMAB VEDOTIN-EJFV 20 MG IV SOLR $16,588.00 HC38420147 ECMO INSERT PERIPH CANNULA PERC W/FLUORO $16,584.00 HC38420154 ECMO/ECLS INSERT PERIPH CANNULA PERC BIRTH-AGE 5 $16,584.00 99999-045-95 PIFLUFOLASTAT F 18 37 MBQ/ML TO 2,960 MBQ/ML IV SOLN $16,583.00 HC44702157 PERC CABG REVAS ATHR/STENT/ANG; SNGL-RI $16,574.00 HC44700474 INSRT PACER ONLY;W/EXIST DUAL LEAD $16,475.00 67457-546-20 CLOFARABINE 1 MG/ML IV SOLN (MCH) $16,463.33 HC44501732 REM & REPLAC EXT URET CATH(IMG,S&I) BI $16,453.00 HC44502789 REVASC ILIAC EA+VES W/TLA-LT $16,447.00 HC44502771 REVASC ILIAC EA+VES W/TLA-RT $16,447.00 HC47200100 ABLAT PULM TUMOR(S) PERC UNILAT W/IMG GUID; RF $16,389.00 HC46501474 REPLC TUNNELED CV ACS DEVICE W/PORT $16,274.00 HC44503225 ATHER' TRLUML VISERCL EA & S&I $16,265.00 0310-3200-01 FACTOR XA,INACTIVATED-ZHZO 200 MG IV SOLR $16,250.00 0310-3200-05 FACTOR XA,INACTIVATED-ZHZO 200 MG IV SOLR $16,250.00 69853-0102-1 FACTOR XA,INACTIVATED-ZHZO 200 MG IV SOLR $16,250.00 HC44503514 ENDOVENOUS ABLAT RADIO FREQ WS&I; INITIAL VEIN $16,245.00 HC44503761 TRANSCATH RETRIEVAL PERC FB W/S&I $16,228.00 HC46502498 EXCHANGE TUBE NEPHRO(NEPH/URET'GRM,S&I) BI $16,189.00 HC23001449 INJ L/S F W/IMAGE 1ST LVL BIL $16,181.00 0169-7201-01 NOVOSEVEN 1MG/ML INJ POST-CARDIAC SURGERY (LBM) $16,120.00 0169-7211-11 NOVOSEVEN RT 1 MG (1,000 MCG) IV SOLR $16,120.00 HC47200365 PLC MAMMOSITE AFTER DOS LT $16,098.00 HC47200373 PLC MAMMOSITE AFTER DOS RT $16,098.00 HC44503753 THROMBOLYSIS NONCOR END OF TX $16,098.00 HC91000404 R&B ICU - INTENSIVE PPE ISOLATION $16,096.00 HC91200404 R&B IICU - INTENSIVE PPE ISOLATION $16,096.00 63459-348-04 BENDAMUSTINE 25 MG/ML IV SOLN $16,079.70 65597-406-01 FAM-TRASTUZUMAB DERUXTECN-NXKI 100 MG IV SOLR $16,074.44 HC45600079 PET W/CT WHOLE BODY $16,042.00 50242-137-01 TOCILIZUMAB 400 MG/20 ML (20 MG/ML) IV SOLN $15,961.92 0069-0342-01 BEVACIZUMAB-BVZR 25 MG/ML IV SOLN $15,948.40 HC44504975 PERC DILAT EXIST TRACT UROLOGIC PX W/IMAGE /&TUBE-BIL $15,882.00 0409-0801-01 PENTOSTATIN 10 MG IV SOLR $15,853.96 0078-0883-61 CRIZANLIZUMAB-TMCA 10 MG/ML IV SOLN $15,786.23 HC47200704 RADIOTHERAPY PLAN 3D W/VOL HISTOGRAM $15,782.00 17156-235-01 IOBENGUANE SULFATE I-123 10 MCI/5 ML (370 MBQ/5 ML) IV SOLN $15,766.70 HC62808449 MONITOR CARDIAC ECG $15,750.00 HC62808423 RECORDER CARDIAC EVENT(ABBOTT/BOSTON SCI) $15,750.00 70720-951-30 GOSERELIN 10.8 MG SUBCUTANEOUS IMPL $15,694.64 HC44501484 TLA AORTA W/S&I:INITIAL $15,680.00 HC46500963 INS TUN VEN ACS DEV 2 SITES $15,641.00 HC44504330 PLCMT CATH BIL DRN PERC(CHOLANG,S&I)EXTRNL $15,619.00 HC44503084 REVASC TIB/PERO EA+VES W/TLA-L $15,589.00 HC44503076 REVASC TIB/PERO EA+VES W/TLA-R $15,589.00 70408-239-32 NITROFURANTOIN 25 MG/5 ML ORAL SUSP $15,550.08 HC46502365 TENOTOMY THIGH MULTIPLE TENDONS $15,524.00 HC74200023 OR TIME INITIAL HR LEVEL 3 (MCAL 1ST HOUR) $15,433.00 HC62807326 STENT COVRD W/DEL SYS(AXIOS) AE $15,400.00 HC62806807 STENT ENDOPRSTH AAA L $15,400.00 69344-101-01 INDOMETHACIN 25 MG/5 ML ORAL SUSP $15,391.14 HC44504801 TRANSLUMINAL BALO ANGIOP ARTERY W/S&I:INTL LEFT $15,363.00 HC44504819 TRANSLUMINAL BALO ANGIOP ARTERY W/S&I:INTL RIGHT $15,363.00 HC44505055 TRANSLUMINAL BALO ANGIOPLST ARTERY W/S&I:INITIAL $15,363.00 HC44703130 TEVAR; PLCMT PROX EXT PROTH; EACH ADD'L+ $15,344.00 HC46502464 CONVERT NEPH CATH -> NEPH'URET PERC(NEPH/URET'GRM,S&I)EXST BI $15,339.00 69932-001-30 FLUCICLOVINE F18 10 MCI (370 MBQ) IV SOLN $15,337.00 0597-0197-05 IDARUCIZUMAB 2.5 GRAM/50 ML IV SOLN $15,331.88 HC46502407 PLCMT NEPHROSTOMY CATHETER,(NEPH/URET'GRM,S&I) BI $15,328.00 HC44504918 TRANSLUMINAL BALO ANGIOP VEIN W/S&I:ADDL + BILAT $15,295.00 99999-045-94 NM GA-68 GALLIUM GOZETOTIDE PSMA-11 $15,275.00 HC45600061 PET W/CT SKULL BASE-MID THIGH $15,256.00 HC25002692 TRAUMA ACT' III W/O CC SERVICE $15,170.00 55513-111-01 DARBEPOETIN ALFA IN POLYSORBAT 300 MCG/0.6 ML INJ SYRG $15,093.00 HC44701100 RIGHT HEART CATH; MSRMT, CO $15,040.00 HC44503746 THROMBOLYSIS NONCOR+S&I SUB DAY $15,033.00 HC44503738 THROMBOLYSIS VEN NONCOR+S&I1ST DAY $15,029.00 HC47200332 PLC BRACHY CATH W/PART MAST LT $15,019.00 HC47200340 PLC BRACHY CATH W/PART MAST RT $15,019.00 HC44701787 PERC COR ANGIOPLST; ADDL CA/BRCH-LC+ $14,940.00 HC44701779 PERC COR ANGIOPLST; ADDL CA/BRCH-LD+ $14,940.00 HC44701761 PERC COR ANGIOPLST; ADDL CA/BRCH-LM+ $14,940.00 HC44701795 PERC COR ANGIOPLST; ADDL CA/BRCH-RC+ $14,940.00 HC44701803 PERC COR ANGIOPLST; ADDL CA/BRCH-RI+ $14,940.00 HC44502318 ENDOVENOUS ABLAT LASER WS&I; INITIAL VEIN $14,930.00 HC91000204 R&B INTENSIVE CARE $14,877.00 HC46500302 BIOPSY NEEDLE RENAL-BILAT $14,862.00 HC44502631 INSERT PLEURAL CATH TUNNELD LT $14,785.00 HC44502623 INSERT PLEURAL CATH TUNNELD RT $14,785.00 HC44504363 PLCMT STNT BIL PERC EA(CHOLANG,BLN DIL,S&I)NEW ACC $14,778.00 HC47201132 HDR RADIONUCLIDE INTRSTTL/INTRVIT BRACH 12+ CHANN $14,730.00 HC62802053 STENT ENDOPRSTH TIPS(VIATORR) K $14,700.00 24201-010-50 PENTOBARBITAL SODIUM 50 MG/ML INJ SOLN $14,670.50 55513-221-01 ROMIPLOSTIM 250 MCG SUBCUTANEOUS SOLR $14,638.65 25021-676-50 PENTOBARBITAL SODIUM 50 MG/ML INJ SOLN $14,625.00 HC44703288 INSERT/REPLACE TRANSCATH PACER LEADLESS RV $14,612.00 HC62808936 BONE GRAFT FILLER VOID 10ML(CERAMENT®BONESUPPORT®) $14,560.00 HC44503845 SEL CATH SUBC/INOM &ANG VRT W/SI LT $14,539.00 HC44503852 SEL CATH SUBC/INOM &ANG VRT W/SI RT $14,539.00 HC23001357 INJ CER/THOR F/IMAGE SNG LVLBI $14,519.00 55135-132-01 SACITUZUMAB GOVITECAN-HZIY 180 MG IV SOLR $14,509.43 HC46501003 INS TUN VEN CATH W/O PORT<5 $14,441.00 0944-2512-02 IGG-HYALURONIDASE,RECOMBINANT 10 GRAM /100 ML (10 %) SUBCUTANEOUS SOLN $14,434.88 0008-1179-01 TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST) IV SOLR $14,426.72 HC44700466 INSRT PACER ONLY;W/EXIST SNGL LEAD $14,414.00 HC44503787 SEL CATH CC/INOM &ANGIO EXCC W/S&I LT $14,407.00 HC44503795 SEL CATH CC/INOM &ANGIO EXCC W/S&I RT $14,407.00 HC46501516 REPLC PICC LINE W/ SQ PORT $14,395.00 HC46500948 INS PICC LINE W/PORT<5YR $14,384.00 HC46500955 INS PICC LINE W/PORT>5YR $14,384.00 HC46501011 INS TUN CV ACS CATH W/O PORT 5YRS+ $14,297.00 24338-260-08 NIMODIPINE 60 MG/10 ML ORAL SOLN $14,268.11 HC44504256 VERTEBROPLASTY 1BODY/GUIDE;LUMBOSACRAL $14,210.00 70257-126-11 VARICELLA-ZOSTER I.GLOB-MALTOS 125 UNIT/1.2 ML IM SOLN $14,186.70 70257-126-51 VARICELLA-ZOSTER I.GLOB-MALTOS 125 UNIT/1.2 ML IM SOLN $14,186.70 HC45400629 MR UP EXT (JNT) W/CONT BIL $14,167.00 HC44500213 ANGIO EXTREMITY BILAT $14,130.00 HC44501435 PHLEBCT VEIN/EXT 10-20 STAB-LT $14,115.00 HC44501443 PHLEBCT VEIN/EXT 10-20 STAB-RT $14,115.00 HC62808027 M: CAGE ACETABULAR $14,060.00 HC44504314 PERC SACRAL AUGMT BILAT W/ GUIDANCE&BX $14,057.00 HC44504306 PERC SACRAL AUGMT UNILAT W/ GUIDANCE&BX $14,057.00 72874-001-01 FLUOROESTRADIOL F-18 148 MBQ/ML TO 3,700 MBQ/ML IV SOLN $14,052.50 HC44700417 INSERT/EXTRAC/RET/REPOS S TV LEAD $14,050.00 HC27001890 EGD PARTIAL/COMPL EG FUNDOPLASTY $14,039.00 HC44504249 VERTEBROPLASTY 1BODY/GUIDE;CERVICOTHORACIC $14,028.00 HC46502381 FASCIOTOMY, FOOT AND/OR TOE $14,027.00 HC62204656 M: SYSTEM NEURO STEALTH $14,024.00 HC44504868 TRANSLUMINAL BALO ANGIOP VEIN W/S&I:INTL LEFT $14,005.00 HC44504876 TRANSLUMINAL BALO ANGIOP VEIN W/S&I:INTL RIGHT $14,005.00 HC44505071 TRANSLUMINAL BALO ANGIOPLST VEIN W/S&I:INITIAL $14,005.00 HC62212063 CATH ANGIOG PERIPH CTO CROSSING AQ $14,000.00 HC62806799 STENT ENDOPRSTH AAA K $14,000.00 HC46501573 THORACENTESIS W/TUBE W/ IMAG BI $13,980.00 74527-022-02 MARGETUXIMAB-CMKB 25 MG/ML IV SOLN $13,977.08 74527-022-03 MARGETUXIMAB-CMKB 25 MG/ML IV SOLN $13,977.08 HC46501060 INSERT PERITONEAL CATH TUNNELED FOR DIALYSIS; OPEN $13,936.00 HC44700151 COMP EP EVAL W/LT ATRIAL PACE+ $13,899.00 HC44900710 CTA UPPER EXT W/CONTRAST-BILAT $13,867.00 50458-563-01 PALIPERIDONE PALMITATE 156 MG/ML IM SYRG $13,831.16 HC44701068 REPOS PREV PLCD LV SYSTEM ELEC $13,829.00 HC44502003 THROMBECTOMY VEIN REPEAT SUBSQ DAY LT $13,828.00 HC44502011 THROMBECTOMY VEIN REPEAT SUBSQ DAY RT $13,828.00 HC44505048 THROMBECTOMY VEIN REPEAT SUBSQ DAY (VENA CAVA'S) $13,828.00 HC44500551 PERC DILATATION INTRACRANIAL VASOSPASM EA ADD VES SAME TERRITORY+ $13,809.00 42023-190-01 VASOPRESSIN 20 UNIT/ML IV SOLN $13,804.51 HC44501922 THROMBECT MECH PRIM ART ADD LT(NONCOR/CRNL)+ $13,804.00 HC44501930 THROMBECT MECH PRIM ART ADD RT(NONCOR/CRNL)+ $13,804.00 61953-0005-3 IMM GLOB G (IGG)-SORB-IGA 0-50 10 % IV SOLN $13,764.40 61953-0005-6 IMM GLOB G (IGG)-SORB-IGA 0-50 10 % IV SOLN $13,764.40 HC45400280 MR LOW EXT(JNT)W/CONT BIL $13,762.00 HC45400538 MR UP EXT(NON JNT)W/CONT BIL $13,760.00 0944-2717-10 IMMUN GLOB G(IGG)-GLY-IGA OV50 10 GRAM/100 ML (10 %) SUBCUTANEOUS SOLN $13,747.50 HC83000786 THER APHER W/EXTRACORP IMMUNO/ADSORP/FILTRATION $13,742.00 HC44702942 INSERT PERC VAD INC S&I ARTERIAL ONLY; LEFT HEART $13,736.00 HC44703635 INSERT VAD PERCUT INC S&I VENOUS ONLY RIGHT $13,736.00 HC23001134 DESTR C/T FAC JOINT SNGL W/IMG-B $13,720.00 HC12800017 THER APHER W/EXTRACORP IMMUNO/ADSORP/FILTRATION $13,653.00 13533-606-12 THROMBATE III 500 (+/-) UNIT IV SOLR $13,650.00 17156-021-01 INDIUM IN-111 OXYQUINOLINE 1 MCI/ML (37 MBQ/ML)(1 ML) IV SOLN $13,643.39 HC44504108 PERC TRNSCTH RENAL SYMP DENRV W/IMG UNILAT $13,618.00 52652-2001-1 METHOTREXATE 2.5 MG/ML ORAL SOLN $13,556.40 HC46501375 REMOVE PERITONEAL CATH TUNNELED $13,515.00 HC44504538 PLCMT URET STENT PERC(NEPH/URET'GRM,S&I)PRE-EXIST LT $13,496.00 HC44504546 PLCMT URET STENT PERC(NEPH/URET'GRM,S&I)PRE-EXIST RT $13,496.00 HC38420097 ECMO INITIATION VENO-ARTERIAL $13,491.00 0944-2658-04 IMMUN GLOB G-GLY-GLUC-IGA 0-50 10 GRAM IV SOLR $13,477.10 0944-2659-08 IMMUN GLOB G-GLY-GLUC-IGA 0-50 10 GRAM IV SOLR $13,477.10 HC44500270 ANGIO PULMONARY BILAT $13,427.00 0003-2291-11 ELOTUZUMAB 300 MG IV SOLR $13,397.35 HC44900660 CTA LOW EXT BILAT $13,339.00 HC23000730 INJ FORAMN EPI LMBR INTLW/S&I-B $13,323.00 HC62806302 CATH ATHERCTMY ROTATNL(DIAMNDBCK) D $13,300.00 HC62205752 PROBE ABLATION CRYO I $13,300.00 HC62806898 STENT ENDOPRSTH PVD(VIABAHN) J $13,300.00 HC46500369 BX VERTEBRAL BODY; OPEN THORACIC $13,295.00 13533-318-03 RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML IM SOLN $13,269.69 13533-318-30 RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML IM SOLN $13,269.69 HC45400199 MR LOW EXT(NON JNT)W/CONT BIL $13,239.00 0009-0283-01 GELATIN ABSORBABLE IMPL FILM $13,227.37 HC46501540 THORACENTESIS ASP W/ IMG GUID-BILAT $13,220.00 67979-001-01 VALRUBICIN 40 MG/ML INTRAVESICAL SOLN $13,125.22 HC44503571 SEL CATH&RENAL ANGIO2NDW/S&I-L $13,105.00 HC44503589 SEL CATH&RENAL ANGIO2NDW/S&I-R $13,105.00 HC23001159 DESTR L/S FAC JOINT SNGL W/IMG-B $13,031.00 HC47200399 PLC MAMMOSITE ON DOS LT $13,017.00 HC47200407 PLC MAMMOSITE ON DOS RT $13,017.00 HC43001239 ABLATION CRYO BREAST MALIG TUMOR(S) &IMAG UNILAT $13,000.00 57894-350-01 GOLIMUMAB 12.5 MG/ML IV SOLN $12,994.75 HC74200015 OR TIME INITIAL HR LEVEL 2 (MCAL 1ST HOUR) $12,973.00 9978000199 CULT SKIN SUBST, HUMAN-BOVINE TOPICAL DISK $12,967.50 69945-064-01 COPPER CU-64 DOTATATE 148 MBQ/4 ML (4 MCI/4 ML) IV SOLN $12,950.00 HC44501948 THROMBECTOMY ART 2ND LT(NONCOR/CRNL) $12,936.00 HC44501955 THROMBECTOMY ART 2ND RT(NONCOR/CRNL) $12,936.00 HC21000195 BX BONE OPEN; SUPERFICIAL $12,922.00 HC46502399 DIVSN PLANTR FASCIA&MUSCLE(STEINDLER STRIP) $12,905.00 HC46502332 TENOTOMY SHOULDER AREA, MULT TENDNS $12,883.00 HC46501458 REPLC CATH ONLY CV ACESS W/PORT $12,854.00 HC45401254 MRA LOW EXT W&W/O CONT BILAT $12,791.00 0008-1030-04 SIROLIMUS 1 MG/ML ORAL SOLN $12,767.43 0008-1030-06 SIROLIMUS 1 MG/ML ORAL SOLN (MCH) $12,767.43 HC44504074 REVAS OTHR PERIPH +ART W/STNT W-S&I $12,764.00 HC44500031 ANGIO ADRENAL BILAT $12,702.00 HC44701548 INCISE FEMEROL; DELIVERY EVS PROTH $12,684.00 HC91400095 R&B PEDS STEPDOWN/DOU $12,677.00 HC45400256 MR LOW EXT(JNT) W/O CONT BIL $12,671.00 HC45400504 MR UP EXT(NON JNT) W/O CONT BIL $12,665.00 13533-603-20 THROMBATE III 500 (+/-) UNIT IV SOLR $12,610.00 HC62225677 CATH EP DIAG/ABLAT 3D/VECT AB $12,600.00 HC62225693 CATH TRANSLUM ANGIO LASER Z $12,600.00 43598-541-25 DOXORUBICIN, PEG-LIPOSOMAL 2 MG/ML IV SUSP $12,593.75 43598-683-25 DOXORUBICIN, PEG-LIPOSOMAL 2 MG/ML IV SUSP $12,593.75 49401-102-01 BELIMUMAB 400 MG IV SOLR $12,583.55 HC23000672 INJ FORAMN EPI C/T INTLW/S&I-BI $12,545.00 HC46000709 SEL CATH AB/PEL/LOEXT1ST OR BI $12,540.00 HC62807649 M: IMPLANT TARSI SINUS $12,481.00 0026-3785-55 KOGENATE FS 1,000 (+/-) UNIT IV SOLR $12,480.00 99999-035-47 INSULIN REGULAR HUM U-500 CONC 500 UNIT/ML INJ SOLN (INSULIN ) $12,441.00 HC44504264 VERTEBROPLASTY1BODY/GUIDE; EA ADD'L VBODY $12,431.00 HC44700243 IMPLANT CARDIAC RHYTHM MONITOR SQ & PROGRAMMING $12,424.00 HC46502373 TENOTOMY ACHILLES TENDON *DS $12,422.00 HC62228168 ORTH WHFO EXT POWERED ELECTRIC CUSTOM $12,415.00 HC46502340 TENOTOMY ELBOW, LATERAL OR MEDIAL $12,415.00 HC44504728 ACCESS DIALYSIS CIRCUIT EVAL->VENA CAVA WS&I; PDS PTA $12,391.00 68516-4604-2 ALPHANATE 1,500 (600 VWF) UNIT/10 ML IV SOLR $12,382.50 67457-297-50 ETHACRYNATE SODIUM 50 MG IV SOLR $12,350.00 HC46502100 DRAIN CYSTS OVA UNI/BIL ABD APPR $12,338.00 HC45400348 MR L-SPINE W&W/O CONTRAST $12,337.00 HC45600046 PET WHOLE BODY TUMOR IMAGING $12,325.00 HC62808373 M: BONE GRAFT MATRIX(FIBERGRAFT BG) $12,250.00 HC62803325 STENT ENDOPRSTH AAA I $12,250.00 HC45400470 MR T-SPINE W&W/O CONTRAST $12,247.00 HC45400165 MR LOW EXT(NON JNT)W/O CONT BIL $12,214.00 HC38420089 ECMO INITIATION VENO-VENOUS $12,209.00 HC45400082 MR CHEST W&W/O CONTRAST $12,154.00 HC45600012 PET BRAIN METABOLIC EVAL $12,145.00 HC44703239 RIGHT HEART CATH; W/SENSOR PULM ARTERY W/S&I $12,139.00 HC44501773 REM & REPLAC URETERAL STENT LT $12,127.00 HC44501781 REM & REPLAC URETERAL STENT RT $12,127.00 HC62800172 CATH ATHERECTOMY DIRECTIONAL H $12,110.00 HC47201124 HDR RADIONUCLIDE INTRSTTL/INTRVIT BRACH 2-12 CHANN $12,105.00 54643-5647-0 MVI, PEDI NO.1 WITH VIT K 80 MG-400 UNIT- 200 MCG/5 ML IV SOLN $12,089.35 HC62227988 EMBOLIZATION PROTECTIVE SYSTEM (TCAR) X $12,075.00 HC46501953 PERC CHOLECYSTOSTOMY WCATH/S&I $12,074.00 HC44701050 REPAIR LEADS TV DUAL PACER/ICD $12,066.00 HC46501466 REPLC TUNNELED CV ACS DEVICE W/O PORT/PUMP $12,058.00 0074-3642-03 LEUPROLIDE 7.5 MG IM SYKT $12,051.39 57894-054-27 USTEKINUMAB 130 MG/26 ML IV SOLN $12,050.55 0008-1279-01 TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST) IV SOLR $12,022.27 HC23001167 DESTR L/S FAC JOINT ADDL W/IMG-B $12,019.00 HC44503779 PLACE CATH THOR AORTA&ANGIO W/S&I $12,018.00 HC23000250 DESTRUCT OTHER PERIPH SNGL BI $11,981.00 HC44700482 INSRT/REPL TEMP DUAL PACER $11,966.00 HC62204003 KIT KYPHOPAK 1ST FRACTURE E $11,953.00 HC44700169 COMP EP EVAL W/LT VENT PACE+ $11,928.00 HC45600053 PET W/CT LIMITED AREA $11,926.00 HC45600038 PET SKULL BASE TO MID-THIGH $11,916.00 HC62806294 CATH ATHERCTMY ROTATNL(DIAMNDBCK) B $11,900.00 HC62225669 CATH EP DIAG/ABLAT 3D/VECT AA $11,900.00 HC62806724 CATH EP/ABLATION COOL-TIP T $11,900.00 HC62805544 CATH THROMBOLYSIS/RX DELIVERY AN $11,900.00 HC62805650 DEVICE ABLAT COOL-TIP NONVASC AN $11,900.00 HC62807094 PROBE ABLATION CRYO H $11,900.00 HC62803838 STENT DES CORO COV W/DEL SYS X $11,900.00 HC62806880 STENT ENDOPRSTH PVD(VIABAHN) H $11,900.00 HC62808084 STENT EXTENDER ENDOGRAFT AAA X $11,900.00 HC62807318 STENT TRACHEOBRONC COV W/DEL SYS L $11,900.00 HC62213335 CATH ATHERECTOMY ROTATNL (STEALTH) $11,883.00 HC44504686 ABLATION UTERINE FIBROID(S) TRANSCERV W US GUIDE; RF $11,865.00 HC46501219 MECH REMOV PERICATH OBSTR MAT CV $11,836.00 HC45400371 MR ORBIT/FACE&OR NECK W&WO CON $11,815.00 HC62808548 LEAD SENSING RESPIRATORY(INSPIRE®) $11,813.00 HC44504090 REVAS OTHR PERIPH +VEIN W/STNT W-S&I $11,780.00 HC44503621 REMOV IVC FILTER/S&I/IMG GUIDE $11,771.00 70257-310-04 RHO(D) IMMUNE GLOBULIN-MALTOSE 5,000 UNIT(1000 MCG)/4.4 ML INJ SOLN $11,769.16 70257-310-51 RHO(D) IMMUNE GLOBULIN-MALTOSE 5,000 UNIT(1000 MCG)/4.4 ML INJ SOLN $11,769.16 HC44901023 CTA ABDOMEN+PELVIS $11,733.00 HC62802111 STENT PV SELF EXP CVRD/DEL SPX $11,690.00 HC46500393 BX DEEP PELV/HIP-SC BIL $11,685.00 68982-850-03 IMMUN GLOBG(IGG)-MALT-IGA OV50 10 % IV SOLN $11,674.00 HC44700425 INSERT/REPLAC TEMP PACER $11,666.00 0944-3053-02 ADVATE 1,000 (+/-) UNIT IV SOLR $11,635.00 0944-3053-03 ADVATE 1,000 (+/-) UNIT IV SOLR $11,635.00 HC44700219 EP FOLLOW UP POST THERAPY $11,599.00 HC25002718 TRAUMA ACT' II W/O P-H ALERT $11,597.00 HC45400116 MR C-SPINE W&W/O CONTRAST $11,580.00 HC44503548 SEL CATH&RENAL ANGIO1STW/S&I-L $11,569.00 HC44503555 SEL CATH&RENAL ANGIO1STW/S&I-R $11,569.00 HC44700540 INTRACARDIAC EP 3D MAPPING+ $11,565.00 HC44503613 REPOS IVC FILTER/S&I/IMG GUIDE $11,556.00 HC62807979 STENT ENDOPRSTH LEG ILIAC G $11,550.00 63833-616-02 HUMATE-P 500-1,200 UNIT IV 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0024-5918-01 DUPILUMAB 200 MG/1.14 ML SUBCUTANEOUS SYRG $11,000.70 HC45400900 MR UPPER EXT JNT W&W/O CONT LT $10,995.00 HC45400892 MR UPPER EXT JNT W&W/O CONT RT $10,995.00 HC44504389 CONVRT CATH DRN BIL EXT->INT-EXT PERC(CHOLANG,S&I) $10,982.00 HC46500559 BX SFT TISS PELV/HIP-BIL $10,980.00 49281-790-20 TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML IM SOLN $10,960.30 0338-0067-01 DOXORUBICIN, PEG-LIPOSOMAL 2 MG/ML IV SUSP $10,946.00 57970-100-01 DALBAVANCIN 500 MG IV SOLN $10,900.50 HC62213327 PACK LAP GASTRIC BY-PASS $10,895.00 HC44703866 PERC TRANSLUM CORONARY LITHOTRIPSY + $10,890.00 HC91000044 R&B STEP DOWN/DOU INTERMD ICU $10,887.00 44206-437-10 IMMUN GLOB G(IGG)-PRO-IGA 0-50 10 % IV SOLN $10,885.55 44206-437-91 IMMUN GLOB G(IGG)-PRO-IGA 0-50 10 % IV SOLN $10,885.55 HC46500351 BIOPSY TRANSCATHETER $10,884.00 HC62802129 STENT DES CORO COV W/DEL SYS V $10,850.00 HC62806864 STENT ENDOPRSTH AAA F $10,850.00 HC45401197 MRA LOW EXT W/CONT BILAT $10,829.00 HC44701092 RELOCATE SKIN POCKET 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UNIT IV SOLR $10,465.00 HC27000017 ANORECTAL WALL BX,ANAL APPROAC $10,463.00 63020-049-01 BORTEZOMIB 3.5 MG INJ SOLR $10,419.50 63323-721-10 BORTEZOMIB 3.5 MG IV SOLR (IV ONLY) (MHS) $10,419.37 60923-363-02 ETEPLIRSEN 50 MG/ML IV SOLN $10,400.00 HC23002009 ABLATE RF NERVE SACROILIAC JT INNRV W/IMAGE BIL $10,396.00 HC44504785 PLACEMENT STENT(S)CDS VIA DIALYSIS CIRCUIT WS&I, PTA+ $10,396.00 HC44700987 REMVL PERM PACER PULSE GN ONLY $10,380.00 HC46502787 INSERT PICC <5 YR AGE W/IMAGING $10,376.00 HC62217013 KIT SPINAL ACCESS DISPOSBL AB $10,360.00 HC44500445 AORTOGRAM ABD W/ RUN OFF $10,359.00 HC46502449 PLCMT CATH NEPHURET PERC(NEPH/URET'GRM,S&I)NEW ACC LT $10,348.00 HC46502456 PLCMT CATH NEPHURET PERC(NEPH/URET'GRM,S&I)NEW ACC RT $10,348.00 HC44900173 CT GUIDANCE STEREOTACTIC LOC $10,342.00 HC91200242 R&B HIGH RISK PERINATAL $10,338.00 8541000101 CULT SKIN SUBST, HUMAN-BOVINE 2 X 3 " TOPICAL SHEE $10,335.00 HC45400710 MRA NECK W&W/O CONTRAST $10,321.00 HC44504835 TRANSLUMINAL BALO ANGIOP ARTERY W/S&I:ADDL + LT $10,314.00 HC44504843 TRANSLUMINAL BALO ANGIOP ARTERY W/S&I:ADDL + RT $10,314.00 HC44505063 TRANSLUMINAL BALO ANGIOPLST ARTERY W/S&I: ADD'L + $10,314.00 HC45400579 MR UP EXT(NON JNT) W&W/O LT $10,290.00 HC45400587 MR UP EXT(NON JNT) W&W/O RT $10,290.00 HC47201090 IMRT TX DELIVERY, GUIDE&TRACK CMPLX $10,284.00 68817-134-50 PACLITAXEL PROTEIN-BOUND 100 MG IV SUSR $10,270.39 HC44500668 CHOLANGIOGRAM W/STONE REMVL $10,258.00 0517-4300-01 PACLITAXEL PROTEIN-BOUND 100 MG IV SUSR $10,239.58 HC45600095 PET ANY SITE, NOS $10,224.00 HC74200171 OR TIME INIT'L HR CASE CX LEVEL 6 (MCAL 1ST HOUR) $10,196.00 HC44503886 SEL CATH EX CAROTID&ANG EC W/SI LT+ $10,184.00 HC44503894 SEL CATH EX CAROTID&ANG EC W/SI RT+ $10,184.00 HC45600020 PET LIMITED AREA $10,181.00 HC46502985 BX SOFT TISS UPPER ARM/ELBOW DEEP BIL $10,164.00 HC26000042 DELIVERY VAGINAL $10,153.00 HC62807110 CATH ABLATION CARDIAC $10,150.00 HC62804968 STENT BILIARY COVRD W/DELSYS V $10,150.00 50242-132-01 TRASTUZUMAB 150 MG IV SOLR $10,129.28 HC45401593 MR BREASTS W/O&W CONTR & CAD (BILAT) [COMM&MCAL] $10,129.00 HC46501250 PERC PLACEMENT CEC TUBE W/FLUORO $10,129.00 HC44900264 CT LOW EXT W/CONTRAST BILAT $10,126.00 HC45400231 MR LO EXT(NON JNT)W&W/O CON LT $10,125.00 HC45400249 MR LO EXT(NON JNT)W&W/O CON RT $10,125.00 HC44500379 ANGIO SPINAL SELECTIVE LT $10,116.00 HC44500387 ANGIO SPINAL SELECTIVE RT $10,116.00 HC62808829 CATH INDIGO 8 THROMB 8FR TORQ/XTORQ[PENUMBRA] $10,115.00 0074-3641-03 LEUPROLIDE 3.75 MG IM SYKT $10,113.16 HC36800118 BRONCH W/DESTRUCT TUMOR/STEN $10,103.00 HC36000875 BRONCH W/DESTRUCT TUMOR/STEN $10,103.00 HC44502177 VENOGRAM ADRENAL BILAT $10,097.00 HC44501898 THROMBEC VC/ILIAC FEMPOP INCSN $10,093.00 0944-2700-05 IMMUN GLOB G(IGG)-GLY-IGA OV50 10 % INJ SOLN $10,090.60 0944-2700-11 IMMUN GLOB G(IGG)-GLY-IGA OV50 10 % INJ SOLN $10,090.60 HC74200221 BEDSIDE/OTHER SURG INITIAL HR 5 (MCAL 1ST HOUR) $10,073.00 HC44700664 MAP TACHYCARDIA SITES NON 3D+ $10,072.00 HC44500437 ANGIO VISCERAL $10,068.00 HC44700789 PERC TRANSLUM COR THROMBECTMY+ $10,063.00 55513-028-01 DARBEPOETIN ALFA IN POLYSORBAT 200 MCG/0.4 ML INJ SYRG $10,062.00 72611-780-01 TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST) IV SOLR $10,061.14 72611-785-02 TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST) IV SOLR $10,061.14 HC45400686 MRA HEAD W&W/O CONTRAST $10,061.00 HC83000760 THERAPEUTIC APHERESIS PLASMA $10,060.00 HC12800041 THERAPEUTIC APHERESIS PLASMA $10,036.00 HC36001121 BRONCH W/EBUS SAMPLING 1/2 NODES $10,023.00 HC36800829 BRONCH W/EBUS SAMPLING 1/2 NODES $10,023.00 0054-0528-63 RUFINAMIDE 40 MG/ML ORAL SUSP $10,013.51 HC44500700 CTA ABD AORTA/ILIOFEM RUNOFF $10,013.00 HC45600004 PET ASSESS MYOCARD VIABILITY $10,013.00 70127-100-01 CANNABIDIOL 100 MG/ML ORAL SOLN $10,010.00 70127-100-10 CANNABIDIOL 100 MG/ML ORAL SOLN $10,010.00 HC23001662 INJ ANES/STEROID INTERCOSTAL ADDL EA BI $9,998.00 HC62802061 STENT CORO COVRD W/DEL SYS $9,975.00 HC83000745 THERAPEUTIC APHERESIS RBC'S $9,968.00 HC44703262 REPOSIT ELECTRODE DEFIBRILLATOR SUBQ $9,955.00 HC45400322 MR LOW EXT(JNT)W&W/O CONT LT $9,940.00 HC45400330 MR LOW EXT(JNT)W&W/O CONT RT $9,940.00 HC44703205 OPEN BRACHIAL FOR ILIAC OR AORTIC ENDOGRAFT, UNI $9,931.00 HC12800066 THERAPEUTIC APHERESIS RBC'S $9,921.00 HC47200852 CT GUIDANCE SRS LOCALIZATION $9,897.00 HC44504793 EMBOLIZATION DIALYSIS CIRCUIT VEIN(S)WS&I+ $9,871.00 66993-489-83 DACTINOMYCIN 0.5 MG IV SOLN (MCH) $9,868.43 HC44700458 INSERTION OF IABP PERCUTANEOUS $9,850.00 HC62208590 KIT HEART LASER CO2 $9,835.00 HC44503902 SEL CATH EA IC CRTD/VERT&ANG W/SI LT+ $9,835.00 HC44503910 SEL CATH EA IC CRTD/VERT&ANG W/SI RT+ $9,835.00 HC62200068 ABLATION DEVICE $9,800.00 HC62800255 CATH BRACHY TX SEED ADMIN K $9,800.00 HC62805080 CATH EP DIAG/ABLAT 3D/VECT X $9,800.00 HC62805585 CATH EP/ABLATION COOL-TIP Q $9,800.00 HC62228036 CATH INTRACARDIAC ECHO/UTZ H $9,800.00 HC62805478 CATH PTCA BALLOON NON-LASER AD $9,800.00 HC62807136 CATH THROMBECTOMY AI $9,800.00 HC62800529 CATH TRANSLUM ANGIO LASER U $9,800.00 HC62214051 CLAMP ABLATION (ISOL SYNERGY) $9,800.00 HC62802962 COIL NEUROVASCULAR AR $9,800.00 HC62210661 DEVICE CLOT SEPARATOR NEURO AD $9,800.00 HC62805858 INTRO/SHEATH EP LASER AH $9,800.00 HC62806492 PROBE ABLATION AT $9,800.00 HC62804950 STENT BILIARY COVRD W/DELSYS U $9,800.00 HC62804695 SYSTEM DRAIN PLEURAL/PERIT (ASPIRA) $9,800.00 HC83000752 THERAPEUTIC APHERESIS PLATELET $9,792.00 0173-0665-18 ATOVAQUONE 750 MG/5 ML ORAL SUSP $9,788.42 70710-1478-1 FOMEPIZOLE 1 GRAM/ML IV SOLN $9,750.00 HC91000243 R&B TELEMETRY CARE $9,745.00 HC12800058 THERAPEUTIC APHERESIS PLATELET $9,745.00 HC44900561 CT UPPER EXT W/CONTRAST BILAT $9,735.00 HC62227293 DEVICE TIF (ESOPHYX) $9,713.00 HC44900595 CT UPPER EXT W/O CONTRAST BIL $9,706.00 99999-033-70 CHLOROTHIAZIDE 25 MG / ML SYRINGE $9,675.25 HC45401221 MRA LOW EXT W/O CONT BILAT $9,671.00 55513-954-01 PANITUMUMAB 100 MG/5 ML (20 MG/ML) IV SOLN $9,633.13 HC38420105 ECMO DAILY MNGMT EA DAY VENO-VENO $9,625.00 HC62224993 MOLDS/FORMS CEMENT FEM&TIB KNEE $9,625.00 HC44503530 ENDOVENOUS ABLAT RADIO FREQ WS&I; ADDL VEIN+ $9,620.00 0781-3006-42 LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS SOLN (MCH) $9,609.60 HC44002855 MYELOGRAPHY INJ W/S&I; LUMBOSAC $9,605.00 55513-710-01 DENOSUMAB 60 MG/ML SUBCUTANEOUS SYRG $9,601.54 39822-2100-1 DACTINOMYCIN 0.5 MG IV SOLR $9,587.50 39822-2100-2 DACTINOMYCIN 0.5 MG IV SOLR $9,587.50 10599-003-01 MOMETASONE 1,350 MCG SINU IMPL $9,583.28 HC44703569 EV REPAIR AORTOILIAC DEPLOY GRAFT ILIAC CATH UNILAT RUPT/NON-RUPT+ $9,571.00 HC62800164 CATH ATHERECTOMY DIRECTIONAL E $9,570.00 HC44504397 EXCHNG CATH DRN BIL EXT->INT-EXT PERC(CHOLANG,S&I) $9,551.00 HC45401338 MRA SPINE W/O & W/ CONTRAST $9,526.00 10019-957-01 CYCLOPHOSPHAMIDE 2 GRAM IV SOLR $9,522.50 10019-957-11 CYCLOPHOSPHAMIDE 2 GRAM IV SOLR $9,522.50 70860-218-10 CYCLOPHOSPHAMIDE 200 MG/ML IV SOLN $9,522.50 HC62807086 KIT KYPHOPAK 1ST FRACTURE C $9,520.00 HC46502803 INSERT PICC>5 YR AGE W/IMAGING $9,516.00 HC46501391 REMVL TUN CV ACS DEVICE W/ SQ PORT $9,501.00 55150-431-01 DACTINOMYCIN 0.5 MG IV SOLN (MCH) $9,477.46 67457-513-05 DACTINOMYCIN 0.5 MG IV SOLN (MCH) $9,477.46 HC23000763 INJ FORAMN EPI LMBR ADD+S&I-BI $9,472.00 66733-958-23 CETUXIMAB 2 MG/ML IV SOLN (MCH) $9,470.50 HC62805460 CATH INTRACARDIAC ECHO/UTZ F $9,450.00 HC62226402 RETRACTOR MIS SPINAL T $9,450.00 HC62804943 STENT BILIARY COVRD W/DELSYS T $9,450.00 HC46500146 BX BONE TROCAR/NEEDLE; DEEP $9,440.00 HC44002848 MYELOGRAPHY INJ W/S&I; THORACIC $9,422.00 HC46500674 CHANGE PERC GT TO GJ TUBE W/FLUORO $9,419.00 HC62808811 CATH INDIGO SEPARATOR TUBING 7-8FR[PENUMBRA] $9,415.00 HC44701027 REMOVE SINGLE LEAD $9,411.00 HC46502183 PERC BX BREAST W/LOC DEV MR 1ST LESN $9,399.00 HC46502506 EXCHANGE TUBE NEPHRO(NEPH/URET'GRM,S&I) LT $9,385.00 HC46502514 EXCHANGE TUBE NEPHRO(NEPH/URET'GRM,S&I) RT $9,385.00 HC44900983 CT ABDOMEN & PELVIS W/CONTRAST $9,381.00 HC23001308 INJ S-I JOINT ANESTH W/IMAG BI $9,376.00 HC46501912 BX LYMPH NODE(S) DEEP CERV-*DS $9,368.00 HC46501755 BX LYMPH NODE(S) DEEP CERVICAL $9,368.00 HC46501714 BX/RMVL LYMPH NODE(S)-OPEN LT $9,368.00 HC46501722 BX/RMVL LYMPH NODE(S)-OPEN RT $9,368.00 60505-6230-4 PACLITAXEL PROTEIN-BOUND 100 MG IV SUSR $9,366.57 HC38420113 ECMO DAILY MNGMT EA DAY VENO-ART $9,361.00 0085-1328-01 POSACONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSP $9,357.08 HC44703452 OPEN AXILL/SUBCLV ART CONDUIT DELIVER PROTH /BYPASS UNILAT+ $9,353.00 HC74200213 BEDSIDE/OTHER SURG INITIAL HR 4 (MCAL 1ST HOUR) $9,323.00 62484-0020-1 MERCAPTOPURINE 20 MG/ML ORAL SUSP $9,313.85 62484-0020-2 MERCAPTOPURINE 20 MG/ML ORAL SUSP $9,313.85 HC45600087 PET MELANOMA, NON-COV INDCTNS $9,291.00 HC46001079 SEL CATH AB/PEL/LOEXT3RD OR $9,291.00 HC46000808 SEL CATH AB/PEL/LOEXT3RD OR LT $9,291.00 HC46000816 SEL CATH AB/PEL/LOEXT3RD OR RT $9,291.00 HC44502334 ENDOVENOUS ABLAT LASER WS&I; ADDL VEIN+ $9,257.00 HC74200163 OR TIME INIT'L HR CASE CX LEVEL 5 (MCAL 1ST HOUR) $9,252.00 HC44700607 IVUS/OCT CORONARY VESS/GRAFT INIT $9,219.00 HC44002830 MYELOGRAPHY INJ W/S&I; CERVICAL $9,219.00 HC44503688 VERT/THOR CAROTID STENT+LT $9,187.00 HC44503696 VERT/THOR CAROTID STENT+RT $9,187.00 HC45400827 MRI CARDIAC FOR MORPH W/CON $9,175.00 HC46501417 REPAIR CV ACCESS CATH W/PORT $9,167.00 HC38420253 ECMO/ECLS RMVL OF PRPH CANNULA PRQ 6 YRS & OLDER $9,158.00 HC27000991 GI TRACT CAPSULE ENDO IMAG ESOPH THRU ILEUM $9,154.00 HC44700995 REMOVAL ICD GENERATOR ONLY $9,154.00 76075-102-01 CARFILZOMIB 30 MG IV SOLR $9,142.97 HC46001269 INJ CHOLANGIO PERC/S&I;NEW ACCESS $9,128.00 HC62219183 CATH CTO-CROSSER $9,100.00 HC62800297 CATH EP DIAG/ABLAT 3D/VECT W $9,100.00 HC62212659 CATH MICRO CTO/REPRFNS(ENTEER/5MAX ACE)AJ $9,100.00 HC62225685 CATH TRANSLUM ANGIO LASER T $9,100.00 HC62807078 COIL NEUROVASC(TARGET XL 360 SOFT)AJ $9,100.00 HC62807730 M: DISC INVERVERTEBRAL ARTIFICIAL $9,100.00 HC62804646 STENT DES CORO COV W/DEL SYS T $9,100.00 HC62802954 STENT NEUROVASCULAR D $9,100.00 HC62805288 STENT NON-COAT/NON-COV W-DEL AJ $9,100.00 HC62804448 STENT TRACHEOBRONC COV W/DEL SYS H $9,100.00 25021-676-20 PENTOBARBITAL SODIUM 50 MG/ML INJ SOLN $9,100.00 99999-038-93 POLIHEXANIDE (PURAPLY AM) 5X5 CM EACH TOPICAL SHEET $9,100.00 HC38420139 ECMO REPSN OPEN A&/V PERC W/FLUOR=5Y $9,096.00 HC38420212 ECMO/ECLS REPOS PERPH CANNULA OPEN 6 YRS & OLDER $9,096.00 HC91400094 R&B PEDIATRIC ACUTE $9,095.00 HC46503041 BX SOFT TISS THIGH/KNEE DEEP BIL $9,075.00 HC46503017 BX SOFT TISS LEG/ANKLE DEEP BIL $9,075.00 HC91200241 R&B L&D PP OBSTETRICS CARE $9,044.00 99999-035-65 EPIFIX SKIN GRAFT ( 2X3 CM ) $9,041.50 HC45400843 MRI CARDIAC MORPH W/STRESS W/O $9,029.00 HC21000492 I&D POST OP WOUND INF COMP' $9,000.00 HC47201116 HDR RADIONUCLIDE INTRSTTL/INTRVIT BRACH 1 CHANNEL $8,992.00 HC23001803 ASP/INJ JOINT LRG W/UTZ GUIDE-BILAT $8,990.00 0004-0261-29 MYCOPHENOLATE MOFETIL 200 MG/ML ORAL SUSR $8,975.20 HC46000923 SEL CATH THOR/BRAC 3RD ORD LT $8,961.00 HC46000931 SEL CATH THOR/BRAC 3RD ORD RT $8,961.00 HC62807144 STENT NON-COAT/NON-COV W-DEL AI $8,925.00 HC62808290 STENT TRANSCAROTID COV W/DEL SYS $8,925.00 HC44504207 XRAY TEVAR W/ LT SUBCLAV; INT'L ENDO& DIST EXTS CELIAC S&I $8,909.00 HC45201399 NM TUMOR LOCALIZE SPECT CT 2+ AREAS 1 DAY//SNGL AREA 2+DAYS $8,907.00 HC43000009 ABLATION CRYO BREAST FIBROADENOMA EA W/US $8,898.00 HC27000918 ESOPHAGEAL REFLUX W/PH ELECTR $8,898.00 HC46503074 BX SOFT TISSUE BACK DEEP BIL $8,894.00 13533-800-71 IMMUNE GLOBUL G-GLY-IGA AVG 46 10 GRAM/100 ML (10 %) INJ SOLN $8,888.10 13533-800-72 IMMUNE GLOBUL G-GLY-IGA AVG 46 10 GRAM/100 ML (10 %) INJ SOLN $8,888.10 69452-223-84 RUFINAMIDE 40 MG/ML ORAL SUSP $8,883.29 HC46501037 INSERT CT(OPEN) W/DRAIN SYSTEM BIL $8,877.00 HC44500478 AORTOGRAM THOR W/ SERIAL(ARCH) $8,873.00 99999-038-97 POLIHEXANIDE (PURAPLY) 5X5 CM EACH TOPICAL SHEET $8,866.00 HC23001837 INJ DX/THER CERVICAL/THORACIC W/IMAG $8,861.00 55513-141-01 TRASTUZUMAB-ANNS 150 MG IV SOLR $8,840.46 HC44500221 ANGIO EXTREMITY UE OR LE LT $8,831.00 HC44500239 ANGIO EXTREMITY UE OR LE RT $8,831.00 HC46502811 REPLC PICC LINE W/O SQ PORT/PUMP W/IMAGING $8,819.00 HC43001072 BREAST PROCEDURE UNSPECIFIED $8,818.00 HC62214473 CHARGER BATTERY NEUROSTIM B $8,817.00 62935-221-04 LEUPROLIDE (3 MONTH) 22.5 MG SUBCUTANEOUS SYRG $8,807.96 62935-223-05 LEUPROLIDE (3 MONTH) 22.5 MG SUBCUTANEOUS SYRG $8,807.96 HC62808985 CATH PTA W/BALLOON RX(DCB) M $8,785.00 HC44700185 EP EVAL ICD LEADS AT IMPLANT $8,776.00 68516-3202-2 PROFILNINE 1,000 (+/-) UNIT IV SOLR $8,775.00 68516-3205-2 PROFILNINE 1,000 (+/-) UNIT IV SOLR $8,775.00 HC46502415 PLCMT NEPHROSTOMY CATHETER,(NEPH/URET'GRM,S&I) LT $8,762.00 HC46502423 PLCMT NEPHROSTOMY CATHETER,(NEPH/URET'GRM,S&I) RT $8,762.00 HC62209309 DECOMPRESSION SYSTEM-IO-FLEX $8,750.00 HC62210364 DEVICE ELECTROSURG ABLAT ENDOVASC $8,750.00 HC44501799 REMOVE NEPHROSTOMY TUBE BIL $8,729.00 HC23001779 ASP/INJ JOINT MED W/UTZ GUIDE-BILAT $8,728.00 HC46503108 BX SOFT TISS FOREARM&/WRIST DEEP BIL $8,712.00 68516-4613-2 ALPHANATE 1,000 (400 VWF) UNIT/10 ML IV SOLR $8,710.00 HC44500759 ENDO BILI W/DILAT W/ STENT $8,705.00 HC62207154 SYSTEM STEALTH ALL $8,690.00 HC62802095 STENT COAT/COVRD W/O DEL SYS $8,680.00 HC62802855 STENT COLONIC/DUOD NOCOV&DEL $8,680.00 HC44501740 REM & REPLAC EXT URET CATH(IMG,S&I) LT $8,662.00 HC44501757 REM & REPLAC EXT URET CATH(IMG,S&I) RT $8,662.00 HC46000550 INTRO CATHETER AORTA $8,645.00 17156-210-01 IOFLUPANE I 123 5 MCI/2.5 ML (185 MBQ/2.5ML) IV SOLN $8,638.00 HC44900298 CT LOW EXT W/O CONTRAST BILAT $8,637.00 HC44703593 TMVR PERC REPAIR MITRAL VALVE ADD'L PROSTH+ $8,630.00 HC44500452 AORTOGRAM ABDOMINAL $8,611.00 67457-991-15 TRASTUZUMAB-DKST 150 MG IV SOLR $8,610.29 HC45401320 MRA SPINE W/ CONTRAST $8,603.00 HC45201217 MIBI SPECT MULTI STUDY W/WM&EF $8,597.00 66621-0790-1 ANTIVENIN CROTALIDAE (EQUINE) INJ SOLR $8,580.00 66621-0790-2 ANTIVENIN CROTALIDAE (EQUINE) INJ SOLR $8,580.00 0002-7669-01 RAMUCIRUMAB 10 MG/ML IV SOLN $8,579.03 HC62224647 CATH DUODENOSCP DIGTL ACCESS/DELVRY $8,575.00 HC62803192 DEVICE MECH' OCCLUDE(COIL/PLUG) $8,558.00 0054-0449-49 POSACONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSP $8,533.98 HC46503132 BX SOFT TISS SHOULDER DEEP BIL $8,531.00 HC25004268 I&D ABSCESS/BURSA/HEMATOMA THIGH/KNEE DEEP BIL $8,529.00 HC27001320 ERCP W/STENT REMV&XCH BILI/PANC DUCT $8,527.00 HC25002726 TRAUMA ACT' III W/O P-H ALERT $8,516.00 HC44504892 TRANSLUMINAL BALO ANGIOP VEIN W/S&I:ADDL + LT $8,490.00 HC44504900 TRANSLUMINAL BALO ANGIOP VEIN W/S&I:ADDL + RT $8,490.00 HC44505089 TRANSLUMINAL BALO ANGIOPLST VEIN W/S&I: ADD'L + $8,490.00 HC46502829 INSERT/DRILL SUBDUR/VENTRIC CATH $8,477.00 0003-2187-13 ABATACEPT (WITH MALTOSE) 250 MG IV SOLR $8,462.94 50474-870-15 BRIVARACETAM 10 MG/ML ORAL SOLN $8,441.55 HC45400355 MR L-SPINE W/CONTRAST $8,435.00 62856-389-01 ERIBULIN 1 MG/2 ML (0.5 MG/ML) IV SOLN $8,424.00 HC44700896 PROG STIM/PACING POST MEDS+ $8,413.00 HC46501094 INSERT PICC <5 YR AGE W/O IMAGING $8,405.00 HC62805072 CATH EP DIAG/ABLAT 3D/VECT V $8,400.00 HC62202775 CATH EP DIAG/MAPPING<20 ELECT V $8,400.00 HC62807060 COIL NEUROVASCULAR AP $8,400.00 HC62800875 M: CATH VENTRICULAR NEURO $8,400.00 HC62227137 PROBE ABLATION AS $8,400.00 HC62807011 PROBE ABLATION CRYO C $8,400.00 HC62808183 STENT DES CORO COV GRAFTMASTER H000001 $8,400.00 HC62806211 STENT DES CORO COV W/DEL SYS S $8,400.00 HC62807953 STENT ENDOPRSTH AAA C $8,400.00 HC62802756 STENT ESOPHAGEAL;CVRD;DEL C $8,400.00 HC62808571 STENT FULLY COVERED VIABIL $8,400.00 HC62803770 STENT NON-COAT/NON-COV W-DEL AH $8,400.00 HC62804430 STENT TRACHEOBRONC COV W/DEL SYS G $8,400.00 HC45401122 MR BREASTS W/O&W CONTRAST (BILAT) $8,378.00 HC46502308 PERC DRAIN CATH W/IMAG; PERITONEAL/RETROPERIT $8,371.00 HC44900504 CT T-SPINE W&W/O CONTRAST $8,363.00 HC46503314 BIOPSY MUSCLE DEEP BIL $8,349.00 HC46501490 REPLC NON-TUN CV ACS CATH W/O PORT/PUMP $8,341.00 0517-0650-01 FERRIC CARBOXYMALTOSE 50 MG IRON/ML IV SOLN $8,337.62 HC62803671 CATH ABLAT TISS COOL-TIP(HALO 360)I $8,313.00 HC23001001 INJ SUPERIOR HYPOGASTRIC PLEXS $8,308.00 HC46000493 INTRO CATH FALLOPIAN TUBE $8,305.00 HC74200155 OR TIME INIT'L HR CASE CX LEVEL 4 (MCAL 1ST HOUR) $8,293.00 HC25004292 REMOVE FB DEEP THIGH/KNEE AREA BIL $8,291.00 HC45400652 MRA CHEST W&W/O CONTRAST $8,283.00 HC45400488 MR T-SPINE W/CONTRAST $8,276.00 HC44500262 ANGIO PELVIC $8,251.00 HC62807755 M: GRAFT REPAIR NERVE $8,226.00 HC62210240 CANNULA ECMO $8,225.00 HC62806989 CATH BI-CAVAL PERFUSION $8,225.00 HC62808159 STENT COV W/DEL SYS PVD B $8,225.00 HC38420303 ARTERY EXPOS/GRAFT ARTERY PERFUSION ECMO/ECLS $8,221.00 HC44703726 TTVR PERC REPAIR TRICUSPID VALVE ADD'L PROSTH+ $8,218.00 0143-9280-01 MITOMYCIN 40 MG IV SOLR $8,216.00 16729-116-38 MITOMYCIN 40 MG IV SOLR $8,215.74 16729-248-38 MITOMYCIN 40 MG IV SOLR $8,215.74 67457-520-40 MITOMYCIN 40 MG IV SOLR $8,215.74 71288-139-51 MITOMYCIN 40 MG IV SOLR $8,215.74 HC45400017 MR ABDOMEN W/ CONTRAST $8,208.00 HC45600103 PET BREAST CA INTL/ SURG PLAN $8,203.00 HC44700912 PTA PULMONARY ARTERY EA ADDL+ $8,184.00 HC44900322 CT L-SPINE W&W/O CONTRAST $8,183.00 73535-208-01 TAFASITAMAB-CXIX 200 MG IV SOLR $8,156.27 HC44701423 PUNCTURE TRANSEPTL (LT HC) + $8,145.00 HC21000351 DBRD SKIN MUSL/BONE TO 20SQCM $8,143.00 99999-044-63 POLIHEXANIDE (PURAPLY AM) 3X4 CM EACH TOPICAL SHEET $8,125.00 HC36000289 VENT DAY INIT-JET VENT $8,123.00 HC46502530 TENOTOMY PERC, TOE; SINGLE TENDON $8,105.00 HC62228002 LOOP PLASMA $8,103.00 HC23001431 INJ L/S F W/IMAGE 1ST LVL LT $8,093.00 HC23001423 INJ L/S F W/IMAGE 1ST LVL RT $8,093.00 HC46502084 BX PROSTATE STEREO/TEMPLAT W/IMG $8,086.00 HC36000263 VENT DAY INITIAL-ADULT $8,082.00 HC36000271 VENT DAY INITIAL-INFANT $8,082.00 HC36000297 VENT DAY INIT-OSCIL&/OR HI FRQ $8,082.00 HC46502472 CONVERT NEPH CATH->NEPH'URET PERC(NEPH/URET'GRM,S&I)EXST LT $8,075.00 HC46502480 CONVERT NEPH CATH->NEPH'URET PERC(NEPH/URET'GRM,S&I)EXST RT $8,075.00 HC44504777 PTA CDS VIA DIALYSIS CIRCUIT WS&I + $8,071.00 HC46500245 BIOPSY LIVER(NEEDLE/PERCUTAN) $8,058.00 HC46501821 BX NECK/THORAX SOFT TISSUE*DS $8,045.00 HC46501730 BX NECK/THORAX SOFT TISSUE-SC $8,045.00 HC44700201 EP EVAL T-ICD W/PROGRAMMING $8,037.00 HC62204342 KIT VERTEBROPLASTY DISP $8,022.00 HC23000748 INJ FORAMN EPI LMBR INTLW/S&I-L $8,001.00 HC23000755 INJ FORAMN EPI LMBR INTLW/S&I-R $8,001.00 HC44900975 CT ABDOMEN & PELVIS W/O CONTRAST $7,997.00 HC46502290 PERC DRAIN CATH W/IMAG; VISCERAL $7,988.00 50242-136-01 TOCILIZUMAB 200 MG/10 ML (20 MG/ML) IV SOLN $7,980.96 67684-1901-2 ETHIODIZED OIL 480 MG IODINE/ML INJ OIL $7,956.00 HC45400728 MRA NECK W/ CONTRAST $7,952.00 HC82204520 BONE MARROW DX; BX(S) ONLY BILAT $7,939.00 50242-040-62 OMALIZUMAB 150 MG SUBCUTANEOUS SOLR $7,937.48 50242-215-01 OMALIZUMAB 150 MG/ML SUBCUTANEOUS SYRG $7,937.48 HC41500885 EEG W/VIDEO MONITOR CONT EA 12-26HR $7,928.00 HC62229216 SYSTEM DILATE MULTI-SINUS XPRESS $7,920.00 HC23000680 INJ FORAMN EPI C/T INTL W/S&I-L $7,902.00 HC23000698 INJ FORAMN EPI C/T INTL W/S&I-R $7,902.00 HC44502201 VENOGRAM CAVAL INFERIOR $7,899.00 10454-712-10 RIMABOTULINUMTOXINB 10,000 UNIT/2 ML IM SOLN $7,896.66 HC62808803 CATH INDIGO THROMB 6FR L135CM[PENUMBRA] $7,893.00 HC83000737 THERAPEUTIC APHERESIS WBC'S $7,885.00 HC44500767 ENDO BILI W/DILAT W/O STENT $7,875.00 0069-0308-01 TRASTUZUMAB-QYYP 150 MG IV SOLR $7,872.15 HC41000118 POLYSMNGRPH CPAP/BIPAP <6Y/O ATTD $7,871.00 24201-010-20 PENTOBARBITAL SODIUM 50 MG/ML INJ SOLN $7,866.69 HC27001338 ERCP W/STENT PLACE BILI/PANC DUCT EA $7,863.00 HC21000963 APPY SKIN SUB T,A,L 1ST 100SQ~LC $7,859.00 HC46001061 SEL CATH AB/PEL/LOEXT2ND OR $7,853.00 HC46000741 SEL CATH AB/PEL/LOEXT2ND OR LT $7,853.00 HC46000758 SEL CATH AB/PEL/LOEXT2ND OR RT $7,853.00 HC46501367 REMOV TUNNELED CV ACS CATH W/O PORT/PUMP $7,852.00 HC45400066 MR BRAIN W/CONTRAST $7,847.00 HC44703890 INJ PRO HRT CATH &IMAG; SELCT PULM VENOUS EA VEIN+ $7,844.00 HC25004623 REMOVE FB FOOT; DEEP BIL $7,843.00 HC25004383 I&D ABSCESS/HEMATOMA LEG/ANKLE DEEP BIL $7,838.00 HC46502142 PERC BX BREAST W/LOC DEV SG 1ST LESN $7,838.00 HC27000983 GI TRACT CAPSULE ENDO IMAG ESOPHAGUS ONLY $7,829.00 67877-673-62 RUFINAMIDE 40 MG/ML ORAL SUSP $7,815.86 HC44504496 ENDOVASC INFUS CRANIAL(NON-THROMB)ADD TRRT+ $7,813.00 0026-3942-25 JIVI 500 (+/-) UNIT IV SOLR $7,800.00 0026-4942-01 JIVI 500 (+/-) UNIT IV SOLR $7,800.00 68727-800-01 DEFIBROTIDE 80 MG/ML IV SOLN $7,792.20 68727-800-02 DEFIBROTIDE 80 MG/ML IV SOLN $7,792.20 HC46502860 PERC BX CORE LUNG/MEDIASTINUM W/ IMAG IF OCCURS $7,790.00 HC23000706 INJ FORAMN EPI C/T ADD+W/S&I-BI $7,776.00 HC44504710 ACCESS DIALYSIS CIRCUIT EVAL->VENA CAVA WS&I $7,775.00 HC23001266 DESTR L/S FAC JOINT SINGL W/IMG-L $7,769.00 HC23001274 DESTR L/S FAC JOINT SNGL W/IMG-R $7,769.00 HC45201068 NM TUMOR LOCALIZE PLNR WHOLE BODY 2+ DAYS $7,769.00 HC44900637 CTA ABDOMEN $7,762.00 59338-775-01 FERUMOXYTOL 510 MG/17 ML (30 MG/ML) IV SOLN $7,758.54 HC46501763 BIOPSY NEEDLE RENAL $7,747.00 HC46500310 BIOPSY NEEDLE RENAL-LT $7,747.00 HC46500328 BIOPSY NEEDLE RENAL-RT $7,747.00 HC74200205 BEDSIDE/OTHER SURG INITIAL HR 3 (MCAL 1ST HOUR) $7,738.00 HC62808977 CATH PTA W/BALLOON RX(DCB) K $7,735.00 HC44504645 EMBOLIZATION/OCCLUSION URETERAL LT $7,724.00 HC44504652 EMBOLIZATION/OCCLUSION URETERAL RT $7,724.00 HC46500690 CHANGE URETEROSTOMY TUBE LT $7,717.00 HC46500708 CHANGE URETEROSTOMY TUBE RT $7,717.00 HC62800180 CATH ATHERECTOMY ROTATIONAL AH $7,700.00 HC62805502 CATH EP DIAG/ABLAT 3D/VECT U $7,700.00 HC62217906 CATH MICRO NEURO (AXS CATALYST) AH $7,700.00 HC62806187 CATH THROMBECTOMY AH $7,700.00 HC62802939 COIL NEUROVASCULAR AO $7,700.00 HC62300462 STABILIZER ENDOWRIST ROBOTIC $7,700.00 HC62804638 STENT DES CORO COV W/DEL SYS R $7,700.00 HC62802186 STENT NON-COAT/NON-COV W-DEL AG $7,700.00 HC62804422 STENT TRACHEOBRONC COV W/DEL SYS F $7,700.00 HC12800074 THERAPEUTIC APHERESIS WBC'S $7,696.00 HC44500049 ANGIO ADRENAL LT $7,695.00 HC44500056 ANGIO ADRENAL RT $7,695.00 HC46501292 INS NO TUN CV ACCESS CATH 5YRS+ $7,685.00 HC45400389 MR ORBIT/FACE&OR NECK W/CONTR $7,685.00 HC45201381 NM TUMOR LOCALIZE SPECT 2+ AREAS 1 DAY//SNGL AREA 2+DAYS $7,678.00 HC44703254 REMOVE ELECTRODE DEFIBRILLATOR SUBQ $7,669.00 HC23001969 DESTR NERVE GENICULAR W/NEUROLYT AGNT W/IMAGE BI $7,667.00 HC44700193 EP EVAL ICD LEADS/GEN AT IMPLA $7,666.00 HC27000801 ESOPH DILATION OVER GUIDE WIRE $7,666.00 HC47201082 IMRT TX DELIVERY,GUIDE&TRACK SIMPLE $7,651.00 0003-3772-11 NIVOLUMAB 40 MG/4 ML IV SOLN $7,641.01 HC46502266 PERC PLC BRST LOC DEV MR 1ST LESN $7,641.00 HC46500542 BX PROSTATE NDL/PUNCH SGL/MULT $7,640.00 HC46502936 ABLATION PERC CRYO LOWER EXTREMITY NERVE INCLDE IMAG $7,627.00 HC46502928 ABLATION PERC CRYO UPPER EXTREMITY NERVE INCLD IMAG $7,627.00 HC44500890 INJ CHEMONUCLEOLYSIS $7,624.00 HC46503165 BX SOFT TISS UPPER ARM/ELBOW SUP BIL $7,623.00 HC45400124 MR C-SPINE W/CONTRAST $7,614.00 HC41000084 POLYSMNGRPH 4+STGS <6 Y/O ATTD $7,609.00 HC44700573 INTRAVENTRICULAR PACING $7,606.00 HC23001340 INJ CER/THOR F/IMAGE SNG LVLLT $7,597.00 HC23001332 INJ CER/THOR F/IMAGE SNG LVLRT $7,597.00 HC44500288 ANGIO PULMONARY LT $7,596.00 HC44500296 ANGIO PULMONARY RT $7,596.00 HC44501211 MISC VASCULAR SURGICAL PROC $7,591.00 57894-030-01 INFLIXIMAB 100 MG IV SOLR $7,590.83 HC23001472 INJ L/S F W/IMAGE 2ND LVL BIL $7,582.00 HC44900702 CTA PELVIS $7,578.00 HC45400363 MR L-SPINE W/O CONTRAST $7,551.00 67877-230-22 MYCOPHENOLATE MOFETIL 200 MG/ML ORAL SUSR $7,540.00 HC45401262 MRA ABDOMEN W&W/O CONTRAST $7,533.00 HC44700532 INTRACARDIAC ECHO + $7,525.00 HC46502316 PERC DRAIN W/IMAG; PERIT/RETROPERIT TRANSVAG/RECTAL $7,519.00 HC44502250 VENOGRAM HEPATIC W/HEMO EVAL $7,510.00 HC44900959 CCTA HEART EVAL W/3D IMAGE $7,506.00 HC44900645 CTA CHEST $7,504.00 HC36000321 VENT DAY SUBSQ-JET VENT $7,501.00 HC44504447 REMOV CALC DUCT(S)BIL&/GB PERC(DESTRCT,S&I)+ $7,499.00 HC74200148 OR TIME INIT'L HR CASE CX LEVEL 3 (MCAL 1ST HOUR) $7,480.00 HC41000050 POLYSOMNOGRAPHY CPAP/BIPAP 6&> ATTD $7,478.00 66993-062-72 ATOVAQUONE 750 MG/5 ML ORAL SUSP $7,465.19 HC45400637 MR UP EXT (JNT) W/CONT LT $7,455.00 HC45400645 MR UP EXT (JNT) W/CONT RT $7,455.00 HC36001170 PERC BX CORE LUNG/MEDIASTINUM W/ IMAG IF OCCURS $7,454.00 HC36800886 PERC BX CORE LUNG/MEDIASTINUM W/ IMAG IF OCCURS $7,454.00 HC62809033 FILTER VENA CAVA N $7,451.00 HC46501102 INSERT PICC >5 YR AGE W/O IMAGING $7,446.00 HC25004417 CLOSED TX TIBIAL SHAFT FX W/MANIP W/W-O FIBFX/TRAC BIL $7,442.00 HC46503199 BX SOFT TISS LEG/ANKLE SUP BIL $7,442.00 HC47200860 PLACE DEVICE/MARKER OTHER SITES(NON-PROST) $7,425.00 HC41000035 POLYSOMNOGRAPHY 4+ STAGES 6&> ATTD $7,425.00 HC45401247 MRA LOW EXT W&W/O CONT LT $7,415.00 HC45401239 MRA LOW EXT W&W/O CONT RT $7,415.00 HC45400413 MR PELVIS W/CONTRAST $7,410.00 10511-3001-2 HEXAMINOLEVULINATE 100 MG INTRAVESICAL SOLR $7,410.00 HC44500171 ANGIO EA ADD'L VESSEL S&I ONLY + $7,392.00 HC23000946 INJ ANES/STEROID NERVE PUDENDAL BIL $7,380.00 HC47200639 TRANSCATH PLCMNT RAD DEL DEVIC $7,380.00 HC36000305 VENT DAY SUBSEQUENT-ADULT $7,377.00 HC36000313 VENT DAY SUBSEQUENT-INFANT $7,377.00 HC36000339 VENT DAY SUBSQ-OSCIL&/OR HI FR $7,377.00 HC25004441 CLOSED TX MEDIAL MALLEO(ANKLE)FX W/MANIP W/W-O TRAC BIL $7,371.00 16714-345-01 MYCOPHENOLATE MOFETIL 200 MG/ML ORAL SUSR $7,369.44 HC44502219 VENOGRAM CAVAL SUPERIOR $7,359.00 HC45400090 MR CHEST W/CONTRAST $7,352.00 HC46501581 THORACENTESIS W/TUBE W/ IMAG LT $7,352.00 HC46501599 THORACENTESIS W/TUBE W/ IMAG RT $7,352.00 HC62806625 COIL EMBOLIZ(3D PRIME BARE SUPER SFT)AN $7,350.00 HC46502167 PERC BX BREAST W/LOC DEV US 1ST LESN $7,331.00 HC44700516 INTRA-ATRIAL PACING $7,322.00 55513-223-01 ROMIPLOSTIM 125 MCG SUBCUTANEOUS SOLR $7,319.39 HC36800076 BRONCH W/NDL ASP BX(S) INITIAL $7,311.00 HC36000834 BRONCH W/NDL ASP BX(S);INITIAL $7,311.00 HC44504215 XRAY TEVAR; INITIAL ENDO & DIST EXTS TO CELIAC S&I $7,304.00 HC44900728 CTA UPPER EXT W/CONTRAST-LT $7,298.00 HC44900736 CTA UPPER EXT W/CONTRAST-RT $7,298.00 HC44504660 DILAT BALLOON STRICTURE URETERAL LT $7,294.00 HC44504678 DILAT BALLOON STRICTURE URETERAL RT $7,294.00 HC44900512 CT T-SPINE W/ CONTRAST $7,289.00 0944-2511-02 IGG-HYALURONIDASE,RECOMBINANT 5 GRAM /50 ML (10 %) SUBCUTANEOUS SOLN $7,286.18 HC46000907 SEL CATH THOR/BRAC 2ND ORD LT $7,285.00 HC46000915 SEL CATH THOR/BRAC 2ND ORD RT $7,285.00 0781-3255-94 CYCLOPHOSPHAMIDE 2 GRAM IV SOLR $7,284.75 HC44900009 CT ABDOMEN W&W/O CONTRAST $7,283.00 HC62808928 BONE GRAFT FILLER VOID 5ML(CERAMENT®BONESUPPORT®) $7,280.00 HC62805064 CATH EP DIAG/ABLAT 3D/VECT Q $7,280.00 HC44900132 CT C-SPINE W&W/O CONTRAST $7,279.00 HC62217898 SET PIN DISTRACTORS-COUNT 10 B $7,273.00 HC91000123 R&B ONCOLOGY $7,264.00 HC62211081 CATHETER SINUS ENDO PLEDGE $7,263.00 HC45400496 MR T-SPINE W/O CONTRAST $7,260.00 HC46503223 BX SOFT TISS SHOULDER SUP BIL $7,260.00 HC45400751 MRA PELVIS W/O & W/ CONTRAST $7,248.00 HC46501284 PLCMNT CENTRAL VEN CATH<5 YR $7,246.00 HC45400546 MR UP EXT(NON JNT)W/CONT LT $7,244.00 HC45400553 MR UP EXT(NON JNT)W/CONT RT $7,244.00 HC45400298 MR LOW EXT(JNT)W/CONT LT $7,243.00 HC45400306 MR LOW EXT(JNT)W/CONT RT $7,243.00 HC45400207 MR LOW EXT(NON JNT)W/CONT LT $7,243.00 HC45400215 MR LOW EXT(NON JNT)W/CONT RT $7,243.00 HC21000385 I&D HEMATOMA OR FLUID COLL $7,231.00 HC44702959 REM PERC VAD DEVICE-SEP SETTING ARTERIAL/AV; LEFT HEART $7,225.00 HC23001225 DESTR C/T FAC JOINT SINGL W/IMG-L $7,219.00 HC23001233 DESTR C/T FAC JOINT SNGL W/IMG-R $7,219.00 HC44501468 PORTOGRAM W/ HEMODYNAMIC EVAL $7,162.00 HC44900330 CT L-SPINE W/ CONTRAST $7,153.00 HC45400694 MRA HEAD W/CONTRAST $7,147.00 HC38420121 ECMO REPSN PERIF A&/V PERC W/FLUOR=5Y $7,143.00 HC38420204 ECMO/ECLS REPOS PERPH CANNULA PRQ 6 YRS & OLDER $7,143.00 HC38420246 ECMO/ECLS RMVL OF PERPH CANNULA PERQ BIRTH-5 YRS $7,143.00 HC46001053 SEL CATH AB/PEL/LOEXT1ST OR $7,139.00 HC45400025 MR ABDOMEN W/O CONTRAST $7,134.00 HC45400033 MR ABDOMEN(MRCP)W/O CONTRAST $7,134.00 HC27000603 ENTEROSCOPY W/ABLATION $7,124.00 52652-2001-6 METHOTREXATE 2.5 MG/ML ORAL SOLN $7,121.40 HC27000629 ENTEROSCOPY W/BLEED CONTROL $7,121.00 70842-140-03 ORITAVANCIN 400 MG IV SOLR $7,113.17 HC44703882 INJ PRO HRT CATH &IMAG; SELCT PULM ARTRL ANGIO BILAT+ $7,113.00 78206-145-01 ETONOGESTREL 68 MG SDRM IMPL $7,101.12 HC44701431 INJ PRO HRT CATH &IMG; SELCT CORON CONGNTL HRT+ $7,099.00 HC44502284 VENOGRAM RENAL LT $7,097.00 HC44502292 VENOGRAM RENAL RT $7,097.00 HC25004508 CLOSED TX BIMALLEOLA ANKLE FX; W/MANIP BIL $7,085.00 HC62204011 KIT KYPHOPAK ADD'L FRACTURE $7,084.00 HC44502185 VENOGRAM ADRENAL LT $7,084.00 HC44502193 VENOGRAM ADRENAL RT $7,084.00 HC46503256 BX SOFT TISS FOREARM&/WRIST SUP BIL $7,079.00 HC46000717 SEL CATH AB/PEL/LOEXT1ST OR LT $7,074.00 HC46000725 SEL CATH AB/PEL/LOEXT1ST OR RT $7,074.00 HC27001601 ILEOSCOPY STOMA W/STENT(W/DILATE) $7,071.00 HC46502191 PERC BX BREAST W/LOC DEV MR ADDL LESN+ $7,056.00 HC44900678 CTA LOW EXT LT $7,055.00 HC44900686 CTA LOW EXT RT $7,055.00 HC62806567 CATH BALLOON NEURO(HYPERFORM) I $7,053.00 0078-0435-61 ZOLEDRONIC ACID-MANNITOL-WATER 5 MG/100 ML IV PGBK $7,044.70 HC44900108 CT CHEST DX W&W/O CONTRAST $7,041.00 HC25003864 CLOSED TX RAD/EPHYSL SEP&ULN FX W/MAN-BIL $7,010.00 42799-813-01 PREDNISOLONE SODIUM PHOSPHATE 20 MG/5 ML (4 MG/ML) ORAL SOLN $7,004.65 HC44900462 CT PELVIS W&W/O CONTRAST $7,002.00 HC62805494 CATH EP DIAG/ABLAT 3D/VECT T $7,000.00 HC62800354 CATH EP/ABLAT NOT COOL-TIP/3D/V MAP AG $7,000.00 HC62212519 CATH MICRO NEURO(ARC132) AA $7,000.00 HC62208913 CATH PTCA BALLOON NON-LASER CRYO Z $7,000.00 HC62800511 CATH THROMBECTOMY AG $7,000.00 HC62212667 CATHETER MICRO CTO(VIANCE) AG $7,000.00 HC62806732 COIL EMBOLIZ(PRIME 3D ES) AM $7,000.00 HC62807052 COIL NEUROVASC(TARGET 360 NANO) AM $7,000.00 HC62805643 DEVICE ABLAT COOL-TIP NONVASC AG $7,000.00 HC62202809 EMBOLIZATION PROTECTIVE SYSTEM Q $7,000.00 HC62219753 KIT VITRECTOMY PROBE Z $7,000.00 HC62219027 RETRACTOR MIS SPINAL Q $7,000.00 HC62220363 SHIM DEVICE ACCESS SPINAL AK $7,000.00 HC62804604 STENT CORO BARE METAL W/DEL K $7,000.00 HC62803853 STENT DES CORO COV W/DEL SYS Q $7,000.00 HC62807961 STENT ENDOPRSTH LEG ILIAC A $7,000.00 HC62807854 STENT EXTENDER ENDOGRAFT AAA Q $7,000.00 HC62808431 STENT EXTENDER ENDOGRAFT AAA Q $7,000.00 HC62807235 STENT NON-COAT/NON-COV W-DEL AF $7,000.00 HC62804414 STENT TRACHEOBRONC COV W/DEL SYS E $7,000.00 HC46001301 INJ ANTEGRAD NEPH/URET'GRM,S&I EXIST ACCESS BI $6,999.00 HC46501359 PUNCTURE CISTERN/LAT CERVICAL C1-C2 W/INJ $6,996.00 50242-138-01 TOCILIZUMAB 162 MG/0.9 ML SUBCUTANEOUS SYRG $6,994.20 HC62204649 M: SYSTEM NERVE RESPONSE $6,989.00 58181-3042-5 LOMUSTINE 100 MG ORAL CAP $6,986.46 HC36800878 BRONCHOSCOPY FIDUCIAL PLMT SGL/MULTI $6,985.00 HC36001162 BRONCHOSCOPY FIDUCIAL PLMT SGL/MULTI $6,985.00 HC62210653 DEVICE EMBOLIC PROTECT NEURO $6,983.00 HC27001346 ERCP W/ABLAT TUMR/POLYP/LESN GUIDEWIRE $6,983.00 HC23001852 INJ W/CATH PLCMT EPI CERV/THOR W/IMAG $6,977.00 76310-017-01 AMIFOSTINE CRYSTALLINE 500 MG IV SOLR $6,964.15 76310-017-50 AMIFOSTINE CRYSTALLINE 500 MG IV SOLR $6,964.15 HC46501557 THORACENTESIS ASP W/ IMG GUID-LT $6,959.00 HC46501565 THORACENTESIS ASP W/ IMG GUID-RT $6,959.00 0004-0039-09 VALGANCICLOVIR 50 MG/ML ORAL SOLR $6,956.09 HC38420055 PERFUSION CARDIOASSIST INL' 2HR $6,949.00 59676-340-00 EPOETIN ALFA 40,000 UNIT/ML INJ SOLN $6,948.50 59676-340-01 EPOETIN ALFA 40,000 UNIT/ML INJ SOLN $6,948.50 HC62220785 OXYGENATOR ECMO PEDS $6,948.00 HC27000868 ESOPHAG REFLUX W/NASAL ELEC>1H $6,928.00 HC47200167 HYPERTHERMIA PROBE 6+ APPS $6,927.00 HC23001506 INJ L/S F /IMAGE 3RD+& LVL BI $6,922.00 HC46503280 BX SOFT TISSUE BACK SUP BIL $6,897.00 67457-220-00 ISOSULFAN BLUE 1 % SUBCUTANEOUS SOLN $6,895.79 67457-220-05 ISOSULFAN BLUE 1 % SUBCUTANEOUS SOLN $6,895.79 HC27000744 ERCP W/LITHOTRIPSY $6,884.00 HC47200258 INTERSTITIAL RADIATION, COMPLEX $6,884.00 61953-0005-2 IMM GLOB G (IGG)-SORB-IGA 0-50 10 % IV SOLN $6,882.20 61953-0005-5 IMM GLOB G (IGG)-SORB-IGA 0-50 10 % IV SOLN $6,882.20 0944-2716-05 IMMUN GLOB G(IGG)-GLY-IGA OV50 5 GRAM/50 ML (10 %) SUBCUTANEOUS SOLN $6,873.75 HC45401346 MRA SPINE W/O CONTRAST $6,869.00 HC62202791 EMBOLIC PROTECT SYSTEM CAROTID $6,861.00 49452-7680-2 TETRACAINE HCL (BULK) MISC POWD $6,857.50 HC46502852 NEUROENDOSCOPY PLACE CATH/DRAIN INTRACRANIAL $6,855.00 HC45400835 MRI CARDIAC MORPH W/O CONT $6,854.00 HC46502563 BONE MARROW DX; BIOPSY(IES) & ASPIRATION(S) $6,853.00 HC46502589 BONE MARROW DX; BIOPSY(IES) & ASPIRATION(S) LT $6,853.00 HC46502571 BONE MARROW DX; BIOPSY(IES) & ASPIRATION(S) RT $6,853.00 HC82204496 BONE MARROW DX; BX(S) & ASP(S) LT $6,853.00 HC82204488 BONE MARROW DX; BX(S) & ASP(S) RT $6,853.00 55513-880-02 ROMOSOZUMAB-AQQG 210MG/2.34ML ( 105MG/1.17MLX2) SUBCUTANEOUS SYRG $6,851.36 HC44700011 BUNDLE OF HIS RECORDING $6,848.00 HC47201074 BRACHYTX ISODOSE W/DOSIMETRY;CMPLX $6,843.00 60505-6197-2 SIROLIMUS 1 MG/ML ORAL SOLN $6,842.16 69238-1594-3 SIROLIMUS 1 MG/ML ORAL SOLN $6,842.16 69238-1594-6 SIROLIMUS 1 MG/ML ORAL SOLN $6,842.16 HC23001993 ABLATE RF NERVE SACROILIAC JT INNRV W/IMAGE $6,836.00 HC23002017 ABLATE RF NERVE SACROILIAC JT INNRV W/IMAGE LT $6,836.00 HC23002025 ABLATE RF NERVE SACROILIAC JT INNRV W/IMAGE RT $6,836.00 HC44700524 INTRA-ATRIAL RECORDING $6,831.00 HC62210695 DEVICE CLOSURE NEUROVASCULAR $6,825.00 50419-423-01 LEVONORGESTREL 21 MCG/24 HOURS (8 YRS) 52 MG INTRAUTERINE IUD $6,820.06 HC21000724 DBRD SKN MUSL/BON EA ADD20CM/< $6,819.00 HC45400074 MR BRAIN W/O CONTRAST $6,804.00 HC25003625 REMOVE FB UPPER ARM/ELBOW DEEP-BIL $6,804.00 HC45400041 MR BONE MARROW BLOOD SUPPLY $6,792.00 HC62808795 CATH INDIGO THROMB L140CM[PENUMBRA] $6,790.00 HC25000209 INSERT/REPLAC TEMP PACER; SNGL $6,786.00 HC46502977 BX SOFT TISS UPPER ARM/ELBOW DEEP LT $6,776.00 HC46502969 BX SOFT TISS UPPER ARM/ELBOW DEEP RT $6,776.00 HC73000184 DIALYSIS URGENT/NON-ROUTINE ESRD (OP) $6,774.00 HC23000318 EPIDUROLYSIS PROCEDURE $6,772.00 17156-251-08 PENTETATE INDIUM DISOD. 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NONSELCT PULM ARTRL ANGIO+ $5,821.00 0944-3052-02 ADVATE 500 (+/-) UNIT IV SOLR $5,817.50 0944-3052-03 ADVATE 500 (+/-) UNIT IV SOLR $5,817.50 HC36000123 CPAP/BIPAP DAILY MGMT $5,810.00 HC46503090 BX SOFT TISS FOREARM&/WRIST DEEP LT $5,808.00 HC46503082 BX SOFT TISS FOREARM&/WRIST DEEP RT $5,808.00 58468-0160-1 ALGLUCOSIDASE ALFA 50 MG IV SOLR $5,796.38 66220-160-10 CONIVAPTAN IN 5 % DEXTROSE 20 MG/100 ML IV SOLN $5,793.45 HC25001157 PLCMNT CENTRAL VEN CATH<5 YR $5,789.00 HC25003591 REMOVE FB UPPER ARM/ELBOW SQ-BIL $5,781.00 HC45400744 MRA PELVIS W/ CONTRAST $5,778.00 HC46502845 PUNCTURE SPINAL TX CSF WITH FLUORO/CT[NOT W/MRI OR US] $5,777.00 HC44000560 DISKOGRAPHY-CERVICAL/THORACIC $5,772.00 63833-615-02 HUMATE-P 250-600 UNIT IV SOLR $5,772.00 HC44504405 REMOVE CATH DRN BIL PERC(CHOLANG,S&I) $5,769.00 HC25005703 AMPUTATE FINGER/THUMB SGL W/CLOSURE $5,755.00 HC46502225 PERC PLC BRST LOC DEV SG 1ST LESN $5,747.00 HC44501476 PORTOGRAM W/O HEMODYNAMIC EVAL $5,742.00 5985700310 HUMAN REGENERATIVE TISSUE MTRX 1.5 X 2 CM TOPICAL SHEE $5,720.00 HC23000938 INJ PARAVERT SYMPATH NERVE $5,714.00 HC27000082 ANOSCOPY W/HOT BIOPSY $5,713.00 HC44900447 CT ORBIT/SELLA/EAR W/ CONTRAST $5,713.00 HC23001126 REMOVE EPIDURAL/INTRATH CATH $5,711.00 HC44703387 PLACMNT EXTNSN PROTH ILIAC ART/PROX RENAL EV PER VESSEL TX+ $5,709.00 HC42000786 ECHO 2D RX STRESS; CONT EKG $5,704.00 HC27000892 ESOPH GASTROESOPH REFLUX PH STDY-LONG $5,695.00 HC62802780 BEAD DC MICROSPHERE PER VIAL $5,688.00 HC46503124 BX SOFT TISS SHOULDER DEEP LT $5,687.00 HC46503116 BX SOFT TISS SHOULDER DEEP RT $5,687.00 50419-422-01 LEVONORGESTREL 14 MCG/24 HRS (3 YRS) 13.5 MG INTRAUTERINE IUD $5,678.86 HC21000799 APPY SKIN SUB T,A,L 1ST 100SQ~HC $5,656.00 HC27001536 ESOPHSCPY W/LES(S) REMOV HOT BX ~FO $5,656.00 HC42000505 TEE COMPLETE $5,656.00 HC47200159 HYPERTHERMIA PROBE 1-5 APPS $5,651.00 0781-3154-01 FERUMOXYTOL 510 MG/17 ML (30 MG/ML) IV SOLN $5,649.42 HC23001654 INJ ANES/STEROID INTERCOSTAL ADDL EA LT $5,642.00 HC23001647 INJ ANES/STEROID INTERCOSTAL ADDL EA RT $5,642.00 HC44504231 XRAY TEVAR; PLCMT OF DISTAL EXTS PROTH(S) DELAYED S&I $5,631.00 HC44504223 XRAY TEVAR; PLCMT PROX EXT PROTH S&I $5,631.00 HC27001957 ESOPHAGUS BALLOON DISTENTION PROVOC STUDY $5,629.00 HC44900488 CT PELVIS W/O CONTRAST $5,618.00 HC25001116 INSERT PICC >5 YR AGE W/O IMAGING $5,611.00 HC74200478 OR TIME ADD'L 15MIN LVL 6 (MCAL 2ND SUBSQNT 0.5 HR) $5,611.00 HC74200114 OR TIME ADD'L 15MIN LVL 6 (MCAL 1ST SUBSQNT 0.5 HR) $5,611.00 HC44701472 INJ PRO CATH; SUPRAVALVULAR AORTAGRPY+ $5,610.00 HC23001241 DESTR C/T FAC JOINT +LVL W/IMG-L $5,609.00 HC23001258 DESTR C/T FAC JOINT +LVL W/IMG-R $5,609.00 HC23000425 INJ ANES/STEROID NERVE SCIATIC BIL $5,609.00 HC46502274 PERC PLC BRST LOC DEV MR ADDL LESN+ $5,603.00 HC62800305 CATH EP DX <20 ELECTRODES Y $5,600.00 HC62805577 CATH EP/ABLATION COOL-TIP I $5,600.00 HC62211461 CATH GUID NEURO/PERIPH(DI058X115/NAVIEN)W $5,600.00 HC62214796 CATH PTA ANGIOPLS BALLOON NON-LSR Y $5,600.00 HC62806260 CATH PTA W/BALLOON RX(DCB) F $5,600.00 HC62805114 CATH PTCA BALLOON NON-LASER X $5,600.00 HC62806591 COIL EMBOLIZ(HELIX BARE SUPER SFT)AI $5,600.00 HC62807045 COIL NEUROVASCULAR(TARGET SOFT) AC $5,600.00 HC62805635 DEVICE ABLAT COOL-TIP NONVASC I $5,600.00 HC62228077 MOLD/FORM CEMENT SPACER FEMORAL $5,600.00 HC62803929 STENT CORO BARE METAL W/DEL I $5,600.00 HC62803812 STENT DES CORO COV W/DEL SYS M $5,600.00 HC62807458 STENT NON-COAT/NON-COV W-DEL AC $5,600.00 HC44701456 INJ PRO HRT CATH &IMG; LT VENT / ATRIUM+ $5,599.00 70720-950-36 GOSERELIN 3.6 MG SUBCUTANEOUS IMPL $5,597.74 58394-013-01 XYNTHA 500 (+/-) UNIT IV SOLN $5,590.00 HC44504454 SCLEROTX FLUID (CYST) PERC(IMAG,S&I) $5,587.00 HC27001064 REPOSIT GASTRO FEED TUBE(PEG) $5,586.00 15054-0500-1 ABOBOTULINUMTOXINA 500 UNIT IM SOLR $5,583.50 HC41500521 CENTRAL MOTOR EVOK UP& LWR LIMBS $5,578.00 HC26000026 EXTERNAL CEPHALIC VERSION W/WO TOCOLYSIS (BREECH) $5,574.00 HC46503306 BIOPSY MUSCLE DEEP LT $5,566.00 HC46503298 BIOPSY MUSCLE DEEP RT $5,566.00 HC27000652 ENTEROSCOPY W/HOT BIOPSY $5,565.00 HC46502613 INSERT MIDLINE CATH >3 YR AGE $5,553.00 HC45401288 MRA ABDOMEN W/O CONT $5,548.00 HC23001639 INJ ANES/STEROID BRACHIAL PLEXUS BI $5,544.00 HC44900215 CT HEAD W/CONTRAST $5,537.00 HC46000857 SEL CATH SEGMNT PULM ART BILAT $5,528.00 HC91600029 R&B REHABILITATION $5,510.00 HC41000001 SLEEP STUDY - MSLT/MWT $5,510.00 HC46502209 PERC PLC BRST LOC DEV MAMMO 1ST LESN $5,509.00 HC44900579 CT UPPER EXT W/CONTRAST LT $5,507.00 HC44900587 CT UPPER EXT W/CONTRAST RT $5,507.00 HC45401031 MR BREAST W/O CONTRAST LT $5,505.00 HC45401023 MR BREAST W/O CONTRAST RT $5,505.00 HC44503704 DEST SUPERIOR HYPOGASTR PLEXUS $5,502.00 63459-103-10 RITUXIMAB-ABBS 10 MG/ML IV SOLN $5,496.08 HC44900082 CT CHEST DX HI RESOLUTION W/O CNTRST $5,496.00 0023-5858-01 LEVONORGESTREL 20.4 MCG/24 HRS (8 YRS) 52 MG INTRAUTERINE IUD $5,493.15 59762-0935-3 VORICONAZOLE 200 MG/5 ML ORAL SUSR (MCH) $5,487.79 HC45201225 MIBI PLANAR SNG STUDY W/WM &EF $5,483.00 HC45401437 MRA UPPER EXT W/O&W/CONT LT $5,475.00 HC45401403 MRA UPPER EXT W/O&W/CONT RT $5,475.00 44206-454-04 IMMUN GLOB G(IGG)-PRO-IGA 0-50 4 GRAM/20 ML (20 %) SUBCUTANEOUS SOLN $5,468.84 HC25001074 INSERT CT(OPEN) W/DRAIN SYSTEM BIL $5,465.00 HC44701464 INJ PRO HRT CATH &IMG; SELCT RT VENT / ATRIUM+ $5,448.00 HC27001833 EGD W/EUS ESOPH->DUOD/SURG ALT STOMCH JEJUN ~FO $5,444.00 HC27001882 CHEMODENERVATION ANAL MUSCLE $5,443.00 44206-436-05 IMMUN GLOB G(IGG)-PRO-IGA 0-50 10 % IV SOLN $5,442.78 44206-436-90 IMMUN GLOB G(IGG)-PRO-IGA 0-50 10 % IV SOLN $5,442.78 HC44900272 CT LOW EXT W/CONTRAST LT $5,432.00 HC44900280 CT LOW EXT W/CONTRAST RT $5,432.00 10122-620-01 CANGRELOR 50 MG IV SOLR $5,418.64 10122-620-10 CANGRELOR 50 MG IV SOLR $5,418.64 HC45401189 MRA LOW EXT W/CONT LT $5,418.00 HC45401171 MRA LOW EXT W/CONT RT $5,418.00 HC46501789 THORACENTESIS ASP W/O IMAG GUIDE $5,418.00 59572-405-00 LENALIDOMIDE 5 MG ORAL CAP $5,415.96 HC27001916 CHANGE GT TUBE W/REV TRACT W/O IMAGE/ENDO INCL REMVL $5,412.00 HC44500882 INJ ART OCCLUS AVM SPINAL $5,407.00 HC27001544 ESOPHSCPY W/OPTICAL ENDOMICRO ~FO $5,395.00 HC44500460 AORTOGRAM ABDOMINAL LTD $5,392.00 HC44700615 IVUS/OCT CORONARY VES/GRFT EA ADL+ $5,388.00 HC44900124 CT CHEST DX W/O CONTRAST $5,381.00 HC44900025 CT ABDOMEN W/O CONTRAST $5,376.00 HC45400769 MRA PELVIS W/O CONTRAST $5,376.00 HC44900363 CT MAXILLO FACIAL W&W/O CONT $5,368.00 70860-203-50 PEMETREXED DISODIUM 500 MG IV SOLR $5,362.50 HC21000831 APPY SKIN SUB HED/HND/FT 1ST100SQ~HC $5,362.00 HC44000578 DISKOGRAPHY-LUMBAR $5,351.00 HC46501524 REPOSITION CV CATH UNDER FLUORO $5,345.00 55566-2300-0 DESMOPRESSIN 4 MCG/ML INJ SOLN $5,339.82 HC62806195 FILTER VENA CAVA (E.G.CELECT) I $5,338.00 HC27001007 HEMORRHOIDECTOMY/BANDING $5,335.00 58406-010-01 ETANERCEPT 25 MG/0.5 ML (0.5) SUBCUTANEOUS SYRG $5,332.99 58406-055-01 ETANERCEPT 25 MG/0.5 ML SUBCUTANEOUS SOLN $5,332.99 58406-010-04 ETANERCEPT 25 MG/0.5 ML (0.5) SUBCUTANEOUS SYRG $5,332.96 58406-055-04 ETANERCEPT 25 MG/0.5 ML SUBCUTANEOUS SOLN $5,332.96 HC74200353 BEDSIDE/OTHER SURGICAL CANCEL LVL 6 $5,331.00 HC46501383 REMVL INTRALUMIN OBST VEN DEV $5,328.00 HC42000513 TEE CONGENITAL COMPLETE $5,324.00 HC62806484 CATH BRACHY TX SEED ADMIN C $5,320.00 HC62800321 CATH EP DX 20+ ELECTRODES J $5,320.00 HC43000827 INCISION BREAST LESION-LT $5,303.00 HC43000819 INCISION BREAST LESION-RT $5,303.00 HC45200995 NM TUMOR LOCALIZE SPECT SNGL AREA 1 DAY $5,297.00 50474-001-48 LEVETIRACETAM 100 MG/ML ORAL SOLN $5,291.22 HC74200189 BEDSIDE/OTHER SURG INITIAL HR 1 (MCAL 1ST HOUR) $5,288.00 HC46501185 MANOMETRIC STDY VIA NEPHRO BI $5,285.00 HC62802137 STENT PV BARE METAL W/O DEL SYS $5,285.00 HC23001746 ASP/INJ JOINT SM W/UTZ GUIDE-BILAT $5,282.00 HC46500716 CIRCUMCISION PROCEDURE $5,274.00 HC36000891 BRONCH THERAPEUTIC INIT (PER DOS) $5,272.00 HC36800092 BRONCH THERAPEUTIC INIT (PER DOS) $5,271.00 HC27001817 EGD W/EUS FNA/BX ESOPH/STOMCH/DUOD~FO $5,271.00 HC47200084 BRACHYTX INSERT HEYMAN CAPSULE $5,260.00 0002-7640-01 PEMETREXED DISODIUM 100 MG IV SOLR $5,255.90 HC62806351 CATH EP/ABLAT NOT COOL-TIP/3D/V MAP AA $5,250.00 HC62805692 CATH GUIDING NEURO(DI058X125) V $5,250.00 HC62806252 CATH PTA W/BALLOON RX(DCB) E $5,250.00 HC62214788 CATH PTCA BALLOON NON-LASER W $5,250.00 HC62806583 COIL EMBOLIZ(AXIUM HELIX BARE) AH $5,250.00 HC62805627 DEVICE ABLAT COOL-TIP NONVASC H $5,250.00 HC62226238 DRILL/DRILL BITS SINGLE USE AR $5,250.00 HC62219332 EMBOLIZATN PROTECT SYSTEM(EZ) L $5,250.00 HC62229018 INTRODUCER/SHEATH AF $5,250.00 HC62219423 KIT MONITORING NERVE(S) SPINAL K $5,250.00 HC62216262 STABILIZER HEART OCTOPUS L $5,250.00 HC62803937 STENT DES CORO COV W/DEL SYS L $5,250.00 HC62807151 STENT NON-COAT/NON-COV W-DEL AB $5,250.00 HC62806682 STENT URETERAL ENDOPYELOTOMY AB $5,250.00 HC46501235 PERITONEAL LAVAGE W-W/O IMAG GUIDE $5,248.00 58394-634-03 BENEFIX 500 UNIT IV SOLR $5,232.50 HC44703403 PLACMNT DELAY DISTL/PRX EXTSN INFRARENL AA ILIAC:ADD'L VSSL+ $5,228.00 HC27001585 ESOPHSCPY W/INJ SUBMUCOSAL ~FO $5,227.00 HC36800100 BRONCH THERAPEUTIC SUBSEQ (PER DOS) $5,223.00 HC36000909 BRONCH THERAPEUTIC SUBSEQ (PER DOS) $5,223.00 HC46500864 EXCHANGE EXISTING DRAIN CATH $5,218.00 HC47201041 TELETX ISODOSE W/DOSIMETRY;COMPLEX $5,218.00 HC46000964 SEL VENOUS CATH 1ST ORD BI $5,211.00 0591-2579-20 VALGANCICLOVIR 50 MG/ML ORAL SOLR $5,201.77 27241-159-19 VALGANCICLOVIR 50 MG/ML ORAL SOLR $5,201.77 13533-636-05 HEPATITIS B IMMUNE GLOBULIN 220 UNIT/ML (5 ML) IM SOLN $5,201.50 13533-636-50 HEPATITIS B IMMUNE GLOBULIN 220 UNIT/ML (5 ML) IM SOLN $5,201.50 HC44700250 INDUCTION OF ARRHYTHMIA $5,198.00 HC21000450 GRAFTING SNGL/MULT UP TO 2CM $5,182.00 50242-060-01 BEVACIZUMAB 25 MG/ML CHEMO INTRAVITREAL SOLN $5,180.11 HC44502649 REPOSIT NASO/ORO GFT THRU DUOD $5,174.00 HC44504702 ENDOVENOUS ABLAT MECHANOCHEM WS&I; ADDL VEIN+ $5,163.00 HC27001403 EGD W/ABLAT TUMR/POLYP/LESN(DIL&GIDEWR)~FO $5,150.00 HC44900223 CT HEAD W/O CONTRAST $5,146.00 HC47200902 PLCMNT INTERSTIT DEV THORACIC $5,146.00 HC44900413 CT NECK SOFT TISSUE W/ CONT $5,138.00 HC46502696 FNA ASP BX W/MR; FIRST LESION $5,137.00 HC44900454 CT ORBIT/SELLA/EAR W/O CONTRAS $5,126.00 HC46501409 REPAIR CV ACCESS CATH $5,126.00 0078-0110-22 CYCLOSPORINE 100 MG/ML ORAL SOLN (MCH) $5,117.78 HC23001951 DESTR NERVE GENICULAR W/NEUROLYT AGNT W/IMAGE $5,113.00 HC23001977 DESTR NERVE GENICULAR W/NEUROLYT AGNT W/IMAGE LT $5,113.00 HC23001985 DESTR NERVE GENICULAR W/NEUROLYT AGNT W/IMAGE RT $5,113.00 HC23001175 INJ S-I JOINT ANESTH W/IMAG LT $5,110.00 HC23001183 INJ S-I JOINT ANESTH W/IMAG RT $5,110.00 HC42000760 TEE MONITORING COMPLT W/WO CONTR $5,109.00 HC27001387 ESOPHSCPY W/DILAT ESOPH RETROGR ~FO $5,099.00 HC46502837 LUMBAR PUNCTR DX WITH FLUORO/CT [NOT W/MRI OR US] $5,097.00 HC46000014 INJ AIR/CONTRAST PERITONEAL CAVITY $5,091.00 HC44200665 AMNIOCENTESIS $5,089.00 HC46503157 BX SOFT TISS UPPER ARM/ELBOW SUP LT $5,082.00 HC46503140 BX SOFT TISS UPPER ARM/ELBOW SUP RT $5,082.00 HC44700177 ENDOMYOCARDIAL BIOPSY $5,080.00 HC44900603 CT UPPER EXT W/O CONTRAST LT $5,072.00 HC44900611 CT UPPER EXT W/O CONTRAST RT $5,072.00 HC62290432 WOUND FILLER DRY COLLAGEN (VENTRIS MED) AF $5,061.00 HC23000771 INJ FORAMN EPI LMBR ADDLWS&I+L $5,058.00 HC23000789 INJ FORAMN EPI LMBR ADDLWS&I+R $5,058.00 0944-2700-04 IMMUN GLOB G(IGG)-GLY-IGA OV50 10 % INJ SOLN $5,045.30 0944-2700-10 IMMUN GLOB G(IGG)-GLY-IGA OV50 10 % INJ SOLN $5,045.30 HC26000000 AMNIOCENTESIS DIAGNOSTIC $5,040.00 HC62227707 KIT CASS KNEE 2 POD IASSIST $5,040.00 HC45200987 NM TUMOR LOCALIZE PLNR WHOLE BODY 1 DAY $5,040.00 HC42000240 ECHO 2D STRESS TRDMLW/EKG W/CON $5,039.00 43598-283-35 DOXORUBICIN, PEG-LIPOSOMAL 2 MG/ML IV SUSP $5,037.50 43598-682-35 DOXORUBICIN, PEG-LIPOSOMAL 2 MG/ML IV SUSP $5,037.50 HC41500877 EEG W/VIDEO MONITOR INTERMT EA 12-26HR $5,032.00 55513-025-01 DARBEPOETIN ALFA IN POLYSORBAT 100 MCG/0.5 ML INJ SYRG $5,031.00 55513-025-04 DARBEPOETIN ALFA IN POLYSORBAT 100 MCG/0.5 ML INJ SYRG $5,031.00 HC47200977 TREATMENT DEVICES MLC FOR IMRT $5,018.00 HC25000597 EMERGENCY DELIVERY VAGINAL $5,016.00 HC45401411 MRA UPPER EXT W/CONT LT $5,010.00 HC45401387 MRA UPPER EXT W/CONT RT $5,010.00 HC91500125 R&B HOSPICE $5,009.00 HC27001056 INJ SCLEROTHERAPY HEMORRHOIDS $5,006.00 HC74200122 OR TIME INIT'L HR CASE CX LEVEL 1 (MCAL 1ST HOUR) $5,004.00 44087-0044-3 INTERFERON BETA-1A (ALBUMIN) 44 MCG/0.5 ML SUBCUTANEOUS SYRG $4,998.87 44087-0044-9 INTERFERON BETA-1A (ALBUMIN) 44 MCG/0.5 ML SUBCUTANEOUS SYRG $4,998.87 HC23001811 ASP/INJ JOINT LRG W/UTZ GUIDE-LT $4,998.00 HC23001829 ASP/INJ JOINT LRG W/UTZ GUIDE-RT $4,998.00 HC27000546 ENDO SM INTST POUCH(KOCK)DX INCL COLLECT $4,992.00 HC43000066 BREAST BX CORE W/O GUIDE-BI $4,989.00 HC41000019 SLEEP STUDY ATTENDED $4,985.00 HC44900942 CT HEART CONGEN EVAL /3D IMAGE $4,976.00 HC27001445 EGD W/EUS ESOPH/STOMCH/DUOD ~FO $4,976.00 HC41500513 SOMATOSENSORY UPPER& LWR LIMBS $4,974.00 HC62211073 CATHETER ENDOVENT PULMONARY $4,970.00 HC74200346 BEDSIDE/OTHER SURGICAL CANCEL LVL 5 $4,964.00 HC44900306 CT LOW EXT W/O CONTRAST LT $4,962.00 HC44900314 CT LOW EXT W/O CONTRAST RT $4,962.00 HC46503181 BX SOFT TISS LEG/ANKLE SUP LT $4,961.00 HC46503173 BX SOFT TISS LEG/ANKLE SUP RT $4,961.00 HC82202532 BONE MARROW DX; BX(S) ONLY $4,954.00 HC82200825 BONE MARROW DX; BX(S) ONLY LT $4,954.00 HC82200817 BONE MARROW DX; BX(S) ONLY RT $4,954.00 55566-8402-0 DEGARELIX 120 MG SUBCUTANEOUS SOLR $4,953.59 55566-8403-1 DEGARELIX 120 MG SUBCUTANEOUS SOLR $4,953.59 HC23000094 ASP/INJ JOINT LRG W/O UTZ GUIDE-BILAT $4,946.00 HC42000752 TEE CONGENITAL COMPLT W/WO CONTR $4,942.00 HC23000904 INJ ANES/STEROID NERVE/BRNCH PERIPH BIL $4,939.00 HC74200460 OR TIME ADD'L 15MIN LVL 5 (MCAL 2ND SUBSQNT 0.5 HR) $4,936.00 HC74200106 OR TIME ADD'L 15MIN LVL 5 (MCAL 1ST SUBSQNT 0.5 HR) $4,936.00 HC46501334 PUNC SHUNT/RES FOR ASP/INJ $4,935.00 HC44700235 ESOPHAGEAL RECORDING W/PACING $4,929.00 HC27000488 EGD W/PEG PLACEMENT ~FO $4,928.00 HC23000714 INJ FORAMN EPI C/T ADD+ W/S&I-L $4,923.00 HC23000722 INJ FORAMN EPI C/T ADD+ W/S&I-R $4,923.00 HC45401544 MRI FETAL INCL PLACENTA PLVC IF PRF; SINGLE 1ST GESTATION $4,916.00 HC44901106 CT BREAST 3D RENDER UNILAT W&W/O CONTRAST $4,912.00 HC62804042 FILTER VENA CAVA H $4,909.00 HC46501987 BONE MARROW DX; BIOPSY(SIES) ONLY $4,906.00 HC46501995 BONE MARROW DX; BIOPSY(SIES) ONLY LT $4,906.00 HC46502001 BONE MARROW DX; BIOPSY(SIES) ONLY RT $4,906.00 HC44900371 CT MAXILLO FACIAL W/ CONTRAST $4,902.00 0527-5160-82 MYCOPHENOLATE MOFETIL 200 MG/ML ORAL SUSR $4,901.52 HC62210646 CATH BALLOON NEURO(SCEPTER) B $4,900.00 HC62806708 CATH EP DIAG/ABLAT 3D/VECT N $4,900.00 HC62800347 CATH EP/ABLATION COOL-TIP G $4,900.00 HC62227657 CATH INTRACARDIAC ECHO/UTZ RPRSD F $4,900.00 HC62806237 CATH PTA W/BALLOON RX(DCB) D $4,900.00 HC62214770 CATH PTCA BALLOON NON-LASER V $4,900.00 HC62225628 CATH TRANSLUM ANGIO LASER K $4,900.00 HC62806575 COIL EMBOLIZATION AG $4,900.00 HC62802913 COIL NEUROVASC(HELIX/ULTRA HELICAL)AA $4,900.00 HC27000884 ESOPH MOTILTY/MANO STDY/I&R;2D $4,900.00 HC62226352 PROGRAMMER NEUROSTIM PAT H $4,900.00 HC62219001 RETRACTOR MIS SPINAL K $4,900.00 HC62228358 SET SHEATH DILATOR (TRUSEAL WATCHMAN) $4,900.00 HC62228721 SLEEP REMOTE(INSPIRE®) $4,900.00 HC62803911 STENT CORO BARE METAL W/DEL H $4,900.00 HC62806526 STENT NON-COAT/NON-COV W-DEL AA $4,900.00 HC27001502 ESOPHSCPY W/BAND VARICES ~FO $4,898.00 HC46000824 SEL CATH PULMONARY ART BILAT $4,898.00 0006-4305-01 INFLIXIMAB-ABDA 100 MG IV SOLR $4,897.04 0006-4305-02 INFLIXIMAB-ABDA 100 MG IV SOLR $4,897.04 78206-162-01 INFLIXIMAB-ABDA 100 MG IV SOLR $4,897.04 HC46502241 PERC PLC BRST LOC DEV US 1ST LESN $4,890.00 HC44900165 CT GUIDANCE NEEDLE PLACEMENT $4,889.00 HC27001825 EGD W/EUS FNA/BX ESOPH->DUOD/SURG ALT STOMCH JEJUN~FO $4,886.00 0143-9565-01 THIOTEPA 15 MG INJ SOLR $4,875.00 HC27001742 COLONOSCOPY FLEX W/PLACE STENT $4,870.00 HC47201025 MOTION RESPIRATORY MGNT SIMULATION+ $4,870.00 HC27000421 EGD W/CONTOL BLEED ~FO $4,865.00 HC45201290 HEPATOBIL SYS IMAGW/RX(&QUANT) $4,863.00 HC25000043 ED LEVEL V - COMPREHENSIVE $4,849.00 HC23001100 INJ/INF NEUROLYTIC LUMB/SACRAL $4,846.00 HC44504470 IVUS VESSEL ADD'L NONCORON W/EXAM++ $4,843.00 HC46503215 BX SOFT TISS SHOULDER SUP LT $4,840.00 HC46503207 BX SOFT TISS SHOULDER SUP RT $4,840.00 63459-390-08 BENDAMUSTINE 25 MG IV SOLR $4,829.18 23155-216-31 CIDOFOVIR 75 MG/ML IV SOLN $4,810.00 HC44701019 REMOVE CARDIAC RHYTHM MONITOR SQ $4,803.00 HC27000405 EGD W/BANDING ESOPH/GASTRIC ~FO $4,797.00 HC62204227 KIT ROTALINK $4,797.00 HC44900926 CT COLONOGRAPHY DX VIRTUAL W/ CONTRAST $4,794.00 HC62209101 CT ELECTRODE SPRSLIM 2.0 CM EA $4,791.00 HC27000447 EGD W/DILATION GASTRIC OUTLET ~FO $4,790.00 HC46501177 PUNCTURE SPINAL TX DRAIN CSF [NOT W/FLUORO/CT] $4,780.00 0078-0683-61 NELARABINE 250 MG/50 ML IV SOLN $4,779.78 HC23001605 INJ CERVICAL PLEXUS BLOCK BIL $4,776.00 HC44901007 CT ABD & PELVIS W/O CONST LTD $4,775.00 HC46501169 LUMBAR PUNCTURE DX [NOT W/ CT OR FLUORO ] $4,775.00 HC44703494 PERICARDIAL DRAIN 0-5YR W/ANOMOLY INCL FLUORO &/US $4,774.00 HC25000183 FB REMOVAL SQ COMPLEX $4,765.00 HC42000232 ECHO 2D STRESS PHARMOCOLOGIC $4,762.00 10019-956-01 CYCLOPHOSPHAMIDE 1 GRAM IV SOLR $4,761.25 10019-956-16 CYCLOPHOSPHAMIDE 1 GRAM IV SOLR $4,761.25 50742-520-05 CYCLOPHOSPHAMIDE 200 MG/ML IV SOLN $4,761.25 70860-218-05 CYCLOPHOSPHAMIDE 200 MG/ML IV SOLN $4,761.25 52652-9001-1 TOPIRAMATE 25 MG/ML ORAL SOLN $4,753.18 HC46502175 PERC BX BREAST W/LOC DEV US ADDL LESN+ $4,747.00 HC27001460 ESOPHSCPY W/BALLN DIL=30MM (W-FLUOR) ~FO $4,743.00 HC36800001 BRONCHOSCOPY THRU ESTAB TRACH $4,742.00 HC36000818 BRONCHOSCOPY THRU ESTAB TRACH $4,742.00 HC25004243 I&D ABSCESS/BURSA/HEMATOMA THIGH/KNEE DEEP LT $4,738.00 HC25004250 I&D ABSCESS/BURSA/HEMATOMA THIGH/KNEE DEEP RT $4,738.00 HC27000397 EGD W/BALLOON DILATION <30MM ~FO $4,736.00 66733-948-23 CETUXIMAB 100 MG/50 ML IV SOLN $4,735.25 HC23001787 ASP/INJ JOINT MED W/UTZ GUIDE-LT $4,735.00 HC23001795 ASP/INJ JOINT MED W/UTZ GUIDE-RT $4,735.00 HC44502615 REMOVAL PLEURAL CATH W/CUFF LT $4,730.00 HC44502607 REMOVAL PLEURAL CATH W/CUFF RT $4,730.00 HC27000454 EGD W/FOREIGN BODY(S) REMOVAL ~FO $4,729.00 HC62212287 FORCEP BIOPSY URETEROSCOP DISP $4,725.00 HC42000521 TEE MONITORING COMPLETE $4,723.00 HC46503249 BX SOFT TISS FOREARM&/WRIST SUP LT $4,719.00 HC46503231 BX SOFT TISS FOREARM&/WRIST SUP RT $4,719.00 52536-600-11 BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSP $4,719.00 52652-6001-1 BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSP $4,719.00 16714-900-01 ATOVAQUONE 750 MG/5 ML ORAL SUSP $4,717.44 HC47201009 DELIV TX ELCTRN INTRAOP SNGL SESS $4,713.00 HC45400157 MR GUIDANCE ABLATION PARENCHYMAL TISSUE $4,707.00 HC27000009 ANORECTAL MANOMETRY $4,704.00 HC44501807 REMOVE NEPHROSTOMY TUBE LT $4,701.00 HC44501815 REMOVE NEPHROSTOMY TUBE RT $4,701.00 HC46503371 PERC BX BREAST W/LOC DEV MR 1ST LESN DC'D PROC $4,700.00 HC62228622 KIT ROTAPRO $4,699.00 HC45200037 NM ADRENAL IMAGING $4,699.00 HC27001809 ESOPHSCPY W/EUS FNA/BX ~FO $4,697.00 HC73000226 PERITONITIS TREATMENT $4,697.00 HC25001058 ASP BLADDER W/INSERT SUPRAPUB $4,694.00 HC44900421 CT NECK SOFT TISSUE W/O CONT $4,689.00 HC27001551 ESOPHSCPY W/DIL OVER GUIDEWIRE ~FO $4,688.00 HC46502670 FNA ASP BX W/CT; FIRST LESION $4,686.00 HC47200993 DELIV TX XRAY INTRAOP SNGL SESSION $4,681.00 HC42000257 ECHO 2D STRESS TREADMILL $4,679.00 HC42000083 ECHO CONGENITAL COMPLETE $4,679.00 0024-0654-01 ISATUXIMAB-IRFC 20 MG/ML IV SOLN $4,660.89 0069-0238-01 RITUXIMAB-PVVR 10 MG/ML IV SOLN $4,659.20 HC27001080 SIGMOIDOSCOPY FLEX BLEED CONT $4,656.00 HC21000344 DBRD SKIN MUSCL UP TO 20 SQCM $4,651.00 HC45400140 MR GUIDANCE NEEDLE PLACEMENT S&I $4,634.00 0781-4003-32 LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS SOLN (MCH) $4,633.20 66302-206-03 TREPROSTINIL 1.74 MG/2.9 ML (0.6 MG/ML) INHALATION NEBU $4,626.51 52817-815-08 AMINOCAPROIC ACID 25 % ORAL SYRP (MCH) $4,624.58 HC62216809 BALLOON VERTEBRAL $4,620.00 HC44900181 CT GUIDANCE ABLATION PARENCHYMAL TISSUE $4,620.00 HC45401429 MRA UPPER EXT W/O CONT LT $4,618.00 HC45401395 MRA UPPER EXT W/O CONT RT $4,618.00 HC47201066 BRACHYTX ISODOSE W/DOSIMETRY;INTRM $4,615.00 HC27001718 SIGMOIDOSCOPY FLEX W/RESECT MUCOSL $4,614.00 HC42000810 TEE GUIDE TRANSCATH INTVNTN INCL US $4,614.00 69800-4203-1 HEPATITIS B IMMUNE GLOBULIN GREATER THAN 1,560 UNIT/5 ML IM SOLN $4,611.88 69800-4203-2 HEPATITIS B IMMUNE GLOBULIN GREATER THAN 1,560 UNIT/5 ML IM SOLN $4,611.88 HC62210257 OXYGENATOR ECMO $4,610.00 HC25002874 DEBRIDE/REMOVL OPEN FX&/DISLOC SQ T/M/BONE $4,607.00 HC25004276 REMOVE FB DEEP THIGH/KNEE AREA LT $4,607.00 HC25004284 REMOVE FB DEEP THIGH/KNEE AREA RT $4,607.00 HC51002681 REPAIR FISTULA ANAL W/PLUG $4,603.00 HC21000989 APPY SKIN SUB HEAD/HND/FT 1ST25SQ~LC $4,602.00 HC46502217 PERC PLC BRST LOC DEV MAMMO ADDL LESN+ $4,602.00 HC43000140 MAMMO DUCTO/GALACTO INJ-BI $4,600.00 HC46503272 BX SOFT TISSUE BACK SUP LT $4,598.00 HC46503264 BX SOFT TISSUE BACK SUP RT $4,598.00 HC74200338 BEDSIDE/OTHER SURGICAL CANCEL LVL 4 $4,593.00 HC62205083 OFF PUMP SUCTION SYS-STABILZER $4,593.00 99988-000-30 NM TC-99M EXAMETAZIME LABELED WBC PER STUDY (CERETEC) $4,592.00 HC82200320 BONE MARROW DX; ASP(S) ONLY $4,591.00 HC82200809 BONE MARROW DX; ASP(S) ONLY LT $4,591.00 HC82200791 BONE MARROW DX; ASP(S) ONLY RT $4,591.00 47335-936-40 LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS SOLN (MCH) $4,586.86 HC44901098 CT BREAST 3D RENDER BILAT W/CONTRAST $4,583.00 HC46501797 INSERT CT(OPEN) W/DRAIN SYSTEM $4,582.00 HC27000439 EGD W/DIL OVER GUIDEWIRE ~FO $4,579.00 HC27000041 ANOSCOPY W/BIOPSY $4,576.00 HC27001734 COLONOSCOPY FLEX ABLAT TUMR/POLYP/LESN GUIDEWIRE $4,573.00 HC51002665 REMOVE HEMORRHOID INT&EXT GROUPS 2+ $4,573.00 HC41500844 EEG W/VIDEO MONITOR INTERMT 2-12 HR $4,567.00 HC27001379 EGD W/RESECT SUBMUCOSAL ~FO $4,562.00 HC27000496 EGD W/SCLEROTHERAPY ~FO $4,562.00 HC47200696 TREATMENT SIMULATION COMPLEX $4,559.00 HC62215744 BLADE SHAVER AH $4,550.00 HC62210638 CATH GUIDING REPERFUS(MARKSMAN) T $4,550.00 HC62214762 CATH PTCA BALLOON NON-LASER U $4,550.00 HC62214465 CHARGER BATTERY NEUROSTIM A $4,550.00 HC62807219 COIL NEUROVASCULAR AD $4,550.00 HC62805619 DEVICE ABLAT COOL-TIP NONVASC F $4,550.00 HC62219324 EMBOLIZATION PROTECTIVE SYSTEM J $4,550.00 HC62208665 FIBER LASER - GREEN LIGHT T $4,550.00 HC23000649 INJ ANES/STEROID NERVE FEMORAL BIL $4,550.00 HC62218540 KIT MONITORING NERVE(S) SPINAL J $4,550.00 HC62228085 MOLD/FORM CEMENT STEM HIP $4,550.00 HC62806914 STENT EXTENDER ENDOGRAFT AAA J $4,550.00 HC46500120 BONE MARROW DX; ASPIRATION(S) ONLY $4,545.00 HC46501961 BONE MARROW DX; ASPIRATION(S) ONLY LT $4,545.00 HC46501979 BONE MARROW DX; ASPIRATION(S) ONLY RT $4,545.00 HC45201258 PULM VENTILATION & PERF IMAG $4,538.00 HC84201409 IADNA-DNA/RNA PROBE TQ 12-25 GI PCR $4,537.00 55513-206-01 BEVACIZUMAB-AWWB 25 MG/ML IV SOLN $4,535.26 99999-038-65 EPIFIX SKIN GRAFT ( 4X4.5 CM ) $4,533.75 HC27000298 COLONOSCOPY W/DILATION/BALLOON $4,532.00 HC46501045 INSERT CT(OPEN) W/DRAIN SYSTEM LT $4,526.00 HC46501052 INSERT CT(OPEN) W/DRAIN SYSTEM RT $4,526.00 HC41500703 EEG PHARMACOLOGICAL/PHYSICAL ACTIVATION $4,525.00 HC27001569 ESOPHSCPY W/BALLOON DILATION <30MM ~FO $4,525.00 HC27001494 ESOPHSCPY W/TUMR/LES REMOV W/SNARE ~FO $4,522.00 HC44700227 ESOPHAG REC ATRIAL ELECTROGRAM $4,510.00 HC27001841 SIGMOIDOSCOPY FLEX W/EUS&FNA/BX $4,507.00 HC23000821 INJ ANES/STEROID NERVE INTERCOSTAL SINGL $4,498.00 HC62203807 KIT CRANIOPLASTIC RESIN $4,494.00 HC62807805 M: SPACER HUMERAL SHOULDER $4,489.00 HC42000935 CTA CORO FFR ANLYSIS FLUID DYNAMICS&HYPEREMIA MAX SIM W/DATA MODEL $4,486.00 HC42000703 ECHO CONGENITAL CMPLT W/ORWO FOL CONTR $4,483.00 HC62805940 CATH EP DX <20 ELECTRODES U $4,480.00 HC62214580 KIT SPINAL ACCESS DISPOSBL(MAXCESS) $4,480.00 HC74200452 OR TIME ADD'L 15MIN LVL 4 (MCAL 2ND SUBSQNT 0.5 HR) $4,480.00 HC74200098 OR TIME ADD'L 15MIN LVL 4 (MCAL 1ST SUBSQNT 0.5 HR) $4,480.00 HC21000500 I&D POLINIDAL CYST: COMPLICATE $4,463.00 HC46500625 CHANGE CYSTOSTOMY; COMPLICATED $4,461.00 HC47200225 INTRACAVITARY TREATMT COMPLEX $4,461.00 HC27000470 EGD W/INJ SUBMUCOSAL ~FO $4,460.00 HC27000066 ANOSCOPY W/DILATION $4,458.00 HC41500851 EEG W/VIDEO MONITOR CONT 2-12 HR $4,458.00 HC36800324 TEST EXERC CARIOPULM INCL VENT,CO2,O2,EKG $4,456.00 HC23001928 INJ ANES/STEROID NERVE GENICULAR IMAGE GUIDE BI $4,453.00 HC45200094 NM BONE SCAN 3 PHASE $4,450.00 HC45201340 NM PARATHYRD SCN W/SPECT & CT $4,448.00 HC21000948 APPY SKIN SUB T,A,L 1ST 25SQ~LC $4,447.00 HC27001700 SIGMOIDOSCOPY FLEX W/PLACE STENT $4,446.00 HC27001429 EGD W/DIL BALLN =30MM (FLUORO) ~FO $4,445.00 99999-041-47 NM TC-99M EXAMETAZIME (CERETEC) MHS $4,444.30 13533-800-20 IMMUNE GLOBUL G-GLY-IGA AVG 46 5 GRAM/50 ML (10 %) INJ SOLN $4,444.05 13533-800-21 IMMUNE GLOBUL G-GLY-IGA AVG 46 5 GRAM/50 ML (10 %) INJ SOLN $4,444.05 61958-0403-1 TENOFOVIR DISOPROXIL FUMARATE 40 MG/SCOOP (40 MG/GRAM) ORAL POWD $4,442.49 0009-5136-01 LINEZOLID 100 MG/5 ML ORAL SUSR (MCH) $4,432.35 HC46001244 INJECTION SINUS TRACT; THERAPEUTIC $4,427.00 13533-318-01 RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML IM SOLN $4,423.25 13533-318-10 RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML IM SOLN $4,423.25 HC27001486 ESOPHSCPY W/CONTROL BLEED ~FO $4,416.00 HC27001510 ESOPHSCPY W/FRN BDY(S)REMOVAL ~FO $4,415.00 47335-049-40 DOXORUBICIN, PEG-LIPOSOMAL 2 MG/ML IV SUSP $4,408.95 70710-1530-1 DOXORUBICIN, PEG-LIPOSOMAL 2 MG/ML IV SUSP $4,408.95 0074-1040-08 BERACTANT IN 0.9 %SOD.CHLORIDE 25 MG/ML INTRATRACH SUSP $4,406.22 HC25005638 DRAIN EXTERNAL EAR LESION COMPLEX BIL $4,400.00 HC25003120 LAC REPAIR INTMD S/A/T/EXT >30.0CM $4,400.00 HC25005927 PARACENTESIS EYE W/REMOVAL AQUEOUS BIL $4,400.00 HC45200532 NM LYMPH GLAND/NODES IMAGING $4,391.00 HC21000971 APPY SKIN SUB T,A,L EA+ 100SQ~LC $4,390.00 HC27001767 COLONOSCOPY FLEX W/DECOMP&PLACE TUBE $4,388.00 HC45200839 NM THYROID CA METS BODY SCAN $4,384.00 HC62801030 FILTER VENA CAVA (E.G.GUNTHER) G $4,383.00 55150-338-01 LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS SOLN (MCH) $4,381.00 55150-478-01 LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS SOLN (MCH) $4,381.00 71288-167-50 PEMETREXED DISODIUM 500 MG IV SOLR $4,379.90 HC62220322 ORTHOTIC TLSO 4MOD SACRO-SCAP PRE $4,379.00 HC45200433 NM KIDNEY FLW/FUNC MULTI STUDY $4,377.00 99988-000-01 NM TC-99M EXAMETAZIME 1-30 MCI (CERETEC) $4,376.51 HC23001696 INJ ANES/STEROID ILIOINGNL/ILIOHYPOGAS BI $4,376.00 HC62808233 M: BEARING TIBIAL $4,375.00 0054-0319-50 LINEZOLID 100 MG/5 ML ORAL SUSR (MCH) $4,367.03 HC45200219 NM CARDIAC BP IMAG GATED MULTI $4,367.00 HC46500609 BX THYROID NEEDLE CORE $4,361.00 HC62228689 PROBE ABLATION CRYO A $4,361.00 HC27001874 SIGMOIDOSCOPY FLEX W/EUS $4,360.00 HC47200142 HYPERTHERMIA EXTERNAL DEEP $4,358.00 HC27001627 COLONOSCOPY STOMA W/PLCMNT STENT $4,354.00 HC27000280 COLONOSCOPY W/BLEED CONTROL $4,352.00 HC25004367 I&D ABSCESS/HEMATOMA LEG/ANKLE DEEP LT $4,349.00 HC25004375 I&D ABSCESS/HEMATOMA LEG/ANKLE DEEP RT $4,349.00 HC27000306 COLONOSCOPY W/FB(S) REMOVAL $4,344.00 HC44504504 PERC PLCMT TISS SOFT DEV 1ST LESN $4,335.00 HC45201365 NM GASTRIC EMPTY SML BWL&COLON>1DAY $4,334.00 HC23000060 ASP/INJ JOINT MED W/O UTZ GUIDE-BILAT $4,330.00 HC45201274 QUANT DIFF PULM PERF& VENT $4,320.00 HC62219548 PROBE LITHOTRIPTOR ELECTRHYDRLC Y $4,319.00 HC27001692 SIGMOIDSCPY FL W/ABLAT LESN(S)GUIDEWIRE $4,319.00 HC27001395 ESOPHSCPY W/RESECT MUCOSAL ~FO $4,316.00 HC44901080 CT BREAST 3D RENDER BILAT W/O CONTRAST $4,314.00 HC27001635 COLONOSCOPY STOMA W/RESECT MUCOSL $4,313.00 HC27001759 COLONOSCOPY FLEX W/RESECTN MUCOSL $4,312.00 0338-0063-01 DOXORUBICIN, PEG-LIPOSOMAL 2 MG/ML IV SUSP $4,309.50 HC84201631 DNA/RNA MENINGITIS/ENCEPHALITIS PCR $4,307.00 HC27000090 ANOSCOPY W/SNARE SINGLE REMVL $4,306.00 HC46000261 INJ DISKOGRAM LUMBAR EA LVL $4,304.00 67457-177-50 DIMETHYL SULFOXIDE 50 % INTRAVESICAL SOLN $4,302.35 24338-136-10 ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL SUSR $4,300.40 HC62221189 BLANKET/PAD TEMP MNGMNT SYSTEM/BOX $4,300.00 HC45401130 MR BREASTS W/O&W CONTRST LTD (BILAT) $4,297.00 70710-1726-1 NELARABINE 250 MG/50 ML IV SOLN $4,296.50 70710-1726-8 NELARABINE 250 MG/50 ML IV SOLN $4,296.50 HC27001726 SIGMOIDOSCOPY FLEX W/LIGATION BAND $4,296.00 HC46502159 PERC BX BREAST W/LOC DEV SG ADDL LESN+ $4,286.00 HC27000900 ESOPHAGEAL REFLUX W/NASAL ELEC $4,285.00 HC27000272 COLONOSCOPY W/BIOPSY $4,283.00 HC45200193 NM CARDIAC BP 1ST PASS(EF)MULT $4,282.00 HC44900389 CT MAXILLO FACIAL W/O CONTRAST $4,268.00 HC44703874 INJ PRO HRT CATH &IMAG; SELCT PULM ARTRL ANGIO UNILAT+ $4,268.00 HC62223359 DEVICE SUTURE ENDO R $4,267.00 HC46501227 PARACENTESIS ABD W/O IMAGING GUIDE $4,267.00 HC46501508 REPLC PICC LINE W/O SQ PORT/PUMP &W/O IMAGING $4,260.00 HC27001148 SIGMOIDSCPY FLEX W/DILAT 1+/>STRICT $4,256.00 HC46503330 BIOPSY MUSCLE SUPERFICIAL LT $4,235.00 HC46503322 BIOPSY MUSCLE SUPERFICIAL RT $4,235.00 HC46502951 INSERTION DEVICE INTRAUTERINE IUD $4,235.00 HC38420337 ASSEMBLY & OPER PUMP OXYGEN; EA HR $4,235.00 HC44500395 ANGIO THRU EXISTING CATH $4,229.00 HC47200894 STEREOTACTIC BODY RAD THER $4,229.00 68516-4612-1 ALPHANATE 500 (200 VWF) UNIT/5 ML IV SOLR $4,225.00 HC21001011 APPY SKIN SUB HED/HND/FT EA+100SQ~LC $4,219.00 HC27000215 COLONOSCOPY STOMA W/BLEED CONT $4,218.00 HC27001866 COLONOSCOPY FLEX W/EUS $4,208.00 HC45200276 NM CISTERNOGRAM $4,206.00 HC45200110 NM BONE SCAN WHOLE BODY $4,203.00 HC62803689 CATH ABLAT TISS(E.G.HALO 60/90) E $4,200.00 HC62800131 CATH ABLAT VASC NON CARDIAC $4,200.00 HC62211768 CATH BALLOON PTA S $4,200.00 HC62211669 CATH DRAINAGE Y $4,200.00 HC62804687 CATH EP DIAG/MAPPING<20 ELECT L $4,200.00 HC62216270 CATH EP/ABLAT NOT COOL-TIP/3D/V MAP Y $4,200.00 HC62224837 CATH GUIDE REPERFUS(DAC/FLOWGATE) S $4,200.00 HC62208798 CATH INTRACARDIAC ECHO/UTZ C $4,200.00 HC62800404 CATH INTRACARDIAC ECHO/UTZ RPRSD E $4,200.00 HC62214754 CATH PTCA BALLOON NON-LASER T $4,200.00 HC62224779 CATH THROMBECTOMY/EMBOLECTOMY V $4,200.00 HC62218623 DEVICE RETRIEVAL I $4,200.00 HC62227152 DRILL/DRILL BITS SINGLE USE AO $4,200.00 HC62806856 HEMOSTATIC GEL/GELFOAM/PAD Y $4,200.00 HC62806013 INTRO/SHEATH STEERABLE NON-PEEL I $4,200.00 HC62217492 KIT CONCENTRATOR PLATELETS X $4,200.00 HC62215454 KIT DECOMPRESSION SPINAL D $4,200.00 HC62218532 KIT MONITORING NERVE(S) SPINAL I $4,200.00 HC62219449 KIT SPINAL ACCESS DISPOSBL F $4,200.00 HC62807680 M: STEM INTERPHALANGEAL $4,200.00 HC62222096 OXYGENATOR PEDIATRIC I $4,200.00 HC62204607 RECHARGER BATTERY NRST RPLCMNT $4,200.00 HC62218995 RETRACTOR MIS SPINAL I $4,200.00 HC62210943 SET CPS CIRCUIT PERFUSION $4,200.00 HC62803903 STENT CORO BARE METAL W/DEL G $4,200.00 HC62804620 STENT DES CORO COV W/DEL SYS I $4,200.00 99988-000-35 NM TC-99M SUCCIMER (DMSA) $4,200.00 HC45201332 NM PARATHYRD SCN W/SPECT W-W/O SUBTR $4,196.00 HC23001084 INJ/INF NEUROLYTIC AGNT SUBARACH $4,193.00 HC27000173 COLONOSCOPY DX (INCL COLLECTION) $4,190.00 HC44703486 PERICARDIAL DRAIN 6+YR W/O ANOMOLY INCL FLUORO &/US $4,186.00 HC45200417 NM KIDNEY IMAG FLOW/FUNCTION $4,185.00 HC23001886 INJ ANES/STEROID NERVE SI JOINT INNRV W/IMAGE BI $4,183.00 HC62210794 KIT INTRAOP PERFUSION (SPY) $4,183.00 HC51003341 CONIZATION CERVIX LOOP ELECTRD $4,179.00 HC51002913 CYSTOURETHRSCPY&/PYELOSCPY W/BX&/FULG $4,179.00 HC51003119 DESTROY LESION(S) VULVA EXTENSIVE $4,179.00 HC27000462 EGD W/TUMR/LES REMOV HOT BX~FO $4,179.00 HC27001619 COLONOSCOPY STOMA W/ABLAT LESN GUIDEWIRE $4,170.00 HC23000458 INJ ANES/STEROID NERVE SUPRASCAP BI $4,168.00 58914-301-80 NITROGLYCERIN 0.4 % (W/W) RECTAL OINT $4,164.81 57894-502-05 DARATUMUMAB 20 MG/ML IV SOLN $4,161.24 0591-1159-30 ACYCLOVIR 5 % TOPICAL OINT $4,159.94 HC44700029 CARDIOVERSION INTERNAL $4,159.00 HC45200342 NM GASTROINTESTINAL BLOOD LOSS $4,156.00 HC44700797 PERICARDIOCENTESIS INCL IMAGING $4,153.00 HC25000324 THORACOTOMY $4,144.00 HC27000330 COLONOSCOPY W/SNARE TECH $4,134.00 0023-1145-01 ONABOTULINUMTOXINA 100 UNIT INJ SOLR $4,121.00 HC62228580 STAPLER INTERNAL EEA $4,119.00 HC27000355 EGD COMPLETE DX W/ BRUSH/SPEC ~FO $4,113.00 HC23001415 INJ CER/THR F/IMAGE 3RD+&LVLBI $4,109.00 HC44900934 CT HEART EVAL W/ 3D IMAGE $4,108.00 HC27000538 EGD W/TUMR/LES REMOV W/SNARE~FO $4,108.00 0143-9279-01 MITOMYCIN 20 MG IV SOLR $4,108.00 16729-108-11 MITOMYCIN 20 MG IV SOLR $4,107.87 16729-247-11 MITOMYCIN 20 MG IV SOLR $4,107.87 67457-519-20 MITOMYCIN 20 MG IV SOLR $4,107.87 71288-138-50 MITOMYCIN 20 MG IV SOLR $4,107.87 HC27001973 DESTRUCT INTRNL HEMORRHOID THERM ENERGY $4,104.00 HC27001858 COLONOSCOPY FLEX W/EUS FNA/BX $4,103.00 HC45200136 NM BRAIN IMAG MIN'4 STATC W/VF $4,096.00 HC27000249 COLONOSCOPY STOMA W/SNARE TECH $4,093.00 63261-250-21 ISOSULFAN BLUE 1 % SUBCUTANEOUS SOLN $4,088.50 HC25003872 CLOSED TX RAD/EPHYSL SEP&ULN FX W/MAN LT $4,088.00 HC25003880 CLOSED TX RAD/EPHYSL SEP&ULN FX W/MAN RT $4,088.00 HC27000413 EGD W/BIOPSY(S) ~FO $4,085.00 HC27001528 ESOPHSCPY W/INJ SCLERO VARICES ~FO $4,085.00 HC84201292 RESP VIRUS 12-25 TRGTS(RVP PNL) $4,077.00 HC46500898 FIX G/COLON TUBE W/ DEVICE W/FLUORO $4,075.00 HC62808779 CATH INDIGO THROMB 3.4&5FR[PENUMBRA] $4,071.00 HC23001753 ASP/INJ JOINT SM W/UTZ GUIDE-LT $4,060.00 HC23001761 ASP/INJ JOINT SM W/UTZ GUIDE-RT $4,060.00 HC62804406 COIL EMBOLIZ(AXIUM PRIME 3D 3MM) AD $4,060.00 HC27001577 ESOPHSCPY W/BIOPSY(S) ~FO $4,053.00 99999-038-64 EPIFIX SKIN GRAFT ( 3X3.5 CM ) $4,046.25 HC45200300 NM GASTRIC EMPTYING $4,046.00 HC25004482 CLOSED TX BIMALLEOLA ANKLE FX; W/MANIP LT $4,037.00 HC25004490 CLOSED TX BIMALLEOLA ANKLE FX; W/MANIP RT $4,037.00 HC21000542 PREP SITE TRUNK/EXT<100SQCM $4,032.00 HC27000512 EGD W/TRANSENDO TUBE/CATH PLC ~FO $4,031.00 HC27000322 COLONOSCOPY W/INJ SUBMUCOSAL $4,028.00 HC91200134 R&B NEWBORN CARE $4,027.00 HC62804471 KIT KYPHOPLASTY BALLOON AUGMENTATN $4,025.00 HC41000076 POLYSMN CPAP/BIPAP6&>ATTD REDCD SVC $4,025.00 HC27001155 SIGMOIDOSCOPY FLEX W/FB(S) REMOV $4,023.00 HC27001908 INSTILL FECAL MICROBIOTA (FMT) $4,021.00 42799-217-01 OPIUM TINCTURE 10 MG/ML (MORPHINE) ORAL TINC $4,014.48 HC44503712 INJ SCLEROTHERAPY LYMPHOCELE $4,012.00 HC25004391 CLOSED TX TIBIAL SHAFT FX W/MANIP W/W-O FIBFX/TRAC LT $4,009.00 HC25004409 CLOSED TX TIBIAL SHAFT FX W/MANIP W/W-O FIBFX/TRAC RT $4,009.00 HC25003633 REMOVE FB UPPER ARM/ELBOW DEEP LT $4,009.00 HC25003641 REMOVE FB UPPER ARM/ELBOW DEEP RT $4,009.00 HC46502654 FNA ASP BX W/FLUORO; FIRST LESION $4,008.00 HC27001775 COLONOSCOPY FLEX W/LIGATION BAND $3,996.00 HC41500828 EEG W/O VID MONITOR CONT EA 12-26HR $3,993.00 HC27001171 SIGMOIDOSCOPY FLEX W/SNARE $3,993.00 HC46001319 INJ ANTEGRAD NEPH/URET'GRM,S&I EXIST ACCESS LT $3,991.00 HC46001327 INJ ANTEGRAD NEPH/URET'GRM,S&I EXIST ACCESS RT $3,991.00 HC25004425 CLOSED TX MEDIAL MALLEO(ANKLE)FX W/MANIP W/W-O TRAC LT $3,990.00 HC25004433 CLOSED TX MEDIAL MALLEO(ANKLE)FX W/MANIP W/W-O TRAC RT $3,990.00 HC27001676 COLONOSCOPY STOMA W/EUS FNA/BX COLON $3,990.00 HC62209176 DEVICE ABLATION GYN KIT $3,989.00 0069-0315-01 BEVACIZUMAB-BVZR 25 MG/ML IV SOLN $3,987.10 HC27000207 COLONOSCOPY STOMA W/BIOPSY $3,986.00 HC89019988 FHL2 PRF1 GENE MUTATION-CN $3,984.00 HC44504017 ANGIO IL/FEM DURING HRTCATH&/CORO W/S&I $3,980.00 HC27000231 COLONOSCOPY STOMA W/HOT BIOPSY $3,979.00 13533-634-02 TETANUS IMMUNE GLOBULIN (PF) 250 UNIT/ML IM SYRG $3,977.35 HC51061034 CONVERT NEPH CATH->NEPH'URET PERC(NEPH/URET'GRM,S&I)EXST BI $3,976.00 HC51061067 EXCHANGE TUBE NEPHRO(NEPH/URET'GRM,S&I) BI $3,976.00 70510-2171-1 EDARAVONE 30 MG/100 ML IV SOLN $3,974.75 70510-2171-2 EDARAVONE 30 MG/100 ML IV SOLN $3,974.75 HC44001642 MYELOGRAM ENTIRE SPINE CANAL $3,971.00 50242-214-01 OMALIZUMAB 75 MG/0.5 ML SUBCUTANEOUS SYRG $3,968.71 HC51002673 REPAIR FISTULA ANAL W/GLUE $3,968.00 62756-352-40 OCTREOTIDE ACETATE 1,000 MCG/ML INJ SOLN $3,964.68 HC47201157 HDR ELECTRONIC BRACHYTHERAPY INTERSTIT/INTRACAV $3,963.00 HC44900835 CT COLONOGRAPHY DX VIRTUAL W/O CONTRAST $3,962.00 HC74200320 BEDSIDE/OTHER SURGICAL CANCEL LVL 3 $3,961.00 HC25005711 AMPUTATE FINGER/THUMB SGL W/CLOSURE LT $3,950.00 HC25005729 AMPUTATE FINGER/THUMB SGL W/CLOSURE RT $3,950.00 HC27000074 ANOSCOPY W/FB REMOVAL $3,950.00 10454-711-10 RIMABOTULINUMTOXINB 5,000 UNIT/ML IM SOLN $3,948.36 HC62804034 FILTER VENA CAVA (E.G. ALN) F $3,941.00 6299115862 ARGININE HCL(L-ARGININE)(BULK) 100 % MISC POWD $3,935.75 HC45201282 HEPATOBILIARY SYSTEM IMAGING $3,933.00 HC81701781 GENOTYPE DNA/RNA HEPATITIS C $3,929.00 HC27001650 COLONOSCOPY STOMA W/DILATN BALLOON $3,924.00 HC41000092 POLYSMNGRPH 4+STG<6Y/O ATTD RDC SVC $3,923.00 0078-0669-13 OFATUMUMAB 100 MG/5 ML IV SOLN $3,921.91 HC62805098 CATH EP DX 20+ ELECTRODES E $3,920.00 HC62804398 COIL EMBOLIZATION AC $3,920.00 HC62216502 KIT SPINAL ACCESS DISPOSBL E $3,920.00 HC46503355 PERC BX BREAST W/LOC DEV SG 1ST LESN DC'D PROC $3,919.00 HC27001668 COLONOSCOPY STOMA W/EXAM US COLON $3,914.00 HC25002742 INSERT PICC <5 YR AGE W/ IMAGING $3,914.00 HC44500908 INJ PERC EXT PSEUDOANEUR BILAT $3,910.00 HC27000314 COLONOSCOPY W/HOT BIOPSY $3,908.00 HC21000336 DEBRID SKIN&SUBQ UP TO 20 SQCM $3,902.00 0944-2884-01 GLASSIA 1 GRAM/50 ML (2 %) IV SOLN $3,900.00 14789-015-05 ISOPROTERENOL HCL 0.2 MG/ML INJ SOLN $3,900.00 14789-015-07 ISOPROTERENOL HCL 0.2 MG/ML INJ SOLN $3,900.00 14789-900-02 PROCAINAMIDE 500 MG/ML INJ SOLN $3,900.00 14789-900-07 PROCAINAMIDE 500 MG/ML INJ SOLN $3,900.00 14789-901-07 PROCAINAMIDE 100 MG/ML INJ SOLN $3,900.00 14789-901-10 PROCAINAMIDE 100 MG/ML INJ SOLN $3,900.00 55111-556-10 DECITABINE 50 MG IV SOLR $3,900.00 HC46502258 PERC PLC BRST LOC DEV US ADDL LESN+ $3,890.00 10019-991-01 BORTEZOMIB 3.5 MG INJ SOLR $3,887.00 HC23000953 INJ ANES/STEROID NERVE PUDENDAL LT $3,885.00 HC23000961 INJ ANES/STEROID NERVE PUDENDAL RT $3,885.00 HC45200425 NM KIDNEY IMAG FLW/FUNC W/PHAR $3,885.00 HC62229208 VACUUM DRAIN TUBE KIT(JADA) $3,884.00 HC46502704 FNA ASP BX W/MR; EACH ADD'L LESION $3,883.00 HC44703502 PERICARDIAL DRAIN W/CATH & CT GUIDANCE $3,877.00 HC12800082 TRANSFUSION BLOOD &/OR COMPNTS $3,876.00 HC45200540 NM MECKEL'S/BOWEL IMAGING $3,872.00 0703-5054-01 DESMOPRESSIN 4 MCG/ML INJ SOLN $3,868.80 69918-901-10 DESMOPRESSIN 4 MCG/ML INJ SOLN $3,868.80 HC25002908 DEBRIDE SKIN MUSL/BONE; FIRST 20SQCM OR LESS $3,865.00 62756-529-40 DESMOPRESSIN 4 MCG/ML INJ SOLN $3,862.30 63323-637-03 ARSENIC TRIOXIDE 1 MG/ML IV SOLN $3,861.00 63323-637-10 ARSENIC TRIOXIDE 1 MG/ML IV SOLN $3,861.00 HC74200445 OR TIME ADD'L 15MIN LVL 3 (MCAL 2ND SUBSQNT 0.5 HR) $3,860.00 HC74200080 OR TIME ADD'L 15MIN LVL 3 (MCAL 1ST SUBSQNT 0.5 HR) $3,860.00 51991-942-98 DEXRAZOXANE HCL 500 MG IV SOLR $3,850.54 HC62805593 CATH ANGIO/GUID NEURO/PERIPH(DAC44)R $3,850.00 HC62806278 CATH EP/ABLAT NOT COOL-TIP/3D/V MAP X $3,850.00 HC62224829 CATH GUIDNG(PX400/SILICONE/STRYKER BLLN)R $3,850.00 HC62219274 DEVICE RETRIEVAL H $3,850.00 HC62800586 DEVICE THROMBECTOMY/EMBOLECTOMY X $3,850.00 HC62219316 EMBOLIZATN PROTECT SYSTEM(SPIDER) H $3,850.00 HC62219365 GUIDEWIRE AE $3,850.00 HC62802384 INTRO/SHEATH EP FIXED PEEL AN $3,850.00 HC62219795 KIT PERFUSION D $3,850.00 HC62219829 PROGRAMMER NEUROSTIM PAT H $3,850.00 HC62803754 STENT NON-COAT/NON-COV W-DEL X $3,850.00 HC62200688 TAMP BONE KYPHOPLASTY J $3,850.00 HC62226659 TAP SURGICAL X $3,850.00 HC46501920 ADJUST GASTRIC BAND VIA PORT $3,839.00 52652-4001-1 ENALAPRIL MALEATE 1 MG/ML ORAL SOLN $3,837.60 HC45401114 MR BREASTS W/O CONTRAST LTD (BILAT) $3,836.00 HC25003534 CLOSED TX HUMRL FX W/MAN W/WO SKLTL TRAC-BIL $3,828.00 HC51003291 COLPOSCPY CERV W/CONIZ LOOP ELECTRD $3,825.00 HC45200029 CSF FLOW W/ VENTRICULOGRAPHY $3,825.00 HC51003176 DESTROY LESION(S) VAGINAL EXTENSIVE $3,825.00 HC47200217 INTRACAVITARY TREATMT INTERMED $3,822.00 HC46502233 PERC PLC BRST LOC DEV SG ADDL LESN+ $3,813.00 HC25001173 THORACENTESIS ASP W/O IMG GUID-BIL $3,813.00 HC73000267 DIALYSIS CVVH (CONT VENOVENOUS) QD $3,810.00 63323-132-12 MITOXANTRONE 2 MG/ML IV CONC $3,807.57 HC27001163 SIGMOIDOSCOPY FLEX W/HOT BX $3,805.00 59572-102-01 AZACITIDINE 100 MG INJ SOLR $3,804.06 HC27001684 COLONOSCOPY STOMA W/DECOMP&PLACE TUBE $3,801.00 HC27000223 COLONOSCOPY STOMA W/FRN BDY(S)REMOV $3,798.00 HC25003922 CLOSED TX CARPAL BONE FX W/M EA BONE LT $3,797.00 HC25003930 CLOSED TX CARPAL BONE FX W/M EA BONE RT $3,797.00 HC44701175 TILT TABLE EVALUATION $3,785.00 HC44900496 CT PELVIS W/O CONTRAST LTD $3,784.00 HC62808753 CATH INDIGO THROMB SEPARATOR 6FR L175CM[PENUMBRA] $3,780.00 HC62804380 COIL EMBOLIZATION AB $3,780.00 HC25001207 THORACENTESIS W/TUBE W/O IMAG BI $3,777.00 HC25003906 CLOSED TX CARPAL SCAPHOID FX W/MAN LT $3,776.00 HC25003914 CLOSED TX CARPAL SCAPHOID FX W/MAN RT $3,776.00 49401-101-01 BELIMUMAB 120 MG IV SOLR $3,775.20 25021-461-10 DESMOPRESSIN 4 MCG/ML INJ SOLN $3,770.00 HC27000256 COLONOSCOPY THRU STOMA INCL COLLECTN $3,768.00 HC25005208 REPAIR LIP FULL THICK; OVER 1/2 VERTICAL HT/COMPLEX $3,768.00 HC44501203 MECH REMOV PERICATH OBSTR CEN VEN S&I ONLY $3,765.00 HC27001114 SIGMOIDOSCOPY FLEX INJ SUBMCSL $3,763.00 HC25004458 CLOSED TX PROX FIBULA/SHAFT FX; W/MANIP LT $3,761.00 HC25004466 CLOSED TX PROX FIBULA/SHAFT FX; W/MANIP RT $3,761.00 HC27001643 COLONOSCOPY STOMA W/INJ SUBMUCOSL $3,759.00 HC25003724 REMOVE FB FOREARM DEEP LT $3,758.00 HC25003732 REMOVE FB FOREARM DEEP RT $3,758.00 HC21000773 APPY SKIN SUB T,A,L 1ST 25SQ~HC $3,747.00 HC62802467 INTRODUCER KYPHOPLASTY OSTEO $3,745.00 HC51062990 DEBRIDE SKIN MUSL/BONE; FIRST 20SQCM $3,744.00 HC42000729 ECHO 2D CMPLT W/O SPC&DOP W/WO CONTR $3,743.00 HC25003815 CLOSED TX RAD&ULN SHAFT FX W/MAN LT $3,739.00 HC25003823 CLOSED TX RAD&ULN SHAFT FX W/MAN RT $3,739.00 HC45200904 THYROID METS IMAG W/ADD STUDIES $3,738.00 HC47200118 CT RAD THER PLANNING $3,735.00 HC25006198 DELIVERY OF PLACENTA $3,727.00 HC62800263 CATH CORONARY SINUS $3,724.00 HC62806948 KIT ANEURYSM ENCAPSULTNG NEUROVASC $3,717.00 0944-2510-02 IGG-HYALURONIDASE,RECOMBINANT 2.5 GRAM /25 ML (10 %) SUBCUTANEOUS SOLN $3,711.83 HC73000085 DIALYSIS CRRT W/SNGL EVAL(IP) $3,705.00 HC25000944 I&D PERIANAL ABSCESS $3,697.00 HC27001130 SIGMOIDOSCOPY FLEX W/BIOPSY $3,696.00 HC23001464 INJ L/S F W/IMAGE 2ND LVL LT $3,692.00 HC23001456 INJ L/S F W/IMAGE 2ND LVL RT $3,692.00 HC44900033 CT ABDOMEN W/O CONTRAST LTD $3,687.00 HC23000367 INJ ANES/STEROID NERVE AXILLARY BIL $3,686.00 HC45200284 NM CSF LEAKAGE IMAGING $3,685.00 HC45201035 NM VENOGRAM(THROMBOSIS)BILAT $3,685.00 HC25003757 CLOSED TX RADIAL SHAFT FX W/MANIP LT $3,684.00 HC25003765 CLOSED TX RADIAL SHAFT FX W/MANIP RT $3,684.00 HC46001111 INJ ARTHRO HIP W/ANESTH-SC BIL $3,684.00 HC21000815 APPY SKIN SUB HEAD/HND/FT 1ST25SQ~HC $3,682.00 HC46000998 SEL VENOUS CATH 2ND+ORDR LT $3,677.00 HC46001004 SEL VENOUS CATH 2ND+ORDR RT $3,677.00 HC12800090 TRANSFUSION EXCHANGE BLOOD NOT NEWBORN $3,675.00 HC27001098 SIGMOIDOSCOPY FL W/DECOMP&PLAC TUBE $3,674.00 HC25006180 BREECH VERSION EXTERNAL MANIP $3,673.00 3877900689 CITRIC ACID (BULK) MISC POWD $3,672.50 HC62217849 CLOSURE WND EXPANDER TISSUE B $3,672.00 HC45200128 NM BRAIN IMAG 430.0CM $3,519.00 HC42000133 ECHO 2D CMPLT W/O SPEC&CLR DOP $3,518.00 HC23001712 N BLOCK INJ PLANTAR DIGIT (MOTONS) BIL $3,518.00 HC51003085 VASECTOMY BILAT/UNILAT(SEP PROCEDURE) $3,514.00 13533-705-01 PROLASTIN-C 1,000 MG (+/-)/20 ML IV SOLN $3,510.00 13533-705-11 PROLASTIN-C 1,000 MG (+/-)/20 ML IV SOLN $3,510.00 70257-330-11 RHO(D) IMMUNE GLOBULIN-MALTOSE 1,500 UNIT (300 MCG)/1.3 ML INJ SOLN $3,508.90 70257-330-51 RHO(D) IMMUNE GLOBULIN-MALTOSE 1,500 UNIT (300 MCG)/1.3 ML INJ SOLN $3,508.90 HC32010373 OT-EVAL SWALLOW CINE/FLUORO 180MIN $3,508.00 HC33010240 ST-EVAL SWALLOW CINE/FLUORO 180MIN $3,508.00 59148-021-50 TOLVAPTAN 30 MG ORAL TAB $3,507.68 66220-315-22 TELAVANCIN 750 MG IV SOLR $3,505.30 66220-315-11 TELAVANCIN 750 MG IV SOLR $3,505.26 HC44901072 CT BREAST 3D RENDER UNILAT W&W/O CONTRAST $3,505.00 HC27002377 COLONOS' SCREEN NOT HI RISK (Q120MO) $3,501.00 HC62210620 CATH ANGIO(BNCHMRK/ECHELN/EXCELSR/DAC57/HEADWY)Q $3,500.00 HC62800339 CATH EP/ABLAT NOT COOL-TIP/3D/V MAP W $3,500.00 HC62201462 CATH INTRA AORTIC BALLOON D $3,500.00 HC62211842 CATH MICRO'P'VASC INJECT SOL/COIL P $3,500.00 HC62214747 CATH PTA ANGIOPLS BALLOON NON-LSR S $3,500.00 HC62805056 CATH PTCA BALLOON NON-LASER R $3,500.00 HC62209861 CATHETER MICRO CTO (CORSAIR) W $3,500.00 HC62804364 COIL EMBOLIZATION Z $3,500.00 HC62226121 DRILL/DRILL BITS SINGLE USE AM $3,500.00 HC62210380 EMBOLIC PROTECT SYSTEM; VASC G $3,500.00 HC62218508 ENDO STAPLER AQ $3,500.00 HC62225891 GUIDE DRILL W $3,500.00 HC62226261 KIT DILATOR SPINAL $3,500.00 HC62215462 KIT HARVESTING BONE GRAFT W $3,500.00 HC62220116 KIT MONITORING NERVE(S) SPINAL G $3,500.00 HC62205422 KIT PERFUSION C $3,500.00 HC62225487 KIT PROCESSING MARROW BONE $3,500.00 HC62808316 M: HIP FEM MODULAR COMPONENT ADAPTER $3,500.00 HC62807623 M: INSERT HIP $3,500.00 HC62806690 MARKER TISSUE 3D $3,500.00 HC62226584 PIN/WIRE FIXATION TEMPORARY AW $3,500.00 HC62806773 POUCH/ENVELOPE PACEMAKER G $3,500.00 HC62807938 SEALANT TISSUE HYDROGEL ET $3,500.00 HC62224167 SET SHEATH DILATOR $3,500.00 HC62804935 STENT BILIARY COVRD W/DELSYS C $3,500.00 HC62803895 STENT CORO BARE METAL W/DEL F $3,500.00 HC62808407 STENT DES CORO COV W/DEL SYS G $3,500.00 HC62220280 SYSTEM DELIVERY LEAD M $3,500.00 HC62223672 SYSTEM DETACHMENT COIL/PLUG (MVP) $3,500.00 HC44200145 US DUPLEX ART LOW EXT COMP BIL $3,500.00 HC21000567 PREP SITE/SCR F/N/HF/G<100SQCM $3,499.00 HC62228648 APPLIER CLIP CLOSURE ANASTOMOSIS $3,497.00 HC47201058 BRACHYTX ISODOSE W/DOSIMETRY; SIMPL $3,497.00 HC21000237 DEBRID/REMVL OPEN FX MUSCLE $3,497.00 HC27001239 COLONOS' SCREEN HI RISK (Q48MO) $3,496.00 HC62217880 SET PIN DISTRACTORS-COUNT 10 A $3,493.00 HC45200086 NM BONE SCAN MULTI AREA $3,492.00 HC45200185 NM CARDIAC BP 1ST PASS(EF)SNGL $3,492.00 HC45201043 NM VENOUS THROMBOSIS PEPTIDE $3,486.00 HC27000694 ERCP DIAGNOSTIC DC'D PROC $3,484.00 HC62804828 CLIP LEFT ATRIAL APPENDAGE-LAA A $3,483.00 HC62209432 KIT LOCATABLE GUIDE (LARGE) $3,483.00 HC62217260 PUNCH ATHROSCOPIC ROTARY $3,483.00 HC21000229 DEBRID/REMVL OPEN FX SKIN/SBQ $3,477.00 59676-320-00 EPOETIN ALFA 20,000 UNIT/ML INJ SOLN $3,474.25 59676-320-04 EPOETIN ALFA 20,000 UNIT/ML INJ SOLN $3,474.25 HC36000933 BRONCH W/LUNG BX; EA ADD'L+ $3,471.00 HC36800480 BRONCH W/LUNG BX; EACH ADD'L+ $3,471.00 HC25003369 REMOVE FB MUSCLE/TNDON SHEATH DEEP/COMP $3,459.00 HC62212527 INTRODUCER/SHEATH Y $3,457.00 55513-209-01 FILGRASTIM 480 MCG/0.8 ML INJ SYRG $3,454.30 55513-209-91 FILGRASTIM 480 MCG/0.8 ML INJ SYRG $3,454.30 HC41000126 POLYSMN CPAP/BIPAP<6 ATTD REDCD SVC $3,453.00 HC44700391 INSERT SWAN-GANZ CATHETER $3,450.00 0085-4331-01 POSACONAZOLE 300 MG/16.7 ML IV SOLN $3,447.87 0527-1948-70 LEVOFLOXACIN 25 MG/ML ORAL LIQUID $3,447.60 47335-178-40 OXALIPLATIN 100 MG IV SOLR $3,445.00 HC45200144 NM BRAIN IMAG MIN'4 STATIC VWS $3,444.00 61953-0005-4 IMM GLOB G (IGG)-SORB-IGA 0-50 10 % IV SOLN $3,441.10 HC45401551 MRI FETAL PLACENTAL PLVC IF PRF; EA ADDL+ $3,441.00 HC27001106 SIGMOIDOSCOPY FLEX DIAGNOSTIC $3,441.00 63323-659-03 INDOMETHACIN SODIUM 1 MG IV SOLR $3,438.11 HC45200979 NM TUMOR LOCALIZE PLNR 2+AREAS 1+DAYS//1AREA 2+ DAYS $3,437.00 0944-2715-25 IMMUN GLOB G(IGG)-GLY-IGA OV50 2.5 GRAM/25 ML (10 %) SUBCUTANEOUS SOLN $3,436.88 HC36800498 BRONCH W/NDL ASP BX(S) EA ADDL+ $3,436.00 HC36000842 BRONCH W/NDL ASP BX; EA ADD'L+ $3,436.00 0003-0852-22 DASATINIB 100 MG ORAL TAB $3,432.67 63323-648-10 LEVOTHYROXINE 500 MCG IV SOLR $3,431.42 HC46502043 BX SOFT TISS THIGH/KNEE;SUP LT $3,430.00 HC46502050 BX SOFT TISS THIGH/KNEE;SUP RT $3,430.00 HC46502688 FNA ASP BX W/CT; EACH ADD'L LESION $3,426.00 HC45200243 NM CARDIAC SCAN SPECT $3,422.00 HC62217310 DEVICE CHECK NEURO SURG SPINAL $3,420.00 HC41500133 EEG MONITORING 61-119MINUTES $3,416.00 HC47200589 SPECIAL TELETHERAPY PORT PLAN $3,411.00 HC44001030 HIP ARTHROGRAM BILAT $3,409.00 HC46000394 INJ PROCEDURE MYELOGRAPHY, LUMBAR $3,401.00 HC46500112 ASP/INJ THYROID CYST $3,399.00 0009-3794-01 IBUTILIDE FUMARATE 0.1 MG/ML IV SOLN $3,397.62 0009-3794-22 IBUTILIDE FUMARATE 0.1 MG/ML IV SOLN $3,397.62 HC25003427 CLOSED TX NOSE FX W/ STABILIZATION $3,396.00 67546-212-21 NITAZOXANIDE 100 MG/5 ML ORAL SUSR $3,393.00 HC41500117 EEG CEREBRAL SILENCE $3,387.00 HC45200524 PULM PERFUSION IMAGING $3,384.00 61958-2901-1 REMDESIVIR 100 MG IV SOLR $3,380.00 61958-2901-2 REMDESIVIR 100 MG IV SOLR $3,380.00 61958-2902-1 REMDESIVIR 100 MG/20 ML (5 MG/ML) IV SOLN $3,380.00 HC46501938 PERC ASP INTERDISCAL DX $3,374.00 HC47200720 US GUIDANCE RAD ELEMENT APP $3,373.00 HC41000043 POLYSOMNOGRAPHY 4+ STG 6&> REDCD SVC $3,365.00 HC62805932 CATH EP DX <20 ELECTRODES Q $3,360.00 HC62806179 CATH EP DX 20+ ELECTRODES C $3,360.00 HC62804356 COIL EMBOLIZATION Y $3,360.00 HC62225800 DEVICE SUTURING ENDOSCPC OVERSTITCH O $3,360.00 HC62807607 M: CLIP JOINT SMALL $3,360.00 50458-575-01 RIVAROXABAN 1 MG/ML ORAL SUSR $3,358.00 15054-0530-6 ABOBOTULINUMTOXINA 300 UNIT IM SOLR $3,350.75 HC41500794 EEG W/O VID MONITOR CONT 2-12HR $3,349.00 0078-0274-22 CYCLOSPORINE MODIFIED 100 MG/ML ORAL SOLN $3,348.80 HC62228853 TEMPLATE BRACHYTHERAPY Y $3,338.00 HC25003476 CLOSED TX CLAVICLE FX W/MANIP-BIL $3,336.00 HC21000559 PREP TRUNK/EXT EA ADDL 100SQCM $3,334.00 0074-3956-46 LOPINAVIR-RITONAVIR 400-100 MG/5 ML ORAL SOLN $3,328.00 HC62214457 SUTURE SET FOOT/ANKLE $3,325.00 HC74200312 BEDSIDE/OTHER SURGICAL CANCEL LVL 2 $3,322.00 HC62217831 CLOSURE WND EXPANDER TISSUE A $3,322.00 HC45200060 NM BONE MARROW WHOLE BODY $3,320.00 42023-182-01 ARGATROBAN 100 MG/ML IV SOLN $3,315.00 HC51002780 INJECT ENDOSCOPIC MATERIAL IMPLANT $3,314.00 HC44001956 SHOULDER ARTHROGRAM BILAT $3,309.00 10122-510-01 PORACTANT ALFA 120 MG/1.5 ML INTRATRACH SUSP $3,306.55 51525-0442-8 FELBAMATE 600 MG/5 ML ORAL SUSP $3,302.83 63323-562-10 BIVALIRUDIN 250 MG IV SOLR $3,302.00 HC45201357 NM GASTRIC EMPTYING SMALL BOWEL $3,301.00 HC44200319 US GUIDE COMP REPR PSEUDOANEUR $3,301.00 HC25002841 I&D HEMATOMA/SEROMA/FLUID COLLECTION $3,300.00 HC25005455 INJ ANES/STEROID NERVE/BRNCH PERIPH BIL $3,300.00 HC42000828 ECG EXT TELEM MCT>24HRS-30DAYS TECH ATTEND TIME;CONNECT&TRANS $3,296.00 HC79200044 SURGERY MINOR 1ST 30 MIN $3,291.00 99999-042-06 AMNIOBAND MEMBRANE (3X4 CM) $3,290.63 HC44200608 TRANSCRANIAL DOPPLER STUDY COMP $3,289.00 HC45200227 NM CARDIAC BP SPECT REST WM/EF $3,285.00 HC25004144 CLOSED TX ARTICULAR FX W/MANIP EA $3,280.00 10019-075-87 ESMOLOL IN NACL (ISO-OSM) 2,000 MG/100 ML IV SOLP $3,275.35 0409-0201-20 DOCETAXEL 160 MG/16 ML (10 MG/ML) IV SOLN $3,272.36 HC21000716 DBRD SKN MUSCL EA ADD 20SQCM/< $3,272.00 HC25004607 REMOVE FB FOOT; DEEP LT $3,269.00 HC25004615 REMOVE FB FOOT; DEEP RT $3,269.00 HC25004599 REMOVE FB FOOT; SUBC BIL $3,269.00 HC25001108 INSERT PICC <5 YR AGE W/O IMAGING $3,267.00 HC45200508 NM LIVER/SPLEEN IMAGING STATIC $3,267.00 HC41500182 ELECTROCORTICOGRAM IN SURGERY $3,266.00 HC25006115 AMNIOCENTESIS $3,265.00 HC41500430 SOMATOSENSORY UPPER LIMBS $3,264.00 HC44001626 MYELOGRAM LUMBOSACRAL $3,260.00 55513-546-01 FILGRASTIM 480 MCG/1.6 ML INJ SOLN $3,258.64 55513-546-10 FILGRASTIM 480 MCG/1.6 ML INJ SOLN $3,258.64 HC44502136 TRANSHEP DIL BILI W/O-W STENT S&I ONLY $3,256.00 HC47200688 TREATMENT SIMULATION INTERMED $3,254.00 0143-9674-01 ARGATROBAN 100 MG/ML IV SOLN $3,250.00 55150-382-01 PEMETREXED DISODIUM 500 MG IV SOLR $3,250.00 55513-670-01 INFLIXIMAB-AXXQ 100 MG IV SOLR $3,250.00 59148-070-91 BUSULFAN 60 MG/10 ML IV SOLN $3,250.00 67457-195-01 MELPHALAN HCL 50 MG IV SOLR $3,250.00 HC42000711 ECHO CNGNTL LTD OR F/U W/WO CONTR $3,249.00 HC51003333 ABLATION LASER CERVIX $3,246.00 HC74200437 OR TIME ADD'L 15MIN LVL 2 (MCAL 2ND SUBSQNT 0.5 HR) $3,243.00 HC74200072 OR TIME ADD'L 15MIN LVL 2 (MCAL 1ST SUBSQNT 0.5 HR) $3,243.00 HC62209143 BLANKET TEMP MNGMNT SYSTEM/BOX $3,241.00 63323-379-05 OCTREOTIDE ACETATE 1,000 MCG/ML INJ SOLN $3,229.72 HC26000125 TRANSABDOMINAL AMNIOINFUSION W/ULTRSND GUIDANCE $3,229.00 HC45200797 NM SHUNT EVALUATION $3,225.00 HC62804349 COIL EMBOLIZATION X $3,220.00 HC62216973 PIN/WIRE FIXATION TEMPORARY AV $3,220.00 HC62222443 TUBE INSERTN LEAD ELECTRODE SINGLE $3,220.00 5985700315 HUMAN REGENERATIVE TISSUE MTRX 14 MM TOPICAL SHEE $3,217.50 54643-9015-8 MVI, ADULT NO.4, VIT K, 1 OF 2 3,300 UNIT- 150 MCG/5 ML IV SOLN $3,205.15 54643-9015-9 MVI, ADULT NO.4, VIT K, 2 OF 2 600 MCG-60 MCG- 5 MCG/5 ML IV SOLN $3,205.15 HC44200103 US DUPLEX ABD/PEL FLOW COMP $3,204.00 HC51002889 CYSTOSCOPY W/INSERT STENT URETER INDW $3,203.00 HC62210984 PACK PERFUSION - ADULT $3,203.00 HC42000646 ECG EXT PT ACTV EVENT MONITOR ATTEND 24HRS-30DAYS; TRANSMIT/ANYS $3,198.00 HC25004631 CLOSED TX TARSAL FX; W/MANIPLTN EA $3,197.00 HC44001634 MYELOGRAM THORACIC $3,197.00 HC62804018 FILTER VENA CAVA(DENLI-ECLPS-MERIDN) D $3,193.00 50242-135-01 TOCILIZUMAB 80 MG/4 ML (20 MG/ML) IV SOLN $3,192.41 HC44200582 TCD EMBOLI DETECT W/ IV MICROBUBBLE $3,191.00 HC62208608 SYSTEM VEIN HARVESTING $3,189.00 HC62803713 KIT CATH HEMO DIAL SHORT TERM V $3,185.00 0143-9564-01 PHENTOLAMINE 5 MG INJ SOLR $3,184.81 0143-9564-10 PHENTOLAMINE 5 MG INJ SOLR $3,184.75 HC21000849 APPY SKIN SUB HED/HND/FT EA+100SQ~HC $3,183.00 HC46500062 ASP&INJ BONE CYST $3,183.00 HC46500732 CT ASP&INJ BONE CYST-LT $3,183.00 HC46500740 CT ASP&INJ BONE CYST-RT $3,183.00 HC47200134 HYPERTHERMIA EXTERNAL SUPERFCL $3,182.00 HC46000469 INJECTION HIP ARTHROGRAM BIL $3,177.00 HC41500620 STUDIES NERVE CONDUCTN 13/> STUDIES $3,177.00 HC38420345 ASSEMBLY & OPER PUMP OXYGEN; 45MIN $3,177.00 55566-8303-1 DEGARELIX 80 MG SUBCUTANEOUS SOLR $3,174.93 HC41500224 EMG 4 EXTREMITY $3,167.00 HC21000807 APPY SKIN SUB T,A,L EA+ 100SQ~HC $3,159.00 68546-325-12 GLATIRAMER 40 MG/ML SUBCUTANEOUS SYRG $3,159.00 HC62201181 CATH EP/ABLAT NOT COOL-TIP/3D/V MAP V $3,150.00 HC62300223 CATH INTRACARDIAC ECHO/UTZ RPRSD C $3,150.00 HC62800107 CATH PTA ANGIOPLS BALLOON NON-LSR R $3,150.00 HC62800099 CATH PTCA BALLOON NON-LASER Q $3,150.00 HC62805601 CATH THROMBECTOMY/EMBOLECTOMY V $3,150.00 HC62218631 DEVICE RETRIEVAL F $3,150.00 HC62226113 DRILL/DRILL BITS SINGLE USE AL $3,150.00 HC62805767 FIBRIN SEALANT S $3,150.00 HC62219381 INTRO/SHEATH STEERABLE NON-PEEL F $3,150.00 HC62216957 KIT MONITORING NERVE(S) SPINAL F $3,150.00 HC62217914 PASSER SUTURE ORTHOPAEDIC AA $3,150.00 HC62219811 PROGRAMMER NEUROSTIM PAT F $3,150.00 HC62228408 SHEATH STEERBL GUIDE SUREFLEX (WATCHMAN) $3,150.00 HC62804927 STENT BILIARY COVRD W/DELSYS B $3,150.00 HC62803747 STENT NON-COAT/NON-COV W-DEL V $3,150.00 HC62226642 TAP SURGICAL V $3,150.00 HC44001618 MYELOGRAM CERVICAL $3,139.00 HC42000190 ECHO FETAL CARDIOVASCULAR $3,132.00 67877-636-02 TOLVAPTAN 30 MG ORAL TAB $3,123.41 67877-636-33 TOLVAPTAN 30 MG ORAL TAB $3,123.41 HC51003192 BX VAGINA EXTENSIVE INCL CYSTS $3,122.00 HC21000476 I&D ABSCESS COMPLICATED MULT $3,120.00 0026-3782-25 KOGENATE FS 250 (+/-) UNIT IV SOLR $3,120.00 76310-024-15 FOSCARNET 24 MG/ML IV SOLN $3,120.00 76310-024-25 FOSCARNET 24 MG/ML IV SOLN $3,120.00 HC77400067 ANESTHESIA INITIAL HR $3,119.00 55566-2800-0 DINOPROSTONE 10 MG VAGINAL INSR $3,118.96 55566-2800-1 DINOPROSTONE 10 MG VAGINAL INSR $3,118.96 HC41500422 SOMATOSENSORY LOWER LIMBS $3,115.00 HC46000626 INTRO NDL/CATH EXT ART UE OR LE LT $3,114.00 HC46000634 INTRO NDL/CATH EXT ART UE OR LE RT $3,114.00 HC41500869 EEG W/VIDEO UNMONITOR EA 12-26 HR $3,111.00 HC46500757 CYSTOGRAM COMPLEX $3,105.00 HC46001095 INJ ARTHRO/CT/MRI SHOULDER-BIL $3,104.00 HC84201839 RESP BACTERIA/VIRAL 22 TRGT SARS-COV-2 QUAL RT-PCR(PNL RP2.1) $3,102.00 HC25003419 CLOSED TX NOSE FX W/O STABILIZATION $3,097.00 HC46001103 INJ ARTHROGRAM ELBOW-SC BIL $3,096.00 HC46000402 INJ OF GT/COLON TUBE; PATENCY W/IMAG $3,091.00 0597-0024-02 IPRATROPIUM-ALBUTEROL 20-100 MCG/ACTUATION INHALATION MIST $3,088.10 55150-218-99 EPTIFIBATIDE 0.75 MG/ML IV SOLN $3,087.50 57894-160-01 INFLIXIMAB 100 MG IV SOLR $3,087.50 HC21000393 ESCHAROTOMY; FULL THICK BURN $3,086.00 HC45201175 RADIOPHARM' TX; ORAL ADMIN $3,086.00 0472-1992-08 NITROFURANTOIN 25 MG/5 ML ORAL SUSP $3,085.68 HC45200409 NM KIDNEY IMAGING W/VASC FLOW $3,084.00 HC45201324 NM THYROID SCAN & UPTAKE SNG/MULT MSRMT [W/VASC FLOW IF PERF] $3,083.00 HC25001017 CARDIOVERSION EXTERNAL $3,081.00 HC21000955 APPY SKIN SUB T,A,L EA +25SQ~LC $3,080.00 HC62804331 COIL EMBOLIZ(BARR PLAT DETACH) W $3,080.00 HC45200052 NM BONE MARROW MULTI AREA $3,078.00 HC46000972 SEL VENOUS CATH 1ST ORD LT $3,077.00 HC46000980 SEL VENOUS CATH 1ST ORD RT $3,077.00 25021-189-84 FOSCARNET 24 MG/ML IV SOLN $3,072.88 HC25001066 BLOOD PATCH (INJ EPIDURAL) $3,071.00 HC27000157 CHANGE GT TUBE W/O IMAGE/ENDO $3,071.00 HC23001530 INJ ANES/STEROID NERVE TRIGEML BRNCH EA BI $3,068.00 HC43000629 PUNCTURE ASP CYST BREAST-LT $3,068.00 HC43000546 PUNCTURE ASP CYST BREAST-RT $3,068.00 HC45200516 NM LIVER/SPLEEN W/VASC FLOW $3,066.00 HC62219357 GUIDE TRANSPORTAL ACL $3,063.00 HC62228176 ORTH WHO W/NONTORSION JOINTS CUSTOM $3,063.00 HC41500166 EEG ROUTINE(AWAKE&ASLEEP) $3,062.00 HC21000575 PREP SITE F/N/HF/G EA +100SQCM $3,060.00 HC44200251 US DUPLEX VEIN EXT COMP BILAT $3,058.00 HC51003168 DESTROY LESION(S) VAGINAL SIMPLE $3,057.00 HC23000433 INJ ANES/STEROID NERVE SCIATIC LT $3,055.00 HC23000441 INJ ANES/STEROID NERVE SCIATIC RT $3,055.00 60793-702-04 PENICILLIN G BENZATHINE 2,400,000 UNIT/4 ML IM SYRG $3,052.09 60793-702-10 PENICILLIN G BENZATHINE 2,400,000 UNIT/4 ML IM SYRG $3,052.09 HC46502605 INSERT MIDLINE CATH <3 YR AGE $3,052.00 68134-201-16 NAPROXEN 125 MG/5 ML ORAL SUSP (MCH) $3,051.75 HC32010365 OT-EVAL SWALLOW CINE/FLUORO 150MIN $3,050.00 HC33010232 ST-EVAL SWALLOW CINE/FLUORO 150MIN $3,050.00 76075-103-01 CARFILZOMIB 10 MG IV SOLR $3,047.66 60505-4705-0 TOLVAPTAN 30 MG ORAL TAB $3,046.67 HC45200649 NM PARATHYROID PLANAR IMAG+SUBTR $3,045.00 HC45201167 RADIOLABEL MONONCLON ANTIBODY $3,045.00 0078-0569-61 INTERFERON BETA-1B 0.3 MG SUBCUTANEOUS SOLR $3,040.64 10019-055-61 ESMOLOL IN NACL (ISO-OSM) 2,500 MG/250 ML (10 MG/ML) IV SOLP $3,040.38 HC47200175 HYPERTHERMIA INTRACAVITARY $3,033.00 HC44000628 ELBOW ARTHROGRAM BILAT $3,025.00 55513-004-04 DARBEPOETIN ALFA IN POLYSORBAT 60 MCG/ML INJ SOLN $3,018.60 55513-023-01 DARBEPOETIN ALFA IN POLYSORBAT 60 MCG/0.3 ML INJ SYRG $3,018.60 55513-023-04 DARBEPOETIN ALFA IN POLYSORBAT 60 MCG/0.3 ML INJ SYRG $3,018.60 HC44200186 US DUPLEX CAROTID COMP BILAT $3,015.00 HC47201033 TELETX ISODOSE W/ DOSIMETRY;SIMPLE $3,010.00 HC51002905 CYSTOURETHRSCPY&/PYELOSCPY FLEX DX $3,009.00 HC51002897 CYSTOURETHRSCPY W/TX URETER STRICT $3,004.00 HC51003101 DESTROY LESION(S) VULVA SIMPLE $3,004.00 13533-335-12 IMMUNE GLOBULIN (HUMAN) (IGG) IM INJ (MCH) $3,000.01 13533-335-13 IMMUNE GLOBULIN (HUMAN) (IGG) IM INJ (MCH) $3,000.01 HC36001147 TRANSENDOSCOPIC EBUS DURING BRONCH DX OR TX FOR PERIPH NODE(S)+ $3,000.00 HC36800845 TRANSENDOSCOPIC EBUS DURING BRONCH DX OR TX FOR PERIPH NODE(S)+ $3,000.00 HC45200078 NM BONE SCAN LTD AREA $2,994.00 HC44901064 CT BREAST 3D RENDER UNILAT W/CONTRAST $2,993.00 HC62228135 ORTH EWHO W/NONTORSION JOINT(S) CUSTOM $2,993.00 HC44200590 TCD EMBOLI DETECT W/O IV MICROBUBBL $2,990.00 HC46500070 ASP/INJ HYDROCELE $2,987.00 HC21000708 DBRD SKIN&SUBQ EA ADD 20SQCM/< $2,986.00 HC25005372 DRAIN ABSCESS WALL SCROTAL $2,981.00 HC44002541 WRIST ARTHROGRAM BILAT $2,981.00 0597-0087-17 IPRATROPIUM BROMIDE 17 MCG/ACTUATION INHALATION HFAA $2,979.02 HC62228770 NEEDLE 22G SPIN FLEX®(ALWAYS-ON TIP TRACKED®) $2,977.00 67871-4790-6 ETHANOLAMINE OLEATE 5 % IV SOLN $2,976.68 HC62211818 CATH ANGIO MICRO(DIAG/MARTHN/EXCLSR)Q $2,975.00 HC62228366 KIT TRANSSEPTAL (WATCHMAN) $2,975.00 HC62229224 TUBE ESOPH THERMAL REG DEV $2,975.00 49452-4050-2 LIDOCAINE HCL (BULK) 100 % MISC POWD $2,970.50 5846800901 HYLAN G-F 20 16 MG/2 ML INTRAARTIC SYRG $2,967.51 5846800902 HYLAN G-F 20 16 MG/2 ML INTRAARTIC SYRG $2,967.51 66993-490-36 IBUPROFEN LYSINE (PF) 20 MG/2 ML IV SOLN $2,965.56 66993-490-84 IBUPROFEN LYSINE (PF) 20 MG/2 ML IV SOLN $2,965.56 HC43000041 BREAST BX CORE W/O GUIDE-LT $2,965.00 HC43000058 BREAST BX CORE W/O GUIDE-RT $2,965.00 HC62803283 KIT MONITOR PRESSURE ICP $2,963.00 HC42000737 ECHO 2D LMTD W/O SPEC&DOP W/WO CONTR $2,962.00 HC62223946 SYSTEM COLLECTION/TRANSFER FAT $2,961.00 16729-230-11 PEMETREXED DISODIUM 500 MG IV SOLR $2,960.49 HC46001012 VENOUS CATH ORGAN BLD SIMPLE $2,958.00 HC27001189 M: UNLISTED PROCEDURE, ESOPH $2,955.00 HC44703429 PERCUT ACCESS & CLOSE FEMORAL ARTERY DELIVERY GRAFT+ $2,953.00 27437-206-03 CEFIXIME 200 MG/5 ML ORAL SUSR $2,949.05 HC62208806 CATH INTRAVASC ULTRASOUND $2,947.00 HC62800412 CATH IVUS PV LARGE VESSEL $2,947.00 HC62800420 CATH IVUS PV SMALL VESSEL $2,947.00 HC45200722 NM RADIONUCLIDE VOIDING CYSTO $2,943.00 66689-307-08 MYCOPHENOLATE MOFETIL 200 MG/ML ORAL SUSR $2,941.12 HC62224571 DEVICE SUTURE ENDOSCOPIC O $2,940.00 HC51002871 CYSTOSCOPY W/REM STNT/FB/CALC COMPLIC $2,939.00 62935-753-75 LEUPROLIDE 7.5 MG (1 MONTH) SUBCUTANEOUS SYRG $2,935.99 HC46000832 SEL CATH PULMONARY ART LT $2,935.00 HC46000840 SEL CATH PULMONARY ART RT $2,935.00 62559-153-04 OPIUM TINCTURE 10 MG/ML (MORPHINE) ORAL TINC $2,925.34 HC41500414 SOMATOSENSORY HEAD/TRUNK $2,925.00 14789-011-01 ISOPROTERENOL HCL 0.2 MG/ML INJ SOLN $2,925.00 14789-011-07 ISOPROTERENOL HCL 0.2 MG/ML INJ SOLN $2,925.00 99999-042-05 AMNIOBAND MEMBRANE (2X4 CM) $2,925.00 HC23000037 ASP/INJ JOINT SM W/O UTZ GUIDE-BILAT $2,917.00 HC46500765 DECLOTTING IVAD W/THROMBOLYTIC $2,913.00 99999-038-92 POLIHEXANIDE (PURAPLY AM) 2X4 CM EACH TOPICAL SHEET $2,912.00 HC47201165 BRACHYTX INSERT VAG RAD AFTRLOAD DEVICE $2,910.00 HC41500174 EEG SLEEP(ONLY) $2,910.00 0944-3051-02 ADVATE 250 (+/-) UNIT IV SOLR $2,908.75 HC62802897 SEALANT PULMONARY (PROGEL) $2,905.00 HC62228978 ORTHOSIS LUMBAR SACRAL SAGCOR RIGID ANT/POST FRAME/PANEL PREFB CUST $2,904.00 17478-503-05 ETHANOL (ETHYL ALCOHOL) 98 % INJ SOLN $2,903.91 HC47201108 GUIDANCE RADIAJ TX DLVR (TRACKING) $2,903.00 HC44200160 US DUPLEX ART UP EXT COMP BIL $2,902.00 HC25000068 CRITICAL CARE EA ADDL 30 MIN $2,899.00 HC46000691 PERC PORTAL VEIN CATH $2,896.00 63323-371-10 DAPTOMYCIN 500 MG IV SOLR $2,895.62 63323-871-15 DAPTOMYCIN 500 MG IV SOLR $2,895.62 HC62205703 PINS CRW HEAD DISP $2,895.00 HC46500054 ASP PERC SPINAL CORD CYST $2,893.00 HC45200896 NM THYROID CA METS LTD AREA $2,893.00 HC62228390 SHEATH TRANSSEPTAL GUIDE KIT(WATCHMAN) $2,888.00 60505-0402-5 PAROXETINE HCL 10 MG/5 ML ORAL SUSP $2,882.75 HC51003093 BX PROSTATE NDL/PUNCH SGL/MULT $2,881.00 HC45200490 NM LIVER IMAGING W/VASC FLOW $2,870.00 0069-1309-01 EPOETIN ALFA-EPBX 40,000 UNIT/ML INJ SOLN $2,867.80 0069-1309-04 EPOETIN ALFA-EPBX 40,000 UNIT/ML INJ SOLN $2,867.80 HC46000543 INTRO CATH RT HEART/PUL ART $2,863.00 HC62208905 BALLOON VALVULOPLASTY $2,861.00 HC41500810 EEG W/O VID MONITOR INTERMT EA 12-26HR $2,857.00 61314-326-01 FILGRASTIM-SNDZ 480 MCG/0.8 ML INJ SYRG $2,853.37 61314-326-10 FILGRASTIM-SNDZ 480 MCG/0.8 ML INJ SYRG $2,853.37 HC23001910 INJ ANES/STEROID NERVE GENICULAR IMAGE GUIDE $2,852.00 HC23001936 INJ ANES/STEROID NERVE GENICULAR IMAGE GUIDE LT $2,852.00 HC23001944 INJ ANES/STEROID NERVE GENICULAR IMAGE GUIDE RT $2,852.00 HC62807813 M: LINER SHOULDER $2,849.00 HC45200151 NM BRAIN IMAG VASC FLOW ONLY $2,847.00 HC21000153 ASPIRATION OF ABCESS/CYST $2,846.00 HC44503464 DECLOT IVAD BY THROMBOLYTIC LT $2,845.00 HC44503472 DECLOT IVAD BY THROMBOLYTIC RT $2,845.00 HC46000253 INJ DISKOGRAM CS/TS EA LVL $2,845.00 HC45200268 NM CARDIAC SHUNT DETECTION $2,845.00 8213000013 PORCINE SUBMUCOSA, MESHED 5 X 7 CM TOPICAL SHEE $2,843.75 HC45200730 NM RED CELL SURVIVAL $2,843.00 HC83000521 PLATELET HLA LR APHER/PHER $2,843.00 0046-0872-21 CONJUGATED ESTROGENS 0.625 MG/GRAM VAGINAL CREAM $2,840.18 HC51061042 CONVERT NEPH CATH->NEPH'URET PERC(NEPH/URET'GRM,S&I)EXST LT $2,840.00 HC51061059 CONVERT NEPH CATH->NEPH'URET PERC(NEPH/URET'GRM,S&I)EXST RT $2,840.00 HC51061075 EXCHANGE TUBE NEPHRO(NEPH/URET'GRM,S&I) LT $2,840.00 HC51061083 EXCHANGE TUBE NEPHRO(NEPH/URET'GRM,S&I) RT $2,840.00 HC46000436 INJ VENOGRAM EXTREMITY- BILAT $2,836.00 99999-038-96 POLIHEXANIDE (PURAPLY) 2X4 CM EACH TOPICAL SHEET $2,834.00 HC62220421 KNIFE ANNULOTOMY (MAXCESS) $2,832.00 HC25005869 I&D ABSCESS RECTAL $2,829.00 0955-1021-04 DOCETAXEL 80 MG/4 ML (20 MG/ML) IV SOLN $2,827.50 63323-140-10 CLADRIBINE 10 MG/10 ML IV SOLN $2,827.50 HC23000102 ASP/INJ JOINT LRG W/O UTZ GUIDE-LT $2,827.00 HC23000110 ASP/INJ JOINT LRG W/O UTZ GUIDE-RT $2,827.00 HC47200530 RAD TREATMENT DELVR, = 1MEV;CMPLX $2,827.00 HC45401072 MR BREAST W/O&W CONTRAST LTD LT $2,825.00 HC45401064 MR BREAST W/O&W CONTRAST LTD RT $2,825.00 HC45401569 MR ELASTOGRAPHY $2,819.00 HC45200813 NM TESTICULAR IMAGING W/FLOW $2,819.00 HC44901056 CT BREAST 3D RENDER UNILAT W/O CONTRAST $2,815.00 HC62200233 ASPIRATOR ULTRASONIC SURG E $2,800.00 HC62200498 BIO GLUE W/APPLICATOR $2,800.00 HC62208731 CATH BALLOON SINUPLASTY J $2,800.00 HC62212188 CATH BALLOON SINUPLASTY SYSTEM J $2,800.00 HC62800230 CATH BALLOON THERMACHOICE U $2,800.00 HC62805700 CATH EP/ABLAT NOT COOL-TIP/3D/V MAP U $2,800.00 HC62800396 CATH INTRA AORTIC BALLOON C $2,800.00 HC62211776 CATH PTA ANGIOPLS BALLOON NON-LSR Q $2,800.00 HC62214739 CATH PTCA BALLOON NON-LASER P $2,800.00 HC62800503 CATH THROMBECTOMY/EMBOLECTOMY U $2,800.00 HC62804315 COIL EMBOLIZATION U $2,800.00 HC62803333 DEVICE CLOSURE VASCULAR PLUG U $2,800.00 HC62223565 DRILL/DRILL BITS SINGLE USE AK $2,800.00 HC62223144 FIBER LASER M $2,800.00 HC62221676 GUIDE DRILL TRANSTIBIAL FEMORAL U $2,800.00 HC62222633 INTRO/SHEATH EP FIXED NON-PEEL S $2,800.00 HC62802376 INTRO/SHEATH EP FIXED PEEL AK $2,800.00 HC62806674 INTRO/SHEATH STEERABLE NON-PEEL E $2,800.00 HC62226675 INTRODUCER/SHEATH X $2,800.00 HC62227871 KIT ARTHROSCOPY DISPSBLS Y $2,800.00 HC62227145 KIT EXTRACT RESURFAC HIP $2,800.00 HC62220272 KIT MONITORING NERVE(S) SPINAL E $2,800.00 HC62204318 KIT TRANSJUGULAR VENOUS ACCESS $2,800.00 HC62219746 KIT VITRECTOMY PROBE N $2,800.00 HC62218474 LEAD DELIVERY SYSTEM J $2,800.00 HC62220462 MOLD/FORM CEMENT TIBIAL KNEE $2,800.00 HC62806765 POUCH/ENVELOPE PACEMAKER E $2,800.00 HC62223243 PROBE DOPPLER NEURO $2,800.00 HC62227590 REAMER AK $2,800.00 HC62807920 SEALANT TISSUE HYDROGEL $2,800.00 HC62219589 SHIM DEVICE ACCESS SPINAL AE $2,800.00 HC62216254 STABILIZER HEART OCTOPUS E $2,800.00 HC62804919 STENT BILIARY COVRD W/DELSYS A $2,800.00 HC62803887 STENT CORO BARE METAL W/DEL E $2,800.00 HC62808399 STENT DES CORO COV W/DEL SYS E $2,800.00 HC62807441 STENT NON-COAT/NON-COV W-DEL U $2,800.00 HC41500612 STUDIES NERVE CONDUCTN11-12 STUDIES $2,800.00 HC62223854 SYSTEM DELIVERY LEAD K $2,800.00 HC62224241 SYSTEM DELIVERY SEPTAL DEFECT U $2,800.00 HC62223961 TAP SURGICAL U $2,800.00 HC62226451 TIP DISSECTOR MICRO ULTRSONC (SONOPET) $2,800.00 HC27001247 ESOPH MOTILTY STDY/STIM/PERF2D $2,799.00 HC45200656 NM PERITON VEN SHUNT PATENCY $2,795.00 HC42000075 CV STRESS TEST PHARMACOLOGIC $2,793.00 0407-1414-72 IOHEXOL 350 MG IODINE/ML IV SOLN $2,791.75 HC46000865 SEL CATH SEGMNT PULM ART LT $2,790.00 HC46000873 SEL CATH SEGMNT PULM ART RT $2,790.00 HC44503449 DECLOTTING VASC ACCES/CATH LT $2,787.00 HC44503456 DECLOTTING VASC ACCES/CATH RT $2,787.00 HC62802822 PROGRAMMER IDD TX (CONTROL) $2,783.00 HC44701167 THROMBOLYSIS CORONARY IV INFUSION $2,783.00 2576773549 CARDIOPLEG-ORGAN PRESERV NO.1 9 MMOL-198 MMOL -2 MMOL/L PERF SOLN $2,782.00 HC23000391 INJ ANES/STEROID BRACHIAL PLEXUS $2,781.00 HC23001621 INJ ANES/STEROID BRACHIAL PLEXUS LT $2,781.00 HC23001613 INJ ANES/STEROID BRACHIAL PLEXUS RT $2,781.00 HC45200326 NM GASTRIC REFLUX STUDY $2,781.00 HC73000127 HEMODIALYSIS W/SNGL EVAL(IP) $2,777.00 HC36000222 INTUBATION $2,777.00 HC46501193 MANOMETRIC STDY VIA NEPHRO LT $2,776.00 HC46501201 MANOMETRIC STDY VIA NEPHRO RT $2,776.00 HC44200996 US OB EVAL PLUS FETAL ANATOMIC DETAIL 1ST GEST $2,775.00 HC44500809 ERCP BILIARY&PANCREATIC SYSTEM S&I ONLY $2,773.00 HC25003351 REMOVE FB MUSCLE/TENDON SHEATH SIMPLE $2,771.00 HC73000275 DIALYSIS URGENT ESRD(OP)CANCEL $2,765.00 0173-0720-20 FLUTICASONE PROPIONATE 220 MCG/ACTUATION INHALATION HFAA $2,764.63 0781-3079-12 FULVESTRANT 250 MG/5 ML IM SYRG $2,762.50 HC45200961 NM TUMOR LOCALIZE PLNR SGL AREA 1 DAY $2,757.00 HC45200250 NM CARDIAC SCAN W/EF 1ST PASS $2,745.00 HC83000554 PLATELETPHER LR IRRAD EA UNIT $2,743.00 0078-0357-52 OXCARBAZEPINE 300 MG/5 ML ORAL SUSP (MCH) $2,743.00 HC23000912 INJ ANES/STEROID NERVE/BRNCH PERIPH LT $2,742.00 HC23000920 INJ ANES/STEROID NERVE/BRNCH PERIPH RT $2,742.00 HC44000107 ANKLE ARTHROGRAM BILAT $2,737.00 HC73000044 DIALYSIS CCPD W/SNGL EVAL(IP) $2,737.00 51224-012-20 PHENTOLAMINE 5 MG INJ SOLR $2,728.70 68094-101-20 PHENTOLAMINE 5 MG INJ SOLR $2,728.70 51167-113-01 TEZACAFTOR-IVACAFTOR 50-75 MG (D)/ 75 MG (N) ORAL TBSQ $2,727.40 51167-661-01 TEZACAFTOR-IVACAFTOR 100-150 MG (D)/ 150 MG (N) ORAL TBSQ $2,727.40 HC41500042 CENTRAL MOTOR EVOKED UP LIMBS $2,727.00 HC44200301 US GUIDANCE INTRAOPERATIVE $2,724.00 24208-535-35 GANCICLOVIR 0.15 % OPHT GEL $2,719.34 HC62805130 M:IMPLANT UROLIFT TIE-BACK (EACH) $2,713.00 HC21000997 APPY SKIN SUB HEAD/HND/FT EA+25SQ~LC $2,704.00 HC62804000 FILTER VENA CAVA (E.G.OPTEASE) C $2,702.00 HC44701233 INSTILL FIBRIN CT INIT' DAY LT $2,702.00 HC44701217 INSTILL FIBRIN CT INIT' DAY RT $2,702.00 46287-020-04 SPIRONOLACTONE 25 MG/5 ML ORAL SUSP $2,700.61 HC51061117 CLOSED TX RAD/EPHYSL SEP&ULN FX W/MAN $2,700.00 HC44000008 3D RENDER W/ INDEPNDNT WORKSTN $2,696.00 HC74200296 BEDSIDE/OTHER SURG ADD'L 15MIN 6 (MCAL 1ST SUBSQNT 0.5 HR) $2,692.00 HC74200536 BEDSIDE/OTHER SURG ADD'L 15MIN 6 (MCAL 2ND SUBSQNT 0.5 HR) $2,692.00 HC45200482 NM LIVER IMAGING STATIC ONLY $2,691.00 HC51003358 DILAT CANAL CERV INSTRMNT(SEP PROC) $2,689.00 HC21000302 DEBRIDE SKIN EXT UP TO 10% BSA $2,687.00 0131-5410-72 LACOSAMIDE 10 MG/ML ORAL SOLN $2,684.50 HC44900355 CT LTD OR LOCALIZED F/U STUDY $2,677.00 65162-686-90 FELBAMATE 600 MG/5 ML ORAL SUSP $2,674.82 HC82202300 ELECTRON MICROSCOPY REDUCE SVC $2,673.00 HC74200429 OR TIME ADD'L 15MIN LVL 1 (MCAL 2ND SUBSQNT 0.5 HR) $2,673.00 HC74200064 OR TIME ADD'L 15MIN LVL 1 (MCAL 1ST SUBSQNT 0.5 HR) $2,673.00 HC25005315 I&D ABSCESS SUBMUCSL RECTUM $2,670.00 HC78600004 PACU I 1ST HOUR (INITIAL) $2,670.00 HC44001295 INTRODUCE TUBE GASTROINTESTINAL LONG $2,664.00 HC44200053 ART STDY BILAT U/L 3/> LVL CMP $2,663.00 HC45201266 QUANT DIFF PULM PERF $2,663.00 HC44900090 CT CHEST/LUNG LOW DOSE SCREENING $2,662.00 HC45201241 PULM VENTILATION IMAGING $2,662.00 HC62210752 CATH ACCESS DUODENOSCOPE $2,660.00 HC62804307 COIL EMBOLIZATION T $2,660.00 HC45200169 NM BRAIN IMAGING 4< STATIC VWS $2,656.00 HC45200235 NM CARDIAC SCAN $2,653.00 HC51002848 CYSTOURETHROSCOPY W/DIL BLADDER $2,651.00 63323-132-10 MITOXANTRONE 2 MG/ML IV CONC $2,649.79 HC44504512 PERC PLCMT TISS SOFT DEV ADDL LESN+ $2,649.00 HC36800134 BRONCHIAL PROVOCATION EVAL $2,642.00 HC46502662 FNA ASP BX W/FLUORO; EACH ADD'L LESION $2,638.00 HC45201316 NM THYROID SCAN IMAGE ONLY [W/VASC FLOW IF PERF] $2,638.00 HC36000255 TRACH TUBE CHANGE $2,638.00 HC44500866 GUIDE PERC DRAIN W/CATH PLCMNT S&I ONLY $2,637.00 HC41500034 CENTRAL MOTOR EVOKED LOW LIMBS $2,631.00 HC45200383 NM INTRAVASCULAR RAD TX $2,630.00 HC42000067 CV STRESS TEST TREADMILL $2,625.00 HC62203906 SYSTEM HEMOSTAT(NEXPOWDER) $2,625.00 HC62807433 POLYMER FILLER RING GRAFT/STENT $2,625.00 HC73000002 DIALYSIS CAPD W/SNGL EVAL(IP) $2,624.00 0944-2850-03 IMMUN GLOB G(IGG)-GLY-IGA OV50 2 GRAM/10 ML (20 %) SUBCUTANEOUS SOLN $2,621.84 0944-2850-04 IMMUN GLOB G(IGG)-GLY-IGA OV50 2 GRAM/10 ML (20 %) SUBCUTANEOUS SOLN $2,621.84 99999-042-04 AMNIOBAND MEMBRANE (2X2 CM) $2,620.31 HC62225024 SET REMOVAL NUCLEUS SPINAL $2,618.00 HC41500000 AUDITORY EVOKED AEP BBS HEARING DETERM W/I&R $2,617.00 HC41500547 AUDITORY EVOKED AEP BBS HEARING DETERM W/I&R $2,617.00 58394-633-03 BENEFIX 250 UNIT IV SOLR $2,616.25 HC51002855 CYSTOURETHROSCOPY W/DIL STRIC URETH $2,616.00 HC41500604 STUDIES NERVE CONDUCTN 9-10 STUDIES $2,616.00 HC42000091 ECHO CONGENITAL LTD OR F/U $2,614.00 HC62802764 ADAPT/EXT PACING LEAD SPX $2,611.00 HC41500067 DBS CORTICAL MAP INITIAL HR $2,609.00 HC41500216 EMG 3 EXTREMITY $2,606.00 HC44500791 ERCP BILIARY DUCT SYSTEM S&I ONLY $2,606.00 HC51002863 CYSTOSCOPY W/REMV STENT/FB/CALC SIMPL $2,604.00 HC62228127 ORTH EWHO RIGID W/O JOINTS CUSTOM $2,604.00 HC62209259 SYSTEM ANASTOMOSIS DEVICE $2,604.00 HC51062776 CLOSED TX CARPAL BONE FX W/MNPLTN EA BONE $2,600.00 55150-210-10 BIVALIRUDIN 250 MG IV SOLR $2,600.00 81284-315-00 INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) IV SOLN $2,600.00 81284-315-05 INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) IV SOLN $2,600.00 HC62220702 KIT ACCESSORY PROSTHESIS PENILE $2,597.00 HC32010357 OT-EVAL SWALLOW CINE/FLUORO 120MIN $2,594.00 HC33010224 ST-EVAL SWALLOW CINE/FLUORO 120MIN $2,594.00 47781-578-07 DEXRAZOXANE HCL 500 MG IV SOLR $2,593.50 49281-860-10 POLIOVIRUS VACCINE 40-8-32 UNIT/0.5 ML INJ SUSP $2,593.50 49281-860-78 POLIOVIRUS VACCINE 40-8-32 UNIT/0.5 ML INJ SUSP $2,593.50 72611-716-01 DEXRAZOXANE HCL 500 MG IV SOLR $2,593.50 HC62226105 DRILL/DRILL BITS SINGLE USE AJ $2,590.00 50632-010-01 RABIES VACCINE, PCEC (PF) 2.5 UNIT IM SUSR $2,586.94 50632-013-01 RABIES VACCINE, PCEC (PF) 2.5 UNIT IM SUSR $2,586.94 HC51002830 CYSTOURETHROSCOPY W/BX(S) $2,586.00 HC62803879 STENT CORO BARE METAL W/DEL D $2,581.00 HC45200391 NM KIDNEY IMAGING MORPHOLOGY $2,580.00 HC25006123 AMNIOCENTESIS FLUID REDUCTION $2,577.00 63323-659-09 INDOMETHACIN SODIUM 1 MG IV SOLR $2,574.00 HC44500726 PERC DIL URETER/URETHRA S&I-LT $2,570.00 HC44500734 PERC DIL URETER/URETHRA S&I-RT $2,570.00 0074-7269-50 CYCLOSPORINE MODIFIED 100 MG/ML ORAL SOLN $2,569.45 67457-316-25 DECITABINE 50 MG IV SOLR $2,567.50 HC74200304 BEDSIDE/OTHER SURGICAL CANCEL LVL 1 $2,560.00 HC62803994 FILTER VENA CAVA (E.G.TRAPEASE) B $2,555.00 HC62212832 GUIDEWIRE AA $2,555.00 HC46000683 INJECT PROC SENTINEL NODE W/ RADIOACTIVE TRACER $2,551.00 HC25002833 I&D POLINIDAL CYST; COMPLICATED $2,549.00 HC45200755 NM SALIVARY GLAND W/SER IMAG $2,549.00 HC74200411 OR TIME ADD'L 15MIN CASE CX 6 (MCAL 1ST SUBSQNT 0.5 HR) $2,548.00 HC74200635 OR TIME ADD'L 15MIN CASE CX 6 (MCAL 2ND SUBSQNT 0.5 HR) $2,548.00 HC23001878 INJ ANES/STEROID NERVE SI JOINT INNRV W/IMAGE $2,544.00 HC23001894 INJ ANES/STEROID NERVE SI JOINT INNRV W/IMAGE LT $2,544.00 HC23001902 INJ ANES/STEROID NERVE SI JOINT INNRV W/IMAGE RT $2,544.00 HC25005935 PARACENTESIS EYE W/REMOVAL AQUEOUS LT $2,544.00 HC25005943 PARACENTESIS EYE W/REMOVAL AQUEOUS RT $2,544.00 71740-112-30 POTASSIUM IODIDE 1 GRAM/ML ORAL SOLN $2,541.44 HC45201001 NM VASCULAR BLOOD FLOW $2,541.00 HC25003252 LAC REPAIR INTMD F/E/E/N/L/MM >30.0CM $2,538.00 HC12400123 CHEMO ADMIN PLEURAL CAV W/THORACENTESIS $2,536.00 HC51002731 CYSTOSTOMY(I&D BLADDER)W/W-OUT DRAIN $2,536.00 58181-3041-5 LOMUSTINE 40 MG ORAL CAP (MCH) $2,530.84 67457-217-20 METHADONE 10 MG/ML INJ SOLN $2,528.37 HC23000482 INJ ANES/STEROID NERVE VAGUS $2,527.00 HC73000168 HEMOPERFUSION $2,523.00 HC25000175 FB REMOVAL SQ SIMPLE $2,521.00 HC62800313 CATH EP DX <20 ELECTRODES N $2,520.00 HC62804299 COIL EMBOLIZATION S $2,520.00 HC62218490 ENDO STAPLER AJ $2,520.00 HC62210760 PROBE BILIARY DIRECT VISUAL $2,520.00 HC62226592 PROBE SPINAL DISPOSABLE AC $2,520.00 HC62224639 REAMER AJ $2,520.00 HC62214069 SET AUTOTRANSFUS(CONSTAVAC CBCII)AP $2,520.00 HC79200036 MUSCLE TEST, FOUR LIMBS $2,510.00 HC74200288 BEDSIDE/OTHER SURG ADD'L 15MIN 5 (MCAL 1ST SUBSQNT 0.5 HR) $2,505.00 HC74200528 BEDSIDE/OTHER SURG ADD'L 15MIN 5 (MCAL 2ND SUBSQNT 0.5 HR) $2,505.00 HC46001343 INJECT PROC SENTINEL NODE W/ NON-RADIOACTIVE TRACER $2,505.00 HC62808746 CATH INDIGO THROMB SEPARATOR L190CM[PENUMBRA] $2,504.00 HC62228788 KIT SPIN PERC®(ALWAYS-ON TIP TRACKED®) $2,504.00 39822-0151-1 LIOTHYRONINE 10 MCG/ML IV SOLN $2,502.50 HC44000230 BONE SURVEY COMPLETE $2,501.00 HC62211180 RETRACTOR HEART POSITIONER $2,501.00 0173-0859-10 FLUTICASONE FUROATE-VILANTEROL 100-25 MCG/DOSE INHALATION DSDV $2,494.83 49281-752-22 TUBERCULIN PPD 5 TUB. UNIT /0.1 ML INTRADERMAL SOLN $2,492.75 49281-752-98 TUBERCULIN PPD 5 TUB. UNIT /0.1 ML INTRADERMAL SOLN $2,492.75 HC45200375 NM INTRACAV RADIOAC COLLOID TX $2,492.00 HC25005174 DRAIN ABSCESS LYMPH NODE/LYMPHADENITIS; SIMPLE $2,488.00 HC44500932 INJ SCLEROTHERAPY MULT VEINS-LT $2,487.00 HC44500940 INJ SCLEROTHERAPY MULT VEINS-RT $2,487.00 HC45401015 MR BREAST W/O CONTRAST LTD LT $2,480.00 HC45401007 MR BREAST W/O CONTRAST LTD RT $2,480.00 HC45201415 NM MYOCARDIAL SYMPATHETIC INNERV IMAGE $2,478.00 HC45200318 NM GASTRIC MUCOSA IMAGING $2,475.00 3877905519 SODIUM BENZOATE (BULK) MISC POWD $2,470.00 HC51002822 CYSTOURETHROSCOPY W/CATH URETERAL $2,468.00 HC46502647 FNA ASP BX W/US; EACH ADD'L LESION $2,468.00 HC44501229 PLACE TUBE NASO/ORO-GASTRIC BY MD W/FLUORO $2,468.00 HC47200670 TREATMENT SIMULATION SIMPLE $2,468.00 68382-997-01 ARSENIC TRIOXIDE 1 MG/ML IV SOLN $2,463.83 68382-997-10 ARSENIC TRIOXIDE 1 MG/ML IV SOLN $2,463.83 HC33000373 ST-SWALLOWING EVAL 180MIN $2,462.00 HC45200292 NM ESOPHAGEAL MOTILITY $2,461.00 HC41500109 EEG AWAKE AND DROWSY $2,460.00 HC44200004 US ABDOMEN $2,460.00 HC21000401 EXCISION OF NAIL/MATRIX PERM $2,457.00 HC45200748 NM RED CELL VOL SNGL SAMPLE $2,457.00 HC62806153 CATH BALLOON DUCT LACRIMAL T $2,450.00 HC62800214 CATH BALLOON PYLORIC T $2,450.00 HC62208715 CATH BALLOON SINUPLASTY I $2,450.00 HC62805510 CATH EP/ABLAT NOT COOL-TIP/3D/V MAP T $2,450.00 HC62211735 CATH GUIDING DEFLECTABLE T $2,450.00 HC62226154 CATH INTRACARDIAC ECHO/UTZ RPRSD B $2,450.00 HC62210612 CATH MICRO NEURO(HEADWAY/MAGIC) N $2,450.00 HC62214721 CATH PTA ANGIOPLS BALLOON NON-LSR P $2,450.00 HC62805965 CATH PTCA ANGIOPLASTY NON-LASER O $2,450.00 HC62800289 CATH THROMBECTOMY/EMBOLECTOMY T $2,450.00 HC62222088 DEVICE RETRIEVAL D $2,450.00 HC62226097 DRILL/DRILL BITS SINGLE USE AI $2,450.00 HC62227038 ELECTRODE BIPOLAR ENDO $2,450.00 HC62218482 ENDO STAPLER AI $2,450.00 HC62223136 FIBER LASER L $2,450.00 HC62212824 GUIDEWIRE Z $2,450.00 HC62223458 INTRODUCER/SHEATH W $2,450.00 HC62226576 KIT DELIVERY GRAFT $2,450.00 HC62220264 KIT MONITORING NERVE(S) SPINAL D $2,450.00 HC62218177 KIT REPAIR PORT ACCESS LAP-BAND D $2,450.00 HC62219738 KIT VITRECTOMY PROBE M $2,450.00 HC62227970 PASSER SUTURE $2,450.00 HC62801733 PORT INDWELLING W/CATH M $2,450.00 HC62224506 PROBE LITHOTRIPTOR KIDNEY T $2,450.00 HC62226618 RETRACTOR MIS SPINAL D $2,450.00 HC62804612 STENT DES CORO COV W/DEL SYS D $2,450.00 HC62807003 STENT NON-COAT/NON-COV W-DEL T $2,450.00 HC62219464 SYSTEM DELIVERY LEAD J $2,450.00 HC62225784 SYSTEM DRESSING WOUND NEG PRES T $2,450.00 HC62223953 TAP SURGICAL T $2,450.00 0575-6200-30 DIAZOXIDE 50 MG/ML ORAL SUSP $2,449.20 HC12200259 INITIATE PROLONG THERA INFUSION VIA PUMP $2,446.00 24338-132-13 ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL SUSR $2,445.30 24338-134-02 ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL SUSR $2,445.30 HC51003853 REPAIR CIRCUMCISION INCOMPLETE $2,444.00 HC83000562 PLATELETPHER LR/CMV-/IRRAD/U $2,439.00 25021-231-20 DECITABINE 50 MG IV SOLR $2,437.50 HC21000781 APPY SKIN SUB T,A,L EA +25SQ~HC $2,437.00 HC27001221 SIGMOIDOSCOPY FLEX SCRN (Q48MO) $2,437.00 HC62209358 APPLIER PORT RAPIDPORT EZ $2,432.00 HC25000225 TRACHEOSTOMY $2,429.00 HC23000557 INJ CERVICAL PLEXUS BLOCK $2,427.00 HC23001597 INJ CERVICAL PLEXUS BLOCK LT $2,427.00 HC23001589 INJ CERVICAL PLEXUS BLOCK RT $2,427.00 HC51002764 ASP BLADDER W/INSERT SUPRAPUB $2,425.00 HC31001845 PT-EVAL HIGH COMPLEXITY 45MIF2F 180MIN $2,425.00 HC25005620 DRAIN EXTERNAL EAR LESION COMPLEX LT $2,420.00 HC25005612 DRAIN EXTERNAL EAR LESION COMPLEX RT $2,420.00 HC25005604 DRAIN EXTERNAL EAR LESION SIMPLE BIL $2,420.00 HC62219167 CATH ATRIOSEPTISTOTOMY $2,415.00 0078-0686-15 ELTROMBOPAG 50 MG ORAL TAB $2,413.69 0078-0686-55 ELTROMBOPAG 50 MG ORAL TAB $2,413.68 HC21000468 I&D ABSCESS SIMPLE SNGL $2,412.00 HC43000157 MAMMO DUCTO/GALACTO INJ-LT $2,411.00 HC43000165 MAMMO DUCTO/GALACTO INJ-RT $2,411.00 HC51002988 INSERT STENT URETHRAL PROSTATIC TEMP $2,410.00 HC41500463 VISUAL EVOKED RESP CNS/FLASH $2,409.00 0597-0138-30 AFATINIB 40 MG ORAL TAB $2,408.22 10019-939-01 CYCLOPHOSPHAMIDE 1 GRAM IV SOLR $2,405.00 10019-939-50 CYCLOPHOSPHAMIDE 1 GRAM IV SOLR $2,405.00 HC62208814 CATH PACING TRANSESOPHAGEAL $2,404.00 HC21000161 ASPIRATION OF ABCESS/CYST-ADDL $2,401.00 HC62208236 DRAIN PLEURAL W/VAC BOTTLE $2,394.00 HC44701241 INSTILL FIBRIN CT SUB' DAY LT $2,394.00 HC44701225 INSTILL FIBRIN CT SUB' DAY RT $2,394.00 HC44200038 US ART NONINVAS REST/STRES LEA $2,392.00 HC46000774 SEL CATH AB/PEL/LOEX 2ND+ORD LT $2,391.00 HC46000782 SEL CATH AB/PEL/LOEX 2ND+ORD RT $2,391.00 HC46001087 SEL CATH AB/PEL/LOEX2ND+ORDERT $2,391.00 HC44200129 US DUPLEX AORTA,IVC,ILIAC COMP $2,388.00 70954-319-10 PAROXETINE HCL 10 MG/5 ML ORAL SUSP $2,387.13 10019-955-01 CYCLOPHOSPHAMIDE 500 MG IV SOLR $2,380.63 10019-955-50 CYCLOPHOSPHAMIDE 500 MG IV SOLR $2,380.63 70860-218-03 CYCLOPHOSPHAMIDE 200 MG/ML IV SOLN $2,380.63 HC62217724 AWL SPINAL SINGLE PATIENT USE X $2,380.00 HC62804281 COIL EMBOLIZ(CONCERTO HELIX NYLON)R $2,380.00 HC62229109 GUIDE PIN ORTHO U $2,380.00 HC25001082 INSERT CT(OPEN) W/DRAIN SYSTEM LT $2,379.00 HC25001090 INSERT CT(OPEN) W/DRAIN SYSTEM RT $2,378.00 HC62803861 STENT CORO BARE METAL W/DEL C $2,377.00 65250-266-09 BUPIVACAINE LIPOSOME (PF) 1.3 % (13.3 MG/ML) LINF SUSP $2,373.54 65250-266-20 BUPIVACAINE LIPOSOME (PF) 1.3 % (13.3 MG/ML) LINF SUSP $2,373.54 0469-0420-01 ISAVUCONAZONIUM SULFATE 372 MG IV SOLR $2,370.29 HC36800514 BRONCH THERAPEUTIC DC'D PROC $2,370.00 HC36800084 BRONCH THERAPEUTIC DC'D PROC $2,370.00 HC36000958 BRONCH THERAPEUTIC DC'D PROC $2,370.00 HC25002866 DEBRIDE/REMOVL OPEN FX SKIN/SBQ $2,370.00 HC38420006 REMOVAL IABP DEVICE; PERC $2,365.00 HC21000690 APPLY MULTILAY COMPRS BK BIL $2,352.00 HC36800050 BRONCH DIAGNOSTIC DC'D PROC $2,352.00 HC36000941 BRONCH DIAGNOSTIC DC'D PROC $2,352.00 HC47200654 TREATMENT DEVICES INTERMEDIATE $2,347.00 HC62212816 GUIDEWIRE Y $2,345.00 HC62217385 DEVICE FIXATION TACKER(LAP) $2,343.00 HC73000176 HEMOPERFUSION DRY RUN $2,337.00 HC36800290 PNEUMOGRAM 12-24HR REC INFANT $2,336.00 HC45200664 NM PLASMA VOL MULTI SAMPLE $2,333.00 0456-2700-01 CEFTAZIDIME-AVIBACTAM 2.5 GRAM IV SOLR $2,332.27 0456-2700-10 CEFTAZIDIME-AVIBACTAM 2.5 GRAM IV SOLR $2,332.26 0046-0749-05 CONJUGATED ESTROGENS 25 MG INJ SOLR $2,322.65 HC46500617 CHANGE CYSTOSTOMY TUBE; SIMPLE $2,321.00 HC25000894 ASP/INJ LARGE JOINT-BILAT $2,320.00 HC74200270 BEDSIDE/OTHER SURG ADD'L 15MIN 4 (MCAL 1ST SUBSQNT 0.5 HR) $2,319.00 HC74200510 BEDSIDE/OTHER SURG ADD'L 15MIN 4 (MCAL 2ND SUBSQNT 0.5 HR) $2,319.00 0009-0856-05 CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN $2,315.33 0009-0856-08 CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN $2,315.33 0378-8712-73 ACYCLOVIR 200 MG/5 ML ORAL SUSP $2,315.10 0472-0082-16 ACYCLOVIR 200 MG/5 ML ORAL SUSP $2,315.10 HC62227004 DEVICE INFLATN ACCESS ABD $2,315.00 HC62203021 ENDOSCOPIC SYSTEM $2,315.00 HC45200714 RADIOPHARM' TX; IV ADMIN $2,314.00 HC45200045 NM BONE MARROW LTD AREA $2,311.00 HC62218987 DRILL/DRILL BITS SINGLE USE AH $2,310.00 HC62224845 KIT PLACEMENT SHUNT ELECTROMAGNETIC $2,310.00 HC62227186 REAMER AG $2,310.00 HC21000914 APPLY MULTILAY COMPRS UPREX B $2,309.00 HC23000656 INJ ANES/STEROID NERVE FEMORAL LT $2,309.00 HC23000664 INJ ANES/STEROID NERVE FEMORAL RT $2,309.00 HC44200392 US OB >1ST TRI/1ST GEST $2,309.00 HC45200805 NM SPLEEN SCAN IMAGING ONLY $2,306.00 HC36800894 BRONCH W/COMPTR-ASST IMAGE-GUIDE NAVIGATE+ $2,303.00 HC36001188 BRONCH W/COMPTR-ASST IMAGE-GUIDE NAVIGATE+ $2,303.00 HC74200403 OR TIME ADD'L 15MIN CASE CX 5 (MCAL 1ST SUBSQNT 0.5 HR) $2,302.00 HC74200627 OR TIME ADD'L 15MIN CASE CX 5 (MCAL 2ND SUBSQNT 0.5 HR) $2,302.00 0641-6040-01 MORPHINE (PF) 25 MG/ML INJ SOLN $2,298.79 HC44001451 KNEE 4 OR MORE VWS BILAT $2,296.00 HC62213756 KIT VITREORETINAL PERFLUORON 7ML $2,295.00 16714-885-02 ACYCLOVIR 5 % TOPICAL OINT $2,294.37 HC51003861 FRENULOTOMY PENIS $2,292.00 HC41500596 STUDIES NERVE CONDUCTN 7-8 STUDIES $2,291.00 HC62228614 WOUND FILLER GEL(PLUROGEL)-14.1OZ $2,287.00 HC51001360 CLOSED TX KNEE FX(S) $2,284.00 0006-3823-10 CASPOFUNGIN 70 MG IV SOLR $2,280.72 0187-0658-20 DIAZEPAM 5-7.5-10 MG RECTAL KIT $2,279.88 HC47200803 RADIOPHARM' TX; IV ADMIN $2,279.00 HC42000141 ECHO 2D LMTD W/O SPEC&CLR /DOP $2,278.00 65628-270-10 OMEPRAZOLE-SODIUM BICARBONATE 2-84 MG/ML ORAL SUSR $2,275.65 65628-272-10 OMEPRAZOLE-SODIUM BICARBONATE 2-84 MG/ML ORAL SUSR $2,275.65 HC62228572 DEVICE EXCHANGE $2,275.00 HC62205745 PRESSURE WIRE $2,275.00 HC62806500 PROBE TEMPERATURE ESOPHAGEAL $2,275.00 HC62223581 SEALER VESSEL LAPAROSCOPIC $2,275.00 0143-9871-01 CLADRIBINE 10 MG/10 ML IV SOLN $2,275.00 25021-830-82 ZOLEDRONIC ACID-MANNITOL-WATER 5 MG/100 ML IV PGBK $2,275.00 42658-010-01 CLADRIBINE 10 MG/10 ML IV SOLN $2,275.00 0703-4636-01 STREPTOZOCIN 1 GRAM IV SOLR $2,270.00 HC45201019 NM VENOGRAM(THROMBOS)UNILAT LT $2,269.00 HC45201027 NM VENOGRAM(THROMBOS)UNILAT RT $2,269.00 HC25005349 HEMORRHOIDECTOMY/BANDING $2,263.00 HC44500692 CORPORA CAVERNOSGRAPHY $2,262.00 25021-309-82 ESMOLOL IN NACL (ISO-OSM) 2,000 MG/100 ML IV SOLP $2,261.35 HC62228846 TEMPLATE BRACHYTHERAPY U $2,261.00 HC62803309 CATH VENTRICL EXT DRAIN/MONITR $2,254.00 HC44200236 US DUPLEX PENILE VESSEL COMP $2,253.00 HC21000294 DEBRIDE P-THICK BURN LG>10%BSA $2,252.00 HC44001345 IVP ROUTINE $2,251.00 HC21000765 COMPARTM'L PRESSURE MEASURM'NT $2,250.00 HC51002814 CYSTOURETHROSCOPY(SEPARATE PROC) $2,250.00 HC46502621 INJECT URETEROGRAPH VIA ILEAL CONDUIT $2,246.00 HC43000611 PUNC ASP CYST BREAST EA ADD+LT $2,246.00 HC43000553 PUNC ASP CYST BREAST EA ADD+RT $2,246.00 HC43000322 PUNC CYST ASP BREAST ADD'L $2,246.00 HC62204763 MORCELLATOR $2,244.00 69344-102-33 INDOMETHACIN 50 MG RECTAL SUPP $2,242.50 HC44000206 XR COLON DOUBLE CONTRAST INC SCOUT,DELAYED $2,241.00 HC62804273 COIL EMBOLIZATION Q $2,240.00 HC62215496 PROBE SPINAL DISPOSABLE AA $2,240.00 HC62226485 WAND LARYNGEAL $2,240.00 42023-104-05 TUBERCULIN PPD 5 TUB. UNIT /0.1 ML INTRADERMAL SOLN $2,238.67 0469-0420-99 ISAVUCONAZONIUM SULFATE 372 MG IV SOLR $2,236.13 HC46000287 INJ FOR CYSTOGRAM $2,235.00 HC23001688 INJ ANES/STEROID ILIOINGNL/ILIOHYPOGAS LT $2,233.00 HC23000797 INJ ANES/STEROID ILIOINGNL/ILIOHYPOGAS NERVE $2,233.00 HC23001670 INJ ANES/STEROID ILIOINGNL/ILIOHYPOGAS RT $2,233.00 HC47200209 INTRACAVITARY TREATMT SIMPLE $2,233.00 HC41500802 EEG W/O VID UNMONITOR EA 12-26HR $2,231.00 0517-6560-01 SELENIUM 60 MCG/ML IV SOLN $2,229.50 0517-6560-05 SELENIUM 60 MCG/ML IV SOLN $2,229.50 0517-6560-25 SELENIUM 60 MCG/ML IV SOLN $2,229.50 HC24000093 HBO TX EA 1/2 HR COMPLEX/M $2,229.00 50458-295-15 ITRACONAZOLE 10 MG/ML ORAL SOLN $2,227.88 HC62808951 DEVICE SUTURE ENDO X-TACK $2,226.00 HC25001512 PARACENTESIS ABD W/ IMAGING $2,226.00 13533-800-15 IMMUNE GLOBUL G-GLY-IGA AVG 46 2.5 GRAM/25 ML (10 %) INJ SOLN $2,222.03 13533-800-16 IMMUNE GLOBUL G-GLY-IGA AVG 46 2.5 GRAM/25 ML (10 %) INJ SOLN $2,222.03 HC23000466 INJ ANES/STEROID NERVE SUPRASCAP LT $2,222.00 HC23000474 INJ ANES/STEROID NERVE SUPRASCAP RT $2,222.00 HC47200316 PHYSICS CONSULT SPECIAL $2,222.00 HC25003245 LAC REPAIR INTMD F/E/E/N/L/MM 20.1-30.0CM $2,220.00 HC62204029 KIT LASER VEIN ABLATION $2,207.00 HC62220108 ACCESS PORTL TRANSJUG INTRAHEP HSKL $2,205.00 HC23001050 INJ(S);TRIGGER POINT 3/>MUSCLES $2,205.00 HC62211149 OXYGENATOR PEDIATRIC C $2,205.00 HC46001137 INJ ARTHROGRAM ANKLE-SC BIL $2,204.00 HC25000027 ED LEVEL III - INTERMEDIATE $2,203.00 16714-859-01 CYCLOPHOSPHAMIDE 500 MG IV SOLR $2,202.79 HC77400141 ANESTHESIA INIT'L HR CASE CX $2,200.00 HC25005794 CLOSED TX ANKLE FX W/MANIP BIL $2,200.00 HC25004029 DRAIN ABSCESS FINGER COMPLEX $2,200.00 HC25005737 CLOSED TX HIP FX W/MANIP BIL $2,198.00 0006-3822-10 CASPOFUNGIN 50 MG IV SOLR $2,195.12 HC62219688 DILATOR SPINE/NERVE NEUROVISION $2,195.00 HC46000238 INJ CORPORA CAVERNOSOGRAM $2,193.00 HC38420014 COLLECT AUTOLOGUS BLD INL' 2 HR $2,191.00 HC25002734 CHANGE GT TUBE W/REV TRACT W/O IMAGE ENDO INCL REMVL $2,188.00 HC41500141 EEG MONITORING 41-60MINUTES $2,188.00 0143-9550-01 DAUNORUBICIN 5 MG/ML IV SOLN $2,179.78 HC62802814 BALLOON HDR APPLICATOR $2,177.00 HC62807789 M: PIN CABLE $2,177.00 HC31002140 PT-APPLIC CAST SHORT LEG WALK BILAT $2,176.00 0006-3061-00 FOSAPREPITANT 150 MG IV SOLR $2,175.10 0006-3061-01 FOSAPREPITANT 150 MG IV SOLR $2,175.10 HC12400115 INITIATE PROLONG CHEMO INFUSION PORTBL PUMP &F/U VISIT $2,175.00 HC44500650 CHANGE PERC DRAINAGE TUBE/CATH S&I ONLY $2,172.00 65862-752-50 CEFIXIME 200 MG/5 ML ORAL SUSR $2,171.65 HC44500916 INJ PERC EXT PSEUDOANEUR LT $2,171.00 HC44500924 INJ PERC EXT PSEUDOANEUR RT $2,171.00 HC38420071 PERFUSION CARDIOASSIST DC'D PROC $2,171.00 HC62223557 DRILL/DRILL BITS SINGLE USE AG $2,170.00 HC62216932 ENDO STAPLER AE $2,170.00 HC62227582 REAMER AH $2,170.00 55513-924-91 FILGRASTIM 300 MCG/0.5 ML INJ SYRG $2,169.05 HC41500786 EEG W/O VID MONITOR INTERMIT 2-12HR $2,166.00 99999-000-19 DINOPROSTONE (PROSTIN E2) 3 MG VAGINAL SUPPOSITORY $2,163.72 HC45200334 NM GASTROINTEST PROTEIN LOSS $2,162.00 HC23001407 INJ CER/THR F/IMAGE 3RD+&LVLLT LT $2,161.00 HC23001399 INJ CER/THR F/IMAGE 3RD+&LVLRT RT $2,161.00 16714-055-02 MUPIROCIN CALCIUM 2 % TOPICAL CREAM $2,160.99 51672-1370-2 MUPIROCIN CALCIUM 2 % TOPICAL CREAM $2,160.99 68462-564-35 MUPIROCIN CALCIUM 2 % TOPICAL CREAM $2,160.99 75834-280-30 POTASSIUM IODIDE 1 GRAM/ML ORAL SOLN $2,160.21 HC83000513 PLATELET PHERESIS EA UNIT $2,160.00 HC44200541 US RETROPERITONEAL COMPLETE $2,160.00 HC23000003 ANALYSIS IMPLANTED PUMP W/PROG $2,159.00 HC25001215 THORACENTESIS W/TUBE W/O IMAG LT $2,159.00 HC25001223 THORACENTESIS W/TUBE W/O IMAG RT $2,159.00 HC44200269 US DUPLEX VEIN EXT UNILAT/LTD $2,159.00 HC44000685 ENEMA THERAPEUTIC CONTRAST/AIR $2,157.00 55513-478-01 EPOETIN ALFA 20,000 UNIT/ML INJ SOLN $2,155.40 HC83000547 PLATELET PHERESIS IRRD EA UNIT $2,154.00 HC32000127 OT-EVAL SWALLOW CINE/FLUORO 90MIN $2,153.00 HC33000191 ST-EVAL SWALLOW CINE/FLUORO 90MIN $2,153.00 HC31002157 PT-APPLIC CAST LONG LEG BILAT $2,152.00 HC25006164 TRANSABDOMINAL AMNIOINFUSION $2,144.00 HC44002079 XR SMALL BOWEL W/DOUBLE CONTRAST INC SCOUT,SERIAL $2,144.00 HC62220546 CUTTER LAPAROSCOPIC S $2,143.00 HC44500957 INJ SCLEROTHERAPY SNGL VEIN-LT $2,137.00 HC44500965 INJ SCLEROTHERAPY SNGL VEIN-RT $2,137.00 HC83000067 PLATELET LR APHER/PHER EA UNIT $2,137.00 HC47200498 RAD TREATMENT DELVR, = 1MEV;INTRMED $2,137.00 16714-767-01 CEFIXIME 200 MG/5 ML ORAL SUSR $2,136.88 HC62219944 KNIFE BAYONET K $2,135.00 HC62229240 DEVICE DELIVER PILLCAM $2,135.00 11994-011-01 PERFLUTREN LIPID MICROSPHERES 1.1 MG/ML IV SUSP $2,134.73 11994-011-04 PERFLUTREN LIPID MICROSPHERES 1.1 MG/ML IV SUSP $2,134.73 HC62800115 BALLOON TAMPONADE UTERINE $2,128.00 HC62800123 BALLOON UTERINE $2,128.00 78206-125-01 MOMETASONE-FORMOTEROL 50-5 MCG/ACTUATION INHALATION HFAA $2,122.98 78206-127-01 MOMETASONE-FORMOTEROL 100-5 MCG/ACTUATION INHALATION HFAA $2,122.98 0469-0871-30 ADENOSINE IV INFUSION $2,122.97 HC23000375 INJ ANES/STEROID NERVE AXILLARY LT $2,122.00 HC23000383 INJ ANES/STEROID NERVE AXILLARY RT $2,122.00 HC25001181 THORACENTESIS ASP W/O IMG GUID-LT $2,119.00 HC25001199 THORACENTESIS ASP W/O IMG GUID-RT $2,119.00 HC38420352 ASSEMBLY & OPER PUMP OXYGEN; 30MIN $2,118.00 HC51003077 DRAIN ABSCESS WALL SCROTAL $2,115.00 HC62211255 SYSTEM DELIVERY SEPTAL DEFECT $2,114.00 HC62211263 SYSTEM EXCHANGE SEPTAL DEFECT $2,114.00 HC42000166 ECHO DOPPLER COMPLETE $2,112.00 0173-0717-22 FLUTICASONE PROPION-SALMETEROL 230-21 MCG/ACTUATION INHALATION HFAA $2,109.64 HC51003895 BONE MARROW DX; BIOPSY(IES) & ASPIRATION(S) $2,109.00 HC44001311 IVP DRIP OR BOLUS W/TOMO $2,107.00 HC32000481 OT-SWALLOWING EVAL 120MIN $2,107.00 HC62225735 ASPIRATOR ULTRASONIC SURG C $2,100.00 HC62217716 AWL SPINAL SINGLE PATIENT USE V $2,100.00 HC62215082 BLADE CUP AB $2,100.00 HC62220876 BLADE INCISIONAL V $2,100.00 HC62226493 CABLE LIGHT MIS SPINAL DISP $2,100.00 HC62227632 CANNULA PERFUSION RETROGRADE $2,100.00 HC62224928 CATH BALLOON DIL NON VASCULAR S $2,100.00 HC62218227 CATH DIAGNOSTIC S $2,100.00 HC62805957 CATH EP/ABLAT NOT COOL-TIP/3D/V MAP S $2,100.00 HC62805528 CATH GUIDING CARDIAC S $2,100.00 HC62214713 CATH PTCA BALLOON NON-LASER N $2,100.00 HC62210596 CATH THROMBECT DELIV INCL NEURO M $2,100.00 HC62807342 CLIP ENDOSCOPIC S $2,100.00 HC62804265 COIL EMBOLIZATION P $2,100.00 HC62205976 DEVICE RETRIEVAL C $2,100.00 HC62223771 DISSECTOR BALLOON ENDOSCOPIC F $2,100.00 HC62219936 DISSECTOR ULTRASONIC CORDLESS $2,100.00 HC62216924 ENDO STAPLER AD $2,100.00 HC62203302 FIBRIN SEALANT P $2,100.00 HC62225438 GRASPER TWIN ENDOSCOPIC $2,100.00 HC62210604 GUIDEWIRE(MIRAGE/X-CELERATOR) X $2,100.00 HC62224795 HANDPIECE VESSEL SEALER DEVICE F $2,100.00 HC62225057 INTRO/SHEATH EP FIXED NON-PEEL Q $2,100.00 HC62805668 INTRO/SHEATH EP LASER P $2,100.00 HC62805973 INTRO/SHEATH STEERABLE NON-PEEL C $2,100.00 HC62227129 INTRODUCER/SHEATH V $2,100.00 HC62807599 KIT CATH HEMO/PERI DIALYS LG TRM S $2,100.00 HC62215447 KIT DECOMPRESSION SPINAL C $2,100.00 HC62220256 KIT MONITORING NERVE(S) SPINAL C $2,100.00 HC62218169 KIT REPAIR PORT ACCESS LAP-BAND C $2,100.00 HC62222880 PAIN PUMP W/ SYSTEM S $2,100.00 HC62226329 PIN/WIRE FIXATION TEMPORARY AM $2,100.00 HC62217328 RETRACTOR MIS SPINAL C $2,100.00 HC62224613 SEALER VESSEL ROBOTIC $2,100.00 HC62225727 SHEARS COAGULATING HARMONIC T $2,100.00 HC62223623 SNARE S $2,100.00 HC62803739 STENT NON-COAT/NON-COV W-DEL S $2,100.00 HC62223755 SYSTEM DELIVERY LEAD I $2,100.00 HC62227954 SYSTEM DRESSING WOUND NEG PRES S $2,100.00 HC62221890 TAP SURGICAL S $2,100.00 HC62223086 TUBING ASPIRATOR (SONASTAR) S $2,100.00 HC62222666 TUBING ASPIRATOR ULTRASONIC S $2,100.00 25021-308-84 ESMOLOL IN NACL (ISO-OSM) 2,500 MG/250 ML (10 MG/ML) IV SOLP $2,099.50 63323-526-03 ARGATROBAN 100 MG/ML IV SOLN $2,099.50 67457-657-25 ESMOLOL IN NACL (ISO-OSM) 2,500 MG/250 ML (10 MG/ML) IV SOLP $2,099.50 HC41500208 EMG 2 EXTREMITY $2,091.00 HC83001206 PLATELET LR PHER EA UNIT $2,088.00 HC83001008 PLATELET LR PHER EA UNIT -SB $2,088.00 11980-180-10 PREDNISOLONE ACETATE 1 % OPHT DRPS $2,085.27 HC25000084 ASPIRATION OF BLADDER TROCAR $2,083.00 HC62229232 FORCEPS BIPOLAR HET $2,082.00 67457-533-16 DOCETAXEL 160 MG/16 ML (10 MG/ML) IV SOLN $2,080.00 HC21000823 APPY SKIN SUB HEAD/HND/FT EA+25SQ~HC $2,079.00 HC27001262 GASTRIC INTUB ASP DX;MULT SPEC $2,077.00 43598-698-11 CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN $2,073.44 43598-698-58 CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN $2,073.44 43598-917-11 CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN $2,073.44 43598-917-58 CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN $2,073.44 70121-1680-1 CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN $2,073.44 70121-1680-7 CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN $2,073.44 HC44200384 US KIDNEY TRANSPLANT W/DOPLER $2,073.00 HC41500836 EEG W/VIDEO UNMONITOR 2-12 HR $2,069.00 HC62228697 DEVICE SUTURE CAPIO $2,068.00 HC46001335 INJ CONTRAST KNEE ARTHRO/CT/MRI $2,067.00 HC25003609 REMOVE FB UPPER ARM/ELBOW SQ LT $2,066.00 HC25003617 REMOVE FB UPPER ARM/ELBOW SQ RT $2,066.00 HC46001046 INJ PERC EXT PSEUDOANEUR $2,063.00 HC74200395 OR TIME ADD'L 15MIN CASE CX 4 (MCAL 1ST SUBSQNT 0.5 HR) $2,063.00 HC74200619 OR TIME ADD'L 15MIN CASE CX 4 MCAL (2ND SUBSQNT 0.5 HR) $2,063.00 0944-2724-03 HYALURONIDASE, HUMAN RECOMB. 2,400 UNIT/15 ML SUBCUTANEOUS SOLN $2,062.13 0781-3056-70 ISONIAZID 100 MG/ML INJ SOLN $2,059.59 61364-181-03 PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) IV SOLN $2,058.29 72769-181-01 PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) IV SOLN $2,058.29 72769-181-03 PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) IV SOLN $2,058.29 HC26000117 POSTPARTUM CARE $2,058.00 HC51003036 BIOPSY PENIS(SEPARATE PROC) $2,057.00 11994-011-16 PERFLUTREN LIPID MICROSPHERES 1.1 MG/ML IV SUSP $2,056.39 HC44900827 CT COLONOGRAPHY SCREEN VIRTUAL W&WO CONTRAST $2,056.00 HC62209150 KIT TISSUE EXPANDER $2,055.00 59572-220-16 THALIDOMIDE 200 MG ORAL CAP $2,052.95 70408-644-34 THEOPHYLLINE 80 MG/15 ML ORAL ELIX $2,050.69 HC47201017 MANAGE RAD TREATMENT INTRAOP $2,049.00 HC36800852 TEST EXERC BRONCHOSPASM INCL SPIR&POX W/O ECG $2,049.00 45963-765-52 DOCETAXEL 80 MG/4 ML (20 MG/ML) IV SOLN $2,047.50 55513-530-10 FILGRASTIM 300 MCG/ML INJ SOLN $2,046.42 55513-530-01 FILGRASTIM 300 MCG/ML INJ SOLN $2,046.40 HC46000030 INJ ARTHRO HIP W/ANESTH-LT $2,045.00 HC46000048 INJ ARTHRO HIP W/ANESTH-RT $2,045.00 HC44002277 TMJ ARTHROGRAM BILAT $2,044.00 HC23001043 INJ(S);TRIGGER POINT 1-2MUSCLES $2,042.00 HC46000378 INJ FOR RETRO URETHROCYSTO $2,037.00 HC44200616 TRANSCRANIAL DOPPLER STUDY LTD $2,037.00 HC44001758 PYELOGRAM RETROGRADE $2,034.00 HC44000222 BONE LENGTH STUDIES $2,033.00 HC26000190 L&D EVAL LEVEL V - COMPREHENSV $2,033.00 HC33000365 ST-SWALLOWING EVAL 120MIN $2,031.00 HC62218979 DRILL/DRILL BITS SINGLE USE AF $2,030.00 HC62216916 ENDO STAPLER AC $2,030.00 HC62213616 REAMER AF $2,030.00 HC44200525 US PELVIC(NON OB) $2,030.00 HC46500930 INJ W/FLUOR, EVAL CV ACCESS DEVICE $2,028.00 99999-042-14 VANCOMYCIN 250 MG / 5 ML ORAL SYRINGE $2,028.00 HC45201308 NM THYROID UPTAKE (PROBE) ONLY SNGL/MULT QNT MSRMT $2,025.00 HC23000086 ASP/INJ JOINT MED W/O UTZ GUIDE-RT $2,024.00 HC42000919 ECG EXT HOLTER >7DAYS-15DAYS; SCANNING ANYS W/REPORT $2,023.00 HC23000078 ASP/INJ JOINT MED W/O UTZ GUIDE-LT $2,021.00 HC31001837 PT-EVAL HIGH COMPLEXITY 45MIF2F 150MIN $2,020.00 HC21000591 DEBRIDE OPN WND 1ST 20SQCM OR< $2,018.00 HC51010148 DESTRUCT OTHER PERIPH NERV/BRNCH BI $2,018.00 HC44200335 US HEAD $2,017.00 0054-3722-63 PREDNISONE 5 MG/5 ML ORAL SOLN $2,015.00 13517-100-30 DIAZOXIDE 50 MG/ML ORAL SUSP $2,012.60 55513-021-01 DARBEPOETIN ALFA IN POLYSORBAT 40 MCG/0.4 ML INJ SYRG $2,012.40 55513-021-04 DARBEPOETIN ALFA IN POLYSORBAT 40 MCG/0.4 ML INJ SYRG $2,012.40 HC42000331 ECG EXT HOLTER UP TO 48HRS; SCANNING ANYS & REPORT $2,009.00 HC12400065 CHEMO ADMIN CNS W/SPINAL PUNCTURE $2,006.00 71837-5843-1 SARGRAMOSTIM 250 MCG INJ SOLR $2,004.98 71837-5843-5 SARGRAMOSTIM 250 MCG INJ SOLR $2,004.98 HC21000286 DEBRIDE P-THICK BURN 5-10% BSA $2,004.00 HC26000109 INSERTION CERVICAL DILATOR $2,003.00 0169-3687-12 INSULIN DETEMIR U-100 100 UNIT/ML SUBCUTANEOUS SOLN $2,002.91 HC74200262 BEDSIDE/OTHER SURG ADD'L 15MIN 3 (MCAL 1ST SUBSQNT 0.5 HR) $2,000.00 HC74200502 BEDSIDE/OTHER SURG ADD'L 15MIN 3 (MCAL 2ND SUBSQNT 0.5 HR) $2,000.00 HC89024251 INFECT PATHOGENS PLASMA KARIUS-KR $2,000.00 HC38420378 LVAD/RVAD MANAGEMNT & SUPPORT DAILY $2,000.00 HC25003237 LAC REPAIR INTMD F/E/E/N/L/MM 12.6-20CM $1,998.00 HC44701209 EXTRA PUMP TIME/.5 HR $1,997.00 HC44200194 US DUPLEX CAROTID UNILAT LT $1,997.00 HC44200202 US DUPLEX CAROTID UNILAT RT $1,997.00 HC62212808 GUIDEWIRE W $1,995.00 HC36800217 HIGH ALTD SIM TEST W/O2TI-HAST $1,992.00 HC12400057 INITIATE PROLONG CHEMO INFUSION VIA PUMP $1,992.00 HC25004235 CLOSED TX HIP DISLOC POST ARTHROPLASTY BIL $1,989.00 HC25004326 CLOSED TX KNEE DISLOC; NO ANESTH BIL $1,989.00 HC45200003 CARDIAC BLOOD POOL 1ST PASS+ $1,988.00 HC62228986 STYLET PROBE NAVIGATION $1,988.00 HC25005760 CLOSED TX FIBULA DISTAL FX W/MANIP BIL $1,987.00 HC62228747 BRUSH(ALWAYS-ON TIP TRACKED®) $1,985.00 HC62228754 FORCEPS(ALWAYS-ON TIP TRACKED®) $1,985.00 HC62228762 NEEDLE 19G HISTO(ALWAYS-ON TIP TRACKED®) $1,985.00 HC25003179 LAC REPAIR INTMD N/H/F/GEN 20.1-30 $1,981.00 HC25005224 REMOVE FB VESTIBULE MOUTH; SIMPLE $1,981.00 49502-500-02 EPINEPHRINE 0.3 MG/0.3 ML INJ ATIN $1,977.98 49502-501-01 EPINEPHRINE 0.15 MG/0.3 ML INJ ATIN $1,977.98 49502-501-02 EPINEPHRINE 0.15 MG/0.3 ML INJ ATIN $1,977.98 HC62219902 CANNULA ARTHRSCPC ROTATING K $1,977.00 HC21001086 WOUND VAC TX W/ DISP ASST/INSTR >50SQ CM SESSION $1,975.00 68682-652-20 DIAZEPAM 5-7.5-10 MG RECTAL KIT $1,971.97 68682-655-20 DIAZEPAM 12.5-15-17.5-20 MG RECTAL KIT $1,971.97 HC41500588 STUDIES NERVE CONDUCTN 5-6 STUDIES $1,967.00 HC44200418 US OB 1ST TRI/1ST GEST $1,967.00 HC25003542 CLOSED TX HUMRL FX W/MAN W/WO SKLTL TRAC LT $1,966.00 HC25003559 CLOSED TX HUMRL FX W/MAN W/WO SKLTL TRAC RT $1,966.00 HC25005190 REPAIR LIP FULL THICK; TO HALF VERTICAL HT $1,964.00 HC83001248 PLATELET PHERESIS PATHOGEN REDUCED EA UNIT $1,963.00 HC12400008 CHEMO ADMIN IV INITIAL HR $1,961.00 HC62226204 BLADE SHAVER AC $1,960.00 HC62806161 CATH EP DX <20 ELECTRODES L $1,960.00 HC62804257 COIL EMBOLIZATION O $1,960.00 HC62216908 ENDO STAPLER AB $1,960.00 HC62213608 REAMER AE $1,960.00 HC25000654 LUMBAR PUNCTURE DX [NOT W/ CT OR FLUORO] $1,958.00 HC44000768 FEMUR 2/> VIEWS BILAT $1,951.00 0169-3685-12 INSULIN ASP PRT-INSULIN ASPART 100 UNIT/ML (70-30) SUBCUTANEOUS SOLN $1,950.78 HC79200028 MUSCLE TEST, THREE LIMBS $1,950.00 0187-4302-02 SODIUM NITROPRUSSIDE 25 MG/ML IV SOLN $1,950.00 23155-186-31 ZOLEDRONIC ACID-MANNITOL-WATER 5 MG/100 ML IV PGBK $1,950.00 55111-688-52 ZOLEDRONIC ACID-MANNITOL-WATER 5 MG/100 ML IV PGBK $1,950.00 63323-966-00 ZOLEDRONIC ACID-MANNITOL-WATER 5 MG/100 ML IV PGBK $1,950.00 70121-1003-1 EPTIFIBATIDE 0.75 MG/ML IV SOLN $1,950.00 HC44200749 US GUIDANCE FNA S&I LT $1,949.00 HC44200756 US GUIDANCE FNA S&I RT $1,949.00 HC44200764 US GUIDANCE PLACEMENT S&I LT $1,949.00 HC44200707 US GUIDANCE PLACEMENT NEEDLE LOC S&I ONLY $1,949.00 HC44200780 US GUIDANCE PLACEMENT NEEDLE LOC S&I LT $1,949.00 HC44200798 US GUIDANCE PLACEMENT NEEDLE LOC S&I RT $1,949.00 HC44200772 US GUIDANCE PLACEMENT S&I RT $1,949.00 HC44200624 US TRANSRECT PROSTATE VOL STDY $1,949.00 HC26000075 FETAL CONTRACT/NIPPLE STIM $1,946.00 HC26000083 FETAL CONTRACTION STRESS TEST $1,946.00 HC44000826 FLUORO GUIDANCE NEEDLE PLACEMENT $1,945.00 0187-5100-01 PIMECROLIMUS 1 % TOPICAL CREAM $1,943.76 HC62211172 KIT PERFUSION - PEDS $1,943.00 HC41500232 EMG FACIAL BILAT $1,941.00 HC25003294 LAC REPAIR CMPLX S/A/L 2.6-7.5 CM $1,941.00 HC25000936 CHANGE GT TUBE W/O IMAGE/ENDO $1,940.00 67457-366-10 IBUTILIDE FUMARATE 0.1 MG/ML IV SOLN $1,938.95 HC51002657 I&D ABSCESS RECTAL $1,938.00 99999-041-49 NM TC-99M MACROAGGREG (MAA) MHS $1,937.08 63323-658-20 CHLOROTHIAZIDE SODIUM 500 MG IV SOLR $1,935.05 70727-497-25 NETARSUDIL 0.02 % OPHT DROP $1,931.15 HC44200152 US DUPLEX ART LOW EXT UNILAT/LTD $1,931.00 0074-4382-20 CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) IV SOLN $1,930.50 0074-4382-93 CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) IV SOLN $1,930.50 HC43000371 US GUIDANCE FNA S&I ONLY $1,930.00 HC44200566 US SCROTUM $1,930.00 HC32001745 OT-EVAL HIGH COMPLEXITY 45MF2F 180MIN $1,929.00 HC62805031 CATH MAPPING PH ESOPHAGEAL $1,925.00 HC62226766 FORCEPS BIOPSY MICRO(MORAY) $1,925.00 99999-038-91 POLIHEXANIDE (PURAPLY AM) 2X2 CM EACH TOPICAL SHEET $1,924.00 HC25005216 DRAIN ABSCESS/LESION MOUTH; SIMPLE $1,923.00 66490-650-20 DIAZEPAM 2.5 MG RECTAL KIT $1,921.92 HC44200111 US DUPLEX ABD/PEL FLOW LTD $1,919.00 HC44001493 KNEE ARTHROGRAM LT $1,918.00 HC44001501 KNEE ARTHROGRAM RT $1,918.00 72682-2625-00 ARGININE-LYSINE-STERILE WATER 25-25 MG/ML IV SOLN $1,917.50 99999-033-52 RADIESSE INJECTABLE IMPLANT $1,917.50 43598-674-50 CEFIXIME 200 MG/5 ML ORAL SUSR $1,916.85 HC41500935 AUDITORY EVOKED AEP NEURODIAGNOSTIC W/I&R $1,915.00 HC41500927 AUDITORY EVOKED AEP THRESHOLD EST MULT FREQ W/I&R $1,915.00 HC23001720 N BLOCK INJ PLANTAR DIGIT (MOTONS) LT $1,915.00 HC23001738 N BLOCK INJ PLANTAR DIGIT (MOTONS) RT $1,915.00 HC62219043 PORT INSTRMNT MULTI LAPAROSCPC $1,914.00 65162-087-74 ITRACONAZOLE 10 MG/ML ORAL SOLN $1,910.03 HC25000092 CPR $1,909.00 HC62804653 FILTER VENA CAVA A $1,908.00 0173-0388-79 BECLOMETHASONE DIPROP (AQ) 42 MCG (0.042 %) NASL SPRY $1,906.78 0003-0524-11 DASATINIB 70 MG ORAL TAB $1,904.57 0003-0528-11 DASATINIB 50 MG ORAL TAB $1,904.57 HC27000850 ESOPH RFLUX W/PH ELECTR DISCTD $1,904.00 HC12200325 IV INFUSE/SC MONOCLONAL CASIRIVIMAB/IMDEVIMAB (REGENERON) $1,904.00 HC25005844 REMOVE CATH CV TUNNELED W/O PORT/PUMP $1,904.00 HC27001965 ESOPHAG REFLUX W/NASAL ELEC>1H DISCON'D $1,903.00 68682-045-50 TIMOLOL MALEATE 0.5 % OPHT DRPD $1,900.86 HC89022792 TARGETED GENOME PNL SEQ 51/>GENES-AU $1,900.00 HC44200178 US DUPLEX ART UP EXT UNILAT/LTD $1,900.00 HC43000736 US GUIDANCE CYST ASPIRATION S&I LT $1,900.00 HC43000744 US GUIDANCE CYST ASPIRATION S&I RT $1,900.00 HC32000473 OT-SWALLOWING EVAL 90MIN $1,898.00 46287-009-01 ISONIAZID 50 MG/5 ML ORAL SOLN $1,896.97 HC44000834 FLUORO GUIDANCE NEEDL/CATH LOCALIZATION SPINE INJ(NONFRMN $1,894.00 HC62217401 SEALER BIPOLAR AQUAMANTYS $1,893.00 HC62218961 DRILL/DRILL BITS SINGLE USE AE $1,890.00 HC62216890 ENDO STAPLER AA $1,890.00 HC62220041 PROBE SPINAL DISPOSABLE V $1,890.00 HC62213590 REAMER AD $1,890.00 HC25003344 LAC REPAIR CMPLX E/N/E/L 2.6-7.5 CM $1,889.00 HC25003229 LAC REPAIR INTMD F/E/E/N/L/MM 7.6-12.5CM $1,889.00 HC44200640 US TRANSVAGINAL(NON OB) $1,887.00 HC44001428 KNEE 3 VIEWS BILAT $1,885.00 HC25000951 INCISION EXTERNAL HEMORRHOID $1,882.00 0169-7501-11 INSULIN ASPART U-100 100 UNIT/ML SUBCUTANEOUS SOLN $1,880.84 HC44000131 ANKLE COMP MIN 3 VWS BILAT $1,880.00 HC27000843 ESOPH RFLUX PH STDY-LNG DISCTD $1,880.00 HC24000101 HBO TX EA 1/2 HR INTERMEDIAT/M $1,880.00 HC44200368 US INFANT HIPS(DYNAMIC) $1,880.00 0591-4385-79 FOSAPREPITANT 150 MG IV SOLR $1,879.28 HC33000357 ST-SWALLOWING EVAL 90MIN $1,878.00 0173-0887-14 FLUTICASONE-UMECLIDIN-VILANTER 100-62.5-25 MCG INHALATION DSDV $1,877.88 HC42000182 ECHO DOPPLER COLOR FLOW $1,877.00 HC25005000 APPLY CAST LONG LEG BILATERAL $1,876.00 HC44201002 US OB EVA PLUS FETAL ANATOMIC DETAIL EA ADL GEST+ $1,875.00 HC21000484 I&D POLINIDAL CYST: SIMPLE $1,874.00 HC51003317 CURETTAGE ENDOCERVICAL (ECC) $1,873.00 HC44002509 UROGRAPHY ANTEGRADE $1,872.00 50484-010-30 COLLAGENASE CLOSTRIDIUM HISTO. 250 UNIT/GRAM TOPICAL OINT $1,871.61 HC36800399 SPIROMETRY W/PRE&POST BRONCHO $1,871.00 HC36001063 SPIROMETRY W/PRE&POST BRONCHO $1,871.00 HC25005513 REMOVE FB EXTRNL EYE; CONJUNCT EMBEDD BIL $1,870.00 0002-8824-01 INSULIN REGULAR HUM U-500 CONC 500 UNIT/ML (3 ML) SUBCUTANEOUS INPN $1,866.15 0002-8824-27 INSULIN REGULAR HUM U-500 CONC 500 UNIT/ML (3 ML) SUBCUTANEOUS INPN $1,866.15 HC44001048 HIP ARTHROGRAM LT $1,863.00 HC44001055 HIP ARTHROGRAM RT $1,863.00 HC74200387 OR TIME ADD'L 15MIN CASE CX 3 (MCAL 1ST SUBSQNT 0.5 HR) $1,861.00 HC74200601 OR TIME ADD'L 15MIN CASE CX 3 (MCAL 2ND SUBSQNT 0.5 HR) $1,861.00 HC46502753 BIOPSY INCISIONAL SKIN; SINGLE INITIAL LESION $1,859.00 HC36800209 HIGH ALTITUDE SIM' TEST- HAST $1,857.00 HC41000068 POLYSMNGRPH 4+STG6&> ATTD DISCONT' $1,857.00 HC62212790 GUIDEWIRE(AVIGO/NEURVSCLR SFT TIP)V $1,855.00 HC62205018 NEEDLE STEREOTACTIC BX $1,855.00 55150-337-01 BORTEZOMIB 3.5 MG INJ SOLR $1,852.50 HC44000016 3D RENDER W/O INDENDNPT WORKSTN $1,852.00 HC62217088 SHIM DEVICE ACCESS SPINAL X $1,852.00 HC44002905 SPINE ENTIRE SKULL-SACRUM 6/> VIEWS $1,852.00 0002-7511-01 INSULIN LISPRO PROTAMIN-LISPRO 100 UNIT/ML (75-25) SUBCUTANEOUS SUSP $1,850.55 0002-7512-01 INSULIN LISPRO PROTAMIN-LISPRO 100 UNIT/ML (50-50) SUBCUTANEOUS SUSP $1,850.55 HC25005034 APPLY CAST SHORT LEG BILATERAL $1,849.00 HC47200308 PHYSICS CONSULT CONTINUOUS $1,847.00 HC46000949 SEL CATH THOR/BRAC+ 2ND/3RD LT $1,847.00 HC46000956 SEL CATH THOR/BRAC+ 2ND/3RD RT $1,847.00 0088-2500-33 INSULIN GLULISINE U-100 100 UNIT/ML SUBCUTANEOUS SOLN $1,845.68 HC51003630 ANOSCOPY W/DILATION $1,845.00 HC51003648 ANOSCOPY W/BIOPSY $1,844.00 HC36800258 O2 UPTAKE COMPLETE $1,843.00 HC44000842 FLUORO GUIDANCE CV ACCESS CATH REPLACE/RMVL R&I $1,841.00 0469-3051-30 AMPHOTERICIN B LIPOSOME 50 MG IV SUSR $1,839.83 16714-834-01 PALONOSETRON 0.25 MG/5 ML IV SOLN $1,837.62 HC46500906 FNA ASP BX W/O GUIDE; FIRST LESION $1,837.00 HC82202524 FNA ASP BX W/O GUIDE; FIRST LESION $1,837.00 HC44001964 SHOULDER ARTHROGRAM LT $1,835.00 HC44001972 SHOULDER ARTHROGRAM RT $1,835.00 HC44200137 US DUPLEX AORTA,IVC,ILIAC UNI/LTD $1,833.00 70436-027-80 EPTIFIBATIDE 0.75 MG/ML IV SOLN $1,833.00 50242-064-01 ERLOTINIB 150 MG ORAL TAB $1,831.14 HC62223235 KIT HEMORRHOID SLIDE ONE $1,830.00 HC44200343 US HEAD/NECK SOFT TISSUE $1,830.00 0703-4680-01 MITOXANTRONE 2 MG/ML IV CONC $1,829.17 HC62808142 I:FECAL MICROBIOTA (FMP250) $1,829.00 0002-8031-01 GLUCAGON 1 MG INJ SOLR $1,825.20 HC38000261 APPLY BODY CAST; FULL ADULT $1,823.00 0781-3233-94 CYCLOPHOSPHAMIDE 500 MG IV SOLR $1,821.24 HC62804240 COIL EMBOLIZATION N $1,820.00 HC62216882 ENDO STAPLER Z $1,820.00 HC62220405 FIT TALAR LOCKING TRIAL $1,820.00 HC62805221 HEMOSTAT VITAGEL SURGICAL $1,820.00 HC62216759 PIN/WIRE FIXATION TEMPORARY AL $1,820.00 HC62213582 REAMER AC $1,820.00 HC62220595 SHEARS COAGULATING HARMONIC R $1,820.00 HC62206677 SPHINCTEROTOME W/WIRE M $1,820.00 HC62228317 STAPLER SINGLE USE ROBOTIC $1,820.00 HC41500554 VESTIBULAR COMPREHENSIVE EVAL $1,820.00 HC44000917 FOOT COMP MIN 3 VWS BILAT $1,818.00 HC73000234 DIALYSIS CRRT CANCEL-MED NEC $1,816.00 45802-210-02 NITROGLYCERIN 400 MCG/SPRAY TL SPRY $1,815.45 HC62207139 SYSTEM DALL MILES CABLE GRIP $1,815.00 0409-0367-01 DOCETAXEL 80 MG/4 ML (20 MG/ML) IV SOLN $1,814.41 HC23000334 INJ ANES/STEROID NERVE OCCIPITAL GREAT $1,814.00 HC23001563 INJ ANES/STEROID NERVE OCCIPITL GREAT LT $1,814.00 HC23001555 INJ ANES/STEROID NERVE OCCIPITL GREAT RT $1,814.00 HC32001794 OT-ENDOSCOPIC EVAL SWALLOW $1,814.00 HC33000159 ST-ENDOSCOPIC EVAL SWALLOW $1,814.00 HC51002756 ASPIRATION OF BLADDER TROCAR $1,813.00 HC43000710 US GUIDANCE BREAST CORE BIOPSY S&I LT $1,812.00 HC43000728 US GUIDANCE BREAST CORE BIOPSY S&I RT $1,811.00 HC25000639 PARACENTESIS ABD W/O IMAGING $1,810.00 HC44000198 XR COLON SINGLE CONTRAST INC SCOUT,DELAYED $1,809.00 HC25004888 APPLY CAST; SHOULDER TO HAND (LONG ARM) BILAT $1,806.00 HC62210927 CANNULA ENDO ARTERIAL $1,806.00 HC25000191 INSERT NEEDLE INTRAOSSEOUS INF $1,806.00 HC44200350 US HYSTEROSONOGRAPHY $1,806.00 HC44000651 ELBOW COMP MIN 3 VWS BILAT $1,801.00 HC28000156 EXTERNAL COUNTERPULSATION/TX $1,801.00 65174-270-30 KIT FOR OF PREP TC-99M-ALBUMIN 2.5 MG IV SOLR $1,799.79 HC62223490 ORTHOTIC ANKLE FOOT TIBIAL FX RT $1,797.00 HC46000428 INJ PROC SPLENOPORTOGRAM $1,794.00 HC25005679 ASP/INJ JOINT/BURSA MAJOR W/US-BIL $1,793.00 99999-035-30 INSULIN ASPART 100 UNIT/ML SUBCUTANEOUS SOLN (INSULIN PUMP) $1,791.27 HC41000027 SLEEP STUDY ATTENDED DISCNT'D $1,791.00 0254-1010-19 DIAZOXIDE 50 MG/ML ORAL SUSP $1,790.88 HC62224449 INJECTOR GUN CEMENT $1,790.00 63323-196-06 FLUDARABINE 50 MG IV SOLR $1,789.26 HC47200001 BASIC DOSIMETRY CALCULATION $1,789.00 HC62223177 DEVICE ILLUMINATION MAST $1,789.00 HC25003278 LAC REPAIR CMPLX TRUNK 2.6-7.5 CM $1,788.00 55111-652-07 BIVALIRUDIN 250 MG IV SOLR $1,787.50 HC44001006 HAND COMPLETE MIN 3 VWS BILAT $1,787.00 HC62224282 DEVICE FIXATION SOFT TISSUE $1,786.00 HC62807672 M: STEM ANKLE TIBIAL $1,786.00 HC62217302 STRIPPER TENDON $1,786.00 0002-7510-01 INSULIN LISPRO 100 UNIT/ML SUBCUTANEOUS SOLN $1,785.55 61314-318-10 FILGRASTIM-SNDZ 300 MCG/0.5 ML INJ SYRG $1,783.36 61314-318-01 FILGRASTIM-SNDZ 300 MCG/0.5 ML INJ SYRG $1,783.34 HC43000991 US BREAST; COMPLETE BILATERAL $1,783.00 0143-9247-01 DEXRAZOXANE HCL 250 MG IV SOLR $1,782.69 70515-711-01 CICLESONIDE 80 MCG/ACTUATION INHALATION HFAA $1,782.35 70515-712-01 CICLESONIDE 160 MCG/ACTUATION INHALATION HFAA $1,782.35 HC44001980 SHOULDER COMP MIN 2VWS BILAT $1,782.00 HC44002574 WRIST COMP MIN 3 VWS BILAT $1,782.00 HC32001570 OT-EVAL DRIVING REHAB/W $1,781.00 0173-0719-20 FLUTICASONE PROPIONATE 110 MCG/ACTUATION INHALATION HFAA $1,779.88 HC25003328 LAC REPAIR CMPLX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM $1,778.00 HC62228473 BASKET RETRIEVAL BILIARY (SPYGLASS) $1,777.00 0409-1103-01 CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) IV SOLN $1,775.80 0409-1103-11 CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) IV SOLN $1,775.80 99999-001-79 CHARGE-ADULT 3 IN 1 ADMIX 3000ML $1,774.50 HC12400107 INTRAPERITONEAL CHEMO THERAPY $1,774.00 HC51061513 REMOVE IMPLANT SUPERFICIAL $1,774.00 HC62203849 KIT DISSECTOR HYDRO PUMP $1,773.00 HC36800126 TEST BRONCHIAL INHAL CHALLENGE W/HISTAMINE $1,771.00 HC46000063 INJ ARTHRO/CT/MRI SHOULDER-LT $1,770.00 HC46000071 INJ ARTHRO/CT/MRI SHOULDER-RT $1,770.00 0093-3541-43 ESTRADIOL 0.01 % (0.1 MG/GRAM) VAGINAL CREAM $1,768.28 HC38000279 APPLY BODY CAST; FULL CHILD $1,768.00 59584-138-01 CANDIDA ALBICANS SKIN TEST FDA STANDARD INTRADERMAL ALRG $1,768.00 63323-192-02 FLUDARABINE 50 MG/2 ML IV SOLN $1,767.22 HC46000477 INJECTION HIP ARTHROGRAM LT $1,767.00 HC46000485 INJECTION HIP ARTHROGRAM RT $1,767.00 HC62226758 WOUND FILLER DRY COLLAGEN S $1,766.00 0409-1140-01 ARGATROBAN 100 MG/ML IV SOLN $1,765.99 HC44200012 US ABDOMEN LTD $1,765.00 HC51061000 REMOVE NEPHROSTOMY TUBE BIL $1,763.00 HC25000860 ASP/INJ MED JOINT-BILAT $1,762.00 0009-5138-02 LINEZOLID 600 MG ORAL TAB $1,761.58 HC25004565 CLOSED TX ANKLE DISLOC; NO ANES BIL $1,760.00 HC25003286 LAC REPAIR CMPLX S/A/L 1.1-2.5 CM $1,760.00 HC25003211 LAC REPAIR INTMD F/E/E/N/L/MM 5.1-7.5CM $1,760.00 HC25003161 LAC REPAIR INTMD N/H/F/GEN 12.6-20 $1,760.00 HC25005547 REMOVE FB EXTRNL EYE; CORNEAL NO SLITLAMP BIL $1,760.00 HC25005182 REPAIR LIP FULL THICK; VERMILION ONLY $1,760.00 67157-101-50 ASCORBIC ACID (VITAMIN C) 500 MG/ML IV SOLN $1,758.90 0703-2045-01 CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) IV SOLN $1,758.25 0703-2045-03 CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) IV SOLN $1,758.25 63323-418-01 CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) IV SOLN $1,758.25 63323-418-20 CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) IV SOLN $1,758.25 16714-927-01 AZACITIDINE 100 MG INJ SOLR $1,758.06 HC12400131 CHEMO INJECT(S) SUBARACHNOID/INTRAVENT VIA RESEVOIR $1,758.00 HC32000465 OT-SWALLOWING EVAL 75 MIN $1,756.00 HC44001329 IVP INFUSION DRIP OR BOLUS $1,755.00 16729-259-38 EPTIFIBATIDE 0.75 MG/ML IV SOLN $1,755.00 HC51003234 COLPOSCOPY VAG W/BX(S)VAGINA/CERVIX $1,754.00 HC41000100 POLYSMNGRPH 4+STGS <6 DISCONT $1,752.00 63713-019-85 MICROFIBRIL. COLLAGEN HEMOSTAT 1 GRAM TOPICAL MISC $1,751.61 69238-2141-7 ENALAPRIL MALEATE 1 MG/ML ORAL SOLN $1,751.10 HC62222377 ASPIRATOR ULTRASONIC SURG B $1,750.00 HC62213079 BLADE SHAVER Z $1,750.00 HC62211560 CATH BALLOON SINUPLASTY G $1,750.00 HC62218219 CATH DIAGNOSTIC R $1,750.00 HC62216767 CATH EP DIAG/ABLAT 3D/VECT E $1,750.00 HC62800370 CATH GUIDING R $1,750.00 HC62218292 CATH INTRODUCER PEEL-AWAY AB $1,750.00 HC62223383 CATH MICRO NEURO(ENVOY/REBAR) L $1,750.00 HC62223417 CATH PTA ANGIOPLS BALLOON NON-LSR N $1,750.00 HC62211867 CATH PTCA ANGIOPLASTY NON-LASER M $1,750.00 HC62806997 CATH SWAN GANZ/THERMODILUTION R $1,750.00 HC62220215 CATH THROMBECTOMY/EMBOLECTOMY R $1,750.00 HC62807334 CLIP ENDOSCOPIC R $1,750.00 HC62220223 CLIP STIMULATION NERVE I $1,750.00 HC62226022 COUNTERSINK R $1,750.00 HC62218953 DRILL/DRILL BITS SINGLE USE AD $1,750.00 HC62227319 ELECTRODE BIPOLAR ENDO D $1,750.00 HC62227681 ELECTRODE MONOPOLAR BALL $1,750.00 HC62224712 ELECTRODE NEEDLE UROLOGICAL HF $1,750.00 HC62216874 ENDO STAPLER Y $1,750.00 HC62805759 FIBRIN SEALANT O $1,750.00 HC62227459 GUIDE COMPONENT KNEE CUSTOM PATIENT $1,750.00 HC62225883 GUIDE DRILL R $1,750.00 HC62219837 HAND ACCESS DEVICE G $1,750.00 HC62212485 HANDPIECE VESSEL SEALER DEVICE C $1,750.00 HC62218185 HEMOSTATIC GEL/GELFOAM/PAD R $1,750.00 HC62224456 INTRO/SHEATH EP FIXED NON-PEEL P $1,750.00 HC62223912 INTRODUCER/SHEATH(NEURON MAX) U $1,750.00 HC62217484 KIT CONCENTRATOR PLATELETS R $1,750.00 HC62221106 KIT CRICOTHYROTOMY EMERGENCY R $1,750.00 HC62204268 KIT TIPS $1,750.00 HC62219720 KIT VITRECTOMY PROBE K $1,750.00 HC62226733 MOLD/FORM CEMENT $1,750.00 HC62222187 NEEDLE BX HIP TAPERED COBALT/FNA(SHARKCORE) $1,750.00 HC62227624 NOTCHER TUNNEL R $1,750.00 HC62220314 ORTHOTIC KNEE W/JNTS PRFB CUSTM O $1,750.00 HC62220140 OVERTUBE ENDOSCOPIC D $1,750.00 HC62801725 PORT INDWELLING W/CATH K $1,750.00 HC62222328 PROBE ABLATION R $1,750.00 HC62224977 PROBE LITHOTRIPTOR R $1,750.00 HC62204599 PROGRAMMER NEUROSTIM PAT B 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GEST+ $1,680.00 HC25003104 LAC REPAIR INTMD S/A/T/EXT 12.6-20CM $1,678.00 HC44200210 US DUPLEX CAROTID LTD $1,677.00 HC74200254 BEDSIDE/OTHER SURG ADD'L 15MIN 2 (MCAL 1ST SUBSQNT 0.5 HR) $1,676.00 HC74200494 BEDSIDE/OTHER SURG ADD'L 15MIN 2 (MCAL 2ND SUBSQNT 0.5 HR) $1,676.00 HC25004714 CLOSED TX BIG TOE FX; W/MANIPULTN BIL $1,676.00 HC62804596 STENT CORO BARE METAL W/DEL B $1,676.00 HC44200632 US TRANSRECTAL $1,676.00 60505-1005-1 TIMOLOL MALEATE 0.5 % OPHT DRPD $1,675.96 0469-6501-89 REGADENOSON 0.4 MG/5 ML IV SYRG $1,675.44 0186-0370-28 BUDESONIDE-FORMOTEROL 160-4.5 MCG/ACTUATION INHALATION HFAA $1,674.47 HC25004532 CLOSED TX PROX TIBIOFIBULAR JNT DISLOC; NO ANES BIL $1,674.00 HC44001204 HYSTEROSALPINGOGRAM $1,674.00 HC44200228 US DUPLEX HEMODIALYSIS ACCESS $1,672.00 HC44001287 INTRALUMINAL DILATION O/STRICT S&I ONLY $1,671.00 0186-0916-12 BUDESONIDE 180 MCG/ACTUATION INHALATION AEPB $1,669.79 99999-039-44 INSULIN REGULAR HUM U-500 CONC 500 UNIT/ML SUBCUTANEOUS SOLN $1,668.87 HC51010841 BONE MARROW DX; BIOPSY(SIES) ONLY $1,668.00 HC25003674 CLOSED TX ELBOW DISLOC W/O ANES-BIL $1,667.00 HC25002825 I&D POLINIDAL CYST; SIMPLE $1,667.00 HC25003310 LAC REPAIR CMPLX F/C/C/M/N/AX/G/H/F 1.1-2.5CM $1,667.00 HC25003096 LAC REPAIR INTMD S/A/T/EXT 7.6-12.5CM $1,667.00 HC25000100 CRICOTHYROIDOSTOMY $1,665.00 HC41500570 STUDIES NERVE CONDUCTN 3-4 STUDIES $1,665.00 HC46502738 BIOPSY PUNCH SKIN; SINGLE INITIAL LESION $1,663.00 HC25002858 DEBRIDE ECZEM/INFCT SKIN UP TO 10% BSA $1,663.00 68682-650-20 DIAZEPAM 2.5 MG RECTAL KIT $1,662.38 HC79200010 MUSCLE TEST, TWO LIMBS $1,661.00 99999-035-28 INSULIN GLULISINE 100 UNIT/ML SUBCUTANEOUS SOLN (INSULIN PUMP) $1,658.22 55150-365-01 AMPHOTERICIN B LIPOSOME 50 MG IV SUSR $1,655.88 62756-233-01 AMPHOTERICIN B LIPOSOME 50 MG IV SUSR $1,655.88 0781-2323-06 APREPITANT 125 MG ORAL CAP $1,655.60 0781-2323-68 APREPITANT 125 MG ORAL CAP $1,655.60 68462-585-40 APREPITANT 125 MG ORAL CAP $1,655.60 68462-585-76 APREPITANT 125 MG ORAL CAP $1,655.60 HC62803804 COIL EMBOLIZATION FIBERED M $1,655.00 HC25003203 LAC REPAIR INTMD F/E/E/N/L/MM 2.6-5.0CM $1,655.00 HC46500914 FNA ASP BX W/O GUIDE; EACH ADD'L LESION $1,653.00 HC82202219 FNA ASP BX W/O GUIDE; EACH ADD'L LESION $1,653.00 HC44900066 CT BONE DENSITY STDY AXIAL SKL $1,651.00 HC44000438 CHOLANGIOGRAM INTRAOPERATIVE S&I ONLY $1,649.00 HC62229125 BLADE TREPHINE S $1,648.00 HC32000457 OT-SWALLOWING EVAL 60MIN $1,647.00 HC62221684 KIT ARTHROSCOPY DISPSBLS T $1,646.00 HC44900744 CT HEART W/CORO CALC W/O CON $1,642.00 HC62228218 ORTH WHO NONTORSION JOINT(S) PREFAB OTS $1,642.00 HC62228200 ORTH WHO W/NONTORSION JOINT(S) PREFAB CUSTOM $1,642.00 HC78600053 PACU II 1ST HOUR (INITIAL) $1,642.00 HC33000332 ST-SWALLOWING EVAL 60MIN $1,641.00 HC25003971 CLOSED TX WRIST DSLOC 1/> BONES W/MAN-BIL $1,640.00 HC44003036 PERITONEOGRAM S&I $1,640.00 HC25000217 REPAIR NAIL BED $1,640.00 HC44900884 CT BODY SCAN NK/CH/ABD/PEL/HRT $1,639.00 0409-0201-10 DOCETAXEL 80 MG/8 ML (10 MG/ML) IV SOLN $1,638.42 HC62802798 SYSTEM SEAL HEART STRING $1,638.00 HC47200126 HANDLING/LOADING RAD SOURCE $1,636.00 HC33000266 ST-SPEECH THERAPY 120MIN/MW $1,636.00 HC32000119 OT-EVAL SWALLOW CINE/FLUORO 60MIN $1,633.00 HC33000183 ST-EVAL SWALLOW CINE/FLUORO 60MIN $1,633.00 HC62219399 KIT ABLATION VEIN LASER $1,632.00 42023-103-01 EPINEPHRINE HCL 1 MG/ML NASL SOLN $1,628.64 42023-168-01 EPINEPHRINE 1 MG/ML INJ SOLN $1,628.64 42023-168-99 EPINEPHRINE 1 MG/ML INJ SOLN $1,628.64 HC43000561 DUCTOGRAM MULTI DUCT(S) LT $1,628.00 HC43000579 DUCTOGRAM MULTI DUCT(S) RT $1,628.00 HC43000116 DUCTOGRAM/GALACTOGRAM MULTI $1,628.00 65628-272-05 OMEPRAZOLE-SODIUM BICARBONATE 2-84 MG/ML ORAL SUSR $1,625.33 8065183150 CHONDROITIN SULF-SOD HYALURON 3 %-4 %(0.5 ML) 1 % (0.55 ML) INTRAOCULAR SYRG $1,625.07 HC44200814 US EXTREMITY NON VASC CMPLT-LT $1,625.00 HC44200806 US EXTREMITY NON VASC CMPLT-RT $1,625.00 25021-408-51 EPTIFIBATIDE 0.75 MG/ML IV SOLN $1,625.00 47335-361-41 DECITABINE 50 MG IV SOLR $1,625.00 55390-253-01 MITOMYCIN 40 MG IV SOLR $1,625.00 25021-822-73 IBANDRONATE 3 MG/3 ML IV SYRG $1,624.99 25021-827-61 IBANDRONATE 3 MG/3 ML IV SYRG $1,624.99 HC25001041 THROMBOLYSIS CORONARY IV INFUSION $1,624.00 HC51060580 DESTROY MUSCLE(S) LARYNX BI $1,622.00 HC25003146 LAC REPAIR INTMD N/H/F/GEN 2.6-7.5 $1,622.00 HC44001550 LUMBAR SPINE W/BEND MIN 6 VWS $1,622.00 HC32000531 OT-SWALLOWING THERAPY 90 MIN $1,621.00 HC32001737 OT-EVAL HIGH COMPLEXITY 45MF2F 150MIN $1,620.00 0078-0799-75 CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1 % OTIC DRPS $1,619.09 50242-063-01 ERLOTINIB 100 MG ORAL TAB $1,618.94 HC12200267 SC INFUSION THERAPY INITIAL UP TO 1HR $1,614.00 HC24000010 HBO TX EA 1/2 HR BASIC/M $1,613.00 HC51063139 BIOPSY NAIL UNIT SEP PROC $1,612.00 HC25004201 CLOSED TX HIP DISLOC TRAUMIC BIL $1,611.00 HC62213053 BLADE SHAVER W $1,610.00 HC62218938 DRILL/DRILL BITS SINGLE USE AB $1,610.00 HC62216858 ENDO STAPLER W $1,610.00 HC62213558 REAMER Z $1,610.00 HC62220355 RETRACTOR DISPOSABLE N $1,610.00 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COCAINE 4 % NASL SOLN $1,592.50 HC44002442 XR UGI W/DOUBLE CONTRAST INC SCOUT,DELAYED $1,590.00 HC51002368 EXCISN/FULGURATN POLYP(S) URETHRAL $1,589.00 HC33001074 ST EVAL SOUND W/LANG COMP&EXPRESS 180MIN/M $1,588.00 HC33000431 ST-SWALLOWING THERAPY 90 MIN $1,588.00 HC25004003 CLOSED TX DISTL RADIOULNAR DISLOC W/M-BIL $1,586.00 HC62200985 CANNULA ARTERIAL V $1,583.00 HC62213749 KIT VITREORETINAL PERFLUORON 5ML $1,583.00 16729-115-05 MITOMYCIN 5 MG IV SOLR $1,581.26 67457-518-05 MITOMYCIN 5 MG IV SOLR $1,581.26 HC62222203 SYRINGE BONE MARROW ASPIRATION 30CC $1,579.00 3877917798 SIMPLE SYRUP ORAL SYRP $1,576.25 HC62808167 DEVICE REPAIR SUTURE MENISCAL $1,576.00 HC62212774 GUIDEWIRE(SYNCHRO/TRANSEND) T $1,576.00 HC62214440 KIT ARTHROSCOPY DISPSBLS R $1,576.00 58914-170-14 SUCRALFATE 100 MG/ML ORAL SUSP $1,575.21 HC23000029 ASP & INJ GANGLION CYST $1,575.00 HC62229273 CATHETER KIT(AQUADEX) $1,575.00 HC25002817 I&D ABSCESS; COMPLICATED/MULT $1,572.00 HC82200551 INTERPHASE IN-SITU HYBRI 25-99 $1,572.00 0069-0338-01 SILDENAFIL (PULM.HYPERTENSION) 10 MG/12.5 ML IV SOLN $1,570.89 HC23001019 INJ(S);SNGL TNDON ORIGN/INSERT $1,569.00 HC51061604 ECHO 2D CMPLT W/SPEC&CLR DOPLR $1,568.00 HC36000784 PULSE OX NOCTURNAL STUDY $1,565.00 HC36800357 PULSE OX NOCTURNAL STUDY $1,563.00 HC62808035 SYSTEM REFLECTOR RADAR LOCALIZ(SCOUT) $1,562.00 99999-040-16 TOLVAPTAN 15 MG ORAL PARTIAL TAB $1,561.69 HC51062982 DEBRIDE SKIN MUSCLE; FIRST 20SQCM $1,560.00 0641-6178-01 OCTREOTIDE ACETATE 1,000 MCG/ML INJ SOLN $1,560.00 0703-3343-01 OCTREOTIDE ACETATE 1,000 MCG/ML INJ SOLN $1,560.00 25021-455-05 OCTREOTIDE ACETATE 1,000 MCG/ML INJ SOLN $1,560.00 55150-191-83 IBANDRONATE 3 MG/3 ML IV SYRG $1,560.00 69918-735-01 ISOPROTERENOL HCL 0.2 MG/ML INJ SOLN $1,560.00 69918-735-10 ISOPROTERENOL HCL 0.2 MG/ML INJ SOLN $1,560.00 0168-0204-37 LIDOCAINE 5 % TOPICAL OINT $1,560.00 HC62802558 KIT QUINTON MAHURKAR CATH $1,559.00 HC62210323 BALLOON EXPANDER AAA STENT $1,558.00 0078-0876-01 TOBRAMYCIN-DEXAMETHASONE 0.3-0.1 % OPHT OINT $1,557.53 HC21000278 DEBRIDE P-THICK BURN SM<5%BSA $1,557.00 HC26000091 FETAL NON-STRESS TEST $1,557.00 HC44002616 XR UGI W/SNGLE CONTRAST INC SCOUT,DELAYED $1,557.00 25208-002-02 TIROFIBAN-0.9% SODIUM CHLORIDE 12.5 MG/250 ML (50 MCG/ML) IV SOLN $1,553.50 99999-001-78 CHARGE-ADULT 3 IN 1 ADMIX 2500ML $1,553.50 HC44000248 BONE SURVEY INFANT $1,552.00 HC62204334 KIT TWIST DRILL DISP $1,549.00 HC23000045 ASP/INJ JOINT SM W/O UTZ GUIDE-LT $1,547.00 HC62228119 ORTH ELBOW ADJUST POSITION LOCK PREFAB CUSTOM $1,544.00 HC25005430 IINJ ANES/STEROID NERVE/BRNCH PERIPH LT $1,542.00 HC25005448 INJ ANES/STEROID NERVE/BRNCH PERIPH RT $1,542.00 HC25005240 LAC REPAIR MOUTH; >2.5 CM/COMPLEX $1,542.00 HC25005299 REMOVE FB PHARYNX $1,542.00 HC44002897 SPINE ENTIRE SKULL-SACRUM 4-5 VIEWS $1,542.00 68546-317-30 GLATIRAMER 20 MG/ML SUBCUTANEOUS SYRG $1,541.37 HC23001035 INJ ANES/STEROID NERVE TRIGEML BRNCH EA $1,541.00 HC23001522 INJ ANES/STEROID NERVE TRIGEML BRNCH EA LT $1,541.00 HC23001514 INJ ANES/STEROID NERVE TRIGEML BRNCH EA RT $1,541.00 HC38000436 APPLY CAST RISSER JACKET BODY; WITH HEAD $1,540.00 HC62217690 AWL SPINAL SINGLE PATIENT USE R $1,540.00 HC62213046 BLADE SHAVER V $1,540.00 HC62804232 COIL EMBOLIZATION L $1,540.00 HC62217427 DEVICE LIGATOR M $1,540.00 HC62218920 DRILL/DRILL BITS SINGLE USE AA $1,540.00 HC62216841 ENDO STAPLER V $1,540.00 HC62216734 PIN/WIRE FIXATION TEMPORARY AJ $1,540.00 HC62213541 REAMER Y $1,540.00 HC62216189 SPHINCTEROTOME CANNULATING K $1,540.00 HC42000315 ECG EXT HOLTER W/CONNECT UP TO 48HRS; RECORD $1,539.00 HC44200095 US CHEST $1,539.00 HC44200293 US FETAL BIOPHYSICAL PROFILE W/O NST $1,539.00 65628-208-10 VANCOMYCIN 50 MG/ML ORAL SOLR $1,536.60 HC44003077 XR ESOPHAGUS W/DOUBLE CONSTRST INC SCOUT&DELAYS $1,536.00 66794-155-02 BACLOFEN 10,000 MCG/20ML (500 MCG/ML) INTRATHECAL SOLN $1,535.95 70121-2501-1 BACLOFEN 500 MCG/ML INTRATHECAL SOLN $1,535.95 70257-560-01 BACLOFEN 500 MCG/ML INTRATHECAL SOLN $1,535.95 70257-560-20 BACLOFEN 500 MCG/ML INTRATHECAL SOLN $1,535.95 70121-2504-2 BACLOFEN 500 MCG/ML INTRATHECAL SOLN $1,535.82 70257-560-02 BACLOFEN 500 MCG/ML INTRATHECAL SOLN $1,535.82 8213100037 PORCINE SUBMUCOSA, FENESTRATED 3 X 7 CM TOPICAL SHEE $1,535.63 HC89023782 CYTOGENO NEO SNP MICROARRAY ONCOLOGY-AU $1,535.00 HC46502555 INJECT URETEROGRAPH VIA URETEROS/CATH $1,535.00 HC25003054 CLOSURE SUPERFCL WOUND DEHISC SIMPLE $1,534.00 HC62205810 PROBE HEMOSTASIS (BICAP) K $1,534.00 0172-7313-20 CYCLOSPORINE MODIFIED 100 MG/ML ORAL SOLN (MCH) $1,532.70 HC21000203 CAUTERIZE W/CHEM; GRAN TISSUE $1,529.00 HC25002890 DEBRIDE SKIN MUSCLE; FIRST 20SQCM OR LESS $1,529.00 HC51003788 LYSIS ADHESIONS POST-CIRCUMCISION $1,529.00 HC51010866 THORACENTESIS W/TUBE W/IMAGING $1,529.00 HC44002400 TRANSCERV CATH FALLOPIAN TUBES S&I ONLY $1,529.00 0013-8303-04 LATANOPROST 0.005 % OPHT DROP $1,529.00 43598-331-11 ZOLEDRONIC ACID-MANNITOL-WATER 5 MG/100 ML IV PGBK $1,527.50 63323-762-10 TOPOTECAN 4 MG IV SOLR $1,527.50 67457-619-10 ZOLEDRONIC ACID-MANNITOL-WATER 5 MG/100 ML IV PGBK $1,527.50 HC25004680 CLOSED TX BIG TOE FX; NO MANIPULTN BIL $1,526.00 HC44900629 CT WHOLE BODY SCREEN $1,525.00 HC25002916 EXCISION OF NAIL/MATRIX PERM $1,521.00 HC46000444 INJ VENOGRAM EXTREMITY-LT $1,521.00 HC46000451 INJ VENOGRAM EXTREMITY-RT $1,521.00 HC47200647 TREATMENT DEVICES SIMPLE $1,521.00 HC27000835 ESOPH MOTILITY/MANO' DISCONT'D $1,520.00 HC25004763 CLOSED TX SESAMOID FX BILAT $1,519.00 HC23001027 INJ(S);SINGLE TENDON/SHEATH $1,519.00 HC77400091 BEDSIDE/OTHER ANESTH' INITIAL HR $1,518.00 HC23000052 ASP/INJ JOINT SM W/O UTZ GUIDE-RT $1,517.00 0005-1971-05 PNEUMOC 13-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG $1,512.94 HC62212501 ELECTRODE UROLOGICAL/ELECTROSURGICL $1,512.00 HC25003088 LAC REPAIR INTMD S/A/T/EXT 2.6-7.5CM $1,512.00 HC62228739 SENSORS TRACKER VPAD® $1,508.00 HC12400099 ADMIN CHEMO INTRA ARTERIAL INJ $1,507.00 HC44000347 CERVICAL SPINE COMP 6/> VWS $1,507.00 HC47200571 SPECIAL DOSIMETRY $1,507.00 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MIN' 7CH $1,470.00 HC62212451 INTRODUCER/SHEATH T $1,470.00 HC26000182 L&D EVAL LEVEL IV - EXTENDED $1,470.00 HC62213533 REAMER X $1,470.00 62542-301-16 HYDROCODONE-CHLORPHENIRAMINE 10-8 MG/5 ML ORAL SU12 $1,469.61 62542-301-17 HYDROCODONE-CHLORPHENIRAMINE 10-8 MG/5 ML ORAL SU12 $1,469.61 HC44200376 US INFANT HIPS LTD/STATIC $1,467.00 0005-1971-01 PNEUMOC 13-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG $1,466.93 0005-1971-02 PNEUMOC 13-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG $1,466.93 HC25000746 ASPIRATION OF ABCESS/CYST $1,466.00 0078-0813-01 TOBRAMYCIN 0.3 % OPHT OINT $1,463.03 0078-0841-01 CIPROFLOXACIN HCL 0.3 % OPHT OINT $1,463.03 HC41500018 AUDITORY EVOKED AEP BBS HEARING DETERM W/I&R $1,463.00 55111-652-37 BIVALIRUDIN 250 MG IV SOLR $1,462.50 76329-9060-0 EPINEPHRINE 1 MG/ML INJ SOLN $1,462.50 99999-041-55 POLIHEXANIDE (PURAPLY AM) 1.6 CM EACH TOPICAL DISC $1,462.50 69784-630-25 THIOGUANINE 40 MG ORAL TAB (MCH) $1,462.37 9029703 GELATIN ABSORBABLE OPHT FILM $1,461.84 HC62222179 CANNULA PERFUSION W/FILTER Q $1,460.00 HC12200390 IV INFUSE MONOCLONAL TOCILIZUMAB >2YEARS DOSE 2ND $1,460.00 HC12200382 IV INFUSE MONOCLONAL TOCILIZUMAB >2YEARS INITIAL $1,460.00 HC12200341 IV INFUSE/SC MONOCLONAL CASIRIVIMAB/IMDEVIMAB (REGENERON) REPEAT $1,460.00 61703-343-65 MITOXANTRONE 2 MG/ML IV CONC $1,458.13 0781-6186-67 CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1 % OTIC DRPS $1,457.19 HC33000720 ST-EVAL LANGUAGE CMPT 180MIN $1,457.00 HC62217872 SET PIN DISTRACTORS-COUNT 2 B $1,456.00 HC44502029 THROMBOLYSIS CEREBRAL/IV RT $1,456.00 HC44502037 THROMBOLYSIS CEREBRAL/IV LT $1,456.00 HC51063147 REPAIR NAIL BED $1,456.00 70954-151-10 NAPROXEN 125 MG/5 ML ORAL SUSP $1,456.00 0069-0550-38 SUNITINIB MALATE 12.5 MG ORAL CAP $1,455.16 HC25005323 PROCTOSIGMOIDOSCOPY RIGID W/REMOVE FB $1,455.00 52015-080-01 FIDAXOMICIN 200 MG ORAL TAB $1,454.44 HC62219290 DILATOR RENAL AMPLATZ $1,451.00 HC44001766 REMOV FB ESOPHAGEAL W/BALLOON $1,451.00 HC89023634 GENOMIC SNP MICROARRAY POC-AU $1,447.50 HC41500059 DBS 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EXTREM $1,400.00 HC44200673 US GUIDANCE AMNIOCENTESIS S&I ONLY $1,398.00 65250-133-09 BUPIVACAINE LIPOSOME (PF) 1.3 % (13.3 MG/ML) LINF SUSP $1,395.88 65250-133-10 BUPIVACAINE LIPOSOME (PF) 1.3 % (13.3 MG/ML) LINF SUSP $1,395.88 HC62210232 FILTER CONT VENOVENOUS HEMO'EA $1,394.00 HC21000757 LAC REPAIR 7.6-12 5CM(MEDIUM) $1,393.00 HC44002483 URETHROCYSTOGRAM RETROGRADE $1,393.00 HC51002947 DILAT STRICTR URETHRL FLFRM MALE INT'L $1,392.00 67457-342-10 VANCOMYCIN 10 GRAM IV SOLR $1,391.07 2576773545 CARDIOPLEG-ORGAN PRESERV NO.1 9 MMOL-198 MMOL -2 MMOL/L PERF SOLN $1,391.00 70436-023-82 VANCOMYCIN 10 GRAM IV SOLR $1,391.00 70594-048-01 VANCOMYCIN 10 GRAM IV SOLR $1,391.00 HC25003138 LAC REPAIR INTMD N/H/F/GEN 2.5CM/< $1,390.00 HC25005653 THROMBOLYSIS CEREBRAL IV INFUSION $1,389.00 HC25003393 INJ(S);SGL TNDN SHEATH/LIGMNT/APONEUR-BIL $1,387.00 HC25003039 LAC REPAIR SIMPLE F/E/E/N/L/M 20.1-30.0 CM $1,387.00 HC44000594 ELBOW 2 VWS BILAT $1,385.00 HC41500281 INFANT HEARING SCREEN AEP BBS AUTO 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VIEW BILAT $1,373.00 99999-045-41 TEMOZOLOMIDE 10 MG/ML ORAL LIQUID (COMPOUND) $1,372.22 69238-1503-1 ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL SUSR $1,370.20 HC31001795 PT-APPLICATION CAST LONG LEG $1,370.00 HC44000941 FOREARM BILAT $1,369.00 HC62800784 CABLE DALL MILES $1,368.00 44206-451-01 IMMUN GLOB G(IGG)-PRO-IGA 0-50 1 GRAM/5 ML (20 %) SUBCUTANEOUS SOLN $1,367.21 HC62214044 DEVICE PRESS BONE (HENSLER) $1,366.00 HC62212766 GUIDEWIRE R $1,366.00 HC33000258 ST-SPEECH THERAPY 90 MIN/MW $1,365.00 HC25005422 INJ ANES/STEROID NERVE TRIGEML BRNCH EA BI $1,363.00 HC27000025 ANOSCOPY DX (INCL COLLECTION) $1,362.00 HC42000018 ECG EXT PT ACTV EVENT MONITOR ATTEND 24HRS-30DAYS;HOOK&RECORD $1,362.00 HC46502761 BIOPSY INCISIONAL SKIN; EACH SEP ADD'L LESION $1,361.00 65162-686-88 FELBAMATE 600 MG/5 ML ORAL SUSP $1,357.20 HC27001791 ESOPHSCPY DX- BRSH/WSH~FO DISCONT'D $1,357.00 16714-782-04 CLOBETASOL 0.05 % TOPICAL OINT $1,354.08 HC44900876 CT BODY SCAN ABD/CHEST/PEL/HRT $1,354.00 66794-160-02 MORPHINE (PF) 10 MG/ML INJ SOLN $1,353.04 HC62211271 AUTO TRANSFUSION SUPPLIES $1,353.00 0641-6039-01 MORPINE (PF) 10 MG/ML INJ FOR INTRATHECAL PAIN PUMP REFILL (OCM) $1,352.00 HC25000357 EXPLORE WOUND $1,351.00 HC32001711 OT-EVAL HIGH COMPLEXITY 45MF2F 120MIN $1,351.00 HC44001923 SHOULDER 1 VIEW BILATERAL $1,351.00 HC83000604 RBC/FRZ/DEGLYC/WSHD/LR/IRRAD $1,350.00 HC62802509 INTRODUCER SUPRAPUB FOLEY CATH $1,349.00 HC25003708 CLOSED TX ELBOW DISLOCATION-BIL $1,347.00 HC42000893 ECG EXT HOLTER >48HRS-7DAYS; SCANNING ANYS W/REPORT $1,346.00 HC33001066 ST EVAL SOUND W/LANG COMP&EXPRESS 120MIN/M $1,346.00 66220-207-30 ACETYLCYSTEINE 200 MG/ML (20 %) IV SOLN $1,345.50 HC77400109 ANESTHESIA MAC INITIAL HOUR $1,345.00 HC44000545 CYSTOGRAM $1,345.00 HC81701476 MORPH STDY ISH MNL PER SPEC INTL SNGL PROBE $1,344.00 HC12400149 CHEMO ADMIN INTRA ARTERIAL INFUSION UP TO 1 HR $1,343.00 HC25001025 PERICARDIOCENTESIS INCL IMAGING $1,343.00 HC44000974 HAND 2 VIEWS BILAT $1,342.00 HC62201140 CARTRIDGE (DIALYSIS) $1,341.00 HC25000019 ED LEVEL II - LIMITED $1,340.00 HC44001170 HUMERUS BILAT $1,340.00 HC25005331 SIGMOIDOSCOPY FLEX W/REMOVE FB $1,340.00 HC46000212 INJ CONT-ASSESS CYST VIA CATH $1,338.00 70842-120-01 MEROPENEM-VABORBACTAM 2 GRAM IV SOLR $1,336.84 70842-120-06 MEROPENEM-VABORBACTAM 2 GRAM IV SOLR $1,336.84 16714-628-01 CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1 % OTIC DRPS $1,336.48 HC12400032 CHEMO ADMIN IVP SNGL/INIT'LINJ $1,336.00 0078-0685-15 ELTROMBOPAG 25 MG ORAL TAB $1,333.76 HC38000295 APPLY SPICA HIP ONE LEG $1,333.00 0781-3153-80 CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) IV SOLN $1,332.11 0781-3153-95 CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) IV SOLN $1,332.11 HC82200965 TISSUE EX G&M LVL 6 DIST SVC $1,332.00 HC82200338 TISSUE EXAM G&M LEVEL 6 $1,332.00 HC82202771 TISSUE EXAM G&M LVL 6(TC ONLY) $1,332.00 HC82200627 TISSUE EXAM LEVEL 6 ADD'L $1,332.00 HC82200619 TISSUE EXAM LVL 6 (PQRI) $1,332.00 HC25004060 CLOSED TX THUMB DISLOC W/MANIP BIL $1,331.00 HC62213012 BLADE SHAVER S $1,330.00 HC62213319 BURR S $1,330.00 HC62212295 CATH RETRIEV STONE BACKSTOP GEL AI $1,330.00 HC25003500 CLOSED TX STERNOCLVCLE DISLOC W/MAN-BIL $1,330.00 HC62218896 DRILL/DRILL BITS SINGLE USE X $1,330.00 HC62218458 ENDO STAPLER S $1,330.00 HC82202466 MORPH STUDY MAN ISH QNT 9P21 $1,330.00 HC82202474 MORPH STUDY MAN ISH QNT CEP 3 $1,330.00 HC82202482 MORPH STUDY MAN ISH QNT CEP 7 $1,330.00 HC82202490 MORPH STUDY MAN ISH QNT CEP17 $1,330.00 HC82202508 MORPH STUDY MAN ISH QNT HER2 $1,330.00 HC62224472 NEEDLE BIOPSY NASHOLD Q $1,330.00 HC62214093 NEEDLE TARGETING(STREAMLINE) Q $1,330.00 HC62213517 REAMER V $1,330.00 HC62216239 SHEARS COAGULATING HARMONIC P $1,330.00 HC31010309 PT-RE-EVAL EST POC 120MIN $1,330.00 0173-0718-20 FLUTICASONE PROPIONATE 44 MCG/ACTUATION INHALATION HFAA $1,329.50 HC44002517 WRIST 2 VIEWS BILAT $1,328.00 HC38000253 APPLY BODY CAST;SHOLD/HIP/1THI $1,327.00 HC81700809 HIV-1 RNA, QUANT $1,327.00 HC62214614 SYRINGE BONE MARROW ASPIRATION 20CC $1,327.00 0023-9211-05 BRIMONIDINE-TIMOLOL 0.2-0.5 % OPHT DROP $1,326.85 HC51003184 BX VAGINA SIMPLE $1,326.00 60267-812-00 SODIUM NITRITE-SOD THIOSULFATE 300 MG/10 ML- 12.5 GRAM/50 ML IV SOLN $1,326.00 HC32000598 OT-DEBRIDE OPN WND 1ST 20SQCM OR< $1,325.00 HC25006206 POSTPARTUM CARE $1,325.00 HC31000656 PT-DEBRIDE OPN WND 1ST 20SQCM OR< $1,325.00 HC51002707 PARACENTESIS ABD W/IMAGING GUIDE $1,323.00 10122-325-01 NICARDIPINE IN NACL (ISO-OS) 40 MG/200 ML (0.2 MG/ML) IV PGBK $1,322.10 10122-325-10 NICARDIPINE IN NACL (ISO-OS) 40 MG/200 ML (0.2 MG/ML) IV PGBK $1,322.10 43066-016-10 NICARDIPINE IN NACL (ISO-OS) 40 MG/200 ML (0.2 MG/ML) IV PGBK $1,322.10 HC84201169 INFLUENZA A&B BY PCR (RVP PNL) $1,322.00 HC26000174 L&D EVAL LEVEL III - INTERMED $1,322.00 HC51010833 BONE MARROW DX; ASPIRATION(S) ONLY $1,321.00 HC25005588 DRAIN EXTERNAL EAR LESION SIMPLE LT $1,319.00 HC25005596 DRAIN EXTERNAL EAR LESION SIMPLE RT $1,319.00 HC43001122 MAMMO DX W/CAD BILAT $1,319.00 0173-0449-02 SUMATRIPTAN SUCCINATE 6 MG/0.5 ML SUBCUTANEOUS SOLN $1,313.25 HC46000220 INJ CONTRAST-ASSESS PV SHUNT $1,313.00 HC25005745 CLOSED TX HIP FX W/MANIP LT $1,312.00 HC25005752 CLOSED TX HIP FX W/MANIP RT $1,312.00 HC62800958 COIL EMBOLIZATION J $1,311.00 0944-2850-01 IMMUN GLOB G(IGG)-GLY-IGA OV50 1 GRAM/5 ML (20 %) SUBCUTANEOUS SOLN $1,310.92 0944-2850-02 IMMUN GLOB G(IGG)-GLY-IGA OV50 1 GRAM/5 ML (20 %) SUBCUTANEOUS SOLN $1,310.92 HC25005356 ANOSCOPY W/REMOVE FB $1,305.00 HC44000073 ANKLE 2 VIEWS BILAT $1,304.00 58160-976-02 MENINGOCOCCAL B VACCINE,4-COMP 50-50-50-25 MCG/0.5 ML IM SYRG $1,303.54 58160-976-20 MENINGOCOCCAL B VACCINE,4-COMP 50-50-50-25 MCG/0.5 ML IM SYRG $1,303.54 HC73000259 DIALYSIS CCPD CANCEL-MED NEC $1,303.00 HC51000552 INSERT PICC <5 YR AGE W/O IMAGING $1,300.00 0187-0994-45 ACYCLOVIR 5 % TOPICAL CREAM $1,300.00 0548-9502-00 ISOPROTERENOL HCL 0.2 MG/ML INJ SOLN $1,300.00 43598-305-62 AZACITIDINE 100 MG INJ SOLR $1,300.00 43598-610-40 DOCETAXEL 80 MG/4 ML (20 MG/ML) IV SOLN $1,300.00 45963-734-54 DOCETAXEL 20 MG/ML (1 ML) IV SOLN $1,300.00 59310-302-40 BECLOMETHASONE DIPROPIONATE 40 MCG/ACTUATION INHALATION HFAB $1,298.21 HC41500729 EMG HEMIDIAPHRAGM $1,296.00 HC62210588 TUBING ASPIRATION NEURO $1,296.00 HC44200954 US MAPPING VESSEL HEMODIALYSIS; COMPLT UNILAT $1,296.00 59630-266-01 CEFIDEROCOL 1 GRAM IV SOLR $1,295.05 59630-266-10 CEFIDEROCOL 1 GRAM IV SOLR $1,295.05 HC47200613 APPLY LOW DOSE RADIONUCLIDE SOURCE $1,294.00 HC51000560 INSERT PICC >5 YR AGE W/O IMAGING $1,294.00 HC32001844 OT-EVAL SWALLOW CINE/FLUORO 45MIN $1,294.00 HC33000571 ST-EVAL SWALLOW CINE/FLUORO 45M $1,294.00 HC33000324 ST-SWALLOWING EVAL 45MIN $1,294.00 HC74200247 BEDSIDE/OTHER SURG ADD'L 15MIN 1 (MCAL 1ST SUBSQNT 0.5 HR) $1,292.00 HC74200486 BEDSIDE/OTHER SURG ADD'L 15MIN 1 (MCAL 2ND SUBSQNT 0.5 HR) $1,292.00 HC62203674 KIT ANEURYSM $1,291.00 99999-046-41 RIFAXIMIN 20 MG/ML ORAL SUSPENSION (COMPOUND) $1,289.15 HC62211917 DSG ABD ABTHERA OPEN $1,288.00 HC25000423 LARYNGOSCOPY FIBEROP W/FB REM $1,288.00 HC21000534 PAIRING BENIGN LESIONS: >4 $1,287.00 0143-9559-01 ARGATROBAN IN 0.9 % SOD CHLOR 1 MG/ML IV SOLN $1,287.00 72205-031-01 DECITABINE 50 MG IV SOLR $1,287.00 72205-036-01 DECITABINE 50 MG IV SOLR $1,287.00 HC32010217 OT-COMPUT DYNAMIC POSTURE SOT 6 CNDTNS; &MCT&ADT $1,284.00 HC31010168 PT-COMPUT DYNAMIC POSTURE SOT 6 CNDTNS; &MCT&ADT $1,284.00 HC83504449 ANATOMIC CONSULT; COMP. REV-CS $1,283.00 HC46502522 LARYNGOSCOPY DIAGNOSTIC $1,283.00 HC38000311 APPLY LONG LEG CAST/WALKER $1,282.00 HC62219340 GUIDE TIBIAL ORTHO $1,282.00 HC42000836 MYOCARDIAL STRAIN QUANT ASSESS + $1,282.00 HC32000440 OT-SWALLOWING EVAL 45MIN $1,282.00 HC62206479 SHEATHS ILLUMINATOR $1,282.00 HC36800761 SPIROMETRY INF PRE&POST RX ADM $1,282.00 HC44002954 HIP (W/PELVIS WHN PRFRMD) 4/>VWS LT $1,281.00 HC44002962 HIP (W/PELVIS WHN PRFRMD) 4/>VWS RT $1,281.00 24208-342-05 DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASL SPRY $1,280.57 HC51002178 CYSTOMETROGRAM W/VOID PRSSR& URTH PRFL $1,278.00 HC51060614 DESTROY MUSCLE(S) 1-4 1ST EXTREMITY $1,277.00 HC51060630 DESTROY MUSCLE(S) 5/+ 1ST EXTREMITY $1,277.00 HC51060655 DESTROY MUSCLE(S) TRUNK 1-5 $1,277.00 HC43001098 MAMMO SCREEN W/IMP W/CAD BIL $1,277.00 46287-006-01 SODIUM POLYSTYRENE SULF-SORBTL 15-20 GRAM/60 ML ORAL SUSP $1,275.92 HC25006107 CLOSED TX INTERPHALANGEAL JNT DISLOC; NO ANES BIL $1,275.00 HC25006081 CLOSED TX METATARSOPHALAN JNT DISLOC; NO ANES BIL $1,275.00 HC25004821 CLOSED TX TALOTARSAL JNT DISLOC; NO ANES BIL $1,275.00 HC25006065 CLOSED TX TARSOMETATARSAL JNT DISLOC; NO ANES BIL $1,275.00 67457-857-30 ADENOSINE (DIAGNOSTIC) 3 MG/ML IV SOLN $1,273.94 HC44200491 US OPHTH B-SCAN $1,273.00 HC41500711 EMG LARYNX $1,271.00 HC25006149 FETAL CONTRACTION STRESS TEST $1,271.00 HC25006172 INSERTION CERVICAL DILATOR $1,271.00 HC33000464 ST-THER SP GEN DEV W/PROG $1,271.00 HC81101917 GENERAL HEALTH PANEL (CHAMPUS) $1,270.00 HC73000200 HEMODIALYSIS CANCEL-MED NEC $1,270.00 HC32000523 OT-SWALLOWING THERAPY 60 MIN $1,270.00 HC21000609 DEBRID OPN WOUND EA ADD 20CM/< $1,269.00 55150-241-01 ARGATROBAN IN 0.9 % SOD CHLOR 1 MG/ML IV SOLN $1,267.50 55150-241-10 ARGATROBAN IN 0.9 % SOD CHLOR 1 MG/ML IV SOLN $1,267.50 HC42000208 ECHO FETAL DOPPLER COMPLETE $1,265.00 HC73000242 DIALYSIS CAPD CANCEL-MED NEC $1,264.00 HC36800704 PLETHYSMOGRAPHY LUNG VOL $1,263.00 HC62205398 PACK NEURO $1,261.00 66215-101-06 BOSENTAN 62.5 MG ORAL TAB $1,260.09 66215-102-06 BOSENTAN 125 MG ORAL TAB $1,260.09 HC62227194 BLADE HOOK ENDOSCOPIC $1,260.00 HC62213004 BLADE SHAVER R $1,260.00 HC62213301 BURR R $1,260.00 HC62223979 CANNISTER SUCTION NEURO/SPINAL $1,260.00 HC62227855 CANNULA ARTHROSCOPIC P $1,260.00 HC62220389 CATH ANGIOG GUIDING DUAL ACCESS(ENVOY)J $1,260.00 HC62806393 CATH EP DX <20 ELECTRODES I $1,260.00 HC62227103 CATH GUIDING (GUIDEZILLA II) P $1,260.00 HC62800081 CATH PTA ANGIOPLS BALLOON NON-LSR L $1,260.00 HC62800073 CATH PTCA BALLOON NON-LASER K $1,260.00 HC62220199 CATH THROMBECTOMY/EMBOLECTOMY P $1,260.00 HC62224126 CUTTER LINEAR ENDO P $1,260.00 HC62217419 DEVICE LIGATOR K $1,260.00 HC62218888 DRILL/DRILL BITS SINGLE USE W $1,260.00 HC62218441 ENDO STAPLER R $1,260.00 HC62215793 FORCEPS BIPOLAR DISPOSABLE P $1,260.00 HC62222385 GUIDE DRILL P $1,260.00 HC62222351 KIT PROCEDURE HYSTEROSCOPIC $1,260.00 HC62219712 KIT VITRECTOMY PROBE I $1,260.00 HC62221213 KIT W/ TRACH PERCUTANEOUS E $1,260.00 HC62223516 ORTHOSIS HUMERAL FRACTURE $1,260.00 HC62216718 PIN/WIRE FIXATION TEMPORARY AH $1,260.00 HC62806443 PORT INDWELLING W/CATH I $1,260.00 HC62205760 PROBE BICAP WITH NEEDLE $1,260.00 HC62213509 REAMER U $1,260.00 HC62216163 SPHINCTEROTOME CANNULATING I $1,260.00 HC62218581 STAPLE CARTRG/ENDO RELOAD P $1,260.00 HC62221866 TAP SURGICAL P $1,260.00 HC62222500 WAND ARTHRO P $1,260.00 HC33000423 ST-SWALLOWING THERAPY 75 MIN $1,258.00 55513-002-01 DARBEPOETIN ALFA IN POLYSORBAT 25 MCG/ML INJ SOLN $1,257.75 HC44001873 SCAPULA BILATERAL $1,257.00 99988-000-22 NM TC-99M MERTIATIDE 1-15 MCI (TC MAG3/DOSE) $1,255.63 HC25001348 DEBRIDE OPN WND 1ST 20SQCM OR< $1,255.00 HC81101982 DRUG TST DEFNTV 22/>RX CLSS W/METBLTS/DAY $1,254.00 HC62205174 PACK CARDIAC ACCESSORY $1,254.00 HC44200459 US OB LIMITED FETUS(S) $1,254.00 HC83000299 AUTOL/DD BLD/COMPON PROC/STOR $1,253.00 HC36000651 PLETHYSMOGRAPHY LUNG VOL $1,252.00 HC33001132 ST EVAL BEHAVRAL QUAL VOICE 180MIN/M $1,252.00 HC44000040 XR ABDOMEN COMPLETE (2/> IMAGES) W/CXR $1,251.00 HC44000693 XR ESOPHAGUS W/SNGLE CONSTRST INC SCOUT&DELAYS $1,251.00 HC62807466 GOLD SEED MARKERS FIDUCIAL KIT/3 $1,250.00 HC36800266 O2 UPTAKE CO2 OUTPUT @REST IND $1,249.00 HC25000902 ASP/INJ LARGE JOINT-LT $1,248.00 HC25000910 ASP/INJ LARGE JOINT-RT $1,248.00 HC51063022 DEBRIDE SKIN MUSL/BONE EA ADD20SQCM/< $1,248.00 HC44200475 US OB NUCHAL MEAS EA ADL GEST+ $1,247.00 HC25001330 M: ED MISC PROCEDURE $1,246.00 HC74200361 OR TIME ADD'L 15MIN CASE CX 1 (MCAL 1ST SUBSQNT 0.5 HR) $1,245.00 HC74200585 OR TIME ADD'L 15MIN CASE CX 1 (MCAL 2ND SUBSQNT 0.5 HR) $1,245.00 HC46501946 M: MISC PROCEDURE $1,244.00 16714-907-01 ALBENDAZOLE 200 MG ORAL TAB $1,242.67 99999-001-77 CHARGE-ADULT 3 IN 1 ADMIX 2000ML $1,241.50 65162-062-05 SUCRALFATE 100 MG/ML ORAL LIQUID (MCH) $1,239.42 HC38420063 PERFUSION CARDIO' EA ADDL .5HR $1,237.00 HC51002640 THORACENTESIS ASP W/ IMG GUID $1,237.00 50419-488-58 SORAFENIB 200 MG ORAL TAB $1,235.78 99999-035-91 SORAFENIB 200 MG/30 ML ORAL LIQUID $1,235.78 HC62203492 SEALANT KIT (FLOSEAL/COSEAL) $1,235.00 53276-1010-02 MICROFIBRIL. COLLAGEN HEMOSTAT TOPICAL POWD $1,235.00 53276-1010-09 MICROFIBRIL. COLLAGEN HEMOSTAT 70 X 35 MM TOPICAL SHEE $1,235.00 HC41500919 VESTIBULR EVOKD MYOGN POTENTL-VEMP; CVEMP & OVEMP $1,234.00 HC25006131 FETAL CONTRACT/NIPPLE STIM $1,233.00 HC44001782 RIBS BILAT MIN 4VWS W/PA CHEST $1,233.00 0121-0678-16 NORTRIPTYLINE 10 MG/5 ML ORAL SOLN $1,232.88 HC62229190 ORTHOTIC TLSO 4 RIGID XLG(DONJOY) $1,232.00 HC42000281 ERGONOVINE PROVOCATION TEST $1,229.00 HC62211016 CANNULA ARTERIAL PEDS P $1,226.00 HC62800479 CATH SWAN GANZ/THERMODILUTION P $1,226.00 HC62201694 CAUTERY HOOK ASSEMBLY AO $1,226.00 HC62208749 ENDO LOOP MONO LINA GOLD $1,226.00 HC62211784 GUIDEWIRE(X-PEDION ANGIO) Q $1,226.00 HC62219977 KIT INSTRUMENTS UROLIFT $1,226.00 HC62807714 M: ANCHOR LEAD NEUROSTIM $1,226.00 HC33001058 ST EVAL SOUND W/LANG COMP&EXPRESS 90MIN/M $1,226.00 0517-0375-01 INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJ SOLN $1,224.73 0517-0375-05 INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJ SOLN $1,224.73 HC36800720 AIRWAY RESISTANCE OSCILLOMETRY $1,224.00 HC36000677 AIRWAY RESISTANCE OSCILLOMETRY $1,224.00 0574-0805-00 ACETYLCYSTEINE 200 MG/ML (20 %) IV SOLN $1,222.07 0574-0805-30 ACETYLCYSTEINE 200 MG/ML (20 %) IV SOLN $1,222.07 0074-4456-04 SEVOFLURANE INHALATION LIQD $1,222.00 0074-4456-51 SEVOFLURANE INHALATION LIQD $1,222.00 HC46000162 INJ ARTHROGRAM WRIST-LT $1,221.00 HC46000170 INJ ARTHROGRAM WRIST-RT $1,221.00 HC27001296 ANORECTAL MANOMETRY DISCON'D $1,220.00 HC32001760 OT-DYSPHAGIA/SWALLOW TX 75MIN/M $1,220.00 99999-035-64 EPIFIX SKIN GRAFT ( 14 MM ) $1,218.75 HC27000363 EGD DIAGNOSTIC DISCONTINUED PROC $1,216.00 42023-111-01 ESTRADIOL VALERATE 20 MG/ML IM OIL $1,215.96 28595-120-49 NITROGLYCERIN 400 MCG/SPRAY TL SPRY $1,215.91 45802-210-01 NITROGLYCERIN 400 MCG/SPRAY TL SPRY $1,215.91 0469-3211-10 MICAFUNGIN 100 MG IV SOLR $1,215.50 25021-191-10 MICAFUNGIN 100 MG IV SOLR $1,215.50 63323-729-01 MICAFUNGIN 100 MG IV SOLR $1,215.50 63323-729-10 MICAFUNGIN 100 MG IV SOLR $1,215.50 99999-034-92 CHARGE-ADULT TPN (LBM) $1,215.50 HC38000246 APPLY BODY CAST;SHOLD-HIP-HEAD $1,215.00 HC43001197 MAMMO DX W/SPC VWS UNILT W/CAD LT $1,214.00 HC43001205 MAMMO DX W/SPC VWS UNILT W/CAD RT $1,214.00 HC39001037 TMS SUBSEQ DELIV MGMNT SESS $1,214.00 HC25005802 CLOSED TX ANKLE FX W/MANIP LT $1,213.00 HC25005810 CLOSED TX ANKLE FX W/MANIP RT $1,213.00 HC32000291 OT-EVAL HIGH COMPLEXITY 45MF2F 90MIN $1,213.00 HC31000367 PT-EVAL HIGH COMPLEXITY 45MF2F 90MIN $1,213.00 HC47200423 RADIATION TX SUPRFCL OR/ORTH PER DAY $1,213.00 HC62229026 CATH ANGIO PERIPH CROSSING SET $1,212.00 99999-046-39 MACITENTAN 5 MG ORAL PARTIAL TAB $1,211.69 HC43500040 DEXA BONE DENS-AXIAL/APPEND COMB $1,210.00 HC41500356 NEUROMUSC REPEAT STIM EA NERVE $1,210.00 HC31000029 PT-APPLIC CAST SHORT LEG WALK $1,207.00 HC32001281 OT-RE-EVAL EST POC 90MIN $1,205.00 HC44000503 CLAVICLE BILATERAL $1,204.00 HC21000211 DEBRID SKIN EXT EA ADDL 10%BSA $1,204.00 99999-039-35 GELFOAM+THROMBIN MIXTURE LBM $1,203.78 HC38420022 COLLECT AUTO'BLOOD ADD'L UNIT $1,203.00 HC62206404 SET THROMBECTOMY PUMP $1,203.00 0548-9501-00 ISOPROTERENOL HCL 0.2 MG/ML INJ SOLN $1,202.50 10019-938-01 CYCLOPHOSPHAMIDE 500 MG IV SOLR $1,202.50 10019-938-25 CYCLOPHOSPHAMIDE 500 MG IV SOLR $1,202.50 55150-166-13 SILDENAFIL (PULM.HYPERTENSION) 10 MG/12.5 ML IV SOLN $1,202.50 0603-1542-58 POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQD $1,202.13 60505-6184-6 POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQD $1,202.13 HC33000712 ST-EVAL LANGUAGE CMPT 120MIN $1,202.00 HC38000055 APPLY CAST SHORT LEG WALKING $1,200.00 HC62207311 TRAY DIALYSIS $1,200.00 HC41500760 EEG SETUP W/VIDEO REC CONT MIN8 CHNNL $1,198.00 HC62211487 PACK CATARACT CUSTOM $1,198.00 HC77400166 ANESTHESIA EPIDURAL INITIAL HR $1,197.00 66658-234-01 ANAKINRA 100 MG/0.67 ML SUBCUTANEOUS SYRG $1,196.13 66658-234-07 ANAKINRA 100 MG/0.67 ML SUBCUTANEOUS SYRG $1,196.13 HC44000735 FACIAL BONES COMP MIN 3 VWS $1,195.00 HC25005687 ASP/INJ JOINT/BURSA MAJOR W/US-LT $1,194.00 HC25005695 ASP/INJ JOINT/BURSA MAJOR W/US-RT $1,194.00 HC62219662 KIT INSTRUMENTS ENDOBUTTON $1,194.00 HC44200855 ART STDY SNG U/L 1-2 LVL LTD-L $1,193.00 HC44200848 ART STDY SNG U/L 1-2 LVL LTD-R $1,193.00 16714-885-01 ACYCLOVIR 5 % TOPICAL OINT $1,191.84 HC41000128 HOME SLEEP STUDY/T III MIN'4CH $1,191.00 HC62217674 AWL SPINAL SINGLE PATIENT USE N $1,190.00 HC62212998 BLADE SHAVER Q $1,190.00 HC62213293 BURR Q $1,190.00 HC62212634 CATH PTCA BALLOON NON-LASER J $1,190.00 HC62218870 DRILL/DRILL BITS SINGLE USE V $1,190.00 HC62227673 ELECTRODE LOOP CUTTING BIPOLAR $1,190.00 HC62218433 ENDO STAPLER Q $1,190.00 HC62223227 INTRODUCER/SHEATH S $1,190.00 HC62213491 REAMER T $1,190.00 HC62214556 RETRACTOR DISPOSABLE K $1,190.00 HC62216221 SHEARS COAGULATING HARMONIC O $1,190.00 HC46501623 UROFLOWMETRY COMPLEX $1,189.00 0078-0939-26 MOXIFLOXACIN 0.5 % OPHT DROP $1,188.39 60793-600-02 PENICILLIN G BENZATHIN,PROCAIN 1,200,000 UNIT/ 2 ML(600K/600K) IM SYRG $1,187.28 60793-600-10 PENICILLIN G BENZATHIN,PROCAIN 1,200,000 UNIT/ 2 ML(600K/600K) IM SYRG $1,187.28 HC41500026 CALORIC VESTIB BITHERM 4 IRRIG W/REC $1,187.00 HC44002376 TOMOGRAM SINGLE PLANE $1,187.00 HC38000147 APPLY SPLINT LONG LEG $1,186.00 HC83001149 RBC'S LEUKO RED IRRAD EACH UNIT $1,186.00 HC25000431 MANIPULATION MAJOR JOINT $1,185.00 HC38000063 APPLY CAST LONG LEG $1,184.00 HC47200563 RADIOELEMENT INFUSION $1,184.00 HC62802590 WIRE INTERVENTIONAL SPECIALTY $1,184.00 HC44200442 US OB FOLLOW UP FETAL RE-EVAL TRANSAB PER FETUS $1,182.00 67919-020-10 ALVIMOPAN 12 MG ORAL CAP $1,181.96 HC83000430 THERAPEUTIC PHLEBOTOMY $1,181.00 HC12800009 PHLEBOTOMY THERAPEUTIC $1,179.00 HC51062099 REMOVE CONTRACEPTIVE CAPSULE $1,179.00 HC21000617 WOUND NON-SEL DEBRID PER SESSN $1,177.00 HC62201447 CATH GASTRO TUBE $1,176.00 HC51010908 CHEMO ADMIN PLEURAL CAV W/THORACENTESIS $1,175.00 HC44200434 US OB FOLLOW UP(RE-EVAL) $1,175.00 99999-042-18 VANCOMYCIN 250 MG / 5 ML ORAL SYRINGE $1,172.60 0407-2223-21 IODIXANOL 320 MG IODINE/ML IV SOLN $1,171.30 HC41500455 VASOMOTOR ADRENERGIC INNERV $1,171.00 HC43001080 MAMMO SCREEN W/CAD BILAT $1,170.00 25021-801-66 ZOLEDRONIC ACID 4 MG/5 ML IV SOLN $1,170.00 25021-826-82 ZOLEDRONIC AC-MANNITOL-0.9NACL 4 MG/100 ML IV PGBK $1,170.00 44206-251-10 ALBUMIN, HUMAN 25 % 25 % IV SOLP $1,170.00 44206-251-91 ALBUMIN, HUMAN 25 % 25 % IV SOLP $1,170.00 44206-310-50 ALBUMIN, HUMAN 5 % 5 % IV SOLP $1,170.00 44206-310-91 ALBUMIN, HUMAN 5 % 5 % IV SOLP $1,170.00 70069-151-01 CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) IV SOLN $1,169.22 70069-151-10 CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) IV SOLN $1,169.22 8065183905 CHONDROITIN SULF-SOD HYALURON 4-3 % (40-30 MG/ML) INTRAOCULAR SYRG $1,169.03 HC12200119 REFILL/MAINTENANCE PORT PUMP $1,167.00 HC44000404 CHEST 4/> VIEWS $1,164.00 0005-0100-01 N.MENINGITIDIS B,LIPID FHBP RC 120 MCG/0.5 ML IM SYRG $1,163.20 0005-0100-05 N.MENINGITIDIS B,LIPID FHBP RC 120 MCG/0.5 ML IM SYRG $1,163.20 HC62215769 ADAPTER INJECTION SPINAL $1,163.00 HC62211628 PAD TEMP MNGMNT SYSTEM/BOX $1,162.00 HC33000241 ST-SPEECH THERAPY 75 MIN/MW $1,162.00 0068-0597-01 RIFAMPIN 600 MG IV SOLR $1,160.64 0068-0599-01 RIFAMPIN 600 MG IV SOLR $1,160.64 HC32001265 OT-DBRD OPN WND EA+20SQCM OR < $1,160.00 HC31001357 PT-DBRD OPN WND EA+20SQCM OR < $1,160.00 0078-0716-56 CAPMATINIB 200 MG ORAL TAB $1,159.48 61314-044-75 TRIFLURIDINE 1 % OPHT DROP $1,159.28 HC44000297 CALCANEUS (HEEL) BILAT $1,159.00 0078-0698-02 MIDOSTAURIN 25 MG ORAL CAP $1,158.66 HC21000922 APPLY MULTILAY COMPRS UPREX LT $1,158.00 HC21000930 APPLY MULTILAY COMPRS UPREX RT $1,158.00 HC33001140 ST EVAL SPEECH FLUENCY 180MIN/M $1,158.00 HC33000852 ST-EVAL SPEECH CMPNT 90MIN $1,158.00 66993-079-96 FLUTICASONE PROPIONATE 110 MCG/ACTUATION INHALATION HFAA $1,156.97 HC62800602 GUIDEWIRE(X-PEDION HYDROPHILIC) P $1,156.00 HC25005281 I&D ABSCESS PERITONSILLAR BILAT $1,156.00 HC62215488 KNIFE BAYONET G $1,156.00 HC25002973 LAC REPAIR SIMPLE S/N/A/GEN/T/EXT >30.0CM $1,156.00 HC62808308 M: ADAPTER SHOULDER $1,156.00 HC62217054 WRENCH TIP SPINAL (DISP) $1,156.00 HC51010320 BACLOPHEN PUMP TRIAL PROCEDURE $1,155.00 HC31000045 PT-APPLICATION SPLINT LONG LEG $1,155.00 HC91200133 R&B NURSERY LEVEL EOL $1,155.00 HC83000612 RBC'S LR/CMV-NEG/IRRAD/UNIT $1,155.00 HC81101107 FETAL FIBRONECTIN $1,154.00 HC25005307 REPOSIT NASO/ORO GASTRIC FEED TUBE THRU DUODENUM $1,154.00 HC25000464 FRACTURE TX LONG BONE $1,153.00 HC44002988 HIPS BILAT3-4VWS(W/PELVIS WHN PRFRMD) $1,153.00 HC44002889 SPINE ENTIRE SKULL-SACRUM 2-3 VIEWS $1,151.00 HC62204573 CATH CARDIAC $1,148.00 HC51010411 EMG 4 EXTREMITY $1,147.00 HC44001469 KNEE 4 OR MORE VWS LT $1,146.00 HC44001477 KNEE 4 OR MORE VWS RT $1,146.00 HC44002772 KNEE 4 VIEWS $1,146.00 HC42000885 ECG EXT HOLTER W/CONNECT>48HRS-7DAYS; RECORDING $1,145.00 HC44001584 MANDIBLE COMPLETE MIN 4 VWS $1,145.00 HC46502746 BIOPSY PUNCH SKIN; EACH SEP ADD'L LESION $1,144.00 HC51063121 EXCISION OF NAIL & MATRIX PERMANENT $1,144.00 99999-035-63 ALTEPLASE 2 MG INTRACATH SOLR $1,144.00 0254-1011-96 SUCRALFATE 100 MG/ML ORAL LIQUID (MCH) $1,143.87 66689-305-16 SUCRALFATE 100 MG/ML ORAL SUSP $1,143.68 HC51002715 REMOVE NEPHROSTOMY TUBE $1,142.00 HC44002681 UROGRAPHY ANTEGRADE LTD LT $1,142.00 HC44002699 UROGRAPHY ANTEGRADE LTD RT $1,142.00 HC51002236 ASP/INJ RENAL CYST/PELVIS $1,141.00 HC44002335 TOE (S) BILAT $1,141.00 70860-403-50 BIVALIRUDIN 250 MG/50 ML (5 MG/ML) IV SOLN $1,140.75 70860-403-51 BIVALIRUDIN 250 MG/50 ML (5 MG/ML) IV SOLN $1,140.75 70860-780-10 FOSAPREPITANT 150 MG IV SOLR $1,140.75 HC21000682 APPLY MULTILAY COMPRS BK LT $1,140.00 HC21000674 APPLY MULTILAY COMPRS BK RT $1,140.00 HC36800860 TEST STRESS PULMON INCL HR,POX,O2 TIT $1,140.00 0006-4992-00 HEPATITIS B VIRUS VACC.REC(PF) 40 MCG/ML IM SUSP $1,139.84 HC62210265 PACK TUBING ECMO $1,139.00 HC31000011 PT-APPLICATION CAST SHORT LEG $1,139.00 HC62225446 DEVICE RESECTION MUCOSAL ENDO(EMR) $1,138.00 HC62225495 TUBE SPLINTING ENDOSCOPIC $1,138.00 16571-071-12 CEFACLOR 250 MG/5 ML ORAL SUSR (MCH) $1,137.83 0641-6253-01 REGADENOSON 0.4 MG/5 ML IV SYRG $1,137.50 25021-414-50 ARGATROBAN IN 0.9 % SOD CHLOR 1 MG/ML IV SOLN $1,137.50 71288-201-85 REGADENOSON 0.4 MG/5 ML IV SYRG $1,137.50 43598-326-75 CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1 % OTIC DRPS $1,137.48 99999-044-98 CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1 % OTIC DRPS $1,137.48 65628-272-03 OMEPRAZOLE-SODIUM BICARBONATE 2-84 MG/ML ORAL SUSR $1,137.24 HC41500562 STUDIES NERVE CONDUCTN 1-2 STUDIES $1,137.00 HC51000107 CYSTOMETROGRAM W/VOID PRESSURE $1,136.00 HC51060986 INJ ANTEGRAD NEPH/URET'GRM,S&I EXIST ACCESS LT $1,136.00 HC51060994 INJ ANTEGRAD NEPH/URET'GRM,S&I EXIST ACCESS RT $1,136.00 HC44001352 JNT SURVEY SNGL VW 2 OR>JNTS $1,136.00 HC44001733 PERINEOGRAM $1,136.00 HC33000761 ST-EVAL NONSPEECH DEVICE RX:1ST HR $1,135.00 HC62802269 TUBE JEJUN LOWPRO TG BUTTON $1,134.00 HC21000625 WOUND VAC W/ DME <50 SQ CM PER SESSION $1,134.00 HC62202874 CUTTER LINEAR ENDO O $1,133.00 HC31001373 PT-RE-EVAL EST POC 90MIN $1,132.00 HC47201140 HDR ELECTRONIC BRACHYTHERAPY SKIN SURFACE $1,131.00 HC62228820 SCISSORS ENDOSCOPIC Q $1,131.00 HC62222583 TUBING ASPIRATOR ULTRASONIC O $1,131.00 HC36800738 DIFFUSING CAPACITY+ $1,129.00 HC51002699 PARACENTESIS ABD W/O IMAGING GUIDE $1,128.00 HC82200957 TISSUE EX G&M LVL 5 DIST SVC $1,128.00 HC82200411 TISSUE EXAM G&M LEVEL 5 $1,128.00 HC82202581 TISSUE EXAM G&M LEVEL 5 *OP $1,128.00 HC82202763 TISSUE EXAM G&M LVL 5(TC ONLY) $1,128.00 HC82200684 TISSUE EXAM LEVEL 5 ADD'L $1,128.00 HC82200601 TISSUE EXAM LVL 5 (PQRI) $1,128.00 HC38000238 APPLY BODY CAST;SHOULDER-HIPS $1,126.00 HC51002749 ASPIRATION OF BLADDER BY NEEDLE $1,125.00 HC37000296 DAILY MNGMT BREAST MILK PROC/STORE/DIST $1,125.00 HC36000685 DIFFUSING CAPACITY+ $1,123.00 HC46000311 INJ FOR DACRYCYSTOGRAPHY $1,123.00 HC25003021 LAC REPAIR SIMPLE F/E/E/N/L/M 12.6-20.0 CM $1,123.00 HC33000415 ST-SWALLOWING THERAPY 60 MIN $1,122.00 61703-343-18 MITOXANTRONE 2 MG/ML IV CONC $1,121.64 HC32003329 OT-EVAL MOD COMPLEXITY 30MF2F 90MIN $1,121.00 99988-000-38 NM I-123 SODIUM IODIDE DIAGNOSTIC CAPSULE (COMPOUNDED) $1,120.88 HC62212980 BLADE SHAVER P $1,120.00 HC62213285 BURR P $1,120.00 HC62226964 CANNULA PERFUSION O $1,120.00 HC62800149 CATH ANGIOGRAPHY W/BALLOON O $1,120.00 HC62222575 CATH BALLOON RENAL O $1,120.00 HC62222260 CATH EP DX <20 ELECTRODES H $1,120.00 HC62223870 CATH EP DX 20+ ELECTRODES RPRSD O $1,120.00 HC62800826 CATH HEMO/PERI DIAL LONG TERM O $1,120.00 HC62221908 CATH INTRODUCER PEEL-AWAY T $1,120.00 HC62223375 CATH MICROCATHETER NEUROVASC I $1,120.00 HC62223334 CATH PTA ANGIOPLS BALLOON NON-LSR K $1,120.00 HC62212626 CATH PTCA BALLOON NON-LASER I $1,120.00 HC62220181 CATH THROMBECTOMY/EMBOLECTOMY O $1,120.00 HC62804208 COIL EMBOLIZATION I $1,120.00 HC62220744 COUNTERSINK CANNULATED O $1,120.00 HC62220033 DEVICE SUTURE ENDO I $1,120.00 HC62218862 DRILL/DRILL BITS SINGLE USE U $1,120.00 HC62218425 ENDO STAPLER P $1,120.00 HC62217435 FORCEPS BIPOLAR DISPOSABLE O $1,120.00 HC62225875 GUIDE DRILL O $1,120.00 HC62224308 KIT ARTHROSCOPY DISPSBLS O $1,120.00 HC62221080 KIT CELL SAVER O $1,120.00 HC62227392 KIT CONCENTRATOR PLATELETS O $1,120.00 HC62203872 KIT FECAL MANAGEMENT O $1,120.00 HC62217237 KIT TUBE TRACH CUFFED O $1,120.00 HC62221205 KIT W/ TRACH PERCUTANEOUS D $1,120.00 HC62224480 NEEDLE BIOPSY BONE O $1,120.00 HC62225511 NEEDLE BIOPSY EUS O $1,120.00 HC62226287 NEEDLE BONE MARROW O $1,120.00 HC62227897 OBTURATOR ARTHRO K $1,120.00 HC62216700 PIN/WIRE FIXATION TEMPORARY AG $1,120.00 HC62216049 PROBE HEMOSTASIS (BICAP) H $1,120.00 HC62217039 PROBE SPINAL DISPOSABLE K $1,120.00 HC62224316 RASP SPINAL DISPSBL $1,120.00 HC83000034 RBC'S WASHED EA UNIT $1,120.00 HC83001032 RBC'S WASHED EA UNIT -SB $1,120.00 HC62213483 REAMER S $1,120.00 HC62223607 SNARE O $1,120.00 HC62206669 SPHINCTEROTOME H $1,120.00 HC62216155 SPHINCTEROTOME CANNULATING H $1,120.00 HC62223656 STAPLE CARTRG/ENDO RELOAD O $1,120.00 HC62221858 TAP SURGICAL O $1,120.00 HC62226816 TROCAR ENDO O $1,120.00 HC62219852 TUBE ET NIM O $1,120.00 HC62222492 WAND ARTHRO O $1,120.00 HC44002970 HIPS BILAT2VWS(W/PELVIS WHN PRFRMD) $1,119.00 HC31002074 PT-EVAL MOD COMPLEXITY 30MF2F 90MIN $1,119.00 HC51061018 REMOVE NEPHROSTOMY TUBE LT $1,119.00 HC51061026 REMOVE NEPHROSTOMY TUBE RT $1,119.00 HC25005778 CLOSED TX FIBULA DISTAL FX W/MANIP LT $1,116.00 HC25005786 CLOSED TX FIBULA DISTAL FX W/MANIP RT $1,116.00 0407-1414-94 IOHEXOL 350 MG IODINE/ML IV SOLN $1,115.40 0597-0053-01 GLUCAGON 1 MG/ML INJ SOLR $1,115.40 0597-0053-45 GLUCAGON 1 MG/ML INJ SOLR $1,115.40 0597-0260-10 GLUCAGON (HUMAN RECOMBINANT) 1 MG INJ SOLR (MHS) $1,115.40 58160-823-11 MHS ZOSTER VACCINE RECOMBINANT (SHINGRIX) INJ $1,115.19 HC43500016 DEXA BONE DENS-AXIAL SKELETAL $1,115.00 0078-0508-83 CARBAMAZEPINE 100 MG/5 ML ORAL SUSP $1,114.43 0015-3012-60 CARMUSTINE 100 MG IV SOLR $1,114.17 HC25000365 FB REMOVAL EYE $1,113.00 HC41500539 EMG FACIAL UNILAT $1,112.00 HC41500240 EMG FACIAL UNILAT LT $1,112.00 HC41500257 EMG FACIAL UNILAT RT $1,112.00 HC39001045 TMS REDETERMINATION THRES DELV MGNT $1,112.00 0517-0602-01 FERRIC CARBOXYMALTOSE 100 MG IRON/2 ML IV SOLN $1,111.70 70408-185-34 PROMETHAZINE-CODEINE 6.25-10 MG/5 ML ORAL SYRP $1,109.90 HC38000287 APPLY CAST SPICA SHOULDER $1,109.00 HC32000747 OT-WOUND NON-SEL DEB 60MIN/MW $1,109.00 HC31000805 PT-WOUND NON-SEL DEB 60MIN/MW $1,109.00 63323-593-03 GLUCAGON (HUMAN RECOMBINANT) 1 MG INJ SOLR (MHS) $1,108.25 63323-596-03 GLUCAGON (HUMAN RECOMBINANT) 1 MG INJ SOLR (MHS) $1,108.25 63323-596-11 GLUCAGON (HUMAN RECOMBINANT) 1 MG INJ SOLR (MHS) $1,108.25 63323-596-13 GLUCAGON (HUMAN RECOMBINANT) 1 MG INJ SOLR (MHS) $1,108.25 61269-410-20 ETOPOSIDE PHOSPHATE 100 MG IV SOLR $1,107.28 HC38000139 APPLY SPLINT LONG ARM $1,106.00 HC43500024 DEXA BONE DENS-BODY $ $1,106.00 HC46000097 INJ ARTHROGRAM ANKLE-LT $1,106.00 HC46000105 INJ ARTHROGRAM ANKLE-RT $1,106.00 HC25004219 CLOSED TX HIP DISLOC POST ARTHROPLASTY LT $1,105.00 HC25004227 CLOSED TX HIP DISLOC POST ARTHROPLASTY RT $1,105.00 0703-4685-01 MITOXANTRONE 2 MG/ML IV CONC $1,105.00 16729-267-65 DOCETAXEL 160 MG/8 ML (20 MG/ML) IV SOLN $1,105.00 72485-113-01 ISOPROTERENOL HCL 0.2 MG/ML INJ SOLN $1,105.00 72485-113-10 ISOPROTERENOL HCL 0.2 MG/ML INJ SOLN $1,105.00 HC43001171 MAMMO DX UNILAT W/CAD LT $1,104.00 HC43001189 MAMMO DX UNILAT W/CAD RT $1,104.00 8065183055 SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRG $1,102.08 0597-0033-34 CLONIDINE 0.3 MG/24 HR TRANSDERMAL PTWK $1,101.64 HC62228515 BRONCHOSCOPE ASCOPE LRG DISP $1,100.00 HC62227111 CONTROL DOSE C02 MANUAL PAT(AEROFORM) $1,100.00 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(LEG) 2 VWS LT $862.00 HC44002251 TIBIA & FIBULA (LEG) 2 VWS RT $862.00 HC44002780 TIBIA AND FIBULA $862.00 HC25004656 CLOSED TX METATARSAL FX; W/MANIPULTN EA $861.00 HC12200127 REFILL&MAINT'N IMPLANT PUMP $861.00 0407-1413-65 IOHEXOL 300 MG IODINE/ML IV SOLN $860.93 HC25004136 CLOSED TX FINGER/THUMB SHAFT FX W/MANIP EA $860.00 HC25004854 CLOSED TX INTERPHALANGEAL JNT DISLOC; NO ANES LT $860.00 60793-700-01 PENICILLIN G BENZATHINE 600,000 UNIT/ML IM SYRG $859.97 60793-700-10 PENICILLIN G BENZATHINE 600,000 UNIT/ML IM SYRG $859.97 HC51010882 PUNCTURE SPINAL TX DRAIN CSF [NOT W/FLUORO/CT] $859.00 HC62221411 TRAY THORAC/PARACENTESIS O $859.00 50419-774-01 CIPROFLOXACIN 10 G/100 ML ORAL SUMC (MCH) $858.65 HC51002335 CIRCUMCISION INFANT >28D EXCISE NO DEVICE $856.00 HC82202185 MORPHOMETRIC STUDY NERVE $856.00 HC44002053 SKULL LTD <4 VIEWS $855.00 HC38000329 APPLY LONG LEG CAST BRACE $854.00 HC36000172 DEMO&/OR EVAL OF INH TX $854.00 HC62203799 KIT COOK TRIPLE LUMEN CATH $854.00 HC62204326 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HC38000006 APPLIC CAST LEG CLUBFOOT $827.00 HC44200962 US ELASTOGRAPHY $827.00 HC44001402 KNEE 2 VIEWS LT $826.00 HC44001410 KNEE 2 VIEWS RT $826.00 0054-0428-25 FLUCYTOSINE 500 MG ORAL CAP $825.79 HC25003450 CLOSED TX CLAVICLE FX LT $825.00 HC25003468 CLOSED TX CLAVICLE FX RT $825.00 HC25005406 INJ ANES/STEROID NERVE TRIGEML BRNCH EA LT $825.00 HC25005414 INJ ANES/STEROID NERVE TRIGEML BRNCH EA RT $825.00 HC25005885 LYSIS & STRETCHING ADHESIONS PREPUTIAL $825.00 0395-1031-28 GLYCERIN (BULK) 100 % MISC LIQD $823.68 61958-0602-1 EMTRICITABINE 10 MG/ML ORAL SOLN $823.23 HC36000016 AEROSOL-CONTINUOUS TX FIRST HR $823.00 HC32001497 OT-REMOVE/BIVAL CAST SHRT LIMB $823.00 HC31001712 PT-REMOVE/BIVAL CAST SHRT LIMB $823.00 70515-260-10 DIGOXIN 250 MCG/ML (0.25 MG/ML) INJ SOLN $821.33 HC46000147 INJ ARTHROGRAM TMJ $821.00 HC32003311 OT-EVAL MOD COMPLEXITY 30MF2F 60MIN $821.00 HC33000696 ST-EVAL LANGUAGE CMPNT 60MIN $820.00 HC44200921 US CHEST LTD $820.00 65649-201-75 PEG3350-SOD 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FINGER DYNAMIC $811.00 HC33000845 ST-EVAL SPEECH CMPNT 60MIN $811.00 51672-1258-2 CLOBETASOL 0.05 % TOPICAL CREAM $809.45 HC51003259 COLPOSCPY CERV&ADJ VAG W/CERV BX(S)&ECC $808.00 HC34000141 OTOACOUSTIC EVOKED EMM COMP $808.00 HC34000042 COMPREHENSIV AUDIOMETRY $807.00 HC62223276 SYSTEM LEAD EXTRACTION $807.00 HC62219985 BASKET RETRIEVAL M $806.00 HC62201322 CATH DIAGNOSTIC M $806.00 HC62300108 DRIVER NEEDLE ROBOTIC $806.00 HC62212725 GUIDEWIRE L $806.00 HC62203666 KIT ARTHROSCOPY DISPSBLS M $806.00 HC62227814 KIT REPAIR BROVIAC/CV/HICKMAN H $806.00 HC62211313 KIT VENT THORACIC (URESIL) $806.00 HC62217823 TEMPLATE STAPLE SPINAL L $806.00 39822-1220-1 NEOMYCIN-POLYMYXIN B GU 40 MG-200,000 UNIT/ML IRR SOLN $806.00 0168-0370-30 CLOTRIMAZOLE-BETAMETHASONE 1-0.05 % TOPICAL LOTN $804.77 61958-0901-1 AZTREONAM LYSINE 75 MG/ML INHALATION NEBU $804.34 HC36800175 EXHALED NITRIC OXIDE MEASRMNT $803.00 HC51010874 LUMBAR PUNCTURE DX [NOT W/ CT OR FLUORO ] $803.00 HC25005158 CHANGE TRACH TUBE PRIOR 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UNIT /0.1 ML INTRADERMAL SOLN $642.85 49281-752-78 TUBERCULIN PPD 5 TUB. UNIT /0.1 ML INTRADERMAL SOLN $642.85 70954-261-10 DICYCLOMINE 10 MG/5 ML ORAL SOLN $642.57 HC22000095 OST EST PT EVAL LVL5-(40 MIN) $642.00 68382-444-05 FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSP $641.88 0574-4022-35 BACITRACIN 500 UNIT/GRAM OPHT OINT $641.55 49502-393-80 INSULIN GLARGINE-YFGN 100 UNIT/ML SUBCUTANEOUS SOLN $641.23 72603-101-01 OXALIPLATIN 100 MG/20 ML IV SOLN $641.16 64980-448-01 NEOMYCIN-POLYMYXIN-HC 3.5-10,000-1 MG/ML-UNIT/ML-% OTIC DRPS $640.38 HC83001024 CRYOPRECIP 5 UNITS POOLED -SB $639.00 HC51002251 X RAY UROGRAPHY ANTEGRADE R&I $639.00 HC25001397 I&D POSTOP WOUND $638.00 HC32001687 OT-WINDOWING CAST $638.00 HC31001928 PT-WINDOWING CAST $638.00 HC62207493 TRAY PERICARIOCENTESIS $638.00 0024-5924-10 INSULIN LISPRO 100 UNIT/ML SUBCUTANEOUS SOLN $637.46 0713-0637-37 METRONIDAZOLE 0.75 % TOPICAL GEL $637.07 HC89023832 ANALY CFTR GENE DELET/DUP VARIANTS-AU $637.00 62135-712-42 LIDOCAINE HCL 2 % MUCOUS MEMB SOLN $637.00 0574-0601-15 PODOPHYLLUM RESIN 25 % TOPICAL LIQD $636.97 HC51002392 EXCISE LESION 0.6-1CM HND-FT-SC-NCK-GN $636.00 HC62229257 TRAY CHEST TUBE THAL-QUICK $636.00 23155-748-31 PENTAMIDINE 300 MG INJ SOLR $635.05 23155-748-41 PENTAMIDINE 300 MG INJ SOLR $635.05 HC36001071 ATTENDANCE AT DELIVERY $635.00 HC62802665 NEEDLE TEMPLAT ENDOCURR $633.00 51672-1303-2 ECONAZOLE 1 % TOPICAL CREAM $632.97 58181-3040-5 LOMUSTINE 10 MG ORAL CAP $632.71 63323-315-01 GANCICLOVIR SODIUM 500 MG IV SOLR $632.26 63323-315-10 GANCICLOVIR SODIUM 500 MG IV SOLR $632.26 HC82200460 ANATOMIC CONSULT:COMP.REVIEW $632.00 HC35000033 REC- EVALUATION 45MIN $632.00 HC62219886 ADAPTER ARTHROSCPC $630.00 HC34000216 AUD-AUDITORY EVOKED AEP NEURODIAGNOSTIC W/I&R $630.00 HC62218060 BASKET RETRIEVAL K $630.00 HC62213111 BLADE INCISIONAL I $630.00 HC62212915 BLADE SHAVER I $630.00 HC62213210 BURR I $630.00 HC62800362 CATH GUIDING K $630.00 HC62223268 CATH PTA ANGIOPLS BALLOON NON-LSR G $630.00 HC62226774 COUNTERSINK CANNULATED G $630.00 HC62224399 CUTTER DISC SPINAL $630.00 HC62218797 DRILL/DRILL BITS SINGLE USE N $630.00 HC62228549 ELECTRODE PACING/DEFIB TEMPORARY K $630.00 HC62218367 ENDO STAPLER I $630.00 HC62300298 FORCEP ROBOTIC K $630.00 HC62215439 FORCEPS BIPOLAR DISPOSABLE K $630.00 HC62225123 GUIDE DRILL K $630.00 HC62222104 GUIDE PIN ORTHO K $630.00 HC62224225 GUIDE ROD K $630.00 HC12200184 INF CNTR-NEW PT EVAL COMPLEX $630.00 HC62220579 INTRO/SHEATH EP FIXED NON-PEEL H $630.00 HC62212394 INTRODUCER/SHEATH K $630.00 HC62224290 KIT ARTHROSCOPY DISPSBLS K $630.00 HC62225248 KIT CAUTERY LEEP (REDIKIT) $630.00 HC62227376 KIT CONCENTRATOR PLATELETS J $630.00 HC62208277 KIT PERICARDIOCENTESIS $630.00 HC62204888 NEEDLE BIOPSY BONE VERTEBROPLASTY K $630.00 HC62217799 NEEDLE BONE MARROW K $630.00 HC62205133 PACK ANGIO $630.00 HC62222864 PAIN PUMP W/ SYSTEM K $630.00 HC62215504 PROBE SPINAL DISPOSABLE D $630.00 HC62213418 REAMER L $630.00 HC62221320 RESERVOIR CELL SAVER K $630.00 HC62214515 RETRACTOR DISPOSABLE G $630.00 HC62224175 SHEARS COAGULATING HARMONIC K $630.00 HC62215702 SUTURE W $630.00 HC62221817 TAP SURGICAL K $630.00 HC62217815 TEMPLATE STAPLE SPINAL G $630.00 HC62219621 TUBE TRACH CUFFED ADJUSTABLE K $630.00 HC62222468 WAND ARTHRO K $630.00 HC62217047 WRENCH TORQUE SHAFT SPINAL (DISP) $630.00 70100-424-01 INDOCYANINE GREEN 25 MG INJ SOLR $629.42 70100-424-02 INDOCYANINE GREEN 25 MG INJ SOLR $629.42 0591-2712-02 ALBENDAZOLE 200 MG ORAL TAB $629.36 0093-3560-19 PEG3350-SOD SUL-NACL-KCL-ASB-C 100-7.5-2.691 GRAM ORAL PWPK $629.20 0093-3560-26 PEG3350-SOD SUL-NACL-KCL-ASB-C 100-7.5-2.691 GRAM ORAL PWPK $629.20 HC36800233 M V V (MAX VOL VENT) $629.00 HC41500380 NYSTAGMUS SPONT GAZE/FIX $629.00 16714-556-01 ADENOSINE (DIAGNOSTIC) 3 MG/ML IV SOLN $628.81 HC62203419 FORCEP BIOPSY DISP J $627.00 HC27001924 GI TRACT CAPSULE PATENCY STUDY $627.00 HC41500752 ORBICULARIS OCULI (BLINK) REFLEX $627.00 99999-043-70 RIFAXIMIN 20 MG/ML ORAL SUSPENSION (COMPOUND) $626.60 HC44500676 CINERADIOGRAPHY W/ EXAM $625.00 HC51002590 FNA ASP BX W/O GUIDE; FIRST LESION $625.00 HC62210133 TUBE TRACH PEDS/NEO CUFFED $625.00 HC47201249 RAD ONC NEW PT MOD MDM 45-59 MIN $625.00 HC81101313 BLOOD GASES LTD $624.00 HC81101768 BLOOD GASES LTD (POS) $624.00 HC36800415 VITAL CAPACITY $624.00 HC11500683 WC NEW E&M ASSESS COMPREHN L:5 $624.00 HC51063097 AVULSION OF NAIL, SIMPLE; SINGLE $624.00 61703-363-22 OXALIPLATIN 100 MG/20 ML IV SOLN $624.00 76125-792-10 ALBUMIN, HUMAN 25 % 25 % IV SOLP $624.00 76125-792-11 ALBUMIN, HUMAN 25 % 25 % IV SOLP $624.00 99999-001-99 CHARGE-NEONATAL LVIV 4-9 ADDS $624.00 HC44000750 FB CHILD NOSE-RECTUM EXAM $623.00 HC11500782 AM/PACU EVAL MOD/HI-IV $622.00 HC44000305 CALCANEUS (HEEL) LT $622.00 HC44000313 CALCANEUS (HEEL) RT $622.00 HC83000844 CRYOPRECIPITATE POOLED 5 UNITS $622.00 HC12200069 IV PUSH SINGLE/INIT'L INJ $622.00 HC44002814 OS CALSIS $622.00 HC25003302 LAC REPAIR CMPLX S/A/L ADDL 5 CM/> $621.00 HC25005828 LARYNGOSCOPY DIAGNOSTIC $621.00 HC62807615 M: CENTRALIZER HIP $621.00 HC39001250 PSYCH TESTING EVAL INTEGR INTERPRET CLIN DES TX; EA ADDL HR+ $621.00 HC62219787 PUMP BLOOD CENTRIFUGAL $621.00 HC83000471 RBC LR/CMV NEG DIVIDED UNIT $621.00 HC33000209 SP-LARYNGEAL FUNCTION STUDIES $621.00 HC33000779 ST-LARYNGEAL FUNCTION STUDIES $621.00 HC83504092 TISSUE IN-SITU HYBRI INTER-IM $621.00 HC84201318 B. PERTUSSIS BY PCR (RVP PNL) $620.00 HC62211057 CANNULA VENOUS STRAIGHT K $620.00 0407-2222-17 IODIXANOL 270 MG IODINE/ML IV SOLN $619.45 HC11200004 OBSERVATION PER HOUR - ICU $619.00 HC11500857 PEDS ESTAB PT ASSESS COMP(40') $619.00 HC65800047 BRACHY NONSTRNDED GOLD 198 SRC $618.00 HC25000290 LAC REPAIR 12.6-20CM $618.00 HC65800039 M: SEED(S) GOLD BRACHYTHERAPY $618.00 HC81100307 PHENYTOIN TOTAL $618.00 0781-3465-94 FONDAPARINUX 7.5 MG/0.6 ML SUBCUTANEOUS SYRG $617.89 HC81700981 FLOW CYT MKR TC CD45 $617.00 HC81701666 FLOW CYT TC; 1ST MARKER $617.00 HC62220165 BLADE SAW AA $616.00 HC62227863 DRESSING CLOT QUICK $616.00 HC44002756 FINGER(S) $616.00 HC44000792 FINGER(S) MIN 2 VWS-LT $616.00 HC44000800 FINGER(S) MIN 2 VWS-RT $616.00 HC62216643 PIN/WIRE FIXATION TEMPORARY AA $616.00 HC81100158 VANCOMYCIN INIT $616.00 54295-308-25 UREA 40 % TOPICAL CREAM $615.14 63323-172-45 CARBOPLATIN 10 MG/ML IV SOLN $615.13 HC81701526 STREPTOCCUS GROUP B, PCR $615.00 45963-609-55 FLUDARABINE 50 MG/2 ML RECONSTITUTED IV SOLN (MCH) $614.25 70860-451-10 LEVOTHYROXINE 100 MCG IV SOLR $614.25 HC34000117 AUD-INFANT HEARING SCREEN AEP BBS AUTO REPEAT OP $612.00 HC62803515 CAP END SCREW $612.00 HC51003838 I&D ABSCESS COMPLICATED MULT $612.00 HC81701765 FACTOR V LEIDEN BY PCR $611.00 70436-026-80 EPTIFIBATIDE 2 MG/ML IV SOLN $610.94 HC39000039 PSYCH TX W/PATIENT 45MIN $610.00 HC12200234 INF CNTR-ESTBL'D PT EVAL-CMPLX $609.00 HC84201219 INFLUENZA A BY PCR $609.00 HC81101727 INFLUENZA A BY PCR $609.00 HC84201227 INFLUENZA B BY PCR $609.00 HC81101735 INFLUENZA B BY PCR $609.00 HC39001268 NEUROPSYCH TESTING EVAL INTRG INTERP CLIN DES TX FEEDBACK; 1ST HOUR $609.00 HC41500372 NYSTAGMUS OPTOKINETIC BIDIRECT $609.00 HC21000518 PAIRING BENIGN LESION: 1 $609.00 HC39001243 PSYCH TESTING EVAL INTEGR INTERPRET CLIN DES TX; 1ST HOUR $609.00 HC84201854 STREPTOCCUS GROUP B, PCR $609.00 0078-0401-34 IMATINIB 100 MG ORAL TAB $608.65 61703-323-22 BLEOMYCIN 30 UNIT INJ SOLR $608.53 67457-446-10 PAMIDRONATE 90 MG/10 ML (9 MG/ML) IV SOLN $608.14 HC31002108 PT-EVAL LOW COMPLEXITY 20MF2F 45MIN $608.00 0469-3250-10 MICAFUNGIN 50 MG IV SOLR $607.75 25021-190-10 MICAFUNGIN 50 MG IV SOLR $607.75 63323-728-01 MICAFUNGIN 50 MG IV SOLR $607.75 63323-728-10 MICAFUNGIN 50 MG IV SOLR $607.75 HC44000057 ABDOMEN SINGLE VIEW $607.00 HC44001667 NECK, SOFT TISSUE $607.00 HC39000989 PSYCH DIAG EVAL W/ MED SERVICE $607.00 HC83000463 RBC LEUKOREDUC/CMV NEG EA $607.00 HC32003295 OT-EVAL LOW COMPLEXITY 20MF2F 45MIN $606.00 99999-046-40 MACITENTAN 2.5 MG ORAL PARTIAL TAB $605.85 68516-5216-2 ALBUMIN, HUMAN 25 % 25 % IV SOLP $605.15 68516-5216-4 ALBUMIN, HUMAN 25 % IV SOLP (MCH) $605.15 HC33000597 ST-SPEECH THERAPY GRP 90MIN/MCW $605.00 HC51061109 US RETROPERITONEAL COMPLETE $605.00 42192-608-16 GABAPENTIN 250 MG/5 ML ORAL SOLN $604.89 67457-299-00 NALOXONE 0.4 MG/ML INJ SOLN $604.50 67457-299-10 NALOXONE 0.4 MG/ML INJ SOLN $604.50 68516-5214-0 ALBUMIN, HUMAN 5 % 5 % IV SOLP $604.50 68516-5214-2 ALBUMIN, HUMAN 5 % 5 % IV SOLP $604.50 68516-5214-4 ALBUMIN, HUMAN 5 % 5 % IV SOLP $604.50 68516-5214-8 ALBUMIN, HUMAN 5 % 5 % IV SOLP $604.50 HC39000955 PSY TX W/PATIENT 45MIN W/E&M+ $604.00 HC81100166 VANCOMYCIN SUBS $604.00 HC51002202 X RAY URETHROCYSTOGRAM VOIDING $604.00 HC62205653 PERFORATOR $602.00 HC62215694 SUTURE V $602.00 HC44002343 TOE (S) LT $602.00 HC44002350 TOE (S) RT $602.00 HC32001828 OT-SWALLOWING EVAL 15MIN $601.00 0006-4047-41 ROTAVIRUS VACCINE LIVE, PENTA 2 ML ORAL SOLN $600.86 HC29000775 ASSESS/INTERV ALCOHOL/SUBS MISUSE >30MIN $600.81 HC51010528 TEST ALLERGY PATCH $600.00 HC51010544 TEST CHALLENGE INGEST 1ST120MIN $600.00 HC51010452 TESTS PERCUTANEOUS ALLERGY $600.00 HC51002293 CIRCUMCISION W/DEVICE RING/BLOCK $599.00 HC62204045 KIT MANIFOLD SPECIALTY $599.00 HC39001276 NEUROPSYCH TEST EVAL INTRG INTERP CLIN DES FEEDBACK; EA ADDL HR+ $599.00 HC83000497 PLATELETS IRRAD EA UNIT $598.00 0069-1002-01 TOFACITINIB 10 MG ORAL TAB $597.32 13533-635-04 IMMUNE GLOB G (IGG)-GLYCINE 15-18 % RANGE IM SOLN $597.03 HC84201185 C DIFFICILE TOXIN GENE PCR $597.00 HC81101941 DRUG TEST PRESUMPTIVE CHEM ANALYZERS/ DOS $597.00 16714-878-02 LIDOCAINE 5 % TOPICAL OINT $596.38 HC84201326 C. PNEUMONIAE BY PCR (RVP PNL) $596.00 HC62212568 FORCEP BIOPSY DISP I $596.00 HC62226899 GUIDEWIRE I $596.00 HC62212717 GUIDEWIRE(NITREX) I $596.00 HC62225370 KIT REPAIR BROVIAC/CV/HICKMAN E $596.00 HC62205125 PACK ANGIO COMBO $596.00 HC81100315 PHENOBARBITOL $596.00 HC62210703 SET DECOMPRESSION COLON $596.00 HC62209002 SPLINT FOOT $596.00 HC33000555 ST-SWALLOWING EVAL 15MIN $596.00 HC62209598 TRACTION PELVIC UNIT $596.00 HC51063006 DEBRIDE SKIN SUBQ EA ADD 20SQCM/< $596.00 HC51001220 CLOSED TX ELBOW DISLOCATION $595.00 HC84600238 FNA INTERPR/REPORT-DIST SVC $595.00 HC84600196 FNA INTERPRETATION/REPORT $595.00 HC51003382 X-RAY ORPORA CAVERNOSGRAPHY $595.00 HC83000828 ALIQUOT PLATELETS $594.00 HC83000810 ALIQUOT RED CELLS $594.00 0456-4300-01 FOSFOMYCIN TROMETHAMINE 3 GRAM ORAL PACK $593.26 HC82200528 IHC/IP PER SPEC INITIAL AB STAIN $593.00 HC82201831 IHC/IP PER SPEC INITIAL AB STAIN ACTH $593.00 HC82200247 IHC/IP PER SPEC INITIAL AB STAIN AFP $593.00 HC82201849 IHC/IP PER SPEC INITIAL AB STAIN ANTI-BCL-2 $593.00 HC82202953 IHC/IP PER SPEC INITIAL AB STAIN BASAL CELL COCKTAIL $593.00 HC82202961 IHC/IP PER SPEC INITIAL AB STAIN BCL-6 $593.00 HC82201567 IHC/IP PER SPEC INITIAL AB STAIN BRST2 $593.00 HC82201575 IHC/IP PER SPEC INITIAL AB STAIN CALCITONIN $593.00 HC82202979 IHC/IP PER SPEC INITIAL AB STAIN CALRETIN $593.00 HC82202987 IHC/IP PER SPEC INITIAL AB STAIN CAM5-2 $593.00 HC82203043 IHC/IP PER SPEC INITIAL AB STAIN CD10 $593.00 HC82203092 IHC/IP PER SPEC INITIAL AB STAIN CD117 $593.00 HC82203100 IHC/IP PER SPEC INITIAL AB STAIN CD138 $593.00 HC82202995 IHC/IP PER SPEC INITIAL AB STAIN CD1A $593.00 HC82203050 IHC/IP PER SPEC INITIAL AB STAIN CD21 $593.00 HC82203068 IHC/IP PER SPEC INITIAL AB STAIN CD23 $593.00 HC82201856 IHC/IP PER SPEC INITIAL AB STAIN CD3 $593.00 HC82203076 IHC/IP PER SPEC INITIAL AB STAIN CD31 $593.00 HC82201583 IHC/IP PER SPEC INITIAL AB STAIN CD-34 $593.00 HC82203001 IHC/IP PER SPEC INITIAL AB STAIN CD4 $593.00 HC82203019 IHC/IP PER SPEC INITIAL AB STAIN CD5 $593.00 HC82203084 IHC/IP PER SPEC INITIAL AB STAIN CD56 $593.00 HC82201864 IHC/IP PER SPEC INITIAL AB STAIN CD-68 $593.00 HC82203027 IHC/IP PER SPEC INITIAL AB STAIN CD7 $593.00 HC82204447 IHC/IP PER SPEC INITIAL AB STAIN CD-79A $593.00 HC82203035 IHC/IP PER SPEC INITIAL AB STAIN CD8 $593.00 HC82203118 IHC/IP PER SPEC INITIAL AB STAIN CDX-2 $593.00 HC82200197 IHC/IP PER SPEC INITIAL AB STAIN CEA $593.00 HC82203126 IHC/IP PER SPEC INITIAL AB STAIN CEA MONOCLONAL $593.00 HC82200221 IHC/IP PER SPEC INITIAL AB STAIN CHROMOGRNIN $593.00 HC82203142 IHC/IP PER SPEC INITIAL AB STAIN CK-19 $593.00 HC82203134 IHC/IP PER SPEC INITIAL AB STAIN CK-5/6 $593.00 HC82203159 IHC/IP PER SPEC INITIAL AB STAIN CMV $593.00 HC82204595 IHC/IP PER SPEC INITIAL AB STAIN C-MYC $593.00 HC82201872 IHC/IP PER SPEC INITIAL AB STAIN CYCLIN D1 $593.00 HC82201880 IHC/IP PER SPEC INITIAL AB STAIN CYTO KERATIN-20 $593.00 HC82201898 IHC/IP PER SPEC INITIAL AB STAIN CYTO KERATIN-7 $593.00 HC82201591 IHC/IP PER SPEC INITIAL AB STAIN DESMIN $593.00 HC82201526 IHC/IP PER SPEC INITIAL AB STAIN DYSTROPH(C-TERMINUS) $593.00 HC82201534 IHC/IP PER SPEC INITIAL AB STAIN DYSTROPH(N-TERMINUS) $593.00 HC82201542 IHC/IP PER SPEC INITIAL AB STAIN DYSTROPH(ROD DOMAIN) $593.00 HC82203167 IHC/IP PER SPEC INITIAL AB STAIN E-CADHERIN $593.00 HC82203332 IHC/IP PER SPEC INITIAL AB STAIN EGFR $593.00 HC82203175 IHC/IP PER SPEC INITIAL AB STAIN EMA (MC5)(LIVER) $593.00 HC82200288 IHC/IP PER SPEC INITIAL AB STAIN EPITH $593.00 HC82201609 IHC/IP PER SPEC INITIAL AB STAIN ESTROGN RECEPT $593.00 HC82201906 IHC/IP PER SPEC INITIAL AB STAIN EWINGS SARCOMA $593.00 HC82201914 IHC/IP PER SPEC INITIAL AB STAIN FACTOR 13-A $593.00 HC82200254 IHC/IP PER SPEC INITIAL AB STAIN FACTOR 8 $593.00 HC82201617 IHC/IP PER SPEC INITIAL AB STAIN GASTRIN $593.00 HC82204579 IHC/IP PER SPEC INITIAL AB STAIN GATA-3 $593.00 HC82200262 IHC/IP PER SPEC INITIAL AB STAIN GFAP $593.00 HC82201625 IHC/IP PER SPEC INITIAL AB STAIN GLUCAGON $593.00 HC82201922 IHC/IP PER SPEC INITIAL AB STAIN GROWTH HORMONE STN $593.00 HC82200270 IHC/IP PER SPEC INITIAL AB STAIN HCG $593.00 HC82203183 IHC/IP PER SPEC INITIAL AB STAIN HEPPAR $593.00 HC82202052 IHC/IP PER SPEC INITIAL AB STAIN HER-2-NEU $593.00 HC82201633 IHC/IP PER SPEC INITIAL AB STAIN HERPES POLY $593.00 HC82200189 IHC/IP PER SPEC INITIAL AB STAIN HMB-45 $593.00 HC82204637 IHC/IP PER SPEC INITIAL AB STAIN HSV-1 $593.00 HC82204652 IHC/IP PER SPEC INITIAL AB STAIN HSV-2 $593.00 HC82203191 IHC/IP PER SPEC INITIAL AB STAIN IGD $593.00 HC82201559 IHC/IP PER SPEC INITIAL AB STAIN IHC/IP STAIN ACTH $593.00 HC82203209 IHC/IP PER SPEC INITIAL AB STAIN INHIBIN $593.00 HC82203217 IHC/IP PER SPEC INITIAL AB STAIN INI-1 $593.00 HC82201641 IHC/IP PER SPEC INITIAL AB STAIN INSULIN $593.00 HC82201658 IHC/IP PER SPEC INITIAL AB STAIN KAPPA $593.00 HC82200304 IHC/IP PER SPEC INITIAL AB STAIN KERATIN $593.00 HC82203225 IHC/IP PER SPEC INITIAL AB STAIN KERATIN (AE1/AE1) LN $593.00 HC82201930 IHC/IP PER SPEC INITIAL AB STAIN KERATIN 903 $593.00 HC82203233 IHC/IP PER SPEC INITIAL AB STAIN KERATIN HMWK $593.00 HC82201666 IHC/IP PER SPEC INITIAL AB STAIN KI-1 $593.00 HC82201955 IHC/IP PER SPEC INITIAL AB STAIN KI-67 $593.00 HC82201674 IHC/IP PER SPEC INITIAL AB STAIN KP1 $593.00 HC82201682 IHC/IP PER SPEC INITIAL AB STAIN L26/CD 20 $593.00 HC82201690 IHC/IP PER SPEC INITIAL AB STAIN LAMBDA $593.00 HC82200213 IHC/IP PER SPEC INITIAL AB STAIN LCA/CD45 $593.00 HC82201963 IHC/IP PER SPEC INITIAL AB STAIN LEU MI (CD15) $593.00 HC82200296 IHC/IP PER SPEC INITIAL AB STAIN LEU-22/CD 43 $593.00 HC82201708 IHC/IP PER SPEC INITIAL AB STAIN LN1 $593.00 HC82201716 IHC/IP PER SPEC INITIAL AB STAIN LN2 $593.00 HC82203241 IHC/IP PER SPEC INITIAL AB STAIN MELAN-A $593.00 HC82204678 IHC/IP PER SPEC INITIAL AB STAIN MLH-1 $593.00 HC82201724 IHC/IP PER SPEC INITIAL AB STAIN MT1 $593.00 HC82203258 IHC/IP PER SPEC INITIAL AB STAIN MUM-1 $593.00 HC82201732 IHC/IP PER SPEC INITIAL AB STAIN MUSCLE $593.00 HC82201989 IHC/IP PER SPEC INITIAL AB STAIN MYELOPEROXIDASE $593.00 HC82201740 IHC/IP PER SPEC INITIAL AB STAIN MYGLOBIN $593.00 HC82203266 IHC/IP PER SPEC INITIAL AB STAIN MYOGENIN $593.00 HC82201757 IHC/IP PER SPEC INITIAL AB STAIN NEUROFILAMENT $593.00 HC82201765 IHC/IP PER SPEC INITIAL AB STAIN NSE $593.00 HC82200437 IHC/IP PER SPEC INITIAL AB STAIN -OP $593.00 HC82203274 IHC/IP PER SPEC INITIAL AB STAIN P16 $593.00 HC82201997 IHC/IP PER SPEC INITIAL AB STAIN P-53 $593.00 HC82203282 IHC/IP PER SPEC INITIAL AB STAIN P63 $593.00 HC82204553 IHC/IP PER SPEC INITIAL AB STAIN PAX8 $593.00 HC82203290 IHC/IP PER SPEC INITIAL AB STAIN PGP 9.5 $593.00 HC82202003 IHC/IP PER SPEC INITIAL AB STAIN PLAP $593.00 HC82201773 IHC/IP PER SPEC INITIAL AB STAIN PROGEST RECEPT $593.00 HC82202011 IHC/IP PER SPEC INITIAL AB STAIN PROLACTIN $593.00 HC82200205 IHC/IP PER SPEC INITIAL AB STAIN PSA $593.00 HC82200171 IHC/IP PER SPEC INITIAL AB STAIN S100 $593.00 HC82202029 IHC/IP PER SPEC INITIAL AB STAIN SMMHC $593.00 HC82201781 IHC/IP PER SPEC INITIAL AB STAIN SMOOTH MUSC $593.00 HC82201799 IHC/IP PER SPEC INITIAL AB STAIN SOMATOSATIN $593.00 HC82204538 IHC/IP PER SPEC INITIAL AB STAIN SOX10 $593.00 HC82200312 IHC/IP PER SPEC INITIAL AB STAIN SYNAPTOPH $593.00 HC82201807 IHC/IP PER SPEC INITIAL AB STAIN T4/CD 4 $593.00 HC82202037 IHC/IP PER SPEC INITIAL AB STAIN TERM DEOZY $593.00 HC82203308 IHC/IP PER SPEC INITIAL AB STAIN TH $593.00 HC82201815 IHC/IP PER SPEC INITIAL AB STAIN THYROGLOBULIN $593.00 HC82203316 IHC/IP PER SPEC INITIAL AB STAIN TTF-1 $593.00 HC82202060 IHC/IP PER SPEC INITIAL AB STAIN UBIQUITIN STAIN $593.00 HC82201823 IHC/IP PER SPEC INITIAL AB STAIN UCHL1 $593.00 HC82200239 IHC/IP PER SPEC INITIAL AB STAIN VIMENTIN $593.00 HC82203324 IHC/IP PER SPEC INITIAL AB STAIN WT-1 $593.00 HC82204611 IP/IHC PER SPEC INITIAL AB STAIN H PYLORI $593.00 HC82204470 IP/IHC PER SPEC INITIAL AB STAIN PROSTATIC ACID PHOS $593.00 HC25000969 INHALATION TREATMENT INITIAL $592.00 HC62204151 KIT PNEUMOTHORAX $592.00 0000-3763-00 STERILE TALC 5 GRAM INTRAPLEURAL SUSR $591.50 0409-6482-01 ERYTHROMYCIN LACTOBIONATE 500 MG IV SOLR $590.75 0409-6482-11 ERYTHROMYCIN LACTOBIONATE 500 MG IV SOLR $590.75 0407-1413-63 IOHEXOL 300 MG IODINE/ML IV SOLN $590.20 HC51010262 INJ(S);SINGLE TENDON/SHEATH BI $590.00 57894-150-12 ABIRATERONE 250 MG ORAL TAB $589.71 HC62218029 BLADE OPHTHALM Z $589.00 43598-204-51 AMOXICILLIN-POT CLAVULANATE 250-62.5 MG/5 ML ORAL SUSR $588.90 0409-0182-01 GEMCITABINE 2 GRAM/52.6 ML (38 MG/ML) IV SOLN $588.75 67457-118-50 ASCORBIC ACID (VITAMIN C) 500 MG/ML INJ SOLN $588.25 HC62215397 BLADE SAW Z $588.00 HC62214325 CATH URETERAL Z $588.00 HC51002954 DILAT STRICTR URETHRL FLFRM MALE SUBSQ $588.00 HC42000380 INTERROGATE PACEMAKER SGL/DUAL/MULTI/LEADLESS $588.00 HC62216635 PIN/WIRE FIXATION TEMPORARY Z $588.00 HC32000770 OT-WOUND VAC 45MIN<50 SQ CM/M $587.00 HC31002017 PT - STRAPPING; ANKLE AND/OR FOOT $587.00 HC31000839 PT-WOUND VAC 45MIN<50 SQ CM/M $587.00 0409-6509-01 VANCOMYCIN 5 GRAM IV SOLR $586.69 HC36000727 ARTERIAL PUNCTURE $586.00 HC36800795 ARTERIAL PUNCTURE $586.00 HC84201334 M. 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HC44000446 CHOLANGIOGRAM INTRAOP ADDL SET S&I ONLY $546.00 HC62213699 FORCEP OPTHALMIC DISPOSABLE $546.00 HC62215678 SUTURE T $546.00 0054-0064-47 ONDANSETRON HCL 4 MG/5 ML ORAL SOLN $545.68 24208-631-10 NEOMYCIN-POLYMYXIN-HC 3.5-10,000-1 MG/ML-UNIT/ML-% OTIC SOLN $545.35 24208-635-62 NEOMYCIN-POLYMYXIN-HC 3.5-10,000-1 MG/ML-UNIT/ML-% OTIC DRPS $545.35 61314-645-11 NEOMYCIN-POLYMYXIN-HC 3.5-10,000-1 MG/ML-UNIT/ML-% OTIC DRPS $545.35 61314-646-10 NEOMYCIN-POLYMYXIN-HC 3.5-10,000-1 MG/ML-UNIT/ML-% OTIC SOLN $545.35 HC84201458 DNA/RNA CMV PCR(PNL) $545.00 HC51003804 EXCISE LESION 0.6-1CM TRNK/ARMS/LEGS $545.00 HC21001045 REMOV IMPACTD EAR WAX IRRIG/LAVG BI $545.00 HC62207592 TUBE CANTOR $545.00 HC44003002 FEMUR 1 VIEW LT $544.00 HC44003010 FEMUR 1 VIEW RT $544.00 HC39000005 PSYCH DX EVAL EXAM (NO MED SVCS) $544.00 HC11500733 WC ESTB E&M COMPREHENSIVE L:5 $544.00 HC11500675 WC NEW E&M ASSESS EXTENDED L:4 $544.00 HC83001065 BB PATH; INVEST TRANFUSION REACTION $543.00 HC62202015 COVER FOOT 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MMOL/ML) IV SOLN $539.50 50419-325-12 GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) IV SOLN $539.50 51715-100-03 BUPIVACAINE HCL 100 MG IMPL IMPL $539.50 51715-100-04 BUPIVACAINE HCL 100 MG IMPL IMPL $539.50 64281-100-00 METHACHOLINE CHLORIDE 100 MG INHALATION SOLR $539.50 64281-100-06 METHACHOLINE CHLORIDE 100 MG INHALATION SOLR $539.50 0168-0202-30 CLINDAMYCIN PHOSPHATE 1 % TOPICAL GEL $538.98 0409-6562-20 TESTOSTERONE CYPIONATE 200 MG/ML IM OIL $538.85 HC51001493 APPLY LONG LEG CAST/WALKER $538.00 HC81100356 THEOPHYLINE $538.00 HC62229182 ORTHOSIS LSO RIGID ANT/POST FRM/PNL PREFB CUST(DJ) $538.00 HC84200708 CULTURE ACID FAST $537.00 HC62221650 DILATOR SPINE $537.00 HC84201557 DNA/RNA ENTEROVIRUS PCR(PNL) $537.00 HC84201565 DNA/RNA HUMAN PARECHOVIRUS PCR(PNL) $537.00 HC51002343 INJ RETROGRADE URETHROCYSTO $537.00 HC62203724 KIT BONE PREP $537.00 HC62206446 MARKER SHADOWFORM/VISICOIL $537.00 HC32003337 OT-EVAL HIGH COMPLEXITY 45MF2F 30MIN $537.00 HC31002082 PT-EVAL HIGH COMPLEXITY 45MF2F 30MIN $537.00 HC81100976 METHOTREXATE $536.00 0002-7510-17 INSULIN LISPRO 100 UNIT/ML SUBCUTANEOUS SOLN $535.67 0069-0206-01 DALTEPARIN (PORCINE) 7,500 ANTI-XA UNIT/0.3 ML SUBCUTANEOUS SYRG $535.28 HC51010239 ASP/INJ LARGE JOINT-BILAT $535.00 HC62209226 DEVICE SUTURE CAPTURE (VAG) $535.00 HC62804661 STAPLE REINFORCEMENT(SEAMGUARD)     B $535.00 16714-137-01 PACLITAXEL 6 MG/ML IV CONC $534.95 16714-248-01 FOSAPREPITANT 150 MG IV SOLR $534.17 43598-948-11 FOSAPREPITANT 150 MG IV SOLR $534.17 67457-889-10 FOSAPREPITANT 150 MG IV SOLR $534.17 HC51000511 CHEMO ADMIN IVP SNGL/INIT'LINJ $534.00 42494-339-03 FLUCYTOSINE 250 MG ORAL CAP $533.45 HC81500373 FACTOR VIII RELATED AG $533.00 67457-925-00 DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN $533.00 67457-925-10 DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN $533.00 0069-5474-01 FOSPHENYTOIN 500 MG PE/10 ML INJ SOLN $532.55 0069-5474-02 FOSPHENYTOIN 500 MG PE/10 ML INJ SOLN $532.55 HC62215371 BLADE SAW X $532.00 HC62800818 CATH CVP/PICC GROSHONG $532.00 HC62214309 CATH URETERAL X $532.00 HC62202064 KIT DRAINAGE $532.00 HC62807797 M: PLUG PORT NEUROSTIMULATOR $532.00 HC62216619 PIN/WIRE FIXATION TEMPORARY X $532.00 HC83000133 RBC ANTIBODY ID EACH TECH $532.00 HC62223706 SENSOR CARDIAC OUTPUT $532.00 HC84200690 CULTURE CHLAMYDIA ANY SOURCE $530.00 HC24000028 HBO FIRST 15MIN BASIC/C $529.00 HC62204409 KNIFE COLD DISP $529.00 HC84201417 CULT DNA/RNA AMP PCR GRAM NEG ISO $528.00 HC84201425 CULT DNA/RNA AMP PCR GRAM POS ISO $528.00 HC84201441 CULT DNA/RNA AMP PCR RESISTANT GENE $528.00 HC84201433 CULT DNA/RNA AMP PCR YEAST ISO $528.00 HC81500498 FACTOR INHIBITOR TEST $528.00 55566-2200-0 DESMOPRESSIN 4 MCG/ML INJ SOLN $527.41 0574-0820-10 TESTOSTERONE CYPIONATE 200 MG/ML IM OIL $527.22 HC25001520 REMOV IMPACTD EAR WAX IRRIG/LAVG BI $527.00 11994-128-21 XENON-133 IN CARBON DIOXIDE 740 MBQ (20 MCI) INHALATION GAS $526.96 HC62202825 BAG/POUCH RETRIEVAL SPECMN ENDO G $526.00 HC51003127 BX VULVA $526.00 HC62213640 CANNULA TROCAR $526.00 HC62800222 CATH BALLOON RETRIEVAL F $526.00 HC62217930 CATH DIAGNOSTIC I $526.00 HC62209697 DEVICE CAPSULE ENDOSCP DELIVER $526.00 HC62225545 EXTENDER CATH DIALYSIS PERITONEAL $526.00 HC62212550 FORCEP BIOPSY DISP H $526.00 HC62211966 GUIDEWIRE BILIARY CURVED TIP H $526.00 HC24000036 HBO EA SUBSEQUNT 15MIN BASIC/C $526.00 HC62220413 KIT ARTHROSCOPY DISPSBLS J $526.00 HC62210430 KIT PUMP REFILL C $526.00 HC62204201 KIT REPAIR BROVIAC/CV/HICKMAN D $526.00 HC62215470 KNIFE BAYONET A $526.00 HC62204896 NEEDLE BONE MARROW H $526.00 HC62216346 NEEDLE INTRODUCER J $526.00 HC51070068 NEUROPSYCH STATUS EXAM/HR $526.00 HC32000796 OT-WOUND VAC 15MIN>50 SQ CM/M $526.00 HC62212113 PORT SINGLE-SITE ROBOTIC $526.00 HC31000854 PT-WOUND VAC 15MIN>50 SQ CM/M $526.00 HC62205893 PUNCH AORTIC O $526.00 HC62300173 TIP CAUTERY HOOK ROBOTIC L $526.00 HC62218656 TUBE LEAD INSERT ELECTRODE ARRAY W/STYLET $526.00 HC89023857 ANSER IFX MEASUOF ABS TO INFLIXIMAB-PR $525.00 HC89023873 ANSER VDZ MEAS OF ABS TO VEDOLIZUM-PR $525.00 HC42000364 INTERROGATE IMP' CVPHYS MONITOR 1 OR MORE DATA $525.00 HC51002061 REMOVE/INSERT DRUG DELIVERY IMPLANT $525.00 HC89024228 ANSER ADA MEAS SER ADALIMUMAB(ASDA)-PR $525.00 61314-204-15 PILOCARPINE HCL 2 % OPHT DROP $524.26 HC84200302 CULTURE FUNGUS BLOOD $524.00 HC84201581 DNA/RNA C NEOFORMANS/GATTII PCR(PNL) $524.00 HC84201508 DNA/RNA E COLI K1 PCR(PNL) $524.00 HC84201516 DNA/RNA INFLUENZAE H PCR(PNL) $524.00 HC84201524 DNA/RNA L MONOCYTOGENES PCR(PNL) $524.00 HC84201532 DNA/RNA N MENINGITIDIS PCR(PNL) $524.00 HC84201540 DNA/RNA S AGALACTIAE PCR(PNL) $524.00 HC84201573 DNA/RNA VARICELLA ZOSTER PCR(PNL) $524.00 HC81101206 PARATHYROID HORMONE $524.00 HC81101347 PARATHYROID HORMONE SUBSEQUENT $524.00 HC84201599 DNA/RNA STREP A AMP PROBE(XPERT XPRESS) $523.00 HC47200779 RAD ONC EST PT LOW MDM 20-29 MIN $523.00 43975-254-14 TEMOZOLOMIDE 100 MG ORAL CAP (MCH) $522.73 24492-850-56 TOBRAMYCIN WITH NEBULIZER 300 MG/5 ML INHALATION NEBU $522.31 70700-268-94 FOSFOMYCIN TROMETHAMINE 3 GRAM ORAL PACK $522.08 70700-268-99 FOSFOMYCIN TROMETHAMINE 3 GRAM ORAL PACK $522.08 HC62219175 CATH CAVITY MAMMOSITE EVAL $522.00 HC51002145 INJ FOR CYSTOGRAM $522.00 HC31000821 PT-WOUND VAC 30MIN<50 SQ CM/CM $522.00 HC33001090 ST EVAL BEHAVRAL QUAL VOICE 45MIN/M $522.00 0781-3440-71 COSYNTROPIN 0.25 MG INJ SOLR $521.30 0781-3440-95 COSYNTROPIN 0.25 MG INJ SOLR $521.30 HC81700379 CD4 AND CD8 COUNT WITH RATIO $521.00 HC51002285 MEATOTOMY (INFANT) $521.00 0054-3722-50 PREDNISONE 5 MG/5 ML ORAL SOLN $520.26 0378-8043-21 CLOBAZAM 2.5 MG/ML ORAL SUSP $520.26 HC51062743 APPLIC CAST LEG CLUBFOOT BILAT $520.00 HC51010205 ASP/INJ MED JOINT-BILAT $520.00 HC81701534 C TRACHOMATIS BY DNA AMP PROBE $520.00 HC89020341 CONNEXIN 26 (GJB2) SEQUENCING-AU $520.00 HC51063055 PAIRING BENIGN HYPERKERATOTIC LESIONS: >4 $520.00 0338-9557-12 DEXMEDETOMIDINE-NS 4 MCG/ML LOADING DOSE (SLH) $520.00 14789-012-02 SODIUM NITROPRUSSIDE 25 MG/ML IV SOLN $520.00 39822-0412-1 TOBRAMYCIN SULFATE 1.2 GRAM INJ SOLR $520.00 43066-557-12 DEXMEDETOMIDINE-NS 4 MCG/ML LOADING DOSE (SLH) $520.00 43598-975-11 DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN $520.00 43598-975-58 DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN $520.00 55150-282-20 ERTAPENEM 1 GRAM INJ SOLR $520.00 60505-6196-4 ERTAPENEM 1 GRAM INJ SOLR $520.00 0054-0062-58 CITALOPRAM 10 MG/5 ML ORAL SOLN $519.48 57237-274-24 LAMIVUDINE 10 MG/ML ORAL SOLN (MCH) $519.48 0023-7824-10 POLYMYXIN B SULF-TRIMETHOPRIM 10,000 UNIT- 1 MG/ML OPHT DROP $519.16 HC51000529 CHEMO ADMIN IVP SNGL/ADD'L INJ $519.00 HC42000422 PROGRAM/EVAL T-ICD PRE/POST PROC $519.00 HC44002178 TEETH/LESS THAN FULL MOUTH $519.00 HC62207097 SUTURE SPECIALTY S $518.00 HC89003958 CHROM ANALYSIS BONE MARROW-GC $517.00 63323-295-61 VANCOMYCIN 5 GRAM IV SOLR $516.75 HC82203795 IHC/IP PER SPEC EA ADD AB STAIN+ ACTH $516.00 HC82203415 IHC/IP PER SPEC EA ADD AB STAIN+ AFP $516.00 HC82204082 IHC/IP PER SPEC EA ADD AB STAIN+ ANTI-BCL-2 $516.00 HC82204090 IHC/IP PER SPEC EA ADD AB STAIN+ ANTI-CD3/HRP $516.00 HC82203514 IHC/IP PER SPEC EA ADD AB STAIN+ BCL-6 $516.00 HC82203811 IHC/IP PER SPEC EA ADD AB STAIN+ CALCITON $516.00 HC82204314 IHC/IP PER SPEC EA ADD AB STAIN+ CALRETININ $516.00 HC82203522 IHC/IP PER SPEC EA ADD AB STAIN+ CAM5-2 $516.00 HC82204363 IHC/IP PER SPEC EA ADD AB STAIN+ CD10 $516.00 HC82204389 IHC/IP PER SPEC EA ADD AB STAIN+ CD117 $516.00 HC82203571 IHC/IP PER SPEC EA ADD AB STAIN+ CD-138 $516.00 HC82203530 IHC/IP PER SPEC EA ADD AB STAIN+ CD-1A $516.00 HC82203548 IHC/IP PER SPEC EA ADD AB STAIN+ CD-21 $516.00 HC82203555 IHC/IP PER SPEC EA ADD AB STAIN+ CD-23 $516.00 HC82203563 IHC/IP PER SPEC EA ADD AB STAIN+ CD-31 $516.00 HC82204322 IHC/IP PER SPEC EA ADD AB STAIN+ CD4 $516.00 HC82204330 IHC/IP PER SPEC EA ADD AB STAIN+ CD5 $516.00 HC82204371 IHC/IP PER SPEC EA ADD AB STAIN+ CD56 $516.00 HC82204108 IHC/IP PER SPEC EA ADD AB STAIN+ CD-68 $516.00 HC82204348 IHC/IP PER SPEC EA ADD AB STAIN+ CD7 $516.00 HC82204454 IHC/IP PER SPEC EA ADD AB STAIN+ CD-79A $516.00 HC82204355 IHC/IP PER SPEC EA ADD AB STAIN+ CD8 $516.00 HC82203589 IHC/IP PER SPEC EA ADD AB STAIN+ CDX-28 $516.00 HC82203365 IHC/IP PER SPEC EA ADD AB STAIN+ CEA $516.00 HC82203597 IHC/IP PER SPEC EA ADD AB STAIN+ CEA MONOCLON $516.00 HC82203399 IHC/IP PER SPEC EA ADD AB STAIN+ CHROMOGRAN $516.00 HC82203613 IHC/IP PER SPEC EA ADD AB STAIN+ CK-19 $516.00 HC82203605 IHC/IP PER SPEC EA ADD AB STAIN+ CK-5/6 $516.00 HC82204397 IHC/IP PER SPEC EA ADD AB STAIN+ CMV $516.00 HC82204603 IHC/IP PER SPEC EA ADD AB STAIN+ C-MYC $516.00 HC82204116 IHC/IP PER SPEC EA ADD AB STAIN+ CYCLIN D1 $516.00 HC82203498 IHC/IP PER SPEC EA ADD AB STAIN+ CYTOCHM $516.00 HC82204124 IHC/IP PER SPEC EA ADD AB STAIN+ CYTOKERATIN-20 $516.00 HC82204132 IHC/IP PER SPEC EA ADD AB STAIN+ CYTOKERATIN-7 $516.00 HC82203837 IHC/IP PER SPEC EA ADD AB STAIN+ DESMIN $516.00 HC82203761 IHC/IP PER SPEC EA ADD AB STAIN+ DYSTROPH (C-TERM) $516.00 HC82203779 IHC/IP PER SPEC EA ADD AB STAIN+ DYSTROPH (N-TERM) $516.00 HC82203787 IHC/IP PER SPEC EA ADD AB STAIN+ DYSTROPH (ROD DOMAIN) $516.00 HC82203621 IHC/IP PER SPEC EA ADD AB STAIN+ E-CADHERIN $516.00 HC82204405 IHC/IP PER SPEC EA ADD AB STAIN+ EGFR $516.00 HC82203639 IHC/IP PER SPEC EA ADD AB STAIN+ EMA (MC5)(LIVER) $516.00 HC82203456 IHC/IP PER SPEC EA ADD AB STAIN+ EPI MEMBR $516.00 HC82203845 IHC/IP PER SPEC EA ADD AB STAIN+ ESTR RCPT $516.00 HC82204140 IHC/IP PER SPEC EA ADD AB STAIN+ EWINGS SARCOMA $516.00 HC82204157 IHC/IP PER SPEC EA ADD AB STAIN+ FACTOR 13-A $516.00 HC82203423 IHC/IP PER SPEC EA ADD AB STAIN+ FCTR 8 AG $516.00 HC82203852 IHC/IP PER SPEC EA ADD AB STAIN+ GASTRIN $516.00 HC82204587 IHC/IP PER SPEC EA ADD AB STAIN+ GATA-3 $516.00 HC82203431 IHC/IP PER SPEC EA ADD AB STAIN+ GFAP $516.00 HC82203860 IHC/IP PER SPEC EA ADD AB STAIN+ GLUCAGON $516.00 HC82204165 IHC/IP PER SPEC EA ADD AB STAIN+ GROWTH HORM $516.00 HC82204629 IHC/IP PER SPEC EA ADD AB STAIN+ H PYLORI $516.00 HC82203449 IHC/IP PER SPEC EA ADD AB STAIN+ HCG $516.00 HC82203647 IHC/IP PER SPEC EA ADD AB STAIN+ HEPPAR $516.00 HC82204298 IHC/IP PER SPEC EA ADD AB STAIN+ HER-2-NEU $516.00 HC82203878 IHC/IP PER SPEC EA ADD AB STAIN+ HERPES POLYV $516.00 HC82203357 IHC/IP PER SPEC EA ADD AB STAIN+ HMB-45 $516.00 HC82203829 IHC/IP PER SPEC EA ADD AB STAIN+ HPCA-1 $516.00 HC82204645 IHC/IP PER SPEC EA ADD AB STAIN+ HSV-1 $516.00 HC82204660 IHC/IP PER SPEC EA ADD AB STAIN+ HSV-2 $516.00 HC82203654 IHC/IP PER SPEC EA ADD AB STAIN+ IGD $516.00 HC82203662 IHC/IP PER SPEC EA ADD AB STAIN+ INHIBIN $516.00 HC82203670 IHC/IP PER SPEC EA ADD AB STAIN+ INI-1 $516.00 HC82203886 IHC/IP PER SPEC EA ADD AB STAIN+ INSULIN $516.00 HC82203894 IHC/IP PER SPEC EA ADD AB STAIN+ KAPPA $516.00 HC82203472 IHC/IP PER SPEC EA ADD AB STAIN+ KERATIN $516.00 HC82203688 IHC/IP PER SPEC EA ADD AB STAIN+ KERATIN (AE1/AE3) LN $516.00 HC82204173 IHC/IP PER SPEC EA ADD AB STAIN+ KERATIN 903 $516.00 HC82203696 IHC/IP PER SPEC EA ADD AB STAIN+ KERATIN HMWK $516.00 HC82203902 IHC/IP PER SPEC EA ADD AB STAIN+ KI-1 $516.00 HC82204199 IHC/IP PER SPEC EA ADD AB STAIN+ KI-67 $516.00 HC82203910 IHC/IP PER SPEC EA ADD AB STAIN+ KP-1 $516.00 HC82203928 IHC/IP PER SPEC EA ADD AB STAIN+ L26 AB $516.00 HC82203936 IHC/IP PER SPEC EA ADD AB STAIN+ LAMBDA $516.00 HC82203381 IHC/IP PER SPEC EA ADD AB STAIN+ LCA AP $516.00 HC82204207 IHC/IP PER SPEC EA ADD AB STAIN+ LEU M1 (CD15) $516.00 HC82203464 IHC/IP PER SPEC EA ADD AB STAIN+ LEU-22 $516.00 HC82203944 IHC/IP PER SPEC EA ADD AB STAIN+ LN 1 $516.00 HC82203951 IHC/IP PER SPEC EA ADD AB STAIN+ LN 2 $516.00 HC82204413 IHC/IP PER SPEC EA ADD AB STAIN+ MELAN-A $516.00 HC82203803 IHC/IP PER SPEC EA ADD AB STAIN+ MONOCLNL BREAST $516.00 HC82204686 IHC/IP PER SPEC EA ADD AB STAIN+ MSH-2 $516.00 HC82204694 IHC/IP PER SPEC EA ADD AB STAIN+ MSH-6 $516.00 HC82203969 IHC/IP PER SPEC EA ADD AB STAIN+ MT-1 $516.00 HC82204215 IHC/IP PER SPEC EA ADD AB STAIN+ MT-1 $516.00 HC82203704 IHC/IP PER SPEC EA ADD AB STAIN+ MUM-1 $516.00 HC82203977 IHC/IP PER SPEC EA ADD AB STAIN+ MUSCLE $516.00 HC82204223 IHC/IP PER SPEC EA ADD AB STAIN+ MYELOPEROXIDASE $516.00 HC82203712 IHC/IP PER SPEC EA ADD AB STAIN+ MYOGENIN $516.00 HC82203985 IHC/IP PER SPEC EA ADD AB STAIN+ MYOGLOBIN $516.00 HC82203993 IHC/IP PER SPEC EA ADD AB STAIN+ NEURFLMNT $516.00 HC82204009 IHC/IP PER SPEC EA ADD AB STAIN+ NSE $516.00 HC82204421 IHC/IP PER SPEC EA ADD AB STAIN+ P16 $516.00 HC82204231 IHC/IP PER SPEC EA ADD AB STAIN+ P-53 $516.00 HC82203720 IHC/IP PER SPEC EA ADD AB STAIN+ P63 $516.00 HC82204561 IHC/IP PER SPEC EA ADD AB STAIN+ PAX8 $516.00 HC82203738 IHC/IP PER SPEC EA ADD AB STAIN+ PGP 9.5 $516.00 HC82204249 IHC/IP PER SPEC EA ADD AB STAIN+ PLAP $516.00 HC82204702 IHC/IP PER SPEC EA ADD AB STAIN+ PMS2 $516.00 HC82204017 IHC/IP PER SPEC EA ADD AB STAIN+ PROGEST REC $516.00 HC82204256 IHC/IP PER SPEC EA ADD AB STAIN+ PROLACTIN $516.00 HC82204462 IHC/IP PER SPEC EA ADD AB STAIN+ PROS ACID PHOS $516.00 HC82203373 IHC/IP PER SPEC EA ADD AB STAIN+ PSA $516.00 HC82203340 IHC/IP PER SPEC EA ADD AB STAIN+ S100 $516.00 HC82204264 IHC/IP PER SPEC EA ADD AB STAIN+ SMMHC $516.00 HC82204025 IHC/IP PER SPEC EA ADD AB STAIN+ SMOOTH MUSC $516.00 HC82204033 IHC/IP PER SPEC EA ADD AB STAIN+ SOMATOSTN $516.00 HC82204546 IHC/IP PER SPEC EA ADD AB STAIN+ SOX10 $516.00 HC82203480 IHC/IP PER SPEC EA ADD AB STAIN+ SYNAPTOP $516.00 HC82204041 IHC/IP PER SPEC EA ADD AB STAIN+ T4 $516.00 HC82204272 IHC/IP PER SPEC EA ADD AB STAIN+ TERM DEOXZYTRANS $516.00 HC82203746 IHC/IP PER SPEC EA ADD AB STAIN+ TH $516.00 HC82204058 IHC/IP PER SPEC EA ADD AB STAIN+ THYROGLOBLN $516.00 HC82204439 IHC/IP PER SPEC EA ADD AB STAIN+ TTF-1 $516.00 HC82204306 IHC/IP PER SPEC EA ADD AB STAIN+ UBIQUITIN $516.00 HC82204066 IHC/IP PER SPEC EA ADD AB STAIN+ UCHL 1 $516.00 HC82204280 IHC/IP PER SPEC EA ADD AB STAIN+ UCHL-1 $516.00 HC82203407 IHC/IP PER SPEC EA ADD AB STAIN+ VIMENTIN $516.00 HC82203753 IHC/IP PER SPEC EA ADD AB STAIN+ WT-1 $516.00 17238-424-06 INDOCYANINE GREEN 25 MG INJ SOLR $514.59 17238-424-25 INDOCYANINE GREEN 25 MG INJ SOLR $514.59 HC51061661 ECHO 2D LMTD W/O SPEC&CLR /DOP $514.00 HC42000455 PROGRAM/EVAL PACEMKR DUAL LEAD $514.00 HC33000910 ST EVAL SPEECH FLUENCY 45MIN/M $514.00 HC33000290 ST-SPEECH THERAPY GRP 60MIN/MCW $514.00 HC62207113 SYRINGE KYPHOPLASTY INFLATION $514.00 HC62211982 TIP PROBE SUCTION LAPARASCOPIC $514.00 0143-9726-01 TESTOSTERONE CYPIONATE 200 MG/ML IM OIL $513.50 0409-1555-54 HETASTARCH IN LACT ELECTROLYTE 6 % IV SOLN $513.50 45802-046-11 GENTAMICIN 0.1 % TOPICAL OINT $513.44 61314-203-15 PILOCARPINE HCL 1 % OPHT DROP $512.56 63323-205-00 FATTY ACID6-FISH OIL-GLY-P-LIP 10 % IV EMUL $512.20 63323-205-31 FATTY ACID6-FISH OIL-GLY-P-LIP 10 % IV EMUL $512.20 HC62228705 IVS TUBING PUMP RAPID INFUSER $512.00 HC25005166 LARYNGOSCOPY W/REMOVE FB $512.00 HC11200095 OBSERVATION PER HOUR - PEDS DOU $512.00 16714-908-01 BLEOMYCIN 30 UNIT INJ SOLR $511.62 38779-0419-5 CAFFEINE (BULK) 100 % MISC POWD $511.55 HC81500670 FACTOR IX ASSAY $511.00 HC51002434 CHANGE CYSTOSTOMY TUBE; SIMPLE $509.00 17478-510-02 PHYSOSTIGMINE SALICYLATE 1 MG/ML INJ SOLN $508.86 67457-162-00 SODIUM TETRADECYL SULFATE 1 % (10 MG/ML) IV SOLN $507.82 67457-162-02 SODIUM TETRADECYL SULFATE 1 % (10 MG/ML) IV SOLN $507.82 67457-163-00 SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) IV SOLN $507.82 67457-163-02 SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) IV SOLN $507.82 16571-675-16 PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIX $507.29 54932-501-81 PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIX $507.29 HC84200146 CULTURE STOOL $507.00 HC62222658 SCALPEL HARMONIC ELECTRODE HOOK $507.00 HC42000588 WCH NEW PT LVL5-COMPREHEN $507.00 81284-411-00 DIHYDROERGOTAMINE 1 MG/ML INJ SOLN $507.00 81284-411-05 DIHYDROERGOTAMINE 1 MG/ML INJ SOLN $507.00 HC32000762 OT-WOUND VAC 30MIN<50 SQ CM/CM $506.00 HC29000346 PLETHYSMOGRAPHY $506.00 0069-4200-30 SILDENAFIL 25 MG ORAL TAB $505.82 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HYPERTENSION) 20 MG ORAL TAB $451.75 HC34000091 CONDITIONING PLAY AUDIO $451.00 HC25005133 CONTROL NASAL HEMORRHAGE,ANTERIOR,COMPLEX ANY TX $451.00 HC25005125 CONTROL NASAL HEMORRHAGE,ANTERIOR,SIMPLE ANY TX $451.00 0409-0302-01 TOPOTECAN 4 MG/4 ML (1 MG/ML) IV SOLN $450.32 68982-623-02 ALBUMIN, HUMAN 5 % 5 % IV SOLP $450.13 0093-8180-64 OSELTAMIVIR 6 MG/ML ORAL SUSR $450.06 HC51003622 ANOSCOPY DX (INCL COLLECTION) $450.00 HC83000489 PLATELETS LEUKO RED EA UNIT $450.00 HC39001078 PSYCH HYPNOTHERAPY $450.00 HC32010480 OT-EVAL HIGH COMPLEX PRELIM &6 MOS MCAL $450.00 HC51070852 OT-EVAL HIGH COMPLEX PRELIM &6 MOS MCAL $450.00 HC31010382 PT- TM CONF INTERDISPLNS 3MNM WPT PRES 60MIN $450.00 HC32010464 OT- TM CONF INTERDISPLNS 3MNM WPT PRES 60MIN $450.00 HC33010323 ST- TM CONF INTERDISPLNS 3MNM WPT PRES 60MIN $450.00 HC35000330 REC- TM CONF INTERDISPLNS 3MNM WPT PRES 60MIN $450.00 59651-026-01 AMOXICILLIN-POT CLAVULANATE 250-62.5 MG/5 ML ORAL SUSR $449.15 60432-065-00 AMOXICILLIN-POT CLAVULANATE 250-62.5 MG/5 ML ORAL SUSR $449.15 HC62217351 SCRAPER MEMBRANE OPHTH $449.00 HC62207204 TIP VITALVUE SUCTION/IRRIG $449.00 13517-107-16 PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIX $448.88 54838-523-40 FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLN $448.50 65649-311-12 CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSP $448.29 16714-403-01 CEFPODOXIME 100 MG/5 ML ORAL SUSR $448.18 65862-141-50 CEFPODOXIME 100 MG/5 ML ORAL SUSR $448.18 HC62200563 BLADE INDIANACTOME $448.00 HC62215348 BLADE SAW U $448.00 HC62214283 CATH URETERAL U $448.00 HC81100760 CPK - MB $448.00 HC62216585 PIN/WIRE FIXATION TEMPORARY U $448.00 HC62216825 POST ANCHOR SPINAL DISPOSABLE G $448.00 HC33000977 ST EVAL SOUND PRODUCTION 45MIN/M $448.00 HC62220793 TRAY DRAIN PNEUMOPERICARDIUM $448.00 HC34000422 EPSDT AUDIO INITIAL 2-5YRS $448.00 HC34000430 EPSDT AUDIO INITIAL 6-20YRS $448.00 HC39001383 PSY-ASSESS APHASIA W/REPORT PER HOUR $447.00 HC33000001 SP-ASSESS APHASIA/REPT EA HR/M $447.00 0054-0517-50 MORPHINE CONCENTRATE 20 MG/ML ORAL SOLN (MHS) $446.94 HC12200036 IV INF HYDRATION EA ADD'L HR $446.00 HC11500667 WC NEW E&M ASSESS INTRMED LVL3 $446.00 10702-036-45 SODIUM POLYSTYRENE SULFONATE ORAL POWD $445.60 99999-004-26 POSACONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSP $445.58 63459-541-04 FENTANYL CITRATE 100 MCG BUCCAL TBEF $445.46 63459-541-28 FENTANYL CITRATE 100 MCG BUCCAL TBEF $445.46 0085-4324-02 POSACONAZOLE 100 MG ORAL TBEC $445.45 0009-0016-12 HYDROCORTISONE SOD SUCC (PF) 500 MG/4 ML INJ SOLR $445.25 HC29000502 E&M PREVENTIVE NEW 18-39 Y/O $445.00 HC29000510 E&M PREVENTIVE NEW 40-64 Y/O $445.00 HC81100927 LIDOCAINE $445.00 HC77400240 MOD CS DIFF PHYS/QHP <5 YR INIT'L 15MIN $445.00 HC62206156 SET CARDIOPLEGIA $445.00 0143-9299-01 GANCICLOVIR SODIUM 500 MG IV SOLR $444.60 0143-9299-10 GANCICLOVIR SODIUM 500 MG IV SOLR $444.60 0641-0477-21 PHENOBARBITAL SODIUM 130 MG/ML INJ SOLN $444.59 0641-0477-25 PHENOBARBITAL SODIUM 130 MG/ML INJ SOLN $444.59 2435730030 POTASSIUM ALUM (BULK) MISC POWD $444.15 63323-424-10 FLUMAZENIL 0.1 MG/ML IV SOLN CODE NEO $444.15 HC25006040 EST PT LVL5-COMPREHENSIVE $444.00 HC44003093 EVAL MED PHYSICS DOSE RADIATION EXPOSE W/REPORT $444.00 HC25005984 NEW PT LVL4-DETAILED $444.00 HC51002483 X RAY FLUORO GUIDANCE $444.00 0281-0326-60 NITROGLYCERIN 2 % TRANSDERMAL OINT $443.04 HC28000073 CR EST PT EVAL LVL4-(25MIN) $443.00 HC89020366 EGFR GENE COM VARIANTS-AU $443.00 HC11500964 WM EXAM NEW PT EVAL HIGH L 4 $443.00 99999-044-38 LEVOCARNITINE 50 MG/ML IV SOLN $442.52 HC51062768 APPLY SPLINT SHORT LEG BILATERAL $442.00 HC51062792 COMPLEX CHRONIC CARE MGMT INITL 60MIN, PER MONTH $442.00 HC62225156 RESERVOIR CSF VENTRICULAR $442.00 HC62205968 RETRACTOR STAYS ELASTIC $442.00 HC81700171 TESTOSTERONE TOTAL $442.00 HC11500717 WC ESTB E&M INTERMEDIATE LVL3 $442.00 0641-6177-01 OCTREOTIDE ACETATE 200 MCG/ML INJ SOLN $442.00 0703-3333-01 OCTREOTIDE ACETATE 200 MCG/ML INJ SOLN $442.00 25021-454-05 OCTREOTIDE ACETATE 200 MCG/ML INJ SOLN $442.00 0591-3221-26 TESTOSTERONE ENANTHATE 200 MG/ML IM OIL $441.74 42494-416-25 PHENOBARBITAL SODIUM 130 MG/ML INJ SOLN $441.71 42494-416-01 PHENOBARBITAL SODIUM 130 MG/ML INJ SOLN $441.68 HC51002996 DESTROY LESION(S) PENILE SIMPLE/CHEM $441.00 HC25005463 REMOVE FB EXTRNL EYE; CONJUNCT SUPERF LT $441.00 HC25005471 REMOVE FB EXTRNL EYE; CONJUNCT SUPERF RT $441.00 HC12200283 SC INFUSION THERAPY; ADD'L SET UP NEW SITE $441.00 HC81100919 ETHOSUXIMIDE $440.00 HC22000087 OST EST PT EVAL LVL4-(25MIN) $440.00 69238-1747-8 PILOCARPINE HCL 4 % OPHT DROP $439.53 HC51003903 FNA ASP BX W/O GUIDE; EACH ADD'L LESION $439.00 HC51010312 INJ(S);TRIGGER POINT 3/>MUSCLS $439.00 HC25005075 STRAPPING; ANKLE AND/OR FOOT LT $439.00 HC25005083 STRAPPING; ANKLE AND/OR FOOT RT $439.00 01035-6101-10 WHITE PETROLATUM 41 % TOPICAL OINT $438.87 HC62208723 CATHETER IRRIGATION SINUPLASTY $438.00 HC81500464 INHIB PROTEIN C ACTIVITY $438.00 HC81101354 LIPID PANEL SUBSEQUENT $438.00 HC62215520 RETRIEVER STENT BILI SOEHENDRA $438.00 HC62219092 TUBE CALIBRATION GASTRIC BANDING $438.00 0037-4401-01 PENICILLAMINE 250 MG ORAL TAB $437.55 50419-325-22 GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) IV SYRG $437.14 50419-325-27 GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) IV SYRG $437.14 HC51001576 APPLY SPLINT LONG LEG $437.00 HC62201710 CEMENT INJECTOR $437.00 HC62201728 CEMENT VERTEBROPLASTY $437.00 HC84600535 CYTOLOGY CONC TECHNIQUE *OP $437.00 HC84600048 CYTOLOGY CONCENTRATE TECHNIQUE $437.00 HC62800560 DEVICE CLOSURE FASCIA $437.00 HC31001860 PT-AQUATIC THERAPY 30MIN/CW $437.00 HC35000025 REC- EVALUATION 30MIN $437.00 HC84600303 CYTO CONC TECHNIQUE DIST SRV $436.00 HC32000499 OT-SWALLOWING THERAPY 15 MIN $436.00 HC33000381 ST-SWALLOWING THERAPY 15 MIN $436.00 49702-228-13 DOLUTEGRAVIR 50 MG ORAL TAB $435.80 60505-0582-4 MOXIFLOXACIN 0.5 % OPHT DROP $435.10 HC34000083 VISUAL REINFORCE AUDIO (VRA) $435.00 59676-566-30 DARUNAVIR ETHANOLATE 800 MG ORAL TAB $434.84 HC62210398 GUIDE ROD H $434.00 HC81500217 LEUKEMIA CELLS, SPINAL FL $434.00 HC62204847 NEEDLE ASPIRATION H $434.00 HC62206628 SOLUTION BSS PLUS 500ML $434.00 HC62215645 SUTURE P $434.00 HC51061638 ECHO DOPPLER COLOR FLOW+ $433.00 HC51070571 NEUROPSYCH TESTING EVAL INTRG INTERP CLIN DES TX FEEDBACK; 1ST HOUR $433.00 HC51070555 PSYCH TESTING EVAL INTEGR INTERPRET CLIN DES TX; 1ST HOUR $433.00 HC51020402 SC INFUSION THERAPY EA ADDL HOUR $433.00 0270-0445-40 DIATRIZOATE MEG-DIATRIZOAT SOD 66-10 % ORAL SOLN $432.12 HC81500431 ANTITHROMBIN III $432.00 HC81101891 BASIC METABOLIC PAN/ION'D CA (POS) $432.00 HC51001303 CLOSED TX FINGER DISTAL FX,EA,NO M $432.00 49884-231-83 PRAZIQUANTEL 600 MG ORAL TAB $431.80 55513-148-01 EPOETIN ALFA 4,000 UNIT/ML INJ SOLN $431.08 55513-148-10 EPOETIN ALFA 4,000 UNIT/ML INJ SOLN $431.08 HC51002152 CYSTOGRAM SIMPLE $431.00 HC62210786 DEVICE ELECTROSURGICAL CUT-CAUTERY H $431.00 HC13500046 GENETIC CNSL RISK REDCTN 60MIN $431.00 HC84200161 MIC SENSITIVITY $431.00 HC42000430 PROGRAM EVAL CARDIAC RHYTHM MON SQ $431.00 HC31000185 PT-DEVEL 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51672-1259-2 CLOBETASOL 0.05 % TOPICAL OINT $427.05 HC81500340 FACTOR II PT SPECIFIC $427.00 HC32000911 OT-THER EXER 30MIN/CW $427.00 0054-0427-25 FLUCYTOSINE 250 MG ORAL CAP $426.76 0407-2223-16 IODIXANOL 320 MG IODINE/ML IV SOLN $426.40 HC51002244 INJECT URETEROGRAGH VIA URETEROS $426.00 HC83000109 X-MATCH I-SPIN TECH EA UNIT $426.00 70710-1359-1 LACOSAMIDE 200 MG/20 ML IV SOLN $425.88 70710-1359-6 LACOSAMIDE 200 MG/20 ML IV SOLN $425.88 70710-1886-1 LACOSAMIDE 200 MG/20 ML IV SOLN $425.88 70710-1886-6 LACOSAMIDE 200 MG/20 ML IV SOLN $425.88 16714-782-01 CLOBETASOL 0.05 % TOPICAL OINT $425.39 25021-791-20 LACOSAMIDE 200 MG/20 ML IV SOLN $425.36 0069-3034-20 DOXORUBICIN 2 MG/ML IV SOLN $425.10 HC11500873 WM EXAM EST' PT EVAL MOD/HI IV $424.00 HC51003366 BX(S)/SAMPL ENDOMETRIAL(SEP PROC) $423.00 HC62206107 SET ANGIO PUMP W/BAG $423.00 HC62208582 VASCULAR PUNCH $423.00 0143-9204-01 DOCETAXEL 20 MG/ML (1 ML) IV SOLN $422.50 0143-9384-01 FOSAPREPITANT 150 MG IV SOLR $422.50 0409-0830-01 AZTREONAM 2 GRAM INJ SOLR $422.50 0409-0830-11 AZTREONAM 2 GRAM INJ SOLR $422.50 25021-179-15 DAPTOMYCIN 350 MG IV SOLR $422.50 25021-179-16 DAPTOMYCIN 350 MG IV SOLR $422.50 31722-203-20 LACOSAMIDE 200 MG/20 ML IV SOLN $422.50 55390-123-01 RIFAMPIN 600 MG IV SOLR $422.50 0703-4248-01 CARBOPLATIN 10 MG/ML IV SOLN $422.37 HC51010353 ANAL' IMPLNTD PUMP W/PROG MD SKILL $422.00 HC51010734 DESENSITIZATION RAPID EA HR $422.00 HC89000871 ENCAINIDE-AU $422.00 HC32001521 OT-THER PROC GRP 90MIN/MC $422.00 HC83000182 X-MATCH AHG TECH EA UNIT $422.00 HC51001626 X-RAY SPINE CERVICAL; 4 OR 5VWS $422.00 49702-212-48 ZIDOVUDINE 10 MG/ML ORAL SYRP $421.20 HC62201363 CATH ERCP (PUSHING) C $421.00 HC51000479 DECLOT IVAD W/THROMBOLYTC(TECH/HOSP) $421.00 HC51000057 DECLOT IVAD W/THROMBOLYTIC $421.00 HC81500399 FACTOR VIII VW MULTI $421.00 HC51010296 INJ(S);SNGL TNDON ORIGN/INSER $421.00 HC81701658 VITAMIN D, 25-HYDROXY $421.00 99999-044-39 LORAZEPAM 100 MG/100 ML DRIP (OCM) $420.55 0270-1411-11 IOPAMIDOL 200 MG IODINE /ML (41 %) INTRATHECAL SOLN $420.03 HC62217591 AWL SPINAL SINGLE PATIENT USE C $420.00 HC62215330 BLADE SAW T $420.00 HC62200605 BLADE SHAVER F $420.00 HC62200613 BLADE TREPHINE F $420.00 HC62200894 BURR F $420.00 HC62200852 BURR MIDAS REX/ANSPACH F $420.00 HC62200886 BURR ORTHO F $420.00 HC62220777 CANNULA ARTHROSCOPIC H $420.00 HC62226162 CARTRIDGE MECHNCL WOUND NEG PRESSURE $420.00 HC62216015 CATH BALLOON DIL NON VASCULAR H $420.00 HC62800248 CATH BALLOON ULTRA THIN H $420.00 HC62224811 CATH BLOCKER BRONCH/TRACH $420.00 HC62222062 CATH CENTRAL VENOUS H $420.00 HC62222054 CATH DIAGNOSTIC H $420.00 HC62805890 CATH EP DX <20 ELECTRODES C $420.00 HC62224753 CATH EP DX <20 ELECTRODES RPRSD H $420.00 HC62219209 CATH EP QUAD RPRSD H $420.00 HC62806070 CATH HICKMAN/BROVIAC H $420.00 HC62226840 CATH INFUS/THROMBOLYSS(CRAGG-MCNAMARA)H $420.00 HC62227236 CATH IV MIDLINE H $420.00 HC62223722 CATH NEPHROSTOMY H $420.00 HC62800545 CATH OCCLUSION H $420.00 HC62806666 CATH PICC PEDS H 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$415.00 HC42000570 WCH NEW PT LVL4-DETAILED $415.00 HC81701468 NK CELL TOTAL COUNT $414.00 HC31001548 PT-INDIV PROC W/COMPUT EQUIP/W $414.00 HC62206941 SUCTION TRAP MICRODEBRIDER $414.00 HC62210463 SUTURE ACCESSORY $414.00 0713-0640-15 HALOBETASOL PROPIONATE 0.05 % TOPICAL CREAM $413.89 49502-900-01 SELEGILINE 6 MG/24 HR TRANSDERMAL PT24 $413.66 63323-122-50 METHOTREXATE SODIUM (PF) 1 GRAM INJ SOLR $413.40 58160-821-01 HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML IM SUSP $413.10 58160-821-11 HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML IM SUSP $413.10 58160-821-43 HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML IM SYRG $413.10 58160-821-52 HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML IM SYRG $413.10 HC84201151 INFLUENZA H1N1 BY PCR $413.00 HC32001182 OT-ELEC STIM/TENS/MCW $413.00 HC51060721 OT-EVAL HIGH COMPLEXITY 45MF2F 60MIN $413.00 HC31001266 PT-ELEC STIM/TENS/MCW $413.00 HC51060705 PT-EVAL HIGH COMPLEXITY 45MF2F 60MIN $413.00 HC33000498 STP-ELEC STIM/TENS/MCW $413.00 HC42000448 PROGRAM EVAL PACEMAKER 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PHYS/QHP <5 YR INIT'L 15MIN $409.00 HC62228861 DEVICE SUTURE CAPTURE (VALVE) $408.00 HC51001709 X-RAY ELBOW 2 VW $408.00 HC51010304 INJ(S);TRIGGER POINT 1-2MUSCLS $407.00 HC51002525 US GUIDANCE PLACEMENT S&I NEEDLE /BX $407.00 99999-035-38 VORINOSTAT 50 MG/ML ORAL LIQUID (COMPOUND) $406.51 HC51001550 APPLY SPLINT LONG ARM $406.00 HC65800021 CESIUM-131 NONSTRND PER SOURCE $406.00 HC62228903 COLLAR CERV SEMI-RIDG OCC/MAND $406.00 HC51003143 COLPOSCOPY VULVA $406.00 HC62207048 SUTURE LAURUS O $406.00 HC62209572 TRACTION CERVICAL UNIT $406.00 HC51061794 X-RAY SPINE THORACIC; MIN 4 VIEWS $406.00 5865731216 POTASSIUM CITRATE-CITRIC ACID 1,100-334 MG/5 ML ORAL SOLN $405.83 6025800316 POTASSIUM CITRATE-CITRIC ACID 1,100-334 MG/5 ML ORAL SOLN $405.83 57664-683-31 LINEZOLID IN DEXTROSE 5% 600 MG/300 ML IV PGBK $405.60 67684-100-04 IOXILAN (OXILAN) 300 MG/ML $405.60 67684-100-14 IOXILAN (OXILAN) 350 MG/ML $405.60 68462-530-35 CLOBETASOL 0.05 % TOPICAL OINT $405.21 HC81100968 CAFFEINE $405.00 HC89019731 HU AUTOANTIBODY TEST-AT $405.00 HC11200043 OBSERVATION PER HOUR - TELEMETRY $405.00 HC32000937 OT-NEUROMUSC RE-ED 30MIN/CW $405.00 HC62214598 PROBE CATH V-PACING TRANSLUM $405.00 51672-1258-1 CLOBETASOL 0.05 % TOPICAL CREAM $404.72 27437-050-57 METHYLERGONOVINE 0.2 MG ORAL TAB $404.63 50419-325-01 GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) IV SOLN $404.63 50419-325-11 GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) IV SOLN $404.63 27437-050-56 METHYLERGONOVINE 0.2 MG ORAL TAB $404.39 63323-104-25 ETOPOSIDE 20 MG/ML IV SOLN $404.30 HC34000158 HEARING AID EXAM MONAURAL $404.00 HC62210976 COIL FLOW MID-CAB SHUNTS $403.00 HC12200101 IVAD IRRIGATION $403.00 HC62203781 KIT CHOLANGIOGRAM $403.00 HC62228184 ORTH HFO FLEX GLOVE W/ELSTC FNGR CNTRL PREFAB OTS $403.00 99988-000-39 SODIUM FLUORIDE F-18 10-200 MCI/ML 370-7,400MBQ/ML IV SOLN $402.50 99999-041-46 FLUDEOXYGLUCOSE F-18 20 MCI TO 200 MCI/ML IV SOLN $402.50 0378-0873-16 CLONIDINE 0.3 MG/24 HR TRANSDERMAL PTWK $402.29 0378-0873-99 CLONIDINE 0.3 MG/24 HR TRANSDERMAL PTWK $402.29 0591-3510-04 CLONIDINE 0.3 MG/24 HR TRANSDERMAL PTWK $402.29 0591-3510-54 CLONIDINE 0.3 MG/24 HR TRANSDERMAL PTWK $402.29 HC81500241 FACTOR 8 INHIB/TITR $402.00 HC42000489 RHYTHM STRIP 1-3 LEADS $402.00 HC62206412 SET TUBING VGFI $402.00 HC84200716 CULTURE MYCOBACTERIAL ID $401.00 HC62212576 NEEDLE BIOPSY EBUS $401.00 HC82200924 TISSUE EX G&M LVL 2 DIST SVC $401.00 HC82200387 TISSUE EXAM G&M LEVEL 2 $401.00 HC82202557 TISSUE EXAM G&M LEVEL 2 *OP $401.00 HC82202730 TISSUE EXAM G&M LVL 2(TC ONLY) $401.00 HC82200643 TISSUE EXAM LEVEL 2 ADD'L $401.00 HC81100091 ACETAMINOPHEN/TYLENOL; 1-2 $400.00 HC62200936 CABLE INTRAUTERINE PRESSURE $400.00 HC62203013 ENDOCURIE RIBBON LONG $400.00 HC32001539 OT-THER PROC GRP 120MIN/MC $400.00 HC81701500 PROTEIN ELECT OTHER FLUIDS $400.00 HC62206065 SENSOR IN-LINE $400.00 HC51070845 PT-EVAL HIGH COMPLEX PRELIM &6 MOS MCAL $400.00 HC31090178 PT-EVAL HIGH COMPLEX PRELIM &6 MOS MCAL $400.00 HC29000726 CA SCREEN-EXAM PELVIC/BREAST INIT 40-64 YRS $400.00 61958-0701-1 EMTRICITABINE-TENOFOVIR (TDF) 200-300 MG ORAL TAB $399.16 HC38000121 APPLY SPLINT FINGER STATIC $399.00 HC83500421 CHROMO AMNIOTIC FLD CT 17-GZ $399.00 HC51060770 OT-DEVEL TEST ADMIN ASSESS COG INSTR; 1ST HR $399.00 HC51070662 PSY-DEVEL TEST ADMIN ASSESS COG INSTR; 1ST HR $399.00 HC51060796 PT-DEVEL TEST ADMIN ASSESS COG INSTR; 1ST HR $399.00 HC31001498 PT-THER PROC GRP 60MIN/MC $399.00 67457-198-00 REMIFENTANIL 1 MG IV SOLR $398.39 67457-198-03 REMIFENTANIL 1 MG IV SOLR $398.39 67457-912-00 REMIFENTANIL 1 MG IV SOLR $398.39 67457-912-01 REMIFENTANIL 1 MG IV SOLR $398.39 0143-9391-01 REMIFENTANIL 1 MG IV SOLR $398.13 0143-9391-10 REMIFENTANIL 1 MG IV SOLR $398.13 HC51001634 X-RAY SPINE LUMBOSACRAL; 2 OR 3VWS $398.00 59762-4537-1 MEDROXYPROGESTERONE 150 MG/ML IM SUSP $397.54 HC82202276 CONSULT DURING SURG DIST SVC $397.00 HC82200361 CONSULT DURING SURGERY $397.00 HC82200692 CONSULT PATH SURGICAL GROSS $397.00 HC83000323 FREEZING BLOOD EA UNIT $397.00 HC81101412 HAPTOGLOBIN/NEPHELOMTRY $397.00 HC22000079 OST EST PT EVAL LVL 3-(15MIN) $397.00 HC62217377 STOPCOCK LUER LOCK ENDOSCOPE $397.00 99988-001-25 NM TC-99M (DTPA) PENTETATE 26-40 MCI (AEROSOL) $396.90 99988-000-25 NM TC-99M (DTPA) PENTETATE UP TO 25 MCI (RENAL) $396.90 65649-411-24 HYDROCORTISONE ACETATE 25 MG RECTAL SUPP $396.79 60432-150-16 HYDROXYZINE HCL 10 MG/5 ML ORAL SOLN $396.61 99999-046-51 TACROLIMUS 1 MG/ML ORAL SUSP (COMPOUND) $396.44 HC51061521 CLOSED TREATMENT TIBIAL FRACTURE PROXIMAL W/O MANIP $395.00 HC31001431 PT-TEST/MEASUREMENT 1ST30MIN/C $395.00 HC81700205 TSH $395.00 0270-1111-16 GADOTERIDOL 279.3 MG/ML IV SYRG $394.94 0013-2650-01 SOMATROPIN 0.4 MG/0.25 ML SUBCUTANEOUS SYRG $394.70 0013-2650-02 SOMATROPIN 0.4 MG/0.25 ML SUBCUTANEOUS SYRG $394.70 HC51061547 CLOSED TREATMENT ULNAR SHAFT FRACTURE W/O MANIP $394.00 HC51001295 CLOSED TX FINGER SHAFT FX,EA,NO MAN $394.00 HC82200726 INTRAOP CNSLT CYT PRP-DIST ADL $394.00 HC82200742 INTRAOP CNSLT CYTOPREP, ADL $394.00 HC11500501 LACTATION E&M COMPRHNS EST'D L:V $394.00 HC11500840 PEDS ESTAB PT ASSESS EXT(25') $394.00 99999-006-94 PENTOBARBITAL SODIUM 50 MG/ML INJ SOLN $393.34 6954323460 ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROP $393.12 HC51000222 IV INFUSION THERAPY 1ST HOUR $393.00 HC32001026 OT-ORTHOTIC FIT/TRNG 30MIN/CW $393.00 HC32001380 OT-TRTMNT(ANY) INIT'L 30MIN $393.00 HC31000086 PT-AQUATIC GRP 60MIN/M $393.00 HC62200589 BLADE NEURO H $392.00 HC62215322 BLADE SAW S $392.00 HC62214267 CATH URETERAL S $392.00 HC62203039 ET BAG COLOSTOMY $392.00 HC32001067 OT-FUNC ACTIVITY 30MIN/CW $392.00 HC32001232 OT-GAIT TRAINING 30MIN/CW $392.00 HC62216569 PIN/WIRE FIXATION TEMPORARY S $392.00 HC31000920 PT-ELEC STIM/TENS ATTD30MIN/CW $392.00 HC31001159 PT-FUNC ACTIVITY 30MIN/CW $392.00 0527-1859-43 SUMATRIPTAN 20 MG/ACTUATION NASL SPRY $391.97 0049-3190-01 VORICONAZOLE 200 MG IV SOLR $391.95 99999-033-77 ALTEPLASE IN BSS (250 MCG/ML) OPHTHALMIC INJECTION $391.73 HC81701450 B CELL TOTAL COUNT $391.00 HC81500555 HEPARIN ASSAY $391.00 HC11200041 OBSERVATION PER HOUR - OB $391.00 HC51001659 X-RAY SPINE LUMBOSCARAL; BEND ONLY 2 OR 3VWS $391.00 50474-002-63 LEVETIRACETAM 500 MG/5 ML IV SOLN $390.94 0270-1316-04 IOPAMIDOL 370 MG IODINE /ML (76 %) IV SOLN $390.81 HC88600002 ARTERIAL PUNCTURE $390.00 HC51062636 FITTING DIAPHRAGM/CERVICAL CAP W/INSTRUCT $390.00 HC65800112 PALLADIUM-103 STRANDED PER SOURCE $390.00 HC34000224 TYMPANOMETRY & REFLEX THRESH $390.00 0143-9729-01 BENZTROPINE 1 MG/ML INJ SOLN $390.00 0143-9729-05 BENZTROPINE 1 MG/ML INJ SOLN $390.00 0781-3317-80 OXALIPLATIN 100 MG/20 ML IV SOLN $390.00 25021-185-10 GANCICLOVIR SODIUM 50 MG/ML IV SOLN $390.00 25021-185-11 GANCICLOVIR SODIUM 50 MG/ML IV SOLN $390.00 25021-305-20 CHLOROTHIAZIDE SODIUM 500 MG IV SOLR $390.00 49884-768-52 TOLVAPTAN 15 MG ORAL TAB $390.00 49884-768-54 TOLVAPTAN 15 MG ORAL TAB $390.00 60432-126-16 MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSP $390.00 65219-190-30 VORICONAZOLE 200 MG IV SOLR $390.00 68462-746-35 ACYCLOVIR 5 % TOPICAL OINT $390.00 71225-126-03 DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN $390.00 71225-126-06 DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN $390.00 71225-133-01 DEXMEDETOMIDINE-NS 4 MCG/ML LOADING DOSE (SLH) $390.00 99999-001-98 CHARGE-NEONATAL LVIV <4 ADDS $390.00 99999-034-84 CH - PHARMACY COMP. 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IM SOLR $372.76 0049-3920-83 ZIPRASIDONE MESYLATE 20 MG/ML (FINAL CONC.) 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ANTIBODY-AT $340.00 HC62206594 SNARE DLP TOURNIKWIK $340.00 HC62200795 BRUSH BRONCHIAL $339.00 HC62209382 BRUSH CYTOLOGY BRONCHIAL G $339.00 HC62808621 CATH/TUBE BRACHY CLICK FIT $339.00 HC62808613 NEEDLE BRACHYTHERAPY METAL CLICK $339.00 HC81700163 PROTEIN ELECT FRACT AND QT $339.00 HC89014526 HLA DR MULT AG-U9 $338.00 HC45201407 NM RADIOPHARM QUANTIFICATION MSRMNT SINGLE AREA+ $338.00 HC32010118 OT-EVAL SWALLOW CINE/FLUORO [15MIN] $338.00 HC33010034 ST-EVAL SWALLOW CINE/FLUORO [15MIN] $338.00 HC51062941 TRANSCUT AURICULAR NEUROSTIM SETUP PT EDUC EQUIP $338.00 HC51063188 EVAL/MANAG DIABETIC PT SENSORY NEUROPATHY FLLWUP $338.00 0019-1323-06 IOVERSOL 320 MG IODINE/ML IV SOLN $338.00 0121-0759-08 PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLN $337.37 HC77400117 ANESTHESIA MAC EACH ADD 15 MIN $337.00 HC51001477 APPLY CAST SHORT ARM $337.00 HC84200831 CHLAMYDIA FA ANTIGEN $337.00 HC62202759 ELECTRODE TUR LOOP $337.00 HC62203831 KIT DIALYSIS $337.00 HC77400026 MOD CS BY MD ADD'L 15 MIN $337.00 HC62206339 SET NEEDLE INTRAOSEOUS $337.00 HC89024038 MPL MUT ANALYSIS-AU $337.00 59651-026-75 AMOXICILLIN-POT CLAVULANATE 250-62.5 MG/5 ML ORAL SUSR $336.38 60432-065-75 AMOXICILLIN-POT CLAVULANATE 250-62.5 MG/5 ML ORAL SUSR $336.38 HC51001568 APPLY SPLINT SHORT ARM $336.00 HC62200597 BLADE OPHTHALM Q $336.00 HC62215306 BLADE SAW Q $336.00 HC62214242 CATH URETERAL Q $336.00 HC11500493 LACTATION E&M EXT'D EST'D L:IV $336.00 HC32000952 OT-MASSAGE 30MIN/CW $336.00 HC32000895 OT-ULTRASOUND 30MIN/CW $336.00 HC62216544 PIN/WIRE FIXATION TEMPORARY Q $336.00 HC31001068 PT-MANUAL THERAPY 30 MIN/CW $336.00 HC31001043 PT-MASSAGE 30MIN/CW $336.00 HC62215751 TEMPLATE ORTHO/ROD SPINAL H $336.00 HC62207287 TRAY BONE MARROW Q $336.00 HC62207865 TUBING IRRIGATION H $336.00 HC81100562 CREATININE CLEARANCE $335.00 HC62202528 DRESSING OXYCEL $335.00 HC81101180 HOMOCYSTINE $335.00 HC14500060 PREGNANCY DIAB MGT 1HR $335.00 68001-525-32 FLUOROURACIL 5 GRAM/100 ML IV SOLN $334.10 70700-189-22 FLUOROURACIL 5 GRAM/100 ML IV SOLN $334.10 HC51010247 ASP/INJ LARGE JOINT-LT $334.00 HC51010254 ASP/INJ LARGE JOINT-RT $334.00 HC81100711 QUINIDINE $334.00 HC35000223 REC' THER' TX 1-30 MIN $334.00 17478-215-05 ATROPINE 1 % OPHT DROP $333.58 HC62229034 GEL VISCOUS SOL PRE-FILLED SYSTEM (ORISE) $333.00 HC38420048 LVAD/RVAD SERVICE/HR $333.00 HC62219472 NEEDLE ACCESS FISTULA DIALYSIS $333.00 HC81500837 PLATELET AGG PLAVIX RESISTANCE $333.00 HC62200209 ARTERIAL LINE $332.00 HC89003545 ARYLSULFATASE A URINE-AU $332.00 HC51000578 CHANGE GT TUBE W/O IMAGE/ENDO $332.00 HC51060192 OT-EVAL MOD COMPLEXITY 30MF2F 45MIN $332.00 HC51061190 ST-LARYNGEAL FUNCTION STUDIES $332.00 16714-643-01 MOXIFLOXACIN 0.5 % OPHT DROP $331.70 0054-0391-68 METHADONE 10 MG/ML ORAL CONC $331.50 25021-460-01 DESMOPRESSIN 4 MCG/ML INJ SOLN $331.50 99999-044-48 NICARDIPINE IN NS 50 MG/250 ML (0.2 MG/ML) IV SOLN (MHS) $331.50 61314-245-01 BETAXOLOL 0.5 % OPHT DROP $331.37 HC62202189 DEVICE BLADDER MONITOR $331.00 HC51070456 PSYCH NARCOSYNTHESIS $331.00 HC31001134 PT-PROSTHETIC TRNG 30MIN/CW $331.00 HC33000548 ST-SPEECH THERAPY 15 MIN/MW $331.00 0049-0530-28 PENICILLIN G POTASSIUM 20 MILLION UNIT INJ SOLR $330.72 0054-3177-57 DEXAMETHASONE 0.5 MG/5 ML ORAL SOLN $330.72 0270-1316-35 IOPAMIDOL 370 MG IODINE /ML (76 %) IV SOLN $330.20 0409-0186-01 GEMCITABINE 1 GRAM IV SOLR $330.07 HC81700288 COMPLEMENT TOT HEMOLYTIC CH50 $330.00 HC83000422 INJECTION IM (RHOGAM) $330.00 HC62205117 PACK ACL $330.00 HC62209630 SLING PELVIC CANVAS $330.00 0065-0303-55 ATROPINE 1 % OPHT DROP $329.94 0065-0817-01 ATROPINE 1 % OPHT DROP $329.94 24208-295-25 TOBRAMYCIN-DEXAMETHASONE 0.3-0.1 % OPHT DRPS $328.71 0407-1414-08 IOHEXOL 350 MG IODINE/ML IV SOLN $328.25 0407-1414-89 IOHEXOL 350 MG IODINE/ML IV SOLN $328.25 HC84600220 CYTP DX EVAL FNA EA ADDL SAME SITE $328.00 HC81500514 D-DIMER ULTRA SENSITIVE $328.00 HC65800104 IODINE-125 STRANDED PER SOURCE $328.00 61703-332-18 BLEOMYCIN 15 UNIT INJ SOLN (MCH) $327.99 99999-046-02 IOHEXOL 350 MG IODINE/ML IV SOLN $327.93 45802-966-94 ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL GEL $327.60 HC51060002 AHCP COORDINATE ACTIVITIES CASE $327.00 HC51001436 CLOSED TX BIG TOE FX $327.00 HC81100455 LACTIC ACID $327.00 HC81101776 LACTIC ACID (POS) $327.00 HC51020253 NP COORDINATOR ACTIVITIES CASE $327.00 HC51040038 RD COORDINATOR ACTIVITIES CASE $327.00 HC51001998 REMOVE DRUG DELIVERY IMPLANT $327.00 HC51020063 RN COORDINATOR ACTIVITIES CASE $327.00 HC51030039 SW COORDINATOR ACTIVITIES CASE $327.00 68382-446-14 BOSENTAN 62.5 MG ORAL TAB $326.26 0121-0721-04 FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLN $326.04 49281-400-10 DIPH,PERTUSS(ACEL),TET VAC(PF) 2 LF-(2.5-5-3-5 MCG)-5LF/0.5 ML IM SUSP $326.04 49281-400-58 DIPH,PERTUSS(ACEL),TET VAC(PF) 2 LF-(2.5-5-3-5 MCG)-5LF/0.5 ML IM SUSP $326.04 55150-386-01 CARBOPLATIN 10 MG/ML IV SOLN $326.04 HC62202437 DRESSING BIOBRANE $326.00 HC51003820 I&D ABSCESS SIMPLE SNGL $326.00 HC62228226 ORTH HFO METACARPAL FRACTURE PREFAB CUSTOM $326.00 HC62228234 ORTH HO METACARPAL FRACTURE PREFAB OTS $326.00 HC62228937 ORTHOSIS BELOW KNEE ADDON S0FT $326.00 HC81700239 T3 FREE $326.00 99996-000-25 TRACE ELEMENTS CR-CU-MN-ZN-SE-0.36-35.6-1.8-714-3.6 MCG/ML IVN $325.07 HC62211800 CIRCUIT VENT O2 HIGH FLOW THERAPY $325.00 HC81100216 GLUCOSE TOLERANCE 3 SPECIMENS $325.00 HC89020317 HLA-A GENOTYPE-AU $325.00 HC32001752 OT-ASSISTV TECH ASSESS' 30MN/C $325.00 HC32001414 OT- TM CONF INTERDISPLNS 3MNM WPT PRES 30MIN $325.00 HC32000671 OT-WHIRLPOOL-EXTREMITY/CMW $325.00 HC31000730 PT-APPLY WHIRLPOOL MODALITY $325.00 HC31000748 PT-APPLY WHIRLPOOL MODALITY $325.00 HC31001191 PT- TM CONF INTERDISPLNS 3MNM WPT PRES 30MIN $325.00 HC35000215 REC- TM CONF INTERDISPLNS 3MNM WPT PRES 30MIN $325.00 HC33000829 ST- TM CONF INTERDISPLNS 3MNM WPT PRES 30MIN $325.00 HC47201223 RAD ONC NEW PT SF MDM 15-29 MIN $325.00 HC31010317 PT- TM CONF INTERDISCPLN F2F PT/FAM WQHCP 45MIN $325.00 HC32010399 OT- TM CONF INTERDISCPLN F2F PT/FAM WQHCP 45MIN $325.00 HC33010257 ST- TM CONF INTERDISCPLN F2F PT/FAM WQHCP 45MIN $325.00 HC35000264 REC- TM CONF INTERDISCPLN F2F PT/FAM WQHCP 45MIN $325.00 HC31010333 PT- TM CONF INTERDISCPLN NO PT/FAM, WMD 45MIN $325.00 HC32010415 OT- TM CONF INTERDISCPLN NO PT/FAM, WMD 45MIN $325.00 HC33010273 ST- TM CONF INTERDISCPLN NO PT/FAM, WMD 45MIN $325.00 HC29000734 CA SCREEN-EXAM PELVIC/BREAST ESTAB 12-17 YRS $325.00 0338-0357-02 MANNITOL 20 % 20 % IV SOLP $325.00 0409-1174-01 DEXMEDETOMIDINE-NS 4 MCG/ML LOADING DOSE (SLH) $325.00 0409-1174-10 DEXMEDETOMIDINE-NS 4 MCG/ML LOADING DOSE (SLH) $325.00 0409-1660-10 DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN $325.00 0409-1660-35 DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN $325.00 0548-9701-00 VASOPRESSIN 20 UNIT/ML IV SOLN $325.00 0703-3985-01 OXALIPLATIN 5 MG/ML IV SOLN (MCH) $325.00 0781-3312-75 PALONOSETRON 0.25 MG/5 ML IV SOLN $325.00 16729-332-05 OXALIPLATIN 100 MG/20 ML IV SOLN $325.00 25021-233-20 OXALIPLATIN 100 MG/20 ML IV SOLN $325.00 25208-003-05 SODIUM NITROPRUSSIDE 25 MG/ML IV SOLN $325.00 42571-147-26 DORZOLAMIDE-TIMOLOL 22.3-6.8 MG/ML OPHT DROP $325.00 43598-611-11 DOCETAXEL 20 MG/ML (1 ML) IV SOLN $325.00 52536-625-10 TESTOSTERONE CYPIONATE 200 MG/ML IM OIL $325.00 55111-694-07 PALONOSETRON 0.25 MG/5 ML IV SOLN $325.00 63323-673-21 PALONOSETRON 0.25 MG/5 ML IV SYRG $325.00 63323-673-89 PALONOSETRON 0.25 MG/5 ML IV SYRG $325.00 99999-036-33 CHARGE - COLD INDUCTION CARDIOPLEGIA SOLN $325.00 99999-036-34 CHARGE - MAINTENANCE CARDIOPLEGIA SOLN $325.00 24208-486-10 DORZOLAMIDE-TIMOLOL 22.3-6.8 MG/ML OPHT DROP $324.94 25021-157-99 VANCOMYCIN 5 GRAM IV SOLR $324.94 HC83590406 EGFR GENE COM VARIANTS-AP $324.58 0168-0089-15 NYSTATIN-TRIAMCINOLONE 100,000-0.1 UNIT/GRAM-% TOPICAL OINT $324.38 51672-1272-1 NYSTATIN-TRIAMCINOLONE 100,000-0.1 UNIT/GRAM-% TOPICAL OINT $324.38 16714-930-01 GEMCITABINE 1 GRAM IV SOLR $324.29 HC51040145 3D RENDER W/ INDEPNDNT WORKSTN $324.00 HC84200666 CULTURE FUNGUS HAIR/SKIN/NAIL $324.00 HC84201789 DNA/RNA LEGIONELLA PNEUMOPHILA (PNL) $324.00 HC51061729 ECHO FETAL DOPPLER F/U OR REPEAT $324.00 HC81101867 LIPID PANEL (DA) $324.00 HC51070373 PSYCH TX W/PATIENT 45MIN $324.00 HC34000000 PURE TONE AUDIO AIR ONLY $324.00 HC51070837 TEST EXERC BRONCHOSPSM INCL SPIR & POX W/O ECG $324.00 55513-267-01 EPOETIN ALFA 3,000 UNIT/ML INJ SOLN $323.31 55513-267-10 EPOETIN ALFA 3,000 UNIT/ML INJ SOLN $323.31 HC81700577 FERRITIN $323.00 HC39000617 PSYCH CASE CONF 60MIN $323.00 HC83000224 SPLITTING BLD/BLD PROD EA UNIT $323.00 63323-377-00 OCTREOTIDE ACETATE 500 MCG/ML INJ SOLN $322.99 63323-377-01 OCTREOTIDE ACETATE 500 MCG/ML INJ SOLN $322.99 25021-235-50 GEMCITABINE 1 GRAM IV SOLR $322.73 64980-511-10 CLINDAMYCIN PALMITATE HCL 75 MG/5 ML ORAL SOLR $322.40 65649-303-02 RIFAXIMIN 550 MG ORAL TAB $322.33 65649-303-03 RIFAXIMIN 550 MG ORAL TAB $322.33 HC51001543 APPLIC CAST LEG CLUBFOOT $322.00 HC81701880 CA 15-3 $322.00 HC81700312 CA 27-29 $322.00 HC62201371 CATH ESOPHAGEAL PH $322.00 HC81500589 OSMOTIC FRAG INCUBATED $322.00 HC51070365 PSY TX W/PATIENT 30MIN W/E&M+ $322.00 HC62215611 SUTURE L $322.00 HC62207386 TRAY INCISION & DRAINAGE DISP $322.00 70954-316-10 FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSP $321.75 HC89002901 ANA FLUID-QD $321.00 HC62803705 COIL EMBOLIZATION MICROCOIL C $321.00 HC11500543 LACTATION E&M EXT'D NEW L:IV $321.00 63323-360-05 CALCIUM GLUCONATE 100 MG/ML (10%) IV SOLN $320.45 63323-360-61 CALCIUM GLUCONATE 100 MG/ML (10%) IV SOLN (TPN-GMS) $320.45 0009-0280-02 METHYLPREDNISOLONE ACETATE 40 MG/ML INJ SUSP $320.39 HC89091342 FAM ADENOM POLYPOSIS DEL/DUP-AU $320.00 HC84200948 INFLUENZA A OR B EIA EACH $320.00 HC84201342 INFLUENZA A OR B EIA EACH (POS) $320.00 HC35000280 REC- TM CONF INTERDISCPLN NO PT/FAM, WMD 45MIN $320.00 63323-184-10 FOLIC ACID 5 MG/ML INJ SOLN $319.67 HC62221981 PIN CHECKPOINT HEX ROBOTIC $319.00 HC31000961 PT-ULTRASOUND 30MIN/CW $319.00 HC62205984 RETRIEVAL NET $319.00 16729-434-05 DAPTOMYCIN 350 MG IV SOLR $318.50 16729-434-45 DAPTOMYCIN 350 MG IV SOLR $318.50 44567-641-01 NOREPINEPHRINE BITARTRATE-NACL 8 MG/250 ML (32 MCG/ML) IV SOLN $318.50 44567-641-10 NOREPINEPHRINE BITARTRATE-NACL 8 MG/250 ML (32 MCG/ML) IV SOLN $318.50 63323-125-53 GEMCITABINE 1 GRAM IV SOLR $318.50 63323-273-01 SUMATRIPTAN SUCCINATE 6 MG/0.5 ML SUBCUTANEOUS SOLN $318.50 70069-031-01 HALOPERIDOL DECANOATE 100 MG/ML IM SOLN $318.50 70069-031-05 HALOPERIDOL DECANOATE 100 MG/ML IM SOLN $318.50 99999-034-74 FENTANYL 2500 MCG IN NS 100 ML $318.50 99999-035-08 FENTANYL 25 MCG/ML IN NS 100 ML OPIOID NAIVE PCA $318.50 0409-9158-01 PHYTONADIONE (VITAMIN K1) 10 MG/ML INJ SOLN $318.29 0409-9158-31 PHYTONADIONE (VITAMIN K1) 10 MG/ML INJ SOLN $318.29 0409-9158-50 PHYTONADIONE (VITAMIN K1) 10 MG/ML INJ SOLN $318.29 HC81700817 ABSOLUTE T4/CELL MRKR ADD+ $318.00 HC81700825 CALLA/ACUTE LYMPH LEUK AG MKR+ $318.00 HC81701419 FLOW CYT MKR (TDT) TC ADD+ $318.00 HC81700858 FLOW CYT MKR TC ADD + CD38 $318.00 HC81701401 FLOW CYT MKR TC ADD+ $318.00 HC81700833 FLOW CYT MKR TC ADD+ CD23 $318.00 HC81700569 FLOW CYT MKR TC ADD+ KAPPA $318.00 HC81700874 FLOW CYTO CELL MKR TC ADD+ $318.00 HC81700866 FLOW CYTO MKR TC ADD + CALLA $318.00 HC81701989 FLW CYT MKR CD10/CA TC ADD+ $318.00 HC81702037 FLW CYT MKR CD103 TC ADD+ $318.00 HC81700882 FLW CYT MKR CD11 TC ADD+ $318.00 HC81702029 FLW CYT MKR CD117 TC ADD+ $318.00 HC81701062 FLW CYT MKR CD11B TC ADD+ $318.00 HC81702045 FLW CYT MKR CD11C TC ADD+ $318.00 HC81702052 FLW CYT MKR CD138 TC ADD+ $318.00 HC81700890 FLW CYT MKR CD14 TC ADD+ $318.00 HC81702060 FLW CYT MKR CD16 TC ADD+ $318.00 HC81700908 FLW CYT MKR CD19 TC ADD+ $318.00 HC81700916 FLW CYT MKR CD2 TC ADD + $318.00 HC81700924 FLW CYT MKR CD20 TC ADD+ $318.00 HC81702086 FLW CYT MKR CD235A TC ADD+ $318.00 HC81700932 FLW CYT MKR CD24 TC ADD+ $318.00 HC81702094 FLW CYT MKR CD25 TC ADD+ $318.00 HC81700940 FLW CYT MKR CD3 (LEU-4)TC ADD+ $318.00 HC81700957 FLW CYT MKR CD30 (KI-1)TC ADD+ $318.00 HC81700965 FLW CYT MKR CD33 TC ADD+ $318.00 HC81700973 FLW CYT MKR CD34 (HPCA-1)ADD+ $318.00 HC81702102 FLW CYT MKR CD4 TC ADD+ $318.00 HC81702110 FLW CYT MKR CD41 TC ADD+ $318.00 HC81700999 FLW CYT MKR CD5 TC ADD+ $318.00 HC81701005 FLW CYT MKR CD56 TC ADD+ $318.00 HC81702128 FLW CYT MKR CD57 TC ADD+ $318.00 HC81702136 FLW CYT MKR CD61 TC ADD+ $318.00 HC81702144 FLW CYT MKR CD64 TC ADD+ $318.00 HC81701013 FLW CYT MKR CD7 TC ADD+ $318.00 HC81702151 FLW CYT MKR CD79A TC ADD+ $318.00 HC81701021 FLW CYT MKR CD8 TC ADD+ $318.00 HC81702193 FLW CYT MKR HLA-DR TC ADD+ $318.00 HC81701039 FLW CYT MKR IGA TC ADD+ $318.00 HC81701047 FLW CYT MKR IGG TC ADD+ $318.00 HC81701054 FLW CYT MKR IGM TC ADD+ $318.00 HC81701070 FLW CYT MKR LAMBDA TC ADD+ $318.00 HC81702169 FLW CYT MKR MPO TC ADD+ $318.00 HC81702177 FLW CYT MKR TCRAB TC ADD+ $318.00 HC81702185 FLW CYT MKR TCRGD TC ADD+ $318.00 HC81701088 FLW CYT MKR VS. CD13 TC ADD+ $318.00 HC81701096 FLW CYT MKR, CDI TC ADD+ $318.00 HC83505529 IP/IHC PER SPEC INITIAL AB STAIN -CS $317.34 0002-7597-01 OLANZAPINE 10 MG IM SOLR $317.20 24208-670-04 SULFACETAMIDE SODIUM 10 % OPHT DROP $316.88 50383-740-16 ALBUTEROL SULFATE 2 MG/5 ML ORAL SYRP $316.67 63323-658-27 CHLOROTHIAZIDE SODIUM 500 MG IV SOLR $316.49 HC12200291 APPLY ON-BODY INJECTOR FOR TIMED SQ INJ $316.00 HC62202908 BAG/POUCH RETRIEVAL SPECMN ENDO D $316.00 HC62224563 CABLE ELECTRODE MICRO TARGET/SCREEN $316.00 HC62806047 CATH DIALYSIS SHORT-TERM E $316.00 HC51004034 COLLCTN SPUTM AEROSL TECH, SEP PROC $316.00 HC62215413 DEVICE TROCHANTER GALILEO $316.00 HC62300074 DISSECTOR ROBOTIC F $316.00 HC62218748 DRILL/DRILL BITS SINGLE USE I $316.00 HC81702078 FLW CYT MKR CD22 TC ADD+ $316.00 HC62800594 GUIDEWIRE E $316.00 HC81500472 INHIB PROTEIN S TOTAL $316.00 HC62203757 KIT CATH RADIAL ARTERY $316.00 HC62802525 KIT CVP LINE $316.00 HC62203930 KIT HYSTEROSALPINGOGRAM $316.00 HC62203948 KIT INFLATION $316.00 HC51002301 LYSIS & STRETCHING ADHESIONS PREPUTIAL $316.00 HC62205802 PROBE GALACTOGRAM $316.00 HC62206420 SET URICATH $316.00 HC62206529 SHUNT CAROTID $316.00 HC62210273 SPLINT WRIST/ HAND RESTING $316.00 HC62300199 TIP CAUTERY HOOK ROBOTIC F $316.00 HC62212105 TIP CAUTERY SINGLE USE ROBOTIC $316.00 HC89020036 TPMT GENETICS (3300)-PR $316.00 HC62208020 TUNNELER SURGICAL F $316.00 HC84200294 YEAST ID EA ORG $316.00 0054-3727-63 PROPRANOLOL 20 MG/5 ML ORAL SOLN (MCH) $315.25 68180-723-04 CEFDINIR 250 MG/5 ML ORAL SUSR $315.12 HC84201367 CULTURE CARBAPENEM RESIST ENTER $315.00 HC84201383 CULTURE CIPROFLOXACIN RESIST SCRN $315.00 HC84201284 CULTURE CRE $315.00 HC84200237 CULTURE GC $315.00 HC84200500 CULTURE GROUP B STREPTOCOCCUS $315.00 HC84200195 CULTURE MRSA $315.00 HC84200211 CULTURE MRSA & VRE $315.00 HC84200658 CULTURE PERTUSSIS $315.00 HC84201144 CULTURE THROAT-SCREENING $315.00 HC84200203 CULTURE VRE $315.00 HC81100869 MYOGLOBIN $315.00 HC31001761 PT-CASE CONF 30MIN/C $315.00 72572-427-01 MICAFUNGIN 100 MG IV SOLR $314.60 0003-3622-12 ATAZANAVIR 300 MG ORAL CAP $314.04 HC81500142 CELL COUNT FLUID W/O DIFF $314.00 HC25006024 EST PT LVL3-EXPANDED $314.00 HC89005227 HERPES VIRUS-6 DNA QUANT -FT $314.00 HC81100729 SALICYLATES; 1-2 $314.00 0065-0092-65 FLUORESCEIN 500 MG/5 ML (10 %) IV SOLN $313.43 HC83000075 CRYOPRECIPITATE EA UNIT $313.00 HC83001172 CRYOPRECIPITATE EA UNIT $313.00 HC83001016 CRYOPRECIPITATE EA UNIT -SB $313.00 HC81700130 LH (LUTEINIZING HORMONE) $313.00 HC36800530 RT THER MUSC STRENGTH 15MIN/MW $313.00 HC29000791 COUNSEL/INTERV MISUSE BEHAVIOR ETOH $312.80 59651-332-01 FLUCYTOSINE 500 MG ORAL CAP $312.23 HC84600295 CYTO FLUID/BRUSH/WASH DIST SRV $312.00 HC84600006 CYTOLOGY FLD/BRSH/WASH-DIST SV $312.00 HC84600014 CYTOLOGY FLUID/BRUSH/WASH $312.00 HC84600527 CYTOLOGY FLUID/BRUSH/WASH *OP $312.00 HC81100653 LIPASE $312.00 HC62210802 SET PERITONEAL DIALYSIS $312.00 HC29000692 TEST CHALLENGE INGEST ADD 60MIN+ $312.00 HC42000638 WCH EST PT LVL5-COMPREHEN $312.00 HC51063212 PUNCH BX SKIN; EA SEP/ADDL LESION $312.00 HC51063089 DEBRIDE OF NAILS: 6 OR > $312.00 0009-4992-01 LINEZOLID IN DEXTROSE 5% 600 MG/300 ML IV PGBK $312.00 0009-4992-02 LINEZOLID IN DEXTROSE 5% 600 MG/300 ML IV PGBK $312.00 0009-5140-01 LINEZOLID IN DEXTROSE 5% 600 MG/300 ML IV PGBK $312.00 0009-5140-04 LINEZOLID IN DEXTROSE 5% 600 MG/300 ML IV PGBK $312.00 61703-363-18 OXALIPLATIN 50 MG/10 ML (5 MG/ML) IV SOLN $312.00 67457-517-00 FOSPHENYTOIN 500 MG PE/10 ML INJ SOLN $312.00 67457-517-01 FOSPHENYTOIN 500 MG PE/10 ML INJ SOLN $312.00 76125-790-25 ALBUMIN, HUMAN 5 % 5 % IV SOLP $312.00 76125-790-26 ALBUMIN, HUMAN 5 % 5 % IV SOLP $312.00 0409-9158-11 PHYTONADIONE (VITAMIN K1) 10 MG/ML INJ SOLN $311.96 0409-9158-55 PHYTONADIONE (VITAMIN K1) 10 MG/ML INJ SOLN $311.96 HC62200704 BOOT BUCKS TRACTION UNIT $311.00 HC84600568 EXM/SELEC ARCHVL TISS MOL ANAL $311.00 HC31001894 PT-EVAL LOCOMOTOR TRAINING $311.00 HC62209564 TRACTION BUCKS UNIT $311.00 16714-358-01 LEVETIRACETAM 100 MG/ML ORAL SOLN $310.53 0409-3024-01 SODIUM NITROPRUSSIDE 25 MG/ML IV SOLN $310.31 HC29000619 AWV ANNUAL WELLNESS PLAN; SUBSEQUENT $310.00 HC81101289 C3 COMPLEMENT $310.00 HC81101297 C4 COMPLEMENT $310.00 HC83000356 IRRADIATION EA UNIT $310.00 HC51000404 IV INF HYDRATION INITIAL HR $310.00 HC32010068 OT-SWALLOWING EVAL [15MIN] $310.00 HC33010026 ST-SWALLOWING EVAL [15MIN] $310.00 HC51070514 PSY TM CONF W/PT&/FAM 60MIN $309.00 HC39000997 PSYCH PSYCHOANALYSIS $309.00 HC51070563 PSYCH TESTING EVAL INTEGR INTERPRET CLIN DES TX; EA ADDL HR+ $309.00 HC89021125 SOLUBLE IL-2R -CN $309.00 0003-0293-20 TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP $308.82 0641-6137-10 FOSPHENYTOIN 500 MG PE/10 ML INJ SOLN $308.75 16714-483-01 CLINDAMYCIN PALMITATE HCL 75 MG/5 ML ORAL SOLR $308.10 43825-102-01 ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN $308.10 HC81101032 AMINO ACIDS SNGL QUAN EA $308.00 HC62214812 BASKET RETRIEVAL F $308.00 HC62215298 BLADE SAW P $308.00 HC62201611 CATH URETERAL P $308.00 HC21000377 DESTRUCT PREMALG LESIONS 2-14 $308.00 HC32010027 OT-SWALLOWING THERAPY [15MIN] $308.00 HC62216536 PIN/WIRE FIXATION TEMPORARY P $308.00 HC33010018 ST-SWALLOWING THERAPY [15MIN] $308.00 HC62207071 SUTURE RETRIEVER $308.00 HC34000455 EPSDT AUDIO SUBSQ 2-5YRS $308.00 HC34000463 EPSDT AUDIO SUBSQ 6-20YRS $308.00 HC34000448 EPSDT AUDIO SUBSQ <2YRS $308.00 63402-304-30 LURASIDONE 40 MG ORAL TAB $307.39 63402-308-30 LURASIDONE 80 MG ORAL TAB $307.39 63459-101-30 MODAFINIL 100 MG ORAL TAB $307.30 HC11200023 OBSERVATION PER HOUR - ONCOLOGY $307.00 16714-294-03 AMOXICILLIN-POT CLAVULANATE 600-42.9 MG/5 ML ORAL SUSR $306.80 60687-523-11 POSACONAZOLE 100 MG ORAL TBEC $306.59 60687-523-21 POSACONAZOLE 100 MG ORAL TBEC $306.59 61703-262-05 CARBOPLATIN 10 MG/ML IV SOLN $306.54 61703-339-50 CARBOPLATIN 10 MG/ML IV SOLN $306.54 63323-278-10 VINBLASTINE 1 MG/ML IV SOLN $306.54 0338-0519-09 FAT EMULSION 20 % IV EMUL $305.50 0338-9540-02 FAT EMULSION-OLIVE-SOY-LIPID 20 % IV EMUL $305.50 0338-9540-06 FAT EMULSION-OLIVE-SOY-LIPID 20 % IV EMUL $305.50 43598-848-11 ZIPRASIDONE MESYLATE 20 MG/ML (FINAL CONC.) IM SOLR $305.50 43598-848-58 ZIPRASIDONE MESYLATE 20 MG/ML (FINAL CONC.) IM SOLR $305.50 65862-596-01 CLINDAMYCIN PALMITATE 75 MG/5 ML ORAL SOLR (MCH) $305.50 68382-860-02 BENZTROPINE 1 MG/ML INJ SOLN $305.50 68382-860-10 BENZTROPINE 1 MG/ML INJ SOLN $305.50 HC84200278 AEROBIC ID EA ISOLATE $305.00 HC83001230 BB PATH; DIFFICULT CROSSMATCH IRREG AB $305.00 HC81700338 CA 125 $305.00 HC81500704 FIBRIN SPLIT PRODUCTS $305.00 HC81701112 IMMUNOELECTROPHERESIS-SRM $305.00 HC81700353 IMMUNOFIXATION ELECTROPHORESIS $305.00 HC89021182 PCA3 PROSTATE CA BIOMARKER-AU $305.00 HC62221361 SPLINT FOOT DROP PREFAB $305.00 16729-114-08 ETOPOSIDE 20 MG/ML IV SOLN $304.53 99999-038-54 IMATINIB 50 MG ORAL PARTIAL TAB $304.32 HC31001902 LOCOMOTOR TRAINING $304.00 HC62215538 ROD WORKING SPINAL $304.00 42023-119-25 TRIMETHOBENZAMIDE 100 MG/ML IM SOLN $303.58 0009-5091-01 EPIRUBICIN 50 MG/25 ML IV SOLN $303.55 HC84201771 DNA/RNA CHLAMYDIA PNEUMONIAE (PNL) $303.00 HC83503854 ELECTRON MICROSCOPY PROF-CS $303.00 HC81700593 IMMUNOGLOBULIN IGA $303.00 HC81700601 IMMUNOGLOBULIN IGG $303.00 HC81700619 IMMUNOGLOBULIN IGM. $303.00 HC12200192 INF CNTR-ESTBD PT EVAL MINOR $303.00 HC51070035 PSY PREPARE REPORT $303.00 HC39000112 PSYCH FAMILY GROUP THERAPY $303.00 68516-5216-1 ALBUMIN, HUMAN 25 % 25 % IV SOLP $302.58 68516-5216-3 ALBUMIN, HUMAN 25 % 25 % IV SOLP $302.58 68516-5214-1 ALBUMIN, HUMAN 5 % 5 % IV SOLP $302.25 68516-5214-3 ALBUMIN, HUMAN 5 % 5 % IV SOLP $302.25 HC51003135 BX VULVA EACH ADDITIONAL+ $302.00 HC81500134 FIBRINOGEN $302.00 HC81700254 HCG QUAL $302.00 HC62209655 KIT ACCESSORY IDD THERAPY $302.00 HC32000713 OT-WOUND NON-SEL DEB 15MIN/MW $302.00 HC31000771 PT-WOUND NON-SEL DEB 15MIN/MW $302.00 99999-046-00 IOHEXOL 350 MG IODINE/ML IV SOLN $301.60 0407-1413-08 IOHEXOL 300 MG IODINE/ML IV SOLN $301.28 0407-1413-61 IOHEXOL 300 MG IODINE/ML IV SOLN $301.28 HC51060713 OT-EVAL LOW COMPLEXITY 20MF2F 30MIN $301.00 HC77400158 ANESTHESIA EPIDURAL EA ADD 15MIN $300.00 HC51001444 CLOSED TX TOE FX $300.00 HC83505339 CONSULTATION PATH; REF SLIDE REV-BR $300.00 HC81700106 FOLIC ACID $300.00 HC81700528 HLA B27 $300.00 HC89022719 HLA CLASS II TYPING HIGH RES EACH LOCUS-U9 $300.00 HC51070696 PSY-TEST COGNITIVE PERFORMANCE STDRD PER HOUR $300.00 HC51063261 EMG NEEDLE GUIDE W/CHEMODENERATION $300.00 HC31010358 PT- TM CONF INTERDISCPLN NO PT/FAM, WQHCP 45MIN $300.00 HC32010431 OT- TM CONF INTERDISCPLN NO PT/FAM, WQHCP 45MIN $300.00 HC33010299 ST- TM CONF INTERDISCPLN NO PT/FAM, WQHCP 45MIN $300.00 HC35000314 REC TM CONF INTERDISCPLN NO PT/FAM, WQHCP 60MIN $300.00 0781-6153-94 PENICILLIN G SODIUM 5 MILLION UNIT INJ SOLR $299.51 0781-6153-95 PENICILLIN G SODIUM 5 MILLION UNIT INJ SOLR $299.51 43386-026-02 FLUOCINONIDE 0.05 % TOPICAL SOLN $299.39 51672-1273-2 FLUOCINONIDE 0.05 % TOPICAL SOLN $299.39 0407-1412-20 IOHEXOL 240 MG IODINE/ML IV SOLN $299.13 HC81700536 HEPATITIS B SURFACE AG $299.00 HC21001052 REMOV IMPACTD EAR WAX IRRIG/LAVG LT $299.00 HC21001060 REMOV IMPACTD EAR WAX IRRIG/LAVG RT $299.00 HC84200906 VARICELLA ZOSTER FA ANTIGEN $299.00 71288-114-50 GEMCITABINE 1 GRAM IV SOLR $298.55 HC62214705 ADAPTER PTCA W/GUIDEWIRE $298.00 HC51010213 ASP/INJ MED JOINT-LT $298.00 HC51010221 ASP/INJ MED JOINT-RT $298.00 HC81700320 CA 19-9 $298.00 HC81701849 IGG SUBCLASS 1; EACH $298.00 HC81701856 IGG SUBCLASS 2; EACH $298.00 HC81701864 IGG SUBCLASS 3; EACH $298.00 HC81701872 IGG SUBCLASS 4; EACH $298.00 HC25001538 REMOV IMPACTD EAR WAX IRRIG/LAVG LT $298.00 HC25001546 REMOV IMPACTD EAR WAX IRRIG/LAVG RT $298.00 0168-0267-30 BETAMETHASONE, AUGMENTED 0.05 % TOPICAL LOTN $297.77 0003-1611-12 ENTECAVIR 0.5 MG ORAL TAB $297.37 HC81700049 AFP $297.00 HC81700270 CARDIOLIPIN AB EA IG CLASS $297.00 HC51062552 CONTROL NASAL HEMORRHAGE,POST W/PCKS+/OR CAUTRY INT'L $297.00 HC81101552 C-PEPTIDE $297.00 HC14500102 DIABETIC SELF MGMT TRNG EA 30M $297.00 HC62213723 GAS INTRAOCULAR A $297.00 HC62204532 LITE PIPE $297.00 HC51070357 PSYCH TX W/PATIENT 30MIN $297.00 HC81500050 CRYSTALS FLUID $296.00 99999-046-03 IOHEXOL 300 MG IODINE/ML IV SOLN $295.10 99999-046-12 IOHEXOL 300 MG IODINE/ML IV SOLN $295.10 99999-046-13 IOHEXOL 300 MG IODINE/ML IV SOLN $295.10 HC62201405 CATH FLUSH $295.00 HC62201975 CONNECTOR SURGICAL $295.00 HC11500865 WM EXAM EST' PT EVAL LO/MODIII $295.00 0409-0181-01 GEMCITABINE 1000 MG/26.3 ML RECONSTITUTED IV SOLN (MCH) $294.38 HC81100539 CPK $294.00 HC81500126 D-DIMER QUAL OR SEMI-QT $294.00 HC62225594 DRESSING COLLAGEN W/ AG $294.00 HC89500698 FREEZING BLOOD EA UNIT-SB $294.00 HC62209283 INFLATOR FOR BALLOON K $294.00 HC51000065 INSERT BLADDER CATH-NON INDWELL $294.00 HC62215892 NEEDLE BIOPSY K $294.00 HC51060697 PT-EVAL LOW COMPLEXITY 20MF2F 30MIN $294.00 HC62215603 SUTURE K $294.00 45802-018-94 MUPIROCIN CALCIUM 2 % TOPICAL CREAM $293.87 0004-1101-50 CAPECITABINE 500 MG ORAL TAB $293.71 0173-0519-00 EPOPROSTENOL (GLYCINE) 1.5 MG IV SOLR $293.41 HC25001298 CS DIFF MD ADD'L 15 MIN $293.00 HC84201797 DNA/RNA MYCOPLASMA PNEUMONIAE (PNL) $293.00 HC81500746 LAMELLAR BODY DENSITY $293.00 HC25001264 MOD CS BY MD ADD'L 15 MIN $293.00 HC62205166 PACK BASIC $293.00 HC81101420 PREALBUMIN $293.00 HC31000318 PT-EVAL LOW COMPLEXITY <20MF2F 15MIN $293.00 HC33000969 ST EVAL SOUND PRODUCTION 30MIN/M $293.00 HC81700080 VITAMIN B12 $293.00 99999-046-09 IODIXANOL 320 MG IODINE/ML IV SOLN $292.83 0496-0882-30 LIDOCAINE 4 % TOPICAL CREAM $292.70 0143-9233-01 BENZTROPINE 1 MG/ML INJ SOLN $292.50 0143-9233-05 BENZTROPINE 1 MG/ML INJ SOLN $292.50 0548-5400-00 MEDROXYPROGESTERONE 150 MG/ML IM SUSP $292.50 0548-5400-25 MEDROXYPROGESTERONE 150 MG/ML IM SUSP $292.50 0703-6801-01 MEDROXYPROGESTERONE 150 MG/ML IM SUSP $292.50 43598-330-11 ZOLEDRONIC ACID 4 MG/5 ML IV SOLN $292.50 55150-242-51 LINEZOLID IN DEXTROSE 5% 600 MG/300 ML IV PGBK $292.50 63323-012-17 OXYTOCIN 10 UNIT/ML INJ SOLN $292.50 68180-405-01 CEFIXIME 100 MG/5 ML ORAL SUSR $292.50 71288-426-03 ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLN $292.50 5633100614 NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRA $292.27 5633100615 NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRA $292.27 24338-230-05 NIMODIPINE 30 MG/5 ML ORAL SYRG $292.21 24338-230-12 NIMODIPINE 30 MG/5 ML ORAL SYRG $292.21 31722-574-47 LEVETIRACETAM 100 MG/ML ORAL SOLN $292.08 HC89003271 CORTISOL FREE URINE-QD $292.00 HC83000364 POOLING PLAT OR OTHER BLD PROD $292.00 HC84200419 CRYPTOCOCCUS NEOFORMANS AG $291.00 HC81700767 IMMUNOFIX ELECTPH URINE $291.00 HC36800688 METHGB,QUANT TRANSCUTANEUS/DAY $291.00 HC36000792 METHGB,QUANT TRANSCUTANEUS/DAY $291.00 72196-0431-1 AA 3.5% NO.2 PED-D10W-HEPARIN 3.5 %-10 %- 125 UNIT/250 ML IV SOLP $290.88 60687-192-11 IMATINIB 100 MG ORAL TAB $290.34 HC81701187 ALPHA1 ANTITRYPSIN $290.00 HC51004133 ANALYZ NRSTM NO REPROGRAMMING $290.00 HC81500621 APTT SUBS PLASMA FRACTIONS EA $290.00 HC82202201 CRYSTALS FLUID $290.00 HC84200153 KIRBY BAUER SENSITIVITY $290.00 0378-0872-16 CLONIDINE 0.2 MG/24 HR TRANSDERMAL PTWK $289.99 0378-0872-99 CLONIDINE 0.2 MG/24 HR TRANSDERMAL PTWK $289.99 0591-3509-04 CLONIDINE 0.2 MG/24 HR TRANSDERMAL PTWK $289.99 0591-3509-54 CLONIDINE 0.2 MG/24 HR TRANSDERMAL PTWK $289.99 0002-8215-17 INSULIN REGULAR HUMAN 100 UNIT/ML INJ SOLN $289.97 0002-8715-17 INSULIN NPH AND REGULAR HUMAN 100 UNIT/ML (70-30) SUBCUTANEOUS SUSP $289.97 11994-127-11 XENON-133 IN CARBON DIOXIDE 370 MBQ (10 MCI) INHALATION GAS $289.70 0409-3213-12 DIAZEPAM 5 MG/ML INJ SOLN $289.64 HC28000222 CR REHAB PAD PERIPHERAL PER SESSION $289.00 HC12200150 INF CNTR-NEW PT EVAL LOW/MOD $289.00 HC81500456 INHIB PROTEIN C AG $289.00 59148-037-13 BREXPIPRAZOLE 1 MG ORAL TAB $288.69 60505-6226-1 ATROPINE 1 % OPHT DROP $288.41 0078-0468-15 DEFERASIROX 125 MG ORAL TBDP $288.21 HC89008809 17-KETOSTEROID FRACTIONAT'N-AU $288.00 HC62200761 BREAST PUMP $288.00 HC62202296 DRAIN $288.00 HC51001980 INSERT DRUG DELIVERY IMPLANT $288.00 HC51060168 PT-DEVEL TEST PER STANDARD INSTRUMENT(SCREENING) $288.00 HC62207022 SUTURE GENERAL MULTI PKG $288.00 0009-0003-02 METHYLPREDNISOLONE SOD SUC(PF) 500 MG/4 ML IV SOLR $287.82 61314-637-05 PREDNISOLONE ACETATE 1 % OPHT DRPS $287.63 16729-242-31 ZOLEDRONIC ACID 4 MG/5 ML IV SOLN $287.43 HC84200518 HUMAN METAPNEUMOVIRUS (HMPV) $287.00 HC51070548 NEUROBEHAVIORAL STATUS EXAM CLIN ASSESS INTERP & REPORT; EA ADDL HR+ $287.00 HC32000754 OT-WOUND VAC 15MIN<50 SQ CM/M $287.00 HC31000813 PT-WOUND VAC 15MIN<50 SQ CM/M $287.00 HC51061802 X-RAY SPINE THORACOLUMBAR JUNCTN MIN 2 VWS $287.00 0069-1307-01 EPOETIN ALFA-EPBX 4,000 UNIT/ML INJ SOLN $286.78 0069-1307-10 EPOETIN ALFA-EPBX 4,000 UNIT/ML INJ SOLN $286.78 99988-000-20 NM TC-99M SULFUR COLLOID (NON-FILTERED) $286.65 HC25005836 ASPIRATION W/ CATHETER; NASOTRACHEAL $286.00 HC84201045 BETA STREP SCREEN(QUAL) $286.00 HC51003374 BX(S)/SAMPL ENDOMETRIAL W/COLPOSCPY+ $286.00 HC81101362 CARBOXYHEMOGLOBIN $286.00 60758-119-05 PREDNISOLONE ACETATE 1 % OPHT DRPS $286.00 67457-323-25 MOXIFLOXACIN-SOD.CHLORIDE(ISO) 400 MG/250 ML IV PGBK $286.00 67457-390-54 ZOLEDRONIC ACID 4 MG/5 ML IV SOLN $286.00 0009-0698-01 METHYLPREDNISOLONE SODIUM SUCC 1,000 MG IV SOLR $285.87 16729-295-12 CARBOPLATIN 10 MG/ML IV SOLN $285.87 0143-9503-01 ACETAZOLAMIDE SODIUM 500 MG INJ SOLR $285.74 HC81101933 DRUG TEST PRESUMP DIR OPT INSTRMNT ASS'T/ DOS $285.00 HC89021216 MAG AUTOANTIBODY-AT $285.00 65219-054-09 POTASSIUM PHOSPHATE M-/D-BASIC 3 MMOL/ML IV SOLN $284.70 65219-054-29 POTASSIUM PHOSPHATE M-/D-BASIC 3 MMOL/ML IV SOLN $284.70 60219-1749-3 ATROPINE 1 % OPHT DROP $284.64 24208-411-15 BRIMONIDINE 0.2 % OPHT DROP $284.41 61874-115-11 CARIPRAZINE 1.5 MG ORAL CAP $284.28 61874-115-20 CARIPRAZINE 1.5 MG ORAL CAP $284.28 61874-115-30 CARIPRAZINE 1.5 MG ORAL CAP $284.28 61874-130-30 CARIPRAZINE 3 MG ORAL CAP $284.28 39822-1055-5 AMPHOTERICIN B 50 MG INJ SOLR $284.05 HC62226931 DEVICE EMULSION SUBMUCOSAL INJ AMPOULE $284.00 HC81101685 DHEA SULFATE $284.00 HC11500030 EST PT MOD MDM 30-39 MIN $284.00 HC41500638 MONITOR NEURO INTRAOP CONT ATTEND 1:1 EA 15MIN+ $284.00 HC39000120 PSYCH GRP TX(NOT MULTI FAMILY)60MIN/COMM $284.00 60505-6193-1 PALONOSETRON 0.25 MG/5 ML IV SOLN $283.14 69543-371-01 PALONOSETRON 0.25 MG/5 ML IV SOLN $283.11 69543-371-10 PALONOSETRON 0.25 MG/5 ML IV SOLN $283.11 HC51020246 NP DEV PT REPORT; COMPREHENSIVE $283.00 HC51020022 RN DEV PT REPORT;COMPREHENSIVE $283.00 99999-043-16 AMPICILLIN-SULBACTAM 30 MG/ML INJ SYRINGE (USING 3G) $282.75 HC34000067 ACOUSTIC REFLEX TEST THRESHOLD $282.00 HC81500068 CBC WITH AUTOMATED DIFF $282.00 HC81500720 PROTAMINE SULFATE/PARACOAG $282.00 HC83000125 RBC ANTIBODY SCREEN $282.00 99999-045-82 NIMODIPINE 30 MG/5 ML ORAL SYRG $281.87 70121-1168-1 TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP $281.78 61958-2301-1 TENOFOVIR ALAFENAMIDE 25 MG ORAL TAB $281.16 HC51070589 NEUROPSYCH TEST EVAL INTRG INTERP CLIN DES FEEDBACK; EA ADDL HR+ $281.00 HC51070688 PSY-ASSESS APHASIA W/REPORT PER HOUR $281.00 HC84201011 SEMEN ANALYSIS POST $281.00 63323-751-10 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $281.00 0781-3433-46 LINEZOLID IN DEXTROSE 5% 600 MG/300 ML IV PGBK $280.80 0781-3433-95 LINEZOLID IN DEXTROSE 5% 600 MG/300 ML IV PGBK $280.80 63323-012-02 OXYTOCIN 10 UNIT/ML INJ SOLN $280.80 63323-012-30 OXYTOCIN 10 UNIT/ML INJ SOLN $280.80 63323-763-16 PACLITAXEL 6 MG/ML IV CONC $280.71 HC62220504 APPLICATOR/TIP SYRINGE ONLY F $280.00 HC62224340 APPLIER LIGA/HEMOCLIP ENDO F $280.00 HC51010189 ASP/INJ SMALL JNT-SC LT $280.00 HC51010197 ASP/INJ SMALL JNT-SC RT $280.00 HC62200530 BLADE INCISIONAL D $280.00 HC62215280 BLADE SAW O $280.00 HC62212873 BLADE SHAVER D $280.00 HC62213194 BURR D $280.00 HC89500300 CALL BACK FEE HRLY(2HR MIN)-AA $280.00 HC62227806 CANNISTER COLLECTING TISSUE (DHS) $280.00 HC62226923 CANNULA ARTERIAL B $280.00 HC62226956 CANNULA ARTERIAL C $280.00 HC62222286 CANNULA ARTHROSCOPIC F $280.00 HC62213939 CANNULA PERFUSION F $280.00 HC62201223 CATH ARTERY PULMONARY $280.00 HC62216007 CATH BALLOON DIL NON VASCULAR F $280.00 HC62201272 CATH CENTRAL VENOUS F $280.00 HC62223904 CATH DIAGNOSTIC F $280.00 HC62201348 CATH DRAINAGE F $280.00 HC62210182 CATH EMBOLECTOMY ARTERIAL FOGARTY F $280.00 HC62805882 CATH EP DX <20 ELECTRODES B $280.00 HC62222278 CATH EP/ABLAT NOT COOL-TIP/3D/V MAP F $280.00 HC62222229 CATH GUIDING F $280.00 HC62218276 CATH INTRODUCER PEEL-AWAY J $280.00 HC62227228 CATH IV MIDLINE F $280.00 HC62222542 CATH NEPHROSTOMY F $280.00 HC62225206 CATH OCCLUSION F $280.00 HC62223342 CATH PTA ANGIOPLS BALLOON NON-LSR B $280.00 HC62213970 CATH PTCA BALLOON NON-LASER B $280.00 HC62204243 CATH SUPRAPUBIC/CYSTOSCOPIC F $280.00 HC62214226 CATH URETERAL O $280.00 HC62226212 CAUTERY PENCIL F $280.00 HC62224191 CAUTERY TIP F $280.00 HC62208244 CLIP TISSUE MARKER $280.00 HC62224381 COLLAR CERVICAL MIAMI J F $280.00 HC62227665 COUNTERSINK C $280.00 HC62220538 DERMABOND F $280.00 HC62209325 DEVICE RETRIEVAL SPIDER NET E $280.00 HC62216056 DEVICE SUTURING ENDOSCOPIC D $280.00 HC62225073 DILATOR SET URETHRAL PEDIATRIC $280.00 HC62218730 DRILL/DRILL BITS SINGLE USE H $280.00 HC62202692 ELECTRODE LEEP LOOPS N $280.00 HC62228564 ELECTRODE PACING/DEFIB(ONESTEP) $280.00 HC62218326 ENDO STAPLER D $280.00 HC62203427 FORCEP JEWELER BIPOLAR F $280.00 HC62300447 FORCEP ROBOTIC F $280.00 HC62300249 GRASPER ANVIL ROBOTIC F $280.00 HC62804844 GUIDE PIN ORTHO F $280.00 HC62203484 HEMOCONCENTATOR $280.00 HC62805783 HEMOSTATIC GEL/GELFOAM/PAD F $280.00 HC36800696 HGB,QUANT TRANSCUTANEOUS DAILY $280.00 HC36001022 HGB,QUANT TRANSCUTANEOUS DAILY $280.00 HC62300439 HOLDER BLADE ROBOTIC (SNAP-FIT) $280.00 HC62225479 IMMOBILIZER SHOULDER PEDS $280.00 HC62208848 INFUSION WIRE $280.00 HC62802400 INTRODUCER/SHEATH F $280.00 HC62226568 INTRODUCER/SHEATH F $280.00 HC62220678 KIT ACCESSORY C $280.00 HC62217096 KIT CHEST TUBE INSERTION $280.00 HC62223730 KIT CONCENTRATOR PLATELETS F $280.00 HC62227947 KIT DRESSING WOUND NEG PRESSURE C $280.00 HC62221148 KIT PRESSURE MONITOR/TRANSDUCER F $280.00 HC62219696 KIT VITRECTOMY PROBE B $280.00 HC62216304 NEEDLE BIOPSY BONE F $280.00 HC62225131 NEEDLE BIOPSY EUS F $280.00 HC62210208 NEEDLE BIOPSY TRACKING $280.00 HC62202890 NEEDLE ENDOSCOPIC F $280.00 HC62205042 NEEDLE WIRE LOCALIZATION F $280.00 HC62205075 OBTURATOR H $280.00 HC62204805 PACKING/BALLOON NASAL F $280.00 HC62216528 PIN/WIRE FIXATION TEMPORARY O $280.00 HC62224951 PROBE LITHOTRIPTOR F $280.00 HC62227798 PROTECTOR OVERFLOW BACTERIA (DHS) $280.00 HC62227566 PUNCH ARTHROSCOPIC B $280.00 HC47200761 RAD ONC EST PT SF MDM 10-19 MIN $280.00 HC62213368 REAMER G $280.00 HC62221296 RESERVOIR CELL SAVER F $280.00 HC62220066 RETRACTOR DISPOSABLE D $280.00 HC62225271 SENSOR OXIMETRY CEREBRAL SOMATIC $280.00 HC62224043 SET DILATORS $280.00 HC62223821 SET DRILL BIT W/PIN(S) F $280.00 HC62227913 SHEATH ARTHROSCOPIC E $280.00 HC62225289 SIZER MAMMARY G $280.00 HC62224183 SNARE F $280.00 HC62226055 SPIKE BONE ORTHO $280.00 HC62210869 SPINAL HOOK DEVICE $280.00 HC62224514 SPLINT ELBOW/KNEE F $280.00 HC62218565 STAPLE CARTRG/ENDO RELOAD F $280.00 HC62221379 STAPLER SKIN F $280.00 HC62807029 STENT NON CORON W/DELIV SYS B $280.00 HC62803788 STENT NON-CORON TEMP NO DELIV SYS F $280.00 HC62225198 SYSTEM DELIVERY STENT BILIARY $280.00 HC62221791 TAP SURGICAL F $280.00 HC62202999 TROCAR ENDO F $280.00 HC62226477 TUBE BRACHY TX SEED ADMIN G $280.00 HC62806310 TUBE GASTROSTOMY STNDRD BTTN OPT F $280.00 HC62222021 TUBE INSUFFLATOR F $280.00 HC62221544 TUBE TRACH CUFFED F $280.00 HC62207766 TUBE TRACH NO CUFF F $280.00 HC62207857 TUBING HYSTEROSCOPY D $280.00 HC62224555 WAND ARTHRO F $280.00 HC62226949 WOUND FILLER GEL COLLAGEN $280.00 HC89024350 HLA II TYPE 1 AG EQUIV LOW RES RISKIMMUNE-PR $280.00 65862-496-47 SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG/5 ML ORAL SUSP $279.78 66993-727-57 SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG/5 ML ORAL SUSP $279.78 70954-258-10 SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG/5 ML ORAL SUSP $279.78 0338-9555-24 DEXMEDETOMIDINE IN 0.9 % NACL 200 MCG/50 ML (4 MCG/ML) IV SOLN $279.50 42023-186-01 DEXMEDETOMIDINE IN 0.9 % NACL 200 MCG/50 ML (4 MCG/ML) IV SOLN $279.50 42023-186-20 DEXMEDETOMIDINE IN 0.9 % NACL 200 MCG/50 ML (4 MCG/ML) IV SOLN $279.50 42023-215-01 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $279.50 HC62202882 ENDO LOOP $279.00 HC51070340 PSY FAMILY CONFERENCE 60MIN $279.00 HC51060531 ST EVAL SOUND PROD W/LANG COMP&EXPRESS/C $279.00 HC33000274 ST-SPEECH THERAPY GRP 30MIN/MCW $279.00 99999-046-05 IOHEXOL 350 MG IODINE/ML IV SOLN $278.85 59676-278-01 RILPIVIRINE HCL 25 MG ORAL TAB $278.62 69097-708-31 PHYTONADIONE (VITAMIN K1) 10 MG/ML INJ SOLN $278.01 69097-708-96 PHYTONADIONE (VITAMIN K1) 10 MG/ML INJ SOLN $278.01 HC81500449 ANTITHROMBIN III AG $278.00 HC81101065 CALCIUM IONIZED $278.00 HC81101800 CALCIUM IONIZED (POS) $278.00 HC81701724 EBV AB TO VIRAL CAPSID AG, IGG $278.00 HC81701732 EBV AB TO VIRAL CAPSID AG, IGM $278.00 HC13500020 GENETIC CNSL RISK REDCTN 30MIN $278.00 HC84200856 HSV 1 FA ANTIGEN $278.00 HC84200849 HSV 2 FA ANTIGEN $278.00 HC51000214 IV PUSH SINGLE/INIT'L INJ $278.00 43598-405-11 PHYTONADIONE (VITAMIN K1) 10 MG/ML INJ SOLN $277.99 43598-405-16 PHYTONADIONE (VITAMIN K1) 10 MG/ML INJ SOLN $277.99 55150-335-01 CARBOPLATIN 10 MG/ML IV SOLN $277.88 16714-397-02 CEFPROZIL 250 MG/5 ML ORAL SUSR $277.39 HC28000107 CR NEW PT EVAL LVL2-(20MIN) $277.00 HC62211214 INJECTOR UTERINE $277.00 HC89013825 OLIGOCLONAL BANDS (CSF)-QD $277.00 HC62228267 ORTH HFO W/O JOINTS PREFAB OTS $277.00 HC81101826 SEX HORMONE BINDING GLOB $277.00 HC81701914 TISSUE TRANSGLUTAMINASE IGA $277.00 HC81701922 TISSUE TRANSGLUTAMINASE IGG $277.00 HC62208616 VEST CHEST/AIRWAY CLEARANCE $277.00 58160-842-01 DIPHTH,PERTUS(ACELL),TETANUS 2.5-8-5 LF-MCG-LF/0.5ML INJECTION (MHS) $276.58 58160-842-11 DIPHTH,PERTUS(ACELL),TETANUS 2.5-8-5 LF-MCG-LF/0.5ML INJECTION (MHS) $276.58 58160-842-43 DIPHTH,PERTUS(ACELL),TETANUS 2.5-8-5 LF-MCG-LF/0.5ML INJECTION (MHS) $276.58 58160-842-52 DIPHTH,PERTUS(ACELL),TETANUS 2.5-8-5 LF-MCG-LF/0.5ML INJECTION (MHS) $276.58 63739-076-33 VALGANCICLOVIR 450 MG ORAL TAB $276.25 68084-965-25 VALGANCICLOVIR 450 MG ORAL TAB $276.25 68084-965-95 VALGANCICLOVIR 450 MG ORAL TAB $276.25 HC84200815 ADENOVIRUS FA ANTIGEN $276.00 HC51000156 BREATH HYDROGEN TEST $276.00 HC84200930 HELICOBACTER PYLORI $276.00 HC29000627 IPPE EXAM INITIAL PREVENTIVE $276.00 HC84200823 PERTUSSIS FA ANTIGEN $276.00 HC81700585 PSA TOTAL $276.00 HC82202292 TISSUE FROZ SECT AD'L DIST SVC $276.00 HC82200502 TISSUE FROZEN SECTION ADDIT'L $276.00 HC25005364 US MEASUR POST-VOID RES&/BLDR CAP NO IMG $276.00 HC11500709 WC ESTB E&M MINOR LVL 2 $276.00 HC11500659 WC NEW E&M ASSESS MINOR LVL 2 $276.00 HC51061810 X-RAY SPINE ENTIRE SKULL-SACRUM 1 VIEW $276.00 0409-1638-02 DEXMEDETOMIDINE 100 MCG/ML IV SOLN $275.73 HC89016927 ANATOMIC CONSULT; CMPLX REV-CE $275.00 HC51002939 DILAT STRICTURE URETHRAL MALE SUBSQ $275.00 HC81101404 FLORESCENCE POLARIZATION $275.00 HC89005193 INFCT AGNT ADENO DNA PCR-FT $275.00 HC62204284 KIT TRACH $275.00 HC84200880 PARAINFLUENZA EA TYPE $275.00 HC89019236 VARICELLA ZOSTER QNT-FT $275.00 HC89024269 CANDIDA AURIS BY PCR-AU $275.00 HC35000306 REC TM CONF INTERDISCPLN NO PT/FAM, WQHCP 45MIN $275.00 HC36800597 CARBOXYHEMOGLOBIN,QUANT $274.00 HC51003200 IRRIG &/APPLY OINTMENT VAGINAL $274.00 HC32001349 OT-CONTRAST BATH 30MIN/CW $274.00 63323-386-01 CEFOTETAN 2 GRAM INJ SOLR $273.78 63323-386-20 CEFOTETAN 2 GRAM INJ SOLR $273.78 HC32000382 OT-RE-EVAL EST POC 15MIN $273.00 HC39000302 PSY TEAM CONF W/PT&/FAM 30MIN $273.00 HC81700221 T3 TOTAL $273.00 0009-0436-01 ARGININE HCL (L-ARGININE) 10 % IV SOLP $273.00 0517-0730-01 CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLN $273.00 0990-7171-17 PARENTERAL AMINO ACID 15% NO.2 15 % IV SOLP $273.00 0143-9851-01 METHYLPREDNISOLONE SODIUM SUCC 1,000 MG IV SOLR $272.29 0009-0342-01 GELATIN SPONGE,ABSORB-PORCINE 100 TOPICAL SPGE $272.12 HC83505537 ANATOMIC CONSULT; COMPLEX REV-UX $272.00 HC81701948 DEAMIDATED GLIADIN PEP IGA $272.00 HC81701955 DEAMIDATED GLIADIN PEP IGG $272.00 HC51002608 IMPLANT PELLET(S) HORMONE SUBQ $272.00 HC25005968 NEW PT LVL2-PROB FOCUS $272.00 HC81500084 PTT (APTT) $272.00 HC81101230 TRANSFERRIN $272.00 61958-0401-1 TENOFOVIR DISOPROXIL FUMARATE 300 MG ORAL TAB $271.59 0009-0353-01 GELATIN SPONGE,ABSORB-PORCINE 100 CM TOPICAL SPGE $271.58 HC62208459 ACAPELLA DEVICE $271.00 HC81101040 AMNIOTIC FLUID SCAN $271.00 HC77400133 ANESTHESIA REGIONAL ADD 15 MIN $271.00 HC77400174 ANESTHESIA SPINAL EA ADD 15MIN $271.00 HC32000036 OT- TM CONF INTERDISCPLN F2F PT/FAM WQHCP 30MIN $271.00 HC32000242 OT-EVAL LOW COMPLEXITY <20MF2F 15MIN $271.00 HC32001323 OT- TM CONF INTERDISCPLN NO PT/FAM, WMD 30MIN $271.00 HC62217187 PAD BOOT $271.00 HC31000128 PT- TM CONF INTERDISCPLN F2F PT/FAM WQHCP 30MIN $271.00 HC31000136 PT- TM CONF INTERDISCPLN NO PT/FAM, WMD 30MIN $271.00 HC62206370 SET SUSPENSION EYE(FRONTALIS) $271.00 HC33000837 ST- TM CONF INTERDISCPLN NO PT/FAM, WMD 30MIN $271.00 HC33000449 ST- TM CONF INTERDISCPLN F2F PT/FAM WQHCP 30MIN $271.00 HC62207394 TRAY INTUBATION $271.00 HC51001824 X-RAY KNEE CMPLET 4+ VWS $271.00 0407-1413-59 IOHEXOL 300 MG IODINE/ML IV SOLN $270.66 HC62204615 ANTENNA TRANSMIT EXT NEUROSTIM $270.00 HC51062545 CONTROL NASAL HEMORRHAGE,ANTERIOR,COMPLEX TX $270.00 HC51062487 CPSP COMPREHENSIVE INIT' ASSESS NUTRITON, PSYCH, HEALTH ED POC; 1ST 30MIN EACH, TOTAL 90MIN $270.00 HC89019889 HLA AB DETECTION-AU $270.00 HC89023550 INFCT AGNT ADENO DNA QUAL-FT $270.00 HC89005219 INFCT AGNT ADENO DNA(RFX QT-FT $270.00 HC83506048 MORPH STDY CAT FISH EA MULTI PROBE - NG $270.00 HC83506063 MORPH STDY CAT FISH EA MULTI PROBE HER2-AP $270.00 HC83505875 MORPH STDY CAT FISH EA MULTI PROBE HER2-NG $270.00 HC51062255 NP ANTEPARTUM INITIAL VISIT $270.00 HC51020311 NP EST PT LVL V; COMPLEX $270.00 HC51020360 NP NEW PT LVL V; COMPLEX $270.00 HC62205299 PACK HIP TOTAL $270.00 HC31000458 PT-RE-EVAL EST POC 15MIN $270.00 HC51061984 REMOTE MONITOR PHYSIOLOGIC PARAM INITIAL SET UP $270.00 HC51061752 X-RAY SPINE CERVICAL; 2 OR 3VWS $270.00 0338-0519-13 FAT EMULSION 20 % IV EMUL $269.75 0517-4002-25 PAPAVERINE 30 MG/ML INJ SOLN $269.17 23155-603-51 CLINDAMYCIN PALMITATE 75 MG/5 ML ORAL SOLR (MCH) $269.10 59762-0016-1 CLINDAMYCIN PALMITATE 75 MG/5 ML ORAL SOLR (MCH) $269.10 62756-017-40 TESTOSTERONE CYPIONATE 100 MG/ML IM OIL $269.10 HC62200860 BURN PADS $269.00 HC81500829 HEMOGLOBIN ELECT QUANT F,S $269.00 HC89005235 HERPESVIRUS 6 QUAL(RFX QNT)-FT $269.00 HC11500485 LACTATION E&M INTRMD NEW L:III $269.00 HC89004808 MTB COMPLEX DNA, PCR-FT $269.00 HC32001729 OT-DYSPHAG/SWAL TX ADD'L 15MIN/C $269.00 HC89019251 PARECHOVIRUS RNA, RT-PCR-FT $269.00 HC39001284 PSYCH/NEUROPSYCH TEST ADMIN & SCORING, 2 OR > TESTS; 1ST 30 MIN $269.00 HC84200898 RESPIRATORY SYNCTAL VIRUS AG $269.00 HC62206214 SET FRAGMATONE $269.00 0009-7529-03 IRINOTECAN 100 MG/5 ML IV SOLN $268.26 HC81500811 HEMOGLOBIN ELECTRO-CONFIRM $268.00 HC81500712 HEMOGLOBIN ELECTROPHERESIS $268.00 HC33010042 ST-SPEECH THERAPY [15MIN] $268.00 HC83500678 TISSUE EXAM G&M LEVEL 4-SU $268.00 HC51001717 X-RAY ELBOW 3+ VW $268.00 HC51001725 X-RAY FOREARM 2 VW $268.00 HC51001816 X-RAY KNEE 3 VWS $268.00 63323-599-30 DEFEROXAMINE 2 GRAM INJ SOLR $267.80 HC89008718 GM1 AUTO AB-AT $267.50 HC83000794 COOMBS INDIRECT QUAL EA $267.00 HC84200484 LACTOFERRIN/LEUK, FECAL; QUAL $267.00 HC25001496 REMOV IMPACTD EAR WAX(INSTRUMENT) LT $267.00 HC25001504 REMOV IMPACTD EAR WAX(INSTRUMENT) RT $267.00 HC84200252 SPECIAL STAIN $267.00 HC51000172 SPIROMETRY W/MEASUREMNTS& REC $267.00 HC84200344 CRYPTOCOCCUS AG EA CSF $266.00 HC12200093 IM OR SQ INJECTION THERAPEUTIC $266.00 HC12200085 IVP SINGLE/REPEAT RX ADD'L INJ $266.00 HC62215884 NEEDLE BIOPSY J $266.00 HC62208871 SET DRAINAGE ANCHOR $266.00 HC62206222 SET GALACTOGRAM INFUSION $266.00 HC62215595 SUTURE J $266.00 HC42000620 WCH EST PT LVL4-DETAILED $266.00 HC62202213 DEVICE EXPRESS CORE BX $265.00 HC89500748 HLA TYPING A,B OR C -SB $265.00 HC51060952 OT-ORTHOTIC FIT/TRNG 30MIN/C $265.00 HC32010159 OT-ORTHOTIC MGMT & TRNG INITIAL ENC 15MIN $265.00 HC32000358 OT-ORTHOTIC MGMT & TRNG INITIAL ENC 15MIN/M $265.00 HC31010135 PT-ORTHOTIC MGMT & TRNG INITIAL ENC 15MIN $265.00 HC31000425 PT-ORTHOTIC MGMT & TRNG INITIAL ENC 15MIN/M $265.00 HC82202243 TISSUE GROSS EXAM LV1-DIST SVC $265.00 HC82200379 TISSUE GROSS EXAM ONLY LEVEL 1 $265.00 HC82202540 TISSUE GROSS EXAM ONLY LVL1*OP $265.00 HC51062891 TRANSITIONAL CARE MANAGE SERVICE HI DECSN 7 DAY DISCHRG $265.00 HC51002194 UROFLOWMETRY COMPLEX $265.00 99999-035-26 APREPITANT 20 MG/ML ORAL LIQUID $264.88 0378-3340-16 NORELGESTROMIN-ETHIN.ESTRADIOL 150-35 MCG/24 HR TRANSDERMAL PTWK $264.66 0378-3340-53 NORELGESTROMIN-ETHIN.ESTRADIOL 150-35 MCG/24 HR TRANSDERMAL PTWK $264.66 63323-165-30 DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJ SOLN $264.62 63323-285-65 ROPIVACAINE PF 0.2% AUTOFUSER PUMP $264.55 HC84201110 C DIFFICILE AG EIA $263.00 HC62220819 CUFF AORTIC ROOT EXPOSURE DEVICE $263.00 HC81101396 FOAM STABILITY $263.00 HC32001000 OT-MANUAL THER S0FT TIS MOB/W $263.00 HC31001563 PT-GROUP EDUCATION MIN 1HR/W $263.00 16714-393-01 CEFDINIR 250 MG/5 ML ORAL SUSR $262.86 0781-3443-94 FONDAPARINUX 2.5 MG/0.5 ML SUBCUTANEOUS SYRG $262.54 47335-891-80 TEMOZOLOMIDE 20 MG ORAL CAP $262.41 63323-229-30 PROTAMINE 10 MG/ML IV SOLN $262.28 HC81700627 HCG QUAL URINE $262.00 HC84200674 MOLD ID EA ORG $262.00 HC11500824 PEDS ESTAB PT ASSESS LTD(10') $262.00 HC62214010 SET CATH CVC QUAD LUMEN $262.00 HC62211578 SET TUBING DUAL WND IRRIG/SUCTN $262.00 HC51001758 X-RAY HAND 3+ VW $262.00 0703-5748-11 CISPLATIN 1 MG/ML IV SOLN $261.95 3877907438 COMPOUND VEHICLE SUSP SF NO.20 ORAL SUSP $261.33 3877907448 COMPOUNDING VEHICLE SYRUP NO23 ORAL SYRP $261.33 60432-606-16 PROMETHAZINE-CODEINE 6.25-10 MG/5 ML ORAL SYRP $261.33 60432-608-16 PROMETHAZINE 6.25 MG/5 ML ORAL SYRP $261.33 0407-1413-10 IOHEXOL 300 MG IODINE/ML IV SOLN $261.30 HC36800654 CALCIUM IONIZED $261.00 HC62208699 DEVICE INFLATE SINUS BALLOON $261.00 HC32001331 OT- TM CONF INTERDISCPLN NO PT/FAM, WQHCP 30MIN $261.00 HC31000607 PT- TM CONF INTERDISCPLN NO PT/FAM, WQHCP 30MIN $261.00 HC51010551 TEST CHALLENGE INGEST ADD 60MIN $261.00 0496-0882-07 LIDOCAINE-TRANSPARENT DRESSING 4 % TOPICAL KIT $260.39 HC51062818 CHRONIC CARE MGMT INITL 20MIN, PER MONTH $260.00 HC51061489 ECG EXT HOLTER >7DAYS-15DAYS; SCANNING ANYS W/REPORT $260.00 HC62203112 ET POUCH/BAG UROSTOMY $260.00 HC89020044 HLA-DQA1(PNL 6260/6360)-PR $260.00 HC89020051 HLA-DQB1(PNL 6260/6360)-PR $260.00 HC62224068 HOLDER PIN $260.00 HC62204219 KIT RESPIRATORY $260.00 HC62202080 NEEDLE BX SPECIALTY $260.00 HC51070415 PSYCH PSYCHOANALYSIS $260.00 HC35000199 REC- TM CONF INTERDISCPLN NO PT/FAM, WMD 30MIN $260.00 HC89018279 SEROTONIN RELEASE ASSAY- QN $260.00 HC62206966 SUPPORT LUMBAR-SACRAL $260.00 HC51062883 TRANSITIONAL CARE MANAGE SERVICE MOD DECSN 14 DAY DISCHRG $260.00 HC62207253 TRAY AMNIOCENTESIS $260.00 HC51061893 X-RAY UPPER EXTREMITY INFANT MIN 2 VWS $260.00 HC51062925 REMOTE AUTO SYSTM INSULIN DOSE CALC; INTL SETUP $260.00 HC51062669 M: MISCL PROCEDURE $260.00 0054-3505-47 LIDOCAINE HCL 4 % (40 MG/ML) MUCOUS MEMB SOLN $260.00 0338-1075-02 DOBUTAMINE IN D5W 500 MG/250 ML (2,000 MCG/ML) IV SOLP $260.00 0517-8905-10 METHYLDOPATE 250 MG/5 ML IV SOLN $260.00 14789-109-10 POTASSIUM CHLORIDE IN WATER 10 MEQ/100 ML IV PGBK $260.00 14789-109-16 POTASSIUM CHLORIDE IN WATER 10 MEQ/100 ML IV PGBK $260.00 25021-253-51 CISPLATIN 1 MG/ML IV SOLN $260.00 25021-815-30 LEUCOVORIN CALCIUM 200 MG INJ SOLN (MCH) $260.00 31722-203-31 LACOSAMIDE 200 MG/20 ML IV SOLN $260.00 39822-1077-1 VORICONAZOLE 200 MG IV SOLR $260.00 42702-103-05 PHENYLEPHRINE HCL 10 % OPHT DROP $260.00 43598-452-02 ALBENDAZOLE 200 MG ORAL TAB $260.00 43598-476-11 DAPTOMYCIN 350 MG IV SOLR $260.00 51754-5060-1 BETAMETHASONE ACET,SOD PHOS 6 MG/ML INJ SUSP $260.00 55150-282-09 ERTAPENEM 1 GRAM INJ SOLR $260.00 63323-673-05 PALONOSETRON 0.25 MG/5 ML IV SOLN $260.00 67457-480-40 METHOTREXATE SODIUM (PF) 25 MG/ML INJ SOLN $260.00 67457-529-20 LEUCOVORIN CALCIUM 200 MG INJ SOLR $260.00 67457-853-50 ACETAZOLAMIDE SODIUM 500 MG INJ SOLR $260.00 70594-053-01 DAPTOMYCIN 350 MG IV SOLR $260.00 63323-713-03 LINEZOLID IN DEXTROSE 5% 600 MG/300 ML IV PGBK $259.35 63323-713-13 LINEZOLID IN DEXTROSE 5% 600 MG/300 ML IV PGBK $259.35 HC83504324 ANATOMIC CONSULT; SLIDE REV-MA $259.00 HC81700783 HEPATITIS B SURFACE AG CONFIRM $259.00 HC81701831 HSV TYPE 2 AB, IGG $259.00 69238-2122-9 PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLN $258.80 54482-145-08 LEVOCARNITINE (WITH SUGAR) 100 MG/ML ORAL SOLN (MCH) $258.48 42494-409-01 CHLORDIAZEPOXIDE-CLIDINIUM 5-2.5 MG ORAL CAP $258.37 0121-0820-16 THEOPHYLLINE 80 MG/15 ML ORAL ELIX $258.26 23155-313-31 ACETAZOLAMIDE SODIUM 500 MG INJ SOLR $258.05 HC89017883 MICRODISSECTION, MANUAL-NG $258.00 HC39000237 PSY TM CONF W/MD 30/+MIN(NO PT) $258.00 HC39001524 PSY-BEHAVIOR ASSESS/RE-ASSESS $258.00 HC39001532 PSY-BEHAVIOR TX INDIV 1ST 30 MIN $258.00 0065-0397-02 CYCLOPENTOLATE 2 % OPHT DROP $257.92 HC62217955 ORTHOSIS SHOULDER FIGURE 8 PREFAB $257.00 HC62206057 SENSOR BISPECTRAL INDEX $257.00 0264-1933-10 AMINO ACID 10 % 10 % IV SOLP $256.75 44567-621-01 CALCIUM GLUC IN NACL, ISO-OSM 2 GRAM/100 ML IV SOLN $256.75 44567-621-24 CALCIUM GLUC IN NACL, ISO-OSM 2 GRAM/100 ML IV SOLN $256.75 70860-782-10 FOSAPREPITANT 150 MG IV SOLR $256.75 70860-783-10 FOSAPREPITANT 150 MG IV SOLR $256.75 70860-200-17 PACLITAXEL 6 MG/ML IV CONC $256.72 45802-046-35 GENTAMICIN 0.1 % TOPICAL OINT $256.72 45802-056-35 GENTAMICIN 0.1 % TOPICAL CREAM $256.72 0065-0023-15 CARBACHOL 0.01 % INTRAOCULAR SOLN $256.04 HC84200260 BACTERIAL ANTIGENS EIA $256.00 HC62200332 BAG NEONATAL HYPERIFLATION $256.00 HC81700486 RUBEOLA AB IGG $256.00 HC81500191 THIN SMEAR, BLOOD PARASITES $256.00 386000404 NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRA $255.06 67386-820-19 DROXIDOPA 100 MG ORAL CAP $255.05 0024-5926-05 INSULIN LISPRO 100 UNIT/ML SUBCUTANEOUS SOLN $255.00 99999-035-29 INSULIN LISPRO 100 UNIT/ML SUBCUTANEOUS SOLN (INSULIN PUMP) $255.00 HC62204417 KNIFE MICROSURGICAL $255.00 HC51070449 PSYCH FAMILY GROUP THERAPY $255.00 HC84200112 WET MOUNT $255.00 78206-118-01 BETAMETHASONE ACET,SOD PHOS 6 MG/ML INJ SUSP $255.00 0121-1984-10 LACOSAMIDE 10 MG/ML ORAL SOLN $254.93 0121-1984-95 LACOSAMIDE 10 MG/ML ORAL SOLN $254.93 0121-2024-10 LACOSAMIDE 10 MG/ML ORAL SOLN $254.93 0407-1412-08 IOHEXOL 240 MG IODINE/ML IV SOLN $254.80 0407-1412-30 IOHEXOL 240 MG IODINE/ML IV SOLN $254.80 0574-0866-01 CYCLOSPORINE 250 MG/5 ML IV SOLN $254.18 0574-0866-10 CYCLOSPORINE 250 MG/5 ML IV SOLN $254.18 HC81700056 BETA-2 MICROGLOBULIN $254.00 HC84600022 CYTOLOGY FILTER ONLY $254.00 HC51061505 ECG EXT PT ACTV EVENT MONITOR ATTEND 24HRS-30DAYS; TRANSMIT/ANYS $254.00 HC51060184 OT-DEVEL TEST PER STANDARD INSTRUMENT(SCREENING) $254.00 HC32001018 OT-MANUAL THER JOINT MOB/W $254.00 HC32000994 OT-MANUAL THER MYOFASC REL/W $254.00 HC51061869 X-RAY PELVIS COMPLETE MIN 3 VWS $254.00 99988-000-32 NM I-131 SODIUM IODIDE DIAGNOSTIC CAPSULE $253.64 0517-1980-01 DICYCLOMINE 10 MG/ML IM SOLN $253.50 0517-1980-05 DICYCLOMINE 10 MG/ML IM SOLN $253.50 0941-0459-02 PERITON.DIALYSIS 8-4.25 % DEXT CA 2.5 MEQ/L- MG 0.5 MEQ/L IP SOLN $253.50 17478-015-02 DICYCLOMINE 10 MG/ML IM SOLN $253.50 HC11200031 OBSERVATION PER HOUR - MED/SURG $253.00 HC81100067 OSMOLALITY URINE $253.00 HC51060200 OT-DYSPHAGIA/SWALLOW TX/M $253.00 HC33000670 ST- TM CONF INTERDISCPLN NO PT/FAM, WQHCP 30MIN $253.00 HC51001691 X-RAY HUMERUS; MIN 2 VWS $253.00 63323-011-15 CHLORAMPHENICOL SOD SUCCINATE 1 GRAM IV SOLR $252.98 70752-138-12 PROMETHAZINE 6.25 MG/5 ML ORAL SYRP $252.11 HC62215272 BLADE SAW N $252.00 HC62214218 CATH URETERAL N $252.00 HC62202254 DEVICE INFLAT ENCORE D $252.00 HC11200000 OBSERVATION PER HOUR $252.00 HC22000061 OST EST PT EVAL LVL2-(10MIN) $252.00 HC62221965 PIN CHECKPOINT TIBL/FEMORAL ROBOTIC $252.00 HC62216510 PIN/WIRE FIXATION TEMPORARY N $252.00 HC62221338 SET AUTOTRANSFUSE K $252.00 HC62217773 TEMPLATE ORTHO/ROD SPINAL E $252.00 63323-406-03 CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) ORAL SOLN $251.88 0517-5602-25 HYDROXYZINE HCL 50 MG/ML IM SOLN $251.88 73302-456-01 ULIPRISTAL 30 MG ORAL TAB $251.88 HC89014898 CHROM ANAL-TISSUE-TISSU CUL-GZ $251.75 58914-501-01 MESALAMINE 1,000 MG RECTAL SUPP $251.72 58914-501-56 MESALAMINE 1,000 MG RECTAL SUPP $251.72 50242-122-06 PIRFENIDONE 267 MG ORAL TAB $251.56 63323-285-55 ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJ SOLN $251.55 0168-0162-15 CLOBETASOL 0.05 % TOPICAL OINT $251.36 51672-1259-1 CLOBETASOL 0.05 % TOPICAL OINT $251.36 HC29000635 COUNSEL ASSESS CA LUNG SCREEN LDCT $251.00 HC51061430 ECG EXT HOLTER UP TO 48HRS; SCANNING ANYS & REPORT $251.00 HC51001949 ECG EXT HOLTER W/CONNECT UP TO 48HRS; RECORD $251.00 HC35500149 MT-BEHAVIOR ASSESS/RE-ASSESS $251.00 HC35500156 MT-BEHAVIOR TX INDIV 1ST 30 MIN $251.00 HC35000181 REC- TM CONF INTERDISCPLN F2F PT/FAM WQHCP 30MIN $251.00 HC51020410 SC INFUSION THERAPY; ADD'L SET UP NEW SITE $251.00 25021-671-82 ROPIVACAINE PF 0.2% AUTOFUSER PUMP $250.90 0069-6001-02 FOSPHENYTOIN 100 MG PE/2 ML INJ SOLN $250.29 0069-6001-25 FOSPHENYTOIN 100 MG PE/2 ML INJ SOLN $250.29 16714-886-01 BLEOMYCIN 15 UNIT INJ SOLN (MCH) $250.19 HC89016935 ANATOMIC CONSULT; CMPLX REV-JH $250.00 HC89014997 CHROM ANAL AF COUNTING-GZ $250.00 HC83503920 TISSUE IN-SITU HYBRI INTER-US $250.00 HC89014187 MYELIN MOG AB W/ REFLEX TITER CBA-IFA-AU $250.00 HC51063253 EMG STIM GUIDE W/ CHEMODENERVATION $250.00 HC81100422 AMYLASE $249.00 HC83000273 CMV IGM $249.00 HC89017479 FUNGUS SUSCEPTIBILITY-FT $249.00 HC84600576 PAP THIN LAYER MNL SCRN DX $249.00 HC84600089 PAP THIN LAYER PREP MANL SCRN $249.00 HC51001683 X-RAY SHOULDER; COMPLETE MIN 2 VWS $249.00 17478-215-02 ATROPINE 1 % OPHT DROP $248.89 0049-3420-41 FLUCONAZOLE 100 MG ORAL TAB $248.63 49281-215-10 TETANUS AND DIPHTHER. TOX (PF) 5 LF UNIT- 2 LF UNIT/0.5ML IM SUSP $248.56 49281-215-15 TETANUS AND DIPHTHER. TOX (PF) 5-2 LF UNIT/0.5 ML IM SYRG $248.56 HC11500899 HOSPITAL OUTPATIENT CLINIC VISIT (FACILITY FEE) $248.00 HC32001471 OT-DEVEL TEST PER STANDARD INSTRUMENT(SCREENING) $248.00 HC62205430 PACK TOTAL JOINT $248.00 HC62229174 BOOT WLKNG AIR W/WO JNTS PREFB F $248.00 50419-451-04 ESTRADIOL 0.05 MG/24 HR TRANSDERMAL PTWK $247.98 0998-0016-15 PROPARACAINE 0.5 % OPHT DROP $247.94 51672-1298-2 KETOCONAZOLE 2 % TOPICAL CREAM $247.26 HC84200773 AFB STAIN DIRECT $247.00 HC81700304 EXTRCTBL NUCLEAR AG AB TO ECH $247.00 HC81700411 HELICOBACTER PYLORI IGG AB $247.00 HC14500052 PREGNANCY DIAB MGT 30MIN $247.00 HC31001480 PT-THER PROC GRP 45MIN/MC $247.00 HC81701484 SCLERODERMA SCL-70 AB, IGG $247.00 HC81700692 SJORGEN SYNDROME AB SSA EIA $247.00 HC81700700 SJORGEN SYNDROME AB SSB EIA $247.00 HC81700718 SMITH ANTIBODY EIA $247.00 0703-5656-01 ETOPOSIDE 20 MG/ML IV SOLN $247.00 43598-931-09 DESMOPRESSIN 4 MCG/ML INJ SOLN $247.00 43598-931-11 DESMOPRESSIN 4 MCG/ML INJ SOLN $247.00 70954-518-10 LIDOCAINE HCL 4 % (40 MG/ML) MUCOUS MEMB SOLN $247.00 99999-041-81 VANCOMYCIN IN NS 1750 MG/500 ML IV SOLN (MHS) $247.00 0574-4031-25 TOBRAMYCIN-DEXAMETHASONE 0.3-0.1 % OPHT DRPS $246.55 61314-647-25 TOBRAMYCIN-DEXAMETHASONE 0.3-0.1 % OPHT DRPS $246.55 HC62220827 BAG/POUCH RETRIEVAL SPECMN ENDO C $246.00 HC62200944 CABLE PACING DISP E $246.00 HC62201009 CANNULA ERCP G $246.00 HC62201249 CATH BONNANO $246.00 HC62806039 CATH DIALYSIS SHORT-TERM D $246.00 HC62218268 CATH INTRODUCER PEEL-AWAY I $246.00 HC62225529 CATH UMBILICAL G $246.00 HC62225925 COLLAR GYN BRACHYTHERAPY $246.00 HC62202247 DEVICE HOLD OCCL LEVERAGE $246.00 HC62218722 DRILL/DRILL BITS SINGLE USE G $246.00 HC62212543 FORCEP BIOPSY DISP D $246.00 HC62212691 GUIDEWIRE D $246.00 HC62219456 KIT STARTER B-CPAP INFANT $246.00 HC62226089 TIP SACRO SURG DISP $246.00 HC62207469 TRAY NASAL HEMORRHAGE $246.00 HC62207477 TRAY PARACERVICAL $246.00 66689-063-01 PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2 MG-0.1037 MG/5 ML (5 ML) ORAL ELIX $245.70 HC37000031 MNT INITIAL ASSESS INDIV EA 15MIN 1ST REF $245.00 HC83000398 SERUM PRETREATMNT W/INHIB EA $245.00 0517-0955-01 OLANZAPINE 10 MG IM SOLR $244.92 0703-9526-01 SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG/5 ML IV SOLN $244.53 67457-779-30 SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG/5 ML IV SOLN $244.53 HC81500753 HEPARIN NEUTRALIZATION $244.00 HC41500653 MONITOR NEURO INTRAOP CONT REMOTE PER PT 15MIN+ $244.00 HC83000406 SERUM PRETREATMNT/ABSORPTION $244.00 16714-973-02 PHYTONADIONE (VITAMIN K1) 5 MG ORAL TAB $243.83 55150-302-01 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $243.75 99999-011-09 ESTRADIOL VALERATE 20 MG/ML IM OIL $243.19 HC81700684 ANTI SMOOTH MUSC/RNP AB $243.00 HC51062537 CONTROL NASAL HEMORRHAGE,ANTERIOR,SIMPLE TX $243.00 HC51004042 INHALATION TREATMENT INITIAL $243.00 HC62211479 PROBE VASCULAR PARSONNET $243.00 HC81700643 PSA COMPLEXED $243.00 HC39000518 PSY-TEAM CONF W/PT &3D 30MINOR> $243.00 HC51062578 REMOVAL FB FRM EAR $243.00 HC51061877 X-RAY SCAPULA $243.00 63402-204-30 ESLICARBAZEPINE 400 MG ORAL TAB $242.78 0075-2915-01 ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRG $242.24 HC36800464 BLOOD GAS O2 SAT ONLY $242.00 HC81101388 HGB O2 AFFINITY $242.00 HC89009401 ORGANIC ACIDS TOT QUANT UR-QD $242.00 HC32000135 OT-FUNCTIONAL ACTIVITY 15MIN $242.00 HC82202813 PREP SURG TISSUE NON-MICRO STUDIES+ $242.00 HC31000052 PT-AQUATIC THERAPY 15MIN/M $242.00 HC33000472 ST-CASE CONFERENCE 30MIN/C $242.00 HC62217203 VEST SYSTEM OSCIL FREQU HI CHEST $242.00 HC51000123 VOIDING PRESSURE STUDIES+ $242.00 386000802 PENTAFLUOROPROPANE-TETRAFLUOROETHANE TOPICAL SPRAY (MHS) $241.80 63739-997-64 LIDOCAINE HCL 4 % (40 MG/ML) MUCOUS MEMB SOLN $241.80 71699-050-30 CENOBAMATE 50 MG ORAL TAB $241.20 HC51000537 CHEMO NONHRMNL ANTINEOPL SQ/IM $241.00 HC62208921 DEVICE EXCHANGE CATH/WIRE $241.00 HC51010429 EMG THORACIC PARASPINAL(NO T1/T12) $241.00 HC83504910 MORPH STDY CAT ISH/SPEC INTL SNGL PROBE HER2-NG $241.00 HC32001703 OT-AQUATIC THERAPY 15MIN/M $241.00 HC31000201 PT-THER ACTIVITIES 15MIN/M $241.00 HC62205927 RESERVIOR JACKSON PRATT $241.00 HC62223094 TUBING PERFUSION PACK PUMP $241.00 HC51002376 US PELVIC(NON OB)LTD OR F/U $241.00 HC51001857 X-RAY ANKLE 3+ VWS $241.00 64980-503-12 LEVOCARNITINE (WITH SUGAR) 100 MG/ML ORAL SOLN (MCH) $240.84 0264-4500-00 PARENTERAL AMINO ACID 15% NO.6 15 % IV SOLP $240.50 0781-3466-70 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $240.50 62856-274-30 PERAMPANEL 4 MG ORAL TAB $240.07 HC81700429 HIV-1 & HIV-2 AB SNGL ASSAY $240.00 HC51010643 IMMNTX 5 STING INSECTS /COMM $240.00 99999-041-18 FLUORESCEIN-PROPARACAINE 0.25-0.5 % OPHT DROP $239.53 54482-147-01 LEVOCARNITINE 200 MG/ML IV SOLN $239.01 HC81101321 BLOOD GAS O2 SAT ONLY $239.00 HC62224670 CATH SENSING PRESSUR INTRNL VESICAL $239.00 HC81700460 HEPATITIS A ANTIBODY $239.00 HC62221114 KIT PRESSURE MONITOR INTRACOMPRTMNT $239.00 HC39000153 PSY MED RECORD REVIEW $239.00 HC31000904 PT-INITIAL EVAL ADDL 15MIN/CW $239.00 0143-9531-01 IFOSFAMIDE 1 GRAM/20 ML IV SOLN $238.81 0703-3427-11 IFOSFAMIDE 1 GRAM/20 ML IV SOLN $238.81 10019-925-01 IFOSFAMIDE 1 GRAM IV SOLR $238.81 10019-925-82 IFOSFAMIDE 1 GRAM IV SOLR $238.81 61703-408-41 METHOTREXATE SODIUM (PF) 25 MG/ML INJ SOLN $238.68 HC89018840 CHROM ANAL TISSUE POC-AU $238.50 HC62201926 COLLAR CERVICAL HARD $238.00 HC51004125 DIFFUSING CAPACITY+ /M $238.00 HC81701898 HIV TYPE 1 OR 2ANTIBODY(RAPID) $238.00 HC62215876 NEEDLE BIOPSY I $238.00 HC81500597 PT SUBS PLASMA FRACTIONS EA $238.00 HC35000207 REC TM CONF INTERDISCPLN NO PT/FAM, WQHCP 30MIN $238.00 HC51003812 REMOV SKIN TAGS UP TO&INCL 15 LESIONS $238.00 HC62215587 SUTURE I $238.00 HC51061745 X-RAY SPINE 1 VIEW ANY LEVEL $238.00 99999-041-50 NM TC-99M PYROPHOSPHATE (PYP) MHS $238.00 24208-398-30 IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASL SPRY $237.32 24208-399-15 IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASL SPRY $237.22 HC11500022 EST PT LOW MDM 20-29 MIN $237.00 HC81700510 HEPATITIS C AB $237.00 HC62212246 MARKER DEVICE BIOPSY $237.00 HC81100679 OSMOLALITY $237.00 HC32010092 OT-EVAL HIGH COMPLEXITY 60MIN [15MIN] $237.00 HC34000497 AUDIOMETRY SELECT PICTURE $237.00 0093-0262-15 FLUOCINONIDE 0.05 % TOPICAL CREAM $236.83 51672-1386-1 FLUOCINONIDE 0.05 % TOPICAL CREAM $236.83 HC89020069 LACTO TYPE (LCT)(CAT #6100-2013) -PR $236.80 69945-602-20 SODIUM IODIDE-123 7.4 MBQ (200 MICROCI) ORAL CAP $236.78 16714-037-01 EPHEDRINE SULFATE 50 MG/ML IV SOLN (MHS) $236.63 51552-1345-1 LIDOCAIN-EPI-TETRACAIN COMP KT 4-0.18-0.5 % TOPICAL SOLN $236.60 61703-326-18 PAMIDRONATE 90 MG/10 ML (9 MG/ML) IV SOLN $236.54 51672-4048-6 CLOTRIMAZOLE-BETAMETHASONE 1-0.05 % TOPICAL CREAM $236.05 HC84200583 CRYPTCOCCUS AB QNT BLOOD $236.00 HC81101925 DRUG TEST PRESUMP DIRECT OBSERV/ DOS $236.00 HC81700445 HEPATITIS B CORE AB IGM $236.00 HC32001422 OT-COMMTY WK/REINTEGRAT 30M/CW $236.00 HC32010084 OT-EVAL MOD COMPLEXITY 45MIN F2F [15MIN] $236.00 HC32000549 OT-THER EXER 15MIN/M $236.00 HC32001364 OT-THER PROC GRP 45MIN/M $236.00 HC81701120 PARTICLE AGGLUT TITER EACH AB $236.00 HC31001084 PT-MANUAL THER MYOFASC REL/W $236.00 HC31001092 PT-MANUAL THER S0FT TIS MOB/W $236.00 HC31000615 PT-THER EXER 15MIN/M $236.00 HC51001865 X-RAY FOOT 3+ VWS $236.00 16714-527-01 IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASL SPRY $235.27 HC62201959 CONCHA COLUMN STANDARD $235.00 HC51002970 DILATION URETHRAL FEMALE SUBSEQUENT $235.00 HC25006016 EST PT LVL2-PROB FOCUS $235.00 HC81101156 HEMOGLOBIN GLYCATED (A1C) $235.00 HC11500535 LACTATION E&M INTRMD EST'L:III $235.00 HC81500563 LEUKOCYTE ALK PHOS W/ COUNT $235.00 HC32000150 OT-GAIT TRAINING 15MIN/M $235.00 HC39000161 PSY FAMILY CONFERENCE $235.00 HC31010077 PT-EVAL HIGH COMPLEXITY 45M F2F [15MIN] $235.00 HC31000227 PT-GAIT TRAINING 15MIN/M $235.00 HC51002558 REMOV IMPACTD EAR WAX IRRIG/LAVG BI $235.00 HC36800563 RT RESP THER GRP 30 MIN/MW $235.00 HC62207972 TUBING SILICON $235.00 63323-170-15 SODIUM PHOSPHATE 3 MMOL/ML IV SOLN $234.98 63323-881-01 SODIUM PHOSPHATE 3 MMOL/ML IV SOLN $234.98 63323-881-16 SODIUM PHOSPHATE 3 MMOL/ML IV SOLN $234.98 63323-103-65 CISPLATIN 1 MG/ML IV SOLN $234.65 63323-401-01 AZTREONAM 1 G INJ SOLR (MCH) $234.52 63323-401-20 AZTREONAM 1 G INJ SOLR (MCH) $234.52 51672-1302-0 TERCONAZOLE 0.8 % VAGINAL CREAM $234.13 HC12200309 EXTENDED RECOVERY PER HOUR $234.00 HC81700437 HEPATITIS B CORE AB, TOT $234.00 HC32010258 OT-AQUATIC THERAPY 15MIN $234.00 HC32000838 OT-INITIAL EVAL ADD 15MIN/CW $234.00 HC29000577 PREVENTATIVE MED COUNSELING 45MIN $234.00 HC31010218 PT-AQUATIC THERAPY 15MIN $234.00 HC31010028 PT-EVAL MOD COMPLEXITY 30M F2F [15MIN] $234.00 HC51004158 REMOV IMPACTD EAR WAX(INSTRUMENT) BI (NO MOD50) $234.00 HC51001972 US MEASUR POST-VD RES&/BLDR CAP NO IMG $234.00 0054-0045-44 IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASL SPRY $234.00 0054-0046-41 IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASL SPRY $234.00 49884-907-38 MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSP $234.00 51672-1304-6 TERCONAZOLE 0.4 % VAGINAL CREAM $234.00 60505-0826-1 IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASL SPRY $234.00 60505-0827-1 IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASL SPRY $234.00 64380-160-01 MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSP $234.00 65862-048-24 ZIDOVUDINE 10 MG/ML ORAL SYRP $234.00 69292-722-25 FLURBIPROFEN SODIUM 0.03 % OPHT DROP $234.00 71285-0431-1 AA 3.5% NO.2 PED-D10W-HEPARIN 3.5 %-10 %- 125 UNIT/250 ML IV SOLP $234.00 60432-651-04 DOXEPIN 10 MG/ML ORAL CONC $233.94 0093-3174-31 ALBUTEROL SULFATE 90 MCG/ACTUATION INHALATION HFAA $233.87 45802-088-01 ALBUTEROL SULFATE 90 MCG/ACTUATION INHALATION HFAA $233.87 68180-963-01 ALBUTEROL SULFATE 90 MCG/ACTUATION INHALATION HFAA $233.87 0781-7296-85 ALBUTEROL SULFATE 90 MCG/ACTUATION INHALATION HFAA $233.86 5865731016 SODIUM CITRATE-CITRIC ACID 500-334 MG/5 ML ORAL SOLN $233.66 6025800116 SODIUM CITRATE-CITRIC ACID 500-334 MG/5 ML ORAL SOLN $233.66 0121-0942-16 PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIX $233.66 63629-2399-1 PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIX $233.66 0121-0888-05 ATOVAQUONE 750 MG/5 ML ORAL SUSP (MCH) $233.64 66689-062-01 ATOVAQUONE 750 MG/5 ML ORAL SUSP $233.64 0006-4831-41 HEPATITIS A VIRUS VACCINE (PF) 25 UNIT/0.5 ML IM SUSP $233.40 60219-1748-2 ATROPINE 1 % OPHT DROP $233.35 386000803 NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRA $233.22 HC84200427 INFLUENZA ANTIGEN DIRECT OPT $233.00 HC32000002 OT-ADL 15MIN $233.00 HC84200757 OVA/PARASITE-CONC PREP W/SMEAR $233.00 HC62808647 PESSARY RUBBER $233.00 HC39000245 PSY TM CONFW/NONMD 30/+MIN(NO PT $233.00 HC31000003 PT-SELF/HOME MGMT/ADL 15MIN/M $233.00 HC35000074 REC' THER' TX ADD'L 15 MIN $233.00 5898096031 EMOLLIENT COMBINATION NO.10 TOPICAL EMUL $232.25 24208-580-60 GENTAMICIN 0.3 % OPHT DROP $232.12 HC62201876 CLIP RANEY $232.00 HC62202957 ENDO SCRUB SHEATH $232.00 HC39001292 PSYCH/NEUROPSYCH TEST ADMIN & SCORING, 2 OR > TESTS; EA ADDL 30MIN+ $232.00 HC39001417 PSY-DEVEL TEST PER STANDARD INSTRUMENT(SCREENING) $232.00 HC81100794 URINALYSIS AUTO W/ MICROSCOPY $232.00 HC62221585 VALVE HEMOSTATIC W/GUIDEWIRE $232.00 99999-041-25 BRIVARACETAM 10 MG/ML ORAL SOLN $231.86 0409-1464-01 NALBUPHINE 10 MG/ML INJ SOLN $231.79 HC77400190 ANESTHESIA LOCAL EA ADD 15MIN $231.00 HC83504795 MORPH STDY CAT ISH QNT HER2-NG $231.00 HC83504803 MORPH STDY CAT ISH QNT/SPEC INTL SNGL PROBE CEP17-NG $231.00 HC32000226 OT-HUBBARD TANK 15MIN/M $231.00 HC32000317 OT-MANUAL THERAPY 15MIN/M $231.00 HC39000609 PSYCH CASE CONF 30MIN $231.00 HC31000292 PT-HUBBARD TANK 15MIN/M $231.00 HC31000383 PT-MANUAL THERAPY 15MIN/M $231.00 24201-100-01 ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN $230.75 24201-100-24 ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN $230.75 121067616 POTASSIUM CITRATE-CITRIC ACID 1,100-334 MG/5 ML ORAL SOLN $230.59 55150-308-01 OLANZAPINE 10 MG IM SOLR $230.36 HC81701138 HEP A ANTIBODY IGM $230.00 HC32010076 OT-EVAL LOW COMPLEXITY 30MIN F2F [15MIN] $230.00 HC32000333 OT-NEUROMUSC RE-ED 15MIN/M $230.00 HC31000409 PT-NEUROMUSC RE-ED 15MIN/M $230.00 HC31010051 PT-THER EXER 15MIN $230.00 4056511182 BENZOIN TOPICAL TINC $229.33 63323-734-10 PAMIDRONATE 30 MG/10 ML (3 MG/ML) IV SOLN $229.13 HC62201488 CATH INTRODUCER $229.00 HC28000057 CR EST PT EVAL LVL2-(10MIN) $229.00 HC51010791 EAR WICK (UNLISTED PROCEDURE) $229.00 HC32010050 OT-THER EXER 15MIN $229.00 HC62801600 PEG REPLACEMENT $229.00 HC39001409 PSY-ASSESS BEHAVIOR W/SCORE & DOCD/STAND INSTRUMENT $229.00 HC31001100 PT-MANUAL THER JOINT MOB/W $229.00 HC51002186 UROFLOWMETRY SIMPLE $229.00 58160-825-43 HEPATITIS A VIRUS VACCINE (PF) 720 ELISA UNIT/0.5 ML IM SYRG $228.28 58160-825-52 HEPATITIS A VIRUS VACCINE (PF) 720 ELISA UNIT/0.5 ML IM SYRG $228.28 0187-3013-30 PYRIDOSTIGMINE BROMIDE 180 MG ORAL TBSR $228.22 0641-6006-01 ATROPINE 0.4 MG/ML INJ SOLN $228.15 0641-6006-10 ATROPINE 0.4 MG/ML INJ SOLN $228.15 16729-512-05 ATROPINE 0.4 MG/ML INJ SOLN $228.15 16729-512-43 ATROPINE 0.4 MG/ML INJ SOLN $228.15 61314-016-01 PROPARACAINE 0.5 % OPHT DROP $228.15 24208-730-06 PROPARACAINE 0.5 % OPHT DROP $228.05 HC81101370 BLOOD GAS PH ONLY $228.00 HC89014872 CHROM ANAL BLOOD TISSU CULT-GZ $228.00 HC84201060 CRYPTOSPORIDIUM $228.00 HC84200922 GIARDIA $228.00 HC11500477 LACTATION E&M LIMITD NEW L:II $228.00 HC81100646 LDH $228.00 HC32000044 OT-COMMTY WK/REINTEGRAT 15M/M $228.00 HC32010043 OT-FUNCTIONAL ACTIVITY 15MIN $228.00 HC32010019 OT-SELF/HOME MGMT/ADL 15MIN $228.00 HC32001307 OT-THER PROC GRP 45MIN/MC $228.00 HC84200351 PARTICLE AGGLUTINATION EA AB $228.00 HC31000144 PT-COMMTY WK/REINTEGRT 15M/M $228.00 HC31010069 PT-EVAL LOW COMPLEXITY 20MIN F2F [15MIN] $228.00 HC31010036 PT-GAIT TRAINING 15MIN $228.00 HC31010002 PT-SELF/HOME MGMT/ADL 15MIN $228.00 HC31010044 PT-THER ACTIVITIES 15MIN $228.00 HC84200070 STREP A ANTIGN SCRN(DIRECT OBS) $228.00 HC51001832 X-RAY TIBULA + FIBULA, 2 VWS $228.00 60432-604-16 PROMETHAZINE-DM 6.25-15 MG/5 ML ORAL SYRP $227.51 62559-190-16 METOCLOPRAMIDE HCL 5 MG/5 ML ORAL SOLN $227.51 65162-680-90 PROMETHAZINE-DM 6.25-15 MG/5 ML ORAL SYRP $227.51 70436-155-42 PROMETHAZINE-DM 6.25-15 MG/5 ML ORAL SYRP $227.51 0781-7135-93 MOXIFLOXACIN 0.5 % OPHT DROP $227.51 47335-289-40 CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) IV SOLN $227.51 0065-0817-02 ATROPINE 1 % OPHT DROP $227.50 0143-9086-01 DOXORUBICIN 50 MG/25 ML IV SOLN $227.50 0338-0108-20 NOREPINEPHRINE BITARTRATE-D5W 8 MG/250 ML (32 MCG/ML) IV SOLN $227.50 0641-6176-01 OCTREOTIDE ACETATE 500 MCG/ML INJ SOLN $227.50 0641-6176-10 OCTREOTIDE ACETATE 500 MCG/ML INJ SOLN $227.50 0703-3321-01 OCTREOTIDE ACETATE 500 MCG/ML INJ SOLN $227.50 0703-3321-04 OCTREOTIDE ACETATE 500 MCG/ML INJ SOLN $227.50 0781-6135-95 PENICILLIN G POTASSIUM 5 MILLION UNIT INJ SOLR $227.50 23155-689-31 OCTREOTIDE ACETATE 500 MCG/ML INJ SOLN $227.50 23155-689-41 OCTREOTIDE ACETATE 500 MCG/ML INJ SOLN $227.50 24571-102-06 BICARB DIALYSIS8 W-OUT CALCIUM K (2 MEQ/L) -MG (1 MEQ/L) HEMO SOLN $227.50 24571-105-06 BICARBONATE DIALYSIS SOLN NO.9 K (4 MEQ/L)-CA (2.5)-MG (1.5) HEMO SOLN $227.50 24571-108-06 BICARB DIALY SOLN 11 WITHOUT K CA (2.5 MEQ/L) -MG (1.5 MEQ/L) HEMO SOLN $227.50 24571-113-06 BICARB DIAL SOLN13-NO CA,K,DEX MG 1.2 MEQ/L HEMO SOLN $227.50 25021-453-01 OCTREOTIDE ACETATE 500 MCG/ML INJ SOLN $227.50 39822-1100-1 FOLIC ACID 5 MG/ML INJ SOLN $227.50 45963-733-68 DOXORUBICIN 50 MG/25 ML IV SOLN $227.50 55150-188-10 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN (FOR TOPICAL USE) $227.50 63323-325-09 ACYCLOVIR SODIUM 50 MG/ML IV SOLN $227.50 63323-325-20 ACYCLOVIR SODIUM 50 MG/ML IV SOLN $227.50 67457-224-00 NICARDIPINE 25 MG/10 ML IV SOLN $227.50 67457-224-10 NICARDIPINE 25 MG/10 ML IV SOLN $227.50 71839-104-01 FOSAPREPITANT 150 MG IV SOLR $227.50 99999-044-49 NOREPINEPHRINE IN NS 8 MG/250 ML (32 MCG/ML) IV SOLN (MHS) $227.50 62332-505-03 MOXIFLOXACIN 0.5 % OPHT DROP $227.43 HC51000289 HOSP OP CAST ROOM VISIT (FACILITY FEE) $227.00 HC51000396 HOSPITAL OUTPATIENT CLINIC VISIT (FACILITY FEE) $227.00 HC62203658 KIT ACCESSORY & LAPAROSCOPIC $227.00 HC22000012 OST NEW PT EVAL LVL2-(20MIN) $227.00 HC32010035 OT-NEUROMUSC RE-ED 15MIN $227.00 HC62211107 PACK CELL SAVER TUBING $227.00 HC31010010 PT-NEUROMUSC RE-ED 15MIN $227.00 HC62207717 TUBE MYRINGOTOMY $227.00 HC51001840 X-RAY ANKLE 2 VWS $227.00 HC51061901 X-RAY KNEE 1 OR 2 VWS $227.00 HC51061919 X-RAY LOWER EXTREMITY, INFANT MIN 2 VWS $227.00 HC51070944 HOSPITAL OP CLINIC VISIT W/ SIGNFCNT PRCDR (MOD25) $227.00 HC34000026 AUDIOMETRY THRESHOLD $226.00 HC81700742 CRYPTOCUCCUS AG - SERUM $226.00 HC81700023 FTA ABSORPTION $226.00 HC81700452 HEPATITIS B SURFACE AB $226.00 HC81701179 HIV 1 AB $226.00 HC51020238 RN-DEVEL TEST PER STANDARD INSTRUMENT(SCREENING) $226.00 HC81700197 T4 FREE $226.00 HC81700494 VARICELLA AB $226.00 HC11500949 WM EXAM NEW PT EVAL MINOR LVL 2 $226.00 HC51001733 X-RAY WRIST 2 VW $226.00 HC89023725 HIV-1 DNA PCR QUAL-QN $225.60 43066-150-10 AMIODARONE IN DEXTROSE,ISO-OSM 150 MG/100 ML (1.5 MG/ML) IV SOLN $225.55 HC83502252 ANATOMIC CONSULT; SLIDE REV-JH $225.00 HC89020929 ANSER IFX MEAS OF SER INFLIXIMAB-PR $225.00 HC89022776 ANSER VDZ MEAS OF SER VEDOLIZUMAB-PR $225.00 HC62201173 CASTING SUPPLIES SYNTHETIC $225.00 HC89000038 HLA TYPING-U2 $225.00 HC62208491 PAD EXTERNAL CLOSURE $225.00 HC51001899 X-RAY BONE LENGTH STUDIES $225.00 HC89024236 ANSER ADA MEAS ABS ADALIMUMAB(ATI)-PR $225.00 50383-667-30 LIDOCAINE-PRILOCAINE 2.5-2.5 % TOPICAL CREAM $224.64 16729-050-53 TEMOZOLOMIDE 100 MG ORAL CAP (MCH) $224.52 HC62215264 BLADE SAW M $224.00 HC62201108 CANNULA VENOUS F $224.00 HC62208996 CATH DIAGNOSTIC RADIAL $224.00 HC62201637 CATH URETERAL M $224.00 HC62200019 CAUTERY CORD $224.00 HC62219845 DRAIN BLAKE ROUND H $224.00 HC11500881 INFANT EXAM 20 MIN $224.00 HC89005086 INFECT AGNT-VARIC ZSTR PCR-FT $224.00 HC62224803 KIT REPAIR CATH DIALYSIS PERITONEAL $224.00 HC62204664 MAGNET DEVICE $224.00 HC32000341 OT-ORTHOTIC/PROSTH MGMT/TRAIN SUBSQ 15MIN/M $224.00 HC62215777 PIN/WIRE FIXATION TEMPORARY M $224.00 HC51070324 PSYCH GRP TX(NOT MULTI FAMILY)90MIN $224.00 HC31000078 PT-AQUATIC GRP 45MIN/M $224.00 HC31000417 PT-ORTHOTIC/PROSTH MGMT/TRAIN SUBSQ 15MIN/CMW $224.00 HC62217765 TEMPLATE ORTHO/ROD SPINAL D $224.00 HC62209770 TRANSCUTANEOUS MNTR SUPPLIES $224.00 HC62216775 TUBING IRRIGATION D $224.00 67877-732-95 LACOSAMIDE 10 MG/ML ORAL SOLN $223.60 0008-1041-05 SIROLIMUS 1 MG ORAL TAB $223.43 0008-1041-10 SIROLIMUS 1 MG ORAL TAB $223.43 HC89014963 15-20 CELLS, 2 KARYO,BAND-GZ $223.25 16729-277-35 METHOTREXATE SODIUM (PF) 25 MG/ML INJ SOLN $223.08 HC62205109 CABLE PACER DISP C $223.00 HC62202007 CO-SET CARDIAC OUTPUT $223.00 HC81701971 HEPATITIS C AB SCREENING $223.00 HC62206297 SET LACRIMAL INTUBATION $223.00 HC42000612 WCH EST PT LVL3-EXPANDED $223.00 HC51003887 X-RAY FEMUR MIN 2 VIEWS $223.00 HC51001741 X-RAY HAND 2 VW $223.00 HC51001774 X-RAY PELVIS 1 OR 2 VWS $223.00 0009-0013-05 HYDROCORTISONE SOD SUCC (PF) 250 MG/2 ML INJ SOLR $222.56 0009-0013-06 HYDROCORTISONE SOD SUCC (PF) 250 MG/2 ML INJ SOLR $222.55 63323-265-30 METHYLPREDNISOLONE SODIUM SUCC 1,000 MG IV SOLR $222.43 99988-000-21 NM TC-99M PYROPHOSPHATE (PYP) 1-25 MCI $222.43 51672-1300-5 AMMONIUM LACTATE 12 % TOPICAL LOTN $222.30 HC81702201 HIV 2 ANTIBODY $222.00 HC89001333 LOXAPINE & METABOLITE-AU $222.00 HC84201052 PARTICLE AGGLUTIN EA AB(PNL) $222.00 HC31010143 PT-MANUAL THERAPY 15MIN $222.00 HC35000173 REC-COMMTY WK/REINTEGRAT 15M $222.00 HC51060515 ST EVAL SPEECH FLUENCY/M $222.00 HC81500928 URINALYSIS AUTO W/ MICROSCOPY $222.00 61703-325-18 PAMIDRONATE 60 MG/10 ML (6 MG/ML) IV SOLN $221.65 0281-0326-30 NITROGLYCERIN 2 % TRANSDERMAL OINT $221.52 66689-008-16 NYSTATIN 100,000 UNIT/ML ORAL SUSP $221.52 0078-0467-61 DEFEROXAMINE 500 MG INJ SOLR $221.26 0078-0467-91 DEFEROXAMINE 500 MG INJ SOLR $221.26 HC32010167 OT-MANUAL THERAPY 15MIN $221.00 HC32010100 OT-RE-EVAL EST POC[15MIN] $221.00 HC62205307 PACK KNEE TOTAL $221.00 0019-1188-27 SALINE LOCK FLUSH (MCH-NICU) $221.00 0990-7172-17 PARENTERAL AMINO ACID 10% NO.1 10 % IV SOLP $221.00 63323-193-05 IRINOTECAN 100 MG/5 ML IV SOLN $221.00 63323-193-55 IRINOTECAN 100 MG/5 ML IV SOLN $221.00 63323-820-03 FAT EMUL-SOY-MCT-OLIV-FISH OIL 20 % IV EMUL $221.00 63323-820-50 FAT EMUL-SOY-MCT-OLIV-FISH OIL 20 % IV EMUL $221.00 24208-485-10 DORZOLAMIDE 2 % OPHT DROP $220.94 42571-141-26 DORZOLAMIDE 2 % OPHT DROP $220.94 HC51062800 COMPLEX CHRONIC CARE MGMT EA ADDL 30MIN, PER MO+ $220.00 HC89022693 HLA CLASS II TYPING LOW RES HLA-DRB1/3/4/5&-DQB1-U9 $220.00 HC32010175 OT-COMMTY WK/REINTEGRAT 15MIN $220.00 HC32010191 OT-DEV COGNITIVE SKILLS INITL 15MIN $220.00 HC81101875 PREGNANCY, HCG-UR (DA) $220.00 HC31010127 PT-COMMTY WK/REINTEGRT 15MIN $220.00 HC33010117 ST-DEV COGNITIVE SKILLS INITL 15MIN $220.00 HC81700502 THYROGLOBULIN AB $220.00 HC84200534 TRICHOMONAS RAPID TEST $220.00 HC51001675 X-RAY CLAVICLE $220.00 0069-0195-01 DALTEPARIN (PORCINE) 2,500 ANTI-XA UNIT/0.2 ML SUBCUTANEOUS SYRG $219.93 HC11500766 AM/PACU EVAL BRIEF-I $219.00 HC27001932 BIOFEEDBACK PERINEAL MSCLS W/EMG&/MNMTRY F2F 1ST 15MIN $219.00 HC81500977 HEMOGLOBIN GLYCATED (A1C) $219.00 HC11500063 NEW PT SF MDM 15-29 MIN $219.00 HC32000309 OT-IONTOPHORESIS 15MIN/MW $219.00 HC51060689 OT-SWALLOWING EVAL $219.00 HC31000375 PT-IONTOPHORESIS 15MIN/MW $219.00 HC31010085 PT-RE-EVAL EST POC[15MIN] $219.00 HC51060671 ST-SWALLOWING EVAL $219.00 45802-055-05 TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINT $218.37 63323-123-10 METHOTREXATE SODIUM 25 MG/ML INJ SOLN $218.34 0781-3299-05 ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRG $218.01 0781-3299-69 ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRG $218.01 HC62209747 CIRCUIT VENT HBO ADAPTABLE $218.00 HC81101834 HEPATITIS C VIRUS (DA) $218.00 HC39000930 INTERACTIVE COMPLEXITY+ $218.00 HC62202056 KIT BIOPSY GUN $218.00 HC84200476 OB FECAL IMM ASSAY QUAL 1-3 DX $218.00 HC32000929 OT-TREATMENT ADD 15 MIN/CW $218.00 HC62205265 PACK EYE $218.00 HC62219530 PASSER SUTURE E $218.00 HC31001878 PT-AQUATIC THERAPY ADD15MIN/CW $218.00 HC31010176 PT-BIOFEEDBACK PERINEAL MSCLS W/EMG&/MNMTRY F2F 1ST 15MIN $218.00 HC31000912 PT-RE-EVAL ADDL 15MIN/CW $218.00 HC33010059 ST EVAL SOUND W/LANG COMP&EXPRESS [15MIN] $218.00 49281-286-10 DIPH,PERTUS(ACEL),TET PED (PF) 15-10-5 LF-MCG-LF/0.5ML IM SUSP $217.75 49281-286-58 DIPH,PERTUS(ACEL),TET PED (PF) 15-10-5 LF-MCG-LF/0.5ML IM SUSP $217.75 62756-826-40 DOXORUBICIN 50 MG/25 ML IV SOLN $217.75 65862-840-03 MOXIFLOXACIN 0.5 % OPHT DROP $217.56 0781-3210-46 CEFTRIAXONE 10 GRAM INJ SOLR $217.49 62542-301-03 HYDROCODONE-CHLORPHENIRAMINE 10-8 MG/5 ML ORAL SU12 $217.49 59676-562-01 DARUNAVIR ETHANOLATE 600 MG ORAL TAB $217.43 HC89005516 ASPERGILLUS ANTIGEN-FT $217.00 99996-000-27 TRACE ELEM ZN-CR-SE 848-0.34-3.03 MCG/ML IV SOLN $216.71 0703-3216-01 PACLITAXEL 6 MG/ML IV CONC $216.67 42292-043-01 IMATINIB 100 MG ORAL TAB $216.67 42292-043-03 IMATINIB 100 MG ORAL TAB $216.67 63323-883-30 DOXORUBICIN 50 MG/25 ML IV SOLN $216.61 0703-3678-01 METHOTREXATE SODIUM (PF) 25 MG/ML INJ SOLN $216.06 HC51061687 3D RENDER W/O INDENDNPT WORKSTN $216.00 HC51062115 GENETIC COUNSELING 30 MIN $216.00 HC65800005 IODINE-125 NONSTRND PER SOURCE $216.00 HC51061950 MONITOR AMB GLUCOSE ASSESS 72+ HRS $216.00 HC51061679 MYOCARDIAL STRAIN QUANT ASSESS+ $216.00 HC51020303 NP EST PT LVL IV;EXTENDED $216.00 HC51020352 NP NEW PT LVL IV;EXTENDED $216.00 HC51060085 OT-EVAL+REPORT INITIAL 30 MIN/C $216.00 HC51062503 PRINCIPAL CARE MGMT HI RISK D; EA ADDL 30MIN, PER MO+ $216.00 HC89021554 THIOPURINE METABOL(CAT#3200)-PR $216.00 HC51061885 X-RAY SHOULDER; 1 VW $216.00 62756-513-40 LEVETIRACETAM 500 MG/5 ML IV SOLN $215.93 62756-513-44 LEVETIRACETAM 500 MG/5 ML IV SOLN $215.93 68546-142-56 RASAGILINE 0.5 MG ORAL TAB $215.91 68546-229-56 RASAGILINE 1 MG ORAL TAB $215.91 55513-126-01 EPOETIN ALFA 2,000 UNIT/ML INJ SOLN $215.54 55513-126-10 EPOETIN ALFA 2,000 UNIT/ML INJ SOLN $215.54 0173-0547-00 ATOVAQUONE 750 MG/5 ML ORAL SUSP $215.51 63323-136-10 BLEOMYCIN 15 UNIT INJ SOLR $215.28 99999-043-60 NIFEDIPINE 4 MG/ML ORAL LIQUID $215.28 0641-1398-31 CHLORPROMAZINE 25 MG/ML INJ SOLN $215.16 0641-1398-35 CHLORPROMAZINE 25 MG/ML INJ SOLN $215.16 0069-1306-01 EPOETIN ALFA-EPBX 3,000 UNIT/ML INJ SOLN $215.09 0069-1306-10 EPOETIN ALFA-EPBX 3,000 UNIT/ML INJ SOLN $215.09 HC89022610 DEOXYCORTICOSTERONE (DOC)-QN $215.06 HC81701807 HERPES I/II AB IGG $215.00 HC81701815 HERPES I/II AB IGM $215.00 HC37000015 MNT REASSESMENT EA 15 MIN $215.00 HC37000049 MNT REASSESS EA INDIV 15MIN 1ST REF $215.00 HC62213715 NEEDLE MICROTIP/TIP PHACOEMULS $215.00 HC32001091 OT-DEV COGNITIV SKLL ADD15M/CW $215.00 HC51070597 PSYCH/NEUROPSYCH TEST ADMIN & SCORING, 2 OR > TESTS; 1ST 30 MIN $215.00 HC51001881 X-RAY BONE AGE STUDIES $215.00 0065-0795-50 BALANCED SALT SOLN NO.2 IRRIG. INTRAOCULAR SOLN $214.50 0143-9006-01 ACETAZOLAMIDE SODIUM 500 MG INJ SOLR $214.50 0409-0829-01 AZTREONAM 1 GRAM INJ SOLR $214.50 0409-0829-11 AZTREONAM 1 GRAM INJ SOLR $214.50 0409-7419-03 DEXTRAN 40 10 % IN 0.9 % NACL 10 % IV SOLP $214.50 43066-018-01 OXALIPLATIN 100 MG/20 ML IV SOLN $214.50 45802-129-35 HALOBETASOL PROPIONATE 0.05 % TOPICAL CREAM $214.50 76329-3369-1 NALOXONE 1 MG/ML INJ SYRG $214.50 16729-295-34 CARBOPLATIN 10 MG/ML IV SOLN $214.40 70257-562-11 BACLOFEN 50 MCG/ML INTRATHECAL SOLN $214.31 70257-562-55 BACLOFEN 50 MCG/ML INTRATHECAL SOLN $214.31 51079-165-01 VORICONAZOLE 200 MG ORAL TAB $214.10 51079-165-03 VORICONAZOLE 200 MG ORAL TAB $214.10 HC36800423 BLOOD GAS PH ONLY $214.00 HC11500527 LACTATION E&M LIMITD EST' L:II $214.00 HC32010183 OT-ORTHOTIC/PROSTH MGMT/TRAIN SUBSQ 15MIN $214.00 HC62221270 POSITIONER FLUIDIZED FULL BODY PEDS $214.00 HC81701377 PSA SCREENING $214.00 HC51070738 PSY-BEHAVIOR ASSESS/RE-ASSESS $214.00 HC51070746 PSY-BEHAVIOR TX INDIV 1ST 30 MIN $214.00 HC31010150 PT-ORTHOTIC/PROSTH MGMT/TRAIN SUBSQ 15MIN $214.00 HC31000722 PT-WHEELCHAIR MGT 15MIN/M $214.00 HC47200753 RAD ONC EST PT NOT REQ PHYS(5MIN) $214.00 61703-327-22 DACARBAZINE 200 MG IV SOLR $213.53 68516-5214-5 ALBUMIN, HUMAN 5 % 5 % IV SOLP $213.20 72266-160-01 ZIPRASIDONE MESYLATE 20 MG/ML (FINAL CONC.) IM SOLR $213.14 72266-160-10 ZIPRASIDONE MESYLATE 20 MG/ML (FINAL CONC.) 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COLI SHIGA-LIKE TOXIN ASSAY $211.00 HC81500738 FACTOR XIII SCREEN $211.00 HC32010142 OT-WHEELCHAIR MGT 15MIN $211.00 HC62205539 PAD ACRYLON $211.00 HC31010119 PT-WHEELCHAIR MGT 15MIN $211.00 HC51003879 X-RAY FEMUR 1 VIEW $211.00 HC51061927 X-RAY FOOT 2 VWS $211.00 45802-419-26 AMMONIUM LACTATE 12 % TOPICAL LOTN $210.60 99999-044-53 VANCOMYCIN IN NS 1.5 GRAM/300 ML IV SOLN (MHS) $210.60 0409-1144-02 VERAPAMIL 2.5 MG/ML IV SOLN (MCH) $210.13 0409-1144-62 VERAPAMIL 2.5 MG/ML IV SOLN $210.13 0168-0163-30 CLOBETASOL 0.05 % TOPICAL CREAM $210.02 HC62227996 APPLICATOR/TIP SYRINGE ONLY $210.00 HC62213624 APPLICATOR/TIP SYRINGE ONLY E $210.00 HC62200449 BANDS RADIAL OCCLUSIVE $210.00 HC62200571 BLADE BEAVER C $210.00 HC62212048 BLADE BONE/ENDO SHAVER C $210.00 HC62200548 BLADE DERMATOME $210.00 HC62220868 BLADE INCISIONAL C $210.00 HC62227749 BLADE ROBOTIC (SNAP-FIT) $210.00 HC62225982 BLADE SHAVER C $210.00 HC62222138 BLADE TREPHINE C $210.00 HC62226824 BOWL CEMENT MIXING E $210.00 HC62213186 BURR C $210.00 HC62220173 CANNULA ARTHROSCOPIC E $210.00 HC62221593 CANNULA CEMENT BONE E $210.00 HC62212261 CATH ANGIOG GUIDING(SLIP/GLIDE) E $210.00 HC62212204 CATH ANGIOGRAPHY W/BALLOON E $210.00 HC62220967 CATH CENTRAL VENOUS E $210.00 HC62217948 CATH EMBOLECTOMY FOGARTY E $210.00 HC62224035 CATH EXCHANGER AIRWAY $210.00 HC62226972 CATH FOLLOWER URETH PHILLIPS F $210.00 HC62807706 CATH HEMO/PERI DIAL LONG TERM E $210.00 HC62218250 CATH INTRODUCER PEEL-AWAY H $210.00 HC62227210 CATH IV MIDLINE E $210.00 HC62211925 CATH SHEATH GUIDING $210.00 HC62803721 CATHETER PACING BIPOLAR E $210.00 HC62222765 CAUTERY PENCIL E $210.00 HC62221767 CLIP ENDOSCOPIC E $210.00 HC62212337 COLLAR CERVICAL MIAMI J PEDS E $210.00 HC62202155 DERMABOND E $210.00 HC62227442 DRESSING ANTIMIC MICRO-CURRENT E $210.00 HC62218714 DRILL/DRILL BITS SINGLE USE F $210.00 HC62202650 ELECTRODE LAP E $210.00 HC62224209 ELECTRODE LOOP E $210.00 HC62218318 ENDO STAPLER C $210.00 HC11500014 EST PT SF MDM 10-19 MIN $210.00 HC62807946 FIBRIN SEALANT D $210.00 HC62228044 GRASPER ENDO $210.00 HC62226709 GUIDE DRILL E $210.00 HC62805775 HEMOSTATIC GEL/GELFOAM/PAD E $210.00 HC89005334 HEPARIN-INDUCED PLATELET AB-EC $210.00 HC62220603 INTRO/SHEATH EP FIXED NON-PEEL B $210.00 HC62226246 INTRODUCER/SHEATH E $210.00 HC62802483 INTRODUCER/SHEATH(FLEXOR CHECK-FLO)E $210.00 HC62220660 KIT ACCESSORY B $210.00 HC62219407 KIT ACCESSORY STIMULATOR NERVE $210.00 HC62221064 KIT CELL SAVER E $210.00 HC62226188 KIT DRESSING WOUND NEG PRESSURE B $210.00 HC62204086 KIT NEEDLE GUIDE (PICC) $210.00 HC62204300 KIT PRESSURE MONITOR/TRANSDUCER E $210.00 HC62808225 M: CENTRALIZER KNEE $210.00 HC62222948 MANIPULATOR UTERINE E $210.00 HC89022727 NBS TESTS PANEL NEWBORN METABLC SCRNING-GE $210.00 HC62215868 NEEDLE BIOPSY H $210.00 HC62227384 NEEDLE DELIVERY BIOCARTILAGE $210.00 HC62220298 NEEDLE ENDOSCOPIC E $210.00 HC62228481 NEEDLE TARGETING E $210.00 HC62219514 ORTHOSIS ANKLE/FT PRFB CUSTMZD D $210.00 HC62210281 ORTHOTIC WHFO NO JOINT CONTOUR E $210.00 HC22000053 OST EST PT EVAL LVL1-(5MIN) $210.00 HC32003360 OT-DEVEL TEST ADMIN ASSESS COG INSTR; EA ADD 30MIN+ $210.00 HC62204102 PACK OPEN HEART $210.00 HC62223813 PACKING NASAL E $210.00 HC62227830 POSITIONER FLUIDIZED LARGE $210.00 HC62205877 PROBE RECTAL/ESOPHAGEAL $210.00 HC39001375 PSY-DEVEL TEST ADMIN ASSESS COG INSTR; EA ADD 30MIN+ $210.00 HC31002132 PT-DEVEL TEST ADMIN ASSESS COG INSTR; EA ADD 30MIN+ $210.00 HC62227574 REAMER F $210.00 HC62221288 RESERVOIR CELL SAVER E $210.00 HC62220058 RETRACTOR DISPOSABLE C $210.00 HC62227780 RETRIEVER GRAFT $210.00 HC62206123 SET TUBING $210.00 HC62206552 SLEEVE COMPRESSION E $210.00 HC62226626 SLEEVE IMPACTOR $210.00 HC62206602 SNARE E $210.00 HC62203633 SOLUTION DEBRIDEMENT WOUND $210.00 HC62219597 STAPLE CARTRG/ENDO RELOAD E $210.00 HC62807912 STENT URETERAL E $210.00 HC62215579 SUTURE H $210.00 HC62227962 SYSTEM LAVAGE CLEANING WOUND $210.00 HC62227764 TIP DISSECTOR MICRO $210.00 HC62221452 TROCAR ENDO E $210.00 HC62217971 TUBE ET E $210.00 HC62802863 TUBE GASTROSTOMY STANDARD E $210.00 HC62207683 TUBE INSUFFLATOR E $210.00 HC62211339 TUBE TRACH CUFFED E $210.00 HC62221569 TUBE TRACH NO-CUFF E $210.00 HC62219647 VALVE TRACH SPEAKING E $210.00 0168-0352-22 MUPIROCIN 2 % TOPICAL OINT $209.64 0023-6082-01 IRON DEXTRAN 50 MG/ML INJ SOLN $209.37 0023-6082-10 IRON DEXTRAN 50 MG/ML INJ SOLN $209.35 HC62203245 EVACUATOR ELLIK $209.00 HC32010340 OT-ONLINE ASSESS & MANAGMNT EST PT 21+MIN $209.00 HC32010274 OT-PROSTHETIC MGMT & TRNG INITIAL ENC 15MIN $209.00 HC32000374 OT-PROSTHETIC MGMT & TRNG INITIAL ENC 15MIN/M $209.00 HC31090160 PT-ONLINE ASSESS & MANAGMNT EST PT 21+MIN $209.00 HC31010234 PT-PROSTHETIC MGMT & TRNG INITIAL ENC 15MIN $209.00 HC31000441 PT-PROSTHETIC MGMT & TRNG INITIAL ENC 15MIN/M $209.00 HC35000165 REC-SELF/HOME MGMT/ADL 15MIN $209.00 HC33010216 ST-ONLINE ASSESS & MANAGMNT EST PT 21+MIN $209.00 HC62207907 TUBING MICRODEBRIDER $209.00 51754-0203-1 VERAPAMIL 2.5 MG/ML IV SOLN $208.98 51754-0203-2 VERAPAMIL 2.5 MG/ML IV SOLN $208.98 60505-1003-1 KETOROLAC 0.5 % OPHT DROP $208.39 0409-2337-15 DEFEROXAMINE 2 GRAM INJ SOLR $208.36 0409-2337-25 DEFEROXAMINE 2 GRAM INJ SOLR $208.36 0093-1010-42 MUPIROCIN 2 % TOPICAL OINT $208.35 47335-220-90 KETOROLAC 0.5 % OPHT DROP $208.33 0548-5608-00 ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLN $208.01 68001-464-41 ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLN $208.01 HC81100349 ACETONE $208.00 HC81700650 ANA TITER $208.00 HC51062784 CHRONIC CARE MGMT EA ADDL 20MIN, PER MO+ $208.00 HC51062826 COMPRE ASSESS&CARE PLAN CHRONIC CARE MGMT+ $208.00 HC34000307 ELECTROACOUSTIC EVAL FOR HEARING AID; BIAURAL $208.00 HC81100661 MAGNESIUM $208.00 HC51070530 PSY-TEAM CONF W/PT &3D 30MINOR> $208.00 HC51060051 PT-TEST&MEASUREMENT 1ST30MIN/C $208.00 HC35000256 REC-DEV COGNITIVE SKILLS ADDL 15MIN $208.00 HC81700775 THYROID PEROXIDASE AB BY EIA $208.00 HC34000398 UNLISTED ENT PROCEDURE/SERVICE $208.00 HC51063105 AVULSION OF NAIL, SIMPLE; EA ADDL' $208.00 HC51063162 TRIMMING NONDYSTROPHIC NAILS $208.00 0054-3555-63 METHADONE 5 MG/5 ML ORAL SOLN $208.00 0143-9525-01 DEXMEDETOMIDINE-NS 4 MCG/ML LOADING DOSE (SLH) $208.00 0143-9525-10 DEXMEDETOMIDINE-NS 4 MCG/ML LOADING DOSE (SLH) $208.00 0941-0457-08 PERITON.DIALYSIS 7-2.5 % DEXTR CA 2.5 MEQ/L- MG 0.5 MEQ/L IP SOLN $208.00 60432-465-50 LIDOCAINE HCL 4 % (40 MG/ML) MUCOUS MEMB SOLN $208.00 60432-465-51 LIDOCAINE HCL 4 % (40 MG/ML) MUCOUS MEMB SOLN $208.00 0121-0654-02 FLUPHENAZINE HCL 2.5 MG/5 ML ORAL ELIX $207.87 HC81700262 ANTI-NUCLEAR AB EIA $207.00 HC89018667 CHROM COUNT 6-12 CELLS, AF-AU $207.00 HC13500053 GENETIC COUNSEL 15MIN CMRCL/C $207.00 HC84200047 GRAM STAIN $207.00 HC84201177 GRAM STAIN (MHL) $207.00 HC81500548 HEMOLYSIN ACID $207.00 HC83503821 IF STUDY DIRECT PROF 1ST STAIN-CS $207.00 HC12200218 INF CNTR-ESTBL'D PT EVAL BRIEF $207.00 HC81100109 LDL CHOLESTEROL DIRECT $207.00 HC62205315 PACK LAMINECTOMY $207.00 HC84200765 SMEAR CELL TYPE $207.00 HC84200393 SPUTUM EVALUATION STAIN $207.00 HC62207808 TUBING ARTHROSCOPIC PUMP $207.00 HC62218011 TUBING SET OPHTH INJECT/EXTRACT $207.00 0024-2792-01 SODIUM FERRIC GLUCONAT-SUCROSE 62.5 MG/5 ML IV SOLN $206.70 0024-2792-10 SODIUM FERRIC GLUCONAT-SUCROSE 62.5 MG/5 ML IV SOLN $206.70 0143-9570-01 SODIUM FERRIC GLUCONAT-SUCROSE 62.5 MG/5 ML IV SOLN $206.70 0143-9570-10 SODIUM FERRIC GLUCONAT-SUCROSE 62.5 MG/5 ML IV SOLN $206.70 69918-899-02 DESMOPRESSIN 4 MCG/ML INJ SOLN $206.36 69918-899-11 DESMOPRESSIN 4 MCG/ML INJ SOLN $206.36 0904-7064-41 ATOVAQUONE 750 MG/5 ML ORAL SUSP $206.21 HC51010635 IMMNTX 4 STING INSECTS /COMM $206.00 HC32000846 OT-RE-EVAL ADDL 15MIN/CW $206.00 HC62206099 SET ANCHOR GASTROINTESTINAL $206.00 HC62208145 VALVE PEEP $206.00 0121-0868-16 NYSTATIN 100,000 UNIT/ML ORAL SUSP $205.99 0065-0359-02 CYCLOPENTOLATE-PHENYLEPHRINE 0.2-1 % OPHT DROP $205.92 25021-305-66 CHLOROTHIAZIDE SODIUM 500 MG IV SOLR $205.92 0019-4816-05 DIATRIZOATE MEG-DIATRIZOAT SOD 66-10 % ORAL SOLN $205.14 0054-3532-44 LORAZEPAM 2 MG/ML ORAL CONC $205.14 HC89008940 BILE ACID FRACTIONATED-AU $205.00 HC81101073 CERULOPLASMIN $205.00 HC62202494 DRESSING INTERDRY AG PKG $205.00 HC81701757 EBV AB TO EARLY (D) AG, IGG $205.00 HC32010241 OT-SENSORY INTEGRT TECH 15MIN $205.00 HC31010275 PT-IONTOPHORESIS 15MIN $205.00 0641-6205-01 NALOXONE 1 MG/ML INJ SYRG $204.75 0641-6205-10 NALOXONE 1 MG/ML INJ SYRG $204.75 39822-0190-1 ACETAZOLAMIDE SODIUM 500 MG INJ SOLR $204.75 0338-0519-58 FAT EMULSION 20 % IV EMUL $204.10 HC62224662 CATH SENSING PRESSUR INTRNL ABDOMEN $204.00 HC81101545 INSULIN TOTAL $204.00 HC62204169 KIT POST OP CATARACT $204.00 HC62204235 KIT SHOULDER SUSPENSION $204.00 HC81101594 LDL CHOLEST DIRECT $204.00 HC62228275 ORTH FO PIP/DIP W/ JOINT/SPRING PREFAB OTS $204.00 HC32000325 OT-MASSAGE 15MIN/M $204.00 HC31000391 PT-MASSAGE 15MIN/M $204.00 HC51002566 REMOV IMPACTD EAR WAX IRRIG/LAVG LT $204.00 HC51002574 REMOV IMPACTD EAR WAX IRRIG/LAVG RT $204.00 HC62801782 RING FALLOPIAN $204.00 HC62207956 TUBING SCD $204.00 43598-750-11 NALOXONE 1 MG/ML INJ SYRG $203.78 43598-750-58 NALOXONE 1 MG/ML INJ SYRG $203.78 67457-218-10 CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLN $203.71 HC81101255 C-REACTIVE PROTEIN HI SENS $203.00 HC81100125 GLUCOSE FLUID/URINE $203.00 HC32000945 OT-NEUROMUSC RE-ED ADD15MIN/CW $203.00 HC31000995 PT-PHYS MED TX ANY ADDL 15MIN/CW $203.00 HC31001449 PT-TEST/MEASUREMENT ADD15MIN/C $203.00 HC81500613 THROMBIN TIME $203.00 HC11500915 WM EXAM EST' PT EVAL MINOR LVL 2 $203.00 0065-0530-04 BALANCED SALT SOLN NON-SURG 3 OPHT SOLN $202.80 17478-284-35 GENTAMICIN 0.3 % (3 MG/GRAM) OPHT OINT $202.54 63323-407-03 CAFFEINE CITRATE 20 MG/ML INJ SOLN (MCH) $202.35 HC65800062 BRACHY SEED IRIDIUM-192\NON HI $202.00 HC14500094 DIABETIC SELF MGMT TRN GRP 30M $202.00 HC32001463 OT-WOUND VAC 15MIN>50 SQ CM+/C $202.00 HC14500078 SS-NUTRIT-POST PARTUM EA 15MIN $202.00 HC11500691 WC ESTB E&M BRIEF LVL1 $202.00 HC42000554 WCH NEW PT LVL2-PROB FOCUS $202.00 0009-0760-04 CLINDAMYCIN PALMITATE 75 MG/5 ML ORAL SOLR (MCH) $201.50 0591-3128-79 PROGESTERONE 50 MG/ML IM OIL $201.50 99999-045-49 ETHYL ALCOHOL (BULK) MISC LIQD $201.50 51862-455-01 CLONIDINE 0.3 MG/24 HR TRANSDERMAL PTWK $201.37 51862-455-04 CLONIDINE 0.3 MG/24 HR TRANSDERMAL PTWK $201.37 HC81500092 BLEEDING TIME $201.00 HC81500159 CBC W/O DIFF $201.00 HC12600003 IMMUNIZATION ADMIN SINGLE $201.00 HC11500469 LACTATION E&M BRIEF EST'D L:I $201.00 HC83504829 MORPH STDY MAN ISH QNT HER2-NG $201.00 HC83504811 MORPH STDY MAN ISH QNTCEP17-NG $201.00 HC83000265 ROSETTE TEST,FETAL HGB $201.00 HC81701609 RUBELLA AB IGG $201.00 0270-0149-60 DIATRIZOATE MEGLUMINE 30 % URETHRAL SOLN $200.20 HC83500322 BM: CHROMOSOME ANALYSIS-GZ $200.00 HC83505891 CHROM ANAL 20-25 CELLS BONE MARROW-NG $200.00 HC32000424 OT-SENSRY INTEGRT TECH 15MIN $200.00 HC32000564 OT-TRACTION/MECHANICAL/CMW $200.00 HC31000623 PT-TRACTION/MECHANICAL/CMW $200.00 HC62207444 TRAY MYELOGRAM DISP $200.00 HC51001766 X-RAY EXAM OF FINGERS MIN 2 VWS $200.00 HC89024020 CALR MUT ANALYSIS-AU $200.00 0517-0735-01 NICARDIPINE 25 MG/10 ML IV SOLN $199.81 0517-0735-10 NICARDIPINE 25 MG/10 ML IV SOLN $199.81 0781-3040-72 PYRIDOSTIGMINE BROMIDE 5 MG/ML INJ SOLN $199.67 0781-3040-95 PYRIDOSTIGMINE BROMIDE 5 MG/ML INJ SOLN $199.67 0143-9505-01 CISPLATIN 1 MG/ML IV SOLN $199.55 71288-106-10 BLEOMYCIN 15 UNIT INJ SOLN (MCH) $199.42 0143-9701-01 IRINOTECAN 100 MG/5 ML IV SOLN $199.29 25021-230-05 IRINOTECAN 100 MG/5 ML IV SOLN $199.29 HC32000143 OT-PHYS PERFORM TEST 15 MIN/MW $199.00 HC31010291 PT-PHYS PERFORM TEST 15 MIN $199.00 HC31000219 PT-PHYS PERFORM TEST 15 MIN/M $199.00 HC31001886 PT-WHEELCHAIR ASSESS 15 MIN/M $199.00 99988-001-02 NM TC-99M DISOFENIN DX50 SQ+/C $194.00 HC84200377 TISSUE PROCESS GRINDING $194.00 0075-2912-01 ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRG $193.78 63323-537-01 ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRG $193.77 63323-537-84 ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRG $193.77 68968-0514-1 ESTRADIOL-NORETHINDRONE ACET 0.05-0.14 MG/24 HR TRANSDERMAL PTTW $193.73 68968-0514-8 ESTRADIOL-NORETHINDRONE ACET 0.05-0.14 MG/24 HR TRANSDERMAL PTTW $193.73 68968-0525-1 ESTRADIOL-NORETHINDRONE ACET 0.05-0.25 MG/24 HR TRANSDERMAL PTTW $193.73 68968-0525-8 ESTRADIOL-NORETHINDRONE ACET 0.05-0.25 MG/24 HR TRANSDERMAL PTTW $193.73 HC83505941 IHC/IP PER SPEC EA ADD AB STAIN+ -MA $193.70 HC83502385 IHC/IP PER SPEC INITIAL AB STAIN -MA $193.70 HC83590422 KRAS MUT ANALYSIS EXON 4-AP $193.25 HC83590414 KRAS MUT ANALYSIS VARIANTS EXONS 2-AP $193.25 HC62218524 APPLICATOR W/MIXING TIP ORTHO $193.00 HC62208681 CATH HANDLE SINUS GUIDE $193.00 80174-100-03 MICROFIBRIL. COLLAGEN HEMOSTAT TOPICAL POWD $192.79 25021-315-98 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $192.40 61990-0213-0 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $192.40 61990-0213-1 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $192.40 25010-711-15 CARBIDOPA 25 MG ORAL TAB $192.30 52959-159-06 PERMETHRIN 5 % TOPICAL CREAM $192.27 HC62200787 BRIDGE CARDIAC OUTPUT $192.00 HC62209408 BRUSH CYTOLOGY NDLTIP TRACKING E $192.00 HC62211586 CASSETTE WND IRRIG/SUCTN $192.00 HC89003990 KARYOTYPING,ADD EA-GC $192.00 HC62203690 KIT ANGIOGRAPHY $192.00 HC62208954 NEEDLE PERCUTANEOUS $192.00 HC32001133 OT-WHEELCHAIR MGT ADD15MIN/C $192.00 HC62206883 STRAP CLAVICLE $192.00 0406-9915-01 TEMAZEPAM 7.5 MG ORAL CAP $191.77 0264-7578-10 MANNITOL 20 % 20 % IV SOLP $191.75 66689-062-42 ATOVAQUONE 750 MG/5 ML ORAL SUSP $191.75 68462-421-69 ATOVAQUONE 750 MG/5 ML ORAL SUSP $191.75 6936728302 ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROP $191.49 7583401060 ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROP $191.49 99999-041-53 NM TC-99M MEBROFENIN MHS $191.45 45802-880-94 NYSTATIN-TRIAMCINOLONE 100,000-0.1 UNIT/G-% TOPICAL CREAM $191.30 51672-1263-2 NYSTATIN-TRIAMCINOLONE 100,000-0.1 UNIT/G-% TOPICAL CREAM $191.30 HC77400281 BEDSIDE/OTHER ANESTH' ADD'L 15MIN CASE CX $191.00 HC62201587 CATH THORACIC $191.00 HC82202912 IMMUNOCYTOCHEMICAL STAIN $191.00 HC62204680 MASK BIPAP $191.00 HC62206776 ORTHOTIC FX WRIST PREFAB $191.00 HC32001224 OT-SENSRY INTEGR TECH ADD15/CW $191.00 HC84600071 PAP SMEAR PATH INTERP+ $191.00 HC62217229 TUBE ENDOBRONCHIAL $191.00 0409-1144-05 VERAPAMIL 2.5 MG/ML IV SOLN $190.94 0409-1144-10 VERAPAMIL 2.5 MG/ML IV SOLN $190.94 0409-1144-11 VERAPAMIL 2.5 MG/ML IV SOLN $190.94 0409-1144-65 VERAPAMIL 2.5 MG/ML IV SOLN $190.94 0283-0679-02 BENZOCAINE 20 % MUCOUS MEMB SPRA $190.81 0517-0740-01 METHYLERGONOVINE 0.2 MG/ML (1 ML) INJ SOLN $190.65 0517-0740-20 METHYLERGONOVINE 0.2 MG/ML (1 ML) INJ SOLN $190.65 0121-0576-16 METOCLOPRAMIDE HCL 5 MG/5 ML ORAL SOLN $190.62 0121-0948-16 POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQD $190.62 0395-1213-16 IODINE-SODIUM IODIDE 2 % TOPICAL TINC $190.62 16714-066-01 ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRG $190.45 16714-066-10 ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRG $190.45 54838-506-15 HYOSCYAMINE SULFATE 0.125 MG/ML ORAL DROP $190.03 HC62211511 BLADE SAW L $190.00 HC62200829 BRUSH MEDULLARY CANAL E $190.00 HC62201538 CATH RADIAL ARTERY $190.00 HC82202946 H&E FROM BLOCK $190.00 HC62802434 INTRODUCER COAXIAL $190.00 HC62203815 KIT CVP MANOMETER $190.00 HC81500571 OSMOTIC FRAGILITY UNINCUBATED $190.00 HC32001299 OT-THER PROC GRP 1ST 30MIN/MW $190.00 HC32001356 OT-THER PROC GRP 30MIN/CMW $190.00 HC32001455 OT-WOUND VAC 15MIN<50 SQ CM+/C $190.00 HC62205604 PAD SPECIALTY/HYPER/OTHERMIA $190.00 HC31001639 PT-WHEELCHAIR MGT ADD 15MIN/C $190.00 HC62207352 TRAY GASTRIC LAVAGE $190.00 HC62207998 TUBING SUCTION NEZHAT DORSEY $190.00 0264-3125-11 CEFOXITIN IN DEXTROSE, ISO-OSM 2 GRAM/50 ML IV PGBK $189.97 25021-608-51 PROPOFOL 10 MG/ML IV EMUL $189.80 49702-213-01 ZIDOVUDINE 10 MG/ML IV SOLN $189.80 49702-213-26 ZIDOVUDINE 10 MG/ML IV SOLN $189.80 45567-0060-1 KIT PREP OF TC-99M-SOD PYROPH 12 MG IV SOLR $189.70 63323-229-35 PROTAMINE 10 MG/ML IV SOLN $189.64 25021-129-99 CEFTAZIDIME 6 GRAM INJ SOLR $189.59 69238-1534-3 FLUOCINONIDE 0.05 % TOPICAL CREAM $189.54 25021-312-02 VERAPAMIL 2.5 MG/ML IV SOLN $189.15 HC51000248 IV INF THER SEQ/NEW RX 1ST HR $189.00 HC51020295 NP EST PT LVL III;INTERMED $189.00 HC51020345 NP NEW PT LVL III;INTERMED $189.00 HC51070316 PSYCH GRP TX (NOT MULTI FAMILY) $189.00 HC51060549 ST EVAL BEHAVRAL QUAL VOICE &RESONANCE/M $189.00 HC81100208 TIBC $189.00 42023-216-01 EPHEDRINE SULFATE 50 MG/ML IV SOLN (MHS) $188.76 42023-216-25 EPHEDRINE SULFATE 50 MG/ML IV SOLN (MHS) $188.76 0003-2560-16 AZTREONAM 1 GRAM INJ SOLR $188.50 72485-105-01 SODIUM NITROPRUSSIDE 25 MG/ML IV SOLN $188.50 0641-6019-01 MORPHINE (PF) 1 MG/ML INJ SOLN $188.24 0641-6019-10 MORPHINE (PF) 1 MG/ML INJ SOLN $188.24 0641-6020-01 MORPHINE (PF) 0.5 MG/ML INJ SOLN $188.24 0641-6020-10 MORPHINE (PF) 0.5 MG/ML INJ SOLN $188.24 HC81101024 ALDOLASE $188.00 HC32000986 OT-MANUAL THERAPY ADDL 15MIN/CW $188.00 HC81100257 UREA NITROGEN CLEARANCE $188.00 HC89022354 FLOW CYTOMETRY 1ST MRKR{W-INT/89}-CC $187.98 55150-318-01 CHLORPROMAZINE 25 MG/ML INJ SOLN $187.79 55150-318-25 CHLORPROMAZINE 25 MG/ML INJ SOLN $187.79 63323-328-20 NAFCILLIN 2 GRAM INJ SOLR $187.79 0641-1397-31 CHLORPROMAZINE 25 MG/ML INJ SOLN $187.78 0641-1397-35 CHLORPROMAZINE 25 MG/ML INJ SOLN $187.78 0093-8675-78 AMOXICILLIN-POT CLAVULANATE 600-42.9 MG/5 ML ORAL SUSR $187.20 HC62202148 DEFOGGER(FRED) $187.00 HC84200492 ENTAMOEBA HISTO AG(DISPAR) $187.00 HC84201078 ENTAMOEBA HISTOL AG $187.00 HC81100570 GGT $187.00 HC62205026 NEEDLE SUTURE GRICE $187.00 HC32000572 OT-ULTRASOUND 15MIN/MW $187.00 HC62213707 PACK CATARACT CUSTOM W/O BSS $187.00 HC31000631 PT-ULTRASOUND 15MIN/MW $187.00 HC81100026 UREA NITROGEN URINE $187.00 HC39001300 PSYCH/NEUROPSYCH TEST ADMIN SNGLE AUTO INSTRU VIA ELECTRONIC AUTO RESULT ON $186.00 50268-086-11 ATOVAQUONE 750 MG/5 ML ORAL SUSP $185.71 68094-247-01 DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN $185.25 68094-247-10 DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN $185.25 63323-671-02 DEXMEDETOMIDINE IN 0.9 % NACL 80 MCG/20 ML (4 MCG/ML) IV SOLN $185.12 63323-671-20 DEXMEDETOMIDINE IN 0.9 % NACL 80 MCG/20 ML (4 MCG/ML) IV SOLN $185.12 HC89022594 CHROMATOGRAPHY/SPECTROMETRY QL/QN-QN $185.00 HC81701823 HSV TYPE 1 AB, IGG $185.00 HC51070019 PSY MED RECORD REVIEW $185.00 HC89024152 APIXABAN ANTI XA-LC $185.00 0998-0408-15 ARTIFICIAL TEARS(HYPROMELLOSE) 0.5 % OPHT DROP $184.76 0781-3156-06 ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN $184.60 0781-3156-95 ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN (MHS) $184.60 0781-3269-71 EPHEDRINE SULFATE 50 MG/ML IV SOLN $184.43 0781-3269-95 EPHEDRINE SULFATE 50 MG/ML IV SOLN $184.43 24208-735-06 CYCLOPENTOLATE 1 % OPHT DROP $184.28 HC12600052 ADMIN VACCINE HEPATITIS B $184.00 HC12600029 ADMIN VACCINE INFLUENZA $184.00 HC12600037 ADMIN VACCINE PNEUMOCOCCAL $184.00 HC28000040 CR EST PT EVAL LVL1-(5MIN) $184.00 HC32001059 OT-PROSTHETIC TRNG ADD15MIN/CW $184.00 HC81100000 PHOSPHORUS URINE $184.00 HC81100133 PROTEIN FLUID $184.00 HC31001530 PT-PHYS PERFORM TEST ADD'15M/W $184.00 HC81500886 RETICULOCYTE MULTI PARAMETERS $184.00 63323-286-35 ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJ SOLN $183.50 0178-0900-01 TIOPRONIN 100 MG ORAL TAB $183.36 61703-342-22 PACLITAXEL 6 MG/ML IV CONC $183.23 99988-000-04 GALLIUM-67 CITRATE 74 MBQ/ML (2 MCI/ML) IV SOLN $183.23 HC62201397 CATH FEM ART SET $183.00 HC89018659 CHROM ANAL TISSUE CULT, AF-AU $183.00 HC25006008 EST PT LVL1-BRIEF $183.00 HC81701161 HTLV I & II $183.00 HC42000877 INTERROGATE CV PHYS MONITOR REMOTE 30 DAYS $183.00 HC81700007 MONOSPOT TEST $183.00 HC51060945 OT-ORTHOTIC/PROSTH MGMT/TRAIN SUBSQ 15MIN/M $183.00 HC62205216 PACK CRANIOTOMY $183.00 HC81500027 PLATELET COUNT- AUTO $183.00 HC33010075 ST EVAL SPEECH FLUENCY [15MIN] $183.00 50458-290-01 ITRACONAZOLE 100 MG ORAL CAP $182.95 63629-2147-1 FLUCYTOSINE 250 MG ORAL CAP $182.78 0006-4897-00 HAEMPH B POLYSAC CONJ-MENIN PF 7.5 MCG/0.5 ML IM SOLN $182.75 0006-4897-01 HAEMPH B POLYSAC CONJ-MENIN PF 7.5 MCG/0.5 ML IM SOLN $182.75 0713-0664-15 FLUOCINONIDE-EMOLLIENT 0.05 % TOPICAL CREAM $182.52 63323-469-01 HALOPERIDOL DECANOATE 50 MG/ML IM SOLN $182.52 0409-4091-01 MANGANESE CHLORIDE 0.1 MG/ML IV SOLN $182.07 0009-0323-01 GELATIN SPONGE,ABSORB-PORCINE 50 TOPICAL SPGE $182.05 52817-816-15 ACETIC ACID 2 % OTIC SOLN $182.03 60432-741-15 ACETIC ACID 2 % OTIC SOLN $182.03 HC62224357 CANNULA INTRAOCULAR E $182.00 HC62201504 CATH MALECOT $182.00 HC62201777 CIRCUIT VENT BIPAP $182.00 HC83000166 COMBS DIRECT(EA) $182.00 HC81700296 DNA DOUBLE STRAND AB IGG EIA $182.00 HC81100075 HDL CHOLESTEROL $182.00 HC51070332 INTERACTIVE COMPLEXITY+ $182.00 HC81100182 IRON $182.00 HC35500065 MT-SENSORY INTEGRATION 15 MIN $182.00 HC62215850 NEEDLE BIOPSY G $182.00 HC89013858 ORGANIC ACID SNGL QUANT UR-AU $182.00 HC32000887 OT-IONTOPHORESIS ADDL 15/CW $182.00 HC31001464 PT-PROC+MOD.COMBO ADD 15MIN/C $182.00 HC31001647 PT-WOUND NON-SEL DEB ADD15M/C $182.00 HC62207006 SUTURE CARDIOVASCULAR G $182.00 HC81100745 TRIGLYCERIDES $182.00 HC51063071 DEBRIDE OF NAILS: 1-5 $182.00 0409-1660-50 DEXMEDETOMIDINE IN 0.9 % NACL 200 MCG/50 ML (4 MCG/ML) IV SOLN $182.00 0409-1660-55 DEXMEDETOMIDINE IN 0.9 % NACL 200 MCG/50 ML (4 MCG/ML) IV SOLN $182.00 0527-6004-80 LIDOCAINE HCL 4 % (40 MG/ML) MUCOUS MEMB SOLN $182.00 0641-6103-01 METHOCARBAMOL 100 MG/ML INJ SOLN $182.00 0641-6103-25 METHOCARBAMOL 100 MG/ML INJ SOLN $182.00 0941-0409-06 PERIT.DIALYSIS 6-1.5 % DEXTROS CA 2.5 MEQ/L- MG 0.5 MEQ/L IP SOLN $182.00 25021-253-50 CISPLATIN 1 MG/ML IV SOLN $182.00 39822-0615-1 COLISTIN (COLISTIMETHATE NA) 150 MG INJ SOLR $182.00 39822-0615-2 COLISTIN (COLISTIMETHATE NA) 150 MG INJ SOLR $182.00 41616-882-44 NICARDIPINE 25 MG/10 ML IV SOLN $182.00 42023-107-01 COLISTIN (COLISTIMETHATE NA) 150 MG INJ SOLR $182.00 43598-549-10 PROPOFOL 10 MG/ML IV EMUL $182.00 43598-549-52 PROPOFOL 10 MG/ML IV EMUL $182.00 44567-703-01 CEFTRIAXONE 10 GRAM INJ SOLR $182.00 47335-153-40 GEMCITABINE 200 MG IV SOLR $182.00 61314-126-05 KETOROLAC 0.5 % OPHT DROP $182.00 63323-270-65 PROPOFOL 10 MG/ML IV EMUL $182.00 70594-023-01 COLISTIN (COLISTIMETHATE NA) 150 MG INJ SOLR $182.00 70594-023-04 COLISTIN (COLISTIMETHATE NA) 150 MG INJ SOLR $182.00 42023-131-01 COLISTIN (COLISTIMETHATE NA) 150 MG INJ SOLR $181.94 63323-393-06 COLISTIN (COLISTIMETHATE NA) 150 MG INJ SOLR $181.94 13533-131-00 TETANUS-DIPHTHERIA TOXOIDS-TD 2-2 LF UNIT/0.5 ML IM SUSP $181.90 13533-131-01 TETANUS-DIPHTHERIA TOXOIDS-TD 2-2 LF UNIT/0.5 ML IM SUSP $181.90 HC89018709 INTERPHS FISH HYBRI 100-300-AU $181.48 HC81500233 BLOOD COUNT/WBC (EOS) $181.00 HC84200567 CONCENTRATION AFB/TB/MYCOBACTERIA $181.00 HC62202130 CURVED LIFT STRL $181.00 HC81701930 CYCLIC CITRULLINATED PEPTIDE $181.00 HC81701393 MUMPS AB IGG $181.00 HC62213731 PACK VITRECTOMY W/O BSS $181.00 HC89000889 PARATHYROID HORMONE TERM-QD $181.00 99999-045-99 IOHEXOL 350 MG IODINE/ML IV SOLN $180.96 0006-4084-01 ANTIVENIN LATRODECTUS MACTANS 6,000 UNIT INJ SOLR $180.12 0006-5424-02 ANTIVENIN LATRODECTUS MACTANS 6,000 UNIT INJ SOLR $180.12 HC89005458 CHLAMYDIA PNEUMONIAE BY PCR-AU $180.00 HC81101099 CHLORIDE OTHER SOURCE $180.00 HC83500389 CHROMO CT 15-20 W/BANDING-US $180.00 HC81500506 COAG TIME OTHER METHODS $180.00 HC89017297 HIV-1 P24 AG - FT $180.00 HC89013049 HLA-A AND B PHENOTYPE-AU $180.00 HC83502369 IHC/IP PER SPEC INITIAL AB STAIN -US $180.00 HC89019467 PROCALCITONIN (PCT) - AU $180.00 HC81101271 PROTEIN OTHER SOURCE $180.00 HC31001670 PT-WOUND VAC 15MIN<50 SQ+/C $180.00 HC84200625 SPECIAL STAIN THICK $180.00 HC81700189 T4/THYROXINE TOTAL $180.00 HC81500209 THICK SMEAR, BLOOD PARASITES $180.00 0009-7529-04 IRINOTECAN 40 MG/2 ML IV SOLN $179.66 0121-0581-04 HALOPERIDOL LACTATE 2 MG/ML ORAL CONC $179.40 63323-088-63 SODIUM CHLORIDE 4 MEQ/ML IV SOLP $179.40 99999-044-93 MIDAZOLAM IN D5W 200 MG/200 ML (1 MG/ML) DRIP (LBM) $179.40 0378-9124-16 FENTANYL 100 MCG/HR TRANSDERMAL PT72 $179.13 0378-9124-98 FENTANYL 100 MCG/HR TRANSDERMAL PT72 $179.13 0406-9000-76 FENTANYL 100 MCG/HR TRANSDERMAL PT72 $179.13 0406-9100-76 FENTANYL 100 MCG/HR TRANSDERMAL PT72 $179.13 47781-428-11 FENTANYL 100 MCG/HR TRANSDERMAL PT72 $179.13 47781-428-47 FENTANYL 100 MCG/HR TRANSDERMAL PT72 $179.13 HC81500282 BUFFY COAT $179.00 HC81500225 CELL COUNT CORD BLOOD $179.00 HC51061463 ECG EXT HOLTER >48HRS-7DAYS; SCANNING ANYS W/REPORT $179.00 HC51061471 ECG EXT HOLTER W/CONNECT >7DAYS-15DAYS; RECORDING $179.00 HC62208467 NEEDLE GUIDE ENDOCAVITY $179.00 HC32010316 OT-ULTRASOUND 15MIN $179.00 HC89005680 PARVOVIRUS B19 DNA QNT PCR-FT $179.00 HC31010283 PT-ULTRASOUND 15MIN $179.00 HC81700213 T3 OR T4 UPTAKE $179.00 HC62210307 TUBE REPOGLE 8 FRENCH $179.00 68084-075-11 TRETINOIN (ANTINEOPLASTIC) 10 MG ORAL CAP $178.93 68084-075-21 TRETINOIN (ANTINEOPLASTIC) 10 MG ORAL CAP $178.93 0074-4380-10 CISATRACURIUM 2 MG/ML IV SOLN $178.75 0074-4380-81 CISATRACURIUM 2 MG/ML IV SOLN $178.75 16729-276-11 FLUOROURACIL 2.5 GRAM/50 ML IV SOLN $178.75 25021-215-98 FLUOROURACIL 2.5 GRAM/50 ML IV SOLN $178.75 61703-303-46 CYTARABINE (PF) 20 MG/ML INJ SOLN $178.75 99999-042-48 FENTANYL DRIP (CONC 50 MCG/ML) 50 ML OCM $178.75 5483800530 VITAMIN E (DL, ACETATE) 22.5 MG (50 UNIT)/ML ORAL DROP $178.62 67386-314-01 CLOBAZAM 10 MG ORAL TAB $178.62 76329-6300-5 LIDOCAINE HCL 4 % LATR SOLN $178.62 6371301974 GELATIN SPONGE,ABSORB-PORCINE 100 TOPICAL SPGE $178.22 16714-037-25 EPHEDRINE SULFATE 50 MG/ML IV SOLN (MHS) $178.02 HC51000545 CHEMO HORMON ANTINEOPL SQ/IM $178.00 HC84200310 CULTURE TYPE AGGLUTINATION EA $178.00 HC81500258 G6-PD SCREEN $178.00 HC81500902 HEPARIN PROTAMINE TOLERANCE $178.00 HC62228945 IMMOBILIZER SHOULDER FIG8 PREFAB $178.00 HC51060929 OT-ORTHOTIC MGMT & TRNG INITIAL ENC 15MIN/M $178.00 HC81500076 PROTHROMBIN TIME $178.00 HC89501027 RARE DONOR SEARCH-SB $178.00 HC89005102 VORICONAZOLE ANTIFNGL-FT $178.00 63323-322-01 IMIPENEM-CILASTATIN 500 MG IV SOLR $177.97 63323-322-25 IMIPENEM-CILASTATIN 500 MG IV SOLR $177.97 69945-601-10 SODIUM IODIDE-123 3.7 MBQ (100 MICROCI) ORAL CAP $177.59 0069-5471-01 FOSPHENYTOIN 100 MG PE/2 ML INJ SOLN $177.52 0069-5471-02 FOSPHENYTOIN 100 MG PE/2 ML INJ SOLN $177.52 63323-401-26 AZTREONAM 1 GRAM INJ SOLR $177.52 99999-046-11 IOHEXOL 300 MG IODINE/ML IV SOLN $177.06 HC62200092 ADAPTER AIRWAY/RESPIRATORY E $177.00 HC81700726 ANTI-DNA (DS) $177.00 HC81700734 CENTROMERE AB $177.00 HC62202395 DRESSING ALLEVYN $177.00 HC81700759 MYOCARDIAL AB $177.00 HC62202072 NEEDLE BIOPSY/ASPIRATION E $177.00 HC62220587 NEEDLE DELIVERY CEMENT $177.00 HC32000960 OT-MASSAGE ADDL 15MIN/CW $177.00 HC31001126 PT-ORTHOTIC FIT/TRNG ADD15M/CW $177.00 HC81702219 TREPONEMA PALLIDUM AB QUALITATIVE $177.00 HC81702003 TREPONEMA PALLIDUM AB, IGG $177.00 HC62212170 TUBE FEEDING NG>36IN TRACKABLE STYLET $177.00 HC51062933 REMOTE AUTO SYSTM INSULIN DOSE CALC; DATA COLLCT EA 30DAYS $177.00 49702-223-18 MARAVIROC 150 MG ORAL TAB $176.92 HC62300215 CABLE EP E $176.00 HC62224092 CANNULA ERCP E $176.00 HC62221627 CANNULA TRACH INNER C $176.00 HC62201264 CATH BRONCH VENTILATION $176.00 HC62219191 CATH DIALYSIS SHORT-TERM C $176.00 HC62218243 CATH INTRODUCER PEEL-AWAY G $176.00 HC62805320 CATH SWAN GANZ/THERMODILUTION E $176.00 HC62226220 CUTTER LEAD $176.00 HC62218706 DRILL/DRILL BITS SINGLE USE E $176.00 HC62212535 FORCEP BIOPSY DISP C $176.00 HC62212683 GUIDEWIRE(GLIDEWIRE ANGL) C $176.00 HC62207782 IVS TUBING BLOOD/FLUID WARMER $176.00 HC62204755 MODULE OB CUSTOM DISP PACK $176.00 HC35500230 MT-DEV COGNITIVE SKILLS INITL 15MIN $176.00 HC62228093 PATCH WIRELESS MONITOR MATERNAL-FETAL $176.00 HC62229117 PIN DISTRACTOR E $176.00 HC31001019 PT-NEUROMUSC RE-ED ADD15MIN/CW $176.00 HC62206172 SET CHEST DRAINAGE $176.00 HC62209622 SLING KODEL $176.00 HC62218516 STAPLE CARTRG/RELOAD LIN CUT H $176.00 HC62226444 STYLET CARDIAC C $176.00 HC62207410 TRAY LACERATION DISPOSABLE $176.00 HC62207485 TRAY PELVIC EXAM $176.00 HC62217070 TUNNELER SURGICAL B $176.00 99999-046-08 IODIXANOL 320 MG IODINE/ML IV SOLN $175.70 0264-4460-10 FAT EMULSION 20 % IV EMUL $175.50 0338-3552-48 VANCOMYCIN IN DEXTROSE 5 % 1 GRAM/200 ML IV PGBK $175.50 67457-430-10 PAMIDRONATE 30 MG/10 ML (3 MG/ML) IV SOLN $175.50 69374-504-25 NOREPINEPHRINE BITARTRATE-NACL 8 MG/250 ML (32 MCG/ML) IV SOLN $175.50 69374-504-28 NOREPINEPHRINE BITARTRATE-NACL 8 MG/250 ML (32 MCG/ML) IV SOLN $175.50 69374-536-50 METHACHOLINE CHLORIDE 48 MG/3 ML (16 MG/ML) INHALATION NEBU $175.50 69374-537-03 METHACHOLINE CHLORIDE 0.1875 MG/3 ML (0.0625 MG/ML) INHALATION NEBU $175.50 69374-538-03 METHACHOLINE CHLORIDE 0.75 MG/3 ML (0.25 MG/ML) INHALATION NEBU $175.50 69374-539-03 METHACHOLINE CHLORIDE 3 MG/3 ML (1 MG/ML) INHALATION NEBU $175.50 69374-540-03 METHACHOLINE CHLORIDE 12 MG/3 ML (4 MG/ML) INHALATION NEBU $175.50 69374-541-03 METHACHOLINE CHLORIDE 0 MG/3 ML (0 MG/ML) INHALATION NEBU $175.50 99999-044-52 VANCOMYCIN IN NS 1.25 GRAM/250 ML IV SOLN (MHS) $175.50 HC83590398 BRAF MUTATION ANALYSIS-AP $175.40 27808-065-02 PROMETHAZINE-CODEINE 6.25-10 MG/5 ML ORAL SYRP $175.25 HC83500397 CHROM ANAL TISSUE COUNT-US $175.00 HC83500272 CHROMO TISSUE BLOOD-IM $175.00 HC83500256 CHROMO TISSUE BLOOD-US $175.00 HC89023394 FACTOR INHIBITOR ADAMTS13-AU $175.00 HC81101131 G6PD $175.00 HC32001117 OT-ADL ADD 15MIN/CW $175.00 HC32000903 OT-ULTRASOUND ADD 15MIN/CW $175.00 HC11500816 PEDS ESTAB PT ASSES BRIEF(5') $175.00 HC31001324 PT-HUBBARD TANK ADD15MIN/CW $175.00 HC89500607 SERUM PRETREATMNT W INHIB-SB $175.00 HC51001873 X-RAY TOES MIN 2 VWS $175.00 HC89008775 IRON TOTAL URINE-AU $174.83 0555-0808-02 TRETINOIN (ANTINEOPLASTIC) 10 MG ORAL CAP $174.81 10370-268-01 TRETINOIN (ANTINEOPLASTIC) 10 MG ORAL CAP $174.81 68462-792-01 TRETINOIN (ANTINEOPLASTIC) 10 MG ORAL CAP $174.81 55513-073-30 CINACALCET 30 MG ORAL TAB $174.79 0078-0181-01 OCTREOTIDE ACETATE 100 MCG/ML INJ SOLN $174.49 0781-3298-04 ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRG $174.41 0781-3298-68 ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRG $174.41 0713-0132-06 PROMETHAZINE 50 MG RECTAL SUPP $174.35 0713-0132-12 PROMETHAZINE 50 MG RECTAL SUPP $174.35 HC81100398 ALK PHOSPHATASE $174.00 HC81101123 GLUCOSE POST DOSE $174.00 HC81101479 LIPOPROTEIN A $174.00 HC81500316 MANUAL CELL COUNT RED/LEUK/PLT $174.00 HC84200559 SHIGELLA TOXIN BY IMM $174.00 HC84200542 SHIGELLA TOXIN BY IMMUNOASSAY $174.00 HC51060523 ST EVAL SOUND PRODUCTION/M $174.00 HC81100141 URIC ACID FLUID $174.00 HC81100034 URIC ACID URINE $174.00 0574-7040-01 BELLADONNA ALKALOIDS-OPIUM 16.2-60 MG RECTAL SUPP $173.95 0574-7040-12 BELLADONNA ALKALOIDS-OPIUM 16.2-60 MG RECTAL SUPP $173.95 63323-184-11 FOLIC ACID 5 MG/ML INJ SOLN $173.55 HC62217195 ORTHOTIC WHFO 1+JOINT(S) PREFAB $173.00 HC33000118 SP-ASSESS ASSIST TECH 15MIN/CM $173.00 0069-3140-19 AZITHROMYCIN 200 MG/5 ML ORAL SUSR $172.58 0555-1009-01 CLONIDINE 0.1 MG/24 HR TRANSDERMAL PTWK $172.41 0409-1660-20 DEXMEDETOMIDINE IN 0.9 % NACL 80 MCG/20 ML (4 MCG/ML) IV SOLN $172.38 0409-1660-22 DEXMEDETOMIDINE IN 0.9 % NACL 80 MCG/20 ML (4 MCG/ML) IV SOLN $172.38 0378-0871-16 CLONIDINE 0.1 MG/24 HR TRANSDERMAL PTWK $172.24 0378-0871-99 CLONIDINE 0.1 MG/24 HR TRANSDERMAL PTWK $172.24 0591-3508-04 CLONIDINE 0.1 MG/24 HR TRANSDERMAL PTWK $172.24 0591-3508-54 CLONIDINE 0.1 MG/24 HR TRANSDERMAL PTWK $172.24 99999-046-15 IODIXANOL 320 MG IODINE/ML IV SOLN $172.09 HC62220751 DEVICE INDEFLATOR $172.00 HC11500006 EST PT NOT REQ PHYS(5MIN) $172.00 HC62205059 NERVE LOCATOR DISP $172.00 HC51060937 OT-PROSTHETIC MGMT & TRNG INITIAL ENC 15MIN/M $172.00 HC31000953 PT-IONTOPHORESIS ADDL 15MIN/CW $172.00 HC51002137 RD COUNSELING NUTRITION VISIT/C $172.00 HC33000787 ST-DYSPHAGIA SCREENING/IP $172.00 HC33000795 ST-LANGUAGE SCREENING/IP $172.00 HC33000803 ST-SPEECH SCREENING/IP $172.00 HC62207378 TRAY HYPERAL DRESSING(DISP) $172.00 HC89018089 VON WILLEBRAND FACT 2N BIND-EC $172.00 0944-2720-03 HYALURONIDASE, HUMAN RECOMB. 200 UNIT/1.25 ML SUBCUTANEOUS SOLN $171.84 62856-583-52 RUFINAMIDE 400 MG ORAL TAB $171.60 69374-314-10 MIDAZOLAM 100MG IN NS 100ML DRIP (MHS) $171.60 0641-0476-21 PHENOBARBITAL SODIUM 65 MG/ML INJ SOLN $171.30 0641-0476-25 PHENOBARBITAL SODIUM 65 MG/ML INJ SOLN $171.30 63323-130-02 DOXYCYCLINE HYCLATE 100 MG IV SOLR $171.15 63323-130-11 DOXYCYCLINE HYCLATE 100 MG IV SOLR $171.15 HC83000141 BLOOD TYPE SEROLOGIC; ABO $171.00 HC14500136 DM HEMOGLOBIN GLYCOSYLATED(A1C $171.00 HC89008627 MYASTHENIA GRAVIS EVAL-SL $171.00 HC62204821 NASAL TAMPON $171.00 HC81700478 RUBELLA SCREEN $171.00 0019-1323-02 IOVERSOL 320 MG IODINE/ML IV SOLN $170.69 70092-1035-05 NOREPINEPHRINE IN NS 8 MG/250 ML (32 MCG/ML) IV SOLN (MHS) $170.63 42494-415-25 PHENOBARBITAL SODIUM 65 MG/ML INJ SOLN $170.20 42494-415-01 PHENOBARBITAL SODIUM 65 MG/ML INJ SOLN $170.17 0093-2026-31 AZITHROMYCIN 200 MG/5 ML ORAL SUSR $170.04 HC83000158 BLOOD TYPE SEROLOGIC; RH(D) $170.00 HC83505636 BRAF MUTATION ANALYSIS-NG $170.00 HC89018071 CALCIUM FOR PTH(PNL)-QD $170.00 HC89007876 DEOXYCORTISOL 11-ES $170.00 HC51010627 IMMNTX 3 STING INSECTS /COMM $170.00 HC12600011 IMMUNIZATION ADMIN ADD'L $170.00 HC32000028 OT-ASSESS ASSIST TECH 15MIN/CM $170.00 HC32001786 OT-DYSPHAGIA SCREENING/IP $170.00 HC81101628 PROTEIN TOTAL, FLUID $170.00 HC31000102 PT-ASSESS ASSIST TECH 15MIN/CM $170.00 HC51002806 STUDY REFLEX BLADDER URINARY $170.00 HC51062867 ASSESSMENT & CARE PLAN PT COG IMP 60 MIN $169.00 HC62201256 CATH BRINKLEY $169.00 HC62203088 ET DRESS STOMAHESIVE $169.00 HC83504928 MORPH STUDY MAN ISH HER2-NG $169.00 HC35500248 MT-DEV COGNITIVE SKILLS ADDL 15MIN $169.00 HC81500605 SICKLE CELL SCREEN $169.00 0143-9552-01 LEUCOVORIN CALCIUM 350 MG INJ SOLR $169.00 63323-820-04 FAT EMUL-SOY-MCT-OLIV-FISH OIL 20 % IV EMUL $169.00 63323-820-74 FAT EMUL-SOY-MCT-OLIV-FISH OIL 20 % IV EMUL $169.00 99999-010-67 NAFCILLIN 50 MG/ML INJ DILUTION $169.00 69097-142-60 ALBUTEROL SULFATE 90 MCG/ACTUATION INHALATION HFAA $168.89 51672-1264-2 FLUOCINONIDE 0.05 % TOPICAL OINT $168.48 HC81700635 ALBUMIN; URINE QUANT $168.00 HC62215256 BLADE SAW K $168.00 HC62214192 CATH URETERAL K $168.00 HC89019442 FUNGITELL ASSAY-BD $168.00 HC62222849 INFLATOR FOR BALLOON F $168.00 HC62211750 KIT CATH IV PERIPH LONGTERM $168.00 HC84600147 PAP BETHESDA MAN & RE-SCREEN $168.00 HC62216486 PIN/WIRE FIXATION TEMPORARY K $168.00 HC31001076 PT-MANUAL THERAPY ADD 15MIN/CW $168.00 HC31001050 PT-MASSAGE ADD 15MIN/CW $168.00 HC62211909 SET VACUUM CANNISTER W/GEL $168.00 HC62207162 TAPE HYPAFIX $168.00 HC62218193 TRAY THORAC/PARACENTESIS G $168.00 HC62208087 VACUUM SUCTION (NEWBORN) $168.00 HC62213665 WOUND FILLER DRY FORM PER GM $168.00 HC62224746 WRAP COMPRESSION BACK/SPINE $168.00 99999-043-28 ARGININE HCL 2.5 MEQ/ML ORAL LIQUID $167.96 60687-525-11 CINACALCET 30 MG ORAL TAB $167.92 60687-525-21 CINACALCET 30 MG ORAL TAB $167.92 0517-2502-01 CAFFEINE-SODIUM BENZOATE 250 MG/ML (125 MG/ML CAFFEINE) INJ SOLN $167.38 0517-2502-10 CAFFEINE-SODIUM BENZOATE 250 MG/ML (125 MG/ML CAFFEINE) INJ SOLN $167.38 62332-751-50 FLUOROURACIL 2.5 GRAM/50 ML IV SOLN $167.05 63323-117-61 FLUOROURACIL 5 GRAM/100 ML IV SOLN $167.05 70700-188-22 FLUOROURACIL 2.5 GRAM/50 ML IV SOLN $167.05 HC89012009 BACTERIAL AG SCREEN - CSF-FT $167.00 HC62219928 CONNECTOR LUERLOCK ICP $167.00 HC81101503 PROTEIN TOTAL, REFRCT $167.00 HC81100059 SODIUM URINE $167.00 0955-1012-10 ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRG $166.66 0517-5601-25 HYDROXYZINE HCL 50 MG/ML IM SOLN $166.47 0006-4981-00 HEPATITIS B VIRUS VACC.REC(PF) 5 MCG/0.5 ML IM SUSP $166.39 0832-1410-03 MOXIFLOXACIN 0.5 % OPHT DROP $166.34 58160-820-43 HEPATITIS B VIRUS VACC.REC(PF) 10 MCG/0.5 ML IM SYRG $166.30 58160-820-52 HEPATITIS B VIRUS VACC.REC(PF) 10 MCG/0.5 ML IM SYRG $166.30 HC81702011 ALLERGEN IGE SPECFC RECOMB QNT/SEMI QNT EA $166.00 HC81101222 SODIUM FLUID $166.00 HC33010083 ST EVAL BEHAVRAL QUAL VOICE [15MIN] $166.00 0143-9689-01 NICARDIPINE 25 MG/10 ML IV SOLN $165.88 0143-9689-10 NICARDIPINE 25 MG/10 ML IV SOLN $165.88 0270-1316-30 IOPAMIDOL 370 MG IODINE /ML (76 %) IV SOLN $165.75 63323-010-03 GENTAMICIN 40 MG/ML INJ SOLN $165.23 63323-010-20 GENTAMICIN 40 MG/ML INJ SOLN $165.23 70677-0038-2 MAGNESIUM SULFATE (LAXATIVE) 495 MG/5 GRAM ORAL GRAN $165.07 50474-802-03 ROTIGOTINE 2 MG/24 HOUR TRANSDERMAL PT24 $165.02 HC29000650 ADMIN/INTERP RISK ASSESS INSTR CAREGIVER FCS $165.00 HC29000643 ADMIN/INTERP RISK ASSESS INSTR PT-FOCUS $165.00 HC81101693 BILIRUBIN TRANSCUTANEOUS(POCS) $165.00 HC81100497 CALCIUM URINE QUANT TIMED SPEC $165.00 HC81100554 CREATININE OTHER $165.00 HC89016588 ENTEROVIRUS BY PCR-FT $165.00 HC84200989 FAT STAIN FECES QUAL $165.00 HC89021315 HEAVY METAL QN EA;IODINE SERUM-AU $165.00 HC89016075 HSV 1-2 BY PCR-FT $165.00 HC31001514 PT-APPLY VASOPNEUMATIC DEV/MW $165.00 HC83000315 RH PHENOTYPE $165.00 HC81500167 WBC MANUAL DIFF $165.00 0409-1754-10 MAGNESIUM SULFATE 4 MEQ/ML INJ SYRG $164.45 HC51004059 AEROSOL-CONTINUOUS TX FIRST HR $164.00 HC89000699 BETA-GLUCURONIDASE, CSF-AU $164.00 HC89020382 KRAS GENE ANALYSIS-AU $164.00 HC89020374 MOLECULAR PATH PROC LVL 4-AU $164.00 HC62205323 PACK LAP CHOLE $164.00 HC81100687 PHOSPHORUS $164.00 HC81100018 PROTEIN URINE $164.00 HC31001142 PT-PROSTHETIC TRNG ADD15MIN/CW $164.00 10539-03697 RIBOSE ORAL POWDER $163.80 16714-867-01 PALIPERIDONE 3 MG ORAL TR24 $163.46 99999-036-46 BOSENTAN 31.25 MG ORAL PARTIAL TAB $163.12 HC81100489 CALCIUM TOTAL $163.00 HC89018295 FACTOR IX ASSAY -EC $163.00 HC89018311 FACTOR V ASSAY -EC $163.00 HC89021174 FACTOR VIII ACTIVITY -EC $163.00 HC89018337 FACTOR X ASSAY -EC $163.00 HC89018345 FACTOR XI ASSAY -EC $163.00 HC89018352 FACTOR XII ASSAY -EC $163.00 HC89018360 FACTOR XIII ASSAY -EC $163.00 HC81101172 HEMOGLOBIN PLASMA $163.00 HC51060788 OT-DEVEL TEST ADMIN ASSESS COG INSTR; EA ADD 30MIN+ $163.00 HC32000234 OT-INFRARED/CMW $163.00 HC51070670 PSY-DEVEL TEST ADMIN ASSESS COG INSTR; EA ADD 30MIN+ $163.00 HC31001613 PT-COMMTY WK/REINT ADD15MIN/CW $163.00 HC51060804 PT-DEVEL TEST ADMIN ASSESS COG INSTR; EA ADD 30MIN+ $163.00 HC31000300 PT-INFRARED/CMW $163.00 HC83000372 RBC PRETREAT W/DRUG/CHEM $163.00 HC81100638 SGPT(ALT) $163.00 HC33000688 ST-SPEECH THERAPY GRP 15MIN/MW $163.00 45802-952-43 IBUPROFEN 100 MG/5 ML ORAL SUSP $162.95 51672-1385-9 IBUPROFEN 100 MG/5 ML ORAL SUSP $162.95 59651-032-47 IBUPROFEN 100 MG/5 ML ORAL SUSP $162.95 45802-466-35 ECONAZOLE 1 % TOPICAL CREAM $162.73 0641-6238-01 EPHEDRINE SULFATE 50 MG/ML IV SOLN (MHS) $162.57 0641-6238-25 EPHEDRINE SULFATE 50 MG/ML IV SOLN (MHS) $162.57 HC89018600 CHROM ANAL 20-25 CELLS, BM-AU $162.50 HC89018592 CHROM ANAL TISSUE CULT, BM-AU $162.50 0019-0953-09 IOTHALAMATE MEGLUMINE 60 % INJ SOLN $162.50 0338-1305-01 MESNA 100 MG/ML IV SOLN $162.50 0641-6030-01 FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN $162.50 10019-953-01 MESNA 100 MG/ML IV SOLN $162.50 10019-953-62 MESNA 100 MG/ML IV SOLN $162.50 16729-267-63 DOCETAXEL 20 MG/ML (1 ML) IV SOLN $162.50 25021-204-01 VINORELBINE 10 MG/ML IV SOLN $162.50 25021-233-10 OXALIPLATIN 5 MG/ML IV SOLN (MCH) $162.50 25021-245-01 DOCETAXEL 20 MG/ML (1 ML) IV SOLN $162.50 39822-2000-1 CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLN $162.50 47781-570-89 LIDOCAINE-TRANSPARENT DRESSING 4 % TOPICAL KIT $162.50 49230-191-50 PERIT. DIALYSIS 21-2.5 % DEXTR CA 3.5 MEQ/L- MG 1.5 MEQ/L IP SOLN $162.50 54838-555-50 ONDANSETRON HCL 4 MG/5 ML ORAL SOLN $162.50 55150-173-01 SUMATRIPTAN SUCCINATE 6 MG/0.5 ML SUBCUTANEOUS SOLN $162.50 55150-173-05 SUMATRIPTAN SUCCINATE 6 MG/0.5 ML SUBCUTANEOUS SOLN $162.50 61314-019-10 DORZOLAMIDE 2 % OPHT DROP $162.50 63323-806-50 FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN $162.50 65162-691-79 ONDANSETRON HCL 4 MG/5 ML ORAL SOLN $162.50 65862-218-01 CEFDINIR 125 MG/5 ML ORAL SUSR $162.50 65862-219-01 CEFDINIR 250 MG/5 ML ORAL SUSR $162.50 67457-317-25 PALONOSETRON 0.25 MG/5 ML IV SOLN $162.50 71288-017-15 DAPTOMYCIN 350 MG IV SOLR $162.50 72205-054-01 FOSAPREPITANT 150 MG IV SOLR $162.50 0168-0099-30 KETOCONAZOLE 2 % TOPICAL CREAM $162.44 47335-892-60 TEMOZOLOMIDE 100 MG ORAL CAP $162.41 47335-892-72 TEMOZOLOMIDE 100 MG ORAL CAP (MCH) $162.41 65162-803-14 TEMOZOLOMIDE 100 MG ORAL CAP $162.41 HC62208962 CLIP WIRE ROTABLATOR $162.00 HC51010437 EMG LTD NOT PARASP/CRANIAL/SPHINC $162.00 HC51062172 PLACENTAL ALPHA MICROGLOBULIN-1 $162.00 HC62223888 PORT ENDOSCOPIC $162.00 HC51062024 SELF MANAGEMENT EDUC & TRAINING INDIV 30MIN (PRIVAT INSAUTHREQ) $162.00 HC62207220 TOURNIQUET $162.00 HC62221957 TUBING IRRIGATION HF ROBOTIC C $162.00 69784-231-20 SODIUM ACETATE 2 MEQ/ML IV SOLN $161.85 72572-128-01 DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN $161.85 72572-128-08 DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN $161.85 67457-582-00 FONDAPARINUX 2.5 MG/0.5 ML SUBCUTANEOUS SYRG $161.58 67457-582-10 FONDAPARINUX 2.5 MG/0.5 ML SUBCUTANEOUS SYRG $161.58 64679-661-01 GRANISETRON (PF) 1 MG/ML (1 ML) IV SOLN $161.53 99999-046-07 IODIXANOL 320 MG IODINE/ML IV SOLN $161.53 0075-0623-00 ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRG $161.43 HC89018634 CHROM ANAL 15-20 CELLS, BLD-AU $161.20 58160-810-43 DIPH,PERTUS(ACEL),TET PED (PF) 25-58-10 LF-MCG-LF/0.5ML IM SYRG $161.08 58160-810-52 DIPH,PERTUS(ACEL),TET PED (PF) 25-58-10 LF-MCG-LF/0.5ML IM SYRG $161.08 HC81101248 C-REACTIVE PROTEIN $161.00 HC81100810 FAT STAIN URINE/FECES/SECRETNS $161.00 HC81500878 PROTHROMBIN TIME (POS) $161.00 HC51002079 REMOV IMPACTD EAR WAX(INSTRUMENT) LT $161.00 HC51002087 REMOV IMPACTD EAR WAX(INSTRUMENT) RT $161.00 HC89024210 PROPOXYPHENE AND METABOLITE UR-AU $161.00 76329-1240-1 PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJ SYRG $160.75 16714-695-01 FLUCONAZOLE 10 MG/ML ORAL SUSR $160.62 63323-360-03 CALCIUM GLUCONATE 100 MG/ML (10%) IV SOLN $160.23 63323-360-59 CALCIUM GLUCONATE 100 MG/ML (10%) IV SOLN $160.23 HC89019285 NEUTROPHIL OXIDATIVE BURST-AU $160.00 HC81100844 PH FLUID $160.00 HC89019749 PLATELET AB IDENTIFY-AU $160.00 HC39000765 PSYCH TEACH/COUNSEL INDIVIDUAL -COMM $160.00 HC36000693 RT-TEAM CONF W/MD >30MIN(NO PT) $160.00 HC81100620 SGOT(AST) $160.00 69339-136-03 DIAZEPAM 5 MG/ML INJ SYRG $159.99 69339-136-34 DIAZEPAM 5 MG/ML INJ SYRG $159.99 0641-6244-01 DIAZEPAM 5 MG/ML INJ SYRG $159.97 0641-6244-10 DIAZEPAM 5 MG/ML INJ SYRG $159.97 0069-3032-20 DOXORUBICIN CHEMOTHERAPY EMBOLIZATION BEADS $159.74 0703-9040-03 AMIKACIN 1,000 MG/4 ML INJ SOLN $159.33 23155-290-32 AMIKACIN 1,000 MG/4 ML INJ SOLN $159.33 23155-290-42 AMIKACIN 1,000 MG/4 ML INJ SOLN $159.33 99999-045-25 ADENOSINE 5 MG IN NS 500 ML IC SOLUTION (OCM CATH LAB) $159.25 66689-058-04 CLOBAZAM 2.5 MG/ML ORAL SUSP $159.12 HC81101016 ACETYLCHOLINESTERASE $159.00 HC62223573 ELECTRODE HOOK LAPAROSCOPIC $159.00 HC62802459 INTRODUCER GUIDE $159.00 HC51020428 NP DEV PT REPORT; INTERMEDIATE $159.00 HC62208970 PADS DEFIBRILLATOR HANDS FREE $159.00 HC81100042 POTASSIUM URINE $159.00 HC51020014 RN DEV PT REPORT; INTERMEDIATE $159.00 HC81700403 RPR/VDRL QUANT $159.00 HC51060739 ST-SPEECH THERAPY 60 MIN $159.00 HC62222294 ORTH KNEE BRACE RANGER $159.00 HC62208939 SYSTEM CONTRAST SAVER $159.00 HC62208947 SYSTEM CONTRAST SPIKE/BAG $159.00 25010-215-15 ETHACRYNIC ACID 25 MG ORAL TAB $158.88 6371301973 GELATIN SPONGE,ABSORB-PORCINE 50 TOPICAL SPGE $158.83 0574-0129-01 CLINDAMYCIN PALMITATE 75 MG/5 ML ORAL SOLR (MCH) $158.60 0310-1105-01 SODIUM ZIRCONIUM CYCLOSILICATE 5 GRAM ORAL PWPK $158.09 0310-1105-30 SODIUM ZIRCONIUM CYCLOSILICATE 5 GRAM ORAL PWPK $158.09 0310-1110-01 SODIUM ZIRCONIUM CYCLOSILICATE 10 GRAM ORAL PWPK $158.09 0310-1110-30 SODIUM ZIRCONIUM CYCLOSILICATE 10 GRAM ORAL PWPK $158.09 0310-1105-39 SODIUM ZIRCONIUM CYCLOSILICATE 5 GRAM ORAL PWPK $158.08 0310-1110-39 SODIUM ZIRCONIUM CYCLOSILICATE 10 GRAM ORAL PWPK $158.08 HC89007223 AMINO ACIDS QUANT URINE-CA $158.00 HC89007215 AMINO ACIDS QUANT-CA $158.00 HC81101081 CHLORIDE URINE $158.00 HC82202268 DECALCIFICATION DIST SVC $158.00 HC82200346 DECALCIFICATION+ $158.00 HC82202599 DECALCIFICATION+ *OP $158.00 HC89005268 HSV 1 QUANT PCR- FT $158.00 HC89005276 HSV 2 QUANT PCR- FT $158.00 HC62205331 PACK LAPAROSCOPIC $158.00 HC62211156 PACK SUCTION SUPPLEMENT $158.00 HC14500045 PREGNANCY DIAB MGT 15MIN $158.00 HC62206388 SET THERM FOR CARDIAC OUTPUT $158.00 HC62209614 SLING CUFF AND COLLAR $158.00 46287-006-60 SODIUM POLYSTYRENE SULFONATE (SORBITOL) 15 GRAM/60 ML ORAL SUSPENSION $157.95 0009-0758-01 METHYLPREDNISOLONE SODIUM SUCC 500 MG IV SOLR $157.82 0641-6173-01 DICYCLOMINE 10 MG/ML IM SOLN $157.56 0641-6173-10 DICYCLOMINE 10 MG/ML IM SOLN $157.56 61874-100-60 ELUXADOLINE 100 MG ORAL TAB $157.35 65649-150-90 METHYLNALTREXONE 150 MG ORAL TAB $157.24 HC83500686 TISSUE EXAM G&M LEVEL 4-CS $157.15 68382-910-01 DOXYCYCLINE HYCLATE 100 MG IV SOLR $157.04 68382-910-10 DOXYCYCLINE HYCLATE 100 MG IV SOLR $157.04 HC81100240 BILIRUBIN DIRECT/CONJUGATED $157.00 HC51000461 BLOOD DRAW IMP'T VENOUS DEVICE $157.00 HC83001057 CMV AB NEGATIVE BLOOD $157.00 HC62223185 DEVICE PEP OSCILLATING $157.00 HC62203054 ET BARRIER WOUND CARE $157.00 HC62203393 FLOWMETER $157.00 HC51010676 IMMUNTX PREP-PROV AG2STING BUG VNM $157.00 HC81101198 LEAD $157.00 HC32010332 OT-ONLINE ASSESS & MANAGMNT EST PT 11-20MIN $157.00 HC81100703 PROTEIN TOTAL $157.00 HC31090152 PT-ONLINE ASSESS & MANAGMNT EST PT 11-20MIN $157.00 HC31000433 PT-PARAFFIN BATH /CMW $157.00 HC33010208 ST-ONLINE ASSESS & MANAGMNT EST PT 11-20MIN $157.00 99999-033-78 ALTEPLASE IN BSS (100 MCG/ML) OPHTHALMIC INJECTION $156.69 63323-631-10 LEUCOVORIN CALCIUM 10 MG/ML INJ SOLN $156.59 55292-201-11 SUCCIMER 100 MG ORAL CAP $156.26 0002-4454-01 OLANZAPINE 10 MG ORAL TBDL $156.13 0002-4454-85 OLANZAPINE 10 MG ORAL TBDL $156.13 HC51062909 ADVANCE CARE PLAN 1ST 30MIN W/PAT FAM OR SURROGATE $156.00 HC81100547 CREATININE $156.00 HC34000299 ELECTROACOUSTIC EVAL FOR HEARING AID; MONOAURAL $156.00 HC34000240 EVOKED OTOACOUSTIC EMISSIONS SCREEN $156.00 HC51010684 IMMUNTX PREP-PROV AG3STING BUG VNM $156.00 HC51010692 IMMUNTX PREP-PROV AG4STING BUG VNM $156.00 HC51010700 IMMUNTX PREP-PROV AG5STING BUG VNM $156.00 HC32000366 OT-PARAFFIN BATH /CMW $156.00 HC29000569 PREVENTATIVE MED COUNSELING 30MIN $156.00 HC34000380 REHAB AUD POSTLINGUAL HEAR LOSS $156.00 HC34000372 REHAB AUD PRELINGUAL HEAR LOSS $156.00 HC51063063 TRIM NONDYSTROPHIC NAILS $156.00 6817600010 PEDI MULTIVIT NO.128-VITAMIN K 500 MCG/ML ORAL LIQD $156.00 0019-0862-07 IOTHALAMATE MEGLUMINE 17.2 % URETHRAL SOLN $156.00 0019-0862-50 IOTHALAMATE MEGLUMINE 17.2 % URETHRAL SOLN $156.00 0143-9553-01 LEUCOVORIN CALCIUM 200 MG INJ SOLN (MCH) $156.00 0264-1944-20 POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN $156.00 0338-0295-47 SORBITOL 3 % IRR SOLN $156.00 10019-360-40 ISOFLURANE 99.9 % INHALATION LIQD $156.00 25021-159-10 COLISTIN (COLISTIMETHATE NA) 150 MG INJ SOLR $156.00 43386-090-19 PEG 3350-ELECTROLYTES 236-22.74-6.74 -5.86 GRAM ORAL SOLR $156.00 44567-237-06 CEFTAZIDIME 6 GRAM INJ SOLR $156.00 51754-0500-1 CAFFEINE CITRATE 20 MG/ML INJ SOLN (MCH) $156.00 51754-0501-3 CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) ORAL SOLN $156.00 51754-0502-1 CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) IV SOLN $156.00 51754-0503-3 CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) ORAL SOLN $156.00 52268-100-01 PEG 3350-ELECTROLYTES 236-22.74-6.74 -5.86 GRAM ORAL SOLR $156.00 64679-728-01 SUMATRIPTAN SUCCINATE 6 MG/0.5 ML SUBCUTANEOUS SOLN $156.00 64679-728-08 SUMATRIPTAN SUCCINATE 6 MG/0.5 ML SUBCUTANEOUS SOLN $156.00 99999-040-17 CAFFEINE CITRATE 5 MG/ML INJ DILUTION (MCH) $156.00 99999-042-67 CAFFEINE CITRATE 5 MG/ML INJ DILUTION (MCH) $156.00 99999-046-30 CAFFEINE CITRATE 5 MG/ML ORAL SOLN (SLH) $156.00 59676-571-01 ETRAVIRINE 200 MG ORAL TAB $155.97 59762-0531-2 PHENYTOIN 125 MG/5 ML ORAL SUSP $155.59 66689-775-08 PHENYTOIN 125 MG/5 ML ORAL SUSP $155.59 0054-3176-44 DEXAMETHASONE 1 MG/ML ORAL DROP $155.03 HC62220157 CATH BALLOON MANOMETRY ANORECTAL $155.00 HC83000802 COLD AGGLUTININS TITER $155.00 HC51000198 DEMO&/OR EVAL OF INH TX $155.00 HC89500722 FREEZING BLOOD EA UNIT AUTO-SB $155.00 HC81101859 HEMOGLOBIN GLYCATED, A1C(DA) $155.00 HC83504399 IRON ASSAY TISSUE-AU $155.00 HC62223201 TUBE NASOJEJUNAL $155.00 0409-4092-01 CUPRIC CHLORIDE 0.4 MG/ML IV SOLN $154.90 0409-4092-11 CUPRIC CHLORIDE 0.4 MG/ML IV SOLN $154.90 62559-111-11 HYDROCORTISONE 100 MG/60 ML RECTAL ENEM $154.83 0338-3583-01 VANCOMYCIN IN 0.9 % SODIUM CHL 1 GRAM/200 ML IV PGBK $154.70 0703-7121-01 HALOPERIDOL DECANOATE 50 MG/ML IM SOLN $154.70 0703-7121-03 HALOPERIDOL DECANOATE 50 MG/ML IM SOLN $154.70 63323-117-69 FLUOROURACIL 5 GRAM/100 ML IV SOLN $154.70 HC89021919 DEOXYCORTICOSTERONE (DOC)-ES $154.50 64597-301-60 DEXTROMETHORPHAN-QUINIDINE 20-10 MG ORAL CAP $154.38 16714-056-01 ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRG $154.05 16714-056-10 ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRG $154.05 HC81100364 ALBUMIN; SERUM/PLASMA/WHOLE BLOOD $154.00 HC62201165 CASTING MATERIAL PLASTER $154.00 HC62201553 CATH SILICONE $154.00 HC51001956 DRAW BLOOD VEN PICC/PERIPH CATH $154.00 HC81100117 GLUCOSE; QUANTITATIVE, BLOOD (EXCEPT REAGENT STRIP) $154.00 HC81101636 GLUCOSE; QUANTITATIVE, BLOOD (EXCEPT REAGENT STRIP) $154.00 HC83503789 IHC/IP PER SPEC INITIAL AB STAIN HER-2-NEU -US $154.00 HC62204862 NEEDLE BIOPSY F $154.00 HC84600113 PAP SLIDES MAN& RE-SCREEN $154.00 HC81100737 SODIUM $154.00 HC81101792 SODIUM (POS) $154.00 HC62206750 SPLINT FULL LEG AIR PREFAB $154.00 HC62206743 SPLINT LEG $154.00 HC62209481 SPLINT WRIST PREFAB $154.00 HC62215561 SUTURE F $154.00 HC62222161 TRAY EXCHANGE TRANSFUSION $154.00 HC62207360 TRAY GENERAL PURPOSE DISP $154.00 HC62223250 WIRE PACING TEMP F $154.00 HC11500907 WM EXAM EST' PT EVAL BRIEF LVL1 $154.00 0409-4090-01 ZINC CHLORIDE 1 MG/ML IV SOLN $153.99 0409-4090-11 ZINC CHLORIDE 1 MG/ML IV SOLN $153.99 0395-0605-01 CITRIC ACID ANHYDROUS (BULK) 100 % MISC GRAN $153.45 HC81100752 URIC ACID $153.00 0781-3443-95 FONDAPARINUX 2.5 MG/0.5 ML SUBCUTANEOUS SYRG $152.75 55111-678-10 FONDAPARINUX 2.5 MG/0.5 ML SUBCUTANEOUS SYRG $152.75 0270-1315-30 IOPAMIDOL 300 MG IODINE /ML (61 %) IV SOLN $152.43 55111-762-60 VALGANCICLOVIR 450 MG ORAL TAB $152.27 HC89008395 HEXOSAMINIDASE-AU $152.25 99999-009-79 BUSULFAN 2MG/ML ORAL SUSPENSION $152.25 0078-0249-15 LETROZOLE 2.5 MG ORAL TAB $152.12 HC51003929 BIOFEEDBACK PERINEAL MSCLS W/EMG&/MNMTRY F2F 1ST 15MIN $152.00 HC89500581 COOMBS INDIR TITER EA -SB $152.00 HC81190043 CREATININE (POS) $152.00 HC84200740 PARASITE ID $152.00 HC51070027 PSY FAMILY CONFERENCE $152.00 HC83500785 SPECIAL STAIN GRP I W/ I&R+-MA $152.00 HC42000596 WCH EST PT LVL1-BRIEF $152.00 0009-0728-05 CLINDAMYCIN PHOSPHATE 150 MG/ML INJ SOLN $151.71 0009-0728-09 CLINDAMYCIN PHOSPHATE 150 MG/ML INJ SOLN $151.71 HC89024178 NEOPTERIN-LC $151.46 0019-0952-11 IOTHALAMATE MEGLUMINE 30 % IV SOLN $151.13 0019-0952-53 IOTHALAMATE MEGLUMINE 30 % IV SOLN $151.13 0781-3159-72 OLANZAPINE 10 MG IM SOLR $151.06 61703-339-22 CARBOPLATIN 10 MG/ML IV SOLN $151.03 HC62209721 G-TUBE DECLOGGER $151.00 HC62209788 KIT CATH LT HEART FLUSH DEVICE $151.00 HC62208053 NEEDLE BIOPSY THYROID $151.00 HC34000232 SCREENING PURE TONE HEARING AIR $151.00 HC81100992 URINALYSIS NON-AUTO W/O MICRO $151.00 0517-4201-25 HYDROXYZINE HCL 25 MG/ML IM SOLN $150.93 0904-7024-04 VORICONAZOLE 200 MG ORAL TAB $150.57 16714-644-01 DOXYCYCLINE HYCLATE 100 MG IV SOLR $150.36 16714-644-10 DOXYCYCLINE HYCLATE 100 MG IV SOLR $150.36 0143-9850-01 METHYLPREDNISOLONE SODIUM SUCC 500 MG IV SOLR $150.28 55111-678-02 FONDAPARINUX 2.5 MG/0.5 ML SUBCUTANEOUS SYRG $150.02 55111-678-11 FONDAPARINUX 2.5 MG/0.5 ML SUBCUTANEOUS SYRG $150.02 HC51004109 ARTERIAL PUNCTURE $150.00 HC27001940 BIOFEEDBACK PERINEAL MSCLS W/EMG&/MNMTRY F2F ADD'L 15MIN+ $150.00 HC83505883 CHROM TISSUE CULT BONE MARROW-NG $150.00 HC62223474 COVER ORTHOTIC 'CTLS' UPRIGHT $150.00 HC89021166 FACTOR IX INHIBITOR TEST(PNL) -EC $150.00 HC89021232 HSV 6 (HHV6)(A&B), QNT PCR-AU $150.00 HC51010726 IMMUNTX PREP-PROV 1/+AG BUG/ARTHPD $150.00 HC51010718 IMMUNTX PREP-PROV 1/+ANTIGNS $150.00 HC62209796 KIT ACCESSORY PACEMAKER $150.00 HC62213350 KIT NEBULIZER AERONEB SOLO $150.00 HC83505982 MORPH STDY TMR IHC-AP $150.00 HC62205554 PAD CPM $150.00 HC83505685 PD-L1 IHC QNT-NG $150.00 HC36800662 PH FLUID $150.00 HC39000757 PSYCH ASSESS/INTERVEN EA30MIN/MCL $150.00 HC81700015 RHEUMATOID FACTOR QUAL $150.00 HC81700031 RHEUMATOID FACTOR QUANT $150.00 HC89013163 VIRAL ISOLATE CONFIRM-U2 $150.00 HC89021885 ZIKA VIRUS BY PCR, BLOOD-AU $150.00 HC89024244 AQUAPORIN-4 ELISA AB-AU $150.00 0270-0445-35 DIATRIZOATE MEG-DIATRIZOAT SOD 66-10 % ORAL SOLN $149.96 27437-208-11 CEFIXIME 400 MG ORAL CAP $149.91 63323-710-50 LEUCOVORIN CALCIUM 200 MG INJ SOLN (MCH) $149.89 0054-0237-63 MORPHINE 10 MG/5 ML ORAL SOLN $149.50 0093-4177-73 CEPHALEXIN 250 MG/5 ML ORAL SUSR $149.50 0338-1007-03 DOPAMINE IN 5 % DEXTROSE 800 MG/500 ML (1,600 MCG/ML) IV SOLN $149.50 0703-2056-01 CISATRACURIUM 2 MG/ML IV SOLN $149.50 0703-2056-03 CISATRACURIUM 2 MG/ML IV SOLN $149.50 24979-155-14 CEPHALEXIN 250 MG/5 ML ORAL SUSR (MCH) $149.50 63323-417-01 CISATRACURIUM 2 MG/ML IV SOLN $149.50 63323-417-10 CISATRACURIUM 2 MG/ML IV SOLN $149.50 63323-930-00 VASOPRESSIN 20 UNIT/ML IV SOLN $149.50 63323-930-01 VASOPRESSIN 20 UNIT/ML IV SOLN $149.50 68180-441-01 CEPHALEXIN 250 MG/5 ML ORAL SUSR $149.50 16729-276-05 FLUOROURACIL 1 GRAM/20 ML IV SOLN $149.24 16729-276-67 FLUOROURACIL 1 GRAM/20 ML IV SOLN $149.24 HC83500629 CHROM ANAL ADDL HI RESOLUTION -GZ $149.00 HC31010184 PT-BIOFEEDBACK PERINEAL MSCLS W/EMG&/MNMTRY F2F ADD'L 15MIN+ $149.00 24208-555-55 BACITRACIN-POLYMYXIN B 500-10,000 UNIT/GRAM OPHT OINT $148.99 HC89018626 CHROM ANAL TISS CULT, BLD-AU $148.80 0078-0501-15 RIVASTIGMINE 4.6 MG/24 HOUR TRANSDERMAL PT24 $148.64 0078-0502-15 RIVASTIGMINE 9.5 MG/24 HOUR TRANSDERMAL PT24 $148.64 0078-0503-15 RIVASTIGMINE 13.3 MG/24 HOUR TRANSDERMAL PT24 $148.64 0078-0501-61 RIVASTIGMINE 4.6 MG/24 HOUR TRANSDERMAL PT24 $148.59 0078-0502-61 RIVASTIGMINE 9.5 MG/24 HOUR TRANSDERMAL PT24 $148.59 0078-0503-61 RIVASTIGMINE 13.3 MG/24 HOUR TRANSDERMAL PT24 $148.59 63323-690-30 ACETYLCYSTEINE 200 MG/ML (20 %) MISC SOLN $148.40 HC81700072 CRYOGLOBULIN $148.00 HC62203153 ET SKIN CARE KIT $148.00 HC62203161 ET SKIN SPRAY $148.00 HC89011845 IMMUNE COMPLEXES RAJI CELL-AU $148.00 HC62204367 KIT WOUND VAC $148.00 HC89001341 METHAQUALONE DEF 1-7CLS-AU $148.00 HC62205349 PACK LAPAROTOMY $148.00 HC84600139 PAP BETHESDA MANUAL SCREEN $148.00 HC81100695 POTASSIUM $148.00 HC81101784 POTASSIUM (POS) $148.00 HC81500324 RETICULOCYTE MANUAL $148.00 HC51003499 SCREENING MISUSE BEHAVIORAL ETOH $148.00 HC84200245 WBC IN FECES $148.00 HC89022347 FLOW CYTOMETRY 1ST MRKR{W-INT/88}-CC $147.68 0173-0682-24 ALBUTEROL SULFATE 90 MCG/ACTUATION INHALATION HFAA $147.68 HC83505610 IHC/IP PER SPEC EA ADD AB STAIN+ -CA $147.60 HC83505602 IP/IHC PER SPEC INITIAL AB STAIN -CA $147.60 55150-123-15 NAFCILLIN 2 GRAM INJ SOLR $147.55 55150-123-16 NAFCILLIN 2 GRAM INJ SOLR $147.55 63323-288-07 ROPIVACAINE (PF) 10 MG/ML (1 %) INJ SOLN $147.55 63323-288-20 ROPIVACAINE (PF) 10 MG/ML (1 %) INJ SOLN $147.55 63323-288-21 ROPIVACAINE (PF) 10 MG/ML (1 %) INJ SOLN $147.55 99999-046-14 IOHEXOL 300 MG IODINE/ML IV SOLN $147.55 51672-1298-1 KETOCONAZOLE 2 % TOPICAL CREAM $147.42 HC89011837 IMMUNE COMPLEX C1Q BIND-AU $147.00 HC31001597 PT-CONTRAST BATH AD15MIN/CW $147.00 HC31000979 PT-ULTRASOUND ADD 15MIN/CW $147.00 HC51003481 SCREENING ETOH MISUSE ANNUAL 5-15MIN $147.00 67850-141-00 POLIDOCANOL 1 % (20 MG/2 ML) IV SOLN $146.90 67850-141-05 POLIDOCANOL 1 % (20 MG/2 ML) IV SOLN $146.90 0338-1049-02 NITROGLYCERIN IN 5 % DEXTROSE 50 MG/250 ML (200 MCG/ML) IV SOLN $146.25 0548-5607-00 ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRG $146.25 0781-6139-57 AMOXICILLIN-POT CLAVULANATE 600-42.9 MG/5 ML ORAL SUSR $146.25 25021-140-10 NAFCILLIN 2 GRAM INJ SOLR $146.25 25021-162-24 OXACILLIN 2 GRAM INJ SOLR $146.25 54288-100-01 ZOLEDRONIC ACID 4 MG/5 ML IV SOLN $146.25 61314-237-10 CROMOLYN 4 % OPHT DROP $146.25 63323-403-04 FOSPHENYTOIN 500 MG PE/10 ML INJ SOLN $146.25 63323-403-10 FOSPHENYTOIN 500 MG PE/10 ML INJ SOLN $146.25 99999-039-69 NITROGLYCERIN 200 MCG/ML INJECTION IR (OCM) $146.25 0409-3375-04 NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN $146.09 0409-3375-14 NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN $146.09 HC84200732 ARTHROPOD ID $146.00 HC84200328 MIC ANTIBIOTIC GRADIENT STRIP $146.00 HC82202649 MISC PATHOLOGY-SOF(CLIENT BILL $146.00 HC81500035 RETICULOCYTE - AUTO $146.00 HC33010067 ST EVAL SOUND PRODUCTION [15MIN] $146.00 HC51061554 STRAPPING; HAND OR FINGER $146.00 HC81101495 URINALYSIS MICROSCOPIC ONLY $146.00 0143-9210-01 CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJ SOLN $145.70 0143-9210-10 CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJ SOLN $145.70 63323-478-01 CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJ SOLN $145.70 63323-478-27 CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJ SOLN $145.70 16714-156-01 POSACONAZOLE 100 MG ORAL TBEC $145.67 0781-3268-05 ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRG $145.29 0781-3268-69 ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRG $145.29 51862-454-01 CLONIDINE 0.2 MG/24 HR TRANSDERMAL PTWK $145.17 51862-454-04 CLONIDINE 0.2 MG/24 HR TRANSDERMAL PTWK $145.17 HC81101149 APT TEST (FETAL HGB) $145.00 HC89018329 FACTOR VII ASSAY-EC $145.00 HC84600105 PAP SLIDES MANUAL SCREEN $145.00 HC89024293 MYELIN MOG-IGG1 AB CBA-AU $145.00 69374-316-25 NOREPINEPHRINE IN NS 8 MG/250 ML (32 MCG/ML) IV SOLN (MHS) $144.63 HC89000848 ANGIOTENSIN CONVERT ENZYME-QD $144.00 HC81100323 BILIRUBIN TOTAL $144.00 HC62217336 CANNULA BIOPSY BREAST $144.00 HC62201678 CAUTERY EYE $144.00 HC62201686 CAUTERY HEMO ERASER (EYE) $144.00 HC84200468 OB FECAL IMM ASSAY 1-3 CA SCR $144.00 HC81500043 SED RATE NON-AUTO $144.00 HC36800639 SODIUM $144.00 HC62206974 SUPPORTER ATHLETIC $144.00 HC62207089 SUTURE WIRE $144.00 70121-1578-1 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $143.55 70121-1578-7 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $143.55 45802-465-64 KETOCONAZOLE 2 % TOPICAL SHAM $143.52 76014-004-10 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $143.46 0069-1305-01 EPOETIN ALFA-EPBX 2,000 UNIT/ML INJ SOLN $143.39 0069-1305-10 EPOETIN ALFA-EPBX 2,000 UNIT/ML INJ SOLN $143.39 0270-1315-25 IOPAMIDOL 300 MG IODINE /ML (61 %) IV SOLN $143.33 0574-7045-12 BELLADONNA ALKALOIDS-OPIUM 16.2-30 MG RECTAL SUPP $143.09 HC62211701 CATHETER ASPIRATION $143.00 HC32000069 OT-CONTRAST BATH 15MIN/MW $143.00 HC84200138 PINWORM PREP $143.00 HC31000169 PT-CONTRAST BATH 15MIN/MW $143.00 HC81500944 URINALYSIS NON-AUTO W/O MICRO $143.00 0781-3458-75 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $143.00 0781-3458-95 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $143.00 0781-9227-75 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $143.00 0781-9227-95 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $143.00 0990-7715-12 MANNITOL 20 % 20 % IV SOLP $143.00 42023-214-01 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $143.00 42023-214-10 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $143.00 43598-128-11 METHYLPREDNISOLONE SODIUM SUCC 500 MG IV SOLR $143.00 44567-222-10 NAFCILLIN 2 GRAM INJ SOLR $143.00 47781-586-56 LABETALOL 5 MG/ML IV SOLN $143.00 55150-201-20 ROPIVACAINE (PF) 10 MG/ML (1 %) INJ SOLN $143.00 63323-820-00 FAT EMUL-SOY-MCT-OLIV-FISH OIL 20 % IV EMUL $143.00 63323-820-01 FAT EMUL-SOY-MCT-OLIV-FISH OIL 20 % IV EMUL $143.00 70092-1509-35 FENTANYL 50 MCG/ML DRIP (MHS) $143.00 63323-306-30 TOBRAMYCIN SULFATE 40 MG/ML INJ SOLN $142.94 61703-349-09 IRINOTECAN 100 MG/5 ML IV SOLN $142.81 66689-202-04 ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSP $142.74 66689-203-04 ACTIVATED CHARCOAL-SORBITOL 25 GRAM/120 ML ORAL SUSP $142.74 99999-042-20 URSODIOL 25 MG/ML ORAL SUSP (COMPOUND) $142.74 16714-496-01 CLOTRIMAZOLE-BETAMETHASONE 1-0.05 % TOPICAL CREAM $142.45 65219-052-09 POTASSIUM PHOSPHATE M-/D-BASIC 3 MMOL/ML IV SOLN $142.35 65219-052-29 POTASSIUM PHOSPHATE M-/D-BASIC 3 MMOL/ML IV SOLN $142.35 63323-089-50 SODIUM BICARBONATE 1 MEQ/ML (8.4 %) IV SOLN $141.70 67457-428-00 TOBRAMYCIN SULFATE 40 MG/ML INJ SOLN $141.57 67457-428-30 TOBRAMYCIN SULFATE 40 MG/ML INJ SOLN $141.57 99999-002-31 HYDROMORPHONE 100 MG IN D5W 100 ML DRIP $141.57 99999-002-33 HYDROMORPHONE 100MG IN NS 100ML DRIP $141.57 0574-4021-35 BACITRACIN-POLYMYXIN B 500-10,000 UNIT/GRAM OPHT OINT $141.51 47335-779-91 AZELASTINE 137 MCG (0.1 %) NASL SPRA $141.38 51991-814-03 AZELASTINE 137 MCG (0.1 %) NASL SPRA $141.38 60505-0833-5 AZELASTINE 137 MCG (0.1 %) NASL SPRA $141.38 5898096012 EMOLLIENT COMBINATION NO.10 TOPICAL EMUL $141.28 63323-286-09 ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJ SOLN $141.18 63323-286-30 ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJ SOLN $141.18 63323-286-31 ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJ SOLN $141.18 70860-117-26 NAFCILLIN 2 GRAM INJ SOLR $141.05 70860-117-41 NAFCILLIN 2 GRAM INJ SOLR $141.05 99999-035-09 HYDROMORPHONE 1 MG/ML IN NS 100 ML OPIOID TOLERANT PCA $141.05 HC62201207 CATH ADAPTOR $141.00 HC81100513 CHLORIDE SERUM $141.00 HC62210901 KIT PRESSURE MONITORING W/SWAN $141.00 69680-120-35 LIDOCAINE 5 % TOPICAL OINT $140.98 50474-470-66 BRIVARACETAM 25 MG ORAL TAB $140.68 50474-570-09 BRIVARACETAM 50 MG ORAL TAB $140.68 50474-570-66 BRIVARACETAM 50 MG ORAL TAB $140.68 50474-770-66 BRIVARACETAM 100 MG ORAL TAB $140.68 0069-0248-01 PROPOFOL 10 MG/ML IV EMUL $140.40 0069-0248-10 PROPOFOL 10 MG/ML IV EMUL $140.40 0409-4699-24 PROPOFOL 10 MG/ML IV EMUL $140.40 0409-4699-54 PROPOFOL 10 MG/ML IV EMUL $140.40 16714-690-01 PROPOFOL 10 MG/ML IV EMUL $140.40 16714-690-10 PROPOFOL 10 MG/ML IV EMUL $140.40 45963-614-51 IRINOTECAN 40 MG/2 ML IV SOLN $140.40 72572-172-01 FENTANYL (PF) 50 MCG/ML INJ FOR INTRATHECAL PAIN PUMP REFILL (OCM) $140.40 99996-000-22 NORMOCARB HF-35 $140.40 HC62200084 ACAPELLA W/MOUTHPIECE (RESP) $140.00 HC83505503 ANATOMIC CONSULT; SLIDE REV-CS $140.00 HC62220496 APPLICATOR/TIP SYRINGE ONLY D $140.00 HC62204482 APPLIER LIGA/HEMOCLIP ENDO D $140.00 HC62228028 AWL SINGLE PATIENT USE $140.00 HC62200373 BAG VENTRICULAR DRAIN $140.00 HC62227343 BAG/POUCH RETRIEVAL SPECMN ENDO B $140.00 HC62212865 BLADE BONE SHAVER B $140.00 HC62213087 BLADE KNIFE B $140.00 HC62204433 BLADE OPHTHALM J $140.00 HC62215249 BLADE SAW J $140.00 HC62222690 BLADE SHAVER B $140.00 HC62221999 BLADE TREPHINE B $140.00 HC62219126 BOOT WLKNG AIR W/WO JNTS PREFB D $140.00 HC62209390 BRUSH BIOPSY TRACKING $140.00 HC62213962 BURR B $140.00 HC62226683 CABLE PACING DISP D $140.00 HC62200969 CANNULA AORTIC ARCH D $140.00 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60 MG/3 ML (20 MG/ML) IV SOLN $130.01 25021-602-03 CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) ORAL SOLN $130.01 HC89007181 AMINO ACID SINGLE QUANT-QD $130.00 HC89000350 CALCIUM IONIZED-QD $130.00 HC51062222 DIABETIC SELF MANGMT TRNG EA 30M $130.00 HC89018303 FACTOR IX BETHESDA TITER(PNL) -EC $130.00 HC89019434 FATTY ACID PROFILE, COMP -MA $130.00 HC89005342 FIBRINOGEN ANTIGEN-EC $130.00 HC81500522 HEINZ BODIES DIRECT $130.00 HC81700346 HETEROPHILE AB TITER $130.00 HC89022743 HLA CLASS II TYPING INTERMED RES 1 LOCUS-U9 $130.00 HC37000304 MNT RE ASSESS INDIV EA 15MIN 2ND REF (DX) $130.00 HC62204839 NEBULIZER (GENERIC) $130.00 HC32000218 OT-HOT/COLD PACKS /CMW $130.00 HC62205687 PILLOW CERVICAL $130.00 HC31000284 PT-HOT/COLD PACKS /CMW $130.00 HC34000273 SENSORINEURAL ACUITY TEST $130.00 HC62206487 SHEEPSKIN $130.00 HC51062586 TYMPANOMETRY IMPEDANCE $130.00 HC62210729 WRAP COMPRESSION KNEE/HIP $130.00 0013-1114-01 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $130.00 0013-1114-20 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SODIUM NITROPRUSSIDE 25 MG/ML IV SOLN $130.00 46783-221-52 POLIDOCANOL 1 % (20 MG/2 ML) IV SOLN $130.00 49230-206-92 PERIT.DIALYSIS 6-1.5 % DEXTROS CA 2.5 MEQ/L- MG 0.5 MEQ/L IP SOLN $130.00 49230-209-92 PERITON.DIALYSIS 7-2.5 % DEXTR CA 2.5 MEQ/L- MG 0.5 MEQ/L IP SOLN $130.00 49230-212-92 PERITON.DIALYSIS 8-4.25 % DEXT CA 2.5 MEQ/L- MG 0.5 MEQ/L IP SOLN $130.00 55150-307-01 ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN (MHS) $130.00 55150-307-24 ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN (MHS) $130.00 61314-030-02 DORZOLAMIDE-TIMOLOL 22.3-6.8 MG/ML OPHT DROP $130.00 63323-318-01 GRANISETRON 1 MG/ML IV SOLN (MHS WRAPPER) $130.00 63323-508-01 MEROPENEM 1 GRAM IV SOLR $130.00 63323-508-30 MEROPENEM 1 GRAM IV SOLR $130.00 66794-017-10 ISOFLURANE 99.9 % INHALATION LIQD $130.00 66794-019-10 ISOFLURANE 99.9 % INHALATION LIQD $130.00 67457-452-20 CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJ SOLN $130.00 67457-528-10 LEUCOVORIN CALCIUM 100 MG INJ SOLR $130.00 70069-051-01 DORZOLAMIDE-TIMOLOL 22.3-6.8 MG/ML OPHT DROP $130.00 70069-261-01 SODIUM NITROPRUSSIDE 25 MG/ML IV SOLN $130.00 71288-101-20 OXALIPLATIN 100 MG/20 ML IV SOLN $130.00 99999-008-27 LEUCOVORIN CALCIUM 10 MG/ML INJ SOLN (FOR ORAL USE) (MCH) $130.00 99999-038-66 EDTA 3.75% OPTH DROPS (COMPOUND) $130.00 51672-1312-0 MUPIROCIN 2 % TOPICAL OINT $129.99 24208-590-64 TROPICAMIDE 0.5 % OPHT DROP $129.97 59762-3120-1 AZITHROMYCIN 200 MG/5 ML ORAL SUSR $129.97 0409-6509-49 VANCOMYCIN 5 GRAM IV SOLR $129.94 5633100616 NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRA $129.90 0517-0960-01 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $129.87 0517-0960-10 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $129.87 65862-219-60 CEFDINIR 250 MG/5 ML ORAL SUSR $129.87 0065-0530-01 BALANCED SALT SOLN NON-SURG 3 OPHT SOLN $129.68 44567-246-25 CEFOXITIN 2 GRAM IV SOLR $129.68 63402-193-10 ESZOPICLONE 3 MG ORAL TAB $129.42 72266-160-41 ZIPRASIDONE MESYLATE 20 MG/ML (FINAL CONC.) IM SOLR $129.42 72266-160-42 ZIPRASIDONE MESYLATE 20 MG/ML (FINAL CONC.) IM SOLR $129.42 47335-290-40 CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) ORAL SOLN $129.34 64980-301-30 HYDROCORTISONE 2.5 % TOPICAL CRPE $129.29 64980-324-30 HYDROCORTISONE 2.5 % TOPICAL CRPE $129.29 63323-605-01 ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRG $129.22 63323-605-84 ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRG $129.22 0075-0622-80 ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRG $129.15 121067716 POT,SODIUM CITRATE-CITRIC ACID 550-500-334 MG/5 ML ORAL SOLN $129.13 0093-3655-28 METHYLERGONOVINE 0.2 MG ORAL TAB $129.08 HC62208640 ET PASTE STOMAHESIVE $129.00 HC82204710 HANDLING AND/OR CONVEYANCE TO REF LAB(AP) $129.00 HC83000976 HANDLING AND/OR CONVEYANCE TO REF LAB(BB) $129.00 HC51000263 IVP SINGLE/EA NEW RX ADD'L INJ $129.00 HC84200997 MEAT FIBERS, FECES $129.00 HC89021141 NK CELLS TOTAL COUNT(PNL) -CN $129.00 HC62219480 ORTHOTIC AF PREFAB W/FIT& ADJUST $129.00 HC51060960 OT-ORTHOTIC FIT/TRNG ADD15M/C $129.00 HC39001003 PHARMACOLOGIC MGMT W/PSYTX+ $129.00 HC39000799 PSYCH GROUP TEACH/COUNS SESSION $129.00 49884-170-04 SODIUM PHENYLBUTYRATE 500 MG ORAL TAB $128.96 0409-4093-01 CHROMIUM CHLORIDE 4 MCG/ML IV SOLN $128.90 0409-4093-11 CHROMIUM CHLORIDE 4 MCG/ML IV SOLN $128.90 HC89021679 BENZODIAZEPINES; 1-12 MEC(PNL)-AU $128.75 0143-9877-01 CEFOXITIN 2 GRAM IV SOLR $128.70 0143-9877-25 CEFOXITIN 2 GRAM IV SOLR $128.70 0409-9094-41 FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN $128.70 0409-9094-61 FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN $128.70 64764-301-14 PIOGLITAZONE 30 MG ORAL TAB $128.66 0517-1825-01 METHOCARBAMOL 100 MG/ML INJ SOLN $128.64 0517-1825-10 METHOCARBAMOL 100 MG/ML INJ SOLN $128.64 42023-113-10 KETAMINE 10 MG/ML INJ SOLN $128.57 0597-0152-30 EMPAGLIFLOZIN 10 MG ORAL TAB $128.55 0597-0152-37 EMPAGLIFLOZIN 10 MG ORAL TAB $128.55 0597-0153-30 EMPAGLIFLOZIN 25 MG ORAL TAB $128.55 0597-0153-37 EMPAGLIFLOZIN 25 MG ORAL TAB $128.55 51991-144-17 METHYLERGONOVINE 0.2 MG/ML (1 ML) INJ SOLN $128.44 51991-144-99 METHYLERGONOVINE 0.2 MG/ML (1 ML) INJ SOLN $128.44 0338-1009-02 DOPAMINE IN 5 % DEXTROSE 800 MG/250 ML (3,200 MCG/ML) IV SOLN $128.38 44567-620-01 CALCIUM GLUC IN NACL, ISO-OSM 1 GRAM/50 ML IV SOLN $128.38 44567-620-24 CALCIUM GLUC IN NACL, ISO-OSM 1 GRAM/50 ML IV SOLN $128.38 63739-008-33 VORICONAZOLE 200 MG ORAL TAB $128.38 65219-162-01 CALCIUM GLUC IN NACL, ISO-OSM 1 GRAM/50 ML IV SOLN $128.38 65219-162-10 CALCIUM GLUC IN NACL, ISO-OSM 1 GRAM/50 ML IV SOLN $128.38 66887-001-01 TESTOSTERONE 50 MG/5 GRAM (1 %) TRANSDERMAL GEL $128.28 66887-001-05 TESTOSTERONE 50 MG/5 GRAM (1 %) TRANSDERMAL GEL $128.28 0009-3475-03 METHYLPREDNISOLONE ACETATE 80 MG/ML INJ SUSP $128.21 0009-3475-23 METHYLPREDNISOLONE ACETATE 80 MG/ML INJ SUSP $128.21 0009-3475-01 METHYLPREDNISOLONE ACETATE 80 MG/ML INJ SUSP $128.18 0009-3475-22 METHYLPREDNISOLONE ACETATE 80 MG/ML INJ SUSP $128.18 63323-665-00 TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLN $128.05 63323-665-01 TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLN $128.05 HC12600086 ADMIN VACCINE COVID-19 100MCG/0.5 INITIAL DOSE {MODERNA} $128.00 HC12600094 ADMIN VACCINE COVID-19 100MCG/O.5 2ND DOSE {MODERNA} $128.00 HC12600326 ADMIN VACCINE COVID-19 25MCG/0.25ML 3RD {MODERNA} $128.00 HC12600078 ADMIN VACCINE COVID-19 30MCG/0.3ML 2ND DOSE {PFIZER-BIONTECH} $128.00 HC81500266 HEMOSIDERIN QUAL $128.00 HC89020358 HEAT SHOCK PROTEIN 70-AU $127.90 99999-045-12 CEFOTAXIME (STERIMAX - CANADA) 2 GRAM INJ SOLR $127.60 0121-0992-05 LACOSAMIDE 10 MG/ML ORAL SOLN $127.47 0121-0992-95 LACOSAMIDE 10 MG/ML ORAL SOLN $127.47 0121-1012-05 LACOSAMIDE 10 MG/ML ORAL SOLN $127.47 0121-1012-95 LACOSAMIDE 10 MG/ML ORAL SOLN $127.47 63323-322-20 IMIPENEM-CILASTATIN 500 MG IV SOLR $127.40 HC62202916 ENDO PUSHER $127.00 HC62204052 KIT MICROINTRODUCER $127.00 HC62210158 KIT PROVOC ASTHMA METHACHOLINE $127.00 HC62205067 NURSER CLEFT PALATE $127.00 HC39001540 PSY-BEHAVIOR TX INDIV ADDL 15 MIN $127.00 HC43001056 TOMO BRST DX 3-D; BILAT+ $127.00 HC43001064 TOMO BRST SCREEN 3-D BILAT+ $127.00 0409-4900-24 SODIUM BICARBONATE 8.4% IV SOLN (MCH) $126.82 16714-293-03 AMOXICILLIN-POT CLAVULANATE 400-57 MG/5 ML ORAL SUSR $126.75 0078-0414-20 EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG ORAL TAB $126.58 59148-006-13 ARIPIPRAZOLE 2 MG ORAL TAB $126.49 59148-007-13 ARIPIPRAZOLE 5 MG ORAL TAB $126.49 99999-004-80 METHADONE 10 MG/ML INJ SOLN $126.42 0409-6562-01 TESTOSTERONE CYPIONATE 200 MG/ML IM OIL $126.17 47781-601-22 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $126.10 0574-2008-15 NYSTATIN 100,000 UNIT/GRAM TOPICAL POWD $126.07 42543-052-61 NYSTATIN 100,000 UNIT/GRAM TOPICAL POWD $126.07 69315-306-15 NYSTATIN 100,000 UNIT/GRAM TOPICAL POWD $126.07 HC62215231 BLADE SAW I $126.00 HC62802632 BUTTON TEFLON/PLASTIC $126.00 HC62201439 CATH FOLEY TEMP SENSOR $126.00 HC62214176 CATH URETERAL I $126.00 HC62222807 DEVICE INFLAT ENCORE B $126.00 HC62217500 DRESSING AQUACEL AG $126.00 HC51000164 ECG ROUTINE 12+ LEADS $126.00 HC51001618 ECG ROUTINE 12+ LEADS; TRACING ONLY $126.00 HC84200336 ENZYME DET BETA LACTAMASE $126.00 HC51000420 IVAD IRRIGATION $126.00 HC62215843 NEEDLE BIOPSY E $126.00 HC62205281 PACK GEN/GYN $126.00 HC62205463 PACK UROLOGY CYSTO MINOR $126.00 HC62205505 PACKING IODOFROM $126.00 HC62216460 PIN/WIRE FIXATION TEMPORARY I $126.00 HC89009674 PORPHYRINS FECAL FRACT-AU $126.00 HC89500417 RBC ANTIBODY ID EA TECH-SB $126.00 HC36800555 RT RESP THER GRP 15 MIN/MW $126.00 HC62206438 SET VACUUM CANNISTER W/O GEL $126.00 HC62213913 SLEEVE VITRECTOMY $126.00 HC62215553 SUTURE E $126.00 HC62215959 TRAY BONE MARROW I $126.00 HC62208129 VALVE HEIMLICH CHEST DRAIN $126.00 0409-6629-02 SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ SOLN $125.91 17478-064-12 HYPROMELLOSE 2.5 % OPHT DROP $125.87 HC89007637 DIURETIC SCREEN, URINE - AU $125.59 66220-287-08 IBUPROFEN 800 MG/8 ML (100 MG/ML) IV SOLR $125.53 49702-207-18 FOSAMPRENAVIR 700 MG ORAL TAB $125.52 16714-046-01 ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRG $125.45 16714-046-10 ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRG $125.45 55150-438-01 KETAMINE 10 MG/ML INJ SOLN $125.45 55150-438-10 KETAMINE 10 MG/ML INJ SOLN $125.45 HC89023899 FACTOR II 20210G>A VARIANT -QN $125.25 99999-041-16 SODIUM POLYSTYRENE SULFONATE (SORBITOL) 15 GRAM/60 ML ORAL SUSPENSION $125.19 HC83505800 ANATOMIC CONSULT; SLIDE REV-BC $125.00 HC36800605 CHLORIDE $125.00 HC89007694 CORTISOL FREE-QN $125.00 HC62202726 ELECTRODE QUICK COMBO $125.00 HC89018204 FACTOR VIII ASSAY -EC $125.00 HC89021976 FACTOR XIII ASSAY -AU $125.00 HC89003560 HEAVY METAL QN EA URINE;BERYLLIUM-AU $125.00 HC89012595 HEMOPHILUS INFLUENZA AB-FT $125.00 HC89013213 HEPATITIS DELTA AG-AU $125.00 HC89016281 LIPOPROTEIN ELECTROPHORESIS-QD $125.00 HC89001200 LIPOPROTEIN-ASSOC PHS(PLAC)-AU $125.00 HC62205273 PACK FACET INJECTION $125.00 HC89003701 PHENMETRAZINE URINE-AU $125.00 HC36500015 SMOKING CESSATION > 10 MIN $125.00 HC89024012 JAK2 V617F QUAL-AU $125.00 49348-030-40 ISOPROPYL ALCOHOL 70 % MISC SOLN $124.80 0781-3411-70 SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ SOLN $124.67 0781-3411-95 SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ SOLN $124.67 HC12600268 ADMIN VACCINE COVID-19 10MCG TRS-SUCR PEDS DOSE 3RD {PFIZER} $124.58 HC12600276 ADMIN VACCINE COVID-19 10MCG TRS-SUCR PEDS DOSE BOOSTER {PFIZER} $124.58 HC12600235 ADMIN VACCINE COVID-19 30MCG TRS-SUCR 2ND DOSE {PFIZER} $124.58 HC12600243 ADMIN VACCINE COVID-19 30MCG TRS-SUCR 3RD DOSE {PFIZER} $124.58 HC12600250 ADMIN VACCINE COVID-19 30MCG TRS-SUCR BOOSTER DOSE {PFIZER} $124.58 HC12600227 ADMIN VACCINE COVID-19 30MCG TRS-SUCR INITIAL DOSE {PFIZER} $124.58 HC12600342 ADMIN VACCINE COVID-19 50 MCG/0.5 ML 2ND {MODERNA} $124.58 HC12600359 ADMIN VACCINE COVID-19 50 MCG/0.5 ML 3RD {MODERNA} $124.58 HC12600284 ADMIN VACCINE COVID-19 50MCG/0.5ML BOOSTER {MODERNA} $124.58 HC12600219 ADMIN VACCINE COVID-19 5MCG/0.5ML 2ND {NOVAVAX} $124.58 HC12600201 ADMIN VACCINE COVID-19 5MCG/0.5ML INITIAL DOSE {NOVAVAX} $124.58 HC12600193 ADMIN VACCINE COVID-19 5X10 10VP/.5ML 2ND DOSE {ASTRAZENECA} $124.58 HC12600185 ADMIN VACCINE COVID-19 5X10 10VP/.5ML INITIAL DOSE {ASTRAZENECA} $124.58 72572-470-01 NICARDIPINE 25 MG/10 ML IV SOLN $124.41 72572-470-10 NICARDIPINE 25 MG/10 ML IV SOLN $124.41 55150-183-02 NICARDIPINE 25 MG/10 ML IV SOLN $124.22 55150-183-11 NICARDIPINE 25 MG/10 ML IV SOLN $124.22 HC89023071 ANAL' GENE NUDT15 COMMON VARIANT-AU $124.00 HC81100463 BICARBONATE/CO2 $124.00 HC89004428 CHLORAMPHENICOL CSF-MA $124.00 HC83503771 IHC/IP PER SPEC INITIAL AB STAIN HER-2-NEU -IM $124.00 HC51000206 IM OR SQ INJECTION THERAPEUTIC $124.00 HC89014013 KLEIHAUER BETKE-AU $124.00 HC35500164 MT-BEHAVIOR TX INDIV ADDL 15 MIN $124.00 HC89024103 BK VIRUS QNT NAAT-AU $124.00 HC89009351 ORGANIC ACIDS TOTAL QUANT-AU $123.75 50458-140-30 CANAGLIFLOZIN 100 MG ORAL TAB $123.51 50458-140-90 CANAGLIFLOZIN 100 MG ORAL TAB $123.51 50458-141-30 CANAGLIFLOZIN 300 MG ORAL TAB $123.51 5155203174 BALSAM PERU (BULK) MISC LIQD $123.50 0093-4175-73 CEPHALEXIN 125 MG/5 ML ORAL SUSR $123.50 0409-7248-03 HETASTARCH 6 % IN 0.9 % NACL 6 % IV SOLN $123.50 0409-7248-13 HETASTARCH 6 % IN 0.9 % NACL 6 % IV SOLN $123.50 0409-7809-24 DOPAMINE IN 5 % DEXTROSE 800 MG/500 ML (1,600 MCG/ML) IV SOLN $123.50 0990-7715-03 MANNITOL 20 % 20 % IV SOLP $123.50 0990-7715-13 MANNITOL 20 % 20 % IV SOLP $123.50 44567-602-24 DEXMEDETOMIDINE IN DEXTROSE 5% 200 MCG/50 ML (4 MCG/ML) IV SOLN $123.50 68180-440-01 CEPHALEXIN 125 MG/5 ML ORAL SUSR $123.50 19515-814-41 FLU VACC QS2023-24 6MOS UP(PF) 60 MCG (15 MCG X 4)/0.5 ML IM SYRG $123.37 19515-814-52 FLU VACC QS2023-24 6MOS UP(PF) 60 MCG (15 MCG X 4)/0.5 ML IM SYRG $123.37 0703-5145-01 LEUCOVORIN CALCIUM 350 MG INJ SOLR $123.18 0703-5145-91 LEUCOVORIN CALCIUM 350 MG INJ SOLR $123.18 67457-530-35 LEUCOVORIN CALCIUM 350 MG INJ SOLR $123.18 HC81701716 CRYOFIBRINOGEN $123.00 HC89022339 FLOW CYTOMETRY 1ST MRKR{W-INT/87}-CC $122.98 66794-219-43 LINEZOLID IN DEXTROSE 5% 600 MG/300 ML IV PGBK $122.85 66794-219-63 LINEZOLID IN DEXTROSE 5% 600 MG/300 ML IV PGBK $122.85 HC29000767 ASSESS/INTERV ALCOHOL/SUBS MISUSE 15-30MIN $122.40 99999-033-66 ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL SUSR $122.27 63323-325-03 ACYCLOVIR SODIUM 50 MG/ML IV SOLN $122.20 63323-325-10 ACYCLOVIR SODIUM 50 MG/ML IV SOLN $122.20 59923-601-10 PAMIDRONATE 30 MG IV SOLR $122.14 HC81101560 BICARBONATE $122.00 HC62214648 CAP KIT LEAD PACEMAKER B $122.00 HC89021158 FACTOR VIII INHIBITOR TEST(PNL) -EC $122.00 63402-911-01 ARFORMOTEROL 15 MCG/2 ML INHALATION NEBU $121.94 63402-911-04 ARFORMOTEROL 15 MCG/2 ML INHALATION NEBU $121.94 63402-911-30 ARFORMOTEROL 15 MCG/2 ML INHALATION NEBU $121.94 63402-911-64 ARFORMOTEROL 15 MCG/2 ML INHALATION NEBU $121.94 62856-272-30 PERAMPANEL 2 MG ORAL TAB $121.55 0173-0517-00 EPOPROSTENOL (GLYCINE) 0.5 MG IV SOLR $121.49 17478-768-30 AMINOCAPROIC ACID 500 MG ORAL TAB $121.35 72572-140-01 DIAZEPAM 5 MG/ML INJ SYRG $121.16 72572-140-02 DIAZEPAM 5 MG/ML INJ SYRG $121.16 HC51060499 PT EVAL/TX/PROG RPT $121.00 HC33010174 ST-SPEECH THERAPY GROUP [15MIN] $121.00 HC25006222 REMOVE SUTURE&STAPLES NO ANESTHESIA REQ+ $121.00 0378-3349-16 ESTRADIOL 0.025 MG/24 HR TRANSDERMAL PTWK $120.67 0378-3349-99 ESTRADIOL 0.025 MG/24 HR TRANSDERMAL PTWK $120.67 0378-3350-16 ESTRADIOL 0.05 MG/24 HR TRANSDERMAL PTWK $120.67 0378-3350-99 ESTRADIOL 0.05 MG/24 HR TRANSDERMAL PTWK $120.67 0378-3352-16 ESTRADIOL 0.1 MG/24 HR TRANSDERMAL PTWK $120.67 0378-3352-99 ESTRADIOL 0.1 MG/24 HR TRANSDERMAL PTWK $120.67 0378-3360-16 ESTRADIOL 0.0375 MG/24 HR TRANSDERMAL PTWK $120.67 0378-3360-99 ESTRADIOL 0.0375 MG/24 HR TRANSDERMAL PTWK $120.67 99999-045-98 IOHEXOL 350 MG IODINE/ML IV SOLN $120.64 0093-4085-63 TOBRAMYCIN IN 0.225 % NACL 300 MG/5 ML INHALATION NEBU $120.54 0574-0820-01 TESTOSTERONE CYPIONATE 200 MG/ML IM OIL $120.51 0574-0827-01 TESTOSTERONE CYPIONATE 200 MG/ML IM OIL $120.51 0409-9630-05 ATROPINE 0.05 MG/ML INJ SYRG $120.41 0187-3010-30 PYRIDOSTIGMINE BROMIDE 60 MG ORAL TAB $120.33 0009-0011-04 HYDROCORTISONE SOD SUCC (PF) 100 MG/2 ML INJ SOLR $120.32 0009-0011-03 HYDROCORTISONE SOD SUCC (PF) 100 MG/2 ML INJ SOLR $120.25 43598-635-10 LEVETIRACETAM IN NACL (ISO-OS) 500 MG/100 ML IV PGBK $120.25 43598-635-52 LEVETIRACETAM IN NACL (ISO-OS) 500 MG/100 ML IV PGBK $120.25 43598-755-52 LEVETIRACETAM IN NACL (ISO-OS) 500 MG/100 ML IV PGBK $120.25 67457-640-00 PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN $120.25 67457-640-99 PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN $120.25 70092-1068-07 OXYTOCIN IN 0.9 % SOD CHLORIDE 30 UNIT/500 ML IV SOLN $120.25 51672-1264-1 FLUOCINONIDE 0.05 % TOPICAL OINT $120.22 52565-040-15 FLUOCINONIDE 0.05 % TOPICAL OINT $120.22 HC89019582 ANTI-EMA IGA AB IFA 1ST STAIN(PNL1155/6360)-PR $120.00 HC62200696 BONE WAX $120.00 HC89007488 CHROMATOGRAPHY QUAL-AU $120.00 HC89020200 DNASE INDIRECT IGG ADDL STAIN(PNL)-PR $120.00 HC62203047 ET BARRIER DUODEEM $120.00 HC62204474 LENS VITRECTOMY FLAT $120.00 HC62204508 LINE PRESSURE MONITOR $120.00 HC62204516 LINE PRESSURE TRANSDUCER $120.00 HC62224720 ORTHOTIC WHO W/O JOINTS SPICA $120.00 HC89020192 PANCA INDIRECT IGG 1ST 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IV SOLR $119.21 HC51000131 IMMUNIZATION ADMIN SINGLE $119.00 99988-000-06 NM TC-99M MEDRONATE/MDP DX 1-25 MCI $119.00 0131-2478-60 LACOSAMIDE 100 MG ORAL TAB $118.98 0409-4011-01 VERAPAMIL 2.5 MG/ML IV SOLN $118.96 99999-045-10 CALCIUM GLUCONATE 2.5% TOPICAL GEL (COMPOUNDED) $118.95 0310-6205-30 DAPAGLIFLOZIN PROPANEDIOL 5 MG ORAL TAB $118.91 0310-6210-30 DAPAGLIFLOZIN PROPANEDIOL 10 MG ORAL TAB $118.91 0310-6210-39 DAPAGLIFLOZIN PROPANEDIOL 10 MG ORAL TAB $118.91 0409-7391-72 SODIUM PHOSPHATE 3 MMOL/ML IV SOLN $118.76 0409-7391-82 SODIUM PHOSPHATE 3 MMOL/ML IV SOLN $118.76 19515-808-41 FLU VACC QS2022-23 6MOS UP(PF) 60 MCG (15 MCG X 4)/0.5 ML IM SYRG $118.63 19515-808-52 FLU VACC QS2022-23 6MOS UP(PF) 60 MCG (15 MCG X 4)/0.5 ML IM SYRG $118.63 52536-625-01 TESTOSTERONE CYPIONATE 200 MG/ML IM OIL $118.63 58160-890-41 FLU VACC QS2022-23 6MOS UP(PF) 60 MCG (15 MCG X 4)/0.5 ML IM SYRG $118.63 58160-890-52 FLU VACC QS2022-23 6MOS UP(PF) 60 MCG (15 MCG X 4)/0.5 ML IM SYRG $118.63 99999-045-61 FAT EMULSION 20 % IV EMUL $118.63 51079-020-01 BUDESONIDE 3 MG ORAL CECX $118.57 51079-020-03 BUDESONIDE 3 MG ORAL CECX $118.57 68180-657-01 DOXYCYCLINE MONOHYDRATE 25 MG/5 ML ORAL SUSR $118.56 49281-545-03 HAEMOPH B POLY CONJ-TET TOX-PF 10 MCG/0.5 ML IM SOLR $118.24 49281-547-58 HAEMOPH B POLY CONJ-TET TOX-PF 10 MCG/0.5 ML IM SOLR $118.24 54643-5646-1 MVI, PEDI NO.1 WITH VIT K 80 MG-400 UNIT- 200 MCG/5 ML IV SOLN $118.20 99999-046-10 IOHEXOL 300 MG IODINE/ML IV SOLN $118.04 99999-046-17 IOHEXOL 300 MG IODINE/ML IV SOLN $118.04 HC81700676 ASO SCREEN $118.00 HC81100224 GLUCOSE TOLERANCE EA ADDL SPEC $118.00 HC81101057 OCCULT BLOOD OTHER SOURCE $118.00 HC51070704 PSY-ASSESS BEHAVIOR W/SCORE & DOCD/STAND INSTRUMENT $118.00 69784-230-20 SODIUM ACETATE 2 MEQ/ML IV SOLN $117.98 51552-1053-4 DIMETHYL SULFOXIDE (BULK) 99.99 % MISC LIQD $117.65 68001-283-32 CISPLATIN 1 MG/ML IV SOLN $117.65 68001-283-33 CISPLATIN 1 MG/ML IV SOLN $117.65 69784-205-30 CROMOLYN 20 MG/2 ML INHALATION NEBU $117.49 69784-205-60 CROMOLYN 20 MG/2 ML INHALATION NEBU $117.49 16729-288-11 CISPLATIN 1 MG/ML IV SOLN $117.33 63323-103-51 CISPLATIN 1 MG/ML IV SOLN $117.33 HC89022636 PREGNENOLONE-QN $117.30 0703-1153-01 NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN $117.13 0703-1153-03 NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN $117.13 70121-1576-1 NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN $117.13 70121-1576-7 NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN $117.13 99999-046-01 IODIXANOL 320 MG IODINE/ML IV SOLN $117.13 39328-020-08 SENNOSIDES 8.8 MG/5 ML ORAL SYRP $117.08 61314-631-36 NEOMYCIN-POLYMYXIN B-DEXAMETH 3.5 MG/G-10,000 UNIT/G-0.1 % OPHT OINT $117.00 HC89021620 FETAL LUNG MATURITY L/S RATIO-AU $117.00 HC62203856 KIT EPIDURAL $117.00 HC62211206 KIT PERITONEAL LAVAGE $117.00 HC62207345 TRAY FOLEY CATH W/URINEMETER $117.00 HC81101578 UA DIPSTICK (DIRECT ACCESS) $117.00 3834400001 PYRITHIONE ZINC 0.25 % TOPICAL SPRY $117.00 0143-9659-01 TESTOSTERONE CYPIONATE 200 MG/ML IM OIL $117.00 0548-5606-00 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AMANTADINE HCL 10 MG/ML ORAL SOLN (MCH) $116.83 70004-100-69 MORPHINE 1 MG/ML IN NS 50 ML OPIOID NAIVE PCA (OCM) $116.35 61958-0601-1 EMTRICITABINE 200 MG ORAL CAP $116.25 0781-3262-04 ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRG $116.24 0781-3262-68 ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRG $116.24 50268-803-11 VORICONAZOLE 200 MG ORAL TAB $116.07 50268-803-12 VORICONAZOLE 200 MG ORAL TAB $116.07 58468-0132-1 SEVELAMER CARBONATE 0.8 GRAM ORAL PWPK $116.01 58468-0132-2 SEVELAMER CARBONATE 0.8 GRAM ORAL PWPK $116.01 HC89012413 COXSACKIE B AB-AU $116.00 HC51000230 IV INFUSION THERAPY EA ADDL HR $116.00 HC62204565 LUER LOCK W/INJ CAP $116.00 HC62216817 NEEDLE INSUFFLATION $116.00 HC62223524 SOCK FRACTURE ORTHOTIC $116.00 HC83504043 TISSUE EXAM G&M LEVEL 4PROF-CS $116.00 42806-502-09 NICARDIPINE 30 MG ORAL CAP $115.40 99999-039-91 DEXTROSE 10% + AMINO ACIDS 3% + HEPARIN (FOR NICU BRIDGE) $115.38 0517-6510-25 SELENIUM 40 MCG/ML IV SOLN $115.25 HC12600318 ADMIN VACCINE COVID-19 25MCG/0.25ML IM 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0597-0140-30 LINAGLIPTIN 5 MG ORAL TAB $113.77 0597-0140-61 LINAGLIPTIN 5 MG ORAL TAB $113.77 0597-0140-90 LINAGLIPTIN 5 MG ORAL TAB $113.77 574030216 COMPOUNDING VEHICLE SF NO.9 ORAL LIQD $113.76 574030316 COMPOUND VEHICLE SUSP SF NO.20 ORAL SUSP $113.76 574030416 COMPOUNDING VEHICLE SYRUP NO23 ORAL SYRP $113.76 574031216 COMPOUND VEH.SUSP SUGAR-FREE 1 ORAL SUSP $113.76 0143-9853-16 AMOXICILLIN-POT CLAVULANATE 600-42.9 MG/5 ML ORAL SUSR $113.75 42192-605-01 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $113.75 42192-605-10 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $113.75 47335-882-40 NICARDIPINE 25 MG/10 ML IV SOLN $113.75 47335-882-44 NICARDIPINE 25 MG/10 ML IV SOLN $113.75 24338-104-03 ERYTHROMYCIN 500 MG ORAL TAB $113.71 HC89023220 FIBRINOLYSIS COAG ADAMTS-13-AU $113.50 HC89022396 FLOW CYT LEUK/LYMPH 1ST MRKR{W-INT/89}-AU $113.50 67457-852-00 NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN $113.49 67457-852-04 NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN $113.49 72078-002-00 NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN $113.49 0008-0841-81 PANTOPRAZOLE 40 MG ORAL TBEC $113.36 63323-047-01 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $113.04 63323-047-10 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $113.04 HC62219142 CANNULA CURVED DUAL ELECTROSURG $113.00 HC62201843 CLIP FOGARTY SOFT JAW $113.00 HC89003594 HYDROXYZINE URINE-AU $113.00 HC43001213 METABOLIC IMAGING RISK ASSESSMENT (MIRA) $113.00 HC81500761 SED RATE AUTOMATED $113.00 HC39000732 SW ASSESS/INTERVEN PER 30MIN/MCL $113.00 HC89006936 TRIMIPRAMINE-AU $113.00 0006-0112-01 SITAGLIPTIN PHOSPHATE 50 MG ORAL TAB $112.97 0006-0112-28 SITAGLIPTIN PHOSPHATE 50 MG ORAL TAB $112.97 0006-0112-31 SITAGLIPTIN PHOSPHATE 50 MG ORAL TAB $112.97 0006-0112-54 SITAGLIPTIN PHOSPHATE 50 MG ORAL TAB $112.97 0006-0221-01 SITAGLIPTIN PHOSPHATE 25 MG ORAL TAB $112.97 0006-0221-28 SITAGLIPTIN PHOSPHATE 25 MG ORAL TAB $112.97 0006-0221-31 SITAGLIPTIN PHOSPHATE 25 MG ORAL TAB $112.97 0006-0221-54 SITAGLIPTIN PHOSPHATE 25 MG ORAL TAB 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$111.10 0955-1008-10 ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRG $111.10 HC25001405 ADMIN VACCINE HEPATITIS B $111.00 HC62200662 BONE MARROW SUPPLY FEE $111.00 HC43001031 TOMO BRST DX 3-D; UNILAT LT+ $111.00 HC43001049 TOMO BRST DX 3-D; UNILAT RT+ $111.00 HC62208012 TUBING VACUUM DELIVERY $111.00 63323-617-20 MILRINONE 1 MG/ML IV SOLN $110.89 99988-000-37 NM TC-99M MEBROFENIN 1-10 MCI $110.85 63323-884-01 SODIUM PHOSPHATE 3 MMOL/ML IV SOLN $110.70 63323-884-06 SODIUM PHOSPHATE 3 MMOL/ML IV SOLN $110.70 54838-510-80 OXYBUTYNIN CHLORIDE 5 MG/5 ML ORAL SYRP $110.68 0264-3153-11 CEFTRIAXONE IN DEXTROSE,ISO-OS 1 GRAM/50 ML IV PGBK $110.66 42571-244-69 CAFFEINE CITRATE 20 MG/ML INJ SOLN (MCH) $110.51 395004912 ALUM, AMMONIUM (BULK) MISC POWD $110.50 5155200516 ACETIC ACID (BULK) 3 % MISC LIQD $110.50 0264-1965-10 HETASTARCH 6 % IN 0.9 % NACL 6 % IV SOLN $110.50 41616-932-40 VECURONIUM BROMIDE 20 MG IV SOLR $110.50 47335-932-40 VECURONIUM BROMIDE 20 MG IV SOLR $110.50 47335-932-44 VECURONIUM BROMIDE 20 MG IV SOLR $110.50 55150-156-20 LEVOFLOXACIN 25 MG/ML IV SOLN $110.50 67457-273-00 METHOCARBAMOL 100 MG/ML INJ SOLN $110.50 67457-273-10 METHOCARBAMOL 100 MG/ML INJ SOLN $110.50 65162-914-46 TOBRAMYCIN IN 0.225 % NACL 300 MG/5 ML INHALATION NEBU $110.27 HC89024004 ANTIBODY ANTI-C1Q IGG-AU $110.25 0517-1001-01 ATROPINE 1 MG/ML INJ SOLN $110.24 0517-1001-25 ATROPINE 1 MG/ML INJ SOLN $110.24 HC89008551 CARNITINE URINE-CA $110.00 HC89014922 CHROM ANALYSIS BONE MARROW-GZ $110.00 HC89014765 ENTEROVIRUS BY PCR -AU $110.00 HC89003529 ENTEROVIRUS BY PCR/BLOOD-AU $110.00 HC81500290 HEMATOCRIT $110.00 HC81500860 HEMATOCRIT (POS) $110.00 HC35500214 MT-BEHAV TX FAM W/O PT 1ST 30MIN $110.00 HC35500198 MT-BEHAVIOR TX FAMW/PT 1ST 30MIN $110.00 HC39001599 PSY-BEHAV TX FAM W/O PT 1ST 30MIN $110.00 HC39001573 PSY-BEHAVIOR TX FAMW/PT 1ST 30MIN $110.00 HC89011720 TOXOCARA CANIS/ELISA-FT $110.00 0173-0642-55 LAMOTRIGINE 100 MG ORAL TAB $109.73 62856-245-30 DONEPEZIL 5 MG ORAL TAB $109.66 0168-0258-15 CLOTRIMAZOLE-BETAMETHASONE 1-0.05 % TOPICAL CREAM $109.59 51672-4048-1 CLOTRIMAZOLE-BETAMETHASONE 1-0.05 % TOPICAL CREAM $109.59 67457-251-00 DEXMEDETOMIDINE 100 MCG/ML IV SOLN $109.46 67457-251-02 DEXMEDETOMIDINE 100 MCG/ML IV SOLN $109.46 0777-3104-02 FLUOXETINE 10 MG ORAL CAP $109.33 0713-0882-30 PRASUGREL 10 MG ORAL TAB $109.30 HC89023543 ACYLCARNITINES QUANT-AU $109.00 HC89017255 AMINO ACIDS QUANT URINE-AU $109.00 HC62200977 CANNULA AORTIC ROOT $109.00 HC89012546 CYSTICERCOSIS AB-FT $109.00 HC62200639 NEEDLE BONE MARROW ADD'L $109.00 HC62221643 NEEDLE WIRE LOCALIZATION E $109.00 HC62228283 ORTH FO PIP/DIP W/O JOINT/SPRING PREFAB OTS $109.00 HC32001398 OT-CASE/TEAM CONF ADD15 MIN/C $109.00 HC62205224 PACK C-SECTION $109.00 HC84600121 PAP DEFIN HORMONAL EVAL+ $109.00 HC39000740 SW TEACH/COUNSEL INDIVIDUAL -COMM $109.00 25021-612-81 MAGNESIUM SULFATE IN WATER 2 GRAM/50 ML (4 %) IV PGBK $108.88 0078-0345-42 ESTRADIOL 0.075 MG/24 HR TRANSDERMAL PTTW $108.47 67457-437-00 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DIALYSIS 19-DEXTR 1.5 % CA 3.5 MEQ/L- MG 1.5 MEQ/L IP SOLN $97.50 49230-206-50 PERIT.DIALYSIS 6-1.5 % DEXTROS CA 2.5 MEQ/L- MG 0.5 MEQ/L IP SOLN $97.50 49230-209-50 PERITON.DIALYSIS 7-2.5 % DEXTR CA 2.5 MEQ/L- MG 0.5 MEQ/L IP SOLN $97.50 49230-212-50 PERITON.DIALYSIS 8-4.25 % DEXT CA 2.5 MEQ/L- MG 0.5 MEQ/L IP SOLN $97.50 51552-0454-9 EPINEPHRINE BITARTRATE (BULK) MISC POWD $97.50 60505-0795-1 ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRG $97.50 60505-0795-4 ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRG $97.50 63323-269-50 PROPOFOL 10 MG/ML IV EMUL $97.50 64980-515-05 OFLOXACIN 0.3 % OPHT DROP $97.50 65162-833-66 DICLOFENAC SODIUM 1 % TOPICAL GEL $97.50 67457-197-00 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $97.50 67457-197-10 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $97.50 67457-464-20 GEMCITABINE 200 MG IV SOLR $97.50 67457-516-00 FOSPHENYTOIN 100 MG PE/2 ML INJ SOLN $97.50 67457-516-25 FOSPHENYTOIN 100 MG PE/2 ML INJ SOLN $97.50 68180-422-01 MOXIFLOXACIN 0.5 % OPHT DROP $97.50 69097-524-44 DICLOFENAC SODIUM 1 % TOPICAL GEL $97.50 69238-1615-3 OFLOXACIN 0.3 % OTIC DROP $97.50 99999-038-00 PHENYLEPHRINE HCL 2.5 % OPHT DROP $97.50 99999-045-31 AMPICILLIN 20 MG/ML INJ SYRINGE (USING 2G) $97.50 21922-017-06 CLOBETASOL 0.05 % TOPICAL OINT $97.40 0574-4024-35 ERYTHROMYCIN 5 MG/GRAM (0.5 %) OPHT OINT $97.30 0574-4024-39 ERYTHROMYCIN 5 MG/GRAM (0.5 %) OPHT OINT $97.30 42023-159-01 EPINEPHRINE 1 MG/ML (1 ML) INJ SOLN $97.24 42023-159-25 EPINEPHRINE 1 MG/ML (1 ML) INJ SOLN $97.24 HC51060093 OT-EVAL+REPORT EA ADD 15 MIN/C $97.00 HC89003719 PHENYLPROPANOLAMINE URINE-AU $97.00 HC89009799 QUININE-AU $97.00 HC62212162 TUBE FEEDING NG >36IN-NO STYLET $97.00 0075-0621-01 ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRG $96.87 0075-0621-60 ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRG $96.87 63323-327-10 NAFCILLIN 1 G INJ SOLR (MCH) $96.77 0409-1755-50 BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJ SOLN $96.53 0409-6581-01 BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJ SOLN $96.53 76329-3352-1 SODIUM BICARBONATE 8.4 % (1 MEQ/ML) IV SYRG $96.53 47781-690-30 RASAGILINE 1 MG ORAL TAB $96.43 63323-086-05 POTASSIUM PHOSPHATE M-/D-BASIC 3 MMOL/ML IV SOLN $96.27 0555-1056-86 ISOTRETINOIN 30 MG ORAL CAP $96.24 64764-720-30 VORTIOXETINE 5 MG ORAL TAB $96.23 64764-730-30 VORTIOXETINE 10 MG ORAL TAB $96.23 64764-750-30 VORTIOXETINE 20 MG ORAL TAB $96.23 0409-6729-11 MAGNESIUM SULFATE IN WATER 2 GRAM/50 ML (4 %) IV PGBK $96.20 0409-6729-24 MAGNESIUM SULFATE IN WATER 2 GRAM/50 ML (4 %) IV PGBK $96.20 0641-6136-01 FOSPHENYTOIN 100 MG PE/2 ML INJ SOLN $96.20 0641-6136-25 FOSPHENYTOIN 100 MG PE/2 ML INJ SOLN $96.20 0409-7295-01 POTASSIUM PHOSPHATE M-/D-BASIC 3 MMOL/ML IV SOLN $96.14 0409-7295-11 POTASSIUM PHOSPHATE M-/D-BASIC 3 MMOL/ML IV SOLN $96.14 0173-0633-02 LAMOTRIGINE 25 MG ORAL TAB $96.07 HC51004067 AEROSOL-CONTINUOUS TX EA AD'HR $96.00 HC89002406 BETA-HCG QUANT-QD $96.00 HC89019400 HLA AB DETECT 1ST MARKERS-AU $96.00 HC51010585 IMMUNOTHERAPY ONE INJECTION /COMM $96.00 HC51002103 MNT INITIAL ASSESSMENT INDIV EA 15MIN 1ST REF $96.00 HC32000556 OT-THER PROC GRP ADD 15MIN/CW $96.00 HC51060747 PT-THER EXER 30MIN/C $96.00 HC51000487 STREP A ANTIGN SCRN(DIRECT OBS) $96.00 16714-718-01 ENTECAVIR 1 MG ORAL TAB $95.97 63323-461-01 BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 INJ SOLN $95.88 63323-461-57 BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 INJ SOLN $95.88 HC89019012 ASPERGILLUS ANTIGEN-MV $95.00 HC89000004 BLOOD TYPE SERO; ABO FRANCSLLA AGLTNS-AU $95.00 HC62209192 CAP PIN PROTECTOR $95.00 HC89020010 FRAGILE X SCREEN REFLEX-AU $95.00 HC89001457 METHYPRYLON-AU $95.00 HC89007678 NTX SERUM-AU $95.00 HC89023295 SARS-COV-2 RNA QUAL RT-PCR-AU $95.00 HC62208095 VALVE ANTI REFLUX $95.00 HC62208137 VALVE NON-REBREATHING TEE $95.00 HC81500274 WBC AUTO DIFF $95.00 0025-1525-31 CELECOXIB 200 MG ORAL CAP $94.99 0025-1525-34 CELECOXIB 200 MG ORAL CAP $94.99 64679-012-01 PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR $94.91 64679-012-02 PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR $94.91 HC89012934 TRICHINELLA AB-AU $94.90 25021-608-50 PROPOFOL 10 MG/ML IV EMUL $94.90 0008-1211-30 DESVENLAFAXINE SUCCINATE 50 MG ORAL TB24 $94.89 0008-1211-01 DESVENLAFAXINE SUCCINATE 50 MG ORAL TB24 $94.89 0008-1211-14 DESVENLAFAXINE SUCCINATE 50 MG ORAL TB24 $94.89 10481-0112-8 FERRIC SUBSULFATE 0.2 TO 0.22 GRAM/ML TOPICAL SOLA $94.80 69238-1534-5 FLUOCINONIDE 0.05 % TOPICAL CREAM $94.77 0049-0014-81 AMPICILLIN-SULBACTAM 3 GRAM INJ SOLR $94.65 0049-0014-83 AMPICILLIN-SULBACTAM 3 GRAM INJ SOLR $94.65 54643-9023-8 MVI,PEDI NO.1,COMPONENT 1 OF 2 400 UNIT-200 MCG/4 ML IV SOLN $94.56 0781-3290-09 CLINDAMYCIN IN 5 % DEXTROSE 900 MG/50 ML IV PGBK $94.25 0781-3290-91 CLINDAMYCIN IN 5 % DEXTROSE 900 MG/50 ML IV PGBK $94.25 24208-411-05 BRIMONIDINE 0.2 % OPHT DROP $94.25 25021-166-48 PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR $94.25 70121-1395-1 GLYCOPYRROLATE 0.2 MG/ML INJ SOLN $94.24 70121-1395-5 GLYCOPYRROLATE 0.2 MG/ML INJ SOLN $94.24 63323-286-05 ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJ SOLN $94.12 63323-286-23 ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJ SOLN $94.12 HC89012983 DENGUE FEVER AB-FT $94.00 HC89000780 DYPHYLLINE-AU $94.00 HC51000412 IV INF HYDRATION EA ADD'L HR $94.00 HC83001255 PATHOGEN(S) TEST PLATELETS $94.00 HC51070803 PSY-BEHAV TX FAM W/O PT 1ST 30MIN $94.00 HC51070787 PSY-BEHAVIOR TX FAMW/PT 1ST 30MIN $94.00 HC31001779 PT-THER PROC GRP 15MIN/M $94.00 HC62206495 SHELL BREAST $94.00 0143-9318-01 NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN $93.70 0143-9318-10 NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN $93.70 0409-6637-14 SODIUM BICARBONATE 8.4 % (1 MEQ/ML) IV SYRG $93.60 0409-6637-24 SODIUM BICARBONATE 8.4 % (1 MEQ/ML) IV SYRG $93.60 0469-2601-30 MIRABEGRON 25 MG ORAL TB24 $93.11 0469-2602-30 MIRABEGRON 50 MG ORAL TB24 $93.11 0002-3239-30 ATOMOXETINE 60 MG ORAL CAP $93.08 63323-614-00 HYDRALAZINE 20 MG/ML INJ SOLN $93.08 63323-614-01 HYDRALAZINE 20 MG/ML INJ SOLN $93.08 HC89018162 11-DEHYROTHROMBOXANE B2 UR-ES $93.00 HC89013080 ANAEROBIC BACTERIAL ID-FT $93.00 HC89018154 ANNEXIN AB V IGG -EC $93.00 HC89018147 ANNEXIN AB V IGM -EC $93.00 HC89005110 B BURGDORFERI C6 PEP RFLX-FT $93.00 HC62219225 CATH SIALOGRAPHY $93.00 HC89008429 HVA URINE-CA $93.00 HC51002111 MNT REASSESSMENT EA INDIV 15MIN 1ST REF $93.00 HC62208483 PACK KYPHOPLASTY $93.00 HC51062842 PHONE CALL BY NONPHYSICIAN HC PROF 11-20MIN $93.00 HC51040004 RD ASSESS/EDUCATE PER 30MIN $93.00 HC62206271 SET IV TAXOL $93.00 HC51030005 SW ASSESS/INTERVENTION EA 30MIN $93.00 HC62218094 TUBING IRRIGATION/SUCTION $93.00 HC89010185 VMA URINE-CA $93.00 0703-0051-01 METHYLPREDNISOLONE ACETATE 80 MG/ML INJ SUSP $92.95 0703-0051-04 METHYLPREDNISOLONE ACETATE 80 MG/ML INJ SUSP $92.95 0517-4810-01 NITROGLYCERIN 50 MG/10 ML (5 MG/ML) IV SOLN $92.76 0517-4810-25 NITROGLYCERIN 50 MG/10 ML (5 MG/ML) IV SOLN $92.76 61703-349-16 IRINOTECAN 40 MG/2 ML IV SOLN $92.69 0338-1007-02 DOPAMINE IN 5 % DEXTROSE 400 MG/250 ML (1,600 MCG/ML) IV SOLN $92.63 HC89023907 FACTOR V LEIDEN -QN $92.45 0037-6860-10 OLSALAZINE 250 MG ORAL CAP $92.42 121059516 SODIUM CITRATE-CITRIC ACID 500-334 MG/5 ML ORAL SOLN $92.24 395009416 COMPOUNDING VEHICLE SF NO.9 ORAL LIQD $92.24 45963-439-65 LACTULOSE 10 GRAM/15 ML ORAL SOLN $92.24 42494-301-00 HYDROCORTISONE ACETATE 25 MG RECTAL SUPP $92.09 42494-301-12 HYDROCORTISONE ACETATE 25 MG RECTAL SUPP $92.09 0409-1134-03 MORPHINE 50 MG/ML IV SOLN $92.04 HC62200050 ABDUCTION PILLOW $92.00 HC62220371 ADAPTOR/SPLINT WALKER WRIST $92.00 HC89019863 AH50-ALTERNATE PATHWAY-SL $92.00 HC62200308 BAG/POUCH DRAINAGE $92.00 HC62221619 CANNULA REDUCER ENDOWRIST $92.00 HC62202288 DONUT PILLOW INFANT/PREMIE $92.00 HC62202403 DRESSING AQUACEL ROPE $92.00 HC62226535 DRESSING FOAM W/BRDR&ANTIMIC/GROUP EA 30 MIN 1ST REF $56.00 HC62211826 PAD STOMA TRACHEOSTOMY $56.00 HC62205612 PAD/PROTECTOR HEEL ELBOW $56.00 HC62216411 PIN/WIRE FIXATION TEMPORARY D $56.00 HC62227822 POSITIONER FLUIDIZED SMALL $56.00 HC62213871 PROBE MYOCARDIAL TEMP $56.00 HC62212055 SET AUTOTRANSFUSE CONSTAVAC A $56.00 HC62206735 SPLINT FINGER (STATIC/RING) $56.00 HC62207196 TIP SUCTION $56.00 HC62215900 TRAY BONE MARROW D $56.00 HC62211883 TRAY FOLEY CATH STATLOCK $56.00 HC62207519 TRAY SPINAL/EPIDURAL $56.00 HC62212147 TUBE FEEDING ENTERAL NG W/STYLET $56.00 HC62222047 VESSEL DILATOR B $56.00 HC62208210 WAFFLE WHEEL CHAIR $56.00 50458-577-01 RIVAROXABAN 2.5 MG ORAL TAB $55.97 50458-577-10 RIVAROXABAN 2.5 MG ORAL TAB $55.97 0517-9702-25 DROPERIDOL 2.5 MG/ML INJ SOLN $55.97 50268-198-42 CAPSAICIN 0.1 % TOPICAL CREAM $55.80 0023-0240-04 WHITE PETROLATUM-MINERAL OIL 57.3-42.5 % OPHT OINT $55.76 0074-3399-30 RITONAVIR 100 MG ORAL PWPK $55.72 0955-1004-01 ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRG $55.51 0955-1004-10 ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRG $55.51 24338-122-03 ERYTHROMYCIN 250 MG ORAL TBEC $55.48 67457-196-00 THIAMINE HCL (VITAMIN B1) 100 MG/ML INJ SOLN $55.48 67457-196-02 THIAMINE HCL (VITAMIN B1) 100 MG/ML INJ SOLN $55.48 0074-6799-22 LOPINAVIR-RITONAVIR 200-50 MG ORAL TAB $55.48 51079-164-01 VORICONAZOLE 50 MG ORAL TAB $55.45 51079-164-03 VORICONAZOLE 50 MG ORAL TAB $55.45 574007216 PROPYLENE GLYCOL (BULK) 99.5 % (NOT LESS THAN, USP) MISC LIQD $55.34 70069-121-01 TROPICAMIDE 1 % OPHT DROP $55.28 0143-9261-01 CEFAZOLIN 10 GRAM INJ SOLR $55.25 0143-9261-10 CEFAZOLIN 10 GRAM INJ SOLR $55.25 25021-611-10 NEOSTIGMINE METHYLSULFATE 1 MG/ML IV SOLN $55.25 41616-931-40 VECURONIUM BROMIDE 10 MG IV SOLR $55.25 41616-931-44 VECURONIUM BROMIDE 10 MG IV SOLR $55.25 47335-931-40 VECURONIUM BROMIDE 10 MG IV SOLR $55.25 47335-931-44 VECURONIUM BROMIDE 10 MG IV SOLR $55.25 63323-806-14 FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN $55.25 63323-806-20 FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN $55.25 70069-301-01 SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ SOLN $55.25 70069-301-10 SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ SOLN $55.25 70121-1049-1 TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP $55.25 70121-1049-2 TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP $55.25 70121-1049-5 TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP $55.25 70121-1651-1 TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP $55.25 70121-1651-5 TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP $55.25 71839-117-01 HEPARIN, PORCINE (PF) 1,000 UNIT/ML INJ SOLN $55.25 71839-117-25 HEPARIN, PORCINE (PF) 1,000 UNIT/ML INJ SOLN $55.25 50268-197-56 CAPSAICIN 0.1 % TOPICAL CREAM $55.19 70069-064-01 ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJ SOLN $55.19 70069-064-25 ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJ SOLN $55.19 17156-299-18 THALLOUS CHLORIDE TL-201 37 MBQ/ML (1 MCI/ML) IV SOLN $55.13 HC89023568 BACTERIAL VAGINOSIS TMA-AU $55.00 HC89023576 CANDIDA SPECIES TMA-AU $55.00 HC62210141 CANNULA SAMPLING CO2 W/W-O O2 $55.00 HC89014633 CULTURE RAPID CYTOMEGALOVIRUS-AU $55.00 HC89013379 HPV HIGH RISK BY NAA-AU $55.00 HC89014716 HSV BY PCR(CSF)-AU $55.00 HC89013296 HSV BY PCR-AU $55.00 HC83503813 IF STUDY DIRECT 1ST STAIN-CS $55.00 HC62212469 LARYNGOSCOPE BLADE W-HANDLE DISP $55.00 HC89017222 METHOTREXATE-U2 $55.00 HC89017305 METHYL MALONIC ACID-QD $55.00 HC35500222 MT-BEHAV TX FAM W/O PT ADD 15 $55.00 HC35500206 MT-BEHAVIOR TX FAMW/PT ADD 15MIN $55.00 HC62213855 NEEDLE NERVE/REGION BLOCK $55.00 HC89016117 ORGANIC ACIDS TOT QUAL-MA $55.00 HC89020945 PANCREATIC ELASTERASE FEC-AU $55.00 HC89009526 PARATHYROID HORMONE TERM-QN $55.00 HC39001607 PSY-BEHAV TX FAM W/O PT ADD 15 $55.00 HC39001581 PSY-BEHAVIOR TX FAMW/PT ADD 15MIN $55.00 HC89023402 RESP DNA/RNA SARS-COV-2/COVID-19 AMP PROBE-ET $55.00 HC89023584 TRICHOMONAS VAGINALIS TMA-AU $55.00 99998-000-57 ERYTHROMYCIN LACTOBIONATE 50 MG/ML IV SOLN (MCH) $54.95 0065-4011-06 KETOTIFEN FUMARATE 0.025 % (0.035 %) OPHT DROP $54.93 63739-069-33 ARIPIPRAZOLE 2 MG ORAL TAB $54.85 0046-1105-11 CONJ ESTROG-MEDROXYPROGEST ACE 0.3-1.5 MG ORAL TAB $54.50 0046-1106-11 CONJ ESTROG-MEDROXYPROGEST ACE 0.45-1.5 MG ORAL TAB $54.50 0904-6510-06 ARIPIPRAZOLE 5 MG ORAL TAB $54.40 0904-6511-06 ARIPIPRAZOLE 10 MG ORAL TAB $54.40 HC89022008 PROGESTERONE MASS SPECTROMETRY-ES $54.36 75834-243-30 ERYTHROMYCIN 500 MG ORAL TAB $54.17 63323-488-17 LIDOCAINE-EPINEPHRINE (MPF) 1.5 %-1:200,000 INJ SOLN (MHS) $54.15 36000-162-01 NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN $54.08 36000-162-10 NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN $54.08 0409-2051-05 KETAMINE 100 MG/ML INJ SOLN $54.05 0409-2051-15 KETAMINE 100 MG/ML INJ SOLN $54.05 99999-008-99 DIATRIZOATE MEG-DIATRIZOAT SOD 66-10 % ORAL SOLN $54.02 HC81701906 ALLERGEN IGE CRUDE EXTRACT, EACH $54.00 HC89013544 CALCITONIN-ES $54.00 HC89022073 CANNABINOIDS NATURAL SERUM QNT(PNL)-AU $54.00 HC89016125 HEPATITIS C PCR QUAL-QD $54.00 HC62229059 KIT TPN/CVP DRESSING B $54.00 HC89021448 MAGNESIUM RBC - AU $54.00 HC51040137 MNT THERAPY GROUP EA 30 MIN 2ND REF(DX) $54.00 HC89010706 PLASMINOGEN ACTIVATOR INH-1-AU $54.00 HC89007686 PYRIDINIUM CROSSLINKS TOTAL-AU $54.00 HC89014781 STREPTOCOCCUS PNEUMONIAE AG-AU $54.00 99999-045-96 POTASSIUM CHLORIDE IN D5W 10 MEQ/100 ML IVPB $53.95 HC89009955 TESTOSTERONE TOTAL-ES $53.82 63323-294-01 MEPIVACAINE (PF) 20 MG/ML (2 %) INJ SOLN $53.82 63323-294-27 MEPIVACAINE (PF) 20 MG/ML (2 %) INJ SOLN $53.82 HC89022560 ANDROSTENEDIONE-QN $53.76 54092-063-01 ANAGRELIDE 0.5 MG ORAL CAP $53.75 0597-0355-09 DABIGATRAN ETEXILATE 75 MG ORAL CAP $53.74 0597-0355-56 DABIGATRAN ETEXILATE 75 MG ORAL CAP $53.74 0597-0360-55 DABIGATRAN ETEXILATE 150 MG ORAL CAP $53.74 0597-0360-82 DABIGATRAN ETEXILATE 150 MG ORAL CAP $53.74 0168-0357-05 LIDOCAINE-PRILOCAINE 2.5-2.5 % TOPICAL CREAM $53.72 0168-0357-55 LIDOCAINE-PRILOCAINE 2.5-2.5 % TOPICAL CREAM $53.72 0409-3815-11 MORPHINE (PF) 1 MG/ML INJ SOLN $53.69 0409-3815-12 MORPHINE (PF) 1 MG/ML INJ SOLN $53.69 62332-582-04 LIDOCAINE-PRILOCAINE 2.5-2.5 % TOPICAL CREAM $53.69 0409-2339-24 LABETALOL 20 MG/4 ML (5 MG/ML) IV SYRG $53.66 0409-2339-34 LABETALOL 20 MG/4 ML (5 MG/ML) IV SYRG $53.66 0703-4244-01 CARBOPLATIN 10 MG/ML IV SOLN $53.63 63323-462-02 BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJ SOLN $53.63 63323-462-31 BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJ SOLN $53.63 63323-523-01 HEPARIN (PORCINE) IN 5 % DEX 25,000 UNIT/250 ML(100 UNIT/ML) IV SOLP $53.63 63323-523-74 HEPARIN (PORCINE) IN 5 % DEX 25,000 UNIT/250 ML(100 UNIT/ML) IV SOLP $53.63 71288-501-10 NEOSTIGMINE METHYLSULFATE 1 MG/ML INJ SOLN (MCH) $53.63 71288-501-11 NEOSTIGMINE METHYLSULFATE 1 MG/ML INJ SOLN (MCH) $53.63 0078-0358-34 VALSARTAN 80 MG ORAL TAB $53.61 60687-179-01 ARIPIPRAZOLE 10 MG ORAL TAB $53.40 60687-179-11 ARIPIPRAZOLE 10 MG ORAL TAB $53.40 87040203 PEDIATRIC MULTIVITAMIN NO.192 250 MCG-50 MG- 10 MCG/ML ORAL DROP $53.30 87040303 VIT A PALMITATE-VIT C-VIT D3 250 MCG-50 MG- 10 MCG/ML ORAL DROP $53.30 87040501 PEDI MV NO.189-FERROUS SULFATE 11 MG IRON/ML ORAL DROP $53.30 87086644 CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROP $53.30 0143-9298-01 SODIUM FERRIC GLUCONAT-SUCROSE 62.5 MG/5 ML IV SOLN $53.30 0143-9298-10 SODIUM FERRIC GLUCONAT-SUCROSE 62.5 MG/5 ML IV SOLN $53.30 50268-732-11 SUCRALFATE 100 MG/ML ORAL SUSP $53.30 50268-732-12 SUCRALFATE 100 MG/ML ORAL SUSP $53.30 45802-065-35 TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM $53.24 0121-1544-10 HYDROCODONE-ACETAMINOPHEN 7.5-325 MG/15 ML ORAL SOLN $53.17 0121-1544-40 HYDROCODONE-ACETAMINOPHEN 7.5-325 MG/15 ML ORAL SOLN $53.17 16714-268-01 TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL OINT $53.14 45802-049-35 TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL OINT $53.14 71288-006-30 AMPICILLIN-SULBACTAM 3 G IV SOLR (MCH) $53.11 71288-006-31 AMPICILLIN-SULBACTAM 3 G IV SOLR (MCH) $53.11 0378-2512-78 CAPECITABINE 500 MG ORAL TAB $53.09 0409-4332-01 VANCOMYCIN 500 MG IV SOLR $53.05 0409-4332-11 VANCOMYCIN 500 MG IV SOLR $53.05 16714-267-02 TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINT $53.04 45802-063-36 TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM $53.04 HC62219118 BINDER/ORTHOSIS LUMBAR/SACRAL PRFB $53.00 HC89018196 FLOW CYT MKR TC ADD+-ES $53.00 HC62213996 FORCEP BIOPSY DISP A $53.00 HC89014617 FUNGUS ID-FT $53.00 HC62210513 GLOVE COMPRESSION OPEN FINGER $53.00 HC62217138 KIT PTCA SYRINGE (CUSTOM) $53.00 HC62802640 NEEDLE HDR BREAST IMPLANT $53.00 HC51020261 NP TEAM CONFER PRTCPNT PER 15MIN $53.00 HC62219654 PRESSURIZER FEMORAL $53.00 HC51020030 RN TEAM CONF PRTCPNT PER 15MIN $53.00 HC62206131 SET BLOOD Y TYPE $53.00 HC89005078 ULTRACENTRIFUG VAP(IN PNL)-AU $53.00 HC89023188 VORICONAZOLE ANTIFNGL-AU $53.00 59767-024-01 LIPASE-PROTEASE-AMYLASE 24,000-86,250- 90,750 UNIT ORAL CPDR $52.98 63323-584-21 ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRG $52.85 63323-584-99 ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRG $52.85 63323-617-01 MILRINONE 1 MG/ML IV SOLN $52.78 63323-617-10 MILRINONE 1 MG/ML IV SOLN $52.78 99999-040-65 DIAZEPAM 5 MG/ML INJ SOLN $52.66 0002-3235-60 DULOXETINE 20 MG ORAL CPDR $52.65 25021-175-20 PIPERACILLIN-TAZOBACTAM 2.25 GRAM IV SOLR $52.65 63323-108-00 MAGNESIUM SULFATE IN D5W 1 GRAM/100 ML IV PGBK $52.65 63323-108-01 MAGNESIUM SULFATE IN D5W 1 GRAM/100 ML IV PGBK $52.65 0904-6596-04 VORICONAZOLE 50 MG ORAL TAB $52.63 0703-0241-01 TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP $52.59 0395-0243-92 BENZOIN-ALOE VERA-STORAX-TOLU 10-2-8-4 % TOPICAL TINC $52.54 70004-433-05 KETAMINE 50 MG/ML (1 ML) IV SYRG $52.52 51672-2035-6 MICONAZOLE NITRATE 2 % VAGINAL CREAM $52.36 43598-666-11 SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ SOLN $52.33 43598-666-25 SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ SOLN $52.33 67457-339-00 VANCOMYCIN 500 MG IV SOLR $52.26 67457-339-50 VANCOMYCIN 500 MG IV SOLR $52.26 64980-178-02 CHLOROQUINE PHOSPHATE 500 MG ORAL TAB $52.24 0378-4105-91 ABACAVIR 300 MG ORAL TAB $52.23 63323-584-63 ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRG $52.20 63323-584-65 ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRG $52.20 3848598035 UREA 10 % TOPICAL CREAM $52.15 43066-023-01 ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJ SOLN $52.07 43066-023-10 ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJ SOLN $52.07 60758-801-10 TIMOLOL MALEATE 0.5 % OPHT DROP $52.07 HC51062917 ADVANCE CARE PLAN DISCUSS DIRECTIVES EA ADD 30MIN+ $52.00 HC89018170 CREATININE URINE (PNL)-ES $52.00 HC89016695 HEPATITIS B SURFACE AB-QD $52.00 HC51060473 OT CONSULT TELEPHONE PER 15MIN $52.00 HC51060101 OT-TEAM CASE CONFERENCE EA 15MIN/C $52.00 HC89000137 PSA TOTAL-QD $52.00 HC89020879 SIN NOMBRE VIRUS IGM-AU $52.00 0067-8152-02 DICLOFENAC SODIUM 1 % TOPICAL GEL $52.00 0093-4125-73 PENICILLIN V POTASSIUM 125 MG/5 ML ORAL SOLR $52.00 0143-9084-01 DOXORUBICIN 10 MG/5 ML IV SOLN $52.00 0143-9872-01 PROPRANOLOL 1 MG/ML IV SOLN $52.00 0143-9872-10 PROPRANOLOL 1 MG/ML IV SOLN $52.00 0338-0023-04 DEXTROSE 10 % IN WATER (D10W) 10 % IV SOLP $52.00 0517-0401-25 ATROPINE 0.4 MG/ML INJ SOLN $52.00 0641-6167-01 AMIKACIN 500 MG/2 ML INJ SOLN $52.00 0641-6167-10 AMIKACIN 500 MG/2 ML INJ SOLN $52.00 0641-6217-01 METHOCARBAMOL 100 MG/ML INJ SOLN $52.00 0641-6217-25 METHOCARBAMOL 100 MG/ML INJ SOLN $52.00 0990-7109-09 POTASSIUM CHLORIDE-D5-0.9%NACL 40 MEQ/L IV SOLP $52.00 17271-701-06 SODIUM CHLORIDE 0.9 % IV SOLP $52.00 24208-585-59 TROPICAMIDE 1 % OPHT DROP $52.00 25021-780-05 LEVETIRACETAM 500 MG/5 ML IV SOLN $52.00 49230-206-20 PERIT.DIALYSIS 6-1.5 % DEXTROS CA 2.5 MEQ/L- MG 0.5 MEQ/L IP SOLN $52.00 60432-464-00 LIDOCAINE HCL 2 % MUCOUS MEMB SOLN $52.00 61990-0611-0 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN (MCH) $52.00 61990-0611-2 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN (MCH) $52.00 63323-106-00 MAGNESIUM SULFATE IN WATER 4 GRAM/100 ML (4 %) IV PGBK $52.00 63323-106-01 MAGNESIUM SULFATE IN WATER 4 GRAM/100 ML (4 %) IV PGBK $52.00 71285-6044-1 OXYTOCIN IN 0.9 % SOD CHLORIDE 30 UNIT/500 ML IV SOLN $52.00 72266-102-01 LABETALOL 5 MG/ML IV SOLN $52.00 99999-039-02 DOBUTAMINE IN D5W (CONC: 2000 MCG/ML) (LBM) $52.00 8137003844 DIMETHICONE-COLLOIDAL OATMEAL 1.25 % TOPICAL LOTN $51.87 63323-943-10 SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ SOLN $51.87 63323-943-21 SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ SOLN $51.87 67877-260-30 RASAGILINE 1 MG ORAL TAB $51.82 HC89012769 LEPTOSPIRA AB-AU $51.75 42571-221-30 RASAGILINE 1 MG ORAL TAB $51.74 69238-1264-1 OSELTAMIVIR 30 MG ORAL CAP $51.71 69238-1265-1 OSELTAMIVIR 45 MG ORAL CAP $51.71 44567-210-10 AMPICILLIN-SULBACTAM 1.5 GRAM INJ SOLR $51.68 63323-535-01 ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRG $51.61 63323-535-87 ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRG $51.61 65219-020-03 AMPICILLIN SODIUM 2 G IV SOLR (MCH) $51.61 65219-020-23 AMPICILLIN SODIUM 2 G IV SOLR (MCH) $51.61 0054-0470-21 EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG ORAL TAB $51.54 60505-4713-3 CARVEDILOL PHOSPHATE 10 MG ORAL CM24 $51.53 1093990033 IBUPROFEN 100 MG/5 ML ORAL SUSP $51.48 45802-064-36 TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM $51.48 16714-227-01 CARVEDILOL PHOSPHATE 10 MG ORAL CM24 $51.43 0487-9601-01 BUDESONIDE 0.25 MG/2 ML INHALATION NBSP $51.39 0093-4161-73 AMOXICILLIN 400 MG/5 ML ORAL SUSR $51.35 395224391 PEPPERMINT SPIRIT ORAL SPRT $51.29 0023-9205-15 CARBOXYMETHYLCELLULOSE SODIUM 1 % OPHT DLGL $51.29 63323-400-05 LEVETIRACETAM 500 MG/5 ML IV SOLN $51.29 63323-642-01 MAGNESIUM SULFATE 4 MEQ/ML (50 %) INJ SOLN $51.22 63323-642-20 MAGNESIUM 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0065-0085-15 NAPHAZOLINE-PHENIRAMINE 0.025-0.3 % OPHT DROP $50.99 16714-199-01 VORICONAZOLE 200 MG ORAL TAB $50.97 42291-666-10 OSELTAMIVIR 30 MG ORAL CAP $50.80 0409-1141-02 SODIUM CHLORIDE 4 MEQ/ML (23.4%) INFUSION (FOR ELEVATED ICP) $50.70 0409-1141-12 SODIUM CHLORIDE 4 MEQ/ML (23.4%) INFUSION (FOR ELEVATED ICP) $50.70 16714-016-01 ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRG $50.70 16714-016-10 ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRG $50.70 63323-012-06 OXYTOCIN 10 UNIT/ML INJ SOLN $50.70 63323-012-10 OXYTOCIN 10 UNIT/ML INJ SOLN $50.70 63323-347-20 CEFTRIAXONE 2 GRAM INJ SOLR $50.70 65219-257-00 EPHEDRINE SULFATE 50 MG/ML IV SOLN $50.64 65219-257-01 EPHEDRINE SULFATE 50 MG/ML IV SOLN $50.64 50580-534-08 DIPHENHYDRAMINE HCL 12.5 MG/5 ML ORAL LIQD $50.62 73562-112-01 LIPASE-PROTEASE-AMYLASE 20,000-63,000- 84,000 UNIT ORAL CPDR $50.57 0409-2720-03 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $50.51 HC89022578 CORTICOSTERONE-QN $50.50 25021-173-02 AMIKACIN 500 MG/2 ML INJ SOLN $50.38 0409-5555-02 SODIUM BICARBONATE 4.2 % IV SOLN $50.34 0409-5555-12 SODIUM BICARBONATE 4.2 % IV SOLN $50.34 8380007906 OSTOMY SUPPLIES TOPICAL POWD $50.22 0049-0013-81 AMPICILLIN-SULBACTAM 1.5 GRAM INJ SOLR $50.13 0049-0013-83 AMPICILLIN-SULBACTAM 1.5 GRAM INJ SOLR $50.13 6845510690 OSTOMY ADHESIVE MISC PSTE $50.12 0409-1630-10 ATROPINE 0.1 MG/ML INJ SYRG $50.12 0409-1630-15 ATROPINE 0.1 MG/ML INJ SYRG $50.12 63323-369-20 AMPICILLIN-SULBACTAM 3 GRAM INJ SOLR $50.12 0009-4544-02 TOLTERODINE 2 MG ORAL TAB $50.10 99999-040-13 MORPHINE 5 MG/ML IN NS 50 ML OPIOID TOLERANT PCA $50.05 0904-6583-04 LAMIVUDINE 150 MG ORAL TAB $50.04 HC62214622 ADAPTER SIDEARM ENDO $50.00 HC89004964 ASPERGILLUS ANTIGEN-AU $50.00 HC62200282 BAG DECANTER $50.00 HC89010292 C PEPTIDE-ES $50.00 HC89021687 CANNABINOIDS, NATURAL MEC(PNL)-AU $50.00 HC62223763 CLIP MAGAZINE RANEY SCALP $50.00 HC62208509 DISC COMPRESSION $50.00 HC62202387 DRAIN WOUND $50.00 HC62202411 DRESSING AQUAPHOR GUAZE $50.00 HC62211602 DRESSING HYDROGEL WND FILLER SM $50.00 HC62202585 DRESSING VIGILON $50.00 HC89011480 GLOMERULAR BSMT MEM IF-AU $50.00 HC83503664 IHC/IP PER SPEC INITIAL AB STAIN PLAP -US $50.00 HC83503680 IHC/IP PER SPEC INITIAL AB STAIN PROLACTIN -US $50.00 HC83503706 IHC/IP PER SPEC INITIAL AB STAIN SEND OUT -US $50.00 HC83503722 IHC/IP PER SPEC INITIAL AB STAIN SMMHC -US $50.00 HC83503748 IHC/IP PER SPEC INITIAL AB STAIN TERM DEOZY -US $50.00 HC83503805 IHC/IP PER SPEC INITIAL AB STAIN UBIQUITIN STAIN -US $50.00 HC51000149 IMMUNIZATION ADMIN ADD'L $50.00 HC62207873 IVS TUBING $50.00 HC62207899 IVS TUBING HOT LINE $50.00 HC83504084 MORPHOMETRIC STUDY TUMOR-PI $50.00 HC62202098 NEEDLE CHIBA $50.00 HC62217179 ORTHOTIC KNEE ELASTIC W/JOINTS PRFB $50.00 HC89021067 PEANUT ALLERGEN F13 (PNL)-AU $50.00 HC89021075 PEANUT COMP ANTGNC EPI ARA H1(PNL)-AU $50.00 HC89021083 PEANUT COMP ANTGNC EPI ARA H2(PNL)-AU $50.00 HC89021091 PEANUT COMP ANTGNC EPI ARA H3(PNL)-AU $50.00 HC89021109 PEANUT COMP ANTGNC EPI ARA H4(PNL)-AU $50.00 HC89021117 PEANUT COMP ANTGNC EPI ARA H5(PNL)-AU $50.00 HC51062834 PHONE CALL BY NONPHYSICIAN HC PROF 5-10MIN $50.00 HC62205901 PUNCH SKIN BX $50.00 HC89020861 SIN NOMBRE VIRUS IGG-AU $50.00 HC83505479 SPECIAL STAIN GROUP II -NG $50.00 HC83505743 SPECIAL STAIN GROUP II(PANEL)-U2 $50.00 HC62206727 SPLINT CLAVICLE $50.00 HC62206982 SUPPORTER COTTON $50.00 HC62214408 TROCAR ENDO A $50.00 HC62217062 WIRE PACING TEMP C $50.00 64679-034-01 PIPERACILLIN-TAZOBACTAM 2.25 GRAM IV SOLR $49.95 64679-034-02 PIPERACILLIN-TAZOBACTAM 2.25 GRAM IV SOLR $49.95 50458-820-02 TAPENTADOL 50 MG ORAL TAB $49.94 58914-601-20 BISMUTH SUBCIT K-METRONIDZ-TCN 140-125-125 MG ORAL CAP $49.92 HC89007843 DHEA SULFATE-ES $49.75 0121-4811-05 HYDROCODONE-HOMATROPINE 5-1.5 MG/5 ML (5 ML) ORAL SYRP $49.60 0641-6117-01 AMPICILLIN-SULBACTAM 3 GRAM INJ SOLR $49.53 0641-6117-10 AMPICILLIN-SULBACTAM 3 GRAM INJ SOLR $49.53 25021-403-04 HEPARIN (PORCINE) 10,000 UNIT/ML INJ SOLN $49.40 43598-129-01 METHYLPREDNISOLONE SODIUM SUCC 125 MG INJ SOLR $49.40 43598-129-25 METHYLPREDNISOLONE SODIUM SUCC 125 MG INJ SOLR $49.40 61990-0130-1 PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR $49.40 61990-0130-2 PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR $49.40 0006-3603-01 RALTEGRAVIR 100 MG ORAL PWPK $49.34 0006-3603-61 RALTEGRAVIR 100 MG ORAL PWPK $49.34 0603-1554-16 POTASSIUM CHLORIDE 20 MEQ ORAL PACK $49.34 4628750001 SORBITOL 70 % MISC SOLN $49.19 0121-0577-16 LACTULOSE 10 G/15 ML ORAL SOLN (MCH) $49.19 45802-952-26 IBUPROFEN 100 MG/5 ML ORAL SUSP $49.14 0069-1530-41 AMLODIPINE 5 MG ORAL TAB $49.01 HC89002927 ANTI-MAG-QD $49.00 HC89001150 C-1 ESTERASE INHIBITOR-QD $49.00 HC51062289 CPSP DEPRESSION SCREENING IND POS $49.00 HC89007975 ESTROGENS TOTAL-ES $49.00 HC89002190 GLOMERULAR BASEMENT MEMB AB-QD $49.00 HC89003503 GM1 AUTO AB-QD $49.00 HC83500561 KARYOTYPING,ADD EA-IM $49.00 HC51060465 PT CONSULT TELEPHONE PER 15MIN $49.00 HC51060077 PT-TEAM CASE CONFERENCE EA 15MIN/C $49.00 HC51040012 RD TEAM CONF PRTCPNT PER 15MIN $49.00 HC51001923 RETICULOCYTE MANUAL $49.00 HC51060135 ST-TEAM CASE CONF EA 15MIN/C $49.00 HC51030013 SW TEAM CONF PRTCPNT PER 15MIN $49.00 HC51070720 TEACH/COUNSEL GROUP SESSION FPACT $49.00 0093-6815-45 BUDESONIDE 0.25 MG/2 ML INHALATION NBSP $48.96 0093-6815-73 BUDESONIDE 0.25 MG/2 ML INHALATION NBSP $48.96 HC89023253 IMMUNO ELECT URINE (IFE)-AU $48.95 0781-3220-75 ROCURONIUM 10 MG/ML IV SOLN $48.91 0781-3220-95 ROCURONIUM 10 MG/ML IV SOLN $48.91 0409-2596-05 MIDAZOLAM 5MG/ML INJECTABLE SOLUTION (MHS) $48.88 0409-2596-15 MIDAZOLAM 5MG/ML INJECTABLE SOLUTION (MHS) $48.88 17478-931-01 CALCITRIOL 1 MCG/ML IV SOLN $48.76 0409-4688-22 FLUCONAZOLE IN SALINE (2MG/ML CONC) INJECTION $48.75 0517-0780-01 ETOMIDATE 2 MG/ML IV SOLN $48.75 17271-701-05 SODIUM CHLORIDE 0.9 % IV SOLP $48.75 25021-137-20 AMPICILLIN SODIUM 2 G IV SOLR (MCH) $48.75 27241-063-03 VORICONAZOLE 200 MG ORAL TAB $48.75 39822-4200-5 ROCURONIUM 10 MG/ML IV SOLN $48.75 39822-4200-6 ROCURONIUM 10 MG/ML IV SOLN $48.75 43598-210-25 SILVER SULFADIAZINE 1 % TOPICAL CREAM $48.75 51552-0269-9 TETRACAINE HCL (BULK) MISC POWD $48.75 68462-573-30 VORICONAZOLE 200 MG ORAL TAB $48.75 70069-806-01 NEOSTIGMINE METHYLSULFATE 1 MG/ML INJ SOLN (MCH) $48.75 70069-806-10 NEOSTIGMINE METHYLSULFATE 1 MG/ML INJ SOLN (MCH) $48.75 70860-105-20 VANCOMYCIN 1000 MG IV SOLR $48.75 70860-105-41 VANCOMYCIN 1000 MG IV SOLR $48.75 72572-050-01 ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN $48.75 72572-050-10 ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN (MHS) $48.75 0054-0382-25 CYCLOPHOSPHAMIDE 25 MG ORAL CAP $48.68 0904-7168-06 URSODIOL 300 MG ORAL CAP $48.65 HC89022081 COCAINE SERUM QNT(PNL)-AU $48.63 0409-3814-11 MORPHINE (PF) 0.5 MG/ML INJ SOLN $48.62 0409-3814-12 MORPHINE (PF) 0.5 MG/ML INJ SOLN $48.62 1093938033 MICONAZOLE NITRATE 2 % VAGINAL CREAM $48.56 49348-530-77 MICONAZOLE NITRATE 2 % VAGINAL CREAM $48.56 49348-872-77 MICONAZOLE NITRATE 2 % VAGINAL CREAM $48.56 0032-1224-01 LIPASE-PROTEASE-AMYLASE 24,000-76,000 -120,000 UNIT ORAL CPDR $48.54 59762-0707-1 DICLOFENAC EPOLAMINE 1.3 % TRANSDERMAL PT12 $48.48 59762-0707-2 DICLOFENAC EPOLAMINE 1.3 % TRANSDERMAL PT12 $48.48 72572-052-01 CALCIUM CHLORIDE 100 MG/ML (10 %) IV SOLN $48.43 72572-052-10 CALCIUM CHLORIDE 100 MG/ML (10 %) IV SOLN $48.43 0075-0624-01 ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRG $48.37 0075-0624-30 ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRG $48.37 63323-260-37 MEPIVACAINE (PF) 10 MG/ML (1 %) INJ SOLN $48.36 HC89010003 THYROGLOBULIN-ES $48.35 60687-449-01 SEVELAMER HCL 800 MG ORAL TAB $48.35 60687-449-11 SEVELAMER HCL 800 MG ORAL TAB $48.35 63323-398-01 AZITHROMYCIN 500 MG IV SOLR $48.30 63323-398-10 AZITHROMYCIN 500 MG IV SOLR $48.30 HC89000517 SPERM ANTIBODIES-AU $48.25 10147-1700-3 ITRACONAZOLE 100 MG ORAL CAP $48.24 63323-424-05 FLUMAZENIL 0.1 MG/ML IV SOLN $48.23 0456-3205-60 MEMANTINE 5 MG ORAL TAB $48.19 0456-3210-60 MEMANTINE 10 MG ORAL TAB $48.19 0456-3205-63 MEMANTINE 5 MG ORAL TAB $48.18 0456-3210-63 MEMANTINE 10 MG ORAL TAB $48.18 0456-3205-11 MEMANTINE 5 MG ORAL TAB $48.17 HC89016091 ACYLCARNITINES QUANT-MA $48.00 HC83505156 HUMAN PAPILLOMAVIRUS HI/LO- PI $48.00 HC89008890 LDL SUBCLASS-AU $48.00 HC51070811 PSY-BEHAV TX FAM W/O PT ADD 15 $48.00 HC51061646 RETICULOCYTE - AUTO $48.00 HC89009856 SEX HORMONE BINDING GLOB-ES $48.00 63323-487-01 LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJ SOLN $47.97 63323-487-17 LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJ SOLN $47.97 45802-868-02 POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWD $47.96 31722-556-12 LOPINAVIR-RITONAVIR 200-50 MG ORAL TAB $47.93 0597-0184-61 PRAMIPEXOLE 0.25 MG ORAL TAB $47.91 0456-1512-60 MILNACIPRAN 12.5 MG ORAL TAB $47.90 0456-1525-60 MILNACIPRAN 25 MG ORAL TAB $47.90 0456-1550-60 MILNACIPRAN 50 MG ORAL TAB $47.90 99999-044-44 DESMOPRESSIN 0.5 MCG/ML INJ DILUTION $47.77 0032-1224-07 LIPASE-PROTEASE-AMYLASE 24,000-76,000 -120,000 UNIT ORAL CPDR $47.76 50458-645-65 TOPIRAMATE 25 MG ORAL CPSP $47.75 0121-4772-05 HYDROCODONE-ACETAMINOPHEN 7.5-325 MG/15 ML ORAL SOLN $47.74 0121-4772-40 HYDROCODONE-ACETAMINOPHEN 7.5-325 MG/15 ML ORAL SOLN $47.74 0409-1632-01 VECURONIUM BROMIDE 10 MG IV SOLR $47.70 0409-1632-21 VECURONIUM BROMIDE 10 MG IV SOLR $47.70 69097-321-87 BUDESONIDE 1 MG/2 ML INHALATION NBSP $47.67 0555-0171-78 MEFLOQUINE 250 MG ORAL TAB $47.65 0555-0171-88 MEFLOQUINE 250 MG ORAL TAB $47.65 99999-038-29 VECURONIUM 1 MG/ML NICU IV SYRINGE $47.65 99999-038-49 CYCLOPHOSPHAMIDE 10 MG/ML ORAL SOLUTION (COMPOUND) $47.61 573051330 MULTIVIT-MIN-FERROUS GLUCONATE 9 MG IRON/15 ML ORAL LIQD $47.55 HC89021745 AMPHETAMINES(MDA,MDEA,MDMA)MEC(CONF PNL)-AU $47.50 HC89021653 AMPHETAMINES;1 OR 2 MEC(CONF PNL)-AU $47.50 0703-9040-01 AMIKACIN 1,000 MG/4 ML INJ SOLN $47.45 0024-5851-30 IRBESARTAN 150 MG ORAL TAB $47.39 0409-4346-16 AMINOCAPROIC ACID 250 MG/ML IV SOLN $47.32 0409-4346-73 AMINOCAPROIC ACID 250 MG/ML IV SOLN $47.32 63323-540-05 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $47.26 63323-540-11 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $47.26 63323-540-15 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $47.26 68094-123-59 OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSP $47.26 70069-421-03 LATANOPROST 0.005 % OPHT DROP $47.26 61703-350-10 METHOTREXATE SODIUM 25 MG/ML INJ SOLN $47.24 61703-350-37 METHOTREXATE 25 MG/ML INJECTION (ECTOPIC PREGNANCY) $47.24 61703-350-38 METHOTREXATE SODIUM 25 MG/ML INJ SOLN $47.24 75834-170-02 ZINC OXIDE 20 % TOPICAL OINT $47.18 0641-6135-01 PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN $47.14 0641-6135-25 PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN $47.14 53489-141-01 QUINIDINE GLUCONATE 324 MG ORAL TBSR $47.13 70860-400-10 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $47.13 70860-400-41 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $47.13 0574-4024-11 ERYTHROMYCIN 5 MG/GRAM (0.5 %) OPHT OINT $47.10 0574-4024-50 ERYTHROMYCIN 5 MG/GRAM (0.5 %) OPHT OINT $47.10 33342-481-15 NYSTATIN 100,000 UNIT/GRAM TOPICAL OINT $47.09 HC51060028 AHCP TEAM CONF PRTCPNT EA 15MIN $47.00 HC89011654 GLOMERULAR BASEMENT MEMB AB-AU $47.00 HC89013361 HPV LO RISK TYPES(6,11,42,43,44)-AU $47.00 HC62202031 INJECTOR KIT DOUBLE $47.00 HC62203765 KIT CATH SUCTION $47.00 HC85100519 MANUAL CELL COUNT RED/LEUK/PLT $47.00 HC89009690 PROLACTIN-ES $47.00 HC89010110 T-3 REVERSE-ES $47.00 HC62208038 URINE METER $47.00 536110945 UREA 20 % TOPICAL CREAM $46.96 59762-1307-2 LINEZOLID 600 MG ORAL TAB $46.95 0603-1554-10 POTASSIUM CHLORIDE 20 MEQ ORAL PACK $46.87 0517-0375-10 INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJ SOLN $46.80 16714-986-03 TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM $46.80 44567-435-24 LEVOFLOXACIN IN D5W 250 MG/50 ML IV PGBK $46.80 55150-209-02 DEXMEDETOMIDINE 100 MCG/ML INJ SOLN (FOR INTRANASAL USE) $46.80 63323-355-50 LEVOFLOXACIN IN D5W 250 MG/50 ML IV PGBK $46.80 64764-119-01 COLCHICINE 0.6 MG ORAL TAB $46.74 64764-119-07 COLCHICINE 0.6 MG ORAL TAB $46.74 0409-0212-01 MILRINONE 1 MG/ML IV SOLN $46.74 0409-0212-10 MILRINONE 1 MG/ML IV SOLN $46.74 16714-851-03 CLOMIPRAMINE 75 MG ORAL CAP $46.66 0904-7269-66 SUCRALFATE 100 MG/ML ORAL SUSP $46.61 0409-9558-10 ROCURONIUM 10 MG/ML IV SOLN $46.54 0409-9558-31 ROCURONIUM 10 MG/ML IV SOLN $46.54 43598-020-40 AMOXICILLIN-POT CLAVULANATE 1,000-62.5 MG ORAL TB12 $46.48 0065-0518-01 WHITE PETROLATUM-MINERAL OIL 94-3 % OPHT OINT $46.48 68180-962-04 TOBRAMYCIN IN 0.225 % NACL 300 MG/5 ML INHALATION NEBU $46.44 68180-962-56 TOBRAMYCIN IN 0.225 % NACL 300 MG/5 ML INHALATION NEBU $46.44 51672-2062-0 CLOTRIMAZOLE 2 % VAGINAL CREAM $46.41 63323-540-33 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $46.41 63323-540-36 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $46.41 6373612003 PERMETHRIN 1 % TOPICAL LIQD $46.40 0173-0947-55 BUPROPION HCL 100 MG ORAL SR12 $46.36 0378-9121-16 FENTANYL 25 MCG/HR TRANSDERMAL PT72 $46.35 0378-9121-98 FENTANYL 25 MCG/HR TRANSDERMAL PT72 $46.35 0406-9025-76 FENTANYL 25 MCG/HR TRANSDERMAL PT72 $46.35 0406-9125-76 FENTANYL 25 MCG/HR TRANSDERMAL PT72 $46.35 47781-424-11 FENTANYL 25 MCG/HR TRANSDERMAL PT72 $46.35 47781-424-47 FENTANYL 25 MCG/HR TRANSDERMAL PT72 $46.35 54092-383-01 DEXTROAMPHETAMINE-AMPHETAMINE 10 MG ORAL CP24 $46.30 54092-387-01 DEXTROAMPHETAMINE-AMPHETAMINE 20 MG ORAL CP24 $46.30 54092-391-01 DEXTROAMPHETAMINE-AMPHETAMINE 30 MG ORAL CP24 $46.30 60505-6146-0 CEFEPIME 1 G INJ SOLR (MCH) $46.28 60505-6146-4 CEFEPIME 1 G INJ SOLR (MCH) $46.28 HC89008882 LIPOPROTEIN ELECTROPHORESIS-AU $46.23 67457-352-02 AMPICILLIN SODIUM 2 G IV SOLR (MCH) $46.22 67457-352-10 AMPICILLIN SODIUM 2 G IV SOLR (MCH) $46.22 72485-422-01 AMPICILLIN SODIUM 2 GRAM INJ SOLR $46.22 72485-422-10 AMPICILLIN SODIUM 2 GRAM INJ SOLR $46.22 72572-416-01 MEROPENEM 1 GRAM IV SOLR $46.22 72572-416-10 MEROPENEM 1 GRAM IV SOLR $46.22 55150-114-20 AMPICILLIN SODIUM 2 GRAM INJ SOLR $46.18 0781-3408-80 AMPICILLIN SODIUM 2 GRAM INJ SOLR $46.17 0781-3408-95 AMPICILLIN SODIUM 2 GRAM INJ SOLR $46.17 0338-3410-24 CLINDAMYCIN IN 5 % DEXTROSE 300 MG/50 ML IV PGBK $46.15 0338-3410-50 CLINDAMYCIN IN 5 % DEXTROSE 300 MG/50 ML IV PGBK $46.15 63323-483-57 LIDOCAINE-EPINEPHRINE 2 %-1:100,000 INJ SOLN $46.15 58657-509-16 GUAIFENESIN 100 MG/5 ML ORAL LIQD $46.12 60432-038-16 LACTULOSE 10 GRAM/15 ML ORAL SOLN $46.12 0009-0260-01 COLESTIPOL 5 GRAM ORAL PACK $46.09 0409-9558-50 ROCURONIUM 10 MG/ML IV SOLN $46.09 0409-9558-70 ROCURONIUM 10 MG/ML IV SOLN $46.09 0186-0776-60 TICAGRELOR 60 MG ORAL TAB $46.08 0186-0777-60 TICAGRELOR 90 MG ORAL TAB $46.08 0186-0777-39 TICAGRELOR 90 MG ORAL TAB $46.07 0591-2070-26 LIDOCAINE-PRILOCAINE 2.5-2.5 % TOPICAL CREAM $46.05 0591-2070-72 LIDOCAINE-PRILOCAINE 2.5-2.5 % TOPICAL CREAM $46.05 36000-148-01 FLUMAZENIL 0.1 MG/ML IV SOLN $46.05 36000-148-10 FLUMAZENIL 0.1 MG/ML IV SOLN $46.05 8137003600 DIMETHICONE-COLLOIDAL OATMEAL 1.25 % TOPICAL LOTN $46.02 0395-1003-92 GENTIAN VIOLET 1 % TOPICAL SOLN $46.02 0395-1031-96 GLYCERIN 99.5 % TOPICAL SOLN $46.02 HC89004113 ADRENAL AB - AU $46.00 HC89020002 B PARAPERTUSSIS PCR - AU $46.00 HC89019996 B PERTUSSIS PCR - AU $46.00 HC62217526 DRESSING FILM IV (MEPITEL) $46.00 HC62202601 DRESSING WOUND $46.00 HC89501035 HISTORICAL ANTIGEN FEE-SB $46.00 HC62213848 KIT CATH HEART RT $46.00 HC62220470 KIT INSERTN PICC PEDS-NO CATH $46.00 HC89002646 PHOSPHATIDYL GLYCEROL-U2 $46.00 HC51070795 PSY-BEHAVIOR TX FAMW/PT ADD 15MIN $46.00 HC85100493 RETICULOCYTE MANUAL $46.00 HC62220769 ORTH KNEE BRACE PROCARE $46.00 HC62211891 TRAY URINEMETER ADD A FOLEY IC $46.00 HC62201041 TUBING NASAL CPAP $46.00 HC62207980 TUBING SUCTION $46.00 0409-9094-16 FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN $45.89 0409-9094-31 FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN $45.89 70594-087-01 AMPICILLIN SODIUM 2 G IV SOLR (MCH) $45.83 70594-087-02 AMPICILLIN SODIUM 2 G IV SOLR (MCH) $45.83 67457-153-09 AMIODARONE 50 MG/ML IV SOLN $45.81 67457-153-99 AMIODARONE 50 MG/ML IV SOLN $45.81 0168-0004-80 TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM $45.76 60505-0759-1 CEFOXITIN 1 GRAM IV SOLR $45.76 60505-0759-5 CEFOXITIN 1 GRAM IV SOLR $45.76 59011-415-20 OXYCODONE 15 MG ORAL TR12 $45.73 0409-1109-01 ATRACURIUM 10 MG/ML IV SOLN $45.73 0597-0183-90 PRAMIPEXOLE 0.125 MG ORAL TAB $45.64 0597-0184-90 PRAMIPEXOLE 0.25 MG ORAL TAB $45.64 0597-0185-90 PRAMIPEXOLE 0.5 MG ORAL TAB $45.64 0597-0190-90 PRAMIPEXOLE 1 MG ORAL TAB $45.64 1093920444 TERBINAFINE HCL 1 % TOPICAL CREAM $45.63 49348-790-72 TERBINAFINE HCL 1 % TOPICAL CREAM $45.63 55150-439-01 KETAMINE 50 MG/ML INJ SOLN $45.63 55150-439-10 KETAMINE 50 MG/ML INJ SOLN $45.63 68308-152-15 NYSTATIN 100,000 UNIT/GRAM TOPICAL POWD $45.53 5155200699 SODIUM METABISULFITE (BULK) 100 % MISC GRAN $45.50 0143-9622-01 LABETALOL 5 MG/ML IV SOLN $45.50 0264-7622-00 D10 %-0.45 % SODIUM CHLORIDE IV SOLP $45.50 0264-9598-20 LIDOCAINE IN 5 % DEXTROSE (PF) 8 MG/ML (0.8 %) IV SOLP $45.50 0338-0656-04 ACETIC ACID 0.25 % IRR SOLN $45.50 0338-0704-34 POTASSIUM CHLORIDE-0.45 % NACL 20 MEQ/L IV SOLP $45.50 0409-4688-12 FLUCONAZOLE IN NACL (ISO-OSM) 400 MG/200 ML IV PGBK $45.50 0409-4688-16 FLUCONAZOLE IN NACL (ISO-OSM) 400 MG/200 ML IV PGBK $45.50 0409-7620-49 HEPARIN (PORCINE) IN NACL (PF) 2,000 UNIT/1,000 ML IV SOLP $45.50 0409-7620-59 HEPARIN (PORCINE) IN NACL (PF) 2,000 UNIT/1,000 ML IV SOLP $45.50 0496-0882-05 LIDOCAINE 4 % TOPICAL CREAM $45.50 0496-0882-06 LIDOCAINE 4 % TOPICAL CREAM $45.50 0990-7107-09 POTASSIUM CHLORIDE-D5-0.9%NACL 20 MEQ/L IV SOLP $45.50 0990-7115-09 POTASSIUM CHLORIDE IN 0.9%NACL 20 MEQ/L IV SOLP $45.50 0990-7901-09 POTASSIUM CHLORIDE-D5-0.2%NACL 20 MEQ/L IV SOLP $45.50 0990-7902-09 POTASSIUM CHLORID-D5-0.45%NACL 20 MEQ/L IV SOLP $45.50 0990-7903-09 POTASSIUM CHLORID-D5-0.45%NACL 30 MEQ/L IV SOLP $45.50 0990-7904-09 POTASSIUM CHLORID-D5-0.45%NACL 40 MEQ/L IV SOLP $45.50 0990-7905-09 POTASSIUM CHLORIDE IN 5 % DEX 20 MEQ/L IV SOLP $45.50 0990-7993-09 POTASSIUM CHLORID-D5-0.45%NACL 10 MEQ/L IV SOLP $45.50 0990-9257-39 POTASSIUM CHLORIDE-0.45 % NACL 20 MEQ/L IV SOLP $45.50 25021-114-87 CIPROFLOXACIN IN 5 % DEXTROSE 400 MG/200 ML IV PGBK $45.50 25021-132-81 LEVOFLOXACIN IN D5W 250 MG/50 ML IV PGBK $45.50 25021-164-30 PIPERACILLIN-TAZOBACTAM 2.25 GRAM IV SOLR $45.50 54879-022-01 CYCLOPHOSPHAMIDE 50 MG ORAL CAP $45.50 60258-151-01 FLUORIDE (SODIUM) 1.1 % DENT GEL $45.50 63323-221-01 VANCOMYCIN 500 MG IV SOLR $45.50 63323-221-10 VANCOMYCIN 500 MG IV SOLR $45.50 67457-182-00 ESMOLOL 100 MG/10 ML (10 MG/ML) IV SOLN $45.50 67457-182-10 ESMOLOL 100 MG/10 ML (10 MG/ML) IV SOLN $45.50 67457-228-10 ROCURONIUM 10 MG/ML IV SOLN $45.50 67457-228-99 ROCURONIUM 10 MG/ML IV SOLN $45.50 69784-003-06 FLUCONAZOLE IN SALINE 400 MG/200 ML IV PGBK (MCH) $45.50 70594-045-01 VANCOMYCIN 500 MG IV SOLR $45.50 70594-045-02 VANCOMYCIN 500 MG IV SOLR $45.50 70860-104-10 VANCOMYCIN 500 MG IV SOLR $45.50 70860-104-41 VANCOMYCIN 500 MG IV SOLR $45.50 99999-002-18 VANCOMYCIN 5% (50 MG/ML) OPHTHALMIC SOLUTION $45.50 99999-045-68 KETAMINE DRIP 500 MG IN NS 250 ML (OCM) $45.50 57782-397-26 CROMOLYN 5.2 MG/SPRAY (4 %) NASL SPRY $45.46 0517-0031-25 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG/ML INJ SOLN $45.44 63323-341-25 CEFOXITIN 1 GRAM IV SOLR $45.44 71288-402-30 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $45.44 71288-402-31 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $45.44 17478-062-35 WHITE PETROLATUM-MINERAL OIL 83-15 % OPHT OINT $45.43 0409-3383-02 PIPERACILLIN-TAZOBACTAM 2.25 GRAM IV SOLR $45.31 0409-3383-11 PIPERACILLIN-TAZOBACTAM 2.25 GRAM IV SOLR $45.31 0409-4933-11 EPINEPHRINE 0.1 MG/ML INJ SYRG $45.31 0536-2525-25 CAPSAICIN 0.025 % TOPICAL CREAM $45.24 99999-046-52 LABETALOL 40 MG/ML ORAL LIQUID (COMPOUND) $45.24 53489-648-01 TEMAZEPAM 7.5 MG ORAL CAP $45.23 HC89022412 ANTI-STRIAT MUSCLE AB IGG TITER -AU $45.13 60687-691-11 DEMECLOCYCLINE 150 MG ORAL TAB $45.08 62584-159-01 DEMECLOCYCLINE 150 MG ORAL TAB $45.08 62584-159-11 DEMECLOCYCLINE 150 MG ORAL TAB $45.08 0409-1582-19 BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJ SOLN $45.05 0409-1582-29 BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJ SOLN $45.05 63323-496-03 LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN $45.05 63323-496-97 LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN $45.05 49702-203-18 LAMIVUDINE 150 MG ORAL TAB $45.04 HC89008445 17-OH CORTICOSTEROIDS -AU $45.00 HC89007116 A-1 ANTITRYPSIN FECES-AU $45.00 HC62211446 AIRWAY MASK LARYNGEAL (LMA) $45.00 HC62200183 AIRWAY SPECIALIZED $45.00 HC89500706 CMV IGM / UNIT-SB $45.00 HC62201983 CONNECTOR Y/T $45.00 HC62202023 CRUTCHES $45.00 HC89022438 CULTURE VIRUS NON-RESPIRATORY-AU $45.00 HC89002034 CYCLOSPORINE-U2 $45.00 HC62210372 DRESSING PROFORE BANDAGE SYS $45.00 HC89021257 ENCEPHALITIS CALIF AB IGM-AU $45.00 HC89021265 ENCEPHALITIS EASTERN AB IGM-AU $45.00 HC89021273 ENCEPHALITIS ST LOUIS AB IGM-AU $45.00 HC89021281 ENCEPHALITIS WESTERN AB IGM-AU $45.00 HC89005185 HSV 2 IGM, IFA -FT $45.00 HC89005177 HSV I IGM, IFA - FT $45.00 HC83504845 IHC EGFR QNT-NG $45.00 HC83504837 IHC MLH1 QNT-NG $45.00 HC83504852 IHC MSH2 QNT-NG $45.00 HC83505727 IHC/IP PER SPEC EA ADD AB STAIN+ MSH-2-NG $45.00 HC83505693 IHC/IP PER SPEC EA ADD AB STAIN+ MSH-6-NG $45.00 HC83505255 IHC/IP PER SPEC EA ADD AB STAIN+ -NG $45.00 HC83505701 IHC/IP PER SPEC EA ADD AB STAIN+ PMS2-NG $45.00 HC83505719 IHC/IP PER SPEC INITIAL AB STAIN MLH-1-NG $45.00 HC83504860 IP/IHC PER SPEC INITIAL AB STAIN -NG $45.00 HC62219415 KIT CATH ARTERIAL $45.00 HC89023212 LAMELLAR BODY DENSITY FETAL LUNG-U2 $45.00 HC89023535 PARATHYROID HORMONE RELPEP-AU $45.00 HC89500193 RBC PRETREAT W/DRUG/CHEM-AA $45.00 HC85100501 RETICULOCYTE - AUTO $45.00 HC83505487 STAIN IMMUNOHISTOCHEMICAL QUANT -NG $45.00 HC62207121 SYSTEM CORE BIOPSY GUN $45.00 HC62211388 TRAY CIRCUMCISION DISPOSABLE $45.00 HC89005417 TROPONIN-UCI $45.00 HC89008668 TRYPSIN-QD $45.00 HC62207774 TUBE URINARY EXTENSION $45.00 0143-9621-01 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG/ML INJ SOLN $44.98 0143-9621-25 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG/ML INJ SOLN $44.98 16729-295-31 CARBOPLATIN 10 MG/ML IV SOLN $44.98 63323-013-09 THIAMINE HCL (VITAMIN B1) 100 MG/ML INJ SOLN $44.98 63323-013-21 THIAMINE HCL (VITAMIN B1) 100 MG/ML INJ SOLN $44.98 63323-013-26 THIAMINE HCL (VITAMIN B1) 100 MG/ML INJ SOLN $44.98 63323-044-00 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG/ML INJ SOLN $44.92 63323-044-01 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG/ML INJ SOLN $44.92 0781-9404-85 AMPICILLIN SODIUM 1 GRAM INJ SOLR $44.90 0781-9404-95 AMPICILLIN SODIUM 1 GRAM INJ SOLR $44.90 0641-6060-01 MIDAZOLAM 5MG/ML INJECTABLE SOLUTION (MHS) $44.85 0641-6060-10 MIDAZOLAM 5MG/ML INJECTABLE SOLUTION (MHS) $44.85 55150-245-52 LEVOFLOXACIN IN D5W 750 MG/150 ML IV PGBK $44.85 63323-464-31 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $44.85 0078-0423-15 VALSARTAN 40 MG ORAL TAB $44.84 60687-286-11 BROMOCRIPTINE 2.5 MG ORAL TAB $44.82 60687-286-21 BROMOCRIPTINE 2.5 MG ORAL TAB $44.82 0409-2344-01 DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) IV SOLN $44.72 0093-3061-56 RASAGILINE 1 MG ORAL TAB $44.69 99999-007-02 PIPERACILLIN-TAZOBACTAM 225 MG/ML IV SOLN DILUTION $44.66 HC89008494 17-D HYDROXYPROGESTERONE-QN $44.65 0173-0675-02 ATOVAQUONE-PROGUANIL 250-100 MG ORAL TAB $44.64 0409-1178-30 MEPERIDINE (PF) 50 MG/ML INJ SYRG $44.64 0781-3114-91 PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR $44.62 0781-3114-95 PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR $44.62 0781-9214-91 PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR $44.62 0781-9214-95 PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR (SLH) $44.62 0409-4759-01 ONDANSETRON HCL 2 MG/ML IV SOLN $44.59 59011-415-10 OXYCODONE 15 MG ORAL TR12 $44.58 HC89013981 TSH-ES $44.53 63323-506-01 DEXAMETHASONE SODIUM PHOS (PF) 10 MG/ML INJ SOLN $44.53 HC89014757 B PARAPERTUSSIS PCR-AU $44.50 HC89014740 B PERTUSSIS PCR(PNL)-AU $44.50 HC89022909 BILIRUBIN SERUM(PANEL)-AU $44.40 16714-849-01 CLOMIPRAMINE 25 MG ORAL CAP $44.38 1011902013 WHITE PETROLATUM-MINERAL OIL 80-20 % OPHT OINT $44.34 1011902239 WHITE PETROLATUM-MINERAL OIL 80-20 % OPHT OINT $44.34 24208-313-34 WHITE PETROLATUM-MINERAL OIL 80-20 % OPHT OINT $44.34 11701-050-33 ZINC OXIDE-PETROLATUM 20-51 % TOPICAL PSTE $44.30 25021-400-30 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $44.27 4467710020 MODIFIED LANOLIN 100 % TOPICAL CREAM $44.20 0069-0105-01 FLUMAZENIL 0.1 MG/ML IV SOLN $44.20 44567-420-00 MAGNESIUM SULFATE IN WATER 2 GRAM/50 ML (4 %) IV PGBK $44.20 44567-420-24 MAGNESIUM SULFATE IN WATER 2 GRAM/50 ML (4 %) IV PGBK $44.20 44567-803-10 PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR $44.20 47781-617-22 ROCURONIUM 10 MG/ML IV SOLN $44.20 47781-617-91 ROCURONIUM 10 MG/ML IV SOLN $44.20 60687-358-25 COLCHICINE 0.6 MG ORAL CAP $44.20 60687-358-95 COLCHICINE 0.6 MG ORAL CAP $44.20 55111-663-30 PARICALCITOL 1 MCG ORAL CAP $44.01 HC89017073 AMNIOTIC BILIRUBIN SCAN-AU $44.00 HC51000503 GLUCOSE SERUM QUANT (POS) $44.00 HC83505750 HISTCHM ST FROZ TIS BLK EA ADD(PANEL)+-U2 $44.00 HC62203542 IMMOBILZER KNEE $44.00 HC89012058 RHEUMATOID FACTOR-RD $44.00 HC51050011 RT TEAM CONF PER CASE $44.00 0781-5439-20 CEFPODOXIME 200 MG ORAL TAB $43.98 16714-395-01 CEFPODOXIME 200 MG ORAL TAB $43.98 72572-056-01 CEFAZOLIN 10 GRAM INJ SOLR $43.94 72572-056-10 CEFAZOLIN 10 GRAM INJ SOLR $43.94 76329-3390-1 LIDOCAINE HCL 100 MG/5 ML IV SYRG $43.88 51672-4011-5 CLOMIPRAMINE 25 MG ORAL CAP $43.84 51672-4011-6 CLOMIPRAMINE 25 MG ORAL CAP $43.84 HC89022453 CULTURE VIRUS ID DEFIN/ADDL+-AU $43.75 0173-0675-01 ATOVAQUONE-PROGUANIL 250-100 MG ORAL TAB $43.75 8770140652 IBUPROFEN 100 MG/5 ML ORAL SUSP $43.68 0054-3294-46 FUROSEMIDE 10 MG/ML ORAL SOLN $43.68 0143-9507-01 ETOMIDATE 2 MG/ML IV SOLN $43.68 0143-9507-10 ETOMIDATE 2 MG/ML IV SOLN (MCH) $43.68 24385-361-34 IBUPROFEN 100 MG/5 ML ORAL SUSP $43.68 67457-245-00 OCTREOTIDE ACETATE 100 MCG/ML (1 ML) INJ SYRG $43.59 67457-245-01 OCTREOTIDE ACETATE 100 MCG/ML (1 ML) INJ SYRG $43.59 0046-1100-81 CONJUGATED ESTROGENS 0.3 MG ORAL TAB $43.58 0046-1101-81 CONJUGATED ESTROGENS 0.45 MG ORAL TAB $43.58 0046-1102-81 CONJUGATED ESTROGENS 0.625 MG ORAL TAB $43.58 0046-1103-81 CONJUGATED ESTROGENS 0.9 MG ORAL TAB $43.58 0046-1104-81 CONJUGATED ESTROGENS 1.25 MG ORAL TAB $43.58 0046-1100-91 CONJUGATED ESTROGENS 0.3 MG ORAL TAB $43.58 63323-494-01 VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) IV SOLN $43.55 63323-494-05 VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) IV SOLN $43.55 0781-3238-01 ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRG $43.54 0781-3238-63 ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRG $43.54 60687-328-11 SEVELAMER CARBONATE 800 MG ORAL TAB $43.52 60687-328-65 SEVELAMER CARBONATE 800 MG ORAL TAB $43.52 HC89091409 CHIKUNGUNYA AB IGG -AU $43.50 HC89091417 CHIKUNGUNYA AB IGM -AU $43.50 HC89020507 CYSTATIN C, SERUM-AU $43.50 0781-3209-95 CEFTRIAXONE 2 GRAM INJ SOLR $43.50 HC89013601 CORTISOL-ES $43.44 1093978844 POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWD $43.32 49884-401-52 RISPERIDONE 2 MG ORAL TBDL $43.17 49884-401-91 RISPERIDONE 2 MG ORAL TBDL $43.17 60505-6202-2 CYCLOSPORINE 0.05 % OPHT DPET $43.17 60505-6202-1 CYCLOSPORINE 0.05 % OPHT DPET $43.16 64980-220-03 PYRIDOSTIGMINE BROMIDE 180 MG ORAL TBSR $43.12 0536-0091-85 ALUMINUM HYDROXIDE GEL 320 MG/5 ML ORAL SUSP $43.04 HC62228663 GUIDEWIRE(BABYWIRE) A $43.00 HC62213830 KIT DRESSING $43.00 HC62213905 KIT REPAIR BAG PLEURAL DRAINAGE $43.00 HC62211453 NEBULIZER W/ RESERVOIR $43.00 HC89017313 NEISSERIA GONORRHOEAE AB-QD $43.00 HC51003515 OBTAIN/PREP/CONVEY SCREEN PAP SMEAR $43.00 HC89016547 TESTOSTERONE FREE FEM/CHILD-AU $43.00 HC62207600 TUBE CONNECTING $43.00 HC62212139 TUBE FEEDING ENTERAL NG W/O STYLET $43.00 0065-0426-36 ARTIFICIAL TEAR(DXTRN-HPM-GLY) 0.1-0.3-0.2 % OPHT DROP $43.00 0093-5571-56 ERYTHROMYCIN 250 MG ORAL TAB $43.00 51672-2002-2 CLOTRIMAZOLE 1 % TOPICAL CREAM $42.90 51754-6001-1 GLYCOPYRROLATE 0.2 MG/ML INJ SOLN (MHS) $42.90 51754-6001-4 GLYCOPYRROLATE 0.2 MG/ML INJ SOLN (MHS) $42.90 63323-472-33 BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJ SOLN $42.90 HC89020481 BENZODIAZEPINES ;13 OR > URINE-AU $42.80 0469-0617-73 TACROLIMUS 1 MG ORAL CAP $42.77 23155-018-01 TETRACYCLINE 500 MG ORAL CAP $42.71 16714-039-01 COLCHICINE 0.6 MG ORAL TAB $42.62 13310-153-07 QUININE SULFATE 324 MG ORAL CAP $42.56 54396-111-11 OXANDROLONE 2.5 MG ORAL TAB $42.52 63323-464-02 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $42.51 63323-464-37 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $42.51 63323-472-01 BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJ SOLN $42.51 63323-472-37 BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJ SOLN $42.51 51672-2120-2 NEOMYCIN-BACITRACNZN-POLYMYXNB 3.5MG-400 UNIT- 5,000 UNIT/GRAM TOPICAL OINT $42.46 0472-0337-30 HYDROCORTISONE 2.5 % TOPICAL CREAM $42.32 0517-1305-25 DOPAMINE 800 MG/5 ML (160 MG/ML) IV SOLN $42.32 0409-9046-01 BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJ SOLN $42.26 4116760352 SELENIUM SULFIDE-ALOE VERA 1 % TOPICAL SHAM $42.25 0143-9284-01 PANTOPRAZOLE 40 MG IV SOLR $42.25 0143-9284-10 PANTOPRAZOLE 40 MG IV SOLR $42.25 0143-9684-01 FLUMAZENIL 0.1 MG/ML IV SOLN $42.25 0143-9684-10 FLUMAZENIL 0.1 MG/ML IV SOLN $42.25 0143-9784-01 FLUMAZENIL 0.1 MG/ML IV SOLN $42.25 0143-9784-10 FLUMAZENIL 0.1 MG/ML IV SOLN $42.25 0143-9887-01 AMOXICILLIN 400 MG/5 ML ORAL SUSR $42.25 0338-0054-03 SODIUM CHLORIDE 3 % HYPERTONIC 3 % IV SOLP $42.25 0641-6175-01 OCTREOTIDE ACETATE 100 MCG/ML INJ SOLN $42.25 0641-6175-10 OCTREOTIDE ACETATE 100 MCG/ML INJ SOLN $42.25 0703-3311-01 OCTREOTIDE ACETATE 100 MCG/ML INJ SOLN $42.25 0703-3311-04 OCTREOTIDE ACETATE 100 MCG/ML INJ SOLN $42.25 0942-0641-03 DEXTROSE-SOD CITRATE-CITRIC AC 2.45-2.2 GRAM- 730 MG/100 ML MISC SOLN $42.25 17271-701-02 SODIUM CHLORIDE 0.9 % IV SOLP $42.25 23155-688-31 OCTREOTIDE ACETATE 100 MCG/ML INJ SOLN $42.25 23155-688-41 OCTREOTIDE ACETATE 100 MCG/ML INJ SOLN $42.25 25021-452-01 OCTREOTIDE ACETATE 100 MCG/ML INJ SOLN $42.25 25021-677-10 SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ SOLN $42.25 50268-649-11 OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSP $42.25 50268-649-12 OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSP $42.25 63323-426-02 ROCURONIUM 10 MG/ML IV SOLN $42.25 63323-426-05 ROCURONIUM 10 MG/ML IV SOLN $42.25 70004-430-09 KETAMINE IN 0.9 % SOD CHLORIDE 50 MG/5 ML (10 MG/ML) IV SYRG $42.25 70860-651-05 ROCURONIUM 10 MG/ML IV SOLN $42.25 99999-010-64 NAFCILLIN 50 MG/ML INJ DILUTION $42.25 99999-044-85 PHENYLEPHRINE IN NS 20 MG/250 ML (80 MCG/ML) IV SOLN (MHS) $42.25 0409-3382-11 SUFENTANIL CITRATE 50 MCG/ML IV SOLN $42.24 0409-3382-21 SUFENTANIL CITRATE 50 MCG/ML IV SOLN $42.24 16714-826-01 PROPAFENONE 325 MG ORAL CP12 $42.13 0409-2344-02 DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) IV SOLN $42.12 0409-2344-62 DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) IV SOLN $42.12 0409-6695-02 ETOMIDATE 2 MG/ML IV SOLN (MCH) $42.12 HC62224654 ADAPTER CATH URETERAL/URINARY A $42.00 HC62200159 ADAPTOR CATH UROLOGICAL $42.00 HC62200175 AEROCHAMBER $42.00 HC62213764 BAG AUTOTRANSFUSION $42.00 HC62200266 BAG BLOOD COLLECTION APHERESIS $42.00 HC62200340 BAG PRESSURE $42.00 HC89007314 BARBITURATES QUANTITATIVE EA SPEC-U2 $42.00 HC62215173 BLADE SAW C $42.00 HC62200647 BOARD PATIENT COMMUNICATION $42.00 HC89008544 CARNITINE-CA $42.00 HC62201157 CASTING MATERIAL FIBERGLASS $42.00 HC62201546 CATH ROBINSON/STRAIGHT $42.00 HC62214127 CATH URETERAL C $42.00 HC62218151 CAUTERY HOOK ASSEMBLY C $42.00 HC89018675 CHROM ADD KARYOTYPE, AF-AU $42.00 HC62212220 COLLAR CERV SEMI-RIDG OCC/MAND SUP $42.00 HC89007652 DEOXYPYRIDINOLIN CROSSLINKS-AU $42.00 HC62202346 DRAIN JACKSON PRATT $42.00 HC62225560 DRESSNG ENDOFRM TEMPLT 2X2 COLLAGEN $42.00 HC62218128 ELECTRODE LEEP LOOPS C $42.00 HC89000020 GLIADIN IGA AND IGG ABS-QD $42.00 HC62203518 HOLDER TUBE{ET,NG&TRACH} $42.00 HC89008593 IGF BINDING PROTEIN-3-ES $42.00 HC62207931 IVS TUBING PLUMSET $42.00 HC89017347 LYME AB IGG & IGM BY WB-AU $42.00 HC62204698 MASK OXYGEN $42.00 HC35500180 MT-BEHAVIOR TX GROUP ADDL 15 MIN $42.00 HC62215819 NEEDLE BIOPSY B $42.00 HC62205646 PEN SKIN MARKER $42.00 HC89015267 PENTOBARBITAL-U2 $42.00 HC62216403 PIN/WIRE FIXATION TEMPORARY C $42.00 HC89010763 PLATELET NEUT-AU $42.00 HC39001565 PSY-BEHAVIOR TX GROUP ADDL 15 MIN $42.00 HC62217450 REAMER B $42.00 HC62224860 SPLINT FINGER OUTRIGGER A $42.00 HC62225180 STRAP FLEXION FINGER $42.00 HC62227079 SUMP INTRACARDIAC PEDS $42.00 HC62206990 SUTURE B $42.00 HC62207758 TUBE SILASTIC $42.00 HC62207964 TUBING SET ASPIRATING CYSTO $42.00 HC62290440 TUBING URO INFUSE PUMP $42.00 0143-9754-01 METHYLPREDNISOLONE SODIUM SUCC 125 MG INJ SOLR $41.99 0143-9754-25 METHYLPREDNISOLONE SODIUM SUCC 125 MG INJ SOLR $41.99 0409-9046-11 BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJ SOLN $41.93 36000-048-24 LEVOFLOXACIN IN D5W 750 MG/150 ML IV PGBK $41.93 63323-185-50 WATER FOR INJECTION, STERILE INJ SOLN $41.93 0071-0805-24 GABAPENTIN 300 MG ORAL CAP $41.87 51672-2080-1 TERBINAFINE HCL 1 % TOPICAL CREAM $41.83 4110082076 POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWD $41.77 50458-639-65 TOPIRAMATE 25 MG ORAL TAB $41.76 HC89014492 YERSINIA AB IGA BY IMMUNOBLOT-ARUP $41.75 0378-3404-93 TOLTERODINE 4 MG ORAL CP24 $41.74 0409-2344-68 DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) IV SOLN $41.73 0409-2344-88 DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) IV SOLN $41.73 70748-175-01 ARFORMOTEROL 15 MCG/2 ML INHALATION NEBU $41.70 70748-175-30 ARFORMOTEROL 15 MCG/2 ML INHALATION NEBU $41.70 66993-473-02 NISOLDIPINE 17 MG ORAL TB24 $41.70 0955-1003-10 ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRG $41.70 HC89022495 CULTURE PRESUMP ID VARICELLA ZV(PNL)-AU $41.60 0143-9508-01 KETAMINE 50 MG/ML INJ SOLN $41.60 0143-9508-10 KETAMINE 50 MG/ML INJ SOLN $41.60 0338-1709-40 MAGNESIUM SULFATE IN D5W 1 GRAM/100 ML IV PGBK $41.60 0409-3299-06 SODIUM ACETATE 2 MEQ/ML IV SOLN $41.60 0409-3299-16 SODIUM ACETATE 2 MEQ/ML IV SOLN $41.60 0781-6157-46 AMOXICILLIN 400 MG/5 ML ORAL SUSR $41.60 25021-674-20 ETOMIDATE 2 MG/ML IV SOLN $41.60 65862-071-01 AMOXICILLIN 400 MG/5 ML ORAL SUSR $41.60 66689-036-01 PHENYTOIN 100 MG/4 ML ORAL SUSP $41.60 45802-897-34 IBUPROFEN 100 MG/5 ML ORAL SUSP $41.59 0409-1179-30 MEPERIDINE (PF) 75 MG/ML INJ SYRG $41.57 0409-1180-69 MEPERIDINE (PF) 100 MG/ML INJ SYRG $41.57 HC89018956 HEINZ BODIES DIRECT-AU $41.50 63323-341-01 CEFOXITIN 1 GRAM IV SOLR $41.47 51079-519-01 CHLORPROMAZINE 25 MG ORAL TAB $41.43 51079-519-20 CHLORPROMAZINE 25 MG ORAL TAB $41.43 5434462 MULTIVIT-MIN-FERROUS GLUCONATE 9 MG IRON/15 ML ORAL LIQD $41.42 1093973944 PERMETHRIN 1 % TOPICAL LIQD $41.42 49348-150-78 PERMETHRIN 1 % TOPICAL LIQD $41.42 16714-019-05 BUDESONIDE 0.5 MG/2 ML INHALATION NBSP $41.39 16714-019-30 BUDESONIDE 0.5 MG/2 ML INHALATION NBSP $41.39 51672-2102-8 CETIRIZINE 1 MG/ML ORAL SOLN $41.34 55150-222-20 ETOMIDATE 2 MG/ML IV SOLN $41.34 63323-326-20 CEFEPIME 1 GRAM INJ SOLR $41.28 70860-778-02 PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN $41.28 70860-778-41 PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN $41.28 99999-000-37 TOBRAMYCIN 15 MG/ML FORTIFIED OPHTHALMIC (SLH) $41.28 0093-5031-56 TIAGABINE 4 MG ORAL TAB $41.26 62756-224-83 TIAGABINE 4 MG ORAL TAB $41.26 25021-673-77 LIDOCAINE HCL 2 % MUCOUS MEMB JELP $41.26 61703-305-38 CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) INJ SOLN $41.24 61703-305-58 CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) INJ SOLN $41.24 0409-3795-01 KETOROLAC 30 MG/ML (1 ML) INJ SOLN $41.21 0409-3795-19 KETOROLAC 30 MG/ML (1 ML) INJ SOLN $41.21 47781-357-03 BUPRENORPHINE-NALOXONE 8-2 MG SL FILM $41.17 47781-357-11 BUPRENORPHINE-NALOXONE 8-2 MG SL FILM $41.17 53746-554-01 DEMECLOCYCLINE 150 MG ORAL TAB $41.16 65162-554-10 DEMECLOCYCLINE 150 MG ORAL TAB $41.16 63323-286-95 ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJ SOLN $41.15 1093957833 CLOTRIMAZOLE 2 % VAGINAL CREAM $41.09 49348-379-54 CLOTRIMAZOLE 2 % VAGINAL CREAM $41.09 99999-036-83 THIOGUANINE 10 MG ORAL PARTIAL TAB $41.07 68382-771-30 LANSOPRAZOLE 15 MG ORAL TBLD $41.05 68382-771-77 LANSOPRAZOLE 15 MG ORAL TBLD $41.05 68382-772-30 LANSOPRAZOLE 30 MG ORAL TBLD $41.05 68382-772-77 LANSOPRAZOLE 30 MG ORAL TBLD $41.05 63323-165-03 DEXAMETHASONE 4 MG/ML INJ SOLN (FOR ORAL USE) $41.02 63323-165-05 DEXAMETHASONE 4 MG/ML INJ SOLN (FOR ORAL USE) $41.02 HC89000616 ALKALINE PHOS ISOENZYMES-QD $41.00 HC89006233 ASSAY PHENCYCLIDINE (PCP)-AU $41.00 HC62200324 BAG FEEDING $41.00 HC89005318 BORDETELLA PERTUS FHA IGA-FT $41.00 HC89005300 BORDETELLA PERTUS FHA IGG-FT $41.00 HC89005292 BORDETELLA PERTUS PT IGA-FT $41.00 HC89005284 BORDETELLA PERTUS PT IGG-FT $41.00 HC62201116 CAP PEG $41.00 HC62214028 DRESSING NONADHERENT OWENS $41.00 HC89023733 FENTANYL &METABOLITE QUANT URINE-AU $41.00 HC62210406 INSUFFLATOR LAPAROSCOPIC $41.00 HC62211396 IVS-INTL PERIPH SUPPLIES/TUBINGS $41.00 HC62222302 MANOMETER INSPIRATORY $41.00 HC62206859 STOCKINGS TED HOSE THIGH HI $41.00 HC89008742 TRYPTASE-AU $41.00 HC62208046 URINE STRAINER $41.00 0143-9720-01 LEVOFLOXACIN IN D5W 750 MG/150 ML IV PGBK $40.95 0143-9720-24 LEVOFLOXACIN IN D5W 750 MG/150 ML IV PGBK $40.95 0338-9159-30 SODIUM CHLORIDE 0.9 % IV PGBK $40.95 0703-2914-01 VECURONIUM BROMIDE 10 MG IV SOLR $40.95 0703-2914-03 VECURONIUM BROMIDE 10 MG IV SOLR $40.95 51672-1282-2 TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM $40.95 55150-244-47 LEVOFLOXACIN IN D5W 500 MG/100 ML IV PGBK $40.95 63323-466-01 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN $40.95 63323-466-37 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN $40.95 72572-740-01 SODIUM BICARBONATE 1 MEQ/ML (8.4 %) IV SOLN $40.95 72572-740-20 SODIUM BICARBONATE 1 MEQ/ML (8.4 %) IV SOLN $40.95 0703-9503-01 SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG/5 ML IV SOLN $40.76 0703-9503-03 SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG/5 ML IV SOLN $40.76 67457-778-00 SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG/5 ML IV SOLN $40.76 67457-778-05 SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG/5 ML IV SOLN $40.76 0143-9710-01 MILRINONE 1 MG/ML IV SOLN $40.63 0143-9710-10 MILRINONE 1 MG/ML IV SOLN $40.63 33342-109-37 RISEDRONATE 35 MG ORAL TAB $40.63 66794-207-02 AMPICILLIN-SULBACTAM 3 GRAM INJ SOLR $40.63 66794-207-41 AMPICILLIN-SULBACTAM 3 GRAM INJ SOLR $40.63 99999-034-57 NITROGLYCERIN IN 5 % DEXTROSE 50 MG/250 ML (200 MCG/ML) IV SOLN $40.63 99999-045-69 HEPARIN (PORCINE) IN 5 % DEX 25,000 UNIT/250 ML(100 UNIT/ML) IV SOLP $40.63 0007-4139-20 CARVEDILOL 3.125 MG ORAL TAB $40.56 0007-4140-20 CARVEDILOL 6.25 MG ORAL TAB $40.56 0007-4141-20 CARVEDILOL 12.5 MG ORAL TAB $40.56 0007-4142-20 CARVEDILOL 25 MG ORAL TAB $40.56 HC89023469 YERSINIA AB IGG BY IMMUNOBLOT-AU $40.50 0641-6014-01 DILTIAZEM HCL 5 MG/ML IV SOLN $40.50 0641-6014-10 DILTIAZEM HCL 5 MG/ML IV SOLN $40.50 66993-141-30 ALISKIREN 150 MG ORAL TAB $40.48 43598-560-78 LANSOPRAZOLE 15 MG ORAL TBLD $40.47 43598-560-79 LANSOPRAZOLE 15 MG ORAL TBLD $40.47 0143-9506-01 ETOMIDATE 2 MG/ML IV SOLN $40.43 0143-9506-10 ETOMIDATE 2 MG/ML IV SOLN $40.43 8164219344 BALSAM PERU-ZINC OXIDE TOPICAL OINT $40.40 HC89018105 ANTI-NEUTROPHIL CYTOPLSM IGG TITR-AU $40.38 0338-1715-40 MAGNESIUM SULFATE IN WATER 4 GRAM/100 ML (4 %) IV PGBK $40.30 55150-174-10 AZITHROMYCIN 500 MG IV SOLR $40.30 55390-003-10 PROPRANOLOL 1 MG/ML IV SOLN $40.30 63323-486-57 LIDOCAINE HCL 20 MG/ML (2 %) INJ SOLN $40.30 67457-554-00 MAGNESIUM SULFATE IN WATER 4 GRAM/100 ML (4 %) IV PGBK $40.30 99999-046-68 NEOMYCIN-POLYMYXIN B GU 40 MG-200,000 UNIT/ML IRR SOLN $40.30 HC89022156 CAFFEINE SERUM/PLASMA - AU $40.25 0378-3000-01 MECLOFENAMATE 100 MG ORAL CAP $40.24 0904-6553-04 LINEZOLID 600 MG ORAL TAB $40.24 64764-080-60 LUBIPROSTONE 8 MCG ORAL CAP $40.20 64764-240-60 LUBIPROSTONE 24 MCG ORAL CAP $40.20 HC89017081 PHOSPHATIDYLSERINE ANTIBODY-AU $40.14 HC89023642 T CELL ABSOLUTE CD4 COUNT-AU $40.13 60687-576-40 MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRP $40.07 HC89006308 ALPRAZOLAM (BENZODZEPNS) 1-12-AU $40.00 HC89023386 ANTIBODY SARS-COV-2 COVID-19 ELISA-AU $40.00 HC89004741 ANTI-CARDIOLIPIN AB (PNL2)-RD $40.00 HC89500839 CMV IGM / UNIT-HC $40.00 HC89020457 C-TELOPEPTIDE BETA-X-LINKED-AU $40.00 HC89018238 FACTOR VIII INHIBITOR-EC $40.00 HC89016976 HIV PHENOTYP EACH ADDL(PNL)-VI $40.00 HC89008155 IGG SUBCLASS-AU $40.00 HC83505842 IHC/IP PER SPEC EA ADD AB STAIN+ - AP $40.00 HC83505511 IHC/IP PER SPEC EA ADD AB STAIN+ -CS $40.00 HC83505834 IHC/IP PER SPEC INITIAL AB STAIN - AP $40.00 HC83502351 IHC/IP PER SPEC INITIAL AB STAIN -IM $40.00 HC83503656 IHC/IP PER SPEC INITIAL AB STAIN PLAP -IM $40.00 HC83503672 IHC/IP PER SPEC INITIAL AB STAIN PROLACTIN -IM $40.00 HC83503797 IHC/IP PER SPEC INITIAL AB STAIN UBIQUITIN STAIN -IM $40.00 HC89500714 IRRADIATION EA UNIT-SB $40.00 HC83505917 SPECIAL STAIN GROUP II -AP $40.00 HC89001994 TACROLIMUS-U2 $40.00 1093914333 POVIDONE-IODINE 10 % TOPICAL SOLN $39.97 0126-0271-16 CHLORHEXIDINE GLUCONATE 0.12 % MUCOUS MEMB MWSH $39.97 0126-0272-16 CHLORHEXIDINE GLUCONATE 0.12 % MUCOUS MEMB MWSH $39.97 0527-5125-70 LACTULOSE 10 GRAM/15 ML ORAL SOLN $39.97 68462-714-08 RUFINAMIDE 400 MG ORAL TAB $39.92 45802-433-21 DEXTROMETHORPHAN POLISTIREX 30 MG/5 ML ORAL SU12 $39.92 0781-1943-82 AMOXICILLIN-POT CLAVULANATE 1,000-62.5 MG ORAL TB12 $39.90 0781-1943-39 AMOXICILLIN-POT CLAVULANATE 1,000-62.5 MG ORAL TB12 $39.89 67618-200-04 CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQD $39.88 0573-2871-93 PHENYLEPH-MIN OIL-PETROLATUM 0.25-14-74.9 % RECTAL OINT $39.86 47335-891-60 TEMOZOLOMIDE 20 MG ORAL CAP $39.85 47335-891-72 TEMOZOLOMIDE 20 MG ORAL CAP $39.85 65162-802-14 TEMOZOLOMIDE 20 MG ORAL CAP $39.85 65162-802-51 TEMOZOLOMIDE 20 MG ORAL CAP $39.85 69784-420-12 OMEGA-3 ACID ETHYL ESTERS 1 GRAM ORAL CAP $39.78 68094-764-59 MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRP $39.72 68094-764-62 MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRP $39.72 70069-231-01 BRIMONIDINE 0.2 % OPHT DROP $39.72 0143-9721-01 LEVOFLOXACIN IN D5W 500 MG/100 ML IV PGBK $39.65 0143-9721-24 LEVOFLOXACIN IN D5W 500 MG/100 ML IV PGBK $39.65 63323-481-01 LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJ SOLN $39.65 63323-481-57 LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJ SOLN $39.65 65219-800-01 PROPOFOL 10 MG/ML IV EMUL $39.65 65219-800-10 PROPOFOL 10 MG/ML IV EMUL $39.65 99999-041-36 LEVOFLOXACIN 5 MG/ML INJECTION (MHS) $39.65 60687-104-11 KETOROLAC 10 MG ORAL TAB $39.62 60687-104-21 KETOROLAC 10 MG ORAL TAB $39.62 0069-3150-83 AZITHROMYCIN 500 MG IV SOLR $39.59 0069-3150-84 AZITHROMYCIN 500 MG IV SOLR $39.59 0409-9566-01 CEFEPIME 1 GRAM INJ SOLR $39.59 0409-9566-10 CEFEPIME 1 GRAM INJ SOLR $39.59 60505-6144-0 CEFEPIME 1 GRAM INJ SOLR $39.59 70069-361-01 SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG/5 ML IV SOLN $39.55 70069-361-10 SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG/5 ML IV SOLN $39.55 54092-191-12 MESALAMINE 500 MG ORAL CPSR $39.47 16714-018-05 BUDESONIDE 0.25 MG/2 ML INHALATION NBSP $39.44 16714-018-30 BUDESONIDE 0.25 MG/2 ML INHALATION NBSP $39.44 51285-424-10 NORETHINDRONE ACETATE 5 MG ORAL TAB $39.43 0074-4637-01 PARICALCITOL 2 MCG/ML IV SOLN $39.39 6845510826 OSTOMY SUPPLIES TOPICAL POWD $39.37 0009-0039-28 METHYLPREDNISOLONE SOD SUC(PF) 40 MG/ML INJ SOLR $39.30 0009-0039-30 METHYLPREDNISOLONE SOD SUC(PF) 40 MG/ML INJ SOLR $39.30 0009-0039-32 METHYLPREDNISOLONE SOD SUC(PF) 40 MG/ML INJ SOLR $39.30 0009-0039-33 METHYLPREDNISOLONE SOD SUC(PF) 40 MG/ML INJ SOLR $39.30 16714-467-01 CAPECITABINE 150 MG ORAL TAB $39.28 0409-1176-03 MEPERIDINE (PF) 25 MG/ML INJ SYRG $39.26 0409-1176-30 MEPERIDINE (PF) 25 MG/ML INJ SYRG $39.26 299391702 GLYCERIN-DIMETHICONE-PETRO, WH TOPICAL CREAM $39.23 0088-1171-12 ALUMINUM HYDROX-MAGNESIUM CARB 95-358 MG/15 ML ORAL SUSP $39.23 0135-0094-41 ALUMINUM HYDROX-MAGNESIUM CARB 95-358 MG/15 ML ORAL SUSP $39.23 42023-189-01 NEOSTIGMINE METHYLSULFATE 1 MG/ML INJ SOLN (MCH) $39.20 42023-189-10 NEOSTIGMINE METHYLSULFATE 1 MG/ML INJ SOLN (MCH) $39.20 HC89010052 THYROID STIM IMMUNOGLOB-AU $39.15 51079-813-01 NADOLOL 40 MG ORAL TAB $39.14 51079-813-20 NADOLOL 40 MG ORAL TAB $39.14 1093985844 GLYCERIN 99.5 % TOPICAL SOLN $39.12 0363-0063-30 CALAMINE-ZINC OXIDE 8-8 % TOPICAL LOTN $39.12 65649-101-02 BALSALAZIDE 750 MG ORAL CAP $39.10 0168-0015-31 HYDROCORTISONE 1 % TOPICAL CREAM $39.07 0168-0020-31 HYDROCORTISONE 1 % TOPICAL OINT $39.07 HC89000285 ANAEROBIC ID PRESUM(PNL)-FT $39.00 HC89000301 ANAEROBIC SUSC(PNL)-FT $39.00 HC89021331 BORDETELLA PERTUSSIS CULTURE-AU $39.00 HC89020390 C.TRACHOMATIS DNA AMP PROBE-PI $39.00 HC62200951 CANNISTER SUCTION $39.00 HC62201082 CANNULA HOLDER/GRIP SKIN TENDER $39.00 HC89007397 CARBOXYHEMOGLOBIN-AU $39.00 HC62219878 CATH FOLLOWER URETH PHILLIPS $39.00 HC89021778 CELIAC DX DUAL ANTIGEN SCREEN-AU $39.00 HC89013098 CULTURE LEGIONELLA-AU $39.00 HC89013114 CULTURE MYCOPLASMA-AU $39.00 HC62213921 DRESSING DYNA-FLEX $39.00 HC62211594 DRESSING HYDROCOLLD WND FILLER $39.00 HC62217518 DRESSING SACRUM<324CM SQ(MEPITEL) $39.00 HC62203252 EYE OCCLUDER $39.00 HC89004121 FIBRINOGEN ANTIGEN-AU $39.00 HC62220637 HEADGEAR CPAP BONNET $39.00 HC89012751 LEISHMANIASIS AB -AU $39.00 HC89008361 METHEMOBLOBIN-AU $39.00 HC89005409 MYOGLOBIN-UCI $39.00 HC89020408 N.GONORRHEA DNA AMP PROBE-PI $39.00 HC89004899 PLAT NEUT RFX - AU $39.00 HC62221924 PLEDGET CARDIOVASCULAR (6/PK) $39.00 HC39000773 PSYCH TEAM CONF PRTCPNT PER 15MIN $39.00 HC89017446 PTT HEPARIN NEUTRALZ RFX - AU $39.00 HC89016422 PYRUVATE KINASE-AU $39.00 HC62206917 STYLET INTUBATION $39.00 8212427181 WHITE PETROLATUM-ZINC TOPICAL PSTE $39.00 0143-9722-01 LEVOFLOXACIN IN D5W 250 MG/50 ML IV PGBK $39.00 0143-9722-24 LEVOFLOXACIN IN D5W 250 MG/50 ML IV PGBK $39.00 0264-7707-00 ELECTROLYTE-S (PH 7.4) IV SOLP $39.00 0338-0077-04 DEXTROSE 5%-0.2 % SOD CHLORIDE IV SOLP $39.00 0548-5602-00 ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRG $39.00 0641-6132-01 NALOXONE 0.4 MG/ML INJ SOLN (MCH) $39.00 0641-6132-25 NALOXONE 0.4 MG/ML INJ SOLN $39.00 0641-6194-01 PROPOFOL 10 MG/ML IV EMUL $39.00 0641-6194-10 PROPOFOL 10 MG/ML IV EMUL $39.00 0641-6204-01 HEPARIN, PORCINE (PF) 5,000 UNIT/0.5 ML INJ SOLN (MHS) $39.00 0641-6204-10 HEPARIN, PORCINE (PF) 5,000 UNIT/0.5 ML INJ SOLN (MHS) $39.00 0990-7118-07 WATER FOR INJECTION, STERILE IV SOLP $39.00 0990-7139-36 WATER FOR IRRIGATION, STERILE IRR SOLN $39.00 0990-7972-07 SODIUM CHLORIDE 0.9 % IRR SOLN $39.00 25021-109-10 CEFOXITIN 1 GRAM IV SOLR $39.00 25021-121-20 CEFEPIME 1 GRAM INJ SOLR $39.00 25021-662-05 ROCURONIUM 10 MG/ML IV SOLN $39.00 36000-326-01 PALONOSETRON 0.25 MG/5 ML IV SOLN $39.00 36000-326-02 PALONOSETRON 0.25 MG/5 ML IV SOLN $39.00 39822-1000-1 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN (MCH) $39.00 44567-102-10 AMPICILLIN SODIUM 1 GRAM INJ SOLR $39.00 49230-209-23 PERITON.DIALYSIS 7-2.5 % DEXTR CA 2.5 MEQ/L- MG 0.5 MEQ/L IP SOLN $39.00 55150-225-05 ROCURONIUM 10 MG/ML IV SOLN $39.00 55150-253-50 LIDOCAINE HCL 10 MG/ML (1 %) INJ SOLN $39.00 55390-037-10 VECURONIUM BROMIDE 10 MG IV SOLR $39.00 60505-0753-3 CEFTRIAXONE 2 GRAM INJ SOLR $39.00 60505-0753-4 CEFTRIAXONE 2 GRAM INJ SOLR $39.00 60505-0792-0 ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRG $39.00 60505-0792-4 ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRG $39.00 62756-512-44 AZITHROMYCIN 500 MG IV SOLR $39.00 63323-106-15 MAGNESIUM SULFATE IN WATER 20 GRAM/500 ML (4 %) IV SOLP $39.00 63323-117-01 FLUOROURACIL 1 GRAM/20 ML IV SOLN $39.00 63323-117-20 FLUOROURACIL 1 GRAM/20 ML IV SOLN $39.00 63323-269-22 PROPOFOL 10 MG/ML IV EMUL $39.00 63323-269-29 PROPOFOL 10 MG/ML IV EMUL $39.00 63323-269-57 PROPOFOL 10 MG/ML IV EMUL $39.00 63323-269-59 PROPOFOL DRIP (CONC: 10 MG/ML) $39.00 63323-507-19 MEROPENEM 500 MG IV SOLR $39.00 63323-507-21 MEROPENEM 500 MG IV SOLR $39.00 63323-824-26 DEXTROSE 10 % IN WATER (D10W) 10 % IV SOLP $39.00 67457-855-00 ADENOSINE 3 MG/ML IV SOLN $39.00 67457-855-02 ADENOSINE 3 MG/ML IV SOLN $39.00 68001-524-28 FLUOROURACIL 500 MG/10 ML IV SOLN $39.00 68001-524-30 FLUOROURACIL 500 MG/10 ML IV SOLN $39.00 69097-709-30 PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJ SOLN $39.00 69097-709-96 PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJ SOLN $39.00 69374-520-05 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $39.00 70069-301-25 SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ SOLN $39.00 70121-1454-1 MEROPENEM 500 MG IV SOLR $39.00 70121-1454-7 MEROPENEM 500 MG IV SOLR $39.00 70700-186-22 FLUOROURACIL 500 MG/10 ML IV SOLN $39.00 70700-186-23 FLUOROURACIL 500 MG/10 ML IV SOLN $39.00 70860-601-10 MIDAZOLAM 5 MG/ML INJ SOLN $39.00 70860-601-42 MIDAZOLAM 5 MG/ML INJ SOLN $39.00 71288-200-20 MILRINONE 1 MG/ML IV SOLN $39.00 71288-200-21 MILRINONE 1 MG/ML IV SOLN $39.00 71288-410-82 ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRG $39.00 71288-410-83 ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRG $39.00 72266-103-41 LABETALOL 5 MG/ML IV SOLN $39.00 0078-0385-66 MYCOPHENOLATE SODIUM 180 MG ORAL TBEC $38.97 63323-474-00 HALOPERIDOL LACTATE 5 MG/ML INJ SOLN $38.94 63323-474-01 HALOPERIDOL LACTATE 5 MG/ML INJ SOLN $38.94 63323-731-01 CALCITRIOL 1 MCG/ML IV SOLN $38.94 0781-3059-72 DIGOXIN 250 MCG/ML (0.25 MG/ML) INJ SOLN $38.87 0781-3059-95 DIGOXIN 250 MCG/ML (0.25 MG/ML) INJ SOLN $38.87 70069-808-01 MILRINONE 1 MG/ML IV SOLN $38.87 70069-808-10 MILRINONE 1 MG/ML IV SOLN $38.87 63323-533-01 ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRG $38.81 63323-533-83 ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRG $38.81 69680-115-30 AMINOCAPROIC ACID 500 MG ORAL TAB $38.79 HC89005920 DRUG SCREEN NONFORENSIC SRM^DOS-AU $38.75 HC89021505 DRUG SCREEN NONFORENSIC URN^DOS-AU $38.75 63323-462-04 BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJ SOLN $38.74 63323-462-17 BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJ SOLN $38.74 25021-673-76 LIDOCAINE HCL 2 % MUCOUS MEMB JELP $38.69 63323-492-08 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $38.68 63323-492-97 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $38.68 72572-601-01 PROPOFOL 10 MG/ML IV EMUL $38.68 72572-601-20 PROPOFOL 10 MG/ML IV EMUL $38.68 58468-0130-1 SEVELAMER CARBONATE 800 MG ORAL TAB $38.67 52427-285-01 NITROFURANTOIN MONOHYD/M-CRYST 100 MG ORAL CAP $38.66 61269-730-41 MICONAZOLE NITRATE 2 % VAGINAL CREAM $38.61 60687-430-01 CHLORPROMAZINE 25 MG ORAL TAB $38.53 60687-430-11 CHLORPROMAZINE 25 MG ORAL TAB $38.53 525113990 LEVOMEFOLATE-ALGAL OIL 7.5-90.314 MG ORAL CAP $38.51 58657-505-08 DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML ORAL SYRP $38.51 60687-249-77 LEVETIRACETAM 500 MG/5 ML (5 ML) ORAL SOLN $38.51 HC89012447 POLIOVIRUS AB (PNL)-AU $38.50 0409-0528-23 LEVOFLOXACIN IN D5W 500 MG/100 ML IV PGBK $38.35 0409-0528-25 LEVOFLOXACIN IN D5W 500 MG/100 ML IV PGBK $38.35 65219-018-01 AMPICILLIN SODIUM 1 GRAM INJ SOLR $38.35 65219-018-10 AMPICILLIN SODIUM 1 GRAM INJ SOLR $38.35 72611-749-01 MIDAZOLAM 5MG/ML INJECTABLE SOLUTION (MHS) $38.35 72611-749-10 MIDAZOLAM 5 MG/ML INJ SOLN $38.35 0074-7126-11 DIVALPROEX 500 MG ORAL TB24 $38.28 31722-749-20 LINEZOLID 600 MG ORAL TAB $38.19 72611-756-01 ROCURONIUM 10 MG/ML IV SOLN $38.19 72611-756-10 ROCURONIUM 10 MG/ML IV SOLN $38.19 66689-020-01 MEGESTROL 400 MG/10 ML (10 ML) ORAL SUSP $38.09 66689-020-50 MEGESTROL 400 MG/10 ML (10 ML) ORAL SUSP $38.09 67877-124-20 SILVER SULFADIAZINE 1 % TOPICAL CREAM $38.09 0143-9254-01 DOPAMINE 400 MG/10 ML (40 MG/ML) IV SOLN $38.03 0143-9254-25 DOPAMINE 400 MG/10 ML (40 MG/ML) IV SOLN $38.03 60505-6231-0 CEFAZOLIN 2 GRAM INJ SOLR $38.03 60505-6231-5 CEFAZOLIN 2 GRAM INJ SOLR $38.03 63323-093-01 SODIUM CHLORIDE 4 MEQ/ML (23.4%) INFUSION (FOR ELEVATED ICP) $38.03 63323-093-30 SODIUM CHLORIDE 4 MEQ/ML (23.4%) INFUSION (FOR ELEVATED ICP) $38.03 99999-045-42 SODIUM CHLORIDE 4 MEQ / ML ORAL SYRINGE $38.03 59762-1005-1 CABERGOLINE 0.5 MG ORAL TAB $38.02 66993-114-60 PROPAFENONE 225 MG ORAL CP12 $38.01 HC89000905 ALDOSTERONE URINE-QD $38.00 HC62201561 CATH SUCTION $38.00 HC62209499 CONTACT LENS REMOVER $38.00 HC62211362 DRESSING SACRUM 23X23CM (MEPILEX) $38.00 HC62213772 DRESSING TUBE W/-W/O ELASTIC PER YD $38.00 HC89008007 ESTRONE-AU $38.00 HC89002539 LEAD URINE-QD $38.00 HC89002182 LEAD-QD $38.00 HC89003891 LIDOCAINE-U2 $38.00 HC62213863 PACK MINOR ACCESSORY $38.00 HC88600267 SPECIAL COURIER 30 $38.00 HC89006621 TOBRAMYCIN INITIAL-U2 $38.00 HC89002588 TOPIRAMATE-QD $38.00 HC62208079 VACUUM CURRETTE $38.00 0409-6102-10 FUROSEMIDE 10 MG/ML INJ SOLN $37.96 0409-6102-20 FUROSEMIDE 10 MG/ML INJ SOLN $37.96 25021-608-20 PROPOFOL 10 MG/ML IV EMUL $37.96 68462-404-44 ATOVAQUONE-PROGUANIL 250-100 MG ORAL TAB $37.94 68462-404-67 ATOVAQUONE-PROGUANIL 250-100 MG ORAL TAB $37.94 99999-009-09 DIPHENOXYLATE-ATROPINE 2.5-0.025 MG/5 ML ORAL LIQD $37.93 99999-039-72 DIPHENOXYLATE-ATROPINE 2.5-0.025 MG/5 ML ORAL LIQD $37.93 50268-179-11 CLARITHROMYCIN 500 MG ORAL TAB $37.89 50268-179-13 CLARITHROMYCIN 500 MG ORAL TAB $37.89 0025-1461-31 MISOPROSTOL 200 MCG ORAL TAB $37.83 0025-1461-60 MISOPROSTOL 200 MCG ORAL TAB $37.83 63323-566-21 ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRG $37.83 63323-566-98 ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRG $37.83 54643-9007-8 MVI, ADULT NO.4, VIT K, 1 OF 2 3,300 UNIT- 150 MCG/5 ML IV SOLN $37.80 54643-9007-9 MVI, ADULT NO.4, VIT K, 2 OF 2 600 MCG-60 MCG- 5 MCG/5 ML IV SOLN $37.80 63323-468-01 BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJ SOLN $37.77 63323-468-17 BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJ SOLN $37.77 4110081127 OXYMETAZOLINE 0.05 % NASL SPRY $37.73 16714-187-01 SIROLIMUS 0.5 MG ORAL TAB $37.72 63323-607-08 ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRG $37.70 63323-607-98 ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRG $37.70 0338-0551-18 DEXTROSE 5 % IN WATER (D5W) 5 % IV PGBK $37.70 0338-0553-11 SODIUM CHLORIDE 0.9 % IV PGBK $37.70 0338-0553-18 SODIUM CHLORIDE 0.9 % IV PGBK $37.70 16714-006-01 ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRG $37.70 16714-006-10 ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRG $37.70 60687-249-40 LEVETIRACETAM 500 MG/5 ML (5 ML) ORAL SOLN $37.70 60687-249-67 LEVETIRACETAM 500 MG/5 ML (5 ML) ORAL SOLN $37.70 99999-043-71 SILDENAFIL 2.5 MG/ML ORAL LIQUID (MCH) (COMPOUND) $37.70 4116775160 CAPSAICIN-MENTHOL 0.025-10 % TOPICAL GEL $37.57 76045-109-10 DEXAMETHASONE SODIUM PHOS (PF) 10 MG/ML INJ SOLN $37.57 HC89021414 HIV 1 AB -AU $37.50 HC89021422 HIV 2 AB -AU $37.50 HC89020275 LACTASE (DISACCHARIDASE)-AU $37.50 HC89020283 MALTASE (DISACCHARIDASE)-AU $37.50 HC89020291 PALATINASE (DISACCHARIDASE)-AU $37.50 HC89018436 PNH RBC CD59-AU $37.50 HC89018444 PNH RBC GLYCOPHORIN-AU $37.50 HC89020309 SUCRASE (DISACCHARIDASE)-AU $37.50 0799-0001-04 MENTHOL-ZINC OXIDE 0.44-20.6 % TOPICAL OINT $37.46 0904-5309-09 IBUPROFEN 100 MG/5 ML ORAL SUSP $37.44 23155-601-32 MIDAZOLAM 5MG/ML INJECTABLE SOLUTION (MHS) $37.44 23155-601-42 MIDAZOLAM 5 MG/ML INJ SOLN $37.44 0121-4799-05 LEVETIRACETAM 500 MG/5 ML (5 ML) ORAL SOLN $37.38 0121-4799-40 LEVETIRACETAM 500 MG/5 ML (5 ML) ORAL SOLN $37.38 76329-3012-5 LIDOCAINE HCL 2 % MUCOUS MEMB JELP $37.38 99999-038-89 HALOPERIDOL LACTATE 5 MG/ML INJ SOLN $37.38 99999-045-54 DIPHENHYDRAMINE HCL 1 MG/ML INJ DILUTION (MCH) $37.38 68462-404-01 ATOVAQUONE-PROGUANIL 250-100 MG ORAL TAB $37.18 60687-266-11 RALOXIFENE 60 MG ORAL TAB $37.06 60687-266-21 RALOXIFENE 60 MG ORAL TAB $37.06 0536-1143-97 WHITE PETROLATUM 42 % TOPICAL OINT $37.05 44567-240-10 CEFEPIME 1 GRAM INJ SOLR $37.05 61990-0120-1 PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR $37.05 61990-0120-2 PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR $37.05 63323-118-01 HEPARIN, PORCINE (PF) 5,000 UNIT/0.5 ML INJ SOLN (MHS) $37.05 63323-118-05 HEPARIN, PORCINE (PF) 5,000 UNIT/0.5 ML INJ SOLN (MHS) $37.05 63323-464-01 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $37.05 63323-464-17 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $37.05 63323-485-03 LIDOCAINE HCL 10 MG/ML (1 %) INJ SOLN $37.05 63323-485-57 LIDOCAINE HCL 10 MG/ML (1 %) INJ SOLN $37.05 HC62214119 CATH URETERAL B $37.00 HC62212238 COLLAR CERV CALIF TRACH $37.00 HC89001226 C-PEPTIDE-QD $37.00 HC51062230 DIABETIC SELF MANGMT TRNG GRP 30M $37.00 HC89015150 FEBRILE AGGLUTININS-AU $37.00 HC51062214 GRAM STAIN $37.00 HC89003099 HEAVY METAL(S) QUALITATIVE-QD $37.00 HC89016646 IMMUNO ELECT URINE-AU $37.00 HC89023139 KAPPA FREE LIGHT CHAINS QT URINE-AU $37.00 HC89023147 LAMBDA FREE LIGHT CHAINS QT URINE-AU $37.00 HC62213897 TIP SUCTION/IRRIG $37.00 63323-781-10 VECURONIUM BROMIDE 10 MG IV SOLR $36.99 63323-781-21 VECURONIUM BROMIDE 10 MG IV SOLR $36.99 63739-070-10 ARIPIPRAZOLE 5 MG ORAL TAB $36.97 149003916 BISMUTH SUBSALICYLATE 262 MG/15 ML ORAL SUSP $36.89 1093974444 MINERAL OIL ORAL OIL $36.89 51079-273-01 ENTACAPONE 200 MG ORAL TAB $36.89 51079-273-03 ENTACAPONE 200 MG ORAL TAB $36.89 0409-3178-02 LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN $36.86 0409-3178-17 LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN $36.86 63323-543-03 HEPARIN, PORCINE (PF) 5,000 UNIT/0.5 ML INJ SOLN (MHS) $36.86 63323-543-13 HEPARIN, PORCINE (PF) 5,000 UNIT/0.5 ML INJ SOLN (MHS) $36.86 47335-379-83 CINACALCET 30 MG ORAL TAB $36.84 70436-007-04 CINACALCET 30 MG ORAL TAB $36.84 7430000412 PYRETHRINS-PIPERONYL BUTOXIDE 0.33-4 % TOPICAL SHAM $36.82 0093-3002-56 QUININE SULFATE 324 MG ORAL CAP $36.78 HC89021968 ANTIDEPRSSNTS TRICYCL =6/> QUANT UR -AU $36.75 HC89014674 LEGIONELLA AG DFA-AU $36.75 HC89021950 PNEUMOCYSTIS JIROVECII DFA-AU $36.75 0409-1610-50 BUPIVACAINE HCL 0.5 % (5 MG/ML) INJ SOLN $36.73 62756-348-44 OCTREOTIDE ACETATE 50 MCG/ML INJ SOLN $36.73 7214003263 WHITE PETROLATUM 41 % TOPICAL OINT $36.68 1093979233 LORATADINE 5 MG/5 ML ORAL SOLN $36.66 1093986044 LORATADINE 5 MG/5 ML ORAL SOLN $36.66 0409-6695-01 ETOMIDATE 2 MG/ML IV SOLN $36.66 0409-6695-11 ETOMIDATE 2 MG/ML IV SOLN $36.66 11523-1159-1 OXYMETAZOLINE 0.05 % NASL SPRAY (MHS) $36.66 49348-636-34 LORATADINE 5 MG/5 ML ORAL SOLN $36.66 63323-412-02 MIDAZOLAM 5MG/ML INJECTABLE SOLUTION (MHS) $36.66 0456-1405-11 NEBIVOLOL 5 MG ORAL TAB $36.61 0456-1405-63 NEBIVOLOL 5 MG ORAL TAB $36.61 75834-242-30 ERYTHROMYCIN 250 MG ORAL TAB $36.56 6371301972 GELATIN SPONGE,ABSORB-PORCINE 12-7 MM TOPICAL SPGE $36.50 0254-2008-01 COLCHICINE 0.6 MG ORAL TAB $36.49 72572-574-01 PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR $36.47 72572-574-10 PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR $36.47 0008-4117-01 ETHIONAMIDE 250 MG ORAL TAB $36.43 0143-9586-01 GLYCOPYRROLATE 0.2 MG/ML INJ SOLN $36.40 0143-9586-25 GLYCOPYRROLATE 0.2 MG/ML INJ SOLN $36.40 0338-5197-41 FAMOTIDINE (PF)-NACL (ISO-OS) 20 MG/50 ML IV PGBK $36.40 0781-3827-72 GLYCOPYRROLATE 0.2 MG/ML INJ SOLN $36.40 0781-3827-96 GLYCOPYRROLATE 0.2 MG/ML INJ SOLN $36.40 54288-135-01 TACROLIMUS 1 MG ORAL CAP $36.40 43598-220-40 AMOXICILLIN-POT CLAVULANATE 1,000-62.5 MG ORAL TB12 $36.30 16714-842-01 DOFETILIDE 500 MCG ORAL CAP $36.25 23155-160-31 ETOMIDATE 2 MG/ML IV SOLN $36.14 23155-160-41 ETOMIDATE 2 MG/ML IV SOLN $36.14 68180-819-42 LANTHANUM 500 MG ORAL CHEW $36.11 68180-819-52 LANTHANUM 500 MG ORAL CHEW $36.11 4110081123 OXYMETAZOLINE 0.05 % NASL SPRAY (MHS) $36.08 63323-484-57 LIDOCAINE HCL 5 MG/ML (0.5 %) INJ SOLN $36.08 HC89008015 ETHYLENE GLYCOL-AU $36.05 52380-1272-4 CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQD $36.05 72572-015-01 AMINOCAPROIC ACID 250 MG/ML IV SOLN $36.01 72572-015-25 AMINOCAPROIC ACID 250 MG/ML IV SOLN $36.01 HC89007207 AMINOLEVULINIC ACID-AU $36.00 HC89019574 ANTI-HU-TTG IGA (PNL1155/6360)-PR $36.00 HC62200365 BAG URINARY LEG $36.00 HC62220843 BINDER ABDOMINAL BASIC A $36.00 HC62220884 BLANKET HYPER/HYPOTHERMIA A $36.00 HC62200779 BREAST SHIELD $36.00 HC62220918 BRUSH CYTOLOGY A $36.00 HC62300207 CABLE EP A $36.00 HC62222526 CABLE PACING DISP A $36.00 HC62217104 CATH ANGIOGRAPHY(LB HNB) A $36.00 HC62220090 CATH BALLOON DIL NON VASCULAR A $36.00 HC62220934 CATH CENTRAL VENOUS A $36.00 HC62220975 CATH FOLEY A $36.00 HC62222534 CATH NEPHROSTOMY A $36.00 HC62220991 CATH UMBILICAL A $36.00 HC62222732 CAUTERY PENCIL A $36.00 HC62222773 CHEST TUBE A $36.00 HC62226865 CIRCUIT VENT A $36.00 HC62221759 CLIP ENDOSCOPIC A $36.00 HC62201884 CLIPPER BLADE $36.00 HC62201892 CLIPPER HEAD SNG/USE FOR 3M $36.00 HC62201900 CLOSURE DRAINABLE POUCH $36.00 HC62224936 DEVICE CLOSURE VASCULAR A $36.00 HC62224894 DILATOR VESSEL A $36.00 HC62227400 DRESSING ANTIMIC MICRO-CURRENT A $36.00 HC62202445 DRESSING BURN NET $36.00 HC62209044 DRESSING SORBAVIEW $36.00 HC62202627 DRILL/DRILL BITS SINGLE USE A $36.00 HC62221023 ET POUCH A $36.00 HC62203146 ET SET IRRIGATION $36.00 HC51000024 GLUCOSE BY REAGENT STRIP $36.00 HC62802731 GOLD SEED MARKER FIDUCIAL EA A $36.00 HC62226717 GUIDEWIRE A $36.00 HC62212303 GUIDEWIRE(E.G. BENTSON) A $36.00 HC62212378 INTRODUCER/SHEATH A $36.00 HC62203880 KIT FEMALE CATH $36.00 HC62221122 KIT PRESSURE MONITOR/TRANSDUCER A $36.00 HC62204441 KNIFE SURGICAL $36.00 HC62209036 LARYNGOSCOPE BLADE DISP INFANT $36.00 HC62228010 MARKER GRAFT RADIOPAQUE $36.00 HC62209275 MASK/SHADES BILI' LIGHTS $36.00 HC89006191 METHADONE &METABOLITE QUANT URINE-AU $36.00 HC62221239 NEEDLE ENDOSCOPIC A $36.00 HC62204979 NEEDLE SCALP VEIN $36.00 HC62221262 NEEDLE SPINAL A $36.00 HC62221700 NEEDLE WIRE LOCALIZATION A $36.00 HC62217161 ORTHOTIC ANKLE RIGID PNEUM/GEL PRFB A $36.00 HC62225164 ORTHOTIC WHFO D-RING A $36.00 HC62219860 ORTHOTIC WHFO NEO/INFANT PREFAB A $36.00 HC62211370 OXISENSOR ADULT OR PEDS $36.00 HC62223797 PACKING NASAL A $36.00 HC62222856 PAD GROUNDING A $36.00 HC62808522 PARTICLES EMBOLIZ (EMBOCUBES) $36.00 HC62225081 SEAL ENDO ROBOTIC A $36.00 HC62222435 SNARE A $36.00 HC62213343 STOCKINGS TED HOSE KNEE HI $36.00 HC62226196 STRAP WOUND CARE $36.00 HC62206925 SUCTION COLLECTION DEVICE A $36.00 HC62207105 SYRINGE ANGIO $36.00 HC89020416 THEOPHYLLINE-U2 $36.00 HC62207337 TRAY FOLEY CATH $36.00 HC62207402 TRAY IRRIGATION $36.00 HC62212154 TUBE GASTROSTOMY STRD BUTTON/NONE A $36.00 HC62222336 TUBE INSUFFLATOR A $36.00 HC62207725 TUBE NASO GASTRIC $36.00 HC62207733 TUBE NASOPHARYNGEAL $36.00 HC62207741 TUBE SALEM SUMP $36.00 HC62207923 TUBING PCA $36.00 HC89014542 UREA PLASMA/MYCOPLASMA-AU $36.00 HC62214697 VALVE ENDOSCOPIC A $36.00 0456-1402-30 NEBIVOLOL 2.5 MG ORAL TAB $35.93 0456-1405-30 NEBIVOLOL 5 MG ORAL TAB $35.93 0456-1405-90 NEBIVOLOL 5 MG ORAL TAB $35.93 0456-1410-30 NEBIVOLOL 10 MG ORAL TAB $35.93 0456-1410-90 NEBIVOLOL 10 MG ORAL TAB $35.93 0781-3404-85 AMPICILLIN SODIUM 1 GRAM INJ SOLR $35.92 0781-3404-95 AMPICILLIN SODIUM 1 GRAM INJ SOLR $35.92 16864-680-03 BENZOCAINE-MENTHOL 20-0.5 % TOPICAL AEROSOL $35.91 67877-746-01 SIROLIMUS 0.5 MG ORAL TAB $35.91 54838-558-40 LORATADINE 5 MG/5 ML ORAL SOLN $35.88 23155-785-31 AMIKACIN 500 MG/2 ML INJ SOLN $35.85 23155-785-41 AMIKACIN 500 MG/2 ML INJ SOLN $35.85 HC89022669 TESTOSTERONE TOTAL-QN $35.82 99999-040-09 MIDAZOLAM 2 MG/ML ORAL SYRP $35.82 99999-039-11 NEOSTIGMINE METHYLSULFATE 1 MG/ML IV SOLN $35.80 99999-040-40 NEOSTIGMINE METHYLSULFATE 1 MG/ML IV SOLN $35.80 58914-785-10 URSODIOL 250 MG ORAL TAB $35.80 0069-5820-61 DOFETILIDE 500 MCG ORAL CAP $35.79 0904-6831-04 METAXALONE 800 MG ORAL TAB $35.76 0000-4124-00 POTASSIUM PHOSPHATE M-/D-BASIC 3 MMOL/ML IV SOLN $35.75 0338-0023-02 DEXTROSE 10 % IN WATER (D10W) 10 % IV SOLP $35.75 0409-7620-03 HEPARIN (PORCINE) IN NACL (PF) 1,000 UNIT/500 ML IV SOLP $35.75 0409-7620-13 HEPARIN (PORCINE) IN NACL (PF) 1,000 UNIT/500 ML IV SOLP $35.75 0641-1410-31 DIGOXIN 250 MCG/ML (0.25 MG/ML) INJ SOLN $35.75 0641-1410-35 DIGOXIN 250 MCG/ML (0.25 MG/ML) INJ SOLN $35.75 0641-6184-01 DIGOXIN 250 MCG/ML (0.25 MG/ML) INJ SOLN $35.75 0641-6184-25 DIGOXIN 250 MCG/ML (0.25 MG/ML) INJ SOLN $35.75 0990-6138-03 SODIUM CHLORIDE 0.9 % IRR SOLN $35.75 0990-6139-03 WATER FOR IRRIGATION, STERILE IRR SOLN $35.75 0990-7670-03 ELECTROLYTE-R (PH 7.4) IV SOLP $35.75 0990-7922-03 DEXTROSE 5 % IN WATER (D5W) IV SOLP $35.75 0990-7924-03 DEXTROSE 5%-0.2 % SOD CHLORIDE IV SOLP $35.75 0990-7930-03 DEXTROSE 10% IN WATER (D10W) IV SOLN (MCH) $35.75 0990-7941-03 D5 % AND 0.9 % SODIUM CHLORIDE IV SOLP $35.75 0990-7983-03 SODIUM CHLORIDE 0.9 % IV SOLP $35.75 25021-142-20 AMPICILLIN-SULBACTAM 1.5 GRAM INJ SOLR $35.75 25021-186-20 AMPICILLIN-SULBACTAM 1.5 GRAM INJ SOLR $35.75 25021-674-10 ETOMIDATE 2 MG/ML IV SOLN $35.75 55150-119-30 PIPERACILLIN-TAZOBACTAM 2.25 GRAM IV SOLR $35.75 55150-221-10 ETOMIDATE 2 MG/ML IV SOLN $35.75 65219-445-01 ETOMIDATE 2 MG/ML IV SOLN $35.75 65219-445-10 ETOMIDATE 2 MG/ML IV SOLN $35.75 70069-807-01 MILRINONE 1 MG/ML IV SOLN $35.75 70069-807-10 MILRINONE 1 MG/ML IV SOLN $35.75 72485-106-01 LEVETIRACETAM 500 MG/5 ML IV SOLN $35.75 72485-106-10 LEVETIRACETAM 500 MG/5 ML IV SOLN $35.75 72485-107-01 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN (MCH) $35.75 72485-107-10 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN (MCH) $35.75 81284-611-00 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN (FOR TOPICAL USE) $35.75 81284-611-10 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN (FOR TOPICAL USE) $35.75 57896-131-01 DIBUCAINE 1 % TOPICAL OINT $35.67 60758-801-05 TIMOLOL MALEATE 0.5 % OPHT DROP $35.56 63304-089-13 MESALAMINE 500 MG ORAL CPSR $35.52 HC89014500 THYROGLOBULIN AB-ES $35.51 16714-841-01 DOFETILIDE 250 MCG ORAL CAP $35.50 99999-046-49 RIFAMPIN 25 MG/ML ORAL LIQUID (COMPOUND) $35.49 68382-520-01 SIROLIMUS 0.5 MG ORAL TAB $35.48 0430-0721-24 ESTRADIOL 1 MG ORAL TAB $35.43 60687-328-31 SEVELAMER CARBONATE 800 MG ORAL TAB $35.43 60687-328-33 SEVELAMER CARBONATE 800 MG ORAL TAB $35.43 99999-033-49 DOCETAXEL IV SOLN (FOR DESENSITIZATION USE) (MHS) $35.43 7214063377 WHITE PETROLATUM 41 % TOPICAL OINT $35.36 43547-544-01 GLYCOPYRROLATE 0.2 MG/ML INJ SOLN $35.36 43547-544-25 GLYCOPYRROLATE 0.2 MG/ML INJ SOLN $35.36 0172-6406-05 CROMOLYN 20 MG/2 ML INHALATION NEBU $35.35 0172-6406-49 CROMOLYN 20 MG/2 ML INHALATION NEBU $35.35 42571-350-08 CROMOLYN 20 MG/2 ML INHALATION NEBU $35.35 0409-1209-01 LIDOCAINE-EPINEPHRINE (MPF) 1.5 %-1:200,000 INJ SOLN (MHS) $35.26 0409-1209-10 LIDOCAINE-EPINEPHRINE (MPF) 1.5 %-1:200,000 INJ SOLN (MHS) $35.26 7214000022 LANOLIN ALCOHOL-MO-W.PET-CERES TOPICAL CREAM $35.26 10356-090-04 LANOLIN ALCOHOL-MO-W.PET-CERES TOPICAL CREAM $35.26 42023-146-25 DEXMEDETOMIDINE 100 MCG/ML INJ SOLN (FOR INTRANASAL USE) $35.23 70860-605-03 DEXMEDETOMIDINE 100 MCG/ML INJ SOLN (FOR INTRANASAL USE) $35.23 70860-605-41 DEXMEDETOMIDINE 100 MCG/ML INJ SOLN (FOR INTRANASAL USE) $35.23 0409-4698-01 LIDOCAINE HCL 4 % LATR SOLN $35.18 16714-620-25 GLYCOPYRROLATE 0.2 MG/ML INJ SOLN $35.10 16729-239-30 DEXMEDETOMIDINE 100 MCG/ML INJ SOLN (FOR INTRANASAL USE) $35.10 16729-239-93 DEXMEDETOMIDINE 100 MCG/ML INJ SOLN (FOR INTRANASAL USE) $35.10 51754-1000-1 MAGNESIUM SULFATE 4 MEQ/ML (50 %) INJ SOLN $35.10 51754-1000-4 MAGNESIUM SULFATE 4 MEQ/ML (50 %) INJ SOLN $35.10 51754-2001-4 POTASSIUM ACETATE 2 MEQ/ML IV SOLN $35.10 66689-031-01 METOCLOPRAMIDE 5 MG/5 ML ORAL SOLN (MCH) $35.10 70069-012-01 GLYCOPYRROLATE 0.2 MG/ML INJ SOLN $35.10 70069-012-25 GLYCOPYRROLATE 0.2 MG/ML INJ SOLN $35.10 99999-043-96 DEXMEDETOMIDINE IN 0.9 % NACL 200 MCG/50 ML (4 MCG/ML) IV SOLN $35.10 0472-0321-26 HYDROCORTISONE 1 % TOPICAL CREAM $35.07 51672-2044-2 BACITRACIN ZINC-POLYMYXIN B 500-10,000 UNIT/GRAM TOPICAL OINT $35.07 0781-5438-20 CEFPODOXIME 100 MG ORAL TAB $35.04 0904-6488-38 WHITE PETROLATUM-MINERAL OIL 83-15 % OPHT OINT $35.04 16714-394-01 CEFPODOXIME 100 MG ORAL TAB $35.04 HC89004261 AMIKACIN - RANDOM-U2 $35.00 HC89006274 AMIKACIN PEAK OR TROUGH-U2 $35.00 HC89022164 ANTIBODY ACETYLCHOLINE RCPTR MODULTNG -AU $35.00 HC89022057 BENZODIAZEPINES 1-12 SERUM QNTS(PNL)-AU $35.00 HC89011621 CHROMOGRANIN A-AU $35.00 HC89021455 CONCENTRATION AGNT INF SPECIMEN -AU $35.00 HC89000970 CULTURE BORD PERTUSSIS(PNL)-U2 $35.00 HC89003909 CULTURE BORDETELLA-U2 $35.00 HC89001291 DIHYDROXYVITAMIN D 1-25-QD $35.00 HC89008577 GLUTAMIC ACID AB-AU $35.00 HC89013189 HELICOBACTER PYLORI AG-AU $35.00 HC89008270 HUMAN GROWTH HORMONE-ES $35.00 HC89011886 INSULIN AB-AU $35.00 HC89500862 IRRADIATION EA UNIT-HC $35.00 HC89023493 ISLET AUTOANTIBODY ANTIGEN-2-AU $35.00 HC51062677 KETONE BODY(S) QUALITATIVE $35.00 HC51000008 OB FECES GUAIAC1-3 NEOPLSM SCR $35.00 HC89003081 PRIMIDONE-U2 $35.00 HC89018402 QUANTIFERON-TB GOLD-AU $35.00 HC89005813 TACROLIMUS-QD $35.00 HC51001915 WBC MANUAL DIFF $35.00 7811201104 PHENOL 1.4 % MUCOUS MEMB SPRA $34.98 63739-964-11 HEPARIN (PORCINE) 10,000 UNIT/ML INJ SOLN $34.94 63739-964-25 HEPARIN (PORCINE) 10,000 UNIT/ML INJ SOLN $34.94 0409-1749-29 BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJ SOLN $34.91 0409-1749-71 BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJ SOLN $34.91 16714-840-01 DOFETILIDE 125 MCG ORAL CAP $34.90 0378-6993-31 LEVALBUTEROL HCL 1.25 MG/0.5 ML INHALATION NEBU $34.83 0378-6993-93 LEVALBUTEROL HCL 1.25 MG/0.5 ML INHALATION NEBU $34.83 55150-117-20 AMPICILLIN-SULBACTAM 3 G IV SOLR (MCH) $34.81 61570-110-01 RAMIPRIL 1.25 MG ORAL CAP $34.67 0054-0407-13 RITONAVIR 100 MG ORAL TAB $34.67 72572-481-01 NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN $34.66 72572-481-10 NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN $34.66 HC89023030 RENIN-QN $34.63 52244-300-10 THEOPHYLLINE 300 MG ORAL CP24 $34.61 60505-2900-9 IMATINIB 100 MG ORAL TAB $34.60 0527-1311-01 TERBUTALINE 5 MG ORAL TAB $34.56 6210333304 ZINC OXIDE 16 % TOPICAL OINT $34.52 149003942 BISMUTH SUBSALICYLATE 262 MG/15 ML ORAL SUSP $34.52 1093955633 PYRETHRINS-PIPERONYL BUTOXIDE 0.33-4 % TOPICAL SHAM $34.52 0143-9787-01 ENALAPRILAT 1.25 MG/ML IV SOLN $34.51 0143-9787-10 ENALAPRILAT 1.25 MG/ML IV SOLN $34.51 43598-078-11 ENALAPRILAT 1.25 MG/ML IV SOLN $34.51 43598-078-58 ENALAPRILAT 1.25 MG/ML IV SOLN $34.51 60687-314-95 AZITHROMYCIN 600 MG ORAL TAB $34.51 99999-010-37 ENALAPRILAT 1.25 MG/ML INJ (MCH) $34.51 25021-790-02 PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN $34.45 25021-790-03 PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN $34.45 43066-090-01 PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN $34.45 43066-090-25 PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN $34.45 72485-417-01 AMPICILLIN-SULBACTAM 3 GRAM INJ SOLR $34.45 72485-417-10 AMPICILLIN-SULBACTAM 3 GRAM INJ SOLR $34.45 76297-001-21 SODIUM CHLORIDE 0.9 % IV SOLP $34.45 76297-001-22 SODIUM CHLORIDE 0.9 % IV SOLP $34.45 99999-045-00 ASCORBIC ACID 500 MG IN NS 50 ML IVPB (SLH) $34.45 0140-0005-01 DIAZEPAM 5 MG ORAL TAB $34.37 7430001067 POLYETHYLENE GLYCOL 400 1 % OPHT DROP $34.32 63323-305-02 TOBRAMYCIN SULFATE 10 MG/ML INJ SOLN $34.32 68094-762-59 MIDAZOLAM 2 MG/ML ORAL SYRP (MHS) $34.26 HC89021497 DS COCAINE CONF-AU $34.25 60505-6145-4 CEFEPIME 2 GRAM INJ SOLR $34.16 75834-170-01 ZINC OXIDE 20 % TOPICAL OINT $34.15 0338-0062-30 DEXTROSE 5 % IN WATER (D5W) IV SOLP $34.13 0409-3182-02 LIDOCAINE-EPINEPHRINE 2 %-1:100,000 INJ SOLN $34.13 0409-7983-53 NS IV BOLUS $34.13 0990-6138-22 SODIUM CHLORIDE 0.9 % IRR SOLN $34.13 0990-6139-22 WATER FOR IRRIGATION, STERILE IRR SOLN $34.13 0990-6143-22 ACETIC ACID 0.25 % IRR SOLN $34.13 0990-7922-02 DEXTROSE 5 % IN WATER (D5W) IV SOLP $34.13 0990-7922-61 DEXTROSE 5 % IN WATER (D5W) IV SOLP $34.13 0990-7926-02 D5 %-0.45 % SODIUM CHLORIDE IV SOLP $34.13 0990-7930-02 DEXTROSE 10 % IN WATER (D10W) 10 % IV SOLP $34.13 0990-7983-02 SODIUM CHLORIDE 0.9% IV SOLP FOR BLD TRANSFUSION $34.13 0990-7983-61 SODIUM CHLORIDE 0.9 % IV SOLP $34.13 66794-230-02 DEXMEDETOMIDINE 100 MCG/ML INJ SOLN (FOR INTRANASAL USE) $34.13 66794-230-42 DEXMEDETOMIDINE 100 MCG/ML INJ SOLN (FOR INTRANASAL USE) $34.13 76297-001-31 SODIUM CHLORIDE 0.9 % IV SOLP $34.13 76297-001-32 SODIUM CHLORIDE 0.9 % IV SOLP $34.13 70069-021-01 DEXAMETHASONE SODIUM PHOS (PF) 10 MG/ML INJ SOLN $34.06 70069-021-25 DEXAMETHASONE SODIUM PHOS (PF) 10 MG/ML INJ SOLN $34.06 99999-033-73 OPIUM TINCTURE 10 MG/ML (MORPHINE) ORAL TINC $34.02 99999-036-17 OPIUM TINCTURE 10 MG/ML (MORPHINE) ORAL TINC $34.02 HC89014211 ANTI-SMOOTH MUSCLE TITER AB-AU $34.00 HC62200274 BAG COLOSTOMY/ILEOSTOMY/LOOP $34.00 HC62200407 BANDAGE ELASTIC(ACE AND COBAN) $34.00 HC62200415 BANDAGE ESMARK $34.00 HC62200423 BANDAGE KLING $34.00 HC62218045 BLADE OPHTHALM B $34.00 HC62215165 BLADE SAW B $34.00 HC62201033 CANNULA NASAL $34.00 HC62214101 CATH URETERAL A $34.00 HC62201835 CLIP COLOSTOMY BAG $34.00 HC62211651 DRESSING ANTIMIC PROTECTV DISC $34.00 HC62208822 END CAP $34.00 HC62203070 ET CLAMP OSOTOMY/ HOLLISTER $34.00 HC89000202 INFLUENZA B SEROLOGY-QD $34.00 HC62203997 KIT IV START W/TEGADERM $34.00 HC62204391 KIT/TRAY SUTURE REMOVAL $34.00 HC62204557 LOOPS VASCULAR $34.00 HC89006423 LORAZEPAM; 1-12-AU $34.00 HC62215801 NEEDLE BIOPSY A $34.00 HC62229042 NEEDLE HUBER/PORT-A-CATH A $34.00 HC62205513 PACKING NUGAUZE $34.00 HC62205547 PAD BREAST $34.00 HC62208756 PADS BREAST HYDROGEL $34.00 HC62216395 PIN/WIRE FIXATION TEMPORARY B $34.00 HC51070779 PSY-BEHAVIOR TX GROUP ADDL 15 MIN $34.00 HC62206792 STAPLE REMOVER $34.00 HC62215546 SUTURE A $34.00 HC62210737 SYSTEM ENTERAL FEED PRESRELIEF $34.00 HC89010011 T4 FREE-ES $34.00 HC62207675 TUBE GAVAGE/FEEDING INFANTS $34.00 51525-0470-8 CROMOLYN 100 MG/5 ML ORAL CONC $34.00 51525-0470-9 CROMOLYN 100 MG/5 ML ORAL CONC $34.00 0904-6682-08 DOFETILIDE 250 MCG ORAL CAP $33.89 0904-7130-61 CHLORPROMAZINE 25 MG ORAL TAB $33.85 54859-811-16 DIPHENHYDRAMINE HCL 12.5 MG/5 ML ORAL LIQD $33.82 0143-9681-01 GLYCOPYRROLATE 0.2 MG/ML INJ SOLN $33.80 0143-9681-25 GLYCOPYRROLATE 0.2 MG/ML INJ SOLN $33.80 25021-127-20 CEFTAZIDIME 1 GRAM INJ SOLR $33.80 64980-513-05 TIMOLOL MALEATE 0.25 % OPHT DROP $33.80 70436-021-82 VANCOMYCIN 1,000 MG IV SOLR $33.77 5618412041 SIMETHICONE 40 MG/0.6 ML ORAL DRPS $33.74 4858200155 SALIVA STIMULANT COMB. NO.3 MUCOUS MEMB SPRY $33.69 61314-226-05 TIMOLOL MALEATE 0.25 % OPHT DROP $33.61 71399-0120-1 HYDROCORTISONE 1 % TOPICAL LOTN $33.54 51079-812-01 NADOLOL 20 MG ORAL TAB $33.53 51079-812-20 NADOLOL 20 MG ORAL TAB $33.53 HC89023618 ANTIBODY SARS-COV-2 COVID-19 QUANT CIA (SPIKE)-AU $33.50 0781-9210-90 PIPERACILLIN-TAZOBACTAM 2.25 GRAM IV SOLR $33.50 0781-9210-95 PIPERACILLIN-TAZOBACTAM 2.25 GRAM IV SOLR $33.50 60687-375-01 DRONABINOL 2.5 MG ORAL CAP $33.49 60687-375-11 DRONABINOL 2.5 MG ORAL CAP $33.49 43598-409-05 LEVALBUTEROL HCL 1.25 MG/3 ML INHALATION NEBU $33.48 43598-409-25 LEVALBUTEROL HCL 1.25 MG/3 ML INHALATION NEBU $33.48 43598-410-05 LEVALBUTEROL HCL 0.63 MG/3 ML INHALATION NEBU $33.48 43598-410-25 LEVALBUTEROL HCL 0.63 MG/3 ML INHALATION NEBU $33.48 0781-3113-90 PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR $33.48 0781-3113-95 PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR $33.48 0781-9213-90 PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR $33.48 0781-9213-95 PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR $33.48 0143-9234-01 VECURONIUM BROMIDE 10 MG IV SOLR $33.46 0143-9234-10 VECURONIUM BROMIDE 10 MG IV SOLR $33.46 44567-802-10 PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR $33.41 0143-9250-01 ROCURONIUM 10 MG/ML IV SOLN $33.38 0143-9250-10 ROCURONIUM 10 MG/ML IV SOLN $33.38 71288-005-20 AMPICILLIN-SULBACTAM 1.5 GRAM INJ SOLR $33.35 71288-005-21 AMPICILLIN-SULBACTAM 1.5 GRAM INJ SOLR $33.35 HC89021984 LEVETIRACETAM (KEPPRA) -AU $33.30 66993-472-02 NISOLDIPINE 8.5 MG ORAL TB24 $33.27 HC89022107 METHAMPHETAMINES(MDA,MDEA,MDMA)SERUM QNTS(PNL)-AU $33.25 5483800650 CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROP $33.15 0781-6041-55 AMOXICILLIN 250 MG/5 ML ORAL SUSR $33.15 0990-7077-26 POTASSIUM CHLORIDE IN WATER 40 MEQ/100 ML IV PGBK $33.15 51672-2002-1 CLOTRIMAZOLE 1 % TOPICAL CREAM $33.15 60687-556-32 MESALAMINE 400 MG ORAL CDTI $33.15 60687-556-33 MESALAMINE 400 MG ORAL CDTI $33.15 HC89005870 FACTOR VIII VW MULTI-AU $33.10 10147-0891-3 GALANTAMINE 8 MG ORAL C24P $33.07 HC89017636 CADMIUM(PNL)-AU $33.00 HC89017784 CULTURE CMV VIR SHELL(PNL)-AU $33.00 HC89017776 CULTURE CMV(PNL)-AU $33.00 HC89008254 LH(LUTEINIZ HORMONE)-ES $33.00 HC89016406 NEPHELOMETRY EA ANALYT UR-AU $33.00 HC89001739 SPERM AB (PNL)-AU $33.00 HC89013999 T3 TOTAL-ES $33.00 HC89016661 ULTRACENTRIFUG VAP(IN PNL)-AH $33.00 HC89009823 VITAMIN B-2-AU $33.00 HC89024053 Q FEVER AB COXIELLA BURNETII PHASE TITER I-AU $33.00 HC89024061 Q FEVER AB COXIELLA BURNETII PHASE TITER II-AU $33.00 0008-0923-60 PANTOPRAZOLE 40 MG IV SOLR $32.99 0008-0923-51 PANTOPRAZOLE 40 MG IV SOLR $32.99 0008-0923-55 PANTOPRAZOLE 40 MG IV SOLR $32.99 63323-365-01 OCTREOTIDE ACETATE 50 MCG/ML INJ SOLN $32.89 16714-247-01 VANCOMYCIN 500 MG IV SOLR $32.88 16714-247-10 VANCOMYCIN 500 MG IV SOLR $32.88 61748-012-06 PYRAZINAMIDE 500 MG ORAL TAB $32.84 66794-217-02 PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR $32.83 66794-217-41 PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR $32.83 HC89006563 PHENYTOIN FREE(PNL)-AU $32.76 0409-3183-01 LIDOCAINE-EPINEPHRINE (MPF) 2 %-1:200,000 INJ SOLN (MHS) $32.76 0409-3183-11 LIDOCAINE-EPINEPHRINE (MPF) 2 %-1:200,000 INJ SOLN (MHS) $32.76 0904-7734-45 MICONAZOLE NITRATE 2 % VAGINAL CREAM $32.76 99999-042-19 DILTIAZEM 12 MG/ML ORAL SUSPENSION $32.76 HC89009641 PORPHOBILINOGEN QUANT-AU $32.73 2390001252 OXYMETAZOLINE 0.05 % NASL SPRAY (MHS) $32.66 37000-803-01 OXYMETAZOLINE 0.05 % NASL SPRAY (MHS) $32.66 42292-036-01 OLMESARTAN 20 MG ORAL TAB $32.65 42292-036-03 OLMESARTAN 20 MG ORAL TAB $32.65 99999-039-82 BOSENTAN 6.25 MG/ML ORAL LIQUID $32.62 0781-5325-31 BROMOCRIPTINE 2.5 MG ORAL TAB $32.60 70121-1000-1 METHYLPREDNISOLONE SODIUM SUCC 40 MG INJ SOLR $32.59 70121-1000-5 METHYLPREDNISOLONE SODIUM SUCC 40 MG INJ SOLR $32.59 12496-1202-1 BUPRENORPHINE-NALOXONE 2-0.5 MG SL FILM $32.57 12496-1202-3 BUPRENORPHINE-NALOXONE 2-0.5 MG SL FILM $32.57 0025-2742-31 DISOPYRAMIDE PHOSPHATE 150 MG ORAL CPSR $32.52 HC89021711 OPIATES, 1 OR MORE MEC(PNL)-AU $32.50 HC89021752 OXYCODONE MEC(PNL)-AU $32.50 0143-9376-01 ETOPOSIDE 20 MG/ML IV SOLN (MCH) $32.50 0264-7638-00 POTASSIUM CHLORID-D5-0.45%NACL 40 MEQ/L IV SOLP $32.50 0338-0017-04 DEXTROSE 5 % IN WATER (D5W) IV SOLP $32.50 0338-0085-04 D5 %-0.45 % SODIUM CHLORIDE IV SOLP $32.50 0338-0089-04 D5 % AND 0.9 % SODIUM CHLORIDE IV SOLP $32.50 0338-0117-04 LACTATED RINGERS IV SOLP $32.50 0338-0125-04 DEXTROSE 5 %-LACTATED RINGERS IV SOLP $32.50 0338-0424-18 HEPARIN (PORCINE) IN NACL (PF) 1,000 UNIT/500 ML IV SOLP $32.50 0409-6102-27 FUROSEMIDE 10 MG/ML INJ SOLN $32.50 0409-6102-37 FUROSEMIDE 10 MG/ML INJ SOLN $32.50 0409-7139-09 WATER FOR IRRIGATION, STERILE IRR SOLN $32.50 0409-7930-09 DEXTROSE 10 % IN WATER (D10W) 10 % IV SOLP $32.50 0487-9701-30 BUDESONIDE 0.5 MG/2 ML INHALATION NBSP $32.50 0990-6141-09 PHYSIOLOGICAL IRRIG SOLN NO.1 140-5-3-98 MEQ/L IRR SOLN $32.50 0990-6143-09 ACETIC ACID 0.25 % IRR SOLN $32.50 0990-7077-14 POTASSIUM CHLORIDE IN WATER 20 MEQ/50 ML IV PGBK $32.50 0990-7138-09 SODIUM CHLORIDE 0.9 % IRR SOLN $32.50 0990-7139-09 WATER FOR IRRIGATION, STERILE IRR SOLN $32.50 0990-7670-09 ELECTROLYTE-R (PH 7.4) IV SOLP $32.50 0990-7922-09 DEXTROSE 5 % IN WATER (D5W) IV SOLP $32.50 0990-7924-09 DEXTROSE 5%-0.2 % SOD CHLORIDE IV SOLP $32.50 0990-7926-09 D5 %-0.45 % SODIUM CHLORIDE IV SOLP $32.50 0990-7929-09 DEXTROSE 5 %-LACTATED RINGERS IV SOLP $32.50 0990-7930-09 DEXTROSE 10 % IN WATER (D10W) 10 % IV SOLP $32.50 0990-7941-09 D5 % AND 0.9 % SODIUM CHLORIDE IV SOLP $32.50 0990-7953-09 LACTATED RINGERS IV SOLP $32.50 0990-7965-09 ELECTROLYTE-M IN 5 % DEXTROSE IV SOLP $32.50 0990-7983-09 SODIUM CHLORIDE 0.9 % IV SOLP $32.50 0990-7985-09 SODIUM CHLORIDE 0.45 % 0.45 % IV SOLP $32.50 0990-7990-09 WATER FOR INJECTION, STERILE IV SOLP $32.50 16729-298-05 ONDANSETRON HCL 2 MG/ML IV SOLN (MCH) $32.50 25021-136-10 AMPICILLIN SODIUM 1 GRAM INJ SOLR $32.50 25021-806-01 HALOPERIDOL LACTATE 5 MG/ML INJ SOLN $32.50 36000-047-24 LEVOFLOXACIN IN D5W 500 MG/100 ML IV PGBK $32.50 43066-997-01 NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN $32.50 43066-997-10 NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN $32.50 43598-172-05 PHENYLEPHRINE HCL 0.1 MG/ML IV SOLN $32.50 43598-172-15 PHENYLEPHRINE HCL 0.1 MG/ML IV SOLN $32.50 47781-729-02 VANCOMYCIN 125 MG ORAL CAP $32.50 50268-295-11 ENTACAPONE 200 MG ORAL TAB $32.50 50268-295-15 ENTACAPONE 200 MG ORAL TAB $32.50 54288-125-01 POTASSIUM CHLORIDE 20 MEQ ORAL PACK $32.50 54288-125-30 POTASSIUM CHLORIDE 20 MEQ ORAL PACK $32.50 54879-021-01 CYCLOPHOSPHAMIDE 25 MG ORAL CAP $32.50 55150-202-00 PANTOPRAZOLE 40 MG IV SOLR $32.50 55150-202-10 PANTOPRAZOLE 40 MG IV SOLR $32.50 55390-500-10 BUMETANIDE 0.25 MG/ML INJ SOLN $32.50 57664-135-65 NIMODIPINE 30 MG ORAL CAP $32.50 61314-633-05 GENTAMICIN 0.3 % OPHT DROP $32.50 62332-061-30 LEFLUNOMIDE 10 MG ORAL TAB $32.50 62756-129-44 PANTOPRAZOLE 40 MG IV SOLR $32.50 63323-162-00 KETOROLAC 30 MG/ML (1 ML) INJ SOLN $32.50 63323-162-01 KETOROLAC 30 MG/ML (1 ML) INJ SOLN $32.50 63323-178-76 WATER FOR INJECTION, STERILE IV SOLP $32.50 63323-626-05 SODIUM CHLORIDE 0.45 % 0.45 % IV SOLP $32.50 63323-626-10 SODIUM CHLORIDE 0.45 % 0.45 % IV SOLP $32.50 67457-438-00 VECURONIUM BROMIDE 10 MG IV SOLR $32.50 67457-438-10 VECURONIUM BROMIDE 10 MG IV SOLR $32.50 70069-131-01 TOBRAMYCIN 0.3 % OPHT DROP $32.50 70860-100-10 AZITHROMYCIN 500 MG IV SOLR $32.50 70860-100-41 AZITHROMYCIN 500 MG IV SOLR $32.50 71288-414-02 GLYCOPYRROLATE 0.2 MG/ML INJ SOLN $32.50 71288-719-10 SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ SOLN $32.50 71288-719-11 SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ SOLN $32.50 72485-101-01 DIPHENHYDRAMINE HCL 50 MG/ML INJ SOLN $32.50 72485-101-25 DIPHENHYDRAMINE HCL 50 MG/ML INJ SOLN $32.50 72572-076-01 CLINDAMYCIN IN 5 % DEXTROSE 900 MG/50 ML IV PGBK $32.50 72572-076-24 CLINDAMYCIN IN 5 % DEXTROSE 900 MG/50 ML IV PGBK $32.50 99999-038-06 SODIUM HYPOCHLORITE 0.125 % MISC SOLUTION (LBM) $32.50 99999-038-07 SODIUM HYPOCHLORITE 0.25 % MISC SOLUTION (LBM) $32.50 99999-038-10 METRONIDAZOLE 5 MG/ML INJECTION (MHS) $32.50 99999-040-38 ACETYLCYSTEINE 5 % (50 MG/ML) ORAL SOLUTION DILUTION $32.50 99999-045-34 AZITHROMYCIN IN NS 500 MG/250 ML IV SOLN (MHS) $32.50 99999-046-35 VANCOMYCIN 1250 MG IN NS 250 ML IVPB (SLH) $32.50 21922-017-04 CLOBETASOL 0.05 % TOPICAL OINT $32.47 HC89011639 NEURON SPECIFIC ENOLASE-AU $32.43 13668-586-30 ERYTHROMYCIN 250 MG ORAL TBEC $32.43 52536-180-03 ERYTHROMYCIN 250 MG ORAL TBEC $32.43 0409-1761-05 BUPIVACAINE-DEXTROSE-WATER(PF) 0.75 % (7.5 MG/ML) INJ SOLN $32.41 0409-1761-10 BUPIVACAINE-DEXTROSE-WATER(PF) 0.75 % (7.5 MG/ML) INJ SOLN $32.41 0074-7362-01 CARBAMIDE PEROXIDE 6.5 % OTIC DROP $32.37 63323-185-20 WATER FOR INJECTION, STERILE INJ SOLN $32.37 68084-651-25 CLARITHROMYCIN 500 MG ORAL TAB $32.37 68084-651-95 CLARITHROMYCIN 500 MG ORAL TAB $32.37 72572-651-01 ROCURONIUM 10 MG/ML IV SOLN $32.37 72572-651-10 ROCURONIUM 10 MG/ML IV SOLN $32.37 11523-4112-1 OXYMETAZOLINE 0.05 % NASL SPRY $32.27 45802-054-35 TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINT $32.27 30698-032-01 ISOCARBOXAZID 10 MG ORAL TAB $32.22 1093935444 CETIRIZINE 1 MG/ML ORAL SOLN $32.21 49348-934-34 CETIRIZINE 1 MG/ML ORAL SOLN $32.21 70677-0014-1 CETIRIZINE 1 MG/ML ORAL SOLN $32.21 HC89009757 PROINSULIN-AU $32.18 0409-3182-03 LIDOCAINE-EPINEPHRINE 2 %-1:100,000 INJ SOLN $32.18 0409-3182-31 LIDOCAINE-EPINEPHRINE 2 %-1:100,000 INJ SOLN $32.18 70069-421-01 LATANOPROST 0.005 % OPHT DROP $32.18 0254-3028-02 LUBIPROSTONE 8 MCG ORAL CAP $32.16 0254-3029-02 LUBIPROSTONE 24 MCG ORAL CAP $32.16 0904-6707-82 SEVELAMER CARBONATE 800 MG ORAL TAB $32.16 HC89010987 C2 COMPLEMENT-AU $32.15 16714-964-01 ASPIRIN-DIPYRIDAMOLE 25-200 MG ORAL CM12 $32.15 16714-267-01 TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINT $32.08 HC89015911 ACIDFAST BACILL STAIN (OTH)-QD $32.00 HC89014047 ANA-RD $32.00 HC89011944 ANTI MICROSOMAL THYROID-ES $32.00 HC89004634 ANTI-CBIR1 (PNL)-PR $32.00 HC89011183 ANTI-CCP AB (PNL)-RD $32.00 HC89004626 ANTI-OMPC IGA (PNL)-PR $32.00 HC89011233 ANTI-RO SS-A (PNL)-RD $32.00 HC89004592 ASCA IGA (PNL)-PR $32.00 HC89004600 ASCA IGG (PNL)-PR $32.00 HC89500490 BLOOD TYPE SEROLOGIC; ABO-SB $32.00 HC89006654 BROMIDES-AU $32.00 HC89016083 CARNITINE FREE & TOTAL-MA $32.00 HC51062446 CPSP ANTEPRTM HEALTH ED F/U ASSES/TX GROUP; EA 15MIN $32.00 HC51062438 CPSP ANTEPRTM HEALTH ED F/U ASSESS/TX INDIV'; EA 15MIN $32.00 HC51062321 CPSP ANTEPRTM NUTRITION F/U ASSESS,TX, INDIVIDUAL; EA 15MIN $32.00 HC51062370 CPSP ANTEPRTM PSYCHOSOCIAL F/U ASSESS/TX INDIV'; EA 15MIN $32.00 HC51062404 CPSP CLIENT ORIENTATION/HEALTH ED; EA 15MIN $32.00 HC51062420 CPSP INITIAL HEALTH ED ASSESS/DEV POC; EA SUBSQ' 15MIN $32.00 HC51062313 CPSP NUTRITION INIT' ASSESS AND DEV POC; EA ADD' 15MIN $32.00 HC51062461 CPSP PERINATAL ED, GROUP; EA 15MIN $32.00 HC51062453 CPSP PERINATAL ED, INDIV'; EA 15MIN $32.00 HC51062479 CPSP POSTPRTM HEALTH ED ASSESS, TX POC INDIV'; EA 15MIN $32.00 HC51062347 CPSP POSTPRTM NUTRITION ASSES,TX POC INDVIDUAL;EA 15MIN $32.00 HC51062396 CPSP POSTPRTM PSYCHOSOCIAL ASSESS, TX POC; INDIV'; EA 15MIN $32.00 HC51062362 CPSP PSYCHOSOCIAL INIR' ASSESS/DEV;EA SUBSQ 15MIN $32.00 HC89022958 NET ABSORBANCE, BILIRUBIN CSF(PANEL)-AU $32.00 HC89022966 NET ABSORBANCE, OXYHEMOGLOBIN, CSF(PANEL)-AU $32.00 HC89004618 PANCA IGG (PNL)-PR $32.00 HC89014252 RHEUMATOID FACT IGM (PNL)-RD $32.00 HC89012835 RICKETTSIA AB PANEL-AU $32.00 HC88600234 SPECIAL COURIER 25 $32.00 HC51062206 URINALYSIS MICROSCOPIC ONLY $32.00 HC88600309 VENIPUNCTURE ROUTINE SPECIAL CLIENT $32.00 HC85100469 WBC MANUAL DIFF $32.00 0472-0337-20 HYDROCORTISONE 2.5 % TOPICAL CREAM $31.98 0904-6767-20 LORATADINE 5 MG/5 ML ORAL SOLN $31.98 63323-282-06 CLINDAMYCIN PHOSPHATE 150 MG/ML INJ SOLN $31.86 0536-1211-95 DIBUCAINE 1 % TOPICAL OINT $31.85 0781-3232-94 PANTOPRAZOLE 40 MG IV SOLR $31.85 0781-3232-95 PANTOPRAZOLE 40 MG IV SOLR $31.85 0990-7074-26 POTASSIUM CHLORIDE IN WATER 10 MEQ/100 ML IV PGBK $31.85 50458-300-01 RISPERIDONE 1 MG ORAL TAB $31.85 71399-5101-2 WHITE PETROLATUM 42 % TOPICAL OINT $31.85 99999-007-63 LIDOCAINE HCL 2 % MUCOUS MEMB SOLN $31.85 99999-043-14 AMIKACIN 40 MG/5 ML INJ SOLN IN D5W (MCH-NICU) $31.85 0121-0892-50 PHENYTOIN 100 MG/4 ML ORAL SUSP $31.82 0121-0892-63 PHENYTOIN 100 MG/4 ML ORAL SUSP $31.82 66689-036-50 PHENYTOIN 100 MG/4 ML ORAL SUSP $31.82 99999-037-58 PHYTONADIONE 1 MG/0.5 ML INJ SOLN DILUTION (COMPOUNDED) $31.82 99999-039-75 PHYTONADIONE 1 MG/ML ORAL SOLUTION (USING INJECTABLE TO MAKE SOLUTION) (LBM) $31.82 2660801201 L. ACIDOPHILUS,CASEI,RHAMNOSUS 100 BILLIION CELL/104 ML ORAL LIQD $31.77 HC89007850 DEOXYCORTISOL 11-AU $31.75 65219-433-01 PANTOPRAZOLE 40 MG IV SOLR $31.72 65219-433-15 PANTOPRAZOLE 40 MG IV SOLR $31.72 62175-485-37 VERAPAMIL 100 MG ORAL CPCT $31.70 30768-02791 VITAMIN E TOPICAL OIL $31.69 50268-178-11 CLARITHROMYCIN 250 MG ORAL TAB $31.62 50268-178-15 CLARITHROMYCIN 250 MG ORAL TAB $31.62 63323-024-01 MANNITOL 25 % 25 % IV SOLN $31.53 63323-024-25 MANNITOL 25 % 25 % IV SOLN $31.53 67457-228-00 ROCURONIUM 10 MG/ML IV SOLN $31.53 67457-228-05 ROCURONIUM 10 MG/ML IV SOLN $31.53 67457-351-01 AMPICILLIN SODIUM 1 GRAM INJ SOLR $31.53 67457-351-10 AMPICILLIN SODIUM 1 GRAM INJ SOLR $31.53 HC89013437 FLUOXETINE; 1-2-AU $31.50 55150-113-10 AMPICILLIN SODIUM 1 GRAM INJ SOLR $31.49 72266-147-01 ETOMIDATE 2 MG/ML IV SOLN $31.46 72266-147-10 ETOMIDATE 2 MG/ML IV SOLN $31.46 16864-680-01 BENZOCAINE-MENTHOL 20-0.5 % TOPICAL AEROSOL $31.43 0409-4283-01 LIDOCAINE (PF) 40 MG/ML (4 %) INJ SOLN $31.43 0409-4283-11 LIDOCAINE (PF) 40 MG/ML (4 %) INJ SOLN $31.43 0409-4283-25 LIDOCAINE (PF) 40 MG/ML (4 %) INJ SOLN $31.43 64896-664-01 CARBIDOPA-LEVODOPA 61.25-245 MG ORAL CPSR $31.42 HC89022503 CULTURE ID W/IMMUNOFLUOR' VZV(PNL)-AU $31.40 1011902090 NAPHAZOLINE-PHENIRAMINE 0.02675-0.315 % OPHT DROP $31.40 0904-6269-08 ZIPRASIDONE HCL 20 MG ORAL CAP $31.36 62541-404-10 LIPASE-PROTEASE-AMYLASE 16,800-56,800- 98,400 UNIT ORAL CPDR $31.34 0409-6653-05 POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN $31.33 0409-6653-18 POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN $31.33 63739-003-33 TEMAZEPAM 7.5 MG ORAL CAP $31.31 HC89018998 BORDETELLA PERTUS IMMUNOBLOT IGA-AU $31.30 0781-6157-57 AMOXICILLIN 400 MG/5 ML ORAL SUSR $31.20 10939-27444 ALOE VERA TOPICAL GEL $31.20 36000-324-01 LABETALOL 5 MG/ML IV SOLN $31.20 36000-324-02 LABETALOL 5 MG/ML IV SOLN $31.20 43598-127-25 METHYLPREDNISOLONE SODIUM SUCC 40 MG INJ SOLR $31.20 43598-127-45 METHYLPREDNISOLONE SODIUM SUCC 40 MG INJ SOLR $31.20 63323-403-01 FOSPHENYTOIN 100 MG PE/2 ML INJ SOLN $31.20 63323-403-02 FOSPHENYTOIN 100 MG PE/2 ML INJ SOLN $31.20 65862-071-75 AMOXICILLIN 400 MG/5 ML ORAL SUSR $31.20 66794-228-02 ROCURONIUM 10 MG/ML IV SOLN $31.20 66794-228-41 ROCURONIUM 10 MG/ML IV SOLN $31.20 99999-035-54 DOBUTAMINE IN D5W (CONC: 2000 MCG/ML) (LBM) $31.20 99999-045-16 MELATONIN 1 MG/ML ORAL LIQUID (COMPOUND) $31.20 99999-046-36 VANCOMYCIN 1500 MG IN NS 300 ML IVPB (SLH) $31.20 0904-7120-04 COLCHICINE 0.6 MG ORAL TAB $31.19 63323-616-02 AMIODARONE 50 MG/ML IV SOLN $31.18 63323-616-09 AMIODARONE 50 MG/ML IV SOLN $31.18 16714-830-01 MESALAMINE 1.2 GRAM ORAL TBEC $31.17 59011-410-20 OXYCODONE 10 MG ORAL TR12 $31.10 16714-165-01 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG/ML INJ SOLN $31.04 16714-165-25 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG/ML INJ SOLN $31.04 HC89003669 ADENOSINE DEAMINASE-AU $31.00 HC89006159 AMPHETAMINE 1-2-AU $31.00 HC89017818 ANTI-RO SS-A (PNL)-RD $31.00 HC89006332 BENZODIAZEPINES; 1-12-AU $31.00 HC89004840 ESTRONE BY TMS-AU $31.00 HC89009849 SEROTONIN-AU $31.00 HC89019293 TSH RECEPTOR AB (TRAB)-AU $31.00 70092-1046-46 PHENYLEPHRINE HCL IN 0.9% NACL 1 MG/10 ML (100 MCG/ML) IV SYRG $30.94 25021-115-06 CLINDAMYCIN PHOSPHATE 150 MG/ML INJ SOLN $30.89 HC89007405 CARNITINE FREE & TOTAL-AU $30.88 0409-4275-01 LIDOCAINE HCL 5 MG/ML (0.5 %) INJ SOLN $30.88 63323-472-17 BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJ SOLN $30.88 63323-824-24 DEXTROSE 10 % IN WATER (D10W) 10 % IV SOLP $30.88 63323-824-74 DEXTROSE 10 % IN WATER (D10W) 10 % IV SOLP $30.88 67457-455-00 CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) INJ SOLN $30.88 99999-046-38 ARGININE HCL 2.5 MEQ/ML ORAL LIQUID $30.88 16714-476-01 AMOXICILLIN-POT CLAVULANATE 250-125 MG ORAL TAB $30.85 0409-9157-01 PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJ SOLN $30.85 0409-9157-31 PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJ SOLN $30.85 0409-9157-50 PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJ SOLN $30.85 46122-547-03 SIMETHICONE 40 MG/0.6 ML ORAL DRPS $30.81 4858200330 SALIVA SUBSTITUTE COMBO NO.9 MUCOUS MEMB MWSH $30.75 67618-150-17 POVIDONE-IODINE 10 % TOPICAL SOLN $30.75 0409-6635-01 POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN $30.71 0409-6635-18 POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN $30.71 0904-7144-61 DRONABINOL 2.5 MG ORAL CAP $30.71 0904-6821-04 TENOFOVIR DISOPROXIL FUMARATE 300 MG ORAL TAB $30.65 0409-4903-11 LIDOCAINE HCL 100 MG/5 ML IV SYRG $30.62 0409-4903-34 LIDOCAINE HCL 100 MG/5 ML IV SYRG $30.62 63323-173-01 GENTAMICIN SULFATE (PED) (PF) 20 MG/2 ML INJ SOLN $30.55 63323-173-02 GENTAMICIN SULFATE (PED) (PF) 20 MG/2 ML INJ SOLN $30.55 70436-019-82 AZITHROMYCIN 500 MG IV SOLR $30.55 99999-046-60 GENTAMICIN 2 MG/ML INJ SOLN IN D5W (MCH-NICU) $30.55 16714-743-02 ITRACONAZOLE 100 MG ORAL CAP $30.47 45013404 LOPERAMIDE 1 MG/7.5 ML ORAL LIQD $30.42 50580-134-04 LOPERAMIDE 1 MG/7.5 ML ORAL LIQD $30.42 0597-0039-37 TELMISARTAN 20 MG ORAL TAB $30.39 0597-0040-37 TELMISARTAN 40 MG ORAL TAB $30.39 59011-410-10 OXYCODONE 10 MG ORAL TR12 $30.28 51672-2075-2 BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINT $30.28 0006-0032-20 IVERMECTIN 3 MG ORAL TAB $30.25 0143-9889-15 AMOXICILLIN 250 MG/5 ML ORAL SUSR $30.23 0168-0006-15 TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINT $30.23 0409-3299-05 SODIUM ACETATE 2 MEQ/ML IV SOLN $30.23 0409-3299-15 SODIUM ACETATE 2 MEQ/ML IV SOLN $30.23 10135-738-01 RIFABUTIN 150 MG ORAL CAP $30.18 0024-5150-06 CAMPHOR-PHENOL 10.8-4.7 % TOPICAL SOLN $30.13 99999-046-16 IOHEXOL 300 MG IODINE/ML IV SOLN $30.13 23155-497-31 PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN $30.07 23155-497-42 PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN $30.07 121119000 SODIUM CITRATE-CITRIC ACID 500-334 MG/5 ML ORAL SOLN $30.03 121119030 SODIUM CITRATE-CITRIC ACID 500-334 MG/5 ML ORAL SOLN $30.03 HC89009682 17-HYDROXYPREGNENOLONE-AU $30.00 HC89009591 ALK PHOS ISO BONE SPECIFIC-AU $30.00 HC89022032 AMPHETAMINES;1 OR 2 SERUM QNT(PNL)-AU $30.00 HC89005045 CALCIUM IONIZED-U2 $30.00 HC89005441 CULTURE - CHLAMYDIA STAIN-FT $30.00 HC89006399 DIAZEPAM; 1-12-AU $30.00 HC89021646 DRUGS OF ABUSE SCRN MEC W-RFLX CONF(PNL)-AU $30.00 HC89017677 GLOMERULAR BSMT MEM EL(PNL)-AU $30.00 HC89017040 HEPARIN AB DETECTION-AU $30.00 HC89015945 HEPATITIS B SURFACE AG (DS)-QD $30.00 HC89015739 IMMUNOFIXATION ELECT(URINE)-QD $30.00 HC89015663 INHIB PROTEIN S FREE (FUNC)-QD $30.00 HC89017719 MYELIN BASIC PROTEIN(PNL)-AU $30.00 HC83500157 PAP SMEAR PATH INTERP+ -PI $30.00 HC89005839 PHENOBARBITAL-U2 $30.00 HC89017115 REPTILASE TIME 1:1 MIX-AU $30.00 HC89006886 SIROLIMUS(RAPAMUNE)-AU $30.00 HC89010029 T4 FREE-AU $30.00 HC89001259 THYROXINE BIND GLOBULIN-QD $30.00 HC51003408 URINALYSIS AUTO W/O MICRO $30.00 4687600025 MENTHOL-ZINC OXIDE 0.44-20.6 % TOPICAL OINT $30.00 4687600030 MENTHOL-ZINC OXIDE 0.44-20.6 % TOPICAL OINT $30.00 8770142972 ALUM-MAG HYDROXIDE-SIMETH 400-400-40 MG/5 ML ORAL SUSP $30.00 0799-0001-02 MENTHOL-ZINC OXIDE 0.44-20.6 % TOPICAL OINT $30.00 0378-2096-01 NISOLDIPINE 8.5 MG ORAL TB24 $29.94 50111-789-10 AZITHROMYCIN 600 MG ORAL TAB $29.93 52959-112-30 SIMVASTATIN 40 MG ORAL TAB $29.91 0406-8390-23 MORPHINE 100 MG ORAL TBSR $29.90 0406-8390-62 MORPHINE 100 MG ORAL TBSR $29.90 0574-0791-01 METHAZOLAMIDE 50 MG ORAL TAB $29.90 55390-077-10 PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN $29.90 99999-000-43 NAFCILLIN 40 MG / ML SYRINGE $29.90 72572-022-01 AMPICILLIN-SULBACTAM 3 G IV SOLR (MCH) $29.84 72572-022-10 AMPICILLIN-SULBACTAM 3 G IV SOLR (MCH) $29.84 7811273621 CARBAMIDE PEROXIDE 6.5 % OTIC DROP $29.74 HC89010227 ARGININE VASOPRESSIN HORMON-AU $29.73 0409-1749-10 BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJ SOLN $29.64 0409-1749-70 BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJ SOLN $29.64 45802-434-11 CLOTRIMAZOLE 1 % TOPICAL CREAM $29.64 63323-466-03 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN $29.64 63323-466-17 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN $29.64 225052848 SODIUM CHLORIDE-ALOE VERA NASL SPRY $29.60 0409-3299-26 SODIUM ACETATE 2 MEQ/ML IV SOLN $29.58 0409-3299-46 SODIUM ACETATE 2 MEQ/ML IV SOLN $29.58 70954-484-10 PYRAZINAMIDE 500 MG ORAL TAB $29.56 72603-128-01 PANTOPRAZOLE 40 MG IV SOLR $29.55 72603-128-10 PANTOPRAZOLE 40 MG IV SOLR $29.55 16864-680-02 BENZOCAINE-MENTHOL 20-0.5 % TOPICAL AEROSOL $29.48 0409-1323-05 LIDOCAINE HCL 100 MG/5 ML IV SYRG $29.35 0409-1323-15 LIDOCAINE HCL 100 MG/5 ML IV SYRG CODE NEO $29.35 45802-055-35 TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINT $29.35 99999-000-38 VANCOMYCIN 250 MG / 5 ML ORAL SYRINGE $29.32 0071-0525-24 METHSUXIMIDE 300 MG ORAL CAP $29.25 0264-7707-10 ELECTROLYTE-S (PH 7.4) IV SOLP $29.25 0338-0085-03 D5 %-0.45 % SODIUM CHLORIDE IV SOLP $29.25 0338-0117-02 LACTATED RINGERS IV SOLP $29.25 0338-0117-03 LACTATED RINGERS IV SOLP $29.25 0409-7100-02 DEXTROSE 5 % IN WATER (D5W) 5 % IV PGBK $29.25 0409-7101-02 SODIUM CHLORIDE 0.9 % IV PGBK $29.25 0548-5601-00 ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRG $29.25 0641-6174-01 OCTREOTIDE ACETATE 50 MCG/ML INJ SOLN $29.25 0641-6174-10 OCTREOTIDE ACETATE 50 MCG/ML INJ SOLN $29.25 0703-3301-01 OCTREOTIDE ACETATE 50 MCG/ML INJ SOLN $29.25 0703-3301-04 OCTREOTIDE ACETATE 50 MCG/ML INJ SOLN $29.25 23155-687-31 OCTREOTIDE ACETATE 50 MCG/ML INJ SOLN $29.25 23155-687-41 OCTREOTIDE ACETATE 50 MCG/ML INJ SOLN $29.25 25021-451-01 OCTREOTIDE ACETATE 50 MCG/ML INJ SOLN $29.25 25021-701-01 KETOROLAC 30 MG/ML (1 ML) INJ SOLN $29.25 39822-4200-1 ROCURONIUM 10 MG/ML IV SOLN $29.25 39822-4200-2 ROCURONIUM 10 MG/ML IV SOLN $29.25 44567-235-25 CEFTAZIDIME 1 GRAM INJ SOLR $29.25 47781-570-36 LIDOCAINE 4 % TOPICAL CREAM $29.25 55150-181-09 AMIODARONE 50 MG/ML IV SOLN $29.25 55390-612-10 ACYCLOVIR SODIUM 500 MG IV SOLR $29.25 63323-519-02 HEPARIN (PORCINE) IN NACL (PF) 1,000 UNIT/500 ML IV SOLP $29.25 63323-519-77 HEPARIN (PORCINE) IN NACL (PF) 1,000 UNIT/500 ML IV SOLP $29.25 68180-677-11 OSELTAMIVIR 75 MG ORAL CAP $29.25 69238-1532-5 CLOBETASOL 0.05 % TOPICAL CREAM $29.25 69374-511-01 KETAMINE IN STERILE WATER 50 MG/ML INJ SYRG $29.25 69680-112-01 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG/ML INJ SOLN $29.25 71288-410-81 ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRG $29.25 99999-044-30 OXYTOCIN IN 0.9 % SOD CHLORIDE 30 UNIT/500 ML IV SOLN $29.25 99999-044-47 AMIODARONE IN D5W 450 MG/250 ML (1.8 MG/ML) IV SOLN (MHS) $29.25 HC89009047 MYELIN BASIC PROTEIN CSF-AU $29.24 58914-171-10 SUCRALFATE 1 GRAM ORAL TAB $29.24 13668-190-30 TOLTERODINE 4 MG ORAL CP24 $29.22 1031028313 BENZOCAINE-MENTHOL-ZINC CHLOR 20-0.26-0.15 % MUCOUS MEMB GEL $29.16 4203710478 CARBAMIDE PEROXIDE 6.5 % OTIC DROP $29.15 6056906204 DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML ORAL LIQD $29.15 6056906304 GUAIFENESIN 100 MG/5 ML ORAL LIQD $29.15 6961800858 MULTIVIT-MIN-FERROUS GLUCONATE 9 MG IRON/15 ML ORAL LIQD $29.15 0904-2528-20 PYRETHRINS-PIPERONYL BUTOXIDE 0.33-4 % TOPICAL SHAM $29.15 61787-062-04 DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML ORAL LIQD $29.15 61787-513-04 DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML ORAL LIQD $29.15 0121-0910-30 BISMUTH SUBSALICYLATE 262 MG/15 ML ORAL SUSP $29.06 0409-1560-19 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN $29.06 0409-1560-29 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN $29.06 99999-041-76 IVABRADINE 2.5 MG ORAL PARTIAL TAB $29.04 60687-671-40 PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIX $29.02 HC89008437 17-OH CORTICOSTEROIDS-QN $29.00 HC89015937 B. PARAPERTUSSIS/PERT DFA-QD $29.00 HC89006381 CLONAZEPAM; 1-12-AU $29.00 HC89008247 FSH-ES $29.00 HC89016349 HELICOBACTER PYLORI AG-QD $29.00 HC89015812 HEPATITIS A ANTIBODY -QD $29.00 HC89015978 HIV AB WESTERN BLOT-QD $29.00 HC89000442 IMMUNE COMPLEXES RAJI CELL-QD $29.00 HC89015747 LYMPH ABS CD4/CD8 CNT(PNL)-QD $29.00 HC89006829 MEXILETINE-AU $29.00 HC89015358 N-TELOPEPTIDE CROSSLINK UR-QD $29.00 HC89021570 PREGNENOLONE, SERUM/PLASMA-AU $29.00 HC51070712 PSYCH TEAM CONF PRTCPNT PER 15MIN $29.00 HC89015838 ROCKY MT SPOTTED FEVER AB-QD $29.00 HC89001390 STRIATED MUSCLE FA AB SCRN-QD $29.00 HC51000016 URINALYSIS NON-AUTO W/O MICRO $29.00 HC89010219 VASOACTIVE INTEST PEPTIDE-AU $29.00 0409-9042-01 BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJ SOLN $28.99 0409-9042-11 BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJ SOLN $28.99 0409-1283-17 HYDROMORPHONE 1 MG/ML INJ SOLN (MHS) $28.97 0409-1283-37 HYDROMORPHONE 1 MG/ML INJ SOLN (MHS) $28.97 0378-7155-01 BUDESONIDE 3 MG ORAL CECX $28.93 70092-1175-46 LIDOCAINE 1%/NA BICARB 10:1 INJ $28.93 0591-2245-22 MESALAMINE 1.2 GRAM ORAL TBEC $28.90 0409-2596-03 MIDAZOLAM 5MG/ML INJECTABLE SOLUTION (MHS) $28.89 0409-2596-13 MIDAZOLAM 5MG/ML INJECTABLE SOLUTION (MHS) $28.89 72266-146-01 ETOMIDATE 2 MG/ML IV SOLN $28.86 72266-146-10 ETOMIDATE 2 MG/ML IV SOLN $28.86 33342-447-11 PYRAZINAMIDE 500 MG ORAL TAB $28.81 HC89010920 PLATELET ASSOCIATED ABS-AU $28.78 65862-070-75 AMOXICILLIN 200 MG/5 ML ORAL SUSR $28.76 43975-252-14 TEMOZOLOMIDE 5 MG ORAL CAP (MCH) $28.74 51079-518-20 CHLORPROMAZINE 10 MG ORAL TAB $28.73 HC89006175 HALOPERIDOL-AU $28.70 0472-1915-01 MESALAMINE 1,000 MG RECTAL SUPP $28.70 0472-1915-30 MESALAMINE 1,000 MG RECTAL SUPP $28.70 68084-947-32 QUININE SULFATE 324 MG ORAL CAP $28.68 68084-947-33 QUININE SULFATE 324 MG ORAL CAP $28.68 70092-1119-44 KETAMINE IN 0.9 % SOD CHLORIDE 50 MG/5 ML (10 MG/ML) IV SYRG $28.67 HC89006720 FLECAINIDE-AU $28.65 0093-2272-34 AMOXICILLIN-POT CLAVULANATE 400-57 MG ORAL CHEW $28.65 0088-2102-01 RIFAPENTINE 150 MG ORAL TAB $28.64 0088-2102-24 RIFAPENTINE 150 MG ORAL TAB $28.64 0409-4887-25 WATER FOR INJECTION, STERILE INJ SOLN $28.60 0409-4887-99 WATER FOR INJECTION, STERILE INJ SOLN $28.60 25021-107-20 CEFTRIAXONE 2 GRAM INJ SOLR $28.60 25021-184-67 FLUCONAZOLE IN SALINE 400 MG/200 ML IV PGBK (MCH) $28.60 43066-008-01 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $28.60 43066-008-10 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $28.60 55150-194-10 ESMOLOL 100 MG/10 ML (10 MG/ML) IV SOLN $28.60 55150-235-01 VECURONIUM BROMIDE 10 MG IV SOLR $28.60 55150-235-10 VECURONIUM BROMIDE 10 MG IV SOLR $28.60 55150-304-01 DEXAMETHASONE SODIUM PHOS (PF) 10 MG/ML INJ SOLN $28.60 55150-304-25 DEXAMETHASONE SODIUM PHOS (PF) 10 MG/ML INJ SOLN $28.60 72266-103-01 LABETALOL 5 MG/ML IV SOLN $28.60 0093-9020-19 CYCLOSPORINE MODIFIED 100 MG ORAL CAP $28.58 0093-9020-65 CYCLOSPORINE MODIFIED 100 MG ORAL CAP $28.58 60505-4632-3 CYCLOSPORINE MODIFIED 100 MG ORAL CAP $28.58 HC89023956 MONONUC CELL ANTGN FLAER&CD157-DEF MONOS-AU $28.57 HC89023964 MONONUC CELL ANTGN FLAER&CD157-DEF NEUTROPHIL-AU $28.57 HC89023998 MONONUC CELL ANTGN PNH PHENOTYPE MONOCYTE-AU $28.57 HC89023980 MONONUC CELL ANTGN PNH PHENOTYPE NEUTROPHIL-AU $28.57 HC89023972 MONONUC CELL ANTIGEN PNH PHENOTYPE RBC-AU $28.57 HC89023931 MONONUC CELL ANTIGEN(I)CD59-DEF RBC-AU $28.57 HC89023949 MONONUC CELL ANTIGEN(II)CD59-DEF RBC-AU $28.57 0121-1884-07 PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIX $28.57 0904-7168-61 URSODIOL 300 MG ORAL CAP $28.56 HC89009666 PORPHYRINS FRACT URINE-AU $28.55 63323-483-03 LIDOCAINE-EPINEPHRINE 2 %-1:100,000 INJ SOLN $28.47 63323-483-27 LIDOCAINE-EPINEPHRINE 2 %-1:100,000 INJ SOLN $28.47 99999-041-04 AMPHOTERICIN B 0.5 MG/ML TOPICAL SOLUTION (COMPOUNDED) $28.41 HC89010995 C5 COMPLEMENT-AU $28.38 44567-311-10 PENICILLIN G POTASSIUM 5 MILLION UNIT INJ SOLR $28.34 60758-188-05 GENTAMICIN 0.3 % OPHT DROP $28.34 0069-5800-61 DOFETILIDE 125 MCG ORAL CAP $28.31 59762-1001-1 SIROLIMUS 0.5 MG ORAL TAB $28.31 0527-1318-01 TERBUTALINE 2.5 MG ORAL TAB $28.30 69918-301-30 TRANEXAMIC ACID 650 MG ORAL TAB $28.24 0409-1582-10 BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJ SOLN $28.21 0409-1582-18 BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJ SOLN $28.21 51672-1284-1 TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINT $28.18 49884-301-01 OXANDROLONE 2.5 MG ORAL TAB $28.11 51672-2001-2 MICONAZOLE NITRATE 2 % TOPICAL CREAM $28.08 63323-482-03 LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN $28.08 63323-482-27 LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN $28.08 HC89013155 CLOSTRIDIUM DIFFICILE TOXIN-AU $28.05 HC89009781 PYRUVATE-AU $28.05 11868-814-01 PRAMOXINE-ZINC OXIDE 1-5 % TOPICAL CREAM $28.03 0409-1560-10 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN $28.02 0409-1560-18 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN $28.02 99999-037-69 ACETYLCYSTEINE 100 MG/ML (10 %) MISC SOLN $28.02 HC89007421 CATECHOLAMINES FRACT-AU $28.00 HC89017065 CHLAMYDIA FA ANTIGEN-AU $28.00 HC89000525 COXSACKIE A AB-SL $28.00 HC89019558 GLIAD PEPTD AB IGA(PNL1155/6360)-PR $28.00 HC89019566 GLIAD PEPTD AB IGG(PNL1155/6360)-PR $28.00 HC62210471 GLOVE NEOPRENE W/THUMB SPLINT $28.00 HC89020150 ICAM CHEMILUMINESCENT (PNL)-PR $28.00 HC83505248 IHC/IP PER SPEC EA ADD AB STAIN+ -PI $28.00 HC89017701 OLIGOCLONAL BANDS (PNL)-AU $28.00 HC89022115 OPIATES 1 OR MORE SERUM QNT(PNL) -AU $28.00 HC89022123 OXYCODONE SERUM QNT(PNL) -AU $28.00 HC83500066 RECEPTOR ASSAY, ESTROGEN-PI $28.00 HC83500074 RECEPTOR ASSAY, PROGESTERON-PI $28.00 HC89017453 REPTILASE TIME RFX- AU $28.00 HC89017107 REPTILASE TIME-AU $28.00 HC89020176 SAA CHEMILUMINESCENT (PNL)-PR $28.00 HC89010037 THYROXINE BIND GLOBULIN-ES $28.00 HC89020168 VCAM CHEMILUMINESCENT (PNL)-PR $28.00 HC89020143 VEGF ELISA(PNL)-PR $28.00 0409-4278-01 LIDOCAINE (PF) 5 MG/ML (0.5 %) INJ SOLN $27.95 0409-4278-16 LIDOCAINE (PF) 5 MG/ML (0.5 %) INJ SOLN $27.95 66794-206-02 AMPICILLIN-SULBACTAM 1.5 GRAM INJ SOLR $27.95 66794-206-41 AMPICILLIN-SULBACTAM 1.5 GRAM INJ SOLR $27.95 81079888 BACITRACIN ZINC-POLYMYXIN B 500-10,000 UNIT/GRAM TOPICAL OINT $27.88 68220-115-10 HYOSCYAMINE SULFATE 0.375 MG ORAL TB12 $27.83 0074-0522-60 LOPINAVIR-RITONAVIR 100-25 MG ORAL TAB $27.74 HC89008650 TRYPSIN-AU $27.73 1093914233 POVIDONE-IODINE 10 % TOPICAL SOLN $27.73 0009-0902-11 CLINDAMYCIN PHOSPHATE 150 MG/ML INJ SOLN $27.73 0009-0902-18 CLINDAMYCIN PHOSPHATE 150 MG/ML INJ SOLN $27.73 0409-5082-11 CEFTAZIDIME 1 GRAM INJ SOLR $27.72 0409-5082-16 CEFTAZIDIME 1 GRAM INJ SOLR $27.72 99999-000-07 CEFTAZIDIME 1000 MG / 10 ML SYRINGE $27.72 121059515 SODIUM CITRATE-CITRIC ACID 500-334 MG/5 ML ORAL SOLN $27.69 1093957144 ALUM-MAG HYDROXIDE-SIMETH 400-400-40 MG/5 ML ORAL SUSP $27.69 1093957844 ALUM-MAG HYDROXIDE-SIMETH 400-400-40 MG/5 ML ORAL SUSP $27.69 0904-7727-14 ALUMINUM HYDROX-MAGNESIUM CARB 95-358 MG/15 ML ORAL SUSP $27.69 49348-302-39 ALUM-MAG HYDROXIDE-SIMETH 400-400-40 MG/5 ML ORAL SUSP $27.69 49348-303-39 ALUM-MAG HYDROXIDE-SIMETH 400-400-40 MG/5 ML ORAL SUSP $27.69 66689-023-50 HYDROCODONE-ACETAMINOPHEN 7.5-325 MG/15 ML ORAL SOLN $27.69 0536-1314-85 GUAIFENESIN 100 MG/5 ML ORAL LIQD $27.67 0409-0528-13 LEVOFLOXACIN IN D5W 250 MG/50 ML IV PGBK $27.63 0409-0528-15 LEVOFLOXACIN IN D5W 250 MG/50 ML IV PGBK $27.63 0409-4282-02 LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN $27.63 0409-4282-12 LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN $27.63 70436-020-82 VANCOMYCIN 500 MG IV SOLR $27.63 99999-046-42 SUCRALFATE 100 MG/ML ORAL SUSP $27.63 1093948233 DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML ORAL LIQD $27.61 49348-861-37 DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML ORAL LIQD $27.61 66689-023-01 HYDROCODONE-ACETAMINOPHEN 7.5-325 MG/15 ML ORAL SOLN $27.59 67877-251-15 TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM $27.59 50268-470-11 LEVETIRACETAM 500 MG/5 ML (5 ML) ORAL SOLN $27.56 50268-470-13 LEVETIRACETAM 500 MG/5 ML (5 ML) ORAL SOLN $27.56 0025-2732-31 DISOPYRAMIDE PHOSPHATE 100 MG ORAL CPSR $27.52 HC89023378 ANTIBODY SARS-COV-2 COVID-19 QUAL CIA-AU $27.50 0409-1559-19 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $27.50 0409-1559-30 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $27.50 55150-172-30 BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJ SOLN $27.50 68084-879-25 CYCLOSPORINE 25 MG ORAL CAP $27.48 68084-879-95 CYCLOSPORINE 25 MG ORAL CAP $27.48 36000-320-01 LABETALOL 5 MG/ML IV SOLN $27.43 36000-320-10 LABETALOL 5 MG/ML IV SOLN $27.43 HC89008403 HISTAMINE, WHOLE BLOOD-AU $27.40 HC89023766 INHIBIN A-AU $27.40 0409-1746-10 BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJ SOLN $27.37 0409-1746-70 BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJ SOLN $27.37 0069-0059-03 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $27.31 0069-0059-04 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $27.31 5483801150 FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROP $27.30 0409-4277-02 LIDOCAINE HCL 20 MG/ML (2 %) INJ SOLN $27.30 0409-4277-17 LIDOCAINE HCL 20 MG/ML (2 %) INJ SOLN $27.30 0641-6116-01 AMPICILLIN-SULBACTAM 1.5 GRAM INJ SOLR $27.30 0641-6116-10 AMPICILLIN-SULBACTAM 1.5 GRAM INJ SOLR $27.30 47781-616-17 ROCURONIUM 10 MG/ML IV SOLN $27.30 47781-616-20 ROCURONIUM 10 MG/ML IV SOLN $27.30 68462-497-76 ZOLMITRIPTAN 2.5 MG ORAL TAB $27.28 0025-1451-34 MISOPROSTOL 100 MCG ORAL TAB $27.25 62135-350-30 ONDANSETRON HCL 4 MG ORAL TAB $27.21 HC89005961 DRUGS OF ABUSE TEST-DTI 7A-AU $27.20 0409-6102-02 FUROSEMIDE 10 MG/ML INJ SOLN $27.18 0409-6102-19 FUROSEMIDE 10 MG/ML INJ SOLN $27.18 58232-071-93 ZINC OXIDE 13 % TOPICAL CREAM $27.18 0121-0945-00 MEGESTROL 400 MG/10 ML (10 ML) ORAL SUSP $27.17 0121-0945-10 MEGESTROL 400 MG/10 ML (10 ML) ORAL SUSP $27.17 59762-0037-2 DOFETILIDE 125 MCG ORAL CAP $27.09 59762-0038-2 DOFETILIDE 250 MCG ORAL CAP $27.09 60687-451-11 EPLERENONE 25 MG ORAL TAB $27.09 60687-451-21 EPLERENONE 25 MG ORAL TAB $27.09 42571-132-21 CROMOLYN 100 MG/5 ML ORAL CONC $27.07 42571-132-52 CROMOLYN 100 MG/5 ML ORAL CONC $27.07 63323-262-03 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $27.04 63323-262-06 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $27.04 HC51062131 AMINES VAGINAL FLUID QUAL $27.00 HC89015903 ANAEROBIC SUSCEPTIBILITY-QD $27.00 HC89002570 ANTI-DNA ANTIBODIES (DS)-QD $27.00 HC89015705 ANTI-DNA ANTIBODIES (SS)-QD $27.00 HC51061976 COLLECT INTERP PHYSIOLOGIC DATA PT TRANSMIT $27.00 HC51062297 CPSP DEPRESSION SCREENING IND NEG $27.00 HC89013130 CULTURE AFB OTHER(PNL)-FT $27.00 HC89014625 CULTURE VIRUS - AU $27.00 HC89006498 DOXEPIN; 1-2 SRM/PLSM-AU $27.00 HC62211354 DRESSING SACRUM 18X18CM (MEPILEX) $27.00 HC89003370 ENCEPHALITIS ST LOUIS AB-QD $27.00 HC51061968 GROUP HEALTH EDUCATION $27.00 HC89014815 HEPATITIS C GENOTYPE PCR-QD $27.00 HC89023774 HLA B27-AU $27.00 HC89015655 INHIB PROTEIN C ACTIVITY-QD $27.00 HC89008874 LEUCINE AMINOPEPTIDASE-AU $27.00 HC89002968 MITOCHONDRIAL FA AB SCRN-QD $27.00 HC89000731 MYCOPLASMA PNEUMONIAE AB-QD $27.00 HC89015549 SEX HORMONE BINDING GLOB-QD $27.00 HC51062123 SMEAR WET MOUNT INFECT AGENT $27.00 HC89002950 SMOOTH MUSCLE FA AB SCRN-QD $27.00 HC89000590 SOMATOMEDIN-QD $27.00 HC83500033 STONE ANALYSIS-AU $27.00 HC51062248 WET MOUNT BY PROVIDER FPACT $27.00 HC89024202 FT4 BY ED/TMS-AU $27.00 0338-0511-41 GENTAMICIN IN NACL (ISO-OSM) 100 MG/50 ML IV PGBK $26.98 76045-009-01 HYDROMORPHONE 1 MG/ML INJ SOLN (MHS) $26.98 76045-009-06 HYDROMORPHONE 0.5 MG/0.5 ML INJ SOLN (MHS) $26.98 76045-009-11 HYDROMORPHONE 1 MG/ML INJ SOLN (MHS) $26.98 76045-009-96 HYDROMORPHONE 0.5 MG/0.5 ML INJ SOLN (MHS) $26.98 76045-010-01 HYDROMORPHONE 2 MG/ML INJ SOLN (MHS) $26.98 76045-010-11 HYDROMORPHONE 2 MG/ML INJ SOLN (MHS) $26.98 42799-806-01 IVERMECTIN 3 MG ORAL TAB $26.92 67457-385-10 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $26.91 67457-385-99 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $26.91 70677-0149-1 CETIRIZINE 1 MG/ML ORAL SOLN $26.85 42291-439-30 EMTRICITABINE-TENOFOVIR (TDF) 200-300 MG ORAL TAB $26.84 51672-1282-1 TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM $26.81 60687-188-11 ENTACAPONE 200 MG ORAL TAB $26.77 60687-188-21 ENTACAPONE 200 MG ORAL TAB $26.77 16714-059-01 FEBUXOSTAT 40 MG ORAL TAB $26.75 HC89023683 T CELL ABSOLUTE CD4/CD8 CNT-AU $26.73 HC89022651 PROGESTERONE-QN $26.66 0078-0240-61 CYCLOSPORINE 25 MG ORAL CAP $26.65 0338-0703-48 POTASSIUM CHLORIDE IN WATER 40 MEQ/100 ML IV PGBK $26.65 0338-0705-48 POTASSIUM CHLORIDE IN WATER 20 MEQ/100 ML IV PGBK $26.65 63323-564-21 ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRG $26.59 63323-564-97 ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRG $26.59 72572-573-01 PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR $26.59 72572-573-10 PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR $26.59 4116700391 HYDROCORTISONE 1 % TOPICAL CREAM $26.57 1170100216 VITAMIN A AND D TOPICAL CREAM $26.52 0536-1254-94 SODIUM CHLORIDE 5 % OPHT DROP $26.52 45802-626-26 CETIRIZINE 1 MG/ML ORAL SOLN $26.52 7811201103 PHENOL 1.4 % MUCOUS MEMB SPRA $26.46 0078-0240-15 CYCLOSPORINE 25 MG ORAL CAP $26.41 0039-0223-10 GLIMEPIRIDE 4 MG ORAL TAB $26.40 99999-005-69 PHENOBARBITAL 10 MG/ML INJ SOLN DILUTION (MCH) $26.35 51079-508-01 MYCOPHENOLATE SODIUM 180 MG ORAL TBEC $26.34 51079-508-20 MYCOPHENOLATE SODIUM 180 MG ORAL TBEC $26.34 23155-038-01 PAROMOMYCIN 250 MG ORAL CAP $26.33 51672-2003-6 CLOTRIMAZOLE 1 % VAGINAL CREAM $26.33 72572-707-01 ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJ SOLN $26.33 72572-707-10 ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJ SOLN $26.33 63010-010-30 NELFINAVIR 250 MG ORAL TAB $26.31 55150-255-20 LIDOCAINE HCL 20 MG/ML (2 %) INJ SOLN $26.26 65628-063-01 PROGESTERONE 200 MG VAGINAL SUPP $26.14 0409-2168-17 MAGNESIUM SULFATE 4 MEQ/ML (50 %) INJ SOLN $26.13 0409-2168-77 MAGNESIUM SULFATE 4 MEQ/ML (50 %) INJ SOLN $26.13 51672-4043-1 CLORAZEPATE DIPOTASSIUM 7.5 MG ORAL TAB $26.10 1093965744 ACETAMINOPHEN 160 MG/5 ML ORAL SUSP $26.08 49348-430-30 ACETAMINOPHEN 160 MG/5 ML ORAL SUSP $26.08 63323-564-63 ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRG $26.07 63323-564-65 ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRG $26.07 0378-8020-93 FLUVASTATIN 20 MG ORAL CAP $26.03 HC89003115 ANTI MICROSOMAL THYROID-QD $26.00 HC89002596 CAFFEINE-U2 $26.00 HC89005557 ECHOVIRUS 11 AB-FT $26.00 HC89005565 ECHOVIRUS 30 AB-FT $26.00 HC89005524 ECHOVIRUS 4 AB-FT $26.00 HC89005532 ECHOVIRUS 7 AB-FT $26.00 HC89005540 ECHOVIRUS 9 AB-FT $26.00 HC89003362 ENCEPHALITIS EASTERN AB-QD $26.00 HC89003388 ENCEPHALITIS WESTERN AB-QD $26.00 HC89010615 FACTOR VIII VW-AU $26.00 HC51000495 HEMOGLOBIN (POS - EG:HEMACUE) $26.00 HC89015804 HEPATITIS B CORE AB IGM-QD $26.00 HC89015689 LEUKOCYTE ALKALINE PHOS-QD $26.00 HC89013684 LIPASE-AU $26.00 HC89015366 N-TELOPEPTIDE CROSSLINK-QD $26.00 HC89015556 THYROID STIM IMMUNOGLOB-QD $26.00 HC89004071 TOPIRAMATE-AU $26.00 0121-0890-20 VANCOMYCIN 250 MG ORAL CAP $26.00 0143-9311-01 ETOMIDATE 2 MG/ML IV SOLN $26.00 0143-9311-10 ETOMIDATE 2 MG/ML IV SOLN $26.00 0143-9373-01 MILRINONE 1 MG/ML IV SOLN $26.00 0143-9673-01 LEVETIRACETAM 500 MG/5 ML IV SOLN $26.00 0143-9673-25 LEVETIRACETAM 500 MG/5 ML IV SOLN $26.00 0143-9746-01 TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLN $26.00 0143-9746-10 TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLN $26.00 0264-7625-00 POTASSIUM CHLORIDE IN 5 % DEX 20 MEQ/L IV SOLP $26.00 0264-7865-00 POTASSIUM CHLORIDE IN 0.9%NACL 20 MEQ/L IV SOLP $26.00 0264-9872-10 HEPARIN (PORCINE) IN NACL (PF) 1,000 UNIT/500 ML IV SOLP $26.00 0338-0004-04 WATER FOR IRRIGATION, STERILE IRR SOLN $26.00 0338-0017-02 DEXTROSE 5 % IN WATER (D5W) IV SOLP $26.00 0338-0017-03 D5W IV BOLUS $26.00 0338-0048-04 SODIUM CHLORIDE 0.9 % IRR SOLN $26.00 0338-0049-02 SODIUM CHLORIDE 0.9 % IV SOLP $26.00 0338-0049-03 SODIUM CHLORIDE 0.9 % IV SOLP $26.00 0338-0503-48 GENTAMICIN IN NACL (ISO-OSM) 80 MG/100 ML IV PGBK $26.00 0406-0127-01 METHYLPHENIDATE HCL 27 MG ORAL TR24 $26.00 0409-3178-03 LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN $26.00 0409-3178-18 LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN $26.00 0641-6142-01 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $26.00 0641-6142-25 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $26.00 25021-184-66 FLUCONAZOLE IN NACL (ISO-OSM) 200 MG/100 ML IV PGBK $26.00 25021-403-01 HEPARIN (PORCINE) 10,000 UNIT/ML INJ SOLN $26.00 36000-046-24 LEVOFLOXACIN IN D5W 250 MG/50 ML IV PGBK $26.00 55390-101-10 TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLN $26.00 63323-513-02 GENTAMICIN 20 MG/2 ML INJ SOLN $26.00 63323-530-21 SODIUM CHLORIDE 3 % HYPERTONIC 3 % IV SOLP $26.00 63323-530-75 SODIUM CHLORIDE 3 % HYPERTONIC 3 % IV SOLP $26.00 65219-472-05 SODIUM CHLORIDE 0.9 % IV SOLP $26.00 65219-472-20 SODIUM CHLORIDE 0.9 % IV SOLP $26.00 67457-379-12 PARICALCITOL 2 MCG/ML IV SOLN $26.00 67457-379-25 PARICALCITOL 2 MCG/ML IV SOLN $26.00 67457-420-10 DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJ SOLN $26.00 68180-675-11 OSELTAMIVIR 30 MG ORAL CAP $26.00 71839-118-01 HEPARIN, PORCINE (PF) 5,000 UNIT/0.5 ML INJ SOLN (MHS) $26.00 71839-118-25 HEPARIN, PORCINE (PF) 5,000 UNIT/0.5 ML INJ SOLN (MHS) $26.00 71839-124-01 GLYCOPYRROLATE 0.2 MG/ML INJ SOLN $26.00 71839-124-25 GLYCOPYRROLATE 0.2 MG/ML INJ SOLN $26.00 72572-074-01 CLINDAMYCIN IN 5 % DEXTROSE 600 MG/50 ML IV PGBK $26.00 72572-074-24 CLINDAMYCIN IN 5 % DEXTROSE 600 MG/50 ML IV PGBK $26.00 76045-737-01 HALOPERIDOL LACTATE 5 MG/ML IM SYRG $26.00 76045-737-10 HALOPERIDOL LACTATE 5 MG/ML IM SYRG $26.00 99999-037-37 CEFAZOLIN 2 GRAM/20 ML SYRINGE (USING 100 G) $26.00 0378-8020-77 FLUVASTATIN 20 MG ORAL CAP $25.99 0093-7442-01 FLUVASTATIN 20 MG ORAL CAP $25.98 0093-7442-56 FLUVASTATIN 20 MG ORAL CAP $25.98 0093-7443-01 FLUVASTATIN 40 MG ORAL CAP $25.98 5002443100 OXYMETAZOLINE 0.05 % NASL SPRY $25.94 0378-8767-16 BUPRENORPHINE-NALOXONE 8-2 MG SL FILM $25.92 0378-8767-93 BUPRENORPHINE-NALOXONE 8-2 MG SL FILM $25.92 0641-9218-01 DILTIAZEM HCL 5 MG/ML IV SOLN $25.81 0641-9218-10 DILTIAZEM HCL 5 MG/ML IV SOLN $25.81 65862-753-60 VALGANCICLOVIR 450 MG ORAL TAB $25.80 73562-110-01 LIPASE-PROTEASE-AMYLASE 10,000-32,000 -42,000 UNIT ORAL CPDR $25.77 51672-4070-8 CETIRIZINE 1 MG/ML ORAL SOLN $25.74 55150-235-02 VECURONIUM BROMIDE 10 MG IV SOLR $25.74 55150-235-11 VECURONIUM BROMIDE 10 MG IV SOLR $25.74 71288-402-10 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $25.74 71288-402-11 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $25.74 67457-349-03 AMPICILLIN-SULBACTAM 3 G IV SOLR (MCH) $25.71 67457-349-10 AMPICILLIN-SULBACTAM 3 G IV SOLR (MCH) $25.71 58980-011-10 BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINT $25.62 63323-473-02 BUPIVACAINE-DEXTROSE-WATER(PF) 0.75 % (7.5 MG/ML) INJ SOLN $25.57 99999-045-46 LIDOCAINE-EPINEPHRINE 2%-1:200,000 BUFFERED WITH SODIUM BICARB 10:1 INJ (OCM) $25.55 0409-1891-13 MORPHINE 4 MG/ML INJ SOLN (MHS) $25.53 0409-1891-23 MORPHINE 4 MG/ML INJ SOLN (MHS) $25.53 16729-277-30 METHOTREXATE SODIUM (PF) 25 MG/ML INJ SOLN $25.48 HC89020994 ECHOVIRUS AB TYPE 11-AU $25.40 HC89021000 ECHOVIRUS AB TYPE 30-AU $25.40 HC89020960 ECHOVIRUS AB TYPE 6-AU $25.40 HC89020978 ECHOVIRUS AB TYPE 7-AU $25.40 HC89020986 ECHOVIRUS AB TYPE 9-AU $25.40 67457-239-00 OCTREOTIDE ACETATE 50 MCG/ML (1 ML) INJ SYRG $25.39 67457-239-01 OCTREOTIDE ACETATE 50 MCG/ML (1 ML) INJ SYRG $25.39 0071-0237-24 ETHOSUXIMIDE 250 MG ORAL CAP $25.38 16714-048-01 CHLORPROMAZINE 25 MG ORAL TAB $25.36 70121-1577-1 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $25.36 70121-1577-5 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $25.36 0338-0709-48 POTASSIUM CHLORIDE IN WATER 10 MEQ/100 ML IV PGBK $25.35 63323-346-10 CEFTRIAXONE 1 GRAM INJ SOLR $25.35 70860-301-10 DILTIAZEM HCL 5 MG/ML IV SOLN $25.35 70860-301-42 DILTIAZEM HCL 5 MG/ML IV SOLN $25.35 99999-001-63 FENTANYL-BUPIVACAINE 2MCG/ML-0.125% IN NS (OB) $25.35 0409-1890-13 MORPHINE 2 MG/ML IV SYRG $25.32 0409-1890-23 MORPHINE 2 MG/ML IV SYRG $25.32 0409-2634-01 HYDROMORPHONE (PF) 10 MG/ML INJ SOLN $25.32 0409-2634-10 HYDROMORPHONE (PF) 10 MG/ML INJ SOLN $25.32 0395-0420-96 PRAMOXINE-CALAMINE 1-8 % TOPICAL LOTN $25.31 51079-925-01 DILTIAZEM HCL 90 MG ORAL CP12 $25.31 51079-925-20 DILTIAZEM HCL 90 MG ORAL CP12 $25.31 8137003658 HYDROCORTISONE-OATMEAL-ALOE-E 1 % TOPICAL CREAM $25.30 99999-000-12 CHLORAMPHENICOL 1000 MG / 10 ML SYRINGE $25.30 0409-1886-02 LEVETIRACETAM 500 MG/5 ML IV SOLN $25.29 0409-1886-22 LEVETIRACETAM 500 MG/5 ML IV SOLN $25.29 0409-2011-05 LEVETIRACETAM 500 MG/5 ML IV SOLN $25.29 0409-2011-25 LEVETIRACETAM 500 MG/5 ML IV SOLN $25.29 63323-368-20 AMPICILLIN-SULBACTAM 1.5 GRAM INJ SOLR $25.29 0310-0275-10 QUETIAPINE 25 MG ORAL TAB $25.25 99999-001-07 LORAZEPAM 2 MG / ML SOLN (ORAL) $25.23 0023-5853-18 MESALAMINE 400 MG ORAL CDTI $25.22 0093-7290-01 RALOXIFENE 60 MG ORAL TAB $25.21 6373637882 BENZOCAINE 20 % TOPICAL AEROSOL $25.19 63323-540-03 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $25.16 63323-540-13 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $25.16 0093-7290-56 RALOXIFENE 60 MG ORAL TAB $25.14 0409-1463-01 NALBUPHINE 10 MG/ML INJ SOLN $25.09 0409-1463-71 NALBUPHINE 10 MG/ML INJ SOLN $25.09 51079-348-01 NITROFURANTOIN MONOHYD/M-CRYST 100 MG ORAL CAP $25.06 51079-348-20 NITROFURANTOIN MONOHYD/M-CRYST 100 MG ORAL CAP $25.06 0409-3177-01 LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJ SOLN $25.03 0409-3177-16 LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJ SOLN $25.03 0409-6648-02 DEXTROSE 50 % IN WATER (D50W) IV SOLP $25.03 0409-6648-16 DEXTROSE 50 % IN WATER (D50W) IV SOLP $25.03 72572-265-01 HYDRALAZINE 20 MG/ML INJ SOLN $25.03 72572-265-25 HYDRALAZINE 20 MG/ML INJ SOLN $25.03 HC89023790 AMPHETAMINES 5 OR > -AU $25.00 HC89004733 ANTI MICROSOMAL THYROI(PNL2-RD $25.00 HC89023808 BENZODIAZEPINES 13 OR > -AU $25.00 HC89019004 BORDETELLA PERTUS IMMUNOBLOT IGG-AU $25.00 HC89017008 CATECHOLAMINES FRACT UR-AU $25.00 HC89018469 CHEMILUMINESCENT ASSAY(PNL)-PR $25.00 HC89003461 EBV AB-VIRAL CAPSID AG-QD $25.00 HC89002141 ERYTHROPOIETIN-QD $25.00 HC89004857 ESTROGENS, FRACTIONATED,TMS-AU $25.00 HC89023824 GABAPENTIN NON-BLOOD-AU $25.00 HC89015788 HELICOBACTER PYLORI AB-QD $25.00 HC89023360 HEMOGLOBIN GLYCATED (A1C)-U2 $25.00 HC89014690 HEPATITIS B DNA BY PCR-QD $25.00 HC89014708 HEPATITIS C RNA BY PCR-QD $25.00 HC89023444 HISTAMINE, URINE-AU $25.00 HC89016273 HIV 1&2 AB-QD $25.00 HC89014732 HIV-1 RNA QUANT BY PCR-QD $25.00 HC89017529 HSV 1 AG(PNL)-AU $25.00 HC89017511 HSV 2 AG(PNL)-AU $25.00 HC89008767 INSULIN TOTAL-ES $25.00 HC89006589 NAPA-U2 $25.00 HC89023816 OPIOID &OPIATE ANALOG 5 OR > -AU $25.00 HC89003867 PROCAINAMIDE W/NAPA-U2 $25.00 HC83505909 SPECIAL STAIN GROUP I -AP $25.00 HC89000145 TESTOSTERONE FREE-QD $25.00 HC89002018 VASOACTIVE INTEST PEPTIDE-QD $25.00 HC89001622 VITAMIN B1 THIAMINE-QD $25.00 904598426 AMMONIUM LACTATE 12 % TOPICAL LOTN $24.97 63323-486-02 LIDOCAINE HCL 20 MG/ML (2 %) INJ SOLN $24.96 63323-486-27 LIDOCAINE HCL 20 MG/ML (2 %) INJ SOLN $24.96 62584-693-11 DOXYCYCLINE HYCLATE 100 MG ORAL TAB $24.92 62584-693-21 DOXYCYCLINE HYCLATE 100 MG ORAL TAB $24.92 0121-0905-05 DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLN $24.90 0121-0905-94 DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLN $24.90 68094-750-59 DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLN $24.90 0409-1463-49 NALBUPHINE 10 MG/ML INJ SOLN $24.87 299391742 GLYCERIN-DIMETHICONE-PETRO, WH TOPICAL CREAM $24.86 299391753 GLYCERIN-DIMETHICONE-PETRO, WH TOPICAL CREAM $24.86 63323-185-10 WATER FOR INJECTION, STERILE INJ SOLN $24.83 0074-7362-03 CARBAMIDE PEROXIDE 6.5 % OTIC DROP $24.77 0121-1760-30 ALUMINUM-MAGNESIUM HYDROXIDE 200-200 MG/5 ML ORAL SUSP $24.77 99999-005-97 CARBAMAZEPINE 100 MG/5 ML ORAL SUSP $24.77 0555-0634-02 DANAZOL 100 MG ORAL CAP $24.75 45802-004-03 HYDROCORTISONE 2.5 % TOPICAL CREAM $24.75 HC89004154 PHOSPHOLIPIDS - AU $24.73 0338-0703-41 POTASSIUM CHLORIDE IN WATER 20 MEQ/50 ML IV PGBK $24.70 44567-421-00 MAGNESIUM SULFATE IN WATER 4 GRAM/100 ML (4 %) IV PGBK $24.70 44567-421-24 MAGNESIUM SULFATE IN WATER 4 GRAM/100 ML (4 %) IV PGBK $24.70 51754-6000-1 GLYCOPYRROLATE (PF) 0.2 MG/ML INJ SOLN $24.70 0121-0489-00 DIPHENHYDRAMINE HCL 12.5 MG/5 ML ORAL ELIX $24.64 0121-0489-05 DIPHENHYDRAMINE HCL 12.5 MG/5 ML ORAL ELIX $24.64 0121-1894-10 CARBAMAZEPINE 200 MG/10 ML ORAL SUSP $24.64 0121-1894-94 CARBAMAZEPINE 200 MG/10 ML ORAL SUSP $24.64 66689-005-01 HYDROCODONE-ACETAMINOPHEN 7.5-325 MG/15 ML ORAL SOLN $24.64 66689-005-50 HYDROCODONE-ACETAMINOPHEN 7.5-325 MG/15 ML ORAL SOLN $24.64 HC89011787 TEICHOIC ACID AB (ID)-AU $24.60 47335-007-88 ENTACAPONE 200 MG ORAL TAB $24.59 0832-0301-00 CHLORPROMAZINE 25 MG ORAL TAB $24.57 72572-415-01 MEROPENEM 500 MG IV SOLR $24.57 72572-415-10 MEROPENEM 500 MG IV SOLR $24.57 149003908 BISMUTH SUBSALICYLATE 262 MG/15 ML ORAL SUSP $24.54 99999-041-14 VANCOMYCIN 50 MG/ML ORAL SOLR $24.54 51525-0430-1 FELBAMATE 400 MG ORAL TAB $24.53 0032-1212-01 LIPASE-PROTEASE-AMYLASE 12,000-38,000 -60,000 UNIT ORAL CPDR $24.49 0032-1212-07 LIPASE-PROTEASE-AMYLASE 12,000-38,000 -60,000 UNIT ORAL CPDR $24.49 0121-0978-00 DIPHENHYDRAMINE HCL 12.5 MG/5 ML ORAL ELIX $24.44 0121-0978-10 DIPHENHYDRAMINE HCL 12.5 MG/5 ML ORAL ELIX $24.44 0409-1316-11 HEPARIN, PORCINE (PF) 5,000 UNIT/0.5 ML INJ SOLN (MHS) $24.43 0409-1316-32 HEPARIN, PORCINE (PF) 5,000 UNIT/0.5 ML INJ SOLN (MHS) $24.43 0338-0048-02 SODIUM CHLORIDE 0.9 % IRR SOLN $24.38 60505-3251-6 LAMIVUDINE 150 MG ORAL TAB $24.38 63323-161-00 KETOROLAC 15 MG/ML INJ SOLN $24.38 63323-161-01 KETOROLAC 15 MG/ML INJ SOLN $24.38 63739-931-14 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $24.31 63739-931-28 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $24.31 HC89006662 CLOZAPINE-AU $24.30 0115-4233-01 MIDODRINE 10 MG ORAL TAB $24.29 0409-6533-31 VANCOMYCIN 1,000 MG IV SOLR $24.28 0409-6533-59 VANCOMYCIN 1,000 MG IV SOLR $24.28 63323-854-03 HYDROMORPHONE (PF) 4 MG/ML INJ SOLN $24.25 63323-854-10 HYDROMORPHONE (PF) 4 MG/ML INJ SOLN $24.25 68084-907-11 MYCOPHENOLATE SODIUM 180 MG ORAL TBEC $24.21 68084-907-21 MYCOPHENOLATE SODIUM 180 MG ORAL TBEC $24.21 0049-3180-30 VORICONAZOLE 200 MG ORAL TAB $24.21 0168-0003-15 TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM $24.18 0409-9558-05 ROCURONIUM 10 MG/ML IV SOLN $24.15 0409-9558-11 ROCURONIUM 10 MG/ML IV SOLN $24.15 63323-492-09 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $24.12 63323-492-57 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $24.12 1254717167 DIPHENHYDRAMINE-ZINC ACETATE 2-0.1 % TOPICAL CREAM $24.10 81073088 NEOMYCIN-BACITRACNZN-POLYMYXNB 3.5MG-400 UNIT- 5,000 UNIT/GRAM TOPICAL OINT $24.09 7214045231 WHITE PETROLATUM 41 % TOPICAL OINT $24.05 0093-4155-73 AMOXICILLIN 250 MG/5 ML ORAL SUSR $24.05 0143-9575-01 LIDOCAINE HCL 20 MG/ML (2 %) INJ SOLN $24.05 0143-9575-10 LIDOCAINE HCL 20 MG/ML (2 %) INJ SOLN $24.05 HC89023022 DHEA SULFATE-QN $24.04 HC89006290 AMITRIPTYLINE (ANTIDEPR)1 OR 2-AU $24.00 HC89013478 ANDROSTENEDIONE-AU $24.00 HC89004725 ANTI-CHROMATIN AB (PNL2)-RD $24.00 HC89004709 ANTI-LA (SS-B) (PNL)-RD $24.00 HC89004691 ANTI-RNP AB (PNL2)-RD $24.00 HC89004717 ANTI-SCL-70 AB (PNL2)-RD $24.00 HC89004683 ANTI-SM AB (PNL2)-RD $24.00 HC89007777 CPK ISO-QN $24.00 HC89003354 ENCEPHALITIS CALIF AB-QD $24.00 HC89000012 ENDOMYSIAL FA AB SCRN-QD $24.00 HC89010623 FACTOR VIII VW AG-AU $24.00 HC51001600 HANDLING & SENDOUT TO REF' LAB $24.00 HC89018451 IMMUNOASSAY ANA QUANT (PNL)-PR $24.00 HC89010664 INHIB PROTEIN C ACTIVITY-AU $24.00 HC51062164 KOH TISSUE EXAM $24.00 HC89015093 MYCOPHENOLIC ACID-AU $24.00 HC89001572 MYOCARDIAL FA AB SCRN-QD $24.00 HC89000467 TEICHOIC ACID AB (ID)-QD $24.00 HC89005789 WEST NILE VIRUS AB EA-QD $24.00 63323-282-04 CLINDAMYCIN PHOSPHATE 150 MG/ML INJ SOLN $24.00 3932815705 FERROUS SULFATE 300 MG (60 MG IRON)/5 ML ORAL LIQD $23.99 66689-004-50 HYDROCODONE-ACETAMINOPHEN 7.5-325 MG/15 ML ORAL SOLN $23.99 0409-9558-49 ROCURONIUM 10 MG/ML IV SOLN $23.95 0409-9558-69 ROCURONIUM 10 MG/ML IV SOLN $23.95 0406-8390-01 MORPHINE 100 MG ORAL TBSR $23.92 66689-004-01 HYDROCODONE-ACETAMINOPHEN 7.5-325 MG/15 ML ORAL SOLN $23.92 99999-036-62 ERYTHROMYCIN 125 MG ORAL PARTIAL TABLET (MCH) $23.91 0225-0810-47 PHENYLEPHRINE HCL 1 % NASL SPRY $23.89 68180-659-06 RIFAMPIN 300 MG ORAL CAP $23.88 68180-659-07 RIFAMPIN 300 MG ORAL CAP $23.88 0409-1559-10 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $23.86 0409-1559-18 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $23.86 76014-004-25 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $23.86 76014-004-30 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $23.86 10135-735-60 PYRAZINAMIDE 500 MG ORAL TAB $23.84 60687-271-11 AZITHROMYCIN 500 MG ORAL TAB $23.84 60687-271-21 AZITHROMYCIN 500 MG ORAL TAB $23.84 HC89022362 FLOW CYTOMETRY MARKERS ADD+-CC $23.81 0409-1165-02 BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJ SOLN $23.79 0409-1165-19 BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJ SOLN $23.79 55150-254-10 LIDOCAINE HCL 20 MG/ML (2 %) INJ SOLN $23.79 50268-676-11 OMEGA-3 ACID ETHYL ESTERS 1 GRAM ORAL CAP $23.76 50268-676-12 OMEGA-3 ACID ETHYL ESTERS 1 GRAM ORAL CAP $23.76 67850-150-00 PANTOPRAZOLE 40 MG IV SOLR $23.73 99999-036-88 MAGNESIUM SULFATE IN WATER 2 GRAM/50 ML (4 %) IV PGBK $23.73 99999-043-94 FLUTICASONE PROPION-SALMETEROL 115-21 MCG/ACTUATION INHALATION HFAA $23.71 54643-9023-9 MVI,PEDI NO.1,COMPONENT 2 OF 2 140-20-1 MCG/ML IV SOLN $23.64 0409-6651-06 POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN $23.60 0409-6651-19 POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN $23.60 72572-160-01 ETOMIDATE 2 MG/ML IV SOLN $23.60 72572-160-10 ETOMIDATE 2 MG/ML IV SOLN $23.60 0904-0430-04 DOXYCYCLINE HYCLATE 100 MG ORAL TAB $23.57 63739-777-10 HYDROXYCHLOROQUINE 200 MG ORAL TAB FOR DISSOLVE (MCH) $23.56 67457-816-00 CLINDAMYCIN PHOSPHATE 150 MG/ML INJ SOLN $23.56 67457-816-06 CLINDAMYCIN PHOSPHATE 150 MG/ML INJ SOLN $23.56 0904-6663-61 ACETAZOLAMIDE 250 MG ORAL TAB $23.47 99999-009-26 PROMETHAZINE-CODEINE 6.25-10 MG/5 ML ORAL SYRP $23.47 HC89004873 DRVVT RUSS VIPER VNM CONFIRM RFX-AU $23.40 0409-0528-31 LEVOFLOXACIN IN D5W 750 MG/150 ML IV PGBK $23.40 0409-2267-20 LABETALOL 5 MG/ML IV SOLN $23.40 0781-6041-46 AMOXICILLIN 250 MG/5 ML ORAL SUSR $23.40 0904-6836-20 LOPERAMIDE 1 MG/7.5 ML ORAL LIQD $23.40 25021-317-20 LABETALOL 5 MG/ML IV SOLN $23.40 25021-400-10 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $23.40 36000-009-24 CIPROFLOXACIN IN 5 % DEXTROSE 400 MG/200 ML IV PGBK $23.40 42023-116-25 OXYTOCIN 10 UNIT/ML INJ SOLN $23.40 45802-063-35 TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM $23.40 51991-735-20 GRANISETRON HCL 1 MG ORAL TAB $23.40 51991-735-99 GRANISETRON HCL 1 MG ORAL TAB $23.40 55390-007-10 VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) IV SOLN $23.40 63323-852-03 HYDROMORPHONE 1 MG/ML INJ SOLN (MHS) $23.40 63323-852-25 HYDROMORPHONE 1 MG/ML INJ SOLN (MHS) $23.40 65219-012-00 POTASSIUM CHLORIDE IN WATER 10 MEQ/100 ML IV PGBK $23.40 65219-012-01 POTASSIUM CHLORIDE IN WATER 10 MEQ/100 ML IV PGBK $23.40 65862-707-01 AMOXICILLIN 250 MG/5 ML ORAL SUSR $23.40 76045-009-03 HYDROMORPHONE 0.5 MG/0.5 ML INJ SOLN (MHS) $23.40 76045-009-05 HYDROMORPHONE 0.5 MG/0.5 ML INJ SOLN (MHS) $23.40 76045-009-10 HYDROMORPHONE 1 MG/ML INJ SOLN (MHS) $23.40 76045-010-00 HYDROMORPHONE 2 MG/ML INJ SOLN (MHS) $23.40 76045-010-10 HYDROMORPHONE 2 MG/ML INJ SOLN (MHS) $23.40 51079-632-01 PRAZOSIN 5 MG ORAL CAP $23.34 51079-632-20 PRAZOSIN 5 MG ORAL CAP $23.34 24385-060-03 BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINT $23.26 60687-313-25 NADOLOL 40 MG ORAL TAB $23.24 60687-313-95 NADOLOL 40 MG ORAL TAB $23.24 50268-625-11 NITROFURANTOIN MONOHYD/M-CRYST 100 MG ORAL CAP $23.21 50268-625-15 NITROFURANTOIN MONOHYD/M-CRYST 100 MG ORAL CAP $23.21 99999-037-45 NALBUPHINE 10 MG/ML INJ SOLN $23.18 55150-252-20 LIDOCAINE HCL 10 MG/ML (1 %) INJ SOLN $23.14 67850-150-25 PANTOPRAZOLE 40 MG IV SOLR $23.14 70069-005-01 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG/ML INJ SOLN $23.14 70069-005-10 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG/ML INJ SOLN $23.14 0024-1352-02 PHENYLEPHRINE HCL 1 % NASL SPRY $23.11 0904-5725-14 ALUM-MAG HYDROXIDE-SIMETH 400-400-40 MG/5 ML ORAL SUSP $23.08 0143-9128-01 GENTAMICIN 40 MG/ML INJ SOLN $23.01 0143-9128-25 GENTAMICIN 40 MG/ML INJ SOLN $23.01 0395-0413-96 CALAMINE-ZINC OXIDE 8-8 % TOPICAL LOTN $23.01 0904-1103-09 POVIDONE-IODINE 10 % TOPICAL SOLN $23.01 63323-010-01 GENTAMICIN 40 MG/ML INJ SOLN $23.01 63323-010-02 GENTAMICIN 40 MG/ML INJ SOLN $23.01 HC89022826 ALCOHOL; 1-2 (URINE)-U2 $23.00 HC89004162 ANTI-GLIADIN, IGA SPEC(PNL)-PR $23.00 HC89004493 ANTI-GLIADIN, IGA SPEC(PNL2-PR $23.00 HC89004170 ANTI-GLIADIN, IGG SPEC(PNL)-PR $23.00 HC89004501 ANTI-GLIADIN, IGG SPEC(PNL2-PR $23.00 HC89015291 BETA HYDROXYBUTYRATE-QD $23.00 HC89000665 COPPER-QD $23.00 HC89016620 CULTURE - CHLAMYDIA STAIN-AU $23.00 HC89017792 CULTURE CHLAMYDIA(PNL)-AU $23.00 HC89003453 EBV AB TO NUCLEAR AG-QD $23.00 HC89002133 EPIDERMAL FA AB SCRN-QD $23.00 HC89003859 HERPES SIMPLEX II AB-QD $23.00 HC89000459 HISTONE REACTIVE ANA-SL $23.00 HC89016240 HLA-A AND B PHENOTYPE-QD $23.00 HC89000236 INFLUENZA A SEROLOGY-QD $23.00 HC89015432 LH(LUTEINIZ HORMONE)-QD $23.00 HC89021430 PROGESTERONE QNT-HPLC MS/MS-AU $23.00 HC89001580 RETICULIN FA AB SCRN-QD $23.00 HC89015861 VARICELLA ZOSTER IGG-QD $23.00 HC89015879 VARICELLA-ZOSTER IGM-QD $23.00 HC89015507 VITAMIN B6 PYRIDOXAL-QD $23.00 47781-355-03 BUPRENORPHINE-NALOXONE 2-0.5 MG SL FILM $22.97 47781-355-11 BUPRENORPHINE-NALOXONE 2-0.5 MG SL FILM $22.97 0781-9407-95 AMPICILLIN SODIUM 500 MG INJ SOLR $22.91 0121-1576-10 METOCLOPRAMIDE HCL 5 MG/5 ML ORAL SOLN $22.88 0781-9407-78 AMPICILLIN SODIUM 500 MG INJ SOLR $22.88 25021-115-04 CLINDAMYCIN PHOSPHATE 150 MG/ML INJ SOLN $22.83 HC89010631 ANTITHROMBIN III-AU $22.78 4110081124 VITS A AND D-WHITE PET-LANOLIN TOPICAL OINT $22.77 4110081132 DIMETHICONE-ZNOX-VIT A-D-ALOE 1-10 % TOPICAL CREAM $22.77 0904-6436-04 TEMAZEPAM 7.5 MG ORAL CAP $22.77 64980-322-12 MENTHOL-ZINC OXIDE 0.44-20.6 % TOPICAL OINT $22.77 6253000011 UREA 15 GRAM ORAL PWPK $22.75 0264-7805-10 SODIUM CHLORIDE 3% IV SOLUTION (LOAD) (MCH) $22.75 0781-3208-85 CEFTRIAXONE 1 GRAM INJ SOLR $22.75 24357-701-05 LIDOCAINE 4 % TOPICAL CREAM $22.75 24357-701-06 LIDOCAINE 4 % TOPICAL CREAM $22.75 25021-751-10 PANTOPRAZOLE 40 MG IV SOLR $22.75 43066-007-10 ROCURONIUM 10 MG/ML IV SOLN $22.75 55150-249-50 BUPIVACAINE HCL 0.25 % (2.5 MG/ML) INJ SOLN $22.75 60505-0752-4 CEFTRIAXONE 1 GRAM INJ SOLR $22.75 60505-6148-0 CEFTRIAXONE 1 GRAM INJ SOLR $22.75 60687-492-11 BUPRENORPHINE HCL 8 MG SL SUBL $22.75 60687-492-21 BUPRENORPHINE HCL 8 MG SL SUBL $22.75 60687-527-11 URSODIOL 250 MG ORAL TAB $22.75 60687-527-21 URSODIOL 250 MG ORAL TAB $22.75 63323-614-21 HYDRALAZINE 20 MG/ML INJ SOLN $22.75 63323-614-55 HYDRALAZINE 20 MG/ML INJ SOLN $22.75 63323-623-74 SODIUM CHLORIDE 0.9 % IV SOLP $22.75 65219-238-01 DEXTROSE 5 % IN WATER (D5W) IV SOLP $22.75 67877-419-33 LINEZOLID 600 MG ORAL TAB $22.75 67877-419-84 LINEZOLID 600 MG ORAL TAB $22.75 68084-729-11 GALANTAMINE 4 MG ORAL TAB $22.75 68084-729-21 GALANTAMINE 4 MG ORAL TAB $22.75 70594-086-01 AMPICILLIN SODIUM 1 GRAM INJ SOLR $22.75 70594-086-02 AMPICILLIN SODIUM 1 GRAM INJ SOLR $22.75 76282-663-39 DICLOFENAC SODIUM 1 % TOPICAL GEL $22.75 0781-3208-95 CEFTRIAXONE 1 GRAM INJ SOLR $22.74 HC89004063 CARNITINE, FREE-AU $22.73 49884-311-52 RISPERIDONE 0.5 MG ORAL TBDL $22.72 49884-311-55 RISPERIDONE 0.5 MG ORAL TBDL $22.72 58980-012-05 BACITRACIN ZINC-POLYMYXIN B 500-10,000 UNIT/GRAM TOPICAL OINT $22.71 HC89012397 COXSACKIE A AB (PNL)-AU $22.70 HC89012405 COXSACKIE A9 AB-AU $22.70 HC89006670 DIGITOXIN-AU $22.70 HC89008189 GLUCAGON-AU $22.70 0074-6214-13 DIVALPROEX 250 MG ORAL TBEC $22.68 67457-153-00 AMIODARONE 50 MG/ML IV SOLN $22.66 67457-153-03 AMIODARONE 50 MG/ML IV SOLN $22.66 1093991144 LOPERAMIDE 1 MG/7.5 ML ORAL LIQD $22.62 0409-9042-16 BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJ SOLN $22.62 0409-9042-17 BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJ SOLN $22.62 70677-0054-1 LOPERAMIDE 1 MG/7.5 ML ORAL LIQD $22.62 70860-125-41 AZITHROMYCIN 500 MG IV SOLR $22.59 70860-125-66 AZITHROMYCIN 500 MG IV SOLR $22.59 0185-5368-09 EPLERENONE 25 MG ORAL TAB $22.57 0185-5368-30 EPLERENONE 25 MG ORAL TAB $22.56 17856-3722-1 PREDNISONE 5 MG/5 ML ORAL SOLN $22.56 0409-8183-01 POTASSIUM ACETATE 2 MEQ/ML IV SOLN $22.49 0409-8183-11 POTASSIUM ACETATE 2 MEQ/ML IV SOLN $22.49 1254717162 DIPHENHYDRAMINE-ZINC ACETATE 1-0.1 % TOPICAL CREAM $22.44 16729-043-01 TACROLIMUS 5 MG ORAL CAP $22.44 0006-0071-31 FINASTERIDE 1 MG ORAL TAB $22.43 63323-012-03 OXYTOCIN 10 UNIT/ML INJ SOLN $22.43 63323-012-11 OXYTOCIN 10 UNIT/ML INJ SOLN $22.43 63323-486-01 LIDOCAINE HCL 20 MG/ML (2 %) INJ SOLN $22.43 63323-486-17 LIDOCAINE HCL 20 MG/ML (2 %) INJ SOLN $22.43 63323-967-01 POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN $22.43 63323-967-30 POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN $22.43 72572-801-01 VANCOMYCIN 1,000 MG IV SOLR $22.43 72572-801-02 VANCOMYCIN 1,000 MG IV SOLR $22.43 HC89020184 C-REACTIVE PROTEIN(PNL2)-PR $22.40 HC89008148 IMMUNOGLOBULIN IGD-AU $22.40 HC89010250 VOLATILES-AU $22.40 HC89024111 ALCOHOL QNT GAS CHROMA URINE-AU $22.40 62135-309-20 CIPROFLOXACIN HCL 500 MG ORAL TAB $22.36 63323-208-01 LIDOCAINE (PF) 20 MG/ML (2%) INJ (MHS) $22.36 63323-208-05 LIDOCAINE (PF) 20 MG/ML (2%) INJ (MHS) $22.36 62332-025-31 THEOPHYLLINE 300 MG ORAL TB12 $22.34 68462-721-01 THEOPHYLLINE 300 MG ORAL TB12 $22.34 0781-3110-90 PIPERACILLIN-TAZOBACTAM 2.25 GRAM IV SOLR $22.33 0781-3110-95 PIPERACILLIN-TAZOBACTAM 2.25 GRAM IV SOLR $22.33 16714-986-01 TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM $22.33 42192-608-05 GABAPENTIN 250 MG/5 ML (5 ML) ORAL SOLN $22.33 HC89019871 ENTAMOEBA ANTIGEN EIA -AU $22.23 0409-6102-25 FUROSEMIDE 10 MG/ML INJ SOLN $22.23 0409-6102-35 FUROSEMIDE 10 MG/ML INJ SOLN $22.23 0641-6013-01 DILTIAZEM HCL 5 MG/ML IV SOLN $22.23 0641-6013-10 DILTIAZEM HCL 5 MG/ML IV SOLN $22.23 0409-9094-17 FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN $22.10 0409-9094-28 FENTANYL (PF) 50 MCG/ML INJ FOR INTRATHECAL PAIN PUMP REFILL (OCM) $22.10 16729-533-08 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG/ML INJ SOLN $22.10 16729-533-63 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG/ML INJ SOLN $22.10 55150-364-01 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG/ML INJ SOLN $22.10 55150-364-25 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG/ML INJ SOLN $22.10 59762-3060-3 AZITHROMYCIN 250 MG ORAL TAB $22.10 63323-485-01 LIDOCAINE HCL 10 MG/ML (1 %) INJ SOLN $22.10 63323-485-27 LIDOCAINE HCL 10 MG/ML (1 %) INJ SOLN $22.10 121053005 FERROUS SULFATE 300 MG (60 MG IRON)/5 ML ORAL LIQD $22.07 0409-5820-01 DOPAMINE 200 MG/5 ML (40 MG/ML) IV SOLN $22.07 0409-5820-11 DOPAMINE 200 MG/5 ML (40 MG/ML) IV SOLN $22.07 63323-306-02 TOBRAMYCIN SULFATE 40 MG/ML INJ SOLN $22.04 HC89016133 AFP-QD $22.00 HC89015648 ANTITHROMBIN III AG-QD $22.00 HC89500508 BLOOD TYPE SEROLOGIC; RH(D)-SB $22.00 HC89010979 C1Q COMPLEMENT-QN $22.00 HC89021018 CANDIDA SPECIES DNA-AU $22.00 HC89002893 COCCIDIOIDES AB CSF-QD $22.00 HC89012389 COXSACKIE A AB (PNL)-FT $22.00 HC89005573 COXSACKIE B1 AB-FT $22.00 HC89005581 COXSACKIE B2 AB-FT $22.00 HC89005599 COXSACKIE B3 AB-FT $22.00 HC89005607 COXSACKIE B4 AB-FT $22.00 HC89005615 COXSACKIE B5 AB-FT $22.00 HC89005623 COXSACKIE B6 AB-FT $22.00 HC51062339 CPSP ANTEPRTM NUTRITION F/U ASSES,TX, GROUP, EACH 15MIN $22.00 HC51062388 CPSP ANTEPRTM PSYCHOSOCIAL F/U ASSESS/TX GROUP; EA 15MIN $22.00 HC89006472 CYCLOSPORINE-AU $22.00 HC89007827 DHEA-AU $22.00 HC89011571 DIPHTHERIA AB TITER-AU $22.00 HC89008049 FATTY ACIDS FREE-QN $22.00 HC89017032 GC/CHL DNA PROBE-AU $22.00 HC51062156 GLUCOSE BY DEVICE $22.00 HC89015796 HEPATITIS B CORE AB-QD $22.00 HC89000269 HERPES SIMPLEX I AB-QD $22.00 HC89002364 INTRINSIC FACTOR AB-QD $22.00 HC89002554 LEGIONELLA AG URINE-QD $22.00 HC89015952 LEGIONELLA AG URINE-QD $22.00 HC89008999 METANEPHRINE-AU $22.00 HC89007660 N-TELOPEPTIDE CROSSLINK UR-AU $22.00 HC89000939 OLIGOCLONAL BANDS (CSF)-SL $22.00 HC89001937 PARIETAL FA AB SCRN-QD $22.00 HC51062180 PH FLUID $22.00 HC89010714 PLASMINOGEN-AU $22.00 HC89015598 UREA NITROGEN URINE-QD $22.00 HC51062149 URINALYSIS AUTO W/ MICROSCOPY $22.00 25021-700-01 KETOROLAC 15 MG/ML INJ SOLN $21.97 0904-6706-06 OMEGA-3 ACID ETHYL ESTERS 1 GRAM ORAL CAP $21.95 0409-2720-02 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $21.91 0409-2720-31 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $21.91 63739-953-11 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $21.91 63739-953-25 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $21.91 68084-561-11 CARBAMAZEPINE 200 MG ORAL TB12 $21.86 68084-561-21 CARBAMAZEPINE 200 MG ORAL TB12 $21.86 0143-9519-01 METHOTREXATE SODIUM (PF) 25 MG/ML INJ SOLN $21.84 0143-9519-10 METHOTREXATE SODIUM (PF) 25 MG/ML INJ SOLN $21.84 0409-8183-15 POTASSIUM ACETATE 2 MEQ/ML IV SOLN $21.84 0409-8183-25 POTASSIUM ACETATE 2 MEQ/ML IV SOLN $21.84 0603-1393-15 LIDOCAINE HCL 2 % MUCOUS MEMB SOLN $21.84 64850-910-01 ISRADIPINE 2.5 MG ORAL CAP $21.81 0074-3826-11 DIVALPROEX 250 MG ORAL TB24 $21.80 0093-5907-86 MESALAMINE 400 MG ORAL CDTI $21.79 0703-4502-01 METOCLOPRAMIDE HCL 5 MG/ML INJ SOLN $21.79 0703-4502-04 METOCLOPRAMIDE HCL 5 MG/ML INJ SOLN $21.79 51079-853-01 GALANTAMINE 8 MG ORAL TAB $21.78 51079-853-03 GALANTAMINE 8 MG ORAL TAB $21.78 0781-9242-78 AMPICILLIN SODIUM 250 MG INJ SOLR $21.76 0781-9242-95 AMPICILLIN SODIUM 250 MG INJ SOLR $21.76 0781-9402-78 AMPICILLIN SODIUM 250 MG INJ SOLR $21.76 0781-9402-95 AMPICILLIN SODIUM 250 MG INJ SOLR $21.76 HC89007819 VIT B12 BINDING CAPACITY-AU $21.75 0409-3182-01 LIDOCAINE-EPINEPHRINE 2 %-1:100,000 INJ SOLN $21.71 0409-3182-11 LIDOCAINE-EPINEPHRINE 2 %-1:100,000 INJ SOLN $21.71 55150-164-02 LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN $21.67 60687-299-25 ITRACONAZOLE 100 MG ORAL CAP $21.67 60687-299-95 ITRACONAZOLE 100 MG ORAL CAP $21.67 64980-282-03 MESALAMINE 1,000 MG RECTAL SUPP $21.67 60687-385-25 COLESEVELAM 625 MG ORAL TAB $21.64 60687-385-95 COLESEVELAM 625 MG ORAL TAB $21.64 99999-040-53 CEFTRIAXONE 1 G/25 ML (40 MG/ML) INJ SYR (USING 10G) $21.61 0781-1874-31 AMOXICILLIN-POT CLAVULANATE 250-125 MG ORAL TAB $21.59 70860-406-10 BUMETANIDE 0.25 MG/ML INJ SOLN $21.58 70860-406-41 BUMETANIDE 0.25 MG/ML INJ SOLN $21.58 1093978744 MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSP $21.52 0536-2470-85 MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSP $21.52 0904-0788-16 MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSP $21.52 51079-924-01 DILTIAZEM HCL 60 MG ORAL CP12 $21.52 51079-924-20 DILTIAZEM HCL 60 MG ORAL CP12 $21.52 57896-980-16 DIPHENHYDRAMINE HCL 12.5 MG/5 ML ORAL LIQD $21.52 0574-0106-03 BROMOCRIPTINE 2.5 MG ORAL TAB $21.52 63304-962-30 BROMOCRIPTINE 2.5 MG ORAL TAB $21.52 7430000300 ZINC OXIDE 13 % TOPICAL CREAM $21.49 7139974805 FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROP $21.45 0168-0080-31 HYDROCORTISONE 2.5 % TOPICAL CREAM $21.45 0409-7101-67 SODIUM CHLORIDE 0.9 % IV PGBK $21.45 99999-038-26 CEFAZOLIN 3 GRAMS/30 ML IV SYRINGE (USING 10 G VIAL) $21.45 99999-039-14 ACETIC ACID (BULK) 5 % MISC LIQD $21.45 51672-2010-2 HYDROCORTISONE 0.5 % TOPICAL CREAM $21.41 0904-6890-04 URSODIOL 250 MG ORAL TAB $21.41 0409-2721-01 HEPARIN (PORCINE) 10,000 UNIT/ML INJ SOLN $21.40 0469-0607-73 TACROLIMUS 0.5 MG ORAL CAP $21.39 HC89022586 CORTISOL-QN $21.38 0168-0146-30 HYDROCORTISONE 2.5 % TOPICAL OINT $21.38 51079-959-01 DOXAZOSIN 4 MG ORAL TAB $21.37 51079-959-20 DOXAZOSIN 4 MG ORAL TAB $21.37 23155-767-01 TETRACYCLINE 500 MG ORAL CAP $21.35 51991-907-01 TETRACYCLINE 500 MG ORAL CAP $21.35 0093-4155-79 AMOXICILLIN 250 MG/5 ML ORAL SUSR $21.32 0641-6007-01 BUMETANIDE 0.25 MG/ML INJ SOLN $21.32 0641-6007-10 BUMETANIDE 0.25 MG/ML INJ SOLN $21.32 10135-701-04 MENTHOL-ZINC OXIDE 0.44-20.6 % TOPICAL OINT $21.30 13668-202-30 DARIFENACIN 7.5 MG ORAL TB24 $21.30 0225-0800-47 PHENYLEPHRINE HCL 0.25 % NASL SPRY $21.26 0225-0805-47 PHENYLEPHRINE HCL 0.5 % NASL SPRY $21.26 0409-4279-02 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $21.26 0409-4279-16 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $21.26 0517-1905-25 DOPAMINE 400 MG/5 ML (80 MG/ML) IV SOLN $21.26 63323-482-01 LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN $21.26 63323-482-17 LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN $21.26 65219-572-01 BUMETANIDE 0.25 MG/ML INJ SOLN $21.26 65219-572-10 BUMETANIDE 0.25 MG/ML INJ SOLN $21.26 HC89011936 LYMPH ABS CD4/CD8 CNT(PNL)-AU $21.25 0378-1903-01 MIDODRINE 10 MG ORAL TAB $21.22 0409-1985-03 LORAZEPAM 2 MG/ML INJ SYRG $21.20 0409-1985-30 LORAZEPAM 2 MG/ML INJ SYRG $21.20 72572-041-01 BUMETANIDE 0.25 MG/ML INJ SOLN $21.19 72572-041-10 BUMETANIDE 0.25 MG/ML INJ SOLN $21.19 HC89010649 ANTITHROMBIN III AG-AU $21.18 0409-1160-01 BUPIVACAINE HCL 0.25 % (2.5 MG/ML) INJ SOLN $21.13 0409-1160-18 BUPIVACAINE HCL 0.25 % (2.5 MG/ML) INJ SOLN $21.13 0409-7100-66 DEXTROSE 5 % IN WATER (D5W) 5 % IV PGBK $21.13 23155-473-33 FUROSEMIDE 10 MG/ML INJ SOLN (MCH) $21.13 23155-473-44 FUROSEMIDE 10 MG/ML INJ SOLN (MCH) $21.13 49884-235-05 HYDROCODONE-CHLORPHENIRAMINE 10-8 MG/5 ML ORAL SU12 $21.13 63323-559-21 ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRG $21.13 63323-559-93 ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRG $21.13 70860-301-05 DILTIAZEM HCL 5 MG/ML IV SOLN $21.13 70860-301-41 DILTIAZEM HCL 5 MG/ML IV SOLN $21.13 99999-045-80 FENTANYL-BUPIVACAINE 2 MCG/ML - 0.1% EPIDURAL PCA (L&D) $21.13 99999-046-34 VANCOMYCIN IN 0.9 % SODIUM CHL 750 MG/250 ML IV SOLN $21.13 1093960244 SIMETHICONE 40 MG/0.6 ML ORAL DRPS $21.06 45802-064-35 TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM $21.06 49348-740-27 SIMETHICONE 40 MG/0.6 ML ORAL DRPS $21.06 HC89008791 17 KETOSTEROIDS-AU $21.00 HC89004139 ACTIVATED PROT C RESISTANCE-AU $21.00 HC89012082 ADENOVIRUS AB-AU $21.00 HC89016323 ANTI JO 1-SL-QD $21.00 HC89004675 ANTI-RO SS-A (PNL2)-RD $21.00 HC89001218 CALCITONIN-QD $21.00 HC89014658 CRYPTOCOCCUS NEOFORMANS AG-AU $21.00 HC89003446 EBV AB TO EARLY AG-QD $21.00 HC89021026 GARDNERELLA VAGINALIS DNA-AU $21.00 HC89008528 GLIADIN IGA AND IGG ABS-AU $21.00 HC89015820 HEPATITIS A AB IGM-QD $21.00 HC89002307 HEPATITIS DELTA AB-QD $21.00 HC89003214 IMMUNO ELECT URINE-QD $21.00 HC89015408 IMMUNOGLOBULIN IGE-QD $21.00 HC89000632 LEGIONNELLA SCREEN-QD $21.00 HC89006415 LIBRIUM; 1-12-AU $21.00 HC89016760 NBS MS/MS AMINO ACID W/PKU-GE $21.00 HC89016901 NORDIAZEPAM; 1-12-AU $21.00 HC89021034 TRICHOMONAS VAGINALIS DNA-AU $21.00 0093-8119-56 FAMCICLOVIR 500 MG ORAL TAB $21.00 69680-112-25 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG/ML INJ SOLN $20.93 0409-4276-02 LIDOCAINE HCL 10 MG/ML (1 %) INJ SOLN $20.80 0409-4276-17 LIDOCAINE HCL 10 MG/ML (1 %) INJ SOLN $20.80 0409-7299-73 SODIUM ACETATE 2 MEQ/ML IV SOLN $20.80 0409-7299-83 SODIUM ACETATE 2 MEQ/ML IV SOLN $20.80 0781-3422-71 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $20.80 0781-3422-92 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $20.80 16729-464-08 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $20.80 16729-464-63 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $20.80 25021-311-10 FUROSEMIDE 10 MG/ML INJ SOLN $20.80 25021-315-01 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $20.80 42023-213-01 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $20.80 42023-213-25 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $20.80 55150-300-01 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $20.80 55150-300-25 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $20.80 55150-324-01 FUROSEMIDE 10 MG/ML INJ SOLN $20.80 55150-324-25 FUROSEMIDE 10 MG/ML INJ SOLN $20.80 63323-280-10 FUROSEMIDE 10 MG/ML INJ SOLN CODE NEO $20.80 63323-751-00 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $20.80 63323-751-01 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $20.80 63323-751-03 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $20.80 63323-751-13 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $20.80 65862-071-50 AMOXICILLIN 400 MG/5 ML ORAL SUSR $20.80 68084-215-11 VALACYCLOVIR 500 MG ORAL TAB $20.80 71288-807-01 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $20.80 71288-807-02 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $20.80 99999-010-90 METHADONE 5 MG/5 ML ORAL SOLN $20.80 5618412105 PHENYLEPHRINE HCL 0.125 % NASL DROP $20.77 71399-2829-1 DIBUCAINE 1 % TOPICAL OINT $20.75 51079-852-01 GALANTAMINE 4 MG ORAL TAB $20.74 51079-852-03 GALANTAMINE 4 MG ORAL TAB $20.74 51672-2075-1 BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINT $20.68 0409-4264-01 HYDROMORPHONE 0.5 MG/0.5 ML INJ SOLN (MHS) $20.67 0409-4264-11 HYDROMORPHONE 0.5 MG/0.5 ML INJ SOLN (MHS) $20.67 50268-195-60 CAPSAICIN 0.025 % TOPICAL CREAM $20.67 55150-163-30 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $20.67 0409-3796-01 KETOROLAC 60 MG/2 ML IM SOLN $20.64 0054-4581-11 MERCAPTOPURINE 50 MG ORAL TAB $20.61 0378-3547-52 MERCAPTOPURINE 50 MG ORAL TAB (MCH) $20.61 69076-913-02 MERCAPTOPURINE 50 MG ORAL TAB $20.61 58232-740-01 DIPHENHYDRAMINE-ZINC ACETATE 1-0.1 % TOPICAL CREAM $20.60 0024-1353-01 PHENYLEPHRINE HCL 0.5 % NASL SPRY $20.57 0378-9080-01 ENTACAPONE 200 MG ORAL TAB $20.57 HC89009443 OXALATE URINE-AU $20.55 68462-851-01 DILTIAZEM HCL 90 MG ORAL CP12 $20.55 0781-5578-01 ENTACAPONE 200 MG ORAL TAB $20.54 57844-208-52 ZINC ACETATE 50 MG (ZINC) ORAL CAP $20.54 574006915 DEXTROSE 40 % ORAL GEL $20.48 574006930 DEXTROSE 40 % ORAL GEL $20.48 574007030 DEXTROSE 40 % ORAL GEL $20.48 0121-1761-30 ALUM-MAG HYDROXIDE-SIMETH 200-200-20 MG/5 ML ORAL SUSP $20.48 0121-1762-30 ALUM-MAG HYDROXIDE-SIMETH 400-400-40 MG/5 ML ORAL SUSP $20.48 0409-4888-06 SODIUM CHLORIDE 0.9 % INJ SOLN $20.48 0409-4888-50 SODIUM CHLORIDE 0.9 % INJ SOLN $20.48 45802-434-01 CLOTRIMAZOLE 1 % TOPICAL CREAM $20.48 0536-1349-57 METHYL SALICYLATE-MENTHOL 15-10 % TOPICAL CREAM $20.44 23155-601-31 MIDAZOLAM 5 MG/ML INJ SOLN $20.44 23155-601-41 MIDAZOLAM 5MG/ML INJECTABLE SOLUTION (MHS) $20.44 0115-5212-30 COLESTIPOL 5 GRAM ORAL PACK $20.44 59762-0260-1 COLESTIPOL 5 GRAM ORAL PACK $20.44 0527-1790-01 FLUPHENAZINE HCL 5 MG ORAL TAB $20.40 50268-076-11 AZITHROMYCIN 500 MG ORAL TAB $20.39 50268-076-12 AZITHROMYCIN 500 MG ORAL TAB $20.39 16714-829-01 BUDESONIDE 3 MG ORAL CECX $20.37 51079-958-01 DOXAZOSIN 2 MG ORAL TAB $20.36 51079-958-20 DOXAZOSIN 2 MG ORAL TAB $20.36 0536-1212-77 ACETAMINOPHEN 160 MG/5 ML ORAL SUSP $20.33 16571-600-96 CROMOLYN 100 MG/5 ML ORAL CONC $20.31 50742-118-08 CABERGOLINE 0.5 MG ORAL TAB $20.31 68084-603-11 NIFEDIPINE 90 MG ORAL TR24 $20.29 68084-603-21 NIFEDIPINE 90 MG ORAL TR24 $20.29 0395-1213-91 IODINE-SODIUM IODIDE 2 % TOPICAL TINC $20.28 0517-3010-25 WATER FOR INJECTION, STERILE INJ SOLN $20.28 0641-6147-01 WATER FOR INJECTION, STERILE INJ SOLN $20.28 0641-6147-10 WATER FOR INJECTION, STERILE INJ SOLN $20.28 51672-2130-8 IBUPROFEN 100 MG/5 ML ORAL SUSP $20.28 63323-495-04 LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN $20.28 63323-495-07 LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN $20.28 65862-707-80 AMOXICILLIN 250 MG/5 ML ORAL SUSR $20.28 99999-045-18 GRANISETRON 50 MCG/ML ORAL LIQUID (COMPOUND) $20.28 51079-024-01 METOLAZONE 5 MG ORAL TAB $20.22 51079-024-20 METOLAZONE 5 MG ORAL TAB $20.22 67877-754-60 DRONABINOL 5 MG ORAL CAP $20.20 0406-8380-62 MORPHINE 60 MG ORAL TBSR $20.20 0406-8380-23 MORPHINE 60 MG ORAL TBSR $20.15 36000-284-25 FUROSEMIDE 10 MG/ML INJ SOLN $20.15 44567-410-24 MAGNESIUM SULFATE IN D5W 1 GRAM/100 ML IV PGBK $20.15 59762-1710-1 EPLERENONE 25 MG ORAL TAB $20.15 99999-010-52 MAGNESIUM SULFATE 4 G IN D5W 100 ML IV (LBM) $20.15 99999-039-00 PREDNISONE 5 MG/5 ML ORAL SOLN $20.15 64980-177-50 CHLOROQUINE PHOSPHATE 250 MG ORAL TAB $20.14 63739-549-72 MEGESTROL 40 MG/ML ORAL SUSPENSION $20.09 63739-549-73 MEGESTROL 40 MG/ML ORAL SUSPENSION $20.09 68084-215-21 VALACYCLOVIR 500 MG ORAL TAB $20.09 0121-0942-05 PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIX $20.05 0121-0942-50 PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIX $20.05 1093950233 DIPHENHYDRAMINE HCL 12.5 MG/5 ML ORAL LIQD $20.03 49348-045-37 DIPHENHYDRAMINE HCL 12.5 MG/5 ML ORAL LIQD $20.03 60505-0133-0 CYCLOSPORINE 25 MG ORAL CAP $20.01 51862-460-01 CYCLOSPORINE MODIFIED 100 MG ORAL CAP $20.00 51862-460-47 CYCLOSPORINE MODIFIED 100 MG ORAL CAP $20.00 HC89020093 ANCA ELISA IGG SPECIF(PNL)-PR $20.00 HC89022149 ANGIOTENSIN CONVERT ENZYME CSF -AU $20.00 HC89020127 ANTI-A4-FLE2 ELISA(PNL)-PR $20.00 HC89020119 ANTI-CBIR1 ELISA(PNL)-PR $20.00 HC89020135 ANTI-FLA-X ELISA (PNL)-PR $20.00 HC89500979 ANTIGLOBULIN INDIRECT TEST COOMBS; QUAL EA REAGENT RC-SB $20.00 HC89020101 ANTI-OMPC ELISA IGA SPC(PN)-PR $20.00 HC89020077 ASCA ELISA IGA SPECIFIC(PNL) -PR $20.00 HC89020085 ASCA ELISA IGG SPECIF(PNL)-PR $20.00 HC89016208 BRUCELLA AB-QD $20.00 HC89011027 C-1 ESTERASE INHIBITOR FUNCTIONAL-AU $20.00 HC89013536 CALCITONIN-AU $20.00 HC89006258 CANNABINOIDS, NATURAL(THC)-AU $20.00 HC89007900 DIHYDROTESTOSTERONE TANDUM SPECT-AU $20.00 HC89006696 DISOPYRAMIDE-AU $20.00 HC89007967 ESTROGENS FRACTIONATED-AU $20.00 HC89016745 FACTOR VIII ASSAY-AU $20.00 HC89015614 FACTOR VIII ASSAY-QD $20.00 HC89015622 FACTOR VIII VW AG-QD $20.00 HC89005037 GROUP B/E COLI K1 AG -AU $20.00 HC89004998 H INFULENZA AG -AU $20.00 HC89000228 HERPES IGM SCREEN-QD $20.00 HC89019418 HLA AB DETECT MARKERS ADD+-AU $20.00 HC89004204 IGA SER NEPHELOMETRY(PNL)-PR $20.00 HC89004535 IGA SER NEPHELOMETRY(PNL2)-PR $20.00 HC89011894 INTRINSIC FACTOR AB-AU $20.00 HC89011902 ISLET AB-AU $20.00 HC89011308 JO 1 AB-AU $20.00 HC89015010 KARYOTYPING,ADD EA-GZ $20.00 HC89013494 LIPOPROTEIN A-QD $20.00 HC89021042 METANEPHRINES, PLASMA(FREE)-AU $20.00 HC89005029 N MENINGITIOIS GROUP A/Y -AU $20.00 HC89005011 N MENINGITIOIS GROUP C/W -AU $20.00 HC89006845 OXCARBAZEPINE METABOLITE-AU $20.00 HC89000657 PROTOZOA AB OTHER-QD $20.00 HC89015754 RHEUMATOID FACTOR-QD $20.00 HC89005003 S PNEUMONIA AG -AU $20.00 HC89004980 STREPTOCOCCUS GROUP B AG -AU $20.00 HC89091391 STRONGYLOIDES AB IGG -AU $20.00 HC89013965 T4/THYROXINE-ES $20.00 HC89019590 TOT SRM IGA NPHLMT(PNL1155/6360)-PR $20.00 HC89003487 TOXOPLASMA AB IGM-QD $20.00 HC89014310 TULAREMIA AB-AU $20.00 HC89016737 WEST NILE VIRUS AB EA-LB $20.00 0713-0229-15 TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINT $19.99 0054-0425-23 RUFINAMIDE 200 MG ORAL TAB $19.96 60687-687-11 LACOSAMIDE 100 MG ORAL TAB $19.96 60687-687-57 LACOSAMIDE 100 MG ORAL TAB $19.96 HC89014393 LCM AB-AU $19.95 1011900252 SOD BORATE-BORIC AC-NACL-WATER OPHT IRSL $19.94 0536-1224-97 SOD BORATE-BORIC AC-NACL-WATER OPHT IRSL $19.94 50268-811-11 ZIPRASIDONE HCL 20 MG ORAL CAP $19.91 0409-1312-03 HYDROMORPHONE 2 MG/ML INJ SOLN (MHS) $19.89 0409-1312-30 HYDROMORPHONE 2 MG/ML INJ SOLN (MHS) $19.89 50268-628-11 OXYBUTYNIN CHLORIDE 10 MG ORAL TR24 $19.88 50268-628-15 OXYBUTYNIN CHLORIDE 10 MG ORAL TR24 $19.88 51079-093-01 VALACYCLOVIR 500 MG ORAL TAB $19.85 51079-093-03 VALACYCLOVIR 500 MG ORAL TAB $19.85 65628-062-01 PROGESTERONE 100 MG VAGINAL SUPP $19.85 62559-722-01 TERBUTALINE 5 MG ORAL TAB $19.83 63323-451-00 MORPHINE 10 MG/ML IV SOLN (PCA, PED NAIVE <30 KG, COMPONENT) $19.83 63323-451-01 MORPHINE 10 MG/ML IV SOLN (PCA, PED NAIVE <30 KG, COMPONENT) $19.83 0054-8550-25 METHOTREXATE SODIUM 2.5 MG ORAL TAB $19.81 68084-948-25 EPLERENONE 25 MG ORAL TAB $19.81 68084-948-95 EPLERENONE 25 MG ORAL TAB $19.81 HC89023659 B CELL TOTAL COUNT-AU $19.80 HC89023667 NK CELL TOTAL COUNT-AU $19.80 HC89023675 T-CELL TOTAL COUNT-AU $19.80 HC89011464 ANTI-PARIETAL AB-AU $19.78 60687-127-11 OMEGA-3 ACID ETHYL ESTERS 1 GRAM ORAL CAP $19.77 60687-127-65 OMEGA-3 ACID ETHYL ESTERS 1 GRAM ORAL CAP $19.77 54092-189-81 MESALAMINE 250 MG ORAL CPSR $19.73 99999-012-99 NOSEBLEEDS QR TOP PWDR $19.73 HC89006928 TRAZODONE; 1-2-AU $19.70 0121-0947-05 CARBAMAZEPINE 100 MG/5 ML (5 ML) ORAL SUSP $19.66 0641-6008-01 BUMETANIDE 0.25 MG/ML INJ SOLN $19.63 0641-6008-10 BUMETANIDE 0.25 MG/ML INJ SOLN $19.63 72572-040-01 BUMETANIDE 0.25 MG/ML INJ SOLN $19.63 72572-040-10 BUMETANIDE 0.25 MG/ML INJ SOLN $19.63 51079-588-01 THIOTHIXENE 5 MG ORAL CAP $19.62 51079-588-20 THIOTHIXENE 5 MG ORAL CAP $19.62 0245-0212-01 MIDODRINE 5 MG ORAL TAB $19.59 33342-094-52 RIZATRIPTAN 10 MG ORAL TBDL $19.58 33342-094-72 RIZATRIPTAN 10 MG ORAL TBDL $19.58 65219-570-01 BUMETANIDE 0.25 MG/ML INJ SOLN $19.58 65219-570-04 BUMETANIDE 0.25 MG/ML INJ SOLN $19.58 68084-549-11 TEMAZEPAM 7.5 MG ORAL CAP $19.58 68084-549-21 TEMAZEPAM 7.5 MG ORAL CAP $19.58 0245-0212-89 MIDODRINE 5 MG ORAL TAB $19.57 63323-533-13 ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRG $19.57 63323-559-63 ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRG $19.57 63323-559-65 ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRG $19.57 63323-664-00 DIPHENHYDRAMINE HCL 50 MG/ML INJ SOLN $19.57 63323-664-01 DIPHENHYDRAMINE HCL 50 MG/ML INJ SOLN $19.57 8770192172 PHENOL 1.4 % MUCOUS MEMB SPRA $19.56 46122-278-30 PHENOL 1.4 % MUCOUS MEMB SPRA $19.56 0574-0106-01 BROMOCRIPTINE 2.5 MG ORAL TAB $19.53 63304-962-01 BROMOCRIPTINE 2.5 MG ORAL TAB $19.53 7139974015 CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROP $19.50 0143-9333-01 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $19.50 0143-9333-10 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $19.50 0143-9334-01 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN $19.50 0143-9334-10 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN $19.50 0143-9856-01 CEFTRIAXONE 2 GRAM INJ SOLR $19.50 0143-9856-25 CEFTRIAXONE 2 GRAM INJ SOLR $19.50 0143-9889-01 AMOXICILLIN 250 MG/5 ML ORAL SUSR $19.50 0168-0004-15 TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM $19.50 0264-2101-00 WATER FOR IRRIGATION, STERILE IRR SOLN $19.50 0264-2201-10 SODIUM CHLORIDE 0.9 % IRR SOLN $19.50 0264-2202-00 RINGER'S IRR SOLN $19.50 0264-5535-32 METRONIDAZOLE IN NACL (ISO-OS) 500 MG/100 ML IV PGBK $19.50 0264-7510-10 DEXTROSE 5 % IN WATER (D5W) IV SOLP $19.50 0264-7520-00 DEXTROSE 10 % IN WATER (D10W) 10 % IV SOLP $19.50 0264-7520-10 DEXTROSE 10 % IN WATER (D10W) 10 % IV SOLP $19.50 0264-7636-00 POTASSIUM CHLORID-D5-0.45%NACL 30 MEQ/L IV SOLP $19.50 0264-7751-00 DEXTROSE 5 %-LACTATED RINGERS IV SOLP $19.50 0264-7800-10 SODIUM CHLORIDE 0.9 % IV SOLP $19.50 0264-7802-00 SODIUM CHLORIDE 0.45 % 0.45 % IV SOLP $19.50 0264-7802-10 SODIUM CHLORIDE 0.45 % 0.45 % IV SOLP $19.50 0264-7850-00 WATER FOR INJECTION, STERILE IV SOLP $19.50 0536-1316-25 ZINC OXIDE 20 % TOPICAL OINT $19.50 0641-6028-01 FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN $19.50 0641-6028-25 FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN $19.50 0641-6151-01 HYDROMORPHONE 2 MG/ML INJ SOLN (MHS) $19.50 0641-6151-25 HYDROMORPHONE 2 MG/ML INJ SOLN (MHS) $19.50 25021-114-82 CIPROFLOXACIN IN 5 % DEXTROSE 200 MG/100 ML IV PGBK $19.50 25021-135-10 AMPICILLIN SODIUM 500 MG INJ SOLR $19.50 36000-008-24 CIPROFLOXACIN IN 5 % DEXTROSE 200 MG/100 ML IV PGBK $19.50 44567-101-10 AMPICILLIN SODIUM 500 MG INJ SOLR $19.50 44567-701-25 CEFTRIAXONE 1 GRAM INJ SOLR $19.50 47781-598-07 VANCOMYCIN 500 MG IV SOLR $19.50 47781-598-91 VANCOMYCIN 500 MG IV SOLR $19.50 63323-117-00 FLUOROURACIL 500 MG/10 ML IV SOLN $19.50 63323-117-10 FLUOROURACIL 500 MG/10 ML IV SOLN $19.50 63323-623-53 SODIUM CHLORIDE 0.9 % IV SOLP $19.50 63323-623-61 SODIUM CHLORIDE 0.9 % IV SOLP $19.50 63323-624-04 DEXTROSE 5 % IN WATER (D5W) IV SOLP $19.50 63323-624-74 DEXTROSE 5 % IN WATER (D5W) IV SOLP $19.50 67457-348-10 AMPICILLIN-SULBACTAM 1.5 GRAM INJ SOLR $19.50 67457-348-15 AMPICILLIN-SULBACTAM 1.5 GRAM INJ SOLR $19.50 72611-761-01 VANCOMYCIN 500 MG IV SOLR $19.50 72611-761-10 VANCOMYCIN 500 MG IV SOLR $19.50 76045-121-01 HYDROMORPHONE (PF) 0.2 MG/ML INJ SYRG $19.50 76045-121-11 HYDROMORPHONE (PF) 0.2 MG/ML INJ SYRG $19.50 99999-005-28 CHLOROTHIAZIDE 25 MG/ML INJ DILUTION (MCH) $19.50 99999-033-08 MORPHINE 100 MG IN NS 100 ML (OCM) $19.50 99999-035-10 MORPHINE 1 MG/ML IN NS 100 ML OPIOID NAIVE PCA $19.50 99999-035-19 MORPHINE 100 MG IN NS 100 ML DRIP $19.50 99999-037-93 ZIDOVUDINE 10 MG/ML ORAL SYRP $19.50 99999-041-37 CIPROFLOXACIN 2 MG/ML INJECTION (MHS) $19.50 44567-801-10 PIPERACILLIN-TAZOBACTAM 2.25 GRAM IV SOLR $19.44 67457-374-12 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $19.44 67457-374-99 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $19.44 72570-122-35 WHITE PETROLATUM-MINERAL OIL 83-15 % OPHT OINT $19.43 0781-7516-14 BUDESONIDE 0.5 MG/2 ML INHALATION NBSP $19.40 0781-7516-87 BUDESONIDE 0.5 MG/2 ML INHALATION NBSP $19.40 82584-604-01 DORZOLAMIDE-TIMOLOL (PF) 2-0.5 % OPHT DPET $19.38 82584-604-30 DORZOLAMIDE-TIMOLOL (PF) 2-0.5 % OPHT DPET $19.38 60758-802-05 TIMOLOL MALEATE 0.25 % OPHT DROP $19.37 0069-3070-30 AZITHROMYCIN 500 MG ORAL TAB $19.35 99999-000-10 CHLOROTHIAZIDE 25 MG / 5 ML SYRINGE $19.35 50268-411-11 HYDROCORTISONE ACETATE 25 MG RECTAL SUPP $19.31 50268-411-12 HYDROCORTISONE ACETATE 25 MG RECTAL SUPP $19.31 42385-920-60 ATAZANAVIR 150 MG ORAL CAP $19.31 65862-711-60 ATAZANAVIR 150 MG ORAL CAP $19.31 68084-954-25 REPAGLINIDE 1 MG ORAL TAB $19.25 68084-954-95 REPAGLINIDE 1 MG ORAL TAB $19.25 55150-162-05 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $19.24 63739-170-13 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $19.24 HC89008379 HEMOGLOBIN PLASMA-AU $19.20 0173-0681-01 ZANAMIVIR 5 MG/ACTUATION INHALATION DSDV $19.18 0009-0775-20 CLINDAMYCIN PHOSPHATE 150 MG/ML INJ SOLN $19.14 0009-0775-26 CLINDAMYCIN PHOSPHATE 150 MG/ML INJ SOLN $19.14 51991-943-33 MOXIFLOXACIN 400 MG ORAL TAB $19.12 55111-112-30 MOXIFLOXACIN 400 MG ORAL TAB $19.12 60687-633-01 NITROFURANTOIN MONOHYD/M-CRYST 100 MG ORAL CAP $19.12 60687-633-11 NITROFURANTOIN MONOHYD/M-CRYST 100 MG ORAL CAP $19.12 65862-603-30 MOXIFLOXACIN 400 MG ORAL TAB $19.12 68084-446-01 NITROFURANTOIN MONOHYD/M-CRYST 100 MG ORAL CAP $19.12 68084-446-11 NITROFURANTOIN MONOHYD/M-CRYST 100 MG ORAL CAP $19.12 16714-985-01 TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM $19.11 0409-6102-04 FUROSEMIDE 10 MG/ML INJ SOLN $19.06 0409-6102-18 FUROSEMIDE 10 MG/ML INJ SOLN $19.06 0409-6102-26 FUROSEMIDE 10 MG/ML INJ SOLN $19.06 0409-6102-36 FUROSEMIDE 10 MG/ML INJ SOLN $19.06 63323-495-09 LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN $19.05 63323-495-27 LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN $19.05 HC89012991 DENGUE FEVER AB-AU $19.03 0143-9252-01 DOPAMINE 200 MG/5 ML (40 MG/ML) IV SOLN $19.01 0143-9252-25 DOPAMINE 200 MG/5 ML (40 MG/ML) IV SOLN $19.01 99999-041-22 CABERGOLINE 0.25 MG ORAL PARTIAL TAB $19.01 HC89008478 17 OH PROGESTERONE-AU $19.00 HC89009062 ALPHA-2 MACROGLOBULIN-AU $19.00 HC89018212 ALPHA-2 UR-AU $19.00 HC89015630 ANTITHROMBIN III-QD $19.00 HC89017800 ASPERGILLUS AB(PNL)-AU $19.00 HC51004091 CAPILLARY/HEEL/FINGER STICK $19.00 HC89003164 CERULOPLASMIN-QD $19.00 HC89014401 CHAGAS AB (PNL)-AU $19.00 HC89002265 CHLAMYDIA AB IGM-QD $19.00 HC89012538 CYSTICERCOSIS AB-AU $19.00 HC62211693 DRESSING SACRUM<324CM SQ(MEPILEX) $19.00 HC89004444 ENCEPHALITIS CALIF AB (PNL)-AU $19.00 HC89012306 ENCEPHALITIS CALIF AB IGG-AU $19.00 HC89012322 ENCEPHALITIS EASTERN AB IGG-AU $19.00 HC89004451 ENCEPHALITIS EASTRN AB(PNL)-AU $19.00 HC89012355 ENCEPHALITIS ST LOUIS AB IGG-AU $19.00 HC89004469 ENCEPHALITIS STLOUIS AB(PNL-AU $19.00 HC89012371 ENCEPHALITIS WESTERN AB IGG-AU $19.00 HC89004477 ENCEPHALITIS WESTRN AB(PNL)-AU $19.00 HC89008353 HEMOGLOBIN GLYCATED (A1C)-ES $19.00 HC89003198 HGB ELECTROPHERESIS-QD $19.00 HC89011746 IMMUNO ELECT CSF-AT $19.00 HC89003289 IMMUNO ELECT CSF-QD $19.00 HC89015242 INDERAL - AU $19.00 HC89009872 LIPID ASSOC SIALIC ACID-AU $19.00 HC89001515 PARAINFLUENZA AB-QD $19.00 HC89000368 T-3 REVERSE-QD $19.00 HC89003107 THYROGLOBULIN AB-QD $19.00 HC89016141 VIRAL ID (SHELL VIAL)-QD $19.00 HC89024160 SOLUBLE TRANSFERRIN RECEPTOR-AU $19.00 0143-9979-22 CEFUROXIME SODIUM 750 MG INJ SOLR $19.00 0143-9979-90 CEFUROXIME SODIUM 750 MG INJ SOLR $19.00 0409-3793-01 KETOROLAC 15 MG/ML INJ SOLN $18.99 0409-3793-19 KETOROLAC 15 MG/ML INJ SOLN $18.99 0480-3310-01 THEOPHYLLINE 300 MG ORAL TB12 $18.99 60687-302-25 NADOLOL 20 MG ORAL TAB $18.97 60687-302-95 NADOLOL 20 MG ORAL TAB $18.97 52244-100-10 THEOPHYLLINE 100 MG ORAL CP24 $18.95 42292-011-01 HYDROXYCHLOROQUINE 200 MG ORAL TAB $18.90 42292-011-06 HYDROXYCHLOROQUINE 200 MG ORAL TAB $18.90 0501-3401-02 ZINC OXIDE 13 % TOPICAL CREAM $18.90 78206-121-01 LOSARTAN 25 MG ORAL TAB $18.89 6373915710 FERROUS SULFATE 300 MG (60 MG IRON)/5 ML ORAL LIQD $18.88 6373915770 FERROUS SULFATE 300 MG (60 MG IRON)/5 ML ORAL LIQD $18.88 HC89009997 THYROGLOBULIN BY CIA-AU $18.88 0378-6090-01 DILTIAZEM HCL 90 MG ORAL CP12 $18.85 0781-6039-46 AMOXICILLIN 125 MG/5 ML ORAL SUSR $18.85 16729-501-43 FUROSEMIDE 10 MG/ML INJ SOLN $18.85 16729-501-64 FUROSEMIDE 10 MG/ML INJ SOLN $18.85 23155-473-32 FUROSEMIDE 10 MG/ML INJ SOLN $18.85 23155-473-42 FUROSEMIDE 10 MG/ML INJ SOLN $18.85 36000-283-25 FUROSEMIDE 10 MG/ML INJ SOLN $18.85 0536-1995-53 SELENIUM SULFIDE 1 % TOPICAL SHAM $18.84 63739-548-33 OXYBUTYNIN CHLORIDE 5 MG ORAL TR24 $18.84 70954-275-10 FLUPHENAZINE HCL 5 MG ORAL TAB $18.84 0641-6054-01 MEPERIDINE (PF) 100 MG/ML INJ SOLN $18.82 0641-6054-25 MEPERIDINE (PF) 100 MG/ML INJ SOLN $18.82 99998-005-09 MORPHINE (PF) 0.5 MG/ML INJ SOLN (MCH) $18.82 99999-036-85 KETAMINE 10 MG/ML INJ SOLN $18.82 99999-044-19 KETAMINE 10 MG/ML INJ SOLN $18.82 0409-7335-03 CEFTRIAXONE 2 GRAM INJ SOLR $18.81 0409-7335-13 CEFTRIAXONE 2 GRAM INJ SOLR $18.81 0409-7335-20 CEFTRIAXONE 2 GRAM INJ SOLR $18.81 0409-7335-21 CEFTRIAXONE 2 GRAM INJ SOLR $18.81 60687-684-11 NATEGLINIDE 120 MG ORAL TAB $18.81 60687-684-21 NATEGLINIDE 120 MG ORAL TAB $18.81 51672-3003-2 HYDROCORTISONE 2.5 % TOPICAL CREAM $18.80 53329-939-13 POVIDONE-IODINE 10 % TOPICAL SOLN $18.79 0121-0940-00 MAGNESIUM HYDROXIDE 2,400 MG/10 ML ORAL SUSP $18.79 0121-0940-10 MAGNESIUM HYDROXIDE 2,400 MG/10 ML ORAL SUSP $18.79 45802-174-53 METHYL SALICYLATE-MENTHOL 15-10 % TOPICAL CREAM $18.79 62542-301-05 HYDROCODONE-CHLORPHENIRAMINE 10-8 MG/5 ML ORAL SU12 $18.79 76045-106-10 DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJ SYRG $18.79 63323-965-01 POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN $18.72 63323-965-05 POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN $18.72 72572-350-01 LABETALOL 5 MG/ML IV SOLN $18.72 HC89023121 ELECTRO FRAC AND QUANT URINE-AU $18.68 63739-797-33 NIMODIPINE 30 MG ORAL CAP $18.68 69452-209-07 NIMODIPINE 30 MG ORAL CAP $18.68 69452-209-13 NIMODIPINE 30 MG ORAL CAP $18.68 69452-209-20 NIMODIPINE 30 MG ORAL CAP $18.68 52959-010-00 CITALOPRAM 20 MG ORAL TAB $18.67 50268-624-11 NITROFURANTOIN MACROCRYSTAL 100 MG ORAL CAP $18.66 50268-624-15 NITROFURANTOIN MACROCRYSTAL 100 MG ORAL CAP $18.66 63323-452-00 MORPHINE 2 MG/ML INJ SOLN $18.66 63323-452-01 MORPHINE 2 MG/ML INJ SOLN (MHS) $18.66 63323-454-00 MORPHINE 4 MG/ML INJ SOLN $18.66 63323-454-01 MORPHINE 4 MG/ML INJ SOLN $18.66 63323-455-00 MORPHINE 5 MG/ML INJ SOLN $18.66 63323-455-01 MORPHINE 5 MG/ML INJ SOLN $18.66 76045-004-01 MORPHINE 2 MG/ML INJ SOLN (MHS) $18.66 76045-004-11 MORPHINE 2 MG/ML INJ SOLN (MHS) $18.66 76045-005-01 MORPHINE 4 MG/ML INJ SOLN (MHS) $18.66 76045-005-10 MORPHINE 4 MG/ML INJ SYRG $18.66 76045-005-11 MORPHINE 4 MG/ML INJ SOLN (MHS) $18.66 76045-006-10 MORPHINE 5 MG/ML INJ SYRG $18.66 23155-747-03 RASAGILINE 1 MG ORAL TAB $18.64 0641-0391-12 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $18.62 0641-0391-37 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $18.62 HC89004378 ADENOVIRUS AG-AU $18.60 63323-412-18 MIDAZOLAM 5 MG/ML INJ SOLN (FOR INTRANASAL USE) $18.59 63323-412-25 MIDAZOLAM 5 MG/ML INJ SOLN (FOR INTRANASAL USE) $18.59 45802-143-03 NEOMYCIN-BACITRACNZN-POLYMYXNB 3.5MG-400 UNIT- 5,000 UNIT/GRAM TOPICAL OINT $18.56 HC89006738 GABAPENTIN (SERUM)-AU $18.55 0054-4581-27 MERCAPTOPURINE 50 MG ORAL TAB $18.55 1093979744 PHENYLEPH-MIN OIL-PETROLATUM 0.25-14-74.9 % RECTAL OINT $18.53 0245-0360-89 POTASSIUM CHLORIDE 20 MEQ ORAL PACK $18.53 49348-198-78 PHENYLEPH-MIN OIL-PETROLATUM 0.25-14-74.9 % RECTAL OINT $18.53 99999-040-54 CEFTRIAXONE 2 G/50 ML (40 MG/ML) INJ SYR (USING 10G) $18.53 60687-584-11 MIRTAZAPINE 7.5 MG ORAL TAB $18.51 60687-584-21 MIRTAZAPINE 7.5 MG ORAL TAB $18.51 4858280220 SALIVA SUBSTITUTE COMBO NO.9 MUCOUS MEMB MWSH $18.49 HC89007702 CORTISOL FREE URINE-AU $18.48 0536-1319-83 MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSP $18.46 63323-411-18 MIDAZOLAM 1MG/ML INJECTABLE SOLUTION (MHS) $18.46 63323-411-25 MIDAZOLAM 1MG/ML INJECTABLE SOLUTION (MHS) $18.46 0116-2001-16 CHLORHEXIDINE GLUCONATE 0.12 % MUCOUS MEMB MWSH $18.45 0781-7515-14 BUDESONIDE 0.25 MG/2 ML INHALATION NBSP $18.42 0781-7515-87 BUDESONIDE 0.25 MG/2 ML INHALATION NBSP $18.42 0245-0360-30 POTASSIUM CHLORIDE 20 MEQ ORAL PACK $18.42 59762-0050-1 METHYLPREDNISOLONE 16 MG ORAL TAB $18.41 47781-607-30 DISULFIRAM 250 MG ORAL TAB $18.38 HC89005821 AMIODARONE-AU $18.38 HC89011829 CIQ BINDING ASSAY-AU $18.38 HC89008585 IGF BINDING PROTEIN-3-AU $18.38 0641-6045-01 LORAZEPAM 4 MG/ML INJ SOLN $18.37 0641-6045-25 LORAZEPAM 4 MG/ML INJ SOLN $18.37 0781-3407-78 AMPICILLIN SODIUM 500 MG INJ SOLR $18.32 0781-3407-95 AMPICILLIN SODIUM 500 MG INJ SOLR $18.32 0378-4145-91 RILUZOLE 50 MG ORAL TAB $18.30 50268-652-11 PILOCARPINE HCL 5 MG ORAL TAB $18.30 50268-652-12 PILOCARPINE HCL 5 MG ORAL TAB $18.30 HC89016778 NBS 17 OH PROGESTERONE-GE $18.25 HC89004758 NBS BIOTINIDASE-GE $18.25 HC89003834 NBS HGB CHROMATOGRAPHY-GE $18.25 HC89004766 NBS IMMUNO TRYPSINOGEN(IRT)-GE $18.25 HC89016711 NBS TANDEM MASS SPEC MS/MS-GE $18.25 HC89003818 NBS TRANSFERASE-GE $18.25 HC89003826 NBS TSH-GE $18.25 0143-9300-01 PANTOPRAZOLE 40 MG IV SOLR $18.20 0143-9300-10 PANTOPRAZOLE 40 MG IV SOLR $18.20 0143-9310-01 ETOMIDATE 2 MG/ML IV SOLN $18.20 0143-9310-10 ETOMIDATE 2 MG/ML IV SOLN $18.20 0143-9577-01 LIDOCAINE HCL 10 MG/ML (1 %) INJ SOLN $18.20 0143-9577-10 LIDOCAINE HCL 10 MG/ML (1 %) INJ SOLN $18.20 0338-0049-10 SODIUM CHLORIDE 0.9 % IV SOLP $18.20 0904-7189-04 NEBIVOLOL 5 MG ORAL TAB $18.20 25021-311-04 FUROSEMIDE 10 MG/ML INJ SOLN (MCH) $18.20 49938-101-30 DAPSONE 100 MG ORAL TAB $18.20 60505-6144-4 CEFEPIME 1 GRAM INJ SOLR $18.20 63323-280-03 FUROSEMIDE 10 MG/ML INJ SOLN $18.20 63323-280-04 FUROSEMIDE 10 MG/ML INJ SOLN CODE NEO $18.20 65162-735-09 FELBAMATE 600 MG ORAL TAB $18.20 68084-964-25 PROPYLTHIOURACIL 50 MG ORAL TAB $18.20 68084-964-95 PROPYLTHIOURACIL 50 MG ORAL TAB $18.20 72572-550-01 PANTOPRAZOLE 40 MG IV SOLR $18.20 72572-550-10 PANTOPRAZOLE 40 MG IV SOLR $18.20 0904-6570-06 OXYBUTYNIN CHLORIDE 5 MG ORAL TR24 $18.19 66993-022-27 LEVALBUTEROL HCL 0.63 MG/3 ML INHALATION NEBU $18.16 66993-023-27 LEVALBUTEROL HCL 1.25 MG/3 ML INHALATION NEBU $18.16 66993-023-35 LEVALBUTEROL HCL 1.25 MG/3 ML INHALATION NEBU $18.16 0245-0144-89 AMIODARONE 100 MG ORAL TAB $18.14 0245-0144-01 AMIODARONE 100 MG ORAL TAB $18.12 0245-0144-30 AMIODARONE 100 MG ORAL TAB $18.12 42858-660-45 FENOFIBRATE 160 MG ORAL TAB $18.12 51672-4055-6 AMIODARONE 100 MG ORAL TAB $18.12 63739-988-32 ZIPRASIDONE HCL 20 MG ORAL CAP $18.08 15310-020-01 ESTROGENS-METHYLTESTOSTERONE 0.625-1.25 MG ORAL TAB $18.07 99999-001-59 ACETYLCYSTEINE 20 % (200 MG/ML) ORAL SOLN $18.07 0121-1008-00 ACETAMINOPHEN-CODEINE 300 MG-30 MG /12.5 ML ORAL SOLN $18.04 0121-1008-12 ACETAMINOPHEN-CODEINE 300 MG-30 MG /12.5 ML ORAL SOLN $18.04 0006-0951-54 LOSARTAN 25 MG ORAL TAB $18.01 51079-670-01 METHOTREXATE SODIUM 2.5 MG ORAL TAB $18.01 51079-670-05 METHOTREXATE SODIUM 2.5 MG ORAL TAB $18.01 68084-103-09 ZIPRASIDONE HCL 20 MG ORAL CAP $18.01 68084-103-11 ZIPRASIDONE HCL 20 MG ORAL CAP $18.01 72572-171-01 FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN $18.01 72572-171-25 FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN $18.01 HC89015325 A-1 ANTITRYPSIN-QD $18.00 HC89007017 ACTH-AU $18.00 HC89015481 ALK PHOSPHATASE-QD $18.00 HC89000830 ANTI CENTROMERE-QD $18.00 HC89001630 ANTI-HISTONE AB-QD $18.00 HC89001499 CRYPTOCOCCUS AB-QD $18.00 HC89001481 CRYPTOCOCCUS AG-QD $18.00 HC89015887 DENGUE FEVER AB-QD $18.00 HC89007926 DIHYDROXYVITAMIN D 1-25-AU $18.00 HC89016430 FLOW CYT MKR TC 1ST-AU $18.00 HC89016448 FLOW CYT MKR TC ADD+-AU $18.00 HC89006167 FLUPHENAZINE; 1-3-AU $18.00 HC89016257 HEPATITIS B SURFACE AB-QD $18.00 HC89003321 HEPATITIS BE AB-QD $18.00 HC89003313 HEPATITIS BE AG-QD $18.00 HC89021224 LCM AB, IGM-AU $18.00 HC89002257 LYME DISEASE AB-QD $18.00 HC89008965 MEPROBAMATE; 1-2-AU $18.00 HC89009450 PARATHYROID HORMONE INTACT-AU $18.00 HC89006878 PROTRIPTYLINE; 1-2-AU $18.00 HC89017420 TRICHROME STAIN CMPLX(O&P)-AU $18.00 HC89015606 URIC ACID FLUID-QD $18.00 HC51001592 VENIPUNCTURE ROUTINE $18.00 HC89007306 VITAMIN C-AU $18.00 HC89002992 VMA URINE-QD $18.00 HC89018097 WEST NILE VIR AB,IGM, CSF-AU $18.00 16714-553-01 DILTIAZEM HCL 60 MG ORAL CP12 $17.98 68462-850-01 DILTIAZEM HCL 60 MG ORAL CP12 $17.98 0409-9045-16 BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJ SOLN $17.94 0409-9045-17 BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJ SOLN $17.94 67457-372-12 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $17.94 67457-372-99 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $17.94 0904-6269-45 ZIPRASIDONE HCL 20 MG ORAL CAP $17.93 0264-7510-20 DEXTROSE 5 % IN WATER (D5W) IV SOLP $17.88 0338-0017-41 DEXTROSE 5 % IN WATER (D5W) IV SOLP $17.88 60687-483-01 NITROFURANTOIN MACROCRYSTAL 100 MG ORAL CAP $17.88 60687-483-11 NITROFURANTOIN MACROCRYSTAL 100 MG ORAL CAP $17.88 0054-8146-22 CLOTRIMAZOLE 10 MG MUCOUS MEMB TROC $17.86 50474-300-01 THEOPHYLLINE 300 MG ORAL CP24 $17.86 0409-9104-20 DOPAMINE 400 MG/10 ML (40 MG/ML) IV SOLN $17.81 0409-9104-21 DOPAMINE 400 MG/10 ML (40 MG/ML) IV SOLN $17.81 60505-6152-4 CEFTRIAXONE 500 MG INJ SOLR $17.81 70860-405-04 BUMETANIDE 0.25 MG/ML INJ SOLN $17.81 70860-405-41 BUMETANIDE 0.25 MG/ML INJ SOLN $17.81 72572-062-01 CEFTRIAXONE 2 GRAM INJ SOLR $17.81 72572-062-25 CEFTRIAXONE 2 GRAM INJ SOLR $17.81 51079-023-01 METOLAZONE 2.5 MG ORAL TAB $17.80 51079-023-20 METOLAZONE 2.5 MG ORAL TAB $17.80 0409-2066-05 LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN $17.78 0409-2066-10 LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN $17.78 63739-158-32 LEVETIRACETAM 500 MG/5 ML (5 ML) ORAL SOLN $17.78 63739-158-70 LEVETIRACETAM 500 MG/5 ML (5 ML) ORAL SOLN $17.78 0409-2585-01 CEFAZOLIN 1 GRAM IV SOLR $17.76 23155-521-31 FUROSEMIDE 10 MG/ML INJ SOLN (MCH) $17.75 25021-502-01 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG/ML INJ SOLN $17.75 51079-722-01 OXYBUTYNIN CHLORIDE 5 MG ORAL TR24 $17.74 51079-722-20 OXYBUTYNIN CHLORIDE 5 MG ORAL TR24 $17.74 51079-723-01 OXYBUTYNIN CHLORIDE 10 MG ORAL TR24 $17.74 51079-723-20 OXYBUTYNIN CHLORIDE 10 MG ORAL TR24 $17.74 55150-116-20 AMPICILLIN-SULBACTAM 1.5 GRAM INJ SOLR $17.71 16714-047-01 CHLORPROMAZINE 10 MG ORAL TAB $17.71 99999-041-24 DIMETHYL SULFOXIDE (BULK) 99.99 % MISC LIQD $17.65 0409-3578-01 TOBRAMYCIN SULFATE 40 MG/ML INJ SOLN $17.64 0409-3578-11 TOBRAMYCIN SULFATE 40 MG/ML INJ SOLN $17.64 45802-395-04 VITS A AND D-WHITE PET-LANOLIN TOPICAL OINT $17.63 72572-021-01 AMPICILLIN-SULBACTAM 1.5 GRAM INJ SOLR $17.62 72572-021-10 AMPICILLIN-SULBACTAM 1.5 GRAM INJ SOLR $17.62 68084-610-11 OXYBUTYNIN CHLORIDE 10 MG ORAL TR24 $17.58 68084-610-21 OXYBUTYNIN CHLORIDE 10 MG ORAL TR24 $17.58 0338-0017-48 DEXTROSE 5 % IN WATER (D5W) IV SOLP $17.55 0409-1163-01 BUPIVACAINE HCL 0.5 % (5 MG/ML) INJ SOLN $17.55 0409-1163-18 BUPIVACAINE HCL 0.5 % (5 MG/ML) INJ SOLN $17.55 0990-7075-26 POTASSIUM CHLORIDE IN WATER 20 MEQ/100 ML IV PGBK $17.55 47335-993-01 METRONIDAZOLE IN NACL (ISO-OS) 500 MG/100 ML IV PGBK $17.55 99999-046-48 CLONIDINE 20 MCG/ML ORAL LIQUID (COMPOUND) $17.55 0143-9660-01 METOPROLOL TARTRATE 5 MG/5 ML IV SOLN $17.52 0143-9660-10 METOPROLOL TARTRATE 5 MG/5 ML IV SOLN $17.52 0143-9873-01 METOPROLOL TARTRATE 5 MG/5 ML IV SOLN $17.52 0143-9873-25 METOPROLOL TARTRATE 5 MG/5 ML IV SOLN $17.52 68084-735-01 FLUCONAZOLE 200 MG ORAL TAB $17.51 68084-735-11 FLUCONAZOLE 200 MG ORAL TAB $17.51 50268-054-11 ACETAZOLAMIDE 250 MG ORAL TAB $17.46 50268-054-15 ACETAZOLAMIDE 250 MG ORAL TAB $17.46 63323-540-07 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $17.42 63323-540-67 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $17.42 0781-3402-78 AMPICILLIN SODIUM 250 MG INJ SOLR $17.41 0781-3402-95 AMPICILLIN SODIUM 250 MG INJ SOLR $17.41 HC89023006 CARCINOEMBRYONIC ANTIGEN (CEA) BODY FLUID-AU $17.40 49884-032-01 TRANYLCYPROMINE 10 MG ORAL TAB $17.38 72572-650-01 ROCURONIUM 10 MG/ML IV SOLN $17.36 72572-650-10 ROCURONIUM 10 MG/ML IV SOLN $17.36 31722-597-30 RITONAVIR 100 MG ORAL TAB $17.34 60505-2502-1 LEFLUNOMIDE 10 MG ORAL TAB $17.34 65862-687-30 RITONAVIR 100 MG ORAL TAB $17.34 16714-693-02 FLUCONAZOLE 200 MG ORAL TAB $17.32 0078-0509-05 CARBAMAZEPINE 200 MG ORAL TAB $17.30 1150900367 BENZOCAINE-RESORCINOL 5-2 % TOPICAL CREAM $17.29 0406-9960-01 TEMAZEPAM 7.5 MG ORAL CAP $17.29 55150-165-05 LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN $17.29 42291-780-30 RASAGILINE 1 MG ORAL TAB $17.28 8770142581 PHENOL 1.4 % MUCOUS MEMB SPRA $17.26 46122-265-30 PHENOL 1.4 % MUCOUS MEMB SPRA $17.26 99999-010-38 ENALAPRILAT 1.25 MG/ML INJ (MCH) $17.26 225052547 SODIUM CHLORIDE-ALOE VERA NASL GEL $17.23 0409-4031-01 MANNITOL 25 % 25 % IV SOLN $17.23 0409-4031-16 MANNITOL 25 % 25 % IV SOLN $17.23 0409-9045-01 BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJ SOLN $17.23 99999-045-44 FENTANYL DRIP 5 MCG/ML IN D5W 25 ML (OCM_NICU) $17.23 0832-0300-00 CHLORPROMAZINE 10 MG ORAL TAB $17.20 0641-6053-01 MEPERIDINE (PF) 50 MG/ML INJ SOLN $17.17 0641-6053-25 MEPERIDINE (PF) 50 MG/ML INJ SOLN $17.17 0143-9889-80 AMOXICILLIN 250 MG/5 ML ORAL SUSR $17.16 50268-140-11 BUPROPION HCL 150 MG ORAL TB24 $17.15 50268-140-13 BUPROPION HCL 150 MG ORAL TB24 $17.15 61570-073-01 ESTERIFIED ESTROGENS 0.625 MG ORAL TAB $17.12 50268-627-11 OXYBUTYNIN CHLORIDE 5 MG ORAL TR24 $17.12 50268-627-15 OXYBUTYNIN CHLORIDE 5 MG ORAL TR24 $17.12 63323-165-01 DEXAMETHASONE 4 MG/ML INJ SOLN (FOR ORAL USE) $17.10 63323-165-02 DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJ SOLN $17.10 60505-6148-4 CEFTRIAXONE 1 GRAM INJ SOLR $17.06 45802-188-16 PHENYLEPH-MIN OIL-PETROLATUM 0.25-14-74.9 % RECTAL OINT $17.04 HC89006548 NORTRIPTYLINE; 1-2-AU $17.03 HC89024145 CENTROMERE ANTIBODY, IGG-AU $17.03 51079-581-01 LEUCOVORIN CALCIUM 5 MG ORAL TAB $17.03 51079-581-06 LEUCOVORIN CALCIUM 5 MG ORAL TAB $17.03 HC89008452 5-HIAA URINE-AU $17.00 HC89015309 ALCOHOL; 1-2 (URINE)-QD $17.00 HC89001135 ASPERGILLUS AB-QD $17.00 HC89001309 BLASTOMYCES AB-QD $17.00 HC89000434 C1Q COMPLEMENT-QD $17.00 HC89007470 CHOLINESTERASE RBC-AU $17.00 HC89014286 COXSACKIE A AB-QD $17.00 HC89014294 COXSACKIE B AB-QD $17.00 HC89005383 ENDOMYSIAL AB IGA SCRN-AU $17.00 HC89011472 ENDOMYSIAL AB IGA TITER-AU $17.00 HC89015374 ESTROGEN TOTAL-QD $17.00 HC89000707 HISTOPLASMA AB-QD $17.00 HC89008411 HOMOVANILLIC ACID-AU $17.00 HC89002026 METANEPHRINE-QD $17.00 HC89015473 NUCLEOTIDASE-5-QD $17.00 HC89011555 RIBOSOMAL P PROTEIN AB-AU $17.00 HC89002679 RUBELLA IGM AB-QD $17.00 HC89015846 RUBEOLA AB IGG-QD $17.00 HC89000764 SEROTONIN-QD $17.00 HC89018378 TESTOSTERONE TOTL FEM/CHILD-AU $17.00 HC89017099 THROMBIN TIME 1:1 MIX-AU $17.00 HC89010045 THYROXINE BIND GLOBULIN-AU $17.00 HC89001416 TRICHINELLA AB-QD $17.00 HC51002210 URINALYSIS DIP STICK NONAUTO W/SCOPE $17.00 HC89019244 WEST NILE VIRUS IGG AB CSF-AU $17.00 68382-920-06 ENTECAVIR 0.5 MG ORAL TAB $16.99 68382-921-06 ENTECAVIR 1 MG ORAL TAB $16.99 42291-077-15 CLOBETASOL 0.05 % TOPICAL OINT $16.97 50268-788-11 VALACYCLOVIR 500 MG ORAL TAB $16.97 50268-788-15 VALACYCLOVIR 500 MG ORAL TAB $16.97 0536-1286-36 BISMUTH SUBSALICYLATE 262 MG/15 ML ORAL SUSP $16.95 HC89020887 WEST NILE VIRUS ELISA(PNL) -AU $16.92 25021-402-01 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $16.90 31722-630-31 OSELTAMIVIR 30 MG ORAL CAP $16.90 31722-631-31 OSELTAMIVIR 45 MG ORAL CAP $16.90 31722-632-31 OSELTAMIVIR 75 MG ORAL CAP $16.90 45802-014-02 HYDROCORTISONE 2.5 % TOPICAL OINT $16.90 55150-251-10 LIDOCAINE HCL 10 MG/ML (1 %) INJ SOLN $16.90 60687-423-11 CLOBAZAM 10 MG ORAL TAB $16.90 60687-423-21 CLOBAZAM 10 MG ORAL TAB $16.90 63323-201-02 LIDOCAINE HCL 10 MG/ML (1 %) INJ (FOR INTRAPLEURAL USE) $16.90 63323-202-02 LIDOCAINE HCL 20 MG/ML (2 %) INJ SOLN $16.90 0409-1283-03 HYDROMORPHONE 1 MG/ML INJ SOLN (MHS) $16.89 0409-1283-31 HYDROMORPHONE 1 MG/ML INJ SOLN (MHS) $16.89 99999-006-57 MAGNESIUM SULFATE 4 MEQ/ML ORAL LIQUID (MCH) $16.87 68180-658-06 RIFAMPIN 150 MG ORAL CAP $16.86 0409-3613-01 BUPIVACAINE-DEXTROSE-WATER(PF) 0.75 % (7.5 MG/ML) INJ SOLN $16.85 0409-3613-11 BUPIVACAINE-DEXTROSE-WATER(PF) 0.75 % (7.5 MG/ML) INJ SOLN $16.85 0641-1496-31 PROMETHAZINE 50 MG/ML INJ SOLN $16.84 0641-1496-35 PROMETHAZINE 50 MG/ML INJ SOLN $16.84 63323-236-10 CEFAZOLIN 500 MG INJ SOLR $16.84 67877-537-14 TEMOZOLOMIDE 5 MG ORAL CAP (MCH) $16.83 0054-0334-25 CEVIMELINE 30 MG ORAL CAP $16.80 63304-479-01 CEVIMELINE 30 MG ORAL CAP $16.80 63323-259-30 SODIUM CHLOR 0.9% BACTERIOSTAT 0.9 % INJ SOLN $16.77 99999-040-95 CEFAZOLIN 50 MG/ML INJ SYRINGE (SLH 10 G) $16.77 0071-0803-24 GABAPENTIN 100 MG ORAL CAP $16.74 HC89012728 HEPATITIS BE AB-AU $16.70 0641-0400-12 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $16.67 0641-0400-37 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $16.67 0121-4766-05 CALCIUM CARBONATE 500 MG/5 ML (1,250 MG/5 ML) ORAL SUSP $16.64 61990-0211-0 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $16.64 61990-0211-3 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $16.64 0378-1430-77 NICARDIPINE 30 MG ORAL CAP $16.60 HC89021612 DRUGS OF ABUSE SCR STIM AMINES,URINE-AU $16.60 HC89021604 DS BENZODIAZEPINES DETECT/PRESUMP-AU $16.60 0071-0350-60 PHENELZINE 15 MG ORAL TAB $16.59 64980-135-01 DIPYRIDAMOLE 75 MG ORAL TAB $16.59 0019-0953-50 IOTHALAMATE MEGLUMINE 60 % INJ SOLN $16.58 99999-043-52 HYDROCORTISONE 10 MG/5 ML ORAL SUSP (COMPOUND) (MCH) $16.58 0641-6127-01 MORPHINE 10 MG/ML IV SOLN (PCA, PED NAIVE <30 KG, COMPONENT) $16.56 0641-6127-25 MORPHINE 10 MG/ML IV SOLN (PCA, PED NAIVE <30 KG, COMPONENT) $16.56 69784-180-14 POLYETHYLENE GLYCOL 3350 17 GRAM ORAL PWPK $16.54 55111-263-79 OLANZAPINE 10 MG ORAL TBDL $16.52 55111-263-81 OLANZAPINE 10 MG ORAL TBDL $16.52 99999-000-45 PENICILLIN G POTASSIUM 100000 UNITS / ML $16.51 HC89002000 DESIPRAMINE; 1-2-AU $16.50 HC89010730 MURAMIDASE-AU $16.50 0378-6060-01 DILTIAZEM HCL 60 MG ORAL CP12 $16.50 0641-6052-01 MEPERIDINE (PF) 25 MG/ML INJ SOLN $16.48 0641-6052-25 MEPERIDINE (PF) 25 MG/ML INJ SOLN $16.48 68084-252-11 BUPROPION HCL 300 MG ORAL TB24 $16.45 68084-252-21 BUPROPION HCL 300 MG ORAL TB24 $16.45 0378-3925-93 FEBUXOSTAT 40 MG ORAL TAB $16.45 53329-013-11 MINERAL OIL RECTAL ENEM $16.43 63739-920-11 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $16.32 63739-920-25 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $16.32 67457-815-00 CLINDAMYCIN PHOSPHATE 150 MG/ML INJ SOLN $16.28 67457-815-04 CLINDAMYCIN PHOSPHATE 150 MG/ML INJ SOLN $16.28 0143-9331-01 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN $16.25 0143-9331-10 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN $16.25 0264-7800-20 SODIUM CHLORIDE 0.9 % IV SOLP $16.25 0338-0017-18 DEXTROSE 5 % IN WATER (D5W) IV SOLP $16.25 0338-0049-48 SODIUM CHLORIDE 0.9 % IV SOLP $16.25 31722-557-60 ABACAVIR 300 MG ORAL TAB $16.25 33342-107-07 RISEDRONATE 5 MG ORAL TAB $16.25 33342-258-66 OSELTAMIVIR 75 MG ORAL CAP $16.25 42799-405-01 ETHACRYNIC ACID 25 MG ORAL TAB $16.25 53489-700-07 QUININE SULFATE 324 MG ORAL CAP $16.25 60687-538-11 FEBUXOSTAT 40 MG ORAL TAB $16.25 60687-538-21 FEBUXOSTAT 40 MG ORAL TAB $16.25 62559-721-01 TERBUTALINE 2.5 MG ORAL TAB $16.25 63323-117-19 FLUOROURACIL 500 MG/10 ML IV SOLN $16.25 63323-117-31 FLUOROURACIL 500 MG/10 ML IV SOLN $16.25 63323-806-05 FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN $16.25 63323-806-13 FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN $16.25 65862-073-60 ABACAVIR 300 MG ORAL TAB $16.25 72485-106-25 LEVETIRACETAM 500 MG/5 ML IV SOLN $16.25 1093956433 BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINT $16.25 1093956833 BACITRACIN ZINC-POLYMYXIN B 500-10,000 UNIT/GRAM TOPICAL OINT $16.25 49348-154-72 BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINT $16.25 49348-274-72 BACITRACIN ZINC-POLYMYXIN B 500-10,000 UNIT/GRAM TOPICAL OINT $16.25 50268-339-11 FLUCONAZOLE 200 MG ORAL TAB $16.24 50268-339-15 FLUCONAZOLE 200 MG ORAL TAB $16.24 99999-044-58 BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJ SOLN $16.24 0641-6125-01 MORPHINE 4 MG/ML IV SOLN $16.23 0641-6125-25 MORPHINE 4 MG/ML IV SOLN $16.23 0378-1430-05 NICARDIPINE 30 MG ORAL CAP $16.22 1093944333 PHENYLEPHRINE HCL 1 % NASL DROP $16.19 49348-197-27 PHENYLEPHRINE HCL 1 % NASL DROP $16.19 HC89022461 CULTURE PRESUMPTIVE ID HSV(PNL)-AU $16.18 0009-0870-21 CLINDAMYCIN PHOSPHATE 150 MG/ML INJ SOLN $16.17 0009-0870-26 CLINDAMYCIN PHOSPHATE 150 MG/ML INJ SOLN $16.17 HC89011688 DIPHTHERIA AB-AU $16.16 51079-767-01 DIVALPROEX 500 MG ORAL TB24 $16.15 51079-767-08 DIVALPROEX 500 MG ORAL TB24 $16.15 59746-003-14 METHYLPREDNISOLONE 16 MG ORAL TAB $16.15 149003904 BISMUTH SUBSALICYLATE 262 MG/15 ML ORAL SUSP $16.11 1093914533 PRAMOXINE-CALAMINE 1-8 % TOPICAL LOTN $16.11 0536-1228-58 PHENOL 1.4 % MUCOUS MEMB SPRA $16.11 37000-032-01 BISMUTH SUBSALICYLATE 262 MG/15 ML ORAL SUSP $16.11 68084-598-01 NIFEDIPINE 60 MG ORAL TR24 $16.08 68084-598-11 NIFEDIPINE 60 MG ORAL TR24 $16.08 0143-9637-01 VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) IV SOLN $16.06 0143-9637-10 VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) IV SOLN $16.06 HC89008924 MANGANESE-AU $16.03 60219-1523-1 TETRACYCLINE 500 MG ORAL CAP $16.02 45802-060-03 BACITRACIN 500 UNIT/GRAM TOPICAL OINT $16.02 HC89006985 ACETYLCHOLINESTERASE-AU $16.00 HC89016687 ACID FAST PARASITES-AU $16.00 HC89013882 ACID PHOS PROSTATIC-AU $16.00 HC89000210 ADENOVIRUS AB-QD $16.00 HC89007132 AFP-AU $16.00 HC89013395 AMPLIFIED PROBE TECH-AU $16.00 HC89014054 ANA-AU $16.00 HC89017750 ANTI MICROSOMAL THYROID(PNL-AU $16.00 HC89011449 ANTI SMOOTH MUSCLE AB-AU $16.00 HC89010953 ANTI-CARDIOLIPIN AB-AU $16.00 HC89017743 ANTI-DNA AB (DS)(PNL)-AU $16.00 HC89011126 ANTI-DNA ANTIBODIES (DS)-AU $16.00 HC89011274 ANTI-SSA AB-AU $16.00 HC89011282 ANTI-SSB AB-AU $16.00 HC89015770 BARTONELLA AB-QD $16.00 HC89007322 BUTALBITAL/FLORINAL-AU $16.00 HC89002281 C2 COMPLEMENT-QD $16.00 HC89003123 C3 COMPLEMENT-QD $16.00 HC89003131 C4 COMPLEMENT-QD $16.00 HC89015341 CALCIUM URINE-QD $16.00 HC89012017 CANDIDA AB-FT $16.00 HC89012181 CANDIDA AB-FT $16.00 HC89004436 CHAGAS AB-AU $16.00 HC89017388 CHLORIDE CSF-AU $16.00 HC89004055 CLOMIPRAMINE; 1-2-AU $16.00 HC89016158 COMPLEMENT TOTAL HEMOLYTIC-QD $16.00 HC89012421 COXSACKIE B AB (PNL)-AU $16.00 HC89016182 CULTURE STOOL ADDL PATH-QD $16.00 HC89015929 CULTURE VIRUS-QD $16.00 HC89007249 DELTA OD 450-U2 $16.00 HC89012504 EBV AB-VIRAL CAPSID AG-AU $16.00 HC89004105 ENTAMOEBA HISTOLYTICA AB - AU $16.00 HC89008031 FATTY ACIDS FREE-AU $16.00 HC89010821 FEBRILE AGGLUTININS-FT $16.00 HC89013171 GIARDIA AG-AU $16.00 HC89008288 HAPTOGLOBIN QUANT-AU $16.00 HC89011696 HBV SURFACE AB QUANT-SL $16.00 HC89008320 HGB ELECTROPHERESIS-AU $16.00 HC89012710 HIV 1&2 AB-AU $16.00 HC89012603 HTLV-I AB-AU $16.00 HC89002802 HU FA AB SCRN-QD $16.00 HC89008502 HYDROXYPROLINE TOTAL-AU $16.00 HC89006746 IBUPROFEN; 1-2-AU $16.00 HC89005375 IMMUNOGLOB IGA-AU $16.00 HC89010680 INHIB PROTEIN S FREE (FUNC)-AU $16.00 HC89008833 LDH ISOENZYMES(PNL)-AU $16.00 HC89000491 LEGIONELLA AG DFA-U2 $16.00 HC89008601 LEGIONELLA AG URINE-AU $16.00 HC89001507 LEPTOSPIRA AB-QD $16.00 HC89006530 LIDOCAINE-AU $16.00 HC89012140 LYME DISEASE AB CONFIRM-AU $16.00 HC89011803 LYSOZYME MURAMIDASE (GID)-AU $16.00 HC89004287 MEAT FIBERS, FECES-AU $16.00 HC89006811 METHOTREXATE-AU $16.00 HC89009039 METHSUXIMIDE; 1-3-AU $16.00 HC89002547 MYOGLOBIN URINE-QD $16.00 HC89011324 NEUTROPHIL CYTOPLAS IFA AB-AU $16.00 HC89004097 OSTEOCALCIN-AU $16.00 HC89002661 PARVOVIRUS AB-QD $16.00 HC89007330 PENTOBARBITAL-AU $16.00 HC89009542 PHENYLALANINE SCREEN-AU $16.00 HC89009633 PHOSPHORUS URINE-AU $16.00 HC89004386 PROCAINAMIDE W/NAPA-AU $16.00 HC89017164 PROPAFENONE-AU $16.00 HC89011340 RNP AB IGG-AU $16.00 HC89011357 RNP REFLEX (PNL)-AU $16.00 HC89015762 RPR/VDRL QUAL-QD $16.00 HC89015853 SALMONELLA AB-QD $16.00 HC89003347 SCL 70 ENA AB-QD $16.00 HC89011365 SCL-70 REFLEX (PNL)-AU $16.00 HC89011373 SCLERODERMA SCL-70 AB IGG-AU $16.00 HC89011381 SMITH (ENA) AD IGG-AU $16.00 HC89011399 SMITH REFLEX (PNL)-AU $16.00 HC89011407 SSA REFLEX (PNL)-AU $16.00 HC89011423 SSB REFLEX (PNL)-AU $16.00 HC89013973 THS 3RD GENERATION-AU $16.00 HC89014468 TOXOPLASMA AB IGG-AU $16.00 HC89003479 TOXOPLASMA AB-QD $16.00 HC89010086 TRANSFERRIN-AU $16.00 HC89008684 TSH RECEPTOR AB-AU $16.00 HC89010144 URIC ACID FLUID-AU $16.00 HC89012074 VDRL TITER QUANT-AU $16.00 HC89009971 VITAMIN B1 THIAMINE-AU $16.00 HC89008908 VLDL CHOLESTEROL-AU $16.00 HC89010193 VMA URINE-AU $16.00 HC89002810 YO FA AB SCRN-QD $16.00 HC51063220 KETONES, URINE DIPSTICK POC $16.00 0409-2552-01 HYDROMORPHONE 1 MG/ML INJ SOLN (MHS) $16.00 0143-9595-01 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $15.99 0143-9595-25 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $15.99 49348-521-78 HYDROCORTISONE-ALOE VERA 1 % TOPICAL CREAM $15.99 63739-170-27 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $15.99 81565-204-01 ROCURONIUM 10 MG/ML IV SOLN $15.99 81565-204-02 ROCURONIUM 10 MG/ML IV SOLN $15.99 99999-001-91 HYDROCODONE-CHLORPHENIRAMINE 10-8 MG/5 ML ORAL SU12 $15.96 0536-1288-06 PHENYLEPH-MIN OIL-PETROLATUM 0.25-14-74.9 % RECTAL OINT $15.93 0990-7984-13 SODIUM CHLORIDE 0.9% IV SOLP FOR BLD TRANSFUSION $15.93 13668-086-30 OLANZAPINE 5 MG ORAL TBDL $15.93 75826-118-10 PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2-0.1037 -0.0194 MG ORAL TAB $15.93 99999-037-59 PHYTONADIONE 1 MG/0.5 ML INJ SOLN DILUTION (COMPOUNDED) $15.91 63323-201-03 LIDOCAINE HCL 10 MG/ML (1 %) INJ SOLN $15.86 63323-201-10 LIDOCAINE HCL 10 MG/ML (1 %) INJ SOLN $15.86 0228-2780-11 PROPRANOLOL 120 MG ORAL CS24 $15.84 99999-000-39 VANCOMYCIN 5MG/ML SYRINGE $15.80 4110081163 VITS A AND D-WHITE PET-LANOLIN TOPICAL OINT $15.75 HC89013205 HEPATITIS BE AG-AU $15.70 71399-3884-6 LIDOCAINE 4 % TOPICAL PTMD $15.70 68084-059-11 ZAFIRLUKAST 20 MG ORAL TAB $15.68 68084-059-21 ZAFIRLUKAST 20 MG ORAL TAB $15.68 68084-850-32 POTASSIUM CITRATE 10 MEQ (1,080 MG) ORAL TBSR $15.68 68084-850-33 POTASSIUM CITRATE 10 MEQ (1,080 MG) ORAL TBSR $15.68 99999-037-00 HYDROCODONE-CHLORPHENIRAMINE 10-8 MG/5 ML ORAL SU12 $15.67 HC89007413 CAROTENE-AU $15.60 0338-0017-38 D5W IV BOLUS $15.60 0338-0049-18 SODIUM CHLORIDE 0.9 % IV SOLP $15.60 0338-0049-38 SODIUM CHLORIDE 0.9 % IV SOLP $15.60 0409-4777-23 CIPROFLOXACIN IN D5W 200 MG/100 ML IV PGBK (MCH) $15.60 0409-4887-24 WATER FOR INJECTION, STERILE INJ SOLN $15.60 0409-4887-50 WATER FOR INJECTION, STERILE INJ SOLN $15.60 25021-106-10 CEFTRIAXONE 1 GRAM INJ SOLR $15.60 25021-400-01 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $15.60 63323-269-37 PROPOFOL 10 MG/ML IV EMUL $15.60 63323-924-03 SODIUM CHLOR 0.9% BACTERIOSTAT 0.9 % INJ SOLN $15.60 63323-924-30 SODIUM CHLOR 0.9% BACTERIOSTAT 0.9 % INJ SOLN $15.60 65162-734-09 FELBAMATE 400 MG ORAL TAB $15.60 70860-302-10 FUROSEMIDE 10 MG/ML INJ SOLN (MCH) $15.60 70860-302-43 FUROSEMIDE 10 MG/ML INJ SOLN $15.60 99999-036-82 MITOTANE 250 MG ORAL PARTIAL TAB $15.60 99999-041-93 CEFAZOLIN IN DEXTROSE (ISO-OS) 2 GRAM/100 ML IV PGBK $15.60 99999-042-27 MEROPENEM 20 MG/ML INJ SOLN $15.60 99999-044-66 MAGNESIUM SULFATE 0.5 MEQ/ML INJ SOLN $15.60 99999-044-67 MAGNESIUM 1 MEQ / ML INJ SOLN $15.60 62332-342-30 CANDESARTAN 8 MG ORAL TAB $15.57 55150-169-10 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN $15.54 55150-171-10 BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJ SOLN $15.54 99999-042-50 HYDROCODONE-CHLORPHENIRAMINE 10-8 MG/5 ML ORAL SU12 $15.54 0078-0246-61 CYCLOSPORINE MODIFIED 25 MG ORAL CAP $15.47 0409-3178-01 LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN $15.47 0409-3178-16 LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN $15.47 61269-735-56 MICONAZOLE NITRATE 2 % TOPICAL CREAM $15.47 63739-168-33 DOXYCYCLINE HYCLATE 100 MG ORAL TAB $15.44 50268-411-24 HYDROCORTISONE ACETATE 25 MG RECTAL SUPP $15.42 55150-112-10 AMPICILLIN SODIUM 500 MG INJ SOLR $15.41 55150-170-30 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN $15.41 71399-7889-1 MAGNESIUM CITRATE ORAL SOLN $15.39 51672-4051-4 ETODOLAC 400 MG ORAL TB24 $15.39 68382-271-14 ETODOLAC 400 MG ORAL TB24 $15.39 0904-7096-61 PIOGLITAZONE 30 MG ORAL TAB $15.38 0078-0246-15 CYCLOSPORINE MODIFIED 25 MG ORAL CAP $15.37 10361-793-01 SOD BICARB-CITRIC AC-SIMETH 2.21-1.53 GRAM/4 GRAM ORAL GREP $15.36 1093972744 GUAIFENESIN 100 MG/5 ML ORAL LIQD $15.34 0904-6985-20 DIPHENHYDRAMINE HCL 12.5 MG/5 ML ORAL LIQD $15.34 63323-492-04 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $15.34 63323-492-27 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $15.34 1093919844 DIPHENHYDRAMINE-ZINC ACETATE 2-0.1 % TOPICAL CREAM $15.32 49348-854-72 DIPHENHYDRAMINE-ZINC ACETATE 2-0.1 % TOPICAL CREAM $15.32 0378-0014-01 METHOTREXATE SODIUM 2.5 MG ORAL TAB $15.31 47335-890-60 TEMOZOLOMIDE 5 MG ORAL CAP $15.30 47335-890-72 TEMOZOLOMIDE 5 MG ORAL CAP $15.30 49884-660-09 CANDESARTAN 16 MG ORAL TAB $15.29 51079-121-01 LANSOPRAZOLE 30 MG ORAL CPDR $15.29 51079-121-08 LANSOPRAZOLE 30 MG ORAL CPDR $15.29 69784-180-01 POLYETHYLENE GLYCOL 3350 17 GRAM ORAL PWPK $15.29 69784-180-10 POLYETHYLENE GLYCOL 3350 17 GRAM ORAL PWPK $15.29 0121-0504-00 ACETAMINOPHEN-CODEINE 120 MG-12 MG /5 ML (5 ML) ORAL SOLN $15.28 0121-0504-05 ACETAMINOPHEN-CODEINE 120 MG-12 MG /5 ML (5 ML) ORAL SOLN $15.28 0338-0017-31 DEXTROSE 5 % IN WATER (D5W) IV SOLP $15.28 0338-0049-31 SODIUM CHLORIDE 0.9 % IV SOLP $15.28 49884-658-09 CANDESARTAN 4 MG ORAL TAB $15.28 49884-659-09 CANDESARTAN 8 MG ORAL TAB $15.28 47781-308-01 NITROFURANTOIN MACROCRYSTAL 100 MG ORAL CAP $15.27 62332-047-90 VALSARTAN 320 MG ORAL TAB $15.24 0409-4277-01 LIDOCAINE HCL 20 MG/ML (2 %) INJ SOLN $15.21 0409-4277-16 LIDOCAINE HCL 20 MG/ML (2 %) INJ SOLN $15.21 60687-629-11 FENOFIBRATE NANOCRYSTALLIZED 145 MG ORAL TAB $15.17 60687-629-21 FENOFIBRATE NANOCRYSTALLIZED 145 MG ORAL TAB $15.17 99999-002-43 DIGOXIN 50 MCG/ML (NICU) ORAL SYRINGE $15.17 72572-017-01 AMPICILLIN SODIUM 2 GRAM INJ SOLR $15.15 72572-017-10 AMPICILLIN SODIUM 2 GRAM INJ SOLR $15.15 0904-6573-04 BUPROPION HCL 300 MG ORAL TB24 $15.13 59762-0117-1 MESALAMINE 400 MG ORAL CDTI $15.13 0527-1789-01 FLUPHENAZINE HCL 2.5 MG ORAL TAB $15.08 HC89007124 A-1 ANTITRYPSIN/PHENOTYPE-AU $15.03 4628750030 SORBITOL 70 % MISC SOLN $15.02 0121-1276-00 DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML ORAL SYRP $15.02 0121-1276-10 DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML ORAL SYRP $15.02 0264-5705-05 HEPARIN, PORCINE (PF) 5,000 UNIT/0.5 ML INJ SOLN (MHS) $15.02 0264-5705-10 HEPARIN, PORCINE (PF) 5,000 UNIT/0.5 ML INJ SOLN (MHS) $15.02 69339-150-01 DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML ORAL SYRP $15.02 69339-150-19 DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML ORAL SYRP $15.02 HC89013940 ACETYLCHOLINE RECEPTOR AB-AU $15.00 HC89007090 ALDOSTERONE-AU $15.00 HC89001325 ANTI-DNASE B-QD $15.00 HC89500961 ANTIGLOBULIN DIRECT TEST COOMBS; EACH ANTISERUM-SB $15.00 HC89017735 APOLIPOPROTEIN A1(PNL)-AU $15.00 HC89007363 CADMIUM-AU $15.00 HC89013247 CHLAMYDIA TRACHOMATIS AMP-AU $15.00 HC89011035 COMPLEMENT TOTAL HEMOLYTIC-AU $15.00 HC89000251 CONCENTRATION INF AGTS(PNL)-FT $15.00 HC89004345 CRYPTOSPORIDIUM ANTIGEN-AU $15.00 HC89012553 ECHINOCOCCUS AB-AU $15.00 HC89001473 ECHOVIRUS AB-QD $15.00 HC89008338 HGB CHROMATOGRAPHY-AU $15.00 HC89003206 IMMUNO ELECT-QD $15.00 HC89011852 IMMUNOFIX ELECTROPHORESIS-AU $15.00 HC89010672 INHIB PROTEIN S TOTAL-AU $15.00 HC89018386 KAPPA FREE LIGHT CHAINS QT-AU $15.00 HC89018394 LAMBDA FREE LIGHT CHAINS QT-AU $15.00 HC89014682 LEGIONELLA AG URINE-AU $15.00 HC89017362 LYME AB, IGG BY WB-AU $15.00 HC89017354 LYME AB, IGM BY WB -AU $15.00 HC89003339 MERCURY-QD $15.00 HC89009427 METHYL MALONIC ACID (B12)-AU $15.00 HC89013692 MYELIN BASIC PROTEIN CSF-QD $15.00 HC89013353 N-GONORRHEA DNA AMP PROBE-AU $15.00 HC89016034 PREGNENOLONE-QD $15.00 HC89016042 PROGESTERONE-QD $15.00 HC89012223 Q FEVER AB-AU $15.00 HC89006597 QUINIDINE-AU $15.00 HC89001598 ROTAVIRUS AG-QD $15.00 HC89006613 TACROLIMUS-AU $15.00 HC89017461 THROMBIN TIME RFX - AU $15.00 HC89004485 THROMBIN TIME-AU $15.00 HC89018055 TISSUE TRANSGLUTAMNS AB IGG-AU $15.00 HC89000475 TULAREMIA AB-QD $15.00 HC89012850 TYPHUS FEVER ANTIBODY-AU $15.00 HC89010177 VANILLYLMANDELIC ACID URINE-AU $15.00 51672-4023-1 ACETAZOLAMIDE 250 MG ORAL TAB $15.00 0264-1510-32 DEXTROSE 5 % IN WATER (D5W) IV SOLP $14.95 0264-1800-32 SODIUM CHLORIDE 0.9 % IV SOLP $14.95 0338-1055-48 METRONIDAZOLE IN NACL (ISO-OS) 500 MG/100 ML IV PGBK $14.95 0574-0790-01 METHAZOLAMIDE 25 MG ORAL TAB $14.95 0990-7984-23 SODIUM CHLORIDE 0.9% IV SOLP FOR BLD TRANSFUSION $14.95 25021-131-82 METRONIDAZOLE IN NACL (ISO-OS) 500 MG/100 ML IV PGBK $14.95 63323-965-02 POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN $14.95 63323-965-20 POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN $14.95 72572-590-01 PROPOFOL 10 MG/ML IV EMUL $14.95 72572-590-10 PROPOFOL 10 MG/ML IV EMUL $14.95 60687-103-25 FAMCICLOVIR 500 MG ORAL TAB $14.91 60687-103-95 FAMCICLOVIR 500 MG ORAL TAB $14.91 HC89012629 HERPES I&II SIMPLE AB (PNL)-AU $14.90 60505-2542-6 GALANTAMINE 4 MG ORAL TAB $14.89 0904-6570-61 OXYBUTYNIN CHLORIDE 5 MG ORAL TR24 $14.89 81565-203-01 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $14.89 81565-203-02 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $14.89 49938-102-30 DAPSONE 25 MG ORAL TAB $14.83 68084-928-25 PILOCARPINE HCL 5 MG ORAL TAB $14.79 68084-928-95 PILOCARPINE HCL 5 MG ORAL TAB $14.79 0115-1911-01 RIMANTADINE 100 MG ORAL TAB $14.78 50268-105-11 BACLOFEN 5 MG ORAL TAB $14.78 50268-105-15 BACLOFEN 5 MG ORAL TAB $14.78 60687-746-01 MISOPROSTOL 200 MCG ORAL TAB $14.76 60687-746-11 MISOPROSTOL 200 MCG ORAL TAB $14.76 68084-041-01 MISOPROSTOL 200 MCG ORAL TAB $14.76 68084-041-11 MISOPROSTOL 200 MCG ORAL TAB $14.76 HC89012801 PARVOVIRUS B19 AB-AU $14.75 HC89008171 GASTRIN-AU $14.73 42571-382-71 DORZOLAMIDE-TIMOLOL (PF) 2-0.5 % OPHT DPET $14.69 42571-382-73 DORZOLAMIDE-TIMOLOL (PF) 2-0.5 % OPHT DPET $14.69 65862-947-15 DORZOLAMIDE-TIMOLOL (PF) 2-0.5 % OPHT DPET $14.69 65862-947-60 DORZOLAMIDE-TIMOLOL (PF) 2-0.5 % OPHT DPET $14.69 31722-623-30 ROFLUMILAST 500 MCG ORAL TAB $14.68 31722-623-90 ROFLUMILAST 500 MCG ORAL TAB $14.68 16714-820-01 TENOFOVIR DISOPROXIL FUMARATE 300 MG ORAL TAB $14.64 50268-599-11 NIFEDIPINE 90 MG ORAL TR24 $14.63 50268-599-15 NIFEDIPINE 90 MG ORAL TR24 $14.63 4771300026 DEXTROSE 40 % ORAL GEL $14.63 0143-9317-01 LEVOFLOXACIN IN D5W 750 MG/150 ML IV PGBK $14.63 0264-1510-31 DEXTROSE 5 % IN WATER (D5W) IV SOLP $14.63 0264-7520-20 DEXTROSE 10 % IN WATER (D10W) 10 % IV SOLP $14.63 0264-7850-20 WATER FOR INJECTION, STERILE IV SOLP $14.63 0990-7923-13 DEXTROSE 5 % IN WATER (D5W) IV SOLP $14.63 60505-6152-1 CEFTRIAXONE 500 MG INJ SOLR $14.63 65219-014-01 AMPICILLIN SODIUM 250 MG INJ SOLR $14.63 65219-014-10 AMPICILLIN SODIUM 250 MG INJ SOLR $14.63 69238-1126-1 ETHACRYNIC ACID 25 MG ORAL TAB $14.63 69339-153-01 MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSP $14.63 99999-036-06 MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSP $14.63 99999-044-46 AMIODARONE IN D5W 225 MG/250 ML (0.9 MG/ML) IV SOLN (MHS) $14.63 0093-3129-01 DISOPYRAMIDE PHOSPHATE 150 MG ORAL CAP $14.61 HC89007165 ALUMINIUM-AU $14.60 HC89007983 ESTRIOL-AU $14.50 HC89022404 FLOW CYT LEUK/LYMPH MRKRS ADD+-AU $14.50 0121-1730-10 DIPHENHYDRAMINE HCL 12.5 MG/5 ML ORAL LIQD $14.50 0409-1165-01 BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJ SOLN $14.50 0409-1165-18 BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJ SOLN $14.50 0990-7984-20 SODIUM CHLORIDE 0.9 % IV SOLP $14.46 65162-778-10 BUDESONIDE 3 MG ORAL CECX $14.46 0378-7401-78 MESALAMINE 1.2 GRAM ORAL TBEC $14.46 17856-4069-4 PHENYTOIN 100 MG/4 ML ORAL SUSP $14.46 99999-037-70 ACETYLCYSTEINE 100 MG/ML (10 %) MISC SOLN $14.46 0132-0703-36 BISACODYL 10 MG/30 ML RECTAL ENEM $14.43 55150-161-02 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $14.43 51672-4026-1 KETOCONAZOLE 200 MG ORAL TAB $14.40 HC89020218 ATG16L1 SNP (RS2241880)(PL)-PR $14.40 HC89020226 ECM1 SNP (RS3737240)(PNL)-PR $14.40 HC89020234 NKX2-3 SNP (RS10883365)(PL)-PR $14.40 HC89020242 STAT3 SNP (RS744166)(PNL)-PR $14.40 0713-0280-31 BACITRACIN 500 UNIT/GRAM TOPICAL OINT $14.40 HC89013510 BETA-2 MICROGLOBULIN URINE-AU $14.38 4110081128 DIMETHICONE-ZNOX-VIT A-D-ALOE 1-10 % TOPICAL CREAM $14.37 0143-9594-01 LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN $14.37 0143-9594-25 LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN $14.37 63323-806-01 FENTANYL (PF) 50 MCG/ML INJ FOR INTRATHECAL PAIN PUMP REFILL (OCM) $14.37 63323-806-11 FENTANYL (PF) 50 MCG/ML INJ FOR INTRATHECAL PAIN PUMP REFILL (OCM) $14.37 0281-0326-08 NITROGLYCERIN 2 % TRANSDERMAL OINT $14.33 0641-6056-01 MIDAZOLAM 1MG/ML INJECTABLE SOLUTION (MHS) $14.30 0641-6056-10 MIDAZOLAM 1MG/ML INJECTABLE SOLUTION (MHS) $14.30 0990-7923-23 DEXTROSE 5 % IN WATER (D5W) IV SOLP $14.30 23155-240-31 METOCLOPRAMIDE HCL 5 MG/ML INJ SOLN $14.30 23155-240-41 METOCLOPRAMIDE HCL 5 MG/ML INJ SOLN $14.30 23155-473-31 FUROSEMIDE 10 MG/ML INJ SOLN $14.30 23155-473-41 FUROSEMIDE 10 MG/ML INJ SOLN (MCH) $14.30 44567-700-25 CEFTRIAXONE 500 MG INJ SOLR $14.30 55390-565-05 DILTIAZEM HCL 5 MG/ML IV SOLN $14.30 63323-624-61 DEXTROSE 5 % IN WATER (D5W) IV SOLP $14.30 70069-801-01 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $14.30 70069-801-25 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $14.30 99999-009-62 LABETALOL 5 MG/ML IV SOLN $14.30 99999-036-41 AMILORIDE 1 MG/ML ORAL LIQUID (MCH) (COMPOUND) $14.30 99999-044-37 CEFAZOLIN 2 GRAM/20 ML SYRINGE (USING 10 G) $14.30 60505-2965-7 MYCOPHENOLATE SODIUM 180 MG ORAL TBEC $14.26 1093962144 PEG 400-HYPROMELLOSE-GLYCERIN 1-0.2-0.2 % OPHT DROP $14.24 49348-095-29 PEG 400-HYPROMELLOSE-GLYCERIN 1-0.2-0.2 % OPHT DROP $14.24 63323-492-26 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $14.24 63323-492-45 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $14.24 HC89012611 HEPATITIS DELTA AB-AU $14.23 68084-415-01 DIVALPROEX 500 MG ORAL TB24 $14.22 68084-415-11 DIVALPROEX 500 MG ORAL TB24 $14.22 0904-0430-06 DOXYCYCLINE HYCLATE 100 MG ORAL TAB $14.20 HC89012819 PARVOVIRUS B19 AB (PNL)-AU $14.19 0378-0860-01 CLOZAPINE 100 MG ORAL TAB $14.18 904727770 FERROUS SULFATE 300 MG (60 MG IRON)/5 ML ORAL LIQD $14.17 0641-9217-01 DILTIAZEM HCL 5 MG/ML IV SOLN $14.17 0641-9217-10 DILTIAZEM HCL 5 MG/ML IV SOLN $14.17 0781-8089-26 AZITHROMYCIN 250 MG ORAL TAB $14.09 33342-123-07 ARIPIPRAZOLE 5 MG ORAL TAB $14.09 33342-276-07 DARIFENACIN 7.5 MG ORAL TB24 $14.09 42571-160-30 AMOXICILLIN-POT CLAVULANATE 250-125 MG ORAL TAB $14.09 0409-9093-35 FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN $14.07 0409-9093-45 FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN $14.07 574006905 DEXTROSE 40 % ORAL GEL $14.06 574006924 DEXTROSE 40 % ORAL GEL $14.06 8770143152 CARBAMIDE PEROXIDE 6.5 % OTIC DROP $14.04 51672-4026-6 KETOCONAZOLE 200 MG ORAL TAB $14.04 45802-358-03 DIPHENHYDRAMINE-ZINC ACETATE 2-0.1 % TOPICAL CREAM $14.01 HC89014070 ANA TITER REFLEX (PNL)-AU $14.00 HC89011969 ANTI MICROSOMAL THYROID-AU $14.00 HC89010318 BETA-HCG QUANT-AU $14.00 HC89020838 BLASTOMYCES AB IMM -AU $14.00 HC89003008 CATECHOLAMINES TOTAL URINE-QD $14.00 HC89017669 CHOLINESTERASE RBC(PNL)-AU $14.00 HC89007454 CHOLINESTERASE-AU $14.00 HC89015085 CYCLIC CITRU PEPTIDE AB-AU $14.00 HC89002166 ETHYLENE GLYCOL-QD $14.00 HC89004089 FAT FECAL QUAL-AU $14.00 HC83504746 FLOW CYT MKR TC ADD+-US $14.00 HC89000749 HEMOGLOBIN PLASMA-QD $14.00 HC89015440 HOMOCYSTINE-QD $14.00 HC89008262 HUMAN GROWTH HORMONE-AU $14.00 HC89000095 JO 1 ENA AB-QD $14.00 HC89023246 KAPPA FREE LIGHT CHAINS QT URINE(IFE)-AU $14.00 HC89015457 LACTIC ACID-QD $14.00 HC89023238 LAMBDA FREE LIGHT CHAINS QT URINE(IFE)-AU $14.00 HC89011928 LYMPH T-CELL TOT CNT (PNL)-AU $14.00 HC89000806 OXALATE URINE-QD $14.00 HC89000152 PSA FREE-QD $14.00 HC89022818 SPECIFIC GRAVITY FLUID -U2 $14.00 HC89010102 T-3 REVERSE-AU $14.00 HC89009930 TESTOSTERONE FREE-AU $14.00 HC89016000 VITAMIN B12-QD $14.00 HC89015523 VITAMIN B-2-QD $14.00 HC89002687 WEST NILE VIR AB IGG/IGM(SERM)ELISA-AU $14.00 HC89001671 YERSINIA AB-QD $14.00 HC89024087 WEST NILE VIRUS IGG AB SERUM-AU $14.00 HC89024079 WEST NILE VIRUS IGM AB SERUM-AU $14.00 0591-2998-01 URSODIOL 250 MG ORAL TAB $13.95 16571-657-10 CEVIMELINE 30 MG ORAL CAP $13.94 62175-262-37 NIFEDIPINE 90 MG ORAL TR24 $13.88 65862-841-30 ENTECAVIR 0.5 MG ORAL TAB $13.87 65862-842-30 ENTECAVIR 1 MG ORAL TAB $13.87 0409-4282-01 LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN $13.86 0409-4282-11 LIDOCAINE (PF) 20 MG/ML (2%) INJ (MHS) $13.86 1093957233 HYDROCORTISONE 1 % TOPICAL OINT $13.85 49348-522-72 HYDROCORTISONE 1 % TOPICAL OINT $13.85 55150-168-30 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $13.85 0409-1890-01 MORPHINE 2 MG/ML IV SYRG $13.84 0409-1890-03 MORPHINE 2 MG/ML INJ SOLN (MHS) $13.84 71399-0122-2 VITS A AND D-WHITE PET-LANOLIN TOPICAL OINT $13.83 4116706003 METHYL SALICYLATE-MENTHOL 15-10 % TOPICAL CREAM $13.81 41167-0600-3 METHYL SALICYLATE-MENTHOL 15-10 % TOPICAL CREAM $13.81 50111-787-10 AZITHROMYCIN 250 MG ORAL TAB $13.81 59762-3060-2 AZITHROMYCIN 250 MG ORAL TAB $13.81 62332-251-30 AZITHROMYCIN 250 MG ORAL TAB $13.81 64679-961-01 AZITHROMYCIN 250 MG ORAL TAB $13.81 1093932933 DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML ORAL LIQD $13.81 0641-6027-01 FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN $13.81 0641-6027-25 FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN $13.81 49348-861-34 DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML ORAL LIQD $13.81 36000-322-01 LABETALOL 5 MG/ML IV SOLN $13.78 36000-322-02 LABETALOL 5 MG/ML IV SOLN $13.78 99999-044-22 MORPHINE (PF) 0.2 MG/ML INJ SOLN $13.78 45802-357-58 SODIUM CHLORIDE 0.65 % NASL SPRA $13.75 0409-4888-01 SODIUM CHLORIDE 0.9 % INJ SOLN $13.72 0409-4888-12 SALINE LOCK FLUSH (MCH-NICU) $13.72 16252-540-01 ISRADIPINE 5 MG ORAL CAP $13.72 45963-343-02 DESIPRAMINE 50 MG ORAL TAB $13.72 51224-022-30 AZITHROMYCIN 250 MG ORAL TAB $13.71 HC89017545 BLASTOMYCES AB(PNL)-AU $13.70 HC89014443 MEASLES (RUBEOLA)(PNL) IGM-AU $13.70 0781-3450-70 CEFAZOLIN 500 MG INJ SOLR $13.67 0781-3450-95 CEFAZOLIN 500 MG INJ SOLR $13.67 51079-631-20 PRAZOSIN 2 MG ORAL CAP $13.67 225055050 SODIUM CHLORIDE 0.65 % NASL DROP $13.65 4467710202 MODIFIED LANOLIN 100 % TOPICAL CREAM $13.65 0143-9330-01 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $13.65 0143-9330-10 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $13.65 0409-1162-01 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN $13.65 0409-1162-18 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN $13.65 0409-9094-18 FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN $13.65 0409-9094-25 FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN $13.65 0990-7923-37 DEXTROSE 5 % IN WATER (D5W) IV SOLP $13.65 25021-311-02 FUROSEMIDE 10 MG/ML INJ SOLN (MCH) $13.65 36000-282-25 FUROSEMIDE 10 MG/ML INJ SOLN $13.65 45802-276-03 HYDROCORTISONE 1 % TOPICAL OINT $13.65 45802-410-59 OXYMETAZOLINE 0.05 % NASL SPRY $13.65 45802-438-03 HYDROCORTISONE 1 % TOPICAL CREAM $13.65 55150-322-25 FUROSEMIDE 10 MG/ML INJ SOLN $13.65 63323-280-01 FUROSEMIDE 10 MG/ML INJ SOLN $13.65 63323-280-02 FUROSEMIDE 10 MG/ML INJ SOLN $13.65 99999-040-93 CEFAZOLIN 50 MG/ML INJ SYRINGE (SLH 10 G) $13.65 4898500151 NICOTINE 14 MG/24 HR TRANSDERMAL PT24 $13.64 4898500156 NICOTINE 7 MG/24 HR TRANSDERMAL PT24 $13.64 0409-1892-01 MORPHINE 8 MG/ML IV SYRG $13.64 0409-1892-03 MORPHINE 8 MG/ML INJ SOLN (MHS) $13.64 0409-1893-01 MORPHINE 10 MG/ML INJ SOLN (MHS WRAPPER) $13.64 0409-1893-03 MORPHINE 10 MG/ML INJ SOLN (MHS WRAPPER) $13.64 43598-446-70 NICOTINE 7 MG/24 HR TRANSDERMAL PT24 $13.64 43598-447-70 NICOTINE 14 MG/24 HR TRANSDERMAL PT24 $13.64 16714-814-01 SEVELAMER CARBONATE 800 MG ORAL TAB $13.64 65862-095-20 CEFPODOXIME 100 MG ORAL TAB $13.61 69784-200-96 CROMOLYN 100 MG/5 ML ORAL CONC $13.55 99999-001-58 ACETYLCYSTEINE 20 % (200 MG/ML) ORAL SYRINGE $13.55 HC89016570 REDUCING SUBS FECAL-AU $13.55 45802-368-00 IMIQUIMOD 5 % TOPICAL CRPK $13.54 45802-368-62 IMIQUIMOD 5 % TOPICAL CRPK $13.54 0121-0638-05 DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML ORAL SYRP $13.52 55150-167-10 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $13.52 69339-149-05 DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML ORAL SYRP $13.52 69339-149-19 DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML ORAL SYRP $13.52 HC89010789 DRVVT RUSS VIPER VENOM-AU $13.50 HC89012652 HERPES SIMPLEX I GLYCO AB-AU $13.50 HC89012678 HERPES SIMPLEX II GLYCO AB-AU $13.50 HC89009807 RENIN-AU $13.50 132070336 BISACODYL 10 MG/30 ML RECTAL ENEM $13.47 0904-6787-44 MAGNESIUM CITRATE ORAL SOLN $13.47 0536-1316-28 ZINC OXIDE 20 % TOPICAL OINT $13.46 0591-0395-01 PENTAZOCINE-NALOXONE 50-0.5 MG ORAL TAB $13.40 HC89003511 MUMPS IGM-AU $13.40 0904-6364-61 DIVALPROEX 500 MG ORAL TB24 $13.39 0904-7182-61 DIVALPROEX 500 MG ORAL TB24 $13.39 99999-046-73 ACETYLCHOLINE 18 MCG/ML INJECTION $13.39 0245-0036-42 CHOLESTYRAMINE-ASPARTAME 4 GRAM ORAL PWPK $13.36 45802-868-00 POLYETHYLENE GLYCOL 3350 17 GRAM ORAL PWPK $13.35 45802-868-66 POLYETHYLENE GLYCOL 3350 17 GRAM ORAL PWPK $13.35 HC89009567 ACID PHOS PROSTATIC-AU $13.35 HC89007447 CHLORIDE FECAL-AU $13.35 HC89014005 POTASSIUM STOOL-AU $13.35 HC89009880 SODIUM OTHER SOURCE-AU $13.35 0904-7245-68 LACOSAMIDE 100 MG ORAL TAB $13.33 42806-266-95 CHOLESTYRAMINE (WITH SUGAR) 4 GRAM ORAL PWPK $13.33 42806-266-98 CHOLESTYRAMINE (WITH SUGAR) 4 GRAM ORAL PWPK $13.33 49884-465-64 CHOLESTYRAMINE (WITH SUGAR) 4 GRAM ORAL PWPK $13.33 49884-465-65 CHOLESTYRAMINE (WITH SUGAR) 4 GRAM ORAL PWPK $13.33 0245-0036-89 CHOLESTYRAMINE-ASPARTAME 4 GRAM ORAL PWPK $13.33 0378-6173-01 METOLAZONE 5 MG ORAL TAB $13.33 63323-624-05 DEXTROSE 5 % IN WATER (D5W) IV SOLP $13.33 63323-624-50 DEXTROSE 5 % IN WATER (D5W) IV SOLP $13.33 HC89022479 CULTURE ID DEFIN/ADDL HSV(PNL)+-AU $13.32 60687-481-11 BUPRENORPHINE HCL 2 MG SL SUBL $13.27 60687-481-21 BUPRENORPHINE HCL 2 MG SL SUBL $13.27 65862-626-90 RIZATRIPTAN 10 MG ORAL TBDL $13.27 0409-1162-02 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN $13.26 0409-1162-09 BUPIVACAINE PF 0.5% AUTOFUSER PUMP $13.26 0409-1162-10 BUPIVACAINE PF 0.5% AUTOFUSER PUMP $13.26 0409-1162-19 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN $13.26 0904-6761-30 OXYMETAZOLINE 0.05 % NASL SPRY $13.26 11523-1314-1 DIMETHICONE-ZNOX-VIT A-D-ALOE 1-10 % TOPICAL CREAM $13.26 51079-109-01 BUPROPION HCL 300 MG ORAL TB24 $13.26 51079-109-03 BUPROPION HCL 300 MG ORAL TB24 $13.26 65862-626-03 RIZATRIPTAN 10 MG ORAL TBDL $13.26 0904-6501-61 FLUCONAZOLE 200 MG ORAL TAB $13.25 0121-1971-00 ACETAMINOPHEN 32 MG/ML ORAL SOLUTION (IMS) $13.20 0121-1971-21 ACETAMINOPHEN 32 MG/ML ORAL SOLUTION (IMS) $13.20 66689-056-01 ACETAMINOPHEN 32 MG/ML ORAL SOLUTION (IMS) $13.20 66689-056-99 ACETAMINOPHEN 32 MG/ML ORAL SOLUTION (IMS) $13.20 99999-005-68 PHENOBARBITAL 5 MG/ML INJ SOLN DILUTION (MCH) $13.18 60793-115-01 LIOTHYRONINE 5 MCG ORAL TAB $13.16 0378-1086-93 COLCHICINE 0.6 MG ORAL TAB $13.14 0409-2723-01 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $13.13 0409-2723-30 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $13.13 0527-1367-01 PROBENECID 500 MG ORAL TAB $13.10 63323-806-02 FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN $13.07 63323-806-12 FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN $13.07 63323-965-03 POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN $13.07 63323-965-10 POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN $13.07 99996-000-14 BECKSTRAND DEODORANT (CHARGE ONLY) $13.07 HC89010961 C1 INHIBITOR-AU $13.05 0591-2341-01 METAXALONE 800 MG ORAL TAB $13.05 HC89013585 CITRATE-AU $13.03 HC89005490 MYELOPEROXIDASE AB (MPO)-AU $13.03 HC89008510 SERINE PROTEASE3 IGG IMMUNOASSAY-AU $13.03 0143-9923-90 CEFAZOLIN 500 MG INJ SOLR $13.01 45802-143-01 NEOMYCIN-BACITRACNZN-POLYMYXNB 3.5MG-400 UNIT- 5,000 UNIT/GRAM TOPICAL OINT $13.01 0143-9875-01 AMIODARONE 50 MG/ML IV SOLN $13.01 0143-9875-25 AMIODARONE 50 MG/ML IV SOLN $13.01 55150-180-03 AMIODARONE 50 MG/ML IV SOLN $13.01 HC89009583 ALKALINE PHOS ISOENZYMES-AU $13.00 HC89014062 ANA TITER (PNL)-RD $13.00 HC89011951 ANTI MICROSOMAL THYROI(PNL)-RD $13.00 HC89010946 ANTI-CARDIOLIPIN AB-RD $13.00 HC89011506 ANTI-CENTROM AB TITER(PNL)-RD $13.00 HC89011191 ANTI-CHROMATIN AB (PNL)-RD $13.00 HC89011134 ANTI-DNA ANTIBODIES (DS)-RD $13.00 HC89011209 ANTI-LA (SS-B) (PNL2)-RD $13.00 HC89011217 ANTI-RNP AB (PNL)-RD $13.00 HC89011241 ANTI-SCL-70 AB (PNL)-RD $13.00 HC89011258 ANTI-SM AB (PNL)-RD $13.00 HC89017602 ARSENIC URINE (PNL)-AU $13.00 HC89003552 ARSENIC URINE-AU $13.00 HC89003917 B.PARAPERTUSSIS/PERT DFA-U2 $13.00 HC89007348 BILE ACIDS TOTAL-AU $13.00 HC89011001 C3 COMPLEMENT (PNL)-RD $13.00 HC89011019 C4 COMPLEMENT (PNL)-RD $13.00 HC89016059 CANDIDA AB - AU $13.00 HC89002125 CANDIDA AB-QD $13.00 HC89017016 CHOLESTEROL ARUP-AU $13.00 HC89003172 CMV AB IGG-QD $13.00 HC89003842 CMV AB IGM-QD $13.00 HC89000186 CULTURE AFB DIR STAIN(PNL)-FT $13.00 HC89000376 DHEA-QD $13.00 HC89015671 FIBRINOGEN-QD $13.00 HC83506014 FLOW CYT MKR CD4/CD8 BAL EA ADD+ (PNL)-NG $13.00 HC83505420 FLOW CYT MKR TC EACH ADD+ -NG $13.00 HC89015390 FOLIC ACID-QD $13.00 HC89012637 HERPES SIMPLEX I&II AB-AU $13.00 HC89017578 HSV AB IGG(PNL)-AU $13.00 HC89014724 HSV PCR QUANT-QD $13.00 HC89023477 HSV TYPE 1 &/OR 2AB IGG PNL)-AU $13.00 HC89001796 INSULIN AB-QD $13.00 HC89017768 PARAINFLUENZA AB(PNL)-AU $13.00 HC89001523 POLIOVIRUS-QD $13.00 HC89016026 PREALBUMIN-QD $13.00 HC89003297 PROTEIN ELECT FRACT&QT CSF-QD $13.00 HC89003230 PROTEIN ELECT FRACT&QT UR-QD $13.00 HC89003222 PROTEIN ELECT FRACT&QT-QD $13.00 HC89000483 Q FEVER AB-QD $13.00 HC89011225 RNP ENA AB-QD $13.00 HC89003248 RUBELLA AB-QD $13.00 HC89009831 SELENIUM-AU $13.00 HC89011415 SSA ENA AB-QD $13.00 HC89011431 SSB ENA AB-QD $13.00 HC89007389 STONE/CALCULI ANALYS MICRO-AU $13.00 HC89012884 TETANUS AB-AU $13.00 HC89012926 TREPONEMA PALLIDUM AB-AU $13.00 0143-9857-01 CEFTRIAXONE 1 GRAM INJ SOLR $13.00 0143-9857-25 CEFTRIAXONE 1 GRAM INJ SOLR $13.00 16729-292-12 DALFAMPRIDINE 10 MG ORAL TB12 $13.00 55390-073-10 METOPROLOL TARTRATE 5 MG/5 ML IV SOLN $13.00 65862-421-30 TENOFOVIR DISOPROXIL FUMARATE 300 MG ORAL TAB $13.00 70594-084-01 AMPICILLIN SODIUM 250 MG INJ SOLR $13.00 70594-084-02 AMPICILLIN SODIUM 250 MG INJ SOLR $13.00 99999-005-15 CAFFEINE CITRATE 5 MG/ML INJ DILUTION (MCH) $13.00 2045187121 LANOLIN TOPICAL CREAM $12.99 50268-069-11 AMANTADINE HCL 100 MG ORAL CAP $12.97 50268-069-15 AMANTADINE HCL 100 MG ORAL CAP $12.97 8019656775 SODIUM PHOSPHATES 19-7 GRAM/118 ML RECTAL ENEM $12.97 8770142560 CARBAMIDE PEROXIDE 6.5 % OTIC DROP $12.97 0641-2555-41 PHENYTOIN SODIUM 50 MG/ML IV SOLN $12.97 0641-2555-45 PHENYTOIN SODIUM 50 MG/ML IV SOLN $12.97 44677-10302 MODIFIED LANOLIN 100 % TOPICAL CREAM $12.97 0093-3127-01 DISOPYRAMIDE PHOSPHATE 100 MG ORAL CAP $12.96 0093-7166-01 CELECOXIB 200 MG ORAL CAP $12.96 0904-6503-61 CELECOXIB 200 MG ORAL CAP $12.96 60687-215-01 PROPRANOLOL 60 MG ORAL CS24 $12.96 60687-215-11 PROPRANOLOL 60 MG ORAL CS24 $12.96 0071-0007-40 PHENYTOIN 50 MG ORAL CHEW $12.94 50268-217-11 DANTROLENE 25 MG ORAL CAP $12.88 50268-217-15 DANTROLENE 25 MG ORAL CAP $12.88 68084-449-01 TACROLIMUS 0.5 MG ORAL CAP $12.88 68084-449-11 TACROLIMUS 0.5 MG ORAL CAP $12.88 67457-473-00 TOBRAMYCIN SULFATE 40 MG/ML INJ SOLN $12.87 67457-473-22 TOBRAMYCIN SULFATE 40 MG/ML INJ SOLN $12.87 70677-0038-1 MAGNESIUM SULFATE (LAXATIVE) 495 MG/5 GRAM ORAL GRAN $12.87 72572-571-01 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $12.87 72572-571-25 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $12.87 0054-4146-22 CLOTRIMAZOLE 10 MG MUCOUS MEMB TROC $12.86 13925-107-01 METHENAMINE MANDELATE 1 GRAM ORAL TAB $12.84 HC89004865 DRVVT RUSS VIPER VENOM 1:1MIX RFX-AU $12.80 0121-0903-15 LIDOCAINE HCL 2 % MUCOUS MEMB SOLN $12.77 0121-0903-40 LIDOCAINE HCL 2 % MUCOUS MEMB SOLN $12.77 0228-2779-11 PROPRANOLOL 80 MG ORAL CS24 $12.77 50268-598-11 NIFEDIPINE 60 MG ORAL TR24 $12.77 50268-598-15 NIFEDIPINE 60 MG ORAL TR24 $12.77 60687-676-11 LACOSAMIDE 50 MG ORAL TAB $12.77 60687-676-57 LACOSAMIDE 50 MG ORAL TAB $12.77 0024-1596-01 PRIMAQUINE 26.3 MG ORAL TAB $12.70 0121-0431-30 MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSP $12.68 66689-053-01 MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSP $12.68 66689-053-99 MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSP $12.68 66794-220-02 AMPICILLIN SODIUM 250 MG INJ SOLR $12.68 66794-220-41 AMPICILLIN SODIUM 250 MG INJ SOLR $12.68 67457-418-00 DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJ SOLN $12.68 67457-418-05 DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJ SOLN $12.68 67457-422-00 DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJ SOLN $12.68 67457-422-54 DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJ SOLN $12.68 68084-269-01 HYDROXYCHLOROQUINE 200 MG ORAL TAB FOR DISSOLVE (MCH) $12.68 68084-269-11 HYDROXYCHLOROQUINE 200 MG ORAL TAB FOR DISSOLVE (MCH) $12.68 1093945944 PHENOL 1.4 % MUCOUS MEMB SPRA $12.66 49348-991-36 PHENOL 1.4 % MUCOUS MEMB SPRA $12.66 0409-1891-01 MORPHINE 4 MG/ML INJ SOLN (MHS) $12.65 0409-1891-03 MORPHINE 4 MG/ML INJ SOLN (MHS) $12.65 50111-918-01 TORSEMIDE 100 MG ORAL TAB $12.64 0115-1365-29 SEVELAMER CARBONATE 0.8 GRAM ORAL PWPK $12.64 0115-1365-30 SEVELAMER CARBONATE 0.8 GRAM ORAL PWPK $12.64 33342-256-66 OSELTAMIVIR 30 MG ORAL CAP $12.53 HC89012843 ROCKY MT SPOTTED FEVER AB-AU $12.50 99999-011-10 METHADONE 5 MG/5 ML ORAL SOLN $12.48 60687-317-25 CHLORTHALIDONE 25 MG ORAL TAB $12.45 60687-317-95 CHLORTHALIDONE 25 MG ORAL TAB $12.45 51079-058-01 CHLORTHALIDONE 25 MG ORAL TAB $12.44 51079-058-20 CHLORTHALIDONE 25 MG ORAL TAB $12.44 64980-134-01 DIPYRIDAMOLE 50 MG ORAL TAB $12.40 0378-3005-01 THIOTHIXENE 5 MG ORAL CAP $12.38 69339-138-15 CHLORHEXIDINE GLUCONATE 0.12 % MUCOUS MEMB MWSH $12.38 69339-138-17 CHLORHEXIDINE GLUCONATE 0.12 % MUCOUS MEMB MWSH $12.38 HC89012173 BRUCELLA AB-AU $12.38 HC89013700 MYOGLOBIN URINE-AU $12.38 0641-6001-01 LORAZEPAM 2 MG/ML INJ SOLN CODE PEDS $12.36 0641-6001-25 LORAZEPAM 2 MG/ML INJ SOLN CODE PEDS $12.36 HC89012124 BLASTOMYCES AB-AU $12.35 HC89016893 HTVL I/II W/ABS RFX TO WB-AU $12.35 0409-0152-01 METRONIDAZOLE IN NACL (ISO-OS) 500 MG/100 ML IV PGBK $12.35 0409-0152-24 METRONIDAZOLE IN NACL (ISO-OS) 500 MG/100 ML IV PGBK (MCH) $12.35 0990-7984-37 SODIUM CHLORIDE 0.9 % IV SOLP $12.35 23155-766-01 TETRACYCLINE 250 MG ORAL CAP $12.35 62332-600-01 KETOROLAC 30 MG/ML (1 ML) INJ SOLN $12.35 62332-600-25 KETOROLAC 30 MG/ML (1 ML) INJ SOLN $12.35 68094-034-59 SEVELAMER CARBONATE 800 MG ORAL TAB $12.35 68094-034-64 SEVELAMER CARBONATE 800 MG ORAL TAB $12.35 70860-701-03 KETOROLAC 30 MG/ML (1 ML) INJ SOLN $12.35 70860-701-41 KETOROLAC 30 MG/ML (1 ML) INJ SOLN $12.35 71288-403-01 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $12.35 71288-403-02 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $12.35 99999-037-65 METRONIDAZOLE 5 MG/ML INJECTION (MHS) $12.35 0406-0523-62 OXYCODONE-ACETAMINOPHEN 10-325 MG ORAL TAB $12.31 57664-685-88 MIGLITOL 50 MG ORAL TAB $12.31 63304-097-11 SUMATRIPTAN SUCCINATE 25 MG ORAL TAB $12.31 63304-097-19 SUMATRIPTAN SUCCINATE 25 MG ORAL TAB $12.31 0869-0831-43 MINERAL OIL ORAL OIL $12.30 0406-0523-23 OXYCODONE-ACETAMINOPHEN 10-325 MG ORAL TAB $12.29 63323-064-04 MAGNESIUM SULFATE 4 MEQ/ML (50 %) INJ SOLN $12.29 63323-064-11 MAGNESIUM SULFATE 4 MEQ/ML (50 %) INJ SOLN $12.29 63323-249-30 WATER FOR INJECT BACT PARABENS INJ SOLN $12.29 63739-159-77 ALUM-MAG HYDROXIDE-SIMETH 200-200-20 MG/5 ML ORAL SUSP $12.29 99999-046-26 LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN $12.29 65862-930-08 SEVELAMER CARBONATE 0.8 GRAM ORAL PWPK $12.28 65862-930-90 SEVELAMER CARBONATE 0.8 GRAM ORAL PWPK $12.28 2660800154 L. ACIDOPHILUS,CASEI,RHAMNOSUS 50 BILLION CELL ORAL CPDR $12.27 2660800156 L. ACIDOPHILUS,CASEI,RHAMNOSUS 50 BILLION CELL ORAL CPDR $12.27 71399-1006-4 DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML ORAL LIQD $12.27 99999-041-15 VANCOMYCIN 50 MG/ML ORAL SOLR $12.27 2660800118 L. ACIDOPHILUS,CASEI,RHAMNOSUS 50 BILLION CELL ORAL CPDR $12.27 0032-1206-01 LIPASE-PROTEASE-AMYLASE 6,000-19,000 -30,000 UNIT ORAL CPDR $12.25 0032-1206-07 LIPASE-PROTEASE-AMYLASE 6,000-19,000 -30,000 UNIT ORAL CPDR $12.25 0185-0055-01 METOLAZONE 5 MG ORAL TAB $12.25 0378-3017-01 CAPTOPRIL 50 MG ORAL TAB $12.25 53489-177-05 ALBUTEROL SULFATE 4 MG ORAL TAB $12.22 99999-045-45 MORPHINE DRIP 0.1 MG/ML IN D5W 25 ML (OCM_NICU) $12.19 68084-728-01 FLUCONAZOLE 100 MG ORAL TAB $12.16 68084-728-11 FLUCONAZOLE 100 MG ORAL TAB $12.16 99999-041-19 RIFABUTIN 20 MG/ML ORAL SOLUTION $12.13 51862-486-01 TRIMETHOPRIM 100 MG ORAL TAB $12.11 132030140 MINERAL OIL RECTAL ENEM $12.10 0132-0301-40 MINERAL OIL RECTAL ENEM $12.10 0536-1303-75 SIMETHICONE 40 MG/0.6 ML ORAL DRPS $12.09 0409-2720-01 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $12.06 0409-2720-30 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $12.06 0904-6914-61 METHYLPREDNISOLONE 4 MG ORAL TAB $12.06 0555-0211-10 NORETHINDRONE ACETATE 5 MG ORAL TAB $12.05 61570-072-01 ESTERIFIED ESTROGENS 0.3 MG ORAL TAB $12.05 62175-261-37 NIFEDIPINE 60 MG ORAL TR24 $12.04 60687-312-01 BUPROPION HCL 150 MG ORAL TB24 $12.03 60687-312-11 BUPROPION HCL 150 MG ORAL TB24 $12.03 65162-475-05 NORETHINDRONE ACETATE 5 MG ORAL TAB $12.03 HC89012744 LEGIONELLA AB-AU $12.03 64380-799-01 OSELTAMIVIR 75 MG ORAL CAP $12.03 72205-044-11 OSELTAMIVIR 75 MG ORAL CAP $12.03 76045-103-20 ONDANSETRON HCL (PF) 4 MG/2 ML INJ SYRG $12.03 0641-0928-21 PROMETHAZINE 25 MG/ML INJ SOLN $12.01 0641-0928-25 PROMETHAZINE 25 MG/ML INJ SOLN $12.01 0641-1495-31 PROMETHAZINE 25 MG/ML INJ SOLN $12.01 0641-1495-35 PROMETHAZINE 25 MG/ML INJ SOLN $12.01 HC89007074 ALBUMIN SERUM/PLASMA NEPHELOMETRY-AU $12.00 HC89002612 ANA TITER-QD $12.00 HC89011456 ANTI-NEUTROPHIL CYTOPLSMC SCRN IGG-AU $12.00 HC89011522 ANTI-STRIAT MUSCLE AB IGG SCREEN-AU $12.00 HC89015697 ASO TITER-QD $12.00 HC89013502 BETA-2 MICROGLOBULIN CSF-AU $12.00 HC89018972 BORDETELLA PERTUS FHA IGA-AU $12.00 HC89018980 BORDETELLA PERTUS FHA IGG-AU $12.00 HC89003677 CHLAMYDIA AB-QD $12.00 HC89016364 CULTURE TYPE AGGLUTIN EA-QD $12.00 HC89000384 DHEA SULFATE-QD $12.00 HC89007892 DIBUCAINE NO +PSEUDOCHOLIN-AU $12.00 HC89016018 ESTRADIOL-QD $12.00 HC89006506 ETHOSUXIMIDE-AU $12.00 HC89500987 FFP THAWING; EA UNIT-SB $12.00 HC89003180 GASTRIN-QD $12.00 HC89015986 INHIBIN A-QD $12.00 HC89003792 NBS PHENYLALANINE SCREEN-GE $12.00 HC89015077 NORTRIPTYLINE(PNL); 3-5-AU $12.00 HC89009328 NUCLEOTIDASE-5-AU $12.00 HC89015283 PRIMIDONE-QD $12.00 HC89015499 PROLACTIN-QD $12.00 HC89003644 RSV AB-AU $12.00 HC89005367 SEX HORMONE BINDING GLOB2ND-AU $12.00 HC89011266 SM ENA AB-QD $12.00 HC89001127 VISCOSITY-QD $12.00 HC89015564 VITAMIN E-QD $12.00 0093-8741-01 MEXILETINE 250 MG ORAL CAP $11.97 0228-2530-10 NIFEDIPINE 20 MG ORAL CAP $11.97 69315-212-01 NIFEDIPINE 20 MG ORAL CAP $11.97 31722-103-30 CINACALCET 30 MG ORAL TAB $11.96 63323-186-03 SODIUM CHLORIDE 0.9 % INJ SOLN $11.96 63323-186-20 SODIUM CHLORIDE 0.9 % INJ SOLN $11.96 16714-693-01 FLUCONAZOLE 200 MG ORAL TAB $11.95 0409-1159-02 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $11.90 0409-1159-19 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $11.90 0409-4282-25 LIDOCAINE (PF) 20 MG/ML (2%) INJ (MHS) $11.83 0054-0177-13 BUPRENORPHINE HCL 8 MG SL SUBL $11.81 0121-1314-00 ACETAMINOPHEN 325 MG/10.15 ML ORAL LIQD (MHS) $11.81 0121-1314-11 ACETAMINOPHEN 32 MG/ML ORAL SOLUTION (IMS) $11.81 66689-055-01 ACETAMINOPHEN 32 MG/ML ORAL SOLUTION (IMS) $11.81 66689-055-99 ACETAMINOPHEN 32 MG/ML ORAL SOLUTION (IMS) $11.81 10939-87244 MAGNESIUM SULFATE (LAXATIVE) 495 MG/5 GRAM ORAL GRAN $11.80 50268-102-11 BALSALAZIDE 750 MG ORAL CAP $11.79 50268-102-13 BALSALAZIDE 750 MG ORAL CAP $11.79 0378-1134-01 KETOROLAC 10 MG ORAL TAB $11.78 68094-030-59 ACETAMINOPHEN 650 MG/20.3 ML ORAL LIQD (MHS) $11.74 68094-030-62 ACETAMINOPHEN 650 MG/20.3 ML ORAL LIQD (MHS) $11.74 0054-4550-15 METHOTREXATE SODIUM 2.5 MG ORAL TAB $11.74 0904-6938-06 BUTALBITAL-ACETAMINOPHEN-CAFF 50-325-40 MG ORAL TAB $11.74 59762-0811-1 NADOLOL 40 MG ORAL TAB $11.73 99999-036-95 PROMETHAZINE-CODEINE 6.25-10 MG/5 ML ORAL SYRP $11.73 0378-6172-01 METOLAZONE 2.5 MG ORAL TAB $11.73 99999-004-78 AZTREONAM 50 MG/ML DILUTION INJECTION $11.73 HC89008346 HEMOGLOBIN GLYCATED (A1C)-AU $11.70 121059530 SODIUM CITRATE-CITRIC ACID 500-334 MG/5 ML ORAL SOLN $11.70 1093941433 OXYMETAZOLINE 0.05 % NASL SPRAY (MHS) $11.70 0409-1159-01 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $11.70 0409-1159-18 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $11.70 25021-105-10 CEFTRIAXONE 500 MG INJ SOLR $11.70 49348-028-27 OXYMETAZOLINE 0.05 % NASL SPRAY (MHS) $11.70 62332-599-01 KETOROLAC 15 MG/ML INJ SOLN $11.70 62332-599-25 KETOROLAC 15 MG/ML INJ SOLN $11.70 63323-738-09 FAMOTIDINE 10 MG/ML IV SOLN $11.70 68308-480-47 OXYCODONE-ACETAMINOPHEN 10-325 MG ORAL TAB $11.70 70860-300-05 METOPROLOL TARTRATE 5 MG/5 ML IV SOLN $11.70 70860-300-41 METOPROLOL TARTRATE 5 MG/5 ML IV SOLN $11.70 70860-700-02 KETOROLAC 15 MG/ML INJ SOLN $11.70 70860-700-41 KETOROLAC 15 MG/ML INJ SOLN $11.70 70860-801-01 TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLN $11.70 71288-402-01 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $11.70 71288-402-02 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $11.70 99998-000-71 MEDIUM CHAIN TRIGLYCERIDES 7.7 KCAL/ML ORAL OIL $11.70 99999-010-88 METHADONE 1 MG/ML INJ SOLN DILUTION (MCH) $11.70 0904-7188-61 HYDROCORTISONE 10 MG ORAL TAB $11.67 0904-7042-61 AMANTADINE HCL 100 MG ORAL CAP $11.66 HC89019475 CONCENTRATION;MICROSPORIDIA-AU $11.65 99999-035-70 TOBRAMYCIN 1.4 % (14 MG/ML) FORTIFIED OPHTHALMIC SOLUTION $11.65 8008799734 CITRULLINE 600 MG ORAL CAP $11.64 0009-0022-01 METHYLPREDNISOLONE 8 MG ORAL TAB $11.61 0093-5245-19 OLANZAPINE 5 MG ORAL TBDL $11.60 0093-5245-65 OLANZAPINE 5 MG ORAL TBDL $11.60 60505-3275-0 OLANZAPINE 5 MG ORAL TBDL $11.60 68682-008-10 DILTIAZEM HCL 90 MG ORAL TAB $11.60 69339-138-19 CHLORHEXIDINE GLUCONATE 0.12 % MUCOUS MEMB MWSH $11.60 0378-1020-77 NICARDIPINE 20 MG ORAL CAP $11.59 99999-046-21 LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN $11.57 4898500150 NICOTINE 14 MG/24 HR TRANSDERMAL PT24 $11.56 4898500152 NICOTINE 21 MG/24 HR TRANSDERMAL PT24 $11.56 4898500155 NICOTINE 7 MG/24 HR TRANSDERMAL PT24 $11.56 43598-446-74 NICOTINE 7 MG/24 HR TRANSDERMAL PT24 $11.56 43598-447-74 NICOTINE 14 MG/24 HR TRANSDERMAL PT24 $11.56 43598-448-74 NICOTINE 21 MG/24 HR TRANSDERMAL PT24 $11.56 60687-472-01 NITROFURANTOIN MACROCRYSTAL 50 MG ORAL CAP $11.55 60687-472-11 NITROFURANTOIN MACROCRYSTAL 50 MG ORAL CAP $11.55 1093991044 MAGNESIUM CITRATE ORAL SOLN $11.54 70677-0051-1 MAGNESIUM CITRATE ORAL SOLN $11.54 70677-0053-1 MAGNESIUM CITRATE ORAL SOLN $11.54 16714-077-01 TADALAFIL 20 MG ORAL TAB $11.53 16714-796-01 SUMATRIPTAN SUCCINATE 25 MG ORAL TAB $11.52 16714-797-01 SUMATRIPTAN SUCCINATE 50 MG ORAL TAB $11.52 55111-291-09 SUMATRIPTAN SUCCINATE 25 MG ORAL TAB $11.52 55111-291-36 SUMATRIPTAN SUCCINATE 25 MG ORAL TAB $11.52 55111-291-98 SUMATRIPTAN SUCCINATE 25 MG ORAL TAB $11.52 55111-292-09 SUMATRIPTAN SUCCINATE 50 MG ORAL TAB $11.52 55111-292-36 SUMATRIPTAN SUCCINATE 50 MG ORAL TAB $11.52 62756-520-69 SUMATRIPTAN SUCCINATE 25 MG ORAL TAB $11.52 62756-521-69 SUMATRIPTAN SUCCINATE 50 MG ORAL TAB $11.52 1093948933 DIPHENHYDRAMINE HCL 12.5 MG/5 ML ORAL LIQD $11.51 0536-1182-97 GUAIFENESIN 100 MG/5 ML ORAL LIQD $11.51 0904-6305-21 PHENOL 1.4 % MUCOUS MEMB SPRA $11.51 10370-832-11 DILTIAZEM HCL 300 MG ORAL CP24 $11.51 49348-045-34 DIPHENHYDRAMINE HCL 12.5 MG/5 ML ORAL LIQ (MCH) $11.51 68455-10842 ALOE VERA-COLLAGEN TOPICAL SOLN $11.51 73750-091-05 CLOTRIMAZOLE 1 % TOPICAL CREAM $11.51 99999-042-96 MEGESTROL 400 MG/10 ML (10 ML) ORAL SUSP $11.51 99999-038-11 ONDANSETRON HCL 4 MG/5 ML ORAL SOLN $11.49 60687-723-11 DULOXETINE 20 MG ORAL CPDR $11.49 60687-723-21 DULOXETINE 20 MG ORAL CPDR $11.49 62332-190-30 FEBUXOSTAT 40 MG ORAL TAB $11.49 0054-4550-25 METHOTREXATE SODIUM 2.5 MG ORAL TAB $11.48 65862-021-06 MIRTAZAPINE 15 MG ORAL TBDL $11.48 0904-5354-31 DIPHENHYDRAMINE-ZINC ACETATE 2-0.1 % TOPICAL CREAM $11.47 0409-1207-03 GENTAMICIN 40 MG/ML INJ SOLN $11.44 0409-1207-13 GENTAMICIN 40 MG/ML INJ SOLN $11.44 HC89024129 COPPER URINE-AU $11.40 16714-887-01 CLOBAZAM 10 MG ORAL TAB $11.39 55390-500-05 BUMETANIDE 0.25 MG/ML INJ SOLN $11.39 0074-3108-32 CYCLOSPORINE MODIFIED 25 MG ORAL CAP $11.38 0338-0072-25 KETOROLAC 30 MG/ML (1 ML) INJ SOLN $11.38 72266-118-01 KETOROLAC 30 MG/ML (1 ML) INJ SOLN $11.38 72266-118-25 KETOROLAC 30 MG/ML (1 ML) INJ SOLN $11.38 99999-000-46 PHENOBARBITAL 10 MG / ML SYRINGE $11.38 62559-822-01 MEXILETINE 250 MG ORAL CAP $11.37 63323-616-01 AMIODARONE 50 MG/ML IV SOLN $11.37 63323-616-03 AMIODARONE 50 MG/ML IV SOLN $11.37 HC89012116 BARTONELLA AB-AU $11.35 HC89006555 PHENOBARBITAL LEVEL-AU $11.35 HC89014419 PROTOZOA AB OTHER-AU $11.35 HC89001143 TOXOPLASMA AB IGG(PNL)-AU $11.35 HC89000061 TOXOPLASMA AB IGG(PNL)-AU $11.35 0378-1020-05 NICARDIPINE 20 MG ORAL CAP $11.33 47781-577-01 METHENAMINE HIPPURATE 1 GRAM ORAL TAB $11.33 0409-3365-10 HYDROMORPHONE 2 MG/ML INJ SOLN $11.32 63323-237-10 CEFAZOLIN 1 GRAM INJ SOLR $11.31 72572-170-01 FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN $11.31 72572-170-25 FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN $11.31 72572-250-01 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $11.31 72572-250-25 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $11.31 72572-255-01 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $11.31 72572-255-25 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $11.31 60687-282-01 AZITHROMYCIN 250 MG ORAL TAB $11.29 60687-282-11 AZITHROMYCIN 250 MG ORAL TAB $11.29 HC89023428 ASPERGILLUS AB BY ID-AU $11.28 HC89010813 VISCOSITY-AU $11.28 68084-930-25 HYDROCORTISONE 20 MG ORAL TAB $11.27 68084-930-95 HYDROCORTISONE 20 MG ORAL TAB $11.27 HC89024194 HSV 1 AND/OR 2 ABS, IGM BY ELISA-AU $11.25 HC89024186 HSV TYPE 1/2 COMBINED AB, IGG-AU $11.25 63323-064-01 MAGNESIUM SULFATE 4 MEQ/ML (50 %) INJ SOLN $11.25 63323-064-03 MAGNESIUM SULFATE 4 MEQ/ML (50 %) INJ SOLN $11.25 63323-064-10 MAGNESIUM SULFATE 4 MEQ/ML (50 %) INJ SOLN $11.25 49348-185-20 MINERAL OIL RECTAL ENEM $11.24 55111-262-79 OLANZAPINE 5 MG ORAL TBDL $11.24 55111-262-81 OLANZAPINE 5 MG ORAL TBDL $11.24 99999-045-70 LIDOCAINE-EPINEPHRINE 2%-1:100,000 BUFFERED WITH SODIUM BICARB 10:1 INJ (FOR NEURAVIVE) (OCM) $11.18 68084-710-01 OXYCODONE-ACETAMINOPHEN 10-325 MG ORAL TAB $11.17 68084-710-11 OXYCODONE-ACETAMINOPHEN 10-325 MG ORAL TAB $11.17 5199191390 LEVOMEFOL-B6-MEB12-ALGAL OIL 3 MG-35 MG-2 MG -90.314 MG ORAL CAP $11.15 0536-1106-88 NICOTINE 7 MG/24 HR TRANSDERMAL PT24 $11.14 0536-5894-88 NICOTINE 7 MG/24 HR TRANSDERMAL PT24 $11.14 0536-5895-88 NICOTINE 14 MG/24 HR TRANSDERMAL PT24 $11.14 0536-5896-88 NICOTINE 21 MG/24 HR TRANSDERMAL PT24 $11.14 43598-446-71 NICOTINE 7 MG/24 HR TRANSDERMAL PT24 $11.14 43598-447-71 NICOTINE 14 MG/24 HR TRANSDERMAL PT24 $11.14 43598-448-71 NICOTINE 21 MG/24 HR TRANSDERMAL PT24 $11.14 60505-7061-0 NICOTINE 7 MG/24 HR TRANSDERMAL PT24 $11.14 60505-7062-0 NICOTINE 14 MG/24 HR TRANSDERMAL PT24 $11.14 60505-7063-0 NICOTINE 21 MG/24 HR TRANSDERMAL PT24 $11.14 0409-1844-32 PHENYTOIN SODIUM 50 MG/ML IV SYRG $11.12 0409-3977-01 WATER FOR INJECT, BACTERIOSTAT INJ SOLN $11.12 0409-3977-03 WATER FOR INJECT, BACTERIOSTAT INJ SOLN $11.12 0409-4713-02 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $11.12 0409-4713-12 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $11.12 99998-000-42 PIPERACILLIN-TAZOBACTAM 112.5 MG/ML INJ SYR (USING 3.375G) $11.12 0904-6820-76 ACETAMINOPHEN 32 MG/ML ORAL SOLUTION (IMS) $11.08 0409-6778-02 LORAZEPAM 2 MG/ML INJ SOLN $11.08 0409-6778-11 LORAZEPAM 2 MG/ML INJ SOLN $11.08 0527-2216-37 METOLAZONE 5 MG ORAL TAB $11.06 50268-337-11 FLUCONAZOLE 100 MG ORAL TAB $11.06 50268-337-15 FLUCONAZOLE 100 MG ORAL TAB $11.06 2660800150 L. ACIDOPHILUS,CASEI,RHAMNOSUS 50 BILLION CELL ORAL CPDR $11.05 62175-490-05 HYDROCODONE-CHLORPHENIRAMINE 10-8 MG/5 ML ORAL SU12 $11.05 67850-024-10 AMPICILLIN SODIUM 500 MG INJ SOLR $11.05 HC89012108 ASPERGILLUS AB(PNL)-AU $11.04 0009-0031-01 HYDROCORTISONE 10 MG ORAL TAB $11.04 HC89012694 HISTOPLASMA AB-AU $11.03 HC89016562 PH FLUID FECAL-AU $11.03 57896-181-05 PEG 400-HYPROMELLOSE-GLYCERIN 1-0.2-0.2 % OPHT DROP $11.02 57896-184-05 PEG 400-HYPROMELLOSE-GLYCERIN 1-0.2-0.2 % OPHT DROP $11.02 63739-052-69 CHLORHEXIDINE GLUCONATE 0.12 % MUCOUS MEMB MWSH $11.02 63739-052-74 CHLORHEXIDINE GLUCONATE 0.12 % MUCOUS MEMB MWSH $11.02 45802-060-01 BACITRACIN 500 UNIT/GRAM TOPICAL OINT $11.01 HC89004394 ADENOVIRUS AB, IGG-AU $11.00 HC89004402 ADENOVIRUS AB, IGM-AU $11.00 HC89007140 AFP-GE $11.00 HC89015317 ALDOLASE-QD $11.00 HC89000566 ANTI-HISTONE AB-AU $11.00 HC89007272 APOLIPOPROTEIN A-1 AU $11.00 HC89007298 ARSENIC, BLOOD-AU $11.00 HC89015465 ASSAY NICOTINE-QD $11.00 HC89013239 CHLAMYDIA DNA PROBE-AU $11.00 HC89000624 COCCIDIOIDES AB-QD $11.00 HC89014476 FLUORESCENT TREPONMAL ABCSF-AU $11.00 HC89013346 GC DNA PROBE-AU $11.00 HC89015960 HIV 1 AB-QD $11.00 HC89017628 MERCURY URINE (PNL)-AU $11.00 HC89000244 MUMPS AB-QD $11.00 HC89003800 NBS TYROSINE SCREEN-GE $11.00 HC89010797 PARTIAL THROMBOPLASTIN-AU $11.00 HC89004881 PTT-D CORR RFX- AU $11.00 HC89015531 SELENIUM-QD $11.00 HC89015572 T3 TOTAL-QD $11.00 HC89010136 TRYPSIN (FECES)-AU $11.00 HC89003263 VDRL CSF-QD $11.00 HC89001036 ZINC-QD $11.00 0093-2275-34 AMOXICILLIN-POT CLAVULANATE 875-125 MG ORAL TAB $10.97 42858-867-06 DRONABINOL 2.5 MG ORAL CAP $10.97 68084-430-98 POLYETHYLENE GLYCOL 3350 17 GRAM ORAL PWPK $10.95 68084-430-99 POLYETHYLENE GLYCOL 3350 17 GRAM ORAL PWPK $10.95 0228-2778-11 PROPRANOLOL 60 MG ORAL CS24 $10.93 70756-621-25 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $10.92 70756-621-82 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $10.92 99999-043-15 TOBRAMYCIN 10 MG/5 ML INJ SOLN IN D5W (MCH-NEONATE) $10.92 68084-149-01 METHYLPREDNISOLONE 4 MG ORAL TAB $10.86 68084-149-11 METHYLPREDNISOLONE 4 MG ORAL TAB $10.86 60687-582-01 HYDROCORTISONE 10 MG ORAL TAB $10.84 60687-582-11 HYDROCORTISONE 10 MG ORAL TAB $10.84 0378-9070-16 RIVASTIGMINE 4.6 MG/24 HOUR TRANSDERMAL PT24 $10.84 0378-9070-93 RIVASTIGMINE 4.6 MG/24 HOUR TRANSDERMAL PT24 $10.84 0378-9071-16 RIVASTIGMINE 9.5 MG/24 HOUR TRANSDERMAL PT24 $10.84 0378-9071-93 RIVASTIGMINE 9.5 MG/24 HOUR TRANSDERMAL PT24 $10.84 0378-9072-16 RIVASTIGMINE 13.3 MG/24 HOUR TRANSDERMAL PT24 $10.84 0378-9072-93 RIVASTIGMINE 13.3 MG/24 HOUR TRANSDERMAL PT24 $10.84 27241-022-38 ZOLMITRIPTAN 5 MG ORAL TAB $10.84 67877-454-30 ITRACONAZOLE 100 MG ORAL CAP $10.84 69097-316-02 EXEMESTANE 25 MG ORAL TAB $10.84 99996-000-28 TRACE ELEM CR-CU-MN-ZN 0.392-39.2-2-784 MCG/ML IV SOLN $10.84 68084-805-11 METHYLPHENIDATE HCL 5 MG ORAL TAB $10.82 68084-805-21 METHYLPHENIDATE HCL 5 MG ORAL TAB $10.82 51079-651-01 DOXEPIN 100 MG ORAL CAP $10.82 51079-651-20 DOXEPIN 100 MG ORAL CAP $10.82 99999-033-71 KETAMINE 100 MG/ML INJ SOLN $10.81 HC89014377 INFLUENZA A SEROLOGY-AU $10.80 HC89014385 INFLUENZA B SEROLOGY-AU $10.80 59746-010-32 RISPERIDONE 0.5 MG ORAL TBDL $10.80 72572-061-01 CEFTRIAXONE 1 GRAM INJ SOLR $10.79 72572-061-25 CEFTRIAXONE 1 GRAM INJ SOLR $10.79 99999-045-37 KETAMINE 10 MG/ML INJ SOLN $10.79 99999-045-62 POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN $10.79 0185-5050-01 METOLAZONE 2.5 MG ORAL TAB $10.78 0071-0369-40 PHENYTOIN SODIUM EXTENDED 100 MG ORAL CAP $10.75 44567-707-25 CEFAZOLIN 1 GRAM INJ SOLR $10.73 51079-922-01 CLOZAPINE 100 MG ORAL TAB $10.73 51079-922-20 CLOZAPINE 100 MG ORAL TAB $10.73 57896-339-05 CARBAMIDE PEROXIDE 6.5 % OTIC DROP $10.73 72205-042-11 OSELTAMIVIR 30 MG ORAL CAP $10.73 72205-043-11 OSELTAMIVIR 45 MG ORAL CAP $10.73 99999-037-15 LIDOCAINE HCL 2 % MUCOUS MEMB SOLN $10.73 99999-041-71 LIDOCAINE HCL 2 % MUCOUS MEMB SOLN $10.73 HC89022883 AMYLASE, BODY FLUID-AU $10.70 HC89012686 HISTOPLASMA AB (PNL)-AU $10.70 HC89004949 HISTOPLASMA AB CF (PNL)-AU $10.70 0115-4433-01 DANTROLENE 100 MG ORAL CAP $10.67 0904-6636-61 BUPROPION HCL 100 MG ORAL TAB $10.65 16714-733-01 CELECOXIB 200 MG ORAL CAP $10.63 0378-1902-01 MIDODRINE 5 MG ORAL TAB $10.61 60687-384-25 BUMETANIDE 1 MG ORAL TAB $10.60 60687-384-95 BUMETANIDE 1 MG ORAL TAB $10.60 68084-300-11 DANTROLENE 25 MG ORAL CAP $10.58 68084-300-21 DANTROLENE 25 MG ORAL CAP $10.58 60687-672-11 BUTALBITAL-ACETAMINOPHEN-CAFF 50-325-40 MG ORAL TAB $10.57 60687-672-65 BUTALBITAL-ACETAMINOPHEN-CAFF 50-325-40 MG ORAL TAB $10.57 7135101312 LACTOBACILLUS ACIDOPH-L.BULGAR 100 MILLION CELL ORAL GRPK $10.56 7135101399 LACTOBACILLUS ACIDOPH-L.BULGAR 100 MILLION CELL ORAL GRPK $10.56 0409-9093-32 FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN $10.56 0409-9093-37 FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN $10.56 51079-513-01 PIOGLITAZONE 15 MG ORAL TAB $10.56 51079-513-20 PIOGLITAZONE 15 MG ORAL TAB $10.56 68462-468-06 RIZATRIPTAN 10 MG ORAL TBDL $10.56 68462-468-40 RIZATRIPTAN 10 MG ORAL TBDL $10.56 0121-0657-00 ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL LIQD (MHS) $10.53 0121-0657-05 ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL LIQD (MHS) $10.53 HC89013650 GLIADIN AB IGA-AU $10.50 HC89017370 GLIADIN AB IGG-AU $10.50 99999-034-55 VANCOMYCIN IV SOLN (FOR DESENSITIZATION USE) $10.48 58394-134-03 BENEFIX 500 UNIT IV SOLR $10.47 63323-545-01 HEPARIN LOCK FLUSH (PORCINE) 100 UNIT/ML IV SOLN $10.47 72572-016-01 AMPICILLIN SODIUM 1 GRAM INJ SOLR $10.47 72572-016-10 AMPICILLIN SODIUM 1 GRAM INJ SOLR $10.47 0093-8118-56 FAMCICLOVIR 250 MG ORAL TAB $10.45 59746-002-04 METHYLPREDNISOLONE 8 MG ORAL TAB $10.45 59762-0049-1 METHYLPREDNISOLONE 8 MG ORAL TAB $10.45 0904-7043-61 DULOXETINE 20 MG ORAL CPDR $10.43 4898500153 NICOTINE 21 MG/24 HR TRANSDERMAL PT24 $10.42 0406-0522-62 OXYCODONE-ACETAMINOPHEN 7.5-325 MG ORAL TAB $10.42 43598-448-28 NICOTINE 21 MG/24 HR TRANSDERMAL PT24 $10.42 0378-7150-01 CELECOXIB 200 MG ORAL CAP $10.41 0245-0012-89 SOTALOL 80 MG ORAL TAB $10.40 0406-0522-23 OXYCODONE-ACETAMINOPHEN 7.5-325 MG ORAL TAB $10.40 25021-101-10 CEFAZOLIN 1 GRAM INJ SOLR $10.40 59651-118-60 DOFETILIDE 125 MCG ORAL CAP $10.40 60687-734-01 DULOXETINE 30 MG ORAL CPDR $10.40 60687-734-11 DULOXETINE 30 MG ORAL CPDR $10.40 63323-485-26 LIDOCAINE HCL 10 MG/ML (1 %) INJ SOLN $10.40 63323-485-41 LIDOCAINE HCL 10 MG/ML (1 %) INJ SOLN $10.40 64253-020-91 WATER FOR INJECTION, STERILE INJ SYRG $10.40 64380-714-04 TENOFOVIR DISOPROXIL FUMARATE 300 MG ORAL TAB $10.40 68094-022-59 DIPHENHYDRAMINE HCL 12.5 MG/5 ML ORAL LIQD $10.40 68094-022-62 DIPHENHYDRAMINE HCL 12.5 MG/5 ML ORAL LIQD $10.40 69452-131-17 DOFETILIDE 125 MCG ORAL CAP $10.40 69452-133-17 DOFETILIDE 500 MCG ORAL CAP $10.40 70860-302-04 FUROSEMIDE 10 MG/ML INJ SOLN (MCH) $10.40 70860-302-42 FUROSEMIDE 10 MG/ML INJ SOLN (MCH) $10.40 72205-041-60 DOFETILIDE 500 MCG ORAL CAP $10.40 81284-211-00 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $10.40 81284-211-25 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $10.40 99999-033-68 GLYCERIN 0.2 ML PEDIATRIC ENEMA SOLN $10.40 76204-800-01 LEVALBUTEROL HCL 0.63 MG/3 ML INHALATION NEBU $10.39 76204-800-11 LEVALBUTEROL HCL 0.63 MG/3 ML INHALATION NEBU $10.39 76204-900-01 LEVALBUTEROL HCL 1.25 MG/3 ML INHALATION NEBU $10.39 76204-900-11 LEVALBUTEROL HCL 1.25 MG/3 ML INHALATION NEBU $10.39 0245-0012-01 SOTALOL 80 MG ORAL TAB $10.37 1093914833 CALAMINE-ZINC OXIDE 8-8 % TOPICAL LOTN $10.36 49348-011-34 CALAMINE-ZINC OXIDE 8-8 % TOPICAL LOTN $10.36 60687-575-11 RIFAMPIN 150 MG ORAL CAP $10.36 60687-575-21 RIFAMPIN 150 MG ORAL CAP $10.36 HC89005482 INFLUENZA A&B ABS, IGG/IGM-AU $10.35 HC89005508 MAGNESIUM URINE 24 HR-AU $10.35 0032-1203-70 LIPASE-PROTEASE-AMYLASE 3,000-9,500- 15,000 UNIT ORAL CPDR $10.35 0406-8330-62 MORPHINE 30 MG ORAL TBSR $10.35 0406-8330-23 MORPHINE 30 MG ORAL TBSR $10.34 68982-182-01 WILATE 500-500 UNIT IV SOLR $10.34 69238-2122-5 PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLN $10.34 99999-037-81 IBUPROFEN 100 MG/5 ML ORAL SUSP $10.34 HC89008841 LEAD URINE-AU $10.31 47335-714-81 FINASTERIDE 1 MG ORAL TAB $10.30 99999-039-92 MERCAPTOPURINE 25 MG ORAL PARTIAL TAB $10.30 0641-6042-25 KETOROLAC 30 MG/ML (1 ML) INJ SOLN $10.28 0409-4276-01 LIDOCAINE HCL 10 MG/ML (1 %) INJ SOLN $10.27 0409-4276-16 LIDOCAINE HCL 10 MG/ML (1 %) INJ SOLN $10.27 63323-064-02 MAGNESIUM SULFATE 50% (500 MG/ML) INJ SOLN (MCH) $10.27 HC89012215 COCCIDIOIDES AB SERUM -AU $10.25 386000103 ETHYL CHLORIDE 100 % TOPICAL SPRA $10.24 0054-8496-19 LEUCOVORIN CALCIUM 5 MG ORAL TAB $10.24 0536-1217-94 TETRAHYDROZOLINE 0.05 % OPHT DROP $10.24 0093-8740-01 MEXILETINE 200 MG ORAL CAP $10.23 16714-439-01 NITROFURANTOIN MONOHYD/M-CRYST 100 MG ORAL CAP $10.22 0409-3365-11 HYDROMORPHONE 2 MG/ML INJ SOLN (MHS) $10.19 0185-0122-01 NITROFURANTOIN MONOHYD/M-CRYST 100 MG ORAL CAP $10.17 47781-303-01 NITROFURANTOIN MONOHYD/M-CRYST 100 MG ORAL CAP $10.17 65862-112-60 STAVUDINE 20 MG ORAL CAP $10.17 0409-1159-09 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $10.14 0409-1159-10 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $10.14 0904-7006-35 OXYMETAZOLINE 0.05 % NASL SPRAY (MHS) $10.14 60687-742-11 AZITHROMYCIN 250 MG ORAL TAB $10.14 60687-742-65 AZITHROMYCIN 250 MG ORAL TAB $10.14 0904-6931-81 POLYETHYLENE GLYCOL 3350 17 GRAM ORAL PWPK $10.13 0904-6931-86 POLYETHYLENE GLYCOL 3350 17 GRAM ORAL PWPK $10.12 0409-4713-26 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $10.11 51079-864-01 CAPTOPRIL 25 MG ORAL TAB $10.10 51079-864-20 CAPTOPRIL 25 MG ORAL TAB $10.10 16714-213-01 RALOXIFENE 60 MG ORAL TAB $10.08 81033-003-10 DIPHENHYDRAMINE HCL 12.5 MG/5 ML ORAL LIQD $10.08 81033-003-40 DIPHENHYDRAMINE HCL 12.5 MG/5 ML ORAL LIQD $10.08 99999-046-33 CLINDAMYCIN IN 5 % DEXTROSE 600 MG/50 ML IV PGBK $10.08 HC89022990 POTASSIUM, BODY FLUID-AU $10.03 0378-0028-01 NADOLOL 20 MG ORAL TAB $10.03 16714-391-02 CEFDINIR 300 MG ORAL CAP $10.02 1093940233 SODIUM CHLORIDE 0.65 % NASL SPRA $10.01 HC89009559 ACID PHOS -TOTAL-AU $10.00 HC89022016 BETA 2 GLYCOPROTEIN, IGA- AU $10.00 HC89004352 BETA 2 GLYCOPROTEIN, IGG- AU $10.00 HC89004360 BETA 2 GLYCOPROTEIN, IGM- AU $10.00 HC89003149 CA 15-3-QD $10.00 HC89015713 CA 19-9-QD $10.00 HC89011613 CANCER AG 15-3-AU $10.00 HC89001408 CITRIC ACID-QD $10.00 HC89012462 EBV AB TO EARLY AG-AU $10.00 HC89007942 ERYTHROPOIETIN-AU $10.00 HC89015382 ESTRIOL-QD $10.00 HC89015895 HLA B27-QD $10.00 HC89000392 HUMAN GROWTH HORMONE-QD $10.00 HC89011860 IMMUNOFIX ELECTROPHOR(PNL)-AU $10.00 HC89006761 LAMOTRIGINE-AU $10.00 HC89003016 LDH ISOENZYMES-QD $10.00 HC89012785 MUMPS AB-AU $10.00 HC89021760 OPIATES CNFRM/QNT 1/> URINE -AU $10.00 HC89019756 OXYCODONE CONFIRM URINE -AU $10.00 HC89010771 PROTHROMBIN -AU $10.00 HC89007462 PSEUDOCHOLINESTERASE-AU $10.00 HC89004832 STREPTOLYSIN O AB (ASO)-AU $10.00 HC89015580 T3 FREE-QD $10.00 HC89012892 TORCH TOXOPLASM AB IGG(PNL)-AU $10.00 HC89012900 TORCH TOXOPLASM AB IGM(PNL)-AU $10.00 HC89023261 TOTAL PROTEIN URINE (IFE)-AU $10.00 HC89001044 TOXOPLASMA AB IGM(PNL)-AU $10.00 HC89012918 TOXOPLASMA AB IGM-AU $10.00 HC89013528 VITAMIN D 25 OH-AU $10.00 60687-315-11 CAPTOPRIL 25 MG ORAL TAB $10.00 60687-315-21 CAPTOPRIL 25 MG ORAL TAB $10.00 1093972644 GUAIFENESIN 100 MG/5 ML ORAL LIQD $9.97 0093-7353-01 CALCITRIOL 0.5 MCG ORAL CAP $9.93 59762-0800-2 TOLTERODINE 2 MG ORAL TAB $9.93 0591-2882-01 VERAPAMIL 180 MG ORAL C24P $9.91 0409-7332-01 CEFTRIAXONE 1 G INJ SOLR (MCH) $9.90 0409-7332-11 CEFTRIAXONE 1 G INJ SOLR (MCH) $9.90 0409-7332-20 CEFTRIAXONE 1 GRAM INJ SOLR $9.90 0409-7332-21 CEFTRIAXONE 1 GRAM INJ SOLR $9.90 68308-475-47 OXYCODONE-ACETAMINOPHEN 7.5-325 MG ORAL TAB $9.90 0904-6363-45 DIVALPROEX 250 MG ORAL TB24 $9.89 0378-0464-01 TRIAMTERENE-HYDROCHLOROTHIAZID 37.5-25 MG ORAL TAB $9.85 1093916733 TETRAHYDROZOLINE 0.05 % OPHT DROP $9.85 49348-037-29 TETRAHYDROZOLINE 0.05 % OPHT DROP $9.85 65862-107-01 ZIDOVUDINE 100 MG ORAL CAP $9.85 62559-821-01 MEXILETINE 200 MG ORAL CAP $9.84 51079-630-01 PRAZOSIN 1 MG ORAL CAP $9.82 51079-630-20 PRAZOSIN 1 MG ORAL CAP $9.82 60687-504-01 VERAPAMIL 180 MG ORAL TBSR $9.80 60687-504-11 VERAPAMIL 180 MG ORAL TBSR $9.80 HC89022917 CHLORIDE, BODY FLUID-AU $9.80 16714-014-02 AMOXICILLIN-POT CLAVULANATE 875-125 MG ORAL TAB $9.79 16714-478-02 AMOXICILLIN-POT CLAVULANATE 875-125 MG ORAL TAB $9.79 51079-306-01 POLYETHYLENE GLYCOL 3350 17 GRAM ORAL PWPK $9.79 51079-306-30 POLYETHYLENE GLYCOL 3350 17 GRAM ORAL PWPK $9.79 0536-1271-80 POVIDONE-IODINE 10 % TOPICAL OINT $9.78 50474-100-01 THEOPHYLLINE 100 MG ORAL CP24 $9.78 99999-040-98 MORPHINE (PF) 1 MG/ML INJ SOLN $9.76 0054-0176-13 BUPRENORPHINE HCL 2 MG SL SUBL $9.75 0409-7811-37 METRONIDAZOLE IN NACL (ISO-OS) 500 MG/100 ML IV PGBK $9.75 0555-0952-02 DEXTROAMPHETAMINE SULFATE 5 MG ORAL TAB $9.75 0781-3451-70 CEFAZOLIN 1 GRAM INJ SOLR $9.75 0781-3451-96 CEFAZOLIN 1 GRAM INJ SOLR $9.75 55111-650-01 METAXALONE 800 MG ORAL TAB $9.75 60687-156-25 PHENYTOIN 50 MG ORAL CHEW $9.75 60687-156-95 PHENYTOIN 50 MG ORAL CHEW $9.75 62135-192-22 CALCIUM ACETATE(PHOSPHAT BIND) 667 MG ORAL TAB $9.75 63323-012-07 OXYTOCIN 10 UNIT/ML INJ SOLN $9.75 68382-471-30 TELMISARTAN 20 MG ORAL TAB $9.75 68382-471-78 TELMISARTAN 20 MG ORAL TAB $9.75 68382-472-30 TELMISARTAN 40 MG ORAL TAB $9.75 68382-472-78 TELMISARTAN 40 MG ORAL TAB $9.75 73293-0001-1 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $9.75 73293-0001-2 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $9.75 99999-037-23 BRILLIANT GREEN 5% TOPICAL SOLUTION $9.75 99999-044-45 AMIODARONE IN D5W 150 MG/100 ML (1.5 MG/ML) IV SOLN (MHS) $9.75 0527-1788-01 FLUPHENAZINE HCL 1 MG ORAL TAB $9.74 0071-0369-24 PHENYTOIN SODIUM EXTENDED 100 MG ORAL CAP $9.74 0904-5046-61 CAPTOPRIL 25 MG ORAL TAB $9.74 0904-7106-61 CAPTOPRIL 25 MG ORAL TAB $9.74 68084-450-01 TACROLIMUS 1 MG ORAL CAP $9.72 68084-450-11 TACROLIMUS 1 MG ORAL CAP $9.72 HC89022800 CHOLESTEROL FLUID SPECTROPHTMTRY-AU $9.70 0527-2215-37 METOLAZONE 2.5 MG ORAL TAB $9.69 63323-660-01 METOPROLOL TARTRATE 5 MG/5 ML IV SOLN $9.69 63323-660-05 METOPROLOL TARTRATE 5 MG/5 ML IV SOLN $9.69 68084-597-01 NIFEDIPINE 30 MG ORAL TR24 $9.69 68084-597-11 NIFEDIPINE 30 MG ORAL TR24 $9.69 81565-201-01 FUROSEMIDE 10 MG/ML INJ SOLN $9.69 81565-201-02 FUROSEMIDE 10 MG/ML INJ SOLN $9.69 0049-3170-30 VORICONAZOLE 50 MG ORAL TAB $9.68 60687-351-01 BUPROPION HCL 100 MG ORAL TAB $9.67 60687-351-11 BUPROPION HCL 100 MG ORAL TAB $9.67 68084-996-11 PRAZOSIN 1 MG ORAL CAP $9.67 13668-216-30 ARIPIPRAZOLE 2 MG ORAL TAB $9.67 13668-217-30 ARIPIPRAZOLE 5 MG ORAL TAB $9.67 13668-218-30 ARIPIPRAZOLE 10 MG ORAL TAB $9.67 60505-2673-3 ARIPIPRAZOLE 5 MG ORAL TAB $9.67 50268-553-11 BUTALBITAL-ACETAMINOPHEN-CAFF 50-325-40 MG ORAL TAB $9.65 HC89019483 SPECIAL STAIN;MICROSPORIDIA-AU $9.65 65862-936-30 PARICALCITOL 1 MCG ORAL CAP $9.64 50268-050-11 ACEBUTOLOL 200 MG ORAL CAP $9.63 50268-050-15 ACEBUTOLOL 200 MG ORAL CAP $9.63 55150-159-74 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $9.62 68084-823-11 METHYLPHENIDATE HCL 10 MG ORAL TAB $9.62 68084-823-21 METHYLPHENIDATE HCL 10 MG ORAL TAB $9.62 0378-6410-01 DOXEPIN 100 MG ORAL CAP $9.61 50268-685-11 PROCHLORPERAZINE MALEATE 10 MG ORAL TAB $9.61 50268-685-15 PROCHLORPERAZINE MALEATE 10 MG ORAL TAB $9.61 55111-649-01 GLYCOPYRROLATE 2 MG ORAL TAB $9.61 50268-412-11 HYDROXYCHLOROQUINE 200 MG ORAL TAB $9.61 50268-412-15 HYDROXYCHLOROQUINE 200 MG ORAL TAB $9.61 51079-766-01 DIVALPROEX 250 MG ORAL TB24 $9.56 51079-766-08 DIVALPROEX 250 MG ORAL TB24 $9.56 60505-3438-3 SELEGILINE HCL 5 MG ORAL TAB $9.56 68084-310-01 DIVALPROEX 250 MG ORAL TB24 $9.56 68084-310-11 DIVALPROEX 250 MG ORAL TB24 $9.56 69315-140-01 GLYCOPYRROLATE 2 MG ORAL TAB $9.56 50383-339-12 ACETAMINOPHEN-CODEINE 300 MG-30 MG /12.5 ML ORAL SOLN $9.51 HC89023451 HSV TYPE 1 &/OR 2AB IGM PNL)-AU $9.50 HC89008981 MERCURY BLOOD-AU $9.50 68462-467-06 RIZATRIPTAN 5 MG ORAL TBDL $9.48 0904-7043-04 DULOXETINE 20 MG ORAL CPDR $9.46 0904-6627-35 CARBAMIDE PEROXIDE 6.5 % OTIC DROP $9.46 13668-110-30 DULOXETINE 30 MG ORAL CPDR $9.45 13668-111-30 DULOXETINE 60 MG ORAL CPDR $9.45 0990-7984-36 SODIUM CHLORIDE 0.9 % IV SOLP $9.43 60687-436-01 CELECOXIB 100 MG ORAL CAP $9.43 60687-436-11 CELECOXIB 100 MG ORAL CAP $9.43 68084-366-01 DIGOXIN 125 MCG (0.125 MG) ORAL TAB $9.43 68084-366-11 DIGOXIN 125 MCG (0.125 MG) ORAL TAB $9.43 68084-680-01 DIGOXIN 250 MCG (0.25 MG) ORAL TAB $9.43 68084-680-11 DIGOXIN 250 MCG (0.25 MG) ORAL TAB $9.43 55111-281-30 LEVOFLOXACIN 750 MG ORAL TAB $9.39 16252-539-01 ISRADIPINE 2.5 MG ORAL CAP $9.38 0641-0121-21 HYDROMORPHONE 2 MG/ML INJ SOLN (MHS) $9.36 0071-0418-13 NITROGLYCERIN 0.4 MG SL SUBL $9.35 0904-7044-61 DULOXETINE 30 MG ORAL CPDR $9.33 0904-7045-61 DULOXETINE 60 MG ORAL CPDR $9.33 0074-3727-90 LEVOTHYROXINE 137 MCG ORAL TAB $9.30 0074-4341-90 LEVOTHYROXINE 25 MCG ORAL TAB $9.30 0074-5182-19 LEVOTHYROXINE 75 MCG ORAL TAB $9.30 0074-5182-90 LEVOTHYROXINE 75 MCG ORAL TAB $9.30 0074-6594-90 LEVOTHYROXINE 88 MCG ORAL TAB $9.30 0074-7068-90 LEVOTHYROXINE 125 MCG ORAL TAB $9.30 0074-7069-90 LEVOTHYROXINE 150 MCG ORAL TAB $9.30 0074-7148-90 LEVOTHYROXINE 200 MCG ORAL TAB $9.30 0074-4552-11 LEVOTHYROXINE 50 MCG ORAL TAB $9.30 0074-4552-19 LEVOTHYROXINE 50 MCG ORAL TAB $9.30 0074-4552-90 LEVOTHYROXINE 50 MCG ORAL TAB $9.30 0074-5182-11 LEVOTHYROXINE 75 MCG ORAL TAB $9.30 0074-6624-11 LEVOTHYROXINE 100 MCG ORAL TAB $9.30 0074-6624-90 LEVOTHYROXINE 100 MCG ORAL TAB $9.30 0074-7068-11 LEVOTHYROXINE 125 MCG ORAL TAB $9.30 0074-7069-11 LEVOTHYROXINE 150 MCG ORAL TAB $9.30 0074-9296-19 LEVOTHYROXINE 112 MCG ORAL TAB $9.30 0074-9296-90 LEVOTHYROXINE 112 MCG ORAL TAB $9.30 53335-006-90 CITRULLINE 600 MG ORAL CAP $9.30 60505-0749-1 CEFAZOLIN 1 GRAM INJ SOLR $9.30 60505-6142-0 CEFAZOLIN 1 GRAM INJ SOLR $9.30 68094-019-59 GUANFACINE 1 MG ORAL TAB $9.30 68094-019-62 GUANFACINE 1 MG ORAL TAB $9.30 0074-7070-90 LEVOTHYROXINE 175 MCG ORAL TAB $9.29 0641-0367-21 DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJ SOLN $9.29 0641-0367-25 DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJ SOLN $9.29 60505-0749-5 CEFAZOLIN 1 GRAM INJ SOLR $9.29 60505-6142-5 CEFAZOLIN 1 GRAM INJ SOLR $9.29 0536-1277-80 HYDROCORTISONE-ALOE VERA 1 % TOPICAL CREAM $9.28 0378-4122-01 ALBUTEROL SULFATE 4 MG ORAL TB12 $9.28 99999-036-48 MERCAPTOPURINE 25 MG ORAL PARTIAL TAB $9.28 0078-0510-05 CARBAMAZEPINE 100 MG ORAL TB12 $9.26 68084-699-01 OXYCODONE-ACETAMINOPHEN 7.5-325 MG ORAL TAB $9.26 68084-699-11 OXYCODONE-ACETAMINOPHEN 7.5-325 MG ORAL TAB $9.26 1093986244 NICOTINE 14 MG/24 HR TRANSDERMAL PT24 $9.25 60951-712-70 OXYCODONE-ACETAMINOPHEN 10-325 MG ORAL TAB $9.25 68462-473-01 URSODIOL 250 MG ORAL TAB $9.21 0904-2533-21 CALAMINE-ZINC OXIDE 8-8 % TOPICAL LOTN $9.20 0904-6500-61 FLUCONAZOLE 100 MG ORAL TAB $9.20 0245-0071-11 POTASSIUM CITRATE 10 MEQ (1,080 MG) ORAL TBSR $9.20 60687-304-11 CAPTOPRIL 12.5 MG ORAL TAB $9.20 60687-304-21 CAPTOPRIL 12.5 MG ORAL TAB $9.20 0904-7105-61 CAPTOPRIL 12.5 MG ORAL TAB $9.19 0093-2274-34 AMOXICILLIN-POT CLAVULANATE 500-125 MG ORAL TAB $9.17 60687-409-25 MIDODRINE 10 MG ORAL TAB $9.16 60687-409-95 MIDODRINE 10 MG ORAL TAB $9.16 60687-493-01 VERAPAMIL 120 MG ORAL TBSR $9.15 60687-493-11 VERAPAMIL 120 MG ORAL TBSR $9.15 50111-787-51 AZITHROMYCIN 250 MG ORAL TAB $9.15 50111-787-66 AZITHROMYCIN 250 MG ORAL TAB $9.15 68180-160-11 AZITHROMYCIN 250 MG ORAL TAB $9.15 68382-537-01 POTASSIUM CITRATE 10 MEQ (1,080 MG) ORAL TBSR $9.15 0378-0094-01 CARBIDOPA-LEVODOPA 50-200 MG ORAL TBSR $9.13 0071-0007-24 PHENYTOIN 50 MG ORAL CHEW $9.12 0904-7042-06 AMANTADINE HCL 100 MG ORAL CAP $9.11 50268-321-11 FLECAINIDE 100 MG ORAL TAB (MCH) $9.11 50268-321-15 FLECAINIDE 100 MG ORAL TAB (MCH) $9.11 0121-0868-50 NYSTATIN 100,000 UNIT/ML ORAL SUSP $9.10 0409-9094-12 FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN $9.10 0409-9094-22 FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN $9.10 27241-162-01 CAPTOPRIL 50 MG ORAL TAB $9.10 50268-297-11 ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) ORAL CAP $9.10 50268-297-15 ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) ORAL CAP $9.10 60687-245-01 ROSUVASTATIN 10 MG ORAL TAB $9.10 60687-245-11 ROSUVASTATIN 10 MG ORAL TAB $9.10 60687-256-01 ROSUVASTATIN 20 MG ORAL TAB $9.10 60687-256-11 ROSUVASTATIN 20 MG ORAL TAB $9.10 60687-549-11 RANOLAZINE 500 MG ORAL TB12 $9.10 60687-549-21 RANOLAZINE 500 MG ORAL TB12 $9.10 16729-293-10 EPLERENONE 25 MG ORAL TAB $9.09 51991-877-33 EPLERENONE 25 MG ORAL TAB $9.09 59762-1710-2 EPLERENONE 25 MG ORAL TAB $9.09 59762-1710-3 EPLERENONE 25 MG ORAL TAB $9.09 68084-479-01 CALCIUM ACETATE(PHOSPHAT BIND) 667 MG ORAL CAP $9.09 68084-479-11 CALCIUM ACETATE(PHOSPHAT BIND) 667 MG ORAL CAP $9.09 60687-105-11 MEDROXYPROGESTERONE 10 MG ORAL TAB $9.08 60687-105-21 MEDROXYPROGESTERONE 10 MG ORAL TAB $9.08 0904-6931-76 POLYETHYLENE GLYCOL 3350 17 GRAM ORAL PWPK $9.04 0641-6059-01 MIDAZOLAM 1MG/ML INJECTABLE SOLUTION (MHS) $9.04 0641-6059-10 MIDAZOLAM 1MG/ML INJECTABLE SOLUTION (MHS) $9.04 51862-321-01 LIOTHYRONINE 25 MCG ORAL TAB $9.04 HC89022933 LIPASE, BODY FLUID-AU $9.03 0904-7046-61 HYDROXYCHLOROQUINE 200 MG ORAL TAB $9.03 17856-0312-2 POLYETHYLENE GLYCOL 3350 8.5 GRAM ORAL PWPK $9.03 17856-0312-5 POLYETHYLENE GLYCOL 3350 8.5 GRAM ORAL PWPK $9.03 99999-036-53 METHOTREXATE SODIUM 1.25 MG ORAL PARTIAL TAB $9.00 HC89007108 A-1 ANTITRYPSIN-AU $9.00 HC89019541 ANTIBODY IGG MUMPS VIRUS -AU $9.00 HC89015721 CA 125-QD $9.00 HC89005052 CALCIUM IONIZED-AU $9.00 HC89014260 COCCIDIOIDES AB (PNL)-AU $9.00 HC89017537 COCCIDIOIDES FUNGAL AB PAN (PNL)-AU $9.00 HC89016166 CORTISOL-QD $9.00 HC89007769 CPK ISO-AU $9.00 HC89007751 CPK-AU $9.00 HC89007785 CRYOFIBRINOGEN-AU $9.00 HC89012512 HELICOBACTER PYLOR AB (PNL)-AU $9.00 HC89008387 HEMOSIDERIN QUAL URINE-AU $9.00 HC89011597 HETEROPHILE AB SCREEN-AU $9.00 HC89020846 HGB CHROMAT-SICKLE-AU $9.00 HC89017131 IM ASSAY TISSUE TG AB-AU $9.00 HC89017727 IMMUNOGLOBULIN G(PNL)-AU $9.00 HC89013627 IMMUNOGLOBULIN IGE-AU $9.00 HC89008825 LD-AU $9.00 HC89008817 LDH-AU $9.00 HC89014450 MEASLES (RUBEOLA)(PNL) IGG-AU $9.00 HC89000756 PYRUVATE-QD $9.00 HC89001028 RAST-INDIVIDUAL-QD $9.00 HC89012041 RHEUMATOID FACTOR-AU $9.00 HC89017248 RUBELLA AB IGG - AU $9.00 HC89017594 RUBELLA AB IGG(PNL)-AU $9.00 HC89017560 RUBELLA IGM AB(PNL)-AU $9.00 HC89012868 RUBELLA IGM AB-AU $9.00 HC89009906 SOMATOMEDIN-AU $9.00 HC89005847 SPECIMEN CONCENTRATION-U2 $9.00 HC89012033 STREPTOZYME AB-AU $9.00 HC89003305 TRANSFERRIN-QD $9.00 HC89005060 TRIGLYCERIDES-VAP(IN GRP)-AU $9.00 HC89000400 UA QUAL/SEMI QUAN MELANIN-AU $9.00 HC89010243 VITAMIN A-AU $9.00 HC89009773 VITAMIN B6 PYRIDOXAL-AU $9.00 HC89010078 VITAMIN E-AU $9.00 47781-307-01 NITROFURANTOIN MACROCRYSTAL 50 MG ORAL CAP $8.99 0121-0868-05 NYSTATIN 100,000 UNIT/ML ORAL SUSP $8.97 11527-143-51 CARBAMIDE PEROXIDE 6.5 % OTIC DROP $8.97 63739-160-10 NYSTATIN 100,000 UNIT/ML ORAL SUSP $8.97 63739-160-70 NYSTATIN 100,000 UNIT/ML ORAL SUSP $8.97 0904-6779-61 ROSUVASTATIN 10 MG ORAL TAB $8.92 0093-1024-06 NEFAZODONE 100 MG ORAL TAB $8.91 53746-194-01 NAPROXEN SODIUM 550 MG ORAL TAB $8.91 99999-006-77 HYDROCORTISONE SOD SUCCINATE 10 MG/ML INJ DILUTION (MCH) $8.90 0143-9924-90 CEFAZOLIN 1 GRAM INJ SOLR $8.89 0904-7097-61 TACROLIMUS 1 MG ORAL CAP $8.89 10370-831-11 DILTIAZEM HCL 240 MG ORAL CP24 $8.89 0093-3125-01 DICLOXACILLIN 500 MG ORAL CAP $8.88 0228-3156-03 BUPRENORPHINE HCL 2 MG SL SUBL $8.88 0003-0830-50 HYDROXYUREA 500 MG ORAL CAP $8.87 63739-077-10 VALACYCLOVIR 500 MG ORAL TAB $8.86 0378-0221-01 TIMOLOL MALEATE 10 MG ORAL TAB $8.85 60429-035-01 PRIMAQUINE 26.3 MG ORAL TAB $8.85 0228-2891-03 DULOXETINE 30 MG ORAL CPDR $8.84 0228-2892-03 DULOXETINE 60 MG ORAL CPDR $8.84 68094-001-59 MORPHINE 10 MG/5 ML ORAL SOLN $8.84 68094-001-62 MORPHINE 10 MG/5 ML ORAL SOLN $8.84 68094-061-59 ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSP $8.84 0093-1077-01 CEFPROZIL 250 MG ORAL TAB $8.82 39822-0310-5 NEOMYCIN 500 MG ORAL TAB $8.82 39822-0310-7 NEOMYCIN 500 MG ORAL TAB $8.82 0121-0904-05 MORPHINE 10 MG/5 ML ORAL SOLN $8.81 49884-347-01 PIMOZIDE 1 MG ORAL TAB $8.81 HC89022891 BILIRUBIN, TOTAL BODY FLUID-AU $8.80 0904-5725-30 ALUM-MAG HYDROXIDE-SIMETH 400-400-40 MG/5 ML ORAL SUSP $8.78 72572-360-01 LEVETIRACETAM 500 MG/5 ML IV SOLN $8.78 72572-360-25 LEVETIRACETAM 500 MG/5 ML IV SOLN $8.78 16714-835-01 ZIPRASIDONE HCL 20 MG ORAL CAP $8.77 0904-5921-61 DIGOXIN 125 MCG (0.125 MG) ORAL TAB $8.76 0904-5922-61 DIGOXIN 250 MCG (0.25 MG) ORAL TAB $8.76 42292-003-20 DIGOXIN 125 MCG (0.125 MG) ORAL TAB $8.76 60687-473-01 PREGABALIN 25 MG ORAL CAP $8.76 60687-473-11 PREGABALIN 25 MG ORAL CAP $8.76 60687-484-01 PREGABALIN 50 MG ORAL CAP $8.76 60687-484-11 PREGABALIN 50 MG ORAL CAP $8.76 60687-495-01 PREGABALIN 75 MG ORAL CAP $8.76 60687-495-11 PREGABALIN 75 MG ORAL CAP $8.76 60687-506-01 PREGABALIN 100 MG ORAL CAP $8.76 60687-506-11 PREGABALIN 100 MG ORAL CAP $8.76 0904-6622-61 PYRIDOSTIGMINE BROMIDE 60 MG ORAL TAB $8.74 50268-684-11 PROCHLORPERAZINE MALEATE 5 MG ORAL TAB $8.73 50268-684-15 PROCHLORPERAZINE MALEATE 5 MG ORAL TAB $8.73 4116705840 LIDOCAINE 4 % TOPICAL PTMD $8.71 0409-4887-20 WATER FOR INJECTION, STERILE INJ SOLN $8.71 0409-4887-23 WATER FOR INJECTION, STERILE INJ SOLN $8.71 0781-3206-85 CEFTRIAXONE 250 MG INJ SOLR $8.71 HC89022925 CREATININE, BODY FLUID-AU $8.70 HC89022974 TRIGLYCERIDES, BODY FLUID-AU $8.70 HC89022982 UREA NITROGEN, BODY FLUID-AU $8.70 76385-102-01 PRIMAQUINE 26.3 MG ORAL TAB $8.70 62559-157-10 POLYETHYLENE GLYCOL 3350 17 GRAM ORAL PWPK $8.68 62559-157-17 POLYETHYLENE GLYCOL 3350 17 GRAM ORAL PWPK $8.68 0527-1315-01 RIFAMPIN 300 MG ORAL CAP $8.68 65862-290-84 RIBAVIRIN 200 MG ORAL CAP $8.67 4561100938 LIDOCAINE 4 % TOPICAL PTMD $8.67 6808476425 SOD PHOS DI, MONO-K PHOS MONO 250 MG ORAL TAB $8.67 6808476495 SOD PHOS DI, MONO-K PHOS MONO 250 MG ORAL TAB $8.67 0781-3206-95 CEFTRIAXONE 250 MG INJ SOLR $8.67 31722-833-30 ENTECAVIR 0.5 MG ORAL TAB $8.67 31722-834-30 ENTECAVIR 1 MG ORAL TAB $8.67 33342-115-07 CANDESARTAN 8 MG ORAL TAB $8.67 68180-331-07 ZIPRASIDONE HCL 20 MG ORAL CAP $8.67 50268-563-11 MIDODRINE 10 MG ORAL TAB $8.65 50268-563-15 MIDODRINE 10 MG ORAL TAB $8.65 64253-020-30 WATER FOR INJECTION, STERILE INJ SYRG $8.65 0039-0221-10 GLIMEPIRIDE 1 MG ORAL TAB $8.64 0487-9904-01 ALBUTEROL SULFATE 1.25 MG/3 ML INHALATION NEBU $8.64 47335-677-81 DILTIAZEM HCL 240 MG ORAL CP24 $8.62 68682-997-98 DILTIAZEM HCL 240 MG ORAL CP24 $8.62 68382-005-14 TOPIRAMATE 25 MG ORAL CPSP $8.61 0409-1761-18 BUPIVACAINE-DEXTROSE-WATER(PF) 0.75 % (7.5 MG/ML) INJ SOLN $8.61 0409-1761-62 BUPIVACAINE-DEXTROSE-WATER(PF) 0.75 % (7.5 MG/ML) INJ SOLN $8.61 17856-2002-3 CHLORHEXIDINE GLUCONATE 0.12 % MUCOUS MEMB MWSH $8.58 62756-538-86 RILUZOLE 50 MG ORAL TAB $8.58 68094-503-62 IBUPROFEN 100 MG/5 ML ORAL SUSP $8.58 68462-381-60 RILUZOLE 50 MG ORAL TAB $8.58 0904-6991-04 PREGABALIN 25 MG ORAL CAP $8.57 0904-7084-04 BUPROPION HCL 150 MG ORAL TB24 $8.56 50268-312-11 FENOFIBRATE 54 MG ORAL TAB $8.56 50268-312-15 FENOFIBRATE 54 MG ORAL TAB $8.56 50268-286-11 DULOXETINE 20 MG ORAL CPDR $8.54 50268-286-15 DULOXETINE 20 MG ORAL CPDR $8.54 49884-364-01 DANTROLENE 100 MG ORAL CAP $8.54 HC89022941 SODIUM, BODY FLUID-AU $8.53 0093-4069-01 PRAZOSIN 5 MG ORAL CAP $8.52 0378-3205-01 PRAZOSIN 5 MG ORAL CAP $8.52 68094-503-59 IBUPROFEN 100 MG/5 ML ORAL SUSP $8.52 0115-4422-01 DANTROLENE 50 MG ORAL CAP $8.51 53489-376-01 TRIMETHOBENZAMIDE 300 MG ORAL CAP $8.51 0591-3331-19 BUPROPION HCL 150 MG ORAL TB24 $8.48 0591-3331-30 BUPROPION HCL 150 MG ORAL TB24 $8.48 0071-0737-20 GEMFIBROZIL 600 MG ORAL TAB $8.47 HC89012199 CHLAMYDIA AB (PNL)-AU $8.45 HC89012207 CHLAMYDIA AB IGM (PNL)-AU $8.45 6498014612 LACTOBACILLUS ACIDOPH-L.BULGAR 100 MILLION CELL ORAL GRPK $8.45 6498014698 LACTOBACILLUS ACIDOPH-L.BULGAR 100 MILLION CELL ORAL GRPK $8.45 0143-9375-01 TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLN $8.45 0143-9375-10 TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLN $8.45 0409-4888-03 SODIUM CHLORIDE 0.9 % INJ SOLN $8.45 0409-4888-20 SODIUM CHLORIDE 0.9 % INJ SOLN $8.45 24658-750-90 NICARDIPINE 20 MG ORAL CAP $8.45 36000-033-10 METOPROLOL TARTRATE 5 MG/5 ML IV SOLN $8.45 57629-203-10 HYOSCYAMINE SULFATE 0.375 MG ORAL TB12 $8.45 60505-2985-3 ANASTROZOLE 1 MG ORAL TAB $8.45 99999-034-87 FENTANYL-BUPIVACAINE 2 MCG/ML - 0.1% EPIDURAL PCA (L&D) $8.45 16714-632-01 ALENDRONATE 35 MG ORAL TAB $8.44 0904-6623-61 TACROLIMUS 0.5 MG ORAL CAP $8.43 13668-109-60 DULOXETINE 20 MG ORAL CPDR $8.42 0641-6044-01 LORAZEPAM 2 MG/ML INJ SOLN CODE NEO $8.41 0641-6044-25 LORAZEPAM 2 MG/ML INJ SOLN $8.41 0093-8739-01 MEXILETINE 150 MG ORAL CAP $8.41 0904-6363-61 DIVALPROEX 250 MG ORAL TB24 $8.41 51672-4017-1 ETODOLAC 300 MG ORAL CAP $8.41 60505-0040-1 ETODOLAC 300 MG ORAL CAP $8.41 60687-651-11 DEXTROMETHORPHAN-GUAIFENESIN 30-600 MG ORAL TB12 $8.41 60687-651-21 DEXTROMETHORPHAN-GUAIFENESIN 30-600 MG ORAL TB12 $8.41 62559-251-01 ETODOLAC 300 MG ORAL CAP $8.41 0071-3740-66 PHENYTOIN SODIUM EXTENDED 30 MG ORAL CAP $8.39 42192-615-01 NIFEDIPINE 10 MG ORAL CAP $8.37 0574-0107-70 CLOTRIMAZOLE 10 MG MUCOUS MEMB TROC $8.36 HC89023691 LDH TOTAL BODY FLUID-AU $8.35 0409-4713-25 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $8.35 0409-4713-32 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $8.35 0409-4713-42 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $8.35 0409-4755-03 ONDANSETRON HCL 2 MG/ML IV SOLN (MCH) $8.35 0409-4755-18 ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN $8.35 47781-014-01 HYOSCYAMINE SULFATE 0.375 MG ORAL TB12 $8.32 63304-460-50 CHLOROQUINE PHOSPHATE 250 MG ORAL TAB $8.32 0228-2890-06 DULOXETINE 20 MG ORAL CPDR $8.29 0406-8330-01 MORPHINE 30 MG ORAL TBSR $8.28 0603-5061-21 PERPHENAZINE 4 MG ORAL TAB $8.28 68084-654-01 SOTALOL 80 MG ORAL TAB $8.27 68084-654-11 SOTALOL 80 MG ORAL TAB $8.27 68180-281-01 ETHAMBUTOL 400 MG ORAL TAB $8.26 62559-820-01 MEXILETINE 150 MG ORAL CAP $8.24 33342-114-07 CANDESARTAN 4 MG ORAL TAB $8.24 42806-102-01 ETHAMBUTOL 400 MG ORAL TAB $8.23 16729-079-01 CARBIDOPA-LEVODOPA 50-200 MG ORAL TBSR $8.22 0904-7046-06 HYDROXYCHLOROQUINE 200 MG ORAL TAB $8.21 0409-1966-01 SODIUM CHLOR 0.9% BACTERIOSTAT 0.9 % INJ SOLN $8.19 0409-1966-05 SODIUM CHLOR 0.9% BACTERIOSTAT 0.9 % INJ SOLN $8.19 99999-005-58 GENTAMICIN 2 MG/ML INJ SOLN IN D5W (MCH-NICU) $8.19 33342-084-07 OLANZAPINE 10 MG ORAL TBDL $8.17 49884-321-52 OLANZAPINE 10 MG ORAL TBDL $8.17 49884-321-55 OLANZAPINE 10 MG ORAL TBDL $8.17 50268-646-11 OXYCODONE-ACETAMINOPHEN 10-325 MG ORAL TAB $8.17 50268-646-15 OXYCODONE-ACETAMINOPHEN 10-325 MG ORAL TAB $8.17 59746-307-12 OLANZAPINE 10 MG ORAL TBDL $8.17 59746-307-32 OLANZAPINE 10 MG ORAL TBDL $8.17 60505-3276-3 OLANZAPINE 10 MG ORAL TBDL $8.17 16714-110-01 HYDROXYCHLOROQUINE 200 MG ORAL TAB $8.16 70954-504-10 SELEGILINE HCL 5 MG ORAL CAP $8.16 132020220 SODIUM PHOSPHATES 9.5-3.5 GRAM/59 ML RECTAL ENEM $8.15 0132-0202-20 SODIUM PHOSPHATES 9.5-3.5 GRAM/59 ML RECTAL ENEM $8.15 0245-0213-11 MIDODRINE 10 MG ORAL TAB $8.15 0536-1202-15 LIDOCAINE 4 % TOPICAL PTMD $8.15 60505-1325-1 MIDODRINE 10 MG ORAL TAB $8.15 99999-045-24 SULFAMETHOXAZOLE-TRIMETHOPRIM IV SOLN (FOR DESENSITIZATION USE) $8.15 0338-0069-10 KETOROLAC 15 MG/ML INJ SOLN $8.15 0904-6558-61 MORPHINE 30 MG ORAL TBSR $8.13 0143-9858-01 CEFTRIAXONE 500 MG INJ SOLR $8.13 0143-9858-25 CEFTRIAXONE 500 MG INJ SOLR (MCH) $8.13 0527-1326-01 URSODIOL 300 MG ORAL CAP $8.13 0641-6063-01 MIDAZOLAM 5MG/ML INJECTABLE SOLUTION (MHS) $8.13 29033-030-01 ACETAZOLAMIDE 500 MG ORAL CPSR $8.13 31722-565-01 INDOMETHACIN 75 MG ORAL CPSR $8.13 31722-565-60 INDOMETHACIN 75 MG ORAL CPSR $8.13 42806-503-01 URSODIOL 300 MG ORAL CAP $8.13 50268-131-11 BUMETANIDE 1 MG ORAL TAB $8.13 50268-131-15 BUMETANIDE 1 MG ORAL TAB $8.13 63739-198-61 POLYETHYLENE GLYCOL 3350 17 GRAM ORAL PWPK $8.13 63739-198-62 POLYETHYLENE GLYCOL 3350 17 GRAM ORAL PWPK $8.13 99999-042-45 MEGESTROL 40 MG/ML ORAL SUSPENSION $8.13 99999-044-13 MEGESTROL 40 MG/ML ORAL SUSPENSION $8.13 55150-158-72 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $8.10 0115-1645-01 NITROFURANTOIN MACROCRYSTAL 100 MG ORAL CAP $8.06 72572-122-01 DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJ SOLN $8.06 72572-122-25 DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJ SOLN $8.06 72572-370-01 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $8.06 72572-370-25 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $8.06 46581-830-06 LIDOCAINE 4 % TOPICAL PTMD $8.04 HC89023717 TOTAL PROTEIN BODY FLUID-AU $8.03 0904-6708-06 AZITHROMYCIN 250 MG ORAL TAB $8.03 68084-494-01 PYRIDOSTIGMINE BROMIDE 60 MG ORAL TAB $8.03 68084-494-11 PYRIDOSTIGMINE BROMIDE 60 MG ORAL TAB $8.03 0409-2308-02 MIDAZOLAM (PF) 5 MG/ML INJ SOLN $8.02 0409-2308-22 MIDAZOLAM (PF) 5 MG/ML INJ SOLN $8.02 0904-6780-61 ROSUVASTATIN 20 MG ORAL TAB $8.02 69238-1522-1 TETRACYCLINE 250 MG ORAL CAP $8.02 0536-1272-11 CLOTRIMAZOLE 1 % TOPICAL CREAM $8.01 0904-7244-68 LACOSAMIDE 50 MG ORAL TAB $8.00 67405-550-55 DOXYCYCLINE HYCLATE 100 MG ORAL TAB $8.00 HC89002984 5-HIAA 24HR URINE-QD $8.00 HC89016299 ALBUMIN; URINE QUANT-QD $8.00 HC89007264 ANGIOTENSIN CONVERT ENZYME-AU $8.00 HC89017503 ANTI-CARDIOLIPIN IGG/GM(PNL-AU $8.00 HC89004279 BETA-2 MICROGLOBULIN SR/PLS-AU $8.00 HC89001069 CARBOXYHEMOGLOBIN-QD $8.00 HC89017586 CMV AB IGG (PNL)-AU $8.00 HC89017289 CMV AB IGG(PNL-2)-AU $8.00 HC89012264 CMV AB IGG-AU $8.00 HC89017552 CMV AB IGM(PNL)-AU $8.00 HC89012272 CMV AB IGM-AU $8.00 HC89018477 C-REACTIVE PROTEIN(PNL)-PR $8.00 HC89003735 CREATININE URINE (PNL)-AU $8.00 HC89016869 CRYOGLOBULIN IGA, QUANT-AU $8.00 HC89016885 CRYOGLOBULIN IGG, QUANT-AU $8.00 HC89016877 CRYOGLOBULIN IGM, QUANT-AU $8.00 HC89016356 CULTURE FUNGUS BLOOD-QD $8.00 HC89007835 DHEA SULFATE-AU $8.00 HC89012454 EBV AB TO EARLY AG (PNL)-AU $8.00 HC89012470 EBV AB TO NUCLEAR AG (PNL)-AU $8.00 HC89012496 EBV AB-VIRAL CAPSID AG(PNL)-AU $8.00 HC89021323 EOSINOPHIL SPUTUM-AU $8.00 HC89000509 F-ACTIN (SM) AB, IGG, RFLX-AU $8.00 HC89008098 FOLATE RBC-AU $8.00 HC89008239 FRUCTOSAMINE-AU $8.00 HC89012520 HELICOBACTER PYLORI AB-AU $8.00 HC89020820 HELICOBACTER PYLORI IGM - AU $8.00 HC89016265 HEPATITIS C AB CONFIRM(DS)-QD $8.00 HC89013676 INSULIN TOTAL-AU $8.00 HC89016851 LACTIC ACID-AU $8.00 HC89012157 LYME DISEASE AB-AU $8.00 HC89017412 PARASITE IDENTIFICATION(O&P)AU $8.00 HC89015515 RENIN-QD $8.00 HC89002919 RHEUMATOID FACTOR-SL $8.00 HC89009864 SEX HORMONE BINDING GLOB-AU $8.00 HC89013015 THYROGLOBULIN AB-AU $8.00 HC89009724 TOT PROT REFRACTOMETRIC-AU $8.00 HC89012942 VARICELLA AB (PNL)-AU $8.00 HC89012959 VARICELLA ZOSTER IGG-AU $8.00 HC89012975 VARICELLA-ZOSTER IGM-AU $8.00 HC88600291 VENIPUNCTURE ROUTINE AFP PROGRAM $8.00 66689-038-01 LACTULOSE 20 GRAM/30 ML ORAL SOLN $8.00 66689-038-50 LACTULOSE 20 GRAM/30 ML ORAL SOLN $8.00 51079-943-01 BUPROPION HCL 75 MG ORAL TAB $7.98 51079-943-20 BUPROPION HCL 75 MG ORAL TAB $7.98 50268-287-11 DULOXETINE 30 MG ORAL CPDR $7.97 50268-287-13 DULOXETINE 30 MG ORAL CPDR $7.97 29033-001-01 THEOPHYLLINE 400 MG ORAL TB24 $7.94 59651-240-90 IMATINIB 100 MG ORAL TAB $7.94 72485-202-90 IMATINIB 100 MG ORAL TAB $7.94 53489-144-01 SPIRONOLACTON-HYDROCHLOROTHIAZ 25-25 MG ORAL TAB $7.93 16714-691-02 FLUCONAZOLE 100 MG ORAL TAB $7.91 0093-7629-98 IMATINIB 100 MG ORAL TAB $7.89 63323-262-09 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $7.87 63323-262-26 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $7.87 0904-6635-61 BUPROPION HCL 75 MG ORAL TAB $7.86 70954-136-10 DAPSONE 100 MG ORAL TAB $7.86 17856-0962-4 POLYETHYLENE GLYCOL 3350 8.5 GRAM ORAL PWPK $7.85 4110081088 LORATADINE-PSEUDOEPHEDRINE 10-240 MG ORAL TB24 $7.85 59762-5028-1 GABAPENTIN 400 MG ORAL CAP $7.85 0904-6502-61 CELECOXIB 100 MG ORAL CAP $7.84 60687-634-01 VALSARTAN 160 MG ORAL TAB $7.84 60687-634-11 VALSARTAN 160 MG ORAL TAB $7.84 0093-7165-01 CELECOXIB 100 MG ORAL CAP $7.82 0143-2112-05 DOXYCYCLINE HYCLATE 100 MG ORAL TAB $7.80 0487-5901-99 RACEPINEPHRINE 2.25 % INHALATION NEBU $7.80 0555-0484-02 LEUCOVORIN CALCIUM 5 MG ORAL TAB $7.80 0641-6061-01 MIDAZOLAM 5 MG/ML INJ SOLN (FOR INTRANASAL USE) $7.80 0641-6061-25 MIDAZOLAM 5MG/ML INJECTABLE SOLUTION (MHS) $7.80 16714-141-01 ARIPIPRAZOLE 2 MG ORAL TAB $7.80 23155-512-00 NIMODIPINE 30 MG ORAL CAP $7.80 23155-512-11 NIMODIPINE 30 MG ORAL CAP $7.80 23155-512-30 NIMODIPINE 30 MG ORAL CAP $7.80 23155-532-01 ETHOSUXIMIDE 250 MG ORAL CAP $7.80 42192-802-01 PHENAZOPYRIDINE 200 MG ORAL TAB $7.80 42571-177-01 PIROXICAM 20 MG ORAL CAP $7.80 42806-711-01 ETHOSUXIMIDE 250 MG ORAL CAP $7.80 52817-367-90 ETHACRYNIC ACID 25 MG ORAL TAB $7.80 63323-064-21 MAGNESIUM SULFATE 4 MEQ/ML (50 %) INJ SOLN $7.80 63323-064-23 MAGNESIUM SULFATE 4 MEQ/ML (50 %) INJ SOLN $7.80 64380-797-01 OSELTAMIVIR 30 MG ORAL CAP $7.80 69452-152-20 ETHOSUXIMIDE 250 MG ORAL CAP $7.80 99999-036-81 MITOTANE 125 MG ORAL PARTIAL TAB $7.80 0904-7095-61 OXYCODONE-ACETAMINOPHEN 10-325 MG ORAL TAB $7.79 16714-142-01 ARIPIPRAZOLE 5 MG ORAL TAB $7.79 50268-717-11 SILDENAFIL (PULM.HYPERTENSION) 20 MG ORAL TAB $7.74 50268-717-15 SILDENAFIL (PULM.HYPERTENSION) 20 MG ORAL TAB $7.74 54482-144-07 LEVOCARNITINE 330 MG ORAL TAB $7.71 16714-590-01 DIGOXIN 125 MCG (0.125 MG) ORAL TAB $7.70 16714-591-01 DIGOXIN 250 MCG (0.25 MG) ORAL TAB $7.70 0409-3414-01 METOCLOPRAMIDE HCL 5 MG/ML INJ SOLN $7.70 0409-3414-18 METOCLOPRAMIDE HCL 5 MG/ML INJ SOLN $7.70 0869-0166-38 MAGNESIUM CITRATE ORAL SOLN $7.70 0869-0667-38 MAGNESIUM CITRATE ORAL SOLN $7.70 0869-0686-38 MAGNESIUM CITRATE ORAL SOLN $7.70 0869-0693-38 MAGNESIUM CITRATE ORAL SOLN $7.70 64980-133-01 DIPYRIDAMOLE 25 MG ORAL TAB $7.70 49884-984-01 NATEGLINIDE 60 MG ORAL TAB $7.68 60687-374-11 NABUMETONE 500 MG ORAL TAB $7.68 HC89007793 CRYOGLOBULIN(QUAL/SEMI QT)-AU $7.68 0143-9249-20 AMOXICILLIN-POT CLAVULANATE 875-125 MG ORAL TAB $7.67 17856-0759-5 PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (5 ML) ORAL SOLN $7.67 68094-015-59 ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL LIQD (MHS) $7.67 99999-044-68 METOCLOPRAMIDE 0.5 MG / ML SYRINGE $7.67 0555-0882-02 HYDROXYUREA 500 MG ORAL CAP $7.66 16714-143-01 ARIPIPRAZOLE 10 MG ORAL TAB $7.65 16714-785-01 ARIPIPRAZOLE 10 MG ORAL TAB $7.65 99999-002-04 NS NICU BOLUS $7.64 0641-0376-21 DIPHENHYDRAMINE HCL 50 MG/ML INJ SOLN $7.62 0641-0376-25 DIPHENHYDRAMINE HCL 50 MG/ML INJ SOLN $7.62 72572-055-01 CEFAZOLIN 1 GRAM INJ SOLR $7.61 72572-055-25 CEFAZOLIN 1 GRAM INJ SOLR $7.61 0555-0484-01 LEUCOVORIN CALCIUM 5 MG ORAL TAB $7.59 0574-7034-12 ASPIRIN 300 MG RECTAL SUPP $7.59 27808-206-01 FEBUXOSTAT 40 MG ORAL TAB $7.59 50268-314-11 FINASTERIDE 5 MG ORAL TAB $7.59 50268-314-15 FINASTERIDE 5 MG ORAL TAB $7.59 62332-088-30 TELMISARTAN 40 MG ORAL TAB $7.59 0115-1487-01 DEXTROAMPHETAMINE-AMPHETAMINE 10 MG ORAL CP24 $7.58 10135-621-01 PHENAZOPYRIDINE 200 MG ORAL TAB $7.58 50268-127-11 BISOPROLOL FUMARATE 5 MG ORAL TAB $7.57 50268-127-15 BISOPROLOL FUMARATE 5 MG ORAL TAB $7.57 60505-3247-3 FAMCICLOVIR 500 MG ORAL TAB $7.57 0904-6671-04 SILDENAFIL (PULM.HYPERTENSION) 20 MG ORAL TAB $7.55 0121-0966-00 ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSP $7.54 0121-0966-05 ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSP $7.54 0121-1781-05 ACETAMINOPHEN 32 MG/ML ORAL SOLUTION (IMS) $7.54 99999-009-08 DIAZEPAM 5 MG/5 ML (1 MG/ML) ORAL SOLN $7.54 99999-039-89 LIDOCAINE 1%/NA BICARB 10:1 INJ $7.54 65862-459-60 GALANTAMINE 8 MG ORAL TAB $7.53 60687-540-01 DIGOXIN 125 MCG (0.125 MG) ORAL TAB $7.52 60687-540-11 DIGOXIN 125 MCG (0.125 MG) ORAL TAB $7.52 60687-551-01 DIGOXIN 250 MCG (0.25 MG) ORAL TAB $7.52 60687-551-11 DIGOXIN 250 MCG (0.25 MG) ORAL TAB $7.52 HC89004048 AMYLASE ISOENZYMES -AU $7.50 HC89012967 VARICELLA ZOSTER (PNL)-AU $7.50 50268-527-11 METHOTREXATE SODIUM 2.5 MG ORAL TAB (MCH) $7.50 50268-527-15 METHOTREXATE SODIUM 2.5 MG ORAL TAB (MCH) $7.50 4110080676 POLYETHYLENE GLYCOL 3350 17 GRAM ORAL PWPK $7.48 11523-7234-1 POLYETHYLENE GLYCOL 3350 17 GRAM ORAL PWPK $7.48 11523-7268-3 POLYETHYLENE GLYCOL 3350 17 GRAM ORAL PWPK $7.48 51079-818-01 TACROLIMUS 1 MG ORAL CAP $7.48 51079-818-20 TACROLIMUS 1 MG ORAL CAP $7.48 68084-022-01 NIFEDIPINE 10 MG ORAL CAP $7.48 68084-022-11 NIFEDIPINE 10 MG ORAL CAP $7.48 99999-045-55 DIPHENHYDRAMINE HCL 1 MG/ML INJ DILUTION (MCH) $7.48 0904-6888-06 MINOCYCLINE 100 MG ORAL CAP $7.46 50268-597-11 NIFEDIPINE 30 MG ORAL TR24 $7.46 50268-597-15 NIFEDIPINE 30 MG ORAL TR24 $7.46 68382-096-01 HYDROXYCHLOROQUINE 200 MG ORAL TAB FOR DISSOLVE (MCH) $7.44 0904-6557-61 MORPHINE 15 MG ORAL TBSR $7.44 50268-709-11 ROSUVASTATIN 10 MG ORAL TAB $7.44 50268-709-15 ROSUVASTATIN 10 MG ORAL TAB $7.44 0574-0107-77 CLOTRIMAZOLE 10 MG MUCOUS MEMB TROC $7.43 0603-4593-21 METHYLPREDNISOLONE 4 MG ORAL TAB $7.43 0781-5022-01 METHYLPREDNISOLONE 4 MG ORAL TAB $7.43 50268-062-11 ACYCLOVIR 800 MG ORAL TAB $7.43 50268-062-15 ACYCLOVIR 800 MG ORAL TAB $7.43 0409-1966-02 SODIUM CHLOR 0.9% BACTERIOSTAT 0.9 % INJ SOLN $7.41 0409-1966-07 SODIUM CHLOR 0.9% BACTERIOSTAT 0.9 % INJ SOLN $7.41 51079-453-01 MIDODRINE 5 MG ORAL TAB $7.41 51079-453-20 MIDODRINE 5 MG ORAL TAB $7.41 51991-073-01 BUTALBITAL-ACETAMINOP-CAF-COD 50-325-40-30 MG ORAL CAP $7.41 63323-411-12 MIDAZOLAM 1 MG/ML INJ SOLN $7.41 63323-411-15 MIDAZOLAM 1 MG/ML INJ SOLN $7.41 50268-783-11 VALSARTAN 40 MG ORAL TAB $7.40 50268-783-15 VALSARTAN 40 MG ORAL TAB $7.40 1093904633 MICONAZOLE NITRATE 100 MG VAGINAL SUPP $7.38 0378-2405-01 TRIFLUOPERAZINE 5 MG ORAL TAB $7.38 0781-1852-20 AMOXICILLIN-POT CLAVULANATE 875-125 MG ORAL TAB $7.38 99999-041-78 MISOPROSTOL 100 MCG ORAL PARTIAL TAB $7.38 60687-480-11 GLIPIZIDE 2.5 MG ORAL TR24 $7.37 60687-480-21 GLIPIZIDE 2.5 MG ORAL TR24 $7.37 HC89023709 GLUCOSE BODY FLUID-AU $7.35 72572-372-01 LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN $7.35 72572-372-25 LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN $7.35 16714-633-01 ALENDRONATE 70 MG ORAL TAB $7.31 0603-2544-21 BUTALBITAL-ACETAMINOPHEN-CAFF 50-325-40 MG ORAL TAB $7.30 51862-540-01 BUTALBITAL-ACETAMINOPHEN-CAFF 50-325-40 MG ORAL TAB $7.30 0409-2308-50 MIDAZOLAM (PF) 5 MG/ML INJ SOLN $7.29 0409-2308-70 MIDAZOLAM (PF) 5 MG/ML INJ SOLN $7.29 45963-342-02 DESIPRAMINE 25 MG ORAL TAB $7.29 0409-1778-05 METOPROLOL TARTRATE 5 MG/5 ML IV SOLN $7.28 0409-1778-15 METOPROLOL TARTRATE 5 MG/5 ML IV SOLN $7.28 47781-584-68 KETOROLAC 30 MG/ML (1 ML) INJ SOLN $7.28 47781-584-93 KETOROLAC 30 MG/ML (1 ML) INJ SOLN $7.28 55111-143-01 FLUCONAZOLE 50 MG ORAL TAB $7.28 55111-143-30 FLUCONAZOLE 50 MG ORAL TAB $7.28 65162-680-05 PROMETHAZINE-DM 6.25-15 MG/5 ML ORAL SYRP $7.28 72572-190-01 FUROSEMIDE 10 MG/ML INJ SOLN $7.28 72572-190-25 FUROSEMIDE 10 MG/ML INJ SOLN $7.28 72572-747-01 WATER FOR INJECTION, STERILE INJ SOLN $7.28 72572-747-10 WATER FOR INJECTION, STERILE INJ SOLN $7.28 0054-4496-13 LEUCOVORIN CALCIUM 5 MG ORAL TAB $7.26 50742-181-30 LEUCOVORIN CALCIUM 5 MG ORAL TAB $7.26 0904-6705-61 PROPRANOLOL 20 MG ORAL TAB $7.25 27241-199-90 DROXIDOPA 100 MG ORAL CAP $7.22 0093-1177-01 NEOMYCIN 500 MG ORAL TAB $7.22 0121-1870-00 DOCUSATE SODIUM 100 MG/10 ML ORAL LIQD $7.22 0121-1870-10 DOCUSATE SODIUM 100 MG/10 ML ORAL LIQD $7.22 16714-691-01 FLUCONAZOLE 100 MG ORAL TAB $7.21 68462-433-18 COLESEVELAM 625 MG ORAL TAB $7.20 68084-244-01 CLINDAMYCIN HCL 300 MG ORAL CAP $7.19 68084-244-11 CLINDAMYCIN HCL 300 MG ORAL CAP $7.19 99999-038-53 NIFEDIPINE 4 MG/ML ORAL LIQUID $7.18 53335-006-89 CITRULLINE 600 MG ORAL CAP $7.16 0378-0055-01 TIMOLOL MALEATE 5 MG ORAL TAB $7.16 0054-0166-25 MYCOPHENOLATE MOFETIL 500 MG ORAL TAB $7.15 0093-9018-19 CYCLOSPORINE MODIFIED 25 MG ORAL CAP $7.15 0093-9018-65 CYCLOSPORINE MODIFIED 25 MG ORAL CAP $7.15 0338-9541-24 METRONIDAZOLE IN NACL (ISO-OS) 500 MG/100 ML IV PGBK $7.15 0603-1585-05 PROMETHAZINE-CODEINE 6.25-10 MG/5 ML ORAL SYRP $7.15 0641-6146-01 DEXAMETHASONE 4 MG/ML INJ SOLN (FOR ORAL USE) $7.15 0641-6146-25 DEXAMETHASONE 4 MG/ML INJ SOLN (FOR ORAL USE) $7.15 51079-817-01 TACROLIMUS 0.5 MG ORAL CAP $7.15 51079-817-20 TACROLIMUS 0.5 MG ORAL CAP $7.15 55111-796-30 FEBUXOSTAT 40 MG ORAL TAB $7.15 60687-336-11 MINOCYCLINE 100 MG ORAL CAP $7.15 60687-336-65 MINOCYCLINE 100 MG ORAL CAP $7.15 60687-438-01 MYCOPHENOLATE MOFETIL 500 MG ORAL TAB $7.15 60687-438-11 MYCOPHENOLATE MOFETIL 500 MG ORAL TAB $7.15 63323-010-41 GENTAMICIN 40 MG/ML INJ SOLN $7.15 99999-034-85 CEFAZOLIN 1 GRAM/10 ML SYRINGE (USING 10 G) $7.15 99999-040-39 EPINEPHRINE 10 MCG/ML INJ DILUTION $7.15 30698-060-01 FUROSEMIDE 40 MG ORAL TAB $7.13 50268-168-11 CELECOXIB 100 MG ORAL CAP $7.13 50268-168-15 CELECOXIB 100 MG ORAL CAP $7.13 99999-035-97 PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIX $7.12 0591-0371-01 LOXAPINE SUCCINATE 25 MG ORAL CAP $7.11 99999-033-00 TETRACAINE - LIDOCAINE - EPINEPHRINE TOP SOLN $7.10 60687-586-01 RIFAMPIN 300 MG ORAL CAP $7.09 60687-586-11 RIFAMPIN 300 MG ORAL CAP $7.09 0054-4496-25 LEUCOVORIN CALCIUM 5 MG ORAL TAB $7.08 0536-1202-07 LIDOCAINE 4 % TOPICAL PTMD $7.08 65862-846-01 CLOZAPINE 100 MG ORAL TAB $7.08 0591-3220-01 BUTALBITAL-ACETAMINOP-CAF-COD 50-325-40-30 MG ORAL CAP $7.07 68382-096-05 HYDROXYCHLOROQUINE 200 MG ORAL TAB $7.07 0143-1172-01 CAPTOPRIL 25 MG ORAL TAB $7.05 0143-1172-10 CAPTOPRIL 25 MG ORAL TAB $7.05 0378-3012-01 CAPTOPRIL 25 MG ORAL TAB $7.05 53489-368-01 FELODIPINE 2.5 MG ORAL TB24 $7.05 53489-369-01 FELODIPINE 5 MG ORAL TB24 $7.05 60687-655-11 FENOFIBRATE 54 MG ORAL TAB $7.05 60687-655-21 FENOFIBRATE 54 MG ORAL TAB $7.05 HC89016398 TOTAL PROTEIN UR-AU $7.05 0904-6709-61 GLYCOPYRROLATE 1 MG ORAL TAB $7.04 68084-280-01 ETHAMBUTOL 400 MG ORAL TAB $7.04 68084-280-11 ETHAMBUTOL 400 MG ORAL TAB $7.04 68382-004-14 TOPIRAMATE 15 MG ORAL CPSP $7.04 60687-384-01 BUMETANIDE 1 MG ORAL TAB $7.03 60687-384-11 BUMETANIDE 1 MG ORAL TAB $7.03 62559-731-01 FELBAMATE 600 MG ORAL TAB $7.03 70954-136-20 DAPSONE 100 MG ORAL TAB $7.02 99999-044-61 LIDOCAINE-EPINEPHRINE 1%-1:100,000 BUFFERED WITH SODIUM BICARB 10:1 INJ (FOR IR/ANGIO) (OCM) $7.02 99999-046-37 LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN $7.02 0093-0314-01 KETOROLAC 10 MG ORAL TAB $7.01 68084-775-25 TIZANIDINE 2 MG ORAL TAB $7.01 68084-775-95 TIZANIDINE 2 MG ORAL TAB $7.01 69543-388-10 KETOROLAC 10 MG ORAL TAB $7.01 0904-7229-61 NIFEDIPINE 10 MG ORAL CAP $7.00 HC89014021 ALLERGEN-AU $7.00 HC89000574 ANTI-DNASE B-AU $7.00 HC89017230 CERULOPLASMIN-AU $7.00 HC89001846 FOLATE RBC-QD $7.00 HC89015416 G6PD-QD $7.00 HC89018253 IMMUNOGLOB IGA AR-AU $7.00 HC89017610 LEAD(PNL)-AU $7.00 HC89016992 LIPOPROTEIN A-AU $7.00 HC89017024 MITOCHONDRIAL M2 AB IGG-AU $7.00 HC89017495 MYCOPLASMA PNEUMONA AB(PNL)-AU $7.00 HC89012793 MYCOPLASMA PNEUMONIAE AB-AU $7.00 HC89009948 TESTOSTERONE FREE-ES $7.00 HC89009963 TESTOSTERONE TOTAL MALE-AU $7.00 HC89003255 TESTOSTERONE TOTAL-QD $7.00 0904-6819-07 MIDODRINE 10 MG ORAL TAB $6.98 50268-738-11 TADALAFIL 5 MG ORAL TAB $6.98 50268-738-13 TADALAFIL 5 MG ORAL TAB $6.98 0378-2921-93 TELMISARTAN 40 MG ORAL TAB $6.97 50268-269-11 DULOXETINE 20 MG ORAL CPDR $6.96 50268-269-15 DULOXETINE 20 MG ORAL CPDR $6.96 60687-623-01 VALSARTAN 80 MG ORAL TAB $6.96 60687-623-11 VALSARTAN 80 MG ORAL TAB $6.96 62175-260-37 NIFEDIPINE 30 MG ORAL TR24 $6.96 64543-111-01 HYOSCYAMINE SULFATE 0.125 MG SL SUBL $6.96 70954-538-10 TRANYLCYPROMINE 10 MG ORAL TAB $6.95 99999-042-42 ENTECAVIR 0.5 MG ORAL PARTIAL TAB $6.93 81033-002-10 ACETAMINOPHEN 32 MG/ML ORAL SOLUTION (IMS) $6.93 81033-002-40 ACETAMINOPHEN 32 MG/ML ORAL SOLUTION (IMS) $6.93 50268-177-11 CILOSTAZOL 100 MG ORAL TAB $6.92 50268-177-15 CILOSTAZOL 100 MG ORAL TAB $6.92 99999-037-95 LORAZEPAM 2 MG/ML INJ SOLN $6.92 0132-0201-40 SODIUM PHOSPHATES 19-7 GRAM/118 ML RECTAL ENEM $6.92 0904-6320-78 SODIUM PHOSPHATES 19-7 GRAM/118 ML RECTAL ENEM $6.92 16571-203-10 DICLOFENAC SODIUM 25 MG ORAL TBEC $6.92 49348-186-20 SODIUM PHOSPHATES 19-7 GRAM/118 ML RECTAL ENEM $6.92 51079-980-01 SPIRONOLACTONE 100 MG ORAL TAB $6.92 0054-0400-13 DESVENLAFAXINE SUCCINATE 50 MG ORAL TB24 $6.90 0054-0400-22 DESVENLAFAXINE SUCCINATE 50 MG ORAL TB24 $6.90 16714-534-01 EMTRICITABINE-TENOFOVIR (TDF) 200-300 MG ORAL TAB $6.90 72572-380-01 LORAZEPAM 2 MG/ML INJ SOLN $6.89 72572-380-25 LORAZEPAM 2 MG/ML INJ SOLN $6.89 0185-0675-01 ETODOLAC 400 MG ORAL TAB $6.88 51862-320-01 LIOTHYRONINE 5 MCG ORAL TAB $6.88 23155-579-01 DESIPRAMINE 25 MG ORAL TAB $6.88 0378-0052-01 PINDOLOL 5 MG ORAL TAB $6.86 50268-633-11 QUETIAPINE 200 MG ORAL TAB $6.86 50268-633-15 QUETIAPINE 200 MG ORAL TAB $6.86 0409-2308-01 MIDAZOLAM 5 MG/ML INJ SOLN (FOR INTRANASAL USE) $6.86 0409-2308-21 MIDAZOLAM 5 MG/ML INJ SOLN (FOR INTRANASAL USE) $6.86 0143-9262-01 CEFAZOLIN 1 GRAM INJ SOLR $6.84 0143-9262-25 CEFAZOLIN 1 GRAM INJ SOLR $6.84 59762-0450-1 COLESTIPOL 1 GRAM ORAL TAB $6.84 99999-038-86 LORAZEPAM 2 MG/ML ORAL CONC $6.84 35573-433-02 KETOCONAZOLE 200 MG ORAL TAB $6.83 64380-827-06 KETOCONAZOLE 200 MG ORAL TAB $6.83 0121-4785-05 NYSTATIN 100,000 UNIT/ML ORAL SUSP $6.83 42043-390-21 GRANISETRON HCL 1 MG ORAL TAB $6.83 42043-390-40 GRANISETRON HCL 1 MG ORAL TAB $6.83 60687-391-01 PIOGLITAZONE 15 MG ORAL TAB $6.83 60687-391-11 PIOGLITAZONE 15 MG ORAL TAB $6.83 68084-896-25 VENLAFAXINE 25 MG ORAL TAB $6.83 68084-896-95 VENLAFAXINE 25 MG ORAL TAB $6.83 69238-1540-1 URSODIOL 300 MG ORAL CAP $6.83 99999-044-86 METHADONE 5 MG/5 ML ORAL SOLN $6.83 11523-7268-8 POLYETHYLENE GLYCOL 3350 17 GRAM ORAL PWPK $6.82 23155-489-01 DESMOPRESSIN 0.1 MG ORAL TAB $6.82 69918-101-01 DESMOPRESSIN 0.1 MG ORAL TAB $6.82 0904-6323-61 METOPROLOL SUCCINATE 50 MG ORAL TB24 $6.81 50268-573-11 MONTELUKAST 4 MG ORAL CHEW $6.80 50268-573-15 MONTELUKAST 4 MG ORAL CHEW $6.80 70408-185-05 PROMETHAZINE-CODEINE 6.25-10 MG/5 ML ORAL SYRP $6.79 50268-270-11 DULOXETINE 30 MG ORAL CPDR $6.78 50268-270-13 DULOXETINE 30 MG ORAL CPDR $6.78 51991-793-06 RIVASTIGMINE TARTRATE 1.5 MG ORAL CAP $6.77 51991-794-06 RIVASTIGMINE TARTRATE 3 MG ORAL CAP $6.77 0054-0237-05 MORPHINE 10 MG/5 ML ORAL SOLN $6.76 55150-238-05 DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJ SOLN $6.76 60687-458-01 GLYCOPYRROLATE 1 MG ORAL TAB $6.76 60687-458-11 GLYCOPYRROLATE 1 MG ORAL TAB $6.76 68462-208-01 MOEXIPRIL 15 MG ORAL TAB $6.76 0378-5630-59 SUMATRIPTAN SUCCINATE 25 MG ORAL TAB $6.75 0378-5631-59 SUMATRIPTAN SUCCINATE 50 MG ORAL TAB $6.75 42858-701-01 THEOPHYLLINE 400 MG ORAL TB24 $6.75 0378-9116-16 NITROGLYCERIN 0.6 MG/HR TRANSDERMAL PT24 $6.74 0378-9116-93 NITROGLYCERIN 0.6 MG/HR TRANSDERMAL PT24 $6.74 0409-2305-04 MIDAZOLAM 1MG/ML INJECTABLE SOLUTION (MHS) $6.73 0409-2305-05 MIDAZOLAM 1MG/ML INJECTABLE SOLUTION (MHS) $6.73 75834-217-30 VENLAFAXINE 75 MG ORAL TR24 $6.73 33342-116-07 CANDESARTAN 16 MG ORAL TAB $6.72 0115-5211-16 COLESTIPOL 1 GRAM ORAL TAB $6.71 62037-600-90 DILTIAZEM HCL 300 MG ORAL CP24 $6.71 0904-6830-61 FINASTERIDE 5 MG ORAL TAB $6.70 17856-0604-5 PROMETHAZINE-DM 6.25-15 MG/5 ML ORAL SYRP $6.70 51079-083-01 ISONIAZID 300 MG ORAL TAB $6.70 51079-083-20 ISONIAZID 300 MG ORAL TAB $6.70 0054-0007-13 CALCITRIOL 0.25 MCG ORAL CAP $6.66 0591-3159-01 URSODIOL 300 MG ORAL CAP $6.64 0781-5274-06 DONEPEZIL 5 MG ORAL TAB $6.64 0781-5275-06 DONEPEZIL 10 MG ORAL TAB $6.64 60432-604-05 PROMETHAZINE-DM 6.25-15 MG/5 ML ORAL SYRP $6.63 63323-186-01 SALINE LOCK FLUSH (MCH-NICU) $6.63 63323-186-10 SALINE LOCK FLUSH (MCH-NICU) $6.63 68682-302-10 PYRIDOSTIGMINE BROMIDE 60 MG ORAL TAB $6.63 16729-073-29 CAPECITABINE 500 MG ORAL TAB $6.62 99999-010-03 CEFTAZIDIME SUBCONJUNCTIVAL INJECTION (MCH) $6.62 42543-115-01 PIROXICAM 20 MG ORAL CAP $6.61 99999-002-35 SODIUM PHOSPHATE 3 MMOL/ML (NICU) ORAL SYRINGE $6.60 0143-1171-01 CAPTOPRIL 12.5 MG ORAL TAB $6.59 0378-3007-01 CAPTOPRIL 12.5 MG ORAL TAB $6.59 0904-7119-06 CALCIUM ACETATE(PHOSPHAT BIND) 667 MG ORAL CAP $6.59 0641-6070-01 MORPHINE 10 MG/ML INJ SOLN (MHS WRAPPER) $6.57 0641-6070-25 MORPHINE 10 MG/ML INJ SOLN (MHS WRAPPER) $6.57 99999-010-98 PYRAZINAMIDE 100 MG/ML ORAL LIQUID (COMPOUND) $6.57 0245-0070-11 POTASSIUM CITRATE 5 MEQ (540 MG) ORAL TBSR $6.56 0009-0012-01 HYDROCORTISONE 5 MG ORAL TAB $6.53 68382-559-01 NITROFURANTOIN MACROCRYSTAL 50 MG ORAL CAP $6.53 0054-8175-25 DEXAMETHASONE 4 MG ORAL TAB $6.53 48102-047-11 DEXAMETHASONE 4 MG ORAL TAB $6.53 48102-047-20 DEXAMETHASONE 4 MG ORAL TAB $6.53 68382-536-01 POTASSIUM CITRATE 5 MEQ (540 MG) ORAL TBSR $6.53 0527-2962-37 CHLORPROMAZINE 25 MG ORAL TAB $6.52 0904-6778-61 ROSUVASTATIN 5 MG ORAL TAB $6.51 6380760051 HEPARIN, PORCINE (PF) 100 UNIT/ML IV SYRG $6.50 6380760055 HEPARIN LOCK FLUSH 100 UNIT/ML IV SOLN (MCH) $6.50 6425311130 SODIUM CHLORIDE 0.9 % (FLUSH) INJ SYRG $6.50 6425322235 HEPARIN LOCK FLUSH (PORCINE) 10 UNIT/ML IV SOLN (MCH) $6.50 6425333335 HEPARIN, PORCINE (PF) 100 UNIT/ML IV SYRG $6.50 6425344422 HEPARIN, PORCINE (PF) 1 UNIT/ML IV SYRG $6.50 0378-0473-01 DIVALPROEX 500 MG ORAL TB24 $6.50 0378-5186-93 PRASUGREL 10 MG ORAL TAB $6.50 0527-1050-01 ACETAZOLAMIDE 250 MG ORAL TAB $6.50 10370-102-03 BUPROPION HCL 300 MG ORAL TB24 $6.50 16714-167-01 LIOTHYRONINE 25 MCG ORAL TAB $6.50 27241-134-21 CHOLESTYRAMINE (WITH SUGAR) 4 GRAM ORAL PWPK $6.50 27241-134-36 CHOLESTYRAMINE (WITH SUGAR) 4 GRAM ORAL PWPK $6.50 31722-535-30 TENOFOVIR DISOPROXIL FUMARATE 300 MG ORAL TAB $6.50 49483-687-03 PARICALCITOL 1 MCG ORAL CAP $6.50 64380-722-06 TACROLIMUS 5 MG ORAL CAP $6.50 65162-596-06 ASPIRIN-DIPYRIDAMOLE 25-200 MG ORAL CM12 $6.50 65862-354-30 EMTRICITABINE-TENOFOVIR (TDF) 200-300 MG ORAL TAB $6.50 67405-602-03 FLUCONAZOLE 100 MG ORAL TAB $6.50 68180-984-05 BUDESONIDE 0.5 MG/2 ML INHALATION NBSP $6.50 68180-984-30 BUDESONIDE 0.5 MG/2 ML INHALATION NBSP $6.50 68462-102-30 FLUCONAZOLE 100 MG ORAL TAB $6.50 70860-302-02 FUROSEMIDE 10 MG/ML INJ SOLN (MCH) $6.50 70860-302-41 FUROSEMIDE 10 MG/ML INJ SOLN (MCH) $6.50 71288-203-02 FUROSEMIDE 10 MG/ML INJ SOLN (MCH) $6.50 71288-203-03 FUROSEMIDE 10 MG/ML INJ SOLN (MCH) $6.50 99999-001-14 POTASSIUM CHLORIDE - STERILE WATER - 20 MEQ / 50 ML IV PGBK $6.50 99999-039-43 POTASSIUM CHLORIDE IN WATER 20 MEQ/100 ML IV PGBK $6.50 6425311123 SODIUM CHLORIDE 0.9 % (FLUSH) INJ SYRG $6.49 6425333323 HEPARIN, PORCINE (PF) 100 UNIT/ML IV SYRG $6.49 6425333333 HEPARIN, PORCINE (PF) 100 UNIT/ML IV SYRG $6.49 51079-379-01 MYCOPHENOLATE MOFETIL 500 MG ORAL TAB $6.47 51079-379-20 MYCOPHENOLATE MOFETIL 500 MG ORAL TAB $6.47 62559-235-01 DIPYRIDAMOLE 25 MG ORAL TAB $6.47 99999-036-67 PHENYTOIN 25 MG ORAL PARTIAL CHEWTAB (MCH) $6.47 68462-209-01 MOEXIPRIL 7.5 MG ORAL TAB $6.46 0054-4184-25 DEXAMETHASONE 4 MG ORAL TAB $6.44 0406-8515-23 OXYCODONE 15 MG ORAL TAB $6.44 0406-8515-62 OXYCODONE 15 MG ORAL TAB $6.44 59762-5014-1 SPIRONOLACTON-HYDROCHLOROTHIAZ 25-25 MG ORAL TAB $6.44 60687-461-01 LABETALOL 300 MG ORAL TAB $6.44 60687-461-11 LABETALOL 300 MG ORAL TAB $6.44 69543-291-10 ALBUTEROL SULFATE 4 MG ORAL TAB $6.44 99999-037-12 ACETIC ACID (BULK) 5 % MISC LIQD $6.44 51079-902-01 LOXAPINE SUCCINATE 25 MG ORAL CAP $6.43 69452-157-73 RIZATRIPTAN 10 MG ORAL TBDL $6.43 0527-1393-30 RIFAMPIN 150 MG ORAL CAP $6.42 16714-732-01 CELECOXIB 100 MG ORAL CAP $6.42 0574-9855-10 BUDESONIDE 3 MG ORAL CECX $6.42 99999-000-32 POTASSIUM PHOSPHATE 3 MMOL / ML SYRINGE $6.41 99999-000-33 POTASSIUM PHOSPHATE 3 MMOL / ML ORAL SYRINGE $6.41 68094-330-59 ACETAMINOPHEN 325 MG/10.15 ML ORAL LIQD (MHS) $6.40 70954-135-10 DAPSONE 25 MG ORAL TAB $6.39 60687-416-11 SILDENAFIL (PULM.HYPERTENSION) 20 MG ORAL TAB $6.38 60687-416-21 SILDENAFIL (PULM.HYPERTENSION) 20 MG ORAL TAB $6.38 70436-010-04 BUPROPION HCL 150 MG ORAL TB24 $6.38 47781-587-17 METOPROLOL TARTRATE 5 MG/5 ML IV SOLN $6.37 47781-587-20 METOPROLOL TARTRATE 5 MG/5 ML IV SOLN $6.37 72611-740-01 METOPROLOL TARTRATE 5 MG/5 ML IV SOLN $6.37 72611-740-10 METOPROLOL TARTRATE 5 MG/5 ML IV SOLN $6.37 99999-005-06 AMIKACIN 40 MG/5 ML INJ SOLN IN D5W (MCH-NICU) $6.37 60687-387-01 MIDODRINE 2.5 MG ORAL TAB $6.36 60687-387-11 MIDODRINE 2.5 MG ORAL TAB $6.36 60687-592-11 PRAMIPEXOLE 1 MG ORAL TAB $6.36 60687-592-21 PRAMIPEXOLE 1 MG ORAL TAB $6.36 43063-871-60 URSODIOL 300 MG ORAL CAP $6.35 HC89021059 ASPERGILLUS AB (PNL2)-AU $6.35 HC89014237 HYPERSENSITIVITY PNEUMO I (PNL)-AU $6.35 0054-0603-13 DESVENLAFAXINE SUCCINATE 25 MG ORAL TB24 $6.34 0591-3659-30 DESVENLAFAXINE SUCCINATE 50 MG ORAL TB24 $6.34 99999-035-05 SODIUM BICARBONATE 1 MEQ/ML (8.4 %) IV SOLN $6.34 0409-2305-16 MIDAZOLAM 1MG/ML INJECTABLE SOLUTION (MHS) $6.33 0409-2305-17 MIDAZOLAM 1MG/ML INJECTABLE SOLUTION (MHS) $6.33 50268-671-11 POTASSIUM CHLORIDE 10 MEQ ORAL CPSR $6.33 50268-671-13 POTASSIUM CHLORIDE 10 MEQ ORAL CPSR $6.33 60687-390-01 METOPROLOL SUCCINATE 25 MG ORAL TB24 $6.32 60687-390-11 METOPROLOL SUCCINATE 25 MG ORAL TB24 $6.32 0456-0459-01 THYROID (PORK) 60 MG ORAL TAB $6.31 76385-134-01 NADOLOL 40 MG ORAL TAB $6.31 68462-807-01 ISRADIPINE 2.5 MG ORAL CAP $6.30 0641-6145-01 DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJ SOLN $6.29 0641-6145-25 DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJ SOLN $6.29 16714-838-01 ZIPRASIDONE HCL 80 MG ORAL CAP $6.29 50268-529-11 METHYLPHENIDATE HCL 20 MG ORAL TAB $6.29 50268-529-15 METHYLPHENIDATE HCL 20 MG ORAL TAB $6.29 60505-2526-3 MODAFINIL 100 MG ORAL TAB $6.29 0378-0222-01 CHLORTHALIDONE 25 MG ORAL TAB $6.28 0378-7160-01 CELECOXIB 100 MG ORAL CAP $6.28 59762-5008-1 MISOPROSTOL 200 MCG ORAL TAB $6.28 59762-5008-2 MISOPROSTOL 200 MCG ORAL TAB $6.28 67877-298-09 CHOLESTYRAMINE (WITH SUGAR) 4 GRAM ORAL PWPK $6.28 67877-298-60 CHOLESTYRAMINE (WITH SUGAR) 4 GRAM ORAL PWPK $6.28 0409-7338-01 CEFTRIAXONE 500 MG INJ SOLR $6.27 0409-7338-11 CEFTRIAXONE 500 MG INJ SOLR $6.27 0409-7338-20 CEFTRIAXONE 500 MG INJ SOLR $6.27 0409-7338-21 CEFTRIAXONE 500 MG INJ SOLR $6.27 0904-6939-61 HYDROXYUREA 500 MG ORAL CAP $6.27 43386-161-01 MISOPROSTOL 200 MCG ORAL TAB $6.27 43386-161-06 MISOPROSTOL 200 MCG ORAL TAB $6.27 70954-444-20 MISOPROSTOL 200 MCG ORAL TAB $6.27 99999-035-24 RIFAXIMIN 20 MG/ML ORAL SUSPENSION (COMPOUND) $6.27 0054-3567-10 MAGNESIUM HYDROXIDE 2,400 MG/10 ML ORAL SUSP $6.24 59762-5013-1 SPIRONOLACTONE 100 MG ORAL TAB $6.24 69097-533-02 TENOFOVIR DISOPROXIL FUMARATE 300 MG ORAL TAB $6.24 69452-156-73 RIZATRIPTAN 5 MG ORAL TBDL $6.23 69452-156-74 RIZATRIPTAN 5 MG ORAL TBDL $6.23 0378-0618-01 THIORIDAZINE 100 MG ORAL TAB $6.20 0781-1695-01 ISOSORBIDE DINITRATE 20 MG ORAL TAB $6.20 0781-1695-10 ISOSORBIDE DINITRATE 20 MG ORAL TAB $6.20 68084-975-01 OXYCODONE 15 MG ORAL TAB $6.20 68084-975-11 OXYCODONE 15 MG ORAL TAB $6.20 0603-5168-21 PHENOBARBITAL 97.2 MG ORAL TAB $6.19 0641-6022-01 FAMOTIDINE (PF) 20 MG/2 ML IV SOLN $6.19 0641-6022-25 FAMOTIDINE (PF) 20 MG/2 ML IV SOLN $6.19 51293-628-01 PHENOBARBITAL 97.2 MG ORAL TAB $6.19 0378-1001-01 THIOTHIXENE 1 MG ORAL CAP $6.18 0641-6078-01 ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN $6.18 0641-6078-25 ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN $6.18 0904-6641-61 QUETIAPINE 200 MG ORAL TAB $6.18 72266-122-01 METOPROLOL TARTRATE 5 MG/5 ML IV SOLN $6.18 72266-122-25 METOPROLOL TARTRATE 5 MG/5 ML IV SOLN $6.18 99999-034-68 CEFTAZIDIME IN BSS INTRAVITREAL INJECTION (SLH) $6.18 99999-035-40 METRONIDAZOLE IN NACL (ISO-OS) 500 MG/100 ML IV PGBK $6.18 HC89010904 ALLERGEN-INDIVIDUAL-AU $6.17 66685-1002-2 AMOXICILLIN-POT CLAVULANATE 500-125 MG ORAL TAB $6.16 0054-0007-25 CALCITRIOL 0.25 MCG ORAL CAP $6.15 0093-5150-01 MOEXIPRIL 15 MG ORAL TAB $6.15 13517-113-01 PHENOBARBITAL 97.2 MG ORAL TAB $6.15 99999-005-57 GENTAMICIN 2 MG/ML INJ SOLN IN D5W (MCH-NICU) $6.14 0869-0078-16 CASTOR OIL 100 % ORAL OIL $6.14 99999-044-02 CINACALCET 5 MG/ML ORAL LIQUID (COMPOUND) $6.14 47781-299-03 NITROGLYCERIN 0.6 MG/HR TRANSDERMAL PT24 $6.13 0409-4887-10 WATER FOR INJECTION, STERILE INJ SOLN $6.11 0409-4887-17 WATER FOR INJECTION, STERILE INJ SOLN $6.11 0409-4888-02 SODIUM CHLORIDE 0.9 % INJ SOLN $6.11 0409-4888-10 SODIUM CHLORIDE 0.9 % INJ SOLN INTRADERMAL SKIN TEST CONTROL $6.11 50268-574-11 MONTELUKAST 5 MG ORAL CHEW $6.11 50268-574-15 MONTELUKAST 5 MG ORAL CHEW $6.11 51927-1123-0 TANNIC ACID (BULK) MISC POWD $6.11 63323-924-01 SODIUM CHLOR 0.9% BACTERIOSTAT 0.9 % INJ SOLN $6.11 99999-041-28 NYSTATIN 100,000 UNIT/ML ORAL SUSP $6.11 7733380025 SACCHAROMYCES BOULARDII 250 MG ORAL CAP $6.10 7733380050 SACCHAROMYCES BOULARDII 250 MG ORAL CAP $6.10 0054-0011-20 FLECAINIDE 100 MG ORAL TAB $6.10 0054-0011-21 FLECAINIDE 100 MG ORAL TAB (MCH) $6.10 0054-0011-25 FLECAINIDE 100 MG ORAL TAB $6.10 0527-1931-06 CLARITHROMYCIN 250 MG ORAL TAB $6.10 0527-1932-06 CLARITHROMYCIN 500 MG ORAL TAB $6.10 57237-045-60 CLARITHROMYCIN 500 MG ORAL TAB $6.10 0185-0022-01 ORPHENADRINE CITRATE 100 MG ORAL TBSR $6.08 68084-856-01 VENLAFAXINE 75 MG ORAL TAB $6.08 68084-856-11 VENLAFAXINE 75 MG ORAL TAB $6.08 10370-830-09 DILTIAZEM HCL 180 MG ORAL CP24 $6.08 62332-365-06 CLONAZEPAM 0.25 MG ORAL TBDL $6.08 45963-341-02 DESIPRAMINE 10 MG ORAL TAB $6.07 55111-532-01 DIVALPROEX 125 MG ORAL CDRS $6.07 65862-225-60 CLARITHROMYCIN 250 MG ORAL TAB $6.07 65862-226-60 CLARITHROMYCIN 500 MG ORAL TAB $6.07 0603-5060-21 PERPHENAZINE 2 MG ORAL TAB $6.06 68084-082-01 ISOSORBIDE DINITRATE 10 MG ORAL TAB $6.05 68084-082-11 ISOSORBIDE DINITRATE 10 MG ORAL TAB $6.05 31722-138-01 BACLOFEN 5 MG ORAL TAB $6.03 68084-373-11 ACETAMINOPHEN-CODEINE 300-60 MG ORAL TAB $6.01 49884-307-02 CLONAZEPAM 0.25 MG ORAL TBDL $6.01 49884-307-52 CLONAZEPAM 0.25 MG ORAL TBDL $6.01 HC89007025 ADRENOCORTICOTROPIC HRMN-AU $6.00 HC89020903 ALBUMIN; OTHER SRC: CSF -AU $6.00 HC89017263 C3 COMPLEMENT-AU $6.00 HC89017271 C4 COMPLEMENT-AU $6.00 HC89015994 CARCINOEMBRYONIC ANTIGEN (CEA)-QD $6.00 HC89013593 COPPER-AU $6.00 HC89015424 FSH-QD $6.00 HC89012660 HERPES SIMPL II GLYCO (PNL)-AU $6.00 HC89012645 HERPES SMPLX I GLYC AB(PNL)-AU $6.00 HC89017156 IA F-ACTIN ANTIBODY, IGG-AU $6.00 HC89006522 IMIPRAMINE; 1-2-AU $6.00 HC89014229 IMMUNO ELEC GEL DIF EA(PNL)-AU $6.00 HC89008114 IMMUNOGLB IGA EA-AU $6.00 HC89008122 IMMUNOGLB IGA,D,G,M EA-QD $6.00 HC89020465 IMMUNOGLB IGG EA -AU $6.00 HC89020473 IMMUNOGLB IGM EA -AU $6.00 HC89000608 IMMUNOGLOB G INDEX(PNL)-AU $6.00 HC89002372 IMMUNOGLOBULIN D-QD $6.00 HC88600028 NEWBORN SCREEN DRAW FEE (GE) $6.00 HC89009716 PSA FREE-AU $6.00 HC89009708 PSA TOTAL-AU $6.00 HC89020424 THYROID HORMONE UPTAKE-AU $6.00 HC89016539 TESTOSTERONE FREE-MALE-AU $6.00 HC89018063 TISSUE TRANSGLUTAMNS AB IGA-AU $6.00 HC89017396 TRANSGLUT'AB IGA REFLEX IFA-AU $6.00 HC89016653 TRIGLYCERIDES-VAP(IN GRP)-AH $6.00 HC89012066 VDRL CSF-AU $6.00 23155-196-31 ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN $5.98 23155-196-42 ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN $5.98 68084-284-01 HYDROXYUREA 500 MG ORAL CAP $5.98 68084-284-11 HYDROXYUREA 500 MG ORAL CAP $5.98 72572-355-01 KETOROLAC 30 MG/ML (1 ML) INJ SOLN $5.98 72572-355-25 KETOROLAC 30 MG/ML (1 ML) INJ SOLN $5.98 0781-2103-01 TACROLIMUS 1 MG ORAL CAP $5.96 43598-230-18 COLESEVELAM 625 MG ORAL TAB $5.96 51660-996-28 COLESEVELAM 625 MG ORAL TAB $5.96 55111-594-30 MONTELUKAST 5 MG ORAL CHEW $5.96 55111-594-90 MONTELUKAST 5 MG ORAL CHEW $5.96 59762-5019-1 QUINAPRIL 5 MG ORAL TAB $5.96 70710-1710-1 KETOROLAC 10 MG ORAL TAB $5.96 0781-8016-01 CARBAMAZEPINE 100 MG ORAL TB12 $5.95 0832-0512-01 BETHANECHOL CHLORIDE 25 MG ORAL TAB $5.94 0121-1882-94 ACETAMINOPHEN 325 MG/10.15 ML ORAL LIQD (MHS) $5.94 4110080217 LORATADINE-PSEUDOEPHEDRINE 5-120 MG ORAL TB12 $5.94 11523-7162-2 LORATADINE-PSEUDOEPHEDRINE 5-120 MG ORAL TB12 $5.94 16714-883-01 DESMOPRESSIN 0.1 MG ORAL TAB $5.93 68084-083-01 ISOSORBIDE DINITRATE 20 MG ORAL TAB $5.92 68084-083-11 ISOSORBIDE DINITRATE 20 MG ORAL TAB $5.92 0832-0512-89 BETHANECHOL CHLORIDE 25 MG ORAL TAB $5.92 51079-736-01 HALOPERIDOL 5 MG ORAL TAB $5.92 51079-736-20 HALOPERIDOL 5 MG ORAL TAB $5.92 60687-161-01 HALOPERIDOL 5 MG ORAL TAB $5.92 60687-161-11 HALOPERIDOL 5 MG ORAL TAB $5.92 68084-109-01 ACYCLOVIR 800 MG ORAL TAB $5.92 68084-109-11 ACYCLOVIR 800 MG ORAL TAB $5.92 68084-851-01 DOXAZOSIN 2 MG ORAL TAB $5.92 68084-851-11 DOXAZOSIN 2 MG ORAL TAB $5.92 68094-231-62 ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSP $5.92 0869-0602-43 MAGNESIUM SULFATE (BULK) 100 % MISC CRYS $5.90 16714-014-01 AMOXICILLIN-POT CLAVULANATE 875-125 MG ORAL TAB $5.90 60687-112-11 ANASTROZOLE 1 MG ORAL TAB $5.89 60687-112-21 ANASTROZOLE 1 MG ORAL TAB $5.89 42291-800-30 TENOFOVIR DISOPROXIL FUMARATE 300 MG ORAL TAB $5.88 51672-4005-1 CARBAMAZEPINE 200 MG ORAL TAB $5.88 0121-1882-11 ACETAMINOPHEN 325 MG/10.15 ML ORAL LIQD (MHS) $5.87 49884-117-01 AMILORIDE 5 MG ORAL TAB $5.87 36000-012-25 ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN $5.85 50383-363-15 LIDOCAINE HCL 2 % MUCOUS MEMB SOLN $5.85 50383-363-17 LIDOCAINE HCL 2 % MUCOUS MEMB SOLN $5.85 60687-428-01 FINASTERIDE 5 MG ORAL TAB $5.85 60687-428-11 FINASTERIDE 5 MG ORAL TAB $5.85 63323-739-11 FAMOTIDINE (PF) 20 MG/2 ML IV SOLN $5.85 63323-739-12 FAMOTIDINE (PF) 20 MG/2 ML IV SOLN $5.85 68094-231-59 ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSP $5.85 68094-231-61 ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSP $5.85 72572-120-01 DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJ SOLN $5.85 72572-120-25 DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJ SOLN $5.85 81565-202-01 DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJ SOLN $5.85 81565-202-02 DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJ SOLN $5.85 99998-000-70 MEDIUM CHAIN TRIGLYCERIDES 7.7 KCAL/ML ORAL OIL $5.85 99999-039-93 SODIUM CITRATE-CITRIC ACID 500-334 MG/5 ML ORAL SOLN $5.85 0904-6172-61 CARBAMAZEPINE 200 MG ORAL TAB $5.82 65862-024-60 ZIDOVUDINE 300 MG ORAL TAB $5.82 0378-4775-01 BENAZEPRIL-HYDROCHLOROTHIAZIDE 20-25 MG ORAL TAB $5.82 67877-506-51 COLESEVELAM 625 MG ORAL TAB $5.82 0409-1207-15 GENTAMICIN 40 MG/ML INJ SOLN $5.81 0409-1207-25 GENTAMICIN 40 MG/ML INJ SOLN $5.81 0904-6615-61 DIVALPROEX 125 MG ORAL CDRS $5.81 51079-923-01 CARBIDOPA-LEVODOPA 50-200 MG ORAL TBSR $5.80 51079-923-20 CARBIDOPA-LEVODOPA 50-200 MG ORAL TBSR $5.80 0904-6718-39 GUAIFENESIN 600 MG ORAL TA12 $5.79 67457-433-00 FAMOTIDINE (PF) 20 MG/2 ML IV SOLN $5.79 67457-433-22 FAMOTIDINE (PF) 20 MG/2 ML IV SOLN $5.79 4603600739 MAGNESIUM CITRATE ORAL SOLN $5.77 16714-813-01 EZETIMIBE 10 MG ORAL TAB $5.77 50268-447-11 ISOSORBIDE DINITRATE 5 MG ORAL TAB $5.76 50268-447-15 ISOSORBIDE DINITRATE 5 MG ORAL TAB $5.76 55111-648-01 GLYCOPYRROLATE 1 MG ORAL TAB $5.75 68084-853-01 OXCARBAZEPINE 300 MG ORAL TAB $5.74 68084-853-11 OXCARBAZEPINE 300 MG ORAL TAB $5.74 0093-5517-98 SILDENAFIL (PULM.HYPERTENSION) 20 MG ORAL TAB $5.73 0121-4675-05 VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLN $5.72 42794-019-12 LIOTHYRONINE 25 MCG ORAL TAB $5.72 57664-655-88 PINDOLOL 5 MG ORAL TAB $5.72 59762-1207-1 LIOTHYRONINE 25 MCG ORAL TAB $5.72 67457-426-00 HALOPERIDOL LACTATE 5 MG/ML INJ SOLN $5.72 67457-426-12 HALOPERIDOL LACTATE 5 MG/ML INJ SOLN $5.72 70860-600-02 MIDAZOLAM 1 MG/ML INJ SOLN $5.72 70860-600-41 MIDAZOLAM 1 MG/ML INJ SOLN $5.72 99998-000-09 CEFEPIME 25 MG/ML INJ DILUTION (MCH) $5.72 16714-009-01 ISOSORBIDE DINITRATE 20 MG ORAL TAB $5.71 70954-492-10 LEVOCARNITINE 330 MG ORAL TAB $5.71 0904-6322-61 METOPROLOL SUCCINATE 25 MG ORAL TB24 $5.69 0904-7276-92 NYSTATIN 100,000 UNIT/ML ORAL SUSP $5.69 51079-169-01 METOPROLOL SUCCINATE 25 MG ORAL TB24 $5.69 51079-169-20 METOPROLOL SUCCINATE 25 MG ORAL TB24 $5.69 51079-170-01 METOPROLOL SUCCINATE 50 MG ORAL TB24 $5.69 51079-170-20 METOPROLOL SUCCINATE 50 MG ORAL TB24 $5.69 16714-632-02 ALENDRONATE 35 MG ORAL TAB $5.68 68084-203-01 PRIMIDONE 250 MG ORAL TAB $5.68 68084-203-11 PRIMIDONE 250 MG ORAL TAB $5.68 0456-0458-01 THYROID (PORK) 30 MG ORAL TAB $5.68 24658-260-60 GEMFIBROZIL 600 MG ORAL TAB $5.68 99999-045-30 AMMONIA AROMATIC 15 % (W/V) INHALATION SOLN $5.66 0869-3851-10 IODINE-SODIUM IODIDE 2 % TOPICAL TINC $5.66 48433-202-30 MINERAL OIL ORAL OIL $5.66 50268-759-11 TIZANIDINE 2 MG ORAL TAB $5.66 50268-759-15 TIZANIDINE 2 MG ORAL TAB $5.66 63323-162-12 KETOROLAC 30 MG/ML (1 ML) INJ SOLN $5.66 63323-162-23 KETOROLAC 30 MG/ML (1 ML) INJ SOLN $5.66 0904-7111-61 LABETALOL 300 MG ORAL TAB $5.64 16714-633-02 ALENDRONATE 70 MG ORAL TAB $5.64 0781-1556-01 ISOSORBIDE DINITRATE 10 MG ORAL TAB $5.64 0781-1556-10 ISOSORBIDE DINITRATE 10 MG ORAL TAB $5.64 0555-0971-02 DEXTROAMPHETAMINE-AMPHETAMINE 5 MG ORAL TAB $5.63 0555-0972-02 DEXTROAMPHETAMINE-AMPHETAMINE 10 MG ORAL TAB $5.63 0555-0973-02 DEXTROAMPHETAMINE-AMPHETAMINE 20 MG ORAL TAB $5.63 11534-192-01 DEXTROAMPHETAMINE-AMPHETAMINE 10 MG ORAL TAB $5.63 67405-651-55 DOXYCYCLINE HYCLATE 100 MG ORAL CAP $5.60 68084-862-95 DOXAZOSIN 4 MG ORAL TAB $5.60 HC89091276 ALBUMIN; OTHER SRC - AU $5.60 70860-751-02 FAMOTIDINE (PF) 20 MG/2 ML IV SOLN $5.59 70860-751-41 FAMOTIDINE (PF) 20 MG/2 ML IV SOLN $5.59 99999-040-94 CEFAZOLIN 50 MG/ML INJ SYRINGE (SLH 10 G) $5.59 0054-0244-24 CODEINE SULFATE 30 MG ORAL TAB $5.58 64380-971-06 HYDROCORTISONE 10 MG ORAL TAB $5.58 68084-844-01 VENLAFAXINE 37.5 MG ORAL TAB $5.58 68084-844-11 VENLAFAXINE 37.5 MG ORAL TAB $5.58 49884-320-52 OLANZAPINE 5 MG ORAL TBDL $5.56 49884-320-55 OLANZAPINE 5 MG ORAL TBDL $5.56 59746-306-12 OLANZAPINE 5 MG ORAL TBDL $5.56 59746-306-32 OLANZAPINE 5 MG ORAL TBDL $5.56 60505-3275-3 OLANZAPINE 5 MG ORAL TBDL $5.56 0228-2497-10 NIFEDIPINE 10 MG ORAL CAP $5.56 0904-5524-61 DOXAZOSIN 4 MG ORAL TAB $5.56 69315-211-01 NIFEDIPINE 10 MG ORAL CAP $5.56 99998-000-41 PIPERACILLIN-TAZOBACTAM 112.5 MG/ML INJ SYR (USING 3.375G) $5.56 16714-832-01 BUMETANIDE 1 MG ORAL TAB $5.55 99999-034-86 LORAZEPAM 2 MG/ML INJ SOLN $5.54 0904-6930-61 POTASSIUM CHLORIDE 10 MEQ ORAL CPSR $5.54 16714-836-01 ZIPRASIDONE HCL 40 MG ORAL CAP $5.54 69238-1056-1 CHLORPROMAZINE 25 MG ORAL TAB $5.54 0781-5994-01 HYDROXYCHLOROQUINE 200 MG ORAL TAB $5.53 0781-8061-01 CAPTOPRIL 25 MG ORAL TAB $5.53 27241-161-01 CAPTOPRIL 25 MG ORAL TAB $5.53 42192-801-01 PHENAZOPYRIDINE 100 MG ORAL TAB $5.53 42937-701-10 PHENAZOPYRIDINE 100 MG ORAL TAB $5.53 60687-229-01 LOPERAMIDE 2 MG ORAL CAP $5.53 60687-229-11 LOPERAMIDE 2 MG ORAL CAP $5.53 68084-044-01 PAROXETINE HCL 10 MG ORAL TAB $5.53 68084-044-11 PAROXETINE HCL 10 MG ORAL TAB $5.53 68094-600-59 IBUPROFEN 100 MG/5 ML ORAL SUSP $5.53 68094-600-61 IBUPROFEN 100 MG/5 ML ORAL SUSP $5.53 68094-600-62 IBUPROFEN 100 MG/5 ML ORAL SUSP $5.53 0904-5522-61 DOXAZOSIN 1 MG ORAL TAB $5.51 31722-142-01 CAPTOPRIL 25 MG ORAL TAB $5.51 43598-436-11 NITROGLYCERIN 0.4 MG SL SUBL $5.50 43598-436-35 NITROGLYCERIN 0.4 MG SL SUBL $5.50 68084-851-25 DOXAZOSIN 2 MG ORAL TAB $5.50 68084-851-95 DOXAZOSIN 2 MG ORAL TAB $5.50 0378-7734-93 ONDANSETRON 8 MG ORAL TBDL $5.49 65862-391-10 ONDANSETRON 8 MG ORAL TBDL $5.49 68001-247-04 ONDANSETRON 8 MG ORAL TBDL $5.49 99999-001-26 ERYTHROMYCIN 25 MG / 5 ML (NICU) IV SYRINGE (5 MG/ML) $5.49 99999-037-05 PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIX $5.49 0904-7263-61 OXCARBAZEPINE 300 MG ORAL TAB $5.49 68084-288-01 FLUDROCORTISONE 0.1 MG ORAL TAB $5.49 68084-288-11 FLUDROCORTISONE 0.1 MG ORAL TAB $5.49 50268-476-11 LETROZOLE 2.5 MG ORAL TAB $5.48 50268-476-15 LETROZOLE 2.5 MG ORAL TAB $5.48 50268-766-11 TERAZOSIN 5 MG ORAL CAP $5.47 50268-766-15 TERAZOSIN 5 MG ORAL CAP $5.47 0406-8315-23 MORPHINE 15 MG ORAL TBSR $5.46 0904-7001-61 PREGABALIN 100 MG ORAL CAP $5.46 23155-135-25 DOXYCYCLINE MONOHYDRATE 100 MG ORAL TAB $5.46 99999-044-57 PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLN $5.46 0904-6671-06 SILDENAFIL (PULM.HYPERTENSION) 20 MG ORAL TAB $5.45 0406-8315-62 MORPHINE 15 MG ORAL TBSR $5.45 68084-313-01 DIVALPROEX 125 MG ORAL CDRS $5.45 68084-313-11 DIVALPROEX 125 MG ORAL CDRS $5.45 13668-156-36 TELMISARTAN 20 MG ORAL TAB $5.44 13668-156-72 TELMISARTAN 20 MG ORAL TAB $5.44 13668-157-36 TELMISARTAN 40 MG ORAL TAB $5.44 13668-157-72 TELMISARTAN 40 MG ORAL TAB $5.44 42571-227-30 TELMISARTAN 40 MG ORAL TAB $5.44 50268-765-11 TERAZOSIN 2 MG ORAL CAP $5.44 50268-765-15 TERAZOSIN 2 MG ORAL CAP $5.44 67877-483-33 TELMISARTAN 40 MG ORAL TAB $5.44 67877-483-84 TELMISARTAN 40 MG ORAL TAB $5.44 68084-572-01 GUAIFENESIN 600 MG ORAL TA12 $5.43 68084-572-11 GUAIFENESIN 600 MG ORAL TA12 $5.43 0172-5241-60 ANAGRELIDE 0.5 MG ORAL CAP $5.42 0487-2784-01 RACEPINEPHRINE 2.25 % INHALATION NEBU $5.42 0543-1009-12 RACEPINEPHRINE 2.25 % INHALATION NEBU $5.42 10370-101-03 BUPROPION HCL 150 MG ORAL TB24 $5.42 13668-453-01 ANAGRELIDE 0.5 MG ORAL CAP $5.42 42385-953-30 EMTRICITABINE-TENOFOVIR (TDF) 200-300 MG ORAL TAB $5.42 42794-019-02 LIOTHYRONINE 25 MCG ORAL TAB $5.42 50268-764-11 TERAZOSIN 1 MG ORAL CAP $5.42 50268-764-15 TERAZOSIN 1 MG ORAL CAP $5.42 55111-593-30 MONTELUKAST 4 MG ORAL CHEW $5.42 55111-593-90 MONTELUKAST 4 MG ORAL CHEW $5.42 60687-581-11 PRAMIPEXOLE 0.5 MG ORAL TAB $5.42 60687-581-21 PRAMIPEXOLE 0.5 MG ORAL TAB $5.42 60687-612-11 VALSARTAN 40 MG ORAL TAB $5.42 60687-612-21 VALSARTAN 40 MG ORAL TAB $5.42 65862-177-60 CEFDINIR 300 MG ORAL CAP $5.42 67877-543-60 CEFDINIR 300 MG ORAL CAP $5.42 69097-526-03 TADALAFIL (PULM. HYPERTENSION) 20 MG ORAL TAB $5.42 0527-1393-01 RIFAMPIN 150 MG ORAL CAP $5.41 0121-1488-00 GUAIFENESIN 100 MG/5 ML ORAL LIQD $5.40 0121-1488-10 GUAIFENESIN 100 MG/5 ML ORAL LIQD $5.40 99999-045-91 POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN $5.40 23155-195-01 NIFEDIPINE 20 MG ORAL CAP $5.39 99999-005-46 ERYTHROMYCIN 5 MG/ML INJ SOLN IN NS (MCH) $5.37 16729-273-10 PRASUGREL 10 MG ORAL TAB $5.36 60505-4642-3 PRASUGREL 5 MG ORAL TAB $5.36 60505-4643-3 PRASUGREL 10 MG ORAL TAB $5.36 65862-830-30 PRASUGREL 10 MG ORAL TAB $5.36 HC89006571 PRIMIDONE-AU $5.35 50268-330-11 FLUDROCORTISONE 0.1 MG ORAL TAB $5.34 50268-330-15 FLUDROCORTISONE 0.1 MG ORAL TAB $5.34 68462-639-25 NITROGLYCERIN 0.4 MG SL SUBL $5.34 68462-639-45 NITROGLYCERIN 0.4 MG SL SUBL $5.34 0591-2562-30 COLCHICINE 0.6 MG ORAL TAB $5.33 51079-782-01 PRAVASTATIN 40 MG ORAL TAB $5.33 99999-044-54 NITROGLYCERIN 100 MCG / ML INJECTION $5.33 0378-0327-01 HALOPERIDOL 5 MG ORAL TAB $5.32 0904-7094-61 OXYCODONE-ACETAMINOPHEN 7.5-325 MG ORAL TAB $5.31 50268-448-11 ISOSORBIDE DINITRATE 10 MG ORAL TAB $5.31 50268-448-15 ISOSORBIDE DINITRATE 10 MG ORAL TAB $5.31 69680-130-60 PROPAFENONE 225 MG ORAL CP12 $5.31 0115-3511-01 PYRIDOSTIGMINE BROMIDE 60 MG ORAL TAB $5.30 0378-9112-16 NITROGLYCERIN 0.4 MG/HR TRANSDERMAL PT24 $5.30 0378-9112-93 NITROGLYCERIN 0.4 MG/HR TRANSDERMAL PT24 $5.30 31722-704-30 VALACYCLOVIR 500 MG ORAL TAB $5.29 65862-448-30 VALACYCLOVIR 500 MG ORAL TAB $5.29 68084-202-01 PRIMIDONE 50 MG ORAL TAB $5.29 68084-202-11 PRIMIDONE 50 MG ORAL TAB $5.29 0378-1901-01 MIDODRINE 2.5 MG ORAL TAB $5.27 16714-698-01 VALACYCLOVIR 500 MG ORAL TAB $5.27 0115-4411-01 DANTROLENE 25 MG ORAL CAP $5.27 51079-542-01 PROCHLORPERAZINE MALEATE 10 MG ORAL TAB $5.27 51079-542-20 PROCHLORPERAZINE MALEATE 10 MG ORAL TAB $5.27 0904-5523-61 DOXAZOSIN 2 MG ORAL TAB $5.25 60505-3170-7 OMEGA-3 ACID ETHYL ESTERS 1 GRAM ORAL CAP $5.25 60687-195-01 DILTIAZEM HCL 120 MG ORAL CP24 $5.24 60687-195-11 DILTIAZEM HCL 120 MG ORAL CP24 $5.24 60687-206-01 DILTIAZEM HCL 180 MG ORAL CP24 $5.24 60687-206-11 DILTIAZEM HCL 180 MG ORAL CP24 $5.24 62332-246-31 AMANTADINE HCL 100 MG ORAL CAP $5.24 62332-246-71 AMANTADINE HCL 100 MG ORAL CAP $5.24 99999-010-04 VANCOMYCIN SUBCONJUNCTIVAL INJECTION (MHS) $5.24 0115-1071-01 DIPYRIDAMOLE 50 MG ORAL TAB $5.23 99999-046-44 KETAMINE 10 MG/ML INJ SOLN $5.21 0904-5676-61 PAROXETINE HCL 10 MG ORAL TAB $5.20 27241-160-01 CAPTOPRIL 12.5 MG ORAL TAB $5.20 60687-428-65 FINASTERIDE 5 MG ORAL TAB $5.20 65862-782-01 METHENAMINE HIPPURATE 1 GRAM ORAL TAB $5.20 68084-697-01 BUPROPION HCL 100 MG ORAL SR12 $5.20 68084-697-11 BUPROPION HCL 100 MG ORAL SR12 $5.20 99999-045-29 CLONIDINE 0.01 MG/ML ORAL LIQUID (COMPOUND) $5.20 0536-7415-51 SODIUM PHOSPHATES 19-7 GRAM/118 ML RECTAL ENEM $5.19 51079-888-01 METOCLOPRAMIDE HCL 10 MG ORAL TAB $5.19 51079-888-20 METOCLOPRAMIDE HCL 10 MG ORAL TAB $5.19 10370-829-11 DILTIAZEM HCL 120 MG ORAL CP24 $5.18 62037-599-90 DILTIAZEM HCL 240 MG ORAL CP24 $5.17 63739-367-10 ISOSORBIDE DINITRATE 20 MG ORAL TAB $5.17 10135-610-01 OXYBUTYNIN CHLORIDE 10 MG ORAL TR24 $5.17 68462-461-60 TROSPIUM 20 MG ORAL TAB $5.16 8142102103 BISACODYL 10 MG RECTAL SUPP $5.16 0597-0052-16 BISACODYL 10 MG RECTAL SUPP $5.16 50268-112-11 BENAZEPRIL 40 MG ORAL TAB $5.16 50268-112-15 BENAZEPRIL 40 MG ORAL TAB $5.16 0904-3865-75 SODIUM CHLORIDE 0.65 % NASL SPRA $5.15 68462-199-11 TELMISARTAN 20 MG ORAL TAB $5.15 68462-199-13 TELMISARTAN 20 MG ORAL TAB $5.15 68462-200-11 TELMISARTAN 40 MG ORAL TAB $5.15 68462-200-13 TELMISARTAN 40 MG ORAL TAB $5.15 10702-237-01 URSODIOL 300 MG ORAL CAP $5.14 51525-0115-1 HYOSCYAMINE SULFATE 0.375 MG ORAL TB12 $5.14 63323-161-12 KETOROLAC 15 MG/ML INJ SOLN $5.14 41167-4310-4 FEXOFENADINE-PSEUDOEPHEDRINE 60-120 MG ORAL TB12 $5.13 0781-1635-01 ISOSORBIDE DINITRATE 5 MG ORAL TAB $5.12 0121-1744-05 GUAIFENESIN 100 MG/5 ML ORAL LIQD $5.10 16714-694-01 FLUCONAZOLE 50 MG ORAL TAB $5.10 68094-494-61 IBUPROFEN 100 MG/5 ML ORAL SUSP $5.10 68094-494-62 IBUPROFEN 100 MG/5 ML ORAL SUSP $5.10 60505-2552-1 GABAPENTIN 800 MG ORAL TAB $5.10 68084-281-01 CARBIDOPA-LEVODOPA 25-100 MG ORAL TBSR $5.10 68084-281-11 CARBIDOPA-LEVODOPA 25-100 MG ORAL TBSR $5.10 30698-067-01 FUROSEMIDE 20 MG ORAL TAB $5.09 60687-709-01 PROPAFENONE 150 MG ORAL TAB $5.08 60687-709-11 PROPAFENONE 150 MG ORAL TAB $5.08 0121-1154-40 LACTULOSE 20 GRAM/30 ML ORAL SOLN $5.07 55150-237-01 DEXAMETHASONE 4 MG/ML INJ SOLN (FOR ORAL USE) $5.07 68094-494-59 IBUPROFEN 100 MG/5 ML ORAL SUSP $5.07 68850-012-01 ETHAMBUTOL 400 MG ORAL TAB $5.07 68850-012-02 ETHAMBUTOL 400 MG ORAL TAB $5.07 49884-066-01 GLYCOPYRROLATE 2 MG ORAL TAB $5.06 53746-669-01 ACEBUTOLOL 200 MG ORAL CAP $5.06 64980-273-01 GLYCOPYRROLATE 2 MG ORAL TAB $5.06 0555-9016-58 NORGESTIMATE-ETHINYL ESTRADIOL 0.25-35 MG-MCG ORAL TAB $5.04 67457-423-00 DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJ SOLN $5.04 67457-423-12 DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJ SOLN $5.04 68084-740-11 OLANZAPINE 10 MG ORAL TAB $5.04 0591-0607-01 LABETALOL 300 MG ORAL TAB $5.04 0904-6991-61 PREGABALIN 25 MG ORAL CAP $5.04 10370-829-09 DILTIAZEM HCL 120 MG ORAL CP24 $5.04 49884-124-01 LABETALOL 300 MG ORAL TAB $5.04 16714-166-01 LIOTHYRONINE 5 MCG ORAL TAB $5.02 5199138490 FOLIC ACID-VIT B6-VIT B12 2.5-25-2 MG ORAL TAB $5.01 0603-1075-05 CODEINE-GUAIFENESIN 10-100 MG/5 ML ORAL LIQD $5.01 HC89015168 ALDOLASE-AU $5.00 HC89002760 ALLERGEN(PNL 2)-AU $5.00 HC89014039 ALLERGEN(PNL)-AU $5.00 HC89001986 AMYLASE ISOENZYME-QD $5.00 HC89013643 FRUCTOSAMINE-QD $5.00 HC89018535 MICRODISSECTION; MANUAL-AU $5.00 HC89001895 NITROGEN TOTAL URINE-QD $5.00 HC89013916 PROTEIN ELECT FRACT&QT(PNL)-AU $5.00 HC89013890 TOTAL PROTEIN(PNL)-AU $5.00 HC89010284 ZINC, SERUM -AU $5.00 HC89024368 ALLERGEN FOOD EGG WHITE IGE-AU $5.00 HC89024376 ALLERGEN FOOD EGG WHOLE IGE-AU $5.00 HC89024392 ALLERGEN FOOD OVALBUMIN IGE-AU $5.00 HC89024384 ALLERGEN FOOD OVOMUCOID IGE-AU $5.00 51079-391-01 BUPROPION HCL 100 MG ORAL SR12 $5.00 51079-391-20 BUPROPION HCL 100 MG ORAL SR12 $5.00 0904-7000-61 PREGABALIN 75 MG ORAL CAP $4.99 68084-327-11 GLIMEPIRIDE 4 MG ORAL TAB $4.97 0409-7337-01 CEFTRIAXONE 250 MG INJ SOLR $4.95 0409-7337-11 CEFTRIAXONE 250 MG INJ SOLR $4.95 0409-7337-20 CEFTRIAXONE 250 MG INJ SOLR $4.95 0409-7337-21 CEFTRIAXONE 250 MG INJ SOLR $4.95 0054-0235-24 MORPHINE 15 MG ORAL TAB $4.93 0003-6335-17 HYDROXYUREA (SICKLE CELL) 200 MG ORAL CAP $4.92 0003-6336-17 HYDROXYUREA (SICKLE CELL) 300 MG ORAL CAP $4.92 0904-6782-61 HALOPERIDOL 5 MG ORAL TAB $4.92 51079-822-01 LEVETIRACETAM 750 MG ORAL TAB $4.92 51079-822-20 LEVETIRACETAM 750 MG ORAL TAB $4.92 61269-402-60 HYDROXYUREA (SICKLE CELL) 200 MG ORAL CAP $4.92 51079-580-01 THIORIDAZINE 100 MG ORAL TAB $4.91 4116742333 FEXOFENADINE 30 MG ORAL TBDL $4.91 41167-4233-3 FEXOFENADINE 30 MG ORAL TBDL $4.91 51991-311-90 DESVENLAFAXINE SUCCINATE 50 MG ORAL TB24 $4.91 0054-0079-28 BALSALAZIDE 750 MG ORAL CAP $4.90 0904-6992-61 PREGABALIN 50 MG ORAL CAP $4.90 51079-886-01 METOCLOPRAMIDE HCL 5 MG ORAL TAB $4.90 51079-886-20 METOCLOPRAMIDE HCL 5 MG ORAL TAB $4.90 378699789 SODIUM CHLORIDE 3 % INHALATION NEBU $4.88 0228-2348-10 PROPYLTHIOURACIL 50 MG ORAL TAB $4.88 0641-6048-01 LORAZEPAM 2 MG/ML INJ SOLN CODE NEO $4.88 0641-6048-25 LORAZEPAM 2 MG/ML INJ SOLN $4.88 31722-509-60 ZIDOVUDINE 300 MG ORAL TAB $4.88 43598-495-01 NAPROXEN SODIUM 550 MG ORAL TAB $4.88 50228-433-01 NAPROXEN SODIUM 550 MG ORAL TAB $4.88 60687-398-01 MIDODRINE 5 MG ORAL TAB $4.88 60687-398-11 MIDODRINE 5 MG ORAL TAB $4.88 60687-550-01 METRONIDAZOLE 500 MG ORAL TAB $4.88 60687-550-11 METRONIDAZOLE 500 MG ORAL TAB $4.88 60687-636-01 ONDANSETRON HCL 4 MG ORAL TAB $4.88 60687-636-11 ONDANSETRON HCL 4 MG ORAL TAB $4.88 65862-516-01 NAPROXEN SODIUM 550 MG ORAL TAB $4.88 67253-651-10 PROPYLTHIOURACIL 50 MG ORAL TAB $4.88 68084-220-01 ONDANSETRON HCL 4 MG ORAL TAB $4.88 68084-220-11 ONDANSETRON HCL 4 MG ORAL TAB $4.88 69452-114-20 CLOBAZAM 10 MG ORAL TAB $4.88 81033-002-05 ACETAMINOPHEN 32 MG/ML ORAL SOLUTION (IMS) $4.88 99999-036-05 MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSP $4.88 99999-045-67 SODIUM CHLORIDE 0.9 % IV SOLP $4.88 71205-893-90 PHENOBARBITAL 97.2 MG ORAL TAB $4.87 99999-001-08 LORAZEPAM 0.5 MG / ML INJ SOLN $4.86 45802-147-62 CETIRIZINE-PSEUDOEPHEDRINE 5-120 MG ORAL TB12 $4.86 0409-9093-09 FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN $4.85 0409-9093-11 FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN $4.85 60687-211-11 DIVALPROEX 125 MG ORAL TBEC $4.84 60687-211-21 DIVALPROEX 125 MG ORAL TBEC $4.84 51079-998-01 TIZANIDINE 4 MG ORAL TAB $4.83 51079-998-20 TIZANIDINE 4 MG ORAL TAB $4.83 16714-698-03 VALACYCLOVIR 500 MG ORAL TAB $4.82 29300-126-13 BISOPROLOL FUMARATE 5 MG ORAL TAB $4.82 29300-127-13 BISOPROLOL FUMARATE 10 MG ORAL TAB $4.82 62175-271-37 OXYBUTYNIN CHLORIDE 10 MG ORAL TR24 $4.82 16729-189-29 MYCOPHENOLATE SODIUM 360 MG ORAL TBEC $4.81 62175-270-37 OXYBUTYNIN CHLORIDE 5 MG ORAL TR24 $4.81 71930-037-12 LABETALOL 300 MG ORAL TAB $4.81 99999-001-74 HYDROCODONE-HOMATROPINE 5-1.5 MG/5 ML ORAL SYRP $4.81 60687-345-01 CALCITRIOL 0.25 MCG ORAL CAP $4.80 60687-345-11 CALCITRIOL 0.25 MCG ORAL CAP $4.80 53489-551-01 PROPAFENONE 150 MG ORAL TAB $4.79 59762-5350-1 PRAZOSIN 5 MG ORAL CAP $4.79 0904-0202-61 AMITRIPTYLINE 50 MG ORAL TAB $4.78 0904-7185-61 AMITRIPTYLINE 50 MG ORAL TAB $4.78 68084-988-32 CALCIUM CARBONATE 200 MG CALCIUM (500 MG) ORAL CHEW $4.78 68084-988-33 CALCIUM CARBONATE 200 MG CALCIUM (500 MG) ORAL CHEW $4.78 65862-641-63 AZITHROMYCIN 250 MG ORAL TAB $4.78 65862-641-69 AZITHROMYCIN 250 MG ORAL TAB $4.78 70752-171-10 PROPYLTHIOURACIL 50 MG ORAL TAB $4.78 0228-2851-11 GUANFACINE 2 MG ORAL TB24 $4.77 0245-0212-11 MIDODRINE 5 MG ORAL TAB $4.77 60505-0257-1 DESMOPRESSIN 0.1 MG ORAL TAB $4.77 60505-1321-1 MIDODRINE 5 MG ORAL TAB $4.77 63739-569-10 ISOSORBIDE DINITRATE 10 MG ORAL TAB $4.77 23155-043-03 LEFLUNOMIDE 10 MG ORAL TAB $4.77 4422920760 SODIUM CHLORIDE 7 % INHALATION NEBU $4.76 8349020760 SODIUM CHLORIDE 7 % INHALATION NEBU $4.76 42292-040-01 LEVOTHYROXINE 175 MCG ORAL TAB $4.75 42292-040-20 LEVOTHYROXINE 175 MCG ORAL TAB $4.75 0121-0914-00 IBUPROFEN 100 MG/5 ML ORAL SUSP $4.75 0121-0914-05 IBUPROFEN 100 MG/5 ML ORAL SUSP $4.75 60687-487-01 SPIRONOLACTONE 100 MG ORAL TAB $4.75 60687-487-11 SPIRONOLACTONE 100 MG ORAL TAB $4.75 99999-035-95 PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIX $4.75 60687-530-01 LEVOTHYROXINE 150 MCG ORAL TAB $4.74 60687-530-11 LEVOTHYROXINE 150 MCG ORAL TAB $4.74 42192-330-01 THYROID (PORK) 60 MG ORAL TAB $4.73 51079-690-01 LOPERAMIDE 2 MG ORAL CAP $4.73 51079-690-20 LOPERAMIDE 2 MG ORAL CAP $4.73 68084-282-01 CARBIDOPA-LEVODOPA 50-200 MG ORAL TBSR $4.73 68084-282-11 CARBIDOPA-LEVODOPA 50-200 MG ORAL TBSR $4.73 57664-116-88 VERAPAMIL 120 MG ORAL TBSR $4.71 65862-538-20 LEVOFLOXACIN 750 MG ORAL TAB $4.71 16729-042-01 TACROLIMUS 1 MG ORAL CAP $4.70 0406-8510-23 OXYCODONE 10 MG ORAL TAB $4.69 0406-8510-62 OXYCODONE 10 MG ORAL TAB $4.69 31722-723-20 LEVOFLOXACIN 750 MG ORAL TAB $4.69 0093-2178-01 LIOTHYRONINE 25 MCG ORAL TAB $4.69 10702-013-01 BETAXOLOL 10 MG ORAL TAB $4.69 10135-541-01 PROBENECID 500 MG ORAL TAB $4.68 0527-1395-01 LOXAPINE SUCCINATE 10 MG ORAL CAP $4.67 50268-111-11 BENAZEPRIL 20 MG ORAL TAB $4.67 50268-111-15 BENAZEPRIL 20 MG ORAL TAB $4.67 63739-973-10 POTASSIUM CHLORIDE 20 MEQ ORAL TBTQ $4.67 68462-179-01 NAPROXEN SODIUM 550 MG ORAL TAB $4.67 59762-1004-1 NIFEDIPINE 10 MG ORAL CAP $4.67 3700035905 OMEPRAZOLE MAGNESIUM 20 MG ORAL TBEC $4.66 37000-455-02 OMEPRAZOLE MAGNESIUM 20 MG ORAL TBEC $4.66 60687-563-01 LEVOTHYROXINE 137 MCG ORAL TAB $4.65 60687-563-11 LEVOTHYROXINE 137 MCG ORAL TAB $4.65 99999-006-75 HYDRALAZINE 1 MG/ML INJ DILUTION (MCH) $4.65 4110080604 LORATADINE 10 MG ORAL TBDL $4.64 55111-534-01 DIVALPROEX 500 MG ORAL TB24 $4.64 99999-036-47 MERCAPTOPURINE 12.5 MG ORAL PARTIAL TAB $4.64 0904-5611-61 ENALAPRIL MALEATE 20 MG ORAL TAB $4.64 0904-6620-61 ISOSORBIDE DINITRATE 20 MG ORAL TAB $4.64 50268-541-11 METOPROLOL SUCCINATE 50 MG ORAL TB24 $4.64 50268-541-15 METOPROLOL SUCCINATE 50 MG ORAL TB24 $4.64 63739-480-10 BACLOFEN 20 MG ORAL TAB $4.64 0904-5893-61 PRAVASTATIN 40 MG ORAL TAB $4.62 60687-519-01 LEVOTHYROXINE 125 MCG ORAL TAB $4.62 60687-519-11 LEVOTHYROXINE 125 MCG ORAL TAB $4.62 0904-6956-61 LEVOTHYROXINE 150 MCG ORAL TAB $4.60 13668-185-90 SILDENAFIL (PULM.HYPERTENSION) 20 MG ORAL TAB $4.60 47781-297-03 NITROGLYCERIN 0.2 MG/HR TRANSDERMAL PT24 $4.60 0378-9104-16 NITROGLYCERIN 0.2 MG/HR TRANSDERMAL PT24 $4.59 0378-9104-93 NITROGLYCERIN 0.2 MG/HR TRANSDERMAL PT24 $4.59 16714-816-01 BICALUTAMIDE 50 MG ORAL TAB $4.59 63739-294-10 PHENOBARBITAL 32.4 MG ORAL TAB $4.59 16714-816-02 BICALUTAMIDE 50 MG ORAL TAB $4.58 64679-926-02 ENALAPRIL MALEATE 20 MG ORAL TAB $4.58 60687-178-01 PRAVASTATIN 20 MG ORAL TAB $4.58 60687-178-11 PRAVASTATIN 20 MG ORAL TAB $4.58 0527-2961-37 CHLORPROMAZINE 10 MG ORAL TAB $4.57 65862-622-01 FLECAINIDE 100 MG ORAL TAB $4.57 0904-7126-61 METRONIDAZOLE 500 MG ORAL TAB $4.56 16714-007-01 ISOSORBIDE DINITRATE 5 MG ORAL TAB $4.56 29033-026-02 CALCIUM ACETATE(PHOSPHAT BIND) 667 MG ORAL CAP $4.56 29300-126-01 BISOPROLOL FUMARATE 5 MG ORAL TAB $4.56 51079-437-01 DOXEPIN 25 MG ORAL CAP $4.56 51079-437-20 DOXEPIN 25 MG ORAL CAP $4.56 99999-045-92 KETAMINE IN STERILE WATER 50 MG/ML INJ SYRG $4.56 6380710011 SODIUM CHLORIDE 0.9 % (FLUSH) INJ SYRG $4.55 0378-0415-01 DIPHENOXYLATE-ATROPINE 2.5-0.025 MG ORAL TAB $4.55 0472-1200-01 ACETAMINOPHEN 80 MG RECTAL SUPP $4.55 13668-105-01 ISOSORBIDE MONONITRATE 60 MG ORAL TB24 $4.55 27241-052-03 ARIPIPRAZOLE 5 MG ORAL TAB $4.55 27241-054-03 ARIPIPRAZOLE 15 MG ORAL TAB $4.55 42571-176-01 PIROXICAM 10 MG ORAL CAP $4.55 43598-554-30 ARIPIPRAZOLE 2 MG ORAL TAB $4.55 43598-555-30 ARIPIPRAZOLE 5 MG ORAL TAB $4.55 43598-556-30 ARIPIPRAZOLE 10 MG ORAL TAB $4.55 43598-966-30 ARIPIPRAZOLE 5 MG ORAL TAB $4.55 51672-2114-0 ACETAMINOPHEN 80 MG RECTAL SUPP $4.55 51672-2114-2 ACETAMINOPHEN 80 MG RECTAL SUPP $4.55 51672-2115-0 ACETAMINOPHEN 120 MG RECTAL SUPP $4.55 51672-2115-2 ACETAMINOPHEN 120 MG RECTAL SUPP $4.55 51672-2116-0 ACETAMINOPHEN 325 MG RECTAL SUPP $4.55 51672-2116-2 ACETAMINOPHEN 325 MG RECTAL SUPP $4.55 62756-457-88 CARBIDOPA-LEVODOPA 50-200 MG ORAL TBSR $4.55 99999-043-17 FENTANYL-NS 1 MCG/ML NICU INJECTION $4.55 0555-0607-02 MEGESTROL 40 MG ORAL TAB $4.54 68084-750-25 TRIAMTERENE-HYDROCHLOROTHIAZID 37.5-25 MG ORAL TAB $4.52 68084-750-95 TRIAMTERENE-HYDROCHLOROTHIAZID 37.5-25 MG ORAL TAB $4.52 0904-5833-48 LORATADINE-PSEUDOEPHEDRINE 10-240 MG ORAL TB24 $4.51 16714-950-01 DEXTROAMPHETAMINE-AMPHETAMINE 10 MG ORAL TAB $4.51 99999-036-52 METHOTREXATE SODIUM 0.625 MG ORAL PARTIAL TAB $4.51 46581-210-06 CAMPHOR-METHYL SALICYL-MENTHOL 3.1-10-6 % TOPICAL PTMD $4.50 0121-1154-00 LACTULOSE 20 GRAM/30 ML ORAL SOLN $4.49 0121-1154-30 LACTULOSE 20 GRAM/30 ML ORAL SOLN $4.49 0904-6955-61 LEVOTHYROXINE 125 MCG ORAL TAB $4.48 68001-246-16 ONDANSETRON 4 MG ORAL TBDL $4.48 99999-041-94 CARBAMAZEPINE 100 MG ORAL PARTIAL TAB $4.47 99999-001-88 VITAMIN E 15 UNIT ORAL SYRINGE NICU $4.47 0093-8162-01 QUETIAPINE 100 MG ORAL TAB $4.46 12870-0001-1 SILVER NITRATE APPLICATORS 75-25 % TOPICAL STCK $4.45 50268-110-11 BENAZEPRIL 10 MG ORAL TAB $4.45 50268-110-15 BENAZEPRIL 10 MG ORAL TAB $4.45 51079-511-01 MECLIZINE 25 MG ORAL TAB $4.45 51079-511-20 MECLIZINE 25 MG ORAL TAB $4.45 99999-005-67 HYDROCORTISONE SOD SUCCINATE 5 MG/ML INJ DILUTION (MCH) $4.45 0093-3123-01 DICLOXACILLIN 250 MG ORAL CAP $4.44 50268-190-11 CYCLOBENZAPRINE 5 MG ORAL TAB $4.44 50268-190-15 CYCLOBENZAPRINE 5 MG ORAL TAB $4.44 53489-500-01 THIORIDAZINE 100 MG ORAL TAB $4.43 51079-445-01 LEVOTHYROXINE 150 MCG ORAL TAB $4.43 51079-445-20 LEVOTHYROXINE 150 MCG ORAL TAB $4.43 60687-508-01 LEVOTHYROXINE 112 MCG ORAL TAB $4.43 60687-508-11 LEVOTHYROXINE 112 MCG ORAL TAB $4.43 42794-018-12 LIOTHYRONINE 5 MCG ORAL TAB $4.42 59762-1206-1 LIOTHYRONINE 5 MCG ORAL TAB $4.42 72572-430-01 MIDAZOLAM 1MG/ML INJECTABLE SOLUTION (MHS) $4.42 72572-430-25 MIDAZOLAM 1MG/ML INJECTABLE SOLUTION (MHS) $4.42 72572-520-01 ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN $4.42 72572-520-25 ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN $4.42 99999-042-32 MORPHINE (PF) 0.5 MG/ML INJ SOLN (MCH) $4.42 99999-045-93 ACETIC ACID (BULK) 3 % MISC LIQD $4.42 13668-484-50 MINOCYCLINE 100 MG ORAL CAP $4.41 50268-523-11 MECLIZINE 25 MG ORAL TAB $4.41 50268-523-15 MECLIZINE 25 MG ORAL TAB $4.41 486112501 SOD PHOS DI, MONO-K PHOS MONO 250 MG ORAL TAB $4.41 0904-6830-06 FINASTERIDE 5 MG ORAL TAB $4.39 68084-229-01 AZATHIOPRINE 50 MG ORAL TAB $4.39 68084-229-11 AZATHIOPRINE 50 MG ORAL TAB $4.39 68084-590-25 ATORVASTATIN 80 MG ORAL TAB $4.39 68084-590-95 ATORVASTATIN 80 MG ORAL TAB $4.39 99999-033-50 AZATHIOPRINE 50 MG/ML ORAL SUSP (COMPOUND) $4.39 0121-4577-40 LACTULOSE 10 GRAM/15 ML (15 ML) ORAL SOLN $4.39 69292-564-01 METOLAZONE 5 MG ORAL TAB $4.39 0093-2069-01 DOXAZOSIN 2 MG ORAL TAB $4.38 0904-6572-61 ALLOPURINOL 300 MG ORAL TAB $4.38 0378-1819-77 LEVOTHYROXINE 200 MCG ORAL TAB $4.38 0378-1817-77 LEVOTHYROXINE 175 MCG ORAL TAB $4.37 0527-1350-01 LEVOTHYROXINE 175 MCG ORAL TAB $4.37 0378-0614-01 THIORIDAZINE 25 MG ORAL TAB $4.36 0904-7276-41 NYSTATIN 100,000 UNIT/ML ORAL SUSP $4.36 0904-7276-70 NYSTATIN 100,000 UNIT/ML ORAL SUSP $4.36 49483-223-10 NITROGLYCERIN 9 MG ORAL CPSR $4.36 487900330 SODIUM CHLORIDE 3 % INHALATION NEBU $4.34 487900730 SODIUM CHLORIDE 7 % INHALATION NEBU $4.34 5019074060 SODIUM CHLORIDE 7 % INHALATION NEBU $4.34 0591-3369-01 BUTALBITAL-ACETAMINOPHEN-CAFF 50-325-40 MG ORAL TAB $4.34 69367-203-01 BUTALBITAL-ACETAMINOPHEN-CAFF 50-325-40 MG ORAL TAB $4.34 0378-0435-01 BUPROPION HCL 100 MG ORAL TAB $4.34 10702-277-03 LEFLUNOMIDE 10 MG ORAL TAB $4.34 31722-803-31 TELMISARTAN 40 MG ORAL TAB $4.34 50228-423-60 RANOLAZINE 500 MG ORAL TB12 $4.34 50742-238-30 QUININE SULFATE 324 MG ORAL CAP $4.34 60687-184-11 MEMANTINE 10 MG ORAL TAB $4.34 60687-184-57 MEMANTINE 10 MG ORAL TAB $4.34 63304-017-60 RANOLAZINE 500 MG ORAL TB12 $4.34 64380-710-03 LAMIVUDINE 150 MG ORAL TAB $4.34 65162-880-03 LURASIDONE 40 MG ORAL TAB $4.34 65862-027-60 NEVIRAPINE 200 MG ORAL TAB $4.34 66993-663-30 DULOXETINE 30 MG ORAL CPDR $4.34 67405-601-03 FLUCONAZOLE 50 MG ORAL TAB $4.34 68462-319-60 RANOLAZINE 500 MG ORAL TB12 $4.34 1650002324 CALCIUM ACETATE-ALUMINUM SULF 952-1,347 MG TOPICAL PWPK $4.33 0904-6476-61 BACLOFEN 20 MG ORAL TAB $4.33 16864-240-01 CALCIUM ACETATE-ALUMINUM SULF 952-1,347 MG TOPICAL PWPK $4.33 57074-00177 CALCIUM ACETATE-ALUMINUM SULF 952-1,347 MG TOPICAL PWPK $4.33 50268-640-11 PAROXETINE HCL 10 MG ORAL TAB $4.32 50268-640-15 PAROXETINE HCL 10 MG ORAL TAB $4.32 67877-286-60 RILUZOLE 50 MG ORAL TAB $4.32 51079-567-20 THIORIDAZINE 50 MG ORAL TAB $4.32 16714-948-01 DEXTROAMPHETAMINE-AMPHETAMINE 5 MG ORAL TAB $4.31 43386-160-12 MISOPROSTOL 100 MCG ORAL TAB $4.31 51079-443-01 LEVOTHYROXINE 125 MCG ORAL TAB $4.31 51079-443-20 LEVOTHYROXINE 125 MCG ORAL TAB $4.31 59762-1210-3 DESVENLAFAXINE SUCCINATE 25 MG ORAL TB24 $4.31 59762-5007-1 MISOPROSTOL 100 MCG ORAL TAB $4.31 70954-443-20 MISOPROSTOL 100 MCG ORAL TAB $4.31 42292-001-01 METRONIDAZOLE 500 MG ORAL TAB $4.30 42292-001-20 METRONIDAZOLE 500 MG ORAL TAB $4.30 43386-160-06 MISOPROSTOL 100 MCG ORAL TAB $4.30 70954-443-10 MISOPROSTOL 100 MCG ORAL TAB $4.30 63739-560-10 GABAPENTIN 600 MG ORAL TAB $4.30 414200024 SACCHAROMYCES BOULARDII 250 MG ORAL CAP $4.29 414200040 SACCHAROMYCES BOULARDII 250 MG ORAL PWPK $4.29 99999-046-54 ACETIC ACID (BULK) 5 % MISC LIQD $4.29 51991-838-01 CYPROHEPTADINE 4 MG ORAL TAB $4.28 65862-458-60 GALANTAMINE 4 MG ORAL TAB $4.28 16714-853-01 METOPROLOL SUCCINATE 50 MG ORAL TB24 $4.27 12870-0001-2 SILVER NITRATE APPLICATORS 75-25 % TOPICAL STCK $4.26 42192-329-01 THYROID (PORK) 30 MG ORAL TAB $4.26 68084-968-01 OXYCODONE 10 MG ORAL TAB $4.26 68084-968-11 OXYCODONE 10 MG ORAL TAB $4.26 57237-049-60 GALANTAMINE 4 MG ORAL TAB $4.25 57237-050-60 GALANTAMINE 8 MG ORAL TAB $4.25 8137003640 COLLOIDAL OATMEAL TOPICAL PACK $4.25 16714-852-01 METOPROLOL SUCCINATE 25 MG ORAL TB24 $4.25 0378-3066-77 FENOFIBRATE NANOCRYSTALLIZED 145 MG ORAL TAB $4.23 50268-189-11 CYPROHEPTADINE 4 MG ORAL TAB $4.23 50268-189-15 CYPROHEPTADINE 4 MG ORAL TAB $4.23 50268-687-11 PRIMIDONE 250 MG ORAL TAB $4.23 50268-687-15 PRIMIDONE 250 MG ORAL TAB $4.23 51407-435-01 CHLORPROMAZINE 25 MG ORAL TAB $4.23 76204-600-01 IPRATROPIUM-ALBUTEROL 0.5 MG-3 MG(2.5 MG BASE)/3 ML INHALATION NEBU $4.23 0121-0918-05 IBUPROFEN 100 MG/5 ML ORAL SUSP $4.23 0121-0918-40 IBUPROFEN 100 MG/5 ML ORAL SUSP $4.23 0121-1550-00 CODEINE-GUAIFENESIN 10-100 MG/5 ML ORAL LIQD $4.23 0121-1550-10 CODEINE-GUAIFENESIN 10-100 MG/5 ML ORAL LIQD $4.23 0641-6057-01 MIDAZOLAM 1MG/ML INJECTABLE SOLUTION (MHS) $4.23 0641-6057-25 MIDAZOLAM 1 MG/ML INJ SOLN CODE NEO $4.23 42858-002-10 OXYCODONE 10 MG ORAL TAB $4.23 46122-645-13 CAMPHOR-METHYL SALICYL-MENTHOL 3.1-10-6 % TOPICAL PTMD $4.23 51079-921-01 CLOZAPINE 25 MG ORAL TAB $4.23 51079-921-20 CLOZAPINE 25 MG ORAL TAB $4.23 69292-586-01 HALOPERIDOL 5 MG ORAL TAB $4.23 76282-257-01 NABUMETONE 500 MG ORAL TAB $4.23 99999-005-59 GLYCOPYRROLATE 50 MCG/ML INJ DILUTION (MCH) $4.23 60505-2551-5 GABAPENTIN 600 MG ORAL TAB $4.22 68084-157-01 MORPHINE 15 MG ORAL TBSR $4.21 68084-157-11 MORPHINE 15 MG ORAL TBSR $4.21 68084-403-11 MORPHINE 15 MG ORAL TBSR $4.21 16714-455-01 QUETIAPINE 200 MG ORAL TAB $4.20 16714-477-01 AMOXICILLIN-POT CLAVULANATE 500-125 MG ORAL TAB $4.20 0093-7334-01 MYCOPHENOLATE MOFETIL 250 MG ORAL CAP $4.18 51079-374-01 CHLORDIAZEPOXIDE HCL 5 MG ORAL CAP $4.18 51079-374-20 CHLORDIAZEPOXIDE HCL 5 MG ORAL CAP $4.18 68084-205-01 MINOXIDIL 10 MG ORAL TAB $4.17 68084-205-11 MINOXIDIL 10 MG ORAL TAB $4.17 47781-588-46 MIDAZOLAM 1MG/ML INJECTABLE SOLUTION (MHS) $4.16 47781-588-68 MIDAZOLAM 1MG/ML INJECTABLE SOLUTION (MHS) $4.16 99999-006-61 METHADONE 5 MG/5 ML ORAL SOLN $4.16 50268-540-11 METOPROLOL SUCCINATE 25 MG ORAL TB24 $4.15 50268-540-15 METOPROLOL SUCCINATE 25 MG ORAL TB24 $4.15 0143-1772-01 ISOSORBIDE DINITRATE 20 MG ORAL TAB $4.13 10135-620-01 PHENAZOPYRIDINE 100 MG ORAL TAB $4.13 51079-929-20 LABETALOL 200 MG ORAL TAB $4.13 99999-002-30 NITROGLYCERIN 400 MCG/SPRAY TL SPRY $4.13 99999-002-16 GENTAMICIN 20 MG/0.5 ML OPHTHALMIC SYRINGE $4.13 0832-0511-01 BETHANECHOL CHLORIDE 10 MG ORAL TAB $4.13 68084-645-01 TIZANIDINE 4 MG ORAL TAB $4.12 68084-645-11 TIZANIDINE 4 MG ORAL TAB $4.12 68462-158-13 ONDANSETRON 8 MG ORAL TBDL $4.12 68462-158-40 ONDANSETRON 8 MG ORAL TBDL $4.12 57237-154-90 MODAFINIL 100 MG ORAL TAB $4.12 5019014123 SODIUM CHLORIDE 7 % INHALATION NEBU $4.11 5019014263 SODIUM CHLORIDE 3 % INHALATION NEBU $4.11 0781-2081-02 CALCIUM ACETATE(PHOSPHAT BIND) 667 MG ORAL CAP $4.11 51079-811-01 GLIPIZIDE 10 MG ORAL TAB $4.11 51079-811-20 GLIPIZIDE 10 MG ORAL TAB $4.11 51079-206-01 ALLOPURINOL 300 MG ORAL TAB $4.10 51079-206-20 ALLOPURINOL 300 MG ORAL TAB $4.10 0378-0156-01 PROBENECID 500 MG ORAL TAB $4.10 0832-0511-89 BETHANECHOL CHLORIDE 10 MG ORAL TAB $4.10 99999-005-56 GENTAMICIN 2 MG/ML INJ SOLN IN D5W (MCH-NICU) $4.10 50268-535-11 METRONIDAZOLE 500 MG ORAL TAB $4.09 50268-535-15 METRONIDAZOLE 500 MG ORAL TAB $4.09 50268-109-11 BENAZEPRIL 5 MG ORAL TAB $4.08 50268-109-15 BENAZEPRIL 5 MG ORAL TAB $4.08 51079-129-01 PHENYTOIN 50 MG ORAL CHEW $4.08 59651-565-01 DICLOXACILLIN 250 MG ORAL CAP $4.07 60687-494-01 MYCOPHENOLATE MOFETIL 250 MG ORAL CAP $4.06 60687-494-11 MYCOPHENOLATE MOFETIL 250 MG ORAL CAP $4.06 68382-079-01 HALOPERIDOL 5 MG ORAL TAB $4.06 99999-043-01 MEGESTROL 40 MG/ML ORAL SUSPENSION $4.06 99999-044-12 MEGESTROL 40 MG/ML ORAL SUSPENSION $4.06 68382-079-10 HALOPERIDOL 5 MG ORAL TAB $4.04 16714-529-01 BISOPROLOL FUMARATE 5 MG ORAL TAB $4.04 16729-078-01 CARBIDOPA-LEVODOPA 25-100 MG ORAL TBSR $4.03 51079-458-01 PRAVASTATIN 20 MG ORAL TAB $4.03 65862-654-01 ENTACAPONE 200 MG ORAL TAB $4.03 68084-713-01 VENLAFAXINE 150 MG ORAL CP24 $4.03 68084-713-11 VENLAFAXINE 150 MG ORAL CP24 $4.03 68094-193-59 VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLN $4.03 0054-8176-25 DEXAMETHASONE 2 MG ORAL TAB $4.02 99999-007-74 ISONIAZID 50 MG/5 ML ORAL SOLN $4.01 0378-3125-01 DOXEPIN 25 MG ORAL CAP $4.00 HC89007082 ALBUMIN URINE -AU $4.00 HC89016174 CRYOGLOBULIN(QUAL/SEMI QT)-QD $4.00 HC89016216 FIBRIN SPLIT PRODUCTS-QD $4.00 HC89009732 PROTEIN ELECT FRACT&QT(PNL)-AU $4.00 HC89013908 TOT PROT REFRACTOM(PNL)-AU $4.00 50111-917-01 TORSEMIDE 20 MG ORAL TAB $4.00 65162-710-03 COLCHICINE 0.6 MG ORAL TAB $4.00 0378-7732-93 ONDANSETRON 4 MG ORAL TBDL $3.98 16714-235-01 PENICILLIN V POTASSIUM 500 MG ORAL TAB $3.98 60687-217-01 DILTIAZEM HCL 240 MG ORAL CP24 $3.98 60687-217-11 DILTIAZEM HCL 240 MG ORAL CP24 $3.98 62756-240-60 ONDANSETRON 4 MG ORAL TBDL $3.98 62756-240-64 ONDANSETRON 4 MG ORAL TBDL $3.98 63824-056-32 DEXTROMETHORPHAN-GUAIFENESIN 30-600 MG ORAL TB12 $3.98 65862-390-10 ONDANSETRON 4 MG ORAL TBDL $3.98 68084-708-25 BUPROPION HCL 150 MG ORAL SR12 $3.98 68084-708-95 BUPROPION HCL 150 MG ORAL SR12 $3.98 0378-9102-16 NITROGLYCERIN 0.1 MG/HR TRANSDERMAL PT24 $3.97 0378-9102-93 NITROGLYCERIN 0.1 MG/HR TRANSDERMAL PT24 $3.97 51079-480-01 VENLAFAXINE 37.5 MG ORAL TAB $3.97 51079-480-20 VENLAFAXINE 37.5 MG ORAL TAB $3.97 0832-1219-89 WARFARIN 10 MG ORAL TAB $3.97 0904-6187-61 PHENYTOIN SODIUM EXTENDED 100 MG ORAL CAP $3.97 0904-6619-61 ISOSORBIDE DINITRATE 10 MG ORAL TAB $3.97 70954-021-10 PRAZOSIN 5 MG ORAL CAP $3.96 50742-251-30 DILTIAZEM HCL 300 MG ORAL CP24 $3.95 0832-1219-01 WARFARIN 10 MG ORAL TAB $3.94 63739-888-10 PAROXETINE HCL 10 MG ORAL TAB $3.94 0591-5557-01 PROPRANOLOL 80 MG ORAL TAB $3.93 50268-362-11 GLIPIZIDE 10 MG ORAL TAB $3.93 50268-362-15 GLIPIZIDE 10 MG ORAL TAB $3.93 50268-816-11 ZONISAMIDE 100 MG ORAL CAP $3.93 50268-816-15 ZONISAMIDE 100 MG ORAL CAP $3.93 68084-347-01 LOSARTAN 50 MG ORAL TAB $3.93 68084-347-11 LOSARTAN 50 MG ORAL TAB $3.93 245010801 FERROUS SULFATE 325 MG (65 MG IRON) ORAL TBEC $3.91 60687-497-01 LEVOTHYROXINE 100 MCG ORAL TAB $3.91 60687-497-11 LEVOTHYROXINE 100 MCG ORAL TAB $3.91 68462-292-01 VERAPAMIL 120 MG ORAL TBSR $3.91 0093-8204-01 CIMETIDINE 400 MG ORAL TAB $3.91 0378-0372-01 CIMETIDINE 400 MG ORAL TAB $3.91 50268-686-11 PRIMIDONE 50 MG ORAL TAB $3.91 50268-686-15 PRIMIDONE 50 MG ORAL TAB $3.91 245010889 FERROUS SULFATE 325 MG (65 MG IRON) ORAL TBEC $3.90 414200037 SACCHAROMYCES BOULARDII 250 MG ORAL PWPK $3.90 0093-7355-56 FINASTERIDE 5 MG ORAL TAB $3.90 0527-1435-01 METAXALONE 800 MG ORAL TAB $3.90 0641-6080-01 ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN $3.90 0641-6080-25 ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN $3.90 13668-083-50 LEVOFLOXACIN 500 MG ORAL TAB $3.90 27241-049-10 ENTACAPONE 200 MG ORAL TAB $3.90 42858-502-03 BUPRENORPHINE HCL 8 MG SL SUBL $3.90 51991-900-01 CLOBAZAM 10 MG ORAL TAB $3.90 52817-325-10 MIDODRINE 10 MG ORAL TAB $3.90 53489-177-01 ALBUTEROL SULFATE 4 MG ORAL TAB $3.90 53746-193-01 NAPROXEN SODIUM 275 MG ORAL TAB $3.90 54879-002-01 ETHAMBUTOL 400 MG ORAL TAB $3.90 57664-136-88 ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) ORAL CAP $3.90 58657-703-10 HALOPERIDOL 5 MG ORAL TAB $3.90 60687-418-01 HYDROCODONE-ACETAMINOPHEN 10-325 MG ORAL TAB $3.90 60687-418-11 HYDROCODONE-ACETAMINOPHEN 10-325 MG ORAL TAB $3.90 60687-631-01 METOCLOPRAMIDE 10 MG ORAL TAB (MCH) $3.90 60687-631-11 METOCLOPRAMIDE HCL 10 MG ORAL TAB $3.90 62332-142-31 CELECOXIB 200 MG ORAL CAP $3.90 62559-159-01 FLUVOXAMINE 50 MG ORAL TAB $3.90 67457-440-00 ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN $3.90 67457-440-22 ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN $3.90 68084-111-01 GLIPIZIDE 5 MG ORAL TR24 $3.90 68084-111-11 GLIPIZIDE 5 MG ORAL TR24 $3.90 68180-157-01 CLOBAZAM 10 MG ORAL TAB $3.90 68462-304-50 NORETHINDRONE ACETATE 5 MG ORAL TAB $3.90 69238-1345-1 ALBUTEROL SULFATE 4 MG ORAL TAB $3.90 69543-374-10 PROGESTERONE MICRONIZED 100 MG ORAL CAP $3.90 99998-000-03 IBUPROFEN 100 MG/5 ML ORAL SUSP $3.90 99999-046-19 DEXTROSE 50 % IN WATER (D50W) IV SOLP $3.90 50268-522-11 MECLIZINE 12.5 MG ORAL TAB $3.89 50268-522-15 MECLIZINE 12.5 MG ORAL TAB $3.89 0904-6818-06 MIDODRINE 5 MG ORAL TAB $3.89 69238-1054-1 CHLORPROMAZINE 10 MG ORAL TAB $3.89 99998-000-31 CEFTAZIDIME 25 MG/ML INJ DILUTION (MCH) $3.87 0591-5347-01 PROBENECID 500 MG ORAL TAB $3.86 57664-441-88 DIGOXIN 250 MCG (0.25 MG) ORAL TAB $3.86 68084-299-01 TAMSULOSIN 0.4 MG ORAL CAP $3.84 68084-299-11 TAMSULOSIN 0.4 MG ORAL CAP $3.84 0115-7033-01 FLUDROCORTISONE 0.1 MG ORAL TAB $3.84 49348-179-34 HYDROGEN PEROXIDE 3 % MISC SOLN $3.84 53329-980-04 HYDROGEN PEROXIDE 3 % MISC SOLN $3.84 60687-544-01 CLONAZEPAM 0.5 MG ORAL TAB $3.84 60687-544-11 CLONAZEPAM 0.5 MG ORAL TAB $3.84 60687-555-01 CLONAZEPAM 1 MG ORAL TAB $3.84 60687-555-11 CLONAZEPAM 1 MG ORAL TAB $3.84 65862-287-01 PERINDOPRIL ERBUMINE 4 MG ORAL TAB $3.84 99999-036-51 CLONAZEPAM 0.1 MG/ML ORAL LIQUID (USING 1 MG TAB) $3.84 0115-7033-02 FLUDROCORTISONE 0.1 MG ORAL TAB $3.83 42292-039-01 LEVOTHYROXINE 112 MCG ORAL TAB $3.83 42292-039-20 LEVOTHYROXINE 112 MCG ORAL TAB $3.83 60687-475-01 LEVOTHYROXINE 75 MCG ORAL TAB $3.82 60687-475-11 LEVOTHYROXINE 75 MCG ORAL TAB $3.82 0904-6953-61 LEVOTHYROXINE 100 MCG ORAL TAB $3.81 0904-7214-61 BUPROPION HCL 150 MG ORAL SR12 $3.81 0121-4577-15 LACTULOSE 10 GRAM/15 ML (15 ML) ORAL SOLN $3.80 0904-7076-61 VENLAFAXINE 150 MG ORAL CP24 $3.80 69292-562-01 METOLAZONE 2.5 MG ORAL TAB $3.80 0781-2167-60 ZIPRASIDONE HCL 60 MG ORAL CAP $3.79 55111-352-60 RIVASTIGMINE TARTRATE 1.5 MG ORAL CAP $3.79 55111-353-60 RIVASTIGMINE TARTRATE 3 MG ORAL CAP $3.79 55111-355-60 RIVASTIGMINE TARTRATE 6 MG ORAL CAP $3.79 60687-450-01 LABETALOL 200 MG ORAL TAB $3.79 60687-450-11 LABETALOL 200 MG ORAL TAB $3.79 62756-145-86 RIVASTIGMINE TARTRATE 1.5 MG ORAL CAP $3.79 62756-146-86 RIVASTIGMINE TARTRATE 3 MG ORAL CAP $3.79 62756-148-86 RIVASTIGMINE TARTRATE 6 MG ORAL CAP $3.79 65862-648-60 RIVASTIGMINE TARTRATE 1.5 MG ORAL CAP $3.79 0591-0606-01 LABETALOL 200 MG ORAL TAB $3.78 49884-123-01 LABETALOL 200 MG ORAL TAB $3.78 51079-821-01 LEVETIRACETAM 500 MG ORAL TAB $3.78 51079-821-20 LEVETIRACETAM 500 MG ORAL TAB $3.78 57648-002-01 THE MAGIC BULLET 10 MG RECTAL SUPP $3.78 58657-603-01 LABETALOL 200 MG ORAL TAB $3.78 71247-127-01 LABETALOL 200 MG ORAL TAB $3.78 8290306414 HEPARIN LOCK FLUSH (PORCINE) 10 UNIT/ML IV SOLN (MCH) $3.77 0832-1218-89 WARFARIN 7.5 MG ORAL TAB $3.77 0904-7047-61 LOSARTAN 25 MG ORAL TAB $3.77 50268-061-11 ACYCLOVIR 400 MG ORAL TAB $3.77 50268-061-15 ACYCLOVIR 400 MG ORAL TAB $3.77 99999-000-13 CLINDAMYCIN 10 MG/ML (NICU) SYRINGE $3.77 0832-1218-00 WARFARIN 7.5 MG ORAL TAB $3.76 0832-1218-01 WARFARIN 7.5 MG ORAL TAB $3.76 1254720436 CETIRIZINE 10 MG ORAL TAB $3.76 0143-1771-01 ISOSORBIDE DINITRATE 10 MG ORAL TAB $3.76 0406-0485-01 ACETAMINOPHEN-CODEINE 300-60 MG ORAL TAB $3.76 0832-1540-11 HALOPERIDOL 5 MG ORAL TAB $3.74 58657-703-01 HALOPERIDOL 5 MG ORAL TAB $3.74 68084-482-01 LEVOFLOXACIN 500 MG ORAL TAB $3.74 68084-482-11 LEVOFLOXACIN 500 MG ORAL TAB $3.74 51079-294-01 TAMSULOSIN 0.4 MG ORAL CAP $3.74 51079-294-20 TAMSULOSIN 0.4 MG ORAL CAP $3.74 63739-972-10 POTASSIUM CHLORIDE 10 MEQ ORAL TBTQ $3.74 0054-0010-20 FLECAINIDE 50 MG ORAL TAB $3.73 0054-0010-21 FLECAINIDE 50 MG ORAL TAB $3.73 0054-0010-25 FLECAINIDE 50 MG ORAL TAB $3.73 0054-0404-01 MORPHINE CONCENTRATE 20 MG/ML ORAL SOLN (MHS) $3.73 0591-0845-01 GLIPIZIDE 10 MG ORAL TR24 $3.73 99999-002-38 MORPHINE CONCENTRATE 20 MG/ML ORAL SOLN (MHS) $3.73 99999-043-04 MORPHINE CONCENTRATE 20 MG/ML ORAL SOLN (MHS) $3.73 0603-2214-21 AMITRIPTYLINE 50 MG ORAL TAB $3.72 51079-133-01 AMITRIPTYLINE 50 MG ORAL TAB $3.72 51079-133-20 AMITRIPTYLINE 50 MG ORAL TAB $3.72 51079-423-01 MECLIZINE 12.5 MG ORAL TAB $3.71 51079-423-20 MECLIZINE 12.5 MG ORAL TAB $3.71 60687-503-01 BACLOFEN 10 MG ORAL TAB $3.71 60687-503-11 BACLOFEN 10 MG ORAL TAB $3.71 0378-0181-05 ALLOPURINOL 300 MG ORAL TAB $3.71 49483-222-10 NITROGLYCERIN 6.5 MG ORAL CPSR $3.71 99999-041-29 OXYCODONE 5 MG/5 ML ORAL SOLN $3.71 0054-0088-26 CALCIUM ACETATE(PHOSPHAT BIND) 667 MG ORAL CAP $3.70 68001-382-00 LABETALOL 200 MG ORAL TAB $3.69 414200007 SACCHAROMYCES BOULARDII 250 MG ORAL CAP $3.69 0904-6374-61 ROPINIROLE 1 MG ORAL TAB $3.69 0904-6987-61 DICYCLOMINE 10 MG ORAL CAP $3.69 99999-041-77 MISOPROSTOL 50 MCG ORAL PARTIAL TAB (USING 200 MCG TABLET) $3.69 62037-560-05 POTASSIUM CHLORIDE 10 MEQ ORAL CPSR $3.68 0121-1775-00 CODEINE-GUAIFENESIN 10-100 MG/5 ML ORAL LIQD $3.67 0121-1775-05 CODEINE-GUAIFENESIN 10-100 MG/5 ML ORAL LIQD $3.67 0378-1815-77 LEVOTHYROXINE 150 MCG ORAL TAB $3.67 63323-286-11 ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJ SOLN $3.67 51079-442-01 LEVOTHYROXINE 100 MCG ORAL TAB $3.67 51079-442-20 LEVOTHYROXINE 100 MCG ORAL TAB $3.67 68382-106-01 DIVALPROEX 125 MG ORAL CDRS $3.67 0904-5892-61 PRAVASTATIN 20 MG ORAL TAB $3.66 53746-642-01 FLECAINIDE 100 MG ORAL TAB $3.66 51079-735-01 HALOPERIDOL 2 MG ORAL TAB $3.65 51079-735-20 HALOPERIDOL 2 MG ORAL TAB $3.65 0832-1217-00 WARFARIN 6 MG ORAL TAB $3.65 0832-1217-01 WARFARIN 6 MG ORAL TAB $3.65 62037-598-90 DILTIAZEM HCL 180 MG ORAL CP24 $3.65 0603-3582-21 FELODIPINE 5 MG ORAL TB24 $3.64 0832-1217-89 WARFARIN 6 MG ORAL TAB $3.64 16714-200-10 ONDANSETRON 4 MG ORAL TBDL $3.64 16714-200-30 ONDANSETRON 4 MG ORAL TBDL $3.64 49884-724-01 HYDROXYUREA 500 MG ORAL CAP $3.64 51079-142-01 LITHIUM CARBONATE 450 MG ORAL TBSR $3.64 51079-142-20 LITHIUM CARBONATE 450 MG ORAL TBSR $3.64 53746-711-01 GUANFACINE 1 MG ORAL TAB $3.64 65162-711-10 GUANFACINE 1 MG ORAL TAB $3.64 51079-820-20 LEVETIRACETAM 250 MG ORAL TAB $3.63 60687-379-01 BENZTROPINE 2 MG ORAL TAB $3.63 60687-609-01 PROPRANOLOL 40 MG ORAL TAB $3.63 60687-609-11 PROPRANOLOL 40 MG ORAL TAB $3.63 0378-1823-77 LEVOTHYROXINE 137 MCG ORAL TAB $3.62 0591-5695-50 MINOCYCLINE 100 MG ORAL CAP $3.62 65862-211-50 MINOCYCLINE 100 MG ORAL CAP $3.62 99999-006-91 NAFCILLIN 50 MG/ML INJ DILUTION $3.62 0378-5815-77 VALSARTAN 320 MG ORAL TAB $3.61 64679-961-05 AZITHROMYCIN 250 MG ORAL TAB $3.61 99999-000-16 DIAZEPAM 2 MG / 10 ML SYRINGE $3.61 99999-012-95 METHADONE 10 MG/5 ML ORAL SOLN $3.61 60687-230-01 ZONISAMIDE 100 MG ORAL CAP $3.60 60687-230-11 ZONISAMIDE 100 MG ORAL CAP $3.60 0591-0606-05 LABETALOL 200 MG ORAL TAB $3.60 60687-656-11 LISINOPRIL 2.5 MG ORAL TAB $3.60 60687-656-21 LISINOPRIL 2.5 MG ORAL TAB $3.60 23155-600-31 MIDAZOLAM 1MG/ML INJECTABLE SOLUTION (MHS) $3.59 23155-600-41 MIDAZOLAM 1MG/ML INJECTABLE SOLUTION (MHS) $3.59 68180-566-01 TRANDOLAPRIL 1 MG ORAL TAB $3.59 0121-1744-10 GUAIFENESIN 100 MG/5 ML ORAL LIQD $3.58 24979-010-01 NIFEDIPINE 60 MG ORAL TR24 $3.58 47335-235-83 METHOTREXATE SODIUM 2.5 MG ORAL TAB $3.58 51079-441-01 LEVOTHYROXINE 75 MCG ORAL TAB $3.58 51079-441-20 LEVOTHYROXINE 75 MCG ORAL TAB $3.58 60505-0165-1 FLUVOXAMINE 50 MG ORAL TAB $3.58 62756-184-88 OXCARBAZEPINE 300 MG ORAL TAB $3.58 68462-138-01 OXCARBAZEPINE 300 MG ORAL TAB $3.58 99999-036-04 FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN $3.58 0378-1813-77 LEVOTHYROXINE 125 MCG ORAL TAB $3.57 0555-0997-02 FLUDROCORTISONE 0.1 MG ORAL TAB $3.57 60687-369-01 DICYCLOMINE 10 MG ORAL CAP $3.57 60687-369-11 DICYCLOMINE 10 MG ORAL CAP $3.57 62756-589-88 LIOTHYRONINE 5 MCG ORAL TAB $3.57 0054-0163-25 MYCOPHENOLATE MOFETIL 250 MG ORAL CAP $3.56 68084-709-01 VENLAFAXINE 75 MG ORAL CP24 $3.56 68084-709-11 VENLAFAXINE 75 MG ORAL CP24 $3.56 0904-6322-06 METOPROLOL SUCCINATE 25 MG ORAL TB24 $3.55 57664-761-88 HYDROXYCHLOROQUINE 200 MG ORAL TAB FOR DISSOLVE (MCH) $3.54 63304-296-01 HYDROXYCHLOROQUINE 200 MG ORAL TAB $3.54 6025800601 POTASSIUM, SODIUM PHOSPHATES 280-160-250 MG ORAL PWPK $3.54 6025800615 POTASSIUM, SODIUM PHOSPHATES 280-160-250 MG ORAL PWPK $3.54 0245-5319-01 POTASSIUM CHLORIDE 20 MEQ ORAL TBTQ $3.54 57237-109-01 FELODIPINE 5 MG ORAL TB24 $3.53 23155-725-01 LABETALOL 300 MG ORAL TAB $3.52 0378-1811-77 LEVOTHYROXINE 112 MCG ORAL TAB $3.52 68084-326-01 GLIMEPIRIDE 2 MG ORAL TAB $3.52 68084-326-11 GLIMEPIRIDE 2 MG ORAL TAB $3.52 0245-5319-89 POTASSIUM CHLORIDE 20 MEQ ORAL TBTQ $3.51 50383-349-10 DOCUSATE SODIUM 100 MG/10 ML ORAL LIQD $3.51 50383-349-11 DOCUSATE SODIUM 100 MG/10 ML ORAL LIQD $3.51 99999-000-97 METOCLOPRAMIDE 1 MG/ML (NICU) ORAL SOLN $3.51 60687-711-01 OXCARBAZEPINE 150 MG ORAL TAB $3.50 60687-711-11 OXCARBAZEPINE 150 MG ORAL TAB $3.50 68084-845-01 OXCARBAZEPINE 150 MG ORAL TAB $3.50 68084-845-11 OXCARBAZEPINE 150 MG ORAL TAB $3.50 69238-1173-9 DOXEPIN 100 MG ORAL CAP $3.50 60687-407-01 HYDROCODONE-ACETAMINOPHEN 7.5-325 MG ORAL TAB $3.50 60687-407-11 HYDROCODONE-ACETAMINOPHEN 7.5-325 MG ORAL TAB $3.50 0378-1101-01 PRAZOSIN 1 MG ORAL CAP $3.49 0093-7355-05 FINASTERIDE 5 MG ORAL TAB $3.48 16571-673-01 PHENOBARBITAL 32.4 MG ORAL TAB $3.48 60505-0158-1 BUPROPION HCL 75 MG ORAL TAB $3.48 68084-376-01 PHENYTOIN SODIUM EXTENDED 100 MG ORAL CAP $3.48 68084-376-11 PHENYTOIN SODIUM EXTENDED 100 MG ORAL CAP $3.48 68382-256-01 OXYBUTYNIN CHLORIDE 10 MG ORAL TR24 $3.48 50268-550-11 METFORMIN 500 MG ORAL TB24 $3.47 50268-550-15 METFORMIN 500 MG ORAL TB24 $3.47 68382-255-01 OXYBUTYNIN CHLORIDE 5 MG ORAL TR24 $3.47 68382-256-05 OXYBUTYNIN CHLORIDE 10 MG ORAL TR24 $3.47 51079-436-01 DOXEPIN 10 MG ORAL CAP $3.47 51079-436-20 DOXEPIN 10 MG ORAL CAP $3.47 62756-459-83 BUPRENORPHINE HCL 2 MG SL SUBL $3.47 99999-046-20 LORAZEPAM 2 MG/ML INJ SOLN $3.46 31722-707-30 FAMCICLOVIR 250 MG ORAL TAB $3.46 60505-3246-3 FAMCICLOVIR 250 MG ORAL TAB $3.46 51079-141-01 CHLORDIAZEPOXIDE HCL 25 MG ORAL CAP $3.45 51079-141-20 CHLORDIAZEPOXIDE HCL 25 MG ORAL CAP $3.45 51079-566-01 THIORIDAZINE 25 MG ORAL TAB $3.45 51079-566-20 THIORIDAZINE 25 MG ORAL TAB $3.45 68084-895-01 HYDROCODONE-ACETAMINOPHEN 5-325 MG ORAL TAB $3.45 68084-895-09 HYDROCODONE-ACETAMINOPHEN 5-325 MG ORAL TAB $3.45 68084-895-11 HYDROCODONE-ACETAMINOPHEN 5-325 MG ORAL TAB $3.45 69238-1342-1 ETODOLAC 400 MG ORAL TAB $3.45 33342-065-10 VALSARTAN 320 MG ORAL TAB $3.43 65862-573-90 VALSARTAN 320 MG ORAL TAB $3.43 0093-0778-01 CARBAMAZEPINE 100 MG ORAL CHEW $3.43 13668-271-01 CARBAMAZEPINE 100 MG ORAL CHEW $3.43 50111-916-01 TORSEMIDE 10 MG ORAL TAB $3.43 0536-1161-34 DEXTROMETHORPHAN-GUAIFENESIN 30-600 MG ORAL TB12 $3.42 0904-6418-61 TIZANIDINE 4 MG ORAL TAB $3.42 0143-1769-01 ISOSORBIDE DINITRATE 5 MG ORAL TAB $3.41 63739-545-10 SPIRONOLACTONE 50 MG ORAL TAB $3.41 63739-686-10 LOSARTAN 50 MG ORAL TAB $3.41 63824-056-34 DEXTROMETHORPHAN-GUAIFENESIN 30-600 MG ORAL TB12 $3.41 99999-002-03 DEXTROSE 10% BOLUS $3.41 50268-096-11 ATORVASTATIN 80 MG ORAL TAB $3.40 50268-096-12 ATORVASTATIN 80 MG ORAL TAB $3.40 59746-115-06 PROCHLORPERAZINE MALEATE 10 MG ORAL TAB $3.40 0904-7077-61 VENLAFAXINE 75 MG ORAL CP24 $3.39 16714-852-02 METOPROLOL SUCCINATE 25 MG ORAL TB24 $3.39 0245-0211-11 MIDODRINE 2.5 MG ORAL TAB $3.39 60505-1320-1 MIDODRINE 2.5 MG ORAL TAB $3.39 68084-204-01 MINOXIDIL 2.5 MG ORAL TAB $3.39 68084-204-11 MINOXIDIL 2.5 MG ORAL TAB $3.39 23155-133-01 DOXYCYCLINE MONOHYDRATE 50 MG ORAL TAB $3.38 49884-726-01 DOXYCYCLINE MONOHYDRATE 50 MG ORAL CAP $3.38 99999-001-11 TETRACAINE - LIDOCAINE - EPINEPHRINE TOP SOLN $3.38 99999-009-75 TETRACAINE - LIDOCAINE - EPINEPHRINE TOP SOLN $3.38 99999-040-25 PROPRANOLOL 1 MG/ML NICU ORAL LIQUID (SLH) $3.38 60687-640-01 METFORMIN 500 MG ORAL TB24 $3.37 60687-640-11 METFORMIN 500 MG ORAL TB24 $3.37 0781-2145-01 AMPICILLIN 500 MG ORAL CAP $3.37 43598-721-01 HYDROXYCHLOROQUINE 200 MG ORAL TAB $3.37 57664-761-13 HYDROXYCHLOROQUINE 200 MG ORAL TAB $3.37 64380-970-25 HYDROCORTISONE 5 MG ORAL TAB $3.36 60687-405-79 IPRATROPIUM-ALBUTEROL 0.5 MG-3 MG(2.5 MG BASE)/3 ML INHALATION NEBU $3.35 60687-405-83 IPRATROPIUM-ALBUTEROL 0.5 MG-3 MG(2.5 MG BASE)/3 ML INHALATION NEBU $3.35 50268-666-11 PRAVASTATIN 20 MG ORAL TAB $3.35 50268-666-15 PRAVASTATIN 20 MG ORAL TAB $3.35 59762-0075-1 HYDROCORTISONE 20 MG ORAL TAB $3.34 68084-346-01 LOSARTAN 25 MG ORAL TAB $3.34 68084-346-11 LOSARTAN 25 MG ORAL TAB $3.34 0781-1766-01 IMIPRAMINE HCL 50 MG ORAL TAB $3.33 0904-3854-61 CARBAMAZEPINE 100 MG ORAL CHEW $3.33 16714-444-01 ENALAPRIL MALEATE 10 MG ORAL TAB $3.32 16571-664-01 METRONIDAZOLE 500 MG ORAL TAB $3.32 29300-227-01 METRONIDAZOLE 500 MG ORAL TAB $3.32 29300-227-46 METRONIDAZOLE 500 MG ORAL TAB $3.32 50111-334-01 METRONIDAZOLE 500 MG ORAL TAB $3.32 99999-008-76 METRONIDAZOLE 500MG/10ML ORAL LIQ $3.32 0228-2620-11 ISOSORBIDE MONONITRATE 20 MG ORAL TAB $3.31 99999-001-56 CEFTAZIDIME 100MG/ML (NICU) IV SYRINGE $3.31 63739-796-10 ALLOPURINOL 300 MG ORAL TAB $3.30 0536-1161-37 DEXTROMETHORPHAN-GUAIFENESIN 30-600 MG ORAL TB12 $3.30 50268-631-11 QUETIAPINE 50 MG ORAL TAB $3.30 50268-631-15 QUETIAPINE 50 MG ORAL TAB $3.30 42292-038-01 LEVOTHYROXINE 88 MCG ORAL TAB $3.29 42292-038-20 LEVOTHYROXINE 88 MCG ORAL TAB $3.29 63739-016-10 DILTIAZEM HCL 240 MG ORAL CP24 $3.29 50268-621-11 ONDANSETRON HCL 4 MG ORAL TAB $3.28 50268-621-15 ONDANSETRON HCL 4 MG ORAL TAB $3.28 68084-094-01 CARBIDOPA-LEVODOPA 25-250 MG ORAL TAB $3.28 68084-094-11 CARBIDOPA-LEVODOPA 25-250 MG ORAL TAB $3.28 99999-008-71 LEVETIRACETAM 100 MG/ML ORAL SOLN $3.28 0245-5316-01 POTASSIUM CHLORIDE 10 MEQ ORAL TBSR $3.28 16714-157-01 PROGESTERONE MICRONIZED 100 MG ORAL CAP $3.28 63739-072-33 SILDENAFIL (PULM.HYPERTENSION) 20 MG ORAL TAB $3.28 0245-5319-11 POTASSIUM CHLORIDE 20 MEQ ORAL TBTQ $3.26 0245-5319-15 POTASSIUM CHLORIDE 20 MEQ ORAL TBTQ $3.26 0832-5325-11 POTASSIUM CHLORIDE 20 MEQ ORAL TBTQ $3.26 0904-7108-61 GABAPENTIN 800 MG ORAL TAB $3.26 51079-992-01 FLUVOXAMINE 50 MG ORAL TAB $3.26 51079-992-20 FLUVOXAMINE 50 MG ORAL TAB $3.26 0378-0184-01 PROPRANOLOL 40 MG ORAL TAB $3.26 0378-9671-30 IPRATROPIUM-ALBUTEROL 0.5 MG-3 MG(2.5 MG BASE)/3 ML INHALATION NEBU $3.26 0378-9671-31 IPRATROPIUM-ALBUTEROL 0.5 MG-3 MG(2.5 MG BASE)/3 ML INHALATION NEBU $3.26 0378-9671-64 IPRATROPIUM-ALBUTEROL 0.5 MG-3 MG(2.5 MG BASE)/3 ML INHALATION NEBU $3.26 0378-9671-93 IPRATROPIUM-ALBUTEROL 0.5 MG-3 MG(2.5 MG BASE)/3 ML INHALATION NEBU $3.26 0487-0201-01 IPRATROPIUM-ALBUTEROL 0.5 MG-3 MG(2.5 MG BASE)/3 ML INHALATION NEBU $3.26 0904-5610-61 ENALAPRIL MALEATE 10 MG ORAL TAB $3.26 31722-154-90 VALSARTAN 320 MG ORAL TAB $3.26 31722-748-90 VALSARTAN 320 MG ORAL TAB $3.26 0115-1070-01 DIPYRIDAMOLE 25 MG ORAL TAB $3.25 0228-2996-11 TAMSULOSIN 0.4 MG ORAL CAP $3.25 0228-2996-50 TAMSULOSIN 0.4 MG ORAL CAP $3.25 0378-0433-01 BUPROPION HCL 75 MG ORAL TAB $3.25 0781-2076-01 TAMSULOSIN 0.4 MG ORAL CAP $3.25 0781-2164-60 ZIPRASIDONE HCL 20 MG ORAL CAP $3.25 16729-035-10 ANASTROZOLE 1 MG ORAL TAB $3.25 16729-318-01 OXYBUTYNIN CHLORIDE 10 MG ORAL TR24 $3.25 16729-440-10 CINACALCET 30 MG ORAL TAB $3.25 16729-440-15 CINACALCET 30 MG ORAL TAB $3.25 27241-125-02 RANOLAZINE 500 MG ORAL TB12 $3.25 42571-161-01 AMOXICILLIN-POT CLAVULANATE 500-125 MG ORAL TAB $3.25 43547-268-10 ROPINIROLE 0.25 MG ORAL TAB $3.25 43547-270-10 ROPINIROLE 1 MG ORAL TAB $3.25 43547-271-10 ROPINIROLE 2 MG ORAL TAB $3.25 50742-233-01 ACETAZOLAMIDE 500 MG ORAL CPSR $3.25 53746-145-01 HYDROCODONE-IBUPROFEN 7.5-200 MG ORAL TAB $3.25 53746-204-01 OXYCODONE-ACETAMINOPHEN 10-325 MG ORAL TAB $3.25 55111-256-60 ZIPRASIDONE HCL 20 MG ORAL CAP $3.25 57237-004-30 FLUCONAZOLE 100 MG ORAL TAB $3.25 60687-357-01 METHIMAZOLE 5 MG ORAL TAB $3.25 60687-357-11 METHIMAZOLE 5 MG ORAL TAB $3.25 60687-669-01 METHIMAZOLE 5 MG ORAL TAB $3.25 60687-669-11 METHIMAZOLE 5 MG ORAL TAB $3.25 64380-184-01 PROPAFENONE 225 MG ORAL CP12 $3.25 65162-750-09 DUTASTERIDE 0.5 MG ORAL CAP $3.25 68001-155-04 ANASTROZOLE 1 MG ORAL TAB $3.25 68084-847-01 HYDROXYZINE PAMOATE 25 MG ORAL CAP $3.25 68084-847-11 HYDROXYZINE PAMOATE 25 MG ORAL CAP $3.25 68084-875-01 MONTELUKAST 10 MG ORAL TAB $3.25 68084-875-11 MONTELUKAST 10 MG ORAL TAB $3.25 69097-410-02 CINACALCET 30 MG ORAL TAB $3.25 70748-129-06 LEFLUNOMIDE 10 MG ORAL TAB $3.25 70748-130-06 LEFLUNOMIDE 20 MG ORAL TAB $3.25 70860-776-02 ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN $3.25 70860-776-41 ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN $3.25 70954-455-10 BISOPROLOL FUMARATE 5 MG ORAL TAB $3.25 70954-456-10 BISOPROLOL FUMARATE 10 MG ORAL TAB $3.25 72205-007-92 CAPECITABINE 500 MG ORAL TAB $3.25 99999-034-66 ADENOSINE 1000 MCG / 100 ML FFR IC SOLUTION $3.25 99999-039-42 POTASSIUM CHLORIDE IN WATER 10 MEQ/100 ML IV PGBK $3.25 99999-044-29 OXYTOCIN IN 0.9 % SOD CHLORIDE 30 UNIT/500 ML IV SOLN $3.25 99999-044-31 OXYTOCIN IN 0.9 % SOD CHLORIDE 30 UNIT/500 ML IV SOLN $3.25 99999-045-77 SODIUM CHLORIDE 0.9 % IV SOLP $3.25 63739-673-10 LOSARTAN 25 MG ORAL TAB $3.24 68084-723-01 OLANZAPINE 5 MG ORAL TAB $3.24 68084-723-11 OLANZAPINE 5 MG ORAL TAB $3.24 51079-118-01 DICYCLOMINE 10 MG ORAL CAP $3.24 51079-118-20 DICYCLOMINE 10 MG ORAL CAP $3.24 51079-440-01 LEVOTHYROXINE 50 MCG ORAL TAB $3.24 51079-440-20 LEVOTHYROXINE 50 MCG ORAL TAB $3.24 59762-0182-3 VENLAFAXINE 150 MG ORAL CP24 $3.24 68084-753-25 CYCLOBENZAPRINE 5 MG ORAL TAB $3.24 68084-753-95 CYCLOBENZAPRINE 5 MG ORAL TAB $3.24 0054-4183-25 DEXAMETHASONE 2 MG ORAL TAB $3.22 0378-5615-78 LEVETIRACETAM 500 MG ORAL TAB $3.22 0904-6551-61 ONDANSETRON HCL 4 MG ORAL TAB $3.22 16714-443-01 ENALAPRIL MALEATE 5 MG ORAL TAB $3.22 51672-4039-1 ENALAPRIL MALEATE 10 MG ORAL TAB $3.22 58980-409-12 GLYCERIN (CHILD) RECTAL SUPP $3.22 64679-925-02 ENALAPRIL MALEATE 10 MG ORAL TAB $3.22 49483-221-10 NITROGLYCERIN 2.5 MG ORAL CPSR $3.22 67877-503-30 CINACALCET 30 MG ORAL TAB $3.22 68084-698-01 VENLAFAXINE 37.5 MG ORAL CP24 $3.22 68084-698-11 VENLAFAXINE 37.5 MG ORAL CP24 $3.22 0245-5317-01 POTASSIUM CHLORIDE 10 MEQ ORAL TBTQ $3.21 0406-0125-23 HYDROCODONE-ACETAMINOPHEN 10-325 MG ORAL TAB $3.21 0406-0125-62 HYDROCODONE-ACETAMINOPHEN 10-325 MG ORAL TAB $3.21 0406-0522-01 OXYCODONE-ACETAMINOPHEN 7.5-325 MG ORAL TAB $3.21 0406-0523-01 OXYCODONE-ACETAMINOPHEN 10-325 MG ORAL TAB $3.21 0904-6564-61 BENZONATATE 100 MG ORAL CAP $3.21 0904-7153-61 BENZONATATE 100 MG ORAL CAP $3.21 68084-490-01 MECLIZINE 12.5 MG ORAL TAB $3.21 68084-490-11 MECLIZINE 12.5 MG ORAL TAB $3.21 68382-525-01 BUMETANIDE 0.5 MG ORAL TAB $3.21 99999-034-37 KETAMINE 5 MG/ML ORAL SOLUTION $3.21 6817600011 MULTIVIT WITH MIN #53-FA-K-Q10 200 MCG-1,000 MCG-10 MG ORAL CAP $3.20 0904-6373-61 ROPINIROLE 0.25 MG ORAL TAB $3.20 50268-604-11 NORTRIPTYLINE 25 MG ORAL CAP $3.20 50268-604-15 NORTRIPTYLINE 25 MG ORAL CAP $3.20 31722-582-30 DULOXETINE 30 MG ORAL CPDR $3.19 43547-380-03 DULOXETINE 30 MG ORAL CPDR $3.19 60505-2996-3 DULOXETINE 30 MG ORAL CPDR $3.19 60505-2997-3 DULOXETINE 60 MG ORAL CPDR $3.19 62559-291-01 POTASSIUM CITRATE 10 MEQ (1,080 MG) ORAL TBSR $3.19 0245-5317-89 POTASSIUM CHLORIDE 10 MEQ ORAL TBTQ $3.19 0573-2883-20 PHENYLEPHRINE-COCOA BUTTER 0.25-88.44 % RECTAL SUPP $3.19 16729-019-01 MYCOPHENOLATE MOFETIL 500 MG ORAL TAB $3.19 60505-2995-6 DULOXETINE 20 MG ORAL CPDR $3.19 67877-225-01 MYCOPHENOLATE MOFETIL 500 MG ORAL TAB $3.19 0228-2631-11 ISOSORBIDE MONONITRATE 10 MG ORAL TAB $3.18 60219-2056-1 DEXAMETHASONE 2 MG ORAL TAB $3.17 60687-479-01 CARBAMAZEPINE 100 MG ORAL CHEW $3.17 60687-479-11 CARBAMAZEPINE 100 MG ORAL CHEW $3.17 0406-0124-23 HYDROCODONE-ACETAMINOPHEN 7.5-325 MG ORAL TAB $3.16 0406-0124-62 HYDROCODONE-ACETAMINOPHEN 7.5-325 MG ORAL TAB $3.16 0603-4975-21 OXYBUTYNIN CHLORIDE 5 MG ORAL TAB $3.16 0486-1111-01 POTASSIUM PHOSPHATE, MONOBASIC 500 MG ORAL TBSO $3.15 16571-664-50 METRONIDAZOLE 500 MG ORAL TAB $3.15 50111-334-02 METRONIDAZOLE 500 MG ORAL TAB $3.15 51672-2116-4 ACETAMINOPHEN 325 MG RECTAL SUPP $3.15 0591-5556-01 PROPRANOLOL 40 MG ORAL TAB $3.14 60687-173-11 MEMANTINE 5 MG ORAL TAB $3.14 60687-173-57 MEMANTINE 5 MG ORAL TAB $3.14 99999-044-20 KETAMINE 10 MG/ML INJ SOLN $3.14 0904-6376-61 OLANZAPINE 10 MG ORAL TAB $3.12 51293-811-01 PHENAZOPYRIDINE 200 MG ORAL TAB $3.12 54879-001-00 ETHAMBUTOL 100 MG ORAL TAB $3.12 65162-682-10 PHENAZOPYRIDINE 200 MG ORAL TAB $3.12 65862-503-01 AMOXICILLIN-POT CLAVULANATE 875-125 MG ORAL TAB $3.12 99998-000-02 IBUPROFEN 100 MG/5 ML ORAL SUSP $3.12 6025819309 PRENATAL VIT,CALC76-IRON-FOLIC 29 MG IRON- 1 MG ORAL TAB $3.11 31722-003-30 VENLAFAXINE 75 MG ORAL CP24 $3.11 53489-149-01 THIORIDAZINE 25 MG ORAL TAB $3.11 51660-724-15 LORATADINE-PSEUDOEPHEDRINE 10-240 MG ORAL TB24 $3.11 63739-143-10 TAMOXIFEN 10 MG ORAL TAB $3.11 0245-5317-90 POTASSIUM CHLORIDE 10 MEQ ORAL TBTQ $3.10 0832-5324-11 POTASSIUM CHLORIDE 10 MEQ ORAL TBTQ $3.10 0904-5502-61 ENALAPRIL MALEATE 5 MG ORAL TAB $3.10 63824-008-34 GUAIFENESIN 600 MG ORAL TA12 $3.10 68462-471-01 POTASSIUM CHLORIDE 10 MEQ ORAL TBTQ $3.10 6817600015 MULTIVIT-MIN #56-FA-VIT K-Q10 200 MCG-1,000 MCG-10 MG ORAL CHEW $3.09 0143-9285-20 AMOXICILLIN 875 MG ORAL TAB $3.09 50111-915-01 TORSEMIDE 5 MG ORAL TAB $3.09 50268-818-11 VENLAFAXINE 75 MG ORAL CP24 $3.09 50268-818-15 VENLAFAXINE 75 MG ORAL CP24 $3.09 68084-344-01 TOPIRAMATE 100 MG ORAL TAB $3.09 68084-344-11 TOPIRAMATE 100 MG ORAL TAB $3.09 68462-200-30 TELMISARTAN 40 MG ORAL TAB $3.09 2159934562 HYDROGEN PEROXIDE 3 % MISC SOLN $3.07 64679-924-02 ENALAPRIL MALEATE 5 MG ORAL TAB $3.07 0378-5615-05 LEVETIRACETAM 500 MG ORAL TAB $3.06 60687-464-01 LEVOTHYROXINE 50 MCG ORAL TAB $3.06 60687-464-11 LEVOTHYROXINE 50 MCG ORAL TAB $3.06 8290306424 HEPARIN, PORCINE (PF) 100 UNIT/ML IV SYRG $3.06 0054-0229-20 QUETIAPINE 50 MG ORAL TAB $3.06 0904-6639-61 QUETIAPINE 50 MG ORAL TAB $3.06 0904-6640-61 QUETIAPINE 100 MG ORAL TAB $3.06 50268-603-11 NORTRIPTYLINE 10 MG ORAL CAP $3.06 50268-603-15 NORTRIPTYLINE 10 MG ORAL CAP $3.06 HC89011704 PNEUMOCOCCAL AB(PNL)-AU $3.05 0904-6950-61 LEVOTHYROXINE 50 MCG ORAL TAB $3.05 8290306423 HEPARIN, PORCINE (PF) 100 UNIT/ML IV SYRG $3.04 0378-1049-01 DOXEPIN 10 MG ORAL CAP $3.04 0378-1809-77 LEVOTHYROXINE 100 MCG ORAL TAB $3.04 50268-399-11 HYDROXYZINE PAMOATE 50 MG ORAL CAP $3.04 50268-399-50 HYDROXYZINE PAMOATE 50 MG ORAL CAP $3.04 60687-169-01 PRAVASTATIN 10 MG ORAL TAB $3.04 60687-169-11 PRAVASTATIN 10 MG ORAL TAB $3.04 51801-011-30 POTASSIUM BICARB-CITRIC ACID 20 MEQ ORAL TBEF $3.04 51801-012-01 POTASSIUM BICARB-CITRIC ACID 20 MEQ ORAL TBEF $3.04 51801-012-30 POTASSIUM BICARB-CITRIC ACID 20 MEQ ORAL TBEF $3.04 51991-349-06 LACOSAMIDE 100 MG ORAL TAB $3.04 69543-121-10 ACARBOSE 50 MG ORAL TAB $3.04 70710-1137-3 FLUCONAZOLE 50 MG ORAL TAB $3.04 0093-7273-56 PIOGLITAZONE 45 MG ORAL TAB $3.03 0093-7273-98 PIOGLITAZONE 45 MG ORAL TAB $3.03 60687-453-01 LEVOTHYROXINE 25 MCG ORAL TAB $3.03 60687-453-11 LEVOTHYROXINE 25 MCG ORAL TAB $3.03 0054-0140-25 ACARBOSE 25 MG ORAL TAB $3.02 0378-1807-77 LEVOTHYROXINE 88 MCG ORAL TAB $3.02 53489-387-01 MINOXIDIL 10 MG ORAL TAB $3.02 62037-597-90 DILTIAZEM HCL 120 MG ORAL CP24 $3.02 69315-910-01 DIPHENOXYLATE-ATROPINE 2.5-0.025 MG ORAL TAB $3.02 0591-5643-01 MINOXIDIL 10 MG ORAL TAB $3.02 68084-214-01 BENZONATATE 100 MG ORAL CAP $3.02 68084-214-11 BENZONATATE 100 MG ORAL CAP $3.02 63739-479-10 BACLOFEN 10 MG ORAL TAB $3.01 67877-392-30 NEBIVOLOL 5 MG ORAL TAB $3.01 0832-0038-01 OXYBUTYNIN CHLORIDE 5 MG ORAL TAB $3.00 0904-5609-61 ENALAPRIL MALEATE 2.5 MG ORAL TAB $3.00 0904-6517-61 MECLIZINE 25 MG ORAL TAB $3.00 23155-621-02 CALCIUM ACETATE(PHOSPHAT BIND) 667 MG ORAL TAB $3.00 50268-632-11 QUETIAPINE 100 MG ORAL TAB $3.00 50268-632-15 QUETIAPINE 100 MG ORAL TAB $3.00 60687-598-01 PROPRANOLOL 20 MG ORAL TAB $3.00 60687-598-11 PROPRANOLOL 20 MG ORAL TAB $3.00 68462-178-01 NAPROXEN SODIUM 275 MG ORAL TAB $3.00 HC89021190 ALLERGEN IGE-EA(IMMUNOCAP ISAC)-PD $3.00 HC89017644 COPPER(PNL)-AU $3.00 HC89017651 ZINC, SERUM (PNL) -AU $3.00 8290306547 SALINE LOCK FLUSH (MCH-NICU) $2.99 0832-0038-89 OXYBUTYNIN CHLORIDE 5 MG ORAL TAB $2.99 23155-547-31 ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN $2.99 23155-547-41 ONDANSETRON HCL 2 MG/ML IV SOLN (MCH) $2.99 23155-547-42 ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN $2.99 49884-257-01 MINOXIDIL 10 MG ORAL TAB $2.99 51660-724-11 LORATADINE-PSEUDOEPHEDRINE 10-240 MG ORAL TB24 $2.99 60505-6130-0 ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN $2.99 60505-6130-5 ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN $2.99 60687-476-01 SPIRONOLACTONE 50 MG ORAL TAB $2.99 60687-476-11 SPIRONOLACTONE 50 MG ORAL TAB $2.99 68180-280-01 ETHAMBUTOL 100 MG ORAL TAB $2.98 68462-157-13 ONDANSETRON 4 MG ORAL TBDL $2.98 68462-157-40 ONDANSETRON 4 MG ORAL TBDL $2.98 55111-328-90 NATEGLINIDE 60 MG ORAL TAB $2.98 59762-0181-3 VENLAFAXINE 75 MG ORAL CP24 $2.98 75834-205-01 NATEGLINIDE 60 MG ORAL TAB $2.98 0054-8181-25 DEXAMETHASONE 1.5 MG ORAL TAB $2.97 0378-1805-77 LEVOTHYROXINE 75 MCG ORAL TAB $2.97 0832-0512-00 BETHANECHOL CHLORIDE 25 MG ORAL TAB $2.97 68382-035-16 VENLAFAXINE 75 MG ORAL CP24 $2.97 0904-6926-61 SERTRALINE 100 MG ORAL TAB $2.96 0904-6949-61 LEVOTHYROXINE 25 MCG ORAL TAB $2.96 53746-573-01 BETHANECHOL CHLORIDE 25 MG ORAL TAB $2.96 60687-670-11 OXYBUTYNIN CHLORIDE 5 MG ORAL TAB $2.96 65162-573-10 BETHANECHOL CHLORIDE 25 MG ORAL TAB $2.96 68084-354-01 OXYCODONE 5 MG ORAL TAB $2.96 68084-354-11 OXYCODONE 5 MG ORAL TAB $2.96 0406-0552-62 OXYCODONE 5 MG ORAL TAB $2.96 50742-262-01 NIFEDIPINE 90 MG ORAL TR24 $2.96 51079-721-01 MYCOPHENOLATE MOFETIL 250 MG ORAL CAP $2.96 51079-721-20 MYCOPHENOLATE MOFETIL 250 MG ORAL CAP $2.96 68084-276-01 METHIMAZOLE 10 MG ORAL TAB $2.96 68084-276-11 METHIMAZOLE 10 MG ORAL TAB $2.96 69543-120-10 ACARBOSE 25 MG ORAL TAB $2.96 99999-038-72 MORPHINE 10 MG/5 ML ORAL SOLN $2.96 0185-0129-01 BUMETANIDE 1 MG ORAL TAB $2.95 0591-4101-01 PERPHENAZINE 2 MG ORAL TAB $2.95 60687-439-01 LABETALOL 100 MG ORAL TAB $2.95 60687-439-11 LABETALOL 100 MG ORAL TAB $2.95 51079-928-01 LABETALOL 100 MG ORAL TAB $2.95 51079-928-20 LABETALOL 100 MG ORAL TAB $2.95 68382-318-18 MINOCYCLINE 100 MG ORAL CAP $2.95 99999-045-11 ANASTROZOLE 0.5 MG ORAL PARTIAL TAB $2.95 0591-3713-19 EZETIMIBE 10 MG ORAL TAB $2.94 0591-3713-30 EZETIMIBE 10 MG ORAL TAB $2.94 16714-448-01 AMITRIPTYLINE 50 MG ORAL TAB $2.93 8290306546 SODIUM CHLORIDE 0.9 % (FLUSH) INJ SYRG $2.93 0406-0552-23 OXYCODONE 5 MG ORAL TAB $2.93 0591-3543-60 BUPROPION HCL (SMOKING DETER) 150 MG ORAL TB12 $2.93 42192-339-01 HYOSCYAMINE SULFATE 0.125 MG SL SUBL $2.93 42192-340-01 HYOSCYAMINE SULFATE 0.125 MG ORAL TAB $2.93 42858-001-10 OXYCODONE 5 MG ORAL TAB $2.93 60219-1076-1 AZATHIOPRINE 50 MG ORAL TAB $2.93 68084-098-01 ATORVASTATIN 20 MG ORAL TAB $2.93 68084-098-11 ATORVASTATIN 20 MG ORAL TAB $2.93 68084-099-01 ATORVASTATIN 40 MG ORAL TAB $2.93 68084-099-11 ATORVASTATIN 40 MG ORAL TAB $2.93 99999-037-30 LACTULOSE 20 GRAM/30 ML ORAL SOLN $2.93 99999-039-95 RIBOSE ORAL POWDER $2.93 99999-045-13 SPIRONOLACTONE-HYDROCHLOROTHIAZIDE ORAL SUSP (MCH) $2.93 99999-045-83 DEXTROSE 50 % IN WATER (D50W) IV SYRG $2.93 0093-7386-56 VENLAFAXINE 150 MG ORAL CP24 $2.91 50268-402-11 HYDROCODONE-ACETAMINOPHEN 10-325 MG ORAL TAB $2.91 50268-402-15 HYDROCODONE-ACETAMINOPHEN 10-325 MG ORAL TAB $2.91 0904-6401-61 TAMSULOSIN 0.4 MG ORAL CAP $2.89 10702-169-01 DESMOPRESSIN 0.1 MG ORAL TAB $2.89 68180-114-16 LEVETIRACETAM 750 MG ORAL TAB $2.89 0378-5814-77 VALSARTAN 160 MG ORAL TAB $2.89 0904-7110-61 LABETALOL 200 MG ORAL TAB $2.89 50268-152-11 CEPHALEXIN 500 MG ORAL CAP $2.89 50268-152-15 CEPHALEXIN 500 MG ORAL CAP $2.89 65862-147-36 SUMATRIPTAN SUCCINATE 50 MG ORAL TAB $2.89 6954326790 PRENATAL VIT,CALC76-IRON-FOLIC 29 MG IRON- 1 MG ORAL TAB $2.88 45963-538-30 ONDANSETRON HCL 4 MG ORAL TAB $2.88 55111-153-30 ONDANSETRON HCL 4 MG ORAL TAB $2.88 60687-253-01 SERTRALINE 100 MG ORAL TAB $2.88 60687-253-11 SERTRALINE 100 MG ORAL TAB $2.88 63304-458-30 ONDANSETRON HCL 4 MG ORAL TAB $2.88 67877-483-30 TELMISARTAN 40 MG ORAL TAB $2.88 70710-1110-1 CYPROHEPTADINE 4 MG ORAL TAB $2.88 0904-6788-61 BENZTROPINE 0.5 MG ORAL TAB $2.87 62332-096-31 LAMOTRIGINE 25 MG ORAL TCHD $2.87 68462-229-01 LAMOTRIGINE 25 MG ORAL TCHD $2.87 0406-0123-23 HYDROCODONE-ACETAMINOPHEN 5-325 MG ORAL TAB $2.86 0406-0123-62 HYDROCODONE-ACETAMINOPHEN 5-325 MG ORAL TAB $2.86 0904-6711-46 FEXOFENADINE 180 MG ORAL TAB $2.86 13517-757-01 PHENOBARBITAL 60 MG ORAL TAB $2.86 65862-502-20 AMOXICILLIN-POT CLAVULANATE 500-125 MG ORAL TAB $2.86 68084-525-01 OLANZAPINE 2.5 MG ORAL TAB $2.86 68084-525-11 OLANZAPINE 2.5 MG ORAL TAB $2.86 0904-6353-61 LEVOFLOXACIN 750 MG ORAL TAB $2.85 51079-444-01 LEVOTHYROXINE 25 MCG ORAL TAB $2.85 51079-444-20 LEVOTHYROXINE 25 MCG ORAL TAB $2.85 68084-243-01 CLINDAMYCIN HCL 150 MG ORAL CAP $2.85 68084-243-11 CLINDAMYCIN HCL 150 MG ORAL CAP $2.85 0832-0310-11 VALPROIC ACID 250 MG ORAL CAP $2.85 0904-6516-61 MECLIZINE 12.5 MG ORAL TAB $2.85 39822-9900-2 AMMONIA AROMATIC 15 % (W/V) INHALATION SOLN $2.85 50111-456-01 OXYBUTYNIN CHLORIDE 5 MG ORAL TAB $2.84 60687-717-01 DILTIAZEM HCL 30 MG ORAL TAB $2.84 60687-717-11 DILTIAZEM HCL 30 MG ORAL TAB $2.84 0143-9285-01 AMOXICILLIN 875 MG ORAL TAB $2.83 51079-425-01 GLIMEPIRIDE 2 MG ORAL TAB $2.83 51079-425-20 GLIMEPIRIDE 2 MG ORAL TAB $2.83 99999-041-70 LOPERAMIDE 1 MG/7.5 ML ORAL LIQD $2.83 13107-014-01 GLYCOPYRROLATE 1 MG ORAL TAB $2.82 49884-065-01 GLYCOPYRROLATE 1 MG ORAL TAB $2.82 0093-0321-01 DILTIAZEM HCL 120 MG ORAL TAB $2.82 0904-6293-04 ATORVASTATIN 80 MG ORAL TAB $2.82 8290306544 SODIUM CHLORIDE 0.9 % (FLUSH) INJ SYRG $2.81 0054-0235-25 MORPHINE 15 MG ORAL TAB $2.81 0904-6705-06 PROPRANOLOL 20 MG ORAL TAB $2.81 0904-6505-61 MEMANTINE 5 MG ORAL TAB $2.80 0904-7184-61 AMITRIPTYLINE 25 MG ORAL TAB $2.80 0054-0020-25 LITHIUM CARBONATE 450 MG ORAL TBSR $2.80 0093-7272-98 PIOGLITAZONE 30 MG ORAL TAB $2.80 55111-533-01 DIVALPROEX 250 MG ORAL TB24 $2.80 60687-433-01 AMITRIPTYLINE 25 MG ORAL TAB $2.80 60687-433-11 AMITRIPTYLINE 25 MG ORAL TAB $2.80 65162-757-10 DIVALPROEX 500 MG ORAL TB24 $2.80 39822-9900-1 AMMONIA AROMATIC 15 % (W/V) INHALATION SOLN $2.79 63739-086-10 VALPROIC ACID 250 MG ORAL CAP $2.79 63739-213-10 PROMETHAZINE 25 MG ORAL TAB $2.79 63739-251-10 VALPROIC ACID 250 MG ORAL CAP $2.79 0378-0243-01 SPIRONOLACTONE 50 MG ORAL TAB $2.77 0378-0243-05 SPIRONOLACTONE 50 MG ORAL TAB $2.77 99999-006-79 LORAZEPAM 0.5 MG / ML INJ DILUTION (MCH) $2.77 0224-1852-81 PSYLLIUM HUSK (WITH SUGAR) 3.4 GRAM ORAL PWPK $2.76 55111-725-30 MONTELUKAST 10 MG ORAL TAB $2.76 55111-725-90 MONTELUKAST 10 MG ORAL TAB $2.76 60505-0094-0 DOXAZOSIN 2 MG ORAL TAB $2.76 67877-731-01 CHLORDIAZEPOXIDE-CLIDINIUM 5-2.5 MG ORAL CAP $2.76 99999-039-16 PROMETHAZINE-CODEINE 6.25-10 MG/5 ML ORAL SYRP $2.76 23155-663-01 CALCITRIOL 0.5 MCG ORAL CAP $2.76 31722-585-30 NEBIVOLOL 2.5 MG ORAL TAB $2.76 31722-586-30 NEBIVOLOL 5 MG ORAL TAB $2.76 31722-586-90 NEBIVOLOL 5 MG ORAL TAB $2.76 31722-587-30 NEBIVOLOL 10 MG ORAL TAB $2.76 60505-0033-6 PENTOXIFYLLINE 400 MG ORAL TBSR $2.75 0904-6475-61 BACLOFEN 10 MG ORAL TAB $2.74 0904-6825-61 HYDROCODONE-ACETAMINOPHEN 10-325 MG ORAL TAB $2.74 63739-145-10 MIDODRINE 5 MG ORAL TAB $2.74 51672-4146-1 PHENYTOIN 50 MG ORAL CHEW $2.74 3700074087 PSYLLIUM HUSK (WITH SUGAR) 3.4 GRAM ORAL PWPK $2.73 0228-2571-11 INDAPAMIDE 2.5 MG ORAL TAB $2.73 10135-586-01 LOXAPINE SUCCINATE 10 MG ORAL CAP $2.73 16714-659-01 VENLAFAXINE 100 MG ORAL TAB $2.73 37000-023-04 PSYLLIUM HUSK (WITH SUGAR) 3.4 GRAM ORAL PWPK $2.73 37000-023-10 PSYLLIUM HUSK (WITH SUGAR) 3.4 GRAM ORAL PWPK $2.73 99999-039-55 PENTOXIFYLLINE 20 MG/ML ORAL LIQUID (COMPOUND) $2.73 50268-551-11 METFORMIN 750 MG ORAL TB24 $2.72 50268-551-15 METFORMIN 750 MG ORAL TB24 $2.72 99999-006-84 METHYLPREDNISOLONE SODIUM SUCC 10 MG/ML INJ DILUTION (MCH) $2.72 62756-711-86 TOPIRAMATE 100 MG ORAL TAB $2.72 68084-388-01 BENZTROPINE 1 MG ORAL TAB $2.72 68084-388-11 BENZTROPINE 1 MG ORAL TAB $2.72 6126932560 FOLIC ACID-VIT B6-VIT B12 0.8-10-115 MG-MG-MCG ORAL TAB $2.71 0591-3870-44 MEMANTINE 5 MG ORAL TAB $2.71 0591-3870-45 MEMANTINE 5 MG ORAL TAB $2.71 0713-0936-81 COLESEVELAM 625 MG ORAL TAB $2.71 27808-190-01 COLESEVELAM 625 MG ORAL TAB $2.71 33342-064-10 VALSARTAN 160 MG ORAL TAB $2.71 33342-098-09 TOLTERODINE 2 MG ORAL TAB $2.71 43598-655-30 BUPROPION HCL 150 MG ORAL TB24 $2.71 55111-596-60 MEMANTINE 5 MG ORAL TAB $2.71 65862-572-90 VALSARTAN 160 MG ORAL TAB $2.71 65862-702-60 ZIPRASIDONE HCL 20 MG ORAL CAP $2.71 99999-046-43 KETAMINE 100 MG/ML INJ SOLN $2.70 51293-821-01 METHIMAZOLE 10 MG ORAL TAB $2.70 99999-042-37 SACUBITRIL-VALSARTAN 4 MG/ML (COMBINED MG CONCENTRATION) ORAL LIQUID $2.70 49884-641-01 METHIMAZOLE 10 MG ORAL TAB $2.69 51079-246-01 LORATADINE 10 MG ORAL TAB $2.69 51079-246-20 LORATADINE 10 MG ORAL TAB $2.69 60687-677-01 ALLOPURINOL 100 MG ORAL TAB $2.69 60687-677-11 ALLOPURINOL 100 MG ORAL TAB $2.69 68462-228-01 LAMOTRIGINE 5 MG ORAL TCHD $2.69 72789-131-60 ACARBOSE 25 MG ORAL TAB $2.69 0378-1803-77 LEVOTHYROXINE 50 MCG ORAL TAB $2.69 0904-6450-61 ISOSORBIDE MONONITRATE 60 MG ORAL TB24 $2.69 68084-343-01 TOPIRAMATE 50 MG ORAL TAB $2.69 68084-343-11 TOPIRAMATE 50 MG ORAL TAB $2.69 68382-916-01 METHYLPREDNISOLONE 4 MG ORAL TAB $2.68 5192712340 SODIUM BENZOATE (BULK) MISC POWD $2.67 0406-0512-23 OXYCODONE-ACETAMINOPHEN 5-325 MG ORAL TAB $2.67 0591-0605-01 LABETALOL 100 MG ORAL TAB $2.67 0832-1216-89 WARFARIN 5 MG ORAL TAB $2.67 42192-366-10 SALSALATE 750 MG ORAL TAB $2.67 49884-122-01 LABETALOL 100 MG ORAL TAB $2.67 49884-122-05 LABETALOL 100 MG ORAL TAB $2.67 51079-734-01 HALOPERIDOL 1 MG ORAL TAB $2.67 51079-734-20 HALOPERIDOL 1 MG ORAL TAB $2.67 59762-1061-1 DIPHENOXYLATE-ATROPINE 2.5-0.025 MG ORAL TAB $2.67 60687-526-01 METRONIDAZOLE 250 MG ORAL TAB $2.67 60687-526-11 METRONIDAZOLE 250 MG ORAL TAB $2.67 71247-126-01 LABETALOL 100 MG ORAL TAB $2.67 0527-1313-01 PILOCARPINE HCL 5 MG ORAL TAB $2.65 0904-6505-06 MEMANTINE 5 MG ORAL TAB $2.65 23155-724-01 LABETALOL 200 MG ORAL TAB $2.65 59762-0180-3 VENLAFAXINE 37.5 MG ORAL CP24 $2.65 0832-1216-00 WARFARIN 5 MG ORAL TAB $2.65 0832-1216-01 WARFARIN 5 MG ORAL TAB $2.65 0378-0577-01 AMILORIDE-HYDROCHLOROTHIAZIDE 5-50 MG ORAL TAB $2.64 0406-0512-62 OXYCODONE-ACETAMINOPHEN 5-325 MG ORAL TAB $2.64 33342-062-07 VALSARTAN 40 MG ORAL TAB $2.64 65862-570-30 VALSARTAN 40 MG ORAL TAB $2.64 0555-0071-01 ISONIAZID 300 MG ORAL TAB $2.63 0904-5790-61 ACYCLOVIR 400 MG ORAL TAB $2.63 50268-756-11 TORSEMIDE 20 MG ORAL TAB $2.63 50268-756-15 TORSEMIDE 20 MG ORAL TAB $2.63 99999-007-22 VANCOMYCIN 25 MG/5 ML INJ SOLN IN D5W (MCH-NICU) $2.63 0406-1146-01 METHYLPHENIDATE HCL 20 MG ORAL TAB $2.62 0904-1453-61 METRONIDAZOLE 250 MG ORAL TAB $2.62 0904-7156-61 METRONIDAZOLE 250 MG ORAL TAB $2.62 99999-040-51 CISPLATIN IV SOLN (FOR DESENSITIZATION USE) (MHS) $2.62 0904-6925-61 SERTRALINE 50 MG ORAL TAB $2.61 51672-4041-1 CARBAMAZEPINE 100 MG ORAL CHEW $2.61 50268-151-11 CEPHALEXIN 250 MG ORAL CAP $2.61 50268-151-15 CEPHALEXIN 250 MG ORAL CAP $2.61 0591-4012-01 VALPROIC ACID 250 MG ORAL CAP $2.60 0832-1214-89 WARFARIN 3 MG ORAL TAB $2.60 0832-1215-89 WARFARIN 4 MG ORAL TAB $2.60 13668-104-01 ISOSORBIDE MONONITRATE 30 MG ORAL TB24 $2.60 23155-178-01 ISOSORBIDE MONONITRATE 60 MG ORAL TB24 $2.60 51079-979-01 SPIRONOLACTONE 50 MG ORAL TAB $2.60 51079-979-20 SPIRONOLACTONE 50 MG ORAL TAB $2.60 51293-804-01 SALSALATE 750 MG ORAL TAB $2.60 51801-013-30 POTASSIUM BICARB-CITRIC ACID 10 MEQ ORAL TBEF $2.60 51801-014-30 POTASSIUM BICARB-CITRIC ACID 10 MEQ ORAL TBEF $2.60 57237-042-30 VALACYCLOVIR 500 MG ORAL TAB $2.60 59762-5210-1 PHENYTOIN 50 MG ORAL CHEW $2.60 65162-513-10 SALSALATE 750 MG ORAL TAB $2.60 65862-601-30 MODAFINIL 100 MG ORAL TAB $2.60 99999-007-03 POTASSIUM CHLORIDE 10 MEQ/25 ML INJECTION $2.60 6126932610 FOLIC ACID-VIT B6-VIT B12 2.2-25-1 MG ORAL TAB $2.59 46122-539-65 LORATADINE 10 MG ORAL TBDL $2.59 47335-756-48 IPRATROPIUM-ALBUTEROL 0.5 MG-3 MG(2.5 MG BASE)/3 ML INHALATION NEBU $2.59 57237-078-10 ONDANSETRON 8 MG ORAL TBDL $2.59 76204-600-30 IPRATROPIUM-ALBUTEROL 0.5 MG-3 MG(2.5 MG BASE)/3 ML INHALATION NEBU $2.59 76204-600-60 IPRATROPIUM-ALBUTEROL 0.5 MG-3 MG(2.5 MG BASE)/3 ML INHALATION NEBU $2.59 0054-4182-25 DEXAMETHASONE 1.5 MG ORAL TAB $2.59 0832-1214-00 WARFARIN 3 MG ORAL TAB $2.59 0832-1214-01 WARFARIN 3 MG ORAL TAB $2.59 0832-1215-00 WARFARIN 4 MG ORAL TAB $2.59 0832-1215-01 WARFARIN 4 MG ORAL TAB $2.59 16729-094-01 MYCOPHENOLATE MOFETIL 250 MG ORAL CAP $2.59 63304-901-90 FENOFIBRATE 160 MG ORAL TAB $2.58 0093-7202-10 PRAVASTATIN 40 MG ORAL TAB $2.57 0093-7202-98 PRAVASTATIN 40 MG ORAL TAB $2.57 31722-153-90 VALSARTAN 160 MG ORAL TAB $2.57 63739-567-10 TAMSULOSIN 0.4 MG ORAL CAP $2.57 49348-543-01 LORATADINE-PSEUDOEPHEDRINE 10-240 MG ORAL TB24 $2.57 63824-008-15 GUAIFENESIN 600 MG ORAL TA12 $2.56 5026858311 NIACIN 500 MG ORAL TBSR $2.56 5026858315 NIACIN 500 MG ORAL TBSR $2.56 0904-5891-61 PRAVASTATIN 10 MG ORAL TAB $2.56 60687-242-01 SERTRALINE 50 MG ORAL TAB $2.55 60687-242-11 SERTRALINE 50 MG ORAL TAB $2.55 16714-442-01 ENALAPRIL MALEATE 2.5 MG ORAL TAB $2.54 60687-642-01 OXYCODONE-ACETAMINOPHEN 5-325 MG ORAL TAB $2.54 60687-642-11 OXYCODONE-ACETAMINOPHEN 5-325 MG ORAL TAB $2.54 0054-8301-25 FUROSEMIDE 80 MG ORAL TAB $2.54 0832-1213-89 WARFARIN 2.5 MG ORAL TAB $2.54 68084-882-01 LEVETIRACETAM 750 MG ORAL TAB $2.54 68084-882-11 LEVETIRACETAM 750 MG ORAL TAB $2.54 71930-035-12 LABETALOL 100 MG ORAL TAB $2.54 0115-5522-10 FENOFIBRATE 160 MG ORAL TAB $2.53 0591-0605-05 LABETALOL 100 MG ORAL TAB $2.53 0832-1213-01 WARFARIN 2.5 MG ORAL TAB $2.53 60219-5522-9 FENOFIBRATE 160 MG ORAL TAB $2.53 63304-719-90 DILTIAZEM HCL 180 MG ORAL CP24 $2.53 65162-058-27 SEVELAMER CARBONATE 800 MG ORAL TAB $2.53 65862-921-27 SEVELAMER CARBONATE 800 MG ORAL TAB $2.53 43598-436-01 NITROGLYCERIN 0.4 MG SL SUBL $2.52 68084-108-01 ACYCLOVIR 400 MG ORAL TAB $2.52 68084-108-11 ACYCLOVIR 400 MG ORAL TAB $2.52 99999-036-40 ISRADIPINE 1 MG/ML ORAL LIQUID (COMPOUND) $2.52 63824-056-50 DEXTROMETHORPHAN-GUAIFENESIN 30-600 MG ORAL TB12 $2.52 16714-896-01 GLIPIZIDE 10 MG ORAL TR24 $2.51 31722-722-50 LEVOFLOXACIN 500 MG ORAL TAB $2.51 55111-280-50 LEVOFLOXACIN 500 MG ORAL TAB $2.51 99999-040-60 VALACYCLOVIR 50 MG/ML ORAL LIQUID $2.51 0591-0582-01 PROPAFENONE 150 MG ORAL TAB $2.50 23155-194-01 NIFEDIPINE 10 MG ORAL CAP $2.50 766784508 NICOTINE (POLACRILEX) 2 MG BUCCAL GUM $2.50 0135-0157-07 NICOTINE (POLACRILEX) 2 MG BUCCAL GUM $2.50 0955-1041-90 IRBESARTAN 150 MG ORAL TAB $2.50 60505-0170-9 PRAVASTATIN 40 MG ORAL TAB $2.50 68084-128-01 OMEPRAZOLE 20 MG ORAL CPDR $2.49 68084-128-11 OMEPRAZOLE 20 MG ORAL CPDR $2.49 68180-840-71 NORGESTIMATE-ETHINYL ESTRADIOL 0.25-35 MG-MCG ORAL TAB $2.48 68180-840-73 NORGESTIMATE-ETHINYL ESTRADIOL 0.25-35 MG-MCG ORAL TAB $2.48 5026884911 VITAMIN A PALMITATE 3,000 MCG (10,000 UNIT) ORAL CAP $2.48 5026884915 VITAMIN A PALMITATE 3,000 MCG (10,000 UNIT) ORAL CAP $2.48 0378-0144-91 TAMOXIFEN 10 MG ORAL TAB $2.48 0591-2472-60 TAMOXIFEN 10 MG ORAL TAB $2.48 59651-300-30 TAMOXIFEN 20 MG ORAL TAB $2.48 68382-826-14 TAMOXIFEN 10 MG ORAL TAB $2.48 0487-9901-30 ALBUTEROL SULFATE 2.5 MG/0.5 ML INHALATION NEBU $2.47 0591-5307-01 PROMETHAZINE 25 MG ORAL TAB $2.47 0832-1212-00 WARFARIN 2 MG ORAL TAB $2.47 0832-1212-01 WARFARIN 2 MG ORAL TAB $2.47 0832-1212-89 WARFARIN 2 MG ORAL TAB $2.47 0904-6449-61 ISOSORBIDE MONONITRATE 30 MG ORAL TB24 $2.47 0904-6656-40 ARIPIPRAZOLE 5 MG ORAL TAB $2.47 13668-132-01 FELODIPINE 2.5 MG ORAL TB24 $2.47 16714-484-01 DIVALPROEX 250 MG ORAL TB24 $2.47 16714-799-01 CETIRIZINE 10 MG ORAL TAB $2.47 51079-978-01 CARBIDOPA-LEVODOPA 25-100 MG ORAL TBSR $2.47 51079-978-20 CARBIDOPA-LEVODOPA 25-100 MG ORAL TBSR $2.47 54879-001-01 ETHAMBUTOL 100 MG ORAL TAB $2.47 65862-537-50 LEVOFLOXACIN 500 MG ORAL TAB $2.47 68462-233-01 FELODIPINE 2.5 MG ORAL TB24 $2.47 68462-234-01 FELODIPINE 5 MG ORAL TB24 $2.47 0904-6575-61 PHENOBARBITAL 32.4 MG ORAL TAB $2.46 67618-310-60 SENNOSIDES-DOCUSATE SODIUM 8.6-50 MG ORAL TAB $2.46 50268-095-11 ATORVASTATIN 40 MG ORAL TAB $2.45 50268-095-15 ATORVASTATIN 40 MG ORAL TAB $2.45 51079-565-20 THIORIDAZINE 10 MG ORAL TAB $2.45 59762-3304-3 NITROGLYCERIN 0.4 MG SL SUBL $2.45 35573-428-51 PANTOPRAZOLE 40 MG ORAL TBEC $2.44 35573-428-80 PANTOPRAZOLE 40 MG ORAL TBEC $2.44 66993-068-51 PANTOPRAZOLE 40 MG ORAL TBEC $2.44 66993-068-80 PANTOPRAZOLE 40 MG ORAL TBEC $2.44 0904-6826-61 HYDROCODONE-ACETAMINOPHEN 7.5-325 MG ORAL TAB $2.44 31722-936-12 OMEGA-3 ACID ETHYL ESTERS 1 GRAM ORAL CAP $2.44 99999-008-82 POTASSIUM CITRATE-CITRIC ACID 1,100-334 MG/5 ML ORAL SOLN $2.44 99999-036-66 ONDANSETRON HCL 2 MG ORAL PARTIAL TAB (MCH) $2.44 5026858211 NIACIN 100 MG ORAL TAB $2.43 5026858215 NIACIN 100 MG ORAL TAB $2.43 0245-0147-01 AMIODARONE 200 MG ORAL TAB $2.43 13107-070-01 DEXTROAMPHETAMINE-AMPHETAMINE 10 MG ORAL TAB $2.43 64679-923-02 ENALAPRIL MALEATE 2.5 MG ORAL TAB $2.42 0832-1211-00 WARFARIN 1 MG ORAL TAB $2.41 0832-1211-01 WARFARIN 1 MG ORAL TAB $2.41 63824-008-50 GUAIFENESIN 600 MG ORAL TA12 $2.41 0093-8192-01 CIMETIDINE 300 MG ORAL TAB $2.41 0245-0147-89 AMIODARONE 200 MG ORAL TAB $2.41 0378-0317-01 CIMETIDINE 300 MG ORAL TAB $2.41 0832-1211-89 WARFARIN 1 MG ORAL TAB $2.41 16714-453-01 QUETIAPINE 50 MG ORAL TAB $2.41 23155-192-01 BUPROPION HCL 100 MG ORAL TAB $2.41 31722-730-30 IRBESARTAN 150 MG ORAL TAB $2.41 31722-730-90 IRBESARTAN 150 MG ORAL TAB $2.41 50268-361-11 GLIPIZIDE 5 MG ORAL TAB $2.41 50268-361-15 GLIPIZIDE 5 MG ORAL TAB $2.41 51079-209-01 ATORVASTATIN 20 MG ORAL TAB $2.41 51079-209-20 ATORVASTATIN 20 MG ORAL TAB $2.41 57664-117-88 VERAPAMIL 180 MG ORAL TBSR $2.41 59746-448-30 IRBESARTAN 150 MG ORAL TAB $2.41 62332-042-30 IRBESARTAN 150 MG ORAL TAB $2.41 68084-097-01 ATORVASTATIN 10 MG ORAL TAB $2.41 68084-097-11 ATORVASTATIN 10 MG ORAL TAB $2.41 70436-155-05 PROMETHAZINE-DM 6.25-15 MG/5 ML ORAL SYRP $2.41 99999-002-42 PROMETHAZINE-DM 6.25-15 MG/5 ML ORAL SYRP $2.41 99999-006-66 METOCLOPRAMIDE HCL 5 MG/5 ML ORAL SOLN $2.41 3700074108 PSYLLIUM HUSK (ASPARTAME) 3.4 GRAM ORAL PWPK $2.40 0378-0257-01 HALOPERIDOL 1 MG ORAL TAB $2.40 0832-1520-11 HALOPERIDOL 1 MG ORAL TAB $2.40 16729-041-01 TACROLIMUS 0.5 MG ORAL CAP $2.40 37000-024-04 PSYLLIUM HUSK (ASPARTAME) 3.4 GRAM ORAL PWPK $2.40 60687-437-01 AMIODARONE 200 MG ORAL TAB $2.40 60687-437-11 AMIODARONE 200 MG ORAL TAB $2.40 68084-371-01 AMIODARONE 200 MG ORAL TAB $2.40 68084-371-11 AMIODARONE 200 MG ORAL TAB $2.40 0093-7386-98 VENLAFAXINE 150 MG ORAL CP24 $2.39 60687-281-01 NORTRIPTYLINE 10 MG ORAL CAP $2.39 60687-281-11 NORTRIPTYLINE 10 MG ORAL CAP $2.39 68462-130-01 ZONISAMIDE 100 MG ORAL CAP $2.39 69097-861-07 ZONISAMIDE 100 MG ORAL CAP $2.39 99999-038-42 CLINDAMYCIN SUBCONJUNCTIVAL INJ $2.39 0093-0311-01 LOPERAMIDE 2 MG ORAL CAP $2.39 0093-0311-05 LOPERAMIDE 2 MG ORAL CAP $2.39 0093-7620-56 LETROZOLE 2.5 MG ORAL TAB $2.39 16714-044-01 VENLAFAXINE 75 MG ORAL CP24 $2.38 51079-747-01 DILTIAZEM HCL 90 MG ORAL TAB $2.38 51079-747-20 DILTIAZEM HCL 90 MG ORAL TAB $2.38 60505-4502-9 ROSUVASTATIN 5 MG ORAL TAB $2.38 60505-4503-9 ROSUVASTATIN 10 MG ORAL TAB $2.38 60505-4504-9 ROSUVASTATIN 20 MG ORAL TAB $2.38 68180-229-07 MEMANTINE 5 MG ORAL TAB $2.38 99999-010-99 URSODIOL 25 MG/ML ORAL SUSP (COMPOUND) $2.38 0093-2064-06 CILOSTAZOL 100 MG ORAL TAB $2.37 60687-661-01 CARBIDOPA-LEVODOPA 25-100 MG ORAL TAB $2.37 60687-661-11 CARBIDOPA-LEVODOPA 25-100 MG ORAL TAB $2.37 62332-012-31 VENLAFAXINE 100 MG ORAL TAB $2.37 99998-002-31 PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIX $2.37 0093-1720-01 WARFARIN 10 MG ORAL TAB $2.37 0378-1800-77 LEVOTHYROXINE 25 MCG ORAL TAB $2.37 16714-631-02 ALENDRONATE 10 MG ORAL TAB $2.37 69452-151-20 ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) ORAL CAP $2.37 16714-035-02 LEVETIRACETAM 500 MG ORAL TAB $2.36 16714-355-02 LEVETIRACETAM 500 MG ORAL TAB $2.36 42806-339-01 DEXTROAMPHETAMINE-AMPHETAMINE 5 MG ORAL TAB $2.36 42806-341-01 DEXTROAMPHETAMINE-AMPHETAMINE 10 MG ORAL TAB $2.36 50268-094-11 ATORVASTATIN 20 MG ORAL TAB $2.36 60687-163-01 CEPHALEXIN 500 MG ORAL CAP $2.36 60687-163-11 CEPHALEXIN 500 MG ORAL CAP $2.36 65862-503-20 AMOXICILLIN-POT CLAVULANATE 875-125 MG ORAL TAB $2.36 0591-5321-01 PRIMIDONE 250 MG ORAL TAB $2.35 53746-545-01 PRIMIDONE 250 MG ORAL TAB $2.35 8068108000 COENZYME Q10 100 MG ORAL CAP $2.35 0172-4097-60 BACLOFEN 20 MG ORAL TAB $2.35 0555-0606-02 MEGESTROL 20 MG ORAL TAB $2.35 0904-6377-61 OLANZAPINE 5 MG ORAL TAB $2.35 99999-033-45 CISPLATIN IV SOLN (FOR DESENSITIZATION USE) (MHS) $2.35 0116-2001-60 CHLORHEXIDINE GLUCONATE 0.12 % MUCOUS MEMB MWSH $2.34 43598-863-60 BUPROPION HCL (SMOKING DETER) 150 MG ORAL TB12 $2.34 64380-726-06 MYCOPHENOLATE MOFETIL 250 MG ORAL CAP $2.34 67877-266-01 MYCOPHENOLATE MOFETIL 250 MG ORAL CAP $2.34 99999-001-82 CHLORHEXIDINE GLUCONATE 0.12 % MUCOUS MEMB MWSH $2.34 99999-008-64 IBUPROFEN 100 MG/5 ML ORAL SUSP $2.34 99999-044-84 DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML ORAL SYRP $2.34 33342-297-09 MEMANTINE 5 MG ORAL TAB $2.33 50268-430-11 INDOMETHACIN 25 MG ORAL CAP $2.33 50268-430-15 INDOMETHACIN 25 MG ORAL CAP $2.33 58980-409-25 GLYCERIN (CHILD) RECTAL SUPP $2.33 99999-006-74 HYDRALAZINE 0.5 MG/ML INJ DILUTION (MCH) $2.33 0378-0183-01 PROPRANOLOL 20 MG ORAL TAB $2.32 0378-3065-77 FENOFIBRATE NANOCRYSTALLIZED 48 MG ORAL TAB $2.32 0378-0053-01 CIMETIDINE 200 MG ORAL TAB (MCH) $2.31 50268-754-11 TORSEMIDE 5 MG ORAL TAB $2.31 50268-754-15 TORSEMIDE 5 MG ORAL TAB $2.31 59651-018-90 NIACIN 500 MG ORAL TB24 $2.31 65162-321-09 NIACIN 500 MG ORAL TB24 $2.31 68084-539-01 TORSEMIDE 20 MG ORAL TAB $2.31 68084-539-11 TORSEMIDE 20 MG ORAL TAB $2.31 68084-782-11 DIVALPROEX 500 MG ORAL TBEC $2.31 68084-782-61 DIVALPROEX 500 MG ORAL TBEC $2.31 69238-1124-9 NADOLOL 40 MG ORAL TAB $2.31 16714-085-02 SPIRONOLACTONE 50 MG ORAL TAB $2.31 51079-935-01 TRIAMTERENE-HYDROCHLOROTHIAZID 37.5-25 MG ORAL CAP $2.31 16714-655-01 VENLAFAXINE 25 MG ORAL TAB $2.30 45802-730-30 ACETAMINOPHEN 650 MG RECTAL SUPP $2.30 0574-7050-12 BISACODYL 10 MG RECTAL SUPP $2.30 29300-139-01 DIVALPROEX 250 MG ORAL TBEC $2.29 51079-180-01 LITHIUM CARBONATE 300 MG ORAL TBSR $2.29 51079-180-20 LITHIUM CARBONATE 300 MG ORAL TBSR $2.29 0093-1723-01 WARFARIN 7.5 MG ORAL TAB $2.28 0406-5771-62 METHADONE 10 MG ORAL TAB $2.28 0904-6823-61 GABAPENTIN 600 MG ORAL TAB $2.28 23155-288-01 ACETAZOLAMIDE 250 MG ORAL TAB $2.28 29300-155-01 ALFUZOSIN 10 MG ORAL TB24 $2.28 47335-956-88 ALFUZOSIN 10 MG ORAL TB24 $2.28 50268-400-11 HYDROCODONE-ACETAMINOPHEN 7.5-325 MG ORAL TAB $2.28 50268-400-15 HYDROCODONE-ACETAMINOPHEN 7.5-325 MG ORAL TAB $2.28 50742-239-01 MEXILETINE 150 MG ORAL CAP $2.28 60505-2850-1 ALFUZOSIN 10 MG ORAL TB24 $2.28 64380-834-06 ACETAZOLAMIDE 250 MG ORAL TAB $2.28 69452-150-20 VALPROIC ACID 250 MG ORAL CAP $2.28 70756-721-11 ACETAZOLAMIDE 250 MG ORAL TAB $2.28 59746-113-06 PROCHLORPERAZINE MALEATE 5 MG ORAL TAB $2.27 60505-3113-0 OLANZAPINE 10 MG ORAL TAB $2.27 99998-005-14 ACETAZOLAMIDE 25 MG/ML ORAL SUSP (COMPOUND) (MCH) $2.27 0904-6283-61 OLANZAPINE 2.5 MG ORAL TAB $2.24 0591-5555-01 PROPRANOLOL 20 MG ORAL TAB $2.24 0781-1764-01 IMIPRAMINE HCL 25 MG ORAL TAB $2.24 53746-641-01 FLECAINIDE 50 MG ORAL TAB $2.24 68180-590-01 RAMIPRIL 5 MG ORAL CAP $2.24 63739-228-10 SULFAMETHOXAZOLE-TRIMETHOPRIM 800-160 MG ORAL TAB $2.23 68180-469-01 LOVASTATIN 40 MG ORAL TAB $2.23 33342-063-10 VALSARTAN 80 MG ORAL TAB $2.22 50268-350-11 GEMFIBROZIL 600 MG ORAL TAB $2.22 50268-350-15 GEMFIBROZIL 600 MG ORAL TAB $2.22 65862-571-90 VALSARTAN 80 MG ORAL TAB $2.22 0904-6618-61 HYDROXYZINE HCL 50 MG ORAL TAB $2.22 50268-504-11 LOSARTAN 25 MG ORAL TAB $2.22 50268-504-15 LOSARTAN 25 MG ORAL TAB $2.22 53489-148-01 THIORIDAZINE 10 MG ORAL TAB $2.22 68084-107-01 ACYCLOVIR 200 MG ORAL CAP $2.22 68084-107-11 ACYCLOVIR 200 MG ORAL CAP $2.22 69097-856-05 FOSINOPRIL 10 MG ORAL TAB $2.22 0904-6824-61 HYDROCODONE-ACETAMINOPHEN 5-325 MG ORAL TAB $2.21 42799-119-01 BUMETANIDE 0.5 MG ORAL TAB $2.21 42799-120-01 BUMETANIDE 1 MG ORAL TAB $2.21 57664-394-88 VENLAFAXINE 50 MG ORAL TAB $2.21 68382-353-16 BUPROPION HCL 150 MG ORAL TB24 $2.21 69238-1490-1 BUMETANIDE 1 MG ORAL TAB $2.21 6498010401 SOD PHOS DI, MONO-K PHOS MONO 250 MG ORAL TAB $2.20 6936725001 SOD PHOS DI, MONO-K PHOS MONO 250 MG ORAL TAB $2.20 7135101101 SOD PHOS DI, MONO-K PHOS MONO 250 MG ORAL TAB $2.20 16714-657-01 VENLAFAXINE 50 MG ORAL TAB $2.20 50268-630-11 QUETIAPINE 25 MG ORAL TAB $2.20 50268-630-15 QUETIAPINE 25 MG ORAL TAB $2.20 5026886711 CHOLECALCIFEROL (VITAMIN D3) 50 MCG (2,000 UNIT) ORAL CAP $2.20 5026886715 CHOLECALCIFEROL (VITAMIN D3) 50 MCG (2,000 UNIT) ORAL CAP $2.20 0093-1718-01 WARFARIN 6 MG ORAL TAB $2.20 50268-505-11 LOSARTAN 50 MG ORAL TAB $2.20 50268-505-15 LOSARTAN 50 MG ORAL TAB $2.20 59762-2198-1 AZITHROMYCIN 250 MG ORAL TAB $2.20 59762-2198-3 AZITHROMYCIN 250 MG ORAL TAB $2.20 99999-036-43 AZATHIOPRINE 25 MG ORAL PARTIAL TAB $2.20 50268-521-11 METHOCARBAMOL 750 MG ORAL TAB $2.19 50268-521-15 METHOCARBAMOL 750 MG ORAL TAB $2.19 69238-1836-1 LEVOTHYROXINE 125 MCG ORAL TAB $2.19 31722-721-50 LEVOFLOXACIN 250 MG ORAL TAB $2.18 0054-0019-20 PREDNISONE 50 MG ORAL TAB $2.18 0904-7109-61 LABETALOL 100 MG ORAL TAB $2.18 42291-374-90 LETROZOLE 2.5 MG ORAL TAB $2.18 51672-4029-1 WARFARIN 2.5 MG ORAL TAB $2.18 0054-0021-25 LITHIUM CARBONATE 300 MG ORAL TBSR $2.17 0904-6637-61 GLIPIZIDE 5 MG ORAL TAB $2.17 0378-5813-77 VALSARTAN 80 MG ORAL TAB $2.17 16571-683-03 CLOMIPRAMINE 25 MG ORAL CAP $2.17 16714-631-01 ALENDRONATE 10 MG ORAL TAB $2.17 33342-089-09 RIVASTIGMINE TARTRATE 1.5 MG ORAL CAP $2.17 33342-090-09 RIVASTIGMINE TARTRATE 3 MG ORAL CAP $2.17 33342-092-09 RIVASTIGMINE TARTRATE 6 MG ORAL CAP $2.17 43547-278-03 IRBESARTAN 150 MG ORAL TAB $2.17 43547-278-09 IRBESARTAN 150 MG ORAL TAB $2.17 43547-375-09 IRBESARTAN 150 MG ORAL TAB $2.17 50228-427-30 SOLIFENACIN 5 MG ORAL TAB $2.17 50228-427-90 SOLIFENACIN 5 MG ORAL TAB $2.17 57237-003-30 FLUCONAZOLE 50 MG ORAL TAB $2.17 57237-018-30 DULOXETINE 30 MG ORAL CPDR $2.17 57237-019-30 DULOXETINE 60 MG ORAL CPDR $2.17 60505-3110-3 OLANZAPINE 2.5 MG ORAL TAB $2.17 62332-131-30 OLMESARTAN 5 MG ORAL TAB $2.17 65862-146-36 SUMATRIPTAN SUCCINATE 25 MG ORAL TAB $2.17 69238-1420-3 SILODOSIN 8 MG ORAL CAP $2.17 487900760 SODIUM CHLORIDE 7 % INHALATION NEBU $2.16 62584-994-01 WARFARIN 5 MG ORAL TAB $2.16 62584-994-11 WARFARIN 5 MG ORAL TAB $2.16 0904-6808-06 MONTELUKAST 10 MG ORAL TAB $2.15 99999-042-01 MISOPROSTOL 50 MCG ORAL PARTIAL TAB (USING 100 MCG TAB) $2.15 0378-0373-01 HYDROXYCHLOROQUINE 200 MG ORAL TAB $2.15 0406-5771-23 METHADONE 10 MG ORAL TAB $2.15 0591-2729-01 POTASSIUM CITRATE 10 MEQ (1,080 MG) ORAL TBSR $2.15 0904-5959-61 CLINDAMYCIN HCL 150 MG ORAL CAP $2.15 0904-6808-61 MONTELUKAST 10 MG ORAL TAB $2.15 0904-7041-61 ALLOPURINOL 100 MG ORAL TAB $2.15 64380-759-06 ACARBOSE 50 MG ORAL TAB $2.15 99999-036-31 MINERAL OIL ORAL OIL $2.15 42806-549-09 DUTASTERIDE 0.5 MG ORAL CAP $2.14 0904-6966-61 OXYCODONE 5 MG ORAL TAB $2.13 31722-537-12 LEVETIRACETAM 500 MG ORAL TAB $2.13 50268-431-11 INDOMETHACIN 50 MG ORAL CAP $2.13 50268-431-15 INDOMETHACIN 50 MG ORAL CAP $2.13 7643935310 FOLIC ACID-VIT B6-VIT B12 2.2-25-1 MG ORAL TAB $2.13 16714-713-01 TAMSULOSIN 0.4 MG ORAL CAP $2.13 68180-589-01 RAMIPRIL 2.5 MG ORAL CAP $2.13 0054-0019-25 PREDNISONE 50 MG ORAL TAB $2.12 16714-647-01 PIOGLITAZONE 45 MG ORAL TAB $2.12 0832-7124-11 DIVALPROEX 500 MG ORAL TBEC $2.11 0904-6861-90 DIVALPROEX 500 MG ORAL TBEC $2.11 31722-152-90 VALSARTAN 80 MG ORAL TAB $2.11 60687-327-01 QUETIAPINE 25 MG ORAL TAB $2.11 60687-327-11 QUETIAPINE 25 MG ORAL TAB $2.11 65162-506-06 INDOMETHACIN 75 MG ORAL CPSR $2.11 65862-528-30 VENLAFAXINE 75 MG ORAL CP24 $2.11 65862-528-90 VENLAFAXINE 75 MG ORAL CP24 $2.11 99999-036-38 DANTROLENE 5 MG/ML ORAL LIQUID $2.11 60687-152-01 CEPHALEXIN 250 MG ORAL CAP $2.11 60687-152-11 CEPHALEXIN 250 MG ORAL CAP $2.11 99999-036-68 TIZANIDINE 1 MG ORAL PARTIAL TAB (MCH) $2.11 0023-4554-30 CARBOXYMETHYLCELLULOSE SODIUM 1 % OPHT DPGE $2.10 0904-7058-61 METHOCARBAMOL 750 MG ORAL TAB $2.10 68084-045-01 PAROXETINE HCL 20 MG ORAL TAB $2.10 68084-045-11 PAROXETINE HCL 20 MG ORAL TAB $2.10 68462-293-01 VERAPAMIL 180 MG ORAL TBSR $2.10 59746-363-90 VALSARTAN 320 MG ORAL TAB $2.09 0093-0320-01 DILTIAZEM HCL 90 MG ORAL TAB $2.09 16714-821-01 METHYLPHENIDATE HCL 5 MG ORAL TAB $2.09 50268-534-11 METRONIDAZOLE 250 MG ORAL TAB $2.09 50268-534-15 METRONIDAZOLE 250 MG ORAL TAB $2.09 59746-001-06 METHYLPREDNISOLONE 4 MG ORAL TAB $2.09 68084-027-01 WARFARIN 2.5 MG ORAL TAB $2.09 68084-027-11 WARFARIN 2.5 MG ORAL TAB $2.09 3676542001 MAGNESIUM L-LACTATE 84 MG ORAL TBSR $2.08 3676542019 MAGNESIUM L-LACTATE 84 MG ORAL TBSR $2.08 5901642019 MAGNESIUM L-LACTATE 84 MG ORAL TBSR $2.08 51293-611-01 PHENAZOPYRIDINE 100 MG ORAL TAB $2.08 51293-810-01 PHENAZOPYRIDINE 100 MG ORAL TAB $2.08 65162-681-10 PHENAZOPYRIDINE 100 MG ORAL TAB $2.08 65862-536-50 LEVOFLOXACIN 250 MG ORAL TAB $2.08 75826-114-10 PHENAZOPYRIDINE 100 MG ORAL TAB $2.08 99999-006-60 METHADONE 5 MG/5 ML ORAL SOLN $2.08 99999-036-65 MINOXIDIL 5 MG ORAL PARTIAL TAB (MCH) $2.08 99999-044-18 PHENYLEPHRINE 100 MCG/ML INJ DILUTION $2.08 0406-8515-01 OXYCODONE 15 MG ORAL TAB $2.07 16714-813-02 EZETIMIBE 10 MG ORAL TAB $2.07 47335-904-88 QUETIAPINE 100 MG ORAL TAB $2.07 99998-005-27 CEFOXITIN 50 MG/ML IV SOLN (MCH) $2.07 0093-2065-06 CILOSTAZOL 50 MG ORAL TAB $2.07 0228-2597-11 INDAPAMIDE 1.25 MG ORAL TAB $2.07 0904-6292-61 ATORVASTATIN 40 MG ORAL TAB $2.07 72603-118-01 MEMANTINE 5 MG ORAL TAB $2.07 0228-2550-11 DICLOFENAC SODIUM 50 MG ORAL TBEC $2.06 53746-572-01 BETHANECHOL CHLORIDE 10 MG ORAL TAB $2.06 59762-0542-1 GLIPIZIDE 10 MG ORAL TR24 $2.06 62584-984-11 WARFARIN 2 MG ORAL TAB $2.06 65162-572-10 BETHANECHOL CHLORIDE 10 MG ORAL TAB $2.06 68084-618-11 ESCITALOPRAM OXALATE 20 MG ORAL TAB $2.06 23155-106-01 HYDROXYZINE HCL 25 MG ORAL TAB $2.05 51079-753-01 SUCRALFATE 1 GRAM ORAL TAB $2.05 51079-753-20 SUCRALFATE 1 GRAM ORAL TAB $2.05 51079-810-20 GLIPIZIDE 5 MG ORAL TAB $2.05 68382-773-05 EZETIMIBE 10 MG ORAL TAB $2.05 68382-773-06 EZETIMIBE 10 MG ORAL TAB $2.05 68382-773-16 EZETIMIBE 10 MG ORAL TAB $2.05 99998-000-01 IBUPROFEN 100 MG/5 ML ORAL SUSP $2.05 99999-005-60 GENTAMICIN 2 MG/ML INJ SOLN IN D5W (MCH-NICU) $2.05 16729-278-01 ARIPIPRAZOLE 2 MG ORAL TAB $2.04 16729-278-10 ARIPIPRAZOLE 2 MG ORAL TAB $2.04 16729-279-01 ARIPIPRAZOLE 5 MG ORAL TAB $2.04 16729-280-01 ARIPIPRAZOLE 10 MG ORAL TAB $2.04 51079-205-01 ALLOPURINOL 100 MG ORAL TAB $2.04 51079-205-20 ALLOPURINOL 100 MG ORAL TAB $2.04 5026886811 CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) ORAL CAP $2.04 5026886815 CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) ORAL CAP $2.04 42799-605-01 LOPERAMIDE 2 MG ORAL CAP $2.03 0093-9147-01 VENLAFAXINE 25 MG ORAL TAB $2.02 57237-018-90 DULOXETINE 30 MG ORAL CPDR $2.02 57237-019-90 DULOXETINE 60 MG ORAL CPDR $2.02 16729-486-01 METHOTREXATE SODIUM 2.5 MG ORAL TAB $2.02 42291-412-60 DOFETILIDE 250 MCG ORAL CAP $2.02 57237-159-01 REPAGLINIDE 2 MG ORAL TAB $2.02 57664-745-88 REPAGLINIDE 1 MG ORAL TAB $2.02 60687-568-01 METHOCARBAMOL 750 MG ORAL TAB $2.02 60687-568-11 METHOCARBAMOL 750 MG ORAL TAB $2.02 65862-670-01 REPAGLINIDE 0.5 MG ORAL TAB $2.02 65862-671-01 REPAGLINIDE 1 MG ORAL TAB $2.02 65862-672-01 REPAGLINIDE 2 MG ORAL TAB $2.02 68180-589-02 RAMIPRIL 2.5 MG ORAL CAP $2.02 68382-144-06 RAMIPRIL 1.25 MG ORAL CAP $2.02 68462-260-01 VERAPAMIL 240 MG ORAL TBSR $2.02 0054-8174-25 DEXAMETHASONE 1 MG ORAL TAB $2.01 51079-208-01 ATORVASTATIN 10 MG ORAL TAB $2.01 51079-208-20 ATORVASTATIN 10 MG ORAL TAB $2.01 62584-734-01 HYDRALAZINE 50 MG ORAL TAB $2.01 62584-734-11 HYDRALAZINE 50 MG ORAL TAB $2.01 0054-0709-20 METHADONE 5 MG ORAL TAB $2.00 0406-5755-62 METHADONE 5 MG ORAL TAB $2.00 0904-7243-61 CIPROFLOXACIN HCL 500 MG ORAL TAB $2.00 45802-732-00 ACETAMINOPHEN 120 MG RECTAL SUPP $2.00 45802-732-30 ACETAMINOPHEN 120 MG RECTAL SUPP $2.00 51079-544-01 ESCITALOPRAM OXALATE 20 MG ORAL TAB $2.00 57237-018-99 DULOXETINE 30 MG ORAL CPDR $2.00 69238-1305-1 CLOBAZAM 10 MG ORAL TAB $2.00 HC89016190 BILE ACID FRACTIONATED-QD $2.00 HC89016372 ELECTRON MICROSCOPY-QD $2.00 HC89016224 FLOW CYT MKR TC ADD+-QD $2.00 HC89016232 GIARDIA AB IFA-QD $2.00 HC89016307 PARASITE IDENTIFICATION(O&P)QD $2.00 HC89016315 REVERSE T3-QD $2.00 0555-0886-02 ESTRADIOL 1 MG ORAL TAB $2.00 0555-0886-04 ESTRADIOL 1 MG ORAL TAB $2.00 42858-501-03 BUPRENORPHINE HCL 2 MG SL SUBL $2.00 50268-755-11 TORSEMIDE 10 MG ORAL TAB $2.00 50268-755-15 TORSEMIDE 10 MG ORAL TAB $2.00 65162-897-03 ARIPIPRAZOLE 5 MG ORAL TAB $1.99 65162-897-09 ARIPIPRAZOLE 5 MG ORAL TAB $1.99 65162-898-03 ARIPIPRAZOLE 10 MG ORAL TAB $1.99 65862-661-30 ARIPIPRAZOLE 2 MG ORAL TAB $1.99 65862-662-30 ARIPIPRAZOLE 5 MG ORAL TAB $1.99 65862-663-30 ARIPIPRAZOLE 10 MG ORAL TAB $1.99 68462-293-05 VERAPAMIL 180 MG ORAL TBSR $1.99 42806-011-01 SULINDAC 200 MG ORAL TAB $1.98 50111-333-01 METRONIDAZOLE 250 MG ORAL TAB $1.98 60687-113-01 CLONIDINE HCL 0.1 MG ORAL TAB $1.98 60687-113-11 CLONIDINE HCL 0.1 MG ORAL TAB $1.98 60687-124-01 CLONIDINE HCL 0.2 MG ORAL TAB $1.98 60687-124-11 CLONIDINE HCL 0.2 MG ORAL TAB $1.98 31722-778-01 ACYCLOVIR 800 MG ORAL TAB $1.97 60505-5307-1 ACYCLOVIR 800 MG ORAL TAB $1.97 61442-113-01 ACYCLOVIR 800 MG ORAL TAB $1.97 68084-738-01 METHADONE 10 MG ORAL TAB $1.97 68084-738-11 METHADONE 10 MG ORAL TAB $1.97 0904-6291-61 ATORVASTATIN 20 MG ORAL TAB $1.96 59762-5310-1 PRAZOSIN 1 MG ORAL CAP $1.96 60687-528-11 CIPROFLOXACIN HCL 250 MG ORAL TAB $1.96 29300-150-01 QUETIAPINE 200 MG ORAL TAB $1.96 59762-0156-1 ATORVASTATIN 20 MG ORAL TAB $1.96 59762-0156-2 ATORVASTATIN 20 MG ORAL TAB $1.96 59762-0157-1 ATORVASTATIN 40 MG ORAL TAB $1.96 59762-0158-1 ATORVASTATIN 80 MG ORAL TAB $1.96 60505-2579-8 ATORVASTATIN 20 MG ORAL TAB $1.96 60505-2579-9 ATORVASTATIN 20 MG ORAL TAB $1.96 60505-2580-8 ATORVASTATIN 40 MG ORAL TAB $1.96 60505-2580-9 ATORVASTATIN 40 MG ORAL TAB $1.96 60505-2671-8 ATORVASTATIN 80 MG ORAL TAB $1.96 60505-2671-9 ATORVASTATIN 80 MG ORAL TAB $1.96 0054-0264-24 HYDROMORPHONE 4 MG ORAL TAB $1.95 0487-0201-00 IPRATROPIUM-ALBUTEROL 0.5 MG-3 MG(2.5 MG BASE)/3 ML INHALATION NEBU $1.95 0487-0201-03 IPRATROPIUM-ALBUTEROL 0.5 MG-3 MG(2.5 MG BASE)/3 ML INHALATION NEBU $1.95 0487-0201-60 IPRATROPIUM-ALBUTEROL 0.5 MG-3 MG(2.5 MG BASE)/3 ML INHALATION NEBU $1.95 0603-1586-05 PROMETHAZINE-DM 6.25-15 MG/5 ML ORAL SYRP $1.95 0781-2248-01 DICLOXACILLIN 250 MG ORAL CAP $1.95 0904-6474-61 PANTOPRAZOLE 40 MG ORAL TBEC $1.95 16729-034-10 LETROZOLE 2.5 MG ORAL TAB $1.95 37000-024-10 PSYLLIUM HUSK (ASPARTAME) 3.4 GRAM ORAL PWPK $1.95 50268-728-11 SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG ORAL TAB (MCH) $1.95 50268-728-15 SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG ORAL TAB (MCH) $1.95 51991-746-90 DULOXETINE 20 MG ORAL CPDR $1.95 51991-759-33 LETROZOLE 2.5 MG ORAL TAB $1.95 53489-120-02 DOXYCYCLINE HYCLATE 100 MG ORAL TAB $1.95 53489-120-05 DOXYCYCLINE HYCLATE 100 MG ORAL TAB $1.95 57237-017-60 DULOXETINE 20 MG ORAL CPDR $1.95 59651-180-30 LETROZOLE 2.5 MG ORAL TAB $1.95 60687-570-01 PRAMIPEXOLE 0.25 MG ORAL TAB $1.95 60687-570-11 PRAMIPEXOLE 0.25 MG ORAL TAB $1.95 62332-032-31 ROPINIROLE 1 MG ORAL TAB $1.95 62332-033-31 ROPINIROLE 2 MG ORAL TAB $1.95 62756-183-88 OXCARBAZEPINE 150 MG ORAL TAB $1.95 64380-758-06 ACARBOSE 25 MG ORAL TAB $1.95 65862-909-01 CELECOXIB 200 MG ORAL CAP $1.95 68462-137-01 OXCARBAZEPINE 150 MG ORAL TAB $1.95 69097-173-53 IPRATROPIUM-ALBUTEROL 0.5 MG-3 MG(2.5 MG BASE)/3 ML INHALATION NEBU $1.95 69097-862-83 CALCIUM ACETATE(PHOSPHAT BIND) 667 MG ORAL CAP $1.95 69238-1154-3 EZETIMIBE 10 MG ORAL TAB $1.95 69452-143-20 BENZONATATE 100 MG ORAL CAP $1.95 50268-520-11 METHOCARBAMOL 500 MG ORAL TAB $1.94 50268-520-15 METHOCARBAMOL 500 MG ORAL TAB $1.94 51079-201-01 METHYLDOPA 500 MG ORAL TAB $1.94 51079-201-20 METHYLDOPA 500 MG ORAL TAB $1.94 99999-041-64 MORPHINE (PF) 0.5 MG/ML INJ SOLN $1.94 68084-342-01 TOPIRAMATE 25 MG ORAL TAB $1.94 68084-342-11 TOPIRAMATE 25 MG ORAL TAB $1.94 0378-3515-93 MIRTAZAPINE 15 MG ORAL TAB $1.93 13107-031-34 MIRTAZAPINE 15 MG ORAL TAB $1.93 51862-856-01 CARBIDOPA-LEVODOPA 25-100 MG ORAL TAB $1.93 53746-514-01 SPIRONOLACTONE 50 MG ORAL TAB $1.93 53746-514-05 SPIRONOLACTONE 50 MG ORAL TAB $1.93 57237-008-30 MIRTAZAPINE 15 MG ORAL TAB $1.93 60505-0247-1 MIRTAZAPINE 15 MG ORAL TAB $1.93 62756-518-88 CARBIDOPA-LEVODOPA 25-100 MG ORAL TAB $1.93 0904-6993-61 AMIODARONE 200 MG ORAL TAB $1.92 10702-016-06 INDOMETHACIN 75 MG ORAL CPSR $1.92 68180-122-01 CEPHALEXIN 500 MG ORAL CAP $1.92 68462-224-01 LITHIUM CARBONATE 450 MG ORAL TBSR $1.92 50268-093-11 ATORVASTATIN 10 MG ORAL TAB $1.92 50268-093-15 ATORVASTATIN 10 MG ORAL TAB $1.92 99999-036-50 CLONAZEPAM 0.1 MG/ML ORAL LIQUID (USING 1 MG TAB) $1.92 29033-003-01 SUCRALFATE 1 GRAM ORAL TAB $1.91 42291-413-60 DOFETILIDE 500 MCG ORAL CAP $1.91 0228-2540-10 CARBIDOPA-LEVODOPA 25-250 MG ORAL TAB $1.90 42291-773-60 RANOLAZINE 500 MG ORAL TB12 $1.90 70756-703-60 RANOLAZINE 500 MG ORAL TB12 $1.90 16714-332-01 GABAPENTIN 800 MG ORAL TAB $1.89 0406-5755-23 METHADONE 5 MG ORAL TAB $1.89 0591-0844-01 GLIPIZIDE 5 MG ORAL TR24 $1.89 0781-5690-92 EZETIMIBE 10 MG ORAL TAB $1.89 0832-7124-89 DIVALPROEX 500 MG ORAL TBEC $1.89 0904-6638-61 QUETIAPINE 25 MG ORAL TAB $1.89 0904-7083-61 CIPROFLOXACIN HCL 500 MG ORAL TAB $1.89 50742-114-01 DESIPRAMINE 50 MG ORAL TAB $1.89 68084-248-01 LORATADINE 10 MG ORAL TAB $1.89 68084-248-11 LORATADINE 10 MG ORAL TAB $1.89 0591-0900-30 GLIPIZIDE 2.5 MG ORAL TR24 $1.88 0832-7124-01 DIVALPROEX 500 MG ORAL TBEC $1.88 51079-733-01 HALOPERIDOL 0.5 MG ORAL TAB $1.88 51079-733-20 HALOPERIDOL 0.5 MG ORAL TAB $1.88 0904-6019-46 BICALUTAMIDE 50 MG ORAL TAB $1.87 16714-656-01 VENLAFAXINE 37.5 MG ORAL TAB $1.87 68180-122-02 CEPHALEXIN 500 MG ORAL CAP $1.87 7733383510 SODIUM CHLORIDE 1,000 MG MISC TBSO $1.87 7733383525 SODIUM CHLORIDE 1,000 MG MISC TBSO $1.87 0023-0506-01 POLYVINYL ALCOHOL-POVIDON(PF) 1.4-0.6 % OPHT DPET $1.87 23155-723-01 LABETALOL 100 MG ORAL TAB $1.87 63739-564-10 PANTOPRAZOLE 40 MG ORAL TBEC $1.87 76385-114-01 SOTALOL 80 MG ORAL TAB $1.87 0591-5660-01 SULINDAC 200 MG ORAL TAB $1.86 0603-2213-21 AMITRIPTYLINE 25 MG ORAL TAB $1.86 0781-1487-01 AMITRIPTYLINE 25 MG ORAL TAB $1.86 59762-0074-1 HYDROCORTISONE 10 MG ORAL TAB $1.86 0093-7385-98 VENLAFAXINE 75 MG ORAL CP24 $1.85 0378-0182-01 PROPRANOLOL 10 MG ORAL TAB $1.85 16714-175-03 ATORVASTATIN 40 MG ORAL TAB $1.85 50268-740-11 TAMSULOSIN 0.4 MG ORAL CAP $1.85 50268-740-15 TAMSULOSIN 0.4 MG ORAL CAP $1.85 51079-051-01 PANTOPRAZOLE 40 MG ORAL TBEC $1.85 51079-051-20 PANTOPRAZOLE 40 MG ORAL TBEC $1.85 53489-328-01 SPIRONOLACTONE 50 MG ORAL TAB $1.85 63739-787-10 LEVETIRACETAM 750 MG ORAL TAB $1.85 99999-007-60 HYDROCORTISONE 10 MG/5 ML ORAL SUSP (COMPOUND) (MCH) $1.85 99999-040-66 MULTIVIT-MIN-FERROUS GLUCONATE 9 MG IRON/15 ML ORAL LIQD $1.85 4116700607 DOXYLAMINE SUCCINATE 25 MG ORAL TAB $1.85 5026837511 GLUCOSAMINE SULFATE 500 MG ORAL CAP $1.85 5026837515 GLUCOSAMINE SULFATE 500 MG ORAL CAP $1.85 0378-0137-01 ALLOPURINOL 100 MG ORAL TAB $1.85 0603-2115-32 ALLOPURINOL 100 MG ORAL TAB $1.85 0904-6053-61 LEVETIRACETAM 750 MG ORAL TAB $1.85 0904-7125-61 LEVETIRACETAM 750 MG ORAL TAB $1.85 16714-035-01 LEVETIRACETAM 500 MG ORAL TAB $1.85 16714-355-01 LEVETIRACETAM 500 MG ORAL TAB $1.85 16714-454-01 QUETIAPINE 100 MG ORAL TAB $1.85 41167-00606 DOXYLAMINE SUCCINATE 25 MG ORAL TAB $1.85 16571-201-06 DICLOFENAC SODIUM 75 MG ORAL TBEC $1.84 0591-0348-01 TRIAMTERENE-HYDROCHLOROTHIAZID 75-50 MG ORAL TAB $1.83 60505-2657-1 TRIAMTERENE-HYDROCHLOROTHIAZID 75-50 MG ORAL TAB $1.83 99999-006-56 LEVOTHYROXINE 25 MCG/ML ORAL SUSP (COMPOUND) $1.83 16714-175-01 ATORVASTATIN 40 MG ORAL TAB $1.83 16714-176-01 ATORVASTATIN 80 MG ORAL TAB $1.83 42291-562-90 MIDODRINE 10 MG ORAL TAB $1.83 60505-0080-0 SOTALOL 80 MG ORAL TAB $1.83 0093-1061-01 SOTALOL 80 MG ORAL TAB $1.82 0228-2820-11 HYDROCHLOROTHIAZIDE 12.5 MG ORAL TAB $1.82 23155-137-01 HYDROCHLOROTHIAZIDE 12.5 MG ORAL TAB $1.82 23155-191-01 BUPROPION HCL 75 MG ORAL TAB $1.82 24689-119-01 BUPROPION HCL 75 MG ORAL TAB $1.82 29033-003-05 SUCRALFATE 1 GRAM ORAL TAB $1.82 62584-267-01 METOPROLOL TARTRATE 100 MG ORAL TAB $1.82 62584-267-11 METOPROLOL TARTRATE 100 MG ORAL TAB $1.82 69238-1100-5 DOXYCYCLINE HYCLATE 100 MG ORAL CAP $1.82 99999-036-27 NITROGLYCERIN 100 MCG / ML INJECTION $1.82 99999-040-50 CEFEPIME 40 MG/ML INJ SYRINGE $1.82 0904-7093-61 OXYCODONE-ACETAMINOPHEN 5-325 MG ORAL TAB $1.81 45802-730-00 ACETAMINOPHEN 650 MG RECTAL SUPP $1.81 45802-730-32 ACETAMINOPHEN 650 MG RECTAL SUPP $1.81 0406-0483-01 ACETAMINOPHEN-CODEINE 300-15 MG ORAL TAB $1.81 16714-159-01 ONDANSETRON HCL 4 MG ORAL TAB $1.81 50268-585-11 PANTOPRAZOLE 20 MG ORAL TBEC $1.81 50268-585-15 PANTOPRAZOLE 20 MG ORAL TBEC $1.81 57237-114-90 ALFUZOSIN 10 MG ORAL TB24 $1.81 0228-2540-50 CARBIDOPA-LEVODOPA 25-250 MG ORAL TAB $1.80 0245-0147-60 AMIODARONE 200 MG ORAL TAB $1.80 51079-076-01 HYDRALAZINE 50 MG ORAL TAB $1.80 51079-076-20 HYDRALAZINE 50 MG ORAL TAB $1.80 0023-0403-30 CARBOXYMETHYLCELLULOSE SODIUM 0.5 % OPHT DPET $1.79 0378-1352-01 TRIAMTERENE-HYDROCHLOROTHIAZID 37.5-25 MG ORAL TAB $1.79 0591-5554-01 PROPRANOLOL 10 MG ORAL TAB $1.79 0904-6928-61 TOPIRAMATE 25 MG ORAL TAB $1.79 50742-261-01 NIFEDIPINE 60 MG ORAL TR24 $1.79 60505-2656-1 TRIAMTERENE-HYDROCHLOROTHIAZID 37.5-25 MG ORAL TAB $1.79 68382-132-01 TAMSULOSIN 0.4 MG ORAL CAP $1.79 68382-132-10 TAMSULOSIN 0.4 MG ORAL CAP $1.79 99999-000-03 AMINOPHYLLINE 5 MG/ML NICU IV DILUTION $1.79 99999-042-31 OXCARBAZEPINE 150 MG ORAL PARTIAL TAB $1.79 0591-5337-10 TRIHEXYPHENIDYL 5 MG ORAL TAB $1.78 16714-646-02 PIOGLITAZONE 30 MG ORAL TAB $1.77 59651-052-90 EZETIMIBE 10 MG ORAL TAB $1.77 59762-0104-5 SULFASALAZINE 500 MG ORAL TBEC $1.77 68084-271-01 RISPERIDONE 0.5 MG ORAL TAB $1.77 68084-271-11 RISPERIDONE 0.5 MG ORAL TAB $1.77 5026886611 CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) ORAL TAB $1.76 5026886615 CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) ORAL TAB $1.76 62559-230-01 PROPAFENONE 150 MG ORAL TAB $1.76 64380-723-06 CALCITRIOL 0.25 MCG ORAL CAP $1.76 69452-207-13 CALCITRIOL 0.25 MCG ORAL CAP $1.76 69452-207-20 CALCITRIOL 0.25 MCG ORAL CAP $1.76 0093-2210-01 SUCRALFATE 1 GRAM ORAL TAB $1.76 0093-7201-10 PRAVASTATIN 20 MG ORAL TAB $1.76 0093-7201-98 PRAVASTATIN 20 MG ORAL TAB $1.76 0185-0144-60 AMIODARONE 200 MG ORAL TAB $1.76 0527-4118-37 PROPRANOLOL 120 MG ORAL CS24 $1.76 0591-3541-25 BUPROPION HCL 150 MG ORAL SR12 $1.76 0591-3541-60 BUPROPION HCL 150 MG ORAL SR12 $1.76 16714-354-01 LEVETIRACETAM 250 MG ORAL TAB $1.76 29300-359-16 AMIODARONE 200 MG ORAL TAB $1.76 47335-737-86 BUPROPION HCL 150 MG ORAL SR12 $1.76 50268-595-11 NAPROXEN 375 MG ORAL TAB $1.76 50268-595-15 NAPROXEN 375 MG ORAL TAB $1.76 51862-241-90 AMIODARONE 200 MG ORAL TAB $1.76 60687-657-01 LEVETIRACETAM 500 MG ORAL TAB $1.76 60687-657-11 LEVETIRACETAM 500 MG ORAL TAB $1.76 68382-227-14 AMIODARONE 200 MG ORAL TAB $1.76 99999-036-63 HYDROXYZINE HCL 5 MG ORAL PARTIAL TAB (MCH) $1.76 0406-0484-62 ACETAMINOPHEN-CODEINE 300-30 MG ORAL TAB $1.75 16714-072-04 BACLOFEN 20 MG ORAL TAB $1.74 51079-746-01 DILTIAZEM HCL 60 MG ORAL TAB $1.74 51079-746-20 DILTIAZEM HCL 60 MG ORAL TAB $1.74 62756-518-18 CARBIDOPA-LEVODOPA 25-100 MG ORAL TAB $1.74 1093991244 GUAIFENESIN 600 MG ORAL TA12 $1.74 0023-5487-30 CARBOXYMETHYLCELLULOSE SODIUM 0.5 % OPHT DPET $1.74 0378-5807-93 VALSARTAN 40 MG ORAL TAB $1.74 0904-6986-40 GUAIFENESIN 600 MG ORAL TA12 $1.74 13107-031-05 MIRTAZAPINE 15 MG ORAL TAB $1.74 31722-820-30 ARIPIPRAZOLE 5 MG ORAL TAB $1.74 33342-048-07 IRBESARTAN 150 MG ORAL TAB $1.74 59762-0540-1 GLIPIZIDE 2.5 MG ORAL TR24 $1.74 62559-532-01 PROPRANOLOL 120 MG ORAL CS24 $1.74 68462-678-60 LACOSAMIDE 50 MG ORAL TAB $1.74 70677-0055-1 GUAIFENESIN 600 MG ORAL TA12 $1.74 0093-0811-01 NORTRIPTYLINE 25 MG ORAL CAP $1.73 16714-795-01 TERBINAFINE HCL 250 MG ORAL TAB $1.73 51672-4002-1 NORTRIPTYLINE 25 MG ORAL CAP $1.73 0093-0771-98 PRAVASTATIN 10 MG ORAL TAB $1.72 0555-0779-02 MEDROXYPROGESTERONE 10 MG ORAL TAB $1.72 0591-5694-01 MINOCYCLINE 50 MG ORAL CAP $1.72 0591-5694-60 MINOCYCLINE 50 MG ORAL CAP $1.72 31722-151-30 VALSARTAN 40 MG ORAL TAB $1.72 31722-745-30 VALSARTAN 40 MG ORAL TAB $1.72 51991-348-06 LACOSAMIDE 50 MG ORAL TAB $1.72 62756-250-83 ANASTROZOLE 1 MG ORAL TAB $1.72 65162-837-03 VALSARTAN 40 MG ORAL TAB $1.72 65862-732-05 AMIODARONE 200 MG ORAL TAB $1.72 68084-372-11 ACETAMINOPHEN-CODEINE 300-30 MG ORAL TAB $1.72 68382-227-05 AMIODARONE 200 MG ORAL TAB $1.72 0904-7057-61 METHOCARBAMOL 500 MG ORAL TAB $1.72 63739-253-40 VALPROIC ACID 250 MG ORAL CAP $1.72 5026886211 ASCORBIC ACID (VITAMIN C) 1,000 MG ORAL TAB $1.71 5026886215 ASCORBIC ACID (VITAMIN C) 1,000 MG ORAL TAB $1.71 0023-0506-50 POLYVINYL ALCOHOL-POVIDON(PF) 1.4-0.6 % OPHT DPET $1.71 67618-101-60 DOCUSATE SODIUM 100 MG ORAL CAP $1.71 0378-0078-01 CARBIDOPA-LEVODOPA 10-100 MG ORAL TAB $1.70 0574-7050-50 BISACODYL 10 MG RECTAL SUPP $1.70 60687-224-01 GEMFIBROZIL 600 MG ORAL TAB $1.70 60687-224-11 GEMFIBROZIL 600 MG ORAL TAB $1.70 0093-8344-01 GLYBURIDE 5 MG ORAL TAB $1.69 0378-0351-01 HALOPERIDOL 0.5 MG ORAL TAB $1.69 0406-8510-01 OXYCODONE 10 MG ORAL TAB $1.69 0832-1510-11 HALOPERIDOL 0.5 MG ORAL TAB $1.69 23155-071-01 METHIMAZOLE 10 MG ORAL TAB $1.69 50268-268-11 DOCUSATE SODIUM 250 MG ORAL CAP $1.69 50268-268-15 DOCUSATE SODIUM 250 MG ORAL CAP $1.69 99999-009-74 TETRACAINE - LIDOCAINE - EPINEPHRINE TOP SOLN $1.69 7733351610 MELATONIN 3 MG ORAL TAB $1.68 7733351625 MELATONIN 3 MG ORAL TAB $1.68 0093-0811-05 NORTRIPTYLINE 25 MG ORAL CAP $1.68 50268-594-11 NAPROXEN 250 MG ORAL TAB $1.68 50268-594-15 NAPROXEN 250 MG ORAL TAB $1.68 63739-486-10 HYDROXYZINE HCL 25 MG ORAL TAB $1.68 68084-536-01 CLOPIDOGREL 75 MG ORAL TAB $1.68 68084-536-11 CLOPIDOGREL 75 MG ORAL TAB $1.68 0781-1762-01 IMIPRAMINE HCL 10 MG ORAL TAB $1.68 71399-8460-5 BISACODYL 10 MG RECTAL SUPP $1.68 6761811128 DOCUSATE SODIUM 50 MG ORAL CAP $1.67 7733395110 VITAMIN E (DL, ACETATE) 180 MG (400 UNIT) ORAL CAP $1.67 7733395125 VITAMIN E (DL, ACETATE) 180 MG (400 UNIT) ORAL CAP $1.67 0904-6704-61 PRAMIPEXOLE 0.25 MG ORAL TAB $1.67 47335-737-88 BUPROPION HCL 150 MG ORAL SR12 $1.67 53746-544-01 PRIMIDONE 50 MG ORAL TAB $1.67 0023-0403-50 CARBOXYMETHYLCELLULOSE SODIUM 0.5 % OPHT DPET $1.66 61442-142-01 LOVASTATIN 20 MG ORAL TAB $1.66 1093988744 COENZYME Q10 100 MG ORAL CAP $1.66 42291-187-90 DILTIAZEM HCL 300 MG ORAL CP24 $1.66 57664-223-88 OXYCODONE 5 MG ORAL TAB $1.66 59746-362-90 VALSARTAN 160 MG ORAL TAB $1.66 67877-446-30 OLMESARTAN 20 MG ORAL TAB $1.66 0603-5484-21 PROPRANOLOL 40 MG ORAL TAB $1.65 0904-6530-61 METHADONE 10 MG ORAL TAB $1.65 23155-112-01 PROPRANOLOL 40 MG ORAL TAB $1.65 99999-034-50 PENICILLIN GK IV SOLN (FOR DESENSITIZATION USE) $1.65 0093-9702-01 CARBIDOPA-LEVODOPA 25-100 MG ORAL TAB $1.65 0904-6617-61 HYDROXYZINE HCL 25 MG ORAL TAB $1.65 50742-260-01 NIFEDIPINE 30 MG ORAL TR24 $1.65 4422930760 SODIUM CHLORIDE 7 % INHALATION NEBU $1.64 8349030760 SODIUM CHLORIDE 7 % INHALATION NEBU $1.64 0904-5448-61 PENTOXIFYLLINE 400 MG ORAL TBSR $1.64 70954-019-10 PRAZOSIN 1 MG ORAL CAP $1.64 57237-077-10 ONDANSETRON 4 MG ORAL TBDL $1.63 62756-798-88 DIVALPROEX 500 MG ORAL TBEC $1.63 0023-0403-70 CARBOXYMETHYLCELLULOSE SODIUM 0.5 % OPHT DPET $1.63 0904-5677-61 PAROXETINE HCL 20 MG ORAL TAB $1.63 16571-813-20 CALCIUM ACETATE(PHOSPHAT BIND) 667 MG ORAL CAP $1.63 23155-531-02 CALCIUM ACETATE(PHOSPHAT BIND) 667 MG ORAL CAP $1.63 29300-171-16 MEMANTINE 5 MG ORAL TAB $1.63 43547-288-10 BUPROPION HCL 100 MG ORAL SR12 $1.63 43547-289-10 BUPROPION HCL 150 MG ORAL SR12 $1.63 53746-542-01 POTASSIUM CHLORIDE 10 MEQ ORAL CPSR $1.63 60687-559-01 METHOCARBAMOL 500 MG ORAL TAB $1.63 60687-559-11 METHOCARBAMOL 500 MG ORAL TAB $1.63 60687-590-01 HYDROMORPHONE 4 MG ORAL TAB $1.63 60687-590-11 HYDROMORPHONE 4 MG ORAL TAB $1.63 60951-602-70 OXYCODONE-ACETAMINOPHEN 5-325 MG ORAL TAB $1.63 62756-511-83 LETROZOLE 2.5 MG ORAL TAB $1.63 67877-493-01 AZATHIOPRINE 50 MG ORAL TAB $1.63 68084-859-01 LEVETIRACETAM 250 MG ORAL TAB $1.63 68084-859-11 LEVETIRACETAM 250 MG ORAL TAB $1.63 99999-037-96 MEGESTROL 20 MG ORAL PARTIAL TAB $1.63 1093969133 NICOTINE (POLACRILEX) 2 MG BUCCAL GUM $1.62 49348-573-08 NICOTINE (POLACRILEX) 2 MG BUCCAL GUM $1.62 63739-410-10 ALLOPURINOL 100 MG ORAL TAB $1.62 0054-4181-25 DEXAMETHASONE 1 MG ORAL TAB $1.61 0555-0071-02 ISONIAZID 300 MG ORAL TAB $1.61 68462-302-01 INDOMETHACIN 50 MG ORAL CAP $1.61 0093-9702-05 CARBIDOPA-LEVODOPA 25-100 MG ORAL TAB $1.61 0591-3540-60 BUPROPION HCL 100 MG ORAL SR12 $1.61 0904-6238-61 CARBIDOPA-LEVODOPA 25-250 MG ORAL TAB $1.61 50268-067-70 CARBOXYMETHYLCELLULOSE SODIUM 0.5 % OPHT DPET $1.61 60687-585-01 PANTOPRAZOLE 20 MG ORAL TBEC $1.61 60687-585-11 PANTOPRAZOLE 20 MG ORAL TBEC $1.61 68084-643-01 PANTOPRAZOLE 20 MG ORAL TBEC $1.61 68084-643-11 PANTOPRAZOLE 20 MG ORAL TBEC $1.61 5026886511 CHOLECALCIFEROL (VITAMIN D3) 50 MCG (2,000 UNIT) ORAL TAB $1.60 5026886515 CHOLECALCIFEROL (VITAMIN D3) 50 MCG (2,000 UNIT) ORAL TAB $1.60 0904-6290-61 ATORVASTATIN 10 MG ORAL TAB $1.60 72603-115-01 TAMSULOSIN 0.4 MG ORAL CAP $1.60 0378-0427-01 SULINDAC 150 MG ORAL TAB $1.59 16571-202-10 DICLOFENAC SODIUM 50 MG ORAL TBEC $1.59 50228-340-90 OLMESARTAN 20 MG ORAL TAB $1.59 57664-756-83 OLMESARTAN 20 MG ORAL TAB $1.59 99999-004-72 AMIKACIN 10 MG/ML INJECTION SYRINGE (MCH) $1.59 99999-041-08 HYDROMORPHONE 1 MG/ML INJ SOLN (MHS) $1.59 55111-466-01 METOPROLOL SUCCINATE 25 MG ORAL TB24 $1.59 55111-467-01 METOPROLOL SUCCINATE 50 MG ORAL TB24 $1.59 55111-467-05 METOPROLOL SUCCINATE 50 MG ORAL TB24 $1.59 62756-160-88 TAMSULOSIN 0.4 MG ORAL CAP $1.59 0904-6352-61 LEVOFLOXACIN 500 MG ORAL TAB $1.58 69584-684-10 PRIMIDONE 50 MG ORAL TAB $1.58 99999-000-41 MIDAZOLAM 0.5 MG/ML NICU INJECTION $1.58 99999-005-23 CEFTAZIDIME 50 MG/ML INJ DILUTION $1.58 5026852411 MELATONIN 3 MG ORAL TAB $1.57 5026852415 MELATONIN 3 MG ORAL TAB $1.57 7733330810 OMEGA 3-DHA-EPA-FISH OIL 1,000 MG (120 MG-180 MG) ORAL CAP $1.57 7733330825 OMEGA 3-DHA-EPA-FISH OIL 1,000 MG (120 MG-180 MG) ORAL CAP $1.57 65862-246-08 LEVETIRACETAM 500 MG ORAL TAB $1.57 75834-158-01 VERAPAMIL 180 MG ORAL TBSR $1.57 0093-8344-10 GLYBURIDE 5 MG ORAL TAB $1.57 53746-571-01 BETHANECHOL CHLORIDE 5 MG ORAL TAB $1.57 65162-571-10 BETHANECHOL CHLORIDE 5 MG ORAL TAB $1.57 76282-329-01 WARFARIN 2.5 MG ORAL TAB $1.57 12165-100-01 SILVER NITRATE APPLICATORS 75-25 % TOPICAL STCK $1.56 12165-100-03 SILVER NITRATE APPLICATORS 75-25 % TOPICAL STCK $1.56 49884-055-01 IMIPRAMINE HCL 25 MG ORAL TAB $1.56 49884-640-01 METHIMAZOLE 5 MG ORAL TAB $1.56 52817-323-10 MIDODRINE 2.5 MG ORAL TAB $1.56 62584-733-01 HYDRALAZINE 25 MG ORAL TAB $1.56 62584-733-11 HYDRALAZINE 25 MG ORAL TAB $1.56 68084-119-01 MIRTAZAPINE 15 MG ORAL TAB $1.56 68084-119-11 MIRTAZAPINE 15 MG ORAL TAB $1.56 68084-512-01 SIMVASTATIN 20 MG ORAL TAB $1.56 68084-512-11 SIMVASTATIN 20 MG ORAL TAB $1.56 69315-134-01 IMIPRAMINE HCL 25 MG ORAL TAB $1.56 0904-6852-61 LORATADINE 10 MG ORAL TAB $1.55 50580-932-01 IBUPROFEN 100 MG ORAL CHEW $1.55 51293-820-01 METHIMAZOLE 5 MG ORAL TAB $1.55 68084-617-01 ESCITALOPRAM OXALATE 10 MG ORAL TAB $1.55 68084-617-11 ESCITALOPRAM OXALATE 10 MG ORAL TAB $1.55 3504600431 COENZYME Q10 50 MG ORAL CAP $1.55 7733311810 CALCIUM POLYCARBOPHIL 625 MG ORAL TAB $1.55 7733311825 CALCIUM POLYCARBOPHIL 625 MG ORAL TAB $1.55 8679001930 FERROUS SULFATE 142 MG (45 MG IRON) ORAL TBSR $1.55 0093-2210-05 SUCRALFATE 1 GRAM ORAL TAB $1.55 13107-155-30 PAROXETINE HCL 20 MG ORAL TAB $1.55 43598-536-60 BUPROPION HCL 100 MG ORAL SR12 $1.54 53489-331-01 IMIPRAMINE HCL 25 MG ORAL TAB $1.54 59762-4900-3 SERTRALINE 50 MG ORAL TAB $1.54 59762-4900-4 SERTRALINE 50 MG ORAL TAB $1.54 99999-033-43 PACLITAXEL IV SOLN (FOR DESENSITIZATION USE) (MHS) $1.54 0904-6294-61 CLOPIDOGREL 75 MG ORAL TAB $1.53 51079-936-01 TERAZOSIN 1 MG ORAL CAP $1.53 51079-936-20 TERAZOSIN 1 MG ORAL CAP $1.53 63739-991-10 METHOCARBAMOL 500 MG ORAL TAB $1.53 5026885811 PYRIDOXINE (VITAMIN B6) 50 MG ORAL TAB $1.53 5026885815 PYRIDOXINE (VITAMIN B6) 50 MG ORAL TAB $1.53 8068110000 GLUCOSE 4 GRAM ORAL CHEW $1.53 0093-0319-01 DILTIAZEM HCL 60 MG ORAL TAB $1.53 0378-0045-01 DILTIAZEM HCL 60 MG ORAL TAB $1.53 0904-6329-46 CARBOXYMETHYLCELLULOSE SODIUM 0.5 % OPHT DPET $1.53 68462-127-01 GABAPENTIN 800 MG ORAL TAB $1.53 77333-812-10 SIMETHICONE 80 MG ORAL CHEW $1.53 77333-812-25 SIMETHICONE 80 MG ORAL CHEW $1.53 5026886311 CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) ORAL TAB $1.52 5026886315 CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) ORAL TAB $1.52 7733398310 ZINC SULFATE 50 MG ZINC (220 MG) ORAL CAP $1.52 7733398325 ZINC SULFATE 50 MG ZINC (220 MG) ORAL CAP $1.52 0904-6550-61 PROPRANOLOL 10 MG ORAL TAB $1.52 16729-414-01 DOXAZOSIN 2 MG ORAL TAB $1.52 68382-784-01 DOXAZOSIN 2 MG ORAL TAB $1.52 99999-006-71 DIPHENHYDRAMINE HCL 10 MG/ML INJ DILUTION (MCH) $1.52 5026886011 ASCORBIC ACID (VITAMIN C) 250 MG ORAL TAB $1.52 5026886015 ASCORBIC ACID (VITAMIN C) 250 MG ORAL TAB $1.52 0603-5448-21 PROPAFENONE 150 MG ORAL TAB $1.52 0904-7236-61 MEGESTROL 40 MG ORAL TAB $1.52 31722-726-30 MONTELUKAST 10 MG ORAL TAB $1.52 59651-256-01 PROPAFENONE 150 MG ORAL TAB $1.52 67877-431-03 ARIPIPRAZOLE 5 MG ORAL TAB $1.52 0378-7970-31 IPRATROPIUM BROMIDE 0.02 % INHALATION SOLN $1.51 0378-7970-55 IPRATROPIUM BROMIDE 0.02 % INHALATION SOLN $1.51 43598-164-30 OLANZAPINE 5 MG ORAL TAB $1.51 51079-387-01 LORAZEPAM 2 MG ORAL TAB $1.51 57237-127-01 WARFARIN 10 MG ORAL TAB $1.51 75834-159-01 VERAPAMIL 240 MG ORAL TBSR $1.51 0093-0319-05 DILTIAZEM HCL 60 MG ORAL TAB $1.50 0378-0045-05 DILTIAZEM HCL 60 MG ORAL TAB $1.50 60505-3111-0 OLANZAPINE 5 MG ORAL TAB $1.50 67877-430-05 ARIPIPRAZOLE 2 MG ORAL TAB $1.50 69543-383-90 OLANZAPINE 10 MG ORAL TAB $1.50 5026834611 FOLIC ACID 400 MCG ORAL TAB $1.50 5026834615 FOLIC ACID 400 MCG ORAL TAB $1.50 63739-544-10 SPIRONOLACTONE 25 MG ORAL TAB $1.50 68094-052-59 DOCUSATE SODIUM 250 MG ORAL CAP $1.50 68094-052-61 DOCUSATE SODIUM 250 MG ORAL CAP $1.50 68784-102-12 BISACODYL 10 MG RECTAL SUPP $1.50 70156-104-01 HYOSCYAMINE SULFATE 0.125 MG ORAL TAB $1.50 70156-105-01 HYOSCYAMINE SULFATE 0.125 MG SL SUBL $1.50 77333-827-25 SODIUM BICARBONATE 650 MG ORAL TAB $1.50 99999-007-67 MORPHINE 10 MG/5 ML ORAL SOLN $1.50 99999-037-04 MORPHINE 10 MG/5 ML ORAL SOLN $1.50 51079-074-01 HYDRALAZINE 10 MG ORAL TAB $1.49 51079-074-20 HYDRALAZINE 10 MG ORAL TAB $1.49 51224-010-60 BENZONATATE 100 MG ORAL CAP $1.49 0054-0018-20 PREDNISONE 20 MG ORAL TAB $1.48 13107-154-30 PAROXETINE HCL 10 MG ORAL TAB $1.48 63739-483-10 HYDROXYZINE HCL 10 MG ORAL TAB $1.48 55111-333-90 PANTOPRAZOLE 40 MG ORAL TBEC $1.48 7733394810 CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) ORAL TAB $1.47 7733394825 CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) ORAL TAB $1.47 0904-6290-06 ATORVASTATIN 10 MG ORAL TAB $1.47 16714-071-06 BACLOFEN 10 MG ORAL TAB $1.47 0527-4117-37 PROPRANOLOL 80 MG ORAL CS24 $1.46 42806-410-01 BUPROPION HCL 100 MG ORAL SR12 $1.46 43598-751-01 BUPROPION HCL 100 MG ORAL SR12 $1.46 59762-2198-7 AZITHROMYCIN 250 MG ORAL TAB $1.46 65862-076-01 CIPROFLOXACIN HCL 250 MG ORAL TAB $1.46 68084-776-01 DIVALPROEX 250 MG ORAL TBEC $1.46 68084-776-11 DIVALPROEX 250 MG ORAL TBEC $1.46 99999-045-84 DEXTROSE 50 % IN WATER (D50W) IV SOLP $1.46 0904-6917-61 OMEPRAZOLE 20 MG ORAL CPDR $1.46 16714-894-01 GLIPIZIDE 2.5 MG ORAL TR24 $1.46 64380-737-06 ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) ORAL CAP $1.46 68462-223-01 LITHIUM CARBONATE 300 MG ORAL TBSR $1.46 39413012 BIOTIN 5 MG ORAL CAP $1.45 6809411061 MELATONIN 3 MG ORAL TAB $1.45 0054-8739-25 PREDNISONE 1 MG ORAL TAB $1.45 0574-0292-01 AMILORIDE 5 MG ORAL TAB $1.45 23155-011-01 INDOMETHACIN 50 MG ORAL CAP $1.45 31722-543-01 INDOMETHACIN 50 MG ORAL CAP $1.45 0093-9701-01 CARBIDOPA-LEVODOPA 10-100 MG ORAL TAB $1.44 59651-138-90 NEBIVOLOL 5 MG ORAL TAB $1.44 65862-688-90 SILDENAFIL (PULM.HYPERTENSION) 20 MG ORAL TAB $1.44 65862-769-90 FENOFIBRATE NANOCRYSTALLIZED 145 MG ORAL TAB $1.44 69097-458-05 FENOFIBRATE NANOCRYSTALLIZED 145 MG ORAL TAB $1.44 4116700609 DOXYLAMINE SUCCINATE 25 MG ORAL TAB $1.44 0054-8180-25 DEXAMETHASONE 0.75 MG ORAL TAB $1.44 0591-5661-01 SULINDAC 150 MG ORAL TAB $1.44 33342-179-10 OLMESARTAN 20 MG ORAL TAB $1.44 53489-478-01 SULINDAC 150 MG ORAL TAB $1.44 63739-963-10 PAROXETINE HCL 20 MG ORAL TAB $1.44 6809411059 MELATONIN 3 MG ORAL TAB $1.43 0832-7123-89 DIVALPROEX 250 MG ORAL TBEC $1.43 0904-6351-61 LEVOFLOXACIN 250 MG ORAL TAB $1.43 23155-731-01 NADOLOL 40 MG ORAL TAB $1.43 42806-400-01 METHYLPREDNISOLONE 4 MG ORAL TAB $1.43 51079-075-01 HYDRALAZINE 25 MG ORAL TAB $1.43 51079-075-20 HYDRALAZINE 25 MG ORAL TAB $1.43 51224-107-50 METFORMIN 750 MG ORAL TB24 $1.43 60505-0114-1 GABAPENTIN 400 MG ORAL CAP $1.43 3839650363 GLUCOSE 4 GRAM ORAL CHEW $1.42 0172-4096-60 BACLOFEN 10 MG ORAL TAB $1.42 0832-7123-01 DIVALPROEX 250 MG ORAL TBEC $1.42 16714-258-01 AMITRIPTYLINE 25 MG ORAL TAB $1.42 16714-447-01 AMITRIPTYLINE 25 MG ORAL TAB $1.42 42858-302-25 HYDROMORPHONE 4 MG ORAL TAB $1.42 68094-018-61 DIPHENHYDRAMINE HCL 25 MG ORAL TAB $1.42 0093-3147-01 CEPHALEXIN 500 MG ORAL CAP $1.42 23155-011-05 INDOMETHACIN 50 MG ORAL CAP $1.42 50268-639-11 PANTOPRAZOLE 40 MG ORAL TBEC $1.42 50268-639-15 PANTOPRAZOLE 40 MG ORAL TBEC $1.42 60687-491-01 NAPROXEN 500 MG ORAL TAB $1.42 60687-491-11 NAPROXEN 500 MG ORAL TAB $1.42 60687-394-79 IPRATROPIUM BROMIDE 0.02 % INHALATION SOLN $1.41 60687-394-83 IPRATROPIUM BROMIDE 0.02 % INHALATION SOLN $1.41 42806-018-01 SULINDAC 150 MG ORAL TAB $1.41 50742-249-90 DILTIAZEM HCL 180 MG ORAL CP24 $1.41 59762-5011-1 SPIRONOLACTONE 25 MG ORAL TAB $1.41 60687-143-01 METFORMIN 850 MG ORAL TAB $1.41 60687-143-11 METFORMIN 850 MG ORAL TAB $1.41 1254723813 BACITRACIN ZINC-POLYMYXIN B 500-10,000 UNIT/GRAM TOPICAL OIPK $1.40 48433-101-01 DOCUSATE SODIUM 250 MG ORAL CAP $1.40 51079-685-01 ATENOLOL 100 MG ORAL TAB $1.40 51079-685-20 ATENOLOL 100 MG ORAL TAB $1.40 69238-1069-1 POTASSIUM CHLORIDE 20 MEQ ORAL TBTQ $1.40 69968-0060-9 BACITRACIN ZINC-POLYMYXIN B 500-10,000 UNIT/GRAM TOPICAL OIPK $1.40 50289-4200-1 GLYCERIN-WHICH HAZEL 12.5-50 % PACKET (MHS) $1.40 59762-1344-1 PREGABALIN 50 MG ORAL CAP $1.40 68180-468-07 LOVASTATIN 20 MG ORAL TAB $1.40 99999-038-45 PENICILLIN G POTASSIUM 60,000 UNITS/ML (MCH) $1.40 0054-0017-20 PREDNISONE 10 MG ORAL TAB $1.39 0054-0077-25 TORSEMIDE 20 MG ORAL TAB $1.39 0555-0873-02 MEDROXYPROGESTERONE 5 MG ORAL TAB $1.39 23155-607-01 GLYCOPYRROLATE 2 MG ORAL TAB $1.39 1381100710 PRENATAL VIT27,CALCIUM-IRON-FA 60 MG IRON-1 MG ORAL TAB $1.39 0115-5511-10 FENOFIBRATE 54 MG ORAL TAB $1.39 60219-5511-9 FENOFIBRATE 54 MG ORAL TAB $1.39 63739-051-10 AMIODARONE 200 MG ORAL TAB $1.39 63739-403-10 NAPROXEN 500 MG ORAL TAB $1.39 64980-279-03 GLIPIZIDE 2.5 MG ORAL TR24 $1.39 68180-468-01 LOVASTATIN 20 MG ORAL TAB $1.39 99999-000-30 POTASSIUM ACETATE 2 MEQ / ML ORAL SYRINGE $1.39 99999-002-23 CEFTAZIDIME - BSS 100 MG/0.5 ML OPHTHALMIC SYRINGE $1.39 50383-079-21 ACETAMINOPHEN-CODEINE 300 MG-30 MG /12.5 ML ORAL SOLN $1.38 7733393810 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG ORAL TAB $1.38 7733393825 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG ORAL TAB $1.38 0093-8035-01 GLYBURIDE MICRONIZED 3 MG ORAL TAB $1.38 0781-2074-01 TRIAMTERENE-HYDROCHLOROTHIAZID 37.5-25 MG ORAL CAP $1.38 16714-795-02 TERBINAFINE HCL 250 MG ORAL TAB $1.38 53489-386-01 MINOXIDIL 2.5 MG ORAL TAB $1.38 59762-0155-1 ATORVASTATIN 10 MG ORAL TAB $1.38 60505-2578-8 ATORVASTATIN 10 MG ORAL TAB $1.38 60505-2578-9 ATORVASTATIN 10 MG ORAL TAB $1.38 0093-8344-98 GLYBURIDE 5 MG ORAL TAB $1.37 0536-1362-23 NICOTINE (POLACRILEX) 2 MG BUCCAL GUM $1.37 0591-5642-01 MINOXIDIL 2.5 MG ORAL TAB $1.37 42291-622-30 MONTELUKAST 4 MG ORAL CHEW $1.37 59762-0155-2 ATORVASTATIN 10 MG ORAL TAB $1.37 68382-857-01 TRIAMTERENE-HYDROCHLOROTHIAZID 75-50 MG ORAL TAB $1.37 0143-9928-01 CIPROFLOXACIN HCL 500 MG ORAL TAB $1.37 0406-0124-01 HYDROCODONE-ACETAMINOPHEN 7.5-325 MG ORAL TAB $1.37 0406-0124-10 HYDROCODONE-ACETAMINOPHEN 7.5-325 MG ORAL TAB $1.37 0487-9801-01 IPRATROPIUM BROMIDE 0.02 % INHALATION SOLN $1.37 16714-042-10 ALLOPURINOL 300 MG ORAL TAB $1.37 16714-042-11 ALLOPURINOL 300 MG ORAL TAB $1.37 16714-577-01 ALLOPURINOL 300 MG ORAL TAB $1.37 16729-031-01 METHYLDOPA 500 MG ORAL TAB $1.37 16729-433-15 EZETIMIBE 10 MG ORAL TAB $1.37 23155-519-01 ISOSORBIDE MONONITRATE 30 MG ORAL TB24 $1.37 42858-104-50 OXYCODONE-ACETAMINOPHEN 10-325 MG ORAL TAB $1.37 49884-256-01 MINOXIDIL 2.5 MG ORAL TAB $1.37 55111-730-01 ALLOPURINOL 300 MG ORAL TAB $1.37 60687-579-01 HYDROMORPHONE 2 MG ORAL TAB $1.37 60687-579-11 HYDROMORPHONE 2 MG ORAL TAB $1.37 60687-593-01 HYDROCHLOROTHIAZIDE 25 MG ORAL TAB $1.37 60687-593-11 HYDROCHLOROTHIAZIDE 25 MG ORAL TAB $1.37 76204-100-01 IPRATROPIUM BROMIDE 0.02 % INHALATION SOLN $1.37 99999-009-24 OXYBUTYNIN CHLORIDE 1 MG/1 ML ORAL LIQUID $1.37 99999-041-10 DEXTROSE 40 % ORAL GEL $1.37 4843311001 OMEGA 3-DHA-EPA-FISH OIL 300-1,000 MG ORAL CAP $1.36 0904-7124-61 LEVETIRACETAM 500 MG ORAL TAB $1.36 59746-360-30 VALSARTAN 40 MG ORAL TAB $1.36 62756-258-02 ZONISAMIDE 25 MG ORAL CAP $1.36 68382-146-01 RAMIPRIL 5 MG ORAL CAP $1.36 99999-006-85 METHYLPREDNISOLONE SODIUM SUCC 5 MG/ML INJ DILUTION (MCH) $1.36 5026885511 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG ORAL TAB $1.35 5026885515 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG ORAL TAB $1.35 47335-894-81 CLOPIDOGREL 75 MG ORAL TAB $1.35 47335-894-83 CLOPIDOGREL 75 MG ORAL TAB $1.35 0054-0018-25 PREDNISONE 20 MG ORAL TAB $1.35 0054-8528-25 LITHIUM CARBONATE 300 MG ORAL TAB $1.35 47781-263-01 OXYCODONE 5 MG ORAL TAB $1.35 57237-220-90 PIOGLITAZONE 30 MG ORAL TAB $1.35 60687-395-79 ALBUTEROL SULFATE 2.5 MG /3 ML (0.083 %) INHALATION NEBU $1.35 60687-395-83 ALBUTEROL SULFATE 2.5 MG /3 ML (0.083 %) INHALATION NEBU $1.35 536135807 COENZYME Q10 30 MG ORAL CAP $1.34 7733371510 PRENATAL VIT NO.130-IRON-FOLIC 27 MG IRON- 800 MCG ORAL TAB $1.34 7733371525 PRENATAL VIT NO.130-IRON-FOLIC 27 MG IRON- 800 MCG ORAL TAB $1.34 0054-4180-25 DEXAMETHASONE 0.75 MG ORAL TAB $1.34 0093-3147-05 CEPHALEXIN 500 MG ORAL CAP $1.34 50111-328-01 HYDRALAZINE 50 MG ORAL TAB $1.34 68382-856-01 TRIAMTERENE-HYDROCHLOROTHIAZID 37.5-25 MG ORAL TAB $1.34 4898500170 FEXOFENADINE 180 MG ORAL TAB $1.33 0054-0018-29 PREDNISONE 20 MG ORAL TAB $1.33 0603-5339-28 PREDNISONE 20 MG ORAL TAB $1.33 0904-6667-61 GABAPENTIN 400 MG ORAL CAP $1.33 10702-253-01 BUTALBITAL-ACETAMINOPHEN-CAFF 50-325-40 MG ORAL TAB $1.33 16714-988-01 ROSUVASTATIN 5 MG ORAL TAB $1.33 45802-730-33 ACETAMINOPHEN 650 MG RECTAL SUPP $1.33 63739-570-10 SIMVASTATIN 5 MG ORAL TAB $1.33 0591-0444-01 GUANFACINE 1 MG ORAL TAB $1.33 47335-321-86 MEMANTINE 5 MG ORAL TAB $1.33 47335-322-86 MEMANTINE 10 MG ORAL TAB $1.33 7733383110 SODIUM BICARBONATE 650 MG ORAL TAB $1.32 7733383125 SODIUM BICARBONATE 650 MG ORAL TAB $1.32 0527-4116-37 PROPRANOLOL 60 MG ORAL CS24 $1.32 0603-5335-21 PREDNISONE 1 MG ORAL TAB $1.32 16729-457-15 LEVOTHYROXINE 200 MCG ORAL TAB $1.32 55111-231-90 PRAVASTATIN 40 MG ORAL TAB $1.32 60505-0252-3 TIZANIDINE 4 MG ORAL TAB $1.32 67618-300-50 SENNOSIDES 8.6 MG ORAL TAB $1.32 77333-827-10 SODIUM BICARBONATE 650 MG ORAL TAB $1.32 0054-4741-25 PREDNISONE 1 MG ORAL TAB $1.31 0378-3515-01 MIRTAZAPINE 15 MG ORAL TAB $1.31 16714-234-01 PENICILLIN V POTASSIUM 250 MG ORAL TAB $1.31 68382-006-01 LAMOTRIGINE 25 MG ORAL TAB $1.31 0378-8270-31 ALBUTEROL SULFATE 2.5 MG /3 ML (0.083 %) INHALATION NEBU $1.31 0378-8270-55 ALBUTEROL SULFATE 2.5 MG /3 ML (0.083 %) INHALATION NEBU $1.31 0487-9501-01 ALBUTEROL SULFATE 2.5 MG /3 ML (0.083 %) INHALATION NEBU $1.31 0591-5642-05 MINOXIDIL 2.5 MG ORAL TAB $1.31 13107-046-01 OXYCODONE-ACETAMINOPHEN 10-325 MG ORAL TAB $1.31 16714-989-01 ROSUVASTATIN 10 MG ORAL TAB $1.31 42291-622-90 MONTELUKAST 4 MG ORAL CHEW $1.31 68462-406-01 INDOMETHACIN 25 MG ORAL CAP $1.31 76204-200-01 ALBUTEROL SULFATE 2.5 MG /3 ML (0.083 %) INHALATION NEBU $1.31 99999-036-89 DISOPYRAMIDE PHOSPHATE 10 MG/ML ORAL SUSP (COMPOUND) $1.29 99999-000-36 SODIUM CHLORIDE 4 MEQ / ML ORAL SYRINGE $1.27 99999-039-77 SODIUM BICARBONATE 1 MEQ/ML INJ SOLN (FOR ORAL USE) $1.27 99998-000-14 CEFUROXIME 50 MG/ML INJ DILUTION (MCH) $1.26 99999-005-35 DEXAMETHASONE 1 MG/ML INJ DILUTION (MCH) $1.26 HC51062628 TELEHEALTH TRANSMISSION PER MIN (MCAL ONLY) $1.25 99999-033-87 FLECAINIDE 20 MG/ML ORAL SUSP (COMPOUND) $1.22 0487-9801-30 IPRATROPIUM BROMIDE 0.02 % INHALATION SOLN $1.20 0487-9801-60 IPRATROPIUM BROMIDE 0.02 % INHALATION SOLN $1.20 99996-001-56 CAPTOPRIL 1 MG/ML ORAL SUSP (COMPOUND) $1.20 99999-033-02 HYDROXYUREA 100 MG/ML ORAL SOLUTION (COMPOUND) (MCH) $1.20 99999-007-17 TOBRAMYCIN 10 MG/5 ML INJ SOLN IN D5W (MCH-NEONATE) $1.17 99999-034-98 DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML ORAL LIQD $1.17 0378-7970-52 IPRATROPIUM BROMIDE 0.02 % INHALATION SOLN $1.15 0378-7970-91 IPRATROPIUM BROMIDE 0.02 % INHALATION SOLN $1.15 99999-037-79 DOCUSATE SODIUM 100 MG/10 ML ORAL LIQD $1.14 99999-000-08 CEFTRIAXONE 100 MG/ML SYRINGE $1.13 7620430003 SODIUM CHLORIDE 0.9 % INHALATION NEBU $1.11 99999-007-01 PIPERACILLIN-TAZOBACTAM 112.5 MG/ML INJ SYR (USING 3.375G) $1.11 99999-042-08 PIPERACILLIN-TAZOBACTAM 112.5 MG/ML INJ SYR (USING 4.5 G) $1.11 99999-002-24 NYSTATIN 100,000 UNITS/ML (NICU) ORAL SYRINGE $1.09 99999-006-78 LORAZEPAM 0.1 MG/1 ML INJ DILUTION (MCH) $1.06 57664-185-05 PROMETHAZINE-CODEINE 6.25-10 MG/5 ML ORAL SYRP $1.04 99999-010-02 VANCOMYCIN IN NS INTRAVITREAL INJECTION $1.04 99999-038-13 PHENYLEPHRINE 100 MCG/ML INJ DILUTION $1.04 0487-9501-00 ALBUTEROL SULFATE 2.5 MG /3 ML (0.083 %) INHALATION NEBU $1.03 0487-9501-03 ALBUTEROL SULFATE 2.5 MG /3 ML (0.083 %) INHALATION NEBU $1.03 0487-9501-25 ALBUTEROL SULFATE 2.5 MG /3 ML (0.083 %) INHALATION NEBU $1.03 0591-3797-83 ALBUTEROL SULFATE 2.5 MG /3 ML (0.083 %) INHALATION NEBU $1.03 76204-200-25 ALBUTEROL SULFATE 2.5 MG /3 ML (0.083 %) INHALATION NEBU $1.03 76204-200-30 ALBUTEROL SULFATE 2.5 MG /3 ML (0.083 %) INHALATION NEBU $1.03 76204-200-60 ALBUTEROL SULFATE 2.5 MG /3 ML (0.083 %) INHALATION NEBU $1.03 99999-042-07 CEFTRIAXONE 40 MG/ML INJ SYRINGE (2 G) $1.03 99999-043-90 HYDROXYCHLOROQUINE 25 MG/ML ORAL LIQUID (COMPOUND) $1.02 HC62808860 BONE GRAFT INFUSE™ IDE G160139 $1.01 HC62808605 BONE GRAFT INFUSE™ IDE G180160 $1.01 HC62229075 CATHETER PRESSURE MIKRO-CATH (MILLAR) $1.01 HC62808696 DEVICE SURGICAL IMPLANT TRIALING $1.01 HC62229083 DEVICE SURGICAL SUPPLY TRIALING $1.01 HC62808175 G150087 KIT STENTS ENDOPRSTH DSC AORTA $1.01 HC62808324 G170044 GENERATOR VITARIA IDE $1.01 HC62808332 G170044 LEAD VITARIA $1.01 HC62808662 G200149 SYSTEM EMBOLIC HYDROGEL EMBRACE (HES) $1.01 HC62808688 G200313 CATH BALLOON NEURESCUE $1.01 HC62808969 G210241 SYSTEM EMBOLIC HYDROGEL EMBRACE INSTYLLA™ $1.01 HC62229133 MULTI-CANCER EARLY DETECT TEST GRAIL IDE G210176 $1.01 HC62229067 PATCH EKG AUSCULA LVDP VIVIO $1.01 HC62228713 SYSTEM EMBOLECTOMY(CAPERE®) G200036 $1.01 HC62228994 SYSTEM NOVOTTF-200T G210071 $1.01 HC62808563 SYSTEM SHUNT INTERATRIAL G180020 $1.01 HC62228523 SYSTEM THROMBECTOMY(CAPERE®) $1.01 HC11200193 EDUCATION & TRAINING SELF MANAGEMENT; 1/2 HR $1.01 HC62809025 ATRIAL FLOW REGULATOR(OCCLUTECH)G210281 $1.01 HC88600101 NBS HANDLE COLLECTION CARD-GE $1.00 HC89020499 T-CELL RECEPTOR EXCISION CIRCLES-GE $1.00 HC31001936 TRANSITIONAL REHAB 1/2 DAY (QA) $1.00 HC31001944 TRANSITIONAL REHAB FULL DAY (QA) $1.00 5417990 MULTIVIT-MIN-FA-LYCOPEN-LUTEIN 0.4 MG-300 MCG- 250 MCG ORAL TAB $1.00 5445174 MULTIVITAMIN-IRON-FOLIC ACID 18-400 MG-MCG ORAL TAB $1.00 39410002 SOD FLUORIDE-CA CARBONATE 3.75 (8.25)-145 (364) MG ORAL TAB $1.00 45044406 ACETAMINOPHEN 500 MG ORAL TAB $1.00 45049660 ACETAMINOPHEN 325 MG ORAL TAB $1.00 132007924 GLYCERIN (ADULT) RECTAL SUPP $1.00 149003977 BISMUTH SUBSALICYLATE 262 MG ORAL CHEW $1.00 149003978 BISMUTH SUBSALICYLATE 262 MG ORAL CHEW $1.00 149032642 BISMUTH SUBSALICYLATE 262 MG ORAL CHEW $1.00 536100901 FERROUS SULFATE 325 MG (65 MG IRON) ORAL TAB $1.00 536135301 CHOLECALCIFEROL (VITAMIN D3) 50 MCG (2,000 UNIT) ORAL CAP $1.00 536322301 CALCIUM CITRATE-VITAMIN D3 200 MG-6.25 MCG (250 UNIT) ORAL TAB $1.00 536408501 PNV CMB#95-FERROUS FUMARATE-FA 28 MG IRON- 800 MCG ORAL TAB $1.00 536440601 PYRIDOXINE (VITAMIN B6) 25 MG ORAL TAB $1.00 536478701 VITAMIN B COMPLEX ORAL CAP $1.00 536509008 VIT A,C AND E-LUTEIN-MINERALS 300 MCG-200 MG-27 MG-2 MG ORAL TAB $1.00 536730001 B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG ORAL TAB $1.00 536781710 CALCIUM CARBONATE-VITAMIN D3 500 MG-5 MCG (200 UNIT) ORAL TAB $1.00 573417990 MULTIVIT-MIN-FA-LYCOPEN-LUTEIN 0.4 MG-300 MCG- 250 MCG ORAL TAB $1.00 573445174 MULTIVITAMIN-IRON-FOLIC ACID 18-400 MG-MCG ORAL TAB $1.00 574050801 FERROUS GLUCONATE 324 MG (38 MG IRON) ORAL TAB $1.00 574050810 FERROUS GLUCONATE 324 MG (38 MG IRON) ORAL TAB $1.00 904026252 MULTIVITAMIN, STRESS FORMULA ORAL TAB $1.00 904027760 VITAMIN E (DL, ACETATE) 450 MG (1,000 UNIT) ORAL CAP $1.00 904052360 ASCORBIC ACID (VITAMIN C) 500 MG ORAL TAB $1.00 904052361 ASCORBIC ACID (VITAMIN C) 500 MG ORAL TAB $1.00 904052372 ASCORBIC ACID (VITAMIN C) 500 MG ORAL TAB $1.00 904052380 ASCORBIC ACID (VITAMIN C) 500 MG ORAL TAB $1.00 904053061 MULTIVITAMIN WITH FOLIC ACID 400 MCG ORAL TAB $1.00 904053913 MULTIVITAMIN WITH FOLIC ACID 400 MCG ORAL TAB $1.00 904053961 MULTIVITAMIN WITH FOLIC ACID 400 MCG ORAL TAB $1.00 904053980 MULTIVITAMIN WITH FOLIC ACID 400 MCG ORAL TAB $1.00 904188260 CALCIUM CARBONATE-VITAMIN D3 250 MG-3.125 MCG (125 UNIT) ORAL TAB $1.00 904188361 CALCIUM CARBONATE 500 MG CALCIUM (1,250 MG) ORAL TAB $1.00 904188372 CALCIUM CARBONATE 500 MG CALCIUM (1,250 MG) ORAL TAB $1.00 904208560 VITAMIN A 3,000 MCG (10,000 UNIT) ORAL CAP $1.00 904227260 NIACIN 500 MG ORAL TAB $1.00 904264172 MULTIVITAMIN-IRON-FOLIC ACID 18-400 MG-MCG ORAL TAB $1.00 904522452 LACTASE 3,000 UNIT ORAL TAB $1.00 904531360 PRENATAL VIT NO.130-IRON-FOLIC 27 MG IRON- 800 MCG ORAL TAB $1.00 904546052 CALCIUM CARBONATE-VITAMIN D3 500 MG-5 MCG (200 UNIT) ORAL TAB $1.00 904546072 CALCIUM CARBONATE-VITAMIN D3 500 MG-5 MCG (200 UNIT) ORAL TAB $1.00 904546080 CALCIUM CARBONATE-VITAMIN D3 500 MG-5 MCG (200 UNIT) ORAL TAB $1.00 904546092 CALCIUM CARBONATE-VITAMIN D3 500 MG-5 MCG (200 UNIT) ORAL TAB $1.00 904548652 MULTIVIT-MIN-FA-LYCOPEN-LUTEIN 0.4 MG-300 MCG- 250 MCG ORAL TAB $1.00 904549261 MULTIVIT-IRON-FA-CALCIUM-MINS 9 MG IRON-400 MCG ORAL TAB $1.00 904549280 MULTIVIT-IRON-FA-CALCIUM-MINS 9 MG IRON-400 MCG ORAL TAB $1.00 904561646 COENZYME Q10 50 MG ORAL CAP $1.00 904582360 CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) ORAL TAB $1.00 904719106 THIAMINE (VITAMIN B1) 100 MG ORAL TAB (MHS) $1.00 904723860 OMEGA 3-DHA-EPA-FISH OIL 300 MG (120 MG- 180MG)-1,000 MG ORAL CAP $1.00 904759060 FERROUS SULFATE 325 MG (65 MG IRON) ORAL TAB $1.00 904759080 FERROUS SULFATE 325 MG (65 MG IRON) ORAL TAB $1.00 904759161 FERROUS SULFATE 325 MG (65 MG IRON) ORAL TAB $1.00 904759180 FERROUS SULFATE 325 MG (65 MG IRON) ORAL TAB $1.00 1000670012 PYRIDOXINE (VITAMIN B6) 50 MG ORAL TAB $1.00 1000670020 NIACIN 250 MG ORAL CPSR $1.00 1000670022 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG ORAL TAB $1.00 1000670028 MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) ORAL TAB $1.00 1000670038 CALCIUM CARBONATE-VITAMIN D3 500 MG-5 MCG (200 UNIT) ORAL TAB $1.00 1000673021 THIAMINE (VITAMIN B1) 100 MG ORAL TAB (MHS) $1.00 1000673027 ZINC SULFATE 50 MG ZINC (220 MG) ORAL TAB $1.00 1013565201 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG ORAL TAB $1.00 1013565250 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG ORAL TAB $1.00 1093913844 FAMOTIDINE 20 MG ORAL TAB $1.00 1093914344 LORATADINE 10 MG ORAL TAB $1.00 1093935633 IBUPROFEN 200 MG ORAL TAB $1.00 1093944144 ASPIRIN 81 MG ORAL TBEC $1.00 1093944344 ASPIRIN 81 MG ORAL TBEC $1.00 1093944444 ASPIRIN 81 MG ORAL TBEC $1.00 1093971244 LORATADINE 10 MG ORAL TAB $1.00 1093979344 SIMETHICONE 80 MG ORAL CHEW $1.00 1093979444 SIMETHICONE 80 MG ORAL CHEW $1.00 1093985244 DOXYLAMINE SUCCINATE 25 MG ORAL TAB $1.00 1093986544 DOCUSATE SODIUM 100 MG ORAL CAP $1.00 1093988244 OMEGA 3-DHA-EPA-FISH OIL 300-1,000 MG ORAL CAP $1.00 1093991444 SENNOSIDES 8.6 MG ORAL TAB $1.00 1093995368 FERROUS SULFATE 142 MG (45 MG IRON) ORAL TBSR $1.00 1093995376 CHOLECALCIFEROL (VITAMIN D3) 50 MCG (2,000 UNIT) ORAL CAP $1.00 1184505651 THIAMINE (VITAMIN B1) 100 MG ORAL TAB (MHS) $1.00 1184513665 LUTEIN 6 MG ORAL CAP $1.00 1184578705 ACTIVATED CHARCOAL 260 MG ORAL CAP $1.00 1191705003 IBUPROFEN 200 MG ORAL CAP $1.00 1191705014 CALCIUM CITRATE 200 MG (950 MG) ORAL TAB $1.00 1284353640 ASPIRIN 81 MG ORAL TBEC $1.00 1650007406 MULTIVIT-IRON-FA-CALCIUM-MINS 18 MG IRON-400 MCG-500 MG CA ORAL TAB $1.00 1650007814 PEDIATRIC MULTIVITAMIN ORAL CHEW $1.00 1650008619 PEDIATRIC MULTIVITAMIN ORAL CHEW $1.00 1650008806 PEDIATRIC MULTIVIT-IRON-MIN ORAL CHEW $1.00 1650059921 PEDIATRIC MULTIVIT-IRON-MIN ORAL CHEW $1.00 1678414012 AMMONIA AROMATIC 15 % (W/V) INHALATION SOLN $1.00 2055500100 ASCORBIC ACID (VITAMIN C) 250 MG ORAL TAB $1.00 2055500400 MULTIVITAMIN-IRON-FOLIC ACID 18-400 MG-MCG ORAL TAB $1.00 2055502101 FERROUS SULFATE 325 MG (65 MG IRON) ORAL TAB $1.00 2055502500 CALCIUM CARBONATE-VITAMIN D3 250 MG-3.125 MCG (125 UNIT) ORAL TAB $1.00 2055503300 CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) ORAL TAB $1.00 2055503600 MELATONIN 3 MG ORAL TAB $1.00 2055503601 MELATONIN 3 MG ORAL TAB $1.00 2055504000 ZINC SULFATE 50 MG ZINC (220 MG) ORAL CAP $1.00 2420838760 VIT A,C AND E-LUTEIN-MINERALS 300 MCG-200 MG-27 MG-2 MG ORAL TAB $1.00 2586610505 NAPROXEN SODIUM 220 MG ORAL TAB $1.00 3076800517 ASCORBIC ACID (VITAMIN C) 500 MG ORAL TAB $1.00 3076813430 BIOTIN 5 MG ORAL CAP $1.00 3076860730 BIOTIN 1 MG ORAL TAB $1.00 3160401281 THIAMINE (VITAMIN B1) 100 MG ORAL TAB (MHS) $1.00 3786400033 SENNOSIDES 8.6 MG ORAL TAB $1.00 3786408289 CALCIUM CARBONATE-VITAMIN D3 500 MG-5 MCG (200 UNIT) ORAL TAB $1.00 3786490599 THIAMINE (VITAMIN B1) 100 MG ORAL TAB (MHS) $1.00 3786490901 PYRIDOXINE (VITAMIN B6) 50 MG ORAL TAB $1.00 4009310107 CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) ORAL CAP $1.00 4009310232 COENZYME Q10 50 MG ORAL CAP $1.00 4009310287 SELENIUM 200 MCG ORAL TAB $1.00 4009310305 MELATONIN 5 MG ORAL TBDL $1.00 4009310609 MELATONIN 1 MG ORAL TAB $1.00 4229140305 LACTOBACILLUS ACIDOPH-L.BULGAR 1 MILLION CELL ORAL TAB $1.00 4329255538 RIBOFLAVIN (VITAMIN B2) 25 MG ORAL TAB $1.00 4329255606 CALCIUM CITRATE 250 MG CALCIUM ORAL TAB $1.00 4329255881 CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) ORAL TAB $1.00 4494610368 PED MVIT A,C,D3 NO.21-FLUORIDE 0.5 MG FLUORIDE (1.1 MG)/ML ORAL DROP $1.00 4843310401 CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) ORAL TAB $1.00 4843310801 THIAMINE (VITAMIN B1) 100 MG ORAL TAB (MHS) $1.00 5026885111 THIAMINE (VITAMIN B1) 100 MG ORAL TAB (MHS) $1.00 5026885115 THIAMINE (VITAMIN B1) 100 MG ORAL TAB (MHS) $1.00 5026885211 CYANOCOBALAMIN (VITAMIN B-12) 100 MCG ORAL TAB $1.00 5026885215 CYANOCOBALAMIN (VITAMIN B-12) 100 MCG ORAL TAB $1.00 5164582899 CALCIUM CARBONATE-VITAMIN D3 500 MG-5 MCG (200 UNIT) ORAL TAB $1.00 5319124401 CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) ORAL CAP $1.00 5445821360 MELATONIN 3 MG ORAL TAB $1.00 5473814001 FOLIC ACID 400 MCG ORAL TAB $1.00 5766407001 FERROUS SULFATE 325 MG (65 MG IRON) ORAL TAB $1.00 5789645101 SENNOSIDES 8.6 MG ORAL TAB $1.00 5789663412 MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) ORAL TAB $1.00 5789675201 VITAMIN E (DL, ACETATE) 180 MG (400 UNIT) ORAL CAP $1.00 5789685101 THIAMINE (VITAMIN B1) 100 MG ORAL TAB (MHS) $1.00 5789685906 GLUCOSAMINE-CHONDROITIN 500-400 MG ORAL CAP $1.00 5789686406 MELATONIN 3 MG ORAL TAB $1.00 5789686501 ZINC SULFATE 50 MG ZINC (220 MG) ORAL TAB $1.00 5789687503 COENZYME Q10 100 MG ORAL CAP $1.00 5789689601 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG ORAL TAB $1.00 6025816001 B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG ORAL TAB $1.00 6025817201 MAGNESIUM GLUCONATE 27 MG MAGNESIUM (500 MG) ORAL TAB $1.00 6382473016 BENZOCAINE-MENTHOL 15-2.6 MG MUCOUS MEMB LOZG $1.00 6382474016 DEXTROMETHORPHAN-BENZOCAINE 5-7.5 MG ORAL LOZG $1.00 6498012950 LACTOBACILLUS ACIDOPH-L.BULGAR 1 MILLION CELL ORAL TAB $1.00 6498033901 MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) ORAL TAB $1.00 6498033990 MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) ORAL TAB $1.00 6858500575 MAGNESIUM CHLORIDE 64 MG ORAL TBEC $1.00 6936722001 SODIUM CHLORIDE 1,000 MG MISC TBSO $1.00 7031246129 BENZOCAINE-MENTHOL 15-3.6 MG MUCOUS MEMB LOZG $1.00 7126950010 NIACIN 500 MG ORAL TBSR $1.00 7132180320 CALCIUM ACETATE 667 MG ORAL TAB $1.00 7431200640 RIBOFLAVIN (VITAMIN B2) 100 MG ORAL TAB $1.00 7431201380 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG ORAL TAB $1.00 7431202832 MELATONIN 1 MG ORAL TAB $1.00 7431205800 NIACIN 250 MG ORAL CPSR $1.00 7431207961 BIOTIN 1 MG ORAL TAB $1.00 7431219377 CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) ORAL CAP $1.00 7431229176 CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) ORAL CAP $1.00 7431258913 BIOTIN 5,000 MCG SL SUBL $1.00 7733393410 THIAMINE (VITAMIN B1) 100 MG ORAL TAB (MHS) $1.00 7733393425 THIAMINE (VITAMIN B1) 100 MG ORAL TAB (MHS) $1.00 7733393710 CYANOCOBALAMIN (VITAMIN B-12) 500 MCG ORAL TAB $1.00 7733393725 CYANOCOBALAMIN (VITAMIN B-12) 500 MCG ORAL TAB $1.00 7733394010 PYRIDOXINE (VITAMIN B6) 50 MG ORAL TAB $1.00 7733394025 PYRIDOXINE (VITAMIN B6) 50 MG ORAL TAB $1.00 7811201106 BENZOCAINE-MENTHOL 6-10 MG MUCOUS MEMB LOZG $1.00 7811201266 BENZOCAINE-MENTHOL 6-10 MG MUCOUS MEMB LOZG $1.00 7811210189 BENZOCAINE 15 MG MUCOUS MEMB LOZG $1.00 7985400938 MULTIVIT-MIN-FA-LYCOPEN-LUTEIN 0.4 MG-300 MCG- 250 MCG ORAL TAB $1.00 7985401107 ALPHA LIPOIC ACID 100 MG ORAL CAP $1.00 7985401162 CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) ORAL TAB $1.00 7985420010 THIAMINE (VITAMIN B1) 100 MG ORAL TAB (MHS) $1.00 7985420030 PYRIDOXINE (VITAMIN B6) 50 MG ORAL TAB $1.00 7985420080 VITAMIN B COMPLEX ORAL CAP $1.00 7985420195 RIBOFLAVIN (VITAMIN B2) 100 MG ORAL TAB $1.00 7985495010 DOCUSATE SODIUM 250 MG ORAL CAP $1.00 8068100400 CALCIUM CARBONATE 500 MG CALCIUM (1,250 MG) ORAL TAB $1.00 8068104100 MELATONIN 1 MG ORAL TAB $1.00 8068104900 PEDIATRIC MULTIVITAMIN NO.42 ORAL CHEW $1.00 8068105700 NIACIN 100 MG ORAL TAB $1.00 8068107100 CYANOCOBALAMIN (VITAMIN B-12) 100 MCG ORAL TAB $1.00 8068109800 THIAMINE (VITAMIN B1) 100 MG ORAL TAB (MHS) $1.00 8068109900 FOLIC ACID 400 MCG ORAL TAB $1.00 8068113100 CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) ORAL CAP $1.00 8068113500 ZINC SULFATE 50 MG ZINC (220 MG) ORAL CAP $1.00 8068114000 CALCIUM CITRATE 200 MG (950 MG) ORAL TAB $1.00 8068114101 MULTIVIT-MIN-FA-LYCOPEN-LUTEIN 0.4 MG-300 MCG- 250 MCG ORAL TAB $1.00 8068115900 VITAMIN E (DL, ACETATE) 90 MG (200 UNIT) ORAL CAP $1.00 8068116801 CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) ORAL TAB $1.00 8068116900 CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) ORAL TAB $1.00 8142102004 BISACODYL 5 MG ORAL TBEC $1.00 8290236850 LACTOBACILLUS ACIDOPH-L.BULGAR 1 MILLION CELL ORAL CHEW $1.00 8770140309 ASPIRIN 81 MG ORAL TBEC $1.00 8770140754 VITAMIN E (DL, ACETATE) 180 MG (400 UNIT) ORAL CAP $1.00 8770170344 SIMETHICONE 80 MG ORAL CHEW $1.00 99999003839 GANCICLOVIR 1 MG INTRAVITREAL INJ $1.00 0005-2500-02 CALCIUM POLYCARBOPHIL 625 MG ORAL TAB $1.00 0005-4177-58 MULTIVITAMIN-MINERALS-LUTEIN ORAL TAB $1.00 0054-0017-25 PREDNISONE 10 MG ORAL TAB $1.00 0054-0017-29 PREDNISONE 10 MG ORAL TAB $1.00 0054-2526-25 LITHIUM CARBONATE 150 MG ORAL CAP $1.00 0054-4179-25 DEXAMETHASONE 0.5 MG ORAL TAB $1.00 0054-4299-25 FUROSEMIDE 40 MG ORAL TAB $1.00 0054-4301-29 FUROSEMIDE 80 MG ORAL TAB $1.00 0054-4728-25 PREDNISONE 5 MG ORAL TAB $1.00 0054-4728-31 PREDNISONE 5 MG ORAL TAB $1.00 0054-8179-25 DEXAMETHASONE 0.5 MG ORAL TAB $1.00 0054-8297-25 FUROSEMIDE 20 MG ORAL TAB $1.00 0054-8299-25 FUROSEMIDE 40 MG ORAL TAB $1.00 0054-8526-25 LITHIUM CARBONATE 150 MG ORAL CAP $1.00 0054-8527-25 LITHIUM CARBONATE 300 MG ORAL CAP $1.00 0054-8724-25 PREDNISONE 5 MG ORAL TAB $1.00 0054-8740-25 PREDNISONE 2.5 MG ORAL TAB $1.00 0067-2000-20 ASPIRIN-ACETAMINOPHEN-CAFFEINE 250-250-65 MG ORAL TAB $1.00 0067-2000-91 ASPIRIN-ACETAMINOPHEN-CAFFEINE 250-250-65 MG ORAL TAB $1.00 0067-2039-91 ASPIRIN-ACETAMINOPHEN-CAFFEINE 250-250-65 MG ORAL TAB $1.00 0067-8203-02 ASPIRIN-ACETAMINOPHEN-CAFFEINE 250-250-65 MG ORAL TAB $1.00 0069-0307-01 WATER FOR INJECT, BACTERIOSTAT INJ SOLN $1.00 0088-1174-47 ALUMINUM HYDROX-MAGNESIUM CARB 160-105 MG ORAL CHEW $1.00 0093-0051-01 CARVEDILOL 3.125 MG ORAL TAB $1.00 0093-0051-05 CARVEDILOL 3.125 MG ORAL TAB $1.00 0093-0053-01 BUSPIRONE 5 MG ORAL TAB $1.00 0093-0054-01 BUSPIRONE 10 MG ORAL TAB $1.00 0093-0054-05 BUSPIRONE 10 MG ORAL TAB $1.00 0093-0058-01 TRAMADOL 50 MG ORAL TAB $1.00 0093-0135-01 CARVEDILOL 6.25 MG ORAL TAB $1.00 0093-0135-05 CARVEDILOL 6.25 MG ORAL TAB $1.00 0093-0318-01 DILTIAZEM HCL 30 MG ORAL TAB $1.00 0093-0318-05 DILTIAZEM HCL 30 MG ORAL TAB $1.00 0093-0752-01 ATENOLOL 50 MG ORAL TAB $1.00 0093-0752-10 ATENOLOL 50 MG ORAL TAB $1.00 0093-0753-01 ATENOLOL 100 MG ORAL TAB $1.00 0093-0787-01 ATENOLOL 25 MG ORAL TAB $1.00 0093-0810-01 NORTRIPTYLINE 10 MG ORAL CAP $1.00 0093-0832-01 CLONAZEPAM 0.5 MG ORAL TAB $1.00 0093-2203-01 METOCLOPRAMIDE 10 MG ORAL TAB (MCH) $1.00 0093-2203-05 METOCLOPRAMIDE HCL 10 MG ORAL TAB $1.00 0093-2203-10 METOCLOPRAMIDE HCL 10 MG ORAL TAB $1.00 0093-2204-01 METOCLOPRAMIDE HCL 5 MG ORAL TAB $1.00 0093-2204-05 METOCLOPRAMIDE HCL 5 MG ORAL TAB $1.00 0093-3107-01 AMOXICILLIN 250 MG ORAL CAP $1.00 0093-3109-05 AMOXICILLIN 500 MG ORAL CAP $1.00 0093-3109-53 AMOXICILLIN 500 MG ORAL CAP $1.00 0093-3145-01 CEPHALEXIN 250 MG ORAL CAP $1.00 0093-3212-01 CLONAZEPAM 1 MG ORAL TAB $1.00 0093-3422-01 CYCLOBENZAPRINE 10 MG ORAL TAB $1.00 0093-3425-01 LORAZEPAM 0.5 MG ORAL TAB $1.00 0093-3425-10 LORAZEPAM 0.5 MG ORAL TAB $1.00 0093-3426-01 LORAZEPAM 1 MG ORAL TAB $1.00 0093-7295-01 CARVEDILOL 12.5 MG ORAL TAB $1.00 0093-7295-05 CARVEDILOL 12.5 MG ORAL TAB $1.00 0093-7296-01 CARVEDILOL 25 MG ORAL TAB $1.00 0093-7296-05 CARVEDILOL 25 MG ORAL TAB $1.00 0093-8343-01 GLYBURIDE 2.5 MG ORAL TAB $1.00 0115-1659-01 PROPRANOLOL 10 MG ORAL TAB $1.00 0115-1800-01 METHYLPHENIDATE HCL 5 MG ORAL TAB $1.00 0115-1801-01 METHYLPHENIDATE HCL 10 MG ORAL TAB $1.00 0115-1802-01 METHYLPHENIDATE HCL 20 MG ORAL TAB $1.00 0132-0079-12 GLYCERIN (ADULT) RECTAL SUPP $1.00 0132-0079-24 GLYCERIN (ADULT) RECTAL SUPP $1.00 0132-0079-50 GLYCERIN (ADULT) RECTAL SUPP $1.00 0132-0190-12 GLYCERIN (LAXATIVE) 2.8 GRAM/2.7 ML RECTAL SOLN $1.00 0135-0071-27 CALCIUM CARBONATE 200 MG CALCIUM (500 MG) ORAL CHEW $1.00 0135-0096-26 AL HYD-MG TR-ALG AC-SOD BICARB 80-14.2 MG ORAL CHEW $1.00 0135-0098-26 ALUMINUM HYDROX-MAGNESIUM CARB 160-105 MG ORAL CHEW $1.00 0135-0178-03 CALCIUM CARBONATE 300 MG (750 MG) ORAL CHEW $1.00 0143-3126-10 DICYCLOMINE 10 MG ORAL CAP $1.00 0143-9927-01 CIPROFLOXACIN HCL 250 MG ORAL TAB $1.00 0172-2083-60 HYDROCHLOROTHIAZIDE 25 MG ORAL TAB $1.00 0172-2083-80 HYDROCHLOROTHIAZIDE 25 MG ORAL TAB $1.00 0172-2089-60 HYDROCHLOROTHIAZIDE 50 MG ORAL TAB $1.00 0172-3925-60 DIAZEPAM 2 MG ORAL TAB $1.00 0172-3926-60 DIAZEPAM 5 MG ORAL TAB $1.00 0172-5728-60 FAMOTIDINE 20 MG ORAL TAB $1.00 0172-5728-70 FAMOTIDINE 20 MG ORAL TAB $1.00 0172-5728-80 FAMOTIDINE 20 MG ORAL TAB $1.00 0185-0674-01 HYDROXYZINE PAMOATE 25 MG ORAL CAP $1.00 0185-0676-01 HYDROXYZINE PAMOATE 50 MG ORAL CAP $1.00 0223-1760-01 SODIUM CHLORIDE 1,000 MG MISC TBSO $1.00 0228-2027-10 ALPRAZOLAM 0.25 MG ORAL TAB $1.00 0228-2027-50 ALPRAZOLAM 0.25 MG ORAL TAB $1.00 0228-2029-10 ALPRAZOLAM 0.5 MG ORAL TAB $1.00 0228-2031-10 ALPRAZOLAM 1 MG ORAL TAB $1.00 0228-2076-10 TEMAZEPAM 15 MG ORAL CAP $1.00 0228-2076-50 TEMAZEPAM 15 MG ORAL CAP $1.00 0228-2127-10 CLONIDINE HCL 0.1 MG ORAL TAB $1.00 0228-2127-50 CLONIDINE HCL 0.1 MG ORAL TAB $1.00 0228-2128-10 CLONIDINE HCL 0.2 MG ORAL TAB $1.00 0228-2128-50 CLONIDINE HCL 0.2 MG ORAL TAB $1.00 0228-2129-10 CLONIDINE HCL 0.3 MG ORAL TAB $1.00 0234-0575-17 CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQD $1.00 0280-2100-12 ASPIRIN 81 MG ORAL TBEC $1.00 0363-0009-20 DOCUSATE SODIUM 100 MG ORAL CAP $1.00 0363-0291-12 IBUPROFEN 200 MG ORAL TAB $1.00 0378-0018-01 METOPROLOL TARTRATE 25 MG ORAL TAB $1.00 0378-0018-05 METOPROLOL TARTRATE 25 MG ORAL TAB $1.00 0378-0023-01 DILTIAZEM HCL 30 MG ORAL TAB $1.00 0378-0032-01 METOPROLOL TARTRATE 50 MG ORAL TAB $1.00 0378-0032-10 METOPROLOL TARTRATE 50 MG ORAL TAB $1.00 0378-0047-01 METOPROLOL TARTRATE 100 MG ORAL TAB $1.00 0378-0208-01 FUROSEMIDE 20 MG ORAL TAB $1.00 0378-0208-10 FUROSEMIDE 20 MG ORAL TAB $1.00 0378-0216-01 FUROSEMIDE 40 MG ORAL TAB $1.00 0378-0218-01 ATENOLOL 25 MG ORAL TAB $1.00 0378-0231-01 ATENOLOL 50 MG ORAL TAB $1.00 0378-0271-01 DIAZEPAM 2 MG ORAL TAB $1.00 0378-0640-10 PREDNISONE 5 MG ORAL TAB $1.00 0378-1150-01 BUSPIRONE 10 MG ORAL TAB $1.00 0378-1454-01 ESTRADIOL 1 MG ORAL TAB $1.00 0378-1610-01 DICYCLOMINE 10 MG ORAL CAP $1.00 0378-1657-77 SILDENAFIL (PULM.HYPERTENSION) 20 MG ORAL TAB $1.00 0378-2146-01 SPIRONOLACTONE 25 MG ORAL TAB $1.00 0378-2146-05 SPIRONOLACTONE 25 MG ORAL TAB $1.00 0378-2268-01 TERAZOSIN 5 MG ORAL CAP $1.00 0378-2610-01 AMITRIPTYLINE 10 MG ORAL TAB $1.00 0378-3631-05 CARVEDILOL 3.125 MG ORAL TAB $1.00 0378-3632-01 CARVEDILOL 6.25 MG ORAL TAB $1.00 0378-3632-05 CARVEDILOL 6.25 MG ORAL TAB $1.00 0378-3634-01 CARVEDILOL 25 MG ORAL TAB $1.00 0378-3635-01 CETIRIZINE 5 MG ORAL TAB $1.00 0378-3950-05 ATORVASTATIN 10 MG ORAL TAB $1.00 0378-3953-05 ATORVASTATIN 80 MG ORAL TAB $1.00 0378-4050-91 NEVIRAPINE 200 MG ORAL TAB $1.00 0378-4151-01 TRAMADOL 50 MG ORAL TAB $1.00 0378-6232-01 CITALOPRAM 20 MG ORAL TAB $1.00 0378-6689-10 PANTOPRAZOLE 40 MG ORAL TBEC $1.00 0378-6689-77 PANTOPRAZOLE 40 MG ORAL TBEC $1.00 0378-7001-10 PAROXETINE HCL 10 MG ORAL TAB $1.00 0378-7001-93 PAROXETINE HCL 10 MG ORAL TAB $1.00 0378-7292-53 NORETHINDRONE (CONTRACEPTIVE) 0.35 MG ORAL TAB $1.00 0378-7292-85 NORETHINDRONE (CONTRACEPTIVE) 0.35 MG ORAL TAB $1.00 0406-0123-01 HYDROCODONE-ACETAMINOPHEN 5-325 MG ORAL TAB $1.00 0406-0123-05 HYDROCODONE-ACETAMINOPHEN 5-325 MG ORAL TAB $1.00 0406-0484-23 ACETAMINOPHEN-CODEINE 300-30 MG ORAL TAB $1.00 0406-0512-01 OXYCODONE-ACETAMINOPHEN 5-325 MG ORAL TAB $1.00 0406-0552-01 OXYCODONE 5 MG ORAL TAB $1.00 0406-1142-01 METHYLPHENIDATE HCL 5 MG ORAL TAB $1.00 0406-3243-01 HYDROMORPHONE 2 MG ORAL TAB $1.00 0406-9961-01 TEMAZEPAM 15 MG ORAL CAP $1.00 0487-9301-03 SODIUM CHLORIDE 0.9 % INHALATION NEBU $1.00 0487-9301-33 SODIUM CHLORIDE 0.9 % INHALATION NEBU $1.00 0527-0586-01 DICYCLOMINE 10 MG ORAL CAP $1.00 0527-1282-01 DICYCLOMINE 20 MG ORAL TAB $1.00 0527-1301-01 PRIMIDONE 50 MG ORAL TAB $1.00 0527-3281-46 LEVOTHYROXINE 50 MCG ORAL TAB $1.00 0527-3282-46 LEVOTHYROXINE 75 MCG ORAL TAB $1.00 0527-3283-46 LEVOTHYROXINE 88 MCG ORAL TAB $1.00 0527-3284-46 LEVOTHYROXINE 100 MCG ORAL TAB $1.00 0527-3286-46 LEVOTHYROXINE 125 MCG ORAL TAB $1.00 0527-3288-46 LEVOTHYROXINE 150 MCG ORAL TAB $1.00 0527-3289-46 LEVOTHYROXINE 175 MCG ORAL TAB $1.00 0536-1007-15 CALCIUM CARBONATE 200 MG CALCIUM (500 MG) ORAL CHEW $1.00 0536-1046-10 SODIUM BICARBONATE 325 MG ORAL TAB $1.00 0536-1047-10 SODIUM BICARBONATE 650 MG ORAL TAB $1.00 0536-1048-15 CALCIUM CARBONATE 200 MG CALCIUM (500 MG) ORAL CHEW $1.00 0536-1054-29 ASPIRIN 325 MG ORAL TAB $1.00 0536-1186-12 PHENYLEPHRINE-COCOA BUTTER 0.25-88.44 % RECTAL SUPP $1.00 0536-1232-01 ASPIRIN 325 MG ORAL TBEC $1.00 0536-1234-41 ASPIRIN 81 MG ORAL TBEC $1.00 0536-1247-01 SENNOSIDES-DOCUSATE SODIUM 8.6-50 MG ORAL TAB $1.00 0536-1248-01 SENNOSIDES-DOCUSATE SODIUM 8.6-50 MG ORAL TAB $1.00 0536-1297-01 MECLIZINE 12.5 MG ORAL TAB $1.00 0536-1298-01 FAMOTIDINE 20 MG ORAL TAB $1.00 0536-1326-01 ASPIRIN-ACETAMINOPHEN-CAFFEINE 250-250-65 MG ORAL TAB $1.00 0536-1327-01 ACETAMINOPHEN 325 MG ORAL TAB $1.00 0536-1327-06 ACETAMINOPHEN 325 MG ORAL TAB $1.00 0536-1327-10 ACETAMINOPHEN 325 MG ORAL TAB $1.00 0536-2450-10 ZINC SULFATE 50 MG ZINC (220 MG) ORAL TAB $1.00 0536-4306-08 CALCIUM POLYCARBOPHIL 625 MG ORAL TAB $1.00 0555-0033-02 CHLORDIAZEPOXIDE HCL 10 MG ORAL CAP $1.00 0555-0066-02 ISONIAZID 100 MG ORAL TAB $1.00 0555-0158-02 CHLORDIAZEPOXIDE HCL 5 MG ORAL CAP $1.00 0555-0159-02 CHLORDIAZEPOXIDE HCL 25 MG ORAL CAP $1.00 0555-0159-04 CHLORDIAZEPOXIDE HCL 25 MG ORAL CAP $1.00 0555-0872-02 MEDROXYPROGESTERONE 2.5 MG ORAL TAB $1.00 0574-0240-01 REPAGLINIDE 0.5 MG ORAL TAB $1.00 0574-0241-01 REPAGLINIDE 1 MG ORAL TAB $1.00 0574-0242-01 REPAGLINIDE 2 MG ORAL TAB $1.00 0591-0343-01 VERAPAMIL 80 MG ORAL TAB $1.00 0591-0404-01 VERAPAMIL 40 MG ORAL TAB $1.00 0591-0407-01 LISINOPRIL 10 MG ORAL TAB $1.00 0591-0408-01 LISINOPRIL 20 MG ORAL TAB $1.00 0591-0460-01 GLIPIZIDE 5 MG ORAL TAB $1.00 0591-0461-01 GLIPIZIDE 10 MG ORAL TAB $1.00 0591-0794-01 DICYCLOMINE 10 MG ORAL CAP $1.00 0591-0794-10 DICYCLOMINE 10 MG ORAL CAP $1.00 0591-5335-01 TRIHEXYPHENIDYL 2 MG ORAL TAB $1.00 0591-5443-10 PREDNISONE 20 MG ORAL TAB $1.00 0591-5513-01 CARISOPRODOL 350 MG ORAL TAB $1.00 0603-0209-22 MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) ORAL TAB $1.00 0603-1567-05 PREDNISOLONE 15 MG/5 ML ORAL SOLN $1.00 0603-2212-21 AMITRIPTYLINE 10 MG ORAL TAB $1.00 0603-2406-21 BACLOFEN 10 MG ORAL TAB $1.00 0603-5337-21 PREDNISONE 5 MG ORAL TAB $1.00 0603-5338-21 PREDNISONE 10 MG ORAL TAB $1.00 0603-5339-32 PREDNISONE 20 MG ORAL TAB $1.00 0603-5482-21 PROPRANOLOL 10 MG ORAL TAB $1.00 0603-5483-21 PROPRANOLOL 20 MG ORAL TAB $1.00 0603-5483-32 PROPRANOLOL 20 MG ORAL TAB $1.00 0781-1061-01 ALPRAZOLAM 0.25 MG ORAL TAB $1.00 0781-1077-01 ALPRAZOLAM 0.5 MG ORAL TAB $1.00 0781-1079-01 ALPRAZOLAM 1 MG ORAL TAB $1.00 0781-1486-01 AMITRIPTYLINE 10 MG ORAL TAB $1.00 0781-1830-01 PROMETHAZINE 25 MG ORAL TAB $1.00 0781-2020-01 AMOXICILLIN 250 MG ORAL CAP $1.00 0781-2020-05 AMOXICILLIN 250 MG ORAL CAP $1.00 0781-2613-01 AMOXICILLIN 500 MG ORAL CAP $1.00 0781-2613-05 AMOXICILLIN 500 MG ORAL CAP $1.00 0781-2868-10 OMEPRAZOLE 20 MG ORAL CPDR $1.00 0781-2868-31 OMEPRAZOLE 20 MG ORAL CPDR $1.00 0781-5222-01 CARVEDILOL 6.25 MG ORAL TAB $1.00 0781-5317-01 ZOLPIDEM 5 MG ORAL TAB $1.00 0832-0038-00 OXYBUTYNIN CHLORIDE 5 MG ORAL TAB $1.00 0832-1054-15 BACLOFEN 10 MG ORAL TAB $1.00 0832-7122-11 DIVALPROEX 125 MG ORAL TBEC $1.00 0832-7123-11 DIVALPROEX 250 MG ORAL TBEC $1.00 0904-0012-59 CHLORPHENIRAMINE MALEATE 4 MG ORAL TAB $1.00 0904-0012-61 CHLORPHENIRAMINE MALEATE 4 MG ORAL TAB $1.00 0904-1315-46 BISMUTH SUBSALICYLATE 262 MG ORAL CHEW $1.00 0904-2056-61 DIPHENHYDRAMINE HCL 50 MG ORAL CAP $1.00 0904-2085-56 VITAMIN A 3,000 MCG (10,000 UNIT) ORAL CAP $1.00 0904-2500-91 CALCIUM POLYCARBOPHIL 625 MG ORAL TAB $1.00 0904-2725-61 SULFAMETHOXAZOLE-TRIMETHOPRIM 800-160 MG ORAL TAB $1.00 0904-4040-73 ASPIRIN 81 MG ORAL CHEW $1.00 0904-5053-59 PSEUDOEPHEDRINE HCL 30 MG ORAL TAB $1.00 0904-5306-60 DIPHENHYDRAMINE HCL 25 MG ORAL CAP $1.00 0904-5306-61 DIPHENHYDRAMINE HCL 25 MG ORAL CAP $1.00 0904-5307-60 DIPHENHYDRAMINE HCL 50 MG ORAL CAP $1.00 0904-5307-80 DIPHENHYDRAMINE HCL 50 MG ORAL CAP $1.00 0904-5351-24 CHLORPHENIRAMINE-PSEUDOEPHED 4-60 MG ORAL TAB $1.00 0904-5365-60 ALUMINUM HYDROX-MAGNESIUM CARB 160-105 MG ORAL CHEW $1.00 0904-5551-24 DIPHENHYDRAMINE HCL 25 MG ORAL TAB $1.00 0904-5780-51 FAMOTIDINE 20 MG ORAL TAB $1.00 0904-5784-61 FLUOXETINE 10 MG ORAL CAP $1.00 0904-5785-61 FLUOXETINE 20 MG ORAL CAP $1.00 0904-5789-61 ACYCLOVIR 200 MG ORAL CAP $1.00 0904-5791-46 ACETAMINOPHEN 80 MG ORAL CHEW $1.00 0904-5853-61 IBUPROFEN 400 MG ORAL TAB $1.00 0904-5854-61 IBUPROFEN 600 MG ORAL TAB $1.00 0904-5855-60 IBUPROFEN 800 MG ORAL TAB $1.00 0904-5855-61 IBUPROFEN 800 MG ORAL TAB $1.00 0904-6007-61 LORAZEPAM 0.5 MG ORAL TAB $1.00 0904-6008-60 LORAZEPAM 1 MG ORAL TAB $1.00 0904-6008-61 LORAZEPAM 1 MG ORAL TAB $1.00 0904-6082-61 ZOLPIDEM 5 MG ORAL TAB $1.00 0904-6084-61 CITALOPRAM 10 MG ORAL TAB $1.00 0904-6085-61 CITALOPRAM 20 MG ORAL TAB $1.00 0904-6255-49 BENZOCAINE-MENTHOL 15-3.6 MG MUCOUS MEMB LOZG $1.00 0904-6300-61 CARVEDILOL 3.125 MG ORAL TAB $1.00 0904-6301-61 CARVEDILOL 6.25 MG ORAL TAB $1.00 0904-6302-61 CARVEDILOL 12.5 MG ORAL TAB $1.00 0904-6303-61 CARVEDILOL 25 MG ORAL TAB $1.00 0904-6358-61 RISPERIDONE 0.5 MG ORAL TAB $1.00 0904-6359-61 RISPERIDONE 1 MG ORAL TAB $1.00 0904-6360-61 RISPERIDONE 2 MG ORAL TAB $1.00 0904-6365-61 TRAMADOL 50 MG ORAL TAB $1.00 0904-6369-61 AMLODIPINE 2.5 MG ORAL TAB $1.00 0904-6370-61 AMLODIPINE 5 MG ORAL TAB $1.00 0904-6371-61 AMLODIPINE 10 MG ORAL TAB $1.00 0904-6401-80 TAMSULOSIN 0.4 MG ORAL CAP $1.00 0904-6407-61 BISACODYL 5 MG ORAL TBEC $1.00 0904-6412-92 CALCIUM CARBONATE 200 MG CALCIUM (500 MG) ORAL CHEW $1.00 0904-6426-61 ESCITALOPRAM OXALATE 10 MG ORAL TAB $1.00 0904-6427-61 ESCITALOPRAM OXALATE 20 MG ORAL TAB $1.00 0904-6440-61 HYDRALAZINE 10 MG ORAL TAB $1.00 0904-6441-61 HYDRALAZINE 25 MG ORAL TAB $1.00 0904-6442-61 HYDRALAZINE 50 MG ORAL TAB $1.00 0904-6461-61 PROMETHAZINE 25 MG ORAL TAB $1.00 0904-6477-61 DONEPEZIL 5 MG ORAL TAB $1.00 0904-6478-61 DONEPEZIL 10 MG ORAL TAB $1.00 0904-6519-61 MIRTAZAPINE 15 MG ORAL TAB $1.00 0904-6522-61 SENNOSIDES 8.6 MG ORAL TAB $1.00 0904-6564-60 BENZONATATE 100 MG ORAL CAP $1.00 0904-6665-61 GABAPENTIN 100 MG ORAL CAP $1.00 0904-6666-61 GABAPENTIN 300 MG ORAL CAP $1.00 0904-6717-41 CETIRIZINE 10 MG ORAL TAB $1.00 0904-6717-61 CETIRIZINE 10 MG ORAL TAB $1.00 0904-6720-40 ACETAMINOPHEN 500 MG ORAL TAB $1.00 0904-6720-80 ACETAMINOPHEN 500 MG ORAL TAB $1.00 0904-6725-59 SENNOSIDES 8.6 MG ORAL TAB $1.00 0904-6730-59 ACETAMINOPHEN 500 MG ORAL TAB $1.00 0904-6730-61 ACETAMINOPHEN 500 MG ORAL TAB $1.00 0904-6730-80 ACETAMINOPHEN 500 MG ORAL TAB $1.00 0904-6747-24 IBUPROFEN 200 MG ORAL TAB $1.00 0904-6747-59 IBUPROFEN 200 MG ORAL TAB $1.00 0904-6747-80 IBUPROFEN 200 MG ORAL TAB $1.00 0904-6748-17 BISACODYL 5 MG ORAL TBEC $1.00 0904-6748-80 BISACODYL 5 MG ORAL TBEC $1.00 0904-6751-80 ASPIRIN 81 MG ORAL TBEC $1.00 0904-6773-61 ACETAMINOPHEN 325 MG ORAL TAB $1.00 0904-6794-30 ASPIRIN 81 MG ORAL CHEW $1.00 0904-6794-80 ASPIRIN 81 MG ORAL CHEW $1.00 0904-6794-89 ASPIRIN 81 MG ORAL CHEW $1.00 0904-6797-61 LISINOPRIL 5 MG ORAL TAB $1.00 0904-6798-61 LISINOPRIL 10 MG ORAL TAB $1.00 0904-6799-61 LISINOPRIL 20 MG ORAL TAB $1.00 0904-6861-61 DIVALPROEX 500 MG ORAL TBEC $1.00 0904-6868-61 TRAZODONE 50 MG ORAL TAB $1.00 0904-6869-61 TRAZODONE 100 MG ORAL TAB $1.00 0904-6870-45 PANTOPRAZOLE 40 MG ORAL TBEC $1.00 0904-6907-06 PSEUDOEPHEDRINE HCL 60 MG ORAL TAB $1.00 0904-6927-61 SPIRONOLACTONE 25 MG ORAL TAB $1.00 0904-6990-61 PSEUDOEPHEDRINE HCL 30 MG ORAL TAB $1.00 0904-6997-60 DOCUSATE CALCIUM 240 MG ORAL CAP $1.00 0904-6999-60 DOCUSATE SODIUM 250 MG ORAL CAP $1.00 0904-6999-80 DOCUSATE SODIUM 250 MG ORAL CAP $1.00 0904-7007-61 LAMOTRIGINE 25 MG ORAL TAB $1.00 0904-7008-61 LAMOTRIGINE 100 MG ORAL TAB $1.00 0904-7023-67 BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OIPK $1.00 0904-7121-61 BUSPIRONE 10 MG ORAL TAB $1.00 0904-7122-61 BUSPIRONE 5 MG ORAL TAB $1.00 0904-7123-61 LEVETIRACETAM 250 MG ORAL TAB $1.00 0904-7162-61 METFORMIN 500 MG ORAL TAB $1.00 0904-7164-61 METFORMIN 1,000 MG ORAL TAB $1.00 0904-7177-61 FUROSEMIDE 20 MG ORAL TAB $1.00 0904-7179-61 TRAMADOL 50 MG ORAL TAB $1.00 0904-7183-61 DOCUSATE SODIUM 100 MG ORAL CAP $1.00 0904-7187-61 ATENOLOL 25 MG ORAL TAB $1.00 0904-7193-06 FAMOTIDINE 20 MG ORAL TAB $1.00 0904-7193-61 FAMOTIDINE 20 MG ORAL TAB $1.00 0904-7200-61 LISINOPRIL 40 MG ORAL TAB $1.00 0904-7205-46 BISMUTH SUBSALICYLATE 262 MG ORAL CHEW $1.00 0904-7206-60 SIMETHICONE 80 MG ORAL CHEW $1.00 0904-7224-61 FOLIC ACID 1 MG ORAL TAB $1.00 0904-7237-61 DIPHENHYDRAMINE HCL 25 MG ORAL CAP $1.00 0904-7252-61 SENNOSIDES 8.6 MG ORAL TAB $1.00 0904-7257-61 CARBIDOPA-LEVODOPA 25-100 MG ORAL TAB $1.00 0904-7280-60 DOCUSATE SODIUM 100 MG ORAL CAP $1.00 0904-7280-80 DOCUSATE SODIUM 100 MG ORAL CAP $1.00 0904-7912-59 IBUPROFEN 200 MG ORAL TAB $1.00 0904-7914-59 IBUPROFEN 200 MG ORAL TAB $1.00 0904-7914-61 IBUPROFEN 200 MG ORAL TAB $1.00 0904-8805-67 NEOMYCIN-BACITRACNZN-POLYMYXNB 3.5-400-5,000 MG-UNIT-UNIT TOPICAL OIPK $1.00 0990-8004-15 DEXTROSE 30 % IN WATER (D30W) IV SOLP $1.00 10135-111-01 DOCUSATE SODIUM 100 MG ORAL CAP $1.00 10135-123-01 ACETAMINOPHEN 325 MG ORAL TAB $1.00 10135-152-01 ACETAMINOPHEN 500 MG ORAL TAB $1.00 10135-173-62 ASPIRIN 81 MG ORAL TBEC $1.00 10135-314-01 SENNOSIDES 8.6 MG ORAL TAB $1.00 10135-638-01 CYPROHEPTADINE 4 MG ORAL TAB $1.00 10135-669-01 SENNOSIDES-DOCUSATE SODIUM 8.6-50 MG ORAL TAB $1.00 10135-689-62 ASPIRIN 81 MG ORAL TBEC $1.00 10702-003-01 PROMETHAZINE 25 MG ORAL TAB $1.00 10702-007-09 CYCLOBENZAPRINE 10 MG ORAL TAB $1.00 10702-010-01 HYDROXYZINE HCL 10 MG ORAL TAB $1.00 10702-018-01 OXYCODONE 5 MG ORAL TAB $1.00 10702-018-50 OXYCODONE 5 MG ORAL TAB $1.00 10702-201-01 OXYBUTYNIN CHLORIDE 5 MG ORAL TAB $1.00 10961-065-02 ACTIVATED CHARCOAL 260 MG ORAL CAP $1.00 11534-165-01 FOLIC ACID 1 MG ORAL TAB $1.00 11534-165-03 FOLIC ACID 1 MG ORAL TAB $1.00 13107-045-01 OXYCODONE-ACETAMINOPHEN 7.5-325 MG ORAL TAB $1.00 13107-083-05 LORAZEPAM 0.5 MG ORAL TAB $1.00 13107-084-01 LORAZEPAM 1 MG ORAL TAB $1.00 13668-007-01 ZOLPIDEM 5 MG ORAL TAB $1.00 13668-008-01 ZOLPIDEM 10 MG ORAL TAB $1.00 13668-009-01 CITALOPRAM 10 MG ORAL TAB $1.00 13668-010-01 CITALOPRAM 20 MG ORAL TAB $1.00 13668-010-05 CITALOPRAM 20 MG ORAL TAB $1.00 13668-031-60 TOPIRAMATE 25 MG ORAL TAB $1.00 13668-038-60 RISPERIDONE 2 MG ORAL TAB $1.00 13668-092-90 PRAMIPEXOLE 0.25 MG ORAL TAB $1.00 13668-093-90 PRAMIPEXOLE 0.5 MG ORAL TAB $1.00 13668-096-90 PANTOPRAZOLE 20 MG ORAL TBEC $1.00 13668-102-30 DONEPEZIL 5 MG ORAL TAB $1.00 13668-102-90 DONEPEZIL 5 MG ORAL TAB $1.00 13668-103-90 DONEPEZIL 10 MG ORAL TAB $1.00 13668-113-10 LOSARTAN 25 MG ORAL TAB $1.00 13668-113-90 LOSARTAN 25 MG ORAL TAB $1.00 13668-136-10 ESCITALOPRAM OXALATE 10 MG ORAL TAB $1.00 13668-409-10 LOSARTAN 50 MG ORAL TAB $1.00 13668-409-90 LOSARTAN 50 MG ORAL TAB $1.00 16500-59918 PEDIATRIC MULTIVIT-IRON-MIN ORAL CHEW $1.00 16571-401-10 CETIRIZINE 5 MG ORAL TAB $1.00 16571-783-01 CYCLOBENZAPRINE 10 MG ORAL TAB $1.00 16714-041-10 ALLOPURINOL 100 MG ORAL TAB $1.00 16714-041-12 ALLOPURINOL 100 MG ORAL TAB $1.00 16714-071-04 BACLOFEN 10 MG ORAL TAB $1.00 16714-081-10 HYDROXYZINE HCL 10 MG ORAL TAB $1.00 16714-082-10 HYDROXYZINE HCL 25 MG ORAL TAB $1.00 16714-082-11 HYDROXYZINE HCL 25 MG ORAL TAB $1.00 16714-083-10 HYDROXYZINE HCL 50 MG ORAL TAB $1.00 16714-084-01 SPIRONOLACTONE 25 MG ORAL TAB $1.00 16714-101-02 GEMFIBROZIL 600 MG ORAL TAB $1.00 16714-101-05 GEMFIBROZIL 600 MG ORAL TAB $1.00 16714-172-01 TIZANIDINE 4 MG ORAL TAB $1.00 16714-174-02 ATORVASTATIN 20 MG ORAL TAB $1.00 16714-175-02 ATORVASTATIN 40 MG ORAL TAB $1.00 16714-181-03 PAROXETINE HCL 10 MG ORAL TAB $1.00 16714-257-01 AMITRIPTYLINE 10 MG ORAL TAB $1.00 16714-298-01 AMOXICILLIN 250 MG ORAL CAP $1.00 16714-299-03 AMOXICILLIN 500 MG ORAL CAP $1.00 16714-299-04 AMOXICILLIN 500 MG ORAL CAP $1.00 16714-352-01 FLUOXETINE 20 MG ORAL CAP $1.00 16714-446-01 AMITRIPTYLINE 10 MG ORAL TAB $1.00 16714-452-01 QUETIAPINE 25 MG ORAL TAB $1.00 16714-510-01 CARISOPRODOL 350 MG ORAL TAB $1.00 16714-576-02 ALLOPURINOL 100 MG ORAL TAB $1.00 16714-612-01 SERTRALINE 50 MG ORAL TAB $1.00 16714-612-04 SERTRALINE 50 MG ORAL TAB $1.00 16714-612-05 SERTRALINE 50 MG ORAL TAB $1.00 16714-612-06 SERTRALINE 50 MG ORAL TAB $1.00 16714-613-01 SERTRALINE 100 MG ORAL TAB $1.00 16714-613-04 SERTRALINE 100 MG ORAL TAB $1.00 16714-613-05 SERTRALINE 100 MG ORAL TAB $1.00 16714-613-06 SERTRALINE 100 MG ORAL TAB $1.00 16714-621-01 ZOLPIDEM 5 MG ORAL TAB $1.00 16714-622-01 ZOLPIDEM 10 MG ORAL TAB $1.00 16714-661-01 GABAPENTIN 100 MG ORAL CAP $1.00 16714-661-02 GABAPENTIN 100 MG ORAL CAP $1.00 16714-662-01 GABAPENTIN 300 MG ORAL CAP $1.00 16714-662-02 GABAPENTIN 300 MG ORAL CAP $1.00 16714-663-01 GABAPENTIN 400 MG ORAL CAP $1.00 16714-663-02 GABAPENTIN 400 MG ORAL CAP $1.00 16714-681-01 SIMVASTATIN 5 MG ORAL TAB $1.00 16714-681-02 SIMVASTATIN 5 MG ORAL TAB $1.00 16714-682-01 SIMVASTATIN 10 MG ORAL TAB $1.00 16714-682-02 SIMVASTATIN 10 MG ORAL TAB $1.00 16714-682-03 SIMVASTATIN 10 MG ORAL TAB $1.00 16714-683-01 SIMVASTATIN 20 MG ORAL TAB $1.00 16714-683-02 SIMVASTATIN 20 MG ORAL TAB $1.00 16714-683-03 SIMVASTATIN 20 MG ORAL TAB $1.00 16714-684-01 SIMVASTATIN 40 MG ORAL TAB $1.00 16714-684-02 SIMVASTATIN 40 MG ORAL TAB $1.00 16714-684-03 SIMVASTATIN 40 MG ORAL TAB $1.00 16714-700-01 LAMOTRIGINE 25 MG ORAL TAB $1.00 16714-701-01 LAMOTRIGINE 100 MG ORAL TAB $1.00 16714-715-03 OMEPRAZOLE 20 MG ORAL CPDR $1.00 16714-720-02 FLUOXETINE 10 MG ORAL CAP $1.00 16714-721-02 FLUOXETINE 20 MG ORAL CAP $1.00 16714-895-01 GLIPIZIDE 5 MG ORAL TR24 $1.00 16714-898-01 LORATADINE 10 MG ORAL TAB $1.00 16714-898-02 LORATADINE 10 MG ORAL TAB $1.00 16714-990-01 ROSUVASTATIN 20 MG ORAL TAB $1.00 16729-002-01 GLIMEPIRIDE 2 MG ORAL TAB $1.00 16729-022-15 PIOGLITAZONE 45 MG ORAL TAB $1.00 16729-030-01 METHYLDOPA 250 MG ORAL TAB $1.00 16729-046-15 ATORVASTATIN 40 MG ORAL TAB $1.00 16729-090-01 FINASTERIDE 5 MG ORAL TAB $1.00 16729-090-15 FINASTERIDE 5 MG ORAL TAB $1.00 16729-136-00 CLONAZEPAM 0.5 MG ORAL TAB $1.00 16729-136-16 CLONAZEPAM 0.5 MG ORAL TAB $1.00 16729-137-00 CLONAZEPAM 1 MG ORAL TAB $1.00 16729-145-01 QUETIAPINE 25 MG ORAL TAB $1.00 16729-145-17 QUETIAPINE 25 MG ORAL TAB $1.00 16729-169-01 ESCITALOPRAM OXALATE 10 MG ORAL TAB $1.00 16729-170-01 ESCITALOPRAM OXALATE 20 MG ORAL TAB $1.00 16729-171-01 AMITRIPTYLINE 10 MG ORAL TAB $1.00 16729-182-01 HYDROCHLOROTHIAZIDE 12.5 MG ORAL TAB $1.00 16729-183-01 HYDROCHLOROTHIAZIDE 25 MG ORAL TAB $1.00 16729-183-17 HYDROCHLOROTHIAZIDE 25 MG ORAL TAB $1.00 16729-184-01 HYDROCHLOROTHIAZIDE 50 MG ORAL TAB $1.00 16729-200-01 BUSPIRONE 5 MG ORAL TAB $1.00 16729-202-01 BUSPIRONE 10 MG ORAL TAB $1.00 16729-216-15 SERTRALINE 50 MG ORAL TAB $1.00 16729-225-01 SPIRONOLACTONE 25 MG ORAL TAB $1.00 16729-321-10 OLMESARTAN 20 MG ORAL TAB $1.00 16729-321-15 OLMESARTAN 20 MG ORAL TAB $1.00 16729-443-10 BUPROPION HCL 150 MG ORAL TB24 $1.00 16729-443-15 BUPROPION HCL 150 MG ORAL TB24 $1.00 16729-447-15 LEVOTHYROXINE 25 MCG ORAL TAB $1.00 16729-448-15 LEVOTHYROXINE 50 MCG ORAL TAB $1.00 16729-449-15 LEVOTHYROXINE 75 MCG ORAL TAB $1.00 16729-450-15 LEVOTHYROXINE 88 MCG ORAL TAB $1.00 16729-451-15 LEVOTHYROXINE 100 MCG ORAL TAB $1.00 16729-452-15 LEVOTHYROXINE 112 MCG ORAL TAB $1.00 16729-453-15 LEVOTHYROXINE 125 MCG ORAL TAB $1.00 16729-454-15 LEVOTHYROXINE 137 MCG ORAL TAB $1.00 17238-900-11 FLUORESCEIN 1 MG OPHT STRP $1.00 17238-900-30 FLUORESCEIN 1 MG OPHT STRP $1.00 17238-900-99 FLUORESCEIN 1 MG OPHT STRP $1.00 23155-001-01 HYDRALAZINE 10 MG ORAL TAB $1.00 23155-002-10 HYDRALAZINE 25 MG ORAL TAB $1.00 23155-010-01 INDOMETHACIN 25 MG ORAL CAP $1.00 23155-026-01 VERAPAMIL 80 MG ORAL TAB $1.00 23155-027-01 VERAPAMIL 120 MG ORAL TAB $1.00 23155-057-01 GLYBURIDE 2.5 MG ORAL TAB $1.00 23155-070-01 METHIMAZOLE 5 MG ORAL TAB $1.00 23155-102-01 METFORMIN 500 MG ORAL TAB $1.00 23155-102-10 METFORMIN 500 MG ORAL TAB $1.00 23155-103-01 METFORMIN 850 MG ORAL TAB $1.00 23155-104-01 METFORMIN 1,000 MG ORAL TAB $1.00 23155-104-05 METFORMIN 1,000 MG ORAL TAB $1.00 23155-104-10 METFORMIN 1,000 MG ORAL TAB $1.00 23155-110-01 PROPRANOLOL 10 MG ORAL TAB $1.00 23155-111-01 PROPRANOLOL 20 MG ORAL TAB $1.00 23155-246-01 VENLAFAXINE 25 MG ORAL TAB $1.00 23155-248-01 VENLAFAXINE 50 MG ORAL TAB $1.00 23155-486-01 VERAPAMIL 120 MG ORAL TAB $1.00 23155-606-01 GLYCOPYRROLATE 1 MG ORAL TAB $1.00 24385-118-78 SIMETHICONE 80 MG ORAL CHEW $1.00 24658-312-50 DOXYCYCLINE HYCLATE 100 MG ORAL TAB $1.00 24689-132-01 MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) ORAL TAB $1.00 24689-855-01 TERAZOSIN 2 MG ORAL CAP $1.00 24979-201-01 DICYCLOMINE 10 MG ORAL CAP $1.00 27241-001-06 RISPERIDONE 1 MG ORAL TAB $1.00 27241-002-06 RISPERIDONE 0.25 MG ORAL TAB $1.00 27241-002-50 RISPERIDONE 0.25 MG ORAL TAB $1.00 27241-003-06 RISPERIDONE 0.5 MG ORAL TAB $1.00 27808-155-01 ROSUVASTATIN 5 MG ORAL TAB $1.00 27808-156-01 ROSUVASTATIN 10 MG ORAL TAB $1.00 27808-157-01 ROSUVASTATIN 20 MG ORAL TAB $1.00 27808-157-03 ROSUVASTATIN 20 MG ORAL TAB $1.00 29300-128-10 HYDROCHLOROTHIAZIDE 25 MG ORAL TAB $1.00 29300-135-01 CLONIDINE HCL 0.1 MG ORAL TAB $1.00 29300-135-05 CLONIDINE HCL 0.1 MG ORAL TAB $1.00 29300-136-01 CLONIDINE HCL 0.2 MG ORAL TAB $1.00 29300-137-01 CLONIDINE HCL 0.3 MG ORAL TAB $1.00 29300-138-01 DIVALPROEX 125 MG ORAL TBEC $1.00 29300-147-01 QUETIAPINE 25 MG ORAL TAB $1.00 29300-149-01 QUETIAPINE 100 MG ORAL TAB $1.00 29300-398-10 AMLODIPINE 10 MG ORAL TAB $1.00 29300-411-01 ATENOLOL 50 MG ORAL TAB $1.00 31722-505-60 NEVIRAPINE 200 MG ORAL TAB $1.00 31722-529-01 TORSEMIDE 5 MG ORAL TAB $1.00 31722-533-01 METHOCARBAMOL 500 MG ORAL TAB $1.00 31722-542-01 INDOMETHACIN 25 MG ORAL CAP $1.00 31722-700-10 LOSARTAN 25 MG ORAL TAB $1.00 31722-700-90 LOSARTAN 25 MG ORAL TAB $1.00 31722-701-10 LOSARTAN 50 MG ORAL TAB $1.00 31722-701-30 LOSARTAN 50 MG ORAL TAB $1.00 31722-701-90 LOSARTAN 50 MG ORAL TAB $1.00 31722-712-90 PANTOPRAZOLE 20 MG ORAL TBEC $1.00 31722-713-90 PANTOPRAZOLE 40 MG ORAL TBEC $1.00 31722-726-90 MONTELUKAST 10 MG ORAL TAB $1.00 31722-738-30 DONEPEZIL 10 MG ORAL TAB $1.00 31722-777-01 ACYCLOVIR 400 MG ORAL TAB $1.00 31722-884-90 ROSUVASTATIN 20 MG ORAL TAB $1.00 31722-949-01 OXYCODONE-ACETAMINOPHEN 5-325 MG ORAL TAB $1.00 33342-004-09 NEVIRAPINE 200 MG ORAL TAB $1.00 33342-032-10 PRAMIPEXOLE 0.25 MG ORAL TAB $1.00 33342-033-10 PRAMIPEXOLE 0.5 MG ORAL TAB $1.00 33342-034-10 PRAMIPEXOLE 1 MG ORAL TAB $1.00 33342-054-07 PIOGLITAZONE 15 MG ORAL TAB $1.00 33342-054-10 PIOGLITAZONE 15 MG ORAL TAB $1.00 33342-055-07 PIOGLITAZONE 30 MG ORAL TAB $1.00 33342-055-10 PIOGLITAZONE 30 MG ORAL TAB $1.00 33342-056-07 PIOGLITAZONE 45 MG ORAL TAB $1.00 33342-056-10 PIOGLITAZONE 45 MG ORAL TAB $1.00 33342-060-15 CLOPIDOGREL 75 MG ORAL TAB $1.00 33342-102-07 MONTELUKAST 10 MG ORAL TAB $1.00 37361-10277 DM-BENZOCAINE-MENTHOL 5-6-10 MG ORAL LOZG $1.00 42291-184-90 DILTIAZEM HCL 120 MG ORAL CP24 $1.00 42291-185-90 DILTIAZEM HCL 180 MG ORAL CP24 $1.00 42291-259-01 DOXAZOSIN 4 MG ORAL TAB $1.00 42291-465-01 CARBIDOPA-LEVODOPA 10-100 MG ORAL TAB $1.00 42291-466-01 CARBIDOPA-LEVODOPA 25-100 MG ORAL TAB $1.00 42291-466-10 CARBIDOPA-LEVODOPA 25-100 MG ORAL TAB $1.00 42291-472-01 CARBIDOPA-LEVODOPA 25-100 MG ORAL TAB $1.00 42291-560-90 MIDODRINE 2.5 MG ORAL TAB $1.00 42291-657-12 OMEGA-3 ACID ETHYL ESTERS 1 GRAM ORAL CAP $1.00 42291-808-15 TIZANIDINE 2 MG ORAL TAB $1.00 42291-898-90 VENLAFAXINE 75 MG ORAL CP24 $1.00 42543-700-01 CARISOPRODOL 350 MG ORAL TAB $1.00 42658-122-04 IRBESARTAN 150 MG ORAL TAB $1.00 42806-087-01 ESTRADIOL 0.5 MG ORAL TAB $1.00 42806-088-01 ESTRADIOL 1 MG ORAL TAB $1.00 42806-312-05 DOXYCYCLINE HYCLATE 100 MG ORAL TAB $1.00 42806-312-50 DOXYCYCLINE HYCLATE 100 MG ORAL TAB $1.00 42806-552-12 OMEGA-3 ACID ETHYL ESTERS 1 GRAM ORAL CAP $1.00 42806-714-01 BENZONATATE 100 MG ORAL CAP $1.00 42806-714-05 BENZONATATE 100 MG ORAL CAP $1.00 42858-001-01 OXYCODONE 5 MG ORAL TAB $1.00 42858-002-01 OXYCODONE 10 MG ORAL TAB $1.00 42858-003-01 OXYCODONE 15 MG ORAL TAB $1.00 42858-102-01 OXYCODONE-ACETAMINOPHEN 5-325 MG ORAL TAB $1.00 42858-103-01 OXYCODONE-ACETAMINOPHEN 7.5-325 MG ORAL TAB $1.00 42858-104-01 OXYCODONE-ACETAMINOPHEN 10-325 MG ORAL TAB $1.00 42858-301-25 HYDROMORPHONE 2 MG ORAL TAB $1.00 43547-226-10 METHOCARBAMOL 750 MG ORAL TAB $1.00 43547-275-03 DONEPEZIL 5 MG ORAL TAB $1.00 43547-275-09 DONEPEZIL 5 MG ORAL TAB $1.00 43547-276-03 DONEPEZIL 10 MG ORAL TAB $1.00 43547-276-09 DONEPEZIL 10 MG ORAL TAB $1.00 43547-281-10 ESCITALOPRAM OXALATE 10 MG ORAL TAB $1.00 43547-281-11 ESCITALOPRAM OXALATE 10 MG ORAL TAB $1.00 43547-282-10 ESCITALOPRAM OXALATE 20 MG ORAL TAB $1.00 43547-335-10 BENAZEPRIL 5 MG ORAL TAB $1.00 43547-336-10 BENAZEPRIL 10 MG ORAL TAB $1.00 43547-336-50 BENAZEPRIL 10 MG ORAL TAB $1.00 43547-337-10 BENAZEPRIL 20 MG ORAL TAB $1.00 43547-338-10 BENAZEPRIL 40 MG ORAL TAB $1.00 43547-339-06 RISPERIDONE 0.25 MG ORAL TAB $1.00 43547-341-06 RISPERIDONE 1 MG ORAL TAB $1.00 43547-347-03 PAROXETINE HCL 10 MG ORAL TAB $1.00 43547-347-09 PAROXETINE HCL 10 MG ORAL TAB $1.00 43547-351-10 LISINOPRIL 2.5 MG ORAL TAB $1.00 43547-352-10 LISINOPRIL 5 MG ORAL TAB $1.00 43547-353-10 LISINOPRIL 10 MG ORAL TAB $1.00 43547-354-10 LISINOPRIL 20 MG ORAL TAB $1.00 43547-354-11 LISINOPRIL 20 MG ORAL TAB $1.00 43547-356-10 LISINOPRIL 40 MG ORAL TAB $1.00 43547-360-09 LOSARTAN 25 MG ORAL TAB $1.00 43547-361-09 LOSARTAN 50 MG ORAL TAB $1.00 43547-386-09 FOSINOPRIL 10 MG ORAL TAB $1.00 43547-397-10 HYDROCHLOROTHIAZIDE 25 MG ORAL TAB $1.00 43547-401-10 FUROSEMIDE 20 MG ORAL TAB $1.00 43547-401-11 FUROSEMIDE 20 MG ORAL TAB $1.00 43547-402-10 FUROSEMIDE 40 MG ORAL TAB $1.00 43547-402-11 FUROSEMIDE 40 MG ORAL TAB $1.00 43547-403-10 FUROSEMIDE 80 MG ORAL TAB $1.00 43547-403-50 FUROSEMIDE 80 MG ORAL TAB $1.00 43547-406-10 CLONAZEPAM 0.5 MG ORAL TAB $1.00 43547-407-10 CLONAZEPAM 1 MG ORAL TAB $1.00 43547-410-09 QUINAPRIL 5 MG ORAL TAB $1.00 43547-411-09 QUINAPRIL 10 MG ORAL TAB $1.00 43547-415-10 LISINOPRIL 5 MG ORAL TAB $1.00 43547-416-10 LISINOPRIL 10 MG ORAL TAB $1.00 43547-417-11 LISINOPRIL 20 MG ORAL TAB $1.00 43598-170-01 CHLORTHALIDONE 25 MG ORAL TAB $1.00 45802-060-00 BACITRACIN 500 UNIT/GRAM TOPICAL PACK $1.00 45802-060-70 BACITRACIN 500 UNIT/GRAM TOPICAL PACK $1.00 45802-143-00 NEOMYCIN-BACITRACNZN-POLYMYXNB 3.5-400-5,000 MG-UNIT-UNIT TOPICAL OIPK $1.00 45802-143-70 NEOMYCIN-BACITRACNZN-POLYMYXNB 3.5-400-5,000 MG-UNIT-UNIT TOPICAL OIPK $1.00 45802-432-62 PSEUDOEPHEDRINE HCL 30 MG ORAL TAB $1.00 45802-490-71 NAPROXEN SODIUM 220 MG ORAL TAB $1.00 45802-650-65 LORATADINE 10 MG ORAL TAB $1.00 45802-650-78 LORATADINE 10 MG ORAL TAB $1.00 45802-650-87 LORATADINE 10 MG ORAL TAB $1.00 45802-732-33 ACETAMINOPHEN 120 MG RECTAL SUPP $1.00 45963-556-50 GABAPENTIN 300 MG ORAL CAP $1.00 45963-557-11 GABAPENTIN 400 MG ORAL CAP $1.00 46122-390-78 ACETAMINOPHEN 325 MG ORAL TAB $1.00 46122-392-72 CAMPHOR-METHYL SALICYL-MENTHOL 3.1-10-6 % TOPICAL PTMD $1.00 46122-615-87 ASPIRIN 81 MG ORAL TBEC $1.00 46581-110-20 CAMPHOR-METHYL SALICYL-MENTHOL 3.1-10-6 % TOPICAL PTMD $1.00 46581-110-60 CAMPHOR-METHYL SALICYL-MENTHOL 3.1-10-6 % TOPICAL PTMD $1.00 47335-603-88 ALPRAZOLAM 0.25 MG ORAL TAB $1.00 47335-707-13 TOPIRAMATE 25 MG ORAL TAB $1.00 47335-707-86 TOPIRAMATE 25 MG ORAL TAB $1.00 47335-710-86 TOPIRAMATE 50 MG ORAL TAB $1.00 47335-711-13 TOPIRAMATE 100 MG ORAL TAB $1.00 47335-711-86 TOPIRAMATE 100 MG ORAL TAB $1.00 47335-902-88 QUETIAPINE 25 MG ORAL TAB $1.00 47781-643-90 LEVOTHYROXINE 50 MCG ORAL TAB $1.00 47781-646-90 LEVOTHYROXINE 75 MCG ORAL TAB $1.00 47781-649-90 LEVOTHYROXINE 88 MCG ORAL TAB $1.00 47781-654-90 LEVOTHYROXINE 112 MCG ORAL TAB $1.00 47781-657-90 LEVOTHYROXINE 125 MCG ORAL TAB $1.00 47781-662-90 LEVOTHYROXINE 150 MCG ORAL TAB $1.00 47781-665-90 LEVOTHYROXINE 175 MCG ORAL TAB $1.00 48433-129-01 ASPIRIN 81 MG ORAL CHEW $1.00 49348-188-10 SIMETHICONE 80 MG ORAL CHEW $1.00 49348-541-10 METHYLCELLULOSE (LAXATIVE) 500 MG ORAL TAB $1.00 49348-757-07 ASPIRIN 81 MG ORAL CHEW $1.00 49348-817-05 FAMOTIDINE 20 MG ORAL TAB $1.00 49348-818-13 LORATADINE 10 MG ORAL TAB $1.00 49348-818-56 LORATADINE 10 MG ORAL TAB $1.00 49348-953-44 BISMUTH SUBSALICYLATE 262 MG ORAL CHEW $1.00 49348-980-23 ASPIRIN 81 MG ORAL TBEC $1.00 49348-980-53 ASPIRIN 81 MG ORAL TBEC $1.00 49348-981-15 ASPIRIN 81 MG ORAL TBEC $1.00 49483-080-10 SENNOSIDES 8.6 MG ORAL TAB $1.00 49483-340-01 ACETAMINOPHEN 325 MG ORAL TAB $1.00 49483-341-50 ACETAMINOPHEN 500 MG ORAL TAB $1.00 49483-481-10 ASPIRIN 81 MG ORAL TBEC $1.00 49483-481-12 ASPIRIN 81 MG ORAL TBEC $1.00 49483-602-01 IBUPROFEN 400 MG ORAL TAB $1.00 49483-604-50 IBUPROFEN 800 MG ORAL TAB $1.00 49884-054-01 IMIPRAMINE HCL 10 MG ORAL TAB $1.00 49884-289-01 MEGESTROL 20 MG ORAL TAB $1.00 49884-689-01 METOCLOPRAMIDE HCL 10 MG ORAL TAB $1.00 50111-327-03 HYDRALAZINE 25 MG ORAL TAB $1.00 50111-328-03 HYDRALAZINE 50 MG ORAL TAB $1.00 50111-398-01 HYDRALAZINE 10 MG ORAL TAB $1.00 50111-560-01 TRAZODONE 50 MG ORAL TAB $1.00 50111-561-01 TRAZODONE 100 MG ORAL TAB $1.00 50111-647-01 FLUOXETINE 10 MG ORAL CAP $1.00 50111-648-01 FLUOXETINE 20 MG ORAL CAP $1.00 50228-109-01 CARISOPRODOL 350 MG ORAL TAB $1.00 50228-177-05 GABAPENTIN 600 MG ORAL TAB $1.00 50228-350-90 PREGABALIN 25 MG ORAL CAP $1.00 50228-351-90 PREGABALIN 50 MG ORAL CAP $1.00 50228-353-90 PREGABALIN 100 MG ORAL CAP $1.00 50228-458-01 CARBIDOPA-LEVODOPA 25-100 MG ORAL TAB $1.00 50228-465-01 NABUMETONE 500 MG ORAL TAB $1.00 50228-482-01 DILTIAZEM HCL 60 MG ORAL TAB $1.00 50268-067-30 CARBOXYMETHYLCELLULOSE SODIUM 0.5 % OPHT DPET $1.00 50268-299-11 FAMOTIDINE 20 MG ORAL TAB $1.00 50268-299-15 FAMOTIDINE 20 MG ORAL TAB $1.00 50268-303-11 FAMOTIDINE 20 MG ORAL TAB $1.00 50268-303-15 FAMOTIDINE 20 MG ORAL TAB $1.00 50268-525-11 MELOXICAM 7.5 MG ORAL TAB $1.00 50268-525-15 MELOXICAM 7.5 MG ORAL TAB $1.00 50289-3250-1 GLYCERIN-WITCH HAZEL 12.5-50 % TOPICAL PADM $1.00 50383-042-05 PREDNISOLONE 15 MG/5 ML ORAL SOLN $1.00 50383-804-05 PROMETHAZINE-CODEINE 6.25-10 MG/5 ML ORAL SYRP $1.00 50580-457-11 ACETAMINOPHEN 500 MG ORAL TAB $1.00 50580-457-70 ACETAMINOPHEN 500 MG ORAL TAB $1.00 50580-458-11 ACETAMINOPHEN 325 MG ORAL TAB $1.00 50742-113-01 DESIPRAMINE 25 MG ORAL TAB $1.00 50742-175-01 ISOSORBIDE MONONITRATE 30 MG ORAL TB24 $1.00 50742-190-01 CYPROHEPTADINE 4 MG ORAL TAB $1.00 50742-615-01 METOPROLOL SUCCINATE 25 MG ORAL TB24 $1.00 50742-616-01 METOPROLOL SUCCINATE 50 MG ORAL TB24 $1.00 51079-072-01 FUROSEMIDE 20 MG ORAL TAB $1.00 51079-072-20 FUROSEMIDE 20 MG ORAL TAB $1.00 51079-073-01 FUROSEMIDE 40 MG ORAL TAB $1.00 51079-073-20 FUROSEMIDE 40 MG ORAL TAB $1.00 51079-086-01 MIRTAZAPINE 15 MG ORAL TAB $1.00 51079-086-20 MIRTAZAPINE 15 MG ORAL TAB $1.00 51079-103-01 SPIRONOLACTONE 25 MG ORAL TAB $1.00 51079-103-20 SPIRONOLACTONE 25 MG ORAL TAB $1.00 51079-182-01 CIPROFLOXACIN HCL 500 MG ORAL TAB $1.00 51079-200-01 METHYLDOPA 250 MG ORAL TAB $1.00 51079-200-20 METHYLDOPA 250 MG ORAL TAB $1.00 51079-255-01 METOPROLOL TARTRATE 25 MG ORAL TAB $1.00 51079-255-20 METOPROLOL TARTRATE 25 MG ORAL TAB $1.00 51079-284-01 DIAZEPAM 2 MG ORAL TAB $1.00 51079-284-20 DIAZEPAM 2 MG ORAL TAB $1.00 51079-285-01 DIAZEPAM 5 MG ORAL TAB $1.00 51079-285-20 DIAZEPAM 5 MG ORAL TAB $1.00 51079-286-01 DIAZEPAM 10 MG ORAL TAB $1.00 51079-286-20 DIAZEPAM 10 MG ORAL TAB $1.00 51079-301-01 CLONIDINE HCL 0.3 MG ORAL TAB $1.00 51079-301-20 CLONIDINE HCL 0.3 MG ORAL TAB $1.00 51079-386-20 LORAZEPAM 1 MG ORAL TAB $1.00 51079-417-20 LORAZEPAM 0.5 MG ORAL TAB $1.00 51079-418-01 TEMAZEPAM 15 MG ORAL CAP $1.00 51079-418-20 TEMAZEPAM 15 MG ORAL CAP $1.00 51079-451-01 AMLODIPINE 5 MG ORAL TAB $1.00 51079-451-20 AMLODIPINE 5 MG ORAL TAB $1.00 51079-454-20 SIMVASTATIN 10 MG ORAL TAB $1.00 51079-455-01 SIMVASTATIN 20 MG ORAL TAB $1.00 51079-455-20 SIMVASTATIN 20 MG ORAL TAB $1.00 51079-456-20 SIMVASTATIN 40 MG ORAL TAB $1.00 51079-499-01 LAMOTRIGINE 100 MG ORAL TAB $1.00 51079-499-20 LAMOTRIGINE 100 MG ORAL TAB $1.00 51079-527-01 FUROSEMIDE 80 MG ORAL TAB $1.00 51079-527-20 FUROSEMIDE 80 MG ORAL TAB $1.00 51079-597-01 CETIRIZINE 10 MG ORAL TAB $1.00 51079-597-20 CETIRIZINE 10 MG ORAL TAB $1.00 51079-644-01 CYCLOBENZAPRINE 10 MG ORAL TAB $1.00 51079-644-20 CYCLOBENZAPRINE 10 MG ORAL TAB $1.00 51079-684-01 ATENOLOL 50 MG ORAL TAB $1.00 51079-684-20 ATENOLOL 50 MG ORAL TAB $1.00 51079-724-01 ZOLPIDEM 5 MG ORAL TAB $1.00 51079-724-20 ZOLPIDEM 5 MG ORAL TAB $1.00 51079-725-01 ZOLPIDEM 10 MG ORAL TAB $1.00 51079-745-01 DILTIAZEM HCL 30 MG ORAL TAB $1.00 51079-745-20 DILTIAZEM HCL 30 MG ORAL TAB $1.00 51079-759-01 ATENOLOL 25 MG ORAL TAB $1.00 51079-759-20 ATENOLOL 25 MG ORAL TAB $1.00 51079-771-01 CARVEDILOL 3.125 MG ORAL TAB $1.00 51079-771-20 CARVEDILOL 3.125 MG ORAL TAB $1.00 51079-776-01 HYDROCHLOROTHIAZIDE 12.5 MG ORAL CAP $1.00 51079-776-20 HYDROCHLOROTHIAZIDE 12.5 MG ORAL CAP $1.00 51079-788-01 ALPRAZOLAM 0.25 MG ORAL TAB $1.00 51079-788-20 ALPRAZOLAM 0.25 MG ORAL TAB $1.00 51079-789-01 ALPRAZOLAM 0.5 MG ORAL TAB $1.00 51079-789-20 ALPRAZOLAM 0.5 MG ORAL TAB $1.00 51079-790-01 ALPRAZOLAM 1 MG ORAL TAB $1.00 51079-790-20 ALPRAZOLAM 1 MG ORAL TAB $1.00 51079-801-01 METOPROLOL TARTRATE 50 MG ORAL TAB $1.00 51079-801-20 METOPROLOL TARTRATE 50 MG ORAL TAB $1.00 51079-802-01 METOPROLOL TARTRATE 100 MG ORAL TAB $1.00 51079-882-01 CLONAZEPAM 1 MG ORAL TAB $1.00 51079-882-20 CLONAZEPAM 1 MG ORAL TAB $1.00 51079-930-01 CARVEDILOL 6.25 MG ORAL TAB $1.00 51079-930-20 CARVEDILOL 6.25 MG ORAL TAB $1.00 51079-931-01 CARVEDILOL 12.5 MG ORAL TAB $1.00 51079-931-20 CARVEDILOL 12.5 MG ORAL TAB $1.00 51079-932-01 CARVEDILOL 25 MG ORAL TAB $1.00 51079-932-20 CARVEDILOL 25 MG ORAL TAB $1.00 51079-937-20 TERAZOSIN 2 MG ORAL CAP $1.00 51079-966-01 FAMOTIDINE 20 MG ORAL TAB $1.00 51079-966-20 FAMOTIDINE 20 MG ORAL TAB $1.00 51079-985-01 BUSPIRONE 5 MG ORAL TAB $1.00 51079-985-20 BUSPIRONE 5 MG ORAL TAB $1.00 51079-986-01 BUSPIRONE 10 MG ORAL TAB $1.00 51079-986-20 BUSPIRONE 10 MG ORAL TAB $1.00 51079-991-01 TRAMADOL 50 MG ORAL TAB $1.00 51079-991-20 TRAMADOL 50 MG ORAL TAB $1.00 51224-007-50 METFORMIN 500 MG ORAL TB24 $1.00 51645-851-01 SENNOSIDES 8.6 MG ORAL TAB $1.00 51672-4001-1 NORTRIPTYLINE 10 MG ORAL CAP $1.00 51672-4001-5 NORTRIPTYLINE 10 MG ORAL CAP $1.00 51672-4002-5 NORTRIPTYLINE 25 MG ORAL CAP $1.00 51672-4131-1 LAMOTRIGINE 100 MG ORAL TAB $1.00 51672-4133-4 LAMOTRIGINE 200 MG ORAL TAB $1.00 52817-181-10 CLONIDINE HCL 0.2 MG ORAL TAB $1.00 52817-210-10 CYPROHEPTADINE 4 MG ORAL TAB $1.00 52817-332-00 CYCLOBENZAPRINE 10 MG ORAL TAB $1.00 52817-332-10 CYCLOBENZAPRINE 10 MG ORAL TAB $1.00 53489-143-01 SPIRONOLACTONE 25 MG ORAL TAB $1.00 53489-143-05 SPIRONOLACTONE 25 MG ORAL TAB $1.00 53489-143-10 SPIRONOLACTONE 25 MG ORAL TAB $1.00 53489-330-01 IMIPRAMINE HCL 10 MG ORAL TAB $1.00 53746-173-60 MEMANTINE 5 MG ORAL TAB $1.00 53746-361-01 FOLIC ACID 1 MG ORAL TAB $1.00 53746-511-01 SPIRONOLACTONE 25 MG ORAL TAB $1.00 53746-511-05 SPIRONOLACTONE 25 MG ORAL TAB $1.00 53746-511-10 SPIRONOLACTONE 25 MG ORAL TAB $1.00 54629-0560-01 VITAMIN B COMPLEX ORAL CAP $1.00 55111-123-90 ATORVASTATIN 40 MG ORAL TAB $1.00 55111-124-90 ATORVASTATIN 80 MG ORAL TAB $1.00 55111-163-30 OLANZAPINE 2.5 MG ORAL TAB $1.00 55111-179-15 TIZANIDINE 2 MG ORAL TAB $1.00 55111-180-15 TIZANIDINE 4 MG ORAL TAB $1.00 55111-196-05 CLOPIDOGREL 75 MG ORAL TAB $1.00 55111-196-90 CLOPIDOGREL 75 MG ORAL TAB $1.00 55111-229-90 PRAVASTATIN 10 MG ORAL TAB $1.00 55111-230-90 PRAVASTATIN 20 MG ORAL TAB $1.00 55111-231-05 PRAVASTATIN 40 MG ORAL TAB $1.00 55111-320-01 GLIMEPIRIDE 1 MG ORAL TAB $1.00 55111-321-01 GLIMEPIRIDE 2 MG ORAL TAB $1.00 55111-342-30 CITALOPRAM 10 MG ORAL TAB $1.00 55111-343-01 CITALOPRAM 20 MG ORAL TAB $1.00 55111-343-30 CITALOPRAM 20 MG ORAL TAB $1.00 55111-682-05 IBUPROFEN 400 MG ORAL TAB $1.00 55111-683-05 IBUPROFEN 600 MG ORAL TAB $1.00 55111-729-01 ALLOPURINOL 100 MG ORAL TAB $1.00 56151-1610-51 GLUCOSE 4 GRAM ORAL CHEW $1.00 57237-031-01 AMOXICILLIN 500 MG ORAL CAP $1.00 57237-040-01 PENICILLIN V POTASSIUM 250 MG ORAL TAB $1.00 57237-101-01 METOPROLOL TARTRATE 50 MG ORAL TAB $1.00 57237-119-01 WARFARIN 1 MG ORAL TAB $1.00 57237-122-01 WARFARIN 3 MG ORAL TAB $1.00 57237-124-01 WARFARIN 5 MG ORAL TAB $1.00 57237-161-30 OMEPRAZOLE 20 MG ORAL CPDR $1.00 57237-168-90 ROSUVASTATIN 5 MG ORAL TAB $1.00 57237-169-90 ROSUVASTATIN 10 MG ORAL TAB $1.00 57237-169-99 ROSUVASTATIN 10 MG ORAL TAB $1.00 57237-170-90 ROSUVASTATIN 20 MG ORAL TAB $1.00 57237-172-01 VENLAFAXINE 25 MG ORAL TAB $1.00 57237-174-01 VENLAFAXINE 50 MG ORAL TAB $1.00 57237-212-30 MONTELUKAST 4 MG ORAL CHEW $1.00 57237-219-30 PIOGLITAZONE 15 MG ORAL TAB $1.00 57237-221-90 PIOGLITAZONE 45 MG ORAL TAB $1.00 57237-223-01 RAMIPRIL 2.5 MG ORAL CAP $1.00 57664-167-52 METOPROLOL TARTRATE 100 MG ORAL TAB $1.00 57664-167-58 METOPROLOL TARTRATE 100 MG ORAL TAB $1.00 57664-228-88 METHYLPHENIDATE HCL 5 MG ORAL TAB $1.00 57664-377-08 TRAMADOL 50 MG ORAL TAB $1.00 57664-397-51 METFORMIN 500 MG ORAL TAB $1.00 57664-397-53 METFORMIN 500 MG ORAL TAB $1.00 57664-435-51 METFORMIN 850 MG ORAL TAB $1.00 57664-474-51 METFORMIN 1,000 MG ORAL TAB $1.00 57664-477-52 METOPROLOL TARTRATE 50 MG ORAL TAB $1.00 57664-506-52 METOPROLOL TARTRATE 25 MG ORAL TAB $1.00 57664-506-58 METOPROLOL TARTRATE 25 MG ORAL TAB $1.00 57896-104-10 ACETAMINOPHEN 325 MG ORAL TAB $1.00 57896-111-09 BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OIPK $1.00 57896-111-14 BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OIPK $1.00 57896-113-09 NEOMYCIN-BACITRACNZN-POLYMYXNB 3.5-400-5,000 MG-UNIT-UNIT TOPICAL OIPK $1.00 57896-113-14 NEOMYCIN-BACITRACNZN-POLYMYXNB 3.5-400-5,000 MG-UNIT-UNIT TOPICAL OIPK $1.00 57896-145-09 BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OIPK $1.00 57896-145-14 BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OIPK $1.00 57896-201-10 ACETAMINOPHEN 500 MG ORAL TAB $1.00 57896-303-01 SENNOSIDES-DOCUSATE SODIUM 8.6-50 MG ORAL TAB $1.00 57896-304-01 SENNOSIDES-DOCUSATE SODIUM 8.6-50 MG ORAL TAB $1.00 57896-304-10 SENNOSIDES-DOCUSATE SODIUM 8.6-50 MG ORAL TAB $1.00 57896-425-01 DOCUSATE SODIUM 250 MG ORAL CAP $1.00 57896-426-01 DOCUSATE SODIUM 250 MG ORAL CAP $1.00 57896-441-01 BISACODYL 5 MG ORAL TBEC $1.00 57896-454-01 SENNOSIDES 8.6 MG ORAL TAB $1.00 57896-555-01 SENNOSIDES-DOCUSATE SODIUM 8.6-50 MG ORAL TAB $1.00 57896-791-01 SIMETHICONE 80 MG ORAL CHEW $1.00 57896-799-01 SIMETHICONE 80 MG ORAL CHEW $1.00 57896-901-01 ASPIRIN 325 MG ORAL TAB $1.00 57896-901-10 ASPIRIN 325 MG ORAL TAB $1.00 57896-921-01 ASPIRIN 325 MG ORAL TBEC $1.00 57896-941-01 IBUPROFEN 200 MG ORAL TAB $1.00 57896-981-01 ASPIRIN 81 MG ORAL TBEC $1.00 58602-702-04 LORATADINE 10 MG ORAL TAB $1.00 58602-702-83 LORATADINE 10 MG ORAL TAB $1.00 58602-773-21 ACETAMINOPHEN 500 MG ORAL TAB $1.00 58657-645-01 CARISOPRODOL 350 MG ORAL TAB $1.00 58657-675-01 CIPROFLOXACIN HCL 250 MG ORAL TAB $1.00 58657-676-01 CIPROFLOXACIN HCL 500 MG ORAL TAB $1.00 59651-299-60 TAMOXIFEN 10 MG ORAL TAB $1.00 59651-457-01 CARBIDOPA-LEVODOPA 25-100 MG ORAL TAB $1.00 59746-171-06 PREDNISONE 1 MG ORAL TAB $1.00 59746-172-06 PREDNISONE 5 MG ORAL TAB $1.00 59746-173-06 PREDNISONE 10 MG ORAL TAB $1.00 59746-175-06 PREDNISONE 20 MG ORAL TAB $1.00 59746-175-09 PREDNISONE 20 MG ORAL TAB $1.00 59746-216-01 SPIRONOLACTONE 25 MG ORAL TAB $1.00 59746-245-01 LAMOTRIGINE 25 MG ORAL TAB $1.00 59746-383-06 TERAZOSIN 1 MG ORAL CAP $1.00 59746-384-06 TERAZOSIN 2 MG ORAL CAP $1.00 59746-385-06 TERAZOSIN 5 MG ORAL CAP $1.00 59762-0073-1 HYDROCORTISONE 5 MG ORAL TAB $1.00 59762-0401-1 SUCRALFATE 1 GRAM ORAL TAB $1.00 59762-0401-5 SUCRALFATE 1 GRAM ORAL TAB $1.00 59762-0541-1 GLIPIZIDE 5 MG ORAL TR24 $1.00 59762-3328-1 CLINDAMYCIN HCL 150 MG ORAL CAP $1.00 59762-3719-1 ALPRAZOLAM 0.25 MG ORAL TAB $1.00 59762-3720-1 ALPRAZOLAM 0.5 MG ORAL TAB $1.00 59762-3721-1 ALPRAZOLAM 1 MG ORAL TAB $1.00 59762-4900-5 SERTRALINE 50 MG ORAL TAB $1.00 59762-5000-5 SULFASALAZINE 500 MG ORAL TAB $1.00 60429-177-30 BICALUTAMIDE 50 MG ORAL TAB $1.00 60505-0083-2 PAROXETINE HCL 20 MG ORAL TAB $1.00 60505-0141-0 GLIPIZIDE 5 MG ORAL TAB $1.00 60505-0142-0 GLIPIZIDE 10 MG ORAL TAB $1.00 60505-0251-3 TIZANIDINE 2 MG ORAL TAB $1.00 60505-0253-2 CLOPIDOGREL 75 MG ORAL TAB $1.00 60505-0253-3 CLOPIDOGREL 75 MG ORAL TAB $1.00 60505-3110-0 OLANZAPINE 2.5 MG ORAL TAB $1.00 60687-122-01 PREDNISONE 5 MG ORAL TAB $1.00 60687-122-11 PREDNISONE 5 MG ORAL TAB $1.00 60687-129-01 DOCUSATE SODIUM 100 MG ORAL CAP $1.00 60687-129-11 DOCUSATE SODIUM 100 MG ORAL CAP $1.00 60687-134-11 PREDNISONE 10 MG ORAL TAB $1.00 60687-145-01 PREDNISONE 20 MG ORAL TAB $1.00 60687-145-11 PREDNISONE 20 MG ORAL TAB $1.00 60687-155-01 METFORMIN 500 MG ORAL TAB $1.00 60687-155-11 METFORMIN 500 MG ORAL TAB $1.00 60687-162-01 METFORMIN 1,000 MG ORAL TAB $1.00 60687-162-11 METFORMIN 1,000 MG ORAL TAB $1.00 60687-210-01 SIMVASTATIN 40 MG ORAL TAB $1.00 60687-210-11 SIMVASTATIN 40 MG ORAL TAB $1.00 60687-292-01 DONEPEZIL 5 MG ORAL TAB $1.00 60687-292-11 DONEPEZIL 5 MG ORAL TAB $1.00 60687-303-01 DONEPEZIL 10 MG ORAL TAB $1.00 60687-303-11 DONEPEZIL 10 MG ORAL TAB $1.00 60687-325-01 LISINOPRIL 10 MG ORAL TAB $1.00 60687-325-11 LISINOPRIL 10 MG ORAL TAB $1.00 60687-333-01 LISINOPRIL 20 MG ORAL TAB $1.00 60687-333-11 LISINOPRIL 20 MG ORAL TAB $1.00 60687-443-01 TRAZODONE 50 MG ORAL TAB $1.00 60687-443-11 TRAZODONE 50 MG ORAL TAB $1.00 60687-446-01 IBUPROFEN 400 MG ORAL TAB $1.00 60687-446-11 IBUPROFEN 400 MG ORAL TAB $1.00 60687-457-01 IBUPROFEN 600 MG ORAL TAB $1.00 60687-457-11 IBUPROFEN 600 MG ORAL TAB $1.00 60687-468-01 IBUPROFEN 800 MG ORAL TAB $1.00 60687-468-11 IBUPROFEN 800 MG ORAL TAB $1.00 60687-488-01 AMLODIPINE 5 MG ORAL TAB $1.00 60687-488-11 AMLODIPINE 5 MG ORAL TAB $1.00 60687-496-01 AMLODIPINE 10 MG ORAL TAB $1.00 60687-496-11 AMLODIPINE 10 MG ORAL TAB $1.00 60687-558-01 CYCLOBENZAPRINE 10 MG ORAL TAB $1.00 60687-558-11 CYCLOBENZAPRINE 10 MG ORAL TAB $1.00 60687-580-01 GABAPENTIN 100 MG ORAL CAP $1.00 60687-580-11 GABAPENTIN 100 MG ORAL CAP $1.00 60687-591-01 GABAPENTIN 300 MG ORAL CAP $1.00 60687-591-11 GABAPENTIN 300 MG ORAL CAP $1.00 60687-595-01 FAMOTIDINE 20 MG ORAL TAB $1.00 60687-595-11 FAMOTIDINE 20 MG ORAL TAB $1.00 60687-602-01 GABAPENTIN 400 MG ORAL CAP $1.00 60687-602-11 GABAPENTIN 400 MG ORAL CAP $1.00 60687-622-01 SENNOSIDES-DOCUSATE SODIUM 8.6-50 MG ORAL TAB $1.00 60687-622-11 SENNOSIDES-DOCUSATE SODIUM 8.6-50 MG ORAL TAB $1.00 60687-627-01 LORAZEPAM 0.5 MG ORAL TAB $1.00 60687-627-11 LORAZEPAM 0.5 MG ORAL TAB $1.00 60687-638-01 LORAZEPAM 1 MG ORAL TAB $1.00 60687-638-11 LORAZEPAM 1 MG ORAL TAB $1.00 60687-681-01 FOLIC ACID 1 MG ORAL TAB $1.00 60687-681-11 FOLIC ACID 1 MG ORAL TAB $1.00 61442-116-01 GLIMEPIRIDE 2 MG ORAL TAB $1.00 61442-121-01 FAMOTIDINE 20 MG ORAL TAB $1.00 61442-121-10 FAMOTIDINE 20 MG ORAL TAB $1.00 62175-118-32 OMEPRAZOLE 20 MG ORAL CPDR $1.00 62175-118-37 OMEPRAZOLE 20 MG ORAL CPDR $1.00 62175-617-43 PANTOPRAZOLE 40 MG ORAL TBEC $1.00 62332-001-31 FAMOTIDINE 20 MG ORAL TAB $1.00 62332-001-91 FAMOTIDINE 20 MG ORAL TAB $1.00 62332-037-31 LAMOTRIGINE 25 MG ORAL TAB $1.00 62332-055-31 CLONIDINE HCL 0.2 MG ORAL TAB $1.00 62332-119-90 PREGABALIN 25 MG ORAL CAP $1.00 62332-120-90 PREGABALIN 50 MG ORAL CAP $1.00 62559-490-01 DIPHENOXYLATE-ATROPINE 2.5-0.025 MG ORAL TAB $1.00 62559-510-01 INDAPAMIDE 1.25 MG ORAL TAB $1.00 62559-530-01 PROPRANOLOL 60 MG ORAL CS24 $1.00 62584-265-01 METOPROLOL TARTRATE 25 MG ORAL TAB $1.00 62584-265-11 METOPROLOL TARTRATE 25 MG ORAL TAB $1.00 62584-266-01 METOPROLOL TARTRATE 50 MG ORAL TAB $1.00 62584-266-11 METOPROLOL TARTRATE 50 MG ORAL TAB $1.00 62756-142-01 METFORMIN 500 MG ORAL TB24 $1.00 62756-142-02 METFORMIN 500 MG ORAL TB24 $1.00 62756-143-01 METFORMIN 750 MG ORAL TB24 $1.00 62756-430-88 LITHIUM CARBONATE 300 MG ORAL TAB $1.00 62756-707-13 TOPIRAMATE 25 MG ORAL TAB $1.00 62756-796-88 DIVALPROEX 125 MG ORAL TBEC $1.00 62756-797-88 DIVALPROEX 250 MG ORAL TBEC $1.00 63304-624-01 FUROSEMIDE 20 MG ORAL TAB $1.00 63304-624-10 FUROSEMIDE 20 MG ORAL TAB $1.00 63304-625-01 FUROSEMIDE 40 MG ORAL TAB $1.00 63304-625-10 FUROSEMIDE 40 MG ORAL TAB $1.00 63304-626-01 FUROSEMIDE 80 MG ORAL TAB $1.00 63304-626-05 FUROSEMIDE 80 MG ORAL TAB $1.00 63304-692-01 CLINDAMYCIN HCL 150 MG ORAL CAP $1.00 63304-830-90 ATORVASTATIN 80 MG ORAL TAB $1.00 63739-018-10 ATORVASTATIN 10 MG ORAL TAB $1.00 63739-087-02 ACETAMINOPHEN 325 MG ORAL TAB $1.00 63739-098-10 MIRTAZAPINE 15 MG ORAL TAB $1.00 63739-212-02 ASPIRIN 81 MG ORAL TBEC $1.00 63739-225-02 SIMETHICONE 80 MG ORAL CHEW $1.00 63739-225-10 SIMETHICONE 80 MG ORAL CHEW $1.00 63739-236-10 GABAPENTIN 300 MG ORAL CAP $1.00 63739-327-10 HYDRALAZINE 25 MG ORAL TAB $1.00 63739-328-10 HYDRALAZINE 50 MG ORAL TAB $1.00 63739-411-10 LEVETIRACETAM 500 MG ORAL TAB $1.00 63739-432-02 SENNOSIDES-DOCUSATE SODIUM 8.6-50 MG ORAL TAB $1.00 63739-432-10 SENNOSIDES-DOCUSATE SODIUM 8.6-50 MG ORAL TAB $1.00 63739-434-02 ASPIRIN 81 MG ORAL CHEW $1.00 63739-478-02 DOCUSATE SODIUM 100 MG ORAL CAP $1.00 63739-478-10 DOCUSATE SODIUM 100 MG ORAL CAP $1.00 63739-518-10 PREDNISONE 5 MG ORAL TAB $1.00 63739-519-10 PREDNISONE 10 MG ORAL TAB $1.00 63739-571-10 SIMVASTATIN 10 MG ORAL TAB $1.00 63739-572-10 SIMVASTATIN 20 MG ORAL TAB $1.00 63739-573-10 SIMVASTATIN 40 MG ORAL TAB $1.00 63739-591-10 GABAPENTIN 100 MG ORAL CAP $1.00 63739-645-10 FAMOTIDINE 20 MG ORAL TAB $1.00 63739-795-10 LEVETIRACETAM 250 MG ORAL TAB $1.00 63739-902-10 GABAPENTIN 100 MG ORAL CAP $1.00 63739-903-10 GABAPENTIN 300 MG ORAL CAP $1.00 63739-904-10 GABAPENTIN 400 MG ORAL CAP $1.00 63739-984-10 GABAPENTIN 400 MG ORAL CAP $1.00 63824-724-82 BENZOCAINE-MENTHOL 15-3.6 MG MUCOUS MEMB LOZG $1.00 63824-732-16 BENZOCAINE-MENTHOL 15-2.6 MG MUCOUS MEMB LOZG $1.00 63824-744-16 DEXTROMETHORPHAN-BENZOCAINE 5-7.5 MG ORAL LOZG $1.00 63868-282-25 GLYCERIN (CHILD) RECTAL SUPP $1.00 64380-734-08 HYDRALAZINE 25 MG ORAL TAB $1.00 64380-741-06 BUSPIRONE 5 MG ORAL TAB $1.00 64380-742-06 BUSPIRONE 10 MG ORAL TAB $1.00 64380-742-07 BUSPIRONE 10 MG ORAL TAB $1.00 64380-742-08 BUSPIRONE 10 MG ORAL TAB $1.00 64980-528-10 SODIUM BICARBONATE 650 MG ORAL TAB $1.00 64980-562-01 FUROSEMIDE 20 MG ORAL TAB $1.00 64980-562-10 FUROSEMIDE 20 MG ORAL TAB $1.00 65162-188-10 NAPROXEN 250 MG ORAL TAB $1.00 65162-189-10 NAPROXEN 375 MG ORAL TAB $1.00 65162-190-10 NAPROXEN 500 MG ORAL TAB $1.00 65162-190-50 NAPROXEN 500 MG ORAL TAB $1.00 65162-247-09 CHLORTHALIDONE 25 MG ORAL TAB $1.00 65162-272-10 SULFAMETHOXAZOLE-TRIMETHOPRIM 800-160 MG ORAL TAB $1.00 65162-351-09 SILDENAFIL (PULM.HYPERTENSION) 20 MG ORAL TAB $1.00 65162-361-10 FOLIC ACID 1 MG ORAL TAB $1.00 65162-361-11 FOLIC ACID 1 MG ORAL TAB $1.00 65162-371-10 OXYBUTYNIN CHLORIDE 5 MG ORAL TR24 $1.00 65162-372-10 OXYBUTYNIN CHLORIDE 10 MG ORAL TR24 $1.00 65162-441-10 MECLIZINE 12.5 MG ORAL TAB $1.00 65162-442-10 MECLIZINE 25 MG ORAL TAB $1.00 65162-464-10 IBUPROFEN 400 MG ORAL TAB $1.00 65162-464-50 IBUPROFEN 400 MG ORAL TAB $1.00 65162-465-10 IBUPROFEN 600 MG ORAL TAB $1.00 65162-465-50 IBUPROFEN 600 MG ORAL TAB $1.00 65162-466-10 IBUPROFEN 800 MG ORAL TAB $1.00 65162-466-50 IBUPROFEN 800 MG ORAL TAB $1.00 65162-556-10 TEMAZEPAM 15 MG ORAL CAP $1.00 65162-627-10 TRAMADOL 50 MG ORAL TAB $1.00 65162-627-50 TRAMADOL 50 MG ORAL TAB $1.00 65162-636-09 PANTOPRAZOLE 20 MG ORAL TBEC $1.00 65162-637-09 PANTOPRAZOLE 40 MG ORAL TBEC $1.00 65162-751-10 BENAZEPRIL 5 MG ORAL TAB $1.00 65162-752-50 BENAZEPRIL 10 MG ORAL TAB $1.00 65162-753-10 BENAZEPRIL 20 MG ORAL TAB $1.00 65162-753-50 BENAZEPRIL 20 MG ORAL TAB $1.00 65862-005-01 CITALOPRAM 10 MG ORAL TAB $1.00 65862-006-01 CITALOPRAM 20 MG ORAL TAB $1.00 65862-008-01 METFORMIN 500 MG ORAL TAB $1.00 65862-008-05 METFORMIN 500 MG ORAL TAB $1.00 65862-009-01 METFORMIN 850 MG ORAL TAB $1.00 65862-010-01 METFORMIN 1,000 MG ORAL TAB $1.00 65862-010-99 METFORMIN 1,000 MG ORAL TAB $1.00 65862-012-30 SERTRALINE 50 MG ORAL TAB $1.00 65862-013-30 SERTRALINE 100 MG ORAL TAB $1.00 65862-017-01 AMOXICILLIN 500 MG ORAL CAP $1.00 65862-018-01 CEPHALEXIN 250 MG ORAL CAP $1.00 65862-019-01 CEPHALEXIN 500 MG ORAL CAP $1.00 65862-019-05 CEPHALEXIN 500 MG ORAL CAP $1.00 65862-062-01 METOPROLOL TARTRATE 25 MG ORAL TAB $1.00 65862-062-99 METOPROLOL TARTRATE 25 MG ORAL TAB $1.00 65862-063-01 METOPROLOL TARTRATE 50 MG ORAL TAB $1.00 65862-063-99 METOPROLOL TARTRATE 50 MG ORAL TAB $1.00 65862-064-01 METOPROLOL TARTRATE 100 MG ORAL TAB $1.00 65862-097-01 MELOXICAM 7.5 MG ORAL TAB $1.00 65862-116-01 BENAZEPRIL 10 MG ORAL TAB $1.00 65862-117-01 BENAZEPRIL 20 MG ORAL TAB $1.00 65862-118-01 BENAZEPRIL 40 MG ORAL TAB $1.00 65862-145-05 CARVEDILOL 25 MG ORAL TAB $1.00 65862-149-05 FINASTERIDE 5 MG ORAL TAB $1.00 65862-149-30 FINASTERIDE 5 MG ORAL TAB $1.00 65862-149-90 FINASTERIDE 5 MG ORAL TAB $1.00 65862-185-01 CLINDAMYCIN HCL 150 MG ORAL CAP $1.00 65862-187-30 ONDANSETRON HCL 4 MG ORAL TAB $1.00 65862-191-05 CYCLOBENZAPRINE 10 MG ORAL TAB $1.00 65862-192-01 FLUOXETINE 10 MG ORAL CAP $1.00 65862-193-01 FLUOXETINE 20 MG ORAL CAP $1.00 65862-193-99 FLUOXETINE 20 MG ORAL CAP $1.00 65862-201-90 LOSARTAN 25 MG ORAL TAB $1.00 65862-201-99 LOSARTAN 25 MG ORAL TAB $1.00 65862-202-30 LOSARTAN 50 MG ORAL TAB $1.00 65862-202-90 LOSARTAN 50 MG ORAL TAB $1.00 65862-202-99 LOSARTAN 50 MG ORAL TAB $1.00 65862-357-05 CLOPIDOGREL 75 MG ORAL TAB $1.00 65862-357-30 CLOPIDOGREL 75 MG ORAL TAB $1.00 65862-374-01 ESCITALOPRAM OXALATE 10 MG ORAL TAB $1.00 65862-374-05 ESCITALOPRAM OXALATE 10 MG ORAL TAB $1.00 65862-375-01 ESCITALOPRAM OXALATE 20 MG ORAL TAB $1.00 65862-375-05 ESCITALOPRAM OXALATE 20 MG ORAL TAB $1.00 65862-419-01 SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG ORAL TAB $1.00 65862-475-01 RAMIPRIL 2.5 MG ORAL CAP $1.00 65862-512-30 PIOGLITAZONE 15 MG ORAL TAB $1.00 65862-512-90 PIOGLITAZONE 15 MG ORAL TAB $1.00 65862-522-01 NAPROXEN 500 MG ORAL TAB $1.00 65862-559-90 PANTOPRAZOLE 20 MG ORAL TBEC $1.00 65862-560-90 PANTOPRAZOLE 40 MG ORAL TBEC $1.00 65862-574-90 MONTELUKAST 10 MG ORAL TAB $1.00 65862-598-01 TAMSULOSIN 0.4 MG ORAL CAP $1.00 65862-598-05 TAMSULOSIN 0.4 MG ORAL CAP $1.00 65862-617-90 QUINAPRIL 5 MG ORAL TAB $1.00 65862-618-90 QUINAPRIL 10 MG ORAL TAB $1.00 65862-619-90 QUINAPRIL 20 MG ORAL TAB $1.00 65862-676-01 ALPRAZOLAM 0.25 MG ORAL TAB $1.00 65862-741-30 OLMESARTAN 5 MG ORAL TAB $1.00 65862-742-30 OLMESARTAN 20 MG ORAL TAB $1.00 65862-859-01 FAMOTIDINE 20 MG ORAL TAB $1.00 65862-927-30 FINASTERIDE 1 MG ORAL TAB $1.00 66553-001-01 ASPIRIN 325 MG ORAL TAB $1.00 66553-002-01 ASPIRIN 81 MG ORAL CHEW $1.00 66553-004-01 CALCIUM CARBONATE 200 MG CALCIUM (500 MG) ORAL CHEW $1.00 66553-008-01 SODIUM BICARBONATE 650 MG ORAL TAB $1.00 67457-846-20 WATER FOR INJECT, BACTERIOSTAT INJ SOLN $1.00 67618-300-10 SENNOSIDES 8.6 MG ORAL TAB $1.00 67877-116-01 METHADONE 10 MG ORAL TAB $1.00 67877-146-01 TEMAZEPAM 15 MG ORAL CAP $1.00 67877-159-01 METFORMIN 500 MG ORAL TB24 $1.00 67877-197-90 AMLODIPINE 2.5 MG ORAL TAB $1.00 67877-198-05 AMLODIPINE 5 MG ORAL TAB $1.00 67877-198-90 AMLODIPINE 5 MG ORAL TAB $1.00 67877-199-05 AMLODIPINE 10 MG ORAL TAB $1.00 67877-199-90 AMLODIPINE 10 MG ORAL TAB $1.00 67877-220-01 CEPHALEXIN 250 MG ORAL CAP $1.00 67877-222-01 GABAPENTIN 100 MG ORAL CAP $1.00 67877-222-10 GABAPENTIN 100 MG ORAL CAP $1.00 67877-223-05 GABAPENTIN 300 MG ORAL CAP $1.00 67877-223-10 GABAPENTIN 300 MG ORAL CAP $1.00 67877-242-01 QUETIAPINE 25 MG ORAL TAB $1.00 67877-288-90 FINASTERIDE 5 MG ORAL TAB $1.00 67877-319-01 IBUPROFEN 400 MG ORAL TAB $1.00 67877-320-01 IBUPROFEN 600 MG ORAL TAB $1.00 67877-320-05 IBUPROFEN 600 MG ORAL TAB $1.00 67877-426-12 MYCOPHENOLATE SODIUM 180 MG ORAL TBEC $1.00 67877-455-90 FINASTERIDE 1 MG ORAL TAB $1.00 67877-561-01 METFORMIN 500 MG ORAL TAB $1.00 67877-573-05 BENZONATATE 100 MG ORAL CAP $1.00 67877-589-01 COLCHICINE 0.6 MG ORAL TAB $1.00 67877-616-01 METHYLPHENIDATE HCL 5 MG ORAL TAB $1.00 68001-153-00 CARVEDILOL 3.125 MG ORAL TAB $1.00 68001-154-00 CARVEDILOL 6.25 MG ORAL TAB $1.00 68001-185-00 QUETIAPINE 25 MG ORAL TAB $1.00 68001-237-00 CLONIDINE HCL 0.1 MG ORAL TAB $1.00 68001-333-00 LISINOPRIL 5 MG ORAL TAB $1.00 68001-334-00 LISINOPRIL 10 MG ORAL TAB $1.00 68001-397-00 FAMOTIDINE 20 MG ORAL TAB $1.00 68001-397-08 FAMOTIDINE 20 MG ORAL TAB $1.00 68001-477-45 BACITRACIN 500 UNIT/GRAM TOPICAL PACK $1.00 68001-477-48 BACITRACIN 500 UNIT/GRAM TOPICAL PACK $1.00 68084-189-01 ZOLPIDEM 5 MG ORAL TAB $1.00 68084-189-11 ZOLPIDEM 5 MG ORAL TAB $1.00 68084-318-01 LAMOTRIGINE 25 MG ORAL TAB $1.00 68084-318-11 LAMOTRIGINE 25 MG ORAL TAB $1.00 68084-319-01 LAMOTRIGINE 100 MG ORAL TAB $1.00 68084-319-11 LAMOTRIGINE 100 MG ORAL TAB $1.00 68084-447-01 HYDRALAZINE 10 MG ORAL TAB $1.00 68084-447-11 HYDRALAZINE 10 MG ORAL TAB $1.00 68084-511-01 SIMVASTATIN 10 MG ORAL TAB $1.00 68084-511-11 SIMVASTATIN 10 MG ORAL TAB $1.00 68084-559-11 LOVASTATIN 20 MG ORAL TAB $1.00 68084-658-01 IBUPROFEN 400 MG ORAL TAB $1.00 68084-658-11 IBUPROFEN 400 MG ORAL TAB $1.00 68084-808-01 TRAMADOL 50 MG ORAL TAB $1.00 68084-808-11 TRAMADOL 50 MG ORAL TAB $1.00 68084-813-09 PANTOPRAZOLE 40 MG ORAL TBEC $1.00 68084-813-11 PANTOPRAZOLE 40 MG ORAL TBEC $1.00 68084-843-01 CARVEDILOL 3.125 MG ORAL TAB $1.00 68084-843-11 CARVEDILOL 3.125 MG ORAL TAB $1.00 68084-854-01 CARVEDILOL 6.25 MG ORAL TAB $1.00 68084-854-11 CARVEDILOL 6.25 MG ORAL TAB $1.00 68180-135-01 ESCITALOPRAM OXALATE 10 MG ORAL TAB $1.00 68180-376-03 LOSARTAN 25 MG ORAL TAB $1.00 68180-376-09 LOSARTAN 25 MG ORAL TAB $1.00 68180-512-01 LISINOPRIL 2.5 MG ORAL TAB $1.00 68180-513-01 LISINOPRIL 5 MG ORAL TAB $1.00 68180-556-09 QUINAPRIL 5 MG ORAL TAB $1.00 68180-558-09 QUINAPRIL 20 MG ORAL TAB $1.00 68180-965-01 LEVOTHYROXINE 25 MCG ORAL TAB $1.00 68180-965-09 LEVOTHYROXINE 25 MCG ORAL TAB $1.00 68180-966-01 LEVOTHYROXINE 50 MCG ORAL TAB $1.00 68180-966-09 LEVOTHYROXINE 50 MCG ORAL TAB $1.00 68180-967-01 LEVOTHYROXINE 75 MCG ORAL TAB $1.00 68180-967-09 LEVOTHYROXINE 75 MCG ORAL TAB $1.00 68180-968-01 LEVOTHYROXINE 88 MCG ORAL TAB $1.00 68180-969-01 LEVOTHYROXINE 100 MCG ORAL TAB $1.00 68180-969-09 LEVOTHYROXINE 100 MCG ORAL TAB $1.00 68180-970-01 LEVOTHYROXINE 112 MCG ORAL TAB $1.00 68180-971-01 LEVOTHYROXINE 125 MCG ORAL TAB $1.00 68180-972-01 LEVOTHYROXINE 137 MCG ORAL TAB $1.00 68180-973-01 LEVOTHYROXINE 150 MCG ORAL TAB $1.00 68180-979-01 LISINOPRIL 40 MG ORAL TAB $1.00 68180-980-01 LISINOPRIL 10 MG ORAL TAB $1.00 68180-980-03 LISINOPRIL 10 MG ORAL TAB $1.00 68180-981-01 LISINOPRIL 20 MG ORAL TAB $1.00 68180-981-03 LISINOPRIL 20 MG ORAL TAB $1.00 68308-325-67 FOLIC ACID-VIT B6-VIT B12 0.8-10-115 MG-MG-MCG ORAL TAB $1.00 68382-022-01 ATENOLOL 25 MG ORAL TAB $1.00 68382-022-10 ATENOLOL 25 MG ORAL TAB $1.00 68382-023-01 ATENOLOL 50 MG ORAL TAB $1.00 68382-023-10 ATENOLOL 50 MG ORAL TAB $1.00 68382-024-01 ATENOLOL 100 MG ORAL TAB $1.00 68382-041-01 PROMETHAZINE 25 MG ORAL TAB $1.00 68382-050-01 MELOXICAM 7.5 MG ORAL TAB $1.00 68382-092-01 CARVEDILOL 3.125 MG ORAL TAB $1.00 68382-092-05 CARVEDILOL 3.125 MG ORAL TAB $1.00 68382-093-01 CARVEDILOL 6.25 MG ORAL TAB $1.00 68382-094-01 CARVEDILOL 12.5 MG ORAL TAB $1.00 68382-094-05 CARVEDILOL 12.5 MG ORAL TAB $1.00 68382-095-01 CARVEDILOL 25 MG ORAL TAB $1.00 68382-121-16 AMLODIPINE 2.5 MG ORAL TAB $1.00 68382-122-05 AMLODIPINE 5 MG ORAL TAB $1.00 68382-122-16 AMLODIPINE 5 MG ORAL TAB $1.00 68382-123-05 AMLODIPINE 10 MG ORAL TAB $1.00 68382-123-16 AMLODIPINE 10 MG ORAL TAB $1.00 68382-135-16 LOSARTAN 25 MG ORAL TAB $1.00 68382-138-05 TOPIRAMATE 25 MG ORAL TAB $1.00 68382-138-14 TOPIRAMATE 25 MG ORAL TAB $1.00 68382-140-14 TOPIRAMATE 100 MG ORAL TAB $1.00 68382-180-01 BUSPIRONE 5 MG ORAL TAB $1.00 68382-181-01 BUSPIRONE 10 MG ORAL TAB $1.00 68382-805-01 TRAZODONE 50 MG ORAL TAB $1.00 68382-805-05 TRAZODONE 50 MG ORAL TAB $1.00 68382-806-01 TRAZODONE 100 MG ORAL TAB $1.00 68382-806-05 TRAZODONE 100 MG ORAL TAB $1.00 68462-108-60 TOPIRAMATE 25 MG ORAL TAB $1.00 68462-126-01 GABAPENTIN 600 MG ORAL TAB $1.00 68462-126-05 GABAPENTIN 600 MG ORAL TAB $1.00 68462-128-01 ZONISAMIDE 25 MG ORAL CAP $1.00 68462-153-60 TOPIRAMATE 50 MG ORAL TAB $1.00 68462-163-05 CARVEDILOL 6.25 MG ORAL TAB $1.00 68462-165-01 CARVEDILOL 25 MG ORAL TAB $1.00 68462-190-01 NAPROXEN 500 MG ORAL TAB $1.00 68462-190-05 NAPROXEN 500 MG ORAL TAB $1.00 68462-220-01 LITHIUM CARBONATE 150 MG ORAL CAP $1.00 68462-253-01 ROPINIROLE 0.25 MG ORAL TAB $1.00 68462-255-01 ROPINIROLE 1 MG ORAL TAB $1.00 68462-256-01 ROPINIROLE 2 MG ORAL TAB $1.00 68462-261-90 ROSUVASTATIN 5 MG ORAL TAB $1.00 68462-262-90 ROSUVASTATIN 10 MG ORAL TAB $1.00 68462-263-90 ROSUVASTATIN 20 MG ORAL TAB $1.00 68462-330-90 PRAMIPEXOLE 0.125 MG ORAL TAB $1.00 68462-331-90 PRAMIPEXOLE 0.25 MG ORAL TAB $1.00 68462-332-90 PRAMIPEXOLE 0.5 MG ORAL TAB $1.00 68462-333-90 PRAMIPEXOLE 1 MG ORAL TAB $1.00 68462-357-01 POTASSIUM CHLORIDE 10 MEQ ORAL CPSR $1.00 68462-357-05 POTASSIUM CHLORIDE 10 MEQ ORAL CPSR $1.00 68462-406-10 INDOMETHACIN 25 MG ORAL CAP $1.00 68462-436-30 OLMESARTAN 5 MG ORAL TAB $1.00 68462-437-30 OLMESARTAN 20 MG ORAL TAB $1.00 68462-437-90 OLMESARTAN 20 MG ORAL TAB $1.00 69076-146-01 ACYCLOVIR 200 MG ORAL CAP $1.00 69097-122-03 TOPIRAMATE 25 MG ORAL TAB $1.00 69097-123-03 TOPIRAMATE 50 MG ORAL TAB $1.00 69097-128-05 AMLODIPINE 10 MG ORAL TAB $1.00 69097-813-07 GABAPENTIN 100 MG ORAL CAP $1.00 69097-834-02 SERTRALINE 50 MG ORAL TAB $1.00 69097-846-07 CYCLOBENZAPRINE 10 MG ORAL TAB $1.00 69097-867-07 NADOLOL 20 MG ORAL TAB $1.00 69238-1166-9 DOXEPIN 10 MG ORAL CAP $1.00 69315-116-01 FUROSEMIDE 20 MG ORAL TAB $1.00 69315-117-01 FUROSEMIDE 40 MG ORAL TAB $1.00 69315-133-01 IMIPRAMINE HCL 10 MG ORAL TAB $1.00 69315-137-01 BENZTROPINE 1 MG ORAL TAB $1.00 69315-137-10 BENZTROPINE 1 MG ORAL TAB $1.00 69315-155-01 HYDROCHLOROTHIAZIDE 12.5 MG ORAL TAB $1.00 69315-904-01 LORAZEPAM 0.5 MG ORAL TAB $1.00 69315-904-05 LORAZEPAM 0.5 MG ORAL TAB $1.00 69315-905-01 LORAZEPAM 1 MG ORAL TAB $1.00 69315-905-10 LORAZEPAM 1 MG ORAL TAB $1.00 69543-380-90 OLANZAPINE 2.5 MG ORAL TAB $1.00 69584-111-10 CARISOPRODOL 350 MG ORAL TAB $1.00 69584-611-50 METHOCARBAMOL 500 MG ORAL TAB $1.00 69584-841-10 SOTALOL 80 MG ORAL TAB $1.00 69584-852-50 SPIRONOLACTONE 25 MG ORAL TAB $1.00 69618-015-01 ASPIRIN 325 MG ORAL TBEC $1.00 69618-033-01 SIMETHICONE 80 MG ORAL CHEW $1.00 69618-048-01 SENNOSIDES 8.6 MG ORAL TAB $1.00 69618-058-01 BISACODYL 5 MG ORAL TBEC $1.00 69618-064-01 SENNOSIDES 8.6 MG ORAL TAB $1.00 69618-066-02 ASPIRIN 81 MG ORAL TBEC $1.00 69618-066-10 ASPIRIN 81 MG ORAL TBEC $1.00 70010-063-01 METFORMIN 500 MG ORAL TAB $1.00 70010-065-01 METFORMIN 1,000 MG ORAL TAB $1.00 70010-065-05 METFORMIN 1,000 MG ORAL TAB $1.00 70010-065-10 METFORMIN 1,000 MG ORAL TAB $1.00 70010-139-01 NAPROXEN 500 MG ORAL TAB $1.00 70010-491-01 METFORMIN 500 MG ORAL TB24 $1.00 70010-491-05 METFORMIN 500 MG ORAL TB24 $1.00 70010-492-01 METFORMIN 750 MG ORAL TB24 $1.00 70010-754-01 METHOCARBAMOL 500 MG ORAL TAB $1.00 70010-754-05 METHOCARBAMOL 500 MG ORAL TAB $1.00 70010-770-01 METHOCARBAMOL 750 MG ORAL TAB $1.00 70010-770-05 METHOCARBAMOL 750 MG ORAL TAB $1.00 70377-006-12 ROSUVASTATIN 5 MG ORAL TAB $1.00 70377-007-12 ROSUVASTATIN 10 MG ORAL TAB $1.00 70377-008-12 ROSUVASTATIN 20 MG ORAL TAB $1.00 70677-0021-1 CAFFEINE 200 MG ORAL TAB $1.00 70677-0025-1 DOXYLAMINE SUCCINATE 25 MG ORAL TAB $1.00 70677-0068-1 DOXYLAMINE SUCCINATE 25 MG ORAL TAB $1.00 70677-0072-1 IBUPROFEN 100 MG ORAL CHEW $1.00 70677-0138-1 BISMUTH SUBSALICYLATE 262 MG ORAL CHEW $1.00 70677-0145-2 LORATADINE 10 MG ORAL TAB $1.00 70710-1161-1 MECLIZINE 12.5 MG ORAL TAB $1.00 70756-201-11 AMITRIPTYLINE 10 MG ORAL TAB $1.00 70756-202-11 AMITRIPTYLINE 25 MG ORAL TAB $1.00 70954-212-10 TRIHEXYPHENIDYL 2 MG ORAL TAB $1.00 72205-011-90 PREGABALIN 25 MG ORAL CAP $1.00 72205-012-90 PREGABALIN 50 MG ORAL CAP $1.00 72205-013-90 PREGABALIN 75 MG ORAL CAP $1.00 72305-112-30 LEVOTHYROXINE 112 MCG ORAL TAB $1.00 72305-150-30 LEVOTHYROXINE 150 MCG ORAL TAB $1.00 72578-002-01 ACYCLOVIR 200 MG ORAL CAP $1.00 72888-035-01 CARVEDILOL 6.25 MG ORAL TAB $1.00 72888-035-05 CARVEDILOL 6.25 MG ORAL TAB $1.00 72888-039-60 AMIODARONE 200 MG ORAL TAB $1.00 72888-052-01 METOLAZONE 2.5 MG ORAL TAB $1.00 72888-062-01 BUSPIRONE 5 MG ORAL TAB $1.00 75826-139-10 PHENOBARBITAL 32.4 MG ORAL TAB $1.00 75834-108-05 METRONIDAZOLE 500 MG ORAL TAB $1.00 75834-124-01 ACYCLOVIR 200 MG ORAL CAP $1.00 75834-221-01 CARBAMAZEPINE 200 MG ORAL TAB $1.00 75834-257-01 ATORVASTATIN 40 MG ORAL TAB $1.00 76282-214-90 SERTRALINE 100 MG ORAL TAB $1.00 76282-348-01 NADOLOL 40 MG ORAL TAB $1.00 76385-123-01 METHOCARBAMOL 500 MG ORAL TAB $1.00 76385-123-50 METHOCARBAMOL 500 MG ORAL TAB $1.00 76385-124-01 METHOCARBAMOL 750 MG ORAL TAB $1.00 99996-001-31 METRONIDAZOLE 500 MG/10 ML ORAL LIQUID (MCH) $1.00 99996-001-55 CAPTOPRIL 1 MG/ML ORAL SUSP (COMPOUND) $1.00 99998-000-76 GLYCOPYRROLATE 100 MCG/ML ORAL SUSP (COMPOUND) $1.00 99998-005-08 HYDROCORTISONE SOD SUCCINATE 1 MG/ML INJ DILUTION (MCH) $1.00 99998-005-26 PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIX $1.00 99999-000-04 CEFAZOLIN 500 MG / 5 ML SYRINGE $1.00 99999-000-15 DEXAMETHASONE 0.5 MG/ML NICU INJECTION $1.00 99999-000-31 POTASSIUM CHLORIDE 2 MEQ / ML ORAL SYRINGE $1.00 99999-000-40 METOCLOPRAMIDE 0.5 MG / ML SYRINGE $1.00 99999-000-95 ERGOCALCIFEROL 800 UNIT / ML ORAL SOLN $1.00 99999-001-28 RIBOSE ORAL POWDER $1.00 99999-001-57 CEFTRIAXONE 40 MG / ML (NICU) IV SYRINGE $1.00 99999-002-13 VANCOMYCIN - BSS 25 MG/0.5 ML OPHTHALMIC SYRINGE $1.00 99999-002-37 PHENOBARBITAL 4MG/ML (NICU) ORAL SYRINGE $1.00 99999-002-44 FUROSEMIDE 10 MG/ML NICU ORAL SYRINGE $1.00 99999-004-74 GENTAMICIN 4 MG/ML INJECTION SYRINGE (MCH) $1.00 99999-004-76 TOBRAMYCIN 4 MG/ML INJECTION SYRINGE IN NS (MCH) $1.00 99999-004-81 ASPIRIN DESENSITIZATION (LB) $1.00 99999-004-82 ASPIRIN DESENSITIZATION TABLET (LB) $1.00 99999-005-18 CEFAZOLIN 50 MG/ML INJ DILUTION (MCH) $1.00 99999-005-22 CARVEDILOL 0.625 MG/ML ORAL LIQUID $1.00 99999-005-31 CLINDAMYCIN 10 MG/ML IV DILUTION (MCH) $1.00 99999-005-33 DEXAMETHASONE 0.1 MG/ML INJ DILUTION (MCH) $1.00 99999-005-34 DEXAMETHASONE 0.5 MG/ML INJ DILUTION (MCH) $1.00 99999-005-42 ENALAPRILAT 20 MCG/ML INJ DILUTION (MCH) $1.00 99999-005-63 METOCLOPRAMIDE 1 MG/ML INJ DILUTION (MCH) $1.00 99999-005-66 FENTANYL CITRATE (PF) 5 MCG/ML INJ DILUTION (MCH) $1.00 99999-005-74 CAFFEINE CITRATED 10 MG/ML ORAL SOLN (COMPOUND) (MCH) $1.00 99999-005-98 OMEPRAZOLE 2 MG/ML ORAL SUSP (COMPOUND) $1.00 99999-005-99 OMEPRAZOLE 2 MG/ML ORAL SUSP (COMPOUND) $1.00 99999-006-00 OMEPRAZOLE 2 MG/ML ORAL SUSP (COMPOUND) $1.00 99999-006-59 METHADONE 5 MG/5 ML ORAL SOLN $1.00 99999-006-62 METOCLOPRAMIDE 5 MG/5 ML ORAL SOLN (MCH) $1.00 99999-006-72 DIPHENHYDRAMINE HCL 5 MG/ML INJ DILUTION (MCH) $1.00 99999-007-29 BETHANECHOL 1 MG/ML COMPOUND ORAL SUSPENSION $1.00 99999-007-66 MORPHINE 10 MG/5 ML ORAL SOLN $1.00 99999-007-80 SODIUM CHLORIDE 2 MEQ/ML ORAL SOLN (MCH) $1.00 99999-008-52 CHERRY FLAVOR (BULK) ORAL LIQD $1.00 99999-010-91 SODIUM BICARBONATE 8.4% NO STING INJ (MCH) $1.00 99999-010-92 SODIUM BICARBONATE 8.4% NO STING INJ (MCH) $1.00 99999-010-95 SILDENAFIL 2.5 MG/ML ORAL LIQUID (MCH) (COMPOUND) $1.00 99999-010-96 VANCOMYCIN 5 MG/ML INJ SOLN (MCH) $1.00 99999-010-97 ARGININE HCL 2.5 MEQ/ML ORAL LIQUID $1.00 99999-011-00 CAPTOPRIL 1 MG/ML ORAL SUSP (COMPOUND) $1.00 99999-012-98 PANTOPRAZOLE 2 MG/ML ORAL LIQUID $1.00 99999-024-13 ATENOLOL 2 MG/ML ORAL LIQUID $1.00 99999-033-04 HYDROMORPHONE 50MG IN NS 50 ML DRIP (OCM) $1.00 99999-033-23 LIDOCAINE 1%/NA BICARB 10:1 INJ $1.00 99999-033-39 SODIUM BENZOATE 200 MG/ML ORAL LIQUID (MCH) $1.00 99999-033-44 CARBOPLATIN IV SOLN (FOR DESENSITIZATION USE) (MHS) $1.00 99999-033-48 OXALIPLATIN IV SOLN (FOR DESENSITIZATION USE) (MHS) $1.00 99999-033-69 CAPTOPRIL 1 MG/ML (NICU) ORAL SYRINGE $1.00 99999-033-79 CEFAZOLIN IN BSS (10 MG/ML) OPHTHALMIC INJECTION $1.00 99999-034-17 CARVEDILOL 0.1 MG/ML ORAL LIQUID (PEDIATRIC DOSING) $1.00 99999-034-20 CARVEDILOL 1.25 MG/ML ORAL LIQUID (PEDIATRIC DOSING) $1.00 99999-034-35 GENTAMICIN 2 MG/ML INJECTION IN NS (OCM) $1.00 99999-034-65 DEXAMETHASONE INTRAVITREAL INJECTION $1.00 99999-034-67 VANCOMYCIN IN BSS INTRAVITREAL INJECTION (SLH) $1.00 99999-034-73 LIDOCAINE 1%/NA BICARB 10:1 INJ $1.00 99999-034-96 ALLOPURINOL 20 MG/ML ORAL SUSP (COMPOUND) $1.00 99999-035-02 DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML ORAL LIQD $1.00 99999-035-23 MISOPROSTOL 25 MCG ORAL PARTIAL TAB $1.00 99999-035-33 BISMUTH SUBSALICYLATE 262 MG/15 ML ORAL SUSP $1.00 99999-035-44 ZONISAMIDE 10 MG/ML ORAL LIQUID (COMPOUND) $1.00 99999-035-55 CEFEPIME IV (FOR DESENSITIZATION USE) $1.00 99999-035-56 PIPERACILLIN-TAZOBACTAM IV (FOR DESENSITIZATION USE) $1.00 99999-035-57 IMIPENEM-CILASTATIN IV (FOR DESENSITIZATION USE) $1.00 99999-035-59 MEROPENEM IV (FOR DESENSITIZATION USE) $1.00 99999-035-60 NAFCILLIN IV (FOR DESENSITIZATION USE) $1.00 99999-035-61 OXACILLIN IV (FOR DESENSITIZATION USE) $1.00 99999-035-62 AZTREONAM IV (FOR DESENSITIZATION USE) $1.00 99999-036-28 SPIRONOLACTONE-HYDROCHLOROTHIAZIDE ORAL SUSP (MCH) $1.00 99999-036-32 SOTALOL 5 MG/ML ORAL LIQUID $1.00 99999-036-36 RIFAMPIN 20 MG/ML ORAL SOLN (COMPOUND) $1.00 99999-036-42 AZATHIOPRINE 12.5 MG ORAL PARTIAL TAB $1.00 99999-036-49 CLONAZEPAM 0.1 MG/ML ORAL LIQUID (USING 1 MG TAB) $1.00 99999-036-54 ASCORBIC ACID 125 MG ORAL PARTIAL TAB (MCH) $1.00 99999-036-55 ASPIRIN 20.25 MG ORAL PARTIAL CHEWTAB (MCH) $1.00 99999-036-56 ASPIRIN 40.5 MG ORAL PARTIAL CHEWTAB (MCH) $1.00 99999-036-60 CYPROHEPTADINE 2 MG ORAL PARTIAL TAB (MCH) $1.00 99999-036-69 ZINC SULFATE 110 MG ORAL PARTIAL TAB (MCH) $1.00 99999-037-01 FENTANYL CITRATE (PF) 5 MCG/ML INJ DILUTION (MCH) $1.00 99999-037-02 METHADONE 5 MG/5 ML ORAL SOLN $1.00 99999-037-34 MAGIC MOUTHWASH ORAL LIQUID (SIMPLE) $1.00 99999-037-50 CEFAZOLIN IN DEXTROSE (ISO-OS) 2 GRAM/50 ML IV PGBK $1.00 99999-037-53 CLOPIDOGREL 5 MG/ML ORAL LIQUID (COMPOUND) $1.00 99999-037-64 SULFASALAZINE 100 MG/ML ORAL LIQUID $1.00 99999-037-71 ALUMINUM HYDROXIDE GEL 320 MG/5 ML ORAL SUSP $1.00 99999-037-78 DOCUSATE SODIUM 100 MG/10 ML ORAL LIQD $1.00 99999-037-99 CEFTRIAXONE IV (FOR DESENSITIZATION USE) $1.00 99999-038-03 PROPYLTHIOURACIL 5 MG/ML ORAL LIQUID (COMPOUND) $1.00 99999-038-12 INSULIN REGULAR HUMAN 1 UNIT/ML INJ SOLN DILUTION $1.00 99999-038-25 MORPHINE 0.2 MG/ML (NICU) ORAL SYRINGE $1.00 99999-038-33 VORICONAZOLE 50 MCG INTRAVITREAL $1.00 99999-038-34 VORICONAZOLE 100 MCG INTRAVITREAL INJ $1.00 99999-038-35 GENTAMICIN INTRAVITREAL INJ $1.00 99999-038-36 TOBRAMYCIN INTRAVITREAL INJ $1.00 99999-038-37 CLINDAMYCIN INTRAVITREAL INJ $1.00 99999-038-38 GANCICLOVIR 200 MCG INTRAVITREAL INJ $1.00 99999-038-40 AMPHOTERICIN B INTRAVITREAL INJ $1.00 99999-038-41 CEFAZOLIN INTRAVITREAL INJ $1.00 99999-038-43 AMIKACIN IN NS INTRAVITREAL $1.00 99999-038-46 CEFTAZIDIME IN NS INTRAVITREAL INJ $1.00 99999-038-47 FENTANYL 5 MCG/ML NICU INJECTION $1.00 99999-038-52 AMIODARONE 5 MG/ML ORAL LIQUID $1.00 99999-038-55 MAALOX/BENADRYL 1:1 $1.00 99999-038-57 MAALOX/BENADRYL 1:1 $1.00 99999-038-73 BUPIVACAINE PF 0.125 % (1.25 MG/ML) INJ DILUTION $1.00 99999-038-74 AMPICILLIN IV (FOR DESENSITIZATION USE) $1.00 99999-038-75 AMPICILLIN-SULBACTAM IV (FOR DESENSITIZATION USE) $1.00 99999-038-76 CEFTAZIDIME IV (FOR DESENSITIZATION USE) $1.00 99999-039-03 CEFAZOLIN 3 G IN NS 100 ML (OCM_USING 10 G VIAL) $1.00 99999-039-08 CEFAZOLIN IV (FOR DESENSITIZATION USE) $1.00 99999-039-10 GI COCKTAIL WITHOUT DONNATAL ORAL LIQUID (SIMPLE) $1.00 99999-039-26 HYDROMORPHONE 0.1 MG/ML INJ DILUTION (MCH) $1.00 99999-039-38 MAGIC MOUTHWASH ORAL LIQUID (SIMPLE) $1.00 99999-039-46 ERTAPENEM IV (FOR DESENSITIZATION USE) $1.00 99999-039-60 GI COCKTAIL ORAL LIQUID (NO DONNATAL) (SLH) $1.00 99999-039-61 MAGIC MOUTHWASH ORAL LIQUID (SIMPLE) $1.00 99999-039-62 SODIUM POLYSTYRENE SULFONATE 1 G/3 ML ORAL SUSP (MCH) $1.00 99999-039-97 CEFOTAXIME 50 MG/ML INJ DILUTION (MCH) $1.00 99999-039-98 MORPHINE 10 MG/5 ML ORAL SOLN $1.00 99999-040-01 METRONIDAZOLE IN NACL (ISO-OS) 500 MG/100 ML IV PGBK (MCH) $1.00 99999-040-15 FINASTERIDE 2.5 MG ORAL PARTIAL TAB $1.00 99999-040-23 ASPIRIN 0.1 MG/ML ORAL SOLUTION - FOR DESENSITIZATION $1.00 99999-040-24 ASPIRIN 2 MG/ML ORAL SOLUTION - FOR DESENSITIZATION $1.00 99999-040-48 HYDRALAZINE 4 MG/ML ORAL LIQUID $1.00 99999-040-49 CEFTRIAXONE 40 MG/ML INJ SYRINGE $1.00 99999-040-85 CARBOPLATIN IV SOLN (FOR DESENSITIZATION USE) (MHS) $1.00 99999-040-99 GUAIFENESIN 100 MG/5 ML ORAL LIQD $1.00 99999-041-05 MORPHINE 1 MG/ML INJ SOLN (COMPOUNDED) $1.00 99999-041-11 MORPHINE 2 MG/ML INJ SOLN (COMPOUNDED) $1.00 99999-041-13 CEFAZOLIN 2 G IN NS 100 ML (SLH) $1.00 99999-041-20 MORPHINE 0.4 MG/ML ORAL SOLN DILUTION (MCH) $1.00 99999-041-32 MORPHINE 2 MG/ML INJ SOLN (MHS) $1.00 99999-041-33 SPIRONOLACTONE 12.5 MG ORAL PARTIAL TAB $1.00 99999-041-65 PERITON.DIALYSIS 7-2.5 % DEXTR CA 2.5 MEQ/L- MG 0.5 MEQ/L IP SOLN $1.00 99999-041-69 CEFAZOLIN IN DEXTROSE (ISO-OS) 2 GRAM/50 ML IV PGBK $1.00 99999-041-74 ESTRADIOL 0.5 MG ORAL PARTIAL TAB $1.00 99999-041-75 MEDROXYPROGESTERONE 2.5 MG ORAL PARTIAL TAB $1.00 99999-041-86 LOSARTAN 2.5 MG/ML ORAL SUSP $1.00 99999-041-97 MEDROXYPROGESTERONE 1.25 MG ORAL PARTIAL TAB $1.00 99999-041-98 METHIMAZOLE 2.5 MG ORAL PARTIAL TAB $1.00 99999-042-09 CLINDAMYCIN 10 MG/ML IV DILUTION (MCH) $1.00 99999-042-13 CEFAZOLIN 1 GRAM/10 ML SYRINGE (USING 100 G) $1.00 99999-042-30 OXCARBAZEPINE 75 MG ORAL PARTIAL TAB $1.00 99999-042-46 VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML ORAL SOLN $1.00 99999-042-76 CHLORHEXIDINE GLUCONATE 0.12 % MUCOUS MEMB MWSH $1.00 99999-042-79 ATENOLOL 2 MG/ML ORAL LIQUID $1.00 99999-044-00 CLONIDINE 0.01 MG/ML ORAL LIQUID (COMPOUND) $1.00 99999-044-24 KETAMINE IN 0.9% NACL 5 MG/50 ML IV PGBK (OCM/SLH) $1.00 99999-044-25 KETAMINE IN 0.9% NACL 10 MG/50 ML IV PGBK (OCM/SLH) $1.00 99999-044-26 ALBUTEROL SULFATE 90 MCG/ACTUATION INHALATION HFAA $1.00 99999-044-42 HYDROCHLOROTHIAZIDE 5 MG/ML ORAL LIQUID (COMPOUND) $1.00 99999-044-62 WARFARIN 0.5 MG ORAL PARTIAL TAB $1.00 99999-045-21 SULFAMETHOXAZOLE-TRIMETHOPRIM 2-0.4 MG/ML ORAL SOLUTION - FOR DESENSITIZATION $1.00 99999-045-22 SULFAMETHOXAZOLE-TRIMETHOPRIM 0.2-0.04 MG/ML ORAL SOLUTION - FOR DESENSITIZATION $1.00 99999-045-23 SULFAMETHOXAZOLE-TRIMETHOPRIM 0.02-0.004 MG/ML ORAL SOLUTION - FOR DESENSITIZATION $1.00 99999-045-27 KETAMINE IN 0.9% NACL 5 MG/50 ML IV PGBK (OCM/SLH) $1.00 99999-045-28 KETAMINE IN 0.9% NACL 10 MG/50 ML IV PGBK (OCM/SLH) $1.00 99999-045-43 CEFAZOLIN 3 G IN NS 100 ML (OCM_USING 10 G VIAL) $1.00 99999-045-51 HYDROMORPHONE IN 0.9 % NACL 1 MG/50 ML IV SOLN $1.00 99999-045-52 HYDROMORPHONE IN 0.9 % NACL 2 MG/50 ML IV SOLN $1.00 99999-045-53 DIPHENHYDRAMINE HCL 1 MG/ML INJ DILUTION (MCH) $1.00 99999-046-69 ESTRADIOL 0.25 MG ORAL PARTIAL TAB (USING 1 MG TAB) $1.00