Updated 12/10/2025 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 $326,180.53 69488-010-61 LU-177 VIPIVOTIDE TETRAXETAN 27 MCI/ML (1,000 MBQ/ML) IV SOLN $322,905.70 50633-210-11 GLUCARPIDASE 1,000 UNIT IV SOLR $281,014.50 0310-4535-30 TREMELIMUMAB-ACTL 20 MG/ML IV SOLN $263,741.40 0003-2328-22 IPILIMUMAB 200 MG/40 ML (5 MG/ML) IV SOLN $235,422.72 HC62809041 GENRTR PULSE OPTIMIZER SMART MINI IPG G200042 $216,666.00 75987-080-10 PEGLOTICASE 8 MG/ML IV SOLN $199,829.44 57894-061-03 USTEKINUMAB 90 MG/ML SUBCUTANEOUS SYRG $189,484.49 72694-515-01 CALASPARGASE PEGOL-MKNL 750 UNIT/ML IV SOLN $188,734.85 79952-110-01 LONCASTUXIMAB TESIRINE-LPYL 10 MG IV SOLR $184,091.25 72694-954-01 PEGASPARGASE 750 UNIT/ML INJ SOLN $174,298.48 50419-208-01 RADIUM RA 223 DICHLORIDE 1,100 KBQ/ML(30 MICROCURIE/ML) IV SOLN $158,485.86 25682-028-01 RAVULIZUMAB-CWVZ 100 MG/ML IV SOLN $155,681.24 0008-0100-01 INOTUZUMAB OZOGAMICIN 0.9 MG (0.25 MG/ML INITIAL) IV SOLR $155,453.68 24338-150-20 TRIPTORELIN PAMOATE(PEDIATRIC) 22.5 MG IM SUSR $144,934.86 24338-150-01 TRIPTORELIN PAMOATE(PEDIATRIC) 22.5 MG IM SUSR $144,934.86 0078-0734-61 CANAKINUMAB (PF) 150 MG/ML SUBCUTANEOUS SOLN $138,998.28 50242-150-01 OCRELIZUMAB 30 MG/ML IV SOLN $134,166.24 99988-000-43 NM THERASPHERE Y-90 GLASS MICROSPHERES $129,512.50 HC62229448 DELIVERY SYSTEM W/TRICLIP G4 $126,000.00 66302-014-01 DINUTUXIMAB 3.5 MG/ML IV SOLN $123,807.26 HC62809223 GENERATOR NEUROSTIM SYSTEM BAROSTIM $122,500.00 50242-105-01 POLATUZUMAB VEDOTIN-PIIQ 140 MG IV SOLR $120,974.17 HC62809413 STENT CORO BARE METAL W/DEL AE $119,700.00 75987-130-15 TEPROTUMUMAB-TRBW 500 MG IV SOLR $117,123.18 99988-000-42 NM SIR-SPHERES Y-90 RESIN MICROSPHERES $116,967.50 47335-177-95 TILDRAKIZUMAB-ASMN 100 MG/ML SUBCUTANEOUS SYRG $116,749.36 47335-177-96 TILDRAKIZUMAB-ASMN 100 MG/ML SUBCUTANEOUS SYRG $116,749.36 99988-000-34 NM YTTRIUM Y-90 IBRITUMOMAB (ZEVALIN) <=40MCI $113,750.00 HC62809058 STENT ENDOPRSTH THOR BRANCH TBE(TAG®GORE®) I $112,000.00 47783-101-01 ECALLANTIDE 10 MG/ML (1 ML) SUBCUTANEOUS SOLN $111,278.25 HC62809231 GENERATOR NEUROSTIM ONLY BAROSTIM $110,250.00 HC62808514 DELIVERY SYSTEM W/MITRACLIP(S) $104,998.00 0003-7125-11 NIVOLUMAB-RELATLIMAB-RMBW 240-80 MG/20 ML IV SOLN $100,242.87 73650-316-10 TEPLIZUMAB-MZWV 1 MG/ML IV SOLN $95,544.62 73650-316-01 TEPLIZUMAB-MZWV 1 MG/ML IV SOLN $95,544.61 57894-060-03 USTEKINUMAB 45 MG/0.5 ML SUBCUTANEOUS SYRG $94,742.31 0024-5824-11 CABAZITAXEL 10 MG/ML (FIRST DILUTION) IV SOLN $94,731.71 0024-5823-15 CABAZITAXEL 10 MG/ML (FIRST DILUTION) IV SOLN $94,731.71 HC62809132 PACEMAKER LEADLESS DUAL CHMBR AVEIR DR $93,625.00 0069-4494-01 ELRANATAMAB-BCMM 40 MG/ML SUBCUTANEOUS SOLN $92,859.65 0069-4494-02 ELRANATAMAB-BCMM 40 MG/ML SUBCUTANEOUS SOLN $92,859.65 0169-7205-01 NOVOSEVEN RT 5 MG (5,000 MCG) IV SOLR $91,325.00 0169-7215-11 NOVOSEVEN RT 5 MG (5,000 MCG) IV SOLR $91,325.00 HC44502946 REVAS FEMPOP TLA&STENT&ATHER-B $90,560.00 50242-245-01 PERTUZUMAB-TRASTUZUMAB-HY-ZZXF 1,200 MG-600MG- 30000 UNIT/15ML SUBCUTANEOUS SOLN $90,457.48 HC62809363 GRAFT TRANSMURAL TRANSVENOUS BYPASS W/ DETOUR™ SYSTEM $87,500.00 HC62809199 G230034 STENT GRAFT ASCENDING AORTA ASG(GORE®) $84,000.00 HC62809421 G250008 STENT GRAFT ASCENDING AORTA ASG(GORE®) $84,000.00 0074-3473-03 LEUPROLIDE ACETATE (6 MONTH) 45 MG IM SYKT $83,706.94 51144-050-01 BRENTUXIMAB VEDOTIN 50 MG IV SOLR $82,392.70 82705-010-01 EPCORITAMAB-BYSP 48 MG/0.8 ML SUBCUTANEOUS SOLN $82,369.87 HC62806963 SENSOR PULMONARY ARTERY PRESS IMPL WIRELESS SYS $80,324.00 HC62809330 SENSOR PULMONARY ARTERY PRESS IMPL WIRELESS SYS CARDIOMEMS $80,324.00 59572-775-01 LUSPATERCEPT-AAMT 75 MG SUBCUTANEOUS SOLR $80,205.91 0173-0898-03 DOSTARLIMAB-GXLY 50 MG/ML IV SOLN $78,196.76 HC44503290 ATHER'TRLUML ILIAC EAVES W/S&I-B $76,960.00 0074-3779-03 LEUPROLIDE (PEDIATRIC 3 MONTH) 11.25 MG IM SYKT $76,707.02 71104-944-01 ALPROLIX 3,000 UNIT IV SOLR $75,855.00 57894-470-01 TALQUETAMAB-TGVS 40 MG/ML SUBCUTANEOUS SOLN $75,094.70 50242-917-01 ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) IV SOLN $73,136.83 HC44503068 REVAS TIB/PERO TLA&STNT&ATHR-B $73,067.00 HC44501005 INSERTION-TIPS $71,365.00 61755-008-01 CEMIPLIMAB-RWLC 50 MG/ML IV SOLN $71,012.26 HC62226915 KIT ABALATION (MAZE) $69,999.00 68727-745-02 DAUNORUBICIN-CYTARABINE LIPOS 44-100 MG IV SOLR $69,988.75 68727-745-01 DAUNORUBICIN-CYTARABINE LIPOS 44-100 MG IV SOLR $69,988.75 HC62808886 STENT THORACIC SG AC CONFORM(TAG®GORE®) $69,194.00 0074-5015-01 RISANKIZUMAB-RZAA 60 MG/ML IV SOLN $69,108.13 57894-503-01 DARATUMUMAB-HYALURONIDASE-FIHJ 1,800 MG-30,000 UNIT/15 ML SUBCUTANEOUS SOLN $68,717.12 57894-450-01 TECLISTAMAB-CQYV 90 MG/ML SUBCUTANEOUS SOLN $67,909.08 HC62809066 DEVICE OCCLUDE AMPLATZER $67,900.00 82959-111-01 IMETELSTAT 188 MG IV SOLR $67,662.27 HC44503266 ATHER'TRLUML BRACH EAVES W/S&I-B $66,951.00 HC62807417 STENT ENDOPRSTH TAA AF $66,499.00 25682-007-01 SEBELIPASE ALFA 2 MG/ML IV SOLN $66,365.00 0008-4510-01 GEMTUZUMAB OZOGAMICIN 4.5 MG (1 MG/ML INITIAL CONC) IV SOLR $66,271.92 HC44503217 ATHER' TRLUML RENAL ART&S&I-BI $66,266.00 HC44702835 COMP EP EVAL W/INDUC&ABLAT 3D MAP ECHO S&I PVI AFIB $66,126.00 HC44502888 REVASC FEM POP W/TLA&ATHER-BI $65,257.00 HC44703056 TAVR/TAVI W/ PROSTH; TRANSAPICAL EXP (LT THORAC) $63,797.00 HC44504611 THROMBECT MECH PERC&/THROMBOLYSIS INF CRANI BI $63,767.00 71336-1000-1 PATISIRAN (LIPID COMPLEX) 2 MG/ML IV SOLN $63,602.50 HC44703809 EV REPAIR STENT PLACE COARCT AORTA ACROSS MAJOR SIDE BRANCHES $63,503.00 HC44703189 OPEN REPAIR INFRARENAL AAA; FAILED ENDOGRAFT; AORTO-BIFEM PRO $63,315.00 HC44703171 OPEN REPAIR INFRARENAL AAA; FAILED ENDOGRAFT; AORTO-BI-ILIAC PRO $63,315.00 HC62806849 STENT ENDOPRSTH TAA AE $62,999.00 HC44703163 OPEN REPAIR INFRARENAL AAA; FAILED ENDOGRAFT; TUBE PRO $62,779.00 HC44703106 TEVAR W/ LT SUBCLAV; INITIAL ENDO& DIST EXTS CELIAC $62,681.00 HC44702934 REPAIR VISC AORTA FEVAR(PROX&DIST);4 PROSTH $62,264.00 15054-1120-4 LANREOTIDE 120 MG/0.5 ML SUBCUTANEOUS SYRG $62,153.00 HC44502912 REVASC FEM POP W/TLA&STENT-BI $61,689.00 HC44703460 REPAIR AORTA ASCENDING ENDOVSC STENT GRAFT $61,633.00 99999-035-68 EPIFIX SKIN GRAFT SHEET ( 7X7 CM ) GS-5770 $61,561.50 HC44501864 REVISION-TIPS $61,528.00 HC44504041 EMBOLIZE TUMOR/ORGAN/INFARCT W/S&I $61,099.00 HC62807748 M: GENRTR NRSTM HI FREQU RE-CHRG&CHRGR $60,990.00 HC44702926 REPAIR VISC AORTA FEVAR(PROX&DIST);3 PROSTH $60,860.00 HC45401601 MRI GUIDED US STEREOTACT ABLAT INTRACRAN LESION $60,859.00 64764-300-20 VEDOLIZUMAB 300 MG IV SOLR $60,839.42 HC44503662 VERT/THOR CAROTID STENT 1ST LT $60,801.00 HC44503670 VERT/THOR CAROTID STENT 1ST RT $60,801.00 HC44504058 EMBOLIZE VES HEMORRG/LYMPH EXTRAVW/S&I $60,685.00 50242-260-01 PERTUZUMAB-TRASTUZUMAB-HY-ZZXF 600 MG-600 MG- 20000 UNIT/10ML SUBCUTANEOUS SOLN $60,302.58 HC62808530 GENERATOR PULSE NEUROSTIM(INSPIRE®) $59,849.00 HC62809264 G230043 DEVICE CLOSURE LAA (WATCHMAN) $59,500.00 HC62808365 DEVICE CLOSURE LAA (WATCHMAN) $59,499.00 HC62807243 STENT ENDOPRSTH TAA AD $59,499.00 HC44503035 REVAS TIB/PERO W/TLA&STENT-BI $58,920.00 0026-4948-01 JIVI 3,000 (+/-) UNIT IV SOLR $58,890.00 0026-3948-25 JIVI 3,000 (+/-) UNIT IV SOLR $58,890.00 HC44702918 REPAIR VISC AORTA FEVAR(PROX&DIST);2 PROSTH $58,860.00 0003-2327-11 IPILIMUMAB 50 MG/10 ML (5 MG/ML) IV SOLN $58,855.81 HC44503001 REVAS TIB/PERO W/TLA & ATHER-BI $58,806.00 68382-396-01 SODIUM BENZOATE-SOD PHENYLACET 10-10 % IV SOLN $58,500.00 HC44702900 REPAIR VISC AORTA FEVAR(PROX&DIS);1 PROSTH $58,394.00 69097-870-67 LANREOTIDE 120 MG/0.5 ML SUBCUTANEOUS SYRG $57,802.29 64406-008-01 NATALIZUMAB 300 MG/15 ML IV SOLN $57,714.93 HC44703353 EV REPAIR INFRARENAL AORTA&/ILIAC GRAFT AORTO-BI-ILIAC ~RUPT $57,525.00 99999-033-30 BOTULISM IMMUNE GLOBULIN INJECTION $57,300.00 68403-1100-6 BOTULISM IMMUNE GLOBULIN,HUMAN 100 MG IV SOLR $57,300.00 50242-085-27 ALTEPLASE (FOR STROKE) BOLUS $57,202.34 50242-085-25 ALTEPLASE (FOR STROKE) BOLUS $57,202.34 HC44703114 TEVAR; INITIAL ENDO & DIST EXTS TO CELIAC $57,099.00 HC44703338 EV REPAIR INFRARENAL AORTA&/ILIAC GRFT AORTO-UNI-ILIAC ~RUPT $57,017.00 HC44702827 COMP EP EVAL W/INDUC&ABLAT 3D MAP TX VT $56,680.00 HC44703049 TAVR/TAVI W/ PROSTH; TRANSAORTIC EXP (STERNO) $56,405.00 HC44503183 REVAS TIB/PER EA+TLA&ATH&STN-B $56,303.00 HC62807987 STENT ENDOPRSTH TAA AC $55,999.00 50242-070-01 OBINUTUZUMAB 1,000 MG/40 ML IV SOLN $55,982.68 0074-3683-03 LEUPROLIDE (4 MONTH) 30 MG IM SYKT $55,803.80 58468-0225-1 CAPLACIZUMAB-YHDP 11 MG INJ KIT $55,715.92 58468-0227-1 CAPLACIZUMAB-YHDP 11 MG INJ SOLR $55,715.92 HC44703817 EV REPAIR STENT PLACE COARCT AORTA NOT CROSSING MAJOR SIDE BRANCHES $54,266.00 HC44502763 REVASC ILIAC W/TLA & STENT-BI $54,261.00 HC62807185 DIVERTER FLOW NEUROVASC(PIPELINE FLX 35)F $54,179.00 50242-037-06 TENECTEPLASE 50 MG INJ SOLR (MHS WRAPPER) $53,932.19 50242-120-47 TENECTEPLASE 50 MG INJ SOLR (MHS WRAPPER) $53,932.19 50242-176-01 TENECTEPLASE 50 MG INJ SOLR (MHS WRAPPER) $53,932.19 0069-2522-01 ELRANATAMAB-BCMM 40 MG/ML SUBCUTANEOUS SOLN $53,760.85 0069-2522-02 ELRANATAMAB-BCMM 40 MG/ML SUBCUTANEOUS SOLN $53,760.85 HC44504033 EMBOLIZE ARTERIAL(ANY MALFORMTN)W/S&I $53,466.00 HC44703015 TAVR/TAVI W/ PROSTH; OPEN FEM ARTERY $53,445.00 HC44702892 REPAIR VISC AORTA FEVAR; 4+PROSTH $52,764.00 68727-712-01 LURBINECTEDIN 4 MG IV SOLR $52,715.00 HC62809116 PACEMAKER SYS LEADLESS SNGL CHMBR AVEIR AR $52,500.00 HC62808118 G040175 STENT ENDOPRSTH TAA $52,499.00 HC62808134 G130136 KIT STENTS ENDOPRSTH ASC AORTA $52,499.00 HC62806930 STENT ENDOPRSTH TAA AB $52,499.00 HC62806641 DIVERTER FLOW NEUROVASC(PIPELINE LG)E $52,482.00 60923-284-10 ETEPLIRSEN 50 MG/ML IV SOLN $52,000.00 0003-3734-13 NIVOLUMAB 240 MG/24 ML IV SOLN $51,630.07 50242-918-01 ATEZOLIZUMAB 840 MG/14 ML (60 MG/ML) IV SOLN $51,195.78 HC44702884 REPAIR VISC AORTA FEVAR; 3 PROSTH $50,989.00 58468-0040-1 AGALSIDASE BETA 35 MG IV SOLR $50,878.56 HC44703031 TAVR/TAVI W/ PROSTH; OPEN ILIAC ARTERY $50,765.00 HC62229505 CATH SYSTEM THROMB/EMBO ANGIOVAC $50,750.00 HC44502938 REVAS FEMPOP TLA&STENT&ATHER-L $50,314.00 HC44502920 REVAS FEMPOP TLA&STENT&ATHER-R $50,314.00 0944-2514-02 IGG-HYALURONIDASE,RECOMBINANT 30 GRAM /300 ML (10 %) SUBCUTANEOUS SOLN $50,190.37 44206-439-40 IMMUN GLOB G(IGG)-PRO-IGA 0-50 10 % IV SOLN $49,883.60 44206-439-93 IMMUN GLOB G(IGG)-PRO-IGA 0-50 10 % IV SOLN $49,883.60 HC62807177 DIVERTER FLOW NEUROVASC(PIPELINE FLX 16)D $49,769.00 HC44702876 REPAIR VISC AORTA FEVAR; 2 PROSTH $49,655.00 HC25001413 TRAUMA ACTVTN I CMPREN $49,520.00 HC44703619 TRANSCATH INTRACARD SHUNT(TIS) STENT ICF CONGENTL INCLUDE IMAGI; 1ST SHUNT (FONTANE) $49,359.00 HC44503159 REVAS TIB/PER EA+V TLA&STENT-B $49,009.00 HC62808068 STENT ENDOPRSTH AAA AA $48,999.00 HC62808076 STENT ENDOPRSTH TAA AA $48,999.00 50242-109-01 RITUXIMAB-HYALURONIDASE,HUMAN 1600 MG/13.4 ML (120 MG/ML) SUBCUTANEOUS SOLN $48,854.57 0002-7678-01 RAMUCIRUMAB 10 MG/ML IV SOLN $48,775.68 HC62802988 DEVICE FLOW DIVERSION PIPELINE $48,649.00 HC44703023 TAVR/TAVI W/ PROSTH; OPEN AXILLARLY ARTERY $48,364.00 HC44702868 REPAIR VISC AORTA FEVAR;1 PROSTH $48,321.00 51144-003-01 TISOTUMAB VEDOTIN-TFTV 40 MG IV SOLR $48,105.20 HC62806633 DIVERTER FLOW NEUROVASC(PIPELINE SM)C $47,949.00 0944-2719-30 IMMUN GLOB G(IGG)-GLY-IGA OV50 30 GRAM/300 ML (10 %) SUBCUTANEOUS SOLN $47,800.35 HC44702819 COMP EP EVAL W/INDUC&ABLAT 3D MAP TX SVT $47,233.00 55513-956-01 PANITUMUMAB 400 MG/20 ML (20 MG/ML) IV SOLN $47,102.90 HC44704153 TAVR/TAVI W/ PROSTH; CAROTID $47,069.00 HC44502821 REVAS ILIAC EA+VES W/TLA&STENT-B $46,842.00 HC62805270 DEVICE EMBOLIZATION NEURO(PIPELINE) $46,549.00 HC62808639 OXYGENATOR ECMO CIRCUIT CARDIOHELP $46,199.00 HC44703221 PERC LT ATRIAL APPEND CLOSURE (LARIAT) $45,566.00 HC25002676 TRAUMA ACT' I W/O CC SERVICE $45,555.00 HC62229513 CATH ONLY THROMB/EMBO ANGIOVAC $45,500.00 HC62806245 SYSTEM PERFUSION VENOUS(ANGIOVAC) $45,499.00 HC44504157 SEL CATH IC CAROTID &ANG IC W/SI BI $45,316.00 HC44504025 EMBOLIZE VENOUS (ANY MALFORMTN)W/S&I $45,296.00 HC44503126 REVASC TIB/PERO EA+VES W/TLA-B $45,157.00 HC44501880 STENT PLAC INTRACRANIAL $45,002.00 0078-0825-81 OCTREOTIDE,MICROSPHERES 30 MG IM SSRR $44,931.64 HC44501583 PTA INTRACRANIAL $44,815.00 HC44504553 PLCMT URET STENT PERC(NEPH/URET'GRM,S&I)NEW ACCES BI $44,621.00 HC44703312 EV REPAIR INFRARENAL AORTA DEPLOY GRAFT A-A ~RUPT $44,532.00 HC44703585 TMVR PERC REPAIR MITRAL VALVE 1ST PROSTHESIS $44,423.00 50242-145-01 PERTUZUMAB 420 MG/14 ML (30 MG/ML) IV SOLN $44,333.20 HC62809348 PACEMAKER ONLY LEADLESS SNGL CHMBR AVEIR AR $44,275.00 HC44703700 PERC TRANSCATH INTRATRIAL SEPTAL SHUNT $44,195.00 72903-853-01 MIRVETUXIMAB SORAVTANSINE-GYNX 5 MG/ML IV SOLN $44,085.34 HC46502118 ABLAT RENAL TUMOR(S) PERC CRYO $43,989.00 HC46502126 ABLATION RENAL TUMOR(S) PERC; CRYO LT $43,989.00 HC46502134 ABLATION RENAL TUMOR(S) PERC; CRYO RT $43,989.00 64193-425-02 FEIBA NF 1,750-3,250 UNIT IV SOLR $43,875.00 HC62808217 DEVICE NEUROVASC PULSERIDER H160002 $43,749.00 HC44703007 TAVR/TAVI W/ PROSTH; PERC FEM ARTERY $43,581.00 HC44704070 IMPLANT/REPLACE SYSTEM CAROTID BAROSTIM $43,560.00 HC62809124 PACEMAKER SYS LEADLESS SNGL CHMBR AVEIR VR $43,225.00 HC44703379 EV REPAIR ILIAC GRFT ILIO-ILIAC AORTIC BI DIST UNILAT ~RUPT $43,095.00 HC44700433 INSERT/REPLC SYSTM T-ICD DUAL W/LDS $43,046.00 50242-108-01 RITUXIMAB-HYALURONIDASE,HUMAN 1400 MG/11.7 ML (120 MG/ML) SUBCUTANEOUS SOLN $42,747.78 HC44703122 TEVAR; PLCMT PROX EXT PROTH; INITIAL $42,619.00 HC44703718 TTVR PERC REPAIR TRICUSPID VALVE 1ST PROSTHESIS $42,509.00 25682-025-01 RAVULIZUMAB-CWVZ 100 MG/ML IV SOLN $42,458.52 25682-001-01 ECULIZUMAB 300 MG/30 ML IV SOLN $42,399.44 64980-588-05 EDETATE CALCIUM DISODIUM 200 MG/ML INJ SOLN $42,391.70 64980-588-51 EDETATE CALCIUM DISODIUM 200 MG/ML INJ SOLN $42,391.70 HC44704195 INSERT CONTRACT MODUL-DEFIB INCL PROGRAM FLUORO SYSTEM GENERATOR&LEADS $42,350.00 HC44503282 ATHER'TRLUML ILIAC EAVES W/S&I-L $42,251.00 HC44503274 ATHER'TRLUML ILIAC EAVES W/S&I-R $42,251.00 HC44504173 SEL CATH VERTEBRAL &ANG VRT W/SI BI $42,213.00 HC62229398 DEVICES INARI VTE CAPITATED $42,000.00 HC62808050 STENT ENDOPRSTH AAA Y $41,999.00 HC44701662 PERC CLOSURE OF VSD W/IMPLANT $41,980.00 HC44500544 PERC DILATATION INTRACRANIAL VASOSPASM EA ADD VES DIFF TERRITORY+ $41,909.00 0074-3346-03 LEUPROLIDE (3 MONTH) 22.5 MG IM SYKT $41,852.72 55513-192-01 PEGFILGRASTIM 6 MG/0.6 ML SUBCUTANEOUS SYIN $41,716.94 55513-190-01 PEGFILGRASTIM 6 MG/0.6 ML SUBCUTANEOUS SYRG $41,716.94 50242-087-01 ADO-TRASTUZUMAB EMTANSINE 160 MG IV SOLR $41,492.10 HC44502045 TRANSCATH EMBOLIZ PERC-CNS $41,405.00 73090-421-01 SILTUXIMAB 400 MG IV SOLR $41,373.87 HC44504587 PLCMT URET STENT PERC(NEPH/URET'GRM,S&I) NEW ACCES SEP CATH BI $40,932.00 HC44703270 PPVI PERC TRANSCATH PV IMPLANT W/STENTING $40,821.00 HC44703346 EV REPAIR INFRARENAL AORTA&/ILIAC GRFT AORT-BI-ILIAC NONRUPT $40,649.00 HC44700441 INSERT/REPLC SYSTM T-ICD SNGL W/LD $40,119.00 HC62808597 CATH LITHOTRIPSY TRANSLUM IVL CORONARY $39,854.00 HC44701415 PLCMT CORON CATH;R&L HRT&GRFT $39,836.00 15054-1060-4 LANREOTIDE 60 MG/0.2 ML SUBCUTANEOUS SYRG $39,572.00 HC44502052 TRANSCATH EMBOLIZ PERC-NON CNS $39,552.00 HC44703601 TRANSCATH ATRIAL SEPT(TAS)CONGENTL INCLED ALL IMAG(RASHKIND) $39,487.00 HC44502730 REVASC ILIAC W/TLA INITL VES-BI $39,416.00 0026-3787-75 KOGENATE FS 3,000 (+/-) UNIT IV SOLR $39,390.00 70020-1911-1 IXABEPILONE 45 MG IV SOLR $39,283.92 70020-1911-2 IXABEPILONE 45 MG IV SOLR $39,283.92 0078-0690-61 OFATUMUMAB 1,000 MG/50 ML IV SOLN $39,219.05 HC44502854 REVASC FEM POP W/TLA-BI $39,155.00 0008-1279-01 TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST) IV SOLR $39,006.24 50474-700-62 CERTOLIZUMAB PEGOL 400 MG (200 MG X 2 VIALS) SUBCUTANEOUS KIT $38,996.30 50474-710-79 CERTOLIZUMAB PEGOL 400 MG/2 ML (200 MG/ML X 2) SUBCUTANEOUS SYKT $38,996.30 HC44704369 PERC TRANSCATH CLOS PARAVALV LEAK AORTIC INIT' $38,787.00 HC44704351 PERC TRANSCATH CLOS PARAVALV LEAK MITRAL INIT' $38,787.00 13533-800-40 IMMUNE GLOBUL G-GLY-IGA AVG 46 40 GRAM/400 ML (10 %) INJ SOLN $38,672.40 13533-800-41 IMMUNE GLOBUL G-GLY-IGA AVG 46 40 GRAM/400 ML (10 %) INJ SOLN $38,672.40 HC44505014 PERC PULM ARTERY REVASC W/STENT INITL; ABNRML NTV BILAT $38,670.00 HC44703916 TMVI W/ PROSTH; PERC SEPTAL PUCNCT $38,670.00 HC44700698 PERC BALLOON VALVPLSTY MITRAL $38,572.00 HC44504140 SEL CATH CC/INOM &ANGIO IC W/S&I BI $38,502.00 HC62809181 STENT ENDOPRSTH THOR BRANCH TBE(TAG®GORE®) B $38,500.00 HC62228895 SYSTEM FLOWTRIEVER® $38,499.00 HC44503050 REVAS TIB/PERO TLA&STNT&ATHR-L $38,451.00 HC44503043 REVAS TIB/PERO TLA&STNT&ATHR-R $38,451.00 0006-3026-04 PEMBROLIZUMAB 25 MG/ML IV SOLN $38,335.18 0006-3026-01 PEMBROLIZUMAB 25 MG/ML IV SOLN $38,335.18 0006-3026-02 PEMBROLIZUMAB 25 MG/ML IV SOLN $38,335.18 HC44703320 EV REPAIR INFRARENAL AORTA&/ILIAC GRFT AORT-UNIILIAC NONRUPT $38,243.00 0944-3046-10 ADVATE 3,000 (+/-) UNIT IV SOLR $38,220.00 0944-3046-11 ADVATE 3,000 (+/-) UNIT IV SOLR $38,220.00 0310-1730-30 BENRALIZUMAB 30 MG/ML SUBCUTANEOUS SYRG $38,005.83 HC44500601 CAROTID STENT W/EMBOL PROT LT $37,954.00 HC44500619 CAROTID STENT W/EMBOL PROT RT $37,954.00 HC44502698 CAROTID STENT W/O EMBO PROT LT $37,954.00 HC44502706 CAROTID STENT W/O EMBO PROT RT $37,954.00 68982-850-05 IMMUN GLOBG(IGG)-MALT-IGA OV50 10 % IV SOLN $37,878.75 HC44701399 PLCMT CORON CATH;LT HRT&GRAFTS $37,708.00 HC62229570 G220229 SYSTEM CRYOABLATION ADAGIO VT $37,625.00 HC44703924 TMVR/TMVI W/PROTH; VIA CORONARY SINUS $37,565.00 HC44703551 REVASC LOWER EXT (NOT TIB/PERONL) INTRAVASC LITHOTRIPSY W/ANGIOPL VESSEL(S) W/STENT(S) &ATHERECTOMY $37,513.00 HC38420196 ECMO/ECLS INSJ OF CENTRAL CANNULA 6 YRS & OLDER $37,422.00 HC38420188 ECMO/ECLS INSJ OF CENTRAL CANNULA BIRTH-5 YRS $37,422.00 HC44702280 PERC COR CHRON REVAS ATHR/STNT/A;SNGL-LC $37,386.00 HC44702272 PERC COR CHRON REVAS ATHR/STNT/A;SNGL-LD $37,386.00 HC44702264 PERC COR CHRON REVAS ATHR/STNT/A;SNGL-LM $37,386.00 HC44702298 PERC COR CHRON REVAS ATHR/STNT/A;SNGL-RC $37,386.00 HC44702306 PERC COR CHRON REVAS ATHR/STNT/A;SNGL-RI $37,386.00 HC44702736 PERC COR CHRONC REVAS ATHR/DES/A;SNGL-LC $37,386.00 HC44702728 PERC COR CHRONC REVAS ATHR/DES/A;SNGL-LD $37,386.00 HC44702710 PERC COR CHRONC REVAS ATHR/DES/A;SNGL-LM $37,386.00 HC44702744 PERC COR CHRONC REVAS ATHR/DES/A;SNGL-RC $37,386.00 HC44702751 PERC COR CHRONC REVAS ATHR/DES/A;SNGL-RI $37,386.00 HC44703148 TEVAR; PLCMT OF DISTAL EXTS PROTH(S) DELAYED $37,275.00 HC44702488 PERC COR ATHR+STENT(DES)ANGIOP; SNGL-LC $37,023.00 HC44702470 PERC COR ATHR+STENT(DES)ANGIOP; SNGL-LD $37,023.00 HC44702462 PERC COR ATHR+STENT(DES)ANGIOP; SNGL-LM $37,023.00 HC44702496 PERC COR ATHR+STENT(DES)ANGIOP; SNGL-RC $37,023.00 HC44702504 PERC COR ATHR+STENT(DES)ANGIOP; SNGL-RI $37,023.00 HC44702033 PERC COR ATHR+STENT/ANGIOP; SNGL-LC $37,023.00 HC44702025 PERC COR ATHR+STENT/ANGIOP; SNGL-LD $37,023.00 HC44702017 PERC COR ATHR+STENT/ANGIOP; SNGL-LM $37,023.00 HC44702041 PERC COR ATHR+STENT/ANGIOP; SNGL-RC $37,023.00 HC44702058 PERC COR ATHR+STENT/ANGIOP; SNGL-RI $37,023.00 HC44502979 REVAS TIB/PERO W/TLA 1ST VES-BI $36,967.00 99999-035-67 EPIFIX SKIN GRAFT SHEET ( 5X6 CM ) GS-5560 $36,790.00 HC44702686 PERC COR AMI REVAS ATHR/DES/ANGP;SNGL-LC $36,688.00 HC44702678 PERC COR AMI REVAS ATHR/DES/ANGP;SNGL-LD $36,688.00 HC44702660 PERC COR AMI REVAS ATHR/DES/ANGP;SNGL-LM $36,688.00 HC44702694 PERC COR AMI REVAS ATHR/DES/ANGP;SNGL-RC $36,688.00 HC44702702 PERC COR AMI REVAS ATHR/DES/ANGP;SNGL-RI $36,688.00 HC44702231 PERC COR AMI REVAS ATHR/STNT/ANG;SNGL-LC $36,688.00 HC44702223 PERC COR AMI REVAS ATHR/STNT/ANG;SNGL-LD $36,688.00 HC44702215 PERC COR AMI REVAS ATHR/STNT/ANG;SNGL-LM $36,688.00 HC44702249 PERC COR AMI REVAS ATHR/STNT/ANG;SNGL-RC $36,688.00 HC44702256 PERC COR AMI REVAS ATHR/STNT/ANG;SNGL-RI $36,688.00 0169-7202-01 NOVOSEVEN RT 2 MG (2,000 MCG) IV SOLR $36,530.00 0169-7212-11 NOVOSEVEN RT 2 MG (2,000 MCG) IV SOLR $36,530.00 HC44504991 PERC PULM ARTERY REVASC W/STENT INITL; NRML NTV BILAT $36,460.00 HC44701407 PLCMT CORON CATH;R&L HRT CATH $36,424.00 HC44502870 REVASC FEM POP W/TLA&ATHER-LT $36,254.00 HC44502862 REVASC FEM POP W/TLA&ATHER-RT $36,254.00 HC44503258 ATHER'TRLUML BRACH EAVES W/S&I-L $36,166.00 HC44503241 ATHER'TRLUML BRACH EAVES W/S&I-R $36,166.00 55513-160-01 BLINATUMOMAB 35 MCG IV KIT $36,119.01 55513-150-01 BLINATUMOMAB 35 MCG IV SOLR $36,119.01 0024-5151-75 RASBURICASE 7.5 MG IV SOLR $35,977.24 0024-5151-74 RASBURICASE 7.5 MG IV SOLR $35,977.24 HC44503209 ATHER' TRLUML RENAL ART&S&I-LT $35,873.00 HC44503191 ATHER' TRLUML RENAL ART&S&I-RT $35,873.00 55513-222-01 ROMIPLOSTIM 500 MCG SUBCUTANEOUS SOLR $35,789.13 HC44503233 ATHER' TRLUML ABD AORTA W/S&I $35,470.00 HC44701621 INSRT ICD W/EXSTNG MULTI LEADS $35,357.00 HC44505006 PERC PULM ARTERY REVASC W/STENT INITL; ABNRML NTV UNILAT $35,356.00 0074-3663-03 LEUPROLIDE (3 MONTH) 11.25 MG IM SYKT $35,121.91 HC38420311 INSERT LEFT HEART VENT BY THORACIC INC ECMO/ECLS $35,083.00 HC44704344 ENDOVENOUS REVASC FEM-POP ART TRANSCATH GRAFT $35,000.00 HC62806831 STENT ENDOPRSTH AAA W $34,999.00 HC62806922 STENT ENDOPRSTH TAA W $34,999.00 HC62808738 KIT THROMBECTOMY/EMBOLECTOMY Z $34,983.00 HC44701654 REMV&REPLC SYSTM ICD LEAD MULTI $34,925.00 HC44504629 THROMBECT MECH PERC&/THROMBOLYSIS INF CRANI LT $34,921.00 HC44504637 THROMBECT MECH PERC&/THROMBOLYSIS INF CRANI RT $34,921.00 71104-806-01 ELOCTATE 2,000 UNIT IV SOLR $34,840.00 0310-3040-00 ANIFROLUMAB-FNIA 300 MG/2 ML (150 MG/ML) IV SOLN $34,670.74 HC44702975 INSERT/REPLC SYSTM ICD PERM&SUBQ LD $34,579.00 HC47200811 SRS LINR ACCL TX 1 SESSN,CMPLT(CRANIAL) $34,488.00 HC47200837 SRS ROBOTIC TX 1 SESSN, CMPLT(CRANIAL) $34,488.00 HC44700680 PERC BALLOON VALVPLSTY AORTIC $34,373.00 24338-050-08 CARMUSTINE IN POLIFEPROSAN 7.7 MG IMPL WAFR $34,319.97 HC62808720 KIT THROMBECTOMY/EMBOLECTOMY Y $34,283.00 HC44502904 REVASC FEM POP W/TLA&STENT-LT $34,273.00 HC44502896 REVASC FEM POP W/TLA&STENT-RT $34,273.00 HC44504769 THROMBECT &/THROMBOLYSIS DIALYSIS CIRC WS&I,PHARM INJ; &PTA,STENT(S)OF PDS $34,261.00 HC44502797 REVASC ILIAC EA+VES W/TLA-BI $34,213.00 0944-2700-07 IMMUN GLOB G(IGG)-GLY-IGA OV50 10 % INJ SOLN $34,048.95 0944-2700-13 IMMUN GLOB G(IGG)-GLY-IGA OV50 10 % INJ SOLN $34,048.95 68727-900-03 ASPARAGINASE ERWINIA-RYWN 10 MG/0.5 ML IM SOLN $34,016.67 68727-900-01 ASPARAGINASE ERWINIA-RYWN 10 MG/0.5 ML IM SOLN $34,016.65 58394-637-03 BENEFIX 3,000 UNIT IV SOLR $33,930.00 HC44504942 PERC DILAT EXIST TRACT UROLOGIC PX W/IMAGE &TUBE PLC; NEW ACCESS RNL COL-BIL $33,855.00 HC44700714 PERC CLOSURE OF ASD W/IMPLANT $33,791.00 HC44701837 PERC COR ANGIOP/ATHRECT; SNGL CA/BR-LC $33,680.00 HC44701829 PERC COR ANGIOP/ATHRECT; SNGL CA/BR-LD $33,680.00 HC44701811 PERC COR ANGIOP/ATHRECT; SNGL CA/BR-LM $33,680.00 HC44701845 PERC COR ANGIOP/ATHRECT; SNGL CA/BR-RC $33,680.00 HC44701852 PERC COR ANGIOP/ATHRECT; SNGL CA/BR-RI $33,680.00 HC44504827 TRANSLUMINAL BALO ANGIOP ARTERY W/S&I:INTL BILAT $33,550.00 0944-2513-02 IGG-HYALURONIDASE,RECOMBINANT 20 GRAM /200 ML (10 %) SUBCUTANEOUS SOLN $33,460.25 HC44503092 REVASC TIB/PERO EA+VES W/TLA-B $33,374.00 HC44504983 PERC PULM ARTERY REVASC W/STENT INITL ; NRML NTV UNILAT $33,146.00 0009-7224-02 LYMPHOCYTE,ANTI-THYMO IMM GLOB 0.5 MG/0.01 ML TEST DOSE $32,898.52 0009-7224-01 LYMPHOCYTE,ANTI-THYMO IMM GLOB 50 MG/ML IV INJ (MCH) $32,898.52 HC44700706 PERC BALLOON VALVPLSTY PULM $32,863.00 HC44703304 EV REPAIR INFRARENAL AORTA DEPLOY GRAFT A-A NON-RUPT $32,780.00 HC44704096 IMPLANT/REPLACE GENERATOR ONLY BAROSTIM $32,670.00 HC44700813 PLACEMENT COIL SEPTUM $32,615.00 HC44502995 REVAS TIB/PERO W/TLA & ATHER-LT $32,603.00 HC44502987 REVAS TIB/PERO W/TLA & ATHER-RT $32,603.00 HC44504520 PLCMT URET STENT PERC(NEPH/URET'GRM,S&I)PRE-EXIST BI $32,539.00 HC44503027 REVAS TIB/PERO W/TLA&STENT-LT $32,490.00 HC44503019 REVAS TIB/PERO W/TLA&STENT-RT $32,490.00 HC47200324 PLC BRACHY CATH W/PART MAST BIL $32,409.00 50633-120-11 DIGOXIN IMMUNE FAB 40 MG IV SOLR $32,331.00 50633-121-11 DIGOXIN IMMUNE FAB 40 MG IV SOLR $32,331.00 50633-120-12 DIGOXIN IMMUNE FAB 40 MG IV SOLR $32,331.00 HC44702587 PERC CABG REVAS ATHR/DES/ANGIOP; SNGL-LC $32,091.00 HC44702579 PERC CABG REVAS ATHR/DES/ANGIOP; SNGL-LD $32,091.00 HC44702561 PERC CABG REVAS ATHR/DES/ANGIOP; SNGL-LM $32,091.00 HC44702595 PERC CABG REVAS ATHR/DES/ANGIOP; SNGL-RC $32,091.00 HC44702603 PERC CABG REVAS ATHR/DES/ANGIOP; SNGL-RI $32,091.00 HC44702132 PERC CABG REVAS ATHR/STENT/ANG; SNGL-LC $32,091.00 HC44702124 PERC CABG REVAS ATHR/STENT/ANG; SNGL-LD $32,091.00 HC44702116 PERC CABG REVAS ATHR/STENT/ANG; SNGL-LM $32,091.00 HC44702140 PERC CABG REVAS ATHR/STENT/ANG; SNGL-RC $32,091.00 0944-2718-20 IMMUN GLOB G(IGG)-GLY-IGA OV50 20 GRAM/200 ML (10 %) SUBCUTANEOUS SOLN $31,866.90 65597-801-01 DATOPOTAMAB DERUXTECAN-DLNK 100 MG/5ML IV RECONSTITUTED VIAL (MHS) $31,791.96 HC44700383 INSERT PACER DUAL CHAMBER $31,709.00 HC47200357 PLC MAMMOSITE AFTER DOS BIL $31,689.00 HC62809355 PACEMAKER ONLY LEADLESS SNGL CHMBR AVEIR VR $31,500.00 HC62803317 STENT ENDOPRSTH AAA V $31,499.00 HC44701316 PERC IMPLANT NEURO ELEC; PERIP $31,400.00 HC44702389 PERC COR DES STENT(S)/ANGIOP; SNGL-LC $31,220.00 HC44702371 PERC COR DES STENT(S)/ANGIOP; SNGL-LD $31,220.00 HC44702363 PERC COR DES STENT(S)/ANGIOP; SNGL-LM $31,220.00 HC44702397 PERC COR DES STENT(S)/ANGIOP; SNGL-RC $31,220.00 HC44702405 PERC COR DES STENT(S)/ANGIOP; SNGL-RI $31,220.00 HC44701936 PERC COR STENT(S)/ANGIOP; SNGL CA/BR-LC $31,184.00 HC44701928 PERC COR STENT(S)/ANGIOP; SNGL CA/BR-LD $31,184.00 HC44701910 PERC COR STENT(S)/ANGIOP; SNGL CA/BR-LM $31,184.00 HC44701944 PERC COR STENT(S)/ANGIOP; SNGL CA/BR-RC $31,184.00 HC44701951 PERC COR STENT(S)/ANGIOP; SNGL CA/BR-RI $31,184.00 HC44703783 RT & LT HRT CATH CONGEN DEFECT INCLUDE IMAGE; ABNRML NATIVE CONNECT $31,174.00 HC44501765 REM & REPLAC URETERAL STENT BI $30,869.00 HC44701373 PLCMT CORON CATH;GRAFTS&RT HRT $30,841.00 HC44701647 REMV&REPLC SYSTM ICD LEAD DUAL $30,789.00 HC44701613 INSRT ICD W/EXSTNG DUAL LEAD $30,754.00 HC44701381 PLCMT CORON CATH;LT HRT CATH $30,656.00 HC44504066 REVAS OTHR PERIPH1ST ART W/STNT W-S&I $30,648.00 HC44703544 REVASC LOWER EXT (NOT TIB/PERONL) INTRAVASC LITHOTRIPSY W/ANGIOPL VESSEL(S) & ATHERECTOMY $30,604.00 50242-053-06 RITUXIMAB 10 MG/ML IV CONC $30,534.40 HC44703577 EV REPAIR NON-AORTOILIAC DEPLOY GRAFT ILIAC CATH UNILAT NON-RUPT $30,523.00 HC44700144 COMP EP EVAL W/ INDUC ARRHYTHM $30,514.00 50242-077-01 TRASTUZUMAB-HYALURONIDASE-OYSK 600 MG-10,000 UNIT/5 ML SUBCUTANEOUS SOLN $30,389.06 55513-123-01 TEZEPELUMAB-EKKO 210 MG/1.91 ML (110 MG/ML) SUBCUTANEOUS PNIJ $30,388.61 HC38420220 ECMO/ECLS REPOS CENTRAL PERPH CANNULA BIRTH-5YRS $30,333.00 HC44703098 PERC CLOSURE OF PDA TRANSCATH $30,316.00 0078-0331-84 BASILIXIMAB 20 MG IV SOLR $30,227.28 HC91200138 R&B NICU-NURSERY LEVEL IV $30,132.00 HC44703775 RT & LT HRT CATH CONGEN DEFECT INCLUDE IMAGE;NRML NATIVE CONNECT $30,018.00 0078-0818-81 OCTREOTIDE,MICROSPHERES 20 MG IM SSRR $30,005.95 HC44504280 VERTEBRAL AUGMNT 1BODY W/GUIDE;LUMBAR $29,950.00 HC44701605 REMV&REPL PACER MULTI LEAD SYS $29,920.00 HC44503175 REVAS TIB/PER EA+TLA&ATH&STN-L $29,643.00 HC44503167 REVAS TIB/PER EA+TLA&ATH&STN-R $29,643.00 HC44703536 REVASC LOWER EXT (NOT TIB/PERONL) INTRAVASC LITHOTRIPSY W/ANGIOPL VESSEL(S) W/STENT(S) $29,617.00 HC44502755 REVASC ILIAC W/TLA & STENT-LT $29,603.00 HC44502748 REVASC ILIAC W/TLA & STENT-RT $29,603.00 HC62809322 CATH EP/ABLAT NOT COOL-TIP/3D/V MAP AY $29,575.00 HC44703767 LT HRT CATH CONGEN DEFECTS INCLUDE IMAG; NRML/ABNRML NATIVE CONNECT' $29,442.00 HC44703361 EV REPAIR ILIAC GRFT ILIO-ILIAC AORTC BI DIST UNILAT NONRUPT $29,394.00 HC25001421 TRAUMA ACTVTN II INTRM $29,382.00 HC44504751 THROMBECT &/THROMBOLYSIS DIALYSIS CIRC WS&I,PHARM INJ;&PTA OF PDS $29,127.00 HC44701332 RT & LT HEART CATH;LT VENT S&I $29,021.00 HC44504884 TRANSLUMINAL BALO ANGIOP VEIN W/S&I:INTL BILAT $28,967.00 HC44700490 INSRT ICD W/EXISTNG SNGL LEAD $28,935.00 HC44700508 INSRT/RPLC DUAL ICD GENERATOR $28,935.00 HC44701191 UPGRADE W/ ADD LV LEAD $28,932.00 HC44703825 PTA NATIVE/RECURRENT COARCTATION AORTA $28,864.00 HC25002684 TRAUMA ACT' II W/O CC SERVICE $28,808.00 50633-220-04 URIDINE TRIACETATE 10 GRAM ORAL GRPK $28,760.88 HC44703080 TAVR/TAVI; BYPASS OPEN CENTRAL A&V(AORTA,RA,PA)+ $28,675.00 HC44703759 RT HRT CATH CONGEN DEFECTS INCLUDE IMAG;ABNRML NATIVE CONNECT' $28,606.00 50242-044-13 ALTEPLASE (FOR STROKE) BOLUS (50 MG VIAL) $28,601.17 50242-044-06 ALTEPLASE (FOR STROKE) BOLUS (50 MG VIAL) $28,601.17 HC44704203 INSERT CONTRACT MODUL-DEFIB INCL PROGRAM FLUORO ONLY GENERATOR $28,459.00 HC44704278 REMOVE& REPLACE CONTRACT MODUL-DEFIB ONLY GENERATOR $28,459.00 HC44504272 VERTEBRAL AUGMNT 1BODY W/GUIDE;THORACIC $28,405.00 HC44701365 PLCMT CORON CATH;RT HRT CATH $28,403.00 55513-112-01 TEZEPELUMAB-EKKO 210 MG/1.91 ML (110 MG/ML) SUBCUTANEOUS SYRG $28,398.25 HC44501823 REMOVE URETERAL STENT BIL $28,296.00 HC44900041 ABLATE BONE TUMOR(S) PERQ W/CT;RF $28,294.00 0024-0656-01 ISATUXIMAB-IRFC 20 MG/ML IV SOLN $28,272.40 HC44901049 ABLATE BONE TUMOR(S) PERQ W/CT;CRYO $28,264.00 HC44703742 RT HRT CATH CONGEN DEFECTS INCLUDE IMAG;NRML NATIVE CONNECT $28,174.00 HC62229380 DEVICES INARI DVT CAPITATED $28,000.00 HC44702991 REMV&REPLC SUBQ ICD GEN ONLY $27,984.00 HC44701639 REMV&REPLC SYSTM ICD LEAD SINGL $27,984.00 HC62229539 G230204 SYSTEM THROMBECTOMY LAGUNA $27,965.00 HC62229620 CATH THROMBECTOMY AY $27,930.00 HC47200381 PLC MAMMOSITE ON DOS BIL $27,917.00 HC44504165 SEL CATH SUBC/INOM &ANG VRT W/SI BI $27,891.00 HC44500007 ABLATION RENAL TUMOR(S) PERC; RF $27,853.00 HC44500015 ABLATION RENAL TUMOR(S) PERC; RF LT $27,853.00 HC44500023 ABLATION RENAL TUMOR(S) PERC; RF RT $27,853.00 63833-825-02 C1 ESTERASE INHIBITOR 500 UNIT (10 ML) IV KIT $27,765.47 81052-138-10 PAFOLACIANINE 3.2 MG/1.6 ML IV SOLN $27,625.00 HC44701597 REMV&REPL PACER DUAL LEAD SYS $27,562.00 63459-104-50 RITUXIMAB-ABBS 10 MG/ML IV SOLN $27,480.38 HC44703072 TAVR/TAVI; BYPASS OPEN PERIPH A&V(F/I/A)+ $27,395.00 51144-030-01 ENFORTUMAB VEDOTIN-EJFV 30 MG IV SOLR $27,387.75 0310-4611-50 DURVALUMAB 50 MG/ML IV SOLN $27,367.93 HC62809173 STENT ENDOPRSTH THOR BRANCH TBE(TAG®GORE®) A $27,300.00 70114-130-01 PEGFILGRASTIM-CBQV 6 MG/0.6 ML SUBCUTANEOUS SYIN $27,137.50 70114-101-01 PEGFILGRASTIM-CBQV 6 MG/0.6 ML SUBCUTANEOUS SYRG $27,137.50 HC44703197 OPEN ILIAC FOR ILIAC OR AORTIC ENDOGRAFT, UNI $27,116.00 HC44703239 RIGHT HEART CATH; W/SENSOR PULM ARTERY W/S&I $27,076.00 HC44701738 PERC COR ANGIOPLST; SNGL CA/BRCH-LC $27,037.00 HC44701720 PERC COR ANGIOPLST; SNGL CA/BRCH-LD $27,037.00 HC44701712 PERC COR ANGIOPLST; SNGL CA/BRCH-LM $27,037.00 HC44701746 PERC COR ANGIOPLST; SNGL CA/BRCH-RC $27,037.00 HC44701753 PERC COR ANGIOPLST; SNGL CA/BRCH-RI $27,037.00 HC44504595 PLCMT URET STENT PERC(NEPH/URET'GRM,S&I) NEW ACCES SEP CATH LT $26,863.00 HC44504603 PLCMT URET STENT PERC(NEPH/URET'GRM,S&I) NEW ACCES SEP CATH RT $26,863.00 HC46501086 INSERT PERITONEAL CATH TUNNELED W/PORT $26,745.00 HC62806716 DEVICE REVSC/THROMBCT(CAPTUR/SOLITAIR/TREVO)E $26,739.00 59572-711-01 LUSPATERCEPT-AAMT 25 MG SUBCUTANEOUS SOLR $26,735.41 HC44501237 OCCL BALLOON TEMP HEAD/NECK $26,662.00 HC44504116 PERC TRNSCTH RENAL SYMP DENRV W/IMG BI $26,600.00 HC44700375 INSERT PACER VENT SNGL CHAMBER $26,587.00 HC44701183 UPGRADE PACER SNGL-DUAL $26,518.00 HC44504132 SEL CATH CC/INOM &ANGIO EXCC W/S&I BI $26,433.00 HC44504355 PLCMT STNT BIL PERC EA(CHOLANG,BLN DIL,S&I)EXIST ACC $26,432.00 HC62808209 STENT NEUROVASC CODMAN ENTRPRS H060001 $26,414.00 HC44703478 PERC CLOSURE LAA (WATCHMAN) $26,289.00 0002-7623-01 PEMETREXED DISODIUM 500 MG IV SOLR $26,279.50 0026-3786-65 KOGENATE FS 2,000 (+/-) UNIT IV SOLR $26,260.00 HC91200137 R&B NICU-NURSERY LEVEL III $26,236.00 HC62806740 KIT LIQ EMBOL ANEURYSM(ONYX HD-500)H060003 $26,232.00 HC62808944 BONE GRAFT FILLER VOID 18ML(CERAMENT®BONESUPPORT®) $26,179.00 HC44504082 REVAS OTHR PERIPH1ST VEIN W/STNT W-S&I $26,174.00 HC44504322 ABLATION LIVER TUMOR(S) PERC; CRYO $26,167.00 HC44503605 PLCMNT IVC FILTER /S&I/IMAGE $25,995.00 HC44704005 REMOVE &REPLACE TRANSCATH PM LEADLESS RA $25,961.00 50242-088-01 ADO-TRASTUZUMAB EMTANSINE 100 MG IV SOLR $25,932.60 50242-103-01 POLATUZUMAB VEDOTIN-PIIQ 30 MG IV SOLR $25,923.11 67457-187-50 ALLOPURINOL SODIUM 500 MG IV SOLR $25,915.89 0003-3756-14 NIVOLUMAB 120 MG/12 ML IV SOLN $25,814.96 HC44503142 REVAS TIB/PER EA+V TLA&STENT-L $25,798.00 HC44503134 REVAS TIB/PER EA+V TLA&STENT-R $25,798.00 HC62807193 STENT NEUROVASC WINGSPAN H050001 $25,532.00 0069-0324-01 PEGFILGRASTIM-APGF 6 MG/0.6 ML SUBCUTANEOUS SYRG $25,512.50 0944-3045-10 ADVATE 2,000 (+/-) UNIT IV SOLR $25,480.00 0944-3045-11 ADVATE 2,000 (+/-) UNIT IV SOLR $25,480.00 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 HC46500971 INS TUN VEN ACS DEV W/PORT<5YR $25,266.00 68982-850-04 IMMUN GLOBG(IGG)-MALT-IGA OV50 10 % IV SOLN $25,252.50 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 HC46501029 INS VEN ACS DEV 2SITES W/PORT $25,198.00 HC44503829 SEL CATH IC CAROTID &ANG IC W/SI LT $25,179.00 HC44503837 SEL CATH IC CAROTID &ANG IC W/SI RT $25,179.00 HC46502910 PERC AV FISTULA UE SEPRT ACCESS ART & VEIN VASC & IMAG $25,175.00 HC46502902 REVASC TIBIAL/PERONEAL INTRAVASC LITHOTRIPSY W/ANGIOPL VESSEL(S) W/STENT(S) &ATHERECTOMY $25,175.00 55513-032-01 DARBEPOETIN ALFA IN POLYSORBAT 500 MCG/ML INJ SYRG $25,155.00 HC46500989 INS TUN CV ACCESS DEV W/PORT 5YRS+ $25,009.00 HC44701324 LEFT HEART CATH; LT VENT,W/S&I $24,979.00 0173-0892-42 MEPOLIZUMAB 100 MG/ML SUBCUTANEOUS SYRG $24,943.62 44206-438-20 IMMUN GLOB G(IGG)-PRO-IGA 0-50 10 % IV SOLN $24,941.80 44206-438-92 IMMUN GLOB G(IGG)-PRO-IGA 0-50 10 % IV SOLN $24,941.80 HC44701589 REMV&REPL PACER SINGL LEAD SYS $24,877.00 HC44700367 INSERT PACER ATRIAL SNGL CHAMB $24,867.00 HC47200845 SRS ROBOTIC FX EA 1-5 SESS,CMPLT $24,828.00 HC44704104 REV/REMVL SYSTEM CAROTID BAROSTIM $24,805.00 HC62808712 STENT COAT/COVRD W/O DEL SYS V $24,769.00 55513-132-01 TRASTUZUMAB-ANNS 420 MG IV SOLR $24,753.17 55513-164-01 TRASTUZUMAB-ANNS 420 MG IV SOLR $24,753.17 57894-501-01 AMIVANTAMAB-VMJW 50 MG/ML IV SOLN $24,743.40 57894-501-00 AMIVANTAMAB-VMJW 50 MG/ML IV SOLN $24,743.40 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 HC44703528 REVASC LOWER EXT (NOT TIB/PERONL) INTRAVASC LITHOTRIPSY W/ANGIOPL VESSEL(S) $24,680.00 HC44701357 PLCMT CORON CATH;BYPASS GRAFTS $24,628.00 HC47200829 SRS LINR ACCL FX 1-5 SESSNS,CMPLT $24,572.00 HC62228796 SYSTEM ENDOAVF WAVELINQ™ $24,499.00 HC44502524 PERC DILATATION INTRACRANIAL VASSOSPASM INITIAL VESSEL -LT $24,444.00 HC44502532 PERC DILATATION INTRACRANIAL VASSOSPASM INITIAL VESSEL -RT $24,444.00 HC44703411 TRANSCATH DELIVERY ENHANCED FIXATION DEVICE $24,437.00 HC44502813 REVAS ILIAC EA+VES W/TLA&STENT-L $24,387.00 HC44502805 REVAS ILIAC EA+VES W/TLA&STENT-R $24,387.00 HC44503498 PHLEBCT VEIN/EXT >20 STAB-LT $24,330.00 HC44503480 PHLEBCT VEIN/EXT >20 STAB-RT $24,330.00 HC44504124 ABLAT PULM TUMOR(S) PERC UNILAT W/IMG GUID; CRYO $24,257.00 HC46502894 REVASC TIBIAL/PERONEAL INTRAVASC LITHOTRIPSY W/ANGIOPL VESSEL(S) & ATHERECTOMY $24,186.00 63833-387-02 KCENTRA 1,000 UNIT (800-1240 UNIT) IV SOLR $24,018.80 63833-397-01 KCENTRA 1,000 UNIT (800-1240 UNIT) IV SOLR $24,018.80 59676-610-01 TRABECTEDIN 1 MG IV SOLR $23,980.71 HC46501706 BX/RMVL LYMPH NODE(S)-OPEN BI $23,847.00 HC62808852 KIT CATH INDIGO 12 THROMB 12FR HTORQ[PENUMBRA] $23,835.00 HC44503118 REVASC TIB/PERO EA+VES W/TLA-L $23,770.00 HC44503100 REVASC TIB/PERO EA+VES W/TLA-R $23,770.00 HC44700136 COMP EP EVAL W/O IND ARRHYTH $23,700.00 HC46502886 REVASC TIBIAL/PERONEAL INTRAVASC LITHOTRIPSY W/ANGIOPL VESSEL(S) W/STENT(S) $23,693.00 HC44703981 INSERT TRANSCATH PM LEADLESS RA $23,662.00 HC44504561 PLCMT URET STENT PERC(NEPH/URET'GRM,S&I)NEW ACCES LT $23,483.00 HC44504579 PLCMT URET STENT PERC(NEPH/URET'GRM,S&I)NEW ACCES RT $23,483.00 HC44700037 CATH ABLAT AV NODE HEART BLOCK $23,459.00 HC46501482 REPLC TUNNELED CV ACS DEV W/PUMP $23,450.00 HC44700359 INSERT LV LEAD AT INIT IMPLNT+ $23,447.00 0173-0881-01 MEPOLIZUMAB 100 MG SUBCUTANEOUS SOLR $23,418.33 HC38420295 ECMO/ECLS REMOVAL OF CENTRAL CANNULA 6 YRS & OLDER $23,390.00 HC25002700 TRAUMA ACT' I W/O P-H ALERT $23,376.00 0078-1000-60 INCLISIRAN 284 MG/1.5 ML SUBCUTANEOUS SYRG $23,320.25 55513-326-01 RITUXIMAB-ARRX 10 MG/ML IV SOLN $23,296.00 0069-0249-01 RITUXIMAB-PVVR 10 MG/ML IV SOLN $23,296.00 HC74200056 OR TIME INITIAL HR LEVEL 6 (MCAL 1ST HOUR) $23,271.00 HC44504348 PLCMT CATH BIL DRN PERC(CHOLANG,S&I)INT/EXT $23,225.00 HC44703627 TRANSCATH INTRACARD SHUNT(TIS) STENT CONGENTL INCLUDE IMAGE; EA ADDL+ $23,176.00 HC38420287 ECMO/ECLS REMOVAL OF CENTRAL CANNULA BIRTH-5 YRS $23,133.00 76075-101-01 CARFILZOMIB 60 MG IV SOLR $22,991.74 HC44704013 INSERT TRANSCATH PM LEADLESS DUAL CHAMB COMPLETE SYS $22,990.00 HC44703064 TAVR/TAVI; BYPASS PERC PERIPH A&V(FEM)+ $22,958.00 HC44701340 PLCMT CORONARY CATH(ANGIO/S&I) $22,944.00 HC46500997 INS TUN VEN ACS DEV W/SQ PUMP $22,933.00 HC23000326 IMPLNT/REV/REPOS TUN EPI CATH $22,894.00 73594-9310-1 FERRIC DERISOMALTOSE 100 MG IRON/ML IV SOLN $22,826.12 HC62802657 VALVE HANCOCK II MEDTRONIC $22,785.00 HC46501078 INSERT PERITONEAL CATH TUNNELED W/IMAGING $22,734.00 HC44700904 PTA PULMONARY ARTERY SNGL $22,732.00 HC46502878 REVASC TIBIAL/PERONEAL INTRAVASC LITHOTRIPSY W/ANGIOPLASTY VESSEL(S) $22,705.00 0944-2700-06 IMMUN GLOB G(IGG)-GLY-IGA OV50 10 % INJ SOLN $22,699.30 0944-2700-12 IMMUN GLOB G(IGG)-GLY-IGA OV50 10 % INJ SOLN $22,699.30 58394-636-03 BENEFIX 2,000 UNIT IV SOLR $22,620.00 HC44500486 ASP/DECOMP PERC DISKECTOMY $22,611.00 HC44703395 PLACMNT DELAY DISTL/PROX EXTSN INFRARENL AA ILIAC:INT'L VSSL $22,596.00 HC62807722 M: BODY VERTEBRAL REPLACEMENT $22,540.00 0074-0616-02 ADALIMUMAB 20 MG/0.2 ML SUBCUTANEOUS SYKT $22,498.52 0074-4339-02 ADALIMUMAB 40 MG/0.8 ML SUBCUTANEOUS PNKT $22,498.52 0074-3799-02 ADALIMUMAB 40 MG/0.8 ML SUBCUTANEOUS SYKT $22,498.52 55513-730-01 DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLN $22,423.31 HC44704161 TRANSCATH PERC REMOVE CARDIAC THROMB VIA SUCTION $22,385.00 HC44704336 RIGHT HEART CATH; W/SENSOR PULM ARTERY W/S&I CARDIOMEMS $22,377.00 HC44703155 OPEN ILIAC FOR ENDOGRAFT OR OCCLUSION, UNI $22,371.00 HC44503860 SEL CATH VERTEBRAL &ANG VRT W/SI LT $22,357.00 HC44503878 SEL CATH VERTEBRAL &ANG VRT W/SI RT $22,357.00 HC46503389 ABLATION PROSTATE WATERJET W US GUIDE $22,278.00 HC38420238 ECMO/ECLS ECLS REPOS CENTRAL CNULA 6YRS & OLDER $22,220.00 HC38420329 REMOVAL LEFT HEART VENT BY THORACIC INCIS ECMO/ECLS $22,220.00 HC25002692 TRAUMA ACT' III W/O CC SERVICE $22,211.00 HC44503639 LIGATION INFERIOR VENA CAVA $22,118.00 HC44504744 THROMBECT &/THROMBOLYSIS DIALYSIS CIRC WS&I,PHARM INJ $22,117.00 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 0069-0305-01 TRASTUZUMAB-QYYP 420 MG IV SOLR $22,042.02 0069-0306-01 TRASTUZUMAB-QYYP 420 MG IV SOLR $22,042.02 HC44501732 REM & REPLAC EXT URET CATH(IMG,S&I) BI $22,038.00 HC44704377 PERC TRANSCATH CLOS PARAVALV LEAK EACH ADD'L $22,000.00 HC44702785 PERC COR CHRON REVAS ATHR/DES/A;ADDL-LC+ $21,997.00 HC44702777 PERC COR CHRON REVAS ATHR/DES/A;ADDL-LD+ $21,997.00 HC44702769 PERC COR CHRON REVAS ATHR/DES/A;ADDL-LM+ $21,997.00 HC44702793 PERC COR CHRON REVAS ATHR/DES/A;ADDL-RC+ $21,997.00 HC44702801 PERC COR CHRON REVAS ATHR/DES/A;ADDL-RI+ $21,997.00 HC44702330 PERC COR CHRON REVAS ATHR/STNT/A;ADDL-LC+ $21,997.00 HC44702322 PERC COR CHRON REVAS ATHR/STNT/A;ADDL-LD+ $21,997.00 HC44702314 PERC COR CHRON REVAS ATHR/STNT/A;ADDL-LM+ $21,997.00 HC44702348 PERC COR CHRON REVAS ATHR/STNT/A;ADDL-RC+ $21,997.00 HC44702355 PERC COR CHRON REVAS ATHR/STNT/A;ADDL-RI+ $21,997.00 HC91400496 R&B ICU PEDS - INTENSIVE PPE ISOLATION $21,962.00 HC44704179 PERC TRNSCTH DRUG DELIV BALLOON INTRACORO INCL ANGIO/IVUS/OCT MARJOR ARTERY/BRANCH SINGLE $21,913.00 64764-108-21 VEDOLIZUMAB 108 MG/0.68 ML SUBCUTANEOUS PNIJ $21,902.21 64764-108-20 VEDOLIZUMAB 108 MG/0.68 ML SUBCUTANEOUS PNIJ $21,902.21 HC44502722 REVASC ILIAC W/TLA INITL VES-LT $21,893.00 HC44502714 REVASC ILIAC W/TLA INITL VES-RT $21,893.00 99999-035-69 EPIFIX SKIN GRAFT ( 6X16 CM ) $21,840.00 HC46501474 REPLC TUNNELED CV ACS DEVICE W/PORT $21,799.00 HC44503225 ATHER' TRLUML VISERCL EA & S&I $21,786.00 HC44702538 PERC COR ATHR+STENT(DES)ANGIOP; ADDL-LC+ $21,763.00 HC44702520 PERC COR ATHR+STENT(DES)ANGIOP; ADDL-LD+ $21,763.00 HC44702512 PERC COR ATHR+STENT(DES)ANGIOP; ADDL-LM+ $21,763.00 HC44702546 PERC COR ATHR+STENT(DES)ANGIOP; ADDL-RC+ $21,763.00 HC44702553 PERC COR ATHR+STENT(DES)ANGIOP; ADDL-RI+ $21,763.00 HC44702082 PERC COR ATHR+STENT/ANGIOP; ADDL-LC+ $21,763.00 HC44702074 PERC COR ATHR+STENT/ANGIOP; ADDL-LD+ $21,763.00 HC44702066 PERC COR ATHR+STENT/ANGIOP; ADDL-LM+ $21,763.00 HC44702090 PERC COR ATHR+STENT/ANGIOP; ADDL-RC+ $21,763.00 HC44702108 PERC COR ATHR+STENT/ANGIOP; ADDL-RI+ $21,763.00 HC44502847 REVASC FEM POP W/TLA-LT $21,754.00 HC44502839 REVASC FEM POP W/TLA-RT $21,754.00 HC46502498 EXCHANGE TUBE NEPHRO(NEPH/URET'GRM,S&I) BI $21,684.00 HC23001449 INJ L/S F W/IMAGE 1ST LVL BIL $21,674.00 HC44503597 SEL CATH&RENAL ANGIO2NDW/S&I-B $21,629.00 HC91000208 R&B TRAUMA ICU $21,543.00 HC62808704 STENT COAT/COVRD W/O DEL SYS U $21,538.00 HC44504850 TRANSLUMINAL BALO ANGIOP ARTERY W/S&I:ADDL + BILAT $21,530.00 0003-3774-12 NIVOLUMAB 100 MG/10 ML IV SOLN $21,512.40 HC62809256 M: STENT ENDOPRSTH THORABD TAMBE (EXCLUDER®GORE®)HC62809256 $21,500.00 99988-000-23 NM IN-111 PENTETREOTIDE (OCTREOSCAN) $21,415.10 HC38420162 ECMO/ECLS INSERT PERIPH CANNULA OPEN BIRTH-AGE 5 $21,308.00 HC38420170 ECMO/ECLS INSJ OF PRPH CANNULA 6 YRS&OLDER OPEN $21,308.00 HC45400918 MR UP EXT JNT W&W/O CONT BILAT $21,126.00 HC62228440 DEVICE REVASC/THROMBCT(EMBOTRAP) $21,000.00 HC62807409 STENT ENDOPRSTH AAA P $21,000.00 HC44504736 ACCESS DIALYSIS CIRCUIT EVAL->VENA CAVA WS&I: PDS PTA,STENT(S) $20,991.00 HC46500963 INS TUN VEN ACS DEV 2 SITES $20,951.00 HC44504330 PLCMT CATH BIL DRN PERC(CHOLANG,S&I)EXTRNL $20,922.00 HC91400096 R&B PEDIATRIC INTENSIVE CARE $20,870.00 61314-228-94 DENOSUMAB-BBDZ 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLN $20,853.69 HC44503803 SEL CATH CC/INOM &ANGIO IC W/S&I LT $20,813.00 HC44503811 SEL CATH CC/INOM &ANGIO IC W/S&I RT $20,813.00 HC46502365 TENOTOMY THIGH MULTIPLE TENDONS $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 HC44504298 VERTEBRAL AUGMNT 1BODY W/GUIDE;EA ADD'L L $20,752.00 50242-061-01 BEVACIZUMAB 25 MG/ML IV SOLN $20,720.44 HC44703734 INSERT PERC VAD INC S&I TRANSSEPTL PUNC; LEFT HEART $20,678.00 HC44703247 INSERT ELECTRODE DEFIBRILLATOR SUBQ $20,611.00 HC44504488 ENDOVASC INFUS CRANIAL(NON-THROMB)INIT'L TRRT $20,562.00 HC44502961 REVAS TIB/PERO W/TLA 1ST VES-LT $20,538.00 HC44502953 REVAS TIB/PERO W/TLA 1ST VES-RT $20,538.00 68982-261-02 BALFAXAR 1,000 UNIT IV SOLR $20,475.00 68982-261-82 BALFAXAR 1,000 UNIT IV SOLR $20,475.00 HC74200049 OR TIME INITIAL HR LEVEL 5 (MCAL 1ST HOUR) $20,470.00 76282-720-67 LANREOTIDE 120 MG/0.5 ML SUBCUTANEOUS SYRG $20,461.22 HC44700409 INSERT/EXTRAC/RET/REPOS D TV LEADS $20,459.00 HC44701886 PERC COR ANGIOP/ATHRECT; ADDL CA/BR-LC+ $20,394.00 HC44701878 PERC COR ANGIOP/ATHRECT; ADDL CA/BR-LD+ $20,394.00 HC44701860 PERC COR ANGIOP/ATHRECT; ADDL CA/BR-LM+ $20,394.00 HC44701894 PERC COR ANGIOP/ATHRECT; ADDL CA/BR-RC+ $20,394.00 HC44701902 PERC COR ANGIOP/ATHRECT; ADDL CA/BR-RI+ $20,394.00 HC44501906 THROMBECTOMY MECH PRIM ART LT(NONCOR/CRNL) $20,376.00 HC44501914 THROMBECTOMY MECH PRIM ART RT(NONCOR/CRNL) $20,376.00 HC62808845 KIT CATH INDIGO 12 THROMB 8FR XTORQ[PENUMBRA] $20,335.00 HC25001439 TRAUMA ACTVTN III LMTD $20,217.00 57894-505-20 DARATUMUMAB 20 MG/ML IV SOLN $20,166.12 0003-4522-11 ELOTUZUMAB 400 MG IV SOLR $20,116.59 70720-951-30 GOSERELIN 10.8 MG SUBCUTANEOUS IMPL $20,099.95 65597-406-01 FAM-TRASTUZUMAB DERUXTECN-NXKI 100 MG IV SOLR $20,062.06 HC44701571 INSRT PACER ONLY;EXST MULTI LD $19,989.00 HC44503563 SEL CATH&RENAL ANGIO1STW/S&I-B $19,934.00 HC46500302 BIOPSY NEEDLE RENAL-BILAT $19,907.00 HC44503936 PLCMNT GRAFT FEM-FEM-AAA REP+ $19,906.00 HC44505022 PERC PULM ARTERY REVASC W/STENT INITL; EA ADDL LESION+ $19,888.00 HC44502631 INSERT PLEURAL CATH TUNNELD LT $19,804.00 HC44502623 INSERT PLEURAL CATH TUNNELD RT $19,804.00 HC62229547 CATH TRANSLUM BALLOON DRUG-COATED AGENT™ $19,775.00 HC45400561 MR UP EXT(NON JNT) W&W/O BIL $19,765.00 HC62210687 SYSTEM MICRODELIVERY FOR STENT $19,744.00 HC91000404 R&B ICU - INTENSIVE PPE ISOLATION $19,718.00 HC91200404 R&B IICU - INTENSIVE PPE ISOLATION $19,718.00 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 HC46502431 PLCMT CATH NEPHURET PERC(NEPH/URET'GRM,S&I)NEW ACC BI $19,620.00 HC62802970 STENT NEUROVASCULAR O $19,600.00 HC44504181 SEL CATH EX CAROTID&ANG EC W/SI BI+ $19,535.00 HC47201173 TRANSPERINEAL PLCMNT BIODEGRADABLE MATERIAL $19,534.00 HC44702439 PERC COR DES STENT(S)/ANGIOP; ADDL-LC+ $19,454.00 HC44702421 PERC COR DES STENT(S)/ANGIOP; ADDL-LD+ $19,454.00 HC44702413 PERC COR DES STENT(S)/ANGIOP; ADDL-LM+ $19,454.00 HC44702447 PERC COR DES STENT(S)/ANGIOP; ADDL-RC+ $19,454.00 HC44702454 PERC COR DES STENT(S)/ANGIOP; ADDL-RI+ $19,454.00 HC44701977 PERC COR STENT(S)/ANGIOP; ADDL CA/BR-LD+ $19,454.00 HC44701969 PERC COR STENT(S)/ANGIOP; ADDL CA/BR-LM+ $19,454.00 HC44701993 PERC COR STENT(S)/ANGIOP; ADDL CA/BR-RC+ $19,454.00 HC44702009 PERC COR STENT(S)/ANGIOP; ADDL CA/BR-RI+ $19,454.00 HC23001357 INJ CER/THOR F/IMAGE SNG LVLBI $19,448.00 HC62806955 WAND ASPIRATION/IRRIG NEUROVASC $19,442.00 HC44701985 PERC COR STENT(S)/ANGIOP; ADDL CA/BR-LC+ $19,433.00 HC44702637 PERC CABG REVAS ATHR/DES/ANGPL; ADDL-LC+ $19,414.00 HC44702629 PERC CABG REVAS ATHR/DES/ANGPL; ADDL-LD+ $19,414.00 HC44702611 PERC CABG REVAS ATHR/DES/ANGPL; ADDL-LM+ $19,414.00 HC44702645 PERC CABG REVAS ATHR/DES/ANGPL; ADDL-RC+ $19,414.00 HC44702652 PERC CABG REVAS ATHR/DES/ANGPL; ADDL-RI+ $19,414.00 HC44702181 PERC CABG REVAS ATHR/STENT/ANG; ADDL-LC+ $19,414.00 HC44702173 PERC CABG REVAS ATHR/STENT/ANG; ADDL-LD+ $19,414.00 HC44702165 PERC CABG REVAS ATHR/STENT/ANG; ADDL-LM+ $19,414.00 HC44702199 PERC CABG REVAS ATHR/STENT/ANG; ADDL-RC+ $19,414.00 HC44702207 PERC CABG REVAS ATHR/STENT/ANG; ADDL-RI+ $19,414.00 99999-035-66 EPIFIX SKIN GRAFT SHEET ( 4X4 CM ) GS-5440 $19,383.00 15054-0043-1 IRINOTECAN LIPOSOMAL 4.3 MG/ML IV DISP $19,363.50 HC46501003 INS TUN VEN CATH W/O PORT<5 $19,344.00 13533-800-24 IMMUNE GLOBUL G-GLY-IGA AVG 46 20 GRAM/200 ML (10 %) INJ SOLN $19,336.20 13533-800-25 IMMUNE GLOBUL G-GLY-IGA AVG 46 20 GRAM/200 ML (10 %) INJ SOLN $19,336.20 63459-391-20 BENDAMUSTINE 100 MG IV SOLR $19,316.70 HC46501516 REPLC PICC LINE W/ SQ PORT $19,282.00 HC46502944 PERC AV FISTULA UE SINGLE ACCESS BOTH ART & VEIN VASC & IMAG $19,277.00 HC46500948 INS PICC LINE W/PORT<5YR $19,267.00 HC46500955 INS PICC LINE W/PORT>5YR $19,267.00 HC62807862 STENT EXTENDER ENDOGRAFT TAA O $19,250.00 0409-0801-01 PENTOSTATIN 10 MG IV SOLR $19,183.32 99999-038-98 POLIHEXANIDE (PURAPLY) 6X9 CM EACH TOPICAL SHEET $19,155.50 HC46501011 INS TUN CV ACS CATH W/O PORT 5YRS+ $19,150.00 0944-3054-02 ADVATE 1,500 (+/-) UNIT IV SOLR $19,110.00 HC38420147 ECMO INSERT PERIPH CANNULA PERC W/FLUORO $19,063.00 HC38420154 ECMO/ECLS INSERT PERIPH CANNULA PERC BIRTH-AGE 5 $19,063.00 HC44702157 PERC CABG REVAS ATHR/STENT/ANG; SNGL-RI $19,051.00 HC46500005 ABLATION LIVER TUMOR(S) PERC; RF $19,000.00 HC26000059 DELIVERY VAGINAL TWINS $19,000.00 HC45400223 MR LO EXT(NON JNT)W&W/O CON BI $18,976.00 HC44700474 INSRT PACER ONLY;W/EXIST DUAL LEAD $18,937.00 HC44501435 PHLEBCT VEIN/EXT 10-20 STAB-LT $18,907.00 HC44501443 PHLEBCT VEIN/EXT 10-20 STAB-RT $18,907.00 HC44502789 REVASC ILIAC EA+VES W/TLA-LT $18,906.00 HC44502771 REVASC ILIAC EA+VES W/TLA-RT $18,906.00 59148-072-80 ARIPIPRAZOLE 400 MG IM SERS $18,878.86 HC44504199 SEL CATH EA IC CRTD/VERT&ANG W/SI BI+ $18,867.00 65219-380-30 ALLOPURINOL SODIUM 500 MG IV SOLR $18,850.00 HC44504314 PERC SACRAL AUGMT BILAT W/ GUIDANCE&BX $18,829.00 HC44504306 PERC SACRAL AUGMT UNILAT W/ GUIDANCE&BX $18,829.00 HC44504926 PERC DILAT EXIST TRACT UROLOGIC PX W/IMAGE &TUBE PLC; NEW ACCESS RNL COL-LT $18,811.00 HC44504934 PERC DILAT EXIST TRACT UROLOGIC PX W/IMAGE &TUBE PLC; NEW ACCESS RNL COL-RT $18,811.00 HC46502381 FASCIOTOMY, FOOT AND/OR TOE $18,788.00 HC46501573 THORACENTESIS W/TUBE W/ IMAG BI $18,726.00 HC44504371 PLCMT STNT BIL PERC EA&CATH(CHOLANG,BLN DIL,S&I)NEW ACC $18,703.00 HC74200031 OR TIME INITIAL HR LEVEL 4 (MCAL 1ST HOUR) $18,582.00 HC23001118 PERC IMPLANT'N NEUROSTIM ELEC $18,572.00 HC62200076 ABLATION DEVICE(CARDIAC TISS) $18,484.00 HC44501989 THROMBECTOMY VENOUS LT $18,429.00 HC44505030 THROMBECTOMY VENOUS MECHANICAL (VENA CAVA'S) $18,429.00 HC44501997 THROMBECTOMY VENOUS RT $18,429.00 50242-227-01 OMALIZUMAB 300 MG/2 ML SUBCUTANEOUS SYRG $18,409.56 50242-227-86 OMALIZUMAB 300 MG/2 ML SUBCUTANEOUS SYRG $18,409.56 HC83000786 THER APHER W/EXTRACORP IMMUNO/ADSORP/FILTRATION $18,407.00 HC47200183 IMRT TX PLAN $18,388.00 HC44503720 THROMBOLYSIS ART OTHER NONCOR/CRNL+S&I1ST DAY $18,379.00 HC91200136 R&B NICU-NURSERY LEVEL II $18,341.00 HC12800017 THER APHER W/EXTRACORP IMMUNO/ADSORP/FILTRATION $18,288.00 0169-7201-01 NOVOSEVEN RT 1 MG (1,000 MCG) IV SOLR $18,265.00 0169-7211-11 NOVOSEVEN RT 1 MG (1,000 MCG) IV SOLR $18,265.00 51144-020-01 ENFORTUMAB VEDOTIN-EJFV 20 MG IV SOLR $18,258.50 HC44504108 PERC TRNSCTH RENAL SYMP DENRV W/IMG UNILAT $18,241.00 HC91000204 R&B INTENSIVE CARE $18,224.00 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 HC51061141 OSTEOTOMY TIBIA $18,153.64 HC44704021 INSERT TRANSCATH PM LEADLESS DUAL CHAMB COMP RA $18,150.00 HC44704039 INSERT TRANSCATH PM LEADLESS DUAL CHAMB COMP RV $18,150.00 55513-207-01 BEVACIZUMAB-AWWB 25 MG/ML IV SOLN $18,140.82 HC46501375 REMOVE PERITONEAL CATH TUNNELED $18,103.00 HC44504538 PLCMT URET STENT PERC(NEPH/URET'GRM,S&I)PRE-EXIST LT $18,078.00 HC44504546 PLCMT URET STENT PERC(NEPH/URET'GRM,S&I)PRE-EXIST RT $18,078.00 HC44501484 TLA AORTA W/S&I:INITIAL $18,024.00 HC62800800 RECORDER CARDIAC EVENT(MEDTRONIC LINQ) $18,008.00 HC44503084 REVASC TIB/PERO EA+VES W/TLA-L $17,920.00 HC44503076 REVASC TIB/PERO EA+VES W/TLA-R $17,920.00 55513-221-01 ROMIPLOSTIM 250 MCG SUBCUTANEOUS SOLR $17,894.63 HC23000730 INJ FORAMN EPI LMBR INTLW/S&I-B $17,846.00 HC46500369 BX VERTEBRAL BODY; OPEN THORACIC $17,809.00 HC47200100 ABLAT PULM TUMOR(S) PERC UNILAT W/IMG GUID; RF $17,760.00 HC46501540 THORACENTESIS ASP W/ IMG GUID-BILAT $17,708.00 HC44504801 TRANSLUMINAL BALO ANGIOP ARTERY W/S&I:INTL LEFT $17,659.00 HC44504819 TRANSLUMINAL BALO ANGIOP ARTERY W/S&I:INTL RIGHT $17,659.00 HC44505055 TRANSLUMINAL BALO ANGIOPLST ARTERY W/S&I:INITIAL $17,659.00 HC44703130 TEVAR; PLCMT PROX EXT PROTH; EACH ADD'L+ $17,638.00 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 HC44503514 ENDOVENOUS ABLAT RADIO FREQ WS&I; INITIAL VEIN $17,604.00 HC62809272 IMPLANT BOVINE COLLAGEN BEAR $17,587.50 HC44503761 TRANSCATH RETRIEVAL PERC FB W/S&I $17,586.00 HC44504918 TRANSLUMINAL BALO ANGIOP VEIN W/S&I:ADDL + BILAT $17,581.00 HC62229679 PROBE ABLATION RF $17,521.14 HC62229000 CATH THROMBECTOMY AZ $17,500.00 HC47200365 PLC MAMMOSITE AFTER DOS LT $17,445.00 HC47200373 PLC MAMMOSITE AFTER DOS RT $17,445.00 HC44503753 THROMBOLYSIS NONCOR END OF TX $17,445.00 HC45400314 MR LOW EXT(JNT)W&W/O CONT BIL $17,402.00 74527-022-02 MARGETUXIMAB-CMKB 25 MG/ML IV SOLN $17,378.92 74527-022-03 MARGETUXIMAB-CMKB 25 MG/ML IV SOLN $17,378.92 HC62219258 DEVICE DELIVERY SUTURE INCL LARIAT $17,325.00 HC21000195 BX BONE OPEN; SUPERFICIAL $17,309.00 43598-051-11 CALCITONIN (SALMON) 200 UNIT/ML INJ SOLN $17,298.78 HC44701100 RIGHT HEART CATH; MSRMT, CO $17,288.00 HC46502399 DIVSN PLANTR FASCIA&MUSCLE(STEINDLER STRIP) $17,286.00 50242-137-01 TOCILIZUMAB 400 MG/20 ML (20 MG/ML) IV SOLN $17,262.83 HC46501458 REPLC CATH ONLY CV ACESS W/PORT $17,217.00 HC44504975 PERC DILAT EXIST TRACT UROLOGIC PX W/IMAGE /&TUBE-BIL $17,211.00 HC44701787 PERC COR ANGIOPLST; ADDL CA/BRCH-LC+ $17,173.00 HC44701779 PERC COR ANGIOPLST; ADDL CA/BRCH-LD+ $17,173.00 HC44701761 PERC COR ANGIOPLST; ADDL CA/BRCH-LM+ $17,173.00 HC44701795 PERC COR ANGIOPLST; ADDL CA/BRCH-RC+ $17,173.00 HC44701803 PERC COR ANGIOPLST; ADDL CA/BRCH-RI+ $17,173.00 HC62802996 RECORDER CARDC EVNT(BIOTRONIK BIOMNTR 2AF) $17,150.00 23155-261-41 CARMUSTINE 100 MG IV SOLR $17,143.04 83257-004-12 TRASTUZUMAB-DKST 420 MG IV SOLR $17,062.83 83257-004-11 TRASTUZUMAB-DKST 420 MG IV SOLR $17,062.83 83257-003-11 TRASTUZUMAB-DKST 420 MG IV SOLR $17,062.83 HC47201264 SIMULATION FIELD RAD THER COMPLX INCL PET &CT $16,961.00 82959-112-01 IMETELSTAT 47 MG IV SOLR $16,915.60 24338-260-08 NIMODIPINE 60 MG/10 ML ORAL SOLN $16,891.58 HC23000672 INJ FORAMN EPI C/T INTLW/S&I-BI $16,804.00 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 HC44703288 INSERT/REPLACE TRANSCATH PACER LEADLESS RV $16,796.00 0944-7553-02 VONVENDI 1,300 (+/-) UNIT RANGE IV SOLR $16,731.00 0944-2512-02 IGG-HYALURONIDASE,RECOMBINANT 10 GRAM /100 ML (10 %) SUBCUTANEOUS SOLN $16,730.12 HC46502373 TENOTOMY ACHILLES TENDON *DS $16,639.00 HC46502464 CONVERT NEPH CATH -> NEPH'URET PERC(NEPH/URET'GRM,S&I)EXST BI $16,623.00 HC46502407 PLCMT NEPHROSTOMY CATHETER,(NEPH/URET'GRM,S&I) BI $16,610.00 99999-045-95 PIFLUFOLASTAT F 18 37 MBQ/ML TO 2,960 MBQ/ML IV SOLN $16,583.00 0597-0197-05 IDARUCIZUMAB 2.5 GRAM/50 ML IV SOLN $16,582.80 HC44700466 INSRT PACER ONLY;W/EXIST SNGL LEAD $16,568.00 HC62229653 CATH LITHOTRIPSY TRANSLUM IVL PERIPHERAL Q $16,450.00 55135-132-01 SACITUZUMAB GOVITECAN-HZIY 180 MG IV SOLR $16,336.06 HC44503746 THROMBOLYSIS NONCOR+S&I SUB DAY $16,291.00 HC44503738 THROMBOLYSIS VEN NONCOR+S&I1ST DAY $16,287.00 HC47200332 PLC BRACHY CATH W/PART MAST LT $16,275.00 HC47200340 PLC BRACHY CATH W/PART MAST RT $16,275.00 52652-2001-1 METHOTREXATE 2.5 MG/ML ORAL SOLN $16,252.86 69853-0102-1 FACTOR XA,INACTIVATED-ZHZO 200 MG IV SOLR $16,250.00 0310-3200-01 FACTOR XA,INACTIVATED-ZHZO 200 MG IV SOLR $16,250.00 0310-3200-04 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 HC44501773 REM & REPLAC URETERAL STENT LT $16,244.00 HC44501781 REM & REPLAC URETERAL STENT RT $16,244.00 HC44502318 ENDOVENOUS ABLAT LASER WS&I; INITIAL VEIN $16,179.00 HC47201272 STEREOTACTIC BODY RAD THER DELIV TX 1-5FRACTIONS $16,155.00 72874-001-01 FLUOROESTRADIOL F-18 148 MBQ/ML TO 3,700 MBQ/ML IV SOLN $16,152.50 HC44700417 INSERT/EXTRAC/RET/REPOS S TV LEAD $16,151.00 HC46501466 REPLC TUNNELED CV ACS DEVICE W/O PORT/PUMP $16,151.00 HC44504868 TRANSLUMINAL BALO ANGIOP VEIN W/S&I:INTL LEFT $16,099.00 HC44504876 TRANSLUMINAL BALO ANGIOP VEIN W/S&I:INTL RIGHT $16,099.00 HC44505071 TRANSLUMINAL BALO ANGIOPLST VEIN W/S&I:INITIAL $16,099.00 63459-348-04 BENDAMUSTINE 25 MG/ML IV SOLN (BENDEKA) (MHS) $16,079.70 HC27001890 EGD PARTIAL/COMPL EG FUNDOPLASTY $16,070.00 HC23000250 DESTRUCT OTHER PERIPH SNGL BI $16,048.00 HC45600079 PET W/CT WHOLE BODY $16,042.00 HC44504363 PLCMT STNT BIL PERC EA(CHOLANG,BLN DIL,S&I)NEW ACC $16,014.00 HC74200023 OR TIME INITIAL HR LEVEL 3 (MCAL 1ST HOUR) $16,004.00 0069-0342-01 BEVACIZUMAB-BVZR 25 MG/ML IV SOLN $15,948.40 0078-0883-61 CRIZANLIZUMAB-TMCA 10 MG/ML IV SOLN $15,944.11 0944-2717-10 IMMUN GLOB G(IGG)-GLY-IGA OV50 10 GRAM/100 ML (10 %) SUBCUTANEOUS SOLN $15,933.45 HC44701068 REPOS PREV PLCD LV SYSTEM ELEC $15,896.00 HC44504686 ABLATION UTERINE FIBROID(S) TRANSCERV W US GUIDE; RF $15,892.00 HC46501219 MECH REMOV PERICATH OBSTR MAT CV $15,854.00 HC44702942 INSERT PERC VAD INC S&I ARTERIAL ONLY; LEFT HEART $15,789.00 HC44703635 INSERT VAD PERCUT INC S&I VENOUS ONLY RIGHT $15,789.00 HC47200704 RADIOTHERAPY PLAN 3D W/VOL HISTOGRAM $15,782.00 HC62229364 KIT MILL BONE BLADE W/PREP $15,750.00 HC62808449 MONITOR CARDIAC ECG $15,750.00 HC62808423 RECORDER CARDIAC EVENT(ABBOTT/BOSTON SCI) $15,750.00 0008-1179-01 TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST) IV SOLR $15,602.50 17156-235-01 IOBENGUANE SULFATE I-123 10 MCI/5 ML (370 MBQ/5 ML) IV SOLN $15,564.89 HC91400095 R&B PEDS STEPDOWN/DOU $15,529.00 HC38420097 ECMO INITIATION VENO-ARTERIAL $15,507.00 HC44503845 SEL CATH SUBC/INOM &ANG VRT W/SI LT $15,498.00 HC44503852 SEL CATH SUBC/INOM &ANG VRT W/SI RT $15,498.00 50458-563-01 PALIPERIDONE PALMITATE 156 MG/ML IM SYRG $15,466.69 HC44700151 COMP EP EVAL W/LT ATRIAL PACE+ $15,422.00 HC62807326 STENT COVRD W/DEL SYS(AXIOS) AE $15,400.00 HC62806807 STENT ENDOPRSTH AAA L $15,400.00 HC44504256 VERTEBROPLASTY 1BODY/GUIDE;LUMBOSACRAL $15,399.00 69344-101-01 INDOMETHACIN 25 MG/5 ML ORAL SUSP $15,391.14 HC44503787 SEL CATH CC/INOM &ANGIO EXCC W/S&I LT $15,358.00 HC44503795 SEL CATH CC/INOM &ANGIO EXCC W/S&I RT $15,358.00 HC47201009 DELIV TX ELCTRN INTRAOP SNGL SESS $15,341.00 HC47200993 DELIV TX XRAY INTRAOP SNGL SESSION $15,341.00 69932-001-30 FLUCICLOVINE F18 10 MCI (370 MBQ) IV SOLN $15,337.00 HC46500088 ASP/INJ RENAL CYST/PELVIS BI $15,306.00 99999-045-94 NM GA-68 GALLIUM GOZETOTIDE PSMA-11 $15,275.00 HC45600061 PET W/CT SKULL BASE-MID THIGH $15,256.00 HC44504249 VERTEBROPLASTY 1BODY/GUIDE;CERVICOTHORACIC $15,202.00 HC44700573 INTRAVENTRICULAR PACING $15,186.00 HC46500047 ASP BLADDER W/INSERT SUPRAPUB $15,172.00 HC46501060 INSERT PERITONEAL CATH TUNNELED FOR DIALYSIS; OPEN $15,102.00 55513-111-01 DARBEPOETIN ALFA IN POLYSORBAT 300 MCG/0.6 ML INJ SYRG $15,093.00 0003-2291-11 ELOTUZUMAB 300 MG IV SOLR $15,087.61 HC44500213 ANGIO EXTREMITY BILAT $15,063.00 HC44505048 THROMBECTOMY VEIN REPEAT SUBSQ DAY (VENA CAVA'S) $14,984.00 HC44502003 THROMBECTOMY VEIN REPEAT SUBSQ DAY LT $14,984.00 HC44502011 THROMBECTOMY VEIN REPEAT SUBSQ DAY RT $14,984.00 HC44500551 PERC DILATATION INTRACRANIAL VASOSPASM EA ADD VES SAME TERRITORY+ $14,964.00 HC44501922 THROMBECT MECH PRIM ART ADD LT(NONCOR/CRNL)+ $14,959.00 HC44501930 THROMBECT MECH PRIM ART ADD RT(NONCOR/CRNL)+ $14,959.00 HC43001239 ABLATION CRYO BREAST MALIG TUMOR(S) &IMAG UNILAT $14,936.00 HC46502357 TENOTOMY THIGH SINGLE TENDON $14,924.00 HC46500450 BX LYMPH NODE(S)-SUPERFCL-BIL $14,906.00 HC44501831 REMOVE URETERAL STENT LT $14,893.00 HC44501849 REMOVE URETERAL STENT RT $14,893.00 HC46502597 BONE MARROW DX; BIOPSY(IES) & ASPIRATION(S) BILAT $14,876.00 HC23001134 DESTR C/T FAC JOINT SNGL W/IMG-B $14,868.00 HC44900710 CTA UPPER EXT W/CONTRAST-BILAT $14,864.00 HC46501268 PERC PLACEMENT DU/J TUBE W/FLUORO $14,845.00 49591-126-51 VARICELLA-ZOSTER I.GLOB-MALTOS 125 UNIT/1.2 ML IM SOLN $14,824.94 49591-126-11 VARICELLA-ZOSTER I.GLOB-MALTOS 125 UNIT/1.2 ML IM SOLN $14,824.94 0944-2659-08 IMMUN GLOB G-GLY-GLUC-IGA 0-50 10 GRAM IV SOLR $14,795.30 0944-2658-04 IMMUN GLOB G-GLY-GLUC-IGA 0-50 10 GRAM IV SOLR $14,795.30 17156-021-01 INDIUM IN-111 OXYQUINOLINE 1 MCI/ML (37 MBQ/ML)(1 ML) IV SOLN $14,734.86 HC47201132 HDR RADIONUCLIDE INTRSTTL/INTRVIT BRACH 12+ CHANN $14,730.00 HC46500559 BX SFT TISS PELV/HIP-BIL $14,707.00 HC62802053 STENT ENDOPRSTH TIPS(VIATORR) K $14,700.00 HC44504074 REVAS OTHR PERIPH +ART W/STNT W-S&I $14,672.00 24201-010-50 PENTOBARBITAL SODIUM 50 MG/ML INJ SOLN $14,670.50 HC44700516 INTRA-ATRIAL PACING $14,620.00 0009-0283-01 GELATIN ABSORBABLE IMPL FILM $14,583.21 HC44701548 INCISE FEMEROL; DELIVERY EVS PROTH $14,580.00 HC62808936 BONE GRAFT FILLER VOID 10ML(CERAMENT®BONESUPPORT®) $14,560.00 HC44704112 REV/REMVL LEAD CAROTID BAROSTIM $14,520.00 13533-606-12 THROMBATE III 500 (+/-) UNIT IV SOLR $14,495.00 49281-790-20 TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML IM SOLN $14,488.05 HC45400629 MR UP EXT (JNT) W/CONT BIL $14,320.00 HC44500270 ANGIO PULMONARY BILAT $14,313.00 HC44900660 CTA LOW EXT BILAT $14,297.00 HC44700243 IMPLANT CARDIAC RHYTHM MONITOR SQ & PROGRAMMING $14,281.00 HC44504728 ACCESS DIALYSIS CIRCUIT EVAL->VENA CAVA WS&I; PDS PTA $14,242.00 HC46501276 PERC PLCMNT GT TUBE W/FLUORO $14,234.00 HC44002863 MYELOGRAPHY INJ W/S&I; =/>2SPINALREGIONS $14,211.00 69945-064-01 COPPER CU-64 DOTATATE 148 MBQ/4 ML (4 MCI/4 ML) IV SOLN $14,175.00 HC46502548 TENOTOMY PERC, TOE; MULTIPLE TENDONS $14,163.00 59148-018-71 ARIPIPRAZOLE 300 MG IM SSRR $14,159.15 59148-018-70 ARIPIPRAZOLE 300 MG IM SSRR $14,159.15 HC23001159 DESTR L/S FAC JOINT SNGL W/IMG-B $14,121.00 HC47200399 PLC MAMMOSITE ON DOS LT $14,106.00 HC47200407 PLC MAMMOSITE ON DOS RT $14,106.00 HC62808027 M: CAGE ACETABULAR $14,060.00 HC38420089 ECMO INITIATION VENO-VENOUS $14,034.00 49401-102-01 BELIMUMAB 400 MG IV SOLR $14,027.07 HC62204656 M: SYSTEM NEURO STEALTH $14,024.00 HC44501948 THROMBECTOMY ART 2ND LT(NONCOR/CRNL) $14,018.00 HC44501955 THROMBECTOMY ART 2ND RT(NONCOR/CRNL) $14,018.00 HC62212063 CATH ANGIOG PERIPH CTO CROSSING AQ $14,000.00 HC62806799 STENT ENDOPRSTH AAA K $14,000.00 HC62809314 DEVICE ENDOSCOPE URINARY TRACT IMAGING ILLUM DISP $13,982.50 HC44503571 SEL CATH&RENAL ANGIO2NDW/S&I-L $13,970.00 HC44503589 SEL CATH&RENAL ANGIO2NDW/S&I-R $13,970.00 HC46502332 TENOTOMY SHOULDER AREA, MULT TENDNS $13,961.00 0074-3642-03 LEUPROLIDE 7.5 MG IM SYKT $13,951.02 HC23002009 ABLATE RF NERVE SACROILIAC JT INNRV W/IMAGE BIL $13,925.00 HC45400280 MR LOW EXT(JNT)W/CONT BIL $13,911.00 HC45400538 MR UP EXT(NON JNT)W/CONT BIL $13,909.00 HC46502787 INSERT PICC <5 YR AGE W/IMAGING $13,898.00 HC44701050 REPAIR LEADS TV DUAL PACER/ICD $13,870.00 31722-039-47 NIMODIPINE 60 MG/20 ML ORAL SOLN $13,862.92 57894-054-27 USTEKINUMAB 130 MG/26 ML IV SOLN $13,777.73 61953-0005-6 IMM GLOB G (IGG)-SORB-IGA 0-50 10 % IV SOLN $13,764.40 61953-0005-3 IMM GLOB G (IGG)-SORB-IGA 0-50 10 % IV SOLN $13,764.40 HC44700482 INSRT/REPL TEMP DUAL PACER $13,755.00 HC62809280 COIL NEUROVASCULAR AZ $13,650.00 25021-676-50 PENTOBARBITAL SODIUM 50 MG/ML INJ SOLN $13,650.00 HC46502985 BX SOFT TISS UPPER ARM/ELBOW DEEP BIL $13,614.00 83257-005-41 PEGFILGRASTIM-JMDB 6 MG/0.6 ML SUBCUTANEOUS SYRG $13,568.75 HC46501250 PERC PLACEMENT CEC TUBE W/FLUORO $13,568.00 HC25000209 INSERT/REPLAC TEMP PACER; SNGL $13,549.00 HC44504090 REVAS OTHR PERIPH +VEIN W/STNT W-S&I $13,541.00 HC44500031 ANGIO ADRENAL BILAT $13,540.00 HC44503621 REMOV IVC FILTER/S&I/IMG GUIDE $13,530.00 HC27000744 ERCP W/LITHOTRIPSY $13,529.00 HC36800878 BRONCHOSCOPY FIDUCIAL PLMT SGL/MULTI $13,484.00 HC36001162 BRONCHOSCOPY FIDUCIAL PLMT SGL/MULTI $13,484.00 HC83000760 THERAPEUTIC APHERESIS PLASMA $13,475.00 HC44504264 VERTEBROPLASTY1BODY/GUIDE; EA ADD'L VBODY $13,471.00 HC46502340 TENOTOMY ELBOW, LATERAL OR MEDIAL $13,454.00 HC74200015 OR TIME INITIAL HR LEVEL 2 (MCAL 1ST HOUR) $13,453.00 HC12800041 THERAPEUTIC APHERESIS PLASMA $13,443.00 HC44700425 INSERT/REPLAC TEMP PACER $13,410.00 HC23001662 INJ ANES/STEROID INTERCOSTAL ADDL EA BI $13,392.00 HC45400199 MR LOW EXT(NON JNT)W/CONT BIL $13,382.00 HC46502100 DRAIN CYSTS OVA UNI/BIL ABD APPR $13,370.00 HC44700524 INTRA-ATRIAL RECORDING $13,369.00 HC46000709 SEL CATH AB/PEL/LOEXT1ST OR BI $13,368.00 HC83000745 THERAPEUTIC APHERESIS RBC'S $13,352.00 HC91000044 R&B STEP DOWN/DOU INTERMD ICU $13,337.00 57894-449-01 TECLISTAMAB-CQYV 10 MG/ML SUBCUTANEOUS SOLN $13,315.44 HC44704229 INSERT CONTRACT MODUL-DEFIB INCL PROGRAM FLUORO ONLY TV LEADS DUAL $13,310.00 HC44704211 INSERT CONTRACT MODUL-DEFIB INCL PROGRAM FLUORO ONLY TV LEADS SINGLE $13,310.00 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 HC91200242 R&B HIGH RISK PERINATAL $13,297.00 HC44700540 INTRACARDIAC EP 3D MAPPING+ $13,294.00 HC12800066 THERAPEUTIC APHERESIS RBC'S $13,289.00 HC44503613 REPOS IVC FILTER/S&I/IMG GUIDE $13,283.00 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 HC44701035 REMOVE DUAL LEAD $13,268.00 HC44700169 COMP EP EVAL W/LT VENT PACE+ $13,235.00 HC82204504 BONE MARROW DX; BX(S) & ASP(S) BILAT $13,151.00 58468-0030-1 THYROTROPIN ALFA 0.9 MG IM SOLR $13,143.81 58468-0030-2 THYROTROPIN ALFA 0.9 MG IM SOLR $13,143.81 0026-3785-55 KOGENATE FS 1,000 (+/-) UNIT IV SOLR $13,130.00 HC83000752 THERAPEUTIC APHERESIS PLATELET $13,116.00 70020-1910-1 IXABEPILONE 15 MG IV SOLR $13,094.64 70020-1910-2 IXABEPILONE 15 MG IV SOLR $13,094.64 44087-3535-1 AVELUMAB 20 MG/ML IV SOLN $13,087.62 HC46501953 PERC CHOLECYSTOSTOMY WCATH/S&I $13,084.00 HC12800058 THERAPEUTIC APHERESIS PLATELET $13,053.00 HC44701043 REPAIR LEAD TV SNGL PACER/ICD $13,052.00 HC23001167 DESTR L/S FAC JOINT ADDL W/IMG-B $13,025.00 HC36001139 BRONCH W/EBUS SAMPLING 3/> NODES $13,015.00 13533-605-21 THROMBATE III 500 (+/-) UNIT IV SOLR $13,000.00 57894-350-01 GOLIMUMAB 12.5 MG/ML IV SOLN $12,994.75 0024-5918-01 DUPILUMAB 200 MG/1.14 ML SUBCUTANEOUS SYRG $12,978.42 0024-5918-00 DUPILUMAB 200 MG/1.14 ML SUBCUTANEOUS SYRG $12,978.42 0024-5915-02 DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PNIJ $12,978.42 0024-5915-00 DUPILUMAB 300 MG/2 ML SUBCUTANEOUS PNIJ $12,978.42 0024-5914-01 DUPILUMAB 300 MG/2 ML SUBCUTANEOUS SYRG $12,978.42 9978000199 CULT SKIN SUBST, HUMAN-BOVINE TOPICAL DISK $12,967.50 HC44701084 RELOCATE SKIN POCKET ICD $12,965.00 HC62229661 CATH INTRAVASC ULTRASOUND M $12,950.00 HC45401254 MRA LOW EXT W&W/O CONT BILAT $12,929.00 72603-201-01 LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS SOLN $12,922.00 HC44701076 REPOSITION PACER/ICD LEAD RT HRT $12,891.00 HC44700219 EP FOLLOW UP POST THERAPY $12,870.00 63833-616-02 HUMATE-P 500-1,200 UNIT IV SOLR $12,870.00 HC44002855 MYELOGRAPHY INJ W/S&I; LUMBOSAC $12,865.00 80203-347-01 SUTIMLIMAB-JOME 50 MG/ML IV SOLN $12,838.40 HC36800837 BRONCH W/EBUS SAMPLING 3/> NODES $12,831.00 HC44503779 PLACE CATH THOR AORTA&ANGIO W/S&I $12,811.00 HC45400256 MR LOW EXT(JNT) W/O CONT BIL $12,808.00 HC44701001 REMOV ICD LEADS EXTRACTN TRANSVENOS $12,805.00 HC45400504 MR UP EXT(NON JNT) W/O CONT BIL $12,802.00 HC44702850 ABLAT ADD'L ATRIUM A FIB POST PVI+ $12,783.00 HC38420279 ECMO/ECLS REMOVAL PRPH CANNULA OPEN 6 YRS & OLDER $12,771.00 HC46502803 INSERT PICC>5 YR AGE W/IMAGING $12,746.00 0944-3053-02 ADVATE 1,000 (+/-) UNIT IV SOLR $12,740.00 0944-3053-03 ADVATE 1,000 (+/-) UNIT IV SOLR $12,740.00 HC46501391 REMVL TUN CV ACS DEVICE W/ SQ PORT $12,726.00 HC44702843 ABLAT NON1 DEG INCL RPT DX INDUC ARRHM+ $12,707.00 HC23000763 INJ FORAMN EPI LMBR ADD+S&I-BI $12,687.00 HC46500393 BX DEEP PELV/HIP-SC BIL $12,662.00 HC46500146 BX BONE TROCAR/NEEDLE; DEEP $12,645.00 68982-850-03 IMMUN GLOBG(IGG)-MALT-IGA OV50 10 % IV SOLN $12,626.25 HC44002848 MYELOGRAPHY INJ W/S&I; THORACIC $12,621.00 HC46500674 CHANGE PERC GT TO GJ TUBE W/FLUORO $12,616.00 HC45600095 PET ANY SITE, NOS $12,613.00 67386-130-51 EPTINEZUMAB-JJMR 100 MG/ML IV SOLN $12,610.46 HC44703999 REMOVE TRANSCATH PM LEADLESS RA $12,605.00 HC62225677 CATH EP DIAG/ABLAT 3D/VECT AB $12,600.00 HC62225693 CATH TRANSLUM ANGIO LASER Z $12,600.00 HC44901023 CTA ABDOMEN+PELVIS $12,576.00 HC46502506 EXCHANGE TUBE NEPHRO(NEPH/URET'GRM,S&I) LT $12,571.00 HC46502514 EXCHANGE TUBE NEPHRO(NEPH/URET'GRM,S&I) RT $12,571.00 HC23001308 INJ S-I JOINT ANESTH W/IMAG BI $12,559.00 HC46501912 BX LYMPH NODE(S) DEEP CERV-*DS $12,548.00 HC46501755 BX LYMPH NODE(S) DEEP CERVICAL $12,548.00 HC46501714 BX/RMVL LYMPH NODE(S)-OPEN LT $12,548.00 HC46501722 BX/RMVL LYMPH NODE(S)-OPEN RT $12,548.00 HC44703866 PERC TRANSLUM CORONARY LITHOTRIPSY + $12,518.00 HC62807649 M: IMPLANT TARSI SINUS $12,481.00 44206-437-10 IMMUN GLOB G(IGG)-PRO-IGA 0-50 10 % IV SOLN $12,470.90 44206-437-91 IMMUN GLOB G(IGG)-PRO-IGA 0-50 10 % IV SOLN $12,470.90 HC45400348 MR L-SPINE W&W/O CONTRAST $12,470.00 HC44701092 RELOCATE SKIN POCKET PACEMAKER $12,443.00 99999-035-47 INSULIN REGULAR HUM U-500 CONC 500 UNIT/ML INJ SOLN (INSULIN ) $12,441.00 HC62228168 ORTH WHFO EXT POWERED ELECTRIC CUSTOM $12,415.00 HC91000243 R&B TELEMETRY CARE $12,415.00 HC44500668 CHOLANGIOGRAM W/STONE REMVL $12,412.00 HC45400470 MR T-SPINE W&W/O CONTRAST $12,379.00 HC44704328 RIGHT HEART CATH; W/SENSOR LEFT ATRIAL PRESSURE W/S&I $12,361.00 HC44501450 PLACEMT OF CHOLEDOCHAL STENT $12,357.00 67457-297-50 ETHACRYNATE SODIUM 50 MG IV SOLR $12,350.00 69315-701-50 ETHACRYNATE SODIUM 50 MG IV SOLR $12,350.00 HC44002830 MYELOGRAPHY INJ W/S&I; CERVICAL $12,348.00 HC45400165 MR LOW EXT(NON JNT)W/O CONT BIL $12,346.00 HC44503548 SEL CATH&RENAL ANGIO1STW/S&I-L $12,333.00 HC44503555 SEL CATH&RENAL ANGIO1STW/S&I-R $12,333.00 HC45600046 PET WHOLE BODY TUMOR IMAGING $12,325.00 HC44503688 VERT/THOR CAROTID STENT+LT $12,305.00 HC44503696 VERT/THOR CAROTID STENT+RT $12,305.00 HC44703296 REMOVE TRANSCATH PACER LEADLESS RV INCL ALL IMAGING $12,291.00 HC45400082 MR CHEST W&W/O CONTRAST $12,285.00 HC44504413 PLCMT ACC BILTREE->SB4ENDO PERC(CHOLANG,S&I) NEW ACC $12,284.00 HC46501417 REPAIR CV ACCESS CATH W/PORT $12,279.00 HC62809249 LEAD NEUROSTIM CAROTID SINUS BAROSTIM $12,250.00 HC62808373 M: BONE GRAFT MATRIX(FIBERGRAFT BG) $12,250.00 HC62803325 STENT ENDOPRSTH AAA I $12,250.00 HC45400371 MR ORBIT/FACE&OR NECK W&WO CON $12,237.00 HC36800118 BRONCH W/DESTRUCT TUMOR/STEN $12,225.00 HC36000875 BRONCH W/DESTRUCT TUMOR/STEN $12,225.00 HC38420261 ECMO/ECLS RMVL OF PERPH CANNULA OPEN BIRTH-5 YRS $12,210.00 55513-710-21 DENOSUMAB 60 MG/ML SUBCUTANEOUS SYRG $12,190.30 55513-710-01 DENOSUMAB 60 MG/ML SUBCUTANEOUS SYRG $12,190.30 HC46503017 BX SOFT TISS LEG/ANKLE DEEP BIL $12,156.00 HC46503041 BX SOFT TISS THIGH/KNEE DEEP BIL $12,156.00 HC45600012 PET BRAIN METABOLIC EVAL $12,145.00 HC36800829 BRONCH W/EBUS SAMPLING 1/2 NODES $12,128.00 HC36001121 BRONCH W/EBUS SAMPLING 1/2 NODES $12,128.00 70257-310-04 RHO(D) IMMUNE GLOBULIN-MALTOSE 5,000 UNIT(1000 MCG)/4.4 ML INJ SOLN $12,122.25 70257-310-51 RHO(D) IMMUNE GLOBULIN-MALTOSE 5,000 UNIT(1000 MCG)/4.4 ML INJ SOLN $12,122.25 HC62800172 CATH ATHERECTOMY DIRECTIONAL H $12,110.00 HC47201124 HDR RADIONUCLIDE INTRSTTL/INTRVIT BRACH 2-12 CHANN $12,105.00 HC44704088 IMPLANT/REPLACE LEAD CAROTID BAROSTIM $12,100.00 HC44704237 REMOVE CONTRACT MODUL-DEFIB ONLY GENERATOR $12,100.00 HC44704252 REMOVE CONTRACT MODUL-DEFIB ONLY TV LEAD SINGLE DEFIB $12,100.00 HC44704245 REMOVE CONTRACT MODUL-DEFIB ONLY TV LEAD SINGLE PACING $12,100.00 HC44704260 REMOVE CONTRACT MODUL-DEFIB ONLY TV LEADS DUAL $12,100.00 HC62809074 CATH LITHOTRIPSY TRANSLUM IVL PERIPHERAL $12,075.00 HC62227988 EMBOLIZATION PROTECTIVE SYSTEM (TCAR) X $12,075.00 HC44703908 INJ PRO HRT CATH &IMAG; SELCT PULM MAPCAS AORTA EA+ $12,064.00 HC21000492 I&D POST OP WOUND INF COMP' $12,055.00 HC23001803 ASP/INJ JOINT LRG W/UTZ GUIDE-BILAT $12,042.00 HC44700623 LIGATION /BANDING A/V FISTULA $12,034.00 67979-001-01 VALRUBICIN 40 MG/ML INTRAVESICAL SOLN $12,026.63 HC25002718 TRAUMA ACT' II W/O P-H ALERT $12,026.00 63833-386-02 KCENTRA 500 UNIT (400-620 UNIT) IV SOLR $12,009.40 63833-396-01 KCENTRA 500 UNIT (400-620 UNIT) IV SOLR $12,009.40 HC45400116 MR C-SPINE W&W/O CONTRAST $11,994.00 HC62204003 KIT KYPHOPAK 1ST FRACTURE E $11,953.00 HC44504785 PLACEMENT STENT(S)CDS VIA DIALYSIS CIRCUIT WS&I, PTA+ $11,949.00 HC44700987 REMVL PERM PACER PULSE GN ONLY $11,931.00 HC45600053 PET W/CT LIMITED AREA $11,926.00 HC27000918 ESOPHAGEAL REFLUX W/PH ELECTR $11,918.00 HC45600038 PET SKULL BASE TO MID-THIGH $11,916.00 HC46503074 BX SOFT TISSUE BACK DEEP BIL $11,913.00 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 HC62229646 CATH INTRACARDIAC ECHO/UTZ L $11,900.00 HC62805544 CATH THROMBOLYSIS/RX DELIVERY AN $11,900.00 HC44504389 CONVRT CATH DRN BIL EXT->INT-EXT PERC(CHOLANG,S&I) $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 HC46501037 INSERT CT(OPEN) W/DRAIN SYSTEM BIL $11,890.00 HC62213335 CATH ATHERECTOMY ROTATNL (STEALTH) $11,883.00 HC23001837 INJ DX/THER CERVICAL/THORACIC W/IMAG $11,868.00 HC44504835 TRANSLUMINAL BALO ANGIOP ARTERY W/S&I:ADDL + LT $11,855.00 HC44504843 TRANSLUMINAL BALO ANGIOP ARTERY W/S&I:ADDL + RT $11,855.00 HC44505063 TRANSLUMINAL BALO ANGIOPLST ARTERY W/S&I: ADD'L + $11,855.00 HC62808548 LEAD SENSING RESPIRATORY(INSPIRE®) $11,813.00 HC46502811 REPLC PICC LINE W/O SQ PORT/PUMP W/IMAGING $11,813.00 HC46500351 BIOPSY TRANSCATHETER $11,794.00 HC45400058 MR BRAIN W&W/O CONTRAST $11,782.00 55513-954-01 PANITUMUMAB 100 MG/5 ML (20 MG/ML) IV SOLN $11,775.73 HC62229562 CATH RENAL DENERVATION RF SYMPLICITY SPYRAL™ $11,767.91 62935-306-40 LEUPROLIDE (4 MONTH) 30 MG SUBCUTANEOUS SYRG $11,743.94 0078-1161-47 TRAMETINIB 0.05 MG/ML ORAL SOLR $11,743.88 HC46502324 TENOTOMY SHOULDER AREA, SNGL TENDON $11,713.00 0074-3641-03 LEUPROLIDE 3.75 MG IM SYKT $11,707.22 HC23001779 ASP/INJ JOINT MED W/UTZ GUIDE-BILAT $11,691.00 HC62802111 STENT PV SELF EXP CVRD/DEL SPX $11,690.00 HC46503108 BX SOFT TISS FOREARM&/WRIST DEEP BIL $11,669.00 HC84201912 RESP VIRUS 12-25 TRGTS(PNEUMO PNL) $11,641.00 HC44504694 ENDOVENOUS ABLAT MECHANOCHEM WS&I; INITIAL VEIN $11,618.00 HC44501740 REM & REPLAC EXT URET CATH(IMG,S&I) LT $11,603.00 HC44501757 REM & REPLAC EXT URET CATH(IMG,S&I) RT $11,603.00 HC44501898 THROMBEC VC/ILIAC FEMPOP INCSN $11,601.00 50458-562-01 PALIPERIDONE PALMITATE 117 MG/0.75 ML IM SYRG $11,599.58 HC91400094 R&B PEDIATRIC ACUTE $11,586.00 HC44700664 MAP TACHYCARDIA SITES NON 3D+ $11,577.00 HC44700789 PERC TRANSLUM COR THROMBECTMY+ $11,567.00 57970-100-01 DALBAVANCIN 500 MG IV SOLN $11,564.35 HC45400884 MRI CARDIAC W/STRESS IMG W/CON $11,550.00 HC62807979 STENT ENDOPRSTH LEG ILIAC G $11,550.00 HC23001142 DESTR C/T FAC JOINT +LVL W/IMG-B $11,540.00 HC45400595 MR UP EXT(JNT) W/O CONT BIL $11,537.00 HC45400405 MR PELVIS W&W/O CONTRAST $11,526.00 HC91200241 R&B L&D PP OBSTETRICS CARE $11,522.00 HC45400009 MR ABDOMEN W&W/O CONTRAST $11,509.00 HC45401536 MR ABDOMEN(MRCP)W&W/O CONTRAST $11,509.00 76075-102-01 CARFILZOMIB 30 MG IV SOLR $11,495.90 HC44504959 PERC DILAT EXIST TRACT UROLOGIC PX W/IMAGE /&TUBE-LT $11,449.00 HC44504967 PERC DILAT EXIST TRACT UROLOGIC PX W/IMAGE /&TUBE-RT $11,449.00 HC44703262 REPOSIT ELECTRODE DEFIBRILLATOR SUBQ $11,442.00 HC62808019 SPACER HYDROGEL PROSTATE-RECTUM $11,428.00 HC46503132 BX SOFT TISS SHOULDER DEEP BIL $11,427.00 HC25004268 I&D ABSCESS/BURSA/HEMATOMA THIGH/KNEE DEEP BIL $11,424.00 HC44703205 OPEN BRACHIAL FOR ILIAC OR AORTIC ENDOGRAFT, UNI $11,415.00 HC44900538 CT UPPER EXT W&W/O CONT BILAT $11,411.00 HC44502060 TRANSCATH EMBOLIZATION S&I ONLY $11,397.00 HC46001277 INJ ANTEGRAD COMP(NEPH/URET'GRM,S&I)NEW ACCESS BI $11,396.00 HC62229331 PREP W/CARTRIDGE MILL BONE $11,392.57 HC62808910 DEVICE FUSION SI JOINT(IFUSE SI-BONE®)K $11,377.00 69488-001-40 KIT FOR PREP OF GA 68-DOTATATE 40 MCG IV SOLR $11,375.00 99999-041-43 NM GA-68 GALLIUM DOTATATE $11,375.00 0944-2700-05 IMMUN GLOB G(IGG)-GLY-IGA OV50 10 % INJ SOLN $11,349.65 0944-2700-11 IMMUN GLOB G(IGG)-GLY-IGA OV50 10 % INJ SOLN $11,349.65 HC44504793 EMBOLIZATION DIALYSIS CIRCUIT VEIN(S)WS&I+ $11,346.00 HC44700458 INSERTION OF IABP PERCUTANEOUS $11,323.00 58394-635-03 BENEFIX 1,000 UNIT IV SOLR $11,310.00 HC44900231 CT LOW EXT W&W/O CONT BILAT $11,308.00 HC44900991 CT ABD & PELVIS W/O&W CONTRAST $11,304.00 HC46501094 INSERT PICC <5 YR AGE W/O IMAGING $11,258.00 46287-020-01 SPIRONOLACTONE 25 MG/5 ML ORAL SUSP $11,255.75 0517-0710-01 FOMEPIZOLE 1 GRAM/ML IV SOLN $11,255.47 HC44502276 VENOGRAM RENAL BILAT $11,250.00 99999-044-64 POLIHEXANIDE (PURAPLY AM) 4X4 CM EACH TOPICAL SHEET $11,232.00 HC74200239 BEDSIDE/OTHER SURG INITIAL HR 6 (MCAL 1ST HOUR) $11,220.00 HC46502449 PLCMT CATH NEPHURET PERC(NEPH/URET'GRM,S&I)NEW ACC LT $11,214.00 HC46502456 PLCMT CATH NEPHURET PERC(NEPH/URET'GRM,S&I)NEW ACC RT 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CORE LUNG/MEDIASTINUM W/ IMAG IF OCCURS $9,984.00 0173-0904-42 MEPOLIZUMAB 40 MG/0.4 ML SUBCUTANEOUS SYRG $9,977.57 HC62802061 STENT CORO COVRD W/DEL SYS $9,975.00 HC46501102 INSERT PICC >5 YR AGE W/O IMAGING $9,974.00 HC46503199 BX SOFT TISS LEG/ANKLE SUP BIL $9,968.00 HC25004417 CLOSED TX TIBIAL SHAFT FX W/MANIP W/W-O FIBFX/TRAC BIL $9,968.00 HC47200860 PLACE DEVICE/MARKER OTHER SITES(NON-PROST) $9,945.00 HC44703593 TMVR PERC REPAIR MITRAL VALVE ADD'L PROSTH+ $9,919.00 HC51002913 CYSTOURETHRSCPY&/PYELOSCPY W/BX&/FULG $9,918.50 HC45600087 PET MELANOMA, NON-COV INDCTNS $9,903.00 HC46001079 SEL CATH AB/PEL/LOEXT3RD OR $9,903.00 HC46000808 SEL CATH AB/PEL/LOEXT3RD OR LT $9,903.00 HC46000816 SEL CATH AB/PEL/LOEXT3RD OR RT $9,903.00 HC23000946 INJ ANES/STEROID NERVE PUDENDAL BIL $9,885.00 HC25004441 CLOSED TX MEDIAL MALLEO(ANKLE)FX W/MANIP W/W-O TRAC BIL $9,873.00 66993-489-83 DACTINOMYCIN 0.5 MG IV SOLN (MCH) $9,868.43 HC46501581 THORACENTESIS W/TUBE W/ IMAG LT $9,848.00 HC46501599 THORACENTESIS W/TUBE W/ IMAG RT $9,848.00 HC62208590 KIT HEART LASER CO2 $9,835.00 0026-4942-01 JIVI 500 (+/-) UNIT IV SOLR $9,815.00 0026-3942-25 JIVI 500 (+/-) UNIT IV SOLR $9,815.00 HC62200068 ABLATION DEVICE $9,800.00 HC47200084 BRACHYTX INSERT HEYMAN CAPSULE $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 0173-0665-18 ATOVAQUONE 750 MG/5 ML ORAL SUSP $9,788.42 HC45401221 MRA LOW EXT W/O CONT BILAT $9,776.00 HC27001320 ERCP W/STENT REMV&XCH BILI/PANC DUCT $9,761.00 HC44504892 TRANSLUMINAL BALO ANGIOP VEIN W/S&I:ADDL + LT $9,759.00 HC44504900 TRANSLUMINAL BALO ANGIOP VEIN W/S&I:ADDL + RT $9,759.00 HC44505089 TRANSLUMINAL BALO ANGIOPLST VEIN W/S&I: ADD'L + $9,759.00 0002-7669-01 RAMUCIRUMAB 10 MG/ML IV SOLN $9,755.14 70710-1478-1 FOMEPIZOLE 1 GRAM/ML IV SOLN $9,750.00 0944-4178-02 PROTEIN C CONCENTRATE, HUMAN 1,000 UNIT IV SOLR $9,750.00 0944-4179-10 PROTEIN C CONCENTRATE, HUMAN 1,000 UNIT IV SOLR $9,750.00 HC46001269 INJ CHOLANGIO PERC/S&I;NEW ACCESS $9,731.00 HC46503223 BX SOFT TISS SHOULDER SUP BIL $9,725.00 HC62227293 DEVICE TIF (ESOPHYX) $9,713.00 HC46501284 PLCMNT CENTRAL VEN CATH<5 YR $9,706.00 HC21000385 I&D HEMATOMA OR FLUID COLL $9,685.00 HC44704187 PERC TRNSCTH DRUG DELIV BALLOON INTRACORO INCL ANGIO/IVUS/OCT MARJOR ARTERY/BRANCH SINGLE ADDL LESIO $9,680.00 99999-033-70 CHLOROTHIAZIDE 25 MG / ML SYRINGE $9,675.25 HC44700896 PROG STIM/PACING POST MEDS+ $9,670.00 13533-800-71 IMMUNE GLOBUL G-GLY-IGA AVG 46 10 GRAM/100 ML (10 %) INJ SOLN $9,668.10 13533-800-72 IMMUNE GLOBUL G-GLY-IGA AVG 46 10 GRAM/100 ML (10 %) INJ SOLN $9,668.10 HC74200213 BEDSIDE/OTHER SURG INITIAL HR 4 (MCAL 1ST HOUR) $9,667.00 0002-8501-01 INSULIN REGULAR HUM U-500 CONC 500 UNIT/ML SUBCUTANEOUS SOLN $9,665.50 HC43000009 ABLATION CRYO BREAST FIBROADENOMA EA W/US $9,642.00 HC45401338 MRA SPINE W/O & W/ CONTRAST $9,629.00 HC62809157 CATH LITHOTRIPSY INCL GUIDEWIRE&INTRODUCER PERIPHERAL $9,625.00 HC62224993 MOLDS/FORMS CEMENT FEM&TIB KNEE $9,625.00 68516-3205-2 PROFILNINE 1,000 (+/-) UNIT IV SOLR $9,620.00 0781-3006-42 LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS SOLN (MCH) $9,609.60 HC74200163 OR TIME INIT'L HR CASE CX LEVEL 5 (MCAL 1ST HOUR) $9,594.00 10599-003-01 MOMETASONE 1,350 MCG SINU IMPL $9,583.28 50474-870-15 BRIVARACETAM 10 MG/ML ORAL SOLN $9,574.50 0517-0650-01 FERRIC CARBOXYMALTOSE 50 MG IRON/ML IV SOLN $9,571.87 HC62800164 CATH ATHERECTOMY DIRECTIONAL E $9,570.00 HC43001072 BREAST PROCEDURE UNSPECIFIED $9,555.00 HC46000923 SEL CATH THOR/BRAC 3RD ORD LT $9,552.00 HC46000931 SEL CATH THOR/BRAC 3RD ORD RT $9,552.00 HC44500767 ENDO BILI W/DILAT W/O STENT $9,529.00 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 50742-521-10 CYCLOPHOSPHAMIDE 200 MG/ML IV SOLN $9,522.50 75907-189-35 CYCLOPHOSPHAMIDE 200 MG/ML IV SOLN $9,522.50 HC62807086 KIT KYPHOPAK 1ST FRACTURE C $9,520.00 HC89024327 GENOME SEQ ANALYS RAPID TRIO-RC $9,500.00 HC44504207 XRAY TEVAR W/ LT SUBCLAV; INT'L ENDO& DIST EXTS CELIAC S&I $9,497.00 HC46502415 PLCMT NEPHROSTOMY CATHETER,(NEPH/URET'GRM,S&I) LT $9,495.00 HC46502423 PLCMT NEPHROSTOMY CATHETER,(NEPH/URET'GRM,S&I) RT $9,495.00 HC25004508 CLOSED TX BIMALLEOLA ANKLE FX; W/MANIP BIL $9,489.00 HC46503256 BX SOFT TISS FOREARM&/WRIST SUP BIL $9,482.00 HC27000983 GI TRACT CAPSULE ENDO IMAG ESOPHAGUS ONLY $9,473.00 HC44501799 REMOVE NEPHROSTOMY TUBE BIL $9,459.00 HC44500478 AORTOGRAM THOR W/ SERIAL(ARCH) $9,458.00 HC38420303 ARTERY EXPOS/GRAFT ARTERY PERFUSION ECMO/ECLS $9,450.00 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 HC44703726 TTVR PERC REPAIR TRICUSPID VALVE ADD'L PROSTH+ $9,446.00 HC62808811 CATH INDIGO SEPARATOR TUBING 7-8FR[PENUMBRA] $9,415.00 HC44500221 ANGIO EXTREMITY UE OR LE LT $9,413.00 HC44500239 ANGIO EXTREMITY UE OR LE RT $9,413.00 HC44700912 PTA PULMONARY ARTERY EA ADDL+ $9,407.00 HC82204520 BONE MARROW DX; BX(S) ONLY BILAT $9,401.00 HC25003864 CLOSED TX RAD/EPHYSL SEP&ULN FX W/MAN-BIL $9,390.00 HC46501359 PUNCTURE CISTERN/LAT CERVICAL C1-C2 W/INJ $9,371.00 60505-6230-4 PACLITAXEL PROTEIN-BOUND 100 MG IV SUSR $9,366.57 HC44701423 PUNCTURE TRANSEPTL (LT HC) + $9,362.00 0085-1328-01 POSACONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSP $9,357.08 HC23001852 INJ W/CATH PLCMT EPI CERV/THOR W/IMAG $9,346.00 HC46501557 THORACENTESIS ASP W/ IMG GUID-LT $9,321.00 HC46501565 THORACENTESIS ASP W/ IMG GUID-RT $9,321.00 62484-0020-2 MERCAPTOPURINE 20 MG/ML ORAL SUSP $9,313.85 62484-0020-1 MERCAPTOPURINE 20 MG/ML ORAL SUSP $9,313.85 72603-176-01 NITROFURANTOIN 25 MG/5 ML ORAL SUSP $9,286.94 64980-593-24 NITROFURANTOIN 25 MG/5 ML ORAL SUSP $9,286.94 HC27000868 ESOPHAG REFLUX W/NASAL ELEC>1H $9,279.00 HC44504777 PTA CDS VIA DIALYSIS CIRCUIT WS&I + $9,277.00 HC45400827 MRI CARDIAC FOR MORPH W/CON $9,274.00 HC23001506 INJ L/S F /IMAGE 3RD+& LVL BI $9,271.00 HC44900298 CT LOW EXT W/O CONTRAST BILAT $9,258.00 HC91000123 R&B ONCOLOGY $9,253.00 0781-3531-91 PACLITAXEL PROTEIN-BOUND 100 MG IV SUSR $9,243.33 69097-398-78 PACLITAXEL PROTEIN-BOUND 100 MG IV SUSR $9,243.33 71288-183-50 PACLITAXEL PROTEIN-BOUND 100 MG IV SUSR $9,243.33 HC46503280 BX SOFT TISSUE BACK SUP BIL $9,238.00 HC46000550 INTRO CATHETER AORTA $9,216.00 50242-040-62 OMALIZUMAB 150 MG SUBCUTANEOUS SOLR $9,204.78 50242-215-01 OMALIZUMAB 150 MG/ML SUBCUTANEOUS SYRG $9,204.78 50242-215-03 OMALIZUMAB 150 MG/ML SUBCUTANEOUS SYRG $9,204.78 65219-200-05 TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST) IV SOLR $9,204.00 65219-205-05 TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST) IV SOLR $9,204.00 68727-800-02 DEFIBROTIDE 80 MG/ML IV SOLN $9,188.40 68727-800-01 DEFIBROTIDE 80 MG/ML IV SOLN $9,188.40 HC46502829 INSERT/DRILL SUBDUR/VENTRIC CATH $9,186.00 HC46502852 NEUROENDOSCOPY PLACE CATH/DRAIN INTRACRANIAL $9,182.00 HC46502563 BONE MARROW DX; BIOPSY(IES) & ASPIRATION(S) $9,180.00 HC46502589 BONE MARROW DX; BIOPSY(IES) & ASPIRATION(S) LT $9,180.00 HC46502571 BONE MARROW DX; BIOPSY(IES) & ASPIRATION(S) RT $9,180.00 HC44500452 AORTOGRAM ABDOMINAL $9,179.00 62856-389-01 ERIBULIN 1 MG/2 ML (0.5 MG/ML) IV SOLN $9,165.00 HC23001993 ABLATE RF NERVE SACROILIAC JT INNRV W/IMAGE $9,157.00 HC23002017 ABLATE RF NERVE SACROILIAC JT INNRV W/IMAGE LT $9,157.00 HC23002025 ABLATE RF NERVE SACROILIAC JT INNRV W/IMAGE RT $9,157.00 HC21000724 DBRD SKN MUSL/BON EA ADD20CM/< $9,133.00 HC45400843 MRI CARDIAC MORPH W/STRESS W/O $9,127.00 HC25003625 REMOVE FB UPPER ARM/ELBOW DEEP-BIL $9,114.00 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 99999-038-93 POLIHEXANIDE (PURAPLY AM) 5X5 CM EACH TOPICAL SHEET $9,100.00 HC46502977 BX SOFT TISS UPPER ARM/ELBOW DEEP LT $9,077.00 HC46502969 BX SOFT TISS UPPER ARM/ELBOW DEEP RT $9,077.00 HC44704120 REV/REMVL GENERATOR ONLY BAROSTIM $9,075.00 73535-208-01 TAFASITAMAB-CXIX 200 MG IV SOLR $9,073.16 HC73000184 DIALYSIS URGENT/NON-ROUTINE ESRD (OP) $9,073.00 17156-210-01 IOFLUPANE I 123 5 MCI/2.5 ML (185 MBQ/2.5ML) IV SOLN $9,072.00 HC23000318 EPIDUROLYSIS PROCEDURE $9,071.00 HC46502308 PERC DRAIN CATH W/IMAG; PERITONEAL/RETROPERIT $9,071.00 HC27000017 ANORECTAL WALL BX,ANAL APPROAC $9,049.00 HC46501425 REPLACE PERC DU/J TUBE W/FLUORO $9,043.00 HC25004474 CLOSED TX PROX FIBULA/SHAFT FX; W/MANIP BIL $9,027.00 HC46501433 REPLACE PERC G-J TUBE W/FLUORO $9,027.00 HC44703890 INJ PRO HRT CATH &IMAG; SELCT PULM VENOUS EA VEIN+ $9,016.00 HC27001338 ERCP W/STENT PLACE BILI/PANC DUCT EA $9,001.00 HC62229455 CATH BALLOON NEURO $9,000.00 HC47201116 HDR RADIONUCLIDE INTRSTTL/INTRVIT BRACH 1 CHANNEL $8,992.00 HC21000245 DEBRID/REMVL OPEN FX &BONE $8,986.00 HC23001381 INJ CER/THOR F/IMAGE 2ND LVLBI $8,986.00 0004-0261-29 MYCOPHENOLATE MOFETIL 200 MG/ML ORAL SUSR $8,975.20 HC44900504 CT T-SPINE W&W/O CONTRAST $8,964.00 55513-223-01 ROMIPLOSTIM 125 MCG SUBCUTANEOUS SOLR $8,947.45 HC44504710 ACCESS DIALYSIS CIRCUIT EVAL->VENA CAVA WS&I $8,937.00 HC44900975 CT ABDOMEN & PELVIS W/O CONTRAST $8,937.00 HC23001860 INJ W/CATH PLCMT EPI LUMBAR W/IMAG $8,933.00 HC62807144 STENT NON-COAT/NON-COV W-DEL AI $8,925.00 HC62808290 STENT TRANSCAROTID COV W/DEL SYS $8,925.00 HC44700201 EP EVAL T-ICD W/PROGRAMMING $8,918.00 HC45201399 NM TUMOR LOCALIZE SPECT CT 2+ AREAS 1 DAY//SNGL AREA 2+DAYS $8,907.00 99999-038-97 POLIHEXANIDE (PURAPLY) 5X5 CM EACH TOPICAL SHEET $8,866.00 HC25004094 CLOSED TX THUMB FX DISLOC W/MAN(BENNETT)BIL $8,849.00 HC36800076 BRONCH W/NDL ASP BX(S) INITIAL $8,846.00 HC36000834 BRONCH W/NDL ASP BX(S);INITIAL $8,846.00 55513-141-01 TRASTUZUMAB-ANNS 150 MG IV SOLR $8,840.46 HC25002726 TRAUMA ACT' III W/O P-H ALERT $8,831.00 HC62229612 CATH GUIDING Z $8,830.50 HC62214473 CHARGER BATTERY NEUROSTIM B $8,817.00 HC44703254 REMOVE ELECTRODE DEFIBRILLATOR SUBQ $8,816.00 HC25003807 CLOSED TX RAD&ULN SHAFT FX W/MAN-BIL $8,813.00 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 62935-227-10 LEUPROLIDE (3 MONTH) 22.5 MG SUBCUTANEOUS SYRG $8,807.96 HC41500885 EEG W/VIDEO MONITOR CONT EA 12-26HR $8,796.00 HC46501441 REPLACE PERC GT/CEC TUBE W/FLUORO $8,796.00 HC44500262 ANGIO PELVIC $8,795.00 HC62808985 CATH PTA W/BALLOON RX(DCB) M $8,785.00 HC21001003 APPY SKIN SUB HED/HND/FT 1ST100SQ~LC $8,782.00 HC23000292 DESTRUCT CELIAC PLEXUS $8,777.00 HC44900322 CT L-SPINE W&W/O CONTRAST $8,771.00 HC51002780 INJECT ENDOSCOPIC MATERIAL IMPLANT $8,764.52 HC23000995 INJ STELLATE GANGLION $8,762.00 HC27000819 ESOPH DILATION UNGUIDED $8,754.00 HC23001845 INJ SINGLE LUMBAR/SACRAL W/IMAG $8,754.00 HC46502472 CONVERT NEPH CATH->NEPH'URET PERC(NEPH/URET'GRM,S&I)EXST LT $8,751.00 HC46502480 CONVERT NEPH CATH->NEPH'URET PERC(NEPH/URET'GRM,S&I)EXST RT $8,751.00 HC62209309 DECOMPRESSION SYSTEM-IO-FLEX $8,750.00 HC62229414 DEVICE DELIVER GUIDE $8,750.00 HC62210364 DEVICE ELECTROSURG ABLAT ENDOVASC $8,750.00 HC25003898 CLOSED TX CARPAL SCAPHOID FX W/MAN-BIL $8,741.00 HC44501211 MISC VASCULAR SURGICAL PROC $8,725.00 58181-3042-5 LOMUSTINE 100 MG ORAL CAP $8,719.48 HC45401320 MRA SPINE W/ CONTRAST $8,696.00 HC46501342 PUNCTURE CISTERN/LAT CERVICAL C1-C2 W/O INJ $8,694.00 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 HC51071066 EGD TRANSNAS INSERT INTRALUM TUBE/CATH $8,668.00 HC46502290 PERC DRAIN CATH W/IMAG; VISCERAL $8,656.00 HC25003948 CLOSED TX CARPAL BONE FX W/M EA BONE-BIL $8,641.00 50242-136-01 TOCILIZUMAB 200 MG/10 ML (20 MG/ML) IV SOLN $8,631.42 HC27000603 ENTEROSCOPY W/ABLATION $8,620.00 HC27000629 ENTEROSCOPY W/BLEED CONTROL $8,616.00 0003-3772-11 NIVOLUMAB 40 MG/4 ML IV SOLN $8,605.04 HC74200155 OR TIME INIT'L HR CASE CX LEVEL 4 (MCAL 1ST HOUR) $8,599.00 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 HC46500567 BX SFT TISS PELV/HIP-LT $8,571.00 HC46500575 BX SFT TISS PELV/HIP-RT $8,571.00 HC46500211 BX BONE TROC/NEEDLE; SUPERFICIAL $8,562.00 HC44703973 VENOGRAPHY CHD VENOVENOUS COLLAT/BELOW+ $8,560.00 HC62803192 DEVICE MECH' OCCLUDE(COIL/PLUG) $8,558.00 HC27001601 ILEOSCOPY STOMA W/STENT(W/DILATE) $8,556.00 55513-880-02 ROMOSOZUMAB-AQQG 210MG/2.34ML ( 105MG/1.17MLX2) SUBCUTANEOUS SYRG $8,543.99 55513-998-02 ROMOSOZUMAB-AQQG 210MG/2.34ML ( 105MG/1.17MLX2) SUBCUTANEOUS SYRG $8,543.99 52652-2001-6 METHOTREXATE 2.5 MG/ML ORAL SOLN $8,537.88 0054-0449-49 POSACONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSP $8,533.98 HC45400355 MR L-SPINE W/CONTRAST $8,526.00 HC23001092 INJ/INF NEUROLYTIC CERV/THOR $8,522.00 HC46503348 BIOPSY MUSCLE SUPERFICIAL BIL $8,510.00 HC91000163 R&B ISOLATION/PRECAUTIONARY $8,508.00 HC44700193 EP EVAL ICD LEADS/GEN AT IMPLA $8,506.00 0054-0879-49 MERCAPTOPURINE 20 MG/ML ORAL SUSP $8,494.20 HC46502142 PERC BX BREAST W/LOC DEV SG 1ST LESN $8,493.00 HC23000516 INJ CELIAC PLEXUS $8,492.00 HC44703965 VENOGRAPHY CHD VENOVENOUS COLLAT/ABOVE+ $8,480.00 HC46500286 BIOPSY NEEDLE ABD/RETROMASS $8,478.00 HC45401122 MR BREASTS W/O&W CONTRAST (BILAT) $8,468.00 HC44504496 ENDOVASC INFUS CRANIAL(NON-THROMB)ADD TRRT+ $8,467.00 HC25003740 CLOSED TX RADIAL SHAFT FX W/MANIP-BIL $8,461.00 HC26000034 DELIVERY OF PLACENTA $8,454.00 0944-2511-02 IGG-HYALURONIDASE,RECOMBINANT 5 GRAM /50 ML (10 %) SUBCUTANEOUS SOLN $8,444.73 HC23000839 INJ ANES/STEROID INTERCOSTAL ADDL EA $8,427.00 HC44502201 VENOGRAM CAVAL INFERIOR $8,420.00 HC23001266 DESTR L/S FAC JOINT SINGL W/IMG-L $8,419.00 HC23001274 DESTR L/S FAC JOINT SNGL W/IMG-R $8,419.00 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 HC46500385 BLOOD PATCH (INJ EPIDURAL) $8,396.00 HC45400652 MRA CHEST W&W/O CONTRAST $8,372.00 HC46001061 SEL CATH AB/PEL/LOEXT2ND OR $8,371.00 HC46000741 SEL CATH AB/PEL/LOEXT2ND OR LT $8,371.00 HC46000758 SEL CATH AB/PEL/LOEXT2ND OR RT $8,371.00 HC44504645 EMBOLIZATION/OCCLUSION URETERAL LT $8,370.00 HC44504652 EMBOLIZATION/OCCLUSION URETERAL RT $8,370.00 HC46503488 BONE MARROW DX; ASP(S) ONLY BILAT $8,368.00 HC45400488 MR T-SPINE W/CONTRAST $8,365.00 0143-9167-01 ERIBULIN 1 MG/2 ML (0.5 MG/ML) IV SOLN $8,352.50 HC44900637 CTA ABDOMEN $8,320.00 HC62803671 CATH ABLAT TISS COOL-TIP(HALO 360)I $8,313.00 HC23000979 INJ DX/THER CERVICAL/THORACIC W/O IMAG $8,308.00 HC44702959 REM PERC VAD DEVICE-SEP SETTING ARTERIAL/AV; LEFT HEART $8,305.00 HC23001076 INJ W/CATH PLCMT EPI LUMBAR W/O IMAG $8,303.00 HC45400017 MR ABDOMEN W/ CONTRAST $8,297.00 17156-251-08 PENTETATE INDIUM DISOD. IN-111 1.5 MCI/1.5 ML INTRATHECAL SOLN $8,294.41 HC45600103 PET BREAST CA INTL/ SURG PLAN $8,292.00 HC46502266 PERC PLC BRST LOC DEV MR 1ST LESN $8,280.00 HC41000118 POLYSMNGRPH CPAP/BIPAP <6Y/O ATTD $8,276.00 HC46502936 ABLATION PERC CRYO LOWER EXTREMITY NERVE INCLDE IMAG $8,265.00 HC46502928 ABLATION PERC CRYO UPPER EXTREMITY NERVE INCLD IMAG $8,265.00 HC44500890 INJ CHEMONUCLEOLYSIS $8,261.00 10454-712-10 RIMABOTULINUMTOXINB 10,000 UNIT/2 ML IM SOLN $8,256.04 HC45400728 MRA NECK W/ CONTRAST $8,236.00 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 16729-116-38 MITOMYCIN 40 MG IV SOLR $8,215.74 16729-248-38 MITOMYCIN 40 MG IV SOLR $8,215.74 HC38420121 ECMO REPSN PERIF A&/V PERC W/FLUOR=5Y $8,211.00 HC38420204 ECMO/ECLS REPOS PERPH CANNULA PRQ 6 YRS & OLDER $8,211.00 HC38420246 ECMO/ECLS RMVL OF PERPH CANNULA PERQ BIRTH-5 YRS $8,211.00 HC46502282 PERC DRAIN CATH W/IMAG; SOFT TISSUE $8,211.00 HC44500049 ANGIO ADRENAL LT $8,202.00 HC44500056 ANGIO ADRENAL RT $8,202.00 HC83000638 GRANULOCYT PHERESIS EA UNIT-OS $8,192.00 HC42000059 CARDIOVERSION EXTERNAL $8,176.00 HC44703882 INJ PRO HRT CATH &IMAG; SELCT PULM ARTRL ANGIO BILAT+ $8,175.00 HC26000018 AMNIOCENTESIS FLUID REDUCTION $8,164.00 HC46502035 BX SOFT TISS THIGH/KNEE;SUP BI $8,164.00 HC46500252 BIOPSY MUSCLE PERC NEEDLE $8,161.00 HC44701431 INJ PRO HRT CATH &IMG; SELCT CORON CONGNTL HRT+ $8,160.00 70710-1531-1 DOXORUBICIN, PEG-LIPOSOMAL 2 MG/ML IV SUSP $8,156.69 HC25001165 PLCMNT CENTRAL VEN CATH>5 YR $8,155.00 HC46502316 PERC DRAIN W/IMAG; PERIT/RETROPERIT TRANSVAG/RECTAL $8,148.00 HC25003716 REMOVE FB FOREARM DEEP-BIL $8,132.00 HC45400066 MR BRAIN W/CONTRAST $8,128.00 43598-541-25 DOXORUBICIN, PEG-LIPOSOMAL 2 MG/ML IV SUSP $8,125.00 47335-050-40 DOXORUBICIN, PEG-LIPOSOMAL 2 MG/ML IV SUSP $8,125.00 43598-683-25 DOXORUBICIN, PEG-LIPOSOMAL 2 MG/ML IV SUSP $8,125.00 99999-044-63 POLIHEXANIDE (PURAPLY AM) 3X4 CM EACH TOPICAL SHEET $8,125.00 HC44900702 CTA PELVIS $8,122.00 HC82204496 BONE MARROW DX; BX(S) & ASP(S) LT $8,115.00 HC82204488 BONE MARROW DX; BX(S) & ASP(S) RT $8,115.00 HC25002759 INSERT PICC >5 YR AGE W/ IMAGING $8,115.00 HC36800506 BRONCHOSCOPY W/FB REMOVAL $8,114.00 HC36000859 BRONCHOSCOPY W/FB REMOVAL $8,113.00 HC46503009 BX SOFT TISS LEG/ANKLE DEEP LT $8,104.00 HC46502993 BX SOFT TISS LEG/ANKLE DEEP RT $8,104.00 HC46503033 BX SOFT TISS THIGH/KNEE DEEP LT $8,104.00 HC46503025 BX SOFT TISS THIGH/KNEE DEEP RT $8,104.00 HC62228002 LOOP PLASMA $8,103.00 HC36800068 BRONCH W/LUNG BX; SINGLE LOBE $8,101.00 HC36000925 BRONCH W/LUNG BX;SINGLE LOBE $8,101.00 HC44500288 ANGIO PULMONARY LT $8,097.00 HC44500296 ANGIO PULMONARY RT $8,097.00 HC51003192 BX VAGINA EXTENSIVE INCL CYSTS $8,079.82 HC51003283 COLPOSCPY CERV W/BX(S)LOOP ELECTRD $8,079.82 HC51003291 COLPOSCPY CERV W/CONIZ LOOP ELECTRD $8,079.82 HC51003341 CONIZATION CERVIX LOOP ELECTRD $8,079.82 HC51003176 DESTROY LESION(S) VAGINAL EXTENSIVE $8,079.82 HC51002319 LYSIS OF LABIAL ADHESIONS $8,079.82 HC46501771 ASP/INJ RENAL CYST/PELVIS $8,065.00 HC46500096 ASP/INJ RENAL CYST/PELVIS LT $8,065.00 HC46500104 ASP/INJ RENAL CYST/PELVIS RT $8,065.00 HC44900959 CCTA HEART EVAL W/3D IMAGE $8,046.00 HC44900645 CTA CHEST $8,043.00 HC27000033 ANOSCOPY W/ABLATION $8,037.00 HC27000595 ENTEROSCOPY W/ PERC JEJUN TUBE $8,027.00 HC74200205 BEDSIDE/OTHER SURG INITIAL HR 3 (MCAL 1ST HOUR) $8,024.00 HC23000268 DESTRUCT OTHER PERIPH SNGL LT $8,023.00 HC23000276 DESTRUCT OTHER PERIPH SNGL RT $8,023.00 HC62204342 KIT VERTEBROPLASTY DISP $8,022.00 HC27000678 ENTEROSCOPY(ILEUM) W/BLEED CON $8,017.00 HC36800035 BRONCH DIAG W/LAVAGE $8,005.00 HC36000883 BRONCH DIAG W/LAVAGE $8,005.00 HC44502250 VENOGRAM HEPATIC W/HEMO EVAL $8,005.00 HC41000084 POLYSMNGRPH 4+STGS <6 Y/O ATTD $8,000.00 HC44504447 REMOV CALC DUCT(S)BIL&/GB PERC(DESTRCT,S&I)+ $7,994.00 HC27001346 ERCP W/ABLAT TUMR/POLYP/LESN GUIDEWIRE $7,993.00 HC38420055 PERFUSION CARDIOASSIST INL' 2HR $7,988.00 0944-2716-05 IMMUN GLOB G(IGG)-GLY-IGA OV50 5 GRAM/50 ML (10 %) SUBCUTANEOUS SOLN $7,966.73 HC47200167 HYPERTHERMIA PROBE 6+ APPS $7,959.00 HC45400389 MR ORBIT/FACE&OR NECK W/CONTR $7,959.00 HC36800019 BRONCH W/BRONCHIAL/ENDO BX(S) $7,957.00 HC36000917 BRONCH W/BRONCHIAL/ENDO BX(S) $7,957.00 67684-1901-2 ETHIODIZED OIL 480 MG IODINE/ML INJ OIL $7,956.00 HC46502167 PERC BX BREAST W/LOC DEV US 1ST LESN $7,944.00 HC46503066 BX SOFT TISSUE BACK DEEP LT $7,942.00 HC46503058 BX SOFT TISSUE BACK DEEP RT $7,942.00 HC36800027 BRONCH DIAG W/BRUSHING $7,939.00 HC36000867 BRONCH DIAG W/BRUSHING $7,939.00 0527-1948-70 LEVOFLOXACIN 25 MG/ML ORAL LIQUID $7,931.04 70954-852-30 LEVOFLOXACIN 25 MG/ML ORAL LIQUID $7,931.04 HC62229216 SYSTEM DILATE MULTI-SINUS XPRESS $7,920.00 HC44504660 DILAT BALLOON STRICTURE URETERAL LT $7,904.00 HC44504678 DILAT BALLOON STRICTURE URETERAL RT $7,904.00 HC23000987 INJ DX/THER LUMBAR/SACRAL W/O IMAG $7,897.00 78206-145-01 ETONOGESTREL 68 MG SDRM IMPL $7,895.10 50419-424-01 LEVONORGESTREL 17.5 MCG/24 HR (5 YRS) 19.5 MG INTRAUTERINE IUD $7,895.10 50419-423-01 LEVONORGESTREL 21 MCG/24HR (UP TO 8 YRS) 52 MG INTRAUTERINE IUD $7,895.10 HC62808803 CATH INDIGO THROMB 6FR L135CM[PENUMBRA] $7,893.00 67457-220-00 ISOSULFAN BLUE 1 % SUBCUTANEOUS SOLN $7,892.24 67457-220-05 ISOSULFAN BLUE 1 % SUBCUTANEOUS SOLN $7,892.24 HC45400124 MR C-SPINE W/CONTRAST $7,886.00 HC44500171 ANGIO EA ADD'L VESSEL S&I ONLY + $7,879.00 0069-0308-01 TRASTUZUMAB-QYYP 150 MG IV SOLR $7,872.15 HC44700011 BUNDLE OF HIS RECORDING $7,872.00 24201-010-20 PENTOBARBITAL SODIUM 50 MG/ML INJ SOLN $7,866.69 25021-676-20 PENTOBARBITAL SODIUM 50 MG/ML INJ SOLN $7,865.00 HC41000050 POLYSOMNOGRAPHY CPAP/BIPAP 6&> ATTD $7,863.00 HC27000611 ENTEROSCOPY W/BIOPSY $7,860.00 HC46500468 BX LYMPH NODE(S)-SUPERFCL-LT $7,845.00 HC46500476 BX LYMPH NODE(S)-SUPERFCL-RT $7,845.00 HC46501813 BX LYMPH NODE(S)SUPERFICIAL*DS $7,845.00 HC46501748 BX LYMPH NODE(S)SUPERFICIAL-SC $7,845.00 HC23000300 DESTRUCT INTERCOSTAL NERVE $7,845.00 HC23001068 INJ W/CATH PLCMT EPI CERV/THOR W/O IMAG $7,844.00 HC44502219 VENOGRAM CAVAL SUPERIOR $7,844.00 HC44900728 CTA UPPER EXT W/CONTRAST-LT $7,822.00 HC44900736 CTA UPPER EXT W/CONTRAST-RT $7,822.00 HC23001225 DESTR C/T FAC JOINT SINGL W/IMG-L $7,822.00 HC23001233 DESTR C/T FAC JOINT SNGL W/IMG-R $7,822.00 67877-673-62 RUFINAMIDE 40 MG/ML ORAL SUSP $7,815.86 0054-0528-63 RUFINAMIDE 40 MG/ML ORAL SUSP $7,815.86 HC44900512 CT T-SPINE W/ CONTRAST $7,813.00 HC51061034 CONVERT NEPH CATH->NEPH'URET PERC(NEPH/URET'GRM,S&I)EXST BI $7,808.52 HC51061067 EXCHANGE TUBE NEPHRO(NEPH/URET'GRM,S&I) BI $7,808.52 HC41000035 POLYSOMNOGRAPHY 4+ STAGES 6&> ATTD $7,807.00 HC44900009 CT ABDOMEN W&W/O CONTRAST $7,806.00 HC44504215 XRAY TEVAR; INITIAL ENDO & DIST EXTS TO CELIAC S&I $7,786.00 HC46503090 BX SOFT TISS FOREARM&/WRIST DEEP LT $7,779.00 HC46503082 BX SOFT TISS FOREARM&/WRIST DEEP RT $7,779.00 HC45201068 NM TUMOR LOCALIZE PLNR WHOLE BODY 2+ DAYS $7,769.00 HC46000907 SEL CATH THOR/BRAC 2ND ORD LT $7,766.00 HC46000915 SEL CATH THOR/BRAC 2ND ORD RT $7,766.00 HC51002889 CYSTOSCOPY W/INSERT STENT URETER INDW $7,764.52 HC51002897 CYSTOURETHRSCPY W/TX URETER STRICT $7,764.52 HC51002905 CYSTOURETHRSCPY&/PYELOSCPY FLEX DX $7,764.52 HC51002350 EXCISION GLAND BULBOURETHRAL $7,764.52 HC51002368 EXCISN/FULGURATN POLYP(S) URETHRAL $7,764.52 59338-775-01 FERUMOXYTOL 510 MG/17 ML (30 MG/ML) IV SOLN $7,758.54 HC74200148 OR TIME INIT'L HR CASE CX LEVEL 3 (MCAL 1ST HOUR) $7,756.00 HC25001157 PLCMNT CENTRAL VEN CATH<5 YR $7,754.00 HC25003591 REMOVE FB UPPER ARM/ELBOW SQ-BIL $7,743.00 HC46502845 PUNCTURE SPINAL TX CSF WITH FLUORO/CT[NOT W/MRI OR US] $7,738.00 HC62808977 CATH PTA W/BALLOON RX(DCB) K $7,735.00 HC27000108 ANOSCOPY W/SNARE MULTI REMVL $7,734.00 HC27000587 ENTEROSCOPY TO ILEUM W/BIOPSY $7,733.00 HC27000579 ENTEROSCOPY TO ILEUM $7,729.00 HC25005703 AMPUTATE FINGER/THUMB SGL W/CLOSURE $7,709.00 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 HC62809090 KIT BRONCHOSCOPE ROBOTIC GALAXY SYSTEM $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 HC27000561 ENTEROSCPY (NOT ILEUM)INCL COLLECTN $7,680.00 HC45201381 NM TUMOR LOCALIZE SPECT 2+ AREAS 1 DAY//SNGL AREA 2+DAYS $7,678.00 10122-510-03 PORACTANT ALFA 240 MG/3 ML INTRATRACH SUSP $7,677.01 HC44900330 CT L-SPINE W/ CONTRAST $7,667.00 HC44703445 OPEN AXILLARY/SUBCLAV ART EXPOSE DELIVER EV PROTH UNILATL+ $7,664.00 HC27001353 ERCP W/BALLN DIL BILI/PANC DUCT/AMP EA $7,658.00 99999-035-65 EPIFIX SKIN GRAFT SHEET ( 2X3 CM ) GS-5230 $7,657.00 HC23000938 INJ PARAVERT SYMPATH NERVE $7,653.00 HC44701670 INSERT IMPLANTED MONITOR DEVIC $7,652.00 HC47201082 IMRT TX DELIVERY,GUIDE&TRACK SIMPLE $7,651.00 HC46502191 PERC BX BREAST W/LOC DEV MR ADDL LESN+ $7,646.00 HC27001452 ESOPHSCPY W/ABLAT TUMR/LESN(S(DILATE)~FO $7,645.00 HC27001593 ILEOSCOPY THRU STOMA DILATN BALLOON $7,644.00 50242-138-01 TOCILIZUMAB 162 MG/0.9 ML SUBCUTANEOUS SYRG $7,636.26 HC44501468 PORTOGRAM W/ HEMODYNAMIC EVAL $7,635.00 HC27001031 ILEOSCOPY THRU STOMA W/BIOPSY(S) $7,634.00 HC45400363 MR L-SPINE W/O CONTRAST $7,633.00 HC27000892 ESOPH GASTROESOPH REFLUX PH STDY-LONG $7,627.00 HC27001478 ESOPHSCPY W/STENT (DIL PRE-POST) ~FO $7,624.00 HC46503124 BX SOFT TISS SHOULDER DEEP LT $7,617.00 HC46503116 BX SOFT TISS SHOULDER DEEP RT $7,617.00 HC45401262 MRA ABDOMEN W&W/O CONTRAST $7,614.00 HC46001053 SEL CATH AB/PEL/LOEXT1ST OR $7,610.00 57894-030-01 INFLIXIMAB 100 MG IV SOLR $7,590.83 HC44701449 INJ PRO HRT CATH &IMG; AORTOCORON GRAFTS+ $7,586.00 HC27000793 ERCP W/STONE(S) REMOVAL $7,570.00 HC44502284 VENOGRAM RENAL LT $7,565.00 HC44502292 VENOGRAM RENAL RT $7,565.00 HC44900678 CTA LOW EXT LT $7,562.00 HC44900686 CTA LOW EXT RT $7,562.00 HC23001654 INJ ANES/STEROID INTERCOSTAL ADDL EA LT $7,557.00 HC23001647 INJ ANES/STEROID INTERCOSTAL ADDL EA RT $7,557.00 HC36800043 BRONCHOSCOPY DIAGNOSTIC $7,556.00 HC46500716 CIRCUMCISION PROCEDURE $7,556.00 HC44502185 VENOGRAM ADRENAL LT $7,551.00 HC44502193 VENOGRAM ADRENAL RT $7,551.00 HC44900108 CT CHEST DX W&W/O CONTRAST $7,547.00 70842-140-03 ORITAVANCIN 400 MG IV SOLR $7,545.27 HC36000826 BRONCH DIAGNOSTIC $7,543.00 HC27001361 ERCP W/STENT/FB REMOV BILI/PANC DUCT $7,543.00 HC27000637 ENTEROSCOPY W/CONVRT PEG>JEJUN $7,540.00 HC46000717 SEL CATH AB/PEL/LOEXT1ST OR LT $7,540.00 HC46000725 SEL CATH AB/PEL/LOEXT1ST OR RT $7,540.00 67877-230-22 MYCOPHENOLATE MOFETIL 200 MG/ML ORAL SUSR $7,540.00 HC27001957 ESOPHAGUS BALLOON DISTENTION PROVOC STUDY $7,539.00 HC45400637 MR UP EXT (JNT) W/CONT LT $7,535.00 HC45400645 MR UP EXT (JNT) W/CONT RT $7,535.00 HC27000751 ERCP W/PRES MEAS SPHINC(ODDI) $7,532.00 HC27000777 ERCP W/SPHINCTER/PAPILLOTOMY $7,532.00 HC25001116 INSERT PICC >5 YR AGE W/O IMAGING $7,515.00 HC23000425 INJ ANES/STEROID NERVE SCIATIC BIL $7,513.00 HC62229307 BRONCHOSCOPE ASCOPE 5 HI-PERF/HD CHIP $7,507.50 HC44900462 CT PELVIS W&W/O CONTRAST $7,505.00 HC25000050 ED LEVEL VI - CRITICAL $7,502.00 HC45401247 MRA LOW EXT W&W/O CONT LT $7,495.00 HC45401239 MRA LOW EXT W&W/O CONT RT $7,495.00 HC45400413 MR PELVIS W/CONTRAST $7,490.00 0254-1016-36 POSACONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSP $7,485.66 HC44504454 SCLEROTX FLUID (CYST) PERC(IMAG,S&I) $7,484.00 HC27001064 REPOSIT GASTRO FEED TUBE(PEG) $7,482.00 66993-062-72 ATOVAQUONE 750 MG/5 ML ORAL SUSP $7,465.19 HC46001301 INJ ANTEGRAD NEPH/URET'GRM,S&I EXIST ACCESS BI $7,461.00 HC46503306 BIOPSY MUSCLE DEEP LT $7,456.00 HC46503298 BIOPSY MUSCLE DEEP RT $7,456.00 HC62809033 FILTER VENA CAVA N $7,451.00 HC91000331 R&B STANDARD $7,445.00 HC91200131 R&B STANDARD-WOMEN $7,445.00 HC46502613 INSERT MIDLINE CATH >3 YR AGE $7,437.00 HC45400090 MR CHEST W/CONTRAST $7,431.00 69238-2512-9 NITROFURANTOIN 25 MG/5 ML ORAL SUSP $7,428.66 HC23001639 INJ ANES/STEROID BRACHIAL PLEXUS BI $7,426.00 10511-3001-2 HEXAMINOLEVULINATE 100 MG INTRAVESICAL SOLR $7,410.00 59365-5128-1 COPPER 380 SQUARE MM INTRAUTERINE IUD $7,403.50 HC45400694 MRA HEAD W/CONTRAST $7,402.00 HC51003333 ABLATION LASER CERVIX $7,400.00 HC82204512 BONE MARROW DX; ASP(S) ONLY BILAT $7,398.00 0944-2656-03 IMMUN GLOB G-GLY-GLUC-IGA 0-50 5 GRAM IV SOLR $7,397.65 0944-2657-07 IMMUN GLOB G-GLY-GLUC-IGA 0-50 5 GRAM IV SOLR $7,397.65 HC45400074 MR BRAIN W/O CONTRAST $7,384.00 HC47200639 TRANSCATH PLCMNT RAD DEL DEVIC $7,380.00 HC44900132 CT C-SPINE W&W/O CONTRAST $7,377.00 HC44503704 DEST SUPERIOR HYPOGASTR PLEXUS $7,370.00 HC91200135 R&B NEWBORN CARE-BOARDER $7,370.00 HC27000728 ERCP W/BIOPSY $7,359.00 HC62806625 COIL EMBOLIZ(3D PRIME BARE SUPER SFT)AN $7,350.00 HC62229554 DEVICE RETRIEVAL R $7,350.00 HC45400496 MR T-SPINE W/O CONTRAST $7,338.00 HC44504439 BX(S) BILTREE PERC SNGL/MULTI(IMG,S&I)+ $7,330.00 HC27000645 ENTEROSCOPY W/FRN BDY(S) REMOVAL $7,329.00 HC45400751 MRA PELVIS W/O & W/ CONTRAST $7,326.00 HC27000553 ENDO SM INTEST POUCH (KOCK) W/BX(S) $7,325.00 HC45400546 MR UP EXT(NON JNT)W/CONT LT $7,322.00 HC45400553 MR UP EXT(NON JNT)W/CONT RT $7,322.00 HC45400298 MR LOW EXT(JNT)W/CONT LT $7,321.00 HC45400306 MR LOW EXT(JNT)W/CONT RT $7,321.00 HC45400207 MR LOW EXT(NON JNT)W/CONT LT $7,321.00 HC45400215 MR LOW EXT(NON JNT)W/CONT RT $7,321.00 HC25001074 INSERT CT(OPEN) W/DRAIN SYSTEM BIL $7,320.00 HC44503928 PLCMNT DEV ENDOVAS OCCLUD ART ILIAC+ $7,313.00 70720-950-36 GOSERELIN 3.6 MG SUBCUTANEOUS IMPL $7,305.68 HC44703437 OPEN FEMORAL ART CONDUIT DELIVER EV PROTH / BYPASS UNILATL+ $7,302.00 HC27001288 ENDO PANCREATOSCOPY DUCT(S) + $7,299.00 0781-3255-94 CYCLOPHOSPHAMIDE 2 GRAM IV SOLR $7,284.75 HC27000686 ERCP DIAGNOSTIC (W/SPEC) $7,281.00 HC62808928 BONE GRAFT FILLER VOID 5ML(CERAMENT®BONESUPPORT®) $7,280.00 HC62805064 CATH EP DIAG/ABLAT 3D/VECT Q $7,280.00 58468-0080-1 ANTI-THYMOCYTE GLOB (RABBIT) 25 MG IV SOLR $7,276.56 HC51003895 BONE MARROW DX; 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FIRST LESION $6,881.00 HC46501409 REPAIR CV ACCESS CATH $6,866.00 HC45400041 MR BONE MARROW BLOOD SUPPLY $6,865.00 82705-002-01 EPCORITAMAB-BYSP 4 MG/0.8 ML SUBCUTANEOUS SOLN $6,864.16 HC45400132 MR C-SPINE W/O CONTRAST $6,864.00 HC44501872 SPLENOPORTOGRAM $6,862.00 HC62202791 EMBOLIC PROTECT SYSTEM CAROTID $6,861.00 HC23001282 DESTR L/S FAC JOINT ADDL W/IMG-L $6,850.00 HC23001290 DESTR L/S FAC JOINT ADDL W/IMG-R $6,850.00 HC23001951 DESTR NERVE GENICULAR W/NEUROLYT AGNT W/IMAGE $6,848.00 HC23001977 DESTR NERVE GENICULAR W/NEUROLYT AGNT W/IMAGE LT $6,848.00 HC23001985 DESTR NERVE GENICULAR W/NEUROLYT AGNT W/IMAGE RT $6,848.00 HC23001175 INJ S-I JOINT ANESTH W/IMAG LT $6,845.00 HC23001183 INJ S-I JOINT ANESTH W/IMAG RT $6,845.00 HC47201074 BRACHYTX ISODOSE W/DOSIMETRY;CMPLX $6,843.00 60505-6197-2 SIROLIMUS 1 MG/ML ORAL SOLN $6,842.16 HC44901106 CT BREAST 3D RENDER UNILAT W&W/O CONTRAST $6,840.00 HC45401106 MR BREASTS W/O CONTRAST (BILAT) $6,831.00 HC46500344 BIOPSY TRANSCATHETER RAD S&I ONLY $6,829.00 HC46502837 LUMBAR PUNCTR DX WITH FLUORO/CT [NOT W/MRI OR US] $6,827.00 HC62212188 CATH BALLOON SINUPLASTY SYSTEM J $6,825.00 HC62210695 DEVICE CLOSURE NEUROVASCULAR $6,825.00 HC46000014 INJ AIR/CONTRAST PERITONEAL CAVITY $6,819.00 HC44502227 VENOGRAM EPIDURAL $6,819.00 HC27001080 SIGMOIDOSCOPY FLEX BLEED CONT $6,817.00 HC44200665 AMNIOCENTESIS $6,816.00 50633-310-11 HYDROXOCOBALAMIN 5 GRAM IV SOLR $6,812.00 HC46503157 BX SOFT TISS UPPER ARM/ELBOW SUP LT $6,807.00 HC46503140 BX SOFT TISS UPPER ARM/ELBOW SUP RT $6,807.00 HC44504421 DILATE DUCT(S)BIL /AMPULLA PERC(IMG,S&I);EA+ $6,807.00 HC51003358 DILAT CANAL CERV INSTRMNT(SEP PROC) $6,800.00 HC44900140 CT C-SPINE W/ CONTRAST $6,795.00 HC46000881 SEL CATH THOR/BRAC 1ST ORD LT $6,794.00 HC46000899 SEL CATH THOR/BRAC 1ST ORD RT $6,794.00 HC62808795 CATH INDIGO THROMB L140CM[PENUMBRA] $6,790.00 HC23000771 INJ FORAMN EPI LMBR ADDLWS&I+L $6,775.00 HC23000789 INJ FORAMN EPI LMBR ADDLWS&I+R $6,775.00 HC27001718 SIGMOIDOSCOPY FLEX W/RESECT MUCOSL $6,755.00 HC26000000 AMNIOCENTESIS DIAGNOSTIC $6,751.00 HC45400397 MR ORBIT/FACE&OR NECK W/O CONT $6,738.00 HC27000652 ENTEROSCOPY W/HOT BIOPSY $6,734.00 HC45400421 MR PELVIS W/O CONTRAST $6,733.00 HC62805106 CATH EP DX 20+ ELECTRODES O $6,720.00 HC27001056 INJ SCLEROTHERAPY HEMORRHOIDS $6,705.00 66794-157-02 BACLOFEN 40,000 MCG/20ML (2,000 MCG/ML) INTRATHECAL SOLN $6,696.30 HC23001811 ASP/INJ JOINT LRG W/UTZ GUIDE-LT $6,694.00 HC23001829 ASP/INJ JOINT LRG W/UTZ GUIDE-RT $6,694.00 HC27001734 COLONOSCOPY FLEX ABLAT TUMR/POLYP/LESN GUIDEWIRE $6,694.00 HC44701480 INJ PRO HRT CATH &IMAG; NONSELCT PULM ARTRL ANGIO+ $6,691.00 HC44502235 VENOGRAM EXTREMITY BILAT $6,687.00 HC42000125 ECHO 2D CMPLT W/SPEC&CLR DOPLR $6,685.00 HC43000066 BREAST BX CORE W/O GUIDE-BI $6,683.00 HC62806559 CATH BALLOON NEURO(HYPERGLIDE/SCEPTER XC)H $6,668.00 HC27000520 EGD W/TRANS DRAIN/STENT CYST(EUS) ~FO $6,665.00 HC44900249 CT LOW EXT W&W/O CONTRAST LT $6,664.00 HC44900256 CT LOW EXT W&W/O CONTRAST RT $6,664.00 HC74200130 OR TIME INIT'L HR CASE CX LEVEL 2 (MCAL 1ST HOUR) $6,662.00 HC62806369 CATH EP/ABLAT NOT COOL-TIP/3D/V MAP AF $6,650.00 HC62225644 CATH EP/ABLATION COOL-TIP L $6,650.00 HC62211743 CATH GUIDING DEFLECTABLE Z $6,650.00 HC62807128 CATH THROMBECTOMY AD $6,650.00 HC62807169 COIL EMBOLIZ(PRIME/HYPERSOFT 3D) AL $6,650.00 HC62803762 STENT NON-COAT/NON-COV W-DEL AE $6,650.00 HC46503181 BX SOFT TISS LEG/ANKLE SUP LT $6,644.00 HC46503173 BX SOFT TISS LEG/ANKLE SUP RT $6,644.00 HC44502268 VENOGRAM HEPATIC W/O HEMO EVAL $6,641.00 HC27000298 COLONOSCOPY W/DILATION/BALLOON $6,635.00 HC42000745 TEE COMPLETE W/WO CONTRAST $6,635.00 HC44900470 CT PELVIS W/ CONTRAST $6,633.00 HC62226501 CHARGER BATTERY NEUROSTIM B $6,629.00 58406-010-04 ETANERCEPT 25 MG/0.5 ML (0.5) SUBCUTANEOUS SYRG $6,628.05 58406-010-01 ETANERCEPT 25 MG/0.5 ML (0.5) SUBCUTANEOUS SYRG $6,628.05 58406-055-04 ETANERCEPT 25 MG/0.5 ML SUBCUTANEOUS SOLN $6,628.05 58406-055-01 ETANERCEPT 25 MG/0.5 ML SUBCUTANEOUS SOLN $6,628.05 HC45400439 MR SPECTROSCOPY $6,627.00 HC23000094 ASP/INJ JOINT LRG W/O UTZ GUIDE-BILAT $6,625.00 HC23000904 INJ ANES/STEROID NERVE/BRNCH PERIPH BIL $6,615.00 HC46501334 PUNC SHUNT/RES FOR ASP/INJ $6,610.00 HC45401056 MR BREAST W/O& W/ CONTRAST LT $6,606.00 HC45401049 MR BREAST W/O& W/ CONTRAST RT $6,606.00 HC44900017 CT ABDOMEN W/ CONTRAST $6,605.00 HC45400702 MRA HEAD W/O CONTRAST $6,602.00 HC45400736 MRA NECK W/O CONTRAST $6,602.00 HC42000778 ECHO 2D RX STRESS;CONT EKG W/WO CONTR $6,601.00 HC27001841 SIGMOIDOSCOPY FLEX W/EUS&FNA/BX $6,598.00 HC23000714 INJ FORAMN EPI C/T ADD+ W/S&I-L $6,594.00 HC23000722 INJ FORAMN EPI C/T ADD+ W/S&I-R $6,594.00 HC62808761 CATH INDIGO THROMB SEPARATOR 8 L150CM[PENUMBRA] $6,580.00 HC44700557 INTRAVASC DOP CORONARY FLOW RESERV W/PHARM INIT VESSEL+ $6,578.00 HC62208178 VALVULTOME $6,577.00 50419-422-01 LEVONORGESTREL 14 MCG/24 HR (3 YRS) 13.5 MG INTRAUTERINE IUD $6,573.97 HC46501987 BONE MARROW DX; BIOPSY(SIES) ONLY $6,571.00 HC46501995 BONE MARROW DX; BIOPSY(SIES) ONLY LT $6,571.00 HC46502001 BONE MARROW DX; BIOPSY(SIES) ONLY RT $6,571.00 HC45400660 MRA CHEST W/CONTRAST $6,571.00 0310-4500-12 DURVALUMAB 50 MG/ML IV SOLN $6,568.32 0026-3783-35 KOGENATE FS 500 (+/-) UNIT IV SOLR $6,565.00 HC46500294 BIOPSY NEEDLE PANCREAS $6,563.00 HC42000158 ECHO 2D DOP SPEC&CLR W/CON $6,563.00 HC44703387 PLACMNT EXTNSN PROTH ILIAC ART/PROX RENAL EV PER VESSEL TX+ $6,563.00 HC45401577 MR BREAST W/O& W/ CONTR & CAD LT [COMM&MCAL] $6,558.00 HC45401585 MR BREAST W/O& W/ CONTR & CAD RT [COMM&MCAL] $6,558.00 HC45201233 MIBI PLANAR MULT STUDY W/WM&EF $6,547.00 HC45400108 MR CHEST W/O CONTRAST $6,524.00 0085-1381-01 TEMOZOLOMIDE 100 MG IV SOLR $6,520.22 HC44900652 CTA HEAD $6,514.00 HC46001285 INJ ANTEGRAD COMP(NEPH/URET'GRM,S&I)NEW ACCESS LT $6,512.00 HC46001293 INJ ANTEGRAD COMP(NEPH/URET'GRM,S&I)NEW ACCESS RT $6,512.00 HC27001700 SIGMOIDOSCOPY FLEX W/PLACE STENT $6,509.00 10122-620-01 CANGRELOR 50 MG IV SOLR $6,507.79 10122-620-10 CANGRELOR 50 MG IV SOLR $6,507.79 67457-675-02 CALCITONIN (SALMON) 200 UNIT/ML INJ SOLN $6,500.00 72078-038-02 CALCITONIN (SALMON) 200 UNIT/ML INJ SOLN $6,500.00 0143-9280-01 MITOMYCIN 40 MG IV SOLR $6,500.00 HC46502092 PARACENTESIS ABD W/IMAGING GUIDE $6,498.00 HC47200159 HYPERTHERMIA PROBE 1-5 APPS $6,493.00 HC46503215 BX SOFT TISS SHOULDER SUP LT $6,483.00 HC46503207 BX SOFT TISS SHOULDER SUP RT $6,483.00 HC44900074 CT CHEST DX HI RESOLUTION W/ CNTRST $6,483.00 HC27001536 ESOPHSCPY W/LES(S) REMOV HOT BX ~FO $6,474.00 54288-105-15 ETHYL ALCOHOL 99 % INTRAARTER SOLN $6,467.50 54288-105-02 ETHYL ALCOHOL 99 % INTRAARTER SOLN $6,467.50 HC62204458 BEAD LC MICROSPHERE PER VIAL $6,461.00 HC45400462 MR TMJ(S) $6,459.00 HC44701472 INJ PRO CATH; SUPRAVALVULAR AORTAGRPY+ $6,449.00 HC62221692 KIT SPINAL ACCESS DISPOSBL M $6,440.00 HC44701456 INJ PRO HRT CATH &IMG; LT VENT / ATRIUM+ $6,435.00 63833-615-02 HUMATE-P 250-600 UNIT IV SOLR $6,435.00 HC27001767 COLONOSCOPY FLEX W/DECOMP&PLACE TUBE $6,423.00 67457-211-02 FOMEPIZOLE 1 GRAM/ML IV SOLN $6,409.00 HC45401270 MRA ABDOMEN W/CONT $6,405.00 25021-829-02 FOMEPIZOLE 1 GRAM/ML IV SOLN $6,402.50 HC46501177 PUNCTURE SPINAL TX DRAIN CSF [NOT W/FLUORO/CT] $6,402.00 HC46501169 LUMBAR PUNCTURE DX [NOT W/ CT OR FLUORO ] $6,396.00 HC44900694 CTA NECK $6,387.00 HC27001874 SIGMOIDOSCOPY FLEX W/EUS $6,383.00 HC25000183 FB REMOVAL SQ COMPLEX $6,382.00 HC44901098 CT BREAST 3D RENDER BILAT W/CONTRAST $6,381.00 HC91500125 R&B HOSPICE $6,381.00 HC36000891 BRONCH THERAPEUTIC INIT (PER DOS) $6,379.00 HC36800092 BRONCH THERAPEUTIC INIT (PER DOS) $6,378.00 HC27000280 COLONOSCOPY W/BLEED CONTROL $6,371.00 0944-3052-02 ADVATE 500 (+/-) UNIT IV SOLR $6,370.00 0944-3052-03 ADVATE 500 (+/-) UNIT IV SOLR $6,370.00 HC45400173 MR LOW EXT(NON JNT)W/O CONT LT $6,363.00 HC45400181 MR LOW EXT(NON JNT)W/O CONT RT $6,363.00 HC27000306 COLONOSCOPY W/FB(S) REMOVAL $6,359.00 HC42000786 ECHO 2D RX STRESS; CONT EKG $6,355.00 HC27001783 M: UNLISTED PROCEDURE, COLON $6,354.00 HC46000857 SEL CATH SEGMNT PULM ART BILAT $6,354.00 HC25004243 I&D ABSCESS/BURSA/HEMATOMA THIGH/KNEE DEEP LT $6,346.00 HC25004250 I&D ABSCESS/BURSA/HEMATOMA THIGH/KNEE DEEP RT $6,346.00 HC23001787 ASP/INJ JOINT MED W/UTZ GUIDE-LT $6,342.00 HC23001795 ASP/INJ JOINT MED W/UTZ GUIDE-RT $6,342.00 HC44900157 CT C-SPINE W/O CONTRAST $6,336.00 HC44502615 REMOVAL PLEURAL CATH W/CUFF LT $6,336.00 HC44502607 REMOVAL PLEURAL CATH W/CUFF RT $6,336.00 HC27001692 SIGMOIDSCPY FL W/ABLAT LESN(S)GUIDEWIRE $6,323.00 HC46503249 BX SOFT TISS FOREARM&/WRIST SUP LT $6,321.00 HC46503231 BX SOFT TISS FOREARM&/WRIST SUP RT $6,321.00 HC36800100 BRONCH THERAPEUTIC SUBSEQ (PER DOS) $6,320.00 HC36000909 BRONCH THERAPEUTIC SUBSEQ (PER DOS) $6,320.00 HC27001635 COLONOSCOPY STOMA W/RESECT MUCOSL $6,314.00 HC27001759 COLONOSCOPY FLEX W/RESECTN MUCOSL $6,313.00 0003-0371-13 BELATACEPT 250 MG IV SOLR $6,304.22 0310-0720-10 FULVESTRANT 250 MG/5 ML IM SYRG $6,301.91 HC42000505 TEE COMPLETE $6,301.00 HC62807037 CATH ATHERECTOMY ROTATIONAL AE $6,300.00 HC62802566 CATH EP DIAG/MAPPING<20 ELECT R $6,300.00 HC62805726 CATH EP/ABLAT NOT COOL-TIP/3D/V MAP AE $6,300.00 HC62807284 CATH PTA W/BALLOON RX(DCB) H $6,300.00 HC62214804 CATH PTCA BALLOON NON-LASER Y $6,300.00 HC62224761 CATH THROMBECTOMY AC $6,300.00 HC62806617 COIL EMBOLIZATION(3D/SMART) AK $6,300.00 HC62802921 COIL NEUROVASC(TARGET 360 SOFT/ULTRA)AK $6,300.00 HC62226782 GUIDE DRILL W $6,300.00 HC62807896 M: STEM ELBOW $6,300.00 HC62807102 PROBE LITHOTRIPTOR ELECTRHYDRLC AE $6,300.00 HC62219019 RETRACTOR MIS SPINAL O $6,300.00 HC62211198 STABILIZER HEART OCTOPUS O $6,300.00 HC62806971 STENT BILIARY COVRD W/DELSYS K $6,300.00 HC62802152 STENT CORO BARE METAL W/DEL J $6,300.00 HC62803846 STENT DES CORO COV W/DEL SYS O $6,300.00 HC62802046 STENT NON-COAT/NON-COV W-DEL AD $6,300.00 HC62807300 STENT TRACHEOBRONC COV W/DEL SYS C $6,300.00 72603-103-01 DOXORUBICIN, PEG-LIPOSOMAL 2 MG/ML IV SUSP $6,298.50 0338-9779-01 CYCLOPHOSPHAMIDE 200 MG/ML IV SOLN $6,293.95 HC27001726 SIGMOIDOSCOPY FLEX W/LIGATION BAND $6,289.00 HC25001058 ASP BLADDER W/INSERT SUPRAPUB $6,287.00 HC44900116 CT CHEST DX W/ CONTRAST $6,283.00 HC44900439 CT ORBIT/SELLA/EAR W&W/O CONT $6,280.00 HC46502670 FNA ASP BX W/CT; FIRST LESION $6,277.00 HC45201209 MIBI SPECT SNG STUDY W/WM & EF $6,273.00 HC27000272 COLONOSCOPY W/BIOPSY $6,270.00 HC62808787 CATH INDIGO THROMB 6FRXL135CM[PENUMBRA] $6,268.00 44206-454-04 IMMUN GLOB G(IGG)-PRO-IGA 0-50 4 GRAM/20 ML (20 %) SUBCUTANEOUS SOLN $6,266.00 HC44701464 INJ PRO HRT CATH &IMG; SELCT RT VENT / ATRIUM+ $6,262.00 HC47200092 BRACHYTX INSERT UTERINE TANDEM $6,253.00 HC45400264 MR LOW EXT(JNT) W/O CONT LT $6,253.00 HC45400272 MR LOW EXT(JNT) W/O CONT RT $6,253.00 HC44504405 REMOVE CATH DRN BIL PERC(CHOLANG,S&I) $6,252.00 44206-436-05 IMMUN GLOB G(IGG)-PRO-IGA 0-50 10 % IV SOLN $6,235.45 44206-436-90 IMMUN GLOB G(IGG)-PRO-IGA 0-50 10 % IV SOLN $6,235.45 HC27001833 EGD W/EUS ESOPH->DUOD/SURG ALT STOMCH JEJUN ~FO $6,232.00 HC27001148 SIGMOIDSCPY FLEX W/DILAT 1+/>STRICT $6,231.00 HC21000344 DBRD SKIN MUSCL UP TO 20 SQCM $6,229.00 HC46502225 PERC PLC BRST LOC DEV SG 1ST LESN $6,227.00 HC26000026 EXTERNAL CEPHALIC VERSION W/WO TOCOLYSIS (BREECH) $6,211.00 58394-013-01 XYNTHA 500 (+/-) UNIT IV SOLN $6,207.50 HC62228150 ORTH WHFO DYNAMIC FLEX HINGE CABLE DRIVEN CUSTOM $6,202.00 99999-043-48 FLUCYTOSINE 50 MG/ML ORAL LIQUID $6,193.20 HC45400603 MR UP EXT(JNT) W/O CONT LT $6,193.00 HC45400611 MR UP EXT(JNT) W/O CONT RT $6,193.00 HC23001126 REMOVE EPIDURAL/INTRATH CATH $6,188.00 HC27000215 COLONOSCOPY STOMA W/BLEED CONT $6,175.00 HC27001544 ESOPHSCPY W/OPTICAL ENDOMICRO ~FO $6,175.00 HC25002874 DEBRIDE/REMOVL OPEN FX&/DISLOC SQ T/M/BONE $6,170.00 HC25004276 REMOVE FB DEEP THIGH/KNEE AREA LT $6,170.00 HC25004284 REMOVE FB DEEP THIGH/KNEE AREA RT $6,170.00 HC21000989 APPY SKIN SUB HEAD/HND/FT 1ST25SQ~LC $6,164.00 HC45400512 MR UP EXT(NON JNT) W/O CONT LT $6,164.00 HC45400520 MR UP EXT(NON JNT) W/O CONT RT $6,164.00 HC27001866 COLONOSCOPY FLEX W/EUS $6,161.00 HC43000140 MAMMO DUCTO/GALACTO INJ-BI $6,161.00 HC46503272 BX SOFT TISSUE BACK SUP LT $6,159.00 HC46503264 BX SOFT TISSUE BACK SUP RT $6,159.00 0069-0809-01 INFLIXIMAB-DYYB 100 MG IV SOLR $6,150.82 70257-563-20 BACLOFEN 2,000 MCG/ML INTRATHECAL SOLN $6,143.41 70257-563-01 BACLOFEN 2,000 MCG/ML INTRATHECAL SOLN $6,143.41 70121-2503-1 BACLOFEN 2,000 MCG/ML INTRATHECAL SOLN $6,143.41 HC45201373 NM TUMOR LOCALIZE SPECT CT SNGL AREA 1 DAY $6,143.00 HC46501797 INSERT CT(OPEN) W/DRAIN SYSTEM $6,138.00 HC46502209 PERC PLC BRST LOC DEV MAMMO 1ST LESN $6,138.00 HC41500513 SOMATOSENSORY UPPER& LWR LIMBS $6,136.00 HC27000173 COLONOSCOPY DX (INCL COLLECTION) $6,134.00 HC21000799 APPY SKIN SUB T,A,L 1ST 100SQ~HC $6,129.00 HC44501476 PORTOGRAM W/O HEMODYNAMIC EVAL $6,121.00 83257-001-11 TRASTUZUMAB-DKST 150 MG IV SOLR $6,113.32 50242-051-21 RITUXIMAB 10 MG/ML IV CONC $6,106.88 HC27001619 COLONOSCOPY STOMA W/ABLAT LESN GUIDEWIRE $6,105.00 72603-107-01 DECITABINE 50 MG IV SOLR $6,104.22 HC23000649 INJ ANES/STEROID NERVE FEMORAL BIL $6,095.00 HC46500120 BONE MARROW DX; ASPIRATION(S) ONLY $6,088.00 HC46501961 BONE MARROW DX; ASPIRATION(S) ONLY LT $6,088.00 HC46501979 BONE MARROW DX; ASPIRATION(S) ONLY RT $6,088.00 HC45401205 MRA LOW EXT W/O CONT RT $6,083.00 HC23001241 DESTR C/T FAC JOINT +LVL W/IMG-L $6,078.00 HC23001258 DESTR C/T FAC JOINT +LVL W/IMG-R $6,078.00 HC46502274 PERC PLC BRST LOC DEV MR ADDL LESN+ $6,072.00 HC44900207 CT HEAD W&W/O CONTRAST $6,068.00 HC45401213 MRA LOW EXT W/O CONT LT $6,064.00 HC46501045 INSERT CT(OPEN) W/DRAIN SYSTEM LT $6,062.00 HC46501052 INSERT CT(OPEN) W/DRAIN SYSTEM RT $6,062.00 0023-5858-01 LEVONORGESTREL 20.4 MCG/24 HR (8 YRS) 52 MG INTRAUTERINE IUD $6,056.25 HC27000330 COLONOSCOPY W/SNARE TECH $6,052.00 HC44900405 CT NECK SOFT TISSUE W&W/O CONT $6,048.00 HC27000884 ESOPH MOTILTY/MANO STDY/I&R;2D $6,045.00 HC62803291 SYSTEM PORT EVACUATING SUBDURAL $6,045.00 HC27000546 ENDO SM INTST POUCH(KOCK)DX INCL COLLECT $6,040.00 HC44504462 IVUS VESSEL INIT'L NONCORON W/EXAM+ $6,038.00 HC27001817 EGD W/EUS FNA/BX ESOPH/STOMCH/DUOD~FO $6,033.00 HC23000821 INJ ANES/STEROID NERVE INTERCOSTAL SINGL $6,024.00 HC44900488 CT PELVIS W/O CONTRAST $6,021.00 HC47200597 SPECIAL RAD TX;IRRAD,ENDO,CONE $6,021.00 HC44703403 PLACMNT DELAY DISTL/PRX EXTSN INFRARENL AA ILIAC:ADD'L VSSL+ $6,010.00 HC47201025 MOTION RESPIRATORY MGNT SIMULATION+ $6,008.00 HC27001858 COLONOSCOPY FLEX W/EUS FNA/BX $6,007.00 HC44901080 CT BREAST 3D RENDER BILAT W/O CONTRAST $6,007.00 HC44700615 IVUS/OCT CORONARY VES/GRFT EA ADL+ $6,003.00 HC44504231 XRAY TEVAR; PLCMT OF DISTAL EXTS PROTH(S) DELAYED S&I $6,002.00 HC44504223 XRAY TEVAR; PLCMT PROX EXT PROTH S&I $6,002.00 50474-001-48 LEVETIRACETAM 100 MG/ML ORAL SOLN $6,001.42 HC27000249 COLONOSCOPY STOMA W/SNARE TECH $5,993.00 HC45400678 MRA CHEST W/O CONTRAST $5,990.00 HC46000964 SEL VENOUS CATH 1ST ORD BI $5,989.00 HC27001585 ESOPHSCPY W/INJ SUBMUCOSAL ~FO $5,983.00 HC21000500 I&D POLINIDAL CYST: COMPLICATE $5,978.00 HC46500625 CHANGE CYSTOSTOMY; COMPLICATED $5,975.00 HC44700250 INDUCTION OF ARRHYTHMIA $5,974.00 HC23001928 INJ ANES/STEROID NERVE GENICULAR IMAGE GUIDE BI $5,965.00 HC21000948 APPY SKIN SUB T,A,L 1ST 25SQ~LC $5,957.00 44087-0044-3 INTERFERON BETA-1A (ALBUMIN) 44 MCG/0.5 ML SUBCUTANEOUS SYRG $5,952.01 44087-0044-9 INTERFERON BETA-1A (ALBUMIN) 44 MCG/0.5 ML SUBCUTANEOUS SYRG $5,952.01 HC62803697 CATH ABLATION THERMO HALO AD $5,950.00 HC62805718 CATH EP/ABLAT NOT COOL-TIP/3D/V MAP AD $5,950.00 HC62806229 CATH THROMBECTOMY/REPERFUS(3MAX) AD $5,950.00 HC62806609 COIL EMBOLIZ(PRIME/NYLON HELIX) AJ $5,950.00 HC62220124 KIT MONITORING NERVE(S) SPINAL M $5,950.00 HC62803820 STENT DES CORO COV W/DEL SYS N $5,950.00 HC42000513 TEE CONGENITAL COMPLETE $5,932.00 HC46001244 INJECTION SINUS TRACT; THERAPEUTIC $5,929.00 HC47200902 PLCMNT INTERSTIT DEV THORACIC $5,912.00 HC44900579 CT UPPER EXT W/CONTRAST LT $5,903.00 HC44900587 CT UPPER EXT W/CONTRAST RT $5,903.00 HC27001882 CHEMODENERVATION ANAL MUSCLE $5,898.00 HC27000322 COLONOSCOPY W/INJ SUBMUCOSAL $5,897.00 HC27001403 EGD W/ABLAT TUMR/POLYP/LESN(DIL&GIDEWR)~FO $5,894.00 HC25005638 DRAIN EXTERNAL EAR LESION COMPLEX BIL $5,893.00 HC25003120 LAC REPAIR INTMD S/A/T/EXT >30.0CM $5,893.00 HC44900082 CT CHEST DX HI RESOLUTION W/O CNTRST $5,891.00 HC27001155 SIGMOIDOSCOPY FLEX W/FB(S) REMOV $5,890.00 HC21000971 APPY SKIN SUB T,A,L EA+ 100SQ~LC $5,880.00 HC62805684 CATH EP DX 20+ ELECTRODES L $5,880.00 HC25000043 ED LEVEL V - COMPREHENSIVE $5,867.00 HC82202532 BONE MARROW DX; BX(S) ONLY $5,866.00 HC82200825 BONE MARROW DX; BX(S) ONLY LT $5,866.00 HC82200817 BONE MARROW DX; BX(S) ONLY RT $5,866.00 HC23001696 INJ ANES/STEROID ILIOINGNL/ILIOHYPOGAS BI $5,862.00 HC44500882 INJ ART OCCLUS AVM SPINAL $5,859.00 HC27001775 COLONOSCOPY FLEX W/LIGATION BAND $5,850.00 HC27001171 SIGMOIDOSCOPY FLEX W/SNARE $5,846.00 HC46500609 BX THYROID NEEDLE CORE $5,841.00 HC27001676 COLONOSCOPY STOMA W/EUS FNA/BX COLON $5,841.00 HC45400744 MRA PELVIS W/ CONTRAST $5,840.00 HC44700177 ENDOMYOCARDIAL BIOPSY $5,839.00 HC27001387 ESOPHSCPY W/DILAT ESOPH RETROGR ~FO $5,836.00 HC27000207 COLONOSCOPY STOMA W/BIOPSY $5,835.00 HC27000231 COLONOSCOPY STOMA W/HOT BIOPSY $5,826.00 HC25004367 I&D ABSCESS/HEMATOMA LEG/ANKLE DEEP LT $5,825.00 HC25004375 I&D ABSCESS/HEMATOMA LEG/ANKLE DEEP RT $5,825.00 HC44900272 CT LOW EXT W/CONTRAST LT $5,822.00 HC44900280 CT LOW EXT W/CONTRAST RT $5,822.00 HC74200478 OR TIME ADD'L 15MIN LVL 6 (MCAL 2ND SUBSQNT 0.5 HR) $5,818.00 HC74200114 OR TIME ADD'L 15MIN LVL 6 (MCAL 1ST SUBSQNT 0.5 HR) $5,818.00 HC21000831 APPY SKIN SUB HED/HND/FT 1ST100SQ~HC $5,810.00 HC27000009 ANORECTAL MANOMETRY $5,803.00 HC23000060 ASP/INJ JOINT MED W/O UTZ GUIDE-BILAT $5,799.00 59572-405-00 LENALIDOMIDE 5 MG ORAL CAP $5,795.08 66220-160-10 CONIVAPTAN IN 5 % DEXTROSE 20 MG/100 ML IV SOLN $5,793.45 HC41000001 SLEEP STUDY - MSLT/MWT $5,793.00 HC44900447 CT ORBIT/SELLA/EAR W/ CONTRAST $5,790.00 HC44000560 DISKOGRAPHY-CERVICAL/THORACIC $5,772.00 HC44900124 CT CHEST DX W/O CONTRAST $5,768.00 HC44900025 CT ABDOMEN W/O CONTRAST $5,763.00 HC44500460 AORTOGRAM ABDOMINAL LTD $5,747.00 HC44703957 VENOGRAPHY CHD CORO SINUS+ $5,747.00 HC27001650 COLONOSCOPY STOMA W/DILATN BALLOON $5,745.00 HC27000900 ESOPHAGEAL REFLUX W/NASAL ELEC $5,739.00 HC36800001 BRONCHOSCOPY THRU ESTAB TRACH $5,738.00 HC36000818 BRONCHOSCOPY THRU ESTAB TRACH $5,738.00 HC27001668 COLONOSCOPY STOMA W/EXAM US COLON $5,730.00 15054-0500-1 ABOBOTULINUMTOXINA 500 UNIT IM SOLR $5,723.25 HC27000314 COLONOSCOPY W/HOT BIOPSY $5,722.00 5985700310 HUMAN REGENERATIVE TISSUE MTRX 1.5 X 2 CM TOPICAL SHEE $5,720.00 HC27001445 EGD W/EUS ESOPH/STOMCH/DUOD ~FO $5,695.00 HC42000760 TEE MONITORING COMPLT W/WO CONTR $5,693.00 HC62802780 BEAD DC MICROSPHERE PER VIAL $5,688.00 99988-000-30 NM TC-99M EXAMETAZIME LABELED WBC PER STUDY (CERETEC) $5,687.50 69238-1594-6 SIROLIMUS 1 MG/ML ORAL SOLN $5,687.37 69238-1594-3 SIROLIMUS 1 MG/ML ORAL SOLN $5,687.37 HC46501235 PERITONEAL LAVAGE W-W/O IMAG GUIDE $5,687.00 HC42000943 ANALYSIS CORONARY FFR CTA $5,681.00 0944-2700-10 IMMUN GLOB G(IGG)-GLY-IGA OV50 10 % INJ SOLN $5,674.83 0944-2700-04 IMMUN GLOB G(IGG)-GLY-IGA OV50 10 % INJ SOLN $5,674.83 HC38420337 ASSEMBLY & OPER PUMP OXYGEN; EA HR $5,673.00 HC46503330 BIOPSY MUSCLE SUPERFICIAL LT $5,673.00 HC46503322 BIOPSY MUSCLE SUPERFICIAL RT $5,673.00 HC44700235 ESOPHAGEAL RECORDING W/PACING $5,666.00 58394-634-03 BENEFIX 500 UNIT IV SOLR $5,655.00 0024-0654-01 ISATUXIMAB-IRFC 20 MG/ML IV SOLN $5,654.42 HC46500864 EXCHANGE EXISTING DRAIN CATH $5,654.00 HC21001011 APPY SKIN SUB HED/HND/FT EA+100SQ~LC $5,651.00 HC27000488 EGD W/PEG PLACEMENT ~FO $5,641.00 57894-469-01 TALQUETAMAB-TGVS 2 MG/ML SUBCUTANEOUS SOLN $5,632.12 HC46000824 SEL CATH PULMONARY ART BILAT $5,630.00 HC42000240 ECHO 2D STRESS TRDMLW/EKG W/CON $5,614.00 HC44900215 CT HEAD W/CONTRAST $5,612.00 HC45401288 MRA ABDOMEN W/O CONT $5,608.00 HC27001502 ESOPHSCPY W/BAND VARICES ~FO $5,606.00 HC23001886 INJ ANES/STEROID NERVE SI JOINT INNRV W/IMAGE BI $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 HC44504702 ENDOVENOUS ABLAT MECHANOCHEM WS&I; ADDL VEIN+ $5,595.00 HC27001825 EGD W/EUS FNA/BX ESOPH->DUOD/SURG ALT STOMCH JEJUN~FO $5,593.00 HC41500877 EEG W/VIDEO MONITOR INTERMT EA 12-26HR $5,583.00 HC23000458 INJ ANES/STEROID NERVE SUPRASCAP BI $5,582.00 HC27001163 SIGMOIDOSCOPY FLEX W/HOT BX $5,570.00 HC27000421 EGD W/CONTOL BLEED ~FO $5,569.00 HC27001684 COLONOSCOPY STOMA W/DECOMP&PLACE TUBE $5,564.00 HC45401031 MR BREAST W/O CONTRAST LT $5,564.00 HC45401023 MR BREAST W/O CONTRAST RT $5,564.00 HC27000223 COLONOSCOPY STOMA W/FRN BDY(S)REMOV $5,561.00 HC44701175 TILT TABLE EVALUATION $5,541.00 HC27000041 ANOSCOPY W/BIOPSY $5,537.00 HC25005927 PARACENTESIS EYE W/REMOVAL AQUEOUS BIL $5,536.00 HC45401437 MRA UPPER EXT W/O&W/CONT LT $5,534.00 HC45401403 MRA UPPER EXT W/O&W/CONT RT $5,534.00 HC74200353 BEDSIDE/OTHER SURGICAL CANCEL LVL 6 $5,528.00 10019-080-01 ERIBULIN 1 MG/2 ML (0.5 MG/ML) IV SOLN $5,525.00 HC44701019 REMOVE CARDIAC RHYTHM MONITOR SQ $5,521.00 HC27000256 COLONOSCOPY THRU STOMA INCL COLLECTN $5,516.00 HC27001114 SIGMOIDOSCOPY FLEX INJ SUBMCSL $5,509.00 HC42000752 TEE CONGENITAL COMPLT W/WO CONTR $5,506.00 HC27001643 COLONOSCOPY STOMA W/INJ SUBMUCOSL $5,503.00 HC62229489 DEVICE REMOVAL TISSUE MYOSURE D $5,500.00 HC36800324 TEST EXERC CARIOPULM INCL VENT,CO2,O2,EKG $5,497.00 63459-103-10 RITUXIMAB-ABBS 10 MG/ML IV SOLN $5,496.08 HC27000405 EGD W/BANDING ESOPH/GASTRIC ~FO $5,491.00 HC84201409 IADNA-DNA/RNA PROBE TQ 12-25 GI PCR $5,490.00 59762-0935-3 VORICONAZOLE 200 MG/5 ML ORAL SUSR (MCH) $5,487.79 HC44703494 PERICARDIAL DRAIN 0-5YR W/ANOMOLY INCL FLUORO &/US $5,487.00 HC74200189 BEDSIDE/OTHER SURG INITIAL HR 1 (MCAL 1ST HOUR) $5,483.00 HC45201225 MIBI PLANAR SNG STUDY W/WM &EF $5,483.00 HC27000447 EGD W/DILATION GASTRIC OUTLET ~FO $5,482.00 HC25003872 CLOSED TX RAD/EPHYSL SEP&ULN FX W/MAN LT $5,476.00 HC25003880 CLOSED TX RAD/EPHYSL SEP&ULN FX W/MAN RT $5,476.00 HC45401189 MRA LOW EXT W/CONT LT $5,476.00 HC45401171 MRA LOW EXT W/CONT RT $5,476.00 HC46502241 PERC PLC BRST LOC DEV US 1ST LESN $5,448.00 HC44704054 TRANSCATH INTRACORO SSO2 NFS $5,445.00 HC44900363 CT MAXILLO FACIAL W&W/O CONT $5,440.00 66733-948-23 CETUXIMAB 100 MG/50 ML IV SOLN $5,437.25 HC23001753 ASP/INJ JOINT SM W/UTZ GUIDE-LT $5,437.00 HC23001761 ASP/INJ JOINT SM W/UTZ GUIDE-RT $5,437.00 HC82200320 BONE MARROW DX; ASP(S) ONLY $5,436.00 HC82200809 BONE MARROW DX; ASP(S) ONLY LT $5,436.00 HC82200791 BONE MARROW DX; ASP(S) ONLY RT $5,436.00 HC44900603 CT UPPER EXT W/O CONTRAST LT $5,436.00 HC44900611 CT UPPER EXT W/O CONTRAST RT $5,436.00 HC25000597 EMERGENCY DELIVERY VAGINAL $5,436.00 HC45400769 MRA PELVIS W/O CONTRAST $5,434.00 HC27001460 ESOPHSCPY W/BALLN DIL=30MM (W-FLUOR) ~FO $5,429.00 HC27000397 EGD W/BALLOON DILATION <30MM ~FO $5,421.00 HC27000454 EGD W/FOREIGN BODY(S) REMOVAL ~FO $5,413.00 HC27001130 SIGMOIDOSCOPY FLEX W/BIOPSY $5,411.00 HC25004482 CLOSED TX BIMALLEOLA ANKLE FX; W/MANIP LT $5,407.00 HC25004490 CLOSED TX BIMALLEOLA ANKLE FX; W/MANIP RT $5,407.00 HC27000066 ANOSCOPY W/DILATION $5,394.00 HC27001098 SIGMOIDOSCOPY FL W/DECOMP&PLAC TUBE $5,379.00 HC27001809 ESOPHSCPY W/EUS FNA/BX ~FO $5,376.00 HC25004391 CLOSED TX TIBIAL SHAFT FX W/MANIP W/W-O FIBFX/TRAC LT $5,370.00 HC25004409 CLOSED TX TIBIAL SHAFT FX W/MANIP W/W-O FIBFX/TRAC RT $5,370.00 HC25003633 REMOVE FB UPPER ARM/ELBOW DEEP LT $5,370.00 HC25003641 REMOVE FB UPPER ARM/ELBOW DEEP RT $5,370.00 HC46502654 FNA ASP BX W/FLUORO; FIRST LESION $5,368.00 HC27001551 ESOPHSCPY W/DIL OVER GUIDEWIRE ~FO $5,366.00 70860-203-50 PEMETREXED DISODIUM 500 MG IV SOLR $5,362.50 HC44000578 DISKOGRAPHY-LUMBAR $5,351.00 HC25004425 CLOSED TX MEDIAL MALLEO(ANKLE)FX W/MANIP W/W-O TRAC LT $5,345.00 HC25004433 CLOSED TX MEDIAL MALLEO(ANKLE)FX W/MANIP W/W-O TRAC RT $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 HC44901007 CT ABD & PELVIS W/O CONST LTD $5,336.00 HC44900942 CT HEART CONGEN EVAL /3D IMAGE $5,334.00 HC62806484 CATH BRACHY TX SEED ADMIN C $5,320.00 HC62800321 CATH EP DX 20+ ELECTRODES J $5,320.00 HC44900306 CT LOW EXT W/O CONTRAST LT $5,318.00 HC44900314 CT LOW EXT W/O CONTRAST RT $5,318.00 HC21000336 DEBRID SKIN&SUBQ UP TO 20 SQCM $5,313.00 HC42000232 ECHO 2D STRESS PHARMOCOLOGIC $5,306.00 HC45200995 NM TUMOR LOCALIZE SPECT SNGL AREA 1 DAY $5,297.00 HC25005711 AMPUTATE FINGER/THUMB SGL W/CLOSURE LT $5,290.00 HC25005729 AMPUTATE FINGER/THUMB SGL W/CLOSURE RT $5,290.00 HC62229323 BRONCHOSCOPE ASCOPE 4 SPEC SAMPLE LRG $5,285.00 HC62802137 STENT PV BARE METAL W/O DEL SYS $5,285.00 16714-070-02 FULVESTRANT 250 MG/5 ML IM SYRG $5,273.16 16714-070-01 FULVESTRANT 250 MG/5 ML IM SYRG $5,273.16 HC42000521 TEE MONITORING COMPLETE $5,263.00 0002-7640-01 PEMETREXED DISODIUM 100 MG IV SOLR $5,255.90 0078-0683-61 NELARABINE 250 MG/50 ML IV SOLN $5,252.98 HC23001100 INJ/INF NEUROLYTIC LUMB/SACRAL $5,251.00 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 HC25002742 INSERT PICC <5 YR AGE W/ IMAGING $5,243.00 HC27000439 EGD W/DIL OVER GUIDEWIRE ~FO $5,241.00 HC41000019 SLEEP STUDY ATTENDED $5,241.00 HC44900165 CT GUIDANCE NEEDLE PLACEMENT $5,240.00 HC27001379 EGD W/RESECT SUBMUCOSAL ~FO $5,222.00 HC27000496 EGD W/SCLEROTHERAPY ~FO $5,222.00 HC47201041 TELETX ISODOSE W/DOSIMETRY;COMPLEX $5,218.00 HC44900223 CT HEAD W/O CONTRAST $5,215.00 HC42000257 ECHO 2D STRESS TREADMILL $5,213.00 HC42000083 ECHO CONGENITAL COMPLETE $5,213.00 HC84201631 DNA/RNA MENINGITIS/ENCEPHALITIS PCR $5,211.00 HC27000090 ANOSCOPY W/SNARE SINGLE REMVL $5,210.00 HC44900413 CT NECK SOFT TISSUE W/ CONT $5,207.00 HC51002764 ASP BLADDER W/INSERT SUPRAPUB $5,205.68 HC51003093 BX PROSTATE NDL/PUNCH SGL/MULT $5,205.68 HC51002335 CIRCUMCISION INFANT >28D EXCISE NO DEVICE $5,205.68 HC51002293 CIRCUMCISION W/DEVICE RING/BLOCK $5,205.68 HC51061042 CONVERT NEPH CATH->NEPH'URET PERC(NEPH/URET'GRM,S&I)EXST LT $5,205.68 HC51061059 CONVERT NEPH CATH->NEPH'URET PERC(NEPH/URET'GRM,S&I)EXST RT $5,205.68 HC51002871 CYSTOSCOPY W/REM STNT/FB/CALC COMPLIC $5,205.68 HC51002863 CYSTOSCOPY W/REMV STENT/FB/CALC SIMPL $5,205.68 HC51002731 CYSTOSTOMY(I&D BLADDER)W/W-OUT DRAIN $5,205.68 HC51002830 CYSTOURETHROSCOPY W/BX(S) $5,205.68 HC51002822 CYSTOURETHROSCOPY W/CATH URETERAL $5,205.68 HC51002848 CYSTOURETHROSCOPY W/DIL BLADDER $5,205.68 HC51002855 CYSTOURETHROSCOPY W/DIL STRIC URETH $5,205.68 HC51061075 EXCHANGE TUBE NEPHRO(NEPH/URET'GRM,S&I) LT $5,205.68 HC51061083 EXCHANGE TUBE NEPHRO(NEPH/URET'GRM,S&I) RT $5,205.68 HC51002988 INSERT STENT URETHRAL PROSTATIC TEMP $5,205.68 HC51003853 REPAIR CIRCUMCISION INCOMPLETE $5,205.68 HC51003390 X-RAY PERC DIL URETER/URETHRA $5,205.68 HC23000953 INJ ANES/STEROID NERVE PUDENDAL LT $5,203.00 HC23000961 INJ ANES/STEROID NERVE PUDENDAL RT $5,203.00 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 HC46502704 FNA ASP BX W/MR; EACH ADD'L LESION $5,201.00 24201-400-02 CALCITONIN (SALMON) 200 UNIT/ML INJ SOLN $5,200.00 42023-205-01 CALCITONIN (SALMON) 200 UNIT/ML INJ SOLN $5,200.00 HC44900454 CT ORBIT/SELLA/EAR W/O CONTRAS $5,195.00 HC12800082 TRANSFUSION BLOOD &/OR COMPNTS $5,192.00 HC74200122 OR TIME INIT'L HR CASE CX LEVEL 1 (MCAL 1ST HOUR) $5,189.00 HC44700227 ESOPHAG REC ATRIAL ELECTROGRAM $5,183.00 50242-060-01 BEVACIZUMAB 25 MG/ML CHEMO INTRAVITREAL SOLN $5,180.11 HC27001569 ESOPHSCPY W/BALLOON DILATION <30MM ~FO $5,180.00 HC25002908 DEBRIDE SKIN MUSL/BONE; FIRST 20SQCM OR LESS $5,177.00 HC27001494 ESOPHSCPY W/TUMR/LES REMOV W/SNARE ~FO $5,176.00 HC23001605 INJ CERVICAL PLEXUS BLOCK BIL $5,175.00 70069-810-01 VALGANCICLOVIR 50 MG/ML ORAL SOLR $5,167.45 43598-387-11 PEMETREXED DISODIUM 500 MG IV SOLR $5,154.50 HC74200346 BEDSIDE/OTHER SURGICAL CANCEL LVL 5 $5,147.00 HC46502175 PERC BX BREAST W/LOC DEV US ADDL LESN+ $5,144.00 66302-206-03 TREPROSTINIL 1.74 MG/2.9 ML (0.6 MG/ML) INHALATION NEBU $5,139.53 HC44900926 CT COLONOGRAPHY DX VIRTUAL W/ CONTRAST $5,138.00 69800-4203-2 HEPATITIS B IMMUNE GLOBULIN GREATER THAN 1,560 UNIT/5 ML IM SOLN $5,137.41 69800-4203-1 HEPATITIS B IMMUNE GLOBULIN GREATER THAN 1,560 UNIT/5 ML IM SOLN $5,137.41 HC25003534 CLOSED TX HUMRL FX W/MAN W/WO SKLTL TRAC-BIL $5,127.00 HC27002377 COLONOS' SCREEN NOT HI RISK (Q120MO) $5,125.00 HC27001239 COLONOS' SCREEN HI RISK (Q48MO) $5,118.00 HC74200460 OR TIME ADD'L 15MIN LVL 5 (MCAL 2ND SUBSQNT 0.5 HR) $5,118.00 HC74200106 OR TIME ADD'L 15MIN LVL 5 (MCAL 1ST SUBSQNT 0.5 HR) $5,118.00 HC25001173 THORACENTESIS ASP W/O IMG GUID-BIL $5,107.00 HC27000470 EGD W/INJ SUBMUCOSAL ~FO $5,105.00 HC44501807 REMOVE NEPHROSTOMY TUBE LT $5,094.00 HC44501815 REMOVE NEPHROSTOMY TUBE RT $5,094.00 HC46502183 PERC BX BREAST W/LOC DEV MR 1ST LESN $5,093.00 HC46503371 PERC BX BREAST W/LOC DEV MR 1ST LESN DC'D PROC $5,093.00 49452-7680-2 TETRACAINE HCL (BULK) MISC POWD $5,089.50 HC73000226 PERITONITIS TREATMENT $5,089.00 HC27001429 EGD W/DIL BALLN =30MM (FLUORO) ~FO $5,088.00 HC25003922 CLOSED TX CARPAL BONE FX W/M EA BONE LT $5,086.00 HC25003930 CLOSED TX CARPAL BONE FX W/M EA BONE RT $5,086.00 HC41500844 EEG W/VIDEO MONITOR INTERMT 2-12 HR $5,067.00 HC45401411 MRA UPPER EXT W/CONT LT $5,064.00 HC45401387 MRA UPPER EXT W/CONT RT $5,064.00 HC62290432 WOUND FILLER DRY COLLAGEN (VENTRIS MED) AF $5,061.00 HC25001207 THORACENTESIS W/TUBE W/O IMAG BI $5,058.00 HC25003906 CLOSED TX CARPAL SCAPHOID FX W/MAN LT $5,057.00 HC25003914 CLOSED TX CARPAL SCAPHOID FX W/MAN RT $5,057.00 HC27001486 ESOPHSCPY W/CONTROL BLEED ~FO $5,054.00 HC27001510 ESOPHSCPY W/FRN BDY(S)REMOVAL ~FO $5,053.00 HC25005208 REPAIR LIP FULL THICK; OVER 1/2 VERTICAL HT/COMPLEX $5,047.00 57894-505-05 DARATUMUMAB 20 MG/ML IV SOLN $5,041.60 HC62227707 KIT CASS KNEE 2 POD IASSIST $5,040.00 HC45200987 NM TUMOR LOCALIZE PLNR WHOLE BODY 1 DAY $5,040.00 HC27001106 SIGMOIDOSCOPY FLEX DIAGNOSTIC $5,038.00 HC25004458 CLOSED TX PROX FIBULA/SHAFT FX; W/MANIP LT $5,037.00 HC25004466 CLOSED TX PROX FIBULA/SHAFT FX; W/MANIP RT $5,037.00 HC25003724 REMOVE FB FOREARM DEEP LT $5,034.00 HC25003732 REMOVE FB FOREARM DEEP RT $5,034.00 55513-025-04 DARBEPOETIN ALFA IN POLYSORBAT 100 MCG/0.5 ML INJ SYRG $5,031.00 55513-025-01 DARBEPOETIN ALFA IN POLYSORBAT 100 MCG/0.5 ML INJ SYRG $5,031.00 HC41500703 EEG PHARMACOLOGICAL/PHYSICAL ACTIVATION $5,020.00 HC47200977 TREATMENT DEVICES MLC FOR IMRT $5,018.00 52652-9001-1 TOPIRAMATE 25 MG/ML ORAL SOLN $5,014.51 HC25003815 CLOSED TX RAD&ULN SHAFT FX W/MAN LT $5,008.00 HC25003823 CLOSED TX RAD&ULN SHAFT FX W/MAN RT $5,008.00 HC47200142 HYPERTHERMIA EXTERNAL DEEP $5,007.00 HC42000703 ECHO CONGENITAL CMPLT W/ORWO FOL CONTR $4,995.00 HC25006198 DELIVERY OF PLACENTA $4,992.00 HC46502217 PERC PLC BRST LOC DEV MAMMO ADDL LESN+ $4,986.00 HC62211073 CATHETER ENDOVENT PULMONARY $4,970.00 HC45401544 MRI FETAL INCL PLACENTA PLVC IF PRF; SINGLE 1ST GESTATION $4,969.00 HC44900371 CT MAXILLO FACIAL W/ CONTRAST $4,968.00 HC27001908 INSTILL FECAL MICROBIOTA (FMT) $4,960.00 55566-8403-1 DEGARELIX 120 MG SUBCUTANEOUS SOLR $4,953.59 55566-8402-0 DEGARELIX 120 MG SUBCUTANEOUS SOLR $4,953.59 HC44900181 CT GUIDANCE ABLATION PARENCHYMAL TISSUE $4,952.00 HC25000944 I&D PERIANAL ABSCESS $4,952.00 HC41500851 EEG W/VIDEO MONITOR CONT 2-12 HR $4,946.00 HC23001464 INJ L/S F W/IMAGE 2ND LVL LT $4,945.00 HC23001456 INJ L/S F W/IMAGE 2ND LVL RT $4,945.00 HC27001395 ESOPHSCPY W/RESECT MUCOSAL ~FO $4,940.00 62484-0015-5 HYDROXYUREA (SICKLE CELL) 100 MG/ML ORAL SOLN $4,939.87 62484-0015-4 HYDROXYUREA (SICKLE CELL) 100 MG/ML ORAL SOLN $4,939.87 HC23000367 INJ ANES/STEROID NERVE AXILLARY BIL $4,937.00 HC25003757 CLOSED TX RADIAL SHAFT FX W/MANIP LT $4,934.00 HC25003765 CLOSED TX RADIAL SHAFT FX W/MANIP RT $4,934.00 HC84201292 RESP VIRUS 12-25 TRGTS(RVP PNL) $4,933.00 HC44504470 IVUS VESSEL ADD'L NONCORON W/EXAM++ $4,928.00 60793-702-04 PENICILLIN G BENZATHINE 2,400,000 UNIT/4 ML IM SYRG $4,915.40 60793-702-10 PENICILLIN G BENZATHINE 2,400,000 UNIT/4 ML IM SYRG $4,915.40 HC62804042 FILTER VENA CAVA H $4,909.00 HC44703874 INJ PRO HRT CATH &IMAG; SELCT PULM ARTRL ANGIO UNILAT+ $4,906.00 0527-5160-82 MYCOPHENOLATE MOFETIL 200 MG/ML ORAL SUSR $4,901.52 99999-047-30 SULFAMETHOXAZOLE-TRIMETHOPRIM 4 MG-0.8 MG/ML DILUTED IV SOLN (FOR DESENSITIZATION) $4,900.48 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 HC62226352 PROGRAMMER NEUROSTIM PAT H $4,900.00 HC62219001 RETRACTOR MIS SPINAL K $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 HC23001571 INJ ANES/STEROID NERVE OCCIPITL GREAT BI $4,897.00 HC46501508 REPLC PICC LINE W/O SQ PORT/PUMP &W/O IMAGING $4,896.00 HC44901072 CT BREAST 3D RENDER UNILAT W&W/O CONTRAST $4,880.00 0143-9565-01 THIOTEPA 15 MG INJ SOLR $4,875.00 HC91200134 R&B NEWBORN CARE $4,873.00 HC45201290 HEPATOBIL SYS IMAGW/RX(&QUANT) $4,863.00 HC23001373 INJ CER/THOR F/IMAGE 2ND LVLLT $4,857.00 HC23001365 INJ CER/THOR F/IMAGE 2ND LVLRT $4,857.00 HC46500336 BIOPSY NEEDLE SALIVARY GLAND $4,850.00 HC46502639 FNA ASP BX W/US; FIRST LESION $4,846.00 HC25004078 CLOSED TX THUMB FX DISLOC W/MAN(BENNETT)LT $4,840.00 HC25004086 CLOSED TX THUMB FX DISLOC W/MAN(BENNETT)RT $4,840.00 HC46000246 INJ SINUS TRACT; DIAGNOSTIC (SINOGRAM) $4,840.00 13533-800-20 IMMUNE GLOBUL G-GLY-IGA AVG 46 5 GRAM/50 ML (10 %) INJ SOLN $4,834.05 13533-800-21 IMMUNE GLOBUL G-GLY-IGA AVG 46 5 GRAM/50 ML (10 %) INJ SOLN $4,834.05 HC83000836 THER APHERESIS PLASMA CX/ABORT $4,830.00 63459-390-08 BENDAMUSTINE 25 MG IV SOLR $4,829.18 HC44703932 VENOGRAPHY CHD ANOMALY/PERSIST SVC NATIVE DRAIN+ $4,823.00 HC51071058 EGD TRANSNAS BIOPSY 1/MORE $4,820.62 HC51071041 EGD TRANSNAS DX INC SPEC BRUSH/WASH $4,820.62 HC51010858 THORACENTESIS W/TUBE W/O IMAG $4,820.62 HC23001498 INJ L/S F /IMAGE 3RD+& LVL LT $4,814.00 HC23001480 INJ L/S F /IMAGE 3RD+& LVL RT $4,814.00 HC44703486 PERICARDIAL DRAIN 6+YR W/O ANOMOLY INCL FLUORO &/US $4,812.00 23155-216-31 CIDOFOVIR 75 MG/ML IV SOLN $4,810.00 HC12800025 THER APHERESIS PLASMA CX/DC'D $4,807.00 0781-3154-01 FERUMOXYTOL 510 MG/17 ML (30 MG/ML) IV SOLN $4,802.00 HC62204227 KIT ROTALINK $4,797.00 55150-431-01 DACTINOMYCIN 0.5 MG IV SOLN (MCH) $4,793.75 39822-2100-1 DACTINOMYCIN 0.5 MG IV SOLN (MCH) $4,793.75 39822-2100-2 DACTINOMYCIN 0.5 MG IV SOLN (MCH) $4,793.75 HC62209101 CT ELECTRODE SPRSLIM 2.0 CM EA $4,791.00 HC51002681 REPAIR FISTULA ANAL W/PLUG $4,787.00 HC27000462 EGD W/TUMR/LES REMOV HOT BX~FO $4,783.00 HC27000074 ANOSCOPY W/FB REMOVAL $4,780.00 HC44700029 CARDIOVERSION INTERNAL $4,780.00 HC44700797 PERICARDIOCENTESIS INCL IMAGING $4,773.00 HC74200338 BEDSIDE/OTHER SURGICAL CANCEL LVL 4 $4,762.00 70860-218-05 CYCLOPHOSPHAMIDE 200 MG/ML IV SOLN $4,761.25 50742-520-05 CYCLOPHOSPHAMIDE 200 MG/ML IV SOLN $4,761.25 75907-190-07 CYCLOPHOSPHAMIDE 200 MG/ML IV SOLN $4,761.25 HC32010373 OT-EVAL SWALLOW CINE/FLUORO 180MIN $4,761.00 HC33010240 ST-EVAL SWALLOW CINE/FLUORO 180MIN $4,761.00 HC45400157 MR GUIDANCE ABLATION PARENCHYMAL TISSUE $4,758.00 HC81701781 GENOTYPE DNA/RNA HEPATITIS C $4,754.00 HC44900421 CT NECK SOFT TISSUE W/O CONT $4,752.00 67457-177-50 DIMETHYL SULFOXIDE 50 % INTRAVESICAL SOLN $4,743.38 HC62212287 FORCEP BIOPSY URETEROSCOP DISP $4,725.00 99999-041-47 NM TC-99M EXAMETAZIME (CERETEC) MHS $4,720.66 16714-900-01 ATOVAQUONE 750 MG/5 ML ORAL SUSP $4,717.44 72603-248-01 ATOVAQUONE 750 MG/5 ML ORAL SUSP $4,717.44 HC25003187 LAC REPAIR INTMD N/H/F/GEN >30.0CM $4,713.00 HC23001712 N BLOCK INJ PLANTAR DIGIT (MOTONS) BIL $4,712.00 HC27000355 EGD COMPLETE DX W/ BRUSH/SPEC ~FO $4,707.00 HC27000538 EGD W/TUMR/LES REMOV W/SNARE~FO $4,702.00 HC62228622 KIT ROTAPRO $4,699.00 HC45200037 NM ADRENAL IMAGING $4,699.00 HC42000810 TEE GUIDE TRANSCATH INTVNTN INCL US $4,695.00 HC21000237 DEBRID/REMVL OPEN FX MUSCLE $4,684.00 HC45400140 MR GUIDANCE NEEDLE PLACEMENT S&I $4,684.00 99988-000-01 NM TC-99M EXAMETAZIME 1-30 MCI (CERETEC) $4,683.00 HC27000413 EGD W/BIOPSY(S) ~FO $4,676.00 HC27001528 ESOPHSCPY W/INJ SCLERO VARICES ~FO $4,676.00 HC45401429 MRA UPPER EXT W/O CONT LT $4,668.00 HC45401395 MRA UPPER EXT W/O CONT RT $4,668.00 HC44704302 EP EVAL CONTRACT MODUL-DEFIB IMPLANT/REPLACE INITIAL $4,665.00 HC44704310 EP EVAL CONTRACT MODUL-DEFIB IMPLANT/REPLACE SUBSEQ $4,665.00 55513-224-01 RITUXIMAB-ARRX 10 MG/ML IV SOLN $4,659.20 0069-0238-01 RITUXIMAB-PVVR 10 MG/ML IV SOLN $4,659.20 HC21000229 DEBRID/REMVL OPEN FX SKIN/SBQ $4,657.00 HC51003119 DESTROY LESION(S) VULVA EXTENSIVE $4,648.44 HC51003101 DESTROY LESION(S) VULVA SIMPLE $4,648.44 HC74200452 OR TIME ADD'L 15MIN LVL 4 (MCAL 2ND SUBSQNT 0.5 HR) $4,645.00 HC74200098 OR TIME ADD'L 15MIN LVL 4 (MCAL 1ST SUBSQNT 0.5 HR) $4,645.00 HC46502159 PERC BX BREAST W/LOC DEV SG ADDL LESN+ $4,644.00 70377-118-31 NITROFURANTOIN 25 MG/5 ML ORAL SUSP $4,643.47 HC27001577 ESOPHSCPY W/BIOPSY(S) ~FO $4,639.00 0781-4003-32 LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS KIT $4,633.20 72664-611-28 LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS KIT $4,633.20 HC25003369 REMOVE FB MUSCLE/TNDON SHEATH DEEP/COMP $4,633.00 HC46501227 PARACENTESIS ABD W/O IMAGING GUIDE $4,624.00 HC62216809 BALLOON VERTEBRAL $4,620.00 HC44504504 PERC PLCMT TISS SOFT DEV 1ST LESN $4,620.00 70069-829-01 NITROFURANTOIN 25 MG/5 ML ORAL SUSP $4,615.07 HC47201066 BRACHYTX ISODOSE W/DOSIMETRY;INTRM $4,615.00 72603-344-01 LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS KIT $4,615.00 HC27000512 EGD W/TRANSENDO TUBE/CATH PLC ~FO $4,613.00 HC62210257 OXYGENATOR ECMO $4,610.00 HC62229315 BRONCHOSCOPE ASCOPE 4 SPEC SAMPLE REG $4,602.50 50242-214-01 OMALIZUMAB 75 MG/0.5 ML SUBCUTANEOUS SYRG $4,602.39 50242-214-03 OMALIZUMAB 75 MG/0.5 ML SUBCUTANEOUS SYRG $4,602.39 HC46502043 BX SOFT TISS THIGH/KNEE;SUP LT $4,593.00 HC46502050 BX SOFT TISS THIGH/KNEE;SUP RT $4,593.00 HC62205083 OFF PUMP SUCTION SYS-STABILZER $4,593.00 HC46502688 FNA ASP BX W/CT; EACH ADD'L LESION $4,589.00 HC46502951 INSERTION DEVICE INTRAUTERINE IUD $4,589.00 HC46000261 INJ DISKOGRAM LUMBAR EA LVL $4,588.00 47335-936-40 LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS KIT $4,586.86 HC47200696 TREATMENT SIMULATION COMPLEX $4,559.00 HC46500112 ASP/INJ THYROID CYST $4,553.00 HC47201157 HDR ELECTRONIC BRACHYTHERAPY INTERSTIT/INTRACAV $4,553.00 HC62215744 BLADE SHAVER AH $4,550.00 HC46503439 BX NECK/THORAX SOFT TISSUE-SC DC'D PROC $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 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 HC25003427 CLOSED TX NOSE FX W/ STABILIZATION $4,548.00 HC23001084 INJ/INF NEUROLYTIC AGNT SUBARACH $4,543.00 HC84201839 RESP BACTERIA/VIRAL 22 TRGT SARS-COV-2 QUAL RT-PCR(PNL RP2.1) $4,541.00 HC45201258 PULM VENTILATION & PERF IMAG $4,538.00 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 HC46501938 PERC ASP INTERDISCAL DX $4,519.00 HC44500395 ANGIO THRU EXISTING CATH $4,508.00 HC51003861 FRENULOTOMY PENIS $4,505.00 HC62203807 KIT CRANIOPLASTIC RESIN $4,494.00 HC44500908 INJ PERC EXT PSEUDOANEUR BILAT $4,493.00 HC62807805 M: SPACER HUMERAL SHOULDER $4,489.00 HC62805940 CATH EP DX <20 ELECTRODES U $4,480.00 HC62214580 KIT SPINAL ACCESS DISPOSBL(MAXCESS) $4,480.00 HC25003476 CLOSED TX CLAVICLE FX W/MANIP-BIL $4,468.00 HC47200225 INTRACAVITARY TREATMT COMPLEX $4,461.00 HC44703502 PERICARDIAL DRAIN W/CATH & CT GUIDANCE $4,456.00 HC23001415 INJ CER/THR F/IMAGE 3RD+&LVLBI $4,452.00 HC45200094 NM BONE SCAN 3 PHASE $4,450.00 HC45201340 NM PARATHYRD SCN W/SPECT & CT $4,448.00 HC27001973 DESTRUCT INTRNL HEMORRHOID THERM ENERGY $4,447.00 61958-0403-1 TENOFOVIR DISOPROXIL FUMARATE 40 MG/SCOOP (40 MG/GRAM) ORAL POWD $4,442.49 HC41500828 EEG W/O VID MONITOR CONT EA 12-26HR $4,431.00 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 HC25002841 I&D HEMATOMA/SEROMA/FLUID COLLECTION $4,420.00 HC25005455 INJ ANES/STEROID NERVE/BRNCH PERIPH BIL $4,420.00 HC46500898 FIX G/COLON TUBE W/ DEVICE W/FLUORO $4,415.00 52652-4001-1 ENALAPRIL MALEATE 1 MG/ML ORAL SOLN $4,412.85 0074-1040-08 BERACTANT IN 0.9 %SOD.CHLORIDE 25 MG/ML INTRATRACH SUSP $4,406.22 HC44900934 CT HEART EVAL W/ 3D IMAGE $4,403.00 HC25004144 CLOSED TX ARTICULAR FX W/MANIP EA $4,393.00 HC45200532 NM LYMPH GLAND/NODES IMAGING $4,391.00 HC45200839 NM THYROID CA METS BODY SCAN $4,384.00 HC62801030 FILTER VENA CAVA (E.G.GUNTHER) G $4,383.00 HC21000716 DBRD SKN MUSCL EA ADD 20SQCM/< $4,382.00 55150-338-01 LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS SOLN (MCH) $4,381.00 HC62220322 ORTHOTIC TLSO 4MOD SACRO-SCAP PRE $4,379.00 HC25004607 REMOVE FB FOOT; DEEP LT $4,379.00 HC25004615 REMOVE FB FOOT; DEEP RT $4,379.00 HC25004599 REMOVE FB FOOT; SUBC BIL $4,379.00 HC45200433 NM KIDNEY FLW/FUNC MULTI STUDY $4,377.00 HC62809397 DEVICE CLOSURE VASCULAR AC $4,375.00 HC25001108 INSERT PICC <5 YR AGE W/O IMAGING $4,375.00 HC62808233 M: BEARING TIBIAL $4,375.00 HC41500182 ELECTROCORTICOGRAM IN SURGERY $4,374.00 HC25006115 AMNIOCENTESIS $4,373.00 HC21000542 PREP SITE TRUNK/EXT<100SQCM $4,368.00 0054-0319-50 LINEZOLID 100 MG/5 ML ORAL SUSR (MCH) $4,367.03 HC45200219 NM CARDIAC BP IMAG GATED MULTI $4,367.00 HC62228689 PROBE ABLATION CRYO A $4,361.00 HC44200913 TCD ICA VASOREACTIVITY STUDY $4,355.00 HC45401130 MR BREASTS W/O&W CONTRST LTD (BILAT) $4,343.00 HC45201365 NM GASTRIC EMPTY SML BWL&COLON>1DAY $4,334.00 HC44900389 CT MAXILLO FACIAL W/O CONTRAST $4,325.00 HC45201274 QUANT DIFF PULM PERF& VENT $4,320.00 HC62219548 PROBE LITHOTRIPTOR ELECTRHYDRLC Y $4,319.00 0944-2510-02 IGG-HYALURONIDASE,RECOMBINANT 2.5 GRAM /25 ML (10 %) SUBCUTANEOUS SOLN $4,302.21 24338-136-10 ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL SUSR $4,300.40 HC62221189 BLANKET/PAD TEMP MNGMNT SYSTEM/BOX $4,300.00 HC62229497 HANDPIECE VESSEL SEALER DEVICE K $4,300.00 HC25000324 THORACOTOMY $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 71288-165-54 NELARABINE 250 MG/50 ML IV SOLN $4,296.50 71288-165-52 NELARABINE 250 MG/50 ML IV SOLN $4,296.50 0944-2884-01 GLASSIA 20 MG/ML (2 %) IV SOLN $4,290.00 HC25004631 CLOSED TX TARSAL FX; W/MANIPLTN EA $4,282.00 HC45200193 NM CARDIAC BP 1ST PASS(EF)MULT $4,282.00 66220-315-11 TELAVANCIN 750 MG IV SOLR $4,268.41 66220-315-22 TELAVANCIN 750 MG IV SOLR $4,268.41 HC62223359 DEVICE SUTURE ENDO R $4,267.00 HC46500062 ASP&INJ BONE CYST $4,263.00 HC46500732 CT ASP&INJ BONE CYST-LT $4,263.00 HC46500740 CT ASP&INJ BONE CYST-RT $4,263.00 HC27000058 ANOSCOPY W/BLEED CONTROL $4,258.00 HC38420345 ASSEMBLY & OPER PUMP OXYGEN; 45MIN $4,255.00 HC46001319 INJ ANTEGRAD NEPH/URET'GRM,S&I EXIST ACCESS LT $4,254.00 HC46001327 INJ ANTEGRAD NEPH/URET'GRM,S&I EXIST ACCESS RT $4,254.00 HC62228358 SHEATH STEERBL CURVE/TRUSTEER(WATCHMAN) $4,250.00 HC44900835 CT COLONOGRAPHY DX VIRTUAL W/O CONTRAST $4,247.00 HC46502142 PERC BX BREAST W/LOC DEV SG 1ST LESN $4,247.00 HC46503355 PERC BX BREAST W/LOC DEV SG 1ST LESN DC'D PROC $4,247.00 HC44504017 ANGIO IL/FEM DURING HRTCATH&/CORO W/S&I $4,242.00 HC41500224 EMG 4 EXTREMITY $4,242.00 HC25006180 BREECH VERSION EXTERNAL MANIP $4,241.00 HC44001642 MYELOGRAM ENTIRE SPINE CANAL $4,232.00 HC41000076 POLYSMN CPAP/BIPAP6&>ATTD REDCD SVC $4,232.00 0023-1145-01 ONABOTULINUMTOXINA 100 UNIT INJ SOLR $4,231.50 HC46000998 SEL VENOUS CATH 2ND+ORDR LT $4,226.00 HC46001004 SEL VENOUS CATH 2ND+ORDR RT $4,226.00 83634-306-41 ETHYL ALCOHOL 99 % INTRAARTER SOLN $4,225.00 83634-306-05 ETHYL ALCOHOL 99 % INTRAARTER SOLN $4,225.00 13533-634-02 TETANUS IMMUNE GLOBULIN (PF) 250 UNIT/ML IM SYRG $4,219.61 70510-2171-2 EDARAVONE 30 MG/100 ML IV SOLN $4,217.85 70510-2171-1 EDARAVONE 30 MG/100 ML IV SOLN $4,217.85 99999-036-83 THIOGUANINE 10 MG ORAL PARTIAL TAB $4,216.94 99999-036-84 THIOGUANINE 20 MG ORAL PARTIAL TAB $4,216.94 99999-037-57 THIOGUANINE 20 MG/ML ORAL LIQUID $4,216.94 80725-630-25 THIOGUANINE 40 MG ORAL TAB $4,216.94 HC46502258 PERC PLC BRST LOC DEV US ADDL LESN+ $4,215.00 HC44701159 THROMBOLYSIS INTRACORONARY INF WANGIO $4,214.00 49401-101-01 BELIMUMAB 120 MG IV SOLR $4,208.43 HC45200276 NM CISTERNOGRAM $4,206.00 HC51002285 MEATOTOMY (INFANT) $4,205.68 HC51002277 MEATOTOMY (NON-INFANT) $4,205.68 HC45200110 NM BONE SCAN WHOLE BODY $4,203.00 62856-215-01 LECANEMAB-IRMB 100 MG/ML IV SOLN $4,202.97 HC36000933 BRONCH W/LUNG BX; EA ADD'L+ $4,200.00 HC36800480 BRONCH W/LUNG BX; EACH ADD'L+ $4,200.00 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 HC27000926 ESOPHSCPY DX- BRUSH/WASH ~FO $4,196.00 HC45201332 NM PARATHYRD SCN W/SPECT W-W/O SUBTR $4,196.00 HC45200417 NM KIDNEY IMAG FLOW/FUNCTION $4,185.00 HC62210794 KIT INTRAOP PERFUSION (SPY) $4,183.00 HC21000476 I&D ABSCESS COMPLICATED MULT $4,178.00 HC21000773 APPY SKIN SUB T,A,L 1ST 25SQ~HC $4,175.00 HC42000729 ECHO 2D CMPLT W/O SPC&DOP W/WO CONTR $4,170.00 HC44901064 CT BREAST 3D RENDER UNILAT W/CONTRAST $4,168.00 0078-0274-22 CYCLOSPORINE MODIFIED 100 MG/ML ORAL SOLN $4,166.18 58914-301-80 NITROGLYCERIN 0.4 % (W/W) RECTAL OINT $4,164.81 HC46501920 ADJUST GASTRIC BAND VIA PORT $4,160.00 HC46500757 CYSTOGRAM COMPLEX $4,159.00 52652-5001-1 AMLODIPINE BENZOATE 1 MG/ML ORAL SUSP $4,158.38 HC36800498 BRONCH W/NDL ASP BX(S) EA ADDL+ $4,158.00 HC36000842 BRONCH W/NDL ASP BX; EA ADD'L+ $4,158.00 HC45200342 NM GASTROINTESTINAL BLOOD LOSS $4,156.00 HC25003419 CLOSED TX NOSE FX W/O STABILIZATION $4,148.00 HC46000402 INJ OF GT/COLON TUBE; PATENCY W/IMAG $4,140.00 HC32010365 OT-EVAL SWALLOW CINE/FLUORO 150MIN $4,139.00 HC33010232 ST-EVAL SWALLOW CINE/FLUORO 150MIN $4,139.00 HC21000393 ESCHAROTOMY; FULL THICK BURN $4,133.00 HC46502233 PERC PLC BRST LOC DEV SG ADDL LESN+ $4,132.00 10454-711-10 RIMABOTULINUMTOXINB 5,000 UNIT/ML IM SOLN $4,128.02 HC51002673 REPAIR FISTULA ANAL W/GLUE $4,127.00 61958-2901-2 REMDESIVIR 100 MG IV SOLR $4,126.53 HC25001017 CARDIOVERSION EXTERNAL $4,126.00 HC21000955 APPY SKIN SUB T,A,L EA +25SQ~LC $4,125.00 HC41000092 POLYSMNGRPH 4+STG<6Y/O ATTD RDC SVC $4,125.00 HC62228580 STAPLER INTERNAL EEA $4,119.00 HC51003036 BIOPSY PENIS(SEPARATE PROC) $4,117.36 HC51010833 BONE MARROW DX; ASPIRATION(S) ONLY $4,117.36 HC51010841 BONE MARROW DX; BIOPSY(SIES) ONLY $4,117.36 HC51062990 DEBRIDE SKIN MUSL/BONE; FIRST 20SQCM $4,117.36 HC51002384 EXCISE LESION <0.5CM HND-FT-SC-NCK-GN $4,117.36 HC51002400 EXCISE LESION 1.1-2CM HND-FT-SC-NCK-GN $4,117.36 HC51002418 EXCISE LESION 2.1-3CM HND-FT-SC-NCK-GN $4,117.36 HC51002426 EXCISE LESION 3.1-4CM HND-FT-SC-NCK-GN $4,117.36 HC51061513 REMOVE IMPLANT SUPERFICIAL $4,117.36 HC25001066 BLOOD PATCH (INJ EPIDURAL) $4,113.00 HC27000157 CHANGE GT TUBE W/O IMAGE/ENDO $4,113.00 HC23001530 INJ ANES/STEROID NERVE TRIGEML BRNCH EA BI $4,109.00 HC43000629 PUNCTURE ASP CYST BREAST-LT $4,109.00 HC43000546 PUNCTURE ASP CYST BREAST-RT $4,109.00 16729-108-11 MITOMYCIN 20 MG IV SOLR $4,107.87 16729-247-11 MITOMYCIN 20 MG IV SOLR $4,107.87 25021-251-50 MITOMYCIN 20 MG IV SOLR $4,107.87 HC74200320 BEDSIDE/OTHER SURGICAL CANCEL LVL 3 $4,107.00 HC21000815 APPY SKIN SUB HEAD/HND/FT 1ST25SQ~HC $4,102.00 HC45200136 NM BRAIN IMAG MIN'4 STATC W/VF $4,096.00 HC23000433 INJ ANES/STEROID NERVE SCIATIC LT $4,091.00 HC23000441 INJ ANES/STEROID NERVE SCIATIC RT $4,091.00 63261-250-21 ISOSULFAN BLUE 1 % SUBCUTANEOUS SOLN $4,088.50 HC46502605 INSERT MIDLINE CATH <3 YR AGE $4,088.00 72603-261-01 RUFINAMIDE 40 MG/ML ORAL SUSP $4,078.36 HC62808779 CATH INDIGO THROMB 3.4&5FR[PENUMBRA] $4,071.00 HC51062776 CLOSED TX CARPAL BONE FX W/MNPLTN EA BONE $4,066.96 HC51061117 CLOSED TX RAD/EPHYSL SEP&ULN FX W/MAN $4,066.96 63323-450-50 PEMETREXED DISODIUM 500 MG IV SOLR $4,062.50 HC62804406 COIL EMBOLIZ(AXIUM PRIME 3D 3MM) AD $4,060.00 67877-833-47 TOPIRAMATE 25 MG/ML ORAL SOLN $4,058.34 HC44900496 CT PELVIS W/O CONTRAST LTD $4,055.00 HC41500471 WADA TEST $4,055.00 99999-038-64 EPIFIX SKIN GRAFT ( 3X3.5 CM ) $4,046.25 HC45200300 NM GASTRIC EMPTYING $4,046.00 HC25000035 ED LEVEL IV - EXTENDED $4,035.00 HC41500430 SOMATOSENSORY UPPER LIMBS $4,026.00 HC62809298 G220093 SYSTEM LAA EXCLUSION ATRICLIP ® $4,025.00 HC62804471 KIT KYPHOPLASTY BALLOON AUGMENTATN $4,025.00 HC82202862 PROSTATE NEEDLE BX ANY METHD $4,020.00 42799-217-01 OPIUM TINCTURE 10 MG/ML (MORPHINE) ORAL TINC $4,014.48 HC44501203 MECH REMOV PERICATH OBSTR CEN VEN S&I ONLY $4,013.00 HC47200118 CT RAD THER PLANNING $4,003.00 HC74200445 OR TIME ADD'L 15MIN LVL 3 (MCAL 2ND SUBSQNT 0.5 HR) $4,002.00 HC74200080 OR TIME ADD'L 15MIN LVL 3 (MCAL 1ST SUBSQNT 0.5 HR) $4,002.00 HC46500070 ASP/INJ HYDROCELE $4,001.00 HC21000708 DBRD SKIN&SUBQ EA ADD 20SQCM/< $4,000.00 HC25005372 DRAIN ABSCESS WALL SCROTAL $3,993.00 HC62209176 DEVICE ABLATION GYN KIT $3,989.00 HC27000694 ERCP DIAGNOSTIC DC'D PROC $3,988.00 0069-0315-01 BEVACIZUMAB-BVZR 25 MG/ML IV SOLN $3,987.10 HC89019988 FHL2 PRF1 GENE MUTATION-CN $3,984.00 0944-2715-25 IMMUN GLOB G(IGG)-GLY-IGA OV50 2.5 GRAM/25 ML (10 %) SUBCUTANEOUS SOLN $3,983.53 HC12800090 TRANSFUSION EXCHANGE BLOOD NOT NEWBORN $3,982.00 HC46502167 PERC BX BREAST W/LOC DEV US 1ST LESN $3,972.00 HC46503363 PERC BX BREAST W/LOC DEV US 1ST LESN DC'D PROC $3,972.00 HC43000041 BREAST BX CORE W/O GUIDE-LT $3,971.00 HC43000058 BREAST BX CORE W/O GUIDE-RT $3,971.00 HC44700391 INSERT SWAN-GANZ CATHETER $3,966.00 HC82202169 ELECTRON MICROSCOPY $3,965.00 62756-352-40 OCTREOTIDE ACETATE 1,000 MCG/ML INJ SOLN $3,964.68 0003-0852-22 DASATINIB 100 MG ORAL TAB $3,953.37 HC44900033 CT ABDOMEN W/O CONTRAST LTD $3,952.00 HC44700565 INTRAVASC DOP CORONARY FLOW RESERV W/PHARM ADDL VESSEL+ $3,949.00 HC51000552 INSERT PICC <5 YR AGE W/O IMAGING $3,947.60 HC51000560 INSERT PICC >5 YR AGE W/O IMAGING $3,947.60 HC51000446 REPAIR CENTRAL VEN CATH W/PORT $3,947.60 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 HC46001111 INJ ARTHRO HIP W/ANESTH-SC BIL $3,927.00 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 HC44901056 CT BREAST 3D RENDER UNILAT W/O CONTRAST $3,919.00 HC42000133 ECHO 2D CMPLT W/O SPEC&CLR DOP $3,919.00 HC41500620 STUDIES NERVE CONDUCTN 13/> STUDIES $3,919.00 HC23000037 ASP/INJ JOINT SM W/O UTZ GUIDE-BILAT $3,907.00 HC46500765 DECLOTTING IVAD W/THROMBOLYTIC $3,901.00 HC46503421 PERC PLC BRST LOC DEV MR 1ST LESN DC'D PROC $3,901.00 55111-556-10 DECITABINE 50 MG IV SOLN (MCH) $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 71288-139-51 MITOMYCIN 40 MG IV SOLR $3,900.00 14789-901-10 PROCAINAMIDE 100 MG/ML INJ SOLN $3,900.00 14789-901-07 PROCAINAMIDE 100 MG/ML INJ SOLN $3,900.00 14789-900-07 PROCAINAMIDE 500 MG/ML INJ SOLN $3,900.00 14789-900-02 PROCAINAMIDE 500 MG/ML INJ SOLN $3,900.00 70954-148-10 PYRIDOSTIGMINE BROMIDE 60 MG/5 ML ORAL SYRP $3,898.47 10122-510-01 PORACTANT ALFA 120 MG/1.5 ML INTRATRACH SUSP $3,893.24 50458-575-01 RIVAROXABAN 1 MG/ML ORAL SUSR $3,886.94 HC45200425 NM KIDNEY IMAG FLW/FUNC W/PHAR $3,885.00 HC62229208 VACUUM DRAIN TUBE KIT(JADA) $3,884.00 HC45401114 MR BREASTS W/O CONTRAST LTD (BILAT) $3,877.00 HC45200540 NM MECKEL'S/BOWEL IMAGING $3,872.00 HC46000675 INTRO OF CATH SVC OR IVC $3,868.00 HC83506188 NEOTYPE COMP HEME CANCERS-NG $3,868.00 72205-099-78 SIROLIMUS 1 MG/ML ORAL SOLN $3,867.63 52536-600-11 BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSP $3,867.24 50458-560-01 PALIPERIDONE PALMITATE 39 MG/0.25 ML IM SYRG $3,866.27 62756-529-40 DESMOPRESSIN 4 MCG/ML INJ SOLN $3,862.30 63323-637-10 ARSENIC TRIOXIDE 1 MG/ML IV SOLN $3,861.00 63323-637-03 ARSENIC TRIOXIDE 1 MG/ML IV SOLN $3,861.00 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 HC41500422 SOMATOSENSORY LOWER LIMBS $3,842.00 13533-705-01 PROLASTIN-C 1,000 MG (+/-)/20 ML IV SOLN $3,835.00 13533-705-11 PROLASTIN-C 1,000 MG (+/-)/20 ML IV SOLN $3,835.00 76075-103-01 CARFILZOMIB 10 MG IV SOLR $3,831.95 HC46502068 BIOPSY PLEURA NEEDLE $3,827.00 HC46500526 BX PLEURA NDL-LT $3,827.00 HC46500534 BX PLEURA NDL-RT $3,827.00 HC45200029 CSF FLOW W/ VENTRICULOGRAPHY $3,825.00 HC47200217 INTRACAVITARY TREATMT INTERMED $3,822.00 HC23001910 INJ ANES/STEROID NERVE GENICULAR IMAGE GUIDE $3,820.00 HC23001936 INJ ANES/STEROID NERVE GENICULAR IMAGE GUIDE LT $3,820.00 HC23001944 INJ ANES/STEROID NERVE GENICULAR IMAGE GUIDE RT $3,820.00 HC25005174 DRAIN ABSCESS LYMPH NODE/LYMPHADENITIS; SIMPLE $3,818.00 HC25001025 PERICARDIOCENTESIS INCL IMAGING $3,818.00 HC21000153 ASPIRATION OF ABCESS/CYST $3,812.00 HC44503464 DECLOT IVAD BY THROMBOLYTIC LT $3,811.00 HC44503472 DECLOT IVAD BY THROMBOLYTIC RT $3,811.00 59572-102-01 AZACITIDINE 100 MG INJ SOLR $3,804.06 HC44502243 VENOGRAM EXTREMITY UNILAT LT $3,797.00 HC44503431 VENOGRAM EXTREMITY UNILAT RT $3,797.00 HC44501013 MECH REMOV INTRALUMIN OBSTR VEN DEV S&I ONLY $3,795.00 HC21000567 PREP SITE/SCR F/N/HF/G<100SQCM $3,791.00 HC41500133 EEG MONITORING 61-119MINUTES $3,790.00 HC25005869 I&D ABSCESS RECTAL $3,789.00 HC23000102 ASP/INJ JOINT LRG W/O UTZ GUIDE-LT $3,786.00 HC23000110 ASP/INJ JOINT LRG W/O UTZ GUIDE-RT $3,786.00 HC62808753 CATH INDIGO THROMB SEPARATOR 6FR L175CM[PENUMBRA] $3,780.00 HC62804380 COIL EMBOLIZATION AB $3,780.00 HC41500117 EEG CEREBRAL SILENCE $3,758.00 HC62802467 INTRODUCER KYPHOPLASTY OSTEO $3,745.00 HC45200904 THYROID METS IMAG W/ADD STUDIES $3,738.00 HC44503449 DECLOTTING VASC ACCES/CATH LT $3,733.00 HC44503456 DECLOTTING VASC ACCES/CATH RT $3,733.00 HC23000391 INJ ANES/STEROID BRACHIAL PLEXUS $3,725.00 HC23001621 INJ ANES/STEROID BRACHIAL PLEXUS LT $3,725.00 HC23001613 INJ ANES/STEROID BRACHIAL PLEXUS RT $3,725.00 HC62800263 CATH CORONARY SINUS $3,724.00 HC46501193 MANOMETRIC STDY VIA NEPHRO LT $3,718.00 HC46501201 MANOMETRIC STDY VIA NEPHRO RT $3,718.00 HC62806948 KIT ANEURYSM ENCAPSULTNG NEUROVASC $3,717.00 HC41500794 EEG W/O VID MONITOR CONT 2-12HR $3,716.00 HC25003351 REMOVE FB MUSCLE/TENDON SHEATH SIMPLE $3,711.00 HC73000275 DIALYSIS URGENT ESRD(OP)CANCEL $3,703.00 HC45200284 NM CSF LEAKAGE IMAGING $3,685.00 HC45201035 NM VENOGRAM(THROMBOSIS)BILAT $3,685.00 HC23000912 INJ ANES/STEROID NERVE/BRNCH PERIPH LT $3,673.00 HC23000920 INJ ANES/STEROID NERVE/BRNCH PERIPH RT $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 424HRS-30DAYS TECH ATTEND TIME;CONNECT&TRANS $3,657.00 HC47200134 HYPERTHERMIA EXTERNAL SUPERFCL $3,656.00 HC51003085 VASECTOMY BILAT/UNILAT(SEP PROCEDURE) $3,655.00 45802-608-01 CALCITRIOL 3 MCG/GRAM TOPICAL OINT $3,654.95 14789-600-10 ARSENIC TRIOXIDE 1 MG/ML IV SOLN $3,654.56 0781-3244-94 CYCLOPHOSPHAMIDE 1 GRAM IV SOLR $3,642.34 HC62804372 COIL EMBOLIZATION AA $3,640.00 HC62804026 FILTER VENA CAVA (E.G.ELITE) E $3,640.00 HC62217005 KIT SPINAL ACCESS DISPOSBL D $3,640.00 HC62229281 SET CIRCUIT(AQUADEX) $3,640.00 0009-3794-01 IBUTILIDE FUMARATE 0.1 MG/ML IV SOLN $3,638.90 HC44001485 KNEE ARTHROGRAM BILAT $3,637.00 HC44001030 HIP ARTHROGRAM BILAT $3,634.00 HC41000126 POLYSMN CPAP/BIPAP<6 ATTD REDCD SVC $3,631.00 HC36800845 TRANSENDOSCOPIC EBUS DURING BRONCH DX OR TX FOR PERIPH NODE(S)+ $3,630.00 HC36001147 TRANSENDOSCOPIC EBUS DURING BRONCH DX OR TX FOR PERIPH NODE(S)+ $3,630.00 HC46000394 INJ PROCEDURE MYELOGRAPHY, LUMBAR $3,625.00 HC45200201 NM CARDIAC BP IMAG GATED SNGLE $3,624.00 HC21000997 APPY SKIN SUB HEAD/HND/FT EA+25SQ~LC $3,622.00 HC73000267 DIALYSIS CVVH (CONT VENOVENOUS) QD $3,620.00 HC42000711 ECHO CNGNTL LTD OR F/U W/WO CONTR $3,620.00 HC47200662 TREATMENT DEVICES COMPLEX $3,619.00 HC44704047 INTRAVASC DOP CORONARY FLOW RESERV IFR/RFR NO PHARM INIT VESSEL+ $3,616.00 43598-012-52 AMOXICILLIN-POT CLAVULANATE 125-31.25 MG/5 ML ORAL SUSR $3,615.30 49281-574-15 NIRSEVIMAB-ALIP 100 MG/ML IM SYRG $3,614.86 49281-575-15 NIRSEVIMAB-ALIP 50 MG/0.5 ML IM SYRG $3,614.86 49281-574-88 NIRSEVIMAB-ALIP 100 MG/ML IM SYRG $3,614.85 49281-575-00 NIRSEVIMAB-ALIP 50 MG/0.5 ML IM SYRG $3,614.85 HC21000559 PREP TRUNK/EXT EA ADDL 100SQCM $3,613.00 HC41500414 SOMATOSENSORY HEAD/TRUNK $3,608.00 HC21000302 DEBRIDE SKIN EXT UP TO 10% BSA $3,599.00 HC51003788 LYSIS ADHESIONS POST-CIRCUMCISION $3,590.00 HC25005802 CLOSED TX ANKLE FX W/MANIP LT $3,582.00 HC25005810 CLOSED TX ANKLE FX W/MANIP RT $3,582.00 55566-2800-1 DINOPROSTONE 10 MG VAGINAL INSR $3,576.17 55566-2800-0 DINOPROSTONE 10 MG VAGINAL INSR $3,576.17 HC25005315 I&D ABSCESS SUBMUCSL RECTUM $3,576.00 HC27001221 SIGMOIDOSCOPY FLEX SCRN (Q48MO) $3,568.00 HC44001295 INTRODUCE TUBE GASTROINTESTINAL LONG $3,567.00 0143-9248-01 DEXRAZOXANE HCL 500 MG IV SOLR $3,565.32 HC44200145 US DUPLEX ART LOW EXT COMP BIL $3,562.00 HC44703940 VENOGRAPHY CHD AZYGOS/HEMIAZYGOS VENOUS+ $3,557.00 HC41500000 AUDITORY EVOKED AEP BBS HEARING DETERM W/I&R $3,552.00 HC41500547 AUDITORY EVOKED AEP BBS HEARING DETERM W/I&R $3,552.00 HC42000646 ECG EXT PT ACTV EVENT MONITOR ATTEND 24HRS-30DAYS; TRANSMIT/ANYS $3,548.00 81033-066-20 METRONIDAZOLE 500 MG/5 ML ORAL SUSP $3,542.50 71656-066-20 METRONIDAZOLE 500 MG/5 ML ORAL SUSP $3,542.50 HC41000043 POLYSOMNOGRAPHY 4+ STG 6&> REDCD SVC $3,538.00 HC46000972 SEL VENOUS CATH 1ST ORD LT $3,536.00 HC46000980 SEL VENOUS CATH 1ST ORD RT $3,536.00 HC46502662 FNA ASP BX W/FLUORO; EACH ADD'L LESION $3,533.00 HC36000255 TRACH TUBE CHANGE $3,533.00 HC44001956 SHOULDER ARTHROGRAM BILAT $3,527.00 HC73000085 DIALYSIS CRRT W/SNGL EVAL(IP) $3,520.00 HC32010357 OT-EVAL SWALLOW CINE/FLUORO 120MIN $3,520.00 HC33010224 ST-EVAL SWALLOW CINE/FLUORO 120MIN $3,520.00 HC44200319 US GUIDE COMP REPR PSEUDOANEUR $3,519.00 59148-021-50 TOLVAPTAN 30 MG ORAL TAB $3,507.68 70710-1610-1 ARSENIC TRIOXIDE 2 MG/ML IV SOLN $3,502.71 70710-1610-6 ARSENIC TRIOXIDE 2 MG/ML IV SOLN $3,502.71 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 HC26000125 TRANSABDOMINAL AMNIOINFUSION W/ULTRSND GUIDANCE $3,498.00 HC62228648 APPLIER CLIP CLOSURE ANASTOMOSIS $3,497.00 HC47201058 BRACHYTX ISODOSE W/DOSIMETRY; SIMPL $3,497.00 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 HC41500216 EMG 3 EXTREMITY $3,491.00 HC45201043 NM VENOUS THROMBOSIS PEPTIDE $3,486.00 HC47200175 HYPERTHERMIA INTRACAVITARY $3,485.00 HC62804828 CLIP LEFT ATRIAL APPENDAGE-LAA A $3,483.00 HC62229356 DEV EXTRACT ELEV/INFLAT FETAL PILLOW $3,483.00 HC62209432 KIT LOCATABLE GUIDE (LARGE) $3,483.00 HC62217260 PUNCH ATHROSCOPIC ROTARY $3,483.00 HC45401551 MRI FETAL PLACENTAL PLVC IF PRF; EA ADDL+ $3,478.00 HC44001626 MYELOGRAM LUMBOSACRAL $3,475.00 59676-320-04 EPOETIN ALFA 20,000 UNIT/ML INJ SOLN $3,474.25 59676-320-00 EPOETIN ALFA 20,000 UNIT/ML INJ SOLN $3,474.25 49452-4050-2 LIDOCAINE HCL (BULK) 100 % MISC POWD $3,471.00 HC62212527 INTRODUCER/SHEATH Y $3,457.00 55513-209-91 FILGRASTIM 480 MCG/0.8 ML INJ SYRG $3,454.30 55513-209-01 FILGRASTIM 480 MCG/0.8 ML INJ SYRG $3,454.30 HC41500612 STUDIES NERVE CONDUCTN11-12 STUDIES $3,454.00 HC27001247 ESOPH MOTILTY STDY/STIM/PERF2D $3,453.00 50242-135-01 TOCILIZUMAB 80 MG/4 ML (20 MG/ML) IV SOLN $3,452.54 HC41500869 EEG W/VIDEO UNMONITOR EA 12-26 HR $3,452.00 HC25006123 AMNIOCENTESIS FLUID REDUCTION $3,451.00 HC21000849 APPY SKIN SUB HED/HND/FT EA+100SQ~HC $3,449.00 0085-4331-01 POSACONAZOLE 300 MG/16.7 ML IV SOLN $3,447.87 47335-178-40 OXALIPLATIN 100 MG IV SOLR $3,445.00 HC74200312 BEDSIDE/OTHER SURGICAL CANCEL LVL 2 $3,444.00 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 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 15054-0530-6 ABOBOTULINUMTOXINA 300 UNIT IM SOLR $3,435.25 HC47200720 US GUIDANCE RAD ELEMENT APP $3,432.00 63323-648-10 LEVOTHYROXINE 500 MCG IV SOLR $3,431.42 0597-0160-61 TIOTROPIUM BROMIDE 1.25 MCG/ACTUATION INHALATION MIST $3,428.05 HC21000807 APPY SKIN SUB T,A,L EA+ 100SQ~HC $3,423.00 HC45200243 NM CARDIAC SCAN SPECT $3,422.00 HC62217310 DEVICE CHECK NEURO SURG SPINAL $3,420.00 HC25002833 I&D POLINIDAL CYST; COMPLICATED $3,414.00 23594-125-01 CEFACLOR 125 MG/5 ML ORAL SUSR $3,412.50 70860-454-10 DESMOPRESSIN 4 MCG/ML INJ SOLN $3,412.50 43598-053-11 DESMOPRESSIN 4 MCG/ML INJ SOLN $3,412.50 HC79200044 SURGERY MINOR 1ST 30 MIN $3,412.00 HC47200589 SPECIAL TELETHERAPY PORT PLAN $3,411.00 HC23001878 INJ ANES/STEROID NERVE SI JOINT INNRV W/IMAGE $3,407.00 HC23001894 INJ ANES/STEROID NERVE SI JOINT INNRV W/IMAGE LT $3,407.00 HC23001902 INJ ANES/STEROID NERVE SI JOINT INNRV W/IMAGE RT $3,407.00 HC44001634 MYELOGRAM THORACIC $3,407.00 HC44200582 TCD ICA V-A SHUNT EMBOLI DETECT W/ IV MICROBUBBLE $3,401.00 HC62800412 CATH IVUS PV LARGE VESSEL $3,400.00 HC25003252 LAC REPAIR INTMD F/E/E/N/L/MM >30.0CM $3,399.00 HC41500166 EEG ROUTINE(AWAKE&ASLEEP) $3,397.00 HC44703429 PERCUT ACCESS & CLOSE FEMORAL ARTERY DELIVERY GRAFT+ $3,394.00 HC51010148 DESTRUCT OTHER PERIPH NERV/BRNCH BI $3,393.60 67546-212-21 NITAZOXANIDE 100 MG/5 ML ORAL SUSR $3,393.00 HC46000469 INJECTION HIP ARTHROGRAM BIL $3,386.00 HC23000482 INJ ANES/STEROID NERVE VAGUS $3,384.00 HC45200524 PULM PERFUSION IMAGING $3,384.00 HC25000175 FB REMOVAL SQ SIMPLE $3,376.00 HC46000832 SEL CATH PULMONARY ART LT $3,373.00 HC46000840 SEL CATH PULMONARY ART RT $3,373.00 HC41500042 CENTRAL MOTOR EVOKED UP LIMBS $3,364.00 HC79200036 MUSCLE TEST, FOUR LIMBS $3,362.00 HC74200437 OR TIME ADD'L 15MIN LVL 2 (MCAL 2ND SUBSQNT 0.5 HR) $3,362.00 HC74200072 OR TIME ADD'L 15MIN LVL 2 (MCAL 1ST SUBSQNT 0.5 HR) $3,362.00 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 HC44200186 US DUPLEX CAROTID COMP BILAT $3,359.00 HC44502136 TRANSHEP DIL BILI W/O-W STENT S&I ONLY $3,350.00 HC44001618 MYELOGRAM CERVICAL $3,346.00 HC33000373 ST-SWALLOWING EVAL 180MIN $3,341.00 0527-1948-68 LEVOFLOXACIN 250 MG/10 ML ORAL SOLN $3,338.40 HC62228853 TEMPLATE BRACHYTHERAPY Y $3,338.00 HC44500932 INJ SCLEROTHERAPY MULT VEINS-LT $3,331.00 HC44500940 INJ SCLEROTHERAPY MULT VEINS-RT $3,331.00 HC46000691 PERC PORTAL VEIN CATH $3,328.00 0074-3956-46 LOPINAVIR-RITONAVIR 400-100 MG/5 ML ORAL SOLN $3,328.00 HC62214457 SUTURE SET FOOT/ANKLE $3,325.00 HC62217831 CLOSURE WND EXPANDER TISSUE A $3,322.00 HC45200060 NM BONE MARROW WHOLE BODY $3,320.00 HC46000626 INTRO NDL/CATH EXT ART UE OR LE LT $3,319.00 HC46000634 INTRO NDL/CATH EXT ART UE OR LE RT $3,319.00 68546-325-12 GLATIRAMER 40 MG/ML SUBCUTANEOUS SYRG $3,316.95 HC21000575 PREP SITE F/N/HF/G EA +100SQCM $3,316.00 42023-182-01 ARGATROBAN 100 MG/ML IV SOLN $3,315.00 0143-9279-01 MITOMYCIN 20 MG IV SOLR $3,315.00 HC46503447 BX LYMPH NODE(S)SUPERFICIAL*DS DC'D PROC $3,312.00 HC46001095 INJ ARTHRO/CT/MRI SHOULDER-BIL $3,309.00 HC46502647 FNA ASP BX W/US; EACH ADD'L LESION $3,305.00 HC44501229 PLACE TUBE NASO/ORO-GASTRIC BY MD W/FLUORO $3,305.00 51525-0442-8 FELBAMATE 600 MG/5 ML ORAL SUSP $3,302.83 HC45201357 NM GASTRIC EMPTYING SMALL BOWEL $3,301.00 HC42000737 ECHO 2D LMTD W/O SPEC&DOP W/WO CONTR $3,300.00 HC46001103 INJ ARTHROGRAM ELBOW-SC BIL $3,300.00 HC46000543 INTRO CATH RT HEART/PUL ART $3,291.00 99999-042-06 AMNIOBAND MEMBRANE (3X4 CM) $3,290.63 HC21000401 EXCISION OF NAIL/MATRIX PERM $3,290.00 HC44200053 ART STDY BILAT U/L 3/> LVL CMP $3,285.00 HC45200227 NM CARDIAC BP SPECT REST WM/EF $3,285.00 0026-3782-25 KOGENATE FS 250 (+/-) UNIT IV SOLR $3,282.50 0597-0024-02 IPRATROPIUM-ALBUTEROL 20-100 MCG/ACTUATION INHALATION MIST $3,276.13 HC12200259 INITIATE PROLONG THERA INFUSION VIA PUMP $3,276.00 10019-075-87 ESMOLOL IN NACL (ISO-OSM) 2,000 MG/100 ML IV SOLP $3,275.35 67871-4790-6 ETHANOLAMINE OLEATE 5 % IV SOLN $3,275.35 0409-0201-20 DOCETAXEL 160 MG/16 ML (10 MG/ML) IV SOLN $3,272.36 HC44701233 INSTILL FIBRIN CT INIT' DAY LT $3,269.00 HC44701217 INSTILL FIBRIN CT INIT' DAY RT $3,269.00 HC45200508 NM LIVER/SPLEEN IMAGING STATIC $3,267.00 70710-1530-1 DOXORUBICIN, PEG-LIPOSOMAL 2 MG/ML IV SUSP $3,262.61 HC44200103 US DUPLEX ABD/PEL FLOW COMP $3,261.00 HC36800134 BRONCHIAL PROVOCATION EVAL $3,259.00 HC46000436 INJ VENOGRAM EXTREMITY- BILAT $3,259.00 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 HC47200688 TREATMENT SIMULATION INTERMED $3,254.00 59148-070-91 BUSULFAN 60 MG/10 ML IV SOLN $3,250.00 71288-129-02 DACTINOMYCIN 0.5 MG IV SOLN (MCH) $3,250.00 42658-008-01 DACTINOMYCIN 0.5 MG IV SOLN (MCH) $3,250.00 63323-715-01 FULVESTRANT 250 MG/5 ML IM SYRG $3,250.00 63323-715-05 FULVESTRANT 250 MG/5 ML IM SYRG $3,250.00 55513-670-01 INFLIXIMAB-AXXQ 100 MG IV SOLR $3,250.00 67457-195-01 MELPHALAN HCL 50 MG IV SOLR $3,250.00 55150-382-01 PEMETREXED DISODIUM 500 MG IV SOLR $3,250.00 62135-502-47 HYDROXYZINE HCL 10 MG/5 ML ORAL SOLN $3,249.75 62135-750-47 HYDROXYZINE HCL 10 MG/5 ML ORAL SOLN $3,249.75 62135-813-47 NYSTATIN 100,000 UNIT/ML ORAL SUSP $3,249.75 HC41500034 CENTRAL MOTOR EVOKED LOW LIMBS $3,246.00 68547-211-20 SULBACTAM SODIUM 1 GRAM IV SOLN $3,243.50 68547-111-10 SULBACTAM-DURLOBACTAM 1 GRAM-1 GRAM (0.5 GRAM X 2) IV SOLR $3,243.50 HC25005620 DRAIN EXTERNAL EAR LESION COMPLEX LT $3,242.00 HC25005612 DRAIN EXTERNAL EAR LESION COMPLEX RT $3,242.00 HC25005604 DRAIN EXTERNAL EAR LESION SIMPLE BIL $3,242.00 HC62209143 BLANKET TEMP MNGMNT SYSTEM/BOX $3,241.00 HC77400067 ANESTHESIA INITIAL HR $3,234.00 HC21000468 I&D ABSCESS SIMPLE SNGL $3,230.00 63323-379-05 OCTREOTIDE ACETATE 1,000 MCG/ML INJ SOLN $3,229.72 HC43000157 MAMMO DUCTO/GALACTO INJ-LT $3,229.00 HC43000165 MAMMO DUCTO/GALACTO INJ-RT $3,229.00 HC41500174 EEG SLEEP(ONLY) $3,228.00 HC41500604 STUDIES NERVE CONDUCTN 9-10 STUDIES $3,226.00 HC44000628 ELBOW ARTHROGRAM BILAT $3,225.00 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 HC21000161 ASPIRATION OF ABCESS/CYST-ADDL $3,216.00 HC46000865 SEL CATH SEGMNT PULM ART LT $3,206.00 HC46000873 SEL CATH SEGMNT PULM ART RT $3,206.00 HC46001012 VENOUS CATH ORGAN BLD SIMPLE $3,205.00 HC27001189 M: UNLISTED PROCEDURE, ESOPH $3,202.00 HC25005935 PARACENTESIS EYE W/REMOVAL AQUEOUS LT $3,201.00 HC25005943 PARACENTESIS EYE W/REMOVAL AQUEOUS RT $3,201.00 HC62229471 DEVICE REMOVAL TISSUE MYOSURE B $3,200.00 HC44701167 THROMBOLYSIS CORONARY IV INFUSION $3,199.00 HC62804018 FILTER VENA CAVA(DENLI-ECLPS-MERIDN) D $3,193.00 HC62208608 SYSTEM VEIN HARVESTING $3,189.00 HC42000190 ECHO FETAL CARDIOVASCULAR $3,187.00 HC25001082 INSERT CT(OPEN) W/DRAIN SYSTEM LT $3,186.00 HC44200590 TCD ICA EMBOLI DETECT W/O IV MICROBUBBL $3,186.00 HC25001090 INSERT CT(OPEN) W/DRAIN SYSTEM RT $3,185.00 HC62803713 KIT CATH HEMO DIAL SHORT TERM V $3,185.00 0944-3051-02 ADVATE 250 (+/-) UNIT IV SOLR $3,185.00 0944-3051-03 ADVATE 250 (+/-) UNIT IV SOLR $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 69452-237-46 ENALAPRIL MALEATE 1 MG/ML ORAL SOLN $3,183.38 0078-0357-52 OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSP $3,183.38 55566-8303-1 DEGARELIX 80 MG SUBCUTANEOUS SOLR $3,174.93 HC25002866 DEBRIDE/REMOVL OPEN FX SKIN/SBQ $3,174.00 HC41500810 EEG W/O VID MONITOR INTERMT EA 12-26HR $3,170.00 HC38420006 REMOVAL IABP DEVICE; PERC $3,167.00 0575-6200-30 DIAZOXIDE 50 MG/ML ORAL SUSP $3,162.90 58181-3041-5 LOMUSTINE 40 MG ORAL CAP (MCH) $3,158.65 HC51010866 THORACENTESIS W/TUBE W/IMAGING $3,156.00 58394-102-06 BENEFIX 500 UNIT IV SOLR $3,152.50 HC21000690 APPLY MULTILAY COMPRS BK BIL $3,150.00 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 HC46500054 ASP PERC SPINAL CORD CYST $3,135.00 67877-636-33 TOLVAPTAN 30 MG ORAL TAB $3,123.41 67877-636-02 TOLVAPTAN 30 MG ORAL TAB $3,123.41 76310-024-25 FOSCARNET 24 MG/ML IV SOLN $3,120.00 76310-024-15 FOSCARNET 24 MG/ML IV SOLN $3,120.00 HC25000068 CRITICAL CARE EA ADDL 30 MIN $3,114.00 HC44200251 US DUPLEX VEIN EXT COMP BILAT $3,111.00 HC46500617 CHANGE CYSTOSTOMY TUBE; SIMPLE $3,108.00 HC25000894 ASP/INJ LARGE JOINT-BILAT $3,107.00 24208-535-35 GANCICLOVIR 0.15 % OPHT GEL $3,101.28 HC42000075 CV STRESS TEST PHARMACOLOGIC $3,099.00 0944-2850-03 IMMUN GLOB G(IGG)-GLY-IGA OV50 2 GRAM/10 ML (20 %) SUBCUTANEOUS SOLN $3,095.82 0944-2850-04 IMMUN GLOB G(IGG)-GLY-IGA OV50 2 GRAM/10 ML (20 %) SUBCUTANEOUS SOLN $3,095.82 HC21000914 APPLY MULTILAY COMPRS UPREX B $3,092.00 HC23000656 INJ ANES/STEROID NERVE FEMORAL LT $3,092.00 HC23000664 INJ ANES/STEROID NERVE FEMORAL RT $3,092.00 13533-335-12 IMMUNE GLOBULIN (HUMAN) (IGG) IM INJ (MCH) $3,090.04 13533-335-13 IMMUNE GLOBULIN (HUMAN) (IGG) IM INJ (MCH) $3,090.04 57894-160-01 INFLIXIMAB 100 MG IV SOLR $3,087.50 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 HC62804331 COIL EMBOLIZ(BARR PLAT DETACH) W $3,080.00 HC45200052 NM BONE MARROW MULTI AREA $3,078.00 25021-189-84 FOSCARNET 24 MG/ML IV SOLN $3,072.88 71740-112-30 POTASSIUM IODIDE 1 GRAM/ML ORAL SOLN $3,071.64 0078-0686-15 ELTROMBOPAG OLAMINE 50 MG ORAL TAB $3,068.71 0078-0686-55 ELTROMBOPAG OLAMINE 50 MG ORAL TAB $3,068.70 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 67457-217-20 METHADONE 10 MG/ML INJ SOLN $3,053.83 HC83000521 PLATELET HLA LR APHER/PHER $3,053.00 10019-956-01 CYCLOPHOSPHAMIDE 1 GRAM IV SOLR $3,051.62 10019-956-16 CYCLOPHOSPHAMIDE 1 GRAM IV SOLR $3,051.62 60505-4318-0 TOLVAPTAN 30 MG ORAL TAB $3,046.67 HC45200649 NM PARATHYROID PLANAR IMAG+SUBTR $3,045.00 HC45201167 RADIOLABEL MONONCLON ANTIBODY $3,045.00 0131-5410-72 LACOSAMIDE 10 MG/ML ORAL SOLN $3,044.60 HC46000253 INJ DISKOGRAM CS/TS EA LVL $3,033.00 HC25005349 HEMORRHOIDECTOMY/BANDING $3,031.00 55513-023-04 DARBEPOETIN ALFA IN POLYSORBAT 60 MCG/0.3 ML INJ SYRG $3,018.60 55513-023-01 DARBEPOETIN ALFA IN POLYSORBAT 60 MCG/0.3 ML INJ SYRG $3,018.60 55513-004-04 DARBEPOETIN ALFA IN POLYSORBAT 60 MCG/ML INJ SOLN $3,018.60 HC21000294 DEBRIDE P-THICK BURN LG>10%BSA $3,017.00 HC21000765 COMPARTM'L PRESSURE MEASURM'NT $3,013.00 HC26000117 POSTPARTUM CARE $3,012.00 HC47201033 TELETX ISODOSE W/ DOSIMETRY;SIMPLE $3,010.00 HC36000222 INTUBATION $3,009.00 HC43000611 PUNC ASP CYST BREAST EA ADD+LT $3,009.00 HC43000553 PUNC ASP CYST BREAST EA ADD+RT $3,009.00 HC43000322 PUNC CYST ASP BREAST ADD'L $3,009.00 HC51002657 I&D ABSCESS RECTAL $2,996.28 0046-0872-21 CONJUGATED ESTROGENS 0.625 MG/GRAM VAGINAL CREAM $2,995.59 HC45200078 NM BONE SCAN LTD AREA $2,994.00 HC62228135 ORTH EWHO W/NONTORSION JOINT(S) CUSTOM $2,993.00 HC23001688 INJ ANES/STEROID ILIOINGNL/ILIOHYPOGAS LT $2,991.00 HC23000797 INJ ANES/STEROID ILIOINGNL/ILIOHYPOGAS NERVE $2,991.00 HC23001670 INJ ANES/STEROID ILIOINGNL/ILIOHYPOGAS RT $2,991.00 HC24000093 HBO TX EA 1/2 HR COMPLEX/M $2,985.00 HC44002541 WRIST ARTHROGRAM BILAT $2,981.00 72266-101-01 DEXRAZOXANE HCL 500 MG IV SOLR $2,980.32 HC62228770 NEEDLE 22G SPIN FLEX®(ALWAYS-ON TIP TRACKED®) $2,977.00 HC23000466 INJ ANES/STEROID NERVE SUPRASCAP LT $2,976.00 HC23000474 INJ ANES/STEROID NERVE SUPRASCAP RT $2,976.00 HC26000190 L&D EVAL LEVEL V - COMPREHENSV $2,976.00 HC62211818 CATH ANGIO MICRO(DIAG/MARTHN/EXCLSR)Q $2,975.00 HC62228366 SHEATH/ACCESS TRANSSEPTAL (WATCHMAN) $2,975.00 HC62229224 TUBE ESOPH THERMAL REG DEV $2,975.00 HC25003245 LAC REPAIR INTMD F/E/E/N/L/MM 20.1-30.0CM $2,974.00 HC41500463 VISUAL EVOKED RESP CNS/FLASH $2,972.00 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 HC62803283 KIT MONITOR PRESSURE ICP $2,963.00 HC62223946 SYSTEM COLLECTION/TRANSFER FAT $2,961.00 16729-230-11 PEMETREXED DISODIUM 500 MG IV SOLR $2,960.49 HC82202300 ELECTRON MICROSCOPY REDUCE SVC $2,955.00 HC23001050 INJ(S);TRIGGER POINT 3/>MUSCLES $2,953.00 HC44200160 US DUPLEX ART UP EXT COMP BIL $2,953.00 HC83506170 NEOTYPE COMP MYELOID DISORDERS-NG $2,950.00 HC44200038 US ART NONINVAS REST/STRES LEA $2,950.00 HC83000554 PLATELETPHER LR IRRAD EA UNIT $2,947.00 HC25005794 CLOSED TX ANKLE FX W/MANIP BIL $2,946.00 HC25004029 DRAIN ABSCESS FINGER COMPLEX $2,946.00 HC45200722 NM RADIONUCLIDE VOIDING CYSTO $2,943.00 66689-307-08 MYCOPHENOLATE MOFETIL 200 MG/ML ORAL SUSR $2,941.12 23155-848-51 MYCOPHENOLATE MOFETIL 200 MG/ML ORAL SUSR $2,941.12 HC62224571 DEVICE SUTURE ENDOSCOPIC O $2,940.00 62935-753-75 LEUPROLIDE 7.5 MG (1 MONTH) SUBCUTANEOUS SYRG $2,935.99 62935-756-80 LEUPROLIDE 7.5 MG (1 MONTH) SUBCUTANEOUS SYRG $2,935.99 42023-104-05 TUBERCULIN PPD 5 TUB. UNIT /0.1 ML INTRADERMAL SOLN $2,931.37 49281-752-22 TUBERCULIN PPD 5 TUB. UNIT /0.1 ML INTRADERMAL SOLN $2,931.37 49281-752-98 TUBERCULIN PPD 5 TUB. UNIT /0.1 ML INTRADERMAL SOLN $2,931.37 HC25002734 CHANGE GT TUBE W/REV TRACT W/O IMAGE ENDO INCL REMVL $2,931.00 62559-153-04 OPIUM TINCTURE 10 MG/ML (MORPHINE) ORAL TINC $2,925.34 99999-042-05 AMNIOBAND MEMBRANE (2X4 CM) $2,925.00 43598-283-35 DOXORUBICIN, PEG-LIPOSOMAL 2 MG/ML IV SUSP $2,925.00 47335-049-40 DOXORUBICIN, PEG-LIPOSOMAL 2 MG/ML IV SUSP $2,925.00 43598-682-35 DOXORUBICIN, PEG-LIPOSOMAL 2 MG/ML IV SUSP $2,925.00 70748-339-01 DOXORUBICIN, PEG-LIPOSOMAL 2 MG/ML IV SUSP $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 55150-478-01 LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS SOLN (MCH) $2,925.00 71288-138-50 MITOMYCIN 20 MG IV SOLR $2,925.00 HC32000127 OT-EVAL SWALLOW CINE/FLUORO 90MIN $2,922.00 HC33000191 ST-EVAL SWALLOW CINE/FLUORO 90MIN $2,922.00 HC31002140 PT-APPLIC CAST SHORT LEG WALK BILAT $2,915.00 HC12400123 CHEMO ADMIN PLEURAL CAV W/THORACENTESIS $2,914.00 HC42000067 CV STRESS TEST TREADMILL $2,912.00 HC42000091 ECHO CONGENITAL LTD OR F/U $2,912.00 99999-038-92 POLIHEXANIDE (PURAPLY AM) 2X4 CM EACH TOPICAL SHEET $2,912.00 HC47201165 BRACHYTX INSERT VAG RAD AFTRLOAD DEVICE $2,910.00 HC62802897 SEALANT PULMONARY (PROGEL) $2,905.00 HC62228978 ORTHOSIS LUMBAR SACRAL SAGCOR RIGID ANT/POST FRAME/PANEL PREFB CUST $2,904.00 HC47201108 GUIDANCE RADIAJ TX DLVR (TRACKING) $2,903.00 HC44701241 INSTILL FIBRIN CT SUB' DAY LT $2,897.00 HC44701225 INSTILL FIBRIN CT SUB' DAY RT $2,897.00 63323-371-10 DAPTOMYCIN 500 MG IV SOLR $2,895.62 HC62205703 PINS CRW HEAD DISP $2,895.00 HC45200896 NM THYROID CA METS LTD AREA $2,893.00 HC23000003 ANALYSIS IMPLANTED PUMP W/PROG $2,891.00 HC25001215 THORACENTESIS W/TUBE W/O IMAG LT $2,891.00 HC25001223 THORACENTESIS W/TUBE W/O IMAG RT $2,891.00 51167-661-01 TEZACAFTOR-IVACAFTOR 100-150 MG (D)/ 150 MG (N) ORAL TBSQ $2,888.31 51167-113-01 TEZACAFTOR-IVACAFTOR 50-75 MG (D)/ 75 MG (N) ORAL TBSQ $2,888.31 HC62228390 SHEATH TRANSSEPTAL GUIDE KIT(WATCHMAN) $2,888.00 60505-0402-5 PAROXETINE HCL 10 MG/5 ML ORAL SUSP $2,882.75 HC36800290 PNEUMOGRAM 12-24HR REC INFANT $2,882.00 HC31002157 PT-APPLIC CAST LONG LEG BILAT $2,882.00 HC44000008 3D RENDER W/ INDEPNDNT WORKSTN $2,873.00 HC45200490 NM LIVER IMAGING W/VASC FLOW $2,870.00 HC44900355 CT LTD OR LOCALIZED F/U STUDY $2,869.00 HC36000958 BRONCH THERAPEUTIC DC'D PROC $2,868.00 HC36800084 BRONCH THERAPEUTIC DC'D PROC $2,868.00 HC36800514 BRONCH THERAPEUTIC DC'D PROC $2,868.00 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 HC44500957 INJ SCLEROTHERAPY SNGL VEIN-LT $2,862.00 HC44500965 INJ SCLEROTHERAPY SNGL VEIN-RT $2,862.00 HC62208905 BALLOON VALVULOPLASTY $2,861.00 HC32000481 OT-SWALLOWING EVAL 120MIN $2,859.00 49281-860-10 POLIOVIRUS VACCINE 40-8-32 UNIT/0.5 ML INJ SUSP $2,858.83 49281-860-78 POLIOVIRUS VACCINE 40-8-32 UNIT/0.5 ML INJ SUSP $2,858.83 HC45401072 MR BREAST W/O&W CONTRAST LTD LT $2,855.00 HC45401064 MR BREAST W/O&W CONTRAST LTD RT $2,855.00 61314-326-01 FILGRASTIM-SNDZ 480 MCG/0.8 ML INJ SYRG $2,853.37 61314-326-05 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 HC44900090 CT CHEST/LUNG LOW DOSE SCREENING $2,853.00 HC44500809 ERCP BILIARY&PANCREATIC SYSTEM S&I ONLY $2,853.00 HC62807813 M: LINER SHOULDER $2,849.00 HC45401569 MR ELASTOGRAPHY $2,849.00 HC45201415 NM MYOCARDIAL SYMPATHETIC INNERV IMAGE $2,848.00 HC45200151 NM BRAIN IMAG VASC FLOW ONLY $2,847.00 HC36000941 BRONCH DIAGNOSTIC DC'D PROC $2,846.00 HC36800050 BRONCH DIAGNOSTIC DC'D PROC $2,846.00 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 HC23000375 INJ ANES/STEROID NERVE AXILLARY LT $2,842.00 HC23000383 INJ ANES/STEROID NERVE AXILLARY RT $2,842.00 HC25001181 THORACENTESIS ASP W/O IMG GUID-LT $2,838.00 HC25001199 THORACENTESIS ASP W/O IMG GUID-RT $2,838.00 0944-2700-09 IMMUN GLOB G(IGG)-GLY-IGA OV50 10 % INJ SOLN $2,837.41 0944-2700-03 IMMUN GLOB G(IGG)-GLY-IGA OV50 10 % INJ SOLN $2,837.41 HC38420352 ASSEMBLY & OPER PUMP OXYGEN; 30MIN $2,837.00 99999-038-96 POLIHEXANIDE (PURAPLY) 2X4 CM EACH TOPICAL SHEET $2,834.00 72603-425-01 PEMETREXED DISODIUM 500 MG IV SOLR $2,832.64 HC62220421 KNIFE ANNULOTOMY (MAXCESS) $2,832.00 58394-633-03 BENEFIX 250 UNIT IV SOLR $2,827.50 63323-140-10 CLADRIBINE 1 MG/ML IV SOLN (MCH) $2,827.50 0955-1021-04 DOCETAXEL 80 MG/4 ML (20 MG/ML) IV SOLN $2,827.50 HC47200530 RAD TREATMENT DELVR, = 1MEV;CMPLX $2,827.00 HC41500067 DBS CORTICAL MAP INITIAL HR $2,826.00 HC41500596 STUDIES NERVE CONDUCTN 7-8 STUDIES $2,826.00 50632-010-01 RABIES VACCINE, PCEC (PF) 2.5 UNIT IM SUSR $2,824.97 50632-013-01 RABIES VACCINE, PCEC (PF) 2.5 UNIT IM SUSR $2,824.97 HC44504512 PERC PLCMT TISS SOFT DEV ADDL LESN+ $2,824.00 HC44200996 US OB EVAL PLUS FETAL ANATOMIC DETAIL 1ST GEST $2,823.00 HC45200813 NM TESTICULAR IMAGING W/FLOW $2,819.00 HC46503405 PERC PLC BRST LOC DEV MAMMO 1ST LESN DC'D PROC $2,813.00 46287-020-04 SPIRONOLACTONE 25 MG/5 ML ORAL SUSP $2,809.52 HC74200064 OR TIME ADD'L 15MIN LVL 1 (MCAL 1ST SUBSQNT 0.5 HR) $2,807.00 HC62200233 ASPIRATOR ULTRASONIC SURG E $2,800.00 HC62200498 BIO GLUE W/APPLICATOR $2,800.00 HC62208731 CATH BALLOON SINUPLASTY J $2,800.00 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 HC41500208 EMG 2 EXTREMITY $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 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 HC45200656 NM PERITON VEN SHUNT PATENCY $2,795.00 HC74200296 BEDSIDE/OTHER SURG ADD'L 15MIN 6 (MCAL 1ST SUBSQNT 0.5 HR) $2,791.00 HC74200536 BEDSIDE/OTHER SURG ADD'L 15MIN 6 (MCAL 2ND SUBSQNT 0.5 HR) $2,791.00 HC25000084 ASPIRATION OF BLADDER TROCAR $2,789.00 HC36001188 BRONCH W/COMPTR-ASST IMAGE-GUIDE NAVIGATE+ $2,787.00 HC36800894 BRONCH W/COMPTR-ASST IMAGE-GUIDE NAVIGATE+ $2,787.00 HC62802822 PROGRAMMER IDD TX (CONTROL) $2,783.00 2576773549 CARDIOPLEG-ORGAN PRESERV NO.1 9 MMOL-198 MMOL -2 MMOL/L PERF SOLN $2,782.00 HC27001262 GASTRIC INTUB ASP DX;MULT SPEC $2,781.00 HC45200326 NM GASTRIC REFLUX STUDY $2,781.00 51991-002-98 METHADONE 10 MG/ML INJ SOLN $2,778.75 HC44200301 US GUIDANCE INTRAOPERATIVE $2,772.00 HC74200429 OR TIME ADD'L 15MIN LVL 1 (MCAL 2ND SUBSQNT 0.5 HR) $2,771.00 HC46001335 INJ CONTRAST KNEE ARTHRO/CT/MRI $2,769.00 HC78600004 PACU I 1ST HOUR (INITIAL) $2,768.00 HC25003609 REMOVE FB UPPER ARM/ELBOW SQ LT $2,767.00 HC25003617 REMOVE FB UPPER ARM/ELBOW SQ RT $2,767.00 HC45200961 NM TUMOR LOCALIZE PLNR SGL AREA 1 DAY $2,757.00 HC33000365 ST-SWALLOWING EVAL 120MIN $2,757.00 0173-0521-00 SALMETEROL 50 MCG/DOSE INHALATION DSDV $2,752.62 39822-0151-1 LIOTHYRONINE 10 MCG/ML IV SOLN $2,749.50 HC45200250 NM CARDIAC SCAN W/EF 1ST PASS $2,745.00 HC44000107 ANKLE ARTHROGRAM BILAT $2,737.00 HC23001043 INJ(S);TRIGGER POINT 1-2MUSCLES $2,735.00 HC41500109 EEG AWAKE AND DROWSY $2,729.00 68094-101-20 PHENTOLAMINE 5 MG INJ SOLR $2,728.70 52652-8001-1 ZONISAMIDE 100 MG/5 ML ORAL SUSP $2,727.08 HC46000683 INJECT PROC SENTINEL NODE W/ RADIOACTIVE TRACER $2,718.00 HC46001343 INJECT PROC SENTINEL NODE W/ NON-RADIOACTIVE TRACER $2,714.00 HC44500866 GUIDE PERC DRAIN W/CATH PLCMNT S&I ONLY $2,713.00 HC62805130 M:IMPLANT UROLIFT TIE-BACK (EACH) $2,713.00 HC23000086 ASP/INJ JOINT MED W/O UTZ GUIDE-RT $2,711.00 HC23000078 ASP/INJ JOINT MED W/O UTZ GUIDE-LT $2,707.00 HC21000591 DEBRIDE OPN WND 1ST 20SQCM OR< $2,703.00 HC62804000 FILTER VENA CAVA (E.G.OPTEASE) C $2,702.00 HC89024319 GENOME SEQ ANALYS EA COMPARATOR+-RC $2,700.00 0456-2700-10 CEFTAZIDIME-AVIBACTAM 2.5 GRAM IV SOLR $2,699.87 0456-2700-01 CEFTAZIDIME-AVIBACTAM 2.5 GRAM IV SOLR $2,699.87 0074-7269-50 CYCLOSPORINE MODIFIED 100 MG/ML ORAL SOLN $2,698.15 HC45200482 NM LIVER IMAGING STATIC ONLY $2,691.00 HC73000176 HEMOPERFUSION DRY RUN $2,686.00 HC21000286 DEBRIDE P-THICK BURN 5-10% BSA $2,684.00 HC26000109 INSERTION CERVICAL DILATOR $2,683.00 HC44500791 ERCP BILIARY DUCT SYSTEM S&I ONLY $2,681.00 HC25003237 LAC REPAIR INTMD F/E/E/N/L/MM 12.6-20CM $2,676.00 65162-686-90 FELBAMATE 600 MG/5 ML ORAL SUSP $2,674.82 81298-7500-1 METHADONE 10 MG/ML INJ SOLN $2,665.00 HC25004235 CLOSED TX HIP DISLOC POST ARTHROPLASTY BIL $2,664.00 HC25004326 CLOSED TX KNEE DISLOC; NO ANESTH BIL $2,664.00 0409-1902-01 PROCAINAMIDE 100 MG/ML INJ SOLN $2,663.90 0409-1902-11 PROCAINAMIDE 100 MG/ML INJ SOLN $2,663.90 HC45201266 QUANT DIFF PULM PERF $2,663.00 HC45201241 PULM VENTILATION IMAGING $2,662.00 HC25005760 CLOSED TX FIBULA DISTAL FX W/MANIP BIL $2,661.00 HC62210752 CATH ACCESS DUODENOSCOPE $2,660.00 HC62804307 COIL EMBOLIZATION T $2,660.00 HC45200169 NM BRAIN IMAGING 4< STATIC VWS $2,656.00 HC74200304 BEDSIDE/OTHER SURGICAL CANCEL LVL 1 $2,654.00 HC25003179 LAC REPAIR INTMD N/H/F/GEN 20.1-30 $2,653.00 HC45200235 NM CARDIAC SCAN $2,653.00 HC25005224 REMOVE FB VESTIBULE MOUTH; SIMPLE $2,653.00 63323-132-10 MITOXANTRONE 2 MG/ML IV CONC $2,649.79 0173-0859-10 FLUTICASONE FUROATE-VILANTEROL 100-25 MCG/DOSE INHALATION DSDV $2,646.93 HC21001086 WOUND VAC TX W/ DISP ASST/INSTR >50SQ CM SESSION $2,645.00 HC44500726 PERC DIL URETER/URETHRA S&I-LT $2,644.00 HC44500734 PERC DIL URETER/URETHRA S&I-RT $2,644.00 HC74200411 OR TIME ADD'L 15MIN CASE CX 6 (MCAL 1ST SUBSQNT 0.5 HR) $2,642.00 HC74200635 OR TIME ADD'L 15MIN CASE CX 6 (MCAL 2ND SUBSQNT 0.5 HR) $2,642.00 HC21000781 APPY SKIN SUB T,A,L EA +25SQ~HC $2,640.00 HC51060580 DESTROY MUSCLE(S) LARYNX BI $2,639.76 HC73000127 HEMODIALYSIS W/SNGL EVAL(IP) $2,638.00 HC45201316 NM THYROID SCAN IMAGE ONLY [W/VASC FLOW IF PERF] $2,638.00 HC25003542 CLOSED TX HUMRL FX W/MAN W/WO SKLTL TRAC LT $2,633.00 HC25003559 CLOSED TX HUMRL FX W/MAN W/WO SKLTL TRAC RT $2,633.00 HC25005190 REPAIR LIP FULL THICK; TO HALF VERTICAL HT $2,631.00 HC25000225 TRACHEOSTOMY $2,631.00 HC45200383 NM INTRAVASCULAR RAD TX $2,630.00 HC23000557 INJ CERVICAL PLEXUS BLOCK $2,629.00 HC23001597 INJ CERVICAL PLEXUS BLOCK LT $2,629.00 HC23001589 INJ CERVICAL PLEXUS BLOCK RT $2,629.00 HC62807433 POLYMER FILLER RING GRAFT/STENT $2,625.00 HC62203906 SYSTEM HEMOSTAT(NEXPOWDER) $2,625.00 HC25000654 LUMBAR PUNCTURE DX [NOT W/ CT OR FLUORO] $2,622.00 99999-042-04 AMNIOBAND MEMBRANE (2X2 CM) $2,620.31 HC83000562 PLATELETPHER LR/CMV-/IRRAD/U $2,619.00 HC62225024 SET REMOVAL NUCLEUS SPINAL $2,618.00 HC79200028 MUSCLE TEST, THREE LIMBS $2,612.00 HC62802764 ADAPT/EXT PACING LEAD SPX $2,611.00 HC26000083 FETAL CONTRACTION STRESS TEST $2,606.00 HC62228127 ORTH EWHO RIGID W/O JOINTS CUSTOM $2,604.00 HC62209259 SYSTEM ANASTOMOSIS DEVICE $2,604.00 69452-252-87 ATOVAQUONE 750 MG/5 ML ORAL SUSP $2,600.33 68462-421-21 ATOVAQUONE 750 MG/5 ML ORAL SUSP $2,600.33 0121-0956-08 ATOVAQUONE 750 MG/5 ML ORAL SUSP $2,600.33 64980-447-15 CALCITRIOL 1 MCG/ML ORAL SOLN $2,600.03 HC73000044 DIALYSIS CCPD W/SNGL EVAL(IP) $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 63459-912-11 TBO-FILGRASTIM 480 MCG/0.8 ML SUBCUTANEOUS SYRG $2,599.29 63459-912-12 TBO-FILGRASTIM 480 MCG/0.8 ML SUBCUTANEOUS SYRG $2,599.29 HC41500232 EMG FACIAL BILAT $2,599.00 HC25003294 LAC REPAIR CMPLX S/A/L 2.6-7.5 CM $2,599.00 HC41500935 AUDITORY EVOKED AEP NEURODIAGNOSTIC W/I&R $2,598.00 HC41500927 AUDITORY EVOKED AEP THRESHOLD EST MULT FREQ W/I&R $2,598.00 HC25000936 CHANGE GT TUBE W/O IMAGE/ENDO $2,598.00 HC74200288 BEDSIDE/OTHER SURG ADD'L 15MIN 5 (MCAL 1ST SUBSQNT 0.5 HR) $2,597.00 HC74200528 BEDSIDE/OTHER SURG ADD'L 15MIN 5 (MCAL 2ND SUBSQNT 0.5 HR) $2,597.00 HC62220702 KIT ACCESSORY PROSTHESIS PENILE $2,597.00 72611-716-01 DEXRAZOXANE HCL 500 MG IV SOLR $2,593.50 65250-266-20 BUPIVACAINE LIPOSOME (PF) 1.3 % (13.3 MG/ML) LINF SUSP $2,591.42 65250-266-04 BUPIVACAINE LIPOSOME (PF) 1.3 % (13.3 MG/ML) LINF SUSP $2,591.42 HC62226105 DRILL/DRILL BITS SINGLE USE AJ $2,590.00 HC51002756 ASPIRATION OF BLADDER TROCAR $2,585.38 HC51010528 TEST ALLERGY PATCH $2,585.38 HC51010452 TESTS PERCUTANEOUS ALLERGY $2,585.38 HC62803879 STENT CORO BARE METAL W/DEL D $2,581.00 HC45200391 NM KIDNEY IMAGING MORPHOLOGY $2,580.00 HC32000473 OT-SWALLOWING EVAL 90MIN $2,576.00 HC25005216 DRAIN ABSCESS/LESION MOUTH; SIMPLE $2,575.00 0268-0247-05 HISTAMINE PHOSPHATE 1 (2.75) MG/ML PERCUTANEOUS SOLN $2,574.00 63323-659-09 INDOMETHACIN SODIUM 1 MG IV SOLR $2,574.00 67457-316-25 DECITABINE 50 MG IV SOLR $2,567.50 69918-901-10 DESMOPRESSIN 4 MCG/ML INJ SOLN $2,567.50 83634-451-10 DESMOPRESSIN 4 MCG/ML INJ SOLN $2,567.50 HC23001720 N BLOCK INJ PLANTAR DIGIT (MOTONS) LT $2,565.00 HC23001738 N BLOCK INJ PLANTAR DIGIT (MOTONS) RT $2,565.00 0469-0420-01 ISAVUCONAZONIUM SULFATE 372 MG IV SOLR $2,563.47 69238-2027-8 SPIRONOLACTONE 25 MG/5 ML ORAL SUSP $2,561.78 HC62803994 FILTER VENA CAVA (E.G.TRAPEASE) B $2,555.00 HC62212832 GUIDEWIRE AA $2,555.00 0597-0138-30 AFATINIB 40 MG ORAL TAB $2,554.88 HC27000850 ESOPH RFLUX W/PH ELECTR DISCTD $2,550.00 HC25005844 REMOVE CATH CV TUNNELED W/O PORT/PUMP $2,550.00 HC45200755 NM SALIVARY GLAND W/SER IMAG $2,549.00 HC27001965 ESOPHAG REFLUX W/NASAL ELEC>1H DISCON'D $2,548.00 HC46000774 SEL CATH AB/PEL/LOEX 2ND+ORD LT $2,548.00 HC46000782 SEL CATH AB/PEL/LOEX 2ND+ORD RT $2,548.00 HC46001087 SEL CATH AB/PEL/LOEX2ND+ORDERT $2,548.00 HC33000357 ST-SWALLOWING EVAL 90MIN $2,548.00 0517-6560-01 SELENIUM 60 MCG/ML IV SOLN $2,544.30 0517-6560-05 SELENIUM 60 MCG/ML IV SOLN $2,544.30 HC51060978 INJ ANTEGRAD NEPH/URET'GRM,S&I EXIST ACCESS BI $2,544.27 HC51061000 REMOVE NEPHROSTOMY TUBE BIL $2,544.27 HC45201001 NM VASCULAR BLOOD FLOW $2,541.00 HC42000141 ECHO 2D LMTD W/O SPEC&CLR /DOP $2,538.00 HC25003344 LAC REPAIR CMPLX E/N/E/L 2.6-7.5 CM $2,530.00 HC25003229 LAC REPAIR INTMD F/E/E/N/L/MM 7.6-12.5CM $2,530.00 HC36800852 TEST EXERC BRONCHOSPASM INCL SPIR&POX W/O ECG $2,527.00 HC62800313 CATH EP DX <20 ELECTRODES N $2,520.00 HC62800420 CATH IVUS PV SMALL VESSEL $2,520.00 HC62804299 COIL EMBOLIZATION S $2,520.00 HC62218490 ENDO STAPLER AJ $2,520.00 HC25000951 INCISION EXTERNAL HEMORRHOID $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 HC27000843 ESOPH RFLUX PH STDY-LNG DISCTD $2,518.00 HC24000101 HBO TX EA 1/2 HR INTERMEDIAT/M $2,518.00 HC25005000 APPLY CAST LONG LEG BILATERAL $2,512.00 HC21000484 I&D POLINIDAL CYST: SIMPLE $2,510.00 HC45401015 MR BREAST W/O CONTRAST LTD LT $2,506.00 HC45401007 MR BREAST W/O CONTRAST LTD RT $2,506.00 HC62808746 CATH INDIGO THROMB SEPARATOR L190CM[PENUMBRA] $2,504.00 HC62228788 KIT SPIN PERC®(ALWAYS-ON TIP TRACKED®) $2,504.00 HC44200004 US ABDOMEN $2,503.00 HC44000230 BONE SURVEY COMPLETE $2,501.00 HC62211180 RETRACTOR HEART POSITIONER $2,501.00 HC51071074 EGD W/BIOPSY(S) ~FO $2,500.00 HC12400115 INITIATE PROLONG CHEMO INFUSION PORTBL PUMP &F/U VISIT $2,499.00 HC25000027 ED LEVEL III - INTERMEDIATE $2,498.00 HC46503413 PERC PLC BRST LOC DEV US 1ST LESN DC'D PROC $2,496.00 HC44500916 INJ PERC EXT PSEUDOANEUR LT $2,495.00 HC44500924 INJ PERC EXT PSEUDOANEUR RT $2,495.00 HC38420071 PERFUSION CARDIOASSIST DC'D PROC $2,495.00 HC73000002 DIALYSIS CAPD W/SNGL EVAL(IP) $2,493.00 HC45200375 NM INTRACAV RADIOAC COLLOID TX $2,492.00 HC46502753 BIOPSY INCISIONAL SKIN; SINGLE INITIAL LESION $2,489.00 65628-272-10 OMEPRAZOLE-SODIUM BICARBONATE 2-84 MG/ML ORAL SUSR $2,480.40 65628-270-10 OMEPRAZOLE-SODIUM BICARBONATE 2-84 MG/ML ORAL SUSR $2,480.40 HC25005034 APPLY CAST SHORT LEG BILATERAL $2,476.00 HC41500802 EEG W/O VID UNMONITOR EA 12-26HR $2,475.00 HC45200318 NM GASTRIC MUCOSA IMAGING $2,475.00 3877905519 SODIUM BENZOATE (BULK) MISC POWD $2,470.00 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 67877-882-71 RIVAROXABAN 1 MG/ML ORAL SUSR $2,463.34 HC32001794 OT-ENDOSCOPIC EVAL SWALLOW $2,462.00 HC33000159 ST-ENDOSCOPIC EVAL SWALLOW $2,462.00 HC45200292 NM ESOPHAGEAL MOTILITY $2,461.00 HC46500906 FNA ASP BX W/O GUIDE; FIRST LESION $2,460.00 HC82202524 FNA ASP BX W/O GUIDE; FIRST LESION $2,460.00 HC36800217 HIGH ALTD SIM TEST W/O2TI-HAST $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 0046-0749-05 CONJUGATED ESTROGENS 25 MG INJ SOLR $2,449.72 24338-132-13 ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL SUSP (MCH) $2,445.30 24338-134-02 ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL SUSP (MCH) $2,445.30 HC38000261 APPLY BODY CAST; FULL ADULT $2,442.00 70121-1463-2 FULVESTRANT 250 MG/5 ML IM SYRG $2,437.50 69452-223-84 RUFINAMIDE 40 MG/ML ORAL SUSP $2,436.85 68180-797-01 RUFINAMIDE 40 MG/ML ORAL SUSP $2,436.85 59651-563-60 RUFINAMIDE 40 MG/ML ORAL SUSP $2,436.85 HC62209358 APPLIER PORT RAPIDPORT EZ $2,432.00 HC44505097 PERC PLCMT TISS SOFT DEV 1ST LESN DC'D PROC $2,432.00 0574-1133-04 SPIRONOLACTONE 25 MG/5 ML ORAL SUSP $2,430.62 HC44200129 US DUPLEX AORTA,IVC,ILIAC COMP $2,430.00 HC23000334 INJ ANES/STEROID NERVE OCCIPITAL GREAT $2,429.00 HC23001563 INJ ANES/STEROID NERVE OCCIPITL GREAT LT $2,429.00 HC23001555 INJ ANES/STEROID NERVE OCCIPITL GREAT RT $2,429.00 HC41500141 EEG MONITORING 41-60MINUTES $2,427.00 HC41500588 STUDIES NERVE CONDUCTN 5-6 STUDIES $2,426.00 HC25004888 APPLY CAST; SHOULDER TO HAND (LONG ARM) BILAT $2,418.00 HC25000191 INSERT NEEDLE INTRAOSSEOUS INF $2,418.00 13533-800-15 IMMUNE GLOBUL G-GLY-IGA AVG 46 2.5 GRAM/25 ML (10 %) INJ SOLN $2,417.03 13533-800-16 IMMUNE GLOBUL G-GLY-IGA AVG 46 2.5 GRAM/25 ML (10 %) INJ SOLN $2,417.03 HC62219167 CATH ATRIOSEPTISTOTOMY $2,415.00 HC28000156 EXTERNAL COUNTERPULSATION/TX $2,412.00 HC25001512 PARACENTESIS ABD W/ IMAGING $2,412.00 11994-011-01 PERFLUTREN LIPID MICROSPHERES 1.1 MG/ML IV SUSP $2,409.89 11994-011-04 PERFLUTREN LIPID MICROSPHERES 1.1 MG/ML IV SUSP $2,409.89 10019-939-50 CYCLOPHOSPHAMIDE 1 GRAM IV SOLR $2,405.00 10019-939-01 CYCLOPHOSPHAMIDE 1 GRAM IV SOLR $2,405.00 HC74200270 BEDSIDE/OTHER SURG ADD'L 15MIN 4 (MCAL 1ST SUBSQNT 0.5 HR) $2,404.00 HC74200510 BEDSIDE/OTHER SURG ADD'L 15MIN 4 (MCAL 2ND SUBSQNT 0.5 HR) $2,404.00 HC62208814 CATH PACING TRANSESOPHAGEAL $2,404.00 HC41500786 EEG W/O VID MONITOR INTERMIT 2-12HR $2,403.00 HC25005679 ASP/INJ JOINT/BURSA MAJOR W/US-BIL $2,401.00 HC51071033 ESOPHSCPY TRANSNAS BIOPSY 1/MORE $2,400.00 60793-701-10 PENICILLIN G BENZATHINE 1,200,000 UNIT/2 ML IM SYRG $2,398.73 60793-701-02 PENICILLIN G BENZATHINE 1,200,000 UNIT/2 ML IM SYRG $2,398.73 HC73000168 HEMOPERFUSION $2,397.00 HC62208236 DRAIN PLEURAL W/VAC BOTTLE $2,394.00 HC46502621 INJECT URETEROGRAPH VIA ILEAL CONDUIT $2,394.00 HC25003278 LAC REPAIR CMPLX TRUNK 2.6-7.5 CM $2,394.00 0944-2724-03 HYALURONIDASE, HUMAN RECOMB. 2,400 UNIT/15 ML SUBCUTANEOUS SOLN $2,390.02 70954-319-10 PAROXETINE HCL 10 MG/5 ML ORAL SUSP $2,387.13 HC74200403 OR TIME ADD'L 15MIN CASE CX 5 (MCAL 1ST SUBSQNT 0.5 HR) $2,387.00 HC74200627 OR TIME ADD'L 15MIN CASE CX 5 (MCAL 2ND SUBSQNT 0.5 HR) $2,387.00 HC32000465 OT-SWALLOWING EVAL 75 MIN $2,383.00 HC51071025 ESOPHSCPY TRANSNAS DX BRSH/WASH $2,382.54 HC51002707 PARACENTESIS ABD W/IMAGING GUIDE $2,382.54 HC51002699 PARACENTESIS ABD W/O IMAGING GUIDE $2,382.54 HC46000287 INJ FOR CYSTOGRAM $2,382.00 HC25005737 CLOSED TX HIP FX W/MANIP BIL $2,381.00 HC25003328 LAC REPAIR CMPLX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM $2,381.00 70860-218-03 CYCLOPHOSPHAMIDE 200 MG/ML IV SOLN $2,380.63 50742-519-02 CYCLOPHOSPHAMIDE 200 MG/ML IV SOLN $2,380.63 75907-191-02 CYCLOPHOSPHAMIDE 200 MG/ML IV SOLN $2,380.63 10019-955-01 CYCLOPHOSPHAMIDE 500 MG IV SOLN (MCH) $2,380.63 10019-955-50 CYCLOPHOSPHAMIDE 500 MG IV SOLN (MCH) $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 HC62803861 STENT CORO BARE METAL W/DEL C $2,377.00 HC44704286 REPOSITION CONTRACT MODUL-DEFIB TV ELECTRODE/LEADS INCL PROGRAM FLUORO $2,375.00 HC46001046 INJ PERC EXT PSEUDOANEUR $2,371.00 HC38000279 APPLY BODY CAST; FULL CHILD $2,367.00 38779-0081-5 LIDOCAINE (BULK) MISC POWD $2,362.10 38779-0082-5 LIDOCAINE HCL (BULK) 100 % MISC POWD $2,362.10 HC25000860 ASP/INJ MED JOINT-BILAT $2,359.00 HC25004565 CLOSED TX ANKLE DISLOC; NO ANES BIL $2,357.00 HC25003286 LAC REPAIR CMPLX S/A/L 1.1-2.5 CM $2,357.00 HC25003211 LAC REPAIR INTMD F/E/E/N/L/MM 5.1-7.5CM $2,357.00 HC25003161 LAC REPAIR INTMD N/H/F/GEN 12.6-20 $2,357.00 HC25005182 REPAIR LIP FULL THICK; VERMILION ONLY $2,357.00 HC38420014 COLLECT AUTOLOGUS BLD INL' 2 HR $2,354.00 HC42000166 ECHO DOPPLER COMPLETE $2,353.00 HC25005513 REMOVE FB EXTRNL EYE; CONJUNCT EMBEDD BIL $2,353.00 69344-102-33 INDOMETHACIN 50 MG RECTAL SUPP $2,352.38 HC44200392 US OB >1ST TRI/1ST GEST $2,350.00 HC46001137 INJ ARTHROGRAM ANKLE-SC BIL $2,349.00 HC47200654 TREATMENT DEVICES INTERMEDIATE $2,347.00 HC62212816 GUIDEWIRE Y $2,345.00 HC33000340 ST-SWALLOWING EVAL 75MIN $2,345.00 HC62217385 DEVICE FIXATION TACKER(LAP) $2,343.00 HC23001407 INJ CER/THR F/IMAGE 3RD+&LVLLT LT $2,341.00 HC23001399 INJ CER/THR F/IMAGE 3RD+&LVLRT RT $2,341.00 HC25003062 CLOSURE SUPERFCL WOUND DEHISC W/PACKING $2,340.00 HC46000238 INJ CORPORA CAVERNOSOGRAM $2,337.00 HC25003336 LAC REPAIR CMPLX E/N/E/L 1.1-2.5 CM $2,337.00 HC21001078 WOUND VAC TX W/ DISP ASST/INSTR <50SQ CM SESSION $2,337.00 81665-301-02 COCAINE 4 % NASL SOLN $2,333.50 HC45200664 NM PLASMA VOL MULTI SAMPLE $2,333.00 HC25003567 CLOSED TX SHOULDR DSLC W/MAN W/O ANES-BIL $2,328.00 HC46500773 DEST CUTANEOUS VASCULAR LESION $2,328.00 HC44500692 CORPORA CAVERNOSGRAPHY $2,327.00 HC25006164 TRANSABDOMINAL AMNIOINFUSION $2,323.00 11994-011-16 PERFLUTREN LIPID MICROSPHERES 1.1 MG/ML IV SUSP $2,321.45 HC83000513 PLATELET PHERESIS EA UNIT $2,320.00 HC25003260 LAC REPAIR CMPLX TRUNK 1.1-2.5 CM $2,319.00 HC51003663 HEMORRHOIDECTOMY/BANDING $2,316.84 HC51003671 INJ SCLEROTHERAPY HEMORRHOIDS $2,316.84 HC44001345 IVP ROUTINE $2,316.00 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 HC83000547 PLATELET PHERESIS IRRD EA UNIT $2,313.00 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 HC36001063 SPIROMETRY W/PRE&POST BRONCHO $2,308.00 HC36800399 SPIROMETRY W/PRE&POST BRONCHO $2,308.00 HC45200805 NM SPLEEN SCAN IMAGING ONLY $2,306.00 HC44000206 XR COLON DOUBLE CONTRAST INC SCOUT,DELAYED $2,306.00 HC12400065 CHEMO ADMIN CNS W/SPINAL PUNCTURE $2,305.00 HC82200551 INTERPHASE IN-SITU HYBRI 25-99 $2,301.00 HC25004912 APPLY CAST; ELBOW TO FINGER (SHORT ARM) BILAT $2,299.00 HC25004359 CLOSED TX PATELLAR DISLOC; NO ANESTH BIL $2,299.00 HC25004797 CLOSED TX TARSAL DISLOC; NO ANES BIL $2,299.00 HC44000685 ENEMA THERAPEUTIC CONTRAST/AIR $2,299.00 HC25003112 LAC REPAIR INTMD S/A/T/EXT 20.1-30CM $2,299.00 HC38420378 LVAD/RVAD MANAGEMNT & SUPPORT DAILY $2,299.00 0641-6040-01 MORPHINE (PF) 25 MG/ML INJ SOLN $2,298.79 HC38000212 APPLY CMPRSSN BOOT/WRAP(UNNA)BI $2,296.00 HC44001451 KNEE 4 OR MORE VWS BILAT $2,296.00 HC41500836 EEG W/VIDEO UNMONITOR 2-12 HR $2,295.00 HC44701209 EXTRA PUMP TIME/.5 HR $2,295.00 HC62213756 KIT VITREORETINAL PERFLUORON 7ML $2,295.00 HC83000067 PLATELET LR APHER/PHER EA UNIT $2,295.00 16714-885-02 ACYCLOVIR 5 % TOPICAL OINT $2,294.37 HC25003484 CLOSED TX CLAVICLE FX W/MANIP LT $2,294.00 HC25003492 CLOSED TX CLAVICLE FX W/MANIP RT $2,294.00 HC44200236 US DUPLEX PENILE VESSEL COMP $2,293.00 HC36800209 HIGH ALTITUDE SIM' TEST- HAST $2,290.00 HC12400057 INITIATE PROLONG CHEMO INFUSION VIA PUMP $2,289.00 99999-035-63 ALTEPLASE 2 MG INTRACATH SOLR $2,288.09 HC62228614 WOUND FILLER GEL(PLUROGEL)-14.1OZ $2,287.00 HC25003153 LAC REPAIR INTMD N/H/F/GEN 7.6-12.5 $2,283.00 HC27001254 GASTRIC INTUB ASP DX;SNGL SPEC $2,282.00 HC77400141 ANESTHESIA INIT'L HR CASE CX $2,281.00 HC47200803 RADIOPHARM' TX; IV ADMIN $2,279.00 69238-1730-2 NAPROXEN 125 MG/5 ML ORAL SUSP $2,275.13 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 42658-010-01 CLADRIBINE 10 MG/10 ML IV SOLN $2,275.00 39822-0650-6 NELARABINE 250 MG/50 ML IV SOLN $2,275.00 39822-0650-1 NELARABINE 250 MG/50 ML IV SOLN $2,275.00 25021-830-82 ZOLEDRONIC ACID-MANNITOL-WATER 5 MG/100 ML IV PGBK $2,275.00 HC25003799 CLOSED TX ULNA SHAFT FX W/MANIP-BIL $2,274.00 HC36800258 O2 UPTAKE COMPLETE $2,273.00 HC45201019 NM VENOGRAM(THROMBOS)UNILAT LT $2,269.00 HC45201027 NM VENOGRAM(THROMBOS)UNILAT RT $2,269.00 HC44200616 TRANSCRANIAL DOPPLER STUDY LTD $2,269.00 HC43000561 DUCTOGRAM MULTI DUCT(S) LT $2,267.00 HC43000579 DUCTOGRAM MULTI DUCT(S) RT $2,267.00 HC43000116 DUCTOGRAM/GALACTOGRAM MULTI $2,267.00 HC44200525 US PELVIC(NON OB) $2,265.00 HC51010320 BACLOPHEN PUMP TRIAL PROCEDURE $2,262.40 HC51010155 DESTRUCT OTHER PERIPH NERV/BRNCH LT $2,262.40 HC51010163 DESTRUCT OTHER PERIPH NERV/BRNCH RT $2,262.40 HC25004573 REMOVE FB FOOT; SUBC LT $2,261.00 HC25004581 REMOVE FB FOOT; SUBC RT $2,261.00 HC62228846 TEMPLATE BRACHYTHERAPY U $2,261.00 HC62803309 CATH VENTRICL EXT DRAIN/MONITR $2,254.00 HC12400008 CHEMO ADMIN IV INITIAL HR $2,253.00 HC21000823 APPY SKIN SUB HEAD/HND/FT EA+25SQ~HC $2,252.00 HC25003104 LAC REPAIR INTMD S/A/T/EXT 12.6-20CM $2,247.00 HC25004714 CLOSED TX BIG TOE FX; W/MANIPULTN BIL $2,245.00 HC41500554 VESTIBULAR COMPREHENSIVE EVAL $2,245.00 HC42000919 ECG EXT HOLTER >7DAYS-15DAYS; SCANNING ANYS W/REPORT $2,244.00 HC62204763 MORCELLATOR $2,244.00 HC44201069 TCD V-A SHUNT DETECT STUDY W/IV MICROBUGGL INJ+ $2,244.00 HC83001206 PLATELET LR PHER EA UNIT $2,243.00 HC83001008 PLATELET LR PHER EA UNIT -SB $2,243.00 HC25004532 CLOSED TX PROX TIBIOFIBULAR JNT DISLOC; NO ANES BIL $2,242.00 HC62804273 COIL EMBOLIZATION Q $2,240.00 HC62215496 PROBE SPINAL DISPOSABLE AA $2,240.00 HC62226485 WAND LARYNGEAL $2,240.00 HC44500650 CHANGE PERC DRAINAGE TUBE/CATH S&I ONLY $2,235.00 HC32000457 OT-SWALLOWING EVAL 60MIN $2,235.00 70710-1852-6 INDOMETHACIN 50 MG RECTAL SUPP $2,234.77 70710-1852-7 INDOMETHACIN 50 MG RECTAL SUPP $2,234.77 HC25003674 CLOSED TX ELBOW DISLOC W/O ANES-BIL $2,233.00 HC25002825 I&D POLINIDAL CYST; SIMPLE $2,233.00 HC47200209 INTRACAVITARY TREATMT SIMPLE $2,233.00 HC25003310 LAC REPAIR CMPLX F/C/C/M/N/AX/G/H/F 1.1-2.5CM $2,233.00 HC25003096 LAC REPAIR INTMD S/A/T/EXT 7.6-12.5CM $2,233.00 0517-6560-25 SELENIUM 60 MCG/ML IV SOLN $2,229.50 HC42000331 ECG EXT HOLTER UP TO 48HRS; SCANNING ANYS & REPORT $2,228.00 HC46502738 BIOPSY PUNCH SKIN; SINGLE INITIAL LESION $2,227.00 HC25002858 DEBRIDE ECZEM/INFCT SKIN UP TO 10% BSA $2,227.00 HC33000332 ST-SWALLOWING EVAL 60MIN $2,227.00 78206-127-01 MOMETASONE-FORMOTEROL 100-5 MCG/ACTUATION INHALATION HFAA $2,227.00 78206-125-01 MOMETASONE-FORMOTEROL 50-5 MCG/ACTUATION INHALATION HFAA $2,227.00 HC62808951 DEVICE SUTURE ENDO X-TACK $2,226.00 HC79200010 MUSCLE TEST, TWO LIMBS $2,225.00 HC44200194 US DUPLEX CAROTID UNILAT LT $2,225.00 HC44200202 US DUPLEX CAROTID UNILAT RT $2,225.00 HC47200316 PHYSICS CONSULT SPECIAL $2,222.00 HC33000266 ST-SPEECH THERAPY 120MIN/MW $2,220.00 HC25003203 LAC REPAIR INTMD F/E/E/N/L/MM 2.6-5.0CM $2,217.00 HC32000119 OT-EVAL SWALLOW CINE/FLUORO 60MIN $2,216.00 HC33000183 ST-EVAL SWALLOW CINE/FLUORO 60MIN $2,216.00 HC25005547 REMOVE FB EXTRNL EYE; CORNEAL NO SLITLAMP BIL $2,215.00 HC46500914 FNA ASP BX W/O GUIDE; EACH ADD'L LESION $2,213.00 HC82202219 FNA ASP BX W/O GUIDE; EACH ADD'L LESION $2,213.00 HC51003184 BX VAGINA SIMPLE $2,212.72 HC51003127 BX VULVA $2,212.72 HC51003309 BX(S)CERVIX / EXCISE LESION(SEP PROC) $2,212.72 HC51003234 COLPOSCOPY VAG W/BX(S)VAGINA/CERVIX $2,212.72 HC51003317 CURETTAGE ENDOCERVICAL (ECC) $2,212.72 HC62204029 KIT LASER VEIN ABLATION $2,207.00 HC44002079 XR SMALL BOWEL W/DOUBLE CONTRAST INC SCOUT,SERIAL $2,206.00 HC62220108 ACCESS PORTL TRANSJUG INTRAHEP HSKL $2,205.00 HC62211149 OXYGENATOR PEDIATRIC C $2,205.00 HC44900827 CT COLONOGRAPHY SCREEN VIRTUAL W&WO CONTRAST $2,203.00 16714-859-01 CYCLOPHOSPHAMIDE 500 MG IV SOLR $2,202.79 HC51003077 DRAIN ABSCESS WALL SCROTAL $2,200.00 HC32000531 OT-SWALLOWING THERAPY 90 MIN $2,199.00 HC44200541 US RETROPERITONEAL COMPLETE $2,198.00 HC25003971 CLOSED TX WRIST DSLOC 1/> BONES W/MAN-BIL $2,196.00 HC25000217 REPAIR NAIL BED $2,196.00 HC44200269 US DUPLEX VEIN EXT UNILAT/LTD $2,196.00 HC62219688 DILATOR SPINE/NERVE NEUROVISION $2,195.00 0003-0528-11 DASATINIB 50 MG ORAL TAB $2,193.48 0003-0524-11 DASATINIB 70 MG ORAL TAB $2,193.48 60687-754-05 LINEZOLID 100 MG/5 ML ORAL SUSR $2,188.88 HC31001845 PT-EVAL HIGH COMPLEXITY 45MIF2F 180MIN $2,188.00 HC62229596 ELECTRODE HEADBAND EEG CERIBELL $2,187.50 24208-358-05 TOBRAMYCIN-LOTEPRED 0.3-0.5 % OPHT DRPS $2,184.26 HC36800126 TEST BRONCHIAL INHAL CHALLENGE W/HISTAMINE $2,184.00 HC33000167 ST-EVAL RX SP GEN DEVC; 1ST HR $2,183.00 46287-009-01 ISONIAZID 50 MG/5 ML ORAL SOLN $2,182.90 HC46000030 INJ ARTHRO HIP W/ANESTH-LT $2,180.00 HC46000048 INJ ARTHRO HIP W/ANESTH-RT $2,180.00 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 0270-7015-46 GADOPICLENOL 0.5 MMOL/ML IV SOLN $2,176.79 0006-3061-00 FOSAPREPITANT 150 MG IV SOLR $2,175.10 0006-3061-01 FOSAPREPITANT 150 MG IV SOLR $2,175.10 HC25003146 LAC REPAIR INTMD N/H/F/GEN 2.6-7.5 $2,173.00 70727-497-25 NETARSUDIL 0.02 % OPHT DROP $2,172.11 65862-752-50 CEFIXIME 200 MG/5 ML ORAL SUSR $2,171.65 HC46000378 INJ FOR RETRO URETHROCYSTO $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 HC44001311 IVP DRIP OR BOLUS W/TOMO $2,168.00 99999-000-19 DINOPROSTONE (PROSTIN E2) 3 MG VAGINAL SUPPOSITORY $2,163.72 HC46500930 INJ W/FLUOR, EVAL CV ACCESS DEVICE $2,162.00 HC45200334 NM GASTROINTEST PROTEIN LOSS $2,162.00 68462-564-35 MUPIROCIN CALCIUM 2 % TOPICAL CREAM $2,160.99 16714-055-02 MUPIROCIN CALCIUM 2 % TOPICAL CREAM $2,160.99 75834-280-30 POTASSIUM IODIDE 1 GRAM/ML ORAL SOLN $2,160.21 HC24000010 HBO TX EA 1/2 HR BASIC/M $2,160.00 HC25004201 CLOSED TX HIP DISLOC TRAUMIC BIL $2,158.00 55513-478-01 EPOETIN ALFA 20,000 UNIT/ML INJ SOLN $2,155.40 HC33001074 ST-EVAL SOUND W/LANG COMP&EXPRESS 180MIN/M $2,154.00 HC33000431 ST-SWALLOWING THERAPY 90 MIN $2,154.00 HC26000182 L&D EVAL LEVEL IV - EXTENDED $2,152.00 HC38000071 APPLY CAST RIGID TOTAL LEG $2,151.00 HC44200335 US HEAD $2,148.00 39822-1030-1 IBUPROFEN LYSINE (PF) 20 MG/2 ML IV SOLN $2,145.00 39822-1030-2 IBUPROFEN LYSINE (PF) 20 MG/2 ML IV SOLN $2,145.00 55150-388-01 POSACONAZOLE 300 MG/16.7 ML IV SOLN $2,144.95 HC62220546 CUTTER LAPAROSCOPIC S $2,143.00 HC74200395 OR TIME ADD'L 15MIN CASE CX 4 (MCAL 1ST SUBSQNT 0.5 HR) $2,139.00 HC74200619 OR TIME ADD'L 15MIN CASE CX 4 MCAL (2ND SUBSQNT 0.5 HR) $2,139.00 HC47200498 RAD TREATMENT DELVR, = 1MEV;INTRMED $2,137.00 HC38000303 APPLY SPICA HIP1 1/2 OR 2 LEGS $2,136.00 HC62229240 DEVICE DELIVER PILLCAM $2,135.00 HC62219944 KNIFE BAYONET K $2,135.00 HC44200046 ART STDY BILAT U/L 1-2 LVL LTD $2,128.00 HC44200871 ART STDY SNG U/L 3/> LVL CMP-L $2,128.00 HC44200863 ART STDY SNG U/L 3/> LVL CMP-R $2,128.00 HC62800115 BALLOON TAMPONADE UTERINE $2,128.00 HC62800123 BALLOON UTERINE $2,128.00 HC25004003 CLOSED TX DISTL RADIOULNAR DISLOC W/M-BIL $2,124.00 HC51003846 I&D HEMATOMA OR FLUID COLL $2,117.36 HC62211255 SYSTEM DELIVERY SEPTAL DEFECT $2,114.00 HC62211263 SYSTEM EXCHANGE SEPTAL DEFECT $2,114.00 HC23000029 ASP & INJ GANGLION CYST $2,109.00 HC44200384 US KIDNEY TRANSPLANT W/DOPLER $2,109.00 HC83001248 PLATELET PHERESIS PATHOGEN REDUCED EA UNIT $2,108.00 HC25002817 I&D ABSCESS; COMPLICATED/MULT $2,105.00 HC23001019 INJ(S);SNGL TNDON ORIGN/INSERT $2,101.00 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 HC62208806 CATH INTRAVASC ULTRASOUND $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 63323-526-03 ARGATROBAN 100 MG/ML IV SOLN $2,099.50 99999-035-64 EPIFIX SKIN GRAFT DISC ( 14 MM ) GS-5140 $2,099.50 67457-657-25 ESMOLOL IN NACL (ISO-OSM) 2,500 MG/250 ML (10 MG/ML) IV SOLP $2,099.50 HC44704062 INTRAVASC DOP CORONARY FLOW RESERV IFR/RFR NO PHARM ADDL VESSEL+ $2,095.00 HC44001758 PYELOGRAM RETROGRADE $2,093.00 59584-138-01 CANDIDA ALBICANS SKIN TEST FDA STANDARD INTRADERMAL ALRG $2,093.00 HC42000182 ECHO DOPPLER COLOR FLOW $2,091.00 70095-031-01 DESMOPRESSIN 4 MCG/ML INJ SOLN $2,089.17 HC27000140 BREATH HYDROGEN TEST $2,089.00 25021-461-10 DESMOPRESSIN 4 MCG/ML INJ SOLN $2,086.50 HC21000278 DEBRIDE P-THICK BURN SM<5%BSA $2,086.00 HC26000091 FETAL NON-STRESS TEST $2,086.00 11980-180-10 PREDNISOLONE ACETATE 1 % OPHT DRPS $2,085.27 HC62229232 FORCEPS BIPOLAR HET $2,082.00 0338-0063-01 DOXORUBICIN, PEG-LIPOSOMAL 2 MG/ML IV SUSP $2,081.04 67457-533-16 DOCETAXEL 160 MG/16 ML (10 MG/ML) IV SOLN $2,080.00 99999-041-49 NM TC-99M MACROAGGREG (MAA) MHS $2,077.92 HC74200262 BEDSIDE/OTHER SURG ADD'L 15MIN 3 (MCAL 1ST SUBSQNT 0.5 HR) $2,074.00 HC74200502 BEDSIDE/OTHER SURG ADD'L 15MIN 3 (MCAL 2ND SUBSQNT 0.5 HR) $2,074.00 43598-698-58 CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN $2,073.44 43598-698-11 CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN $2,073.44 70121-1680-7 CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN $2,073.44 70121-1680-1 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 HC44000826 FLUORO GUIDANCE NEEDLE PLACEMENT $2,073.00 HC23000045 ASP/INJ JOINT SM W/O UTZ GUIDE-LT $2,072.00 0469-3051-30 AMPHOTERICIN B LIPOSOME 50 MG IV SUSR $2,069.02 HC62228697 DEVICE SUTURE CAPIO $2,068.00 HC33000746 ST-NASOPHARYNGOSCOPY $2,067.00 HC25005430 IINJ ANES/STEROID NERVE/BRNCH PERIPH LT $2,065.00 HC25005448 INJ ANES/STEROID NERVE/BRNCH PERIPH RT $2,065.00 HC25005240 LAC REPAIR MOUTH; >2.5 CM/COMPLEX $2,065.00 HC25005299 REMOVE FB PHARYNX $2,065.00 HC23001035 INJ ANES/STEROID NERVE TRIGEML BRNCH EA $2,064.00 HC23001522 INJ ANES/STEROID NERVE TRIGEML BRNCH EA LT $2,064.00 HC23001514 INJ ANES/STEROID NERVE TRIGEML BRNCH EA RT $2,064.00 50484-010-30 COLLAGENASE CLOSTRIDIUM HISTO. 250 UNIT/GRAM TOPICAL OINT $2,063.49 HC38000436 APPLY CAST RISSER JACKET BODY; WITH HEAD $2,063.00 0781-3056-70 ISONIAZID 100 MG/ML INJ SOLN $2,059.59 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 61364-181-03 PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) IV SOLN $2,058.29 0409-1555-54 HETASTARCH IN LACT ELECTROLYTE 6 % IV SOLN $2,057.25 HC62209150 KIT TISSUE EXPANDER $2,055.00 0006-3856-01 IMIPENEM-CILASTATIN-RELEBACTAM 1.25 GRAM IV SOLR $2,054.91 0006-3856-02 IMIPENEM-CILASTATIN-RELEBACTAM 1.25 GRAM IV SOLR $2,054.91 HC25003054 CLOSURE SUPERFCL WOUND DEHISC SIMPLE $2,054.00 HC41500570 STUDIES NERVE CONDUCTN 3-4 STUDIES $2,054.00 71266-8020-1 ARGININE-LYSINE-STERILE WATER 25-25 MG/ML IV SOLN $2,054.00 0173-0887-14 FLUTICASONE-UMECLIDIN-VILANTER 100-62.5-25 MCG INHALATION DSDV $2,052.05 45963-765-52 DOCETAXEL 80 MG/4 ML (20 MG/ML) IV SOLN $2,047.50 HC21000203 CAUTERIZE W/CHEM; GRAN TISSUE $2,047.00 HC25002890 DEBRIDE SKIN MUSCLE; FIRST 20SQCM OR LESS $2,047.00 55513-530-10 FILGRASTIM 300 MCG/ML INJ SOLN $2,046.42 55513-530-01 FILGRASTIM 300 MCG/ML INJ SOLN $2,046.40 HC46503397 FNA ASP BX W/US; FIRST LESION DC'D PROC $2,046.00 71837-5843-5 SARGRAMOSTIM 250 MCG INJ SOLR $2,045.08 71837-5843-1 SARGRAMOSTIM 250 MCG INJ SOLR $2,045.08 HC25004680 CLOSED TX BIG TOE FX; NO MANIPULTN BIL $2,044.00 HC44002277 TMJ ARTHROGRAM BILAT $2,044.00 HC12400107 CHEMO ADMIN PERITONEAL CAV VIA IMPLANT $2,038.00 HC25002916 EXCISION OF NAIL/MATRIX PERM $2,037.00 HC25004763 CLOSED TX SESAMOID FX BILAT $2,035.00 HC23001027 INJ(S);SINGLE TENDON/SHEATH $2,035.00 HC44000222 BONE LENGTH STUDIES $2,033.00 HC23000052 ASP/INJ JOINT SM W/O UTZ GUIDE-RT $2,031.00 HC62218979 DRILL/DRILL BITS SINGLE USE AF $2,030.00 HC62216916 ENDO STAPLER AC $2,030.00 HC32001810 OT-ENDOSCOP EVAL SWALLOW/LARYN $2,030.00 HC62213616 REAMER AF $2,030.00 HC33000134 ST-ENDOSCOP EVAL SWALLOW/LARYN $2,030.00 HC45201308 NM THYROID UPTAKE (PROBE) ONLY SNGL/MULT QNT MSRMT $2,025.00 HC25003088 LAC REPAIR INTMD S/A/T/EXT 2.6-7.5CM $2,024.00 HC12400131 CHEMO INJECT(S) SUBARACHNOID/INTRAVENT VIA RESEVOIR $2,020.00 HC27000181 COLONOSCOPY DIAGNOSTIC DC'D $2,020.00 HC44000834 FLUORO GUIDANCE NEEDL/CATH LOCALIZATION SPINE INJ(NONFRMN $2,018.00 13517-100-30 DIAZOXIDE 50 MG/ML ORAL SUSP $2,012.60 55513-021-04 DARBEPOETIN ALFA IN POLYSORBAT 40 MCG/0.4 ML INJ SYRG $2,012.40 55513-021-01 DARBEPOETIN ALFA IN POLYSORBAT 40 MCG/0.4 ML INJ SYRG $2,012.40 0054-1950-30 INDOMETHACIN 50 MG RECTAL SUPP $2,011.29 HC44200418 US OB 1ST TRI/1ST GEST $2,002.00 HC89024251 INFECT PATHOGENS PLASMA KARIUS-KR $2,000.00 HC62212808 GUIDEWIRE W $1,995.00 0597-0087-17 IPRATROPIUM BROMIDE 17 MCG/ACTUATION INHALATION HFAA $1,994.46 0069-0344-01 RSV VAC, PREF A AND PREF B(PF) 120 MCG/0.5 ML IM SOLR $1,994.20 0069-0207-01 RSV VAC, PREF A AND PREF B(PF) 120 MCG/0.5 ML IM SOLR $1,994.20 0069-0344-05 RSV VAC, PREF A AND PREF B(PF) 120 MCG/0.5 ML IM SOLR $1,994.20 0069-2465-01 RSV VAC, PREF A AND PREF B(PF) 120 MCG/0.5 ML IM SOLR $1,994.20 0069-2465-19 RSV VAC, PREF A AND PREF B(PF) 120 MCG/0.5 ML IM SOLR $1,994.20 0069-2465-10 RSV VAC, PREF A AND PREF B(PF) 120 MCG/0.5 ML IM SOLR $1,994.20 HC45200003 CARDIAC BLOOD POOL 1ST PASS+ $1,988.00 HC25002882 DEBRIDE SKIN SUBQ; FIRST 20SQCM OR LESS $1,988.00 HC62228986 STYLET PROBE NAVIGATION $1,988.00 HC44001048 HIP ARTHROGRAM LT $1,986.00 HC44001055 HIP ARTHROGRAM RT $1,986.00 HC41500018 AUDITORY EVOKED AEP BBS HEARING DETERM W/I&R $1,985.00 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 HC43000686 DUCTOGRAM SINGLE LT $1,984.00 HC43000694 DUCTOGRAM SINGLE RT $1,984.00 HC43000108 DUCTOGRAM/GALACTOGRAM SINGLE $1,984.00 HC42000976 ECHO 3D RENDERING FOR TEE/TTE+ $1,984.00 HC44200749 US GUIDANCE FNA S&I LT $1,983.00 HC44200756 US GUIDANCE FNA S&I RT $1,983.00 HC44200780 US GUIDANCE PLACEMENT NEEDLE LOC S&I LT $1,983.00 HC44200707 US GUIDANCE PLACEMENT NEEDLE LOC S&I ONLY $1,983.00 HC44200798 US GUIDANCE PLACEMENT NEEDLE LOC S&I RT $1,983.00 HC44200764 US GUIDANCE PLACEMENT S&I LT $1,983.00 HC44200772 US GUIDANCE PLACEMENT S&I RT $1,983.00 HC44200624 US TRANSRECT PROSTATE VOL STDY $1,983.00 HC41500406 SINUSOIDAL VERT ROTATION(VORT) $1,978.00 49502-501-02 EPINEPHRINE 0.15 MG/0.3 ML INJ ATIN $1,977.98 49502-501-01 EPINEPHRINE 0.15 MG/0.3 ML INJ ATIN $1,977.98 49502-500-02 EPINEPHRINE 0.3 MG/0.3 ML INJ ATIN $1,977.98 HC62219902 CANNULA ARTHRSCPC ROTATING K $1,977.00 HC33000720 ST-EVAL LANGUAGE CMPT 180MIN $1,977.00 72606-029-01 USTEKINUMAB-STBA 130 MG/26 ML IV SOLN $1,973.92 HC44000016 3D RENDER W/O INDENDNPT WORKSTN $1,973.00 68682-655-20 DIAZEPAM 12.5-15-17.5-20 MG RECTAL KIT $1,971.97 43386-281-01 DIAZEPAM 12.5-15-17.5-20 MG RECTAL KIT $1,971.97 43386-281-03 DIAZEPAM 12.5-15-17.5-20 MG RECTAL KIT $1,971.97 68682-652-20 DIAZEPAM 5-7.5-10 MG RECTAL KIT $1,971.97 43386-280-01 DIAZEPAM 5-7.5-10 MG RECTAL KIT $1,971.97 43386-280-03 DIAZEPAM 5-7.5-10 MG RECTAL KIT $1,971.97 HC44200012 US ABDOMEN LTD $1,970.00 HC46000949 SEL CATH THOR/BRAC+ 2ND/3RD LT $1,969.00 HC46000956 SEL CATH THOR/BRAC+ 2ND/3RD RT $1,969.00 HC44200152 US DUPLEX ART LOW EXT UNILAT/LTD $1,965.00 HC43000371 US GUIDANCE FNA S&I ONLY $1,964.00 HC44200566 US SCROTUM $1,964.00 HC25000746 ASPIRATION OF ABCESS/CYST $1,963.00 HC44000842 FLUORO GUIDANCE CV ACCESS CATH REPLACE/RMVL R&I $1,962.00 HC25000639 PARACENTESIS ABD W/O IMAGING $1,961.00 HC25005331 SIGMOIDOSCOPY FLEX W/REMOVE FB $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 HC44001964 SHOULDER ARTHROGRAM LT $1,955.00 HC44001972 SHOULDER ARTHROGRAM RT $1,955.00 HC41000068 POLYSMNGRPH 4+STG6&> ATTD DISCONT' $1,953.00 HC44200111 US DUPLEX ABD/PEL FLOW LTD $1,953.00 HC44000768 FEMUR 2/> VIEWS BILAT $1,951.00 HC33000860 ST-EVAL SPEECH CMPNT 120MIN $1,951.00 62135-481-42 CEPHALEXIN 250 MG/5 ML ORAL SUSR $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 63459-910-17 TBO-FILGRASTIM 300 MCG/0.5 ML SUBCUTANEOUS SYRG $1,947.40 63459-910-18 TBO-FILGRASTIM 300 MCG/0.5 ML SUBCUTANEOUS SYRG $1,947.40 0187-5100-01 PIMECROLIMUS 1 % TOPICAL CREAM $1,943.76 HC62211172 KIT PERFUSION - PEDS $1,943.00 HC25006206 POSTPARTUM CARE $1,939.00 67457-366-10 IBUTILIDE FUMARATE 0.1 MG/ML IV SOLN $1,938.95 23155-326-31 IBUTILIDE FUMARATE 0.1 MG/ML IV SOLN $1,938.95 HC32001802 OT-ENDOSCOPIC EVAL LARYNGEAL $1,938.00 HC33000142 ST-ENDOSCOPIC EVAL LARYNGEAL $1,938.00 0078-0876-01 TOBRAMYCIN-DEXAMETHASONE 0.3-0.1 % OPHT OINT $1,937.60 HC26000174 L&D EVAL LEVEL III - INTERMED $1,936.00 HC25003047 LAC REPAIR SIMPLE F/E/E/N/L/M >30.0 CM $1,936.00 63323-658-20 CHLOROTHIAZIDE SODIUM 500 MG IV SOLR $1,935.05 HC25003195 LAC REPAIR INTMD F/E/E/N/L&/MM 2.5CM/< $1,935.00 HC44200178 US DUPLEX ART UP EXT UNILAT/LTD $1,934.00 HC43000736 US GUIDANCE CYST ASPIRATION S&I LT $1,934.00 HC43000744 US GUIDANCE CYST ASPIRATION S&I RT $1,934.00 HC27000835 ESOPH MOTILITY/MANO' DISCONT'D $1,931.00 HC36000784 PULSE OX NOCTURNAL STUDY $1,931.00 0074-4382-20 CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) IV SOLN $1,930.50 HC44701555 PHYSIOLOGIC EXERCISE STUDY+ $1,930.00 HC74200387 OR TIME ADD'L 15MIN CASE CX 3 (MCAL 1ST SUBSQNT 0.5 HR) $1,929.00 HC74200601 OR TIME ADD'L 15MIN CASE CX 3 (MCAL 2ND SUBSQNT 0.5 HR) $1,929.00 HC36800357 PULSE OX NOCTURNAL STUDY $1,928.00 HC27000959 GASTRIC INTUB ASP THER' LAVAGE $1,927.00 HC44002509 UROGRAPHY ANTEGRADE $1,926.00 HC62805031 CATH MAPPING PH ESOPHAGEAL $1,925.00 HC62226766 FORCEPS BIOPSY MICRO(MORAY) $1,925.00 HC62229422 GASTROSCOPE DISP ASCOPE $1,925.00 99999-038-91 POLIHEXANIDE (PURAPLY AM) 2X2 CM EACH TOPICAL SHEET $1,924.00 72603-339-01 ARSENIC TRIOXIDE 1 MG/ML IV SOLN $1,923.03 72603-339-10 ARSENIC TRIOXIDE 1 MG/ML IV SOLN $1,923.03 HC38000428 APPLY CAST RISSER JACKET BODY; ONLY $1,920.00 HC44200640 US TRANSVAGINAL(NON OB) $1,920.00 HC51003630 ANOSCOPY W/DILATION $1,919.00 HC51003648 ANOSCOPY W/BIOPSY $1,918.00 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 14789-122-05 FLUORESCEIN 500 MG/5 ML (10 %) IV SOLN $1,917.50 14789-122-07 FLUORESCEIN 500 MG/5 ML (10 %) IV SOLN $1,917.50 99999-033-52 RADIESSE INJECTABLE IMPLANT $1,917.50 59651-444-01 VALGANCICLOVIR 50 MG/ML ORAL SOLR $1,917.34 HC82202458 MORPH STDY ISH CAT QNT/SPEC INTL SNGL PROBE CEP17 $1,915.00 HC82202441 MORPH STDY ISH CAT QNT/SPEC INTL SNGL PROBE HER2 $1,915.00 HC62219043 PORT INSTRMNT MULTI LAPAROSCPC $1,914.00 HC44200368 US INFANT HIPS(DYNAMIC) $1,913.00 HC46000428 INJ PROC SPLENOPORTOGRAM $1,912.00 70839-362-04 COCAINE 4 % NASL SOLN $1,911.00 65162-087-74 ITRACONAZOLE 10 MG/ML ORAL SOLN $1,910.03 60505-4317-0 TOLVAPTAN 15 MG ORAL TAB $1,908.97 HC62804653 FILTER VENA CAVA A $1,908.00 HC44201002 US OB EVA PLUS FETAL ANATOMIC DETAIL EA ADL GEST+ $1,908.00 HC41500190 EMG 1 EXTREMITY $1,906.00 HC25003070 LAC REPAIR INTMD S/A/T/EXT 2.5 CM/< $1,905.00 HC12200325 IV INFUSE/SC MONOCLONAL CASIRIVIMAB/IMDEVIMAB (REGENERON) $1,904.00 HC46501615 URO-EMG $1,903.00 HC89022792 TARGETED GENOME PNL SEQ 51/>GENES-AU $1,900.00 HC43000991 US BREAST; COMPLETE BILATERAL $1,899.00 HC46502712 BIOPSY TANGENTIAL SKIN; SINGLE INITIAL LESION $1,897.00 HC82202193 NERVE TEASING $1,896.00 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 HC46000063 INJ ARTHRO/CT/MRI SHOULDER-LT $1,887.00 HC46000071 INJ ARTHRO/CT/MRI SHOULDER-RT $1,887.00 72819-154-04 MITOMYCIN 40 MG IV SOLR $1,886.24 HC21000633 WOUND VAC W/ DME >50 SQ CM PER SESSION $1,886.00 HC44001428 KNEE 3 VIEWS BILAT $1,885.00 HC46000477 INJECTION HIP ARTHROGRAM LT $1,884.00 HC46000485 INJECTION HIP ARTHROGRAM RT $1,884.00 HC62223987 MANIPULATOR UTERINE I $1,884.00 HC41000027 SLEEP STUDY ATTENDED DISCNT'D $1,883.00 99999-035-30 INSULIN ASPART 100 UNIT/ML SUBCUTANEOUS SOLN (INSULIN PUMP) $1,880.84 HC44000131 ANKLE COMP MIN 3 VWS BILAT $1,880.00 HC25005646 PACING TRANSCUTANEOUS TEMPORARY $1,880.00 0591-4385-79 FOSAPREPITANT 150 MG IV SOLR $1,879.28 HC47200886 REMOVAL OF FIXATION DEVICE $1,878.00 HC25000837 ASP/INJ SMALL JOINT-BILAT $1,877.00 HC44200210 US DUPLEX CAROTID LTD $1,869.00 HC25001041 THROMBOLYSIS CORONARY IV INFUSION $1,867.00 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 99999-039-44 INSULIN REGULAR HUM U-500 CONC 500 UNIT/ML SUBCUTANEOUS SOLN $1,866.15 HC21000757 LAC REPAIR 7.6-12 5CM(MEDIUM) $1,865.00 HC44200137 US DUPLEX AORTA,IVC,ILIAC UNI/LTD $1,865.00 HC25003138 LAC REPAIR INTMD N/H/F/GEN 2.5CM/< $1,862.00 HC44200343 US HEAD/NECK SOFT TISSUE $1,862.00 HC44000198 XR COLON SINGLE CONTRAST INC SCOUT,DELAYED $1,861.00 HC44000867 FLUOROSCOPY < 1HR $1,860.00 70100-825-02 INDOCYANINE GREEN 25 MG INJ SOLR $1,857.92 70100-725-01 INDOCYANINE GREEN 25 MG INJ SOLR $1,857.90 HC25003393 INJ(S);SGL TNDN SHEATH/LIGMNT/APONEUR-BIL $1,857.00 HC25003039 LAC REPAIR SIMPLE F/E/E/N/L/M 20.1-30.0 CM $1,857.00 HC62212790 GUIDEWIRE(AVIGO/NEURVSCLR SFT TIP)V $1,855.00 HC62205018 NEEDLE STEREOTACTIC BX $1,855.00 HC23001704 EXAM CSF PUMP (MISC PROC) $1,853.00 HC44701688 FLUORO GUIDANCE UNLISTED PROCEDURE $1,853.00 HC33000258 ST-SPEECH THERAPY 90 MIN/MW $1,853.00 HC62217088 SHIM DEVICE ACCESS SPINAL X $1,852.00 HC44002905 SPINE ENTIRE SKULL-SACRUM 6/> VIEWS $1,852.00 HC47200308 PHYSICS CONSULT CONTINUOUS $1,847.00 99999-035-28 INSULIN GLULISINE 100 UNIT/ML SUBCUTANEOUS SOLN (INSULIN PUMP) $1,845.68 HC25003856 CLOSED TX RAD/EPHYSL SEP&ULN FX NO M-BIL $1,845.00 HC43000710 US GUIDANCE BREAST CORE BIOPSY S&I LT $1,843.00 65628-208-10 VANCOMYCIN 50 MG/ML ORAL SOLR $1,842.75 HC46000501 INTRO CATH HYSTERO $1,842.00 HC41000100 POLYSMNGRPH 4+STGS <6 DISCONT $1,842.00 HC43000728 US GUIDANCE BREAST CORE BIOPSY S&I RT $1,842.00 HC62809306 STENT DES CORO COV W/DEL SYS C $1,838.00 16714-834-01 PALONOSETRON 0.25 MG/5 ML IV SOLN $1,837.62 HC44200350 US HYSTEROSONOGRAPHY $1,837.00 3877900688 CITRIC ACID (BULK) MISC POWD $1,836.25 0005-2000-02 PNEUMOC 20-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG $1,835.99 0005-2000-01 PNEUMOC 20-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG $1,835.99 HC81101982 DRUG TST DEFNTV 22/>RX CLSS W/METBLTS/DAY $1,835.00 HC31001795 PT-APPLICATION CAST LONG LEG $1,834.00 HC46000121 INJ ARTHROGRAM ELBOW-LT $1,833.00 HC46000139 INJ ARTHROGRAM ELBOW-RT $1,833.00 70436-027-80 EPTIFIBATIDE 0.75 MG/ML IV SOLN $1,833.00 HC62223235 KIT HEMORRHOID SLIDE ONE $1,830.00 HC62808142 I:FECAL MICROBIOTA (FMP250) $1,829.00 HC44200574 US SPINAL CANAL & CONTENT $1,828.00 HC33001066 ST-EVAL SOUND W/LANG COMP&EXPRESS 120MIN/M $1,827.00 HC25005422 INJ ANES/STEROID NERVE TRIGEML BRNCH EA BI $1,825.00 HC46502761 BIOPSY INCISIONAL SKIN; EACH SEP ADD'L LESION $1,823.00 HC31001837 PT-EVAL HIGH COMPLEXITY 45MIF2F 150MIN $1,823.00 0781-3233-94 CYCLOPHOSPHAMIDE 500 MG IV SOLN (MCH) $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 0078-0813-01 TOBRAMYCIN 0.3 % OPHT OINT $1,820.00 HC44000917 FOOT COMP MIN 3 VWS BILAT $1,818.00 HC62207139 SYSTEM DALL MILES CABLE GRIP $1,815.00 0409-0367-01 DOCETAXEL 20 MG/ML IV SOLN (MCH) $1,814.41 HC41000127 HOME SLEEP STUDY/T II MIN' 7CH $1,813.00 HC83000539 PLATELET LR CMV NEG APHER/PHER $1,807.00 HC62210927 CANNULA ENDO ARTERIAL $1,806.00 HC44001329 IVP INFUSION DRIP OR BOLUS $1,806.00 HC25003708 CLOSED TX ELBOW DISLOCATION-BIL $1,804.00 HC25000100 CRICOTHYROIDOSTOMY $1,804.00 HC44000651 ELBOW COMP MIN 3 VWS BILAT $1,801.00 65174-270-30 KIT FOR PREP OF TC-99M-ALBUMIN 2.5 MG IV SOLR $1,799.79 HC62223490 ORTHOTIC ANKLE FOOT TIBIAL FX RT $1,797.00 8065183150 CHONDROITIN SULF-SOD HYALURON 3 %-4 %(0.5 ML) 1 % (0.55 ML) INTRAOCULAR SYRG $1,791.47 HC44001337 IVP LIMITED $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 HC51003069 ASP/INJ HYDROCELE $1,787.96 HC51002236 ASP/INJ RENAL CYST/PELVIS $1,787.96 HC51003796 EXCISE LESION <0.5CM TRNK/ARMS/LEGS $1,787.96 HC51002392 EXCISE LESION 0.6-1CM HND-FT-SC-NCK-GN $1,787.96 HC51002624 PUNCTURE ASP CYST BREAST $1,787.96 HC51062099 REMOVE CONTRACEPTIVE CAPSULE $1,787.96 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 HC38000295 APPLY SPICA HIP ONE LEG $1,785.00 HC44500817 ERCP PANCREATIC DUCT SYSTEM S&I ONLY $1,785.00 61314-318-05 FILGRASTIM-SNDZ 300 MCG/0.5 ML INJ SYRG $1,783.36 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 0143-9247-01 DEXRAZOXANE HCL 250 MG IV SOLR $1,782.69 55150-434-01 DEXRAZOXANE HCL 250 MG IV SOLR $1,782.69 55150-432-01 DEXRAZOXANE HCL 250 MG IV SOLR $1,782.69 70515-712-01 CICLESONIDE 160 MCG/ACTUATION INHALATION HFAA $1,782.35 70515-711-01 CICLESONIDE 80 MCG/ACTUATION INHALATION HFAA $1,782.35 HC25004060 CLOSED TX THUMB DISLOC W/MANIP BIL $1,782.00 HC44001980 SHOULDER COMP MIN 2VWS BILAT $1,782.00 HC44002574 WRIST COMP MIN 3 VWS BILAT $1,782.00 HC25003500 CLOSED TX STERNOCLVCLE DISLOC W/MAN-BIL $1,781.00 0005-2000-10 PNEUMOC 20-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG $1,780.03 HC44200244 US DUPLEX PENILE VESSEL F/U OR LTD $1,780.00 HC44200285 US FETAL BIOPHYSICAL PROFILE W/ NST $1,778.00 HC38000253 APPLY BODY CAST;SHOLD/HIP/1THI $1,777.00 HC62228473 BASKET RETRIEVAL BILIARY (SPYGLASS) $1,777.00 0409-1103-11 CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) IV SOLN $1,775.80 0409-1103-01 CISATRACURIUM 10 MG/ML CONC. 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SMEAR INTERP $1,695.00 HC82200759 INTRAOP CNSLT CYT PREP INT'L $1,695.00 HC82200734 INTRAOP CNSLT CYT PRP-DIST SRV $1,695.00 HC62203435 FORCEPS GRASPING $1,694.00 52015-080-01 FIDAXOMICIN 200 MG ORAL TAB $1,691.63 0143-9205-01 DOCETAXEL 80 MG/4 ML (20 MG/ML) IV SOLN $1,690.00 HC44003036 PERITONEOGRAM S&I $1,687.00 HC44201044 TCD VASOREACTIVITY STUDY OF ICA+ $1,683.00 62856-212-01 LECANEMAB-IRMB 100 MG/ML IV SOLN $1,681.16 HC25001348 DEBRIDE OPN WND 1ST 20SQCM OR< $1,681.00 HC62205844 PROBE PERCUTANEOUS $1,681.00 70842-160-10 MINOCYCLINE 100 MG IV SOLR $1,680.25 70842-160-01 MINOCYCLINE 100 MG IV SOLR $1,680.25 HC62217708 AWL SPINAL SINGLE PATIENT USE S $1,680.00 HC62213061 BLADE SHAVER X $1,680.00 HC62800792 CAPSULE PH (IMPLANT) I $1,680.00 HC62805924 CATH EP DX <20 ELECTRODES K $1,680.00 HC62800883 CATHETER PERITONEAL AH $1,680.00 HC62800891 CATHETER PLEURAL/KIT $1,680.00 HC62218946 DRILL/DRILL BITS SINGLE USE AC $1,680.00 HC62216866 ENDO STAPLER X $1,680.00 HC62203294 FIBER LASER K $1,680.00 HC62226139 KIT ACCESSORY P $1,680.00 HC62213566 REAMER AA $1,680.00 HC62203476 SCALPEL SHEARS HARMONIC $1,680.00 HC62206081 SET AMPLATZ $1,680.00 HC62206313 SET LIVER BIOPSY $1,680.00 HC62211974 SPHINCTEROTOME CANNULATING L $1,680.00 HC51063139 BIOPSY NAIL UNIT SEP PROC $1,676.00 HC62804596 STENT CORO BARE METAL W/DEL B $1,676.00 0469-6501-89 REGADENOSON 0.4 MG/5 ML IV SYRG $1,675.44 66794-155-02 BACLOFEN 10,000 MCG/20ML (500 MCG/ML) INTRATHECAL SOLN $1,674.14 0456-0400-01 CEFTAROLINE FOSAMIL 400 MG IV SOLR $1,673.49 0456-0400-10 CEFTAROLINE FOSAMIL 400 MG IV SOLR $1,673.49 0456-0600-10 CEFTAROLINE FOSAMIL 600 MG IV SOLR $1,673.49 0456-0600-01 CEFTAROLINE FOSAMIL 600 MG IV SOLR $1,673.49 HC44502029 THROMBOLYSIS CEREBRAL/IV RT $1,673.00 HC44502037 THROMBOLYSIS CEREBRAL/IV LT $1,673.00 HC25000902 ASP/INJ LARGE JOINT-LT $1,671.00 HC25000910 ASP/INJ LARGE JOINT-RT $1,671.00 70954-852-10 LEVOFLOXACIN 250 MG/10 ML ORAL SOLN $1,669.20 0527-1948-66 LEVOFLOXACIN 250 MG/10 ML ORAL SOLN $1,669.20 HC84201805 RESP VIRUS 6-11 TARGETS (PNL) $1,667.00 HC42000174 ECHO DOPPLER F/U OR LTD* $1,665.00 HC33001058 ST-EVAL SOUND W/LANG COMP&EXPRESS 90MIN/M $1,663.00 0173-0717-22 FLUTICASONE PROPION-SALMETEROL 230-21 MCG/ACTUATION INHALATION HFAA $1,662.39 68682-650-20 DIAZEPAM 2.5 MG RECTAL KIT $1,662.38 HC74200379 OR TIME ADD'L 15MIN CASE CX 2 (MCAL 1ST SUBSQNT 0.5 HR) $1,658.00 HC74200593 OR TIME ADD'L 15MIN CASE CX 2 (MCAL 2ND SUBSQNT 0.5 HR) $1,658.00 0469-3016-01 TACROLIMUS 5 MG/ML IV SOLN $1,657.68 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 68462-585-40 APREPITANT 125 MG ORAL CAP $1,655.60 68462-585-76 APREPITANT 125 MG ORAL CAP $1,655.60 13668-593-86 APREPITANT 125 MG ORAL CAP $1,655.60 13668-593-80 APREPITANT 125 MG ORAL CAP $1,655.60 0781-2323-06 APREPITANT 125 MG ORAL CAP $1,655.60 0781-2323-68 APREPITANT 125 MG ORAL CAP $1,655.60 HC62803804 COIL EMBOLIZATION FIBERED M $1,655.00 HC32001760 OT-DYSPHAGIA/SWALLOW TX 75MIN/M $1,655.00 HC44200814 US EXTREMITY NON VASC CMPLT-LT $1,654.00 HC44200806 US EXTREMITY NON VASC CMPLT-RT $1,654.00 HC44002491 URETHROCYSTOGRAM VOIDING $1,653.00 HC25006131 FETAL CONTRACT/NIPPLE STIM $1,651.00 HC62221049 EVACUATOR BLADDER W/ADAPTER $1,649.00 68682-110-01 PIMECROLIMUS 1 % TOPICAL CREAM $1,648.53 HC27000025 ANOSCOPY DX (INCL COLLECTION) $1,648.00 HC62229125 BLADE TREPHINE S $1,648.00 HC62221684 KIT ARTHROSCOPY DISPSBLS T $1,646.00 HC44002061 XR SMALL BOWEL W/SINGLE CONTRAST INC SCOUT,SERIAL $1,646.00 25021-248-51 CYCLOPHOSPHAMIDE 1 GRAM IV SOLR $1,644.50 63323-593-03 GLUCAGON (HUMAN RECOMBINANT) 1 MG INJ SOLR (MHS WRAPPER) $1,642.42 63323-596-03 GLUCAGON (HUMAN RECOMBINANT) 1 MG INJ SOLR (MHS WRAPPER) $1,642.42 63323-596-11 GLUCAGON (HUMAN RECOMBINANT) 1 MG INJ SOLR (MHS WRAPPER) $1,642.42 63323-596-13 GLUCAGON (HUMAN RECOMBINANT) 1 MG INJ SOLR (MHS WRAPPER) $1,642.42 HC62228218 ORTH WHO NONTORSION JOINT(S) PREFAB OTS $1,642.00 HC62228200 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KIT(AQUADEX) $1,575.00 HC81101974 DRUG TST DEFNTV15-21RX CLSS W/METBLTS/DAY $1,575.00 HC77400091 BEDSIDE/OTHER ANESTH' INITIAL HR $1,574.00 HC44002400 TRANSCERV CATH FALLOPIAN TUBES S&I ONLY $1,573.00 HC51000453 REMOV IMPL VEN CATH DEVICE $1,571.12 HC51000438 REPAIR CENTRAL VEN CATH(TECH/HOSP) $1,571.12 HC51000040 REPAIR CENTRAL VENOUS CATH $1,571.12 HC51002640 THORACENTESIS ASP W/ IMG GUID $1,571.12 HC51002632 THORACENTESIS ASP W/O IMG GUID $1,571.12 HC33000852 ST-EVAL SPEECH CMPNT 90MIN $1,571.00 HC33001140 ST-EVAL SPEECH FLUENCY 180MIN/M $1,571.00 65250-133-09 BUPIVACAINE LIPOSOME (PF) 1.3 % (13.3 MG/ML) LINF SUSP $1,568.39 65250-133-10 BUPIVACAINE LIPOSOME (PF) 1.3 % (13.3 MG/ML) LINF SUSP $1,568.39 HC41500711 EMG LARYNX $1,568.00 HC41500059 DBS CORTICAL MAP EA ADDL' HRS $1,567.00 44206-451-01 IMMUN GLOB G(IGG)-PRO-IGA 0-50 1 GRAM/5 ML (20 %) SUBCUTANEOUS SOLN $1,566.50 HC44200095 US CHEST $1,565.00 HC44200293 US FETAL BIOPHYSICAL PROFILE W/O NST $1,565.00 HC62808035 SYSTEM 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INFANT $1,552.00 HC46502522 LARYNGOSCOPY DIAGNOSTIC $1,552.00 HC21000922 APPLY MULTILAY COMPRS UPREX LT $1,550.00 HC21000930 APPLY MULTILAY COMPRS UPREX RT $1,550.00 HC62204334 KIT TWIST DRILL DISP $1,549.00 HC25005281 I&D ABSCESS PERITONSILLAR BILAT $1,548.00 HC25002973 LAC REPAIR SIMPLE S/N/A/GEN/T/EXT >30.0CM $1,548.00 0944-2850-01 IMMUN GLOB G(IGG)-GLY-IGA OV50 1 GRAM/5 ML (20 %) SUBCUTANEOUS SOLN $1,547.91 0944-2850-02 IMMUN GLOB G(IGG)-GLY-IGA OV50 1 GRAM/5 ML (20 %) SUBCUTANEOUS SOLN $1,547.91 HC31000045 PT-APPLICATION SPLINT LONG LEG $1,547.00 HC25005307 REPOSIT NASO/ORO GASTRIC FEED TUBE THRU DUODENUM $1,545.00 HC62228119 ORTH ELBOW ADJUST POSITION LOCK PREFAB CUSTOM $1,544.00 HC36000651 PLETHYSMOGRAPHY LUNG VOL $1,544.00 HC12400149 CHEMO ADMIN INTRA ARTERIAL INFUSION UP TO 1 HR $1,543.00 HC44002897 SPINE ENTIRE SKULL-SACRUM 4-5 VIEWS $1,542.00 68546-317-30 GLATIRAMER 20 MG/ML SUBCUTANEOUS SYRG $1,541.37 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 HC36800266 O2 UPTAKE CO2 OUTPUT @REST IND $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 HC33000761 ST-EVAL NONSPEECH DEVICE RX:1ST HR $1,540.00 HC81101917 GENERAL HEALTH PANEL (CHAMPUS) $1,537.00 52536-108-10 VANCOMYCIN 50 MG/ML ORAL SOLR $1,536.60 58160-976-20 MENINGOCOCCAL B VACCINE,4-COMP 50-50-50-25 MCG/0.5 ML IM SYRG $1,536.44 58160-976-02 MENINGOCOCCAL B VACCINE,4-COMP 50-50-50-25 MCG/0.5 ML IM SYRG $1,536.44 70257-560-20 BACLOFEN 500 MCG/ML INTRATHECAL SOLN $1,535.95 70257-560-01 BACLOFEN 500 MCG/ML INTRATHECAL SOLN $1,535.95 70257-560-02 BACLOFEN 500 MCG/ML INTRATHECAL SOLN $1,535.82 70121-2504-2 BACLOFEN 500 MCG/ML INTRATHECAL SOLN $1,535.82 8213100037 PORCINE SUBMUCOSA, FENESTRATED 3 X 7 CM TOPICAL SHEE $1,535.63 HC12400032 CHEMO ADMIN IVP SNGL/INIT'LINJ $1,535.00 HC89023782 CYTOGENO NEO SNP MICROARRAY ONCOLOGY-AU $1,535.00 HC62205810 PROBE HEMOSTASIS (BICAP) K $1,534.00 HC44002467 UGI W/O KUB $1,534.00 70121-1239-1 CYCLOPHOSPHAMIDE 1 GRAM IV SOLR $1,534.00 0172-7313-20 CYCLOSPORINE MODIFIED 100 MG/ML ORAL SOLN $1,532.70 HC46502746 BIOPSY PUNCH SKIN; EACH SEP ADD'L LESION $1,532.00 HC42000901 ECG EXT HOLTER W/CONNECT >7DAYS-15DAYS; RECORDING $1,528.00 60267-812-00 SODIUM NITRITE-SOD THIOSULFATE 300 MG/10 ML- 12.5 GRAM/50 ML IV SOLN $1,527.63 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 HC21000682 APPLY MULTILAY COMPRS BK LT $1,527.00 HC21000674 APPLY MULTILAY COMPRS BK RT $1,527.00 HC39001037 TMS SUBSEQ DELIV MGMNT SESS $1,527.00 HC31000011 PT-APPLICATION CAST SHORT LEG $1,526.00 HC44200947 US MAPPING VESSEL HEMODIALYSIS; COMPLT BILAT $1,526.00 0517-0374-05 METHYLENE BLUE (ANTIDOTE) 5 MG/ML IV SOLN $1,523.54 0517-0374-01 METHYLENE BLUE (ANTIDOTE) 5 MG/ML IV SOLN $1,523.54 70710-1838-1 METHYLENE BLUE (ANTIDOTE) 5 MG/ML IV SOLN $1,523.54 70710-1838-5 METHYLENE BLUE (ANTIDOTE) 5 MG/ML IV SOLN $1,523.54 HC33000415 ST-SWALLOWING THERAPY 60 MIN $1,523.00 HC41500919 VESTIBULR EVOKD MYOGN POTENTL-VEMP; CVEMP & OVEMP $1,522.00 HC47200647 TREATMENT DEVICES SIMPLE $1,521.00 HC25000019 ED LEVEL II - LIMITED $1,520.00 HC21000625 WOUND VAC W/ DME <50 SQ CM PER SESSION $1,519.00 31722-691-11 SPIRONOLACTONE 25 MG/5 ML ORAL SUSP $1,517.13 HC43001023 US BREAST; LIMITED BILATERAL $1,517.00 HC81101750 ACTH STIMULATION PANEL $1,514.00 59630-266-10 CEFIDEROCOL 1 GRAM IV SOLR $1,513.46 59630-266-01 CEFIDEROCOL 1 GRAM IV SOLR $1,513.46 HC62212501 ELECTRODE UROLOGICAL/ELECTROSURGICL $1,512.00 HC44002608 XR EXAM SURGICAL SPECIMEN $1,512.00 HC42000018 ECG EXT PT ACTV EVENT MONITOR ATTEND 24HRS-30DAYS;HOOK&RECORD $1,511.00 HC44200558 US RETROPERITONEAL LTD $1,511.00 HC36000677 AIRWAY RESISTANCE OSCILLOMETRY 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SHAVER S $1,330.00 HC62213319 BURR S $1,330.00 HC62212295 CATH RETRIEV STONE BACKSTOP GEL AI $1,330.00 HC62218896 DRILL/DRILL BITS SINGLE USE X $1,330.00 HC62218458 ENDO STAPLER S $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 HC44002517 WRIST 2 VIEWS BILAT $1,328.00 HC62214614 SYRINGE BONE MARROW ASPIRATION 20CC $1,327.00 0023-9211-05 BRIMONIDINE-TIMOLOL 0.2-0.5 % OPHT DROP $1,326.85 HC25004540 CLOSED TX ANKLE DISLOC; NO ANES LT $1,326.00 HC25004557 CLOSED TX ANKLE DISLOC; NO ANES RT $1,326.00 HC25003443 CLOSED TX CLAVICLE FX-BIL $1,326.00 70100-424-01 INDOCYANINE GREEN 25 MG INJ SOLR $1,324.38 70100-424-02 INDOCYANINE GREEN 25 MG INJ SOLR $1,324.38 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 HC43001122 MAMMO DX W/CAD BILAT $1,319.00 HC44000388 CHEST 2 VWS W/APICAL LORDOTIC (3VIEWS) $1,318.00 HC44003051 CHEST 3 VIEWS $1,318.00 HC81101966 DRUG TST DEFNTV 8-14RX CLSS W/METBLTS/DAY $1,318.00 HC25005067 ADDING WALKER HEEL PREV CAST BILAT $1,315.00 HC25005380 I&D ABSCESS VULVA/PERINEUM $1,315.00 HC62800958 COIL EMBOLIZATION J $1,311.00 HC33000944 ST-EVAL SPEECH FLUENCY 120MIN/M $1,310.00 HC81701559 MULTI ORGANIZ DNA BY AMP PROBE $1,309.00 HC84201623 MULTI ORGANIZ DNA BY AMP PROBE $1,309.00 HC36000669 GAS DILUT/WASHOUT LUNG VOL $1,308.00 HC36800712 GAS DILUT/WASHOUT LUNG VOL $1,308.00 HC44000073 ANKLE 2 VIEWS BILAT $1,304.00 HC46000162 INJ ARTHROGRAM WRIST-LT $1,301.00 HC46000170 INJ ARTHROGRAM WRIST-RT $1,301.00 HC39000914 PSYCH TX FOR CRISIS 1ST 60MINS/COMM $1,301.00 0187-0994-45 ACYCLOVIR 5 % TOPICAL CREAM $1,300.00 43598-305-62 AZACITIDINE 100 MG INJ SOLR $1,300.00 45963-734-54 DOCETAXEL 20 MG/ML (1 ML) IV SOLN $1,300.00 43598-610-40 DOCETAXEL 80 MG/4 ML (20 MG/ML) IV SOLN $1,300.00 14789-116-05 ERYTHROMYCIN LACTOBIONATE 500 MG IV SOLR $1,300.00 14789-116-07 ERYTHROMYCIN LACTOBIONATE 500 MG IV SOLR $1,300.00 0548-9502-00 ISOPROTERENOL HCL 0.2 MG/ML INJ SOLN $1,300.00 42023-190-01 VASOPRESSIN 20 UNIT/ML IV SOLN $1,300.00 HC47201140 HDR ELECTRONIC BRACHYTHERAPY SKIN SURFACE $1,299.00 58151-115-35 PHENYTOIN 125 MG/5 ML ORAL SUSP $1,298.64 HC51063022 DEBRIDE SKIN MUSL/BONE EA ADD20SQCM/< $1,298.00 HC25003013 LAC REPAIR SIMPLE F/E/E/N/L/M 7.6-12.5 CM $1,296.00 HC62210588 TUBING ASPIRATION NEURO $1,296.00 HC44200491 US OPHTH B-SCAN $1,295.00 HC51062560 BRONCHOSCOPY VIA ESTAB TRACH $1,294.10 HC51010783 DEBRIDE MASTOIDECT CAVITY COMPLEX $1,294.10 HC47200613 APPLY LOW DOSE RADIONUCLIDE SOURCE $1,294.00 0078-0508-83 CARBAMAZEPINE 100 MG/5 ML ORAL SUSP $1,292.85 HC38420022 COLLECT AUTO'BLOOD ADD'L UNIT $1,292.00 HC25001330 M: ED MISC PROCEDURE $1,292.00 HC62203674 KIT ANEURYSM $1,291.00 HC74200361 OR TIME ADD'L 15MIN CASE CX 1 (MCAL 1ST SUBSQNT 0.5 HR) $1,291.00 HC74200585 OR TIME ADD'L 15MIN CASE CX 1 (MCAL 2ND SUBSQNT 0.5 HR) $1,291.00 HC46502720 BIOPSY TANGENTIAL SKIN; EACH SEP ADD'L LESION $1,290.00 8065183905 CHONDROITIN SULF-SOD HYALURON 4-3 % (40-30 MG/ML) INTRAOCULAR SYRG $1,288.76 HC62211917 DSG ABD ABTHERA OPEN $1,288.00 HC32000051 OT-COMPUT DYNAMIC POSTURE SOT 6 CONDITIONS $1,288.00 HC31000151 PT-COMPUT DYNAMIC POSTURE SOT 6 CONDITIONS $1,288.00 HC42000208 ECHO FETAL DOPPLER COMPLETE $1,287.00 HC44000040 XR ABDOMEN COMPLETE (2/> IMAGES) W/CXR $1,287.00 HC44000693 XR ESOPHAGUS W/SNGLE CONSTRST INC SCOUT&DELAYS $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 HC83504449 ANATOMIC CONSULT; COMP. REV-CS $1,283.00 HC62219340 GUIDE TIBIAL ORTHO $1,282.00 HC62206479 SHEATHS ILLUMINATOR $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 HC32001695 OT-APP SPLINT SHORTARM;DYNAMIC $1,279.00 54643-5653-0 MVI, PEDI NO.1 WITH VIT K 80 MG-400 UNIT- 200 MCG/5 ML IV SOLN $1,278.94 HC43001098 MAMMO SCREEN W/IMP W/CAD BIL $1,277.00 0517-0602-01 FERRIC CARBOXYMALTOSE 100 MG IRON/2 ML IV SOLN $1,276.28 HC44200459 US OB LIMITED FETUS(S) $1,276.00 61314-044-75 TRIFLURIDINE 1 % OPHT DROP $1,274.08 HC38000162 APPLY SPLINT SHORT LEG $1,274.00 HC25000878 ASP/INJ MED JOINT-LT $1,274.00 HC25000886 ASP/INJ MED JOINT-RT $1,274.00 HC32001612 OT-APPLICATION CAST SHORT ARM $1,274.00 HC83001149 RBC'S LEUKO RED IRRAD EACH UNIT $1,274.00 HC39001029 TMS INITIAL MAP THRES DEL MGMT SESS $1,274.00 67457-857-30 ADENOSINE (DIAGNOSTIC) 3 MG/ML IV SOLN $1,273.94 HC25004011 DRAIN ABSCESS FINGER SIMPLE $1,272.00 HC33000407 ST-SWALLOWING THERAPY 45 MIN $1,272.00 16714-178-01 FLUOROURACIL 5 % TOPICAL CREAM $1,271.40 62327-444-04 STERILE TALC 4 GRAM INTRAPLEURAL SUSR $1,270.75 62327-444-44 STERILE TALC 4 GRAM INTRAPLEURAL SUSR $1,270.75 HC38000022 APPLY CAST SHORT ARM $1,270.00 HC42000885 ECG EXT HOLTER W/CONNECT>48HRS-7DAYS; RECORDING $1,270.00 HC44200475 US OB NUCHAL MEAS EA ADL GEST+ $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 64950-343-16 HYDROCODONE-ACETAMINOPHEN 7.5-325 MG/15 ML ORAL SOLN $1,266.69 HC31001787 PT-EVAL HIGH COMPLEXITY 45MIF2F 120MIN $1,266.00 HC42000968 CARDIOVAS STRESS TEST W/ PROCAINAMIDE ECG TRACING ONLY $1,264.00 0023-9321-05 BRIMONIDINE 0.1 % OPHT DROP $1,263.86 0037-6822-10 HYDROCORTISONE-PRAMOXINE 1-1 % RECTAL FOAM $1,263.47 HC25006156 FETAL NON-STRESS TEST $1,263.00 HC32000820 OT-WOUND VAC 60>50 SQ CM/M $1,263.00 HC31000888 PT-WOUND VAC 60>50 SQ CM/M $1,263.00 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 HC25000530 SPLINT LONG LEG $1,260.00 HC62218581 STAPLE CARTRG/ENDO RELOAD P $1,260.00 HC62221866 TAP SURGICAL P $1,260.00 HC36000263 VENT DAY INITIAL-ADULT $1,260.00 HC36000271 VENT DAY INITIAL-INFANT $1,260.00 HC36000289 VENT DAY INIT-JET VENT $1,260.00 HC36000297 VENT DAY INIT-OSCIL&/OR HI FRQ $1,260.00 HC36000305 VENT DAY SUBSEQUENT-ADULT $1,260.00 HC36000313 VENT DAY SUBSEQUENT-INFANT $1,260.00 HC36000321 VENT DAY SUBSQ-JET VENT $1,260.00 HC36000339 VENT DAY SUBSQ-OSCIL&/OR HI FR $1,260.00 HC62222500 WAND ARTHRO P $1,260.00 55513-002-01 DARBEPOETIN ALFA IN POLYSORBAT 25 MCG/ML INJ SOLN $1,257.75 HC44001873 SCAPULA BILATERAL $1,257.00 HC25005018 APPLY CAST SHORT LEG LT $1,255.00 HC25005026 APPLY CAST SHORT LEG RT $1,255.00 HC25000571 BLADDER IRRIGATION SIMPLE $1,255.00 HC25004805 CLOSED TX TALOTARSAL JNT DISLOC; NO ANES LT $1,255.00 HC25004813 CLOSED TX TALOTARSAL JNT DISLOC; NO ANES RT $1,255.00 HC25004839 CLOSED TX TARSOMETATARSAL JNT DISLOC; NO ANES LT $1,255.00 HC46503454 IRRIGATION BLADDER SIMPLE $1,255.00 23155-686-31 OCTREOTIDE ACETATE 1,000 MCG/ML INJ SOLN $1,254.50 HC25003658 CLOSED TX ELBOW DISLOC W/O ANES LT $1,253.00 HC25003666 CLOSED TX ELBOW DISLOC W/O ANES RT $1,253.00 HC41000129 HOME SLEEP STUDY/T IV MIN' 3CH $1,252.00 HC62807466 GOLD SEED MARKERS FIDUCIAL KIT/3 $1,250.00 HC38000105 REMV/BIVALVE FULL CAST ARM/LEG $1,250.00 HC33001041 ST-EVAL SOUND W/LANG COMP&EXPRESS 60MIN/M $1,247.00 HC82200957 TISSUE EX G&M LVL 5 DIST SVC $1,247.00 HC82200411 TISSUE EXAM G&M LEVEL 5 $1,247.00 HC82202581 TISSUE EXAM G&M LEVEL 5 *OP $1,247.00 HC82202763 TISSUE EXAM G&M LVL 5(TC ONLY) $1,247.00 HC82200684 TISSUE EXAM LEVEL 5 ADD'L $1,247.00 HC82200601 TISSUE EXAM LVL 5 (PQRI) $1,247.00 HC46501946 M: MISC PROCEDURE $1,244.00 HC32010381 OT-RE-EVAL EST POC 120MIN $1,243.00 HC36001055 SPIROMETRY W/MEASUREMNTS& REC $1,243.00 HC36800381 SPIROMETRY W/MEASUREMNTS& REC $1,243.00 99999-001-77 CHARGE-ADULT 3 IN 1 ADMIX 2000ML $1,241.50 HC77400166 ANESTHESIA EPIDURAL INITIAL HR $1,241.00 HC83000612 RBC'S LR/CMV-NEG/IRRAD/UNIT $1,241.00 65162-062-05 SUCRALFATE 100 MG/ML ORAL LIQUID (MCH) $1,239.42 HC44701563 ADMIN RX;MULT MSRMNTS PRE/PST+ $1,239.00 HC73000259 DIALYSIS CCPD CANCEL-MED NEC $1,238.00 HC25004771 CLOSED TX TARSAL DISLOC; NO ANES LT $1,237.00 HC25004789 CLOSED TX TARSAL DISLOC; NO ANES RT $1,237.00 HC62203492 SEALANT KIT (FLOSEAL/COSEAL) $1,235.00 0143-9674-01 ARGATROBAN 100 MG/ML IV SOLN $1,235.00 53276-1010-09 MICROFIBRIL. COLLAGEN HEMOSTAT 70 X 35 MM TOPICAL SHEE $1,235.00 53276-1010-02 MICROFIBRIL. COLLAGEN HEMOSTAT TOPICAL POWD $1,235.00 HC31000037 PT-APPLIC SPLINT SHORT LEG $1,234.00 HC44001782 RIBS BILAT MIN 4VWS W/PA CHEST $1,233.00 0121-0678-16 NORTRIPTYLINE 10 MG/5 ML ORAL SOLN $1,232.88 72888-157-39 NORTRIPTYLINE 10 MG/5 ML ORAL SOLN $1,232.88 HC62229190 ORTHOTIC TLSO 4 RIGID XLG(DONJOY) $1,232.00 HC44200954 US MAPPING VESSEL HEMODIALYSIS; COMPLT UNILAT $1,231.00 HC25004102 CLOSED TX FINGER JNT DISLOC W/MAN SINGLE $1,229.00 HC32001653 OT-APPLICATION SPLINT SHORTARM $1,229.00 HC25000431 MANIPULATION MAJOR JOINT $1,228.00 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 HC38000097 APPLY CMPRSSN BOOT/WRAP(UNNA) $1,224.00 HC38000204 APPLY CMPRSSN BOOT/WRAP(UNNA)L $1,224.00 HC38000196 APPLY CMPRSSN BOOT/WRAP(UNNA)R $1,224.00 99999-039-35 GELFOAM+THROMBIN MIXTURE LBM $1,223.42 HC25004896 APPLY CAST; ELBOW TO FINGER (SHORT ARM) LT $1,222.00 HC25004904 APPLY CAST; ELBOW TO FINGER (SHORT ARM) RT $1,222.00 HC25004128 CLOSED TX FINGER/THUMB SHAFT FX NO MANIP EA $1,222.00 HC25004185 CLOSED TX HIP DISLOC TRAUMIC LT $1,222.00 HC25004193 CLOSED TX HIP DISLOC TRAUMIC RT $1,222.00 HC25004649 CLOSED TX METATARSAL FX; NO MANIPULTN EA $1,222.00 HC25004334 CLOSED TX PATELLAR DISLOC; NO ANESTH LT $1,222.00 HC25004342 CLOSED TX PATELLAR DISLOC; NO ANESTH RT $1,222.00 HC25004516 CLOSED TX PROX TIBIOFIBULAR JNT DISLOC; NO ANES LT $1,222.00 HC25004524 CLOSED TX PROX TIBIOFIBULAR JNT DISLOC; NO ANES RT $1,222.00 HC25003831 CLOSED TX RAD/EPHYSL SEP&ULN FX NO M LT $1,222.00 HC25003849 CLOSED TX RAD/EPHYSL SEP&ULN FX NO M RT $1,222.00 0074-4456-04 SEVOFLURANE 99.97 % INHALATION LIQD $1,222.00 0074-4456-51 SEVOFLURANE 99.97 % INHALATION LIQD $1,222.00 HC25003005 LAC REPAIR SIMPLE F/E/E/N/L/M 5.1-7.5 CM $1,221.00 HC33000936 ST-EVAL SPEECH FLUENCY 90MIN/M $1,221.00 HC44002376 TOMOGRAM SINGLE PLANE $1,221.00 HC32001711 OT-EVAL HIGH COMPLEXITY 45MF2F 120MIN $1,218.00 45802-210-01 NITROGLYCERIN 400 MCG/SPRAY TL SPRY $1,215.91 66993-241-50 NITROGLYCERIN 400 MCG/SPRAY TL SPRY $1,215.91 99999-034-92 CHARGE-ADULT TPN (LBM) $1,215.50 25021-191-10 MICAFUNGIN 100 MG IV SOLR $1,215.50 16714-301-10 MICAFUNGIN 100 MG IV SOLR $1,215.50 16714-301-01 MICAFUNGIN 100 MG IV SOLR $1,215.50 0469-3211-10 MICAFUNGIN 100 MG IV SOLR $1,215.50 25021-191-11 MICAFUNGIN 100 MG IV SOLR $1,215.50 8065183055 SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRG $1,214.91 HC25004169 CLOSED TX FINGER/THUMB DISTAL FX W/MANIP EA $1,214.00 HC25001140 INSRT BLADDER CATH-TEMP-COMPLX $1,214.00 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 HC11500790 AM/PACU EVAL & MANAGE 40MIN $1,213.00 HC25003526 CLOSED TX STERNOCLVCLE DISLOC W/MAN RT $1,213.00 HC25003518 CLOSED TX STRENOCLVCLE DISLOC W/MAN LT $1,213.00 HC41500737 EMG THORACIC PARASPINAL(NO T1/T12) $1,213.00 HC25000142 EXCISE NAIL FOLD INGROWN $1,213.00 HC21000526 PAIRING BENIGN LESIONS: 2-4 $1,213.00 HC47200423 RADIATION TX SUPRFCL OR/ORTH PER DAY $1,213.00 HC62229026 CATH ANGIO PERIPH CROSSING SET $1,212.00 HC36800225 HTN ASSESSMENT W/ NITRIC OXIDE $1,212.00 HC25005877 CHANGE CYSTOSTOMY TUBE; SIMPLE $1,210.00 HC25004730 CLOSED TX PHALANX(TOE) FX; W/MANIPULTN EA $1,210.00 HC43500040 DEXA BONE DENS-AXIAL/APPEND COMB $1,210.00 HC73000200 HEMODIALYSIS CANCEL-MED NEC $1,206.00 HC44000503 CLAVICLE BILATERAL $1,204.00 50242-041-64 ALTEPLASE 2 MG INJ (FOR INTERVENTIONAL NEUROLOGY) (SLH) $1,203.61 50242-041-10 ALTEPLASE 2 MG INJ (FOR INTERVENTIONAL NEUROLOGY) (SLH) $1,203.53 HC36000982 HTN ASSESSMENT W/ NITRIC OXIDE $1,203.00 HC62206404 SET THROMBECTOMY PUMP $1,203.00 10019-938-25 CYCLOPHOSPHAMIDE 500 MG IV SOLR $1,202.50 10019-938-01 CYCLOPHOSPHAMIDE 500 MG IV SOLR $1,202.50 0548-9501-00 ISOPROTERENOL HCL 0.2 MG/ML INJ SOLN $1,202.50 55150-166-13 SILDENAFIL (PULM.HYPERTENSION) 10 MG/12.5 ML IV SOLN $1,202.50 0603-1542-58 POTASSIUM CHLORIDE 10% ORAL LIQD (1.33 MEQ/ML) (MCH) $1,202.13 60505-6184-6 POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQD $1,202.13 HC83000034 RBC'S WASHED EA UNIT $1,202.00 HC83001032 RBC'S WASHED EA UNIT -SB $1,202.00 HC44200442 US OB FOLLOW UP FETAL RE-EVAL TRANSAB PER FETUS $1,202.00 HC73000242 DIALYSIS CAPD CANCEL-MED NEC $1,201.00 HC25004151 CLOSED TX FINGER/THUMB DISTAL FX NO MANIP EA $1,200.00 HC32001505 OT-REMOVE/BIVAL CAST FULL LIMB $1,200.00 HC31010309 PT-RE-EVAL EST POC 120MIN $1,200.00 HC31001720 PT-REMOVE/BIVAL CAST FULL LIMB $1,200.00 HC62207311 TRAY DIALYSIS $1,200.00 99988-000-38 NM I-123 SODIUM IODIDE DIAGNOSTIC CAPSULE (COMPOUNDED) $1,199.35 HC46000311 INJ FOR DACRYCYSTOGRAPHY $1,197.00 HC44000735 FACIAL BONES COMP MIN 3 VWS $1,195.00 HC25000464 FRACTURE TX LONG BONE $1,195.00 HC44200434 US OB FOLLOW UP(RE-EVAL) $1,195.00 HC25004698 CLOSED TX BIG TOE FX; W/MANIPULTN LT $1,194.00 HC25004706 CLOSED TX BIG TOE FX; W/MANIPULTN RT $1,194.00 HC62219662 KIT INSTRUMENTS ENDOBUTTON $1,194.00 16729-267-65 DOCETAXEL 160 MG/8 ML (20 MG/ML) IV SOLN $1,193.40 HC25004177 CLOSED TX FINGER JNT DISLOC $1,193.00 16714-885-01 ACYCLOVIR 5 % TOPICAL OINT $1,191.84 HC38000154 APPLY SPLINT SHORT ARM $1,191.00 HC25005851 DECLOT IVAD W/THROMBOLYTIC $1,191.00 HC25002940 LAC REPAIR SIMPLE S/N/A/GEN/T/EXT 7.6-12.5CM $1,191.00 HC46501631 UROFLOWMETRY SIMPLE $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 HC51063121 EXCISION OF NAIL & MATRIX PERMANENT $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 HC33001009 ST-EVAL SOUND PRODUCTION 120MIN/M $1,190.00 HC62229349 VEST CHEST THERAPY WRAP $1,190.00 0006-4827-00 VARICELLA VIRUS VACC LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSR $1,184.64 0006-4827-01 VARICELLA VIRUS VACC LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSR $1,184.64 HC47200563 RADIOELEMENT INFUSION $1,184.00 HC33001165 ST EVAL BEHAVRAL QUAL VOICE 90MIN/M $1,184.00 HC62802590 WIRE INTERVENTIONAL SPECIALTY $1,184.00 HC12200002 IV INFUSION THERAPY 1ST HOUR $1,183.00 HC12400040 CHEMO ADMIN IVP SNGL/ADD'L INJ $1,181.00 HC46000097 INJ ARTHROGRAM ANKLE-LT $1,179.00 HC46000105 INJ ARTHROGRAM ANKLE-RT $1,179.00 HC25005497 REMOVE FB EXTRNL EYE; CONJUNCT EMBEDD LT $1,179.00 HC25005505 REMOVE FB EXTRNL EYE; CONJUNCT EMBEDD RT $1,179.00 HC25005232 LAC REPAIR MOUTH; 2.5 CM OR LESS $1,178.00 HC25000241 BURNS LOCAL TREATMENT MED 18% $1,176.00 HC62201447 CATH GASTRO TUBE $1,176.00 HC25001355 DEBRID OPN WOUND EA ADD 20CM/< $1,176.00 HC25000522 SPLINT LONG ARM $1,176.00 HC44002681 UROGRAPHY ANTEGRADE LTD LT $1,175.00 HC44002699 UROGRAPHY ANTEGRADE LTD RT $1,175.00 54288-152-01 EPINEPHRINE 1 MG/ML (1:1,000) INJ SOLN CODE NEO $1,173.32 HC35000041 REC- EVALUATION 40MIN $1,173.00 HC42000034 AMB BP MONITOR 24HR+ ANALYSIS W/RPT; SCANNING $1,172.00 HC42000026 AMB BP MONITOR 24HR+ RECORD ONLY $1,170.00 HC43001080 MAMMO SCREEN W/CAD BILAT $1,170.00 44206-251-91 ALBUMIN, HUMAN 25 % 25 % IV SOLP $1,170.00 44206-251-10 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 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 HC41500497 EMG EA EXTRM /PRSPNL;CMPL 5MUS+ $1,169.00 HC44001733 PERINEOGRAM $1,169.00 HC44000362 CHEST 2 VIEWS $1,166.00 HC82202417 MORPH STDY TMR IHC CAT EGFR PER SPEC EA ADDL AB $1,166.00 HC82202375 MORPH STDY TMR IHC CAT ER PER SPEC EA ADDL AB $1,166.00 HC82202409 MORPH STDY TMR IHC CAT HER2 PER SPEC EA ADDL AB $1,166.00 HC82202391 MORPH STDY TMR IHC CAT KI67 PER SPEC EA ADDL AB $1,166.00 HC82202425 MORPH STDY TMR IHC CAT NOS PER SPEC EA ADDL AB $1,166.00 HC82202433 MORPH STDY TMR IHC CAT PER SPEC EA ADDL AB $1,166.00 HC82202383 MORPH STDY TMR IHC CAT PR PER SPEC EA ADDL AB $1,166.00 HC25004946 APPLY CAST HAND & LWR FOREARM (GAUNTLET) BIL $1,165.00 HC82201492 ACID PTASE STAIN, GRP III $1,164.00 HC82201518 ALPHA NAPBUT STAIN, GRP III $1,164.00 HC25004847 CLOSED TX METATARSOPHALAN JNT DISLOC; NO ANES LT $1,164.00 HC82201286 HISTCHM ST ALK PTASE,FRZ TIS $1,164.00 HC82201294 HISTCHM ST ATPSE PH4.3,FR TS $1,164.00 HC82201302 HISTCHM ST ATPSE PH4.6,FR TS $1,164.00 HC82201310 HISTCHM ST ATPSE PH9.4,FR TS $1,164.00 HC82201385 HISTCHM ST CYTCHRM OXDS,FR TS $1,164.00 HC82201336 HISTCHM ST MYPHSPHRYLS,FR TS $1,164.00 HC82201344 HISTCHM ST NADH-TR,FROZ TISS $1,164.00 HC82201476 HISTOCHEM DETERMINATIVE,GRIII $1,164.00 HC82201435 HISTOCHM STN SDH, FRZ TIS BLK $1,164.00 HC82201500 N-CHLORO EST STAIN, GRP III $1,164.00 HC82201484 PEROXIDASE STAIN, GRP III $1,164.00 HC62215769 ADAPTER INJECTION SPINAL $1,163.00 HC62211628 PAD TEMP MNGMNT SYSTEM/BOX $1,162.00 HC25005521 REMOVE FB EXTRNL EYE; CORNEAL NO SLITLAMP LT $1,162.00 HC25005539 REMOVE FB EXTRNL EYE; CORNEAL NO SLITLAMP RT $1,162.00 71288-208-30 ADENOSINE (DIAGNOSTIC) 3 MG/ML IV SOLN $1,161.81 HC22000046 OST NEW PT EVAL 60MIN $1,161.00 0068-0597-01 RIFAMPIN 600 MG IV SOLR $1,160.64 0068-0599-01 RIFAMPIN 600 MG IV SOLR $1,160.64 HC44000297 CALCANEUS (HEEL) BILAT $1,159.00 65628-206-05 VANCOMYCIN 50 MG/ML ORAL SOLR $1,157.33 HC36001097 OSCILLATE CHEST WALL MECH EA SESSION $1,157.00 66993-079-96 FLUTICASONE PROPIONATE 110 MCG/ACTUATION INHALATION HFAA $1,156.97 HC41500489 EMG 1 EXTREM W/PARASPINAL LTD+ $1,156.00 HC62800602 GUIDEWIRE(X-PEDION HYDROPHILIC) P $1,156.00 HC62215488 KNIFE BAYONET G $1,156.00 HC62808308 M: ADAPTER SHOULDER $1,156.00 HC62217054 WRENCH TIP SPINAL (DISP) $1,156.00 49471-001-05 BENZYLPENICILLOYL POLYLYSINE 0.25 ML INTRADERMAL SOLN $1,154.40 HC25000365 FB REMOVAL EYE $1,154.00 HC81101107 FETAL FIBRONECTIN $1,154.00 HC25002809 I&D ABSCESS; SIMPLE/SINGLE $1,154.00 HC25004656 CLOSED TX METATARSAL FX; W/MANIPULTN EA $1,153.00 HC44002988 HIPS BILAT3-4VWS(W/PELVIS WHN PRFRMD) $1,153.00 HC25004136 CLOSED TX FINGER/THUMB SHAFT FX W/MANIP EA $1,151.00 HC25004854 CLOSED TX INTERPHALANGEAL JNT DISLOC; NO ANES LT $1,151.00 HC44002889 SPINE ENTIRE SKULL-SACRUM 2-3 VIEWS $1,151.00 0052-0602-02 BCG LIVE 50 MG INTRAVESICAL SUSR $1,148.36 HC62204573 CATH CARDIAC $1,148.00 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 HC44001584 MANDIBLE COMPLETE MIN 4 VWS $1,145.00 HC51061422 IV INFUSE/SC MONOCLONAL CASIRIVIMAB/IMDEVIMAB (REGENERON) $1,144.82 HC51062057 IV INFUSE/SC MONOCLONAL CASIRIVIMAB/IMDEVIMAB (REGENERON) REPEAT $1,144.82 HC51061737 IV INFUSION MONOCLONAL ABX BAMLANIVIMAB/ETESEVIMAB $1,144.82 77777-003-09 ALTEPLASE 2 MG INTRACATH SOLR $1,144.05 HC38000329 APPLY LONG LEG CAST BRACE $1,143.00 HC32000739 OT-WOUND NON-SEL DEB 45MIN/MW $1,143.00 HC31000797 PT-WOUND NON-SEL DEB 45MIN/MW $1,143.00 HC25000845 ASP/INJ SMALL JOINT-LT $1,141.00 HC25000852 ASP/INJ SMALL JOINT-RT $1,141.00 HC25004110 CLOSED TX KNUCLE DISLOC W/MANIP EA $1,141.00 HC44002335 TOE (S) BILAT $1,141.00 70860-403-51 BIVALIRUDIN 250 MG/50 ML (5 MG/ML) IV SOLN $1,140.75 70860-403-50 BIVALIRUDIN 250 MG/50 ML (5 MG/ML) IV SOLN $1,140.75 70860-780-10 FOSAPREPITANT 150 MG IV SOLR $1,140.75 HC25006057 CLOSED TX TARSOMETATARSAL JNT DISLOC; NO ANES RT $1,140.00 HC62225446 DEVICE RESECTION MUCOSAL ENDO(EMR) $1,138.00 HC25005265 I&D ABSCESS PERITONSILLAR LT $1,138.00 HC25005273 I&D ABSCESS PERITONSILLAR RT $1,138.00 HC62225495 TUBE SPLINTING ENDOSCOPIC $1,138.00 69097-644-48 SUMATRIPTAN 20 MG/ACTUATION NASL SPRY $1,137.51 25021-414-50 ARGATROBAN IN 0.9 % SOD CHLOR 1 MG/ML IV SOLN $1,137.50 39822-0255-1 CYCLOPHOSPHAMIDE 1 GRAM IV SOLR $1,137.50 0009-0005-01 HYDROCORTISONE SOD SUCC (PF) 1,000 MG/8 ML INJ SOLR $1,136.40 HC25004664 CLOSED TX BIG TOE FX; NO MANIPULTN LT $1,136.00 HC25004672 CLOSED TX BIG TOE FX; NO MANIPULTN RT $1,136.00 HC25004748 CLOSED TX SESAMOID FX LT $1,136.00 HC25004755 CLOSED TX SESAMOID FX RT $1,136.00 HC44001352 JNT SURVEY SNGL VW 2 OR>JNTS $1,136.00 0781-6023-46 CLARITHROMYCIN 250 MG/5 ML ORAL SUSR (MCH) $1,134.25 HC62802269 TUBE JEJUN LOWPRO TG BUTTON $1,134.00 67919-030-01 CEFTOLOZANE-TAZOBACTAM 1.5 GRAM IV SOLR $1,133.34 HC62202874 CUTTER LINEAR ENDO O $1,133.00 HC46503470 I&D ABSCESS PERITONSILLAR $1,131.00 HC62228820 SCISSORS ENDOSCOPIC Q $1,131.00 HC62222583 TUBING ASPIRATOR ULTRASONIC O $1,131.00 HC32001620 OT-APPLICATION CAST GAUNTLET $1,130.00 HC44002095 SPEECH STUDY - CINE/VIDEO $1,128.00 HC47200621 THERAPEUTIC RAD PORT IMAGES $1,128.00 HC51010239 ASP/INJ LARGE JOINT-BILAT $1,125.21 HC51010205 ASP/INJ MED JOINT-BILAT $1,125.21 HC51010171 ASP/INJ SMALL JNT-SC BILAT $1,125.21 HC51010056 DESTROY MUSCLE(S) FACIAL NERVE BI $1,125.21 HC51010262 INJ(S);SINGLE TENDON/SHEATH BI $1,125.21 HC83000588 BLOOD LR FROZ/DEGLY/WASH'D $1,124.00 HC25004722 CLOSED TX PHALANX(TOE) FX; NO MANIPULTN $1,122.00 HC25005570 REMOVE FB EXTRNL EYE; CORNL W/SLITLAMP BIL $1,122.00 61703-343-18 MITOXANTRONE 2 MG/ML IV CONC $1,121.64 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 HC12400024 CHEMO INF SEQ/NEW RX 1ST HR $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 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 HC44002012 SIALOGRAPHY $1,119.00 HC77400182 ANESTHESIA SPINAL INITIAL HR $1,118.00 HC82202177 MORPHOMETRIC STUDY SKEL MUSC $1,118.00 HC44200426 US OB 1ST TRI ADD'L GEST + $1,118.00 69800-4202-2 HEPATITIS B IMMUNE GLOBULIN GREATR THAN 312 UNIT/ML IM SOLN $1,117.29 69800-4202-1 HEPATITIS B IMMUNE GLOBULIN GREATR THAN 312 UNIT/ML IM SOLN $1,117.29 HC43500016 DEXA BONE DENS-AXIAL SKELETAL $1,115.00 0015-3012-60 CARMUSTINE 100 MG IV SOLN (MCH) $1,114.17 HC81100877 ACUTE HEPATITIS PANEL $1,114.00 HC77400125 ANESTHESIA REGIONAL INITIAL HOUR $1,114.00 HC25004037 CLOSED TX METACARPAL FX W/MAN EA $1,113.00 HC33000696 ST-EVAL LANGUAGE CMPNT 60MIN $1,112.00 HC33000225 ST-SPEECH THERAPY 45 MIN/MW $1,110.00 HC12400081 CHEMO NONHRMNL ANTINEOPL SQ/IM $1,109.00 HC21000013 ABRASION; SNGL LESION $1,108.00 61269-410-20 ETOPOSIDE PHOSPHATE 100 MG IV SOLR $1,107.28 HC38000006 APPLIC CAST LEG CLUBFOOT $1,107.00 HC43500024 DEXA BONE DENS-BODY $ $1,106.00 HC41500778 EEG W/O VID UNMONITOR 2-12 HR $1,106.00 44206-300-01 RHO(D) IMMUNE GLOBULIN 1,500 UNIT (300 MCG) IM ONLY INJ (MHS WRAPPER) $1,105.98 44206-300-90 RHO(D) IMMUNE GLOBULIN 1,500 UNIT (300 MCG) IM ONLY INJ (MHS WRAPPER) $1,105.98 63323-851-50 HYDROMORPHONE (PF) 10 MG/ML INJ SOLN $1,105.33 HC25003450 CLOSED TX CLAVICLE FX LT $1,105.00 HC25003468 CLOSED TX CLAVICLE FX RT $1,105.00 HC25005406 INJ ANES/STEROID NERVE TRIGEML BRNCH EA LT $1,105.00 HC25005414 INJ ANES/STEROID NERVE TRIGEML BRNCH EA RT $1,105.00 HC25005885 LYSIS & STRETCHING ADHESIONS PREPUTIAL $1,105.00 ADULT TPN (OCM, REPORT) $1,105.00 67457-781-08 DOCETAXEL 160 MG/8 ML (20 MG/ML) IV SOLN $1,105.00 65649-551-02 METHYLNALTREXONE 12 MG/0.6 ML SUBCUTANEOUS (MHS WRAPPER) $1,104.55 65649-551-07 METHYLNALTREXONE 12 MG/0.6 ML SUBCUTANEOUS (MHS WRAPPER) $1,104.55 65649-551-03 METHYLNALTREXONE 12 MG/0.6 ML SUBCUTANEOUS (MHS WRAPPER) $1,104.54 HC43001171 MAMMO DX UNILAT W/CAD LT $1,104.00 HC43001189 MAMMO DX UNILAT W/CAD RT $1,104.00 HC32001497 OT-REMOVE/BIVAL CAST SHRT LIMB $1,102.00 HC31001712 PT-REMOVE/BIVAL CAST SHRT LIMB $1,102.00 0009-3169-06 ALPROSTADIL 500 MCG/ML INJ SOLN $1,100.74 0009-3169-01 ALPROSTADIL 500 MCG/ML INJ SOLN $1,100.74 HC62228515 BRONCHOSCOPE ASCOPE 4 LRG $1,100.00 HC62227111 CONTROL DOSE C02 MANUAL PAT(AEROFORM) $1,100.00 HC33000845 ST-EVAL SPEECH CMPNT 60MIN $1,100.00 99999-045-63 NM TC-99M TILMANOCEPT 0.25 MCI (LYMPHOSEEK) $1,099.70 HC11501053 HOSPITAL OUTPATIENT VISIT W/PROC $1,098.00 HC44700334 INSERT ARTERIAL LINE LT $1,098.00 HC44700342 INSERT ARTERIAL LINE RT $1,098.00 0003-0527-11 DASATINIB 20 MG ORAL TAB $1,096.74 75834-295-01 ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL SUSP (MCH) $1,096.55 HC81101958 DRUG TST DEFNTV 1-7RX CLSS W/METBLTS/DAY $1,096.00 HC25005117 WEDGING CAST EXCEPT CLUBFOOT $1,096.00 0173-0715-22 FLUTICASONE PROPION-SALMETEROL 45-21 MCG/ACTUATION INHALATION HFAA $1,095.33 11980-211-05 FLUOROMETHOLONE 0.1 % OPHT DRPS $1,094.73 11980-228-05 FLUOROMETHOLONE 0.25 % OPHT DRPS $1,094.73 HC32000291 OT-EVAL HIGH COMPLEXITY 45MF2F 90MIN $1,094.00 HC31000367 PT-EVAL HIGH COMPLEXITY 45MF2F 90MIN $1,094.00 HC44001543 LUMBAR SPINE BEND ONLY;2/3 VWS $1,093.00 HC62211933 STAPLER ENDO POWERED $1,093.00 HC62800024 BALLOON DILATOR BILIARY/NEPHRO $1,092.00 HC62211404 KIT VENTRICULOSTOMY ACCESS $1,092.00 HC62807763 M: RING ACETABULAR HIP $1,092.00 HC46501128 INSRT BLADDER CATH-TEMP FOLEY $1,090.00 HC62802624 TUBE GASTROSTOMY LOWPRFL BTTN O $1,089.00 HC44003069 ABDOMEN 3/> VIEWS $1,088.00 HC44000032 ABDOMEN W/DECUB &/OR ERECT (3/>VIEWS) $1,088.00 HC44001279 INTERNAL AUDITORY CANAL $1,088.00 HC25000761 AVULSION OF NAIL, SIMPLE:1 $1,087.00 HC32001281 OT-RE-EVAL EST POC 90MIN $1,087.00 HC62212758 GUIDEWIRE O $1,086.00 HC32001679 OT-APPLY SPLINT FINGER DYNAMIC $1,085.00 63323-877-15 PENTAMIDINE 300 MG INHALATION SOLR $1,084.79 63323-113-10 PENTAMIDINE 300 MG INJ SOLR $1,084.79 63323-113-01 PENTAMIDINE 300 MG INJ SOLR $1,084.79 HC51062974 DEBRIDE SKIN SUBQ; FIRST 20SQCM $1,082.00 HC51070936 FB REMOVAL SQ SIMPLE $1,082.00 HC62214341 PROBE PEDICLE $1,081.00 HC41500661 CALORIC VESTIB BITHERM 2 IRRIG W/REC $1,080.00 58160-958-01 MENING A CONJ VACC,2 OF 2 (PF) 10 MCG /0.5 ML (FINAL) IM SOLR $1,078.99 58160-955-09 MENING VAC A,C,Y,W135 DIP (PF) 10-5 MCG/0.5 ML IM KIT $1,078.99 58160-959-01 MENINGOCOCCAL VACCINE COMPONENTS A & C,Y,W-135 SHELL $1,078.99 HC44001741 XR PHARYNX/CERVICAL ESOPHAGUS W/CNSTRST INC SCOUT&DELAYS $1,078.00 55513-144-10 EPOETIN ALFA 10,000 UNIT/ML INJ SOLN $1,077.70 55513-144-01 EPOETIN ALFA 10,000 UNIT/ML INJ SOLN $1,077.70 HC42000497 SIGNAL AVERAGE ECG $1,076.00 65162-649-78 OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSP $1,075.75 0409-2634-50 HYDROMORPHONE (PF) 10 MG/ML INJ SOLN $1,074.78 HC25005158 CHANGE TRACH TUBE PRIOR ESTAB FISTULA TRACT $1,074.00 HC38000113 REMV/BIVALVE SHRT CAST ARM/LEG $1,074.00 HC44002939 HIP (W/PELVIS WHN PRFRMD) 2-3VWS LT $1,073.00 HC44002947 HIP (W/PELVIS WHN PRFRMD) 2-3VWS RT $1,073.00 HC62206305 SET LITHOTRIPTOR $1,073.00 25021-308-84 ESMOLOL IN NACL (ISO-OSM) 2,500 MG/250 ML (10 MG/ML) IV SOLP $1,072.50 HC12400016 CHEMO ADMIN IV ADD'L HR $1,072.00 HC21000260 DEBRIDE OF NAILS: 6 OR > $1,071.00 HC42000216 ECHO FETAL DOPPLER F/U OR REP $1,071.00 HC44001774 RIBS BILAT 3 VIEWS $1,071.00 HC33000993 ST-EVAL SOUND PRODUCTION 90MIN/M $1,071.00 HC36800910 PULM REHAB PER SESSION (90MIN) W POX2 $1,070.00 38779-0598-8 IODINE STRONG (LUGOLS) 5 % ORAL SOLN $1,069.25 HC44900868 CT BODY SCAN LTD ABD/CHEST/PEL $1,069.00 HC25005109 REMOVE/BIVALVING; GAUNTLET,BOOT OR BODY CAST $1,069.00 HC44001691 ORBITS COMPLETE MIN 4 VWS $1,068.00 HC44002210 THORACIC SPINE MIN 4 VIEWS $1,068.00 50458-305-03 RISPERIDONE 1 MG/ML ORAL SOLN $1,067.63 HC62222195 BARRIER/BAG DEFECT WALL VENTRAL/ABD $1,067.00 HC81100596 GENTAMICIN INIT $1,067.00 HC62207451 TRAY NASAL $1,065.00 HC62224738 SYSTEM ILLUMINATION ENDOSCOPIC $1,064.00 0781-2322-06 APREPITANT 80 MG ORAL CAP $1,059.66 68462-584-40 APREPITANT 80 MG ORAL CAP $1,059.55 68462-584-76 APREPITANT 80 MG ORAL CAP $1,059.55 13668-592-86 APREPITANT 80 MG ORAL CAP $1,059.55 13668-592-83 APREPITANT 80 MG ORAL CAP $1,059.55 0781-2322-68 APREPITANT 80 MG ORAL CAP $1,059.55 HC21000005 ABRASION; EA ADDL LESION 4OR< $1,059.00 HC25006073 CLOSED TX METATARSOPHALAN JNT DISLOC; NO ANES RT $1,059.00 HC62202486 BARRIER ADHESION PELVIC(INTERCEED) $1,058.00 HC62202833 ENDO BALLOON PERITONEAL SYSTEM $1,058.00 HC44002020 SINUSES COMP MIN 3 VIEWS $1,058.00 0143-9633-01 NICARDIPINE IN NACL (ISO-OS) 40 MG/200 ML (0.2 MG/ML) IV PGBK $1,056.90 0143-9633-10 NICARDIPINE IN NACL (ISO-OS) 40 MG/200 ML (0.2 MG/ML) IV PGBK $1,056.90 HC44003093 EVAL MED PHYSICS DOSE RADIATION EXPOSE W/REPORT $1,056.00 HC25000449 MANIPULATION MINOR JOINT $1,056.00 HC51070571 NEUROPSYCH TESTING EVAL INTRG INTERP CLIN DES TX FEEDBACK; 1ST HOUR $1,056.00 68803-722-25 C.I. ACID BLUE 90 0.025 % INTRAOCULAR SYRG $1,054.30 68803-722-05 C.I. ACID BLUE 90 0.025 % INTRAOCULAR SYRG $1,054.30 HC62211420 SENSOR PRESSURE HEMODYN (FLOTRAC) $1,053.00 69374-542-06 METHACHOLINE CHLORIDE 0 TO 48 MG/3 ML INHALATION NEBU $1,053.00 99999-041-52 NM TC-99M (DTPA) PENTETATE AEROSOL MHS $1,052.45 HC62200456 BASKET RETRIEVAL O $1,050.00 HC62213160 BLADE INCISIONAL O $1,050.00 HC62212972 BLADE SHAVER O $1,050.00 HC62213277 BURR O $1,050.00 HC62219159 CANNULA TIP SOFT LONG $1,050.00 HC62800156 CATH BALLOON PTA(COYOTE) H $1,050.00 HC62212618 CATH PTCA BALLOON NON-LASER H $1,050.00 HC62227012 DILATOR BALLOON ENDO PULM $1,050.00 HC62218854 DRILL/DRILL BITS SINGLE USE T $1,050.00 HC62202700 ELECTRODE PACER TEMPORARY $1,050.00 HC62218417 ENDO STAPLER O $1,050.00 HC62203468 HANDPIECE VESSEL SEALER DEVICE A $1,050.00 HC62212444 INTRODUCER/SHEATH Q $1,050.00 HC62227491 OVERTUBE ENDOSCOPIC B $1,050.00 HC62213475 REAMER R $1,050.00 HC62214549 RETRACTOR DISPOSABLE J $1,050.00 HC62225230 ROD EXTRACTION CONICAL $1,050.00 HC62214374 SHEARS COAGULATING 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$955.00 HC32000283 OT-EVAL HIGH COMPLEXITY 45MF2F 75MIN $955.00 HC62804679 STAPLE REINFORCEMENT(SEAMGUARD)     D $955.00 65219-256-00 PIPERACILLIN-TAZOBACTAM 40.5 GRAM IV SOLR $954.01 HC62218110 CAPSULE PH (IMPLANT) C $948.00 HC62223128 DEVICE COUPLER ANASTAMOSIS $948.00 HC33000811 ST-EVAL NONSP'CH DEV RX:ADD30MIN $948.00 0121-1034-16 HYDROXYZINE HCL 10 MG/5 ML ORAL SOLN $946.95 HC77400208 ANESTHESIA LOCAL INITIAL HR $946.00 HC62220835 BAG/POUCH RETRIEVAL SPECMN ENDO M $946.00 HC62212741 GUIDEWIRE N $946.00 HC62223029 HANDPIECE ILLUMINATOR/SUCTION $946.00 HC25002924 LAC REPAIR SIMPLE S/N/AX/GEN/T/EXT 2.5CM OR LESS $946.00 HC82202185 MORPHOMETRIC STUDY NERVE $946.00 HC29000684 TEST CHALLENGE INGEST 1ST120MIN $946.00 HC32000812 OT-WOUND VAC 45MIN>50 SQ CM/M $945.00 HC31000870 PT-WOUND VAC 45MIN>50 SQ CM/M $945.00 HC82200536 MORPH STDY ISH PER SPEC INTL SNGL PROBE $943.00 HC62205778 PROBE FLOW VASCULAR UTZ N $943.00 70860-402-10 BIVALIRUDIN 250 MG IV SOLR $942.50 70860-402-41 BIVALIRUDIN 250 MG IV SOLR $942.50 63323-562-10 BIVALIRUDIN 250 MG IV SOLR $942.50 HC83000026 WHOLE BLOOD EA UNIT $942.00 67546-111-14 NITAZOXANIDE 500 MG ORAL TAB $941.96 HC44000149 ANKLE COMP MIN 3 VWS LT $941.00 HC44000156 ANKLE COMP MIN 3 VWS RT $941.00 HC44002806 ANKLE MIN 3 VIEWS $941.00 HC34000281 STENGER TEST SPEECH $941.00 HC22000095 OST EST PT EVAL 40 MIN $940.00 52652-1950-1 LEVOTHYROXINE 20 MCG/ML ORAL SOLN $938.60 52652-1950-2 LEVOTHYROXINE 20 MCG/ML ORAL SOLN $938.60 99999-001-76 CHARGE-ADULT 3 IN 1 ADMIX 1500ML $936.00 HC62212345 COLLAR CERV 2 PIECE W-THORA EXTN $935.00 HC62801279 KIT CVP (PASSPORT) $934.00 HC44001998 SHOULDER COMP MIN 2VWS LT $933.00 HC44002004 SHOULDER COMP MIN 2VWS RT $933.00 HC33000175 ST-EVAL RX SP GEN DEV ADD30MIN $933.00 HC44500684 CINERADIOGRAPHY(SEPARATE PROC) $932.00 HC82200585 TISSUE EXAM - OP $932.00 0054-3120-41 CALCITRIOL 1 MCG/ML ORAL SOLN $930.83 HC43500032 DEXA VERTEBRAL FX ASSESSMENT $930.00 HC83000570 RBC IRRADIATED EA UNIT $930.00 55150-193-01 ADENOSINE IV INFUSION $929.57 99999-001-80 CHARGE-NEONATAL HYPERAL $929.50 HC62217120 ADVANCER SYSTM ROTALINK $928.00 0517-1075-01 LEVOCARNITINE 200 MG/ML IV SOLN $927.42 HC35000033 REC- EVALUATION 30MIN $925.00 54643-5650-2 MVI, ADULT NO.4 WITH VIT K 3,300 UNIT- 150 MCG/10 ML IV SOLN $924.30 HC25003435 CLOSED TX TMJ DISLOCATION 1ST/SBSQ $924.00 38779-0566-4 TETRACAINE HCL (BULK) MISC POWD $923.81 69292-605-60 DIGOXIN 50 MCG/ML (0.05 MG/ML) ORAL SOLN $923.13 HC21000252 DEBRIDE OF NAILS: 1-5 $923.00 HC62207188 KIT TUBING DELIVER AERONOX $923.00 HC44001535 LUMBAR SPINE 2 OR 3 VWS $923.00 HC36800753 SPIROMETRY INFANT-2Y/O $923.00 50419-320-01 GADOXETATE 0.25 MMOL/ML (181.43 MG/ML) IV SOLN $922.74 50419-320-05 GADOXETATE 0.25 MMOL/ML (181.43 MG/ML) IV SOLN $922.74 HC11200011 ASSESS-DIRECT OBSERV ADMIT $922.00 HC12200184 INF CNTR-NEW PT EVAL 60MIN $922.00 63323-330-60 NAFCILLIN 10 GRAM INJ SOLR $920.08 HC32001273 OT-RE-EVAL EST POC 75MIN $920.00 65174-288-30 KIT PREP TC 99M-PENTETIC ACID 20 MG IV SOLR $919.69 HC62211412 SYSTEM VENTRICULAR DRAINAGE $918.00 HC44000701 EYE FOR FOREIGN BODY BILAT $917.00 HC44000412 CHEST SINGLE VIEW $916.00 HC25000456 FRACTURE TX FINGER/TOE $915.00 HC39001391 PSY-TEST COGNITIVE PERFORMANCE STDRD PER HOUR $915.00 HC62208889 ADVANCER ROTALINK $914.00 61958-2501-1 BICTEGRAV-EMTRICIT-TENOFOV ALA 50-200-25 MG ORAL TAB $913.49 61958-2501-3 BICTEGRAV-EMTRICIT-TENOFOV ALA 50-200-25 MG ORAL TAB $913.49 61958-1901-1 ELVITEG-COB-EMTRI-TENOF ALAFEN 150-150-200-10 MG ORAL TAB $913.49 10223-0201-3 BUTAMBEN-TETRACAINE-BENZOCAINE 2 %-2 %-14 % (200 MG/SEC) TOPICAL SPRA $913.25 HC11500683 E&M ASSESS NEW 60MIN $913.00 HC11500782 AM/PACU EVAL & MANAGE 30MIN $911.00 HC62204094 KIT NEEDLE US VACUUM ASSIST $911.00 HC36800522 PULM REHAB PER SESSION (90MIN) W/O POX2 $911.00 99999-043-28 ARGININE HCL 2.5 MEQ/ML ORAL LIQUID $910.20 HC62217658 AWL SPINAL SINGLE PATIENT USE J $910.00 HC62800032 BALLOON ERCP $910.00 HC62800040 BALLOON ESOPHAGEAL $910.00 HC62211503 BLADE INCISIONAL M $910.00 HC62212956 BLADE SHAVER M $910.00 HC62213251 BURR M $910.00 HC62227640 CATH EP DX <20 ELECTRODES RPRSD M $910.00 HC62220736 COUNTERSINK CANNULATED L $910.00 HC62202270 DISSECTOR CURVED SHORT $910.00 HC62218839 DRILL/DRILL BITS SINGLE USE R $910.00 HC62218391 ENDO STAPLER M $910.00 HC44000925 FOOT COMP MIN 3 VWS LT $910.00 HC62212428 INTRODUCER/SHEATH O $910.00 HC62802541 KIT PICC LINE M $910.00 HC62807904 M: CONNECTOR JOINT NAIL TO NAIL $910.00 HC62228069 MOLD/FORM CEMENT ADAPTER FEMORAL $910.00 HC62218607 PROBE SPINAL DISPOSABLE H $910.00 HC62213459 REAMER P $910.00 HC62214531 RETRACTOR DISPOSABLE I $910.00 65145-126-01 ARGATROBAN IN 0.9 % SOD CHLOR 1 MG/ML IV SOLN $910.00 0009-0856-08 CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN $910.00 0009-0856-05 CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN $910.00 0143-9087-01 DOXORUBICIN 2 MG/ML IV SOLN $910.00 45963-733-60 DOXORUBICIN 2 MG/ML IV SOLN $910.00 47335-154-40 GEMCITABINE 1 GRAM IV SOLR $910.00 69918-735-10 ISOPROTERENOL HCL 0.2 MG/ML INJ SOLN $910.00 69918-735-01 ISOPROTERENOL HCL 0.2 MG/ML INJ SOLN $910.00 70860-306-06 ISOPROTERENOL HCL 0.2 MG/ML INJ SOLN $910.00 70860-306-42 ISOPROTERENOL HCL 0.2 MG/ML INJ SOLN $910.00 23155-661-42 ISOPROTERENOL HCL 0.2 MG/ML INJ SOLN $910.00 23155-661-31 ISOPROTERENOL HCL 0.2 MG/ML INJ SOLN $910.00 99999-008-41 TOPOTECAN 1 MG/ML INJ SOLN (FOR ORAL USE)(MCH) $910.00 16729-151-31 TOPOTECAN 4 MG IV SOLR $910.00 0054-0057-46 DIGOXIN 50 MCG/ML (0.05 MG/ML) ORAL SOLN $909.87 HC44000065 AC JOINTS BILAT $909.00 HC36000024 AEROSOL-CONTINUOUS TX EA AD'HR $909.00 HC44000933 FOOT COMP MIN 3 VWS RT $909.00 HC25000514 SPLINT FINGER STATIC $909.00 55150-420-01 ESMOLOL IN NACL (ISO-OSM) 2,500 MG/250 ML (10 MG/ML) IV SOLP $908.38 HC41500745 EMG LMTD EXTRM 1 (NOT PARASP/CRANIAL/SPHINC) $908.00 HC51061091 X RAY PYELOGRAM RETROGRADE $907.54 HC81700791 HEPATITIS C QT BY DNA OR RNA $906.00 HC11500857 PEDS ASSESS ESTAB PT 40MIN $906.00 HC25000399 LAC REPAIR 30.0+CM $905.00 HC81100307 PHENYTOIN TOTAL $905.00 0407-1414-93 IOHEXOL 350 MG IODINE/ML IV SOLN $904.80 HC21000187 AVULSION OF NAIL, EA ADDL' $904.00 HC11200096 OBSERVATION PER HOUR - PEDS ICU $904.00 71285-0102-1 CARDIOPLEGIC SOLUTION NO.10 108 MEQ/500 ML (POTASSIUM) PERF SOLN $903.50 8544636981 SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRG $903.50 44567-820-01 ERTAPENEM 1 GRAM INJ SOLR $902.20 44567-820-10 ERTAPENEM 1 GRAM INJ SOLR $902.20 HC25000258 BURNS LOCAL TREATMENT SM 9% $902.00 HC47201256 RAD ONC NEW PT HIGH MDM 60MIN $901.00 HC44001832 SACRO-ILIAC JNTS 3 OR MORE VWS $901.00 HC44002202 THORACIC SPINE 3 VIEWS $901.00 HC81100158 VANCOMYCIN INIT $901.00 0409-0302-01 TOPOTECAN 4 MG/4 ML (1 MG/ML) IV SOLN $900.64 68982-623-03 ALBUMIN, HUMAN 5 % 5 % IV SOLP $900.25 HC51010908 CHEMO ADMIN PLEURAL CAV W/THORACENTESIS $900.00 HC51001410 CLOSED TX BIMALLEO ANKLE FX NO MAN $900.00 HC89019905 CYTOGENOMIC SNP MICROARRAY -AU $900.00 HC21000369 DESTRUCT PREMALG LESION 1ST $900.00 HC38000089 APPLICATION CAST GAUNTLET $899.00 HC38000360 APPLY STRAPPNG KNEE(ROBRTJONES $899.00 HC31002009 PT - STRAPPING; KNEE $899.00 0009-0417-02 TESTOSTERONE CYPIONATE 200 MG/ML IM OIL $898.11 HC44002707 ELBOW - COMPLETE $898.00 HC44000669 ELBOW COMP MIN 3 VWS LT $898.00 HC44001659 NASAL BONES $898.00 HC44000024 ABDOMEN 2 VIEWS $897.00 HC44000677 ELBOW COMP MIN 3 VWS RT $897.00 HC44001014 HAND COMPLETE MIN 3 VWS LT $897.00 HC44001022 HAND COMPLETE MIN 3 VWS RT $897.00 66993-962-45 METRONIDAZOLE 0.75 % TOPICAL GEL $896.22 70515-260-10 DIGOXIN 250 MCG/ML (0.25 MG/ML) INJ SOLN $895.25 HC81701385 HEPATITIS B DNA ULTRA QNT PCR $895.00 HC43001155 MAMMO DX LTD/FOCUS EXM UNILT W/CAD LT $895.00 HC43001163 MAMMO DX LTD/FOCUS EXM UNILT W/CAD RT $895.00 99999-034-76 CH - NITRIC OXIDE GAS PER HOUR/ EACH $894.40 HC24000127 HBO EA SUBSEQUNT 15MIN CMPLX/C $894.00 HC24000135 HBO FIRST 15MIN COMPLEX/C $894.00 HC33000928 ST-EVAL SPEECH FLUENCY 60MIN/M $893.00 HC33000399 ST-SWALLOWING THERAPY 30 MIN $893.00 63323-886-56 SODIUM PHOSPHATE 3 MMOL/ML IV SOLN $892.78 63323-886-01 SODIUM PHOSPHATE 3 MMOL/ML IV SOLN $892.78 HC32000507 OT-SWALLOWING THERAPY 30 MIN $892.00 HC39000039 PSYCH TX W/PATIENT 45MIN $892.00 HC44002228 SPINE THORACOLUMBAR JUNCTN MIN 2 VWS $892.00 HC12200234 INF CNTR-ESTBD PT EVAL 40MIN $891.00 HC12200242 DRAW BLOOD VEN PICC/PERIPH CATH $890.00 45802-923-41 MESALAMINE WITH CLEANSING WIPE 4 GRAM/60 ML RECTAL ENKT $889.46 72266-248-05 SINCALIDE 5 MCG INJ SOLR $888.10 72266-248-01 SINCALIDE 5 MCG INJ SOLR $888.10 HC39000989 PSYCH DIAG EVAL W/ MED SERVICE $888.00 62327-222-02 STERILE TALC 2 GRAM INTRAPLEURAL SUSR $887.25 0006-5423-02 SUGAMMADEX 100 MG/ML IV SOLN $884.91 0006-5423-12 SUGAMMADEX 100 MG/ML IV SOLN $884.91 63304-241-59 CALCITRIOL 1 MCG/ML ORAL SOLN $884.23 HC39000955 PSY TX W/PATIENT 45MIN W/E&M+ $884.00 HC81100166 VANCOMYCIN SUBS $884.00 39822-1220-1 NEOMYCIN-POLYMYXIN B GU 40 MG-200,000 UNIT/ML IRR SOLN $884.00 HC81100273 COMP METABOLIC PANEL $883.00 HC12200275 SC INFUSION THERAPY EA ADDL HOUR $881.00 0168-0416-30 TACROLIMUS 0.1 % TOPICAL OINT $880.23 HC83500124 CHEMOSENSITIVITY ASSAY-WD $880.00 HC33001215 ST-TEST COGNITIVE PERFORMANCE STDRD PER HOUR $880.00 HC33001108 ST-EVAL BEHAVRAL QUAL VOICE 60MIN/M $879.00 HC62208103 VALVE BIOPSY $879.00 72819-153-02 MITOMYCIN 20 MG IV SOLR $878.74 HC65800054 BRACHY SEED HDR IRIDIUM 192 $878.00 69452-116-45 CLOBAZAM 2.5 MG/ML ORAL SUSP $877.50 64281-110-05 METHACHOLINE CHLORIDE 0 TO 48 MG/3 ML INHALATION NEBU $877.50 64281-110-06 METHACHOLINE CHLORIDE 0 TO 48 MG/3 ML INHALATION NEBU $877.50 14789-119-05 METHYLENE BLUE (ANTIDOTE) 5 MG/ML IV SOLN $877.50 14789-119-07 METHYLENE BLUE (ANTIDOTE) 5 MG/ML IV SOLN $877.50 HC44001857 SACRUM & COCCYX MIN 2VWS $877.00 HC62212733 GUIDEWIRE M $876.00 HC62225552 INJECTOR GRAFT/STENT $876.00 HC62218557 KIT ACP AUTO COND PLASMA SERIES II $876.00 HC62227889 KIT REPAIR BROVIAC/CV/HICKMAN I $876.00 HC44002749 WRIST - FOUR VIEWS $876.00 HC44002582 WRIST COMP MIN 3 VWS LT $876.00 HC44002590 WRIST COMP MIN 3 VWS RT $876.00 HC44002731 WRIST MIN 3 VIEWS $876.00 72078-035-00 REMIFENTANIL 2 MG IV SOLR $875.66 72078-035-02 REMIFENTANIL 2 MG IV SOLR $875.66 67546-111-12 NITAZOXANIDE 500 MG ORAL TAB $875.12 HC46000147 INJ ARTHROGRAM TMJ $875.00 HC42000042 BIOIMPEDENCE THORACIC $873.00 HC62212030 CANNULA PERFUSN VENOUS FEMORAL M $873.00 HC62201785 CIRCUIT VENT HI-FREQ $873.00 HC81101941 DRUG TEST PRESUMPTIVE CHEM ANALYZERS/ DOS $873.00 HC81100315 PHENOBARBITOL $872.00 HC25005091 STRAPPING; ANKLE AND/OR FOOT BILAT $872.00 HC33000217 ST-SPEECH THERAPY 30 MIN/MCW $872.00 0143-9551-01 DAUNORUBICIN 5 MG/ML IV SOLN $871.91 0143-9551-10 DAUNORUBICIN 5 MG/ML IV SOLN $871.91 0143-9218-01 IDARUBICIN 1 MG/ML IV SOLN $870.22 50242-100-39 DORNASE ALFA 1 MG/ML INHALATION SOLN $869.54 50242-100-40 DORNASE ALFA 1 MG/ML INHALATION SOLN $869.54 HC12200135 BLOOD DRAW IMP'T VENOUS DEVICE $868.00 HC25001124 INSRT BLADDER CATH-NON INDWELL $867.00 HC51010890 CHEMO ADMIN CNS W/SPINAL PUNCTURE $866.00 HC51002251 X RAY UROGRAPHY ANTEGRADE R&I $865.00 25021-207-51 DOXORUBICIN 2 MG/ML IV SOLN $864.50 66993-078-96 FLUTICASONE PROPIONATE 44 MCG/ACTUATION INHALATION HFAA $864.14 HC62220231 CUP UTERINE KOH $864.00 42023-110-01 ESTRADIOL VALERATE 10 MG/ML IM OIL $862.75 HC34000190 AUD-INFANT HEARING SCREEN AEP BBS AUTO INITIAL IP $862.00 HC82202714 BM BIOPSY PROC & INT 2ND SITE $862.00 HC82202706 BM BIOPSY PROCESSING & INTERP $862.00 HC82202722 BM CELL BLOCK & INTER-2ND SITE $862.00 HC82202367 BM CELL BLOCK & INTERP $862.00 HC84600261 CELL BLOCK (TISSUE EX)DIST SVC $862.00 HC84600253 CELL BLOCK (TISSUE EXAM LVL 4) $862.00 HC62228804 DEVICE CLOSURE VASCULAR           M $862.00 HC62229158 ORTHOTIC TLSO 4 RIGID(DONJOY) $862.00 HC44002244 TIBIA & FIBULA (LEG) 2 VWS LT $862.00 HC44002251 TIBIA & FIBULA (LEG) 2 VWS RT $862.00 HC44002780 TIBIA AND FIBULA $862.00 HC82200940 TISSUE EX G&M LVL 4 DIST SVC $862.00 HC82200403 TISSUE EXAM G&M LEVEL 4 $862.00 HC82202573 TISSUE EXAM G&M LEVEL 4 *OP $862.00 HC82202250 TISSUE EXAM G&M LEVEL 4-REDUCE $862.00 HC82202755 TISSUE EXAM G&M LVL 4(TC ONLY) $862.00 HC82200718 TISSUE EXAM G&M SLIDE PREP-MHL $862.00 HC82200668 TISSUE EXAM LEVEL 4 SKIN $862.00 HC82200676 TISSUE EXAM LEVEL 4 SPECIAL $862.00 0407-1413-65 IOHEXOL 300 MG IODINE/ML IV SOLN $860.93 HC84600287 MORPH STDY IHC QT MANUAL PER SPEC EA AB $859.00 HC84600329 MORPH STDY IHC/ESTROG RCPTR PER SPEC EA AB $859.00 HC84600311 MORPH STDY IHC/HER-2/NEU PER SPEC EA AB $859.00 HC84600337 MORPH STDY IHC/PROG RCPTR PER SPEC EA AB $859.00 HC47200795 RAD ONC EST PT HIGH MDM 40MIN $859.00 HC62221411 TRAY THORAC/PARACENTESIS O $859.00 50419-774-01 CIPROFLOXACIN 10 G/100 ML ORAL SUMC (MCH) $858.65 0078-0182-01 OCTREOTIDE ACETATE 500 MCG/ML INJ SOLN $858.44 HC44000552 DACRYOCYSTOGRAPHY $858.00 0338-0502-06 PARENTERAL AMINO ACID 15% NO.5 15 % IV SOLP $858.00 60758-119-15 PREDNISOLONE ACETATE 1 % OPHT DRPS $858.00 HC28000016 CR REHAB CARDIAC IP SESSION PHASE I $856.00 HC28000024 CR REHAB CARDIAC W/ ECG SESSION (II) $856.00 HC44002053 SKULL LTD <4 VIEWS $855.00 HC62203799 KIT COOK TRIPLE LUMEN CATH $854.00 HC62204326 KIT TRIPLE LUMEN/IV CATH $854.00 HC32001687 OT-WINDOWING CAST $854.00 HC31001928 PT-WINDOWING CAST $854.00 HC84201813 RESP VIRUS 3-5 TARGETS $854.00 HC44200830 US EXTREMITY NON VASC LTD- LT $854.00 HC44200822 US EXTREMITY NON VASC LTD-RT $854.00 99999-042-03 AMNIOBAND MEMBRANE (14 MM) $853.13 HC62212279 KIT INTRODUCER PERC MRI VISIBLE $853.00 16714-403-02 CEFPODOXIME 100 MG/5 ML ORAL SUSR $852.80 64980-403-10 CEFPODOXIME 100 MG/5 ML ORAL SUSR $852.80 42658-021-02 DAUNORUBICIN 5 MG/ML IV SOLN $852.41 42658-021-01 DAUNORUBICIN 5 MG/ML IV SOLN $852.41 HC26000208 INSERT &CONTROL UTERINE HEMORRHAGE DEVICE $852.00 HC39000187 PSY PREPARE REPORT 2 HOURS $850.00 24208-539-20 ACETYLCHOLINE CHLORIDE 1 % (10 MG/ML) INTRAOCULAR KIT $848.71 0270-0556-15 SINCALIDE 5 MCG INJ SOLR $848.01 HC62201652 CATH VASCULAR $848.00 HC51001279 CLOSED TX FX RAD/ULN DISTAL FX NO M $848.00 HC62217286 PASSER SUTURE M $848.00 54643-9015-2 MVI, ADULT NO.4 WITH VIT K 3,300 UNIT- 150 MCG/10 ML IV SOLN $847.60 HC83000018 RBC'S EA UNIT $847.00 HC83001198 RBC'S EA UNIT $847.00 HC83001040 RBC'S EA UNIT (AUTOLOGOUS)-SB $847.00 HC83000984 RBC'S EA UNIT -SB $847.00 0074-0576-22 VENETOCLAX 100 MG ORAL TAB $846.12 0074-0576-30 VENETOCLAX 100 MG ORAL TAB $846.05 0074-0576-11 VENETOCLAX 100 MG ORAL TAB $845.98 64980-526-60 NITAZOXANIDE 500 MG ORAL TAB $845.60 0054-3566-99 MIDAZOLAM 2 MG/ML ORAL SYRP $845.23 67457-856-20 ADENOSINE (DIAGNOSTIC) 3 MG/ML IV SOLN $845.00 25021-310-02 SODIUM NITROPRUSSIDE 25 MG/ML IV SOLN $845.00 67457-839-02 SODIUM NITROPRUSSIDE 25 MG/ML IV SOLN $845.00 0054-3721-44 PREDNISONE 5 MG/ML ORAL CONC $844.94 HC36001113 BREATHING RESPONSE HYPOXIA CURVE $844.00 HC36800811 BREATHING RESPONSE HYPOXIA CURVE $844.00 HC31001365 PT-RE-EVAL EST POC 75MIN $844.00 HC51000511 CHEMO ADMIN IVP SNGL/INIT'LINJ $842.88 HC51010932 CHEMO INJECT(S) SUBARACHNOID/INTRAVENT VIA RESEVOIR $842.88 HC51010916 CHEMO TX ADMIN PERITONEAL CAV VIA IMPLANT $842.88 HC51000479 DECLOT IVAD W/THROMBOLYTC(TECH/HOSP) $842.88 HC51000057 DECLOT IVAD W/THROMBOLYTIC $842.88 HC51010361 REFILL MAINT IMPLNT PMP/RESV WANAL' $842.88 HC25005992 E&M NEW OP PT 60MIN $842.00 10019-055-61 ESMOLOL IN NACL (ISO-OSM) 2,500 MG/250 ML (10 MG/ML) IV SOLP $841.75 HC41500364 NYSTAGMUS MIN 4POSITIONS W/REC $841.00 HC44200962 US ELASTOGRAPHY $841.00 63323-763-52 PACLITAXEL 6 MG/ML IV CONC $840.45 63323-763-50 PACLITAXEL 6 MG/ML IV CONC $840.45 59762-0040-1 TRIFLURIDINE 1 % OPHT DROP $840.06 HC62223052 APPLIER LIGA/HEMOCLIP ENDO N $840.00 HC62217641 AWL SPINAL SINGLE PATIENT USE I $840.00 HC62213145 BLADE OSTEOTOME/CUP J $840.00 HC62212949 BLADE SHAVER L $840.00 HC62213244 BURR L $840.00 HC62222963 CANNULA ARTERIAL K $840.00 HC62219910 CANNULA ARTHRSCPC ROTATING/BUR E $840.00 HC62224365 CANNULA SUCTION & COAGULATION $840.00 HC62216031 CATH BALLOON DIL NON VASCULAR M $840.00 HC62222070 CATH CENTRAL 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PNEUMONIAE BY PCR (RVP PNL) $721.00 HC41500398 OSCILLAT TRACKING TEST W/REC $721.00 49702-205-48 LAMIVUDINE 10 MG/ML ORAL SOLN $720.72 HC62217997 GUIDE SHAFT DRIVER ORTHO $718.00 0069-1308-01 EPOETIN ALFA-EPBX 10,000 UNIT/ML INJ SOLN $716.95 0069-1308-10 EPOETIN ALFA-EPBX 10,000 UNIT/ML INJ SOLN $716.95 99999-046-67 EPOETIN ALFA-EPBX 10,000 UNIT/ML INJ SOLN $716.95 HC32003352 OT-DEVEL TEST ADMIN ASSESS COG INSTR; 1ST HR $716.00 HC39001367 PSY-DEVEL TEST ADMIN ASSESS COG INSTR; 1ST HR $716.00 HC31002116 PT-DEVEL TEST ADMIN ASSESS COG INSTR; 1ST HR $716.00 63323-963-30 ACETYLCYSTEINE 200 MG/ML (20 %) IV SOLN $715.07 63323-963-21 ACETYLCYSTEINE 200 MG/ML (20 %) IV SOLN $715.07 0574-0805-00 ACETYLCYSTEINE 200 MG/ML (20 %) IV SOLN $715.07 0574-0805-30 ACETYLCYSTEINE 200 MG/ML (20 %) IV SOLN $715.07 24201-237-01 FLUDARABINE 50 MG IV SOLR $715.00 69452-125-50 OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSP $715.00 HC83000919 BLOOD TYPE SERO; PER AG/ANTIGEN DONOR $714.00 HC83000091 RBC ANTIGENS OTHER THAN ABO/RH $714.00 HC62215736 SUTURE Z $714.00 0409-6482-01 ERYTHROMYCIN LACTOBIONATE 500 MG IV SOLR $713.32 0409-6482-11 ERYTHROMYCIN LACTOBIONATE 500 MG IV SOLR $713.32 HC44001881 SCAPULA LT $713.00 HC44001899 SCAPULA RT $713.00 99999-045-81 NIMODIPINE 60 MG/10 ML ORAL SYRG $712.73 HC25000092 CPR $712.00 HC11500725 E&M ASSESS ESTB 30MIN $712.00 HC24000119 HBO EA SUBSEQNT 15MIN INTERM/C $712.00 HC24000143 HBO FIRST 15MIN INTERMEDIATE/C $711.00 HC62203989 KIT INTRODUCER NEPHR/BILI/GI $711.00 HC44001931 SHOULDER 1 VIEW LT $710.00 HC44001949 SHOULDER 1 VIEW RT $710.00 HC84201334 M. PNEUMONIAE BY PCR (RVP PNL) $709.00 HC44001576 MANDIBLE < 4 VIEWS $709.00 99999-045-48 BRILLIANT GREEN (BULK) MISC CRYS $708.50 0955-1020-01 DOCETAXEL 20 MG/ML (1 ML) IV SOLN $708.50 66794-015-25 SEVOFLURANE 99.97 % INHALATION LIQD $708.50 HC33001090 ST-EVAL BEHAVRAL QUAL VOICE 45MIN/M $708.00 0093-3541-43 ESTRADIOL 0.01 % (0.1 MG/GRAM) VAGINAL CREAM $707.20 HC81701773 FACTOR 2 MUTATION BY PCR $707.00 HC81100901 AMIKACIN SUBS $706.00 HC81100893 AMIKACIN INIT $706.00 HC81500951 FACTOR V LEIDEN BY PCR $705.00 HC89016950 HIV PHENOTYP P'SENS GT(PNL)-VI $705.00 HC25001520 REMOV IMPACTD EAR WAX IRRIG/LAVG BI $705.00 HC32000796 OT-WOUND VAC 15MIN>50 SQ CM/M $704.00 HC31000854 PT-WOUND VAC 15MIN>50 SQ CM/M $704.00 HC62206453 SHEATH ABLATION $704.00 66887-004-10 TESTOSTERONE 75 MG IMPL PLLT $703.19 HC62223540 DILATOR SET URETHRAL $703.00 HC51003051 INJECT RX CORPORA CAVERNOSA $703.00 HC31000482 PT-RE-EVAL EST POC 60MIN $703.00 0574-4022-35 BACITRACIN 500 UNIT/GRAM OPHT OINT $702.52 HC44000602 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SOLR $692.77 99999-035-43 LORAZEPAM 200MG IN D5W 100ML IV DRIP $692.25 HC51061448 ECG EXT TELEM MCT>24HRS-30DAYS TECH ATTEND TIME;CONNECT&TRANS $691.00 HC44001253 INFANT UP EXTREM MIN 2VWS LT $691.00 HC44001261 INFANT UP EXTREM MIN 2VWS RT $691.00 HC44002715 UPPER EXTREMITY - INFANT $691.00 99999-035-91 SORAFENIB 200 MG/30 ML ORAL LIQUID $690.98 16714-889-01 ERTAPENEM 1 GRAM INJ SOLR $689.86 16714-889-10 ERTAPENEM 1 GRAM INJ SOLR $689.86 0143-9241-01 BLEOMYCIN 30 UNIT INJ SOLR $689.65 HC44000982 HAND 2 VIEWS LT $689.00 HC44000990 HAND 2 VIEWS RT $689.00 0407-2223-17 IODIXANOL 320 MG IODINE/ML IV SOLN $688.35 99999-043-70 RIFAXIMIN 20 MG/ML ORAL SUSPENSION (COMPOUND) $688.35 HC25000472 FRACTURE TX RIBS $688.00 HC42000349 INTERROGATE REMOTE ^90 D; SGL/DUAL/MULTI/LEADLESS/DEFIB $688.00 HC84201862 S AUREUS BY PCR $688.00 HC81701625 ENTEROVIRUS RNA RT PCR $687.00 63323-735-10 PAMIDRONATE 90 MG/10 ML (9 MG/ML) IV SOLN $686.40 42023-201-01 LEVOTHYROXINE 100 MCG IV SOLR $686.27 HC62209200 BONE TUNNELING SYSTEM $686.00 HC83001024 CRYOPRECIP 5 UNITS POOLED -SB $686.00 HC62215728 SUTURE Y $686.00 99999-046-40 MACITENTAN 2.5 MG ORAL PARTIAL TAB $684.41 6371301962 SURGICEL FIBRILLAR 2 X 4 TOPICAL SPONGE $684.00 65162-705-88 ESCITALOPRAM OXALATE 5 MG/5 ML ORAL SOLN $683.28 70121-1642-1 VASOPRESSIN 20 UNIT/ML INJ SOLN (MCH) $683.18 70121-1642-5 VASOPRESSIN 20 UNIT/ML INJ SOLN (MCH) $683.18 70121-1642-7 VASOPRESSIN 20 UNIT/ML INJ SOLN (MCH) $683.18 0270-1111-03 GADOTERIDOL 279.3 MG/ML IV SOLN $683.15 HC12200176 INF CNTR-NEW PT EVAL 45MIN $683.00 HC44001840 SACROILIAC JOINTS < 3VWS $683.00 HC62300165 SCISSORS POTTS ROBOTIC $683.00 HC62228382 WIRE PIGTAIL PROTRACK (WATCHMAN) $683.00 57665-101-41 AMPHOTERICIN B LIPID COMPLEX 5 MG/ML IV SUSP $682.50 0143-9273-01 DIHYDROERGOTAMINE 1 MG/ML INJ SOLN $682.50 0143-9273-10 DIHYDROERGOTAMINE 1 MG/ML INJ SOLN $682.50 53276-1010-08 MICROFIBRIL. COLLAGEN HEMOSTAT 35 X 35 MM TOPICAL SHEE $682.50 70594-035-01 TIGECYCLINE 50 MG IV SOLR $682.50 70594-035-02 TIGECYCLINE 50 MG IV SOLR $682.50 71288-019-10 TIGECYCLINE 50 MG IV SOLR $682.50 71288-019-11 TIGECYCLINE 50 MG IV SOLR $682.50 60505-6098-1 TIGECYCLINE 50 MG IV SOLR $682.50 60505-6098-0 TIGECYCLINE 50 MG IV SOLR $682.50 HC84200013 CULTURE ANAEROBIC $682.00 HC81700981 FLOW CYT MKR TC CD45 $682.00 HC81701666 FLOW CYT TC; 1ST MARKER $682.00 HC44001592 MASTOIDS < 3 VIEWS PER SIDE $682.00 HC62228424 ORTH FINGER NONTORSION JOINT CUSTOM $682.00 HC12200200 INF CNTR-ESTBD PT EVAL 30MIN $681.00 HC47200787 RAD ONC EST PT MOD MDM 30MIN $681.00 0338-3993-01 IFOSFAMIDE 3 GRAM IV SOLR $680.10 HC84201391 M TUBERCULOSIS DNA AMP PROBE $680.00 70954-051-10 FELBAMATE 600 MG/5 ML ORAL SUSP $679.36 72603-325-01 PEMETREXED DISODIUM 100 MG IV SOLR $679.25 HC44001709 ORTHOPANTOGRAM $679.00 HC51003044 INJ CORPORA CAVERNOSOGRAM $678.00 0168-0277-40 CLINDAMYCIN PHOSPHATE 2 % VAGINAL CREAM $677.82 HC32000762 OT-WOUND VAC 30MIN<50 SQ CM/CM $677.00 13533-335-04 IMMUNE GLOBULIN (HUMAN) (IGG) IM INJ (MCH) $676.26 HC36800456 BLOOD GAS W/MEASURED O2 SAT $676.00 HC11500089 E&M NEW PT 45MIN $676.00 55150-228-10 TIGECYCLINE 50 MG IV SOLR $676.00 HC51061653 ECHO 2D CMPLT W/O SPEC&CLR DOP $675.00 HC62202866 ENDO INSTRUMENT $675.00 HC81500381 FACTOR VIII VW $675.00 HC51010940 INSERT DEVICE INTRAUTERINE IUD $675.00 HC62207691 TUBE JEUJUNOSTOMY $675.00 HC51001469 APPLY CAST LONG ARM $674.90 HC51001485 APPLY CAST LONG LEG $674.90 HC51001519 APPLY CAST PATELR TENDN BEARNG $674.90 HC51001477 APPLY CAST SHORT ARM $674.90 HC51001527 APPLY CAST SHORT LEG $674.90 HC51001535 APPLY CAST SHORT LEG WALKING $674.90 HC51001501 APPLY CYLINDER CAST(THI-ANKLE) $674.90 HC51001493 APPLY LONG LEG CAST/WALKER $674.90 HC81500969 FACTOR 2 MUTATION BY PCR $674.00 HC44000511 CLAVICLE LT $673.00 HC44000529 CLAVICLE RT $673.00 HC62214390 STYLET TUNNELING DIALYSIS $673.00 0065-0800-50 BALANCED SALT SOLN NO.1 IRRIG. INTRAOCULAR SOLN $672.75 0703-0018-01 HYDROMORPHONE (PF) 10 MG/ML INJ SOLN $672.75 HC62203740 KIT CATH CV $672.00 HC62216668 PIN/WIRE FIXATION TEMPORARY AC $672.00 HC62216833 POST ANCHOR SPINAL DISPOSABLE O $672.00 HC62225792 TEMPLATE ORTHO/ROD SPINAL S $672.00 51672-4118-6 FLUOROURACIL 5 % TOPICAL CREAM $669.24 0407-0690-20 GADODIAMIDE 10 MMOL/20 ML (287 MG/ML) IV SOLN $669.11 HC83000844 CRYOPRECIPITATE POOLED 5 UNITS $668.00 HC25000159 FB REMOVAL EAR $668.00 HC31001910 LOCOMOTOR TRAINING/W $667.00 HC31001753 PT-EVAL LOCOMOTOR /W $667.00 HC83000471 RBC LR/CMV NEG DIVIDED UNIT $667.00 HC62200902 BUTTON GASTRIC EXTENSION $666.00 HC62201330 CATH DIALYSIS SHORT-TERM J $666.00 HC62806906 CATH SWAN GANZ/THERMODILUTION L $666.00 HC62212311 GUIDEWIRE(ADVANTAGE/URO ANGLE/STRGHT)J $666.00 HC62225388 KIT REPAIR BROVIAC/CV/HICKMAN F $666.00 HC62216353 NEEDLE INTRODUCER N $666.00 HC47201231 RAD ONC NEW PT LOW MDM 30MIN $666.00 HC62203914 SEALANT (FLOSEAL) KIT 5CC $666.00 HC62802079 STENT BILIARY PLASTIC L $666.00 11994-128-21 XENON-133 IN CARBON DIOXIDE 740 MBQ (20 MCI) INHALATION GAS $664.30 HC81100984 NORPACE/DISOPYRAM $664.00 HC84201003 SEMEN ANALYSIS COMPLETE $664.00 HC89023840 ANALY CFTR GENE FULL SEQUENCE-AU $663.00 HC32003345 OT-EVAL HIGH COMPLEXITY 45MF2F 45MIN $662.00 HC31002090 PT-EVAL HIGH COMPLEXITY 45MF2F 45MIN $662.00 HC62223714 SYSTEM MIX/DELIVR GRAFT BIOCARTLG $662.00 HC62217252 CURETTE ADENOID $661.00 HC25001397 I&D POSTOP WOUND $661.00 HC39000013 PSYCH TX W/PATIENT 30MIN $661.00 42291-781-42 SUCRALFATE 100 MG/ML ORAL LIQUID (MCH) $660.66 10122-314-10 NICARDIPINE IN DEXTROSE,ISO-OS 20 MG/200 ML (0.1 MG/ML) IV PGBK $660.40 10122-314-01 NICARDIPINE IN DEXTROSE,ISO-OS 20 MG/200 ML (0.1 MG/ML) IV PGBK $660.40 73043-010-03 AMOXICILLIN-POT CLAVULANATE 250-62.5 MG/5 ML ORAL SUSR $660.08 69097-098-08 AMOXICILLIN-POT CLAVULANATE 250-62.5 MG/5 ML ORAL SUSR $660.08 HC62201389 CATH EXCHANGE PTCA $659.00 HC84201458 DNA/RNA CMV PCR(PNL) $659.00 0065-0395-15 CYCLOPENTOLATE 0.5 % OPHT DROP $658.03 HC62210992 CANNULA AORTIC EASY FLOW $658.00 HC84600238 FNA INTERPR/REPORT-DIST SVC $658.00 HC84600196 FNA INTERPRETATION/REPORT $658.00 HC62216791 INFLATOR FOR BALLOON U $658.00 HC62228291 ORTH FO W/O JOINTS CUSTOM $658.00 HC32010464 OT- TM CONF INTERDISPLNS 3MNM WPT PRES 60MIN $658.00 HC39001078 PSYCH HYPNOTHERAPY $658.00 HC31010382 PT- TM CONF INTERDISPLNS 3MNM WPT PRES 60MIN $658.00 HC35000330 REC- TM CONF INTERDISPLNS 3MNM WPT PRES 60MIN $658.00 HC33010323 ST- TM CONF INTERDISPLNS 3MNM WPT PRES 60MIN $658.00 HC62215710 SUTURE X $658.00 99999-007-88 LYMPHOCYTE,ANTI-THYMO IMM GLOB 50000 MCG/ML INJ SOLN FOR TEST DOSE (MCH) $657.97 0069-1002-01 TOFACITINIB 10 MG ORAL TAB $657.92 0270-1316-45 IOPAMIDOL 370 MG IODINE /ML (76 %) IV SOLN $657.80 HC44704138 INTERROGATION EVAL SYS BAROSTIM W/I&R $657.00 HC82200528 IHC/IP PER SPEC INITIAL AB STAIN $656.00 HC82201831 IHC/IP PER SPEC INITIAL AB STAIN ACTH $656.00 HC82200247 IHC/IP PER SPEC INITIAL AB STAIN AFP $656.00 HC82201849 IHC/IP PER SPEC INITIAL AB STAIN ANTI-BCL-2 $656.00 HC82202953 IHC/IP PER SPEC INITIAL AB STAIN BASAL CELL COCKTAIL $656.00 HC82202961 IHC/IP PER SPEC INITIAL AB STAIN BCL-6 $656.00 HC82201567 IHC/IP PER SPEC INITIAL AB STAIN BRST2 $656.00 HC82201575 IHC/IP PER SPEC INITIAL AB STAIN CALCITONIN $656.00 HC82202979 IHC/IP PER SPEC INITIAL AB STAIN CALRETIN $656.00 HC82202987 IHC/IP PER SPEC INITIAL AB STAIN CAM5-2 $656.00 HC82203043 IHC/IP PER SPEC INITIAL AB STAIN CD10 $656.00 HC82203092 IHC/IP PER SPEC INITIAL AB STAIN CD117 $656.00 HC82203100 IHC/IP PER SPEC INITIAL AB STAIN CD138 $656.00 HC82202995 IHC/IP PER SPEC INITIAL AB STAIN CD1A $656.00 HC82203050 IHC/IP PER SPEC INITIAL AB STAIN CD21 $656.00 HC82203068 IHC/IP PER SPEC INITIAL AB STAIN CD23 $656.00 HC82201856 IHC/IP PER SPEC INITIAL AB STAIN CD3 $656.00 HC82203076 IHC/IP PER SPEC INITIAL AB STAIN CD31 $656.00 HC82201583 IHC/IP PER SPEC INITIAL AB STAIN CD-34 $656.00 HC82203001 IHC/IP PER SPEC INITIAL AB STAIN CD4 $656.00 HC82203019 IHC/IP PER SPEC INITIAL AB STAIN CD5 $656.00 HC82203084 IHC/IP PER SPEC INITIAL AB STAIN CD56 $656.00 HC82201864 IHC/IP PER SPEC INITIAL AB STAIN CD-68 $656.00 HC82203027 IHC/IP PER SPEC INITIAL AB STAIN CD7 $656.00 HC82204447 IHC/IP PER SPEC INITIAL AB STAIN CD-79A $656.00 HC82203035 IHC/IP PER SPEC INITIAL AB STAIN CD8 $656.00 HC82203118 IHC/IP PER SPEC INITIAL AB STAIN CDX-2 $656.00 HC82200197 IHC/IP PER SPEC INITIAL AB STAIN CEA $656.00 HC82203126 IHC/IP PER SPEC INITIAL AB STAIN CEA MONOCLONAL $656.00 HC82200221 IHC/IP PER SPEC INITIAL AB STAIN CHROMOGRNIN $656.00 HC82203142 IHC/IP PER SPEC INITIAL AB STAIN CK-19 $656.00 HC82203134 IHC/IP PER SPEC INITIAL AB STAIN CK-5/6 $656.00 HC82203159 IHC/IP PER SPEC INITIAL AB STAIN CMV $656.00 HC82204595 IHC/IP PER SPEC INITIAL AB STAIN C-MYC $656.00 HC82201872 IHC/IP PER SPEC INITIAL AB STAIN CYCLIN D1 $656.00 HC82201880 IHC/IP PER SPEC INITIAL AB STAIN CYTO KERATIN-20 $656.00 HC82201898 IHC/IP PER SPEC INITIAL AB STAIN CYTO KERATIN-7 $656.00 HC82201591 IHC/IP PER SPEC INITIAL AB STAIN DESMIN $656.00 HC82201526 IHC/IP PER SPEC INITIAL AB STAIN DYSTROPH(C-TERMINUS) $656.00 HC82201534 IHC/IP PER SPEC INITIAL AB STAIN DYSTROPH(N-TERMINUS) $656.00 HC82201542 IHC/IP PER SPEC INITIAL AB STAIN DYSTROPH(ROD DOMAIN) $656.00 HC82203167 IHC/IP PER SPEC INITIAL AB STAIN E-CADHERIN $656.00 HC82203332 IHC/IP PER SPEC INITIAL AB STAIN EGFR $656.00 HC82203175 IHC/IP PER SPEC INITIAL AB STAIN EMA (MC5)(LIVER) $656.00 HC82200288 IHC/IP PER SPEC INITIAL AB STAIN EPITH $656.00 HC82201609 IHC/IP PER SPEC INITIAL AB STAIN ESTROGN RECEPT $656.00 HC82201906 IHC/IP PER SPEC INITIAL AB STAIN EWINGS SARCOMA $656.00 HC82201914 IHC/IP PER SPEC INITIAL AB STAIN FACTOR 13-A $656.00 HC82200254 IHC/IP PER SPEC INITIAL AB STAIN FACTOR 8 $656.00 HC82201617 IHC/IP PER SPEC INITIAL AB STAIN GASTRIN $656.00 HC82204579 IHC/IP PER SPEC INITIAL AB STAIN GATA-3 $656.00 HC82200262 IHC/IP PER SPEC INITIAL AB STAIN GFAP $656.00 HC82201625 IHC/IP PER SPEC INITIAL AB STAIN GLUCAGON $656.00 HC82201922 IHC/IP PER SPEC INITIAL AB STAIN GROWTH HORMONE STN $656.00 HC82200270 IHC/IP PER SPEC INITIAL AB STAIN HCG $656.00 HC82203183 IHC/IP PER SPEC INITIAL AB STAIN HEPPAR $656.00 HC82202052 IHC/IP PER SPEC INITIAL AB STAIN HER-2-NEU $656.00 HC82201633 IHC/IP PER SPEC INITIAL AB STAIN HERPES POLY $656.00 HC82200189 IHC/IP PER SPEC INITIAL AB STAIN HMB-45 $656.00 HC82204637 IHC/IP PER SPEC INITIAL AB STAIN HSV-1 $656.00 HC82204652 IHC/IP PER SPEC INITIAL AB STAIN HSV-2 $656.00 HC82203191 IHC/IP PER SPEC INITIAL AB STAIN IGD $656.00 HC82201559 IHC/IP PER SPEC INITIAL AB STAIN IHC/IP STAIN ACTH $656.00 HC82203209 IHC/IP PER SPEC INITIAL AB STAIN INHIBIN $656.00 HC82203217 IHC/IP PER SPEC INITIAL AB STAIN INI-1 $656.00 HC82201641 IHC/IP PER SPEC INITIAL AB STAIN INSULIN $656.00 HC82201658 IHC/IP PER SPEC INITIAL AB STAIN KAPPA $656.00 HC82200304 IHC/IP PER SPEC INITIAL AB STAIN KERATIN $656.00 HC82203225 IHC/IP PER SPEC INITIAL AB STAIN KERATIN (AE1/AE1) LN $656.00 HC82201930 IHC/IP PER SPEC INITIAL AB STAIN KERATIN 903 $656.00 HC82203233 IHC/IP PER SPEC INITIAL AB STAIN KERATIN HMWK $656.00 HC82201666 IHC/IP PER SPEC INITIAL AB STAIN KI-1 $656.00 HC82201955 IHC/IP PER SPEC INITIAL AB STAIN KI-67 $656.00 HC82201674 IHC/IP PER SPEC INITIAL AB STAIN KP1 $656.00 HC82201682 IHC/IP PER SPEC INITIAL AB STAIN L26/CD 20 $656.00 HC82201690 IHC/IP PER SPEC INITIAL AB STAIN LAMBDA $656.00 HC82200213 IHC/IP PER SPEC INITIAL AB STAIN LCA/CD45 $656.00 HC82201963 IHC/IP PER SPEC INITIAL AB STAIN LEU MI (CD15) $656.00 HC82200296 IHC/IP PER SPEC INITIAL AB STAIN LEU-22/CD 43 $656.00 HC82201708 IHC/IP PER SPEC INITIAL AB STAIN LN1 $656.00 HC82201716 IHC/IP PER SPEC INITIAL AB STAIN LN2 $656.00 HC82203241 IHC/IP PER SPEC INITIAL AB STAIN MELAN-A $656.00 HC82204678 IHC/IP PER SPEC INITIAL AB STAIN MLH-1 $656.00 HC82201724 IHC/IP PER SPEC INITIAL AB STAIN MT1 $656.00 HC82203258 IHC/IP PER SPEC INITIAL AB STAIN MUM-1 $656.00 HC82201732 IHC/IP PER SPEC INITIAL AB STAIN MUSCLE $656.00 HC82201989 IHC/IP PER SPEC INITIAL AB STAIN MYELOPEROXIDASE $656.00 HC82201740 IHC/IP PER SPEC INITIAL AB STAIN MYGLOBIN $656.00 HC82203266 IHC/IP PER SPEC INITIAL AB STAIN MYOGENIN $656.00 HC82201757 IHC/IP PER SPEC INITIAL AB STAIN NEUROFILAMENT $656.00 HC82201765 IHC/IP PER SPEC INITIAL AB STAIN NSE $656.00 HC82200437 IHC/IP PER SPEC INITIAL AB STAIN -OP $656.00 HC82203274 IHC/IP PER SPEC INITIAL AB STAIN P16 $656.00 HC82201997 IHC/IP PER SPEC INITIAL AB STAIN P-53 $656.00 HC82203282 IHC/IP PER SPEC INITIAL AB STAIN P63 $656.00 HC82204553 IHC/IP PER SPEC INITIAL AB STAIN PAX8 $656.00 HC82203290 IHC/IP PER SPEC INITIAL AB STAIN PGP 9.5 $656.00 HC82202003 IHC/IP PER SPEC INITIAL AB STAIN PLAP $656.00 HC82201773 IHC/IP PER SPEC INITIAL AB STAIN PROGEST RECEPT $656.00 HC82202011 IHC/IP PER SPEC INITIAL AB STAIN PROLACTIN $656.00 HC82200205 IHC/IP PER SPEC INITIAL AB STAIN PSA $656.00 HC82200171 IHC/IP PER SPEC INITIAL AB STAIN S100 $656.00 HC82202029 IHC/IP PER SPEC INITIAL AB STAIN SMMHC $656.00 HC82201781 IHC/IP PER SPEC INITIAL AB STAIN SMOOTH MUSC $656.00 HC82201799 IHC/IP PER SPEC INITIAL AB STAIN SOMATOSATIN $656.00 HC82204538 IHC/IP PER SPEC INITIAL AB STAIN SOX10 $656.00 HC82200312 IHC/IP PER SPEC INITIAL AB STAIN SYNAPTOPH $656.00 HC82201807 IHC/IP PER SPEC INITIAL AB STAIN T4/CD 4 $656.00 HC82202037 IHC/IP PER SPEC INITIAL AB STAIN TERM DEOZY $656.00 HC82203308 IHC/IP PER SPEC INITIAL AB STAIN TH $656.00 HC82201815 IHC/IP PER SPEC INITIAL AB STAIN THYROGLOBULIN $656.00 HC82203316 IHC/IP PER SPEC INITIAL AB STAIN TTF-1 $656.00 HC82202060 IHC/IP PER SPEC INITIAL AB STAIN UBIQUITIN STAIN $656.00 HC82201823 IHC/IP PER SPEC INITIAL AB STAIN UCHL1 $656.00 HC82200239 IHC/IP PER SPEC INITIAL AB STAIN VIMENTIN $656.00 HC82203324 IHC/IP PER SPEC INITIAL AB STAIN WT-1 $656.00 HC82204611 IP/IHC PER SPEC INITIAL AB STAIN H PYLORI $656.00 HC82204470 IP/IHC PER SPEC INITIAL AB STAIN PROSTATIC ACID PHOS $656.00 0407-1414-91 IOHEXOL 350 MG IODINE/ML IV SOLN $655.85 HC34000216 AUD-AUDITORY EVOKED AEP NEURODIAGNOSTIC W/I&R $655.00 HC36800431 BLOOD GAS LTD $655.00 HC36800449 BLOOD GAS LTD CORD $655.00 HC81101313 BLOOD GASES LTD $655.00 HC81101768 BLOOD GASES LTD (POS) $655.00 HC62807821 STAPLE REINFORCEMENT(SEAMGUARD)     C $655.00 68682-201-75 PEG3350-SOD SUL-NACL-KCL-ASB-C 100-7.5-2.691 GRAM ORAL PWPK $654.68 HC39001383 PSY-ASSESS APHASIA W/REPORT PER HOUR $654.00 HC33000001 ST-ASSESS APHASIA/REPT EA HR/M $654.00 HC12200069 IV PUSH SINGLE/INIT'L INJ $653.10 HC84201490 DNA/RNA S PNEUMONIAE GROUP B PCR(PNL) $653.00 HC11500667 E&M ASSESS NEW 30MIN $653.00 HC11200095 OBSERVATION PER HOUR - PEDS DOU $652.00 HC83000463 RBC LEUKOREDUC/CMV NEG EA $652.00 69238-1273-6 OSELTAMIVIR 6 MG/ML ORAL SUSR $651.69 42291-567-60 OSELTAMIVIR 6 MG/ML ORAL SUSR $651.69 47781-384-26 OSELTAMIVIR 6 MG/ML ORAL SUSR $651.69 55150-354-01 IRINOTECAN 300 MG/15 ML IV SOLN $650.03 HC84200708 CULTURE ACID FAST $650.00 HC84201557 DNA/RNA ENTEROVIRUS PCR(PNL) $650.00 HC84201565 DNA/RNA HUMAN PARECHOVIRUS PCR(PNL) $650.00 HC51010288 INJ(S);SINGLE TENDON/SHEATH LT $650.00 HC51010270 INJ(S);SINGLE TENDON/SHEATH RT $650.00 HC81100927 LIDOCAINE $650.00 55150-393-01 AZACITIDINE 100 MG INJ SOLR $650.00 60505-6271-1 AZACITIDINE 100 MG INJ SOLR $650.00 43598-143-62 AZACITIDINE 100 MG/10ML INJ RECONSTITUTED VIAL (MHS) $650.00 55111-652-37 BIVALIRUDIN 250 MG IV SOLR $650.00 67457-256-00 BIVALIRUDIN 250 MG IV SOLR $650.00 67457-256-10 BIVALIRUDIN 250 MG IV SOLR $650.00 71288-713-21 CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) IV SOLN $650.00 71288-713-20 CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) IV SOLN $650.00 0781-3153-80 CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) IV SOLN $650.00 0781-3153-95 CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) IV SOLN $650.00 43598-413-11 DAPTOMYCIN 500 MG IV SOLR $650.00 0143-9385-01 DECITABINE 50 MG IV SOLR $650.00 25021-231-20 DECITABINE 50 MG IV SOLR $650.00 16729-224-05 DECITABINE 50 MG IV SOLR $650.00 71288-119-20 DECITABINE 50 MG IV SOLR $650.00 25021-219-20 DECITABINE 50 MG IV SOLR $650.00 47335-361-41 DECITABINE 50 MG IV SOLR $650.00 67457-631-10 EPTIFIBATIDE 0.75 MG/ML IV SOLN $650.00 71288-413-51 EPTIFIBATIDE 0.75 MG/ML IV SOLN $650.00 72078-026-10 EPTIFIBATIDE 0.75 MG/ML IV SOLN $650.00 43598-901-58 ERTAPENEM 1 GRAM INJ SOLR $650.00 43598-901-11 ERTAPENEM 1 GRAM INJ SOLR $650.00 43598-262-23 FULVESTRANT 250 MG/5 ML IM SYRG $650.00 43598-262-11 FULVESTRANT 250 MG/5 ML IM SYRG $650.00 25021-141-99 NAFCILLIN 10 GRAM INJ SOLR $650.00 70860-119-99 NAFCILLIN 10 GRAM INJ SOLR $650.00 67457-442-20 OXALIPLATIN 100 MG/20 ML IV SOLN $650.00 0703-3218-01 PACLITAXEL 6 MG/ML IV CONC $650.00 0338-1130-04 PARENTERAL AMINO ACID 10% NO.7 10 % IV SOLP $650.00 8544636971 SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRG $650.00 5047-4636-97 SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRG $650.00 0008-4990-20 TIGECYCLINE 50 MG IV SOLR $650.00 0008-4990-19 TIGECYCLINE 50 MG IV SOLR $650.00 68462-534-35 TACROLIMUS 0.1 % TOPICAL OINT $649.94 16729-422-10 TACROLIMUS 0.1 % TOPICAL OINT $649.94 58160-811-52 HEP B-DP(A)T-POLIO VAC (PF) 10 MCG-25LF-25 MCG-10LF/0.5 ML IM SYRG $649.16 58160-811-43 HEP B-DP(A)T-POLIO VAC (PF) 10 MCG-25LF-25 MCG-10LF/0.5 ML IM SYRG $649.16 HC51063097 AVULSION OF NAIL, SIMPLE; SINGLE $649.00 HC25006040 E&M EST OP PT 40MIN $649.00 HC25005984 E&M NEW OP PT 45MIN $649.00 HC24000028 HBO FIRST 15MIN BASIC/C $649.00 42192-619-16 NAPROXEN 125 MG/5 ML ORAL SUSP $648.72 47335-330-40 CHLOROTHIAZIDE SODIUM 500 MG IV SOLR $648.70 3932835760 ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROP $648.57 57894-150-12 ABIRATERONE 250 MG ORAL TAB $648.30 HC25004920 APPLY CAST HAND & LWR FOREARM (GAUNTLET) LT $648.00 HC25004938 APPLY CAST HAND & LWR FOREARM (GAUNTLET) RT $648.00 HC11500717 E&M ASSESS ESTB 20MIN $647.00 HC42000364 INTERROGATE IMP' CVPHYS MONITOR 1 OR MORE DATA $647.00 70069-151-10 CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) IV SOLN $646.75 70069-151-01 CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) IV SOLN $646.75 63256-200-05 STERILE TALC 5 GRAM INTRAPLEURAL SUSR $646.75 HC24000036 HBO EA SUBSEQUNT 15MIN BASIC/C $646.00 52817-840-16 SUCRALFATE 100 MG/ML ORAL SUSP $645.65 HC81500373 FACTOR VIII RELATED AG $645.00 0131-1810-67 LACOSAMIDE 200 MG/20 ML IV SOLN $644.02 HC62209705 DEVICE HEMOSTATIC CLIPPING $644.00 HC62216650 PIN/WIRE FIXATION TEMPORARY AB $644.00 72603-171-01 FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSR $643.50 16714-897-01 PERMETHRIN 5 % TOPICAL CREAM $643.50 25021-158-99 VANCOMYCIN 10 GRAM IV SOLR $643.44 HC44500676 CINERADIOGRAPHY W/ EXAM $643.00 HC81100919 ETHOSUXIMIDE $643.00 HC22000087 OST EST PT EVAL 30MIN $643.00 70954-261-10 DICYCLOMINE 10 MG/5 ML ORAL SOLN $642.57 HC83000497 PLATELETS IRRAD EA UNIT $642.00 68382-444-05 FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSR $641.88 72603-101-01 OXALIPLATIN 100 MG/20 ML IV SOLN $641.16 72603-320-01 OXALIPLATIN 100 MG/20 ML IV SOLN $641.16 HC84200690 CULTURE CHLAMYDIA ANY SOURCE $641.00 HC44000750 FB CHILD NOSE-RECTUM EXAM $641.00 HC81701104 TDT TEST IFA 1ST STAIN $641.00 64980-448-01 NEOMYCIN-POLYMYXIN-HC 3.5-10,000-1 MG/ML-UNIT/ML-% OTIC DRPS $640.38 0065-0800-94 BALANCED SALT SOLN NO.1 IRRIG. INTRAOCULAR SOLN $640.25 HC51010353 ANAL' IMPLNTD PUMP W/PROG MD SKILL $640.00 HC36001089 ASPIRATION W/ CATHETER; NASOTRACHEAL $640.00 HC25000290 LAC REPAIR 12.6-20CM $640.00 HC42000422 PROGRAM/EVAL T-ICD PRE/POST PROC $640.00 HC35000025 REC- EVALUATION 20MIN $640.00 HC84201417 CULT DNA/RNA AMP PCR GRAM NEG ISO $639.00 HC84201425 CULT DNA/RNA AMP PCR GRAM POS ISO $639.00 HC84201441 CULT DNA/RNA AMP PCR RESISTANT GENE $639.00 HC84201433 CULT DNA/RNA AMP PCR YEAST ISO $639.00 HC81500498 FACTOR INHIBITOR TEST $639.00 HC83000828 ALIQUOT PLATELETS $638.00 HC83000810 ALIQUOT RED CELLS $638.00 HC42000406 PROGRAM/EVAL T-ICD DUAL LEAD $638.00 HC62207493 TRAY PERICARIOCENTESIS $638.00 0024-5924-10 INSULIN LISPRO 100 UNIT/ML SUBCUTANEOUS SOLN $637.46 51672-4116-6 METRONIDAZOLE 0.75 % TOPICAL GEL $637.07 0713-0637-37 METRONIDAZOLE 0.75 % TOPICAL GEL $637.07 HC89023832 ANALY CFTR GENE DELET/DUP VARIANTS-AU $637.00 HC82200353 TISSUE FROZEN SECTION $637.00 HC82202284 TISSUE FROZEN SECTION DIST SVC $637.00 62135-712-42 LIDOCAINE HCL 2 % MUCOUS MEMB SOLN $637.00 0574-0601-15 PODOPHYLLUM RESIN 25 % TOPICAL LIQD $636.97 HC34000117 AUD-INFANT HEARING SCREEN AEP BBS AUTO REPEAT OP $636.00 HC62229257 TRAY CHEST TUBE THAL-QUICK $636.00 23155-748-41 PENTAMIDINE 300 MG INJ SOLR $635.05 23155-748-31 PENTAMIDINE 300 MG INJ SOLR $635.05 HC84200302 CULTURE FUNGUS BLOOD $634.00 HC84201581 DNA/RNA C NEOFORMANS/GATTII PCR(PNL) $634.00 HC84201508 DNA/RNA E COLI K1 PCR(PNL) $634.00 HC84201516 DNA/RNA INFLUENZAE H PCR(PNL) $634.00 HC84201524 DNA/RNA L MONOCYTOGENES PCR(PNL) $634.00 HC84201532 DNA/RNA N MENINGITIDIS PCR(PNL) $634.00 HC84201540 DNA/RNA S AGALACTIAE PCR(PNL) $634.00 HC84201573 DNA/RNA VARICELLA ZOSTER PCR(PNL) $634.00 HC25000118 REMOV IMPACTD EAR WAX(INSTRUMENT) BI (NO MOD50) $634.00 HC84201599 DNA/RNA STREP A AMP PROBE(XPERT XPRESS) $633.00 HC62802665 NEEDLE TEMPLAT ENDOCURR $633.00 HC47200779 RAD ONC EST PT LOW MDM 20MIN $633.00 63323-315-10 GANCICLOVIR SODIUM 500 MG IV SOLR $632.26 63323-315-01 GANCICLOVIR SODIUM 500 MG IV SOLR $632.26 HC51063055 PAIRING BENIGN HYPERKERATOTIC LESIONS: >4 $631.18 HC13500046 GENETIC CNSL RISK REDCTN 60MIN $631.00 HC31000185 PT-DEVEL TEST PER STANDARD INSTRUMENT(SCREENING) $631.00 HC62219886 ADAPTER ARTHROSCPC $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 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 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 42799-110-02 ALBENDAZOLE 200 MG ORAL TAB $629.36 0591-2712-02 ALBENDAZOLE 200 MG ORAL TAB $629.36 0093-3560-26 PEG3350-SOD SUL-NACL-KCL-ASB-C 100-7.5-2.691 GRAM ORAL PWPK $629.20 0093-3560-19 PEG3350-SOD SUL-NACL-KCL-ASB-C 100-7.5-2.691 GRAM ORAL PWPK $629.20 HC81701534 C TRACHOMATIS BY DNA AMP PROBE $629.00 HC42000463 PROGRAM/EVAL PACEMKR MULT LEAD $629.00 16714-556-01 ADENOSINE (DIAGNOSTIC) 3 MG/ML IV SOLN $628.81 HC51002202 X RAY URETHROCYSTOGRAM VOIDING $628.00 70121-1733-9 ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJ SOLN $627.90 70121-1733-1 ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJ SOLN $627.90 HC62203419 FORCEP BIOPSY DISP J $627.00 HC32000697 OT-WORK HARDENING INIT 2HR/CMW $627.00 HC31000755 PT-WORK HARDENING INIT 2HR/CMW $627.00 HC44000057 ABDOMEN SINGLE VIEW $625.00 HC29000775 ASSESS/INTERV ALCOHOL/SUBS MISUSE >30MIN $625.00 HC44001667 NECK, SOFT TISSUE $625.00 HC25005554 REMOVE FB EXTRNL EYE; CORNEAL W/SLITLAMP LT $625.00 HC25005562 REMOVE FB EXTRNL EYE; CORNEAL W/SLITLAMP RT $625.00 HC62210133 TUBE TRACH PEDS/NEO CUFFED $625.00 HC83000505 PLATELETS LR IRRAD EA UNIT $624.00 55150-192-01 ADENOSINE (DIAGNOSTIC) 3 MG/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 61703-363-22 OXALIPLATIN 100 MG/20 ML IV SOLN $624.00 HC25000779 AVULSION OF NAIL, EA ADDL' $623.00 66794-151-01 BACLOFEN 50 MCG/ML (1 ML) INTRATHECAL SYRG $622.90 HC44000305 CALCANEUS (HEEL) LT $622.00 HC44000313 CALCANEUS (HEEL) RT $622.00 HC42000299 EVAL PCMKR TRANSTELEPH ^90D $622.00 HC44002814 OS CALSIS $622.00 HC31000334 PT-EVAL MOD COMPLEXITY 30MF2F 45MIN $622.00 62135-802-45 CARBAMAZEPINE 100 MG/5 ML (5 ML) ORAL SUSP $621.11 HC82202078 IF STUDY DIRECT 1ST STAIN $621.00 HC62807615 M: CENTRALIZER HIP $621.00 HC62219787 PUMP BLOOD CENTRIFUGAL $621.00 HC83504092 TISSUE IN-SITU HYBRI INTER-IM $621.00 99999-042-49 FENTANYL DRIP (CONC 50 MCG/ML) 100 ML OCM $620.75 72603-305-01 LACOSAMIDE 10 MG/ML ORAL SOLN $620.10 HC62211057 CANNULA VENOUS STRAIGHT K $620.00 HC51063006 DEBRIDE SKIN SUBQ EA ADD 20SQCM/< $620.00 HC25005166 LARYNGOSCOPY W/REMOVE FB $620.00 0407-2222-17 IODIXANOL 270 MG IODINE/ML IV SOLN $619.45 63323-205-00 FATTY ACID6-FISH OIL-GLYCERIN 10 % IV EMUL $618.80 63323-205-31 FATTY ACID6-FISH OIL-GLYCERIN 10 % IV EMUL $618.80 0069-0206-01 DALTEPARIN (PORCINE) 7,500 ANTI-XA UNIT/0.3 ML SUBCUTANEOUS SYRG $618.24 HC51002749 ASPIRATION OF BLADDER BY NEEDLE $618.04 HC51002434 CHANGE CYSTOSTOMY TUBE; SIMPLE $618.04 HC51000578 CHANGE GT TUBE W/O IMAGE/ENDO $618.04 HC51003911 CHANGE GT TUBE W/REV TRACT W/O IMAGE/ENDO INCL REMVL $618.04 HC51000099 CYSTOGRAM COMPLEX $618.04 HC51002954 DILAT STRICTR URETHRL FLFRM MALE SUBSQ $618.04 HC51002921 DILAT STRICTURE URETHRAL MALE INT'L $618.04 HC51002772 IRRIGATION BLADDER SIMPLE $618.04 HC51002301 LYSIS & STRETCHING ADHESIONS PREPUTIAL $618.04 HC65800047 BRACHY NONSTRNDED GOLD 198 SRC $618.00 HC81500670 FACTOR IX ASSAY $618.00 HC65800039 M: SEED(S) GOLD BRACHYTHERAPY $618.00 HC32000408 OT-RE-EVAL EST POC 45MIN $617.00 HC44201036 US ELASTOGRAPHY LIVER SHEAR WAVE WO/IMAG $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 HC36800589 RT RESP THER GRP 60 MIN/MW $616.00 51754-1007-1 CYSTEINE (L-CYSTEINE) 50 MG/ML INJ SOLN FOR CATHETER OCCLUSION $615.55 51754-1007-3 CYSTEINE (L-CYSTEINE) 50 MG/ML INJ SOLN FOR CATHETER OCCLUSION $615.55 54295-308-25 UREA 40 % TOPICAL CREAM $615.14 63323-172-45 CARBOPLATIN 10 MG/ML IV SOLN $615.13 HC89024855 IGLON5 AB IGG CBA-IFA TITER CSF-AU $615.00 HC51061703 ECHO FETAL CARDIO 2D F/U OR REPEAT $614.26 HC51002483 X RAY FLUORO GUIDANCE $614.26 HC51002269 X RAY URETHROCYSTOGRAM RETROGRADE $614.26 45963-609-55 FLUDARABINE 50 MG IV SOLR $614.25 HC82200452 ANATOMIC CONSULT:REVIEW/PREP $614.00 HC31001704 REPOSITIONING CANALITH/DAY $614.00 HC84200146 CULTURE STOOL $613.00 HC39001060 PSYCH THERAPY W/BIOFEEDBACK 45 MIN $613.00 0781-6023-52 CLARITHROMYCIN 250 MG/5 ML ORAL SUSR $612.30 HC62803515 CAP END SCREW $612.00 HC32000267 OT-EVAL MOD COMPLEXITY 30MF2F 45MIN $611.00 72572-067-01 CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) IV SOLN $611.00 72572-067-10 CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) IV SOLN $611.00 99999-047-49 SACUBITRIL-VALSARTAN 4 MG/ML (COMBINED MG CONCENTRATION) ORAL LIQUID $611.00 70436-026-80 EPTIFIBATIDE 2 MG/ML IV SOLN $610.94 0409-6562-20 TESTOSTERONE CYPIONATE 200 MG/ML IM OIL $610.55 0009-3794-22 IBUTILIDE FUMARATE 0.1 MG/ML IV SOLN $610.22 HC51061547 CLOSED TREATMENT ULNAR SHAFT FRACTURE W/O MANIP $609.58 HC51001394 CLOSED TX ANKLE FX $609.58 HC51001436 CLOSED TX BIG TOE FX $609.58 HC51061125 CLOSED TX CARPAL SCAPHOID FX W/O MAN $609.58 HC51001220 CLOSED TX ELBOW DISLOCATION $609.58 HC51001386 CLOSED TX FIBULA FX $609.58 HC51001303 CLOSED TX FINGER DISTAL FX,EA,NO M $609.58 HC51001295 CLOSED TX FINGER SHAFT FX,EA,NO MAN $609.58 HC51001188 CLOSED TX HUMERUS NECK FX NO MANIP $609.58 HC51001196 CLOSED TX HUMERUS SHAFT FX NO MANIP $609.58 HC51001352 CLOSED TX KNEECAP FX $609.58 HC51001329 CLOSED TX OF FEMUR FX $609.58 HC51001337 CLOSED TX OF THIGH FX $609.58 HC51001311 CLOSED TX PELVIC RING FX W/O MANIPULATION $609.58 HC51001378 CLOSED TX TIBIA FX $609.58 HC51001444 CLOSED TX TOE FX $609.58 HC51001246 CLOSED TX ULNAR FX $609.58 HC29000585 PREVENTATIVE MED COUNSELING 60MIN $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 16714-164-10 MICAFUNGIN 50 MG IV SOLR $607.75 16714-164-01 MICAFUNGIN 50 MG IV SOLR $607.75 0469-3250-10 MICAFUNGIN 50 MG IV SOLR $607.75 25021-190-11 MICAFUNGIN 50 MG IV SOLR $607.75 25021-190-10 MICAFUNGIN 50 MG IV SOLR $607.75 HC51070407 PSY TX W/PATIENT 60MIN W/E&M+ $607.00 HC33000977 ST-EVAL SOUND PRODUCTION 45MIN/M $607.00 HC42000570 WCH NEW PT EVAL 45MIN $607.00 68516-5216-2 ALBUMIN, HUMAN 25 % 25 % IV SOLP $605.15 68516-5216-4 ALBUMIN, HUMAN 25 % 25 % IV SOLP $605.15 HC82200049 ACID FAST STN/GR I W/INT&RPT+ $605.00 HC82200130 ALCIAN BLUE STAIN/ GR I W/I&R+ $605.00 HC82200056 BROWN BREEN GRM STN/GR I W/I&R+ $605.00 HC82200973 DIETERLE MODF STN/GR I W/I&R+ $605.00 HC82200163 GENTA STAIN/GROUP I W/INT&RPT+ $605.00 HC82200023 GIEMSA STAIN/GRP I W/INT&RPT+ $605.00 HC82200981 GRAMS STAIN-AP/GR I W/INT&RPT+ $605.00 HC82200999 GROCOTT SILVER STN/GR I W/I&R+ $605.00 HC82200080 PAS STAIN/GROUP I W/ INT&RPT+ $605.00 HC82200114 SILVER METHENMN ST/GR I W/I&R+ $605.00 HC82202607 SPECIAL STAIN GROUP I+ $605.00 HC82200569 SPECIAL STAIN GRP I W/INT&RPT+ $605.00 HC82200445 SPECIAL STN GRP I W/I&R * OP $605.00 HC82200155 STEINER STN/GR I W/I&R+ $605.00 HC82201005 WADES MOD FITE STN/GR I W/I&R+ $605.00 HC82201013 WARTHIN-STARRY STN/GR I W/I&R+ $605.00 HC82201021 ZIEHL NEELSON STN/GR I W/I&R+ $605.00 42192-608-16 GABAPENTIN 250 MG/5 ML ORAL SOLN $604.89 68516-5214-4 ALBUMIN, HUMAN 5 % 5 % IV SOLP $604.50 68516-5214-2 ALBUMIN, HUMAN 5 % 5 % IV SOLP $604.50 68516-5214-0 ALBUMIN, HUMAN 5 % 5 % IV SOLP $604.50 68516-5214-8 ALBUMIN, HUMAN 5 % 5 % IV SOLP $604.50 44567-450-01 ESMOLOL IN NACL (ISO-OSM) 2,500 MG/250 ML (10 MG/ML) IV SOLP $604.50 67457-299-00 NALOXONE 0.4 MG/ML INJ (MHS WRAPPER) $604.50 67457-299-10 NALOXONE 0.4 MG/ML INJ SOLN $604.50 0006-4681-00 MEASLES,MUMPS,RUBELLA VACC(PF) 1,000-12,500 TCID50/0.5 ML SUBCUTANEOUS SOLR $604.18 0006-4681-01 MEASLES,MUMPS,RUBELLA VACC(PF) 1,000-12,500 TCID50/0.5 ML SUBCUTANEOUS SOLR $604.18 HC25005133 CONTROL NASAL HEMORRHAGE,ANTERIOR,COMPLEX ANY TX $604.00 HC25005125 CONTROL NASAL HEMORRHAGE,ANTERIOR,SIMPLE ANY TX $604.00 HC81500910 INHIB CLOT PROTEIN S FREE (FUNC) $604.00 HC62205653 PERFORATOR $602.00 HC62215694 SUTURE V $602.00 HC44002343 TOE (S) LT $602.00 HC44002350 TOE (S) RT $602.00 HC51062743 APPLIC CAST LEG CLUBFOOT BILAT $601.47 HC51062750 APPLY SPLINT LONG LEG BILATERAL $601.47 HC51062768 APPLY SPLINT SHORT LEG BILATERAL $601.47 HC84200039 CULTURE FUNGUS OTHER SOURCE $601.00 HC81100950 PROCAINAMIDE $601.00 0713-0791-75 SUCRALFATE 100 MG/ML ORAL LIQUID (MCH) $600.60 82182-106-14 SUCRALFATE 100 MG/ML ORAL LIQUID (MCH) $600.60 66689-305-16 SUCRALFATE 100 MG/ML ORAL SUSP $600.09 HC83001131 ALIQUOT PLASMA $600.00 HC83001289 ALIQUOT PLASMA CONVALESCENT $600.00 HC51010338 ANAL' IMPLANTED PUMP NO PROG/REFILL $600.00 HC83001123 CRYOPRECIPITATE 4 UNITS POOLED-SB $600.00 0002-4182-30 BARICITINIB 2 MG ORAL TAB $599.60 72819-152-05 MITOMYCIN 5 MG IV SOLR $599.24 HC62204045 KIT MANIFOLD SPECIALTY $599.00 HC81100299 CARBAMAZEPINE TOTAL $598.00 HC34000133 OTOACOUSTIC EVOKED RESP LTD $598.00 70860-451-10 LEVOTHYROXINE 100 MCG IV SOLR $596.77 25021-468-10 LEVOTHYROXINE 100 MCG IV SOLR $596.77 16729-267-64 DOCETAXEL 80 MG/4 ML (20 MG/ML) IV SOLN $596.70 16714-878-02 LIDOCAINE 5 % TOPICAL OINT $596.38 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 HC62210703 SET DECOMPRESSION COLON $596.00 HC62209002 SPLINT FOOT $596.00 HC62209598 TRACTION PELVIC UNIT $596.00 HC81500423 FACTOR XII $594.00 HC81100968 CAFFEINE $592.00 HC84200088 CULTURE, BACTERIAL-OTHR SOURCE $592.00 HC62204151 KIT PNEUMOTHORAX $592.00 HC32000499 OT-SWALLOWING THERAPY 15 MIN $592.00 HC33000381 ST-SWALLOWING THERAPY 15 MIN $592.00 64281-100-06 METHACHOLINE CHLORIDE 100 MG INHALATION SOLR $591.50 64281-100-00 METHACHOLINE CHLORIDE 100 MG INHALATION SOLR $591.50 0000-3763-00 STERILE TALC 5 GRAM INTRAPLEURAL SUSR $591.50 HC42000471 PROGRAM EVAL PERI-OP PACEMAKER SGL/DUAL/MULTI/LEADLESS $591.00 99999-044-97 OMEPRAZOLE-SODIUM BICARBONATE 2-84 MG/ML ORAL SUSR $590.53 65219-383-04 IODIXANOL 320 MG IODINE/ML IV SOLN $590.20 65219-383-10 IODIXANOL 320 MG IODINE/ML IV SOLN $590.20 0407-1413-63 IOHEXOL 300 MG IODINE/ML IV SOLN $590.20 HC51010791 EAR WICK (UNLISTED PROCEDURE) $590.12 HC51004117 TRACH TUBE CHANGE $590.12 HC84200005 CULTURE CATH TIP $590.00 HC84200120 CULTURE CSF $590.00 HC84200054 CULTURE DECUBITUS $590.00 HC84200229 CULTURE NASAL $590.00 HC84200633 CULTURE RESPIRATORY $590.00 HC84200187 CULTURE SCREEN $590.00 HC84200104 CULTURE THROAT $590.00 HC84201029 CULTURE WHIRLPOOL $590.00 HC84200575 M: CULTURE MISC $590.00 55513-488-40 SOTORASIB 120 MG ORAL TAB $589.05 55513-488-24 SOTORASIB 120 MG ORAL TAB $589.05 HC62218029 BLADE OPHTHALM Z $589.00 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 HC84200641 CULTURE WOUND $588.00 HC62216635 PIN/WIRE FIXATION TEMPORARY Z $588.00 HC31000474 PT-RE-EVAL EST POC 45MIN $588.00 HC25005075 STRAPPING; ANKLE AND/OR FOOT LT $588.00 HC25005083 STRAPPING; ANKLE AND/OR FOOT RT $588.00 0409-6509-01 VANCOMYCIN 5 GRAM IV SOLR $586.69 HC81100091 ACETAMINOPHEN/TYLENOL; 1-2 $585.00 HC62224704 ELECTRODE ENDOSCOPIC BALL TIP $585.00 HC62220025 PROBE ABLATION RF BIPOLR ARTHROSCPC $585.00 44206-251-05 ALBUMIN, HUMAN 25 % 25 % IV SOLP $585.00 44206-251-90 ALBUMIN, HUMAN 25 % 25 % IV SOLP $585.00 44206-310-25 ALBUMIN, HUMAN 5 % 5 % IV SOLP $585.00 44206-310-90 ALBUMIN, HUMAN 5 % 5 % IV SOLP $585.00 83634-400-10 BIVALIRUDIN 250 MG IV SOLR $585.00 83634-400-41 BIVALIRUDIN 250 MG IV SOLR $585.00 68180-407-03 CEFIXIME 200 MG/5 ML ORAL SUSR $585.00 0143-9160-01 CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) IV SOLN $585.00 0143-9160-10 CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) IV SOLN $585.00 54288-120-01 EPINEPHRINE 1 MG/ML INJ SOLN $585.00 68462-760-10 EPINEPHRINE 1 MG/ML INJ SOLN $585.00 0338-9558-10 EPTIFIBATIDE 0.75 MG/ML IV SOLN $585.00 16729-260-03 EPTIFIBATIDE 2 MG/ML IV SOLN $585.00 39822-3050-2 PENTAMIDINE 300 MG INJ SOLR $585.00 39822-3050-1 PENTAMIDINE 300 MG INJ SOLR $585.00 70756-649-35 PHENYLEPHRINE HCL 2.5 % OPHT DROP $585.00 25021-204-05 VINORELBINE 10 MG/ML IV SOLN (MCH) $585.00 45963-607-56 VINORELBINE 10 MG/ML IV SOLN (MCH) $585.00 HC84201649 DNA/RNA ACINETOBACTER CALCOACETICUS-BAUMANNII CMPLX(PNL) $584.00 HC84201656 DNA/RNA ENTEROBACTER CLOACAE CMPLX (PNL) $584.00 HC84201664 DNA/RNA KLEBSIELLA AEROGENES (PNL) $584.00 HC84201672 DNA/RNA KLEBSIELLA OXYTOCA (PNL) $584.00 HC84201680 DNA/RNA KLEBSIELLA PNEUMONIAE GROUP (PNL) $584.00 HC84201698 DNA/RNA MORAXELLA CATARRHALIS (PNL) $584.00 HC84201706 DNA/RNA PROTEUS SPP (PNL) $584.00 HC84201714 DNA/RNA PSEUDOMONAS AERUGINOSA (PNL) $584.00 HC84201722 DNA/RNA SERRATIA MARCESCENS (PNL) $584.00 HC84201730 DNA/RNA STAPHYLOCOCCUS AUREUS (PNL) $584.00 HC84201748 DNA/RNA STREPTOCOCCUS AGALACTIAE (PNL) $584.00 HC84201755 DNA/RNA STREPTOCOCCUS PNEUMONIAE (PNL) $584.00 HC84201763 DNA/RNA STREPTOCOCCUS PYOGENES (PNL) $584.00 HC62208632 DRIVER CATH CAPSULE EGD $584.00 0270-7025-40 GADOPICLENOL 0.5 MMOL/ML IV SOLN $583.13 HC83001065 BB PATH; INVEST TRANFUSION REACTION $582.00 HC34000489 CONSULT PHYS/MENTAL HANDICAP SEVERE OVER 7YRS $582.00 HC84201466 DNA/RNA HERPES SIMPLEX I PCR(PNL) $582.00 HC84201474 DNA/RNA HERPES SIMPLEX II PCR(PNL) $582.00 HC84201482 DNA/RNA HERPES VIRUS-6 PCR(PNL) $582.00 HC34000414 EPSDT AUDIO INITIAL <2YRS $582.00 HC34000471 EPSDT DIFF-TO-TEST <7YRS $582.00 6299129141 POLYETHYLENE GLYCOL 400 (BULK) MISC LIQD $581.75 HC42000372 INTERROGATE SQ CARDIAC RHYTHM MONITOR $581.00 HC81100372 HEPATIC FUNCTION PANEL $580.00 HC22000079 OST EST PT EVAL 20MIN $580.00 HC34000166 HEARING AID EXAM&SEL BILAT $579.00 25021-409-10 EPTIFIBATIDE 2 MG/ML IV SOLN $578.50 67457-341-05 VANCOMYCIN 5 GRAM IV SOLR $578.05 HC44703791 CARDIAC OUTPUT MEASUREMENT, THERMO/OTHR W/ HRT CATH CONGEN DEFECT+ $578.00 HC81500357 FACTOR V LABILE $578.00 HC84200401 CULT QT AEROBIC OTHER SOURCE $577.00 HC84200591 CULTURE SPUTUM QUANT $577.00 HC11500840 PEDS ASSESS ESTAB PT 30MIN $577.00 63323-885-10 LEVOTHYROXINE 20 MCG/ML IV SOLN $576.49 42023-123-06 DANTROLENE 20 MG IV SOLR $576.16 0270-1411-25 IOPAMIDOL 200 MG IODINE /ML (41 %) INTRATHECAL SOLN $575.51 HC84201193 C DIFFICILE TOXIN $575.00 HC81701237 HPV HI RISK(16,18,31,33,35,39,45,51,52,56,58,59,68) $575.00 HC12200416 INJECTIONS MONOCLONAL TIXAGEN/CILGAV $575.00 HC81701542 N-GONORRHEA BY DNA AMP PROBE $575.00 HC84201615 N-GONORRHEA BY DNA AMP PROBE $575.00 HC89500946 RBC AG PROFILE-MOLECULAR LEVEL 4-SB $575.00 HC81100281 RENAL FUNCTION PANEL $575.00 13533-636-03 HEPATITIS B IMMUNE GLOBULIN 110 UNIT/0.5 ML IM SYRG $574.93 61314-637-10 PREDNISOLONE ACETATE 1 % OPHT DRPS $574.80 0004-0038-22 VALGANCICLOVIR 450 MG ORAL TAB $574.61 HC84200369 CULTURE URINE QUANTITATIVE $574.00 HC62219761 INSTRUMENT KYPHO PAC BEVELED $574.00 HC12200051 IV INF THER SEQ/NEW RX 1ST HR $574.00 HC62215686 SUTURE U $574.00 63323-649-16 LEVOTHYROXINE 100 MCG IV SOLR $573.82 67457-227-02 COSYNTROPIN 0.25 MG INJ SOLR $573.10 67457-227-00 COSYNTROPIN 0.25 MG INJ SOLR $573.10 HC81500415 FACTOR XI PTA $572.00 HC25000316 LAC REPAIR 7.6-12 5CM(MEDIUM) $572.00 25021-828-50 LEUCOVORIN CALCIUM 500 MG INJ SOLR $572.00 HC77400273 ANESTHESIA ADD'L 15MIN CASE CX $571.00 HC81500407 FACTOR X $571.00 HC83000133 RBC ANTIBODY ID EACH TECH $571.00 HC82203795 IHC/IP PER SPEC EA ADD AB STAIN+ ACTH $570.00 HC82203415 IHC/IP PER SPEC EA ADD AB STAIN+ AFP $570.00 HC82204082 IHC/IP PER SPEC EA ADD AB STAIN+ ANTI-BCL-2 $570.00 HC82204090 IHC/IP PER SPEC EA ADD AB STAIN+ ANTI-CD3/HRP $570.00 HC82203514 IHC/IP PER SPEC EA ADD AB STAIN+ BCL-6 $570.00 HC82203811 IHC/IP PER SPEC EA ADD AB STAIN+ CALCITON $570.00 HC82204314 IHC/IP PER SPEC EA ADD AB STAIN+ CALRETININ $570.00 HC82203522 IHC/IP PER SPEC EA ADD AB STAIN+ CAM5-2 $570.00 HC82204363 IHC/IP PER SPEC EA ADD AB STAIN+ CD10 $570.00 HC82204389 IHC/IP PER SPEC EA ADD AB STAIN+ CD117 $570.00 HC82203571 IHC/IP PER SPEC EA ADD AB STAIN+ CD-138 $570.00 HC82203530 IHC/IP PER SPEC EA ADD AB STAIN+ CD-1A $570.00 HC82203548 IHC/IP PER SPEC EA ADD AB STAIN+ CD-21 $570.00 HC82203555 IHC/IP PER SPEC EA ADD AB STAIN+ CD-23 $570.00 HC82203563 IHC/IP PER SPEC EA ADD AB STAIN+ CD-31 $570.00 HC82204322 IHC/IP PER SPEC EA ADD AB STAIN+ CD4 $570.00 HC82204330 IHC/IP PER SPEC EA ADD AB STAIN+ CD5 $570.00 HC82204371 IHC/IP PER SPEC EA ADD AB STAIN+ CD56 $570.00 HC82204108 IHC/IP PER SPEC EA ADD AB STAIN+ CD-68 $570.00 HC82204348 IHC/IP PER SPEC EA ADD AB STAIN+ CD7 $570.00 HC82204454 IHC/IP PER SPEC EA ADD AB STAIN+ CD-79A $570.00 HC82204355 IHC/IP PER SPEC EA ADD AB STAIN+ CD8 $570.00 HC82203589 IHC/IP PER SPEC EA ADD AB STAIN+ CDX-28 $570.00 HC82203365 IHC/IP PER SPEC EA ADD AB STAIN+ CEA $570.00 HC82203597 IHC/IP PER SPEC EA ADD AB STAIN+ CEA MONOCLON $570.00 HC82203399 IHC/IP PER SPEC EA ADD AB STAIN+ CHROMOGRAN $570.00 HC82203613 IHC/IP PER SPEC EA ADD AB STAIN+ CK-19 $570.00 HC82203605 IHC/IP PER SPEC EA ADD AB STAIN+ CK-5/6 $570.00 HC82204397 IHC/IP PER SPEC EA ADD AB STAIN+ CMV $570.00 HC82204603 IHC/IP PER SPEC EA ADD AB STAIN+ C-MYC $570.00 HC82204116 IHC/IP PER SPEC EA ADD AB STAIN+ CYCLIN D1 $570.00 HC82203498 IHC/IP PER SPEC EA ADD AB STAIN+ CYTOCHM $570.00 HC82204124 IHC/IP PER SPEC EA ADD AB STAIN+ CYTOKERATIN-20 $570.00 HC82204132 IHC/IP PER SPEC EA ADD AB STAIN+ CYTOKERATIN-7 $570.00 HC82203837 IHC/IP PER SPEC EA ADD AB STAIN+ DESMIN $570.00 HC82203761 IHC/IP PER SPEC EA ADD AB STAIN+ DYSTROPH (C-TERM) $570.00 HC82203779 IHC/IP PER SPEC EA ADD AB STAIN+ DYSTROPH (N-TERM) $570.00 HC82203787 IHC/IP PER SPEC EA ADD AB STAIN+ DYSTROPH (ROD DOMAIN) $570.00 HC82203621 IHC/IP PER SPEC EA ADD AB STAIN+ E-CADHERIN $570.00 HC82204405 IHC/IP PER SPEC EA ADD AB STAIN+ EGFR $570.00 HC82203639 IHC/IP PER SPEC EA ADD AB STAIN+ EMA (MC5)(LIVER) $570.00 HC82203456 IHC/IP PER SPEC EA ADD AB STAIN+ EPI MEMBR $570.00 HC82203845 IHC/IP PER SPEC EA ADD AB STAIN+ ESTR RCPT $570.00 HC82204140 IHC/IP PER SPEC EA ADD AB STAIN+ EWINGS SARCOMA $570.00 HC82204157 IHC/IP PER SPEC EA ADD AB STAIN+ FACTOR 13-A $570.00 HC82203423 IHC/IP PER SPEC EA ADD AB STAIN+ FCTR 8 AG $570.00 HC82203852 IHC/IP PER SPEC EA ADD AB STAIN+ GASTRIN $570.00 HC82204587 IHC/IP PER SPEC EA ADD AB STAIN+ GATA-3 $570.00 HC82203431 IHC/IP PER SPEC EA ADD AB STAIN+ GFAP $570.00 HC82203860 IHC/IP PER SPEC EA ADD AB STAIN+ GLUCAGON $570.00 HC82204165 IHC/IP PER SPEC EA ADD AB STAIN+ GROWTH HORM $570.00 HC82204629 IHC/IP PER SPEC EA ADD AB STAIN+ H PYLORI $570.00 HC82203449 IHC/IP PER SPEC EA ADD AB STAIN+ HCG $570.00 HC82203647 IHC/IP PER SPEC EA ADD AB STAIN+ HEPPAR $570.00 HC82204298 IHC/IP PER SPEC EA ADD AB STAIN+ HER-2-NEU $570.00 HC82203878 IHC/IP PER SPEC EA ADD AB STAIN+ HERPES POLYV $570.00 HC82203357 IHC/IP PER SPEC EA ADD AB STAIN+ HMB-45 $570.00 HC82203829 IHC/IP PER SPEC EA ADD AB STAIN+ HPCA-1 $570.00 HC82204645 IHC/IP PER SPEC EA ADD AB STAIN+ HSV-1 $570.00 HC82204660 IHC/IP PER SPEC EA ADD AB STAIN+ HSV-2 $570.00 HC82203654 IHC/IP PER SPEC EA ADD AB STAIN+ IGD $570.00 HC82203662 IHC/IP PER SPEC EA ADD AB STAIN+ INHIBIN $570.00 HC82203670 IHC/IP PER SPEC EA ADD AB STAIN+ INI-1 $570.00 HC82203886 IHC/IP PER SPEC EA ADD AB STAIN+ INSULIN $570.00 HC82203894 IHC/IP PER SPEC EA ADD AB STAIN+ KAPPA $570.00 HC82203472 IHC/IP PER SPEC EA ADD AB STAIN+ KERATIN $570.00 HC82203688 IHC/IP PER SPEC EA ADD AB STAIN+ KERATIN (AE1/AE3) LN $570.00 HC82204173 IHC/IP PER SPEC EA ADD AB STAIN+ KERATIN 903 $570.00 HC82203696 IHC/IP PER SPEC EA ADD AB STAIN+ KERATIN HMWK $570.00 HC82203902 IHC/IP PER SPEC EA ADD AB STAIN+ KI-1 $570.00 HC82204199 IHC/IP PER SPEC EA ADD AB STAIN+ KI-67 $570.00 HC82203910 IHC/IP PER SPEC EA ADD AB STAIN+ KP-1 $570.00 HC82203928 IHC/IP PER SPEC EA ADD AB STAIN+ L26 AB $570.00 HC82203936 IHC/IP PER SPEC EA ADD AB STAIN+ LAMBDA $570.00 HC82203381 IHC/IP PER SPEC EA ADD AB STAIN+ LCA AP $570.00 HC82204207 IHC/IP PER SPEC EA ADD AB STAIN+ LEU M1 (CD15) $570.00 HC82203464 IHC/IP PER SPEC EA ADD AB STAIN+ LEU-22 $570.00 HC82203944 IHC/IP PER SPEC EA ADD AB STAIN+ LN 1 $570.00 HC82203951 IHC/IP PER SPEC EA ADD AB STAIN+ LN 2 $570.00 HC82204413 IHC/IP PER SPEC EA ADD AB STAIN+ MELAN-A $570.00 HC82203803 IHC/IP PER SPEC EA ADD AB STAIN+ MONOCLNL BREAST $570.00 HC82204686 IHC/IP PER SPEC EA ADD AB STAIN+ MSH-2 $570.00 HC82204694 IHC/IP PER SPEC EA ADD AB STAIN+ MSH-6 $570.00 HC82203969 IHC/IP PER SPEC EA ADD AB STAIN+ MT-1 $570.00 HC82204215 IHC/IP PER SPEC EA ADD AB STAIN+ MT-1 $570.00 HC82203704 IHC/IP PER SPEC EA ADD AB STAIN+ MUM-1 $570.00 HC82203977 IHC/IP PER SPEC EA ADD AB STAIN+ MUSCLE $570.00 HC82204223 IHC/IP PER SPEC EA ADD AB STAIN+ MYELOPEROXIDASE $570.00 HC82203712 IHC/IP PER SPEC EA ADD AB STAIN+ MYOGENIN $570.00 HC82203985 IHC/IP PER SPEC EA ADD AB STAIN+ MYOGLOBIN $570.00 HC82203993 IHC/IP PER SPEC EA ADD AB STAIN+ NEURFLMNT $570.00 HC82204009 IHC/IP PER SPEC EA ADD AB STAIN+ NSE $570.00 HC82204421 IHC/IP PER SPEC EA ADD AB STAIN+ P16 $570.00 HC82204231 IHC/IP PER SPEC EA ADD AB STAIN+ P-53 $570.00 HC82203720 IHC/IP PER SPEC EA ADD AB STAIN+ P63 $570.00 HC82204561 IHC/IP PER SPEC EA ADD AB STAIN+ PAX8 $570.00 HC82203738 IHC/IP PER SPEC EA ADD AB STAIN+ PGP 9.5 $570.00 HC82204249 IHC/IP PER SPEC EA ADD AB STAIN+ PLAP $570.00 HC82204702 IHC/IP PER SPEC EA ADD AB STAIN+ PMS2 $570.00 HC82204017 IHC/IP PER SPEC EA ADD AB STAIN+ PROGEST REC $570.00 HC82204256 IHC/IP PER SPEC EA ADD AB STAIN+ PROLACTIN $570.00 HC82204462 IHC/IP PER SPEC EA ADD AB STAIN+ PROS ACID PHOS $570.00 HC82203373 IHC/IP PER SPEC EA ADD AB STAIN+ PSA $570.00 HC82203340 IHC/IP PER SPEC EA ADD AB STAIN+ S100 $570.00 HC82204264 IHC/IP PER SPEC EA ADD AB STAIN+ SMMHC $570.00 HC82204025 IHC/IP PER SPEC EA ADD AB STAIN+ SMOOTH MUSC $570.00 HC82204033 IHC/IP PER SPEC EA ADD AB STAIN+ SOMATOSTN $570.00 HC82204546 IHC/IP PER SPEC EA ADD AB STAIN+ SOX10 $570.00 HC82203480 IHC/IP PER SPEC EA ADD AB STAIN+ SYNAPTOP $570.00 HC82204041 IHC/IP PER SPEC EA ADD AB STAIN+ T4 $570.00 HC82204272 IHC/IP PER SPEC EA ADD AB STAIN+ TERM DEOXZYTRANS $570.00 HC82203746 IHC/IP PER SPEC EA ADD AB STAIN+ TH $570.00 HC82204058 IHC/IP PER SPEC EA ADD AB STAIN+ THYROGLOBLN $570.00 HC82204439 IHC/IP PER SPEC EA ADD AB STAIN+ TTF-1 $570.00 HC82204306 IHC/IP PER SPEC EA ADD AB STAIN+ UBIQUITIN $570.00 HC82204066 IHC/IP PER SPEC EA ADD AB STAIN+ UCHL 1 $570.00 HC82204280 IHC/IP PER SPEC EA ADD AB STAIN+ UCHL-1 $570.00 HC82203407 IHC/IP PER SPEC EA ADD AB STAIN+ VIMENTIN $570.00 HC82203753 IHC/IP PER SPEC EA ADD AB STAIN+ WT-1 $570.00 HC42000455 PROGRAM/EVAL PACEMKR DUAL LEAD $570.00 HC39000922 PSYCH TX FOR CRISIS EA ADD 30MINS+/COMM $569.00 71288-102-10 BENDAMUSTINE 25 MG IV SOLR $568.75 25021-471-74 FULVESTRANT 250 MG/5 ML IM SYRG $568.75 0009-0016-12 HYDROCORTISONE SOD SUCC (PF) 500 MG/4 ML INJ SOLR $568.36 0069-4200-30 SILDENAFIL 25 MG ORAL TAB $568.28 0069-4210-30 SILDENAFIL 50 MG ORAL TAB $568.28 HC41500646 MONITOR NEURO INTRAOP CONT REMOTE >1 PT PER HR $568.00 HC84200914 C DIFFICILE AG, EIA $566.00 HC33000282 ST-SPEECH THERAPY GRP 45MIN/MCW $566.00 HC11500071 E&M NEW PT 30MIN $565.00 HC84201896 SARS-COVID-2 QUAL ANTIGEN OPTICAL $565.00 59762-5009-1 CLINDAMYCIN PHOSPHATE 2 % VAGINAL CREAM $564.72 60977-141-01 PRALIDOXIME 1 GRAM INJ SOLR $563.55 60977-141-27 PRALIDOXIME 1 GRAM INJ SOLR $563.55 0378-3266-94 ETOPOSIDE 50 MG ORAL CAP $562.60 HC44000446 CHOLANGIOGRAM INTRAOP ADDL SET S&I ONLY $562.00 HC39000948 PSY TX W/PATIENT 30MIN W/E&M+ $562.00 16714-137-01 PACLITAXEL 6 MG/ML IV CONC $561.93 69238-2352-6 ZOLMITRIPTAN 5 MG NASL SPRY $561.42 71288-164-50 LEUCOVORIN CALCIUM 500 MG INJ SOLR $560.24 63323-711-00 LEUCOVORIN CALCIUM 500 MG INJ SOLR $560.24 HC62223045 APPLIER LIGA/HEMOCLIP ENDO J $560.00 HC62217617 AWL SPINAL SINGLE 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CARDIOPLEGIC SOLN 16 MEQ/L (= K+) PERF SOLN $552.50 25021-245-04 DOCETAXEL 20 MG/ML IV SOLN (MCH) $552.50 76329-3399-5 PROCAINAMIDE 100 MG/ML IV SYRG $552.50 43598-616-11 REGADENOSON 0.4 MG/5 ML IV SYRG $552.50 54288-127-01 TETRACAINE HCL (PF) 1 % (10 MG/ML) INJ SOLN $552.50 54288-127-10 TETRACAINE HCL (PF) 1 % (10 MG/ML) INJ SOLN $552.50 HC31001571 PT-ELEC STIM/WOUND CARE/M $552.00 HC25004953 STRAPPING; SHOULDER LT $552.00 HC25004961 STRAPPING; SHOULDER RT $552.00 0409-6557-01 TESTOSTERONE CYPIONATE 100 MG/ML IM OIL $551.27 HC62229166 ORTHOTIC LSO RIGID ANT POST LAT PANEL SACROCOC PREFAB $551.00 HC62205919 PUSHER OCCLUSION COIL $550.00 HC44002137 STRESS VIEW, ANY JOINT $550.00 99999-045-64 NM TC-99M TILMANOCEPT 0.5 MCI (LYMPHOSEEK) $549.85 61314-206-15 PILOCARPINE HCL 4 % OPHT DROP $549.61 0409-6476-44 ERYTHROMYCIN LACTOBIONATE 500 MG IV SOLR $549.48 0054-3545-63 MEPERIDINE 50 MG/5 ML ORAL SOLN $549.25 HC81100083 LIPID PANEL $549.00 HC32010407 OT- TM CONF INTERDISCPLN F2F PT/FAM WQHCP 60MIN $549.00 HC32010423 OT- TM CONF INTERDISCPLN NO PT/FAM, WMD 60MIN $549.00 HC31010325 PT- TM CONF INTERDISCPLN F2F PT/FAM WQHCP 60MIN $549.00 HC31010341 PT- TM CONF INTERDISCPLN NO PT/FAM, WMD 60MIN $549.00 HC31002108 PT-EVAL LOW COMPLEXITY 20MF2F 45MIN $549.00 HC35000272 REC- TM CONF INTERDISCPLN F2F PT/FAM WQHCP 60MIN $549.00 HC33010265 ST- TM CONF INTERDISCPLN F2F PT/FAM WQHCP 60MIN $549.00 HC33010281 ST- TM CONF INTERDISCPLN NO PT/FAM, WMD 60MIN $549.00 HC81100380 ALCOHOL; 1-2 $548.00 HC39000252 PSY TM CONF W/PT&/FAM 60MIN $548.00 99999-047-35 BRILLIANT GREEN (BULK) MISC CRYS $547.95 61990-0411-0 DIHYDROERGOTAMINE 1 MG/ML INJ SOLN $547.37 61990-0411-1 DIHYDROERGOTAMINE 1 MG/ML INJ SOLN $547.37 HC32003295 OT-EVAL LOW COMPLEXITY 20MF2F 45MIN $547.00 HC62213699 FORCEP OPTHALMIC DISPOSABLE $546.00 HC62215678 SUTURE T $546.00 0054-0064-47 ONDANSETRON HCL 4 MG/5 ML ORAL SOLN $545.68 0009-0433-04 GELATIN ABSORBABLE MUCOUS MEMB POWD $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 24208-631-10 NEOMYCIN-POLYMYXIN-HC 3.5-10,000-1 MG/ML-UNIT/ML-% OTIC SOLN $545.35 HC62207592 TUBE CANTOR $545.00 HC44003002 FEMUR 1 VIEW LT $544.00 HC44003010 FEMUR 1 VIEW RT $544.00 HC81100778 PROCAINAMIDE W/NAPA $544.00 HC62202015 COVER FOOT AV IMPULSE $543.00 HC25005976 E&M NEW OP PT 30MIN $543.00 HC51002145 INJ FOR CYSTOGRAM $543.00 HC62209689 OVERTUBE ESOPHAGEAL $543.00 63323-303-51 TOBRAMYCIN SULFATE 1.2 GRAM INJ SOLR $542.75 63323-303-01 TOBRAMYCIN SULFATE 1.2 GRAM INJ SOLR $542.75 70700-173-22 TOBRAMYCIN SULFATE 1.2 GRAM INJ SOLR $542.75 70700-173-86 TOBRAMYCIN SULFATE 1.2 GRAM INJ SOLR $542.75 HC62211545 CATH IRRIG/DRAIN SINUSPLASTY $542.00 HC84201201 CHARCOT-LEYDEN CRYSTALS $542.00 HC12200010 IV INFUSION THERAPY EA ADDL HR $542.00 HC35000298 REC- TM CONF INTERDISCPLN NO PT/FAM, WMD 60MIN $542.00 HC62210851 TRANSDCR OPTCL DATARSO2WIRELSS $542.00 HC38000170 USE OF CAST ROOM $542.00 0407-0690-15 GADODIAMIDE 7.5 MMOL/15 ML (287 MG/ML) IV SOLN $541.61 HC62804059 KIT CATH VENTRICULAR $540.00 50419-747-01 PRAZIQUANTEL 600 MG ORAL TAB $539.75 51715-100-04 BUPIVACAINE HCL 100 MG IMPL IMPL $539.50 51715-100-03 BUPIVACAINE HCL 100 MG IMPL IMPL $539.50 0168-0202-30 CLINDAMYCIN PHOSPHATE 1 % TOPICAL GEL $538.98 68803-612-10 TRYPAN BLUE 0.06 % INTRAOCULAR SYRG $538.85 13533-631-02 RHO(D) IMMUNE GLOBULIN 1,500 UNIT (300 MCG) IM ONLY INJ (MHS WRAPPER) $538.40 13533-631-20 RHO(D) IMMUNE GLOBULIN 1,500 UNIT (300 MCG) IM ONLY INJ (MHS WRAPPER) $538.40 HC77400257 MOD CS DIFF PHYS/QHP 5/>YR INIT'L 15MIN $538.00 HC62229182 ORTHOSIS LSO RIGID ANT/POST FRM/PNL PREFB CUST(DJ) $538.00 HC62221650 DILATOR SPINE $537.00 HC62203724 KIT BONE PREP $537.00 HC62206446 MARKER SHADOWFORM/VISICOIL $537.00 HC42000398 PROGRAM/EVAL T-ICD SNGL LEAD $537.00 HC39000724 PSY PREPARE REPORT $537.00 HC39000179 PSY PREPARE REPORT 1 HOUR $537.00 70121-1647-7 TIGECYCLINE 50 MG IV SOLR $536.25 70121-1647-1 TIGECYCLINE 50 MG IV SOLR $536.25 63323-103-64 CISPLATIN 1 MG/ML IV SOLN $535.60 HC51000404 IV INF HYDRATION INITIAL HR $535.40 HC51000222 IV INFUSION THERAPY 1ST HOUR $535.40 HC51000214 IV PUSH SINGLE/INIT'L INJ $535.40 HC51001451 REFILL&MAINT'N IMPLANT PUMP $535.40 HC51020394 SC INFUSION THERAPY INITIAL UP TO 1HR $535.40 HC62209226 DEVICE SUTURE CAPTURE (VAG) $535.00 HC51061661 ECHO 2D LMTD W/O SPEC&CLR /DOP $535.00 HC62804661 STAPLE REINFORCEMENT(SEAMGUARD)     B $535.00 99999-041-44 NM I-131 SODIUM IODIDE THERAPEUTIC CAPSULE $534.69 99999-041-48 NM TC-99M MEDRONATE/MDP DX MHS $534.66 44567-451-01 ESMOLOL IN NACL (ISO-OSM) 2,000 MG/100 ML IV SOLP $534.30 44567-451-10 ESMOLOL IN NACL (ISO-OSM) 2,000 MG/100 ML IV SOLP $534.30 67457-889-10 FOSAPREPITANT 150 MG IV SOLR $534.17 43598-948-11 FOSAPREPITANT 150 MG IV SOLR $534.17 HC13500038 GENETIC CNSL RISK REDCTN 45MIN $534.00 0143-9750-01 TESTOSTERONE ENANTHATE 200 MG/ML IM OIL $533.52 42494-339-03 FLUCYTOSINE 250 MG ORAL CAP $533.45 HC82201039 ALCIAN BLUE NO DIGEST'N/GRPII+ $533.00 HC38000121 APPLY SPLINT FINGER STATIC $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 70121-1389-7 DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN $533.00 70121-1389-1 DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN $533.00 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 HC22000020 OST NEW PT EVAL 30MIN $532.00 HC62216619 PIN/WIRE FIXATION TEMPORARY X $532.00 HC62223706 SENSOR CARDIAC OUTPUT $532.00 HC11500774 AM/PACU EVAL & MANAGE 10MIN $531.00 HC81500464 INHIB PROTEIN C ACTIVITY $530.00 HC81101354 LIPID PANEL SUBSEQUENT $530.00 HC62204409 KNIFE COLD DISP $529.00 HC39000310 PSYCH GRP TX(NOT MULTI FAMILY)90MIN $529.00 55566-2200-0 DESMOPRESSIN 4 MCG/ML INJ SOLN $527.41 0574-0820-10 TESTOSTERONE CYPIONATE 200 MG/ML IM OIL $527.22 HC62202825 BAG/POUCH RETRIEVAL SPECMN ENDO G $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 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 HC29000346 PLETHYSMOGRAPHY $526.00 HC62212113 PORT SINGLE-SITE ROBOTIC $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 54838-502-80 HYDROXYZINE HCL 10 MG/5 ML ORAL SOLN $525.74 HC89024228 ANSER ADA MEAS SER ADALIMUMAB(ASDA)-PR $525.00 HC89023857 ANSER IFX MEASUOF ABS TO INFLIXIMAB-PR $525.00 HC89023873 ANSER VDZ MEAS OF ABS TO VEDOLIZUM-PR $525.00 HC62226683 CABLE PACING DISP D $525.00 HC11500832 PEDS ASSESS ESTAB PT 20MIN $525.00 61314-204-15 PILOCARPINE HCL 2 % OPHT DROP $524.26 HC82201047 ALCIAN BLUE STN W/DIG/GRP II+ $524.00 HC82200007 AMYLOID (CONGO RED)/GRP II+ $524.00 HC82200148 AMYLOID (CRYST VIOLET)/GRP II+ $524.00 HC82201054 AMYLOID ST BENNHOLDS/GRP II+ $524.00 HC82201062 BONE MAR IRON STN/GRP II+ $524.00 HC84600493 COLLOIDAL IRON STAIN/GRP II+ $524.00 HC84600485 COPPER STAIN/GRP II+ $524.00 HC82200015 ELASTIC STAIN/GRP II+ $524.00 HC82201070 F-M ARGENTAFFIN STAIN/GRP II+ $524.00 HC82201088 F-M MELANIN STN BLEACH/GRPII+ $524.00 HC82201096 GIEMSA STAIN MAST CELL/GRP II+ $524.00 HC82201104 GRIMELIUS ARGYROPHL STN GRPII+ $524.00 HC82201112 HALLS BILE STAIN/GRP II+ $524.00 HC82200494 IRON STAIN/B.M. SMEARS+ $524.00 HC82200031 IRON STAIN/GRP II+ $524.00 HC82201120 JONES SILVER STAIN/GRP II+ $524.00 HC82201138 KOSSA CALCIUM STAIN/GRP II+ $524.00 HC82201146 LUXOL FAST BLUE STAIN GRP II+ $524.00 HC82201153 MASSON TRICHROME STAIN/GRP II+ $524.00 HC82201161 MAY GRUNWALD GIEMS STN GRP II+ $524.00 HC82201179 MELANIN BLEACHING/GRP II+ $524.00 HC82201187 METHYL GREEN PYRON STN/GRP II+ $524.00 HC82200064 MUCIN MUCICARMINE STN/GRP II+ $524.00 HC82201195 MYELIN STAIN GRP II+ $524.00 HC82200072 OIL RED O STAIN/GRP II+ $524.00 HC81101206 PARATHYROID HORMONE $524.00 HC81101347 PARATHYROID HORMONE SUBSEQUENT $524.00 HC82201203 PAS STAIN W/DIGESTION GRP II+ $524.00 HC82201211 PAS STAIN/GRP II+ $524.00 HC82201229 PERLS PRUSSIAN BLU STN GRP II+ $524.00 HC82200098 PTAH STAIN/GRP II+ $524.00 HC82200122 RETICULUM STAIN/GRP II+ $524.00 HC82201237 SNOOKS RETICULIN STAIN GRP II+ $524.00 HC82200577 SPECIAL STAIN GROUP II+ $524.00 HC82202615 SPECIAL STAIN GROUP II+ *OP $524.00 HC82201245 SUDA BLACK B STN/GRP II+ $524.00 HC82201252 TOLUID BLU MAST CL STN/GRP II+ $524.00 HC82200106 TRICHROME STAIN/GRP II+ $524.00 HC82201260 VERHOFF ELASTI TIS STN/GRP II+ $524.00 HC81500431 ANTITHROMBIN III $523.00 HC81101891 BASIC METABOLIC PAN/ION'D CA (POS) $523.00 HC12200168 INF CNTR-NEW PT EVAL 30MIN $523.00 43975-254-14 TEMOZOLOMIDE 100 MG ORAL CAP $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 HC84200161 MIC SENSITIVITY $522.00 0781-3440-95 COSYNTROPIN 0.25 MG INJ SOLR $521.30 0781-3440-71 COSYNTROPIN 0.25 MG INJ SOLR $521.30 HC81100190 LITHIUM $521.00 0378-8043-21 CLOBAZAM 2.5 MG/ML ORAL SUSP $520.26 0054-3722-50 PREDNISONE 5 MG/5 ML ORAL SOLN $520.26 HC89020341 CONNEXIN 26 (GJB2) SEQUENCING-AU $520.00 HC82201328 HISTCHM ST GOM TRICHRM,FR TS $520.00 HC82201450 PAS W/DIGESTON,FROZ TIS BLK $520.00 HC81100943 PRIMIDONE $520.00 HC89501043 RBC DNA GENOTYPE 16 GROUPS 51 AG-SB $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 43066-557-12 DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN $520.00 43066-016-10 NICARDIPINE IN NACL (ISO-OS) 40 MG/200 ML (0.2 MG/ML) IV PGBK $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 31722-681-47 ACYCLOVIR 200 MG/5 ML ORAL SUSP $519.59 0054-0062-58 CITALOPRAM 10 MG/5 ML ORAL SOLN $519.48 57237-274-24 LAMIVUDINE 10 MG/ML ORAL SOLN $519.48 HC44002178 TEETH/LESS THAN FULL MOUTH $519.00 HC84200724 AFB ID BY PROBE $518.00 HC81700361 CD3 ABSOLUTE COUNT $518.00 HC34000018 PURE TONE AUDIO AIR&BONE $518.00 HC62207097 SUTURE SPECIALTY S $518.00 0121-0874-16 CETIRIZINE 1 MG/ML ORAL SOLN $517.92 70069-201-01 PILOCARPINE HCL 4 % OPHT DROP $517.04 HC89003958 CHROM ANALYSIS BONE MARROW-GC $517.00 HC81500340 FACTOR II PT SPECIFIC $517.00 HC12200226 INF CNTR-ESTBD PT EVAL 20MIN $517.00 HC51070381 PSY TX W/PATIENT 45MIN W/E&M+ $517.00 HC51000198 DEMO&/OR EVAL OF INH TX $516.86 63323-295-61 VANCOMYCIN 5 GRAM IV SOLR $516.75 HC83506246 ANALY MICROSATELLITE INSTABILITY-NG $515.00 HC11200043 OBSERVATION PER HOUR - TELEMETRY $515.00 HC51070928 ENDOSCOP EVAL SWALLOW/LARYN $514.32 HC51061182 ST-ENDOSCOP EVAL SWALLOW/LARYN $514.32 HC77400224 MOD CS SAME PHYS/QHP <5 YR INIT'L 15MIN $514.00 HC51063048 PAIRING BENIGN HYPERKERATOTIC LESIONS: 2-4 $514.00 HC62207113 SYRINGE KYPHOPLASTY INFLATION $514.00 HC62211982 TIP PROBE SUCTION LAPARASCOPIC $514.00 HC84200971 TRICHROME STAIN $514.00 0143-9726-01 TESTOSTERONE CYPIONATE 200 MG/ML IM OIL $513.50 45802-046-11 GENTAMICIN 0.1 % TOPICAL OINT $513.44 HC32010449 OT- TM CONF INTERDISCPLN NO PT/FAM, WQHCP 60MIN $513.00 HC31010366 PT- TM CONF INTERDISCPLN NO PT/FAM, WQHCP 60MIN $513.00 HC33010307 ST- TM CONF INTERDISCPLN NO PT/FAM, WQHCP 60MIN $513.00 61314-203-15 PILOCARPINE HCL 1 % OPHT DROP $512.56 HC84600188 CYTP DX EVAL FNA 1ST EVAL EA SITE $512.00 HC62228705 IVS TUBING PUMP RAPID INFUSER $512.00 HC82200635 TISSUE FRZN SECTION REDUCED $512.00 16714-908-01 BLEOMYCIN 30 UNIT INJ SOLR $511.62 38779-0419-5 CAFFEINE (BULK) 100 % MISC POWD $511.55 HC51003366 BX(S)/SAMPL ENDOMETRIAL(SEP PROC) $511.22 HC51003242 COLPOSCOPY CERVIX&ADJACENT VAGINA $511.22 HC51003143 COLPOSCOPY VULVA $511.22 HC51003218 FIT&INSERT PESSARY/INTRAVAG SPPRT DEV $511.22 HC51062636 FITTING DIAPHRAGM/CERVICAL CAP W/INSTRUCT $511.22 HC21001029 REMOV IMPACTD EAR WAX(INSTRUMENT) LT $511.00 HC21001037 REMOV IMPACTD EAR WAX(INSTRUMENT) RT $511.00 HC11500048 E&M EST PT 40MIN $510.00 HC25006230 INSERT &CONTROL UTERINE HEMORRHAGE DEVICE $510.00 49281-125-65 FLU VACC TS2025-26(65YR UP)-PF 180 MCG/0.5 ML IM SYRG $509.74 49281-125-88 FLU VACC TS2025-26(65YR UP)-PF 180 MCG/0.5 ML IM SYRG $509.73 HC81500399 FACTOR VIII VW MULTI $509.00 HC84200682 CULTURE MYCOPLASMA ANY SOURCE $508.00 HC81701997 HIV-1 AG W/ HIV-1 & HIV-2 ABS, SINGLE RESULT $508.00 HC42000562 WCH NEW PT EVAL 30MIN $508.00 67457-162-02 SODIUM TETRADECYL SULFATE 1 % (10 MG/ML) IV SOLN $507.82 67457-162-00 SODIUM TETRADECYL SULFATE 1 % (10 MG/ML) IV SOLN $507.82 67457-163-02 SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) IV SOLN $507.82 67457-163-00 SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) IV SOLN $507.82 54932-501-81 PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIX $507.29 HC62222658 SCALPEL HARMONIC ELECTRODE HOOK $507.00 69374-984-10 CARDIOPLEGIC SOLUTION NO.25 29 MMOL/L (POTASSIUM) PERF SOLN $507.00 81284-411-05 DIHYDROERGOTAMINE 1 MG/ML INJ SOLN $507.00 81284-411-00 DIHYDROERGOTAMINE 1 MG/ML INJ SOLN $507.00 0406-0527-10 METHADONE 10 MG/ML ORAL CONC $507.00 63323-424-10 FLUMAZENIL 0.1 MG/ML IV SOLN CODE NEO $506.35 HC51061612 ECHO DOPPLER COMPLETE+ $506.00 HC51061851 X-RAY SPINE LUMBOSACRAL; CMPLT W/BEND MIN 6 VWS $506.00 HC62201090 CANNULA VEIN IRRIGATION $505.00 HC51001170 CLOSED TX CLAVICLE FX $505.00 HC62202171 DETECTOR CO2 (RESP) $505.00 HC51002616 CAUTERIZE W/CHEM; GRAN TISSUE $504.94 HC51063196 FOOT CARE DIABETIC PT W/LOPS BY MD $504.94 HC51003820 I&D ABSCESS SIMPLE SNGL $504.94 HC51063030 PAIRING BENIGN HYPERKERATOTIC LESION: 1 $504.94 HC51003812 REMOV SKIN TAGS UP TO&INCL 15 LESIONS $504.94 HC62215363 BLADE SAW W $504.00 HC62214291 CATH URETERAL W $504.00 HC62216601 PIN/WIRE FIXATION TEMPORARY W $504.00 HC39001052 PSYCH THERAPY W/BIOFEEDBACK 30 MIN $504.00 HC44200988 US ELASTOGRAPHY ADDTL LESION $504.00 49702-228-13 DOLUTEGRAVIR 50 MG ORAL TAB $503.78 10481-3008-1 TRICHLOROACETIC ACID 80 % TOPICAL SOLN $503.78 60758-880-05 FLUOROMETHOLONE 0.1 % OPHT DRPS $503.36 HC82200510 TISSUE EXAM - LAB REPORT - OP $503.00 72603-160-01 TOBRAMYCIN SULFATE 1.2 GRAM INJ SOLR $502.80 72603-160-06 TOBRAMYCIN SULFATE 1.2 GRAM INJ SOLR $502.80 0143-9217-01 IDARUBICIN 1 MG/ML IV SOLN $502.13 25021-671-87 ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJ SOLN $501.80 HC62209606 TRACTION RUSSELLS UNIT $501.00 24201-201-05 SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) IV SOLN $500.50 24201-201-01 SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) IV SOLN $500.50 72266-163-06 TOBRAMYCIN SULFATE 1.2 GRAM INJ SOLR $500.50 72266-163-01 TOBRAMYCIN SULFATE 1.2 GRAM INJ SOLR $500.50 HC51061521 CLOSED TREATMENT TIBIAL FRACTURE PROXIMAL W/O MANIP $500.00 HC84201151 INFLUENZA H1N1 BY PCR $500.00 HC84600097 PAP THIN LAYER PREP MAN&RE SCN $500.00 0517-8005-25 ZINC SULFATE 5 MG/ML IV SOLN $498.88 HC11200041 OBSERVATION PER HOUR - OB $498.00 HC62219522 PASSER SURGICAL INCL PERITONEAL I $498.00 HC81100174 B-TYPE NATRIURETIC PEPTIDE $495.00 HC62202262 DEVICE KYPHOPLASTY BONE FILLER $495.00 HC89016943 HIV GENE SEQ-VI $495.00 HC44001865 SALIVARY GLAND FOR CALCULUS $495.00 HC62206032 SCISSORS EYE(DISP) $495.00 HC51010767 ENDOSCOPY NASAL DX UNI/BILAT $493.34 HC51010775 LARYNGOSCOPY DIAGNOSTIC $493.34 HC51010445 NASOPHARYNGOSCOPY $493.34 HC51070886 ST-LARYNGOSCOPY DIAGNOSTIC $493.34 HC51070902 ST-NASOPHARYNGOSCOPY $493.34 70069-191-01 PILOCARPINE HCL 2 % OPHT DROP $493.25 HC51060531 ST EVAL SOUND PROD W/LANG COMP&EXPRESS/C $492.74 HC51070878 ST-EVAL SOUND W/LANG COMP&EXPRESS PRELIM&6 MOS MCAL $492.74 61990-0411-2 DIHYDROERGOTAMINE 1 MG/ML INJ SOLN $492.63 60793-215-05 THROMBIN (BOVINE) 5,000 UNIT TOPICAL SOLR $492.57 60793-315-01 THROMBIN (BOVINE) 5,000 UNIT TOPICAL SOLR $492.57 0173-0736-01 SUMATRIPTAN SUCCINATE 50 MG ORAL TAB $492.17 0037-4401-01 PENICILLAMINE 250 MG ORAL TAB $491.59 0407-1412-33 IOHEXOL 240 MG IODINE/ML IV SOLN $491.40 70651-001-03 PENTETATE CALCIUM TRISODIUM 200 MG/ML IV SOLN $491.40 70651-002-03 PENTETATE ZINC TRISODIUM 200 MG/ML IV SOLN $491.40 HC62220512 APPLICATOR/TIP SYRINGE ONLY I $490.00 HC62223037 APPLIER LIGA/HEMOCLIP ENDO I $490.00 HC62217609 AWL SPINAL SINGLE PATIENT USE D $490.00 HC62200555 BLADE INCISIONAL G $490.00 HC62212899 BLADE SHAVER G $490.00 HC62200845 BURR G $490.00 HC62807698 CAP KIT LEAD PACEMAKER I $490.00 HC62201280 CATH CENTRAL VENOUS MULT LUMEN I $490.00 HC62800271 CATH DILATOR I $490.00 HC62223433 CATH EP DX <20 ELECTRODES RPRSD I $490.00 HC62201413 CATH FOGARTY I $490.00 HC62806088 CATH HICKMAN/BROVIAC I $490.00 HC62223219 CATH INTRODUCER PEEL-AWAY N $490.00 HC62227244 CATH IV MIDLINE I $490.00 HC62201512 CATH NEPHROSTOMY I $490.00 HC62212196 CATH PTA ANGIOPLS BALLOON NON-LSR E $490.00 HC62806104 CATH SWAN GANZ/THERMODILUTION I $490.00 HC62221775 CLIP ENDOSCOPIC I $490.00 HC62226519 COLLAR CERV OCC/MAND SUP MULTI POST $490.00 HC62803523 COUNTERSINK CANNULATED F $490.00 HC62214416 DEVICE PASSING NEEDLE ARTHR $490.00 HC62218771 DRILL/DRILL BITS SINGLE USE L $490.00 HC62226550 ELECTRODE EEG/EMG DISP $490.00 HC62222617 ELECTRODE ROLLER BALL I $490.00 HC62224134 ELECTRODE SEALING (E.G. 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$487.60 0378-8700-06 ACYCLOVIR 5 % TOPICAL OINT $487.50 0781-3158-94 BIVALIRUDIN 250 MG IV SOLR $487.50 0781-3158-95 BIVALIRUDIN 250 MG IV SOLR $487.50 43598-258-11 DOCETAXEL 20 MG/ML (1 ML) IV SOLN $487.50 99999-038-09 GLYCERIN 100% INJ LBM $487.50 45567-0455-1 KIT PREP OF TC-99M-MEBROFENIN 45 MG IV SOLR $487.50 39822-0706-2 STREPTOMYCIN 1 GRAM IM SOLR $487.50 0597-0100-51 TIOTROPIUM BROMIDE 2.5 MCG/ACTUATION INHALATION MIST $487.50 39822-0412-6 TOBRAMYCIN SULFATE 1.2 GRAM INJ SOLR $487.50 55111-685-07 ZOLEDRONIC ACID 4 MG/5 ML IV SOLN $487.50 99999-045-41 TEMOZOLOMIDE 10 MG/ML ORAL LIQUID (COMPOUND) $487.11 0281-0326-60 NITROGLYCERIN 2 % TRANSDERMAL OINT $486.72 60505-0823-6 CALCITONIN (SALMON) 200 UNIT/ACTUATION NASL SPRY $486.65 0143-9361-01 MICAFUNGIN 50 MG IV SOLR $486.20 42023-229-10 MICAFUNGIN 50 MG IV SOLR $486.20 42023-229-01 MICAFUNGIN 50 MG IV SOLR $486.20 HC81500241 FACTOR 8 INHIB/TITR $486.00 HC44001915 SELLA TURCICA $486.00 27808-033-01 THEOPHYLLINE 80 MG/15 ML ORAL SOLN $485.77 HC84200716 CULTURE MYCOBACTERIAL ID $485.00 HC25000308 LAC REPAIR 2.6-7 5CM $485.00 HC83001222 X-MATCH ELECTRONIC TECH EA UNIT $485.00 99988-000-19 NM TC-99M MACROAGGREG MAA 1-7 MCI $485.00 5047-4508-58 SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRG $484.44 HC36000008 ADMIN SURFACTANT THRU TUBE $484.00 HC32003337 OT-EVAL HIGH COMPLEXITY 45MF2F 30MIN $484.00 HC31002082 PT-EVAL HIGH COMPLEXITY 45MF2F 30MIN $484.00 0075-0626-03 ENOXAPARIN 100 MG/ML SUBCUTANEOUS SOLN (MCH) $483.74 HC84600535 CYTOLOGY CONC TECHNIQUE *OP $483.00 HC84600048 CYTOLOGY CONCENTRATE TECHNIQUE $483.00 HC83000489 PLATELETS LEUKO RED EA UNIT $483.00 HC33001082 ST-EVAL BEHAVRAL QUAL VOICE 30MIN/M $483.00 70069-181-01 PILOCARPINE HCL 1 % OPHT DROP $482.24 HC84600303 CYTO CONC TECHNIQUE DIST SRV $482.00 HC46001038 INTRO NDL/INTRACATH VEIN $482.00 HC46000576 INTRO NDL/INTRACATH VEIN LT $482.00 HC46000584 INTRO NDL/INTRACATH VEIN RT $482.00 HC89024863 MGLUR1 AB IGG CBA-IFA TITER CSF-AU $482.00 HC11200143 OBSERVATION 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$476.00 HC62216593 PIN/WIRE FIXATION TEMPORARY V $476.00 HC62214366 SET AUTOTRANSFUSE S $476.00 HC62216296 TEMPLATE ORTHO/ROD SPINAL M $476.00 63323-137-20 BLEOMYCIN 30 UNIT INJ SOLR $476.00 0187-0730-30 BUPROPION HCL 150 MG ORAL TB24 $475.56 HC62208541 CANNULA WATERS $475.00 HC25001587 MOD CS DIFF PHYS/QHP 5/>YR INIT'L 15MIN $475.00 HC32010399 OT- TM CONF INTERDISCPLN F2F PT/FAM WQHCP 45MIN $475.00 HC32010415 OT- TM CONF INTERDISCPLN NO PT/FAM, WMD 45MIN $475.00 HC32001414 OT- TM CONF INTERDISPLNS 3MNM WPT PRES 30MIN $475.00 HC31010317 PT- TM CONF INTERDISCPLN F2F PT/FAM WQHCP 45MIN $475.00 HC31010333 PT- TM CONF INTERDISCPLN NO PT/FAM, WMD 45MIN $475.00 HC31001191 PT- TM CONF INTERDISPLNS 3MNM WPT PRES 30MIN $475.00 HC35000264 REC- TM CONF INTERDISCPLN F2F PT/FAM WQHCP 45MIN $475.00 HC35000215 REC- TM CONF INTERDISPLNS 3MNM WPT PRES 30MIN $475.00 HC33010257 ST- TM CONF INTERDISCPLN F2F PT/FAM WQHCP 45MIN $475.00 HC33010273 ST- TM CONF INTERDISCPLN NO PT/FAM, WMD 45MIN $475.00 HC33000829 ST- TM CONF INTERDISPLNS 3MNM WPT PRES 30MIN $475.00 HC33000902 ST-EVAL SPEECH FLUENCY 30MIN/M $475.00 HC82200429 ANATOMIC CONSULT:SLIDE REVIEW $474.00 HC82202623 ANATOMIC CONSULT:SLIDE REVW*OP $474.00 0093-0262-30 FLUOCINONIDE 0.05 % TOPICAL CREAM $473.66 HC81500555 HEPARIN ASSAY $473.00 HC39000617 PSYCH CASE CONF 60MIN $473.00 42023-172-04 MYCOPHENOLATE MOFETIL (HCL) 500 MG IV SOLR $471.25 71288-803-20 MYCOPHENOLATE MOFETIL (HCL) 500 MG IV SOLR $471.25 71288-803-21 MYCOPHENOLATE MOFETIL (HCL) 500 MG IV SOLR $471.25 67457-386-81 MYCOPHENOLATE MOFETIL (HCL) 500 MG IV SOLR $471.25 67457-386-00 MYCOPHENOLATE MOFETIL (HCL) 500 MG IV SOLR $471.25 HC25000332 ANOSCOPY W/PROCEDURE $471.00 HC62224423 EXTRACTOR TISSUE SPINAL $471.00 HC42000802 INTERROGATION S-ICD $471.00 HC42000794 PROGRAM/EVAL S-ICD SNGL LEAD $471.00 0093-8675-74 AMOXICILLIN-POT CLAVULANATE 600-42.9 MG/5 ML ORAL SUSR $470.60 0169-3685-12 INSULIN ASP PRT-INSULIN ASPART 100 UNIT/ML (70-30) SUBCUTANEOUS SOLN $470.21 0169-7501-11 INSULIN ASPART U-100 100 UNIT/ML SUBCUTANEOUS SOLN $470.21 HC62221940 PINS BONE REFERENCE ROBOTIC(2 PK) $470.00 HC81500480 ACTIVATED PROT C RESISTANCE $469.00 HC34000091 CONDITIONING PLAY AUDIO $469.00 HC77400216 MOD CS GI ENDO SVCS>5YRS INIT'L 15MIN $469.00 HC81100828 FETAL LUNG MATURITY L/S $468.00 HC51070852 OT-EVAL HIGH COMPLEX PRELIM &6 MOS MCAL $468.00 HC81500183 PLATELET AGG EA AGENT $468.00 HC35000280 REC- TM CONF INTERDISCPLN NO PT/FAM, WMD 45MIN $468.00 81298-8660-1 FLUORESCEIN 500 MG/5 ML (10 %) IV SOLN $468.00 81298-8660-3 FLUORESCEIN 500 MG/5 ML (10 %) IV SOLN $468.00 42023-173-01 GANCICLOVIR SODIUM 500 MG IV SOLR $468.00 42023-173-25 GANCICLOVIR SODIUM 500 MG IV SOLR $468.00 66993-371-79 MEDROXYPROGESTERONE 150 MG/ML IM SYRG $468.00 70954-896-10 MEGESTROL 40 MG/ML ORAL SUSPENSION (MHS WRAPPER) $468.00 64380-160-02 MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSP $468.00 70436-110-36 TOBRAMYCIN SULFATE 1.2 GRAM INJ SOLR $468.00 70436-110-56 TOBRAMYCIN SULFATE 1.2 GRAM INJ SOLR $468.00 59676-566-30 DARUNAVIR 800 MG ORAL TAB $467.60 HC62209713 FORCEP HOT BIOPSY G $467.00 HC36800571 RT RESP THER GRP 45 MIN/MW $467.00 HC34000422 EPSDT AUDIO INITIAL 2-5YRS $466.00 HC34000430 EPSDT AUDIO INITIAL 6-20YRS $466.00 HC25001579 MOD CS DIFF PHYS/QHP <5 YR INIT'L 15MIN $466.00 51672-1290-1 HYDROCORTISONE VALERATE 0.2 % TOPICAL CREAM $465.56 HC44000719 EYE FOR FOREIGN BODY LT $465.00 HC44000727 EYE FOR FOREIGN BODY RT $465.00 HC84200955 RESPIRATORY SYNCTAL VIRUS EIA $465.00 HC84201359 RESPIRATORY SYNCTAL VIRUS EIA (POS) $465.00 58160-821-01 HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML IM SUSP $464.69 58160-821-11 HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML IM SUSP $464.69 58160-821-52 HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML IM SYRG $464.69 58160-821-43 HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML IM SYRG $464.69 0168-0323-46 METRONIDAZOLE 0.75 % TOPICAL CREAM $463.91 66993-960-45 METRONIDAZOLE 0.75 % TOPICAL CREAM $463.91 61703-342-50 PACLITAXEL 6 MG/ML IV CONC $463.45 HC62201199 CATH ABR TRIPLE LUMEN $463.00 HC29000502 E&M PREVENTIVE NEW 18-39 Y/O $463.00 HC29000510 E&M PREVENTIVE NEW 40-64 Y/O $463.00 HC12200101 IVAD IRRIGATION $463.00 HC39001102 PHP OT SKILLS PER SESSION 45 M/> $463.00 0078-0109-61 CYCLOSPORINE 250 MG/5 ML IV SOLN $462.74 0078-0109-01 CYCLOSPORINE 250 MG/5 ML IV SOLN $462.64 HC77400059 CS DIFF MD ADD'L 15 MIN $462.00 HC62210422 KIT INTRASPINAL TRIAL $462.00 HC11200094 OBSERVATION PER HOUR - PEDS ACUTE $462.00 HC62224233 PROBE ELECTROHEMOSTASIS $462.00 HC62215652 SUTURE Q $462.00 0003-0293-28 TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP $461.24 39328-530-16 AMANTADINE HCL 10 MG/ML ORAL SOLN (MCH) $461.18 0143-9297-01 DANTROLENE 20 MG IV SOLR $460.92 HC51062792 COMPLEX CHRONIC CARE MGMT INITL 60MIN, PER MONTH $460.00 HC89019897 FRAGILE X (FMR1) DIAGNOSTIC-AU $460.00 HC13500061 GENETIC COUNSELING EA 30MIN/P $460.00 16714-671-02 ONDANSETRON HCL 4 MG/5 ML ORAL SOLN $459.55 70954-240-10 CARBAMAZEPINE 100 MG/5 ML ORAL SUSP $459.23 51672-4047-4 CARBAMAZEPINE 100 MG/5 ML ORAL SUSP $459.23 51672-4047-9 CARBAMAZEPINE 100 MG/5 ML ORAL SUSP (MCH) $459.23 HC81500142 CELL COUNT FLUID W/O DIFF $459.00 HC25006024 E&M EST OP PT 20MIN $459.00 HC62205695 PIN PASSING $459.00 HC81500175 PLATELET AGG EPINEPHRINE $459.00 HC36800548 RT THER INC RESP FUNC 15MIN/MW $459.00 HC81100729 SALICYLATES; 1-2 $459.00 HC12200077 IVP SINGLE/EA NEW RX ADD'L INJ $458.00 HC32010118 OT-EVAL SWALLOW CINE/FLUORO [15MIN] $458.00 HC33010034 ST-EVAL SWALLOW CINE/FLUORO [15MIN] $458.00 63323-539-03 ENOXAPARIN 100 MG/ML SUBCUTANEOUS SOLN (MCH) $457.72 HC62202783 ELECTRODES 4 CHANNEL NIM $457.00 HC51003903 FNA ASP BX W/O GUIDE; EACH ADD'L LESION $457.00 HC42000448 PROGRAM EVAL PACEMAKER SINGLE LEAD/LEADLESS $457.00 HC42000638 WCH EST PT EVAL 40MIN $457.00 HC83000109 X-MATCH I-SPIN TECH EA UNIT $457.00 70710-1165-6 OSELTAMIVIR 6 MG/ML ORAL SUSR $456.30 HC62222369 BAG/POUCH RETRIEVAL SPECMN ENDO F $456.00 HC62225917 BASKET RETRIEVAL H $456.00 HC62219134 CANNULA ARTHRSCPC(STICK SWITCHING)H $456.00 HC62805569 CATH DIALYSIS SHORT-TERM G $456.00 HC62805296 CATHETER PERITONEAL F $456.00 HC62226873 DILATOR URETERAL $456.00 HC62226881 GUIDEWIRE G $456.00 HC62212014 GUIDEWIRE(E.G. HALO/SUPER STIFF) G $456.00 HC62225362 KIT REPAIR BROVIAC/CV/HICKMAN C $456.00 59762-5050-7 GABAPENTIN 250 MG/5 ML ORAL SOLN $455.20 0054-3194-46 DIPHENOXYLATE-ATROPINE 2.5-0.025 MG/5 ML ORAL LIQD $455.13 62559-190-16 METOCLOPRAMIDE 5 MG/5 ML ORAL SOLN (MCH) $455.03 HC84201102 CLOTEST FOR H. PYLORI $455.00 71288-427-11 BIVALIRUDIN 250 MG IV SOLR $455.00 71288-427-10 BIVALIRUDIN 250 MG IV SOLR $455.00 25021-244-10 BORTEZOMIB 3.5 MG INJ SOLR $455.00 78670-003-67 DANTROLENE 20 MG IV SOLR $455.00 69315-312-28 HYDROCORTISONE 2.5 % TOPICAL CRPE $455.00 72485-113-01 ISOPROTERENOL HCL 0.2 MG/ML INJ SOLN $455.00 72485-113-10 ISOPROTERENOL HCL 0.2 MG/ML INJ SOLN $455.00 25021-816-30 LEUCOVORIN CALCIUM 350 MG INJ SOLR $455.00 55150-330-01 MEDROXYPROGESTERONE 150 MG/ML IM SYRG $455.00 62756-016-40 TESTOSTERONE CYPIONATE 200 MG/ML IM OIL $455.00 10631-407-01 HYDROCORTISONE 2.5 % TOPICAL CRPE $454.98 16714-119-02 TOBRAMYCIN IN 0.225 % NACL 300 MG/5 ML INHALATION NEBU $454.55 16714-119-03 TOBRAMYCIN IN 0.225 % NACL 300 MG/5 ML INHALATION NEBU $454.55 HC81500100 D-DIMER QT ULTRA-SENS OR STD $454.00 HC32003303 OT-EVAL MOD COMPLEXITY 30MF2F 30MIN $454.00 67877-749-57 FOSFOMYCIN TROMETHAMINE 3 GRAM ORAL PACK $453.70 0409-0366-01 DOCETAXEL 20 MG/ML (1 ML) IV SOLN $453.57 HC31001860 PT-AQUATIC THERAPY 30MIN/CW $453.00 HC36001196 AEROSOL-HHN TREATMENT DAILY $452.00 HC36001204 AEROSOL-IPPB TREATMENT DAILY $452.00 HC36001212 AEROSOL-MDI TREATMENT DAILY $452.00 HC36001220 AEROSOL-TREATMENT DAILY $452.00 HC36000172 DEMO&/OR EVAL OF INH TX $452.00 HC44003101 EYE FOR FOREIGN BODY 1VW $452.00 HC36001238 INHALATION W/GAS TX DAILY $452.00 HC36001246 IPV TREATMENT DAILY $452.00 HC44001683 OPTIC FORAMINA $452.00 HC39000997 PSYCH PSYCHOANALYSIS $452.00 HC36001253 SPUTUM INDUCTION DAILY TX $452.00 HC34000083 VISUAL REINFORCE AUDIO (VRA) $452.00 HC83000182 X-MATCH AHG TECH EA UNIT $452.00 0409-7419-03 DEXTRAN 40 10 % IN 0.9 % NACL 10 % IV SOLP $451.75 66302-467-60 TADALAFIL (PULM. HYPERTENSION) 20 MG ORAL TAB $451.75 HC84200807 VIRAL ID (SHELL VIAL) $451.00 68982-623-02 ALBUMIN, HUMAN 5 % 5 % IV SOLP $450.13 HC51061638 ECHO DOPPLER COLOR FLOW+ $450.00 HC51070555 PSYCH TESTING EVAL INTEGR INTERPRET CLIN DES TX; 1ST HOUR $450.00 59651-026-01 AMOXICILLIN-POT CLAVULANATE 250-62.5 MG/5 ML ORAL SUSR $449.15 69097-098-44 AMOXICILLIN-POT CLAVULANATE 250-62.5 MG/5 ML ORAL SUSR $449.15 73043-010-02 AMOXICILLIN-POT CLAVULANATE 250-62.5 MG/5 ML ORAL SUSR $449.15 HC81500530 KLEIHAUER-BETKE $449.00 HC62217351 SCRAPER MEMBRANE OPHTH $449.00 HC33000548 ST-SPEECH THERAPY 15 MIN/MW $449.00 HC62207204 TIP VITALVUE SUCTION/IRRIG $449.00 65862-306-12 FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLN $448.50 81284-155-00 PIPERACILLIN-TAZOBACTAM 40.5 GRAM IV SOLR $448.50 81284-155-01 PIPERACILLIN-TAZOBACTAM 40.5 GRAM IV SOLR $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 HC51002152 CYSTOGRAM SIMPLE $448.00 HC62216585 PIN/WIRE FIXATION TEMPORARY U $448.00 HC62216825 POST ANCHOR SPINAL DISPOSABLE G $448.00 HC62220793 TRAY DRAIN PNEUMOPERICARDIUM $448.00 0009-0018-20 METHYLPREDNISOLONE SOD SUC(PF) 1,000 MG/8 ML IV SOLR $447.98 16714-517-01 VANCOMYCIN 5 GRAM IV SOLR $447.92 HC51070910 ENDOSCOPIC EVAL SWALLOW $447.80 HC51061174 ST-ENDOSCOPIC EVAL SWALLOW $447.80 0054-0517-50 MORPHINE CONCENTRATE 20 MG/ML ORAL SOLN (MHS WRAPPER) $446.94 HC12400156 CHEMO ADMIN INTRA ARTERIAL INF EA ADDL HR+ $446.00 HC12200036 IV INF HYDRATION EA ADD'L HR $446.00 HC11200131 OBSERVATION PER HOUR -PACU $446.00 HC83000174 RBC ANTIBODY ELUTION $446.00 10702-036-45 SODIUM POLYSTYRENE SULFONATE 15 GRAM ORAL POWD $445.60 99999-004-26 POSACONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSP $445.58 0085-4324-02 POSACONAZOLE 100 MG ORAL TBEC $445.45 HC81701963 HIV TYPE 1 ANTIGEN (RAPID) $445.00 HC31002058 PT-EVAL MOD COMPLEXITY 30MF2F 30MIN $445.00 HC31000987 PT-THER EXER 30MIN/CW $445.00 HC42000489 RHYTHM STRIP 1-3 LEADS $445.00 HC62206156 SET CARDIOPLEGIA $445.00 71285-9005-1 CARDIOPLEGIC SOLUTION NO.35 26 MEQ/1,052.8 ML (POTASSIUM) PERF SOLN $444.81 0143-9299-10 GANCICLOVIR SODIUM 500 MG IV SOLR $444.60 0143-9299-01 GANCICLOVIR SODIUM 500 MG IV SOLR $444.60 0641-0477-25 PHENOBARBITAL SODIUM 130 MG/ML INJ SOLN $444.59 0641-0477-21 PHENOBARBITAL SODIUM 130 MG/ML INJ SOLN $444.59 HC81700544 C TRACHOMATIS BY DNA PROBE $444.00 HC12200192 INF CNTR-ESTBD PT EVAL 10MIN $444.00 HC81701468 NK CELL TOTAL COUNT $444.00 HC32000259 OT-EVAL LOW COMPLEXITY 20MF2F 30MIN $444.00 HC39000112 PSYCH FAMILY GROUP THERAPY $444.00 50474-002-63 LEVETIRACETAM 500 MG/5 ML IV SOLN $443.46 HC89020366 EGFR GENE COM VARIANTS-AU $443.00 HC51002244 INJECT URETEROGRAGH VIA URETEROS $443.00 HC82200924 TISSUE EX G&M LVL 2 DIST SVC $443.00 HC82200387 TISSUE EXAM G&M LEVEL 2 $443.00 HC82202557 TISSUE EXAM G&M LEVEL 2 *OP $443.00 HC82202730 TISSUE EXAM G&M LVL 2(TC ONLY) $443.00 HC82200643 TISSUE EXAM LEVEL 2 ADD'L $443.00 HC25001561 MOD CS SAME PHYS/QHP 5/>YR INIT'L 15MIN $442.00 HC32000911 OT-THER EXER 30MIN/CW $442.00 HC62225156 RESERVOIR CSF VENTRICULAR $442.00 HC62205968 RETRACTOR STAYS ELASTIC $442.00 HC81700171 TESTOSTERONE TOTAL $442.00 25021-454-05 OCTREOTIDE ACETATE 200 MCG/ML INJ SOLN $442.00 0641-6177-01 OCTREOTIDE ACETATE 200 MCG/ML INJ SOLN $442.00 64679-679-01 PIPERACILLIN-TAZOBACTAM 40.5 GRAM IV SOLR $442.00 64679-679-02 PIPERACILLIN-TAZOBACTAM 40.5 GRAM IV SOLR $442.00 42494-416-25 PHENOBARBITAL SODIUM 130 MG/ML INJ SOLN $441.71 42494-416-01 PHENOBARBITAL SODIUM 130 MG/ML INJ SOLN $441.68 HC83000620 PLASMA CRYO REDUCED EA UNIT-OS $441.00 HC12200283 SC INFUSION THERAPY; ADD'L SET UP NEW SITE $441.00 HC31001852 CAST ROOM USE $440.00 72603-198-01 ZOLEDRONIC ACID 4 MG/5 ML IV SOLN $439.66 69238-1747-8 PILOCARPINE HCL 4 % OPHT DROP $439.53 HC82202276 CONSULT DURING SURG DIST SVC $439.00 HC82200361 CONSULT DURING SURGERY $439.00 HC82200692 CONSULT PATH SURGICAL GROSS $439.00 HC83000083 FRESH FROZEN PLASMA EA UNIT $439.00 HC32010431 OT- TM CONF INTERDISCPLN NO PT/FAM, WQHCP 45MIN $439.00 HC31010358 PT- TM CONF INTERDISCPLN NO PT/FAM, WQHCP 45MIN $439.00 HC35000314 REC TM CONF INTERDISCPLN NO PT/FAM, WQHCP 60MIN $439.00 HC33010299 ST- TM CONF INTERDISCPLN NO PT/FAM, WQHCP 45MIN $439.00 HC62208723 CATHETER IRRIGATION SINUPLASTY $438.00 HC25001553 MOD CS SAME PHYS/QHP<5YR INIT'L 15MIN $438.00 HC62215520 RETRIEVER STENT BILI SOEHENDRA $438.00 HC62219092 TUBE CALIBRATION GASTRIC BANDING $438.00 72078-034-00 REMIFENTANIL 1 MG IV SOLR $437.83 72078-034-01 REMIFENTANIL 1 MG IV SOLR $437.83 67457-912-00 REMIFENTANIL 1 MG IV SOLR $437.83 67457-912-01 REMIFENTANIL 1 MG IV SOLR $437.83 HC62201710 CEMENT INJECTOR $437.00 HC62201728 CEMENT VERTEBROPLASTY $437.00 HC62800560 DEVICE CLOSURE FASCIA $437.00 HC84200963 ROTAVIRUS ASSAY EIA/ANTIGEN $437.00 HC84200179 CLOSTRIDIUM DIFFICILE TOXIN $436.00 HC82200726 INTRAOP CNSLT CYT PRP-DIST ADL $436.00 HC82200742 INTRAOP CNSLT CYTOPREP, ADL $436.00 HC51004034 COLLCTN SPUTM AEROSL TECH, SEP PROC $435.46 0409-0830-01 AZTREONAM 2 GRAM INJ SOLR $435.18 0409-0830-11 AZTREONAM 2 GRAM INJ SOLR $435.18 60505-0582-4 MOXIFLOXACIN 0.5 % OPHT DROP $435.10 HC62210398 GUIDE ROD H $434.00 HC62204847 NEEDLE ASPIRATION H $434.00 HC62206628 SOLUTION BSS PLUS 500ML $434.00 HC62215645 SUTURE P $434.00 HC51000115 URO-EMG $434.00 63323-205-21 FATTY ACID6-FISH OIL-GLYCERIN 10 % IV EMUL $433.55 63323-205-50 FATTY ACID6-FISH OIL-GLYCERIN 10 % IV EMUL $433.55 71288-107-20 BLEOMYCIN 30 UNIT INJ SOLR $433.49 0037-0066-03 MESALAMINE WITH CLEANSING WIPE 4 GRAM/60 ML RECTAL ENKT $433.46 0037-0066-06 MESALAMINE 4 GRAM/60 ML RECTAL ENEM $433.29 HC81500050 CRYSTALS FLUID $433.00 0409-7418-03 DEXTRAN 40 10 % IN 5% DEXTROSE 10 % IV SOLP $432.25 0409-7418-13 DEXTRAN 40 10 % IN 5% DEXTROSE 10 % IV SOLP $432.25 0270-0445-40 DIATRIZOATE MEG-DIATRIZOAT SOD 66-10 % ORAL SOLN $432.12 49884-231-83 PRAZIQUANTEL 600 MG ORAL TAB $431.80 0002-7510-01 INSULIN LISPRO 100 UNIT/ML SUBCUTANEOUS SOLN $431.60 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 HC84200799 ADDITIONAL VIRUS TEST $431.00 HC62210786 DEVICE ELECTROSURGICAL CUT-CAUTERY H $431.00 81284-411-10 DIHYDROERGOTAMINE 1 MG/ML INJ SOLN $430.95 63323-733-11 MESNA 100 MG/ML IV SOLN $430.95 63323-733-10 MESNA 100 MG/ML IV SOLN $430.95 HC89021133 NK FUNCTION ASSAY(PNL) -CN $430.00 HC51060721 OT-EVAL HIGH COMPLEXITY 45MF2F 60MIN $430.00 HC51060705 PT-EVAL HIGH COMPLEXITY 45MF2F 60MIN $430.00 HC31000326 PT-EVAL LOW COMPLEXITY 20MF2F 30MIN $430.00 HC84200435 TRICHROME STAIN CMPLX OVA/PARA $430.00 0703-4239-01 CARBOPLATIN 10 MG/ML IV SOLN $429.39 HC82201351 HISTCHM ST ACID PTASE,FRO TS $429.00 HC82201369 HISTCHM ST ACRIDINE OR,FR TS $429.00 HC82201377 HISTCHM ST AZURE-II MB,FR TS $429.00 HC82201393 HISTCHM ST MAD, FROZ TIS BLK $429.00 HC82201401 HISTCHM ST MYPHSPHFRC1,FRO TS $429.00 HC82201419 HISTCHM ST MYPHSPHFRC2,FRO TS $429.00 HC82201427 HISTCHM ST NNSPC ESTERS,FR TS $429.00 HC82201278 HISTOCHM STAIN,FROZ TIS BLK $429.00 HC82201443 HISTOCHM STN OS-PPD,FROZ TIS $429.00 HC82201468 OIL RED O STAIN,FROZ TIS BLK $429.00 54288-111-01 HYOSCYAMINE SULFATE 0.5 MG/ML INJ SOLN $429.00 0703-3217-01 PACLITAXEL 6 MG/ML IV CONC $429.00 65649-411-24 HYDROCORTISONE ACETATE 25 MG RECTAL SUPP $428.54 HC62201744 CHEST DRAINAGE (PLEUREVAC) $428.00 HC84200385 CULTURE STOOL ADDL PATH $428.00 HC62204185 KIT PTCA CUSTOM NAMIC $428.00 HC62210968 PUMP CENTRIFUGAL $428.00 HC62211537 SCREW EXTRACTOR BOLT $428.00 HC62206354 SET PROSTATE STABILIZATION $428.00 HC32000390 OT-RE-EVAL EST POC 30MIN $427.00 0054-0427-25 FLUCYTOSINE 250 MG ORAL CAP $426.76 0407-2223-16 IODIXANOL 320 MG IODINE/ML IV SOLN $426.40 HC83000323 FREEZING BLOOD EA UNIT $426.00 HC78600046 PACU II 15MIN (SUBSEQUENT) $426.00 70710-1359-6 LACOSAMIDE 200 MG/20 ML IV SOLN $425.88 70710-1359-1 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 25021-791-20 LACOSAMIDE 200 MG/20 ML IV SOLN $425.36 99988-001-25 NM TC-99M (DTPA) PENTETATE 26-40 MCI (AEROSOL) $424.69 99988-000-25 NM TC-99M (DTPA) PENTETATE UP TO 25 MCI (RENAL) $424.69 HC82202201 CRYSTALS FLUID $424.00 HC77400026 MOD CS BY MD ADD'L 15 MIN $424.00 HC81500894 RETICULATED PLATELET ASSAY $424.00 54643-9015-8 MVI, ADULT NO.4, VIT K, 1 OF 2 3,300 UNIT- 150 MCG/5 ML IV SOLN $423.80 54643-9015-9 MVI, ADULT NO.4, VIT K, 2 OF 2 600 MCG-60 MCG- 5 MCG/5 ML IV SOLN $423.80 0074-0566-11 VENETOCLAX 50 MG ORAL TAB $423.09 HC28000222 CR REHAB PAD PERIPHERAL PER SESSION $423.00 HC12200150 INF CNTR-NEW PT EVAL 15MIN $423.00 HC62206107 SET ANGIO PUMP W/BAG $423.00 HC51002525 US GUIDANCE PLACEMENT S&I NEEDLE /BX $423.00 HC62208582 VASCULAR PUNCH $423.00 0065-0359-05 CYCLOPENTOLATE-PHENYLEPHRINE 0.2-1 % OPHT DROP $422.76 25021-179-16 DAPTOMYCIN 350 MG IV SOLR $422.50 25021-179-15 DAPTOMYCIN 350 MG IV SOLR $422.50 0143-9204-01 DOCETAXEL 20 MG/ML (1 ML) IV SOLN $422.50 31722-203-20 LACOSAMIDE 200 MG/20 ML IV SOLN $422.50 0703-4248-01 CARBOPLATIN 10 MG/ML IV SOLN $422.37 HC84200286 ANAEROBIC ID EA ISOLATE $422.00 HC51001550 APPLY SPLINT LONG ARM $422.00 HC89000871 ENCAINIDE-AU $422.00 HC44001675 NECK, SOFT TISSUE (REDUCED SVC) $422.00 HC51061794 X-RAY SPINE THORACIC; MIN 4 VIEWS $422.00 49702-212-48 ZIDOVUDINE 10 MG/ML ORAL SYRP $421.20 HC62201363 CATH ERCP (PUSHING) C $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 $420.00 HC62213988 CATH PTCA BALLOON NON-LASER C $420.00 HC62210562 CATH SELECT NEURO A $420.00 HC62201579 CATH SUPRAPUBIC/CYSTOSCOPIC H $420.00 HC62219233 CATH THROMBECTOMY/EMBOLECTOMY E $420.00 HC62214275 CATH URETERAL T $420.00 HC62224373 CIRCUIT VENT SHORT WIRE HEATED $420.00 HC62202841 CLIP ENDOSCOPIC H $420.00 HC62804166 COIL EMBOLIZATION D $420.00 HC62209424 COIL MARKER FIDUCIAL $420.00 HC62224415 DERMABOND H $420.00 HC62216064 DEVICE SUTURE ENDO E $420.00 HC62300082 DISSECTOR ROBOTIC I $420.00 HC62218763 DRILL/DRILL BITS SINGLE USE K $420.00 HC62300454 DRIVER NEEDLE ROBOTIC I $420.00 HC62202718 ELECTRODE PACING/DEFIB TEMPORARY H $420.00 HC62222609 ELECTRODE ROLLER BALL H $420.00 HC62805981 FIBRIN SEALANT G $420.00 HC62300272 FORCEP ROBOTIC H $420.00 HC62300124 GRASPER ROBOTIC C $420.00 HC62225818 GUIDE DRILL H $420.00 HC62227335 GUIDE PIN ORTHO H $420.00 HC62225933 GUIDE VAGINAL BRACHYTHERAPY $420.00 HC34000158 HEARING AID EXAM MONAURAL $420.00 HC62803606 HEMOSTATIC GEL/GELFOAM/PAD I $420.00 HC62300231 HOOK VALVE ROBOTIC $420.00 HC62216783 INSERTER TIP SURGICAL H $420.00 HC62220561 INTRO/SHEATH EP FIXED NON-PEEL E $420.00 HC62802426 INTRODUCER/SHEATH H $420.00 HC62211958 KIT CRICOTHYROTOMY EMERGENCY H $420.00 HC62211685 KIT DRESSING WOUND NEG PRESSURE E $420.00 HC62204060 KIT MICROPUNCTURE(SPECIALTY) $420.00 HC62219704 KIT VITRECTOMY PROBE C $420.00 HC62224852 NEEDLE PROBE VASCULAR SMART $420.00 HC62216999 NEEDLE TARGETING H $420.00 HC62219951 OBTURATOR ARTHRO E $420.00 HC32010068 OT-SWALLOWING EVAL [15MIN] $420.00 HC62216577 PIN/WIRE FIXATION TEMPORARY T $420.00 HC62210836 POSITIONER FLUIDIZED FULL BODY $420.00 HC51070431 PSYCH FAMILY TX W/PT 50MIN $420.00 HC62220348 PUNCH ARTHROSCOPIC $420.00 HC62217922 PUSHER/CUTTER KNOT SUTURE ARTHRS E $420.00 HC62213384 REAMER I $420.00 HC62221312 RESERVOIR CELL SAVER H $420.00 HC62224019 SCISSORS ENDOSCOPIC H $420.00 HC62202312 SET AUTOTRANSFUSE Q $420.00 HC62223078 SLEEVE HOLDING ORTHO $420.00 HC62227533 SPHINCTEROTOME C $420.00 HC62202932 STAPLE CARTRG/ENDO RELOAD H $420.00 HC62216106 STENT REMOVER C $420.00 HC62803978 STENT URETERAL H $420.00 HC33010026 ST-SWALLOWING EVAL [15MIN] $420.00 HC62212840 STYLET CARDIAC G $420.00 HC62225958 TAP SURGICAL H $420.00 HC62226063 TAP SURGICAL H $420.00 HC62210844 TRANSDCR OPTCL DATA RSO2 P/A $420.00 HC62221460 TROCAR ENDO H $420.00 HC62800776 TUBE GASTROSTOMY LOWPRFL BTTN H $420.00 HC62806336 TUBE GASTROSTOMY STNDRD BTTN OPT H $420.00 HC62227715 TUBING HYSTEROSCOPY F $420.00 HC62224001 TUBING SUCTN/IRRIG NEURO/SPINAL $420.00 HC51061109 US RETROPERITONEAL COMPLETE $420.00 HC62802608 WIRE PACING TEMP T $420.00 16714-878-01 LIDOCAINE 5 % TOPICAL OINT $419.72 69238-1746-8 PILOCARPINE HCL 2 % OPHT DROP $419.25 0713-0655-40 TRIAMCINOLONE ACETONIDE 0.1 % DENT PSTE $419.06 51672-1267-5 TRIAMCINOLONE ACETONIDE 0.1 % DENT PSTE $419.06 64980-320-05 TRIAMCINOLONE ACETONIDE 0.1 % DENT PSTE $419.06 HC89017149 ALLERGEN SPECIFIC IGE, EACH-IB $419.00 HC81701450 B CELL TOTAL COUNT $419.00 HC62202734 ELECTRODE RESECTOSCOPE E $419.00 HC32000937 OT-NEUROMUSC RE-ED 30MIN/CW $419.00 HC36800530 RT THER MUSC STRENGTH 15MIN/MW $419.00 4167936513 MEDIUM CHAIN TRIGLYCERIDES 7.7 KCAL/ML ORAL OIL $418.13 HC84600212 CYTO PREP NON GYN S&I-DIST SVC $418.00 HC84600162 CYTOLOGY PREP NON GYN S&I $418.00 HC32010027 OT-SWALLOWING THERAPY [15MIN] $418.00 HC33010018 ST-SWALLOWING THERAPY [15MIN] $418.00 0088-2220-33 INSULIN GLARGINE 100 UNIT/ML SUBCUTANEOUS SOLN $417.69 61314-665-05 APRACLONIDINE 0.5 % OPHT DROP $417.63 HC81101933 DRUG TEST PRESUMP DIR OPT INSTRMNT ASS'T/ DOS $417.00 HC81700551 N-GONORRHEA BY DNA PROBE $417.00 HC84200062 URINE ISOLATE, PRESUMP ID, EA $417.00 0955-1016-01 ENOXAPARIN 100 MG/ML SUBCUTANEOUS SOLN (MCH) $416.97 60505-1003-2 KETOROLAC 0.5 % OPHT DROP $416.78 HC29000726 CA SCREEN-EXAM PELVIC/BREAST INIT 40-64 YRS $416.00 HC81700064 CARCINOEMBRYONIC ANTIGEN (CEA) $416.00 HC11500030 E&M EST PT 30MIN $416.00 HC83001156 PLASMA FRZN COLL 8-24 HRS EA UNIT $416.00 HC39000120 PSYCH GRP TX(NOT MULTI FAMILY)60MIN/COMM $416.00 HC51070845 PT-EVAL HIGH COMPLEX PRELIM &6 MOS MCAL $416.00 HC84200609 STREP PNEUMONIAE URINE AG $416.00 0264-4500-05 PARENTERAL AMINO ACID 15% NO.6 15 % IV SOLP $416.00 63323-184-10 FOLIC ACID 5 MG/ML INJ SOLN $415.48 HC62200654 BODY ALIGNER $415.00 HC62200506 DEVICE BIOPSY $415.00 HC84200872 INFLUENZA A FA ANTIGEN $415.00 HC84200864 INFLUENZA B FA ANTIGEN $415.00 HC62204540 LOOPS CYSTO $415.00 HC83000190 X-MATCH INCUB TECH EA UNIT $415.00 HC81100430 ELECTROLYTE PANEL $414.00 HC81500696 FACTOR XIII ASSAY $414.00 HC83506287 KRAS FULL GENE SEQ MOLECUL PATH LEV 6-NG $414.00 HC84200617 LEGIONELLA AG URINE $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 63323-122-50 METHOTREXATE SODIUM (PF) 1 GRAM INJ SOLR $413.40 0069-0196-01 DALTEPARIN (PORCINE) 5,000 ANTI-XA UNIT/0.2 ML SUBCUTANEOUS SYRG $412.11 HC21000377 DESTRUCT PREMALG LESIONS 2-14 $412.00 HC31000466 PT-RE-EVAL EST POC 30MIN $411.00 HC84201011 SEMEN ANALYSIS POST $411.00 50474-970-63 BRIVARACETAM 50 MG/5 ML IV SOLN $410.35 50474-970-75 BRIVARACETAM 50 MG/5 ML IV SOLN 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$392.00 HC84200666 CULTURE FUNGUS HAIR/SKIN/NAIL $392.00 HC84201789 DNA/RNA LEGIONELLA PNEUMOPHILA (PNL) $392.00 HC62203039 ET BAG COLOSTOMY $392.00 HC81101867 LIPID PANEL (DA) $392.00 HC62216569 PIN/WIRE FIXATION TEMPORARY S $392.00 0049-3190-28 VORICONAZOLE 200 MG IV SOLR $391.95 HC11200023 OBSERVATION PER HOUR - ONCOLOGY $391.00 HC31001621 PT-WHEELCHAIR MGT 30MIN/C $391.00 HC29000759 CA SCREEN-EXAM PELVIC/BREAST ESTAB 40-64 YRS $390.00 HC81500589 OSMOTIC FRAG INCUBATED $390.00 HC32001083 OT-DEV COGNITIVE SKLL 30MIN/CW $390.00 HC65800112 PALLADIUM-103 STRANDED PER SOURCE $390.00 70594-111-02 ACETYLCYSTEINE 200 MG/ML (20 %) IV SOLN $390.00 70594-111-01 ACETYLCYSTEINE 200 MG/ML (20 %) IV SOLN $390.00 0143-9729-05 BENZTROPINE 1 MG/ML INJ SOLN $390.00 0143-9729-01 BENZTROPINE 1 MG/ML INJ SOLN $390.00 81298-5010-3 CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN $390.00 81298-5010-1 CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN $390.00 81298-5010-5 CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN $390.00 99999-034-84 CH - PHARMACY COMP. FEE $390.00 99999-001-98 CHARGE-NEONATAL LVIV <4 ADDS $390.00 25021-305-20 CHLOROTHIAZIDE SODIUM 500 MG IV SOLR $390.00 70594-034-01 DAPTOMYCIN 500 MG IV SOLR $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 IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN $390.00 71225-133-02 DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN $390.00 55150-282-20 ERTAPENEM 1 GRAM INJ SOLR $390.00 69097-579-67 FOSFOMYCIN TROMETHAMINE 3 GRAM ORAL PACK $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 69238-2029-3 MUPIROCIN CALCIUM 2 % TOPICAL CREAM $390.00 0781-3317-80 OXALIPLATIN 100 MG/20 ML IV SOLN $390.00 70860-200-50 PACLITAXEL 6 MG/ML IV CONC $390.00 25021-255-50 PACLITAXEL 6 MG/ML IV CONC $390.00 65219-632-04 ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJ SOLN $390.00 0781-3481-70 TIGECYCLINE 50 MG IV SOLR $390.00 0781-3481-92 TIGECYCLINE 50 MG IV SOLR $390.00 49884-768-54 TOLVAPTAN 15 MG ORAL TAB $390.00 49884-768-52 TOLVAPTAN 15 MG ORAL TAB $390.00 31722-868-31 TOLVAPTAN 15 MG ORAL TAB $390.00 31722-868-03 TOLVAPTAN 15 MG ORAL TAB $390.00 72205-130-11 TOLVAPTAN 15 MG ORAL TAB $390.00 70594-048-01 VANCOMYCIN 10 GRAM IV SOLR $390.00 70436-023-82 VANCOMYCIN 10 GRAM IV SOLR $390.00 72266-131-01 VORICONAZOLE 200 MG IV SOLR $390.00 72266-242-01 LACOSAMIDE 200 MG/20 ML IV SOLN $389.74 72266-242-05 LACOSAMIDE 200 MG/20 ML IV SOLN $389.74 24208-344-25 FLUNISOLIDE 25 MCG (0.025 %) NASL SPRY $389.68 67457-638-10 IRON SUCROSE 100 MG IRON/5 ML IV SOLN $389.42 67457-638-00 IRON SUCROSE 100 MG IRON/5 ML IV SOLN $389.42 HC62214572 PROBE ELECTROSURG LAPARASCOPIC DISP $389.00 HC42000620 WCH EST PT EVAL 30MIN $389.00 HC36000032 AEROSOL-HHN TREATMENT INIT $388.00 HC36000057 AEROSOL-IPPB TREATMENT INIT $388.00 HC36000073 AEROSOL-MDI TREATMENT INIT $388.00 HC36000107 AEROSOL-TREATMENT INITIAL $388.00 HC36000123 CPAP/BIPAP DAILY MGMT $388.00 HC25000969 INHALATION TREATMENT INITIAL $388.00 HC36000206 INHALATION W/GAS TX INITIAL $388.00 HC36000735 IPV TREATMENT INITIAL $388.00 HC31001456 PT-PROC+MODALITY.COMBO 30MIN/C $388.00 HC31001829 PT-THER PROC GRP 120MIN/MC $388.00 HC36000966 RT INHALATION TREATMENT $388.00 HC36000230 SPUTUM INDUCTION INIT TX $388.00 HC51001642 X-RAY SPINE LUMBOSACRAL; MIN 4VWS $388.00 HC81701492 IMMUNOFIX ELECT OTHER FLUIDS $387.00 HC84200948 INFLUENZA A OR B EIA EACH $387.00 HC84201342 INFLUENZA A OR B EIA EACH (POS) $387.00 HC81700148 PROGESTERONE $387.00 0003-2570-16 AZTREONAM 2 GRAM INJ SOLR $386.43 16729-276-38 FLUOROURACIL 5 GRAM/100 ML IV SOLN $386.10 70700-189-22 FLUOROURACIL 5 GRAM/100 ML IV SOLN $386.10 HC83506295 BRAF FULL GENE SEQ MOLECUL PATH LEV 7-NG $386.00 HC62201066 CANNULA RETROPLEGIA $386.00 HC62806054 CATH DIALYSIS SHORT-TERM F $386.00 HC62226527 COVER/SLEEVE PROBE $386.00 HC62228598 DEVICE CLOSURE SKIN(ZIPLINE) $386.00 HC62203401 FORCEP BIOPSY F $386.00 HC62210190 FORCEP BIOPSY DISP/TRACKING E $386.00 HC62212709 GUIDEWIRE F $386.00 HC62805791 HEMOSTATIC GEL/GELFOAM/PAD H $386.00 HC62210919 KIT CARDIOPLEGIA CANNULA $386.00 HC62227517 KIT COLON W-SEAL ,HYDRA, ORCA VALVE $386.00 HC62216379 NEEDLE BONE MARROW D $386.00 HC62204904 NEEDLE DOPPLER $386.00 HC62214382 STAPLE CARTRG/RELOAD LIN CUT N $386.00 HC62220801 SUCTION DEVICE ENDOSCOPIC BIOVAC $386.00 HC62802582 WIRE INTERVENTIONAL $386.00 7768306306 CALCIUM GLUCONATE (CALGONATE) 2.5% TOPICAL GEL $385.61 99999-035-87 CHARGE-DEL NIDO CARDIOPLEGIC SOLUTION 1059 ML $385.48 HC83506212 ANALY MLH1 PROMOTER METHYLATION-NG $385.00 HC32001216 OT-SENSRY INTEGR TECH 30MIN/CW $385.00 HC81701799 T CELL ABSOLUTE CD4 COUNT $385.00 61703-339-56 CARBOPLATIN 10 MG/ML IV SOLN $384.54 HC32000754 OT-WOUND VAC 15MIN<50 SQ CM/M $384.00 HC31000813 PT-WOUND VAC 15MIN<50 SQ CM/M $384.00 HC81701195 TSH SUBSEQUENT $384.00 39328-024-30 LIDOCAINE 4 % TOPICAL CREAM $383.57 63323-303-55 TOBRAMYCIN SULFATE 1.2 GRAM INJ SOLR $383.29 0591-2927-54 LEVALBUTEROL TARTRATE 45 MCG/ACTUATION INHALATION HFAA $383.27 HC25005836 ASPIRATION W/ CATHETER; NASOTRACHEAL $383.00 HC34000034 AUDIO THRESHOLD W/RECOG $383.00 HC81700627 HCG QUAL URINE $383.00 HC25000274 LAC REPAIR TO 2.5 CM(SMALL) $383.00 HC11500824 PEDS ASSESS ESTAB PT 10MIN $383.00 HC62209671 CATHETER IMPEDANCE PH $382.00 HC62211719 DRESSING HYDROGEL WND FILLER LG $382.00 HC81500472 INHIB PROTEIN S TOTAL $382.00 HC38420048 LVAD/RVAD SERVICE/HR $382.00 HC32001331 OT- TM CONF INTERDISCPLN NO PT/FAM, WQHCP 30MIN $382.00 HC31000607 PT- TM CONF INTERDISCPLN NO PT/FAM, WQHCP 30MIN $382.00 HC84200294 YEAST ID EA ORG $382.00 HC84201367 CULTURE CARBAPENEM RESIST ENTER $381.00 HC84201383 CULTURE CIPROFLOXACIN RESIST SCRN $381.00 HC84201284 CULTURE CRE $381.00 HC84200237 CULTURE GC $381.00 HC84200500 CULTURE GROUP B STREPTOCOCCUS $381.00 HC84200195 CULTURE MRSA $381.00 HC84200211 CULTURE MRSA & VRE $381.00 HC84200658 CULTURE PERTUSSIS $381.00 HC84201144 CULTURE THROAT-SCREENING $381.00 HC84200203 CULTURE VRE $381.00 HC62219993 FASTENERS/ANCHORS TUBE GI-SET OF 3 $381.00 HC81101164 METHEMOBLOBIN QT $381.00 HC35000199 REC- TM CONF INTERDISCPLN NO PT/FAM, WMD 30MIN $381.00 67457-584-06 FONDAPARINUX 7.5 MG/0.6 ML SUBCUTANEOUS SYRG $380.24 67457-584-00 FONDAPARINUX 7.5 MG/0.6 ML SUBCUTANEOUS SYRG $380.24 HC89500532 CALL BACK FEE HRLY-SB $380.00 HC83000349 FREEZING & THAW BLD EA UNIT $380.00 HC62228960 ORTHOSIS BOOT NON-PNEUMATIC $380.00 HC32001521 OT-THER PROC GRP 90MIN/MC $380.00 HC29000700 CA SCREEN-EXAM PELVIC/BREAST INIT 18-39 YRS $379.00 HC62209762 COMPARTM'L PRESS' MSRMT SUPPLY $379.00 HC62202122 CURRETTE VACCUUM SUCTION $379.00 HC51063113 EVACUATION SUBUNGUAL HEMATOMA $379.00 HC51063170 EVAL/MANAG DIABETIC PT SENSORY NEUROPATHY INITIAL $379.00 HC32000978 OT-MANUAL THERAPY 30 MIN/CW $379.00 HC33000274 ST-SPEECH THERAPY GRP 30MIN/MCW $379.00 0270-5164-13 GADOBENATE DIMEGLUMINE 529 MG/ML (0.1MMOL/0.2ML) IV SOLN $378.04 0270-1111-01 GADOTERIDOL 279.3 MG/ML IV SOLN $378.04 HC62208897 CABLE THRESHOLD $378.00 HC81700098 ESTRADIOL $378.00 HC29000528 EVAL COMP PREVNTV MED NEW 18-39 $378.00 HC29000536 EVAL COMP PREVNTV MED NEW 40-64 $378.00 HC81700114 IMMUNOGLOBULIN IGE $378.00 HC62215637 SUTURE N $378.00 63323-142-10 IFOSFAMIDE 1 GRAM IV SOLR $377.33 55150-232-00 FONDAPARINUX 7.5 MG/0.6 ML SUBCUTANEOUS SYRG $377.00 55150-232-10 FONDAPARINUX 7.5 MG/0.6 ML SUBCUTANEOUS SYRG $377.00 HC81500795 HEMOGLOBIN -HPLC $377.00 HC39000237 PSY TM CONF W/MD 30/+MIN(NO PT) $377.00 HC39001524 PSY-BEHAVIOR ASSESS/RE-ASSESS $377.00 HC39001532 PSY-BEHAVIOR TX INDIV 1ST 30 MIN $377.00 HC83506105 ELECTRON MICROSCOPY-PA $376.86 0409-3213-12 DIAZEPAM 5 MG/ML INJ SOLN $376.16 HC34000406 AUD PURE TONE AIR&BONE PRELIM &6 MOS MCAL $376.00 0944-0495-05 ALBUMIN, HUMAN 5 % 5 % IV SOLP $375.38 0944-0495-06 ALBUMIN, HUMAN 5 % 5 % IV SOLP $375.38 65649-303-03 RIFAXIMIN 550 MG ORAL TAB $375.19 65649-303-02 RIFAXIMIN 550 MG ORAL TAB $375.19 HC62200753 BOWL CEMENT MIXING $375.00 HC62211941 DRESSING SACRUM10X20CM(MEPILEX) $375.00 HC62801493 NEEDLE BRACHYTHERAPY TANDEM CLICK $375.00 HC31001811 PT-THER PROC GRP 90MIN/MC $375.00 99999-046-38 ARGININE HCL 2.5 MEQ/ML ORAL LIQUID $374.21 HC44002160 TEETH SINGLE VIEW $374.00 63323-474-10 HALOPERIDOL LACTATE 5 MG/ML INJ SOLN $373.75 62756-351-44 OCTREOTIDE ACETATE 500 MCG/ML INJ SOLN $373.69 0065-0092-65 FLUORESCEIN 500 MG/5 ML (10 %) IV SOLN $373.36 68982-643-01 ALBUMIN, HUMAN 25 % 25 % IV SOLP $373.10 HC83506279 HRAS FULL GENE SEQ MOLECUL PATH LEV 5-NG $373.00 HC12200044 IV INF THER CONCURRENT/ ENCNTR $373.00 HC81101214 PHOSPHATIDYL GLYCEROL $373.00 HC62209135 TRAY ARTHROGRAM(DISP) $373.00 HC62207709 TUBE LAVAGE $372.00 0143-9240-01 BLEOMYCIN 15 UNIT INJ SOLR $371.80 HC81700247 HCG QUANT $371.00 16714-696-01 FLUCONAZOLE 40 MG/ML ORAL SUSR $370.83 0173-0682-20 ALBUTEROL SULFATE 90 MCG/ACTUATION INHALATION HFAA $370.66 HC33000670 ST- TM CONF INTERDISCPLN NO PT/FAM, WQHCP 30MIN $370.00 HC51002533 US TRANSVAGINAL(NON OB) $370.00 HC84200278 AEROBIC ID EA ISOLATE $369.00 HC25001298 CS DIFF MD ADD'L 15 MIN $369.00 HC81500704 FIBRIN SPLIT PRODUCTS $369.00 HC25001264 MOD CS BY MD ADD'L 15 MIN $369.00 HC22000061 OST EST PT EVAL 10MIN $369.00 HC32001042 OT-PROSTHETIC TRNG 30MIN/CW $369.00 HC81101818 PROCALCITONIN $369.00 HC25005364 US MEASUR POST-VOID RES&/BLDR CAP NO IMG $369.00 42794-010-08 FLUCYTOSINE 500 MG ORAL CAP $368.34 HC62220074 EXTRACTOR KATZ SURGICAL $368.00 HC89014161 LYSOSOMAL SCREEN-CA $368.00 HC62217344 RFID CHANDELIER OPTHALMIC $368.00 HC62225016 SPLINT NERVE RADIAL HAND-BASED $368.00 HC62203278 SYSTEM COMPRESSION (FEMOSTOP) $368.00 HC34000059 TYMPANOMETRY IMPEDANCE $368.00 27808-086-01 HYDROCODONE-CHLORPHENIRAMINE 10-8 MG/5 ML ORAL SU12 $367.02 HC84201771 DNA/RNA CHLAMYDIA PNEUMONIAE (PNL) $367.00 HC83000216 FFP THAWING EA UNIT $367.00 HC35500149 MT-BEHAVIOR ASSESS/RE-ASSESS $367.00 HC35500156 MT-BEHAVIOR TX INDIV 1ST 30 MIN $367.00 HC35000181 REC- TM CONF INTERDISCPLN F2F PT/FAM WQHCP 30MIN $367.00 HC62225651 SET TUBING CATH COOL-TIP $367.00 59923-603-10 PAMIDRONATE 90 MG IV SOLR $366.41 HC51061828 X-RAY SPINE ENTIRE SKULL-SACRUM 2-3 VIEWS $366.00 HC51061778 X-RAY SPINE THORACIC; 2 VIEWS $366.00 0121-0670-16 ETHOSUXIMIDE 250 MG/5 ML ORAL SOLN $365.87 60687-847-42 LACOSAMIDE 10 MG/ML ORAL SOLN $365.30 HC62201355 CATH EPIDURAL $365.00 HC81500134 FIBRINOGEN $365.00 HC11500550 LACTATION E&M NEW PT 60MIN $365.00 HC32000853 OT-ELEC STIM/TENS ATTD30MIN/CW $365.00 HC32000879 OT-IONTOPHORESIS 30MIN/CW $365.00 HC31001605 PT-COMMTY WK/REINTEGRAT 30M/CW $365.00 HC31001027 PT-GAIT TRAINING 30MIN/CW $365.00 HC31001316 PT-HUBBARD TANK 30MIN/CW $365.00 HC31001118 PT-ORTHOTIC FIT/TRNG 30MIN/CW $365.00 HC33001207 ST-DEV COGNITIVE SKILL 30MIN/CW $365.00 HC83504050 TISSUE EXAM G&M LEVEL 5-CS $365.00 69238-1535-2 CLOBAZAM 2.5 MG/ML ORAL SUSP $364.26 HC62208533 BIT VERTEBROPLASTY $364.00 HC62215314 BLADE SAW R $364.00 HC29000742 CA SCREEN-EXAM PELVIC/BREAST ESTAB 18-39 YRS $364.00 HC62214259 CATH URETERAL R $364.00 HC62222427 INSERTER FUNNEL IMPLANT BREAST $364.00 HC62228929 ORTHOSIS KNEE HINGE PREFAB $364.00 HC84600089 PAP THIN LAYER PREP MANL SCRN $364.00 HC62216551 PIN/WIRE FIXATION TEMPORARY R $364.00 61314-126-10 KETOROLAC 0.5 % OPHT DROP $364.00 0338-0644-06 PARENTERAL AMINO ACID 10% NO.6 10 % IV SOLP $364.00 16714-601-02 SERTRALINE 20 MG/ML ORAL CONC $363.48 59762-0067-1 SERTRALINE 20 MG/ML ORAL CONC $363.48 HC84600220 CYTP DX EVAL FNA EA ADDL SAME SITE $363.00 HC11500899 HOSPITAL OUTPATIENT CLINIC VISIT (FACILITY FEE) $363.00 HC62204961 NEEDLE RETROBULBAR $363.00 HC32001471 OT-DEVEL TEST PER STANDARD INSTRUMENT(SCREENING) $363.00 HC33010042 ST-SPEECH THERAPY [15MIN] $363.00 HC62207428 TRAY LUMBAR PUNCTURE $363.00 HC51002509 US SCROTUM W/DOPPLER $363.00 HC51002517 US TRANSRECTAL $363.00 63459-101-30 MODAFINIL 100 MG ORAL TAB $362.72 18657-117-02 HYALURONIDASE, HUMAN RECOMB. 150 UNIT/ML INJ SOLN $362.70 18657-117-04 HYALURONIDASE, HUMAN RECOMB. 150 UNIT/ML INJ SOLN $362.70 18657-117-01 HYALURONIDASE, HUMAN RECOMB. 150 UNIT/ML INJ SOLN $362.70 HC81700536 HEPATITIS B SURFACE AG $362.00 HC31001001 PT-NEUROMUSC RE-ED 30MIN/CW $362.00 HC84200906 VARICELLA ZOSTER FA ANTIGEN $362.00 HC62202197 DEVICE CIRCULATORY ENHANCER $361.00 HC62222971 DILATOR/BOUGIE ESOPHAGEAL $361.00 HC32001539 OT-THER PROC GRP 120MIN/MC $361.00 HC31090178 PT-EVAL HIGH COMPLEX PRELIM &6 MOS MCAL $361.00 HC62206834 STIMULATOR NERVE LOCATOR $361.00 0054-3556-63 METHADONE 10 MG/5 ML ORAL SOLN $360.75 HC83504019 CHROM ANAL 45 CELLS-GZ $360.00 HC51000073 INSERT BLADDER CATH-TEMP FOLEY $360.00 HC31001498 PT-THER PROC GRP 60MIN/MC $360.00 HC62207576 VACUUM TREPHINE $360.00 55111-680-10 FONDAPARINUX 7.5 MG/0.6 ML SUBCUTANEOUS SYRG $359.45 55111-681-10 FONDAPARINUX 10 MG/0.8 ML SUBCUTANEOUS SYRG $359.45 66215-402-01 EPOPROSTENOL 1.5 MG IV SOLR $359.19 HC81100406 TROPONIN $359.00 0270-0149-57 DIATRIZOATE MEGLUMINE 30 % URETHRAL SOLN $358.80 HC62205588 HEMOSTATIC GEL/GELFOAM/PAD G $358.00 HC62204193 KIT RADICAL PROSTATECTOMY $358.00 HC32001109 OT-ADL 30MIN/CW $358.00 HC65800013 PALLADIUM-103 NONSTRND PER SOURCE $358.00 HC62206933 SUCTION IRRIGATOR $358.00 0713-0664-31 FLUOCINONIDE-EMOLLIENT 0.05 % TOPICAL CREAM $357.83 0517-0720-01 BETAMETHASONE ACET,SOD PHOS 6 MG/ML INJ SUSP $357.70 25021-215-99 FLUOROURACIL 5 GRAM/100 ML IV SOLN $357.50 60687-813-94 METHYLERGONOVINE 0.2 MG ORAL TAB $357.50 60687-813-11 METHYLERGONOVINE 0.2 MG ORAL TAB $357.50 0143-9164-01 VANCOMYCIN 10 GRAM IV SOLR $357.50 0009-7376-11 MEDROXYPROGESTERONE 150 MG/ML IM SYRG $357.18 HC25001496 REMOV IMPACTD EAR WAX(INSTRUMENT) LT $357.00 HC25001504 REMOV IMPACTD EAR WAX(INSTRUMENT) RT $357.00 0574-4190-35 SULFACETAMIDE SODIUM 10 % OPHT OINT $356.72 99999-045-82 NIMODIPINE 30 MG/5 ML ORAL SYRG $356.36 16714-397-03 CEFPROZIL 250 MG/5 ML ORAL SUSR (MCH) $356.20 HC81500126 D-DIMER QUAL OR SEMI-QT $356.00 HC84201797 DNA/RNA MYCOPLASMA PNEUMONIAE (PNL) $355.00 HC89020325 HLA-B GENOTYPE-AU $355.00 HC39000518 PSY-TEAM CONF W/PT &3D 30MINOR> $355.00 HC31001589 PT-CONTRAST BATH 30MIN/CW $355.00 HC51060143 PT-EVAL MOD COMPLEXITY 30MF2F 45MIN $355.00 HC31000946 PT-IONTOPHORESIS 30MIN/CW $355.00 HC62209168 STAPLE STONE/TABLE $355.00 0338-0357-02 MANNITOL 20 % 20 % IV SOLP $354.25 72578-082-01 ACYCLOVIR 5 % TOPICAL OINT $354.02 HC81700288 COMPLEMENT TOT HEMOLYTIC CH50 $354.00 HC31000086 PT-AQUATIC GRP 60MIN/M $354.00 0409-2022-01 MORPHINE 50 MG/ML IV SOLN $353.60 61958-0501-1 ADEFOVIR 10 MG ORAL TAB $353.22 55111-681-02 FONDAPARINUX 10 MG/0.8 ML SUBCUTANEOUS SYRG $353.08 55111-681-11 FONDAPARINUX 10 MG/0.8 ML SUBCUTANEOUS SYRG $353.08 55111-680-11 FONDAPARINUX 7.5 MG/0.6 ML SUBCUTANEOUS SYRG $353.08 55111-680-02 FONDAPARINUX 7.5 MG/0.6 ML SUBCUTANEOUS SYRG $353.08 HC32001430 OT-COMMTY WK/REINT ADD15MIN/CW $353.00 HC83504076 IF STUDY INDIRECT 1ST STAIN-CS $352.34 5047-4508-38 SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRG $352.32 HC81700817 ABSOLUTE T4/CELL MRKR ADD+ $352.00 HC81700825 CALLA/ACUTE LYMPH LEUK AG MKR+ $352.00 HC84200419 CRYPTOCOCCUS NEOFORMANS AG $352.00 HC51063188 EVAL/MANAG DIABETIC PT SENSORY NEUROPATHY FLLWUP $352.00 HC81701419 FLOW CYT MKR (TDT) TC ADD+ $352.00 HC81700858 FLOW CYT MKR TC ADD + CD38 $352.00 HC81701401 FLOW CYT MKR TC ADD+ $352.00 HC81700833 FLOW CYT MKR TC ADD+ CD23 $352.00 HC81700569 FLOW CYT MKR TC ADD+ KAPPA $352.00 HC81700874 FLOW CYTO CELL MKR TC ADD+ $352.00 HC81700866 FLOW CYTO MKR TC ADD + CALLA $352.00 HC81701989 FLW CYT MKR CD10/CA TC ADD+ $352.00 HC81702037 FLW CYT MKR CD103 TC ADD+ $352.00 HC81700882 FLW CYT MKR CD11 TC ADD+ $352.00 HC81702029 FLW CYT MKR CD117 TC ADD+ $352.00 HC81701062 FLW CYT MKR CD11B TC ADD+ $352.00 HC81702045 FLW CYT MKR CD11C TC ADD+ $352.00 HC81702052 FLW CYT MKR CD138 TC ADD+ $352.00 HC81700890 FLW CYT MKR CD14 TC ADD+ $352.00 HC81702060 FLW CYT MKR CD16 TC ADD+ $352.00 HC81700908 FLW CYT MKR CD19 TC ADD+ $352.00 HC81700916 FLW CYT MKR CD2 TC ADD + $352.00 HC81700924 FLW CYT MKR CD20 TC ADD+ $352.00 HC81702086 FLW CYT MKR CD235A TC ADD+ $352.00 HC81700932 FLW CYT MKR CD24 TC ADD+ $352.00 HC81702094 FLW CYT MKR CD25 TC ADD+ $352.00 HC81700940 FLW CYT MKR CD3 (LEU-4)TC ADD+ $352.00 HC81700957 FLW CYT MKR CD30 (KI-1)TC ADD+ $352.00 HC81700965 FLW CYT MKR CD33 TC ADD+ $352.00 HC81700973 FLW CYT MKR CD34 (HPCA-1)ADD+ $352.00 HC81702102 FLW CYT MKR CD4 TC ADD+ $352.00 HC81702110 FLW CYT MKR CD41 TC ADD+ $352.00 HC81700999 FLW CYT MKR CD5 TC ADD+ $352.00 HC81701005 FLW CYT MKR CD56 TC ADD+ $352.00 HC81702128 FLW CYT MKR CD57 TC ADD+ $352.00 HC81702136 FLW CYT MKR CD61 TC ADD+ $352.00 HC81702144 FLW CYT MKR CD64 TC ADD+ $352.00 HC81701013 FLW CYT MKR CD7 TC ADD+ $352.00 HC81702151 FLW CYT MKR CD79A TC ADD+ $352.00 HC81701021 FLW CYT MKR CD8 TC ADD+ $352.00 HC81702193 FLW CYT MKR HLA-DR TC ADD+ $352.00 HC81701039 FLW CYT MKR IGA TC ADD+ $352.00 HC81701047 FLW CYT MKR IGG TC ADD+ $352.00 HC81701054 FLW CYT MKR IGM TC ADD+ $352.00 HC81701070 FLW CYT MKR LAMBDA TC ADD+ $352.00 HC81702169 FLW CYT MKR MPO TC ADD+ $352.00 HC81702177 FLW CYT MKR TCRAB TC ADD+ $352.00 HC81702185 FLW CYT MKR TCRGD TC ADD+ $352.00 HC81701088 FLW CYT MKR VS. CD13 TC ADD+ $352.00 HC81701096 FLW CYT MKR, CDI TC ADD+ $352.00 HC81700155 PROLACTIN $352.00 HC81500621 APTT SUBS PLASMA FRACTIONS EA $351.00 HC62201850 CLIP GUN COMPLETE $351.00 HC62202429 DRESSING BAND UNIV. FACIAL $351.00 HC84200153 KIRBY BAUER SENSITIVITY $351.00 HC31001522 PT-PHYS PERFORM TEST INL'30M/W $351.00 71285-0429-1 AA3.5% NO2 PED-D10-CALCIUM-HEP 3.5 %-10 %- 2.33 MEQ/250 ML IV SOLP $351.00 63323-360-05 CALCIUM GLUCONATE 100 MG/ML (10%) IV SOLN $351.00 63323-360-61 CALCIUM GLUCONATE 100 MG/ML (10%) IV SOLN $351.00 0990-7171-17 PARENTERAL AMINO ACID 15% NO.2 15 % IV SOLP $351.00 99999-046-51 TACROLIMUS 1 MG/ML ORAL SUSP (COMPOUND) $351.00 70069-728-01 CALCIUM GLUCONATE 100 MG/ML (10%) IV SOLN $350.35 70069-728-20 CALCIUM GLUCONATE 100 MG/ML (10%) IV SOLN $350.35 24208-720-02 DEXAMETHASONE SODIUM PHOSPHATE 0.1 % OPHT DROP $350.35 0013-2576-91 IDARUBICIN 1 MG/ML IV SOLN $350.35 0121-2024-10 LACOSAMIDE 10 MG/ML ORAL SOLN $350.22 52565-009-50 LIDOCAINE HCL 4 % (40 MG/ML) MUCOUS MEMB SOLN $350.03 HC62800057 BALLOON HYSTEROSALPINGOGRAM $350.00 HC62200522 BLADE INCISIONAL E $350.00 HC62213095 BLADE INCISIONAL ORTHO E $350.00 HC62212881 BLADE SHAVER ORTHO E $350.00 HC62200803 BRUSH CYTOLOGY G $350.00 HC62200878 BURR E $350.00 HC62806658 CATH BALLOON RETRIEVAL D $350.00 HC62226832 CATH CENTRAL VENOUS G $350.00 HC62225354 CATH ERCP (PUSHING) B $350.00 HC62201496 CATH INTRODUCER PEEL-AWAY L $350.00 HC62222559 CATH NEPHROSTOMY G $350.00 HC62804562 CATH PICC PEDS G $350.00 HC62226998 CATH PTA ANGIOPLS BALLOON NON-LSR C $350.00 HC62800461 CATH SINGLE LUMEN $350.00 HC62805338 CATH SWAN GANZ/THERMODILUTION G $350.00 HC62800537 CATH TRIPLE LUMEN $350.00 HC62808381 CATHETER PACING BIPOLAR G $350.00 HC62213657 CATHETER PICC PEDS $350.00 HC62222039 CATHETER VENOGRAM BALLOON $350.00 HC83500199 CHROMO ANALYSIS, TISSUE -GZ $350.00 HC62201991 COOKS TRIPLE LUMEN $350.00 HC62220728 COUNTERSINK CANNULATED E $350.00 HC62224100 CUTTER LINEAR ENDO G $350.00 HC62225065 DEVICE LIGATOR B $350.00 HC62218755 DRILL/DRILL BITS SINGLE USE J $350.00 HC62202742 ELECTRODE ROLLER BALL G $350.00 HC62218334 ENDO STAPLER E $350.00 HC62222419 GUIDE ROD G $350.00 HC62202544 HEMOSTATIC GEL/SURGICEL G 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LIGATNG HEMOSTATC ENDO $350.00 HC62807227 PARTICLES EMBOLIZ (CONTOUR) G $350.00 HC62222898 PROBE LASER G $350.00 HC62209317 PROBE PH $350.00 HC62227061 PROBE SINUS $350.00 HC62226337 PROBE SPINAL DISPOSABLE A $350.00 HC51070373 PSYCH TX W/PATIENT 45MIN $350.00 HC62213376 REAMER H $350.00 HC62221304 RESERVOIR CELL SAVER G $350.00 HC62214499 RETRACTOR DISPOSABLE E $350.00 HC62802848 SET PEG 14-20 FR CONMED G $350.00 HC62206347 SET PERFUSION $350.00 HC62206586 SNARE G $350.00 HC62803960 STENT URETERAL G $350.00 HC62215629 SUTURE M $350.00 HC62227608 TAP SURGICAL G $350.00 HC62201595 TROCAR ENDO G $350.00 HC62806344 TUBE GASTROSTOMY LOWPRFL BTTN OPT G $350.00 HC62806328 TUBE GASTROSTOMY STNDRD BTTN OPT G $350.00 HC62221510 TUBE INSUFFLATOR G $350.00 HC62806534 TUBE JEJUN STANDRD TRANSGAS G $350.00 HC62211438 TUBE TRACH CUFFED ADJUSTABLE G $350.00 HC62224050 VALVE ENDOSCOPIC G $350.00 0270-0523-30 DIATRIZOATE AND IODIPAMIDE MEG 52.7-26.8 % INJ SOLN $349.64 63323-278-10 VINBLASTINE 1 MG/ML IV SOLN $349.44 HC77400117 ANESTHESIA MAC EACH ADD 15 MIN $349.00 HC51001568 APPLY SPLINT SHORT ARM $349.00 HC81101453 CORTISOL(INITIAL) $349.00 HC81101461 CORTISOL(SUBSEQ) $349.00 HC81701211 CORTISOL, PREDOSE $349.00 HC81702078 FLW CYT MKR CD22 TC ADD+ $349.00 HC39000153 PSY MED RECORD REVIEW $349.00 HC32000952 OT-MASSAGE 30MIN/CW $348.00 HC32000895 OT-ULTRASOUND 30MIN/CW $348.00 HC31001068 PT-MANUAL THERAPY 30 MIN/CW $348.00 HC31001043 PT-MASSAGE 30MIN/CW $348.00 HC35000207 REC TM CONF INTERDISCPLN NO PT/FAM, WQHCP 30MIN $348.00 59676-302-00 EPOETIN ALFA 2,000 UNIT/ML INJ SOLN $347.49 59676-302-01 EPOETIN ALFA 2,000 UNIT/ML INJ SOLN $347.49 3877926008 COMPOUND VEHICLE SUSP SF NO.18 ORAL SUSP $347.42 64980-504-48 CYPROHEPTADINE 2 MG/5 ML ORAL SYRP $347.42 24338-230-05 NIMODIPINE 30 MG/5 ML ORAL SYRG $347.20 24338-230-12 NIMODIPINE 30 MG/5 ML ORAL SYRG $347.20 24338-230-15 NIMODIPINE 30 MG/5 ML ORAL SYRG $347.20 24338-230-30 NIMODIPINE 30 MG/5 ML ORAL SYRG $347.20 HC11500022 E&M EST PT 30MIN $347.00 HC84200518 HUMAN METAPNEUMOVIRUS (HMPV) $347.00 HC62205794 PROBE ENDO EYE $347.00 HC83000224 SPLITTING BLD/BLD PROD EA UNIT $347.00 55150-259-30 ACETYLCYSTEINE 200 MG/ML (20 %) IV SOLN $346.13 70069-788-04 ACETYLCYSTEINE 200 MG/ML (20 %) IV SOLN $346.13 70069-788-01 ACETYLCYSTEINE 200 MG/ML (20 %) IV SOLN $346.13 99999-001-95 LORAZEPAM 100MG IN D5W 100ML IV DRIP $346.13 HC84201045 BETA STREP SCREEN(QUAL) $346.00 HC81101925 DRUG TEST PRESUMP DIRECT OBSERV/ DOS $346.00 0641-6018-01 DOXAPRAM 20 MG/ML IV SOLN $345.93 HC81701880 CA 15-3 $345.00 HC81700312 CA 27-29 $345.00 HC84600295 CYTO FLUID/BRUSH/WASH DIST SRV $345.00 HC84600006 CYTOLOGY FLD/BRSH/WASH-DIST SV $345.00 HC84600014 CYTOLOGY FLUID/BRUSH/WASH $345.00 HC84600527 CYTOLOGY FLUID/BRUSH/WASH *OP $345.00 HC62204995 NEEDLE SPECIALTY $345.00 HC51060192 OT-EVAL MOD COMPLEXITY 30MF2F 45MIN $345.00 71288-029-10 MICAFUNGIN 100 MG IV SOLR $344.96 71288-029-11 MICAFUNGIN 100 MG IV SOLR $344.96 50742-515-01 NITROGLYCERIN 0.3 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$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 72485-201-01 AZACITIDINE 100 MG INJ SOLR $292.50 71288-115-30 AZACITIDINE 100 MG INJ SOLR $292.50 0143-9606-01 AZACITIDINE 100 MG INJ SOLR $292.50 16729-306-10 AZACITIDINE 100 MG INJ SOLR $292.50 0143-9233-05 BENZTROPINE 1 MG/ML INJ SOLN $292.50 0143-9233-01 BENZTROPINE 1 MG/ML INJ SOLN $292.50 68180-405-01 CEFIXIME 100 MG/5 ML ORAL SUSR $292.50 55150-219-10 EPTIFIBATIDE 2 MG/ML IV SOLN $292.50 63323-012-17 OXYTOCIN 10 UNIT/ML INJ SOLN $292.50 80830-1691-1 POTASSIUM PHOSPHATE 3 MMOL / ML ORAL LIQUID (MCH) $292.50 80830-1691-2 POTASSIUM PHOSPHATE 3 MMOL / ML ORAL LIQUID (MCH) $292.50 43598-330-11 ZOLEDRONIC ACID 4 MG/5 ML IV SOLN $292.50 5633100615 NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRA $292.27 5633100614 NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRA $292.27 16571-675-16 PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIX $292.08 HC89003271 CORTISOL 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PHOSPHATE 3 MMOL / ML ORAL LIQUID (MCH) $285.58 70069-747-25 POTASSIUM PHOSPHATE 3 MMOL / ML ORAL LIQUID (MCH) $285.58 HC84200344 CRYPTOCOCCUS AG EA CSF $285.00 HC89021216 MAG AUTOANTIBODY-AT $285.00 HC42000604 WCH EST PT EVAL 10MIN $285.00 60219-1749-3 ATROPINE 1 % OPHT DROP $284.64 24208-411-15 BRIMONIDINE 0.2 % OPHT DROP $284.41 0009-0013-06 HYDROCORTISONE SOD SUCC (PF) 250 MG/2 ML INJ SOLR $284.04 HC39001623 CAREGVR TRAIN BEHAVIOR MGMT F2F PT NOT PRESENT FIRST 30MIN $284.00 HC21001094 CAREGVR TRAIN DIRECT CARE ONGOING ILLNESS INCL WOUND &INFECT F2F PT NOT PRESENT 1ST 30MIN $284.00 HC62226931 DEVICE EMULSION SUBMUCOSAL INJ AMPOULE $284.00 HC81101685 DHEA SULFATE $284.00 HC81500563 LEUKOCYTE ALK PHOS W/ COUNT $284.00 HC32001349 OT-CONTRAST BATH 30MIN/CW $284.00 HC32010498 OT-TRAIN CAREGVR ADL,MOBILE,SAFE PT NOT PRESENT FIRST 30MIN $284.00 HC31090194 PT-TRAIN CAREGVR ADL,MOBILE,TRANSFER PT NOT PRESENT FIRST 30MIN $284.00 HC33010349 ST-TRAIN CAREGVR ADL,FEED,SWALLOW PT NOT PRESENT 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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 HC89024806 DPPX AB IGG CBA-IFA TITER CSF-AU $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 HC89024350 HLA II TYPE 1 AG EQUIV LOW RES RISKIMMUNE-PR $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 HC62216528 PIN/WIRE FIXATION TEMPORARY O $280.00 HC62224951 PROBE LITHOTRIPTOR F $280.00 HC62227798 PROTECTOR OVERFLOW BACTERIA (DHS) $280.00 HC31001894 PT-EVAL LOCOMOTOR TRAINING $280.00 HC62227566 PUNCH ARTHROSCOPIC B $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 69945-602-20 SODIUM IODIDE-123 7.4 MBQ (200 MICROCI) ORAL CAP $280.00 65862-496-47 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 66993-727-57 SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG/5 ML ORAL SUSP $279.78 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 65219-535-50 FAT EMULSION 20 % IV (FOR LIPID RESCUE) $279.50 65219-535-01 FAT EMULSION 20 % IV (FOR LIPID RESCUE) $279.50 42023-215-01 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $279.50 HC62202882 ENDO LOOP $279.00 HC12200093 IM OR SQ INJECTION THERAPEUTIC $279.00 HC51001717 X-RAY ELBOW 3+ VW $279.00 HC51001816 X-RAY KNEE 3 VWS $279.00 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 HC81101065 CALCIUM IONIZED $278.00 HC81101800 CALCIUM IONIZED (POS) $278.00 HC81701831 HSV TYPE 2 AB, IGG $278.00 43598-405-16 PHYTONADIONE (VITAMIN K1) 10 MG/ML INJ SOLN $277.99 43598-405-11 PHYTONADIONE (VITAMIN K1) 10 MG/ML INJ SOLN $277.99 68462-758-01 PHYTONADIONE (VITAMIN K1) 10 MG/ML INJ SOLN $277.99 68462-758-25 PHYTONADIONE (VITAMIN K1) 10 MG/ML INJ SOLN $277.99 68462-758-05 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 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 HC62208616 VEST CHEST/AIRWAY CLEARANCE $277.00 0409-7248-03 HETASTARCH 6 % IN 0.9 % NACL 6 % IV SOLN $276.25 0409-7248-13 HETASTARCH 6 % IN 0.9 % NACL 6 % IV SOLN $276.25 63739-076-33 VALGANCICLOVIR 450 MG ORAL TAB $276.25 HC84201060 CRYPTOSPORIDIUM $276.00 HC84200922 GIARDIA $276.00 HC51060952 OT-ORTHOTIC FIT/TRNG 30MIN/C $276.00 HC81700585 PSA TOTAL $276.00 HC84200070 STREP A ANTIGN SCRN(DIRECT OBS) $276.00 HC83506238 ANALY KIT(C-KIT)MUTATION-NG $275.00 HC89016927 ANATOMIC CONSULT; CMPLX REV-CE $275.00 HC89024269 CANDIDA AURIS BY PCR-AU $275.00 HC81101404 FLORESCENCE POLARIZATION $275.00 HC89005193 INFCT AGNT ADENO DNA PCR-FT $275.00 HC62204284 KIT TRACH $275.00 HC84600576 PAP THIN LAYER MNL SCRN DX $275.00 HC51070415 PSYCH PSYCHOANALYSIS $275.00 HC89019236 VARICELLA ZOSTER QNT-FT $275.00 HC36800597 CARBOXYHEMOGLOBIN,QUANT $274.00 HC31001902 LOCOMOTOR TRAINING $274.00 HC81700486 RUBEOLA AB IGG $274.00 HC81700221 T3 TOTAL $273.00 0009-0436-01 ARGININE HCL (L-ARGININE) 10 % (0.475 MEQ/ML) ORAL SOLN $273.00 55150-337-01 BORTEZOMIB 3.5 MG INJ SOLR $273.00 71288-118-10 BORTEZOMIB 3.5 MG INJ SOLR $273.00 0143-9724-01 CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLN $273.00 0517-0730-01 CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLN $273.00 0143-9384-01 FOSAPREPITANT 150 MG IV SOLR $273.00 0093-8180-64 OSELTAMIVIR 6 MG/ML ORAL SUSR $273.00 0143-9851-01 METHYLPREDNISOLONE SODIUM SUCC 1,000 MG IV SOLR $272.29 99999-041-50 NM TC-99M PYROPHOSPHATE (PYP) MHS $272.16 HC83505537 ANATOMIC CONSULT; COMPLEX REV-UX $272.00 HC81101230 TRANSFERRIN $272.00 HC51001758 X-RAY HAND 3+ VW $272.00 61958-0401-1 TENOFOVIR DISOPROXIL FUMARATE 300 MG ORAL TAB $271.59 68546-142-56 RASAGILINE 0.5 MG ORAL TAB $271.07 68546-229-56 RASAGILINE 1 MG ORAL TAB $271.07 HC62208459 ACAPELLA DEVICE $271.00 HC81101040 AMNIOTIC FLUID SCAN $271.00 HC88600002 ARTERIAL PUNCTURE $271.00 HC36800795 ARTERIAL PUNCTURE $271.00 HC36000727 ARTERIAL PUNCTURE $271.00 HC36000164 MANIP CHEST (INFANT) SUBSEQ $271.00 HC36000131 MANIP CHEST WALL INIT DEMO/EVAL $271.00 HC36000156 MANIP CHEST WALL SUBSEQUENT $271.00 HC36000149 MANIP CHEST(INFANT) INIT DEMO/EVAL $271.00 HC62217187 PAD BOOT $271.00 HC62206370 SET SUSPENSION EYE(FRONTALIS) $271.00 HC51010551 TEST CHALLENGE INGEST ADD 60MIN $271.00 HC62207394 TRAY INTUBATION $271.00 0065-0817-02 ATROPINE 1 % OPHT DROP $270.99 0407-1413-59 IOHEXOL 300 MG IODINE/ML IV SOLN $270.66 HC51002541 US ABDOMEN $270.22 HC51002376 US PELVIC(NON OB)LTD OR F/U $270.22 HC51001881 X-RAY BONE AGE STUDIES $270.22 HC51001899 X-RAY BONE LENGTH STUDIES $270.22 HC51003382 X-RAY ORPORA CAVERNOSGRAPHY $270.22 HC51061869 X-RAY PELVIS COMPLETE MIN 3 VWS $270.22 HC51061877 X-RAY SCAPULA $270.22 HC51001626 X-RAY SPINE CERVICAL; 4 OR 5VWS $270.22 HC51061760 X-RAY SPINE CERVICAL; COMP 6/> VWS $270.22 HC51001634 X-RAY SPINE LUMBOSACRAL; 2 OR 3VWS $270.22 HC62204615 ANTENNA TRANSMIT EXT NEUROSTIM $270.00 HC51062818 CHRONIC CARE MGMT INITL 20MIN, PER MONTH $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 HC51062669 M: MISCL PROCEDURE $270.00 HC83506063 MORPH STDY CAT FISH EA MULTI PROBE HER2-AP $270.00 HC51070449 PSYCH FAMILY GROUP THERAPY $270.00 HC51062925 REMOTE AUTO SYSTM INSULIN DOSE CALC; INTL SETUP $270.00 HC51061893 X-RAY UPPER EXTREMITY INFANT MIN 2 VWS $270.00 0517-4002-25 PAPAVERINE 30 MG/ML INJ SOLN $269.17 0517-4002-01 PAPAVERINE 30 MG/ML INJ SOLN $269.17 23155-603-51 CLINDAMYCIN PALMITATE 75 MG/5 ML ORAL SOLR (MCH) $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 NEW PT 30MIN $269.00 HC47200290 M: MISC RAD TX PROC PLANNING $269.00 HC47200555 M: MISC RADIATION THERAPY $269.00 HC89004808 MTB COMPLEX DNA, PCR-FT $269.00 HC89019251 PARECHOVIRUS RNA, RT-PCR-FT $269.00 HC62206214 SET FRAGMATONE $269.00 0009-0112-05 IRINOTECAN 100 MG/5 ML IV SOLN $268.26 HC81500811 HEMOGLOBIN ELECTRO-CONFIRM $268.00 HC81500712 HEMOGLOBIN ELECTROPHERESIS $268.00 HC82202813 PREP SURG TISSUE NON-MICRO STUDIES+ $268.00 HC83500678 TISSUE EXAM G&M LEVEL 4-SU $268.00 63323-881-16 SODIUM PHOSPHATE 3 MMOL/ML IV SOLN $267.83 63323-881-01 SODIUM PHOSPHATE 3 MMOL/ML IV SOLN $267.83 63323-103-65 CISPLATIN 1 MG/ML IV SOLN $267.80 63323-599-30 DEFEROXAMINE 2 GRAM INJ SOLR $267.80 HC89008718 GM1 AUTO AB-AT $267.50 HC34000521 HEARING AID CHECK BINAURAL $267.40 HC83000273 CMV IGM $267.00 HC25006008 EVAL EST PT BRIEF 5MIN $267.00 HC84200484 LACTOFERRIN/LEUK, FECAL; QUAL $267.00 99988-000-21 NM TC-99M PYROPHOSPHATE (PYP) 1-25 MCI $266.91 0187-3013-30 PYRIDOSTIGMINE BROMIDE 180 MG ORAL TBSR $266.57 68180-441-02 CEPHALEXIN 250 MG/5 ML ORAL SUSR $266.50 0093-4177-74 CEPHALEXIN 250 MG/5 ML ORAL SUSR $266.50 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 HC84200534 TRICHOMONAS RAPID TEST $266.00 HC62202213 DEVICE EXPRESS CORE BX $265.00 HC81700304 EXTRCTBL NUCLEAR AG AB TO ECH $265.00 HC81700411 HELICOBACTER PYLORI IGG AB $265.00 HC89500748 HLA TYPING A,B OR C -SB $265.00 HC81701484 SCLERODERMA SCL-70 AB, IGG $265.00 HC81700692 SJORGEN SYNDROME AB SSA EIA $265.00 HC81700700 SJORGEN SYNDROME AB SSB EIA $265.00 HC81700718 SMITH ANTIBODY EIA $265.00 99999-035-26 APREPITANT 20 MG/ML ORAL LIQUID $264.90 0409-1754-10 MAGNESIUM SULFATE 500 MG/ML (50 %) INJ SYRG $264.88 49281-215-58 TETANUS AND DIPHTHER. TOX (PF) 5 LF UNIT- 2 LF UNIT/0.5ML IM SUSP $264.88 49281-215-88 TETANUS AND DIPHTHER. TOX (PF) 5-2 LF UNIT/0.5 ML IM SYRG $264.88 49281-215-15 TETANUS AND DIPHTHER. TOX (PF) 5-2 LF UNIT/0.5 ML IM SYRG $264.85 0409-2337-25 DEFEROXAMINE 2 GRAM INJ SOLR $264.71 0409-2337-15 DEFEROXAMINE 2 GRAM INJ SOLR $264.71 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 70436-127-82 IOPAMIDOL 370 MG IODINE /ML (76 %) IV SOLN $264.55 70436-127-40 IOPAMIDOL 370 MG IODINE /ML (76 %) IV SOLN $264.55 63323-285-65 ROPIVACAINE PF 0.2% AUTOFUSER PUMP $264.55 99999-038-00 PHENYLEPHRINE HCL 2.5 % OPHT DROP $264.06 HC51061505 ECG EXT PT ACTV EVENT MONITOR ATTEND 24HRS-30DAYS; TRANSMIT/ANYS $264.00 HC51060184 OT-DEVEL TEST PER STANDARD INSTRUMENT(SCREENING) $264.00 HC31000318 PT-EVAL LOW COMPLEXITY <20MF2F 15MIN $264.00 16714-955-02 KETOCONAZOLE 2 % TOPICAL CREAM $263.45 71699-025-30 CENOBAMATE 25 MG ORAL TAB $263.34 71699-050-30 CENOBAMATE 50 MG ORAL TAB $263.34 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 HC51001691 X-RAY HUMERUS; MIN 2 VWS $263.00 0069-6001-02 FOSPHENYTOIN 100 MG PE/2 ML INJ SOLN $262.81 0069-6001-25 FOSPHENYTOIN 100 MG PE/2 ML INJ SOLN $262.81 70004-202-32 FENTANYL CITRATE (PF)-0.9%NACL 10 MCG/ML IV SOLN $262.60 47335-891-80 TEMOZOLOMIDE 20 MG ORAL CAP $262.41 HC83000398 SERUM PRETREATMNT W/INHIB EA $262.00 HC62214010 SET CATH CVC QUAD LUMEN $262.00 HC62211578 SET TUBING DUAL WND IRRIG/SUCTN $262.00 0703-5748-11 CISPLATIN 1 MG/ML IV SOLN $261.95 0409-7391-82 SODIUM PHOSPHATE 3 MMOL/ML IV SOLN $261.40 0409-7391-72 SODIUM PHOSPHATE 3 MMOL/ML IV SOLN $261.40 3877907438 COMPOUND VEHICLE SUSP SF NO.20 ORAL SUSP $261.33 3877907448 COMPOUNDING VEHICLE SYRUP NO23 ORAL SYRP $261.33 70408-146-34 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 HC29000635 COUNSEL ASSESS CA LUNG SCREEN LDCT $261.00 HC62208699 DEVICE INFLATE SINUS BALLOON $261.00 HC83000406 SERUM PRETREATMNT/ABSORPTION $261.00 70954-600-10 FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLN $260.52 0496-0882-07 LIDOCAINE-TRANSPARENT DRESSING 4 % TOPICAL KIT $260.39 49884-161-11 CALCITONIN (SALMON) 200 UNIT/ACTUATION NASL SPRY $260.01 HC81700684 ANTI SMOOTH MUSC/RNP AB $260.00 HC51063253 EMG STIM GUIDE W/ CHEMODENERVATION $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 HC89018279 SEROTONIN RELEASE ASSAY- QN $260.00 HC62206966 SUPPORT LUMBAR-SACRAL $260.00 HC62207253 TRAY AMNIOCENTESIS $260.00 67457-853-50 ACETAZOLAMIDE SODIUM 500 MG INJ SOLR $260.00 43598-452-02 ALBENDAZOLE 200 MG ORAL TAB $260.00 51754-5060-1 BETAMETHASONE ACET,SOD PHOS 6 MG/ML INJ SUSP $260.00 70594-112-02 CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN $260.00 70594-112-01 CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN $260.00 72485-513-01 CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) IV SOLN $260.00 72485-513-10 CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) IV SOLN $260.00 25021-253-51 CISPLATIN 1 MG/ML IV SOLN $260.00 72266-253-01 CISPLATIN 1 MG/ML IV SOLN $260.00 43598-476-11 DAPTOMYCIN 350 MG IV SOLR $260.00 70594-053-01 DAPTOMYCIN 350 MG IV SOLR $260.00 72603-147-01 DAPTOMYCIN 350 MG IV SOLR $260.00 0338-1075-02 DOBUTAMINE IN D5W 500 MG/250 ML (2,000 MCG/ML) IV SOLP $260.00 0143-9398-01 ERTAPENEM 1 GRAM INJ SOLR $260.00 0143-9398-10 ERTAPENEM 1 GRAM INJ SOLR $260.00 55150-282-09 ERTAPENEM 1 GRAM INJ SOLR $260.00 0270-1317-02 IOPAMIDOL 250 MG IODINE /ML (51 %) IV SOLN $260.00 31722-203-31 LACOSAMIDE 200 MG/20 ML IV SOLN $260.00 43598-087-58 LACOSAMIDE 200 MG/20 ML IV SOLN $260.00 43598-087-11 LACOSAMIDE 200 MG/20 ML IV SOLN $260.00 72205-220-01 LACOSAMIDE 200 MG/20 ML IV SOLN $260.00 67457-529-20 LEUCOVORIN CALCIUM 200 MG INJ SOLR $260.00 0054-3505-47 LIDOCAINE HCL 4 % (40 MG/ML) MUCOUS MEMB SOLN $260.00 0517-8905-10 METHYLDOPATE 250 MG/5 ML IV SOLN $260.00 60505-6132-7 OXALIPLATIN 100 MG/20 ML IV SOLN $260.00 63323-673-05 PALONOSETRON 0.25 MG/5 ML IV SOLN $260.00 0264-4500-00 PARENTERAL AMINO ACID 15% NO.6 15 % IV SOLP $260.00 0941-0457-08 PERITON.DIALYSIS 7-2.5 % DEXTR CA 2.5 MEQ/L- MG 0.5 MEQ/L IP SOLN $260.00 70756-614-30 PHENYLEPHRINE HCL 10 % OPHT DROP $260.00 75907-130-23 PHENYLEPHRINE HCL 10 % OPHT DROP $260.00 14789-109-16 POTASSIUM CHLORIDE IN WATER 10 MEQ/100 ML IV PGBK $260.00 14789-109-10 POTASSIUM CHLORIDE IN WATER 10 MEQ/100 ML IV PGBK $260.00 14789-108-10 POTASSIUM CHLORIDE IN WATER 20 MEQ/100 ML IV PGBK $260.00 14789-108-16 POTASSIUM CHLORIDE IN WATER 20 MEQ/100 ML IV PGBK $260.00 0143-9163-01 VANCOMYCIN 5 GRAM IV SOLR $260.00 70594-067-01 VORICONAZOLE 200 MG IV SOLR (MHS WRAPPER) $260.00 HC83504324 ANATOMIC CONSULT; SLIDE REV-MA $259.00 HC47200753 RAD ONC EST PT NOT REQ PHYS(5MIN) $259.00 HC51001683 X-RAY SHOULDER; COMPLETE MIN 2 VWS $259.00 69238-2122-9 PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLN $258.80 42799-815-01 PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLN $258.80 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 HC81700429 HIV-1 & HIV-2 AB SNGL ASSAY $257.00 HC62217955 ORTHOSIS SHOULDER FIGURE 8 PREFAB $257.00 HC62206057 SENSOR BISPECTRAL INDEX $257.00 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 83634-451-01 DESMOPRESSIN 4 MCG/ML INJ SOLN $256.75 83634-451-41 DESMOPRESSIN 4 MCG/ML INJ SOLN $256.75 70860-782-10 FOSAPREPITANT 150 MG IV SOLR $256.75 70069-471-01 LACOSAMIDE 200 MG/20 ML IV SOLN $256.75 70069-471-10 LACOSAMIDE 200 MG/20 ML IV SOLN $256.75 45802-056-35 GENTAMICIN 0.1 % TOPICAL CREAM $256.72 45802-046-35 GENTAMICIN 0.1 % TOPICAL OINT $256.72 0713-0682-15 GENTAMICIN 0.1 % TOPICAL OINT $256.72 0517-0955-01 OLANZAPINE 10 MG IM SOLR $256.69 HC62200332 BAG NEONATAL HYPERIFLATION $256.00 HC81700460 HEPATITIS A ANTIBODY $256.00 HC11500816 PEDS ASSESS ESTAB PT BRIEF 5MIN $256.00 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 HC84200526 E. COLI SHIGA-LIKE TOXIN ASSAY $255.00 HC81500738 FACTOR XIII SCREEN $255.00 HC81701898 HIV TYPE 1 OR 2ANTIBODY(RAPID) $255.00 HC62204417 KNIFE MICROSURGICAL $255.00 0409-1464-01 NALBUPHINE 10 MG/ML INJ SOLN $255.00 0407-1412-30 IOHEXOL 240 MG IODINE/ML IV SOLN $254.80 0407-1412-08 IOHEXOL 240 MG IODINE/ML IV SOLN $254.80 0069-0195-01 DALTEPARIN (PORCINE) 2,500 ANTI-XA UNIT/0.2 ML SUBCUTANEOUS SYRG $254.02 HC81700056 BETA-2 MICROGLOBULIN $254.00 HC81700510 HEPATITIS C AB $254.00 HC32001018 OT-MANUAL THER JOINT MOB/W $254.00 HC32000994 OT-MANUAL THER MYOFASC REL/W $254.00 99988-000-32 NM I-131 SODIUM IODIDE DIAGNOSTIC CAPSULE $253.64 71288-153-95 AZACITIDINE 100 MG/10ML INJ RECONSTITUTED VIAL (MHS) $253.50 0517-1980-05 DICYCLOMINE 10 MG/ML IM SOLN $253.50 0517-1980-01 DICYCLOMINE 10 MG/ML IM SOLN $253.50 63323-842-21 DICYCLOMINE 10 MG/ML IM SOLN $253.50 63323-842-02 DICYCLOMINE 10 MG/ML IM SOLN $253.50 70436-147-80 DICYCLOMINE 10 MG/ML IM SOLN $253.50 70436-147-81 DICYCLOMINE 10 MG/ML IM SOLN $253.50 0409-2347-32 DOBUTAMINE IN D5W 500 MG/250 ML (2,000 MCG/ML) IV SOLP $253.50 0409-2347-31 DOBUTAMINE IN D5W 500 MG/250 ML (2,000 MCG/ML) IV SOLP $253.50 HC84200583 CRYPTCOCCUS AB QNT BLOOD $253.00 HC81700445 HEPATITIS B CORE AB IGM $253.00 HC83506048 MORPH STDY CAT FISH EA MULTI PROBE - NG $253.00 HC83505875 MORPH STDY CAT FISH EA MULTI PROBE HER2-NG $253.00 HC83506261 MORPH STDY MANUAL FISH EA MULTI PROBE-NG $253.00 HC81100067 OSMOLALITY URINE $253.00 HC81701120 PARTICLE AGGLUT TITER EACH AB $253.00 54482-147-01 LEVOCARNITINE 200 MG/ML IV SOLN $252.69 70752-138-12 PROMETHAZINE 6.25 MG/5 ML ORAL SYRP $252.11 HC51070621 BEHAVIOR ADAPT TX ADMN QHCP EA 15MIN $252.00 HC62215272 BLADE SAW N $252.00 HC62214218 CATH URETERAL N $252.00 HC62202254 DEVICE INFLAT ENCORE D $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 HC51000123 VOIDING PRESSURE STUDIES+ $252.00 73302-456-01 ULIPRISTAL 30 MG ORAL TAB $251.88 HC89014898 CHROM ANAL-TISSUE-TISSU CUL-GZ $251.75 58914-501-56 MESALAMINE 1,000 MG RECTAL SUPP $251.72 50242-122-06 PIRFENIDONE 267 MG ORAL TAB $251.56 HC89024566 EPSTEIN BARR VIR DNA PCR-LC $251.21 HC11500006 EVAL EST PT BRIEF 5MIN $251.00 HC81700437 HEPATITIS B CORE AB, TOT $251.00 HC51001857 X-RAY ANKLE 3+ VWS $251.00 25021-671-82 ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJ SOLN $250.90 0065-0795-50 BALANCED SALT SOLN NO.2 IRRIG. INTRAOCULAR SOLN $250.25 16714-886-01 BLEOMYCIN 15 UNIT INJ SOLN (MCH) $250.19 HC89024764 AMPA RECEPTOR AB IGG CBA-IFA TITER CSF-AU $250.00 HC89016935 ANATOMIC CONSULT; CMPLX REV-JH $250.00 HC89014997 CHROM ANAL AF COUNTING-GZ $250.00 HC89024772 GABA-BR AB IGG CBA-IFA TITER CSF-AU $250.00 HC84200047 GRAM STAIN $250.00 HC84201177 GRAM STAIN (MHL) $250.00 HC81500548 HEMOLYSIN ACID $250.00 HC51010643 IMMNTX 5 STING INSECTS /COMM $250.00 HC89014187 MYELIN MOG AB W/ REFLEX TITER CBA-IFA-AU $250.00 HC84200765 SMEAR CELL TYPE $250.00 HC84200393 SPUTUM EVALUATION STAIN $250.00 HC83503920 TISSUE IN-SITU HYBRI INTER-US $250.00 0338-9791-01 NS IV AFTER MEDICATION INFUSION (TO FLUSH RESIDUAL MED) $250.00 47335-236-83 AMBRISENTAN 5 MG ORAL TAB $249.61 58160-825-43 HEPATITIS A VIRUS VACCINE (PF) 720 ELISA UNIT/0.5 ML IM SYRG $249.45 58160-825-52 HEPATITIS A VIRUS VACCINE (PF) 720 ELISA UNIT/0.5 ML IM SYRG $249.45 HC81100422 AMYLASE $249.00 HC89017479 FUNGUS SUSCEPTIBILITY-FT $249.00 386000404 NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRA $248.07 HC81500118 ACTIVATED COAG TIME $248.00 HC62229174 BOOT WLKNG AIR W/WO JNTS PREFB F $248.00 HC51004125 DIFFUSING CAPACITY+ /M $248.00 HC51061745 X-RAY SPINE 1 VIEW ANY LEVEL $248.00 51672-1298-2 KETOCONAZOLE 2 % TOPICAL CREAM $247.26 HC81701138 HEP A ANTIBODY IGM $247.00 HC31000904 PT-INITIAL EVAL ADDL 15MIN/CW $247.00 HC33010075 ST-EVAL SPEECH FLUENCY [15MIN] $247.00 69918-899-10 DESMOPRESSIN 4 MCG/ML INJ SOLN $247.00 69918-899-01 DESMOPRESSIN 4 MCG/ML INJ 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 0143-9511-01 ETOPOSIDE 20 MG/ML IV SOLN $247.00 81298-9655-1 NOREPINEPHRINE BITARTRATE-NACL 8 MG/250 ML (32 MCG/ML) IV SOLN $247.00 81298-9655-3 NOREPINEPHRINE BITARTRATE-NACL 8 MG/250 ML (32 MCG/ML) IV SOLN $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 HC34000497 AUDIOMETRY SELECT PICTURE $246.00 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 HC32000382 OT-RE-EVAL EST POC 15MIN $246.00 HC81500613 THROMBIN TIME $246.00 HC62226089 TIP SACRO SURG DISP $246.00 HC62207469 TRAY NASAL HEMORRHAGE $246.00 HC62207477 TRAY PARACERVICAL $246.00 0121-0854-16 SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG/5 ML ORAL SUSP $245.96 66689-063-01 PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2 MG-0.1037 MG/5 ML (5 ML) ORAL ELIX $245.70 HC51001865 X-RAY FOOT 3+ VWS $245.00 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 HC32001422 OT-COMMTY WK/REINTEGRAT 30M/CW $244.00 HC32000242 OT-EVAL LOW COMPLEXITY <20MF2F 15MIN $244.00 HC84200351 PARTICLE AGGLUTINATION EA AB $244.00 HC39001649 TELEPHONE F/U POST ED DISCHARGE BEHAVIOR/CRISIS, 4 CALLS PER MONTH $244.00 16714-973-02 PHYTONADIONE (VITAMIN K1) 5 MG ORAL TAB $243.83 63323-820-50 FAT EMUL-SOY-MCT-OLIV-FISH OIL 20 % IV EMUL $243.75 63323-820-03 FAT EMUL-SOY-MCT-OLIV-FISH OIL 20 % IV EMUL $243.75 14789-121-07 PAPAVERINE 30 MG/ML INJ SOLN $243.75 14789-121-05 PAPAVERINE 30 MG/ML INJ SOLN $243.75 55150-302-01 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN (PEDS SQ-IM) $243.75 99999-041-81 VANCOMYCIN IN NS 1750 MG/500 ML IV SOLN (MHS) $243.75 61703-326-18 PAMIDRONATE 90 MG/10 ML (9 MG/ML) IV SOLN $243.62 HC34000513 HEARING AID CHECK MONAURAL $243.60 0281-0326-30 NITROGLYCERIN 2 % TRANSDERMAL OINT $243.36 99999-011-09 ESTRADIOL VALERATE 20 MG/ML IM OIL $243.19 46287-024-10 POTASSIUM PHOSPHATE M-/D-BASIC 3 MMOL/ML (4.7 MEQ/ML) IV SOLN $243.07 46287-024-15 POTASSIUM PHOSPHATE M-/D-BASIC 3 MMOL/ML (4.7 MEQ/ML) IV SOLN $243.07 HC81500092 BLEEDING TIME $243.00 HC81500159 CBC W/O DIFF $243.00 HC29000577 PREVENTATIVE MED COUNSELING 45MIN $243.00 HC62211479 PROBE VASCULAR PARSONNET $243.00 HC81700643 PSA COMPLEXED $243.00 HC31000458 PT-RE-EVAL EST POC 15MIN $243.00 HC83000265 ROSETTE TEST,FETAL HGB $243.00 0023-6082-01 IRON DEXTRAN 50 MG/ML INJ SOLN $242.35 0023-6082-10 IRON DEXTRAN 50 MG/ML INJ SOLN $242.35 0409-4091-01 MANGANESE CHLORIDE 0.1 MG/ML IV SOLN $242.32 0075-2915-01 ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRG $242.24 HC36800464 BLOOD GAS O2 SAT ONLY $242.00 HC81700742 CRYPTOCUCCUS AG - SERUM $242.00 HC12200309 EXTENDED RECOVERY PER HOUR $242.00 HC84200989 FAT STAIN FECES QUAL $242.00 HC81700023 FTA ABSORPTION $242.00 HC81700452 HEPATITIS B SURFACE AB $242.00 HC81101388 HGB O2 AFFINITY $242.00 HC81701179 HIV 1 AB $242.00 HC89009401 ORGANIC ACIDS TOT QUANT UR-QD $242.00 HC32000838 OT-INITIAL EVAL ADD 15MIN/CW $242.00 HC81700494 VARICELLA AB $242.00 HC62217203 VEST SYSTEM OSCIL FREQU HI CHEST $242.00 HC62208921 DEVICE EXCHANGE CATH/WIRE $241.00 HC83504910 MORPH STDY CAT ISH/SPEC INTL SNGL PROBE HER2-NG $241.00 HC62205927 RESERVIOR JACKSON PRATT $241.00 64980-503-12 LEVOCARNITINE (WITH SUGAR) 100 MG/ML ORAL SOLN $240.84 16729-277-35 METHOTREXATE 25 MG/ML INJECTION (ECTOPIC PREGNANCY) $240.76 0065-0359-02 CYCLOPENTOLATE-PHENYLEPHRINE 0.2-1 % OPHT DROP $240.63 99999-047-21 ACETIC ACID (BULK) 5 % MISC LIQD $240.50 HC89018840 CHROM ANAL TISSUE POC-AU $240.00 HC84200096 KOH PREP $240.00 HC89024541 GROWTH STIMULATION EXPRESSED GENE ST2-VC $239.76 99999-041-18 FLUORESCEIN-PROPARACAINE 0.25-0.5 % OPHT DROP $239.53 HC77400190 ANESTHESIA LOCAL EA ADD 15MIN $239.00 HC81101321 BLOOD GAS O2 SAT ONLY $239.00 HC62224670 CATH SENSING PRESSUR INTRNL VESICAL $239.00 HC62221114 KIT PRESSURE MONITOR INTRACOMPRTMNT $239.00 HC32010159 OT-ORTHOTIC MGMT & TRNG INITIAL ENC 15MIN $239.00 HC32000358 OT-ORTHOTIC MGMT & TRNG INITIAL ENC 15MIN/M $239.00 HC31010135 PT-ORTHOTIC MGMT & TRNG INITIAL ENC 15MIN $239.00 HC31000425 PT-ORTHOTIC MGMT & TRNG INITIAL ENC 15MIN/M $239.00 10019-925-01 IFOSFAMIDE 1 GRAM IV SOLR $238.81 10019-925-82 IFOSFAMIDE 1 GRAM IV SOLR $238.81 0143-9531-01 IFOSFAMIDE 1 GRAM/20 ML IV SOLN $238.81 HC51060523 ST EVAL SOUND PRODUCTION/M $238.70 61703-408-41 METHOTREXATE 25 MG/ML INJECTION (ECTOPIC PREGNANCY) $238.68 67457-798-10 ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJ SOLN $238.55 67457-798-99 ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJ SOLN $238.55 HC62201926 COLLAR CERVICAL HARD $238.00 HC81702201 HIV 2 ANTIBODY $238.00 HC62215876 NEEDLE BIOPSY I $238.00 HC84201052 PARTICLE AGGLUTIN EA AB(PNL) $238.00 HC62215587 SUTURE I $238.00 70436-219-82 IOPAMIDOL 300 MG IODINE /ML (61 %) IV SOLN $237.90 70436-219-40 IOPAMIDOL 300 MG IODINE /ML (61 %) IV SOLN $237.90 HC89024517 PHOSPHOLIPASE A2 RECEPTOR IGG TITER-AU $237.50 0517-2502-01 CAFFEINE-SODIUM BENZOATE 250 MG/ML (125 MG/ML CAFFEINE) INJ SOLN $237.32 0517-2502-10 CAFFEINE-SODIUM BENZOATE 250 MG/ML (125 MG/ML CAFFEINE) INJ SOLN $237.32 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 HC47200738 M: UNLISTED BRACHY PROCEDURE $237.00 HC62212246 MARKER DEVICE BIOPSY $237.00 HC81100679 OSMOLALITY $237.00 HC51001832 X-RAY TIBULA + FIBULA, 2 VWS $237.00 0093-0262-15 FLUOCINONIDE 0.05 % TOPICAL CREAM $236.83 60505-6226-0 ATROPINE 1 % OPHT DROP $236.41 51672-4048-6 CLOTRIMAZOLE-BETAMETHASONE 1-0.05 % TOPICAL CREAM $236.05 HC89020069 LACTO TYPE (LCT)(CAT #6100-2013) -PR $236.00 HC31001084 PT-MANUAL THER MYOFASC REL/W $236.00 HC31001092 PT-MANUAL THER S0FT TIS MOB/W $236.00 HC81700502 THYROGLOBULIN AB $236.00 HC51001840 X-RAY ANKLE 2 VWS $236.00 HC51061901 X-RAY KNEE 1 OR 2 VWS $236.00 HC51061919 X-RAY LOWER EXTREMITY, INFANT MIN 2 VWS $236.00 16714-526-01 IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASL SPRY $235.56 16714-527-01 IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASL SPRY $235.27 386000802 NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRA $235.25 HC51062909 ADVANCE CARE PLAN 1ST 30MIN W/PAT FAM OR SURROGATE $235.06 HC51062867 ASSESSMENT & CARE PLAN PT COG IMP 60 MIN $235.06 HC51062495 PRINCIPAL CARE MGMT HI RISK D; 1ST 30 MIN, PER MONTH $235.06 HC51070738 PSY-BEHAVIOR ASSESS/RE-ASSESS $235.06 HC51070316 PSYCH GRP TX (NOT MULTI FAMILY) $235.06 HC51070324 PSYCH GRP TX(NOT MULTI FAMILY)90MIN $235.06 HC51070464 PSYCH HYPNOTHERAPY $235.06 HC51003499 SCREENING MISUSE BEHAVIORAL ETOH $235.06 HC34000026 AUDIOMETRY THRESHOLD $235.00 HC62201959 CONCHA COLUMN STANDARD $235.00 HC81100810 FAT STAIN URINE/FECES/SECRETNS $235.00 HC81101156 HEMOGLOBIN GLYCATED (A1C) $235.00 HC11500535 LACTATION E&M EST PT 20MIN $235.00 HC51020238 RN-DEVEL TEST PER STANDARD INSTRUMENT(SCREENING) $235.00 HC84200377 TISSUE PROCESS GRINDING $235.00 HC62207972 TUBING SILICON $235.00 HC51001733 X-RAY WRIST 2 VW $235.00 70954-316-10 FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSR $234.98 63323-401-20 AZTREONAM 1 GRAM INJ SOLR $234.52 63323-401-01 AZTREONAM 1 GRAM INJ SOLR $234.52 HC51060549 ST EVAL BEHAVRAL QUAL VOICE &RESONANCE/M $234.40 72603-264-01 ATROPINE 1 % OPHT DROP $234.39 51672-1302-0 TERCONAZOLE 0.8 % VAGINAL CREAM $234.13 HC51063071 DEBRIDE OF NAILS: 1-5 $234.00 HC81101834 HEPATITIS C VIRUS (DA) $234.00 HC36000693 RT-TEAM CONF W/MD >30MIN(NO PT) $234.00 HC51002806 STUDY REFLEX BLADDER URINARY $234.00 99999-046-27 CAFFEINE CITRATE 20 MG/ML ORAL SOLN (MHS) $234.00 69292-722-25 FLURBIPROFEN SODIUM 0.03 % OPHT DROP $234.00 0054-0045-44 IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASL SPRY $234.00 60505-0826-1 IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASL SPRY $234.00 0054-0046-41 IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASL SPRY $234.00 60505-0827-1 IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASL SPRY $234.00 64380-160-01 MEGESTROL 40 MG/ML ORAL SUSPENSION (MHS WRAPPER) $234.00 54288-137-25 PHENOBARBITAL SODIUM 130 MG/ML INJ SOLN $234.00 51672-1304-6 TERCONAZOLE 0.4 % VAGINAL CREAM $234.00 65862-048-24 ZIDOVUDINE 10 MG/ML ORAL SYRP $234.00 0093-3174-31 ALBUTEROL SULFATE 90 MCG/ACTUATION INHALATION HFAA $233.87 0781-7296-85 ALBUTEROL SULFATE 90 MCG/ACTUATION INHALATION HFAA $233.86 59676-562-01 DARUNAVIR 600 MG ORAL TAB $233.80 63629-2399-1 PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIX $233.66 64380-166-01 PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIX $233.66 0121-0942-16 PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIX $233.66 6025800116 SODIUM CITRATE-CITRIC ACID 500-334 MG/5 ML ORAL SOLN $233.66 5865731016 SODIUM CITRATE-CITRIC ACID 500-334 MG/5 ML ORAL SOLN $233.66 0121-1016-05 ATOVAQUONE 750 MG/5 ML ORAL SUSP $233.64 0121-1016-18 ATOVAQUONE 750 MG/5 ML ORAL SUSP $233.64 60219-1748-2 ATROPINE 1 % OPHT DROP $233.35 70756-651-25 ATROPINE 1 % OPHT DROP $233.35 11704-600-01 DIAZEPAM 5 MG/ML INJ SYRG $233.29 HC51002582 ANALYZ COMPLX NRSTM SPNL CD/PERIPH W/PROG $233.26 HC62808647 PESSARY RUBBER $233.00 43066-154-10 ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJ SOLN $232.70 43066-154-01 ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJ SOLN $232.70 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 HC62221585 VALVE HEMOSTATIC W/GUIDEWIRE $232.00 HC51003887 X-RAY FEMUR MIN 2 VIEWS $232.00 HC51001741 X-RAY HAND 2 VW $232.00 HC51001774 X-RAY PELVIS 1 OR 2 VWS $232.00 0143-9852-10 LEVOCARNITINE 200 MG/ML IV SOLN $231.86 0143-9852-01 LEVOCARNITINE 200 MG/ML IV SOLN $231.86 0517-1045-05 LEVOCARNITINE 200 MG/ML IV SOLN $231.86 16729-295-34 CARBOPLATIN 10 MG/ML IV SOLN $231.66 HC83504795 MORPH STDY CAT ISH QNT HER2-NG $231.00 HC83504803 MORPH STDY CAT ISH QNT/SPEC INTL SNGL PROBE CEP17-NG $231.00 121067616 POTASSIUM CITRATE-CITRIC ACID 1,100-334 MG/5 ML ORAL SOLN $230.59 HC89024798 LGI1 AB IGG CBA-IFA TITER CSF-AU $230.50 55150-308-01 OLANZAPINE 10 MG IM SOLR $230.36 0065-0396-02 CYCLOPENTOLATE 1 % OPHT DROP $230.30 HC81701807 HERPES I/II AB IGG $230.00 HC81701815 HERPES I/II AB IGM $230.00 HC81500571 OSMOTIC FRAGILITY UNINCUBATED $230.00 4056511182 BENZOIN TOPICAL TINC $229.33 40565-1118-28 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 HC51062800 COMPLEX CHRONIC CARE MGMT EA ADDL 30MIN, PER MO+ $229.00 HC32010332 OT-ONLINE ASSESS & MANAGMNT EST PT 11-20MIN $229.00 HC62801600 PEG REPLACEMENT $229.00 HC39001300 PSYCH/NEUROPSYCH TEST ADMIN SNGLE AUTO INSTRU VIA ELECTRONIC AUTO RESULT ON $229.00 HC31001100 PT-MANUAL THER JOINT MOB/W $229.00 HC31090152 PT-ONLINE ASSESS & MANAGMNT EST PT 11-20MIN $229.00 HC33010208 ST-ONLINE ASSESS & MANAGMNT EST PT 11-20MIN $229.00 HC51001675 X-RAY CLAVICLE $229.00 16729-512-05 ATROPINE 0.4 MG/ML INJ SOLN (MHS WRAPPER) $228.15 16729-512-43 ATROPINE 0.4 MG/ML INJ SOLN (MHS WRAPPER) $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 HC81701740 EBV AB TO NUCLEAR AG, IGG $228.00 HC11500477 LACTATION E&M NEW PT 15MIN $228.00 HC81100646 LDH $228.00 59651-420-11 SILDENAFIL (PULM.HYPERTENSION) 10 MG/ML ORAL SUSR $227.86 51672-4227-8 CLOBAZAM 2.5 MG/ML ORAL SUSP $227.76 59651-401-12 CLOBAZAM 2.5 MG/ML ORAL SUSP $227.76 70069-601-01 PROPARACAINE 0.5 % OPHT DROP $227.57 0121-0868-16 NYSTATIN 100,000 UNIT/ML ORAL SUSP $227.51 70436-155-42 PROMETHAZINE-DM 6.25-15 MG/5 ML ORAL SYRP $227.51 65162-680-90 PROMETHAZINE-DM 6.25-15 MG/5 ML ORAL SYRP $227.51 64679-604-16 PROMETHAZINE-DM 6.25-15 MG/5 ML ORAL SYRP $227.51 47335-289-40 CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) IV SOLN $227.51 0781-7135-93 MOXIFLOXACIN 0.5 % OPHT DROP $227.51 24571-113-06 BICARB DIAL SOLN13-NO CA,K,DEX MG 1.2 MEQ/L 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 24571-102-06 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 0143-9098-01 BORTEZOMIB 3.5 MG INJ SOLR $227.50 99999-041-40 CHLORHEXIDINE GLUCONATE 0.05% IN STERILE WATER FOR IRRIGATION $227.50 71921-226-10 DORZOLAMIDE-TIMOLOL 22.3-6.8 MG/ML OPHT DROP $227.50 0143-9086-01 DOXORUBICIN 2 MG/ML IV SOLN (MCH) $227.50 45963-733-68 DOXORUBICIN 50 MG/25 ML IV SOLN $227.50 39822-1100-1 FOLIC ACID 5 MG/ML INJ 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 99999-044-49 NOREPINEPHRINE BITARTRATE-NACL 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 25021-453-01 OCTREOTIDE ACETATE 500 MCG/ML INJ SOLN $227.50 68462-897-01 OCTREOTIDE ACETATE 500 MCG/ML INJ SOLN $227.50 68462-897-10 OCTREOTIDE ACETATE 500 MCG/ML INJ SOLN $227.50 0703-4094-01 PALONOSETRON 0.25 MG/5 ML IV SOLN $227.50 0781-3312-75 PALONOSETRON 0.25 MG/5 ML IV SOLN $227.50 70860-785-05 PALONOSETRON 0.25 MG/5 ML IV SOLN $227.50 HC51020287 NP EST PT EVAL 10MIN $227.48 HC51020295 NP EST PT EVAL 20MIN $227.48 HC51020337 NP NEW PT EVAL 15MIN $227.48 HC51020345 NP NEW PT EVAL 30MIN $227.48 HC62203658 KIT ACCESSORY & LAPAROSCOPIC $227.00 HC62207717 TUBE MYRINGOTOMY $227.00 HC51002558 REMOV IMPACTD EAR WAX IRRIG/LAVG BI $226.41 HC51004158 REMOV IMPACTD EAR WAX(INSTRUMENT) BI (NO MOD50) $226.41 386000803 NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRA $226.20 HC84200492 ENTAMOEBA HISTO AG(DISPAR) $226.00 HC84201078 ENTAMOEBA HISTOL AG $226.00 HC32000929 OT-TREATMENT ADD 15 MIN/CW $226.00 HC81500076 PROTHROMBIN TIME $226.00 HC31001878 PT-AQUATIC THERAPY ADD15MIN/CW $226.00 HC31000912 PT-RE-EVAL ADDL 15MIN/CW $226.00 HC81700197 T4 FREE $226.00 0173-0735-00 SUMATRIPTAN SUCCINATE 25 MG ORAL TAB $225.79 0078-0467-61 DEFEROXAMINE 500 MG INJ SOLR $225.75 0078-0467-91 DEFEROXAMINE 500 MG INJ SOLR $225.68 0006-0227-61 RALTEGRAVIR 400 MG ORAL TAB $225.68 HC89023725 HIV-1 DNA PCR QUAL-QN $225.60 43066-150-10 AMIODARONE IN D5W 150 MG/100 ML (1.5 MG/ML) IV SOLN (MHS) $225.55 HC51061687 3D RENDER W/O INDENDNPT WORKSTN $225.00 HC83502252 ANATOMIC CONSULT; SLIDE REV-JH $225.00 HC89024236 ANSER ADA MEAS ABS ADALIMUMAB(ATI)-PR $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 HC89024871 CV2 AB IGG CBA-IFA TITER CSF-AU $225.00 HC51062115 GENETIC COUNSELING 30 MIN $225.00 HC89000038 HLA TYPING-U2 $225.00 HC51061679 MYOCARDIAL STRAIN QUANT ASSESS+ $225.00 HC89022727 NBS TESTS PANEL NEWBORN METABLC SCRNING-GE $225.00 HC51060085 OT-EVAL+REPORT INITIAL 30 MIN/C $225.00 HC62208491 PAD EXTERNAL CLOSURE $225.00 HC51062503 PRINCIPAL CARE MGMT HI RISK D; EA ADDL 30MIN, PER MO+ $225.00 HC33010083 ST-EVAL BEHAVRAL QUAL VOICE [15MIN] $225.00 HC51061885 X-RAY SHOULDER; 1 VW $225.00 63323-412-10 MIDAZOLAM 5 MG/ML INJ SOLN $224.90 63323-412-13 MIDAZOLAM 5 MG/ML INJ SOLN $224.90 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 HC89005086 INFECT AGNT-VARIC ZSTR PCR-FT $224.00 HC62224803 KIT REPAIR CATH DIALYSIS PERITONEAL $224.00 HC62204664 MAGNET DEVICE $224.00 HC62215777 PIN/WIRE FIXATION TEMPORARY M $224.00 HC51070597 PSYCH/NEUROPSYCH TEST ADMIN & SCORING, 2 OR > TESTS; 1ST 30 MIN $224.00 HC62217765 TEMPLATE ORTHO/ROD SPINAL D $224.00 HC62209770 TRANSCUTANEOUS MNTR SUPPLIES $224.00 HC62216775 TUBING IRRIGATION D $224.00 HC51060713 OT-EVAL LOW COMPLEXITY 20MF2F 30MIN $223.78 HC51001709 X-RAY ELBOW 2 VW $223.76 HC51001725 X-RAY FOREARM 2 VW $223.76 HC51061752 X-RAY SPINE CERVICAL; 2 OR 3VWS $223.76 HC51061810 X-RAY SPINE ENTIRE SKULL-SACRUM 1 VIEW $223.76 HC51061802 X-RAY SPINE THORACOLUMBAR JUNCTN MIN 2 VWS $223.76 67877-732-95 LACOSAMIDE 10 MG/ML ORAL SOLN $223.60 HC89014963 15-20 CELLS, 2 KARYO,BAND-GZ $223.25 HC81700650 ANA TITER $223.00 HC62205109 CABLE PACER DISP C $223.00 HC62202007 CO-SET CARDIAC OUTPUT $223.00 HC51070746 PSY-BEHAVIOR TX INDIV 1ST 30 MIN $223.00 HC31001480 PT-THER PROC GRP 45MIN/MC $223.00 HC81500886 RETICULOCYTE MULTI PARAMETERS $223.00 HC62206297 SET LACRIMAL INTUBATION $223.00 HC81700775 THYROID PEROXIDASE AB BY EIA $223.00 HC89018832 CHROM ANAL 15-20 CELLS, POC-AU $222.50 0406-9915-01 TEMAZEPAM 7.5 MG ORAL CAP $222.46 63323-265-30 METHYLPREDNISOLONE SODIUM SUCC 1,000 MG IV SOLR $222.43 51672-1300-5 AMMONIUM LACTATE 12 % TOPICAL LOTN $222.30 HC81700262 ANTI-NUCLEAR AB EIA $222.00 HC89001333 LOXAPINE & METABOLITE-AU $222.00 HC32001091 OT-DEV COGNITIV SKLL ADD15M/CW $222.00 HC51070522 PSY TM CONF W/MD 30/+MIN(ØPT) $222.00 HC42000596 WCH EST PT EVAL BRIEF 5MIN $222.00 HC81500027 PLATELET COUNT- AUTO $221.00 HC81100992 URINALYSIS NON-AUTO W/O MICRO $221.00 0264-4460-10 FAT EMULSION 20 % IV (FOR LIPID RESCUE) $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 0409-0829-01 AZTREONAM 1 GRAM INJ SOLR $220.94 0409-0829-11 AZTREONAM 1 GRAM INJ SOLR $220.94 42571-141-26 DORZOLAMIDE 2 % OPHT DROP $220.94 24208-485-10 DORZOLAMIDE 2 % OPHT DROP $220.94 0270-7020-38 GADOPICLENOL 0.5 MMOL/ML IV SOLN $220.33 67877-539-14 TEMOZOLOMIDE 100 MG ORAL CAP $220.19 HC27001940 BIOFEEDBACK PERINEAL MSCLS W/EMG&/MNMTRY F2F ADD'L 15MIN+ $220.00 HC81701757 EBV AB TO EARLY (D) AG, IGG $220.00 HC89022693 HLA CLASS II TYPING LOW RES HLA-DRB1/3/4/5&-DQB1-U9 $220.00 HC32001448 OT-WD SEL DEBRID<20CM 15MIN+/C $220.00 HC81101875 PREGNANCY, HCG-UR (DA) $220.00 HC62222815 SCISSORS ENDOSCOPIC D $220.00 HC33000688 ST-SPEECH THERAPY GRP 15MIN/MW $220.00 HC51070696 PSY-TEST COGNITIVE PERFORMANCE STDRD PER HOUR $219.56 0781-3040-95 PYRIDOSTIGMINE BROMIDE 5 MG/ML INJ SOLN $219.44 0781-3040-72 PYRIDOSTIGMINE BROMIDE 5 MG/ML INJ SOLN $219.44 67877-539-07 TEMOZOLOMIDE 100 MG ORAL CAP $219.05 HC81500233 BLOOD COUNT/WBC (EOS) $219.00 HC84200567 CONCENTRATION AFB/TB/MYCOBACTERIA $219.00 HC81500977 HEMOGLOBIN GLYCATED (A1C) $219.00 HC31001654 PT-WD SEL DEBRID<20CM 15MIN+/C $219.00 HC31001662 PT-WD SEL DEBRID>20CM 15MIN+/C $219.00 HC51003879 X-RAY FEMUR 1 VIEW $219.00 HC51061927 X-RAY FOOT 2 VWS $219.00 0409-1273-32 DIAZEPAM 5 MG/ML INJ SYRG $218.80 0409-1273-03 DIAZEPAM 5 MG/ML INJ SYRG $218.80 45802-055-05 TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINT $218.37 63323-123-10 METHOTREXATE SODIUM 25 MG/ML INJ SOLN $218.34 43598-605-11 TOBRAMYCIN IN 0.225 % NACL 300 MG/5 ML INHALATION NEBU $218.21 43598-605-58 TOBRAMYCIN IN 0.225 % NACL 300 MG/5 ML INHALATION NEBU $218.21 0264-3125-11 CEFOXITIN IN DEXTROSE, ISO-OSM 2 GRAM/50 ML IV PGBK $218.01 HC62209747 CIRCUIT VENT HBO ADAPTABLE $218.00 HC81500506 COAG TIME OTHER METHODS $218.00 HC81101255 C-REACTIVE PROTEIN HI SENS $218.00 HC14500094 DIABETIC SELF MGMT TRN GRP 30M $218.00 HC62202056 KIT BIOPSY GUN $218.00 HC84200476 OB FECAL IMM ASSAY QUAL 1-3 DX $218.00 HC32000135 OT-FUNCTIONAL ACTIVITY 15MIN $218.00 HC62219530 PASSER SUTURE E $218.00 HC31000052 PT-AQUATIC THERAPY 15MIN/M $218.00 HC84200625 SPECIAL STAIN THICK $218.00 HC81500209 THICK SMEAR, BLOOD PARASITES $218.00 62756-826-40 DOXORUBICIN 50 MG/25 ML IV SOLN $217.75 HC51060697 PT-EVAL LOW COMPLEXITY 20MF2F 30MIN $217.60 65862-840-03 MOXIFLOXACIN 0.5 % OPHT DROP $217.56 HC83505651 KRAS GENE ADDL VARIANTS-NG $217.50 HC83505644 KRAS MUT ANALSYS VARIANTS EXONS 2-NG $217.50 0781-3210-46 CEFTRIAXONE 10 GRAM INJ SOLR $217.49 HC89005516 ASPERGILLUS ANTIGEN-FT $217.00 HC81500282 BUFFY COAT $217.00 HC81500225 CELL COUNT CORD BLOOD $217.00 HC32001703 OT-AQUATIC THERAPY 15MIN/M $217.00 HC31010184 PT-BIOFEEDBACK PERINEAL MSCLS W/EMG&/MNMTRY F2F ADD'L 15MIN+ $217.00 HC31000201 PT-THER ACTIVITIES 15MIN/M $217.00 99999-047-14 POVIDONE-IODINE (PV-I) (SURGIPHOR) IRRIGATION SOLUTION $217.00 62144-5510-5 ARTIFI.TEARS(HYPROMELLOSE)(PF) 1.7 % OPHT DRPA $216.78 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 63323-883-30 DOXORUBICIN 2 MG/ML IV SOLN (MCH) $216.61 63323-010-20 GENTAMICIN 40 MG/ML INJ SOLN $216.58 63323-010-03 GENTAMICIN 40 MG/ML INJ SOLN $216.58 0338-0108-20 NOREPINEPHRINE BITARTRATE-D5W 8 MG/250 ML (32 MCG/ML) IV SOLN $216.13 0703-3678-01 METHOTREXATE 25 MG/ML INJECTION (ECTOPIC PREGNANCY) $216.06 HC51063105 AVULSION OF NAIL, SIMPLE; EA ADDL' $216.00 HC51062826 COMPRE ASSESS&CARE PLAN CHRONIC CARE MGMT+ $216.00 HC34000307 ELECTROACOUSTIC EVAL FOR HEARING AID; BIAURAL $216.00 HC65800005 IODINE-125 NONSTRND PER SOURCE $216.00 HC51060051 PT-TEST&MEASUREMENT 1ST30MIN/C $216.00 HC33000787 ST-DYSPHAGIA SCREENING/IP $216.00 HC33000795 ST-LANGUAGE SCREENING/IP $216.00 HC33000803 ST-SPEECH SCREENING/IP $216.00 HC89021554 THIOPURINE METABOL(CAT#3200)-PR $216.00 HC51063162 TRIMMING NONDYSTROPHIC NAILS $216.00 HC34000398 UNLISTED ENT PROCEDURE/SERVICE $216.00 62756-513-44 LEVETIRACETAM 500 MG/5 ML IV SOLN $215.93 62756-513-40 LEVETIRACETAM 500 MG/5 ML IV SOLN $215.93 0173-0547-00 ATOVAQUONE 750 MG/5 ML ORAL SUSP $215.51 63323-136-10 BLEOMYCIN 15 UNIT INJ SOLR $215.28 0641-1398-35 CHLORPROMAZINE 25 MG/ML INJ SOLN $215.16 0641-1398-31 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 HC84200310 CULTURE TYPE AGGLUTINATION EA $215.00 HC81500902 HEPARIN PROTAMINE TOLERANCE $215.00 HC62213715 NEEDLE MICROTIP/TIP PHACOEMULS $215.00 HC81701609 RUBELLA AB IGG $215.00 0143-9006-01 ACETAZOLAMIDE SODIUM 500 MG INJ SOLR $214.50 45802-129-35 HALOBETASOL PROPIONATE 0.05 % TOPICAL CREAM $214.50 63739-997-64 LIDOCAINE HCL 4 % (40 MG/ML) MUCOUS MEMB SOLN $214.50 0009-5140-01 LINEZOLID 600 MG/300 ML IV SOLP (MCH) $214.50 0009-5140-04 LINEZOLID 600 MG/300 ML IV SOLP (MCH) $214.50 76329-3369-1 NALOXONE 1 MG/ML INJ SYRG $214.50 63323-229-35 PROTAMINE 10 MG/ML IV SOLN $214.34 70257-562-11 BACLOFEN 50 MCG/ML INTRATHECAL SOLN $214.31 70257-562-55 BACLOFEN 50 MCG/ML INTRATHECAL SOLN $214.31 70121-2496-5 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 HC51010635 IMMNTX 4 STING INSECTS /COMM $214.00 HC11500527 LACTATION E&M EST PT 10MIN $214.00 HC82202649 MISC PATHOLOGY-SOF(CLIENT BILL $214.00 HC32001786 OT-DYSPHAGIA SCREENING/IP $214.00 HC62221270 POSITIONER FLUIDIZED FULL BODY PEDS $214.00 HC81701377 PSA SCREENING $214.00 HC81101495 URINALYSIS MICROSCOPIC ONLY $214.00 38779-0598-5 IODINE-POTASSIUM IODIDE 5-10 % TOPICAL SOLN $213.85 44567-402-06 MEROPENEM 2 GRAM IV SOLR $213.85 44567-402-01 MEROPENEM 2 GRAM IV SOLR $213.85 66689-203-08 ACTIVATED CHARCOAL-SORBITOL 50 GRAM/240 ML ORAL SUSP $213.72 68516-5214-5 ALBUMIN, HUMAN 5 % 5 % IV SOLP $213.20 68516-5214-6 ALBUMIN, HUMAN 5 % 5 % IV SOLP $213.20 72266-160-10 ZIPRASIDONE MESYLATE 20 MG/ML (FINAL CONC.) IM SOLR $213.14 72266-160-01 ZIPRASIDONE MESYLATE 20 MG/ML (FINAL CONC.) IM SOLR $213.14 HC81101487 ALBUMIN; OTHER SOURCE $213.00 HC62203138 ET SET COLO/ILEO $213.00 HC89003628 NITROGEN URINE-AU $213.00 HC32010092 OT-EVAL HIGH COMPLEXITY 60MIN [15MIN] $213.00 HC32000846 OT-RE-EVAL ADDL 15MIN/CW $213.00 72205-205-07 ZIPRASIDONE MESYLATE 20 MG/ML (FINAL CONC.) IM SOLR $212.55 72205-205-01 ZIPRASIDONE MESYLATE 20 MG/ML (FINAL CONC.) IM SOLR $212.55 0006-3516-59 IMIPENEM-CILASTATIN 500 MG IV SOLR $212.23 72572-805-01 VANCOMYCIN 10 GRAM IV SOLR $212.23 HC81701633 KAPPA FREE LIGHT CHAINS QT $212.00 HC81701641 LAMBDA FREE LIGHT CHAINS QT $212.00 HC32010084 OT-EVAL MOD COMPLEXITY 45MIN F2F [15MIN] $212.00 HC32000549 OT-THER EXER 15MIN/M $212.00 HC32001364 OT-THER PROC GRP 45MIN/M $212.00 HC31000615 PT-THER EXER 15MIN/M $212.00 68968-0514-8 ESTRADIOL-NORETHINDRONE ACET 0.05-0.14 MG/24 HR TRANSDERMAL PTTW $211.54 68968-0514-1 ESTRADIOL-NORETHINDRONE ACET 0.05-0.14 MG/24 HR TRANSDERMAL PTTW $211.54 68968-0525-1 ESTRADIOL-NORETHINDRONE ACET 0.05-0.25 MG/24 HR TRANSDERMAL PTTW $211.54 68968-0525-8 ESTRADIOL-NORETHINDRONE ACET 0.05-0.25 MG/24 HR TRANSDERMAL PTTW $211.54 0009-0760-04 CLINDAMYCIN PALMITATE 75 MG/5 ML ORAL SOLR (MCH) $211.25 0990-8004-15 DEXTROSE 30 % IN WATER (D30W) IV SOLP $211.25 43598-130-74 METHYLPREDNISOLONE SODIUM SUCC 1,000 MG IV SOLR $211.25 54288-142-10 PAPAVERINE 30 MG/ML INJ SOLN $211.25 54288-142-01 PAPAVERINE 30 MG/ML INJ SOLN $211.25 70756-629-25 PHENYLEPHRINE HCL 2.5 % OPHT DROP $211.25 75907-129-07 PHENYLEPHRINE HCL 2.5 % OPHT DROP $211.25 72603-520-01 PHENYLEPHRINE HCL 2.5 % OPHT DROP $211.25 HC62200720 BOTTLE DRAIN DBL DUAL LUMEN $211.00 HC82202912 IMMUNOCYTOCHEMICAL STAIN $211.00 HC81500316 MANUAL CELL COUNT RED/LEUK/PLT $211.00 HC32000150 OT-GAIT TRAINING 15MIN/M $211.00 HC62205539 PAD ACRYLON $211.00 HC84600071 PAP SMEAR PATH INTERP+ $211.00 HC31010077 PT-EVAL HIGH COMPLEXITY 45M F2F [15MIN] $211.00 HC31000227 PT-GAIT TRAINING 15MIN/M $211.00 HC84200559 SHIGELLA TOXIN BY IMM $211.00 HC84200542 SHIGELLA TOXIN BY IMMUNOASSAY $211.00 45802-419-26 AMMONIUM LACTATE 12 % TOPICAL LOTN $210.60 16729-288-38 CISPLATIN 1 MG/ML IV SOLN $210.60 0409-1144-02 VERAPAMIL 2.5 MG/ML IV SOLN $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 HC83000141 BLOOD TYPE SEROLOGIC; ABO $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 HC62807946 FIBRIN SEALANT D $210.00 HC62228044 GRASPER ENDO $210.00 HC62226709 GUIDE DRILL E $210.00 HC82202946 H&E FROM BLOCK $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 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 HC32010258 OT-AQUATIC THERAPY 15MIN $210.00 HC32000945 OT-NEUROMUSC RE-ED ADD15MIN/CW $210.00 HC62223813 PACKING NASAL E $210.00 HC62227830 POSITIONER FLUIDIZED LARGE $210.00 HC62205877 PROBE RECTAL/ESOPHAGEAL $210.00 HC31010218 PT-AQUATIC THERAPY 15MIN $210.00 HC31010028 PT-EVAL MOD COMPLEXITY 30M F2F [15MIN] $210.00 HC31000995 PT-PHYS MED TX ANY ADDL 15MIN/CW $210.00 HC31001449 PT-TEST/MEASUREMENT ADD15MIN/C $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 69945-601-10 SODIUM IODIDE-123 3.7 MBQ (100 MICROCI) ORAL CAP $210.00 0517-5601-25 HYDROXYZINE HCL 50 MG/ML IM SOLN $209.69 0517-5601-01 HYDROXYZINE HCL 50 MG/ML IM SOLN $209.69 48433-230-15 IODINE STRONG (LUGOLS) 5 % ORAL SOLN $209.66 HC62203245 EVACUATOR ELLIK $209.00 HC32000002 OT-ADL 15MIN $209.00 HC32001463 OT-WOUND VAC 15MIN>50 SQ CM+/C $209.00 HC31000003 PT-SELF/HOME MGMT/ADL 15MIN/M $209.00 HC35000074 REC' THER' TX ADD'L 15 MIN $209.00 HC62207907 TUBING MICRODEBRIDER $209.00 HC81500944 URINALYSIS NON-AUTO W/O MICRO $209.00 HC89024780 CASPR2 AB IGG CBA-IFA TITER CSF-AU $208.75 99999-044-53 VANCOMYCIN IN NS 1.5 GRAM/300 ML IV SOLN (MHS) $208.65 60505-1003-1 KETOROLAC 0.5 % OPHT DROP $208.39 47335-220-90 KETOROLAC 0.5 % OPHT DROP $208.33 0548-5608-00 ENOXAPARIN 100 MG/ML SUBCUTANEOUS SOLN (MCH) $208.01 68001-464-41 ENOXAPARIN 100 MG/ML SUBCUTANEOUS SOLN (MCH) $208.01 71288-426-03 ENOXAPARIN 100 MG/ML SUBCUTANEOUS SOLN (MCH) $208.01 HC81100349 ACETONE $208.00 HC81100661 MAGNESIUM $208.00 HC32000226 OT-HUBBARD TANK 15MIN/M $208.00 HC32000317 OT-MANUAL THERAPY 15MIN/M $208.00 HC31000292 PT-HUBBARD TANK 15MIN/M $208.00 HC31000383 PT-MANUAL THERAPY 15MIN/M $208.00 HC51001766 X-RAY EXAM OF FINGERS MIN 2 VWS $208.00 0143-9525-01 DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN $208.00 0143-9525-10 DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN $208.00 64679-465-50 LIDOCAINE HCL 4 % (40 MG/ML) MUCOUS MEMB SOLN $208.00 64679-465-51 LIDOCAINE HCL 4 % (40 MG/ML) MUCOUS MEMB SOLN $208.00 0054-3555-63 METHADONE 5 MG/5 ML ORAL SOLN $208.00 0406-6225-05 METHADONE 5 MG/5 ML ORAL SOLN $208.00 0941-0409-06 PERIT.DIALYSIS 6-1.5 % DEXTROS CA 2.5 MEQ/L- MG 0.5 MEQ/L IP SOLN $208.00 0121-0654-02 FLUPHENAZINE HCL 2.5 MG/5 ML ORAL ELIX $207.87 HC89018667 CHROM COUNT 6-12 CELLS, AF-AU $207.00 HC13500053 GENETIC COUNSEL 15MIN CMRCL/C $207.00 HC83503821 IF STUDY DIRECT PROF 1ST STAIN-CS $207.00 HC81100109 LDL CHOLESTEROL DIRECT $207.00 HC83506303 NRAS FULL GENE SEQ MOLECUL PATH UNLISTED-NG $207.00 HC32010076 OT-EVAL LOW COMPLEXITY 30MIN F2F [15MIN] $207.00 HC32000333 OT-NEUROMUSC RE-ED 15MIN/M $207.00 HC32010050 OT-THER EXER 15MIN $207.00 HC31000409 PT-NEUROMUSC RE-ED 15MIN/M $207.00 HC31010051 PT-THER EXER 15MIN $207.00 HC62207808 TUBING ARTHROSCOPIC PUMP $207.00 HC62218011 TUBING SET OPHTH INJECT/EXTRACT $207.00 66794-235-02 DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN $206.70 66794-235-41 DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN $206.70 0024-2792-10 NA FERRIC GLUC CPLX IN SUCROSE 12.5 MG/ML IV SOLN (MCH) $206.70 0143-9570-10 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 0024-2792-01 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 0409-4092-11 CUPRIC CHLORIDE 0.4 MG/ML IV SOLN $206.12 0409-4092-01 CUPRIC CHLORIDE 0.4 MG/ML IV SOLN $206.12 25021-460-01 DESMOPRESSIN 4 MCG/ML INJ SOLN $206.05 65219-531-10 FAT EMULSION (INTRALIPID, LIPOSYN) 20% (NICU) (OCM) $206.05 65219-531-01 FAT EMULSION (INTRALIPID, LIPOSYN) 20% (NICU) (OCM) $206.05 HC32000044 OT-COMMTY WK/REINTEGRAT 15M/M $206.00 HC32010043 OT-FUNCTIONAL ACTIVITY 15MIN $206.00 HC32010019 OT-SELF/HOME MGMT/ADL 15MIN $206.00 HC32001307 OT-THER PROC GRP 45MIN/MC $206.00 HC31000144 PT-COMMTY WK/REINTEGRT 15M/M $206.00 HC31010069 PT-EVAL LOW COMPLEXITY 20MIN F2F [15MIN] $206.00 HC31010036 PT-GAIT TRAINING 15MIN $206.00 HC31010002 PT-SELF/HOME MGMT/ADL 15MIN $206.00 HC31010044 PT-THER ACTIVITIES 15MIN $206.00 HC62206099 SET ANCHOR GASTROINTESTINAL $206.00 HC62208145 VALVE PEEP $206.00 69315-504-47 NYSTATIN 100,000 UNIT/ML ORAL SUSP $205.99 99999-047-58 CARDIOPLEGIC SOLUTION NO.35 26 MEQ/1,052.8 ML (POTASSIUM) PERF SOLN $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 HC39001326 BEHAVIOR ADAPT TX ADMN QHCP EA 15MIN $205.00 HC89008940 BILE ACID FRACTIONATED-AU $205.00 HC81101073 CERULOPLASMIN $205.00 HC62202494 DRESSING INTERDRY AG PKG $205.00 HC32010035 OT-NEUROMUSC RE-ED 15MIN $205.00 HC51070282 PSY-DEVEL TEST PER STANDARD INSTRUMENT(SCREENING) $205.00 HC31010010 PT-NEUROMUSC RE-ED 15MIN $205.00 0517-2325-10 IRON SUCROSE 50 MG IRON/2.5 ML IV SOLN $204.95 99999-041-53 NM TC-99M MEBROFENIN MHS $204.86 HC51070688 PSY-ASSESS APHASIA W/REPORT PER HOUR $204.84 39822-0190-1 ACETAZOLAMIDE SODIUM 500 MG INJ SOLR $204.75 0641-6205-01 NALOXONE 1 MG/ML INJ SYRG $204.75 0641-6205-10 NALOXONE 1 MG/ML INJ SYRG $204.75 55150-345-01 NALOXONE 1 MG/ML INJ SYRG $204.75 55150-345-10 NALOXONE 1 MG/ML INJ SYRG $204.75 72603-181-01 OLANZAPINE 10 MG IM SOLR $204.43 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 HC32000861 OT-ELEC STIM/TENS ATT ADD15/CW $204.00 HC32001034 OT-ORTHOTIC FIT/TRNG ADD15M/CW $204.00 HC62801782 RING FALLOPIAN $204.00 HC81500605 SICKLE CELL SCREEN $204.00 HC62207956 TUBING SCD $204.00 HC81100802 URINALYSIS AUTO W/O MICRO $204.00 0023-6151-08 PROGESTERONE MICRONIZED 8 % VAGINAL GEL $203.93 0023-6151-09 PROGESTERONE MICRONIZED 8 % VAGINAL GEL $203.93 0409-9094-41 FENTANYL (PF) 50 MCG/ML INJ FOR INTRATHECAL PAIN PUMP REFILL (OCM) $203.78 99999-044-72 FENTANYL 50 MCG/ML DRIP (MHS) $203.78 0409-9094-61 FENTANYL CITRATE (PF) 0.05 MG/ML INJ SOLN (MCH) $203.78 43598-750-11 NALOXONE 1 MG/ML INJ SYRG $203.78 43598-750-58 NALOXONE 1 MG/ML INJ SYRG $203.78 67457-992-02 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 67386-314-01 CLOBAZAM 10 MG ORAL TAB $203.50 0517-0740-01 METHYLERGONOVINE 0.2 MG/ML (1 ML) INJ SOLN $203.32 0517-0740-20 METHYLERGONOVINE 0.2 MG/ML (1 ML) INJ SOLN $203.32 HC13500012 GENETIC CNSL RISK REDCTN 15MIN $203.00 HC81100125 GLUCOSE FLUID/URINE $203.00 HC32001075 OT-FUNC ACTIVITY ADDL 15MIN/CW $203.00 HC32001240 OT-GAIT TRAINING ADD 15MIN/CW $203.00 HC31001183 PT-ADL ADD 15MIN/CW $203.00 HC31000938 PT-ELEC STIM/TENS ATT ADD15/CW $203.00 HC31001167 PT-FUNC ACTIVITY ADDL 15MIN/CW $203.00 HC89500680 PLATELET ANTIBODY ID -SB $202.80 63323-407-03 CAFFEINE CITRATE 20 MG/ML INJ SOLN (MCH) $202.35 HC65800062 BRACHY SEED IRIDIUM-192\NON HI $202.00 HC32001919 OT - RANGE OF MOTION MEASUREMENTS $202.00 HC32000341 OT-ORTHOTIC/PROSTH MGMT/TRAIN SUBSQ 15MIN/M $202.00 HC31000078 PT-AQUATIC GRP 45MIN/M $202.00 HC31000417 PT-ORTHOTIC/PROSTH MGMT/TRAIN SUBSQ 15MIN/CMW $202.00 99999-045-49 ETHYL ALCOHOL (BULK) MISC LIQD $201.50 0591-3128-79 PROGESTERONE 50 MG/ML IM OIL $201.50 75907-025-11 CLONIDINE 0.3 MG/24 HR TRANSDERMAL PTWK $201.37 75907-025-48 CLONIDINE 0.3 MG/24 HR TRANSDERMAL PTWK $201.37 HC12600003 IMMUNIZATION ADMIN SINGLE $201.00 HC11500469 LACTATION E&M EST BRIEF 5MIN $201.00 HC83504829 MORPH STDY MAN ISH QNT HER2-NG $201.00 HC83504811 MORPH STDY MAN ISH QNTCEP17-NG $201.00 HC39000765 PSYCH TEACH/COUNSEL INDIVIDUAL -COMM $201.00 HC31001035 PT-GAIT TRAINING ADD 15MIN/CW $201.00 HC31001688 PT-WOUND VAC 15MIN>50 SQ+/C $201.00 0009-0323-01 GELATIN SPONGE,ABSORB-PORCINE 50 TOPICAL SPGE $200.71 0270-0149-60 DIATRIZOATE MEGLUMINE 30 % URETHRAL SOLN $200.20 HC83500322 BM: CHROMOSOME ANALYSIS-GZ $200.00 HC89024020 CALR MUT ANALYSIS-AU $200.00 HC62222716 CANNULA PERFUSION ARTRL/VENOUS B $200.00 HC62224696 CATH EP DIAG/ABLAT 3D/VECT $200.00 HC62223425 CATH EP DX <20 ELECTRODES D $200.00 HC51071090 ECHO 3D RENDERING FOR TEE/TTE+ $200.00 HC62222849 INFLATOR FOR BALLOON F $200.00 HC62204680 MASK BIPAP/CPAP $200.00 HC83505685 PD-L1 IHC QNT-NG $200.00 HC31010143 PT-MANUAL THERAPY 15MIN $200.00 HC35000173 REC-COMMTY WK/REINTEGRAT 15M $200.00 HC62207444 TRAY MYELOGRAM DISP $200.00 HC81500167 WBC MANUAL DIFF $200.00 0517-0735-10 NICARDIPINE 25 MG/10 ML IV SOLN $199.81 0517-0735-01 NICARDIPINE 25 MG/10 ML IV SOLN $199.81 0143-9505-01 CISPLATIN 1 MG/ML IV SOLN $199.55 71288-106-10 BLEOMYCIN 15 UNIT INJ SOLR $199.42 25021-230-05 IRINOTECAN 100 MG/5 ML IV SOLN $199.29 0944-2720-03 HYALURONIDASE, HUMAN RECOMB. 200 UNIT/1.25 ML SUBCUTANEOUS SOLN $199.18 HC32010167 OT-MANUAL THERAPY 15MIN $199.00 HC32010100 OT-RE-EVAL EST POC[15MIN] $199.00 HC32001133 OT-WHEELCHAIR MGT ADD15MIN/C $199.00 99988-001-02 NM TC-99M DISOFENIN DX 10 MIN $182.00 HC62207006 SUTURE CARDIOVASCULAR G $182.00 HC81100745 TRIGLYCERIDES $182.00 HC51001873 X-RAY TOES MIN 2 VWS $182.00 44567-703-01 CEFTRIAXONE 10 GRAM INJ SOLR $182.00 25021-253-50 CISPLATIN 1 MG/ML IV SOLN $182.00 70594-023-01 COLISTIN (COLISTIMETHATE NA) 150 MG INJ SOLR $182.00 42023-107-01 COLISTIN (COLISTIMETHATE NA) 150 MG INJ SOLR $182.00 70594-023-04 COLISTIN (COLISTIMETHATE NA) 150 MG INJ SOLR $182.00 0409-1660-55 DEXMEDETOMIDINE IN 0.9 % NACL 200 MCG/50 ML (4 MCG/ML) IV SOLN $182.00 0409-1660-50 DEXMEDETOMIDINE IN 0.9 % NACL 200 MCG/50 ML (4 MCG/ML) IV SOLN $182.00 71839-104-01 FOSAPREPITANT 150 MG IV SOLR $182.00 47335-153-40 GEMCITABINE 200 MG IV SOLR $182.00 61314-126-05 KETOROLAC 0.5 % OPHT DROP $182.00 0527-6004-80 LIDOCAINE HCL 4 % (40 MG/ML) MUCOUS MEMB SOLN $182.00 63323-415-10 NEOSTIGMINE METHYLSULFATE 1 MG/ML INJ SOLN (MCH) $182.00 41616-882-44 NICARDIPINE 25 MG/10 ML IV SOLN $182.00 43598-549-10 PROPOFOL 10 MG/ML IV EMUL $182.00 43598-549-52 PROPOFOL 10 MG/ML IV EMUL $182.00 55150-370-25 VASOPRESSIN 20 UNIT/ML INJ SOLN (MCH) $182.00 55150-370-01 VASOPRESSIN 20 UNIT/ML INJ SOLN (MCH) $182.00 63323-393-06 COLISTIN (COLISTIMETHATE NA) 150 MG INJ SOLR $181.94 23155-193-31 COLISTIN (COLISTIMETHATE NA) 150 MG INJ SOLR $181.94 42023-131-01 COLISTIN (COLISTIMETHATE NA) 150 MG INJ SOLR $181.94 0065-0408-72 ARTIFICIAL TEARS(HYPROMELLOSE) 0.5 % OPHT DROP $181.74 HC89018709 INTERPHS FISH HYBRI 100-300-AU $181.48 HC62202130 CURVED LIFT STRL $181.00 HC35500164 MT-BEHAVIOR TX INDIV ADDL 15 MIN $181.00 HC32001117 OT-ADL ADD 15MIN/CW $181.00 HC32000903 OT-ULTRASOUND ADD 15MIN/CW $181.00 HC89000889 PARATHYROID HORMONE TERM-QD $181.00 HC31090186 PT-APPLY LASER THERAPY LOW LEVL 1/MORE AREAS $181.00 HC31001324 PT-HUBBARD TANK ADD15MIN/CW $181.00 99999-045-99 IOHEXOL 350 MG IODINE/ML IV SOLN $180.96 HC51000529 CHEMO ADMIN IVP SNGL/ADD'L INJ $180.86 HC51000537 CHEMO NONHRMNL ANTINEOPL SQ/IM $180.86 HC51000206 IM OR SQ INJECTION THERAPEUTIC $180.86 HC51000131 IMMUNIZATION ADMIN SINGLE $180.86 HC51010684 IMMUNTX PREP-PROV AG3STING BUG VNM $180.86 HC51010692 IMMUNTX PREP-PROV AG4STING BUG VNM $180.86 HC51010700 IMMUNTX PREP-PROV AG5STING BUG VNM $180.86 HC51000248 IV INF THER SEQ/NEW RX 1ST HR $180.86 HC51020410 SC INFUSION THERAPY; ADD'L SET UP NEW SITE $180.86 0781-3466-70 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $180.38 0006-5424-02 ANTIVENIN LATRODECTUS MACTANS 6,000 UNIT INJ SOLR $180.12 0006-4084-01 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 HC62202601 DRESSING WOUND $180.00 HC89023394 FACTOR INHIBITOR ADAMTS13-AU $180.00 HC62224787 GUIDE PIN ORTHO D $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 HC44900397 M: CT MISC STUDY $180.00 HC32000424 OT-SENSRY INTEGRT TECH 15MIN $180.00 HC32000564 OT-TRACTION/MECHANICAL/CMW $180.00 HC89019467 PROCALCITONIN (PCT) - AU $180.00 HC81101271 PROTEIN OTHER SOURCE $180.00 HC31000623 PT-TRACTION/MECHANICAL/CMW $180.00 HC81700189 T4/THYROXINE TOTAL $180.00 HC62225974 TEMPLATE BRACHYTHERAPY D $180.00 HC62224746 WRAP COMPRESSION BACK/SPINE $180.00 68516-5216-5 ALBUMIN, HUMAN 25 % 25 % IV SOLP $179.79 68516-5216-6 ALBUMIN, HUMAN 25 % 25 % IV SOLP $179.79 0009-7529-10 IRINOTECAN 40 MG/2 ML IV SOLN $179.66 66215-403-01 EPOPROSTENOL 0.5 MG IV SOLR $179.60 0121-0581-04 HALOPERIDOL LACTATE 2 MG/ML ORAL CONC $179.40 47781-428-11 FENTANYL 100 MCG/HR TRANSDERMAL PT72 $179.13 47781-428-47 FENTANYL 100 MCG/HR TRANSDERMAL PT72 $179.13 0406-9100-76 FENTANYL 100 MCG/HR TRANSDERMAL PT72 $179.13 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 61703-600-05 CARBOPLATIN 10 MG/ML IV SOLN $179.01 HC62208467 NEEDLE GUIDE ENDOCAVITY $179.00 HC32000143 OT-PHYS PERFORM TEST 15 MIN/MW $179.00 HC89005680 PARVOVIRUS B19 DNA QNT PCR-FT $179.00 HC31010291 PT-PHYS PERFORM TEST 15 MIN $179.00 HC31000219 PT-PHYS PERFORM TEST 15 MIN/M $179.00 HC31001886 PT-WHEELCHAIR ASSESS 15 MIN/M $179.00 HC51002137 RD COUNSELING NUTRITION VISIT/C $179.00 HC81500324 RETICULOCYTE MANUAL $179.00 HC81700213 T3 OR T4 UPTAKE $179.00 HC62210307 TUBE REPOGLE 8 FRENCH $179.00 HC84200245 WBC IN FECES $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 25021-215-98 FLUOROURACIL 2.5 GRAM/50 ML IV SOLN $178.75 70092-1068-07 OXYTOCIN IN 0.9 % SOD CHLORIDE 30 UNIT/500 ML IV SOLN $178.75 7132180230 VITAMIN E (DL, ACETATE) 22.5 MG (50 UNIT)/ML ORAL DROP $178.43 0121-0873-32 LACTULOSE 10 GRAM/15 ML ORAL SOLN $178.32 6371301975 GELATIN SPONGE,ABSORB-PORCINE 100 CM TOPICAL SPGE $178.22 6371301974 GELATIN SPONGE,ABSORB-PORCINE 100 TOPICAL SPGE $178.22 HC81702011 ALLERGEN IGE SPECFC RECOMB QNT/SEMI QNT EA $178.00 HC81500258 G6-PD SCREEN $178.00 HC62228945 IMMOBILIZER SHOULDER FIG8 PREFAB $178.00 HC89024897 L-ASPARAGINASE ANTIBODY-GR $178.00 HC32000101 OT-ELEC STIM/TENS ATTD15MIN/MW $178.00 HC31000193 PT-ELEC STIM/TENS ATTD15MIN/MW $178.00 HC31000953 PT-IONTOPHORESIS ADDL 15MIN/CW $178.00 HC35000157 REC-SENSRY INTEGRT TECH 15MIN $178.00 HC89005102 VORICONAZOLE ANTIFNGL-FT $178.00 0078-0181-01 OCTREOTIDE ACETATE 100 MCG/ML INJ SOLN $177.98 44567-705-01 IMIPENEM-CILASTATIN 500 MG IV SOLR $177.78 44567-705-10 IMIPENEM-CILASTATIN 500 MG IV SOLR $177.78 58160-810-52 DIPH,PERTUS(ACEL),TET PED (PF) 25-58-10 LF-MCG-LF/0.5ML IM SYRG $177.72 58160-810-43 DIPH,PERTUS(ACEL),TET PED (PF) 25-58-10 LF-MCG-LF/0.5ML IM SYRG $177.72 0409-9158-11 PHYTONADIONE (VITAMIN K1) 10 MG/ML INJ SOLN $177.45 0409-9158-55 PHYTONADIONE (VITAMIN K1) 10 MG/ML INJ SOLN $177.45 24208-411-10 BRIMONIDINE 0.2 % OPHT DROP $177.13 99999-046-11 IOHEXOL 300 MG IODINE/ML IV SOLN $177.06 HC62200092 ADAPTER AIRWAY/RESPIRATORY E $177.00 HC84200732 ARTHROPOD ID $177.00 HC51070613 BEHAVIOR ID ASSESS ADMIN BY QHCP PT/GUARD EA 15MIN $177.00 HC62202395 DRESSING ALLEVYN $177.00 HC51010627 IMMNTX 3 STING INSECTS /COMM $177.00 HC84200328 MIC ANTIBIOTIC GRADIENT STRIP $177.00 HC62202072 NEEDLE BIOPSY/ASPIRATION E $177.00 HC62220587 NEEDLE DELIVERY CEMENT $177.00 HC31001472 PT-THER PROC GRP 30MIN/MWC $177.00 HC81500035 RETICULOCYTE - AUTO $177.00 HC83000315 RH PHENOTYPE $177.00 HC51020006 RN ASSESSMENT EA 30MIN $177.00 HC43001056 TOMO BRST DX 3-D; BILAT+ $177.00 HC62212170 TUBE FEEDING NG>36IN TRACKABLE STYLET $177.00 71288-028-11 MICAFUNGIN 50 MG IV SOLR $176.93 71288-028-10 MICAFUNGIN 50 MG IV SOLR $176.93 54288-165-01 CARBOPLATIN 10 MG/ML IV SOLN $176.67 0078-0249-15 LETROZOLE 2.5 MG ORAL TAB $176.50 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 HC35500040 MT-FUNCTIONAL ACTIVITY 15 MIN $176.00 HC62228093 PATCH WIRELESS MONITOR MATERNAL-FETAL $176.00 HC62229117 PIN DISTRACTOR E $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 63323-360-03 CALCIUM GLUCONATE 100 MG/ML (10%) IV SOLN $175.50 63323-360-59 CALCIUM GLUCONATE 100 MG/ML (10%) IV SOLN $175.50 16729-267-63 DOCETAXEL 20 MG/ML (1 ML) IV SOLN $175.50 0264-4460-30 FAT EMULSION 20 % IV (FOR LIPID RESCUE) $175.50 69374-541-03 METHACHOLINE CHLORIDE 0 MG/3 ML (0 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 69374-540-03 METHACHOLINE CHLORIDE 12 MG/3 ML (4 MG/ML) INHALATION NEBU $175.50 69374-539-03 METHACHOLINE CHLORIDE 3 MG/3 ML (1 MG/ML) INHALATION NEBU $175.50 69374-536-50 METHACHOLINE CHLORIDE 48 MG/3 ML (16 MG/ML) INHALATION NEBU $175.50 67457-430-10 PAMIDRONATE 30 MG/10 ML (3 MG/ML) IV SOLN $175.50 6817600010 PEDI MULTIVIT NO.128-VITAMIN K 500 MCG/ML ORAL LIQD $175.50 70069-596-01 TETRACAINE HCL 0.5 % OPHT DROP $175.50 0338-3552-48 VANCOMYCIN IN DEXTROSE 5 % 1 GRAM/200 ML IV PGBK $175.50 HC83590398 BRAF MUTATION ANALYSIS-AP $175.40 0517-9305-01 TRACE ELEMENTS ZN-CU-MN-SE 3 MG-0.3 MG-55 MCG-60 MCG/ML IV SOLN $175.37 0517-9305-25 TRACE ELEMENTS ZN-CU-MN-SE 3 MG-0.3 MG-55 MCG-60 MCG/ML IV SOLN $175.37 0121-0646-16 AMANTADINE HCL 10 MG/ML ORAL SOLN (MCH) $175.25 27808-065-02 PROMETHAZINE-CODEINE 6.25-10 MG/5 ML ORAL SYRP $175.25 HC51003929 BIOFEEDBACK PERINEAL MSCLS W/EMG&/MNMTRY F2F 1ST 15MIN $175.24 0121-1012-05 LACOSAMIDE 10 MG/ML ORAL SOLN $175.11 0121-1012-95 LACOSAMIDE 10 MG/ML ORAL SOLN $175.11 HC89024590 AQUAPORIN-4 AB CBA-AU $175.00 HC62200308 BAG/POUCH DRAINAGE $175.00 HC83505891 CHROM ANAL 20-25 CELLS BONE MARROW-NG $175.00 HC83500397 CHROM ANAL TISSUE COUNT-US $175.00 HC83505883 CHROM TISSUE CULT BONE MARROW-NG $175.00 HC83500272 CHROMO TISSUE BLOOD-IM $175.00 HC83500256 CHROMO TISSUE BLOOD-US $175.00 HC82202268 DECALCIFICATION DIST SVC $175.00 HC82200346 DECALCIFICATION+ $175.00 HC82202599 DECALCIFICATION+ *OP $175.00 HC62229372 ELECTRODES EP STIM SOMATOSSENSORY $175.00 HC81101131 G6PD $175.00 HC62224142 GUIDE PIN ORTHO B $175.00 HC62222401 GUIDE ROD B $175.00 HC62226717 GUIDEWIRE A $175.00 HC62221403 NEEDLE THORAC/PARACENTESIS $175.00 HC62228283 ORTH FO PIP/DIP W/O JOINT/SPRING PREFAB OTS $175.00 HC62217195 ORTHOTIC WHFO 1+JOINT(S) PREFAB $175.00 HC62224720 ORTHOTIC WHO W/O JOINTS SPICA $175.00 HC32010472 OT ORTHOTIC CUSTOMIZATION EA 15MIN (ROLL 2L CODES) $175.00 HC32010134 OT-ELEC STIM/TENS ATTD 15MIN $175.00 HC62216486 PIN/WIRE FIXATION TEMPORARY K $175.00 HC31010101 PT-ELEC STIM/TENS ATTD 15MIN $175.00 HC83000372 RBC PRETREAT W/DRUG/CHEM $175.00 HC62215561 SUTURE F $175.00 HC89008775 IRON TOTAL URINE-AU $174.83 10370-268-01 TRETINOIN (ANTINEOPLASTIC) 10 MG ORAL CAP $174.81 55513-073-30 CINACALCET 30 MG ORAL TAB $174.79 0713-0132-12 PROMETHAZINE 50 MG RECTAL SUPP $174.35 0713-0132-06 PROMETHAZINE 50 MG RECTAL SUPP $174.35 HC81100398 ALK PHOSPHATASE $174.00 HC38000410 APPLY TRACTN MECHANCL 1+ AREAS $174.00 HC81101123 GLUCOSE POST DOSE $174.00 HC81101479 LIPOPROTEIN A $174.00 HC31001076 PT-MANUAL THERAPY ADD 15MIN/CW $174.00 HC31001050 PT-MASSAGE ADD 15MIN/CW $174.00 HC81500043 SED RATE NON-AUTO $174.00 HC81100141 URIC ACID FLUID $174.00 HC81100034 URIC ACID URINE $174.00 99999-044-52 VANCOMYCIN IN NS 1.25 GRAM/250 ML IV SOLN (MHS) $173.88 63323-184-11 FOLIC ACID 5 MG/ML INJ SOLN $173.55 HC81101693 BILIRUBIN TRANSCUTANEOUS(POCS) $173.00 HC84200138 PINWORM PREP $173.00 70954-518-10 LIDOCAINE HCL 4 % (40 MG/ML) MUCOUS MEMB SOLN $172.90 0069-3140-19 AZITHROMYCIN 200 MG/5 ML ORAL SUSR $172.58 0904-7165-07 AMINOCAPROIC ACID 500 MG ORAL TAB $172.47 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 0378-0871-99 CLONIDINE 0.1 MG/24 HR TRANSDERMAL PTWK $172.24 0378-0871-16 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 HC29000650 ADMIN/INTERP RISK ASSESS INSTR CAREGIVER FCS $172.00 HC29000643 ADMIN/INTERP RISK ASSESS INSTR PT-FOCUS $172.00 HC89018089 VON WILLEBRAND FACT 2N BIND-EC $172.00 69374-314-10 MIDAZOLAM 100 MG IN NS 100 ML DRIP (SLH WRAPPER) $171.60 62856-583-52 RUFINAMIDE 400 MG ORAL TAB $171.60 0641-0476-25 PHENOBARBITAL SODIUM 65 MG/ML INJ SOLN $171.30 0641-0476-21 PHENOBARBITAL SODIUM 65 MG/ML INJ SOLN $171.30 63323-130-11 DOXYCYCLINE HYCLATE 100 MG IV SOLR $171.15 63323-130-02 DOXYCYCLINE HYCLATE 100 MG IV SOLR $171.15 HC39001342 BEHAVIOR ADAPT MULT FAM TX GDN W/O PT; EA 15MIN $171.00 HC39001334 BEHAVIOR ADAPT TX FAMILY GUIDNC QHCP W GUARDIANS EA 15MIN $171.00 HC39001359 BEHAVIOR ADAPT TX GROUP BY QHCP; EA 15MIN $171.00 HC39001318 BEHAVIOR ID ASSESS ADMIN BY QHCP PT/GUARD EA 15MIN $171.00 HC89008627 MYASTHENIA GRAVIS EVAL-SL $171.00 HC32001299 OT-THER PROC GRP 1ST 30MIN/MW $171.00 HC32001356 OT-THER PROC GRP 30MIN/CMW $171.00 HC81101578 UA DIPSTICK (DIRECT ACCESS) $171.00 0019-1323-02 IOVERSOL 320 MG IODINE/ML IV SOLN $170.69 62559-111-11 HYDROCORTISONE 100 MG/60 ML RECTAL ENEM $170.43 51754-0103-4 CUPRIC CHLORIDE 0.4 MG/ML IV SOLN $170.30 51754-0103-1 CUPRIC CHLORIDE 0.4 MG/ML IV SOLN $170.30 42494-415-25 PHENOBARBITAL SODIUM 65 MG/ML INJ SOLN $170.20 42494-415-01 PHENOBARBITAL SODIUM 65 MG/ML INJ SOLN $170.17 HC89018071 CALCIUM FOR PTH(PNL)-QD $170.00 HC89007876 DEOXYCORTISOL 11-ES $170.00 HC12600011 IMMUNIZATION ADMIN ADD'L $170.00 HC89019285 NEUTROPHIL OXIDATIVE BURST-AU $170.00 HC51060788 OT-DEVEL TEST ADMIN ASSESS COG INSTR; EA ADD 30MIN+ $170.00 HC84600113 PAP SLIDES MAN& RE-SCREEN $170.00 HC81101628 PROTEIN TOTAL, FLUID $170.00 HC51070670 PSY-DEVEL TEST ADMIN ASSESS COG INSTR; EA ADD 30MIN+ $170.00 HC51060804 PT-DEVEL TEST ADMIN ASSESS COG INSTR; EA ADD 30MIN+ $170.00 HC31001142 PT-PROSTHETIC TRNG ADD15MIN/CW $170.00 HC81700403 RPR/VDRL QUANT $170.00 8019629660 SILVER TOPICAL GLSR $169.70 63323-690-22 ACETYLCYSTEINE 200 MG/ML (20 %) MISC SOLN $169.07 HC83504928 MORPH STUDY MAN ISH HER2-NG $169.00 HC32000572 OT-ULTRASOUND 15MIN/MW $169.00 HC31001613 PT-COMMTY WK/REINT ADD15MIN/CW $169.00 HC31000631 PT-ULTRASOUND 15MIN/MW $169.00 70069-506-01 CUPRIC CHLORIDE 0.4 MG/ML IV SOLN $169.00 70069-506-25 CUPRIC CHLORIDE 0.4 MG/ML IV SOLN $169.00 0781-3493-80 DEXMEDETOMIDINE IN 0.9 % NACL 80 MCG/20 ML (4 MCG/ML) IV SOLN $169.00 0781-3493-95 DEXMEDETOMIDINE IN 0.9 % NACL 80 MCG/20 ML (4 MCG/ML) IV SOLN $169.00 0143-9552-01 LEUCOVORIN CALCIUM 350 MG INJ SOLR $169.00 68180-963-01 ALBUTEROL SULFATE 90 MCG/ACTUATION INHALATION HFAA $168.84 45802-088-01 ALBUTEROL SULFATE 90 MCG/ACTUATION INHALATION HFAA $168.84 HC89024608 AQUAPORIN AB TITER CBA-IFA-AU $168.75 51672-1264-2 FLUOCINONIDE 0.05 % TOPICAL OINT $168.48 HC81700635 ALBUMIN; URINE QUANT $168.00 HC83001057 CMV AB NEGATIVE BLOOD $168.00 HC51062172 PLACENTAL ALPHA MICROGLOBULIN-1 $168.00 HC36800555 RT RESP THER GRP 15 MIN/MW $168.00 HC51062024 SELF MANAGEMENT EDUC & TRAINING INDIV 30MIN (PRIVAT INSAUTHREQ) $168.00 62332-751-50 FLUOROURACIL 2.5 GRAM/50 ML IV SOLN $167.05 HC89012009 BACTERIAL AG SCREEN - CSF-FT $167.00 HC81101503 PROTEIN TOTAL, REFRCT $167.00 HC81100059 SODIUM URINE $167.00 70069-020-01 ACETYLCYSTEINE 20 % (200 MG/ML) ORAL SOLN $166.92 70069-020-03 ACETYLCYSTEINE 20 % (200 MG/ML) ORAL SOLN $166.92 63323-403-10 FOSPHENYTOIN 500 MG PE/10 ML INJ SOLN $166.73 63323-403-04 FOSPHENYTOIN 500 MG PE/10 ML INJ SOLN $166.73 0955-1012-10 ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRG $166.66 0832-1410-03 MOXIFLOXACIN 0.5 % OPHT DROP $166.34 68462-181-47 CLOTRIMAZOLE 1 % TOPICAL CREAM $166.14 HC83000802 COLD AGGLUTININS TITER $166.00 HC81101222 SODIUM FLUID $166.00 0143-9689-10 NICARDIPINE 25 MG/10 ML IV SOLN $165.88 0143-9689-01 NICARDIPINE 25 MG/10 ML IV SOLN $165.88 65219-650-10 MIDAZOLAM (PF) IN 0.9 % NACL 1 MG/ML IV SOLN $165.75 65219-650-02 MIDAZOLAM (PF) IN 0.9 % NACL 1 MG/ML IV SOLN $165.75 70092-1552-07 OXYTOCIN IN 0.9 % SOD CHLORIDE 30 UNIT/500 ML IV SOLN $165.75 0409-3308-03 ACETYLCYSTEINE 20 % (200 MG/ML) ORAL SOLN $165.56 0409-3308-11 ACETYLCYSTEINE 20 % (200 MG/ML) ORAL SOLN $165.56 70677-0038-2 MAGNESIUM SULFATE (LAXATIVE) 495 MG/5 GRAM ORAL GRAN $165.07 HC81100497 CALCIUM URINE QUANT TIMED SPEC $165.00 HC81100554 CREATININE OTHER $165.00 HC89016588 ENTEROVIRUS BY PCR-FT $165.00 HC89021315 HEAVY METAL QN EA;IODINE SERUM-AU $165.00 HC89016075 HSV 1-2 BY PCR-FT $165.00 HC51020428 NP DEV PT REPORT; INTERMEDIATE $165.00 HC51020014 RN DEV PT REPORT; INTERMEDIATE $165.00 HC51060739 ST-SPEECH THERAPY 60 MIN $165.00 16714-131-01 IRINOTECAN 100 MG/5 ML IV SOLN $164.91 HC89000699 BETA-GLUCURONIDASE, CSF-AU $164.00 HC89020382 KRAS GENE ANALYSIS-AU $164.00 HC89020374 MOLECULAR PATH PROC LVL 4-AU $164.00 HC35500065 MT-SENSORY INTEGRATION 15 MIN $164.00 HC84600139 PAP BETHESDA MANUAL SCREEN $164.00 HC81100687 PHOSPHORUS $164.00 HC81100018 PROTEIN URINE $164.00 63323-401-26 AZTREONAM 1 GRAM INJ SOLR $163.80 80830-1673-2 CALCIUM GLUCONATE 100 MG/ML (10%) IV SOLN $163.48 80830-1673-1 CALCIUM GLUCONATE 100 MG/ML (10%) IV SOLN $163.48 16714-867-01 PALIPERIDONE 3 MG ORAL TR24 $163.46 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 HC81100638 SGPT(ALT) $163.00 HC33010174 ST-SPEECH THERAPY GROUP [15MIN] $163.00 59651-032-47 IBUPROFEN 100 MG/5 ML ORAL SUSP $162.95 51672-1385-9 IBUPROFEN 100 MG/5 ML ORAL SUSP $162.95 45802-952-43 IBUPROFEN 100 MG/5 ML ORAL SUSP $162.95 45802-466-35 ECONAZOLE NITRATE 1 % TOPICAL CREAM $162.73 0641-6238-01 EPHEDRINE SULFATE 50 MG/ML IV SOLN $162.57 0641-6238-25 EPHEDRINE SULFATE 50 MG/ML IV SOLN $162.57 51672-1297-1 CLOBETASOL-EMOLLIENT 0.05 % TOPICAL CREAM $162.53 72888-148-37 IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASL SPRY $162.53 HC89018600 CHROM ANAL 20-25 CELLS, BM-AU $162.50 HC89018592 CHROM ANAL TISSUE CULT, BM-AU $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 72266-252-01 CISPLATIN 1 MG/ML IV SOLN $162.50 39822-2000-1 CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLN $162.50 71288-017-15 DAPTOMYCIN 350 MG IV SOLR $162.50 25021-245-01 DOCETAXEL 20 MG/ML (1 ML) IV SOLN $162.50 70121-1221-1 DOCETAXEL 20 MG/ML (1 ML) IV SOLN $162.50 61314-019-10 DORZOLAMIDE 2 % OPHT DROP $162.50 0641-6030-01 FENTANYL (PF) 50 MCG/ML INJ FOR INTRATHECAL PAIN PUMP REFILL (OCM) $162.50 63323-806-50 FENTANYL (PF) 50 MCG/ML INJ FOR INTRATHECAL PAIN PUMP REFILL (OCM) $162.50 72205-054-01 FOSAPREPITANT 150 MG IV SOLR $162.50 0002-7737-01 INSULIN LISPRO 100 UNIT/ML SUBCUTANEOUS SOLN $162.50 0019-0953-09 IOTHALAMATE MEGLUMINE 60 % INJ SOLN $162.50 0548-5400-00 MEDROXYPROGESTERONE 150 MG/ML IM SUSP $162.50 0548-5400-25 MEDROXYPROGESTERONE 150 MG/ML IM SUSP $162.50 0548-5701-00 MEDROXYPROGESTERONE 150 MG/ML IM SYRG $162.50 10019-953-01 MESNA 100 MG/ML INJ SOLN (FOR ORAL USE)(MCH) $162.50 10019-953-62 MESNA 100 MG/ML INJ SOLN (FOR ORAL USE)(MCH) $162.50 0338-1305-01 MESNA 100 MG/ML INJ SOLN (FOR ORAL USE)(MCH) $162.50 65162-691-79 ONDANSETRON HCL 4 MG/5 ML ORAL SOLN $162.50 25021-233-10 OXALIPLATIN 5 MG/ML IV SOLN (MCH) $162.50 71266-5000-1 OXYTOCIN IN 0.9 % SOD CHLORIDE 30 UNIT/500 ML IV SOLN $162.50 67457-317-25 PALONOSETRON 0.25 MG/5 ML IV SOLN $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 70069-803-01 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $162.50 60505-6116-0 REGADENOSON 0.4 MG/5 ML IV SYRG $162.50 55150-443-01 REGADENOSON 0.4 MG/5 ML IV SYRG $162.50 36000-364-01 REGADENOSON 0.4 MG/5 ML IV SYRG $162.50 25021-204-01 VINORELBINE 10 MG/ML IV SOLN $162.50 0591-2888-30 HYDROXOCOBALAMIN 1,000 MCG/ML IM SOLN $162.44 72888-149-38 IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASL SPRY $162.44 0168-0099-30 KETOCONAZOLE 2 % TOPICAL CREAM $162.44 65162-803-14 TEMOZOLOMIDE 100 MG ORAL CAP $162.41 47335-892-60 TEMOZOLOMIDE 100 MG ORAL CAP $162.41 47335-892-72 TEMOZOLOMIDE 100 MG ORAL CAP $162.41 16729-050-53 TEMOZOLOMIDE 100 MG ORAL CAP $162.41 47335-892-74 TEMOZOLOMIDE 100 MG ORAL CAP $162.41 51672-3020-9 LIDOCAINE 5 % TOPICAL OINT $162.40 63323-651-04 ADENOSINE 3 MG/ML IV SOLN CODE NEO $162.32 59676-571-01 ETRAVIRINE 200 MG ORAL TAB $162.27 70710-1849-1 CHLORPROMAZINE 25 MG/ML INJ SOLN $162.24 70710-1849-7 CHLORPROMAZINE 25 MG/ML INJ SOLN $162.24 43598-140-25 CHLORPROMAZINE 25 MG/ML INJ SOLN $162.24 43598-140-11 CHLORPROMAZINE 25 MG/ML INJ SOLN $162.24 HC34000299 ELECTROACOUSTIC EVAL FOR HEARING AID; MONOAURAL $162.00 HC34000240 EVOKED OTOACOUSTIC EMISSIONS SCREEN $162.00 HC29000569 PREVENTATIVE MED COUNSELING 30MIN $162.00 HC39000799 PSYCH GROUP TEACH/COUNS SESSION $162.00 HC34000380 REHAB AUD POSTLINGUAL HEAR LOSS $162.00 HC34000372 REHAB AUD PRELINGUAL HEAR LOSS $162.00 0517-9302-25 TRACE ELEMENTS (WEIGHT < 0.6 KG) ZN-CU-MN-SE 1,000MCG-60MCG- 3 MCG-6 MCG/ML IV SOLN (MCH) $161.98 0517-9302-01 TRACE ELEMENTS (WEIGHT < 0.6 KG) ZN-CU-MN-SE 1,000MCG-60MCG- 3 MCG-6 MCG/ML IV SOLN (MCH) $161.98 57664-683-57 LINEZOLID 600 MG/300 ML IV SOLP (MCH) $161.85 99999-041-16 SODIUM POLYSTYRENE SULFONATE (SORBITOL) 15 GRAM/60 ML ORAL SUSPENSION WRAPPER MHS $161.85 66220-207-30 ACETYLCYSTEINE 200 MG/ML (20 %) IV SOLN $161.66 67457-582-10 FONDAPARINUX 2.5 MG/0.5 ML SUBCUTANEOUS SYRG $161.58 67457-582-00 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 63323-089-50 SODIUM BICARBONATE 1 MEQ/ML (8.4 %) 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 16729-276-67 FLUOROURACIL 1 GRAM/20 ML IV SOLN $161.07 16729-276-05 FLUOROURACIL 1 GRAM/20 ML IV SOLN $161.07 46287-006-60 SODIUM POLYSTYRENE SULFONATE (SORBITOL) 15 GRAM/60 ML ORAL SUSPENSION WRAPPER MHS $161.07 62559-356-01 SODIUM POLYSTYRENE SULFONATE (SORBITOL) 15 GRAM/60 ML ORAL SUSPENSION WRAPPER MHS $161.07 62559-356-60 SODIUM POLYSTYRENE SULFONATE (SORBITOL) 15 GRAM/60 ML ORAL SUSPENSION WRAPPER MHS $161.07 HC32010316 OT-ULTRASOUND 15MIN $161.00 HC89024210 PROPOXYPHENE AND METABOLITE UR-AU $161.00 HC31010283 PT-ULTRASOUND 15MIN $161.00 HC81700015 RHEUMATOID FACTOR QUAL $161.00 HC81700031 RHEUMATOID FACTOR QUANT $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 HC81500803 HEMATOCRIT SPUN $160.00 HC35500214 MT-BEHAV TX FAM W/O PT 1ST 30MIN $160.00 HC35500198 MT-BEHAVIOR TX FAMW/PT 1ST 30MIN $160.00 HC84600105 PAP SLIDES MANUAL SCREEN $160.00 HC81100844 PH FLUID $160.00 HC89019749 PLATELET AB IDENTIFY-AU $160.00 HC39001599 PSY-BEHAV TX FAM W/O PT 1ST 30MIN $160.00 HC39001573 PSY-BEHAVIOR TX FAMW/PT 1ST 30MIN $160.00 HC81100620 SGOT(AST) $160.00 69339-136-34 DIAZEPAM 5 MG/ML INJ SYRG $159.99 69339-136-03 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 43598-106-10 DIAZEPAM 5 MG/ML INJ SYRG $159.97 43598-106-11 DIAZEPAM 5 MG/ML INJ SYRG $159.97 72266-127-01 DICYCLOMINE 10 MG/ML IM SOLN $159.90 72266-127-05 DICYCLOMINE 10 MG/ML IM SOLN $159.90 0069-0343-02 DOXORUBICIN 2 MG/ML IV SOLN (MCH) $159.74 50474-770-66 BRIVARACETAM 100 MG ORAL TAB $159.58 50474-470-66 BRIVARACETAM 25 MG ORAL TAB $159.58 50474-570-66 BRIVARACETAM 50 MG ORAL TAB $159.58 50474-570-09 BRIVARACETAM 50 MG ORAL TAB $159.58 0009-0728-09 CLINDAMYCIN PHOSPHATE 150 MG/ML INJ SOLN $159.51 0009-0728-05 CLINDAMYCIN PHOSPHATE 150 MG/ML INJ SOLN $159.51 0904-7463-41 LACOSAMIDE 10 MG/ML ORAL SOLN $159.32 25021-207-25 DOXORUBICIN 2 MG/ML IV SOLN (MCH) $159.25 HC81101016 ACETYLCHOLINESTERASE $159.00 HC81100042 POTASSIUM URINE $159.00 25010-215-15 ETHACRYNIC ACID 25 MG ORAL TAB $158.88 66220-287-08 IBUPROFEN 800 MG/8 ML (100 MG/ML) IV SOLR $158.65 HC89500581 COOMBS INDIR TITER EA -SB $158.08 HC89007223 AMINO ACIDS QUANT URINE-CA $158.00 HC89007215 AMINO ACIDS QUANT-CA $158.00 HC81101081 CHLORIDE URINE $158.00 HC35500230 MT-DEV COGNITIVE SKILLS INITL 15MIN $158.00 HC84600063 PAP SMEAR SCREEN (MCR) $158.00 HC51070027 PSY FAMILY CONFERENCE $158.00 0143-9184-01 CALCIUM GLUCONATE 100 MG/ML (10%) IV SOLN $157.95 0143-9184-25 CALCIUM GLUCONATE 100 MG/ML (10%) IV SOLN $157.95 63323-477-01 CHLOROPROCAINE (PF) 20 MG/ML (2 %) INJ SOLN $157.95 63323-477-27 CHLOROPROCAINE (PF) 20 MG/ML (2 %) INJ SOLN $157.95 0009-0758-01 METHYLPREDNISOLONE SODIUM SUCC 500 MG IV SOLR $157.82 25021-682-20 KETAMINE 10 MG/ML INJ SOLN $157.69 0641-6173-10 DICYCLOMINE 10 MG/ML IM SOLN $157.56 0641-6173-01 DICYCLOMINE 10 MG/ML IM SOLN $157.56 17156-299-18 THALLOUS CHLORIDE TL-201 37 MBQ/ML (1 MCI/ML) IV SOLN $157.50 63323-385-10 CEFOTETAN 1 GRAM INJ SOLR $157.43 63323-385-01 CEFOTETAN 1 GRAM INJ SOLR $157.43 63323-820-00 FAT EMUL-SOY-MCT-OLIV-FISH OIL 20 % IV EMUL $157.30 63323-820-01 FAT EMUL-SOY-MCT-OLIV-FISH OIL 20 % IV EMUL $157.30 HC83500686 TISSUE EXAM G&M LEVEL 4-CS $157.15 HC89005268 HSV 1 QUANT PCR- FT $157.05 HC89005276 HSV 2 QUANT PCR- FT $157.05 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 HC81500522 HEINZ BODIES DIRECT $157.00 HC81101198 LEAD $157.00 HC81100703 PROTEIN TOTAL $157.00 HC34000232 SCREENING PURE TONE HEARING AIR $157.00 66689-202-04 ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSP $156.78 70069-431-01 DICYCLOMINE 10 MG/ML IM SOLN $156.65 70069-431-05 DICYCLOMINE 10 MG/ML IM SOLN $156.65 63323-631-10 LEUCOVORIN CALCIUM 10 MG/ML INJ SOLN $156.59 0009-0011-03 HYDROCORTISONE SOD SUCC (PF) 100 MG/2 ML INJ SOLR $156.46 16714-955-01 KETOCONAZOLE 2 % TOPICAL CREAM $156.39 54643-5646-1 MVI, PEDI NO.1 WITH VIT K 80 MG-400 UNIT- 200 MCG/5 ML IV SOLN $156.29 54643-5648-1 MVI, PEDI NO.1 WITH VIT K 80 MG-400 UNIT- 200 MCG/5 ML IV SOLN $156.29 54643-5651-1 MVI, PEDI NO.1 WITH VIT K 80 MG-400 UNIT- 200 MCG/5 ML IV SOLN $156.29 HC81100547 CREATININE $156.00 44567-237-06 CEFTAZIDIME 6 GRAM INJ SOLR $156.00 25021-159-10 COLISTIN (COLISTIMETHATE NA) 150 MG INJ SOLR $156.00 55150-230-10 FONDAPARINUX 2.5 MG/0.5 ML SUBCUTANEOUS SYRG $156.00 55150-230-00 FONDAPARINUX 2.5 MG/0.5 ML SUBCUTANEOUS SYRG $156.00 0019-0862-07 IOTHALAMATE MEGLUMINE 17.2 % URETHRAL SOLN $156.00 0019-0862-50 IOTHALAMATE MEGLUMINE 17.2 % URETHRAL SOLN $156.00 10019-360-40 ISOFLURANE 99.9 % INHALATION LIQD $156.00 0143-9553-01 LEUCOVORIN CALCIUM 200 MG INJ SOLN (MCH) $156.00 63323-728-01 MICAFUNGIN 50 MG IV SOLR $156.00 63323-728-10 MICAFUNGIN 50 MG IV SOLR $156.00 52268-100-01 PEG 3350-ELECTROLYTES 236-22.74-6.74 -5.86 GRAM ORAL SOLR $156.00 43386-090-19 PEG 3350-ELECTROLYTES 236-22.74-6.74 -5.86 GRAM ORAL SOLR $156.00 10572-100-01 PEG 3350-ELECTROLYTES 236-22.74-6.74 -5.86 GRAM ORAL SOLR $156.00 49230-209-32 PERITON.DIALYSIS 7-2.5 % DEXTR CA 2.5 MEQ/L- MG 0.5 MEQ/L IP SOLN $156.00 0338-0295-47 SORBITOL 3 % IRR SOLN $156.00 65219-052-09 POTASSIUM PHOSPHATE 3 MMOL / ML ORAL LIQUID (MCH) $155.87 65219-052-29 POTASSIUM PHOSPHATE 3 MMOL / ML ORAL LIQUID (MCH) $155.87 0121-0976-10 CEFOTETAN 1 GRAM INJ SOLR $155.68 0121-0976-55 CEFOTETAN 1 GRAM INJ SOLR $155.68 71266-5055-2 HYDROMORPHONE 50 MG IN NS 50 ML DRIP (OCM WRAPPER) $155.68 59762-0531-2 PHENYTOIN 125 MG/5 ML ORAL SUSP $155.59 51672-4069-2 PHENYTOIN 125 MG/5 ML ORAL SUSP $155.59 51672-4069-1 PHENYTOIN 125 MG/5 ML ORAL SUSP $155.59 0054-3176-44 DEXAMETHASONE 1 MG/ML ORAL DROP $155.03 HC89500722 FREEZING BLOOD EA UNIT AUTO-SB $155.00 HC81101859 HEMOGLOBIN GLYCATED, A1C(DA) $155.00 HC83504399 IRON ASSAY TISSUE-AU $155.00 HC39000757 PSYCH ASSESS/INTERVEN EA30MIN/MCL $155.00 HC33000118 ST-ASSESS ASSIST TECH 15MIN/CM $155.00 46287-020-50 SPIRONOLACTONE 25 MG/5 ML ORAL SUSP $154.83 46287-020-20 SPIRONOLACTONE 25 MG/5 ML ORAL SUSP $154.83 0338-3583-01 VANCOMYCIN IN 0.9 % SODIUM CHL 1 GRAM/200 ML IV PGBK $154.70 0009-0417-01 TESTOSTERONE CYPIONATE 200 MG/ML IM OIL $154.64 HC89021919 DEOXYCORTICOSTERONE (DOC)-ES $154.50 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 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 HC84200468 OB FECAL IMM ASSAY 1-3 CA SCR $154.00 HC81100737 SODIUM $154.00 HC81101792 SODIUM (POS) $154.00 HC43001031 TOMO BRST DX 3-D; UNILAT LT+ $154.00 HC43001049 TOMO BRST DX 3-D; UNILAT RT+ $154.00 HC43001064 TOMO BRST SCREEN 3-D BILAT+ $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 51754-0102-4 ZINC CHLORIDE 1 MG/ML IV SOLN $153.73 51754-0102-1 ZINC CHLORIDE 1 MG/ML IV SOLN $153.73 0009-0011-04 HYDROCORTISONE SOD SUCC (PF) 100 MG/2 ML INJ SOLR $153.56 63629-9570-1 TOBRAMYCIN-DEXAMETHASONE 0.3-0.1 % OPHT DRPS $153.14 HC32000028 OT-ASSESS ASSIST TECH 15MIN/CM $153.00 HC32010324 OT-ONLINE ASSESS & MANAGMNT EST PT 5-10MIN $153.00 HC31000102 PT-ASSESS ASSIST TECH 15MIN/CM $153.00 HC31090145 PT-ONLINE ASSESS & MANAGMNT EST PT 5-10MIN $153.00 HC33010190 ST-ONLINE ASSESS & MANAGMNT EST PT 5-10MIN $153.00 HC81100752 URIC ACID $153.00 55111-678-10 FONDAPARINUX 2.5 MG/0.5 ML SUBCUTANEOUS SYRG $152.75 0781-3443-95 FONDAPARINUX 2.5 MG/0.5 ML SUBCUTANEOUS SYRG $152.75 63323-489-27 LIDOCAINE-EPINEPHRINE (MPF) 2 %-1:200,000 INJ SOLN (MHS) $152.75 63323-489-02 LIDOCAINE-EPINEPHRINE (MPF) 2 %-1:200,000 INJ SOLN (MHS) $152.75 0264-1944-20 POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN $152.75 99999-004-80 METHADONE 10 MG/ML INJ SOLN $152.69 70069-526-01 ZINC CHLORIDE 1 MG/ML IV SOLN $152.30 70069-526-25 ZINC CHLORIDE 1 MG/ML IV SOLN $152.30 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 99999-035-46 LACOSAMIDE 10 MG/ML ORAL SOLN $152.23 HC84201904 CARBAPENEMASES (CARBA-5) $152.00 HC81190043 CREATININE (POS) $152.00 HC84200336 ENZYME DET BETA LACTAMASE $152.00 HC35500248 MT-DEV COGNITIVE SKILLS ADDL 15MIN $152.00 HC31001597 PT-CONTRAST BATH AD15MIN/CW $152.00 HC31000979 PT-ULTRASOUND ADD 15MIN/CW $152.00 HC83500785 SPECIAL STAIN GRP I W/ I&R+-MA $152.00 HC51061554 STRAPPING; HAND OR FINGER $152.00 HC89011837 IMMUNE COMPLEX C1Q BIND-AU $151.50 HC89024178 NEOPTERIN-LC $151.46 63323-642-50 MAGNESIUM SULFATE 500 MG/ML (50 %) INJ SOLN $151.45 63323-642-02 MAGNESIUM SULFATE 500 MG/ML (50 %) INJ SOLN $151.45 0019-0952-11 IOTHALAMATE MEGLUMINE 30 % IV SOLN $151.13 0019-0952-53 IOTHALAMATE MEGLUMINE 30 % IV SOLN $151.13 61703-339-22 CARBOPLATIN 10 MG/ML IV SOLN $151.03 HC36001071 ATTENDANCE AT DELIVERY $151.00 HC38420030 IABP SERV/SUPPORT PER HR $151.00 HC51061430 ECG EXT HOLTER UP TO 48HRS; SCANNING ANYS & REPORT $150.94 HC51000164 ECG ROUTINE 12+ LEADS $150.94 HC51001618 ECG ROUTINE 12+ LEADS; TRACING ONLY $150.94 HC51061158 ECG ROUTINE 15 LEADS $150.94 HC51003200 IRRIG &/APPLY OINTMENT VAGINAL $150.94 HC51000420 IVAD IRRIGATION $150.94 HC51061950 MONITOR AMB GLUCOSE ASSESS 72+ HRS $150.94 HC51002566 REMOV IMPACTD EAR WAX IRRIG/LAVG LT $150.94 HC51002574 REMOV IMPACTD EAR WAX IRRIG/LAVG RT $150.94 HC51002079 REMOV IMPACTD EAR WAX(INSTRUMENT) LT $150.94 HC51002087 REMOV IMPACTD EAR WAX(INSTRUMENT) RT $150.94 HC51010494 TEST ALLERGY INTRAQ RX/BIOLOGIC $150.94 HC51010536 TEST ALLERGY PATCH PHOTO $150.94 HC51070837 TEST EXERC BRONCHOSPSM INCL SPIR & POX W/O ECG $150.94 HC51063063 TRIM NONDYSTROPHIC NAILS $150.94 HC51001972 US MEASUR POST-VD RES&/BLDR CAP NO IMG $150.94 70092-1092-36 FENTANYL CITRATE (PF)-0.9%NACL 10 MCG/ML IV SOLN $150.80 16714-644-10 DOXYCYCLINE HYCLATE 100 MG IV SOLR $150.36 16714-644-01 DOXYCYCLINE HYCLATE 100 MG IV SOLR $150.36 0143-9850-01 METHYLPREDNISOLONE SODIUM SUCC 500 MG IV SOLR $150.28 65219-039-00 VASOPRESSIN 20 UNIT/ML INJ SOLN (MCH) $150.15 65219-039-01 VASOPRESSIN 20 UNIT/ML INJ SOLN (MCH) $150.15 55111-678-11 FONDAPARINUX 2.5 MG/0.5 ML SUBCUTANEOUS SYRG $150.02 55111-678-02 FONDAPARINUX 2.5 MG/0.5 ML SUBCUTANEOUS SYRG $150.02 HC89024244 AQUAPORIN-4 ELISA AB-AU $150.00 HC51004109 ARTERIAL PUNCTURE $150.00 HC89021166 FACTOR IX INHIBITOR TEST(PNL) -EC $150.00 HC89021232 HSV 6 (HHV6)(A&B), QNT PCR-AU $150.00 HC83505982 MORPH STDY TMR IHC-AP $150.00 HC89024293 MYELIN MOG-IGG1 AB CBA-AU $150.00 HC36800662 PH FLUID $150.00 HC89013163 VIRAL ISOLATE CONFIRM-U2 $150.00 HC89021885 ZIKA VIRUS BY PCR, BLOOD-AU $150.00 0270-0445-35 DIATRIZOATE MEG-DIATRIZOAT SOD 66-10 % ORAL SOLN $149.96 68462-622-64 FOSPHENYTOIN 500 MG PE/10 ML INJ SOLN $149.96 68462-622-10 FOSPHENYTOIN 500 MG PE/10 ML INJ SOLN $149.96 63323-710-50 LEUCOVORIN CALCIUM 200 MG INJ SOLN (MCH) $149.89 0093-4177-73 CEPHALEXIN 250 MG/5 ML ORAL SUSR $149.50 68180-441-01 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 0054-0237-63 MORPHINE 10 MG/5 ML ORAL SOLN $149.50 63323-930-00 VASOPRESSIN 20 UNIT/ML INJ SOLN (MCH) $149.50 63323-930-01 VASOPRESSIN 20 UNIT/ML INJ SOLN (MCH) $149.50 43598-914-11 VASOPRESSIN 20 UNIT/ML INJ SOLN (MCH) $149.50 43598-914-06 VASOPRESSIN 20 UNIT/ML INJ SOLN (MCH) $149.50 43598-914-25 VASOPRESSIN 20 UNIT/ML INJ SOLN (MCH) $149.50 25021-474-01 VASOPRESSIN 20 UNIT/ML INJ SOLN (MCH) $149.50 HC83500629 CHROM ANAL ADDL HI RESOLUTION -GZ $149.00 HC31001514 PT-APPLY VASOPNEUMATIC DEV/MW $149.00 24208-555-55 BACITRACIN-POLYMYXIN B 500-10,000 UNIT/GRAM OPHT OINT $148.99 72572-875-01 VORICONAZOLE 200 MG IV SOLR $148.92 HC89018626 CHROM ANAL TISS CULT, BLD-AU $148.80 0078-0503-15 RIVASTIGMINE 13.3 MG/24 HOUR TRANSDERMAL PT24 $148.64 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 0078-0503-61 RIVASTIGMINE 13.3 MG/24 HOUR TRANSDERMAL PT24 $148.59 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 63739-203-01 ATOVAQUONE 750 MG/5 ML ORAL SUSP $148.33 63739-203-02 ATOVAQUONE 750 MG/5 ML ORAL SUSP $148.33 6332325410 MINERAL OIL, LIGHT STERILE MISC OIL $148.07 HC81700072 CRYOGLOBULIN $148.00 HC89011845 IMMUNE COMPLEXES RAJI CELL-AU $148.00 HC89001341 METHAQUALONE DEF 1-7CLS-AU $148.00 HC81100695 POTASSIUM $148.00 HC81101784 POTASSIUM (POS) $148.00 HC81701617 SYPHILIS TOTAL IGG&IGM $148.00 0409-7810-22 DOPAMINE IN 5 % DEXTROSE 800 MG/250 ML (3,200 MCG/ML) IV SOLN $147.88 0409-7810-11 DOPAMINE IN 5 % DEXTROSE 800 MG/250 ML (3,200 MCG/ML) IV SOLN $147.88 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 63323-288-21 ROPIVACAINE (PF) 10 MG/ML (1 %) INJ SOLN $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 51672-1298-1 KETOCONAZOLE 2 % TOPICAL CREAM $147.42 HC12600417 ADMIN VACCINE SARS-COV-2/COVID-19 $147.00 HC39001227 AHCP CONSULT TELEPHONE PER 15MIN/C $147.00 HC32000234 OT-INFRARED/CMW $147.00 HC31000300 PT-INFRARED/CMW $147.00 HC81700395 RPR/VDRL QUAL $147.00 HC81700387 RPR/VDRL SPINAL FLUID/QUAL. $147.00 67850-141-05 POLIDOCANOL 1 % (20 MG/2 ML) IV SOLN $146.90 67850-141-00 POLIDOCANOL 1 % (20 MG/2 ML) IV SOLN $146.90 63323-286-35 ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJ SOLN $146.84 69097-999-07 PHYTONADIONE (VITAMIN K1) 5 MG ORAL TAB $146.30 69097-999-02 PHYTONADIONE (VITAMIN K1) 5 MG ORAL TAB $146.30 0781-6139-57 AMOXICILLIN-POT CLAVULANATE 600-42.9 MG/5 ML ORAL SUSR $146.25 61314-237-10 CROMOLYN 4 % OPHT DROP $146.25 71839-108-01 DAPTOMYCIN 350 MG IV SOLR $146.25 0548-5607-00 ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRG $146.25 99999-039-81 LEVOTHYROXINE 25 MCG/ML ORAL SUSP (COMPOUND) $146.25 99999-039-69 NITROGLYCERIN 200 MCG/ML INJECTION IR (OCM) $146.25 0338-1049-02 NITROGLYCERIN IN 5 % DEXTROSE 50 MG/250 ML (200 MCG/ML) IV SOLN $146.25 99999-034-57 NITROGLYCERIN IN 5 % DEXTROSE 50 MG/250 ML (200 MCG/ML) IV SOLN $146.25 54288-100-01 ZOLEDRONIC ACID 4 MG/5 ML IV SOLN $146.25 0409-3375-14 NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN $146.09 0409-3375-04 NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN $146.09 HC37000312 MNT THERAPY GROUP EA 30 MIN 2ND REF(DX) $146.00 HC11501046 WC/HB PROLONGED E&M SERVICE ADDL 15MIN+ $146.00 HC89024426 NMDA RECEPTOR AB IGG TITER-AU $145.75 16714-535-01 POSACONAZOLE 100 MG ORAL TBEC $145.67 63323-478-27 CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJ SOLN $145.47 0143-9210-10 CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJ SOLN $145.47 0143-9210-01 CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJ SOLN $145.47 63323-478-01 CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJ SOLN $145.47 75907-024-48 CLONIDINE 0.2 MG/24 HR TRANSDERMAL PTWK $145.17 75907-024-11 CLONIDINE 0.2 MG/24 HR TRANSDERMAL PTWK $145.17 HC81101149 APT TEST (FETAL HGB) $145.00 HC81700668 ASO TITER $145.00 HC89018329 FACTOR VII ASSAY-EC $145.00 HC89023600 GENOTYPE DNA/RNA HIV-AU $145.00 HC89013403 HIV-1 GENOTYPING-AU $145.00 HC51010593 IMMUNOTHERAPY 2/> INJECTIONS /COMM $145.00 HC89024954 MECA/MECC GENE SUSCEPTIBILITY BY PCR-AU $145.00 HC89023592 PHENOTYPE INFECT AGENT DRUG-AU $145.00 62756-059-40 EPOPROSTENOL 0.5 MG IV SOLR $144.63 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 HC51070134 PSY TM CONFW/NONMD 30/+MIN(NO PT)/M $144.00 HC36800639 SODIUM $144.00 HC39000807 SW TEACH/COUNSEL GROUP SESSION - COMM/CCS $144.00 51672-1275-2 CLOTRIMAZOLE 1 % TOPICAL CREAM $143.91 0409-5534-24 SODIUM BICARBONATE 4.2 % (0.5 MEQ/ML) INJ SOLN (MHS WRAPPER) $143.78 0409-5534-14 SODIUM BICARBONATE 4.2 % (0.5 MEQ/ML) IV SYRG $143.78 0591-2511-60 BOSENTAN 62.5 MG ORAL TAB $143.65 45802-465-64 KETOCONAZOLE 2 % TOPICAL SHAM $143.52 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 55292-201-11 SUCCIMER 100 MG ORAL CAP $143.23 0904-7024-04 VORICONAZOLE 200 MG ORAL TAB $143.11 99999-011-06 BETAMETHASONE ACET,SOD PHOS 6 MG/ML INJ SUSP $143.08 0990-7120-07 DEXTROSE 70 % IN WATER (D70W) IV SOLP $143.00 99999-047-36 ELECTROLYTE-A IV SOLP $143.00 31722-063-31 FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSR $143.00 70092-1509-35 FENTANYL 50 MCG/ML DRIP (MHS) $143.00 0990-7715-12 MANNITOL 20 % 20 % IV SOLP $143.00 43598-128-11 METHYLPREDNISOLONE SODIUM SUCC 500 MG IV SOLR $143.00 44567-222-10 NAFCILLIN 2 GRAM INJ SOLR $143.00 42023-214-10 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $143.00 42023-214-01 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $143.00 51754-2004-1 POTASSIUM ACETATE 2 MEQ/ML IV SOLN $143.00 42192-715-06 CICLOPIROX 8 % TOPICAL SOLN $142.94 0409-6562-01 TESTOSTERONE CYPIONATE 200 MG/ML IM OIL $142.94 63323-306-30 TOBRAMYCIN SULFATE 40 MG/ML INJ SOLN $142.94 61703-349-09 IRINOTECAN 100 MG/5 ML IV SOLN $142.81 HC89024756 PURKINJE CELL AB TITER CSF-AU $142.75 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 0078-0414-20 EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG ORAL TAB $142.55 HC89024509 PHOSPHOLIPASE A2 RECEPTOR AB IGG-AU $142.50 16714-496-01 CLOTRIMAZOLE-BETAMETHASONE 1-0.05 % TOPICAL CREAM $142.45 70069-067-10 ROPIVACAINE (PF) 10 MG/ML (1 %) INJ SOLN $141.70 70069-067-01 ROPIVACAINE (PF) 10 MG/ML (1 %) INJ SOLN $141.70 70095-050-01 SODIUM BICARBONATE 1 MEQ/ML (8.4 %) IV SOLN $141.70 99999-002-31 HYDROMORPHONE 100 MG IN D5W 100 ML DRIP $141.57 99999-002-33 HYDROMORPHONE 100MG IN NS 100ML DRIP $141.57 67457-428-30 TOBRAMYCIN SULFATE 40 MG/ML INJ SOLN $141.57 67457-428-00 TOBRAMYCIN SULFATE 40 MG/ML INJ SOLN $141.57 0574-4021-35 BACITRACIN-POLYMYXIN B 500-10,000 UNIT/GRAM OPHT OINT $141.51 0409-4904-34 LIDOCAINE (PF) 50 MG/5 ML (1 %) IV SYRG $141.51 HC89500433 SERUM PRETREATMNT/ABSORP-SB $141.44 0409-1896-20 MORPHINE 50 MG/ML IV SOLN $141.44 60505-0833-5 AZELASTINE 137 MCG (0.1 %) NASL SPRY $141.38 47335-779-91 AZELASTINE 137 MCG (0.1 %) NASL SPRY $141.38 5898096012 EMOLLIENT COMBINATION NO.10 TOPICAL EMUL $141.28 63323-180-01 PYRIDOXINE (VITAMIN B6) 100 MG/ML INJ SOLN $141.25 63323-180-00 PYRIDOXINE (VITAMIN B6) 100 MG/ML INJ SOLN $141.25 63323-286-31 ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJ SOLN $141.18 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 99999-035-09 HYDROMORPHONE 1 MG/ML IN NS 100 ML OPIOID NAIVE PCA $141.05 70860-117-41 NAFCILLIN 2 GRAM INJ SOLR $141.05 70860-117-26 NAFCILLIN 2 GRAM INJ SOLR $141.05 43066-152-10 ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJ SOLN $141.05 43066-152-01 ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJ SOLN $141.05 HC81100513 CHLORIDE SERUM $141.00 HC28000008 CR REHAB PHASE III MONTHLYNTH $141.00 HC31000433 PT-PARAFFIN BATH /CMW $141.00 69680-120-35 LIDOCAINE 5 % TOPICAL OINT $140.98 0187-3010-30 PYRIDOSTIGMINE BROMIDE 60 MG ORAL TAB $140.54 72572-172-01 FENTANYL (PF) 50 MCG/ML INJ FOR INTRATHECAL PAIN PUMP REFILL (OCM) $140.40 45963-614-51 IRINOTECAN 40 MG/2 ML IV SOLN $140.40 99996-000-22 NORMOCARB HF-35 $140.40 0409-4699-24 PROPOFOL 10 MG/ML IV EMUL $140.40 0409-4699-54 PROPOFOL 10 MG/ML IV EMUL $140.40 16714-690-10 PROPOFOL 10 MG/ML IV EMUL $140.40 16714-690-01 PROPOFOL 10 MG/ML IV EMUL $140.40 0069-0248-01 PROPOFOL 10 MG/ML IV EMUL $140.40 0069-0248-10 PROPOFOL 10 MG/ML IV EMUL $140.40 HC89024749 NEURONAL NUCLEAR AB TITER IGG CSF-AU $140.25 HC83505503 ANATOMIC CONSULT; SLIDE REV-CS $140.00 HC51062263 NP ANTEPARTUM FOLLOW UP VISIT $140.00 HC51062271 NP POST PARTUM FOLLOW UP VISIT $140.00 HC32000366 OT-PARAFFIN BATH /CMW $140.00 HC89002356 PLATELET ANTIBODIES-QD $140.00 HC51061992 REMOTE MONITOR PHYSIOL PARAM INTL SUPPLY DEVICE EA 30DAY $140.00 HC89024277 SIROLIMUS-UC $140.00 99999-042-78 MAGNESIUM SULFATE IN NS 20 GRAM/500 ML IV (4%) SOLP (SLH) $139.75 99999-044-51 VANCOMYCIN IN NS 1 GRAM/250 ML IV SOLN (MHS) $139.75 16714-407-03 NORETHINDRONE AC-ETH ESTRADIOL 1.5-30 MG-MCG ORAL TAB $139.64 0378-7274-85 NORETHINDRONE AC-ETH ESTRADIOL 1.5-30 MG-MCG ORAL TAB $139.64 0378-7274-53 NORETHINDRONE AC-ETH ESTRADIOL 1.5-30 MG-MCG ORAL TAB $139.64 49411-050-30 AMINOCAPROIC ACID 500 MG ORAL TAB $139.62 64764-451-24 PIOGLITAZONE 45 MG ORAL TAB $139.56 36000-242-01 TOBRAMYCIN SULFATE 40 MG/ML INJ SOLN $139.43 0641-2341-41 HYDROMORPHONE 2 MG/ML INJ SOLN $139.36 0641-2341-39 HYDROMORPHONE 2 MG/ML INJ SOLN $139.36 62559-138-07 HYDROCORTISONE 100 MG/60 ML RECTAL ENEM $139.23 62559-138-11 HYDROCORTISONE 100 MG/60 ML RECTAL ENEM $139.23 HC81700346 HETEROPHILE AB TITER $139.00 HC36800621 POTASSIUM $139.00 HC43001221 QT SCAN BREAST $139.00 HC29000296 TB TEST (PPD) PROCEDURE $139.00 99999-010-88 METHADONE 1 MG/ML INJ SOLN DILUTION (MCH) $138.94 99999-040-78 METHADONE 10 MG/ML INJ SOLN $138.94 0955-1010-10 ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRG $138.91 HC12600144 ADMIN VACCINE COVID-19 0.5ML AD26 BOOSTER DOSE {JANSSEN } $138.66 HC12600136 ADMIN VACCINE COVID-19 0.5ML AD26 INITIAL DOSE {JANSSEN } $138.66 HC12600128 ADMIN VACCINE COVID-19 100MCG/0.5 3RD DOSE {MODERNA} $138.66 HC12600177 ADMIN VACCINE COVID-19 10MCG TRS-SUCR PEDS DOSE 2ND {PFIZER} $138.66 HC12600169 ADMIN VACCINE COVID-19 10MCG TRS-SUCR PEDS DOSE INITIAL {PFIZER} $138.66 HC12600102 ADMIN VACCINE COVID-19 30MCG/0.3ML 3RD DOSE {PFIZER-BIONTECH} $138.66 HC12600110 ADMIN VACCINE COVID-19 30MCG/0.3ML BOOSTER DOSE {PFIZER-BIONTECH} $138.66 HC12600334 ADMIN VACCINE COVID-19 50 MCG/0.5 ML1ST {MODERNA} $138.66 HC12600151 ADMIN VACCINE COVID-19 50MCG/0.25 LO DOSE BOOSTER {MODERNA} $138.66 10019-553-03 SCOPOLAMINE BASE 1 MG OVER 3 DAYS TRANSDERMAL PT3D $138.42 10019-553-04 SCOPOLAMINE BASE 1 MG OVER 3 DAYS TRANSDERMAL PT3D $138.42 10019-553-90 SCOPOLAMINE BASE 1 MG OVER 3 DAYS TRANSDERMAL PT3D $138.42 0395-1031-16 GLYCERIN 99.5 % TOPICAL SOLN $138.35 55150-183-01 NICARDIPINE 25 MG/10 ML IV SOLN $138.06 55150-183-10 NICARDIPINE 25 MG/10 ML IV SOLN $138.06 HC81500308 HEMOGLOBIN $138.00 HC51010619 IMMNTX 2 STING INSECTS /COMM $138.00 0409-3814-12 MORPHINE (PF) 0.5 MG/ML INJ SOLN $137.54 0409-3814-11 MORPHINE (PF) 0.5 MG/ML INJ SOLN $137.54 0409-6637-24 SODIUM BICARBONATE 8.4 % (1 MEQ/ML) IV SYRG $137.15 0409-6637-14 SODIUM BICARBONATE 8.4 % (1 MEQ/ML) IV SYRG $137.15 HC89016109 AMINO ACIDS QUANT-MA $137.00 HC89024673 AMPHIPHYSIN AB CSF-AU $137.00 HC81500761 SED RATE AUTOMATED $137.00 HC89024665 SOX1 AB IGG BY IMMUNOBLOT CSF-AU $137.00 HC39000740 SW TEACH/COUNSEL INDIVIDUAL -COMM $137.00 0143-9381-01 DOXYCYCLINE HYCLATE 100 MG IV SOLR $136.89 0143-9381-10 DOXYCYCLINE HYCLATE 100 MG IV SOLR $136.89 70004-200-61 FENTANYL (PF) 50 MCG/ML INJ FOR INTRATHECAL PAIN PUMP REFILL (OCM) $136.89 63323-710-59 LEUCOVORIN CALCIUM 200 MG INJ SOLR $136.89 55150-155-20 ACYCLOVIR SODIUM 50 MG/ML IV SOLN $136.50 0409-1967-03 ANTICOAG CITRATE PHOS DEXTROSE 2.63-222 GRAM-MG/100ML MISC SOLN $136.50 0703-4246-01 CARBOPLATIN 10 MG/ML IV SOLN $136.50 0409-7809-24 DOPAMINE IN 5 % DEXTROSE 800 MG/500 ML (1,600 MCG/ML) IV SOLN $136.50 0409-7809-31 DOPAMINE IN 5 % DEXTROSE 800 MG/500 ML (1,600 MCG/ML) IV SOLN $136.50 45802-059-11 NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM $136.50 0472-0166-30 NYSTATIN 100,000 UNIT/GRAM TOPICAL OINT $136.50 45802-048-11 NYSTATIN 100,000 UNIT/GRAM TOPICAL OINT $136.50 71266-5103-1 OXYTOCIN IN 0.9 % SOD CHLORIDE 30 UNIT/500 ML IV SOLN $136.50 14789-137-05 POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN $136.50 14789-137-07 POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN $136.50 65162-673-84 RISPERIDONE 1 MG/ML ORAL SOLN $136.50 0597-0152-37 EMPAGLIFLOZIN 10 MG ORAL TAB $136.38 0597-0152-30 EMPAGLIFLOZIN 10 MG ORAL TAB $136.38 0597-0153-37 EMPAGLIFLOZIN 25 MG ORAL TAB $136.38 0597-0153-30 EMPAGLIFLOZIN 25 MG ORAL TAB $136.38 0409-3815-12 MORPHINE (PF) 1 MG/ML INJ SOLN $136.37 0409-3815-11 MORPHINE (PF) 1 MG/ML INJ SOLN $136.37 51672-1263-1 NYSTATIN-TRIAMCINOLONE 100,000-0.1 UNIT/G-% TOPICAL CREAM $136.21 45802-880-14 NYSTATIN-TRIAMCINOLONE 100,000-0.1 UNIT/G-% TOPICAL CREAM $136.21 63323-120-20 CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJ SOLN $135.85 54838-501-15 HALOPERIDOL LACTATE 2 MG/ML ORAL CONC $135.62 HC89020358 HEAT SHOCK PROTEIN 70-AU $135.55 HC89021661 BARBITURATES MEC(PNL)-AU $135.50 0338-6045-37 FLUCONAZOLE IN NACL (ISO-OSM) 400 MG/200 ML IV PGBK $135.20 HC81100521 CHOLESTEROL $135.00 HC83504035 CHROM ANAL ADD SPEC BAND-GZ $135.00 HC51062222 DIABETIC SELF MANGMT TRNG EA 30M $135.00 HC34000273 SENSORINEURAL ACUITY TEST $135.00 HC89091425 SEROTONIN RELEASE ASSAY -AU $135.00 HC83505933 TISSUE IN-SITU HYBRI EA ADDL -AP $135.00 HC83505925 TISSUE IN-SITU HYBRI INITIAL -AP $135.00 HC81100471 UREA NITROGEN $135.00 0131-2478-60 LACOSAMIDE 100 MG ORAL TAB $134.95 63323-463-57 BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJ SOLN $134.88 63323-463-01 BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJ SOLN $134.88 0409-1391-22 MEROPENEM 1 GRAM IV SOLR $134.58 0409-1391-21 MEROPENEM 1 GRAM IV SOLR $134.58 69616-272-30 PERAMPANEL 2 MG ORAL TAB $134.55 HC89002505 HEPARIN-INDUCED PLATELET AB-QD $134.53 42494-302-00 HYDROCORTISONE ACETATE 25 MG RECTAL SUPP $134.06 HC51060960 OT-ORTHOTIC FIT/TRNG ADD15M/C $134.00 63323-103-51 CISPLATIN 1 MG/ML IV SOLN $133.90 64980-514-15 TIMOLOL MALEATE 0.5 % OPHT DROP $133.87 0409-1775-10 DEXTROSE 25 % IN WATER (D25W) IV SYRG $133.84 0409-1775-40 DEXTROSE 25 % IN WATER (D25W) IV SYRG $133.84 43547-378-03 VORICONAZOLE 200 MG ORAL TAB $133.74 52817-830-04 LEVOCARNITINE (WITH SUGAR) 100 MG/ML ORAL SOLN $133.46 70860-209-10 MESNA 100 MG/ML IV SOLN $133.25 0338-1047-02 NITROGLYCERIN IN 5 % DEXTROSE 25 MG/250 ML (100 MCG/ML) IV SOLN $133.25 25021-310-66 SODIUM NITROPRUSSIDE 25 MG/ML IV SOLN $133.25 72572-100-01 DAPTOMYCIN 350 MG IV SOLR $133.19 HC81500290 HEMATOCRIT $133.00 HC81500860 HEMATOCRIT (POS) $133.00 HC89017909 TUMOR IMMUNOHISTOCHEM/MANL-NG $133.00 24208-434-05 OFLOXACIN 0.3 % OPHT DROP $132.86 63323-285-55 ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJ SOLN $132.60 0013-1114-01 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $132.60 0078-1154-21 DABRAFENIB 10 MG ORAL TBSU $132.26 0713-0882-30 PRASUGREL HCL 10 MG ORAL TAB $132.11 61703-319-22 CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJ SOLN $132.08 HC89021356 A FUMIGATUS-VC $132.00 HC89021349 PAN-ASPERGILLUS-VC $132.00 0069-3031-20 DOXORUBICIN 20 MG/10 ML IV SOLN $131.95 0069-0277-02 DOXORUBICIN 20 MG/10 ML IV SOLN $131.95 0338-9636-01 PIPERACILLIN-TAZOBACTAM-DEXTRS 3.375 GRAM/50 ML EXTENDED INFUSION IVPB (SLH) $131.95 27437-060-60 ARFORMOTEROL 15 MCG/2 ML INHALATION NEBU $131.89 27437-060-01 ARFORMOTEROL 15 MCG/2 ML INHALATION NEBU $131.89 63323-374-20 ONDANSETRON HCL 2 MG/ML IV SOLN $131.69 45802-419-54 AMMONIUM LACTATE 12 % TOPICAL LOTN $131.63 76329-3302-1 DEXTROSE 50 % IN WATER (D50W) IV SYRG $131.63 70121-2309-1 CALCIUM CHLORIDE 100 MG/ML (10 %) IV (STAT-PACK) $131.43 70121-2309-7 CALCIUM CHLORIDE 100 MG/ML (10 %) IV (STAT-PACK) $131.43 0517-6710-01 CALCIUM CHLORIDE 100 MG/ML (10 %) IV (STAT-PACK) $131.43 0517-6710-10 CALCIUM CHLORIDE 100 MG/ML (10 %) IV (STAT-PACK) $131.43 HC89021737 PHENCYCLIDINE (PCP) MEC(PNL)-AU $131.25 HC89500417 RBC ANTIBODY ID EA TECH-SB $131.04 HC89021364 A TERREUS-VC $131.00 HC12600060 ADMIN VACCINE COVID-19 30MCG/0.3ML INITIAL DOSE {PFIZER-BIONTECH} $131.00 HC89019459 FUNGITELL ASSAY, DILUTION-BD $131.00 HC45401668 MR SAFETY IMPLANT POSITN & IMMOBILZ APPLIC PHYS PROTECT PREVENTION $131.00 HC36500007 SMOKING CESSATION 3-10 MIN $131.00 0703-5747-11 CISPLATIN 1 MG/ML IV SOLN $130.98 HC89023097 ANTI-DNA ANTIBODIES SNGL STRND-QI $130.25 47781-427-11 FENTANYL 75 MCG/HR TRANSDERMAL PT72 $130.13 47781-427-47 FENTANYL 75 MCG/HR TRANSDERMAL PT72 $130.13 0378-9123-98 FENTANYL 75 MCG/HR TRANSDERMAL PT72 $130.13 0378-9123-16 FENTANYL 75 MCG/HR TRANSDERMAL PT72 $130.13 0406-9175-76 FENTANYL 75 MCG/HR TRANSDERMAL PT72 $130.13 0406-9075-76 FENTANYL 75 MCG/HR TRANSDERMAL PT72 $130.13 45802-139-70 METRONIDAZOLE 0.75 % (37.5MG/5 GRAM) VAGINAL GEL $130.13 73473-303-70 METRONIDAZOLE 0.75 % (37.5MG/5 GRAM) VAGINAL GEL $130.13 21922-039-23 METRONIDAZOLE 0.75 % (37.5MG/5 GRAM) VAGINAL GEL $130.13 99999-046-25 CAFFEINE CITRATE 5 MG/ML INJ DILUTION (MCH) $130.10 65162-676-84 AZELASTINE 137 MCG (0.1 %) NASL SPRY $130.07 59762-3140-1 AZITHROMYCIN 200 MG/5 ML ORAL SUSR $130.07 51672-1258-2 CLOBETASOL 0.05 % TOPICAL CREAM $130.07 27808-002-01 RISPERIDONE 1 MG/ML ORAL SOLN $130.07 59762-3130-1 AZITHROMYCIN 200 MG/5 ML ORAL SUSR $130.02 25021-601-03 CAFFEINE CITRATE 20 MG/ML INJ SOLN (MCH) $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 HC89024103 BK VIRUS QNT NAAT-AU $130.00 HC89000350 CALCIUM IONIZED-QD $130.00 HC42000950 EVAL DEV FUNCT W/ANLYSIS PM LEADLESS SGL-CHAMB $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 HC89022743 HLA CLASS II TYPING INTERMED RES 1 LOCUS-U9 $130.00 60505-6150-5 CEFTRIAXONE 10 GRAM INJ SOLR $130.00 0143-9678-01 CEFTRIAXONE 10 GRAM INJ SOLR $130.00 67457-452-20 CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJ SOLN $130.00 39822-6200-1 DESMOPRESSIN 4 MCG/ML INJ SOLN $130.00 39822-6200-2 DESMOPRESSIN 4 MCG/ML INJ SOLN $130.00 0338-0719-06 DEXTROSE 70 % IN WATER (D70W) IV SOLP $130.00 61314-030-02 DORZOLAMIDE-TIMOLOL 22.3-6.8 MG/ML OPHT DROP $130.00 70069-051-01 DORZOLAMIDE-TIMOLOL 22.3-6.8 MG/ML OPHT DROP $130.00 65862-946-01 DORZOLAMIDE-TIMOLOL 22.3-6.8 MG/ML OPHT DROP $130.00 99999-038-66 EDTA 3.75% OPTH DROPS (COMPOUND) $130.00 25021-199-20 ERTAPENEM 1 GRAM INJ SOLR $130.00 59651-332-01 FLUCYTOSINE 500 MG ORAL CAP $130.00 43386-770-01 FLUCYTOSINE 500 MG ORAL CAP $130.00 23155-861-03 FLUCYTOSINE 500 MG ORAL CAP $130.00 43386-026-02 FLUOCINONIDE 0.05 % TOPICAL SOLN $130.00 25021-798-10 FOSPHENYTOIN 500 MG PE/10 ML INJ SOLN $130.00 63323-318-01 GRANISETRON (PF) 1 MG/ML (1 ML) IV SOLN $130.00 66794-017-10 ISOFLURANE 99.9 % INHALATION LIQD $130.00 66794-019-10 ISOFLURANE 99.9 % INHALATION LIQD $130.00 99999-008-27 LEUCOVORIN CALCIUM 10 MG/ML INJ SOLN (FOR ORAL USE) (MCH) $130.00 67457-528-10 LEUCOVORIN CALCIUM 100 MG INJ SOLN (MCH) $130.00 25021-814-30 LEUCOVORIN CALCIUM 100 MG INJ SOLN (MCH) $130.00 25021-815-30 LEUCOVORIN CALCIUM 200 MG INJ SOLN (MCH) $130.00 0121-0972-51 LIDOCAINE HCL 4 % (40 MG/ML) MUCOUS MEMB SOLN $130.00 70594-076-02 MEROPENEM 1 GRAM IV SOLR $130.00 70594-076-01 MEROPENEM 1 GRAM IV SOLR $130.00 25021-201-11 MESNA 100 MG/ML IV SOLN $130.00 25021-201-10 MESNA 100 MG/ML IV SOLN $130.00 31722-308-01 OLANZAPINE 10 MG IM SOLR $130.00 60505-6132-6 OXALIPLATIN 50 MG/10 ML (5 MG/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 0641-6188-01 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $130.00 0641-6188-10 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $130.00 71288-201-85 REGADENOSON 0.4 MG/5 ML IV SYRG $130.00 70069-261-01 SODIUM NITROPRUSSIDE 25 MG/ML IV SOLN $130.00 72485-105-01 SODIUM NITROPRUSSIDE 25 MG/ML IV SOLN $130.00 43598-587-23 SODIUM NITROPRUSSIDE 25 MG/ML IV SOLN $130.00 70436-028-80 SODIUM NITROPRUSSIDE 25 MG/ML IV SOLN $130.00 59923-615-05 TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLN $130.00 59923-615-01 TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLN $130.00 0013-1114-21 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $130.00 0013-1114-20 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $130.00 42023-164-01 VASOPRESSIN 20 UNIT/ML INJ SOLN (MCH) $130.00 42023-164-25 VASOPRESSIN 20 UNIT/ML INJ SOLN (MCH) $130.00 42023-164-10 VASOPRESSIN 20 UNIT/ML INJ SOLN (MCH) $130.00 59762-3120-1 AZITHROMYCIN 200 MG/5 ML ORAL SUSR $129.97 0310-6205-30 DAPAGLIFLOZIN PROPANEDIOL 5 MG ORAL TAB $129.94 0409-5921-16 AMINOPHYLLINE 250 MG/10 ML IV SOLN $129.94 0409-5921-01 AMINOPHYLLINE 250 MG/10 ML IV SOLN $129.94 0409-6509-49 VANCOMYCIN 5 GRAM IV SOLR $129.94 5633100616 NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRA $129.90 65862-218-60 CEFDINIR 125 MG/5 ML ORAL SUSR $129.87 68180-723-04 CEFDINIR 250 MG/5 ML ORAL SUSR $129.87 65862-219-60 CEFDINIR 250 MG/5 ML ORAL SUSR $129.87 0713-0678-31 NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM $129.87 50458-140-30 CANAGLIFLOZIN 100 MG ORAL TAB $129.69 50458-141-30 CANAGLIFLOZIN 300 MG ORAL TAB $129.69 44567-246-25 CEFOXITIN 2 GRAM IV SOLR $129.68 50458-580-10 RIVAROXABAN 10 MG ORAL TAB $129.58 50458-580-30 RIVAROXABAN 10 MG ORAL TAB $129.58 50458-580-90 RIVAROXABAN 10 MG ORAL TAB $129.58 50458-580-01 RIVAROXABAN 10 MG ORAL TAB $129.58 50458-578-10 RIVAROXABAN 15 MG ORAL TAB $129.58 50458-578-01 RIVAROXABAN 15 MG ORAL TAB $129.58 50458-578-30 RIVAROXABAN 15 MG ORAL TAB $129.58 50458-579-10 RIVAROXABAN 20 MG ORAL TAB $129.58 50458-579-01 RIVAROXABAN 20 MG ORAL TAB $129.58 50458-579-30 RIVAROXABAN 20 MG ORAL TAB $129.58 0002-7533-01 INSULIN LISPRO 100 UNIT/ML SUBCUTANEOUS SOLN $129.48 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 0093-3655-28 METHYLERGONOVINE 0.2 MG ORAL TAB $129.08 HC89021141 NK CELLS TOTAL COUNT(PNL) -CN $129.00 HC32000069 OT-CONTRAST BATH 15MIN/MW $129.00 HC31000169 PT-CONTRAST BATH 15MIN/MW $129.00 49884-170-04 SODIUM PHENYLBUTYRATE 500 MG ORAL TAB $128.96 0409-4093-11 CHROMIUM CHLORIDE 4 MCG/ML IV SOLN $128.90 0409-4093-01 CHROMIUM CHLORIDE 4 MCG/ML IV SOLN $128.90 0338-9557-12 DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN $128.70 64764-301-14 PIOGLITAZONE 30 MG ORAL TAB $128.66 42023-113-10 KETAMINE 10 MG/ML INJ SOLN $128.57 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 44567-620-24 CALCIUM GLUC IN NACL, ISO-OSM 1 GRAM/50 ML IV SOLN $128.38 44567-620-01 CALCIUM GLUC IN NACL, ISO-OSM 1 GRAM/50 ML IV SOLN $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 80830-2362-2 CALCIUM GLUC IN NACL, ISO-OSM 1 GRAM/50 ML IV SOLN $128.38 80830-2362-1 CALCIUM GLUC IN NACL, ISO-OSM 1 GRAM/50 ML IV SOLN $128.38 0338-1009-02 DOPAMINE IN 5 % DEXTROSE 800 MG/250 ML (3,200 MCG/ML) IV SOLN $128.38 63739-008-33 VORICONAZOLE 200 MG ORAL TAB $128.38 19515-904-41 FLU VAC TS 2025-26(6MOS UP)-PF 45 MCG (15 MCG X 3)/0.5 ML IM SYRG $128.30 19515-904-52 FLU VAC TS 2025-26(6MOS UP)-PF 45 MCG (15 MCG X 3)/0.5 ML IM SYRG $128.30 0009-3475-03 METHYLPREDNISOLONE ACETATE 80 MG/ML INJ SUSP $128.21 0009-3475-01 METHYLPREDNISOLONE ACETATE 80 MG/ML INJ SUSP $128.18 6332325402 MINERAL OIL, LIGHT STERILE MISC OIL $128.12 0409-7517-16 DEXTROSE 50 % IN WATER (D50W) IV SYRG $128.05 0409-7517-66 DEXTROSE 50 % IN WATER (D50W) IV SYRG $128.05 76329-3352-1 SODIUM BICARBONATE 8.4 % (1 MEQ/ML) IV SYRG $128.05 63323-665-01 TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLN $128.05 63323-665-00 TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLN $128.05 63402-911-30 ARFORMOTEROL 15 MCG/2 ML INHALATION NEBU $128.04 63402-911-01 ARFORMOTEROL 15 MCG/2 ML INHALATION NEBU $128.04 63402-911-04 ARFORMOTEROL 15 MCG/2 ML INHALATION NEBU $128.04 63402-911-64 ARFORMOTEROL 15 MCG/2 ML INHALATION NEBU $128.04 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 HC36800647 HEMOGLOBIN $128.00 HC81500266 HEMOSIDERIN QUAL $128.00 HC35500172 MT-BEHAVIOR TX GROUP 1ST 30 MIN $128.00 HC39001557 PSY-BEHAVIOR TX GROUP 1ST 30 MIN $128.00 0264-3153-11 CEFTRIAXONE IN DEXTROSE,ISO-OS 1 GRAM/50 ML IV PGBK $127.92 99988-000-40 NM TC-99M GENERIC SESTAMIBI $127.79 99999-045-12 CEFOTAXIME (STERIMAX - CANADA) 2 GRAM INJ SOLR $127.60 63323-322-20 IMIPENEM-CILASTATIN 500 MG IV SOLR $127.40 99988-000-06 NM TC-99M MEDRONATE/MDP DX 1-25 MCI $127.33 HC29000767 ASSESS/INTERV ALCOHOL/SUBS MISUSE 15-30MIN $127.00 16714-293-03 AMOXICILLIN-POT CLAVULANATE 400-57 MG/5 ML ORAL SUSR $126.75 0409-4910-11 ATROPINE 0.1 MG/ML INJ (STAT-PACK) $126.75 16729-288-11 CISPLATIN 1 MG/ML IV SOLN $126.75 23155-689-41 OCTREOTIDE ACETATE 500 MCG/ML INJ SOLN $126.75 23155-689-31 OCTREOTIDE ACETATE 500 MCG/ML INJ SOLN $126.75 59148-007-13 ARIPIPRAZOLE 5 MG ORAL TAB $126.49 99999-046-33 CLINDAMYCIN IN 5 % DEXTROSE 600 MG/50 ML IV PGBK $126.43 70069-773-01 CALCIUM CHLORIDE 100 MG/ML (10 %) IV (STAT-PACK) $126.23 70069-773-10 CALCIUM CHLORIDE 100 MG/ML (10 %) IV (STAT-PACK) $126.23 63323-884-06 SODIUM PHOSPHATE 3 MMOL/ML IV SOLN $126.17 63323-884-01 SODIUM PHOSPHATE 3 MMOL/ML IV SOLN $126.17 63323-461-57 BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 INJ SOLN $126.10 63323-461-01 BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 INJ SOLN $126.10 72572-128-01 DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN $126.10 72572-128-08 DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN $126.10 0517-7305-25 SODIUM PHOSPHATE 3 MMOL/ML IV SOLN $126.10 0517-7305-01 SODIUM PHOSPHATE 3 MMOL/ML IV SOLN $126.10 42543-052-61 NYSTATIN 100,000 UNIT/GRAM TOPICAL POWD $126.07 69315-306-15 NYSTATIN 100,000 UNIT/GRAM TOPICAL POWD $126.07 68382-446-14 BOSENTAN 62.5 MG ORAL TAB $126.01 HC81700676 ASO SCREEN $126.00 HC89009674 PORPHYRINS FECAL FRACT-AU $126.00 HC51060499 PT EVAL/TX/PROG RPT $126.00 0409-6629-02 SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ SOLN $125.91 HC89007637 DIURETIC SCREEN, URINE - AU $125.59 16714-046-10 ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRG $125.45 16714-046-01 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 61703-262-05 CARBOPLATIN 10 MG/ML IV SOLN $125.19 54643-9023-8 MVI,PEDI NO.1,COMPONENT 1 OF 2 400 UNIT-200 MCG/4 ML IV SOLN $125.03 HC83505800 ANATOMIC CONSULT; SLIDE REV-BC $125.00 HC36800605 CHLORIDE $125.00 HC51070969 COMMUNITY HLTH INTEG PER MO ADDL 30MIN+ $125.00 HC89007694 CORTISOL FREE-QN $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 HC89024012 JAK2 V617F QUAL-AU $125.00 HC89016281 LIPOPROTEIN ELECTROPHORESIS-QD $125.00 HC89001200 LIPOPROTEIN-ASSOC PHS(PLAC)-AU $125.00 HC89003701 PHENMETRAZINE URINE-AU $125.00 HC51070985 PRINCPL ILL NAV PATIENT NAV PER ADDL 30MIN+ $125.00 HC51071017 PRINCPL ILL NAV PEER SUPP PER MO ADDL 30MIN+ $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 HC34000547 EPSDT EAR MEASUREMENT BINAURAL $124.62 HC34000539 EPSDT EAR MEASUREMENT MONOAURAL $124.62 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 0009-0825-01 HYDROCORTISONE SOD SUCCINATE 100 MG INJ SOLR $124.48 72572-470-10 NICARDIPINE 25 MG/10 ML IV SOLN $124.41 72572-470-01 NICARDIPINE 25 MG/10 ML IV SOLN $124.41 55150-183-11 NICARDIPINE 25 MG/10 ML IV SOLN $124.22 55150-183-02 NICARDIPINE 25 MG/10 ML IV SOLN $124.22 99999-039-37 FENTANYL CITRATE (PF)-0.9%NACL 10 MCG/ML IV SOLN $124.15 HC89023071 ANAL' GENE NUDT15 COMMON VARIANT-AU $124.00 HC81100463 BICARBONATE/CO2 $124.00 HC89004428 CHLORAMPHENICOL CSF-MA $124.00 HC89005466 EPSTEIN-BARR VIRUS QNT NAAT PLASMA-AU $124.00 HC83503771 IHC/IP PER SPEC INITIAL AB STAIN HER-2-NEU -IM $124.00 HC89014013 KLEIHAUER BETKE-AU $124.00 50419-451-04 ESTRADIOL 0.05 MG/24 HR TRANSDERMAL PTWK $123.99 HC89009351 ORGANIC ACIDS TOTAL QUANT-AU $123.75 0071-0156-23 ATORVASTATIN 20 MG ORAL TAB $123.73 0093-4175-73 CEPHALEXIN 125 MG/5 ML ORAL SUSR $123.50 68180-440-01 CEPHALEXIN 125 MG/5 ML ORAL SUSR $123.50 44567-602-24 DEXMEDETOMIDINE IN DEXTROSE 5% 200 MCG/50 ML (4 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 72578-089-04 NYSTATIN 100,000 UNIT/GRAM TOPICAL OINT $123.44 0574-0521-76 ACTIVATED CHARCOAL 50 GRAM/240 ML ORAL SUSP $123.24 0574-0520-76 ACTIVATED CHARCOAL-SORBITOL 50 GRAM/240 ML ORAL SUSP $123.24 67457-530-35 LEUCOVORIN CALCIUM 350 MG INJ SOLR $123.18 0456-1201-30 LINACLOTIDE 145 MCG ORAL CAP $123.06 0456-1202-30 LINACLOTIDE 290 MCG ORAL CAP $123.06 0456-1203-30 LINACLOTIDE 72 MCG ORAL CAP $123.06 HC81701716 CRYOFIBRINOGEN $123.00 HC36800274 PHYSIOLOGIC DATA COLLECTION $123.00 HC51070704 PSY-ASSESS BEHAVIOR W/SCORE & DOCD/STAND INSTRUMENT $123.00 HC89022339 FLOW CYTOMETRY 1ST MRKR{W-INT/87}-CC $122.98 0121-0675-85 VALPROATE SODIUM 250 MG/5 ML ORAL SYRP (MCH) $122.98 66794-219-43 LINEZOLID 600 MG/300 ML IV SOLP (MCH) $122.85 66794-219-63 LINEZOLID 600 MG/300 ML IV SOLP (MCH) $122.85 0781-3433-46 LINEZOLID 600 MG/300 ML IV SOLP (MCH) $122.85 0781-3433-95 LINEZOLID IN DEXTROSE 5% 600 MG/300 ML IV PGBK $122.85 0131-2478-35 LACOSAMIDE 100 MG ORAL TAB $122.68 65649-003-30 PLECANATIDE 3 MG ORAL TAB $122.60 0264-3123-11 CEFOXITIN IN DEXTROSE, ISO-OSM 1 GRAM/50 ML IV PGBK $122.58 16729-526-08 ATROPINE 1 MG/ML INJ SOLN (MHS WRAPPER) $122.46 16729-526-63 ATROPINE 1 MG/ML INJ SOLN (MHS WRAPPER) $122.46 72603-203-01 EPHEDRINE SULFATE 50 MG/ML IV SOLN $122.29 72603-203-25 EPHEDRINE SULFATE 50 MG/ML IV SOLN $122.29 99999-033-66 ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL SUSP (MCH) $122.27 59923-601-10 PAMIDRONATE 30 MG IV SOLR $122.14 0781-3299-69 ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRG $122.08 0781-3299-05 ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRG $122.08 HC81101560 BICARBONATE $122.00 HC89021158 FACTOR VIII INHIBITOR TEST(PNL) -EC $122.00 HC89024418 NMDA RECEPTOR AB IGG CBA-IFA SCRN-AU $121.50 0173-0517-00 EPOPROSTENOL (GLYCINE) 0.5 MG IV SOLR $121.49 72572-140-02 DIAZEPAM 5 MG/ML INJ SYRG $121.16 72572-140-01 DIAZEPAM 5 MG/ML INJ SYRG $121.16 HC39001631 CAREGVR TRAIN BEHAVIOR MGMT F2F PT NOT PRESENT EA ADDL 15MIN+ $121.00 HC21001102 CAREGVR TRAIN DIRECT CARE ONGOING ILLNESS INCL WOUND &INFECT F2F PT NOT PRESENT EA ADDL 15MIN+ $121.00 HC89013304 HIV-1 DNA PCR QUAL-AU $121.00 HC32010506 OT-TRAIN CAREGVR ADL,MOBILE,SAFE PT NOT PRESENT ADDL 15MIN+ $121.00 HC84600121 PAP DEFIN HORMONAL EVAL+ $121.00 HC31090202 PT-TRAIN CAREGVR ADL,MOBILE,TRANSFER PT NOT PRESENT ADDL 15MIN+ $121.00 HC33010356 ST-TRAIN CAREGVR ADL,FEED,SWALLOW PT NOT PRESENT ADDL 15MIN+ $121.00 99999-047-06 RIFAMPIN 25 MG/ML ORAL LIQUID (COMPOUND) $120.90 54092-547-01 PRUCALOPRIDE 2 MG ORAL TAB $120.73 0378-3349-99 ESTRADIOL 0.025 MG/24 HR TRANSDERMAL PTWK $120.67 0378-3349-16 ESTRADIOL 0.025 MG/24 HR TRANSDERMAL PTWK $120.67 0378-3360-99 ESTRADIOL 0.0375 MG/24 HR TRANSDERMAL PTWK $120.67 0378-3360-16 ESTRADIOL 0.0375 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 99999-045-98 IOHEXOL 350 MG IODINE/ML IV SOLN $120.64 59011-440-20 OXYCODONE 40 MG ORAL TR12 $120.59 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 0409-3181-01 LIDOCAINE-EPINEPHRINE (MPF) 1.5 %-1:200,000 INJ SOLN (MHS) $120.32 0409-3181-11 LIDOCAINE-EPINEPHRINE (MPF) 1.5 %-1:200,000 INJ SOLN (MHS) $120.32 67457-640-99 PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN $120.25 67457-640-00 PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN $120.25 51672-1264-1 FLUOCINONIDE 0.05 % TOPICAL OINT $120.22 0065-0349-05 PHENYLEPHRINE HCL 2.5 % OPHT DROP $120.12 HC89019582 ANTI-EMA IGA AB IFA 1ST STAIN(PNL1155/6360)-PR $120.00 HC81500787 BLOOD COUNT LEUKOCYTE(WBC)AUTO $120.00 HC89007488 CHROMATOGRAPHY QUAL-AU $120.00 HC89020200 DNASE INDIRECT IGG ADDL STAIN(PNL)-PR $120.00 HC89020192 PANCA INDIRECT IGG 1ST STAIN(PN)-PR $120.00 HC89016331 RICKETTSIA AB PANEL-QD $120.00 HC89010060 TSH RECEPTOR AB-ES $120.00 99999-038-55 MAALOX/BENADRYL 1:1 $120.00 99999-037-34 MAGIC MOUTHWASH ORAL LIQUID (SIMPLE) $120.00 0409-4911-11 ATROPINE 0.1 MG/ML INJ (STAT-PACK) $119.99 0409-4911-34 ATROPINE 0.1 MG/ML INJ (STAT-PACK) $119.99 3932806412 SODIUM HYPOCHLORITE 0.125 % MISC SOLN $119.91 39328-063-25 SODIUM HYPOCHLORITE 0.25 % MISC SOLN $119.91 72603-286-01 TESTOSTERONE CYPIONATE 200 MG/ML IM OIL $119.73 63323-417-10 CISATRACURIUM 2 MG/ML IV SOLN $119.60 63323-417-01 CISATRACURIUM 2 MG/ML IV SOLN $119.60 63323-117-69 FLUOROURACIL 5 GRAM/100 ML IV SOLN $119.60 25021-223-20 CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJ SOLN $119.47 71288-109-20 CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJ SOLN $119.47 0378-6470-16 SCOPOLAMINE BASE 1 MG OVER 3 DAYS TRANSDERMAL PT3D $119.47 0378-6470-44 SCOPOLAMINE BASE 1 MG OVER 3 DAYS TRANSDERMAL PT3D $119.47 51754-1220-3 NEOSTIGMINE METHYLSULFATE 1 MG/ML INJ SOLN (MCH) $119.34 51754-1220-1 NEOSTIGMINE METHYLSULFATE 1 MG/ML INJ SOLN (MCH) $119.34 51754-1240-1 NEOSTIGMINE METHYLSULFATE 1 MG/ML IV SOLN $119.34 51754-1240-3 NEOSTIGMINE METHYLSULFATE 1 MG/ML IV SOLN $119.34 0409-4902-34 DEXTROSE 50 % IN WATER (D50W) IV SYRG $119.28 0409-4902-64 DEXTROSE 50 % IN WATER (D50W) IV SYRG $119.28 71266-6290-1 LIDOCAINE-EPINEPHR-TETRACAINE 4-0.18-0.5 % TOPICAL GEL $119.09 HC82202797 ADDITIONAL UNSTAINED SLIDES $119.00 HC51010809 MICROSCOPY BINOCULAR EAR $119.00 0409-4011-01 VERAPAMIL 2.5 MG/ML IV SOLN $118.96 0409-4011-61 VERAPAMIL 2.5 MG/ML IV SOLN $118.96 0409-1755-50 BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJ SOLN $118.95 0078-0241-61 CYCLOSPORINE 100 MG ORAL CAP $118.82 0078-0241-15 CYCLOSPORINE 100 MG ORAL CAP $118.69 99999-045-61 FAT EMULSION 20 % IV EMUL $118.63 52536-625-01 TESTOSTERONE CYPIONATE 200 MG/ML IM OIL $118.63 99988-000-37 NM TC-99M MEBROFENIN 1-10 MCI $118.62 68180-657-01 DOXYCYCLINE MONOHYDRATE 25 MG/5 ML ORAL SUSR $118.56 68462-181-35 CLOTRIMAZOLE 1 % TOPICAL CREAM $118.37 63323-692-22 ACETYLCYSTEINE 20 % (200 MG/ML) ORAL SOLN $118.25 99999-046-10 IOHEXOL 300 MG IODINE/ML IV SOLN $118.04 HC83505636 BRAF MUTATION ANALYSIS-NG $118.00 HC81100224 GLUCOSE TOLERANCE EA ADDL SPEC $118.00 HC81101057 OCCULT BLOOD OTHER SOURCE $118.00 59212-242-55 DIGOXIN 125 MCG (0.125 MG) ORAL TAB $117.99 59212-242-56 DIGOXIN 125 MCG (0.125 MG) ORAL TAB $117.99 59212-249-55 DIGOXIN 250 MCG (0.25 MG) ORAL TAB $117.99 51552-1053-4 DIMETHYL SULFOXIDE (BULK) 99.99 % MISC LIQD $117.65 HC89022636 PREGNENOLONE-QN $117.30 HC51062511 ADMIN VACCINE HEPATITIS B $117.24 HC51020378 ADMIN VACCINE INFLUENZA $117.24 HC51020386 ADMIN VACCINE PNEUMOCOCCAL $117.24 HC51010577 IMMUNTX NOT INCL EXTRCT 2/+ INJ $117.24 HC51010726 IMMUNTX PREP-PROV 1/+AG BUG/ARTHPD $117.24 HC51010718 IMMUNTX PREP-PROV 1/+ANTIGNS $117.24 HC51010650 IMMUNTX PREP-PROV AG SNGL DOSE VL $117.24 HC51010676 IMMUNTX PREP-PROV AG2STING BUG VNM $117.24 HC51000412 IV INF HYDRATION EA ADD'L HR $117.24 HC51000230 IV INFUSION THERAPY EA ADDL HR $117.24 HC51000263 IVP SINGLE/EA NEW RX ADD'L INJ $117.24 HC51020402 SC INFUSION THERAPY EA ADDL HOUR $117.24 99999-046-01 IODIXANOL 320 MG IODINE/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 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 HC32000218 OT-HOT/COLD PACKS /CMW $117.00 HC82202938 PROCESS & EMBED ONLY $117.00 HC82202920 PROCESS, EMBED & 1 UNSTN SLIDE $117.00 HC31000284 PT-HOT/COLD PACKS /CMW $117.00 HC39000732 SW ASSESS/INTERVEN PER 30MIN/MCL $117.00 59651-214-30 AZELASTINE 137 MCG (0.1 %) NASL SPRY $117.00 64980-511-10 CLINDAMYCIN PALMITATE 75 MG/5 ML ORAL SOLR (MCH) $117.00 69238-1532-6 CLOBETASOL 0.05 % TOPICAL CREAM $117.00 0548-5606-00 ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRG $117.00 60505-0829-1 FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASL SPSN $117.00 24208-463-25 LATANOPROST 0.005 % OPHT DROP $117.00 99999-010-51 MAGNESIUM SULFATE 20 G IN D5W 250 ML IV (LBM) $117.00 61314-630-06 NEOMYCIN-POLYMYXIN B-DEXAMETH 3.5MG/ML-10,000 UNIT/ML-0.1 % OPHT DRPS $117.00 43598-529-11 NEOSTIGMINE METHYLSULFATE 1 MG/ML INJ SOLN (MCH) $117.00 43598-529-36 NEOSTIGMINE METHYLSULFATE 1 MG/ML INJ SOLN (MCH) $117.00 55111-694-07 PALONOSETRON 0.25 MG/5 ML IV SOLN $117.00 25021-783-05 PALONOSETRON 0.25 MG/5 ML IV SOLN $117.00 0781-3312-95 PALONOSETRON 0.25 MG/5 ML IV SOLN $117.00 60505-6193-1 PALONOSETRON 0.25 MG/5 ML IV SOLN $117.00 54288-136-25 PHENOBARBITAL SODIUM 65 MG/ML INJ SOLN $117.00 3834400001 PYRITHIONE ZINC 0.25 % TOPICAL SPRY $117.00 0338-0047-47 SODIUM CHLORIDE 0.9 % IRR SOLN $117.00 45963-607-55 VINORELBINE 10 MG/ML IV SOLN $117.00 63323-652-10 ESMOLOL 100 MG/10 ML (10 MG/ML) IV SOLN $116.74 24208-505-05 LEVOBUNOLOL 0.5 % OPHT DROP $116.42 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 50268-803-12 VORICONAZOLE 200 MG ORAL TAB $116.07 50268-803-11 VORICONAZOLE 200 MG ORAL TAB $116.07 HC89012413 COXSACKIE B AB-AU $116.00 HC83504043 TISSUE EXAM G&M LEVEL 4PROF-CS $116.00 HC81100331 VOL MEASURE TIMED COLLECTION $116.00 63323-488-37 LIDOCAINE-EPINEPHRINE (MPF) 1.5 %-1:200,000 INJ SOLN (MHS) $115.83 63323-488-07 LIDOCAINE-EPINEPHRINE (MPF) 1.5 %-1:200,000 INJ SOLN (MHS) $115.83 HC89023220 FIBRINOLYSIS COAG ADAMTS-13-AU $115.75 76282-739-52 OSELTAMIVIR 6 MG/ML ORAL SUSR $115.44 0065-0411-30 POVIDONE-IODINE 5 % OPHT SOLN $115.44 99999-039-91 DEXTROSE 10% + AMINO ACIDS 3% + HEPARIN (FOR NICU BRIDGE) $115.38 61703-309-06 VINCRISTINE 1 MG/ML IV SOLN $115.38 0517-6510-25 SELENIUM 40 MCG/ML IV SOLN $115.25 0135-0200-01 DOCOSANOL 10 % TOPICAL CREAM $115.05 HC12600318 ADMIN VACCINE COVID-19 25MCG/0.25ML IM PEDS DOSE 2ND {MODERNA} $115.00 HC12600300 ADMIN VACCINE COVID-19 25MCG/0.25ML IM PEDS DOSE INITIAL {MODERNA} $115.00 HC12600391 ADMIN VACCINE COVID-19 BIVALENT 30MCG/0.3ML BOOSTER {PFIZER-BIONTECH} $115.00 HC12600409 ADMIN VACCINE COVID-19 BIVALENT 50MCG/0.5ML BOOSTER {MODERNA} $115.00 HC81101701 CHOLESTEROL (DA) $115.00 HC89003586 EPHEDRINE; 1-2 URINE-AU $115.00 HC36800613 METHEMOGLOBIN,QUANT $115.00 HC81500274 WBC AUTO DIFF $115.00 61919-505-30 PREGABALIN 100 MG ORAL CAP $114.98 HC51060945 OT-ORTHOTIC/PROSTH MGMT/TRAIN SUBSQ 15MIN/M $114.68 63323-095-02 SODIUM CHLORIDE 4 MEQ/ML (23.4%) INFUSION (FOR ELEVATED ICP) $114.40 63323-095-61 SODIUM CHLORIDE 4 MEQ/ML (23.4%) INFUSION (FOR ELEVATED ICP) $114.40 0456-2220-30 LEVOMILNACIPRAN 20 MG ORAL CS24 $114.05 HC81100851 OB FECES GUAIAC1-3 NEOPLSM SCR $114.00 HC89012579 SCHISTOSOMA AB-FT $114.00 0597-0140-30 LINAGLIPTIN 5 MG ORAL TAB $113.77 0597-0140-90 LINAGLIPTIN 5 MG ORAL TAB $113.77 574031216 COMPOUND VEH.SUSP SUGAR-FREE 1 ORAL SUSP $113.76 574030316 COMPOUND VEHICLE SUSP SF NO.20 ORAL SUSP $113.76 574030216 COMPOUNDING VEHICLE SF NO.9 ORAL LIQD $113.76 574030416 COMPOUNDING VEHICLE SYRUP NO23 ORAL SYRP $113.76 3172295901 COMPOUNDING VEHICLE SYRUP NO23 ORAL SYRP $113.76 47335-882-44 NICARDIPINE 25 MG/10 ML IV SOLN $113.75 47335-882-40 NICARDIPINE 25 MG/10 ML IV SOLN $113.75 14789-127-05 PHENOBARBITAL SODIUM 65 MG/ML INJ SOLN $113.75 14789-127-07 PHENOBARBITAL SODIUM 65 MG/ML INJ SOLN $113.75 42192-605-10 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $113.75 42192-605-01 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $113.75 24338-104-03 ERYTHROMYCIN 500 MG ORAL TAB $113.71 99999-046-23 TACROLIMUS 1 MG/ML ORAL SUSP (COMPOUND) $113.69 HC89024004 ANTIBODY ANTI-C1Q IGG-AU $113.63 HC89022396 FLOW CYT LEUK/LYMPH 1ST MRKR{W-INT/89}-AU $113.50 67457-852-04 NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN $113.49 67457-852-00 NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN $113.49 72078-002-00 NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN $113.49 71357-008-01 SODIUM ACETATE 2 MEQ/ML IV SOLN $113.10 71357-008-10 SODIUM ACETATE 2 MEQ/ML IV SOLN $113.10 70710-1644-1 VERAPAMIL 2.5 MG/ML IV SOLN $113.10 70710-1644-5 VERAPAMIL 2.5 MG/ML IV SOLN $113.10 70756-606-05 VERAPAMIL 2.5 MG/ML IV SOLN $113.10 70756-606-85 VERAPAMIL 2.5 MG/ML IV SOLN $113.10 63323-047-10 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $113.04 63323-047-01 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $113.04 HC82202789 ADDL UNSTAINED SLIDE/PROC BLK $113.00 HC82202672 H & E BLOCK (CLIENT) $113.00 HC82202680 H & E BLOCK ADDITIONAL(CLIENT) $113.00 HC89003594 HYDROXYZINE URINE-AU $113.00 HC82202698 LEVEL/RECUTS (CLIENT) $113.00 HC32001398 OT-CASE/TEAM CONF ADD15 MIN/C $113.00 HC39001615 PSYC GROUP EVAL/TX MENT/SUB USE DO REMOTE $113.00 HC89006936 TRIMIPRAMINE-AU $113.00 63323-130-17 DOXYCYCLINE HYCLATE 100 MG IV SOLR $112.65 63323-130-13 DOXYCYCLINE HYCLATE 100 MG IV SOLR $112.61 63323-130-03 DOXYCYCLINE HYCLATE 100 MG IV SOLR $112.61 0409-7334-10 CEFTRIAXONE 10 GRAM INJ SOLR $112.58 HC89023014 ACTH-QN $112.45 HC89500599 BLOOD TYPING AG SCREEN(PT)-SB $112.32 HC89500557 COOMBS DIRECT(EA)-SB $112.32 63323-692-10 ACETYLCYSTEINE 200 MG/ML (20 %) MISC SOLN $112.32 99999-045-72 PENICILLIN G POT IN DEXTROSE 3 MILLION UNIT/50 ML IV PGBK $112.13 HC81101305 GLUCOSE BY REAGENT STRIP $112.00 HC89001648 PHENSUXIMIDE-AU $112.00 HC89018246 PLATELET NEUT-EC $112.00 HC51070308 PSYCH TX FOR CRISIS EA ADD 30MINS+ $112.00 HC51062032 SELF MANAGEMENT EDUC & TRAINING 2-4PTS 30MIN (PRIVAT INSAUTHREQ) $112.00 0054-0517-44 MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLN $111.74 67457-153-18 AMIODARONE 50 MG/ML IV SOLN $111.62 72078-046-18 AMIODARONE 50 MG/ML IV SOLN $111.62 64764-730-30 VORTIOXETINE 10 MG ORAL TAB $111.40 64764-750-30 VORTIOXETINE 20 MG ORAL TAB $111.40 64764-720-30 VORTIOXETINE 5 MG ORAL TAB $111.40 HC83506113 IF STUDY DIRECT 1ST STAIN-PA $111.19 0409-4928-34 CALCIUM CHLORIDE 10% IV SOLN (MCH) $111.15 0409-4928-11 CALCIUM CHLORIDE 10% IV SOLN (MCH) $111.15 0955-1008-01 ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRG $111.10 0955-1008-10 ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRG $111.10 63323-349-25 IMIPENEM-CILASTATIN 250 MG IV SOLR $111.09 HC25001405 ADMIN VACCINE HEPATITIS B $111.00 HC89024624 GLUTAMIC ACID DECARBOXYLASE AB CSF-AU $111.00 63323-617-20 MILRINONE 1 MG/ML IV SOLN $110.89 54838-510-80 OXYBUTYNIN CHLORIDE 1 MG/1 ML ORAL LIQUID $110.68 42571-244-69 CAFFEINE CITRATE 20 MG/ML INJ SOLN (MCH) $110.51 5155200516 ACETIC ACID (BULK) 3 % MISC LIQD $110.50 395004912 ALUM, AMMONIUM (BULK) MISC POWD $110.50 0409-1752-50 BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 INJ SOLN $110.50 0338-0221-04 ELECTROLYTE-A IV SOLP $110.50 67457-273-00 METHOCARBAMOL 100 MG/ML INJ SOLN $110.50 67457-273-10 METHOCARBAMOL 100 MG/ML INJ SOLN $110.50 47335-932-44 VECURONIUM BROMIDE 20 MG IV SOLR $110.50 47335-932-40 VECURONIUM BROMIDE 20 MG IV SOLR $110.50 41616-932-40 VECURONIUM BROMIDE 20 MG IV SOLR $110.50 65162-914-46 TOBRAMYCIN IN 0.225 % NACL 300 MG/5 ML INHALATION NEBU $110.27 99988-000-14 NM TC-99M TETROFOSMIN 1-30 MCI (MYOVIEW) $110.25 0517-1001-25 ATROPINE 1 MG/ML INJ SOLN (MHS WRAPPER) $110.24 0517-1001-01 ATROPINE 1 MG/ML INJ SOLN (MHS WRAPPER) $110.24 67877-124-05 SILVER SULFADIAZINE 1 % TOPICAL CREAM $110.18 67877-124-50 SILVER SULFADIAZINE 1 % TOPICAL CREAM $110.18 HC89008551 CARNITINE URINE-CA $110.00 HC89014922 CHROM ANALYSIS BONE MARROW-GZ $110.00 HC89003529 ENTEROVIRUS BY PCR/BLOOD-AU $110.00 HC34000554 EPSDT HEARING AID CONFORMITY ASSESS $110.00 HC51010569 IMMUNTX NOT INCL EXTRACT 1 INJ $110.00 HC51010668 IMMUNTX PREP-PROV AG1STING BUG VNM $110.00 HC89011720 TOXOCARA CANIS/ELISA-FT $110.00 0069-5474-01 FOSPHENYTOIN 500 MG PE/10 ML INJ SOLN $109.98 0069-5474-02 FOSPHENYTOIN 500 MG PE/10 ML INJ SOLN $109.98 62856-245-30 DONEPEZIL 5 MG ORAL TAB $109.66 51672-4048-1 CLOTRIMAZOLE-BETAMETHASONE 1-0.05 % TOPICAL CREAM $109.59 0168-0258-15 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 99999-000-17 DIAZEPAM 0.5 MG/ML (NICU) INJECTION $109.40 24208-277-15 SODIUM CHLORIDE 5 % OPHT DROP $109.10 24208-385-55 SODIUM CHLORIDE 5 % OPHT OINT $109.06 HC89023543 ACYLCARNITINES QUANT-AU $109.00 HC89017255 AMINO ACIDS QUANT URINE-AU $109.00 HC89012546 CYSTICERCOSIS AB-FT $109.00 63323-851-07 HYDROMORPHONE (PF) 10 MG/ML INJ FOR INTRATHECAL PAIN PUMP REFILL (OCM) $108.42 63323-851-15 HYDROMORPHONE (PF) 10 MG/ML INJ FOR INTRATHECAL PAIN PUMP REFILL (OCM) $108.42 72989-372-30 PROGESTERONE MICRONIZED 100 MG ORAL CAP $108.39 67457-437-00 DOXYCYCLINE HYCLATE 100 MG IV SOLR $108.37 67457-437-10 DOXYCYCLINE HYCLATE 100 MG IV SOLR $108.37 HC89000921 CATECHOLAMINES TOTAL-QD $108.00 HC89008064 FLUORIDE-AU $108.00 HC51000255 IV INF THER CONCURRENT/ ENCNTR $108.00 HC82202334 M: MISC SURGICAL PATH PROC $108.00 HC89019780 QUANT HPLC 6-TGN RBC(P THIOPUR)-PR $108.00 HC89019798 QUANT HPLC-6-MMPN RBC(P THIOPUR)-PR $108.00 HC34000257 STENGER TEST PURE TONE $108.00 70069-641-01 ATROPINE 1 MG/ML INJ SOLN (MHS WRAPPER) $107.70 70069-641-25 ATROPINE 1 MG/ML INJ SOLN (MHS WRAPPER) $107.70 68084-921-25 CYCLOSPORINE 100 MG ORAL CAP $107.55 68084-921-95 CYCLOSPORINE 100 MG ORAL CAP $107.55 63323-286-23 ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJ SOLN $107.38 63323-286-05 ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJ SOLN $107.38 5155200556 ACETIC ACID (BULK) 5 % MISC LIQD $107.25 0990-7936-19 DEXTROSE 50 % IN WATER (D50W) IV SOLP $107.25 0019-4816-04 DIATRIZOATE MEG-DIATRIZOAT SOD 66-10 % ORAL SOLN $107.25 0264-9577-10 HEPARIN (PORCINE) IN 5 % DEX 25,000 UNIT/500 ML (50 UNIT/ML) IV SOLP $107.25 70069-101-05 METHOCARBAMOL 100 MG/ML INJ SOLN $107.25 70069-101-01 METHOCARBAMOL 100 MG/ML INJ SOLN $107.25 69238-1605-8 METHYLERGONOVINE 0.2 MG ORAL TAB $107.25 69238-1605-2 METHYLERGONOVINE 0.2 MG ORAL TAB $107.25 0781-3458-75 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $107.25 0781-3458-95 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $107.25 0781-9227-95 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $107.25 0781-9227-75 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $107.25 HC29000783 ASSESS ALCOHOL/SUBS MISUSE 5-14MIN $107.00 72572-803-01 VANCOMYCIN 5 GRAM IV SOLR $106.80 0025-1525-34 CELECOXIB 200 MG ORAL CAP $106.72 0409-2634-10 HYDROMORPHONE (PF) 10 MG/ML INJ SOLN $106.37 0409-2634-01 HYDROMORPHONE (PF) 10 MG/ML INJ SOLN $106.37 16714-294-01 AMOXICILLIN-POT CLAVULANATE 600-42.9 MG/5 ML ORAL SUSR $106.28 HC51071082 ADMIN VACCINE SARS-COV-2/COVID-19 $106.18 70121-1574-1 METHYLPREDNISOLONE ACETATE 80 MG/ML INJ SUSP $106.08 70121-1574-5 METHYLPREDNISOLONE ACETATE 80 MG/ML INJ SUSP $106.08 70121-1552-1 METHYLPREDNISOLONE ACETATE 80 MG/ML INJ SUSP $106.08 HC89004196 ANTI-ENDOMY IGA AB IFA1ST STAIN(PNL)-PR $106.00 HC89004527 ANTI-ENDOMY IGA AB IFA1ST STAIN(PNL2-PR $106.00 HC51000032 DM HEMOGLOBIN GLYCOSYLATED(A1C $106.00 HC89006837 NAPROXEN-AU $106.00 HC51070753 PSY-BEHAVIOR TX INDIV ADDL 15 MIN $106.00 HC89009989 THIOCYANATE, QUANT S/P-AU $106.00 99999-046-88 PIPERACILLIN-TAZOBACTAM 90 MG/ML INJ SYR (USING 40.5 G) $105.95 0409-6533-11 VANCOMYCIN 1,000 MG IV SOLR $105.83 0409-6533-21 VANCOMYCIN 1,000 MG IV SOLR $105.83 0093-5420-88 CABERGOLINE 0.5 MG ORAL TAB $105.63 72485-305-01 SODIUM NITROPRUSSIDE 25 MG/ML IV SOLN $105.63 47781-423-11 FENTANYL 12 MCG/HR TRANSDERMAL PT72 $105.57 47781-423-47 FENTANYL 12 MCG/HR TRANSDERMAL PT72 $105.57 0406-9112-76 FENTANYL 12 MCG/HR TRANSDERMAL PT72 $105.57 0378-9119-98 FENTANYL 12 MCG/HR TRANSDERMAL PT72 $105.57 0378-9119-16 FENTANYL 12 MCG/HR TRANSDERMAL PT72 $105.57 0406-9012-76 FENTANYL 12 MCG/HR TRANSDERMAL PT72 $105.57 0409-6729-11 MAGNESIUM SULFATE IN WATER 2 GRAM/50 ML (4 %) IV PGBK $105.30 0409-6729-24 MAGNESIUM SULFATE IN WATER 2 GRAM/50 ML (4 %) IV PGBK $105.30 0254-2045-02 POSACONAZOLE 100 MG ORAL TBEC $105.09 70092-1611-44 LIDOCAINE-RACEPINEP-TETRACAINE 4-0.05-0.5 % TOPICAL GEL $105.05 0378-6470-99 SCOPOLAMINE BASE 1 MG OVER 3 DAYS TRANSDERMAL PT3D $105.04 0168-0163-15 CLOBETASOL 0.05 % TOPICAL CREAM $105.01 HC51060069 PT-TEST/MEASUREMENT ADD15MIN/C $105.00 47781-335-30 PYRIDOSTIGMINE BROMIDE 180 MG ORAL TBSR $104.81 0115-1404-08 PYRIDOSTIGMINE BROMIDE 180 MG ORAL TBSR $104.81 43975-253-14 TEMOZOLOMIDE 20 MG ORAL CAP $104.55 HC51060929 OT-ORTHOTIC MGMT & TRNG INITIAL ENC 15MIN/M $104.44 65862-301-30 EMTRICITABINE 200 MG ORAL CAP $104.44 61703-304-36 CYTARABINE 20 MG/ML INJ SOLN $104.33 99999-044-50 VANCOMYCIN IN NS 750 MG/150 ML IV SOLN (MHS) $104.33 0456-2020-01 ESCITALOPRAM OXALATE 20 MG ORAL TAB $104.29 16714-309-10 VANCOMYCIN 1,000 MG IV SOLR $104.26 16714-309-01 VANCOMYCIN 1,000 MG IV SOLR $104.26 67457-340-01 VANCOMYCIN 1,000 MG IV SOLR $104.26 67457-340-00 VANCOMYCIN 1,000 MG IV SOLR $104.26 42806-757-60 SULFADIAZINE 500 MG ORAL TAB $104.19 24357-701-15 LIDOCAINE 4 % TOPICAL CREAM $104.03 HC89500441 RBC ANTIBODY ELUTION-SB $104.00 HC89500482 RBC ANTIBODY SCRN EA TECH-SB $104.00 HC29000460 SCREENING VISION $104.00 99999-043-93 ASCORBIC ACID 1500 MG IN NS 100 ML IVPB (SLH) $104.00 0054-3177-63 DEXAMETHASONE 0.5 MG/5 ML ORAL SOLN $104.00 71288-030-20 DOXYCYCLINE HYCLATE 100 MG IV SOLR $104.00 71288-030-21 DOXYCYCLINE HYCLATE 100 MG IV SOLR $104.00 0143-9554-01 LEUCOVORIN CALCIUM 100 MG INJ SOLN (MCH) $104.00 68001-416-36 LEUCOVORIN CALCIUM 100 MG INJ SOLN (MCH) $104.00 71288-161-20 LEUCOVORIN CALCIUM 100 MG INJ SOLN (MCH) $104.00 0409-2045-10 MILRINONE IN 5 % DEXTROSE 20 MG/100 ML (200 MCG/ML) IV PGBK $104.00 0409-2045-01 MILRINONE IN 5 % DEXTROSE 20 MG/100 ML (200 MCG/ML) IV PGBK $104.00 54288-136-01 PHENOBARBITAL SODIUM 65 MG/ML INJ SOLN $104.00 54288-136-10 PHENOBARBITAL SODIUM 65 MG/ML INJ SOLN $104.00 63323-694-04 ACETYLCYSTEINE 20 % (200 MG/ML) ORAL SOLN $103.82 63323-694-22 ACETYLCYSTEINE 20 % (200 MG/ML) ORAL SOLN $103.82 44567-211-10 AMPICILLIN-SULBACTAM 3 G IV SOLR (MCH) $103.68 HC89022511 OROTIC ACID QUANT URINE -AU $103.63 68084-965-25 VALGANCICLOVIR 450 MG ORAL TAB $103.61 68084-965-95 VALGANCICLOVIR 450 MG ORAL TAB $103.61 50268-787-11 VALGANCICLOVIR 450 MG ORAL TAB $103.60 50268-787-12 VALGANCICLOVIR 450 MG ORAL TAB $103.60 0472-1738-03 MICONAZOLE NITRATE 200 MG VAGINAL SUPP $103.46 63323-531-01 ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRG $103.35 63323-531-90 ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRG $103.35 70069-802-01 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $103.35 70069-802-10 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $103.35 63323-284-01 VANCOMYCIN 1,000 MG IV SOLR $103.35 63323-284-20 VANCOMYCIN 1,000 MG IV SOLR $103.35 24208-795-35 NEOMYCIN-POLYMYXIN B-DEXAMETH 3.5 MG/G-10,000 UNIT/G-0.1 % OPHT OINT $103.29 24208-830-60 NEOMYCIN-POLYMYXIN B-DEXAMETH 3.5MG/ML-10,000 UNIT/ML-0.1 % OPHT DRPS $103.29 99999-037-31 FLUCYTOSINE 50 MG/ML ORAL LIQUID $103.22 0054-0471-21 EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG ORAL TAB $103.07 HC89018261 HIV-2 AB CONFIRM IMMUNOBLOT-AU $103.00 HC89003610 MEPERIDINE ANLG; 1-2 URINE-AU $103.00 HC31000060 PT-AQUATIC GRP 30MIN/MCW $103.00 0409-1215-01 NALOXONE 0.4 MG/ML INJ (MHS WRAPPER) $102.90 0409-1215-21 NALOXONE 0.4 MG/ML INJ (MHS WRAPPER) $102.90 62135-842-60 SULFADIAZINE 500 MG ORAL TAB $102.81 70069-019-01 ACETYLCYSTEINE 20 % (200 MG/ML) ORAL SOLN $102.70 70069-019-25 ACETYLCYSTEINE 20 % (200 MG/ML) ORAL SOLN $102.70 16714-036-10 ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRG $102.70 16714-036-01 ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRG $102.70 0409-7809-22 DOPAMINE IN 5 % DEXTROSE 400 MG/250 ML (1,600 MCG/ML) IV SOLN $102.38 0409-7809-11 DOPAMINE IN 5 % DEXTROSE 400 MG/250 ML (1,600 MCG/ML) IV SOLN $102.38 0264-9587-20 HEPARIN (PORCINE) IN 5 % DEX 25,000 UNIT/250 ML(100 UNIT/ML) IV SOLP $102.38 69097-004-67 HYDROCORTISONE SOD SUCCINATE 100 MG INJ SOLR $102.05 HC51061398 ADMIN VACCINE COVID-19 100MCG/0.5 INITIAL DOSE {MODERNA} $102.00 HC51061406 ADMIN VACCINE COVID-19 100MCG/O.5 2ND DOSE {MODERNA} $102.00 HC51061380 ADMIN VACCINE COVID-19 30MCG/0.3ML 2ND DOSE {PFIZER-BIONTECH} $102.00 HC51061372 ADMIN VACCINE COVID-19 30MCG/0.3ML INITIAL DOSE {PFIZER-BIONTECH} $102.00 HC89018287 FACTOR VIII BETHESDA TITER(PNL) -EC $102.00 HC89020515 ISONIAZID -AU $102.00 HC51070605 PSYCH/NEUROPSYCH TEST ADMIN & SCORING, 2 OR > TESTS; EA ADDL 30MIN+ $102.00 0074-4378-05 CISATRACURIUM 2 MG/ML IV SOLN $101.92 0037-6860-10 OLSALAZINE 250 MG ORAL CAP $101.89 0121-0775-16 CODEINE-GUAIFENESIN 10-100 MG/5 ML ORAL LIQD $101.46 45802-244-14 NYSTATIN-TRIAMCINOLONE 100,000-0.1 UNIT/GRAM-% TOPICAL OINT $101.40 51672-1272-1 NYSTATIN-TRIAMCINOLONE 100,000-0.1 UNIT/GRAM-% TOPICAL OINT $101.40 0409-3379-04 PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR $101.40 99999-036-27 NITROGLYCERIN 100 MCG / ML INJECTION $101.08 0517-4810-25 NITROGLYCERIN 50 MG/10 ML (5 MG/ML) IV SOLN $101.08 0517-4810-01 NITROGLYCERIN 50 MG/10 ML (5 MG/ML) IV SOLN $101.08 HC89020895 17-D OH PROGES NEONATE STT -ES $101.00 HC89000533 COXSACKIE B AB (PNL)-SL $101.00 HC81101586 GLUCOSE BY DEVICE (POS) $101.00 HC51060093 OT-EVAL+REPORT EA ADD 15 MIN/C $101.00 61314-643-05 TOBRAMYCIN 0.3 % OPHT DROP $100.75 63323-516-10 DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJ SOLN $100.69 0555-1057-56 ISOTRETINOIN 40 MG ORAL CAP $100.63 63323-229-05 PROTAMINE 10 MG/ML IV SOLN $100.62 63323-229-01 PROTAMINE 10 MG/ML IV SOLN $100.62 69097-642-02 EMTRICITABINE 200 MG ORAL CAP $100.43 0037-0430-01 FELBAMATE 400 MG ORAL TAB $100.32 HC89005094 PARVOVIRUS B19 DNA QUAL PCR-FT $100.30 0781-3269-71 EPHEDRINE SULFATE 50 MG/ML IV SOLN $100.10 0781-3269-95 EPHEDRINE SULFATE 50 MG/ML IV SOLN $100.10 51754-4200-4 EPHEDRINE SULFATE 50 MG/ML IV SOLN $100.10 51754-4200-1 EPHEDRINE SULFATE 50 MG/ML IV SOLN $100.10 43598-725-25 EPHEDRINE SULFATE 50 MG/ML IV SOLN $100.10 43598-725-11 EPHEDRINE SULFATE 50 MG/ML IV SOLN $100.10 0409-1141-02 SODIUM CHLORIDE 4 MEQ/ML (23.4%) INFUSION (FOR ELEVATED ICP) $100.10 0409-1141-12 SODIUM CHLORIDE 4 MEQ/ML (23.4%) INFUSION (FOR ELEVATED ICP) $100.10 61703-309-16 VINCRISTINE 1 MG/ML IV SOLN (MCH) $100.10 63323-487-37 LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJ SOLN $100.04 63323-487-07 LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJ SOLN $100.04 HC83500348 15-20 CELLS, 2 KARYO,BAND-GZ $100.00 HC51004067 AEROSOL-CONTINUOUS TX EA AD'HR $100.00 HC81500639 BLOOD SMEAR SCAN $100.00 HC89005391 B-TYPE NATRIURETIC PEPTIDE-UCI $100.00 HC83500405 CHROM ANAL TISSUE COUNT-GZ $100.00 HC89000772 CIMETIDINE/TAGAMET-AU $100.00 HC89005433 CULTURE CHLAMYDIA-FT $100.00 HC89008023 FECAL FAT QUANT-AU $100.00 HC89017487 HERPESVIRUS 6 (HHV-6)AB IGG-AU $100.00 HC89013320 HIV-1 ULTRA RNA QUANT PCR-AU $100.00 HC89091375 HLA-B*5701-ABACAVIR SENS EA-AU $100.00 HC83504381 IHC/IP PER SPEC INITIAL AB STAIN ANTI-BCL-2 -BR $100.00 HC51010585 IMMUNOTHERAPY ONE INJECTION /COMM $100.00 HC89011639 NEURON SPECIFIC ENOLASE-AU $100.00 HC89009385 ORGANIC ACIDS TOT QUANT UR-AU $100.00 HC32010514 OT-GROUP TRAIN CAREGVR ADL,MOBILE,SAFE PT NOT PRESENT $100.00 HC83001255 PATHOGEN(S) TEST PLATELETS $100.00 HC31090210 PT-GROUP TRAIN CAREGVR ADL,MOBILE,TRANSFER PT NOT PRESENT $100.00 HC51060747 PT-THER EXER 30MIN/C $100.00 HC89023287 SARS-COV-2 RNA QUAL RT-PCR-QN $100.00 HC33010364 ST-GROUP TRAIN CAREGVR ADL,FEED,SWALLOW PT NOT PRESENT $100.00 HC51000487 STREP A ANTIGN SCRN(DIRECT OBS) $100.00 99999-041-13 CEFAZOLIN 2 G IN NS 100 ML (SLH) $100.00 99999-045-43 CEFAZOLIN 3 G IN NS 100 ML (OCM/SLH_USING 10 G VIAL) $100.00 99999-039-03 CEFAZOLIN 3 G IN NS 100 ML (OCM/SLH_USING 10 G VIAL) $100.00 0409-1174-01 DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN $100.00 0409-1174-10 DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN $100.00 54643-5649-1 MVI, ADULT NO.4 WITH VIT K 3,300 UNIT- 150 MCG/10 ML IV SOLN $99.97 54643-9007-1 MVI, ADULT NO.4 WITH VIT K 3,300 UNIT- 150 MCG/10 ML IV SOLN $99.97 0456-2010-01 ESCITALOPRAM OXALATE 10 MG ORAL TAB $99.94 HC89010912 PLATELET ANTIBODIES-AU $99.88 0143-9504-01 CISPLATIN 1 MG/ML IV SOLN $99.78 99999-034-13 ZINC SULFATE 1 MG/ML ORAL LIQUID (MCH) $99.78 HC51061471 ECG EXT HOLTER W/CONNECT >7DAYS-15DAYS; RECORDING $99.74 HC51061455 ECG EXT HOLTER W/CONNECT>48HRS-7DAYS; RECORDING $99.74 HC51010460 MEASURE NO2 EXHALED $99.74 HC51010510 TEST ALLERGY INTRAQ DELAYED RXN $99.74 HC51010486 TEST ALLERGY PERQ&INTRAQ RX/BIOLOGIC $99.74 HC51062586 TYMPANOMETRY IMPEDANCE $99.74 0469-2601-30 MIRABEGRON 25 MG ORAL TB24 $99.73 0469-2602-30 MIRABEGRON 50 MG ORAL TB24 $99.73 67457-134-50 MAGNESIUM CHLORIDE 200 MG/ML (20 %) INJ SOLN $99.45 0409-2634-05 HYDROMORPHONE (PF) 10 MG/ML INJ FOR INTRATHECAL PAIN PUMP REFILL (OCM) $99.13 0409-2634-25 HYDROMORPHONE (PF) 10 MG/ML INJ SOLN $99.13 0310-0095-30 ROFLUMILAST 500 MCG ORAL TAB $99.05 HC89023568 BACTERIAL VAGINOSIS TMA-AU $99.00 HC89005425 CULTURE MYCOPLASMA-FT $99.00 HC89023519 HEPATITIS B DNA/RNA QUANT BY NAAT-AU $99.00 HC47201181 TELEHEALTH ORIGINATING SITE FACILITY FEE $99.00 HC89021695 COCAINE MEC(PNL)-AU $98.88 24208-910-55 ERYTHROMYCIN 5 MG/GRAM (0.5 %) OPHT OINT $98.80 0143-9719-01 MILRINONE IN 5 % DEXTROSE 20 MG/100 ML (200 MCG/ML) IV PGBK $98.80 0143-9719-10 MILRINONE IN 5 % DEXTROSE 20 MG/100 ML (200 MCG/ML) IV PGBK $98.80 50268-086-11 ATOVAQUONE 750 MG/5 ML ORAL SUSP $98.77 50268-086-12 ATOVAQUONE 750 MG/5 ML ORAL SUSP $98.77 0004-0800-85 OSELTAMIVIR 75 MG ORAL CAP $98.72 HC89022388 FLOW CYT LEUK/LYMPH 1ST MRKR{W-INT/88}-AU $98.50 HC89021703 METHADONE MEC(PNL)-AU $98.38 63323-293-01 MEPIVACAINE (PF) 15 MG/ML (1.5 %) INJ SOLN $98.28 63323-293-37 MEPIVACAINE (PF) 15 MG/ML (1.5 %) INJ SOLN $98.28 25021-684-05 KETAMINE 100 MG/ML INJ SOLN $98.15 0049-3190-01 VORICONAZOLE 200 MG IV SOLR $98.15 HC89018139 17-KETOSTEROID FRACTIONAT'N-QD $98.00 HC89018121 CREATININE OTHER SRC (PNL)-QD $98.00 HC89001432 METHOCARBAMOL-AU $98.00 HC89004642 NSNAII IGG 1ST STAIN(PNL)-PR $98.00 HC89004659 NSNAII IGG DNASE 1ST STAIN(PNL)-PR $98.00 HC81101602 OB FECES GUAIC 1-3 NON NEOPLSM $98.00 HC51070803 PSY-BEHAV TX FAM W/O PT 1ST 30MIN $98.00 0781-3298-04 ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRG $97.67 0781-3298-68 ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRG $97.67 68462-746-17 ACYCLOVIR 5 % TOPICAL OINT $97.50 42806-151-34 AZITHROMYCIN 200 MG/5 ML ORAL SUSR $97.50 67877-548-88 CEFDINIR 250 MG/5 ML ORAL SUSR $97.50 65219-293-00 DESMOPRESSIN 4 MCG/ML INJ SOLN $97.50 65219-293-01 DESMOPRESSIN 4 MCG/ML INJ SOLN $97.50 69097-720-44 DICLOFENAC SODIUM 1 % TOPICAL GEL $97.50 72266-197-01 DORZOLAMIDE 2 % OPHT DROP $97.50 0548-5605-00 ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRG $97.50 60505-0795-4 ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRG $97.50 60505-0795-1 ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRG $97.50 70377-113-11 FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSR $97.50 51672-1386-1 FLUOCINONIDE 0.05 % TOPICAL CREAM $97.50 67457-464-20 GEMCITABINE 200 MG IV SOLR $97.50 0990-7974-08 GLYCINE UROLOGIC SOLUTION 1.5 % IRR SOLN $97.50 0517-0901-25 HYDRALAZINE 20 MG/ML INJ SOLN $97.50 0517-0901-01 HYDRALAZINE 20 MG/ML INJ SOLN $97.50 0143-9701-01 IRINOTECAN 100 MG/5 ML IV SOLN $97.50 60505-6128-1 IRINOTECAN 100 MG/5 ML IV SOLN $97.50 0168-0099-15 KETOCONAZOLE 2 % TOPICAL CREAM $97.50 68180-422-01 MOXIFLOXACIN 0.5 % OPHT DROP $97.50 42023-224-01 NALOXONE 1 MG/ML INJ SYRG $97.50 64980-515-05 OFLOXACIN 0.3 % OPHT DROP $97.50 69238-1615-3 OFLOXACIN 0.3 % OTIC DROP $97.50 70756-609-15 OFLOXACIN 0.3 % OTIC DROP $97.50 68180-678-01 OSELTAMIVIR 6 MG/ML ORAL SUSR $97.50 71288-171-11 OXALIPLATIN 50 MG/10 ML (5 MG/ML) IV SOLN $97.50 71285-6044-1 OXYTOCIN IN 0.9 % SOD CHLORIDE 30 UNIT/500 ML IV SOLN $97.50 0781-3415-75 PALONOSETRON 0.25 MG/5 ML IV SOLN $97.50 49230-188-50 PERIT. 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 49230-206-52 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 49230-209-52 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 49230-212-52 PERITON.DIALYSIS 8-4.25 % DEXT CA 2.5 MEQ/L- MG 0.5 MEQ/L IP SOLN $97.50 63323-269-50 PROPOFOL 10 MG/ML IV EMUL $97.50 0990-7981-08 SORBITOL-MANNITOL 2.7-0.54 GRAM/100 ML TRANSURETHRA SOLN $97.50 24208-317-05 SULFACETAMIDE-PREDNISOLONE 10 %-0.23 % (0.25 %) OPHT DROP $97.50 0143-9659-01 TESTOSTERONE CYPIONATE 200 MG/ML IM OIL $97.50 67457-197-00 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN (FOR TOPICAL USE) $97.50 67457-197-10 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN (FOR TOPICAL USE) $97.50 0409-9137-05 LIDOCAINE (PF) 50 MG/5 ML (1 %) IV SYRG $97.44 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 HC51002111 MNT REASSESSMENT EA INDIV 15MIN 1ST REF $97.00 HC89003719 PHENYLPROPANOLAMINE URINE-AU $97.00 HC89009799 QUININE-AU $97.00 HC51040004 RD ASSESS/EDUCATE PER 30MIN $97.00 HC11500998 TELEHEALTH ORIGINATING SITE FACILITY FEE $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 99999-033-33 LACOSAMIDE 200 MG/20 ML IV SOLN $96.60 HC89024582 PHOSPHATIDYLETHANOL WHOLE BLOOD QNT-AU $96.59 59212-002-01 TRIAMTERENE 50 MG ORAL CAP $96.47 47781-690-30 RASAGILINE 1 MG ORAL TAB $96.43 63323-086-05 POTASSIUM PHOSPHATE 3 MMOL / ML ORAL LIQUID (MCH) $96.27 0641-6136-25 FOSPHENYTOIN 100 MG PE/2 ML INJ SOLN $96.20 0641-6136-01 FOSPHENYTOIN 100 MG PE/2 ML INJ SOLN $96.20 0409-7295-01 POTASSIUM PHOSPHATE 3 MMOL / ML ORAL LIQUID (MCH) $96.14 0409-7295-11 POTASSIUM PHOSPHATE 3 MMOL / ML ORAL LIQUID (MCH) $96.14 HC89002406 BETA-HCG QUANT-QD $96.00 HC89019400 HLA AB DETECT 1ST MARKERS-AU $96.00 16714-718-01 ENTECAVIR 1 MG ORAL TAB $95.97 0264-3105-11 CEFAZOLIN IN DEXTROSE (ISO-OS) 2 GRAM/50 ML IV PGBK $95.94 63323-597-10 DEFEROXAMINE 500 MG INJ SOLR $95.94 395266216 CHERRY FLAVOR (BULK) ORAL LIQD $95.31 63323-117-51 FLUOROURACIL 2.5 GRAM/50 ML IV SOLN $95.23 71288-170-75 FLUOROURACIL 2.5 GRAM/50 ML IV SOLN $95.23 63323-460-37 BUPIVACAINE-EPINEPHRINE (PF) 0.75 %-1:200,000 INJ SOLN $95.16 HC89019012 ASPERGILLUS ANTIGEN-MV $95.00 HC89000004 BLOOD TYPE SERO; ABO FRANCSLLA AGLTNS-AU $95.00 HC89020010 FRAGILE X SCREEN REFLEX-AU $95.00 HC89001457 METHYPRYLON-AU $95.00 HC89007678 NTX SERUM-AU $95.00 HC31000094 PT-AQUATIC GRP ADDL 15 MIN/CW $95.00 HC89023295 SARS-COV-2 RNA QUAL RT-PCR-AU $95.00 HC83506253 TISSUE CULT BONE MARROW ADDL-NG $95.00 HC89012934 TRICHINELLA AB-AU $94.90 55150-307-24 ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN $94.90 55150-307-01 ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN $94.90 0338-9555-24 DEXMEDETOMIDINE IN 0.9 % NACL 200 MCG/50 ML (4 MCG/ML) IV SOLN $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 HC51061497 ECG EXT PT ACTV EVENT MONITOR ATTEND 24HRS-30DAYS;HOOK&RECORD $94.76 HC89024343 CYTOMEGALOVIRUS PCR SALIVA-AU $94.69 0049-0014-83 AMPICILLIN-SULBACTAM 3 GRAM INJ SOLR $94.65 0049-0014-81 AMPICILLIN-SULBACTAM 3 GRAM INJ SOLR $94.65 63323-695-04 ACETYLCYSTEINE 100 MG/ML (10 %) MISC SOLN $94.64 44567-400-01 MEROPENEM 500 MG IV SOLR $94.58 44567-400-10 MEROPENEM 500 MG IV SOLR $94.58 82625-8802-3 NALOXEGOL 25 MG ORAL TAB $94.56 82625-8801-1 NALOXEGOL 12.5 MG ORAL TAB $94.55 82625-8802-1 NALOXEGOL 25 MG ORAL TAB $94.55 24208-411-05 BRIMONIDINE 0.2 % OPHT DROP $94.25 0781-3290-91 CLINDAMYCIN IN 5 % DEXTROSE 900 MG/50 ML IV PGBK $94.25 0781-3290-09 CLINDAMYCIN IN 5 % DEXTROSE 900 MG/50 ML IV PGBK $94.25 0173-0857-01 DILUENT FOR EPOPROSTENOL (GLY) PH 11.7 - 12.3 IV SOLN $94.25 0173-0857-02 DILUENT FOR EPOPROSTENOL (GLY) PH 11.7 - 12.3 IV SOLN $94.25 63323-491-57 LIDOCAINE (PF) 5 MG/ML (0.5 %) INJ SOLN $94.25 63323-491-01 LIDOCAINE (PF) 5 MG/ML (0.5 %) INJ SOLN $94.25 25021-166-48 PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR $94.25 99999-047-23 SODIUM CHLORIDE 3 % HYPERTONIC 3 % IV SOLP $94.25 0008-0841-81 PANTOPRAZOLE 40 MG ORAL TBEC $94.09 HC89012983 DENGUE FEVER AB-FT $94.00 HC89000780 DYPHYLLINE-AU $94.00 HC83506006 FLOW CYT MKR CD4/CD8 BAL 1ST (PNL)-NG $94.00 HC83505412 FLOW CYT MKR TC 1ST (PNL) -NG $94.00 HC89012587 TOXOCARA AB ELISA -AU $94.00 0517-7604-25 ACETYLCYSTEINE 20 % (200 MG/ML) ORAL SOLN $93.86 0517-7604-01 ACETYLCYSTEINE 20 % (200 MG/ML) ORAL SOLN $93.86 61703-324-18 PAMIDRONATE 30 MG/10 ML (3 MG/ML) IV SOLN $93.86 0143-9318-10 NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN $93.70 0143-9318-01 NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN $93.70 HC89500953 HEMOGLOBIN SICKLE TESTING-SB $93.60 61570-131-50 SILVER SULFADIAZINE 1 % TOPICAL CREAM $93.60 HC89008643 PANCREATIC POLYPEPTIDE-AU $93.32 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 HC51010601 IMMNTX 1 STING INSECT /COMM $93.00 23155-290-42 AMIKACIN 1,000 MG/4 ML INJ SOLN $92.95 23155-290-32 AMIKACIN 1,000 MG/4 ML INJ SOLN $92.95 0067-8152-03 DICLOFENAC SODIUM 1 % TOPICAL GEL $92.95 61703-349-16 IRINOTECAN 40 MG/2 ML IV SOLN $92.69 0143-9853-75 AMOXICILLIN-POT CLAVULANATE 600-42.9 MG/5 ML ORAL SUSR $92.63 65862-535-75 AMOXICILLIN-POT CLAVULANATE 600-42.9 MG/5 ML ORAL SUSR $92.63 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 24510-075-10 TAPENTADOL 75 MG ORAL TAB $92.44 395009416 COMPOUNDING VEHICLE SF NO.9 ORAL LIQD $92.24 395009016 COMPOUNDING VEHICLE SYRUP NO23 ORAL SYRP $92.24 45963-439-65 LACTULOSE 10 GRAM/15 ML ORAL SOLN $92.24 0527-5125-78 LACTULOSE 10 GRAM/15 ML ORAL SOLN $92.24 121059516 SODIUM CITRATE-CITRIC ACID 500-334 MG/5 ML ORAL SOLN $92.24 0436-0672-16 SODIUM HYPOCHLORITE 0.125 % MISC SOLN $92.24 0436-0936-16 SODIUM HYPOCHLORITE 0.25 % MISC SOLN $92.24 0436-0946-16 SODIUM HYPOCHLORITE 0.5 % MISC SOLN $92.24 42494-301-00 HYDROCORTISONE ACETATE 25 MG RECTAL SUPP $92.09 HC89019863 AH50-ALTERNATE PATHWAY-SL $92.00 HC51070647 BEHAVIOR ADAPT MULT FAM TX GDN W/O PT; EA 15MIN $92.00 HC51070639 BEHAVIOR ADAPT TX FAMILY GUIDNC QHCP W GUARDIANS EA 15MIN $92.00 HC51070654 BEHAVIOR ADAPT TX GROUP BY QHCP; EA 15MIN $92.00 HC51001907 CBC WITH AUTOMATED DIFF $92.00 HC85100477 CBC WITH AUTOMATED DIFF $92.00 HC51040129 MNT RE ASSESS INDIV EA 15MIN 2ND REF (DX) $92.00 60505-6147-4 CEFEPIME 2 GRAM INJ SOLR $91.85 60505-6147-0 CEFEPIME 2 GRAM INJ SOLR $91.85 60505-0134-0 CYCLOSPORINE 100 MG ORAL CAP $91.83 70710-1459-2 AZITHROMYCIN 200 MG/5 ML ORAL SUSR $91.70 70710-1460-2 AZITHROMYCIN 200 MG/5 ML ORAL SUSR $91.65 99999-046-79 CEFEPIME 40 MG/ML INJ SYRINGE $91.65 55150-242-51 LINEZOLID 600 MG/300 ML IV SOLP (MCH) $91.65 0143-9534-01 LINEZOLID 600 MG/300 ML IV SOLP (MCH) $91.65 0143-9534-10 LINEZOLID 600 MG/300 ML IV SOLP (MCH) $91.65 HC89020952 ARSENIC, FRACTIONATED-AU $91.50 63323-467-57 BUPIVACAINE HCL 0.5 % (5 MG/ML) INJ SOLN $91.33 HC51060937 OT-PROSTHETIC MGMT & TRNG INITIAL ENC 15MIN/M $91.32 70010-786-28 METHYLERGONOVINE 0.2 MG ORAL TAB $91.16 70436-232-74 AMIODARONE 50 MG/ML IV SOLN $91.03 70436-232-50 AMIODARONE 50 MG/ML IV SOLN $91.03 HC89003537 ACETAZOLAMIDE URINE-AU $91.00 HC89003776 TRICHLOROACETIC URINE(PNL)-AU $91.00 69315-308-05 CIPROFLOXACIN HCL 0.3 % OPHT DROP $91.00 61314-656-05 CIPROFLOXACIN HCL 0.3 % OPHT DROP $91.00 63323-416-05 CISATRACURIUM 2 MG/ML IV SOLN $91.00 0000-3668-00 FENTANYL 2 MCG/ML - BUPIVACAINE 0.125% IN NS 100 ML EPIDURAL PCA (SLH) $91.00 25021-184-87 FLUCONAZOLE IN NACL (ISO-OSM) 400 MG/200 ML IV PGBK $91.00 0641-6231-25 HYDRALAZINE 20 MG/ML INJ SOLN $91.00 0641-6231-01 HYDRALAZINE 20 MG/ML INJ SOLN $91.00 0143-9623-01 LABETALOL 5 MG/ML IV SOLN $91.00 39822-1800-1 OLANZAPINE 10 MG IM SOLR $91.00 42023-116-02 OXYTOCIN 10 UNIT/ML INJ SOLN $91.00 42806-150-33 AZITHROMYCIN 200 MG/5 ML ORAL SUSR $90.97 45802-059-35 NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM $90.97 0472-0166-15 NYSTATIN 100,000 UNIT/GRAM TOPICAL OINT $90.97 45802-048-35 NYSTATIN 100,000 UNIT/GRAM TOPICAL OINT $90.97 59762-1350-1 RIFABUTIN 150 MG ORAL CAP $90.97 63323-342-25 CEFOXITIN 2 GRAM IV SOLR $90.74 63323-342-01 CEFOXITIN 2 GRAM IV SOLR $90.74 63323-589-94 ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRG $90.74 63323-589-21 ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRG $90.74 71288-438-93 ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRG $90.74 71288-438-94 ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRG $90.74 64980-513-01 TIMOLOL MALEATE 0.25 % OPHT DROP $90.74 0409-3390-11 PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR $90.62 0409-3390-04 PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR $90.62 0004-0802-85 OSELTAMIVIR 30 MG ORAL CAP $90.57 0004-0801-85 OSELTAMIVIR 45 MG ORAL CAP $90.57 59212-425-10 PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2-0.1037 -0.0194 MG ORAL TAB $90.43 68084-915-95 SIROLIMUS 1 MG ORAL TAB $90.23 68084-915-25 SIROLIMUS 1 MG ORAL TAB $90.23 0065-0741-14 TETRACAINE HCL (PF) 0.5 % OPHT DROP $90.22 63323-983-21 PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR $90.16 63323-983-23 PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR $90.16 HC89025100 ANTI-PHOSPHOLIPASE A2 RECPT AB IGG-AU $90.00 HC89005664 C PNEUMONIAE IGA ANTIBODY-FT $90.00 HC89005656 C PNEUMONIAE IGG ANTIBODY-FT $90.00 HC89005672 C PNEUMONIAE IGM ANTIBODY-FT $90.00 HC89006688 DIPHENHYDRAMINE SERUM/PLASMA-AU $90.00 HC89003578 DIPHENHYDRAMINE URINE-AU $90.00 HC89012439 ECHOVIRUS AB (PNL)- AU $90.00 HC89019277 FACTOR VIII INHIBITOR-OS $90.00 HC89019269 FACTOR VIII VW FACTOR AG-OS $90.00 HC89018188 FLOW CYT MKR TC 1ST-ES $90.00 HC89019525 HIV GENO DRUG SPECIFIC SUS-VI $90.00 HC89008429 HVA URINE-CA $90.00 HC89006753 ISONIAZID-NM $90.00 HC89004816 KAPPA LIGHT CHAINS-QD $90.00 HC89014823 LIMULUS LYSSATE ASSAY-AU $90.00 HC89012561 SCHISTOSOMA AB-AU $90.00 HC89021463 SUSCEPTIBILITY ANTIMICROB MIC -AU $90.00 HC89010185 VMA URINE-CA $90.00 64764-543-11 LANSOPRAZOLE 15 MG ORAL TBLD $89.94 64764-543-30 LANSOPRAZOLE 15 MG ORAL TBLD $89.94 64764-544-11 LANSOPRAZOLE 30 MG ORAL TBLD $89.94 64764-544-30 LANSOPRAZOLE 30 MG ORAL TBLD $89.94 99999-045-08 MIDAZOLAM 100MG IN NS 100ML DRIP (MHS WRAPPER) $89.70 99999-033-06 MIDAZOLAM 100MG IN NS 100ML DRIP (MHS WRAPPER) $89.70 99999-044-78 MIDAZOLAM IN D5W 100 MG/100 ML (1 MG/ML) DRIP (LBM) $89.70 16729-276-03 FLUOROURACIL 500 MG/10 ML IV SOLN $89.51 16729-276-68 FLUOROURACIL 500 MG/10 ML IV SOLN $89.51 60505-6129-2 BUDESONIDE 32 MCG/ACTUATION NASL SPRY $89.37 0054-0383-25 CYCLOPHOSPHAMIDE 50 MG ORAL CAP $89.34 48783-112-08 FERRIC SUBSULFATE 0.2 TO 0.22 GRAM/ML TOPICAL SOLA $89.34 76329-3318-1 EPINEPHRINE 0.1 MG/ML (1:10,000) INJ SYRG (FOR PULMONARY HEMORRHAGE) $89.31 0409-4933-05 EPINEPHRINE 0.1 MG/ML (1:10,000) INJ SYRG (FOR PULMONARY HEMORRHAGE) $89.25 0409-4933-10 EPINEPHRINE 0.1 MG/ML (1:10,000) INJ SYRG (FOR PULMONARY HEMORRHAGE) $89.25 3172293847 CHERRY FLAVOR (BULK) ORAL LIQD $89.16 0121-0873-16 LACTULOSE 10 GRAM/15 ML ORAL SOLN $89.16 395266116 SIMPLE SYRUP ORAL SYRP $89.16 3172293747 SIMPLE SYRUP ORAL SYRP $89.16 HC89000863 ACTH-QD $89.00 HC89005128 B BURGDORFERI IGG WB -FT $89.00 HC89005136 B BURGDORFERI IGM WB -FT $89.00 HC51062875 CARE MGMT BEHAVORAL HEALTH CONDITION 20 MIN $89.00 HC89023352 DIGITOXIN QUANTITATIVE-AU $89.00 HC89019913 HEMOCHROMATOSIS MUTATION-AU $89.00 HC83503714 IHC/IP PER SPEC INITIAL AB STAIN SMMHC -IM $89.00 HC83503730 IHC/IP PER SPEC INITIAL AB STAIN TERM DEOZY -IM $89.00 HC88600051 VENIPUNCTURE BY PHYSICIAN OR QHC <3YRS $89.00 16714-770-01 RASAGILINE 0.5 MG ORAL TAB $88.93 0096-0732-04 HYDROCORTISONE 1 % TOPICAL LOTN $88.92 72603-218-25 ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJ SOLN $88.92 72603-218-01 ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJ SOLN $88.92 0054-3270-99 FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASL SPSN $88.71 64764-125-30 ALOGLIPTIN 12.5 MG ORAL TAB $88.62 16714-771-01 RASAGILINE 1 MG ORAL TAB $88.58 HC89500565 RH PHENOTYPE (CCEE)-SB $88.40 HC89018691 MOLECUL CYTO DNA PROBE FISH-AU $88.21 HC89007009 ACTH-ES $88.00 HC89019764 ENZYME ACT-RBC(P TPMT ENZYME)-PR $88.00 HC83504779 IHC/IP PER SPEC INITIAL AB STAIN (PNL X 4)-HP $88.00 HC31001555 PT-THER PROC GRP ADD 15MIN/CW $88.00 HC89019772 QUANT HPLC-6-MTG(P TPMT ENZYME)-PR $88.00 0781-7313-58 RIVASTIGMINE 13.3 MG/24 HOUR TRANSDERMAL PT24 $87.86 0781-7313-31 RIVASTIGMINE 13.3 MG/24 HOUR TRANSDERMAL PT24 $87.86 0781-7304-58 RIVASTIGMINE 4.6 MG/24 HOUR TRANSDERMAL PT24 $87.86 0781-7304-31 RIVASTIGMINE 4.6 MG/24 HOUR TRANSDERMAL PT24 $87.86 0781-7309-58 RIVASTIGMINE 9.5 MG/24 HOUR TRANSDERMAL PT24 $87.86 60687-596-32 BUDESONIDE 3 MG ORAL CECX $87.75 60687-596-33 BUDESONIDE 3 MG ORAL CECX $87.75 0024-4142-60 DRONEDARONE 400 MG ORAL TAB $87.75 69097-802-32 TESTOSTERONE CYPIONATE 200 MG/ML IM OIL $87.75 0173-0933-08 VALACYCLOVIR 500 MG ORAL TAB $87.28 386000801 NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRA $87.17 386000804 NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRA $87.17 0781-9408-80 AMPICILLIN SODIUM 2 GRAM INJ SOLR $87.11 0781-9408-95 AMPICILLIN SODIUM 2 GRAM INJ SOLR $87.11 61703-339-18 CARBOPLATIN 10 MG/ML IV SOLN $87.10 61314-547-03 LATANOPROST 0.005 % OPHT DROP $87.10 HC89012777 LEPTOSPIRA AB-FT $87.00 63739-986-25 HEPARIN (PORCINE) 20,000 UNIT/ML INJ SOLN $86.97 0002-8715-17 INSULIN NPH AND REGULAR HUMAN 100 UNIT/ML (70-30) SUBCUTANEOUS SUSP $86.97 0002-0213-01 INSULIN REGULAR HUMAN 100 UNIT/ML INJ SOLN $86.97 61269-881-35 DOCOSANOL 10 % TOPICAL CREAM $86.84 61269-981-35 DOCOSANOL 10 % TOPICAL CREAM $86.84 72266-196-01 TOBRAMYCIN 0.3 % OPHT DROP $86.84 0591-2258-54 SCOPOLAMINE BASE 1 MG OVER 3 DAYS TRANSDERMAL PT3D $86.80 0591-2258-23 SCOPOLAMINE BASE 1 MG OVER 3 DAYS TRANSDERMAL PT3D $86.80 0591-2258-79 SCOPOLAMINE BASE 1 MG OVER 3 DAYS TRANSDERMAL PT3D $86.79 42023-115-10 KETAMINE 100 MG/ML INJ SOLN $86.71 0574-0521-74 ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSP $86.58 0574-0520-74 ACTIVATED CHARCOAL-SORBITOL 25 GRAM/120 ML ORAL SUSP $86.58 0131-2477-60 LACOSAMIDE 50 MG ORAL TAB $86.33 75907-023-48 CLONIDINE 0.1 MG/24 HR TRANSDERMAL PTWK $86.21 75907-023-11 CLONIDINE 0.1 MG/24 HR TRANSDERMAL PTWK $86.21 99999-038-05 CHLORAMBUCIL 1 MG ORAL PARTIAL TAB $86.18 70710-1159-3 MIRABEGRON 25 MG ORAL TB24 $86.17 70710-1160-3 MIRABEGRON 50 MG ORAL TB24 $86.17 68180-152-09 MIRABEGRON 50 MG ORAL TB24 $86.17 68180-151-06 MIRABEGRON 25 MG ORAL TB24 $86.16 68180-152-06 MIRABEGRON 50 MG ORAL TB24 $86.16 0116-1061-16 CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQD $86.09 HC89017321 ANTI-RIBOSOMAL AB-QD $86.00 HC32000556 OT-THER PROC GRP ADD 15MIN/CW $86.00 0187-4420-10 FAMOTIDINE 20 MG ORAL TAB $85.96 70700-187-23 FLUOROURACIL 1 GRAM/20 ML IV SOLN $85.80 70700-187-22 FLUOROURACIL 1 GRAM/20 ML IV SOLN $85.80 62856-582-52 RUFINAMIDE 200 MG ORAL TAB $85.80 69374-214-50 SODIUM BICARBONATE 8.4 % (1 MEQ/ML) IV SYRG $85.80 0069-2670-66 NIFEDIPINE 90 MG ORAL TR24 $85.75 63323-276-02 HEPARIN, PORCINE (PF) 1,000 UNIT/ML INJ SOLN $85.74 63323-276-01 HEPARIN, PORCINE (PF) 1,000 UNIT/ML INJ SOLN $85.74 0395-1005-92 GENTIAN VIOLET 2 % TOPICAL SOLN $85.52 72603-453-10 NAFCILLIN 2 GRAM INJ SOLR $85.50 72603-453-01 NAFCILLIN 2 GRAM INJ SOLR $85.50 0054-3294-50 FUROSEMIDE 10 MG/ML ORAL SOLN $85.02 45802-098-46 MESALAMINE 4 GRAM/60 ML RECTAL ENEM $85.02 51672-1289-2 NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM $85.02 HC89007801 CYANIDE-AU $85.00 HC83504563 HANDLING SPEC COURIER-CS $85.00 HC89004022 HEPARIN ANTI-XA -AU $85.00 HC89023741 ORTHOPOXVIRUS (MONKEYPOX) PCR-AU $85.00 HC89021877 ZIKA VIRUS IGM AB CAPTURE-AU $85.00 25021-179-66 DAPTOMYCIN 350 MG IV SOLR $84.96 0338-9553-24 CLINDAMYCIN IN 0.9 % SOD CHLOR 900 MG/50 ML IV PGBK $84.83 0338-9553-50 CLINDAMYCIN IN 0.9 % SOD CHLOR 900 MG/50 ML IV PGBK $84.83 0338-3814-50 CLINDAMYCIN IN 5 % DEXTROSE 900 MG/50 ML IV PGBK $84.83 0338-3814-24 CLINDAMYCIN IN 5 % DEXTROSE 900 MG/50 ML IV PGBK $84.83 63323-355-60 LEVOFLOXACIN IN D5W 750 MG/150 ML IV PGBK $84.83 63323-462-01 BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJ SOLN $84.63 63323-462-37 BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJ SOLN $84.63 0074-0561-14 VENETOCLAX 10 MG ORAL TAB $84.60 0074-0561-11 VENETOCLAX 10 MG ORAL TAB $84.57 42806-149-32 AZITHROMYCIN 200 MG/5 ML ORAL SUSR $84.53 67877-545-88 CEPHALEXIN 250 MG/5 ML ORAL SUSR $84.50 0143-9532-01 DEXMEDETOMIDINE 100 MCG/ML INJ SOLN (FOR INTRANASAL USE) $84.50 0143-9532-25 DEXMEDETOMIDINE 100 MCG/ML INJ SOLN (FOR INTRANASAL USE) $84.50 0143-9090-01 DOXORUBICIN 2 MG/ML IV SOLN (MCH) $84.50 0143-9783-10 FLUMAZENIL 0.1 MG/ML IV SOLN $84.50 0143-9783-01 FLUMAZENIL 0.1 MG/ML IV SOLN $84.50 65174-660-30 KIT PREP TC-99M-MEDRONATE SOD 25 MG IV SOLR $84.50 63323-482-05 LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN $84.50 63323-482-57 LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN $84.50 0054-0238-49 MORPHINE 20 MG/5 ML (4 MG/ML) ORAL SOLN $84.50 0093-4127-74 PENICILLIN V POTASSIUM 250 MG/5 ML ORAL SOLR $84.50 63323-426-01 ROCURONIUM 10 MG/ML IV SOLN $84.50 63323-426-10 ROCURONIUM 10 MG/ML IV SOLN $84.50 63323-241-20 SODIUM GLYCEROPHOSPHATE 1 MMOL/ML IV SOLN $84.50 0713-0678-15 NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM $84.44 60505-6236-0 DEFEROXAMINE 500 MG INJ SOLR $84.18 60505-6236-6 DEFEROXAMINE 500 MG INJ SOLR $84.18 70860-126-20 PENICILLIN G POTASSIUM 5 MILLION UNIT INJ SOLR $84.18 70860-126-41 PENICILLIN G POTASSIUM 5 MILLION UNIT INJ SOLR $84.18 HC89007231 AMINO ACIDS QUANT-AU $84.00 HC89011514 ANTI-RETICULIN AB TITER-AU $84.00 HC89000715 CHLORPROPAMIDE-AU $84.00 HC89017339 FUNGUS AB OTHER-QD $84.00 HC89005706 H. INFLUENZA TYPE B ANTIGEN-FT $84.00 HC89005730 N. MENINGITIDIS GRP A/Y-FT $84.00 HC89005722 N. MENINGITIDIS GRP C/W135-FT $84.00 HC51020279 NP EST PT EVAL BRIEF 5MIN $84.00 HC31001779 PT-THER PROC GRP 15MIN/M $84.00 HC89005714 S. PNEUMONIAE ANTIGEN-FT $84.00 HC51062040 SELF MANAGEMENT EDUC & TRAINING 5-8PTS 30MIN (PRIVAT INSAUTHREQ) $84.00 HC51062008 SELF MEASURE BP PT EDUCATION/TRAINING $84.00 HC51062198 TEACH/COUNSEL INDIVIDUAL FPACT $84.00 HC89011795 TEICHOIC ACID AB (ID)-FT $84.00 70594-119-01 BUPIVACAINE HCL 0.5 % (5 MG/ML) INJ SOLN $83.85 99999-043-60 NIFEDIPINE 4 MG/ML ORAL LIQUID $83.85 61570-131-55 SILVER SULFADIAZINE 1 % TOPICAL CREAM $83.85 0078-0360-34 VALSARTAN 320 MG ORAL TAB $83.79 HC83506121 IF, EACH ADD'L SINGLE AB STAIN-PA $83.69 72572-750-10 SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ SOLN $83.66 72572-750-01 SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ SOLN $83.66 0409-5922-01 AMINOPHYLLINE 500 MG/20 ML IV SOLN $83.59 0409-5922-16 AMINOPHYLLINE 500 MG/20 ML IV SOLN $83.59 63323-106-05 MAGNESIUM SULFATE IN WATER 2 GRAM/50 ML (4 %) IV PGBK $83.53 63323-106-02 MAGNESIUM SULFATE IN WATER 2 GRAM/50 ML (4 %) IV PGBK $83.53 25021-612-81 MAGNESIUM SULFATE IN WATER 2 GRAM/50 ML (4 %) IV PGBK $83.53 51248-150-01 SOLIFENACIN 5 MG ORAL TAB $83.53 0955-1006-10 ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRG $83.35 0955-1006-01 ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRG $83.35 0536-1294-97 DICLOFENAC SODIUM 1 % TOPICAL GEL $83.20 0121-1036-05 HYDROCODONE-HOMATROPINE 5-1.5 MG/5 ML (5 ML) ORAL SOLN $83.20 72603-180-10 NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN $83.07 72603-180-01 NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN $83.07 63323-695-22 ACETYLCYSTEINE 100 MG/ML (10 %) MISC SOLN $83.02 HC51060010 AHCP GROUP TEACH/COUNS SESSION $83.00 HC89009435 MEPERIDINE ANLG; 1-2 SRM/PLSM-AU $83.00 HC51020048 RN GROUP TEACH/COUNS SESSION $83.00 HC81100836 SPECIFIC GRAVITY FLUID $83.00 1571889305 WHITE PETROLATUM-MINERAL OIL 80-20 % OPHT OINT $82.94 0781-3755-95 NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN $82.84 0781-3755-75 NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN $82.84 0143-9509-10 KETAMINE 100 MG/ML INJ SOLN $82.81 0143-9509-01 KETAMINE 100 MG/ML INJ SOLN $82.81 0049-0520-83 PENICILLIN G POTASSIUM 5 MILLION UNIT INJ SOLR $82.69 0049-0520-84 PENICILLIN G POTASSIUM 5 MILLION UNIT INJ SOLR $82.69 7214000021 LANOLIN ALCOHOL-MO-W.PET-CERES TOPICAL CREAM $82.63 44567-622-24 CALCIUM GLUC IN NACL, ISO-OSM 1 GRAM/100 ML IV SOLN $82.55 44567-622-01 CALCIUM GLUC IN NACL, ISO-OSM 1 GRAM/100 ML IV SOLN $82.55 72603-210-10 PENICILLIN G POTASSIUM 5 MILLION UNIT INJ SOLR $82.55 72603-210-01 PENICILLIN G POTASSIUM 5 MILLION UNIT INJ SOLR $82.55 0781-6135-95 PENICILLIN G POTASSIUM 5 MILLION UNIT INJ SOLR $82.55 63739-901-28 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $82.36 63739-901-14 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $82.36 0406-9050-76 FENTANYL 50 MCG/HR TRANSDERMAL PT72 $82.33 47781-426-11 FENTANYL 50 MCG/HR TRANSDERMAL PT72 $82.33 47781-426-47 FENTANYL 50 MCG/HR TRANSDERMAL PT72 $82.33 0378-9122-16 FENTANYL 50 MCG/HR TRANSDERMAL PT72 $82.33 0378-9122-98 FENTANYL 50 MCG/HR TRANSDERMAL PT72 $82.33 42806-143-01 DEMECLOCYCLINE 150 MG ORAL TAB $82.31 49281-547-58 HAEMOPH B POLY CONJ-TET TOX-PF 10 MCG/0.5 ML IM SOLR $82.29 49281-545-03 HAEMOPH B POLY CONJ-TET TOX-PF 10 MCG/0.5 ML IM SOLR $82.26 9468801162 PROTEIN ORAL POWD $82.23 0065-0795-15 BALANCED SALT SOLN NO.2 IRRIG. INTRAOCULAR SOLN $82.19 0574-4160-35 NEOMYCIN-POLYMYXIN B-DEXAMETH 3.5 MG/G-10,000 UNIT/G-0.1 % OPHT OINT $82.11 HC83506139 SPECIAL STAIN GROUP I+-PA $82.10 99999-034-83 LAMINARIA JAPONICA (DILATERIA) EXTRA THICK $82.10 99999-034-80 LAMINARIA JAPONICA (DILATERIA) MEDIUM $82.10 99999-034-81 LAMINARIA JAPONICA (DILATERIA) THICK $82.10 99999-034-82 LAMINARIA JAPONICA (DILATERIA) THIN $82.10 0409-1631-40 CALCIUM CHLORIDE 10% IV SOLN (MCH) $82.03 66993-456-30 DAPAGLIFLOZIN PROPANEDIOL 5 MG ORAL TAB $82.00 70069-018-25 ACETYLCYSTEINE 100 MG/ML (10 %) MISC SOLN $81.90 70069-018-01 ACETYLCYSTEINE 100 MG/ML (10 %) MISC SOLN $81.90 63323-465-57 BUPIVACAINE HCL 0.25 % (2.5 MG/ML) INJ SOLN $81.90 63323-465-01 BUPIVACAINE HCL 0.25 % (2.5 MG/ML) INJ SOLN $81.90 67457-553-00 MAGNESIUM SULFATE IN WATER 2 GRAM/50 ML (4 %) IV PGBK $81.90 0338-1708-40 MAGNESIUM SULFATE IN WATER 2 GRAM/50 ML (4 %) IV PGBK $81.90 47335-992-01 MAGNESIUM SULFATE IN WATER 2 GRAM/50 ML (4 %) IV PGBK $81.90 70954-041-10 RIFABUTIN 150 MG ORAL CAP $81.87 63323-238-01 CEFAZOLIN 10 GRAM INJ SOLR $81.51 63323-238-61 CEFAZOLIN 10 GRAM INJ SOLR $81.51 0703-9514-03 SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG/5 ML IV SOLN $81.51 0703-9514-01 SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG/5 ML IV SOLN $81.51 HC89023204 ALDOSTERONE-QN $81.50 0781-3268-05 ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRG $81.36 0781-3268-69 ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRG $81.36 50458-550-01 PALIPERIDONE 3 MG ORAL TR24 $81.30 50458-551-01 PALIPERIDONE 6 MG ORAL TR24 $81.30 99999-008-92 THEOPHYLLINE 80 MG/15 ML ORAL ELIX $81.29 16714-188-01 SIROLIMUS 1 MG ORAL TAB $81.28 70069-501-01 DORZOLAMIDE 2 % OPHT DROP $81.25 70004-300-69 HYDROMORPHONE 0.2 MG/ML IN NS 50 ML OPIOID NAIVE PCA (OCM) $81.25 63323-355-65 LEVOFLOXACIN IN D5W 500 MG/100 ML IV PGBK $81.25 70121-1719-1 MAGNESIUM SULFATE IN WATER 2 GRAM/50 ML (4 %) IV PGBK $81.25 70121-1719-2 MAGNESIUM SULFATE IN WATER 2 GRAM/50 ML (4 %) IV PGBK $81.25 55150-123-15 NAFCILLIN 2 GRAM INJ SOLR $81.25 67850-032-00 NAFCILLIN 2 GRAM INJ SOLR $81.25 67850-032-10 NAFCILLIN 2 GRAM INJ SOLR $81.25 55150-123-16 NAFCILLIN 2 GRAM INJ SOLR $81.25 70756-622-10 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $81.25 70756-622-85 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $81.25 58980-824-05 LIDOCAINE 4 % TOPICAL CREAM $81.24 52565-022-15 ECONAZOLE NITRATE 1 % TOPICAL CREAM $81.22 10702-036-15 SODIUM POLYSTYRENE SULFONATE 15 GRAM ORAL POWD $81.22 11534-166-15 SODIUM POLYSTYRENE SULFONATE 15 GRAM ORAL POWD $81.22 0591-3217-26 TESTOSTERONE 1 % (50 MG/5 GRAM) TRANSDERMAL GLPK $81.19 0591-3217-30 TESTOSTERONE 1 % (50 MG/5 GRAM) TRANSDERMAL GLPK $81.19 59676-570-01 ETRAVIRINE 100 MG ORAL TAB $81.13 HC89018220 FACTOR VIII VW AG-EC $81.00 HC89005243 HERPESVIRUS 6 AB IGG- FT $81.00 HC89005250 HERPESVIRUS 6 AB IGM -FT $81.00 HC35500222 MT-BEHAV TX FAM W/O PT ADD 15 $81.00 HC35500206 MT-BEHAVIOR TX FAMW/PT ADD 15MIN $81.00 HC29000551 PREVENTATIVE MED COUNSELING 15MIN $81.00 HC82202805 PROCESS, EMBED & 2 H&E'S $81.00 HC39001607 PSY-BEHAV TX FAM W/O PT ADD 15 $81.00 HC39001581 PSY-BEHAVIOR TX FAMW/PT ADD 15MIN $81.00 HC89005698 STREPTOCOCCUS GRP B ANTIGEN-FT $81.00 0641-6261-01 SODIUM ACETATE 2 MEQ/ML IV SOLN $80.99 63323-104-01 ETOPOSIDE 20 MG/ML INJ SOLN (FOR ORAL USE) (MCH) $80.86 63323-104-05 ETOPOSIDE 20 MG/ML INJ SOLN (FOR ORAL USE) (MCH) $80.86 63323-104-06 ETOPOSIDE 20 MG/ML INJ SOLN (FOR ORAL USE) (MCH) $80.86 58160-726-15 HAEMOPH B POLY CONJ-TET TOX-PF 10 MCG/0.5 ML IM SOLR $80.70 58160-816-03 HAEMOPH B POLY CONJ-TET TOX-PF 10 MCG/0.5 ML IM SOLR $80.70 HC89004410 HTLV I/II AB, WESTERN BLOT-AU $80.67 43598-210-55 SILVER SULFADIAZINE 1 % TOPICAL CREAM $80.60 43598-210-50 SILVER SULFADIAZINE 1 % TOPICAL CREAM $80.60 63323-127-10 DACARBAZINE 100 MG IV SOLN (MCH) $80.54 63323-127-00 DACARBAZINE 100 MG IV SOLR $80.54 4110082073 POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWD $80.44 62756-349-44 OCTREOTIDE ACETATE 100 MCG/ML INJ SOLN $80.44 63323-294-27 MEPIVACAINE (PF) 20 MG/ML (2 %) INJ SOLN $80.34 63323-294-01 MEPIVACAINE (PF) 20 MG/ML (2 %) INJ SOLN $80.34 HC89008460 5-HIAA URINE-CA $80.00 HC89024095 CANDIDA QUAL PCR-QD $80.00 HC89014765 ENTEROVIRUS BY PCR -AU $80.00 HC89023154 ENZYME ACTIVITY NONRAD; DISACCHARIDASE-AU $80.00 HC83505735 EXAM GROSS&MICRO INTERM LVL IV(PANEL)-U2 $80.00 HC89014807 HEPATITIS C GENOTYPE PCR-AU $80.00 HC83504456 IHC/IP PER SPEC INITIAL AB STAIN -EM $80.00 45802-953-01 DICLOFENAC SODIUM 1 % TOPICAL GEL $79.95 HC89022560 ANDROSTENEDIONE-QN $79.93 0517-7610-03 ACETYLCYSTEINE 200 MG/ML (20 %) MISC SOLN $79.63 0338-0819-09 FAT EMULSION 20 % IV (FOR LIPID RESCUE) $79.63 43598-607-11 FONDAPARINUX 2.5 MG/0.5 ML SUBCUTANEOUS SYRG $79.63 43598-607-10 FONDAPARINUX 2.5 MG/0.5 ML SUBCUTANEOUS SYRG $79.63 0517-7201-25 TRACE ELEMENTS CR-CU-MN-ZN 10 MCG-1 MG- 0.5 MG-5 MG/ML IV SOLN $79.63 HC51002103 MNT INITIAL ASSESSMENT INDIV EA 15MIN 1ST REF $79.44 573287194 PHENYLEPH-MIN OIL-PETROLATUM 0.25-14-74.9 % RECTAL OINT $79.29 HC89013619 DHEA-ES $79.23 24510-050-10 TAPENTADOL 50 MG ORAL TAB $79.12 0597-0075-75 TIOTROPIUM BROMIDE 18 MCG INHALATION CPDV $79.11 0456-1110-30 VILAZODONE 10 MG ORAL TAB $79.05 0456-1120-30 VILAZODONE 20 MG ORAL TAB $79.05 10019-120-39 ESMOLOL 100 MG/10 ML (10 MG/ML) IV SOLN $79.04 10019-120-01 ESMOLOL 100 MG/10 ML (10 MG/ML) IV SOLN $79.04 70069-362-10 SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG/5 ML IV SOLN $79.04 70069-362-01 SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG/5 ML IV SOLN $79.04 HC89021729 BUPRENORPHINE MEC(PNL)-AU $79.00 HC32010126 OT-THER PROC GROUP [15MIN] $79.00 HC31010093 PT-THER PROC GROUP [15MIN] $79.00 0591-3216-30 TESTOSTERONE 1 % (25 MG/2.5GRAM) TRANSDERMAL GLPK $78.99 0591-3216-17 TESTOSTERONE 1 % (25 MG/2.5GRAM) TRANSDERMAL GLPK $78.99 0409-3299-05 SODIUM ACETATE 2 MEQ/ML IV SOLN $78.98 0409-3299-15 SODIUM ACETATE 2 MEQ/ML IV SOLN $78.98 0517-9203-25 TRACE ELEMENT PEDI CR-CU-MN-ZN 1 MCG-0.1 MG-25 MCG-1 MG/ML IV SOLN $78.98 0409-3378-13 PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR $78.75 24208-735-01 CYCLOPENTOLATE 1 % OPHT DROP $78.65 0409-5093-11 CEFTAZIDIME 2 GRAM IV SOLR $78.61 63323-468-37 BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJ SOLN $78.59 63323-468-02 BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJ SOLN $78.59 0003-0494-20 TRIAMCINOLONE ACETONIDE 10 MG/ML INJ SUSP $78.59 72603-336-01 HEPARIN, PORCINE (PF) 1,000 UNIT/ML INJ SOLN $78.55 72603-336-25 HEPARIN, PORCINE (PF) 1,000 UNIT/ML INJ SOLN $78.55 HC89022370 FLOW CYT LEUK/LYMPH 1ST MRKR{W-INT/87}-AU $78.50 0131-2477-35 LACOSAMIDE 50 MG ORAL TAB $78.47 42806-513-30 QUINIDINE SULFATE 200 MG ORAL TAB $78.46 25021-234-10 GEMCITABINE 200 MG IV SOLR $78.33 63323-782-20 VECURONIUM BROMIDE 20 MG IV SOLR $78.33 63323-782-23 VECURONIUM BROMIDE 20 MG IV SOLR $78.33 0078-0405-05 AMLODIPINE-BENAZEPRIL 5-10 MG ORAL CAP $78.25 67877-473-79 LIDOCAINE 5 % TOPICAL OINT $78.09 54092-254-90 LANTHANUM 1,000 MG ORAL CHEW $78.05 54092-254-10 LANTHANUM 1,000 MG ORAL CHEW $78.05 54092-252-45 LANTHANUM 500 MG ORAL CHEW $78.05 54092-252-90 LANTHANUM 500 MG ORAL CHEW $78.05 HC89014906 CHROM ANAL AF TISSUE CULT-GZ $78.00 HC89021596 DRUG SCRN, TOF PRESUMP-AU $78.00 0143-9386-01 ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN $78.00 0143-9386-10 ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN $78.00 67457-940-10 ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN $78.00 69374-330-05 ALBUTEROL SULFATE 5 MG/ML CONTINUOUS NEB (AEROGEN) $78.00 51754-0500-1 CAFFEINE CITRATE 20 MG/ML INJ SOLN (MCH) $78.00 99999-042-67 CAFFEINE CITRATE 5 MG/ML INJ DILUTION (MCH) $78.00 99999-040-17 CAFFEINE CITRATE 5 MG/ML INJ DILUTION (MCH) $78.00 99999-046-30 CAFFEINE CITRATE 5 MG/ML ORAL SOLN (SLH) $78.00 51754-0501-3 CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) ORAL SOLN $78.00 0781-3452-46 CEFAZOLIN 10 GRAM INJ SOLR $78.00 0781-3452-95 CEFAZOLIN 10 GRAM INJ SOLR $78.00 60505-6143-0 CEFAZOLIN 10 GRAM INJ SOLR $78.00 60505-6143-4 CEFAZOLIN 10 GRAM INJ SOLR $78.00 43386-096-60 CLOBETASOL 0.05 % TOPICAL OINT $78.00 63323-128-20 DACARBAZINE 200 MG IV SOLN (MCH) $78.00 0143-9245-10 DACARBAZINE 200 MG IV SOLN (MCH) $78.00 0143-9245-01 DACARBAZINE 200 MG IV SOLN (MCH) $78.00 63323-128-00 DACARBAZINE 200 MG IV SOLN (MCH) $78.00 43598-977-10 DICLOFENAC SODIUM 1 % TOPICAL GEL $78.00 0548-5604-00 ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRG $78.00 60505-0794-4 ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRG $78.00 60505-0794-0 ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRG $78.00 25021-836-01 EPHEDRINE SULFATE 50 MG/ML IV SOLN $78.00 68001-524-29 FLUOROURACIL 1 GRAM/20 ML IV SOLN $78.00 68001-524-31 FLUOROURACIL 1 GRAM/20 ML IV SOLN $78.00 63323-102-13 GEMCITABINE 200 MG IV SOLR $78.00 63323-522-01 HEPARIN (PORCINE) IN 5 % DEX 25,000 UNIT/500 ML (50 UNIT/ML) IV SOLP $78.00 63323-522-77 HEPARIN (PORCINE) IN 5 % DEX 25,000 UNIT/500 ML (50 UNIT/ML) IV SOLP $78.00 67457-291-00 HYDRALAZINE 20 MG/ML INJ SOLN $78.00 67457-291-01 HYDRALAZINE 20 MG/ML INJ SOLN $78.00 0990-7828-08 LACTATED RINGERS IRR SOLN $78.00 72578-089-01 NYSTATIN 100,000 UNIT/GRAM TOPICAL OINT $78.00 0338-0695-04 POTASSIUM CHLORIDE IN 0.9%NACL 40 MEQ/L IV SOLP $78.00 63323-269-67 PROPOFOL 10 MG/ML IV EMUL $78.00 0990-7972-08 SODIUM CHLORIDE 0.9 % IRR SOLN $78.00 0990-7972-07 SODIUM CHLORIDE 0.9 % IRR SOLN $78.00 0143-9638-05 SUMATRIPTAN SUCCINATE 6 MG/0.5 ML SUBCUTANEOUS SOLN $78.00 0143-9638-01 SUMATRIPTAN SUCCINATE 6 MG/0.5 ML SUBCUTANEOUS SOLN $78.00 63323-147-10 TRACE ELEM PED ZN-CU-MN-SE-F-I 521-53.7-3.6 MCG/ML IV SOLN $78.00 0069-0043-01 HEPARIN, PORCINE (PF) 1,000 UNIT/ML INJ SOLN $77.86 0069-0043-02 HEPARIN, PORCINE (PF) 1,000 UNIT/ML INJ SOLN $77.86 50458-098-01 PENTOSAN POLYSULFATE SODIUM 100 MG ORAL CAP $77.84 68084-451-11 TACROLIMUS 5 MG ORAL CAP $77.72 61314-396-01 CYCLOPENTOLATE 1 % OPHT DROP $77.68 63323-607-01 ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRG $77.54 63323-607-88 ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRG $77.54 71288-403-10 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $77.48 71288-403-11 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $77.48 99999-040-04 FENTANYL 25 MCG/ML IN NS 50 ML OPIOID NAIVE PCA $77.35 99999-035-16 MAGNESIUM SULFATE IN D5W 6 GRAM/100ML IV SOLUTION $77.35 0065-0426-37 ARTIFICIAL TEAR(DXTRN-HPM-GLY) 0.1-0.3-0.2 % OPHT DROP $77.22 25021-315-98 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $77.22 0781-3289-09 CLINDAMYCIN IN 5 % DEXTROSE 600 MG/50 ML IV PGBK $77.03 0781-3289-91 CLINDAMYCIN IN 5 % DEXTROSE 600 MG/50 ML IV PGBK $77.03 HC89022487 DFA W/REFLEX CULT VARICELLA ZV-AU $77.00 HC89013031 HEPATITIS C AB CONFIRM-AU $77.00 HC29000353 OB FECES GUAIAC1-3SCR(IN DEPT) $77.00 99999-034-10 ZINC CHLORIDE 1 MG/ML ORAL LIQUID (MCH) $76.99 58657-525-16 ACETAMINOPHEN 160 MG/5 ML ORAL LIQD $76.86 58657-528-16 DIPHENHYDRAMINE HCL 12.5 MG/5 ML ORAL LIQ (MCH) $76.86 16714-026-10 ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRG $76.70 16714-026-01 ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRG $76.70 99999-001-86 MIDAZOLAM 100 MG IN NS 100 ML DRIP (SLH WRAPPER) $76.70 63323-492-37 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $76.64 63323-492-07 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $76.64 0078-0248-61 CYCLOSPORINE MODIFIED 100 MG ORAL CAP $76.57 0536-1264-56 CAPSAICIN 0.1 % TOPICAL CREAM $76.52 HC89018964 HEINZ BODIES INDUCED-AU $76.50 HC89022131 PHENCYCLIDINE (PCP)SERUM QNT(PNL)-AU $76.50 4110081102 LORATADINE 5 MG/5 ML ORAL SOLN $76.44 0078-0248-15 CYCLOSPORINE MODIFIED 100 MG ORAL CAP $76.43 0078-0659-20 SACUBITRIL-VALSARTAN 24-26 MG ORAL TAB $76.40 0078-0777-20 SACUBITRIL-VALSARTAN 49-51 MG ORAL TAB $76.40 0078-0696-20 SACUBITRIL-VALSARTAN 97-103 MG ORAL TAB $76.40 24208-290-05 TOBRAMYCIN 0.3 % OPHT DROP $76.38 43598-605-04 TOBRAMYCIN IN 0.225 % NACL 300 MG/5 ML INHALATION NEBU $76.38 43598-605-56 TOBRAMYCIN IN 0.225 % NACL 300 MG/5 ML INHALATION NEBU $76.38 60505-3250-6 LAMIVUDINE 100 MG ORAL TAB $76.16 16714-245-30 MESALAMINE 1,000 MG RECTAL SUPP $76.15 99999-035-45 LACOSAMIDE 10 MG/ML ORAL SOLN $76.12 63323-489-17 LIDOCAINE-EPINEPHRINE (MPF) 2 %-1:200,000 INJ SOLN (MHS) $76.12 63323-489-01 LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJ SOLN $76.12 51672-1275-1 CLOTRIMAZOLE 1 % TOPICAL CREAM $76.05 0641-6046-01 LORAZEPAM 2 MG/ML INJ SOLN $76.05 0641-6046-10 LORAZEPAM 2 MG/ML INJ SOLN $76.05 55150-122-15 NAFCILLIN 1 GRAM INJ SOLR $76.05 HC89023063 ANAL' GENE TPMT COMMON VARIANT-AU $76.00 HC89004972 CRYPTOCOCCUS AB (SERUM)-FT $76.00 HC89012256 CRYPTOCOCCUS AB-FT $76.00 HC51000271 IVP SINGLE/REPEAT RX ADD'L INJ $76.00 HC51060754 PT-THER EXER 15MIN/M $76.00 HC89500573 RBC AG OTHER THAN ABO/RH-SB $75.92 31722-579-60 MARAVIROC 150 MG ORAL TAB $75.84 72319-025-02 MARAVIROC 300 MG ORAL TAB $75.84 63323-815-02 AMIKACIN 500 MG/2 ML INJ SOLN $75.73 0409-2723-02 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $75.73 0409-2723-31 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $75.73 63323-258-03 METHYLPREDNISOLONE SODIUM SUCC 125 MG INJ SOLR $75.73 HC51070993 ASSESS TOOL SDOH 5-15MIN $75.70 HC51070787 PSY-BEHAVIOR TX FAMW/PT 1ST 30MIN $75.70 HC51070761 PSY-BEHAVIOR TX GROUP 1ST 30 MIN $75.70 HC51003507 SCREENING DEPRESSION ANNUAL 5-15MIN $75.70 HC51003481 SCREENING ETOH MISUSE ANNUAL 5-15MIN $75.70 HC51003440 SMOKING CESSATION > 10 MIN $75.70 HC51003432 SMOKING CESSATION 3-10 MIN $75.70 42291-094-30 AZELASTINE 137 MCG (0.1 %) NASL SPRY $75.47 0409-1746-71 BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJ SOLN $75.47 0409-1746-30 BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJ SOLN $75.47 70069-631-01 ATROPINE 0.4 MG/ML INJ SOLN (MHS WRAPPER) $75.41 70069-631-25 ATROPINE 0.4 MG/ML INJ SOLN (MHS WRAPPER) $75.41 72266-158-01 MOXIFLOXACIN 0.5 % OPHT DROP $75.41 0093-4125-74 PENICILLIN V POTASSIUM 125 MG/5 ML ORAL SOLR $75.40 0168-0006-80 TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINT $75.40 99988-000-36 NM TC-99M OXIDRONATE (HDP) $75.32 0517-6202-25 TRACE ELEMENTS CR-CU-MN-ZN 0.85 MCG-0.1 MG -25MCG-1.5MG/ML IV SOLN $75.27 99999-040-65 DIAZEPAM 5 MG/ML INJ SOLN $75.23 0574-7090-12 HYDROCORTISONE ACETATE 25 MG RECTAL SUPP $75.01 HC89012249 CRYPTOCOCCUS AB-AU $75.00 HC89017123 CYCLOSPORINE-U4 $75.00 HC89008106 GALACTOSE-1-PHOS URIDYL TR-AU $75.00 HC89004147 HEXA P'LIPID NEUTRALIZATION-AU $75.00 HC89017438 HEXAGONL PHOSLPD NEUTLZ RFX-AU $75.00 HC89013312 HIV-1 RNA QUANT BY PCR-AU $75.00 HC89008619 LEPTIN-QN $75.00 HC89020259 MAJOR BREAKPOINT (BCR/ABL1)-AU $75.00 HC89020267 MINOR BREAKPOINT (BCR/ABL1)-AU $75.00 HC45401619 MR SAFETY IMPLANT/FB ASSESS,CLINICAL STFF, ID, VERIFY, IMAGE REV; INITIAL 15MIN $75.00 HC89013668 NEURONAL CELL AB-AU $75.00 HC89005359 PARATHYROID HORMONE RELPEP-AU $75.00 HC89004956 PARVOVIRUS B19 BY PCR -AU $75.00 HC89000798 PORPHYRINS FRACT URINE-QD $75.00 HC89019947 PROTHROMBIN(F2) G20210A MUT-AU $75.00 HC89500425 RBC PRETREAT W/DRUG/CHEM-SB $75.00 HC89500995 RBC PRETX AB DETECT, ID, COMPAT; INCUB EZYM, EACH-SB $75.00 HC89500458 SAMPLE TRANSPORT-SB $75.00 HC89012025 SPOROTRICHOSIS AB-FT $75.00 HC89004667 STREPTOCOCCUS PNEUM AG-FT $75.00 69367-243-12 HYDROCORTISONE ACETATE 25 MG RECTAL SUPP $74.97 70839-150-30 ALISKIREN 150 MG ORAL TAB $74.82 67457-124-10 DIPHENHYDRAMINE HCL 50 MG/ML INJ SOLN $74.75 0641-6103-01 METHOCARBAMOL 100 MG/ML INJ SOLN $74.75 99999-045-88 MIDAZOLAM 100 MG IN D5W 100 ML DRIP (SLH) $74.75 70860-116-41 NAFCILLIN 1 GRAM INJ SOLR $74.75 70860-116-26 NAFCILLIN 1 GRAM INJ SOLR $74.75 55150-226-10 ROCURONIUM 10 MG/ML IV SOLN $74.75 0143-9338-01 SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ SOLN (MCH) $74.75 0143-9338-25 SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ SOLN (MCH) $74.75 0713-0503-06 HYDROCORTISONE ACETATE 25 MG RECTAL SUPP $74.74 0713-0503-12 HYDROCORTISONE ACETATE 25 MG RECTAL SUPP $74.74 27808-082-01 MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLN $74.69 63323-604-01 PROPRANOLOL 1 MG/ML IV SOLN $74.62 63323-604-00 PROPRANOLOL 1 MG/ML IV SOLN $74.62 16714-293-02 AMOXICILLIN-POT CLAVULANATE 400-57 MG/5 ML ORAL SUSR $74.59 0781-6104-57 AMOXICILLIN-POT CLAVULANATE 400-57 MG/5 ML ORAL SUSR $74.59 76329-3340-1 ATROPINE 0.1 MG/ML INJ (CRRT PRIME LESS THAN 10 KG) $74.43 45020504 CETIRIZINE 1 MG/ML ORAL SOLN $74.40 0173-0642-55 LAMOTRIGINE 100 MG ORAL TAB $74.26 67457-475-00 VECURONIUM BROMIDE 20 MG IV SOLR $74.10 67457-475-20 VECURONIUM BROMIDE 20 MG IV SOLR $74.10 63323-321-10 POLYMYXIN B SULFATE 500,000 UNIT INJ SOLR $74.04 63323-321-01 POLYMYXIN B SULFATE 500,000 UNIT INJ SOLR $74.04 HC51001931 CBC W/O DIFF $74.00 HC85100485 CBC W/O DIFF $74.00 HC89020432 ZINC, WHOLE BLOOD -AU $74.00 0009-3073-03 METHYLPREDNISOLONE ACETATE 40 MG/ML INJ SUSP $73.89 0009-3073-01 METHYLPREDNISOLONE ACETATE 40 MG/ML INJ SUSP $73.84 4628750001 SORBITOL 70 % MISC SOLN $73.79 0409-3178-02 LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN $73.71 0409-3178-17 LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN $73.71 0409-0212-02 MILRINONE 1 MG/ML IV SOLN $73.71 0409-0212-11 MILRINONE 1 MG/ML IV SOLN $73.71 HC89010755 OSMOTIC FRAGILITY UNINCUBAT-AU $73.52 39822-1201-5 NEOMYCIN-POLYMYXIN B GU 40 MG-200,000 UNIT/ML IRR SOLN $73.45 60505-3165-0 RISEDRONATE 35 MG ORAL TAB $73.45 0054-4499-11 LEUCOVORIN CALCIUM 25 MG ORAL TAB $73.44 55150-154-10 ACYCLOVIR SODIUM 50 MG/ML IV SOLN $73.13 55150-154-11 ACYCLOVIR SODIUM 50 MG/ML IV SOLN $73.13 70594-049-02 POLYMYXIN B SULFATE 500,000 UNIT INJ SOLR $73.13 0283-0610-43 BENZOCAINE 20 % MUCOUS MEMB SPRY $73.03 65162-918-38 LIDOCAINE 5 % TOPICAL OINT $73.03 HC89007256 AMYLASE-QD $73.00 HC89007439 CHLORAMPHENICOL-AU $73.00 HC89013122 CULTURE CHLAMYDIA-AU $73.00 HC89000558 DENGUE FEVER AB-SL $73.00 HC89012702 HIV-2 AB-AU $73.00 HC89009005 METHADONE &METABOLITE QUANT SERUM-AU $73.00 HC89019301 PM/SCL-100 AB, IGG-AU $73.00 HC89013452 VERAPAMIL-AU $73.00 0517-1004-01 ATROPINE 0.4 MG/ML INJ SOLN (MHS WRAPPER) $73.00 0517-1004-25 ATROPINE 0.4 MG/ML INJ SOLN (MHS WRAPPER) $73.00 65649-301-03 RIFAXIMIN 200 MG ORAL TAB $72.97 11701-050-32 ZINC OXIDE-PETROLATUM 20-51 % TOPICAL PSTE $72.93 63323-322-93 IMIPENEM-CILASTATIN 500 MG IV SOLR $72.89 HC89500516 BLOOD TYPE SERO; PER AG/ANTIGEN DNR-SB $72.80 0409-3294-51 POTASSIUM ACETATE 2 MEQ/ML IV SOLN $72.80 0409-3294-61 POTASSIUM ACETATE 2 MEQ/ML IV SOLN $72.80 0409-7299-73 SODIUM ACETATE 2 MEQ/ML IV SOLN $72.80 0409-7299-83 SODIUM ACETATE 2 MEQ/ML IV SOLN $72.80 HC89004030 NEUTROPHIL-ASSOC ANTIBODIES -AU $72.67 63323-229-15 PROTAMINE 10 MG/ML IV SOLN $72.48 63323-229-21 PROTAMINE 10 MG/ML IV SOLN $72.48 0071-1015-41 PREGABALIN 100 MG ORAL CAP $72.35 0071-1014-41 PREGABALIN 75 MG ORAL CAP $72.35 63323-260-37 MEPIVACAINE (PF) 10 MG/ML (1 %) INJ SOLN $72.35 0409-0185-01 GEMCITABINE 200 MG IV SOLR $72.28 63323-655-99 ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRG $72.09 63323-655-21 ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRG $72.09 71288-437-92 ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRG $72.09 71288-437-91 ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRG $72.09 HC89019954 FACTOR V LEIDEN PCR-AU $72.00 HC89017404 H. PYLORI BREATH (& KIT)-AU $72.00 0409-6581-01 BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJ SOLN $71.83 0143-9983-03 CEFAZOLIN 10 GRAM INJ SOLR $71.83 0143-9983-91 CEFAZOLIN 10 GRAM INJ SOLR $71.83 99999-033-72 LEVOFLOXACIN 25 MG/ML ORAL LIQUID $71.83 63323-487-17 LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJ SOLN $71.76 63323-487-01 LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJ SOLN $71.76 61703-309-25 VINCRISTINE 2 MG/2 ML IV SOLN $71.70 72485-104-10 CAFFEINE CITRATE 20 MG/ML INJ SOLN (MCH) $71.51 64764-918-30 FEBUXOSTAT 40 MG ORAL TAB $71.51 44567-103-10 AMPICILLIN SODIUM 2 GRAM INJ SOLR $71.50 0143-9329-10 BUPIVACAINE HCL 0.5 % (5 MG/ML) INJ SOLN $71.50 0143-9329-01 BUPIVACAINE HCL 0.5 % (5 MG/ML) INJ SOLN $71.50 44567-708-10 CEFAZOLIN 10 GRAM INJ SOLR $71.50 25021-128-50 CEFTAZIDIME 2 GRAM INJ SOLR $71.50 54288-103-10 EPINEPHRINE HCL (PF) 1 MG/ML (1 ML) INJ SOLN $71.50 54288-103-01 EPINEPHRINE HCL (PF) 1 MG/ML (1 ML) INJ SOLN $71.50 68462-933-01 EPINEPHRINE HCL (PF) 1 MG/ML (1 ML) INJ SOLN $71.50 68462-933-10 EPINEPHRINE HCL (PF) 1 MG/ML (1 ML) INJ SOLN $71.50 0641-6029-01 FENTANYL (PF) 50 MCG/ML INJ FOR INTRATHECAL PAIN PUMP REFILL (OCM) $71.50 0781-3829-75 GLYCOPYRROLATE 0.2 MG/ML INJ SOLN $71.50 0781-3829-96 GLYCOPYRROLATE 0.2 MG/ML INJ SOLN $71.50 0409-4520-30 HEPARIN (PORCINE) IN 5 % DEX 25,000 UNIT/250 ML(100 UNIT/ML) IV SOLP $71.50 0409-4520-02 HEPARIN (PORCINE) IN 5 % DEX 25,000 UNIT/250 ML(100 UNIT/ML) IV SOLP $71.50 0054-3500-49 LIDOCAINE HCL 2 % MUCOUS MEMB SOLN $71.50 72888-125-26 LIDOCAINE HCL 2 % MUCOUS MEMB SOLN $71.50 55150-208-30 MEROPENEM 1 GRAM IV SOLR $71.50 0781-3098-95 MEROPENEM 1 GRAM IV SOLR $71.50 70121-1453-7 MEROPENEM 1 GRAM IV SOLR $71.50 70121-1453-1 MEROPENEM 1 GRAM IV SOLR $71.50 0781-3098-94 MEROPENEM 1 GRAM IV SOLR $71.50 68084-621-11 MODAFINIL 100 MG ORAL TAB $71.50 68084-621-21 MODAFINIL 100 MG ORAL TAB $71.50 44567-221-10 NAFCILLIN 1 GRAM INJ SOLR $71.50 0338-0691-04 POTASSIUM CHLORIDE IN 0.9%NACL 20 MEQ/L IV SOLP $71.50 0990-7111-09 POTASSIUM CHLORIDE IN LR-D5 20 MEQ/L IV SOLP $71.50 0338-0803-04 POTASSIUM CHLORIDE-D5-0.9%NACL 20 MEQ/L IV SOLP $71.50 0006-0277-28 SITAGLIPTIN PHOSPHATE 100 MG ORAL TAB $71.50 0006-0277-01 SITAGLIPTIN PHOSPHATE 100 MG ORAL TAB $71.50 0006-0277-54 SITAGLIPTIN PHOSPHATE 100 MG ORAL TAB $71.50 0006-0277-31 SITAGLIPTIN PHOSPHATE 100 MG ORAL TAB $71.50 0006-0221-28 SITAGLIPTIN PHOSPHATE 25 MG ORAL TAB $71.50 0006-0221-01 SITAGLIPTIN PHOSPHATE 25 MG ORAL TAB $71.50 0006-0221-31 SITAGLIPTIN PHOSPHATE 25 MG ORAL TAB $71.50 0006-0221-54 SITAGLIPTIN PHOSPHATE 25 MG ORAL TAB $71.50 0006-0112-28 SITAGLIPTIN PHOSPHATE 50 MG ORAL TAB $71.50 0006-0112-54 SITAGLIPTIN PHOSPHATE 50 MG ORAL TAB $71.50 0006-0112-01 SITAGLIPTIN PHOSPHATE 50 MG ORAL TAB $71.50 0006-0112-31 SITAGLIPTIN PHOSPHATE 50 MG ORAL TAB $71.50 55150-173-01 SUMATRIPTAN SUCCINATE 6 MG/0.5 ML SUBCUTANEOUS SOLN $71.50 55150-173-05 SUMATRIPTAN SUCCINATE 6 MG/0.5 ML SUBCUTANEOUS SOLN $71.50 72603-590-01 NALOXONE 0.4 MG/ML INJ (MHS WRAPPER) $71.39 72603-590-10 NALOXONE 0.4 MG/ML INJ (MHS WRAPPER) $71.39 0078-0417-61 EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG ORAL TAB $71.31 0078-0417-20 EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG ORAL TAB $71.27 70700-167-25 GLYCOPYRROLATE 0.2 MG/ML INJ SOLN $71.24 70700-167-22 GLYCOPYRROLATE 0.2 MG/ML INJ SOLN $71.24 70069-013-01 GLYCOPYRROLATE 0.2 MG/ML INJ SOLN $71.24 70069-013-25 GLYCOPYRROLATE 0.2 MG/ML INJ SOLN $71.24 62332-628-05 GLYCOPYRROLATE 0.2 MG/ML INJ SOLN $71.24 62332-628-25 GLYCOPYRROLATE 0.2 MG/ML INJ SOLN $71.24 63323-651-02 ADENOSINE 3 MG/ML IV SOLN $71.18 25021-132-83 LEVOFLOXACIN IN D5W 750 MG/150 ML IV PGBK $71.18 10481-0111-8 IODINE-POTASSIUM IODIDE 5-10 % TOPICAL SOLN $71.08 39822-1201-1 NEOMYCIN-POLYMYXIN B GU 40 MG-200,000 UNIT/ML IRR SOLN $71.01 0713-0503-24 HYDROCORTISONE ACETATE 25 MG RECTAL SUPP $71.01 HC89002885 AMIKACIN SUBSEQUENT-QD $71.00 HC89014112 ANTIBODY PM-1 AB-AU $71.00 HC89015259 CODEINE URINE - U2 $71.00 HC89004584 COPPER, LIVER TISSUE-MA $71.00 HC44900900 CT PRIVATE CONSULT W/RAD $71.00 HC89003768 FLUORIDE URINE (PNL)-AU $71.00 HC89014336 GIARDIA AB IFA-AU $71.00 63323-488-17 LIDOCAINE-EPINEPHRINE (MPF) 1.5 %-1:200,000 INJ SOLN (MHS) $70.98 0832-0465-15 NYSTATIN 100,000 UNIT/GRAM TOPICAL POWD $70.88 HC89022040 BARBITURATES SERUM QNTS(PNL)-AU $70.87 24201-100-01 ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN $70.85 24201-100-24 ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN $70.85 0409-3294-25 POTASSIUM ACETATE 2 MEQ/ML IV SOLN $70.85 0409-3294-15 POTASSIUM ACETATE 2 MEQ/ML IV SOLN $70.85 HC51062859 PHONE CALL BY NONPHYSICIAN HC PROF 21-30MIN $70.76 299024133 VIT E-GLYCERIN-DIMETHICONE TOPICAL LOTN $70.71 0517-7504-25 ACETYLCYSTEINE 10 % (100 MG/ML) ORAL SOLN (MCH) $70.67 0517-7504-01 ACETYLCYSTEINE 100 MG/ML (10 %) MISC SOLN $70.67 0054-0080-13 EXEMESTANE 25 MG ORAL TAB $70.58 HC89024962 HIV-1 PCR QUAL-AU $70.50 HC89024970 HIV-2 PCR QUAL-AU $70.50 63323-340-20 CEFEPIME 2 GRAM INJ SOLR $70.46 72572-150-01 EPHEDRINE SULFATE 50 MG/ML IV SOLN $70.46 72572-150-10 EPHEDRINE SULFATE 50 MG/ML IV SOLN $70.46 72572-151-01 EPHEDRINE SULFATE 50 MG/ML IV SOLN $70.46 72572-151-10 EPHEDRINE SULFATE 50 MG/ML IV SOLN $70.46 59011-420-20 OXYCODONE 20 MG ORAL TR12 $70.44 72205-049-30 AMINOCAPROIC ACID 500 MG ORAL TAB $70.42 0781-3156-06 ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN $70.20 0781-3156-95 ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN $70.20 99999-043-97 DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN $70.20 0409-4699-53 PROPOFOL 10 MG/ML IV EMUL $70.20 0409-4699-33 PROPOFOL 10 MG/ML IV EMUL $70.20 16714-977-01 PROPOFOL 10 MG/ML IV EMUL $70.20 16714-977-20 PROPOFOL 10 MG/ML IV EMUL $70.20 66993-424-75 LANTHANUM 1,000 MG ORAL CHEW $70.16 66993-424-85 LANTHANUM 1,000 MG ORAL CHEW $70.16 66993-422-85 LANTHANUM 500 MG ORAL CHEW $70.16 66993-422-47 LANTHANUM 500 MG ORAL CHEW $70.16 66993-423-85 LANTHANUM 750 MG ORAL CHEW $70.16 66993-423-53 LANTHANUM 750 MG ORAL CHEW $70.16 HC83505495 SPECIAL STAIN GROUP II+-CS $70.10 HC89000111 ADENOVIRUS AB (PNL)-FT $70.00 HC89022735 CALPROTECTIN FECAL-AU $70.00 HC89014278 CMV AB IGG (PNL)-FT $70.00 HC89012280 CMV AB IGM(PNL)-FT $70.00 HC89000046 EBV CAPSID AG AB (PNL)-FT $70.00 HC89000129 EBV NUCLEAR AG AB (PNL)-FT $70.00 HC81100786 FECAL FAT QUAL $70.00 HC89014203 FLUORESCNT AB TITER EA AB-SL $70.00 HC89019533 FUNGITELL (1,3)BETA D-GLUC-AU $70.00 HC89013262 HEPATITIS B DNA BY PCR-AU $70.00 HC89013288 HEPATITIS C RNA BY PCR-AU $70.00 HC89000178 HERPES 1 IGM AB (PNL)-FT $70.00 HC89000160 HERPES 1&2 IGM AB (PNL)-FT $70.00 HC89000103 HERPES 2 IGM AB (PNL)-FT $70.00 HC89002976 IGG SUBCLASS-QD $70.00 HC83504787 IHC/IP PER SPEC INITIAL AB STAIN (PNL X 5)-HP $70.00 HC89023758 INHIBIN B-AU $70.00 HC89008783 IRON LIVER TISSUE-MA $70.00 HC89023501 ISLET AB ZINC TRANSPORTER 8-AU $70.00 HC89021372 PROCALCITONIN-U2 $70.00 HC89014484 VARICELLA AB (PNL)-FT $70.00 99999-001-28 RIBOSE ORAL POWDER $70.00 0023-9163-60 CYCLOSPORINE 0.05 % OPHT DPET $69.95 0023-9163-30 CYCLOSPORINE 0.05 % OPHT DPET $69.94 63323-523-01 HEPARIN (PORCINE) IN 5 % DEX 25,000 UNIT/250 ML(100 UNIT/ML) IV SOLP $69.88 63323-523-74 HEPARIN (PORCINE) IN 5 % DEX 25,000 UNIT/250 ML(100 UNIT/ML) IV SOLP $69.88 99999-046-47 NOREPINEPHRINE BITARTRATE-D5W 8 MG/250 ML (32 MCG/ML) IV SOLN $69.88 0338-1025-41 PENICILLIN G POT IN DEXTROSE 3 MILLION UNIT/50 ML IV PGBK $69.88 24208-315-10 POLYMYXIN B SULF-TRIMETHOPRIM 10,000 UNIT- 1 MG/ML OPHT DROP $69.88 24338-124-03 ERYTHROMYCIN 333 MG ORAL TBEC $69.86 0173-0633-02 LAMOTRIGINE 25 MG ORAL TAB $69.80 60219-1721-7 ETRAVIRINE 100 MG ORAL TAB $69.73 60687-227-11 LEUCOVORIN CALCIUM 25 MG ORAL TAB $69.59 60687-227-94 LEUCOVORIN CALCIUM 25 MG ORAL TAB $69.59 99999-045-71 ASCORBIC ACID 1000 MG IN NS 100 ML IVPB (SLH) $69.55 0338-3612-50 CLINDAMYCIN IN 5 % DEXTROSE 600 MG/50 ML IV PGBK $69.55 0338-3612-24 CLINDAMYCIN IN 5 % DEXTROSE 600 MG/50 ML IV PGBK $69.55 43066-993-24 CLINDAMYCIN IN 5 % DEXTROSE 600 MG/50 ML IV PGBK $69.55 61314-547-01 LATANOPROST 0.005 % OPHT DROP $69.55 66869-104-90 PITAVASTATIN CALCIUM 1 MG ORAL TAB $69.28 0517-9702-25 DROPERIDOL 2.5 MG/ML INJ SOLN $69.10 0517-9702-01 DROPERIDOL 2.5 MG/ML INJ SOLN $69.10 HC51003937 BIOFEEDBACK PERINEAL MSCLS W/EMG&/MNMTRY F2F ADD'L 15MIN+ $69.04 0395-0247-92 BENZOIN (BULK) TOPICAL TINC $69.03 HC51050003 RT ASSESS/INTERVENTION EA 30MIN $69.00 0536-1252-40 KETOTIFEN FUMARATE 0.025 % (0.035 %) OPHT DROP $68.90 63323-483-57 LIDOCAINE-EPINEPHRINE 2 %-1:100,000 INJ SOLN $68.90 HC83505768 SPECIAL STAIN GRP III ENZYMES(PANEL)-U2 $68.80 65219-259-45 PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR $68.77 65219-259-05 PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR $68.77 HC89007199 CYSTINE QUANT URINE-AU $68.73 436960042 ARTIFICIAL SALIVA (CMCE-LYTES) MUCOUS MEMB SPRP $68.64 99999-002-48 MIDAZOLAM 2 MG/ML ORAL SYRP $68.51 0283-0610-26 BENZOCAINE 20 % MUCOUS MEMB SPRY $68.47 4580251377 AMMONIUM LACTATE 12 % TOPICAL CREAM $68.25 76329-3304-1 CALCIUM CHLORIDE 10% IV SOLN (MCH) $68.25 61314-656-25 CIPROFLOXACIN HCL 0.3 % OPHT DROP $68.25 69315-308-02 CIPROFLOXACIN HCL 0.3 % OPHT DROP $68.25 72205-082-30 ERLOTINIB 150 MG ORAL TAB $68.25 0409-3150-20 HEPARIN(PORCINE) IN 0.45% NACL 25,000 UNIT/500 ML IV SOLP $68.25 67457-790-00 LEVETIRACETAM 500 MG/5 ML IV SOLN $68.25 67457-790-05 LEVETIRACETAM 500 MG/5 ML IV SOLN $68.25 63323-940-04 NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN $68.25 63323-940-21 NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN $68.25 99999-044-30 OXYTOCIN IN 0.9 % SOD CHLORIDE 30 UNIT/500 ML IV SOLN $68.25 81298-7620-1 SODIUM BICARBONATE 1 MEQ/ML (8.4 %) IV SOLN $68.25 81298-7620-3 SODIUM BICARBONATE 1 MEQ/ML (8.4 %) IV SOLN $68.25 72603-209-25 SODIUM BICARBONATE 1 MEQ/ML (8.4 %) IV SOLN $68.25 72603-209-01 SODIUM BICARBONATE 1 MEQ/ML (8.4 %) IV SOLN $68.25 16714-115-01 RIVASTIGMINE 4.6 MG/24 HOUR TRANSDERMAL PT24 $68.24 16714-115-02 RIVASTIGMINE 4.6 MG/24 HOUR TRANSDERMAL PT24 $68.24 61958-1401-1 COBICISTAT 150 MG ORAL TAB $68.19 52565-008-14 LIDOCAINE 5 % TOPICAL OINT $68.19 0409-9094-16 FENTANYL (PF) 50 MCG/ML INJ FOR INTRATHECAL PAIN PUMP REFILL (OCM) $68.12 0409-9094-31 FENTANYL (PF) 50 MCG/ML INJ FOR INTRATHECAL PAIN PUMP REFILL (OCM) $68.12 HC89001077 AMINO ACID SCREEN-QD $68.00 HC89009070 ASSAY NICOTINE-AU $68.00 HC89007959 ESTRADIOL-ES $68.00 HC83504027 KARYOTYPING,ADD EA-GZ $68.00 HC89002075 PLATELET ASSOCIATED IGG-QD $68.00 0409-3385-11 PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR $67.97 0409-3385-13 PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR $67.97 55513-800-60 IVABRADINE 5 MG ORAL TAB $67.81 55513-810-60 IVABRADINE 7.5 MG ORAL TAB $67.81 55513-813-28 IVABRADINE 5 MG/5 ML ORAL SOLN $67.80 55513-813-01 IVABRADINE 5 MG/5 ML ORAL SOLN $67.80 0536-1266-59 SENNOSIDES 8.8 MG/5 ML ORAL SYRP $67.78 0009-0047-22 METHYLPREDNISOLONE SOD SUC(PF) 125 MG/2 ML INJ SOLR $67.72 0009-0047-25 METHYLPREDNISOLONE SOD SUC(PF) 125 MG/2 ML INJ SOLR $67.72 68462-181-17 CLOTRIMAZOLE 1 % TOPICAL CREAM $67.67 0536-1304-85 DOCUSATE SODIUM 100 MG/10 ML ORAL LIQD $67.64 25021-401-02 HEPARIN, PORCINE (PF) 1,000 UNIT/ML INJ SOLN $67.60 0065-4011-05 KETOTIFEN FUMARATE 0.025 % (0.035 %) OPHT DROP $67.60 60687-397-25 MESALAMINE 1.2 GRAM ORAL TBEC $67.60 60687-397-95 MESALAMINE 1.2 GRAM ORAL TBEC $67.60 0409-2267-54 LABETALOL 5 MG/ML IV SOLN $67.34 0703-3671-01 METHOTREXATE 25 MG/ML INJECTION (ECTOPIC PREGNANCY) $67.28 0338-1023-41 PENICILLIN G POT IN DEXTROSE 2 MILLION UNIT/50 ML IV PGBK $67.28 61314-628-10 POLYMYXIN B SULF-TRIMETHOPRIM 10,000 UNIT- 1 MG/ML OPHT DROP $67.28 60687-373-21 EZETIMIBE 10 MG ORAL TAB $67.15 60687-373-11 EZETIMIBE 10 MG ORAL TAB $67.15 HC51062412 CPSP INITIAL HEALTH ED ASSESS/DEV POC; 1ST 30MIN $67.00 HC51062305 CPSP NUTRITION INITIAL ASSESS AND DEV POC; 1ST 30MIN $67.00 HC51062354 CPSP PSYCHOSOCIAL INIT' ASSESS/DEVEL POC; 1ST 30MIN $67.00 HC51060762 PT-PROC+MOD.COMBO ADD 15MIN/C $67.00 0409-1390-21 MEROPENEM 500 MG IV SOLR $66.97 0409-1390-51 MEROPENEM 500 MG IV SOLR $66.97 16729-114-31 ETOPOSIDE 20 MG/ML INJ SOLN (FOR ORAL USE) (MCH) $66.95 0143-9232-01 VECURONIUM BROMIDE 20 MG IV SOLR $66.92 0143-9232-10 VECURONIUM BROMIDE 20 MG IV SOLR $66.92 0517-9120-01 AMINOCAPROIC ACID 250 MG/ML IV SOLN $66.82 0517-9120-25 AMINOCAPROIC ACID 250 MG/ML IV SOLN $66.82 0409-1630-10 ATROPINE 0.1 MG/ML INJ (STAT-PACK) $66.76 0409-1630-15 ATROPINE 0.1 MG/ML INJ (STAT-PACK) $66.76 0143-9251-01 ROCURONIUM 10 MG/ML IV SOLN $66.76 0143-9251-10 ROCURONIUM 10 MG/ML IV SOLN $66.76 0536-1253-91 SODIUM CHLORIDE 5 % OPHT OINT $66.68 0186-1989-04 BUDESONIDE 0.5 MG/2 ML INHALATION NBSP $66.68 45802-055-36 TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINT $66.56 HC83506147 SPECIAL STAIN GROUP II+-PA $66.47 82347-0405-5 DICLOFENAC EPOLAMINE 1.3 % TRANSDERMAL PT12 $66.33 82347-0405-4 DICLOFENAC EPOLAMINE 1.3 % TRANSDERMAL PT12 $66.33 47781-470-13 OSELTAMIVIR 75 MG ORAL CAP $66.31 70121-1706-1 ATROPINE 0.1 MG/ML INJ (CRRT PRIME LESS THAN 10 KG) $66.30 63323-012-10 OXYTOCIN 10 UNIT/ML INJ SOLN $66.30 63323-012-06 OXYTOCIN 10 UNIT/ML INJ SOLN $66.30 61314-355-01 TROPICAMIDE 1 % OPHT DROP $66.30 16714-117-02 RIVASTIGMINE 13.3 MG/24 HOUR TRANSDERMAL PT24 $66.26 16714-117-01 RIVASTIGMINE 13.3 MG/24 HOUR TRANSDERMAL PT24 $66.26 16714-116-02 RIVASTIGMINE 9.5 MG/24 HOUR TRANSDERMAL PT24 $66.25 16714-116-01 RIVASTIGMINE 9.5 MG/24 HOUR TRANSDERMAL PT24 $66.25 57896-462-08 SENNOSIDES 8.8 MG/5 ML ORAL SYRP $66.24 57896-472-08 SENNOSIDES 8.8 MG/5 ML ORAL SYRP $66.24 0078-0359-34 VALSARTAN 160 MG ORAL TAB $66.23 63323-487-31 LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJ SOLN $66.11 70710-1272-6 SACUBITRIL-VALSARTAN 24-26 MG ORAL TAB $66.01 HC89002869 ANTI NEUT CYTOPLASMIC AB-QD $66.00 HC89013270 HEPATITIS C PCR QUAL-AU $66.00 HC89014773 VAGINAL PATHOGEN DNA PROBE-AU $66.00 0069-3030-20 DOXORUBICIN 10 MG/5 ML IV SOLN $65.98 0409-4776-01 LIDOCAINE (PF) 15 MG/ML (1.5 %) INJ SOLN $65.91 0409-4776-10 LIDOCAINE (PF) 15 MG/ML (1.5 %) INJ SOLN $65.91 0472-0379-15 CLOTRIMAZOLE-BETAMETHASONE 1-0.05 % TOPICAL CREAM $65.81 50474-595-40 LEVETIRACETAM 500 MG ORAL TAB $65.78 0071-1015-68 PREGABALIN 100 MG ORAL CAP $65.78 0071-1014-68 PREGABALIN 75 MG ORAL CAP $65.78 0003-0893-31 APIXABAN 2.5 MG ORAL TAB $65.69 0003-0894-31 APIXABAN 5 MG ORAL TAB $65.69 0003-0893-21 APIXABAN 2.5 MG ORAL TAB $65.68 0003-0894-21 APIXABAN 5 MG ORAL TAB $65.68 72572-612-10 PROPOFOL 10 MG/ML IV EMUL $65.65 72572-612-01 PROPOFOL 10 MG/ML IV EMUL $65.65 0409-9735-10 CEFEPIME 2 GRAM INJ SOLR $65.33 0409-9735-01 CEFEPIME 2 GRAM INJ SOLR $65.33 0409-4444-01 LEVOFLOXACIN IN D5W 750 MG/150 ML IV PGBK $65.33 0409-4444-24 LEVOFLOXACIN IN D5W 750 MG/150 ML IV PGBK $65.33 HC89019970 17 HYDROXYPREGNENOLONE -ES $65.29 HC89008486 17 OH PROGESTERONE-ES $65.29 HC89013486 ANDROSTENEDIONE-ES $65.29 63323-605-04 ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRG $65.26 63323-605-94 ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRG $65.26 63323-360-19 CALCIUM GLUCONATE 100 MG/ML (10%) IV SOLN $65.13 63323-360-01 CALCIUM GLUCONATE 100 MG/ML (10%) IV SOLN $65.13 0143-9180-25 CALCIUM GLUCONATE 100 MG/ML (10%) IV SOLN $65.13 0143-9180-01 CALCIUM GLUCONATE 100 MG/ML (10%) IV SOLN $65.13 75834-171-01 CALCIUM GLUCONATE 100 MG/ML (10%) IV SOLN $65.13 75834-171-19 CALCIUM GLUCONATE 100 MG/ML (10%) IV SOLN $65.13 67877-548-98 CEFDINIR 250 MG/5 ML ORAL SUSR $65.13 45802-098-51 MESALAMINE 4 GRAM/60 ML RECTAL ENEM $65.13 21922-045-47 MESALAMINE 4 GRAM/60 ML RECTAL ENEM $65.13 21922-045-01 MESALAMINE 4 GRAM/60 ML RECTAL ENEM $65.13 0781-3262-68 ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRG $65.09 0781-3262-04 ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRG $65.09 51672-1258-1 CLOBETASOL 0.05 % TOPICAL CREAM $65.03 68180-954-01 HYDROCORTISONE VALERATE 0.2 % TOPICAL CREAM $65.03 0121-4820-40 THEOPHYLLINE 80 MG/15 ML ORAL ELIX $65.03 0121-4820-15 THEOPHYLLINE 80 MG/15 ML ORAL ELIX $65.03 HC89013866 CHLORPROMAZINE; 1-3-AU $65.00 HC89013577 COENZYME Q10(PNL)-AU $65.00 HC89000541 EPSTEIN BARR VIR DNA PCR-AU $65.00 HC89022172 HSV1&HSV2 SUBTYPES BY PCR -AU $65.00 HC89023311 INTERLEUKIN 6-AU $65.00 HC83500546 INTERPHS FISH HYBRI 100-300-US $65.00 HC83500462 MOLECUL CYTO DNA PROBE FISH-US $65.00 HC89009344 OLIGOCLONAL BANDS (CSF)-AU $65.00 64253-400-30 ATROPINE 0.1 MG/ML INJ (STAT-PACK) $65.00 64253-400-91 ATROPINE 0.1 MG/ML INJ (STAT-PACK) $65.00 61314-143-05 BRIMONIDINE 0.2 % OPHT DROP $65.00 0143-9328-01 BUPIVACAINE HCL 0.25 % (2.5 MG/ML) INJ SOLN $65.00 0143-9328-10 BUPIVACAINE HCL 0.25 % (2.5 MG/ML) INJ SOLN $65.00 80830-1672-2 CALCIUM GLUCONATE 100 MG/ML (10%) IV SOLN $65.00 80830-1672-1 CALCIUM GLUCONATE 100 MG/ML (10%) IV SOLN $65.00 25021-122-50 CEFEPIME 2 GRAM INJ SOLR $65.00 25021-110-20 CEFOXITIN 2 GRAM IV SOLR $65.00 44567-236-10 CEFTAZIDIME 2 GRAM INJ SOLR $65.00 71288-714-10 CISATRACURIUM 2 MG/ML IV SOLN $65.00 71288-714-11 CISATRACURIUM 2 MG/ML IV SOLN $65.00 0942-0641-04 DEXTROSE-SOD CITRATE-CITRIC AC 2.45-2.2 GRAM- 730 MG/100 ML MISC SOLN $65.00 58602-604-07 DICLOFENAC SODIUM 1 % TOPICAL GEL $65.00 45963-733-55 DOXORUBICIN 10 MG/5 ML IV SOLN $65.00 99999-038-21 EDTA 3% OPHT DROPS (COMPOUND) $65.00 43386-771-01 FLUCYTOSINE 250 MG ORAL CAP $65.00 59651-331-01 FLUCYTOSINE 250 MG ORAL CAP $65.00 23155-860-03 FLUCYTOSINE 250 MG ORAL CAP $65.00 0143-9680-25 GLYCOPYRROLATE 0.2 MG/ML INJ SOLN $65.00 0143-9680-01 GLYCOPYRROLATE 0.2 MG/ML INJ SOLN $65.00 67457-863-01 GRANISETRON (PF) 1 MG/ML (1 ML) IV SOLN $65.00 0143-9555-01 LEUCOVORIN CALCIUM 50 MG INJ SOLR $65.00 76329-8261-1 LORAZEPAM 2 MG/ML INJ SOLN $65.00 76329-8261-0 LORAZEPAM 2 MG/ML INJ SOLN $65.00 43598-839-36 METHOCARBAMOL 100 MG/ML INJ SOLN $65.00 43598-839-11 METHOCARBAMOL 100 MG/ML INJ SOLN $65.00 55150-223-10 METHOCARBAMOL 100 MG/ML INJ SOLN $65.00 63323-778-21 METHOCARBAMOL 100 MG/ML INJ SOLN $65.00 63323-778-10 METHOCARBAMOL 100 MG/ML INJ SOLN $65.00 71286-2040-6 MORPHINE 100 MG IN NS 100 ML (OCM) $65.00 67457-292-00 NALOXONE 0.4 MG/ML INJ (MHS WRAPPER) $65.00 67457-292-02 NALOXONE 0.4 MG/ML INJ (MHS WRAPPER) $65.00 70069-071-01 NALOXONE 0.4 MG/ML INJ (MHS WRAPPER) $65.00 70069-071-10 NALOXONE 0.4 MG/ML INJ (MHS WRAPPER) $65.00 70860-777-20 ONDANSETRON HCL 2 MG/ML IV SOLN $65.00 72196-6044-1 OXYTOCIN IN 0.9 % SOD CHLORIDE 30 UNIT/500 ML IV SOLN $65.00 70860-200-05 PACLITAXEL 6 MG/ML IV CONC $65.00 62756-129-40 PANTOPRAZOLE 40 MG IV SOLR $65.00 55150-234-10 POLYMYXIN B SULFATE 500,000 UNIT INJ SOLR $65.00 0264-7638-00 POTASSIUM CHLORID-D5-0.45%NACL 40 MEQ/L IV SOLP $65.00 0338-0683-04 POTASSIUM CHLORIDE IN 5 % DEX 20 MEQ/L IV SOLP $65.00 0264-7625-00 POTASSIUM CHLORIDE IN 5 % DEX 20 MEQ/L IV SOLP $65.00 43066-027-10 ROPIVACAINE (PF) 10 MG/ML (1 %) INJ SOLN $65.00 43066-027-01 ROPIVACAINE (PF) 10 MG/ML (1 %) INJ SOLN $65.00 70095-050-03 SODIUM BICARBONATE 1 MEQ/ML (8.4 %) IV SOLN $65.00 70069-271-01 VERAPAMIL 2.5 MG/ML IV SOLN $65.00 70069-271-25 VERAPAMIL 2.5 MG/ML IV SOLN $65.00 70710-1643-1 VERAPAMIL 2.5 MG/ML IV SOLN $65.00 70710-1643-7 VERAPAMIL 2.5 MG/ML IV SOLN $65.00 51754-0203-4 VERAPAMIL 2.5 MG/ML IV SOLN $65.00 51754-0203-1 VERAPAMIL 2.5 MG/ML IV SOLN $65.00 70756-605-82 VERAPAMIL 2.5 MG/ML IV SOLN $65.00 70756-605-25 VERAPAMIL 2.5 MG/ML IV SOLN $65.00 70069-271-05 VERAPAMIL 2.5 MG/ML IV SOLN $65.00 70710-1643-5 VERAPAMIL 2.5 MG/ML IV SOLN $65.00 70756-605-05 VERAPAMIL 2.5 MG/ML IV SOLN $65.00 72485-104-01 CAFFEINE CITRATE 20 MG/ML INJ SOLN (MCH) $64.99 0641-6267-01 CAFFEINE CITRATE 20 MG/ML INJ SOLN (MCH) $64.99 0641-6267-10 CAFFEINE CITRATE 20 MG/ML INJ SOLN (MCH) $64.99 0641-6164-10 CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) IV SOLN $64.99 0641-6164-01 CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) IV SOLN $64.99 62332-505-03 MOXIFLOXACIN 0.5 % OPHT DROP $64.99 33342-405-35 LIDOCAINE 5 % TOPICAL OINT $64.96 HC89022644 17-HYDROXYPREGNENOLONE-QN $64.96 51672-1259-2 CLOBETASOL 0.05 % TOPICAL OINT $64.94 21922-017-05 CLOBETASOL 0.05 % TOPICAL OINT $64.94 50458-577-10 RIVAROXABAN 2.5 MG ORAL TAB $64.79 50458-577-01 RIVAROXABAN 2.5 MG ORAL TAB $64.79 50458-577-60 RIVAROXABAN 2.5 MG ORAL TAB $64.79 72266-251-01 CALCITRIOL 1 MCG/ML IV SOLN $64.68 72266-251-10 CALCITRIOL 1 MCG/ML IV SOLN $64.68 44567-245-25 CEFOXITIN 1 GRAM IV SOLR $64.68 63323-013-02 THIAMINE HCL (VITAMIN B1) 100 MG/ML INJ SOLN $64.68 63323-013-01 THIAMINE HCL (VITAMIN B1) 100 MG/ML INJ SOLN $64.68 25021-500-02 THIAMINE HCL (VITAMIN B1) 100 MG/ML INJ SOLN $64.68 0641-6228-25 THIAMINE HCL (VITAMIN B1) 100 MG/ML INJ SOLN $64.68 0641-6228-01 THIAMINE HCL (VITAMIN B1) 100 MG/ML INJ SOLN $64.68 63323-376-01 OCTREOTIDE ACETATE 100 MCG/ML INJ SOLN $64.61 63323-376-00 OCTREOTIDE ACETATE 100 MCG/ML INJ SOLN $64.61 0121-0766-16 CALCIUM CARBONATE 500 MG/5 ML (1,250 MG/5 ML) ORAL SUSP $64.57 71399-0039-6 DOCUSATE SODIUM 100 MG/10 ML ORAL LIQD $64.57 24208-910-19 ERYTHROMYCIN 5 MG/GRAM (0.5 %) OPHT OINT $64.56 0075-0620-40 ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRG $64.50 72485-670-31 ERYTHROMYCIN 5 MG/GRAM (0.5 %) OPHT OINT $64.50 51672-1284-8 TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINT $64.48 0143-9878-01 CEFOXITIN 1 GRAM IV SOLR $64.35 0143-9878-25 CEFOXITIN 1 GRAM IV SOLR $64.35 0536-1183-99 FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASL SPSN $64.35 99999-043-21 HYGROSCOPIC CERVICAL DILATOR ROD (DILAPAN-S) $64.35 50742-505-24 SCOPOLAMINE BASE 1 MG OVER 3 DAYS TRANSDERMAL PT3D $64.32 0409-6625-14 SODIUM BICARBONATE 1 MEQ/ML (8.4 %) IV SOLN $64.03 0409-6625-22 SODIUM BICARBONATE 1 MEQ/ML (8.4 %) IV SOLN $64.03 HC89022099 METHADONE&METABOLITE SERUM QNT(PNL)-AU $63.82 0574-7224-06 HYDROMORPHONE 3 MG RECTAL SUPP $63.79 0904-7248-04 SIROLIMUS 1 MG ORAL TAB $63.78 0409-1749-29 BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJ SOLN $63.77 0409-1749-71 BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJ SOLN $63.77 67457-902-00 ETOMIDATE 2 MG/ML IV SOLN $63.77 67457-902-10 ETOMIDATE 2 MG/ML IV SOLN $63.77 31722-205-24 ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN $63.70 31722-205-31 ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN $63.70 44567-241-10 CEFEPIME 2 GRAM INJ SOLR $63.70 48102-057-11 ERYTHROMYCIN 5 MG/GRAM (0.5 %) OPHT OINT $63.70 39328-024-55 LIDOCAINE 4 % TOPICAL CREAM $63.70 42806-263-01 ISRADIPINE 2.5 MG ORAL CAP $63.47 4580252555 AMMONIUM LACTATE 12 % TOPICAL LOTN $63.45 64950-342-05 HYDROCODONE-HOMATROPINE 5-1.5 MG/5 ML (5 ML) ORAL SOLN $63.38 64950-342-45 HYDROCODONE-HOMATROPINE 5-1.5 MG/5 ML (5 ML) ORAL SOLN $63.38 0713-0536-12 PROMETHAZINE 12.5 MG RECTAL SUPP $63.36 0713-0536-06 PROMETHAZINE 12.5 MG RECTAL SUPP $63.36 45802-758-00 PROMETHAZINE 12.5 MG RECTAL SUPP $63.36 45802-758-30 PROMETHAZINE 12.5 MG RECTAL SUPP $63.36 45802-759-30 PROMETHAZINE 25 MG RECTAL SUPP $63.36 45802-759-00 PROMETHAZINE 25 MG RECTAL SUPP $63.36 51672-5297-1 PROMETHAZINE 25 MG RECTAL SUPP $63.36 51672-5297-4 PROMETHAZINE 25 MG RECTAL SUPP $63.36 0713-0526-12 PROMETHAZINE 25 MG RECTAL SUPP $63.36 0409-1362-01 MEPERIDINE (PF) 25 MG/ML INJ SOLN (WRAPPER) $63.28 0409-1362-11 MEPERIDINE (PF) 25 MG/ML INJ SOLN (WRAPPER) $63.28 64980-514-05 TIMOLOL MALEATE 0.5 % OPHT DROP $63.05 99999-036-46 BOSENTAN 31.25 MG ORAL PARTIAL TAB $63.01 HC89008221 ALPHA-1 ACID GLYCOPROTEIN-AU $63.00 HC89091367 ANTI-MULLERIAN HORMONE-AU $63.00 HC89002836 ARSENIC URINE-QD $63.00 HC89002059 ARSENIC-QD $63.00 HC36800670 HGB,QUANT TRANSCUTANEOUS $63.00 HC36000800 HGB,QUANT TRANSCUTANEOUS $63.00 HC89005151 HSV 2 IGG INDEX&INTERP -FT $63.00 HC89005144 HSV I IGG INDEX&INTERP -FT $63.00 HC89005169 HSV I/2 IGM INDEX&INTERP- FT $63.00 HC89005631 INFLUENZA A ANTIBODY-FT $63.00 HC89005649 INFLUENZA B ANTIBODY-FT $63.00 HC51061208 TELEHEALTH ORIGINATING SITE FACILITY FEE $63.00 72603-540-01 TIMOLOL MALEATE 0.5 % OPHT DROP $62.86 HC89023253 IMMUNO ELECT URINE (IFE)-AU $62.78 61314-227-05 TIMOLOL MALEATE 0.5 % OPHT DROP $62.73 70121-1573-1 METHYLPREDNISOLONE ACETATE 40 MG/ML INJ SUSP $62.66 HC83506154 IHC/IP PER SPEC INITIAL AB STAIN-PA $62.65 70121-1573-5 METHYLPREDNISOLONE ACETATE 40 MG/ML INJ SUSP $62.63 51672-2080-2 TERBINAFINE HCL 1 % TOPICAL CREAM $62.60 HC89022065 BUPRENORPHINE&METABLTS SERUM QNTS(PNL)-AU $62.57 HC89021489 DS BARBITURATES CONFIRM-AU $62.57 63323-434-41 ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN $62.40 63323-434-00 ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN $62.40 99999-047-53 AMPHOTERICIN B 5 MG/ML INJ DILUTION (LBMC) $62.40 69374-947-50 LIDOCAINE 1%/NA BICARB 10:1 INJ $62.40 0186-4040-01 ESOMEPRAZOLE MAGNESIUM 40 MG ORAL GRPS $62.24 HC51003515 OBTAIN/PREP/CONVEY SCREEN PAP SMEAR $62.24 HC51060812 PSYCH/NEUROPSYCH TEST ADMIN SNGLE AUTO INSTRU VIA ELECTRONIC AUTO RESULT ON $62.24 HC51002095 TB TEST (PPD) PROCEDURE $62.24 HC51010502 TEST ALLERGY INTRAQ AIRBORNE $62.24 HC51010478 TEST ALLERGY PERQ&INTRAQ VENOM $62.24 72266-249-01 POLYMYXIN B SULFATE 500,000 UNIT INJ SOLR $62.14 72266-249-10 POLYMYXIN B SULFATE 500,000 UNIT INJ SOLR $62.14 0409-5084-11 CEFTAZIDIME 2 GRAM INJ SOLR $62.09 0409-5084-13 CEFTAZIDIME 2 GRAM INJ SOLR $62.09 66993-831-02 TRIAMTERENE 50 MG ORAL CAP $62.02 HC89005201 ADENOVIRUS AB (SERUM) -FT $62.00 HC89014591 AFB MIC PRIMARY(PNL)-AU $62.00 HC89004188 ANTI-HUMAN TIS TRNS IGA(PNL-PR $62.00 HC89004519 ANTI-HUMAN TIS TRNSIGA(PNL2-PR $62.00 HC83505461 SPECIAL STAIN GROUP I -NG $62.00 HC89006969 WARFARIN-AU $62.00 16714-717-01 ENTECAVIR 0.5 MG ORAL TAB $61.96 HC89025035 ANDROSTENEDIONE SER(PNL)-ES $61.95 63824-175-63 DEXTROMETHORPHAN POLISTIREX 30 MG/5 ML ORAL SU12 $61.90 0009-0315-08 GELATIN SPONGE,ABSORB-PORCINE 12-7 MM TOPICAL SPGE $61.90 HC89009740 PROTOPORPHYRINS RBC QUANT-AU $61.82 36000-306-60 ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN $61.75 25021-139-10 NAFCILLIN 1 GRAM INJ SOLR $61.75 67850-031-10 NAFCILLIN 1 GRAM INJ SOLR $61.75 67850-031-00 NAFCILLIN 1 GRAM INJ SOLR $61.75 50742-505-10 SCOPOLAMINE BASE 1 MG OVER 3 DAYS TRANSDERMAL PT3D $61.75 50742-505-01 SCOPOLAMINE BASE 1 MG OVER 3 DAYS TRANSDERMAL PT3D $61.75 50742-505-04 SCOPOLAMINE BASE 1 MG OVER 3 DAYS TRANSDERMAL PT3D $61.75 45802-580-84 SCOPOLAMINE BASE 1 MG OVER 3 DAYS TRANSDERMAL PT3D $61.75 45802-580-01 SCOPOLAMINE BASE 1 MG OVER 3 DAYS TRANSDERMAL PT3D $61.75 0781-9053-95 SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ SOLN (MCH) $61.75 0781-9053-70 SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ SOLN (MCH) $61.75 0143-9786-01 ENALAPRILAT 1.25 MG/ML IV SOLN $61.63 0143-9786-10 ENALAPRILAT 1.25 MG/ML IV SOLN $61.63 43598-169-11 ENALAPRILAT 1.25 MG/ML IV SOLN $61.63 43598-169-58 ENALAPRILAT 1.25 MG/ML IV SOLN $61.63 00363-141-78 DIPHENHYDRAMINE HCL 12.5 MG/5 ML ORAL LIQ (MCH) $61.62 63323-492-31 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $61.62 0078-0358-34 VALSARTAN 80 MG ORAL TAB $61.59 HC89021638 SUGARS; SNGL QT GLYCOMARK EA SPEC -AU $61.50 0456-4020-01 CITALOPRAM 20 MG ORAL TAB $61.50 299391816 VIT E-GLYCERIN-DIMETHICONE TOPICAL LOTN $61.49 574006945 DEXTROSE 40 % ORAL GEL $61.43 HC89022602 DHEA-QN $61.23 0703-0113-01 HYDROMORPHONE (PF) 10 MG/ML INJ FOR INTRATHECAL PAIN PUMP REFILL (OCM) $61.23 0703-0113-03 HYDROMORPHONE (PF) 10 MG/ML INJ FOR INTRATHECAL PAIN PUMP REFILL (OCM) $61.23 0121-1544-10 HYDROCODONE-ACETAMINOPHEN 7.5-325 MG/15 ML ORAL SOLN $61.17 0121-1544-40 HYDROCODONE-ACETAMINOPHEN 7.5-325 MG/15 ML ORAL SOLN $61.17 0409-3812-01 BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 INJ SOLN $61.10 52536-103-03 ERYTHROMYCIN 250 MG ORAL TAB $61.10 99999-044-01 HYDROMORPHONE 1 MG/ML IN NS 50 ML OPIOID NAIVE PCA (SLH) $61.10 99999-040-14 HYDROMORPHONE 1 MG/ML IN NS 50 ML OPIOID TOLERANT PCA $61.10 72603-139-01 THIAMINE HCL (VITAMIN B1) 100 MG/ML INJ SOLN $61.01 72603-139-25 THIAMINE HCL (VITAMIN B1) 100 MG/ML INJ SOLN $61.01 HC89001382 ACETYLCHOLINE RECEPTOR AB-QD $61.00 HC89010235 ARGININE VASOPRESSIN HORMON-QN $61.00 HC51001964 HCG QUAL URINE (POS) $61.00 HC35500180 MT-BEHAVIOR TX GROUP ADDL 15 MIN $61.00 HC39001565 PSY-BEHAVIOR TX GROUP ADDL 15 MIN $61.00 0143-9510-01 ETOPOSIDE 20 MG/ML INJ SOLN (FOR ORAL USE) (MCH) $60.91 16729-262-31 ETOPOSIDE 20 MG/ML IV SOLN $60.91 0003-0293-05 TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP $60.84 47781-468-13 OSELTAMIVIR 30 MG ORAL CAP $60.83 60687-157-11 ARIPIPRAZOLE 2 MG ORAL TAB $60.74 60687-157-21 ARIPIPRAZOLE 2 MG ORAL TAB $60.74 60687-524-83 BUDESONIDE 0.5 MG/2 ML INH NBSP (FOR ORAL VISCOUS SLURRY) $60.67 60687-524-79 BUDESONIDE 0.5 MG/2 ML INH NBSP (FOR ORAL VISCOUS SLURRY) $60.67 0409-0183-01 GEMCITABINE 200 MG/5.26 ML (38 MG/ML) IV SOLN $60.65 0904-6791-04 MODAFINIL 100 MG ORAL TAB $60.60 63323-586-96 ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRG $60.58 63323-586-21 ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRG $60.58 71288-436-89 ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRG $60.58 71288-436-88 ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRG $60.58 63323-586-63 ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRG $60.58 63323-586-65 ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRG $60.58 0487-9701-01 BUDESONIDE 0.5 MG/2 ML INH NBSP (FOR ORAL VISCOUS SLURRY) $60.48 69097-319-32 BUDESONIDE 0.5 MG/2 ML INH NBSP (FOR ORAL VISCOUS SLURRY) $60.48 69097-319-53 BUDESONIDE 0.5 MG/2 ML INH NBSP (FOR ORAL VISCOUS SLURRY) $60.48 0409-9046-11 BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJ SOLN $60.45 0409-9046-01 BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJ SOLN $60.45 0338-3508-41 CEFAZOLIN IN DEXTROSE (ISO-OS) 2 GRAM/100 ML IV PGBK $60.45 63323-108-01 MAGNESIUM SULFATE IN D5W 1 GRAM/100 ML IV PGBK $60.45 63323-108-00 MAGNESIUM SULFATE IN D5W 1 GRAM/100 ML IV PGBK $60.45 99999-046-49 RIFAMPIN 25 MG/ML ORAL LIQUID (COMPOUND) $60.45 42292-054-01 COLCHICINE 0.6 MG ORAL TAB $60.40 42292-054-03 COLCHICINE 0.6 MG ORAL TAB $60.40 60687-727-11 COLCHICINE 0.6 MG ORAL TAB $60.40 60687-727-21 COLCHICINE 0.6 MG ORAL TAB $60.40 0536-1267-20 LIDOCAINE 4 % TOPICAL CREAM $60.35 0121-4772-05 HYDROCODONE-ACETAMINOPHEN 7.5-325 MG/15 ML ORAL SOLN $60.32 0121-4772-40 HYDROCODONE-ACETAMINOPHEN 7.5-325 MG/15 ML ORAL SOLN $60.32 0168-0003-80 TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM $60.32 0168-0005-80 TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINT $60.32 42858-631-01 MORPHINE 30 MG ORAL TBSR $60.30 0781-5668-31 VORICONAZOLE 200 MG ORAL TAB $60.29 0168-0002-15 TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM $60.16 72485-406-01 NAFCILLIN 2 GRAM INJ SOLR $60.15 72485-406-10 NAFCILLIN 2 GRAM INJ SOLR $60.15 63323-981-21 PIPERACILLIN-TAZOBACTAM 2.25 GRAM IV SOLR $60.13 63323-981-23 PIPERACILLIN-TAZOBACTAM 2.25 GRAM IV SOLR $60.13 HC89022628 11 DEOXYCORTISOL-QN $60.00 HC89007173 AMINO ACID SINGLE QUANT-AU $60.00 HC89001853 AMIODARONE-QD $60.00 HC89500128 BLOOD TYPING AG SCREEN(PT)-AA $60.00 HC89023329 B-TYPE NATRIURETIC PEPTIDE-AU $60.00 HC89002943 CIMETIDINE/TAGAMET-QD $60.00 HC89001861 CODEINE URINE-QD $60.00 HC89022446 CULTURE VIRUS RESPIRATORY-AU $60.00 HC89013254 CYTOMEGALOVIRUS DNA QNT PCR-AU $60.00 HC89001366 DARVON-QD $60.00 HC89000681 DIGITOXIN-QD $60.00 HC89002828 DISOPYRAMIDE-QD $60.00 HC89023196 ESTRADIOL-QN $60.00 HC89003651 FLECAINIDE-QD $60.00 HC89001085 FLUOROCYTOSINE-QD $60.00 HC89002794 GABAPENTIN (SERUM)-QD $60.00 HC89017172 HISTOPLASMA AG-AU $60.00 HC89023279 HIV-1 DNA/RNA QUANT BY NAAT-AU $60.00 HC89001184 INDERAL-QD $60.00 HC89001275 IODINE-QD $60.00 HC89005797 LAMOTRIGINE-QD $60.00 HC89017214 LEPTIN ELISA-AU $60.00 HC89010722 LEUKOCYTE ALKALINE PHOS-AU $60.00 HC89002042 METHOTREXATE-QD $60.00 HC89002232 MEXILETINE-QD $60.00 HC89019939 MTHFR MUTATION DETECTION-AU $60.00 HC89006852 OXCARBAZEPINE METABOLITE-QD $60.00 HC89003032 PROPAFENONE-QD $60.00 HC89009815 RENIN-ES $60.00 HC89001887 SULFONAMIDES-QD $60.00 HC89001762 THIOTHIXENE-QD $60.00 HC89019707 THYROGLOBULIN BY LC/MS/MS-AU $60.00 HC89001911 TOCAINIDE-QD $60.00 0641-6051-01 LORAZEPAM 4 MG/ML INJ SOLN $59.93 0641-6051-10 LORAZEPAM 4 MG/ML INJ SOLN $59.93 51754-5011-4 SODIUM BICARBONATE 1 MEQ/ML (8.4 %) IV SOLN $59.80 51754-5011-1 SODIUM BICARBONATE 1 MEQ/ML (8.4 %) IV SOLN $59.80 71288-113-10 GEMCITABINE 200 MG IV SOLR $59.74 0143-9709-01 MILRINONE 1 MG/ML IV SOLN $59.67 0143-9709-10 MILRINONE 1 MG/ML IV SOLN $59.67 0713-0503-01 HYDROCORTISONE ACETATE 25 MG RECTAL SUPP $59.64 0904-7103-04 EZETIMIBE 10 MG ORAL TAB $59.59 67877-124-20 SILVER SULFADIAZINE 1 % TOPICAL CREAM $59.54 63323-481-57 LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJ SOLN $59.48 63323-481-01 LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJ SOLN $59.48 0409-6625-30 SODIUM BICARBONATE 1 MEQ/ML (8.4 %) IV SOLN $59.48 0409-6625-35 SODIUM BICARBONATE 1 MEQ/ML (8.4 %) IV SOLN $59.48 70069-161-01 CISATRACURIUM 2 MG/ML IV SOLN $59.28 0409-2168-17 MAGNESIUM SULFATE 4 MEQ/ML INJ SOLN $59.28 0409-2168-77 MAGNESIUM SULFATE 4 MEQ/ML INJ SOLN $59.28 0093-1010-42 MUPIROCIN 2 % TOPICAL OINT $59.20 70860-301-25 DILTIAZEM HCL 5 MG/ML IV SOLN $59.15 70860-301-43 DILTIAZEM HCL 5 MG/ML IV SOLN $59.15 0641-6015-10 DILTIAZEM HCL 5 MG/ML IV SOLN $59.15 0641-6015-01 DILTIAZEM HCL 5 MG/ML IV SOLN $59.15 25021-319-25 DILTIAZEM HCL 5 MG/ML IV SOLN $59.15 63323-106-01 MAGNESIUM SULFATE 4 GRAM/100 ML IV PGBK (SLH) $59.15 63323-106-00 MAGNESIUM SULFATE IN WATER 4 GRAM/100 ML (4 %) IV PGBK $59.15 0054-0237-49 MORPHINE 10 MG/5 ML ORAL SOLN $59.15 61570-131-20 SILVER SULFADIAZINE 1 % TOPICAL CREAM $59.15 68094-043-62 SUCRALFATE 100 MG/ML ORAL SUSP $59.15 54288-164-01 CARBOPLATIN 10 MG/ML IV SOLN $59.09 0409-2339-34 LABETALOL 20 MG/4 ML (5 MG/ML) IV SYRG $59.05 0409-2339-24 LABETALOL 20 MG/4 ML (5 MG/ML) IV SYRG $59.05 0378-4640-16 ESTRADIOL 0.1 MG/24 HR TRANSDERMAL PTTW $59.04 65162-997-04 ESTRADIOL 0.1 MG/24 HR TRANSDERMAL PTTW $59.04 0378-4640-26 ESTRADIOL 0.1 MG/24 HR TRANSDERMAL PTTW $59.04 65162-997-08 ESTRADIOL 0.1 MG/24 HR TRANSDERMAL PTTW $59.04 0378-4641-16 ESTRADIOL 0.075 MG/24 HR TRANSDERMAL PTTW $59.01 0378-4641-26 ESTRADIOL 0.075 MG/24 HR TRANSDERMAL PTTW $59.01 HC83502344 IHC/IP PER SPEC INITIAL AB STAIN (PNL 6&7)-HP $59.00 HC89009609 PHOSPHATIDYL GLYCEROL-FE $59.00 HC51001923 RETICULOCYTE MANUAL $59.00 HC89009898 SOMATOMEDIN-ES $59.00 HC39000781 SW TEAM CONF PRTCPNT PER 15MIN $59.00 65162-993-08 ESTRADIOL 0.05 MG/24 HR TRANSDERMAL PTTW $58.95 65162-993-04 ESTRADIOL 0.05 MG/24 HR TRANSDERMAL PTTW $58.95 0378-4642-16 ESTRADIOL 0.05 MG/24 HR TRANSDERMAL PTTW $58.95 0378-4642-26 ESTRADIOL 0.05 MG/24 HR TRANSDERMAL PTTW $58.95 70069-819-10 EPHEDRINE SULFATE 50 MG/ML IV SOLN $58.92 70069-819-01 EPHEDRINE SULFATE 50 MG/ML IV SOLN $58.92 65162-989-08 ESTRADIOL 0.025 MG/24 HR TRANSDERMAL PTTW $58.91 65162-989-04 ESTRADIOL 0.025 MG/24 HR TRANSDERMAL PTTW $58.91 65162-992-04 ESTRADIOL 0.0375 MG/24 HR TRANSDERMAL PTTW $58.91 65162-992-08 ESTRADIOL 0.0375 MG/24 HR TRANSDERMAL PTTW $58.91 63323-642-20 MAGNESIUM SULFATE 4 MEQ/ML INJ SOLN $58.89 63323-642-01 MAGNESIUM SULFATE 500 MG/ML (50 %) INJ SOLN $58.89 51293-696-01 CHLORDIAZEPOXIDE-CLIDINIUM 5-2.5 MG ORAL CAP $58.83 8137003844 DIMETHICONE-COLLOIDAL OATMEAL 1.25 % TOPICAL LOTN $58.79 70092-1046-46 PHENYLEPHRINE HCL IN 0.9% NACL 1 MG/10 ML (100 MCG/ML) IV SYRG $58.76 0703-3675-01 METHOTREXATE 25 MG/ML INJECTION (ECTOPIC PREGNANCY) $58.70 0378-6981-88 LANSOPRAZOLE 15 MG ORAL TBLD $58.65 0378-6981-32 LANSOPRAZOLE 15 MG ORAL TBLD $58.65 0378-6982-85 LANSOPRAZOLE 30 MG ORAL TBLD $58.65 0378-6982-32 LANSOPRAZOLE 30 MG ORAL TBLD $58.65 0378-6982-88 LANSOPRAZOLE 30 MG ORAL TBLD $58.65 68094-043-59 SUCRALFATE 100 MG/ML ORAL SUSP $58.63 68094-043-61 SUCRALFATE 100 MG/ML ORAL SUSP $58.63 0338-0656-04 ACETIC ACID 0.25 % IRR SOLN $58.50 0517-9191-01 AMINOCAPROIC ACID 250 MG/ML IV SOLN $58.50 0517-9191-25 AMINOCAPROIC ACID 250 MG/ML IV SOLN $58.50 25021-143-30 AMPICILLIN-SULBACTAM 3 G IV SOLR (MCH) $58.50 70594-082-01 AMPICILLIN-SULBACTAM 3 G IV SOLR (MCH) $58.50 70594-082-02 AMPICILLIN-SULBACTAM 3 G IV SOLR (MCH) $58.50 64253-900-36 CALCIUM CHLORIDE 10% IV SOLN (MCH) $58.50 64253-900-30 CALCIUM CHLORIDE 10% IV SOLN (MCH) $58.50 60505-6145-0 CEFEPIME 2 GRAM INJ SOLR $58.50 0143-9397-10 CISATRACURIUM 2 MG/ML IV SOLN $58.50 0143-9397-01 CISATRACURIUM 2 MG/ML IV SOLN $58.50 69238-1532-3 CLOBETASOL 0.05 % TOPICAL CREAM $58.50 0264-7622-00 D10 %-0.45 % SODIUM CHLORIDE IV SOLP $58.50 17271-720-07 D5W IV BOLUS $58.50 63323-883-05 DOXORUBICIN 10 MG/5 ML IV SOLN $58.50 0548-5603-00 ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRG $58.50 71288-410-84 ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRG $58.50 71288-410-85 ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRG $58.50 63323-738-20 FAMOTIDINE 10 MG/ML IV SOLN $58.50 63323-738-06 FAMOTIDINE 10 MG/ML IV SOLN $58.50 25021-184-82 FLUCONAZOLE IN NACL (ISO-OSM) 200 MG/100 ML IV PGBK $58.50 0143-9744-01 GRANISETRON 1 MG/ML IV SOLN (MHS WRAPPER) $58.50 0143-9744-10 GRANISETRON 1 MG/ML IV SOLN (MHS WRAPPER) $58.50 63323-519-01 HEPARIN (PORCINE) IN NACL (PF) 2,000 UNIT/1,000 ML IV SOLP $58.50 63323-519-10 HEPARIN (PORCINE) IN NACL (PF) 2,000 UNIT/1,000 ML IV SOLP $58.50 0264-9594-10 LIDOCAINE IN 5 % DEXTROSE (PF) 4 MG/ML (0.4 %) IV SOLP $58.50 71288-716-11 METHOCARBAMOL 100 MG/ML INJ SOLN $58.50 71288-716-10 METHOCARBAMOL 100 MG/ML INJ SOLN $58.50 0641-6149-01 NEOSTIGMINE METHYLSULFATE 1 MG/ML INJ SOLN (MCH) $58.50 0641-6149-10 NEOSTIGMINE METHYLSULFATE 1 MG/ML INJ SOLN (MCH) $58.50 25021-162-24 OXACILLIN 2 GRAM INJ SOLR $58.50 70860-103-10 POLYMYXIN B SULFATE 500,000 UNIT INJ SOLR $58.50 70860-103-41 POLYMYXIN B SULFATE 500,000 UNIT INJ SOLR $58.50 0990-7116-09 POTASSIUM CHLOR-0.9%NACL 40 MEQ/L IV SOL REPLACEMENT $58.50 0264-7636-00 POTASSIUM CHLORID-D5-0.45%NACL 30 MEQ/L IV SOLP $58.50 0338-0663-04 POTASSIUM CHLORIDE-D5-0.2%NACL 20 MEQ/L IV SOLP $58.50 65219-119-01 POTASSIUM CHLORIDE-D5-0.9%NACL 40 MEQ/L IV SOLP $58.50 65219-119-10 POTASSIUM CHLORIDE-D5-0.9%NACL 40 MEQ/L IV SOLP $58.50 65145-118-05 SUMATRIPTAN SUCCINATE 6 MG/0.5 ML SUBCUTANEOUS SOLN $58.50 65145-118-01 SUMATRIPTAN SUCCINATE 6 MG/0.5 ML SUBCUTANEOUS SOLN $58.50 0904-6624-61 TACROLIMUS 5 MG ORAL CAP $58.50 67850-041-00 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $58.50 67850-041-10 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $58.50 55150-236-20 VECURONIUM BROMIDE 20 MG IV SOLR $58.50 55150-236-01 VECURONIUM BROMIDE 20 MG IV SOLR $58.50 68462-180-22 MUPIROCIN 2 % TOPICAL OINT $58.49 51672-1312-0 MUPIROCIN 2 % TOPICAL OINT $58.49 45802-112-22 MUPIROCIN 2 % TOPICAL OINT $58.49 0004-0259-01 MYCOPHENOLATE MOFETIL 250 MG ORAL CAP $58.47 52376-021-02 CHLORHEXIDINE GLUCONATE 0.12 % MUCOUS MEMB MWSH $58.42 1093976244 HYDROGEN PEROXIDE 3 % MISC SOLN $58.42 49348-179-38 HYDROGEN PEROXIDE 3 % MISC SOLN $58.42 12496-1208-3 BUPRENORPHINE-NALOXONE 8-2 MG SL FILM $58.37 12496-1208-1 BUPRENORPHINE-NALOXONE 8-2 MG SL FILM $58.37 50458-830-02 TAPENTADOL 75 MG ORAL TAB $58.35 50580-534-08 DIPHENHYDRAMINE HCL 12.5 MG/5 ML ORAL LIQ (MCH) $58.29 76329-3390-1 LIDOCAINE HCL 100 MG/5 ML IV SYRG $58.24 0067-8152-02 DICLOFENAC SODIUM 1 % TOPICAL GEL $58.18 0409-3182-03 LIDOCAINE-EPINEPHRINE 2 %-1:100,000 INJ SOLN $58.18 0409-3182-31 LIDOCAINE-EPINEPHRINE 2 %-1:100,000 INJ SOLN $58.18 52817-364-10 TRIAMTERENE 50 MG ORAL CAP $58.18 0555-0485-27 LEUCOVORIN CALCIUM 25 MG ORAL TAB $58.12 42806-359-25 LEUCOVORIN CALCIUM 25 MG ORAL TAB $58.12 HC89017057 AEROBIC BACTERIAL ID-FT $58.00 HC81701906 ALLERGEN IGE CRUDE EXTRACT, EACH $58.00 HC83504845 IHC EGFR QNT-NG $58.00 HC83504837 IHC MLH1 QNT-NG $58.00 HC83504852 IHC MSH2 QNT-NG $58.00 HC51002129 MNT THERAPY 2>/GROUP EA 30 MIN 1ST REF $58.00 HC81101842 OB FECES GUAIAC1-3 NEO SCR(DA) $58.00 HC51061646 RETICULOCYTE - AUTO $58.00 HC83505487 STAIN IMMUNOHISTOCHEMICAL QUANT -NG $58.00 16714-185-02 LANSOPRAZOLE 15 MG ORAL TBLD $57.94 16714-185-01 LANSOPRAZOLE 15 MG ORAL TBLD $57.94 16714-186-02 LANSOPRAZOLE 30 MG ORAL TBLD $57.94 16714-186-01 LANSOPRAZOLE 30 MG ORAL TBLD $57.94 0395-0243-92 BENZOIN-ALOE VERA-STORAX-TOLU 10-2-8-4 % TOPICAL TINC $57.91 6373612002 PERMETHRIN 1 % TOPICAL LIQD $57.91 67457-457-20 FAMOTIDINE 10 MG/ML IV SOLN $57.85 67457-457-00 FAMOTIDINE 10 MG/ML IV SOLN $57.85 87074002 FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROP $57.85 0093-4127-73 PENICILLIN V POTASSIUM 250 MG/5 ML ORAL SOLR $57.85 67457-153-09 AMIODARONE 50 MG/ML IV SOLN $57.80 67457-153-99 AMIODARONE 50 MG/ML IV SOLN $57.80 67457-621-02 TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP $57.79 67457-621-99 TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP $57.79 50268-198-42 CAPSAICIN 0.1 % TOPICAL CREAM $57.74 5529960104 ARTIFICIAL SALIVA (CMCE-LYTES) MUCOUS MEMB SPRP $57.72 0093-6816-73 BUDESONIDE 0.5 MG/2 ML INHALATION NBSP $57.62 0093-6816-45 BUDESONIDE 0.5 MG/2 ML INHALATION NBSP $57.62 0143-9298-10 SODIUM FERRIC GLUCONAT-SUCROSE 62.5 MG/5 ML IV SOLN $57.59 0143-9298-01 SODIUM FERRIC GLUCONAT-SUCROSE 62.5 MG/5 ML IV SOLN $57.59 0536-1294-34 DICLOFENAC SODIUM 1 % TOPICAL GEL $57.53 0046-1105-11 CONJ ESTROG-MEDROXYPROGEST ACE 0.3-1.5 MG ORAL TAB $57.48 0046-1106-11 CONJ ESTROG-MEDROXYPROGEST ACE 0.45-1.5 MG ORAL TAB $57.48 16714-067-01 CARBIDOPA 25 MG ORAL TAB $57.47 76385-106-17 KETOTIFEN FUMARATE 0.025 % (0.035 %) OPHT DROP $57.20 25021-813-10 LEUCOVORIN CALCIUM 50 MG INJ SOLN (MCH) $57.20 25021-675-10 METHOCARBAMOL 100 MG/ML INJ SOLN $57.20 0409-3299-06 SODIUM ACETATE 2 MEQ/ML IV SOLN $57.20 0409-3299-16 SODIUM ACETATE 2 MEQ/ML IV SOLN $57.20 HC89018436 PNH RBC CD59-AU $57.15 72888-173-47 HALOPERIDOL LACTATE 2 MG/ML ORAL CONC $57.14 0641-6021-10 FAMOTIDINE 10 MG/ML IV SOLN $57.07 0641-6021-01 FAMOTIDINE 10 MG/ML IV SOLN $57.07 0143-9140-01 CEFAZOLIN 3 GRAM IV SOLR $57.04 0143-9140-25 CEFAZOLIN 3 GRAM IV SOLR $57.04 HC85100519 MANUAL CELL COUNT RED/LEUK/PLT $57.00 HC89011050 NEISSERIA GONORRHOEAE AB-AU $57.00 HC89020853 NEISSERIA GONORRHOEAE CF-AU $57.00 HC89024137 POSACONAZOLE QNT LC-MS-AU $57.00 HC89010201 VASOACTIVE INTEST PEPTIDE-QN $57.00 23155-549-31 ONDANSETRON HCL 2 MG/ML IV SOLN $56.94 43975-220-10 CARBIDOPA 25 MG ORAL TAB $56.88 51754-5001-1 SODIUM BICARBONATE 1 MEQ/ML (8.4 %) IV SOLN $56.88 51754-5001-4 SODIUM BICARBONATE 1 MEQ/ML (8.4 %) IV SOLN $56.88 51754-5001-5 SODIUM BICARBONATE 1 MEQ/ML (8.4 %) IV SOLN $56.88 HC89009641 PORPHOBILINOGEN QUANT-AU $56.82 70436-155-41 PROMETHAZINE-DM 6.25-15 MG/5 ML ORAL SYRP $56.76 0781-3220-92 ROCURONIUM 10 MG/ML IV SOLN $56.75 51672-1289-1 NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM $56.65 0713-0135-12 PROCHLORPERAZINE 25 MG RECTAL SUPP $56.64 0574-7226-12 PROCHLORPERAZINE 25 MG RECTAL SUPP $56.64 4116775142 CAPSAICIN 0.1 % TOPICAL CREAM $56.63 4116775146 CAPSAICIN 0.1 % TOPICAL CREAM $56.63 0713-0135-06 PROCHLORPERAZINE 25 MG RECTAL SUPP $56.62 99999-033-94 LEECH $56.55 HC89024699 AMPA RECEPTOR AB IGG CBA-IFA SCRN CSF-AU $56.50 HC89024723 CASPR2 AB IGG CBA-IFA SCRN CSF-AU $56.50 HC89024657 CV2 AB IGG CBA-IFA SCRN CSF-AU $56.50 HC89024632 DPPX AB IGG CBA-IFA SCRN CSF-AU $56.50 HC89024715 GABA-BR AB IGG CBA-IFA SCRN CSF-AU $56.50 HC89024681 IGLON5 AB IGG CBA-IFA SCRN CSF-AU $56.50 HC89024731 LGI1 AB IGG CBA-IFA SCRN CSF-AU $56.50 HC89024640 MGLUR1 AB IGG CBA-IFA SCRN CSF-AU $56.50 HC89024707 NMDA RECEPTOR AB IGG CBA-IFA CSF-AU $56.50 HC89024616 PARANEOPLASTIC ABS(PCCA/ANNA)IGG CSF-AU $56.50 HC89024285 CANNABINOIDS NON-BLOOD-AU $56.48 0023-9205-15 CARBOXYMETHYLCELLULOSE SODIUM 1 % OPHT DLGL $56.45 59365-6064-0 IODINE-POTASSIUM IODIDE 5-10 % TOPICAL SOLN $56.42 59365-6064-1 IODINE-POTASSIUM IODIDE 5-10 % TOPICAL SOLN $56.42 0006-3603-01 RALTEGRAVIR 100 MG ORAL PWPK $56.42 0006-3603-61 RALTEGRAVIR 100 MG ORAL PWPK $56.42 HC89025027 HYDROXYPROGESTERONE 17-A SER(PNL)-ES $56.40 69238-1266-1 OSELTAMIVIR 75 MG ORAL CAP $56.36 51079-204-06 ABACAVIR 300 MG ORAL TAB $56.13 51079-204-01 ABACAVIR 300 MG ORAL TAB $56.13 24208-601-10 KETOTIFEN FUMARATE 0.025 % (0.035 %) OPHT DROP $56.10 0409-3374-02 PIPERACILLIN-TAZOBACTAM 2.25 GRAM IV SOLR $56.10 68084-956-95 SIROLIMUS 0.5 MG ORAL TAB $56.08 68084-956-25 SIROLIMUS 0.5 MG ORAL TAB $56.08 HC51040137 MNT THERAPY GROUP EA 30 MIN 2ND REF(DX) $56.00 HC85100493 RETICULOCYTE MANUAL $56.00 HC83506162 IHC/IP PER SPEC EA ADD AB STAIN+-PA $55.79 0074-3399-30 RITONAVIR 100 MG ORAL PWPK $55.72 59011-415-20 OXYCODONE 15 MG ORAL TR12 $55.62 0009-0047-26 METHYLPREDNISOLONE SOD SUC(PF) 125 MG/2 ML INJ SOLR $55.54 0009-0047-27 METHYLPREDNISOLONE SOD SUC(PF) 125 MG/2 ML INJ SOLR $55.54 0955-1004-10 ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRG $55.51 0955-1004-01 ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRG $55.51 24338-122-03 ERYTHROMYCIN 250 MG ORAL TBEC $55.48 67457-196-02 THIAMINE HCL (VITAMIN B1) 100 MG/ML INJ SOLN $55.48 67457-196-00 THIAMINE HCL (VITAMIN B1) 100 MG/ML INJ SOLN $55.48 51079-164-01 VORICONAZOLE 50 MG ORAL TAB $55.45 51079-164-03 VORICONAZOLE 50 MG ORAL TAB $55.45 0456-1512-60 MILNACIPRAN 12.5 MG ORAL TAB $55.45 0456-1550-60 MILNACIPRAN 50 MG ORAL TAB $55.45 51672-1312-1 MUPIROCIN 2 % TOPICAL OINT $55.28 70069-121-01 TROPICAMIDE 1 % OPHT DROP $55.28 0032-2636-01 LIPASE-PROTEASE-AMYLASE 24,000-76,000 -120,000 UNIT ORAL CPDR $55.28 0143-9261-01 CEFAZOLIN 10 GRAM INJ SOLR $55.25 0143-9261-10 CEFAZOLIN 10 GRAM INJ SOLR $55.25 63323-806-14 FENTANYL (PF) 50 MCG/ML INJ FOR INTRATHECAL PAIN PUMP REFILL (OCM) $55.25 63323-806-20 FENTANYL (PF) 50 MCG/ML INJ FOR INTRATHECAL PAIN PUMP REFILL (OCM) $55.25 71839-117-25 HEPARIN, PORCINE (PF) 1,000 UNIT/ML INJ SOLN $55.25 71839-117-01 HEPARIN, PORCINE (PF) 1,000 UNIT/ML INJ SOLN $55.25 0264-9598-20 LIDOCAINE IN 5 % DEXTROSE (PF) 8 MG/ML (0.8 %) IV SOLP $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 70121-1049-2 TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP $55.25 70121-1049-1 TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP $55.25 16714-130-01 TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP $55.25 16714-130-25 TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP $55.25 70121-1049-5 TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP $55.25 70121-1651-5 TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP $55.25 70121-1651-1 TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP $55.25 47335-931-44 VECURONIUM BROMIDE 10 MG IV SOLR $55.25 47335-931-40 VECURONIUM BROMIDE 10 MG IV SOLR $55.25 41616-931-40 VECURONIUM BROMIDE 10 MG IV SOLR $55.25 41616-931-44 VECURONIUM BROMIDE 10 MG IV SOLR $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 70069-064-10 ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJ SOLN $55.19 0121-0974-40 SUCRALFATE 100 MG/ML ORAL SUSP $55.12 0121-0974-94 SUCRALFATE 100 MG/ML ORAL SUSP $55.12 HC89014633 CULTURE RAPID CYTOMEGALOVIRUS-AU $55.00 HC89025068 DEOXYCORTICOSTERONE(DOC) SER(PNL)-ES $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 HC89024467 LH(LUTEINIZ HORMONE) UP TO 6 YRS-AU $55.00 HC89017222 METHOTREXATE-U2 $55.00 HC89017305 METHYL MALONIC ACID-QD $55.00 HC51020261 NP TEAM CONFER PRTCPNT PER 15MIN $55.00 HC89016117 ORGANIC ACIDS TOT QUAL-MA $55.00 HC89020945 PANCREATIC ELASTERASE FEC-AU $55.00 HC89009526 PARATHYROID HORMONE TERM-QN $55.00 HC89023402 RESP DNA/RNA SARS-COV-2/COVID-19 AMP PROBE-ET $55.00 HC51020030 RN TEAM CONF PRTCPNT PER 15MIN $55.00 69238-1472-3 ERYTHROMYCIN 333 MG ORAL TBEC $54.93 0065-4011-06 KETOTIFEN FUMARATE 0.025 % (0.035 %) OPHT DROP $54.93 63739-069-33 ARIPIPRAZOLE 2 MG ORAL TAB $54.85 HC89024947 CULTURE TYPE IMMUNOLOGIC-AU $54.69 50580-433-02 ACETAMINOPHEN 160 MG/5 ML ORAL SUSP $54.60 HC89022008 PROGESTERONE MASS SPECTROMETRY-ES $54.36 59011-415-10 OXYCODONE 15 MG ORAL TR12 $54.22 75834-243-30 ERYTHROMYCIN 500 MG ORAL TAB $54.17 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 HC51062917 ADVANCE CARE PLAN DISCUSS DIRECTIVES EA ADD 30MIN+ $54.00 HC89013544 CALCITONIN-ES $54.00 HC89022073 CANNABINOIDS NATURAL SERUM QNT(PNL)-AU $54.00 HC89016125 HEPATITIS C PCR QUAL-QD $54.00 HC89021448 MAGNESIUM RBC - AU $54.00 HC51060473 OT CONSULT TELEPHONE PER 15MIN $54.00 HC51060101 OT-TEAM CASE CONFERENCE EA 15MIN/C $54.00 HC89010706 PLASMINOGEN ACTIVATOR INH-1-AU $54.00 HC89007686 PYRIDINIUM CROSSLINKS TOTAL-AU $54.00 HC85100501 RETICULOCYTE - AUTO $54.00 HC83505479 SPECIAL STAIN GROUP II -NG $54.00 HC89014781 STREPTOCOCCUS PNEUMONIAE AG-AU $54.00 24201-110-01 ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN $53.95 24201-110-24 ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN $53.95 25021-146-10 OXACILLIN 1 GRAM INJ SOLR $53.89 HC89009955 TESTOSTERONE TOTAL-ES $53.82 54092-063-01 ANAGRELIDE 0.5 MG ORAL CAP $53.75 57664-663-83 CARVEDILOL PHOSPHATE 10 MG ORAL CM24 $53.68 72162-2068-2 LIDOCAINE 5 % TOPICAL OINT $53.67 73562-112-01 LIPASE-PROTEASE-AMYLASE 20,000-63,000- 84,000 UNIT ORAL CPDR $53.65 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 0703-4244-01 CARBOPLATIN 10 MG/ML IV SOLN $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 63323-472-37 BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJ SOLN $53.43 60687-179-01 ARIPIPRAZOLE 10 MG ORAL TAB $53.40 60687-179-11 ARIPIPRAZOLE 10 MG ORAL TAB $53.40 25021-140-10 NAFCILLIN 2 GRAM INJ SOLR $53.37 87086644 CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROP $53.30 0409-6727-11 MAGNESIUM SULFATE IN D5W 1 GRAM/100 ML IV PGBK $53.30 0409-6727-23 MAGNESIUM SULFATE IN D5W 1 GRAM/100 ML IV PGBK $53.30 87040501 PEDI MV NO.189-FERROUS SULFATE 11 MG IRON/ML ORAL DROP $53.30 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 63323-464-37 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $53.24 63323-464-02 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $53.24 45802-065-35 TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM $53.24 45802-049-35 TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL OINT $53.14 16714-268-01 TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL OINT $53.14 71288-032-21 AMPICILLIN-SULBACTAM 3 GRAM INJ SOLR $53.11 71288-032-20 AMPICILLIN-SULBACTAM 3 GRAM INJ SOLR $53.11 0409-4332-01 VANCOMYCIN 500 MG IV SOLR $53.05 0409-4332-11 VANCOMYCIN 500 MG IV SOLR $53.05 50268-678-15 POLYVINYL ALCOHOL 1.4 % OPHT DROP $53.04 45802-063-36 TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM $53.04 16714-267-02 TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINT $53.04 HC51060036 AHCP CONSULT TELEPHONE PER 15MIN $53.00 HC89018196 FLOW CYT MKR TC ADD+-ES $53.00 HC89014617 FUNGUS ID-FT $53.00 HC51060341 OT CONSULT TELEPHONE PER 15MIN $53.00 HC51060333 PT CONSULT TELEPHONE PER 15MIN $53.00 HC51040020 RD CONSULT TELEPHONE PER 15MIN $53.00 HC51020055 RN CONSULT TELEPHONE PER 15MIN $53.00 HC51050029 RT CONSULT TELEPHONE PER 15MIN $53.00 HC51030021 SW CONSULT TELEPHONE PER 15MIN $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 HC89012769 LEPTOSPIRA AB-AU $52.88 63323-617-10 MILRINONE 1 MG/ML IV SOLN $52.78 63323-617-01 MILRINONE 1 MG/ML IV SOLN $52.78 0264-4100-90 ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN $52.65 0904-6596-04 VORICONAZOLE 50 MG ORAL TAB $52.63 0703-0241-01 TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP $52.59 HC89022081 COCAINE SERUM QNT(PNL)-AU $52.57 70004-433-05 KETAMINE 50 MG/ML INJ SOLN (MHS WRAPPER) $52.52 70092-1175-46 LIDOCAINE 1%/NA BICARB 10:1 INJ $52.52 81079887 BACITRACIN ZINC-POLYMYXIN B 500-10,000 UNIT/GRAM TOPICAL OINT $52.43 HC89025084 TESTOSTERONE TOTAL SER(PNL)-ES $52.39 62559-205-90 NICARDIPINE 20 MG ORAL CAP $52.36 51672-2035-6 MICONAZOLE NITRATE 2 % VAGINAL CREAM $52.36 43598-666-25 SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ SOLN $52.33 43598-666-11 SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ SOLN $52.33 31722-053-60 IVABRADINE 5 MG ORAL TAB $52.31 64980-592-48 LACTULOSE 10 GRAM/15 ML ORAL SOLN $52.27 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 3848598035 UREA 10 % TOPICAL CREAM $52.15 55150-198-30 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 43066-023-01 ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJ SOLN $52.07 60758-801-10 TIMOLOL MALEATE 0.5 % OPHT DROP $52.07 HC89018170 CREATININE URINE (PNL)-ES $52.00 HC89016695 HEPATITIS B SURFACE AB-QD $52.00 HC51000149 IMMUNIZATION ADMIN ADD'L $52.00 HC89000137 PSA TOTAL-QD $52.00 HC89020879 SIN NOMBRE VIRUS IGM-AU $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 71288-726-52 BUPIVACAINE HCL 0.5 % (5 MG/ML) INJ SOLN $52.00 0143-9877-25 CEFOXITIN 2 GRAM IV SOLR $52.00 0143-9877-01 CEFOXITIN 2 GRAM IV SOLR $52.00 0338-0023-04 DEXTROSE 10 % IN WATER (D10W) 10 % IV SOLP $52.00 99999-039-02 DOBUTAMINE IN D5W (CONC: 2000 MCG/ML) (LBM) $52.00 0143-9084-01 DOXORUBICIN 10 MG/5 ML IV SOLN $52.00 0990-7965-09 ELECTROLYTE-M IN 5 % DEXTROSE IV SOLP $52.00 71288-415-06 GLYCOPYRROLATE 0.2 MG/ML INJ SOLN $52.00 71288-415-05 GLYCOPYRROLATE 0.2 MG/ML INJ SOLN $52.00 72266-102-01 LABETALOL 5 MG/ML IV SOLN $52.00 0409-6729-23 MAGNESIUM SULFATE IN WATER 4 GRAM/100 ML (4 %) IV PGBK $52.00 0409-6729-41 MAGNESIUM SULFATE IN WATER 4 GRAM/100 ML (4 %) IV PGBK $52.00 0409-4121-01 MAGNESIUM SULFATE IN WATER 4 GRAM/100 ML (4 %) IV PGBK $52.00 0409-4121-50 MAGNESIUM SULFATE IN WATER 4 GRAM/100 ML (4 %) IV PGBK $52.00 0641-6217-01 METHOCARBAMOL 100 MG/ML INJ SOLN $52.00 25021-316-04 NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN $52.00 17271-701-06 NS IV AFTER MEDICATION INFUSION (TO FLUSH RESIDUAL MED) $52.00 70069-686-01 OFLOXACIN 0.3 % OTIC DROP $52.00 0093-4125-73 PENICILLIN V POTASSIUM 125 MG/5 ML ORAL SOLR $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 0990-7993-09 POTASSIUM CHLORID-D5-0.45%NACL 10 MEQ/L IV SOLP $52.00 0990-7901-09 POTASSIUM CHLORIDE-D5-0.2%NACL 20 MEQ/L IV SOLP $52.00 0990-7109-09 POTASSIUM CHLORIDE-D5-0.9%NACL 40 MEQ/L IV SOLP $52.00 0143-9872-01 PROPRANOLOL 1 MG/ML IV SOLN $52.00 0143-9872-10 PROPRANOLOL 1 MG/ML IV SOLN $52.00 71288-718-10 ROCURONIUM 10 MG/ML IV SOLN $52.00 71288-718-11 ROCURONIUM 10 MG/ML IV SOLN $52.00 55150-201-20 ROPIVACAINE (PF) 10 MG/ML (1 %) INJ SOLN $52.00 61990-0611-2 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $52.00 61990-0611-0 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $52.00 25021-686-20 VECURONIUM BROMIDE 20 MG IV SOLR $52.00 63323-943-10 SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ SOLN $51.87 63323-943-21 SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ SOLN $51.87 HC89007207 AMINOLEVULINIC ACID-AU $51.82 67877-260-30 RASAGILINE 1 MG ORAL TAB $51.82 42571-220-30 RASAGILINE 0.5 MG ORAL TAB $51.74 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 0409-3178-03 LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN $51.68 0409-3178-18 LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN $51.68 65219-020-03 AMPICILLIN SODIUM 2 G IV SOLR (MCH) $51.61 65219-020-23 AMPICILLIN SODIUM 2 G IV SOLR (MCH) $51.61 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 HC51062842 PHONE CALL BY NONPHYSICIAN HC PROF 11-20MIN $51.60 99999-047-29 HYDROCORTISONE SOD SUCCINATE 10 MG/ML INJ DILUTION (MCH) $51.55 0054-0470-21 EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG ORAL TAB $51.54 0078-0423-15 VALSARTAN 40 MG ORAL TAB $51.53 45802-064-36 TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM $51.48 16714-227-01 CARVEDILOL PHOSPHATE 10 MG ORAL CM24 $51.43 65197-401-01 VITS A AND D-WHITE PET-LANOLIN TOPICAL OINT $51.42 0487-9601-01 BUDESONIDE 0.25 MG/2 ML INHALATION NBSP $51.39 72603-454-01 AMPICILLIN SODIUM 2 G IV SOLR (MCH) $51.38 72603-454-10 AMPICILLIN SODIUM 2 G IV SOLR (MCH) $51.38 0093-4161-73 AMOXICILLIN 400 MG/5 ML ORAL SUSR $51.35 63323-466-37 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN $51.29 63323-466-01 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN $51.29 63323-400-05 LEVETIRACETAM 500 MG/5 ML IV SOLN $51.29 63323-400-01 LEVETIRACETAM 500 MG/5 ML IV SOLN $51.29 395224391 PEPPERMINT SPIRIT ORAL SPRT $51.29 50268-745-14 SUCRALFATE 100 MG/ML ORAL SUSP $51.09 50268-745-11 SUCRALFATE 100 MG/ML ORAL SUSP $51.09 0781-3288-09 CLINDAMYCIN IN 5 % DEXTROSE 300 MG/50 ML IV PGBK $51.03 70092-1119-44 KETAMINE IN 0.9 % SOD CHLORIDE 50 MG/5 ML (10 MG/ML) IV SYRG $51.03 43598-394-67 TETRABENAZINE 12.5 MG ORAL TAB $51.01 HC89002380 CPK ISO-QD $51.00 HC51062289 CPSP DEPRESSION SCREENING IND POS $51.00 HC89022024 DRUG SCRN 9 SERUM W-RFLX CONF(PNL)-AU $51.00 HC89019038 HYDROXYPROLINE TOTAL URINE -AU $51.00 HC83505263 IF, EACH ADD'L SINGLE AB STAIN-CS $51.00 HC89018485 IMMUNOFLUOR' STUDY EA AB1ST STAIN(PNL)-PR $51.00 HC51060465 PT CONSULT TELEPHONE PER 15MIN $51.00 HC51060077 PT-TEAM CASE CONFERENCE EA 15MIN/C $51.00 HC51040012 RD TEAM CONF PRTCPNT PER 15MIN $51.00 HC51060135 ST-TEAM CASE CONF EA 15MIN/C $51.00 HC51030013 SW TEAM CONF PRTCPNT PER 15MIN $51.00 HC51070720 TEACH/COUNSEL GROUP SESSION FPACT $51.00 0065-0085-15 NAPHAZOLINE-PHENIRAMINE 0.025-0.3 % OPHT DROP $50.99 16714-199-01 VORICONAZOLE 200 MG ORAL TAB $50.97 63323-462-17 BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJ SOLN $50.96 63323-462-04 BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJ SOLN $50.96 67457-384-99 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $50.90 67457-384-31 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $50.90 42291-666-10 OSELTAMIVIR 30 MG ORAL CAP $50.80 16714-987-01 TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM $50.80 63323-347-20 CEFTRIAXONE 2 G INJ SOLR (MCH) $50.70 16714-016-10 ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRG $50.70 16714-016-01 ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRG $50.70 65219-257-01 EPHEDRINE SULFATE 50 MG/ML IV SOLN $50.64 65219-257-00 EPHEDRINE SULFATE 50 MG/ML IV SOLN $50.64 8137003600 DIMETHICONE-COLLOIDAL OATMEAL 1.25 % TOPICAL LOTN $50.62 0409-2720-32 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $50.51 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 0338-0411-02 LIDOCAINE IN 5 % DEXTROSE (PF) 8 MG/ML (0.8 %) IV SOLP $50.38 0186-0776-60 TICAGRELOR 60 MG ORAL TAB $50.35 0186-0777-39 TICAGRELOR 90 MG ORAL TAB $50.35 0186-0777-60 TICAGRELOR 90 MG ORAL TAB $50.35 0409-5555-12 SODIUM BICARBONATE 4.2 % (0.5 MEQ/ML) INJ SOLN (MHS WRAPPER) $50.34 0409-5555-02 SODIUM BICARBONATE 4.2 % (0.5 MEQ/ML) INJ SOLN (MHS WRAPPER) $50.34 0409-2344-01 DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) IV SOLN $50.31 0527-5137-62 OSELTAMIVIR 6 MG/ML ORAL SUSR $50.31 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 63323-369-20 AMPICILLIN-SULBACTAM 3 GRAM INJ SOLR $50.12 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 HC12600425 ADMIN RSV MONOCLONAL ANTIBODY IM $50.00 HC89010292 C PEPTIDE-ES $50.00 HC89021687 CANNABINOIDS, NATURAL MEC(PNL)-AU $50.00 HC89021562 CYTOMEGALOVIRUS DNA QUAL PCR-AU $50.00 HC89011480 GLOMERULAR BSMT MEM IF-AU $50.00 HC89019202 HPV TYPES 16&18(45) ONLY-AU $50.00 HC83505727 IHC/IP PER SPEC EA ADD AB STAIN+ MSH-2-NG $50.00 HC83505693 IHC/IP PER SPEC EA ADD AB STAIN+ MSH-6-NG $50.00 HC83505255 IHC/IP PER SPEC EA ADD AB STAIN+ -NG $50.00 HC83505701 IHC/IP PER SPEC EA ADD AB STAIN+ PMS2-NG $50.00 HC83505719 IHC/IP PER SPEC INITIAL AB STAIN MLH-1-NG $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 HC89024558 INTERLEUKIN 2 SOLUBLE SERUM-AU $50.00 HC83504860 IP/IHC PER SPEC INITIAL AB STAIN -NG $50.00 HC83504084 MORPHOMETRIC STUDY TUMOR-PI $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 HC51070811 PSY-BEHAV TX FAM W/O PT ADD 15 $50.00 HC89020861 SIN NOMBRE VIRUS IGG-AU $50.00 HC83505743 SPECIAL STAIN GROUP II(PANEL)-U2 $50.00 99999-037-50 CEFAZOLIN IN DEXTROSE (ISO-OS) 2 GRAM/50 ML IV PGBK $50.00 99999-041-69 CEFAZOLIN IN DEXTROSE (ISO-OS) 2 GRAM/50 ML IV PGBK $50.00 99999-033-04 HYDROMORPHONE 50 MG IN NS 50 ML DRIP (OCM WRAPPER) $50.00 99999-045-51 HYDROMORPHONE IN 0.9 % NACL 1 MG/50 ML IV SOLN $50.00 99999-045-52 HYDROMORPHONE IN 0.9 % NACL 2 MG/50 ML IV SOLN $50.00 54643-5657-1 MVI, ADULT NO.4 WITH VIT K 3,300 UNIT- 150 MCG/10 ML IV SOLN $49.99 54643-5659-1 MVI, ADULT NO.4 WITH VIT K 3,300 UNIT- 150 MCG/10 ML IV SOLN $49.99 54643-9007-8 MVI, ADULT NO.4, VIT K, 1 OF 2 3,300 UNIT- 150 MCG/5 ML IV SOLN $49.99 54643-9007-9 MVI, ADULT NO.4, VIT K, 2 OF 2 600 MCG-60 MCG- 5 MCG/5 ML IV SOLN $49.99 70700-902-22 GLYCOPYRROLATE 0.2 MG/ML INJ SOLN $49.86 70700-902-25 GLYCOPYRROLATE 0.2 MG/ML INJ SOLN $49.86 0024-5851-30 IRBESARTAN 150 MG ORAL TAB $49.76 HC89007843 DHEA SULFATE-ES $49.75 63323-468-17 BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJ SOLN $49.73 63323-468-01 BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJ SOLN $49.73 99999-045-42 SODIUM CHLORIDE 4 MEQ / ML ORAL SYRINGE $49.73 63323-093-30 SODIUM CHLORIDE 4 MEQ/ML (23.4%) INFUSION (FOR ELEVATED ICP) $49.73 63323-093-01 SODIUM CHLORIDE 4 MEQ/ML (23.4%) INFUSION (FOR ELEVATED ICP) $49.73 50458-645-65 TOPIRAMATE 25 MG ORAL CPSP $49.68 70092-1120-43 KETAMINE 50 MG/ML (1 ML) IV SYRG $49.66 0641-6117-01 AMPICILLIN-SULBACTAM 3 GRAM INJ SOLR $49.53 0641-6117-10 AMPICILLIN-SULBACTAM 3 GRAM INJ SOLR $49.53 0143-9141-01 DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) IV SOLN $49.53 0143-9141-10 DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) IV SOLN $49.53 25021-403-04 HEPARIN (PORCINE) 10,000 UNIT/ML INJ SOLN $49.40 43598-129-25 METHYLPREDNISOLONE SODIUM SUCC 125 MG INJ SOLR $49.40 43598-129-01 METHYLPREDNISOLONE SODIUM SUCC 125 MG INJ SOLR $49.40 0603-1554-16 POTASSIUM CHLORIDE 20 MEQ ORAL PACK $49.34 0409-4903-11 LIDOCAINE HCL 100 MG/5 ML IV SYRG $49.30 0409-4903-34 LIDOCAINE HCL 100 MG/5 ML IV SYRG $49.30 0126-0272-16 CHLORHEXIDINE GLUCONATE 0.12 % MUCOUS MEMB MWSH $49.19 45802-952-26 IBUPROFEN 100 MG/5 ML ORAL SUSP $49.14 70069-706-01 TIMOLOL MALEATE 0.5 % OPHT DROP $49.14 0409-1178-30 MEPERIDINE (PF) 50 MG/ML INJ SYRG $49.10 573051330 MULTIVIT-MIN-FERROUS GLUCONATE 9 MG IRON/15 ML ORAL LIQD $49.09 HC51060028 AHCP TEAM CONF PRTCPNT EA 15MIN $49.00 HC89002927 ANTI-MAG-QD $49.00 HC89001150 C-1 ESTERASE INHIBITOR-QD $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 0093-6815-73 BUDESONIDE 0.25 MG/2 ML INHALATION NBSP $48.96 0093-6815-45 BUDESONIDE 0.25 MG/2 ML INHALATION NBSP $48.96 99999-047-41 DIPHENHYDRAMINE HCL 5 MG/ML INJ DILUTION (MCH) $48.91 0781-3220-95 ROCURONIUM 10 MG/ML IV SOLN $48.91 0781-3220-75 ROCURONIUM 10 MG/ML IV SOLN $48.91 0409-2596-05 MIDAZOLAM 5 MG/ML INJ SOLN $48.88 0409-2596-15 MIDAZOLAM 5 MG/ML INJ SOLN $48.88 0781-3256-66 ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRG $48.82 0781-3256-03 ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRG $48.82 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 $48.75 23155-290-31 AMIKACIN 500 MG/2 ML INJ SOLN $48.75 23155-290-41 AMIKACIN 500 MG/2 ML INJ SOLN $48.75 25021-137-20 AMPICILLIN SODIUM 2 GRAM INJ SOLR $48.75 63323-506-01 DEXAMETHASONE SODIUM PHOS (PF) 10 MG/ML INJ SOLN $48.75 63323-506-00 DEXAMETHASONE SODIUM PHOS (PF) 10 MG/ML INJ SOLN $48.75 0409-3435-01 FLUCONAZOLE IN NACL (ISO-OSM) 200 MG/100 ML IV PGBK $48.75 0409-3435-24 FLUCONAZOLE IN NACL (ISO-OSM) 200 MG/100 ML IV PGBK $48.75 0143-9702-01 IRINOTECAN 40 MG/2 ML IV SOLN $48.75 60505-6128-0 IRINOTECAN 40 MG/2 ML IV SOLN $48.75 60687-720-21 LAMIVUDINE 150 MG ORAL TAB $48.75 60687-720-11 LAMIVUDINE 150 MG ORAL TAB $48.75 62135-321-90 METHYLDOPA 250 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 17271-701-05 NS IV AFTER MEDICATION INFUSION (TO FLUSH RESIDUAL MED) $48.75 70748-258-07 POSACONAZOLE 100 MG ORAL TBEC $48.75 72319-023-02 POSACONAZOLE 100 MG ORAL TBEC $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 70860-105-20 VANCOMYCIN 1,000 MG IV SOLR $48.75 70860-105-41 VANCOMYCIN 1000 MG IV SOLR $48.75 27241-063-03 VORICONAZOLE 200 MG ORAL TAB $48.75 0054-0382-25 CYCLOPHOSPHAMIDE 25 MG ORAL CAP $48.68 49348-530-77 MICONAZOLE NITRATE 2 % VAGINAL CREAM $48.56 70677-1222-1 MICONAZOLE NITRATE 2 % VAGINAL CREAM $48.56 1093938033 MICONAZOLE NITRATE 2 % VAGINAL CREAM $48.56 49348-872-77 MICONAZOLE NITRATE 2 % VAGINAL CREAM $48.56 59762-0707-1 DICLOFENAC EPOLAMINE 1.3 % TRANSDERMAL PT12 $48.48 59762-0707-2 DICLOFENAC EPOLAMINE 1.3 % TRANSDERMAL PT12 $48.48 0078-0385-66 MYCOPHENOLATE SODIUM 180 MG ORAL TBEC $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 0075-0624-30 ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRG $48.37 0075-0624-01 ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRG $48.37 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 0395-1031-96 GLYCERIN 99.5 % TOPICAL SOLN $48.32 63323-398-10 AZITHROMYCIN 500 MG IV SOLR $48.30 63323-398-01 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 1990301020 SIMETHICONE 40 MG/0.6 ML ORAL DRPS $48.17 63323-584-99 ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRG $48.10 63323-584-21 ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRG $48.10 71288-435-86 ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRG $48.10 71288-435-87 ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRG $48.10 63323-584-63 ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRG $48.10 63323-584-65 ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRG $48.10 51754-5012-4 SODIUM BICARBONATE 4.2 % (0.5 MEQ/ML) INJ SOLN (MHS WRAPPER) $48.10 51754-5012-1 SODIUM BICARBONATE 4.2 % (0.5 MEQ/ML) INJ SOLN (MHS WRAPPER) $48.10 0469-0617-73 TACROLIMUS 1 MG ORAL CAP $48.10 62332-413-10 OSELTAMIVIR 30 MG ORAL CAP $48.09 62332-414-10 OSELTAMIVIR 45 MG ORAL CAP $48.09 HC89016091 ACYLCARNITINES QUANT-MA $48.00 HC83505156 HUMAN PAPILLOMAVIRUS HI/LO- PI $48.00 HC89008890 LDL SUBCLASS-AU $48.00 HC51070795 PSY-BEHAVIOR TX FAMW/PT ADD 15MIN $48.00 HC89009856 SEX HORMONE BINDING GLOB-ES $48.00 0071-0805-24 GABAPENTIN 300 MG ORAL CAP $47.98 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 HC89024939 CULTURE BACTERIAL AEROBIC ID-AU $47.88 HC89501035 HISTORICAL ANTIGEN FEE-SB $47.84 99999-044-44 DESMOPRESSIN 0.5 MCG/ML INJ DILUTION $47.77 0173-0947-55 BUPROPION HCL 100 MG ORAL SR12 $47.75 7214000022 LANOLIN ALCOHOL-MO-W.PET-CERES TOPICAL CREAM $47.74 1011902239 WHITE PETROLATUM-MINERAL OIL 80-20 % OPHT OINT $47.71 99999-038-29 VECURONIUM 1 MG/ML NICU IV SYRINGE $47.65 99999-038-49 CYCLOPHOSPHAMIDE 10 MG/ML ORAL SOLUTION (COMPOUND) $47.61 HC89021745 AMPHETAMINES(MDA,MDEA,MDMA)MEC(CONF PNL)-AU $47.50 HC89021653 AMPHETAMINES;1 OR 2 MEC(CONF PNL)-AU $47.50 0409-4346-73 AMINOCAPROIC ACID 250 MG/ML IV SOLN $47.32 0409-4346-16 AMINOCAPROIC ACID 250 MG/ML IV SOLN $47.32 63323-540-15 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $47.26 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 70069-421-03 LATANOPROST 0.005 % OPHT DROP $47.26 0409-1323-05 LIDOCAINE HCL 100 MG/5 ML IV SYRG $47.26 0409-1323-15 LIDOCAINE HCL 100 MG/5 ML IV SYRG $47.26 68094-123-59 OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSP $47.26 61703-350-37 METHOTREXATE 25 MG/ML INJECTION (ECTOPIC PREGNANCY) $47.24 61703-350-38 METHOTREXATE 25 MG/ML INJECTION (ECTOPIC PREGNANCY) $47.24 70594-118-01 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN $47.19 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 HC89011654 GLOMERULAR BASEMENT MEMB AB-AU $47.00 HC89013361 HPV LO RISK TYPES(6,11,42,43,44)-AU $47.00 HC89009690 PROLACTIN-ES $47.00 HC89010110 T-3 REVERSE-ES $47.00 0409-4282-02 LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN $47.00 0409-4282-12 LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN $47.00 536110945 UREA 20 % TOPICAL CREAM $46.96 59762-1307-2 LINEZOLID 600 MG ORAL TAB $46.95 72603-323-01 CLOBETASOL 0.05 % TOPICAL CREAM $46.90 0603-1554-10 POTASSIUM CHLORIDE 20 MEQ ORAL PACK $46.87 HC89022412 ANTI-STRIAT MUSCLE AB IGG TITER -AU $46.82 HC89500706 CMV IGM / UNIT-SB $46.80 55150-209-02 DEXMEDETOMIDINE 100 MCG/ML INJ SOLN (FOR INTRANASAL USE) $46.80 0517-0375-10 INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJ SOLN $46.80 0409-4759-01 ONDANSETRON HCL 2 MG/ML IV SOLN $46.80 16714-986-03 TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM $46.80 64764-119-07 COLCHICINE 0.6 MG ORAL TAB $46.74 64764-119-01 COLCHICINE 0.6 MG ORAL TAB $46.74 0409-0212-10 MILRINONE 1 MG/ML IV SOLN $46.74 0409-0212-01 MILRINONE 1 MG/ML IV SOLN $46.74 0409-9558-31 ROCURONIUM 10 MG/ML IV SOLN $46.54 0409-9558-10 ROCURONIUM 10 MG/ML IV SOLN $46.54 0409-7037-10 ROCURONIUM 10 MG/ML IV SOLN $46.54 0409-7037-01 ROCURONIUM 10 MG/ML IV SOLN $46.54 76282-740-30 PHYTONADIONE (VITAMIN K1) 5 MG ORAL TAB $46.53 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 63323-464-17 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $46.48 63323-464-01 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $46.48 63323-486-57 LIDOCAINE HCL 20 MG/ML (2 %) INJ SOLN $46.48 63323-486-05 LIDOCAINE HCL 20 MG/ML (2 %) INJ SOLN $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 70756-604-56 TOBRAMYCIN IN 0.225 % NACL 300 MG/5 ML INHALATION NEBU $46.44 70756-604-44 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 47781-424-11 FENTANYL 25 MCG/HR TRANSDERMAL PT72 $46.35 47781-424-47 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 0378-9121-16 FENTANYL 25 MCG/HR TRANSDERMAL PT72 $46.35 0378-9121-98 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 16714-985-02 TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM $46.28 HC89008882 LIPOPROTEIN ELECTROPHORESIS-AU $46.23 67457-352-10 AMPICILLIN SODIUM 2 GRAM INJ SOLR $46.22 67457-352-02 AMPICILLIN SODIUM 2 GRAM INJ SOLR $46.22 72572-416-10 MEROPENEM 1 GRAM IV SOLR $46.22 72572-416-01 MEROPENEM 1 GRAM IV SOLR $46.22 72572-410-10 MEROPENEM 1 GRAM IV SOLR $46.22 72572-410-01 MEROPENEM 1 GRAM IV SOLR $46.22 54859-808-08 SENNOSIDES 8.8 MG/5 ML ORAL SYRP $46.22 55150-114-20 AMPICILLIN SODIUM 2 G IV SOLR (MCH) $46.18 0781-3408-95 AMPICILLIN SODIUM 2 G IV SOLR (MCH) $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 57896-423-16 DOCUSATE SODIUM 100 MG/10 ML ORAL LIQD $46.12 58657-508-16 GUAIFENESIN 100 MG/5 ML ORAL LIQD $46.12 45963-438-64 LACTULOSE 10 GRAM/15 ML ORAL SOLN $46.12 36000-148-10 FLUMAZENIL 0.1 MG/ML IV SOLN $46.05 36000-148-01 FLUMAZENIL 0.1 MG/ML IV SOLN $46.05 72603-267-25 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $46.02 72603-267-01 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $46.02 HC89004113 ADRENAL AB - AU $46.00 HC89020002 B PARAPERTUSSIS PCR - AU $46.00 HC89019996 B PERTUSSIS PCR - AU $46.00 HC51000503 GLUCOSE SERUM QUANT (POS) $46.00 HC89002646 PHOSPHATIDYL GLYCEROL-U2 $46.00 HC51050011 RT TEAM CONF PER CASE $46.00 0046-1100-81 CONJUGATED ESTROGENS 0.3 MG ORAL TAB $45.96 0046-1100-91 CONJUGATED ESTROGENS 0.3 MG ORAL TAB $45.96 0046-1101-81 CONJUGATED ESTROGENS 0.45 MG ORAL TAB $45.96 0046-1102-81 CONJUGATED ESTROGENS 0.625 MG ORAL TAB $45.96 0046-1103-81 CONJUGATED ESTROGENS 0.9 MG ORAL TAB $45.96 0046-1104-81 CONJUGATED ESTROGENS 1.25 MG ORAL TAB $45.96 52244-300-10 THEOPHYLLINE 300 MG ORAL CP24 $45.94 0168-0004-80 TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM $45.76 55150-439-10 KETAMINE 50 MG/ML INJ SOLN $45.63 55150-439-01 KETAMINE 50 MG/ML INJ SOLN $45.63 0574-2008-15 NYSTATIN 100,000 UNIT/GRAM TOPICAL POWD $45.53 68382-370-01 NYSTATIN 100,000 UNIT/GRAM TOPICAL POWD $45.53 75907-060-44 NYSTATIN 100,000 UNIT/GRAM TOPICAL POWD $45.53 42806-186-15 NYSTATIN 100,000 UNIT/GRAM TOPICAL POWD $45.53 33342-332-15 TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL OINT $45.53 99999-047-04 ARGININE HCL (L-ARGININE) 10 % IV SOLP $45.50 71288-723-52 BUPIVACAINE HCL 0.25 % (2.5 MG/ML) INJ SOLN $45.50 25021-114-87 CIPROFLOXACIN IN 5 % DEXTROSE 400 MG/200 ML IV PGBK $45.50 0409-3300-01 CIPROFLOXACIN IN 5 % DEXTROSE 400 MG/200 ML IV PGBK $45.50 0409-3300-24 CIPROFLOXACIN IN 5 % DEXTROSE 400 MG/200 ML IV PGBK $45.50 0781-3150-75 CISATRACURIUM 2 MG/ML IV SOLN $45.50 0781-3150-95 CISATRACURIUM 2 MG/ML IV SOLN $45.50 71288-712-06 CISATRACURIUM 2 MG/ML IV SOLN $45.50 71288-712-05 CISATRACURIUM 2 MG/ML IV SOLN $45.50 54879-022-01 CYCLOPHOSPHAMIDE 50 MG ORAL CAP $45.50 0990-7924-09 DEXTROSE 5%-0.2 % SOD CHLORIDE IV SOLP $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 60258-151-01 FLUORIDE (SODIUM) 1.1 % DENT GEL $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 99999-045-68 KETAMINE DRIP 500 MG IN NS 250 ML (OCM) $45.50 0143-9622-01 LABETALOL 5 MG/ML IV SOLN $45.50 0496-0882-05 LIDOCAINE 4 % TOPICAL CREAM $45.50 0496-0882-06 LIDOCAINE 4 % TOPICAL CREAM $45.50 0990-9257-39 POTASSIUM CHLOR-0.45%NACL 20 MEQ/L IV SOL REPLACEMENT $45.50 0990-7115-09 POTASSIUM CHLOR-0.9%NACL 20 MEQ/L IV SOL REPLACEMENT $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 0338-0704-34 POTASSIUM CHLORIDE-0.45 % NACL 20 MEQ/L IV SOLP $45.50 0990-7107-09 POTASSIUM CHLORIDE-D5-0.9%NACL 20 MEQ/L IV SOLP $45.50 0264-2202-00 RINGER'S IRR SOLN $45.50 67457-228-99 ROCURONIUM 10 MG/ML IV SOLN $45.50 67457-228-10 ROCURONIUM 10 MG/ML IV SOLN $45.50 0143-9785-01 VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) IV SOLN $45.50 0143-9785-10 VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) IV SOLN $45.50 63323-221-01 VANCOMYCIN 500 MG IV SOLR $45.50 63323-221-10 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 57782-397-26 CROMOLYN 5.2 MG/SPRAY (4 %) NASL SPRY $45.46 63323-341-25 CEFOXITIN 1 GRAM IV SOLR $45.44 63323-341-01 CEFOXITIN 1 GRAM IV SOLR $45.44 0517-0031-25 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG/ML INJ SOLN $45.44 0517-0031-01 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG/ML INJ SOLN $45.44 71288-402-31 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $45.44 71288-402-30 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $45.44 0409-3383-02 PIPERACILLIN-TAZOBACTAM 2.25 GRAM IV SOLR $45.31 0409-3383-11 PIPERACILLIN-TAZOBACTAM 2.25 GRAM IV SOLR $45.31 58657-810-21 PYRIDOSTIGMINE BROMIDE 30 MG ORAL TAB $45.26 0395-1003-92 GENTIAN VIOLET 1 % TOPICAL SOLN $45.25 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 0573-2871-93 PHENYLEPH-MIN OIL-PETROLATUM 0.25-14-74.9 % RECTAL OINT $45.14 0409-2344-02 DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) IV SOLN $45.11 0409-2344-62 DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) IV SOLN $45.11 60687-556-33 MESALAMINE 400 MG ORAL CDTI $45.11 60687-556-32 MESALAMINE 400 MG ORAL CDTI $45.11 60687-691-11 DEMECLOCYCLINE 150 MG ORAL TAB $45.08 63323-496-97 LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN $45.05 63323-496-03 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 HC89004964 ASPERGILLUS ANTIGEN-AU $45.00 HC89021679 BENZODIAZEPINES; 1-12 MEC(PNL)-AU $45.00 HC89022438 CULTURE VIRUS NON-RESPIRATORY-AU $45.00 HC89002034 CYCLOSPORINE-U2 $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 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 HC89005417 TROPONIN-UCI $45.00 HC89008668 TRYPSIN-QD $45.00 0555-1056-86 ISOTRETINOIN 30 MG ORAL CAP $44.94 63323-044-01 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG/ML INJ SOLN $44.92 63323-044-00 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG/ML INJ SOLN $44.92 63323-165-05 DEXAMETHASONE 4 MG/ML INJ SOLN (FOR ORAL USE) $44.92 63323-165-03 DEXAMETHASONE 4 MG/ML INJ SOLN (FOR ORAL USE) $44.92 0781-9404-85 AMPICILLIN SODIUM 1 GRAM INJ SOLR $44.90 0781-9404-95 AMPICILLIN SODIUM 1 GRAM INJ SOLR $44.90 4110082076 POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWD $44.86 63323-464-31 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $44.85 0641-6060-10 MIDAZOLAM 5 MG/ML INJ SOLN $44.85 0641-6060-01 MIDAZOLAM 5 MG/ML INJ SOLN $44.85 0093-3061-56 RASAGILINE 1 MG ORAL TAB $44.69 HC89008494 17-D HYDROXYPROGESTERONE-QN $44.65 0173-0675-02 ATOVAQUONE-PROGUANIL 250-100 MG ORAL TAB $44.64 0781-3114-95 PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR $44.62 0781-3114-91 PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR $44.62 HC89013981 TSH-ES $44.53 HC89014757 B PARAPERTUSSIS PCR-AU $44.50 HC89014740 B PERTUSSIS PCR(PNL)-AU $44.50 63323-117-20 FLUOROURACIL 1 GRAM/20 ML IV SOLN $44.46 63323-117-01 FLUOROURACIL 1 GRAM/20 ML IV SOLN $44.46 HC89022909 BILIRUBIN SERUM(PANEL)-AU $44.40 HC89022453 CULTURE VIRUS ID DEFIN/ADDL+-AU $44.38 16714-849-01 CLOMIPRAMINE 25 MG ORAL CAP $44.38 4116760352 SELENIUM SULFIDE-ALOE VERA 1 % TOPICAL SHAM $44.36 24208-313-34 WHITE PETROLATUM-MINERAL OIL 80-20 % OPHT OINT $44.34 1011902013 WHITE PETROLATUM-MINERAL OIL 80-20 % OPHT OINT $44.34 0409-1749-10 BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJ SOLN $44.33 0409-1749-70 BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJ SOLN $44.33 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 0781-3543-10 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $44.27 0781-3543-25 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $44.27 60687-358-95 COLCHICINE 0.6 MG ORAL CAP $44.20 60687-358-25 COLCHICINE 0.6 MG ORAL CAP $44.20 0409-9094-28 FENTANYL (PF) 50 MCG/ML INJ FOR INTRATHECAL PAIN PUMP REFILL (OCM) $44.20 0409-9094-17 FENTANYL CITRATE (PF) 0.05 MG/ML INJ SOLN (MCH) $44.20 55150-400-01 HYDRALAZINE 20 MG/ML INJ SOLN $44.20 55150-400-25 HYDRALAZINE 20 MG/ML INJ 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 4467710020 MODIFIED LANOLIN 100 % TOPICAL CREAM $44.20 99999-046-68 NEOMYCIN-POLYMYXIN B GU 40 MG-200,000 UNIT/ML IRR SOLN $44.20 44567-803-10 PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR $44.20 55111-663-30 PARICALCITOL 1 MCG ORAL CAP $44.01 HC89017073 AMNIOTIC BILIRUBIN SCAN-AU $44.00 HC83505750 HISTCHM ST FROZ TIS BLK EA ADD(PANEL)+-U2 $44.00 HC89012058 RHEUMATOID FACTOR-RD $44.00 16714-395-01 CEFPODOXIME 200 MG ORAL TAB $43.98 0781-5439-20 CEFPODOXIME 200 MG ORAL TAB $43.98 72572-056-10 CEFAZOLIN 10 GRAM INJ SOLR $43.94 72572-056-01 CEFAZOLIN 10 GRAM INJ SOLR $43.94 99999-047-22 FINASTERIDE 0.333 MG/ML ORAL SUSP (COMPOUND) $43.88 0781-1943-39 AMOXICILLIN-POT CLAVULANATE 1,000-62.5 MG ORAL TB12 $43.84 0173-0675-01 ATOVAQUONE-PROGUANIL 250-100 MG ORAL TAB $43.75 65649-101-02 BALSALAZIDE 750 MG ORAL CAP $43.73 0409-1746-10 BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJ SOLN $43.68 0409-1746-70 BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJ SOLN $43.68 0143-9507-01 ETOMIDATE 2 MG/ML IV SOLN $43.68 0143-9507-10 ETOMIDATE 2 MG/ML IV SOLN $43.68 0054-3294-46 FUROSEMIDE 10 MG/ML ORAL SOLN $43.68 99999-043-74 SODIUM CHLORIDE 2 MEQ/ML ORAL SOLN (MCH) $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 70069-232-01 BRIMONIDINE 0.2 % OPHT DROP $43.55 60687-275-66 PHENYTOIN 100 MG/4 ML ORAL SUSP $43.55 60687-275-63 PHENYTOIN 100 MG/4 ML ORAL SUSP $43.55 63323-494-05 VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) IV SOLN $43.55 63323-494-01 VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) IV SOLN $43.55 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 0781-3209-90 CEFTRIAXONE 2 G INJ SOLR (MCH) $43.50 0781-3209-95 CEFTRIAXONE 2 G INJ SOLR (MCH) $43.50 50458-639-65 TOPIRAMATE 25 MG ORAL TAB $43.45 HC89013601 CORTISOL-ES $43.44 61570-112-01 RAMIPRIL 5 MG ORAL CAP $43.36 72603-813-01 VILAZODONE 10 MG ORAL TAB $43.30 99999-047-60 CEFTRIAXONE 40 MG/ML INJ SYRINGE (2 G) $43.23 49884-401-91 RISPERIDONE 2 MG ORAL TBDL $43.17 49884-401-52 RISPERIDONE 2 MG ORAL TBDL $43.17 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 HC89025050 DHEA SER(PNL)-ES $43.00 HC89017313 NEISSERIA GONORRHOEAE AB-QD $43.00 HC89016547 TESTOSTERONE FREE FEM/CHILD-AU $43.00 HC89023584 TRICHOMONAS VAGINALIS TMA-AU $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 67618-200-04 CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQD $42.95 70069-141-10 CISATRACURIUM 2 MG/ML IV SOLN $42.90 70069-141-01 CISATRACURIUM 2 MG/ML IV SOLN $42.90 51672-2002-2 CLOTRIMAZOLE 1 % TOPICAL CREAM $42.90 70700-186-22 FLUOROURACIL 50 MG/ML INJ SOLN (SURGERY) $42.90 70700-186-23 FLUOROURACIL 50 MG/ML INJ SOLN (SURGERY) $42.90 51754-6001-1 GLYCOPYRROLATE (PF) 0.2 MG/ML INJ SOLN $42.90 51754-6001-4 GLYCOPYRROLATE (PF) 0.2 MG/ML INJ SOLN $42.90 65219-065-05 ROCURONIUM 10 MG/ML IV SOLN $42.90 65219-065-02 ROCURONIUM 10 MG/ML IV SOLN $42.90 525113990 LEVOMEFOLATE-ALGAL OIL 7.5-90.314 MG ORAL CAP $42.87 HC89020481 BENZODIAZEPINES ;13 OR > URINE-AU $42.80 0168-0020-31 HYDROCORTISONE 1 % TOPICAL OINT $42.75 55150-273-25 THIAMINE HCL (VITAMIN B1) 100 MG/ML INJ SOLN $42.73 55150-273-01 THIAMINE HCL (VITAMIN B1) 100 MG/ML INJ SOLN $42.73 0409-1761-10 BUPIVACAINE-DEXTROSE-WATER(PF) 0.75 % (7.5 MG/ML) INJ SOLN $42.71 0409-1761-05 BUPIVACAINE-DEXTROSE-WATER(PF) 0.75 % (7.5 MG/ML) INJ SOLN $42.71 23155-018-01 TETRACYCLINE 500 MG ORAL CAP $42.71 70594-114-01 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $42.64 70594-114-02 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $42.64 16714-039-01 COLCHICINE 0.6 MG ORAL TAB $42.62 13310-153-07 QUININE SULFATE 324 MG ORAL CAP $42.56 0409-3795-01 KETOROLAC 30 MG/ML (1 ML) INJ SOLN $42.45 0409-3795-19 KETOROLAC 30 MG/ML (1 ML) INJ SOLN $42.45 0517-1305-25 DOPAMINE 800 MG/5 ML (160 MG/ML) IV SOLN $42.32 0472-0337-30 HYDROCORTISONE 2.5 % TOPICAL CREAM $42.32 0143-9887-01 AMOXICILLIN 400 MG/5 ML ORAL SUSR $42.25 0990-7924-03 DEXTROSE 5%-0.2 % SOD CHLORIDE IV SOLP $42.25 0942-0641-03 DEXTROSE-SOD CITRATE-CITRIC AC 2.45-2.2 GRAM- 730 MG/100 ML MISC 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 0143-9684-01 FLUMAZENIL 0.1 MG/ML IV SOLN $42.25 0143-9684-10 FLUMAZENIL 0.1 MG/ML IV SOLN $42.25 72485-617-10 KETOTIFEN FUMARATE 0.025 % (0.035 %) OPHT DROP $42.25 17271-701-02 NS IV AFTER MEDICATION INFUSION (TO FLUSH RESIDUAL MED) $42.25 0641-6175-10 OCTREOTIDE ACETATE 100 MCG/ML INJ SOLN $42.25 0641-6175-01 OCTREOTIDE ACETATE 100 MCG/ML INJ SOLN $42.25 25021-452-01 OCTREOTIDE ACETATE 100 MCG/ML INJ SOLN $42.25 0143-9284-10 PANTOPRAZOLE 40 MG IV SOLR $42.25 0143-9284-01 PANTOPRAZOLE 40 MG IV SOLR $42.25 99999-044-85 PHENYLEPHRINE IN NS 20 MG/250 ML (80 MCG/ML) IV SOLN (MHS) $42.25 64679-012-02 PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR $42.25 64679-012-01 PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR $42.25 55150-121-50 PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR $42.25 60505-6159-4 PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR $42.25 60505-6159-0 PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR $42.25 72485-404-10 PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR $42.25 72485-404-01 PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR $42.25 70860-651-05 ROCURONIUM 10 MG/ML IV SOLN $42.25 63323-426-05 ROCURONIUM 10 MG/ML IV SOLN $42.25 63323-426-02 ROCURONIUM 10 MG/ML IV SOLN $42.25 0338-0054-03 SODIUM CHLORIDE 3 % 3 % IV SOLP (BOLUS) - HYPONATREMIA (LBMC) $42.25 25021-797-05 VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) IV SOLN $42.25 0074-7126-11 DIVALPROEX 500 MG ORAL TB24 $42.21 16714-826-01 PROPAFENONE 325 MG ORAL CP12 $42.13 70436-203-80 DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) IV SOLN $42.12 70436-203-82 DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) IV SOLN $42.12 24385-361-34 IBUPROFEN 100 MG/5 ML ORAL SUSP $42.12 8770140652 IBUPROFEN 100 MG/5 ML ORAL SUSP $42.12 0009-0039-28 METHYLPREDNISOLONE SOD SUC(PF) 40 MG/ML INJ SOLR $42.05 0009-0039-30 METHYLPREDNISOLONE SOD SUC(PF) 40 MG/ML INJ SOLR $42.05 HC89007314 BARBITURATES QUANTITATIVE EA SPEC-U2 $42.00 HC89008544 CARNITINE-CA $42.00 HC89018675 CHROM ADD KARYOTYPE, AF-AU $42.00 HC89007652 DEOXYPYRIDINOLIN CROSSLINKS-AU $42.00 HC89000020 GLIADIN IGA AND IGG ABS-QD $42.00 HC89024533 HPV HIGH RISK BY TMA W/REFLEX-AU $42.00 HC89008593 IGF BINDING PROTEIN-3-ES $42.00 HC89017347 LYME AB IGG & IGM BY WB-AU $42.00 HC89015267 PENTOBARBITAL-U2 $42.00 HC89010763 PLATELET NEUT-AU $42.00 HC51001915 WBC MANUAL DIFF $42.00 0143-9754-25 METHYLPREDNISOLONE SODIUM SUCC 125 MG INJ SOLR $41.99 0143-9754-01 METHYLPREDNISOLONE SODIUM SUCC 125 MG INJ SOLR $41.99 51672-2080-1 TERBINAFINE HCL 1 % TOPICAL CREAM $41.83 HC89024921 CULTURE STAPHYLOCOCCUS-AU $41.82 HC89023642 T CELL ABSOLUTE CD4 COUNT-AU $41.82 63323-412-02 MIDAZOLAM 5MG/ML INJECTABLE SOLUTION (MHS WRAPPER) $41.80 HC89014492 YERSINIA AB IGA BY IMMUNOBLOT-ARUP $41.75 0409-9042-01 BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJ SOLN $41.73 0409-9042-11 BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJ SOLN $41.73 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 HC89025001 DESOXYCORTISOL 11 SER(PNL)-ES $41.60 65862-071-01 AMOXICILLIN 400 MG/5 ML ORAL SUSR $41.60 0781-6157-46 AMOXICILLIN 400 MG/5 ML ORAL SUSR $41.60 0143-9508-10 KETAMINE 50 MG/ML INJ SOLN (MHS WRAPPER) $41.60 0143-9508-01 KETAMINE 50 MG/ML INJ SOLN (MHS WRAPPER) $41.60 0338-1709-40 MAGNESIUM SULFATE IN D5W 1 GRAM/100 ML IV PGBK $41.60 43598-050-25 THIAMINE HCL (VITAMIN B1) 100 MG/ML INJ SOLN $41.60 43598-050-11 THIAMINE HCL (VITAMIN B1) 100 MG/ML INJ SOLN $41.60 45802-897-34 IBUPROFEN 100 MG/5 ML ORAL SUSP $41.59 0456-1402-30 NEBIVOLOL 2.5 MG ORAL TAB $41.59 0456-1410-90 NEBIVOLOL 10 MG ORAL TAB $41.59 0456-1405-90 NEBIVOLOL 5 MG ORAL TAB $41.59 0409-1180-69 MEPERIDINE (PF) 100 MG/ML INJ SYRG $41.57 0409-1179-30 MEPERIDINE (PF) 75 MG/ML INJ SYRG $41.57 HC89018956 HEINZ BODIES DIRECT-AU $41.50 72266-259-30 ARFORMOTEROL 15 MCG/2 ML INHALATION NEBU $41.47 72266-259-01 ARFORMOTEROL 15 MCG/2 ML INHALATION NEBU $41.47 4110081127 OXYMETAZOLINE 0.05 % NASL SPRAY (MHS WRAPPER) $41.44 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 60687-803-01 AMOXICILLIN-POT CLAVULANATE 875-125 MG ORAL TAB $41.39 60687-803-11 AMOXICILLIN-POT CLAVULANATE 875-125 MG ORAL TAB $41.39 50268-570-12 MODAFINIL 100 MG ORAL TAB $41.35 50268-570-11 MODAFINIL 100 MG ORAL TAB $41.35 55150-222-20 ETOMIDATE 2 MG/ML IV SOLN $41.34 63323-326-20 CEFEPIME 1 GRAM INJ SOLR $41.28 62756-224-83 TIAGABINE 4 MG ORAL TAB $41.26 0093-5031-56 TIAGABINE 4 MG ORAL TAB $41.26 25021-673-77 LIDOCAINE HCL 2 % MUCOUS MEMB JELP $41.26 61703-305-58 CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) INJ SOLN $41.24 61703-305-38 CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) INJ SOLN $41.24 HC89010052 THYROID STIM IMMUNOGLOB-AU $41.18 53746-554-01 DEMECLOCYCLINE 150 MG ORAL TAB $41.16 65162-554-10 DEMECLOCYCLINE 150 MG ORAL TAB $41.16 7430001067 POLYETHYLENE GLYCOL 400 1 % OPHT DROP $41.15 HC89022156 CAFFEINE SERUM/PLASMA - AU $41.13 60687-326-25 ATOMOXETINE 40 MG ORAL CAP $41.10 60687-326-95 ATOMOXETINE 40 MG ORAL CAP $41.10 1093957833 CLOTRIMAZOLE 2 % VAGINAL CREAM $41.09 49348-379-54 CLOTRIMAZOLE 2 % VAGINAL CREAM $41.09 76329-3012-5 LIDOCAINE HCL 2 % MUCOUS MEMB JELP $41.08 65862-896-10 LANSOPRAZOLE 30 MG ORAL TBLD $41.07 65862-896-78 LANSOPRAZOLE 30 MG ORAL TBLD $41.07 68382-771-30 LANSOPRAZOLE 15 MG ORAL TBLD $41.05 68382-771-77 LANSOPRAZOLE 15 MG ORAL TBLD $41.05 68382-772-77 LANSOPRAZOLE 30 MG ORAL TBLD $41.05 68382-772-30 LANSOPRAZOLE 30 MG ORAL TBLD $41.05 0555-1055-56 ISOTRETINOIN 20 MG ORAL CAP $41.03 HC89000616 ALKALINE PHOS ISOENZYMES-QD $41.00 HC89006233 ASSAY PHENCYCLIDINE (PCP)-AU $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 HC89008742 TRYPTASE-AU $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 70121-1720-1 MAGNESIUM SULFATE 4 GRAM/100 ML IV PGBK (SLH) $40.95 25021-612-82 MAGNESIUM SULFATE IN WATER 4 GRAM/100 ML (4 %) IV PGBK $40.95 70121-1720-3 MAGNESIUM SULFATE IN WATER 4 GRAM/100 ML (4 %) IV PGBK $40.95 72572-740-20 SODIUM BICARBONATE 1 MEQ/ML (8.4 %) IV SOLN $40.95 72572-740-25 SODIUM BICARBONATE 1 MEQ/ML (8.4 %) IV SOLN $40.95 72572-740-01 SODIUM BICARBONATE 1 MEQ/ML (8.4 %) IV SOLN $40.95 51672-1282-2 TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM $40.95 67457-778-05 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 0703-9503-03 SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG/5 ML IV SOLN $40.76 0703-9503-01 SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG/5 ML IV SOLN $40.76 0409-3977-03 WATER FOR INJECT, BACTERIOSTAT INJ SOLN $40.76 0409-3977-01 WATER FOR INJECT, BACTERIOSTAT INJ SOLN $40.76 0338-0023-02 DEXTROSE 10 % IN WATER (D10W) 10 % IV SOLP $40.63 99999-045-69 HEPARIN (PORCINE) IN 5 % DEX 25,000 UNIT/250 ML(100 UNIT/ML) IV SOLP $40.63 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 72603-146-01 LABETALOL 5 MG/ML IV SOLN $40.56 HC89023469 YERSINIA AB IGG BY IMMUNOBLOT-AU $40.50 0641-6014-10 DILTIAZEM HCL 5 MG/ML IV SOLN $40.50 0641-6014-01 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 55150-174-10 AZITHROMYCIN 500 MG IV SOLR $40.30 25021-229-05 CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) INJ SOLN $40.30 0338-1715-40 MAGNESIUM SULFATE 4 GRAM/100 ML IV PGBK (SLH) $40.30 67457-554-00 MAGNESIUM SULFATE IN WATER 4 GRAM/100 ML (4 %) IV PGBK $40.30 47335-992-02 MAGNESIUM SULFATE IN WATER 4 GRAM/100 ML (4 %) IV PGBK $40.30 69918-560-30 MESALAMINE 1,000 MG RECTAL SUPP $40.27 0904-6553-04 LINEZOLID 600 MG ORAL TAB $40.24 0378-3000-01 MECLOFENAMATE 100 MG ORAL CAP $40.24 64764-080-60 LUBIPROSTONE 8 MCG ORAL CAP $40.20 63323-173-02 GENTAMICIN SULFATE (PED) (PF) 20 MG/2 ML INJ SOLN $40.11 63323-173-01 GENTAMICIN SULFATE (PED) (PF) 20 MG/2 ML INJ SOLN $40.11 60687-309-21 LINEZOLID 600 MG ORAL TAB $40.09 60687-309-11 LINEZOLID 600 MG ORAL TAB $40.09 0121-4950-15 LIDOCAINE HCL 2 % MUCOUS MEMB SOLN $40.07 0121-4950-40 LIDOCAINE HCL 2 % MUCOUS MEMB SOLN $40.07 60687-576-40 MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRP $40.07 HC51071116 ADMIN RSV MONOCLONAL ANTIBODY IM $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 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 HC39000773 PSYCH TEAM CONF PRTCPNT PER 15MIN $40.00 HC83505917 SPECIAL STAIN GROUP II -AP $40.00 HC89001994 TACROLIMUS-U2 $40.00 50289-3250-1 GLYCERIN-WHICH HAZEL 12.5-50 % PACKET (MHS WRAPPER) $40.00 0264-4050-80 ACETAMINOPHEN 500 MG/50 ML (10 MG/ML) IV SOLN $39.98 54859-811-16 DIPHENHYDRAMINE HCL 12.5 MG/5 ML ORAL LIQ (MCH) $39.97 0527-5125-70 LACTULOSE 10 GRAM/15 ML ORAL SOLN $39.97 0054-0426-23 RUFINAMIDE 400 MG ORAL TAB $39.92 45802-433-21 DEXTROMETHORPHAN POLISTIREX 30 MG/5 ML ORAL SU12 $39.92 65162-802-14 TEMOZOLOMIDE 20 MG ORAL CAP $39.85 47335-891-60 TEMOZOLOMIDE 20 MG ORAL CAP $39.85 47335-891-72 TEMOZOLOMIDE 20 MG ORAL CAP $39.85 65162-802-51 TEMOZOLOMIDE 20 MG ORAL CAP $39.85 70069-231-01 BRIMONIDINE 0.2 % OPHT DROP $39.72 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 4110081123 OXYMETAZOLINE 0.05 % NASL SPRAY (MHS WRAPPER) $39.68 99999-041-36 LEVOFLOXACIN 5 MG/ML INJECTION (MHS) $39.65 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 0409-4031-01 MANNITOL 25 % 25 % IV SOLN $39.65 0409-4031-16 MANNITOL 25 % 25 % IV 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 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 63323-255-03 METHYLPREDNISOLONE SODIUM SUCC 40 MG INJ SOLR $39.52 63323-255-01 METHYLPREDNISOLONE SODIUM SUCC 40 MG INJ SOLR $39.52 54092-191-12 MESALAMINE 500 MG ORAL CPSR $39.47 0074-4637-01 PARICALCITOL 2 MCG/ML IV SOLN $39.39 6845510826 OSTOMY SUPPLIES TOPICAL POWD $39.37 0904-7540-12 WHITE PETROLATUM-MINERAL OIL 83-15 % OPHT OINT $39.34 63323-024-25 MANNITOL 25 % 25 % IV SOLN $39.33 63323-024-01 MANNITOL 25 % 25 % IV SOLN $39.33 0121-0974-10 SUCRALFATE 100 MG/ML ORAL SUSP $39.33 0121-0974-00 SUCRALFATE 100 MG/ML ORAL SUSP $39.33 16714-467-01 CAPECITABINE 150 MG ORAL TAB $39.28 0409-1176-03 MEPERIDINE (PF) 25 MG/ML INJ SOLN (WRAPPER) $39.26 0409-1176-30 MEPERIDINE (PF) 25 MG/ML INJ SOLN (WRAPPER) $39.26 299391702 GLYCERIN-DIMETHICONE-PETRO, WH TOPICAL CREAM $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 0363-0063-30 CALAMINE-ZINC OXIDE 8-8 % TOPICAL LOTN $39.12 1093995959 GLYCERIN 99.5 % TOPICAL SOLN $39.12 0168-0015-31 HYDROCORTISONE 1 % TOPICAL CREAM $39.07 70436-232-73 AMIODARONE 50 MG/ML IV SOLN $39.02 70436-232-62 AMIODARONE 50 MG/ML IV SOLN $39.02 0409-1761-18 BUPIVACAINE-DEXTROSE-WATER(PF) 0.75 % (7.5 MG/ML) INJ SOLN $39.01 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 HC89007397 CARBOXYHEMOGLOBIN-AU $39.00 HC89021778 CELIAC DX DUAL ANTIGEN SCREEN-AU $39.00 HC89013098 CULTURE LEGIONELLA-AU $39.00 HC89013114 CULTURE MYCOPLASMA-AU $39.00 HC89004121 FIBRINOGEN ANTIGEN-AU $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 HC89017446 PTT HEPARIN NEUTRALZ RFX - AU $39.00 HC89016422 PYRUVATE KINASE-AU $39.00 HC85100469 WBC MANUAL DIFF $39.00 67457-855-00 ADENOSINE 3 MG/ML IV SOLN $39.00 67457-855-02 ADENOSINE 3 MG/ML IV SOLN $39.00 25021-318-02 ADENOSINE 3 MG/ML IV SOLN $39.00 99999-044-47 AMIODARONE IN D5W 450 MG/250 ML (1.8 MG/ML) IV SOLN (MHS) $39.00 44567-102-10 AMPICILLIN SODIUM 1 GRAM INJ SOLR $39.00 62756-512-44 AZITHROMYCIN 500 MG IV SOLR $39.00 25021-121-20 CEFEPIME 1 GRAM INJ SOLR $39.00 25021-109-10 CEFOXITIN 1 GRAM IV SOLR $39.00 60505-6149-0 CEFTRIAXONE 2 G INJ SOLR (MCH) $39.00 0338-0089-04 D5 % AND 0.9 % SODIUM CHLORIDE IV SOLP $39.00 0338-0085-04 D5 %-0.45 % SODIUM CHLORIDE IV SOLP $39.00 0338-0017-04 D5W IV BOLUS $39.00 0409-1638-32 DEXMEDETOMIDINE 100 MCG/ML INJ SOLN (FOR INTRANASAL USE) $39.00 0409-1638-02 DEXMEDETOMIDINE 100 MCG/ML INJ SOLN (FOR INTRANASAL USE) $39.00 0990-7930-03 DEXTROSE 10 % IN WATER (D10W) 10 % IV SOLP $39.00 0264-7520-00 DEXTROSE 10 % IN WATER (D10W) 10 % IV SOLP $39.00 63323-824-26 DEXTROSE 10 % IN WATER (D10W) 10 % IV SOLP $39.00 0338-0125-04 DEXTROSE 5 %-LACTATED RINGERS IV SOLP $39.00 0338-0077-04 DEXTROSE 5%-0.2 % SOD CHLORIDE IV SOLP $39.00 0264-7707-00 ELECTROLYTE-S (PH 7.4) IV SOLP $39.00 0548-5602-00 ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRG $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 0641-6204-01 HEPARIN, PORCINE (PF) 5,000 UNIT/0.5 ML INJ SOLN (MHS WRAPPER) $39.00 0641-6204-10 HEPARIN, PORCINE (PF) 5,000 UNIT/0.5 ML INJ SOLN (MHS WRAPPER) $39.00 72266-103-01 LABETALOL 5 MG/ML IV SOLN $39.00 72266-103-41 LABETALOL 5 MG/ML IV SOLN $39.00 0990-7953-09 LACTATED RINGERS IV SOLP $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 69374-520-05 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $39.00 55150-253-50 LIDOCAINE 1% (10 MG/ML) FOR RT USE $39.00 0409-2050-01 MAGNESIUM SULFATE IN WATER 20 GRAM/500 ML (4 %) IV SOLP $39.00 63323-106-15 MAGNESIUM SULFATE IN WATER 20 GRAM/500 ML (4 %) IV SOLP $39.00 0409-2050-20 MAGNESIUM SULFATE IN WATER 20 GRAM/500 ML (4 %) IV SOLP $39.00 0143-9431-10 MEROPENEM 1 GRAM IV SOLR $39.00 0143-9431-01 MEROPENEM 1 GRAM IV SOLR $39.00 55150-207-20 MEROPENEM 500 MG IV SOLR $39.00 70121-1454-7 MEROPENEM 500 MG IV SOLR $39.00 70121-1454-1 MEROPENEM 500 MG IV SOLR $39.00 71288-200-21 MILRINONE 1 MG/ML IV SOLN $39.00 71288-200-20 MILRINONE 1 MG/ML IV SOLN $39.00 0641-6132-01 NALOXONE 0.4 MG/ML INJ (MHS WRAPPER) $39.00 0641-6132-25 NALOXONE 0.4 MG/ML INJ (MHS WRAPPER) $39.00 76297-001-01 NS IV AFTER MEDICATION INFUSION (TO FLUSH RESIDUAL MED) $39.00 76297-001-02 NS IV AFTER MEDICATION INFUSION (TO FLUSH RESIDUAL MED) $39.00 36000-326-02 PALONOSETRON 0.25 MG/5 ML IV SOLN $39.00 36000-326-01 PALONOSETRON 0.25 MG/5 ML IV SOLN $39.00 49230-206-32 PERIT.DIALYSIS 6-1.5 % DEXTROS CA 2.5 MEQ/L- MG 0.5 MEQ/L IP SOLN $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 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 25021-177-50 PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR $39.00 63323-688-10 POTASSIUM CHLORIDE IN 0.9%NACL 40 MEQ/L IV SOLP $39.00 63323-688-01 POTASSIUM CHLORIDE IN 0.9%NACL 40 MEQ/L IV SOLP $39.00 63323-269-29 PROPOFOL 10 MG/ML IV EMUL $39.00 63323-269-22 PROPOFOL 10 MG/ML IV EMUL $39.00 0641-6194-10 PROPOFOL 10 MG/ML IV EMUL $39.00 0641-6194-01 PROPOFOL 10 MG/ML IV EMUL $39.00 63323-269-57 PROPOFOL 10 MG/ML IV EMUL $39.00 55150-225-05 ROCURONIUM 10 MG/ML IV SOLN $39.00 0990-7985-09 SODIUM CHLORIDE 0.45 % 0.45 % IV SOLP $39.00 70069-301-25 SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ SOLN $39.00 64380-151-01 TESTOSTERONE 1 % (25 MG/2.5GRAM) TRANSDERMAL GLPK $39.00 64380-151-02 TESTOSTERONE 1 % (25 MG/2.5GRAM) TRANSDERMAL GLPK $39.00 31722-363-31 THIAMINE HCL (VITAMIN B1) 100 MG/ML INJ SOLN $39.00 31722-363-32 THIAMINE HCL (VITAMIN B1) 100 MG/ML INJ SOLN $39.00 55150-188-10 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $39.00 39822-1000-1 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $39.00 0143-9162-10 VANCOMYCIN 1,000 MG IV SOLR $39.00 0143-9162-01 VANCOMYCIN 1,000 MG IV SOLR $39.00 71288-023-20 VANCOMYCIN 1,000 MG IV SOLR $39.00 71288-023-21 VANCOMYCIN 1,000 MG IV SOLR $39.00 70594-123-01 VANCOMYCIN 1,000 MG IV SOLR $39.00 70594-046-01 VANCOMYCIN 1,000 MG IV SOLR $39.00 70594-046-02 VANCOMYCIN 1,000 MG IV SOLR $39.00 25021-312-02 VERAPAMIL 2.5 MG/ML IV SOLN $39.00 8212427181 WHITE PETROLATUM-ZINC TOPICAL PSTE $39.00 63323-731-01 CALCITRIOL 1 MCG/ML IV SOLN $38.94 63323-474-01 HALOPERIDOL LACTATE 5 MG/ML INJ SOLN $38.94 63323-474-00 HALOPERIDOL LACTATE 5 MG/ML INJ SOLN $38.94 69339-160-01 MEGESTROL 400 MG/10 ML (10 ML) ORAL SUSP $38.94 69339-160-16 MEGESTROL 400 MG/10 ML (10 ML) ORAL SUSP $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 63323-533-83 ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRG $38.81 63323-533-01 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 70069-101-25 METHOCARBAMOL 100 MG/ML INJ SOLN $38.74 60687-100-01 URSODIOL 300 MG ORAL CAP $38.70 60687-100-11 URSODIOL 300 MG ORAL CAP $38.70 25021-673-76 LIDOCAINE HCL 2 % MUCOUS MEMB JELP $38.69 HC89010219 VASOACTIVE INTEST PEPTIDE-AU $38.68 63323-472-17 BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJ SOLN $38.68 63323-472-03 BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJ SOLN $38.68 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 52427-285-01 NITROFURANTOIN MONOHYD/M-CRYST 100 MG ORAL CAP $38.66 61269-730-41 MICONAZOLE NITRATE 2 % VAGINAL CREAM $38.61 61269-730-63 MICONAZOLE NITRATE 2 % VAGINAL CREAM $38.61 0409-1283-17 HYDROMORPHONE 1 MG/ML INJ SOLN (MHS WRAPPER) $38.56 0409-1283-37 HYDROMORPHONE 1 MG/ML INJ SOLN (MHS WRAPPER) $38.56 61703-309-26 VINCRISTINE 1 MG/ML IV SOLN $38.55 60687-430-11 CHLORPROMAZINE 25 MG ORAL TAB $38.53 60687-430-01 CHLORPROMAZINE 25 MG ORAL TAB $38.53 58657-504-08 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 0409-2596-03 MIDAZOLAM 5 MG/ML INJ SOLN $38.45 0409-2596-13 MIDAZOLAM 5 MG/ML INJ SOLN $38.45 62559-225-30 AMINOCAPROIC ACID 500 MG ORAL TAB $38.40 65219-018-01 AMPICILLIN SODIUM 1 G IV SOLR (MCH) $38.35 65219-018-10 AMPICILLIN SODIUM 1 G IV SOLR (MCH) $38.35 44567-845-25 CEFAZOLIN 3 GRAM IV SOLR $38.35 44567-845-01 CEFAZOLIN 3 GRAM IV SOLR $38.35 0409-3330-24 LEVOFLOXACIN IN D5W 500 MG/100 ML IV PGBK $38.35 0409-3330-01 LEVOFLOXACIN IN D5W 500 MG/100 ML IV PGBK $38.35 63323-508-30 MEROPENEM 1 GRAM IV SOLR $38.35 63323-508-01 MEROPENEM 1 GRAM IV SOLR $38.35 63323-508-21 MEROPENEM 1 GRAM IV SOLR $38.35 63323-508-31 MEROPENEM 1 GRAM IV SOLR $38.35 72611-749-10 MIDAZOLAM 5 MG/ML INJ SOLN $38.35 72611-749-01 MIDAZOLAM 5 MG/ML INJ SOLN $38.35 83634-778-02 PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN $38.35 83634-778-41 PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN $38.35 1031028313 BENZOCAINE-MENTHOL-ZINC CHLOR 20-0.26-0.15 % MUCOUS MEMB GEL $38.21 0025-1461-60 MISOPROSTOL 200 MCG ORAL TAB $38.21 0025-1461-31 MISOPROSTOL 200 MCG ORAL TAB $38.21 31722-749-20 LINEZOLID 600 MG ORAL TAB $38.19 70677-1026-1 DEXTROMETHORPHAN POLISTIREX 30 MG/5 ML ORAL SU12 $38.18 7811201104 PHENOL 1.4 % MUCOUS MEMB SPRA $38.03 60505-6231-0 CEFAZOLIN 2 GRAM INJ SOLR $38.03 60505-6231-5 CEFAZOLIN 2 GRAM INJ SOLR $38.03 0143-9139-25 CEFAZOLIN 2 GRAM IV SOLR $38.03 0143-9139-01 CEFAZOLIN 2 GRAM IV SOLR $38.03 0143-9254-25 DOPAMINE 400 MG/10 ML (40 MG/ML) IV SOLN $38.03 0143-9254-01 DOPAMINE 400 MG/10 ML (40 MG/ML) IV SOLN $38.03 59762-1005-1 CABERGOLINE 0.5 MG ORAL TAB $38.02 HC89000905 ALDOSTERONE URINE-QD $38.00 HC51062230 DIABETIC SELF MANGMT TRNG GRP 30M $38.00 HC51062214 GRAM STAIN $38.00 HC89002539 LEAD URINE-QD $38.00 HC89002182 LEAD-QD $38.00 HC89003891 LIDOCAINE-U2 $38.00 HC89006621 TOBRAMYCIN INITIAL-U2 $38.00 HC89002588 TOPIRAMATE-QD $38.00 0409-6102-20 FUROSEMIDE 10 MG/ML INJ SOLN $37.96 0409-6102-10 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 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 0409-9104-20 DOPAMINE 400 MG/10 ML (40 MG/ML) IV SOLN $37.90 0409-9104-21 DOPAMINE 400 MG/10 ML (40 MG/ML) IV SOLN $37.90 HC89021968 ANTIDEPRSSNTS TRICYCL =6/> QUANT UR -AU $37.88 HC89014674 LEGIONELLA AG DFA-AU $37.88 59011-410-20 OXYCODONE 10 MG ORAL TR12 $37.81 60687-789-11 PYRAZINAMIDE 500 MG ORAL TAB $37.73 60687-789-01 PYRAZINAMIDE 500 MG ORAL TAB $37.73 16714-187-01 SIROLIMUS 0.5 MG ORAL TAB $37.72 63323-607-98 ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRG $37.70 63323-607-08 ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRG $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 25021-132-82 LEVOFLOXACIN IN D5W 500 MG/100 ML IV PGBK $37.70 99999-043-71 SILDENAFIL 2.5 MG/ML ORAL LIQUID (MCH) (COMPOUND) $37.70 83634-401-10 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $37.70 83634-401-41 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $37.70 16864-680-03 BENZOCAINE-MENTHOL 20-0.5 % TOPICAL AEROSOL $37.57 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 HC89018444 PNH RBC GLYCOPHORIN-AU $37.50 HC89020309 SUCRASE (DISACCHARIDASE)-AU $37.50 6961801854 ASCORBIC ACID (VITAMIN C) 500 MG/5 ML ORAL LIQD $37.44 0904-5309-09 IBUPROFEN 100 MG/5 ML ORAL SUSP $37.44 23155-601-42 MIDAZOLAM 5 MG/ML INJ SOLN $37.44 23155-601-32 MIDAZOLAM 5 MG/ML INJ SOLN $37.44 99999-038-89 HALOPERIDOL LACTATE 5 MG/ML INJ SOLN $37.38 69339-157-17 LEVETIRACETAM 500 MG/5 ML (5 ML) ORAL SOLN $37.38 69339-157-05 LEVETIRACETAM 500 MG/5 ML (5 ML) ORAL SOLN $37.38 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 52244-200-10 THEOPHYLLINE 200 MG ORAL CP24 $37.38 68462-404-01 ATOVAQUONE-PROGUANIL 250-100 MG ORAL TAB $37.18 71266-9011-1 PHENYLEPHRINE HCL IN 0.9% NACL 1 MG/10 ML (100 MCG/ML) IV SYRG $37.18 72603-590-25 NALOXONE 0.4 MG/ML INJ (MHS WRAPPER) $37.17 63323-466-17 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN $37.12 60687-266-11 RALOXIFENE 60 MG ORAL TAB $37.06 60687-266-21 RALOXIFENE 60 MG ORAL TAB $37.06 44567-240-10 CEFEPIME 1 GRAM INJ SOLR $37.05 63323-162-00 KETOROLAC 30 MG/ML (1 ML) INJ SOLN $37.05 63323-162-01 KETOROLAC 30 MG/ML (1 ML) INJ SOLN $37.05 44567-437-24 LEVOFLOXACIN IN D5W 750 MG/150 ML IV PGBK $37.05 63323-485-57 LIDOCAINE 1% (10 MG/ML) FOR RT USE $37.05 63323-485-03 LIDOCAINE 1% (10 MG/ML) FOR RT USE $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 0990-7077-26 POTASSIUM CHLORIDE IN WATER 40 MEQ/100 ML IV PGBK $37.05 67457-438-00 VECURONIUM BROMIDE 10 MG IV SOLR $37.05 67457-438-10 VECURONIUM BROMIDE 10 MG IV SOLR $37.05 HC89001226 C-PEPTIDE-QD $37.00 HC89015150 FEBRILE AGGLUTININS-AU $37.00 HC51000024 GLUCOSE BY REAGENT STRIP $37.00 HC89003099 HEAVY METAL(S) QUALITATIVE-QD $37.00 HC89016646 IMMUNO ELECT URINE-AU $37.00 HC89023147 LAMBDA FREE LIGHT CHAINS QT URINE-AU $37.00 63323-781-10 VECURONIUM BROMIDE 10 MG IV SOLR $36.99 63323-781-21 VECURONIUM BROMIDE 10 MG IV SOLR $36.99 49884-936-64 CHOLESTYRAMINE (WITH SUGAR) 4 GRAM ORAL PWPK $36.97 49884-936-65 CHOLESTYRAMINE (WITH SUGAR) 4 GRAM ORAL PWPK $36.97 63323-483-27 LIDOCAINE-EPINEPHRINE 2 %-1:100,000 INJ SOLN $36.92 63323-483-03 LIDOCAINE-EPINEPHRINE 2 %-1:100,000 INJ SOLN $36.92 149003916 BISMUTH SUBSALICYLATE 262 MG/15 ML ORAL SUSP $36.89 70677-1110-1 MINERAL OIL ORAL OIL $36.89 4858200330 SALIVA SUBSTITUTE COMBO NO.9 MUCOUS MEMB MWSH $36.89 51079-273-03 ENTACAPONE 200 MG ORAL TAB $36.89 51079-273-01 ENTACAPONE 200 MG ORAL TAB $36.89 63323-543-03 HEPARIN, PORCINE (PF) 5,000 UNIT/0.5 ML INJ SOLN (MHS WRAPPER) $36.86 63323-543-13 HEPARIN, PORCINE (PF) 5,000 UNIT/0.5 ML INJ SOLN (MHS WRAPPER) $36.86 59011-410-10 OXYCODONE 10 MG ORAL TR12 $36.83 1006104817 PYRETHRINS-PIPERONYL BUTOXIDE 0.33-4 % TOPICAL SHAM $36.82 0093-3002-56 QUININE SULFATE 324 MG ORAL CAP $36.78 HC89008015 ETHYLENE GLYCOL-AU $36.73 62756-348-44 OCTREOTIDE ACETATE 50 MCG/ML INJ SOLN $36.73 0409-6695-01 ETOMIDATE 2 MG/ML IV SOLN $36.66 0409-6695-11 ETOMIDATE 2 MG/ML IV SOLN $36.66 49348-636-34 LORATADINE 5 MG/5 ML ORAL SOLN $36.66 1093979233 LORATADINE 5 MG/5 ML ORAL SOLN $36.66 1093986044 LORATADINE 5 MG/5 ML ORAL SOLN $36.66 11523-1159-1 OXYMETAZOLINE 0.05 % NASL SPRAY (MHS WRAPPER) $36.66 60687-792-01 AMOXICILLIN-POT CLAVULANATE 500-125 MG ORAL TAB $36.61 60687-792-11 AMOXICILLIN-POT CLAVULANATE 500-125 MG ORAL TAB $36.61 72603-387-01 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $36.60 72603-387-10 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $36.60 4858200155 SALIVA STIMULANT COMB. NO.3 MUCOUS MEMB SPRY $36.57 75834-242-30 ERYTHROMYCIN 250 MG ORAL TAB $36.56 7985407723 CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROP $36.50 6371301972 GELATIN SPONGE,ABSORB-PORCINE 12-7 MM TOPICAL SPGE $36.50 72572-574-10 PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR $36.47 72572-574-01 PIPERACILLIN-TAZOBACTAM 4.5 GRAM IV SOLR $36.47 0338-3616-50 CLINDAMYCIN IN 5 % DEXTROSE 600 MG/50 ML IV PGBK $36.40 0338-5197-41 FAMOTIDINE (PF)-NACL (ISO-OS) 20 MG/50 ML IV PGBK $36.40 0781-3827-96 GLYCOPYRROLATE 0.2 MG/ML INJ SOLN $36.40 0781-3827-72 GLYCOPYRROLATE 0.2 MG/ML INJ SOLN $36.40 63323-482-03 LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN $36.40 63323-482-27 LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN $36.40 83634-500-42 MAGNESIUM SULFATE 4 GRAM/100 ML IV PGBK (SLH) $36.40 83634-500-82 MAGNESIUM SULFATE IN WATER 4 GRAM/100 ML (4 %) IV PGBK $36.40 0121-0945-40 MEGESTROL 40 MG/ML ORAL SUSPENSION (MHS WRAPPER) $36.40 23155-294-42 PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN $36.40 72572-601-20 PROPOFOL 10 MG/ML IV EMUL $36.40 72572-601-01 PROPOFOL 10 MG/ML IV EMUL $36.40 54288-135-01 TACROLIMUS 1 MG ORAL CAP $36.40 HC89004857 ESTROGENS, FRACTIONATED,TMS-AU $36.38 HC51062248 WET MOUNT BY PROVIDER FPACT $36.38 43598-220-40 AMOXICILLIN-POT CLAVULANATE 1,000-62.5 MG ORAL TB12 $36.30 50268-649-05 OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSP $36.27 50268-649-30 OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSP $36.27 72603-132-01 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 HC89021497 DS COCAINE CONF-AU $36.13 68180-821-10 LANTHANUM 1,000 MG ORAL CHEW $36.11 68180-821-47 LANTHANUM 1,000 MG ORAL CHEW $36.11 68180-819-42 LANTHANUM 500 MG ORAL CHEW $36.11 68180-819-52 LANTHANUM 500 MG ORAL CHEW $36.11 63323-484-57 LIDOCAINE HCL 5 MG/ML (0.5 %) INJ SOLN $36.08 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 HC89019574 ANTI-HU-TTG IGA (PNL1155/6360)-PR $36.00 HC51062677 KETONE BODY(S) QUALITATIVE $36.00 HC89006191 METHADONE &METABOLITE QUANT URINE-AU $36.00 HC51000008 OB FECES GUAIAC1-3 NEOPLSM SCR $36.00 HC88600226 SPECIAL COURIER 85 $36.00 HC88600275 SPECIAL COURIER 110 $36.00 HC89020416 THEOPHYLLINE-U2 $36.00 HC89014542 UREA PLASMA/MYCOPLASMA-AU $36.00 0781-3404-95 AMPICILLIN SODIUM 1 G IV SOLR (MCH) $35.92 0781-3404-85 AMPICILLIN SODIUM 1 G IV SOLR (MCH) $35.92 67877-746-01 SIROLIMUS 0.5 MG ORAL TAB $35.91 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 0069-5820-61 DOFETILIDE 500 MCG ORAL CAP $35.79 0904-6831-04 METAXALONE 800 MG ORAL TAB $35.76 25021-142-20 AMPICILLIN-SULBACTAM 1.5 GRAM INJ SOLR $35.75 0990-7941-03 D5 % AND 0.9 % SODIUM CHLORIDE IV SOLP $35.75 0990-7922-03 DEXTROSE 5 % IN WATER (D5W) IV SOLP $35.75 0641-1410-31 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 0641-6184-01 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 0990-7670-03 ELECTROLYTE-R (PH 7.4) IV SOLP $35.75 55150-221-10 ETOMIDATE 2 MG/ML IV SOLN $35.75 65219-445-10 ETOMIDATE 2 MG/ML IV SOLN $35.75 65219-445-01 ETOMIDATE 2 MG/ML IV SOLN $35.75 99999-044-32 HEPARIN (PORCINE) IN 5 % DEX 25,000 UNIT/250 ML(100 UNIT/ML) IV SOLP $35.75 70069-807-01 MILRINONE 1 MG/ML IV SOLN $35.75 70069-807-10 MILRINONE 1 MG/ML IV SOLN $35.75 0990-7983-03 NS IV AFTER MEDICATION INFUSION (TO FLUSH RESIDUAL MED) $35.75 16729-298-05 ONDANSETRON HCL 2 MG/ML IV SOLN $35.75 55150-120-30 PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR $35.75 0000-4124-00 POTASSIUM PHOSPHATE M-/D-BASIC 3 MMOL/ML IV SOLN $35.75 0990-6138-03 SODIUM CHLORIDE 0.9 % IRR SOLN $35.75 0264-7805-10 SODIUM CHLORIDE 3 % 3 % IV SOLP (BOLUS) - HYPONATREMIA (LBMC) $35.75 81284-611-10 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $35.75 81284-611-00 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $35.75 99999-043-88 ZONISAMIDE 10 MG/ML ORAL LIQUID (COMPOUND) $35.75 57896-131-01 DIBUCAINE 1 % TOPICAL OINT $35.67 0406-8390-62 MORPHINE 100 MG ORAL TBSR $35.58 63323-616-09 AMIODARONE 50 MG/ML IV SOLN $35.57 63323-616-02 AMIODARONE 50 MG/ML IV SOLN $35.57 63323-403-02 FOSPHENYTOIN 100 MG PE/2 ML INJ SOLN $35.56 63323-403-01 FOSPHENYTOIN 100 MG PE/2 ML INJ SOLN $35.56 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 72603-131-01 DOFETILIDE 250 MCG ORAL CAP $35.50 25021-115-06 CLINDAMYCIN PHOSPHATE 150 MG/ML INJ SOLN $35.49 6068783445 SODIUM CITRATE-CITRIC ACID 500-334 MG/5 ML ORAL SOLN $35.49 68382-520-01 SIROLIMUS 0.5 MG ORAL TAB $35.48 0430-0721-24 ESTRADIOL 1 MG ORAL TAB $35.43 99999-033-49 DOCETAXEL IV SOLN (FOR DESENSITIZATION USE) (MHS) $35.43 60687-328-31 SEVELAMER CARBONATE 800 MG ORAL TAB $35.43 60687-328-33 SEVELAMER CARBONATE 800 MG ORAL TAB $35.43 43547-544-01 GLYCOPYRROLATE (ROBINUL) INHALATION SOLN (0.2MG/ML) $35.36 43547-544-25 GLYCOPYRROLATE (ROBINUL) INHALATION SOLN (0.2MG/ML) $35.36 23155-294-31 PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN $35.36 23155-294-41 PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN $35.36 0172-6406-49 CROMOLYN 20 MG/2 ML INHALATION NEBU $35.35 0172-6406-05 CROMOLYN 20 MG/2 ML INHALATION NEBU $35.35 42571-350-08 CROMOLYN 20 MG/2 ML INHALATION NEBU $35.35 99999-037-69 ACETYLCYSTEINE 100 MG/ML (10 %) MISC SOLN $35.33 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 42023-146-25 DEXMEDETOMIDINE 100 MCG/ML INJ SOLN (FOR INTRANASAL USE) $35.23 70069-371-01 PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN $35.23 70069-371-25 PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN $35.23 99999-046-60 GENTAMICIN 2 MG/ML INJ SOLN IN D5W (MCH-NICU) $35.17 81964-207-51 AMOXICILLIN 400 MG/5 ML ORAL SUSR $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 71288-505-02 DEXMEDETOMIDINE 100 MCG/ML INJ SOLN (FOR INTRANASAL USE) $35.10 71288-505-03 DEXMEDETOMIDINE 100 MCG/ML INJ SOLN (FOR INTRANASAL USE) $35.10 99999-043-96 DEXMEDETOMIDINE IN 0.9 % NACL 200 MCG/50 ML (4 MCG/ML) IV SOLN $35.10 70069-012-25 GLYCOPYRROLATE (ROBINUL) INHALATION SOLN (0.2MG/ML) $35.10 70069-012-01 GLYCOPYRROLATE (ROBINUL) INHALATION SOLN (0.2MG/ML) $35.10 62332-627-02 GLYCOPYRROLATE (ROBINUL) INHALATION SOLN (0.2MG/ML) $35.10 62332-627-25 GLYCOPYRROLATE (ROBINUL) INHALATION SOLN (0.2MG/ML) $35.10 70860-501-82 MAGNESIUM SULFATE IN WATER 4 GRAM/100 ML (4 %) IV PGBK $35.10 70860-501-42 MAGNESIUM SULFATE IN WATER 4 GRAM/100 ML (4 %) IV PGBK $35.10 99999-039-11 NEOSTIGMINE METHYLSULFATE 1 MG/ML IV SOLN $35.10 99999-040-40 NEOSTIGMINE METHYLSULFATE 1 MG/ML IV SOLN $35.10 0409-8183-01 POTASSIUM ACETATE 2 MEQ/ML IV SOLN $35.10 0409-8183-11 POTASSIUM ACETATE 2 MEQ/ML IV SOLN $35.10 51754-2001-4 POTASSIUM ACETATE 2 MEQ/ML IV SOLN $35.10 65219-510-20 POTASSIUM ACETATE 2 MEQ/ML IV SOLN $35.10 65219-510-02 POTASSIUM ACETATE 2 MEQ/ML IV SOLN $35.10 23155-524-31 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $35.10 0472-0321-26 HYDROCORTISONE 1 % TOPICAL CREAM $35.07 81565-206-02 VECURONIUM BROMIDE 10 MG IV SOLR $35.07 81565-206-01 VECURONIUM BROMIDE 10 MG IV SOLR $35.07 0781-5438-20 CEFPODOXIME 100 MG ORAL TAB $35.04 16714-394-01 CEFPODOXIME 100 MG ORAL TAB $35.04 0904-6488-38 WHITE PETROLATUM-MINERAL OIL 83-15 % OPHT OINT $35.04 61570-110-01 RAMIPRIL 1.25 MG ORAL CAP $35.02 HC89004261 AMIKACIN - RANDOM-U2 $35.00 HC89006274 AMIKACIN PEAK OR TROUGH-U2 $35.00 HC89022164 ANTIBODY ACETYLCHOLINE RCPTR MODULTNG -AU $35.00 HC89023436 B. PERTUSSIS & PARAPERTUSSIS PCR-AU $35.00 HC89022057 BENZODIAZEPINES 1-12 SERUM QNTS(PNL)-AU $35.00 HC89011621 CHROMOGRANIN A-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 HC89003081 PRIMIDONE-U2 $35.00 HC51070779 PSY-BEHAVIOR TX GROUP ADDL 15 MIN $35.00 HC89024053 Q FEVER AB COXIELLA BURNETII PHASE TITER I-AU $35.00 HC89024061 Q FEVER AB COXIELLA BURNETII PHASE TITER II-AU $35.00 HC89018402 QUANTIFERON-TB GOLD-AU $35.00 HC89005813 TACROLIMUS-QD $35.00 63739-964-25 HEPARIN (PORCINE) 10,000 UNIT/ML INJ SOLN $34.94 63739-964-11 HEPARIN (PORCINE) 10,000 UNIT/ML INJ SOLN $34.94 0409-1560-29 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN $34.91 0409-1560-19 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN $34.91 63323-566-98 ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRG $34.91 63323-566-21 ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRG $34.91 25021-410-77 ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRG $34.91 71288-434-85 ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRG $34.91 71288-434-84 ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRG $34.91 0009-0039-32 METHYLPREDNISOLONE SOD SUC(PF) 40 MG/ML INJ SOLR $34.90 0009-0039-33 METHYLPREDNISOLONE SOD SUC(PF) 40 MG/ML INJ SOLR $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 0536-1408-94 POLYVINYL ALCOHOL 1.4 % OPHT DROP $34.81 0054-0407-13 RITONAVIR 100 MG ORAL TAB $34.67 72572-481-10 NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN $34.66 72572-481-01 NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN $34.66 HC89023030 RENIN-QN $34.63 0904-7103-10 EZETIMIBE 10 MG ORAL TAB $34.61 60505-2900-9 IMATINIB 100 MG ORAL TAB $34.60 0555-1054-56 ISOTRETINOIN 10 MG ORAL CAP $34.60 0527-1311-01 TERBUTALINE 5 MG ORAL TAB $34.56 62541-404-10 LIPASE-PROTEASE-AMYLASE 16,800-56,800- 98,400 UNIT ORAL CPDR $34.55 6210333304 ZINC OXIDE 16 % TOPICAL OINT $34.52 149003942 BISMUTH SUBSALICYLATE 262 MG/15 ML ORAL SUSP $34.52 99999-010-37 ENALAPRILAT 1.25 MG/ML INJ (MCH) $34.51 0143-9787-01 ENALAPRILAT 1.25 MG/ML INJ (MCH) $34.51 0143-9787-10 ENALAPRILAT 1.25 MG/ML IV SOLN $34.51 43598-078-58 ENALAPRILAT 1.25 MG/ML IV SOLN $34.51 43598-078-11 ENALAPRILAT 1.25 MG/ML IV SOLN $34.51 16714-825-01 PROPAFENONE 225 MG ORAL CP12 $34.47 HC89005870 FACTOR VIII VW MULTI-AU $34.45 72485-417-10 AMPICILLIN-SULBACTAM 3 GRAM INJ SOLR $34.45 72485-417-01 AMPICILLIN-SULBACTAM 3 GRAM INJ SOLR $34.45 99999-045-00 ASCORBIC ACID 500 MG IN NS 100 ML IVPB (SLH) $34.45 43066-090-25 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 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 61703-350-10 METHOTREXATE SODIUM 25 MG/ML INJ SOLN $34.40 0140-0005-01 DIAZEPAM 5 MG ORAL TAB $34.37 45013404 LOPERAMIDE 1 MG/7.5 ML ORAL LIQD $34.32 50580-134-04 LOPERAMIDE 1 MG/7.5 ML ORAL LIQD $34.32 68094-762-59 MIDAZOLAM 2 MG/ML ORAL SYRP (MHS WRAPPER) $34.26 72603-335-01 AMPICILLIN-SULBACTAM 3 G IV SOLR (MCH) $34.24 72603-335-10 AMPICILLIN-SULBACTAM 3 G IV SOLR (MCH) $34.24 1011902090 NAPHAZOLINE-PHENIRAMINE 0.02675-0.315 % OPHT DROP $34.22 HC89010987 C2 COMPLEMENT-AU $34.18 60505-6145-4 CEFEPIME 2 GRAM INJ SOLR $34.16 75834-170-01 ZINC OXIDE 20 % TOPICAL OINT $34.15 0990-6143-22 ACETIC ACID 0.25 % IRR SOLN $34.13 0990-7926-02 D5 %-0.45 % SODIUM CHLORIDE IV SOLP $34.13 0990-7922-02 D5W IV BOLUS $34.13 0990-7922-61 D5W IV BOLUS $34.13 0338-0062-30 D5W IV BOLUS $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 0990-7930-02 DEXTROSE 10 % IN WATER (D10W) 10 % IV SOLP $34.13 0409-3182-02 LIDOCAINE-EPINEPHRINE 2 %-1:100,000 INJ SOLN $34.13 0990-7983-02 NS IV AFTER MEDICATION INFUSION (TO FLUSH RESIDUAL MED) $34.13 0990-7983-61 NS IV AFTER MEDICATION INFUSION (TO FLUSH RESIDUAL MED) $34.13 0990-6138-22 SODIUM CHLORIDE 0.9 % IRR SOLN $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 HC89000202 INFLUENZA B SEROLOGY-QD $34.00 HC89024913 LIPOPROTEIN PARTICLE COUNT BY NMR-AU $34.00 HC89006423 LORAZEPAM; 1-12-AU $34.00 HC89010011 T4 FREE-ES $34.00 64896-664-01 CARBIDOPA-LEVODOPA 61.25-245 MG ORAL CPSR $33.94 0904-7130-61 CHLORPROMAZINE 25 MG ORAL TAB $33.85 0116-2001-16 CHLORHEXIDINE GLUCONATE 0.12 % MUCOUS MEMB MWSH $33.82 0536-1313-85 DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML ORAL SYRP $33.82 25021-127-20 CEFTAZIDIME 1 G INJ SOLR (MCH) $33.80 0409-6648-02 DEXTROSE 50 % IN WATER (D50W) IV SOLP $33.80 0409-6648-16 DEXTROSE 50 % IN WATER (D50W) IV SOLP $33.80 0143-9681-25 GLYCOPYRROLATE (ROBINUL) INHALATION SOLN (0.2MG/ML) $33.80 0143-9681-01 GLYCOPYRROLATE (ROBINUL) INHALATION SOLN (0.2MG/ML) $33.80 83634-500-41 MAGNESIUM SULFATE IN WATER 2 GRAM/50 ML (4 %) IV PGBK $33.80 83634-500-81 MAGNESIUM SULFATE IN WATER 2 GRAM/50 ML (4 %) IV PGBK $33.80 70860-501-81 MAGNESIUM SULFATE IN WATER 2 GRAM/50 ML (4 %) IV PGBK $33.80 70860-501-41 MAGNESIUM SULFATE IN WATER 2 GRAM/50 ML (4 %) IV PGBK $33.80 64980-513-05 TIMOLOL MALEATE 0.25 % OPHT DROP $33.80 0143-9387-25 TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP $33.80 0143-9387-01 TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP $33.80 25021-151-20 VANCOMYCIN 1,000 MG IV SOLR $33.80 HC89091870 CYTOGENOMIC SNP MICROARRAY FCC-AU $33.75 HC89024822 NEURONAL NUCLEAR AB(HU)IGG IB CSF-AU $33.75 HC89024830 NEURONAL NUCLEAR AB(RI)IGG IB CSF-AU $33.75 HC89024814 NEURONAL NUCLEAR AB(TR/DNER)IGG CSF-AU $33.75 HC89024848 NEURONAL NUCLEAR AB(YO)IGG IB CSF-AU $33.75 70677-1184-1 PYRETHRINS-PIPERONYL BUTOXIDE 0.33-4 % TOPICAL SHAM $33.75 0409-1560-10 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN $33.74 0409-1560-18 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN $33.74 46122-547-03 SIMETHICONE 40 MG/0.6 ML ORAL DRPS $33.74 5618412041 SIMETHICONE 40 MG/0.6 ML ORAL DRPS $33.74 0409-1890-13 MORPHINE 2 MG/ML INJ SOLN (MHS WRAPPER) $33.72 0409-1890-23 MORPHINE 2 MG/ML INJ SOLN (MHS WRAPPER) $33.72 16714-528-10 PROPOFOL 10 MG/ML IV EMUL $33.67 16714-528-01 PROPOFOL 10 MG/ML IV EMUL $33.67 61314-226-05 TIMOLOL MALEATE 0.25 % OPHT DROP $33.61 70677-1231-1 CLOTRIMAZOLE 2 % VAGINAL CREAM $33.58 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 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 99999-007-02 PIPERACILLIN-TAZOBACTAM 225 MG/ML IV SOLN DILUTION $33.48 0781-3113-95 PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR $33.48 0781-3113-90 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 16714-039-02 COLCHICINE 0.6 MG ORAL TAB $33.42 44567-802-10 PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR $33.41 0143-9250-10 ROCURONIUM 10 MG/ML IV SOLN $33.38 0143-9250-01 ROCURONIUM 10 MG/ML IV SOLN $33.38 HC89021984 LEVETIRACETAM (KEPPRA) -AU $33.30 HC89500490 BLOOD TYPE SEROLOGIC; ABO-SB $33.28 66993-472-02 NISOLDIPINE 8.5 MG ORAL TB24 $33.27 0025-2742-31 DISOPYRAMIDE PHOSPHATE 150 MG ORAL CPSR $33.18 0049-0520-22 PENICILLIN G POTASSIUM 5 MILLION UNIT INJ SOLR $33.17 0049-0520-23 PENICILLIN G POTASSIUM 5 MILLION UNIT INJ SOLR $33.17 0781-6041-55 AMOXICILLIN 250 MG/5 ML ORAL SUSR $33.15 0409-1559-19 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $33.15 0409-1559-30 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $33.15 5483800650 CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROP $33.15 51672-2002-1 CLOTRIMAZOLE 1 % TOPICAL CREAM $33.15 63323-013-09 THIAMINE HCL (VITAMIN B1) 100 MG/ML INJ SOLN $33.15 63323-013-26 THIAMINE HCL (VITAMIN B1) 100 MG/ML INJ SOLN $33.15 63323-013-21 THIAMINE HCL (VITAMIN B1) 100 MG/ML INJ SOLN $33.15 10147-0891-3 GALANTAMINE 8 MG ORAL C24P $33.07 HC89009757 PROINSULIN-AU $33.04 0409-2344-88 DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) IV SOLN $33.02 0409-2344-68 DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) IV SOLN $33.02 HC89017636 CADMIUM(PNL)-AU $33.00 HC51062446 CPSP ANTEPRTM HEALTH ED F/U ASSES/TX GROUP; EA 15MIN $33.00 HC51062438 CPSP ANTEPRTM HEALTH ED F/U ASSESS/TX INDIV'; EA 15MIN $33.00 HC51062321 CPSP ANTEPRTM NUTRITION F/U ASSESS,TX, INDIVIDUAL; EA 15MIN $33.00 HC51062370 CPSP ANTEPRTM PSYCHOSOCIAL F/U ASSESS/TX INDIV'; EA 15MIN $33.00 HC51062404 CPSP CLIENT ORIENTATION/HEALTH ED; EA 15MIN $33.00 HC51062420 CPSP INITIAL HEALTH ED ASSESS/DEV POC; EA SUBSQ' 15MIN $33.00 HC51062313 CPSP NUTRITION INIT' ASSESS AND DEV POC; EA ADD' 15MIN $33.00 HC51062461 CPSP PERINATAL ED, GROUP; EA 15MIN $33.00 HC51062453 CPSP PERINATAL ED, INDIV'; EA 15MIN $33.00 HC51062479 CPSP POSTPRTM HEALTH ED ASSESS, TX POC INDIV'; EA 15MIN $33.00 HC51062347 CPSP POSTPRTM NUTRITION ASSES,TX POC INDVIDUAL;EA 15MIN $33.00 HC51062396 CPSP POSTPRTM PSYCHOSOCIAL ASSESS, TX POC; INDIV'; EA 15MIN $33.00 HC51062362 CPSP PSYCHOSOCIAL INIR' ASSESS/DEV;EA SUBSQ 15MIN $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 HC83506097 TISSUE EXAM G&M LEVEL 4-PA $33.00 HC89016661 ULTRACENTRIFUG VAP(IN PNL)-AH $33.00 HC51062206 URINALYSIS MICROSCOPIC ONLY $33.00 HC89009823 VITAMIN B-2-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 63323-286-95 ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJ SOLN $32.96 121119000 SODIUM CITRATE-CITRIC ACID 500-334 MG/5 ML ORAL SOLN $32.96 121119030 SODIUM CITRATE-CITRIC ACID 500-334 MG/5 ML ORAL SOLN $32.96 25021-102-99 CEFAZOLIN 10 GRAM INJ SOLR $32.90 63323-365-01 OCTREOTIDE ACETATE 50 MCG/ML INJ SOLN $32.89 0409-6653-05 POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN $32.89 0409-6653-18 POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN $32.89 HC89007850 DEOXYCORTISOL 11-AU $32.88 68220-115-10 HYOSCYAMINE SULFATE 0.375 MG ORAL TB12 $32.83 60505-6146-0 CEFEPIME 1 GRAM INJ SOLR $32.83 60505-6146-4 CEFEPIME 1 GRAM INJ SOLR $32.79 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 6068783244 SODIUM CITRATE-CITRIC ACID 500-334 MG/5 ML ORAL SOLN $32.76 6068783216 SODIUM CITRATE-CITRIC ACID 500-334 MG/5 ML ORAL SOLN $32.76 81079888 BACITRACIN ZINC-POLYMYXIN B 500-10,000 UNIT/GRAM TOPICAL OINT $32.68 4203710478 CARBAMIDE PEROXIDE 6.5 % OTIC DROP $32.66 2390001252 OXYMETAZOLINE 0.05 % NASL SPRAY (MHS WRAPPER) $32.66 37000-803-01 OXYMETAZOLINE 0.05 % NASL SPRAY (MHS WRAPPER) $32.66 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 HC89021711 OPIATES, 1 OR MORE MEC(PNL)-AU $32.50 HC89021752 OXYCODONE MEC(PNL)-AU $32.50 0990-6143-09 ACETIC ACID 0.25 % IRR SOLN $32.50 70860-100-10 AZITHROMYCIN 500 MG IV SOLR $32.50 70860-100-41 AZITHROMYCIN 500 MG IV SOLR $32.50 99999-045-34 AZITHROMYCIN IN NS 500 MG/250 ML IV SOLN (MHS) $32.50 0487-9701-30 BUDESONIDE 0.5 MG/2 ML INHALATION NBSP $32.50 0143-9383-01 CEFEPIME 2 GRAM INJ SOLR $32.50 0143-9383-10 CEFEPIME 2 GRAM INJ SOLR $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 54879-021-01 CYCLOPHOSPHAMIDE 25 MG ORAL CAP $32.50 0990-7941-09 D5 % AND 0.9 % SODIUM CHLORIDE IV SOLP $32.50 0990-7926-09 D5 %-0.45 % SODIUM CHLORIDE IV SOLP $32.50 0990-7922-09 D5W IV BOLUS $32.50 0990-7930-09 DEXTROSE 10 % IN WATER (D10W) 10 % IV SOLP $32.50 0990-7929-09 DEXTROSE 5 %-LACTATED RINGERS IV SOLP $32.50 0990-7670-09 ELECTROLYTE-R (PH 7.4) IV SOLP $32.50 0264-7707-10 ELECTROLYTE-S (PH 7.4) IV SOLP $32.50 50268-295-15 ENTACAPONE 200 MG ORAL TAB $32.50 50268-295-11 ENTACAPONE 200 MG ORAL TAB $32.50 0143-9376-01 ETOPOSIDE 20 MG/ML INJ SOLN (FOR ORAL USE) (MCH) $32.50 50742-550-05 FENTANYL 25 MCG/HR TRANSDERMAL PT72 $32.50 50742-550-01 FENTANYL 25 MCG/HR TRANSDERMAL PT72 $32.50 0409-6102-27 FUROSEMIDE 10 MG/ML INJ SOLN $32.50 0409-6102-37 FUROSEMIDE 10 MG/ML INJ SOLN $32.50 61314-633-05 GENTAMICIN 0.3 % OPHT DROP $32.50 71288-414-02 GLYCOPYRROLATE (ROBINUL) INHALATION SOLN (0.2MG/ML) $32.50 71288-414-04 GLYCOPYRROLATE (ROBINUL) INHALATION SOLN (0.2MG/ML) $32.50 0338-0117-04 LACTATED RINGERS IV SOLP $32.50 36000-308-01 NALOXONE 0.4 MG/ML INJ (MHS WRAPPER) $32.50 36000-308-10 NALOXONE 0.4 MG/ML INJ (MHS WRAPPER) $32.50 57664-135-65 NIMODIPINE 30 MG ORAL CAP $32.50 43066-997-10 NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN $32.50 43066-997-01 NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN $32.50 0990-7983-09 NS IV AFTER MEDICATION INFUSION (TO FLUSH RESIDUAL MED) $32.50 76297-001-32 NS IV AFTER MEDICATION INFUSION (TO FLUSH RESIDUAL MED) $32.50 76297-001-31 NS IV AFTER MEDICATION INFUSION (TO FLUSH RESIDUAL MED) $32.50 72266-124-01 ONDANSETRON HCL 2 MG/ML IV SOLN $32.50 70095-024-02 PANTOPRAZOLE 40 MG IV SOLR $32.50 70095-024-01 PANTOPRAZOLE 40 MG IV SOLR $32.50 55150-202-00 PANTOPRAZOLE 40 MG IV SOLR $32.50 62756-129-44 PANTOPRAZOLE 40 MG IV SOLR $32.50 43598-172-15 PHENYLEPHRINE HCL 0.1 MG/ML IV SOLN $32.50 43598-172-05 PHENYLEPHRINE HCL 0.1 MG/ML IV SOLN $32.50 43598-172-25 PHENYLEPHRINE HCL 0.1 MG/ML IV SOLN $32.50 0990-6141-09 PHYSIOLOGICAL IRRIG SOLN NO.1 140-5-3-98 MEQ/L IRR SOLN $32.50 72485-403-01 PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR $32.50 72485-403-10 PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR $32.50 64679-056-01 PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR $32.50 64679-056-02 PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR $32.50 0264-7635-00 POTASSIUM CHLORID-D5-0.45%NACL 20 MEQ/L IV SOLP $32.50 54288-125-01 POTASSIUM CHLORIDE 20 MEQ ORAL PACK $32.50 54288-125-30 POTASSIUM CHLORIDE 20 MEQ ORAL PACK $32.50 0264-7865-00 POTASSIUM CHLORIDE IN 0.9%NACL 20 MEQ/L IV SOLP $32.50 0990-7077-14 POTASSIUM CHLORIDE IN WATER 20 MEQ/50 ML IV PGBK $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 0338-0048-04 SODIUM CHLORIDE 0.9 % IRR SOLN $32.50 0990-7138-09 SODIUM CHLORIDE 0.9 % IRR SOLN $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 71288-719-10 SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ SOLN $32.50 71288-719-11 SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ SOLN $32.50 70069-131-01 TOBRAMYCIN 0.3 % OPHT DROP $32.50 62559-391-50 VANCOMYCIN 250 MG ORAL CAP $32.50 71351-022-10 BUPIVACAINE-DEXTROSE-WATER(PF) 0.75 % (7.5 MG/ML) INJ SOLN $32.49 71351-022-02 BUPIVACAINE-DEXTROSE-WATER(PF) 0.75 % (7.5 MG/ML) INJ SOLN $32.49 50268-298-12 EZETIMIBE 10 MG ORAL TAB $32.48 50268-298-11 EZETIMIBE 10 MG ORAL TAB $32.48 21922-016-04 CLOBETASOL 0.05 % TOPICAL CREAM $32.47 21922-017-04 CLOBETASOL 0.05 % TOPICAL OINT $32.47 51672-1259-1 CLOBETASOL 0.05 % TOPICAL OINT $32.47 21922-031-04 NYSTATIN-TRIAMCINOLONE 100,000-0.1 UNIT/GRAM-% TOPICAL OINT $32.47 25021-701-01 KETOROLAC 30 MG/ML (1 ML) INJ SOLN $32.44 52536-180-03 ERYTHROMYCIN 250 MG ORAL TBEC $32.43 13668-586-30 ERYTHROMYCIN 250 MG ORAL TBEC $32.43 0409-9042-17 BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJ SOLN $32.37 0409-9042-16 BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJ SOLN $32.37 68084-651-95 CLARITHROMYCIN 500 MG ORAL TAB $32.37 68084-651-25 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 8770142972 ALUM-MAG HYDROXIDE-SIMETH 400-400-40 MG/5 ML ORAL SUSP $32.31 70677-1065-1 ALUM-MAG HYDROXIDE-SIMETH 400-400-40 MG/5 ML ORAL SUSP $32.31 99999-041-76 IVABRADINE 2.5 MG ORAL PARTIAL TAB $32.29 11523-4112-1 OXYMETAZOLINE 0.05 % NASL SPRY $32.27 0409-6635-18 POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN $32.27 0409-6635-01 POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN $32.27 0088-2102-24 RIFAPENTINE 150 MG ORAL TAB $32.27 0088-2102-01 RIFAPENTINE 150 MG ORAL TAB $32.27 45802-054-35 TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINT $32.27 58914-171-10 SUCRALFATE 1 GRAM ORAL TAB $32.23 30698-032-01 ISOCARBOXAZID 10 MG ORAL TAB $32.22 99999-046-56 ADENOSINE 5 MG IN NS 50 ML IC SOLN (100 MCG/ML) (OCM) $32.18 72603-179-01 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $32.18 72603-179-25 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $32.18 70069-421-01 LATANOPROST 0.005 % OPHT DROP $32.18 0904-6707-82 SEVELAMER CARBONATE 800 MG ORAL TAB $32.16 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 HC89006654 BROMIDES-AU $32.00 HC89016083 CARNITINE FREE & TOTAL-MA $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 HC89006928 TRAZODONE; 1-2-AU $32.00 68462-621-02 FOSPHENYTOIN 100 MG PE/2 ML INJ SOLN $31.99 68462-621-54 FOSPHENYTOIN 100 MG PE/2 ML INJ SOLN $31.99 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 99999-043-14 AMIKACIN 40 MG/5 ML INJ SOLN IN D5W (MCH-NICU) $31.85 0536-1211-95 DIBUCAINE 1 % TOPICAL OINT $31.85 44567-436-24 LEVOFLOXACIN IN D5W 500 MG/100 ML IV PGBK $31.85 58980-824-15 LIDOCAINE 4 % TOPICAL CREAM $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 62135-486-90 QUINAPRIL 20 MG ORAL TAB $31.85 99999-037-58 PHYTONADIONE 1 MG/0.5 ML INJ SOLN DILUTION (COMPOUNDED) $31.83 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 HC89024905 DEOXYCORTICOSTERONE 11 QNT HPLC-MS/MS-AU $31.75 42858-515-01 MORPHINE 15 MG ORAL TBSR $31.73 44567-840-01 CEFAZOLIN 2 GRAM IV SOLR $31.72 0143-9887-75 AMOXICILLIN 400 MG/5 ML ORAL SUSR $31.69 30768-02791 VITAMIN E TOPICAL OIL $31.69 99999-000-12 CHLORAMPHENICOL 1000 MG / 10 ML SYRINGE $31.62 17856-0312-2 POLYETHYLENE GLYCOL 3350 8.5 GRAM ORAL PWPK $31.60 17856-0312-5 POLYETHYLENE GLYCOL 3350 8.5 GRAM ORAL PWPK $31.60 0799-0001-04 MENTHOL-ZINC OXIDE 0.44-20.6 % TOPICAL OINT $31.58 67457-351-01 AMPICILLIN SODIUM 1 GRAM INJ SOLR $31.53 67457-351-10 AMPICILLIN SODIUM 1 GRAM INJ SOLR $31.53 62135-485-90 QUINAPRIL 10 MG ORAL TAB $31.53 67457-228-00 ROCURONIUM 10 MG/ML IV SOLN $31.53 67457-228-05 ROCURONIUM 10 MG/ML IV SOLN $31.53 HC89013437 FLUOXETINE; 1-2-AU $31.50 99999-036-45 BOSENTAN 15.625 MG ORAL PARTIAL TAB $31.50 55150-113-10 AMPICILLIN SODIUM 1 G IV SOLR (MCH) $31.49 7214003868 LANOLIN ALCOHOL-MO-W.PET-CERES TOPICAL CREAM $31.49 25021-674-20 ETOMIDATE 2 MG/ML IV SOLN $31.46 72266-147-10 ETOMIDATE 2 MG/ML IV SOLN $31.46 72266-147-01 ETOMIDATE 2 MG/ML IV SOLN $31.46 16864-680-01 BENZOCAINE-MENTHOL 20-0.5 % TOPICAL AEROSOL $31.43 7214063382 EMOLLIENT COMBINATION NO.117 TOPICAL CREAM $31.43 0409-4283-11 LIDOCAINE (PF) 40 MG/ML (4 %) INJ SOLN $31.43 0409-4283-01 LIDOCAINE (PF) 40 MG/ML (4 %) INJ SOLN $31.43 0409-4283-25 LIDOCAINE (PF) 40 MG/ML (4 %) INJ SOLN $31.43 HC89022503 CULTURE ID W/IMMUNOFLUOR' VZV(PNL)-AU $31.40 99999-046-97 KETAMINE 10 MG/ML INJ SOLN $31.36 0904-6269-08 ZIPRASIDONE HCL 20 MG ORAL CAP $31.36 63739-003-33 TEMAZEPAM 7.5 MG ORAL CAP $31.31 HC89018998 BORDETELLA PERTUS IMMUNOBLOT IGA-AU $31.30 54643-9023-9 MVI,PEDI NO.1,COMPONENT 2 OF 2 140-20-1 MCG/ML IV SOLN $31.26 10939-27444 ALOE VERA TOPICAL GEL $31.20 65862-071-75 AMOXICILLIN 400 MG/5 ML ORAL SUSR $31.20 0781-6157-57 AMOXICILLIN 400 MG/5 ML ORAL SUSR $31.20 99999-041-04 AMPHOTERICIN B 0.5 MG/ML TOPICAL SOLUTION (COMPOUNDED) $31.20 0409-1165-19 BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJ SOLN $31.20 0409-1165-02 BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJ SOLN $31.20 44567-131-10 CEFEPIME 2 GRAM INJ SOLR $31.20 99999-035-54 DOBUTAMINE IN D5W (CONC: 2000 MCG/ML) (LBM) $31.20 36000-324-02 LABETALOL 5 MG/ML IV SOLN $31.20 36000-324-01 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 62135-484-60 QUINAPRIL 5 MG ORAL TAB $31.20 66794-228-41 ROCURONIUM 10 MG/ML IV SOLN $31.20 66794-228-02 ROCURONIUM 10 MG/ML IV SOLN $31.20 99999-046-36 VANCOMYCIN 1500 MG IN NS 300 ML IVPB (SLH) $31.20 HC89007405 CARNITINE FREE & TOTAL-AU $31.19 0904-7120-04 COLCHICINE 0.6 MG ORAL TAB $31.19 16714-830-01 MESALAMINE 1.2 GRAM ORAL TBEC $31.17 68084-879-25 CYCLOSPORINE 25 MG ORAL CAP $31.14 68084-879-95 CYCLOSPORINE 25 MG ORAL CAP $31.14 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 HC51003408 URINALYSIS AUTO W/O MICRO $31.00 72603-363-01 AMPICILLIN SODIUM 1 G IV SOLR (MCH) $31.00 72603-363-10 AMPICILLIN SODIUM 1 G IV SOLR (MCH) $31.00 99999-046-81 CLINDAMYCIN 18 MG/ML INJ SYRINGE (MCWH) $30.88 67457-455-00 CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) INJ SOLN $30.88 63323-824-74 DEXTROSE 10 % IN WATER (D10W) 10 % IV SOLP $30.88 63323-824-24 DEXTROSE 10 % IN WATER (D10W) 10 % IV SOLP $30.88 0409-4275-01 LIDOCAINE HCL 5 MG/ML (0.5 %) INJ SOLN $30.88 44567-146-10 MEROPENEM 1 GRAM IV SOLR $30.88 44567-146-01 MEROPENEM 1 GRAM IV SOLR $30.88 0338-0048-02 SODIUM CHLORIDE 0.9 % IRR SOLN $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 0409-9157-50 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 99999-046-73 ACETYLCHOLINE 18.2 MCG/ML INJECTION $30.81 0904-6985-16 DIPHENHYDRAMINE HCL 12.5 MG/5 ML ORAL LIQ (MCH) $30.75 99999-041-14 VANCOMYCIN 50 MG/ML ORAL SOLR $30.71 0904-6821-04 TENOFOVIR DISOPROXIL FUMARATE 300 MG ORAL TAB $30.65 0121-1760-30 ALUMINUM-MAGNESIUM HYDROXIDE 200-200 MG/5 ML ORAL SUSP $30.62 70436-019-82 AZITHROMYCIN 500 MG IV SOLR $30.55 63323-851-03 HYDROMORPHONE (PF) 10 MG/ML INJ SOLN $30.55 63323-851-10 HYDROMORPHONE (PF) 10 MG/ML INJ SOLN $30.55 HC89008791 17 KETOSTEROIDS-AU $30.52 HC89006308 ALPRAZOLAM (BENZODZEPNS) 1-12-AU $30.52 HC89010227 ARGININE VASOPRESSIN HORMON-AU $30.52 16714-743-02 ITRACONAZOLE 100 MG ORAL CAP $30.47 HC89006720 FLECAINIDE-AU $30.43 121059515 SODIUM CITRATE-CITRIC ACID 500-334 MG/5 ML ORAL SOLN $30.42 0597-0040-37 TELMISARTAN 40 MG ORAL TAB $30.39 99999-036-51 CLONAZEPAM 0.1 MG/ML ORAL LIQUID (USING 1 MG TAB) $30.36 68094-063-59 MEGESTROL 40 MG/ML ORAL SUSPENSION (MHS WRAPPER) $30.36 68094-063-61 MEGESTROL 40 MG/ML ORAL SUSPENSION (MHS WRAPPER) $30.36 60505-6202-1 CYCLOSPORINE 0.05 % OPHT DPET $30.34 0121-2316-15 HYDROCODONE-ACETAMINOPHEN 7.5-325 MG/15 ML ORAL SOLN $30.32 51672-2075-2 BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINT $30.28 0006-0032-20 IVERMECTIN 3 MG ORAL TAB $30.25 HC89010920 PLATELET ASSOCIATED ABS-AU $30.24 55150-172-30 BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJ SOLN $30.23 0168-0006-15 TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINT $30.23 HC89009047 MYELIN BASIC PROTEIN CSF-AU $30.20 63304-191-30 DESVENLAFAXINE 50 MG ORAL TB24 $30.19 10135-738-01 RIFABUTIN 150 MG ORAL CAP $30.18 63323-010-02 GENTAMICIN 40 MG/ML INJ SOLN $30.16 63323-010-01 GENTAMICIN 40 MG/ML INJ SOLN $30.16 0024-5150-06 CAMPHOR-PHENOL 10.8-4.7 % TOPICAL SOLN $30.13 0078-0240-61 CYCLOSPORINE 25 MG ORAL CAP $30.10 23155-497-42 PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN $30.07 23155-497-31 PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN $30.07 0713-0351-09 PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN $30.07 0713-0351-02 PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN $30.07 0713-0351-25 PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN $30.07 0009-3073-23 METHYLPREDNISOLONE ACETATE 40 MG/ML INJ SUSP $30.03 HC89009682 17-HYDROXYPREGNENOLONE-AU $30.00 HC89024400 ACETYLCHOLINE RECEPTOR BLOC AB-AU $30.00 HC89009591 ALK PHOS ISO BONE SPECIFIC-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 HC51070712 PSYCH TEAM CONF PRTCPNT PER 15MIN $30.00 HC89006886 SIROLIMUS(RAPAMUNE)-AU $30.00 HC89001259 THYROXINE BIND GLOBULIN-QD $30.00 HC51000016 URINALYSIS NON-AUTO W/O MICRO $30.00 0378-2096-01 NISOLDIPINE 8.5 MG ORAL TB24 $29.94 50111-789-10 AZITHROMYCIN 600 MG ORAL TAB $29.93 0574-0791-01 METHAZOLAMIDE 50 MG ORAL TAB $29.90 0406-8390-23 MORPHINE 100 MG ORAL TBSR $29.90 99999-000-43 NAFCILLIN 40 MG / ML SYRINGE $29.90 72485-108-01 VERAPAMIL 2.5 MG/ML IV SOLN $29.90 72485-108-25 VERAPAMIL 2.5 MG/ML IV SOLN $29.90 72485-108-05 VERAPAMIL 2.5 MG/ML IV SOLN $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 72266-204-01 PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN $29.84 72266-204-10 PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN $29.84 7811273621 CARBAMIDE PEROXIDE 6.5 % OTIC DROP $29.74 0078-0240-15 CYCLOSPORINE 25 MG ORAL CAP $29.74 45802-434-11 CLOTRIMAZOLE 1 % TOPICAL CREAM $29.64 225052848 SODIUM CHLORIDE-ALOE VERA NASL SPRY $29.60 HC89025019 PREGNENOLONE 17-HYDROXY SER(PNL)-ES $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 0054-0812-21 PYRAZINAMIDE 500 MG ORAL TAB $29.56 72603-128-10 PANTOPRAZOLE 40 MG IV SOLR $29.55 72603-128-01 PANTOPRAZOLE 40 MG IV SOLR $29.55 16864-680-02 BENZOCAINE-MENTHOL 20-0.5 % TOPICAL AEROSOL $29.48 99999-045-46 LIDOCAINE-EPINEPHRINE 2%-1:200,000 BUFFERED WITH SODIUM BICARB 10:1 INJ (OCM) $29.38 45802-055-35 TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINT $29.35 70677-1186-2 GUAIFENESIN 100 MG/5 ML ORAL LIQD $29.27 0143-9335-10 BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJ SOLN $29.25 0143-9335-01 BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJ SOLN $29.25 44567-235-25 CEFTAZIDIME 1 G INJ SOLR (MCH) $29.25 60505-6149-4 CEFTRIAXONE 2 G INJ SOLR (MCH) $29.25 69238-1532-5 CLOBETASOL 0.05 % TOPICAL CREAM $29.25 69680-112-01 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG/ML INJ SOLN $29.25 0338-0085-03 D5 %-0.45 % SODIUM CHLORIDE IV SOLP $29.25 0338-0017-03 D5W IV BOLUS $29.25 0264-7520-10 DEXTROSE 10 % IN WATER (D10W) 10 % IV SOLP $29.25 0548-5601-00 ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRG $29.25 69374-511-01 KETAMINE 50 MG/ML INJ SOLN (MHS WRAPPER) $29.25 0338-0117-03 LACTATED RINGERS IV SOLP $29.25 0338-0117-02 LACTATED RINGERS IV SOLP $29.25 79672-613-30 NS IV AFTER MEDICATION INFUSION (TO FLUSH RESIDUAL MED) $29.25 79672-613-03 NS IV AFTER MEDICATION INFUSION (TO FLUSH RESIDUAL MED) $29.25 0641-6174-10 OCTREOTIDE ACETATE 50 MCG/ML INJ SOLN $29.25 0641-6174-01 OCTREOTIDE ACETATE 50 MCG/ML INJ SOLN $29.25 25021-451-01 OCTREOTIDE ACETATE 50 MCG/ML INJ SOLN $29.25 39822-4200-2 ROCURONIUM 10 MG/ML IV SOLN $29.25 39822-4200-1 ROCURONIUM 10 MG/ML IV SOLN $29.25 55111-653-01 SIROLIMUS 1 MG ORAL TAB $29.25 0338-0048-03 SODIUM CHLORIDE 0.9 % IRR SOLN $29.25 61787-062-04 DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML ORAL LIQD $29.15 6056906204 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 6961800858 MULTIVIT-MIN-FERROUS GLUCONATE 9 MG IRON/15 ML ORAL LIQD $29.15 63323-854-03 HYDROMORPHONE (PF) 4 MG/ML INJ SOLN $29.12 63323-854-10 HYDROMORPHONE (PF) 4 MG/ML INJ SOLN $29.12 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 HC89015838 ROCKY MT SPOTTED FEVER AB-QD $29.00 HC89001390 STRIATED MUSCLE FA AB SCRN-QD $29.00 HC89009666 PORPHYRINS FRACT URINE-AU $28.98 0409-1463-01 NALBUPHINE 10 MG/ML INJ SOLN $28.98 0409-1463-71 NALBUPHINE 10 MG/ML INJ SOLN $28.98 HC89017115 REPTILASE TIME 1:1 MIX-AU $28.94 0378-7155-01 BUDESONIDE 3 MG ORAL CECX $28.93 0591-2245-22 MESALAMINE 1.2 GRAM ORAL TBEC $28.90 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 7811201103 PHENOL 1.4 % MUCOUS MEMB SPRA $28.76 43975-252-14 TEMOZOLOMIDE 5 MG ORAL CAP (MCH) $28.74 HC89013155 CLOSTRIDIUM DIFFICILE TOXIN-AU $28.73 HC89009781 PYRUVATE-AU $28.73 99999-005-97 CARBAMAZEPINE 100 MG/5 ML ORAL SUSP $28.73 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 0409-1559-10 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $28.67 0409-1559-18 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $28.67 0093-2272-34 AMOXICILLIN-POT CLAVULANATE 400-57 MG ORAL CHEW $28.65 67457-153-00 AMIODARONE 50 MG/ML IV SOLN $28.61 67457-153-03 AMIODARONE 50 MG/ML IV SOLN $28.61 60846-805-01 LEVOTHYROXINE 100 MCG ORAL TAB $28.61 25021-107-20 CEFTRIAXONE 2 GRAM INJ 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 55150-194-10 ESMOLOL 100 MG/10 ML (10 MG/ML) IV SOLN $28.60 50742-549-01 FENTANYL 12 MCG/HR TRANSDERMAL PT72 $28.60 50742-549-05 FENTANYL 12 MCG/HR TRANSDERMAL PT72 $28.60 25021-184-67 FLUCONAZOLE IN NACL (ISO-OSM) 400 MG/200 ML IV PGBK $28.60 0264-4204-52 MAGNESIUM SULFATE IN WATER 2 GRAM/50 ML (4 %) IV PGBK $28.60 76297-001-21 SODIUM CHLORIDE 0.9 % IV SOLP $28.60 76297-001-22 SODIUM CHLORIDE 0.9 % IV SOLP $28.60 43066-008-10 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $28.60 43066-008-01 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $28.60 55150-235-10 VECURONIUM BROMIDE 10 MG IV SOLR $28.60 55150-235-01 VECURONIUM BROMIDE 10 MG IV SOLR $28.60 60505-4632-3 CYCLOSPORINE MODIFIED 100 MG ORAL CAP $28.58 0093-9020-65 CYCLOSPORINE MODIFIED 100 MG ORAL CAP $28.58 0093-9020-19 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 72572-450-01 NALOXONE 0.4 MG/ML INJ (MHS WRAPPER) $28.54 72572-450-25 NALOXONE 0.4 MG/ML INJ (MHS WRAPPER) $28.54 0536-1254-94 SODIUM CHLORIDE 5 % OPHT DROP $28.47 HC89024483 HSV 1 DFA-AU $28.41 HC89024491 HSV 2 DFA-AU $28.41 HC89010995 C5 COMPLEMENT-AU $28.38 44567-311-10 PENICILLIN G POTASSIUM 5 MILLION UNIT INJ SOLR $28.34 0069-5800-61 DOFETILIDE 125 MCG ORAL CAP $28.31 59762-1001-1 SIROLIMUS 0.5 MG ORAL TAB $28.31 HC89008403 HISTAMINE, WHOLE BLOOD-AU $28.30 HC89023766 INHIBIN A-AU $28.30 0527-1318-01 TERBUTALINE 2.5 MG ORAL TAB $28.30 1990301021 SIMETHICONE 40 MG/0.6 ML ORAL DRPS $28.28 69918-301-30 TRANEXAMIC ACID 650 MG ORAL TAB $28.24 51672-1284-1 TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINT $28.18 33342-333-15 TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINT $28.18 HC51062834 PHONE CALL BY NONPHYSICIAN HC PROF 5-10MIN $28.12 63323-852-03 HYDROMORPHONE (PF) 1 MG/ML INJ SOLN $28.08 63323-852-25 HYDROMORPHONE (PF) 1 MG/ML INJ SOLN $28.08 63323-853-03 HYDROMORPHONE (PF) 2 MG/ML INJ SOLN $28.08 63323-853-25 HYDROMORPHONE (PF) 2 MG/ML INJ SOLN $28.08 51672-2001-2 MICONAZOLE NITRATE 2 % TOPICAL CREAM $28.08 0409-6010-02 PROPOFOL 10 MG/ML IV EMUL $28.08 0409-6010-25 PROPOFOL 10 MG/ML IV EMUL $28.08 5026818330 SODIUM CITRATE-CITRIC ACID 500-334 MG/5 ML ORAL SOLN $28.08 5026818311 SODIUM CITRATE-CITRIC ACID 500-334 MG/5 ML ORAL SOLN $28.08 0025-2732-31 DISOPYRAMIDE PHOSPHATE 100 MG ORAL CPSR $28.07 81073088 NEOMYCIN-BACITRACNZN-POLYMYXNB 3.5MG-400 UNIT- 5,000 UNIT/GRAM TOPICAL OINT $28.06 11868-814-01 PRAMOXINE-ZINC OXIDE 1-5 % TOPICAL CREAM $28.03 HC51062131 AMINES VAGINAL FLUID QUAL $28.00 HC89007421 CATECHOLAMINES FRACT-AU $28.00 HC89017065 CHLAMYDIA FA ANTIGEN-AU $28.00 HC51061976 COLLECT INTERP PHYSIOLOGIC DATA PT TRANSMIT $28.00 HC89000525 COXSACKIE A AB-SL $28.00 HC51062297 CPSP DEPRESSION SCREENING IND NEG $28.00 HC89024459 ESTRADIOL ULTRASENS LC/MS-AU $28.00 HC89023733 FENTANYL &METABOLITE QUANT URINE-AU $28.00 HC89019558 GLIAD PEPTD AB IGA(PNL1155/6360)-PR $28.00 HC89019566 GLIAD PEPTD AB IGG(PNL1155/6360)-PR $28.00 HC51061968 GROUP HEALTH EDUCATION $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 HC51062123 SMEAR WET MOUNT INFECT AGENT $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 69618-067-82 MENTHOL-ZINC OXIDE 0.44-20.6 % TOPICAL OINT $27.91 60687-750-11 TRANEXAMIC ACID 650 MG ORAL TAB $27.91 60687-750-21 TRANEXAMIC ACID 650 MG ORAL TAB $27.91 0032-0047-70 LIPASE-PROTEASE-AMYLASE 12,000-38,000 -60,000 UNIT ORAL CPDR $27.89 60687-758-21 LURASIDONE 40 MG ORAL TAB $27.80 60687-758-11 LURASIDONE 40 MG ORAL TAB $27.80 99999-036-62 ERYTHROMYCIN 125 MG ORAL PARTIAL TABLET (MCH) $27.74 HC89008650 TRYPSIN-AU $27.73 0009-0902-18 CLINDAMYCIN PHOSPHATE 150 MG/ML INJ SOLN $27.73 0009-0902-11 CLINDAMYCIN PHOSPHATE 150 MG/ML INJ SOLN $27.73 0409-5082-16 CEFTAZIDIME 1 G INJ SOLR (MCH) $27.72 0409-5082-11 CEFTAZIDIME 1 G INJ SOLR (MCH) $27.72 99999-000-07 CEFTAZIDIME 1000 MG / 10 ML SYRINGE $27.72 0904-7727-14 ALUMINUM HYDROX-MAGNESIUM CARB 95-358 MG/15 ML ORAL SUSP $27.69 70677-1066-1 ALUM-MAG HYDROXIDE-SIMETH 200-200-20 MG/5 ML ORAL SUSP $27.69 60687-769-11 LURASIDONE 60 MG ORAL TAB $27.68 57896-980-16 DIPHENHYDRAMINE HCL 12.5 MG/5 ML ORAL LIQD $27.67 0536-1314-85 GUAIFENESIN 100 MG/5 ML ORAL LIQD $27.67 57896-758-16 SORBITOL 70 % MISC SOLN $27.67 65219-572-10 BUMETANIDE 0.25 MG/ML INJ SOLN $27.63 65219-572-01 BUMETANIDE 0.25 MG/ML INJ SOLN $27.63 0338-0017-02 D5W IV BOLUS $27.63 0264-7520-20 DEXTROSE 10 % IN WATER (D10W) 10 % IV SOLP $27.63 71288-405-80 HEPARIN, PORCINE (PF) 5,000 UNIT/0.5 ML INJ SOLN (MHS WRAPPER) $27.63 71288-405-81 HEPARIN, PORCINE (PF) 5,000 UNIT/0.5 ML INJ SOLN (MHS WRAPPER) $27.63 0409-2220-01 LEVOFLOXACIN IN D5W 250 MG/50 ML IV PGBK $27.63 0409-2220-24 LEVOFLOXACIN IN D5W 250 MG/50 ML IV PGBK $27.63 0338-0049-02 NS IV AFTER MEDICATION INFUSION (TO FLUSH RESIDUAL MED) $27.63 0395-0420-96 PRAMOXINE-CALAMINE 1-8 % TOPICAL LOTN $27.61 67877-251-15 TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM $27.59 0409-3365-11 HYDROMORPHONE 2 MG/ML INJ SOLN $27.53 0409-3365-10 HYDROMORPHONE 2 MG/ML INJ SOLN $27.53 HC89023378 ANTIBODY SARS-COV-2 COVID-19 QUAL CIA-AU $27.50 16729-277-30 METHOTREXATE 25 MG/ML INJECTION (ECTOPIC PREGNANCY) $27.50 36000-320-10 LABETALOL 5 MG/ML IV SOLN $27.43 36000-320-01 LABETALOL 5 MG/ML IV SOLN $27.43 72603-474-25 FUROSEMIDE 10 MG/ML INJ SOLN $27.37 72603-474-01 FUROSEMIDE 10 MG/ML INJ SOLN $27.37 50268-772-13 TRANEXAMIC ACID 650 MG ORAL TAB $27.35 50268-772-11 TRANEXAMIC ACID 650 MG ORAL TAB $27.35 73562-110-01 LIPASE-PROTEASE-AMYLASE 10,000-32,000 -42,000 UNIT ORAL CPDR $27.35 0641-6116-10 AMPICILLIN-SULBACTAM 1.5 GRAM INJ SOLR $27.30 0641-6116-01 AMPICILLIN-SULBACTAM 1.5 GRAM INJ SOLR $27.30 60505-6202-2 CYCLOSPORINE 0.05 % OPHT DPET $27.30 5483801150 FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROP $27.30 25021-132-81 LEVOFLOXACIN IN D5W 250 MG/50 ML IV PGBK $27.30 0409-4277-17 LIDOCAINE HCL 20 MG/ML (2 %) INJ SOLN $27.30 0409-4277-02 LIDOCAINE HCL 20 MG/ML (2 %) INJ SOLN $27.30 71288-200-11 MILRINONE 1 MG/ML IV SOLN $27.30 71288-200-10 MILRINONE 1 MG/ML IV SOLN $27.30 99999-045-40 PENTOXIFYLLINE 20 MG/ML ORAL LIQUID (COMPOUND) $27.30 1254749380 TETRAHYDROZOLINE 0.05 % OPHT DROP $27.30 99999-040-98 MORPHINE (PF) 1 MG/ML INJ SOLN $27.27 62135-350-30 ONDANSETRON HCL 4 MG ORAL TAB $27.21 HC89005961 DRUGS OF ABUSE TEST-DTI 7A-AU $27.20 0409-6102-19 FUROSEMIDE 10 MG/ML INJ SOLN $27.18 0409-6102-02 FUROSEMIDE 10 MG/ML INJ SOLN $27.18 65197-402-00 DIMETHICONE-ZNOX-VIT A-D-ALOE 1-10 % TOPICAL CREAM $27.18 58232-071-93 ZINC OXIDE 13 % TOPICAL CREAM $27.18 0121-0945-10 MEGESTROL 40 MG/ML ORAL SUSPENSION (MHS WRAPPER) $27.17 0121-0945-00 MEGESTROL 400 MG/10 ML (10 ML) ORAL SUSP $27.17 62756-277-01 ARFORMOTEROL 15 MCG/2 ML INHALATION NEBU $27.11 63323-965-05 POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN $27.11 63323-965-01 POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN $27.11 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 0527-2133-35 POSACONAZOLE 100 MG ORAL TBEC $27.09 31722-832-60 VALGANCICLOVIR 450 MG ORAL TAB $27.09 0121-0489-05 DIPHENHYDRAMINE HCL 12.5 MG/5 ML ORAL ELIX $27.07 0121-0489-00 DIPHENHYDRAMINE HCL 12.5 MG/5 ML ORAL ELIX $27.07 63323-262-06 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $27.04 63323-262-03 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $27.04 HC89015903 ANAEROBIC SUSCEPTIBILITY-QD $27.00 HC89002570 ANTI-DNA ANTIBODIES (DS)-QD $27.00 HC89015705 ANTI-DNA ANTIBODIES (SS)-QD $27.00 HC89025043 CORTISOL SER(PNL)-ES $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 HC89003370 ENCEPHALITIS ST LOUIS AB-QD $27.00 HC89024202 FT4 BY ED/TMS-AU $27.00 HC51000495 HEMOGLOBIN (POS - EG:HEMACUE) $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 HC89002950 SMOOTH MUSCLE FA AB SCRN-QD $27.00 HC89000590 SOMATOMEDIN-QD $27.00 HC83500033 STONE ANALYSIS-AU $27.00 99999-047-43 GENTAMICIN 4 MG/ML INJECTION SYRINGE (MCH) $26.98 0338-0511-41 GENTAMICIN IN NACL (ISO-OSM) 100 MG/50 ML IV PGBK $26.98 76045-009-96 HYDROMORPHONE (PF) 0.5 MG/0.5 ML INJ SYRG $26.98 76045-009-06 HYDROMORPHONE (PF) 0.5 MG/0.5 ML INJ SYRG $26.98 76045-009-01 HYDROMORPHONE (PF) 1 MG/ML INJ SYRG $26.98 76045-009-11 HYDROMORPHONE (PF) 1 MG/ML INJ SYRG $26.98 76045-010-01 HYDROMORPHONE (PF) 2 MG/ML INJ SYRG $26.98 76045-010-11 HYDROMORPHONE (PF) 2 MG/ML INJ SYRG $26.98 42799-806-01 IVERMECTIN 3 MG ORAL TAB $26.92 67457-385-99 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $26.91 67457-385-10 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $26.91 50268-797-15 URSODIOL 300 MG ORAL CAP $26.88 50268-797-11 URSODIOL 300 MG ORAL CAP $26.88 0409-1316-11 HEPARIN, PORCINE (PF) 5,000 UNIT/0.5 ML INJ SOLN (MHS WRAPPER) $26.87 0409-1316-32 HEPARIN, PORCINE (PF) 5,000 UNIT/0.5 ML INJ SOLN (MHS WRAPPER) $26.87 0121-0978-00 DIPHENHYDRAMINE HCL 12.5 MG/5 ML ORAL ELIX $26.85 0121-0978-10 DIPHENHYDRAMINE HCL 12.5 MG/5 ML ORAL ELIX $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 99999-047-13 HYDROCODONE-ACETAMINOPHEN 7.5-325 MG/15 ML ORAL SOLN $26.78 60687-837-56 METOCLOPRAMIDE HCL 5 MG/5 ML ORAL SOLN $26.78 60687-837-42 METOCLOPRAMIDE HCL 5 MG/5 ML ORAL SOLN $26.78 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 70677-1039-1 OXYMETAZOLINE 0.05 % NASL MIST $26.72 82260-001-01 ATROPINE SULFATE (PF) 1 % OPHT DPET $26.69 HC89022651 PROGESTERONE-QN $26.66 0121-1550-10 CODEINE-GUAIFENESIN 10-100 MG/5 ML ORAL LIQD $26.65 0121-1550-40 CODEINE-GUAIFENESIN 10-100 MG/5 ML ORAL LIQD $26.65 0338-0705-48 POTASSIUM CHLORIDE IN WATER 20 MEQ/100 ML IV PGBK $26.65 0338-0703-48 POTASSIUM CHLORIDE IN WATER 40 MEQ/100 ML IV PGBK $26.65 23155-166-41 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $26.65 23155-166-31 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $26.65 60687-417-50 HYDROCODONE-ACETAMINOPHEN 7.5-325 MG/15 ML ORAL SOLN $26.62 60687-417-44 HYDROCODONE-ACETAMINOPHEN 7.5-325 MG/15 ML ORAL SOLN $26.62 72572-573-10 PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR $26.59 72572-573-01 PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR $26.59 45802-626-26 CETIRIZINE 1 MG/ML ORAL SOLN $26.52 1170100216 VITAMIN A AND D TOPICAL CREAM $26.52 99999-005-69 PHENOBARBITAL 10 MG/ML INJ SOLN DILUTION (MCH) $26.35 51672-2003-6 CLOTRIMAZOLE 1 % VAGINAL CREAM $26.33 0121-1576-10 METOCLOPRAMIDE 5 MG/5 ML ORAL SOLN (MCH) $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 HC89020994 ECHOVIRUS AB TYPE 11-AU $26.30 HC89021000 ECHOVIRUS AB TYPE 30-AU $26.30 HC89020960 ECHOVIRUS AB TYPE 6-AU $26.30 HC89020978 ECHOVIRUS AB TYPE 7-AU $26.30 HC89020986 ECHOVIRUS AB TYPE 9-AU $26.30 55150-255-20 LIDOCAINE HCL 20 MG/ML (2 %) INJ SOLN $26.26 25021-115-04 CLINDAMYCIN PHOSPHATE 150 MG/ML INJ SOLN $26.23 HC89006530 LIDOCAINE-AU $26.15 65628-063-01 PROGESTERONE 200 MG VAGINAL SUPP $26.14 0395-0515-92 CASTOR OIL 100 % ORAL OIL $26.08 70752-104-06 CETIRIZINE 1 MG/ML ORAL SOLN $26.08 0409-5820-01 DOPAMINE 200 MG/5 ML (40 MG/ML) IV SOLN $26.03 0409-5820-11 DOPAMINE 200 MG/5 ML (40 MG/ML) IV SOLN $26.03 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 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 25021-136-10 AMPICILLIN SODIUM 1 G IV SOLR (MCH) $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 0264-7510-00 D5W IV BOLUS $26.00 67457-420-10 DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJ SOLN $26.00 67457-420-00 DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJ SOLN $26.00 0264-7510-10 DEXTROSE 5 % IN WATER (D5W) IV SOLP $26.00 0143-9311-10 ETOMIDATE 2 MG/ML IV SOLN $26.00 0143-9311-01 ETOMIDATE 2 MG/ML IV SOLN $26.00 25021-184-66 FLUCONAZOLE IN NACL (ISO-OSM) 200 MG/100 ML IV PGBK $26.00 0338-0503-48 GENTAMICIN IN NACL (ISO-OSM) 80 MG/100 ML IV PGBK $26.00 71839-124-01 GLYCOPYRROLATE (ROBINUL) INHALATION SOLN (0.2MG/ML) $26.00 71839-124-25 GLYCOPYRROLATE (ROBINUL) INHALATION SOLN (0.2MG/ML) $26.00 76045-737-10 HALOPERIDOL LACTATE 5 MG/ML IM SYRG $26.00 76045-737-01 HALOPERIDOL LACTATE 5 MG/ML IM SYRG $26.00 71839-118-01 HEPARIN, PORCINE (PF) 5,000 UNIT/0.5 ML INJ SOLN $26.00 71839-118-25 HEPARIN, PORCINE (PF) 5,000 UNIT/0.5 ML INJ 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 99999-036-88 MAGNESIUM SULFATE IN WATER 2 GRAM/50 ML (4 %) IV PGBK $26.00 0406-0127-01 METHYLPHENIDATE HCL 27 MG ORAL TR24 $26.00 0143-9373-01 MILRINONE 1 MG/ML IV SOLN $26.00 25021-611-10 NEOSTIGMINE METHYLSULFATE 1 MG/ML INJ SOLN (MCH) $26.00 99999-047-59 NICARDIPINE 5 MG IN NS 50 ML IC SOLN (SLH) $26.00 0338-0049-03 NS IV AFTER MEDICATION INFUSION (TO FLUSH RESIDUAL MED) $26.00 65219-472-20 NS IV AFTER MEDICATION INFUSION (TO FLUSH RESIDUAL MED) $26.00 65219-472-05 NS IV AFTER MEDICATION INFUSION (TO FLUSH RESIDUAL MED) $26.00 65219-224-01 NS IV AFTER MEDICATION INFUSION (TO FLUSH RESIDUAL MED) $26.00 65219-224-50 NS IV AFTER MEDICATION INFUSION (TO FLUSH RESIDUAL MED) $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 71288-700-06 ROCURONIUM 10 MG/ML IV SOLN $26.00 71288-700-05 ROCURONIUM 10 MG/ML IV SOLN $26.00 68462-682-01 SIROLIMUS 0.5 MG ORAL TAB $26.00 0264-7802-00 SODIUM CHLORIDE 0.45 % 0.45 % IV SOLP $26.00 0264-7802-10 SODIUM CHLORIDE 0.45 % 0.45 % IV SOLP $26.00 63323-530-21 SODIUM CHLORIDE 3 % 3 % IV SOLP (BOLUS) - HYPONATREMIA (LBMC) $26.00 63323-530-75 SODIUM CHLORIDE 3 % 3 % IV SOLP (BOLUS) - HYPONATREMIA (LBMC) $26.00 0143-9746-10 TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLN $26.00 0143-9746-01 TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLN $26.00 99999-046-35 VANCOMYCIN 1250 MG IN NS 250 ML IVPB (SLH) $26.00 0143-9161-25 VANCOMYCIN 500 MG IV SOLR $26.00 0143-9161-01 VANCOMYCIN 500 MG IV SOLR $26.00 0143-9161-10 VANCOMYCIN 500 MG IV SOLR $26.00 0378-8020-77 FLUVASTATIN 20 MG ORAL CAP $25.99 0093-7442-56 FLUVASTATIN 20 MG ORAL CAP $25.98 0093-7442-01 FLUVASTATIN 20 MG ORAL CAP $25.98 57896-116-03 METHYL SALICYLATE-MENTHOL 15-10 % TOPICAL CREAM $25.97 99999-047-50 ACETYLCYSTEINE 200 MG/ML (20 %) ORAL SOLUTION $25.96 0009-3073-22 METHYLPREDNISOLONE ACETATE 40 MG/ML INJ SUSP $25.94 5002443100 OXYMETAZOLINE 0.05 % NASL SPRAY (MHS WRAPPER) $25.94 0409-9558-50 ROCURONIUM 10 MG/ML IV SOLN $25.94 0409-9558-70 ROCURONIUM 10 MG/ML IV SOLN $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 0409-4277-01 LIDOCAINE HCL 20 MG/ML (2 %) INJ SOLN $25.87 0409-4277-16 LIDOCAINE HCL 20 MG/ML (2 %) INJ SOLN $25.87 8137003658 HYDROCORTISONE-OATMEAL-ALOE-E 1 % TOPICAL CREAM $25.84 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 0409-9045-17 BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJ SOLN $25.74 0409-9045-16 BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJ SOLN $25.74 51672-4070-8 CETIRIZINE 1 MG/ML ORAL SOLN $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 0409-0125-01 LABETALOL 5 MG/ML IV SOLN $25.74 0409-0125-25 LABETALOL 5 MG/ML IV SOLN $25.74 63323-482-17 LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN $25.74 63323-482-01 LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ 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 67457-349-10 AMPICILLIN-SULBACTAM 3 G IV SOLR (MCH) $25.71 67457-349-03 AMPICILLIN-SULBACTAM 3 G IV SOLR (MCH) $25.71 71399-0122-4 VITS A AND D-WHITE PET-LANOLIN TOPICAL OINT $25.71 99999-001-59 ACETYLCYSTEINE 20 % (200 MG/ML) ORAL SOLN $25.69 72485-501-10 MILRINONE 1 MG/ML IV SOLN $25.68 72485-501-01 MILRINONE 1 MG/ML IV SOLN $25.68 58980-011-10 BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINT $25.62 HC89025076 PROGESTERONE SER(PNL)-ES $25.60 63323-473-02 BUPIVACAINE-DEXTROSE-WATER(PF) 0.75 % (7.5 MG/ML) INJ SOLN $25.57 60687-755-40 DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLN $25.55 60687-755-86 DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLN $25.55 63323-492-09 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $25.55 63323-492-57 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $25.55 63323-967-30 POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN $25.55 63323-967-01 POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN $25.55 99999-037-45 NALBUPHINE 10 MG/ML INJ SOLN $25.50 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 57896-619-12 ALUM-MAG HYDROXIDE-SIMETH 400-400-40 MG/5 ML ORAL SUSP $25.38 0799-0001-02 MENTHOL-ZINC OXIDE 0.44-20.6 % TOPICAL OINT $25.38 4687600030 MENTHOL-ZINC OXIDE 0.44-20.6 % TOPICAL OINT $25.38 4687600025 MENTHOL-ZINC OXIDE 0.44-20.6 % TOPICAL OINT $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 63323-346-10 CEFTRIAXONE 1 GRAM INJ SOLR $25.35 25021-319-10 DILTIAZEM HCL 5 MG/ML IV SOLN $25.35 99999-001-63 FENTANYL 2 MCG/ML - BUPIVACAINE 0.125% IN NS 100 ML EPIDURAL PCA (SLH) $25.35 81665-108-30 ISONIAZID 300 MG ORAL TAB $25.35 23155-688-31 OCTREOTIDE ACETATE 100 MCG/ML INJ SOLN $25.35 23155-688-41 OCTREOTIDE ACETATE 100 MCG/ML INJ SOLN $25.35 0338-0709-48 POTASSIUM CHLORIDE IN WATER 10 MEQ/100 ML IV PGBK $25.35 51079-925-20 DILTIAZEM HCL 90 MG ORAL CP12 $25.31 51079-925-01 DILTIAZEM HCL 90 MG ORAL CP12 $25.31 63323-368-20 AMPICILLIN-SULBACTAM 1.5 GRAM INJ SOLR $25.29 0409-1886-02 LEVETIRACETAM 500 MG/5 ML IV SOLN $25.29 0409-1886-22 LEVETIRACETAM 500 MG/5 ML IV SOLN $25.29 0480-3631-98 PITAVASTATIN CALCIUM 1 MG ORAL TAB $25.27 0225-0810-47 PHENYLEPHRINE HCL 1 % NASL SPRY $25.25 0310-0275-10 QUETIAPINE 25 MG ORAL TAB $25.25 0093-7290-01 RALOXIFENE 60 MG ORAL TAB $25.21 6373637882 BENZOCAINE 20 % TOPICAL AEROSOL $25.19 7430000300 ZINC OXIDE 13 % TOPICAL CREAM $25.19 63323-540-13 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $25.16 63323-540-03 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $25.16 52244-100-10 THEOPHYLLINE 100 MG ORAL CP24 $25.15 0093-7290-56 RALOXIFENE 60 MG ORAL TAB $25.14 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 55150-249-50 BUPIVACAINE HCL 0.25 % (2.5 MG/ML) INJ SOLN $25.03 72572-265-01 HYDRALAZINE 20 MG/ML INJ SOLN $25.03 72572-265-25 HYDRALAZINE 20 MG/ML INJ SOLN $25.03 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 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 HC89024434 CULTURE HSV-AU $25.00 HC89003461 EBV AB-VIRAL CAPSID AG-QD $25.00 HC89002141 ERYTHROPOIETIN-QD $25.00 HC89008007 ESTRONE-AU $25.00 HC89023824 GABAPENTIN NON-BLOOD-AU $25.00 HC51001600 HANDLING & SENDOUT TO REF' LAB $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 HC51062164 KOH TISSUE EXAM $25.00 HC45401627 MR SAFETY IMPLANT/FB ASSESS, CLINICAL STFF, ID, VERIFY, IMAGES; EA ADD'L 30MIN+ $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 HC89023261 TOTAL PROTEIN URINE (IFE)-AU $25.00 HC89002018 VASOACTIVE INTEST PEPTIDE-QD $25.00 HC89001622 VITAMIN B1 THIAMINE-QD $25.00 904598426 AMMONIUM LACTATE 12 % TOPICAL LOTN $24.97 63323-486-27 LIDOCAINE HCL 20 MG/ML (2 %) INJ SOLN $24.96 63323-486-02 LIDOCAINE HCL 20 MG/ML (2 %) INJ SOLN $24.96 0378-8760-58 CYCLOSPORINE 0.05 % OPHT DPET $24.92 0378-8760-98 CYCLOSPORINE 0.05 % OPHT DPET $24.92 62584-693-21 DOXYCYCLINE HYCLATE 100 MG ORAL TAB $24.92 62584-693-11 DOXYCYCLINE HYCLATE 100 MG ORAL TAB $24.92 68094-750-59 DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLN $24.90 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 299391742 GLYCERIN-DIMETHICONE-PETRO, WH TOPICAL CREAM $24.86 299391753 GLYCERIN-DIMETHICONE-PETRO, WH TOPICAL CREAM $24.86 25021-415-10 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $24.83 0409-9045-01 BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJ SOLN $24.77 0074-7362-03 CARBAMIDE PEROXIDE 6.5 % OTIC DROP $24.77 0409-6651-19 POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN $24.77 0409-6651-06 POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN $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 0990-7923-13 DEXTROSE 5 % IN WATER (D5W) IV SOLP $24.70 0990-7923-23 DEXTROSE 5 % IN WATER (D5W) IV SOLP $24.70 51754-6000-4 GLYCOPYRROLATE (PF) 0.2 MG/ML INJ SOLN $24.70 51754-6000-1 GLYCOPYRROLATE (PF) 0.2 MG/ML INJ SOLN $24.70 44567-421-24 MAGNESIUM SULFATE 4 GRAM/100 ML IV PGBK (SLH) $24.70 44567-421-00 MAGNESIUM SULFATE IN WATER 4 GRAM/100 ML (4 %) IV PGBK $24.70 0990-7984-13 NS IV AFTER MEDICATION INFUSION (TO FLUSH RESIDUAL MED) $24.70 0990-7984-23 NS IV AFTER MEDICATION INFUSION (TO FLUSH RESIDUAL MED) $24.70 0338-0703-41 POTASSIUM CHLORIDE IN WATER 20 MEQ/50 ML IV PGBK $24.70 81284-612-00 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $24.70 81284-612-10 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $24.70 1254717167 DIPHENHYDRAMINE-ZINC ACETATE 2-0.1 % TOPICAL CREAM $24.65 HC89011787 TEICHOIC ACID AB (ID)-AU $24.60 57896-693-16 GUAIFENESIN 100 MG/5 ML ORAL LIQD $24.60 47335-007-88 ENTACAPONE 200 MG ORAL TAB $24.59 0121-1762-30 ALUM-MAG HYDROXIDE-SIMETH 400-400-40 MG/5 ML ORAL SUSP $24.57 72572-415-10 MEROPENEM 500 MG IV SOLR $24.57 72572-415-01 MEROPENEM 500 MG IV SOLR $24.57 149003956 BISMUTH SUBSALICYLATE 262 MG/15 ML ORAL SUSP $24.54 51525-0430-1 FELBAMATE 400 MG ORAL TAB $24.53 0264-7510-20 D5W IV BOLUS $24.38 99999-045-80 FENTANYL-BUPIVACAINE 2 MCG/ML - 0.1% EPIDURAL PCA (L&D) $24.38 63323-161-01 KETOROLAC 15 MG/ML INJ SOLN $24.38 63323-161-00 KETOROLAC 15 MG/ML INJ SOLN $24.38 60505-3251-6 LAMIVUDINE 150 MG ORAL TAB $24.38 63323-208-05 LIDOCAINE (PF) 20 MG/ML (2 %) IV SOLN $24.38 63323-208-01 LIDOCAINE (PF) 20 MG/ML (2 %) IV SOLN $24.38 70860-601-10 MIDAZOLAM 5 MG/ML INJ SOLN $24.38 70860-601-42 MIDAZOLAM 5 MG/ML INJ SOLN $24.38 HC89007124 A-1 ANTITRYPSIN/PHENOTYPE-AU $24.37 42192-608-05 GABAPENTIN 250 MG/5 ML (5 ML) ORAL SOLN $24.34 42192-608-45 GABAPENTIN 250 MG/5 ML (5 ML) ORAL SOLN $24.34 25021-700-01 KETOROLAC 15 MG/ML INJ SOLN $24.31 65862-096-20 CEFPODOXIME 200 MG ORAL TAB $24.27 HC89021950 PNEUMOCYSTIS JIROVECII DFA-AU $24.24 60687-192-21 IMATINIB 100 MG ORAL TAB $24.23 60687-192-11 IMATINIB 100 MG ORAL TAB $24.23 68084-907-11 MYCOPHENOLATE SODIUM 180 MG ORAL TBEC $24.21 68084-907-21 MYCOPHENOLATE SODIUM 180 MG ORAL TBEC $24.21 50268-187-11 COLCHICINE 0.6 MG ORAL TAB $24.18 50268-187-15 COLCHICINE 0.6 MG ORAL TAB $24.18 0168-0003-15 TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM $24.18 0395-0413-96 CALAMINE-ZINC OXIDE 8-8 % TOPICAL LOTN $24.16 0409-9558-11 ROCURONIUM 10 MG/ML IV SOLN $24.15 0409-9558-05 ROCURONIUM 10 MG/ML IV SOLN $24.15 0409-3189-10 ROCURONIUM 10 MG/ML IV SOLN $24.15 0409-3189-05 ROCURONIUM 10 MG/ML IV SOLN $24.15 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 0469-0607-73 TACROLIMUS 0.5 MG ORAL CAP $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 HC88600200 AP TRANSPORT CHARGE $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 HC88600317 HANDLING & SHIPPING-BD $24.00 HC82204710 HANDLING AND/OR CONVEYANCE TO REF LAB(AP) $24.00 HC83000976 HANDLING AND/OR CONVEYANCE TO REF LAB(BB) $24.00 HC88600093 HANDLING AND/OR CONVEYANCE TO REF LAB(TRIAGE) $24.00 HC83503946 HANDLING AND/OR SHIPPING $24.00 HC89018451 IMMUNOASSAY ANA QUANT (PNL)-PR $24.00 HC89010664 INHIB PROTEIN C ACTIVITY-AU $24.00 HC89015093 MYCOPHENOLIC ACID-AU $24.00 HC89001572 MYOCARDIAL FA AB SCRN-QD $24.00 HC88600242 SPECIAL COURIER 40 $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 63323-564-97 ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRG $23.92 63323-564-21 ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRG $23.92 0781-3246-64 ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRG $23.92 0781-3246-02 ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRG $23.92 71288-433-82 ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRG $23.92 71288-433-83 ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRG $23.92 0406-8390-01 MORPHINE 100 MG ORAL TBSR $23.92 68180-659-06 RIFAMPIN 300 MG ORAL CAP $23.88 68180-659-07 RIFAMPIN 300 MG ORAL CAP $23.88 76014-004-25 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $23.86 76014-004-30 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $23.86 42291-973-60 VALGANCICLOVIR 450 MG ORAL TAB $23.86 10135-735-60 PYRAZINAMIDE 500 MG ORAL TAB $23.84 HC89022362 FLOW CYTOMETRY MARKERS ADD+-CC $23.81 55150-254-10 LIDOCAINE HCL 20 MG/ML (2 %) INJ SOLN $23.79 HC89010631 ANTITHROMBIN III-AU $23.74 63323-106-03 MAGNESIUM SULFATE IN WATER 2 GRAM/50 ML (4 %) IV PGBK $23.73 63323-106-26 MAGNESIUM SULFATE IN WATER 2 GRAM/50 ML (4 %) IV PGBK $23.73 99999-036-85 KETAMINE 10 MG/ML INJ SOLN $23.65 72572-160-10 ETOMIDATE 2 MG/ML IV SOLN $23.60 72572-160-01 ETOMIDATE 2 MG/ML IV SOLN $23.60 0904-0430-04 DOXYCYCLINE HYCLATE 100 MG ORAL TAB $23.57 6253000011 UREA 15 GRAM ORAL PWPK $23.56 67457-816-06 CLINDAMYCIN PHOSPHATE 150 MG/ML INJ SOLN $23.56 67457-816-00 CLINDAMYCIN PHOSPHATE 150 MG/ML INJ SOLN $23.56 HC89007090 ALDOSTERONE-AU $23.52 HC89006662 CLOZAPINE-AU $23.52 13668-088-30 OLANZAPINE 10 MG ORAL TBDL $23.51 0409-1207-03 GENTAMICIN 40 MG/ML INJ SOLN $23.48 0409-1207-13 GENTAMICIN 40 MG/ML INJ SOLN $23.48 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 0781-6041-46 AMOXICILLIN 250 MG/5 ML ORAL SUSR $23.40 65862-707-01 AMOXICILLIN 250 MG/5 ML ORAL SUSR $23.40 99999-047-11 CINACALCET 5 MG/ML ORAL LIQUID (COMPOUND) $23.40 99999-047-52 CINACALCET 5 MG/ML ORAL LIQUID (COMPOUND) $23.40 51991-735-20 GRANISETRON HCL 1 MG ORAL TAB $23.40 51991-735-99 GRANISETRON HCL 1 MG ORAL TAB $23.40 25021-400-10 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $23.40 76045-009-10 HYDROMORPHONE (PF) 1 MG/ML INJ SYRG $23.40 76045-010-00 HYDROMORPHONE (PF) 2 MG/ML INJ SYRG $23.40 76045-010-10 HYDROMORPHONE (PF) 2 MG/ML INJ SYRG $23.40 76045-009-05 HYDROMORPHONE 0.5 MG/0.5 ML INJ SOLN (MHS WRAPPER) $23.40 76045-009-03 HYDROMORPHONE 0.5 MG/0.5 ML INJ SOLN (MHS WRAPPER) $23.40 0904-6836-20 LOPERAMIDE 1 MG/7.5 ML ORAL LIQD $23.40 99999-010-52 MAGNESIUM SULFATE 4 G IN D5W 100 ML IV (LBM) $23.40 79672-613-02 NS IV AFTER MEDICATION INFUSION (TO FLUSH RESIDUAL MED) $23.40 79672-613-20 NS IV AFTER MEDICATION INFUSION (TO FLUSH RESIDUAL MED) $23.40 42023-116-25 OXYTOCIN 10 UNIT/ML INJ SOLN $23.40 65219-012-01 POTASSIUM CHLORIDE IN WATER 10 MEQ/100 ML IV PGBK $23.40 65219-012-00 POTASSIUM CHLORIDE IN WATER 10 MEQ/100 ML IV PGBK $23.40 45802-063-35 TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM $23.40 63323-495-04 LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN $23.34 63323-495-07 LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN $23.34 51079-632-20 PRAZOSIN 5 MG ORAL CAP $23.34 51079-632-01 PRAZOSIN 5 MG ORAL CAP $23.34 0409-1985-30 LORAZEPAM 2 MG/ML INJ SOLN (MHS WRAPPER) $23.32 0409-1985-03 LORAZEPAM 2 MG/ML INJ SOLN (MHS WRAPPER) $23.32 HC89024111 ALCOHOL QNT GAS CHROMA URINE-AU $23.30 HC89008148 IMMUNOGLOBULIN IGD-AU $23.30 0409-1463-49 NALBUPHINE 10 MG/ML INJ SOLN $23.28 HC89019871 ENTAMOEBA ANTIGEN EIA -AU $23.27 24385-060-03 BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINT $23.26 50268-279-15 DOXYCYCLINE HYCLATE 100 MG ORAL TAB $23.24 50268-279-11 DOXYCYCLINE HYCLATE 100 MG ORAL TAB $23.24 10135-735-01 PYRAZINAMIDE 500 MG ORAL TAB $23.24 HC89012405 COXSACKIE A9 AB-AU $23.15 HC89008189 GLUCAGON-AU $23.15 70069-005-10 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG/ML INJ SOLN $23.14 70069-005-01 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG/ML INJ SOLN $23.14 55150-252-20 LIDOCAINE HCL 10 MG/ML (1 %) INJ (FOR INTRAPLEURAL USE) $23.14 0024-1352-02 PHENYLEPHRINE HCL 1 % NASL SPRY $23.11 0536-1293-83 ALUM-MAG HYDROXIDE-SIMETH 200-200-20 MG/5 ML ORAL SUSP $23.08 0904-5725-14 ALUM-MAG HYDROXIDE-SIMETH 400-400-40 MG/5 ML ORAL SUSP $23.08 0536-0015-83 ALUM-MAG HYDROXIDE-SIMETH 400-400-40 MG/5 ML ORAL SUSP $23.08 0409-1160-18 BUPIVACAINE HCL 0.25 % (2.5 MG/ML) INJ SOLN $23.08 0409-1160-01 BUPIVACAINE HCL 0.25 % (2.5 MG/ML) INJ SOLN $23.08 0143-9128-01 GENTAMICIN 40 MG/ML INJ SOLN $23.01 0143-9128-25 GENTAMICIN 40 MG/ML INJ SOLN $23.01 0904-1103-09 POVIDONE-IODINE 10 % TOPICAL SOLN $23.01 60505-0133-0 CYCLOSPORINE 25 MG ORAL CAP $23.00 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 HC51062339 CPSP ANTEPRTM NUTRITION F/U ASSES,TX, GROUP, EACH 15MIN $23.00 HC51062388 CPSP ANTEPRTM PSYCHOSOCIAL F/U ASSESS/TX GROUP; EA 15MIN $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 HC51062156 GLUCOSE BY DEVICE $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 HC51062180 PH FLUID $23.00 HC89021430 PROGESTERONE QNT-HPLC MS/MS-AU $23.00 HC89001580 RETICULIN FA AB SCRN-QD $23.00 HC51062149 URINALYSIS AUTO W/ MICROSCOPY $23.00 HC89015861 VARICELLA ZOSTER IGG-QD $23.00 HC89015879 VARICELLA-ZOSTER IGM-QD $23.00 HC89015507 VITAMIN B6 PYRIDOXAL-QD $23.00 99999-047-26 PERI-ARTICULAR MIXTURE SOLUTION (SLH) $23.00 64980-427-12 TINIDAZOLE 500 MG ORAL TAB $23.00 72572-580-01 PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN $22.95 72572-580-25 PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN $22.95 0781-9407-78 AMPICILLIN SODIUM 500 MG INJ SOLR $22.91 0781-9407-95 AMPICILLIN SODIUM 500 MG INJ SOLR $22.91 HC89500508 BLOOD TYPE SEROLOGIC; RH(D)-SB $22.88 1254717162 DIPHENHYDRAMINE-ZINC ACETATE 1-0.1 % TOPICAL CREAM $22.81 64980-322-12 MENTHOL-ZINC OXIDE 0.44-20.6 % TOPICAL OINT $22.77 0904-6436-04 TEMAZEPAM 7.5 MG ORAL CAP $22.77 4110081124 VITS A AND D-WHITE PET-LANOLIN TOPICAL OINT $22.77 72485-422-01 AMPICILLIN SODIUM 2 G IV SOLR (MCH) $22.75 72485-422-10 AMPICILLIN SODIUM 2 G IV SOLR (MCH) $22.75 70095-025-01 AZITHROMYCIN 500 MG IV SOLR $22.75 70095-025-02 AZITHROMYCIN 500 MG IV SOLR $22.75 60687-492-21 BUPRENORPHINE HCL 8 MG SL SUBL $22.75 60687-492-11 BUPRENORPHINE HCL 8 MG SL SUBL $22.75 60505-6148-0 CEFTRIAXONE 1 G INJ SOLR (MCH) $22.75 0781-3208-85 CEFTRIAXONE 1 GRAM INJ SOLR $22.75 65219-238-01 D5W IV BOLUS $22.75 68084-729-11 GALANTAMINE 4 MG ORAL TAB $22.75 68084-729-21 GALANTAMINE 4 MG ORAL TAB $22.75 25021-806-01 HALOPERIDOL LACTATE 5 MG/ML INJ SOLN $22.75 0781-3540-25 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $22.75 0781-3540-10 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $22.75 63323-614-55 HYDRALAZINE 20 MG/ML INJ SOLN $22.75 63323-614-21 HYDRALAZINE 20 MG/ML INJ SOLN $22.75 64950-217-03 ISONIAZID 300 MG ORAL TAB $22.75 24357-701-05 LIDOCAINE 4 % TOPICAL CREAM $22.75 24357-701-06 LIDOCAINE 4 % TOPICAL CREAM $22.75 67877-419-33 LINEZOLID 600 MG ORAL TAB $22.75 67877-419-84 LINEZOLID 600 MG ORAL TAB $22.75 0264-4206-54 MAGNESIUM SULFATE 4 GRAM/100 ML IV PGBK (SLH) $22.75 0264-7800-10 NS IV AFTER MEDICATION INFUSION (TO FLUSH RESIDUAL MED) $22.75 65219-222-01 NS IV AFTER MEDICATION INFUSION (TO FLUSH RESIDUAL MED) $22.75 65219-222-25 NS IV AFTER MEDICATION INFUSION (TO FLUSH RESIDUAL MED) $22.75 25021-751-10 PANTOPRAZOLE 40 MG IV SOLR $22.75 60505-6156-4 PIPERACILLIN-TAZOBACTAM 2.25 GRAM IV SOLR $22.75 60505-6156-0 PIPERACILLIN-TAZOBACTAM 2.25 GRAM IV SOLR $22.75 60505-6157-4 PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR $22.75 60505-6157-0 PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR $22.75 25021-662-05 ROCURONIUM 10 MG/ML IV SOLN $22.75 0264-2201-10 SODIUM CHLORIDE 0.9 % IRR SOLN $22.75 72485-510-10 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $22.75 72485-510-01 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $22.75 72485-107-01 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $22.75 72485-107-10 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $22.75 60687-527-21 URSODIOL 250 MG ORAL TAB $22.75 60687-527-11 URSODIOL 250 MG ORAL TAB $22.75 0904-6221-61 URSODIOL 300 MG ORAL CAP $22.75 99999-046-75 VANCOMYCIN 2.5 % (25 MG/ML) FORTIFIED OPHTHALMIC SOLUTION $22.75 99999-002-18 VANCOMYCIN 5% (50 MG/ML) OPHTHALMIC SOLUTION $22.75 0781-3208-95 CEFTRIAXONE 1 GRAM INJ SOLR $22.74 HC89004063 CARNITINE, FREE-AU $22.73 49884-311-55 RISPERIDONE 0.5 MG ORAL TBDL $22.72 49884-311-52 RISPERIDONE 0.5 MG ORAL TBDL $22.72 49884-311-91 RISPERIDONE 0.5 MG ORAL TBDL $22.72 58980-012-05 BACITRACIN ZINC-POLYMYXIN B 500-10,000 UNIT/GRAM TOPICAL OINT $22.71 HC89006670 DIGITOXIN-AU $22.70 0703-0110-01 HYDROMORPHONE (PF) 10 MG/ML INJ SOLN $22.69 0703-0110-03 HYDROMORPHONE (PF) 10 MG/ML INJ SOLN $22.69 70677-1107-1 LOPERAMIDE 1 MG/7.5 ML ORAL LIQD $22.62 70677-1078-1 SIMETHICONE 40 MG/0.6 ML ORAL DRPS $22.62 0225-0800-47 PHENYLEPHRINE HCL 0.25 % NASL SPRY $22.52 0225-0805-47 PHENYLEPHRINE HCL 0.5 % NASL SPRY $22.52 65219-570-04 BUMETANIDE 0.25 MG/ML INJ SOLN $22.49 65219-570-01 BUMETANIDE 0.25 MG/ML INJ SOLN $22.49 99999-040-54 CEFTRIAXONE 2 G/50 ML (40 MG/ML) INJ SYR (USING 10G) $22.43 63323-486-17 LIDOCAINE HCL 20 MG/ML (2 %) INJ SOLN $22.43 63323-486-01 LIDOCAINE HCL 20 MG/ML (2 %) INJ SOLN $22.43 63323-012-03 OXYTOCIN 10 UNIT/ML INJ SOLN $22.43 63323-012-11 OXYTOCIN 10 UNIT/ML INJ SOLN $22.43 72572-801-02 VANCOMYCIN 1,000 MG IV SOLR $22.43 72572-801-01 VANCOMYCIN 1,000 MG IV SOLR $22.43 HC89020184 C-REACTIVE PROTEIN(PNL2)-PR $22.40 HC89010250 VOLATILES-AU $22.40 82584-604-01 DORZOLAMIDE-TIMOLOL (PF) 2-0.5 % OPHT DPET $22.39 82584-604-30 DORZOLAMIDE-TIMOLOL (PF) 2-0.5 % OPHT DPET $22.39 62135-309-20 CIPROFLOXACIN HCL 500 MG ORAL TAB $22.36 67877-754-60 DRONABINOL 5 MG ORAL CAP $22.33 0781-3110-95 PIPERACILLIN-TAZOBACTAM 2.25 GRAM IV SOLR $22.33 0781-3110-90 PIPERACILLIN-TAZOBACTAM 2.25 GRAM IV SOLR $22.33 16714-986-01 TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM $22.33 5852600557 FERROUS SULFATE 300 MG (60 MG IRON)/5 ML ORAL LIQD $22.26 5852600559 FERROUS SULFATE 300 MG (60 MG IRON)/5 ML ORAL LIQD $22.26 0990-7984-20 SODIUM CHLORIDE 0.9 % IV SOLP $22.26 0641-6013-10 DILTIAZEM HCL 5 MG/ML IV SOLN $22.23 0641-6013-01 DILTIAZEM HCL 5 MG/ML IV SOLN $22.23 0409-9094-25 FENTANYL CITRATE (PF) 0.05 MG/ML INJ SOLN (MCH) $22.23 0409-9094-18 FENTANYL CITRATE (PF) 0.05 MG/ML INJ SOLN (MCH) $22.23 63323-117-10 FLUOROURACIL 50 MG/ML INJ SOLN (SURGERY) $22.23 63323-117-00 FLUOROURACIL 50 MG/ML INJ SOLN (SURGERY) $22.23 0409-6102-25 FUROSEMIDE 10 MG/ML INJ SOLN $22.23 0409-6102-35 FUROSEMIDE 10 MG/ML INJ SOLN $22.23 99999-006-57 MAGNESIUM SULFATE 4 MEQ/ML ORAL LIQUID (MCH) $22.13 HC89011936 LYMPH ABS CD4/CD8 CNT(PNL)-AU $22.13 59762-3060-3 AZITHROMYCIN 250 MG ORAL TAB $22.10 536134380 CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROP $22.10 99999-041-37 CIPROFLOXACIN 2 MG/ML INJECTION (MHS) $22.10 16729-533-63 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG/ML INJ SOLN $22.10 16729-533-08 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG/ML INJ SOLN $22.10 536134480 FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROP $22.10 63323-485-27 LIDOCAINE HCL 10 MG/ML (1 %) INJ (FOR INTRAPLEURAL USE) $22.10 63323-485-01 LIDOCAINE HCL 10 MG/ML (1 %) INJ (FOR INTRAPLEURAL USE) $22.10 121053005 FERROUS SULFATE 300 MG (60 MG IRON)/5 ML ORAL LIQD $22.07 5499500700 CAMPHOR-PHENOL 10.8-4.7 % TOPICAL GEL $22.06 HC89010649 ANTITHROMBIN III AG-AU $22.04 70677-1153-1 CARBAMIDE PEROXIDE 6.5 % OTIC DROP $22.04 70069-817-01 MIDAZOLAM (PF) 1 MG/ML INJ SOLN $22.04 70069-817-10 MIDAZOLAM (PF) 1 MG/ML INJ SOLN $22.04 63323-306-02 TOBRAMYCIN 300MG/7.5ML FOR INHALATION SOLUTION $22.04 0406-8380-62 MORPHINE 60 MG ORAL TBSR $22.01 60687-846-65 OMEGA-3 ACID ETHYL ESTERS 1 GRAM ORAL CAP $22.00 60687-846-11 OMEGA-3 ACID ETHYL ESTERS 1 GRAM ORAL CAP $22.00 HC89016133 AFP-QD $22.00 HC89015648 ANTITHROMBIN III AG-QD $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 HC89006472 CYCLOSPORINE-AU $22.00 HC89007827 DHEA-AU $22.00 HC89011571 DIPHTHERIA AB TITER-AU $22.00 HC89091854 DNA AB IGG IFA (DS)-AU $22.00 HC89008049 FATTY ACIDS FREE-QN $22.00 HC89017032 GC/CHL DNA PROBE-AU $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 HC89010714 PLASMINOGEN-AU $22.00 HC89015598 UREA NITROGEN URINE-QD $22.00 0121-1775-05 CODEINE-GUAIFENESIN 10-100 MG/5 ML ORAL LIQD $21.94 0121-1775-40 CODEINE-GUAIFENESIN 10-100 MG/5 ML ORAL LIQD $21.94 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 63739-953-25 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $21.91 63739-953-11 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $21.91 0409-1312-03 HYDROMORPHONE 2 MG/ML INJ SOLN (MHS WRAPPER) $21.88 0409-1312-30 HYDROMORPHONE 2 MG/ML INJ SOLN (MHS WRAPPER) $21.88 0143-9519-01 METHOTREXATE 25 MG/ML INJECTION (ECTOPIC PREGNANCY) $21.84 0143-9519-10 METHOTREXATE 25 MG/ML INJECTION (ECTOPIC PREGNANCY) $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 8770114975 TETRAHYDROZOLINE 0.05 % OPHT DROP $21.84 24385-075-05 TETRAHYDROZOLINE 0.05 % OPHT DROP $21.84 72603-650-25 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG/ML INJ SOLN $21.81 72603-650-01 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG/ML INJ SOLN $21.81 64850-910-01 ISRADIPINE 2.5 MG ORAL CAP $21.81 0093-5907-86 MESALAMINE 400 MG ORAL CDTI $21.79 0703-4502-04 METOCLOPRAMIDE 5 MG/ML INJ SOLN (MCH) $21.79 0703-4502-01 METOCLOPRAMIDE 5 MG/ML INJ SOLN (MCH) $21.79 51079-853-01 GALANTAMINE 8 MG ORAL TAB $21.78 51079-853-03 GALANTAMINE 8 MG ORAL TAB $21.78 44567-435-24 LEVOFLOXACIN IN D5W 250 MG/50 ML IV PGBK $21.78 0781-9402-95 AMPICILLIN SODIUM 250 MG INJ SOLR $21.76 0781-9402-78 AMPICILLIN SODIUM 250 MG INJ SOLR $21.76 HC89007819 VIT B12 BINDING CAPACITY-AU $21.75 78206-121-01 LOSARTAN 25 MG ORAL TAB $21.74 0409-0147-10 LIDOCAINE-EPINEPHRINE 2 %-1:100,000 INJ SOLN $21.71 0409-0147-01 LIDOCAINE-EPINEPHRINE 2 %-1:100,000 INJ SOLN $21.71 59746-030-22 RISPERIDONE 2 MG ORAL TBDL $21.71 21922-019-02 TESTOSTERONE 1 % (50 MG/5 GRAM) TRANSDERMAL GLPK $21.68 21922-019-56 TESTOSTERONE 1 % (50 MG/5 GRAM) TRANSDERMAL GLPK $21.68 55150-164-02 LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN $21.67 60687-299-95 ITRACONAZOLE 100 MG ORAL CAP $21.67 60687-299-25 ITRACONAZOLE 100 MG ORAL CAP $21.67 64980-282-03 MESALAMINE 1,000 MG RECTAL SUPP $21.67 42806-502-09 NICARDIPINE 30 MG ORAL CAP $21.67 68462-121-90 NICARDIPINE 30 MG ORAL CAP $21.67 60687-385-25 COLESEVELAM 625 MG ORAL TAB $21.64 60687-385-95 COLESEVELAM 625 MG ORAL TAB $21.64 0781-1874-31 AMOXICILLIN-POT CLAVULANATE 250-125 MG ORAL TAB $21.59 4858280220 SALIVA SUBSTITUTE COMBO NO.9 MUCOUS MEMB MWSH $21.57 HC89023659 B CELL TOTAL COUNT-AU $21.53 HC89023667 NK CELL TOTAL COUNT-AU $21.53 HC89023675 T-CELL TOTAL COUNT-AU $21.53 51079-924-20 DILTIAZEM HCL 60 MG ORAL CP12 $21.52 51079-924-01 DILTIAZEM HCL 60 MG ORAL CP12 $21.52 57896-403-16 DOCUSATE SODIUM 100 MG/10 ML ORAL LIQD $21.52 0904-0788-16 MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSP $21.52 0536-2470-85 MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSP $21.52 0574-0106-03 BROMOCRIPTINE 2.5 MG ORAL TAB $21.52 63304-962-30 BROMOCRIPTINE 2.5 MG ORAL TAB $21.52 0597-0360-82 DABIGATRAN ETEXILATE 150 MG ORAL CAP $21.50 0597-0360-55 DABIGATRAN ETEXILATE 150 MG ORAL CAP $21.50 0597-0355-56 DABIGATRAN ETEXILATE 75 MG ORAL CAP $21.50 0597-0355-09 DABIGATRAN ETEXILATE 75 MG ORAL CAP $21.50 1011900252 SOD BORATE-BORIC AC-NACL-WATER OPHT IRSL $21.48 99999-039-14 ACETIC ACID (BULK) 5 % MISC LIQD $21.45 99999-038-26 CEFAZOLIN 3 GRAMS/30 ML IV SYRINGE (USING 10 G VIAL) $21.45 68180-346-06 DARUNAVIR 800 MG ORAL TAB $21.45 7139974805 FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROP $21.45 0168-0080-31 HYDROCORTISONE 2.5 % TOPICAL CREAM $21.45 7139974205 PEDI MV NO.197-IRON SULFATE 11 MG IRON/ML ORAL DROP $21.45 64679-034-02 PIPERACILLIN-TAZOBACTAM 2.25 GRAM IV SOLR $21.45 64679-034-01 PIPERACILLIN-TAZOBACTAM 2.25 GRAM IV SOLR $21.45 23155-345-44 PROPOFOL 10 MG/ML IV EMUL $21.45 23155-345-31 PROPOFOL 10 MG/ML IV EMUL $21.45 60687-629-11 FENOFIBRATE NANOCRYSTALLIZED 145 MG ORAL TAB $21.44 51079-608-20 FENOFIBRATE NANOCRYSTALLIZED 145 MG ORAL TAB $21.44 51079-608-01 FENOFIBRATE NANOCRYSTALLIZED 145 MG ORAL TAB $21.44 HC89024442 CULTURE HSV TYPING-AU $21.44 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 0904-7265-93 LEVETIRACETAM 500 MG/5 ML (5 ML) ORAL SOLN $21.39 HC89022586 CORTISOL-QN $21.38 0168-0146-30 HYDROCORTISONE 2.5 % TOPICAL OINT $21.38 51079-959-20 DOXAZOSIN 4 MG ORAL TAB $21.37 51079-959-01 DOXAZOSIN 4 MG ORAL TAB $21.37 51991-907-01 TETRACYCLINE 500 MG ORAL CAP $21.35 62135-266-60 TETRACYCLINE 500 MG ORAL CAP $21.35 0641-6007-10 BUMETANIDE 0.25 MG/ML INJ SOLN $21.32 0641-6007-01 BUMETANIDE 0.25 MG/ML INJ SOLN $21.32 70748-323-11 BUMETANIDE 0.25 MG/ML INJ SOLN $21.32 70748-323-02 BUMETANIDE 0.25 MG/ML INJ SOLN $21.32 0904-7265-41 LEVETIRACETAM 500 MG/5 ML (5 ML) ORAL SOLN $21.32 10135-701-04 MENTHOL-ZINC OXIDE 0.44-20.6 % TOPICAL OINT $21.30 0517-1905-25 DOPAMINE 400 MG/5 ML (80 MG/ML) IV SOLN $21.26 0409-3796-01 KETOROLAC 60 MG/2 ML IM SOLN $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 HC89011464 ANTI-PARIETAL AB-AU $21.24 0378-1903-01 MIDODRINE 10 MG ORAL TAB $21.22 72572-041-01 BUMETANIDE 0.25 MG/ML INJ SOLN $21.19 72572-041-10 BUMETANIDE 0.25 MG/ML INJ SOLN $21.19 63323-412-18 MIDAZOLAM 5 MG/ML INJ SOLN $21.19 63323-412-25 MIDAZOLAM 5 MG/ML INJ SOLN $21.19 55150-250-50 BUPIVACAINE HCL 0.5 % (5 MG/ML) INJ SOLN $21.13 23155-473-33 FUROSEMIDE 10 MG/ML INJ SOLN $21.13 23155-473-44 FUROSEMIDE 10 MG/ML INJ SOLN $21.13 49884-235-05 HYDROCODONE-CHLORPHENIRAMINE 10-8 MG/5 ML ORAL SU12 $21.13 81665-108-10 ISONIAZID 300 MG ORAL TAB $21.13 68462-896-10 OCTREOTIDE ACETATE 100 MCG/ML INJ SOLN $21.13 68462-896-01 OCTREOTIDE ACETATE 100 MCG/ML INJ SOLN $21.13 5042100882 SODIUM CHLORIDE 0.9 % IRR SOLN $21.13 0904-6872-04 CLARITHROMYCIN 500 MG ORAL TAB $21.11 63323-411-18 MIDAZOLAM 1 MG/ML INJ SOLN $21.06 63323-411-25 MIDAZOLAM 1 MG/ML INJ SOLN $21.06 45802-064-35 TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM $21.06 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 HC89009443 OXALATE URINE-AU $20.98 69680-112-25 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG/ML INJ SOLN $20.93 57237-316-03 ALUM-MAG HYDROXIDE-SIMETH 200-200-20 MG/5 ML ORAL SUSP $20.87 57237-316-31 ALUM-MAG HYDROXIDE-SIMETH 200-200-20 MG/5 ML ORAL SUSP $20.87 65862-071-50 AMOXICILLIN 400 MG/5 ML ORAL SUSR $20.80 0409-2300-01 CIPROFLOXACIN IN 5 % DEXTROSE 200 MG/100 ML IV PGBK $20.80 55150-324-01 FUROSEMIDE 10 MG/ML INJ SOLN (MCH) $20.80 55150-324-25 FUROSEMIDE 10 MG/ML INJ SOLN (MCH) $20.80 63323-280-10 FUROSEMIDE 10 MG/ML INJ SOLN CODE NEO $20.80 0409-4276-02 LIDOCAINE HCL 10 MG/ML (1 %) INJ (FOR INTRAPLEURAL USE) $20.80 0409-4276-17 LIDOCAINE HCL 10 MG/ML (1 %) INJ SOLN $20.80 99999-010-90 METHADONE 5 MG/5 ML ORAL SOLN $20.80 0264-5535-32 METRONIDAZOLE IN NACL (ISO-OS) 500 MG/100 ML IV PGBK $20.80 63323-751-01 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $20.80 63323-751-00 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $20.80 55150-300-25 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $20.80 55150-300-01 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 25021-677-10 SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ SOLN $20.80 68084-215-11 VALACYCLOVIR 500 MG ORAL TAB $20.80 50268-313-15 FENOFIBRATE 160 MG ORAL TAB $20.79 50268-313-11 FENOFIBRATE 160 MG ORAL TAB $20.79 HC89014393 LCM AB-AU $20.78 71399-2829-1 DIBUCAINE 1 % TOPICAL OINT $20.75 73043-005-01 CYCLOSPORINE 0.05 % OPHT DPET $20.74 73043-005-03 CYCLOSPORINE 0.05 % OPHT DPET $20.74 51079-852-03 GALANTAMINE 4 MG ORAL TAB $20.74 51079-852-01 GALANTAMINE 4 MG ORAL TAB $20.74 60687-575-11 RIFAMPIN 150 MG ORAL CAP $20.70 60687-575-21 RIFAMPIN 150 MG ORAL CAP $20.70 51672-2075-1 BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINT $20.68 50268-195-60 CAPSAICIN 0.025 % TOPICAL CREAM $20.67 0409-4264-11 HYDROMORPHONE 0.5 MG/0.5 ML INJ SOLN (MHS WRAPPER) $20.67 0409-4264-01 HYDROMORPHONE 0.5 MG/0.5 ML INJ SOLN (MHS WRAPPER) $20.67 55150-163-30 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $20.67 0409-4276-01 LIDOCAINE HCL 10 MG/ML (1 %) INJ (FOR INTRAPLEURAL USE) $20.67 0409-4276-16 LIDOCAINE HCL 10 MG/ML (1 %) INJ (FOR INTRAPLEURAL USE) $20.67 69618-059-51 SIMETHICONE 40 MG/0.6 ML ORAL DRPS $20.67 0054-4581-11 MERCAPTOPURINE 50 MG ORAL TAB $20.61 0378-3547-52 MERCAPTOPURINE 50 MG ORAL TAB $20.61 99999-037-70 ACETYLCYSTEINE 100 MG/ML (10 %) MISC SOLN $20.57 0378-9080-01 ENTACAPONE 200 MG ORAL TAB $20.57 16714-554-01 DILTIAZEM HCL 90 MG ORAL CP12 $20.55 68462-851-01 DILTIAZEM HCL 90 MG ORAL CP12 $20.55 0781-5578-01 ENTACAPONE 200 MG ORAL TAB $20.54 70756-646-25 LIDOCAINE HCL 10 MG/ML (1 %) INJ SOLN $20.54 70756-646-87 LIDOCAINE HCL 10 MG/ML (1 %) INJ SOLN $20.54 0121-1761-30 ALUM-MAG HYDROXIDE-SIMETH 200-200-20 MG/5 ML ORAL SUSP $20.48 60687-877-45 ALUM-MAG HYDROXIDE-SIMETH 200-200-20 MG/5 ML ORAL SUSP $20.48 72485-416-10 AMPICILLIN-SULBACTAM 1.5 GRAM INJ SOLR $20.48 72485-416-01 AMPICILLIN-SULBACTAM 1.5 GRAM INJ SOLR $20.48 45802-434-01 CLOTRIMAZOLE 1 % TOPICAL CREAM $20.48 574006915 DEXTROSE 40 % ORAL GEL $20.48 574006930 DEXTROSE 40 % ORAL GEL $20.48 574007030 DEXTROSE 40 % ORAL GEL $20.48 0536-1349-57 METHYL SALICYLATE-MENTHOL 15-10 % TOPICAL CREAM $20.44 23155-601-41 MIDAZOLAM 5 MG/ML INJ SOLN $20.44 23155-601-31 MIDAZOLAM 5 MG/ML INJ SOLN $20.44 59762-0260-1 COLESTIPOL 5 GRAM ORAL PACK $20.44 0115-5212-30 COLESTIPOL 5 GRAM ORAL PACK $20.44 0527-1790-01 FLUPHENAZINE HCL 5 MG ORAL TAB $20.40 16714-829-01 BUDESONIDE 3 MG ORAL CECX $20.37 51079-958-20 DOXAZOSIN 2 MG ORAL TAB $20.36 51079-958-01 DOXAZOSIN 2 MG ORAL TAB $20.36 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 65862-707-80 AMOXICILLIN 250 MG/5 ML ORAL SUSR $20.28 99999-045-18 GRANISETRON 50 MCG/ML ORAL LIQUID (COMPOUND) $20.28 51672-2130-8 IBUPROFEN 100 MG/5 ML ORAL SUSP $20.28 0395-1213-91 IODINE-SODIUM IODIDE 2 % TOPICAL TINC $20.28 63323-564-65 ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRG $20.28 63323-564-63 ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRG $20.28 99999-002-30 NITROGLYCERIN 400 MCG/SPRAY TL SPRY $20.27 0501-3200-01 DIPHENHYDRAMINE-ZINC ACETATE 1-0.1 % TOPICAL CREAM $20.24 60687-786-21 ROFLUMILAST 500 MCG ORAL TAB $20.24 60687-786-11 ROFLUMILAST 500 MCG ORAL TAB $20.24 51079-024-20 METOLAZONE 5 MG ORAL TAB $20.22 51079-024-01 METOLAZONE 5 MG ORAL TAB $20.22 0641-6045-25 LORAZEPAM 4 MG/ML INJ SOLN $20.19 0641-6045-01 LORAZEPAM 4 MG/ML INJ SOLN $20.19 42858-868-06 DRONABINOL 5 MG ORAL CAP $20.18 0990-7923-37 D5W IV BOLUS $20.15 59762-1710-1 EPLERENONE 25 MG ORAL TAB $20.15 63323-118-01 HEPARIN, PORCINE (PF) 5,000 UNIT/0.5 ML INJ SOLN (MHS WRAPPER) $20.15 63323-118-05 HEPARIN, PORCINE (PF) 5,000 UNIT/0.5 ML INJ SOLN (MHS WRAPPER) $20.15 44567-410-24 MAGNESIUM SULFATE IN D5W 1 GRAM/100 ML IV PGBK $20.15 0406-8380-23 MORPHINE 60 MG ORAL TBSR $20.15 6961806259 PEDIATRIC MULTIVITAMIN NO.171 750 UNIT-35 MG- 400 UNIT/ML ORAL DROP $20.15 64980-177-50 CHLOROQUINE PHOSPHATE 250 MG ORAL TAB $20.14 0054-4581-27 MERCAPTOPURINE 50 MG ORAL TAB $20.09 68084-215-21 VALACYCLOVIR 500 MG ORAL TAB $20.09 0078-0509-05 CARBAMAZEPINE 200 MG ORAL TAB $20.07 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 51862-460-01 CYCLOSPORINE MODIFIED 100 MG ORAL CAP $20.00 51862-460-47 CYCLOSPORINE MODIFIED 100 MG ORAL CAP $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 HC89020507 CYSTATIN C, SERUM-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 60687-687-11 LACOSAMIDE 100 MG ORAL TAB $19.96 60687-687-57 LACOSAMIDE 100 MG ORAL TAB $19.96 0054-0425-23 RUFINAMIDE 200 MG ORAL TAB $19.96 0536-1224-97 SOD BORATE-BORIC AC-NACL-WATER OPHT IRSL $19.94 50268-811-11 ZIPRASIDONE HCL 20 MG ORAL CAP $19.91 50268-811-12 ZIPRASIDONE HCL 20 MG ORAL CAP $19.91 50268-628-11 OXYBUTYNIN CHLORIDE 10 MG ORAL TR24 $19.88 50268-628-15 OXYBUTYNIN CHLORIDE 10 MG ORAL TR24 $19.88 0069-5471-01 FOSPHENYTOIN 100 MG PE/2 ML INJ SOLN $19.88 0069-5471-02 FOSPHENYTOIN 100 MG PE/2 ML INJ SOLN $19.88 65628-062-01 PROGESTERONE 100 MG VAGINAL SUPP $19.85 51079-093-01 VALACYCLOVIR 500 MG ORAL TAB $19.85 51079-093-03 VALACYCLOVIR 500 MG ORAL TAB $19.85 63323-451-00 MORPHINE 10 MG/ML INJ SOLN $19.83 63323-451-01 MORPHINE 10 MG/ML INJ SOLN $19.83 68084-948-25 EPLERENONE 25 MG ORAL TAB $19.81 68084-948-95 EPLERENONE 25 MG ORAL TAB $19.81 0054-8550-25 METHOTREXATE SODIUM 2.5 MG ORAL TAB $19.81 54092-189-81 MESALAMINE 250 MG ORAL CPSR $19.73 99999-012-99 NOSEBLEEDS QR TOP PWDR $19.73 0641-6008-10 BUMETANIDE 0.25 MG/ML INJ SOLN $19.63 0641-6008-01 BUMETANIDE 0.25 MG/ML INJ SOLN $19.63 70748-323-10 BUMETANIDE 0.25 MG/ML INJ SOLN $19.63 70748-323-01 BUMETANIDE 0.25 MG/ML INJ SOLN $19.63 72572-040-10 BUMETANIDE 0.25 MG/ML INJ SOLN $19.63 72572-040-01 BUMETANIDE 0.25 MG/ML INJ SOLN $19.63 68084-549-11 TEMAZEPAM 7.5 MG ORAL CAP $19.58 68084-549-21 TEMAZEPAM 7.5 MG ORAL CAP $19.58 63323-664-01 DIPHENHYDRAMINE HCL 50 MG/ML INJ SOLN $19.57 63323-664-00 DIPHENHYDRAMINE HCL 50 MG/ML INJ SOLN $19.57 63323-533-13 ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRG $19.57 72603-350-25 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $19.57 0409-3793-01 KETOROLAC 15 MG/ML INJ SOLN $19.56 0409-3793-19 KETOROLAC 15 MG/ML INJ SOLN $19.56 0409-3793-25 KETOROLAC 15 MG/ML INJ SOLN $19.56 53329-939-13 POVIDONE-IODINE 10 % TOPICAL SOLN $19.56 0574-0106-01 BROMOCRIPTINE 2.5 MG ORAL TAB $19.53 63304-962-01 BROMOCRIPTINE 2.5 MG ORAL TAB $19.53 70436-232-52 AMIODARONE 50 MG/ML IV SOLN $19.50 70436-232-72 AMIODARONE 50 MG/ML IV SOLN $19.50 99999-044-46 AMIODARONE IN D5W 225 MG/250 ML (0.9 MG/ML) IV SOLN (MHS) $19.50 0143-9889-01 AMOXICILLIN 250 MG/5 ML ORAL SUSR $19.50 44567-101-10 AMPICILLIN SODIUM 500 MG INJ SOLR $19.50 25021-135-10 AMPICILLIN SODIUM 500 MG INJ SOLR $19.50 67457-348-15 AMPICILLIN-SULBACTAM 1.5 GRAM INJ SOLR $19.50 67457-348-10 AMPICILLIN-SULBACTAM 1.5 GRAM INJ SOLR $19.50 72205-102-01 BUMETANIDE 0.25 MG/ML INJ SOLN $19.50 72205-102-07 BUMETANIDE 0.25 MG/ML INJ SOLN $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 72603-415-01 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $19.50 0143-9334-10 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN $19.50 0143-9334-01 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN $19.50 44567-701-25 CEFTRIAXONE 1 GRAM INJ SOLR $19.50 0143-9856-01 CEFTRIAXONE 2 G INJ SOLR (MCH) $19.50 0143-9856-25 CEFTRIAXONE 2 G INJ SOLR (MCH) $19.50 25021-114-82 CIPROFLOXACIN IN 5 % DEXTROSE 200 MG/100 ML IV PGBK $19.50 25021-192-82 CIPROFLOXACIN IN 5 % DEXTROSE 200 MG/100 ML IV PGBK $19.50 65219-460-05 D5W IV BOLUS $19.50 65219-460-20 D5W IV BOLUS $19.50 65219-458-05 D5W IV BOLUS $19.50 65219-458-30 D5W IV BOLUS $19.50 0990-7923-36 DEXTROSE 5 % IN WATER (D5W) IV SOLP $19.50 0264-7751-00 DEXTROSE 5 %-LACTATED RINGERS IV SOLP $19.50 0641-6028-01 FENTANYL (PF) 50 MCG/ML INJ FOR INTRATHECAL PAIN PUMP REFILL (OCM) $19.50 0641-6028-25 FENTANYL (PF) 50 MCG/ML INJ FOR INTRATHECAL PAIN PUMP REFILL (OCM) $19.50 0641-6028-10 FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN $19.50 69452-350-60 GRANISETRON HCL 1 MG ORAL TAB $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 0641-6151-01 HYDROMORPHONE (PF) 2 MG/ML INJ SOLN $19.50 0641-6151-25 HYDROMORPHONE (PF) 2 MG/ML INJ SOLN $19.50 62135-067-90 INDOMETHACIN 25 MG ORAL CAP $19.50 25021-317-20 LABETALOL 5 MG/ML IV SOLN $19.50 55150-177-05 LEVETIRACETAM 500 MG/5 ML IV SOLN $19.50 63323-507-21 MEROPENEM 500 MG IV SOLR $19.50 63323-507-20 MEROPENEM 500 MG IV SOLR $19.50 63323-507-01 MEROPENEM 500 MG IV SOLR $19.50 0143-9430-01 MEROPENEM 500 MG IV SOLR $19.50 0143-9430-10 MEROPENEM 500 MG IV SOLR $19.50 63323-507-19 MEROPENEM 500 MG IV SOLR $19.50 99999-035-10 MORPHINE 1 MG/ML IN NS 100 ML OPIOID NAIVE PCA $19.50 99999-033-08 MORPHINE 100 MG IN NS 100 ML (OCM) $19.50 99999-035-19 MORPHINE 100 MG IN NS 100 ML DRIP $19.50 0990-7984-37 NS IV AFTER MEDICATION INFUSION (TO FLUSH RESIDUAL MED) $19.50 0338-0049-48 NS IV AFTER MEDICATION INFUSION (TO FLUSH RESIDUAL MED) $19.50 99999-044-31 OXYTOCIN IN 0.9 % SOD CHLORIDE 30 UNIT/500 ML IV SOLN $19.50 55150-202-10 PANTOPRAZOLE 40 MG IV SOLR $19.50 55150-119-30 PIPERACILLIN-TAZOBACTAM 2.25 GRAM IV SOLR $19.50 25021-175-20 PIPERACILLIN-TAZOBACTAM 2.25 GRAM IV SOLR $19.50 25021-165-30 PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR $19.50 25021-176-20 PIPERACILLIN-TAZOBACTAM 3.375 GRAM IV SOLR $19.50 0168-0004-15 TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM $19.50 70436-021-82 VANCOMYCIN 1,000 MG IV SOLR $19.50 70436-020-82 VANCOMYCIN 500 MG IV SOLR $19.50 70594-045-01 VANCOMYCIN 500 MG IV SOLR $19.50 70594-045-02 VANCOMYCIN 500 MG IV SOLR $19.50 99999-037-93 ZIDOVUDINE 10 MG/ML ORAL SYRP $19.50 0536-1316-25 ZINC OXIDE 20 % TOPICAL OINT $19.50 50268-450-12 ITRACONAZOLE 100 MG ORAL CAP $19.48 50268-450-11 ITRACONAZOLE 100 MG ORAL CAP $19.48 67457-374-99 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $19.44 67457-374-12 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $19.44 25021-164-30 PIPERACILLIN-TAZOBACTAM 2.25 GRAM IV SOLR $19.44 44567-801-10 PIPERACILLIN-TAZOBACTAM 2.25 GRAM IV SOLR $19.44 72570-122-35 WHITE PETROLATUM-MINERAL OIL 83-15 % OPHT OINT $19.43 0781-7516-87 BUDESONIDE 0.5 MG/2 ML INHALATION NBSP $19.40 0781-7516-14 BUDESONIDE 0.5 MG/2 ML INHALATION NBSP $19.40 0409-3578-01 TOBRAMYCIN SULFATE 40 MG/ML INJ SOLN $19.40 0904-7141-10 METHOTREXATE SODIUM 2.5 MG ORAL TAB $19.39 HC89012991 DENGUE FEVER AB-AU $19.37 60758-802-05 TIMOLOL MALEATE 0.25 % OPHT DROP $19.37 99999-000-10 CHLOROTHIAZIDE 25 MG / 5 ML SYRINGE $19.35 65862-711-60 ATAZANAVIR 150 MG ORAL CAP $19.31 42385-920-60 ATAZANAVIR 150 MG ORAL CAP $19.31 0078-0246-61 CYCLOSPORINE MODIFIED 25 MG ORAL CAP $19.31 71288-600-10 PANTOPRAZOLE 40 MG IV SOLR $19.31 71288-600-11 PANTOPRAZOLE 40 MG IV SOLR $19.31 99999-044-58 BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJ SOLN $19.29 42292-043-01 IMATINIB 100 MG ORAL TAB $19.29 42292-043-03 IMATINIB 100 MG ORAL TAB $19.29 99999-001-58 ACETYLCYSTEINE 20 % (200 MG/ML) ORAL SYRINGE $19.27 68084-954-95 REPAGLINIDE 1 MG ORAL TAB $19.25 68084-954-25 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 63739-170-24 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $19.24 63323-202-02 LIDOCAINE HCL 20 MG/ML (2 %) INJ SOLN $19.24 0904-7418-44 MAGNESIUM CITRATE ORAL SOLN $19.24 71399-7889-1 MAGNESIUM CITRATE ORAL SOLN $19.24 HC89008379 HEMOGLOBIN PLASMA-AU $19.20 0071-0803-24 GABAPENTIN 100 MG ORAL CAP $19.19 0409-1163-01 BUPIVACAINE HCL 0.5 % (5 MG/ML) INJ SOLN $19.18 0409-1163-18 BUPIVACAINE HCL 0.5 % (5 MG/ML) INJ SOLN $19.18 0990-7984-36 NS IV AFTER MEDICATION INFUSION (TO FLUSH RESIDUAL MED) $19.18 0173-0681-01 ZANAMIVIR 5 MG/ACTUATION INHALATION DSDV $19.18 0009-0775-26 CLINDAMYCIN PHOSPHATE 150 MG/ML INJ SOLN $19.14 0009-0775-20 CLINDAMYCIN PHOSPHATE 150 MG/ML INJ SOLN $19.14 0078-0246-15 CYCLOSPORINE MODIFIED 25 MG ORAL CAP $19.13 65862-603-30 MOXIFLOXACIN 400 MG ORAL TAB $19.12 0409-1165-01 BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJ SOLN $19.11 0409-1165-18 BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJ SOLN $19.11 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 63323-495-27 LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN $19.05 63323-495-09 LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN $19.05 99999-042-96 MEGESTROL 400 MG/10 ML (10 ML) ORAL SUSP $19.05 62332-619-31 CYCLOPHOSPHAMIDE 50 MG ORAL CAP $19.03 70860-125-41 AZITHROMYCIN 500 MG IV SOLR $19.03 70860-125-66 AZITHROMYCIN 500 MG IV SOLR $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 60687-641-11 NEBIVOLOL 5 MG ORAL TAB $19.01 60687-641-21 NEBIVOLOL 5 MG ORAL 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 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 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 HC89024160 SOLUBLE TRANSFERRIN RECEPTOR-AU $19.00 HC89000368 T-3 REVERSE-QD $19.00 HC89003107 THYROGLOBULIN AB-QD $19.00 HC89016141 VIRAL ID (SHELL VIAL)-QD $19.00 0143-9979-22 CEFUROXIME SODIUM 750 MG INJ SOLR $19.00 0143-9979-90 CEFUROXIME SODIUM 750 MG INJ SOLR $19.00 0480-3310-01 THEOPHYLLINE 300 MG ORAL TB12 $18.99 HC89006738 GABAPENTIN (SERUM)-AU $18.98 70860-301-10 DILTIAZEM HCL 5 MG/ML IV SOLN $18.98 70860-301-42 DILTIAZEM HCL 5 MG/ML IV SOLN $18.98 60687-302-25 NADOLOL 20 MG ORAL TAB $18.97 60687-302-95 NADOLOL 20 MG ORAL TAB $18.97 16729-043-01 TACROLIMUS 5 MG ORAL CAP $18.96 HC89005821 AMIODARONE-AU $18.94 HC89011829 CIQ BINDING ASSAY-AU $18.94 HC89008585 IGF BINDING PROTEIN-3-AU $18.94 42292-011-06 HYDROXYCHLOROQUINE 200 MG ORAL TAB $18.90 42292-011-01 HYDROXYCHLOROQUINE 200 MG ORAL TAB $18.90 0501-3401-02 ZINC OXIDE 13 % TOPICAL CREAM $18.90 HC89007702 CORTISOL FREE URINE-AU $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 0781-6039-46 AMOXICILLIN 125 MG/5 ML ORAL SUSR $18.85 65862-706-01 AMOXICILLIN 125 MG/5 ML ORAL SUSR $18.85 0378-6090-01 DILTIAZEM HCL 90 MG ORAL CP12 $18.85 16729-501-64 FUROSEMIDE 10 MG/ML INJ SOLN $18.85 16729-501-43 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 0338-0049-18 NS IV AFTER MEDICATION INFUSION (TO FLUSH RESIDUAL MED) $18.85 23155-687-31 OCTREOTIDE ACETATE 50 MCG/ML INJ SOLN $18.85 23155-687-41 OCTREOTIDE ACETATE 50 MCG/ML INJ SOLN $18.85 63739-548-33 OXYBUTYNIN CHLORIDE 5 MG ORAL TR24 $18.84 0536-1995-53 SELENIUM SULFIDE 1 % TOPICAL SHAM $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 99999-044-19 KETAMINE 10 MG/ML INJ SOLN $18.82 0409-7335-13 CEFTRIAXONE 2 G INJ SOLR (MCH) $18.81 0409-7335-03 CEFTRIAXONE 2 G INJ SOLR (MCH) $18.81 0409-7335-21 CEFTRIAXONE 2 GRAM INJ SOLR $18.81 0409-7335-20 CEFTRIAXONE 2 GRAM INJ SOLR $18.81 60687-684-21 NATEGLINIDE 120 MG ORAL TAB $18.81 51672-3003-2 HYDROCORTISONE 2.5 % TOPICAL CREAM $18.80 76045-106-10 DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJ SYRG $18.79 62542-301-05 HYDROCODONE-CHLORPHENIRAMINE 10-8 MG/5 ML ORAL SU12 $18.79 0121-0940-10 MAGNESIUM HYDROXIDE 2,400 MG/10 ML ORAL SUSP $18.79 0121-0940-00 MAGNESIUM HYDROXIDE 2,400 MG/10 ML ORAL SUSP $18.79 63323-165-01 DEXAMETHASONE 4 MG/ML INJ SOLN (FOR ORAL USE) $18.72 63323-165-02 DEXAMETHASONE 4 MG/ML INJ SOLN (FOR ORAL USE) $18.72 72572-350-01 LABETALOL 5 MG/ML IV SOLN $18.72 4628750030 SORBITOL 70 % MISC 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 69452-209-20 NIMODIPINE 30 MG ORAL CAP $18.68 69452-209-13 NIMODIPINE 30 MG ORAL CAP $18.68 50268-624-15 NITROFURANTOIN MACROCRYSTAL 100 MG ORAL CAP $18.66 50268-624-11 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 $18.66 76045-004-01 MORPHINE 2 MG/ML INJ SOLN (MHS WRAPPER) $18.66 76045-004-11 MORPHINE 2 MG/ML INJ SOLN (MHS WRAPPER) $18.66 63323-454-00 MORPHINE 4 MG/ML INJ SOLN $18.66 63323-454-01 MORPHINE 4 MG/ML INJ SOLN $18.66 76045-005-10 MORPHINE 4 MG/ML INJ SOLN (MHS WRAPPER) $18.66 76045-005-01 MORPHINE 4 MG/ML INJ SOLN (MHS WRAPPER) $18.66 76045-005-11 MORPHINE 4 MG/ML INJ SOLN (MHS WRAPPER) $18.66 63323-455-00 MORPHINE 5 MG/ML INJ SOLN $18.66 63323-455-01 MORPHINE 5 MG/ML INJ SOLN $18.66 76045-006-10 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 50268-178-15 CLARITHROMYCIN 250 MG ORAL TAB $18.57 50268-178-11 CLARITHROMYCIN 250 MG ORAL TAB $18.57 45802-143-03 NEOMYCIN-BACITRACNZN-POLYMYXNB 3.5MG-400 UNIT- 5,000 UNIT/GRAM TOPICAL OINT $18.56 0409-3613-11 BUPIVACAINE-DEXTROSE-WATER(PF) 0.75 % (7.5 MG/ML) INJ SOLN $18.53 0409-3613-01 BUPIVACAINE-DEXTROSE-WATER(PF) 0.75 % (7.5 MG/ML) INJ SOLN $18.53 63323-806-05 FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN $18.53 63323-806-13 FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN $18.53 31722-306-25 KETOROLAC 30 MG/ML (1 ML) INJ SOLN $18.53 31722-306-01 KETOROLAC 30 MG/ML (1 ML) INJ SOLN $18.53 70677-1108-1 PHENYLEPH-MIN OIL-PETROLATUM 0.25-14-74.9 % RECTAL OINT $18.53 60687-584-21 MIRTAZAPINE 7.5 MG ORAL TAB $18.51 60687-584-11 MIRTAZAPINE 7.5 MG ORAL TAB $18.51 0536-1319-83 MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSP $18.46 57896-660-16 DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML ORAL SYRP $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 59762-0050-1 METHYLPREDNISOLONE 16 MG ORAL TAB $18.41 0536-1228-58 PHENOL 1.4 % MUCOUS MEMB SPRA $18.41 63323-201-02 LIDOCAINE 1% (10 MG/ML) FOR RT USE $18.40 63323-201-01 LIDOCAINE HCL 10 MG/ML (1 %) INJ SOLN $18.40 0904-6559-61 MORPHINE 60 MG ORAL TBSR $18.37 63323-064-11 MAGNESIUM SULFATE 4 MEQ/ML INJ SOLN $18.33 63323-064-04 MAGNESIUM SULFATE 50 % (4 MEQ/ML) IV SOLN (TPN-MEQ) $18.33 0781-3407-78 AMPICILLIN SODIUM 500 MG INJ SOLR $18.32 0781-3407-95 AMPICILLIN SODIUM 500 MG INJ SOLR $18.32 47781-357-03 BUPRENORPHINE-NALOXONE 8-2 MG SL FILM $18.31 47781-357-11 BUPRENORPHINE-NALOXONE 8-2 MG SL FILM $18.31 HC89023006 CARCINOEMBRYONIC ANTIGEN (CEA) BODY FLUID-AU $18.30 70860-301-05 DILTIAZEM HCL 5 MG/ML IV SOLN $18.27 70860-301-41 DILTIAZEM HCL 5 MG/ML IV SOLN $18.27 25021-319-05 DILTIAZEM HCL 5 MG/ML IV SOLN $18.27 71288-433-92 ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRG $18.27 71288-433-91 ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRG $18.27 0409-9094-22 FENTANYL (PF) 50 MCG/ML INJ FOR INTRATHECAL PAIN PUMP REFILL (OCM) $18.25 0409-9094-12 FENTANYL 50 MCG/ML INJ SOLN (FOR INTRANASAL USE) $18.25 HC89010730 MURAMIDASE-AU $18.25 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 60505-6144-4 CEFEPIME 1 GRAM INJ SOLR $18.20 0338-0017-18 D5W IV BOLUS $18.20 49938-101-30 DAPSONE 100 MG ORAL TAB $18.20 0143-9310-01 ETOMIDATE 2 MG/ML IV SOLN $18.20 0143-9310-10 ETOMIDATE 2 MG/ML IV SOLN $18.20 65162-735-09 FELBAMATE 600 MG ORAL TAB $18.20 63323-280-03 FUROSEMIDE 10 MG/ML INJ SOLN $18.20 63323-280-04 FUROSEMIDE 10 MG/ML INJ SOLN $18.20 0143-9577-01 LIDOCAINE 1% (10 MG/ML) FOR RT USE $18.20 0143-9577-10 LIDOCAINE HCL 10 MG/ML (1 %) INJ (FOR INTRAPLEURAL USE) $18.20 0338-0049-38 NS IV AFTER MEDICATION INFUSION (TO FLUSH RESIDUAL MED) $18.20 72572-550-10 PANTOPRAZOLE 40 MG IV SOLR $18.20 72572-550-01 PANTOPRAZOLE 40 MG IV SOLR $18.20 72572-553-10 PANTOPRAZOLE 40 MG IV SOLR $18.20 72572-553-01 PANTOPRAZOLE 40 MG IV SOLR $18.20 0143-9300-01 PANTOPRAZOLE 40 MG IV SOLR $18.20 0143-9300-10 PANTOPRAZOLE 40 MG IV SOLR $18.20 68084-964-95 PROPYLTHIOURACIL 50 MG ORAL TAB $18.20 68084-964-25 PROPYLTHIOURACIL 50 MG ORAL TAB $18.20 0338-0049-10 SODIUM CHLORIDE 0.9 % IV SOLP $18.20 0904-6570-06 OXYBUTYNIN CHLORIDE 5 MG ORAL TR24 $18.19 HC51001592 VENIPUNCTURE ROUTINE $18.18 0245-0144-89 AMIODARONE 100 MG ORAL TAB $18.14 72572-462-01 NEOSTIGMINE METHYLSULFATE 1 MG/ML INJ SOLN (MCH) $18.14 72572-462-10 NEOSTIGMINE METHYLSULFATE 1 MG/ML INJ SOLN (MCH) $18.14 72603-350-01 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $18.12 0245-0144-01 AMIODARONE 100 MG ORAL TAB $18.12 0245-0144-30 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 225052547 SODIUM CHLORIDE-ALOE VERA NASL GEL $18.06 0409-1162-18 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN $18.01 0409-1162-01 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN $18.01 63323-559-93 ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRG $18.01 63323-559-21 ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRG $18.01 71288-432-81 ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRG $18.01 71288-432-80 ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRG $18.01 72572-171-25 FENTANYL (PF) 50 MCG/ML INJ FOR INTRATHECAL PAIN PUMP REFILL (OCM) $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 68084-103-11 ZIPRASIDONE HCL 20 MG ORAL CAP $18.01 68084-103-09 ZIPRASIDONE HCL 20 MG ORAL CAP $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 HC88600267 SPECIAL COURIER 30 $18.00 HC89017420 TRICHROME STAIN CMPLX(O&P)-AU $18.00 HC89015606 URIC ACID FLUID-QD $18.00 HC51002210 URINALYSIS DIP STICK NONAUTO W/SCOPE $18.00 HC89007306 VITAMIN C-AU $18.00 HC89002992 VMA URINE-QD $18.00 HC89018097 WEST NILE VIR AB,IGM, CSF-AU $18.00 68462-850-01 DILTIAZEM HCL 60 MG ORAL CP12 $17.98 16714-553-01 DILTIAZEM HCL 60 MG ORAL CP12 $17.98 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 0713-0268-31 NEOMYCIN-BACITRACNZN-POLYMYXNB 3.5MG-400 UNIT- 5,000 UNIT/GRAM TOPICAL OINT $17.91 0338-0017-41 D5W IV BOLUS $17.88 65862-497-30 EFAVIRENZ-EMTRICITABIN-TENOFOV 600-200-300 MG ORAL TAB $17.88 63323-117-19 FLUOROURACIL 500 MG/10 ML IV SOLN $17.88 63323-117-31 FLUOROURACIL 500 MG/10 ML IV SOLN $17.88 55150-402-25 GENTAMICIN 40 MG/ML INJ SOLN $17.88 55150-402-01 GENTAMICIN 40 MG/ML INJ SOLN $17.88 62135-584-30 GLYBURIDE 2.5 MG ORAL TAB $17.88 0264-7800-20 NS IV AFTER MEDICATION INFUSION (TO FLUSH RESIDUAL MED) $17.88 0054-8146-22 CLOTRIMAZOLE 10 MG MUCOUS MEMB TROC $17.86 50474-300-01 THEOPHYLLINE 300 MG ORAL CP24 $17.86 17856-2002-3 CHLORHEXIDINE GLUCONATE 0.12 % MUCOUS MEMB MWSH $17.84 99999-037-20 ACETAMINOPHEN-CODEINE 120 MG-12 MG /5 ML (5 ML) ORAL SOLN $17.81 68462-470-40 BUMETANIDE 0.25 MG/ML INJ SOLN $17.81 68462-470-54 BUMETANIDE 0.25 MG/ML INJ SOLN $17.81 25021-321-10 BUMETANIDE 0.25 MG/ML INJ SOLN $17.81 72572-062-25 CEFTRIAXONE 2 G INJ SOLR (MCH) $17.81 72572-062-01 CEFTRIAXONE 2 G INJ SOLR (MCH) $17.81 60505-6152-4 CEFTRIAXONE 500 MG INJ SOLR $17.81 51079-023-20 METOLAZONE 2.5 MG ORAL TAB $17.80 51079-023-01 METOLAZONE 2.5 MG ORAL TAB $17.80 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 0409-2066-05 LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN $17.78 0409-2066-10 LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN $17.78 68094-065-62 GUANFACINE 1 MG ORAL TAB $17.77 0409-2585-01 CEFAZOLIN 1 GRAM IV SOLR $17.76 25021-502-01 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG/ML INJ SOLN $17.75 23155-521-31 FUROSEMIDE 10 MG/ML INJ SOLN $17.75 68094-065-59 GUANFACINE 1 MG ORAL TAB $17.75 51079-723-20 OXYBUTYNIN CHLORIDE 10 MG ORAL TR24 $17.74 51079-723-01 OXYBUTYNIN CHLORIDE 10 MG ORAL TR24 $17.74 51079-722-20 OXYBUTYNIN CHLORIDE 5 MG ORAL TR24 $17.74 51079-722-01 OXYBUTYNIN CHLORIDE 5 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 43547-543-01 GLYCOPYRROLATE 0.2 MG/ML INJ SOLN $17.68 43547-543-25 GLYCOPYRROLATE 0.2 MG/ML INJ SOLN $17.68 72603-133-01 FUROSEMIDE 10 MG/ML INJ SOLN $17.67 72603-133-25 FUROSEMIDE 10 MG/ML INJ SOLN $17.67 99999-041-24 DIMETHYL SULFOXIDE (BULK) 99.99 % MISC LIQD $17.65 72603-161-25 KETOROLAC 30 MG/ML (1 ML) INJ SOLN $17.64 72603-161-01 KETOROLAC 30 MG/ML (1 ML) INJ SOLN $17.64 72572-021-01 AMPICILLIN-SULBACTAM 1.5 GRAM INJ SOLR $17.62 72572-021-10 AMPICILLIN-SULBACTAM 1.5 GRAM INJ SOLR $17.62 68084-610-21 OXYBUTYNIN CHLORIDE 10 MG ORAL TR24 $17.58 68084-610-11 OXYBUTYNIN CHLORIDE 10 MG ORAL TR24 $17.58 99999-046-48 CLONIDINE 20 MCG/ML ORAL LIQUID (COMPOUND) $17.55 0338-0017-48 D5W IV BOLUS $17.55 0781-3238-63 ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRG $17.55 0781-3238-01 ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRG $17.55 8103301105 FERROUS SULFATE 300 MG (60 MG IRON)/5 ML ORAL LIQD $17.55 0781-3555-25 HEPARIN, PORCINE (PF) 1,000 UNIT/ML INJ SOLN $17.55 0781-3555-10 HEPARIN, PORCINE (PF) 1,000 UNIT/ML INJ SOLN $17.55 99999-038-10 METRONIDAZOLE 5 MG/ML INJECTION (MHS) $17.55 47335-993-01 METRONIDAZOLE IN NACL (ISO-OS) 500 MG/100 ML IV PGBK $17.55 0264-1800-32 NS IV AFTER MEDICATION INFUSION (TO FLUSH RESIDUAL MED) $17.55 0990-7075-26 POTASSIUM CHLORIDE IN WATER 20 MEQ/100 ML IV PGBK $17.55 0409-6533-59 VANCOMYCIN 1,000 MG IV SOLR $17.54 0409-6533-31 VANCOMYCIN 1,000 MG IV SOLR $17.54 71399-0071-1 MICONAZOLE NITRATE 2 % TOPICAL CREAM $17.54 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 68084-735-11 FLUCONAZOLE 200 MG ORAL TAB $17.51 68084-735-01 FLUCONAZOLE 200 MG ORAL TAB $17.51 HC89012223 Q FEVER AB-AU $17.50 61570-073-01 ESTERIFIED ESTROGENS 0.625 MG ORAL TAB $17.47 50268-814-12 ZIPRASIDONE HCL 80 MG ORAL CAP $17.47 50268-814-11 ZIPRASIDONE HCL 80 MG ORAL CAP $17.47 50268-054-15 ACETAZOLAMIDE 250 MG ORAL TAB $17.46 50268-054-11 ACETAZOLAMIDE 250 MG ORAL TAB $17.46 68180-214-60 CYCLOSPORINE 0.05 % OPHT DPET $17.44 68180-214-30 CYCLOSPORINE 0.05 % OPHT DPET $17.44 10702-808-03 CYCLOSPORINE 0.05 % OPHT DPET $17.44 99999-002-35 SODIUM PHOSPHATE 3 MMOL/ML (NICU) ORAL SYRINGE $17.43 0781-3402-78 AMPICILLIN SODIUM 250 MG INJ SOLR $17.41 0781-3402-95 AMPICILLIN SODIUM 250 MG INJ SOLR $17.41 4110081163 VITS A AND D-WHITE PET-LANOLIN TOPICAL OINT $17.40 65197-400-10 VITS A AND D-WHITE PET-LANOLIN TOPICAL OINT $17.40 HC89024145 CENTROMERE ANTIBODY, IGG-AU $17.37 0409-1162-02 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN $17.36 0409-1162-19 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN $17.36 72572-650-01 ROCURONIUM 10 MG/ML IV SOLN $17.36 72572-650-10 ROCURONIUM 10 MG/ML IV SOLN $17.36 65862-049-30 EFAVIRENZ 600 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 31722-597-30 RITONAVIR 100 MG ORAL TAB $17.34 72603-505-01 LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN $17.32 72603-505-10 LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN $17.32 16714-693-02 FLUCONAZOLE 200 MG ORAL TAB $17.32 4771300026 DEXTROSE 40 % ORAL GEL $17.31 1150900367 BENZOCAINE-RESORCINOL 5-2 % TOPICAL CREAM $17.29 55150-165-05 LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN $17.29 63323-201-10 LIDOCAINE HCL 10 MG/ML (1 %) INJ SOLN $17.29 63323-201-03 LIDOCAINE HCL 10 MG/ML (1 %) INJ SOLN $17.29 0406-9960-01 TEMAZEPAM 7.5 MG ORAL CAP $17.29 46122-265-30 PHENOL 1.4 % MUCOUS MEMB SPRA $17.26 8770142581 PHENOL 1.4 % MUCOUS MEMB SPRA $17.26 99999-010-38 ENALAPRILAT 1.25 MG/ML INJ (MCH) $17.26 99999-045-44 FENTANYL DRIP 5 MCG/ML IN D5W 25 ML (OCM_NICU) $17.23 6961807059 FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROP $17.23 0641-6053-25 MEPERIDINE (PF) 50 MG/ML INJ SOLN $17.17 0641-6053-01 MEPERIDINE (PF) 50 MG/ML INJ SOLN $17.17 0143-9889-80 AMOXICILLIN 250 MG/5 ML ORAL SUSR $17.16 68094-129-59 LOPERAMIDE 1 MG/7.5 ML ORAL LIQD $17.16 68094-129-62 LOPERAMIDE 1 MG/7.5 ML ORAL LIQD $17.16 57896-798-01 SIMETHICONE 40 MG/0.6 ML ORAL DRPS $17.16 HC89012728 HEPATITIS BE AB-AU $17.15 50268-627-15 OXYBUTYNIN CHLORIDE 5 MG ORAL TR24 $17.12 50268-627-11 OXYBUTYNIN CHLORIDE 5 MG ORAL TR24 $17.12 0406-0523-62 OXYCODONE-ACETAMINOPHEN 10-325 MG ORAL TAB $17.12 55150-169-10 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN $17.10 0093-5246-65 OLANZAPINE 10 MG ORAL TBDL $17.05 0093-5246-19 OLANZAPINE 10 MG ORAL TBDL $17.05 60505-3276-0 OLANZAPINE 10 MG ORAL TBDL $17.05 45802-188-16 PHENYLEPH-MIN OIL-PETROLATUM 0.25-14-74.9 % RECTAL OINT $17.04 HC89006548 NORTRIPTYLINE; 1-2-AU $17.03 55150-171-10 BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJ SOLN $17.03 51079-581-06 LEUCOVORIN CALCIUM 5 MG ORAL TAB $17.03 51079-581-01 LEUCOVORIN CALCIUM 5 MG ORAL TAB $17.03 63323-965-20 POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN $17.03 63323-965-02 POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN $17.03 72603-251-25 FUROSEMIDE 10 MG/ML INJ SOLN $17.00 72603-251-01 FUROSEMIDE 10 MG/ML INJ SOLN $17.00 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 HC89019244 WEST NILE VIRUS IGG AB CSF-AU $17.00 42291-077-15 CLOBETASOL 0.05 % TOPICAL OINT $16.97 60687-830-42 DIPHENHYDRAMINE HCL 12.5 MG/5 ML ORAL LIQD $16.97 60687-830-08 DIPHENHYDRAMINE HCL 12.5 MG/5 ML ORAL LIQD $16.97 99999-043-94 FLUTICASONE PROPION-SALMETEROL 115-21 MCG/ACTUATION INHALATION HFAA $16.95 HC89006563 PHENYTOIN FREE(PNL)-AU $16.94 HC89016521 PHENYTOIN TOTAL(PNL)-AU $16.94 HC89020887 WEST NILE VIRUS ELISA(PNL) -AU $16.92 72205-101-07 BUMETANIDE 0.25 MG/ML INJ SOLN $16.90 72205-101-01 BUMETANIDE 0.25 MG/ML INJ SOLN $16.90 60687-423-21 CLOBAZAM 10 MG ORAL TAB $16.90 60687-423-11 CLOBAZAM 10 MG ORAL TAB $16.90 0338-0017-38 D5W IV BOLUS $16.90 0143-9682-25 GLYCOPYRROLATE 0.2 MG/ML INJ SOLN $16.90 0143-9682-01 GLYCOPYRROLATE 0.2 MG/ML INJ SOLN $16.90 45802-004-02 HYDROCORTISONE 2.5 % TOPICAL CREAM $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 99999-046-26 LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN $16.90 25021-131-82 METRONIDAZOLE IN NACL (ISO-OS) 500 MG/100 ML IV PGBK $16.90 68180-675-11 OSELTAMIVIR 30 MG ORAL CAP $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 68180-677-11 OSELTAMIVIR 75 MG ORAL CAP $16.90 16714-528-20 PROPOFOL 10 MG/ML IV EMUL $16.90 0409-1283-31 HYDROMORPHONE 1 MG/ML INJ SOLN (MHS WRAPPER) $16.89 0409-1283-03 HYDROMORPHONE 1 MG/ML INJ SOLN (MHS WRAPPER) $16.89 68180-658-06 RIFAMPIN 150 MG ORAL CAP $16.86 63323-236-10 CEFAZOLIN 500 MG INJ SOLR $16.84 0641-1496-35 PROMETHAZINE 50 MG/ML INJ SOLN $16.84 0641-1496-31 PROMETHAZINE 50 MG/ML INJ SOLN $16.84 67877-537-14 TEMOZOLOMIDE 5 MG ORAL CAP (MCH) $16.83 63304-479-01 CEVIMELINE 30 MG ORAL CAP $16.80 0054-0334-25 CEVIMELINE 30 MG ORAL CAP $16.80 63323-559-63 ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRG $16.79 63323-559-65 ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRG $16.79 55150-170-30 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN $16.77 99999-040-95 CEFAZOLIN 50 MG/ML INJ SYRINGE (SLH 10 G) $16.77 44567-130-10 CEFEPIME 1 GRAM INJ SOLR $16.77 63323-492-45 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $16.77 63323-492-26 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $16.77 0641-6191-01 MORPHINE 2 MG/ML INJ SOLN (MHS WRAPPER) $16.77 0641-6191-10 MORPHINE 2 MG/ML INJ SOLN (MHS WRAPPER) $16.77 0641-6192-01 MORPHINE 4 MG/ML INJ SOLN (MHS WRAPPER) $16.77 0641-6192-10 MORPHINE 4 MG/ML INJ SOLN (MHS WRAPPER) $16.77 0071-0350-60 PHENELZINE 15 MG ORAL TAB $16.75 10939958228 CARBAMIDE PEROXIDE 6.5 % OTIC DROP $16.67 70677-1154-1 CARBAMIDE PEROXIDE 6.5 % OTIC DROP $16.67 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 64980-135-01 DIPYRIDAMOLE 75 MG ORAL TAB $16.59 0338-0017-31 DEXTROSE 5 % IN WATER (D5W) IV SOLP $16.58 99999-043-52 HYDROCORTISONE 2 MG/ML ORAL LIQUID (COMPOUND) $16.58 0019-0953-50 IOTHALAMATE MEGLUMINE 60 % INJ SOLN $16.58 0338-0049-31 NS IV AFTER MEDICATION INFUSION (TO FLUSH RESIDUAL MED) $16.58 0641-6127-25 MORPHINE 10 MG/ML INJ SOLN (MHS WRAPPER) $16.56 0641-6127-01 MORPHINE 10 MG/ML INJ SOLN (MHS WRAPPER) $16.56 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 HC89023576 CANDIDA SPECIES TMA-AU $16.50 HC89002000 DESIPRAMINE; 1-2-AU $16.50 0378-6060-01 DILTIAZEM HCL 60 MG ORAL CP12 $16.50 0641-6052-25 MEPERIDINE (PF) 25 MG/ML INJ SOLN $16.48 0641-6052-01 MEPERIDINE (PF) 25 MG/ML INJ SOLN $16.48 58914-601-20 BISMUTH SUBCIT K-METRONIDZ-TCN 140-125-125 MG ORAL CAP $16.47 53329-013-11 MINERAL OIL RECTAL ENEM $16.43 HC89008924 MANGANESE-AU $16.37 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 67457-815-04 CLINDAMYCIN PHOSPHATE 150 MG/ML INJ SOLN $16.28 67457-815-00 CLINDAMYCIN PHOSPHATE 150 MG/ML INJ SOLN $16.28 31722-557-60 ABACAVIR 300 MG ORAL TAB $16.25 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 0143-9332-01 BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJ SOLN $16.25 0143-9332-10 BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJ SOLN $16.25 0143-9382-01 CEFEPIME 1 GRAM INJ SOLR $16.25 0143-9382-10 CEFEPIME 1 GRAM INJ SOLR $16.25 76204-028-12 CROMOLYN 20 MG/2 ML INHALATION NEBU $16.25 76204-028-60 CROMOLYN 20 MG/2 ML INHALATION NEBU $16.25 23155-839-11 CYCLOSPORINE MODIFIED 100 MG ORAL CAP $16.25 23155-839-30 CYCLOSPORINE MODIFIED 100 MG ORAL CAP $16.25 62332-636-06 DABIGATRAN ETEXILATE 150 MG ORAL CAP $16.25 62332-634-06 DABIGATRAN ETEXILATE 75 MG ORAL CAP $16.25 0264-1510-32 DEXTROSE 5 % IN WATER (D5W) IV SOLP $16.25 42799-405-01 ETHACRYNIC ACID 25 MG ORAL TAB $16.25 60687-538-11 FEBUXOSTAT 40 MG ORAL TAB $16.25 60687-538-21 FEBUXOSTAT 40 MG ORAL TAB $16.25 71288-414-01 GLYCOPYRROLATE 0.2 MG/ML INJ SOLN (MHS WRAPPER) $16.25 25021-403-01 HEPARIN (PORCINE) 10,000 UNIT/ML INJ SOLN $16.25 59762-0333-2 LATANOPROST 0.005 % OPHT DROP $16.25 72485-106-25 LEVETIRACETAM 500 MG/5 ML IV SOLN $16.25 72485-106-01 LEVETIRACETAM 500 MG/5 ML IV SOLN $16.25 25021-780-05 LEVETIRACETAM 500 MG/5 ML IV SOLN $16.25 72485-106-10 LEVETIRACETAM 500 MG/5 ML IV SOLN $16.25 33342-258-66 OSELTAMIVIR 75 MG ORAL CAP $16.25 99999-047-51 OXALIPLATIN 0.1 MG/ML DILUTED IV SOLN (FOR DESENSITIZATION) $16.25 53489-700-07 QUININE SULFATE 324 MG ORAL CAP $16.25 33342-107-07 RISEDRONATE 5 MG ORAL TAB $16.25 68462-714-08 RUFINAMIDE 400 MG ORAL TAB $16.25 99999-046-34 VANCOMYCIN IN 0.9 % SODIUM CHL 750 MG/250 ML IV SOLN $16.25 1093956433 BACITRACIN ZINC 500 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 1093956833 BACITRACIN ZINC-POLYMYXIN B 500-10,000 UNIT/GRAM TOPICAL OINT $16.25 70677-1212-1 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 0641-6125-01 MORPHINE 4 MG/ML INJ SOLN (MHS WRAPPER) $16.23 0641-6125-25 MORPHINE 4 MG/ML INJ SOLN (MHS WRAPPER) $16.23 0378-1430-05 NICARDIPINE 30 MG ORAL CAP $16.22 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 51079-767-08 DIVALPROEX 500 MG ORAL TB24 $16.15 51079-767-01 DIVALPROEX 500 MG ORAL TB24 $16.15 57896-647-12 MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSP $16.15 59746-003-14 METHYLPREDNISOLONE 16 MG ORAL TAB $16.15 HC89013205 HEPATITIS BE AG-AU $16.15 57896-736-04 DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML ORAL LIQD $16.11 0904-6305-21 PHENOL 1.4 % MUCOUS MEMB SPRA $16.11 50268-477-11 LEFLUNOMIDE 10 MG ORAL TAB $16.08 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 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 HC89025092 AMPHETAMINES 3 OR 4-AU $16.00 HC89013395 AMPLIFIED PROBE TECH-AU $16.00 HC89011449 ANTI SMOOTH MUSCLE AB-AU $16.00 HC89010953 ANTI-CARDIOLIPIN AB-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 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 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 HC89011381 SMITH (ENA) AD IGG-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 65219-016-10 AMPICILLIN SODIUM 500 MG INJ SOLR $15.99 65219-016-01 AMPICILLIN SODIUM 500 MG INJ SOLR $15.99 0143-9595-25 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $15.99 0143-9595-01 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $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 42291-374-90 LETROZOLE 2.5 MG ORAL TAB $15.94 0536-1288-06 PHENYLEPH-MIN OIL-PETROLATUM 0.25-14-74.9 % RECTAL OINT $15.93 0264-1510-31 DEXTROSE 5 % IN WATER (D5W) IV SOLP $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 16714-198-01 VORICONAZOLE 50 MG ORAL TAB $15.88 0228-2780-11 PROPRANOLOL 120 MG ORAL CS24 $15.84 0409-1159-02 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $15.80 0409-1159-19 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $15.80 69339-152-01 DIPHENHYDRAMINE HCL 12.5 MG/5 ML ORAL LIQD $15.80 69339-152-17 DIPHENHYDRAMINE HCL 12.5 MG/5 ML ORAL LIQD $15.80 99999-000-39 VANCOMYCIN 5MG/ML SYRINGE $15.80 0281-0326-08 NITROGLYCERIN 2 % TRANSDERMAL OINT $15.74 71399-3884-6 LIDOCAINE 4 % TOPICAL PTMD $15.70 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 0132-0703-36 BISACODYL 10 MG/30 ML RECTAL ENEM $15.63 HC89007413 CAROTENE-AU $15.60 65862-706-80 AMOXICILLIN 125 MG/5 ML ORAL SUSR $15.60 99999-037-37 CEFAZOLIN 2 GRAM/20 ML SYRINGE (USING 100 G) $15.60 99999-041-93 CEFAZOLIN IN DEXTROSE (ISO-OS) 2 GRAM/100 ML IV PGBK $15.60 25021-106-10 CEFTRIAXONE 1 GRAM INJ SOLR $15.60 65162-734-09 FELBAMATE 400 MG ORAL TAB $15.60 25021-400-01 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $15.60 99999-036-82 MITOTANE 250 MG ORAL PARTIAL TAB $15.60 0781-3422-92 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $15.60 0781-3422-71 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $15.60 63323-269-37 PROPOFOL 10 MG/ML IV EMUL $15.60 62332-343-30 CANDESARTAN 16 MG ORAL TAB $15.57 62332-341-30 CANDESARTAN 4 MG ORAL TAB $15.57 62332-342-30 CANDESARTAN 8 MG ORAL TAB $15.57 99999-042-50 HYDROCODONE-CHLORPHENIRAMINE 10-8 MG/5 ML ORAL SU12 $15.54 HC89008171 GASTRIN-AU $15.52 0409-0007-10 LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN $15.47 0409-0007-01 LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN $15.47 63739-168-33 DOXYCYCLINE HYCLATE 100 MG ORAL TAB $15.44 71266-9070-2 KETAMINE 50 MG/ML INJ SOLN (MHS WRAPPER) $15.44 0409-1159-01 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $15.41 0409-1159-18 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $15.41 57896-661-08 DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML ORAL LIQD $15.41 0904-7096-61 PIOGLITAZONE 30 MG ORAL TAB $15.38 10361-793-01 SOD BICARB-CITRIC AC-SIMETH 2.21-1.53 GRAM/4 GRAM ORAL GREP $15.36 99999-041-15 VANCOMYCIN 50 MG/ML ORAL SOLR $15.36 0904-6985-20 DIPHENHYDRAMINE HCL 12.5 MG/5 ML ORAL LIQ (MCH) $15.34 63323-492-27 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $15.34 63323-492-04 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $15.34 49348-854-72 DIPHENHYDRAMINE-ZINC ACETATE 2-0.1 % TOPICAL CREAM $15.32 1093919844 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 49884-658-09 CANDESARTAN 4 MG ORAL TAB $15.28 49884-659-09 CANDESARTAN 8 MG ORAL TAB $15.28 55150-168-30 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $15.21 99999-036-50 CLONAZEPAM 0.1 MG/ML ORAL LIQUID (USING 1 MG TAB) $15.18 70748-175-01 ARFORMOTEROL 15 MCG/2 ML INHALATION NEBU $15.17 70748-175-30 ARFORMOTEROL 15 MCG/2 ML INHALATION NEBU $15.17 70756-612-70 ARFORMOTEROL 15 MCG/2 ML INHALATION NEBU $15.17 70756-612-12 ARFORMOTEROL 15 MCG/2 ML INHALATION NEBU $15.17 99999-002-43 DIGOXIN 50 MCG/ML (NICU) ORAL SYRINGE $15.17 60687-629-21 FENOFIBRATE NANOCRYSTALLIZED 145 MG ORAL TAB $15.17 72572-017-01 AMPICILLIN SODIUM 2 G IV SOLR (MCH) $15.15 72572-017-10 AMPICILLIN SODIUM 2 G IV SOLR (MCH) $15.15 59762-0117-1 MESALAMINE 400 MG ORAL CDTI $15.13 60687-828-42 DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML ORAL SYRP $15.08 0527-1789-01 FLUPHENAZINE HCL 2.5 MG ORAL TAB $15.08 99999-047-10 MIDAZOLAM DRIP 1 MG/ML IN D5W 10 ML (OCM_NICU) $15.08 0121-1276-10 DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML ORAL SYRP $15.02 0121-1276-00 DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML ORAL SYRP $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 0904-7137-61 NITROFURANTOIN MONOHYD/M-CRYST 100 MG ORAL CAP $15.00 HC89013940 ACETYLCHOLINE RECEPTOR BINDING AB-AU $15.00 HC89091862 ALDOSTERONE, SERUM-AU $15.00 HC89022032 AMPHETAMINES;1 OR 2 SERUM QNT(PNL)-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 HC89022107 METHAMPHETAMINES(MDA,MDEA,MDMA)SERUM QNTS(PNL)-AU $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 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 99999-000-05 CEFAZOLIN 50 MG/ML OPHTHALMIC SOLUTION $15.00 HC89014070 ANA TITER REFLEX (PNL)-AU $14.98 0143-9173-10 LIDOCAINE HCL 20 MG/ML (2 %) INJ SOLN $14.95 0143-9173-01 LIDOCAINE HCL 20 MG/ML (2 %) INJ SOLN $14.95 0574-0790-01 METHAZOLAMIDE 25 MG ORAL TAB $14.95 0338-1055-48 METRONIDAZOLE IN NACL (ISO-OS) 500 MG/100 ML IV PGBK $14.95 HC89013510 BETA-2 MICROGLOBULIN URINE-AU $14.94 60687-103-95 FAMCICLOVIR 500 MG ORAL TAB $14.91 60687-103-25 FAMCICLOVIR 500 MG ORAL TAB $14.91 HC89012629 HERPES I&II SIMPLE AB (PNL)-AU $14.90 55150-167-10 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $14.89 63323-806-12 FENTANYL (PF) 50 MCG/ML INJ FOR INTRATHECAL PAIN PUMP REFILL (OCM) $14.89 63323-806-02 FENTANYL (PF) 50 MCG/ML INJ FOR INTRATHECAL PAIN PUMP REFILL (OCM) $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 0904-6570-61 OXYBUTYNIN CHLORIDE 5 MG ORAL TR24 $14.89 63323-965-10 POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN $14.89 63323-965-03 POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN $14.89 49938-102-30 DAPSONE 25 MG ORAL TAB $14.83 62332-343-90 CANDESARTAN 16 MG ORAL TAB $14.81 62332-341-90 CANDESARTAN 4 MG ORAL TAB $14.81 62332-342-90 CANDESARTAN 8 MG ORAL TAB $14.81 0904-7351-04 AZITHROMYCIN 500 MG ORAL TAB $14.80 68462-469-54 BUMETANIDE 0.25 MG/ML INJ SOLN $14.79 68462-469-40 BUMETANIDE 0.25 MG/ML INJ SOLN $14.79 25021-321-04 BUMETANIDE 0.25 MG/ML INJ SOLN $14.79 68084-928-95 PILOCARPINE HCL 5 MG ORAL TAB $14.79 68084-928-25 PILOCARPINE HCL 5 MG ORAL TAB $14.79 0115-1911-01 RIMANTADINE 100 MG ORAL TAB $14.78 HC89012611 HEPATITIS DELTA AB-AU $14.77 60687-746-01 MISOPROSTOL 200 MCG ORAL TAB $14.76 60687-746-11 MISOPROSTOL 200 MCG ORAL TAB $14.76 25021-674-10 ETOMIDATE 2 MG/ML IV SOLN $14.76 65219-445-12 ETOMIDATE 2 MG/ML IV SOLN $14.76 65219-445-22 ETOMIDATE 2 MG/ML IV SOLN $14.76 63323-064-01 MAGNESIUM SULFATE 4 MEQ/ML INJ SOLN $14.76 63323-064-03 MAGNESIUM SULFATE 4 MEQ/ML INJ SOLN $14.76 HC89012801 PARVOVIRUS B19 AB-AU $14.75 60687-430-65 CHLORPROMAZINE 25 MG ORAL TAB $14.72 60687-787-01 AMOXICILLIN 500 MG ORAL CAP $14.69 60687-787-11 AMOXICILLIN 500 MG ORAL CAP $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 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 16714-820-01 TENOFOVIR DISOPROXIL FUMARATE 300 MG ORAL TAB $14.64 50268-599-15 NIFEDIPINE 90 MG ORAL TR24 $14.63 50268-599-11 NIFEDIPINE 90 MG ORAL TR24 $14.63 65219-014-10 AMPICILLIN SODIUM 250 MG INJ SOLR $14.63 65219-014-01 AMPICILLIN SODIUM 250 MG INJ SOLR $14.63 72603-415-25 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $14.63 60505-6152-1 CEFTRIAXONE 500 MG INJ SOLR $14.63 69238-1126-1 ETHACRYNIC ACID 25 MG ORAL TAB $14.63 99999-047-42 FAMOTIDINE 2 MG/ML INJ DILUTION (MCH) $14.63 0143-9317-01 LEVOFLOXACIN IN D5W 750 MG/150 ML IV PGBK $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 99999-045-45 MORPHINE DRIP 0.1 MG/ML IN D5W 25 ML (OCM_NICU) $14.63 0904-7427-30 OXYMETAZOLINE 0.05 % NASL SPRAY (MHS WRAPPER) $14.63 0093-3129-01 DISOPYRAMIDE PHOSPHATE 150 MG ORAL CAP $14.61 50268-179-13 CLARITHROMYCIN 500 MG ORAL TAB $14.55 50268-179-11 CLARITHROMYCIN 500 MG ORAL TAB $14.55 50268-163-15 CHLORPROMAZINE 25 MG ORAL TAB $14.53 50268-163-11 CHLORPROMAZINE 25 MG ORAL TAB $14.53 81565-205-02 FENTANYL 50 MCG/ML INJ SOLN (FOR INTRANASAL USE) $14.53 81565-205-01 FENTANYL 50 MCG/ML INJ SOLN (FOR INTRANASAL USE) $14.53 0071-0007-40 PHENYTOIN 50 MG ORAL CHEW $14.53 39328-034-50 ACETAMINOPHEN 650 MG/20.3 ML ORAL LIQD (MHS WRAPPER) $14.52 39328-034-20 ACETAMINOPHEN 650 MG/20.3 ML ORAL LIQD (MHS WRAPPER) $14.52 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 0121-1730-00 DIPHENHYDRAMINE HCL 12.5 MG/5 ML ORAL LIQD $14.50 71288-432-91 ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRG $14.50 71288-432-92 ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRG $14.50 99999-046-42 SUCRALFATE 100 MG/ML ORAL SUSP $14.50 0406-0522-62 OXYCODONE-ACETAMINOPHEN 7.5-325 MG ORAL TAB $14.48 HC89012819 PARVOVIRUS B19 AB (PNL)-AU $14.47 47781-355-11 BUPRENORPHINE-NALOXONE 2-0.5 MG SL FILM $14.47 47781-355-03 BUPRENORPHINE-NALOXONE 2-0.5 MG SL FILM $14.47 0378-8765-16 BUPRENORPHINE-NALOXONE 2-0.5 MG SL FILM $14.47 0378-8765-93 BUPRENORPHINE-NALOXONE 2-0.5 MG SL FILM $14.47 65162-778-10 BUDESONIDE 3 MG ORAL CECX $14.46 8770143152 CARBAMIDE PEROXIDE 6.5 % OTIC DROP $14.43 55150-161-02 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $14.43 99999-045-16 MELATONIN 1 MG/ML ORAL LIQUID (COMPOUND) $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 4467710202 MODIFIED LANOLIN 100 % TOPICAL CREAM $14.38 HC89011423 SSB REFLEX (PNL)-AU $14.37 4110081128 DIMETHICONE-ZNOX-VIT A-D-ALOE 1-10 % TOPICAL CREAM $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 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 63323-660-05 METOPROLOL TARTRATE 5 MG/5 ML IV SOLN $14.37 63323-660-01 METOPROLOL TARTRATE 5 MG/5 ML IV SOLN $14.37 21922-063-04 TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINT $14.33 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 44567-700-25 CEFTRIAXONE 500 MG INJ SOLR $14.30 0143-9621-01 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG/ML INJ SOLN $14.30 0143-9621-25 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG/ML INJ SOLN $14.30 65219-464-05 DEXTROSE 5 % IN WATER (D5W) IV SOLP $14.30 65219-464-50 DEXTROSE 5 % IN WATER (D5W) IV SOLP $14.30 23155-473-41 FUROSEMIDE 10 MG/ML INJ SOLN $14.30 23155-473-31 FUROSEMIDE 10 MG/ML INJ SOLN $14.30 16729-500-08 FUROSEMIDE 10 MG/ML INJ SOLN $14.30 16729-500-30 FUROSEMIDE 10 MG/ML INJ SOLN $14.30 99999-009-62 LABETALOL 5 MG/ML IV SOLN $14.30 44567-145-01 MEROPENEM 500 MG IV SOLR $14.30 44567-145-10 MEROPENEM 500 MG IV SOLR $14.30 23155-240-41 METOCLOPRAMIDE 5 MG/ML INJ SOLN (MCH) $14.30 23155-240-31 METOCLOPRAMIDE 5 MG/ML INJ SOLN (MCH) $14.30 0641-6056-01 MIDAZOLAM 1MG/ML INJECTABLE SOLUTION (MHS WRAPPER) $14.30 0641-6056-10 MIDAZOLAM 1MG/ML INJECTABLE SOLUTION (MHS WRAPPER) $14.30 70069-801-25 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $14.30 70069-801-01 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $14.30 60687-344-25 DOXYCYCLINE MONOHYDRATE 100 MG ORAL TAB $14.29 60687-344-95 DOXYCYCLINE MONOHYDRATE 100 MG ORAL TAB $14.29 60687-673-21 NATEGLINIDE 60 MG ORAL TAB $14.29 60687-673-11 NATEGLINIDE 60 MG ORAL TAB $14.29 60505-2965-7 MYCOPHENOLATE SODIUM 180 MG ORAL TBEC $14.26 60687-721-21 DESMOPRESSIN 0.1 MG ORAL TAB $14.24 60687-721-11 DESMOPRESSIN 0.1 MG ORAL TAB $14.24 70677-1000-1 MICONAZOLE NITRATE 2 % TOPICAL CREAM $14.24 0536-1303-75 SIMETHICONE 40 MG/0.6 ML ORAL DRPS $14.24 61269-385-12 BISMUTH SUBCIT K-METRONIDZ-TCN 140-125-125 MG ORAL CAP $14.22 68084-415-11 DIVALPROEX 500 MG ORAL TB24 $14.22 68084-415-01 DIVALPROEX 500 MG ORAL TB24 $14.22 0904-0430-06 DOXYCYCLINE HYCLATE 100 MG ORAL TAB $14.20 0378-0860-01 CLOZAPINE 100 MG ORAL TAB $14.18 0641-9217-01 DILTIAZEM HCL 5 MG/ML IV SOLN $14.17 0641-9217-10 DILTIAZEM HCL 5 MG/ML IV SOLN $14.17 904727770 FERROUS SULFATE 300 MG (60 MG IRON)/5 ML ORAL LIQD $14.17 72572-590-01 PROPOFOL 10 MG/ML IV EMUL $14.17 72572-590-10 PROPOFOL 10 MG/ML IV EMUL $14.17 HC89007165 ALUMINIUM-AU $14.15 HC89017545 BLASTOMYCES AB(PNL)-AU $14.15 HC89014443 MEASLES (RUBEOLA)(PNL) IGM-AU $14.15 50268-813-12 ZIPRASIDONE HCL 60 MG ORAL CAP $14.13 50268-813-11 ZIPRASIDONE HCL 60 MG ORAL CAP $14.13 42571-160-30 AMOXICILLIN-POT CLAVULANATE 250-125 MG ORAL TAB $14.09 0781-8089-26 AZITHROMYCIN 250 MG ORAL TAB $14.09 65862-891-30 VORICONAZOLE 50 MG ORAL TAB $14.09 574006905 DEXTROSE 40 % ORAL GEL $14.06 574006924 DEXTROSE 40 % ORAL GEL $14.06 51672-4026-6 KETOCONAZOLE 200 MG ORAL TAB $14.04 0121-4675-40 VALPROATE SODIUM 250 MG/5 ML ORAL SYRP (MCH) $14.04 HC89011357 RNP REFLEX (PNL)-AU $14.03 HC89011373 SCLERODERMA SCL-70 AB IGG-AU $14.03 HC89011399 SMITH REFLEX (PNL)-AU $14.03 45802-358-03 DIPHENHYDRAMINE-ZINC ACETATE 2-0.1 % TOPICAL CREAM $14.01 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 HC88600077 VENIPUNCTURE ROUTINE $14.00 HC36001006 VENIPUNCTURE ROUTINE $14.00 HC88600044 VENIPUNCTURE ROUTINE (BY UNIT) $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 HC89024087 WEST NILE VIRUS IGG AB SERUM-AU $14.00 HC89024079 WEST NILE VIRUS IGM AB SERUM-AU $14.00 HC89001671 YERSINIA AB-QD $14.00 HC89016570 REDUCING SUBS FECAL-AU $13.95 0032-0046-70 LIPASE-PROTEASE-AMYLASE 6,000-19,000 -30,000 UNIT ORAL CPDR $13.95 16571-657-10 CEVIMELINE 30 MG ORAL CAP $13.94 42291-076-15 CLOBETASOL 0.05 % TOPICAL CREAM $13.94 HC89017081 PHOSPHATIDYLSERINE ANTIBODY-AU $13.94 60687-778-11 MEXILETINE 150 MG ORAL CAP $13.92 60687-778-21 MEXILETINE 150 MG ORAL CAP $13.92 63323-540-07 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $13.91 63323-540-67 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $13.91 50268-652-11 PILOCARPINE HCL 5 MG ORAL TAB $13.91 50268-652-12 PILOCARPINE HCL 5 MG ORAL TAB $13.91 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 SOLN $13.86 0409-4282-25 LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN $13.86 1093957233 HYDROCORTISONE 1 % TOPICAL OINT $13.85 49348-522-72 HYDROCORTISONE 1 % TOPICAL OINT $13.85 0409-1890-01 MORPHINE 2 MG/ML INJ SOLN (MHS WRAPPER) $13.84 0409-1890-03 MORPHINE 2 MG/ML INJ SOLN (MHS WRAPPER) $13.84 71399-0122-2 VITS A AND D-WHITE PET-LANOLIN TOPICAL OINT $13.83 59762-3060-2 AZITHROMYCIN 250 MG ORAL TAB $13.81 50111-787-10 AZITHROMYCIN 250 MG ORAL TAB $13.81 39328-029-24 HYDROCORTISONE ACETATE 25 MG RECTAL SUPP $13.81 4116706003 METHYL SALICYLATE-MENTHOL 15-10 % TOPICAL CREAM $13.81 41167-0600-3 METHYL SALICYLATE-MENTHOL 15-10 % TOPICAL CREAM $13.81 0641-6027-01 FENTANYL 50 MCG/ML INJ SOLN (FOR INTRANASAL USE) $13.81 0641-6027-25 FENTANYL 50 MCG/ML INJ SOLN (FOR INTRANASAL USE) $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 (SLH) $13.78 99999-042-32 MORPHINE (PF) 0.5 MG/ML INJ SOLN (MCH) $13.75 45802-357-58 SODIUM CHLORIDE 0.65 % NASL SPRA $13.75 HC89010961 C1 INHIBITOR-AU $13.73 45963-343-02 DESIPRAMINE 50 MG ORAL TAB $13.72 16252-540-01 ISRADIPINE 5 MG ORAL CAP $13.72 51079-631-20 PRAZOSIN 2 MG ORAL CAP $13.67 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 99999-040-93 CEFAZOLIN 50 MG/ML INJ SYRINGE (SLH 10 G) $13.65 60687-817-40 DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML ORAL SYRP $13.65 63323-280-02 FUROSEMIDE 10 MG/ML INJ SOLN $13.65 63323-280-01 FUROSEMIDE 10 MG/ML INJ SOLN $13.65 55150-322-25 FUROSEMIDE 10 MG/ML INJ SOLN (MCH) $13.65 45802-438-03 HYDROCORTISONE 1 % TOPICAL CREAM $13.65 45802-276-03 HYDROCORTISONE 1 % TOPICAL OINT $13.65 0409-0152-01 METRONIDAZOLE IN NACL (ISO-OS) 500 MG/100 ML IV PGBK $13.65 0409-0152-24 METRONIDAZOLE IN NACL (ISO-OS) 500 MG/100 ML IV PGBK $13.65 45802-410-59 OXYMETAZOLINE 0.05 % NASL SPRAY (MHS WRAPPER) $13.65 69618-050-51 OXYMETAZOLINE 0.05 % NASL SPRAY (MHS WRAPPER) $13.65 43066-007-10 ROCURONIUM 10 MG/ML IV SOLN $13.65 225055050 SODIUM CHLORIDE 0.65 % NASL DROP $13.65 43598-447-70 NICOTINE 14 MG/24 HR TRANSDERMAL PT24 $13.64 4898500151 NICOTINE 14 MG/24 HR TRANSDERMAL PT24 $13.64 4898500154 NICOTINE 21 MG/24 HR TRANSDERMAL PT24 $13.64 4898500156 NICOTINE 7 MG/24 HR TRANSDERMAL PT24 $13.64 43598-446-70 NICOTINE 7 MG/24 HR TRANSDERMAL PT24 $13.64 HC89021455 CONCENTRATION AGNT INF SPECIMEN -AU $13.64 16714-814-01 SEVELAMER CARBONATE 800 MG ORAL TAB $13.64 0904-7350-61 AZITHROMYCIN 250 MG ORAL TAB $13.62 65862-095-20 CEFPODOXIME 100 MG ORAL TAB $13.61 HC89009567 ACID PHOS PROSTATIC-AU $13.58 HC89007447 CHLORIDE FECAL-AU $13.58 HC89014005 POTASSIUM STOOL-AU $13.58 HC89009880 SODIUM OTHER SOURCE-AU $13.58 45802-368-00 IMIQUIMOD 5 % TOPICAL CRPK $13.54 45802-368-62 IMIQUIMOD 5 % TOPICAL CRPK $13.54 57237-312-51 DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML ORAL LIQD $13.52 57237-312-05 DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML ORAL LIQD $13.52 0121-0638-05 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 69339-149-05 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 70677-1111-1 MAGNESIUM CITRATE ORAL SOLN $13.47 70677-1112-1 MAGNESIUM CITRATE ORAL SOLN $13.47 0536-1316-28 ZINC OXIDE 20 % TOPICAL OINT $13.46 60687-735-11 MISOPROSTOL 100 MCG ORAL TAB $13.43 0591-0395-01 PENTAZOCINE-NALOXONE 50-0.5 MG ORAL TAB $13.40 HC89003511 MUMPS IGM-AU $13.40 42858-867-06 DRONABINOL 2.5 MG ORAL CAP $13.40 0904-7182-61 DIVALPROEX 500 MG ORAL TB24 $13.39 99999-047-12 HYDROCODONE-ACETAMINOPHEN 7.5-325 MG/15 ML ORAL SOLN $13.39 HC89013585 CITRATE-AU $13.37 HC89005490 MYELOPEROXIDASE AB (MPO)-AU $13.37 HC89008510 SERINE PROTEASE3 IGG IMMUNOASSAY-AU $13.37 45802-868-66 POLYETHYLENE GLYCOL 3350 17 GRAM ORAL PWPK $13.35 45802-868-00 POLYETHYLENE GLYCOL 3350 17 GRAM ORAL PWPK $13.35 68084-805-11 METHYLPHENIDATE HCL 5 MG ORAL TAB $13.34 68084-805-21 METHYLPHENIDATE HCL 5 MG ORAL TAB $13.34 49884-465-64 CHOLESTYRAMINE (WITH SUGAR) 4 GRAM ORAL PWPK $13.33 49884-465-65 CHOLESTYRAMINE (WITH SUGAR) 4 GRAM ORAL PWPK $13.33 0904-7245-68 LACOSAMIDE 100 MG ORAL TAB $13.33 17433-9876-5 DOCUSATE SODIUM 283 MG/5 ML RECTAL ENEM $13.33 0378-6173-01 METOLAZONE 5 MG ORAL TAB $13.33 HC89022479 CULTURE ID DEFIN/ADDL HSV(PNL)+-AU $13.32 0024-1596-01 PRIMAQUINE 26.3 MG (15 MG BASE) ORAL TAB $13.30 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 51079-109-01 BUPROPION HCL 300 MG ORAL TB24 $13.26 51079-109-03 BUPROPION HCL 300 MG ORAL TB24 $13.26 99998-000-71 MEDIUM CHAIN TRIGLYCERIDES 7.7 KCAL/ML ORAL OIL $13.26 65862-626-03 RIZATRIPTAN 10 MG ORAL TBDL $13.26 68382-528-60 CHOLESTYRAMINE (WITH SUGAR) 4 GRAM ORAL PWPK $13.25 0904-6501-61 FLUCONAZOLE 200 MG ORAL TAB $13.25 23155-823-73 CABERGOLINE 0.5 MG ORAL TAB $13.20 0121-1971-00 ACETAMINOPHEN 650 MG/20.3 ML ORAL LIQD (MHS WRAPPER) $13.20 0121-1971-21 ACETAMINOPHEN 650 MG/20.3 ML ORAL LIQD (MHS WRAPPER) $13.20 63739-115-10 FLUCONAZOLE 200 MG ORAL TAB $13.20 99999-005-68 PHENOBARBITAL 5 MG/ML INJ SOLN DILUTION (MCH) $13.18 60687-447-01 CELECOXIB 200 MG ORAL CAP $13.16 60687-447-11 CELECOXIB 200 MG ORAL CAP $13.16 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 HC89023139 KAPPA FREE LIGHT CHAINS QT URINE-AU $13.11 0536-1265-95 CLOTRIMAZOLE 1 % TOPICAL CREAM $13.10 0527-1367-01 PROBENECID 500 MG ORAL TAB $13.10 99996-000-14 BECKSTRAND DEODORANT (CHARGE ONLY) $13.07 0591-2341-01 METAXALONE 800 MG ORAL TAB $13.05 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 63323-616-03 AMIODARONE 50 MG/ML IV SOLN $13.01 0143-9875-25 AMIODARONE 50 MG/ML IV SOLN $13.01 0143-9875-01 AMIODARONE 50 MG/ML IV SOLN $13.01 63323-616-01 AMIODARONE 50 MG/ML IV SOLN $13.01 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 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 HC89018253 IMMUNOGLOB IGA AR-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 HC89018063 TISSUE TRANSGLUTAMNS AB IGA-AU $13.00 HC89012926 TREPONEMA PALLIDUM AB-AU $13.00 99999-044-45 AMIODARONE IN D5W 150 MG/100 ML (1.5 MG/ML) IV SOLN (MHS) $13.00 0143-9857-01 CEFTRIAXONE 1 G INJ SOLR (MCH) $13.00 0143-9857-25 CEFTRIAXONE 1 G INJ SOLR (MCH) $13.00 25021-311-04 FUROSEMIDE 10 MG/ML INJ SOLN $13.00 0143-9157-10 FUROSEMIDE 10 MG/ML INJ SOLN $13.00 0143-9157-01 FUROSEMIDE 10 MG/ML INJ SOLN $13.00 50742-184-25 LEUCOVORIN CALCIUM 25 MG ORAL TAB $13.00 23155-620-41 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $13.00 23155-620-31 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $13.00 71288-807-02 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $13.00 71288-807-01 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $13.00 0487-5901-99 RACEPINEPHRINE 2.25 % INHALATION NEBU $13.00 0487-2784-01 RACEPINEPHRINE 2.25 % INHALATION NEBU $13.00 65862-421-30 TENOFOVIR DISOPROXIL FUMARATE 300 MG ORAL TAB $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 8770142560 CARBAMIDE PEROXIDE 6.5 % OTIC DROP $12.97 13709-230-01 CARBAMIDE PEROXIDE 6.5 % OTIC DROP $12.97 0132-0301-40 MINERAL OIL RECTAL ENEM $12.97 44677-10302 MODIFIED LANOLIN 100 % TOPICAL CREAM $12.97 0904-7435-35 OXYMETAZOLINE 0.05 % NASL SPRAY (MHS WRAPPER) $12.97 0641-2555-41 PHENYTOIN SODIUM 50 MG/ML IV SOLN $12.97 8019656775 SODIUM PHOSPHATES 19-7 GRAM/118 ML RECTAL ENEM $12.97 0093-3127-01 DISOPYRAMIDE PHOSPHATE 100 MG ORAL CAP $12.96 59762-0386-1 DISOPYRAMIDE PHOSPHATE 100 MG ORAL CAP $12.96 60687-215-11 PROPRANOLOL 60 MG ORAL CS24 $12.96 60687-215-01 PROPRANOLOL 60 MG ORAL CS24 $12.96 HC89012397 COXSACKIE A AB (PNL)-AU $12.95 HC89013700 MYOGLOBIN URINE-AU $12.94 69076-913-02 MERCAPTOPURINE 50 MG ORAL TAB $12.94 68084-449-01 TACROLIMUS 0.5 MG ORAL CAP $12.88 68084-449-11 TACROLIMUS 0.5 MG ORAL CAP $12.88 70677-1253-1 ACETAMINOPHEN 160 MG/5 ML ORAL SUSP $12.87 0121-1154-40 LACTULOSE 10 GRAM/15 ML ORAL SOLN $12.87 72572-571-25 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $12.87 72572-571-01 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $12.87 67457-473-00 TOBRAMYCIN 300MG/7.5ML FOR INHALATION SOLUTION $12.87 67457-473-22 TOBRAMYCIN 300MG/7.5ML FOR INHALATION SOLUTION $12.87 0054-4146-22 CLOTRIMAZOLE 10 MG MUCOUS MEMB TROC $12.86 HC89004865 DRVVT RUSS VIPER VENOM 1:1MIX RFX-AU $12.80 60687-676-57 LACOSAMIDE 50 MG ORAL TAB $12.77 60687-676-11 LACOSAMIDE 50 MG ORAL TAB $12.77 50268-598-15 NIFEDIPINE 60 MG ORAL TR24 $12.77 50268-598-11 NIFEDIPINE 60 MG ORAL TR24 $12.77 0228-2779-11 PROPRANOLOL 80 MG ORAL CS24 $12.77 0121-0868-50 NYSTATIN 100,000 UNIT/ML ORAL SUSP $12.74 67457-418-00 DEXAMETHASONE 4 MG/ML INJ SOLN (FOR ORAL USE) $12.68 67457-418-05 DEXAMETHASONE 4 MG/ML INJ SOLN (FOR ORAL USE) $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 0641-6247-25 FENTANYL (PF) 50 MCG/ML INJ FOR INTRATHECAL PAIN PUMP REFILL (OCM) $12.68 0641-6247-01 FENTANYL (PF) 50 MCG/ML INJ FOR INTRATHECAL PAIN PUMP REFILL (OCM) $12.68 68084-269-01 HYDROXYCHLOROQUINE 200 MG ORAL TAB $12.68 68084-269-11 HYDROXYCHLOROQUINE 200 MG ORAL TAB $12.68 0121-0431-30 MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSP $12.68 70677-1040-1 OXYMETAZOLINE 0.05 % NASL SPRAY (MHS WRAPPER) $12.68 0409-1891-01 MORPHINE 4 MG/ML INJ SOLN (MHS WRAPPER) $12.65 0409-1891-03 MORPHINE 4 MG/ML INJ SOLN (MHS WRAPPER) $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 99999-039-82 BOSENTAN 6.25 MG/ML ORAL LIQUID $12.60 HC89012124 BLASTOMYCES AB-AU $12.58 HC89016893 HTVL I/II W/ABS RFX TO WB-AU $12.58 33342-256-66 OSELTAMIVIR 30 MG ORAL CAP $12.53 50268-407-15 HYDROCORTISONE 20 MG ORAL TAB $12.53 50268-407-11 HYDROCORTISONE 20 MG ORAL TAB $12.53 HC89012843 ROCKY MT SPOTTED FEVER AB-AU $12.50 HC89500987 FFP THAWING; EA UNIT-SB $12.48 99999-037-81 IBUPROFEN 100 MG/5 ML ORAL SUSP $12.48 71351-021-05 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $12.48 99999-011-10 METHADONE 5 MG/5 ML ORAL SOLN $12.48 60687-317-95 CHLORTHALIDONE 25 MG ORAL TAB $12.45 60687-317-25 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 0071-0369-40 PHENYTOIN SODIUM EXTENDED 100 MG ORAL CAP $12.43 58151-110-32 PHENYTOIN SODIUM EXTENDED 100 MG ORAL CAP $12.43 58151-110-88 PHENYTOIN SODIUM EXTENDED 100 MG ORAL CAP $12.43 64980-134-01 DIPYRIDAMOLE 50 MG ORAL TAB $12.40 69339-138-15 CHLORHEXIDINE GLUCONATE 0.12 % MUCOUS MEMB MWSH $12.38 0121-0893-40 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 0641-6001-25 LORAZEPAM 2 MG/ML INJ SOLN $12.36 0641-6001-01 LORAZEPAM 2 MG/ML INJ SOLN $12.36 71288-403-02 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $12.35 71288-403-01 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $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 62332-600-25 KETOROLAC 30 MG/ML (1 ML) INJ SOLN $12.35 62332-600-01 KETOROLAC 30 MG/ML (1 ML) INJ SOLN $12.35 99999-037-65 METRONIDAZOLE 5 MG/ML INJECTION (MHS) $12.35 60687-800-40 NYSTATIN 100,000 UNIT/ML ORAL SUSP $12.35 72485-504-25 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $12.35 72485-504-01 PHENYLEPHRINE HCL 10 MG/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 68094-690-30 AZITHROMYCIN 600 MG ORAL TAB $12.32 60687-123-01 LANSOPRAZOLE 30 MG ORAL CPDR $12.32 60687-123-11 LANSOPRAZOLE 30 MG ORAL CPDR $12.32 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 HC89024129 COPPER URINE-AU $12.30 0869-0831-43 MINERAL OIL ORAL OIL $12.30 61570-072-01 ESTERIFIED ESTROGENS 0.3 MG ORAL TAB $12.29 63739-159-77 ALUM-MAG HYDROXIDE-SIMETH 200-200-20 MG/5 ML ORAL SUSP $12.29 0121-0868-05 NYSTATIN 100,000 UNIT/ML ORAL SUSP $12.29 0121-0868-00 NYSTATIN 100,000 UNIT/ML ORAL SUSP $12.29 0406-0523-23 OXYCODONE-ACETAMINOPHEN 10-325 MG ORAL TAB $12.29 63323-249-30 WATER FOR INJECT BACT PARABENS INJ SOLN $12.29 71399-1006-4 DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML ORAL LIQD $12.27 71399-0026-4 DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML ORAL LIQD $12.27 2660800154 L. ACIDOPHILUS,CASEI,RHAMNOSUS 50 BILLION CELL ORAL CPDR $12.27 2660800156 L. ACIDOPHILUS,CASEI,RHAMNOSUS 50 BILLION CELL ORAL CPDR $12.27 72603-505-25 LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN $12.22 68084-728-01 FLUCONAZOLE 100 MG ORAL TAB $12.16 68084-728-11 FLUCONAZOLE 100 MG ORAL TAB $12.16 72603-153-25 KETOROLAC 15 MG/ML INJ SOLN $12.16 72603-153-01 KETOROLAC 15 MG/ML INJ SOLN $12.16 HC89016869 CRYOGLOBULIN IGA, QUANT-AU $12.15 HC89016885 CRYOGLOBULIN IGG, QUANT-AU $12.15 HC89016877 CRYOGLOBULIN IGM, QUANT-AU $12.15 99999-041-19 RIFABUTIN 20 MG/ML ORAL SOLUTION $12.13 17433-9876-3 DOCUSATE SODIUM 283 MG/5 ML RECTAL ENEM $12.12 17433-9876-0 DOCUSATE SODIUM 283 MG/5 ML RECTAL ENEM $12.12 67877-753-60 DRONABINOL 2.5 MG ORAL CAP $12.11 132030140 MINERAL OIL RECTAL ENEM $12.10 60687-586-11 RIFAMPIN 300 MG ORAL CAP $12.09 60687-586-01 RIFAMPIN 300 MG ORAL CAP $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 62175-261-37 NIFEDIPINE 60 MG ORAL TR24 $12.04 68682-109-10 NIFEDIPINE 60 MG ORAL TR24 $12.04 60687-782-11 BUPROPION HCL 150 MG ORAL TB24 $12.03 60687-782-01 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 72485-118-25 DEXAMETHASONE SODIUM PHOS (PF) 10 MG/ML INJ SOLN $12.03 72485-118-01 DEXAMETHASONE SODIUM PHOS (PF) 10 MG/ML INJ SOLN $12.03 0121-1870-10 DOCUSATE SODIUM 100 MG/10 ML ORAL LIQD $12.03 0121-1870-00 DOCUSATE SODIUM 100 MG/10 ML ORAL LIQD $12.03 81033-102-52 GUAIFENESIN 100 MG/5 ML ORAL LIQD $12.03 81033-102-10 GUAIFENESIN 100 MG/5 ML ORAL LIQD $12.03 71351-021-25 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $12.03 76045-103-20 ONDANSETRON HCL (PF) 4 MG/2 ML INJ SYRG $12.03 64380-799-01 OSELTAMIVIR 75 MG ORAL CAP $12.03 72205-044-11 OSELTAMIVIR 75 MG ORAL CAP $12.03 0641-0928-25 PROMETHAZINE 25 MG/ML INJ SOLN $12.01 0641-0928-21 PROMETHAZINE 25 MG/ML INJ SOLN $12.01 0641-1495-35 PROMETHAZINE 25 MG/ML INJ SOLN $12.01 0641-1495-31 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 HC83506014 FLOW CYT MKR CD4/CD8 BAL EA ADD+ (PNL)-NG $12.00 HC83505420 FLOW CYT MKR TC EACH ADD+ -NG $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 HC88600234 SPECIAL COURIER 25 $12.00 HC89001127 VISCOSITY-QD $12.00 HC89015564 VITAMIN E-QD $12.00 0093-8741-01 MEXILETINE 250 MG ORAL CAP $11.97 69315-212-01 NIFEDIPINE 20 MG ORAL CAP $11.97 0074-3108-32 CYCLOSPORINE MODIFIED 25 MG ORAL CAP $11.95 16714-693-01 FLUCONAZOLE 200 MG ORAL TAB $11.95 50268-406-15 HYDROCORTISONE 10 MG ORAL TAB $11.93 50268-406-11 HYDROCORTISONE 10 MG ORAL TAB $11.93 6809411459 CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) ORAL TAB $11.90 0121-1154-00 LACTULOSE 10 GRAM/15 ML ORAL SOLN $11.90 0121-1154-30 LACTULOSE 10 GRAM/15 ML ORAL SOLN $11.90 60687-883-11 PRASUGREL HCL 10 MG ORAL TAB $11.90 60687-883-21 PRASUGREL HCL 10 MG ORAL TAB $11.90 0409-9558-49 ROCURONIUM 10 MG/ML IV SOLN $11.86 0409-9558-69 ROCURONIUM 10 MG/ML IV SOLN $11.86 0536-1271-80 POVIDONE-IODINE 10 % TOPICAL OINT $11.82 0054-0177-13 BUPRENORPHINE HCL 8 MG SL SUBL $11.81 0121-1314-00 ACETAMINOPHEN 325 MG/10.15 ML ORAL LIQD (MHS WRAPPER) $11.81 0121-1314-11 ACETAMINOPHEN 325 MG/10.15 ML ORAL LIQD (MHS WRAPPER) $11.81 70677-1210-1 MAGNESIUM SULFATE (LAXATIVE) 495 MG/5 GRAM ORAL GRAN $11.80 10939-87244 MAGNESIUM SULFATE (LAXATIVE) 495 MG/5 GRAM ORAL GRAN $11.80 0032-0045-70 LIPASE-PROTEASE-AMYLASE 3,000-9,500- 15,000 UNIT ORAL CPDR $11.79 0378-1134-01 KETOROLAC 10 MG ORAL TAB $11.78 68094-030-59 ACETAMINOPHEN 650 MG/20.3 ML ORAL LIQD (MHS WRAPPER) $11.74 68094-030-62 ACETAMINOPHEN 650 MG/20.3 ML ORAL LIQD (MHS WRAPPER) $11.74 0904-6938-06 BUTALBITAL-ACETAMINOPHEN-CAFF 50-325-40 MG ORAL TAB $11.74 0054-4550-15 METHOTREXATE SODIUM 2.5 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 HC89008346 HEMOGLOBIN GLYCATED (A1C)-AU $11.70 99999-034-66 ADENOSINE 1000 MCG / 100 ML FFR IC SOLUTION $11.70 25021-105-10 CEFTRIAXONE 500 MG INJ SOLR $11.70 60687-714-44 CHLORHEXIDINE GLUCONATE 0.12 % MUCOUS MEMB MWSH $11.70 60687-714-16 CHLORHEXIDINE GLUCONATE 0.12 % MUCOUS MEMB MWSH $11.70 63323-738-09 FAMOTIDINE 10 MG/ML IV SOLN $11.70 83634-302-43 FUROSEMIDE 10 MG/ML INJ SOLN $11.70 83634-302-04 FUROSEMIDE 10 MG/ML INJ SOLN $11.70 71288-402-02 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $11.70 71288-402-01 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $11.70 62332-599-25 KETOROLAC 15 MG/ML INJ SOLN $11.70 62332-599-01 KETOROLAC 15 MG/ML INJ 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 70860-300-05 METOPROLOL TARTRATE 5 MG/5 ML IV SOLN $11.70 70860-300-41 METOPROLOL TARTRATE 5 MG/5 ML IV SOLN $11.70 49348-028-27 OXYMETAZOLINE 0.05 % NASL SPRAY (MHS WRAPPER) $11.70 1093941433 OXYMETAZOLINE 0.05 % NASL SPRAY (MHS WRAPPER) $11.70 70677-1037-1 OXYMETAZOLINE 0.05 % NASL SPRAY (MHS WRAPPER) $11.70 70860-801-01 TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLN $11.70 0904-7188-61 HYDROCORTISONE 10 MG ORAL TAB $11.67 99999-035-70 TOBRAMYCIN 1.4 % (14 MG/ML) FORTIFIED OPHTHALMIC SOLUTION $11.65 13668-462-01 ANAGRELIDE 1 MG ORAL CAP $11.64 8008799734 CITRULLINE 600 MG ORAL CAP $11.64 0009-0022-01 METHYLPREDNISOLONE 8 MG ORAL TAB $11.61 69339-138-19 CHLORHEXIDINE GLUCONATE 0.12 % MUCOUS MEMB MWSH $11.60 0121-0893-15 CHLORHEXIDINE GLUCONATE 0.12 % MUCOUS MEMB MWSH $11.60 68682-008-10 DILTIAZEM HCL 90 MG ORAL TAB $11.60 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 0378-1020-77 NICARDIPINE 20 MG ORAL CAP $11.59 HC89012116 BARTONELLA AB-AU $11.58 HC89014419 PROTOZOA AB OTHER-AU $11.58 HC89000061 TOXOPLASMA AB IGG(PNL)-AU $11.58 71288-303-02 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG/ML INJ SOLN $11.57 71288-303-01 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG/ML INJ SOLN $11.57 64950-216-10 ISONIAZID 100 MG ORAL TAB $11.57 99999-046-21 LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN $11.57 99999-047-38 MAGNESIUM SULFATE 0.8 MEQ/ML DILUTION INJ SOLN (MHS) $11.57 4898500150 NICOTINE 14 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 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 16714-077-01 TADALAFIL 20 MG ORAL TAB $11.53 62756-520-69 SUMATRIPTAN SUCCINATE 25 MG ORAL TAB $11.52 16714-796-01 SUMATRIPTAN SUCCINATE 25 MG ORAL TAB $11.52 55111-291-36 SUMATRIPTAN SUCCINATE 25 MG ORAL TAB $11.52 62756-521-69 SUMATRIPTAN SUCCINATE 50 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 16714-797-01 SUMATRIPTAN SUCCINATE 50 MG ORAL TAB $11.52 55111-292-98 SUMATRIPTAN SUCCINATE 50 MG ORAL TAB $11.52 68455-10842 ALOE VERA-COLLAGEN TOPICAL SOLN $11.51 99999-046-24 CLINDAMYCIN 10 MG/ML INJ SYRINGE (OCM) $11.51 73750-091-05 CLOTRIMAZOLE 1 % TOPICAL CREAM $11.51 10370-832-11 DILTIAZEM HCL 300 MG ORAL CP24 $11.51 HC89023428 ASPERGILLUS AB BY ID-AU $11.49 HC89010813 VISCOSITY-AU $11.49 99999-038-11 ONDANSETRON HCL 4 MG/5 ML ORAL SOLN $11.49 50268-143-15 BUPROPION HCL 100 MG ORAL TAB $11.49 50268-143-11 BUPROPION HCL 100 MG ORAL TAB $11.49 60687-723-21 DULOXETINE 20 MG ORAL CPDR $11.49 60687-723-11 DULOXETINE 20 MG ORAL CPDR $11.49 HC89012694 HISTOPLASMA AB-AU $11.48 0054-4550-25 METHOTREXATE SODIUM 2.5 MG ORAL TAB $11.48 63739-760-01 POLYETHYLENE GLYCOL 3350 17 GRAM ORAL PWPK $11.47 0904-5354-31 DIPHENHYDRAMINE-ZINC ACETATE 2-0.1 % TOPICAL CREAM $11.47 63304-352-60 LUBIPROSTONE 24 MCG ORAL CAP $11.46 63304-351-60 LUBIPROSTONE 8 MCG ORAL CAP $11.46 HC89017263 C3 COMPLEMENT-AU $11.45 16714-887-01 CLOBAZAM 10 MG ORAL TAB $11.39 72266-118-25 KETOROLAC 30 MG/ML (1 ML) INJ SOLN $11.38 72266-118-01 KETOROLAC 30 MG/ML (1 ML) INJ SOLN $11.38 0338-0072-25 KETOROLAC 30 MG/ML (1 ML) INJ SOLN $11.38 99999-000-46 PHENOBARBITAL 10 MG / ML SYRINGE $11.38 50268-788-11 VALACYCLOVIR 500 MG ORAL TAB $11.38 50268-788-15 VALACYCLOVIR 500 MG ORAL TAB $11.38 68982-182-01 WILATE 500-500 UNIT IV SOLR $11.38 HC89012108 ASPERGILLUS AB(PNL)-AU $11.37 HC89016562 PH FLUID FECAL-AU $11.37 HC89017271 C4 COMPLEMENT-AU $11.36 HC89006555 PHENOBARBITAL LEVEL-AU $11.35 HC89001143 TOXOPLASMA AB IGG(PNL)-AU $11.35 0378-1020-05 NICARDIPINE 20 MG ORAL CAP $11.33 0409-1159-09 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $11.31 0409-1159-10 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN $11.31 63323-237-10 CEFAZOLIN 1 GRAM INJ SOLR $11.31 72572-250-25 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $11.31 72572-250-01 HEPARIN (PORCINE) 1,000 UNIT/ML INJ SOLN $11.31 72572-255-25 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $11.31 72572-255-01 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $11.31 60687-742-11 AZITHROMYCIN 250 MG ORAL TAB $11.29 60687-742-01 AZITHROMYCIN 250 MG ORAL TAB $11.29 0406-8330-62 MORPHINE 30 MG ORAL TBSR $11.28 68084-930-95 HYDROCORTISONE 20 MG ORAL TAB $11.27 68084-930-25 HYDROCORTISONE 20 MG ORAL TAB $11.27 0071-0369-24 PHENYTOIN SODIUM EXTENDED 100 MG ORAL CAP $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 63323-064-10 MAGNESIUM SULFATE 500 MG/ML (50 %) INJ SOLN $11.25 49348-185-20 MINERAL OIL RECTAL ENEM $11.24 70677-1090-1 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 99999-040-53 CEFTRIAXONE 1 G/25 ML (40 MG/ML) INJ SYR (USING 10G) $11.21 0904-7035-87 CHLORHEXIDINE GLUCONATE 0.12 % MUCOUS MEMB MWSH $11.21 68084-710-11 OXYCODONE-ACETAMINOPHEN 10-325 MG ORAL TAB $11.17 68084-710-01 OXYCODONE-ACETAMINOPHEN 10-325 MG ORAL TAB $11.17 HC89022883 AMYLASE, BODY FLUID-AU $11.15 HC89004949 HISTOPLASMA AB CF (PNL)-AU $11.15 HC89010029 T4 FREE-AU $11.15 43598-447-71 NICOTINE 14 MG/24 HR TRANSDERMAL PT24 $11.14 0536-5895-88 NICOTINE 14 MG/24 HR TRANSDERMAL PT24 $11.14 60505-7062-0 NICOTINE 14 MG/24 HR TRANSDERMAL PT24 $11.14 0536-1107-88 NICOTINE 14 MG/24 HR TRANSDERMAL PT24 $11.14 60505-7063-0 NICOTINE 21 MG/24 HR TRANSDERMAL PT24 $11.14 0536-5896-88 NICOTINE 21 MG/24 HR TRANSDERMAL PT24 $11.14 0536-5894-88 NICOTINE 7 MG/24 HR TRANSDERMAL PT24 $11.14 60505-7061-0 NICOTINE 7 MG/24 HR TRANSDERMAL PT24 $11.14 43598-446-71 NICOTINE 7 MG/24 HR TRANSDERMAL PT24 $11.14 0536-1106-88 NICOTINE 7 MG/24 HR TRANSDERMAL PT24 $11.14 0409-4713-12 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $11.12 0409-4713-26 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $11.12 0409-4713-02 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $11.12 0409-1844-32 PHENYTOIN SODIUM 50 MG/ML IV SYRG $11.12 50268-337-15 FLUCONAZOLE 100 MG ORAL TAB $11.06 50268-337-11 FLUCONAZOLE 100 MG ORAL TAB $11.06 67850-024-10 AMPICILLIN SODIUM 500 MG INJ SOLR $11.05 67850-024-00 AMPICILLIN SODIUM 500 MG INJ SOLR $11.05 83634-302-42 FUROSEMIDE 10 MG/ML INJ SOLN $11.05 83634-302-02 FUROSEMIDE 10 MG/ML INJ SOLN $11.05 62175-490-05 HYDROCODONE-CHLORPHENIRAMINE 10-8 MG/5 ML ORAL SU12 $11.05 23155-767-01 TETRACYCLINE 500 MG ORAL CAP $11.05 0009-0031-01 HYDROCORTISONE 10 MG ORAL TAB $11.04 63739-052-74 CHLORHEXIDINE GLUCONATE 0.12 % MUCOUS MEMB MWSH $11.02 63739-052-57 CHLORHEXIDINE GLUCONATE 0.12 % MUCOUS MEMB MWSH $11.02 63739-052-69 CHLORHEXIDINE GLUCONATE 0.12 % MUCOUS MEMB MWSH $11.02 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 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 HC89004279 BETA-2 MICROGLOBULIN SR/PLS-AU $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 60505-6151-4 CEFTRIAXONE 250 MG INJ SOLR $10.99 0093-2275-34 AMOXICILLIN-POT CLAVULANATE 875-125 MG ORAL TAB $10.97 68084-430-99 POLYETHYLENE GLYCOL 3350 17 GRAM ORAL PWPK $10.95 68084-430-98 POLYETHYLENE GLYCOL 3350 17 GRAM ORAL PWPK $10.95 62332-618-31 CYCLOPHOSPHAMIDE 25 MG ORAL CAP $10.95 0228-2778-11 PROPRANOLOL 60 MG ORAL CS24 $10.93 70756-647-25 LIDOCAINE HCL 20 MG/ML (2 %) INJ SOLN $10.92 70756-647-86 LIDOCAINE HCL 20 MG/ML (2 %) INJ SOLN $10.92 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 0904-7081-06 NIFEDIPINE 60 MG ORAL TR24 $10.90 68084-149-11 METHYLPREDNISOLONE 4 MG ORAL TAB $10.86 68084-149-01 METHYLPREDNISOLONE 4 MG ORAL TAB $10.86 99999-045-70 LIDOCAINE-EPINEPHRINE 2%-1:100,000 BUFFERED WITH SODIUM BICARB 10:1 INJ (FOR NEURAVIVE) (OCM) $10.86 60687-582-01 HYDROCORTISONE 10 MG ORAL TAB $10.84 60687-582-11 HYDROCORTISONE 10 MG ORAL TAB $10.84 65862-073-60 ABACAVIR 300 MG ORAL TAB $10.84 51672-4055-6 AMIODARONE 100 MG ORAL TAB $10.84 50742-364-01 BUPRENORPHINE-NALOXONE 8-2 MG SL FILM $10.84 50742-364-30 BUPRENORPHINE-NALOXONE 8-2 MG SL FILM $10.84 65162-630-03 ITRACONAZOLE 100 MG ORAL CAP $10.84 67877-454-30 ITRACONAZOLE 100 MG ORAL CAP $10.84 42806-501-09 NICARDIPINE 20 MG ORAL CAP $10.84 68462-120-90 NICARDIPINE 20 MG ORAL CAP $10.84 69452-436-19 NICARDIPINE 20 MG ORAL CAP $10.84 72205-168-60 POSACONAZOLE 100 MG ORAL TBEC $10.84 0378-9072-93 RIVASTIGMINE 13.3 MG/24 HOUR TRANSDERMAL PT24 $10.84 0378-9072-16 RIVASTIGMINE 13.3 MG/24 HOUR TRANSDERMAL PT24 $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 51991-897-99 RIVASTIGMINE 4.6 MG/24 HOUR TRANSDERMAL PT24 $10.84 51991-897-30 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 51991-898-99 RIVASTIGMINE 9.5 MG/24 HOUR TRANSDERMAL PT24 $10.84 51991-898-30 RIVASTIGMINE 9.5 MG/24 HOUR TRANSDERMAL PT24 $10.84 72205-280-60 SACUBITRIL-VALSARTAN 24-26 MG ORAL TAB $10.84 72205-281-60 SACUBITRIL-VALSARTAN 49-51 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 27241-022-38 ZOLMITRIPTAN 5 MG ORAL TAB $10.84 50268-584-11 NIACIN 500 MG ORAL TB24 $10.82 50268-584-13 NIACIN 500 MG ORAL TB24 $10.82 51991-906-01 TETRACYCLINE 250 MG ORAL CAP $10.82 HC89019483 SPECIAL STAIN;MICROSPORIDIA-AU $10.82 51079-651-01 DOXEPIN 100 MG ORAL CAP $10.82 51079-651-20 DOXEPIN 100 MG ORAL CAP $10.82 50268-411-11 HYDROCORTISONE ACETATE 25 MG RECTAL SUPP $10.81 50268-411-12 HYDROCORTISONE ACETATE 25 MG RECTAL SUPP $10.81 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 72572-061-25 CEFTRIAXONE 1 G INJ SOLR (MCH) $10.79 72572-061-01 CEFTRIAXONE 1 G INJ SOLR (MCH) $10.79 99999-005-58 GENTAMICIN 2 MG/ML INJ SOLN IN D5W (MCH-NICU) $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 68084-823-11 METHYLPHENIDATE HCL 10 MG ORAL TAB $10.78 68084-823-21 METHYLPHENIDATE HCL 10 MG ORAL TAB $10.78 0074-7068-90 LEVOTHYROXINE 125 MCG ORAL TAB $10.77 0074-7069-90 LEVOTHYROXINE 150 MCG ORAL TAB $10.77 0074-6624-90 LEVOTHYROXINE 100 MCG ORAL TAB $10.76 0074-9296-90 LEVOTHYROXINE 112 MCG ORAL TAB $10.76 0074-3727-90 LEVOTHYROXINE 137 MCG ORAL TAB $10.76 0074-7148-90 LEVOTHYROXINE 200 MCG ORAL TAB $10.76 0074-4341-90 LEVOTHYROXINE 25 MCG ORAL TAB $10.76 0074-4552-90 LEVOTHYROXINE 50 MCG ORAL TAB $10.76 0074-4552-19 LEVOTHYROXINE 50 MCG ORAL TAB $10.76 0074-5182-90 LEVOTHYROXINE 75 MCG ORAL TAB $10.76 0074-5182-19 LEVOTHYROXINE 75 MCG ORAL TAB $10.76 0074-6594-90 LEVOTHYROXINE 88 MCG ORAL TAB $10.76 0074-6624-11 LEVOTHYROXINE 100 MCG ORAL TAB $10.76 0074-9296-19 LEVOTHYROXINE 112 MCG ORAL TAB $10.76 0074-7068-11 LEVOTHYROXINE 125 MCG ORAL TAB $10.76 0074-7069-11 LEVOTHYROXINE 150 MCG ORAL TAB $10.76 0074-4552-11 LEVOTHYROXINE 50 MCG ORAL TAB $10.76 0074-5182-11 LEVOTHYROXINE 75 MCG ORAL TAB $10.76 0074-7070-90 LEVOTHYROXINE 175 MCG ORAL TAB $10.75 0078-0510-05 CARBAMAZEPINE 100 MG ORAL TB12 $10.74 44567-707-25 CEFAZOLIN 1 GRAM INJ SOLR $10.73 51079-922-20 CLOZAPINE 100 MG ORAL TAB $10.73 51079-922-01 CLOZAPINE 100 MG ORAL TAB $10.73 0116-4005-30 LACTULOSE 10 GRAM/15 ML ORAL SOLN $10.73 99999-041-71 LIDOCAINE HCL 2 % MUCOUS MEMB SOLN $10.73 99999-037-15 LIDOCAINE HCL 2 % MUCOUS MEMB SOLN $10.73 48433-202-30 MINERAL OIL ORAL OIL $10.73 72205-042-11 OSELTAMIVIR 30 MG ORAL CAP $10.73 72205-043-11 OSELTAMIVIR 45 MG ORAL CAP $10.73 HC89014260 COCCIDIOIDES AB (PNL)-AU $10.70 HC89012686 HISTOPLASMA AB (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 60505-2805-7 CARBAMAZEPINE 100 MG ORAL CM12 $10.64 16714-733-01 CELECOXIB 200 MG ORAL CAP $10.63 0378-1902-01 MIDODRINE 5 MG ORAL TAB $10.61 68084-300-21 DANTROLENE 25 MG ORAL CAP $10.58 68084-300-11 DANTROLENE 25 MG ORAL CAP $10.58 HC89005508 MAGNESIUM URINE 24 HR-AU $10.58 50268-405-15 HYDROCORTISONE 5 MG ORAL TAB $10.58 50268-405-11 HYDROCORTISONE 5 MG ORAL TAB $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 51079-513-20 PIOGLITAZONE 15 MG ORAL TAB $10.56 51079-513-01 PIOGLITAZONE 15 MG ORAL TAB $10.56 68180-862-11 AZITHROMYCIN 500 MG ORAL TAB $10.55 50268-102-13 BALSALAZIDE 750 MG ORAL CAP $10.55 50268-102-11 BALSALAZIDE 750 MG ORAL CAP $10.55 0121-0657-00 ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL LIQD (MHS WRAPPER) $10.53 0121-0657-05 ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL LIQD (MHS WRAPPER) $10.53 0904-7035-88 CHLORHEXIDINE GLUCONATE 0.12 % MUCOUS MEMB MWSH $10.53 0071-0418-13 NITROGLYCERIN 0.4 MG SL SUBL $10.51 HC89013650 GLIADIN AB IGA-AU $10.50 HC89017370 GLIADIN AB IGG-AU $10.50 72572-016-10 AMPICILLIN SODIUM 1 G IV SOLR (MCH) $10.47 72572-016-01 AMPICILLIN SODIUM 1 G IV SOLR (MCH) $10.47 0121-1488-10 GUAIFENESIN 100 MG/5 ML ORAL LIQD $10.47 0121-1488-00 GUAIFENESIN 100 MG/5 ML ORAL LIQD $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 50268-217-15 DANTROLENE 25 MG ORAL CAP $10.45 50268-217-11 DANTROLENE 25 MG ORAL CAP $10.45 4898500153 NICOTINE 21 MG/24 HR TRANSDERMAL PT24 $10.42 43598-448-28 NICOTINE 21 MG/24 HR TRANSDERMAL PT24 $10.42 43598-448-71 NICOTINE 21 MG/24 HR TRANSDERMAL PT24 $10.42 0904-7505-61 BUPROPION HCL 150 MG ORAL TB24 $10.40 72485-101-25 DIPHENHYDRAMINE HCL 50 MG/ML INJ SOLN $10.40 72485-101-01 DIPHENHYDRAMINE HCL 50 MG/ML INJ SOLN $10.40 25021-311-10 FUROSEMIDE 10 MG/ML INJ SOLN $10.40 99999-033-68 GLYCERIN 0.2 ML PEDIATRIC ENEMA SOLN $10.40 63323-485-41 LIDOCAINE HCL 10 MG/ML (1 %) INJ SOLN $10.40 63323-485-26 LIDOCAINE HCL 10 MG/ML (1 %) INJ SOLN $10.40 0406-0522-23 OXYCODONE-ACETAMINOPHEN 7.5-325 MG ORAL TAB $10.40 64253-020-91 WATER FOR INJECTION, STERILE INJ SYRG $10.40 50742-323-60 DORZOLAMIDE-TIMOLOL (PF) 2-0.5 % OPHT DPET $10.39 50742-323-05 DORZOLAMIDE-TIMOLOL (PF) 2-0.5 % OPHT DPET $10.39 76204-800-11 LEVALBUTEROL HCL 0.63 MG/3 ML INHALATION NEBU $10.39 76204-800-01 LEVALBUTEROL HCL 0.63 MG/3 ML INHALATION NEBU $10.39 76204-900-11 LEVALBUTEROL HCL 1.25 MG/3 ML INHALATION NEBU $10.39 76204-900-01 LEVALBUTEROL HCL 1.25 MG/3 ML INHALATION NEBU $10.39 HC89022990 POTASSIUM, BODY FLUID-AU $10.37 0121-1744-00 GUAIFENESIN 100 MG/5 ML ORAL LIQD $10.37 0121-1744-05 GUAIFENESIN 100 MG/5 ML ORAL LIQD $10.37 1093914833 CALAMINE-ZINC OXIDE 8-8 % TOPICAL LOTN $10.36 49348-011-34 CALAMINE-ZINC OXIDE 8-8 % TOPICAL LOTN $10.36 HC89005482 INFLUENZA A&B ABS, IGG/IGM-AU $10.35 0406-8330-23 MORPHINE 30 MG ORAL TBSR $10.34 69238-2122-5 PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLN $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 0904-7211-04 DANTROLENE 25 MG ORAL CAP $10.28 63323-064-02 MAGNESIUM SULFATE 50 % (4 MEQ/ML) IV SOLN (TPN-MEQ) $10.27 0071-0007-24 PHENYTOIN 50 MG ORAL CHEW $10.25 HC89012215 COCCIDIOIDES AB SERUM -AU $10.25 72603-412-25 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $10.24 72603-412-01 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $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 36000-284-25 FUROSEMIDE 10 MG/ML INJ SOLN $10.21 68382-920-06 ENTECAVIR 0.5 MG ORAL TAB $10.19 68382-921-06 ENTECAVIR 1 MG ORAL TAB $10.19 0641-6044-25 LORAZEPAM 2 MG/ML INJ SOLN $10.16 0641-6044-01 LORAZEPAM 2 MG/ML INJ SOLN $10.16 68462-756-25 KETOROLAC 30 MG/ML (1 ML) INJ SOLN $10.15 68462-756-01 KETOROLAC 30 MG/ML (1 ML) INJ SOLN $10.15 HC89022800 CHOLESTEROL FLUID SPECTROPHTMTRY-AU $10.15 60687-742-65 AZITHROMYCIN 250 MG ORAL TAB $10.14 70756-645-25 LIDOCAINE HCL 10 MG/ML (1 %) INJ SOLN $10.14 70756-645-86 LIDOCAINE HCL 10 MG/ML (1 %) INJ SOLN $10.14 60687-841-01 PHENYTOIN SODIUM EXTENDED 100 MG ORAL CAP $10.14 60687-841-11 PHENYTOIN SODIUM EXTENDED 100 MG ORAL CAP $10.14 64980-566-01 DAPSONE 100 MG ORAL TAB $10.08 0143-9315-01 LEVOFLOXACIN IN D5W 250 MG/50 ML IV PGBK $10.08 0143-9315-24 LEVOFLOXACIN IN D5W 250 MG/50 ML IV PGBK $10.08 72572-380-01 LORAZEPAM 2 MG/ML INJ SOLN $10.08 72572-380-25 LORAZEPAM 2 MG/ML INJ SOLN $10.08 16714-213-01 RALOXIFENE 60 MG ORAL TAB $10.08 1093940233 SODIUM CHLORIDE 0.65 % NASL SPRA $10.01 HC89009559 ACID PHOS -TOTAL-AU $10.00 HC89017743 ANTI-DNA AB (DS)(PNL)-AU $10.00 HC89024988 APOLIPOPROTEIN B-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 HC89024996 CREATINNE, SERUM-AU $10.00 HC89012462 EBV AB TO EARLY AG-AU $10.00 HC89007942 ERYTHROPOIETIN-AU $10.00 HC89015382 ESTRIOL-QD $10.00 HC89024475 FSH-AU $10.00 HC89015895 HLA B27-QD $10.00 HC89000392 HUMAN GROWTH HORMONE-QD $10.00 HC89008155 IGG SUBCLASS-AU $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 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 0093-7353-01 CALCITRIOL 0.5 MCG ORAL CAP $9.93 16714-099-01 TACROLIMUS 1 MG ORAL CAP $9.91 0409-7332-11 CEFTRIAXONE 1 G INJ SOLR (MCH) $9.90 0409-7332-01 CEFTRIAXONE 1 G INJ SOLR (MCH) $9.90 60505-6148-4 CEFTRIAXONE 1 G INJ SOLR (MCH) $9.90 0904-6363-45 DIVALPROEX 250 MG ORAL TB24 $9.89 0245-0360-89 POTASSIUM CHLORIDE 20 MEQ ORAL PACK $9.88 0245-0360-01 POTASSIUM CHLORIDE 20 MEQ ORAL PACK $9.88 65862-107-01 ZIDOVUDINE 100 MG ORAL CAP $9.85 51079-630-20 PRAZOSIN 1 MG ORAL CAP $9.82 51079-630-01 PRAZOSIN 1 MG ORAL CAP $9.82 72603-196-01 NITROFURANTOIN MONOHYD/M-CRYST 100 MG ORAL CAP $9.80 16714-014-02 AMOXICILLIN-POT CLAVULANATE 875-125 MG ORAL TAB $9.79 16714-297-02 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 50474-100-01 THEOPHYLLINE 100 MG ORAL CP24 $9.78 HC89024525 LH(LUTEINIZ HORMONE)-AU $9.76 0904-7366-04 ARIPIPRAZOLE 2 MG ORAL TAB $9.75 99999-037-23 BRILLIANT GREEN 5% TOPICAL SOLUTION $9.75 0054-0176-13 BUPRENORPHINE HCL 2 MG SL SUBL $9.75 62135-192-22 CALCIUM ACETATE(PHOSPHAT BIND) 667 MG ORAL TAB $9.75 0781-3451-96 CEFAZOLIN 1 GRAM INJ SOLR $9.75 0781-3451-70 CEFAZOLIN 1 GRAM INJ SOLR $9.75 43598-641-60 DABIGATRAN ETEXILATE 150 MG ORAL CAP $9.75 0555-0952-02 DEXTROAMPHETAMINE SULFATE 5 MG ORAL TAB $9.75 81033-103-50 DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML ORAL LIQD $9.75 81033-103-05 DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML ORAL LIQD $9.75 50228-334-10 ETHACRYNIC ACID 25 MG ORAL TAB $9.75 72572-171-01 FENTANYL (PF) 50 MCG/ML INJ FOR INTRATHECAL PAIN PUMP REFILL (OCM) $9.75 72572-171-10 FENTANYL CITRATE (PF) 0.05 MG/ML INJ SOLN (MCH) $9.75 99999-034-87 FENTANYL-BUPIVACAINE 2 MCG/ML - 0.1% EPIDURAL PCA (L&D) $9.75 25021-311-02 FUROSEMIDE 10 MG/ML INJ SOLN $9.75 25021-402-01 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $9.75 0781-3545-10 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $9.75 0781-3545-25 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $9.75 81033-241-30 LACTULOSE 10 GRAM/15 ML ORAL SOLN $9.75 81033-241-51 LACTULOSE 10 GRAM/15 ML ORAL SOLN $9.75 0116-4005-11 LACTULOSE 10 GRAM/15 ML ORAL SOLN $9.75 73293-0001-2 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $9.75 73293-0001-1 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $9.75 46581-830-01 LIDOCAINE 4 % TOPICAL PTMD $9.75 55111-650-01 METAXALONE 800 MG ORAL TAB $9.75 63323-012-07 OXYTOCIN 10 UNIT/ML INJ SOLN $9.75 60687-156-95 PHENYTOIN 50 MG ORAL CHEW $9.75 60687-156-25 PHENYTOIN 50 MG ORAL CHEW $9.75 0245-0360-30 POTASSIUM CHLORIDE 20 MEQ ORAL PACK $9.75 33342-308-07 RASAGILINE 0.5 MG ORAL TAB $9.75 31722-598-12 RUFINAMIDE 200 MG ORAL TAB $9.75 42571-392-12 RUFINAMIDE 400 MG ORAL TAB $9.75 68382-471-78 TELMISARTAN 20 MG ORAL TAB $9.75 68382-471-30 TELMISARTAN 20 MG ORAL TAB $9.75 68382-472-78 TELMISARTAN 40 MG ORAL TAB $9.75 68382-472-30 TELMISARTAN 40 MG ORAL TAB $9.75 72888-178-30 TRANEXAMIC ACID 650 MG ORAL TAB $9.75 0527-1788-01 FLUPHENAZINE HCL 1 MG ORAL TAB $9.74 99999-011-00 CAPTOPRIL 1 MG/ML ORAL SUSP (COMPOUND) $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 0071-3740-66 PHENYTOIN SODIUM EXTENDED 30 MG ORAL CAP $9.71 58151-118-01 PHENYTOIN SODIUM EXTENDED 30 MG ORAL CAP $9.71 HC89019475 CONCENTRATION;MICROSPORIDIA-AU $9.70 81565-201-02 FUROSEMIDE 10 MG/ML INJ SOLN $9.69 81565-201-01 FUROSEMIDE 10 MG/ML INJ SOLN $9.69 4116705840 LIDOCAINE 4 % TOPICAL PTMD $9.69 68084-597-11 NIFEDIPINE 30 MG ORAL TR24 $9.69 68084-597-01 NIFEDIPINE 30 MG ORAL TR24 $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 60505-2674-3 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 50268-553-13 BUTALBITAL-ACETAMINOPHEN-CAFF 50-325-40 MG ORAL TAB $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 68462-755-25 KETOROLAC 15 MG/ML INJ SOLN $9.62 68462-755-01 KETOROLAC 15 MG/ML INJ SOLN $9.62 69452-390-98 MAGNESIUM CITRATE ORAL SOLN $9.62 69452-389-98 MAGNESIUM CITRATE ORAL SOLN $9.62 0378-6410-01 DOXEPIN 100 MG ORAL CAP $9.61 55111-649-01 GLYCOPYRROLATE 2 MG ORAL TAB $9.61 0904-7161-04 FENOFIBRATE NANOCRYSTALLIZED 145 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 72578-056-16 FELBAMATE 400 MG ORAL TAB $9.60 68084-310-11 DIVALPROEX 250 MG ORAL TB24 $9.56 68084-310-01 DIVALPROEX 250 MG ORAL TB24 $9.56 51079-766-08 DIVALPROEX 250 MG ORAL TB24 $9.56 51079-766-01 DIVALPROEX 250 MG ORAL TB24 $9.56 60505-3438-3 SELEGILINE HCL 5 MG ORAL TAB $9.56 72319-006-02 SELEGILINE HCL 5 MG ORAL TAB $9.56 386000111 ETHYL CHLORIDE 100 % TOPICAL SPRA $9.56 69315-140-01 GLYCOPYRROLATE 2 MG ORAL TAB $9.56 HC89023451 HSV TYPE 1 &/OR 2AB IGM PNL)-AU $9.50 HC89008981 MERCURY BLOOD-AU $9.50 0409-1761-62 BUPIVACAINE-DEXTROSE-WATER(PF) 0.75 % (7.5 MG/ML) INJ SOLN $9.46 0904-6501-06 FLUCONAZOLE 200 MG ORAL TAB $9.44 60687-436-11 CELECOXIB 100 MG ORAL CAP $9.43 60687-436-01 CELECOXIB 100 MG ORAL CAP $9.43 55111-281-30 LEVOFLOXACIN 750 MG ORAL TAB $9.39 99999-036-40 ISRADIPINE 1 MG/ML ORAL LIQUID (COMPOUND) $9.38 16252-539-01 ISRADIPINE 2.5 MG ORAL CAP $9.38 HC89022933 LIPASE, BODY FLUID-AU $9.37 68382-917-11 METHYLPREDNISOLONE 8 MG ORAL TAB $9.37 72572-170-01 FENTANYL (PF) 50 MCG/ML INJ FOR INTRATHECAL PAIN PUMP REFILL (OCM) $9.36 72572-170-25 FENTANYL (PF) 50 MCG/ML INJ FOR INTRATHECAL PAIN PUMP REFILL (OCM) $9.36 0904-7044-61 DULOXETINE 30 MG ORAL CPDR $9.33 60687-804-11 BACLOFEN 5 MG ORAL TAB $9.30 60687-804-65 BACLOFEN 5 MG ORAL TAB $9.30 60505-6142-0 CEFAZOLIN 1 GRAM INJ SOLR $9.30 60505-0749-1 CEFAZOLIN 1 GRAM INJ SOLR $9.30 53335-006-90 CITRULLINE 600 MG ORAL CAP $9.30 60505-6142-5 CEFAZOLIN 1 GRAM INJ SOLR $9.29 60505-0749-5 CEFAZOLIN 1 GRAM INJ SOLR $9.29 0641-0367-25 DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJ SOLN $9.29 0641-0367-21 DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJ SOLN $9.29 99999-036-48 MERCAPTOPURINE 25 MG ORAL PARTIAL TAB $9.28 HC89022917 CHLORIDE, BODY FLUID-AU $9.27 50268-105-15 BACLOFEN 5 MG ORAL TAB $9.26 50268-105-11 BACLOFEN 5 MG ORAL TAB $9.26 50268-411-24 HYDROCORTISONE ACETATE 25 MG RECTAL SUPP $9.26 68084-699-11 OXYCODONE-ACETAMINOPHEN 7.5-325 MG ORAL TAB $9.26 68084-699-01 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 99999-006-78 LORAZEPAM 0.1 MG/1 ML INJ DILUTION (MCH) $9.24 99999-006-79 LORAZEPAM 0.5 MG / ML INJ DILUTION (MCH) $9.24 67877-707-60 SACUBITRIL-VALSARTAN 24-26 MG ORAL TAB $9.21 67877-708-60 SACUBITRIL-VALSARTAN 49-51 MG ORAL TAB $9.21 13668-747-60 SACUBITRIL-VALSARTAN 97-103 MG ORAL TAB $9.21 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 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 65219-368-02 LORAZEPAM 2 MG/ML INJ SOLN $9.17 65219-368-01 LORAZEPAM 2 MG/ML INJ SOLN $9.17 60687-409-95 MIDODRINE 10 MG ORAL TAB $9.16 60687-409-25 MIDODRINE 10 MG ORAL TAB $9.16 63739-760-04 POLYETHYLENE GLYCOL 3350 17 GRAM ORAL PWPK $9.16 HC89022974 TRIGLYCERIDES, BODY FLUID-AU $9.15 50111-787-51 AZITHROMYCIN 250 MG ORAL TAB $9.15 50111-787-66 AZITHROMYCIN 250 MG ORAL TAB $9.15 0378-0094-01 CARBIDOPA-LEVODOPA 50-200 MG ORAL TBSR $9.13 HC89022941 SODIUM, BODY FLUID-AU $9.12 0904-7042-06 AMANTADINE HCL 100 MG ORAL CAP $9.11 27241-162-01 CAPTOPRIL 50 MG ORAL TAB $9.10 70512-840-25 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG/ML INJ SOLN $9.10 70512-840-01 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG/ML INJ SOLN $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 0338-9541-24 METRONIDAZOLE IN NACL (ISO-OS) 500 MG/100 ML IV PGBK $9.10 60687-549-11 RANOLAZINE 500 MG ORAL TB12 $9.10 60687-549-21 RANOLAZINE 500 MG ORAL TB12 $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 60687-234-01 ROSUVASTATIN 5 MG ORAL TAB $9.10 60687-234-11 ROSUVASTATIN 5 MG ORAL TAB $9.10 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 59762-1710-3 EPLERENONE 25 MG ORAL TAB $9.09 16729-293-10 EPLERENONE 25 MG ORAL TAB $9.09 60687-105-11 MEDROXYPROGESTERONE 10 MG ORAL TAB $9.08 60687-105-21 MEDROXYPROGESTERONE 10 MG ORAL TAB $9.08 60505-6151-1 CEFTRIAXONE 250 MG INJ SOLR $9.07 51672-4043-1 CLORAZEPATE DIPOTASSIUM 7.5 MG ORAL TAB $9.07 72578-056-01 FELBAMATE 400 MG ORAL TAB $9.07 0904-6931-76 POLYETHYLENE GLYCOL 3350 17 GRAM ORAL PWPK $9.04 0409-2011-05 LEVETIRACETAM 500 MG/5 ML IV SOLN $9.04 0409-2011-25 LEVETIRACETAM 500 MG/5 ML IV SOLN $9.04 0641-6059-01 MIDAZOLAM 1 MG/ML INJ SOLN $9.04 0641-6059-10 MIDAZOLAM 1 MG/ML INJ SOLN $9.04 0641-0493-25 PHENYTOIN SODIUM 50 MG/ML IV SOLN $9.04 0641-0493-21 PHENYTOIN SODIUM 50 MG/ML IV SOLN $9.04 HC89012199 CHLAMYDIA AB (PNL)-AU $9.03 HC89012207 CHLAMYDIA AB IGM (PNL)-AU $9.03 0904-7046-61 HYDROXYCHLOROQUINE 200 MG ORAL TAB $9.03 0132-0202-20 SODIUM PHOSPHATES 9.5-3.5 GRAM/59 ML RECTAL ENEM $9.01 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 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 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 68084-494-11 PYRIDOSTIGMINE BROMIDE 60 MG ORAL TAB $9.00 68084-494-01 PYRIDOSTIGMINE BROMIDE 60 MG ORAL TAB $9.00 11527-143-51 CARBAMIDE PEROXIDE 6.5 % OTIC DROP $8.97 63739-160-70 NYSTATIN 100,000 UNIT/ML ORAL SUSP $8.97 63739-160-10 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 60687-760-40 MORPHINE 10 MG/5 ML ORAL SOLN $8.91 0121-4675-05 VALPROATE SODIUM 250 MG/5 ML ORAL SYRP (MCH) $8.91 0121-4675-00 VALPROATE SODIUM 250 MG/5 ML ORAL SYRP (MCH) $8.91 0143-9924-90 CEFAZOLIN 1 GRAM INJ SOLR $8.89 10370-831-11 DILTIAZEM HCL 240 MG ORAL CP24 $8.89 62332-556-60 SACUBITRIL-VALSARTAN 24-26 MG ORAL TAB $8.89 62332-557-60 SACUBITRIL-VALSARTAN 49-51 MG ORAL TAB $8.89 0904-7097-61 TACROLIMUS 1 MG ORAL CAP $8.89 0228-3156-03 BUPRENORPHINE HCL 2 MG SL SUBL $8.88 0093-3125-01 DICLOXACILLIN 500 MG ORAL CAP $8.88 63739-077-10 VALACYCLOVIR 500 MG ORAL TAB $8.86 0378-0221-01 TIMOLOL MALEATE 10 MG ORAL TAB $8.85 68094-061-59 ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL LIQD (MHS WRAPPER) $8.84 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 0093-1077-01 CEFPROZIL 250 MG ORAL TAB $8.82 0409-2308-02 MIDAZOLAM (PF) 5 MG/ML INJ SOLN $8.81 0409-2308-22 MIDAZOLAM (PF) 5 MG/ML INJ SOLN $8.81 0121-0935-05 DOCUSATE SODIUM 100 MG/10 ML ORAL LIQD $8.81 0121-0904-05 MORPHINE 10 MG/5 ML ORAL SOLN $8.81 49884-347-01 PIMOZIDE 1 MG ORAL TAB $8.81 0143-9156-01 FUROSEMIDE 10 MG/ML INJ SOLN $8.79 0143-9156-10 FUROSEMIDE 10 MG/ML INJ SOLN $8.79 71288-203-05 FUROSEMIDE 10 MG/ML INJ SOLN $8.79 71288-203-04 FUROSEMIDE 10 MG/ML INJ SOLN $8.79 4110081088 LORATADINE-PSEUDOEPHEDRINE 10-240 MG ORAL TB24 $8.79 72572-360-01 LEVETIRACETAM 500 MG/5 ML IV SOLN $8.78 72572-360-25 LEVETIRACETAM 500 MG/5 ML IV SOLN $8.78 0904-7020-61 PRAZOSIN 1 MG ORAL CAP $8.77 16714-835-01 ZIPRASIDONE HCL 20 MG ORAL CAP $8.77 0904-5921-61 DIGOXIN 125 MCG (0.125 MG) ORAL TAB $8.76 42292-003-20 DIGOXIN 125 MCG (0.125 MG) ORAL TAB $8.76 0904-5922-61 DIGOXIN 250 MCG (0.25 MG) ORAL TAB $8.76 60687-506-11 PREGABALIN 100 MG ORAL CAP $8.76 60687-506-01 PREGABALIN 100 MG ORAL CAP $8.76 60687-473-01 PREGABALIN 25 MG ORAL CAP $8.76 60687-473-11 PREGABALIN 25 MG ORAL CAP $8.76 60687-484-11 PREGABALIN 50 MG ORAL CAP $8.76 60687-484-01 PREGABALIN 50 MG ORAL CAP $8.76 60687-495-11 PREGABALIN 75 MG ORAL CAP $8.76 60687-495-01 PREGABALIN 75 MG ORAL CAP $8.76 0904-6622-61 PYRIDOSTIGMINE BROMIDE 60 MG ORAL TAB $8.74 0781-3206-85 CEFTRIAXONE 250 MG INJ SOLR $8.71 HC89022925 CREATININE, BODY FLUID-AU $8.70 76385-102-01 PRIMAQUINE 26.3 MG (15 MG BASE) ORAL TAB $8.70 68462-380-01 THEOPHYLLINE 400 MG ORAL TB24 $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 62559-157-30 POLYETHYLENE GLYCOL 3350 17 GRAM ORAL PWPK $8.68 65862-290-84 RIBAVIRIN 200 MG ORAL CAP $8.67 33342-115-07 CANDESARTAN 8 MG ORAL TAB $8.67 0781-3206-95 CEFTRIAXONE 250 MG INJ SOLR $8.67 59651-118-60 DOFETILIDE 125 MCG ORAL CAP $8.67 31722-833-90 ENTECAVIR 0.5 MG ORAL TAB $8.67 31722-833-30 ENTECAVIR 0.5 MG ORAL TAB $8.67 31722-834-30 ENTECAVIR 1 MG ORAL TAB $8.67 4561100938 LIDOCAINE 4 % TOPICAL PTMD $8.67 6808476495 SOD PHOS DI, MONO-K PHOS MONO 250 MG ORAL TAB $8.67 6808476425 SOD PHOS DI, MONO-K PHOS MONO 250 MG ORAL TAB $8.67 68180-331-07 ZIPRASIDONE HCL 20 MG ORAL CAP $8.67 50268-563-15 MIDODRINE 10 MG ORAL TAB $8.65 50268-563-11 MIDODRINE 10 MG ORAL TAB $8.65 64253-020-30 WATER FOR INJECTION, STERILE INJ SYRG $8.65 0487-9904-01 ALBUTEROL SULFATE 1.25 MG/3 ML INHALATION NEBU $8.64 0487-9904-25 ALBUTEROL SULFATE 1.25 MG/3 ML INHALATION NEBU $8.64 0071-0237-24 ETHOSUXIMIDE 250 MG ORAL CAP $8.63 68682-997-98 DILTIAZEM HCL 240 MG ORAL CP24 $8.62 47335-677-81 DILTIAZEM HCL 240 MG ORAL CP24 $8.62 0904-6500-06 FLUCONAZOLE 100 MG ORAL TAB $8.61 68382-005-14 TOPIRAMATE 25 MG ORAL CPSP $8.61 HC89022891 BILIRUBIN, TOTAL BODY FLUID-AU $8.58 HC89023691 LDH TOTAL BODY FLUID-AU $8.58 0378-0972-01 CLOZAPINE 50 MG ORAL TAB $8.58 68094-503-62 IBUPROFEN 100 MG/5 ML ORAL SUSP $8.58 62756-538-86 RILUZOLE 50 MG ORAL TAB $8.58 68462-381-60 RILUZOLE 50 MG ORAL TAB $8.58 0904-6991-04 PREGABALIN 25 MG ORAL CAP $8.57 0904-7505-04 BUPROPION HCL 150 MG ORAL TB24 $8.56 50268-312-15 FENOFIBRATE 54 MG ORAL TAB $8.56 50268-312-11 FENOFIBRATE 54 MG ORAL TAB $8.56 0071-0737-20 GEMFIBROZIL 600 MG ORAL TAB $8.55 49884-364-01 DANTROLENE 100 MG ORAL CAP $8.54 68094-503-59 IBUPROFEN 100 MG/5 ML ORAL SUSP $8.52 0378-3205-01 PRAZOSIN 5 MG ORAL CAP $8.52 0115-4422-01 DANTROLENE 50 MG ORAL CAP $8.51 53489-376-01 TRIMETHOBENZAMIDE 300 MG ORAL CAP $8.51 50268-748-11 VALSARTAN 160 MG ORAL TAB $8.51 50268-748-15 VALSARTAN 160 MG ORAL TAB $8.51 0904-7199-07 PHENYTOIN 50 MG ORAL CHEW $8.49 0591-3331-30 BUPROPION HCL 150 MG ORAL TB24 $8.48 0591-3331-19 BUPROPION HCL 150 MG ORAL TB24 $8.48 63323-751-03 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $8.46 63323-751-13 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $8.46 60505-2985-3 ANASTROZOLE 1 MG ORAL TAB $8.45 60687-679-21 BISOPROLOL FUMARATE 5 MG ORAL TAB $8.45 60687-679-11 BISOPROLOL FUMARATE 5 MG ORAL TAB $8.45 60687-878-42 DOCUSATE SODIUM 100 MG/10 ML ORAL LIQD $8.45 57629-203-10 HYOSCYAMINE SULFATE 0.375 MG ORAL TB12 $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 63323-411-15 MIDAZOLAM 1 MG/ML INJ SOLN $8.45 63323-411-12 MIDAZOLAM 1 MG/ML INJ SOLN $8.45 0143-9375-10 TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLN $8.45 0143-9375-01 TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLN $8.45 81033-266-05 VALPROATE SODIUM 250 MG/5 ML ORAL SYRP (MCH) $8.45 16714-632-01 ALENDRONATE 35 MG ORAL TAB $8.44 62332-025-31 THEOPHYLLINE 300 MG ORAL TB12 $8.43 68462-721-01 THEOPHYLLINE 300 MG ORAL TB12 $8.43 69452-267-20 THEOPHYLLINE 300 MG ORAL TB12 $8.43 0409-1778-05 METOPROLOL TARTRATE 5 MG/5 ML IV SOLN $8.42 0409-1778-15 METOPROLOL TARTRATE 5 MG/5 ML IV SOLN $8.42 0527-4593-13 OSELTAMIVIR 75 MG ORAL CAP $8.42 0641-6048-01 LORAZEPAM 2 MG/ML INJ SOLN $8.41 0641-6048-25 LORAZEPAM 2 MG/ML INJ SOLN $8.41 0904-6363-61 DIVALPROEX 250 MG ORAL TB24 $8.41 0093-8739-01 MEXILETINE 150 MG ORAL CAP $8.41 99999-001-08 LORAZEPAM 0.5 MG / ML INJ SOLN $8.40 0904-6931-81 POLYETHYLENE GLYCOL 3350 17 GRAM ORAL PWPK $8.39 HC89023717 TOTAL PROTEIN BODY FLUID-AU $8.37 42192-615-01 NIFEDIPINE 10 MG ORAL CAP $8.37 0574-0107-70 CLOTRIMAZOLE 10 MG MUCOUS MEMB TROC $8.36 0409-4713-25 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $8.35 0409-4713-42 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $8.35 0409-4713-32 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $8.35 0409-4755-18 ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN $8.35 0409-4755-03 ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN $8.35 60687-814-11 PROCHLORPERAZINE MALEATE 5 MG ORAL TAB $8.33 60687-814-65 PROCHLORPERAZINE MALEATE 5 MG ORAL TAB $8.33 63304-460-50 CHLOROQUINE PHOSPHATE 250 MG ORAL TAB $8.32 63739-976-01 DOCUSATE SODIUM 100 MG/10 ML ORAL LIQD $8.32 63739-976-10 DOCUSATE SODIUM 100 MG/10 ML ORAL LIQD $8.32 99999-039-89 LIDOCAINE 1%/NA BICARB 10:1 INJ $8.32 0228-2890-06 DULOXETINE 20 MG ORAL CPDR $8.29 99999-002-04 NS NICU BOLUS $8.29 0406-8330-01 MORPHINE 30 MG ORAL TBSR $8.28 0603-5061-21 PERPHENAZINE 4 MG ORAL TAB $8.28 68084-654-11 SOTALOL 80 MG ORAL TAB $8.27 68084-654-01 SOTALOL 80 MG ORAL TAB $8.27 68180-281-01 ETHAMBUTOL 400 MG ORAL TAB $8.26 33342-114-07 CANDESARTAN 4 MG ORAL TAB $8.24 42806-102-01 ETHAMBUTOL 400 MG ORAL TAB $8.23 0904-7046-06 HYDROXYCHLOROQUINE 200 MG ORAL TAB $8.21 33342-084-07 OLANZAPINE 10 MG ORAL TBDL $8.17 60505-3276-3 OLANZAPINE 10 MG ORAL TBDL $8.17 64380-173-01 OLANZAPINE 10 MG ORAL TBDL $8.17 64380-173-02 OLANZAPINE 10 MG ORAL TBDL $8.17 50268-646-15 OXYCODONE-ACETAMINOPHEN 10-325 MG ORAL TAB $8.17 50268-646-11 OXYCODONE-ACETAMINOPHEN 10-325 MG ORAL TAB $8.17 16714-110-01 HYDROXYCHLOROQUINE 200 MG ORAL TAB $8.16 70954-504-10 SELEGILINE HCL 5 MG ORAL CAP $8.16 54482-144-07 LEVOCARNITINE 330 MG ORAL TAB $8.15 0536-1202-15 LIDOCAINE 4 % TOPICAL PTMD $8.15 60505-1325-1 MIDODRINE 10 MG ORAL TAB $8.15 132020220 SODIUM PHOSPHATES 9.5-3.5 GRAM/59 ML RECTAL ENEM $8.15 0338-0069-10 KETOROLAC 15 MG/ML INJ SOLN $8.15 0904-6558-61 MORPHINE 30 MG ORAL TBSR $8.13 0409-7332-21 CEFTRIAXONE 1 GRAM INJ SOLR $8.13 0409-7332-20 CEFTRIAXONE 1 GRAM INJ SOLR $8.13 0143-9858-01 CEFTRIAXONE 500 MG INJ SOLR $8.13 71288-414-93 GLYCOPYRROLATE (ROBINUL) INHALATION SOLN (0.2MG/ML) $8.13 71288-414-94 GLYCOPYRROLATE (ROBINUL) INHALATION SOLN (0.2MG/ML) $8.13 31722-565-01 INDOMETHACIN 75 MG ORAL CPSR $8.13 31722-565-60 INDOMETHACIN 75 MG ORAL CPSR $8.13 99999-044-13 MEGESTROL 40 MG/ML ORAL SUSPENSION (MHS WRAPPER) $8.13 99999-042-45 MEGESTROL 40 MG/ML ORAL SUSPENSION (MHS WRAPPER) $8.13 0641-6063-01 MIDAZOLAM 5MG/ML INJECTABLE SOLUTION (MHS WRAPPER) $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 70860-407-10 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $8.13 70860-407-41 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN $8.13 0527-1326-01 URSODIOL 300 MG ORAL CAP $8.13 42806-503-01 URSODIOL 300 MG ORAL CAP $8.13 99999-005-57 GENTAMICIN 2 MG/ML INJ SOLN IN D5W (MCH-NICU) $8.09 0409-3414-11 METOCLOPRAMIDE 5 MG/ML INJ SOLN (MCH) $8.07 0409-3414-21 METOCLOPRAMIDE 5 MG/ML INJ SOLN (MCH) $8.07 25021-053-01 DEXAMETHASONE SODIUM PHOS (PF) 10 MG/ML INJ SOLN $8.06 72572-122-25 DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJ SOLN $8.06 72572-122-01 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 99999-044-68 METOCLOPRAMIDE 0.5 MG / ML SYRINGE $8.06 0115-1645-01 NITROFURANTOIN MACROCRYSTAL 100 MG ORAL CAP $8.06 4110080676 POLYETHYLENE GLYCOL 3350 17 GRAM ORAL PWPK $8.06 46581-830-06 LIDOCAINE 4 % TOPICAL PTMD $8.04 HC89022982 UREA NITROGEN, BODY FLUID-AU $8.03 0904-7350-06 AZITHROMYCIN 250 MG ORAL TAB $8.03 69238-1522-1 TETRACYCLINE 250 MG ORAL CAP $8.02 0536-1265-11 CLOTRIMAZOLE 1 % TOPICAL CREAM $8.01 67405-550-55 DOXYCYCLINE HYCLATE 100 MG ORAL TAB $8.00 0904-7244-68 LACOSAMIDE 50 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 HC89017750 ANTI MICROSOMAL THYROID(PNL-AU $8.00 HC89017503 ANTI-CARDIOLIPIN IGG/GM(PNL-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 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 HC89012041 RHEUMATOID FACTOR-AU $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 65282-1605-1 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $8.00 51079-943-20 BUPROPION HCL 75 MG ORAL TAB $7.98 51079-943-01 BUPROPION HCL 75 MG ORAL TAB $7.98 0904-7016-61 BUMETANIDE 1 MG ORAL TAB $7.98 0904-7276-92 NYSTATIN 100,000 UNIT/ML ORAL SUSP $7.96 72485-202-90 IMATINIB 100 MG ORAL TAB $7.94 59651-240-90 IMATINIB 100 MG ORAL TAB $7.94 53489-144-01 SPIRONOLACTON-HYDROCHLOROTHIAZ 25-25 MG ORAL TAB $7.93 62559-722-01 TERBUTALINE 5 MG ORAL TAB $7.93 16714-691-02 FLUCONAZOLE 100 MG ORAL TAB $7.91 60687-858-11 DIGOXIN 125 MCG (0.125 MG) ORAL TAB $7.90 60687-858-01 DIGOXIN 125 MCG (0.125 MG) ORAL TAB $7.90 0093-7629-98 IMATINIB 100 MG ORAL TAB $7.89 63323-010-41 GENTAMICIN 40 MG/ML INJ SOLN $7.87 63323-010-94 GENTAMICIN 40 MG/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 59762-5028-1 GABAPENTIN 400 MG ORAL CAP $7.85 68382-189-01 DIPYRIDAMOLE 75 MG ORAL TAB $7.84 60687-634-11 VALSARTAN 160 MG ORAL TAB $7.84 60687-634-01 VALSARTAN 160 MG ORAL TAB $7.84 16714-141-01 ARIPIPRAZOLE 2 MG ORAL TAB $7.80 99999-042-13 CEFAZOLIN 1 GRAM/10 ML SYRINGE (USING 100 G) $7.80 23155-532-01 ETHOSUXIMIDE 250 MG ORAL CAP $7.80 42806-711-01 ETHOSUXIMIDE 250 MG ORAL CAP $7.80 25021-320-04 FUROSEMIDE 10 MG/ML INJ SOLN $7.80 0555-0484-02 LEUCOVORIN CALCIUM 5 MG ORAL TAB $7.80 63323-064-21 MAGNESIUM SULFATE 50 % (4 MEQ/ML) IV SOLN (TPN-MEQ) $7.80 63323-064-23 MAGNESIUM SULFATE 50 % (4 MEQ/ML) IV SOLN (TPN-MEQ) $7.80 99999-042-27 MEROPENEM 20 MG/ML INJ SOLN $7.80 0641-6061-01 MIDAZOLAM 5 MG/ML INJ SOLN $7.80 0641-6061-25 MIDAZOLAM 5 MG/ML INJ SOLN (FOR INTRANASAL USE) $7.80 99999-036-81 MITOTANE 125 MG ORAL PARTIAL 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 64380-797-01 OSELTAMIVIR 30 MG ORAL CAP $7.80 42192-802-01 PHENAZOPYRIDINE 200 MG ORAL TAB $7.80 72205-264-25 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $7.80 72205-264-01 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $7.80 42571-177-01 PIROXICAM 20 MG ORAL CAP $7.80 99999-045-13 SPIRONOLACTONE-HYDROCHLOROTHIAZIDE ORAL SUSP (MCH) $7.80 HC89007793 CRYOGLOBULIN(QUAL/SEMI QT)-AU $7.79 16714-142-01 ARIPIPRAZOLE 5 MG ORAL TAB $7.79 0121-0970-01 LIDOCAINE 4 % TOPICAL PTMD $7.79 0904-7095-61 OXYCODONE-ACETAMINOPHEN 10-325 MG ORAL TAB $7.79 50268-685-15 PROCHLORPERAZINE MALEATE 10 MG ORAL TAB $7.77 50268-685-11 PROCHLORPERAZINE MALEATE 10 MG ORAL TAB $7.77 42806-358-01 LEUCOVORIN CALCIUM 5 MG ORAL TAB $7.76 39328-031-05 ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL LIQD (MHS WRAPPER) $7.74 39328-031-50 ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL LIQD (MHS WRAPPER) $7.74 99999-046-37 LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN $7.74 99999-044-61 LIDOCAINE-EPINEPHRINE 1%-1:100,000 BUFFERED WITH SODIUM BICARB 10:1 INJ (FOR IR/ANGIO) (OCM) $7.74 0904-7276-41 NYSTATIN 100,000 UNIT/ML ORAL SUSP $7.74 0904-7276-70 NYSTATIN 100,000 UNIT/ML ORAL SUSP $7.74 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 64980-133-01 DIPYRIDAMOLE 25 MG ORAL TAB $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 60687-374-11 NABUMETONE 500 MG ORAL TAB $7.68 0143-9249-20 AMOXICILLIN-POT CLAVULANATE 875-125 MG ORAL TAB $7.67 0409-0001-25 MIDAZOLAM 1MG/ML INJECTABLE SOLUTION (MHS WRAPPER) $7.67 0409-0001-01 MIDAZOLAM 1MG/ML INJECTABLE SOLUTION (MHS WRAPPER) $7.67 50268-260-13 DIVALPROEX 500 MG ORAL TB24 $7.66 50268-260-11 DIVALPROEX 500 MG ORAL TB24 $7.66 16714-143-01 ARIPIPRAZOLE 10 MG ORAL TAB $7.65 50268-747-11 VALSARTAN 80 MG ORAL TAB $7.63 50268-747-15 VALSARTAN 80 MG ORAL TAB $7.63 0641-0376-25 DIPHENHYDRAMINE HCL 50 MG/ML INJ SOLN $7.62 0641-0376-21 DIPHENHYDRAMINE HCL 50 MG/ML INJ SOLN $7.62 25021-481-01 DIPHENHYDRAMINE HCL 50 MG/ML INJ SOLN $7.62 72572-055-25 CEFAZOLIN 1 GRAM INJ SOLR $7.61 72572-055-01 CEFAZOLIN 1 GRAM INJ SOLR $7.61 99999-037-95 LORAZEPAM 2 MG/ML INJ SOLN $7.61 0574-7034-12 ASPIRIN 300 MG RECTAL SUPP $7.59 27808-206-01 FEBUXOSTAT 40 MG ORAL TAB $7.59 0555-0484-01 LEUCOVORIN CALCIUM 5 MG ORAL TAB $7.59 HC89023709 GLUCOSE BODY FLUID-AU $7.58 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 60687-788-11 SILDENAFIL (PULM.HYPERTENSION) 20 MG ORAL TAB $7.56 60687-788-21 SILDENAFIL (PULM.HYPERTENSION) 20 MG ORAL TAB $7.56 0904-6671-04 SILDENAFIL (PULM.HYPERTENSION) 20 MG ORAL TAB $7.55 0409-2308-21 MIDAZOLAM (PF) 5 MG/ML INJ SOLN $7.55 0409-2308-01 MIDAZOLAM (PF) 5 MG/ML INJ SOLN $7.55 0121-1781-00 ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL LIQD (MHS WRAPPER) $7.54 0121-1781-05 ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL LIQD (MHS WRAPPER) $7.54 99999-009-08 DIAZEPAM 5 MG/5 ML (1 MG/ML) ORAL SOLN $7.54 0832-1550-89 HALOPERIDOL 10 MG ORAL TAB $7.54 70756-640-82 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $7.54 70756-640-25 LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN $7.54 70756-644-25 LIDOCAINE 1% (10 MG/ML) FOR RT USE $7.54 70756-644-82 LIDOCAINE 1% (10 MG/ML) FOR RT USE $7.54 65862-459-60 GALANTAMINE 8 MG ORAL TAB $7.53 50268-720-15 SEVELAMER CARBONATE 800 MG ORAL TAB $7.52 50268-720-11 SEVELAMER CARBONATE 800 MG ORAL TAB $7.52 HC89004048 AMYLASE ISOENZYMES -AU $7.50 HC89012967 VARICELLA ZOSTER (PNL)-AU $7.50 0832-1550-01 HALOPERIDOL 10 MG ORAL TAB $7.50 99999-001-14 POTASSIUM CHLORIDE - STERILE WATER - 20 MEQ / 50 ML IV PGBK $7.48 51079-818-20 TACROLIMUS 1 MG ORAL CAP $7.48 51079-818-01 TACROLIMUS 1 MG ORAL CAP $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 0121-1882-94 ACETAMINOPHEN 325 MG/10.15 ML ORAL LIQD (MHS WRAPPER) $7.46 0904-6557-61 MORPHINE 15 MG ORAL TBSR $7.44 50268-062-11 ACYCLOVIR 800 MG ORAL TAB $7.43 50268-062-15 ACYCLOVIR 800 MG ORAL TAB $7.43 0574-0107-77 CLOTRIMAZOLE 10 MG MUCOUS MEMB TROC $7.43 0603-4593-21 METHYLPREDNISOLONE 4 MG ORAL TAB $7.43 0904-6931-86 POLYETHYLENE GLYCOL 3350 17 GRAM ORAL PWPK $7.43 0904-6931-26 POLYETHYLENE GLYCOL 3350 17 GRAM ORAL PWPK $7.43 51991-073-01 BUTALBITAL-ACETAMINOP-CAF-COD 50-325-40-30 MG ORAL CAP $7.41 0904-7279-66 DOCUSATE SODIUM 100 MG/10 ML ORAL LIQD $7.41 0904-7279-72 DOCUSATE SODIUM 100 MG/10 ML ORAL LIQD $7.41 51079-453-01 MIDODRINE 5 MG ORAL TAB $7.41 51079-453-20 MIDODRINE 5 MG ORAL TAB $7.41 50268-749-13 VALSARTAN 320 MG ORAL TAB $7.40 50268-749-11 VALSARTAN 320 MG ORAL TAB $7.40 0527-3012-48 MESALAMINE 1.2 GRAM ORAL TBEC $7.40 0121-1882-11 ACETAMINOPHEN 325 MG/10.15 ML ORAL LIQD (MHS WRAPPER) $7.39 0378-2405-01 TRIFLUOPERAZINE 5 MG ORAL TAB $7.38 0409-2305-05 MIDAZOLAM 1MG/ML INJECTABLE SOLUTION (MHS WRAPPER) $7.38 0409-2305-04 MIDAZOLAM 1MG/ML INJECTABLE SOLUTION (MHS WRAPPER) $7.38 99999-041-78 MISOPROSTOL 100 MCG ORAL PARTIAL TAB $7.38 6332300110 EMPTY VIAL MISC MISC $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 25021-315-01 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $7.35 70069-811-25 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $7.35 70069-811-01 PHENYLEPHRINE HCL 10 MG/ML INJ SOLN $7.35 16714-633-01 ALENDRONATE 70 MG ORAL TAB $7.31 0456-0459-01 THYROID (PORK) 60 MG ORAL TAB $7.30 45963-342-02 DESIPRAMINE 25 MG ORAL TAB $7.29 55111-143-30 FLUCONAZOLE 50 MG ORAL TAB $7.28 55111-143-01 FLUCONAZOLE 50 MG ORAL TAB $7.28 72572-190-01 FUROSEMIDE 10 MG/ML INJ SOLN $7.28 72572-190-25 FUROSEMIDE 10 MG/ML INJ SOLN $7.28 65162-680-05 PROMETHAZINE-DM 6.25-15 MG/5 ML ORAL SYRP $7.28 99999-036-67 PHENYTOIN 25 MG ORAL PARTIAL CHEWTAB (MCH) $7.27 0054-4496-13 LEUCOVORIN CALCIUM 5 MG ORAL TAB $7.26 0904-7143-61 SOTALOL 80 MG ORAL TAB $7.25 63304-758-01 MORPHINE 60 MG ORAL TBSR $7.25 31722-014-90 DROXIDOPA 100 MG ORAL CAP $7.22 0093-1177-01 NEOMYCIN 500 MG ORAL TAB $7.22 16714-691-01 FLUCONAZOLE 100 MG ORAL TAB $7.21 36000-283-25 FUROSEMIDE 10 MG/ML INJ SOLN $7.20 50268-684-15 PROCHLORPERAZINE MALEATE 5 MG ORAL TAB $7.20 50268-684-11 PROCHLORPERAZINE MALEATE 5 MG ORAL TAB $7.20 68084-244-11 CLINDAMYCIN HCL 300 MG ORAL CAP $7.19 68084-244-01 CLINDAMYCIN HCL 300 MG ORAL CAP $7.19 60687-592-21 PRAMIPEXOLE 1 MG ORAL TAB $7.18 60687-592-11 PRAMIPEXOLE 1 MG ORAL TAB $7.18 HC89011407 SSA REFLEX (PNL)-AU $7.18 53335-006-89 CITRULLINE 600 MG ORAL CAP $7.16 65862-845-01 CLOZAPINE 50 MG ORAL TAB $7.16 99999-034-85 CEFAZOLIN 1 GRAM/10 ML SYRINGE (USING 10 G) $7.15 0093-9018-65 CYCLOSPORINE MODIFIED 25 MG ORAL CAP $7.15 0093-9018-19 CYCLOSPORINE MODIFIED 25 MG ORAL CAP $7.15 0641-6146-01 DEXAMETHASONE 4 MG/ML INJ SOLN (FOR ORAL USE) $7.15 0641-6146-10 DEXAMETHASONE 4 MG/ML INJ SOLN (FOR ORAL USE) $7.15 99999-040-39 EPINEPHRINE 10 MCG/ML INJ DILUTION $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 0054-0166-25 MYCOPHENOLATE MOFETIL 500 MG ORAL TAB $7.15 60687-438-01 MYCOPHENOLATE MOFETIL 500 MG ORAL TAB $7.15 60687-438-11 MYCOPHENOLATE MOFETIL 500 MG ORAL TAB $7.15 99999-039-43 POTASSIUM CHLORIDE IN WATER 20 MEQ/100 ML IV PGBK $7.15 51079-817-01 TACROLIMUS 0.5 MG ORAL CAP $7.15 51079-817-20 TACROLIMUS 0.5 MG ORAL CAP $7.15 50268-168-11 CELECOXIB 100 MG ORAL CAP $7.13 50268-168-15 CELECOXIB 100 MG ORAL CAP $7.13 30698-060-01 FUROSEMIDE 40 MG ORAL TAB $7.13 81033-002-54 ACETAMINOPHEN 325 MG/10.15 ML ORAL LIQD (MHS WRAPPER) $7.13 81033-512-15 CHLORHEXIDINE GLUCONATE 0.12 % MUCOUS MEMB MWSH $7.12 81033-512-50 CHLORHEXIDINE GLUCONATE 0.12 % MUCOUS MEMB MWSH $7.12 99999-035-97 PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIX $7.12 99999-044-57 PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLN $7.12 62332-061-30 LEFLUNOMIDE 10 MG ORAL TAB $7.11 0054-4496-25 LEUCOVORIN CALCIUM 5 MG ORAL TAB $7.08 0536-1202-07 LIDOCAINE 4 % TOPICAL PTMD $7.08 70512-812-30 LIDOCAINE 4 % TOPICAL PTMD $7.08 70512-812-01 LIDOCAINE 4 % TOPICAL PTMD $7.08 0591-3220-01 BUTALBITAL-ACETAMINOP-CAF-COD 50-325-40-30 MG ORAL CAP $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 HC89016398 TOTAL PROTEIN UR-AU $7.05 68084-280-11 ETHAMBUTOL 400 MG ORAL TAB $7.04 68084-280-01 ETHAMBUTOL 400 MG ORAL TAB $7.04 0904-6709-61 GLYCOPYRROLATE 1 MG ORAL TAB $7.04 0121-0970-30 LIDOCAINE 4 % TOPICAL PTMD $7.04 68382-004-14 TOPIRAMATE 15 MG ORAL CPSP $7.04 60687-384-11 BUMETANIDE 1 MG ORAL TAB $7.03 60687-384-01 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 0406-8515-62 OXYCODONE 15 MG ORAL TAB $7.01 0406-8515-23 OXYCODONE 15 MG ORAL TAB $7.01 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 0115-1072-01 DIPYRIDAMOLE 75 MG ORAL TAB $7.00 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 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 0378-2921-93 TELMISARTAN 40 MG ORAL TAB $6.97 60687-623-01 VALSARTAN 80 MG ORAL TAB $6.96 60687-623-11 VALSARTAN 80 MG ORAL TAB $6.96 64543-111-01 HYOSCYAMINE SULFATE 0.125 MG SL SUBL $6.96 62175-260-37 NIFEDIPINE 30 MG ORAL TR24 $6.96 0904-7016-06 BUMETANIDE 1 MG ORAL TAB $6.94 99999-042-42 ENTECAVIR 0.5 MG ORAL PARTIAL TAB $6.93 81033-002-10 ACETAMINOPHEN 325 MG/10.15 ML ORAL LIQD (MHS WRAPPER) $6.93 81033-002-40 ACETAMINOPHEN 325 MG/10.15 ML ORAL LIQD (MHS WRAPPER) $6.93 50268-177-11 CILOSTAZOL 100 MG ORAL TAB $6.92 50268-177-15 CILOSTAZOL 100 MG ORAL TAB $6.92 16571-203-10 DICLOFENAC SODIUM 25 MG ORAL TBEC $6.92 0132-0201-40 SODIUM PHOSPHATES 19-7 GRAM/118 ML RECTAL ENEM $6.92 70677-1089-1 SODIUM PHOSPHATES 19-7 GRAM/118 ML RECTAL ENEM $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 99999-036-04 FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN $6.90 0409-2308-50 MIDAZOLAM (PF) 5 MG/ML INJ SOLN $6.90 0409-2308-70 MIDAZOLAM (PF) 5 MG/ML INJ SOLN $6.90 16714-534-01 EMTRICITABINE-TENOFOVIR (TDF) 200-300 MG ORAL TAB $6.90 51862-320-01 LIOTHYRONINE 5 MCG ORAL TAB $6.88 99999-035-24 RIFAXIMIN 20 MG/ML ORAL SUSPENSION (COMPOUND) $6.88 23155-579-01 DESIPRAMINE 25 MG ORAL TAB $6.88 72603-184-01 NITROFURANTOIN MACROCRYSTAL 100 MG ORAL CAP $6.88 60687-857-21 DIVALPROEX 125 MG ORAL TBEC $6.85 60687-857-11 DIVALPROEX 125 MG ORAL TBEC $6.85 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 64380-827-06 KETOCONAZOLE 200 MG ORAL TAB $6.83 35573-433-02 KETOCONAZOLE 200 MG ORAL TAB $6.83 35573-433-30 KETOCONAZOLE 200 MG ORAL TAB $6.83 68094-044-61 CALCIUM ACETATE(PHOSPHAT BIND) 667 MG ORAL CAP $6.83 68094-044-59 CALCIUM ACETATE(PHOSPHAT BIND) 667 MG ORAL CAP $6.83 69452-350-92 GRANISETRON HCL 1 MG ORAL TAB $6.83 69452-350-11 GRANISETRON HCL 1 MG ORAL TAB $6.83 60687-391-11 PIOGLITAZONE 15 MG ORAL TAB $6.83 60687-391-01 PIOGLITAZONE 15 MG ORAL TAB $6.83 0904-6623-61 TACROLIMUS 0.5 MG ORAL CAP $6.83 69238-1540-1 URSODIOL 300 MG ORAL CAP $6.83 68084-896-95 VENLAFAXINE 25 MG ORAL TAB $6.83 68084-896-25 VENLAFAXINE 25 MG ORAL TAB $6.83 50268-074-11 AZITHROMYCIN 250 MG ORAL TAB $6.82 69918-101-01 DESMOPRESSIN 0.1 MG ORAL TAB $6.82 23155-489-01 DESMOPRESSIN 0.1 MG ORAL TAB $6.82 0904-6323-61 METOPROLOL SUCCINATE 50 MG ORAL TB24 $6.81 0093-4069-01 PRAZOSIN 5 MG ORAL CAP $6.81 50268-573-15 MONTELUKAST 4 MG ORAL CHEW $6.80 50268-573-11 MONTELUKAST 4 MG ORAL CHEW $6.80 0904-7266-61 DEXAMETHASONE 4 MG ORAL TAB $6.79 68462-208-01 MOEXIPRIL 15 MG ORAL TAB $6.76 0054-0237-05 MORPHINE 10 MG/5 ML ORAL SOLN $6.76 27808-065-05 PROMETHAZINE-CODEINE 6.25-10 MG/5 ML ORAL SYRP $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 50268-087-12 ARIPIPRAZOLE 2 MG ORAL TAB $6.74 50268-087-11 ARIPIPRAZOLE 2 MG ORAL TAB $6.74 0378-9116-93 NITROGLYCERIN 0.6 MG/HR TRANSDERMAL PT24 $6.74 0378-9116-16 NITROGLYCERIN 0.6 MG/HR TRANSDERMAL PT24 $6.74 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 51079-083-20 ISONIAZID 300 MG ORAL TAB $6.70 51079-083-01 ISONIAZID 300 MG ORAL TAB $6.70 0054-0007-13 CALCITRIOL 0.25 MCG ORAL CAP $6.66 11523-7162-2 LORATADINE-PSEUDOEPHEDRINE 5-120 MG ORAL TB12 $6.65 4110080217 LORATADINE-PSEUDOEPHEDRINE 5-120 MG ORAL TB12 $6.65 0591-3159-01 URSODIOL 300 MG ORAL CAP $6.64 71399-4456-5 LIDOCAINE 4 % TOPICAL PTMD $6.63 71399-4456-1 LIDOCAINE 4 % TOPICAL PTMD $6.63 99998-000-70 MEDIUM CHAIN TRIGLYCERIDES 7.7 KCAL/ML ORAL OIL $6.63 16729-073-29 CAPECITABINE 500 MG ORAL TAB $6.62 99999-010-03 CEFTAZIDIME SUBCONJUNCTIVAL INJECTION $6.62 51672-2116-0 ACETAMINOPHEN 325 MG RECTAL SUPP $6.61 51672-2116-2 ACETAMINOPHEN 325 MG RECTAL SUPP $6.61 42543-115-01 PIROXICAM 20 MG ORAL CAP $6.61 0904-7119-06 CALCIUM ACETATE(PHOSPHAT BIND) 667 MG ORAL CAP $6.59 0143-1171-01 CAPTOPRIL 12.5 MG ORAL TAB $6.59 HC89021059 ASPERGILLUS AB (PNL2)-AU $6.58 HC89014237 HYPERSENSITIVITY PNEUMO I (PNL)-AU $6.58 0456-0458-01 THYROID (PORK) 30 MG ORAL TAB $6.57 50268-746-11 VALSARTAN 40 MG ORAL TAB $6.57 50268-746-15 VALSARTAN 40 MG ORAL TAB $6.57 72266-234-25 KETOROLAC 15 MG/ML INJ SOLN $6.57 72266-234-01 KETOROLAC 15 MG/ML INJ SOLN $6.57 99999-010-98 PYRAZINAMIDE 100 MG/ML ORAL LIQUID (COMPOUND) $6.57 60687-718-01 DEXAMETHASONE 4 MG ORAL TAB $6.53 60687-718-11 DEXAMETHASONE 4 MG ORAL TAB $6.53 0009-0012-01 HYDROCORTISONE 5 MG ORAL TAB $6.53 0054-8175-25 DEXAMETHASONE 4 MG ORAL TAB $6.53 48102-047-20 DEXAMETHASONE 4 MG ORAL TAB $6.53 48102-047-11 DEXAMETHASONE 4 MG ORAL TAB $6.53 66993-730-80 DEXAMETHASONE 4 MG ORAL TAB $6.53 66993-730-51 DEXAMETHASONE 4 MG ORAL TAB $6.53 63824-041-24 PSEUDOEPHEDRINE-GUAIFENESIN 120-1,200 MG ORAL TB12 $6.51 HC89009575 ALK PHOSPHATASE-AU $6.50 HC89009583 ALKALINE PHOS ISOENZYMES-AU $6.50 99999-046-55 ADENOSINE 1 MG IN NS 100 ML IC SOLN (10 MCG/ML) (OCM) $6.50 65162-596-06 ASPIRIN-DIPYRIDAMOLE 25-200 MG ORAL CM12 $6.50 68180-984-30 BUDESONIDE 0.5 MG/2 ML INHALATION NBSP $6.50 68180-984-05 BUDESONIDE 0.5 MG/2 ML INHALATION NBSP $6.50 50268-131-15 BUMETANIDE 1 MG ORAL TAB $6.50 50268-131-11 BUMETANIDE 1 MG ORAL TAB $6.50 99999-005-15 CAFFEINE CITRATE 5 MG/ML INJ DILUTION (MCH) $6.50 42806-266-95 CHOLESTYRAMINE (WITH SUGAR) 4 GRAM ORAL PWPK $6.50 42806-266-98 CHOLESTYRAMINE (WITH SUGAR) 4 GRAM ORAL PWPK $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 72205-184-60 DARUNAVIR 600 MG ORAL TAB $6.50 0378-0473-01 DIVALPROEX 500 MG ORAL TB24 $6.50 65862-354-30 EMTRICITABINE-TENOFOVIR (TDF) 200-300 MG ORAL TAB $6.50 68462-102-30 FLUCONAZOLE 100 MG ORAL TAB $6.50 71288-203-02 FUROSEMIDE 10 MG/ML INJ SOLN $6.50 71288-203-03 FUROSEMIDE 10 MG/ML INJ SOLN $6.50 6380750005 HEPARIN LOCK FLUSH (PORCINE) 10 UNIT/ML IV SOLN (MCH) $6.50 60687-552-01 LEVOTHYROXINE 200 MCG ORAL TAB $6.50 60687-552-11 LEVOTHYROXINE 200 MCG ORAL TAB $6.50 16714-167-01 LIOTHYRONINE 25 MCG ORAL TAB $6.50 0254-3029-02 LUBIPROSTONE 24 MCG ORAL CAP $6.50 0254-3028-02 LUBIPROSTONE 8 MCG ORAL CAP $6.50 36000-033-10 METOPROLOL TARTRATE 5 MG/5 ML IV SOLN $6.50 99999-033-12 MORPHINE (DURAMORPH) 10MG/100ML NS (CONC: 0.1 MG/ML) $6.50 49483-687-03 PARICALCITOL 1 MCG ORAL CAP $6.50 0378-5186-93 PRASUGREL HCL 10 MG ORAL TAB $6.50 99999-035-05 SODIUM BICARBONATE 1 MEQ/ML (8.4 %) IV SOLN $6.50 64380-722-06 TACROLIMUS 5 MG ORAL CAP $6.50 31722-535-30 TENOFOVIR DISOPROXIL FUMARATE 300 MG ORAL TAB $6.50 62559-721-01 TERBUTALINE 2.5 MG ORAL TAB $6.50 51079-379-01 MYCOPHENOLATE MOFETIL 500 MG ORAL TAB $6.47 51079-379-20 MYCOPHENOLATE MOFETIL 500 MG ORAL TAB $6.47 0904-7367-06 ARIPIPRAZOLE 5 MG ORAL TAB $6.47 68462-209-01 MOEXIPRIL 7.5 MG ORAL TAB $6.46 0054-4184-25 DEXAMETHASONE 4 MG ORAL TAB $6.44 99999-037-12 ACETIC ACID (BULK) 5 % MISC LIQD $6.44 60687-461-11 LABETALOL 300 MG ORAL TAB $6.44 60687-461-01 LABETALOL 300 MG ORAL TAB $6.44 69452-157-73 RIZATRIPTAN 10 MG ORAL TBDL $6.43 16714-732-01 CELECOXIB 100 MG ORAL CAP $6.42 0574-9855-10 BUDESONIDE 3 MG ORAL CECX $6.42 99999-000-33 POTASSIUM PHOSPHATE 3 MMOL / ML ORAL SYRINGE $6.41 99999-000-32 POTASSIUM PHOSPHATE 3 MMOL / ML SYRINGE $6.41 68094-330-59 ACETAMINOPHEN 325 MG/10.15 ML ORAL LIQD (MHS WRAPPER) $6.40 70954-135-10 DAPSONE 25 MG ORAL TAB $6.39 60687-653-21 POTASSIUM CHLORIDE 10 MEQ ORAL CPSR $6.39 69680-131-60 PROPAFENONE 325 MG ORAL CP12 $6.39 70436-010-04 BUPROPION HCL 150 MG ORAL TB24 $6.38 60687-387-11 MIDODRINE 2.5 MG ORAL TAB $6.36 60687-387-01 MIDODRINE 2.5 MG ORAL TAB $6.36 43063-871-60 URSODIOL 300 MG ORAL CAP $6.35 0054-0603-13 DESVENLAFAXINE SUCCINATE 25 MG ORAL TB24 $6.34 0591-3659-30 DESVENLAFAXINE SUCCINATE 50 MG ORAL TB24 $6.34 50268-671-11 POTASSIUM CHLORIDE 10 MEQ ORAL CPSR $6.33 50268-671-13 POTASSIUM CHLORIDE 10 MEQ ORAL CPSR $6.33 60687-390-11 METOPROLOL SUCCINATE 25 MG ORAL TB24 $6.32 60687-402-11 METOPROLOL SUCCINATE 50 MG ORAL TB24 $6.32 60687-402-01 METOPROLOL SUCCINATE 50 MG ORAL TB24 $6.32 63323-262-09 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $6.31 63323-262-26 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $6.31 0641-6145-25 DEXAMETHASONE 4 MG/ML INJ SOLN (FOR ORAL USE) $6.29 0641-6145-01 DEXAMETHASONE 4 MG/ML INJ SOLN (FOR ORAL USE) $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 16714-838-01 ZIPRASIDONE HCL 80 MG ORAL CAP $6.29 0378-7160-01 CELECOXIB 100 MG ORAL CAP $6.28 0378-0222-01 CHLORTHALIDONE 25 MG 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 59762-5008-1 MISOPROSTOL 200 MCG ORAL TAB $6.28 59762-5008-2 MISOPROSTOL 200 MCG ORAL TAB $6.28 0409-7338-01 CEFTRIAXONE 500 MG INJ SOLR $6.27 0409-7338-11 CEFTRIAXONE 500 MG INJ SOLR $6.27 70954-444-20 MISOPROSTOL 200 MCG ORAL TAB $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 72603-189-01 DEXAMETHASONE 4 MG ORAL TAB $6.21 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 72603-816-01 METHENAMINE HIPPURATE 1 GRAM ORAL TAB $6.20 0641-6022-25 FAMOTIDINE (PF) 20 MG/2 ML IV SOLN $6.19 0641-6022-01 FAMOTIDINE (PF) 20 MG/2 ML IV SOLN $6.19 0603-5168-21 PHENOBARBITAL 97.2 MG ORAL TAB $6.19 51293-628-01 PHENOBARBITAL 97.2 MG ORAL TAB $6.19 0904-7278-70 ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL LIQD (MHS WRAPPER) $6.18 0904-7278-41 ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL LIQD (MHS WRAPPER) $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 99999-035-40 METRONIDAZOLE IN NACL (ISO-OS) 500 MG/100 ML IV PGBK $6.18 0904-7208-61 NIFEDIPINE 30 MG ORAL TR24 $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 HC89010904 ALLERGEN-INDIVIDUAL-AU $6.17 0781-1831-01 AMOXICILLIN-POT CLAVULANATE 500-125 MG ORAL TAB $6.16 50268-176-15 CILOSTAZOL 50 MG ORAL TAB $6.16 50268-176-11 CILOSTAZOL 50 MG ORAL TAB $6.16 0054-0007-25 CALCITRIOL 0.25 MCG ORAL CAP $6.15 13517-113-01 PHENOBARBITAL 97.2 MG ORAL TAB $6.15 0409-2308-69 MIDAZOLAM (PF) 5 MG/ML INJ SOLN $6.14 0409-2308-49 MIDAZOLAM (PF) 5 MG/ML INJ SOLN $6.14 99999-047-18 NYSTATIN 100,000 UNIT/ML ORAL SUSP $6.14 0869-0078-16 CASTOR OIL 100 % ORAL OIL $6.14 72789-253-20 AMOXICILLIN-POT CLAVULANATE 875-125 MG ORAL TAB $6.12 50268-574-15 MONTELUKAST 5 MG ORAL CHEW $6.11 50268-574-11 MONTELUKAST 5 MG ORAL CHEW $6.11 99999-041-28 NYSTATIN 100,000 UNIT/ML ORAL SUSP $6.11 51927-1123-0 TANNIC ACID (BULK) MISC POWD $6.11 7733380050 SACCHAROMYCES BOULARDII 250 MG ORAL CAP $6.10 7733380025 SACCHAROMYCES BOULARDII 250 MG ORAL CAP $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 0054-0011-21 FLECAINIDE 100 MG ORAL TAB $6.10 0054-0011-25 FLECAINIDE 100 MG ORAL TAB $6.10 0054-0011-20 FLECAINIDE 100 MG ORAL TAB $6.10 16714-128-01 CHLORTHALIDONE 25 MG ORAL TAB $6.09 65862-846-01 CLOZAPINE 100 MG ORAL TAB $6.09 0904-7087-61 CLOZAPINE 100 MG ORAL TAB $6.09 68084-856-01 VENLAFAXINE 75 MG ORAL TAB $6.08 68084-856-11 VENLAFAXINE 75 MG ORAL TAB $6.08 62332-365-06 CLONAZEPAM 0.25 MG ORAL TBDL $6.08 0093-9291-67 CLONAZEPAM 0.25 MG ORAL TBDL $6.08 0093-9291-19 CLONAZEPAM 0.25 MG ORAL TBDL $6.08 10370-830-09 DILTIAZEM HCL 180 MG ORAL CP24 $6.08 68682-994-98 DILTIAZEM HCL 180 MG ORAL CP24 $6.08 51672-2115-0 ACETAMINOPHEN 120 MG RECTAL SUPP $6.07 51672-2115-2 ACETAMINOPHEN 120 MG RECTAL SUPP $6.07 51672-2114-0 ACETAMINOPHEN 80 MG RECTAL SUPP $6.07 51672-2114-2 ACETAMINOPHEN 80 MG RECTAL SUPP $6.07 65862-225-60 CLARITHROMYCIN 250 MG ORAL TAB $6.07 65862-226-60 CLARITHROMYCIN 500 MG ORAL TAB $6.07 45963-341-02 DESIPRAMINE 10 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 50268-142-15 BUPROPION HCL 75 MG ORAL TAB $6.04 50268-142-11 BUPROPION HCL 75 MG ORAL TAB $6.04 31722-138-01 BACLOFEN 5 MG ORAL TAB $6.03 49884-307-52 CLONAZEPAM 0.25 MG ORAL TBDL $6.01 49884-307-02 CLONAZEPAM 0.25 MG ORAL TBDL $6.01 0904-3865-75 SODIUM CHLORIDE 0.65 % NASL SPRA $6.01 HC89007025 ADRENOCORTICOTROPIC HRMN-AU $6.00 HC89020903 ALBUMIN; OTHER SRC: CSF -AU $6.00 HC89014054 ANA-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 HC89009716 PSA FREE-AU $6.00 HC89009708 PSA TOTAL-AU $6.00 HC89016539 TESTOSTERONE FREE-MALE-AU $6.00 HC89020424 THYROID HORMONE UPTAKE-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 68084-284-01 HYDROXYUREA 500 MG ORAL CAP $5.98 68084-284-11 HYDROXYUREA 500 MG ORAL CAP $5.98 72572-355-25 KETOROLAC 30 MG/ML (1 ML) INJ SOLN $5.98 72572-355-01 KETOROLAC 30 MG/ML (1 ML) INJ SOLN $5.98 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 51660-996-28 COLESEVELAM 625 MG ORAL TAB $5.96 43598-230-18 COLESEVELAM 625 MG ORAL TAB $5.96 55111-594-30 MONTELUKAST 5 MG ORAL CHEW $5.96 59762-5019-1 QUINAPRIL 5 MG ORAL TAB $5.96 0781-2103-01 TACROLIMUS 1 MG ORAL CAP $5.96 16714-063-01 CARBAMAZEPINE 100 MG ORAL TB12 $5.95 0832-0512-01 BETHANECHOL CHLORIDE 25 MG ORAL TAB $5.94 50268-185-11 CLINDAMYCIN HCL 300 MG ORAL CAP $5.94 50268-185-15 CLINDAMYCIN HCL 300 MG ORAL CAP $5.94 0406-8315-62 MORPHINE 15 MG ORAL TBSR $5.94 68084-083-01 ISOSORBIDE DINITRATE 20 MG ORAL TAB $5.92 68084-083-11 ISOSORBIDE DINITRATE 20 MG ORAL TAB $5.92 68094-231-62 ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSP $5.92 0832-0512-89 BETHANECHOL CHLORIDE 25 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 51079-736-20 HALOPERIDOL 5 MG ORAL TAB $5.92 51079-736-01 HALOPERIDOL 5 MG ORAL TAB $5.92 60687-161-11 HALOPERIDOL 5 MG ORAL TAB $5.92 60687-161-01 HALOPERIDOL 5 MG ORAL TAB $5.92 72572-354-01 KETOROLAC 15 MG/ML INJ SOLN $5.92 72572-354-10 KETOROLAC 15 MG/ML INJ SOLN $5.92 99999-047-33 SULFAMETHOXAZOLE-TRIMETHOPRIM 0.02-0.004 MG/ML ORAL SOLUTION - FOR DESENSITIZATION $5.92 99999-047-32 SULFAMETHOXAZOLE-TRIMETHOPRIM 0.2-0.04 MG/ML ORAL SOLUTION - FOR DESENSITIZATION $5.92 99999-047-31 SULFAMETHOXAZOLE-TRIMETHOPRIM 2-0.4 MG/ML ORAL SOLUTION - FOR DESENSITIZATION $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 16714-297-01 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 64380-714-04 TENOFOVIR DISOPROXIL FUMARATE 300 MG ORAL TAB $5.88 42291-800-30 TENOFOVIR DISOPROXIL FUMARATE 300 MG ORAL TAB $5.88 49884-117-01 AMILORIDE 5 MG ORAL TAB $5.87 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 72572-120-25 DEXAMETHASONE 4 MG/ML INJ SOLN (FOR ORAL USE) $5.85 72572-120-01 DEXAMETHASONE 4 MG/ML INJ SOLN (FOR ORAL USE) $5.85 81565-202-01 DEXAMETHASONE FOR NEBULIZER SOLUTION (LB/MCH) $5.85 81565-202-02 DEXAMETHASONE FOR NEBULIZER SOLUTION (LB/MCH) $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 60687-428-11 FINASTERIDE 5 MG ORAL TAB $5.85 60687-428-01 FINASTERIDE 5 MG ORAL TAB $5.85 36000-012-25 ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN $5.85 60687-908-01 PRAVASTATIN 40 MG ORAL TAB $5.85 60687-908-11 PRAVASTATIN 40 MG ORAL TAB $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 67877-506-51 COLESEVELAM 625 MG ORAL TAB $5.82 0904-6615-61 DIVALPROEX 125 MG ORAL CDRS $5.81 50268-321-11 FLECAINIDE 100 MG ORAL TAB $5.81 50268-321-15 FLECAINIDE 100 MG ORAL TAB $5.81 51079-923-20 CARBIDOPA-LEVODOPA 50-200 MG ORAL TBSR $5.80 51079-923-01 CARBIDOPA-LEVODOPA 50-200 MG ORAL TBSR $5.80 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 0904-6718-39 GUAIFENESIN 600 MG ORAL TA12 $5.79 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 60687-722-01 OXCARBAZEPINE 300 MG ORAL TAB $5.74 60687-722-11 OXCARBAZEPINE 300 MG ORAL TAB $5.74 25021-052-05 DEXAMETHASONE 4 MG/ML INJ SOLN (FOR ORAL USE) $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 59762-1207-1 LIOTHYRONINE 25 MCG ORAL TAB $5.72 42794-019-12 LIOTHYRONINE 25 MCG ORAL TAB $5.72 57664-655-88 PINDOLOL 5 MG ORAL TAB $5.72 16714-009-01 ISOSORBIDE DINITRATE 20 MG ORAL TAB $5.71 16571-762-09 LEVOCARNITINE 330 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 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 62559-822-01 MEXILETINE 250 MG ORAL CAP $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 24658-260-60 GEMFIBROZIL 600 MG ORAL TAB $5.68 99999-045-30 AMMONIA AROMATIC 15 % (W/V) INHALATION SOLN $5.66 50268-074-15 AZITHROMYCIN 250 MG ORAL TAB $5.66 0869-3851-10 IODINE-SODIUM IODIDE 2 % TOPICAL TINC $5.66 0245-0212-89 MIDODRINE 5 MG ORAL TAB $5.66 50268-759-11 TIZANIDINE 2 MG ORAL TAB $5.66 50268-759-15 TIZANIDINE 2 MG ORAL TAB $5.66 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 0555-0973-02 DEXTROAMPHETAMINE-AMPHETAMINE 20 MG ORAL TAB $5.63 0245-0212-01 MIDODRINE 5 MG ORAL TAB $5.63 0904-7082-06 NIFEDIPINE 90 MG ORAL TR24 $5.62 16714-549-01 LACOSAMIDE 100 MG ORAL TAB $5.62 68084-862-95 DOXAZOSIN 4 MG ORAL TAB $5.60 67405-651-55 DOXYCYCLINE HYCLATE 100 MG ORAL CAP $5.60 HC89091276 ALBUMIN; OTHER SRC - AU $5.60 70436-010-06 BUPROPION HCL 150 MG ORAL TB24 $5.60 HC89024368 ALLERGEN FOOD EGG WHITE IGE-AU $5.59 HC89024376 ALLERGEN FOOD EGG WHOLE IGE-AU $5.59 HC89024392 ALLERGEN FOOD OVALBUMIN IGE-AU $5.59 HC89024384 ALLERGEN FOOD OVOMUCOID IGE-AU $5.59 99999-040-94 CEFAZOLIN 50 MG/ML INJ SYRINGE (SLH 10 G) $5.59 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 99999-046-94 LACOSAMIDE 10 MG/ML ORAL SOLN $5.59 0054-0244-24 CODEINE SULFATE 30 MG ORAL TAB $5.58 64380-971-06 HYDROCORTISONE 10 MG ORAL TAB $5.58 68084-844-11 VENLAFAXINE 37.5 MG ORAL TAB $5.58 68084-844-01 VENLAFAXINE 37.5 MG ORAL TAB $5.58 50268-167-15 CHLORTHALIDONE 25 MG ORAL TAB $5.57 50268-167-11 CHLORTHALIDONE 25 MG ORAL TAB $5.57 60505-3275-3 OLANZAPINE 5 MG ORAL TBDL $5.56 64380-172-02 OLANZAPINE 5 MG ORAL TBDL $5.56 64380-172-01 OLANZAPINE 5 MG ORAL TBDL $5.56 0904-5524-61 DOXAZOSIN 4 MG ORAL TAB $5.56 69315-211-01 NIFEDIPINE 10 MG ORAL CAP $5.56 99999-034-86 LORAZEPAM 2 MG/ML INJ SOLN $5.54 69238-1056-1 CHLORPROMAZINE 25 MG ORAL TAB $5.54 16714-836-01 ZIPRASIDONE HCL 40 MG ORAL CAP $5.54 27241-161-01 CAPTOPRIL 25 MG ORAL TAB $5.53 99999-043-17 FENTANYL-NS 1 MCG/ML NICU INJECTION $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 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 42937-701-10 PHENAZOPYRIDINE 100 MG ORAL TAB $5.53 42192-801-01 PHENAZOPYRIDINE 100 MG ORAL TAB $5.53 60687-653-11 POTASSIUM CHLORIDE 10 MEQ ORAL CPSR $5.53 60687-653-01 POTASSIUM CHLORIDE 10 MEQ ORAL CPSR $5.53 31722-142-01 CAPTOPRIL 25 MG ORAL TAB $5.51 0904-5522-61 DOXAZOSIN 1 MG ORAL TAB $5.51 60687-541-01 LEVOTHYROXINE 175 MCG ORAL TAB $5.51 60687-541-11 LEVOTHYROXINE 175 MCG ORAL TAB $5.51 68084-851-25 DOXAZOSIN 2 MG ORAL TAB $5.50 68084-851-95 DOXAZOSIN 2 MG ORAL TAB $5.50 43598-436-35 NITROGLYCERIN 0.4 MG SL SUBL $5.50 43598-436-11 NITROGLYCERIN 0.4 MG SL SUBL $5.50 99999-001-26 ERYTHROMYCIN 25 MG / 5 ML (NICU) IV SYRINGE (5 MG/ML) $5.49 68001-247-04 ONDANSETRON 8 MG ORAL TBDL $5.49 65862-391-10 ONDANSETRON 8 MG ORAL TBDL $5.49 68084-288-11 FLUDROCORTISONE 0.1 MG ORAL TAB $5.49 68084-288-01 FLUDROCORTISONE 0.1 MG ORAL TAB $5.49 0904-7263-61 OXCARBAZEPINE 300 MG ORAL TAB $5.49 50268-766-15 TERAZOSIN 5 MG ORAL CAP $5.47 50268-766-11 TERAZOSIN 5 MG ORAL CAP $5.47 23155-135-25 DOXYCYCLINE MONOHYDRATE 100 MG ORAL TAB $5.46 0406-8315-23 MORPHINE 15 MG ORAL TBSR $5.46 0527-4591-13 OSELTAMIVIR 30 MG ORAL CAP $5.46 0904-7001-61 PREGABALIN 100 MG ORAL CAP $5.46 0904-6671-06 SILDENAFIL (PULM.HYPERTENSION) 20 MG ORAL TAB $5.45 68084-313-11 DIVALPROEX 125 MG ORAL CDRS $5.45 68084-313-01 DIVALPROEX 125 MG ORAL CDRS $5.45 67877-483-33 TELMISARTAN 40 MG ORAL TAB $5.44 67877-483-84 TELMISARTAN 40 MG ORAL TAB $5.44 42571-227-30 TELMISARTAN 40 MG ORAL TAB $5.44 50268-765-15 TERAZOSIN 2 MG ORAL CAP $5.44 50268-765-11 TERAZOSIN 2 MG ORAL CAP $5.44 0132-0190-12 GLYCERIN (LAXATIVE) 2.8 GRAM/2.7 ML RECTAL SOLN $5.43 68084-572-11 GUAIFENESIN 600 MG ORAL TA12 $5.43 68084-572-01 GUAIFENESIN 600 MG ORAL TA12 $5.43 99999-040-38 ACETYLCYSTEINE 5 % (50 MG/ML) ORAL SOLUTION DILUTION $5.42 13668-453-01 ANAGRELIDE 0.5 MG ORAL CAP $5.42 65862-177-60 CEFDINIR 300 MG ORAL CAP $5.42 42385-953-30 EMTRICITABINE-TENOFOVIR (TDF) 200-300 MG ORAL TAB $5.42 51991-877-33 EPLERENONE 25 MG ORAL TAB $5.42 51991-877-90 EPLERENONE 25 MG ORAL TAB $5.42 99999-002-16 GENTAMICIN 20 MG/0.5 ML OPHTHALMIC SYRINGE $5.42 42794-019-02 LIOTHYRONINE 25 MCG ORAL TAB $5.42 55111-593-90 MONTELUKAST 4 MG ORAL CHEW $5.42 55111-593-30 MONTELUKAST 4 MG ORAL CHEW $5.42 60687-581-21 PRAMIPEXOLE 0.5 MG ORAL TAB $5.42 60687-581-11 PRAMIPEXOLE 0.5 MG ORAL TAB $5.42 0543-1009-12 RACEPINEPHRINE 2.25 % INHALATION NEBU $5.42 69097-526-03 TADALAFIL (PULM. HYPERTENSION) 20 MG ORAL TAB $5.42 50268-764-15 TERAZOSIN 1 MG ORAL CAP $5.42 50268-764-11 TERAZOSIN 1 MG ORAL CAP $5.42 60687-612-21 VALSARTAN 40 MG ORAL TAB $5.42 60687-612-11 VALSARTAN 40 MG ORAL TAB $5.42 99999-005-56 GENTAMICIN 2 MG/ML INJ SOLN IN D5W (MCH-NICU) $5.40 99999-045-91 POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN $5.40 23155-195-01 NIFEDIPINE 20 MG ORAL CAP $5.39 50268-482-15 LOPERAMIDE 2 MG ORAL CAP $5.38 50268-482-11 LOPERAMIDE 2 MG ORAL CAP $5.38 99999-046-19 DEXTROSE 50 % IN WATER (D50W) IV SOLP $5.36 65862-830-30 PRASUGREL HCL 10 MG ORAL TAB $5.36 16729-273-10 PRASUGREL HCL 10 MG ORAL TAB $5.36 60505-4643-3 PRASUGREL HCL 10 MG ORAL TAB $5.36 60505-4642-3 PRASUGREL HCL 5 MG ORAL TAB $5.36 HC89006571 PRIMIDONE-AU $5.35 68084-750-95 TRIAMTERENE-HYDROCHLOROTHIAZID 37.5-25 MG ORAL TAB $5.34 68084-750-25 TRIAMTERENE-HYDROCHLOROTHIAZID 37.5-25 MG ORAL TAB $5.34 8142102103 BISACODYL 10 MG RECTAL SUPP $5.33 0409-9093-09 FENTANYL CITRATE (PF) 0.05 MG/ML INJ SOLN (MCH) $5.33 0409-9093-11 FENTANYL CITRATE (PF) 0.05 MG/ML INJ SOLN (MCH) $5.33 99999-044-54 NITROGLYCERIN 100 MCG / ML INJECTION $5.33 51079-782-01 PRAVASTATIN 40 MG ORAL TAB $5.33 0378-0327-01 HALOPERIDOL 5 MG ORAL TAB $5.32 50268-448-11 ISOSORBIDE DINITRATE 10 MG ORAL TAB $5.31 50268-448-15 ISOSORBIDE DINITRATE 10 MG ORAL TAB $5.31 0904-7094-61 OXYCODONE-ACETAMINOPHEN 7.5-325 MG ORAL TAB $5.31 69680-130-60 PROPAFENONE 225 MG ORAL CP12 $5.31 50268-558-15 MYCOPHENOLATE MOFETIL 500 MG ORAL TAB $5.30 50268-558-11 MYCOPHENOLATE MOFETIL 500 MG ORAL TAB $5.30 0378-9112-93 NITROGLYCERIN 0.4 MG/HR TRANSDERMAL PT24 $5.30 0378-9112-16 NITROGLYCERIN 0.4 MG/HR TRANSDERMAL PT24 $5.30 0115-3511-01 PYRIDOSTIGMINE BROMIDE 60 MG ORAL TAB $5.30 50268-779-11 TEMAZEPAM 15 MG ORAL CAP $5.30 50268-779-15 TEMAZEPAM 15 MG ORAL CAP $5.30 31722-704-30 VALACYCLOVIR 500 MG ORAL TAB $5.29 65862-448-30 VALACYCLOVIR 500 MG ORAL TAB $5.29 68084-202-11 PRIMIDONE 50 MG ORAL TAB $5.29 68084-202-01 PRIMIDONE 50 MG ORAL TAB $5.29 0378-1901-01 MIDODRINE 2.5 MG ORAL TAB $5.27 63629-8601-1 TEMAZEPAM 7.5 MG ORAL CAP $5.27 0115-4411-01 DANTROLENE 25 MG ORAL CAP $5.27 72572-420-10 METOPROLOL TARTRATE 5 MG/5 ML IV SOLN $5.27 72572-420-01 METOPROLOL TARTRATE 5 MG/5 ML IV SOLN $5.27 72789-437-20 KETOROLAC 10 MG ORAL TAB $5.26 68084-157-11 MORPHINE 15 MG ORAL TBSR $5.25 68084-157-01 MORPHINE 15 MG ORAL TBSR $5.25 60505-3170-7 OMEGA-3 ACID ETHYL ESTERS 1 GRAM ORAL CAP $5.25 60687-195-11 DILTIAZEM HCL 120 MG ORAL CP24 $5.24 60687-195-01 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 0115-1071-01 DIPYRIDAMOLE 50 MG ORAL TAB $5.23 68462-405-60 ASPIRIN-DIPYRIDAMOLE 25-200 MG ORAL CM12 $5.23 49884-007-02 ASPIRIN-DIPYRIDAMOLE 25-200 MG ORAL CM12 $5.23 0904-7053-61 DOXEPIN 25 MG ORAL CAP $5.21 99999-046-44 KETAMINE 10 MG/ML INJ SOLN $5.21 42858-502-03 BUPRENORPHINE HCL 8 MG SL SUBL $5.20 68084-697-11 BUPROPION HCL 100 MG ORAL SR12 $5.20 68084-697-01 BUPROPION HCL 100 MG ORAL SR12 $5.20 99999-045-29 CLONIDINE 0.01 MG/ML ORAL LIQUID (COMPOUND) $5.20 60687-428-65 FINASTERIDE 5 MG ORAL TAB $5.20 65862-782-01 METHENAMINE HIPPURATE 1 GRAM ORAL TAB $5.20 0904-5676-61 PAROXETINE HCL 10 MG ORAL TAB $5.20 57074-00177 CALCIUM ACETATE-ALUMINUM SULF 952-1,347 MG TOPICAL PWPK $5.19 51079-888-01 METOCLOPRAMIDE 10 MG ORAL TAB (MCH) $5.19 51079-888-20 METOCLOPRAMIDE 10 MG ORAL TAB (MCH) $5.19 67877-459-12 CAPECITABINE 500 MG ORAL TAB $5.18 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 50268-112-11 BENAZEPRIL 40 MG ORAL TAB $5.16 50268-112-15 BENAZEPRIL 40 MG ORAL TAB $5.16 0597-0052-16 BISACODYL 10 MG RECTAL SUPP $5.16 68462-199-13 TELMISARTAN 20 MG ORAL TAB $5.15 68462-199-11 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 60687-881-01 GLIPIZIDE 5 MG ORAL TR24 $5.14 60687-881-11 GLIPIZIDE 5 MG ORAL TR24 $5.14 51525-0115-1 HYOSCYAMINE SULFATE 0.375 MG ORAL TB12 $5.14 10702-237-01 URSODIOL 300 MG ORAL CAP $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 0406-8510-23 OXYCODONE 10 MG ORAL TAB $5.12 0406-8510-62 OXYCODONE 10 MG ORAL TAB $5.12 16714-008-01 ISOSORBIDE DINITRATE 10 MG ORAL TAB $5.11 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 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 50268-710-15 ROSUVASTATIN 20 MG ORAL TAB $5.08 50268-710-11 ROSUVASTATIN 20 MG ORAL TAB $5.08 25021-101-10 CEFAZOLIN 1 GRAM INJ SOLR $5.07 68094-494-59 IBUPROFEN 100 MG/5 ML ORAL SUSP $5.07 53746-669-01 ACEBUTOLOL 200 MG ORAL CAP $5.06 49884-066-01 GLYCOPYRROLATE 2 MG ORAL TAB $5.06 64980-273-01 GLYCOPYRROLATE 2 MG ORAL TAB $5.06 67457-423-00 DEXAMETHASONE FOR NEBULIZER SOLUTION (LB/MCH) $5.04 67457-423-12 DEXAMETHASONE FOR NEBULIZER SOLUTION (LB/MCH) $5.04 0555-9016-58 NORGESTIMATE-ETHINYL ESTRADIOL 0.25-0.035 MG ORAL TAB $5.04 68084-740-11 OLANZAPINE 10 MG ORAL TAB $5.04 10370-829-09 DILTIAZEM HCL 120 MG ORAL CP24 $5.04 49884-124-01 LABETALOL 300 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 68682-993-98 DILTIAZEM HCL 120 MG ORAL CP24 $5.03 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 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 0143-9873-25 METOPROLOL TARTRATE 5 MG/5 ML IV SOLN $5.00 0143-9873-01 METOPROLOL TARTRATE 5 MG/5 ML IV SOLN $5.00 50383-804-05 PROMETHAZINE-CODEINE 6.25-10 MG/5 ML ORAL SYRP $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 68084-327-01 GLIMEPIRIDE 4 MG ORAL TAB $4.97 42192-330-01 THYROID (PORK) 60 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 25021-052-01 DEXAMETHASONE 4 MG/ML INJ SOLN (FOR ORAL USE) $4.94 0832-1540-89 HALOPERIDOL 5 MG ORAL TAB $4.94 16729-023-10 BICALUTAMIDE 50 MG ORAL TAB $4.93 16729-023-01 BICALUTAMIDE 50 MG ORAL TAB $4.93 0054-0235-24 MORPHINE 15 MG ORAL TAB $4.93 0904-6782-61 HALOPERIDOL 5 MG ORAL TAB $4.92 0832-1540-01 HALOPERIDOL 5 MG ORAL TAB $4.92 61269-402-60 HYDROXYUREA (SICKLE CELL) 200 MG ORAL CAP $4.92 61269-403-60 HYDROXYUREA (SICKLE CELL) 300 MG ORAL CAP $4.92 51079-822-20 LEVETIRACETAM 750 MG ORAL TAB $4.92 51079-822-01 LEVETIRACETAM 750 MG ORAL TAB $4.92 62559-821-01 MEXILETINE 200 MG ORAL CAP $4.92 51991-311-90 DESVENLAFAXINE SUCCINATE 50 MG ORAL TB24 $4.91 4116742333 FEXOFENADINE 30 MG ORAL TBDL $4.91 12870-0001-1 SILVER NITRATE APPLICATORS 75-25 % TOPICAL STCK $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 5 MG ORAL TAB (MCH) $4.90 51079-886-20 METOCLOPRAMIDE 5 MG ORAL TAB (MCH) $4.90 81033-002-05 ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL LIQD (MHS WRAPPER) $4.88 81033-002-55 ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL LIQD (MHS WRAPPER) $4.88 63739-995-10 DIVALPROEX 125 MG ORAL CDRS $4.88 50742-362-60 IVABRADINE 5 MG ORAL TAB $4.88 99999-036-05 MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSP $4.88 62332-533-31 METOLAZONE 5 MG ORAL TAB $4.88 60687-550-11 METRONIDAZOLE 500 MG ORAL TAB $4.88 60687-550-01 METRONIDAZOLE 500 MG ORAL TAB $4.88 62332-340-31 MIDODRINE 10 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 68084-220-01 ONDANSETRON HCL 4 MG ORAL TAB $4.88 68084-220-11 ONDANSETRON HCL 4 MG ORAL TAB $4.88 67253-651-10 PROPYLTHIOURACIL 50 MG ORAL TAB $4.88 99999-045-67 SODIUM CHLORIDE 0.9 % IV SOLP $4.88 378699789 SODIUM CHLORIDE 3 % INHALATION NEBU $4.88 99999-047-44 VANCOMYCIN 5 MG/ML INJ SOLN (MCH) $4.88 31722-509-60 ZIDOVUDINE 300 MG ORAL TAB $4.88 71205-893-90 PHENOBARBITAL 97.2 MG ORAL TAB $4.87 45802-147-62 CETIRIZINE-PSEUDOEPHEDRINE 5-120 MG ORAL TB12 $4.86 51079-998-20 TIZANIDINE 4 MG ORAL TAB $4.83 51079-998-01 TIZANIDINE 4 MG ORAL TAB $4.83 16714-698-03 VALACYCLOVIR 500 MG ORAL TAB $4.82 62175-271-37 OXYBUTYNIN CHLORIDE 10 MG ORAL TR24 $4.82 50268-717-11 SILDENAFIL (PULM.HYPERTENSION) 20 MG ORAL TAB $4.82 50268-717-15 SILDENAFIL (PULM.HYPERTENSION) 20 MG ORAL TAB $4.82 99999-001-74 HYDROCODONE-HOMATROPINE 5-1.5 MG/5 ML ORAL SOLN $4.81 71930-037-12 LABETALOL 300 MG ORAL TAB $4.81 99999-006-66 METOCLOPRAMIDE 5 MG/5 ML ORAL SOLN (MCH) $4.81 62175-270-37 OXYBUTYNIN CHLORIDE 5 MG ORAL TR24 $4.81 33342-314-11 PROPYLTHIOURACIL 50 MG ORAL TAB $4.81 60687-826-11 BACLOFEN 20 MG ORAL TAB $4.80 60687-826-01 BACLOFEN 20 MG ORAL TAB $4.80 60687-345-11 CALCITRIOL 0.25 MCG ORAL CAP $4.80 60687-345-01 CALCITRIOL 0.25 MCG ORAL CAP $4.80 99999-010-97 ARGININE HCL 2.5 MEQ/ML ORAL LIQUID $4.79 53489-551-01 PROPAFENONE 150 MG ORAL TAB $4.79 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 60505-0257-1 DESMOPRESSIN 0.1 MG ORAL TAB $4.77 0228-2851-11 GUANFACINE 2 MG ORAL TB24 $4.77 63739-569-10 ISOSORBIDE DINITRATE 10 MG ORAL TAB $4.77 60505-1321-1 MIDODRINE 5 MG ORAL TAB $4.77 47335-379-83 CINACALCET 30 MG ORAL TAB $4.77 31722-103-30 CINACALCET 30 MG ORAL TAB $4.77 23155-043-03 LEFLUNOMIDE 10 MG ORAL TAB $4.77 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 0121-0914-05 IBUPROFEN 100 MG/5 ML ORAL SUSP $4.75 60687-743-17 IBUPROFEN 100 MG/5 ML ORAL SUSP $4.75 60687-743-40 IBUPROFEN 100 MG/5 ML ORAL SUSP $4.75 63739-798-01 IBUPROFEN 100 MG/5 ML ORAL SUSP $4.75 63739-798-10 IBUPROFEN 100 MG/5 ML ORAL SUSP $4.75 0121-0914-00 IBUPROFEN 100 MG/5 ML ORAL SUSP $4.75 99999-035-95 PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIX $4.75 99999-037-05 PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIX $4.75 60687-487-11 SPIRONOLACTONE 100 MG ORAL TAB $4.75 60687-487-01 SPIRONOLACTONE 100 MG ORAL TAB $4.75 16714-445-01 ENALAPRIL MALEATE 20 MG ORAL TAB $4.74 60687-530-01 LEVOTHYROXINE 150 MCG ORAL TAB $4.74 60687-530-11 LEVOTHYROXINE 150 MCG ORAL TAB $4.74 51079-690-20 LOPERAMIDE 2 MG ORAL CAP $4.73 51079-690-01 LOPERAMIDE 2 MG ORAL CAP $4.73 65862-538-20 LEVOFLOXACIN 750 MG ORAL TAB $4.71 57664-116-88 VERAPAMIL 120 MG ORAL TBSR $4.71 64380-721-06 TACROLIMUS 1 MG ORAL CAP $4.70 31722-723-20 LEVOFLOXACIN 750 MG ORAL TAB $4.69 10702-013-01 BETAXOLOL 10 MG ORAL TAB $4.69 0093-2178-01 LIOTHYRONINE 25 MCG ORAL TAB $4.69 10135-541-01 PROBENECID 500 MG ORAL TAB $4.68 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 59762-1004-1 NIFEDIPINE 10 MG ORAL CAP $4.67 50268-667-11 PRAVASTATIN 40 MG ORAL TAB $4.67 50268-667-15 PRAVASTATIN 40 MG ORAL TAB $4.67 99999-041-64 MORPHINE (PF) 0.5 MG/ML INJ SOLN $4.66 3700035905 OMEPRAZOLE MAGNESIUM 20 MG ORAL TBEC $4.66 37000-455-02 OMEPRAZOLE MAGNESIUM 20 MG ORAL TBEC $4.66 60687-773-01 DEXAMETHASONE 2 MG ORAL TAB $4.65 60687-773-11 DEXAMETHASONE 2 MG ORAL TAB $4.65 60505-2575-7 BALSALAZIDE 750 MG ORAL CAP $4.64 0409-7338-21 CEFTRIAXONE 500 MG INJ SOLR $4.64 0409-7338-20 CEFTRIAXONE 500 MG INJ SOLR $4.64 55111-534-01 DIVALPROEX 500 MG ORAL TB24 $4.64 99999-036-47 MERCAPTOPURINE 12.5 MG ORAL PARTIAL TAB $4.64 68084-968-11 OXYCODONE 10 MG ORAL TAB $4.64 68084-968-01 OXYCODONE 10 MG ORAL TAB $4.64 63739-480-10 BACLOFEN 20 MG ORAL TAB $4.64 0904-6620-61 ISOSORBIDE DINITRATE 20 MG ORAL TAB $4.64 60687-402-65 METOPROLOL SUCCINATE 50 MG ORAL TB24 $4.64 0904-7465-61 BUPROPION HCL 150 MG ORAL SR12 $4.62 99999-007-74 ISONIAZID 50 MG/5 ML ORAL SOLN $4.62 60687-519-11 LEVOTHYROXINE 125 MCG ORAL TAB $4.62 60687-519-01 LEVOTHYROXINE 125 MCG ORAL TAB $4.62 0904-5893-61 PRAVASTATIN 40 MG ORAL TAB $4.62 0904-6956-61 LEVOTHYROXINE 150 MCG ORAL TAB $4.60 16714-816-01 BICALUTAMIDE 50 MG ORAL TAB $4.59 0555-0572-02 METHOTREXATE SODIUM 2.5 MG ORAL TAB $4.59 0378-9104-16 NITROGLYCERIN 0.2 MG/HR TRANSDERMAL PT24 $4.59 0378-9104-93 NITROGLYCERIN 0.2 MG/HR TRANSDERMAL PT24 $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 63323-161-12 KETOROLAC 15 MG/ML INJ SOLN $4.58 63323-161-21 KETOROLAC 15 MG/ML INJ SOLN $4.58 65862-622-01 FLECAINIDE 100 MG ORAL TAB $4.57 12870-0001-2 SILVER NITRATE APPLICATORS 75-25 % TOPICAL STCK $4.57 51079-437-20 DOXEPIN 25 MG ORAL CAP $4.56 51079-437-01 DOXEPIN 25 MG ORAL CAP $4.56 16714-007-01 ISOSORBIDE DINITRATE 5 MG ORAL TAB $4.56 99999-045-92 KETAMINE 50 MG/ML INJ SOLN (MHS WRAPPER) $4.56 0904-7126-61 METRONIDAZOLE 500 MG ORAL TAB $4.56 27241-052-03 ARIPIPRAZOLE 5 MG ORAL TAB $4.55 43598-966-30 ARIPIPRAZOLE 5 MG ORAL TAB $4.55 43598-555-30 ARIPIPRAZOLE 5 MG ORAL TAB $4.55 62756-457-88 CARBIDOPA-LEVODOPA 50-200 MG ORAL TBSR $4.55 50268-222-15 DOXAZOSIN 1 MG ORAL TAB $4.55 50268-222-11 DOXAZOSIN 1 MG ORAL TAB $4.55 50268-223-11 DOXAZOSIN 2 MG ORAL TAB $4.55 50268-223-15 DOXAZOSIN 2 MG ORAL TAB $4.55 50268-224-11 DOXAZOSIN 4 MG ORAL TAB $4.55 50268-224-15 DOXAZOSIN 4 MG ORAL TAB $4.55 63323-162-12 KETOROLAC 30 MG/ML (1 ML) INJ SOLN $4.55 63323-162-23 KETOROLAC 30 MG/ML (1 ML) INJ SOLN $4.55 60687-730-65 MECLIZINE 25 MG ORAL TAB $4.55 42571-176-01 PIROXICAM 10 MG ORAL CAP $4.55 50633-910-20 POTASSIUM IODIDE 65 MG ORAL TAB $4.55 0555-0607-02 MEGESTROL 40 MG ORAL TAB $4.54 25021-402-66 HEPARIN (PORCINE) 5,000 UNIT/ML INJ SOLN $4.52 0904-7355-04 LURASIDONE 20 MG ORAL TAB $4.51 0904-5833-48 LORATADINE-PSEUDOEPHEDRINE 10-240 MG ORAL TB24 $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 % (LARGE) TOPICAL PTMD $4.50 61442-116-01 GLIMEPIRIDE 2 MG ORAL TAB $4.49 77333-120-50 CALCIUM POLYCARBOPHIL 625 MG ORAL TAB $4.48 77333-120-25 CALCIUM POLYCARBOPHIL 625 MG ORAL TAB $4.48 0904-6955-61 LEVOTHYROXINE 125 MCG ORAL TAB $4.48 68001-246-16 ONDANSETRON 4 MG ORAL TBDL $4.48 72603-183-01 NITROFURANTOIN MACROCRYSTAL 50 MG ORAL CAP $4.47 42192-329-01 THYROID (PORK) 30 MG ORAL TAB $4.47 0406-0125-62 HYDROCODONE-ACETAMINOPHEN 10-325 MG ORAL TAB $4.47 0406-0125-23 HYDROCODONE-ACETAMINOPHEN 10-325 MG ORAL TAB $4.47 68382-096-01 HYDROXYCHLOROQUINE 200 MG ORAL TAB $4.47 50268-561-15 MIDODRINE 2.5 MG ORAL TAB $4.46 50268-561-11 MIDODRINE 2.5 MG ORAL TAB $4.46 0093-8162-01 QUETIAPINE 100 MG ORAL TAB $4.46 50268-110-15 BENAZEPRIL 10 MG ORAL TAB $4.45 50268-110-11 BENAZEPRIL 10 MG ORAL TAB $4.45 51079-511-20 MECLIZINE 25 MG ORAL TAB $4.45 51079-511-01 MECLIZINE 25 MG ORAL TAB $4.45 65162-710-09 COLCHICINE 0.6 MG ORAL TAB $4.44 50268-190-15 CYCLOBENZAPRINE 5 MG ORAL TAB $4.44 50268-190-11 CYCLOBENZAPRINE 5 MG ORAL TAB $4.44 0093-3123-01 DICLOXACILLIN 250 MG ORAL CAP $4.44 36000-282-25 FUROSEMIDE 10 MG/ML INJ SOLN $4.43 60687-508-11 LEVOTHYROXINE 112 MCG ORAL TAB $4.43 60687-508-01 LEVOTHYROXINE 112 MCG ORAL TAB $4.43 51079-445-01 LEVOTHYROXINE 150 MCG ORAL TAB $4.43 51079-445-20 LEVOTHYROXINE 150 MCG ORAL TAB $4.43 99999-045-93 ACETIC ACID (BULK) 3 % MISC LIQD $4.42 59762-1206-1 LIOTHYRONINE 5 MCG ORAL TAB $4.42 42794-018-12 LIOTHYRONINE 5 MCG ORAL TAB $4.42 72572-430-25 MIDAZOLAM 1 MG/ML INJ SOLN $4.42 72572-430-01 MIDAZOLAM 1 MG/ML INJ SOLN $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 50268-523-11 MECLIZINE 25 MG ORAL TAB $4.41 50268-523-15 MECLIZINE 25 MG ORAL TAB $4.41 0904-6954-61 LEVOTHYROXINE 112 MCG ORAL TAB $4.41 486112501 SOD PHOS DI, MONO-K PHOS MONO 250 MG ORAL TAB $4.41 68084-590-95 ATORVASTATIN 80 MG ORAL TAB $4.39 68084-590-25 ATORVASTATIN 80 MG ORAL TAB $4.39 68084-229-11 AZATHIOPRINE 50 MG ORAL TAB $4.39 68084-229-01 AZATHIOPRINE 50 MG ORAL TAB $4.39 99999-033-50 AZATHIOPRINE 50 MG/ML ORAL SUSP (COMPOUND) $4.39 0904-6830-06 FINASTERIDE 5 MG ORAL TAB $4.39 50268-709-15 ROSUVASTATIN 10 MG ORAL TAB $4.39 50268-709-11 ROSUVASTATIN 10 MG ORAL TAB $4.39 0406-0124-62 HYDROCODONE-ACETAMINOPHEN 7.5-325 MG ORAL TAB $4.39 0406-0124-23 HYDROCODONE-ACETAMINOPHEN 7.5-325 MG ORAL TAB $4.39 0904-7048-61 LOSARTAN 50 MG ORAL TAB $4.39 0185-0055-01 METOLAZONE 5 MG ORAL TAB $4.39 69292-564-01 METOLAZONE 5 MG ORAL TAB $4.39 0904-6572-61 ALLOPURINOL 300 MG ORAL TAB $4.38 0093-2069-01 DOXAZOSIN 2 MG ORAL TAB $4.38 99999-000-16 DIAZEPAM 2 MG / 10 ML SYRINGE $4.38 75834-312-01 THYROID (PORK) 60 MG ORAL TAB $4.37 60687-658-01 DICLOFENAC SODIUM 75 MG ORAL TBEC $4.36 60687-658-11 DICLOFENAC SODIUM 75 MG ORAL TBEC $4.36 0406-8315-01 MORPHINE 15 MG ORAL TBSR $4.36 0378-0614-01 THIORIDAZINE 25 MG ORAL TAB $4.36 69367-203-01 BUTALBITAL-ACETAMINOPHEN-CAFF 50-325-40 MG ORAL TAB $4.34 0591-3369-01 BUTALBITAL-ACETAMINOPHEN-CAFF 50-325-40 MG ORAL TAB $4.34 487900330 SODIUM CHLORIDE 3 % INHALATION NEBU $4.34 487900730 SODIUM CHLORIDE 7 % INHALATION NEBU $4.34 5019074060 SODIUM CHLORIDE 7 % INHALATION NEBU $4.34 0378-0435-01 BUPROPION HCL 100 MG ORAL TAB $4.34 67405-601-03 FLUCONAZOLE 50 MG ORAL TAB $4.34 64380-710-03 LAMIVUDINE 150 MG ORAL TAB $4.34 10702-277-03 LEFLUNOMIDE 10 MG ORAL TAB $4.34 62332-495-30 LURASIDONE 40 MG ORAL TAB $4.34 62332-496-30 LURASIDONE 60 MG ORAL TAB $4.34 72205-209-30 LURASIDONE 60 MG ORAL TAB $4.34 62332-497-30 LURASIDONE 80 MG ORAL TAB $4.34 60687-184-11 MEMANTINE 10 MG ORAL TAB $4.34 60687-184-57 MEMANTINE 10 MG ORAL TAB $4.34 65862-027-60 NEVIRAPINE 200 MG ORAL TAB $4.34 50742-238-30 QUININE SULFATE 324 MG ORAL CAP $4.34 50228-423-60 RANOLAZINE 500 MG ORAL TB12 $4.34 68462-319-60 RANOLAZINE 500 MG ORAL TB12 $4.34 31722-803-31 TELMISARTAN 40 MG ORAL TAB $4.34 0904-6476-61 BACLOFEN 20 MG ORAL TAB $4.33 1650002324 CALCIUM ACETATE-ALUMINUM SULF 952-1,347 MG TOPICAL PWPK $4.33 16864-240-01 CALCIUM ACETATE-ALUMINUM SULF 952-1,347 MG TOPICAL PWPK $4.33 57896-490-03 POLYETHYLENE GLYCOL 3350 17 GRAM ORAL PWPK $4.33 57896-490-01 POLYETHYLENE GLYCOL 3350 17 GRAM ORAL PWPK $4.33 8137003640 COLLOIDAL OATMEAL TOPICAL PACK $4.32 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 59762-1210-3 DESVENLAFAXINE SUCCINATE 25 MG ORAL TB24 $4.31 51079-443-01 LEVOTHYROXINE 125 MCG ORAL TAB $4.31 51079-443-20 LEVOTHYROXINE 125 MCG ORAL TAB $4.31 59762-5007-1 MISOPROSTOL 100 MCG ORAL TAB $4.31 59762-5007-2 MISOPROSTOL 100 MCG ORAL TAB $4.31 70954-443-20 MISOPROSTOL 100 MCG ORAL TAB $4.31 60687-807-11 CHLORDIAZEPOXIDE HCL 25 MG ORAL CAP $4.30 60687-807-01 CHLORDIAZEPOXIDE HCL 25 MG ORAL CAP $4.30 42292-001-01 METRONIDAZOLE 500 MG ORAL TAB $4.30 42292-001-20 METRONIDAZOLE 500 MG ORAL TAB $4.30 70954-443-10 MISOPROSTOL 100 MCG ORAL TAB $4.30 99999-046-54 ACETIC ACID (BULK) 5 % MISC LIQD $4.29 99999-001-82 CHLORHEXIDINE GLUCONATE 0.12 % MUCOUS MEMB MWSH $4.29 0116-2001-60 CHLORHEXIDINE GLUCONATE 0.12 % MUCOUS MEMB MWSH $4.29 70860-600-02 MIDAZOLAM 1 MG/ML INJ SOLN $4.29 70860-600-41 MIDAZOLAM 1 MG/ML INJ SOLN $4.29 414200024 SACCHAROMYCES BOULARDII 250 MG ORAL CAP $4.29 414200040 SACCHAROMYCES BOULARDII 250 MG ORAL PWPK $4.29 65862-458-60 GALANTAMINE 4 MG ORAL TAB $4.28 50268-633-15 QUETIAPINE 200 MG ORAL TAB $4.28 50268-633-11 QUETIAPINE 200 MG ORAL TAB $4.28 68084-645-65 TIZANIDINE 4 MG ORAL TAB $4.28 72603-143-01 METOPROLOL SUCCINATE 50 MG ORAL TB24 $4.27 50268-760-11 TIZANIDINE 4 MG ORAL TAB $4.27 50268-760-15 TIZANIDINE 4 MG ORAL TAB $4.27 72603-623-01 LURASIDONE 60 MG ORAL TAB $4.26 50268-107-15 BACLOFEN 20 MG ORAL TAB $4.25 50268-107-11 BACLOFEN 20 MG ORAL TAB $4.25 57237-049-60 GALANTAMINE 4 MG ORAL TAB $4.25 57237-050-60 GALANTAMINE 8 MG ORAL TAB $4.25 72603-142-01 METOPROLOL SUCCINATE 25 MG ORAL TB24 $4.25 68382-096-05 HYDROXYCHLOROQUINE 200 MG ORAL TAB $4.24 60687-885-11 MYCOPHENOLATE MOFETIL 250 MG ORAL CAP $4.24 60687-885-01 MYCOPHENOLATE MOFETIL 250 MG ORAL CAP $4.24 51407-435-01 CHLORPROMAZINE 25 MG ORAL TAB $4.23 0378-3066-77 FENOFIBRATE NANOCRYSTALLIZED 145 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 50268-687-15 PRIMIDONE 250 MG ORAL TAB $4.23 50268-687-11 PRIMIDONE 250 MG ORAL TAB $4.23 46122-645-13 CAMPHOR-METHYL SALICYL-MENTHOL 3.1 %-10 %-6 % (LARGE) TOPICAL PTMD $4.23 51079-921-20 CLOZAPINE 25 MG ORAL TAB $4.23 51079-921-01 CLOZAPINE 25 MG ORAL TAB $4.23 69292-586-01 HALOPERIDOL 5 MG ORAL TAB $4.23 62332-532-31 METOLAZONE 2.5 MG ORAL TAB $4.23 0641-6057-25 MIDAZOLAM 1 MG/ML INJ SOLN CODE NEO $4.23 0641-6057-01 MIDAZOLAM 1 MG/ML INJ SOLN CODE NEO $4.23 76282-257-01 NABUMETONE 500 MG ORAL TAB $4.23 42858-002-10 OXYCODONE 10 MG ORAL TAB $4.23 60687-405-83 IPRATROPIUM-ALBUTEROL 0.5 MG-3 MG(2.5 MG BASE)/3 ML INHALATION NEBU $4.21 60687-405-79 IPRATROPIUM-ALBUTEROL 0.5 MG-3 MG(2.5 MG BASE)/3 ML INHALATION NEBU $4.21 68084-403-11 MORPHINE 15 MG ORAL TBSR $4.21 16714-296-01 AMOXICILLIN-POT CLAVULANATE 500-125 MG ORAL TAB $4.20 51079-374-01 CHLORDIAZEPOXIDE HCL 5 MG ORAL CAP $4.18 51079-374-20 CHLORDIAZEPOXIDE HCL 5 MG ORAL CAP $4.18 0093-7334-01 MYCOPHENOLATE MOFETIL 250 MG ORAL CAP $4.18 68084-205-11 MINOXIDIL 10 MG ORAL TAB $4.17 68084-205-01 MINOXIDIL 10 MG ORAL TAB $4.17 4110080604 LORATADINE 10 MG ORAL TBDL $4.16 99999-006-61 METHADONE 5 MG/5 ML ORAL SOLN $4.16 60687-390-65 METOPROLOL SUCCINATE 25 MG ORAL TB24 $4.15 50268-540-11 METOPROLOL SUCCINATE 25 MG ORAL TB24 $4.15 50268-540-15 METOPROLOL SUCCINATE 25 MG ORAL TB24 $4.15 16714-529-02 BISOPROLOL FUMARATE 5 MG ORAL TAB $4.15 99999-007-03 POTASSIUM CHLORIDE 10 MEQ/25 ML INJECTION $4.14 0143-1772-01 ISOSORBIDE DINITRATE 20 MG ORAL TAB $4.13 51079-929-20 LABETALOL 200 MG ORAL TAB $4.13 10135-620-01 PHENAZOPYRIDINE 100 MG ORAL TAB $4.13 0832-0511-01 BETHANECHOL CHLORIDE 10 MG ORAL TAB $4.13 62559-820-01 MEXILETINE 150 MG ORAL CAP $4.12 68462-158-13 ONDANSETRON 8 MG ORAL TBDL $4.12 68462-158-40 ONDANSETRON 8 MG ORAL TBDL $4.12 68084-645-11 TIZANIDINE 4 MG ORAL TAB $4.12 68084-645-01 TIZANIDINE 4 MG ORAL TAB $4.12 23155-837-30 CYCLOSPORINE MODIFIED 25 MG ORAL CAP $4.12 23155-837-11 CYCLOSPORINE MODIFIED 25 MG ORAL CAP $4.12 57237-154-90 MODAFINIL 100 MG ORAL TAB $4.12 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 5019014263 SODIUM CHLORIDE 3 % INHALATION NEBU $4.11 50190-142-63 SODIUM CHLORIDE 3 % INHALATION NEBU $4.11 5019014123 SODIUM CHLORIDE 7 % INHALATION NEBU $4.11 57648-002-01 THE MAGIC BULLET 10 MG RECTAL SUPP $4.11 51079-206-01 ALLOPURINOL 300 MG ORAL TAB $4.10 51079-206-20 ALLOPURINOL 300 MG ORAL TAB $4.10 0832-0511-89 BETHANECHOL CHLORIDE 10 MG ORAL TAB $4.10 16729-079-01 CARBIDOPA-LEVODOPA 50-200 MG ORAL TBSR $4.10 0378-0156-01 PROBENECID 500 MG ORAL TAB $4.10 50268-535-15 METRONIDAZOLE 500 MG ORAL TAB $4.09 50268-535-11 METRONIDAZOLE 500 MG ORAL TAB $4.09 50268-109-15 BENAZEPRIL 5 MG ORAL TAB $4.08 50268-109-11 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 68382-079-01 HALOPERIDOL 5 MG ORAL TAB $4.06 99999-044-12 MEGESTROL 40 MG/ML ORAL SUSPENSION (MHS WRAPPER) $4.06 99999-043-01 MEGESTROL 40 MG/ML ORAL SUSPENSION (MHS WRAPPER) $4.06 50268-089-11 ARIPIPRAZOLE 10 MG ORAL TAB $4.04 50268-089-15 ARIPIPRAZOLE 10 MG ORAL TAB $4.04 68382-079-10 HALOPERIDOL 5 MG ORAL TAB $4.04 16714-530-01 BISOPROLOL FUMARATE 10 MG ORAL TAB $4.04 16714-529-01 BISOPROLOL FUMARATE 5 MG ORAL TAB $4.04 65862-654-01 ENTACAPONE 200 MG ORAL TAB $4.03 51079-458-01 PRAVASTATIN 20 MG ORAL TAB $4.03 68094-193-59 VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLN $4.03 68084-713-11 VENLAFAXINE 150 MG ORAL CP24 $4.03 68084-713-01 VENLAFAXINE 150 MG ORAL CP24 $4.03 0054-8176-25 DEXAMETHASONE 2 MG ORAL TAB $4.02 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 65162-710-03 COLCHICINE 0.6 MG ORAL TAB $4.00 49884-171-01 COLCHICINE 0.6 MG ORAL TAB $4.00 50111-917-01 TORSEMIDE 20 MG ORAL TAB $4.00 68084-708-25 BUPROPION HCL 150 MG ORAL SR12 $3.98 68084-708-95 BUPROPION HCL 150 MG ORAL SR12 $3.98 60687-217-11 DILTIAZEM HCL 240 MG ORAL CP24 $3.98 60687-217-01 DILTIAZEM HCL 240 MG ORAL CP24 $3.98 0406-0123-62 HYDROCODONE-ACETAMINOPHEN 5-325 MG ORAL TAB $3.98 0406-0123-23 HYDROCODONE-ACETAMINOPHEN 5-325 MG ORAL TAB $3.98 65862-390-10 ONDANSETRON 4 MG ORAL TBDL $3.98 62756-240-60 ONDANSETRON 4 MG ORAL TBDL $3.98 62756-240-64 ONDANSETRON 4 MG ORAL TBDL $3.98 16714-235-01 PENICILLIN V POTASSIUM 500 MG ORAL TAB $3.98 0378-9102-93 NITROGLYCERIN 0.1 MG/HR TRANSDERMAL PT24 $3.97 0378-9102-16 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 0904-6619-61 ISOSORBIDE DINITRATE 10 MG ORAL TAB $3.97 0378-1819-77 LEVOTHYROXINE 200 MCG ORAL TAB $3.97 0832-1219-89 WARFARIN 10 MG ORAL TAB $3.97 50742-251-30 DILTIAZEM HCL 300 MG ORAL CP24 $3.95 0904-7052-61 DOXEPIN 10 MG ORAL CAP $3.95 0378-1817-77 LEVOTHYROXINE 175 MCG ORAL TAB $3.95 42292-041-20 LEVOTHYROXINE 137 MCG ORAL TAB $3.94 42292-041-01 LEVOTHYROXINE 137 MCG ORAL TAB $3.94 63739-888-10 PAROXETINE HCL 10 MG ORAL TAB $3.94 0832-1219-01 WARFARIN 10 MG ORAL TAB $3.94 50268-362-15 GLIPIZIDE 10 MG ORAL TAB $3.93 50268-362-11 GLIPIZIDE 10 MG ORAL TAB $3.93 68084-347-01 LOSARTAN 50 MG ORAL TAB $3.93 68084-347-11 LOSARTAN 50 MG ORAL TAB $3.93 0591-5557-01 PROPRANOLOL 80 MG ORAL TAB $3.93 68382-559-01 NITROFURANTOIN MACROCRYSTAL 50 MG ORAL CAP $3.92 60687-497-11 LEVOTHYROXINE 100 MCG ORAL TAB $3.91 60687-497-01 LEVOTHYROXINE 100 MCG ORAL TAB $3.91 68462-292-01 VERAPAMIL 120 MG ORAL TBSR $3.91 75834-320-01 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 42571-162-42 AMOXICILLIN-POT CLAVULANATE 875-125 MG ORAL TAB $3.90 72888-183-30 BUPRENORPHINE HCL 8 MG SL SUBL $3.90 62332-142-31 CELECOXIB 200 MG ORAL CAP $3.90 68180-157-01 CLOBAZAM 10 MG ORAL TAB $3.90 0904-5523-61 DOXAZOSIN 2 MG ORAL TAB $3.90 27241-049-10 ENTACAPONE 200 MG ORAL TAB $3.90 54879-002-01 ETHAMBUTOL 400 MG ORAL TAB $3.90 0093-7355-56 FINASTERIDE 5 MG ORAL TAB $3.90 70954-275-10 FLUPHENAZINE HCL 5 MG ORAL TAB $3.90 62559-159-01 FLUVOXAMINE 50 MG ORAL TAB $3.90 68084-111-11 GLIPIZIDE 5 MG ORAL TR24 $3.90 68084-111-01 GLIPIZIDE 5 MG ORAL TR24 $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 99998-000-03 IBUPROFEN 100 MG/5 ML ORAL SUSP $3.90 99999-044-67 MAGNESIUM SULFATE 1 MEQ/ML INJ SOLN (SLH) $3.90 0527-1435-01 METAXALONE 800 MG ORAL TAB $3.90 60687-631-01 METOCLOPRAMIDE 10 MG ORAL TAB (MCH) $3.90 60687-631-11 METOCLOPRAMIDE 10 MG ORAL TAB (MCH) $3.90 0245-0213-11 MIDODRINE 10 MG ORAL TAB $3.90 52817-325-10 MIDODRINE 10 MG ORAL TAB $3.90 68462-304-50 NORETHINDRONE ACETATE 5 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 0904-7027-61 OXYBUTYNIN CHLORIDE 5 MG ORAL TAB $3.90 68094-005-59 OXYCODONE 15 MG ORAL TAB $3.90 60687-632-01 POTASSIUM CHLORIDE 10 MEQ ORAL TBTQ $3.90 60687-632-11 POTASSIUM CHLORIDE 10 MEQ ORAL TBTQ $3.90 31722-623-30 ROFLUMILAST 500 MCG ORAL TAB $3.90 414200037 SACCHAROMYCES BOULARDII 250 MG ORAL PWPK $3.90 7620402260 SODIUM CHLORIDE 3 % INHALATION NEBU $3.90 62332-047-90 VALSARTAN 320 MG ORAL TAB $3.90 99999-034-55 VANCOMYCIN IV SOLN (FOR DESENSITIZATION USE) $3.90 69238-1054-1 CHLORPROMAZINE 10 MG ORAL TAB $3.89 0904-6818-06 MIDODRINE 5 MG ORAL TAB $3.89 60687-669-01 METHIMAZOLE 5 MG ORAL TAB $3.88 60687-669-11 METHIMAZOLE 5 MG ORAL TAB $3.88 16714-133-01 DOXEPIN 25 MG ORAL CAP $3.87 68094-005-61 OXYCODONE 15 MG ORAL TAB $3.87 60687-730-01 MECLIZINE 25 MG ORAL TAB $3.86 60687-730-11 MECLIZINE 25 MG ORAL TAB $3.86 0591-5347-01 PROBENECID 500 MG ORAL TAB $3.86 68084-299-11 TAMSULOSIN 0.4 MG ORAL CAP $3.84 68084-299-01 TAMSULOSIN 0.4 MG ORAL CAP $3.84 0904-7411-61 AMITRIPTYLINE 50 MG ORAL TAB $3.84 1254720436 CETIRIZINE 10 MG ORAL TAB $3.84 0115-7033-01 FLUDROCORTISONE 0.1 MG ORAL TAB $3.84 53329-980-04 HYDROGEN PEROXIDE 3 % MISC SOLN $3.84 49348-179-34 HYDROGEN PEROXIDE 3 % MISC SOLN $3.84 65862-287-01 PERINDOPRIL ERBUMINE 4 MG ORAL TAB $3.84 69680-166-00 THYROID (PORK) 30 MG ORAL 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 0904-6817-06 MIDODRINE 2.5 MG ORAL TAB $3.81 99999-046-20 LORAZEPAM 2 MG/ML INJ SOLN $3.80 0185-5050-01 METOLAZONE 2.5 MG ORAL TAB $3.80 69292-562-01 METOLAZONE 2.5 MG ORAL TAB $3.80 0904-7076-61 VENLAFAXINE 150 MG ORAL CP24 $3.80 16729-042-01 TACROLIMUS 1 MG ORAL CAP $3.80 60687-450-11 LABETALOL 200 MG ORAL TAB $3.79 60687-450-01 LABETALOL 200 MG ORAL TAB $3.79 60687-486-11 LEVOTHYROXINE 88 MCG ORAL TAB $3.79 60687-486-01 LEVOTHYROXINE 88 MCG ORAL TAB $3.79 62756-145-86 RIVASTIGMINE TARTRATE 1.5 MG ORAL CAP $3.79 55111-352-60 RIVASTIGMINE TARTRATE 1.5 MG ORAL CAP $3.79 65862-648-60 RIVASTIGMINE TARTRATE 1.5 MG ORAL CAP $3.79 62756-146-86 RIVASTIGMINE TARTRATE 3 MG ORAL CAP $3.79 55111-353-60 RIVASTIGMINE TARTRATE 3 MG ORAL CAP $3.79 62756-148-86 RIVASTIGMINE TARTRATE 6 MG ORAL CAP $3.79 55111-355-60 RIVASTIGMINE TARTRATE 6 MG ORAL CAP $3.79 62332-088-30 TELMISARTAN 40 MG ORAL TAB $3.79 49884-123-01 LABETALOL 200 MG ORAL TAB $3.78 0591-0606-01 LABETALOL 200 MG ORAL TAB $3.78 58657-603-01 LABETALOL 200 MG ORAL TAB $3.78 71247-127-01 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 0904-6952-61 LEVOTHYROXINE 88 MCG ORAL TAB $3.78 60687-444-11 AMITRIPTYLINE 50 MG ORAL TAB $3.77 60687-444-01 AMITRIPTYLINE 50 MG ORAL TAB $3.77 99999-000-13 CLINDAMYCIN 10 MG/ML (NICU) SYRINGE $3.77 0904-7047-61 LOSARTAN 25 MG ORAL TAB $3.77 60687-588-01 ROPINIROLE 1 MG ORAL TAB $3.77 60687-588-11 ROPINIROLE 1 MG ORAL TAB $3.77 0832-1218-89 WARFARIN 7.5 MG ORAL TAB $3.77 0832-1218-01 WARFARIN 7.5 MG ORAL TAB $3.76 0832-1218-00 WARFARIN 7.5 MG ORAL TAB $3.76 0406-0485-01 ACETAMINOPHEN-CODEINE 300-60 MG ORAL TAB $3.76 0409-7337-21 CEFTRIAXONE 250 MG INJ SOLR $3.76 0409-7337-20 CEFTRIAXONE 250 MG INJ SOLR $3.76 5199108490 FOLIC ACID-VIT B6-VIT B12 2.5-25-1 MG ORAL TAB $3.76 0143-1771-01 ISOSORBIDE DINITRATE 10 MG ORAL TAB $3.76 58657-703-01 HALOPERIDOL 5 MG ORAL TAB $3.74 0832-1540-11 HALOPERIDOL 5 MG ORAL TAB $3.74 60687-620-11 METOCLOPRAMIDE HCL 5 MG ORAL TAB $3.74 99999-047-40 AMPICILLIN 20 MG/ML INJ SYRINGE (USING 2G) $3.74 72603-170-01 FLUDROCORTISONE 0.1 MG ORAL TAB $3.74 51079-294-20 TAMSULOSIN 0.4 MG ORAL CAP $3.74 51079-294-01 TAMSULOSIN 0.4 MG ORAL CAP $3.74 0054-0010-25 FLECAINIDE 50 MG ORAL TAB $3.73 0054-0010-21 FLECAINIDE 50 MG ORAL TAB $3.73 0054-0010-20 FLECAINIDE 50 MG ORAL TAB $3.73 99999-043-04 MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLN $3.73 99999-002-38 MORPHINE CONCENTRATE 20 MG/ML ORAL SOLN (MHS WRAPPER) $3.73 51079-133-01 AMITRIPTYLINE 50 MG ORAL TAB $3.72 51079-133-20 AMITRIPTYLINE 50 MG ORAL TAB $3.72 0904-6951-61 LEVOTHYROXINE 75 MCG ORAL TAB $3.72 51079-423-20 MECLIZINE 12.5 MG ORAL TAB $3.71 51079-423-01 MECLIZINE 12.5 MG ORAL TAB $3.71 0378-0181-05 ALLOPURINOL 300 MG ORAL TAB $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 50268-314-15 FINASTERIDE 5 MG ORAL TAB $3.70 50268-314-11 FINASTERIDE 5 MG ORAL TAB $3.70 46122-539-65 LORATADINE 10 MG ORAL TBDL $3.70 70710-1710-1 KETOROLAC 10 MG ORAL TAB $3.69 68001-382-00 LABETALOL 200 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 0904-6374-61 ROPINIROLE 1 MG ORAL TAB $3.69 414200007 SACCHAROMYCES BOULARDII 250 MG ORAL CAP $3.69 68084-444-11 CARBAMAZEPINE 200 MG ORAL TAB $3.68 68084-444-01 CARBAMAZEPINE 200 MG ORAL TAB $3.68 62037-560-05 POTASSIUM CHLORIDE 10 MEQ ORAL CPSR $3.68 68382-106-01 DIVALPROEX 125 MG ORAL CDRS $3.67 51079-442-01 LEVOTHYROXINE 100 MCG ORAL TAB $3.67 51079-442-20 LEVOTHYROXINE 100 MCG ORAL TAB $3.67 0406-0512-62 OXYCODONE-ACETAMINOPHEN 5-325 MG ORAL TAB $3.67 53746-642-01 FLECAINIDE 100 MG ORAL TAB $3.66 68382-537-01 POTASSIUM CITRATE 10 MEQ (1,080 MG) ORAL TBSR $3.66 0904-5892-61 PRAVASTATIN 20 MG ORAL TAB $3.66 62332-241-60 TICAGRELOR 90 MG ORAL TAB $3.66 51079-735-20 HALOPERIDOL 2 MG ORAL TAB $3.65 51079-735-01 HALOPERIDOL 2 MG ORAL TAB $3.65 0406-0484-62 ACETAMINOPHEN-CODEINE 300-30 MG ORAL TAB $3.65 62037-598-90 DILTIAZEM HCL 180 MG ORAL CP24 $3.65 16714-485-01 DIVALPROEX 500 MG ORAL TB24 $3.65 50268-441-15 IRBESARTAN 150 MG ORAL TAB $3.65 50268-441-11 IRBESARTAN 150 MG ORAL TAB $3.65 0832-1217-01 WARFARIN 6 MG ORAL TAB $3.65 0832-1217-00 WARFARIN 6 MG ORAL TAB $3.65 0603-3582-21 FELODIPINE 5 MG ORAL TB24 $3.64 65162-711-10 GUANFACINE 1 MG ORAL TAB $3.64 53746-711-01 GUANFACINE 1 MG ORAL TAB $3.64 0555-0882-02 HYDROXYUREA 500 MG ORAL CAP $3.64 16714-200-30 ONDANSETRON 4 MG ORAL TBDL $3.64 16714-200-10 ONDANSETRON 4 MG ORAL TBDL $3.64 0832-1217-89 WARFARIN 6 MG ORAL TAB $3.64 63824-056-34 DEXTROMETHORPHAN-GUAIFENESIN 30-600 MG ORAL TB12 $3.63 51079-820-20 LEVETIRACETAM 250 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 50268-875-11 VENLAFAXINE 150 MG ORAL CP24 $3.63 50268-875-15 VENLAFAXINE 150 MG ORAL CP24 $3.63 50268-816-11 ZONISAMIDE 100 MG ORAL CAP $3.63 50268-816-15 ZONISAMIDE 100 MG ORAL CAP $3.63 0904-6988-61 DICYCLOMINE 20 MG ORAL TAB $3.63 0591-5695-50 MINOCYCLINE 100 MG ORAL CAP $3.62 65862-211-50 MINOCYCLINE 100 MG ORAL CAP $3.62 31722-623-90 ROFLUMILAST 500 MCG ORAL TAB $3.61 0378-5815-77 VALSARTAN 320 MG ORAL TAB $3.61 50268-476-15 LETROZOLE 2.5 MG ORAL TAB $3.61 50268-476-11 LETROZOLE 2.5 MG ORAL TAB $3.61 99999-012-95 METHADONE 10 MG/5 ML ORAL SOLN $3.61 92265-85041 AMMONIA AROMATIC 15 % (W/V) INHALATION SOLN $3.60 60687-230-11 ZONISAMIDE 100 MG ORAL CAP $3.60 60687-230-01 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 23155-600-41 MIDAZOLAM 1 MG/ML INJ SOLN $3.59 23155-600-31 MIDAZOLAM 1 MG/ML INJ SOLN $3.59 60505-0165-1 FLUVOXAMINE 50 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 24979-010-01 NIFEDIPINE 60 MG ORAL TR24 $3.58 62756-184-88 OXCARBAZEPINE 300 MG ORAL TAB $3.58 68462-138-01 OXCARBAZEPINE 300 MG ORAL TAB $3.58 51801-012-01 POTASSIUM BICARB-CITRIC ACID 20 MEQ ORAL TBEF $3.58 51801-012-30 POTASSIUM BICARB-CITRIC ACID 20 MEQ ORAL TBEF $3.58 51801-011-30 POTASSIUM BICARB-CITRIC ACID 20 MEQ ORAL TBEF $3.58 60687-577-01 ROPINIROLE 0.25 MG ORAL TAB $3.58 60687-577-11 ROPINIROLE 0.25 MG ORAL TAB $3.58 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 68084-709-11 VENLAFAXINE 75 MG ORAL CP24 $3.56 68084-709-01 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 $3.54 63304-296-01 HYDROXYCHLOROQUINE 200 MG ORAL TAB $3.54 16714-548-01 LACOSAMIDE 50 MG ORAL TAB $3.54 0245-5319-01 POTASSIUM CHLORIDE 20 MEQ ORAL TBTQ $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 57237-109-01 FELODIPINE 5 MG ORAL TB24 $3.53 23155-725-01 LABETALOL 300 MG ORAL TAB $3.52 68084-326-11 GLIMEPIRIDE 2 MG ORAL TAB $3.52 68084-326-01 GLIMEPIRIDE 2 MG ORAL TAB $3.52 99999-000-97 METOCLOPRAMIDE 1 MG/ML (NICU) ORAL SOLN $3.51 0245-5319-89 POTASSIUM CHLORIDE 20 MEQ ORAL TBTQ $3.51 69238-1173-9 DOXEPIN 100 MG ORAL CAP $3.50 50268-358-15 GLIMEPIRIDE 1 MG ORAL TAB $3.50 50268-358-11 GLIMEPIRIDE 1 MG ORAL TAB $3.50 60687-711-01 OXCARBAZEPINE 150 MG ORAL TAB $3.50 60687-711-11 OXCARBAZEPINE 150 MG ORAL TAB $3.50 65862-078-50 CIPROFLOXACIN HCL 750 MG ORAL TAB $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 HC51063220 KETONES, URINE DIPSTICK POC $3.48 60505-0158-1 BUPROPION HCL 75 MG ORAL TAB $3.48 62756-459-83 BUPRENORPHINE HCL 2 MG SL SUBL $3.47 42858-501-03 BUPRENORPHINE HCL 2 MG SL SUBL $3.47 51079-436-01 DOXEPIN 10 MG ORAL CAP $3.47 51079-436-20 DOXEPIN 10 MG ORAL CAP $3.47 60687-701-11 GLIPIZIDE 10 MG ORAL TAB $3.47 6817600011 MULTIVIT-MIN NO.53-FA-K-Q10 200 MCG-1,000 MCG-10 MG ORAL CAP $3.47 33342-096-07 TENOFOVIR DISOPROXIL FUMARATE 300 MG ORAL TAB $3.47 60505-3246-3 FAMCICLOVIR 250 MG ORAL TAB $3.46 31722-707-30 FAMCICLOVIR 250 MG ORAL TAB $3.46 42858-802-01 MORPHINE 30 MG ORAL TBSR $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 60687-396-11 HYDROCODONE-ACETAMINOPHEN 5-325 MG ORAL TAB $3.45 60687-396-01 HYDROCODONE-ACETAMINOPHEN 5-325 MG ORAL TAB $3.45 65862-573-90 VALSARTAN 320 MG ORAL TAB $3.43 33342-065-10 VALSARTAN 320 MG ORAL TAB $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 72578-136-06 FEBUXOSTAT 40 MG ORAL TAB $3.42 0904-6418-61 TIZANIDINE 4 MG ORAL TAB $3.42 99999-002-03 DEXTROSE 10% BOLUS $3.41 0143-1769-01 ISOSORBIDE DINITRATE 5 MG ORAL TAB $3.41 63739-686-10 LOSARTAN 50 MG ORAL TAB $3.41 63739-545-10 SPIRONOLACTONE 50 MG ORAL TAB $3.41 50268-096-12 ATORVASTATIN 80 MG ORAL TAB $3.40 50268-096-11 ATORVASTATIN 80 MG ORAL TAB $3.40 59746-115-06 PROCHLORPERAZINE MALEATE 10 MG ORAL TAB $3.40 0904-7227-61 CLONAZEPAM 0.5 MG ORAL TAB $3.39 0904-7728-61 CLONAZEPAM 1 MG ORAL TAB $3.39 72603-142-02 METOPROLOL SUCCINATE 25 MG ORAL TB24 $3.39 60505-1320-1 MIDODRINE 2.5 MG ORAL TAB $3.39 68084-204-11 MINOXIDIL 2.5 MG ORAL TAB $3.39 68084-204-01 MINOXIDIL 2.5 MG ORAL TAB $3.39 23155-133-01 DOXYCYCLINE MONOHYDRATE 50 MG ORAL TAB $3.38 99999-040-25 PROPRANOLOL 1 MG/ML NICU ORAL LIQUID (SLH) $3.38 50268-106-15 BACLOFEN 10 MG ORAL TAB $3.37 50268-106-11 BACLOFEN 10 MG ORAL TAB $3.37 5002442902 LORATADINE-PSEUDOEPHEDRINE 5-120 MG ORAL TB12 $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 68382-722-16 NATEGLINIDE 120 MG ORAL TAB $3.37 16729-072-12 CAPECITABINE 150 MG ORAL TAB $3.36 64380-970-25 HYDROCORTISONE 5 MG ORAL TAB $3.36 50268-666-15 PRAVASTATIN 20 MG ORAL TAB $3.35 50268-666-11 PRAVASTATIN 20 MG ORAL TAB $3.35 59762-0075-1 HYDROCORTISONE 20 MG ORAL TAB $3.34 59651-415-01 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 0904-3854-61 CARBAMAZEPINE 100 MG ORAL CHEW $3.33 0378-1815-77 LEVOTHYROXINE 150 MCG ORAL TAB $3.33 16714-444-01 ENALAPRIL MALEATE 10 MG ORAL TAB $3.32 50268-173-11 CLONAZEPAM 0.5 MG ORAL TAB $3.32 50268-173-15 CLONAZEPAM 0.5 MG ORAL TAB $3.32 50111-334-01 METRONIDAZOLE 500 MG ORAL TAB $3.32 0228-2620-11 ISOSORBIDE MONONITRATE 20 MG ORAL TAB $3.31 63739-796-10 ALLOPURINOL 300 MG ORAL TAB $3.30 63824-008-34 GUAIFENESIN 600 MG ORAL TA12 $3.30 6817600015 MULTIVIT-MINS 56-FA-VIT K-Q10 200 MCG-1,000 MCG-10 MG ORAL CHEW $3.30 0536-1161-37 DEXTROMETHORPHAN-GUAIFENESIN 30-600 MG ORAL TB12 $3.30 60687-728-11 DILTIAZEM HCL 60 MG ORAL TAB $3.30 60687-728-01 DILTIAZEM HCL 60 MG ORAL TAB $3.30 63739-016-10 DILTIAZEM HCL 240 MG ORAL CP24 $3.29 42292-038-01 LEVOTHYROXINE 88 MCG ORAL TAB $3.29 42292-038-20 LEVOTHYROXINE 88 MCG ORAL TAB $3.29 99999-008-71 LEVETIRACETAM 100 MG/ML ORAL SOLN $3.28 0378-1823-77 LEVOTHYROXINE 137 MCG ORAL TAB $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 51079-992-20 FLUVOXAMINE 50 MG ORAL TAB $3.26 51079-992-01 FLUVOXAMINE 50 MG ORAL TAB $3.26 0832-5325-11 POTASSIUM CHLORIDE 20 MEQ ORAL TBTQ $3.26 0245-5319-15 POTASSIUM CHLORIDE 20 MEQ ORAL TBTQ $3.26 0245-5319-11 POTASSIUM CHLORIDE 20 MEQ ORAL TBTQ $3.26 0487-0201-01 IPRATROPIUM-ALBUTEROL 0.5 MG-3 MG(2.5 MG BASE)/3 ML INHALATION NEBU $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 0378-9671-93 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 0378-0184-01 PROPRANOLOL 40 MG ORAL TAB $3.26 31722-748-90 VALSARTAN 320 MG ORAL TAB $3.26 31722-154-90 VALSARTAN 320 MG ORAL TAB $3.26 0487-9901-30 ALBUTEROL SULFATE 2.5 MG/0.5 ML INHALATION NEBU $3.25 42571-161-01 AMOXICILLIN-POT CLAVULANATE 500-125 MG ORAL TAB $3.25 68001-155-04 ANASTROZOLE 1 MG ORAL TAB $3.25 47335-485-88 BICALUTAMIDE 50 MG ORAL TAB $3.25 0378-0433-01 BUPROPION HCL 75 MG ORAL TAB $3.25 72205-007-92 CAPECITABINE 500 MG ORAL TAB $3.25 43547-364-10 CAPTOPRIL 25 MG ORAL TAB $3.25 16729-440-15 CINACALCET 30 MG ORAL TAB $3.25 16729-440-10 CINACALCET 30 MG ORAL TAB $3.25 65862-831-30 CINACALCET 30 MG ORAL TAB $3.25 64380-883-04 CINACALCET 30 MG ORAL TAB $3.25 69097-410-02 CINACALCET 30 MG ORAL TAB $3.25 70436-007-04 CINACALCET 30 MG ORAL TAB $3.25 0115-1070-01 DIPYRIDAMOLE 25 MG ORAL TAB $3.25 55111-532-01 DIVALPROEX 125 MG ORAL CDRS $3.25 65162-750-09 DUTASTERIDE 0.5 MG ORAL CAP $3.25 62332-190-30 FEBUXOSTAT 40 MG ORAL TAB $3.25 72205-028-30 FEBUXOSTAT 40 MG ORAL TAB $3.25 57237-004-30 FLUCONAZOLE 100 MG ORAL TAB $3.25 53746-145-01 HYDROCODONE-IBUPROFEN 7.5-200 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 50742-181-30 LEUCOVORIN CALCIUM 5 MG ORAL TAB $3.25 50742-142-01 METHENAMINE HIPPURATE 1 GRAM ORAL TAB $3.25 50742-240-01 MEXILETINE 200 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 0185-0122-01 NITROFURANTOIN MONOHYD/M-CRYST 100 MG ORAL CAP $3.25 53746-204-01 OXYCODONE-ACETAMINOPHEN 10-325 MG ORAL TAB $3.25 99999-044-29 OXYTOCIN IN 0.9 % SOD CHLORIDE 30 UNIT/500 ML IV SOLN $3.25 99999-039-42 POTASSIUM CHLORIDE IN WATER 10 MEQ/100 ML IV PGBK $3.25 50268-686-15 PRIMIDONE 50 MG ORAL TAB $3.25 50268-686-11 PRIMIDONE 50 MG ORAL TAB $3.25 64380-184-01 PROPAFENONE 225 MG ORAL CP12 $3.25 27241-125-02 RANOLAZINE 500 MG ORAL TB12 $3.25 99999-045-77 SODIUM CHLORIDE 0.9 % IV SOLP $3.25 0781-2076-01 TAMSULOSIN 0.4 MG ORAL CAP $3.25 55111-256-60 ZIPRASIDONE HCL 20 MG ORAL CAP $3.25 0781-2164-60 ZIPRASIDONE HCL 20 MG ORAL CAP $3.25 68084-723-01 OLANZAPINE 5 MG ORAL TAB $3.24 68084-723-11 OLANZAPINE 5 MG ORAL TAB $3.24 68084-753-25 CYCLOBENZAPRINE 5 MG ORAL TAB $3.24 68084-753-95 CYCLOBENZAPRINE 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 0378-1813-77 LEVOTHYROXINE 125 MCG ORAL TAB $3.23 63323-089-25 SODIUM BICARBONATE 1 MEQ/ML (8.4 %) IV SOLN $3.23 0054-4183-25 DEXAMETHASONE 2 MG ORAL TAB $3.22 64679-925-02 ENALAPRIL MALEATE 10 MG ORAL TAB $3.22 16714-443-01 ENALAPRIL MALEATE 5 MG ORAL TAB $3.22 58980-409-12 GLYCERIN (CHILD) RECTAL SUPP $3.22 0378-5615-78 LEVETIRACETAM 500 MG ORAL TAB $3.22 0904-6551-61 ONDANSETRON HCL 4 MG ORAL TAB $3.22 0406-0552-62 OXYCODONE 5 MG ORAL TAB $3.22 67877-503-30 CINACALCET 30 MG ORAL TAB $3.22 50268-550-15 METFORMIN 500 MG ORAL TB24 $3.22 50268-550-11 METFORMIN 500 MG ORAL TB24 $3.22 68084-698-01 VENLAFAXINE 37.5 MG ORAL CP24 $3.22 68084-698-11 VENLAFAXINE 37.5 MG ORAL CP24 $3.22 0904-7153-61 BENZONATATE 100 MG ORAL CAP $3.21 99999-034-37 KETAMINE 5 MG/ML ORAL SOLUTION $3.21 60687-775-01 MECLIZINE 12.5 MG ORAL TAB $3.21 60687-775-11 MECLIZINE 12.5 MG ORAL TAB $3.21 0406-0523-01 OXYCODONE-ACETAMINOPHEN 10-325 MG ORAL TAB $3.21 0406-0522-01 OXYCODONE-ACETAMINOPHEN 7.5-325 MG ORAL TAB $3.21 0245-5317-01 POTASSIUM CHLORIDE 10 MEQ ORAL TBTQ $3.21 51079-375-01 CHLORDIAZEPOXIDE HCL 10 MG ORAL CAP $3.20 0904-6373-61 ROPINIROLE 0.25 MG ORAL TAB $3.20 51079-210-01 ATORVASTATIN 40 MG ORAL TAB $3.19 51079-210-20 ATORVASTATIN 40 MG ORAL TAB $3.19 60505-2996-3 DULOXETINE 30 MG ORAL CPDR $3.19 31722-582-30 DULOXETINE 30 MG ORAL CPDR $3.19 43547-380-03 DULOXETINE 30 MG ORAL CPDR $3.19 0378-1811-77 LEVOTHYROXINE 112 MCG ORAL TAB $3.19 62559-291-01 POTASSIUM CITRATE 10 MEQ (1,080 MG) ORAL TBSR $3.19 68084-381-01 BENZTROPINE 0.5 MG ORAL TAB $3.19 68084-381-11 BENZTROPINE 0.5 MG ORAL TAB $3.19 68084-388-01 BENZTROPINE 1 MG ORAL TAB $3.19 68084-388-11 BENZTROPINE 1 MG ORAL TAB $3.19 67877-225-01 MYCOPHENOLATE MOFETIL 500 MG ORAL TAB $3.19 0573-2883-20 PHENYLEPHRINE-COCOA BUTTER 0.25-88.44 % RECTAL SUPP $3.19 0245-5317-89 POTASSIUM CHLORIDE 10 MEQ ORAL TBTQ $3.19 3932810710 SOD PHOS DI, MONO-K PHOS MONO 250 MG ORAL TAB $3.19 72603-188-01 DEXAMETHASONE 2 MG ORAL TAB $3.18 60687-479-11 CARBAMAZEPINE 100 MG ORAL CHEW $3.17 60687-479-01 CARBAMAZEPINE 100 MG ORAL CHEW $3.17 60219-2056-1 DEXAMETHASONE 2 MG ORAL TAB $3.17 0486-1111-01 POTASSIUM PHOSPHATE, MONOBASIC 500 MG ORAL TBSO $3.15 29300-132-01 ZALEPLON 10 MG ORAL CAP $3.15 51672-2116-4 ACETAMINOPHEN 325 MG RECTAL SUPP $3.15 50111-334-02 METRONIDAZOLE 500 MG ORAL TAB $3.15 60687-173-11 MEMANTINE 5 MG ORAL TAB $3.14 60687-173-57 MEMANTINE 5 MG ORAL TAB $3.14 0591-5556-01 PROPRANOLOL 40 MG ORAL TAB $3.14 99999-044-20 KETAMINE 10 MG/ML INJ SOLN $3.14 50268-088-11 ARIPIPRAZOLE 5 MG ORAL TAB $3.13 50268-088-15 ARIPIPRAZOLE 5 MG ORAL TAB $3.13 0904-7219-61 DILTIAZEM HCL 240 MG ORAL CP24 $3.13 HC89011704 PNEUMOCOCCAL AB(PNL)-AU $3.12 65862-503-01 AMOXICILLIN-POT CLAVULANATE 875-125 MG ORAL TAB $3.12 33342-260-11 ENTACAPONE 200 MG ORAL TAB $3.12 54879-001-00 ETHAMBUTOL 100 MG ORAL TAB $3.12 99998-000-02 IBUPROFEN 100 MG/5 ML ORAL SUSP $3.12 60687-775-65 MECLIZINE 12.5 MG ORAL TAB $3.12 0904-6376-61 OLANZAPINE 10 MG ORAL TAB $3.12 51293-811-01 PHENAZOPYRIDINE 200 MG ORAL TAB $3.12 65162-682-10 PHENAZOPYRIDINE 200 MG ORAL TAB $3.12 42291-923-01 URSODIOL 300 MG ORAL CAP $3.12 50268-522-11 MECLIZINE 12.5 MG ORAL TAB $3.11 50268-522-15 MECLIZINE 12.5 MG ORAL TAB $3.11 6025819309 PRENATAL VIT,CAL 76-IRON-FOLIC 29 MG IRON- 1 MG ORAL TAB $3.11 53489-149-01 THIORIDAZINE 25 MG ORAL TAB $3.11 60687-815-01 BACLOFEN 10 MG ORAL TAB $3.11 60687-815-11 BACLOFEN 10 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 51801-013-30 POTASSIUM BICARB-CITRIC ACID 10 MEQ ORAL TBEF $3.10 51801-014-30 POTASSIUM BICARB-CITRIC ACID 10 MEQ ORAL TBEF $3.10 68462-471-01 POTASSIUM CHLORIDE 10 MEQ ORAL TBTQ $3.10 0832-5324-11 POTASSIUM CHLORIDE 10 MEQ ORAL TBTQ $3.10 0245-5317-90 POTASSIUM CHLORIDE 10 MEQ ORAL TBTQ $3.10 75834-206-01 NATEGLINIDE 120 MG ORAL TAB $3.09 0143-9285-20 AMOXICILLIN 875 MG ORAL TAB $3.09 50268-330-11 FLUDROCORTISONE 0.1 MG ORAL TAB $3.09 50268-330-15 FLUDROCORTISONE 0.1 MG ORAL TAB $3.09 62756-184-18 OXCARBAZEPINE 300 MG ORAL TAB $3.09 68462-200-30 TELMISARTAN 40 MG ORAL TAB $3.09 68084-344-01 TOPIRAMATE 100 MG ORAL TAB $3.09 68084-344-11 TOPIRAMATE 100 MG ORAL TAB $3.09 50111-915-01 TORSEMIDE 5 MG ORAL TAB $3.09 64679-924-02 ENALAPRIL MALEATE 5 MG ORAL TAB $3.07 2159934562 HYDROGEN PEROXIDE 3 % MISC SOLN $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 0904-6640-61 QUETIAPINE 100 MG ORAL TAB $3.06 0904-6639-61 QUETIAPINE 50 MG ORAL TAB $3.06 0904-6950-61 LEVOTHYROXINE 50 MCG ORAL TAB $3.05 0378-1049-01 DOXEPIN 10 MG ORAL CAP $3.04 68382-583-01 LIOTHYRONINE 25 MCG ORAL TAB $3.04 7075666360 SODIUM CHLORIDE 3 % INHALATION NEBU $3.04 7075666460 SODIUM CHLORIDE 7 % INHALATION NEBU $3.04 99999-036-49 CLONAZEPAM 0.1 MG/ML ORAL LIQUID (USING 1 MG TAB) $3.04 50268-174-15 CLONAZEPAM 1 MG ORAL TAB $3.04 50268-174-11 CLONAZEPAM 1 MG ORAL TAB $3.04 51991-349-06 LACOSAMIDE 100 MG ORAL TAB $3.04 42858-801-01 MORPHINE 15 MG ORAL TBSR $3.04 60687-453-01 LEVOTHYROXINE 25 MCG ORAL TAB $3.03 60687-453-11 LEVOTHYROXINE 25 MCG ORAL TAB $3.03 0093-7273-56 PIOGLITAZONE 45 MG ORAL TAB $3.03 0093-7273-98 PIOGLITAZONE 45 MG ORAL TAB $3.03 0054-0140-25 ACARBOSE 25 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 53489-387-01 MINOXIDIL 10 MG ORAL TAB $3.02 68084-214-11 BENZONATATE 100 MG ORAL CAP $3.02 68084-214-01 BENZONATATE 100 MG ORAL CAP $3.02 0591-5643-01 MINOXIDIL 10 MG ORAL TAB $3.02 23155-486-01 VERAPAMIL 120 MG ORAL TAB $3.02 63739-479-10 BACLOFEN 10 MG ORAL TAB $3.01 67877-392-30 NEBIVOLOL 5 MG ORAL TAB $3.01 23155-621-02 CALCIUM ACETATE(PHOSPHAT BIND) 667 MG ORAL TAB $3.00 0904-7376-61 MECLIZINE 25 MG ORAL TAB $3.00 0832-0038-01 OXYBUTYNIN CHLORIDE 5 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 0781-2102-01 TACROLIMUS 0.5 MG ORAL CAP $3.00 HC89021190 ALLERGEN IGE-EA(IMMUNOCAP ISAC)-PD $3.00 HC89017644 COPPER(PNL)-AU $3.00 HC89017651 ZINC, SERUM (PNL) -AU $3.00 13668-484-50 MINOCYCLINE 100 MG ORAL CAP $2.99 49884-257-01 MINOXIDIL 10 MG ORAL TAB $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 23155-547-31 ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN $2.99 23155-547-42 ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN $2.99 70860-776-02 ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN $2.99 70860-776-41 ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN $2.99 23155-547-41 ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN $2.99 0832-0038-89 OXYBUTYNIN CHLORIDE 5 MG ORAL TAB $2.99 50268-744-11 ROPINIROLE 2 MG ORAL TAB $2.99 50268-744-15 ROPINIROLE 2 MG ORAL TAB $2.99 60687-476-11 SPIRONOLACTONE 50 MG ORAL TAB $2.99 60687-476-01 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 99999-042-37 SACUBITRIL-VALSARTAN 4 MG/ML (COMBINED MG CONCENTRATION) ORAL LIQUID $2.98 55111-328-90 NATEGLINIDE 60 MG ORAL TAB $2.98 75834-205-01 NATEGLINIDE 60 MG ORAL TAB $2.98 59762-0181-3 VENLAFAXINE 75 MG ORAL CP24 $2.98 0832-0512-00 BETHANECHOL CHLORIDE 25 MG ORAL TAB $2.97 0054-8181-25 DEXAMETHASONE 1.5 MG ORAL TAB $2.97 65162-573-10 BETHANECHOL CHLORIDE 25 MG ORAL TAB $2.96 53746-573-01 BETHANECHOL CHLORIDE 25 MG ORAL TAB $2.96 0904-6949-61 LEVOTHYROXINE 25 MCG ORAL TAB $2.96 68084-354-01 OXYCODONE 5 MG ORAL TAB $2.96 68084-354-11 OXYCODONE 5 MG ORAL TAB $2.96 0904-6926-61 SERTRALINE 100 MG ORAL TAB $2.96 99999-038-72 MORPHINE 10 MG/5 ML ORAL SOLN $2.96 51079-721-01 MYCOPHENOLATE MOFETIL 250 MG ORAL CAP $2.96 51079-721-20 MYCOPHENOLATE MOFETIL 250 MG ORAL CAP $2.96 50742-262-01 NIFEDIPINE 90 MG ORAL TR24 $2.96 0185-0129-01 BUMETANIDE 1 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 99999-043-12 MORPHINE (PF) 0.5 MG/ML INJ SOLN $2.95 0591-4101-01 PERPHENAZINE 2 MG ORAL TAB $2.95 99999-045-11 ANASTROZOLE 0.5 MG ORAL PARTIAL 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 50268-743-11 ROPINIROLE 1 MG ORAL TAB $2.94 50268-743-15 ROPINIROLE 1 MG ORAL TAB $2.94 63323-286-11 ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJ SOLN $2.94 16714-259-01 AMITRIPTYLINE 50 MG ORAL TAB $2.93 42291-415-30 FAMCICLOVIR 250 MG ORAL TAB $2.93 0406-5771-62 METHADONE 10 MG ORAL TAB $2.93 50268-541-15 METOPROLOL SUCCINATE 50 MG ORAL TB24 $2.93 50268-541-11 METOPROLOL SUCCINATE 50 MG ORAL TB24 $2.93 68084-098-01 ATORVASTATIN 20 MG ORAL TAB $2.93 68084-098-11 ATORVASTATIN 20 MG ORAL TAB $2.93 68084-099-11 ATORVASTATIN 40 MG ORAL TAB $2.93 68084-099-01 ATORVASTATIN 40 MG ORAL TAB $2.93 60219-1076-1 AZATHIOPRINE 50 MG ORAL TAB $2.93 0591-3543-60 BUPROPION HCL (SMOKING DETER) 150 MG ORAL TB12 $2.93 16571-680-01 CARBAMAZEPINE 100 MG ORAL TB12 $2.93 24979-198-01 GUANFACINE 1 MG ORAL TAB $2.93 42192-340-01 HYOSCYAMINE SULFATE 0.125 MG ORAL TAB $2.93 42192-339-01 HYOSCYAMINE SULFATE 0.125 MG SL SUBL $2.93 50228-323-01 METAXALONE 800 MG ORAL TAB $2.93 0406-0552-23 OXYCODONE 5 MG ORAL TAB $2.93 42858-001-10 OXYCODONE 5 MG ORAL TAB $2.93 31722-532-01 TORSEMIDE 100 MG ORAL TAB $2.93 50268-557-15 MYCOPHENOLATE MOFETIL 250 MG ORAL CAP $2.92 50268-557-11 MYCOPHENOLATE MOFETIL 250 MG ORAL CAP $2.92 60687-854-01 PREDNISONE 50 MG ORAL TAB $2.91 60687-854-11 PREDNISONE 50 MG ORAL TAB $2.91 0093-7386-56 VENLAFAXINE 150 MG ORAL CP24 $2.91 0904-7217-61 DILTIAZEM HCL 120 MG ORAL CP24 $2.90 10702-169-01 DESMOPRESSIN 0.1 MG ORAL TAB $2.89 0904-7383-61 TAMSULOSIN 0.4 MG ORAL CAP $2.89 5865713390 PRENATAL VIT,CAL 76-IRON-FOLIC 29 MG IRON- 1 MG ORAL TAB $2.89 65862-147-36 SUMATRIPTAN SUCCINATE 50 MG ORAL TAB $2.89 69452-345-72 SUMATRIPTAN SUCCINATE 50 MG ORAL TAB $2.89 69452-345-60 SUMATRIPTAN SUCCINATE 50 MG ORAL TAB $2.89 0378-5814-77 VALSARTAN 160 MG ORAL TAB $2.89 70710-1110-1 CYPROHEPTADINE 4 MG ORAL TAB $2.88 63304-458-30 ONDANSETRON HCL 4 MG ORAL TAB $2.88 55111-153-30 ONDANSETRON HCL 4 MG ORAL TAB $2.88 60687-253-11 SERTRALINE 100 MG ORAL TAB $2.88 60687-253-01 SERTRALINE 100 MG ORAL TAB $2.88 67877-483-30 TELMISARTAN 40 MG ORAL TAB $2.88 0904-7288-61 BENZTROPINE 0.5 MG ORAL TAB $2.87 50268-401-15 HYDROCODONE-ACETAMINOPHEN 5-325 MG ORAL TAB $2.87 50268-401-11 HYDROCODONE-ACETAMINOPHEN 5-325 MG ORAL TAB $2.87 62332-096-31 LAMOTRIGINE 25 MG ORAL TCHD $2.87 65862-502-20 AMOXICILLIN-POT CLAVULANATE 500-125 MG ORAL TAB $2.86 68084-525-11 OLANZAPINE 2.5 MG ORAL TAB $2.86 68084-525-01 OLANZAPINE 2.5 MG ORAL TAB $2.86 99999-047-55 PENICILLIN G POTASSIUM 50,000 UNITS/ML INJECTION DILUTION $2.86 68084-243-11 CLINDAMYCIN HCL 150 MG ORAL CAP $2.85 68084-243-01 CLINDAMYCIN HCL 150 MG ORAL CAP $2.85 0904-6353-61 LEVOFLOXACIN 750 MG ORAL TAB $2.85 51079-444-20 LEVOTHYROXINE 25 MCG ORAL TAB $2.85 51079-444-01 LEVOTHYROXINE 25 MCG ORAL TAB $2.85 0904-7375-61 MECLIZINE 12.5 MG ORAL TAB $2.85 0832-0310-11 VALPROIC ACID 250 MG ORAL CAP $2.85 60687-717-01 DILTIAZEM HCL 30 MG ORAL TAB $2.84 60687-717-11 DILTIAZEM HCL 30 MG ORAL TAB $2.84 50111-456-01 OXYBUTYNIN CHLORIDE 5 MG ORAL TAB $2.84 0143-9285-01 AMOXICILLIN 875 MG ORAL TAB $2.83 50268-588-11 MEMANTINE 10 MG ORAL TAB $2.83 50268-588-13 MEMANTINE 10 MG ORAL TAB $2.83 99999-041-70 LOPERAMIDE 1 MG/7.5 ML ORAL LIQD $2.83 49884-065-01 GLYCOPYRROLATE 1 MG ORAL TAB $2.82 13107-014-01 GLYCOPYRROLATE 1 MG ORAL TAB $2.82 0904-6293-04 ATORVASTATIN 80 MG ORAL TAB $2.82 0093-0321-01 DILTIAZEM HCL 120 MG ORAL TAB $2.82 50268-741-15 ROPINIROLE 0.25 MG ORAL TAB $2.82 50268-741-11 ROPINIROLE 0.25 MG ORAL TAB $2.82 0054-0235-25 MORPHINE 15 MG ORAL TAB $2.81 0904-6506-61 MEMANTINE 10 MG ORAL TAB $2.80 0904-6505-61 MEMANTINE 5 MG ORAL TAB $2.80 60687-433-01 AMITRIPTYLINE 25 MG ORAL TAB $2.80 60687-433-11 AMITRIPTYLINE 25 MG ORAL TAB $2.80 55111-533-01 DIVALPROEX 250 MG ORAL TB24 $2.80 65162-757-10 DIVALPROEX 500 MG ORAL TB24 $2.80 0054-0020-25 LITHIUM CARBONATE 450 MG ORAL TBSR $2.80 99999-038-53 NIFEDIPINE 4 MG/ML ORAL LIQUID $2.80 0093-7272-98 PIOGLITAZONE 30 MG ORAL TAB $2.80 63739-086-10 VALPROIC ACID 250 MG ORAL CAP $2.79 66983-350-20 POTASSIUM IODIDE 65 MG ORAL TAB $2.78 50268-663-15 PROPRANOLOL 20 MG ORAL TAB $2.78 50268-663-11 PROPRANOLOL 20 MG ORAL TAB $2.78 0527-2962-37 CHLORPROMAZINE 25 MG ORAL TAB $2.77 63824-008-15 GUAIFENESIN 600 MG ORAL TA12 $2.77 65862-021-06 MIRTAZAPINE 15 MG ORAL TBDL $2.77 70677-1104-2 OMEPRAZOLE 20 MG ORAL TBEC $2.77 0378-0243-05 SPIRONOLACTONE 50 MG ORAL TAB $2.77 0378-0243-01 SPIRONOLACTONE 50 MG ORAL TAB $2.77 60687-856-01 ACYCLOVIR 400 MG ORAL TAB $2.76 60687-856-11 ACYCLOVIR 400 MG ORAL TAB $2.76 67877-731-01 CHLORDIAZEPOXIDE-CLIDINIUM 5-2.5 MG ORAL CAP $2.76 60505-0094-0 DOXAZOSIN 2 MG ORAL TAB $2.76 55111-725-90 MONTELUKAST 10 MG ORAL TAB $2.76 55111-725-30 MONTELUKAST 10 MG ORAL TAB $2.76 62332-391-31 NITROFURANTOIN MACROCRYSTAL 100 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 0378-1809-77 LEVOTHYROXINE 100 MCG ORAL TAB $2.76 60505-0033-6 PENTOXIFYLLINE 400 MG ORAL TBSR $2.75 0904-6475-61 BACLOFEN 10 MG ORAL TAB $2.74 63739-145-10 MIDODRINE 5 MG ORAL TAB $2.74 0378-1807-77 LEVOTHYROXINE 88 MCG ORAL TAB $2.74 51672-4146-1 PHENYTOIN 50 MG ORAL CHEW $2.74 69452-152-20 ETHOSUXIMIDE 250 MG ORAL CAP $2.73 0832-1520-89 HALOPERIDOL 1 MG ORAL TAB $2.73 60687-590-01 HYDROMORPHONE 4 MG ORAL TAB $2.73 60687-590-11 HYDROMORPHONE 4 MG ORAL TAB $2.73 0228-2571-11 INDAPAMIDE 2.5 MG ORAL TAB $2.73 3700074087 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 37000-023-04 PSYLLIUM HUSK (WITH SUGAR) 3.4 GRAM ORAL PWPK $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 0406-0483-01 ACETAMINOPHEN-CODEINE 300-15 MG ORAL TAB $2.71 57237-327-21 BISACODYL 10 MG RECTAL SUPP $2.71 43598-655-30 BUPROPION HCL 150 MG ORAL TB24 $2.71 68462-433-18 COLESEVELAM 625 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 6126932560 FOLIC ACID-VIT B6-VIT B12 0.8-10-115 MG-MG-MCG ORAL TAB $2.71 55111-596-60 MEMANTINE 5 MG ORAL TAB $2.71 0591-3870-44 MEMANTINE 5 MG ORAL TAB $2.71 0591-3870-45 MEMANTINE 5 MG ORAL TAB $2.71 63304-017-60 RANOLAZINE 500 MG ORAL TB12 $2.71 68084-272-01 RISPERIDONE 1 MG ORAL TAB $2.71 68084-272-11 RISPERIDONE 1 MG ORAL TAB $2.71 65862-572-90 VALSARTAN 160 MG ORAL TAB $2.71 33342-064-10 VALSARTAN 160 MG ORAL TAB $2.71 65862-702-60 ZIPRASIDONE HCL 20 MG ORAL CAP $2.71 68084-640-01 LITHIUM CARBONATE 300 MG ORAL TBSR $2.70 68084-640-11 LITHIUM CARBONATE 300 MG ORAL TBSR $2.70 99999-046-43 KETAMINE 100 MG/ML INJ SOLN $2.70 50268-038-11 AMITRIPTYLINE 25 MG ORAL TAB $2.70 50268-038-15 AMITRIPTYLINE 25 MG ORAL TAB $2.70 99999-005-60 GENTAMICIN 2 MG/ML INJ SOLN IN D5W (MCH-NICU) $2.70 51293-821-01 METHIMAZOLE 10 MG ORAL TAB $2.70 0135-0157-07 NICOTINE (POLACRILEX) 2 MG BUCCAL GUM $2.70 766784508 NICOTINE (POLACRILEX) 2 MG BUCCAL GUM $2.70 72789-131-60 ACARBOSE 25 MG ORAL TAB $2.69 60687-677-11 ALLOPURINOL 100 MG ORAL TAB $2.69 60687-677-01 ALLOPURINOL 100 MG ORAL TAB $2.69 50268-037-15 AMITRIPTYLINE 10 MG ORAL TAB $2.69 50268-037-11 AMITRIPTYLINE 10 MG ORAL TAB $2.69 60687-794-11 ISOSORBIDE MONONITRATE 60 MG ORAL TB24 $2.69 60687-794-01 ISOSORBIDE MONONITRATE 60 MG ORAL TB24 $2.69 0378-1805-77 LEVOTHYROXINE 75 MCG ORAL TAB $2.69 51079-246-01 LORATADINE 10 MG ORAL TAB $2.69 51079-246-20 LORATADINE 10 MG ORAL TAB $2.69 0904-7363-61 RISPERIDONE 2 MG ORAL TAB $2.69 0904-6450-61 ISOSORBIDE MONONITRATE 60 MG ORAL TB24 $2.69 68084-155-11 PROMETHAZINE 25 MG ORAL TAB $2.69 68084-155-01 PROMETHAZINE 25 MG ORAL TAB $2.69 69097-825-02 RALOXIFENE 60 MG ORAL TAB $2.69 68084-343-01 TOPIRAMATE 50 MG ORAL TAB $2.69 68084-343-11 TOPIRAMATE 50 MG ORAL TAB $2.69 99999-033-45 CISPLATIN IV SOLN (FOR DESENSITIZATION USE) (MHS) $2.68 68382-916-01 METHYLPREDNISOLONE 4 MG ORAL TAB $2.68 69339-174-02 NITROGLYCERIN 0.4 MG SL SUBL $2.67 69339-174-41 NITROGLYCERIN 0.4 MG SL SUBL $2.67 59762-1061-1 DIPHENOXYLATE-ATROPINE 2.5-0.025 MG ORAL TAB $2.67 51079-734-20 HALOPERIDOL 1 MG ORAL TAB $2.67 51079-734-01 HALOPERIDOL 1 MG ORAL TAB $2.67 0832-1520-01 HALOPERIDOL 1 MG ORAL TAB $2.67 0591-0605-01 LABETALOL 100 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 71247-126-01 LABETALOL 100 MG ORAL TAB $2.67 58657-602-01 LABETALOL 100 MG ORAL TAB $2.67 60687-526-11 METRONIDAZOLE 250 MG ORAL TAB $2.67 60687-526-01 METRONIDAZOLE 250 MG ORAL TAB $2.67 0406-0512-23 OXYCODONE-ACETAMINOPHEN 5-325 MG ORAL TAB $2.67 70954-668-20 PENTOXIFYLLINE 400 MG ORAL TBSR $2.67 42192-366-10 SALSALATE 750 MG ORAL TAB $2.67 5192712340 SODIUM BENZOATE (BULK) MISC POWD $2.67 0832-1216-89 WARFARIN 5 MG ORAL TAB $2.67 51672-4005-1 CARBAMAZEPINE 200 MG ORAL TAB $2.65 23155-724-01 LABETALOL 200 MG ORAL TAB $2.65 0904-6505-06 MEMANTINE 5 MG ORAL TAB $2.65 0527-1313-01 PILOCARPINE HCL 5 MG ORAL TAB $2.65 0228-2801-11 PILOCARPINE HCL 5 MG ORAL TAB $2.65 0574-0792-01 PILOCARPINE HCL 5 MG ORAL TAB $2.65 0904-7293-61 POTASSIUM CHLORIDE 20 MEQ ORAL TBTQ $2.65 59762-0180-3 VENLAFAXINE 37.5 MG ORAL CP24 $2.65 0832-1216-01 WARFARIN 5 MG ORAL TAB $2.65 0832-1216-00 WARFARIN 5 MG ORAL TAB $2.65 0378-0577-01 AMILORIDE-HYDROCHLOROTHIAZIDE 5-50 MG ORAL TAB $2.64 65862-570-30 VALSARTAN 40 MG ORAL TAB $2.64 33342-062-07 VALSARTAN 40 MG ORAL TAB $2.64 0904-7507-61 ACYCLOVIR 400 MG ORAL TAB $2.63 99999-007-22 VANCOMYCIN 25 MG/5 ML INJ SOLN IN D5W (MCH-NICU) $2.63 50742-250-30 DILTIAZEM HCL 240 MG ORAL CP24 $2.63 99999-040-51 CISPLATIN IV SOLN (FOR DESENSITIZATION USE) (MHS) $2.62 50742-249-30 DILTIAZEM HCL 180 MG ORAL CP24 $2.62 70677-1018-2 LORATADINE-PSEUDOEPHEDRINE 10-240 MG ORAL TB24 $2.62 0406-1146-01 METHYLPHENIDATE HCL 20 MG ORAL TAB $2.62 0904-7156-61 METRONIDAZOLE 250 MG ORAL TAB $2.62 51672-4041-1 CARBAMAZEPINE 100 MG ORAL CHEW $2.61 68382-536-01 POTASSIUM CITRATE 5 MEQ (540 MG) ORAL TBSR $2.61 0904-6925-61 SERTRALINE 50 MG ORAL TAB $2.61 50268-151-11 CEPHALEXIN 250 MG ORAL CAP $2.61 50268-151-15 CEPHALEXIN 250 MG ORAL CAP $2.61 42291-310-01 GUANFACINE 1 MG ORAL TAB $2.61 16729-019-01 MYCOPHENOLATE MOFETIL 500 MG ORAL TAB $2.61 64380-725-06 MYCOPHENOLATE MOFETIL 500 MG ORAL TAB $2.61 62332-246-31 AMANTADINE HCL 100 MG ORAL CAP $2.60 62332-246-71 AMANTADINE HCL 100 MG ORAL CAP $2.60 49884-724-01 HYDROXYUREA 500 MG ORAL CAP $2.60 76204-100-01 IPRATROPIUM BROMIDE 0.02 % INHALATION SOLN $2.60 23155-178-01 ISOSORBIDE MONONITRATE 60 MG ORAL TB24 $2.60 65862-601-30 MODAFINIL 100 MG ORAL TAB $2.60 99999-045-96 POTASSIUM CHLORIDE IN D5W 10 MEQ/100 ML IVPB $2.60 65162-807-10 PROGESTERONE MICRONIZED 100 MG ORAL CAP $2.60 72241-010-22 RALOXIFENE 60 MG ORAL TAB $2.60 51293-804-01 SALSALATE 750 MG ORAL TAB $2.60 65162-513-10 SALSALATE 750 MG ORAL TAB $2.60 51079-979-01 SPIRONOLACTONE 50 MG ORAL TAB $2.60 51079-979-20 SPIRONOLACTONE 50 MG ORAL TAB $2.60 57237-042-30 VALACYCLOVIR 500 MG ORAL TAB $2.60 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 76204-600-60 IPRATROPIUM-ALBUTEROL 0.5 MG-3 MG(2.5 MG BASE)/3 ML INHALATION NEBU $2.59 76204-600-30 IPRATROPIUM-ALBUTEROL 0.5 MG-3 MG(2.5 MG BASE)/3 ML INHALATION NEBU $2.59 47335-756-48 IPRATROPIUM-ALBUTEROL 0.5 MG-3 MG(2.5 MG BASE)/3 ML INHALATION NEBU $2.59 0799-0001-05 MENTHOL-ZINC OXIDE 0.44-20.6 % TOPICAL OIPK $2.59 16729-480-01 METHYLPHENIDATE HCL 20 MG ORAL TAB $2.59 57237-078-10 ONDANSETRON 8 MG ORAL TBDL $2.59 0054-4182-25 DEXAMETHASONE 1.5 MG ORAL TAB $2.59 0832-1214-01 WARFARIN 3 MG ORAL TAB $2.59 0832-1214-00 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 99988-000-07 NM TC-99M PERTECHNETATE 1 MCI (NATCO4) $2.58 63304-901-90 FENOFIBRATE 160 MG ORAL TAB $2.58 0406-5755-62 METHADONE 5 MG ORAL TAB $2.58 63739-567-10 TAMSULOSIN 0.4 MG ORAL CAP $2.57 31722-153-90 VALSARTAN 160 MG ORAL TAB $2.57 0904-7410-61 AMITRIPTYLINE 25 MG ORAL TAB $2.56 50268-259-15 DIVALPROEX 250 MG ORAL TB24 $2.56 50268-259-11 DIVALPROEX 250 MG ORAL TB24 $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 60687-242-11 SERTRALINE 50 MG ORAL TAB $2.55 60687-242-01 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 99999-044-28 DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJ SOLN $2.54 0054-8301-25 FUROSEMIDE 80 MG ORAL TAB $2.54 71930-035-12 LABETALOL 100 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 0832-1213-89 WARFARIN 2.5 MG ORAL TAB $2.54 63304-719-90 DILTIAZEM HCL 180 MG ORAL CP24 $2.53 0115-5522-10 FENOFIBRATE 160 MG ORAL TAB $2.53 60219-5522-9 FENOFIBRATE 160 MG ORAL TAB $2.53 0591-0605-05 LABETALOL 100 MG ORAL TAB $2.53 65162-058-27 SEVELAMER CARBONATE 800 MG ORAL TAB $2.53 0378-4275-77 VALACYCLOVIR 500 MG ORAL TAB $2.53 57237-042-90 VALACYCLOVIR 500 MG ORAL TAB $2.53 0832-1213-01 WARFARIN 2.5 MG ORAL TAB $2.53 0904-7218-61 DILTIAZEM HCL 180 MG ORAL CP24 $2.52 43598-436-01 NITROGLYCERIN 0.4 MG SL SUBL $2.52 72205-368-91 TICAGRELOR 90 MG ORAL TAB $2.52 16714-896-01 GLIPIZIDE 10 MG ORAL TR24 $2.51 55111-280-50 LEVOFLOXACIN 500 MG ORAL TAB $2.51 31722-722-50 LEVOFLOXACIN 500 MG ORAL TAB $2.51 60793-115-01 LIOTHYRONINE 5 MCG ORAL TAB $2.50 23155-194-01 NIFEDIPINE 10 MG ORAL CAP $2.50 50268-359-15 GLIMEPIRIDE 2 MG ORAL TAB $2.50 50268-359-11 GLIMEPIRIDE 2 MG ORAL TAB $2.50 60505-0170-9 PRAVASTATIN 40 MG ORAL TAB $2.50 60687-783-01 ISOSORBIDE MONONITRATE 30 MG ORAL TB24 $2.49 60687-783-11 ISOSORBIDE MONONITRATE 30 MG ORAL TB24 $2.49 29300-227-01 METRONIDAZOLE 500 MG ORAL TAB $2.48 68180-840-71 NORGESTIMATE-ETHINYL ESTRADIOL 0.25-0.035 MG ORAL TAB $2.48 68180-840-73 NORGESTIMATE-ETHINYL ESTRADIOL 0.25-0.035 MG ORAL TAB $2.48 76204-200-01 ALBUTEROL SULFATE 2.5 MG /3 ML (0.083 %) INHALATION NEBU $2.48 68382-826-14 TAMOXIFEN 10 MG ORAL TAB $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 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 0904-6656-40 ARIPIPRAZOLE 5 MG ORAL TAB $2.47 51079-978-20 CARBIDOPA-LEVODOPA 25-100 MG ORAL TBSR $2.47 51079-978-01 CARBIDOPA-LEVODOPA 25-100 MG ORAL TBSR $2.47 16714-799-01 CETIRIZINE 10 MG ORAL TAB $2.47 16714-484-01 DIVALPROEX 250 MG ORAL TB24 $2.47 54879-001-01 ETHAMBUTOL 100 MG ORAL TAB $2.47 13668-132-01 FELODIPINE 2.5 MG ORAL TB24 $2.47 0904-6449-61 ISOSORBIDE MONONITRATE 30 MG ORAL TB24 $2.47 65862-537-50 LEVOFLOXACIN 500 MG ORAL TAB $2.47 0591-5307-01 PROMETHAZINE 25 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 0832-1212-00 WARFARIN 2 MG ORAL TAB $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 50268-769-15 SERTRALINE 50 MG ORAL TAB $2.46 50268-769-11 SERTRALINE 50 MG ORAL TAB $2.46 99999-044-26 ALBUTEROL SULFATE 90 MCG/ACTUATION INHALATION HFAA $2.46 29300-227-46 METRONIDAZOLE 500 MG ORAL TAB $2.46 16714-560-01 PRAVASTATIN 40 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 59762-3304-3 NITROGLYCERIN 0.4 MG SL SUBL $2.45 72888-139-32 NITROGLYCERIN 0.4 MG SL SUBL $2.45 72888-139-33 NITROGLYCERIN 0.4 MG SL SUBL $2.45 51079-565-20 THIORIDAZINE 10 MG ORAL TAB $2.45 0904-7337-61 CEPHALEXIN 500 MG ORAL CAP $2.44 35573-428-51 PANTOPRAZOLE 40 MG ORAL TBEC $2.44 35573-428-80 PANTOPRAZOLE 40 MG ORAL TBEC $2.44 99998-000-01 IBUPROFEN 100 MG/5 ML ORAL SUSP $2.44 31722-936-12 OMEGA-3 ACID ETHYL ESTERS 1 GRAM ORAL CAP $2.44 99999-036-66 ONDANSETRON HCL 2 MG ORAL PARTIAL TAB (MCH) $2.44 99999-008-82 POTASSIUM CITRATE-CITRIC ACID 1,100-334 MG/5 ML ORAL SOLN $2.44 0378-1803-77 LEVOTHYROXINE 50 MCG ORAL TAB $2.43 5026858215 NIACIN 100 MG ORAL TAB $2.43 5026858211 NIACIN 100 MG ORAL TAB $2.43 0245-0147-01 AMIODARONE 200 MG ORAL TAB $2.43 64679-923-02 ENALAPRIL MALEATE 2.5 MG ORAL TAB $2.42 63824-008-50 GUAIFENESIN 600 MG ORAL TA12 $2.41 0832-1211-01 WARFARIN 1 MG ORAL TAB $2.41 0832-1211-00 WARFARIN 1 MG ORAL TAB $2.41 0245-0147-89 AMIODARONE 200 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 51079-209-01 ATORVASTATIN 20 MG ORAL TAB $2.41 51079-209-20 ATORVASTATIN 20 MG ORAL TAB $2.41 23155-192-01 BUPROPION HCL 100 MG ORAL TAB $2.41 0093-8192-01 CIMETIDINE 300 MG ORAL TAB $2.41 0378-0317-01 CIMETIDINE 300 MG ORAL TAB $2.41 62332-042-30 IRBESARTAN 150 MG ORAL TAB $2.41 75826-115-10 PHENAZOPYRIDINE 200 MG ORAL TAB $2.41 8068117200 POTASSIUM, SODIUM PHOSPHATES 280-160-250 MG ORAL PWPK $2.41 99999-002-42 PROMETHAZINE-DM 6.25-15 MG/5 ML ORAL SYRP $2.41 70436-155-05 PROMETHAZINE-DM 6.25-15 MG/5 ML ORAL SYRP $2.41 57664-117-88 VERAPAMIL 180 MG ORAL TBSR $2.41 0832-1211-89 WARFARIN 1 MG ORAL TAB $2.41 68084-371-11 AMIODARONE 200 MG ORAL TAB $2.40 60687-437-11 AMIODARONE 200 MG ORAL TAB $2.40 60687-437-01 AMIODARONE 200 MG ORAL TAB $2.40 68084-371-01 AMIODARONE 200 MG ORAL TAB $2.40 0832-1520-11 HALOPERIDOL 1 MG ORAL TAB $2.40 0378-0257-01 HALOPERIDOL 1 MG ORAL TAB $2.40 3700074108 PSYLLIUM HUSK 3.4 GRAM ORAL PWPK $2.40 37000-024-04 PSYLLIUM HUSK 3.4 GRAM ORAL PWPK $2.40 60687-388-01 ALPRAZOLAM 0.5 MG ORAL TAB $2.39 60687-388-11 ALPRAZOLAM 0.5 MG ORAL TAB $2.39 99999-038-42 CLINDAMYCIN SUBCONJUNCTIVAL INJ $2.39 0093-7386-98 VENLAFAXINE 150 MG ORAL CP24 $2.39 68462-130-01 ZONISAMIDE 100 MG ORAL CAP $2.39 69097-861-07 ZONISAMIDE 100 MG ORAL CAP $2.39 70677-1271-1 ACETAMINOPHEN 650 MG RECTAL SUPP $2.39 0023-4554-30 CARBOXYMETHYLCELLULOSE SODIUM 1 % OPHT DPGE $2.39 31722-131-90 DUTASTERIDE 0.5 MG ORAL CAP $2.39 0093-0311-01 LOPERAMIDE 2 MG ORAL CAP $2.39 0093-0311-05 LOPERAMIDE 2 MG ORAL CAP $2.39 16729-189-29 MYCOPHENOLATE SODIUM 360 MG ORAL TBEC $2.39 51079-747-20 DILTIAZEM HCL 90 MG ORAL TAB $2.38 51079-747-01 DILTIAZEM HCL 90 MG ORAL TAB $2.38 31722-131-30 DUTASTERIDE 0.5 MG ORAL CAP $2.38 68180-229-07 MEMANTINE 5 MG ORAL TAB $2.38 99999-010-99 URSODIOL 25 MG/ML ORAL SUSP (COMPOUND) $2.38 60687-661-11 CARBIDOPA-LEVODOPA 25-100 MG ORAL TAB $2.37 60687-661-01 CARBIDOPA-LEVODOPA 25-100 MG ORAL TAB $2.37 60687-836-11 CARBIDOPA-LEVODOPA 25-250 MG ORAL TAB $2.37 60687-836-01 CARBIDOPA-LEVODOPA 25-250 MG ORAL TAB $2.37 0093-2064-06 CILOSTAZOL 100 MG ORAL TAB $2.37 60687-860-11 CIPROFLOXACIN HCL 500 MG ORAL TAB $2.37 60687-860-01 CIPROFLOXACIN HCL 500 MG ORAL TAB $2.37 99998-002-31 PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIX $2.37 62332-012-31 VENLAFAXINE 100 MG ORAL TAB $2.37 16714-631-02 ALENDRONATE 10 MG ORAL TAB $2.37 0093-1720-01 WARFARIN 10 MG ORAL TAB $2.37 51672-4035-1 WARFARIN 10 MG ORAL TAB $2.37 99999-000-03 AMINOPHYLLINE 5 MG/ML NICU IV DILUTION $2.36 65862-503-20 AMOXICILLIN-POT CLAVULANATE 875-125 MG ORAL TAB $2.36 60687-163-11 CEPHALEXIN 500 MG ORAL CAP $2.36 60687-163-01 CEPHALEXIN 500 MG ORAL CAP $2.36 16714-035-02 LEVETIRACETAM 500 MG ORAL TAB $2.36 50268-665-11 PRAVASTATIN 10 MG ORAL TAB $2.36 50268-665-15 PRAVASTATIN 10 MG ORAL TAB $2.36 43547-369-09 VALSARTAN 160 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 99998-005-14 ACETAZOLAMIDE 25 MG/ML ORAL SUSP (COMPOUND) (MCH) $2.35 0172-4097-60 BACLOFEN 20 MG ORAL TAB $2.35 50268-194-11 CLONIDINE HCL 0.3 MG ORAL TAB $2.35 50268-194-15 CLONIDINE HCL 0.3 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 43598-863-60 BUPROPION HCL (SMOKING DETER) 150 MG ORAL TB12 $2.34 42806-413-60 BUPROPION HCL (SMOKING DETER) 150 MG ORAL TB12 $2.34 99999-044-84 DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML ORAL SYRP $2.34 72888-123-01 GUANFACINE 1 MG ORAL TAB $2.34 99999-008-64 IBUPROFEN 100 MG/5 ML ORAL SUSP $2.34 0245-0212-11 MIDODRINE 5 MG ORAL TAB $2.34 58980-409-25 GLYCERIN (CHILD) RECTAL SUPP $2.33 50268-430-15 INDOMETHACIN 25 MG ORAL CAP $2.33 50268-430-11 INDOMETHACIN 25 MG ORAL CAP $2.33 70756-404-11 NITROFURANTOIN MONOHYD/M-CRYST 100 MG ORAL CAP $2.33 0378-3065-77 FENOFIBRATE NANOCRYSTALLIZED 48 MG ORAL TAB $2.32 60687-579-11 HYDROMORPHONE 2 MG ORAL TAB $2.32 60687-579-01 HYDROMORPHONE 2 MG ORAL TAB $2.32 68382-582-01 LIOTHYRONINE 5 MCG ORAL TAB $2.32 0378-0183-01 PROPRANOLOL 20 MG ORAL TAB $2.32 0378-6985-01 SODIUM CHLORIDE 0.9 % INHALATION NEBU $2.32 0378-0053-01 CIMETIDINE 200 MG ORAL TAB $2.31 0904-7442-61 CLONIDINE 0.1 MG ORAL TAB (MCH) $2.31 24979-029-07 DILTIAZEM HCL 300 MG ORAL CP24 $2.31 69238-1124-9 NADOLOL 40 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 68084-539-11 TORSEMIDE 20 MG ORAL TAB $2.31 68084-539-01 TORSEMIDE 20 MG ORAL TAB $2.31 50268-754-11 TORSEMIDE 5 MG ORAL TAB $2.31 50268-754-15 TORSEMIDE 5 MG ORAL TAB $2.31 0904-7362-61 RISPERIDONE 1 MG ORAL TAB $2.31 45802-730-30 ACETAMINOPHEN 650 MG RECTAL SUPP $2.30 0574-7050-12 BISACODYL 10 MG RECTAL SUPP $2.30 0904-7283-06 TORSEMIDE 20 MG ORAL TAB $2.29 70010-135-05 POTASSIUM CHLORIDE 20 MEQ ORAL TBTQ $2.28 70010-135-01 POTASSIUM CHLORIDE 20 MEQ ORAL TBTQ $2.28 70010-135-10 POTASSIUM CHLORIDE 20 MEQ ORAL TBTQ $2.28 63304-987-01 POTASSIUM CHLORIDE 20 MEQ ORAL TBTQ $2.28 6025819001 PRENATAL VIT,CAL 78-IRON-FOLIC 29-1 MG ORAL TAB $2.28 16714-085-01 SPIRONOLACTONE 50 MG ORAL TAB $2.28 51672-4023-1 ACETAZOLAMIDE 250 MG ORAL TAB $2.28 64380-834-06 ACETAZOLAMIDE 250 MG ORAL TAB $2.28 23155-288-01 ACETAZOLAMIDE 250 MG ORAL TAB $2.28 70756-721-11 ACETAZOLAMIDE 250 MG ORAL TAB $2.28 47335-956-88 ALFUZOSIN 10 MG ORAL TB24 $2.28 29300-155-01 ALFUZOSIN 10 MG ORAL TB24 $2.28 60505-2850-1 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 5901642019 MAGNESIUM L-LACTATE 84 MG ORAL TBSR $2.28 3676542019 MAGNESIUM L-LACTATE 84 MG ORAL TBSR $2.28 3676542001 MAGNESIUM L-LACTATE 84 MG ORAL TBSR $2.28 0054-0710-20 METHADONE 10 MG ORAL TAB $2.28 50742-239-01 MEXILETINE 150 MG ORAL CAP $2.28 31722-036-01 MEXILETINE 150 MG ORAL CAP $2.28 69452-150-20 VALPROIC ACID 250 MG ORAL CAP $2.28 0093-1723-01 WARFARIN 7.5 MG ORAL TAB $2.28 99999-037-96 MEGESTROL 20 MG ORAL PARTIAL TAB $2.27 60505-3113-0 OLANZAPINE 10 MG ORAL TAB $2.27 59746-113-06 PROCHLORPERAZINE MALEATE 5 MG ORAL TAB $2.27 68382-256-01 OXYBUTYNIN CHLORIDE 10 MG ORAL TR24 $2.26 68382-256-05 OXYBUTYNIN CHLORIDE 10 MG ORAL TR24 $2.26 68382-255-01 OXYBUTYNIN CHLORIDE 5 MG ORAL TR24 $2.26 1678414012 AMMONIA AROMATIC 15 % (W/V) INHALATION SOLN $2.24 67777-251-01 AMMONIA AROMATIC 15 % (W/V) INHALATION SOLN $2.24 0527-2961-37 CHLORPROMAZINE 10 MG ORAL TAB $2.24 7733344110 LACTOBACILLUS ACIDOPH-L.BULGAR 1 MILLION CELL ORAL TAB $2.24 7733344125 LACTOBACILLUS ACIDOPH-L.BULGAR 1 MILLION CELL ORAL TAB $2.24 70954-688-10 PROCHLORPERAZINE MALEATE 5 MG ORAL TAB $2.24 50268-193-11 CLONIDINE HCL 0.2 MG ORAL TAB $2.24 50268-193-15 CLONIDINE HCL 0.2 MG ORAL TAB $2.24 53746-641-01 FLECAINIDE 50 MG ORAL TAB $2.24 0591-5555-01 PROPRANOLOL 20 MG ORAL TAB $2.24 68180-590-01 RAMIPRIL 5 MG ORAL CAP $2.24 68180-469-01 LOVASTATIN 40 MG ORAL TAB $2.23 50268-350-11 GEMFIBROZIL 600 MG ORAL TAB $2.22 50268-350-15 GEMFIBROZIL 600 MG ORAL TAB $2.22 33342-063-10 VALSARTAN 80 MG ORAL TAB $2.22 65862-571-90 VALSARTAN 80 MG ORAL TAB $2.22 68462-337-01 FLUPHENAZINE HCL 5 MG ORAL TAB $2.22 69097-856-05 FOSINOPRIL 10 MG ORAL TAB $2.22 0904-6618-61 HYDROXYZINE HCL 50 MG ORAL TAB $2.22 53489-148-01 THIORIDAZINE 10 MG ORAL TAB $2.22 42799-119-01 BUMETANIDE 0.5 MG ORAL TAB $2.21 69238-1489-1 BUMETANIDE 0.5 MG ORAL TAB $2.21 69238-1490-1 BUMETANIDE 1 MG ORAL TAB $2.21 42799-120-01 BUMETANIDE 1 MG ORAL TAB $2.21 50268-756-11 TORSEMIDE 20 MG ORAL TAB $2.21 50268-756-15 TORSEMIDE 20 MG ORAL TAB $2.21 57664-394-88 VENLAFAXINE 50 MG ORAL TAB $2.21 68382-020-01 VENLAFAXINE 50 MG ORAL TAB $2.21 6498010401 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 6936725001 SOD PHOS DI, MONO-K PHOS MONO 250 MG ORAL TAB $2.20 99999-036-43 AZATHIOPRINE 25 MG ORAL PARTIAL TAB $2.20 59762-2198-3 AZITHROMYCIN 250 MG ORAL TAB $2.20 59762-2198-1 AZITHROMYCIN 250 MG ORAL TAB $2.20 16729-078-01 CARBIDOPA-LEVODOPA 25-100 MG ORAL TBSR $2.20 50268-505-11 LOSARTAN 50 MG ORAL TAB $2.20 50268-505-15 LOSARTAN 50 MG ORAL TAB $2.20 65862-692-01 PHENYTOIN SODIUM EXTENDED 100 MG ORAL CAP $2.20 0093-1718-01 WARFARIN 6 MG ORAL TAB $2.20 51672-4033-1 WARFARIN 6 MG ORAL TAB $2.20 50268-192-11 CLONIDINE 0.1 MG ORAL TAB (MCH) $2.19 50268-192-15 CLONIDINE 0.1 MG ORAL TAB (MCH) $2.19 69238-1836-1 LEVOTHYROXINE 125 MCG ORAL TAB $2.19 50268-521-15 METHOCARBAMOL 750 MG ORAL TAB $2.19 50268-521-11 METHOCARBAMOL 750 MG ORAL TAB $2.19 31722-721-50 LEVOFLOXACIN 250 MG ORAL TAB $2.18 0904-7336-61 CEPHALEXIN 250 MG ORAL CAP $2.18 0054-0019-20 PREDNISONE 50 MG ORAL TAB $2.18 16729-041-01 TACROLIMUS 0.5 MG ORAL CAP $2.18 0904-6637-61 GLIPIZIDE 5 MG ORAL TAB $2.17 0054-0021-25 LITHIUM CARBONATE 300 MG ORAL TBSR $2.17 70010-136-01 POTASSIUM CHLORIDE 10 MEQ ORAL TBTQ $2.17 16714-631-01 ALENDRONATE 10 MG ORAL TAB $2.17 51672-4011-5 CLOMIPRAMINE 25 MG ORAL CAP $2.17 69452-131-17 DOFETILIDE 125 MCG ORAL CAP $2.17 72205-039-60 DOFETILIDE 125 MCG ORAL CAP $2.17 72205-040-60 DOFETILIDE 250 MCG ORAL CAP $2.17 69452-133-17 DOFETILIDE 500 MCG ORAL CAP $2.17 72205-041-60 DOFETILIDE 500 MCG ORAL CAP $2.17 57237-018-30 DULOXETINE 30 MG ORAL CPDR $2.17 57237-019-30 DULOXETINE 60 MG ORAL CPDR $2.17 57237-003-30 FLUCONAZOLE 50 MG ORAL TAB $2.17 43547-278-09 IRBESARTAN 150 MG ORAL TAB $2.17 43547-278-03 IRBESARTAN 150 MG ORAL TAB $2.17 43547-375-09 IRBESARTAN 150 MG ORAL TAB $2.17 60505-3110-3 OLANZAPINE 2.5 MG ORAL TAB $2.17 62332-131-30 OLMESARTAN 5 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 69238-1420-3 SILODOSIN 8 MG ORAL CAP $2.17 50228-427-90 SOLIFENACIN 5 MG ORAL TAB $2.17 50228-427-30 SOLIFENACIN 5 MG ORAL TAB $2.17 72205-020-90 SOLIFENACIN 5 MG ORAL TAB $2.17 69452-344-60 SUMATRIPTAN SUCCINATE 25 MG ORAL TAB $2.17 69452-344-72 SUMATRIPTAN SUCCINATE 25 MG ORAL TAB $2.17 65862-146-36 SUMATRIPTAN SUCCINATE 25 MG ORAL TAB $2.17 0378-5813-77 VALSARTAN 80 MG ORAL TAB $2.17 62584-994-11 WARFARIN 5 MG ORAL TAB $2.16 62584-994-01 WARFARIN 5 MG ORAL TAB $2.16 99999-042-01 MISOPROSTOL 50 MCG ORAL PARTIAL TAB (USING 100 MCG TAB) $2.15 0904-6808-06 MONTELUKAST 10 MG ORAL TAB $2.15 64380-759-06 ACARBOSE 50 MG ORAL TAB $2.15 0904-7041-61 ALLOPURINOL 100 MG ORAL TAB $2.15 99999-047-15 ALUM-MAG HYDROXIDE-SIMETH 400-400-40 MG/5 ML ORAL SUSP $2.15 0904-5959-61 CLINDAMYCIN HCL 150 MG ORAL CAP $2.15 59651-381-01 CLOMIPRAMINE 25 MG ORAL CAP $2.15 0378-1800-77 LEVOTHYROXINE 25 MCG ORAL TAB $2.15 0406-5771-23 METHADONE 10 MG ORAL TAB $2.15 0904-6808-61 MONTELUKAST 10 MG ORAL TAB $2.15 50268-556-11 MONTELUKAST 10 MG ORAL TAB $2.15 50268-556-15 MONTELUKAST 10 MG ORAL TAB $2.15 0591-2729-01 POTASSIUM CITRATE 10 MEQ (1,080 MG) ORAL TBSR $2.15 42806-549-09 DUTASTERIDE 0.5 MG ORAL CAP $2.14 50268-431-15 INDOMETHACIN 50 MG ORAL CAP $2.13 50268-431-11 INDOMETHACIN 50 MG ORAL CAP $2.13 0904-6966-61 OXYCODONE 5 MG ORAL TAB $2.13 70710-1137-3 FLUCONAZOLE 50 MG ORAL TAB $2.13 68180-589-01 RAMIPRIL 2.5 MG ORAL CAP $2.13 16714-647-01 PIOGLITAZONE 45 MG ORAL TAB $2.12 16714-647-02 PIOGLITAZONE 45 MG ORAL TAB $2.12 0054-0019-25 PREDNISONE 50 MG ORAL TAB $2.12 99999-036-38 DANTROLENE 5 MG/ML ORAL LIQUID $2.11 0904-6861-90 DIVALPROEX 500 MG ORAL TBEC $2.11 60687-327-01 QUETIAPINE 25 MG ORAL TAB $2.11 60687-327-11 QUETIAPINE 25 MG ORAL TAB $2.11 31722-152-90 VALSARTAN 80 MG ORAL TAB $2.11 60687-152-11 CEPHALEXIN 250 MG ORAL CAP $2.11 60687-152-01 CEPHALEXIN 250 MG ORAL CAP $2.11 0904-7058-61 METHOCARBAMOL 750 MG ORAL TAB $2.10 68084-045-11 PAROXETINE HCL 20 MG ORAL TAB $2.10 68084-045-01 PAROXETINE HCL 20 MG ORAL TAB $2.10 68462-293-01 VERAPAMIL 180 MG ORAL TBSR $2.10 0093-0320-01 DILTIAZEM HCL 90 MG ORAL TAB $2.09 59746-001-06 METHYLPREDNISOLONE 4 MG ORAL TAB $2.09 50268-534-15 METRONIDAZOLE 250 MG ORAL TAB $2.09 50268-534-11 METRONIDAZOLE 250 MG ORAL TAB $2.09 0093-9148-01 VENLAFAXINE 37.5 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 65862-536-50 LEVOFLOXACIN 250 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 0536-1362-25 NICOTINE (POLACRILEX) 2 MG BUCCAL GUM $2.08 51293-810-01 PHENAZOPYRIDINE 100 MG ORAL TAB $2.08 65162-681-10 PHENAZOPYRIDINE 100 MG ORAL TAB $2.08 51293-611-01 PHENAZOPYRIDINE 100 MG ORAL TAB $2.08 99999-044-18 PHENYLEPHRINE 100 MCG/ML INJ DILUTION $2.08 68382-035-16 VENLAFAXINE 75 MG ORAL CP24 $2.08 16714-813-02 EZETIMIBE 10 MG ORAL TAB $2.07 50268-504-15 LOSARTAN 25 MG ORAL TAB $2.07 50268-504-11 LOSARTAN 25 MG ORAL TAB $2.07 0406-8515-01 OXYCODONE 15 MG ORAL TAB $2.07 47335-904-88 QUETIAPINE 100 MG ORAL TAB $2.07 0904-6292-61 ATORVASTATIN 40 MG ORAL TAB $2.07 0093-2065-06 CILOSTAZOL 50 MG ORAL TAB $2.07 0228-2597-11 INDAPAMIDE 1.25 MG ORAL TAB $2.07 72603-118-01 MEMANTINE 5 MG ORAL TAB $2.07 65162-572-10 BETHANECHOL CHLORIDE 10 MG ORAL TAB $2.06 53746-572-01 BETHANECHOL CHLORIDE 10 MG ORAL TAB $2.06 0228-2550-11 DICLOFENAC SODIUM 50 MG ORAL TBEC $2.06 23155-773-01 ENALAPRIL MALEATE 20 MG ORAL TAB $2.06 68084-618-11 ESCITALOPRAM OXALATE 20 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 68382-773-06 EZETIMIBE 10 MG ORAL TAB $2.05 68382-773-16 EZETIMIBE 10 MG ORAL TAB $2.05 68382-773-05 EZETIMIBE 10 MG ORAL TAB $2.05 51079-810-20 GLIPIZIDE 5 MG ORAL TAB $2.05 23155-106-01 HYDROXYZINE HCL 25 MG ORAL TAB $2.05 60687-675-11 HYDROXYZINE HCL 25 MG ORAL TAB $2.05 60687-675-01 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 5026886715 CHOLECALCIFEROL (VITAMIN D3) 50 MCG (2,000 UNIT) ORAL CAP $2.05 5026886711 CHOLECALCIFEROL (VITAMIN D3) 50 MCG (2,000 UNIT) ORAL CAP $2.05 68462-229-01 LAMOTRIGINE 25 MG ORAL TCHD $2.05 50268-644-11 OXYCODONE-ACETAMINOPHEN 5-325 MG ORAL TAB $2.05 50268-644-15 OXYCODONE-ACETAMINOPHEN 5-325 MG ORAL TAB $2.05 51079-205-20 ALLOPURINOL 100 MG ORAL TAB $2.04 51079-205-01 ALLOPURINOL 100 MG ORAL TAB $2.04 16729-280-01 ARIPIPRAZOLE 10 MG ORAL TAB $2.04 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 72603-338-01 POTASSIUM CHLORIDE 20 MEQ ORAL TBTQ $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 60687-568-11 METHOCARBAMOL 750 MG ORAL TAB $2.02 60687-568-01 METHOCARBAMOL 750 MG ORAL TAB $2.02 10702-008-01 OXYCODONE 15 MG ORAL TAB $2.02 68382-144-06 RAMIPRIL 1.25 MG ORAL CAP $2.02 68180-589-02 RAMIPRIL 2.5 MG ORAL CAP $2.02 65862-670-01 REPAGLINIDE 0.5 MG ORAL TAB $2.02 57664-745-88 REPAGLINIDE 1 MG ORAL TAB $2.02 65862-671-01 REPAGLINIDE 1 MG ORAL TAB $2.02 57237-159-01 REPAGLINIDE 2 MG ORAL TAB $2.02 65862-672-01 REPAGLINIDE 2 MG ORAL TAB $2.02 68462-260-01 VERAPAMIL 240 MG ORAL TBSR $2.02 23155-026-01 VERAPAMIL 80 MG ORAL TAB $2.02 51079-208-20 ATORVASTATIN 10 MG ORAL TAB $2.01 51079-208-01 ATORVASTATIN 10 MG ORAL TAB $2.01 0054-8174-25 DEXAMETHASONE (PEDS ONC) 1MG TAB $2.01 60687-833-01 HYDRALAZINE 50 MG ORAL TAB $2.01 60687-833-11 HYDRALAZINE 50 MG ORAL TAB $2.01 0904-5448-61 PENTOXIFYLLINE 400 MG ORAL TBSR $2.01 45802-732-00 ACETAMINOPHEN 120 MG RECTAL SUPP $2.00 45802-732-30 ACETAMINOPHEN 120 MG RECTAL SUPP $2.00 0904-7243-61 CIPROFLOXACIN HCL 500 MG ORAL TAB $2.00 69238-1305-1 CLOBAZAM 10 MG ORAL TAB $2.00 42571-315-01 CLOBAZAM 10 MG ORAL TAB $2.00 51079-544-01 ESCITALOPRAM OXALATE 20 MG ORAL TAB $2.00 0054-0709-20 METHADONE 5 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 72888-182-30 BUPRENORPHINE HCL 2 MG SL SUBL $2.00 0904-7337-35 CEPHALEXIN 500 MG ORAL CAP $2.00 0904-7337-06 CEPHALEXIN 500 MG ORAL CAP $2.00 0555-0886-02 ESTRADIOL 1 MG ORAL TAB $2.00 0555-0886-04 ESTRADIOL 1 MG ORAL TAB $2.00 50268-755-11 TORSEMIDE 10 MG ORAL TAB $2.00 50268-755-15 TORSEMIDE 10 MG ORAL TAB $2.00 65862-663-30 ARIPIPRAZOLE 10 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 65162-896-09 ARIPIPRAZOLE 2 MG ORAL TAB $1.99 65162-897-03 ARIPIPRAZOLE 5 MG ORAL TAB $1.99 65862-662-30 ARIPIPRAZOLE 5 MG ORAL TAB $1.99 65162-897-09 ARIPIPRAZOLE 5 MG ORAL TAB $1.99 0023-0506-01 POLYVINYL ALCOHOL-POVIDONE(PF) 1.4-0.6 % OPHT DPET $1.99 50268-631-11 QUETIAPINE 50 MG ORAL TAB $1.99 50268-631-15 QUETIAPINE 50 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 60687-377-11 ALPRAZOLAM 0.25 MG ORAL TAB $1.98 60687-377-01 ALPRAZOLAM 0.25 MG ORAL TAB $1.98 60687-113-11 CLONIDINE 0.1 MG ORAL TAB (MCH) $1.98 60687-113-01 CLONIDINE 0.1 MG ORAL TAB (MCH) $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 50111-333-01 METRONIDAZOLE 250 MG ORAL TAB $1.98 60505-5307-1 ACYCLOVIR 800 MG ORAL TAB $1.97 60687-394-83 IPRATROPIUM BROMIDE 0.02 % INHALATION SOLN $1.97 60687-394-79 IPRATROPIUM BROMIDE 0.02 % INHALATION SOLN $1.97 0904-6291-61 ATORVASTATIN 20 MG ORAL TAB $1.96 60687-528-11 CIPROFLOXACIN HCL 250 MG ORAL TAB $1.96 69452-275-20 KETOROLAC 10 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 245010801 FERROUS SULFATE 325 MG (65 MG IRON) ORAL TBEC $1.96 63304-450-01 MORPHINE 15 MG ORAL TBSR $1.96 59651-489-01 PREDNISONE 50 MG ORAL TAB $1.96 29300-150-01 QUETIAPINE 200 MG ORAL TAB $1.96 64380-758-06 ACARBOSE 25 MG ORAL TAB $1.95 0487-9501-01 ALBUTEROL SULFATE 2.5 MG /3 ML (0.083 %) INHALATION NEBU $1.95 99999-047-09 ALUM-MAG HYDROXIDE-SIMETH 200-200-20 MG/5 ML ORAL SUSP $1.95 16729-035-10 ANASTROZOLE 1 MG ORAL TAB $1.95 16729-035-15 ANASTROZOLE 1 MG ORAL TAB $1.95 51991-620-33 ANASTROZOLE 1 MG ORAL TAB $1.95 33342-123-07 ARIPIPRAZOLE 5 MG ORAL TAB $1.95 50228-158-01 CELECOXIB 200 MG ORAL CAP $1.95 70010-002-01 COLCHICINE 0.6 MG ORAL TAB $1.95 72578-170-01 DEXAMETHASONE 1.5 MG ORAL TAB $1.95 99999-045-83 DEXTROSE 50 % IN WATER (D50W) IV SYRG $1.95 53489-120-02 DOXYCYCLINE HYCLATE 100 MG ORAL TAB $1.95 53489-120-05 DOXYCYCLINE HYCLATE 100 MG ORAL TAB $1.95 51991-746-90 DULOXETINE 20 MG ORAL CPDR $1.95 27241-097-06 DULOXETINE 20 MG ORAL CPDR $1.95 68180-294-07 DULOXETINE 20 MG ORAL CPDR $1.95 68180-295-09 DULOXETINE 30 MG ORAL CPDR $1.95 68180-295-06 DULOXETINE 30 MG ORAL CPDR $1.95 68180-296-06 DULOXETINE 60 MG ORAL CPDR $1.95 27241-099-03 DULOXETINE 60 MG ORAL CPDR $1.95 68180-296-09 DULOXETINE 60 MG ORAL CPDR $1.95 69238-1154-3 EZETIMIBE 10 MG ORAL TAB $1.95 245010889 FERROUS SULFATE 325 MG (65 MG IRON) ORAL TBEC $1.95 0054-0264-24 HYDROMORPHONE 4 MG ORAL TAB $1.95 16477-738-01 HYOSCYAMINE SULFATE 0.375 MG ORAL TB12 $1.95 0487-9801-01 IPRATROPIUM BROMIDE 0.02 % INHALATION SOLN $1.95 0487-0201-03 IPRATROPIUM-ALBUTEROL 0.5 MG-3 MG(2.5 MG BASE)/3 ML INHALATION NEBU $1.95 0487-0201-00 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 69097-173-53 IPRATROPIUM-ALBUTEROL 0.5 MG-3 MG(2.5 MG BASE)/3 ML INHALATION NEBU $1.95 68462-228-01 LAMOTRIGINE 5 MG ORAL TCHD $1.95 0093-7620-56 LETROZOLE 2.5 MG ORAL TAB $1.95 59651-180-30 LETROZOLE 2.5 MG ORAL TAB $1.95 23155-875-03 LETROZOLE 2.5 MG ORAL TAB $1.95 99999-044-66 MAGNESIUM SULFATE 0.5 MEQ/ML INJ SOLN $1.95 72578-005-06 MODAFINIL 100 MG ORAL TAB $1.95 99999-033-48 OXALIPLATIN IV SOLN (FOR DESENSITIZATION USE) (MHS) $1.95 68462-137-01 OXCARBAZEPINE 150 MG ORAL TAB $1.95 62756-183-88 OXCARBAZEPINE 150 MG ORAL TAB $1.95 0904-6474-61 PANTOPRAZOLE 40 MG ORAL TBEC $1.95 5789684401 POTASSIUM, SODIUM PHOSPHATES 280-160-250 MG ORAL PWPK $1.95 60687-570-11 PRAMIPEXOLE 0.25 MG ORAL TAB $1.95 60687-570-01 PRAMIPEXOLE 0.25 MG ORAL TAB $1.95 37000-024-10 PSYLLIUM HUSK 3.4 GRAM ORAL PWPK $1.95 0487-9301-33 SODIUM CHLORIDE 0.9 % INHALATION NEBU $1.95 50268-728-11 SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG ORAL TAB $1.95 50268-728-15 SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG ORAL TAB $1.95 99999-010-04 VANCOMYCIN SUBCONJUNCTIVAL INJECTION (MHS) $1.95 50268-520-15 METHOCARBAMOL 500 MG ORAL TAB $1.94 50268-520-11 METHOCARBAMOL 500 MG ORAL TAB $1.94 51079-201-20 METHYLDOPA 500 MG ORAL TAB $1.94 51079-201-01 METHYLDOPA 500 MG ORAL TAB $1.94 41167-00606 DOXYLAMINE SUCCINATE 25 MG ORAL TAB $1.94 4116700607 DOXYLAMINE SUCCINATE 25 MG ORAL TAB $1.94 68084-342-11 TOPIRAMATE 25 MG ORAL TAB $1.94 68084-342-01 TOPIRAMATE 25 MG ORAL TAB $1.94 75907-020-01 CARBIDOPA-LEVODOPA 25-100 MG ORAL TAB $1.93 0023-0403-30 CARBOXYMETHYLCELLULOSE SODIUM 0.5 % OPHT DPET $1.93 60505-0247-1 MIRTAZAPINE 15 MG ORAL TAB $1.93 0378-3515-93 MIRTAZAPINE 15 MG ORAL TAB $1.93 57237-008-30 MIRTAZAPINE 15 MG ORAL TAB $1.93 13107-031-34 MIRTAZAPINE 15 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 0904-6993-61 AMIODARONE 200 MG ORAL TAB $1.92 68180-122-01 CEPHALEXIN 500 MG ORAL CAP $1.92 0904-7449-61 HYDRALAZINE 50 MG ORAL TAB $1.92 10702-016-06 INDOMETHACIN 75 MG ORAL CPSR $1.92 68462-224-01 LITHIUM CARBONATE 450 MG ORAL TBSR $1.92 65862-921-27 SEVELAMER CARBONATE 800 MG ORAL TAB $1.92 50268-093-15 ATORVASTATIN 10 MG ORAL TAB $1.92 50268-093-11 ATORVASTATIN 10 MG ORAL TAB $1.92 50268-061-15 ACYCLOVIR 400 MG ORAL TAB $1.91 50268-061-11 ACYCLOVIR 400 MG ORAL TAB $1.91 0054-8527-25 LITHIUM CARBONATE 300 MG ORAL CAP $1.91 64380-720-06 TACROLIMUS 0.5 MG ORAL CAP $1.91 70756-703-60 RANOLAZINE 500 MG ORAL TB12 $1.90 70377-015-11 TACROLIMUS 1 MG ORAL CAP $1.90 76204-200-30 ALBUTEROL SULFATE 2.5 MG /3 ML (0.083 %) INHALATION NEBU $1.89 72888-046-01 PRIMIDONE 250 MG ORAL TAB $1.89 71930-056-12 ACETAMINOPHEN-CODEINE 300-60 MG ORAL TAB $1.89 50742-114-01 DESIPRAMINE 50 MG ORAL TAB $1.89 68084-248-11 LORATADINE 10 MG ORAL TAB $1.89 68084-248-01 LORATADINE 10 MG ORAL TAB $1.89 0406-5755-23 METHADONE 5 MG ORAL TAB $1.89 0904-6638-61 QUETIAPINE 25 MG ORAL TAB $1.89 51079-733-20 HALOPERIDOL 0.5 MG ORAL TAB $1.88 51079-733-01 HALOPERIDOL 0.5 MG ORAL TAB $1.88 60687-395-79 ALBUTEROL SULFATE 2.5 MG /3 ML (0.083 %) FOR CONTINUOUS NEBULIZATION $1.87 60687-395-83 ALBUTEROL SULFATE 2.5 MG /3 ML (0.083 %) FOR CONTINUOUS NEBULIZATION $1.87 68180-122-02 CEPHALEXIN 500 MG ORAL CAP $1.87 23155-723-01 LABETALOL 100 MG ORAL TAB $1.87 70756-014-02 NITROGLYCERIN 0.4 MG SL SUBL $1.87 70756-014-05 NITROGLYCERIN 0.4 MG SL SUBL $1.87 63739-564-10 PANTOPRAZOLE 40 MG ORAL TBEC $1.87 77333-844-10 SODIUM CHLORIDE 1,000 MG MISC TBSO $1.87 77333-844-25 SODIUM CHLORIDE 1,000 MG MISC TBSO $1.87 76385-114-01 SOTALOL 80 MG ORAL TAB $1.87 0781-1487-01 AMITRIPTYLINE 25 MG ORAL TAB $1.86 59762-0074-1 HYDROCORTISONE 10 MG ORAL TAB $1.86 59651-414-01 HYDROCORTISONE 10 MG ORAL TAB $1.86 0591-5660-01 SULINDAC 200 MG ORAL TAB $1.86 16714-175-03 ATORVASTATIN 40 MG ORAL TAB $1.85 50268-152-11 CEPHALEXIN 500 MG ORAL CAP $1.85 50268-152-15 CEPHALEXIN 500 MG ORAL CAP $1.85 99999-007-60 HYDROCORTISONE 2 MG/ML ORAL LIQUID (COMPOUND) $1.85 50580-932-01 IBUPROFEN 100 MG ORAL CHEW $1.85 68382-799-01 LABETALOL 200 MG ORAL TAB $1.85 63739-787-10 LEVETIRACETAM 750 MG ORAL TAB $1.85 99999-040-66 MULTIVIT-MIN-FERROUS GLUCONATE 9 MG IRON/15 ML ORAL LIQD $1.85 51079-051-20 PANTOPRAZOLE 40 MG ORAL TBEC $1.85 51079-051-01 PANTOPRAZOLE 40 MG ORAL TBEC $1.85 0378-0182-01 PROPRANOLOL 10 MG ORAL TAB $1.85 53489-328-01 SPIRONOLACTONE 50 MG ORAL TAB $1.85 59762-0104-5 SULFASALAZINE 500 MG ORAL TBEC $1.85 50268-740-15 TAMSULOSIN 0.4 MG ORAL CAP $1.85 50268-740-11 TAMSULOSIN 0.4 MG ORAL CAP $1.85 0093-7385-98 VENLAFAXINE 75 MG ORAL CP24 $1.85 0378-0137-01 ALLOPURINOL 100 MG ORAL TAB $1.85 50268-361-11 GLIPIZIDE 5 MG ORAL TAB $1.85 50268-361-15 GLIPIZIDE 5 MG ORAL TAB $1.85 5026837515 GLUCOSAMINE SULFATE 500 MG ORAL CAP $1.85 5026837511 GLUCOSAMINE SULFATE 500 MG ORAL CAP $1.85 16714-035-01 LEVETIRACETAM 500 MG ORAL TAB $1.85 0904-7125-61 LEVETIRACETAM 750 MG ORAL TAB $1.85 99999-041-94 CARBAMAZEPINE 100 MG ORAL PARTIAL TAB $1.84 16571-201-06 DICLOFENAC SODIUM 75 MG ORAL TBEC $1.84 50742-248-30 DILTIAZEM HCL 120 MG ORAL CP24 $1.84 50268-067-30 CARBOXYMETHYLCELLULOSE SODIUM 0.5 % OPHT DPET $1.83 99999-040-50 CEFEPIME 40 MG/ML INJ SYRINGE $1.83 60505-2657-1 TRIAMTERENE-HYDROCHLOROTHIAZID 75-50 MG ORAL TAB $1.83 0591-0348-01 TRIAMTERENE-HYDROCHLOROTHIAZID 75-50 MG ORAL TAB $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 23155-191-01 BUPROPION HCL 75 MG ORAL TAB $1.82 24689-119-01 BUPROPION HCL 75 MG ORAL TAB $1.82 69238-1100-5 DOXYCYCLINE HYCLATE 100 MG ORAL CAP $1.82 0143-2112-05 DOXYCYCLINE HYCLATE 100 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 62584-267-11 METOPROLOL TARTRATE 100 MG ORAL TAB $1.82 62584-267-01 METOPROLOL TARTRATE 100 MG ORAL TAB $1.82 42858-003-01 OXYCODONE 15 MG ORAL TAB $1.82 0023-0506-50 POLYVINYL ALCOHOL-POVIDONE(PF) 1.4-0.6 % OPHT DPET $1.82 0093-1061-01 SOTALOL 80 MG ORAL TAB $1.82 65862-528-30 VENLAFAXINE 75 MG ORAL CP24 $1.82 31722-003-30 VENLAFAXINE 75 MG ORAL CP24 $1.82 45802-730-00 ACETAMINOPHEN 650 MG RECTAL SUPP $1.81 45802-730-32 ACETAMINOPHEN 650 MG RECTAL SUPP $1.81 50268-094-11 ATORVASTATIN 20 MG ORAL TAB $1.81 0904-7093-61 OXYCODONE-ACETAMINOPHEN 5-325 MG ORAL TAB $1.81 7620430003 SODIUM CHLORIDE 0.9 % INHALATION NEBU $1.81 57237-114-90 ALFUZOSIN 10 MG ORAL TB24 $1.81 16714-159-01 ONDANSETRON HCL 4 MG ORAL TAB $1.81 50268-585-15 PANTOPRAZOLE 20 MG ORAL TBEC $1.81 50268-585-11 PANTOPRAZOLE 20 MG ORAL TBEC $1.81 51079-076-01 HYDRALAZINE 50 MG ORAL TAB $1.80 51079-076-20 HYDRALAZINE 50 MG ORAL TAB $1.80 0023-0403-50 CARBOXYMETHYLCELLULOSE SODIUM 0.5 % OPHT DPET $1.79 0904-7458-61 PANTOPRAZOLE 20 MG ORAL TBEC $1.79 8349030760 SODIUM CHLORIDE 7 % INHALATION NEBU $1.79 4422930760 SODIUM CHLORIDE 7 % INHALATION NEBU $1.79 50742-261-01 NIFEDIPINE 60 MG ORAL TR24 $1.79 99999-042-31 OXCARBAZEPINE 150 MG ORAL PARTIAL TAB $1.79 0591-5554-01 PROPRANOLOL 10 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 0904-6928-61 TOPIRAMATE 25 MG ORAL TAB $1.79 60505-2656-1 TRIAMTERENE-HYDROCHLOROTHIAZID 37.5-25 MG ORAL TAB $1.79 0378-1352-01 TRIAMTERENE-HYDROCHLOROTHIAZID 37.5-25 MG ORAL TAB $1.79 65862-941-88 NORETHINDRONE-E.ESTRADIOL-IRON 1.5 MG-30 MCG (21)/75 MG (7) ORAL TAB $1.78 65862-941-87 NORETHINDRONE-E.ESTRADIOL-IRON 1.5 MG-30 MCG (21)/75 MG (7) ORAL TAB $1.78 60687-811-11 HYDRALAZINE 10 MG ORAL TAB $1.78 60687-811-01 HYDRALAZINE 10 MG ORAL TAB $1.78 0904-7361-61 RISPERIDONE 0.5 MG ORAL TAB $1.78 0591-5337-10 TRIHEXYPHENIDYL 5 MG ORAL TAB $1.78 0536-1387-92 CARBOXYMETHYLCELLULOSE SODIUM 0.5 % OPHT DPET $1.77 59651-052-90 EZETIMIBE 10 MG ORAL TAB $1.77 68462-302-01 INDOMETHACIN 50 MG ORAL CAP $1.77 64380-159-03 MEGESTROL 40 MG ORAL TAB $1.77 16714-646-02 PIOGLITAZONE 30 MG ORAL TAB $1.77 16714-646-01 PIOGLITAZONE 30 MG ORAL TAB $1.77 70954-021-10 PRAZOSIN 5 MG ORAL CAP $1.77 69452-207-13 CALCITRIOL 0.25 MCG ORAL CAP $1.76 64380-723-06 CALCITRIOL 0.25 MCG ORAL CAP $1.76 23155-662-03 CALCITRIOL 0.25 MCG ORAL CAP $1.76 69452-207-20 CALCITRIOL 0.25 MCG ORAL CAP $1.76 5026886615 CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) ORAL TAB $1.76 5026886611 CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) ORAL TAB $1.76 62559-230-01 PROPAFENONE 150 MG ORAL TAB $1.76 68382-227-14 AMIODARONE 200 MG ORAL TAB $1.76 29300-359-16 AMIODARONE 200 MG ORAL TAB $1.76 51672-4025-4 AMIODARONE 200 MG ORAL TAB $1.76 47335-737-86 BUPROPION HCL 150 MG ORAL SR12 $1.76 0591-3541-25 BUPROPION HCL 150 MG ORAL SR12 $1.76 0591-3541-60 BUPROPION HCL 150 MG ORAL SR12 $1.76 60687-664-01 HYDROXYZINE HCL 10 MG ORAL TAB $1.76 60687-664-11 HYDROXYZINE HCL 10 MG ORAL TAB $1.76 16714-354-01 LEVETIRACETAM 250 MG ORAL TAB $1.76 60687-657-11 LEVETIRACETAM 500 MG ORAL TAB $1.76 60687-657-01 LEVETIRACETAM 500 MG ORAL TAB $1.76 50268-595-11 NAPROXEN 375 MG ORAL TAB $1.76 50268-595-15 NAPROXEN 375 MG ORAL TAB $1.76 75826-114-10 PHENAZOPYRIDINE 100 MG ORAL TAB $1.76 0527-4118-37 PROPRANOLOL 120 MG ORAL CS24 $1.76 0093-2210-01 SUCRALFATE 1 GRAM ORAL TAB $1.76 0054-8528-25 LITHIUM CARBONATE 300 MG ORAL TAB $1.75 62756-518-18 CARBIDOPA-LEVODOPA 25-100 MG ORAL TAB $1.74 99999-000-41 MIDAZOLAM 0.5 MG/ML NICU INJECTION $1.74 31722-819-30 ARIPIPRAZOLE 2 MG ORAL TAB $1.74 31722-820-30 ARIPIPRAZOLE 5 MG ORAL TAB $1.74 29300-127-13 BISOPROLOL FUMARATE 10 MG ORAL TAB $1.74 29300-126-13 BISOPROLOL FUMARATE 5 MG ORAL TAB $1.74 42806-658-30 ENTECAVIR 0.5 MG ORAL TAB $1.74 59762-0540-1 GLIPIZIDE 2.5 MG ORAL TR24 $1.74 0904-6986-40 GUAIFENESIN 600 MG ORAL TA12 $1.74 31722-730-30 IRBESARTAN 150 MG ORAL TAB $1.74 33342-048-07 IRBESARTAN 150 MG ORAL TAB $1.74 68462-678-60 LACOSAMIDE 50 MG ORAL TAB $1.74 13107-031-05 MIRTAZAPINE 15 MG ORAL TAB $1.74 0378-5807-93 VALSARTAN 40 MG ORAL TAB $1.74 51672-4002-1 NORTRIPTYLINE 25 MG ORAL CAP $1.73 0093-0811-01 NORTRIPTYLINE 25 MG ORAL CAP $1.73 75907-070-01 NORTRIPTYLINE 25 MG ORAL CAP $1.73 16714-795-01 TERBINAFINE HCL 250 MG ORAL TAB $1.73 68084-372-11 ACETAMINOPHEN-CODEINE 300-30 MG ORAL TAB $1.72 68382-227-05 AMIODARONE 200 MG ORAL TAB $1.72 65862-732-05 AMIODARONE 200 MG ORAL TAB $1.72 51991-348-06 LACOSAMIDE 50 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 65162-837-03 VALSARTAN 40 MG ORAL TAB $1.72 7733311025 CALCIUM CARBONATE-VITAMIN D3 500 MG-5 MCG (200 UNIT) ORAL TAB $1.72 7733311010 CALCIUM CARBONATE-VITAMIN D3 500 MG-5 MCG (200 UNIT) ORAL TAB $1.72 50268-489-15 LORATADINE 10 MG ORAL TAB $1.72 50268-489-11 LORATADINE 10 MG ORAL TAB $1.72 0904-7057-61 METHOCARBAMOL 500 MG ORAL TAB $1.72 67618-101-60 DOCUSATE SODIUM 100 MG ORAL CAP $1.71 0574-7050-50 BISACODYL 10 MG RECTAL SUPP $1.70 0378-0078-01 CARBIDOPA-LEVODOPA 10-100 MG ORAL TAB $1.70 50268-662-15 PROPRANOLOL 10 MG ORAL TAB $1.70 50268-662-11 PROPRANOLOL 10 MG ORAL TAB $1.70 99999-046-93 CLINDAMYCIN 18 MG/ML INJ SYRINGE (MCWH) $1.70 60687-224-01 GEMFIBROZIL 600 MG ORAL TAB $1.70 60687-224-11 GEMFIBROZIL 600 MG ORAL TAB $1.70 0023-0403-70 CARBOXYMETHYLCELLULOSE SODIUM 0.5 % OPHT DPET $1.69 50268-268-11 DOCUSATE SODIUM 250 MG ORAL CAP $1.69 50268-268-15 DOCUSATE SODIUM 250 MG ORAL CAP $1.69 0093-8344-01 GLYBURIDE 5 MG ORAL TAB $1.69 0378-0351-01 HALOPERIDOL 0.5 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 0406-8510-01 OXYCODONE 10 MG ORAL TAB $1.69 68084-536-11 CLOPIDOGREL 75 MG ORAL TAB $1.68 68084-536-01 CLOPIDOGREL 75 MG ORAL TAB $1.68 63739-486-10 HYDROXYZINE HCL 25 MG ORAL TAB $1.68 7733351625 MELATONIN 3 MG ORAL TAB $1.68 7733351610 MELATONIN 3 MG ORAL TAB $1.68 50268-594-11 NAPROXEN 250 MG ORAL TAB $1.68 50268-594-15 NAPROXEN 250 MG ORAL TAB $1.68 0093-0811-05 NORTRIPTYLINE 25 MG ORAL CAP $1.68 71399-8460-5 BISACODYL 10 MG RECTAL SUPP $1.68 7733386110 MULTIVIT-IRON-FA-CALCIUM-MINS 9 MG IRON-400 MCG ORAL TAB $1.68 7733386125 MULTIVIT-IRON-FA-CALCIUM-MINS 9 MG IRON-400 MCG ORAL TAB $1.68 83980-007-01 PROPRANOLOL 40 MG ORAL TAB $1.68 47335-737-88 BUPROPION HCL 150 MG ORAL SR12 $1.67 6761811128 DOCUSATE SODIUM 50 MG ORAL CAP $1.67 0904-6704-61 PRAMIPEXOLE 0.25 MG ORAL TAB $1.67 16714-559-01 PRAVASTATIN 20 MG ORAL TAB $1.67 53746-544-01 PRIMIDONE 50 MG ORAL TAB $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 33342-274-07 FEBUXOSTAT 40 MG ORAL TAB $1.66 67877-446-30 OLMESARTAN 20 MG ORAL TAB $1.66 57664-223-88 OXYCODONE 5 MG ORAL TAB $1.66 99999-000-36 SODIUM CHLORIDE 4 MEQ / ML ORAL SYRINGE $1.66 0904-7417-61 METHADONE 10 MG ORAL TAB $1.65 99999-034-50 PENICILLIN GK IV SOLN (FOR DESENSITIZATION USE) $1.65 23155-112-01 PROPRANOLOL 40 MG ORAL TAB $1.65 0603-5484-21 PROPRANOLOL 40 MG ORAL TAB $1.65 69238-2079-1 PROPRANOLOL 40 MG ORAL TAB $1.65 69238-2079-7 PROPRANOLOL 40 MG ORAL TAB $1.65 0093-9702-01 CARBIDOPA-LEVODOPA 25-100 MG ORAL TAB $1.65 50742-260-01 NIFEDIPINE 30 MG ORAL TR24 $1.65 1254717021 DIPHENHYDRAMINE HCL 25 MG ORAL CAP $1.64 50580-228-24 DIPHENHYDRAMINE HCL 25 MG ORAL CAP $1.64 70954-019-50 PRAZOSIN 1 MG ORAL CAP $1.64 62756-798-88 DIVALPROEX 500 MG ORAL TBEC $1.63 57237-077-10 ONDANSETRON 4 MG ORAL TBDL $1.63 67877-493-01 AZATHIOPRINE 50 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 69097-862-83 CALCIUM ACETATE(PHOSPHAT BIND) 667 MG ORAL CAP $1.63 23155-531-02 CALCIUM ACETATE(PHOSPHAT BIND) 667 MG ORAL CAP $1.63 16571-813-20 CALCIUM ACETATE(PHOSPHAT BIND) 667 MG ORAL CAP $1.63 0904-7501-61 CARBIDOPA-LEVODOPA 25-100 MG ORAL TAB $1.63 50228-461-01 CARBIDOPA-LEVODOPA 50-200 MG ORAL TBSR $1.63 99999-047-24 DEXTROSE 5 % IN WATER (D5W) IV SOLP $1.63 0487-9801-60 IPRATROPIUM BROMIDE 0.02 % INHALATION SOLN $1.63 0487-9801-30 IPRATROPIUM BROMIDE 0.02 % INHALATION SOLN $1.63 16729-034-10 LETROZOLE 2.5 MG ORAL TAB $1.63 51991-759-33 LETROZOLE 2.5 MG ORAL TAB $1.63 51991-759-90 LETROZOLE 2.5 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 29300-171-16 MEMANTINE 5 MG ORAL TAB $1.63 60687-559-01 METHOCARBAMOL 500 MG ORAL TAB $1.63 60687-559-11 METHOCARBAMOL 500 MG ORAL TAB $1.63 16729-318-01 OXYBUTYNIN CHLORIDE 10 MG ORAL TR24 $1.63 60951-602-70 OXYCODONE-ACETAMINOPHEN 5-325 MG ORAL TAB $1.63 0904-5677-61 PAROXETINE HCL 20 MG ORAL TAB $1.63 53746-542-01 POTASSIUM CHLORIDE 10 MEQ ORAL CPSR $1.63 60687-587-11 PROPRANOLOL 10 MG ORAL TAB $1.63 60687-587-01 PROPRANOLOL 10 MG ORAL TAB $1.63 0487-9501-03 ALBUTEROL SULFATE 2.5 MG /3 ML (0.083 %) INHALATION NEBU $1.62 0487-9501-25 ALBUTEROL SULFATE 2.5 MG /3 ML (0.083 %) INHALATION NEBU $1.62 63739-410-10 ALLOPURINOL 100 MG ORAL TAB $1.62 0487-9301-03 SODIUM CHLORIDE 0.9 % INHALATION NEBU $1.62 0054-4181-25 DEXAMETHASONE (PEDS ONC) 1MG TAB $1.61 51672-4111-1 PHENYTOIN SODIUM EXTENDED 100 MG ORAL CAP $1.61 0591-3540-60 BUPROPION HCL 100 MG ORAL SR12 $1.61 0093-9702-05 CARBIDOPA-LEVODOPA 25-100 MG ORAL TAB $1.61 50268-067-70 CARBOXYMETHYLCELLULOSE SODIUM 0.5 % OPHT DPET $1.61 68084-643-11 PANTOPRAZOLE 20 MG ORAL TBEC $1.61 68084-643-01 PANTOPRAZOLE 20 MG ORAL TBEC $1.61 60687-725-01 PANTOPRAZOLE 20 MG ORAL TBEC $1.61 60687-725-11 PANTOPRAZOLE 20 MG ORAL TBEC $1.61 0904-6290-61 ATORVASTATIN 10 MG ORAL TAB $1.60 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 72603-115-01 TAMSULOSIN 0.4 MG ORAL CAP $1.60 16571-202-10 DICLOFENAC SODIUM 50 MG ORAL TBEC $1.59 99999-041-08 HYDROMORPHONE 1 MG/ML INJ SOLN (MHS WRAPPER) $1.59 50228-340-90 OLMESARTAN 20 MG ORAL TAB $1.59 57664-756-83 OLMESARTAN 20 MG ORAL TAB $1.59 42858-104-50 OXYCODONE-ACETAMINOPHEN 10-325 MG ORAL TAB $1.59 0378-0427-01 SULINDAC 150 MG ORAL TAB $1.59 55111-466-01 METOPROLOL SUCCINATE 25 MG ORAL TB24 $1.59 55111-467-05 METOPROLOL SUCCINATE 50 MG ORAL TB24 $1.59 55111-467-01 METOPROLOL SUCCINATE 50 MG ORAL TB24 $1.59 99999-036-36 RIFAMPIN 20 MG/ML ORAL SOLN (COMPOUND) $1.59 99999-036-28 SPIRONOLACTONE-HYDROCHLOROTHIAZIDE ORAL SUSP (MCH) $1.59 62756-160-88 TAMSULOSIN 0.4 MG ORAL CAP $1.59 0904-6292-06 ATORVASTATIN 40 MG ORAL TAB $1.58 6809411561 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG ORAL TAB $1.58 0904-6352-61 LEVOFLOXACIN 500 MG ORAL TAB $1.58 69584-684-10 PRIMIDONE 50 MG ORAL TAB $1.58 7733330810 OMEGA 3-DHA-EPA-FISH OIL 1,000 (120-180) MG ORAL CAP $1.57 7733330825 OMEGA 3-DHA-EPA-FISH OIL 1,000 (120-180) MG ORAL CAP $1.57 42858-104-01 OXYCODONE-ACETAMINOPHEN 10-325 MG ORAL TAB $1.57 75834-158-01 VERAPAMIL 180 MG ORAL TBSR $1.57 60505-2579-9 ATORVASTATIN 20 MG ORAL TAB $1.57 60505-2579-8 ATORVASTATIN 20 MG ORAL TAB $1.57 60505-2580-9 ATORVASTATIN 40 MG ORAL TAB $1.57 60505-2580-8 ATORVASTATIN 40 MG ORAL TAB $1.57 60505-2671-9 ATORVASTATIN 80 MG ORAL TAB $1.57 60505-2671-8 ATORVASTATIN 80 MG ORAL TAB $1.57 65162-571-10 BETHANECHOL CHLORIDE 5 MG ORAL TAB $1.57 53746-571-01 BETHANECHOL CHLORIDE 5 MG ORAL TAB $1.57 16714-052-11 CLOPIDOGREL 75 MG ORAL TAB $1.57 16714-052-10 CLOPIDOGREL 75 MG ORAL TAB $1.57 0093-8344-10 GLYBURIDE 5 MG ORAL TAB $1.57 76282-329-01 WARFARIN 2.5 MG ORAL TAB $1.57 48433-127-01 BISMUTH SUBSALICYLATE 262 MG ORAL CHEW $1.56 48433-127-10 BISMUTH SUBSALICYLATE 262 MG ORAL CHEW $1.56 6809411559 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG ORAL TAB $1.56 60687-822-01 HYDRALAZINE 25 MG ORAL TAB $1.56 60687-822-11 HYDRALAZINE 25 MG ORAL TAB $1.56 69315-134-01 IMIPRAMINE HCL 25 MG ORAL TAB $1.56 31722-730-90 IRBESARTAN 150 MG ORAL TAB $1.56 33342-048-10 IRBESARTAN 150 MG ORAL TAB $1.56 0245-0211-11 MIDODRINE 2.5 MG ORAL TAB $1.56 52817-323-10 MIDODRINE 2.5 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 0536-1186-12 PHENYLEPHRINE-COCOA BUTTER 0.25-88.44 % RECTAL SUPP $1.56 12165-100-01 SILVER NITRATE APPLICATORS 75-25 % TOPICAL STCK $1.56 68084-512-01 SIMVASTATIN 20 MG ORAL TAB $1.56 68084-512-11 SIMVASTATIN 20 MG ORAL TAB $1.56 24979-028-07 DILTIAZEM HCL 240 MG ORAL CP24 $1.55 50742-250-90 DILTIAZEM HCL 240 MG ORAL CP24 $1.55 68084-617-11 ESCITALOPRAM OXALATE 10 MG ORAL TAB $1.55 68084-617-01 ESCITALOPRAM OXALATE 10 MG ORAL TAB $1.55 51293-820-01 METHIMAZOLE 5 MG ORAL TAB $1.55 7733311825 CALCIUM POLYCARBOPHIL 625 MG ORAL TAB $1.55 7733311810 CALCIUM POLYCARBOPHIL 625 MG ORAL TAB $1.55 3504600431 COENZYME Q10 50 MG ORAL CAP $1.55 0904-7448-61 HYDRALAZINE 25 MG ORAL TAB $1.55 43598-166-30 OLANZAPINE 10 MG ORAL TAB $1.55 13107-155-30 PAROXETINE HCL 20 MG ORAL TAB $1.55 0093-2210-05 SUCRALFATE 1 GRAM ORAL TAB $1.55 51672-4032-1 WARFARIN 5 MG ORAL TAB $1.55 99999-047-54 PEG 400-HYPROMELLOSE-GLYCERIN 1-0.2-0.2 % OPHT SOLN FOR COMPOUNDING (LBMC) $1.54 53489-331-01 IMIPRAMINE HCL 25 MG ORAL TAB $1.54 99999-033-43 PACLITAXEL IV SOLN (FOR DESENSITIZATION USE) (MHS) $1.54 59762-4900-3 SERTRALINE 50 MG ORAL TAB $1.54 59762-4900-4 SERTRALINE 50 MG ORAL TAB $1.54 0093-1716-01 WARFARIN 4 MG ORAL TAB $1.54 0904-6294-61 CLOPIDOGREL 75 MG ORAL TAB $1.53 63739-991-10 METHOCARBAMOL 500 MG ORAL TAB $1.53 0093-0319-01 DILTIAZEM HCL 60 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 77333-812-25 SIMETHICONE 80 MG ORAL CHEW $1.53 77333-812-10 SIMETHICONE 80 MG ORAL CHEW $1.53 51672-4029-1 WARFARIN 2.5 MG ORAL TAB $1.53 5026886315 CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) ORAL TAB $1.52 5026886311 CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) ORAL TAB $1.52 16729-414-01 DOXAZOSIN 2 MG ORAL TAB $1.52 4116700609 DOXYLAMINE SUCCINATE 25 MG ORAL TAB $1.52 42858-002-01 OXYCODONE 10 MG 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 13668-218-30 ARIPIPRAZOLE 10 MG ORAL TAB $1.52 13668-217-30 ARIPIPRAZOLE 5 MG ORAL TAB $1.52 67877-431-03 ARIPIPRAZOLE 5 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 31722-587-30 NEBIVOLOL 10 MG ORAL TAB $1.52 31722-585-30 NEBIVOLOL 2.5 MG ORAL TAB $1.52 31722-586-30 NEBIVOLOL 5 MG ORAL TAB $1.52 31722-586-90 NEBIVOLOL 5 MG ORAL TAB $1.52 59651-256-01 PROPAFENONE 150 MG ORAL TAB $1.52 65862-528-90 VENLAFAXINE 75 MG ORAL CP24 $1.52 0378-7970-55 IPRATROPIUM BROMIDE 0.02 % INHALATION SOLN $1.51 0378-7970-31 IPRATROPIUM BROMIDE 0.02 % INHALATION SOLN $1.51 0536-1387-93 CARBOXYMETHYLCELLULOSE SODIUM 0.5 % OPHT DPET $1.51 59651-138-30 NEBIVOLOL 5 MG ORAL TAB $1.51 75834-159-01 VERAPAMIL 240 MG ORAL TBSR $1.51 57237-127-01 WARFARIN 10 MG ORAL TAB $1.51 67877-430-05 ARIPIPRAZOLE 2 MG ORAL TAB $1.50 0093-0319-05 DILTIAZEM HCL 60 MG ORAL TAB $1.50 60505-3111-0 OLANZAPINE 5 MG ORAL TAB $1.50 68784-102-12 BISACODYL 10 MG RECTAL SUPP $1.50 70954-456-10 BISOPROLOL FUMARATE 10 MG ORAL TAB $1.50 70954-455-20 BISOPROLOL FUMARATE 5 MG ORAL TAB $1.50 70954-455-10 BISOPROLOL FUMARATE 5 MG ORAL TAB $1.50 50289-4200-1 GLYCERIN-WHICH HAZEL 12.5-50 % PACKET (MHS WRAPPER) $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 72603-315-01 METHIMAZOLE 5 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 70756-440-11 PRAZOSIN 5 MG ORAL CAP $1.50 63739-544-10 SPIRONOLACTONE 25 MG ORAL TAB $1.50 51224-010-60 BENZONATATE 100 MG ORAL CAP $1.49 51079-074-01 HYDRALAZINE 10 MG ORAL TAB $1.49 51079-074-20 HYDRALAZINE 10 MG ORAL TAB $1.49 68180-320-09 BUPROPION HCL 300 MG ORAL TB24 $1.48 63739-483-10 HYDROXYZINE HCL 10 MG ORAL TAB $1.48 13107-154-30 PAROXETINE HCL 10 MG ORAL TAB $1.48 0054-0018-20 PREDNISONE 20 MG ORAL TAB $1.48 55111-333-90 PANTOPRAZOLE 40 MG ORAL TBEC $1.48 68084-270-01 RISPERIDONE 0.25 MG ORAL TAB $1.48 68084-270-11 RISPERIDONE 0.25 MG ORAL TAB $1.48 904723961 SODIUM CHLORIDE 1,000 MG MISC TBSO $1.48 0904-6290-06 ATORVASTATIN 10 MG ORAL TAB $1.47 16714-071-06 BACLOFEN 10 MG ORAL TAB $1.47 7733394810 CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) ORAL TAB $1.47 7733394825 CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) ORAL TAB $1.47 59762-2198-7 AZITHROMYCIN 250 MG ORAL TAB $1.46 43598-751-01 BUPROPION HCL 100 MG ORAL SR12 $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 0527-4117-37 PROPRANOLOL 80 MG ORAL CS24 $1.46 69452-151-20 ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) ORAL CAP $1.46 64380-737-06 ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) ORAL CAP $1.46 16714-894-01 GLIPIZIDE 2.5 MG ORAL TR24 $1.46 68462-223-01 LITHIUM CARBONATE 300 MG ORAL TBSR $1.46 0904-6917-61 OMEPRAZOLE 20 MG ORAL CPDR $1.46 99999-000-30 POTASSIUM ACETATE 2 MEQ / ML ORAL SYRINGE $1.46 0574-0292-01 AMILORIDE 5 MG ORAL TAB $1.45 39413012 BIOTIN 5 MG ORAL CAP $1.45 23155-772-01 ENALAPRIL MALEATE 10 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 6809411061 MELATONIN 3 MG ORAL TAB $1.45 0054-8739-25 PREDNISONE 1 MG ORAL TAB $1.45 0093-9701-01 CARBIDOPA-LEVODOPA 10-100 MG ORAL TAB $1.44 68180-231-09 FENOFIBRATE 54 MG ORAL TAB $1.44 59651-575-90 FENOFIBRATE 54 MG ORAL TAB $1.44 69097-458-05 FENOFIBRATE NANOCRYSTALLIZED 145 MG ORAL TAB $1.44 65862-769-90 FENOFIBRATE NANOCRYSTALLIZED 145 MG ORAL TAB $1.44 59651-138-90 NEBIVOLOL 5 MG ORAL TAB $1.44 43547-525-09 NEBIVOLOL 5 MG ORAL TAB $1.44 65862-688-90 SILDENAFIL (PULM.HYPERTENSION) 20 MG ORAL TAB $1.44 60687-210-01 SIMVASTATIN 40 MG ORAL TAB $1.44 60687-210-11 SIMVASTATIN 40 MG ORAL TAB $1.44 0054-8180-25 DEXAMETHASONE 0.75 MG ORAL TAB $1.44 33342-179-10 OLMESARTAN 20 MG ORAL TAB $1.44 60687-736-11 PANTOPRAZOLE 40 MG ORAL TBEC $1.44 63739-963-10 PAROXETINE HCL 20 MG ORAL TAB $1.44 0591-5661-01 SULINDAC 150 MG ORAL TAB $1.44 53489-478-01 SULINDAC 150 MG ORAL TAB $1.44 0832-7123-89 DIVALPROEX 250 MG ORAL TBEC $1.43 51672-4245-1 ENALAPRIL MALEATE 10 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 0406-0125-10 HYDROCODONE-ACETAMINOPHEN 10-325 MG ORAL TAB $1.43 0406-0125-01 HYDROCODONE-ACETAMINOPHEN 10-325 MG ORAL TAB $1.43 0406-3244-01 HYDROMORPHONE 4 MG ORAL TAB $1.43 68462-406-01 INDOMETHACIN 25 MG ORAL CAP $1.43 0904-6351-61 LEVOFLOXACIN 250 MG ORAL TAB $1.43 6809411059 MELATONIN 3 MG ORAL TAB $1.43 42806-400-01 METHYLPREDNISOLONE 4 MG ORAL TAB $1.43 76385-134-01 NADOLOL 40 MG ORAL TAB $1.43 23155-731-01 NADOLOL 40 MG ORAL TAB $1.43 62332-403-31 NADOLOL 40 MG ORAL TAB $1.43 16571-668-01 PHENOBARBITAL 97.2 MG ORAL TAB $1.43 16714-258-01 AMITRIPTYLINE 25 MG ORAL TAB $1.42 0172-4096-60 BACLOFEN 10 MG ORAL TAB $1.42 68094-018-61 DIPHENHYDRAMINE HCL 25 MG ORAL TAB $1.42 0832-7123-01 DIVALPROEX 250 MG ORAL TBEC $1.42 42858-302-25 HYDROMORPHONE 4 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 60687-491-01 NAPROXEN 500 MG ORAL TAB $1.42 60687-491-11 NAPROXEN 500 MG ORAL TAB $1.42 51672-4027-1 WARFARIN 1 MG ORAL TAB $1.42 0093-1712-01 WARFARIN 1 MG ORAL TAB $1.42 50742-249-90 DILTIAZEM HCL 180 MG ORAL CP24 $1.41 24979-027-07 DILTIAZEM HCL 180 MG ORAL CP24 $1.41 60687-143-11 METFORMIN 850 MG ORAL TAB $1.41 60687-143-01 METFORMIN 850 MG ORAL TAB $1.41 43547-342-06 RISPERIDONE 2 MG ORAL TAB $1.41 59762-5011-1 SPIRONOLACTONE 25 MG ORAL TAB $1.41 42806-018-01 SULINDAC 150 MG ORAL TAB $1.41 51079-685-01 ATENOLOL 100 MG ORAL TAB $1.40 51079-685-20 ATENOLOL 100 MG ORAL TAB $1.40 69968-0060-9 BACITRACIN ZINC-POLYMYXIN B 500-10,000 UNIT/GRAM TOPICAL OIPK $1.40 1254723813 BACITRACIN ZINC-POLYMYXIN B 500-10,000 UNIT/GRAM TOPICAL OIPK $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 59762-1344-1 PREGABALIN 50 MG ORAL CAP $1.40 23155-607-01 GLYCOPYRROLATE 2 MG ORAL TAB $1.39 13107-015-01 GLYCOPYRROLATE 2 MG ORAL TAB $1.39 0555-0873-02 MEDROXYPROGESTERONE 5 MG ORAL TAB $1.39 0054-0017-20 PREDNISONE 10 MG ORAL TAB $1.39 0054-0077-25 TORSEMIDE 20 MG ORAL TAB $1.39 63739-051-10 AMIODARONE 200 MG ORAL TAB $1.39 99999-002-23 CEFTAZIDIME - BSS 100 MG/0.5 ML OPHTHALMIC SYRINGE $1.39 0115-5511-10 FENOFIBRATE 54 MG ORAL TAB $1.39 60219-5511-9 FENOFIBRATE 54 MG ORAL TAB $1.39 70756-214-90 FENOFIBRATE 54 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 63739-403-10 NAPROXEN 500 MG ORAL TAB $1.39 1381100710 PRENATAL VIT 27,CALC-IRON-FA 60 MG IRON-1 MG ORAL TAB $1.39 31722-778-01 ACYCLOVIR 800 MG ORAL TAB $1.38 59762-0155-1 ATORVASTATIN 10 MG ORAL TAB $1.38 7733393825 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG ORAL TAB $1.38 7733393810 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG ORAL TAB $1.38 23155-705-01 ENALAPRIL MALEATE 5 MG ORAL TAB $1.38 72603-273-01 ESTRADIOL 0.5 MG ORAL TAB $1.38 0093-8035-01 GLYBURIDE MICRONIZED 3 MG ORAL TAB $1.38 53489-386-01 MINOXIDIL 2.5 MG ORAL TAB $1.38 67877-445-30 OLMESARTAN 5 MG ORAL TAB $1.38 16714-795-02 TERBINAFINE HCL 250 MG ORAL TAB $1.38 0781-2074-01 TRIAMTERENE-HYDROCHLOROTHIAZID 37.5-25 MG ORAL CAP $1.38 59762-0155-2 ATORVASTATIN 10 MG ORAL TAB $1.37 0093-8344-98 GLYBURIDE 5 MG ORAL TAB $1.37 0591-5642-01 MINOXIDIL 2.5 MG ORAL TAB $1.37 42291-622-30 MONTELUKAST 4 MG ORAL CHEW $1.37 0536-1362-23 NICOTINE (POLACRILEX) 2 MG BUCCAL GUM $1.37 50268-632-11 QUETIAPINE 100 MG ORAL TAB $1.37 50268-632-15 QUETIAPINE 100 MG ORAL TAB $1.37 68382-857-01 TRIAMTERENE-HYDROCHLOROTHIAZID 75-50 MG ORAL TAB $1.37 16714-577-01 ALLOPURINOL 300 MG ORAL TAB $1.37 55111-730-01 ALLOPURINOL 300 MG ORAL TAB $1.37 72578-166-01 DEXAMETHASONE (PEDS ONC) 1MG TAB $1.37 99999-041-10 DEXTROSE 40 % ORAL GEL $1.37 51672-4038-1 ENALAPRIL MALEATE 5 MG ORAL TAB $1.37 16729-433-15 EZETIMIBE 10 MG ORAL TAB $1.37 17238-900-99 FLUORESCEIN 1 MG OPHT STRP $1.37 17238-900-11 FLUORESCEIN 1 MG OPHT STRP $1.37 60687-593-11 HYDROCHLOROTHIAZIDE 25 MG ORAL TAB $1.37 60687-593-01 HYDROCHLOROTHIAZIDE 25 MG ORAL TAB $1.37 0406-0124-10 HYDROCODONE-ACETAMINOPHEN 7.5-325 MG ORAL TAB $1.37 0406-0124-01 HYDROCODONE-ACETAMINOPHEN 7.5-325 MG ORAL TAB $1.37 23155-519-01 ISOSORBIDE MONONITRATE 30 MG ORAL TB24 $1.37 49884-256-01 MINOXIDIL 2.5 MG ORAL TAB $1.37 13517-693-01 PHENOBARBITAL 60 MG ORAL TAB $1.37 0904-7124-61 LEVETIRACETAM 500 MG ORAL TAB $1.36 4843311001 OMEGA 3-DHA-EPA-FISH OIL 300-1,000 MG ORAL CAP $1.36 68382-146-01 RAMIPRIL 5 MG ORAL CAP $1.36 62756-258-02 ZONISAMIDE 25 MG ORAL CAP $1.36 68001-242-00 ZONISAMIDE 25 MG ORAL CAP $1.36 47335-894-81 CLOPIDOGREL 75 MG ORAL TAB $1.35 47335-894-83 CLOPIDOGREL 75 MG ORAL TAB $1.35 5026885511 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG ORAL TAB $1.35 5026885515 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG ORAL TAB $1.35 7132180010 MAGNESIUM L-LACTATE 84 MG ORAL TBSR $1.35 0904-7163-61 METFORMIN 850 MG ORAL TAB $1.35 42806-552-12 OMEGA-3 ACID ETHYL ESTERS 1 GRAM ORAL CAP $1.35 47781-263-01 OXYCODONE 5 MG ORAL TAB $1.35 16714-645-02 PIOGLITAZONE 15 MG ORAL TAB $1.35 0054-0018-25 PREDNISONE 20 MG ORAL TAB $1.35 0591-5443-01 PREDNISONE 20 MG ORAL TAB $1.35 5026886011 ASCORBIC ACID (VITAMIN C) 250 MG ORAL TAB $1.34 5026886015 ASCORBIC ACID (VITAMIN C) 250 MG ORAL TAB $1.34 0093-3147-05 CEPHALEXIN 500 MG ORAL CAP $1.34 536143607 COENZYME Q10 30 MG ORAL CAP $1.34 0054-4180-25 DEXAMETHASONE 0.75 MG ORAL TAB $1.34 50111-328-01 HYDRALAZINE 50 MG ORAL TAB $1.34 7733371525 PRENATAL VIT NO.130-IRON-FOLIC 27 MG IRON- 800 MCG ORAL TAB $1.34 7733371510 PRENATAL VIT NO.130-IRON-FOLIC 27 MG IRON- 800 MCG ORAL TAB $1.34 68382-856-01 TRIAMTERENE-HYDROCHLOROTHIAZID 37.5-25 MG ORAL TAB $1.34 45802-730-33 ACETAMINOPHEN 650 MG RECTAL SUPP $1.33 59651-455-01 COLCHICINE 0.6 MG ORAL TAB $1.33 55111-784-01 FEXOFENADINE 180 MG ORAL TAB $1.33 4898500170 FEXOFENADINE 180 MG ORAL TAB $1.33 0904-6667-61 GABAPENTIN 400 MG ORAL CAP $1.33 0603-5339-28 PREDNISONE 20 MG ORAL TAB $1.33 0054-0018-29 PREDNISONE 20 MG ORAL TAB $1.33 16714-988-01 ROSUVASTATIN 5 MG ORAL TAB $1.33 63739-570-10 SIMVASTATIN 5 MG ORAL TAB $1.33 0603-2435-21 BENZTROPINE 2 MG ORAL TAB $1.33 0591-0444-01 GUANFACINE 1 MG ORAL TAB $1.33 47335-322-86 MEMANTINE 10 MG ORAL TAB $1.33 47335-321-86 MEMANTINE 5 MG ORAL TAB $1.33 904561646 COENZYME Q10 50 MG ORAL CAP $1.32 55111-231-90 PRAVASTATIN 40 MG ORAL TAB $1.32 0603-5335-21 PREDNISONE 1 MG ORAL TAB $1.32 0527-4116-37 PROPRANOLOL 60 MG ORAL CS24 $1.32 67618-300-50 SENNOSIDES 8.6 MG ORAL TAB $1.32 7733383125 SODIUM BICARBONATE 650 MG ORAL TAB $1.32 7733383110 SODIUM BICARBONATE 650 MG ORAL TAB $1.32 77333-827-25 SODIUM BICARBONATE 650 MG ORAL TAB $1.32 77333-827-10 SODIUM BICARBONATE 650 MG ORAL TAB $1.32 60505-0252-3 TIZANIDINE 4 MG ORAL TAB $1.32 68382-006-01 LAMOTRIGINE 25 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 0054-4741-25 PREDNISONE 1 MG ORAL TAB $1.31 16729-486-01 METHOTREXATE SODIUM 2.5 MG ORAL TAB $1.31 0591-5642-05 MINOXIDIL 2.5 MG ORAL TAB $1.31 42291-622-90 MONTELUKAST 4 MG ORAL CHEW $1.31 13107-046-01 OXYCODONE-ACETAMINOPHEN 10-325 MG ORAL TAB $1.31 16714-989-01 ROSUVASTATIN 10 MG ORAL TAB $1.31 99999-036-89 DISOPYRAMIDE PHOSPHATE 10 MG/ML ORAL SUSP (COMPOUND) $1.29 HC51062628 TELEHEALTH TRANSMISSION PER MIN (MCAL ONLY) $1.25 99999-033-87 FLECAINIDE 20 MG/ML ORAL SUSP (COMPOUND) $1.22 99996-001-56 CAPTOPRIL 1 MG/ML ORAL SUSP (COMPOUND) $1.20 0054-8740-25 PREDNISONE 2.5 MG ORAL TAB $1.20 59651-485-01 PREDNISONE 2.5 MG ORAL TAB $1.20 99999-033-02 HYDROXYUREA 100 MG/ML ORAL SOLUTION (COMPOUND) (MCH) $1.20 99999-034-98 DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML ORAL LIQD $1.17 99999-009-24 OXYBUTYNIN CHLORIDE 1 MG/1 ML ORAL LIQUID $1.17 99999-040-60 VALACYCLOVIR 50 MG/ML ORAL LIQUID $1.16 0378-7970-52 IPRATROPIUM BROMIDE 0.02 % INHALATION SOLN $1.15 0378-7970-91 IPRATROPIUM BROMIDE 0.02 % INHALATION SOLN $1.15 0378-7970-64 IPRATROPIUM BROMIDE 0.02 % INHALATION SOLN $1.15 0378-7970-93 IPRATROPIUM BROMIDE 0.02 % INHALATION SOLN $1.15 99999-045-84 DEXTROSE 50 % IN WATER (D50W) IV SOLP $1.14 99999-037-79 DOCUSATE SODIUM 100 MG/10 ML ORAL LIQD $1.14 99999-000-08 CEFTRIAXONE 100 MG/ML SYRINGE $1.13 99999-046-92 FERROUS SULFATE 5 MG IRON (25 MG)/ML ORAL DROP (SLH) $1.09 99999-002-24 NYSTATIN 100,000 UNITS/ML (NICU) ORAL SYRINGE $1.09 99999-004-74 GENTAMICIN 4 MG/ML INJECTION SYRINGE (MCH) $1.08 99999-045-59 PEDI MV NO.189-FERROUS SULFATE 11 MG IRON/ML ORAL DROP $1.07 99999-038-13 PHENYLEPHRINE 100 MCG/ML INJ DILUTION $1.04 99999-043-90 HYDROXYCHLOROQUINE 25 MG/ML ORAL LIQUID (COMPOUND) $1.02 HC62229075 CATHETER PRESSURE MIKRO-CATH (MILLAR) $1.01 HC62808696 DEVICE SURGICAL IMPLANT TRIALING $1.01 HC62229083 DEVICE SURGICAL SUPPLY TRIALING $1.01 HC11200193 EDUCATION & TRAINING SELF MANAGEMENT; 1/2 HR $1.01 HC62229588 ELECTRODE STIM ABDOM FES BREATH-SYNC $1.01 HC62808175 G150087 KIT STENTS ENDOPRSTH DSC AORTA $1.01 HC62809140 G150210 SYSTEM SHUNT ATRIAL CORVIA® $1.01 HC62808860 G160139 BONE GRAFT INFUSE™ $1.01 HC62809165 G160223 DEV CARILLON MITRAL CONTOUR SYSTEM® $1.01 HC62808324 G170044 GENERATOR VITARIA IDE $1.01 HC62808332 G170044 LEAD VITARIA $1.01 HC62808563 G180020 SYSTEM SHUNT INTERATRIAL $1.01 HC62808605 G180160 BONE GRAFT INFUSE™ $1.01 HC62228713 G200036 SYSTEM EMBOLECTOMY(CAPERE®) $1.01 HC62808662 G200149 SYSTEM EMBOLIC HYDROGEL EMBRACE (HES) $1.01 HC62808688 G200313 CATH BALLOON NEURESCUE $1.01 HC62228994 G210071 SYSTEM NOVOTTF-200T $1.01 HC62809108 G210167 ATRIAL FLOW REGULATOR (OCCLUTECH) $1.01 HC62229133 G210176 MULTI-CANCER EARLY DETECT TEST GRAIL $1.01 HC62808969 G210241 SYSTEM EMBOLIC HYDROGEL EMBRACE INSTYLLA™ $1.01 HC62809025 G210281 ATRIAL FLOW REGULATOR(OCCLUTECH) $1.01 HC62229521 G220255 MULTI-CANCER EARLY DETECT TEST GALLERI $1.01 HC62229299 G220303 DEVICE ABLATION THERMAL WATER $1.01 HC62809371 G220318 DEVICE EMBOLIC MICROSPHERE EMBOSPHERE® $1.01 HC62229067 PATCH EKG AUSCULA LVDP VIVIO $1.01 HC62228523 SYSTEM THROMBECTOMY(CAPERE®) $1.01 99999-008-52 CHERRY FLAVOR (BULK) ORAL LIQD $1.01 HC88600101 NBS HANDLE COLLECTION CARD-GE $1.00 HC89020499 T-CELL RECEPTOR EXCISION CIRCLES-GE $1.00 45802-732-33 ACETAMINOPHEN 120 MG RECTAL SUPP $1.00 0904-6773-61 ACETAMINOPHEN 325 MG ORAL TAB $1.00 50580-458-11 ACETAMINOPHEN 325 MG ORAL TAB $1.00 63739-087-02 ACETAMINOPHEN 325 MG ORAL TAB $1.00 0536-1327-10 ACETAMINOPHEN 325 MG ORAL TAB $1.00 0536-1327-01 ACETAMINOPHEN 325 MG ORAL TAB $1.00 71399-1025-3 ACETAMINOPHEN 325 MG ORAL TAB $1.00 45049660 ACETAMINOPHEN 325 MG ORAL TAB $1.00 57896-104-10 ACETAMINOPHEN 325 MG ORAL TAB $1.00 49483-340-01 ACETAMINOPHEN 325 MG ORAL TAB $1.00 0536-1327-06 ACETAMINOPHEN 325 MG ORAL TAB $1.00 0904-6730-61 ACETAMINOPHEN 500 MG ORAL TAB $1.00 57896-201-10 ACETAMINOPHEN 500 MG ORAL TAB $1.00 0904-6720-80 ACETAMINOPHEN 500 MG ORAL TAB $1.00 58602-773-21 ACETAMINOPHEN 500 MG ORAL TAB $1.00 50580-457-11 ACETAMINOPHEN 500 MG ORAL TAB $1.00 0904-6730-59 ACETAMINOPHEN 500 MG ORAL TAB $1.00 49483-341-50 ACETAMINOPHEN 500 MG ORAL TAB $1.00 10135-152-01 ACETAMINOPHEN 500 MG ORAL TAB $1.00 0904-6720-40 ACETAMINOPHEN 500 MG ORAL TAB $1.00 0904-6730-80 ACETAMINOPHEN 500 MG ORAL TAB $1.00 69618-011-01 ACETAMINOPHEN 500 MG ORAL TAB $1.00 71399-1026-1 ACETAMINOPHEN 500 MG ORAL TAB $1.00 0904-6720-59 ACETAMINOPHEN 500 MG ORAL TAB $1.00 50580-457-70 ACETAMINOPHEN 500 MG ORAL TAB $1.00 57896-204-01 ACETAMINOPHEN 500 MG ORAL TAB $1.00 70677-1138-3 ACETAMINOPHEN 500 MG ORAL TAB $1.00 0904-5791-46 ACETAMINOPHEN 80 MG ORAL CHEW $1.00 0406-0484-23 ACETAMINOPHEN-CODEINE 300-30 MG ORAL TAB $1.00 52817-201-10 ACETAZOLAMIDE 250 MG ORAL TAB $1.00 99999-047-28 ACETYLCHOLINE 0.182 MCG/ML INJECTION $1.00 1184578705 ACTIVATED CHARCOAL 260 MG ORAL CAP $1.00 10961-065-02 ACTIVATED CHARCOAL 260 MG ORAL CAP $1.00 69076-146-01 ACYCLOVIR 200 MG ORAL CAP $1.00 72578-002-01 ACYCLOVIR 200 MG ORAL CAP $1.00 0904-5789-61 ACYCLOVIR 200 MG ORAL CAP $1.00 31722-777-01 ACYCLOVIR 400 MG ORAL TAB $1.00 16714-576-02 ALLOPURINOL 100 MG ORAL TAB $1.00 55111-729-01 ALLOPURINOL 100 MG ORAL TAB $1.00 0603-2115-32 ALLOPURINOL 100 MG ORAL TAB $1.00 16714-576-04 ALLOPURINOL 100 MG ORAL TAB $1.00 16714-576-01 ALLOPURINOL 100 MG ORAL TAB $1.00 23155-693-01 ALLOPURINOL 100 MG ORAL TAB $1.00 99999-034-96 ALLOPURINOL 20 MG/ML ORAL SUSP (COMPOUND) $1.00 7985401107 ALPHA LIPOIC ACID 100 MG ORAL CAP $1.00 51079-788-01 ALPRAZOLAM 0.25 MG ORAL TAB $1.00 59762-3719-1 ALPRAZOLAM 0.25 MG ORAL TAB $1.00 0781-1061-01 ALPRAZOLAM 0.25 MG ORAL TAB $1.00 65862-676-01 ALPRAZOLAM 0.25 MG ORAL TAB $1.00 0228-2027-10 ALPRAZOLAM 0.25 MG ORAL TAB $1.00 0228-2027-50 ALPRAZOLAM 0.25 MG ORAL TAB $1.00 51079-788-20 ALPRAZOLAM 0.25 MG ORAL TAB $1.00 59762-3720-1 ALPRAZOLAM 0.5 MG ORAL TAB $1.00 0781-1077-01 ALPRAZOLAM 0.5 MG ORAL TAB $1.00 0228-2029-10 ALPRAZOLAM 0.5 MG ORAL TAB $1.00 51079-789-20 ALPRAZOLAM 0.5 MG ORAL TAB $1.00 51079-789-01 ALPRAZOLAM 0.5 MG ORAL TAB $1.00 51079-790-20 ALPRAZOLAM 1 MG ORAL TAB $1.00 51079-790-01 ALPRAZOLAM 1 MG ORAL TAB $1.00 59762-3721-1 ALPRAZOLAM 1 MG ORAL TAB $1.00 0781-1079-01 ALPRAZOLAM 1 MG ORAL TAB $1.00 0228-2031-10 ALPRAZOLAM 1 MG ORAL TAB $1.00 99999-037-71 ALUMINUM HYDROXIDE GEL 320 MG/5 ML ORAL SUSP $1.00 88117447 ALUMINUM HYDROX-MAGNESIUM CARB 160-105 MG ORAL CHEW $1.00 0904-5365-60 ALUMINUM HYDROX-MAGNESIUM CARB 160-105 MG ORAL CHEW $1.00 0135-0098-26 ALUMINUM HYDROX-MAGNESIUM CARB 160-105 MG ORAL CHEW $1.00 16571-834-01 AMANTADINE HCL 100 MG ORAL CAP $1.00 99999-038-43 AMIKACIN IN NS INTRAVITREAL $1.00 72888-039-60 AMIODARONE 200 MG ORAL TAB $1.00 99999-038-52 AMIODARONE 5 MG/ML ORAL LIQUID $1.00 16729-171-01 AMITRIPTYLINE 10 MG ORAL TAB $1.00 70756-201-11 AMITRIPTYLINE 10 MG ORAL TAB $1.00 16714-257-01 AMITRIPTYLINE 10 MG ORAL TAB $1.00 29300-419-01 AMITRIPTYLINE 10 MG ORAL TAB $1.00 69367-388-01 AMITRIPTYLINE 10 MG ORAL TAB $1.00 0781-1486-01 AMITRIPTYLINE 10 MG ORAL TAB $1.00 70756-202-11 AMITRIPTYLINE 25 MG ORAL TAB $1.00 68382-123-16 AMLODIPINE 10 MG ORAL TAB $1.00 68382-123-05 AMLODIPINE 10 MG ORAL TAB $1.00 67877-199-90 AMLODIPINE 10 MG ORAL TAB $1.00 0904-6371-61 AMLODIPINE 10 MG ORAL TAB $1.00 29300-398-10 AMLODIPINE 10 MG ORAL TAB $1.00 67877-199-05 AMLODIPINE 10 MG ORAL TAB $1.00 69097-128-05 AMLODIPINE 10 MG ORAL TAB $1.00 69097-128-15 AMLODIPINE 10 MG ORAL TAB $1.00 60687-496-11 AMLODIPINE 10 MG ORAL TAB $1.00 60687-496-01 AMLODIPINE 10 MG ORAL TAB $1.00 42806-057-10 AMLODIPINE 10 MG ORAL TAB $1.00 68382-121-16 AMLODIPINE 2.5 MG ORAL TAB $1.00 0904-6369-61 AMLODIPINE 2.5 MG ORAL TAB $1.00 67877-197-90 AMLODIPINE 2.5 MG ORAL TAB $1.00 0480-0083-98 AMLODIPINE 2.5 MG ORAL TAB $1.00 59762-2242-9 AMLODIPINE 2.5 MG ORAL TAB $1.00 68382-122-16 AMLODIPINE 5 MG ORAL TAB $1.00 51079-451-01 AMLODIPINE 5 MG ORAL TAB $1.00 51079-451-20 AMLODIPINE 5 MG ORAL TAB $1.00 67877-198-90 AMLODIPINE 5 MG ORAL TAB $1.00 67877-198-05 AMLODIPINE 5 MG ORAL TAB $1.00 68382-122-05 AMLODIPINE 5 MG ORAL TAB $1.00 0904-6370-61 AMLODIPINE 5 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 29300-397-05 AMLODIPINE 5 MG ORAL TAB $1.00 16714-298-01 AMOXICILLIN 250 MG ORAL CAP $1.00 0781-2020-05 AMOXICILLIN 250 MG ORAL CAP $1.00 0781-2020-01 AMOXICILLIN 250 MG ORAL CAP $1.00 0093-3107-01 AMOXICILLIN 250 MG ORAL CAP $1.00 16714-299-03 AMOXICILLIN 500 MG ORAL CAP $1.00 57237-031-01 AMOXICILLIN 500 MG ORAL CAP $1.00 0093-3109-53 AMOXICILLIN 500 MG ORAL CAP $1.00 16714-299-02 AMOXICILLIN 500 MG ORAL CAP $1.00 81964-205-01 AMOXICILLIN 500 MG ORAL CAP $1.00 16714-299-04 AMOXICILLIN 500 MG ORAL CAP $1.00 0093-3109-05 AMOXICILLIN 500 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 99999-038-40 AMPHOTERICIN B INTRAVITREAL INJ $1.00 99999-038-74 AMPICILLIN IV (FOR DESENSITIZATION USE) $1.00 99999-038-75 AMPICILLIN-SULBACTAM IV (FOR DESENSITIZATION USE) $1.00 8068116600 ASCORBIC ACID (VITAMIN C) 1,000 MG ORAL TAB $1.00 2055500100 ASCORBIC ACID (VITAMIN C) 250 MG ORAL TAB $1.00 904052361 ASCORBIC ACID (VITAMIN C) 500 MG ORAL TAB $1.00 904052360 ASCORBIC ACID (VITAMIN C) 500 MG ORAL TAB $1.00 904052380 ASCORBIC ACID (VITAMIN C) 500 MG ORAL TAB $1.00 904052372 ASCORBIC ACID (VITAMIN C) 500 MG ORAL 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 99999-036-55 ASPIRIN 20.25 MG ORAL PARTIAL CHEWTAB (MCH) $1.00 66553-001-01 ASPIRIN 325 MG ORAL TAB $1.00 57896-901-01 ASPIRIN 325 MG ORAL TAB $1.00 0536-1054-29 ASPIRIN 325 MG ORAL TAB $1.00 57896-901-10 ASPIRIN 325 MG ORAL TAB $1.00 1284353635 ASPIRIN 325 MG ORAL TAB $1.00 0280-2000-10 ASPIRIN 325 MG ORAL TAB $1.00 57896-921-01 ASPIRIN 325 MG ORAL TBEC $1.00 0536-1232-01 ASPIRIN 325 MG ORAL TBEC $1.00 69618-015-01 ASPIRIN 325 MG ORAL TBEC $1.00 99999-036-56 ASPIRIN 40.5 MG ORAL PARTIAL CHEWTAB (MCH) $1.00 0904-4040-73 ASPIRIN 81 MG ORAL CHEW $1.00 0904-6794-89 ASPIRIN 81 MG ORAL CHEW $1.00 0904-6794-80 ASPIRIN 81 MG ORAL CHEW $1.00 66553-002-01 ASPIRIN 81 MG ORAL CHEW $1.00 49348-757-07 ASPIRIN 81 MG ORAL CHEW $1.00 63739-434-02 ASPIRIN 81 MG ORAL CHEW $1.00 77333-049-20 ASPIRIN 81 MG ORAL CHEW $1.00 77333-049-25 ASPIRIN 81 MG ORAL CHEW $1.00 0904-7509-30 ASPIRIN 81 MG ORAL CHEW $1.00 48433-129-10 ASPIRIN 81 MG ORAL CHEW $1.00 48433-129-01 ASPIRIN 81 MG ORAL CHEW $1.00 0904-6794-30 ASPIRIN 81 MG ORAL CHEW $1.00 8770140309 ASPIRIN 81 MG ORAL TBEC $1.00 49483-481-12 ASPIRIN 81 MG ORAL TBEC $1.00 10135-173-62 ASPIRIN 81 MG ORAL TBEC $1.00 1093944444 ASPIRIN 81 MG ORAL TBEC $1.00 1284353640 ASPIRIN 81 MG ORAL TBEC $1.00 46122-615-87 ASPIRIN 81 MG ORAL TBEC $1.00 10135-689-62 ASPIRIN 81 MG ORAL TBEC $1.00 0904-6751-80 ASPIRIN 81 MG ORAL TBEC $1.00 0536-1234-41 ASPIRIN 81 MG ORAL TBEC $1.00 63739-212-02 ASPIRIN 81 MG ORAL TBEC $1.00 69618-066-10 ASPIRIN 81 MG ORAL TBEC $1.00 69618-066-02 ASPIRIN 81 MG ORAL TBEC $1.00 57896-981-01 ASPIRIN 81 MG ORAL TBEC $1.00 57896-983-12 ASPIRIN 81 MG ORAL TBEC $1.00 57896-981-12 ASPIRIN 81 MG ORAL TBEC $1.00 10135-729-62 ASPIRIN 81 MG ORAL TBEC $1.00 77333-031-25 ASPIRIN 81 MG ORAL TBEC $1.00 77333-031-20 ASPIRIN 81 MG ORAL TBEC $1.00 49483-481-10 ASPIRIN 81 MG ORAL TBEC $1.00 0280-2100-12 ASPIRIN 81 MG ORAL TBEC $1.00 49348-981-15 ASPIRIN 81 MG ORAL TBEC $1.00 99999-004-81 ASPIRIN DESENSITIZATION (LB) $1.00 99999-004-82 ASPIRIN DESENSITIZATION TABLET (LB) $1.00 0536-1326-01 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 0067-2000-20 ASPIRIN-ACETAMINOPHEN-CAFFEINE 250-250-65 MG ORAL TAB $1.00 0067-2001-02 ASPIRIN-ACETAMINOPHEN-CAFFEINE 250-250-65 MG ORAL TAB $1.00 0093-0753-01 ATENOLOL 100 MG ORAL TAB $1.00 68382-024-01 ATENOLOL 100 MG ORAL TAB $1.00 99999-024-13 ATENOLOL 2 MG/ML ORAL LIQUID $1.00 99999-042-79 ATENOLOL 2 MG/ML ORAL LIQUID $1.00 51079-759-01 ATENOLOL 25 MG ORAL TAB $1.00 0378-0218-01 ATENOLOL 25 MG ORAL TAB $1.00 0093-0787-01 ATENOLOL 25 MG ORAL TAB $1.00 51079-759-20 ATENOLOL 25 MG ORAL TAB $1.00 0904-7187-61 ATENOLOL 25 MG ORAL TAB $1.00 68382-022-10 ATENOLOL 25 MG ORAL TAB $1.00 68382-022-01 ATENOLOL 25 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 0378-0231-10 ATENOLOL 50 MG ORAL TAB $1.00 29300-411-01 ATENOLOL 50 MG ORAL TAB $1.00 68382-023-01 ATENOLOL 50 MG ORAL TAB $1.00 0093-0752-01 ATENOLOL 50 MG ORAL TAB $1.00 0378-0231-01 ATENOLOL 50 MG ORAL TAB $1.00 68382-023-10 ATENOLOL 50 MG ORAL TAB $1.00 0093-0752-10 ATENOLOL 50 MG ORAL TAB $1.00 60505-2578-9 ATORVASTATIN 10 MG ORAL TAB $1.00 60505-2578-8 ATORVASTATIN 10 MG ORAL TAB $1.00 63739-018-10 ATORVASTATIN 10 MG ORAL TAB $1.00 31722-424-90 ATORVASTATIN 10 MG ORAL TAB $1.00 0378-3950-05 ATORVASTATIN 10 MG ORAL TAB $1.00 16714-174-02 ATORVASTATIN 20 MG ORAL TAB $1.00 55111-123-90 ATORVASTATIN 40 MG ORAL TAB $1.00 75834-257-01 ATORVASTATIN 40 MG ORAL TAB $1.00 16714-175-02 ATORVASTATIN 40 MG ORAL TAB $1.00 16729-046-15 ATORVASTATIN 40 MG ORAL TAB $1.00 63304-830-90 ATORVASTATIN 80 MG ORAL TAB $1.00 55111-124-90 ATORVASTATIN 80 MG ORAL TAB $1.00 0378-3953-05 ATORVASTATIN 80 MG ORAL TAB $1.00 99999-036-42 AZATHIOPRINE 12.5 MG ORAL PARTIAL TAB $1.00 99999-035-62 AZTREONAM IV (FOR DESENSITIZATION USE) $1.00 6025816001 B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG ORAL TAB $1.00 536141501 B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG ORAL TAB $1.00 5789660501 B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG ORAL TAB $1.00 7985401269 B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG ORAL TAB $1.00 45802-060-70 BACITRACIN 500 UNIT/GRAM TOPICAL PACK $1.00 45802-060-00 BACITRACIN 500 UNIT/GRAM TOPICAL PACK $1.00 68001-477-45 BACITRACIN 500 UNIT/GRAM TOPICAL PACK $1.00 68001-477-48 BACITRACIN 500 UNIT/GRAM TOPICAL PACK $1.00 0904-7402-67 BACITRACIN 500 UNIT/GRAM TOPICAL PACK $1.00 0904-7023-67 BACITRACIN ZINC 500 UNIT/GRAM 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 16714-071-04 BACLOFEN 10 MG ORAL TAB $1.00 0832-1054-15 BACLOFEN 10 MG ORAL TAB $1.00 0603-2406-21 BACLOFEN 10 MG ORAL TAB $1.00 52817-319-10 BACLOFEN 5 MG ORAL TAB $1.00 72888-009-01 BACLOFEN 5 MG ORAL TAB $1.00 43547-336-10 BENAZEPRIL 10 MG ORAL TAB $1.00 65862-116-01 BENAZEPRIL 10 MG ORAL TAB $1.00 43547-336-50 BENAZEPRIL 10 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 43547-337-10 BENAZEPRIL 20 MG ORAL TAB $1.00 65162-753-50 BENAZEPRIL 20 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 43547-338-10 BENAZEPRIL 40 MG ORAL TAB $1.00 65162-751-10 BENAZEPRIL 5 MG ORAL TAB $1.00 43547-335-10 BENAZEPRIL 5 MG ORAL TAB $1.00 7811210189 BENZOCAINE 15 MG MUCOUS MEMB LOZG $1.00 63824-732-16 BENZOCAINE-MENTHOL 15 LOZG (MHS WRAPPER) $1.00 0904-6255-49 BENZOCAINE-MENTHOL 15 LOZG (MHS WRAPPER) $1.00 63824-713-16 BENZOCAINE-MENTHOL 15 LOZG (MHS WRAPPER) $1.00 6382473016 BENZOCAINE-MENTHOL 15 LOZG (MHS WRAPPER) $1.00 63824-724-82 BENZOCAINE-MENTHOL 15 LOZG (MHS WRAPPER) $1.00 42806-714-01 BENZONATATE 100 MG ORAL CAP $1.00 42806-714-05 BENZONATATE 100 MG ORAL CAP $1.00 0904-6564-60 BENZONATATE 100 MG ORAL CAP $1.00 69315-137-01 BENZTROPINE 1 MG ORAL TAB $1.00 69315-137-10 BENZTROPINE 1 MG ORAL TAB $1.00 50228-227-01 BENZTROPINE 2 MG ORAL TAB $1.00 99999-007-29 BETHANECHOL 1 MG/ML COMPOUND ORAL SUSPENSION $1.00 7431207961 BIOTIN 1 MG ORAL TAB $1.00 7431258913 BIOTIN 5,000 MCG SL SUBL $1.00 57896-443-01 BISACODYL 10 MG RECTAL SUPP $1.00 0904-6407-61 BISACODYL 5 MG ORAL TBEC $1.00 57896-441-01 BISACODYL 5 MG ORAL TBEC $1.00 8142102004 BISACODYL 5 MG ORAL TBEC $1.00 0904-6748-80 BISACODYL 5 MG ORAL TBEC $1.00 0904-6748-17 BISACODYL 5 MG ORAL TBEC $1.00 149003977 BISMUTH SUBSALICYLATE 262 MG ORAL CHEW $1.00 149032642 BISMUTH SUBSALICYLATE 262 MG ORAL CHEW $1.00 0904-7205-46 BISMUTH SUBSALICYLATE 262 MG ORAL CHEW $1.00 149003978 BISMUTH SUBSALICYLATE 262 MG ORAL CHEW $1.00 29300-127-01 BISOPROLOL FUMARATE 10 MG ORAL TAB $1.00 29300-126-01 BISOPROLOL FUMARATE 5 MG ORAL TAB $1.00 52817-270-30 BISOPROLOL FUMARATE 5 MG ORAL TAB $1.00 43547-896-10 BUMETANIDE 0.5 MG ORAL TAB $1.00 99999-038-73 BUPIVACAINE PF 0.125 % (1.25 MG/ML) INJ DILUTION $1.00 50228-174-01 BUPROPION HCL 100 MG ORAL SR12 $1.00 59651-875-01 BUPROPION HCL 100 MG ORAL TAB $1.00 0904-7530-60 BUPROPION HCL 100 MG ORAL TAB $1.00 68382-353-16 BUPROPION HCL 150 MG ORAL TB24 $1.00 16729-443-10 BUPROPION HCL 150 MG ORAL TB24 $1.00 68180-319-09 BUPROPION HCL 150 MG ORAL TB24 $1.00 42806-414-30 BUPROPION HCL 150 MG ORAL TB24 $1.00 16729-443-15 BUPROPION HCL 150 MG ORAL TB24 $1.00 68382-353-06 BUPROPION HCL 150 MG ORAL TB24 $1.00 24979-101-07 BUPROPION HCL 150 MG ORAL TB24 $1.00 50228-144-90 BUPROPION HCL 150 MG ORAL TB24 $1.00 50228-145-90 BUPROPION HCL 300 MG ORAL TB24 $1.00 0093-0054-01 BUSPIRONE 10 MG ORAL TAB $1.00 0378-1150-01 BUSPIRONE 10 MG ORAL TAB $1.00 51079-986-20 BUSPIRONE 10 MG ORAL TAB $1.00 64380-742-06 BUSPIRONE 10 MG ORAL TAB $1.00 68382-181-01 BUSPIRONE 10 MG ORAL TAB $1.00 64380-742-08 BUSPIRONE 10 MG ORAL TAB $1.00 0093-0054-05 BUSPIRONE 10 MG ORAL TAB $1.00 51079-986-01 BUSPIRONE 10 MG ORAL TAB $1.00 0904-7121-61 BUSPIRONE 10 MG ORAL TAB $1.00 16729-202-01 BUSPIRONE 10 MG ORAL TAB $1.00 64380-742-07 BUSPIRONE 10 MG ORAL TAB $1.00 51079-985-20 BUSPIRONE 5 MG ORAL TAB $1.00 51079-985-01 BUSPIRONE 5 MG ORAL TAB $1.00 64380-741-06 BUSPIRONE 5 MG ORAL TAB $1.00 0093-0053-01 BUSPIRONE 5 MG ORAL TAB $1.00 16729-200-01 BUSPIRONE 5 MG ORAL TAB $1.00 68382-180-01 BUSPIRONE 5 MG ORAL TAB $1.00 0904-7122-61 BUSPIRONE 5 MG ORAL TAB $1.00 29300-244-01 BUSPIRONE 5 MG ORAL TAB $1.00 72888-062-01 BUSPIRONE 5 MG ORAL TAB $1.00 69584-091-10 BUSPIRONE 5 MG ORAL TAB $1.00 10702-253-01 BUTALBITAL-ACETAMINOPHEN-CAFF 50-325-40 MG ORAL TAB $1.00 70677-0021-1 CAFFEINE 200 MG ORAL TAB $1.00 99999-005-74 CAFFEINE CITRATED 10 MG/ML ORAL SOLN (COMPOUND) (MCH) $1.00 7132180320 CALCIUM ACETATE 667 MG ORAL TAB $1.00 66553-004-01 CALCIUM CARBONATE 200 MG CALCIUM (500 MG) ORAL CHEW $1.00 0536-1007-15 CALCIUM CARBONATE 200 MG CALCIUM (500 MG) ORAL CHEW $1.00 0904-6412-92 CALCIUM CARBONATE 200 MG CALCIUM (500 MG) ORAL CHEW $1.00 0536-1048-15 CALCIUM CARBONATE 200 MG CALCIUM (500 MG) ORAL CHEW $1.00 0135-0071-27 CALCIUM CARBONATE 200 MG CALCIUM (500 MG) ORAL CHEW $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 8068100400 CALCIUM CARBONATE 500 MG CALCIUM (1,250 MG) ORAL TAB $1.00 2055502500 CALCIUM CARBONATE-VITAMIN D3 250 MG-3.125 MCG (125 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 904546052 CALCIUM CARBONATE-VITAMIN D3 500 MG-5 MCG (200 UNIT) ORAL TAB $1.00 5164582899 CALCIUM CARBONATE-VITAMIN D3 500 MG-5 MCG (200 UNIT) ORAL TAB $1.00 3786408289 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 1000670038 CALCIUM CARBONATE-VITAMIN D3 500 MG-5 MCG (200 UNIT) ORAL TAB $1.00 536781710 CALCIUM CARBONATE-VITAMIN D3 500 MG-5 MCG (200 UNIT) ORAL TAB $1.00 1191705014 CALCIUM CITRATE 200 MG (950 MG) ORAL TAB $1.00 8068114000 CALCIUM CITRATE 200 MG (950 MG) ORAL TAB $1.00 4329255606 CALCIUM CITRATE 250 MG CALCIUM ORAL TAB $1.00 0536-4306-08 CALCIUM POLYCARBOPHIL 625 MG ORAL TAB $1.00 0005-2500-02 CALCIUM POLYCARBOPHIL 625 MG ORAL TAB $1.00 0904-2500-91 CALCIUM POLYCARBOPHIL 625 MG ORAL TAB $1.00 46581-110-60 CAMPHOR-METHYL SALICYL-MENTHOL 3.1-10-6 % TOPICAL PTMD $1.00 46122-392-72 CAMPHOR-METHYL SALICYL-MENTHOL 3.1-10-6 % TOPICAL PTMD $1.00 99999-033-69 CAPTOPRIL 1 MG/ML (NICU) ORAL SYRINGE $1.00 99996-001-55 CAPTOPRIL 1 MG/ML ORAL SUSP (COMPOUND) $1.00 75834-221-01 CARBAMAZEPINE 200 MG ORAL TAB $1.00 50228-458-01 CARBIDOPA-LEVODOPA 25-100 MG ORAL TAB $1.00 42291-472-01 CARBIDOPA-LEVODOPA 25-100 MG ORAL TAB $1.00 59651-457-01 CARBIDOPA-LEVODOPA 25-100 MG ORAL TAB $1.00 72888-107-01 CARBIDOPA-LEVODOPA 25-100 MG ORAL TAB $1.00 50228-459-01 CARBIDOPA-LEVODOPA 25-250 MG ORAL TAB $1.00 99999-033-44 CARBOPLATIN IV SOLN (FOR DESENSITIZATION USE) (MHS) $1.00 99999-040-85 CARBOPLATIN IV SOLN (FOR DESENSITIZATION USE) (MHS) $1.00 70677-1190-1 CARBOXYMETHYLCELLULOSE SODIUM 0.5 % OPHT DPET $1.00 69584-111-10 CARISOPRODOL 350 MG ORAL TAB $1.00 50228-109-01 CARISOPRODOL 350 MG ORAL TAB $1.00 50742-656-01 CARISOPRODOL 350 MG ORAL TAB $1.00 42543-700-01 CARISOPRODOL 350 MG ORAL TAB $1.00 99999-034-17 CARVEDILOL 0.1 MG/ML ORAL LIQUID (PEDIATRIC DOSING) $1.00 99999-005-22 CARVEDILOL 0.625 MG/ML ORAL LIQUID $1.00 99999-034-20 CARVEDILOL 1.25 MG/ML ORAL LIQUID (PEDIATRIC DOSING) $1.00 51079-931-01 CARVEDILOL 12.5 MG ORAL TAB $1.00 0093-7295-01 CARVEDILOL 12.5 MG ORAL TAB $1.00 51079-931-20 CARVEDILOL 12.5 MG ORAL TAB $1.00 0093-7295-05 CARVEDILOL 12.5 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 0904-7307-61 CARVEDILOL 12.5 MG ORAL TAB $1.00 72888-036-01 CARVEDILOL 12.5 MG ORAL TAB $1.00 51079-932-01 CARVEDILOL 25 MG ORAL TAB $1.00 0093-7296-01 CARVEDILOL 25 MG ORAL TAB $1.00 51079-932-20 CARVEDILOL 25 MG ORAL TAB $1.00 0093-7296-05 CARVEDILOL 25 MG ORAL TAB $1.00 68382-095-01 CARVEDILOL 25 MG ORAL TAB $1.00 65862-145-05 CARVEDILOL 25 MG ORAL TAB $1.00 68462-165-01 CARVEDILOL 25 MG ORAL TAB $1.00 72888-037-01 CARVEDILOL 25 MG ORAL TAB $1.00 72888-037-00 CARVEDILOL 25 MG ORAL TAB $1.00 0904-7308-61 CARVEDILOL 25 MG ORAL TAB $1.00 68382-095-05 CARVEDILOL 25 MG ORAL TAB $1.00 0093-0051-01 CARVEDILOL 3.125 MG ORAL TAB $1.00 51079-771-01 CARVEDILOL 3.125 MG ORAL TAB $1.00 68001-153-00 CARVEDILOL 3.125 MG ORAL TAB $1.00 68084-843-11 CARVEDILOL 3.125 MG ORAL TAB $1.00 68084-843-01 CARVEDILOL 3.125 MG ORAL TAB $1.00 0093-0051-05 CARVEDILOL 3.125 MG ORAL TAB $1.00 68382-092-05 CARVEDILOL 3.125 MG ORAL TAB $1.00 68382-092-01 CARVEDILOL 3.125 MG ORAL TAB $1.00 0904-7305-61 CARVEDILOL 3.125 MG ORAL TAB $1.00 72888-034-01 CARVEDILOL 3.125 MG ORAL TAB $1.00 51079-771-20 CARVEDILOL 3.125 MG ORAL TAB $1.00 0093-0135-01 CARVEDILOL 6.25 MG ORAL TAB $1.00 0781-5222-01 CARVEDILOL 6.25 MG ORAL TAB $1.00 68001-154-00 CARVEDILOL 6.25 MG ORAL TAB $1.00 0093-0135-05 CARVEDILOL 6.25 MG ORAL TAB $1.00 68462-163-05 CARVEDILOL 6.25 MG ORAL TAB $1.00 72888-035-01 CARVEDILOL 6.25 MG ORAL TAB $1.00 72888-035-05 CARVEDILOL 6.25 MG ORAL TAB $1.00 68382-093-01 CARVEDILOL 6.25 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 0904-7306-61 CARVEDILOL 6.25 MG ORAL TAB $1.00 99999-038-41 CEFAZOLIN INTRAVITREAL INJ $1.00 99999-005-18 CEFAZOLIN 50 MG/ML INJ DILUTION (MCH) $1.00 99999-000-04 CEFAZOLIN 500 MG / 5 ML SYRINGE $1.00 99999-033-79 CEFAZOLIN IN BSS (10 MG/ML) OPHTHALMIC INJECTION $1.00 99999-039-08 CEFAZOLIN IV (FOR DESENSITIZATION USE) $1.00 99999-035-55 CEFEPIME IV (FOR DESENSITIZATION USE) $1.00 99999-038-46 CEFTAZIDIME IN NS INTRAVITREAL INJ $1.00 99999-038-76 CEFTAZIDIME IV (FOR DESENSITIZATION USE) $1.00 99999-001-57 CEFTRIAXONE 40 MG / ML (NICU) IV SYRINGE $1.00 99999-040-49 CEFTRIAXONE 40 MG/ML INJ SYRINGE $1.00 99999-037-99 CEFTRIAXONE IV (FOR DESENSITIZATION USE) $1.00 72241-023-05 CELECOXIB 100 MG ORAL CAP $1.00 65862-909-01 CELECOXIB 200 MG ORAL CAP $1.00 72241-024-05 CELECOXIB 200 MG ORAL CAP $1.00 0093-3145-01 CEPHALEXIN 250 MG ORAL CAP $1.00 65862-018-01 CEPHALEXIN 250 MG ORAL CAP $1.00 67877-220-01 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 51079-597-01 CETIRIZINE 10 MG ORAL TAB $1.00 51079-597-20 CETIRIZINE 10 MG ORAL TAB $1.00 0904-6717-61 CETIRIZINE 10 MG ORAL TAB $1.00 0904-6717-41 CETIRIZINE 10 MG ORAL TAB $1.00 0378-3635-01 CETIRIZINE 5 MG ORAL TAB $1.00 16571-401-10 CETIRIZINE 5 MG ORAL TAB $1.00 0555-0033-02 CHLORDIAZEPOXIDE HCL 10 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 0555-0158-02 CHLORDIAZEPOXIDE HCL 5 MG ORAL CAP $1.00 0234-0575-17 CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQD $1.00 0904-5351-24 CHLORPHENIRAMINE-PSEUDOEPHED 4-60 MG ORAL TAB $1.00 62332-735-31 CHLORPROMAZINE 10 MG ORAL TAB $1.00 62332-736-31 CHLORPROMAZINE 25 MG ORAL TAB $1.00 43598-170-01 CHLORTHALIDONE 25 MG ORAL TAB $1.00 65162-247-09 CHLORTHALIDONE 25 MG ORAL TAB $1.00 904582360 CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) ORAL TAB $1.00 4329255881 CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) ORAL TAB $1.00 7985401162 CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) ORAL TAB $1.00 6809411461 CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) ORAL TAB $1.00 7139974015 CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROP $1.00 7431219377 CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) ORAL CAP $1.00 8068113100 CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) ORAL CAP $1.00 5319124401 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 4009310107 CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) ORAL CAP $1.00 2055503300 CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) ORAL TAB $1.00 4843310401 CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) ORAL TAB $1.00 7985405024 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 8068116801 CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) ORAL TAB $1.00 1013574901 CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) ORAL TAB $1.00 536135301 CHOLECALCIFEROL (VITAMIN D3) 50 MCG (2,000 UNIT) ORAL CAP $1.00 10939957245 CHOLECALCIFEROL (VITAMIN D3) 50 MCG (2,000 UNIT) ORAL CAP $1.00 1093995376 CHOLECALCIFEROL (VITAMIN D3) 50 MCG (2,000 UNIT) ORAL CAP $1.00 1093995724 CHOLECALCIFEROL (VITAMIN D3) 50 MCG (2,000 UNIT) ORAL CAP $1.00 99999-044-02 CINACALCET 5 MG/ML ORAL LIQUID (COMPOUND) $1.00 0143-9927-01 CIPROFLOXACIN HCL 250 MG ORAL TAB $1.00 43547-688-10 CIPROFLOXACIN HCL 250 MG ORAL TAB $1.00 58657-675-01 CIPROFLOXACIN HCL 250 MG ORAL TAB $1.00 59651-867-05 CIPROFLOXACIN HCL 500 MG ORAL TAB $1.00 51079-182-01 CIPROFLOXACIN HCL 500 MG ORAL TAB $1.00 0904-6084-61 CITALOPRAM 10 MG ORAL TAB $1.00 13668-009-01 CITALOPRAM 10 MG ORAL TAB $1.00 65862-005-01 CITALOPRAM 10 MG ORAL TAB $1.00 69097-822-07 CITALOPRAM 10 MG ORAL TAB $1.00 55111-342-30 CITALOPRAM 10 MG ORAL TAB $1.00 0904-6085-61 CITALOPRAM 20 MG ORAL TAB $1.00 13668-010-01 CITALOPRAM 20 MG ORAL TAB $1.00 0378-6232-01 CITALOPRAM 20 MG ORAL TAB $1.00 65862-006-05 CITALOPRAM 20 MG ORAL TAB $1.00 13668-010-05 CITALOPRAM 20 MG ORAL TAB $1.00 55111-343-30 CITALOPRAM 20 MG ORAL TAB $1.00 65862-006-01 CITALOPRAM 20 MG ORAL TAB $1.00 99999-046-95 CITRULLINE 600 MG ORAL CAP $1.00 59762-3328-1 CLINDAMYCIN HCL 150 MG ORAL CAP $1.00 63304-692-01 CLINDAMYCIN HCL 150 MG ORAL CAP $1.00 65862-185-01 CLINDAMYCIN HCL 150 MG ORAL CAP $1.00 68462-143-01 CLINDAMYCIN HCL 150 MG ORAL CAP $1.00 99999-038-37 CLINDAMYCIN INTRAVITREAL INJ $1.00 0093-0832-01 CLONAZEPAM 0.5 MG ORAL TAB $1.00 59651-722-01 CLONAZEPAM 0.5 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 72888-152-01 CLONAZEPAM 0.5 MG ORAL TAB $1.00 43547-406-10 CLONAZEPAM 0.5 MG ORAL TAB $1.00 16729-137-00 CLONAZEPAM 1 MG ORAL TAB $1.00 59651-723-99 CLONAZEPAM 1 MG ORAL TAB $1.00 59651-723-01 CLONAZEPAM 1 MG ORAL TAB $1.00 51079-882-20 CLONAZEPAM 1 MG ORAL TAB $1.00 51079-882-01 CLONAZEPAM 1 MG ORAL TAB $1.00 43547-407-10 CLONAZEPAM 1 MG ORAL TAB $1.00 0093-3212-01 CLONAZEPAM 1 MG ORAL TAB $1.00 72603-308-01 CLONAZEPAM 1 MG ORAL TAB $1.00 99999-044-00 CLONIDINE 0.01 MG/ML ORAL LIQUID (COMPOUND) $1.00 0228-2127-10 CLONIDINE 0.1 MG ORAL TAB (MCH) $1.00 0228-2127-50 CLONIDINE 0.1 MG ORAL TAB (MCH) $1.00 68001-237-00 CLONIDINE HCL 0.1 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 0228-2128-10 CLONIDINE HCL 0.2 MG ORAL TAB $1.00 29300-136-01 CLONIDINE HCL 0.2 MG ORAL TAB $1.00 62332-055-31 CLONIDINE HCL 0.2 MG ORAL TAB $1.00 52817-181-10 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 29300-137-01 CLONIDINE HCL 0.3 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 99999-037-53 CLOPIDOGREL 5 MG/ML ORAL LIQUID (COMPOUND) $1.00 60505-0253-3 CLOPIDOGREL 75 MG ORAL TAB $1.00 16714-052-02 CLOPIDOGREL 75 MG ORAL TAB $1.00 65862-357-30 CLOPIDOGREL 75 MG ORAL TAB $1.00 60505-0253-2 CLOPIDOGREL 75 MG ORAL TAB $1.00 33342-060-15 CLOPIDOGREL 75 MG ORAL TAB $1.00 65862-357-05 CLOPIDOGREL 75 MG ORAL TAB $1.00 5789687503 COENZYME Q10 100 MG ORAL CAP $1.00 4009310232 COENZYME Q10 50 MG ORAL CAP $1.00 67877-589-01 COLCHICINE 0.6 MG ORAL TAB $1.00 7431201380 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG ORAL TAB $1.00 1000670022 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG 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 5789689601 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG ORAL TAB $1.00 536136601 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG ORAL TAB $1.00 2055500600 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG ORAL TAB $1.00 904740361 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG ORAL TAB $1.00 5026885211 CYANOCOBALAMIN (VITAMIN B-12) 100 MCG ORAL TAB $1.00 5026885215 CYANOCOBALAMIN (VITAMIN B-12) 100 MCG ORAL TAB $1.00 8068107100 CYANOCOBALAMIN (VITAMIN B-12) 100 MCG ORAL TAB $1.00 7733393725 CYANOCOBALAMIN (VITAMIN B-12) 500 MCG ORAL TAB $1.00 7733393710 CYANOCOBALAMIN (VITAMIN B-12) 500 MCG ORAL TAB $1.00 5026885415 CYANOCOBALAMIN (VITAMIN B-12) 500 MCG ORAL TAB $1.00 5026885411 CYANOCOBALAMIN (VITAMIN B-12) 500 MCG ORAL TAB $1.00 2055503200 CYANOCOBALAMIN (VITAMIN B-12) 500 MCG ORAL TAB $1.00 51079-644-01 CYCLOBENZAPRINE 10 MG ORAL TAB $1.00 51079-644-20 CYCLOBENZAPRINE 10 MG ORAL TAB $1.00 69097-846-07 CYCLOBENZAPRINE 10 MG ORAL TAB $1.00 0093-3422-01 CYCLOBENZAPRINE 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 10702-007-09 CYCLOBENZAPRINE 10 MG ORAL TAB $1.00 65862-191-05 CYCLOBENZAPRINE 10 MG ORAL TAB $1.00 50268-191-11 CYCLOBENZAPRINE 10 MG ORAL TAB $1.00 50268-191-15 CYCLOBENZAPRINE 10 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 10702-006-01 CYCLOBENZAPRINE 5 MG ORAL TAB $1.00 29300-413-01 CYCLOBENZAPRINE 5 MG ORAL TAB $1.00 99999-036-60 CYPROHEPTADINE 2 MG ORAL PARTIAL TAB (MCH) $1.00 52817-210-10 CYPROHEPTADINE 4 MG ORAL TAB $1.00 50742-190-01 CYPROHEPTADINE 4 MG ORAL TAB $1.00 10135-638-01 CYPROHEPTADINE 4 MG ORAL TAB $1.00 50742-113-01 DESIPRAMINE 25 MG ORAL TAB $1.00 0054-8179-25 DEXAMETHASONE 0.5 MG ORAL TAB $1.00 72603-212-01 DEXAMETHASONE 0.5 MG ORAL TAB $1.00 0054-4179-25 DEXAMETHASONE 0.5 MG ORAL TAB $1.00 99999-000-15 DEXAMETHASONE 0.5 MG/ML NICU INJECTION $1.00 72578-169-01 DEXAMETHASONE 0.75 MG ORAL TAB $1.00 99999-035-02 DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5 ML ORAL LIQD $1.00 51079-286-20 DIAZEPAM 10 MG ORAL TAB $1.00 51079-286-01 DIAZEPAM 10 MG ORAL TAB $1.00 51079-284-20 DIAZEPAM 2 MG ORAL TAB $1.00 51079-284-01 DIAZEPAM 2 MG ORAL TAB $1.00 0378-0271-01 DIAZEPAM 2 MG ORAL TAB $1.00 0172-3925-60 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 0172-3926-60 DIAZEPAM 5 MG ORAL TAB $1.00 0591-0794-01 DICYCLOMINE 10 MG ORAL CAP $1.00 0527-0586-01 DICYCLOMINE 10 MG ORAL CAP $1.00 0591-0794-10 DICYCLOMINE 10 MG ORAL CAP $1.00 24979-201-01 DICYCLOMINE 10 MG ORAL CAP $1.00 0527-1282-01 DICYCLOMINE 20 MG ORAL TAB $1.00 50228-484-01 DILTIAZEM HCL 120 MG ORAL TAB $1.00 0093-0318-01 DILTIAZEM HCL 30 MG ORAL TAB $1.00 0378-0023-01 DILTIAZEM HCL 30 MG ORAL TAB $1.00 0093-0318-05 DILTIAZEM HCL 30 MG ORAL TAB $1.00 50228-481-01 DILTIAZEM HCL 30 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 50228-482-01 DILTIAZEM HCL 60 MG ORAL TAB $1.00 50228-483-01 DILTIAZEM HCL 90 MG ORAL TAB $1.00 71399-1027-1 DIPHENHYDRAMINE HCL 25 MG ORAL CAP $1.00 69618-024-01 DIPHENHYDRAMINE HCL 25 MG ORAL CAP $1.00 70677-1015-2 DIPHENHYDRAMINE HCL 25 MG ORAL CAP $1.00 0501-2001-24 DIPHENHYDRAMINE HCL 25 MG ORAL CAP $1.00 0904-7237-61 DIPHENHYDRAMINE HCL 25 MG ORAL CAP $1.00 46122-440-78 DIPHENHYDRAMINE HCL 25 MG ORAL CAP $1.00 69618-025-01 DIPHENHYDRAMINE HCL 25 MG ORAL TAB $1.00 99999-006-72 DIPHENHYDRAMINE HCL 5 MG/ML INJ DILUTION (MCH) $1.00 0904-2056-61 DIPHENHYDRAMINE HCL 50 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 62559-490-01 DIPHENOXYLATE-ATROPINE 2.5-0.025 MG ORAL TAB $1.00 0406-1236-01 DIPHENOXYLATE-ATROPINE 2.5-0.025 MG ORAL TAB $1.00 71205-909-60 DIPHENOXYLATE-ATROPINE 2.5-0.025 MG ORAL TAB $1.00 71205-909-30 DIPHENOXYLATE-ATROPINE 2.5-0.025 MG ORAL TAB $1.00 0832-7122-11 DIVALPROEX 125 MG ORAL TBEC $1.00 62756-796-88 DIVALPROEX 125 MG ORAL TBEC $1.00 29300-138-01 DIVALPROEX 125 MG ORAL TBEC $1.00 29300-139-01 DIVALPROEX 250 MG ORAL TBEC $1.00 0904-6860-61 DIVALPROEX 250 MG ORAL TBEC $1.00 62756-797-88 DIVALPROEX 250 MG ORAL TBEC $1.00 0832-7123-11 DIVALPROEX 250 MG ORAL TBEC $1.00 0904-6861-61 DIVALPROEX 500 MG ORAL TBEC $1.00 0904-7183-61 DOCUSATE SODIUM 100 MG ORAL CAP $1.00 60687-129-01 DOCUSATE SODIUM 100 MG ORAL CAP $1.00 60687-129-11 DOCUSATE SODIUM 100 MG ORAL CAP $1.00 0904-7280-60 DOCUSATE SODIUM 100 MG ORAL CAP $1.00 10135-111-01 DOCUSATE SODIUM 100 MG ORAL CAP $1.00 63739-478-02 DOCUSATE SODIUM 100 MG ORAL CAP $1.00 0904-7280-80 DOCUSATE SODIUM 100 MG ORAL CAP $1.00 99999-037-78 DOCUSATE SODIUM 100 MG/10 ML ORAL LIQD $1.00 54859-813-16 DOCUSATE SODIUM 100 MG/10 ML ORAL LIQD $1.00 0904-7281-80 DOCUSATE SODIUM 250 MG ORAL CAP $1.00 0904-7281-60 DOCUSATE SODIUM 250 MG ORAL CAP $1.00 57896-426-01 DOCUSATE SODIUM 250 MG ORAL CAP $1.00 13668-103-90 DONEPEZIL 10 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 60687-303-11 DONEPEZIL 10 MG ORAL TAB $1.00 60687-303-01 DONEPEZIL 10 MG ORAL TAB $1.00 0904-6478-61 DONEPEZIL 10 MG ORAL TAB $1.00 31722-738-30 DONEPEZIL 10 MG ORAL TAB $1.00 13668-102-90 DONEPEZIL 5 MG ORAL TAB $1.00 13668-102-30 DONEPEZIL 5 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 16571-778-09 DONEPEZIL 5 MG ORAL TAB $1.00 0904-6477-61 DONEPEZIL 5 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 68382-784-01 DOXAZOSIN 2 MG ORAL TAB $1.00 68382-785-01 DOXAZOSIN 4 MG ORAL TAB $1.00 42291-259-01 DOXAZOSIN 4 MG ORAL TAB $1.00 69238-1166-9 DOXEPIN 10 MG ORAL CAP $1.00 27808-233-02 DOXYCYCLINE HYCLATE 100 MG ORAL CAP $1.00 24658-312-50 DOXYCYCLINE HYCLATE 100 MG ORAL TAB $1.00 42806-312-50 DOXYCYCLINE HYCLATE 100 MG ORAL TAB $1.00 42806-312-05 DOXYCYCLINE HYCLATE 100 MG ORAL TAB $1.00 27808-234-02 DOXYCYCLINE HYCLATE 100 MG ORAL TAB $1.00 27808-234-01 DOXYCYCLINE HYCLATE 100 MG ORAL TAB $1.00 24658-310-01 DOXYCYCLINE HYCLATE 100 MG ORAL TAB $1.00 42806-310-05 DOXYCYCLINE HYCLATE 100 MG ORAL TAB $1.00 70677-0068-1 DOXYLAMINE SUCCINATE 25 MG ORAL TAB $1.00 70677-1129-1 DOXYLAMINE SUCCINATE 25 MG ORAL TAB $1.00 57237-017-60 DULOXETINE 20 MG ORAL CPDR $1.00 57237-018-90 DULOXETINE 30 MG ORAL CPDR $1.00 57237-018-99 DULOXETINE 30 MG ORAL CPDR $1.00 57237-019-90 DULOXETINE 60 MG ORAL CPDR $1.00 50228-230-01 ENALAPRIL MALEATE 10 MG ORAL TAB $1.00 51672-4037-1 ENALAPRIL MALEATE 2.5 MG ORAL TAB $1.00 43547-545-10 ENALAPRIL MALEATE 2.5 MG ORAL TAB $1.00 50228-229-01 ENALAPRIL MALEATE 5 MG ORAL TAB $1.00 42806-547-01 ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) ORAL CAP $1.00 99999-000-95 ERGOCALCIFEROL 800 UNIT / ML ORAL SOLN $1.00 99999-039-46 ERTAPENEM IV (FOR DESENSITIZATION USE) $1.00 65862-374-01 ESCITALOPRAM OXALATE 10 MG ORAL TAB $1.00 43547-281-10 ESCITALOPRAM OXALATE 10 MG ORAL TAB $1.00 0904-6426-61 ESCITALOPRAM OXALATE 10 MG ORAL TAB $1.00 16729-169-01 ESCITALOPRAM OXALATE 10 MG ORAL TAB $1.00 65862-374-05 ESCITALOPRAM OXALATE 10 MG ORAL TAB $1.00 72603-150-01 ESCITALOPRAM OXALATE 10 MG ORAL TAB $1.00 43547-281-11 ESCITALOPRAM OXALATE 10 MG ORAL TAB $1.00 13668-136-10 ESCITALOPRAM OXALATE 10 MG ORAL TAB $1.00 65862-375-01 ESCITALOPRAM OXALATE 20 MG ORAL TAB $1.00 0904-6427-61 ESCITALOPRAM OXALATE 20 MG ORAL TAB $1.00 16729-170-01 ESCITALOPRAM OXALATE 20 MG ORAL TAB $1.00 43547-282-10 ESCITALOPRAM OXALATE 20 MG ORAL TAB $1.00 65862-375-05 ESCITALOPRAM OXALATE 20 MG ORAL TAB $1.00 99999-046-69 ESTRADIOL 0.25 MG ORAL PARTIAL TAB (USING 1 MG TAB) $1.00 99999-041-74 ESTRADIOL 0.5 MG ORAL PARTIAL TAB $1.00 42806-087-01 ESTRADIOL 0.5 MG ORAL TAB $1.00 0378-1454-01 ESTRADIOL 1 MG ORAL TAB $1.00 42806-088-01 ESTRADIOL 1 MG ORAL TAB $1.00 10135-787-90 EZETIMIBE 10 MG ORAL TAB $1.00 10135-787-30 EZETIMIBE 10 MG ORAL TAB $1.00 51079-966-01 FAMOTIDINE 20 MG ORAL TAB $1.00 0172-5728-70 FAMOTIDINE 20 MG ORAL TAB $1.00 0172-5728-60 FAMOTIDINE 20 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 51079-966-20 FAMOTIDINE 20 MG ORAL TAB $1.00 63739-645-10 FAMOTIDINE 20 MG ORAL TAB $1.00 0172-5728-80 FAMOTIDINE 20 MG ORAL TAB $1.00 68001-397-08 FAMOTIDINE 20 MG ORAL TAB $1.00 62332-001-91 FAMOTIDINE 20 MG ORAL TAB $1.00 68001-397-00 FAMOTIDINE 20 MG ORAL TAB $1.00 65862-859-01 FAMOTIDINE 20 MG ORAL TAB $1.00 0904-5780-51 FAMOTIDINE 20 MG ORAL TAB $1.00 62332-001-31 FAMOTIDINE 20 MG ORAL TAB $1.00 60687-595-01 FAMOTIDINE 20 MG ORAL TAB $1.00 60687-595-11 FAMOTIDINE 20 MG ORAL TAB $1.00 0904-7193-61 FAMOTIDINE 20 MG ORAL TAB $1.00 0904-7193-06 FAMOTIDINE 20 MG ORAL TAB $1.00 0536-1298-01 FAMOTIDINE 20 MG ORAL TAB $1.00 50268-299-15 FAMOTIDINE 20 MG ORAL TAB $1.00 50268-299-11 FAMOTIDINE 20 MG ORAL TAB $1.00 31722-017-01 FAMOTIDINE 20 MG ORAL TAB $1.00 67877-842-01 FAMOTIDINE 20 MG ORAL TAB $1.00 68462-233-01 FELODIPINE 2.5 MG ORAL TB24 $1.00 68462-234-01 FELODIPINE 5 MG ORAL TB24 $1.00 42858-660-45 FENOFIBRATE 160 MG ORAL TAB $1.00 99999-005-66 FENTANYL CITRATE (PF) 5 MCG/ML INJ DILUTION (MCH) $1.00 99999-037-01 FENTANYL CITRATE (PF) 5 MCG/ML INJ DILUTION (MCH) $1.00 99999-038-47 FENTANYL-NS 5 MCG/ML NICU INJECTION $1.00 574050810 FERROUS GLUCONATE 324 MG (38 MG IRON) ORAL TAB $1.00 574050801 FERROUS GLUCONATE 324 MG (38 MG IRON) ORAL TAB $1.00 1000673013 FERROUS SULFATE 140 MG (45 MG IRON) ORAL TBSR $1.00 5766407001 FERROUS SULFATE 325 MG (65 MG IRON) ORAL TAB $1.00 904759060 FERROUS SULFATE 325 MG (65 MG IRON) ORAL TAB $1.00 904759161 FERROUS SULFATE 325 MG (65 MG IRON) ORAL TAB $1.00 904759080 FERROUS SULFATE 325 MG (65 MG IRON) ORAL TAB $1.00 904759160 FERROUS SULFATE 325 MG (65 MG IRON) ORAL TAB $1.00 536100901 FERROUS SULFATE 325 MG (65 MG IRON) ORAL TAB $1.00 904759180 FERROUS SULFATE 325 MG (65 MG IRON) ORAL TAB $1.00 2055502101 FERROUS SULFATE 325 MG (65 MG IRON) ORAL TAB $1.00 65862-927-30 FINASTERIDE 1 MG ORAL TAB $1.00 67877-455-90 FINASTERIDE 1 MG ORAL TAB $1.00 99999-040-15 FINASTERIDE 2.5 MG ORAL PARTIAL TAB $1.00 65862-149-30 FINASTERIDE 5 MG ORAL TAB $1.00 16729-090-01 FINASTERIDE 5 MG ORAL TAB $1.00 65862-149-90 FINASTERIDE 5 MG ORAL TAB $1.00 67877-288-90 FINASTERIDE 5 MG ORAL TAB $1.00 16729-090-15 FINASTERIDE 5 MG ORAL TAB $1.00 65862-149-05 FINASTERIDE 5 MG ORAL TAB $1.00 17238-900-30 FLUORESCEIN 1 MG OPHT STRP $1.00 65862-192-01 FLUOXETINE 10 MG ORAL CAP $1.00 50111-647-01 FLUOXETINE 10 MG ORAL CAP $1.00 16714-720-02 FLUOXETINE 10 MG ORAL CAP $1.00 50228-113-10 FLUOXETINE 10 MG ORAL CAP $1.00 0904-7345-61 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 16714-721-02 FLUOXETINE 20 MG ORAL CAP $1.00 0904-7346-61 FLUOXETINE 20 MG ORAL CAP $1.00 50111-648-01 FLUOXETINE 20 MG ORAL CAP $1.00 16714-352-01 FLUOXETINE 20 MG ORAL CAP $1.00 65162-361-10 FOLIC ACID 1 MG ORAL TAB $1.00 53746-361-01 FOLIC ACID 1 MG ORAL TAB $1.00 60687-681-11 FOLIC ACID 1 MG ORAL TAB $1.00 60687-681-01 FOLIC ACID 1 MG ORAL TAB $1.00 53746-361-10 FOLIC ACID 1 MG ORAL TAB $1.00 6809411259 FOLIC ACID 1 MG ORAL TAB $1.00 6809411261 FOLIC ACID 1 MG ORAL TAB $1.00 11534-165-03 FOLIC ACID 1 MG ORAL TAB $1.00 0904-7224-61 FOLIC ACID 1 MG ORAL TAB $1.00 65162-361-11 FOLIC ACID 1 MG ORAL TAB $1.00 11534-165-01 FOLIC ACID 1 MG ORAL TAB $1.00 5473814001 FOLIC ACID 400 MCG ORAL TAB $1.00 5026834611 FOLIC ACID 400 MCG ORAL TAB $1.00 5026834615 FOLIC ACID 400 MCG ORAL TAB $1.00 8068109900 FOLIC ACID 400 MCG ORAL TAB $1.00 6936722209 FOLIC ACID-VIT B6-VIT B12 2.5-25-1 MG ORAL TAB $1.00 43547-386-09 FOSINOPRIL 10 MG ORAL TAB $1.00 99999-002-44 FUROSEMIDE 10 MG/ML NICU ORAL SYRINGE $1.00 63304-624-01 FUROSEMIDE 20 MG ORAL TAB $1.00 0054-8297-25 FUROSEMIDE 20 MG ORAL TAB $1.00 43547-401-10 FUROSEMIDE 20 MG ORAL TAB $1.00 64980-562-10 FUROSEMIDE 20 MG ORAL TAB $1.00 64980-562-01 FUROSEMIDE 20 MG ORAL TAB $1.00 0904-7177-61 FUROSEMIDE 20 MG ORAL TAB $1.00 69315-116-01 FUROSEMIDE 20 MG ORAL TAB $1.00 63304-624-10 FUROSEMIDE 20 MG ORAL TAB $1.00 43547-401-11 FUROSEMIDE 20 MG ORAL TAB $1.00 42291-468-01 FUROSEMIDE 20 MG ORAL TAB $1.00 63304-625-01 FUROSEMIDE 40 MG ORAL TAB $1.00 0054-8299-25 FUROSEMIDE 40 MG ORAL TAB $1.00 0378-0216-01 FUROSEMIDE 40 MG ORAL TAB $1.00 69315-117-01 FUROSEMIDE 40 MG ORAL TAB $1.00 0054-4299-25 FUROSEMIDE 40 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 0904-7178-61 FUROSEMIDE 40 MG ORAL TAB $1.00 64980-563-01 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 43547-403-10 FUROSEMIDE 80 MG ORAL TAB $1.00 0054-4301-29 FUROSEMIDE 80 MG ORAL TAB $1.00 43547-403-50 FUROSEMIDE 80 MG ORAL TAB $1.00 64980-564-01 FUROSEMIDE 80 MG ORAL TAB $1.00 63304-626-05 FUROSEMIDE 80 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 67877-222-01 GABAPENTIN 100 MG ORAL CAP $1.00 69097-813-07 GABAPENTIN 100 MG ORAL CAP $1.00 63739-591-10 GABAPENTIN 100 MG ORAL CAP $1.00 0904-6665-61 GABAPENTIN 100 MG ORAL CAP $1.00 60687-580-11 GABAPENTIN 100 MG ORAL CAP $1.00 60687-580-01 GABAPENTIN 100 MG ORAL CAP $1.00 63739-902-10 GABAPENTIN 100 MG ORAL CAP $1.00 67877-222-10 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 67877-223-05 GABAPENTIN 300 MG ORAL CAP $1.00 0904-6666-61 GABAPENTIN 300 MG ORAL CAP $1.00 45963-556-50 GABAPENTIN 300 MG ORAL CAP $1.00 63739-236-10 GABAPENTIN 300 MG ORAL CAP $1.00 60687-591-11 GABAPENTIN 300 MG ORAL CAP $1.00 67877-223-10 GABAPENTIN 300 MG ORAL CAP $1.00 60687-591-01 GABAPENTIN 300 MG ORAL CAP $1.00 63739-903-10 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 45963-557-11 GABAPENTIN 400 MG ORAL CAP $1.00 63739-984-10 GABAPENTIN 400 MG ORAL CAP $1.00 63739-904-10 GABAPENTIN 400 MG ORAL CAP $1.00 60687-602-01 GABAPENTIN 400 MG ORAL CAP $1.00 60687-602-11 GABAPENTIN 400 MG ORAL CAP $1.00 69097-815-07 GABAPENTIN 400 MG ORAL CAP $1.00 16714-101-05 GEMFIBROZIL 600 MG ORAL TAB $1.00 16714-101-02 GEMFIBROZIL 600 MG ORAL TAB $1.00 72603-206-01 GEMFIBROZIL 600 MG ORAL TAB $1.00 99999-034-35 GENTAMICIN 2 MG/ML INJECTION IN NS (OCM) $1.00 99999-038-35 GENTAMICIN INTRAVITREAL INJ $1.00 99999-039-10 GI COCKTAIL WITHOUT DONNATAL ORAL LIQUID (SIMPLE) $1.00 55111-320-01 GLIMEPIRIDE 1 MG ORAL TAB $1.00 16729-002-01 GLIMEPIRIDE 2 MG ORAL TAB $1.00 55111-321-01 GLIMEPIRIDE 2 MG ORAL TAB $1.00 60505-0142-0 GLIPIZIDE 10 MG ORAL TAB $1.00 0591-0461-01 GLIPIZIDE 10 MG ORAL TAB $1.00 60505-0141-0 GLIPIZIDE 5 MG ORAL TAB $1.00 0591-0460-01 GLIPIZIDE 5 MG ORAL TAB $1.00 59762-0541-1 GLIPIZIDE 5 MG ORAL TR24 $1.00 16714-895-01 GLIPIZIDE 5 MG ORAL TR24 $1.00 4329255857 GLUCOSAMINE SULFATE 500 MG ORAL CAP $1.00 5789685906 GLUCOSAMINE-CHONDROITIN 500-400 MG ORAL CAP $1.00 0093-8343-01 GLYBURIDE 2.5 MG ORAL TAB $1.00 23155-057-01 GLYBURIDE 2.5 MG ORAL TAB $1.00 72241-039-05 GLYBURIDE 2.5 MG ORAL TAB $1.00 0132-0079-24 GLYCERIN (ADULT) RECTAL SUPP $1.00 132007924 GLYCERIN (ADULT) RECTAL SUPP $1.00 0132-0079-50 GLYCERIN (ADULT) RECTAL SUPP $1.00 0132-0079-12 GLYCERIN (ADULT) RECTAL SUPP $1.00 63868-282-25 GLYCERIN (CHILD) RECTAL SUPP $1.00 23155-606-01 GLYCOPYRROLATE 1 MG ORAL TAB $1.00 99998-000-76 GLYCOPYRROLATE 100 MCG/ML ORAL SUSP (COMPOUND) $1.00 99999-040-99 GUAIFENESIN 100 MG/5 ML ORAL LIQD $1.00 70756-004-11 HALOPERIDOL 5 MG ORAL TAB $1.00 50111-398-01 HYDRALAZINE 10 MG ORAL TAB $1.00 23155-001-01 HYDRALAZINE 10 MG ORAL TAB $1.00 23155-832-01 HYDRALAZINE 10 MG ORAL TAB $1.00 23155-002-10 HYDRALAZINE 25 MG ORAL TAB $1.00 50111-327-03 HYDRALAZINE 25 MG ORAL TAB $1.00 63739-327-10 HYDRALAZINE 25 MG ORAL TAB $1.00 64380-734-08 HYDRALAZINE 25 MG ORAL TAB $1.00 23155-833-01 HYDRALAZINE 25 MG ORAL TAB $1.00 31722-520-01 HYDRALAZINE 25 MG ORAL TAB $1.00 99999-040-48 HYDRALAZINE 4 MG/ML ORAL LIQUID $1.00 50111-328-03 HYDRALAZINE 50 MG ORAL TAB $1.00 63739-328-10 HYDRALAZINE 50 MG ORAL TAB $1.00 23155-834-01 HYDRALAZINE 50 MG ORAL TAB $1.00 50228-184-01 HYDRALAZINE 50 MG ORAL TAB $1.00 16729-182-01 HYDROCHLOROTHIAZIDE 12.5 MG ORAL TAB $1.00 69315-155-10 HYDROCHLOROTHIAZIDE 12.5 MG ORAL TAB $1.00 69315-155-01 HYDROCHLOROTHIAZIDE 12.5 MG ORAL TAB $1.00 0172-2083-60 HYDROCHLOROTHIAZIDE 25 MG ORAL TAB $1.00 16729-183-01 HYDROCHLOROTHIAZIDE 25 MG ORAL TAB $1.00 43547-397-10 HYDROCHLOROTHIAZIDE 25 MG ORAL TAB $1.00 0172-2083-80 HYDROCHLOROTHIAZIDE 25 MG ORAL TAB $1.00 16729-183-17 HYDROCHLOROTHIAZIDE 25 MG ORAL TAB $1.00 29300-128-10 HYDROCHLOROTHIAZIDE 25 MG ORAL TAB $1.00 99999-044-42 HYDROCHLOROTHIAZIDE 5 MG/ML ORAL LIQUID (COMPOUND) $1.00 0172-2089-60 HYDROCHLOROTHIAZIDE 50 MG ORAL TAB $1.00 16729-184-01 HYDROCHLOROTHIAZIDE 50 MG ORAL TAB $1.00 0406-0123-05 HYDROCODONE-ACETAMINOPHEN 5-325 MG ORAL TAB $1.00 0406-0123-01 HYDROCODONE-ACETAMINOPHEN 5-325 MG ORAL TAB $1.00 59762-0073-1 HYDROCORTISONE 5 MG ORAL TAB $1.00 99999-039-26 HYDROMORPHONE 0.1 MG/ML INJ DILUTION (MCH) $1.00 42858-301-25 HYDROMORPHONE 2 MG ORAL TAB $1.00 0406-3243-01 HYDROMORPHONE 2 MG ORAL TAB $1.00 16714-081-10 HYDROXYZINE HCL 10 MG ORAL TAB $1.00 10702-010-01 HYDROXYZINE HCL 10 MG ORAL TAB $1.00 23155-500-01 HYDROXYZINE HCL 10 MG ORAL TAB $1.00 16714-082-10 HYDROXYZINE HCL 25 MG ORAL TAB $1.00 23155-501-01 HYDROXYZINE HCL 25 MG ORAL TAB $1.00 16714-082-11 HYDROXYZINE HCL 25 MG ORAL TAB $1.00 99999-036-63 HYDROXYZINE HCL 5 MG ORAL PARTIAL TAB (MCH) $1.00 16714-083-10 HYDROXYZINE HCL 50 MG ORAL TAB $1.00 57896-941-01 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 0904-7912-59 IBUPROFEN 200 MG ORAL TAB $1.00 0904-7914-61 IBUPROFEN 200 MG ORAL TAB $1.00 0904-7914-59 IBUPROFEN 200 MG ORAL TAB $1.00 0904-6747-24 IBUPROFEN 200 MG ORAL TAB $1.00 0904-5853-61 IBUPROFEN 400 MG ORAL TAB $1.00 65162-464-10 IBUPROFEN 400 MG ORAL TAB $1.00 67877-319-01 IBUPROFEN 400 MG ORAL TAB $1.00 49483-602-01 IBUPROFEN 400 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 60687-446-11 IBUPROFEN 400 MG ORAL TAB $1.00 60687-446-01 IBUPROFEN 400 MG ORAL TAB $1.00 65162-464-50 IBUPROFEN 400 MG ORAL TAB $1.00 59651-360-01 IBUPROFEN 400 MG ORAL TAB $1.00 55111-682-05 IBUPROFEN 400 MG ORAL TAB $1.00 0904-5854-61 IBUPROFEN 600 MG ORAL TAB $1.00 55111-683-05 IBUPROFEN 600 MG ORAL TAB $1.00 60687-457-11 IBUPROFEN 600 MG ORAL TAB $1.00 65162-465-50 IBUPROFEN 600 MG ORAL TAB $1.00 60687-457-01 IBUPROFEN 600 MG ORAL TAB $1.00 65162-465-10 IBUPROFEN 600 MG ORAL TAB $1.00 67877-320-01 IBUPROFEN 600 MG ORAL TAB $1.00 59651-361-01 IBUPROFEN 600 MG ORAL TAB $1.00 67877-320-05 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 65162-466-50 IBUPROFEN 800 MG ORAL TAB $1.00 65162-466-10 IBUPROFEN 800 MG ORAL TAB $1.00 60687-468-11 IBUPROFEN 800 MG ORAL TAB $1.00 60687-468-01 IBUPROFEN 800 MG ORAL TAB $1.00 49483-604-50 IBUPROFEN 800 MG ORAL TAB $1.00 99999-035-57 IMIPENEM-CILASTATIN IV (FOR DESENSITIZATION USE) $1.00 69315-133-01 IMIPRAMINE HCL 10 MG ORAL TAB $1.00 53489-330-01 IMIPRAMINE HCL 10 MG ORAL TAB $1.00 69584-425-10 IMIPRAMINE HCL 10 MG ORAL TAB $1.00 69584-426-10 IMIPRAMINE HCL 25 MG ORAL TAB $1.00 62559-510-01 INDAPAMIDE 1.25 MG ORAL TAB $1.00 23155-010-01 INDOMETHACIN 25 MG ORAL CAP $1.00 31722-542-01 INDOMETHACIN 25 MG ORAL CAP $1.00 68462-406-10 INDOMETHACIN 25 MG ORAL CAP $1.00 99999-038-12 INSULIN REGULAR HUMAN 1 UNIT/ML INJ SOLN DILUTION $1.00 42658-122-04 IRBESARTAN 150 MG ORAL TAB $1.00 0555-0066-02 ISONIAZID 100 MG ORAL TAB $1.00 13668-104-01 ISOSORBIDE MONONITRATE 30 MG ORAL TB24 $1.00 50742-175-01 ISOSORBIDE MONONITRATE 30 MG ORAL TB24 $1.00 59651-539-01 ISOSORBIDE MONONITRATE 30 MG ORAL TB24 $1.00 13668-105-01 ISOSORBIDE MONONITRATE 60 MG ORAL TB24 $1.00 99999-044-25 KETAMINE IN 0.9% NACL 10 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 99999-044-24 KETAMINE IN 0.9% NACL 5 MG/50 ML IV PGBK (OCM/SLH) $1.00 99999-045-27 KETAMINE IN 0.9% NACL 5 MG/50 ML IV PGBK (OCM/SLH) $1.00 63629-2214-1 LABETALOL 200 MG ORAL TAB $1.00 50228-193-60 LACOSAMIDE 100 MG ORAL TAB $1.00 69367-349-60 LACOSAMIDE 100 MG ORAL TAB $1.00 904522452 LACTASE 3,000 UNIT ORAL TAB $1.00 6498012950 LACTOBACILLUS ACIDOPH-L.BULGAR 1 MILLION CELL ORAL TAB $1.00 4229140305 LACTOBACILLUS ACIDOPH-L.BULGAR 1 MILLION CELL ORAL TAB $1.00 51079-499-01 LAMOTRIGINE 100 MG ORAL TAB $1.00 51079-499-20 LAMOTRIGINE 100 MG ORAL TAB $1.00 68084-319-11 LAMOTRIGINE 100 MG ORAL TAB $1.00 68084-319-01 LAMOTRIGINE 100 MG ORAL TAB $1.00 0904-7008-61 LAMOTRIGINE 100 MG ORAL TAB $1.00 16714-195-01 LAMOTRIGINE 100 MG ORAL TAB $1.00 51672-4131-1 LAMOTRIGINE 100 MG ORAL TAB $1.00 51672-4133-4 LAMOTRIGINE 200 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 0904-7007-61 LAMOTRIGINE 25 MG ORAL TAB $1.00 65862-227-01 LAMOTRIGINE 25 MG ORAL TAB $1.00 51672-4130-1 LAMOTRIGINE 25 MG ORAL TAB $1.00 62332-037-31 LAMOTRIGINE 25 MG ORAL TAB $1.00 63739-795-10 LEVETIRACETAM 250 MG ORAL TAB $1.00 0904-7123-61 LEVETIRACETAM 250 MG ORAL TAB $1.00 31722-537-12 LEVETIRACETAM 500 MG ORAL TAB $1.00 63739-411-10 LEVETIRACETAM 500 MG ORAL TAB $1.00 65862-246-08 LEVETIRACETAM 500 MG ORAL TAB $1.00 68180-114-16 LEVETIRACETAM 750 MG ORAL TAB $1.00 68180-969-01 LEVOTHYROXINE 100 MCG ORAL TAB $1.00 16729-451-15 LEVOTHYROXINE 100 MCG ORAL TAB $1.00 0527-3284-46 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 47781-654-90 LEVOTHYROXINE 112 MCG ORAL TAB $1.00 16729-452-15 LEVOTHYROXINE 112 MCG ORAL TAB $1.00 68180-970-09 LEVOTHYROXINE 112 MCG ORAL TAB $1.00 72305-112-30 LEVOTHYROXINE 112 MCG ORAL TAB $1.00 16729-453-15 LEVOTHYROXINE 125 MCG ORAL TAB $1.00 0527-3286-46 LEVOTHYROXINE 125 MCG ORAL TAB $1.00 68180-971-01 LEVOTHYROXINE 125 MCG ORAL TAB $1.00 68180-971-09 LEVOTHYROXINE 125 MCG ORAL TAB $1.00 47781-657-90 LEVOTHYROXINE 125 MCG ORAL TAB $1.00 16729-454-15 LEVOTHYROXINE 137 MCG ORAL TAB $1.00 68180-972-01 LEVOTHYROXINE 137 MCG ORAL TAB $1.00 0527-3287-46 LEVOTHYROXINE 137 MCG ORAL TAB $1.00 68180-972-09 LEVOTHYROXINE 137 MCG ORAL TAB $1.00 72305-150-30 LEVOTHYROXINE 150 MCG ORAL TAB $1.00 47781-662-90 LEVOTHYROXINE 150 MCG ORAL TAB $1.00 0527-3288-46 LEVOTHYROXINE 150 MCG ORAL TAB $1.00 68180-973-01 LEVOTHYROXINE 150 MCG ORAL TAB $1.00 68180-973-09 LEVOTHYROXINE 150 MCG ORAL TAB $1.00 47781-665-90 LEVOTHYROXINE 175 MCG ORAL TAB $1.00 0527-3289-46 LEVOTHYROXINE 175 MCG ORAL TAB $1.00 16729-456-15 LEVOTHYROXINE 175 MCG ORAL TAB $1.00 16729-457-15 LEVOTHYROXINE 200 MCG ORAL TAB $1.00 68180-965-09 LEVOTHYROXINE 25 MCG ORAL TAB $1.00 68180-965-01 LEVOTHYROXINE 25 MCG ORAL TAB $1.00 16729-447-15 LEVOTHYROXINE 25 MCG ORAL TAB $1.00 68180-966-09 LEVOTHYROXINE 50 MCG ORAL TAB $1.00 16729-448-15 LEVOTHYROXINE 50 MCG ORAL TAB $1.00 0527-3281-46 LEVOTHYROXINE 50 MCG ORAL TAB $1.00 68180-966-01 LEVOTHYROXINE 50 MCG ORAL TAB $1.00 47781-643-90 LEVOTHYROXINE 50 MCG ORAL TAB $1.00 47781-646-90 LEVOTHYROXINE 75 MCG ORAL TAB $1.00 0527-3282-46 LEVOTHYROXINE 75 MCG ORAL TAB $1.00 16729-449-15 LEVOTHYROXINE 75 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 16729-450-15 LEVOTHYROXINE 88 MCG ORAL TAB $1.00 0527-3283-46 LEVOTHYROXINE 88 MCG ORAL TAB $1.00 68180-968-01 LEVOTHYROXINE 88 MCG ORAL TAB $1.00 68180-968-09 LEVOTHYROXINE 88 MCG ORAL TAB $1.00 47781-649-90 LEVOTHYROXINE 88 MCG ORAL TAB $1.00 99999-033-23 LIDOCAINE 1%/NA BICARB 10:1 INJ $1.00 99999-034-73 LIDOCAINE 1%/NA BICARB 10:1 INJ $1.00 99999-040-08 LIDOCAINE HCL 10 MG/ML (1 %) INJ SOLN $1.00 43547-416-10 LISINOPRIL 10 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 0591-0407-01 LISINOPRIL 10 MG ORAL TAB $1.00 0904-6798-61 LISINOPRIL 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 43547-353-10 LISINOPRIL 10 MG ORAL TAB $1.00 68001-334-00 LISINOPRIL 10 MG ORAL TAB $1.00 68180-512-01 LISINOPRIL 2.5 MG ORAL TAB $1.00 43547-351-10 LISINOPRIL 2.5 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 43547-354-11 LISINOPRIL 20 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 0904-6799-61 LISINOPRIL 20 MG ORAL TAB $1.00 43547-354-10 LISINOPRIL 20 MG ORAL TAB $1.00 0591-0408-01 LISINOPRIL 20 MG ORAL TAB $1.00 43547-417-11 LISINOPRIL 20 MG ORAL TAB $1.00 43547-356-10 LISINOPRIL 40 MG ORAL TAB $1.00 68180-979-01 LISINOPRIL 40 MG ORAL TAB $1.00 0904-7200-61 LISINOPRIL 40 MG ORAL TAB $1.00 76282-733-90 LISINOPRIL 40 MG ORAL TAB $1.00 43547-415-10 LISINOPRIL 5 MG ORAL TAB $1.00 43547-352-10 LISINOPRIL 5 MG ORAL TAB $1.00 68180-513-01 LISINOPRIL 5 MG ORAL TAB $1.00 0904-6797-61 LISINOPRIL 5 MG ORAL TAB $1.00 68001-333-00 LISINOPRIL 5 MG ORAL TAB $1.00 0054-8526-25 LITHIUM CARBONATE 150 MG ORAL CAP $1.00 0054-2526-25 LITHIUM CARBONATE 150 MG ORAL CAP $1.00 68462-220-01 LITHIUM CARBONATE 150 MG ORAL CAP $1.00 62756-430-88 LITHIUM CARBONATE 300 MG ORAL TAB $1.00 45802-650-65 LORATADINE 10 MG ORAL TAB $1.00 16714-898-02 LORATADINE 10 MG ORAL TAB $1.00 58602-702-04 LORATADINE 10 MG ORAL TAB $1.00 58602-702-83 LORATADINE 10 MG ORAL TAB $1.00 0904-6852-89 LORATADINE 10 MG ORAL TAB $1.00 70010-162-01 LORATADINE 10 MG ORAL TAB $1.00 45802-650-87 LORATADINE 10 MG ORAL TAB $1.00 69315-904-01 LORAZEPAM 0.5 MG ORAL TAB $1.00 0093-3425-01 LORAZEPAM 0.5 MG ORAL TAB $1.00 13107-083-05 LORAZEPAM 0.5 MG ORAL TAB $1.00 0093-3425-10 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 13107-084-01 LORAZEPAM 1 MG ORAL TAB $1.00 69315-905-10 LORAZEPAM 1 MG ORAL TAB $1.00 0093-3426-05 LORAZEPAM 1 MG ORAL TAB $1.00 69315-905-05 LORAZEPAM 1 MG ORAL TAB $1.00 13107-084-05 LORAZEPAM 1 MG ORAL TAB $1.00 0093-3426-01 LORAZEPAM 1 MG ORAL TAB $1.00 63304-773-01 LORAZEPAM 1 MG ORAL TAB $1.00 99999-041-86 LOSARTAN 2.5 MG/ML ORAL SUSP $1.00 65862-201-90 LOSARTAN 25 MG ORAL TAB $1.00 31722-700-90 LOSARTAN 25 MG ORAL TAB $1.00 68382-135-16 LOSARTAN 25 MG ORAL TAB $1.00 31722-700-10 LOSARTAN 25 MG ORAL TAB $1.00 68180-376-03 LOSARTAN 25 MG ORAL TAB $1.00 65862-201-99 LOSARTAN 25 MG ORAL TAB $1.00 43547-360-09 LOSARTAN 25 MG ORAL TAB $1.00 68180-376-09 LOSARTAN 25 MG ORAL TAB $1.00 31722-701-10 LOSARTAN 50 MG ORAL TAB $1.00 65862-202-90 LOSARTAN 50 MG ORAL TAB $1.00 65862-202-30 LOSARTAN 50 MG ORAL TAB $1.00 43547-361-09 LOSARTAN 50 MG ORAL TAB $1.00 31722-701-90 LOSARTAN 50 MG ORAL TAB $1.00 31722-701-30 LOSARTAN 50 MG ORAL TAB $1.00 61442-142-01 LOVASTATIN 20 MG ORAL TAB $1.00 1184513665 LUTEIN 6 MG ORAL CAP $1.00 99999-038-57 MAALOX/BENADRYL 1:1 $1.00 99999-039-38 MAGIC MOUTHWASH ORAL LIQUID (SIMPLE) $1.00 6858500575 MAGNESIUM CHLORIDE 64 MG ORAL TBEC $1.00 1000670013 MAGNESIUM CHLORIDE 64 MG ORAL TBEC $1.00 6025817201 MAGNESIUM GLUCONATE 27 MG MAGNESIUM (500 MG) ORAL TAB $1.00 0603-0209-22 MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) ORAL TAB $1.00 1000670028 MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) ORAL TAB $1.00 5789663412 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 6498033901 MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) ORAL TAB $1.00 24689-132-01 MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) ORAL TAB $1.00 69367-298-20 MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) ORAL TAB $1.00 10135-786-62 MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) ORAL TAB $1.00 58657-120-12 MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) ORAL TAB $1.00 65162-441-10 MECLIZINE 12.5 MG ORAL TAB $1.00 70710-1161-1 MECLIZINE 12.5 MG ORAL TAB $1.00 0536-1297-01 MECLIZINE 12.5 MG ORAL TAB $1.00 0536-1299-01 MECLIZINE 25 MG ORAL CHEW $1.00 65162-442-10 MECLIZINE 25 MG ORAL TAB $1.00 70710-1162-1 MECLIZINE 25 MG ORAL TAB $1.00 59746-121-06 MECLIZINE 25 MG ORAL TAB $1.00 99999-041-97 MEDROXYPROGESTERONE 1.25 MG ORAL PARTIAL TAB $1.00 99999-041-75 MEDROXYPROGESTERONE 2.5 MG ORAL PARTIAL TAB $1.00 0555-0872-02 MEDROXYPROGESTERONE 2.5 MG ORAL TAB $1.00 64380-158-01 MEGESTROL 20 MG ORAL TAB $1.00 7431202832 MELATONIN 1 MG ORAL TAB $1.00 8068104100 MELATONIN 1 MG ORAL TAB $1.00 4009310609 MELATONIN 1 MG ORAL TAB $1.00 5789688406 MELATONIN 1 MG ORAL TAB $1.00 5026852411 MELATONIN 3 MG ORAL TAB $1.00 5026852415 MELATONIN 3 MG ORAL TAB $1.00 5445821360 MELATONIN 3 MG ORAL TAB $1.00 5789686406 MELATONIN 3 MG ORAL TAB $1.00 2055503600 MELATONIN 3 MG ORAL TAB $1.00 2055503601 MELATONIN 3 MG ORAL TAB $1.00 8068108600 MELATONIN 3 MG ORAL TAB $1.00 4009310305 MELATONIN 5 MG ORAL TBDL $1.00 50268-525-11 MELOXICAM 7.5 MG ORAL TAB $1.00 50268-525-15 MELOXICAM 7.5 MG ORAL TAB $1.00 68382-050-01 MELOXICAM 7.5 MG ORAL TAB $1.00 65862-097-01 MELOXICAM 7.5 MG ORAL TAB $1.00 53746-173-60 MEMANTINE 5 MG ORAL TAB $1.00 33342-297-09 MEMANTINE 5 MG ORAL TAB $1.00 65162-173-06 MEMANTINE 5 MG ORAL TAB $1.00 99999-035-59 MEROPENEM IV (FOR DESENSITIZATION USE) $1.00 57664-474-51 METFORMIN 1,000 MG ORAL TAB $1.00 65862-010-01 METFORMIN 1,000 MG ORAL TAB $1.00 23155-104-01 METFORMIN 1,000 MG ORAL TAB $1.00 60687-162-11 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 70010-065-05 METFORMIN 1,000 MG ORAL TAB $1.00 60687-162-01 METFORMIN 1,000 MG ORAL TAB $1.00 70010-065-01 METFORMIN 1,000 MG ORAL TAB $1.00 0904-7164-61 METFORMIN 1,000 MG ORAL TAB $1.00 65862-010-99 METFORMIN 1,000 MG ORAL TAB $1.00 42385-949-01 METFORMIN 1,000 MG ORAL TAB $1.00 70010-065-99 METFORMIN 1,000 MG ORAL TAB $1.00 57664-397-53 METFORMIN 500 MG ORAL TAB $1.00 65862-008-05 METFORMIN 500 MG ORAL TAB $1.00 57664-397-51 METFORMIN 500 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 0904-7162-61 METFORMIN 500 MG ORAL TAB $1.00 70010-063-01 METFORMIN 500 MG ORAL TAB $1.00 65862-008-01 METFORMIN 500 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 65862-008-99 METFORMIN 500 MG ORAL TAB $1.00 42385-947-01 METFORMIN 500 MG ORAL TAB $1.00 42385-947-11 METFORMIN 500 MG ORAL TAB $1.00 70010-063-05 METFORMIN 500 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 67877-159-01 METFORMIN 500 MG ORAL TB24 $1.00 70010-491-01 METFORMIN 500 MG ORAL TB24 $1.00 70010-491-05 METFORMIN 500 MG ORAL TB24 $1.00 68094-904-50 METFORMIN 500 MG ORAL TB24 $1.00 62756-143-01 METFORMIN 750 MG ORAL TB24 $1.00 67877-414-01 METFORMIN 750 MG ORAL TB24 $1.00 42385-978-01 METFORMIN 750 MG ORAL TB24 $1.00 23155-103-01 METFORMIN 850 MG ORAL TAB $1.00 42385-948-01 METFORMIN 850 MG ORAL TAB $1.00 65862-009-01 METFORMIN 850 MG ORAL TAB $1.00 67877-116-01 METHADONE 10 MG ORAL TAB $1.00 99999-006-59 METHADONE 5 MG/5 ML ORAL SOLN $1.00 99999-037-02 METHADONE 5 MG/5 ML ORAL SOLN $1.00 99999-041-98 METHIMAZOLE 2.5 MG ORAL PARTIAL TAB $1.00 23155-070-01 METHIMAZOLE 5 MG ORAL TAB $1.00 64980-264-01 METHIMAZOLE 5 MG ORAL TAB $1.00 31722-533-01 METHOCARBAMOL 500 MG ORAL TAB $1.00 70010-754-01 METHOCARBAMOL 500 MG ORAL TAB $1.00 76385-123-01 METHOCARBAMOL 500 MG ORAL TAB $1.00 70010-754-05 METHOCARBAMOL 500 MG ORAL TAB $1.00 69584-611-50 METHOCARBAMOL 500 MG ORAL TAB $1.00 76385-123-50 METHOCARBAMOL 500 MG ORAL TAB $1.00 43547-226-10 METHOCARBAMOL 750 MG ORAL TAB $1.00 70010-770-05 METHOCARBAMOL 750 MG ORAL TAB $1.00 70010-770-01 METHOCARBAMOL 750 MG ORAL TAB $1.00 76385-124-01 METHOCARBAMOL 750 MG ORAL TAB $1.00 49348-541-10 METHYLCELLULOSE (LAXATIVE) 500 MG ORAL TAB $1.00 51079-200-20 METHYLDOPA 250 MG ORAL TAB $1.00 51079-200-01 METHYLDOPA 250 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 57664-228-88 METHYLPHENIDATE HCL 5 MG ORAL TAB $1.00 67877-616-01 METHYLPHENIDATE HCL 5 MG ORAL TAB $1.00 0406-1142-01 METHYLPHENIDATE HCL 5 MG ORAL TAB $1.00 0115-1800-01 METHYLPHENIDATE HCL 5 MG ORAL TAB $1.00 16729-478-01 METHYLPHENIDATE HCL 5 MG ORAL TAB $1.00 99999-000-40 METOCLOPRAMIDE 0.5 MG / ML SYRINGE $1.00 0093-2203-01 METOCLOPRAMIDE 10 MG ORAL TAB (MCH) $1.00 0093-2204-01 METOCLOPRAMIDE 5 MG ORAL TAB (MCH) $1.00 99999-006-62 METOCLOPRAMIDE 5 MG/5 ML ORAL SOLN (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 0093-2204-05 METOCLOPRAMIDE HCL 5 MG ORAL TAB $1.00 81005-124-01 METOLAZONE 2.5 MG ORAL TAB $1.00 72888-052-01 METOLAZONE 2.5 MG ORAL TAB $1.00 81005-125-01 METOLAZONE 5 MG ORAL TAB $1.00 50742-615-01 METOPROLOL SUCCINATE 25 MG ORAL TB24 $1.00 70010-780-10 METOPROLOL SUCCINATE 25 MG ORAL TB24 $1.00 50742-616-01 METOPROLOL SUCCINATE 50 MG ORAL TB24 $1.00 57664-167-52 METOPROLOL TARTRATE 100 MG ORAL TAB $1.00 65862-064-01 METOPROLOL TARTRATE 100 MG ORAL TAB $1.00 51079-802-01 METOPROLOL TARTRATE 100 MG ORAL TAB $1.00 57664-167-58 METOPROLOL TARTRATE 100 MG ORAL TAB $1.00 0378-0047-01 METOPROLOL TARTRATE 100 MG ORAL TAB $1.00 57664-506-52 METOPROLOL TARTRATE 25 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 57664-506-58 METOPROLOL TARTRATE 25 MG ORAL TAB $1.00 51079-255-01 METOPROLOL TARTRATE 25 MG ORAL TAB $1.00 65862-062-01 METOPROLOL TARTRATE 25 MG ORAL TAB $1.00 62584-265-11 METOPROLOL TARTRATE 25 MG ORAL TAB $1.00 51079-255-20 METOPROLOL TARTRATE 25 MG ORAL TAB $1.00 62584-265-01 METOPROLOL TARTRATE 25 MG ORAL TAB $1.00 65862-062-99 METOPROLOL TARTRATE 25 MG ORAL TAB $1.00 57237-100-01 METOPROLOL TARTRATE 25 MG ORAL TAB $1.00 51079-801-01 METOPROLOL TARTRATE 50 MG ORAL TAB $1.00 57664-477-52 METOPROLOL TARTRATE 50 MG ORAL TAB $1.00 57237-101-01 METOPROLOL TARTRATE 50 MG ORAL TAB $1.00 65862-063-01 METOPROLOL TARTRATE 50 MG ORAL TAB $1.00 51079-801-20 METOPROLOL TARTRATE 50 MG ORAL TAB $1.00 65862-063-99 METOPROLOL TARTRATE 50 MG ORAL TAB $1.00 62584-266-11 METOPROLOL TARTRATE 50 MG ORAL TAB $1.00 62584-266-01 METOPROLOL TARTRATE 50 MG ORAL TAB $1.00 52817-361-00 METOPROLOL TARTRATE 50 MG ORAL TAB $1.00 0378-0032-10 METOPROLOL TARTRATE 50 MG ORAL TAB $1.00 0378-0032-01 METOPROLOL TARTRATE 50 MG ORAL TAB $1.00 16571-664-50 METRONIDAZOLE 500 MG ORAL TAB $1.00 16571-664-01 METRONIDAZOLE 500 MG ORAL TAB $1.00 99996-001-31 METRONIDAZOLE 500 MG/10 ML ORAL LIQUID (MCH) $1.00 99999-040-01 METRONIDAZOLE IN NACL (ISO-OS) 500 MG/100 ML IV PGBK (MCH) $1.00 72888-114-01 MIDODRINE 10 MG ORAL TAB $1.00 42291-560-90 MIDODRINE 2.5 MG ORAL TAB $1.00 72888-113-01 MIDODRINE 5 MG ORAL TAB $1.00 99999-036-31 MINERAL OIL ORAL OIL $1.00 51079-086-20 MIRTAZAPINE 15 MG ORAL TAB $1.00 51079-086-01 MIRTAZAPINE 15 MG ORAL TAB $1.00 0904-6519-61 MIRTAZAPINE 15 MG ORAL TAB $1.00 63739-098-10 MIRTAZAPINE 15 MG ORAL TAB $1.00 99999-035-23 MISOPROSTOL 25 MCG ORAL PARTIAL TAB $1.00 31722-726-90 MONTELUKAST 10 MG ORAL TAB $1.00 65862-574-90 MONTELUKAST 10 MG ORAL TAB $1.00 33342-102-07 MONTELUKAST 10 MG ORAL TAB $1.00 57237-212-30 MONTELUKAST 4 MG ORAL CHEW $1.00 99999-038-25 MORPHINE 0.2 MG/ML (NICU) ORAL SYRINGE $1.00 99999-041-20 MORPHINE 0.4 MG/ML ORAL SOLN DILUTION (MCH) $1.00 99999-041-05 MORPHINE 1 MG/ML INJ SOLN (COMPOUNDED) $1.00 99999-007-66 MORPHINE 10 MG/5 ML ORAL SOLN $1.00 99999-039-98 MORPHINE 10 MG/5 ML ORAL SOLN $1.00 99999-047-37 MORPHINE 10 MG/5 ML ORAL SOLN $1.00 99999-041-11 MORPHINE 2 MG/ML INJ SOLN (COMPOUNDED) $1.00 99999-041-32 MORPHINE 2 MG/ML INJ SOLN (MHS WRAPPER) $1.00 904053961 MULTIVITAMIN WITH FOLIC ACID 400 MCG ORAL TAB $1.00 904053061 MULTIVITAMIN WITH FOLIC ACID 400 MCG ORAL TAB $1.00 8068105000 MULTIVITAMIN WITH FOLIC ACID 400 MCG ORAL TAB $1.00 904026252 MULTIVITAMIN, STRESS FORMULA ORAL TAB $1.00 5445174 MULTIVITAMIN-IRON-FOLIC ACID 18-400 MG-MCG ORAL TAB $1.00 904264172 MULTIVITAMIN-IRON-FOLIC ACID 18-400 MG-MCG ORAL TAB $1.00 8068114202 MULTIVITAMIN-IRON-FOLIC ACID 18-400 MG-MCG ORAL TAB $1.00 8068106300 MULTIVITAMIN-IRON-FOLIC ACID 18-400 MG-MCG ORAL TAB $1.00 573445174 MULTIVITAMIN-IRON-FOLIC ACID 18-400 MG-MCG ORAL TAB $1.00 2055500400 MULTIVITAMIN-IRON-FOLIC ACID 18-400 MG-MCG ORAL TAB $1.00 1650007406 MULTIVIT-IRON-FA-CALCIUM-MINS 18 MG IRON-400 MCG-500 MG CA ORAL TAB $1.00 904548652 MULTIVIT-MIN-FA-LYCOPEN-LUTEIN 0.4 MG-300 MCG- 250 MCG ORAL TAB $1.00 8068114101 MULTIVIT-MIN-FA-LYCOPEN-LUTEIN 0.4 MG-300 MCG- 250 MCG ORAL TAB $1.00 7985400938 MULTIVIT-MIN-FA-LYCOPEN-LUTEIN 0.4 MG-300 MCG- 250 MCG ORAL TAB $1.00 54629-0009-38 MULTIVIT-MIN-FA-LYCOPEN-LUTEIN 0.4 MG-300 MCG- 250 MCG ORAL TAB $1.00 5417990 MULTIVIT-MIN-FA-LYCOPEN-LUTEIN 0.4 MG-300 MCG- 250 MCG ORAL TAB $1.00 573417990 MULTIVIT-MIN-FA-LYCOPEN-LUTEIN 0.4 MG-300 MCG- 250 MCG ORAL TAB $1.00 573446391 MULTIVIT-MIN-FA-LYCOPEN-LUTEIN 0.4 MG-300 MCG- 250 MCG ORAL TAB $1.00 16729-094-01 MYCOPHENOLATE MOFETIL 250 MG ORAL CAP $1.00 67877-266-01 MYCOPHENOLATE MOFETIL 250 MG ORAL CAP $1.00 64380-726-06 MYCOPHENOLATE MOFETIL 250 MG ORAL CAP $1.00 67877-426-12 MYCOPHENOLATE SODIUM 180 MG ORAL TBEC $1.00 50228-465-01 NABUMETONE 500 MG ORAL TAB $1.00 69097-867-07 NADOLOL 20 MG ORAL TAB $1.00 76282-348-01 NADOLOL 40 MG ORAL TAB $1.00 99999-035-60 NAFCILLIN IV (FOR DESENSITIZATION USE) $1.00 65162-188-10 NAPROXEN 250 MG ORAL TAB $1.00 65162-189-10 NAPROXEN 375 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 65162-190-50 NAPROXEN 500 MG ORAL TAB $1.00 65162-190-10 NAPROXEN 500 MG ORAL TAB $1.00 65862-522-01 NAPROXEN 500 MG ORAL TAB $1.00 70010-139-01 NAPROXEN 500 MG ORAL TAB $1.00 45802-143-70 NEOMYCIN-BACITRACNZN-POLYMYXNB 3.5-400-5,000 MG-UNIT-UNIT TOPICAL OIPK $1.00 45802-143-00 NEOMYCIN-BACITRACNZN-POLYMYXNB 3.5-400-5,000 MG-UNIT-UNIT TOPICAL OIPK $1.00 0904-8805-67 NEOMYCIN-BACITRACNZN-POLYMYXNB 3.5-400-5,000 MG-UNIT-UNIT TOPICAL OIPK $1.00 57896-143-09 NEOMYCIN-BACITRACNZN-POLYMYXNB 3.5-400-5,000 MG-UNIT-UNIT TOPICAL OIPK $1.00 57896-143-14 NEOMYCIN-BACITRACNZN-POLYMYXNB 3.5-400-5,000 MG-UNIT-UNIT TOPICAL OIPK $1.00 31722-505-60 NEVIRAPINE 200 MG ORAL TAB $1.00 33342-004-09 NEVIRAPINE 200 MG ORAL TAB $1.00 0378-4050-91 NEVIRAPINE 200 MG ORAL TAB $1.00 8068105700 NIACIN 100 MG ORAL TAB $1.00 1000670020 NIACIN 250 MG ORAL CPSR $1.00 4329255740 NIACIN 250 MG ORAL TAB $1.00 7126925010 NIACIN 250 MG ORAL TBSR $1.00 904227260 NIACIN 500 MG ORAL TAB $1.00 7126950010 NIACIN 500 MG ORAL TBSR $1.00 8068109000 NIACIN 500 MG ORAL TBSR $1.00 68462-639-25 NITROGLYCERIN 0.4 MG SL SUBL $1.00 68462-639-45 NITROGLYCERIN 0.4 MG SL SUBL $1.00 68462-639-01 NITROGLYCERIN 0.4 MG SL SUBL $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 0093-0810-01 NORTRIPTYLINE 10 MG ORAL CAP $1.00 51672-4001-5 NORTRIPTYLINE 10 MG ORAL CAP $1.00 51672-4001-1 NORTRIPTYLINE 10 MG ORAL CAP $1.00 75907-069-01 NORTRIPTYLINE 10 MG ORAL CAP $1.00 51672-4002-5 NORTRIPTYLINE 25 MG ORAL CAP $1.00 60505-3110-0 OLANZAPINE 2.5 MG ORAL TAB $1.00 55111-163-30 OLANZAPINE 2.5 MG ORAL TAB $1.00 43598-164-30 OLANZAPINE 5 MG ORAL TAB $1.00 33342-068-07 OLANZAPINE 5 MG ORAL TAB $1.00 68462-437-30 OLMESARTAN 20 MG ORAL TAB $1.00 16729-321-15 OLMESARTAN 20 MG ORAL TAB $1.00 16729-321-10 OLMESARTAN 20 MG ORAL TAB $1.00 68462-437-90 OLMESARTAN 20 MG ORAL TAB $1.00 65862-742-30 OLMESARTAN 20 MG ORAL TAB $1.00 68462-436-30 OLMESARTAN 5 MG ORAL TAB $1.00 65862-741-30 OLMESARTAN 5 MG ORAL TAB $1.00 0527-2425-32 OLMESARTAN 5 MG ORAL TAB $1.00 904723860 OMEGA 3-DHA-EPA-FISH OIL 300 MG (120 MG- 180MG)-1,000 MG ORAL CAP $1.00 24658-350-12 OMEGA-3 ACID ETHYL ESTERS 1 GRAM ORAL CAP $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 0781-2868-10 OMEPRAZOLE 20 MG ORAL CPDR $1.00 16714-715-03 OMEPRAZOLE 20 MG ORAL CPDR $1.00 0781-2868-31 OMEPRAZOLE 20 MG ORAL CPDR $1.00 57237-161-30 OMEPRAZOLE 20 MG ORAL CPDR $1.00 65862-187-30 ONDANSETRON HCL 4 MG ORAL TAB $1.00 99999-035-61 OXACILLIN IV (FOR DESENSITIZATION USE) $1.00 99999-042-30 OXCARBAZEPINE 75 MG ORAL PARTIAL TAB $1.00 64980-210-01 OXYBUTYNIN CHLORIDE 10 MG ORAL TR24 $1.00 0832-0038-00 OXYBUTYNIN CHLORIDE 5 MG ORAL TAB $1.00 10702-201-01 OXYBUTYNIN CHLORIDE 5 MG ORAL TAB $1.00 70954-005-10 OXYBUTYNIN CHLORIDE 5 MG ORAL TAB $1.00 65162-371-10 OXYBUTYNIN CHLORIDE 5 MG ORAL TR24 $1.00 64980-209-01 OXYBUTYNIN CHLORIDE 5 MG ORAL TR24 $1.00 0406-0552-01 OXYCODONE 5 MG ORAL TAB $1.00 10702-018-50 OXYCODONE 5 MG ORAL TAB $1.00 10702-018-01 OXYCODONE 5 MG ORAL TAB $1.00 42858-001-01 OXYCODONE 5 MG ORAL TAB $1.00 42858-102-01 OXYCODONE-ACETAMINOPHEN 5-325 MG ORAL TAB $1.00 0406-0512-01 OXYCODONE-ACETAMINOPHEN 5-325 MG ORAL TAB $1.00 31722-949-01 OXYCODONE-ACETAMINOPHEN 5-325 MG ORAL TAB $1.00 31722-950-01 OXYCODONE-ACETAMINOPHEN 7.5-325 MG ORAL TAB $1.00 42858-103-01 OXYCODONE-ACETAMINOPHEN 7.5-325 MG ORAL TAB $1.00 13107-045-01 OXYCODONE-ACETAMINOPHEN 7.5-325 MG ORAL TAB $1.00 99999-012-98 PANTOPRAZOLE 2 MG/ML ORAL LIQUID $1.00 31722-712-90 PANTOPRAZOLE 20 MG ORAL TBEC $1.00 65862-559-90 PANTOPRAZOLE 20 MG ORAL TBEC $1.00 65162-636-09 PANTOPRAZOLE 20 MG ORAL TBEC $1.00 13668-096-90 PANTOPRAZOLE 20 MG ORAL TBEC $1.00 65862-560-90 PANTOPRAZOLE 40 MG ORAL TBEC $1.00 0378-6689-77 PANTOPRAZOLE 40 MG ORAL TBEC $1.00 0378-6689-10 PANTOPRAZOLE 40 MG ORAL TBEC $1.00 62175-617-43 PANTOPRAZOLE 40 MG ORAL TBEC $1.00 31722-713-90 PANTOPRAZOLE 40 MG ORAL TBEC $1.00 50268-639-15 PANTOPRAZOLE 40 MG ORAL TBEC $1.00 50268-639-11 PANTOPRAZOLE 40 MG ORAL TBEC $1.00 0904-6870-45 PANTOPRAZOLE 40 MG ORAL TBEC $1.00 65162-637-09 PANTOPRAZOLE 40 MG ORAL TBEC $1.00 60687-736-09 PANTOPRAZOLE 40 MG ORAL TBEC $1.00 43547-347-03 PAROXETINE HCL 10 MG ORAL TAB $1.00 0378-7001-10 PAROXETINE HCL 10 MG ORAL TAB $1.00 0378-7001-93 PAROXETINE HCL 10 MG ORAL TAB $1.00 43547-347-09 PAROXETINE HCL 10 MG ORAL TAB $1.00 16714-181-03 PAROXETINE HCL 10 MG ORAL TAB $1.00 60505-0083-2 PAROXETINE HCL 20 MG 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 99999-045-58 PEDI MV NO.189-FERROUS SULFATE 11 MG IRON/ML ORAL DROP $1.00 8068104900 PEDIATRIC MULTIVITAMIN NO.42 ORAL CHEW $1.00 1650008619 PEDIATRIC MULTIVITAMIN ORAL CHEW $1.00 1650007814 PEDIATRIC MULTIVITAMIN ORAL CHEW $1.00 16500-59918 PEDIATRIC MULTIVIT-IRON-MIN ORAL CHEW $1.00 1650059921 PEDIATRIC MULTIVIT-IRON-MIN ORAL CHEW $1.00 57237-040-01 PENICILLIN V POTASSIUM 250 MG ORAL TAB $1.00 0093-1172-01 PENICILLIN V POTASSIUM 250 MG ORAL 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 99998-005-26 PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIX $1.00 75826-139-10 PHENOBARBITAL 32.4 MG ORAL TAB $1.00 16571-673-01 PHENOBARBITAL 32.4 MG ORAL TAB $1.00 99999-002-37 PHENOBARBITAL 4MG/ML (NICU) ORAL SYRINGE $1.00 33342-054-10 PIOGLITAZONE 15 MG ORAL TAB $1.00 33342-054-07 PIOGLITAZONE 15 MG ORAL TAB $1.00 57237-219-30 PIOGLITAZONE 15 MG ORAL TAB $1.00 65862-512-90 PIOGLITAZONE 15 MG ORAL TAB $1.00 65862-512-30 PIOGLITAZONE 15 MG ORAL TAB $1.00 33342-055-10 PIOGLITAZONE 30 MG ORAL TAB $1.00 65862-513-30 PIOGLITAZONE 30 MG ORAL TAB $1.00 33342-055-07 PIOGLITAZONE 30 MG ORAL TAB $1.00 33342-056-07 PIOGLITAZONE 45 MG ORAL TAB $1.00 16729-022-15 PIOGLITAZONE 45 MG ORAL TAB $1.00 33342-056-10 PIOGLITAZONE 45 MG ORAL TAB $1.00 57237-221-90 PIOGLITAZONE 45 MG ORAL TAB $1.00 99999-035-56 PIPERACILLIN-TAZOBACTAM IV (FOR DESENSITIZATION USE) $1.00 536408501 PNV NO.95-FERROUS FUMARATE-FA 28 MG IRON- 800 MCG ORAL TAB $1.00 70010-148-01 POTASSIUM CHLORIDE 10 MEQ ORAL CPSR $1.00 99999-000-31 POTASSIUM CHLORIDE 2 MEQ / ML ORAL SYRINGE $1.00 31722-129-01 POTASSIUM CITRATE 5 MEQ (540 MG) ORAL TBSR $1.00 68462-330-90 PRAMIPEXOLE 0.125 MG ORAL TAB $1.00 57237-180-90 PRAMIPEXOLE 0.125 MG ORAL TAB $1.00 68462-331-90 PRAMIPEXOLE 0.25 MG ORAL TAB $1.00 33342-032-10 PRAMIPEXOLE 0.25 MG ORAL TAB $1.00 13668-092-90 PRAMIPEXOLE 0.25 MG ORAL TAB $1.00 57237-181-90 PRAMIPEXOLE 0.25 MG ORAL TAB $1.00 13668-093-90 PRAMIPEXOLE 0.5 MG ORAL TAB $1.00 33342-033-10 PRAMIPEXOLE 0.5 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 33342-034-10 PRAMIPEXOLE 1 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 70954-019-10 PRAZOSIN 1 MG ORAL CAP $1.00 10135-666-01 PRAZOSIN 1 MG ORAL CAP $1.00 70756-429-11 PRAZOSIN 1 MG ORAL CAP $1.00 59746-171-06 PREDNISONE 1 MG ORAL TAB $1.00 59651-484-01 PREDNISONE 1 MG ORAL TAB $1.00 64380-782-06 PREDNISONE 1 MG ORAL TAB $1.00 59746-173-06 PREDNISONE 10 MG ORAL TAB $1.00 0603-5338-21 PREDNISONE 10 MG ORAL TAB $1.00 60687-134-11 PREDNISONE 10 MG ORAL TAB $1.00 0054-0017-29 PREDNISONE 10 MG ORAL TAB $1.00 0054-9817-25 PREDNISONE 10 MG ORAL TAB $1.00 0054-9817-29 PREDNISONE 10 MG ORAL TAB $1.00 0904-6923-61 PREDNISONE 10 MG ORAL TAB $1.00 59651-487-01 PREDNISONE 10 MG ORAL TAB $1.00 60687-134-01 PREDNISONE 10 MG ORAL TAB $1.00 59746-175-06 PREDNISONE 20 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 59746-175-09 PREDNISONE 20 MG ORAL TAB $1.00 0603-5339-32 PREDNISONE 20 MG ORAL TAB $1.00 59651-488-01 PREDNISONE 20 MG ORAL TAB $1.00 0591-5443-10 PREDNISONE 20 MG ORAL TAB $1.00 0603-5337-21 PREDNISONE 5 MG ORAL TAB $1.00 0054-8724-25 PREDNISONE 5 MG ORAL TAB $1.00 0378-0640-10 PREDNISONE 5 MG ORAL TAB $1.00 59746-172-06 PREDNISONE 5 MG ORAL TAB $1.00 0054-9828-25 PREDNISONE 5 MG ORAL TAB $1.00 59651-486-01 PREDNISONE 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 0054-4728-31 PREDNISONE 5 MG ORAL TAB $1.00 0054-4728-25 PREDNISONE 5 MG ORAL TAB $1.00 64380-783-06 PREDNISONE 5 MG ORAL TAB $1.00 50228-353-90 PREGABALIN 100 MG ORAL CAP $1.00 64980-413-09 PREGABALIN 100 MG ORAL CAP $1.00 62332-119-90 PREGABALIN 25 MG ORAL CAP $1.00 50228-350-90 PREGABALIN 25 MG ORAL CAP $1.00 72205-011-90 PREGABALIN 25 MG ORAL CAP $1.00 72205-012-90 PREGABALIN 50 MG ORAL CAP $1.00 62332-120-90 PREGABALIN 50 MG ORAL CAP $1.00 50228-351-90 PREGABALIN 50 MG ORAL CAP $1.00 82619-123-01 PREGABALIN 50 MG ORAL CAP $1.00 72205-013-90 PREGABALIN 75 MG ORAL CAP $1.00 904531360 PRENATAL VIT NO.130-IRON-FOLIC 27 MG IRON- 800 MCG ORAL TAB $1.00 904531346 PRENATAL VIT NO.130-IRON-FOLIC 27 MG IRON- 800 MCG ORAL TAB $1.00 0527-1301-01 PRIMIDONE 50 MG ORAL TAB $1.00 59651-152-01 PROGESTERONE MICRONIZED 100 MG ORAL CAP $1.00 10702-003-01 PROMETHAZINE 25 MG ORAL TAB $1.00 0904-7304-61 PROMETHAZINE 25 MG ORAL TAB $1.00 68382-041-01 PROMETHAZINE 25 MG ORAL TAB $1.00 0603-5482-21 PROPRANOLOL 10 MG ORAL TAB $1.00 23155-110-01 PROPRANOLOL 10 MG ORAL TAB $1.00 0115-1659-01 PROPRANOLOL 10 MG ORAL TAB $1.00 69238-2077-1 PROPRANOLOL 10 MG ORAL TAB $1.00 69238-2077-7 PROPRANOLOL 10 MG ORAL TAB $1.00 0603-5483-21 PROPRANOLOL 20 MG ORAL TAB $1.00 71335-0082-5 PROPRANOLOL 20 MG ORAL TAB $1.00 23155-111-01 PROPRANOLOL 20 MG ORAL TAB $1.00 0603-5483-32 PROPRANOLOL 20 MG ORAL TAB $1.00 99999-038-03 PROPYLTHIOURACIL 5 MG/ML ORAL LIQUID (COMPOUND) $1.00 0904-5053-59 PSEUDOEPHEDRINE HCL 30 MG ORAL TAB $1.00 45802-432-62 PSEUDOEPHEDRINE HCL 30 MG ORAL TAB $1.00 0904-6990-61 PSEUDOEPHEDRINE HCL 30 MG ORAL TAB $1.00 0904-6907-06 PSEUDOEPHEDRINE HCL 60 MG ORAL TAB $1.00 0904-6728-46 PSEUDOEPHEDRINE HCL 60 MG ORAL TAB $1.00 536440601 PYRIDOXINE (VITAMIN B6) 25 MG ORAL TAB $1.00 7733394010 PYRIDOXINE (VITAMIN B6) 50 MG ORAL TAB $1.00 7733394025 PYRIDOXINE (VITAMIN B6) 50 MG ORAL TAB $1.00 7985420030 PYRIDOXINE (VITAMIN B6) 50 MG ORAL TAB $1.00 1000670012 PYRIDOXINE (VITAMIN B6) 50 MG ORAL TAB $1.00 3786490901 PYRIDOXINE (VITAMIN B6) 50 MG ORAL TAB $1.00 29300-149-01 QUETIAPINE 100 MG ORAL TAB $1.00 16714-377-01 QUETIAPINE 100 MG ORAL TAB $1.00 67877-246-01 QUETIAPINE 200 MG ORAL TAB $1.00 16729-145-01 QUETIAPINE 25 MG ORAL TAB $1.00 50268-630-15 QUETIAPINE 25 MG ORAL TAB $1.00 50268-630-11 QUETIAPINE 25 MG ORAL TAB $1.00 67877-242-01 QUETIAPINE 25 MG ORAL TAB $1.00 16729-145-17 QUETIAPINE 25 MG ORAL TAB $1.00 29300-147-01 QUETIAPINE 25 MG ORAL TAB $1.00 16571-717-01 QUETIAPINE 25 MG ORAL TAB $1.00 47335-902-88 QUETIAPINE 25 MG ORAL TAB $1.00 65862-618-90 QUINAPRIL 10 MG ORAL TAB $1.00 43547-411-09 QUINAPRIL 10 MG ORAL TAB $1.00 65862-619-90 QUINAPRIL 20 MG ORAL TAB $1.00 65862-617-90 QUINAPRIL 5 MG ORAL TAB $1.00 43547-410-09 QUINAPRIL 5 MG ORAL TAB $1.00 65862-475-01 RAMIPRIL 2.5 MG ORAL CAP $1.00 57237-223-01 RAMIPRIL 2.5 MG ORAL CAP $1.00 42291-773-60 RANOLAZINE 500 MG ORAL TB12 $1.00 33342-248-11 REPAGLINIDE 0.5 MG ORAL TAB $1.00 7431200640 RIBOFLAVIN (VITAMIN B2) 100 MG ORAL TAB $1.00 7985420195 RIBOFLAVIN (VITAMIN B2) 100 MG ORAL TAB $1.00 4329255538 RIBOFLAVIN (VITAMIN B2) 25 MG ORAL TAB $1.00 43547-339-06 RISPERIDONE 0.25 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 43547-341-06 RISPERIDONE 1 MG ORAL TAB $1.00 27241-001-50 RISPERIDONE 1 MG ORAL TAB $1.00 27241-001-06 RISPERIDONE 1 MG ORAL TAB $1.00 13668-038-60 RISPERIDONE 2 MG ORAL TAB $1.00 68462-253-01 ROPINIROLE 0.25 MG ORAL TAB $1.00 43547-268-10 ROPINIROLE 0.25 MG ORAL TAB $1.00 43547-270-10 ROPINIROLE 1 MG ORAL TAB $1.00 68462-255-01 ROPINIROLE 1 MG ORAL TAB $1.00 62332-032-31 ROPINIROLE 1 MG ORAL TAB $1.00 68462-256-01 ROPINIROLE 2 MG ORAL TAB $1.00 43547-271-10 ROPINIROLE 2 MG ORAL TAB $1.00 62332-033-31 ROPINIROLE 2 MG ORAL TAB $1.00 57237-169-90 ROSUVASTATIN 10 MG ORAL TAB $1.00 27808-156-01 ROSUVASTATIN 10 MG ORAL TAB $1.00 57237-169-99 ROSUVASTATIN 10 MG ORAL TAB $1.00 70377-007-12 ROSUVASTATIN 10 MG ORAL TAB $1.00 68462-262-90 ROSUVASTATIN 10 MG ORAL TAB $1.00 13668-721-90 ROSUVASTATIN 10 MG ORAL TAB $1.00 65862-294-90 ROSUVASTATIN 10 MG ORAL TAB $1.00 57237-170-90 ROSUVASTATIN 20 MG ORAL TAB $1.00 68462-263-90 ROSUVASTATIN 20 MG ORAL TAB $1.00 70377-008-12 ROSUVASTATIN 20 MG ORAL TAB $1.00 27808-157-01 ROSUVASTATIN 20 MG ORAL TAB $1.00 16714-990-01 ROSUVASTATIN 20 MG ORAL TAB $1.00 31722-884-90 ROSUVASTATIN 20 MG ORAL TAB $1.00 65862-295-90 ROSUVASTATIN 20 MG ORAL TAB $1.00 13668-722-90 ROSUVASTATIN 20 MG ORAL TAB $1.00 27808-157-03 ROSUVASTATIN 20 MG ORAL TAB $1.00 68462-261-90 ROSUVASTATIN 5 MG ORAL TAB $1.00 70377-006-12 ROSUVASTATIN 5 MG ORAL TAB $1.00 72205-027-90 ROSUVASTATIN 5 MG ORAL TAB $1.00 57237-168-90 ROSUVASTATIN 5 MG ORAL TAB $1.00 27808-155-01 ROSUVASTATIN 5 MG ORAL TAB $1.00 13668-720-90 ROSUVASTATIN 5 MG ORAL TAB $1.00 50228-116-05 ROSUVASTATIN 5 MG ORAL TAB $1.00 4009310287 SELENIUM 200 MCG ORAL TAB $1.00 57896-454-01 SENNOSIDES 8.6 MG ORAL TAB $1.00 49483-080-10 SENNOSIDES 8.6 MG ORAL TAB $1.00 0904-7252-61 SENNOSIDES 8.6 MG ORAL TAB $1.00 57896-434-01 SENNOSIDES 8.6 MG ORAL TAB $1.00 0904-7252-60 SENNOSIDES 8.6 MG ORAL TAB $1.00 3786400033 SENNOSIDES 8.6 MG ORAL TAB $1.00 51645-851-01 SENNOSIDES 8.6 MG ORAL TAB $1.00 69618-064-01 SENNOSIDES 8.6 MG ORAL TAB $1.00 70677-1097-1 SENNOSIDES 8.6 MG ORAL TAB $1.00 0536-1247-01 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 60687-622-01 SENNOSIDES-DOCUSATE SODIUM 8.6-50 MG ORAL TAB $1.00 63739-432-02 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 0536-1248-01 SENNOSIDES-DOCUSATE SODIUM 8.6-50 MG ORAL TAB $1.00 0904-7440-61 SENNOSIDES-DOCUSATE SODIUM 8.6-50 MG ORAL TAB $1.00 57896-555-01 SENNOSIDES-DOCUSATE SODIUM 8.6-50 MG ORAL TAB $1.00 10135-669-01 SENNOSIDES-DOCUSATE SODIUM 8.6-50 MG ORAL TAB $1.00 70677-1069-1 SENNOSIDES-DOCUSATE SODIUM 8.6-50 MG ORAL TAB $1.00 16714-613-04 SERTRALINE 100 MG ORAL TAB $1.00 16714-613-01 SERTRALINE 100 MG ORAL TAB $1.00 65862-013-30 SERTRALINE 100 MG ORAL TAB $1.00 76282-214-90 SERTRALINE 100 MG ORAL TAB $1.00 68180-353-09 SERTRALINE 100 MG ORAL TAB $1.00 16714-613-06 SERTRALINE 100 MG ORAL TAB $1.00 16714-613-05 SERTRALINE 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 65862-012-30 SERTRALINE 50 MG ORAL TAB $1.00 69097-834-02 SERTRALINE 50 MG ORAL TAB $1.00 16729-216-15 SERTRALINE 50 MG ORAL TAB $1.00 59762-4900-5 SERTRALINE 50 MG ORAL TAB $1.00 16714-612-06 SERTRALINE 50 MG ORAL TAB $1.00 13668-185-90 SILDENAFIL (PULM.HYPERTENSION) 20 MG ORAL TAB $1.00 65162-351-09 SILDENAFIL (PULM.HYPERTENSION) 20 MG ORAL TAB $1.00 72888-018-90 SILDENAFIL (PULM.HYPERTENSION) 20 MG ORAL TAB $1.00 99999-010-95 SILDENAFIL 2.5 MG/ML ORAL LIQUID (MCH) (COMPOUND) $1.00 69618-033-01 SIMETHICONE 80 MG ORAL CHEW $1.00 8770170344 SIMETHICONE 80 MG ORAL CHEW $1.00 24385-118-78 SIMETHICONE 80 MG ORAL CHEW $1.00 0904-7206-60 SIMETHICONE 80 MG ORAL CHEW $1.00 63739-225-02 SIMETHICONE 80 MG ORAL CHEW $1.00 57896-791-01 SIMETHICONE 80 MG ORAL CHEW $1.00 57896-799-01 SIMETHICONE 80 MG ORAL CHEW $1.00 16714-682-02 SIMVASTATIN 10 MG ORAL TAB $1.00 68084-511-11 SIMVASTATIN 10 MG ORAL TAB $1.00 68084-511-01 SIMVASTATIN 10 MG ORAL TAB $1.00 51079-454-20 SIMVASTATIN 10 MG ORAL TAB $1.00 16714-682-03 SIMVASTATIN 10 MG ORAL TAB $1.00 16714-682-01 SIMVASTATIN 10 MG ORAL TAB $1.00 63739-572-10 SIMVASTATIN 20 MG ORAL TAB $1.00 16714-683-03 SIMVASTATIN 20 MG ORAL TAB $1.00 16714-683-02 SIMVASTATIN 20 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 16714-683-01 SIMVASTATIN 20 MG ORAL TAB $1.00 63739-573-10 SIMVASTATIN 40 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 51079-456-20 SIMVASTATIN 40 MG ORAL TAB $1.00 16714-684-03 SIMVASTATIN 40 MG ORAL TAB $1.00 16714-681-02 SIMVASTATIN 5 MG ORAL TAB $1.00 16714-681-01 SIMVASTATIN 5 MG ORAL TAB $1.00 39410002 SOD FLUORIDE-CA CARBONATE 3.75 (8.25)-145 (364) MG ORAL TAB $1.00 99999-033-39 SODIUM BENZOATE 200 MG/ML ORAL LIQUID (MCH) $1.00 99999-039-77 SODIUM BICARBONATE 1 MEQ/ML INJ SOLN (FOR ORAL USE) $1.00 0536-1046-10 SODIUM BICARBONATE 325 MG ORAL TAB $1.00 66553-008-01 SODIUM BICARBONATE 650 MG ORAL TAB $1.00 64980-528-10 SODIUM BICARBONATE 650 MG ORAL TAB $1.00 0536-1047-10 SODIUM BICARBONATE 650 MG ORAL TAB $1.00 0904-7261-61 SODIUM BICARBONATE 650 MG ORAL TAB $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 6936722001 SODIUM CHLORIDE 1,000 MG MISC TBSO $1.00 0223-1760-01 SODIUM CHLORIDE 1,000 MG MISC TBSO $1.00 536134201 SODIUM CHLORIDE 1,000 MG MISC TBSO $1.00 99999-007-80 SODIUM CHLORIDE 2 MEQ/ML ORAL SOLN (MCH) $1.00 99999-036-32 SOTALOL 5 MG/ML ORAL LIQUID $1.00 60505-0080-0 SOTALOL 80 MG ORAL TAB $1.00 69584-841-10 SOTALOL 80 MG ORAL TAB $1.00 99999-041-33 SPIRONOLACTONE 12.5 MG ORAL PARTIAL TAB $1.00 53746-511-01 SPIRONOLACTONE 25 MG ORAL TAB $1.00 53746-511-10 SPIRONOLACTONE 25 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 51079-103-20 SPIRONOLACTONE 25 MG ORAL TAB $1.00 51079-103-01 SPIRONOLACTONE 25 MG ORAL TAB $1.00 59746-216-01 SPIRONOLACTONE 25 MG ORAL TAB $1.00 16729-225-01 SPIRONOLACTONE 25 MG ORAL TAB $1.00 53489-143-05 SPIRONOLACTONE 25 MG ORAL TAB $1.00 0904-6927-61 SPIRONOLACTONE 25 MG ORAL TAB $1.00 69584-852-50 SPIRONOLACTONE 25 MG ORAL TAB $1.00 72603-134-01 SPIRONOLACTONE 25 MG ORAL TAB $1.00 53489-143-01 SPIRONOLACTONE 25 MG ORAL TAB $1.00 53746-511-05 SPIRONOLACTONE 25 MG ORAL TAB $1.00 53489-143-10 SPIRONOLACTONE 25 MG ORAL TAB $1.00 60687-465-01 SPIRONOLACTONE 25 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 99999-045-23 SULFAMETHOXAZOLE-TRIMETHOPRIM 0.02-0.004 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 99999-045-21 SULFAMETHOXAZOLE-TRIMETHOPRIM 2-0.4 MG/ML ORAL SOLUTION - FOR DESENSITIZATION $1.00 65862-419-01 SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG ORAL TAB $1.00 0904-2725-61 SULFAMETHOXAZOLE-TRIMETHOPRIM 800-160 MG ORAL TAB $1.00 65862-420-01 SULFAMETHOXAZOLE-TRIMETHOPRIM 800-160 MG ORAL TAB $1.00 65162-272-10 SULFAMETHOXAZOLE-TRIMETHOPRIM 800-160 MG ORAL TAB $1.00 99999-037-64 SULFASALAZINE 100 MG/ML ORAL LIQUID $1.00 59762-5000-5 SULFASALAZINE 500 MG ORAL TAB $1.00 59651-299-60 TAMOXIFEN 10 MG ORAL TAB $1.00 75907-058-60 TAMOXIFEN 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 51079-418-20 TEMAZEPAM 15 MG ORAL CAP $1.00 51079-418-01 TEMAZEPAM 15 MG ORAL CAP $1.00 67877-146-01 TEMAZEPAM 15 MG ORAL CAP $1.00 0406-9961-01 TEMAZEPAM 15 MG ORAL CAP $1.00 0228-2076-10 TEMAZEPAM 15 MG ORAL CAP $1.00 0228-2076-50 TEMAZEPAM 15 MG ORAL CAP $1.00 59746-383-06 TERAZOSIN 1 MG ORAL CAP $1.00 59746-384-06 TERAZOSIN 2 MG ORAL CAP $1.00 24689-855-01 TERAZOSIN 2 MG ORAL CAP $1.00 51079-937-20 TERAZOSIN 2 MG ORAL CAP $1.00 59746-384-10 TERAZOSIN 2 MG ORAL CAP $1.00 59746-385-06 TERAZOSIN 5 MG ORAL CAP $1.00 24689-882-01 TERAZOSIN 5 MG ORAL CAP $1.00 0378-2268-01 TERAZOSIN 5 MG ORAL CAP $1.00 51991-526-01 TERBINAFINE HCL 250 MG ORAL TAB $1.00 99999-001-11 TETRACAINE - LIDOCAINE - EPINEPHRINE TOP SOLN $1.00 99999-009-74 TETRACAINE - LIDOCAINE - EPINEPHRINE TOP SOLN $1.00 99999-009-75 TETRACAINE - LIDOCAINE - EPINEPHRINE TOP SOLN $1.00 904719106 THIAMINE (VITAMIN B1) 100 MG ORAL TAB (MHS WRAPPER) $1.00 1000673021 THIAMINE (VITAMIN B1) 100 MG ORAL TAB (MHS WRAPPER) $1.00 8068109800 THIAMINE (VITAMIN B1) 100 MG ORAL TAB (MHS WRAPPER) $1.00 3160401281 THIAMINE (VITAMIN B1) 100 MG ORAL TAB (MHS WRAPPER) $1.00 3786490599 THIAMINE (VITAMIN B1) 100 MG ORAL TAB (MHS WRAPPER) $1.00 4843310801 THIAMINE (VITAMIN B1) 100 MG ORAL TAB (MHS WRAPPER) $1.00 5026885111 THIAMINE (VITAMIN B1) 100 MG ORAL TAB (MHS WRAPPER) $1.00 5026885115 THIAMINE (VITAMIN B1) 100 MG ORAL TAB (MHS WRAPPER) $1.00 5789685101 THIAMINE (VITAMIN B1) 100 MG ORAL TAB (MHS WRAPPER) $1.00 7733393410 THIAMINE (VITAMIN B1) 100 MG ORAL TAB (MHS WRAPPER) $1.00 7733393425 THIAMINE (VITAMIN B1) 100 MG ORAL TAB (MHS WRAPPER) $1.00 6809411661 THIAMINE (VITAMIN B1) 100 MG ORAL TAB (MHS WRAPPER) $1.00 6809411659 THIAMINE (VITAMIN B1) 100 MG ORAL TAB (MHS WRAPPER) $1.00 1184505651 THIAMINE (VITAMIN B1) 100 MG ORAL TAB (MHS WRAPPER) $1.00 7985420010 THIAMINE (VITAMIN B1) 100 MG ORAL TAB (MHS WRAPPER) $1.00 99999-036-68 TIZANIDINE 1 MG ORAL PARTIAL TAB (MCH) $1.00 60505-0251-3 TIZANIDINE 2 MG ORAL TAB $1.00 42291-808-15 TIZANIDINE 2 MG ORAL TAB $1.00 55111-179-15 TIZANIDINE 2 MG ORAL TAB $1.00 16714-172-01 TIZANIDINE 4 MG ORAL TAB $1.00 55111-180-15 TIZANIDINE 4 MG ORAL TAB $1.00 72789-325-77 TIZANIDINE 4 MG ORAL TAB $1.00 99999-038-36 TOBRAMYCIN INTRAVITREAL INJ $1.00 47335-711-13 TOPIRAMATE 100 MG ORAL TAB $1.00 47335-711-86 TOPIRAMATE 100 MG ORAL TAB $1.00 68382-140-14 TOPIRAMATE 100 MG ORAL TAB $1.00 62756-707-13 TOPIRAMATE 25 MG ORAL TAB $1.00 47335-707-86 TOPIRAMATE 25 MG ORAL TAB $1.00 68462-108-60 TOPIRAMATE 25 MG ORAL TAB $1.00 47335-707-13 TOPIRAMATE 25 MG ORAL TAB $1.00 69097-122-03 TOPIRAMATE 25 MG ORAL TAB $1.00 68382-138-14 TOPIRAMATE 25 MG ORAL TAB $1.00 68382-138-05 TOPIRAMATE 25 MG ORAL TAB $1.00 47335-710-86 TOPIRAMATE 50 MG ORAL TAB $1.00 69097-123-03 TOPIRAMATE 50 MG ORAL TAB $1.00 68462-153-60 TOPIRAMATE 50 MG ORAL TAB $1.00 31722-530-01 TORSEMIDE 10 MG ORAL TAB $1.00 23155-872-01 TORSEMIDE 10 MG ORAL TAB $1.00 31722-529-01 TORSEMIDE 5 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 65162-627-50 TRAMADOL 50 MG ORAL TAB $1.00 60687-795-01 TRAMADOL 50 MG ORAL TAB $1.00 60687-795-11 TRAMADOL 50 MG ORAL TAB $1.00 29300-355-01 TRAMADOL 50 MG ORAL TAB $1.00 0904-7496-61 TRAMADOL 50 MG ORAL TAB $1.00 57664-377-08 TRAMADOL 50 MG ORAL TAB $1.00 65162-627-10 TRAMADOL 50 MG ORAL TAB $1.00 0378-4151-01 TRAMADOL 50 MG ORAL TAB $1.00 68382-806-01 TRAZODONE 100 MG ORAL TAB $1.00 0904-6869-61 TRAZODONE 100 MG ORAL TAB $1.00 50111-561-01 TRAZODONE 100 MG ORAL TAB $1.00 68382-806-05 TRAZODONE 100 MG ORAL TAB $1.00 68382-805-05 TRAZODONE 50 MG ORAL TAB $1.00 0904-6868-61 TRAZODONE 50 MG ORAL TAB $1.00 68382-805-01 TRAZODONE 50 MG ORAL TAB $1.00 50111-560-01 TRAZODONE 50 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 13668-330-01 TRAZODONE 50 MG ORAL TAB $1.00 42291-868-90 TRAZODONE 50 MG ORAL TAB $1.00 0591-5335-01 TRIHEXYPHENIDYL 2 MG ORAL TAB $1.00 70954-212-10 TRIHEXYPHENIDYL 2 MG ORAL TAB $1.00 99999-042-46 VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML ORAL SOLN $1.00 99999-002-13 VANCOMYCIN - BSS 25 MG/0.5 ML OPHTHALMIC SYRINGE $1.00 99999-010-96 VANCOMYCIN 5 MG/ML INJ SOLN (MCH) $1.00 99999-010-02 VANCOMYCIN IN NS INTRAVITREAL INJECTION $1.00 23155-250-01 VENLAFAXINE 100 MG ORAL TAB $1.00 23155-246-01 VENLAFAXINE 25 MG ORAL TAB $1.00 57237-172-01 VENLAFAXINE 25 MG ORAL TAB $1.00 42291-897-30 VENLAFAXINE 37.5 MG ORAL CP24 $1.00 57237-174-01 VENLAFAXINE 50 MG ORAL TAB $1.00 23155-248-01 VENLAFAXINE 50 MG ORAL TAB $1.00 42291-898-90 VENLAFAXINE 75 MG ORAL CP24 $1.00 23155-027-01 VERAPAMIL 120 MG ORAL TAB $1.00 0591-0404-01 VERAPAMIL 40 MG ORAL TAB $1.00 23155-059-01 VERAPAMIL 40 MG ORAL TAB $1.00 0591-0343-01 VERAPAMIL 80 MG ORAL TAB $1.00 2420838760 VIT A,C AND E-LUTEIN-MINERALS 300 MCG-200 MG-27 MG-2 MG ORAL TAB $1.00 536509008 VIT A,C AND E-LUTEIN-MINERALS 300 MCG-200 MG-27 MG-2 MG ORAL TAB $1.00 1093995702 VIT A,C AND E-LUTEIN-MINERALS 300 MCG-200 MG-27 MG-2 MG ORAL TAB $1.00 0904-2085-56 VITAMIN A 3,000 MCG (10,000 UNIT) ORAL CAP $1.00 904208560 VITAMIN A 3,000 MCG (10,000 UNIT) ORAL CAP $1.00 4009310144 VITAMIN A 3,000 MCG (10,000 UNIT) ORAL CAP $1.00 536478701 VITAMIN B COMPLEX ORAL CAP $1.00 54629-0560-01 VITAMIN B COMPLEX ORAL CAP $1.00 7985420080 VITAMIN B COMPLEX ORAL CAP $1.00 536137801 VITAMIN B COMPLEX ORAL CAP $1.00 8770140754 VITAMIN E (DL, ACETATE) 180 MG (400 UNIT) ORAL CAP $1.00 5789675201 VITAMIN E (DL, ACETATE) 180 MG (400 UNIT) ORAL CAP $1.00 904027760 VITAMIN E (DL, ACETATE) 450 MG (1,000 UNIT) ORAL CAP $1.00 8068115900 VITAMIN E (DL, ACETATE) 90 MG (200 UNIT) ORAL CAP $1.00 7985490010 VITAMIN E (DL, ACETATE) 90 MG (200 UNIT) ORAL CAP $1.00 99999-038-34 VORICONAZOLE 100 MCG INTRAVITREAL INJ $1.00 99999-038-33 VORICONAZOLE 50 MCG INTRAVITREAL $1.00 99999-044-62 WARFARIN 0.5 MG ORAL PARTIAL 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 99999-036-69 ZINC SULFATE 110 MG ORAL PARTIAL TAB (MCH) $1.00 2055504000 ZINC SULFATE 50 MG ZINC (220 MG) ORAL CAP $1.00 8068113500 ZINC SULFATE 50 MG ZINC (220 MG) ORAL CAP $1.00 5789686501 ZINC SULFATE 50 MG ZINC (220 MG) ORAL TAB $1.00 1000673027 ZINC SULFATE 50 MG ZINC (220 MG) ORAL TAB $1.00 5789686506 ZINC SULFATE 50 MG ZINC (220 MG) ORAL TAB $1.00 13668-008-01 ZOLPIDEM 10 MG ORAL TAB $1.00 16714-622-01 ZOLPIDEM 10 MG ORAL TAB $1.00 51079-725-01 ZOLPIDEM 10 MG ORAL TAB $1.00 0904-6082-61 ZOLPIDEM 5 MG ORAL TAB $1.00 51079-724-01 ZOLPIDEM 5 MG ORAL TAB $1.00 16714-621-01 ZOLPIDEM 5 MG ORAL TAB $1.00 60687-838-11 ZOLPIDEM 5 MG ORAL TAB $1.00 51079-724-20 ZOLPIDEM 5 MG ORAL TAB $1.00 60687-838-01 ZOLPIDEM 5 MG ORAL TAB $1.00 13668-007-01 ZOLPIDEM 5 MG ORAL TAB $1.00 0781-5317-01 ZOLPIDEM 5 MG ORAL TAB $1.00 99999-035-44 ZONISAMIDE 10 MG/ML ORAL LIQUID (COMPOUND) $1.00 68462-128-01 ZONISAMIDE 25 MG ORAL CAP $1.00