ITEMNUM105906

ITEMDESCOBSERVATION - TELE 1ST HOUR

ITEMPRICE515.00

105953 OBSERVATION - TELE EA ADDL HR 112.25109630 IV HYDRATION INITIAL 22.25163049 ZIKA VIRUS IGM (163049) 75.00164125 GLUTEN SENSITIVITY ANTIBODIES (164125) 220.00400653 HEP B SURF AB QUANT (006530) 23.00401417 INSULIN-LIKE GROWTH FAC IGF-2(141770) 71.46506102 RIBS BILATERAL NO CXR 545.50674174 CTA HEAD (COW) 5,117.00800593 WRIST SPLINT MEDIUM LEFT 79.25823239 PORPHYRINS PLASMA (823239) 171.25823248 PORPHYRINS FECAL (823248) 181.00

1005905 OBSERVATION - MED-SURG 1ST HOUR 330.751005906 OBSERVATION - TELE 1ST HOUR 515.001005907 OBSERVATION - TELE EA ADDL HR 112.251005953 OBSERVATION - MED-SURG EA ADDL HR 75.251010061 DRAINAGE OF SKIN ABSCESS 464.001010080 INCIS DRAIN PILONIDAL CYST SIMPLE 282.001010120 REM FB SUBQ SIMPLE 332.751010160 PUNCTURE DRAINAGE OF LESION 465.001011042 DEBRIDE 20 SQ CM 780.001011740 EVACUATION OF SUBUNGUAL HEMATOMA 197.001011760 REPAIR OF NAIL BED 500.001012002 REPAIR SUPERFICIAL WOUND 560.751012004 REPAIR SUPERFICIAL WOUND - PROF 929.001012005 LAC REPAIR CALF - PROF 1,121.001012011 LAC REPAIR SIMPLE 359.501012013 SUPERF WOUNDS FACE, EARS 2.6CM TO 5.0CM 405.001012014 SUPERF WOUND FACE, EARS 5.1CM TO 7.5CM 428.001012015 7.6 CM TO 12.5 CM 600.001012032 LAYER CLOSURE OF WOUNDS 475.751012034 PROF REPAIR INT WOUNDS SCALP TRUNK 978.001012035 INTERMED WOUNDS SCALP 12.6-20.0 522.001012041 INTERME OF NECK HANDS FEET 2.5CM OR LESS 508.001012042 2.6 CM TO 7.5 CM 367.001012051 INTERM FACE EARS TO 2.5 CM 508.001012052 2.6CM TO 5.0CM 478.001012053 5.1 CM TO 7.5 CM 610.001012054 7.6 CM TO 12.5 CM 794.001013120 COMPLEX SCALP ARMS LEGS 1.1CM TO 2.5CM 705.001013121 COMPLEX REPAIR PROF FEE 1,600.001013122 EACH ADDL 5CM OR LESS 375.001013131 COMPLEX FOREHEAD CHEEKS MOUTH 1.1-2.5CM 793.001013132 COMPLEX FOREHEAD CHEEKS MOUTH 2.6-7.5CM 1,243.001013133 EACH ADD 5CM OR LESS 567.001013151 COMPLEX EYELIDS NOSE EARS 1.1-2.5CM 828.001013152 COMPLEX EYELIDS NOSE EARS 2.6 - 7.5CM 1,418.001016000 INITIAL TREATMENT OF BURN(S) 410.00

1016020 TREATMENT OF BURN 410.001018470 DERMABOND 241.501020000 INCISION OF ABSCESS 459.501020520 REMOVAL OF FOREIGN BODY 1,200.001020600 SM JOINT INJ 330.001020605 INT JOINT INJ 271.001020610 ASPIRATION OF JOINT 491.251021480 RESET DISLOCATED JAW 391.501023650 TREAT SHOULDER DISLOCATION 504.751024505 HUMERAL SHAFT FRACT W MANIPULATION 1,212.001024600 TREAT ELBOW DISLOCATION 526.751024640 ELBOW NURSE MAID 241.501024655 RADIAL HEAD NECK FRACT W MANIPULATION 1,296.001024670 TREAT ULNAR FRACTURE 526.751024675 ULNAR FRACT PROX W MANIPULATION 1,296.001025505 RADIAL SHAFT FRACT W MANIPULATION 1,163.001025535 ULNAR SHAFT FRACT W MANIPULATION 733.001025565 RADIAL&ULNAR SHAFT FRACT W MANIPULATION 1,394.001025605 TREAT WRIST FRACTURE 1,296.001025622 TREAT WRIST BONE FRACTURE 526.751026010 DRAINAGE OF FINGER ABSCESS SIM 263.251026605 METACARPAL FRACT SING W MANIPULATION 586.001026725 PHALANGEAL SHAFT FRACT W MANIP 838.001026755 DISTAL PHALANGEAL FRACT W MANIP 702.001026770 TREAT FINGER DISLOCATION 322.001027550 TREAT KNEE/TIBIA FRACTURE 546.501027560 TREAT KNEECAP DISLOCATION 425.501027788 DISTAL FIBULAR FRAC W MANIP 1,029.001027818 TRIMALLEOLAR ANKLE FRACT W MANIPULATION 1,548.001027840 TREAT ANKLE DISLOCATION 504.751028515 NON GREAT TOE FRACT W MANIPULATION 386.001029075 CAST SHORT ARM 593.001029105 APPLY LONG ARM SPLINT 422.251029125 APPLY SHORT ARM SPLINT 422.251029130 APPLICATION OF FINGER SPLINT 404.251029240 STRAPPING OF SHOULDER 5.001029260 STRAPPING ELBOW OR WRIST 5.001029280 STRAPPING HAND OR FINGER 5.001029505 SPLINT LONG LEG APPLICATION 253.501029515 SPLINT LOWER LEG APPLICATION 253.501029530 STRAPPING KNEE LEG THIGH 5.001029540 STRAPPING ANKLE AND OR FOOT 5.001029550 STRAPPING OF TOES 5.001029580 UNNA BOOT STRAPPING 420.001030901 CONTROL OF NOSEBLEED 511.501030903 NASAL HEMMOR ANTER COMPLEX ANY METHOD 297.001030905 NASAL HEMORRHAGE POSTERIOR 465.001031500 INSERT EMERGENCY AIRWAY 1,115.501031605 TRACH EMERG PROCED CRICOTHYROID MEMBRANE 1,834.00

1032002 PNEUMOTHORAX 841.001032551 TUBE THORACOSTOMY INCL CONNEC TO DRAIN 3,044.001036420 CENTRAL LINE INSERT/JUGULAR 1,250.001036430 BLOOD TRANSFUSION O/P 1,166.001036680 PLACEMENT OF NEEDLE TRAOUSSEOUS INFUSION 424.001037195 THROMBOLYSIS CEREBRAL INTRAVENOUS INFUS 1,177.001043760 CHANGE GASTROSTOMY TUBE 549.001046050 INCIS DRAIN PERIANAL ABCESS SUPERFICIAL 464.001046600 ANOSCOPY 123.501049080 PUNCTURE PERITONEAL CAVITY 1,042.251049083 PARACENTESIS PERITONEAL CAVITY W/US GUID 1,042.251051701 BLADDER IRRIGATION 358.501051702 INSERT FOLEY CATH 233.751051703 COMPLICATED INDWELLING BLADDER CATHETER 309.001056420 DRAINAGE OF GLAND ABCESS 552.001059409 VAGINAL DELIVERY NORMAL 3,930.001062270 LUMBAR PUNCTURE 1,069.251064405 INJ - OCCIPITAL NERVE 296.751064450 INJECTION FOR NERVE BLOCK 649.001065205 FOREIGN BODY EXTERNAL EYE CONJUNC SUPERF 145.001065220 REM FOREIGN BODY EYE 500.501065222 FOREIGN BODY CORNEAL W SLIT LAMP 201.001065435 CORNEAL EPITHELIUM CHEMOCAUTERIZATION 900.001069200 EAR LAVAGE 241.501069201 FOREIGN BDY EXTERN AUDITORY CANAL WO GEN 434.001069210 IMPACTED EAR WAX REMOVAL W/ INSTRUMENTS 241.501088001 ER MANAGEMENT LEVEL 1 176.251088002 ER MANAGEMENT LEVEL 2 606.251088003 ER MANAGEMENT LEVEL 3 992.001088004 ER MANAGEMENT LEVEL 4 1,322.501088005 ER MANAGEMENT LEVEL 5 1,983.751088200 LACERATION REPAIR SIMPLE 359.501088201 LACERATION REPAIR INTERMEDIATE 410.001088202 LACERATION REPAIR COMPLEX 1,600.001088888 IV THERAPY 324.001090471 ADMIN IMMUN > 8YR 154.001090472 ADMIN IMMUN + ADDITIONAL > 8 YRS 23.001092950 CPR HEART/LUNG RESUSCITATION 1,520.751092960 CARDIOVERSION ELECTRIC EXT 1,045.001092961 CARDIOVERS ELECT CONV OF ARRHYTHMIA 700.001096360 IV HYDRATION INITIAL 165.251096361 IV HYDRATION SUB 48.501096366 DRIP ADDITIONAL HR 96.001096367 DRIP ADDITIONAL SEQ 158.001096368 DRIP CONCURRENT 97.001096372 INJ ADMIN OF THERAPEUTIC 61.751096374 IV PUSH INITIAL 165.251096375 IV PUSH SUB 70.501096376 IVP-PUSH ADDL SEQ 171.25

1096523 PICC LINE IRRIGATION 35.001099144 5 YR > 1ST 30 MIN INTRA SERVICE 356.001099195 PHLEBATOMY-THERAPEUTIC 132.251099291 CRITICAL CARE 2,942.751099435 NEWBORN CARE 1,284.001500002 DEPO-PROVERA 182.001500396 ALCOHOL ABUSE SCREEN 15-30 MIN 125.001500434 TOXCUP DRUG SCREEN CUP-5 PANEL 20.831501055 MEDROXYPROG (DEPO-PROVERA) 150MG VL 182.001501100 DEXAMETHASONE(DECADRON) 4MG/ML VL 28.001503420 CYANOCOBALAMIN(B-12) 1MG/1ML VL 39.501503940 MARCAINE 29.001504315 FOLEY TRAY W/CATH 79.251507120 RHOGAM -1507611 ALBUTEROL(VENTOLIN) 0.5% NEB SOL 16.001507644 IPRATROPIUM(ATROVENT) NEB UDV 16.001510061 DRAIN SKIN ABSCESS (CLINIC) 148.091511100 BIOPSY SKIN LESION 97.741511101 SHAVE BIOPSY 1ST 97.741511102 SHAVE BIOPSY EA ADD 63.551511200 REMOVAL SKIN TAGS 90.361511765 TOE NAIL REMOVAL 398.001514565 ARM SLING MEDIUM 61.751517110 CRYOTHERAPY 101.351520550 INJECTION TENDON SHEATH/LIGAMENT 275.001520551 INJECTION TENDON ORIGIN/INSERTION 275.001520552 TRIGGER POINT INJECTION 1-2 SITES 490.251520600 SM JOINT INJ 70.761520605 INT JOINT INJ 71.971520610 LG JOINT INJ 76.951525375 LIDOCAINE 2% 22.501529065 CAST LONG ARM 94.821529075 CAST SHORT ARM 90.181529105 SPLINT LONG ARM 90.701529125 SPLINT SHORT ARM 79.191529425 CAST SHORT LEG 86.231569200 EAR WAX LAVAGE ONLY 73.001569210 EAR WAX REMOVAL W/ INTRUMENTATION 73.001586580 TUBERCULIN PPD(TUBERSOL) 5U/0.1ML 28.001590465 ADMIN IMMUN 1-18YRS 19.501590466 ADMIN IMMUN THRU 18 YRS EA ADD'T 13.001590471 ADMIN IMMUN > 8YR 19.501590472 ADMIN IMMUN + ADDITIONAL > 8 YRS 13.001590657 INFLUENZA IMMUN.CHILD 17.001590707 MMR VIRUS IMMUN. 71.501590716 VARICELLA 201.001590791 INITIAL PSYCHIATRIC EVALUATION 275.001590792 INITIAL PSYCHIATRIC W MED SERV 275.001590805 PSYCHIACTRIC 20-30 MIN W/ MED E/M 210.00

1590832 PSYCHOTHERAPY 30 MINS 125.001590834 PSYCHOTHERAPY 134.001590837 PSYCHOTHERAPY 60 MIN 160.501597810 ACUPUNTURE NO ELECT STEM INITIAL 15 MIN 135.001597811 ACUPUNCTURE NO ELECT STEM EACH ADD 15 MI 70.001598941 CHIROPRACTIC 3-4 REGIONS 155.001599202 NEW PT LEVEL 2 170.001599203 NEW PT LEVEL 3 210.001599204 NEW PT LEVEL 4 245.001599211 NURSE VISIT 44.001599212 ESTB PT LEVEL 2 135.001599213 ESTB PT LEVEL 3 175.001599214 ESTB PT LEVEL 4 210.001599215 ESTB PT LEVEL 5 (40 MIN ONE ON ONE) 225.001599243 CONSULT - MODERATE 160.501599244 CONSULT - HIGH 187.501599381 WELL CHILD NEW INFANT-12 MON 120.501599382 WELL CHILD NEW 1-4 YRS 130.001599383 WELL CHILD NEW-WCE 5-11 YRS 139.501599384 WELL CHILD NEW 12-17 YRS 142.001599385 NEW PT WELL EXAM 142.001599386 NEW PT WELL EXAM 40-64 YO 121.291599391 WELL CHILD EST INFANT-12 MON 96.501599392 WELL CHILD EST 1-4 107.001599393 WELL CHILD EST 5-11 YRS 116.501599394 WELL CHILD EST 12-17 125.001599395 EST PT WELL EXAM 119.001599396 EST PT WELL EXAM 40-64YO 108.571599397 EST PT WELL EXAM 65+ YR 113.211599408 ALCOHOL/SUBSTANCE ABUSE SCREEN 15-30 MIN 125.001599409 ALCOHOL/SUBSTANCE ABUSE SCREEN 15-30 MIN 150.001599410 ALCOHOL ABUSE SCREEN 30+ MINUTES 150.001599998 EST PT WELL EXAM 119.001599999 NEW PT WELL EXAM 142.002000120 ORAL EVAL PERIODIC 48.002000148 COMPLETE PRAL EVAL 80.502000210 INTRAORAL - COMPLETE SERIES 128.502000220 INTRAORAL - PERIAPICAL 1ST 32.002000230 INTRORAL - PERIAPICAL EACH ADDTL 9.502000240 INTRAORAL - OCCLUSAL 32.002000270 BITEWING- SINGLE 17.002000272 BITEWING - 2 FILMS 34.002000274 BITEWING - 4 FILMS 61.002002330 RESIN - 1 SURFACE ANT 176.502002331 RESIN - 2 SURFACES ANT 192.502002332 RESIN - 3 SURFACES ANT 208.502002335 RESIN - 4+ VIN INCISION 273.002002391 RESIN COMP 1 SURFACE POST 125.002002392 RESIN COMP - 2 SURF POST 154.00

2002393 RESIN COMP - 3 SURF POST 183.002002394 RESIN COMP 4+ SURF POST 192.502002920 RECEMENT CROWN 96.502002931 CROWN STAINLESS PERM 304.002002940 PROTECTIVE RESTORATION 135.002002954 PREFABRICATED POST & CORE ADDTL TO CROWN 225.002002999 UNSPECIFIED RESTORATIVE PROC BY REPORT 150.002003220 THERAPEUTIC PULPOTOMY 239.502003221 PULPAL DEBRIDEMENT PRIMARY PERM TEETH 135.002003310 ENDODONIC THERAPY ANTERIOR TOOTH EXC FIN 648.002003320 ENDODONIC THERAPY BICUSPID TOOTH 783.002004341 PERI SCALING/ROOT PLANING 4+ PER QUAD 150.002004342 PERI SCALING/ROOT PLANING 1-3 PER QUAD 150.002005411 ADJUST COMPLETE DENTURE MANDIBULAR 75.002007111 EXTRACTION CORONAL REMNANTS DECID TOOTH 123.002007140 EXTRACTION ERUPTED TOOTH 138.002007210 SURG REMOVAL ERUPTED TOOTH 273.002007250 SURGICAL REMOVAL OF RESIDUAL TOOTH ROOTS 300.002007971 EXCISION PERICORONAL GINGIVA 50.002007999 ORAL SURGERY UNSPECIFIED BY REPORT 205.502009110 PALLIATIVE TX EMER OF DENTAL PAIN (MINOR 135.002009430 OFFICE VISIT FOR OBS NO OTHER SERVICES 60.002011034 ANTEPARTUM MEDICAL VISITS 176.502011038 POSTPARTUM MEDICAL VISIT 176.502016200 INITIAL NUTRITION ASSESSMENT 176.502016201 NUTRITION ASSESSMENT 176.502016202 INITIAL NUT ASSESS SUB 15 MIN 176.502016204 FOLLOW UP NUTRITION INDIVIDUAL 176.502016208 POSTPARTUM NUTRITION ASSESMENT 176.502016300 INITIAL PSYCHOSOCIAL ASSESS 176.502016302 PSYCHOSOCIAL ASSESSMENT 176.502016304 FOLLOW-UP PSYCHOSOCAIL IND 176.502016308 POSTPARTUM PSYCHOSOCIAL ASSE 176.502016400 INDIVIDUAL CLIENT ORIENTATION 176.502016402 HEALTH ED ASSESSMENT 176.502016404 INITIAL HEALTH ED EA 15MIN 176.502016406 FOLLOW UP HEALTH ED IND 176.502016410 PERINATAL ED 176.502016414 POSTPARTUM HEALTH ED ASSES 176.502026402 INITIAL HEALTH ED ASSE CARE PL 176.502057452 COLPOSCOPY 121.002057500 CERIX BX 262.002058100 ENDIMETRAL BIOPSY 99.502059025 FETAL NST 52.502076815 LIMITCOL ULTRA SOUND/AFI 147.502081003 URINALYSIS W/O SCOPE 37.502081025 URINE PREG TEST 30.002082948 GLUCOSE BLOOD REAGENT 15.002085013 HEMOGLOBIN 30.00

2087430 RAPID STREP 60.002088136 ANKLE STIRRUP 189.502500003 ORTHO SURGERY MAJOR 1ST HR 5,800.002500004 ORTHO SURGERY MINOR 1ST HR 2,300.002501000 ALCON IOC IMPLANT(NOT RESTORE) 265.752504789 RECOVER RM PROCDURE + 1/4HR 38.752504790 RECOVERY ROOM 1 HR 84.002512113 ORTHO SURGERY MAJOR EA ADDT 15 MIN 550.002512114 ORTHO SURGERY MINOR EA ADDT 15 MIN 350.002512875 RECOVERY ROOM PROCEDURE 551.002520552 TRIGGER POINT 1-2 MUSCLES 225.002520553 TRIGGER POINT 3 OR MORE MUSCLES 225.002525236 JURGANS BALLS 39.752525260 REP TENDON/FOREARM MUSCLE PROF 1,236.502525333 SKIN STAPLE RICHARD ALLEN 69.502525387 SURGICAL PROCEDURE MINOR 1,875.752525511 ETH 3-0 VICRYL TIES 99.502525514 ETH 6-0 VICRYL S29 75.252525516 ETH VICRYL SINGLE (ALL OTHER) 16.502525527 ETHIBOND SINGLE (ALL OTHER) 16.502525529 ETH 4-0 MERSILENE P3 29.752525536 3-0 MONOCRYL PS2 33.002525537 ETH MONOCRYL/BIOSYN SINGLE AL 16.502525538 ETHILON 3-0 FSI 40.752525539 ETH ETHILON/MOMOSOFT SINGLE 12.252525597 K WIRE SMITH/NEPHEW 37.502546040 I & D PERIRECTAL ABSCESS 1,150.502562311 PROF- INJECT SPINE L/S 463.002564470 PROF- INJ PARAVERTBAL C/T 473.752564483 PROF - EPIDURAL LUMBAR/SACRAL 473.752564490 PROF - INJ THERAPEUTIC 534.502588888 IV THERAPY 303.252596372 THERAPUTIC INJECTION IM/SC 61.752599195 THEURAPEUTIC PHLEBOTOMY 132.253000140 ANES - CATARACT 142.253000190 ANES - FACIAL BONES/SKULL 142.253000450 ANES CLAVICLE 142.253000520 ANES - CLOSED CHEST PROCEDURE 142.253000524 PNEUMOCENTESIS 142.253000532 ANES CENTRAL VENOUS 142.253000635 ANES - EPIDURAL 142.253000640 ANES-SPINE LESI 142.253001200 ANES - CLOSED HIP 142.253001320 ANES ALL PROC NERVES MUSCLES 142.253001462 ANES-CLOSED ANKLE/LEG/FOOT 142.253001480 ANES - OPEN PROC LOWER EXT 142.253001610 ANES-NERVES/MUSCLES 142.253001620 ANES-CLOSED HEAD/NECK/SHOULDER 142.253001630 ANES OPEN HUMERAL NECK ETC 142.25

3001730 ANES-CLOSED ELBOW/HUMERUS 142.253001740 ANES OPEN HUMERUS/ELBOW 142.253001810 ANES -NERVES MUSCLES TENDONS 142.253001820 ANES - WRIST 142.253001830 ANES - OPEN RADIU/ULNA 142.253001991 ANES-LESI 142.253001995 REGIONAL IV FOR PAIN MGMT 142.253001999 ANES UNLISTED PROCEDURE 142.253020550 INJECTION SINGLE TENDON SHEATH LIGAMENT 490.253020552 TRIGGER POINT ONE/TWO MUSCLES 490.253020553 TRIGGER POINT THREE OR MORE 735.003053166 ANESTHESIA BIER BLOCK ADD 15 92.753053171 ANESTHESIA REGIONAL 1ST HR 478.503053172 MONITORED ANESTHESIA CARE 239.003053306 ANESTHESIA GENERAL + 1/4H99 185.503053322 ANESTHESIA GENERAL 1 3/4 99 572.253053637 ANESTHESIA LOCAL 1/2HR 99 44.253062270 ANES SPINAL TAP 142.253062273 ANES BLOOD PATCH 142.253062289 EDIDURAL PAIN CONTROL TRAY 248.253064447 FEMORAL BLOCK 650.003064450 SCIATIC/POPLITEAL BLOCK 650.003079996 ANESTHESIA GENERAL 1 HR 99 896.003079997 ANESTHESIA EA ADDTL 15 MIN 60.753099156 ANES 5YRS+ MOD SEDATION 239.003099157 ANES 5YRS+ EACH ADD 15 MIN 239.003511034 TUBING IV BLOOD Y TYPE 10.753512082 ENEMA OIL MINERAL OIL 22.253512095 THUMB SPICA MEDIUM RIGHT 146.753512124 SHOULDER IMMOBILIZER PREMIUM 89.003512331 KLING BANDAGE 6 10.753512467 TRAY CHEST TUBE 1,080.003513290 SOD CHLOR 0.9% 100ML 85.003514563 ARM SLING X SMALL 61.753514565 ARM SLING MEDIUM 61.753514568 ARM SLING LARGE 61.753514570 KNEE IMMOBILIZER 24 205.003514571 KNEE IMMOBILIZER 16 181.753514617 ACE BANDAGE 6 12.253514633 ACE BANDAGE 3 12.253514647 ACE BANDAGE 2 12.253514666 FOLEY CATH KIT 23.253516968 FOLEY TRAY 27.753517959 KLING BANDAGE 2 10.753518071 ABD PADS 8X10 10.753518271 SCAPELS DISPOSABLE # 11 7.753518301 IV NON PUMP 10.253518449 IV TUBING 15GTT NON-PUMP 10.003518537 KNEE IMMOBILIZER 20 205.00

3518667 IV PUMP TUBING 10.253519392 PLEUR-E-VAC 575.253519805 WRIST SPLINT LARGE LEFT 79.253519806 WRIST SPLINT MEDIUM RIGHT 79.253519807 WRIST SPLINT SMALL LEFT 79.253519811 WRIST SPLINT SMALL RIGHT 79.253519812 WRIST SPLINT LARGE RIGHT 79.253519818 THUMB SPICA MEDIUM LEFT 146.753519819 THUMB SPICA LARGE LEFT 146.753519822 THUMB SPICA LARGE RIGHT 146.753519830 SPLINT FINGER STRIP 1/2X 18 18.503519831 SPLINT FINGER STRIP 3/4 X 18 18.503519832 SPLINT FINGER STRIP 1X 18 18.503519970 STERI-STRIP 1/8 12.253519971 STERI-STRIP 1/4 10.753519972 STERI-STRIP 1/2 12.253520168 SURGICEL 138.003520420 STOCKINETTE BIAS 2 12.253520421 STOCKINETTE 3 BIAS 12.253520422 STOCKINETTE BIAS 4 17.503524569 ARM SLING X LARGE 61.753534001 ORTHO GLASS 2 9.753534002 ORTHO GLASS 3 9.753534003 ORTHO GLASS 4 9.753534005 ORTHO GLASS 6 9.753534568 ARM SLING SMALL 61.753540133 EKG PADS ADULT DFIB 10.753540633 SUTURES MONO PDSII O 6-0 TP-1 165.253553072 STAPLES SKIN ALL 241.503558117 FIBERGLASS CAST ROLL 2 47.503558118 FIBERGLASS CASTING ROLL 3 49.503558119 FIBERGLASS CASTING ROLL 4 49.503560259 D5W (DEXTROSE 5%) 500ML 85.003560564 D5W + LACT RINGERS 1000ML 85.003560689 D5W+ NS 0.45% 1000ML LVP 85.003560713 D5W + 0.9% NS 1000ML 84.003560754 D5W (DEXTROSE 5%) 250ML 85.003560903 RINGERS LACTATE 1000ML 85.003560945 SOD CHLOR (SALINE) 0.9% 250ML 85.003561109 SOD CHLOR (SALINE) 0.9% 500ML 85.003561117 SOD CHLOR 0.9% 1000ML 85.003561257 SOD CHLOR 0.45% 1000ML 85.003561695 D5W (DEXTROSE 5%) 50ML 85.003561729 SOD CHLOR (SALINE) 0.9%50ML 85.003561745 D5W (DEXTROSE 5%) 100ML 85.003564053 KLING BANDAGE 3 10.753564056 KLING BANDAGE 4 IN 10.753579855 FLUSH NS 0.9% 17.503588135 ACE BANDAGE 4 12.25

3588136 AIR CAST ANKLE STIRRUP UNIVERSAL 195.254000455 THYROID PANEL (000455) 11.944000540 THYROGLOBULIN COMP PANEL (500540) 57.004000633 ANTI-EXTRACT NUCLEAR ANTIGEN (006338) 38.254000904 URINALYSIS -4000905 OCCULT BLOOD FECAL IMMUNOASSAY(182949) 66.304001768 IMMUNOGLOBULINS A/G/M QN (001768) 29.724001870 ANTI-SCLERODERMA 70 ABS (018705) 18.004002103 URINE PROTEIN (24 HR) (003277) 6.004003129 PROT+CREAT (RANDOM) (003129) 12.714003277 PROTEIN TOTAL, QN 24HR URINE (003277) 6.004004176 CATECHOLAMINES FRAC UR FREE 24HR (004176 27.004005223 HEMOGLOBIN HB (005223) 22.004006668 ANTI-SMOOTH MUSCLE M2 AB (006668) 37.934007441 SOLUBLE LIVER ANTIGEN (007441) 140.504008352 GQ1B AB IGG (808602) 17.084011173 ANTI-CCP IGG/IGA (164914) 20.204013914 CMV QUANT PCR (139149) 323.504014033 NEOPTERIN (140335) 84.924016195 CARDIOLIPIN AB PANEL (161950) 39.284016204 IBD EXPANDED PANEL (162045) 243.004016369 TETANUS ANTITOXOID AB (163691) 22.644016486 ANA W/RFLX IF POSITIVE (164868) 21.754016488 ANA W/ REFLEX CASCADE (164880) 457.254018083 H. PYLORI BREATH TEST (180836) 225.004019560 BB BLOOD FFP 60.754020061 IHC 1ST AB STAIN X1 GLBL (W20061) 84.254020532 IHC EA ADDL AB STAIN X3 GLBL (W20532) 252.754021140 NEONATAL BILIRUBIN PANEL 38.754030000 HEP B VIRUS QUANT PCR (551610) 204.004030180 PLATELET COUNT 21.004030551 ANTI-MULLERIAN HORMONE AMH (500183) 78.544033214 EOSINOPHIL COUNT 13.504036415 VENIPUNCTURE 35.004036417 LAB CORP VENIPUNCTURE 35.004039490 EBV PCR QUANT(138230) 306.004039998 IGA HEAVY LIGHT CHAINS (HLC) (123540) 270.004039999 IGM HEAVY LIGHT CHAINS (123560) 270.004040250 OCCULT BLOOD #2 49.504040260 OCCULT BLOOD #3 49.504040560 URIC ACID URINE (012898) 6.894042045 THYROGLOBULIN TUMOR MARKER (042045) 10.004048920 JAK2 MUTATION ANALYSIS, QUAL (489200) 204.004050123 HEP C FIBROSURE (550123) 163.204050200 BB CROSSMATCH #2 123.504050210 BB CROSSMATCH #3 123.504050220 BB CROSSMATCH #4 123.504050411 VITAMIN D 25-HYDROXY LCMS D2+D3 (504115) 173.404053173 LITHIUM 27.21

4055007 HEP C RT-PCR QUANT (550080) 132.604055009 HEP C RNA PCR QN RFX GENO (550090) 172.994055042 HIV 1 RNA BY PCR (550420) 153.004055084 HEP C RNA QUAL RFX TO QUANT (550840) 114.754055088 HIV 1 QUANT, RNA REAL TIME (550880) 439.504055130 HEP C REALTIME ABBOTT (551300) 647.754060183 ALLERGEN PROFILE VEGETABLE I (601831) 96.314060185 ALLERGEN PR MILK (601856) 91.254060247 M003-IGE ASPERGILLUS FUMIGATUS (602471) 14.254060264 ALLERGENS IGE AREA 13 (602643) 687.504060290 MOLD/DUST ALLERGY PANEL, IGE (602904) 121.254060298 ALLERGEN CHILDHOOD IGE (602988) 93.184062255 STREP A SCREEN 60.754062263 DRUG (DOA)SCR, URINE I/H 134.504070112 CA 125 (002303) 13.254070113 CA 19-9 (002261) 15.064070227 RETICULOCYTE COUNT 80.254070235 SED RATE (ESR) 49.504070326 AMYLASE 93.754070359 CALCIUM 20.004070417 POTASSIUM 20.004070441 SODIUM 20.004070573 BUN 20.004070599 CHOLESTEROL 80.254070620 CREATININE 20.004070672 DIGOXIN 136.504070755 ALBUMIN 20.004070789 QUANTIFERON TB GOLD (182873) 61.204070847 LD (LDH) (001115) 3.754070870 ALKALINE PHOSPHATASE 20.004071001 URIC ACID 59.754071035 TRIGLYCERIDES 79.254071076 PT INR (PT) 101.504071258 CULTURE BLOOD #1 168.504071621 BB ANTIBODY SCREEN 62.754071738 GRAM STAIN 39.754071746 OCCULT BLOOD #1 49.504071749 CULTURE EYE 157.504071750 CULTURE EAR 157.504071751 CULTURE BODY FLUID 157.504071753 CULTURE STOOL 157.504071755 CULTURE CSF 157.504071845 GLUCOSE TOL 2HR. 189.504072579 PROTEIN TOTAL SERUM 20.004073783 MAGNESIUM 80.254073874 THYROID STIM HORM (TSH) 221.504073980 BB BLOOD PROCESSING FEE 28.754073981 BB RH(D) TYPING 60.754073988 BB ABO TYPE 60.75

4074492 DILANTIN 171.004074980 CO2 20.004075044 ALCOHOL(ETHANOL) SERUM 141.004075234 HDL 79.254075250 HEP C AB W/RFLX (144065) 14.004076372 BILIRUBIN TOTAL 20.004076706 LIPID PANEL CHL TRG HDL LDL 217.254076927 APTT 101.504076928 STOOL CULTURE YESINIA ONLY (182410) 56.254076929 STOOL CULTURE VIBRIO ONLY (182311) 56.254076935 HCG QUAL 107.004077012 CELL CT, NON CSF 77.254077015 CELL CT, CSF 93.754077057 CULTURE URINE SCREEN 135.504077061 CULTURE BETA STREP B 60.754077081 HEMOGRAM & PLATLET COUNT AUTO 103.504077085 HEMOGRAM 77.254077099 KETONES, SERUM 15.504077115 MONO SCREEN 62.754077172 PHENOBARBITAL SERUM 35.004077271 WET MOUNT 60.754077321 ACETAMINOPHEN 168.504077347 GLUCOSE TOL 1HR. 126.754077350 GLUCOSE 20.004077404 CEREBRO SPINAL FLUID PROTEIN 60.754077481 CULTURE GENITAL 157.504077484 CULTURE WOUND 157.504077567 T4 FREE 86.004077628 KOH SLIDE PREP 32.004077636 PHOSPHORUS 20.004077644 SALICYLATE 84.004077696 GAMMA GT (GGT) (001958) 12.254077701 REPEAT BASIC METABOLIC PANEL 151.004077711 REPEAT CBC 96.754077712 REPEAT POTASSIUM 20.004077718 REPEAT HEPATIC PANEL 135.504077719 REPEAT COMP METABOLIC PANEL 260.004077720 RPR (006072) 2.504077721 VITAMIN B12 (001503) 9.754077725 COMPLEMENT C4 (001834) 29.254077726 VITAMIN B12 & FOLATE (000810) 30.814077727 CULT ID AERO 1 135.504077729 PROTEIN ELECTRO. RANDOM URINE (354928) 18.054077750 OVA & PARASITE EXAM. ROUTINE(008623) 10.924079262 TITANIUM WB (792620) 37.254079335 URINE SODIUM 24 HOUR (003178) 4.594079670 CULTURE ANAEROBIC I/H 172.004079674 DRUG PROFILE BLOOD (SEVEN DRUGS) (766477 319.254079676 GLUCOSE TOL 3HR. 208.00

4079681 ELECTROLYTES 77.254079682 AMMONIA 138.004079683 TROPONIN I 174.004079684 CBC WITH AUTOMATED DIFFERENTIAL 96.754079685 MYOGLOBIN 174.004079686 COMPREHENSIVE METABOLIC PANEL 260.004079687 BASIC METABOLIC PANEL 151.004079689 RENAL FUNCTION PANEL 193.254079690 LIVER FUNCTION PANEL 135.504079691 BILIRUBIN DIRECT 20.004079696 IgA SERUM (001784) 6.254079697 IgM SERUM (001792) 6.254079880 APOLIPOPROTEIN B (167015) 24.754079882 ANTI-NUCLEAR ANTIBODIES (ANA) (164947) 33.504079884 ALLERGEN PR MINI (649749) 294.004079885 CELIAC DISEASE PANEL (165142) 288.504079888 CELIAC DISEASE COMP PANEL (165126) 336.754079894 CMV (PCR) QUAL (138693) 321.254079895 TESTOSTERONE FREE & TOT 36170 (140103) 37.504079897 LEVETIRACETAM (KEPPRA) (716936) 84.154079903 ALLERGEN PINE TREE (062489) 143.824079904 CRYPTOCOCCAL AG (006551) 35.004079908 HEP C RNA PCR QUANT (550080) 132.604079909 GLUTAMIC ACID (GAD) AUTOANTIBODY (143008 52.504079910 MICROALBUMIN/CREAT RATIO RANDOM (140285) 13.694079916 ANCA SCN WITH REFLEX (162388) 45.754079919 A1-ANTITRYPSIN PHENOTYPING (095653) 28.004079920 CHROMIUM, PLASMA (071522) 71.404079924 ALLERGEN PR ZONE 19 (650820) 359.554079925 ALLERGEN MOLD GRP (062448) 347.754079927 LUPUS ANTICOAGULANT (117054) 291.984079929 GLUCOSE, BODY FLUID (019497) 5.014079930 PROTEIN, TOTAL, BODY FLUID (019588) 6.004079934 ALLERGEN W/TOTAL IGE AREA 12 (603719) 639.004079938 VITAMIN D 1 25 DI-HYDROXY (081091) 49.504079944 GLUTEN (069781) 26.754079946 EBV QUAL PCR (138289) 328.954079948 IMMUNO-FECAL OCCULT BLOOD (182949) 66.304079950 METHYLMALONIC ACID SERUM (706961) 48.754079952 TISSUE TRANSGLUTAM ANTI IGG (164988) 108.754079953 STOOL FOR WBC 53.504079954 EST GLOM FILTRATION RATE 12.254079958 PTH INTACT (015610) 61.254079959 ANTI-EXTRACTABLE NUCLEAR AG (006338) 34.004079960 LIVER KIDNEY MICROSOMAL AB (163980) 31.004079961 D DIMER 174.004079967 KAPPA-LAMBDA LIGHT CHAIN (121137) 61.204079968 LIPASE 80.254079972 REPEAT LIPASE 80.25

4079973 REPEAT D-DIMER 174.004079985 PHOSPHORUS 24 HR URINE (003251) 11.254079986 BHCG QUANT. 220.504079987 RUBEOLA IGM (160218) 15.004079989 TISSUE TRANSGLUTAM ANTI IGA (164640) 35.004079990 H. PYLORI ANTIBODIES(IGM IGG & IGA) (163 6.834079992 LEAD BLOOD (PEDIATRIC) (717009) 26.254079993 ANTI-JO-1 (161455) 40.004079995 PORPHOBILINOGEN QUARAND URINE(003053) 32.504079996 ANDROSTENEDIONE SERUM(004705) 223.004079997 C-TELOPEPTIDE SERUM(500089) 126.004079998 PAP W REFLEX TO HPV (192630) 81.254079999 MTHFR (511238) 127.504080002 VITAMIN K1 SERUM (121200) 178.504080003 PAP ONLY (192005) 61.714080004 FECAL REDUCING SUBSTANCES (016766) 21.004080005 URINE CYTOLOGY (009068) 86.964080006 BABESIA MICROTI ANTIBODIES IGG AND IGM ( 275.004080008 CORTISOL FREE & TOTAL(500440) 80.584080009 T & B LYMPHOCYTE DIFF. PANEL (096917) 506.254080011 NATURAL KILLER CELL SURFACE ANTIGEN (CD3 214.254080014 BETA 2 GLYC AB IGA IGG IGM (163915) 41.314080015 BK VIRUS DNA BY PCR(138962) 370.264080017 TRYPTASE (826008) 37.504080020 CREATININE URINE (013672) 16.004080022 HTLV I & II ANTIBODY (164277) 49.984080026 LYME DISEASE AB W/REFLEX TO WESTERN (258 97.254080028 ANA COMPREHENSIVE PANEL (165092) 364.424080031 TESTOSTERONE FREE & WEAKLY BOUND (143255 337.254080034 MRSA SCREEN 60.754080035 ALLERGEN BASIC FOOD (660423) 267.254080036 HOUSE DUST QUANT. IGE (069450) 26.754080037 COPPER PLASMA (001586) 61.204080038 ANCA PROFILE (163873) 72.504080040 PROTEIN, TOTAL, URINE (013664) 13.004080042 INFLAMMATORY BOWEL DISEASE (IBD) PROFILE 461.004080044 17-HYDROXPROGESTERONE(070085) 29.604080045 PROINSULIN (140533) 153.004080047 URINE SODIUM RANDOM(013326) 5.824080048 URINE POTASSIUM RANDOM(013334) 10.754080049 CHROMOGRANIN A (140848) 123.424080058 LD (LDH) BODY FLUID (100156) 6.004080062 IMMUNOFIXATION(IFE) AND PROTEIN ELECTROP 116.004080063 IMMUNOFIXATION(IFE) SERUM AND PROTEIN EL 109.254080064 IgG SUBCLASSES (209601) 195.254080065 ETHANOL URINE (007237) 15.914080067 ACTIN (SMOOTH MUSCLE) ANTIBODY (006643) 5.294080068 CANDIDA ANTIBODIES IGG IGA IGM (163135) 171.004080074 HEPATITIS PANEL ACUTE (322744) 82.13

4080156 CARBAMAZEPINE 83.004080158 CYCLOSPORIN (706556) 54.504080159 CLOZAPINE (CLOZARIL) SERUM (706440) 71.404080162 REPEAT DIGOXIN 136.504080164 VALPROIC ACID (007260) 11.504080197 TACROLIMUS (PROGRAF) (700248) 101.254080201 TOPIRAMATE (TOPAMAX) (716285) 27.754080202 VANCOMYCIN 18.004080203 ZONISAMIDE (ZONEGRAN) (007915) 91.804080211 ADALIMUMAB CONCENTRATION W/ SB (504575) 400.004080377 DRUG SCREEN 9 ALC (733002) 82.504081001 URINALYSIS AUTO W MICRO 11.764081015 URINALYSIS MICRO ONLY 37.504081105 HPA 1A PLATELET ANTIGEN (500314) 282.254081206 BCR-ABLI CML/ALL PCR QUANT (480481) 433.504081217 BRCA2 TARGETED ANALYSIS (252250) 417.004081404 TRANSTHYRETIN (252810) 529.004081405 GENESEQ CARDIO FAMILIAL AORTOPA (48003) 2,750.004082024 ACTH PLASMA (004440) 5.754082026 PLASMA IODINE (070034) 61.504082043 MICROALBUMIN 24 HR URINE (140050) 10.654082085 ALDOLASE (002030) 28.254082103 ALPHA 1 ANTITRYPSIN SCREEN (001982) 27.754082104 ALPHA1 ANTITRYPSIN STOOL QUANT (123010) 189.504082105 ALPHA-FETO PROTEIN SERUM TUMOR MARKER (0 4.074082131 HOMOCYSTEINE SERUM OR PLASMA (706994) 102.004082150 REPEAT AMYLASE 93.754082164 ANGIOTENSIN-1-CONVERTING ENZYME (010116) 40.254082172 LIPOPROTEIN A (120188) 18.054082232 BETA 2 MICROGLOBULIN SERUM (010181) 115.254082273 GASTROCCULT 50.504082306 VITAMIN D 25-HYDROXY 122.004082330 CALCIUM IONIZED (004804) 35.004082340 URINE CALCIUM (24 HR) (003269) 7.144082360 CALCULI URINARY W/PHOTO (120691) 20.814082375 CARBOXYHEMOGLOBIN (007187) 36.004082378 CEA (002139) 13.504082383 CATECHOLAMINES PLASMA (084152) 70.004082384 CATECHOLAMINES FRAC. RANDOM URINE (3162 37.944082390 CERULOPLASMIN (001560) 25.754082399 PTHRP(503380) 33.664082435 CHLORIDE 20.004082436 URINE CHLORIDE RANDOM (013656) 13.004082530 CORTISOL 24HR URINE FREE (004432) 22.564082533 CORTISOL (004051) 11.444082535 CORTISOL, AM (104018) 11.444082536 CORTISOL W/ REFLX DEXAMETHASONE (503990) 93.504082542 BILE ACIDS FRACT (503640) 281.254082550 CK TOTAL 77.25

4082552 CK ISOENZYMES SERUM (002154) 19.744082553 CKMB 174.004082570 URINECREATININE (24 HR) (003012) 6.904082575 CREATININE CLEARANCE (003004) 9.254082595 CRYOGLOBULIN (001594) 12.254082626 DHEA (00401) 41.254082627 DHEA SULFATE (004020) 25.754082652 THYROID ABS (006684) 69.004082668 ERYTHROPOIETIN (EPO) SERUM (140277) 23.944082670 ESTRADIOL (004515) 25.754082672 ESTROGEN TOTAL (004549) 23.254082677 ESTRIOL SERUM (004614) 116.004082679 ESTRONE SERUM (004564) 179.754082705 FECAL FAT QL (001677) 33.004082710 FECAL FAT QN (001354) 54.504082728 FERRITIN SERUM (004598) 9.254082746 FOLATE SERUM (002014) 8.754082747 FOLATE RBC (266015) 54.504082755 ALLERGEN W/ TOTAL IGE AREA 19 (602987) 614.754082784 IgG SERUM (001776) 6.254082785 IgE TOTAL (002170) 14.314082786 IMMUNOGLOBULIN AEGM (002295) 45.254082945 GLUCOSE, CSF 20.004082995 G-6PD QN 500 (001917) 17.524083001 FOLLICLE-STIMULATING HORMONE (FSH)(00430 12.254083002 LUTEINIZING HORMONE (LH) (004283) 12.254083003 GROWTH HORMONE SERUM (004275) 21.044083005 FSH AND LH (028480) 35.394083010 HAPTOGLOBIN (001628) 31.004083015 HEAVY METALS PROFILE 1 BLOOD (042580) 151.394083018 CHROMIUM AND COBALT WB (MOM)(738770) 105.754083021 HEMOGLOBINOPATHY PROFILE (121679) 41.164083036 HEMOGLOBIN A1C 68.504083088 HISTAMINE DETERMINATION WHOLE B (081315) 226.444083497 5-HIAA 24-HR URINE (004069) 32.504083499 ANEMIA PROFILE A (030577) 22.254083502 HANTAVIRUS ANTIBODIES (835027) 143.254083516 PHOSPHOLIPIDS SERUM (001727) 23.754083517 TRANSGLUTAMINASE IGA AB (164640) 32.004083518 PHOSPHOLIPASE A2 RECEPTOR AUTO (141330) 200.004083519 INSULIN-LIKE PROTEIN3 (IGFBP-3) (140152) 33.004083520 GLIADEN IGG & IGA ANTIBODY PANEL (163402 76.254083521 INTERLEUKIN-6 (140816) 125.504083522 INSULIN LIKE GROWTH FCTR BINDIN (140822) 63.244083525 INSULIN (004333) 29.254083526 INSULIN ANTIBODIES (141598) 26.014083540 IRON SERUM TOTAL (001339) 4.594083550 IRON & TIBC W/%SAT.(001321) 8.754083631 LACTOFERRIN FECAL QUANT (123016) 132.75

4083655 LEAD BLOOD (ADULT) (007625) 10.754083727 GONADOTROPIN-RELEASING HORMONE (502421) 241.004083789 IODINE LEVEL (070034) 61.504083790 ESTRONE SULFATE (501049) 175.004083833 IGG HEAVY LIGHT CHAINS (123550) 270.004083835 METANEPH 24HR URINE (004234) 31.484083883 FREE KAPPA LAMBDA LIGHT CHAINS (121137) 61.204083896 FACTOR V LEIDEN MUTATION ANALYSIS (51115 122.004083901 CYSTIC FIBRO DNA (480533) 114.754083915 5' NUCLROTIDASE (001701) 37.004083930 OSMOLALITY SERUM (002071) 23.254083935 OSMOLALITY URINE (003442) 23.254083987 STOOL, PH (010991) 6.254084075 ALK PHOS BONE (513002) 62.994084080 ALK PHOS ISO (001612) 36.504084134 PREALBUMIN (016931) 12.004084144 PROGESTERONE (004317) 14.004084146 PROLACTIN SERUM (004465) 15.004084153 PSA TOTAL 37.504084154 PSA FREE & TOTAL (480947) 146.254084156 UPEP 24 HOUR (003368) 18.054084157 PROTEIN, CSF 58.254084165 PROTEIN ELECTROPHORESES W/ INT (225920) 11.004084207 VITAMIN B6 PLASMA (004655) 25.504084235 THYROTROPIN RECEP. AB SERUM (010314) 149.254084244 RENIN ACTIVITY (002006) 27.154084246 RENIN ACTIVITY & ALDOSTERONE (000703) 72.004084252 VITAMIN B2, WHOLE BLOOD (123220) 67.504084255 SELENIUM SERUM (716910) 71.404084260 SEROTONIN (120204) 61.204084270 SEX HORM BIND GLOB (082016) 123.504084305 INSULIN LIKE GROWTH FACTOR1 PED (503660) 71.404084402 TESTOSTERONE FREE (144980) 182.754084403 TESTOSTERONE (004226) 12.504084425 VITAMIN B1 THIAMINE (121186) 75.004084432 THYROGLOBULIN QUANT. (042100) 28.754084436 T4 TOTAL 28.264084445 THYROID STIM IMMUNOGLOB (140749) 257.004084446 VITAMIN E SERUM (081000) 38.004084450 AST 20.004084460 ALT (SGPT) 20.004084466 TRANSFERRIN (004937) 32.004084479 T3 UPTAKE (T3U) (001156) 4.004084480 T3 TOTAL (002188) 12.004084481 T3 FREE SERUM (010389) 23.004084482 T3 REVERSE (002212) 196.504084503 TESTOSTERONE TOTAL WOMEN & CHIL (070001) 22.754084560 URINE URIC ACID (003418) 3.754084586 VASOACTIVE INTESTINAL POLY(010397) 55.45

4084588 ANTI-DIURETIC HORMONE (046557) 182.224084590 VITAMIN A (017509) 22.254084591 VITAMIN B3 (070115) 310.004084630 ZINC (001800) 29.754084681 C-PEPTIDE (010108) 18.254084987 PROTEIN ELECTROPHORESES (001487) 16.304085007 MANUAL DIFFERENTIAL 52.004085014 HEMATOCRIT 21.004085018 HEMOGLOBIN 21.004085220 FACTOR V ACTIVITY (086249) 160.754085240 FACTOR VIII ACTIVITY (086264) 135.924085246 VON WILLEBRAND FACTOR ANTIGEN (086280) 92.754085260 FACTOR X ACTIVITY (086306) 131.074085300 ANTI-THROMBIN ACTIVITY (015040) 30.594085302 PROTEIN C ANTIGEN (080465) 123.174085303 PROTEIN C ACTIVITY (CHROMOGENIC) (500463 88.004085305 PROTEIN S ANTIGEN (164517) 68.804085306 PROTEIN S FUNCTIONAL (164525) 65.504085384 FIBRINOGEN ACTIVITY (001610) 25.754085385 FIBRINOGEN AG (117052) 174.504085597 ANTI-PHOSPHOLIPID SYNDROME (117079) 820.254085705 LUPUS ANTICOAGULANT REFLEX (117892) 51.504085730 PTT-LUPUS ANTICOAGULANT (117002) 99.004085933 ACHR MODULATING ABS (085933) 201.964086003 SJOGREN'S ANTI-SS-B (012690) 11.754086007 ACETYLCHOLINE RECPT AB,ALL (086007) 580.004086014 SMOOTH MUSCLE MITOCHOND (006668) 11.274086031 ALLERGEN PROFILE NUTS (671926) 96.394086038 ANA (164855) 16.004086039 ANA, IFA (164947) 9.364086113 ALLERGEN PROFILE FOOD W/ REFLEX (603857) 19.564086133 LATEX (602669) 3.264086141 CRP-CARDIAC (120766) 13.774086157 COLD AGGLUTININS (006353) 28.254086160 COMPLEMENT C3 (006452) 29.254086171 COCCIDIODAL SEROLOGY (807048) 80.004086223 ALLERGEN PROFILE FOOD (602989) 39.124086225 ANTI-DNA DBL. STRANDED (096339) 16.004086235 ANTI-SMITH (016360) 61.204086253 CULTURE BLOOD #3 168.504086255 ANTI-CHROMATIN ANTIBODIES (012580) 130.254086295 ANA W/REFLEX TO MULTIPLE (164863) 9.364086300 CA 15.3 (143404) 23.634086316 CA 27.29 (140293) 15.004086317 SJOGREN'S ANTI-SS-A (012682) 61.204086333 ALLERGEN MILK (602753) 3.264086334 IMMUNOFIXATION (IFE) SERUM (001685) 37.754086341 IA2 AUTOANTIBODIES (141531) 79.564086356 HNK1 (CD57) PANEL (505026) 85.17

4086376 THYROID PEROXIDASE AB (006676) 8.754086431 RHEUMATOID FACTOR (006502) 7.994086443 ALLERGEN WHEAT (602459) 3.264086553 ALLERGEN SOYBEAN (602457) 3.264086592 RPR W/ RELX TO QUANT (012005) 4.004086603 ALLERGENS 5 (602904) 121.254086606 ASPERGILLUS AB IGG (164285) 83.504086615 B. PERTUSSIS AB IGG (161745) 19.284086617 LYME DISEASE IGM (160333) 24.094086644 CMV AB IGG (006494) 42.254086645 CMV AB IGM (096727) 22.954086648 DIPTHERIA ANTITOX AB (163709) 22.654086658 PORPHYRINS QUANT. RANDOM URINE (120980) 24.484086664 EBV ACUTE ANTIBODIES (216655) 52.024086665 EPSTEIN BARR CAPSID IGM (096735) 17.504086667 LYME WESTERN BLOT (163601) 103.024086677 H. PYLORI IGG AB (I/H) 118.004086694 HERPES SIMPLEX VIRUS 1/2 IGM (164806) 32.004086696 HERPES SIMPLEX VIRUS (HSV) TYPES 1-/2-SP 73.754086702 HIV SCR 4TH GEN RFX (083935) 20.504086704 HEP B CORE AB,TOTAL (006718) 34.004086705 HEP B CORE AB IGM (016881) 11.004086706 HEP B SURF AB QUAL (006395) 22.284086707 HEP BE ANTIBODY (006635) 16.004086708 HEP A AB TOTAL (006726) 28.254086709 HEP A AB IGM (006734) 12.254086710 INFLUNZA A&B AB QUANT (096487) 14.104086711 STRATIFY JC VIRUS AB W/TITER (819372) 22.004086712 STRATIFY JCV AB ELISA W/ RFLX (90257) 0.014086738 MYCOPLASMA IGG IGM (163758) 80.754086747 PARVOVIRUS B19 (HUMAN) IGG IGM (163303) 206.004086756 RSV TEST 31.004086762 RUBELLA IGG AB (006197) 5.504086765 RUBEOLA IGG (096560) 13.754086773 ALLERGEN RICE (716530) 3.264086777 TOXOPLASMOSIS IGG (006478) 32.504086787 VARICELLA IGG (096206) 12.254086800 THYROGLOBULIN Ab (006685) 10.754086801 COMPREHENSIVE THYROGLOBULIN (500540) 186.504086803 HEP C AB (140659) 20.014086812 HLA B27 DISEASE ASSOC (006924) 59.844086813 RAPID PLASMA REAGIN QUANTITAT (06460) 10.754086850 ANTIBODY SCREEN (006015) 7.004086880 BB DIRECT ANTIGLOBULIN TEST 62.754086883 ALLERGEN CHEESE CHEDDAR (602732) 3.264086901 LS RH 20.004086920 BB CROSSMATCH #1 123.504086927 BB BLOOD FFP THW UNIT 43.004086993 ALLERGEN TOMATO (602468) 3.26

4087072 CULTURE UPPER RESPIRATORY 157.504087073 CULTURE LOWER RESPIRATORY 157.504087100 CULT SENSI 1 163.254087101 CULTURE FUNGUS I/H 103.504087103 METANEPHRINES PLASMA (121806) 178.504087104 MITOCHONDRIAL ANTIBODY (006650) 38.004087108 N-TELOPEPTIDE URINE (141093) 59.934087114 IMMUNOFIXATION (IFE) URINE (123034) 65.004087116 AFB CULTURE WITH SMEAR (183764) 38.754087118 ANTI-CENTROMERE B ANTIBODIES (164814) 113.754087119 SCLERODERMA DIAGNOSTIC PROFILE (052373) 73.754087120 BB BLOOD PRBC LEUCO RED 303.254087123 LAMICTAL(LAMOTRIGINE SERUM (716944) 42.754087125 URINALYSIS AUTO W/O MICRO 8.314087127 CT/GC AMP NAA (183194) 63.244087129 DRUG ABUSE PROFILE, URINE (SEVEN DRUGS + 76.754087130 DRUG PROFILE, URINE (NINE DRUGS), IMMUNO 94.754087134 BNP (B TYPE NATRIURETIC PEPTIDE 176.254087144 ACETYLCHOLINE RECEPTOR BLOCKING (085926) 179.524087145 INSULIN-LIKE GROWTH FAC IGF-1 (010363) 29.004087146 SJOGRENS ABS SSA/SSB (012708) 122.404087147 CULTURE BLOOD #2 168.504087148 OXCARBAZEPINE (TRILEPTAL) SERUM (716928) 47.504087150 ABSOLUTE CD4 AND CD8 COUNT INC RATION 262.754087151 CULT ID AERO >1 135.504087152 CULT UA ID PRESUMPTIVE 163.254087153 CULT SENSI >1 163.254087154 HEAVY METAL PROFILE UR (007492) 91.804087159 CRP QT. 77.254087162 HEP C RNA QUAL (550713) 108.344087164 ENDOMYSIAL AB IGA (164996) 111.254087165 RBC MAGNESIUM (080283) 9.974087176 WEST NILE AB SERUM (138842) 117.304087177 HERPES SIMPLEX TYPE II IGG (163147) 25.754087182 HERPES (HSV) CULTURE & TYPING (008250) 30.504087185 BETA LACTAMASE 36.004087189 ALLERGEN PR PERENNIAL (062497) 215.734087192 HEMATOPATHOLOGY CONSULTATION, PERIPHERAL 27.254087193 LYME DISEASE ANTIBODIES, TOTAL IMMUNOGLO 49.004087194 ANTI-CARDIOLIPIN AB (ACA), QUANT 48.004087195 MUMPS AB IGG (096552) 12.004087198 SIROLIMUS (716712) 42.754087203 ALLERGEN PEDS 3-6 (671934) 160.254087205 H. PYLORI IGM AB (163204) 22.004087207 PARASITE EXAM. BLOOD (008185) 22.754087253 POLIOVIRUS 1 3 AB (186542) 322.504087324 C. DIFFICILE TOXIN A & B (086207) 15.004087328 GIARDIA LAMBLIA DIRECT EIA (182204) 35.194087329 GIARDIA CRYPTOSPORIDIUM EIA STL (183558) 135.15

4087338 H. PYLORI STOOL ANTIGEN (180764) 129.294087340 HEP B SURFACE ANTIGEN (006510) 8.004087350 HEP BE AG (006619) 10.254087400 INFLUENZA A+B SWAB 46.254087521 HEP C NAA QUAL RFLX GENO (550825) 102.004087522 HEP C RNA QNT REF GENO (550100) 153.004087535 HIV RNA QUAL (139350) 143.004087536 HIV 1 QUANT RT PCR (550430) NONGRAPHICAL 112.204087624 PAP W HPV (195050) 132.254087768 PARASITE IDENTFY ARTHROPOD (188664) 47.754087799 EBV QUANT DNA PCR (139490) 454.254087811 STREPTOCOCCUS PNEUMONIAE AG (018788) 19.504087902 HEP C GENO NONRFLX (550475) 245.004088108 LACTIC ACID 135.504088140 SPINAL MUS ATROPHY SMA CARRIER (450010) 858.334088164 PANCREATIC ELASTASE FECAL (123234) 245.004088165 PANCREATIC ISLET CELLS (160721) 26.934088188 SPUTUM CYTOLOGY (009076) 86.364088304 SURG PATH L III (88304) 74.464088305 SURG PATH L IV 1ST SITE (88305) 58.754088307 SURG PATH L V (88307) 110.254088312 SPECIAL STAINS (883121) 58.254088313 GROUP II STAIN (88313) 79.824088321 ALLERGEN PR FOOD-SHELLFISH (062695) 160.254088341 IHC EA ADD AB STAIN X1 (W20530) 84.254089060 CRYSTALS FLUID (005355) 27.254093446 SYSTEMIC LUPUS (SLE) PROFILE A (056499) 276.504096230 EBV-VCA ANTIBODIES, IGG (096230) 16.994096776 VARICELLA IGM (096776) 20.114099999 CALPROTECTIN FECAL (123255) 220.504119819 THUMB SPICA 146.754551032 RHYTHM STRIP 29.754581008 EKG INITIAL 354.754581012 EKG SUBSEQUENT 354.755001170 MAMMOGRAM 2D SCREENING 519.005014724 MAMMOGRAM 2D BILAT DIAGN 587.505014731 MAMMOGRAM 2D UNIL LT 396.505014732 MAMMOGRAM 2D UNIL RT 396.505014733 MAMMOGRAM 3D SCREENING 650.005014734 MAMMOGRAM DIAGNOSTIC 3D UNI LT 285.005014735 MAMMOGRAM DIAGNOSTIC 3D UNI RT 94.005014736 MAMMOGRAM DIAGNOSTIC 3D BILAT 363.005014737 3D DIAG CHARGE UNI/BILAT 76.445060000 SINUS COMPLETE 359.505060012 ABDOMEN 2V 477.505060020 ABDOMEN SERIES ACUTE 672.005060046 CHEST SINGLE VIEW 228.255060053 CHEST TWO VIEWS 368.255060054 CHEST 2v INS/EXP 368.25

5060061 CHEST FOUR VIEWS 459.505060062 CHEST I v Port 228.255060094 RIBS UNI W/1VW CXR LT 393.505060095 RIBS UNI W/1VW CXR RT 393.505060096 RIBS RT UNI - NO CXR 336.255060097 RIBS UNI - NO CXR LT 393.505060102 RIBS BILATERAL NO CXR 545.505060103 RIBS BILATERALW/1VW CXR 545.505060111 STERNUM 331.755060152 ACROMIOCLAVICUL. JTS BIL 388.755060179 CLAVICLE COMPLETE LT 336.255060180 CLAVICLE COMPLETE RT 336.255060187 ELBOW 1-2 VWS LT 257.005060188 ELBOW 1-2 VWS RT 257.005060195 ELBOW COMPLETE 3+V LT 329.505060196 ELBOW COMPLETE 3+V RT 329.505060202 FINGERS LT 231.255060204 FINGERS RT 231.255060211 FOREARM LT 316.255060212 FOREARM RT 316.255060228 HAND 1-2 VWS LT 228.255060229 BOTH HANDS AP (ARTHRITIS) 228.255060230 HAND 1-2 VWS RT 228.255060237 HAND 3+VWS LT 357.005060238 HAND 3+VWS RT 357.005060252 HUMERUS LT 324.005060253 HUMERUS RT 324.005060270 SCAPULA LT 331.755060271 SCAPULA RT 331.755060278 SHOULDER COMPLETE LT 368.255060279 SHOULDER COMPLETE RT 368.255060286 SHOULDER LIMITED LT 249.255060287 SHOULDER LIMITED RT 249.255060288 SHOULDER POST REDUCTION LEFT 368.255060289 SHOULDER POST REDUCTION RIGHT 368.255060294 WRIST 3+VWS LT 368.255060295 WRIST 3+VWS RT 368.255060302 WRIST 1-2VWS LT 281.255060303 WRIST 1-2VWS RT 281.255060320 ANKLE 3+VIEWS LT 368.255060321 ANKLE 3+VIEWS RT 368.255060328 ANKLE PLAIN 1-2 VWS LT 264.755060329 ANKLE PLAIN 1-2 VWS RT 264.755060344 FEMUR LT 373.505060345 FEMUR RT 373.505060369 FOOT 3+VWS LT 336.255060370 FOOT 3+VWS RT 336.255060377 FOOT 1-2 VWS LT 249.255060378 FOOT 1-2 VWS RT 249.25

5060385 HIP COMPLETE 2V LT 402.255060386 HIP COMPLETE 2V RT 402.255060393 HIP UNILATERAL LIMITED LT 280.255060394 HIP UNILATERAL LIMITED RT 280.255060402 HIP PELVIS INFANT/CHILD RT 338.255060435 KNEE COMP 3-4 VWS LT 413.505060436 KNEE COMP 3-4 VWS RT 413.505060443 KNEE 1-2 VWS LT 291.005060444 KNEE 1-2 VWS RT 291.005060460 TIBIA FIBULA LT +1 JT 308.505060461 TIBIA FIBULA RT +1 JT 308.505060468 OS CALCIS CALCANEUS HEEL LT 280.255060469 OS CALCIS CALCANEUS HEEL RT 280.255060476 TOES LT 249.255060477 TOES RT 249.255060558 BARIUM ENEMA 780.255060582 ESOPHAGUS 477.505060632 UGI WITH SM BOWEL W/AIR 1,088.755060715 FACIAL BONES 3+VWS 569.505060749 MANDIBLE 4+VWS 373.505060780 NASAL BONES 359.505060806 ORBITS BIL 545.505060814 NECK SOFT TISSUE 280.255060897 SKULL COMPLETE 4+VWS 664.255060905 SKULL LIMITED 2-3 VIEWS 329.505060954 TEMPOROMANDIBULR JTS BIL 545.505061028 CERVICAL SPINE LIMITED 2-3V 402.255061036 C-SPINE COMP MIN 4V 597.505061069 COCCYX SACRUM 2+VWS 376.005061085 LUMBAR SPINE 1V 228.255061093 LUMBAR SPINE 2-3VWS 373.505061101 LUMBAR SPINE COMPLETE 5V 753.005061119 L SPINE BEND/F E ONLY 2V 423.255061127 L SPINE COMP W F E/BD 824.505061135 PELVIS ROUTINE EXAM AP VIEW 291.005061168 SACRO ILIAC JOINTS 3+V 424.255061192 THORACIC SPINE 2V LIMITED 376.005061200 THORACO LUMBAR REGION 376.005061283 IVP WITH TOMOGRAMS 1,027.005061531 FLUORO UNDER 1HR 242.505061616 MAMMO 2D SPECIAL SCREENING 83.005061619 SINUSES < 3 VIEWS 240.505061633 KNEE BILATERAL STANDING 1 VW 435.755061634 BVCH EMP CXR 188.505062190 C SPINE 1V LAT 228.255062802 INFANT BONE SURVEY 619.505062810 FACIAL BONES 1-2 VWS 266.755062836 CERVICAL COMP W/FLEX EXT 7V 839.005062851 SCOLIOSIS STUDY 385.75

5062869 HIP BILATERAL COMPLETE 525.755063354 CHEST 3V 388.755063818 UGI W/AIR CONTRAST 970.755064139 PELVIS EXTENDED EXAM 3V 413.505064162 ABDOMEN ONE VIEW 243.505067676 3V LSS EMP. PHYS SPECIAL 206.005077063 3D SCREEN CHARGE 650.005077067 MAMMOGRAM 2D SCREENING 519.005077072 BONE AGE STUDY 120.005077777 BONE SURVEY COMPLETE 1,422.005079814 THORACIC SPINE 3V 423.255079823 KNEE EXTENDED 4+ LT 423.255079824 KNEE EXTENDED 4+ RT 423.255561619 US OB U/S <14WKS 672.005561621 US BREAST UNI SPECIAL LT COMPL 88.005561622 US BREAST UNI SPECIAL RT COMPL 88.005561717 US SINGLE QUAD/ORGAN LOW BACK 664.255561721 US NON VASCULAR EXT RIGHT 672.005561747 US LIVER ONLY 672.005561754 US GALLBLADDER ONLY 583.005561762 US SPLEEN ONLY 672.005561788 US AORTA 672.005561796 US KIDNEYS BILAT 672.005561804 US BLADDER 672.005561853 US ABDOMEN COMPLETE 1,096.505561911 US NON OB PELV-COMP 672.005561929 US ABSCESS LOCAL SCAN 672.005561978 US CHEST 672.005561986 US THYROID/NECK U SCAN 494.005562174 US IUD LOCALIZATION 672.005562919 US CAROTID DUP BILAT 747.255562943 US GUIDED NEEDLE INJ/BIOPSY 583.005564154 US PAROTID 494.005564220 US BREAST BILATERAL 375.005564428 US OB COMP >14 WEEKS 672.005564642 US EXT. VEN DOP BILAT 672.005564643 US EXT VEN DOP UNI/LMT LT 583.005564644 US EXT VEN DOP UNI/LMT RT 583.005564659 US ART BIL LOWER EXT SCAN 672.005564660 US ART LOWER EXT LEFT 533.505564690 US BREAST UNI LT COMPL 346.005564691 US SCROTUM U SCAN 672.005564692 US BREAST UNI RT COMPL 346.005564693 US TRANSVAGINAL 375.005564694 US KIDNEY UNILAT LEFT 672.005564695 US BREAST UNI LT LIMITED 242.505564696 US BREAST UNI RT LIMITED 242.505567176 US LIMITED ABDOMEN 583.005576775 US KIDNEY UNILAT RIGHT 672.00

5576881 US NON VASCULAR EXT LEFT 672.005576883 US NON VASCULAR EXT RIGHT SPECIFIC 572.005593926 US ART LOWER EXT RIGHT 533.505593930 US ART BIL UPPER EXT SCAN 672.005593931 US ART UPPER EXT RIGHT 533.505593932 US ART UPPER EXT LEFT 533.506061629 CT ABD/PEL W-WO/CONTRAST (ORAL) 4,000.506061630 CT ABD/PEL W-WO/CONTRAST 4,000.506061631 CT ABD/PEL WO/CONTRAST 3,273.256061632 CT ABD/PEL W/CONTRAST 3,531.006061633 CT ABD/PEL W/CONTRAST (ORAL) 3,531.006061634 CT ABD/PEL WO/CONTRAST (ORAL) 3,273.256061636 CT MAX/FACIAL W/WO CONTRAST 2,183.756061637 CT MAX/FACIAL W/O CONTRAST 1,786.506062968 CT ABDOMEN W/CONTRAST 3,016.256062969 CT ABDOMEN W/CONTRAST (ORAL) 3,016.256062976 CT CHEST W/O CONTRAST 2,488.506063008 CT HEAD W/CONTRAST 1,930.756063111 CT L-SPINE W CONTRAST 2,744.506063537 CT C-SPINE W/CONTRAST 2,744.506063552 CT C-SPINE W/O CONTRAST 2,561.006063560 CT SOFT TISSUE NECK W+W/O 1,910.256063578 CT ABDOMEN W/O CONT 2,818.006063594 CT ABDOMEN W & W/O CONT 3,154.506063595 CT ABDOMEN W & W/O CONT (+ ORAL) 3,154.506063602 CT CHEST W & W/O CONT 2,796.006063610 CT CHEST W/CONTRAST 2,667.256063611 CT BONE MINERAL DENSITY STUDY 402.256063636 CT UPPER EXT W/CONTRAST LEFT 1,395.506063644 CT T-SPINE W/O CONTRAST 2,250.006063651 CT ORBIT/IAC W CONTRAST 1,786.506063669 CT ORBIT/IAC W/O CONTRAST 1,638.756063685 CT L-SPINE W/O CONTRAST 2,561.006063701 CT HEAD W/O CONTRAST 1,678.506063792 CT LOWER EXT W/O CONT 1,113.006063834 CT PELVIS W/WO CONT 1,560.006063835 CT PELVIS W/WO CONT (ORAL) 1,560.006063859 CT PELVIS W/CONTRAST 1,392.006063958 CT HEAD W & W/O CONT 2,061.006065789 CT PELVIS W/O CONT 1,343.756065797 CT UPPER EXT W/O CONT LEFT 1,113.006065920 CT SOFT TISSUE NECK W/ 1,786.506065938 CT SOFT TISSUE NECK W/O 1,638.756066102 CT MAXILLOFACIAL/SINUS W 1,983.756070486 CT SINUS W/O CONTRAST 1,786.506070487 CT SINUS W/CONTRAST 1,983.756070498 CTA CAROTID/NECK 2,882.006071275 CTA CHEST 3,410.006073200 CT UPPER EXT W/O CONT RIGHT 1,113.00

6073201 CT UPPER EXT W/CONTRAST RIGHT 1,295.256073700 CT LOWER EXT W/O CONT LEFT 1,113.006073701 CT LOWER EXT LEFT W/CONTRAST 1,295.256073702 CT LOWER EXT RIGHT W/CONTRAST 1,295.256073704 CT LOWER EXT LEFT W/WO CONTRAST 1,400.756073705 CT LOWER EXT W/O CONT RIGHT 1,113.006073706 CT HIP L W/O CONT 1,113.006073707 CT HIP R W/O CONT 1,113.006074170 CT LIVER 3 PHASE 1,883.006074175 CT ANGIO/AAA 2,728.006074178 CT UROGRAM 2,824.006075635 CTA PELVIS RUNOFF 2,586.006500003 TETANUS-DIPHTHERIA (DECAVAC) VL 63.756500022 RISPERIDONE(RISPERDAL) 0.5MG TAB 20.006500032 MUPIROCIN(BACTROBAN) 2% OINT 35.006500061 DOPAMINE(INTROPIN) 800MG/250ML IVPB 203.006500070 FLUORESCEIN (FUL-GLO) EYE STRIP 14.506500078 HYDROCORTISONE 2.5% CREAM 42.756500089 ACETAMINOPHEN(TYLENOL) 325MG SUPP 9.756500094 TROPICAMIDE(MYDRIACYL) 1% EYE DROP 52.006500097 ACETAMINOPHEN(TYLENOL) 650MG SUPP 9.756500102 TUBERCULIN PPD(TUBERSOL) 5U/0.1ML 28.756500124 MIDAZOLAM(VERSED) 2MG/2ML SDV 29.756500126 LISINOPRIL (ZESTRIL) 10MG TAB 7.756500128 FLUOXETINE(PROZAC) 20MG CAP 12.256500145 CEPHALEXIN(KEFLEX) 500MG CAP 7.756500360 OXYMETAZOLINE(AFRIN)NASAL SOL 0.05% 27.756500444 SPIRONOLACTONE(ALDACTONE) 25MG TAB 7.756500899 AMOXICILLIN(AMOXIL) 250MG CAP 7.756500948 AMOXICILLIN(AMOXIL) 250MG/5ML SUSP 27.756501061 AMPICILLIN(PENBRITIN) 500MG VL 56.256501204 ENALAPRILAT(VASOTEC)2.5 MG/2ML VL 54.006501267 CLONIDINE(CATAPRESS) TD 0.1MG/24H 63.756501285 SUCCINYLCHOLINE(QUELICIN)200MG/10ML 35.006501343 PHYSOSTIGMINE(ANTILIRIUM) 1MG/ML VL 40.756501368 MECLIZINE (ANTIVERT) 25MG TAB 17.506501481 D50W (DEXTROSE 50%) 50ML PFS 84.006501483 HYDRALAZINE (APRESOLINE) 25MG TAB 7.756501509 HYDRALAZINE(APRESOLINE) 20MG/ML VL 17.506501525 PHYTONADIONE(VIT-K3) 10MG/ML SDV 110.256501855 ASPIRIN(ECOTRIN) 325MG TAB 7.756501970 ATROPINE 1MG/10ML ADULT PFS 46.256502002 ATROPINE 1MG/ML VL 32.006502267 SULFASALAZINE(AZULFIDINE) 500MG TAB 9.756502273 HEPARIN 25 000 UNITS/250 ML IVPB 23.256502580 DIPHENHYDRAMINE(BENADRYL)50MG/ML 28.756502606 DIPHENHYDRAMINE(BENADRYL) 25MG CAP 7.756502622 DIPHENHYDRAMINE(BENADRYL)12.5/5 SYR 13.506502646 GLYCERIN ADULT SUPP 13.50

6502648 DICYCLOMINE(BENTYL) 20MG/2ML VL 128.926502663 DICYCLOMINE(BENTYL) 10MG CAP 7.756502676 SULFA-TRIMETH DS (BACTRIM DS) TAB 7.756502897 MAGNESIUM CL(SLOW MAG) 70 MG TB 7.756502903 PEN BENZATHINE(BICILLIN LA)IM 1.2MU 206.006503455 CALCIUM GLUCONATE INJ 10% 10ML VL 38.756503495 POT CHLOR(KLOR-CON) ER 10MEQ TAB 7.756503505 CALCIUM CHLORIDE INJ 10% 10ML PFS 35.006503877 CLONIDINE (CATAPRESS) 0.1MG TAB 7.756503950 CEFAZOLIN (ANCEF) 1GM/50ML IVPB 52.006504495 MAGNESIUM CITRATE SOLN 296ML 18.506504545 CLINDAMYCIN(CLEOCIN) 150MG CAP 7.756504733 IBUPROFEN(MOTRIN) 800MG TAB 7.756504832 IBUPROFEN(MOTRIN) 200 MG TAB 7.756504834 COLCHICINE (COLCRYS)0.6MG TAB 31.006504933 PROCHLORPERAZINE(COMPAZINE)10MG/2ML 28.756504964 HEPATITIS B VACCINE (ENGERIX) 298.756505128 ALBUTEROL(VENTOLIN) 2.5MG/3ML UDV 16.506505193 ACETAMINO(TYLENOL#3)+COD SYRUP 5ML 14.506505575 NEO-POLY-HC(CORTISPORIN) OTIC SUSP 83.006505623 LOVASTATIN (MEVACOR) 20MG TAB 7.756505631 CEFTRIAXONE (ROCEPHIN) 250MG VL 35.006505668 ADENOSINE(ADENOCARD) 6MG/2ML 147.756505676 NITRO (TRIDIL) 50MG/250ML IVPB 114.756505722 AMPI & SULB(UNASYN) 1-0.5GM VL 48.506505730 AMPI & SULB(UNASYN) 2-1GM VL 68.506505760 WARFARIN(COUMADIN) 1MG TAB 14.506505765 WARFARIN(COUMADIN) 2 MG TAB 14.506505773 WARFARIN(COUMADIN) 2.5 MG TAB 14.506505781 WARFARIN(COUMADIN) 5 MG TAB 14.506505896 CIPROFLOXACIN(CIPRO) 500MG TAB 9.756505898 CYCLOPENTOLATE(CYCLOGYL) 1% EYE DRP 41.756505997 EYE WASH (DACRIOSE) 30ML 60.756506268 CARBAMIDE PERO(DEBROX) OTIC DR 15ML 24.256506334 DEXAMETHASONE(DECADRON) 0.5MG/5 SYR 26.256506755 METHYLPRED (DEPO-MEDROL)40MG/ML VL 78.256506789 MEDROXYPROG (DEPO-PROVERA) 150MG VL 187.506507144 PROPOFOL (DIPRIVAN) 200MG/20ML SDV 84.006507167 ACETAZOLAMIDE (DIAMOX) 250MG TAB 13.506507456 PHENYTOIN(DILANTIN) 100MG CAPS 7.756507514 PHENYTOIN (DILANTIN) 250MG/5ML SDV 84.006507837 BELLADO-PHENO(DONNATAL) ELIX 10ML 85.006507936 DOCUSATE(COLACE) 100MG CAP 7.756507971 METFORMIN(GLUCOPHAGE) 500MG TAB 7.756508082 BISACODYL(DULCOLAX) 10MG SUPP 13.506508090 BISACODYL(DULCOLAX) DR 5MG TAB 7.756508140 TRIAM/HCTZ (DYAZIDE) 37.5/25 CP 7.756508314 AMITRIPTYLINE(ELAVIL) 25MG TAB 7.756508611 EPHEDRINE 50MG/1ML VL 45.25

6508627 ACETAMINOPHEN(TYLENOL) 160/5 SYR 7.756509262 FERROUS SULF (FEOSOL) 325MG TAB 7.756509338 METRONIDAZOLE (FLAGYL) 250MG TAB 7.756509452 FOLIC ACID 1MG TAB 7.756509486 FOLIC ACID 50MG/10ML MDV 60.756509833 GENTAMICIN(GARAMYCIN) 80MG/2ML VL 127.756509866 GENTAMICIN(GARAMYCIN) 0.3% EYE DRP 49.506509874 GENTAMICIN(GARAMYCIN) 0.3% EYE OINT 77.256509878 TRAMADOL 50MG TAB ER-4-PK 27.756509902 VALSARTAN(DIOVAN) 80MG TAB 10.756510112 GLUCAGON (GLUCAGEN) 1MG VL 356.256510252 HALOPERIDOL (HALDOL) 0.5MG TAB 7.756510286 HALOPERIDOL (HALDOL) 5MG/ML VL 28.756510427 HEPARIN 10 000 UNITS/1ML VL 7.756510831 HYDROMORPHONE(DILAUDID) 2MG/ML 17.506511185 PROPRANOLOL (INDERAL) 10 MG TAB 7.756511201 INDOMETHACIN (INDOCIN) 25MG CAP 7.756511235 INFLUENZA VACC ADULT 0.5ML 33.006511888 SOD POLYSTYRENE (KAYEXALATE) 28.756512019 CEPHALEXIN (KEFLEX) 250MG CAP 7.756512100 TRIAMCINOLONE(KENALOG) 40MG/ML VL 40.756512340 DIGOXIN (LANOXIN) 0.5MG/2ML VL 78.256512357 DIGOXIN (LANOXIN) 0.125MG TAB 7.756512365 DIGOXIN (LANOXIN) 0.25MG TAB 7.756512407 FUROSEMIDE (LASIX) 20MG/2ML VL 28.756512415 FUROSEMIDE (LASIX) 20MG TAB 7.756512423 FUROSEMIDE (LASIX) 100MG/10ML VL 36.006512431 FUROSEMIDE (LASIX) 40MG TAB 7.756512506 NOREPINEPHRINE(LEVOPHED)4MG/4ML VL 50.506512530 CHLORDIAZEPOXIDE(LIBRIUM) 25MG CAP 14.506512647 LIDOCAINE IV 100MG/5ML ADULT PFS 81.256512852 DIPHENOX+ATROPINE(LOMOTIL) TAB 10.756513025 MAGNESIUM SULFATE INJ 1GM/2ML SDV 32.006513132 MANNITOL 20% 500ML IVPB 57.256514031 MAGNESIUM HYDROX (MOM) 30ML SUSP 13.506514155 ACETYLCHOLINE(MIOCHOL) 0.001% EYE 138.006514296 IBUPROFEN(MOTRIN) 400 MG TAB 7.756514692 SIMETHICONE (GAS-X) 80MG CHEW TAB 7.756514858 NALOXONE(NARCAN) 0.4 MG/ML SDV 63.936515327 NEO-POLY-BACI (NEOSPORIN) TOP 0.9G 9.756515368 NEO-POLY-GRAMI(NEOSPORIN) EYE DRP 97.756515434 PHENYLEPHRINE(NEO-SYNEPH)10MG/ML VL 46.256516208 ISOFLURANE(FORANE) PER MIN 2.006516216 ENFLURANE(ETHRANE) 250ML PER MIN 2.006517166 PROMETHAZINE(PHENERGAN) 25MG/ML VL 84.006517190 PROMETH+COD(PHENERGAN) SYRUP 10ML 8.256517240 PROMETHAZINE(PHENERGAN) 25MG SUPP 14.506517273 PROMETHAZINE(PHENERGAN) 25MG TAB 7.756517513 OXYTOCIN(PITOCIN) 10 UNIT/ML VL 44.25

6517547 VASOPRESSIN(VASOSTRICT) 20U/1ML 165.256517927 PREDNISONE (METICORTEN) 5MG TAB 7.756517935 PREDNISONE (METICORTEN) 20MG TAB 7.756518818 PHENAZOPYRIDINE(PYRIDIUM) 100MG TAB 9.756519337 METHOCARBAMOL(ROBAXIN) 500MG TAB 7.756519428 GUAIFENESIN(ROBITUSSIN)200MG/10 SYRUP 10.756519451 GUAIFEN-DM(ROBITUSSIN DM) SYR 10ML 13.506519576 RIFAMPIN(RIMACTANE) 300MG CAP 9.756520046 SOD BICARBONATE 8.4% 50MEQ AD PFS 73.756520509 PSEUDOEPHEDRINE(SUDAFED) 30MG TAB 10.756520525 SULFACETAMIDE(BLEH-10)EYE DROPS 10% 42.756520616 METHYLPRED (SOLU-MEDROL) 40MG VL 84.006520624 HYDROCORTISONE(SOLU-CORTEF)250MG VL 56.256520632 METHYLPRED (SOLU-MEDROL) 125MG VL 84.006520673 METHYLPRED (SOLU-MEDROL) 1000MG VL 93.756520715 FENTANYL(SUBLIMAZE)100MCG/2ML AMP 42.756520723 CARISOPRODOL(SOMA) 350MG TAB 13.506520731 FENTANYL(SUBLIMAZE)250MCG/5ML AMP 42.756521036 LEVOTHYROXINE(LEVOXYL) 50MCG TAB 7.756521044 LEVOTHYROXINE(LEVOXYL) 100 MCG TAB 7.756522222 PENICILLIN VK 250MG/5ML PED SUSP 14.506522240 CARBAMAZEPINE(TEGRETOL) 200MG TAB 7.756522489 BENZONATATE(TESSALON) 100MG CAP 7.756522524 BUPIVACAINE(MARCAINE)INJ 0.5% 50ML 41.756522554 TETANUS IMM GLOB (HYTERTET) PFS 1,093.256522557 BUPIV 0.5% + EPI(MARCAINE) PF 35.006522626 TETRACAINE 0.5% EYE DROPS 31.006522760 MULTIVITS + MIN (THERA M) TABS 7.756522786 THIAMINE(VIT-B1) 200MG/2ML SDV 70.506522794 THIAMINE(VITA-B1) 100MG TAB 9.756522885 CHLORPROMAZINE(LARGACTIL)50MG/2MLVL 57.256523859 ACETAMINOPHEN(TYLENOL) 80/0.8 DROP 22.256523867 ACETAMINOPHEN(TYLENOL) 325MG TAB 7.756523870 ACETAMINOPHEN(TYLENOL) 500MG TAB 7.756523883 ACETAMINOPHEN(TYLENOL#3)+COD TAB 9.756524255 KETAMINE(KETALAR) 500MG/10ML MDV 24.256524329 DIAZEPAM (VALIUM) 5MG TAB 9.756524345 DIAZEPAM (VALIUM) INJ 10MG/2ML CJ 84.006524428 VANCOMYCIN(VANCOCIN) INJ 500 MG VL 84.006524550 PENICILLIN VK 500MG TAB 7.756524667 DOXYCYCLINE(VIBRAMYCIN) 100MG TAB 7.756524931 HYDROXYZINE(ATARAX) 50MG/ML VL 14.506525078 PHYTONADIONE(VITA-K3) 1MG/0.5ML VL 63.756525110 CYANOCOBALAMIN(B-12) 1MG/1ML VL 40.756525300 LIDOCAINE(UROJECT) GEL 2% 10ML PFS 60.756525359 LIDOCAINE TOPICAL 4% SOLN 40ML 27.756525367 LIDOCAINE(XYLOCAINE) 1% LOCAL MDV 25.006525375 LIDOCAINE(XYLOCAINE) 2% MDV 23.256525383 LIDOCAINE 2%+EPI(XYLOCAINE+EPI)20ML 49.50

6525433 ZINC OXIDE(DESITIN) 20% OINTMENT 10.756525490 ALLOPURINOL(ZYLOPRIM) 100MG TAB 8.256525722 RACEPINEPRINE 2.25% NEB UDV 17.506526530 DEXAMETHASONE(DECADRON) 4MG/ML VL 28.756526597 DEXAMETHASONE(DECADRON) 4MG TAB 7.756527769 NAPROXEN (NAPROSYN) 250MG TAB 7.756528791 LIDOCAINE 2% + EPI (XYLOCAINE+EPI) 55.006528841 METOLAZONE (ZAROXYLIN) 5MG TAB 7.756529013 TERBUTALINE(BRETHINE) 1MG/ML SDV 24.256529401 ACETAMINOPHEN(TYLENOL) 120MG SUPP 7.756529427 OXYBUTYNIN(DITROPAN) 5MG TAB 7.756529658 NITRO (NITRO-BID) 2% OINT 46.256529732 LACTULOSE(KRISTALOSE) 10GM/15ML CUP 10.756529781 GLYCOPYRROLATE(ROBINUL)0.4MG/2ML VL 77.256529880 PREDNISOLONE(PRED-FORTE) 1% EYE DRP 85.256529930 ERYTHROMYCIN(ILOTYCIN)EYE OINT 3.5G 88.006530045 CIMETIDINE(TAGAMET) 300MG TAB 7.756530144 LOPERAMIDE (IMODIUM) 2MG CAP 9.756530193 HYDROCORTISONE 1% CREAM 8.756530474 LORAZEPAM (ATIVAN) 1MG TAB 10.756530516 OXYCODONE-APAP (PERCOCET) 5-325 TAB 9.756530540 CYCLOBENZAPRINE(FLEXERIL) 10MG TAB 7.756530599 PHENYTOIN(DILANTIN) 100MG/4ML ORAL SUSP 52.006531308 PROCAINAMIDE(PRONESTYL) 1GM/10ML SDV 60.756531894 HYDROMORPHONE(DILAUDID) 2MG TAB 9.756531969 POT CHLOR(MICRO-K) 20MEQ PWD PKT 9.756531977 METOPROLOL (LOPRESSOR) 50MG TAB 7.756532124 FUROSEMIDE (LASIX) 40MG/4ML VL 28.756532520 IBUPROFEN(MOTRIN) 600MG TAB 7.756532553 GUAIFEN-COD (ROBITUSSIN AC)5ML 9.756532686 PNEUMOCOCCAL(PNEUMOVAX-23) 0.5ML 200.256533080 LORAZEPAM (ATIVAN) 0.5MG TAB 10.756533296 METOCLOPRAMIDE(REGLAN) 10MG/2ML SDV 33.006533445 LIDOCAINE VISCOUS 2% SOLN 15 ML 14.506533452 CEFOXITIN(MEFOXIN) 1GM IVPB 84.006533585 LORAZEPAM (ATIVAN) 2MG/ML SDV 27.756534385 CEFOTAXIME(CLAFORAN) 1GM VL 37.506534476 CARBI-LEVODOPA(SINEMET) 25-100 TAB 7.756534559 ACETYLCYSTEINE(MUCOMYST) 20% 30ML 93.756534641 METOCLOPRAMIDE (REGLAN) 10MG TAB 7.756534674 TEMAZEPAM(RESTORIL) 15MG CAP 9.756535093 VITAMINS A & D OINT 9.756535432 ATENOLOL (TENORMIN) 50MG TAB 7.756535481 METRONIDAZOLE (FLAGYL) 500 MG IVPB 84.006535499 CAPTOPRIL(CAPOTEN) 25MG TAB 7.756535804 SUCRALFATE (CARAFATE) 1000MG TAB 7.756535853 ALPRAZOLAM(XANAX) 0.25MG TAB 9.756535960 VERAPAMIL (CALAN) 80MG TAB 7.756535978 VERAPAMIL (ISOPTIN) SR 120MG TAB 7.75

6536000 TRAZODONE(DESERYL) 50MG TAB 7.756536208 ALUM-MGOH-SI(MYLANTA)SUSP 30ML 13.506536448 AMPICILLIN(PENBRITIN) 1000MG VL 54.006536737 DILTIAZEM(CARDIZEM) 30MG TAB 7.756537271 PEG3350-KCL-BICARB(GOLYTELY) 4L 63.756537339 RANITIDINE (ZANTAC) 150MG TAB 7.756537651 METHADONE(METHADOSE) 10MG TAB 14.506537792 MORPHINE SULFATE INJ 4 MG/ML 42.756538162 GLIPIZIDE(GLUCOTROL) 5MG TAB 7.756538204 GLYBURIDE(MICRONASE)5MG TAB 7.756538535 METOPROLOL (LOPRESSOR) 5MG/5ML SDV 84.006538618 AMOX/CLAV(AUGMENTIN) 500MG TAB 14.856538659 LABETALOL(TRANDATE) 100MG/20ML MDV 58.256539004 CEFAZOLIN (ANCEF) 1GM VL 37.506539194 MORPHINE(MS CONTIN) 12HR 30MG TAB 14.506539418 CEFTRIAXONE (ROCEPHIN) 1GM VL 84.006539939 AMIODARONE(CORDARONE) 200MG TAB 12.256540121 NIFEDIPINE(ADALAT) ER 30 MG TAB 14.506540133 NITRO (NITRO-STAT) SL 0.4MG TAB 8.756561406 D5W + NS 0.45% + 20K 1000ML 84.006561430 NS 0.9% + 40K 1000ML 84.006574262 MORPHINE SULFATE INJ 10 MG/ML CJ 60.756578659 AMOX/CLAV(AUGMENTIN) 250/5ML SUSP 178.756578967 CLONAZEPAM(KLONOPIN) 0.5MG TAB 9.756578969 FENTANYL(DURAGESIC) TD 50MCG/HR PAT 87.006578970 CELECOXIB(CELEBREX) 100MG CAP 18.006578971 SENNOSIDES (SENOKOT) 8.6MG TAB 7.756578973 GABAPENTIN (NEURONTIN) 100MG CAP 7.756578974 MONTELUKAST (SINGULAIR) 10MG TAB 16.506578975 ETOMIDATE(AMIDATE) IV 20MG/10ML MDV 84.006578992 LANSOPRAZOLE(PREVACID)DR 30MG CAP 22.256578994 ALBUMIN HUMAN 25% 50ML VL 457.256578996 ATORVASTATIN(LIPITOR)10MG TAB 17.506578999 TAMSULOSIN(FLOMAX) 0.4MG CAP 9.756579000 GABAPENTIN (NEURONTIN) 300MG CAP 8.506579004 OCTREOTIDE(SANDOSTATIN) 50MCG/ML 55.006579005 PREDNISOLONE(ORAPRED) 30MG/10ML SYRUP 17.506579008 ENOXAPARIN(LOVENOX)80MG/0.8ML SYR 276.506579010 PROPARACAINE 0.5% EYE DROPS 29.756579100 ZOLPIDEM (AMBIEM) 5MG TAB 9.756579103 AZITHROMYCIN(ZITHROMAX) 250MG TAB 27.756579588 KETOROLAC(TORADOL) 60MG/2ML SDV 84.006579592 FLUMAZENIL(RAMAZICON) 0.5MG/5ML VL 61.756579593 KETOROLAC(TORADOL) 30MG/ML SDV 84.006579595 NITROFURANTOIN (MACRODANTIN) 50 MG CP 9.506579598 KETOROLAC(TORADOL) 15MG/ML SDV 29.756579600 CEFTRIAXONE (ROCEPHIN) 500MG VL 40.756579606 TOBRA-DEXA (TOBRADEX) EYE OINT 3.5G 459.506579609 NICOTINE(NICODERM) 21 MG/24HR PATCH 17.00

6579622 SUMATRIPTAN(IMITREX) 6MG/0.5ML SDV 364.506579654 DIVALPROEX(DEPAKOTE) DR 250MG TAB 7.756579662 ASPIRIN(ECOTRIN) 81MG CHEW TAB 7.756579665 RANITIDINE (ZANTAC) 50MG/2ML SDV 42.756579667 RHOD IMM GLOBULIN(RHOGAM)300MCG PFS 329.506579669 IBUPROFEN(MOTRIN) 100MG/5ML SUSP 13.506579672 HYDROCHLOROTHIAZIDE (HCTZ) 25MG TAB 7.756579676 CEPHALEXIN(KEFLEX) 250MG/5ML SUSP 97.756579680 IPRATROPIUM (ATROVENT) 0.02% NEB 16.506579686 CLARITHROMYCIN(BIAXIN) 250MG TAB 16.506579689 DILTIAZEM(CARDIZEM) 25MG/5ML SDV 115.256579691 VENLAFAXINE (EFFEXOR) XR 75 MG CAP 18.506579692 FAMOTIDINE (PEPCID) 20MG TAB 7.756579698 DILTIAZEM(CARDIZEM)24HR 120 MG CAP 8.956579706 POT CHLOR(MICRO-K) CR 20MEQ TAB 9.756579708 SERTRALINE (ZOLOFT) 50MG TAB 9.756579709 BENAZEPRIL(LOTENSIN) 10MG TAB 7.756579710 BACLOFEN(LIORESAL)10MG TAB 7.756579714 ENOXAPARIN(LOVENOX)30MG/0.3ML SYR 110.256579715 FENTANYL(DURAGESIC) TD 25MCG/HR PAT 47.506579717 DILTIAZEM(CARDIZEM)24HR 180 MG CAP 7.756579720 AMLODIPINE(NORVASC) 5MG TAB 7.756579722 ISOSORBIDE MONO (IMDUR)ER 60 MG TAB 9.756579727 BUMETANIDE(BUMEX) 1MG TAB 7.756579728 DOXAZOSIN(CARDURA) 2MG TAB 7.756579732 CLINDAMYCIN(CLEOCIN) 600MG/4ML VL 87.006579736 MIDAZOLAM(VERSED) 5MG/5ML SDV 40.756579746 PAROXETINE (PAXIL) 20 MG TAB 9.756579752 FAMOTIDINE (PEPCID) 20MG/2ML SDV 29.756579756 AZITHROMYCIN(ZITHROMAX) 500MG VL 100.506579758 NICOTINE(NICODERM) 14MG/24HR PATCH 16.006579762 CARVEDILOL (COREG) 3.125MG TAB 7.756579763 CHARCOAL ACT-SORB(ACTIDOSE) SUSP 60.756579772 LOSARTAN (COZAAR) 50MG TAB 7.756579773 ALBUTEROL(VENTOLIN) 0.5% NEB SOL 68.506579775 ROCURONIUM (ZEMURON) 50MG/5ML MDV 113.256579776 ESMOLOL(BREVIBLOC) 100MG/10ML VL 96.756579780 POT CHLOR(KRIDER)20 MEQ/100 ML IVPB 52.006579781 LEVOFLOXACIN(LEVAQUIN) 500MG IVPB 211.756579785 CLOPIDOGREL(PLAVIX) 75MG TAB 21.006579792 HEPATITIS A VACCINE(HAVRIX) 277.506579803 LEVOFLOXACIN(LEVAQUIN) 250MG IVPB 211.756579820 LEVOFLOXACIN(LEVAQUIN) 500MG TAB 50.506579837 AMIODARONE(CORDARONE)150MG/3ML 35.006579838 TENECTEPLASE (TNKASE) IV 50MG -340B 12,985.006579839 TRAMADOL (ULTRAM) 50MG TAB 7.756579841 NALOXONE(NARCAN) 2MG/2ML PFS 102.506579848 LABETALOL(TRANDATE) 20MG/4ML PFS 44.256579851 BUPIVACAINE(MARCAINE)INJ 0.25% 50ML 35.00

6579856 ONDANSETRON (ZOFRAN) 4MG/2ML SDV 23.756579857 OXYCODONE(OXYCONTIN) SR 10MG TAB 9.756579863 PHENYLEPHRINE(AK-DILATE)2.5% EYE DR 54.506579864 CIPROFLOXACIN(CIPRO) 0.3% EYE DROPS 166.256579869 SEVOFLURANE(ULTANE) PER MIN 2.006579871 ONDANSETRON (ZOFRAN) 4MG TAB 14.006579872 MIRTAZAPINE (REMERON) 15MG TAB 9.756579873 ATENOLOL (TENORMIN) 25MG TAB 7.756579875 ENOXAPARIN(LOVENOX)60MG/0.6ML SYR 190.506579884 LEVALBUTEROL(XOPENEX)1.25MG/3ML UDV 27.756579888 MORPHINE SULF CONC 20 MG/ML PO LIQ 67.256579892 METOPROLOL (LOPRESSOR) 25MG TAB 7.756579893 ENOXAPARIN(LOVENOX)100MG/1ML SYR 300.756579894 PREGABALIN(LYRICA) 50MG CAP 20.006579895 ENOXAPARIN(LOVENOX)40MG/0.4ML SYR 136.506579896 DILTIAZEM(CARDIZEM) 125MG/25ML SDV 192.006579899 ZIPRASIDONE(GEODON) 20MG CAP 87.006579900 CARVEDILOL (COREG) 12.5MG TAB 7.756579901 PILOCARPINE(ISOPTO-CARPINE) 2% DRP 144.256579902 HYDROXYZINE(ATARAX) 25MG TAB 9.756579904 CLINDAMYCIN 150MG CAP ER 4PK 24.256579905 CLINDAMYCIN(CLEOCIN) 900MG/50 IVPB 104.506579908 D5W + NS 0.9% + 20K 1000ML 84.006579909 CITALOPRAM(CELEXA) 20MG TAB 9.756579910 NS 0.9% + 20K 1000ML 84.006579911 MAGNESIUM SULFATE 2GM/50ML IVPB 72.506579913 NS 0.45% + 20K 1000ML 84.006579917 QUETIAPINE(SEROQUEL) 25MG TAB 9.756579918 INSULIN-REG (HUMULIN-R) 100U/ML MDV 9.756579919 INSULIN GLARNINE (LANTUS) 100U/ML 14.506579920 INSULIN-NPH (NOVOLIN-N) 100U/ML MDV 9.756579922 INSULIN LISPRO (HUMALOG) 100U/ML 23.256579926 VANCOMYCIN(VANCOCIN) INJ 1000 MG VL 84.006579927 ENALAPRIL(VASOTEC) 10MG TAB 7.756579929 FENTANYL(DURAGESIC) TD 100MCG/HR PAT 234.756579932 DONEPEZIL(ARICEPT) 10MG TAB 31.006579934 GUAIFENESIN(MUCINEX) 12HR 600MG TAB 13.506579935 HYDROCODONE-APAP(NORCO) 10-325 TAB 10.756579936 DIAZEPAM (VALIUM) INJ 50MG/10ML MDV 144.256579937 PANTOPRAZOLE(PROTONIX) 40MG SDV 81.256579939 ALBUTEROL(VENTOLIN) 90MCG/PUFF MDI 128.756579947 VALPROATE(DEPAKOTE) 500 MG/5ML VL 54.006579949 OSELTAMIVIR(TAMIFLU) 75MG CAP 42.006579950 SIMVASTATIN (ZOCOR) 20MG TAB 9.756579951 VANCOMYCIN(VANCOCIN) 125MG CAP 69.506579961 DULOXETINE(CYMBALTA) 30MG CAP 17.506579962 CEFEPIME (MAXIPIME) 1GM VL 52.006579963 ONDANSETRON (ZOFRAN) 4MG ODT TAB 14.506579964 LEVALBUTEROL(XOPENEX)0.63MG/3ML UDV 27.75

6579965 PANTOPRAZOLE(PROTONIX) EC 40MG TAB 14.506579966 HYDROMORPHONE(DILAUDID) 1MG/ML AMP 18.506579968 PIPERA-TAZO(ZOSYN) 3.375GM VL 96.756579975 ZIPRASIDONE(GEODON) 20MG/ML VL 546.506579976 VECURONIUM (NORCURON) 20MG SDV 66.006579979 METHYLPRED (DEPO-MEDROL)80MG/ML VL 78.256579980 MIDAZOLAM(VERSED) 10MG/10ML SDV 73.756579981 BUPIV(MARCAINE)INJ 0.25% PF 30ML 36.506579983 ACYCLOVIR(ZOVIRAX) 400MG TAB 7.756579984 ACYCLOVIR 400MG TAB ER 4 PK 23.256579986 LIDOCAINE(XYLOCAINE) 1% PF 26.256579987 TOPIRAMATE(TOPAMAX) 25MG TAB 9.756579988 HEPARIN LOCK FLUSH 500 UNITS/5 ML MDV 14.006579989 MORPHINE SULFATE INJ 2 MG/ML CJ 42.756579991 FLUTIC-SALMET(ADVAIR) 250-50 DISKUS 375.006580002 AMOXICILLIN 250MG CAP ER 4PK 7.756580013 SULFA-TRIMETH 200-40 MG/5ML PO SUSP 50.506580014 SULFAMETHOX-TRIMETH DS TAB ER 4PK 26.256580016 DIPHENHYDRAMINE 25MG CAP 4PK 16.506580021 CLONIDINE 0.1MG TAB ER 4PK 24.256580026 CIPROFLOXACIN 500MG TAB ER 4PK 24.256580027 PROCHLORPERAZINE 5MG TAB ER 4PK 26.256580032 DEXAMETHASONE 4MG TAB ER 4PK 24.256580044 METRONIDAZOLE 250MG TAB ER 4PK 26.256580045 CYCLOBENZAPRINE 10MG TAB ER 4PK 24.256580050 GLYCERIN PED SUPP 13.506580056 CEPHALEXIN 250MG CAP ER 4PK 23.256580057 CEPHALEXIN 500MG CAP ER 4PK 24.256580066 IBUPROFEN 600 MG TAB ER 4PK 24.256580067 IBUPROFEN 800MG TAB ER 4PK 24.256580073 PHENYLEPHRINEN(NEO-SYNEPH) NASAL SP 14.506580074 PHENYLEPHRINE(AK-DILATE) 10% EYE DR 35.006580075 NITRO SL 0.4MG TAB ER 25PK 26.256580079 PENICILLIN VK 500MG TAB ER 4PK 26.256580081 PROMETHAZINE 25MG SUPP ER 4 PK 26.256580086 PREDNISONE 20MG TAB ER 4PK 28.006580094 SILVER SULFA (SILVADENE)1% CRM 50G 83.006580106 ACETAMINOPHEN #3 +COD TAB ER 4PK 26.256580114 DOXYCYCLINE 100MG CAP ER 4PK 7.756581015 EPINEPHRINE 30MG/30ML MDV 258.956588038 EPINEPHRINE 1 MG/1ML AMP 35.506588039 EPINEPHRINE 1MG/10ML PFS 93.756588042 NYSTATIN(MYCOSTATIN) 500KU/5ML SUSP 9.756588044 GENTAMICIN(GARAMYCIN) 100MG IVPB 84.006588047 MIDAZOLAM(VERSED)10MG/5ML ORAL SYR 31.006588048 OXY-APAP (PERCOCET) 5-325 TAB ER-4-PK 26.256588051 ACETYLCYSTEINE (MUCOMYST) 10% 4ML 35.006588052 RABIES VIRUS VACCINE(RABAVERT) PFS 989.756588055 HYDROCODONE-APAP(NORCO) 5-325 TAB 10.75

6588057 HEPARIN 1000 UNITS/1ML VL 14.506588060 ONDANSETRON 4MG TAB ER 4PK 40.756588062 FENTANYL(DURAGESIC) TD 75MCG/HR PAT 144.256588065 MULTIVITAMIN(INFUVITE) INJ 10ML 58.256588070 AZITHROMYCIN(ZITHROMAX)200MG/5 SUSP 49.506588071 LEVOFLOXACIN(LEVAQUIN) 750MG IVPB 211.756588072 AMOX/CLAV 875MG TAB ER 4PK 57.256588073 IPRATROPIUM-ALBUTEROL(DUOneb) UDV 7.756588075 LIDO-PRILO (EMLA) CREAM 2.5-2.5% 52.006588077 FLUCONAZOLE(DIFLUCAN) 150MG TAB 31.006588078 LEVETIRACETAM(KEPPRA) 500MG/5ML VL 71.506588082 LOSARTAN/HCTZ (HYZAAR) 100/25 TAB 7.756588083 AMLODIPINE(NORVASC) 10MG TAB 7.756588085 AMOX/CLAV(AUGMENTIN) 875MG TAB 17.506588099 BUPIVACAINE(MARCAINE)INJ 0.25% 10ML 35.006588100 CALCIUM CARB(TUMS) 500MG CHEW TAB 7.756588101 CALCIUM CARB(TUMS) 750MG CHEW TAB 7.756588107 GLUCOSE(GLUTOSE) GEL 40% 37.5GM 22.256588117 LORATADINE (CLARITIN) 10MG TAB 7.506588119 PROPOFOL (DIPRIVAN) 1000MG/100ML SDV 128.756588125 WATER FOR IRRIGATION 1000ML 11.006588128 INFLUENZA VACCINE HD 0.5ML 70.006588129 NEO-POLY-BACI (NEOSPORIN) TOP 30G 14.506588132 SOD CHLOR 0.9% NEB SOLN 3ML UDV 16.506588900 POLYVINYL ALC (TEARS NATURALE) 1.4% DRPS 16.506588910 SODIUM CHLORIDE (SALT) 1000MG TAB 9.756588918 SOD BICARBONATE SDV 2.5MEQ/5ML 14.506588921 RABIES (HYPERRAB) IMM GLOB 300 UNITS 1,628.006588929 LEVOTHYROXINE(LEVOXYL) 75 MCG TAB 7.756588932 SALINE 0.9% WARMED 1000ML 85.006588940 CHLORDIAZEPOX(LIBRIUM)25MG 4 PAK 24.256588950 OMEPRAZOLE(PRILOSEC) 20MG CAP 16.506589000 TIOTROPIUM (SPIRIVA) 18MCG INH 485.006589069 METOPROLOL XL(TOPROL) 50MG TABS 7.756589080 DEXTROSE 10% (D10W) 1000ML 85.006589120 CIPROFLOXACIN(CILOXAN) EYE OINT 0.3% 315.106589139 BUPROPION (WELLBUTRIN) SR 150MG 7.756589261 ASPIRIN 300MG SUPP 20.006589268 HYDROCO/APAP(NORCO) 5/325 ER-4-PK 27.756589354 CEFTRIAXONE/D5W IVPB : 1GM/50ML 133.506589357 NF-GLIPIZIDE 10MG ORAL TABLET 2.006589416 NF-ADVAIR DISKUS 500/50 0.5MG/ACTUATION- 15.006589469 LIDO/EPI/TETRACAINE TOP SOLN 25.956589655 SALINE (OCEAN) NASAL SPRAY 0.65% 9.006589700 WOUND GEL (SOLOSITE) 22.256589710 RIVAROXABAN(XARELTO) 10MG TAB 43.756589752 FOSPHENYTOIN(CEREBYX) 500MG/10ML 275.506589792 ALTEPLASE (ACTIVASE) 100MG 11,294.256589794 NICARDIPINE(CARDENE) 25MG/10ML 98.25

6589845 CIPROFLOXACIN(CIPRO) 400MG/200ML IVPB 67.006589846 PIPER-TAZO (ZOSYN) 4.5GM VL 99.006590059 MORPHINE SULFATE ER 15 MG 52.236590075 MELOXICAM(MOBIC)15MG TAB 13.406590151 CHLORPROMAZINE HCL 50 MG/ 2 ML 57.256590191 ERYTHROMYCIN OPHTHALMIC 0.5 % 5MG/G 1 G 45.006590203 HALOPERIDOL 1 MG TAB 7.506590224 MIDAZOLAM 5 MG/ML 50 MG 47.506590248 LAMOTRIGINE 100 MG TABLET 7.506590289 IRON DEXTRAN 100 MG/2 ML 180.176590298 ATORVASTATIN (LIPITOR) 40MG TAB 22.396590300 HEPATITIS A VACCINE 25 UNITS/0.5 ML VIAL 290.886590301 NF-BUSPIRONE (BUSPAR) 10MG TABS 3.636590308 MAGNESIUM SULFATE 1 G IN D5W 100 ML 39.416590333 LORAZEPAM(ATIVAN) 1MG 4PAK ER 25.856590344 PROPOFOL (DIPRIVAN) 500MG/50ML SDV 98.006590347 BUDESONIDE(PULMICORT) 0.5MG/2ML UDV 46.256590357 ACETAMINOPHEN(OFIRMEV) 1000MG/100ML 155.106590362 HYDROCODONE-APAP(NORCO) 10-325 ER-4-PK 36.006590378 LEVETIRACETAM(KEPPRA) 500MG TABS 12.006590379 PNEUMOCOCCAL(PREVNAR 13) VACC 0.5ML 289.006590382 AMOXICILLIN(AMOXIL) 500MG CAP 7.956590391 ALPRAZOLAM(XANAX) 0.5MG TAB 8.856590399 FLUORESCEIN/BENOX EYE DROPS 5.006590403 QUETIAPINE(SEROQUEL) 100MG TAB 10.856590439 NF-Depakote Delayed-Release Tablet 125MG 5.006590441 NF-Lyrica Oral Capsule 25MG 24.006590448 ONDANSETRON (ZOFRAN) 4MG TABS 8.956590455 BENZOCAINE(HURRICAINE)SPRAY 20% 42.206590471 ADMIN VACCINE 65+ 27.756590688 ADMIN VACCINE UNDER 65 27.756599926 DEXAMETHASONE(DECADRON) 10MG/ML VL 35.006599997 MUMP-MEASLES-RUB (MMR II) VACCINE 168.506599999 TDAP (BOOSTRIX) VACCINE 0.5ML 159.757001002 VENTILATOR 440.757001212 CARBOXYHEMOGLOBIN CHECK 94.757031500 AIRWAY INTUBATION 903.257036600 ARTERIAL BLOOD GAS COLLECTION 70.007062511 ABG INITAL 392.507062512 ABG SUBSEQUENT 392.507062628 SPIROMETRY 185.507062875 SPIROMETRY BRONCHODILATOR B&A 394.507062876 TAKE HOME OXYGEN 162.257065191 AEROSOL INITIAL FFN 255.507065192 AEROSOL SUB FFN 94.757065266 CHEST PT 1ST TX 111.257065399 VOL VENT S/U-FIRST DAY 361.507065456 IS DAILY INPT 134.507065912 MASK CPAP INIATION FIRST DAY 887.25

7069337 CHEST PT SUBSEQ 90.257069349 MASK CPAP SUBSEQUENT 582.007069352 CONT BRONCHODILATION SETUP 583.007089350 SPUTUM COLLECTION 47.507094640 INHALATION AIRWAY TREATMENT MEDICATED 305.007094664 AEROSOL ADMIN 156.007094760 SINGLE PULSE OX CHECK 27.757094762 CONTINUOUS OVERNIGHT SPO2 322.007094770 END TIDAL CO2 235.007505541 PT GAIT TRAINING (NON CRUTCH) 97116 135.507505581 PT ELECTRICL STIM 97014 105.507505584 PT PARAFFIN BATH 97018 89.007505609 PT EVAL 97163 HIGH COMPLEXITY 243.507505612 PT RE EVAL 97164 197.257505616 PT ADL SELF CARE/HOME MGNT 97535 99.507505617 PT PROPULSION WC TRAIN 97542 83.007505656 PT TRACTION (MECHANICAL) 97012 101.507505707 PT MCR ELEC STIM G0283 105.507505771 PT SKILLED GAIT TRAINING 97116 135.507505804 PT TENS INSTRUCT 64550 130.257505813 PT THERAPEUTIC EXERISE 97110 83.007505839 PT FUNCTIONAL ACTIVITIES 97530 70.507505854 PT ULTRASOUND 97035 61.757505860 PT MANUAL THERAPY 97140 70.507505862 PT NEUROMUSCULAR RE-ED BALANCE 97112 83.007577145 GCPT MOBILITY GOAL G8979CH -7577148 GCPT BODY POS GOAL G8982CH -7577151 GCPT CARRY GOAL G8985CH -7577152 GCPT CARRY DC G8986CH -7577163 GCPT MOBILITY CURRENT G8978CI -7577164 GCPT MOBILITY CURRENT G8978CJ -7577165 GCPT MOBILITY CURRENT G8978CK -7577166 GCPT MOBILITY CURRENT G8978CL -7577167 GCPT MOBILITY CURRENT G8978CM -7577168 GCPT MOBILITY CURRENT G8978CN -7577169 GCPT MOBILITY GOAL G8979CI -7577170 GCPT MOBILITY GOAL G8979CJ -7577171 GCPT MOBILITY GOAL G8979CK -7577172 GCPT MOBILITY GOAL G8979CL -7577173 GCPT MOBILITY GOAL G8979CM -7577175 GCPT MOBILITY DC G8980CI -7577176 GCPT MOBILITY DC G8980CJ -7577177 GCPT MOBILITY DC G8980CK -7577178 GCPT MOBILITY DC G8980CL -7577179 GCPT MOBILITY DC G8980CM -7577181 GCPT BODY POS CURRENT G8981CI -7577182 GCPT BODY POS CURRENT G8981CJ -7577183 GCPT BODY POS CURRENT G8981CK -7577185 GCPT BODY POS CURRENT G8981CM -

7577187 GCPT BODY POS GOAL G8982CI -7577188 GCPT BODY POS GOAL G8982CJ -7577190 GCPT BODY POS GOAL G8982CL -7577193 GCPT BODY POS DC G8983CI -7577194 GCPT BODY POS DC G8983CJ -7577199 GCPT CARRY CURRENT G8984CI -7577200 GCPT CARRY CURRENT G8984CJ -7577201 GCPT CARRY CURRENT G8984CK -7577202 GCPT CARRY CURRENT G8984CL -7577203 GCPT CARRY CURRENT G8984CM -7577205 GCPT CARRY GOAL G8985CI -7577206 GCPT CARRY GOAL G8985CJ -7577207 GCPT CARRY GOAL G8985CK -7577208 GCPT CARRY GOAL G8985CL -7577211 GCPT CARRY DC G8986CI -7577212 GCPT CARRY DC G8986CJ -7577213 GCPT CARRY DC G8986CK -7577214 GCPT CARRY DC G8986CL -7597003 PT IONTOPHORESIS 97033 114.757597161 PT EVAL LOW COMPLEXITY 168.507597162 PT EVAL MODERATE COMPLEXITY 243.507597163 PT EVAL HIGH COMPLEXITY 318.508000421 SODIUM IRRIGATION 0.9% 1000ML 13.008000596 EPIDURAL TRAY 62.958000599 HUBER NEEDLE 1.008000622 BITRAC LARGE NIV FULL FACE BIPAP 329.008000627 FEM CATH 8FR 9.758000629 SUTURE MONOSOF BLACK 5/0 P-13 165.258000632 CERVICAL COLLAR MEDIUM SOFT 10.758000633 STAPLE REMOVER HAND PLIER 10.758000643 LUMBAR PUNCTURE TRAY ADULT 62.758000645 DIAL A FLOW 16.758000684 TRAY PARACENTESIS 275.508000697 GASTRIC SUMP TUBE 14FR 8.758000698 GASTRIC SUMP TUBE 12 FR 8.758000707 WALKER BOOT SHORT LEG LARGE 118.238000708 WALKER BOOT SHORT LEG MEDIUM 118.238000709 WALKER BOOT SHORT LEG SMALL 118.238000711 THUMB SPICA SMALL RIGHT 146.758000712 THUMB SPICA SMALL LEFT 146.758000713 CAST SHOE LARGE 20.198000714 CAST SHOE SMALL 20.198000715 CAST SHOE MEDIUM 20.198000721 ADAPTIC 3X8 OIL DRESSING 33.008000725 STERILE WATER IRRIGATION 500ML 10.758000726 SALINE IRRIGATION 500ML 11.758000901 TRAY WRIST ORTHO SURGERY 5,000.008000902 TRAY LARGE FRAG ORTHO SURGERY 3,000.008000903 TRAY SMALL FRAG ORTHO SURGERY 2,000.00

8000904 TRAY EYE 700.0015800000 CHIROPRACTIC 1-2 REGIONS 130.0020000250 EXTRAORAL-FIRST RADIOGRAPHIC IMAGE 66.0020000260 EXTRAORAL-EACH ADDTL RADIOGRAPHIC IMAGE 15.00

20001110 PROPHYLAXIS-ADULT 128.5020001120 PROPHYLAXIS-CHILC 96.5020001203 TOPICAL FLUORIDE - CHILD 54.0020001204 TOPICAL FLUORIDE - ADULT 54.0020001206 TOPICAL APP OF FLUORIDE VARNISH 54.0020001351 SEALANT - PER TOOTH 70.5020001515 SPACE MAINTAINER FIXED BILATERAL 600.0020002140 AMALGAM - 1 SURFACE 125.0020002150 AMALGAM - 2 SURFACES 154.0020002160 AMALGAM - 3 SURFACES 183.0020002161 AMALGAM - 4+ SURFACES 192.5040003376 GLUCOSE QUANT URINE (003376) 6.9040086007 ACETYLCHOLINE RECEPTOR AB (086007) 563.1740140640 VGCC ANTIBODY (140640) 178.5040160184 STRIATIONAL ABS (160184) 80.0040808968 PARANEOPLASTIC PROFILE 1 (808968) 774.0075772230 COOL AEROSOL 160.7580000031 KERLEX 2.0080000080 TRAY SUTURE REMOVAL w FCP LITT SCIS 10.7580000103 STERILE 4X4 1.0080000537 GASTRIC TUBE SUMP 16FR 48IN DUAL LUMEN 8.7580000539 TRAY LACERATION CLOTH TOWELS/DRAPE 27.7580000543 ADAPTIC 3X3 STRL 2.0080000576 CRUTCHES ADULT TALL 40.7580000579 CVP TRAY ADULT 226.0080000595 CERVICAL COLLAR LARGE SOFT 10.75