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Hospital Name: Lucile Salter Packard Children's HospitalOSHPD Facility No: 106434040

Effective Date of Charges: June 1, 2014

CDM # [key] Description Price 1100000001 HC F1F2 OB SEMI PRIVATE LEVEL 1 $ 4,571.00 1100000002 HC F1F2 OB SEMI PRIVATE LEVEL 2 $ 6,683.00 1100000003 HC F1F2 OB SEMI PRIVATE LEVEL 3 $ 8,202.00 1100000004 HC F1F2 OB SEMI PRIVATE LEVEL 4 $ 13,011.00 1100000005 HC F1F2 OB/LDR SEMI PRIVATE $ 4,571.00 1100000006 HC 1N - PEDS MED/SURG $ 11,808.00 1100000007 HC 1N-ONCOLOGY MEDSURG L1 $ 11,808.00 1100000008 HC 1N-ONCOLOGY MEDSURG L2 $ 11,808.00 1100000009 HC 1N-ONCOLOGY MEDSURG L3 $ 11,808.00 1100000010 HC 3E-MEDSURG L1 $ 11,808.00 1100000011 HC 3E-MEDSURG L2 $ 11,808.00 1100000012 HC 3E-MEDSURG L3 $ 11,808.00 1100000013 HC 3N - PED TXP MED/SURG LVL 1 $ 11,808.00 1100000014 HC 3N - PED TXP MED/SURG LVL 2 $ 11,808.00 1100000015 HC 3N - PED TXP MED/SURG LVL 3 $ 11,808.00 1100000016 HC 3N ONC MEDSURG LV1 $ 11,808.00 1100000017 HC 3N ONC MEDSURG LV2 $ 11,808.00 1100000018 HC 3N ONC MEDSURG LV3 $ 11,808.00 1100000019 HC 3N-MEDSURG L1 $ 11,808.00 1100000020 HC 3N-MEDSURG L2 $ 11,808.00 1100000021 HC 3N-MEDSURG L3 $ 11,808.00 1100000022 HC 3S - PED TXP MED/SURG LVL 1 $ 11,808.00 1100000023 HC 3S - PED TXP MED/SURG LVL 2 $ 11,808.00 1100000024 HC 3S - PED TXP MED/SURG LVL 3 $ 11,808.00 1100000025 HC 3S-MEDSURG L1 $ 11,808.00 1100000026 HC 3S-MEDSURG L2 $ 11,808.00 1100000027 HC 3S-MEDSURG L3 $ 11,808.00 1100000028 HC 3W-MEDSURG L1 $ 11,808.00 1100000029 HC 3W-MEDSURG L2 $ 11,808.00 1100000030 HC 3W-MEDSURG L3 $ 11,808.00 1100000031 HC CCU - PEDS MED/SURG $ 11,808.00 1100000032 HC ECH CPCU MEDSURG L1 $ 11,808.00 1100000033 HC ECH CPCU MEDSURG L2 $ 11,808.00 1100000034 HC ECH CPCU MEDSURG L3 $ 11,808.00 1100000035 HC ECH ONC MEDSURG L1 $ 11,808.00 1100000036 HC ECH ONC MEDSURG L2 $ 11,808.00 1100000037 HC ECH ONC MEDSURG L3 $ 11,808.00 1100000038 HC ECH PEC MEDSURG L1 $ 11,808.00 1100000039 HC ECH PEC MEDSURG L2 $ 11,808.00 1100000040 HC ECH PEC MEDSURG L3 $ 11,808.00 1100000041 HC NICU - PEDS MED/SURG $ 11,808.00 1100000042 HC PEDS MEDSURG LEV 2 $ 11,808.00 1100000043 HC PICN: PEDS MED/SURG $ 11,808.00 1100000044 HC PICU - PEDS MED/SURG $ 11,808.00 1100000045 HC NURSERY LEVEL 1 $ 3,082.00

1100000046 HC BOARDER BABY $ 4,725.00 1100000047 HC INICU (SQ) CONT CARE LVL2 (L1) $ 13,392.00 1100000049 HC INICU/NICU CONT CARE LVL2 (L1) $ 13,392.00 1100000050 HC PICN: CONTINUING CARE $ 13,392.00 1100000051 HC INICU (SQ) INTERMED LVL3 (L2) $ 13,392.00 1100000052 HC INICU (SQ) INTERMED LVL3 (L3) $ 14,635.00 1100000055 HC INICU/NICU INTERMED LVL3 (L2) $ 18,170.00 1100000056 HC PICN: INTERMED LVL3 $ 14,070.00 1100000057 HC PICN: INTERMED LVL3 $ 14,070.00 1100000058 HC NICU ICU LVL4 (L3) $ 21,516.00 1100000059 HC NICU ICU LVL4 (L4) $ 30,999.00 1100000060 HC NICU/CVVH $ 33,763.00 1100000061 HC NICU/ECMO $ 45,608.00 1100000062 HC NICU/INICU (SQ) ICU LVL4 (L4) $ 21,516.00 1100000064 HC NICU/NITRIC OXIDE $ 32,873.00 1100000065 HC PICN: INTENSIVE CARE $ 15,646.00 1100000066 HC INTERMEDIATE ICU LVL 3 (PICU) $ 18,837.00 1100000067 HC PICU LEVEL 1 $ 15,370.00 1100000068 HC PICU LEVEL 2 $ 20,328.00 1100000069 HC PICU LEVEL 2 $ 20,328.00 1100000070 HC PICU LEVEL 3 $ 33,753.00 1100000071 HC PICU/CVVH $ 33,763.00 1100000072 HC PICU/ECMO $ 45,608.00 1100000073 HC PICU/NITRIC $ 32,873.00 1100000074 HC BMT IICU (1N) $ 13,832.00 1100000075 HC INTERMEDIATE ICU LEVEL 1 (3W) $ 14,350.00 1100000076 HC INTERMEDIATE ICU LEVEL 2 (3W) $ 16,666.00 1100000077 HC INTERMEDIATE ICU LEVEL 3 (3W) $ 18,837.00 1100000078 HC CARDIAC CARE UNIT (CCU) CVVH $ 33,763.00 1100000079 HC CARDIAC CARE UNIT (CCU) ECMO $ 45,608.00 1100000080 HC CARDIAC CARE UNIT (CCU) IABP $ 33,753.00 1100000081 HC CARDIAC CARE UNIT (CCU) LVAD $ 33,753.00 1100000082 HC CARDIAC CARE UNIT (CCU) LVL 1 $ 15,370.00 1100000083 HC CARDIAC CARE UNIT (CCU) LVL 2 $ 20,328.00 1100000084 HC CARDIAC CARE UNIT (CCU) LVL 3 $ 33,753.00 1100000085 HC CARDIAC CARE UNIT (CCU) NITRIC $ 32,873.00 1100000086 HC INTERMEDIATE ICU LVL 3 (CCU) $ 18,837.00 1100000087 HC NICU/NEURO LVL 4 $ 33,318.00 1100000088 HC NICU/DIALYSIS LVL 4 $ 33,318.00 1200000001 HC F1F2 OBSERVATION 1ST HR $ 2,550.00 1200000002 HC F1F2 OBSERVATION EA ADDL 1 HR $ 246.00 1200000003 HC OBSERVATION 1ST HR $ 3,670.00 1200000004 HC OBSERVATION EA ADDL 1 HR $ 354.00 1200000005 HC OB OBSERVATION 1ST HR $ 920.00 1200000006 HC OB OBSERVATION EA ADDL 1 HR $ 237.00 1300000001 HC IP CONVENT HEMODIALYSIS <2YRS $ 2,569.00 1300000002 HC IP CONVENT HEMODIALYSIS >2 YRS $ 2,569.00 1300000003 HC IP HIGH FLUX HEMODIALYSIS>2YRS $ 2,569.00 1300000004 HC OP CONVENT HEMODIALYSIS <2 YRS $ 2,569.00 1300000005 HC OP CONVENT HEMODIALYSIS >2 YRS $ 2,569.00 1300000006 HC OP HIGH FLUX HEMODIALYSIS>2YRS $ 2,569.00 1300000007 HC HEMODIALYSIS ACCESS FLOW STUDY $ 428.00 1300000008 HC CRRT INPT ACUTE $ 4,356.00

1300000009 HC CAPD CHRONIC OUTPATIENT $ 3,796.00 1300000010 HC CCPD CHRONIC OUTPATIENT $ 4,250.00 1300000011 HC CAPD ACUTE INPT $ 6,861.00 1300000012 HC CAPD CHRONIC INPT $ 3,796.00 1300000013 HC CCPD ACUTE INPT $ 7,685.00 1300000014 HC CCPD CHRONIC INPT $ 4,250.00 1300000015 HC ICU MANUAL PD PER DAY $ 4,250.00 1300000016 HC IP ONLY HEMOPERFUSION 1-4 HRS $ 4,472.00 1300000017 HC CCPD TRAINING PER SESSION $ 764.00 1300000018 HC CAPD HOME $ 367.00 1300000019 HC CAPD HOME $ 413.00 1400000001 HC ECH PSYCH DAY CARE/30 MIN $ 159.00 1400000002 HC ECH PSYCHOSOMATIC DAY CARE $ 2,109.00 1400000003 HC ECH PATIENT EDUCATION 15 MIN $ 65.00 19100601 HC IPPB S T $ 357.00 19101146 HC MDI SUBSEQUENT-LPCH $ 357.00 19101153 HC VENT ASSIST & MGMT-INIT-LPCH $ 6,184.00 19103050 HC VENT MNGMNT EA SUBSQ DAY $ 3,924.00 19103449 HC MDI TX INITIAL $ 357.00 19103753 HC ARTERIAL PUNCTURE $ 355.00 19103902 HC BRONCH W NDL BX UPP AIRWAY $ 6,173.00 19160035 HC BRONCHOSCOPY/LAVAGE SINGLE $ 5,854.00 2100003122 HC BERLIN HEART VAD GP122 $ 104,400.00 2100003141 HC BERLIN HEART VAD GP141 $ 148,000.00 2100004147 HC HEARTMATE II LVAD GP147 $ 172,000.00 2100005146 HC IMPL HEARTWARE HVAD GP146 $ 168,000.00 2100006019 HC VAD PUMP REVOLUTION LEV 19 $ 2,125.00 2110000004 HC SOLN LACTATED RINGERS 3L $ 50.00 2110000005 HC TOBRADEX OINTMENT 3.5G $ 123.30 2110000006 HC GLUTARALDEHYDE 16OZ 0.625PERCT $ 1,080.00 2110000011 HC AVITENE POWDER 1GM $ 900.00 2110000014 HC BAG CONSOLIDATED HMII $ 2,550.00 2110000015 HC BATTERY CHARGER UNIVSL HMII $ 28,000.00 2110000016 HC BATTERY MODULE SYS HMII $ 2,125.00 2110000017 HC MODULE DISPLAY HMII $ 13,000.00 2110000018 HC MODULE POWER CABLE DC INPT $ 1,750.00 2110000019 HC MODULE POWER CABLE HMII $ 6,300.00 2110000020 HC MODULE POWER HMII $ 30,400.00 2110000021 HC POWER PACK EMERGENCY HMII $ 5,800.00 2110000022 HC SET BATTERY LI-ON HMII $ 12,600.00 2110000023 HC SET CLIP LI-ON HMII $ 6,750.00 2110000024 HC SHOWER COVER HMII $ 3,300.00 2110000025 HC VEST HOLSTER HMII $ 2,888.00 2110000026 HC SYRINGE ASSEMBLY ALLIANCE 60ML $ 293.00 2111001057 HC IMPL DISTAL HUMERAL BODY GP057 $ 18,400.00 2111001067 HC IMPL DISTAL HUMERAL BODY GP067 $ 26,400.00 2111002023 HC IMPL BI-ANGULAR HUMERAL GP023 $ 3,600.00 2111002045 HC IMPL BI-ANGULAR HUMERAL GP045 $ 11,550.00 2111003002 HC CATH ARTERIAL LINE GP002 $ 50.00 2111004015 HC BLOCKER ENDOBRONCHIAL GP015 $ 1,225.00 2111005005 HC CATH IV GP005 $ 195.00 2111006006 HC CATH THERMODILATION GP006 $ 293.00 2111007019 HC KIT CATH OXIMETRIX GP019 $ 2,125.00

2111008009 HC KIT INTRODUCER GP009 $ 570.00 2111008012 HC KIT INTRODUCER GP012 $ 810.00 2111009004 HC FORM CELL SAVER GP004 $ 146.00 2111009006 HC RESERVOIR CELL SAVER GP006 $ 293.00 2111010002 HC SET WARMER RANGER FLUID GP002 $ 50.00 2111010008 HC SET WARMER RANGER FLUID GP008 $ 475.00 2120001016 HC ADAPTER DIAL GP016 $ 1,400.00 2120001017 HC ADAPTER DIAL GP017 $ 1,575.00 2120001018 HC ADAPTER DIAL GP018 $ 1,750.00 2120002025 HC BIOGLUE ADH GP025 $ 4,263.00 2120002026 HC BIOGLUE ADH GP026 $ 4,650.00 2120002038 HC BIOGLUE ADH GP038 $ 8,750.00 2120002045 HC BIOGLUE ADH GP045 $ 11,550.00 2120002050 HC BIOGLUE ADH GP050 $ 15,200.00 2120003003 HC ADH DERMABOND GP003 $ 100.00 2120003005 HC ADH DERMABOND GP005 $ 195.00 2120004004 HC ADH INDERMIL GP004 $ 146.00 2120004005 HC ADH INDERMIL GP005 $ 195.00 2120006014 HC APPLIER ENDOCLIP GP014 $ 1,080.00 2120006016 HC APPLIER ENDOCLIP GP016 $ 1,400.00 2120007002 HC BAG DRAINAGE GP002 $ 50.00 2120007003 HC BAG DRAINAGE GP003 $ 100.00 2120007004 HC BAG DRAINAGE GP004 $ 146.00 2120007006 HC BAG DRAINAGE GP006 $ 293.00 2120007007 HC BAG DRAINAGE GP007 $ 380.00 2120008018 HC BALL DISSECT RND GP018 $ 1,750.00 2120008019 HC BALL DISSECT RND GP019 $ 2,125.00 2120008020 HC BALL DISSECT RND GP020 $ 2,550.00 2120009009 HC BALL FLUT SHRT GP009 $ 570.00 2120009010 HC BALL FLUT SHRT GP010 $ 665.00 2120010003 HC BINDER BREAST GP003 $ 100.00 2120010004 HC BINDER BREAST GP004 $ 146.00 2120010005 HC BINDER BREAST GP005 $ 195.00 2120011002 HC BLADE GP002 $ 50.00 2120011003 HC BLADE GP003 $ 100.00 2120011004 HC BLADE GP004 $ 146.00 2120011005 HC BLADE GP005 $ 195.00 2120011006 HC BLADE GP006 $ 293.00 2120011007 HC BLADE GP007 $ 380.00 2120011008 HC BLADE GP008 $ 475.00 2120011009 HC BLADE GP009 $ 570.00 2120011010 HC BLADE GP010 $ 665.00 2120011011 HC BLADE GP011 $ 740.00 2120011012 HC BLADE GP012 $ 810.00 2120011013 HC BLADE GP013 $ 900.00 2120011014 HC BLADE GP014 $ 1,080.00 2120011015 HC BLADE GP015 $ 1,225.00 2120011016 HC BLADE GP016 $ 1,400.00 2120011017 HC BLADE GP017 $ 1,575.00 2120011018 HC BLADE GP018 $ 1,750.00 2120011019 HC BLADE GP019 $ 2,125.00 2120011020 HC BLADE GP020 $ 2,550.00 2120011021 HC BLADE GP021 $ 2,888.00

2120011022 HC BLADE GP022 $ 3,300.00 2120011023 HC BLADE GP023 $ 3,600.00 2120011027 HC BLADE GP027 $ 4,875.00 2120011035 HC BLADE GP035 $ 7,150.00 2120012002 HC BLADE SAW GP002 $ 50.00 2120012003 HC BLADE SAW GP003 $ 100.00 2120012004 HC BLADE SAW GP004 $ 146.00 2120012005 HC BLADE SAW GP005 $ 195.00 2120012006 HC BLADE SAW GP006 $ 293.00 2120012007 HC BLADE SAW GP007 $ 380.00 2120012008 HC BLADE SAW GP008 $ 475.00 2120012009 HC BLADE SAW GP009 $ 570.00 2120012010 HC BLADE SAW GP010 $ 665.00 2120012011 HC BLADE SAW GP011 $ 740.00 2120012012 HC BLADE SAW GP012 $ 810.00 2120012018 HC BLADE SAW GP018 $ 1,750.00 2120012020 HC BLADE SAW GP020 $ 2,550.00 2120012021 HC BLADE SAW GP021 $ 2,888.00 2120012029 HC BLADE SAW GP029 $ 5,438.00 2120012033 HC BLADE SAW GP033 $ 6,413.00 2120013008 HC BLOCK BONE GP008 $ 475.00 2120014014 HC BLOCK SIL GP014 $ 1,080.00 2120014015 HC BLOCK SIL GP015 $ 1,225.00 2120015005 HC BOBBIN NO WIRE GP005 $ 195.00 2120016008 HC BOWL MIXING CEMENT GP008 $ 475.00 2120016009 HC BOWL CEMENT GP009 $ 570.00 2120016010 HC BOWL MIXING CEMENT GP010 $ 665.00 2120016011 HC BOWL CEMENT GP011 $ 740.00 2120016018 HC BOWL MIXING CEMENT GP018 $ 1,750.00 2120017002 HC BUR GP002 $ 50.00 2120017003 HC BUR GP003 $ 100.00 2120017004 HC BUR GP004 $ 146.00 2120017005 HC BUR GP005 $ 195.00 2120017006 HC BUR GP006 $ 293.00 2120017007 HC BUR GP007 $ 380.00 2120017008 HC BUR GP008 $ 475.00 2120017009 HC BUR GP009 $ 570.00 2120017010 HC BUR GP010 $ 665.00 2120017011 HC BUR GP011 $ 740.00 2120017012 HC BUR GP012 $ 810.00 2120017013 HC BUR GP013 $ 900.00 2120017014 HC BUR GP014 $ 1,080.00 2120017018 HC BUR GP018 $ 1,750.00 2120017019 HC BUR GP019 $ 2,125.00 2120017020 HC BUR GP020 $ 2,550.00 2120018009 HC BUR LEGEND GP009 $ 570.00 2120018010 HC BUR LEGEND GP010 $ 665.00 2120018011 HC BUR LEGEND GP011 $ 740.00 2120018012 HC BUR LEGEND GP012 $ 810.00 2120018013 HC BUR LEGEND GP013 $ 900.00 2120018014 HC BUR LEGEND GP014 $ 1,080.00 2120018015 HC BUR LEGEND GP015 $ 1,225.00 2120019002 HC BUR OVAL GP002 $ 50.00

2120019003 HC BUR OVAL GP003 $ 100.00 2120019004 HC BUR OVAL GP004 $ 146.00 2120019007 HC BUR OVAL GP007 $ 380.00 2120019008 HC BUR OVAL GP008 $ 475.00 2120019009 HC BUR OVAL GP009 $ 570.00 2120020002 HC BUR ROUND GP002 $ 50.00 2120020003 HC BUR ROUND GP003 $ 100.00 2120020004 HC BUR ROUND GP004 $ 146.00 2120020005 HC BUR ROUND GP005 $ 195.00 2120020006 HC BUR ROUND GP006 $ 293.00 2120020007 HC BUR ROUND GP007 $ 380.00 2120020008 HC BUR ROUND GP008 $ 475.00 2120020009 HC BUR ROUND GP009 $ 570.00 2120020010 HC BUR ROUND GP010 $ 665.00 2120020012 HC BUR ROUND GP012 $ 810.00 2120020013 HC BUR ROUND GP013 $ 900.00 2120020014 HC BUR ROUND GP014 $ 1,080.00 2120020015 HC BUR ROUND GP015 $ 1,225.00 2120020016 HC BUR ROUND GP016 $ 1,400.00 2120020017 HC BUR ROUND GP017 $ 1,575.00 2120020018 HC BUR ROUND GP018 $ 1,750.00 2120021002 HC BUR WIRE PASS GP002 $ 50.00 2120021004 HC BUR WIRE PASS GP004 $ 146.00 2120021007 HC BUR WIRE PASS GP007 $ 380.00 2120021008 HC BUR WIRE PASS GP008 $ 475.00 2120022004 HC BUTTON GP004 $ 146.00 2120022005 HC BUTTON GP005 $ 195.00 2120022006 HC BUTTON GP006 $ 293.00 2120023002 HC CANNULA GP002 $ 50.00 2120023003 HC CANNULA GP003 $ 100.00 2120023004 HC CANNULA GP004 $ 146.00 2120023005 HC CANNULA GP005 $ 195.00 2120023006 HC CANNULA GP006 $ 293.00 2120023007 HC CANNULA GP007 $ 380.00 2120023008 HC CANNULA GP008 $ 475.00 2120023009 HC CANNULA GP009 $ 570.00 2120023010 HC CANNULA GP010 $ 665.00 2120023011 HC CANNULA GP011 $ 740.00 2120023012 HC CANNULA GP012 $ 810.00 2120023013 HC CANNULA GP013 $ 900.00 2120023014 HC CANNULA GP014 $ 1,080.00 2120023015 HC CANNULA GP015 $ 1,225.00 2120023016 HC CANNULA GP016 $ 1,400.00 2120023017 HC CANNULA GP017 $ 1,575.00 2120023018 HC CANNULA GP018 $ 1,750.00 2120023019 HC CANNULA GP019 $ 2,125.00 2120023020 HC CANNULA GP020 $ 2,550.00 2120023021 HC CANNULA GP021 $ 2,888.00 2120024002 HC CANNULA ARTERIAL GP002 $ 50.00 2120024003 HC CANNULA ARTERIAL GP003 $ 100.00 2120024004 HC CANNULA ARTERIAL GP004 $ 146.00 2120024005 HC CANNULA ARTERIAL GP005 $ 195.00 2120024006 HC CANNULA ARTERIAL GP006 $ 293.00

2120024007 HC CANNULA ARTERIAL GP007 $ 380.00 2120024009 HC CANNULA ARTERIAL GP009 $ 570.00 2120024010 HC CANNULA ARTERIAL GP010 $ 665.00 2120024017 HC CANNULA ARTERIAL GP017 $ 1,575.00 2120024018 HC CANNULA ARTERIAL GP018 $ 1,750.00 2120024019 HC CANNULA ARTERIAL GP019 $ 2,125.00 2120024047 HC CANNULA ARTERIAL GP047 $ 13,000.00 2120024049 HC CANNULA ARTERIAL GP049 $ 14,250.00 2120024051 HC CANNULA ARTERIAL GP051 $ 15,300.00 2120024053 HC CANNULA ARTERIAL GP053 $ 16,300.00 2120025008 HC IMPL CANNULA VENTRICULAR GP008 $ 475.00 2120025047 HC IMPL CANNULA VENTRICULAR GP047 $ 13,000.00 2120025049 HC IMPL CANNULA VENTRICULAR GP049 $ 14,250.00 2120026005 HC CAP GP005 $ 195.00 2120026006 HC CAP GP006 $ 293.00 2120026014 HC CAP GP014 $ 1,080.00 2120026018 HC CAP GP018 $ 1,750.00 2120026020 HC CAP GP020 $ 2,550.00 2120027005 HC IMPL CAP END GP005 $ 195.00 2120027009 HC CAP END GP009 $ 570.00 2120027010 HC CAP END GP010 $ 665.00 2120027014 HC IMPL CAP END GP014 $ 1,080.00 2120027015 HC IMPL CAP END GP015 $ 1,225.00 2120027016 HC IMPL CAP END GP016 $ 1,400.00 2120027017 HC IMPL CAP END GP017 $ 1,575.00 2120027018 HC IMPL CAP END GP018 $ 1,750.00 2120027020 HC IMPL CAP END GP020 $ 2,550.00 2120028009 HC IMPL CAP PIN GP009 $ 570.00 2120029002 HC CATH GP002 $ 50.00 2120029003 HC CATH GP003 $ 100.00 2120029004 HC CATH GP004 $ 146.00 2120029005 HC CATH GP005 $ 195.00 2120029006 HC CATH GP006 $ 293.00 2120029007 HC CATH GP007 $ 380.00 2120029008 HC CATH GP008 $ 475.00 2120029009 HC CATH GP009 $ 570.00 2120029010 HC CATH GP010 $ 665.00 2120029011 HC CATH GP011 $ 740.00 2120029012 HC CATH GP012 $ 810.00 2120029013 HC CATH GP013 $ 900.00 2120029014 HC CATH GP014 $ 1,080.00 2120029015 HC CATH GP015 $ 1,225.00 2120029016 HC CATH GP016 $ 1,400.00 2120029017 HC CATH GP017 $ 1,575.00 2120029018 HC CATH GP018 $ 1,750.00 2120029019 HC CATH GP019 $ 2,125.00 2120029024 HC CATH GP024 $ 4,000.00 2120029029 HC CATH GP029 $ 5,438.00 2120029047 HC CATH GP047 $ 13,000.00 2120030017 HC CATH BLLN OCCL GP017 $ 1,575.00 2120031005 HC CATH FOGARTY GP005 $ 195.00 2120031007 HC CATH FOGARTY GP007 $ 380.00 2120031009 HC CATH FOGARTY GP009 $ 570.00

2120031010 HC CATH FOGARTY GP010 $ 665.00 2120031011 HC CATH FOGARTY GP011 $ 740.00 2120031013 HC CATH FOGARTY GP013 $ 900.00 2120031014 HC CATH FOGARTY GP014 $ 1,080.00 2120031017 HC CATH FOGARTY GP017 $ 1,575.00 2120031018 HC CATH FOGARTY GP018 $ 1,750.00 2120031020 HC CATH FOGARTY GP020 $ 2,550.00 2120032002 HC CATH FOLEY GP002 $ 50.00 2120032003 HC CATH FOLEY GP003 $ 100.00 2120032004 HC CATH FOLEY GP004 $ 146.00 2120032005 HC CATH FOLEY GP005 $ 195.00 2120032006 HC CATH FOLEY GP006 $ 293.00 2120032018 HC CATH FOLEY GP018 $ 1,750.00 2120032019 HC CATH FOLEY GP019 $ 2,125.00 2120033002 HC CATH GUIDING GP002 $ 50.00 2120033003 HC CATH GUIDING GP003 $ 100.00 2120033005 HC CATH GUIDING GP005 $ 195.00 2120033006 HC CATH GUIDING GP006 $ 293.00 2120033007 HC CATH GUIDING GP007 $ 380.00 2120033018 HC CATH GUIDING GP018 $ 1,750.00 2120033037 HC CATH GUIDING GP037 $ 8,125.00 2120034025 HC CATH INTRASPINAL GP025 $ 4,263.00 2120035002 HC CATH PED ULTRAMER GP002 $ 50.00 2120035003 HC CATH PED ULTRAMER GP003 $ 100.00 2120036006 HC IMPL CATH PERIT/HEMODIAL GP006 $ 293.00 2120036010 HC IMPL CATH PERIT/HEMODIAL GP010 $ 665.00 2120036011 HC IMPL CATH PERIT/HEMODIAL GP011 $ 740.00 2120036013 HC IMPL CATH PERIT/HEMODIAL GP013 $ 900.00 2120036014 HC IMPL CATH PERIT/HEMODIAL GP014 $ 1,080.00 2120036015 HC IMPL CATH PERIT/HEMODIAL GP015 $ 1,225.00 2120036016 HC IMPL CATH PERIT/HEMODIAL GP016 $ 1,400.00 2120036017 HC IMPL CATH PERIT/HEMODIAL GP017 $ 1,575.00 2120036018 HC IMPL CATH PERIT/HEMODIAL GP018 $ 1,750.00 2120036019 HC IMPL CATH PERIT/HEMODIAL GP019 $ 2,125.00 2120036020 HC IMPL CATH PERIT/HEMODIAL GP020 $ 2,550.00 2120036022 HC IMPL CATH PERIT/HEMODIAL GP022 $ 3,300.00 2120036023 HC IMPL CATH PERIT/HEMODIAL GP023 $ 3,600.00 2120036024 HC IMPL CATH PERIT/HEMODIAL GP024 $ 4,000.00 2120036027 HC IMPL CATH PERIT/HEMODIAL GP027 $ 4,875.00 2120037013 HC CATH QUINTON GP013 $ 900.00 2120037014 HC CATH QUINTON GP014 $ 1,080.00 2120037016 HC CATH QUINTON GP016 $ 1,400.00 2120037017 HC CATH QUINTON GP017 $ 1,575.00 2120037018 HC CATH QUINTON GP018 $ 1,750.00 2120037023 HC CATH QUINTON GP023 $ 3,600.00 2120038003 HC CATH TROCAR GP003 $ 100.00 2120038004 HC CATH TROCAR GP004 $ 146.00 2120038005 HC CATH TROC GP005 $ 195.00 2120039003 HC CATH UMBILICAL GP003 $ 100.00 2120039004 HC CATH UMBILICAL GP004 $ 146.00 2120039005 HC CATH UMBILICAL GP005 $ 195.00 2120039006 HC CATH UMBILICAL GP006 $ 293.00 2120040004 HC CATH VENT GP004 $ 146.00

2120040005 HC CATH VENT GP005 $ 195.00 2120040006 HC CATH VENT GP006 $ 293.00 2120040012 HC CATH VENT GP012 $ 810.00 2120040013 HC CATH VENT GP013 $ 900.00 2120040014 HC CATH VENT GP014 $ 1,080.00 2120040015 HC CATH VENT GP015 $ 1,225.00 2120040016 HC CATH VENT GP016 $ 1,400.00 2120040017 HC CATH VENT GP017 $ 1,575.00 2120040018 HC CATH VENT GP018 $ 1,750.00 2120040019 HC CATH VENT GP019 $ 2,125.00 2120041006 HC IMPL CEMENT BONE GP006 $ 293.00 2120041008 HC IMPL CEMENT BONE GP008 $ 475.00 2120041009 HC IMPL CEMENT BONE GP009 $ 570.00 2120041010 HC IMPL CEMENT BONE GP010 $ 665.00 2120041011 HC IMPL CEMENT BONE GP011 $ 740.00 2120041012 HC IMPL CEMENT BONE GP012 $ 810.00 2120041013 HC IMPL CEMENT BONE GP013 $ 900.00 2120041016 HC IMPL CEMENT BONE GP016 $ 1,400.00 2120041020 HC IMPL CEMENT BONE GP020 $ 2,550.00 2120041024 HC IMPL CEMENT BONE GP024 $ 4,000.00 2120041029 HC IMPL CEMENT BONE GP029 $ 5,438.00 2120041050 HC IMPL CEMENT BONE GP050 $ 15,200.00 2120042020 HC IMPL CEMENT BONE TOBRA GP020 $ 2,550.00 2120042021 HC IMPL CEMENT BONE TOBRA GP021 $ 2,888.00 2120042050 HC IMPL CEMENT BONE TOBRA GP050 $ 15,200.00 2120043005 HC CENTRALIZER GP005 $ 195.00 2120043010 HC CENTRALIZER GP010 $ 665.00 2120043011 HC CENTRALIZER GP011 $ 740.00 2120043013 HC CENTRALIZER GP013 $ 900.00 2120043014 HC CENTRALIZER GP014 $ 1,080.00 2120043042 HC CENTRALIZER GP042 $ 10,350.00 2120043043 HC CENTRALIZER GP043 $ 10,450.00 2120044019 HC IMPL CLIP ANEURYSM GP019 $ 2,125.00 2120044020 HC IMPL CLIP ANEURYSM GP020 $ 2,550.00 2120044021 HC IMPL CLIP ANEURYSM GP021 $ 2,888.00 2120044022 HC IMPL CLIP ANEURYSM GP022 $ 3,300.00 2120044024 HC IMPL CLIP ANEURYSM GP024 $ 4,000.00 2120044025 HC IMPL CLIP ANEURYSM GP025 $ 4,263.00 2120045009 HC CLIP APPLIER GP009 $ 570.00 2120045012 HC CLIP APPLIER GP012 $ 810.00 2120045013 HC CLIP APPLIER GP013 $ 900.00 2120045015 HC CLIP APPLIER GP015 $ 1,225.00 2120045016 HC CLIP APPLIER GP016 $ 1,400.00 2120045018 HC CLIP APPLIER GP018 $ 1,750.00 2120045020 HC CLIP APPLIER GP020 $ 2,550.00 2120045021 HC CLIP APPLIER GP021 $ 2,888.00 2120045022 HC CLIP APPLIER GP022 $ 3,300.00 2120045027 HC CLIP APPLIER GP027 $ 4,875.00 2120045033 HC CLIP APPLIER GP033 $ 6,413.00 2120045035 HC CLIP APPLIER GP035 $ 7,150.00 2120045037 HC CLIP APPLIER GP037 $ 8,125.00 2120046002 HC IMPL CLIP HEMO GP002 $ 50.00 2120046003 HC IMPL CLIP HEMO GP003 $ 100.00

2120046004 HC IMPL CLIP HEMO GP004 $ 146.00 2120046005 HC IMPL CLIP HEMO GP005 $ 195.00 2120046011 HC IMPL CLIP HEMO GP011 $ 740.00 2120047019 HC CLIP LAP GP019 $ 2,125.00 2120048002 HC IMPL CLIP LIGA GP002 $ 50.00 2120048004 HC IMPL CLIP LIGA GP004 $ 146.00 2120049002 HC CLIP SPRING GP002 $ 50.00 2120049003 HC CLIP SPRING GP003 $ 100.00 2120049009 HC CLIP SPRING GP009 $ 570.00 2120049014 HC CLIP SPRING GP014 $ 1,080.00 2120050019 HC IMPL CLIP SUGITA GP019 $ 2,125.00 2120050020 HC IMPL CLIP SUGITA GP020 $ 2,550.00 2120051005 HC COLLODION GP005 $ 195.00 2120052006 HC IMPL CONFORMER EYE GP006 $ 293.00 2120052007 HC IMPL CONFORMER EYE GP007 $ 380.00 2120053005 HC DERMACARRIER GP005 $ 195.00 2120053006 HC DERMACARRIER GP006 $ 293.00 2120054024 HC DERMAGRAFT GP024 $ 4,000.00 2120055014 HC DEVICE LIGASURE CUTTING GP014 $ 1,080.00 2120055018 HC DEVICE LIGASURE CUTTING GP018 $ 1,750.00 2120055019 HC DEVICE LIGASURE CUTTING GP019 $ 2,125.00 2120055022 HC DEVICE LIGASURE CUTTING GP022 $ 3,300.00 2120055023 HC DEVICE LIGASURE CUTTING GP023 $ 3,600.00 2120055025 HC DEVICE LIGASURE CUTTING GP025 $ 4,263.00 2120056012 HC DEVICE WOUND CLOSURE GP012 $ 810.00 2120056013 HC DEVICE WOUND CLOSURE GP013 $ 900.00 2120056017 HC DEVICE WOUND CLOSURE GP017 $ 1,575.00 2120057002 HC DILATOR GP002 $ 50.00 2120057003 HC DILATOR GP003 $ 100.00 2120057004 HC DILATOR GP004 $ 146.00 2120057005 HC DILATOR GP005 $ 195.00 2120057006 HC DILATOR GP006 $ 293.00 2120057007 HC DILATOR GP007 $ 380.00 2120057008 HC DILATOR GP008 $ 475.00 2120057009 HC DILATOR GP009 $ 570.00 2120057010 HC DILATOR GP010 $ 665.00 2120057018 HC DILATOR GP018 $ 1,750.00 2120057019 HC DILATOR GP019 $ 2,125.00 2120058002 HC DRAIN GP002 $ 50.00 2120058003 HC DRAIN GP003 $ 100.00 2120058004 HC DRAIN GP004 $ 146.00 2120058005 HC DRAIN GP005 $ 195.00 2120058006 HC DRAIN GP006 $ 293.00 2120058008 HC DRAIN GP008 $ 475.00 2120058010 HC DRAIN GP010 $ 665.00 2120058018 HC DRAIN GP018 $ 1,750.00 2120058025 HC DRAIN GP025 $ 4,263.00 2120059002 HC DRAIN CHEST GP002 $ 50.00 2120059004 HC DRAIN CHEST GP004 $ 195.00 2120059005 HC DRAIN CHEST GP005 $ 195.00 2120059006 HC DRAIN CHEST GP006 $ 293.00 2120059007 HC DRAIN CHEST GP007 $ 380.00 2120059014 HC DRAIN CHEST GP014 $ 1,080.00

2120059015 HC DRAIN CHEST GP015 $ 1,225.00 2120060002 HC DRAIN HEMOVAC GP002 $ 50.00 2120060003 HC DRAIN HEMOVAC GP003 $ 100.00 2120060005 HC DRAIN HEMOVAC GP005 $ 195.00 2120060012 HC DRAIN HEMOVAC GP012 $ 810.00 2120060018 HC DRAIN HEMOVAC GP018 $ 1,750.00 2120061002 HC DRILL BIT GP002 $ 50.00 2120061003 HC DRILL BIT GP003 $ 100.00 2120061004 HC DRILL BIT GP004 $ 146.00 2120061006 HC DRILL BIT GP006 $ 293.00 2120061007 HC DRILL BIT GP007 $ 380.00 2120061008 HC DRILL BIT GP008 $ 475.00 2120061009 HC DRILL BIT GP009 $ 570.00 2120061010 HC DRILL BIT GP010 $ 665.00 2120061011 HC DRILL BIT GP011 $ 740.00 2120061012 HC DRILL BIT GP012 $ 810.00 2120061013 HC DRILL BIT GP013 $ 900.00 2120061014 HC DRILL BIT GP014 $ 1,080.00 2120061015 HC DRILL BIT GP015 $ 1,225.00 2120061016 HC DRILL BIT GP016 $ 1,400.00 2120061017 HC DRILL BIT GP017 $ 1,575.00 2120061018 HC DRILL BIT GP018 $ 1,750.00 2120061019 HC DRILL BIT GP019 $ 2,125.00 2120061020 HC DRILL BIT GP020 $ 2,550.00 2120061021 HC DRILL BIT GP021 $ 2,888.00 2120061022 HC DRILL BIT GP022 $ 3,300.00 2120061023 HC DRILL BIT GP023 $ 3,600.00 2120061024 HC DRILL BIT GP024 $ 4,000.00 2120061027 HC DRILL BIT GP027 $ 4,875.00 2120063010 HC IMPL EYEBOLT GP010 $ 665.00 2120064019 HC IMPL FIXATOR GP019 $ 2,125.00 2120064020 HC IMPL FIXATOR GP020 $ 2,550.00 2120064021 HC IMPL FIXATOR GP021 $ 2,888.00 2120064022 HC IMPL FIXATOR GP022 $ 3,300.00 2120064024 HC IMPL FIXATOR GP024 $ 4,000.00 2120064025 HC IMPL FIXATOR GP025 $ 4,263.00 2120064027 HC IMPL FIXATOR GP027 $ 4,875.00 2120064028 HC IMPL FIXATOR GP028 $ 5,250.00 2120064037 HC IMPL FIXATOR GP037 $ 8,125.00 2120064038 HC IMPL FIXATOR WRIST GP038 $ 8,750.00 2120064039 HC IMPL FIXATOR GP039 $ 9,000.00 2120064040 HC IMPL FIXATOR GP040 $ 9,600.00 2120064049 HC IMPL FIXATOR GP049 $ 14,250.00 2120064051 HC IMPL FIXATOR GP051 $ 15,300.00 2120064052 HC IMPL FIXATOR GP052 $ 16,200.00 2120064055 HC IMPL FIXATOR GP055 $ 17,300.00 2120065007 HC IMPL GELFILM GP007 $ 380.00 2120065008 HC IMPL GELFILM GP008 $ 475.00 2120065009 HC IMPL GELFILM GP009 $ 570.00 2120065010 HC IMPL GELFILM GP010 $ 665.00 2120065011 HC IMPL GELFILM GP011 $ 740.00 2120065024 HC IMPL GELFILM GP024 $ 4,000.00 2120066022 HC GELFILM GP022 $ 3,300.00

2120066023 HC GELFILM GP010 $ 3,600.00 2120066025 HC GELPORT GP025 $ 4,263.00 2120067004 HC IMPL CANNULA VENOUS GP004 $ 146.00 2120067005 HC IMPL CANNULA VENOUS GP005 $ 195.00 2120067006 HC IMPL CANNULA VENOUS GP006 $ 293.00 2120067010 HC IMPL CANNULA VENOUS GP010 $ 665.00 2120067014 HC IMPL CANNULA VENOUS GP014 $ 1,080.00 2120067015 HC IMPL CANNULA VENOUS GP015 $ 1,225.00 2120067017 HC IMPL CANNULA VENOUS GP017 $ 1,575.00 2120067018 HC IMPL CANNULA VENOUS GP018 $ 1,750.00 2120067019 HC IMPL CANNULA VENOUS GP019 $ 2,125.00 2120067022 HC IMPL CANNULA VENOUS GP022 $ 3,300.00 2120067023 HC IMPL CANNULA VENOUS GP023 $ 3,600.00 2120068002 HC GUIDEWIRE GP002 $ 50.00 2120068003 HC GUIDEWIRE GP003 $ 100.00 2120068004 HC GUIDEWIRE GP004 $ 146.00 2120068005 HC GUIDEWIRE GP005 $ 195.00 2120068006 HC GUIDEWIRE GP006 $ 293.00 2120068007 HC GUIDEWIRE GP007 $ 380.00 2120068008 HC GUIDEWIRE GP008 $ 475.00 2120068009 HC GUIDEWIRE GP009 $ 570.00 2120068010 HC GUIDEWIRE GP010 $ 665.00 2120068011 HC GUIDEWIRE GP011 $ 740.00 2120068012 HC GUIDEWIRE GP012 $ 810.00 2120068013 HC GUIDEWIRE GP013 $ 900.00 2120068014 HC GUIDEWIRE GP014 $ 1,080.00 2120068015 HC GUIDEWIRE GP015 $ 1,225.00 2120068016 HC GUIDEWIRE GP016 $ 1,400.00 2120068017 HC GUIDEWIRE GP017 $ 1,575.00 2120068018 HC GUIDEWIRE GP018 $ 1,750.00 2120068019 HC GWR GP019 $ 2,125.00 2120068021 HC GUIDEWIRE GP021 $ 2,888.00 2120068022 HC GUIDEWIRE GP022 $ 3,300.00 2120068023 HC GUIDEWIRE GP023 $ 3,600.00 2120068024 HC GUIDEWIRE GP024 $ 4,000.00 2120069006 HC HEMOSTATIC COLLAGEN GP006 $ 293.00 2120069008 HC HEMOSTATIC COLLAGEN GP008 $ 475.00 2120069009 HC HEMOSTATIC COLLAGEN GP009 $ 570.00 2120069013 HC HEMOSTATIC COLLAGEN GP013 $ 900.00 2120069014 HC HEMOSTATIC COLLAGEN GP014 $ 1,080.00 2120070015 HC FLOSEAL HEMOSTATIC GP015 $ 1,225.00 2120070016 HC FLOSEAL HEMOSTATIC GP016 $ 1,400.00 2120070017 HC FLOSEAL HEMOSTATIC GP017 $ 1,575.00 2120071019 HC IMPL ALLODERM GP019 $ 2,125.00 2120071022 HC IMPL ALLODERM GP022 $ 3,300.00 2120071025 HC IMPL ALLODERM GP025 $ 4,263.00 2120071037 HC IMPL ALLODERM GP037 $ 8,125.00 2120071041 HC IMPL ALLODERM GP041 $ 9,775.00 2120072013 HC IMPL ALLOGRAFT GP013 $ 900.00 2120072016 HC IMPL ALLOGRAFT GP017 $ 1,400.00 2120072018 HC IMPL ALLOGRAFT GP018 $ 1,750.00 2120072020 HC IMPL ALLOGRAFT GP020 $ 2,550.00 2120072021 HC IMPL ALLOGRAFT GP021 $ 2,888.00

2120072025 HC IMPL ALLOGRAFT GP025 $ 4,263.00 2120072042 HC IMPL ALLOGRAFT GP042 $ 10,350.00 2120072043 HC IMPL ALLOGRAFT GP043 $ 10,450.00 2120072046 HC IMPL ALLOGRAFT GP046 $ 12,600.00 2120072051 HC IMPL ALLOGRAFT GP051 $ 15,300.00 2120072053 HC IMPL ALLOGRAFT GP053 $ 16,300.00 2120072056 HC IMPL ALLOGRAFT GP056 $ 17,600.00 2120072059 HC IMPL ALLOGRAFT GP057 $ 20,000.00 2120072063 HC IMPL ALLOGRAFT GP063 $ 23,200.00 2120073013 HC IMPL ANCHOR GP013 $ 900.00 2120073016 HC IMPL ANCHOR GP016 $ 1,400.00 2120073017 HC IMPL ANCHOR GP017 $ 1,575.00 2120073018 HC IMPL ANCHOR GP018 $ 1,750.00 2120073019 HC IMPL ANCHOR GP019 $ 2,125.00 2120073020 HC IMPL ANCHOR GP020 $ 2,550.00 2120073021 HC IMPL ANCHOR GP021 $ 2,888.00 2120073022 HC IMPL ANCHOR GP022 $ 3,300.00 2120073031 HC IMPL ANCHOR GP031 $ 5,950.00 2120073034 HC IMPL ANCHOR GP034 $ 6,750.00 2120073035 HC IMPL ANCHOR GP035 $ 7,150.00 2120073036 HC IMPL ANCHOR GP036 $ 7,800.00 2120073040 HC IMPL ANCHOR GP040 $ 9,600.00 2120073041 HC IMPL ANCHOR GP041 $ 9,775.00 2120073042 HC IMPL ANCHOR GP042 $ 10,350.00 2120074037 HC IMPL ANKLE GP037 $ 8,125.00 2120075033 HC IMPL RING ANNULOPLASTY GP033 $ 6,413.00 2120075041 HC IMPL RING ANNULOPLASTY GP041 $ 9,775.00 2120075043 HC IMPL RING ANNULOPLASTY GP043 $ 10,450.00 2120076038 HC IMPL ARTICULAR SURFACE GP038 $ 8,750.00 2120077008 HC IMPL AVITINE ENDO GP008 $ 475.00 2120077013 HC IMPL AVITINE ENDO GP013 $ 900.00 2120077021 HC IMPL AVITINE ENDO GP021 $ 2,888.00 2120078027 HC IMPL BAERVELDT GP027 $ 4,875.00 2120078028 HC IMPL BAERVELDT GP028 $ 5,250.00 2120079013 HC IMPL BAR GP013 $ 900.00 2120079014 HC IMPL BAR GP014 $ 1,080.00 2120079015 HC IMPL BAR GP015 $ 1,225.00 2120079016 HC IMPL BAR GP016 $ 1,400.00 2120079017 HC IMPL BAR GP017 $ 1,575.00 2120079018 HC IMPL BAR GP018 $ 1,750.00 2120079019 HC IMPL BAR GP019 $ 2,125.00 2120079027 HC IMPL BAR GP027 $ 4,875.00 2120079031 HC IMPL BAR GP031 $ 5,950.00 2120080039 HC IMPL BLLN URIN SPHINCT GP039 $ 9,000.00 2120081025 HC IMPL BLOCK GP025 $ 4,263.00 2120081028 HC IMPL BLOCK GP028 $ 5,250.00 2120081030 HC IMPL BLOCK GP030 $ 5,800.00 2120081036 HC IMPL BLOCK GP036 $ 7,800.00 2120082011 HC IMPL BOLT GP011 $ 740.00 2120082013 HC IMPL BOLT GP013 $ 900.00 2120082014 HC IMPL BOLT GP014 $ 1,080.00 2120082015 HC IMPL BOLT GP015 $ 1,225.00 2120082017 HC IMPL BOLT GP017 $ 1,575.00

2120082018 HC IMPL BOLT GP018 $ 1,750.00 2120082023 HC IMPL BOLT GP023 $ 3,600.00 2120082025 HC IMPL BOLT GP025 $ 4,263.00 2120083017 HC IMPL BONE GP017 $ 1,575.00 2120083021 HC IMPL BONE GP021 $ 2,888.00 2120083028 HC IMPL BONE GP028 $ 5,250.00 2120083029 HC IMPL BONE GP029 $ 5,438.00 2120083030 HC IMPL BONE GP030 $ 5,800.00 2120083031 HC IMPL BONE GP031 $ 5,950.00 2120083032 HC IMPL BONE GP032 $ 6,300.00 2120083035 HC IMPL BONE GP035 $ 7,150.00 2120083036 HC IMPL BONE GP036 $ 7,800.00 2120083039 HC IMPL BONE GP039 $ 9,000.00 2120083042 HC IMPL BONE GP042 $ 10,350.00 2120083044 HC IMPL BONE GP044 $ 11,000.00 2120083046 HC IMPL BONE GP046 $ 12,600.00 2120083048 HC IMPL BONE GP048 $ 14,000.00 2120083049 HC IMPL BONE GP049 $ 14,250.00 2120083051 HC IMPL BONE GP051 $ 15,300.00 2120083052 HC IMPL BONE GP052 $ 16,200.00 2120083054 HC IMPL BONE GP054 $ 17,000.00 2120083055 HC IMPL BONE GP055 $ 17,300.00 2120083056 HC IMPL BONE GP056 $ 17,600.00 2120083058 HC IMPL BONE GP058 $ 19,200.00 2120084021 HC IMPL BONE CHIPS GP021 $ 2,888.00 2120084022 HC IMPL BONE CHIPS GP022 $ 3,300.00 2120084023 HC IMPL BONE CHIPS GP023 $ 3,600.00 2120085023 HC IMPL BONE FILLER GP023 $ 3,600.00 2120085028 HC IMPL BONE FILLER GP028 $ 5,250.00 2120085030 HC IMPL BONE FILLER GP030 $ 5,800.00 2120085032 HC IMPL BONE FILLER GP032 $ 6,300.00 2120085034 HC IMPL BONE FILLER GP034 $ 6,750.00 2120085035 HC IMPL BONE FILLER GP035 $ 7,150.00 2120085036 HC IMPL BONE FILLER GP036 $ 7,800.00 2120085037 HC IMPL BONE FILLER GP037 $ 8,125.00 2120085038 HC IMPL BONE FILLER GP038 $ 8,750.00 2120085039 HC IMPL BONE FILLER GP039 $ 9,000.00 2120085041 HC IMPL BONE FILLER GP041 $ 9,775.00 2120085046 HC IMPL BONE FILLER GP046 $ 12,600.00 2120085047 HC IMPL BONE FILLER GP047 $ 13,000.00 2120086007 HC IMPL BREAST GP007 $ 380.00 2120086017 HC IMPL BREAST GP017 $ 1,575.00 2120086022 HC IMPL BREAST GP022 $ 3,300.00 2120086025 HC IMPL BREAST GP025 $ 4,263.00 2120086026 HC IMPL BREAST GP026 $ 4,650.00 2120086029 HC IMPL BREAST GP029 $ 5,438.00 2120086030 HC IMPL BREAST GP030 $ 5,800.00 2120086031 HC IMPL BREAST GP031 $ 5,950.00 2120086032 HC IMPL BREAST GP032 $ 6,300.00 2120086035 HC IMPL BREAST GP035 $ 7,150.00 2120086036 HC IMPL BREAST GP036 $ 7,800.00 2120086037 HC IMPL BREAST GP037 $ 8,125.00 2120086043 HC IMPL BREAST GP043 $ 10,450.00

2120087013 HC IMPL COVER BUR HOLE GP013 $ 900.00 2120087014 HC IMPL COVER BUR HOLE GP014 $ 1,080.00 2120087015 HC IMPL COVER BUR HOLE GP015 $ 1,225.00 2120087016 HC IMPL COVER BUR HOLE GP016 $ 1,400.00 2120087017 HC IMPL COVER BUR HOLE GP017 $ 1,575.00 2120087018 HC IMPL COVER BUR HOLE GP018 $ 1,750.00 2120088006 HC IMPL CABLE GP006 $ 293.00 2120088020 HC IMPL CABLE GP020 $ 2,550.00 2120088021 HC IMPL CABLE GP021 $ 2,888.00 2120089035 HC IMPL CAGE GP035 $ 7,150.00 2120090048 HC IMPL CARTILAGE FRESH GP048 $ 14,000.00 2120090053 HC IMPL CARTILAGE FRESH GP053 $ 16,300.00 2120090054 HC IMPL CARTILAGE FRESH GP054 $ 17,000.00 2120090064 HC IMPL CARTILAGE FRESH GP064 $ 24,000.00 2120090068 HC IMPL CARTILAGE FRESH GP068 $ 27,200.00 2120090073 HC IMPL CARTILAGE FRESH GP073 $ 31,200.00 2120090085 HC IMPL CARTILAGE FRESH GP085 $ 40,800.00 2120090101 HC IMPL CARTILAGE FRESH GP101 $ 50,250.00 2120090103 HC IMPL CARTILAGE FRESH GP103 $ 50,370.00 2120090113 HC IMPL CARTILAGE FRESH GP113 $ 59,400.00 2120090138 HC IMPL CARTILAGE FRESH GP138 $ 136,000.00 2120091059 HC IMPL COCHLEAR GP059 $ 20,000.00 2120091068 HC IMPL COCHLEAR GP068 $ 27,200.00 2120091090 HC IMPL COCHLEAR GP090 $ 44,800.00 2120091093 HC IMPL COCHLEAR GP093 $ 47,200.00 2120091105 HC IMPL COCHLEAR GP105 $ 50,410.00 2120091107 HC IMPL COCHLEAR GP107 $ 50,516.00 2120091109 HC IMPL COCHLEAR GP109 $ 51,000.00 2120091111 HC IMPL COCHLEAR GP111 $ 51,590.00 2120091112 HC IMPL COCHLEAR GP112 $ 53,120.00 2120091113 HC IMPL COCHLEAR GP113 $ 59,400.00 2120091114 HC IMPL COCHLEAR GP114 $ 65,400.00 2120091115 HC IMPL COCHLEAR GP115 $ 71,500.00 2120091116 HC IMPL COCHLEAR GP116 $ 72,000.00 2120091117 HC IMPL COCHLEAR GP117 $ 78,000.00 2120091118 HC IMPL COCHLEAR GP118 $ 84,000.00 2120092007 HC IMPL COLLAGEN GP007 $ 380.00 2120092020 HC IMPL COLLAGEN GP020 $ 2,550.00 2120092022 HC IMPL COLLAGEN GP022 $ 3,300.00 2120092024 HC IMPL COLLAGEN GP024 $ 4,000.00 2120092030 HC IMPL COLLAGEN GP030 $ 5,800.00 2120092033 HC IMPL COLLAGEN GP033 $ 6,413.00 2120092036 HC IMPL COLLAGEN GP036 $ 7,800.00 2120092037 HC IMPL COLLAGEN GP037 $ 8,125.00 2120092038 HC IMPL COLLAGEN GP038 $ 8,750.00 2120093014 HC IMPL COLLAR GP014 $ 1,080.00 2120093015 HC IMPL COLLAR GP015 $ 1,225.00 2120093016 HC IMPL COLLAR GP016 $ 1,400.00 2120093017 HC IMPL COLLAR GP017 $ 1,575.00 2120093018 HC IMPL COLLAR GP018 $ 1,750.00 2120095045 HC IMPL CORNEAL TISSUE GP045 $ 11,550.00 2120095047 HC IMPL CORNEAL TISSUE GP047 $ 13,000.00 2120095048 HC IMPL CORNEAL TISSUE GP048 $ 14,000.00

2120095049 HC IMPL CORNEAL TISSUE GP049 $ 14,250.00 2120096015 HC IMPL CROSSLINK GP015 $ 1,225.00 2120096027 HC IMPL CROSSLINK GP027 $ 4,875.00 2120096029 HC IMPL CROSSLINK GP029 $ 5,438.00 2120096030 HC IMPL CROSSLINK GP030 $ 5,800.00 2120096031 HC IMPL CROSSLINK GP031 $ 5,950.00 2120096032 HC IMPL CROSSLINK GP032 $ 6,300.00 2120096033 HC IMPL CROSSLINK GP033 $ 6,413.00 2120096034 HC IMPL CROSSLINK GP034 $ 6,750.00 2120096035 HC IMPL CROSSLINK GP035 $ 7,150.00 2120096036 HC IMPL CROSSLINK GP036 $ 7,800.00 2120096037 HC IMPL CROSSLINK GP037 $ 8,125.00 2120096038 HC IMPL CROSSLINK GP038 $ 8,750.00 2120096039 HC IMPL CROSSLINK GP039 $ 9,000.00 2120096040 HC IMPL CROSSLINK GP040 $ 9,600.00 2120096041 HC IMPL CROSSLINK GP041 $ 9,775.00 2120097042 HC IMPL CUFF URIN SPHINCT GP042 $ 10,350.00 2120097046 HC IMPL CUFF URIN SPHINCT GP046 $ 12,600.00 2120097048 HC IMPL CUFF URIN SPHINCT GP048 $ 14,000.00 2120098042 HC IMPL CUFFS AORTIC GP042 $ 10,350.00 2120099042 HC IMPL CUFFS ILIAC GP042 $ 10,350.00 2120100051 HC IMPL CV GP051 $ 15,300.00 2120101037 HC IMPL DBX MIX GP037 $ 8,125.00 2120101047 HC IMPL DBX MIX GP047 $ 13,000.00 2120102115 HC IMPL DEFIBRILLATOR GP115 $ 71,500.00 2120103013 HC IMPL DERMAMATRIX GP013 $ 900.00 2120103014 HC IMPL DERMAMATRIX GP014 $ 1,080.00 2120103017 HC IMPL DERMAMATRIX GP017 $ 1,575.00 2120103018 HC IMPL DERMAMATRIX GP018 $ 1,750.00 2120103030 HC IMPL DERMAMATRIX GP030 $ 5,800.00 2120103031 HC IMPL DERMAMATRIX GP031 $ 5,950.00 2120103032 HC IMPL DERMAMATRIX GP032 $ 6,300.00 2120103038 HC IMPL DERMAMATRIX GP038 $ 8,750.00 2120103039 HC IMPL DERMAMATRIX GP039 $ 9,000.00 2120103040 HC IMPL DERMAMATRIX GP040 $ 9,600.00 2120103042 HC IMPL DERMAMATRIX GP042 $ 10,350.00 2120103044 HC IMPL DERMAMATRIX GP044 $ 11,000.00 2120103045 HC IMPL DERMAMATRIX GP045 $ 11,550.00 2120103055 HC IMPL DERMAMATRIX GP055 $ 17,300.00 2120103056 HC IMPL DERMAMATRIX GP056 $ 17,600.00 2120104035 HC IMPL DURAGEN GP035 $ 7,150.00 2120104039 HC IMPL DURAGEN GP039 $ 9,000.00 2120105026 HC IMPL DURASEAL GP026 $ 4,650.00 2120105027 HC IMPL DURASEAL GP027 $ 4,875.00 2120105047 HC IMPL DURASEAL GP047 $ 13,000.00 2120105050 HC IMPL DURASEAL GP050 $ 15,200.00 2120106010 HC IMPL EAR GP010 $ 665.00 2120106011 HC IMPL EAR GP011 $ 740.00 2120106012 HC IMPL EAR GP012 $ 810.00 2120106013 HC IMPL EAR GP013 $ 900.00 2120106014 HC IMPL EAR GP014 $ 1,080.00 2120106015 HC IMPL EAR GP015 $ 1,225.00 2120106016 HC IMPL EAR GP016 $ 1,400.00

2120106017 HC IMPL EAR GP017 $ 1,575.00 2120106018 HC IMPL EAR GP018 $ 1,750.00 2120106019 HC IMPL EAR GP019 $ 2,125.00 2120106020 HC IMPL EAR GP020 $ 2,550.00 2120106021 HC IMPL EAR GP021 $ 2,888.00 2120106024 HC IMPL EAR GP024 $ 4,000.00 2120106026 HC IMPL EAR GP026 $ 4,650.00 2120106048 HC IMPL EAR GP048 $ 14,000.00 2120106063 HC IMPL EAR GP063 $ 23,200.00 2120107002 HC IMPL EAR TUBE GP002 $ 50.00 2120107003 HC IMPL EAR TUBE GP003 $ 100.00 2120107004 HC IMPL EAR TUBE GP004 $ 146.00 2120107005 HC IMPL EAR TUBE GP005 $ 195.00 2120107006 HC IMPL EAR TUBE GP006 $ 293.00 2120107007 HC IMPL EAR TUBE GP007 $ 380.00 2120108035 HC IMPL ELBOW GP035 $ 7,150.00 2120109018 HC IMPL ENDURA GP018 $ 1,750.00 2120109020 HC IMPL ENDURA GP020 $ 2,550.00 2120109027 HC IMPL ENDURA GP027 $ 4,875.00 2120110014 HC IMPL ENT GP014 $ 1,080.00 2120110019 HC IMPL ENT GP019 $ 2,125.00 2120110020 HC IMPL ENT GP020 $ 2,550.00 2120110021 HC IMPL ENT GP021 $ 2,888.00 2120111016 HC IMPL FASCIA LATA GP016 $ 1,400.00 2120111017 HC IMPL FASCIA LATA GP017 $ 1,575.00 2120111019 HC IMPL FASCIA LATA GP019 $ 2,125.00 2120111020 HC IMPL FASCIA LATA GP020 $ 2,550.00 2120111021 HC IMPL FASCIA LATA GP021 $ 2,888.00 2120111023 HC IMPL FASCIA LATA GP023 $ 3,600.00 2120111024 HC IMPL FASCIA LATA GP024 $ 4,000.00 2120111031 HC IMPL FASCIA LATA GP031 $ 5,950.00 2120111033 HC IMPL FASCIA LATA GP033 $ 6,413.00 2120112021 HC IMPL FEMORAL GP021 $ 2,888.00 2120112027 HC IMPL FEMORAL GP027 $ 4,875.00 2120112031 HC IMPL FEMORAL GP031 $ 5,950.00 2120112033 HC IMPL FEMORAL GP033 $ 6,413.00 2120112034 HC IMPL FEMORAL GP034 $ 6,750.00 2120112036 HC IMPL FEMORAL GP036 $ 7,800.00 2120112040 HC IMPL FEMORAL GP040 $ 9,600.00 2120112041 HC IMPL FEMORAL GP041 $ 9,775.00 2120112042 HC IMPL FEMORAL GP042 $ 10,350.00 2120112050 HC IMPL FEMORAL GP050 $ 15,200.00 2120112055 HC IMPL FEMORAL GP055 $ 17,300.00 2120112056 HC IMPL FEMORAL GP056 $ 17,600.00 2120112057 HC IMPL FEMORAL GP057 $ 18,400.00 2120113040 HC IMPL FEMUR GP040 $ 9,600.00 2120113044 HC IMPL FEMUR GP044 $ 11,000.00 2120113046 HC IMPL FEMUR GP046 $ 12,600.00 2120113047 HC IMPL FEMUR GP047 $ 13,000.00 2120113048 HC IMPL FEMUR GP048 $ 14,000.00 2120113050 HC IMPL FEMUR GP050 $ 15,200.00 2120113051 HC IMPL FEMUR GP051 $ 15,300.00 2120113118 HC IMPL FEMUR GP118 $ 84,000.00

2120114025 HC IMPL FIBULA GP025 $ 4,263.00 2120114037 HC IMPL FIBULA GP037 $ 8,125.00 2120116035 HC IMPL FILTER VENA CAVA GP035 $ 7,150.00 2120117018 HC IMPL FINGER JOINT GP018 $ 1,750.00 2120117023 HC IMPL FINGER JOINT GP023 $ 3,600.00 2120117024 HC IMPL FINGER JOINT GP024 $ 4,000.00 2120117025 HC IMPL FINGER JOINT GP025 $ 4,263.00 2120117026 HC IMPL FINGER JOINT GP026 $ 4,650.00 2120117027 HC IMPL FINGER JOINT GP027 $ 4,875.00 2120117028 HC IMPL FINGER JOINT GP028 $ 5,250.00 2120117033 HC IMPL FINGER JOINT GP033 $ 6,413.00 2120117035 HC IMPL FINGER JOINT GP035 $ 7,150.00 2120118093 HC IMPL GEN NROSTIM NONRCHG GP093 $ 47,200.00 2120118099 HC IMPL GEN NROSTIM NONRCHG GP099 $ 50,050.00 2120118112 HC IMPL GEN NROSTIM NONRCHG GP112 $ 53,120.00 2120118113 HC IMPL GEN NROSTIM NONRCHG GP113 $ 59,400.00 2120120029 HC IMPL GRAFT BONE GP029 $ 5,438.00 2120120035 HC IMPL GRAFT BONE GP035 $ 7,150.00 2120120036 HC IMPL GRAFT BONE GP036 $ 7,800.00 2120120038 HC IMPL GRAFT BONE GP038 $ 8,750.00 2120120040 HC IMPL GRAFT BONE GP040 $ 9,600.00 2120120044 HC IMPL GRAFT BONE GP044 $ 11,000.00 2120120045 HC IMPL GRAFT BONE GP045 $ 11,550.00 2120120047 HC IMPL GRAFT BONE GP047 $ 13,000.00 2120120048 HC IMPL GRAFT BONE GP048 $ 14,000.00 2120120049 HC IMPL GRAFT BONE GP049 $ 14,250.00 2120121031 HC IMPL GRAFT BOVINE GP031 $ 5,950.00 2120121032 HC IMPL GRAFT BOVINE GP032 $ 6,300.00 2120122016 HC IMPL GRAFT DURAGEN GP016 $ 1,400.00 2120122017 HC IMPL GRAFT DURAGEN GP017 $ 1,575.00 2120122020 HC IMPL GRAFT DURAGEN GP020 $ 2,550.00 2120122024 HC IMPL GRAFT DURAGEN GP024 $ 4,000.00 2120122025 HC IMPL GRAFT DURAGEN GP025 $ 4,263.00 2120122026 HC IMPL GRAFT DURAGEN GP026 $ 4,650.00 2120122034 HC IMPL GRAFT DURAGEN GP034 $ 6,750.00 2120122035 HC IMPL GRAFT DURAGEN GP035 $ 7,150.00 2120122038 HC IMPL GRAFT DURAGEN GP038 $ 8,750.00 2120123025 HC IMPL GRAFT FIB SHAFT GP025 $ 4,263.00 2120123027 HC IMPL GRAFT FIB SHAFT GP027 $ 4,875.00 2120123029 HC IMPL GRAFT FIB SHAFT GP029 $ 5,438.00 2120124020 HC IMPL GRAFT GORTEX GP020 $ 2,550.00 2120124021 HC IMPL GRAFT GORTEX GP021 $ 2,888.00 2120124022 HC IMPL GRAFT GORTEX GP022 $ 3,300.00 2120124023 HC IMPL GRAFT GORTEX GP023 $ 3,600.00 2120124024 HC IMPL GRAFT GORTEX GP024 $ 4,000.00 2120124025 HC IMPL GRAFT GORTEX GP025 $ 4,263.00 2120124026 HC IMPL GRAFT GORTEX GP026 $ 4,650.00 2120124027 HC IMPL GRAFT GORTEX GP027 $ 4,875.00 2120124028 HC IMPL GRAFT GORTEX GP028 $ 5,250.00 2120124029 HC IMPL GRAFT GORTEX GP029 $ 5,438.00 2120124030 HC IMPL GRAFT GORTEX GP030 $ 5,800.00 2120124031 HC IMPL GRAFT GORTEX GP031 $ 5,950.00 2120124032 HC IMPL GRAFT GORTEX GP032 $ 6,300.00

2120124033 HC IMPL GRAFT GORTEX GP033 $ 6,413.00 2120124034 HC IMPL GRAFT GORTEX GP034 $ 6,750.00 2120124035 HC IMPL GRAFT GORTEX GP035 $ 7,150.00 2120125019 HC IMPL GRAFT HEMASHIELD GP019 $ 2,125.00 2120125020 HC IMPL GRAFT HEMASHIELD GP020 $ 2,550.00 2120125021 HC IMPL GRAFT HEMASHIELD GP021 $ 2,888.00 2120125022 HC IMPL GRAFT HEMASHIELD GP022 $ 3,300.00 2120125023 HC IMPL GRAFT HEMASHIELD GP023 $ 3,600.00 2120125024 HC IMPL GRAFT HEMASHIELD GP024 $ 4,000.00 2120125025 HC IMPL GRAFT HEMASHIELD GP025 $ 4,263.00 2120125026 HC IMPL GRAFT HEMASHIELD GP026 $ 4,650.00 2120125027 HC IMPL GRAFT HEMASHIELD GP027 $ 4,875.00 2120125030 HC IMPL GRAFT HEMASHIELD GP030 $ 5,800.00 2120125033 HC IMPL GRAFT HEMASHIELD GP033 $ 6,413.00 2120125036 HC IMPL GRAFT HEMASHIELD GP036 $ 7,800.00 2120125037 HC IMPL GRAFT HEMASHIELD GP037 $ 8,125.00 2120125045 HC IMPL GRAFT HEMASHIELD GP045 $ 11,550.00 2120126018 HC IMPL GRAFT PLUG GP018 $ 1,750.00 2120126019 HC IMPL GRAFT PLUG GP019 $ 2,125.00 2120127013 HC IMPL GRAFT VASC GP013 $ 900.00 2120127014 HC IMPL GRAFT VASC GP014 $ 1,080.00 2120127017 HC IMPL GRAFT VASC GP017 $ 1,575.00 2120127018 HC IMPL GRAFT VASC GP018 $ 1,750.00 2120127019 HC IMPL GRAFT VASC GP019 $ 2,125.00 2120127020 HC IMPL GRAFT VASC GP020 $ 2,550.00 2120127021 HC IMPL GRAFT VASC GP021 $ 2,888.00 2120127022 HC IMPL GRAFT VASC GP022 $ 3,300.00 2120127023 HC IMPL GRAFT VASC GP023 $ 3,600.00 2120127024 HC IMPL GRAFT VASC GP024 $ 4,000.00 2120127025 HC IMPL GRAFT VASC GP025 $ 4,263.00 2120127026 HC IMPL GRAFT VASC GP026 $ 4,650.00 2120127027 HC IMPL GRAFT VASC GP027 $ 4,875.00 2120127028 HC IMPL GRAFT VASC GP028 $ 5,250.00 2120127029 HC IMPL GRAFT VASC GP029 $ 5,438.00 2120127030 HC IMPL GRAFT VASC GP030 $ 5,800.00 2120127031 HC IMPL GRAFT VASC GP031 $ 5,950.00 2120127032 HC IMPL GRAFT VASC GP032 $ 6,300.00 2120127033 HC IMPL GRAFT VASC GP033 $ 6,413.00 2120127034 HC IMPL GRAFT VASC GP034 $ 6,750.00 2120127039 HC IMPL GRAFT VASC GP039 $ 9,000.00 2120127047 HC IMPL GRAFT VASC GP047 $ 13,000.00 2120127053 HC IMPL GRAFT VASC GP053 $ 6,413.00 2120127072 HC IMPL GRAFT VASC GP072 $ 30,400.00 2120127075 HC IMPL GRAFT VASC GP075 $ 32,800.00 2120127104 HC IMPL GRAFT VASC GP104 $ 50,400.00 2120127105 HC IMPL GRAFT VASC GP105 $ 50,410.00 2120127106 HC IMPL GRAFT VASC GP106 $ 50,450.00 2120128015 HC IMPL GRAFTON GP015 $ 1,225.00 2120128026 HC IMPL GRAFTON GP026 $ 4,650.00 2120128032 HC IMPL GRAFTON GP032 $ 6,300.00 2120128039 HC IMPL GRAFTON GP039 $ 9,000.00 2120129013 HC IMPL HIP GP013 $ 900.00 2120129017 HC IMPL HIP GP017 $ 1,575.00

2120129018 HC IMPL HIP GP018 $ 1,750.00 2120129019 HC IMPL HIP GP019 $ 2,125.00 2120129021 HC IMPL HIP GP021 $ 2,888.00 2120129023 HC IMPL HIP GP023 $ 3,600.00 2120129024 HC IMPL HIP GP024 $ 4,000.00 2120129026 HC IMPL HIP GP026 $ 4,650.00 2120129027 HC IMPL HIP GP027 $ 4,875.00 2120129029 HC IMPL HIP GP029 $ 5,438.00 2120129030 HC IMPL HIP GP030 $ 5,800.00 2120129031 HC IMPL HIP GP031 $ 5,950.00 2120129032 HC IMPL HIP GP032 $ 6,300.00 2120129033 HC IMPL HIP GP033 $ 6,413.00 2120129034 HC IMPL HIP GP034 $ 6,750.00 2120129035 HC IMPL HIP GP035 $ 7,150.00 2120129036 HC IMPL HIP GP036 $ 7,800.00 2120129038 HC IMPL HIP GP038 $ 8,750.00 2120129041 HC IMPL HIP GP041 $ 9,775.00 2120129042 HC IMPL HIP GP042 $ 10,350.00 2120129043 HC IMPL HIP GP043 $ 10,450.00 2120129044 HC IMPL HIP GP044 $ 11,000.00 2120129045 HC IMPL HIP GP045 $ 11,550.00 2120129046 HC IMPL HIP GP046 $ 12,600.00 2120129047 HC IMPL HIP GP047 $ 13,000.00 2120129048 HC IMPL HIP GP048 $ 14,000.00 2120129050 HC IMPL HIP GP050 $ 15,200.00 2120129051 HC IMPL HIP GP051 $ 15,300.00 2120129054 HC IMPL HIP GP054 $ 17,000.00 2120129059 HC IMPL HIP GP059 $ 20,000.00 2120130013 HC IMPL HOLE ELIMINATOR GP013 $ 900.00 2120131003 HC IMPL HOOK GP003 $ 100.00 2120131006 HC IMPL HOOK GP006 $ 293.00 2120131007 HC IMPL HOOK GP007 $ 380.00 2120131012 HC IMPL HOOK GP012 $ 810.00 2120131015 HC IMPL HOOK GP015 $ 1,225.00 2120131016 HC IMPL HOOK GP016 $ 1,400.00 2120131017 HC IMPL HOOK GP017 $ 1,575.00 2120131018 HC IMPL HOOK GP018 $ 1,750.00 2120131019 HC IMPL HOOK GP019 $ 2,125.00 2120131020 HC IMPL HOOK GP020 $ 2,550.00 2120131021 HC IMPL HOOK GP021 $ 2,888.00 2120131022 HC IMPL HOOK GP022 $ 3,300.00 2120131023 HC IMPL HOOK GP023 $ 3,600.00 2120131024 HC IMPL HOOK GP024 $ 4,000.00 2120131025 HC IMPL HOOK GP025 $ 4,263.00 2120131026 HC IMPL HOOK GP026 $ 4,650.00 2120131027 HC IMPL HOOK GP027 $ 4,875.00 2120131028 HC IMPL HOOK GP028 $ 5,250.00 2120131029 HC IMPL HOOK GP029 $ 5,438.00 2120131030 HC IMPL HOOK GP030 $ 5,800.00 2120131031 HC IMPL HOOK GP031 $ 5,950.00 2120131032 HC IMPL HOOK GP032 $ 6,300.00 2120131033 HC IMPL HOOK GP033 $ 6,413.00 2120131034 HC IMPL HOOK GP034 $ 6,750.00

2120131035 HC IMPL HOOK GP035 $ 7,150.00 2120131036 HC IMPL HOOK GP036 $ 7,800.00 2120131038 HC IMPL HOOK GP038 $ 8,750.00 2120131039 HC IMPL HOOK GP039 $ 9,000.00 2120132023 HC IMPL HUMERAL GP023 $ 3,600.00 2120132033 HC IMPL HUMERAL GP033 $ 6,413.00 2120132038 HC IMPL HUMERAL GP038 $ 8,750.00 2120132044 HC IMPL HUMERAL GP044 $ 11,000.00 2120132048 HC IMPL HUMERAL GP048 $ 14,000.00 2120132050 HC IMPL HUMERAL GP050 $ 15,200.00 2120132072 HC IMPL HUMERAL GP072 $ 30,400.00 2120132078 HC IMPL HUMERAL GP078 $ 35,200.00 2120133043 HC IMPL ILIAC EXT GP043 $ 10,450.00 2120134050 HC IMPL INFUSE GP050 $ 15,200.00 2120134051 HC IMPL INFUSE GP051 $ 15,300.00 2120134056 HC IMPL INFUSE GP056 $ 17,600.00 2120134059 HC IMPL INFUSE GP059 $ 20,000.00 2120136012 HC IMPL IOL GP012 $ 810.00 2120136013 HC IMPL IOL GP013 $ 900.00 2120138019 HC IMPL KNEE GP019 $ 2,125.00 2120138021 HC IMPL KNEE GP021 $ 2,888.00 2120138022 HC IMPL KNEE GP022 $ 3,300.00 2120138023 HC IMPL KNEE GP023 $ 3,600.00 2120138024 HC IMPL KNEE GP024 $ 4,000.00 2120138025 HC IMPL KNEE GP025 $ 4,263.00 2120138026 HC IMPL KNEE GP026 $ 4,650.00 2120138027 HC IMPL KNEE GP027 $ 4,875.00 2120138028 HC IMPL KNEE GP028 $ 5,250.00 2120138029 HC IMPL KNEE GP029 $ 5,438.00 2120138030 HC IMPL KNEE GP030 $ 5,800.00 2120138031 HC IMPL KNEE GP031 $ 5,950.00 2120138032 HC IMPL KNEE GP032 $ 6,300.00 2120138033 HC IMPL KNEE GP033 $ 6,413.00 2120138034 HC IMPL KNEE GP034 $ 6,750.00 2120138035 HC IMPL KNEE GP035 $ 7,150.00 2120138036 HC IMPL KNEE GP036 $ 7,800.00 2120138037 HC IMPL KNEE GP037 $ 8,125.00 2120138038 HC IMPL KNEE GP038 $ 8,750.00 2120138039 HC IMPL KNEE GP039 $ 9,000.00 2120138042 HC IMPL KNEE GP042 $ 10,350.00 2120138047 HC IMPL KNEE GP047 $ 13,000.00 2120138050 HC IMPL KNEE GP050 $ 15,200.00 2120138052 HC IMPL KNEE GP052 $ 16,200.00 2120138053 HC IMPL KNEE GP053 $ 16,300.00 2120138054 HC IMPL KNEE GP054 $ 17,000.00 2120138058 HC IMPL KNEE GP058 $ 19,200.00 2120138060 HC IMPL KNEE GP060 $ 20,800.00 2120138061 HC IMPL KNEE GP061 $ 21,600.00 2120138062 HC IMPL KNEE GP062 $ 22,400.00 2120138065 HC IMPL KNEE GP065 $ 24,800.00 2120139019 HC IMPL LEAD NEUROSTIM GP019 $ 2,125.00 2120139040 HC IMPL LEAD NEUROSTIM GP040 $ 9,600.00 2120139043 HC IMPL LEAD NEUROSTIM GP043 $ 10,450.00

2120139047 HC IMPL LEAD NEUROSTIM GP047 $ 13,000.00 2120139048 HC IMPL LEAD NEUROSTIM GP048 $ 14,000.00 2120139049 HC IMPL LEAD NEUROSTIM GP049 $ 14,250.00 2120139055 HC IMPL LEAD NEUROSTIM GP055 $ 17,300.00 2120139056 HC IMPL LEAD NEUROSTIM GP056 $ 17,600.00 2120139062 HC IMPL LEAD NEUROSTIM GP062 $ 22,400.00 2120139063 HC IMPL LEAD NEUROSTIM GP063 $ 23,200.00 2120140043 HC IMPL LIMB GP043 $ 10,450.00 2120141017 HC IMPL LINER GP017 $ 1,575.00 2120141021 HC IMPL LINER GP021 $ 2,888.00 2120141027 HC IMPL LINER GP027 $ 4,875.00 2120141028 HC IMPL LINER GP028 $ 5,250.00 2120141038 HC IMPL LINER GP038 $ 8,750.00 2120141039 HC IMPL LINER GP039 $ 9,000.00 2120141045 HC IMPL LINER GP045 $ 11,550.00 2120141047 HC IMPL LINER GP047 $ 13,000.00 2120141048 HC IMPL LINER GP048 $ 14,000.00 2120141050 HC IMPL LINER GP050 $ 15,200.00 2120142018 HC IMPL LINK GP018 $ 1,750.00 2120142019 HC IMPL LINK GP019 $ 2,125.00 2120142030 HC IMPL LINK GP030 $ 5,800.00 2120142046 HC IMPL LINK GP046 $ 12,600.00 2120144018 HC IMPL LINK EBI GP018 $ 1,750.00 2120144019 HC IMPL LINK EBI GP019 $ 2,125.00 2120145008 HC IMPL NUT LOCKING GP008 $ 475.00 2120145009 HC IMPL NUT LOCKING GP009 $ 570.00 2120145012 HC IMPL NUT LOCKING GP012 $ 810.00 2120145018 HC IMPL NUT LOCKING GP018 $ 1,750.00 2120146005 HC IMPL MESH GP005 $ 195.00 2120146008 HC IMPL MESH GP008 $ 475.00 2120146011 HC IMPL MESH GP011 $ 740.00 2120146013 HC IMPL MESH GP013 $ 900.00 2120146015 HC IMPL MESH GP015 $ 1,225.00 2120146016 HC IMPL MESH GP016 $ 1,400.00 2120146017 HC IMPL MESH GP017 $ 1,575.00 2120146018 HC IMPL MESH GP018 $ 1,750.00 2120146019 HC IMPL MESH GP019 $ 2,125.00 2120146020 HC IMPL MESH GP020 $ 2,550.00 2120146021 HC IMPL MESH GP021 $ 2,888.00 2120146022 HC IMPL MESH GP022 $ 3,300.00 2120146023 HC IMPL MESH GP023 $ 3,600.00 2120146024 HC IMPL MESH GP024 $ 4,000.00 2120146025 HC IMPL MESH GP025 $ 4,263.00 2120146026 HC IMPL MESH GP026 $ 4,650.00 2120146027 HC IMPL MESH GP027 $ 4,875.00 2120146028 HC IMPL MESH GP028 $ 5,250.00 2120146029 HC IMPL MESH GP029 $ 5,438.00 2120146030 HC IMPL MESH GP030 $ 5,800.00 2120146031 HC IMPL MESH GP031 $ 5,950.00 2120146032 HC IMPL MESH GP032 $ 6,300.00 2120146033 HC IMPL MESH GP033 $ 6,413.00 2120146034 HC IMPL MESH GP034 $ 6,750.00 2120146035 HC IMPL MESH GP035 $ 7,150.00

2120146036 HC IMPL MESH GP036 $ 7,800.00 2120146037 HC IMPL MESH GP037 $ 8,125.00 2120146038 HC IMPL MESH GP038 $ 8,750.00 2120146039 HC IMPL MESH GP039 $ 9,000.00 2120146040 HC IMPL MESH GP040 $ 9,600.00 2120146041 HC IMPL MESH GP041 $ 9,775.00 2120146042 HC IMPL MESH GP042 $ 10,350.00 2120146043 HC IMPL MESH GP043 $ 10,450.00 2120146044 HC IMPL MESH GP044 $ 11,000.00 2120146045 HC IMPL MESH GP045 $ 11,550.00 2120146047 HC IMPL MESH GP047 $ 13,000.00 2120146048 HC IMPL MESH GP048 $ 14,000.00 2120146049 HC IMPL MESH GP049 $ 14,250.00 2120146053 HC IMPL MESH GP053 $ 16,300.00 2120146054 HC IMPL MESH GP054 $ 17,000.00 2120146056 HC IMPL MESH GP056 $ 17,600.00 2120146057 HC IMPL MESH GP057 $ 18,400.00 2120146058 HC IMPL MESH GP058 $ 19,200.00 2120146060 HC IMPL MESH GP060 $ 20,800.00 2120146066 HC IMPL MESH GP066 $ 25,600.00 2120146072 HC IMPL MESH GP072 $ 30,400.00 2120146074 HC IMPL MESH GP074 $ 32,000.00 2120146083 HC IMPL MESH GP083 $ 39,200.00 2120147017 HC IMPL NAIL GP017 $ 1,575.00 2120147018 HC IMPL NAIL GP018 $ 1,750.00 2120147019 HC IMPL NAIL GP019 $ 2,125.00 2120147020 HC IMPL NAIL GP020 $ 2,550.00 2120147021 HC IMPL NAIL GP021 $ 2,888.00 2120147024 HC IMPL NAIL GP024 $ 4,000.00 2120147026 HC IMPL NAIL GP026 $ 4,650.00 2120147027 HC IMPL NAIL GP027 $ 4,875.00 2120147029 HC IMPL NAIL GP029 $ 5,438.00 2120147030 HC IMPL NAIL GP030 $ 5,800.00 2120147031 HC IMPL NAIL GP031 $ 5,950.00 2120147032 HC IMPL NAIL GP032 $ 6,300.00 2120147034 HC IMPL NAIL GP034 $ 6,750.00 2120147035 HC IMPL NAIL GP035 $ 7,150.00 2120147036 HC IMPL NAIL GP036 $ 7,800.00 2120147037 HC IMPL NAIL GP037 $ 8,125.00 2120147038 HC IMPL NAIL GP038 $ 8,750.00 2120147039 HC IMPL NAIL GP039 $ 9,000.00 2120148033 HC IMPL NEURAGEN GP033 $ 6,413.00 2120149010 HC IMPL NEURO GP010 $ 665.00 2120149027 HC IMPL NEURO GP027 $ 4,875.00 2120149043 HC IMPL NEURO GP043 $ 10,450.00 2120149044 HC IMPL NEURO GP044 $ 11,000.00 2120149045 HC IMPL NEURO GP045 $ 11,550.00 2120149046 HC IMPL NEURO GP046 $ 12,600.00 2120149048 HC IMPL NEURO GP048 $ 14,000.00 2120149050 HC IMPL NEURO GP050 $ 15,200.00 2120149057 HC IMPL NEURO GP057 $ 18,400.00 2120150003 HC IMPL NUT GP003 $ 100.00 2120150008 HC IMPL NUT GP008 $ 475.00

2120150009 HC IMPL NUT GP009 $ 570.00 2120150010 HC IMPL NUT GP010 $ 665.00 2120150011 HC IMPL NUT GP011 $ 740.00 2120150012 HC IMPL NUT GP012 $ 810.00 2120150013 HC IMPL NUT GP013 $ 900.00 2120150017 HC IMPL NUT GP017 $ 1,575.00 2120150018 HC IMPL NUT GP018 $ 1,750.00 2120150020 HC IMPL NUT GP020 $ 2,550.00 2120150022 HC IMPL NUT GP022 $ 3,300.00 2120150025 HC IMPL NUT GP025 $ 4,263.00 2120150034 HC IMPL NUT GP034 $ 6,750.00 2120151020 HC IMPL MESH ORBITAL FLOOR GP020 $ 2,550.00 2120151021 HC IMPL MESH ORBITAL FLOOR GP021 $ 2,888.00 2120151034 HC IMPL MESH ORBITAL FLOOR GP034 $ 6,750.00 2120152026 HC IMPL CLAMP ORTHO FIX GP026 $ 4,650.00 2120152032 HC IMPL CLAMP ORTHO FIX GP032 $ 6,300.00 2120152033 HC IMPL CLAMP ORTHO FIX GP033 $ 6,413.00 2120153015 HC IMPL PATCH GORTEX GP015 $ 1,225.00 2120153018 HC IMPL PATCH GORTEX GP018 $ 1,750.00 2120153019 HC IMPL PATCH GORTEX GP019 $ 2,125.00 2120153020 HC IMPL PATCH GORTEX GP020 $ 2,550.00 2120154012 HC IMPL PATCH HEMA GP012 $ 810.00 2120154013 HC IMPL PATCH HEMA GP013 $ 900.00 2120154014 HC IMPL PATCH HEMA GP014 $ 1,080.00 2120154019 HC IMPL PATCH HEMA GP019 $ 2,125.00 2120154024 HC IMPL PATCH HEMA GP024 $ 4,000.00 2120155017 HC IMPL PATCH MESH GP017 $ 1,575.00 2120155018 HC IMPL PATCH MESH GP018 $ 1,750.00 2120155020 HC IMPL PATCH MESH GP020 $ 2,550.00 2120155022 HC IMPL PATCH MESH GP022 $ 3,300.00 2120155023 HC IMPL PATCH MESH GP023 $ 3,600.00 2120155030 HC IMPL PATCH MESH GP030 $ 5,800.00 2120155031 HC IMPL PATCH MESH GP031 $ 5,950.00 2120155035 HC IMPL PATCH MESH GP035 $ 7,150.00 2120155038 HC IMPL PATCH MESH GP038 $ 8,750.00 2120155042 HC IMPL PATCH MESH GP042 $ 10,350.00 2120156017 HC IMPL PATCH PERICARD GP017 $ 1,575.00 2120156019 HC IMPL PATCH PERICARD GP019 $ 2,125.00 2120156020 HC IMPL PATCH PERICARD GP020 $ 2,550.00 2120156021 HC IMPL PATCH PERICARD GP021 $ 2,888.00 2120156023 HC IMPL PATCH PERICARD GP023 $ 3,600.00 2120156024 HC IMPL PATCH PERICARD GP024 $ 4,000.00 2120156025 HC IMPL PATCH PERICARD GP025 $ 4,263.00 2120157031 HC IMPL PATCH SFT TISS GP031 $ 5,950.00 2120158035 HC IMPL PATELLA TENDON GRFT GP035 $ 7,150.00 2120158042 HC IMPL PATELLA TENDON GRFT GP042 $ 10,350.00 2120158044 HC IMPL PATELLA TENDON GRFT GP044 $ 11,000.00 2120158045 HC IMPL PATELLA TENDON GRFT GP045 $ 11,550.00 2120158046 HC IMPL PATELLA TENDON GRFT GP046 $ 12,600.00 2120158047 HC IMPL PATELLA TENDON GRFT GP047 $ 13,000.00 2120158048 HC IMPL PATELLA TENDON GRFT GP048 $ 14,000.00 2120158054 HC IMPL PATELLA TENDON GRFT GP054 $ 17,000.00 2120159022 HC IMPL PELVICOL GP022 $ 3,300.00

2120159030 HC IMPL PELVICOL GP030 $ 5,800.00 2120160022 HC IMPL PENILE INFL GP022 $ 3,300.00 2120160048 HC IMPL PENILE INFL GP048 $ 14,000.00 2120160053 HC IMPL PENILE INFL GP053 $ 16,300.00 2120160067 HC IMPL PENILE INFL GP067 $ 26,400.00 2120160068 HC IMPL PENILE INFL GP068 $ 27,200.00 2120161046 HC IMPL PENILE NON INFL GP046 $ 12,600.00 2120161049 HC IMPL PENILE NON INFL GP049 $ 14,250.00 2120162018 HC IMPL PERICARDIUM GP018 $ 1,750.00 2120162019 HC IMPL PERICARDIUM GP019 $ 2,125.00 2120162023 HC IMPL PERICARDIUM GP023 $ 3,600.00 2120162031 HC IMPL PERICARDIUM GP031 $ 5,950.00 2120163002 HC IMPL PLATE GP002 $ 50.00 2120163003 HC IMPL PLATE GP003 $ 100.00 2120163005 HC IMPL PLATE GP005 $ 195.00 2120163006 HC IMPL PLATE GP006 $ 293.00 2120163007 HC IMPL PLATE GP007 $ 380.00 2120163008 HC IMPL PLATE GP008 $ 475.00 2120163009 HC IMPL PLATE GP009 $ 570.00 2120163010 HC IMPL PLATE GP010 $ 665.00 2120163011 HC IMPL PLATE GP011 $ 740.00 2120163012 HC IMPL PLATE GP012 $ 810.00 2120163013 HC IMPL PLATE GP013 $ 900.00 2120163014 HC IMPL PLATE GP014 $ 1,080.00 2120163015 HC IMPL PLATE GP015 $ 1,225.00 2120163016 HC IMPL PLATE GP016 $ 1,400.00 2120163017 HC IMPL PLATE GP017 $ 1,575.00 2120163018 HC IMPL PLATE GP018 $ 1,750.00 2120163019 HC IMPL PLATE GP019 $ 2,125.00 2120163020 HC IMPL PLATE GP020 $ 2,550.00 2120163021 HC IMPL PLATE GP021 $ 2,888.00 2120163022 HC IMPL PLATE GP022 $ 3,300.00 2120163023 HC IMPL PLATE GP023 $ 3,600.00 2120163024 HC IMPL PLATE GP024 $ 4,000.00 2120163025 HC IMPL PLATE GP025 $ 4,263.00 2120163026 HC IMPL PLATE GP026 $ 4,650.00 2120163027 HC IMPL PLATE GP027 $ 4,875.00 2120163028 HC IMPL PLATE GP028 $ 5,250.00 2120163029 HC IMPL PLATE GP029 $ 5,438.00 2120163030 HC IMPL PLATE GP030 $ 5,800.00 2120163031 HC IMPL PLATE GP031 $ 5,950.00 2120163032 HC IMPL PLATE GP032 $ 6,300.00 2120163033 HC IMPL PLATE GP033 $ 6,413.00 2120163034 HC IMPL PLATE GP034 $ 6,750.00 2120163035 HC IMPL PLATE GP035 $ 7,150.00 2120163036 HC IMPL PLATE GP036 $ 7,800.00 2120163037 HC IMPL PLATE GP037 $ 8,125.00 2120163038 HC IMPL PLATE GP038 $ 8,750.00 2120163039 HC IMPL PLATE GP039 $ 9,000.00 2120163040 HC IMPL PLATE GP040 $ 9,600.00 2120163041 HC IMPL PLATE GP041 $ 9,775.00 2120163042 HC IMPL PLATE GP042 $ 10,350.00 2120163043 HC IMPL PLATE GP043 $ 10,450.00

2120163044 HC IMPL PLATE GP044 $ 11,000.00 2120163045 HC IMPL PLATE GP045 $ 11,550.00 2120163046 HC IMPL PLATE GP046 $ 12,600.00 2120163047 HC IMPL PLATE GP047 $ 13,000.00 2120163048 HC IMPL PLATE GP048 $ 14,000.00 2120163050 HC IMPL PLATE GP050 $ 15,200.00 2120163051 HC IMPL PLATE GP051 $ 15,300.00 2120163054 HC IMPL PLATE GP054 $ 17,000.00 2120163055 HC IMPL PLATE GP055 $ 17,300.00 2120163056 HC IMPL PLATE GP056 $ 17,600.00 2120165007 HC IMPL PLUG GP007 $ 380.00 2120165012 HC IMPL PLUG GP012 $ 810.00 2120165013 HC IMPL PLUG GP013 $ 900.00 2120165017 HC IMPL PLUG GP017 $ 1,575.00 2120165018 HC IMPL PLUG GP018 $ 1,750.00 2120165019 HC IMPL PLUG GP019 $ 2,125.00 2120165020 HC IMPL PLUG GP020 $ 2,550.00 2120165021 HC IMPL PLUG GP021 $ 2,888.00 2120165022 HC IMPL PLUG GP022 $ 3,300.00 2120165024 HC IMPL PLUG GP024 $ 4,000.00 2120165027 HC IMPL PLUG GP027 $ 4,875.00 2120165029 HC IMPL PLUG GP029 $ 5,438.00 2120165030 HC IMPL PLUG GP030 $ 5,800.00 2120165032 HC IMPL PLUG GP032 $ 6,300.00 2120165036 HC IMPL PLUG GP036 $ 7,800.00 2120165042 HC IMPL PLUG GP042 $ 10,350.00 2120166005 HC IMPL PORT GP005 $ 195.00 2120166018 HC IMPL PORT GP018 $ 1,750.00 2120166020 HC IMPL PORT GP020 $ 2,550.00 2120166024 HC IMPL PORT GP024 $ 4,000.00 2120166026 HC IMPL PORT GP026 $ 4,650.00 2120166028 HC IMPL PORT GP028 $ 5,250.00 2120167040 HC IMPL PULMON ART GP040 $ 9,600.00 2120167044 HC IMPL PULMON ART GP044 $ 11,000.00 2120167045 HC IMPL PULMON ART GP045 $ 11,550.00 2120167048 HC IMPL PULMON ART GP048 $ 14,000.00 2120167050 HC IMPL PULMON ART GP050 $ 15,200.00 2120167058 HC IMPL PULMON ART GP058 $ 19,200.00 2120167059 HC IMPL PULMON ART GP059 $ 20,000.00 2120167061 HC IMPL PULMON ART GP061 $ 21,600.00 2120167062 HC IMPL PULMON ART GP062 $ 22,400.00 2120167063 HC IMPL PULMON ART GP063 $ 23,200.00 2120168047 HC IMPL PUMP CONTR URIN SP GP047 $ 13,000.00 2120169082 HC IMPL PUMP PAIN GP082 $ 38,400.00 2120170045 HC IMPL PUMP PENILE INFL GP045 $ 11,550.00 2120170049 HC IMPL PUMP PENILE INFL GP049 $ 14,250.00 2120170051 HC IMPL PUMP PENILE INFL GP051 $ 15,300.00 2120171012 HC IMPL PUTTY BONE GP012 $ 810.00 2120171016 HC IMPL PUTTY BONE GP016 $ 1,400.00 2120171017 HC IMPL PUTTY BONE GP017 $ 1,575.00 2120171018 HC IMPL PUTTY BONE GP018 $ 1,750.00 2120171028 HC IMPL PUTTY BONE GP028 $ 5,250.00 2120171029 HC IMPL PUTTY BONE GP029 $ 5,438.00

2120171030 HC IMPL PUTTY BONE GP030 $ 5,800.00 2120171032 HC IMPL PUTTY BONE GP032 $ 6,300.00 2120171034 HC IMPL PUTTY BONE GP034 $ 6,750.00 2120171036 HC IMPL PUTTY BONE GP036 $ 7,800.00 2120171037 HC IMPL PUTTY BONE GP037 $ 8,125.00 2120171038 HC IMPL PUTTY BONE GP038 $ 8,750.00 2120171044 HC IMPL PUTTY BONE GP044 $ 11,000.00 2120171046 HC IMPL PUTTY BONE GP046 $ 12,600.00 2120171047 HC IMPL PUTTY BONE GP047 $ 13,000.00 2120171049 HC IMPL PUTTY BONE GP049 $ 14,250.00 2120171051 HC IMPL PUTTY BONE GP051 $ 15,300.00 2120171052 HC IMPL PUTTY BONE GP052 $ 16,200.00 2120171054 HC IMPL PUTTY BONE GP054 $ 17,000.00 2120172019 HC IMPL RADIANCE INJ GP019 $ 2,125.00 2120173032 HC IMPL RESV PENILE GP032 $ 6,300.00 2120174042 HC IMPL RING ANNULOFLO GP042 $ 10,350.00 2120175010 HC IMPL ROD GP010 $ 665.00 2120175012 HC IMPL ROD GP012 $ 810.00 2120175013 HC IMPL ROD GP013 $ 900.00 2120175014 HC IMPL ROD GP014 $ 1,080.00 2120175015 HC IMPL ROD GP015 $ 1,225.00 2120175016 HC IMPL ROD GP016 $ 1,400.00 2120175017 HC IMPL ROD GP017 $ 1,575.00 2120175018 HC IMPL ROD GP018 $ 1,750.00 2120175019 HC IMPL ROD GP019 $ 2,125.00 2120175020 HC IMPL ROD GP020 $ 2,550.00 2120175021 HC IMPL ROD GP021 $ 2,888.00 2120175022 HC IMPL ROD GP022 $ 3,300.00 2120175023 HC IMPL ROD GP023 $ 3,600.00 2120175024 HC IMPL ROD GP024 $ 4,000.00 2120175025 HC IMPL ROD GP025 $ 4,263.00 2120175026 HC IMPL ROD GP026 $ 4,650.00 2120175027 HC IMPL ROD GP027 $ 4,875.00 2120175028 HC IMPL ROD GP028 $ 5,250.00 2120175029 HC IMPL ROD GP029 $ 5,438.00 2120175030 HC IMPL ROD GP030 $ 5,800.00 2120175031 HC IMPL ROD GP031 $ 5,950.00 2120175032 HC IMPL ROD GP032 $ 6,300.00 2120175033 HC IMPL ROD GP033 $ 6,413.00 2120175034 HC IMPL ROD GP034 $ 6,750.00 2120175035 HC IMPL ROD GP035 $ 7,150.00 2120175043 HC IMPL ROD GP043 $ 10,450.00 2120175046 HC IMPL ROD GP046 $ 12,600.00 2120176002 HC IMPL SCREW CANNULATED GP002 $ 50.00 2120176003 HC IMPL SCREW CANNULATED GP003 $ 100.00 2120176004 HC IMPL SCREW CANNULATED GP004 $ 146.00 2120176005 HC IMPL SCREW CANNULATED GP005 $ 195.00 2120176006 HC IMPL SCREW CANNULATED GP006 $ 293.00 2120176007 HC IMPL SCREW CANNULATED GP007 $ 380.00 2120176008 HC IMPL SCREW CANNULATED GP008 $ 475.00 2120176009 HC IMPL SCREW CANNULATED GP009 $ 570.00 2120176010 HC IMPL SCREW CANNULATED GP010 $ 665.00 2120176011 HC IMPL SCREW CANNULATED GP011 $ 740.00

2120176012 HC IMPL SCREW CANNULATED GP012 $ 810.00 2120176013 HC IMPL SCREW CANNULATED GP013 $ 900.00 2120176014 HC IMPL SCREW CANNULATED GP014 $ 1,080.00 2120176015 HC IMPL SCREW CANNULATED GP015 $ 1,225.00 2120176016 HC IMPL SCREW CANNULATED GP016 $ 1,400.00 2120176017 HC IMPL SCREW CANNULATED GP017 $ 1,575.00 2120176018 HC IMPL SCREW CANNULATED GP018 $ 1,750.00 2120176019 HC IMPL SCREW CANNULATED GP019 $ 2,125.00 2120176020 HC IMPL SCREW CANNULATED GP020 $ 2,550.00 2120176021 HC IMPL SCREW CANNULATED GP021 $ 2,888.00 2120176022 HC IMPL SCREW CANNULATED GP022 $ 3,300.00 2120176023 HC IMPL SCREW CANNULATED GP023 $ 3,600.00 2120176024 HC IMPL SCREW CANNULATED GP024 $ 4,000.00 2120176025 HC IMPL SCREW CANNULATED GP025 $ 4,263.00 2120176026 HC IMPL SCREW CANNULATED GP026 $ 4,650.00 2120176028 HC IMPL SCREW CANNULATED GP028 $ 5,250.00 2120176029 HC IMPL SCREW CANNULATED GP029 $ 5,438.00 2120176030 HC IMPL SCREW CANNULATED GP030 $ 5,800.00 2120176031 HC IMPL SCREW CANNULATED GP031 $ 5,950.00 2120176033 HC IMPL SCREW CANNULATED GP033 $ 6,413.00 2120176034 HC IMPL SCREW CANNULATED GP034 $ 6,750.00 2120176035 HC IMPL SCREW CANNULATED GP035 $ 7,150.00 2120176037 HC IMPL SCREW CANNULATED GP037 $ 8,125.00 2120176038 HC IMPL SCREW CANNULATED GP038 $ 8,750.00 2120176043 HC IMPL SCREW CANNULATED GP043 $ 10,450.00 2120177031 HC IMPL SHELL GP031 $ 5,950.00 2120177037 HC IMPL SHELL GP037 $ 8,125.00 2120178015 HC IMPL SPACER GP015 $ 1,225.00 2120178016 HC IMPL SPACER GP016 $ 1,400.00 2120178020 HC IMPL SPACER GP020 $ 2,550.00 2120178023 HC IMPL SPACER GP023 $ 3,600.00 2120178031 HC IMPL SPACER GP031 $ 5,950.00 2120178032 HC IMPL SPACER GP032 $ 6,300.00 2120178033 HC IMPL SPACER GP033 $ 6,413.00 2120178034 HC IMPL SPACER GP034 $ 6,750.00 2120178035 HC IMPL SPACER GP035 $ 7,150.00 2120178036 HC IMPL SPACER GP036 $ 7,800.00 2120178037 HC IMPL SPACER GP037 $ 8,125.00 2120178038 HC IMPL SPACER GP038 $ 8,750.00 2120178045 HC IMPL SPACER GP045 $ 11,550.00 2120178046 HC IMPL SPACER GP046 $ 12,600.00 2120178047 HC IMPL SPACER GP047 $ 13,000.00 2120178048 HC IMPL SPACER GP048 $ 14,000.00 2120178049 HC IMPL SPACER GP049 $ 14,250.00 2120178050 HC IMPL SPACER GP050 $ 15,200.00 2120178051 HC IMPL SPACER GP051 $ 15,300.00 2120178052 HC IMPL SPACER GP052 $ 16,200.00 2120178053 HC IMPL SPACER GP053 $ 16,300.00 2120178054 HC IMPL SPACER GP054 $ 17,000.00 2120178055 HC IMPL SPACER GP055 $ 17,300.00 2120179019 HC IMPL SPINAL GP019 $ 2,125.00 2120179020 HC IMPL SPINAL GP020 $ 2,550.00 2120179021 HC IMPL SPINAL GP021 $ 2,888.00

2120179024 HC IMPL SPINAL GP024 $ 4,000.00 2120179028 HC IMPL SPINAL GP028 $ 5,250.00 2120179034 HC IMPL SPINAL GP034 $ 6,750.00 2120179035 HC IMPL SPINAL GP035 $ 7,150.00 2120179037 HC IMPL SPINAL GP037 $ 8,125.00 2120179051 HC IMPL SPINAL GP051 $ 15,300.00 2120180034 HC IMPL STEM FEMORAL GP034 $ 6,750.00 2120180035 HC IMPL STEM GP035 $ 7,150.00 2120180041 HC IMPL STEM GP041 $ 9,775.00 2120180042 HC IMPL STEM GP042 $ 10,350.00 2120180045 HC IMPL STEM GP045 $ 11,550.00 2120180047 HC IMPL STEM GP047 $ 13,000.00 2120180048 HC IMPL STEM GP048 $ 14,000.00 2120180050 HC IMPL STEM GP050 $ 15,200.00 2120180052 HC IMPL STEM GP052 $ 16,200.00 2120180054 HC IMPL STEM GP054 $ 17,000.00 2120182018 HC IMPL STENT COV W D GP018 $ 1,750.00 2120182041 HC IMPL STENT COV W D GP041 $ 9,775.00 2120182043 HC IMPL STENT COV W D GP043 $ 10,450.00 2120182044 HC IMPL STENT COV W D GP044 $ 11,000.00 2120182045 HC IMPL STENT COV W D GP045 $ 11,550.00 2120183014 HC IMPL STENT COV WO D GP014 $ 1,080.00 2120183015 HC IMPL STENT COV WO D GP015 $ 1,225.00 2120183016 HC IMPL STENT COV WO D GP016 $ 1,400.00 2120183017 HC IMPL STENT COV WO D GP017 $ 1,575.00 2120183043 HC IMPL STENT COV WO D GP043 $ 10,450.00 2120184013 HC IMPL STENT NCOV W D GP013 $ 900.00 2120184034 HC IMPL STENT NCOV W D GP034 $ 6,750.00 2120184035 HC IMPL STENT NCOV W D GP035 $ 7,150.00 2120184036 HC IMPL STENT NCOV W D GP036 $ 7,800.00 2120184053 HC IMPL STENT NCOV W D GP053 $ 16,300.00 2120184061 HC IMPL STENT NCOV W D GP061 $ 21,600.00 2120184066 HC IMPL STENT NCOV W D GP066 $ 25,600.00 2120184067 HC IMPL STENT NCOV W D GP067 $ 26,400.00 2120184068 HC IMPL STENT NCOV W D GP068 $ 27,200.00 2120185008 HC IMPL STENT NCOV WO D GP008 $ 475.00 2120185009 HC IMPL STENT NCOV WO D GP009 $ 570.00 2120185010 HC IMPL STENT NCOV WO D GP010 $ 665.00 2120185011 HC IMPL STENT NCOV WO D GP011 $ 740.00 2120185013 HC IMPL STENT NCOV WO D GP013 $ 900.00 2120185036 HC IMPL STENT NCOV WO D GP036 $ 7,800.00 2120186009 HC IMPL STENT NCOR TMP W D GP009 $ 570.00 2120186010 HC IMPL STENT NCOR TMP W D GP010 $ 665.00 2120186013 HC IMPL STENT NCOR TMP W D GP013 $ 900.00 2120186014 HC IMPL STENT NCOR TMP W D GP014 $ 1,080.00 2120186015 HC IMPL STENT NCOR TMP W D GP015 $ 1,225.00 2120186016 HC IMPL STENT NCOR TMP W D GP016 $ 1,400.00 2120186017 HC IMPL STENT NCOR TMP W D GP017 $ 1,575.00 2120186018 HC IMPL STENT NCOR TMP W D GP018 $ 1,750.00 2120186035 HC IMPL STENT NCOR TMP W D GP035 $ 7,150.00 2120187007 HC IMPL STENT NCOR TMP WO D GP007 $ 380.00 2120187008 HC IMPL STENT NCOR TMP WO D GP008 $ 475.00 2120187009 HC IMPL STENT NCOR TMP WO D GP009 $ 570.00

2120187014 HC IMPL STENT NCOR TMP WO D GP014 $ 1,080.00 2120187015 HC IMPL STENT NCOR TMP WO D GP015 $ 1,225.00 2120187017 HC IMPL STENT NCOR TMP WO D GP017 $ 1,575.00 2120187020 HC IMPL STENT NCOR TMP WO D GP020 $ 2,550.00 2120187021 HC IMPL STENT NCOR TMP WO D GP021 $ 2,888.00 2120187041 HC IMPL STENT NCOR TMP WO D GP041 $ 9,775.00 2120187046 HC IMPL STENT NCOR TMP WO D GP046 $ 12,600.00 2120187048 HC IMPL STENT NCOR TMP WO D GP048 $ 14,000.00 2120187049 HC IMPL STENT NCOR TMP WO D GP049 $ 14,250.00 2120188036 HC IMPL STRIP DBX GP036 $ 7,800.00 2120189033 HC IMPL TENDON GP033 $ 6,413.00 2120189034 HC IMPL TENDON GP034 $ 6,750.00 2120189035 HC IMPL TENDON GP035 $ 7,150.00 2120189036 HC IMPL TENDON GP036 $ 7,800.00 2120189037 HC IMPL TENDON GP037 $ 8,125.00 2120189039 HC IMPL TENDON GP039 $ 9,000.00 2120189041 HC IMPL TENDON GP041 $ 9,775.00 2120189043 HC IMPL TENDON GP043 $ 10,450.00 2120189048 HC IMPL TENDON GP048 $ 14,000.00 2120191009 HC IMPL TIBIAL GP009 $ 570.00 2120191012 HC IMPL TIBIAL GP012 $ 810.00 2120191013 HC IMPL TIBIAL GP013 $ 900.00 2120191022 HC IMPL TIBIAL GP022 $ 3,300.00 2120191024 HC IMPL TIBIAL GP024 $ 4,000.00 2120191025 HC IMPL TIBIAL GP025 $ 4,263.00 2120191026 HC IMPL TIBIAL GP026 $ 4,650.00 2120191027 HC IMPL TIBIAL GP027 $ 4,875.00 2120191028 HC IMPL TIBIAL GP028 $ 5,250.00 2120191029 HC IMPL TIBIAL GP029 $ 5,438.00 2120191030 HC IMPL TIBIAL GP030 $ 5,800.00 2120191032 HC IMPL TIBIAL GP032 $ 6,300.00 2120191033 HC IMPL TIBIAL GP033 $ 6,413.00 2120191034 HC IMPL TIBIAL GP034 $ 6,750.00 2120191035 HC IMPL TIBIAL GP035 $ 7,150.00 2120191036 HC IMPL TIBIAL GP036 $ 7,800.00 2120191037 HC IMPL TIBIAL GP037 $ 8,125.00 2120191038 HC IMPL TIBIAL GP038 $ 8,750.00 2120191040 HC IMPL TIBIAL GP040 $ 9,600.00 2120191045 HC IMPL TIBIAL GP045 $ 11,550.00 2120191048 HC IMPL TIBIAL GP048 $ 14,000.00 2120191050 HC IMPL TIBIAL GP050 $ 15,200.00 2120191052 HC IMPL TIBIAL GP052 $ 16,200.00 2120191057 HC IMPL TIBIAL GP057 $ 18,400.00 2120192035 HC IMPL TISSUE GP035 $ 7,150.00 2120193022 HC IMPL TISSUE SCLERAL GP022 $ 3,300.00 2120193023 HC IMPL TISSUE SCLERAL GP023 $ 3,600.00 2120194019 HC IMPL TRANSCONNECTOR GP019 $ 2,125.00 2120194020 HC IMPL TRANSCONNECTOR GP020 $ 2,550.00 2120194028 HC IMPL TRANSCONNECTOR GP028 $ 5,250.00 2120194029 HC IMPL TRANSCONNECTOR GP029 $ 5,438.00 2120194030 HC IMPL TRANSCONNECTOR GP030 $ 5,800.00 2120194031 HC IMPL TRANSCONNECTOR GP031 $ 5,950.00 2120194034 HC IMPL TRANSCONNECTOR GP034 $ 6,750.00

2120194035 HC IMPL TRANSCONNECTOR GP035 $ 7,150.00 2120194036 HC IMPL TRANSCONNECTOR GP036 $ 7,800.00 2120194037 HC IMPL TRANSCONNECTOR GP037 $ 8,125.00 2120194038 HC IMPL TRANSCONNECTOR GP038 $ 8,750.00 2120195019 HC IMPL PERICARD TUTOPLAST GP019 $ 2,125.00 2120196023 HC IMPL VALVE HEART GP023 $ 3,600.00 2120196024 HC IMPL VALVE HEART GP024 $ 4,000.00 2120196025 HC IMPL VALVE HEART GP025 $ 4,263.00 2120196033 HC IMPL VALVE HEART GP033 $ 6,413.00 2120196048 HC IMPL VALVE HEART GP048 $ 14,000.00 2120196049 HC IMPL VALVE HEART GP049 $ 14,250.00 2120196050 HC IMPL VALVE HEART GP050 $ 15,200.00 2120196051 HC IMPL VALVE HEART GP051 $ 15,300.00 2120196053 HC IMPL VALVE HEART GP053 $ 16,300.00 2120196054 HC IMPL VALVE HEART GP054 $ 17,000.00 2120196055 HC IMPL VALVE HEART GP055 $ 17,300.00 2120196056 HC IMPL VALVE HEART GP056 $ 17,600.00 2120196057 HC IMPL VALVE HEART GP057 $ 18,400.00 2120196058 HC IMPL VALVE HEART GP058 $ 19,200.00 2120196059 HC IMPL VALVE HEART GP059 $ 20,000.00 2120196060 HC IMPL VALVE HEART GP060 $ 20,800.00 2120196061 HC IMPL VALVE HEART GP061 $ 21,600.00 2120196062 HC IMPL VALVE HEART GP062 $ 22,400.00 2120196063 HC IMPL VALVE HEART GP063 $ 23,200.00 2120196064 HC IMPL VALVE HEART GP064 $ 24,000.00 2120196065 HC IMPL VALVE HEART GP065 $ 24,800.00 2120196066 HC IMPL VALVE HEART GP066 $ 25,600.00 2120196070 HC IMPL VALVE HEART GP070 $ 28,800.00 2120196072 HC IMPL VALVE HEART GP072 $ 30,400.00 2120196075 HC IMPL VALVE HEART GP075 $ 32,800.00 2120196079 HC IMPL VALVE HEART GP079 $ 36,000.00 2120196080 HC IMPL VALVE HEART GP080 $ 36,800.00 2120196081 HC IMPL VALVE HEART GP081 $ 37,600.00 2120196082 HC IMPL VALVE HEART GP082 $ 38,400.00 2120196090 HC IMPL VALVE HEART GP090 $ 44,800.00 2120197024 HC IMPL VALVE NEURO GP024 $ 4,000.00 2120197025 HC IMPL VALVE NEURO GP025 $ 4,263.00 2120197026 HC IMPL VALVE NEURO GP026 $ 4,650.00 2120197027 HC IMPL VALVE NEURO GP027 $ 4,875.00 2120197028 HC IMPL VALVE NEURO GP028 $ 5,250.00 2120197029 HC IMPL VALVE NEURO GP029 $ 5,438.00 2120197030 HC IMPL VALVE NEURO GP030 $ 5,800.00 2120197032 HC IMPL VALVE NEURO GP032 $ 6,300.00 2120197033 HC IMPL VALVE NEURO GP033 $ 6,413.00 2120197034 HC IMPL VALVE NEURO GP034 $ 6,750.00 2120197035 HC IMPL VALVE NEURO GP035 $ 7,150.00 2120197037 HC IMPL VALVE NEURO GP037 $ 8,125.00 2120197046 HC IMPL VALVE NEURO GP046 $ 12,600.00 2120197047 HC IMPL VALVE NEURO GP047 $ 13,000.00 2120197051 HC IMPL VALVE NEURO GP051 $ 15,300.00 2120197052 HC IMPL VALVE NEURO GP052 $ 16,200.00 2120197053 HC IMPL VALVE NEURO GP053 $ 16,300.00 2120198043 HC IMPL VASC GP043 $ 10,450.00

2120198061 HC IMPL VASC GP061 $ 21,600.00 2120199056 HC IMPL VBR GP056 $ 17,600.00 2120199068 HC IMPL VBR GP068 $ 27,200.00 2120199070 HC IMPL VBR GP070 $ 28,800.00 2120200045 HC IMPL VEIN GP045 $ 11,550.00 2120200047 HC IMPL VEIN GP047 $ 13,000.00 2120200050 HC IMPL VEIN GP050 $ 15,200.00 2120200062 HC IMPL VEIN GP062 $ 22,400.00 2120201024 HC IMPL VITOSS GP024 $ 4,000.00 2120201028 HC IMPL VITOSS GP028 $ 5,250.00 2120201033 HC IMPL VITOSS GP033 $ 6,413.00 2120201034 HC IMPL VITOSS GP034 $ 6,750.00 2120201038 HC IMPL VITOSS GP038 $ 8,750.00 2120201039 HC IMPL VITOSS GP039 $ 9,000.00 2120201040 HC IMPL VITOSS GP040 $ 9,600.00 2120201041 HC IMPL VITOSS GP041 $ 9,775.00 2120202004 HC IMPL WASHER GP004 $ 146.00 2120202005 HC IMPL WASHER GP005 $ 195.00 2120202006 HC IMPL WASHER GP006 $ 293.00 2120202007 HC IMPL WASHER GP007 $ 380.00 2120202008 HC IMPL WASHER GP008 $ 475.00 2120202011 HC IMPL WASHER GP011 $ 740.00 2120202012 HC IMPL WASHER GP012 $ 810.00 2120202018 HC IMPL WASHER GP018 $ 1,750.00 2120202032 HC IMPL WASHER GP032 $ 6,300.00 2120202037 HC IMPL WASHER GP037 $ 8,125.00 2120203028 HC IMPL WEDGE ILIAC CREST GP028 $ 5,250.00 2120205004 HC IMPL INSERT NOVARE GP004 $ 146.00 2120206005 HC INTRODUCER GP005 $ 195.00 2120206006 HC INTRODUCER GP006 $ 293.00 2120206007 HC INTRODUCER GP007 $ 380.00 2120206008 HC INTRODUCER GP008 $ 475.00 2120206009 HC INTRODUCER GP009 $ 570.00 2120206010 HC INTRODUCER GP010 $ 665.00 2120206011 HC INTRODUCER GP011 $ 740.00 2120206014 HC INTRODUCER GP014 $ 1,080.00 2120207015 HC KIT COLL BONE MARROW GP015 $ 1,225.00 2120207018 HC KIT COLL BONE MARROW GP018 $ 1,750.00 2120208003 HC KIT COLLAGEN FEMALE GP003 $ 100.00 2120209005 HC KIT COLLAGEN MALE GP005 $ 195.00 2120210024 HC KIT CRANIOPLASTY GP024 $ 4,000.00 2120210025 HC KIT CRANIOPLASTY GP025 $ 4,263.00 2120210028 HC KIT CRANIOPLASTY GP028 $ 5,250.00 2120210031 HC KIT CRANIOPLASTY GP031 $ 5,950.00 2120249020 HC KIT EVD SYS W CATH GP020 $ 2,550.00 2120249021 HC KIT EVD SYS W CATH GP021 $ 2,888.00 2120249022 HC KIT EVD SYS W CATH GP022 $ 3,300.00 2120250043 HC KIT GASTRIC BYP GP043 $ 10,450.00 2120250044 HC KIT GASTRIC BYP GP044 $ 11,000.00 2120251029 HC KIT HIP GP029 $ 5,438.00 2120252005 HC KIT HIP PULSAVAC PLUS GP005 $ 195.00 2120252010 HC KIT HIP PULSAVAC PLUS GP010 $ 665.00 2120253082 HC KIT INTERSTIM GP082 $ 38,400.00

2120254019 HC KIT LEAD GP019 $ 2,125.00 2120254040 HC KIT LEAD GP040 $ 9,600.00 2120255021 HC KIT ORTHOPAT AUTOTRANSFUS GP21 $ 2,888.00 2120255033 HC KIT ORTHOPAT AUTOTRANSFUS GP33 $ 6,413.00 2120256014 HC KIT ORTHOSORB GP014 $ 1,080.00 2120257022 HC KIT PENILE ACC GP022 $ 3,300.00 2120258007 HC KIT PHACO INFINITI GP007 $ 380.00 2120259081 HC KIT SOLETRA GP081 $ 37,600.00 2120260006 HC KIT SUCT LEVINE GP006 $ 293.00 2120261013 HC KIT TISSEEL GP013 $ 900.00 2120261014 HC KIT TISSEEL GP014 $ 1,080.00 2120261016 HC KIT TISSEEL GP016 $ 1,400.00 2120261017 HC KIT TISSEEL GP017 $ 1,575.00 2120261018 HC KIT TISSEEL GP018 $ 1,750.00 2120261022 HC KIT TISSEEL GP022 $ 3,300.00 2120261024 HC KIT TISSEEL GP024 $ 4,000.00 2120262036 HC KIT WRISTJACK GP036 $ 7,800.00 2120263045 HC KYPHOPAK GP045 $ 11,550.00 2120264049 HC BAND LAP GP049 $ 14,250.00 2120265024 HC LEAD PCMKR OTH TRANS VDD GP024 $ 4,000.00 2120265026 HC LEAD PCMKR OTH TRANS VDD GP026 $ 4,650.00 2120265028 HC LEAD PCMKR OTH TRANS VDD GP028 $ 5,250.00 2120265029 HC LEAD PCMKR OTH TRANS VDD GP029 $ 5,438.00 2120265031 HC LEAD PCMKR OTH TRANS VDD GP031 $ 5,950.00 2120265032 HC LEAD PCMKR OTH TRANS VDD GP032 $ 6,300.00 2120265036 HC LEAD PCMKR OTH TRANS VDD GP036 $ 7,800.00 2120265038 HC LEAD PCMKR OTH TRANS VDD GP038 $ 8,750.00 2120265046 HC LEAD PCMKR OTH TRANS VDD GP046 $ 12,600.00 2120266014 HC IMPL LEAD PACING GP014 $ 1,080.00 2120266016 HC IMPL LEAD PACING GP016 $ 1,400.00 2120267018 HC LENS GONI GP018 $ 1,750.00 2120268002 HC MANOMETER SPINAL GP002 $ 50.00 2120270002 HC NDL GP002 $ 50.00 2120270003 HC NDL GP003 $ 100.00 2120270004 HC NDL GP004 $ 146.00 2120270005 HC NDL GP005 $ 195.00 2120270006 HC NDL GP006 $ 293.00 2120270007 HC NDL GP007 $ 380.00 2120270008 HC NDL GP008 $ 475.00 2120270009 HC NDL GP009 $ 570.00 2120270010 HC NDL GP010 $ 665.00 2120270013 HC NDL GP013 $ 900.00 2120270014 HC NDL GP014 $ 1,080.00 2120270015 HC NDL GP015 $ 1,225.00 2120270016 HC NDL GP016 $ 1,400.00 2120270018 HC NDL GP018 $ 1,750.00 2120270019 HC NDL GP019 $ 2,125.00 2120270021 HC NDL GP021 $ 2,888.00 2120270022 HC NDL GP022 $ 3,300.00 2120270023 HC NDL GP023 $ 3,600.00 2120270024 HC NDL GP024 $ 4,000.00 2120270034 HC NDL GP034 $ 6,750.00 2120270036 HC NDL GP036 $ 7,800.00

2120270037 HC NDL GP037 $ 8,125.00 2120270038 HC NDL GP038 $ 8,750.00 2120270044 HC NDL GP044 $ 11,000.00 2120271046 HC IMPL PACEMKR SGL CHMBR GP046 $ 12,600.00 2120271048 HC IMPL PACEMKR SGL CHMBR GP048 $ 14,000.00 2120271049 HC IMPL PACEMKR SGL CHMBR GP049 $ 14,250.00 2120271054 HC IMPL PACEMKR SGL CHMBR GP054 $ 17,000.00 2120271057 HC IMPL PACEMKR SGL CHMBR GP057 $ 18,400.00 2120271058 HC IMPL PACEMKR SGL CHMBR GP058 $ 19,200.00 2120271059 HC IMPL PACEMKR SGL CHMBR GP059 $ 20,000.00 2120271062 HC IMPL PACEMKR SGL CHMBR GP062 $ 22,400.00 2120271067 HC IMPL PACEMKR SGL CHMBR GP067 $ 26,400.00 2120271108 HC IMPL PACEMKR SGL CHMBR GP108 $ 50,616.00 2120272013 HC PACK CELL SAVER GP013 $ 900.00 2120292006 HC PATCH DEFIB ANT GP006 $ 293.00 2120292010 HC PATCH DEFIB ANT GP010 $ 665.00 2120293005 HC PATCH DEFIB ANT PED GP005 $ 195.00 2120293007 HC PATCH DEFIB ANT PED GP007 $ 380.00 2120293008 HC PATCH DEFIB ANT PED GP008 $ 475.00 2120294002 HC IMPL PIN GP002 $ 50.00 2120294003 HC IMPL PIN GP003 $ 100.00 2120294004 HC IMPL PIN GP004 $ 146.00 2120294005 HC IMPL PIN GP005 $ 195.00 2120294006 HC IMPL PIN GP006 $ 293.00 2120294007 HC IMPL PIN GP007 $ 380.00 2120294008 HC IMPL PIN GP008 $ 475.00 2120294010 HC IMPL PIN GP010 $ 665.00 2120294012 HC IMPL PIN GP012 $ 810.00 2120294013 HC IMPL PIN GP013 $ 900.00 2120294014 HC IMPL PIN GP014 $ 1,080.00 2120294015 HC IMPL PIN GP015 $ 1,225.00 2120294016 HC IMPL PIN GP016 $ 1,400.00 2120294017 HC IMPL PIN GP017 $ 1,575.00 2120294018 HC IMPL PIN GP018 $ 1,750.00 2120294019 HC IMPL PIN GP019 $ 2,125.00 2120294020 HC IMPL PIN GP020 $ 2,550.00 2120294021 HC IMPL PIN GP021 $ 2,888.00 2120294023 HC IMPL PIN GP023 $ 3,600.00 2120294024 HC IMPL PIN GP024 $ 4,000.00 2120294029 HC IMPL PIN GP029 $ 5,438.00 2120294038 HC IMPL PIN GP038 $ 8,750.00 2120295005 HC PIN GUIDE GP005 $ 195.00 2120295006 HC PIN GUIDE GP006 $ 293.00 2120295009 HC PIN GUIDE GP009 $ 570.00 2120295010 HC PIN GUIDE GP010 $ 665.00 2120295013 HC PIN GUIDE GP013 $ 900.00 2120295014 HC PIN GUIDE GP014 $ 1,080.00 2120295015 HC PIN GUIDE GP015 $ 1,225.00 2120295017 HC PIN GUIDE GP017 $ 1,575.00 2120295018 HC PIN GUIDE GP018 $ 1,750.00 2120296006 HC IMPL PIN RUSH GP006 $ 293.00 2120296007 HC IMPL PIN RUSH GP007 $ 380.00 2120296008 HC IMPL PIN RUSH GP008 $ 475.00

2120296009 HC IMPL PIN RUSH GP009 $ 570.00 2120296010 HC IMPL PIN RUSH GP010 $ 665.00 2120296011 HC IMPL PIN RUSH GP011 $ 740.00 2120296012 HC IMPL PIN RUSH GP012 $ 810.00 2120296013 HC IMPL PIN RUSH GP013 $ 900.00 2120297010 HC PIN SKULL GP010 $ 665.00 2120297013 HC PIN SKULL GP013 $ 900.00 2120297018 HC PIN SKULL GP018 $ 1,750.00 2120297024 HC PIN SKULL GP024 $ 4,000.00 2120297025 HC PIN SKULL GP025 $ 4,263.00 2120298002 HC IMPL PIN STEINMAN GP002 $ 50.00 2120298003 HC IMPL PIN STEINMAN GP003 $ 100.00 2120298004 HC IMPL PIN STEINMAN GP004 $ 146.00 2120298005 HC IMPL PIN STEINMAN GP005 $ 195.00 2120298006 HC IMPL PIN STEINMAN GP006 $ 293.00 2120298008 HC IMPL PIN STEINMAN GP008 $ 475.00 2120298010 HC IMPL PIN STEINMAN GP010 $ 665.00 2120298012 HC IMPL PIN STEINMAN GP012 $ 810.00 2120298017 HC IMPL PIN STEINMAN GP017 $ 1,575.00 2120299006 HC IMPL PIN TITAN GP006 $ 293.00 2120300003 HC PLEDGET GP003 $ 100.00 2120300005 HC PLEDGET GP005 $ 195.00 2120301007 HC IMPL PLUG CEMNT RESTRCT GP007 $ 380.00 2120301014 HC IMPL PLUG CEMNT RESTRCT GP014 $ 1,080.00 2120301018 HC IMPL PLUG CEMNT RESTRCT GP018 $ 1,750.00 2120302007 HC POUCH ENDO GP007 $ 380.00 2120302011 HC POUCH ENDO GP011 $ 740.00 2120302017 HC POUCH ENDO GP017 $ 1,575.00 2120302018 HC POUCH ENDO GP018 $ 1,750.00 2120302019 HC POUCH ENDO GP019 $ 2,125.00 2120303003 HC PROBE GP003 $ 100.00 2120303004 HC PROBE GP004 $ 146.00 2120303005 HC PROBE GP005 $ 195.00 2120303006 HC PROBE GP006 $ 293.00 2120303007 HC PROBE GP007 $ 380.00 2120303008 HC PROBE GP008 $ 475.00 2120303009 HC PROBE GP009 $ 570.00 2120303010 HC PROBE GP011 $ 665.00 2120303011 HC PROBE GP011 $ 740.00 2120303012 HC PROBE GP012 $ 810.00 2120303013 HC PROBE GP013 $ 900.00 2120303014 HC PROBE GP014 $ 1,080.00 2120303015 HC PROBE GP015 $ 1,225.00 2120303016 HC PROBE GP016 $ 1,400.00 2120303017 HC PROBE GP017 $ 1,575.00 2120303018 HC PROBE GP018 $ 1,750.00 2120303019 HC PROBE GP019 $ 2,125.00 2120303020 HC PROBE GP020 $ 2,550.00 2120303021 HC PROBE GP021 $ 2,888.00 2120303022 HC PROBE GP022 $ 3,300.00 2120303023 HC PROBE GP023 $ 3,600.00 2120303024 HC PROBE GP024 $ 4,000.00 2120303027 HC PROBE GP027 $ 4,875.00

2120303029 HC PROBE GP029 $ 5,438.00 2120303032 HC PROBE GP032 $ 6,300.00 2120303034 HC PROBE GP034 $ 6,750.00 2120303037 HC PROBE GP037 $ 8,125.00 2120304018 HC IMPL PROBE TISSUE TAC II GP018 $ 1,750.00 2120304020 HC IMPL PROBE TISSUE TAC II GP020 $ 2,550.00 2120304035 HC IMPL PROBE TISSUE TAC II GP035 $ 7,150.00 2120305003 HC PUNCH GP003 $ 100.00 2120305005 HC PUNCH GP005 $ 195.00 2120305009 HC PUNCH GP009 $ 570.00 2120306003 HC PUNCH VASC GP003 $ 100.00 2120306004 HC PUNCH VASC GP004 $ 146.00 2120306006 HC PUNCH VASC GP006 $ 293.00 2120307002 HC REDUCER MINI STEP GP002 $ 50.00 2120308005 HC RETRIEVER GP005 $ 195.00 2120308006 HC RETRIEVER GP006 $ 293.00 2120308007 HC RETRIEVER GP007 $ 380.00 2120308011 HC RETRIEVER GP011 $ 740.00 2120309018 HC RETRIEVER STONE GP018 $ 1,750.00 2120309019 HC RETRIEVER STONE GP019 $ 2,125.00 2120309021 HC RETRIEVER STONE GP021 $ 2,888.00 2120310020 HC IMPL HOOK TRANSVERSE GP020 $ 2,550.00 2120310025 HC IMPL HOOK TRANSVERSE GP025 $ 4,263.00 2120310027 HC IMPL HOOK TRANSVERSE GP027 $ 4,875.00 2120310028 HC IMPL HOOK TRANSVERSE GP028 $ 5,250.00 2120310029 HC IMPL HOOK TRANSVERSE GP029 $ 5,438.00 2120310030 HC IMPL HOOK TRANSVERSE GP030 $ 5,800.00 2120310031 HC IMPL HOOK TRANSVERSE GP031 $ 5,950.00 2120310033 HC IMPL HOOK TRANSVERSE GP033 $ 6,413.00 2120310035 HC IMPL HOOK TRANSVERSE GP035 $ 7,150.00 2120311017 HC IMPL SEPRAFILM GP017 $ 1,575.00 2120311021 HC IMPL SEPRAFILM GP021 $ 2,888.00 2120311023 HC IMPL SEPRAFILM GP023 $ 3,600.00 2120311025 HC IMPL SEPRAFILM GP025 $ 4,263.00 2120311026 HC IMPL SEPRAFILM GP026 $ 4,650.00 2120311027 HC IMPL SEPRAFILM GP027 $ 4,875.00 2120312002 HC SHEATH GP002 $ 50.00 2120312005 HC SHEATH GP005 $ 195.00 2120312006 HC SHEATH GP006 $ 293.00 2120312007 HC SHEATH GP007 $ 380.00 2120312008 HC SHEATH GP008 $ 475.00 2120312009 HC SHEATH GP009 $ 570.00 2120312010 HC SHEATH GP010 $ 665.00 2120312011 HC SHEATH GP011 $ 740.00 2120312012 HC SHEATH GP012 $ 810.00 2120312014 HC SHEATH GP014 $ 1,080.00 2120312015 HC SHEATH GP015 $ 1,225.00 2120312016 HC SHEATH GP016 $ 1,400.00 2120312017 HC SHEATH GP017 $ 1,575.00 2120312018 HC SHEATH GP018 $ 1,750.00 2120312019 HC SHEATH GP019 $ 2,125.00 2120313008 HC SHEET SILAS NONREINF GP008 $ 475.00 2120313009 HC SHEET SILAS NONREINF GP009 $ 570.00

2120313010 HC SHEET SILAS NONREINF GP010 $ 665.00 2120313017 HC IMPL SHEET SILAS NONREIN GP017 $ 1,575.00 2120314003 HC SHEETING SILAS NON REIN GP003 $ 100.00 2120314004 HC SHEETING SILAS NON REIN GP004 $ 146.00 2120314009 HC SHEETING SILAS NON REIN GP009 $ 570.00 2120314012 HC SHEETING SILAS NON REIN GP012 $ 810.00 2120314013 HC SHEETING SILAS NON REIN GP013 $ 900.00 2120314016 HC SHEETING SILAS NON REIN GP016 $ 1,400.00 2120315014 HC SHEET SILAS REINF GP014 $ 1,080.00 2120315015 HC SHEET SILAS REINF GP015 $ 1,225.00 2120316006 HC SHELL SCLERAL GP006 $ 293.00 2120318008 HC IMPL SHUNT CAROTID GP008 $ 475.00 2120318009 HC IMPL SHUNT CAROTID GP009 $ 570.00 2120318011 HC IMPL SHUNT CAROTID GP011 $ 740.00 2120318012 HC IMPL SHUNT CAROTID GP012 $ 810.00 2120318015 HC IMPL SHUNT CAROTID GP015 $ 1,225.00 2120318022 HC IMPL SHUNT LUMBAR GP022 $ 3,300.00 2120318023 HC IMPL SHUNT LUMBAR GP023 $ 3,600.00 2120318025 HC IMPL SHUNT LUMBAR GP025 $ 4,263.00 2120319024 HC IMPL SHUNT LUMBAR GP024 $ 4,000.00 2120319025 HC IMPL SHUNT LUMBAR GP025 $ 4,263.00 2120319026 HC IMPL SHUNT LUMBAR GP026 $ 4,650.00 2120320004 HC SLEEVE SCD KNEE GP004 $ 146.00 2120320005 HC SLEEVE SCD KNEE GP005 $ 195.00 2120320007 HC SLEEVE SCD KNEE GP007 $ 380.00 2120321006 HC SLEEVE SCD THIGH GP006 $ 293.00 2120321007 HC SLEEVE SCD THIGH GP007 $ 380.00 2120321008 HC SLEEVE SCD THIGH GP008 $ 475.00 2120321009 HC SLEEVE SCD THIGH GP009 $ 570.00 2120322002 HC SLEEVE SCLERAL GP002 $ 50.00 2120323009 HC SLEEVE SHRT RAD GP009 $ 570.00 2120323010 HC SLEEVE SHRT RAD GP010 $ 665.00 2120324004 HC SPECIAL LS 1 2 D3000 GP004 $ 146.00 2120325003 HC IMPL SPHERE EYE GP003 $ 100.00 2120325004 HC IMPL SPHERE EYE GP004 $ 146.00 2120325006 HC IMPL SPHERE EYE GP006 $ 293.00 2120325008 HC IMPL SPHERE EYE GP008 $ 475.00 2120325022 HC IMPL EYE SPHERE GP022 $ 3,300.00 2120325024 HC IMPL SPHERE EYE GP024 $ 4,000.00 2120325026 HC IMPL SPHERE EYE GP026 $ 4,650.00 2120325027 HC IMPL SPHERE EYE GP027 $ 4,875.00 2120325034 HC IMPL SPHERE EYE GP034 $ 6,750.00 2120326002 HC SPLINT NASAL GP002 $ 50.00 2120326004 HC SPLINT NASAL GP004 $ 146.00 2120326005 HC SPLINT NASAL GP005 $ 195.00 2120326006 HC SPLINT NASAL GP006 $ 293.00 2120326007 HC SPLINT NASAL GP007 $ 380.00 2120326008 HC SPLINT NASAL GP008 $ 475.00 2120326010 HC SPLINT NASAL GP010 $ 665.00 2120326012 HC SPLINT NASAL GP012 $ 810.00 2120326013 HC SPLINT NASAL GP013 $ 900.00 2120327006 HC SPRAY TB HEMASEEL GP006 $ 293.00 2120327007 HC SPRAY TB HEMASEEL GP007 $ 380.00

2120328007 HC IMPL STAPLE GP007 $ 380.00 2120328009 HC IMPL STAPLE GP009 $ 570.00 2120328013 HC IMPL STAPLE GP013 $ 900.00 2120328014 HC IMPL STAPLE GP014 $ 1,080.00 2120328015 HC IMPL STAPLE GP015 $ 1,225.00 2120328016 HC IMPL STAPLE GP016 $ 1,400.00 2120328017 HC IMPL STAPLE GP017 $ 1,575.00 2120328018 HC IMPL STAPLE GP018 $ 1,750.00 2120328019 HC IMPL STAPLE GP019 $ 2,125.00 2120328021 HC IMPL STAPLE GP021 $ 2,888.00 2120328022 HC IMPL STAPLE GP022 $ 3,300.00 2120328023 HC IMPL STAPLE GP023 $ 3,600.00 2120328041 HC IMPL STAPLE GP041 $ 9,775.00 2120329002 HC STAPLER GP002 $ 50.00 2120329007 HC STAPLER GP007 $ 380.00 2120329008 HC STAPLER GP008 $ 475.00 2120329009 HC STAPLER GP009 $ 570.00 2120329012 HC STAPLER GP012 $ 810.00 2120329013 HC STAPLER GP013 $ 900.00 2120329014 HC STAPLER GP014 $ 1,080.00 2120329015 HC STAPLER GP015 $ 1,225.00 2120329016 HC STAPLER GP016 $ 1,400.00 2120329018 HC STAPLER GP018 $ 1,750.00 2120329019 HC STAPLER GP019 $ 2,125.00 2120329020 HC STAPLER GP020 $ 2,550.00 2120329021 HC STAPLER GP021 $ 2,888.00 2120329022 HC STAPLER GP022 $ 3,300.00 2120329023 HC STAPLER GP023 $ 3,600.00 2120329025 HC STAPLER GP025 $ 4,263.00 2120329026 HC STAPLER GP026 $ 4,650.00 2120329028 HC STAPLER GP028 $ 5,250.00 2120329032 HC STAPLER GP032 $ 6,300.00 2120329037 HC STAPLER GP037 $ 8,125.00 2120330007 HC STAPLER RELOAD GP007 $ 380.00 2120330008 HC STAPLER RELOAD GP008 $ 475.00 2120330009 HC STAPLER RELOAD GP009 $ 570.00 2120330011 HC STAPLER RELOAD GP011 $ 740.00 2120330012 HC STAPLER RELOAD GP012 $ 810.00 2120330013 HC STAPLER RELOAD GP013 $ 900.00 2120330014 HC STAPLER RELOAD GP014 $ 1,080.00 2120330015 HC STAPLER RELOAD GP015 $ 1,225.00 2120330016 HC STAPLER RELOAD GP016 $ 1,400.00 2120330017 HC STAPLER RELOAD GP017 $ 1,575.00 2120330018 HC STAPLER RELOAD GP018 $ 1,750.00 2120330019 HC STAPLER RELOAD GP019 $ 2,125.00 2120330020 HC STAPLER RELOAD GP020 $ 2,550.00 2120330021 HC STAPLER RELOAD GP021 $ 2,888.00 2120330022 HC STAPLER RELOAD GP022 $ 3,300.00 2120330024 HC STAPLER RELOAD GP024 $ 4,000.00 2120331002 HC STAPLER SKIN GP002 $ 50.00 2120332007 HC STIM NERVE DISP GP007 $ 380.00 2120332008 HC STIM NERVE DISP GP008 $ 475.00 2120333045 HC STMLTR BONE GROWTH GP045 $ 11,550.00

2120333053 HC STMLTR BONE GROWTH GP053 $ 16,300.00 2120333054 HC STMLTR BONE GROWTH GP054 $ 17,000.00 2120334021 HC STRIP FASCIA GP021 $ 2,888.00 2120335030 HC STRIP HEALOS GP030 $ 5,800.00 2120335039 HC STRIP HEALOS GP039 $ 9,000.00 2120336003 HC SUMP PERICARD GP003 $ 100.00 2120337005 HC SURGICEL GP005 $ 195.00 2120337006 HC SURGICEL GP006 $ 293.00 2120337007 HC SURGICEL GP007 $ 380.00 2120337008 HC SURGICEL GP008 $ 475.00 2120337009 HC SURGICEL GP009 $ 570.00 2120337010 HC SURGICEL GP010 $ 665.00 2120338005 HC SURGIFOAM GP005 $ 195.00 2120338008 HC SURGIFOAM GP008 $ 475.00 2120339013 HC SUT PASSER GP013 $ 900.00 2120340002 HC SUTURE GP002 $ 50.00 2120340003 HC SUTURE GP003 $ 100.00 2120340004 HC SUTURE GP004 $ 146.00 2120340005 HC SUTURE GP005 $ 195.00 2120340006 HC SUTURE GP006 $ 293.00 2120340007 HC SUTURE GP007 $ 380.00 2120340008 HC SUTURE GP008 $ 475.00 2120340009 HC SUTURE GP009 $ 570.00 2120340010 HC SUTURE GP010 $ 665.00 2120340011 HC SUTURE GP011 $ 740.00 2120340013 HC SUTURE GP013 $ 900.00 2120340014 HC SUTURE GP014 $ 1,080.00 2120340015 HC SUTURE GP015 $ 1,225.00 2120340016 HC SUTURE GP016 $ 1,400.00 2120340017 HC SUTURE GP017 $ 1,575.00 2120340018 HC SUTURE GP018 $ 1,750.00 2120340019 HC SUTURE GP019 $ 2,125.00 2120340020 HC SUTURE GP020 $ 2,125.00 2120340021 HC SUTURE GP021 $ 2,888.00 2120340037 HC SUTURE GP037 $ 8,125.00 2120341013 HC SYR ZYPLAST GP013 $ 900.00 2120341016 HC SYR ZYPLAST GP016 $ 1,400.00 2120342013 HC SYS POST-OP PAIN GP013 $ 900.00 2120342016 HC SYS POST-OP PAIN GP016 $ 1,400.00 2120342017 HC SYS POST-OP PAIN GP017 $ 1,575.00 2120343020 HC TIP CUSA EXCEL STD GP020 $ 2,550.00 2120344007 HC TIP MICRO FLARED GP007 $ 380.00 2120345007 HC TIP PHACO FLARED GP007 $ 380.00 2120346007 HC TIP PHACO KELMAN CVD GP007 $ 380.00 2120347004 HC TIP PULSAVAC GP004 $ 146.00 2120347016 HC TIP PULSAVAC GP016 $ 1,400.00 2120348014 HC TIP SUCT VITAL VUE GP014 $ 1,080.00 2120348015 HC TIP SUCT VITAL VUE GP015 $ 1,225.00 2120348016 HC TIP SUCT VITAL VUE GP016 $ 1,400.00 2120348017 HC TIP SUCT VITAL VUE GP017 $ 1,575.00 2120349023 HC IMPL TISSUE EXPANDER GP023 $ 3,600.00 2120349024 HC IMPL TISSUE EXPANDER GP024 $ 4,000.00 2120349032 HC IMPL TISSUE EXPANDER GP032 $ 6,300.00

2120349034 HC IMPL TISSUE EXPANDER GP034 $ 6,750.00 2120349035 HC IMPL TISSUE EXPANDER GP035 $ 7,150.00 2120349036 HC IMPL TISSUE EXPANDER GP036 $ 7,800.00 2120349037 HC IMPL TISSUE EXPANDER GP037 $ 8,125.00 2120350051 HC TRAY KYPHOPAK LUMB GP051 $ 15,300.00 2120351045 HC TRAY KYPHOPAK THOR GP045 $ 11,550.00 2120351051 HC TRAY KYPHOPAK THOR GP051 $ 15,300.00 2120352006 HC TROCAR GP006 $ 293.00 2120352007 HC TROCAR GP007 $ 380.00 2120352008 HC TROCAR GP008 $ 475.00 2120352009 HC TROCAR GP009 $ 570.00 2120352010 HC TROCAR GP010 $ 665.00 2120352011 HC TROCAR GP011 $ 740.00 2120352012 HC TROCAR GP012 $ 810.00 2120352013 HC TROCAR GP013 $ 900.00 2120352014 HC TROCAR GP014 $ 1,080.00 2120352015 HC TROCAR GP015 $ 1,225.00 2120352016 HC TROCAR GP016 $ 1,400.00 2120352017 HC TROCAR GP017 $ 1,575.00 2120352021 HC TROCAR GP021 $ 2,888.00 2120352022 HC TROCAR GP022 $ 3,300.00 2120352023 HC TROCAR GP023 $ 3,600.00 2120353005 HC TUBE TRACHEOSTOMY GP005 $ 195.00 2120353006 HC TUBE TRACHEOSTOMY GP006 $ 293.00 2120353007 HC TUBE TRACHEOSTOMY GP007 $ 380.00 2120353008 HC TUBE TRACHEOSTOMY GP008 $ 475.00 2120353015 HC TUBE TRACHEOSTOMY GP015 $ 1,225.00 2120353016 HC TUBE TRACHEOSTOMY GP016 $ 1,400.00 2120354005 HC TUBING IRRIG GP005 $ 195.00 2120354008 HC TUBING IRRIG GP008 $ 475.00 2120354011 HC TUBING IRRIG GP011 $ 740.00 2120354012 HC TUBING IRRIG GP012 $ 810.00 2120354013 HC TUBING IRRIG GP013 $ 900.00 2120354014 HC TUBING IRRIG GP014 $ 1,080.00 2120355019 HC TUBING MANIFOLD GP019 $ 2,125.00 2120355020 HC TUBING MANIFOLD GP020 $ 2,550.00 2120355022 HC TUBING MANIFOLD GP022 $ 3,300.00 2120356002 HC URINEMETER GP002 $ 50.00 2120357025 HC IMPL VALVE GLAUCOMA GP025 $ 4,263.00 2120358002 HC WIRE GP002 $ 50.00 2120358003 HC WIRE GP003 $ 100.00 2120358005 HC WIRE GP005 $ 195.00 2120358006 HC WIRE GP006 $ 293.00 2120358007 HC WIRE GP007 $ 380.00 2120358008 HC WIRE GP008 $ 475.00 2120358009 HC WIRE GP009 $ 570.00 2120358010 HC WIRE GP010 $ 665.00 2120358015 HC WIRE GP015 $ 1,225.00 2120358022 HC WIRE GP022 $ 3,300.00 2120358023 HC WIRE GP023 $ 3,600.00 2120358024 HC WIRE GP024 $ 4,000.00 2120358025 HC WIRE GP025 $ 4,263.00 2120358027 HC WIRE GP027 $ 4,875.00

2120359007 HC WIRE CERCLAGE GP007 $ 380.00 2120360002 HC IMPL WIRE K GP002 $ 50.00 2120360003 HC IMPL WIRE K GP003 $ 100.00 2120360004 HC IMPL WIRE K GP004 $ 146.00 2120360005 HC IMPL WIRE K GP005 $ 195.00 2120360006 HC IMPL WIRE K GP006 $ 293.00 2120360009 HC IMPL WIRE K GP009 $ 570.00 2120360010 HC IMPL WIRE K GP010 $ 665.00 2120360012 HC IMPL WIRE K GP012 $ 810.00 2120360016 HC IMPL WIRE K GP016 $ 1,400.00 2120360017 HC IMPL WIRE K GP017 $ 1,575.00 2120361004 HC BLOCK PUNCH CORNEAL GP004 $ 146.00 2120384005 HC BAG ENDO GP005 $ 195.00 2120385006 HC IMPL RING FALOPE GP006 $ 293.00 2120386002 HC BINDER ABDOMINAL GP002 $ 50.00 2120387017 HC DRILL GUIDE GP017 $ 1,575.00 2120387018 HC DRILL GUIDE GP018 $ 1,750.00 2120387023 HC DRILL GUIDE GP023 $ 3,600.00 2120388005 HC CABLE PACING TEMP GP005 $ 195.00 2120389011 HC IMPL CARPAL SCAPHOID GP011 $ 740.00 2120390010 HC CATH CARDIO GP010 $ 665.00 2120391019 HC CATH NEPHRO GP019 $ 2,125.00 2120392015 HC DISSECTOR ENDO GP015 $ 1,225.00 2120392016 HC DISSECTOR ENDO GP016 $ 1,400.00 2120392017 HC DISSECTOR ENDO GP017 $ 1,575.00 2120392018 HC DISSECTOR ENDO GP018 $ 1,750.00 2120393014 HC EXTRACTOR STONE GP014 $ 1,080.00 2120393017 HC EXTRACTOR STONE GP017 $ 1,575.00 2120394002 HC CATH FOLLOWER GP002 $ 50.00 2120395015 HC KIT APPLICATOR GP015 $ 1,225.00 2120396016 HC KIT GASTROS INTROD GP016 $ 1,400.00 2120397017 HC IMPL INJ BULKING AGENT GP017 $ 1,575.00 2120398007 HC MICROTIP PHACO GP007 $ 380.00 2120399017 HC IMPL POWDER GP017 $ 1,575.00 2120400032 HC IMPL SLING GP032 $ 6,300.00 2120401002 HC SNARE GP002 $ 50.00 2120401003 HC SNARE GP003 $ 100.00 2120401004 HC SNARE GP004 $ 146.00 2120401005 HC SNARE GP005 $ 195.00 2120401019 HC SNARE GP019 $ 2,125.00 2120401037 HC SNARE GP037 $ 8,125.00 2120402023 HC SYR AUTOGRAFT GP023 $ 3,600.00 2120403018 HC ADH INTERCEED GP018 $ 1,750.00 2120404004 HC ADH MASTISOL GP004 $ 146.00 2120405009 HC AUTOSUTURE ENDOSTICH GP009 $ 570.00 2120405010 HC AUTOSUTURE ENDOSTICH GP010 $ 665.00 2120405011 HC AUTOSUTURE ENDOSTICH GP011 $ 740.00 2120405018 HC AUTOSUTURE ENDOSTICH GP018 $ 1,750.00 2120406004 HC BAG INFUSOR GP004 $ 146.00 2120407002 HC BLANKET HYPOTHERMIA GP002 $ 50.00 2120407003 HC BLANKET HYPOTHERMIA GP003 $ 100.00 2120407006 HC IMPL CATH INFUSION GP006 $ 293.00 2120407009 HC IMPL CATH INFUSION GP009 $ 570.00

2120407018 HC CATH INFUSION GP018 $ 1,750.00 2120408004 HC BRUSH SPECIMEN GR004 $ 146.00 2120409005 HC CORD ENDO DISP GP005 $ 195.00 2120410006 HC CUTTER GP006 $ 293.00 2120410007 HC CUTTER GP007 $ 380.00 2120410008 HC CUTTER GP008 $ 475.00 2120410009 HC CUTTER GP009 $ 570.00 2120410010 HC CUTTER GP010 $ 665.00 2120410011 HC CUTTER GP011 $ 740.00 2120410012 HC CUTTER GP012 $ 810.00 2120410013 HC CUTTER GP013 $ 900.00 2120410015 HC CUTTER GP015 $ 1,225.00 2120410016 HC CUTTER GP016 $ 1,400.00 2120410019 HC CUTTER GP019 $ 2,125.00 2120410020 HC CUTTER GP020 $ 2,550.00 2120410021 HC CUTTER GP021 $ 2,888.00 2120410034 HC CUTTER GP034 $ 6,750.00 2120411013 HC CUTTER LINEAR GP013 $ 900.00 2120411014 HC CUTTER LINEAR GP014 $ 1,080.00 2120411015 HC CUTTER LINEAR GP015 $ 1,225.00 2120411018 HC CUTTER LINEAR GP018 $ 1,750.00 2120411019 HC CUTTER LINEAR GP019 $ 2,125.00 2120411022 HC CUTTER LINEAR GP022 $ 3,300.00 2120411031 HC CUTTER LINEAR GP031 $ 5,950.00 2120412006 HC CUTTER RELOAD GP006 $ 293.00 2120412007 HC CUTTER RELOAD GP007 $ 380.00 2120412008 HC CUTTER RELOAD GP008 $ 475.00 2120412009 HC CUTTER RELOAD GP009 $ 570.00 2120412011 HC CUTTER RELOAD GP011 $ 740.00 2120412013 HC CUTTER RELOAD GP013 $ 900.00 2120412018 HC CUTTER RELOAD GP018 $ 1,750.00 2120412020 HC CUTTER RELOAD GP020 $ 2,550.00 2120413013 HC ELECTRODE KNIFE GP013 $ 900.00 2120414014 HC ELECTRODE LIGASURE GP014 $ 1,080.00 2120414015 HC ELECTRODE LIGASURE GP015 $ 1,225.00 2120416010 HC ELECTRODE VAPORIZATION GP010 $ 665.00 2120416016 HC ELECTRODE VAPORIZATION GR016 $ 1,400.00 2120417017 HC IMPL SLEEVE COMPRSS KNEE GP017 $ 1,575.00 2120417018 HC IMPL SLEEVE COMPRSS CNTR GP018 $ 1,750.00 2120417019 HC IMPL SLEEVE COMPRSS CNTR GP019 $ 2,125.00 2120418014 HC FELT PFTE GP014 $ 1,080.00 2120419011 HC HEMOSTATIC COLLAGEN GP011 $ 740.00 2120420009 HC INFLATOR LEVEEN GP009 $ 570.00 2120421019 HC KIT ENDO LAP CHOLE GP019 $ 2,125.00 2120422002 HC KIT FILL TISSUE UNIV GP002 $ 50.00 2120423008 HC KIT VEN PERC GP008 $ 475.00 2120424004 HC MANIPULATOR UTERINE GP004 $ 146.00 2120424005 HC MANIPULATOR UTERINE GP005 $ 195.00 2120425002 HC MARKER GP002 $ 50.00 2120425003 HC MARKER GP003 $ 100.00 2120425004 HC MARKER GP004 $ 146.00 2120426024 HC MORCELLATOR GP024 $ 4,000.00 2120427023 HC OMNIPORT GP023 $ 3,600.00

2120435002 HC PACK EAR AMBRUS GP002 $ 50.00 2120436002 HC PACK EAR POPE GP002 $ 50.00 2120437004 HC PACK SINUS KENNEDY GP004 $ 146.00 2120438013 HC SCALPEL HARMONIC DISP GP013 $ 900.00 2120438022 HC SCALPEL HARMONIC DISP GP022 $ 3,300.00 2120438023 HC SCALPEL HARMONIC DISP GP023 $ 3,600.00 2120438024 HC SCALPEL HARMONIC DISP GP024 $ 4,000.00 2120439003 HC SEAL BIOPSY GP003 $ 100.00 2120440006 HC SET PRESSURE GP006 $ 293.00 2120441003 HC SET SUCTION GP003 $ 100.00 2120442002 HC SET TUR GP002 $ 50.00 2120443020 HC SHEARS COAG GP020 $ 2,550.00 2120443021 HC SHEARS COAG GP021 $ 2,888.00 2120444020 HC SHEARS LAPAROSCOPY GP020 $ 2,550.00 2120445005 HC SLEEVE TROCAR THORACIC GP005 $ 195.00 2120446002 HC SOLN SORBITAL MANNITOL GP002 $ 50.00 2120447002 HC ELECTRODE GP002 $ 50.00 2120447003 HC ELECTRODE GP003 $ 100.00 2120447004 HC ELECTRODE GP004 $ 146.00 2120447005 HC ELECTRODE GP005 $ 195.00 2120447007 HC ELECTRODE GP007 $ 380.00 2120447014 HC ELECTRODE GP014 $ 1,080.00 2120448005 HC VEIN STRIPPER GP005 $ 195.00 2120449002 HC SYRINGE GP002 $ 50.00 2120450003 HC TIP SUCT CARD GP003 $ 100.00 2120453006 HC TUBE GASTRO GP006 $ 293.00 2120453007 HC TUBE GASTRO GP007 $ 380.00 2120453008 HC TUBE GASTRO GP008 $ 475.00 2120453013 HC TUBE GASTRO GP013 $ 900.00 2120453014 HC TUBE GASTRO GP014 $ 1,080.00 2120453016 HC TUBE GASTRO GP016 $ 1,400.00 2120453018 HC TUBE GASTRO GP018 $ 1,750.00 2120454006 HC TUBE GASTROSTOMY GP006 $ 293.00 2120454007 HC TUBE GASTROSTOMY GP007 $ 380.00 2120454008 HC TUBE GASTROSTOMY GP008 $ 475.00 2120454016 HC TUBE GASTROSTOMY GP016 $ 1,400.00 2120454018 HC TUBE GASTROSTOMY GP018 $ 1,750.00 2120456005 HC TUBE T GP005 $ 195.00 2120456015 HC TUBE T GP015 $ 1,225.00 2120456016 HC TUBE T GP016 $ 1,400.00 2120457006 HC TUBING LAP GP006 $ 293.00 2120459010 HC VALVE SLEEVE GP010 $ 665.00 2120460015 HC HOOK NEURO DISP GP015 $ 1,225.00 2120460016 HC HOOK NEURO DISP GP016 $ 1,400.00 2120461018 HC CATH BLLN ENDO DIST GP018 $ 1,750.00 2120462003 HC IMPL CONNECTOR PARALLEL GP003 $ 100.00 2120462024 HC IMPL CONNECTOR PARALLEL GP024 $ 4,000.00 2120462025 HC IMPL CONNECTOR PARALLEL GP025 $ 4,263.00 2120462026 HC IMPL CONNECTOR PARALLEL GP026 $ 4,650.00 2120462027 HC IMPL CONNECTOR PARALLEL GP027 $ 4,875.00 2120462028 HC IMPL CONNECTOR PARALLEL GP028 $ 5,250.00 2120462029 HC IMPL CONNECTOR PARALLEL GP029 $ 5,438.00 2120463015 HC DEVICE ANASTOMOTIC MICRO GP015 $ 1,225.00

2120463016 HC DEVICE ANASTOMOTIC MICRO GP016 $ 1,400.00 2120464023 HC DEVICE HAND ACCESS GP023 $ 3,600.00 2120465022 HC PASTE TEFLON GP022 $ 3,300.00 2120467003 HC BAG HYDRO GP003 $ 100.00 2120468002 HC IMPL EYE GP002 $ 50.00 2120468003 HC IMPL EYE GP003 $ 100.00 2120468004 HC IMPL EYE GP004 $ 146.00 2120468005 HC IMPL EYE GP005 $ 195.00 2120468012 HC IMPL EYE GP012 $ 810.00 2120468015 HC IMPL EYE GP015 $ 1,225.00 2120468016 HC IMPL EYE GP016 $ 1,400.00 2120468033 HC IMPL EYE GP033 $ 6,413.00 2120468034 HC IMPL EYE GP034 $ 6,750.00 2120468037 HC IMPL EYE GP037 $ 8,125.00 2120468042 HC IMPL EYE GP042 $ 10,350.00 2120469005 HC BRUSH DIATHERMY GP005 $ 195.00 2120470003 HC BRUSH INTRAMEDULLARY GP003 $ 100.00 2120471008 HC BUR SPHERICAL GP008 $ 475.00 2120471010 HC BUR SPHERICAL GP010 $ 665.00 2120472008 HC CATH BROV GP008 $ 475.00 2120472010 HC CATH BROV GP010 $ 665.00 2120472016 HC CATH BROV GP016 $ 1,400.00 2120472017 HC CATH BROV GP017 $ 1,575.00 2120473009 HC CATH HICK GP009 $ 570.00 2120473010 HC CATH HICK GP010 $ 665.00 2120473012 HC CATH HICK GP012 $ 810.00 2120473014 HC CATH HICK GP014 $ 1,080.00 2120473016 HC CATH HICK GP016 $ 1,400.00 2120473018 HC CATH HICK GP018 $ 1,750.00 2120473020 HC CATH HICK GP020 $ 2,550.00 2120473021 HC CATH HICK GP021 $ 2,888.00 2120474005 HC CATH LASER GP005 $ 195.00 2120474006 HC CATH LASER GP006 $ 293.00 2120474007 HC CATH LASER GP007 $ 380.00 2120474008 HC CATH LASER GP008 $ 475.00 2120475018 HC IMPL CATH PERIT/HEMODIAL GP018 $ 1,750.00 2120475042 HC IMPL CATH PERIT/HEMODIAL GP042 $ 10,350.00 2120476015 HC CATH PERMCATH GP015 $ 1,225.00 2120476017 HC CATH PERMCATH GP017 $ 1,575.00 2120476018 HC CATH PERMCATH GP018 $ 1,750.00 2120477002 HC CATH PEZZAR GP002 $ 50.00 2120477003 HC CATH PEZZAR GP003 $ 100.00 2120477004 HC CATH PEZZAR GP004 $ 146.00 2120477005 HC CATH PEZZAR GP005 $ 195.00 2120478007 HC CATH TENCKHOFF GP007 $ 380.00 2120479003 HC CLAMP ALLIS GP003 $ 100.00 2120479004 HC CLAMP ALLIS GP004 $ 146.00 2120480003 HC CLAMP BABCOCK GP003 $ 100.00 2120480011 HC CLAMP BABCOCK GP011 $ 740.00 2120481004 HC CLAMP GNAT GP004 $ 146.00 2120481005 HC CLAMP GNAT GP005 $ 195.00 2120482003 HC CLAMP MOSQUITO GP003 $ 100.00 2120482004 HC CLAMP MOSQUITO GP004 $ 146.00

2120483005 HC CLAMP GP005 $ 195.00 2120483008 HC CLAMP GP008 $ 475.00 2120483014 HC CLAMP GP014 $ 1,080.00 2120483015 HC CLAMP GP015 $ 1,225.00 2120484002 HC CONNECTOR GP002 $ 50.00 2120484003 HC CONNECTOR GP003 $ 100.00 2120484004 HC CONNECTOR GP004 $ 146.00 2120484005 HC CONNECTOR GP005 $ 195.00 2120484006 HC CONNECTOR GP006 $ 293.00 2120484007 HC CONNECTOR GP007 $ 380.00 2120484008 HC CONNECTOR GP008 $ 475.00 2120484009 HC CONNECTOR GP009 $ 570.00 2120484011 HC CONNECTOR GP011 $ 740.00 2120485002 HC CORD GP002 $ 50.00 2120485012 HC CORD GP012 $ 810.00 2120486004 HC DISSECTOR GP004 $ 146.00 2120486005 HC DISSECTOR GP005 $ 195.00 2120486016 HC DISSECTOR GP016 $ 1,400.00 2120486017 HC DISSECTOR GP017 $ 1,575.00 2120486018 HC DISSECTOR GP018 $ 1,750.00 2120486019 HC DISSECTOR GP019 $ 2,125.00 2120486023 HC DISSECTOR GP023 $ 3,600.00 2120487012 HC PROBE DOPPLER GP012 $ 810.00 2120487013 HC PROBE DOPPLER GP013 $ 900.00 2120488002 HC DRESSING GP002 $ 50.00 2120488003 HC DRESSING GP003 $ 100.00 2120488004 HC DRESSING GP004 $ 146.00 2120488005 HC DRESSING GP005 $ 195.00 2120488007 HC DRESSING GP007 $ 380.00 2120488008 HC DRESSING GP008 $ 475.00 2120488009 HC DRESSING GP009 $ 570.00 2120488010 HC DRESSING GP010 $ 665.00 2120488015 HC DRESSING GP015 $ 1,225.00 2120488016 HC DRESSING GP016 $ 1,400.00 2120488017 HC DRESSING GP017 $ 1,575.00 2120488018 HC DRESSING GP018 $ 1,750.00 2120488020 HC DRESSING GP020 $ 2,550.00 2120488024 HC DRESSING GP024 $ 4,000.00 2120488037 HC DRESSING GP037 $ 8,125.00 2120489002 HC ELECTRODE WECK GP002 $ 50.00 2120490003 HC HOOK GP003 $ 100.00 2120490007 HC HOOK GP007 $ 380.00 2120490011 HC HOOK GP011 $ 740.00 2120490020 HC HOOK GP020 $ 2,550.00 2120490022 HC HOOK GP022 $ 3,300.00 2120490025 HC HOOK GP025 $ 4,263.00 2120490028 HC HOOK GP028 $ 5,250.00 2120490029 HC HOOK GP029 $ 5,438.00 2120490030 HC HOOK GP030 $ 5,800.00 2120491011 HC TUBE LEGEND GP011 $ 740.00 2120492010 HC IMPL SHUNT CORONARY GP010 $ 665.00 2120492012 HC IMPL SHUNT CORONARY GP012 $ 810.00 2120493005 HC IMPL SCREW MATTA THREAD GP005 $ 195.00

2120493006 HC IMPL SCREW MATTA THREAD GP006 $ 293.00 2120493007 HC IMPL SCREW MATTA THREAD GP007 $ 380.00 2120494002 HC IMPL SCREW BONE GP002 $ 50.00 2120494003 HC IMPL SCREW BONE GP003 $ 100.00 2120494004 HC IMPL SCREW BONE GP004 $ 146.00 2120494005 HC IMPL SCREW BONE GP005 $ 195.00 2120494006 HC IMPL SCREW BONE GP006 $ 293.00 2120494007 HC IMPL SCREW BONE GP007 $ 380.00 2120494008 HC IMPL SCREW BONE GP008 $ 475.00 2120494009 HC IMPL SCREW BONE GP009 $ 570.00 2120494010 HC IMPL SCREW BONE GP010 $ 665.00 2120494011 HC IMPL SCREW BONE GP011 $ 740.00 2120494012 HC IMPL SCREW BONE GP012 $ 810.00 2120494013 HC IMPL SCREW BONE GP013 $ 900.00 2120494014 HC IMPL SCREW BONE GP014 $ 1,080.00 2120494015 HC IMPL SCREW BONE GP015 $ 1,225.00 2120494016 HC IMPL SCREW BONE GP016 $ 1,400.00 2120494017 HC IMPL SCREW BONE GP017 $ 1,575.00 2120494018 HC IMPL SCREW BONE GP018 $ 1,750.00 2120494019 HC IMPL SCREW BONE GP019 $ 2,125.00 2120494020 HC IMPL SCREW BONE GP020 $ 2,550.00 2120494021 HC IMPL SCREW BONE GP021 $ 2,888.00 2120494022 HC IMPL SCREW BONE GP022 $ 3,300.00 2120494023 HC IMPL SCREW BONE GP023 $ 3,600.00 2120494024 HC IMPL SCREW BONE GP024 $ 4,000.00 2120494027 HC IMPL SCREW BONE GP027 $ 4,875.00 2120494028 HC IMPL SCREW BONE GP028 $ 5,250.00 2120494029 HC IMPL SCREW BONE GP029 $ 5,438.00 2120494030 HC IMPL SCREW BONE GP030 $ 5,800.00 2120494031 HC IMPL SCREW BONE GP031 $ 5,950.00 2120494032 HC IMPL SCREW BONE GP032 $ 6,300.00 2120494033 HC IMPL SCREW BONE GP033 $ 6,413.00 2120494034 HC IMPL SCREW BONE GP034 $ 6,750.00 2120494035 HC IMPL SCREW BONE GP035 $ 7,150.00 2120494036 HC IMPL SCREW BONE GP036 $ 7,800.00 2120494037 HC IMPL SCREW BONE GP037 $ 8,125.00 2120494038 HC IMPL SCREW BONE GP038 $ 8,750.00 2120494039 HC IMPL SCREW BONE GP039 $ 9,000.00 2120494041 HC IMPL SCREW BONE GP041 $ 9,775.00 2120494042 HC IMPL SCREW BONE GP042 $ 10,350.00 2120494043 HC IMPL SCREW BONE GP043 $ 10,450.00 2120494044 HC IMPL SCREW BONE GP044 $ 11,000.00 2120494045 HC IMPL SCREW BONE GP045 $ 11,550.00 2120494046 HC IMPL SCREW BONE GP046 $ 12,600.00 2120494052 HC IMPL SCREW BONE GP052 $ 16,200.00 2120494056 HC IMPL SCREW BONE GP056 $ 17,600.00 2120494116 HC IMPL SCREW BONE GP116 $ 72,000.00 2120495018 HC IMPL SCREW THREADED GP018 $ 1,750.00 2120495019 HC IMPL SCREW THREADED GP019 $ 2,125.00 2120495020 HC IMPL SCREW THREADED GP020 $ 2,550.00 2120495021 HC IMPL SCREW THREADED GP021 $ 2,888.00 2120495028 HC IMPL SCREW THREADED GP028 $ 5,250.00 2120495030 HC IMPL SCREW THREADED GP030 $ 5,800.00

2120495031 HC IMPL SCREW THREADED GP031 $ 5,950.00 2120495032 HC IMPL SCREW THREADED GP032 $ 6,300.00 2120495033 HC IMPL SCREW THREADED GP033 $ 6,413.00 2120495034 HC IMPL SCREW THREADED GP034 $ 6,750.00 2120495035 HC IMPL SCREW THREADED GP035 $ 7,150.00 2120495036 HC IMPL SCREW THREADED GP036 $ 7,800.00 2120495037 HC IMPL SCREW THREADED GP037 $ 8,125.00 2120496002 HC IMPL SCREW CORTEX GP002 $ 50.00 2120496003 HC IMPL SCREW CORTEX GP003 $ 100.00 2120496004 HC IMPL SCREW CORTEX GP004 $ 146.00 2120496005 HC IMPL SCREW CORTEX GP005 $ 195.00 2120496006 HC IMPL SCREW CORTEX GP006 $ 293.00 2120496007 HC IMPL SCREW CORTEX GP007 $ 380.00 2120496008 HC IMPL SCREW CORTEX GP008 $ 475.00 2120496009 HC IMPL SCREW CORTEX GP009 $ 570.00 2120496010 HC IMPL SCREW CORTEX GP010 $ 665.00 2120496011 HC IMPL SCREW CORTEX GP011 $ 740.00 2120496018 HC IMPL SCREW CORTEX GP018 $ 1,750.00 2120496019 HC IMPL SCREW CORTEX GP019 $ 2,125.00 2120496020 HC IMPL SCREW CORTEX GP020 $ 2,550.00 2120496025 HC IMPL SCREW CORTEX GP025 $ 4,263.00 2120496026 HC IMPL SCREW CORTEX GP026 $ 4,650.00 2120496027 HC IMPL SCREW CORTEX GP027 $ 4,875.00 2120496028 HC IMPL SCREW CORTEX GP028 $ 5,250.00 2120498003 HC IMPL SCREW CORTICAL GP003 $ 100.00 2120498004 HC IMPL SCREW CORTICAL GP004 $ 146.00 2120498005 HC IMPL SCREW CORTICAL GP005 $ 195.00 2120498006 HC IMPL SCREW CORTICAL GP006 $ 293.00 2120498010 HC IMPL SCREW CORTICAL GP010 $ 665.00 2120498011 HC IMPL SCREW CORTICAL GP011 $ 740.00 2120498012 HC IMPL SCREW CORTICAL GP012 $ 810.00 2120498013 HC IMPL SCREW CORTICAL GP013 $ 900.00 2120498017 HC IMPL SCREW CORTICAL GP017 $ 1,575.00 2120498018 HC IMPL SCREW CORTICAL GP018 $ 1,750.00 2120498019 HC IMPL SCREW CORTICAL GP019 $ 2,125.00 2120499002 HC IMPL SCREW SHAFT GP002 $ 50.00 2120499003 HC IMPL SCREW SHAFT GP003 $ 100.00 2120499004 HC IMPL SCREW SHAFT GP004 $ 146.00 2120499005 HC IMPL SCREW SHAFT GP005 $ 195.00 2120500003 HC IMPL SCREW EMERGENCY GP003 $ 100.00 2120500006 HC IMPL SCREW EMERGENCY GP006 $ 293.00 2120500007 HC IMPL SCREW EMERGENCY GP007 $ 380.00 2120500008 HC IMPL SCREW EMERGENCY GP008 $ 475.00 2120500009 HC IMPL SCREW EMERGENCY GP009 $ 570.00 2120500010 HC IMPL SCREW EMERGENCY GP010 $ 665.00 2120500011 HC IMPL SCREW EMERGENCY GP011 $ 740.00 2120500012 HC IMPL SCREW EMERGENCY GP012 $ 810.00 2120500013 HC IMPL SCREW EMERGENCY GP013 $ 900.00 2120500018 HC IMPL SCREW EMERGENCY GP018 $ 1,750.00 2120500019 HC IMPL SCREW EMERGENCY GP019 $ 2,125.00 2120501005 HC IMPL SCREW MALLEOLAR GP005 $ 195.00 2120501006 HC IMPL SCREW MALLEOLAR GP006 $ 293.00 2120502005 HC IMPL SCREW MINI GP005 $ 195.00

2120502006 HC IMPL SCREW MINI GP006 $ 293.00 2120502007 HC IMPL SCREW MINI GP007 $ 380.00 2120502008 HC IMPL SCREW MINI GP008 $ 475.00 2120502009 HC IMPL SCREW MINI GP009 $ 570.00 2120503006 HC IMPL SCREW LOCKING GP006 $ 293.00 2120503009 HC IMPL SCREW LOCKING GP009 $ 570.00 2120503010 HC IMPL SCREW LOCKING GP010 $ 665.00 2120503011 HC IMPL SCREW LOCKING GP011 $ 740.00 2120503012 HC IMPL SCREW LOCKING GP012 $ 810.00 2120503013 HC IMPL SCREW LOCKING GP013 $ 900.00 2120503014 HC IMPL SCREW LOCKING GP014 $ 1,080.00 2120503015 HC IMPL SCREW LOCKING GP015 $ 1,225.00 2120503016 HC IMPL SCREW LOCKING GP016 $ 1,400.00 2120503017 HC IMPL SCREW LOCKING GP017 $ 1,575.00 2120503018 HC IMPL SCREW LOCKING GP018 $ 1,750.00 2120503019 HC IMPL SCREW LOCKING GP019 $ 2,125.00 2120504005 HC IMPL SCREW CANCELLOUS GP005 $ 195.00 2120504006 HC IMPL SCREW CANCELLOUS GP006 $ 293.00 2120504009 HC IMPL SCREW CANCELLOUS GP009 $ 570.00 2120504010 HC IMPL SCREW CANCELLOUS GP010 $ 665.00 2120504012 HC IMPL SCREW CANCELLOUS GP012 $ 810.00 2120504013 HC IMPL SCREW CANCELLOUS GP013 $ 900.00 2120504015 HC IMPL SCREW CANCELLOUS GP015 $ 1,225.00 2120504019 HC IMPL SCREW CANCELLOUS GP019 $ 2,125.00 2120505019 HC IMPL SCREW HERB WHIPPLE GP019 $ 2,125.00 2120505020 HC IMPL SCREW HERB WHIPPLE GP020 $ 2,550.00 2120505021 HC IMPL SCREW HERB WHIPPLE GP021 $ 2,888.00 2120505022 HC IMPL SCREW HERB WHIPPLE GP022 $ 3,300.00 2120507006 HC IMPL SCREW CERVICAL GP006 $ 293.00 2120507018 HC IMPL SCREW CERVICAL GP018 $ 1,750.00 2120507019 HC IMPL SCREW CERVICAL GP019 $ 2,125.00 2120507020 HC IMPL SCREW CERVICAL GP020 $ 2,550.00 2120507021 HC IMPL SCREW CERVICAL GP021 $ 2,888.00 2120508006 HC IMPL SCREW SELF TAPPING GP006 $ 293.00 2120508007 HC IMPL SCREW SELF TAPPING GP007 $ 380.00 2120508008 HC IMPL SCREW SELF TAPPING GP008 $ 475.00 2120508009 HC IMPL SCREW SELF TAPPING GP009 $ 570.00 2120508010 HC IMPL SCREW SELF TAPPING GP010 $ 665.00 2120508011 HC IMPL SCREW SELF TAPPING GP011 $ 740.00 2120508014 HC IMPL SCREW SELF TAPPING GP014 $ 1,080.00 2120508015 HC IMPL SCREW SELF TAPPING GP015 $ 1,225.00 2120508016 HC IMPL SCREW SELF TAPPING GP016 $ 1,400.00 2120508018 HC IMPL SCREW SELF TAPPING GP018 $ 1,750.00 2120508019 HC IMPL SCREW SELF TAPPING GP019 $ 2,125.00 2120509009 HC IMPL PEG GP009 $ 570.00 2120509010 HC IMPL PEG GP010 $ 665.00 2120509012 HC IMPL PEG GP012 $ 810.00 2120509013 HC IMPL PEG GP013 $ 900.00 2120510038 HC IMPL PACEMKR DUAL CHMBR GP038 $ 8,750.00 2120510052 HC IMPL PACEMKR DUAL CHMBR GP052 $ 16,200.00 2120510053 HC IMPL PACEMKR DUAL CHMBR GP053 $ 16,300.00 2120510054 HC IMPL PACEMKR DUAL CHMBR GP054 $ 17,000.00 2120510055 HC IMPL PACEMKR DUAL CHMBR GP055 $ 17,300.00

2120510056 HC IMPL PACEMKR DUAL CHMBR GP056 $ 17,600.00 2120510057 HC IMPL PACEMKR DUAL CHMBR GP057 $ 18,400.00 2120510058 HC IMPL PACEMKR DUAL CHMBR GP058 $ 19,200.00 2120510059 HC IMPL PACEMKR DUAL CHMBR GP059 $ 20,000.00 2120510060 HC IMPL PACEMKR DUAL CHMBR GP060 $ 20,800.00 2120510061 HC IMPL PACEMKR DUAL CHMBR GP061 $ 21,600.00 2120510062 HC IMPL PACEMKR DUAL CHMBR GP062 $ 22,400.00 2120510063 HC IMPL PACEMKR DUAL CHMBR GP063 $ 23,200.00 2120510064 HC IMPL PACEMKR DUAL CHMBR GP064 $ 24,000.00 2120510065 HC IMPL PACEMKR DUAL CHMBR GP065 $ 24,800.00 2120510066 HC IMPL PACEMKR DUAL CHMBR GP066 $ 25,600.00 2120510067 HC IMPL PACEMKR DUAL CHMBR GP067 $ 26,400.00 2120510113 HC IMPL PACEMKR DUAL CHMBR GP113 $ 59,400.00 2120510115 HC IMPL PACEMKR DUAL CHMBR GP115 $ 71,500.00 2120511010 HC SET CATH GP010 $ 665.00 2120511013 HC SET CATH GP013 $ 900.00 2120511014 HC SET CATH GP014 $ 1,080.00 2120511015 HC SET CATH GP015 $ 1,225.00 2120511016 HC SET CATH GP016 $ 1,400.00 2120511017 HC SET CATH GP017 $ 1,575.00 2120511021 HC SET CATH GP021 $ 2,888.00 2120511042 HC SET CATH GP042 $ 10,350.00 2120512011 HC KIT CATH REPAIR GP011 $ 740.00 2120512013 HC KIT CATH REPAIR GP013 $ 900.00 2120512014 HC KIT CATH REPAIR GP014 $ 1,080.00 2120513011 HC TRAY CATH GP011 $ 740.00 2120513013 HC TRAY CATH GP013 $ 900.00 2120513014 HC TRAY CATH GP014 $ 1,080.00 2120513015 HC TRAY CATH GP015 $ 1,225.00 2120514015 HC KIT CATH GP015 $ 1,225.00 2120514016 HC KIT CATH GP016 $ 1,400.00 2120515011 HC RETAINER NOSTRIL GP011 $ 740.00 2120515012 HC RETAINER NOSTRIL GP012 $ 810.00 2120515014 HC RETAINER NOSTRIL GP014 $ 1,080.00 2120515015 HC RETAINER NOSTRIL GP015 $ 1,225.00 2120516014 HC CHISEL GP014 $ 1,080.00 2120517015 HC WAND GP015 $ 1,225.00 2120517017 HC WAND GP017 $ 1,575.00 2120517018 HC WAND GP018 $ 1,750.00 2120517019 HC WAND GP019 $ 2,125.00 2120518012 HC KIT MICKEY GASTRO TUBE GP012 $ 810.00 2120518020 HC KIT MICKEY GASTRO TUBE GP020 $ 2,550.00 2120519008 HC TUBE JEJUNAL GP008 $ 475.00 2120519009 HC TUBE JEJUNAL GP009 $ 570.00 2120519016 HC TUBE JEJUNAL GP016 $ 1,400.00 2120519017 HC TUBE JEJUNAL GP017 $ 1,575.00 2120519018 HC TUBE JEJUNAL GP018 $ 1,750.00 2120519020 HC TUBE JEJUANAL GP020 $ 2,550.00 2120520008 HC LOOP ELECT GP008 $ 475.00 2120520009 HC LOOP ELECT GP009 $ 570.00 2120520010 HC LOOP ELECT GP010 $ 665.00 2120520011 HC LOOP ELECT GP011 $ 740.00 2120520013 HC LOOP ELECT GP013 $ 900.00

2120520014 HC LOOP ELECT GP014 $ 1,080.00 2120520015 HC LOOP ELECT GP015 $ 1,225.00 2120521009 HC ELECT HOOK GP009 $ 570.00 2120521012 HC ELECT HOOK GP012 $ 810.00 2120521013 HC ELECT HOOK GP013 $ 900.00 2120521014 HC ELECT HOOK GP014 $ 1,080.00 2120521017 HC ELECT HOOK GP017 $ 1,575.00 2120522013 HC ELECT KNIFE GP013 $ 900.00 2120522014 HC ELECT KNIFE GP014 $ 1,080.00 2120523008 HC ELECT PEDI GP008 $ 475.00 2120523009 HC ELECT PEDI GP009 $ 570.00 2120523010 HC ELECT PEDI GP010 $ 665.00 2120524012 HC ELECT ROLLERBALL GP012 $ 810.00 2120524013 HC ELECT ROLLERBALL GP013 $ 900.00 2120524014 HC ELECT ROLLERBALL GP014 $ 1,080.00 2120524015 HC ELECT ROLLERBALL GP015 $ 1,225.00 2120525011 HC ELECT BLUNT GP011 $ 740.00 2120525014 HC ELECT BLUNT GP014 $ 1,080.00 2120525015 HC ELECT BLUNT GP015 $ 1,225.00 2120526013 HC ELECT POINTED GP013 $ 900.00 2120526014 HC ELECT POINTED GP014 $ 1,080.00 2120527016 HC ELECT END/SIDE GP016 $ 1,400.00 2120527017 HC ELECT END/SIDE GP017 $ 1,575.00 2120527018 HC ELECT END/SIDE GP018 $ 1,750.00 2120528009 HC DRILL WIRE PASS GP009 $ 570.00 2120529020 HC SHEARS HARMONIC GP020 $ 2,550.00 2120529021 HC SHEARS HARMONIC GP021 $ 2,888.00 2120529022 HC SHEARS HARMONIC GP022 $ 3,300.00 2120529023 HC SHEARS HARMONIC GP023 $ 3,600.00 2120529024 HC SHEARS HARMONIC GP024 $ 4,000.00 2120529025 HC SHEARS HARMONIC GP025 $ 4,263.00 2120530013 HC LOOP GP013 $ 900.00 2120530014 HC LOOP GP014 $ 1,080.00 2120531017 HC KIT JEJUNAL GP017 $ 1,575.00 2120532002 HC STRIP SCLERAL GP002 $ 50.00 2120532003 HC STRIP SCLERAL GP003 $ 100.00 2120533006 HC FORCEP GP006 $ 293.00 2120533012 HC FORCEP GP012 $ 810.00 2120533013 HC FORCEP GP013 $ 900.00 2120533014 HC FORCEP GP014 $ 1,080.00 2120533017 HC FORCEP GP017 $ 1,575.00 2120533018 HC FORCEP GP018 $ 1,750.00 2120533019 HC FORCEP GP019 $ 2,125.00 2120533020 HC FORCEP GP020 $ 2,550.00 2120533021 HC FORCEP GP021 $ 2,888.00 2120533022 HC FORCEP GP022 $ 3,300.00 2120533023 HC FORCEP GP023 $ 3,600.00 2120533030 HC FORCEP GP030 $ 5,800.00 2120533032 HC FORCEP GP032 $ 6,300.00 2120533035 HC FORCEP GP035 $ 7,150.00 2120534005 HC TIP BIOGLUE GP005 $ 195.00 2120534006 HC TIP BIOGLUE GP006 $ 293.00 2120534007 HC TIP BIOGLUE GP007 $ 380.00

2120534008 HC TIP BIOGLUE GP008 $ 475.00 2120534020 HC TIP BIOGLUE GP020 $ 2,550.00 2120535005 HC BLOCK TEFLON GP005 $ 195.00 2120536002 HC KNIFE GP002 $ 50.00 2120536003 HC KNIFE GP003 $ 100.00 2120536004 HC KNIFE GP004 $ 146.00 2120536005 HC KNIFE GP005 $ 195.00 2120536006 HC KNIFE GP006 $ 293.00 2120536010 HC KNIFE GP010 $ 665.00 2120536013 HC KNIFE GP013 $ 900.00 2120536014 HC KNIFE GP014 $ 1,080.00 2120536015 HC KNIFE GP015 $ 1,225.00 2120536016 HC KNIFE GP016 $ 1,400.00 2120536018 HC KNIFE GP018 $ 1,750.00 2120536024 HC KNIFE GP024 $ 4,000.00 2120536025 HC KNIFE GP025 $ 4,263.00 2120537005 HC PORT GP005 $ 195.00 2120537018 HC PORT GP018 $ 1,750.00 2120537020 HC PORT GP020 $ 2,550.00 2120537021 HC PORT GP021 $ 2,888.00 2120537022 HC PORT GP022 $ 3,300.00 2120537024 HC PORT GP024 $ 4,000.00 2120537025 HC PORT GP025 $ 4,263.00 2120537032 HC PORT GP032 $ 6,300.00 2120538019 HC RESEVOIR GP019 $ 2,125.00 2120538020 HC RESEVOIR GP020 $ 2,550.00 2120538028 HC RESEVOIR GP028 $ 5,250.00 2120539020 HC BIOGLUE GP020 $ 2,550.00 2120539021 HC BIOGLUE GP021 $ 2,888.00 2120539022 HC BIOGLUE GP022 $ 3,300.00 2120539023 HC BIOGLUE GP023 $ 3,600.00 2120539027 HC BIOGLUE GP027 $ 4,875.00 2120539029 HC BIOGLUE GP029 $ 5,438.00 2120540004 HC BAND GP004 $ 146.00 2120540005 HC BAND GP005 $ 195.00 2120541007 HC DRILL GP007 $ 380.00 2120541008 HC DRILL GP008 $ 475.00 2120541009 HC DRILL GP009 $ 570.00 2120541010 HC DRILL GP010 $ 665.00 2120541011 HC DRILL GP011 $ 740.00 2120541013 HC DRILL GP013 $ 900.00 2120541014 HC DRILL GP014 $ 1,080.00 2120541015 HC DRILL GP015 $ 1,225.00 2120541016 HC DRILL GP016 $ 1,400.00 2120541017 HC DRILL GP017 $ 1,575.00 2120541018 HC DRILL GP018 $ 1,750.00 2120541019 HC DRILL GP019 $ 2,125.00 2120541020 HC DRILL GP020 $ 2,550.00 2120541023 HC DRILL GP023 $ 3,600.00 2120542014 HC PATCH GP014 $ 1,080.00 2120542016 HC PATCH GP016 $ 1,400.00 2120543003 HC LASIK FLAP GP003 $ 100.00 2120544043 HC HOOK CAUT DAVINCI GP043 $ 10,450.00

2120545002 HC TAMPON NASAL GP002 $ 50.00 2120545003 HC TAMPON NASAL GP003 $ 100.00 2120545004 HC TAMPON NASAL GP004 $ 146.00 2120546003 HC NASAL PACKING GP003 $ 100.00 2120546004 HC NASAL PACKING GP004 $ 146.00 2120546005 HC NASAL PACKING GP005 $ 195.00 2120546013 HC NASAL PACKING GP013 $ 900.00 2120547032 HC GRAFTON FLEX GP032 $ 6,300.00 2120548012 HC SKULL PERFORATOR GP012 $ 810.00 2120548013 HC SKULL PERFORATOR GP013 $ 900.00 2120548014 HC SKULL PERFORATOR GP014 $ 1,080.00 2120548017 HC SKULL PERFORATOR GP017 $ 1,575.00 2120549015 HC SET NOSTRIL SIZING GP015 $ 1,225.00 2120549016 HC SET NOSTRIL SIZING GP016 $ 1,400.00 2120549018 HC SET NOSTRIL SIZING GP018 $ 1,750.00 2120550009 HC SET INTRODUCER GP009 $ 570.00 2120550011 HC SET INTRODUCER GP011 $ 740.00 2120551009 HC SET SUTURE GP009 $ 570.00 2120551012 HC SET SUTURE GP012 $ 810.00 2120551013 HC SET SUTURE GP013 $ 900.00 2120552006 HC IMPL PISTON GP006 $ 293.00 2120552007 HC IMPL PISTON GP007 $ 380.00 2120552013 HC IMPL PISTON GP013 $ 900.00 2120552014 HC IMPL PISTON GP014 $ 1,080.00 2120552015 HC IMPL PISTON GP015 $ 1,225.00 2120552016 HC IMPL PISTON GP016 $ 1,400.00 2120552017 HC IMPL PISTON GP017 $ 1,575.00 2120552018 HC IMPL PISTON GP018 $ 1,750.00 2120553013 HC IMPL PISTON LOOP GP013 $ 900.00 2120555018 HC IMPL TOE GP018 $ 1,750.00 2120555020 HC IMPL TOE GP020 $ 2,550.00 2120555027 HC IMPL TOE GP027 $ 4,875.00 2120556015 HC IMPL TESTICULAR GP015 $ 1,225.00 2120556016 HC IMPL TESTICULAR GP016 $ 1,400.00 2120556038 HC IMPL TESTICULAR GP038 $ 8,750.00 2120556040 HC IMPL TESTICULAR GP040 $ 9,600.00 2120556041 HC IMPL TESTICULAR GP041 $ 9,775.00 2120557039 HC IMPL SPHINCTER GP039 $ 9,000.00 2120557041 HC IMPL SPHINCTER GP041 $ 9,775.00 2120557043 HC IMPL SPHINCTER GP043 $ 10,450.00 2120557047 HC IMPL SPHINCTER GP047 $ 13,000.00 2120557049 HC IMPL SPHINCTER GP049 $ 14,250.00 2120558021 HC IMPL BAR PECTUS GP021 $ 2,888.00 2120558027 HC IMPL BAR PECTUS GP027 $ 4,875.00 2120558031 HC IMPL BAR PECTUS GP031 $ 5,950.00 2120558034 HC IMPL BAR PECTUS GP034 $ 6,750.00 2120559018 HC IMPL BAND TENSION GP018 $ 1,750.00 2120559019 HC IMPL BAND TENSION GP019 $ 2,125.00 2120559021 HC IMPL BAND TENSION GP021 $ 2,888.00 2120560048 HC IMPL RAMP ANTERIOR GP048 $ 14,000.00 2120561052 HC IMPL CONDYLE GP052 $ 16,200.00 2120561076 HC IMPL CONDYLE GP076 $ 33,600.00 2120562018 HC IMPL RIM ORBITAL GP018 $ 1,750.00

2120562019 HC IMPL RIM ORBITAL GP019 $ 2,125.00 2120562020 HC IMPL RIM ORBITAL GP020 $ 2,550.00 2120563020 HC IMPL RIM ORBITAL GP020 $ 2,550.00 2120563026 HC IMPL RIM ORBITAL GP026 $ 4,650.00 2120564014 HC IMPL PISTON EAR GP014 $ 1,080.00 2120565013 HC IMPL CATH GP013 $ 900.00 2120565015 HC IMPL CATH INFUSION GP018 $ 1,225.00 2120565016 HC IMPL CATH GP016 $ 1,400.00 2120565018 HC IMPL CATH INFUSION GP018 $ 1,750.00 2120565020 HC IMPL CATH GP020 $ 2,550.00 2120565021 HC IMPL CATH GP021 $ 2,888.00 2120565023 HC IMPL CATH INFUSION GP023 $ 3,600.00 2120565024 HC IMPL CATH GP024 $ 4,000.00 2120565026 HC IMPL CATH GP026 $ 4,650.00 2120565027 HC IMPL CATH GP027 $ 4,875.00 2120565028 HC IMPL CATH GP028 $ 5,250.00 2120566023 HC KIT BIOGLUE GP023 $ 3,600.00 2120566027 HC KIT BIOGLUE GP027 $ 4,875.00 2120567027 HC IMPL CRYOLIFE GP027 $ 4,875.00 2120567041 HC IMPL CRYOLIFE GP041 $ 9,775.00 2120567054 HC IMPL CRYOLIFE GP054 $ 17,000.00 2120568003 HC IMPL GUIDEWIRE GP003 $ 100.00 2120568004 HC IMPL GUIDEWIRE GP004 $ 146.00 2120568005 HC IMPL GUIDEWIRE GP005 $ 195.00 2120568006 HC IMPL GUIDEWIRE GP006 $ 293.00 2120568021 HC IMPL GUIDEWIRE GP021 $ 2,888.00 2120569020 HC FORCEP BIOPSY GP020 $ 2,550.00 2120570003 HC CLAMP MUSCLE BIOPSY GP003 $ 100.00 2120570004 HC CLAMP MUSCLE BIOPSY GP004 $ 146.00 2120571006 HC KNIFE OPHTHALMOLOGY GP006 $ 293.00 2120571007 HC KNIFE OPHTHALMOLOGY GP007 $ 380.00 2120572019 HC IMPL WEDGE ENOPHTAL GP019 $ 2,125.00 2120572020 HC IMPL WEDGE ENOPHTAL GP020 $ 2,550.00 2120573030 HC IMPL WEDGE PATELLA GP030 $ 5,800.00 2120573032 HC IMPL WEDGE PATELLA GP032 $ 6,300.00 2120573033 HC IMPL WEDGE PATELLA GP033 $ 6,413.00 2120573034 HC IMPL WEDGE PATELLA GP034 $ 6,750.00 2120574013 HC STAPLE GP013 $ 900.00 2120574014 HC STAPLE GP014 $ 1,080.00 2120574016 HC STAPLE GP016 $ 1,400.00 2120575002 HC IMPL WIRE GP002 $ 50.00 2120575003 HC IMPL WIRE GP003 $ 100.00 2120575004 HC IMPL WIRE GP004 $ 146.00 2120575005 HC IMPL WIRE GP005 $ 195.00 2120575006 HC IMPL WIRE GP006 $ 293.00 2120575007 HC IMPL WIRE GP007 $ 380.00 2120575008 HC IMPL WIRE GP008 $ 475.00 2120575011 HC IMPL WIRE GP011 $ 740.00 2120575012 HC IMPL WIRE GP012 $ 810.00 2120575013 HC IMPL WIRE GP013 $ 900.00 2120575024 HC IMPL WIRE GP024 $ 4,000.00 2120575025 HC IMPL WIRE GP025 $ 4,263.00 2120575026 HC IMPL WIRE GP026 $ 4,650.00

2120575027 HC IMPL WIRE GP027 $ 4,875.00 2120576072 HC IMPL NEURO STIMULATOR GP072 $ 30,400.00 2120576076 HC IMPL NEURO STIMULATOR GP076 $ 33,600.00 2120576077 HC IMPL NEURO STIMULATOR GP077 $ 34,400.00 2120576078 HC IMPL NEURO STIMULATOR GP078 $ 35,200.00 2120576081 HC IMPL NEURO STIMULATOR GP081 $ 37,600.00 2120576082 HC IMPL NEURO STIMULATOR GP082 $ 38,400.00 2120576085 HC IMPL NEURO STIMULATOR GP085 $ 40,800.00 2120577011 HC CLAMP ENDO GP011 $ 740.00 2120578026 HC IMPL SHUNT PERITONEAL GP026 $ 4,650.00 2120579022 HC HEADSET MIC GP022 $ 3,300.00 2120580035 HC IMPL PATCH PULM GP035 $ 7,150.00 2120580040 HC IMPL PATCH PULM GP040 $ 9,600.00 2120580042 HC IMPL PATCH PULM GP042 $ 10,350.00 2120580049 HC IMPL PATCH PULM GP049 $ 14,250.00 2120580050 HC IMPL PATCH PULM GP050 $ 15,200.00 2120580051 HC IMPL PATCH PULM GP051 $ 15,300.00 2120580052 HC IMPL PATCH PULM GP052 $ 16,200.00 2120580053 HC IMPL PATCH PULM GP053 $ 16,300.00 2120580057 HC IMPL PATCH PULM GP057 $ 18,400.00 2120580058 HC IMPL PATCH PULM GP058 $ 19,200.00 2120581063 HC IMPL SPEECH PROCESSOR GP063 $ 23,200.00 2120582007 HC SCISSOR ENDO DISP GP007 $ 380.00 2120582010 HC SCISSOR ENDO DISP GP010 $ 665.00 2120583004 HC CATH APPLICATION GP004 $ 146.00 2120583008 HC CATH APPLICATION GP008 $ 475.00 2120584051 HC IMPL AORTA THORAC DESCND GP051 $ 15,300.00 2120584062 HC IMPL AORTA THORAC DESCND GP062 $ 22,400.00 2120585051 HC IMPL AORTA THORAC ASCND GP051 $ 15,300.00 2120586100 HC IMPL CARD DEFIB DUAL GP100 $ 50,160.00 2120586108 HC IMPL CARD DEFIB DUAL GP108 $ 50,616.00 2120586113 HC IMPL CARD DEFIB DUAL GP113 $ 59,400.00 2120586114 HC IMPL CARD DEFIB DUAL GP114 $ 65,400.00 2120586121 HC IMPL CARD DEFIB DUALGP121 $ 102,000.00 2120586149 HC IMPL CARD DEFIB DUAL GP149 $ 180,000.00 2120587008 HC IMPL SCREW MAXI GP008 $ 475.00 2120587009 HC IMPL SCREW MAXI GP009 $ 570.00 2120588007 HC IMPL SCREW MICRO GP007 $ 380.00 2120588008 HC IMPL SCREW MICRO GP008 $ 475.00 2120588009 HC IMPL SCREW MICRO GP009 $ 570.00 2120589007 HC IMPL SCREW SELF DRILLING GP007 $ 380.00 2120589008 HC IMPL SCREW SELF DRILLING GP008 $ 475.00 2120589009 HC IMPL SCREW SELF DRILLING GP009 $ 570.00 2120589010 HC IMPL SCREW SELF DRILLING GP010 $ 665.00 2120589011 HC IMPL SCREW SELF DRILLING GP011 $ 740.00 2120589013 HC IMPL SCREW SELF DRILLING GP013 $ 900.00 2120589016 HC IMPL SCREW SELF DRILLING GP016 $ 1,400.00 2120590017 HC TIP SONOTRODE STRT GP017 $ 1,575.00 2120591007 HC IMPL CONNECTOR GP007 $ 380.00 2120591021 HC IMPL CONNECTOR GP021 $ 2,888.00 2120591024 HC IMPL CONNECTOR GP024 $ 4,000.00 2120591028 HC IMPL CONNECTOR GP028 $ 5,250.00 2120591029 HC IMPL CONNECTOR GP029 $ 5,438.00

2120591030 HC IMPL CONNECTOR GP030 $ 5,800.00 2120591031 HC IMPL CONNECTOR GP031 $ 5,950.00 2120591032 HC IMPL CONNECTOR GP032 $ 6,300.00 2120591034 HC IMPL CONNECTOR GP034 $ 6,750.00 2120591035 HC IMPL CONNECTOR GP035 $ 7,150.00 2120591036 HC IMPL CONNECTOR GP036 $ 7,800.00 2120591037 HC IMPL CONNECTOR GP037 $ 8,125.00 2120591038 HC IMPL CONNECTOR GP038 $ 8,750.00 2120591042 HC IMPL CONNECTOR GP042 $ 10,350.00 2120591044 HC IMPL CONNECTOR GP044 $ 11,000.00 2120592032 HC IMPL HOOD GP032 $ 6,300.00 2120593003 HC IMPL CLIP NEURO GP003 $ 100.00 2120593007 HC IMPL CLIP NEURO GP007 $ 380.00 2120593011 HC IMPL CLIP NEURO GP011 $ 740.00 2120594008 HC IMPL SCREW SET GP008 $ 475.00 2120594012 HC IMPL SCREW SET GP012 $ 810.00 2120594013 HC IMPL SCREW SET GP013 $ 900.00 2120594014 HC IMPL SCREW SET GP014 $ 1,080.00 2120594015 HC IMPL SCREW SET GP015 $ 1,225.00 2120594016 HC IMPL SCREW SET GP016 $ 1,400.00 2120595073 HC IMPL CRANIAL CUSTOM GP073 $ 31,200.00 2120595076 HC IMPL CRANIAL CUSTOM GP076 $ 33,600.00 2120595087 HC IMPL CRANIAL CUSTOM GP087 $ 42,400.00 2120595092 HC IMPL CRANIAL CUSTOM GP092 $ 46,400.00 2120595097 HC IMPL CRANIAL CUSTOM GP097 $ 49,770.00 2120595098 HC IMPL CRANIAL CUSTOM GP098 $ 49,920.00 2120595109 HC IMPL CRANIAL CUSTOM GP109 $ 51,000.00 2120596017 HC APPLICATOR GP017 $ 1,575.00 2120596018 HC APPLICATOR GP018 $ 1,750.00 2120596019 HC APPLICATOR GP019 $ 2,125.00 2120596021 HC APPLICATOR GP021 $ 2,888.00 2120596024 HC APPLICATOR GP024 $ 4,000.00 2120597002 HC TUBE VENT GP002 $ 50.00 2120597003 HC TUBE VENT GP003 $ 100.00 2120597004 HC TUBE VENT GP004 $ 146.00 2120597005 HC TUBE VENT GP005 $ 195.00 2120597006 HC TUBE VENT GP006 $ 293.00 2120598032 HC PROBE NEURO GP032 $ 6,300.00 2120598033 HC PROBE NEURO GP033 $ 6,413.00 2120599010 HC KIT CATH NASAL GP010 $ 665.00 2120599012 HC KIT CATH NASAL GP012 $ 810.00 2120600019 HC IMPL MEDPOR SHEET GP019 $ 2,125.00 2120600021 HC IMPL MEDPOR SHEET GP021 $ 2,888.00 2120601004 HC HOOKWIRE GP004 $ 146.00 2120601006 HC HOOKWIRE GP006 $ 293.00 2120602035 HC SYSTEM EQUIFLOW GP035 $ 7,150.00 2120603019 HC IMPL MATRIX REGENERATN GP019 $ 2,125.00 2120603020 HC IMPL MATRIX REGENERATN GP020 $ 2,550.00 2120603025 HC IMPL MATRIX REGENERATN GP025 $ 4,263.00 2120603026 HC IMPL MATRIX REGENERATN GP026 $ 4,650.00 2120603034 HC IMPL MATRIX REGENERATN GP034 $ 6,750.00 2120603038 HC IMPL MATRIX REGENERATN GP038 $ 8,750.00 2120603039 HC IMPL MATRIX REGENERATN GP039 $ 9,000.00

2120604006 HC TUNNELER GP006 $ 293.00 2120604007 HC TUNNELER GP007 $ 380.00 2120604011 HC TUNNELER GP011 $ 740.00 2120605010 HC CATH BALLOON DIL NONVASC GP010 $ 665.00 2120605013 HC CATH BALLOON DIL NONVASC GP013 $ 900.00 2120605014 HC CATH BALLOON DIL NONVASC GP014 $ 1,080.00 2120605015 HC CATH BALLOON DIL NONVASC GP015 $ 1,225.00 2120605016 HC CATH BALLOON DIL NONVASC GP016 $ 1,400.00 2120605017 HC CATH BALLOON DIL NONVASC GP017 $ 1,575.00 2120605018 HC CATH BALLOON DIL NONVASC GP018 $ 1,750.00 2120605019 HC CATH BALLOON DIL NONVASC GP019 $ 2,125.00 2120605020 HC CATH BALLOON DIL NONVASC GP020 $ 2,550.00 2120605025 HC CATH BALLOON DIL NONVASC GP025 $ 4,263.00 2120605026 HC CATH BALLOON DIL NONVASC GP026 $ 4,650.00 2120605027 HC CATH BALLOON DIL NONVASC GP027 $ 4,875.00 2120605028 HC CATH BALLOON DIL NONVASC GP028 $ 5,250.00 2120605029 HC CATH BALLOON DIL NONVASC GP029 $ 5,438.00 2120605030 HC CATH BALLOON DIL NONVASC GP030 $ 5,800.00 2120605033 HC CATH BALLOON DIL NONVASC GP033 $ 6,413.00 2120605034 HC CATH BALLOON DIL NONVASC GP034 $ 6,750.00 2120605035 HC CATH BALLOON DIL NONVASC GP035 $ 7,150.00 2120605050 HC CATH BALLOON DIL NONVASC GP050 $ 15,200.00 2120606026 HC IMPL GRID CORTICAL GP026 $ 4,650.00 2120606029 HC IMPL GRID CORTICAL GP029 $ 5,438.00 2120606037 HC IMPL GRID CORTICAL GP037 $ 8,125.00 2120607022 HC IMPL STRIP CORTICAL GP022 $ 3,300.00 2120607025 HC IMPL STRIP CORTICAL GP025 $ 4,263.00 2120608019 HC KIT INTRACRANIAL MONITOR GP019 $ 2,125.00 2120608025 HC KIT INTRACRANIAL MONITOR GP025 $ 4,263.00 2120608026 HC KIT INTRACRANIAL MONITOR GP026 $ 4,650.00 2120609050 HC SYSTEM OSV II LOW PRO GP050 $ 15,200.00 2120610015 HC IMPL BONE MATRIX DEMIN GP015 $ 1,225.00 2120610026 HC IMPL BONE MATRIX DEMIN GP026 $ 4,650.00 2120610030 HC IMPL BONE MATRIX DEMIN GP030 $ 5,800.00 2120610031 HC IMPL BONE MATRIX DEMIN GP031 $ 5,950.00 2120610033 HC IMPL BONE MATRIX DEMIN GP033 $ 6,413.00 2120610034 HC IMPL BONE MATRIX DEMIN GP034 $ 6,750.00 2120610037 HC IMPL BONE MATRIX DEMIN GP037 $ 8,125.00 2120610038 HC IMPL BONE MATRIX DEMIN GP038 $ 8,750.00 2120610039 HC IMPL BONE MATRIX DEMIN GP039 $ 9,000.00 2120610041 HC IMPL BONE MATRIX DEMIN GP041 $ 9,775.00 2120610048 HC IMPL BONE MATRIX DEMIN GP048 $ 14,000.00 2120610050 HC IMPL BONE MATRIX DEMIN GP050 $ 15,200.00 2120611025 HC KIT VENT MONITORING GP025 $ 4,263.00 2120612025 HC KIT SHUNT PERITONEAL GP025 $ 4,263.00 2120613008 HC IMPL CAP LOCKING GP008 $ 475.00 2120613009 HC IMPL CAP LOCKING GP009 $ 570.00 2120613021 HC IMPL CAP LOCKING GP021 $ 2,888.00 2120613022 HC IMPL CAP LOCKING GP022 $ 3,300.00 2120615005 HC TIP FILIFORM GP005 $ 195.00 2120615006 HC TIP FILIFORM GP006 $ 293.00 2120615007 HC TIP FILIFORM GP007 $ 293.00 2120616014 HC IMPL PATCH DURA REPAIR GP014 $ 1,080.00

2120616015 HC IMPL PATCH DURA REPAIR GP015 $ 1,225.00 2120616019 HC IMPL PATCH DURA REPAIR GP019 $ 2,125.00 2120616020 HC IMPL PATCH DURA REPAIR GP020 $ 2,550.00 2120616021 HC IMPL PATCH DURA REPAIR GP021 $ 2,888.00 2120616024 HC IMPL PATCH DURA REPAIR GP024 $ 4,000.00 2120616025 HC IMPL PATCH DURA REPAIR GP025 $ 4,263.00 2120616027 HC IMPL PATCH DURA REPAIR GP027 $ 4,875.00 2120617011 HC KIT CORFLOW MAX PEG GP011 $ 740.00 2120617013 HC KIT CORFLOW MAX PEG GP013 $ 900.00 2120617014 HC KIT CORFLOW MAX PEG GP014 $ 1,080.00 2120617015 HC KIT CORFLOW MAX PEG GP015 $ 1,225.00 2120617017 HC KIT CORFLOW MAX PEG GP017 $ 1,575.00 2120618013 HC IMPL BLOCKER GP013 $ 900.00 2120618014 HC IMPL BLOCKER GP014 $ 1,080.00 2120618015 HC IMPL BLOCKER GP015 $ 1,225.00 2120618017 HC IMPL BLOCKER GP017 $ 1,575.00 2120618018 HC IMPL BLOCKER GP018 $ 1,750.00 2120619016 HC LASER FIBER GP017 $ 1,400.00 2120619017 HC LASER FIBER GP017 $ 1,575.00 2120619018 HC LASER FIBER GP018 $ 1,750.00 2120619019 HC LASER FIBER GP019 $ 2,125.00 2120619020 HC LASER FIBER GP020 $ 2,550.00 2120619021 HC LASER FIBER GP021 $ 2,888.00 2120619022 HC LASER FIBER GP022 $ 3,300.00 2120619023 HC LASER FIBER GP023 $ 3,600.00 2120619024 HC LASER FIBER GP024 $ 4,000.00 2120619028 HC LASER FIBER GP028 $ 5,250.00 2120619029 HC LASER FIBER GP029 $ 5,438.00 2120619034 HC LASER FIBER GP034 $ 6,750.00 2120619036 HC LASER FIBER GP036 $ 7,800.00 2120619038 HC LASER FIBER GP038 $ 8,750.00 2120619061 HC LASER FIBER GP061 $ 21,600.00 2120619071 HC LASER FIBER GP071 $ 29,600.00 2120619108 HC LASER FIBER GP108 $ 50,616.00 2120620004 HC IMPL TENDONOSIS GP004 $ 146.00 2120620033 HC IMPL TENDONOSIS GP033 $ 6,413.00 2120620034 HC IMPL TENDONOSIS GP034 $ 6,750.00 2120620036 HC IMPL TENDONOSIS GP036 $ 7,800.00 2120620043 HC IMPL TENDONOSIS GP043 $ 10,450.00 2120621020 HC IMPL CARTILAGE COSTAL GP020 $ 2,550.00 2120621021 HC IMPL CARTILAGE COSTAL GP021 $ 2,888.00 2120622035 HC KIT IMPL SHUNT GP035 $ 7,150.00 2120622037 HC KIT IMPL SHUNT GP037 $ 8,125.00 2120622038 HC KIT IMPL SHUNT GP038 $ 8,750.00 2120622041 HC KIT IMPL SHUNT GP041 $ 9,775.00 2120622042 HC KIT IMPL SHUNT GP042 $ 10,350.00 2120623030 HC BOW HORIZONTAL GP030 $ 5,800.00 2120624002 HC CATH URETAL GP002 $ 50.00 2120624003 HC CATH URETAL GP003 $ 100.00 2120624004 HC CATH URETAL GP004 $ 146.00 2120624005 HC CATH URETAL GP005 $ 195.00 2120625011 HC SET SHEATH GP011 $ 740.00 2120626002 HC NDL BONE MARROW ASP GP002 $ 50.00

2120626003 HC NDL BONE MARROW ASP GP003 $ 100.00 2120626004 HC NDL BONE MARROW ASP GP004 $ 146.00 2120626005 HC NDL BONE MARROW ASP GP005 $ 195.00 2120626013 HC NDL BONE MARROW ASP GP013 $ 900.00 2120627021 HC SEALANT DEVICE DISP GP021 $ 2,888.00 2120627024 HC SEALANT DEVICE DISP GP024 $ 4,000.00 2120627025 HC SEALANT DEVICE DISP GP025 $ 4,263.00 2120628003 HC MATTRESS GEL FILLED GP003 $ 100.00 2120628004 HC MATTRESS GEL FILLED GP004 $ 146.00 2120628005 HC MATTRESS GEL FILLED GP005 $ 195.00 2120629004 HC TRAY BONE MARROW GP004 $ 146.00 2120629005 HC TRAY BONE MARROW GP005 $ 195.00 2120629006 HC TRAY BONE MARROW GP006 $ 293.00 2120630004 HC IMPL SHEET GP004 $ 146.00 2120630022 HC IMPL SHEET GP022 $ 3,300.00 2120630023 HC IMPL SHEET GP023 $ 3,600.00 2120630028 HC IMPL SHEET GP028 $ 5,250.00 2120630065 HC IMPL SHEET GP065 $ 24,800.00 2120630080 HC IMPL SHEET GP080 $ 36,800.00 2120630082 HC IMPL SHEET GP082 $ 38,400.00 2120631029 HC IMPL CLAMP GP029 $ 5,438.00 2120631034 HC IMPL CLAMP GP034 $ 6,750.00 2120631037 HC IMPL CLAMP GP037 $ 8,125.00 2120632024 HC SEALANT GP024 $ 4,000.00 2120632025 HC SEALANT GP025 $ 4,263.00 2120632030 HC SEALANT GP030 $ 5,800.00 2120633014 HC DISTRACTION TOOL DISP GP014 $ 1,080.00 2120633016 HC DISTRACTION TOOL DISP GP016 $ 1,400.00 2120633018 HC DISTRACTION TOOL DISP GP018 $ 1,750.00 2120633019 HC DISTRACTION TOOL DISP GP019 $ 2,125.00 2120633020 HC DISTRACTION TOOL DISP GP020 $ 2,550.00 2120633021 HC DISTRACTION TOOL DISP GP021 $ 2,888.00 2120633022 HC DISTRACTION TOOL DISP GP022 $ 3,300.00 2120634008 HC DISTRACTION CAP ROD $ 475.00 2120634013 HC IMPL CAP ROD GP013 $ 900.00 2120635003 HC KIT DRESSING GP003 $ 100.00 2120636018 HC IMPL DISTRACTOR GP018 $ 1,750.00 2120636019 HC IMPL DISTRACTOR GP019 $ 2,125.00 2120636029 HC IMPL DISTRACTOR GP029 $ 5,438.00 2120636030 HC IMPL DISTRACTOR GP030 $ 5,800.00 2120636032 HC IMPL DISTRACTOR GP032 $ 6,300.00 2120636044 HC IMPL DISTRACTOR GP044 $ 11,000.00 2120636045 HC IMPL DISTRACTOR GP045 $ 11,550.00 2120636048 HC IMPL DISTRACTOR GP048 $ 14,000.00 2120636052 HC IMPL DISTRACTOR GP052 $ 16,200.00 2120636053 HC IMPL DISTRACTOR GP053 $ 16,300.00 2120636055 HC IMPL DISTRACTOR GP055 $ 17,300.00 2120636056 HC IMPL DISTRACTOR GP056 $ 17,600.00 2120636058 HC IMPL DISTRACTOR GP058 $ 19,200.00 2120636059 HC IMPL DISTRACTOR GP059 $ 20,000.00 2120636061 HC IMPL DISTRACTOR GP061 $ 21,600.00 2120636062 HC IMPL DISTRACTOR GP062 $ 22,400.00 2120636063 HC IMPL DISTRACTOR GP063 $ 23,200.00

2120637013 HC IMPL TUBING SILICONE GP013 $ 900.00 2120637014 HC IMPL TUBING SILICONE GP014 $ 1,080.00 2120638011 HC MICKEY GASTRO G TUBE GP011 $ 740.00 2120638012 HC MICKEY GASTRO G TUBE GP012 $ 810.00 2120638013 HC TUBE MICKEY GASTRO G GP013 $ 900.00 2120638014 HC MICKEY GASTRO G TUBE GP014 $ 1,080.00 2120638015 HC MICKEY GASTRO G TUBE GP015 $ 1,225.00 2120638019 HC MICKEY GASTRO G TUBE GP019 $ 2,125.00 2120638020 HC MICKEY GASTRO G TUBE GP020 $ 2,550.00 2120639034 HC IMPL GEL DEFLUX GP034 $ 6,750.00 2120639036 HC IMPL GEL DEFLUX GP036 $ 7,800.00 2120639042 HC IMPL GEL DEFLUX GP042 $ 10,350.00 2120640026 HC IMPL RING FEMORAL GP026 $ 4,650.00 2120641031 HC IMPL GRAFT BONE INFUSE GP031 $ 5,950.00 2120641041 HC IMPL GRAFT BONE INFUSE GP041 $ 9,775.00 2120641056 HC IMPL GRAFT BONE INFUSE GP056 $ 17,600.00 2120641059 HC IMPL GRAFT BONE INFUSE GP059 $ 20,000.00 2120641060 HC IMPL GRAFT BONE INFUSE GP060 $ 20,800.00 2120641061 HC IMPL GRAFT BONE INFUSE GP061 $ 21,600.00 2120642015 HC FLOSEAL GP015 $ 1,225.00 2120642016 HC FLOSEAL GP016 $ 1,400.00 2120642017 HC FLOSEAL GP017 $ 1,575.00 2120642019 HC FLOSEAL GP019 $ 2,125.00 2120642020 HC FLOSEAL GP020 $ 2,550.00 2120643002 HC TRAY LUMBAR GP002 $ 50.00 2120643003 HC TRAY LUMBAR GP003 $ 100.00 2120643004 HC TRAY LUMBAR GP004 $ 146.00 2120644002 HC IMPL SUTURE GP002 $ 50.00 2120645021 HC LIGASURE HANDPIECE DISP GP021 $ 2,888.00 2120645024 HC LIGASURE HANDPIECE DISP GP024 $ 4,000.00 2120646037 HC PUTTY BONE GP037 $ 8,125.00 2120647034 HC IMPL NAIL DISTAL FEMORAL GP034 $ 6,750.00 2120647036 HC IMPL NAIL DISTAL FEMORAL GP036 $ 7,800.00 2120647037 HC IMPL NAIL DISTAL FEMORAL GP037 $ 8,125.00 2120647038 HC IMPL NAIL DISTAL FEMORAL GP038 $ 8,750.00 2120647039 HC IMPL NAIL DISTAL FEMORAL GP039 $ 9,000.00 2120647040 HC IMPL NAIL DISTAL FEMORAL GP040 $ 9,600.00 2120647041 HC IMPL NAIL DISTAL FEMORAL GP041 $ 9,775.00 2120647044 HC IMPL NAIL DISTAL FEMORAL GP044 $ 11,000.00 2120647047 HC IMPL NAIL DISTAL FEMORAL GP047 $ 13,000.00 2120648041 HC IMPL PLATE DISTAL FEMUR GP041 $ 9,775.00 2120649042 HC IMPL BIOACTVE STRIP FOAM GP042 $ 10,350.00 2120649043 HC IMPL BIOACTVE STRIP FOAM GP043 $ 10,450.00 2120649051 HC IMPL BIOACTVE STRIP FOAM GP051 $ 15,300.00 2120650019 HC IMPL SHEA TORP GP019 $ 2,125.00 2120651022 HC IMPL NON-MESHED SKIN GP022 $ 3,300.00 2120652029 HC IMPL GRAFT VASC RINGED GP029 $ 5,438.00 2120652031 HC IMPL GRAFT VASC RINGED GP031 $ 5,950.00 2120652032 HC IMPL GRAFT VASC RINGED GP032 $ 6,300.00 2120652034 HC IMPL GRAFT VASC RINGED GP034 $ 6,750.00 2120653015 HC IMPL GRAFT VASC STRETCH GP015 $ 1,225.00 2120653016 HC IMPL GRAFT VASC STRETCH GP016 $ 1,400.00 2120653019 HC IMPL GRAFT VASC STRETCH GP019 $ 2,125.00

2120653020 HC IMPL GRAFT VASC STRETCH GP020 $ 2,550.00 2120653023 HC IMPL GRAFT VASC STRETCH GP023 $ 3,600.00 2120653024 HC IMPL GRAFT VASC STRETCH GP024 $ 4,000.00 2120653025 HC IMPL GRAFT VASC STRETCH GP025 $ 4,263.00 2120653026 HC IMPL GRAFT VASC STRETCH GP026 $ 4,650.00 2120653029 HC IMPL GRAFT VASC STRETCH GP029 $ 5,438.00 2120653035 HC IMPL GRAFT VASC STRETCH GP035 $ 7,150.00 2120653042 HC IMPL GRAFT VASC STRETCH GP042 $ 10,350.00 2120653045 HC IMPL GRAFT VASC STRETCH GP045 $ 11,550.00 2120654018 HC IMPL PATCH CARDIOVASC GP018 $ 1,750.00 2120654019 HC IMPL PATCH CARDIOVASC GP019 $ 2,125.00 2120654034 HC IMPL PATCH CARDIOVASC GP034 $ 6,750.00 2120654035 HC IMPL PATCH CARDIOVASC GP035 $ 7,150.00 2120655025 HC IMPL GRAFT VASC RMV RING GP025 $ 4,263.00 2120655026 HC IMPL GRAFT VASC RMV RING GP026 $ 4,650.00 2120656019 HC IMPL MEMBRANE PERICARD GP019 $ 2,125.00 2120656020 HC IMPL MEMBRANE PERICARD GP020 $ 2,550.00 2120656021 HC IMPL MEMBRANE PERICARD GP021 $ 2,888.00 2120656028 HC IMPL MEMBRANE PERICARD GP028 $ 5,250.00 2120656037 HC IMPL MEMBRANE PERICARD GP037 $ 8,125.00 2120657054 HC IMPL VALVED CONDUIT GP054 $ 17,000.00 2120657058 HC IMPL VALVED CONDUIT GP058 $ 19,200.00 2120658017 HC IMPL EYELID GOLD WEIGHT GP017 $ 1,575.00 2120658018 HC IMPL EYELID GOLD WEIGHT GP018 $ 1,750.00 2120658019 HC IMPL EYELID GOLD WEIGHT GP019 $ 2,125.00 2120658020 HC IMPL EYELID GOLD WEIGHT GP020 $ 2,550.00 2120659048 HC PROBE SURG ABLATION DISP GP048 $ 14,000.00 2120659049 HC PROBE SURG ABLATION DISP GP049 $ 14,250.00 2120660002 HC STOCKINETTE GP002 $ 50.00 2120660003 HC STOCKINETTE GP003 $ 100.00 2120660004 HC STOCKINETTE GP004 $ 146.00 2120660005 HC STOCKINETTE GP005 $ 195.00 2120660013 HC STOCKINETTE GP013 $ 900.00 2120661012 HC IMPL RESERVOIR VENTRCLR GP012 $ 810.00 2120661014 HC IMPL RESERVOIR VENTRCLR GP014 $ 1,080.00 2120661019 HC IMPL RESERVOIR VENTRCLR GP019 $ 2,125.00 2120661020 HC IMPL RESERVOIR VENTRCLR GP020 $ 2,550.00 2120662008 HC IRRIGATOR DISP GP008 $ 475.00 2120662013 HC IRRIGATOR DISP GP013 $ 900.00 2120663006 HC IMPL PIN GUIDE GP006 $ 293.00 2120664005 HC SCISSORS DISP GP0005 $ 195.00 2120664011 HC SCISSORS DISP GP011 $ 740.00 2120664016 HC SCISSORS DISP GP016 $ 1,400.00 2120664017 HC SCISSORS DISP GP017 $ 1,575.00 2120664020 HC SCISSORS DISP GP020 $ 2,550.00 2120664021 HC SCISSORS DISP GP021 $ 2,888.00 2120664022 HC SCISSORS DISP GP022 $ 3,300.00 2120664049 HC SCISSORS DISP GP049 $ 14,250.00 2120665014 HC LAPAROSCOPIC GRASP DISP GP014 $ 1,080.00 2120665019 HC LAPAROSCOPIC GRASP DISP GP019 $ 2,125.00 2120665022 HC LAPAROSCOPIC GRASP DISP GP022 $ 3,300.00 2120667022 HC IMPL CATH DURA FLOW GP022 $ 3,300.00 2120668032 HC IMPL SHUNT NEURO GP032 $ 6,300.00

2120668033 HC IMPL SHUNT NEURO GP033 $ 6,413.00 2120668035 HC IMPL SHUNT NEURO GP035 $ 7,150.00 2120668041 HC IMPL SHUNT NEURO GP041 $ 9,775.00 2120668045 HC IMPL SHUNT NEURO GP045 $ 11,550.00 2120668046 HC IMPL SHUNT NEURO GP046 $ 12,600.00 2120668049 HC IMPL SHUNT NEURO GP049 $ 14,250.00 2120669003 HC KIT NDL GUIDE GP003 $ 100.00 2120670020 HC CATH SINUS GP020 $ 2,550.00 2120670021 HC CATH SINUS GP021 $ 2,888.00 2120671008 HC BRACE KNEE POST-OP GP008 $ 475.00 2120671013 HC BRACE KNEE POST-OP GP013 $ 900.00 2120671014 HC BRACE KNEE POST-OP GP014 $ 1,080.00 2120672013 HC IMPL PISTON PROSTHESIS GP013 $ 900.00 2120672015 HC IMPL PISTON PROSTHESIS GP015 $ 1,225.00 2120673010 HC CATH NASAL GP010 $ 665.00 2120674010 HC SET DRAINAGE CATH GP010 $ 665.00 2120674011 HC SET DRAINAGE CATH GP011 $ 740.00 2120674013 HC SET DRAINAGE CATH GP013 $ 900.00 2120675003 HC IMPL DRAIN GP003 $ 100.00 2120675004 HC IMPL DRAIN GP004 $ 146.00 2120675006 HC IMPL DRAIN GP006 $ 293.00 2120676002 HC WIRE PACING GP002 $ 50.00 2120676003 HC WIRE PACING GP003 $ 100.00 2120676004 HC WIRE PACING GP004 $ 146.00 2120676005 HC WIRE PACING GP005 $ 195.00 2120677070 HC IMPL PACEMKR OTHER GP070 $ 28,800.00 2120677072 HC IMPL PACEMKR OTHER GP072 $ 30,400.00 2120677075 HC IMPL PACEMKR OTHER GP075 $ 32,800.00 2120678015 HC KIT LUMBAR CATH ACCESS GP015 $ 1,225.00 2120678016 HC KIT LUMBAR CATH ACCESS GP016 $ 1,400.00 2120679006 HC IMPL TYMPANIC PATCH PERF GP006 $ 293.00 2120679014 HC IMPL TYMPANIC PATCH PERF GP014 $ 1,080.00 2120679015 HC IMPL TYMPANIC PATCH PERF GP015 $ 1,225.00 2120680005 HC CATH CENTRAL VENOUS GP005 $ 195.00 2120680006 HC CATH CENTRAL VENOUS GP006 $ 293.00 2120681044 HC IMPL STENT DRUG ELUTING GP044 $ 11,000.00 2120682020 HC TUNNELING TOOL DISP GP020 $ 2,550.00 2120682021 HC TUNNELING TOOL DISP GP021 $ 2,888.00 2120683030 HC IMPL PLATE RESORB-X FOIL GP030 $ 5,800.00 2120684037 HC IMPL UNISCREW GP037 $ 8,125.00 2120685021 HC IMPL MENISCAL CINCH GP021 $ 2,888.00 2120686015 HC IMPL CANNULA ATRIAL GP015 $ 1,225.00 2120686017 HC IMPL CANNULA ATRIAL GP017 $ 1,575.00 2120686018 HC BASKET STONE RETRIEVAL GP018 $ 1,750.00 2120686047 HC IMPL CANNULA ATRIAL GP047 $ 13,000.00 2120686049 HC IMPL CANNULA ATRIAL GP049 $ 14,250.00 2120687002 HC DRESSING FOAM GP002 $ 50.00 2120687004 HC DRESSING FOAM GP004 $ 146.00 2120687006 HC DRESSING FOAM GP006 $ 293.00 2120687007 HC DRESSING FOAM GP007 $ 380.00 2120687008 HC DRESSING FOAM GP008 $ 475.00 2120687013 HC DRESSING FOAM GP013 $ 900.00 2120687014 HC DRESSING FOAM GP014 $ 1,080.00

2120687036 HC IMPL NAIL FEMORAL GP036 $ 7,800.00 2120688003 HC SET INTRODUCER GP003 $ 100.00 2120688005 HC SET INTRODUCER GP005 $ 195.00 2120688006 HC SET INTRODUCER GP006 $ 293.00 2120689006 HC SET FRONTALIS SUSPENSION GP006 $ 293.00 2120690006 HC CANISTER VAC W GEL 500ML GP006 $ 293.00 2120691022 HC IMPL ELECTRODE SUBDURAL GP022 $ 3,300.00 2120691023 HC IMPL ELECTRODE SUBDURAL GP023 $ 3,600.00 2120692062 HC IMPL VAD GP062 $ 22,400.00 2120692117 HC IMPL VAD GP117 $ 78,000.00 2120692132 HC IMPL VAD GP132 $ 114,800.00 2120693003 HC IMPL CLIP MICRO GP003 $ 100.00 2120693006 HC IMPL CLIP MICRO GP006 $ 293.00 2120693007 HC IMPL CLIP MICRO GP007 $ 380.00 2120693020 HC IMPL CLIP MICRO GP020 $ 2,550.00 2120694003 HC DRESSING ACTICOAT GP003 $ 100.00 2120694007 HC DRESSING ACTICOAT GP007 $ 380.00 2120695018 HC IMPL LEAD VAD GP018 $ 1,750.00 2120695019 HC IMPL LEAD VAD GP019 $ 2,125.00 2120696003 HC IMPL CANNULA ARTERIAL GP003 $ 100.00 2120696004 HC IMPL CANNULA ARTERIAL GP004 $ 146.00 2120696005 HC IMPL CANNULA ARTERIAL GP005 $ 195.00 2120696006 HC IMPL CANNULA ARTERIAL GP006 $ 293.00 2120696007 HC IMPL CANNULA ARTERIAL GP007 $ 380.00 2120696009 HC IMPL CANNULA ARTERIAL GP009 $ 570.00 2120696010 HC IMPL CANNULA ARTERIAL GP010 $ 665.00 2120696017 HC IMPL CANNULA ARTERIAL GP017 $ 1,575.00 2120696018 HC IMPL CANNULA ARTERIAL GP018 $ 1,750.00 2120696019 HC IMPL CANNULA ARTERIAL GP019 $ 2,125.00 2120696047 HC IMPL CANNULA ARTERIAL GP047 $ 13,000.00 2120696048 HC IMPL CANNULA ARTERIAL GP048 $ 14,000.00 2120696049 HC IMPL CANNULA ARTERIAL GP049 $ 14,250.00 2120696050 HC IMPL CANNULA ARTERIAL GP050 $ 15,200.00 2120696052 HC IMPL CANNULA ARTERIAL GP052 $ 16,200.00 2120698033 HC CLOSURE PERICARDIAL GP033 $ 6,413.00 2120699002 HC TUBE CHEST GP002 $ 50.00 2120700010 HC CATH CENTESIS GP010 $ 665.00 2120700011 HC CATH CENTESIS GP011 $ 740.00 2120700012 HC CATH CENTESIS GP012 $ 810.00 2120701004 HC CANNULA AORT GP004 $ 146.00 2120701005 HC CANNULA AORT GP005 $ 195.00 2120701006 HC CANNULA AORT GP006 $ 293.00 2120702019 HC REAMER CANNULATED GP019 $ 2,125.00 2120703018 HC REAMER FLEXIBLE GP018 $ 1,750.00 2120704005 HC IMPL SCREW WEDGE GP005 $ 195.00 2120704013 HC IMPL SCREW WEDGE GP013 $ 900.00 2120704016 HC IMPL SCREW WEDGE GP016 $ 1,400.00 2120704017 HC IMPL SCREW WEDGE GP017 $ 1,575.00 2120705003 HC LOOP ENDO GP003 $ 100.00 2120706005 HC CATH INTRODUCER GP005 $ 195.00 2120706006 HC CATH INTRODUCING GP006 $ 293.00 2120706013 HC CATH INTRODUCING GP013 $ 900.00 2120707002 HC CATH EPIDURAL GP002 $ 50.00

2120707008 HC CATH EPIDURAL GP008 $ 475.00 2120707010 HC CATH EPIDURAL GP010 $ 665.00 2120707012 HC CATH EPIDURAL GP012 $ 810.00 2120707016 HC CATH EPIDURAL GP016 $ 1,400.00 2120707018 HC REAMER FLEXIBLE GP018 $ 1,750.00 2120708005 HC LOOP CHAIN GP005 $ 195.00 2120708006 HC SET CATH NERVE BLOCK GP006 $ 293.00 2120708009 HC SET CATH NERVE BLOCK GP009 $ 570.00 2120709018 HC BAG VENTRAL WALL DEFECT GP018 $ 1,750.00 2120709019 HC BAG VENTRAL WALL DEFECT GP019 $ 2,125.00 2120709020 HC TIP BLADE GP020 $ 2,550.00 2120710002 HC KNEE IMMOBILIZER GP002 $ 50.00 2120710003 HC KNEE IMMOBILIZER GP003 $ 100.00 2120710004 HC KNEE IMMOBILIZER GP004 $ 146.00 2120710005 HC KNEE IMMOBILIZER GP005 $ 195.00 2120710006 HC KNEE IMMOBILIZER GP006 $ 293.00 2120710013 HC KNEE IMMOBILIZER GP013 $ 900.00 2120711002 HC DEVICE CATH FIXATION GP002 $ 50.00 2120711003 HC DEVICE CATH FIXATION GP003 $ 100.00 2120711007 HC ELECTRODE MENISCECTOMY GP007 $ 380.00 2120712003 HC BRUSH CYTOLOGY GP003 $ 100.00 2120712005 HC BRUSH CYTOLOGY GP005 $ 195.00 2120712007 HC BRUSH CYTOLOGY GP007 $ 380.00 2120712013 HC BRUSH CYTOLOGY GP013 $ 900.00 2120712019 HC TIP FORCEPS GP019 $ 2,125.00 2120712021 HC TIP FORCEPS GP021 $ 2,888.00 2120712037 HC TIP FORCEPS GP037 $ 8,125.00 2120712043 HC TIP FORCEPS GP043 $ 10,450.00 2120713002 HC DRESSING BARRIER ADHSIVE GP002 $ 50.00 2120713003 HC DRESSING BARRIER ADHSIVE GP003 $ 100.00 2120713006 HC IMPL BAND FALLOPIAN GP006 $ 293.00 2120713009 HC IMPL BAND FALLOPIAN GP009 $ 570.00 2120713018 HC DRESSING BARRIER ADHSIVE GP018 $ 1,750.00 2120713019 HC DRESSING BARRIER ADHSIVE GP019 $ 2,125.00 2120713023 HC DRESSING BARRIER ADHSIVE GP023 $ 3,600.00 2120714022 HC OIL SILICONE GP022 $ 3,300.00 2120714023 HC OIL SILICONE GP023 $ 3,600.00 2120715009 HC PACK VFC SILICONE OIL GP009 $ 570.00 2120715010 HC PACK VFC SILICONE OIL GP010 $ 665.00 2120716022 HC PERFLURON GP022 $ 3,300.00 2120716024 HC PERFLURON GP024 $ 4,000.00 2120717004 HC TUBE NASOGASTRIC GP004 $ 146.00 2120717020 HC TUBE NASOGASTRIC GP020 $ 2,550.00 2120718004 HC NDL W SUTURE GP004 $ 146.00 2120719003 HC KIT SHEATH BARRIER GP003 $ 100.00 2120719008 HC KIT SHEATH BARRIER GP008 $ 475.00 2120719009 HC KIT SHEATH BARRIER GP009 $ 570.00 2120720018 HC CATH BALLOON W GWR GP018 $ 1,750.00 2120721011 HC HOOK CAUT DAVINCI GP011 $ 740.00 2120721017 HC HOOK CAUT DAVINCI GP017 $ 1,575.00 2120721043 HC HOOK CAUT DAVINCI GP043 $ 10,450.00 2120722022 HC HOOK MONOPOLAR REAL HAND GP022 $ 3,300.00 2120723010 HC IMPL TUBE INTUBATION GP010 $ 665.00

2120723011 HC IMPL TUBE INTUBATION GP011 $ 740.00 2120724016 HC IMPL SUTURE ANCHOR GP016 $ 1,400.00 2120724018 HC IMPL SUTURE ANCHOR GP018 $ 1,750.00 2120724020 HC IMPL SUTURE ANCHOR GP020 $ 2,550.00 2120724021 HC IMPL SUTURE ANCHOR GP021 $ 2,888.00 2120724022 HC IMPL SUTURE ANCHOR GP022 $ 3,300.00 2120724023 HC IMPL SUTURE ANCHOR GP023 $ 3,600.00 2120724036 HC IMPL SUTURE ANCHOR GP036 $ 7,800.00 2120725043 HC IMPL RING ROTATING GP043 $ 10,450.00 2120726022 HC GRASPER REALHAND GP022 $ 3,300.00 2120727021 HC PROGRASPER DAVINCI GP021 $ 2,888.00 2120727022 HC PROGRASPER DAVINCI GP022 $ 3,300.00 2120728022 HC MONOPOLAR REALHAND GP022 $ 3,300.00 2120729011 HC CAUTERY DAVINCI GP011 $ 740.00 2120729017 HC CAUTERY DAVINCI GP017 $ 1,575.00 2120729022 HC CAUTERY DAVINCI GP022 $ 3,300.00 2120729054 HC CAUTERY DAVINCI GP054 $ 17,000.00 2120730007 HC SPATULA DISP GP007 $ 380.00 2120730022 HC SPATULA DISP GP022 $ 3,300.00 2120731021 HC DISSECTOR DAVINCI GP021 $ 2,888.00 2120731023 HC DISSECTOR DAVINCI GP023 $ 3,600.00 2120732021 HC FORCEPS DAVINCI GP021 $ 2,888.00 2120732023 HC FORCEPS DAVINCI GP023 $ 3,600.00 2120733039 HC KIT MARROW STIM CONC SYS GP039 $ 9,000.00 2120733041 HC KIT MARROW STIM CONC SYS GP041 $ 9,775.00 2120733043 HC KIT MARROW STIM CONC SYS GP043 $ 10,450.00 2120733044 HC KIT MARROW STIM CONC SYS GP044 $ 11,000.00 2120734004 HC WRENCH ALLEN DISP GP004 $ 146.00 2120734008 HC WRENCH ALLEN DISP GP008 $ 475.00 2120734009 HC WRENCH ALLEN DISP GP009 $ 570.00 2120734010 HC WRENCH ALLEN DISP GP010 $ 665.00 2120734012 HC WRENCH ALLEN DISP GP012 $ 810.00 2120735037 HC DRAIN NEURO EVAC GP037 $ 8,125.00 2120735038 HC DRAIN NEURO EVAC GP038 $ 8,750.00 2120735040 HC DRAIN NEURO EVAC GP040 $ 9,600.00 2120736028 HC IMPL GRID ELECTRODE GP028 $ 5,250.00 2120736034 HC IMPL GRID ELECTRODE GP034 $ 6,750.00 2120737006 HC TIP CANNULA GP006 $ 293.00 2120738002 HC TIP ELECTRODE GP002 $ 50.00 2120738004 HC TIP ELECTRODE GP004 $ 146.00 2120739005 HC RETAINER VISCERA GP005 $ 195.00 2120740033 HC IMPL GRID GP033 $ 6,413.00 2120741018 HC GRASPER ALLIGATOR DISP GP018 $ 1,750.00 2120741020 HC GRASPER ALLIGATOR DISP GP020 $ 2,550.00 2120742002 HC PACKING EAR AMBRUS GP002 $ 50.00 2120743054 HC IMPL CANNULA APICAL GP054 $ 17,000.00 2120744035 HC KIT PLASMAX SYSTEM GP035 $ 7,150.00 2120745014 HC IMPL PIN LOCKING GP014 $ 1,080.00 2120745015 HC IMPL PIN LOCKING GP015 $ 1,225.00 2120745018 HC IMPL PIN LOCKING GP018 $ 1,750.00 2120745019 HC IMPL PIN LOCKING GP019 $ 2,125.00 2120746043 HC IMPL PLATE TIBIA BASE GP043 $ 10,450.00 2120746051 HC IMPL PLATE TIBIA BASE GP051 $ 15,300.00

2120747044 HC IMPL KNEE SPINDLE GP044 $ 11,000.00 2120747045 HC IMPL KNEE SPINDLE GP045 $ 11,550.00 2120747047 HC IMPL KNEE SPINDLE GP047 $ 13,000.00 2120747049 HC IMPL KNEE SPINDLE GP049 $ 14,250.00 2120747053 HC IMPL KNEE SPINDLE GP053 $ 16,300.00 2120747054 HC IMPL KNEE SPINDLE GP054 $ 17,000.00 2120747058 HC IMPL KNEE SPINDLE GP058 $ 19,200.00 2120747065 HC IMPL KNEE SPINDLE GP065 $ 24,800.00 2120748054 HC IMPL KNEE SPINDLE GP054 $ 17,000.00 2120748058 HC IMPL KNEE SPINDLE GP058 $ 19,200.00 2120748059 HC IMPL KNEE SEGM FEMORAL GP059 $ 20,000.00 2120748069 HC IMPL KNEE SEGM FEMORAL GP069 $ 28,000.00 2120749018 HC IMPL KNEE FEM BUSHING GP018 $ 1,750.00 2120749019 HC IMPL KNEE FEM BUSHING GP019 $ 2,125.00 2120749022 HC IMPL KNEE FEM BUSHING GP022 $ 3,300.00 2120749024 HC IMPL KNEE FEM BUSHING GP024 $ 4,000.00 2120750050 HC IMPL KNEE DIAPHYSEAL SEG GP050 $ 15,200.00 2120750054 HC IMPL KNEE DIAPHYSEAL SEG GP054 $ 17,000.00 2120750055 HC IMPL KNEE DIAPHYSEAL SEG GP055 $ 17,300.00 2120750062 HC IMPL KNEE DIAPHYSEAL SEG GP062 $ 22,400.00 2120751011 HC IMPL KNEE ADAPTER GP011 $ 740.00 2120751013 HC IMPL KNEE ADAPTER GP013 $ 900.00 2120751015 HC IMPL KNEE ADAPTER GP015 $ 1,225.00 2120751017 HC IMPL KNEE ADAPTER GP017 $ 1,575.00 2120751023 HC IMPL KNEE ADAPTER GP023 $ 3,600.00 2120751025 HC IMPL KNEE ADAPTER GP025 $ 4,263.00 2120751030 HC IMPL KNEE ADAPTER GP030 $ 5,800.00 2120751034 HC IMPL KNEE ADAPTER GP034 $ 6,750.00 2120751035 HC IMPL KNEE ADAPTER GP035 $ 7,150.00 2120751081 HC IMPL KNEE ADAPTER GP081 $ 37,600.00 2120752016 HC IMPL KNEE TIBIAL BUSHING GP016 $ 1,400.00 2120752018 HC IMPL KNEE TIBIAL BUSHING GP018 $ 1,750.00 2120752019 HC IMPL KNEE TIBIAL BUSHING GP019 $ 2,125.00 2120752020 HC IMPL KNEE TIBIAL BUSHING GP020 $ 2,550.00 2120752021 HC IMPL KNEE TIBIAL BUSHING GP021 $ 2,888.00 2120753019 HC IMPL KNEE AXLE GP019 $ 2,125.00 2120753020 HC IMPL KNEE AXLE GP020 $ 2,550.00 2120753021 HC IMPL KNEE AXLE GP021 $ 2,888.00 2120753022 HC IMPL KNEE AXLE GP022 $ 3,300.00 2120753025 HC IMPL KNEE AXLE GP025 $ 4,263.00 2120753036 HC IMPL KNEE AXLE GP036 $ 7,800.00 2120754025 HC IMPL KNEE REINF YOKE GP025 $ 4,263.00 2120754028 HC IMPL KNEE REINF YOKE GP028 $ 5,250.00 2120754030 HC IMPL KNEE REINF YOKE GP030 $ 5,800.00 2120754034 HC IMPL KNEE REINF YOKE GP034 $ 6,750.00 2120754037 HC IMPL KNEE REINF YOKE GP037 $ 8,125.00 2120755002 HC FASTENER CARTRIDGE GP002 $ 50.00 2120756049 HC KIT ESOPHYX2 GP049 $ 14,250.00 2120756050 HC KIT ESOPHYX2 GP050 $ 15,200.00 2120757018 HC ELECTRODE TUNGSTEN GP018 $ 1,750.00 2120758010 HC ROTH NET GP010 $ 665.00 2120758011 HC ROTH NET GP011 $ 740.00 2120758012 HC ROTH NET GP012 $ 810.00

2120759065 HC IMPL CRANIAL PEEK GP065 $ 24,800.00 2120759073 HC IMPL CRANIAL PEEK GP073 $ 31,200.00 2120759077 HC IMPL CRANIAL PEEK GP077 $ 34,400.00 2120759100 HC IMPL CRANIAL PEEK GP100 $ 50,160.00 2120760004 HC FORCEPS BIOP RAD JAW GP004 $ 146.00 2120760005 HC FORCEPS BIOP RAD JAW GP005 $ 195.00 2120760006 HC FORCEPS BIOP RAD JAW GP006 $ 293.00 2120761011 HC PACK VITRECT CONSTELLATN GP011 $ 740.00 2120761016 HC PACK VITRECT CONSTELLATN GP016 $ 1,400.00 2120761018 HC PACK VITRECT CONSTELLATN GP018 $ 1,750.00 2120761024 HC PACK VITRECT CONSTELLATN GP024 $ 4,000.00 2120761025 HC PACK VITRECT CONSTELLATN GP025 $ 4,263.00 2120761037 HC PACK VITRECT CONSTELLATN GP037 $ 8,125.00 2120761051 HC PACK VITRECT CONSTELLATN GP051 $ 15,300.00 2120762002 HC PIK ASP DISP GP002 $ 50.00 2120763034 HC IMPL FIXTURE FLANGE GP034 $ 6,750.00 2120764021 HC PACK VITRECT TOTAL PLUS GP021 $ 2,888.00 2120764022 HC PACK VITRECT TOTAL PLUS GP022 $ 3,300.00 2120764023 HC PACK VITRECT TOTAL PLUS GP023 $ 3,600.00 2120764024 HC PACK VITRECT TOTAL PLUS GP024 $ 4,000.00 2120764025 HC PACK VITRECT TOTAL PLUS GP025 $ 4,263.00 2120765007 HC PICK MICRO DISP GP007 $ 380.00 2120766002 HC DIALATOR W PLUG GP002 $ 50.00 2120767015 HC SYSTEM DRAINAGE NEURO GP015 $ 1,225.00 2120767018 HC SYSTEM DRAINAGE NEURO GP018 $ 1,750.00 2120767019 HC SYSTEM DRAINAGE NEURO GP019 $ 2,125.00 2120768013 HC DUSTER DIAMOND GP013 $ 900.00 2120768014 HC DUSTER DIAMOND GP014 $ 1,080.00 2120769018 HC DISSECTOR LAPAROSCOPIC GP018 $ 1,750.00 2120770006 HC SUTURE GRASPER GP006 $ 293.00 2120770007 HC SUTURE GRASPER GP007 $ 380.00 2120771017 HC HANDPIECE ENDOPROBE GP017 $ 1,575.00 2120772024 HC HANDPIECE SELECTOR GP024 $ 4,000.00 2120772025 HC HANDPIECE SELECTOR GP025 $ 4,263.00 2120773008 HC IMPL BONE OSTENE GP008 $ 475.00 2120774004 HC IMPL BUTTON MICK GASTRO GP004 $ 146.00 2120774005 HC IMPL BUTTON MICK GASTRO GP005 $ 195.00 2120774012 HC IMPL BUTTON MICK GASTRO GP012 $ 810.00 2120774017 HC IMPL BUTTON MICK GASTRO GP017 $ 1,575.00 2120775022 HC IMPL GRAFT SURGISIS GP022 $ 3,300.00 2120775025 HC IMPL GRAFT SURGISIS GP025 $ 4,263.00 2120775026 HC IMPL GRAFT SURGISIS GP026 $ 4,650.00 2120775030 HC IMPL GRAFT SURGISIS GP030 $ 5,800.00 2120775034 HC IMPL GRAFT SURGISIS GP034 $ 6,750.00 2120775049 HC IMPL GRAFT SURGISIS GP049 $ 14,250.00 2120775050 HC IMPL GRAFT SURGISIS GP050 $ 15,200.00 2120775056 HC IMPL GRAFT SURGISIS GP056 $ 17,600.00 2120776014 HC PIPE IRRIGATING GP014 $ 1,080.00 2120777002 HC TUBE FEEDING GP002 $ 50.00 2120777003 HC TUBE FEEDING GP003 $ 100.00 2120777004 HC TUBE FEEDING GP004 $ 146.00 2120777005 HC TUBE FEEDING GP005 $ 195.00 2120777006 HC TUBE FEEDING GP006 $ 293.00

2120777008 HC TUBE FEEDING GP008 $ 475.00 2120777013 HC TUBE FEEDING GP013 $ 900.00 2120777017 HC TUBE FEEDING GP017 $ 1,575.00 2120777018 HC TUBE FEEDING GP018 $ 1,750.00 2120778023 HC SYSTEM INTRAUTERINE GP023 $ 3,600.00 2120780038 HC COUPLING SNAP GP038 $ 8,750.00 2120781006 HC GLIDEWIRE GP006 $ 293.00 2120782007 HC KIT CATH GP007 $ 380.00 2120782008 HC KIT CATH GP008 $ 475.00 2120783003 HC CATH DRAINAGE GP003 $ 100.00 2120783005 HC CATH DRAINAGE GP005 $ 195.00 2120783007 HC CATH DRAINAGE GP007 $ 380.00 2120783008 HC CATH DRAINAGE GP008 $ 475.00 2120783015 HC CATH DRAINAGE GP015 $ 1,225.00 2120784019 HC PROSTHESIS POP GP019 $ 2,125.00 2120785031 HC IMPL PATNT PROG NROSTIM GP031 $ 5,950.00 2120785035 HC IMPL PATNT PROG NROSTIM GP035 $ 7,150.00 2120786004 HC TIP SUCTION GP004 $ 146.00 2120787016 HC SPHINCTERTOME GP016 $ 1,400.00 2120787017 HC SPHINCTERTOME GP017 $ 1,575.00 2120787018 HC SPHINCTERTOME GP018 $ 1,750.00 2120788005 HC IMPL WIRE THREADED GP005 $ 195.00 2120788012 HC IMPL WIRE THREADED GP012 $ 810.00 2120789010 HC IMPL ANTENNA PROGRAMMER GP010 $ 665.00 2120790036 HC CATH INNERCOOL GP036 $ 7,800.00 2120790039 HC CATH INNERCOOL GP039 $ 9,000.00 2120790041 HC CATH INNERCOOL GP039 $ 9,775.00 2120791002 HC COLLAR CERVICAL FLEX GP002 $ 50.00 2120791005 HC COLLAR CERVICAL FLEX GP005 $ 195.00 2120792018 HC IMPL CHIN GP018 $ 1,750.00 2120792021 HC IMPL CHIN GP021 $ 2,888.00 2120793006 HC KIT MICROINTRODUCER GP006 $ 293.00 2120794050 HC SOUND PROCESSOR GP050 $ 15,200.00 2120794091 HC SOUND PROCESSOR GP091 $ 45,600.00 2120795017 HC SET DILATOR GP017 $ 1,575.00 2120795018 HC SET DILATOR GP018 $ 1,750.00 2120796009 HC IMPL EPIDISC LAMINA GP009 $ 570.00 2120796010 HC IMPL EPIDISC LAMINA GP010 $ 665.00 2120797018 HC IMPL TRANSPHENOIDAL GP018 $ 1,750.00 2120797019 HC IMPL TRANSPHENOIDAL GP019 $ 2,125.00 2120797020 HC IMPL TRANSPHENOIDAL GP020 $ 2,550.00 2120797025 HC IMPL TRANSPHENOIDAL GP025 $ 4,263.00 2120799018 HC BREAST SIZER GP018 $ 1,750.00 2120800002 HC KIT ARTERIAL LINE DISP GP002 $ 50.00 2120800003 HC KIT ARTERIAL LINE DISP GP003 $ 100.00 2120800005 HC KIT ARTERIAL LINE DISP GP005 $ 195.00 2120800006 HC KIT ARTERIAL LINE DISP GP006 $ 293.00 2120801013 HC HANDPIECE CAUTERY NASAL GP013 $ 900.00 2120801015 HC HANDPIECE CAUTERY NASAL GP015 $ 1,225.00 2120802017 HC IMPL MARKER GOLD SEEDS GP017 $ 1,575.00 2120803003 HC IMMOBILIZER SHOULDER GP003 $ 100.00 2120803004 HC IMMOBILIZER SHOULDER GP004 $ 146.00 2120803014 HC IMMOBILIZER SHOULDER GP014 $ 1,080.00

2120804007 HC KIT LIVER BIOPSY GP007 $ 380.00 2120805039 HC IMPL ACETABULAR LINER GP039 $ 9,000.00 2120806015 HC KIT CATH DRAINAGE GP015 $ 1,225.00 2120807007 HC CAP KNEE COMPRESSION GP007 $ 380.00 2120808022 HC IMPL PROBE FLOW DOPPLER GP022 $ 3,300.00 2120809020 HC DISTRACTION TOOL DISP GP020 $ 2,550.00 2120810003 HC TUBE ET LUMEN G003 $ 100.00 2120810008 HC TUBE ET LUMEN G008 $ 475.00 2120811018 HC IMPL TISSUE SYNTHETIC GP018 $ 1,750.00 2120812019 HC KIT IMPL THORATEC GP019 $ 2,125.00 2120813022 HC REAL HAND THERMA GP022 $ 3,300.00 2120813023 HC REAL HAND THERMA GP023 $ 3,600.00 2120814012 HC IMPL LOCK GP012 $ 810.00 2120814020 HC IMPL LOCK GP020 $ 2,550.00 2120815081 HC IMPL CARD DEFIB SGL GP081 $ 37,600.00 2120815093 HC IMPL CARD DEFIB SGL GP093 $ 47,200.00 2120816006 HC FASTENER SAFE-T GP006 $ 293.00 2120816017 HC FASTENER SAFE-T GP017 $ 1,575.00 2120817112 HC IMPL CARD DEFIB OTH GP112 $ 53,120.00 2120817114 HC IMPL CARD DEFIB OTH GP114 $ 65,400.00 2120818035 HC IMPL LEAD CARD DEFIB OTH GP035 $ 7,150.00 2120818045 HC IMPL LEAD CARD DEFIB OTH GP045 $ 11,550.00 2120819009 HC BLOCK CONTINUOUS NERVE GP009 $ 570.00 2120820037 HC IMPL ABUTMENT GP037 $ 8,125.00 2120820046 HC IMPL ABUTMENT GP046 $ 12,600.00 2120821005 HC KIT EPIDURAL GP005 $ 195.00 2120822033 HC IMPL PONTO GP033 $ 6,413.00 2120822035 HC IMPL PONTO GP035 $ 7,150.00 2120822037 HC IMPL PONTO GP037 $ 8,125.00 2120822044 HC IMPL PONTO GP044 $ 11,000.00 2120822046 HC IMPL PONTO GP046 $ 12,600.00 2120822050 HC IMPL PONTO GP050 $ 15,200.00 2120823017 HC COUNTERSINK GP017 $ 1,575.00 2120823018 HC COUNTERSINK GP018 $ 1,750.00 2120824002 HC COAGULATOR SUCTION GP002 $ 50.00 2120824010 HC COAGULATOR SUCTION GP010 $ 665.00 2120825019 HC KIT REVISION CATH SPINAL GP019 $ 2,125.00 2120826024 HC SEALER DISP GP024 $ 4,000.00 2120826101 HC SEALER DISP GP101 $ 50,250.00 2120827024 HC IMPL KNEE TIBIAL BEARING GP024 $ 4,000.00 2120827027 HC IMPL KNEE TIBIAL BEARING GP027 $ 4,875.00 2120827029 HC IMPL KNEE TIBIAL BEARING GP029 $ 5,438.00 2120827032 HC IMPL KNEE TIBIAL BEARING GP032 $ 6,300.00 2120828051 HC IMPL KNEE TIBIAL INSERT GP051 $ 15,300.00 2120830017 HC IMPL MICROVASC COUPLER GP017 $ 1,575.00 2120830018 HC IMPL MICROVASC COUPLER GP018 $ 1,750.00 2120831008 HC SET TUBING VGFI GP008 $ 475.00 2120832018 HC INSTRUMENT ACTIVATION GP018 $ 1,750.00 2120833026 HC IMPL ARM REMOVABLE EXT GP026 $ 4,650.00 2120833027 HC IMPL ARM REMOVABLE EXT GP027 $ 4,875.00 2120834021 HC IMPL CABLE ATLAS GP021 $ 2,888.00 2120834028 HC IMPL CABLE ATLAS GP028 $ 5,250.00 2120835008 HC IMPL ABUTMENT HEALING GP008 $ 475.00

2120836006 HC NDL CONTRAST GP006 $ 293.00 2120836007 HC NDL CONTRAST GP007 $ 380.00 2120836008 HC NDL CONTRAST GP008 $ 475.00 2120836009 HC NDL CONTRAST GP009 $ 570.00 2120837021 HC IMPL JAW GP021 $ 2,888.00 2120838004 HC SUCTION RETINAL GP004 $ 146.00 2120839027 HC IMPL SPHERE ORBITAL GP027 $ 4,875.00 2120840033 HC IMPL DUREREPAIR GP033 $ 6,413.00 2120841030 HC IMPL GRAFT AMT GP030 $ 5,800.00 2120842016 HC IMPL RING TENSION GP016 $ 1,400.00 2120843029 HC CATH MICRO CANALOPLASTY GP029 $ 5,438.00 2120845015 HC IMPL CLIP RESOLUTION GP015 $ 1,225.00 2120846026 HC HALO SYSTEM GP026 $ 4,650.00 2120847006 HC VEST SUPPORT GP006 $ 293.00 2120847033 HC VEST SUPPORT GP033 $ 6,413.00 2120847034 HC VEST SUPPORT GP034 $ 6,750.00 2120848005 HC ADAPTOR/EXT PACING LEAD GP005 $ 195.00 2120848018 HC ADAPTOR/EXT PACING LEAD GP018 $ 1,750.00 2120848026 HC ADAPTOR/EXT PACING LEAD GP026 $ 4,650.00 2120850117 HC IMPL PUMP HEART GP117 $ 78,000.00 2120851015 HC IMPL COVER SCREW GP015 $ 1,225.00 2120851016 HC IMPL COVER SCREW GP016 $ 1,400.00 2120852019 HC CATH SWAN GP019 $ 2,125.00 2120852020 HC CATH SWAN GP020 $ 2,550.00 2120853002 HC SHOE CAST POST-OP GP002 $ 50.00 2120854023 HC HANDPIECE VERSAJET DISP GP023 $ 3,600.00 2120855015 HC SET UROLOGY ENTRY PERC GP015 $ 1,225.00 2120856019 HC IMPL KNEE FEM BUSHING GP019 $ 2,125.00 2120857008 HC SET NERVE BLCK STIMUPLEX GP008 $ 475.00 2120857010 HC SET NERVE BLCK STIMUPLEX GP010 $ 665.00 2120858037 HC IMPL MESH COLLAGEN GP037 $ 8,125.00 2120858038 HC IMPL MESH COLLAGEN GP038 $ 8,750.00 2120858043 HC IMPL MESH COLLAGEN GP043 $ 10,450.00 2120858044 HC IMPL MESH COLLAGEN GP044 $ 11,000.00 2120858045 HC IMPL MESH COLLAGEN GP045 $ 11,550.00 2120858047 HC IMPL MESH COLLAGEN GP047 $ 13,000.00 2120858048 HC IMPL MESH COLLAGEN GP048 $ 14,000.00 2120858054 HC IMPL MESH COLLAGEN GP054 $ 17,000.00 2120858072 HC IMPL MESH COLLAGEN GP072 $ 30,400.00 2120858074 HC IMPL MESH COLLAGEN GP074 $ 32,000.00 2120858080 HC IMPL MESH COLLAGEN GP080 $ 36,800.00 2120858082 HC IMPL MESH COLLAGEN GP082 $ 38,400.00 2120859025 HC TIP MICRO EXCEL GP025 $ 4,263.00 2120860017 HC HANDPIECE HYDRODEBRIDER GP017 $ 1,575.00 2120860019 HC HANDPIECE HYDRODEBRIDER GP019 $ 2,125.00 2120861030 HC NEUROSCOPE GP030 $ 5,800.00 2120861031 HC NEUROSCOPE GP031 $ 5,950.00 2120862002 HC NDL NERVE BLOCK GP002 $ 50.00 2120862003 HC NDL NERVE BLOCK GP003 $ 100.00 2120862004 HC NDL NERVE BLOCK GP004 $ 146.00 2120863005 HC KIT DISC PATCH EPI GP005 $ 195.00 2120863010 HC KIT DISC PATCH EPI GP010 $ 665.00 2120863014 HC KIT DISC PATCH EPI GP014 $ 1,080.00

2120864002 HC IMPL GLASS TUBE GP002 $ 50.00 2120865018 HC SCALPEL ROUND GP018 $ 1,750.00 2120866021 HC SHEARS INSERTS DISP GP021 $ 2,888.00 2120867017 HC MICRO ANASTO DEVICE GP017 $ 1,575.00 2120868012 HC IMPL IOL ANTERIOR CHMBR GP012 $ 810.00 2120868014 HC IMPL IOL ANTERIOR CHMBR GP014 $ 1,080.00 2120868015 HC IMPL IOL ANTERIOR CHMBR GP015 $ 1,225.00 2120869014 HC IMPL IOL POSTERIOR CHMBR GP014 $ 1,080.00 2120870014 HC CATH CARDIAC GP014 $ 1,080.00 2120870015 HC CATH CARDIAC GP015 $ 1,225.00 2120871013 HC FASTENER MENISCAL GP013 $ 900.00 2120872033 HC IMPL SHAFT FEMORAL GP033 $ 6,413.00 2120872034 HC IMPL SHAFT FEMORAL GP034 $ 6,750.00 2120873046 HC IMPL FIXTURE FLANGE GP046 $ 12,600.00 2120874021 HC IMPL MATRIX FIRM GP021 $ 2,888.00 2120875038 HC IMPL ARTICULAR SURFACE GP038 $ 8,750.00 2120876019 HC IMPL KNEE PATELLA GP019 $ 2,125.00 2120876020 HC IMPL KNEE PATELLA GP020 $ 2,550.00 2120877010 HC MATCHSTICK DIAM GP010 $ 665.00 2120877011 HC MATCHSTICK DIAM GP011 $ 740.00 2120877012 HC MATCHSTICK DIAM GP012 $ 810.00 2120878010 HC MATCHSTICK FLUTED GP010 $ 665.00 2120878012 HC MATCHSTICK FLUTED GP012 $ 810.00 2120879017 HC IMPL MICRO ANASTAMOTIC GP017 $ 1,575.00 2120879018 HC IMPL MICRO ANASTAMOTIC GP018 $ 1,750.00 2120880007 HC SPLINT LEG GP007 $ 380.00 2120881007 HC SET CATH SUBCLAVEAN GP007 $ 380.00 2120882003 HC STENT TURBINATE GP003 $ 100.00 2120882006 HC KIT CATH INTRO GP006 $ 293.00 2120882010 HC WRENCH T GP010 $ 665.00 2120882011 HC T WRENCH GP011 $ 740.00 2120882020 HC ANCHOR PEEK PSHLCK GP020 $ 2,550.00 2120882022 HC TAP INSTRMENT CANN SCREW GP022 $ 3,300.00 2120882028 HC CLAMP STRAIGHT GP028 $ 5,250.00 2120882029 HC CLAMP STRAIGHT GP029 $ 5,438.00 2120883022 HC CLICKER C/D STANDARD GP022 $ 3,300.00 2120884015 HC CLICKER C/D LONG GP015 $ 1,225.00 2120885022 HC FIXATOR EXTERNAL CLAMP GP022 $ 3,300.00 2120885024 HC FIXATOR EXTERNAL CLAMP GP022 $ 4,000.00 2120885035 HC FIXATOR EXTERNAL CLAMP GP035 $ 7,150.00 2120886006 HC SCREW COVER GP006 $ 293.00 2120886016 HC SCREW COVER GP016 $ 1,400.00 2120886017 HC SCREW COVER GP017 $ 1,575.00 2120888034 HC RAIL RADIOLUCENT GP034 $ 6,750.00 2120888037 HC CLAMP TRANLATION ANG GP037 $ 8,125.00 2120889035 HC IMPL SCREW BAHA GP035 $ 7,150.00 2120889037 HC IMPL SCREW BAHA GP037 $ 8,125.00 2120891037 HC INLINE CONNECTOR GP37 $ 8,125.00 2120892024 HC IMPL PORCINE TISSUE GP024 $ 4,000.00 2120892048 HC IMPL PORCINE TISSUE GP048 $ 14,000.00 2120892049 HC IMPL PORCINE TISSUE GP049 $ 14,250.00 2120892052 HC IMPL PORCINE TISSUE GP052 $ 16,200.00 2120892063 HC IMPL PORCINE TISSUE GP063 $ 23,200.00

2120892065 HC IMPL PORCINE TISSUE GP065 $ 24,800.00 2120892089 HC IMPL PORCINE TISSUE GP089 $ 44,000.00 2120893073 HC IMPL DIAPHYSEAL SEGMENT $ 31,200.00 2120894018 HC IMPL SLEEVE CENTERING GP018 $ 1,750.00 2120894023 HC IMPL SLEEVE CENTERING GP023 $ 3,600.00 2120895038 HC IMPL TIBIAL POLY BEARING $ 8,750.00 2120896016 HC TUBE SALIVARY GP016 $ 1,400.00 2120897002 HC CATH RECTAL GP002 $ 50.00 2120897004 HC CATH RECTAL GP004 $ 146.00 2120898004 HC SET LIPIVAGE HARVESTER GP004 $ 146.00 2120898011 HC SET LIPIVAGE HARVESTER GP011 $ 740.00 2120898012 HC SET LIPIVAGE HARVESTER GP012 $ 810.00 2120898014 HC SET LIPIVAGE HARVESTER GP014 $ 1,080.00 2120899015 HC CATH LUMB DRAINAGE GP015 $ 1,225.00 2120900003 HC CATH RAPID EXCHANGE GP003 $ 100.00 2120900013 HC CATH RAPID EXCHANGE GP013 $ 900.00 2120900015 HC CATH RAPID EXCHANGE GP015 $ 1,225.00 2120901003 HC CATH FOGARTY CHOLANGIO GP003 $ 100.00 2120901005 HC CATH FOGARTY CHOLANGIO GP005 $ 195.00 2120901008 HC CATH FOGARTY CHOLANGIO GP008 $ 475.00 2120902002 HC CATH MULTI PERFUSION $ 50.00 2120903020 HC CATH NEPH BALLOON GP020 $ 2,550.00 2120904016 HC CATH BALLOON COMPRESSION GP016 $ 1,400.00 2120905010 HC CANNULA RETROGRADE GP010 $ 665.00 2120906007 HC CATH TRANSTRACHEAL GP007 $ 380.00 2120907003 HC BRUSH GASTROSCOPE CYTOLOGY GP3 $ 100.00 2120908016 HC NEEDLE KNIFE GP016 $ 1,400.00 2120908017 HC NEEDLE KNIFE GP017 $ 1,575.00 2120909004 HC CATH DIAGNOSTIC GP004 $ 146.00 2120910015 HC TRAY IMPL POWER PORT GP015 $ 1,225.00 2120910016 HC TRAY IMPL POWER PORT GP016 $ 1,400.00 2120911011 HC PAK ALCON AUTO GAS FILL GP011 $ 740.00 2120912018 HC KIT TUBE FEEDING JEJUNAL GP018 $ 1,750.00 2120912020 HC KIT TUBE FEEDING JEJUNAL GP020 $ 2,550.00 2120913014 HC IMPL TUBE EXTENSION GP014 $ 1,080.00 2120913027 HC IMPL TUBE EXTENSION GP027 $ 4,875.00 2120914003 HC CLAVICLE SPLINT GP003 $ 100.00 2120915044 HC IMPL GRAFT NERVE GP044 $ 11,000.00 2120915046 HC IMPL GRAFT NERVE GP046 $ 12,600.00 2120916002 HC PACKING EAR SCHINDLER GP002 $ 50.00 2120916003 HC PACKING EAR SCHINDLER GP003 $ 100.00 2120917003 HC SLEEVE STERILE GP003 $ 100.00 2120918026 HC WOUND HEALING SYS GP026 $ 4,650.00 2120918028 HC WOUND HEALING SYS GP028 $ 5,250.00 2120919026 HC IMPL EXTENDER GP026 $ 4,650.00 2120920024 HC IMPL CLAW TROCHANTER GP024 $ 4,000.00 2120921057 HC IMPL LEAD CARD DEFIB SGL GP057 $ 18,400.00 2120921058 HC IMPL LEAD CARD DEFIB SGL GP058 $ 19,200.00 2120922037 HC IMPL MED PATELLOFEM LIG GP037 $ 8,125.00 2120922038 HC IMPL MED PATELLOFEM LIG GP038 $ 8,750.00 2120993013 HC DEVICE EMBOL DISP GP013 $ 900.00 2120993014 HC DEVICE EMBOL DISP GP014 $ 1,080.00 2120994032 HC IMPL AMNIONIC MEMBRANE GP032 $ 6,300.00

2120995013 HC FIXATOR EXTERNAL CUBE GP013 $ 900.00 2120995014 HC FIXATOR EXTERNAL CUBE GP014 $ 1,080.00 2120995015 HC FIXATOR EXTERNAL CUBE GP015 $ 1,225.00 2120995016 HC FIXATOR EXTERNAL CUBE GP016 $ 1,400.00 2120995017 HC FIXATOR EXTERNAL CUBE GP017 $ 1,575.00 2120996031 HC FIXATOR EXTERNAL STRUT GP031 $ 5,950.00 2120996033 HC FIXATOR EXTERNAL STRUT GP033 $ 6,413.00 2120996034 HC FIXATOR EXTERNAL STRUT GP034 $ 6,750.00 2120996037 HC FIXATOR EXTERNAL STRUT GP037 $ 8,125.00 2120997004 HC FIXATOR EXTERNAL BOLT GP004 $ 146.00 2120997006 HC FIXATOR EXTERNAL BOLT GP006 $ 293.00 2120997007 HC FIXATOR EXTERNAL BOLT GP007 $ 380.00 2120997014 HC FIXATOR EXTERNAL BOLT GP014 $ 1,080.00 2120998020 HC FIXATOR EXTERNAL RING GP020 $ 2,550.00 2120998021 HC FIXATOR EXTERNAL RING GP021 $ 2,888.00 2120998026 HC FIXATOR EXTERNAL RING GP026 $ 4,650.00 2120998028 HC FIXATOR EXTERNAL RING GP028 $ 5,250.00 2120998031 HC FIXATOR EXTERNAL RING GP031 $ 5,950.00 2120998032 HC EXTERNAL FIXATOR RING GP032 $ 6,300.00 2120998034 HC FIXATOR EXTERNAL RING GP034 $ 6,750.00 2120999010 HC FIXATOR EXTERNAL HINGE GP010 $ 665.00 2120999012 HC FIXATOR EXTERNAL HINGE GP012 $ 810.00 2120999013 HC FIXATOR EXTERNAL HINGE GP013 $ 900.00 2120999035 HC FIXATOR EXTERNAL HINGE GP035 $ 7,150.00 2121000013 HC FIXATOR EXTERNAL SLEEVE GP013 $ 900.00 2121001007 HC IMPL WIRE BAY CORTICAL GP007 $ 380.00 2121001008 HC IMPL WIRE BAY CORTICAL GP008 $ 475.00 2121001011 HC IMPL WIRE BAY GP011 $ 740.00 2121001017 HC IMPL WIRE BAY GP017 $ 1,575.00 2121002002 HC IMPL CATH INFUSION GP002 $ 50.00 2121002003 HC IMPL CATH INFUSION GP003 $ 100.00 2121002006 HC IMPL CATH INFUSION GP006 $ 293.00 2121002007 HC IMPL CATH INFUSION GP007 $ 380.00 2121002009 HC IMPL CATH INFUSION GP009 $ 570.00 2121002011 HC IMPL CATH INFUSION GP011 $ 740.00 2121002013 HC IMPL CATH INFUSION GP013 $ 900.00 2121002020 HC IMPL CATH INFUSION GP020 $ 2,550.00 2121003037 HC FIXATOR EXTERNAL RAIL GP037 $ 8,125.00 2121003039 HC FIXATOR EXTERNAL RAIL GP039 $ 9,000.00 2121004017 HC FIXATOR EXTERNAL CLAMP GP017 $ 1,575.00 2121004026 HC FIXATOR EXTERNAL CLAMP GP029 $ 4,650.00 2121004029 HC FIXATOR EXTERNAL CLAMP GP029 $ 5,438.00 2121004034 HC FIXATOR EXTERNAL CLAMP GP034 $ 6,750.00 2121004037 HC EXTERNAL FIXATOR CLAMP GP037 $ 8,125.00 2121005024 HC FIXATOR EXT COMP/DIST GP024 $ 4,000.00 2121006013 HC IMPL CAP GP013 $ 900.00 2121007013 HC INSTRUMENT TRACKING GP013 $ 900.00 2121007014 HC INSTRUMENT TRACKING GP014 $ 1,080.00 2121008045 HC SET ACCESS BERLIN HEART GP045 $ 11,550.00 2121009028 HC MORCELLATOR TISSUE GP028 $ 5,250.00 2121010056 HC HEARTMATE II CONTROLLER GP056 $ 17,600.00 2121011047 HC SHEATH LASER GP047 $ 13,000.00 2121012023 HC SET SMALL JOINTS OATS GP023 $ 3,600.00

2121013028 HC KIT ICP MONITORING GP028 $ 5,250.00 2121014005 HC KIT TONSIL & ADENOID GP005 $ 195.00 2121015037 HC CATH LASER GP037 $ 8,125.00 2121016006 HC IMPL CATH RADL ART W GWR GP006 $ 293.00 2121017013 HC SCRAPER MEMBRANE GP013 $ 900.00 2121017024 HC SCRAPER MEMBRANE GP024 $ 4,000.00 2121018014 HC LASER PROBE VISION SYST GP014 $ 1,080.00 2121018040 HC LASER PROBE VISION SYST GP040 $ 9,600.00 2121019013 HC FIXATOR EXTERNAL SPACER GP013 $ 900.00 2121020002 HC FIXATOR EXTERNAL STOPPER GP002 $ 50.00 2121021002 HC FIXATOR EXTERNAL WASHER GP002 $ 50.00 2121021008 HC FIXATOR EXTERNAL WASHER GP008 $ 475.00 2121022015 HC FIXATOR EXTERNAL POST GP015 $ 1,225.00 2121022016 HC FIXATOR EXTERNAL POST GP016 $ 1,400.00 2121022017 HC FIXATOR EXTERNAL POST GP017 $ 1,575.00 2121023034 HC IMPL KNEE STEM GP034 $ 6,750.00 2121023114 HC IMPL HIP PROXIML FEMORAL GP114 $ 65,400.00 2121024004 HC NDL BIOPSY GP004 $ 146.00 2121024005 HC NDL BIOPSY GP005 $ 195.00 2121024006 HC NDL BIOPSY GP006 $ 293.00 2121024007 HC NDL BIOPSY GP007 $ 380.00 2121024008 HC NDL BIOPSY GP008 $ 475.00 2121024025 HC NDL BIOPSY GP025 $ 4,263.00 2121025002 HC NDL EPIDURAL GP002 $ 50.00 2121025003 HC NDL EPIDURAL GP003 $ 100.00 2121025004 HC NDL EPIDURAL GP004 $ 146.00 2121025005 HC NDL EPIDURAL GP005 $ 195.00 2121026006 HC FIXATOR EXTERNAL ROD GP006 $ 293.00 2121026007 HC FIXATOR EXTERNAL ROD GP007 $ 380.00 2121026009 HC FIXATOR EXTERNAL ROD GP009 $ 570.00 2121026014 HC FIXATOR EXTERNAL ROD GP014 $ 1,080.00 2121026019 HC FIXATOR EXTERNAL ROD GP019 $ 2,125.00 2121026035 HC FIXATOR EXTERNAL ROD GP035 $ 7,150.00 2121026038 HC FIXATOR EXTERNAL ROD GP038 $ 8,750.00 2121026047 HC FIXATOR EXTERNAL ROD GP047 $ 13,000.00 2121027006 HC CATH CENTRAL VENOUS GP006 $ 293.00 2121028015 HC ON-Q POST-OP PAIN SYSTEM GP015 $ 1,225.00 2121029006 HC KNIFE SCLERAL GP006 $ 293.00 2121030004 HC PROBE PH SENSING GP004 $ 146.00 2121031014 HC CATH AUROUS SIZING GP014 $ 1,080.00 2121032006 HC PACK VISCOUS FLUID DISP GP006 $ 293.00 2121033044 HC IMPL NAIL TIBIAL GP044 $ 11,000.00 2121034014 HC CATH PASSER DISP GP014 $ 1,080.00 2121035018 HC PROBE APC W FILTER GP018 $ 1,750.00 2121036021 HC BASKET EXTRACT LTHTRPSY LEV 21 $ 2,888.00 2121036024 HC BASKET EXTRACT LTHTRPSY LEV 24 $ 4,000.00 2121037019 HC BASKET MEMORY EXTRACT LEV 19 $ 2,125.00 2121037021 HC BASKET MEMORY EXTRACT LEV 21 $ 2,888.00 2121038022 HC CAPSULE SMALL BOWEL GP022 $ 3,300.00 2121039006 HC CATH MALECOT GP006 $ 293.00 2121040008 HC CATH ERCP GP008 $ 475.00 2121040009 HC CATH ERCP GP009 $ 570.00 2121040010 HC CATH ERCP GP010 $ 665.00

2121041005 HC CATH MANOMETRIC GP005 $ 195.00 2121041006 HC CATH MANOMETRIC GP006 $ 293.00 2121041007 HC CATH MANOMETRIC GP007 $ 380.00 2121041020 HC CATH MANOMETRIC GP020 $ 2,550.00 2121042004 HC FUSION WIRE LOCK GP004 $ 146.00 2121043011 HC INTRO SYST FOR STENT GP011 $ 740.00 2121044018 HC LIGATOR MULTIBAND GP018 $ 1,750.00 2121044019 HC LIGATOR MULTIBAND GP019 $ 2,125.00 2121044020 HC LIGATOR MULTIBAND GP020 $ 2,550.00 2121045018 HC OMNITOME GP018 $ 1,750.00 2121046005 HC PACK T&A GP005 $ 195.00 2121046008 HC PACK T&A GP008 $ 475.00 2121047002 HC PUMP ENDO GP002 $ 50.00 2121048014 HC DEVICE QUANTUM INFL GP014 $ 1,080.00 2121049003 HC TRAY BIOPSY GP003 $ 100.00 2121049004 HC TRAY BIOPSY GP004 $ 146.00 2121050003 HC TRAY PLASTIC PROC GP003 $ 100.00 2121051019 HC WIRE BASKET SOFT MEMORY GP019 $ 2,125.00 2121051021 HC WIRE BASKET SOFT MEMORY GP021 $ 2,888.00 2121052005 HC COLLAR CERVICAL SEMI 2PC GP005 $ 195.00 2121053005 HC KIT CATH CENTRAL VENOUS GP005 $ 195.00 2121053006 HC KIT CATH CENTRAL VENOUS GP006 $ 293.00 2121053007 HC KIT CATH CENTRAL VENOUS GP007 $ 380.00 2121053008 HC KIT CATH CENTRAL VENOUS GP008 $ 475.00 2121053009 HC KIT CVP GP009 $ 570.00 2121053020 HC KIT CATH CENTRAL VENOUS GP020 $ 2,550.00 2121054002 HC AEROCHAMBER W MASK GP002 $ 100.00 2121054005 HC AEROCHAMBER W MASK GP005 $ 195.00 2121055003 HC ADAPTER GP003 $ 100.00 2121055004 HC ADAPTER GP004 $ 146.00 2121056018 HC TUBE FECAL MGMT SYST GP018 $ 1,750.00 2121057007 HC VEST COMPRESSION GP007 $ 380.00 2121058017 HC GRASPER BOWEL GP017 $ 1,575.00 2121059019 HC TAP INSTRMENT SCREW BONE GP019 $ 2,125.00 2121060010 HC TIP BIPOLAR GP010 $ 665.00 2121061022 HC SHAFT REAMER GP022 $ 3,300.00 2121062020 HC TUBE TEFLON GP020 $ 2,550.00 2121063017 HC SET CATH DRAINAGE GP017 $ 1,575.00 2121064002 HC NDL INFUSION GP002 $ 50.00 2121065020 HC IMPL KNEE TIBIAL RING GP020 $ 2,550.00 2121066119 HC IMPL SCREW BONE CUSTOM GP119 $ 90,000.00 2121067004 HC SPLINT THUMB GP004 $ 146.00 2121068065 HC HEARTWARE CONTROLLER GP065 $ 24,800.00 2121069019 HC FIXATOR EXT ADJUST INST GP019 $ 2,125.00 2121069020 HC FIXATOR EXT ADJUST INST GP020 $ 2,550.00 2121070012 HC EXTERNAL FIXATOR SCREW GP012 $ 810.00 2121071055 HC FIXATOR EXT HEAD FRAME GP055 $ 17,300.00 2121072022 HC SCALPEL BONE GP022 $ 3,300.00 2121073024 HC FIXATOR EXT COUPLING GP024 $ 4,000.00 2121074034 HC SCALPEL RETRACTABLE GP034 $ 6,750.00 2121075027 HC SYST SLF RET RETRACTOR GP027 $ 4,875.00 2121076015 HC IMPL CATH PERIT/HEMOD ST GP015 $ 1,225.00 2121077014 HC TOOL REDUCTION DISP GP014 $ 1,080.00

2121077018 HC TOOL REDUCTION DISP GP018 $ 1,750.00 2121078023 HC FIXATOR EXTERNAL JOINT GP023 $ 3,600.00 2121079010 HC FIXATOR EXT DISTRACTION GP010 $ 665.00 2121080021 HC IMPL CRANIAL PTERIONAL GP021 $ 2,888.00 2121080032 HC IMPL CRANIAL PTERIONAL GP032 $ 6,300.00 2121081022 HC IMPL CATH BACTISEAL $ 3,300.00 2121081031 HC IMPL HMII SHORT BEND REL GP031 $ 5,950.00 2121082019 HC VAD PUMP REVOLUTION GP019 $ 2,125.00 2121085012 HC BUTTON GASTRO GP012 $ 810.00 2121086030 HC CATH ABLATION NCARD ENDO GP030 $ 5,800.00 2121088002 HC TIP IRRIGATION SYST GP002 $ 50.00 2121089019 HC IMPL TIGHTROPE GP019 $ 2,125.00 2121090018 HC IMPL BUTTON TIGHTROPE GP018 $ 1,750.00 2121091014 HC IMPL DART CHONDRAL GP014 $ 1,080.00 2121092005 HC TIP DISTAL ATTACHMENT GP005 $ 195.00 2121093044 HC IMPL RING MITRAL VALVE GP044 $ 11,000.00 2121805016 HC SET CATH INFUSION GP016 $ 1,400.00 2200000001 HC BRACE WRIST W THUMB SPICA $ 100.00 2200000002 HC FRESNEL PRISM PER LENS $ 293.00 2200000003 HC ABDUCTION PILLOW HIP $ 570.00 2200000004 HC SPLINT WRIST THERMO < 5 YRS $ 195.00 2200000005 HC SPLINT WRIST THERMO > 5 YRS $ 195.00 2200000006 HC ELECTRODE INTERHEM 16 CONTACT $ 5,438.00 2200000008 HC ELECTRODE GRID 20 CONTACT $ 5,800.00 2200000009 HC ELECTRODE GRID 32 CONTACT $ 6,300.00 2200000010 HC ELECTRODE GRID 64 CONTACT $ 6,750.00 2200000011 HC ELECTRODE STRIP 1 CONTACT $ 1,080.00 2200000012 HC ELECTRODE STRIP 4 CONTACT $ 4,263.00 2200000013 HC ELECTRODE STRIP 6 CONTACT $ 4,263.00 2200000014 HC ELECTRODE STRIP 8 CONTACT $ 4,650.00 2200000015 HC ELECTRODE SPINAL 2 CONTACTS $ 740.00 2200000016 HC ELECTRODE SPINAL 3 CONTACTS $ 810.00 2200000017 HC ELECTRODE CORKSCREW $ 50.00 2200000018 HC ELECTRODE DEPTH $ 3,300.00 2200000019 HC SET ELECTRODE $ 50.00 2200000020 HC SET NDL ELECTRODE $ 195.00 2200000021 HC WIRE HOOK EMG $ 293.00 2200000022 HC TRACH TUBE GP008 $ 475.00 2200000023 HC TRACH TUBE GP009 $ 570.00 2200000024 HC TRACH TUBE GP012 $ 810.00 2200000025 HC TRACH TUBE GP015 $ 1,225.00 2200000026 HC TRACH TUBE GP016 $ 1,400.00 2200000027 HC TRACH TUBE GP018 $ 1,750.00 2200000028 HC TRACH TUBE GP019 $ 2,125.00 2200000029 HC IMPL INTERCEED GP021 $ 2,888.00 2200000030 HC IMPL SEPRAFILM GP017 $ 1,575.00 2200000031 HC LAMINARIA HYGROSCOP STCK GP003 $ 100.00 2200000032 HC DEVICE ANTI-SHOCK GP017 $ 1,575.00 2200000033 HC SET BELMONT DISP W TUB GP013 $ 900.00 2200000034 HC FLOSEAL GP020 $ 2,550.00 2200000035 HC KIT AMNISURE GP026 $ 4,650.00 2200000036 HC ON Q PUMP GP025 $ 4,263.00 2200000037 HC ON Q POST-OP PAIN SYST GP017 $ 1,575.00

2200000038 HC SET BUDDY DISP LEVEL 4 $ 146.00 2200000039 HC DAILY OXYGEN $ 449.00 2200000040 HC FLUTTER VALVE $ 293.00 2200000041 HC PEAK FLOW METER $ 50.00 2200000043 HC RESUSCIT BAG/MASK 195.00 2200000044 HC NDL ELECTRODE L34 7150.00 2200000045 HC BELT STABILIZATION HMII 810.00 2200000046 HC GWR LEVEL 8 475.00 2200000047 HC CATH ANGIO LEVEL 4 146.00 2200000048 HC CATHETER BALLOON 1750.00 2200000049 HC CERVICAL RIPENING BALLOON L6 293.00 2200000050 HC BREASTSHIELD SZ 27MM 50.00 2200000051 HC BREASTSHIELD SZ 30MM 50.00 2200000052 HC BREASTSHIELD SZ 36MM 50.00 2200000053 HC NEEDLE AMNIO SPECIAL 50.00 2200000054 HC HABERMAN FEEDER 195.00 2200000055 HC SNS FULL KIT 195.00 2200000056 HC SNS STARTER KIT 146.00 2200000057 HC SOOTHIES 50.00 2200000058 HC TRAY SWAN-GANZ 380.00 2200000059 HC DILATOR LEV 2 50.00 2200000060 HC NDL PERCUTANEOUS LEV 2 50.00 2200000061 HC GUIDEWIRE LEV 3 100.00 2200000062 HC GUIDEWIRE LEV 4 146.00 2200000063 HC GUIDEWIRE LEV 5 195.00 2200000064 HC GUIDEWIRE LEV 6 293.00 2200000065 HC NEEDLE BIOPSY LEV 3 100.00 2200000066 HC NEEDLE BIOPSY LEV 7 380.00 2200000067 HC NEEDLE TROCAR LEV 4 146.00 2200000068 HC CATH DRAINAGE LEV 4 146.00 2200000069 HC CATH LEV 6 293.00 2200000070 HC CATH LEV 9 570.00 2200000071 HC CATH DRAINAGE LEV 10 665.00 2200000072 HC CATH DRAINAGE LEV 11 740.00 2200000073 HC TUBE GASTROSTOMY LEV 5 195.00 2200000074 HC TUBE FEEDING LEV 7 380.00 2200000075 HC TUBE FEEDING LEV 18 1750.00 2200000076 HC TUBE FEEDING LEV 20 2550.00 2200000077 HC INTRO/SHEATH FXD PL-AWAY LEV 6 293.00 2200000078 HC INTRO/SHEATH FXD PL-AWAY LEV 7 475.00 2200000079 HC INTRO/SHEATH FXD PL-AWAY LEV 9 570.00 2200000080 HC INTRO/SHEATH NON LASER LEV 7 380.00 2200000081 HC INTRO/SHEATH NON LASER LEV 10 665.00 2200000082 HC IMPL PICC LEV 8 475.00 2200000083 HC IMPL PICC LEV 9 570.00 2200000084 HC IMPL PICC LEV 10 665.00 2200000085 HC IMPL CATH PERIT/HEMOD ST LEV 13 900.00 2200000086 HC IMPL CATH PERIT/HEMOD ST LEV 14 1080.00 2200000087 HC IMPL CATH PERIT/HEMOD LT LEV 15 1225.00 2200000088 HC IMPL CATH PERIT/HEMOD LT LEV 18 1750.00 2200000090 HC BILLIRUBIN TIP 50.00 22605604 HC WEDGE PILLOW-LEG $ 460.00 22606347 HC BLEDSOE BRACE $ 815.00

22606370 HC WALKER FX BT $ 659.00 22606545 HC SKI BOX SUPPLY $ 383.00 2300000001 HC REPAIR PROS DEVIC LABR PER 15M 54.00 2300000002 HC ALKALINE BATTERY EA 3.00 2300000003 HC HEARING AID REPLACEMENT FEE 500.00 2300000004 HC HEARING AID REPAIR 12MOS WARRA $ 340.00 2300000005 HC HEARING AID REPAIR 6MOS WARRAN $ 365.05 2300000006 HC BONE CONDUCTION HA 2087.00 2300000007 HC CONV MONAURAL ITE 1557.00 2300000008 HC CONV MONAURAL BTE 1557.00 2300000009 HC CONV BINAURAL ITE 3108.00 2300000010 HC CONV BINAURAL BTE 3108.00 2300000011 HC BINAURAL EAR MOLD/INSERT,ANY T 200.00 2300000012 HC MONAURAL EAR MOLD/INSERT,ANY 100.00 2300000013 HC EAR PROTECTOR-BINAUARAL 144.00 2300000014 HC EAR PROTECTOR-MONAURAL 75.00 2300000017 HC DRI-AID KIT 32.00 2300000018 HC DRY & STORE 321.00 2300000019 HC DRY & STORE REFILLS 6.00 2300000020 HC EARGENE 12.00 2300000022 HC HEARING AID ACCESSORY (LT50) $ 57.50 2300000023 HC HEARING AID STETHOSCOPES 40.00 2300000024 HC KIDS CLIPS 15.00 2300000025 HC HEARING AID RENTAL/DAY 11.00 2300000026 HC HEARING AID BATTERIES EA 2.00 2300000027 HC DEVICE ASSISTED LISTENING $ 763.67 2300000028 HC BI HEARING AID S(GT3000) $ 4,847.16 2300000029 HC BI HEARING AID S(LT3000) $ 1,200.00 2300000030 HC FM SYSTEM $ 1,157.00 2300000031 HC MON HEARING AID S(GT1500) $ 3,436.45 2300000032 HC MON HEARING AIDS (LT1500) $ 3,220.00 2300000033 HC EAR COUPLERS 54.00 2300000034 HC SPLINT WRIST 40.00 2300000035 HC SPLINT LONG LEG 250.00 2300000036 HC SPLINT SHORT LEG 93.00 2300000037 HC SPLINT FINGER 19.00 2300000038 HC SPLINT LONG ARM 80.00 2300000039 HC SPLINT SHORT ARM 54.00 2300000040 HC SPLINT THUMB 80.00 2300000041 HC CAST LIGHT LONG ARM 145.00 2300000042 HC CAST LIGHT SHORT ARM 93.00 2300000043 HC CAST LIGHT LONG LEG 208.00 2300000044 HC CAST LIGHT SHORT LEG 145.00 2300000045 HC CAST BOOT WALKING 40.00 2300000046 HC CAST FOOT CLUB 28.00 2300000047 HC POST OP SHOE 195.00 2300000049 HC BANGERTER PRESS ON FILTER 295.00 2300000052 HC IMMOBILIZER KNEE 131.00 2300000055 HC ABDUCTION BRACE ORTHOMEDICS 245.00 2300000056 HC SUPPORT ANKLE 70.00 2300000057 HC SLING ARM 40.00 2300000058 HC FX WALKER BRACE RIGID 170.00 2300000059 HC FX WALKER BRACE SEMI-RIGID 110.00

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2400000001 HC RH IMMUNE GLOBULIN (RHOGAM) 98.50 2400000002 HC RHOGAM D IMM GLOB (HUM) 300MCG 220.84 2400000002 HC RHOGAM D IMM GLOB (HUM) 300MCG 501.00 2400000003 HC FLUMIST ADMIN - VFC 20.00 2400000004 HC MINERA - IUD DEVICE 1860.00 2400000007 HC IV SOLUTION 1000CC (L&D) 124.00 2400000008 HC IV SOLUTION 500CC (L&D) 88.00 2500000001 HC POWDER MICROMATRIX 100MG 550.00 26100313 HC 7041 BUSULFAN LEVEL $ 251.00 26702001 HC IV INFUSION-THERAPEUTIC-1ST HR $ 1,226.00 26702019 HC IN INFUSION-THER-EA ADDL HR $ 607.00 26702043 HC IV PUSH INJ-ADDTL SEQUENTIAL $ 400.00 26703165 HC HC OP VISIT LEVEL 1-EST-W PX $ 160.00 26703215 HC IVP INJ-ADDTL SEQ SAME DRUG $ 405.00 26710178 HC IV PUSH INJECTION $ 542.00 26730002 HC ROUTINE VENIPUNCTURE $ 115.00 26730218 HC INJECTION SUBQ/IM $ 344.00 26730226 HC TRANSFUSION BLOOD-1 HR $ 3,300.00 26730325 HC APHERESIS-WBC $ 6,998.00 26730333 HC APHERESIS-RBC $ 6,752.00 26730358 HC APHERESIS-PLASMA $ 11,254.00 26730380 HC PBSC HARVESTING ALLOGENIC $ 6,795.00 26730382 HC STEM CELL APHERESIS AUTOLOGOUS $ 6,971.00 26730390 HC PHOTOPHERESIS $ 13,619.00 26730416 HC CANNULA DECLOTTING/VAD OR CATH $ 2,257.00 26730515 HC PHOTOPHERESIS KIT $ 3,266.00 26730549 HC FILTER 40 MICRONS $ 99.00 26730556 HC FILTER PALL PXL 8 $ 455.00 26730564 HC APHERESIS DISP SUPPLY $ 723.00 26730614 HC NEEDLE HUBER $ 99.00 26730689 HC TUBING BLOOD WARMER $ 151.00 26730960 HC COLLECT BLOOD IMPL VAD $ 571.00 26731018 HC BLOOD COLLECT CVC/PICC LINE $ 576.00 28000034 HC KIT SEALANT HEMOS FLOSEAL 10ML $ 2,705.57 28000097 HC IMPL COIL EMOBOLIZATION 10MM 30X $ 11,550.00 28000128 HC IMPL SYST DEL SEPTAL DEFECT $ 5,134.00 28000132 HC IMPL SEPTAL DEFECT SYSTEM 10FX45D $ 5,134.00 28000226 HC CATH DRAINAGE 16F $ 705.50 28000229 HC GASTROJEJENOSTOMY SHETTY SET $ 4,455.36 28000236 HC IMPL CATH INF 65CM 0.035IN 4F $ 113.14 28000314 HC IMPL CATH DRAIN 10.2F 25CM 18G $ 622.97 28000462 HC CATH BALLOON DIL 4F 75CM $ 1,133.65 28000678 HC IMPL COIL EMBOLIZATION 7-3MM 0.018 $ 766.62 28000792 HC CATH GUIDING 95X6CM 6F $ 5,057.50 28000871 HC CATH EMBOLIZATION PERIPHERAL 4X1 $ 2,741.93 28001091 HC IMPL CATH DRAIN 14F 38IN 25CM $ 667.00 28001409 HC INTRO SHEATH OTH 5F 25X11CM $ 229.50 28001486 HC CATH DIL CORONARY 5X12MM $ 1,487.50 28001543 HC INTRO/SHEATH OTH 3FX7CM $ 289.00 28002162 HC IMPL EMBOLIC TRUFILL 1 GRAM KIT $ 18,455.36 28002166 HC CATH BALLOON DIL 3X12MM $ 1,487.50 28002541 HC IMPL WIRE K 91X80MM $ 153.00 28002719 HC INTRO/SHEATH NON LASER 12F $ 2,125.00

28002865 HC IMLP VALVE MELODY 18X22MM $ 84,000.00 28002972 HC IMPL MESH SHEET 40X52X2.3 CM $ 31,500.00 28003598 HC CATH BALLOON DIL 10MMX20CM 75CM $ 2,125.00 28003749 HC IMPL TISSUE CONNECT SYNTH $ 3,681.56 28003835 HC NEEDLE BIOPSY 14GX11CM $ 3,638.00 28003837 HC IMPL CATH GUIDING 5F 80CM $ 158.19 28003839 HC SET INTRODUCER MICRO SS 10CM $ 204.00 28003892 HC GUIDEWIRE 145CM 0.032 IN 3MM $ 110.50 28004002 HC INTR0/SHEETH PEEL AWAY 7F 13CM $ 467.50 28004015 HC GUIDEWIRE 035IN 260CM $ 139.83 28004067 HC IMPL STENT NCOV W DEL 8X59X135 $ 9,750.00 28004105 HC IMPL LEAD DUAL COIL 62CM $ 33,600.00 28004157 HC IMPL INTRODUCER 10MM SET $ 221.00 28004158 HC SET INTRODUCER MICRO 5F $ 229.50 28004340 HC IMPL PORT INDWELLING 5F $ 2,830.50 28004366 HC DEVICE RETREIVER 15MM 6 F $ 2,337.50 28004453 HC GUIDEWIRE 18X60CM $ 271.92 28004455 HC CATH BALLOON DILN 3X80CM 6.3F $ 425.00 28004545 HC IMPL SCREW CANNULATED 50MM $ 1,901.62 28004674 HC GUIDEWIRE 325X2.2CM $ 1,360.00 28004774 HC INTRODUCER ARROW FLEX 6F SET $ 136.77 28004899 HC CATH DRAINAGE 12F $ 654.50 28004918 HC CATH BALLOON DIL 60CM 4F $ 256.79 28004927 HC CATH BALLOON DIL 7F 110CM $ 285.60 28004989 HC INTRODUCER SHEATH GUID 60CM 8F $ 2,439.50 28005106 HC GUIDEWIRE 145CM 35IN 10MM $ 552.50 28005210 HC CATH GUIDING 7F AR1 $ 442.00 28005228 HC GUIDEWIRE 25IN 180CM $ 91.38 28005292 HC INTRO/SHEATH 35MMX5.5CM 6F $ 301.33 28005296 HC CATH DRAINAGE 10.2F 38IN 40CM $ 667.00 28005297 HC CATH DRAINAGE 10.2F $ 667.00 28005406 HC INTRO/SHEATH PEEL AWAY 22X13X20 $ 309.40 28005495 HC GUIDEWIRE 190X6CM $ 798.07 28005774 HC GUIDEWIRE 35IN 150X15CM $ 127.16 28005995 HC SHEATH INTEGRA 11CM 6F SET $ 166.94 28006422 HC GUIDEWIRE 14IN 5X190CM $ 875.93 28006627 HC CATH EP 10PLR FXDCRV 65CM 5F $ 2,975.00 28006711 HC IMPL EMBOLIZATION SPHERE $ 1,105.00 28006781 HC CATHETER INTRO FAST 12CM 10F $ 204.00 28006794 HC CATHETER GUIDING 7X55CM $ 759.65 28007023 HC GUIDEWIRE 300X3CM $ 697.00 28007188 HC IMPL COIL EMBOLIZATION 035 10X14 $ 729.73 28007492 HC IMPL SEPTAL DEFECT SYSTEM 9F 24MM $ 35,100.00 28007622 HC CATH BALLOON DIL 018 5X20X80CM $ 2,337.50 28007700 HC IMPL CATH GUIDING 2.8FX150X20 $ 6,679.64 28008289 HC INTRO/SHEATH NON LASER .35INX8FX $ 478.81 28008364 HC IMPL OCCLUDER 5X4X5MM $ 12,000.00 28008429 HC IMPL LEAD PMKR OTHER 52CM $ 4,675.00 28008539 HC CATH BALLOON DIL 10X4X75 $ 2,128.91 28008697 HC IMPL CATH ABLATION 6MM 7F $ 11,625.00 28008714 HC INTRO/SHEATH NON LASER AAA 12X30 $ 722.50 28008715 HC CATH ABLATION 7F 8X1X6X2MM $ 6,995.50 28008759 HC CATH BALLOON DIL PTA 6X2X75 $ 2,128.91

28008762 HC CATH BALLOON DIL PTA 8X2X75 $ 2,128.91 28008781 HC CATH ABLATION 7F 49MM $ 11,625.00 28008844 HC CATH GUIDING 30X130CM $ 3,070.63 28008845 HC IMPL COIL EMBOLIZATION 2X4MM $ 586.70 28009047 HC INTRO/SHEATH NPEEL 67CM 8F $ 767.13 28009087 HC IMPL CATH GUIDING 2.3FX150X5CM $ 7,015.22 28009158 HC FIBER LASER 0.6X12 $ 3,102.50 28009452 HC INTRO/SHEATH NPEEL 6FX44X52CM $ 722.50 28009708 HC IMPL COIL EMBOLIZATION 4CM 3X360D $ 17,372.85 28009979 HC CATH BALLOON DIL PTCA 3X12MM $ 2,116.50 28009982 HC CATH BALLOON DIL PTCA 3.75X12M $ 2,116.50 28009983 HC CATH BALLOON DIL PTCA 4X12MM $ 2,116.50 28009984 HC CATH BALLOON DIL PTCA 4.5X12MM $ 2,116.50 28010050 HC GUIDEWIRE 25IN 260CM $ 97.92 28010077 HC CATH GUIDING 5F AT 65CM $ 412.68 28010143 HC GUIDEWIRE 35IN 80CM 1.5MM $ 97.75 28010145 HC CATH BALLOON DIL 22MM 75X4CM 10F $ 4,046.00 28010161 HC IMPL CEMENT BONE 40GRN $ 595.00 28010532 HC GUIDEWIRE 14IN 200CM 14MM $ 3,962.36 28010570 HC CATH BALLOON DIL 4MM 2X142CM 4 $ 2,893.40 28010620 HC TUBE JEJUNAL 3-5 ML 16F 1.2X15 $ 2,737.77 28011772 HC CATH BALLOON 4 80CM 5F $ 1,133.65 28011776 HC CATH BALLOON VALVULOPLASTY 22M $ 2,720.00 28011798 HC CATH DIAGNOSTIC 7X115 $ 8,250.00 28011855 HC CATH DRAINAGE 8FX24CM $ 739.50 28011889 HC CATH ELECTROPHYS 7FX4MM $ 6,970.00 28011891 HC CATH ELECTROPHYS 5FX110CM $ 344.25 28012056 HC CATH INFUSION 1.6FX156CM $ 5,312.50 28012189 HC CATH GUIDING 1 .035 5FX65CM $ 92.31 28012396 HC IMPL COIL EMBOLIZATION 5MMX20CM $ 13,125.00 28013050 HC GUIDEWIRE 14X200CM $ 3,230.00 28013057 HC GUIDEWIRE 80CM 8CM $ 150.88 28013091 HC GUIDEWIRE 145CM 0.032IN $ 91.38 28014216 HC INTRO/SHEATH NON LASER 5F 6CM 2.5 $ 183.60 28014255 HC INTRODUCER SHEATH 11CM 6F $ 243.30 28019830 HC IMPL COIL EMBOLIZATION 18 SYS 10M $ 4,972.50 28020233 HC GUIDEWIRE .018X145CM $ 637.50 28022227 HC INTRO/SHEATH NON LASER 14CM 9F $ 425.00 28022248 HC INTRO/SHEATH NON LASER 12F 30CM $ 561.00 28022426 HC CATH BALLOON DIL 6X8X135 $ 1,487.50 28022431 HC CATH INFUSION 4.2F $ 1,214.82 28023417 HC IMPL GUIDEWIRE .35X145CM $ 552.50 28024972 HC INTRODUCER SHEATH 11CM 7F $ 73.00 28024973 HC INTRO SHEATH CATH 11CM X 9FR $ 67.00 28024986 HC LOCM BO 300MG 100ML PER ML $ 59.00 28024987 HC LOCM IOHXL 300MGL/ML PER ML $ 164.00 28024989 HC LOCM 320MG 50ML PER ML $ 157.00 28024995 HC OMNIPAQUE 300 50ML PER ML $ 38.00 28025015 HC CATH GUIDING 6X16X145CM .035IN $ 244.00 28025169 HC CATH GUIDING TAPER 5X100X40 $ 413.00 28025171 HC IMPL CATH GUIDING 4X65X38 $ 413.00 28025176 HC VISIPAQUE 320MG/100ML PER ML $ 313.00 28025488 HC GUIDEWIRE 0.25X145CM $ 113.00

28025492 HC CATH DIAGNOSTIC 6F $ 74.00 28025628 HC IMPL CATH GUIDING 5X40X.038 $ 129.00 28026395 HC INTRO/SHEATH NON LASER 6X90 $ 1,063.00 28026644 HC IMPL SCREW CANNULATED 16MM X 50 $ 2,355.00 28026693 HC INTRO/SEHATH PEEL AWAY 12FR X 15. $ 324.00 30000038 HC MAJOR SURGERY 15 MINUTES $ 7,045.00 30000251 HC MAJOR SURGERY TIME 1 HOUR/45 $ 28,639.00 30000301 HC MAJOR SURGERY TIME 2 HOURS $ 31,039.00 30000350 HC MAJOR SURGERY TIME 2 HOURS/15 $ 33,439.00 30000400 HC MAJOR SURGERY TIME 2 HOURS/30 $ 35,839.00 30000459 HC MAJOR SURGERY TIME 2 HRS 45MIN $ 38,239.00 30000509 HC MAJOR SURGERY TIME 3 HOURS $ 40,639.00 30000558 HC MAJOR SURGERY TIME 3 HOURS/15 $ 43,039.00 30000608 HC MAJOR SURGERY TIME 3 HOURS/30 $ 45,439.00 30000657 HC OR MAJOR 3HR45 $ 47,839.00 30000707 HC MAJOR SURGERY TIME 4 HOURS $ 50,239.00 30000756 HC MAJOR SURGERY TIME 4 HOURS/15 $ 52,639.00 30000905 HC MAJOR SURGERY TIME 5 HOURS $ 59,839.00 30000954 HC OR MAJOR 5HR 15 $ 62,239.00 30001358 HC MAJOR SURGERY TIME 7 HOURS/15 $ 81,439.00 30001556 HC MAJOR SURGERY TIME 8 HOURS/15 $ 91,039.00 30002406 HC OR MAJOR 12 HRS 30 $ 131,839.00 30003958 HC OR 2MAJOR 9HR $ 153,974.00 30005201 HC MINOR SURGERY TIME 1 HOUR/15 $ 17,803.00 30005219 HC MINOR SURGERY TIME 1 HOUR/30 $ 20,303.00 30005409 HC MINOR SURGERY TIME 2 HOURS/45 $ 32,803.00 30007876 HC HEMOSTATIC SEALANT LVL 20 $ 2,763.00 30008445 HC HC BUR BLADE LVL 29 $ 6,588.00 30008577 HC IMPL TISSUE CONN ALLOGRAFT L20 $ 2,869.00 30008783 HC IMPL TISSUE CONN ALLOGRAFT L41 $ 13,500.00 30008817 HC IMPLANT TISSUE ALLOGRAFT L44 $ 16,253.00 30009302 HC IMPL TISSUE CONNECT SYNTH L22 $ 3,806.00 30020051 HC MINOR PROCEDURE 15 MIN $ 1,517.00 30040232 HC HC SURGICAL SUPPLY L39 $ 11,625.00 30040547 HC BURR/BLADE LEVEL 24 $ 4,463.00 30072045 HC IMPL BONE FIXATION L5 $ 218.00 30072052 HC IMPL BONE FIXATION L6 $ 303.00 30072078 HC IMPL BONE FIXATION L8 $ 578.00 30072086 HC IMPL BONE FIXATION L9 $ 565.00 30072094 HC IMPL BONE FIXATION L10 $ 611.00 30072128 HC IMPL BONE FIXATION L13 $ 938.00 30072136 HC IMPL BONE FIXATION L14 $ 1,078.00 30072151 HC IMPL BONE FIXATION L16 $ 1,549.00 30072177 HC IMPL BONE FIXATION L18 $ 1,991.00 30072185 HC IMPL BONE FIXATION L19 $ 2,072.00 30072532 HC IMPL CARDIAC/VASC L14 $ 1,105.00 30073076 HC ENDOVASCULAR SUPPLY 7 $ 393.00 30075741 HC IMPLANT ORTHOPED L26 $ 5,383.00 30075808 HC IMPLANT ORTHOPED L32 $ 7,565.00 30075881 HC IMPLANT ORTHOPED L39 $ 11,779.00 30075949 HC IMPLANT ORTHOPED L45 $ 17,320.00 30076954 HC EQUIP SUPPLY DISP L21 $ 3,188.00 30078588 HC SUTURES L19 $ 2,338.00

30078752 HC EQUIP SUPPLY DISP L26 $ 5,313.00 30078810 HC EQUIP SUPPLY DISP L32 $ 7,863.00 30079016 HC IMPL BONE FIXATION L28 $ 6,527.00 30081533 HC URIN DRAIN/CATHTR L4 $ 127.00 30095095 HC IMPL VASCULAR GRAFT LVL 22 $ 3,400.00 30096549 HC GUIDEWIRE L13 $ 757.00 30096561 HC RETRIEVAL DEVICE L19 $ 2,125.00 30096659 HC IMPL VASC GRAFT SYNTH L20 $ 2,811.00 30098010 HC COCHLEAR ALLN1 LVL 117 $ 78,000.00 30098011 HC COCHLEAR ALLN1 LVL 118 $ 84,000.00 30100903 HC PHLEBOTOMY $ 115.00 30200257 HC OR MAJOR 1HR45 $ 28,639.00 30200307 HC OR MAJOR 2HR $ 31,039.00 30200356 HC OR MAJOR 2HR15 $ 33,439.00 30200406 HC OR MAJOR 2HR30 $ 35,839.00 30200455 HC OR MAJOR 2HR45 $ 38,239.00 30200554 HC OR MAJOR 3HR15 $ 43,039.00 30200604 HC OR MAJOR 3HR30 $ 45,439.00 30200653 HC OR MAJOR 3HR45 $ 47,839.00 30200703 HC OR MAJOR 4HR $ 50,239.00 30200851 HC OR MAJOR 4HR45 $ 57,439.00 30200901 HC OR MAJOR 5HR $ 59,839.00 30200950 HC OR MAJOR 5HR15 $ 62,239.00 30201008 HC OR MAJOR 5HR30 $ 64,639.00 30202329 HC COCHLEAR IMPLANT LVL 117 $ 67,411.00 30202576 HC IMPL HEMOSTAT SEAL L18 $ 1,913.00 30202675 HC HC IMPLNT HEMOSTAT SEAL L14 $ 1,105.00 30205108 HC OR MINOR 45 MIN $ 12,803.00 30205157 HC OR MINOR 1HR $ 15,303.00 30205751 HC HC OR MINOR 5HR $ 55,303.00 30240436 HC ACUTE POST ANES CARE 15 MIN $ 631.00 30240444 HC INTENSE POST ANES CARE 15 MIN $ 1,142.00 30240451 HC CRITICAL POST ANES CARE 15 MIN $ 1,356.00 30265060 HC IMPLANT COCHLEAR $ 80,233.00 30272017 HC BONE FIXATION IMPLANT LVL 6 $ 419.00 30293062 HC HC PATIENT IMPLANT-LEVEL 28 $ 6,163.00 30293161 HC PATIENT IMPLANT - LVL 51 $ 24,500.00 30293385 HC PATIENT IMPLANT - LVL 73 $ 51,350.00 30301006 HC ANES SPINAL-CAUD-EPI $ 3,160.00 30301055 HC BRACHIAL BLOCK $ 2,948.00 30301204 HC ANESTHESIA-FIRST HOUR $ 4,176.00 30301253 HC ANES TIME 1 HR 15 $ 4,596.00 30301303 HC ANES TIME 1 HR 30 $ 5,016.00 30301352 HC ANES TIME 1 HR 45 $ 5,436.00 30301402 HC ANES TIME 2 HR $ 5,856.00 30301451 HC ANES TIME 2 HR 15 $ 6,276.00 30301501 HC ANES TIME 2 HR 30 $ 6,696.00 30301550 HC ANES TIME 2 HR 45 $ 7,116.00 30301600 HC ANES TIME 3 HR $ 7,536.00 30301659 HC ANES TIME 3 HR 15 $ 7,956.00 30301709 HC ANES TIME 3 HR 30 $ 8,376.00 30301758 HC ANES TIME 3 HR 45 $ 8,796.00 30301808 HC ANES TIME 4 HR $ 9,216.00

30301857 HC ANES TIME 4 HR 15 $ 9,636.00 30301907 HC ANES TIME 4 HR 30 $ 10,056.00 30302053 HC ANES TIME 5 HR 15 $ 11,316.00 30302103 HC ANES TIME 5 HR 30 $ 11,736.00 30302152 HC ANES TIME 5 HR 45 $ 12,156.00 30302202 HC ANES TIME 6 HR $ 12,576.00 30302509 HC ANES TIME 7 HR 30 $ 14,846.00 30302707 HC ANES TIME 8 HR 30 $ 16,026.00 30302905 HC ANES TIME 9 HR 30 $ 17,206.00 30303762 HC ANES TIME 15 HR 45 $ 24,581.00 30402028 HC ACUTE POST ANES CARE 15 MIN $ 631.00 30402044 HC INTENSE POST ANES CARE ** $ 1,142.00 30402069 HC CRITICAL POST ANES CARE 15 MIN $ 1,356.00 30568299 HC SOLN CARDIOPLEGIA MEDTRONIC $ 237.00 30568331 HC TUBING VENTR ASSIST DISP $ 425.00 30568406 HC HEMO-CONCENTRATOR 400TS DISP $ 808.00 30568414 HC SENSOR CDI ARTERIAL DISP $ 850.00 30568422 HC TUBING CELLSAVER DISP $ 1,105.00 30568448 HC TUBING PACK 1/2 ADULT DISP $ 1,913.00 30568513 HC OXGENATOR ADULT DISP $ 2,338.00 30570238 HC PERFUSION SUPPLY $ 4,463.00 30600852 HC LIVER BIOPSY $ 3,429.00 30601843 HC ERCP/BALLOON $ 11,923.00 30601900 HC ERCP/STONE EXTRACTN $ 10,625.00 30601926 HC ERCP/SPHINCTEROTOMY $ 11,923.00 30604714 HC STENT NCOV W DEL LEVEL 44 $ 17,963.00 30604847 HC STENT PLASTIC LEVEL 11 $ 765.00 30604854 HC HC PLASTIC STENT-C2625 LEVEL13 $ 1,000.00 30604920 HC ENDO RETRIEVAL DEVICE LEVEL 15 $ 850.00 30605026 HC HC GUIDEWIRE LEVEL 12 $ 850.00 30605034 HC GWR LEV 13 $ 1,020.00 30605075 HC BALLOON ENDO PROC LEVEL 4 $ 148.00 30605174 HC ENDO CAN PAPILLA W DV OF CB $ 11,173.00 30605620 HC SPHINCTEROTOME L20 $ 2,763.00 30605679 HC HC ERCP GUIDEWIRE WILSON COOK $ 1,221.00 30680672 HC EGD W/BIOPSY $ 5,934.00 30683023 HC EGD W/EUS/FNA $ 6,977.00 30683031 HC ERCP W/STENT PLACEMENT $ 10,317.00 30683221 HC HC ENDO CHOLANGIOPANCREATOGRAP $ 15,697.00 30688725 HC ENDO GI PRC LVL 3 INT 30 MIN $ 7,647.00 30688726 HC ENDO GI PRC LVL 3 ADDTL 5 MIN $ 611.00 30688727 HC ENDO GI PROC LVL 4 INT 30 MIN $ 8,874.00 30688729 HC ENDO GI PROC LVL 4 ADL 5 MIN $ 710.00 30688731 HC ENDO GI GEN ANESTHESIA $ 300.00 30800908 HC VENIPUNCTURE $ 115.00 3100000001 HC ANES SPINAL CAUD EPIDURAL 2307.00 3100000002 HC MOD SED: <5YRS 1ST 30 MIN 1080.00 3100000003 HC MOD SED: >5YRS 1ST 30MIN 786.00 3100000004 HC MOD SED: EA ADDL 15MIN 276.00 3100000005 HC MOD SED OTH: <5YRS 1ST 30 MIN 1080.00 3100000006 HC MOD SED OTH: >5YRS 1ST 30 MIN 786.00 3100000007 HC MOD SED OTH: EA ADDL 15MIN 276.00 3100000008 HC ANESTHESIA GAS UP TO 1ST HOUR 3256.00

3100000009 HC ANESTHESIA GAS EA ADDL 1 MIN 33.00 3100000010 HC OB ANESTHESIA GAS UP TO 1ST HR 2538.00 3100000011 HC OB ANESTHESIA GAS EA ADDL 1MIN 16.00 3200000011 HC LEVEL 1 UP TO 1ST HR 12105.00 3200000012 HC LEVEL 1 EA ADDL 1 MIN 70.00 3200000021 HC LEVEL 2 UP TO 1ST HR 14949.00 3200000022 HC LEVEL 2 EA ADDL 1 MIN 112.00 3200000031 HC LEVEL 3 UP TO 1ST HR 18054.00 3200000032 HC LEVEL 3 EA ADDL 1 MIN 155.00 3200000041 HC LEVEL 4 UP TO 1ST HR 22191.00 3200000042 HC LEVEL 4 EA ADDL 1 MIN 212.00 3200000051 HC OPEN HRT WO PERF UP TO 1ST HR 29692.00 3200000052 HC OPEN HRT WO PERF EA ADDL 1 MIN 316.00 3200000061 HC OPEN HRT W PERF UP TO 1ST HR 31244.00 3200000062 HC OPEN HRT W PERF EA ADDL 1 MIN 338.00 3200000111 HC SIMPLE SURGERY UP TO 1ST HR 2856.00 3200000112 HC SIMPLE SURGERY EA ADDL 1 MIN 35.00 3200000121 HC MINOR UP TO 1ST HR 6811.00 3200000122 HC MINOR EA ADDL 1 MIN 87.00 3200000131 HC MAJOR UP TO 1ST HR 9196.00 3200000132 HC MAJOR EA ADDL 1 MIN 121.00 3200000141 HC OPER PROC MINOR UP TO 1ST HR 4734.00 3200000142 HC OPER PROC MINOR EA ADDL MIN 20.00 3200000151 HC OPER PROC MAJOR UP TO 1ST HR 10371.00 3200000152 HC OPER PROC MAJOR EA ADDL MIN 76.00 3200000200 HC CANCELLED CASE 629.00 3200000211 HC C-SECTION LEVEL 1 UP TO 1ST HR 11797.00 3200000212 HC C-SECTION LEVEL 1 EA ADDL MIN 91.00 3200000221 HC C-SECTION LEVEL 2 UP TO 1ST HR 12123.00 3200000222 HC C-SECTION LEVEL 2 EA ADDL MIN 94.00 3200000231 HC C-SECTION LEVEL 3 UP TO 1ST HR 12448.00 3200000232 HC C-SECTION LEVEL 3 EA ADDL MIN 99.00 3200000241 HC C-SECTION LEVEL 4 UP TO 1ST HR 13098.00 3200000242 HC C-SECTION LEVEL 4 EA ADDL MIN 107.00 3300000001 HC ESOPHAGEAL MOTILITY STUDY 4644.00 3300000002 HC ESOPHAG MOTILITY STUDY W STIM 4644.00 3300000004 HC ESOPHAGEAL PH STUDY PROLONGED 3021.00 3300000005 HC GASTROESOPHAGEAL REFLUX TEST 2712.00 3300000006 HC PH PROBE STUDY TWO CHANNEL 2999.00 3300000007 HC PH REFLUX TEST BRAVO 3532.00 3300000009 HC RECTAL MANOMETRY 4644.00 3300000010 HC EYE EXAM 152.00 3300000011 HC SENSIMOTOR 260.00 3300000012 HC EXAM AMBLYOPIA 177.00 3300000013 HC BINOCULAR SINGLE VISION LTD 292.00 3300000014 HC SERIAL TONOMETRY MLT MEAS IO 214.00 3300000015 HC FLUORESCEIN ANGIOGRAPHY LT 1014.00 3300000016 HC FLUORESCEIN ANGIOGRAPHY RT 1014.00 3300000017 HC FUNDUS PHOTOGRAPHY 617.00 3300000018 HC COLOR VISION EXAM, EXTENDED 320.00 3300000019 HC EXT OCULAR PHOTOGRAPHY 320.00 3300000020 HC ANTERIOR SEGMENT PHOTOGRAPHY 646.00 3300000021 HC PRISM PLACEMENT 430.00

3300000022 HC TONOGRAPHY I&R REC INDNT/SUC 340.00 3300000023 HC NEG PRESSURE WND TX <50 SQ CM 398.00 3300000024 HC NEG PRESSURE WND TX >50 SQ CM 398.00 3300000025 HC FLUORESCEIN ANGIOGRAPHY BIL 2027.00 3400000011 HC RECOVERY CARE LVL1 UP TO 1ST HR 2195.00 3400000012 HC RECOVERY CARE LVL1 EA ADDL 1MIN 26.00 3400000021 HC RECOVERY CARE LVL2 UP TO 1ST HR 3298.00 3400000022 HC RECOVERY CARE LVL2 EA ADDL 1MIN 37.00 3400000031 HC SURGICAL RECOVERY FIRST HOUR 1983.00 3400000032 HC SURGICAL RECOVERY ADDTL 15 MIN 111.00 3500000001 HC VAGINAL DELIVERY LEVEL 1 4751.00 3500000002 HC VAGINAL DELIVERY LEVEL 2 5077.00 3500000003 HC VAGINAL DELIVERY LEVEL 3 5728.00 3500000004 HC LABOR ROOM PER HOUR 571.00 3500000005 HC HIGH RISK CARE PER HOUR 695.00 3500000006 HC INT HIGH RISK CARE PER HOUR 546.00 3500000007 HC AMNIOCENTESIS DIAG 635.00 3500000008 HC AMNIOCENTESIS FLUID REDUCTION 577.00 3500000009 HC CORDOCENTESIS/PUBS 4319.00 3500000010 HC CHORIONIC VILLUS SAMPLING 515.00 3500000011 HC FETAL STRESS TEST 669.00 3500000012 HC FETAL NON-STRESS TEST 573.00 3500000013 HC FETAL FLUID DRAINAGE 1208.00 3500000014 HC EXTERNAL CEPHALIC VERSION 2374.00 3500000015 HC MULTIFETAL PREG REDUCTION 515.00 3500000016 HC INJ BLOOD PATCH 1730.00 3600000001 HC REMOVL GAUNTLET BOOT/BODY CAST 423.00 3600000002 HC REMOVL FULL ARM/LEG CAST 337.00 3600000003 HC REMOVL SHOULDER/HIP JACKET 337.00 3600000004 HC REPAIR SPICA/BODY CAST/JACKET 676.00 3600000005 HC WINDOWING OF CAST 255.00 3600000006 HC WEDGING OF CAST 255.00 3600000008 HC INTUBATION ENDOTRACH EMERGENCY 1381.00 3600000009 HC BRONCHOSCOPY FIBEROPTIC 2083.00 3600000011 HC VENIPUNCTURE ROUTINE 50.00 3600000012 HC VENIPUNCTURE CAPILLARY 87.00 3600000013 HC VENIPUNCTURE CUTDOWN < 1 YR 118.00 3600000014 HC VENIPUNCTURE CUTDOWN 1+ YR 118.00 3600000015 HC TRANSFUS BLD/BLD COMPONENT 665.00 3600000016 HC TRANSFUS BLD/COMP LEV 1 665.00 3600000017 HC TRANSFUS BLD/COMP LEV 2 1129.00 3600000018 HC TRANSFUS BLD/COMP LEV 3 1726.00 3600000019 HC TRANSFUS BLD/BLD COMPONENT 665.00 3600000020 HC TRANSFUS BLD PUSH <= 2 YRS 885.00 3600000021 HC TRANSFUS BLD EXCHNG NEWBORN 1730.00 3600000022 HC TRANSFUS BLD EXCHNG NOT NWBRN 159.00 3600000023 HC CATHETERIZATION UMBIL VEIN NWBRN 1617.00 3600000024 HC INSERT PICC WO PORT/PUMP < 5 YRS 3596.00 3600000025 HC INSERT PICC WO PORT/PUMP 5+ YRS 3596.00 3600000026 HC REPAIR TUN/NON-TUN CVC WO PORT 1520.00 3600000027 HC REPLACE PICC WO PUMP SM ACCESS 3250.00 3600000028 HC BLOOD COLLECTION FROM VAD 149.00 3600000029 HC BLOOD COLLECTION PICC 144.00

3600000030 HC DECLOT W THROMBOAGENT VAD/CATH 1292.00 3600000031 HC REPOSITION VENOUS CATH FL GUID 1520.00 3600000032 HC ARTERIAL PUNCTURE DX 1138.00 3600000033 HC ARTERIAL CATHETERIZATION UMBIL 1617.00 3600000034 HC ASPIRATION BONE MARROW 970.00 3600000035 HC BIOPSY BONE MARROW 1299.00 3600000036 HC GASTROSTOMY TUBE CHNG WO GUID 933.00 3600000037 HC BIOPSY LIVER NDL PERC 1834.00 3600000038 HC BIOPSY RENAL PERC 2213.00 3600000039 HC INSERT CATH URETHTRA 310.00 3600000040 HC INSERT CATH BLADDER TEMP SIMP 356.00 3600000041 HC INSERT CATH BLADDER TEMP COMPLX 898.00 3600000042 HC COMPLEX CYSTOMETROGRAM 1220.00 3600000043 HC COMPLEX CYSTOMETROGRAM W VP 1511.00 3600000045 HC UROFLOMETRY COMPLEX 498.00 3600000046 HC EMG OF ANAL/URETHRAL SPHINCTER 498.00 3600000047 HC VOIDING PRESSURE STUDY-INTRA ABD 829.00 3600000048 HC CIRCUMCISION 2653.00 3600000049 HC INSERTION IUD 440.00 3600000050 HC LUMBAR PUNCTURE DIAGNOSTIC 1165.00 3600000051 HC LUMBAR PUNCTURE THERAPEUTIC 1717.00 3600000052 HC LUCENTIS INJECTION 1076.00 3600000053 HC RMVAL IMPCTD CERUM 1/BOTH EARS 403.00 3600000054 HC THORACENTESIS 1382.00 3600000056 HC BRONCHOSCOPY FIBEROPTIC W BIOP 3295.00 3600000057 HC IV START < 3 YRS 133.00 3600000058 HC IV START 3+ YRS 283.00 3600000059 HC LOCAL TRMT BURN, INITAL 300.00 36000024 HC FDG PET RADIOPHARMACEUTICAL $ 2,415.00 36000503 HC STEREOSCOPIC X-RAY GUIDANCE RT $ 1,723.00 36001501 HC VISIPAQUE 300-399MG PER ML $ 9.00 36001584 HC RESPIRATORY GATING $ 703.00 36033124 HC 3D RADIOTHERAPY PLAN W/HD HIST $ 12,192.00 36033249 HC WEEKLY PHYSICS QA $ 1,424.00 36033280 HC CT GUIDANCE/PCM RAD $ 3,582.00 36033285 HC ACQ OF PET FOR RT TX PLAN $ 454.00 36033389 HC INJECTION SUBQ/IM $ 344.00 36033405 HC IMRT TREATMENT PLAN $ 19,230.00 36033413 HC IMRT DAILY TREATMENT 15X $ 7,929.00 36033421 HC IMRT DAILY TREATMENT 6X $ 7,929.00 36060325 HC VENIPUNCTURE $ 115.00 36070142 HC SPCL RX PRC/TBI/HEM $ 6,226.00 36070159 HC TTL BDY IRRADTN-BMT $ 6,226.00 36070167 HC TTL BDY IRRADTN-MF $ 6,226.00 36070761 HC TX DLVRY SIMP 6-10M $ 1,259.00 36070779 HC TX DLVR SIMP 11-19M $ 1,383.00 36070910 HC TX DLVR CMPLX 6-10M $ 2,446.00 36070936 HC TX DLVR CMPL 11-19M $ 2,756.00 36071108 HC SPECIAL PHYSICS CONSULT $ 5,752.00 36079028 HC ISODOSE PLAN/COMPLX $ 3,983.00 36079036 HC ISODOSE PLAN 3D $ 3,983.00 36079200 HC SPEC DOSM/TLD MICRO $ 1,412.00 36079226 HC COMPLEX TX DEVICE $ 2,439.00

36079234 HC TRTMNT DEVICE/INTER $ 1,347.00 36079275 HC CMPLX MOLDED BLOCK $ 2,439.00 36079309 HC BSC RADIAT DOSIMTRY $ 1,428.00 36079408 HC SIM ELCTRN BEAM SIM $ 2,050.00 36079416 HC CMPLX EXTR BEAM SIM $ 4,747.00 36099158 HC HC MCL FOR IMRT DESIGN&CONSTR $ 13,988.00 36099935 HC THERAPTIC RAD PORT $ 800.00 36200087 HC BASIC RAD DOSI CALC $ 1,428.00 36300077 HC SIMULTN/STEROTACTIC COMPLEX $ 4,747.00 36300085 HC BASIC RAD DOSIM CLC $ 1,428.00 36300093 HC ISODOSE PLAN 3D $ 3,983.00 36300101 HC TX DEVICE COMPLEX $ 2,439.00 36300119 HC WEEKLY PHYSICS QA $ 1,424.00 36300127 HC PHYS CNSL STEREOTCT $ 5,752.00 36300135 HC SPECIAL TX PROCEDUR $ 6,226.00 36300192 HC SRS CYBERKNIFE 1 SESSION-BRAIN $ 27,992.00 36300200 HC CYBERKNIFE MULTI 2-5 TX-BRAIN $ 27,992.00 36300218 HC CT GUIDE PLC RAD TX FIELD $ 3,582.00 36300507 HC 77295 SIM BY 3-D RECONSTRUCTIO $ 12,192.00 36300515 HC SIMULATION SIMP FOR CYBERKNIFE $ 2,050.00 36301505 HC CT GUIDE STEROTAC LOCAL $ 4,470.00 36301513 HC LOCM 300-399 MG/1ML $ 9.00 36301521 HC OMNIPAQUE 300-399MG PER ML $ 2.00 36400240 HC FDG PET RADIOPHARMACEUTICAL $ 2,156.00 36400307 HC PET SCAN BRAIN METABOLIC $ 10,566.00 36400331 HC PETCT WHOLE BODY $ 10,566.00 36400539 HC PETCT SKULL-THIGH $ 10,566.00 36400620 HC PET SCAN - UNLISTED $ 4,521.00 36516110 HC LOCM 300-399 MG/ML $ 3.00 36516409 HC CT ABDOMEN-PELVIS WO CONTRAST $ 6,470.00 36516417 HC CT ABD-PELVIS W/CONTRAST $ 7,711.00 36523108 HC CT HEAD WO CON $ 3,850.00 36524759 HC CT THORAX WO CONTRAST $ 4,426.00 36524916 HC CT SFT TIS NCK W/CON $ 4,628.00 36525004 HC CT THORAX W/CONTRAST $ 5,564.00 37000254 HC RADIODN TX/HYPRTHYR $ 2,995.00 37000486 HC KIDNY FNCTN CLEARNC $ 2,099.00 37000502 HC CARD ANGIOGRM STRES $ 5,038.00 37000601 HC BRAIN SCAN 4+ VIEWS $ 744.00 37000700 HC BONE SCAN WHOLE BODY $ 4,580.00 37001179 HC LYMPHTC/LYMPHGL IMG $ 4,375.00 37001302 HC LUNG PERFUSION STDY $ 3,596.00 37001526 HC MYOCARD TOMO MULTI $ 7,246.00 37001534 HC MYOCARD TOMO SINGLE $ 5,014.00 37001559 HC BOWL IMAG MCKLS LCL $ 3,192.00 37001609 HC RBC GI BLEED $ 4,521.00 37001914 HC PARATHYROID IMAGING $ 3,656.00 37002144 HC CSF LEAK DETECT & LOCALIZATN $ 3,679.00 37002151 HC CSF KINETICS $ 1,804.00 37002177 HC BODY WHITE BLD CELL $ 3,523.00 37002201 HC TUMOR LOCALIZATION WB SGL DAY $ 5,209.00 37003134 HC BONE DENSITY DEXA AXIAL $ 1,077.00 37003423 HC GASTRC EMPT TIM STD $ 4,131.00

37003506 HC RENAL PERFUS/EXCRT $ 2,332.00 37003514 HC DMSA RENAL TOMO $ 1,903.00 37003704 HC BONE SCAN THREE PHASE $ 4,984.00 37003720 HC RESTING HEART FUNCTION $ 4,164.00 37003803 HC R TO L SHUNT $ 2,178.00 37003829 HC RENAL V-CYSTO $ 2,193.00 37003886 HC BONE IMAG TOMO SPECT $ 4,065.00 37003936 HC LIVER IMAGING (SPECT) $ 3,991.00 37003944 HC GAST ESOPH REFL STD $ 1,653.00 37004009 HC BRAIN SCN - SPECT $ 4,212.00 37005022 HC 1-123-CAPSULE PER 100 UCI $ 298.00 37005030 HC TX I-131 CAPSULE PER MCI $ 57.00 37005048 HC CERETEC HMPAO PER DOSE<25MCI $ 8,378.00 37005071 HC SULFUR COLLOID PER DOSE <20MCI $ 468.00 37005089 HC IN 111 OXYQUINOLINE/0.5 MCI $ 6,756.00 37005097 HC IN 111 PENETATE PER 0.5 MCI $ 4,106.00 37005105 HC TC99M SUCCIMER <10 MCI $ 3,366.00 37005113 HC TC-99M BICISATE <25 MCI $ 8,400.00 37005121 HC TC-99M MCRAGGRGT ALBMN <15 $ 2,550.00 37005139 HC DTPA AEROSOL PER DOSE <75MCI $ 799.00 37005147 HC MAA PER DOS <10MCI $ 289.00 37005154 HC ULTRATAG PER DOSE <30MCI $ 1,020.00 37005212 HC ECG STRESS TEST TRACING ONLY $ 2,736.00 37005964 HC PULM VENTILATION (AERO OR GAS) $ 10,658.00 37005972 HC PULM VENT & PERF (AERO OR GAS) $ 2,900.00 37005998 HC HEPATOBILI SCAN W/WO GB $ 2,839.00 37006004 HC THROID IMG SGL/MLT QT MEAS VAS $ 1,722.00 37010055 HC TC99 MEDRONATE UP TO 30 MCI $ 145.00 37010121 HC TC-99M MEBROFENIN UP TO 15 MC $ 340.00 37010204 HC TC99 PERTECHNETATE DX PER MCI $ 39.00 37010311 HC IN 111 PENTETREOTIDE/MCI $ 21,749.00 37010352 HC TC-99M PENETATE UP TO 25 MCI $ 289.00 37010501 HC TC99 SESTAMIBI PER STUDY DOSE $ 493.00 37010584 HC TC99 MYOVIEW DX UP TO 40 MCI $ 298.00 37020427 HC TUMOR LOC SPECT $ 6,146.00 37020906 HC CIST/LAT PUNC W/INJ $ 1,663.00 37021102 HC MYOCARD PERF QUAL/QUAN $ 5,014.00 37021128 HC I-125 SODIUM IOTHALAMATE/10 UC $ 663.00 37021433 HC RADIOPHARM I-123 MIBG $ 7,650.00 37021524 HC WHOLE BODY SCAN-2 OR MORE $ 9,741.00 37100245 HC F-18 FDG FLUORODEOXYGLUCOSE 45 $ 2,156.00 37100302 HC PET SCAN BRAIN METABOLIC $ 4,521.00 37100336 HC PETCT WHOLE BODY $ 10,566.00 37100534 HC PETCT SKULL-THIGH $ 10,566.00 37100625 HC PETCT SKULL-THIGH $ 4,521.00 37216116 HC LOCM 300-399 MG/ML-ISOV $ 3.00 37216405 HC HC CT ABDOMEN-PELVIS W/O CONT $ 6,470.00 37216413 HC CT ABDOMEN-PELVIS W CONTRAST $ 7,711.00 37224755 HC CT THORAX WO CONTRAST $ 4,426.00 37224904 HC HC CT SOFT TISS NECK W/O CONT $ 4,347.00 37224912 HC HC CT SFT TIS NCK W/CON $ 4,628.00 37224953 HC CT ABDOMEN W/CONTRAST $ 6,285.00 37225000 HC CT THORAX W/CNTRST $ 5,564.00

37225059 HC CT PELVIS W/CONTRAST $ 7,439.00 38105003 HC MRI GAD CONTRAST/ML $ 29.00 38105961 HC GADAVIST PER ML NDC 5041932512 $ 38.00 38110110 HC MRI PELVIS W & WO CONTRAST $ 7,794.00 38110219 HC MRI ABD W & WO CONTRAST $ 8,002.00 39000021 HC HC PM CHK DUAL W/REPROG $ 595.00 40300022 HC 3D RENDERING CT - 3D LAB $ 1,984.00 40300048 HC 3D RENDERING MR - 3D LAB $ 1,984.00 40300097 HC CT SURGICAL PLANNING $ 3,122.00 40300105 HC MR SURGICAL PLANNING $ 3,858.00 40300113 HC CT TX PLANNING NON AORTA $ 3,122.00 40805954 HC BIOPSY TRAY LVL 4 $ 149.00 40828527 HC US BRST(U OR B)MAMMO AREA $ 948.00 40871667 HC FINE NEEDLE ASPIRATION $ 2,086.00 40880288 HC US GUID NDL PLC: MAMMO AREA $ 1,896.00 40905002 HC US: PREG UTER TRANSVAGINAL $ 1,150.00 40905051 HC US: PREG UTRS 1ST TRI 1ST FET $ 1,778.00 40905705 HC US SUPPLY LEVEL 3 $ 85.00 40905762 HC US SUPPLY LEVEL 6 $ 298.00 40911216 HC US GUIDANCE NEEDLE PLCMNT $ 1,896.00 40928657 HC US: PREGNANT UTERUS W/EVAL $ 1,928.00 40928707 HC US: PELV NON-OB LTD $ 1,237.00 40928780 HC US: ABDOMEN $ 2,294.00 40928798 HC US:ABDOMEN LIMITED $ 1,584.00 40928806 HC US: RETROPERITONEAL $ 1,822.00 40928814 HC US:RETROPERITON LTD $ 1,321.00 40930133 HC DPLX VENOUS EX IMAN BIL $ 2,966.00 40930141 HC DPLX VEN EXT LTD UNIL $ 2,072.00 40930182 HC DPLX AORT/IVC/ILIAC LTD $ 1,627.00 40980096 HC BX RENAL NDL $ 2,637.00 4100000001 HC APPLY LONG ARM SPLINT $ 335.00 4100000002 HC APPLY SHORT ARM SPLINT $ 232.00 4100000003 HC APPLY DYNAMIC ARM SPLINT $ 297.00 4100000004 HC APPLY STATIC FINGER SPLINT $ 227.00 4100000005 HC APPLY DYNAMIC FINGER SPLINT $ 226.00 4100000006 HC APPLY THORAX STRAPPING $ 232.00 4100000007 HC APPLY LONG LEG WALKING CAST $ 732.00 4100000008 HC APPLY SHORT LEG CAST $ 474.00 4100000009 HC APPLY RIGID TOTL CNTCT CAST $ 919.00 4100000010 HC APPLY LONG LEG SPLINT $ 367.00 4100000011 HC APPLY SHORT LEG SPLINT $ 360.00 4100000012 HC BIOFEEDBACK TRAINING $ 427.00 4100000013 HC BIOFEEDBACK TRAINING ANORECTAL $ 853.00 4100000014 HC SPEECH PATH EVAL LIMITED $ 304.00 4100000015 HC SPEECH PATH EVAL REG $ 604.00 4100000016 HC SPEECH PATH EVAL COMPREHENSIVE $ 823.00 4100000017 HC SP PATH TRTMNT INDIV 15 MIN $ 159.00 4100000018 HC SP PATH TRTMNT INDIV 30 MIN $ 285.00 4100000019 HC SP PATH TRTMNT INDIV 45 MIN $ 425.00 4100000020 HC SP PATH TRTMNT INDIV 60 MIN $ 569.00 4100000021 HC SP PATH TRTMNT GRP 30 MIN $ 146.00 4100000022 HC SP PATH TRTMNT GRP 60 MIN $ 292.00 4100000023 HC OT ORAL MOTOR TRTMNT LIMITED $ 169.00

4100000024 HC OT ORAL MOTOR TRTMNT REG $ 376.00 4100000025 HC OT ORAL MOTOR TRTMNT COMPLEX $ 453.00 4100000026 HC ORAL FUNCTION TRTMNT $ 419.00 4100000027 HC SP ORAL MOTOR TRTMNT LIMITED $ 164.00 4100000028 HC SP ORAL MOTOR TRTMNT REG $ 365.00 4100000029 HC SP ORAL MOTOR TRTMNT COMPLEX $ 440.00 4100000030 HC OT ORAL MOTOR EVAL LIMITED $ 262.00 4100000031 HC OT ORAL MOTOR EVAL REG $ 579.00 4100000032 HC OT ORAL MOTOR EVAL COMPLEX $ 698.00 4100000033 HC SP ORAL MOTOR EVAL LIMITED $ 262.00 4100000034 HC SP ORAL MOTOR EVAL REG $ 579.00 4100000035 HC SWALLOW FUNCTION EVAL $ 1,132.00 4100000036 HC MODIFIED BARIUM SWALLOW EVAL $ 1,062.00 4100000037 HC EVAL AUD REHAB STATUS 1ST HR $ 473.00 4100000038 HC EVAL AUD REHAB STATUS ADDL 15M $ 136.00 4100000039 HC AUD REHAB PRELINGUAL HL $ 228.00 4100000040 HC AUD REHAB POSTLINGUAL HL $ 228.00 4100000041 HC OT DEVELOP TESTING W INT & RPT $ 437.00 4100000042 HC PT EVAL LIMITED $ 304.00 4100000043 HC PT EVAL REG $ 455.00 4100000044 HC PT EVAL COMPREHENSIVE $ 606.00 4100000045 HC PT RE-EVAL $ 275.00 4100000046 HC OT EVAL LIMITED $ 304.00 4100000047 HC OT EVAL REG $ 455.00 4100000048 HC OT EVAL COMPREHENSIVE $ 606.00 4100000049 HC OT RE-EVAL $ 266.00 4100000050 HC APPL MOD 1+ HOT/COLD PACK $ 103.00 4100000051 HC PARAFFIN BATH $ 78.00 4100000052 HC E-STIM MANUAL EA 15 MIN $ 195.00 4100000053 HC CONTRAST BATH EA 15 MIN $ 157.00 4100000054 HC OT ULTRASOUND EA 15 MIN $ 162.00 4100000055 HC TX STRGTH ROM FLEX EA 15 MIN $ 277.00 4100000056 HC NEUROMUSC RE-ED EA 15 MIN $ 225.00 4100000057 HC OT AQUA THER W THER EXERCISE EA15 $ 165.00 4100000058 HC GAIT TRAINING EA 15 MIN $ 228.00 4100000059 HC TX MASSAGE EA 15 MIN $ 128.00 4100000060 HC MANUAL THERAPY EA 15 MIN $ 225.00 4100000061 HC THERAPEUTIC PROC GRP $ 192.00 4100000062 HC THERAPEUTIC ACTIV EA 15 MIN $ 239.00 4100000063 HC COGNITIVE SKLS DEVEL EA 15 MIN $ 235.00 4100000064 HC SENSORY INTEG TECH EA 15 MN $ 176.00 4100000065 HC OT SELF CARE/HOME MGMT EA 15MN $ 211.00 4100000066 HC PT SELF CARE/HOME MGMT EA 15MN $ 239.00 4100000067 HC COMM/WRK REINTEGRAT EA 15 MIN $ 237.00 4100000068 HC WHEELCHR MGMT/PROP EA 15 MIN $ 195.00 4100000069 HC NON-SELECTIVE DEBRIDEMENT $ 330.00 4100000070 HC PHYS PERFORM TEST EA 15 MIN $ 332.00 4100000071 HC ASSISTIVE TECH ASSESS EA 15 MIN $ 202.00 4100000072 HC ORTHO FIT/TRAIN EA 15 MIN $ 195.00 4100000073 HC PROSTHETIC TRAIN EA 15 MIN $ 276.00 4100000074 HC CHECKOUT PROS/ORTH EA 15 MIN $ 117.00 4100000075 HC PT SGL MDLTY 1 AREA INIT 30 MIN $ 256.00 4100000076 HC PT SGL MDLTY 1 AREA ADDL 15 MIN $ 157.00

4100000077 HC PT SGL PROC INIT 30 MIN $ 354.00 4100000078 HC PT SNGL PROC 1 AREA EA 15 MIN $ 240.00 4100000079 HC PT X-COMB PROC/MOD INIT 30 MIN $ 432.00 4100000080 HC PT X-COMB PROC/MOD ADDL 15 MIN $ 225.00 4100000081 HC PT X-TEST MEASRMNT INIT 30MIN $ 339.00 4100000082 HC PT X-TEST MEASRMNT ADDL 15 MN $ 174.00 4100000083 HC PT X-CASE CONF/RPT INIT 30 MIN $ 65.00 4100000084 HC PT X-CASE CONSULT & REPORT $ 542.00 4100000085 HC PT X-CASE CONF/RPT EA ADDL 15 MIN $ 34.00 4100000086 HC OT X-EVAL/RPT INIT 30 MIN $ 474.00 4100000087 HC OT X-EVAL/RPT ADDL 15 MIN $ 241.00 4100000088 HC OT X-CASE CONF/RPT INIT 30 MIN $ 225.00 4100000089 HC OT X-CASE CONF/RPT EA ADDL15 $ 111.00 4100000090 HC OT X-TREATMENT INIT 30 MIN $ 320.00 4100000091 HC OT X-TREATMENT EA ADDL 15 MIN $ 161.00 4100000092 HC OT X-CASE CONSULT & REPORT $ 474.00 4100000093 HC SPEECH X-LANGUAGE EVAL $ 402.00 4100000094 HC SPEECH X-SPEECH EVAL $ 402.00 4100000095 HC DEVELOP SCREEN W INT & REPORT $ 399.00 4100000096 HC OT DEVELOP TESTING W INT & RPT $ 620.00 4100000097 HC PT TEAM CONFERENCE EA 15MIN $ 23.00 4100000098 HC HRIF PT/OT ASSESS/EVAL 30 MIN $ 276.00 4100000099 HC AURAL REHAB HEARING AID 30 MIN $ 228.00 4100000100 HC AURAL REHAB COCHLEAR 30 MIN $ 228.00 4100000101 HC AUGMENT/ASSIST DEVICE CONSULT $ 235.00 4100000102 HC SPEEC/LANG INDIV TREATMENT 30MIN $ 304.00 4100000103 HC SPEECH/LANG X-GROUP TREATMENT $ 304.00 4100000104 HC OT WHIRLPOOL THERAPY $ 128.00 4100000105 HC PT WHIRLPOOL THERAPY $ 128.00 4100000106 HC PHYS PERFORM TEST EA 15MIN $ 179.00 4100000107 HC SP PATH EVAL FLUENCY LIMITED $ 304.00 4100000108 HC SP PATH EVAL FLUENCY $ 604.00 4100000109 HC SP PATH EVAL SOUND LIMITED $ 304.00 4100000110 HC SP PATH EVAL SOUND $ 604.00 4100000111 HC SP PATH EVAL SOUND & LANG LMTD $ 304.00 4100000112 HC SP PATH EVAL SOUND & LANG $ 604.00 4100000113 HC SP PATH EVAL SOUND & LANG COMP $ 823.00 4100000114 HC BEH & QUAL ANAL VOICE&RES LMTD $ 304.00 4100000115 HC BEH & QUAL ANAL VOICE&RES $ 604.00 4100000116 HC PT E-STIM MANUAL EA 15 MIN $ 195.00 4100000117 HC PT ULTRASOUND EA 15 MIN $ 162.00 4100000118 HC PT TX STRGTH ROM FLEX EA 15 MIN $ 277.00 4100000119 HC PT NEUROMUSC RE-ED EA 15 MIN $ 225.00 4100000120 HC PT AQUA THER W THER EXERCISE EA15 $ 165.00 4100000121 HC PT TX MASSAGE EA 15 MIN $ 176.00 4100000122 HC PT MANUAL THERAPY EA 15 MIN $ 225.00 4100000123 HC PT THERAPEUTIC PROC GRP $ 192.00 4100000124 HC PT THERAPEUTIC ACTIV EA 15 MIN $ 239.00 4100000125 HC PT WHEELCHR MGMT/PROP EA 15 MIN $ 195.00 4100000126 HC PT ORTHO FIT/TRAIN EA 15 MIN $ 195.00 41000985 HC SKULL <4 VIEWS $ 806.00 41002551 HC PELVIS ONE OR TWO VIEWS $ 804.00 41002957 HC HIP 1 VIEW $ 885.00

41003401 HC HUMERUS MIN 2V $ 771.00 41004003 HC FEMUR 2V AP + LAT $ 879.00 41004102 HC KNEE 3V $ 815.00 41004201 HC TIBIA + FIBULA AP $ 864.00 41004706 HC CHEST 1 VIEW $ 593.00 41004755 HC CHEST 2V FRONT + LA $ 765.00 41006156 HC CYSTOGRAM MIN 3V $ 1,561.00 41007303 HC ABDOMEN AP ONLY $ 718.00 41007519 HC VIDEO ESOPHOGRAM $ 1,678.00 41007600 HC UGI W/KUB $ 2,383.00 41008608 HC ENDO PANC CATH S&I $ 1,173.00 41008616 HC ENDO CATH BILIARY DUCTAL SYS $ 2,036.00 41008624 HC XR ERCP CATH BILIARY&PANCREAS $ 3,847.00 41010208 HC FLUOROSCOPY UP 1HR $ 1,849.00 41010216 HC FLUOROSCOPY OVER 1 HOUR $ 3,786.00 41045337 HC INJ VOID URETHROCYS $ 1,666.00 41100009 HC NEPHRO TUBE REMOVAL $ 1,436.00 41100017 HC HC URT EXT STNT, REM/REP $ 3,620.00 41100058 HC CNTRST INJCT, EVL CVC $ 487.00 41100066 HC THRMBCTY VEIN SUBSEQUENT $ 7,892.00 41100082 HC THRMBCTY, VENOUS $ 11,952.00 41100132 HC URT INT STNT PERC REMOVAL $ 3,186.00 41100173 HC BALLOON ANGIO INTRACRANIAL $ 3,413.00 41100256 HC UNLIST HEMIC OR LYMPH $ 2,100.00 41100264 HC UNLIST FLURO PROC $ 645.00 41100371 HC INSERT INDW TUNN PLEURAL CATH $ 7,314.00 41100405 HC PTA DIAL ACCESS ART $ 16,243.00 41100413 HC PTA VENOUS $ 17,478.00 41100425 HC SLCTV CATH RENAL 1ST ORD BIL $ 11,304.00 41100427 HC SUPSEL CATH 2ND+RENL ART UNIL $ 6,252.00 41100429 HC SUPSEL CATH 2ND + RENL ART BIL $ 9,363.00 41100431 HC INS VC FILTR ENDOVASC W IMAGE $ 12,864.00 41100434 HC SLCTV CATH RENAL 1STORD UNIL $ 8,679.00 41100436 HC PARACENTESIS W IMAGE $ 2,568.00 41100447 HC 3D REND W IMG POSTPRC CONC SUP $ 1,984.00 41100561 HC UNLISTED URINARY SYSTEM $ 502.00 41100579 HC UNLISTED PROC BILIARY TRACT $ 9,739.00 41100587 HC US ABDOMEN LIMITED $ 1,584.00 41100665 HC HC COLON BARIUM W/CONTRAST $ 2,360.00 41100678 HC BX LYMPHNODE $ 3,219.00 41100702 HC UNLISTED PROC ABDOMEN $ 7,498.00 41100769 HC INJ EPIDURAL BLD/CLOT $ 2,381.00 41100827 HC DESTR VASC LESIONS 10-50 CM $ 762.00 41100835 HC DESTR VASC LESIONS >50 $ 1,121.00 41100884 HC BRONCHOSCOPY W/STENT PLCMT $ 6,786.00 41100920 HC HC XR LMPHANGIO EXTREMITY UNI $ 907.00 41100926 HC HC BRONCHOSCOPY W/REV STENT $ 4,428.00 41100942 HC HC INJ LYMPHANGIOGRAPHY $ 703.00 41100975 HC TUNNELED CVA W/PORT UNDER 5 $ 9,118.00 41101221 HC CONVERT G-TUBE TO GJ TUBE $ 4,775.00 41101239 HC REPLC G OR CECOSTOMY TUBE $ 1,239.00 41101247 HC REPLC DUODEN OR J-TUBE $ 1,446.00 41101254 HC REPLACE GJ TUBE $ 4,852.00

41101270 HC CONTRAST INJECTION - TUBE(S) $ 2,544.00 41106659 HC RNL ANGIOGRAPH BIL $ 10,872.00 41106675 HC VENOGRM RNL UNILAT $ 7,730.00 41108101 HC CHOLANGIOGRAM T-TB $ 1,141.00 41108200 HC CHOLANG PERCUTAN $ 1,871.00 41108291 HC BILIARY STENT PLACEMENT $ 1,689.00 41116039 HC HC ABD AORT/BIL ILEOFM $ 6,252.00 41117292 HC PEDS INSERT FLOW $ 3,857.00 41118100 HC INF VEN CAVA FLTR $ 9,933.00 41118159 HC FOREIGN BODY RETRIEV TRANSCATH $ 8,815.00 41118357 HC CAROTID ANG UNILAT $ 8,802.00 41119850 HC PULMONARY ANGIOGRAPHY $ 8,275.00 41122607 HC SUP VENACAVOGRAM $ 8,166.00 41122656 HC INF VENA CAVOGRAM $ 7,970.00 41124058 HC EXTR ANGIOG UNILAT $ 9,202.00 41125451 HC EXTR VENOGRAM UNILA $ 2,856.00 41126251 HC VERTEBRAL ANGGRPH $ 9,683.00 41126335 HC THORACIC AORTOGRAM $ 7,302.00 41126350 HC ABD AORTOGRAPHY $ 6,252.00 41126392 HC RENAL ANGIO UNILAT $ 9,694.00 41126418 HC PELVIS ANGIOGRAPHY $ 6,252.00 41126558 HC ANGGRPH EACH AD VSL $ 7,328.00 41126954 HC FLUORO-SEP PROC<1HR $ 1,849.00 41127051 HC VENOUS SAMPLING $ 11,880.00 41127150 HC BILIARY DRAINAGE $ 1,161.00 41127408 HC THROMBOLYTIC THRPY $ 14,154.00 41127507 HC PERC NEPH TUBE CHANGE $ 2,465.00 41127556 HC PERC NEPHROSTOMY $ 5,094.00 41127655 HC ANTEGRADE PYELOGRM $ 1,036.00 41127713 HC NEPHROSTMY TRCT DIL $ 3,186.00 41127754 HC PLCMT-URET STENT $ 5,094.00 41127853 HC ABCESS DRAIN GUIDE $ 2,894.00 41128463 HC ULTRASOUND GD/NDL $ 1,896.00 41128505 HC GI TUBE PLCMT $ 6,450.00 41130006 HC ANGIOPLSTY PERPH EXCL REN/VISC $ 9,456.00 41130048 HC ANGIOPLST VISCERAL $ 8,209.00 41130063 HC PTA ADDL VISC VSL $ 1,479.00 41130089 HC ANGIOPLSTY VENOUS $ 12,081.00 41130121 HC FLUORO GUIDE NDL PLACEMENT $ 2,021.00 41144304 HC ANGIO FLU W/ TRANS $ 4,292.00 41144395 HC ANGIO CAROTID CERBRL BIL $ 13,443.00 41144429 HC ANGIO CAROTID CERV UNI $ 8,791.00 41144437 HC ANGIO CAROTID CERV BIL $ 10,589.00 41144452 HC ANGIO EXT CAROTID UNI $ 10,392.00 41144460 HC ANGIO EXT CAROTID BIL $ 20,784.00 41144502 HC ANGIO SPINAL 1 VSL $ 7,229.00 41144601 HC ANGIOGRPH AV SHUNT $ 2,017.00 41144676 HC ANG CRVICOCERE ARCH $ 14,463.00 41144700 HC ANGIO EXTREM BILAT $ 10,431.00 41144759 HC FISTULOGRAM $ 3,012.00 41144809 HC HEPATIC VENOGRAM $ 6,252.00 41144825 HC INTRAVAS OCCL NON $ 16,094.00 41144908 HC INTRAVASC STENT NON $ 8,001.00

41144957 HC TRANSCATHETER BIOPS $ 7,830.00 41145020 HC VENGRM EXTRM BILAT $ 3,492.00 41145046 HC VISCERAL ANGIOGRPH $ 9,432.00 41145061 HC HEPT VENO W/O HEMO $ 6,252.00 41145129 HC INTRO GASTRO TUBE $ 1,192.00 41145160 HC RAD EXAM ESOPHAGUS $ 1,492.00 41145186 HC PST-OP BIL STN RMVL $ 812.00 41145202 HC PERC DIL BIL STRICK $ 5,995.00 41145319 HC INTEG PUNC/ASP PROC $ 1,423.00 41145368 HC INTRAV. US NON-COR $ 889.00 41145376 HC HC INTRAV. US NON-CORONARY $ 155.00 41151036 HC BRONCHOSCOPY W/TRACH/BRONC DIL $ 6,142.00 41151093 HC ABD PARACENTESIS:INIT $ 863.00 41151101 HC TUBE THORACOSTOMY H20 SEALOPEN $ 1,512.00 41151119 HC PNEUMOTHO CHEST TUBE $ 3,897.00 41151127 HC BILIARY TRACK DIL $ 6,123.00 41151168 HC INJ PROC URETER $ 393.00 41151176 HC INJECTION FOR CYSTOGRAM $ 1,666.00 41151184 HC INJECTION FOR CYSTOGRAM $ 1,561.00 41151200 HC CT GUIDANCE FOR NDL BX $ 4,373.00 41151226 HC REMOVAL CENT VEN CATH W/O PORT $ 3,651.00 41151234 HC ESOPH DIL $ 1,361.00 41151358 HC INJ PERC TRANSHEP $ 604.00 41151366 HC ASPIR RENAL CYST $ 2,010.00 41151374 HC PERC NDL BX LUNG/MEDIASTINUM $ 3,287.00 41151382 HC VENOUS SMPL CATH $ 10,704.00 41151390 HC INTRO CATH BILI $ 5,711.00 41151416 HC NEPHRO TUBE CHANGE $ 2,578.00 41151432 HC INJ ANTEGRADE PYELO $ 391.00 41151440 HC INTRO URET CATH/STE $ 5,376.00 41151500 HC INJECT SINUS TRACK THERAP $ 3,820.00 41151507 HC DIAG SINOGRAM $ 2,549.00 41151523 HC TRANS CATH INTRAVAS $ 22,982.00 41151549 HC INTRO LONG GI TUBE $ 1,809.00 41151564 HC BIL STONE EXTRACTION $ 6,818.00 41151580 HC BIL STRICTURE W/ ST $ 5,711.00 41151606 HC INTRAVASC US NON-CO $ 3,311.00 41151614 HC HC INTRAVASC US NON-CORONARY E $ 2,498.00 41151615 HC INJ SPLENOPORTOGRAM $ 280.00 41151622 HC ANGIO-BRACH RETRO $ 6,252.00 41151663 HC INITIAL 2ND ORDER $ 6,436.00 41151671 HC FIRST ORDER VESSEL $ 5,773.00 41151689 HC SEL CATH PLMT ADD $ 1,883.00 41151697 HC INITIAL 3RD ORDER $ 7,294.00 41151705 HC INITIAL 2ND ORDER $ 4,084.00 41151713 HC FIRST ORDER VESSEL $ 4,547.00 41151721 HC SEL CATH PLMT EA AD $ 2,002.00 41151739 HC INTR NDL OR INTRACATH EXT ART $ 610.00 41151747 HC RT OR LT PULM ART CATH PLCMNT $ 3,040.00 41151770 HC SEL CATH PLMT RT OR $ 4,631.00 41151804 HC INJ VENOGRAPHY $ 4,831.00 41151812 HC INTRO CATH SUP/INF VENA CAVA $ 6,297.00 41151820 HC 1ST ORDER CATH PLMT $ 6,196.00

41151838 HC 2ND ORDER CATH PLMT $ 6,939.00 41151846 HC PORTAL VEIN CATH PL $ 2,226.00 41151853 HC TRANSHEP PORTOGRAM $ 6,252.00 41151879 HC BONE BX DEEP $ 5,930.00 41151887 HC PERC NDL BX LIVER $ 4,317.00 41151895 HC PERC NDL BX LIVER:W/OTH MAJ PR $ 4,360.00 41151911 HC RENAL NDL BX $ 2,637.00 41152034 HC TRANSCATH TX INFUS $ 4,778.00 41152042 HC EMBOLIZATION-CNS $ 11,265.00 41152059 HC EMBOL NON-CNS $ 30,629.00 41152083 HC PTA RENAL/VISC ART $ 17,039.00 41152133 HC PTA VENOUS $ 17,478.00 41152190 HC TRANSCATH BX $ 5,152.00 41152216 HC CATH PLMT RENAL/PEL $ 3,186.00 41152265 HC INJ CHOLANGIO/EXIST $ 2,435.00 41152273 HC BILI ENDO W/ STENT $ 11,396.00 41152281 HC CHANGE BILI CATH $ 4,733.00 41152299 HC AORTA CATH PLCMT $ 6,438.00 41152323 HC VENOGRAM ORBITAL $ 2,017.00 41152349 HC VENOG SINUS OR JUG $ 5,737.00 41152364 HC RENAL CYST TRANSL $ 720.00 41152372 HC INITIAL 3RD ORDER $ 11,086.00 41152380 HC TRANSHEP PORTOGRAM $ 2,025.00 41152414 HC UNLISTED VASCULAR PROCEDURE $ 10,333.00 41152420 HC PERCT MESOCAVAL SHUNT PLCMT $ 5,181.00 41152422 HC PERC DRN LVR LESION $ 3,150.00 41152455 HC PERC DRN RETROP ABS $ 5,215.00 41152463 HC PERC DRN RENAL ABS $ 3,662.00 41152471 HC PERC DRN, PELVIC $ 4,097.00 41152489 HC EXCHANGE DRN CATH $ 6,666.00 41152497 HC ASSESS CYST CONT $ 2,240.00 41152547 HC PERCU DRAIN LUNG $ 1,613.00 41152554 HC DRN APP ABSC PERCUT $ 3,662.00 41152562 HC PERC DRN PEROTONEAL $ 3,150.00 41152604 HC FLUORO GUIDANCE SPINE INJ $ 1,593.00 41152869 HC INJ PERC TX OF EXT PSEUDOANEUR $ 436.00 41152877 HC INSERT TIPS SHUNT $ 7,908.00 41152885 HC INTRO NEEDLE OR INTRACATH VEIN $ 151.00 41152898 HC SEL CATH PLCMT CARAT/INOM ART $ 6,252.00 41152899 HC PLCMT INTRACRAN INTERCAROTD $ 15,335.00 41152902 HC ANGIO VERTEBRAL VERTBL ART $ 15,335.00 41152903 HC ADD ANGIO EXT CART UNIL $ 10,392.00 41152904 HC SEL CATH PLCMT EA INTRACRAN BR $ 3,244.00 41152984 HC RPR DTAA NO COV LSA $ 8,493.00 41153024 HC RPR DTAA NO COV LSA S&I $ 8,755.00 41153149 HC PERCUT CHOLECYSTOSTOMY $ 8,494.00 41153214 HC UNLISTED DX IR PROC $ 4,171.00 41153222 HC UNLISTED PROC,INTESTINE $ 7,498.00 41153297 HC OCCLUSIVE DEVICE-VEIN $ 2,473.00 41153321 HC INSERT NON-TUNNEL CVC UNDER 5 $ 5,677.00 41153339 HC INSERT NON-TUNNEL CVC 5 YO $ 7,725.00 41153347 HC INSERT TUNNELED CVC UNDER 5 YO $ 5,231.00 41153354 HC INSERT TUNNELD CVC 5 YO $ 5,382.00

41153362 HC INSERT TUNNELED CVC 5 YO $ 9,772.00 41153370 HC INSERT TUNNELED PICC UNDER 5 Y $ 3,628.00 41153375 HC TUN INTRAPERITONEAL CATH W/S&I $ 6,421.00 41153388 HC INSERT TUNNELED PICC 5 YO $ 3,045.00 41153412 HC REPLC CATH PARTIAL TUNNLD CVAD $ 4,674.00 41153420 HC REPLACE COMPLETE NON-TUN CVC $ 2,214.00 41153438 HC REPLACE COMPLETE TUNNELED CVC $ 5,223.00 41153446 HC REPLACE COMPLETE TUN CVAD PORT $ 9,370.00 41153453 HC REPLACE COMPLETE TUNNELED PICC $ 4,020.00 41153461 HC REMOVAL TUNNELED CVC $ 3,651.00 41153479 HC REMOVAL TUNNELED CVAD PORT $ 5,402.00 41153487 HC REPOSITION VENOUS CATHETER $ 2,214.00 41153495 HC FLUORO GUIDANCE FOR VEIN DEVIC $ 2,530.00 41153503 HC US GUIDANCE VASCULAR ACCESS $ 1,813.00 41153586 HC CATH INJ PORT CHECK $ 716.00 41153588 HC NEEDLE/CATH JUGULAR VEIN $ 2,482.00 41153677 HC ENDO TEMP VESS OCC HEAD/NCK $ 30,629.00 41154188 HC FINE NEEDLE ASPIRATION W IMAG $ 2,086.00 41154385 HC HC US EXTR NON VASCULAR LTD $ 952.00 41154485 HC CATH AV SHUNT, EVAL; W S&I $ 2,017.00 41154552 HC HYBRID COMPLX INIT 30 MIN $ 17,188.00 41154553 HC HYBRID COMPLX ADDTL 15 MIN $ 2,000.00 41157232 HC PLEURAL DRAINAGE W/CATH W/IMAG $ 3,200.00 41158326 HC BRONCHOSC W/REM FB $ 3,227.00 41158346 HC INJECT VASCULAR UNLSTD PROC $ 3,835.00 41160116 HC VASC EMBOLIZE/OCCLUDE VENOUS $ 52,746.00 41160125 HC IMAGE CATH FLUID PERI/RETRO $ 5,133.98 41160130 HC OPEN/PERQ PLACE STENT INITIAL $ 39,282.00 41175033 HC AORTOGR THORACIC SNGL IMG S&I $ 6,252.00 41175038 HC SPLENOPORTOGRAPHY S&I $ 8,407.00 41175042 HC SCLEROTHERAPY, AVM, SKIN $ 880.00 41179653 HC BRONCHOSC W/ASP TRANSBRONCH $ 6,173.00 41185433 HC INFUS THROMBO VENOUS THER INIT $ 2,214.00 41199353 HC SCLEROTHER PERC AVM HEAD/NCK $ 19,337.00 41304759 HC CHEST 2V FRONT + LA $ 765.00 41530056 HC ABI/UP&LW EXT 1-2 LVL BIL $ 1,276.00 41530064 HC SEG/UP&LW EXT MULT BILA $ 2,048.00 41530098 HC ART DPLX LOWER EXT UNILAT $ 2,177.00 41530106 HC ART DPLX UPPER EXT UNILAT $ 1,939.00 41530130 HC VENOUS DPLX UP&LW BILAT $ 2,966.00 41530148 HC VENOUS DPLX UP&LW LIMITED $ 2,072.00 41530171 HC AORTA/IVC/ILIAC DPLX COMPL $ 1,665.00 41802026 HC CATHTR-GUIDING L16 $ 1,700.00 41802208 HC CATHTR-INFUSION L18 $ 2,083.00 41807447 HC EMBOLIZATION COIL L40 $ 12,375.00 41807520 HC SURFACE ELECT KIT L32 $ 7,863.00 41807660 HC EMBOLIZATION COIL L41 $ 13,125.00 41808049 HC EMBOLIZATION GLUE L43 $ 14,625.00 41810094 HC ACCESS SET SHEATH INTR/OTH L11 $ 759.00 41810110 HC HC BALLOON-RAD L13 $ 961.00 41810177 HC CATHTR-ABLATN L31 $ 7,073.00 41810185 HC CATHTR-ABLATN L38 $ 10,875.00 41810193 HC CATHTR-ABLATN L40 $ 12,375.00

41810219 HC CATHTR-DIAGNSTC L11 $ 722.50 41810250 HC CATHTR-EP ABLAT L42 $ 14,250.00 41810268 HC CATHTR-GUIDING L24 $ 8,115.00 41810276 HC CATHTR-GUIDING L27 $ 7,286.00 41810292 HC CATHTR-MICROCATH L21 $ 2,998.00 41810367 HC HC DRUG ELUTING STNT L47 $ 20,090.00 41810417 HC EMOBLIZATION PART L12 $ 808.00 41810425 HC FORCEPS L23 $ 4,038.00 41810490 HC RETRVL BASKET L26 $ 4,888.00 41810821 HC EMBOLIZATION PART L15 $ 1,275.00 41810854 HC SHEATH L6 $ 300.00 41810870 HC HC DEFIB DUAL CHAMB L112 $ 81,000.00 41810896 HC DRUG ELUTING STENT L44 $ 13,463.00 41810946 HC LOCM 250-299 MG/ML, 1ML $ 4.00 41810961 HC LOCM 300-349 MG/ML, 1ML $ 2.00 41810979 HC LOCM 300-349 MG/ML, 1ML $ 1.00 41810987 HC LOCM 300-349 MG/ML, 1ML $ 1.00 41810995 HC LOCM 300-349 MG/ML, 1ML $ 5.00 41811001 HC LOCM 300-349 MG/ML, 1ML $ 4.00 41811019 HC LOCM 300-349 MG/ML, 1ML $ 5.00 41811183 HC BALLOON CATH RAD-L24 $ 4,565.00 41811217 HC EMBOLIZATION COIL L44 $ 15,750.00 41811290 HC HC STNT-RD COT W/DEL L47 $ 19,252.00 41811308 HC STENT RD COATED W DEL L51 $ 28,700.00 41811316 HC SEPTAL DEVICE L63 $ 43,940.00 41811365 HC CLOSURE DEVICE VASCULAR L29 $ 7,072.00 41811415 HC TUBE JEJUNAL L20 $ 2,763.00 41811423 HC IMPL LOOP RECORDER L53 $ 28,000.00 41811449 HC STENT-RD NONCOV WO/ D L13 $ 893.00 41811472 HC CATHETER-INFUSION L47 $ 14,044.00 41811480 HC TUBE GJ L22 $ 3,613.00 41811530 HC IMPL CATHETER-INFUSION L12 $ 1,022.00 41811555 HC SHEATH INTRO/OTH L21 $ 3,570.00 41811571 HC CATHTR-INFUS IMPLT L6 $ 334.00 41811662 HC CATHETER-DRAIN L34 $ 8,250.00 41811670 HC SHEATH-GUIDING L31 $ 8,492.00 41811688 HC IMPLANT HEMOSTAT SEAL L24 $ 4,463.00 41811696 HC IMPL HEMOSTAT SEAL L18 $ 1,913.00 41811761 HC CATH BALLN DIL 10MMX20CM 135CM $ 70,452.00 41811803 HC HC BALLOON-CRD L17 $ 1,640.00 41811852 HC LEAD SINGLE COIL L58 $ 35,000.00 41811860 HC DEBIB SINGLE CHAMBER L81 $ 61,750.00 41811878 HC DEFIB SGL CHAMG L98 $ 76,800.00 41811886 HC PCMKR SINGLE CHAMBER L46 $ 17,447.00 41811894 HC DEFIBRILLATOR DUAL CHAMB L101 $ 81,000.00 41811902 HC PROTECTA DUAL CHAMBER DEFIB $ 78,750.00 41811910 HC PACEMAKER DUAL CHAMBER L55 $ 29,750.00 41811944 HC HC LEAD DUAL COIL L58 $ 35,000.00 41811969 HC LEAD PACEMAKER-OTHER L24 $ 4,675.00 41890047 HC BALLOON L5 $ 212.00 41890054 HC BALLOON- CRD L18 $ 2,094.00 41890062 HC BALLOON- CRD L19 $ 1,704.00 41890096 HC BALLOON- CRD L22 $ 4,004.00

41890104 HC BALLOON-CRD L23 $ 4,004.00 41890112 HC BALLOON CRD L25 $ 5,059.00 41890146 HC BALLOON-RAD L16 $ 1,460.00 41890153 HC BALLOON-RAD L17 $ 1,609.00 41890161 HC BALLOON-RAD L18 $ 1,449.00 41890179 HC BALLOON-RAD L19 $ 2,323.00 41890187 HC BALLOON-RAD L20 $ 2,160.00 41890195 HC BALLOON-RAD L21 $ 3,218.00 41890203 HC BALLOON-RAD L22 $ 2,997.00 41890211 HC BALLOON-RAD L25 $ 4,973.00 41890310 HC CABLE L19 $ 2,338.00 41890393 HC CATHETER-EP L12 $ 885.00 41890401 HC CATHETER-EP <20 L17 $ 1,700.00 41890427 HC CATHETER-EP L20 $ 2,890.00 41890435 HC CATHETER-EP L21 $ 3,400.00 41890443 HC CATHETER-EP L22 $ 3,825.00 41890450 HC CATHETER-EP L23 $ 4,917.00 41890468 HC CATH-EP NON 3D <19 ELECTRD L28 $ 1,234.00 41890492 HC CATHETER-EP L34 $ 8,054.00 41890542 HC CATHTR-DIAGNSTC L10 $ 595.00 41890559 HC CATHTR-DIAGNSTC L2 $ 43.00 41890567 HC CATHTR-DIAGNSTC L3 $ 85.00 41890575 HC CATHTR-DIAGNSTC L4 $ 149.00 41890583 HC CATHTR-DIAGNSTC L5 $ 213.00 41890591 HC CATHTR-DIAGNSTC L6 $ 298.00 41890609 HC CATHTR-DIAGNSTC L7 $ 383.00 41890625 HC CATHTR-DIAGNSTC L9 $ 510.00 41890682 HC CATHTR-GUIDING L13 $ 949.00 41890708 HC CATHTR-GUIDING L18 $ 2,125.00 41890716 HC CATHTR-GUIDING L19 $ 447.00 41890724 HC CATHTR-GUIDING L25 $ 5,331.00 41890732 HC CATHTR-GUIDING L7 $ 412.00 41890740 HC CATHTR-GUIDING L8 $ 442.00 41890757 HC CATHTR-GUIDING L9 $ 557.00 41890765 HC CATHTR-INFUSION L10 $ 1,051.00 41890773 HC CATHTR-INFUSION L12 $ 202.00 41890781 HC CATHTR-INFUSION L13 $ 1,050.00 41890799 HC CATHTR-INFUSION L14 $ 1,082.00 41890807 HC CATHTR-INFUSION L15 $ 1,312.00 41890815 HC CATHTR-INFUSION L20 $ 2,685.00 41890823 HC CATHTR-INFUSION L22 $ 4,165.00 41890831 HC CATHTR-MICROCATH L20 $ 2,798.00 41890849 HC CATHTR-MICROCATH L22 $ 3,613.00 41890872 HC CLOSURE DEVICE L18 $ 1,777.00 41890898 HC COMPRESSION DEVICE L $ 510.00 41890963 HC VENA CAVA FILTER L34 $ 7,608.00 41891029 HC GUIDEWIRE L10 $ 677.00 41891037 HC GUIDEWIRE L11 $ 697.00 41891045 HC GUIDEWIRE L12 $ 825.00 41891060 HC GUIDEWIRE L14 $ 680.00 41891078 HC GUIDEWIRE L15 $ 1,275.00 41891086 HC GUIDEWIRE L16 $ 1,462.00 41891094 HC GUIDEWIRE L17 $ 1,532.00

41891227 HC SEPTAL DEVICE L58 $ 36,504.00 41891243 HC SHEATH L7 $ 821.00 41891466 HC GUIDEWIRE L18 $ 2,125.00 41891474 HC GUIDEWIRE L19 $ 2,465.00 41891482 HC GUIDEWIRE L2 $ 74.00 41891490 HC GUIDEWIRE L20 $ 3,096.00 41891508 HC HC GUIDEWIRE L22 $ 3,681.00 41891516 HC HC GUIDEWIRE L23 $ 3,875.00 41891524 HC GUIDEWIRE L25 $ 4,814.00 41891532 HC GUIDEWIRE L26 $ 5,693.00 41891540 HC GUIDEWIRE L3 $ 125.00 41891557 HC GUIDEWIRE L4 $ 158.00 41891565 HC GUIDEWIRE L5 $ 176.00 41891573 HC GUIDEWIRE L6 $ 336.00 41891581 HC GUIDEWIRE L7 $ 477.00 41891599 HC GUIDEWIRE L8 $ 482.00 41891607 HC GUIDEWIRE L9 $ 805.00 41891730 HC FORCEPS L19 $ 2,338.00 41891797 HC GUIDEWIRE L13 $ 618.00 41891847 HC BALLOON L6 $ 257.00 41891920 HC CATHTR-EP DIAG/3D3MAP L45 $ 17,456.00 41891953 HC CATHTR-DRAIN L12 $ 825.00 41891961 HC DELIVERY SYSTEM L20 $ 2,763.00 41892159 HC CATHTR-GUIDING L26 $ 7,869.00 41892191 HC GELFOAM L8 $ 2,720.00 41892225 HC CATHTR-MAPPING L44 $ 11,025.00 41892324 HC HC CABLE L21 $ 3,188.00 41892381 HC EMBOLIZATION COIL L3 $ 10,875.00 41892399 HC EMBOLIZATION COIL L39 $ 11,625.00 41892407 HC IMPLANTED PORT L18 $ 2,005.00 41892415 HC EMBOLIZATION COIL L3 $ 10,125.00 41892423 HC BALLOON-CUT RAD L29 $ 6,376.00 41892472 HC STNT-RD NON W/DEL L36 $ 9,755.00 41892480 HC STNT-RD NON W/DEL L41 $ 13,301.00 41892498 HC HC EMBOLIZATION COIL L33 $ 8,288.00 41892506 HC EMBOLIZATION COIL L27 $ 5,738.00 41892522 HC HC STNT-RD COT W/DEL L46 $ 18,154.00 41892548 HC CATHTR-MICROCATH L24 $ 4,590.00 41892555 HC CATHTR-MICROCATH L25 $ 5,377.00 41892571 HC STNT-RD NON W/DEL L42 $ 14,141.00 41892605 HC CATHTR-MICROCATH L26 $ 5,601.00 41892662 HC EMBOLIZATION COIL L32 $ 7,863.00 41892704 HC SHEATH PEELAWAY L7 $ 306.00 41892894 HC DEFIB SGL CHAMB L112 $ 80,000.00 41892977 HC BALLOON-CUT CARD L29 $ 6,814.00 41893017 HC RETRVL BASKET L21 $ 3,295.00 41893033 HC CATHTR-DRAIN L10 $ 652.00 41893041 HC CATHTR-DRAIN L11 $ 721.00 41893074 HC CATHTR-DRAIN L8 $ 497.00 41893116 HC CATHETER-EP L34 $ 8,754.00 41893157 HC CATHTR-ABLATN L25 $ 4,896.00 41893165 HC CATHETER EP L13 $ 885.00 41893173 HC CATHTR-EP DX ABLATION OTHER 3D $ 5,950.00

41893199 HC CATHTR-RF ABLATN L30 $ 6,919.00 41893207 HC CATHTR-ABLATN L42 $ 13,500.00 41893223 HC CATHTR DIALYSIS L18 $ 2,720.00 41893231 HC CATHTR DIALYSIS L20 $ 2,720.00 41893256 HC CATHTR DIALYSIS L22 $ 3,585.00 41893272 HC CATHTR-INFUSION L16 $ 1,352.00 41893298 HC CATHTR-INFUSION L9 $ 415.00 41893322 HC CATHTR-ULTRASND INTRAVASC L26 $ 5,313.00 41893355 HC CATHTR ULTRASOUND $ 5,950.00 41893397 HC CATHETER-EP L46 $ 18,270.00 41893421 HC GUIDEWIRE L21 $ 3,386.00 41893447 HC LEAD LOCK DEVICE L22 $ 3,613.00 41893454 HC RETRVL BASKET L19 $ 2,338.00 41893496 HC HC PACMKR DUAL CHAM 57 $ 29,750.00 41893504 HC PACMKR DUAL CHAM LEVEL 65 $ 40,300.00 41893595 HC HC PACMKR SGNL CHAM 47 $ 18,750.00 41893678 HC PORT INDWELLING L20 $ 3,016.00 41893710 HC DRUG ELUTING STNT L46 $ 18,071.00 41893736 HC STNT-CD NON W/DEL L31 $ 7,650.00 41893744 HC STENT NONCOV W DEL L3 $ 7,944.00 41893751 HC STNT-CD NONCOV W/DEL L35 $ 8,528.00 41893769 HC STNT-CD NON W/DEL L36 $ 9,752.00 41893777 HC STNT-CD NON W/DEL L37 $ 9,987.00 41893785 HC STNT-RD NON W/DEL L3 $ 8,320.00 41893793 HC STNT-RD NON W/DEL L35 $ 8,379.00 41893801 HC STNT-RD NON W/DEL L37 $ 10,285.00 41893819 HC STNT-RD NON W/DEL L38 $ 11,215.00 41893827 HC STENT RD NONCOV W DEL L3 $ 11,733.00 41893850 HC STNT-RD NON W/DEL L45 $ 18,713.00 41893876 HC STENT-RD NON W/DEL L3 $ 7,650.00 41893892 HC STNT-RD NONC W/O DEL L38 $ 10,592.00 41893900 HC HC STNT-RD NON W/O D L39 $ 11,385.00 41893926 HC STNT-RD NON COAT W/O D L35 $ 8,970.00 41893942 HC HC DEBIF OTHER L115 $ 71,750.00 41894007 HC CATHTR-GUIDING L17 $ 1,632.00 41894015 HC CATHTR-GUIDING L20 $ 2,890.00 41894023 HC CATHTR-GUIDING L21 $ 3,188.00 41894031 HC CATHTR-DIAGNSTC L8 $ 451.00 41894056 HC CATHTR-MICROCATH L27 $ 6,834.00 41894072 HC SHEATH PEELAWAY L6 $ 306.00 41894098 HC SHEATH PEELAWAY L8 $ 442.00 41894106 HC SHEATH PEELAWAY L9 $ 716.00 41894114 HC SHEATH FIXED CUR L16 $ 1,700.00 41894122 HC SHEATH FIXED CUR L17 $ 1,743.00 41894130 HC SHEATH FIXED CUR L19 $ 1,913.00 41894148 HC MICROPUNCTURE SET L7 $ 347.00 41894163 HC ACCESS SET L6 $ 323.00 41894171 HC ACCESS SET L23 $ 5,957.00 41894197 HC MICROPUNCTURE SET L6 $ 327.00 41894205 HC SHEATH INTRO/OTH L2 $ 69.00 41894213 HC SHEATH INTRO/OTH L3 $ 167.00 41894221 HC SHEATH INTRO/OTH L4 $ 170.00 41894239 HC SHEATH INTRO/OTH L5 $ 258.00

41894247 HC SHEATH INTRO/OTH L6 $ 326.00 41894254 HC SHEATH INTRO/OTH L7 $ 345.00 41894262 HC SHEATH INTRO/OTH L8 $ 519.00 41894270 HC SHEATH INTRO/OTH L9 $ 535.00 41894288 HC SHEATH INTRO/OTH L10 $ 665.00 41894296 HC SHEATH INTRO/OTH L11 $ 762.00 41894304 HC SHEATH INTRO/OTH L12 $ 770.00 41894312 HC SHEATH INTRO/OTH L13 $ 897.00 41894320 HC SHEATH INTRO/OTH L14 $ 897.00 41894353 HC SHEATH INTRO/OTH L18 $ 1,743.00 41894361 HC SHEATH INTRO/OTH L19 $ 2,315.00 41894379 HC SHEATH INTRO/OTH L20 $ 2,763.00 41894551 HC LEAD PACMKR-OTHER L33 $ 8,458.00 41894585 HC IMPL LEAD LFT CORONARY L44 $ 17,963.00 41894627 HC STNT-RD NC W/O DEL L14 $ 1,095.00 41894668 HC STENT-RD NONCOR W/DEL L13 $ 889.00 41894676 HC STNT-RD NC W/DEL L14 $ 1,087.00 41894734 HC BALLOON-RAD OCCL L35 $ 8,753.00 41894742 HC SHEATH-LASER L44 $ 18,760.00 41894775 HC CATHETER-EP ABLAT L36 $ 8,333.00 41894809 HC CATHETER-EP ABLAT L46 $ 17,640.00 41894825 HC RETRVL BASKET L20 $ 2,550.00 41894833 HC HC STNT-RD COT W/DEL L48 $ 21,595.00 41894908 HC BALLOON- CRD L9 $ 432.00 41894916 HC CATHTR-DIAGNSTC L14 $ 1,037.00 41894940 HC IMPL EMBOLIZATION COIL L10 $ 595.00 41894957 HC EMBOLIZATION COIL L11 $ 723.00 41894965 HC EMBOLIZATION COIL L12 $ 808.00 41894973 HC EMBOLIZATION COIL L13 $ 850.00 41894981 HC EMBOLIZATION COIL L14 $ 1,105.00 41895012 HC EMBOLIZATION COIL L25 $ 4,888.00 41895020 HC EMBOLIZATION COIL L26 $ 5,313.00 41895046 HC EMBOLIZATION COIL L29 $ 6,588.00 41895053 HC EMBOLIZATION COIL L30 $ 7,013.00 41895061 HC EMBOLIZATION COIL L31 $ 7,438.00 41895079 HC EMBOLIZATION COIL L36 $ 9,375.00 41895111 HC EMBOLIZATION COIL L7 $ 383.00 41895129 HC EMBOLIZATION COIL L8 $ 425.00 41895137 HC EMBOLIZATION COIL L9 $ 510.00 41895194 HC MICROSPHERES L13 $ 850.00 41895202 HC MICROSPHERES L18 $ 1,913.00 41895236 HC NEEDLE L20 $ 2,763.00 41895277 HC TUBE GJ L18 $ 1,913.00 41895343 HC DELIVERY SYSTEM L23 $ 4,038.00 41895566 HC STNT-RD COT W/DEL L50 $ 27,986.00 41895616 HC EP REFEREN PATCH L23 $ 4,038.00 41895640 HC CATHTR-ABLATN L48 $ 15,998.00 41895657 HC VASCULAR PLUG L21 $ 6,188.00 41895681 HC SHEATH FIXED CUR L15 $ 1,360.00 41895772 HC STENT- NONCOV WO DEL L40 $ 12,075.00 41895830 HC LEAD SGL COIL SYS $ 23,175.00 41895871 HC LEAD OTHER SYS $ 4,244.00 41895970 HC LEAD DEFIB OTHER L46 $ 18,750.00

41896093 HC CONTRAST MED 300-349 L3 $ 110.00 41896101 HC DEFIB DUAL CHAMB L106 $ 86,486.00 41896135 HC CARDIO DEFIB OTHER L114 $ 71,750.00 41896176 HC CATHETER THRMCTMY L11 $ 1,003.00 41896200 HC TUBE JEJUNAL L19 $ 2,338.00 41896259 HC CATHTR-ABLATN L37 $ 10,367.00 41896291 HC TUBE GASTROSTOMY L15 $ 1,275.00 41896408 HC TUBE GASTROSTOMY L13 $ 850.00 41896432 HC CATHETER MICROCATH L29 $ 6,863.00 41896457 HC DUCT OCCULDER L35 $ 8,625.00 41896481 HC INTRODUCER KIT L11 $ 740.00 41896648 HC HC CATHTR-DRAIN L22 $ 2,619.00 41896754 HC CATH OCCL FRONTRUNNER CTO L34 $ 8,016.00 41896770 HC EMBOLIZATION COIL L42 $ 13,875.00 41896861 HC DEFIB DUAL CHAMB L103 $ 90,000.00 41896879 HC PACMKR DUAL CHAM L58 $ 33,768.00 41896895 HC DEFIB OTHER SGL/DUAL L113 $ 95,000.00 41896952 HC TUBE JEJUNAL L14 $ 1,105.00 41896994 HC HC BALLOON-RAD L29 $ 6,800.00 41897125 HC CATH PTA LVL17 $ 1,615.00 41897158 HC CATH MICRO GUIDING LVL 33 $ 8,458.00 41897505 HC STENT NCOV W DEL LVL 38 $ 11,250.00 41897856 HC PULM VALVE TRANSCATHR LVL 115 $ 71,500.00 41897857 HC BALLOON CATH LVL66 $ 42,250.00 41898126 HC IMPL CATH NONLASER L28 $ 6,375.00 41898129 HC CRYOABLATION PROBE L15 $ 23,765.00 41898137 HC ASD OCCLUDR L60 $ 34,450.00 41898145 HC HC LOOP RECORDER L56 $ 31,500.00 41898147 HC CATH - ECHO L36 $ 9,375.00 41898150 HC CATHETER- EP L18 $ 2,040.00 41898157 HC HC EMBOLIZATION GLUE L44 $ 15,750.00 41898161 HC CATHETER INFUSION, PICC L15 $ 1,343.00 41898163 HC GUIDING CATH W INF/PROF L 30 $ 6,868.00 41898164 HC GUIDING CATH W INFUSION L28 $ 7,161.00 41898166 HC PORT INDWELLING L23 $ 3,868.00 41898167 HC NEUROEMBLN COIL L16 $ 1,445.00 41898168 HC EP MAPPNG ELECTR PATCH KIT L34 $ 7,875.00 41898170 HC CATHETER- EP L24 $ 4,505.00 41898180 HC INTR SHTH GUIDNG EPFXDCRV L11 $ 723.00 41898183 HC TUBE GASTROSTOMY L17 $ 1,472.00 41898185 HC CATH EMBLZN /THRMB L14 $ 1,147.00 41898186 HC CATH EMBLZN/THRMB L15 $ 1,260.00 41898187 HC CATH EMBLZN /THRMB L13 $ 1,165.00 41898190 HC PCMKR DUAL CHMBR L59 $ 20,166.00 41898196 HC MIC-KEY 16FR FEEDING TUBE L20 $ 2,738.00 41898197 HC CATH ABLATION OTHER L34 $ 8,250.00 41898206 HC RETREIVAL DEVICE L25 $ 4,888.00 41898211 HC EP CATH OTHER L24 $ 4,897.00 41898216 HC PLEURAL/CARDIO DRNAGE SET L10 $ 707.00 41898223 HC PORT INDWELLING L23 $ 3,868.00 41898224 HC STENT ROUND NONCV W DEL L59 $ 33,150.00 41898229 HC PACMKR DUAL CHAMBR L75 $ 53,625.00 41898230 HC MICROCATH W INF/PERF L32 $ 7,905.00

41898237 HC AICD, SINGLE CHAMBER $ 72,000.00 41898247 HC SHEATH FIXED L12 $ 785.00 41898268 HC LEAD LFT CORONARY L45 $ 17,963.00 41898281 HC GUIDEWIRE W/DOPPLER L35 $ 8,625.00 41898294 HC CATHTR BALLOON DILAT L20 $ 2,907.00 41898296 HC CATHETER BALLOON DILAT L21 $ 4,038.00 41898298 HC CATHTR NEURO W/DEL SYST L28 $ 6,163.00 41898302 HC GRAFT THORACIC ANGIO L107 $ 88,200.00 41898311 HC CATH GUIDING W INFSN/PRFSN L38 $ 10,425.00 41898315 HC CATHTR - BALLOON DILAT L18 $ 2,125.00 41898325 HC TEMP PROBE ESOPHAGEAL L28 $ 6,163.00 41898328 HC INTRODUCER SHEATH L10 $ 672.00 41898336 HC EMBOLIC SPHERE L39 $ 11,625.00 41898353 HC EMBOLIZATION SPHERE L19 $ 2,338.00 41898354 HC STNT-RD NON W/DEL L33 $ 8,134.00 41898356 HC HC CATHTR-GUIDING L11 $ 803.00 41898357 HC CATHETER INFUSION L11 $ 697.00 41898359 HC CATH INFUSION L19 $ 2,495.00 41898366 HC CATHETER-MICRO GUID L28 $ 5,984.00 41898367 HC GUIDING CATH W INFSN L29 $ 6,426.00 41898369 HC CATHTR-GUIDING L30 $ 6,800.00 41898371 HC BALLOON-RAD L28 $ 6,329.00 41898379 HC STENT-RD NON W/DEL L33 $ 8,076.00 41898384 HC CATHTR-DIALYSIS ST L18 $ 1,700.00 41898392 HC CATHETER-GUIDING L4 $ 122.00 41898393 HC STENT-RD COT W/DEL L53 $ 27,986.00 41898394 HC STENT RD COATED W DEL L52 $ 25,200.00 41898397 HC MIC-KEY 18FR FEEDING TUBE L20 $ 2,763.00 41898400 HC CATH BALLN DILAT PTA L27 $ 5,525.00 41898401 HC CARDVAS OCCLUDER L29 $ 6,588.00 41898409 HC CATH NEEDLE L4 $ 146.00 41898412 HC SHEATH OTH THAN GUID L49 $ 14,250.00 41898417 HC CATHTR ANGIOGRAPHY DIAGNSTC L8 $ 475.00 41898419 HC CATHETER-EP L35 $ 7,150.00 41898428 HC CATHETER BALLOON DIL PTA L19 $ 2,125.00 41898435 HC CATH GUIDING L3 $ 100.00 41898439 HC LEAD SNGL COIL L46 $ 12,600.00 41898458 HC CATHTER-EP/DIAG/3D3MAP LL41 $ 13,125.00 41898460 HC ICD DEFIB SINGL CHMBR L92 $ 70,200.00 41898462 HC DEFIB DUAL CHMBR L100 $ 79,800.00 41898464 HC CATHTR-EP DIAG/3D3MAP L42 $ 13,875.00 41898465 HC CATHTR-EP ABLAT L35 $ 8,625.00 41898467 HC COIL PUSH L26 $ 5,313.00 41898481 HC THERMOCOOL SF CATH DF CURVE 8F $ 18,900.00 41898484 HC SHEATH GUIDING L25 $ 4,888.00 41898493 HC FEEDING TUBE BUTTON G-JET $ 3,188.00 41898500 HC VASCLR OCCLSN PLUG L32 $ 6,300.00 41898510 HC BLADE ELECSRG TISS DISS PEAK $ 7,875.00 41898522 HC DEFIB DUAL CHAMB L107 $ 88,200.00 41898541 HC CATHETER DIALYSIS $ 604.00 41898544 HC AMPLATZER OCCLUD SEPTAL17 MM $ 39,423.00 41898547 HC CANNULA VENOUS FEM-MEDISCUS $ 2,113.00 41898549 HC CATH BLAZER HI TORQ $ 8,063.00

41898554 HC CATH ABLN BLAZER II STD CRV 7F $ 8,063.00 41898610 HC SHEATH INTRO KIT 7F $ 2,695.00 41898615 HC DEVICE RETREIVER 7FR X80 $ 5,542.00 41898616 HC DEVICE RETREIVER 6X80 $ 4,930.00 41898671 HC CATH BALLOON DIL $ 494.00 41898680 HC CATH CRSS SET TRIFORCE 4.0X65 $ 2,975.00 41898681 HC CATH CRSS SET TRIFORCE 4.0X65 $ 2,975.00 41898688 HC CATH INTRODUCER 8X63 $ 1,318.00 41898693 HC HBLLN CATH THERMODILUTION 5X80 $ 1,133.00 41898696 HC GUIDEWIRE WHOLEY 35X145 $ 667.00 41898729 HC SET INTRODUCER MICRO 4FX10CM $ 349.00 41898741 HC CATH BALLOON DIL 12X2 $ 2,933.00 41898770 HC CATH BALLOON ATLAS GOLD 16X2 $ 3,188.00 41898778 HC CATH GUIDING DUO 2.1-1.6 $ 5,313.00 41898780 HC CATH EP 19 OR FEW ELECT 4X65 $ 1,700.00 41898781 HC IMPL COIL EMBOLIZATION 2.5X4 $ 8,775.00 41898823 HC IMPL CATH ABLTN SAFIRE 7X5 $ 5,525.00 41898837 HC IMPL CATH BALLOON DIL $ 2,338.00 41898854 HC CATH BLLN THERMODIL 7X110 $ 1,304.00 41898856 HC BLLN CTH DILAT STERL 8X20 $ 3,215.00 4200000001 HC AUDITORY REHAB GROUP $ 342.00 4200000002 HC TYMPANOMETRY & REFRESH THRESH $ 267.00 4200000003 HC HEARING SCREENING PURE TONE AIR $ 161.00 4200000004 HC AUDIOMETRY PURE TONE AIR ONLY $ 242.00 4200000005 HC AUDIOMETRY PURE TONE AIR & BONE $ 339.00 4200000006 HC AUDIOMETRY SPCH THRESHOLD $ 119.00 4200000007 HC AUDIOMETRY SPCH THRES W/SP REC $ 244.00 4200000008 HC COMP EVAL 0-7 YRS $ 678.00 4200000009 HC COMP AUDIO EVAL >7 $ 678.00 4200000010 HC DIAGNOSTIC AUDIO F/U >7 $ 453.00 4200000011 HC AUDIO DX EVAL F/UP PEDS 0-7YRS $ 453.00 4200000012 HC AUD EVAL PHYS/MENT HCAP >7 YRS $ 1,014.00 4200000013 HC STENGER TEST PURE TONE $ 133.00 4200000014 HC TYMPANOMETRY $ 218.00 4200000015 HC ACOUSTIC IMMITTANCE $ 290.00 4200000016 HC FILTERED SPEECH TEST $ 112.00 4200000017 HC SYNTHETIC SENTENCE ID (SSI) $ 279.00 4200000018 HC VISUAL REINFORCEMENT AUDIO $ 639.00 4200000019 HC CONDITIONED PLAY AUDIO (CPA) $ 639.00 4200000020 HC SELECT PICTURE AUDIOMETRY $ 121.00 4200000021 HC AUD EVOKED POTENTIALS $ 2,583.00 4200000022 HC AUD EVOKED POTENTIALS ADV $ 1,285.00 4200000023 HC AUD EVOKED POTENTIALS $ 1,053.00 4200000024 HC AUD EVOKED POTENTIALS LTD $ 857.00 4200000025 HC INFANT HEARING SCREEN $ 266.00 4200000026 HC AUD EVOKED POTENTIALS SCREEN $ 266.00 4200000027 HC OTOACOUSTIC EMISSIONS LIMITED $ 348.00 4200000028 HC OTOACOUSTIC EMISSIONS COMPLETE $ 396.00 4200000029 HC HEARING AID EVAL MONAURAL $ 335.00 4200000030 HC HEARING AID EVAL BINAURAL $ 335.00 4200000031 HC HEARING AID CHECK MONAURAL $ 335.00 4200000032 HC HEARING AID CHECK BINAURAL $ 427.00 4200000033 HC ELECTROACOUSTIC EVAL MONAURAL $ 189.00

4200000034 HC ELECTROACOUSTIC EVAL BINAURAL $ 297.00 4200000035 HC DIAG ANALYSIS-CI<7YRS $ 723.00 4200000036 HC SUB REANALYSIS-CI<7YRS $ 723.00 4200000037 HC DIAG ANALYSIS-CI->7YRS $ 723.00 4200000038 HC SUB REANALYSIS-CI->7YRS $ 723.00 4200000039 HC CENT AUD FUNCT TESTS INIT 60M $ 743.00 4200000040 HC CENT AUD FUNCT TESTS ADDL 15M $ 186.00 4200000041 HC EVAL AUD REHAB STATUS 1ST HR $ 473.00 4200000043 HC HEARING THERAPY-INDIVIDUAL $ 406.00 4200000044 HC HEARING THERAPY-GROUP $ 307.00 4200000045 HC BEHAVIORAL AUD TESTING $ 76.00 4200000046 HC UNLISTED OTO SERVICE OR PROC $ 456.00 4200000047 HC AUDITORY MEDICAL LEGAL REPORT $ 1,687.00 4200000048 HC TEAM CONF NON PHYS >29 MIN $ 171.00 4200000050 HC TYMP AS PART OF EXAM $ 114.00 4200000051 HC CASE CONF COORDINATOR $ 228.00 4200000052 HC CASE CONF PARTICIPANT 1/4 HR $ 85.00 4200000053 HC CCS INIT AUDIO EVAL <2 YRS $ 147.00 4200000054 HC CCS INIT AUDIO EVAL 2-5 YRS $ 135.00 4200000055 HC CCS INTI AUDIO EVAL 6-20 YRS $ 80.00 4200000056 HC CCS SUB AUDIOLOGY EVAL <2 YRS $ 54.00 4200000057 HC CCS SUB AUDIOLOGY EVAL 2-5 YRS $ 50.00 4200000058 HC CCS SUB AUDIOLOGY EVAL 6-20 YR $ 45.00 4200000059 HC CCS AUD EVAL DIFF TEST <7 YRS $ 116.00 4200000061 HC CCS SRT/SDT $ 112.00 4200000062 HC CCS WRS TEST $ 117.00 4200000063 HC CCS IMMITANCE TESTING MONAURAL $ 45.00 4200000064 HC CCS IMMITANCE TESTING BINAURAL $ 66.00 4200000065 HC CCS APD TEST $ 489.00 4200000066 HC FUNCTIONAL GAIN TESTING $ 68.00 4200000067 HC REM-MONAURAL $ 49.00 4200000068 HC REM-BINAURAL $ 69.00 4200000071 HC AURAL REHAB (CONV AID) $ 117.00 4200000072 HC AURAL REHAB HA 1/2 HR $ 228.00 4200000073 HC AURAL REHAB CI 1/2 HR $ 228.00 4200000074 HC AURAL REHAB (NON CONV AID) $ 117.00 4200000075 HC AURAL REHAB ALD 1/2 HR $ 228.00 4200000076 HC CI COUNSELING PER HR $ 320.00 4200000077 HC SECOND AUDIOLOGIST $ 171.00 4200000078 HC SPEECH PERCEPTION PER TEST $ 114.00 4200000079 HC MAPPING/PROGRAMMING PER HR $ 723.00 4200000080 HC RECHECK/TROUBLESHOOTING $ 342.00 4200000081 HC CI ORIENTATION $ 456.00 4200000082 HC CI SOUNDFIELD TESTING 30 MIN $ 228.00 4200000083 HC BAHA FITTING FEE $ 2,361.00 42005993 HC NEEDLE INTRODUCER $ 161.00 42016113 HC LOCM 350-399 MG/ML $ 3.00 42016220 HC TUBE THORACOSTOMY W/WO WTR SEA $ 1,512.00 42016261 HC CT CEREBRAL PERFUSION $ 6,996.00 42016352 HC HC BX/EXC LYMPH NODES CERV DP $ 8,585.00 42016402 HC CT ABDOMEN-PELVIS NO CONTRAST $ 6,470.00 42016410 HC CT ABDOMEN-PELVIS W CONTRAST $ 7,711.00 42016428 HC HC CT ABDOMEN-PELVIS WO/W CONT $ 8,993.00

42016675 HC DRAINAGE CATHETER $ 650.00 42016709 HC BIOPSY TRAY $ 149.00 42016717 HC CT NDLE/GDEWIRE LVL 4 $ 149.00 42016725 HC BIOPSY NEEDLE - LVL7 $ 383.00 42016733 HC DRAINAGE BAG LVL 6 $ 298.00 42016741 HC CT GUIDEWIRE - LVL 7 $ 465.00 42016774 HC CT DRN CATH/PERC SET LVL 11 $ 906.00 42016790 HC CT DRN CATH/PERC SET LVL 13 $ 723.00 42016816 HC CT SUPPLY DRAIN BAG LVL 3 $ 85.00 42016832 HC CT SUPPLY RF ABLATN NDL LVL 5 $ 213.00 42016858 HC ABLATION PROBE L36 $ 9,375.00 42016865 HC ABLATION PROBE L37 $ 10,125.00 42016866 HC ABLATION PROBE L38 $ 10,875.00 42016881 HC CT SUPPLY LVL33 $ 8,288.00 42016923 HC CT BIOPSY NEEDLE - LVL6 $ 298.00 42016944 HC NEEDLE INTRODUCER L13 $ 850.00 42016945 HC NEEDLE INTRODUCER L12 $ 808.00 42016956 HC CT MCROPUNCTRE SET - LVL 5 $ 213.00 42016964 HC CT GUIDEWIRE LVL 4 $ 179.00 42016966 HC HC CT GUIDEWIRE L6 $ 255.00 42016972 HC CT SUPPLY DRAIN BAG LVL 5 $ 213.00 42016998 HC CT BIOPSY NEEDLE - LVL 3 $ 85.00 42017012 HC HC CT BIOPSY NEEDLE - LVL10 $ 732.00 42017020 HC BIOPSY NEEDLE L11 $ 814.00 42017038 HC HC CT BIOPSY NEEDLE - LVL12 $ 891.00 42021360 HC CT GUIDANCE FOR NDL PLCMNT $ 4,373.00 42021386 HC CT GUIDANCE ABSCESS DRAIN $ 2,894.00 42023101 HC CT HEAD $ 3,850.00 42023309 HC CT HEAD WO/W CON $ 5,077.00 42023382 HC CT MAXFACIAL W/CNTRST $ 4,848.00 42024752 HC CT THORAX W/O CONTRAST $ 4,426.00 42024760 HC CT UPPER EXTREM W/O CONTRAST $ 4,016.00 42024802 HC CT PELVIS $ 4,373.00 42024851 HC CT LOWER EXTREMITY $ 3,592.00 42024919 HC CT SFT TIS NCK W/CON $ 4,628.00 42024950 HC CT ABDOMEN W/CONTRAST $ 6,285.00 42025007 HC CT THORAX W/CNTRST $ 5,564.00 42025056 HC CT PELVIS W/CONTRAST $ 7,439.00 42025106 HC CT ABDOMEN WO/W CONTRAST $ 6,956.00 42025205 HC CT PELVIS WO/W CONTRAST $ 7,944.00 42025866 HC CT C-SPINE $ 5,262.00 42025882 HC CT L-SPINE $ 5,155.00 42044446 HC CT ANGIO HEAD WO/W CONTRAST $ 8,725.00 42044453 HC CT ANGIO NECK WO/W CONTRAST $ 9,345.00 42044461 HC CT ANGIO CHEST WO/W CONTR $ 7,745.00 42053579 HC ABLATION BONE TUMOR INC CT $ 12,895.00 42062034 HC BX BONE TROC/NDL DEEP $ 5,930.00 42062125 HC BX PLEURA PERC NDL $ 2,384.00 42062133 HC BX LUNG/MEDIAST PERC NDL $ 3,287.00 42062208 HC BX LIVER NDL PERC $ 4,317.00 42062224 HC BX PANCREAS PERC NDL $ 2,295.00 42062232 HC DRAIN PERIT ABSCS PERC $ 3,150.00 42062240 HC DRAIN SUBDIAPH ABSCS PER $ 3,156.00

42062257 HC DRAIN RETROPERIT ABSCS $ 5,215.00 42062265 HC BX ABD/TETRO MASS PERC NDL $ 2,277.00 42062315 HC BX RENAL BY NDL $ 2,637.00 42072744 HC HC BIOPSY SALIVARY GLAND $ 1,761.00 42080192 HC BX LYMPHNODE SUPERFICIAL $ 3,219.00 4300000002 HC RESUSCITATION $ 1,673.00 4300000004 HC BIPAP INIT & MANAGE INITIAL $ 5,654.00 4300000005 HC BIPAP INIT & MANAGE SUBSQ DAY $ 4,256.00 4300000006 HC VENT ASSIST & MGMT INITIAL $ 7,212.00 4300000007 HC VENT ASSIST & MGMT SUBSQ $ 5,815.00 4300000008 HC VENT HIGH FREQ INITIAL $ 5,314.00 4300000009 HC VENT HIGH FREQ SUBSQ DAY $ 4,935.00 4300000012 HC SPIROMETRY $ 665.00 4300000013 HC BRONCHODILATION RESPONSIVENESS $ 1,292.00 4300000016 HC INF FORCED EXP FVL PRE/POST $ 2,241.00 4300000018 HC SPIROMETRY PRE/POST BRONCHO $ 1,292.00 4300000019 HC BRONCHIAL PROVOCATON $ 3,827.00 4300000020 HC SLOW VITAL CAPACITY $ 571.00 4300000021 HC FLOW VITAL CAPACITY $ 571.00 4300000024 HC MAXIMUM VOLUNTARY VENTILATION $ 571.00 4300000025 HC FLOW VOLUME LOOP $ 1,050.00 4300000026 HC FLOW VOLUME PRE/POST $ 1,050.00 4300000027 HC FLOW VOLUME LOOP INF FORCED $ 1,050.00 4300000028 HC HYPOXIC GAS CHALLENGE $ 491.00 4300000030 HC INTRAPULMONARY SURFACTANT ADMI $ 560.00 4300000031 HC 6 MINUTE WALK $ 1,138.00 4300000032 HC EXERCISE BRONC PROVOC STUDY $ 1,192.00 4300000033 HC AEROSOL TREATMENT $ 91.00 4300000034 HC HAND NEBULIZER INITIAL $ 297.00 4300000035 HC HAND NEBULIZER SUBSQ $ 255.00 4300000036 HC HAND NEBULIZER TREATMENT $ 301.00 4300000037 HC INCENTIVE SPIROMETRY INITIAL $ 348.00 4300000039 HC IPV TREATMENT INITIAL $ 645.00 4300000040 HC IPV TREATMENT SUBSQ $ 472.00 4300000041 HC MDI INITIAL $ 257.00 4300000042 HC MDI SUBSEQUENT $ 220.00 4300000044 HC PRESS/NONPRES INH TX $ 257.00 4300000045 HC SPECIAL GAS ADMINISTRATION $ 2,632.00 4300000046 HC SPUTUM INDUCTION $ 257.00 4300000048 HC AEROSOL PENTAMIDINE TX $ 660.00 4300000049 HC AEROSOL CONTIN MED 1ST HR $ 783.00 4300000050 HC AEROSOL CONTIN MED > 1 HR $ 196.00 4300000051 HC CPAP INIT & MANAGE $ 4,256.00 4300000053 HC CPAP/BIPAP INITIATION & MGMT $ 2,365.66 4300000054 HC CPAP THERAPY PER HR $ 503.98 4300000055 HC CPAP NASAL SETUP (PULM) $ 503.98 4300000056 HC HAND NEBULIZER DEMO/EVAL $ 257.00 4300000057 HC INHALER/NEB DEMONSTRATION $ 337.00 4300000059 HC MDI DEMO/EVAL $ 348.00 4300000060 HC CHEST PT INITIAL $ 367.00 4300000061 HC CHEST PT SUBSEQUENT $ 472.00 4300000066 HC AIRWAY RESISTANCE MEASUREMENT $ 825.00 4300000067 HC ARM POST BRONCHODILATOR $ 1,125.00

4300000068 HC TGV POST BRONCHODILATOR $ 1,344.00 4300000069 HC THORACIC GAS VOLUME (TGV) $ 1,125.00 4300000070 HC LUNG VOLUMES (REV/FRC) $ 1,138.00 4300000071 HC DIFFUSION CAPACITY $ 1,138.00 4300000072 HC COMPLIANCE RESISTANCE STATIC $ 896.00 4300000073 HC COMPLIANCE RESISTANCE PRE/POST $ 1,223.00 4300000075 HC OXIMETRY SPOT SIMPLE $ 308.00 4300000076 HC PULSE OXIMETRY SNGL DETERM $ 190.00 4300000079 HC OXYGEN CONSUMPTION ANALYSIS $ 402.00 4300000080 HC PULSE OXIMETRY MULT DETERM $ 571.00 4300000081 HC VO2 MAX TEST $ 571.00 4300000082 HC SLEEP OXIMETRY $ 577.00 4300000083 HC END TIDAL CO2 MONITOR SU $ 332.22 4300000086 HC CO2 EXPIRED GAS INFRARED $ 1,170.24 4300000088 HC HYPERNOXIC GAS CHALLENGE $ 433.00 4300000089 HC MAXIMAL INSPIRATORY PRESSURE $ 571.00 4300000090 HC NITRIC OXIDE MGMT/DAILY $ 2,526.00 4300000091 HC OXYGEN/VENTILATION/APNEA STUDY $ 4,031.00 4300000092 HC PEAKFLOW EACH $ 76.00 4300000093 HC TRANSCUT PCO2 $ 1,938.00 4300000095 HC POLYSOMNOGRAPHY 4+ < 6 YRS $ 7,519.00 4300000096 HC POLYSOMNOGRAPHY 4+ 6+ YRS $ 7,519.00 4300000097 HC POLYSOMNOGRAPHY 4+ < 6 YRS $ 8,690.00 4300000098 HC POLYSOMNOGRAPHY 4+ 6+ YRS $ 8,690.00 4300000104 HC ACTIGRAPHY TESTING $ 515.00 4400000001 HC IV INFUS HYD 31 MIN-1HR INIT $ 832.00 4400000002 HC IV INFUS HYD EA ADDL HR 2-8 $ 468.00 4400000003 HC IV INFSN TX PRYLXS 1ST HR $ 832.00 4400000004 HC IV INFSN TX PRYLXS 1<EA HR<8 $ 468.00 4400000005 HC TX/DX ADL SEQ NW IV INF TO 1HR $ 468.00 4400000006 HC THER/DIAG CONCURRENT INF $ 468.00 4400000007 HC INJECTION IM/SUBQ ANTIB $ 75.00 4400000008 HC INJECTION IM/SUBQ $ 325.00 4400000009 HC PDC RHOGAM INJ VISIT $ 164.00 4400000010 HC TX INJECTION IM/SUBQ EXC ANTIB $ 88.00 4400000011 HC IV PUSH INITIAL DRUG $ 823.00 4400000012 HC TX/DX EA ADD SEQ IV PUSH NW DR $ 330.00 4400000013 HC CHEMO IM/SUBQ NON HORMONAL $ 190.00 4400000014 HC CHEMO IM/SUBQ HORMONAL $ 190.00 4400000015 HC CHEMO IV PUSH INIT/SGL DRUG $ 796.00 4400000016 HC CHEMO IV PUSH ADDL DRUG $ 628.00 4400000017 HC CHEMO IV INFUSION INIT HR $ 1,114.00 4400000018 HC CHEMO IV INF EA ADDL HR UP TO 8 $ 1,114.00 4400000019 HC CHEMO IV INIT PRLNGD INFUS 8+ $ 981.00 4400000020 HC CHEMO IV INFUS EA ADDL SEQ $ 726.00 4400000021 HC CHEMO INTRATHECAL $ 2,399.00 4400000022 HC CHEMO INFUSION IT W LP $ 193.00 4400000023 HC IMMUN <= 18 YRS W COUNS 1ST $ 69.00 4400000024 HC IMMUN <= 18 YRS W COUNS EA >1 $ 69.00 4400000025 HC IMMUNIZATION ADMIN 1 VACCINE $ 93.00 4400000026 HC IMMUNIZATION ADMIN EA ADDL VAC $ 65.00 4400000027 HC TX/DX EA ADD SEQ IV PUSH SM DR $ 330.00 4400000028 HC IMM - ORAL/INTRANASAL - SGL $ 93.00

4400000029 HC IMM - ORAL/INTRANASAL EA ADDL $ 65.00 4400000030 HC FLU VACCINE TRIV PRESFREE 6-35 $ 56.00 4400000031 HC FLU VACCINE TRIV PRESFREE>3YRS $ 56.00 4500000001 HC COMPUTER DYNAM POSTUROGRAPHY $ 751.00 4500000002 HC MULT SLEEP LATENCY TEST $ 5,052.00 4500000003 HC APNEA STUDY W HR & RESP ANAL $ 5,376.00 4500000005 HC EEG EXT MONITOR UP TO 1 HR $ 2,994.00 4500000006 HC EEG EXT MONITOR > 1 HR $ 4,144.00 4500000007 HC EEG AWAKE & DROWSY $ 2,075.00 4500000008 HC EEG AWAKE & ASLEEP $ 1,934.00 4500000009 HC SPENOIDAL RECORDING $ 2,374.00 4500000010 HC EEG COMA OR SLEEP ONLY $ 1,486.00 4500000011 HC EEG CEREBRAL SILENCE $ 2,244.00 4500000012 HC INSERT SPHENOIDAL ELECTRODE $ 1,809.00 4500000013 HC MANUAL MUSCLE TEST $ 269.00 4500000014 HC MANUAL MUSCLE TEST - EA HAND $ 269.00 4500000015 HC RANGE OF MOTION EA LEG $ 179.00 4500000016 HC RANGE OF MOTION - EA HAND $ 133.00 4500000017 HC EMG ONE EXTREMITIES $ 1,053.00 4500000018 HC EMG TWO EXTREMITIES $ 1,491.00 4500000019 HC EMG THREE EXTREMITIES $ 669.00 4500000020 HC EMG FOUR EXTREMITIES $ 800.00 4500000021 HC EMG CRANIAL UNILAT $ 267.00 4500000022 HC EMG CRANIAL BILAT $ 367.00 4500000023 HC EMG LTD ONE EXT /NON LIMB $ 768.00 4500000024 HC EMG W NERVE TEST LTD EA EXT $ 768.00 4500000025 HC EMG W NERVE TEST COMPL EA EXT $ 850.00 4500000026 HC EMG W NERVE TEST NON EXT $ 842.00 4500000030 HC NERVE CONDUCTION 1-2 STUDIES $ 2,529.00 4500000031 HC NERVE CONDUCTION 3-4 STUDIES $ 3,795.00 4500000032 HC NERVE CONDUCTION 5-6 STUDIES $ 5,059.00 4500000033 HC NERVE CONDUCTION 7-8 STUDIES $ 5,902.00 4500000034 HC NERVE CONDUCTION 9-10 STUDIES $ 6,745.00 4500000035 HC NERVE CONDUCTION 11-12 STUDIES $ 7,588.00 4500000036 HC NERVE CONDUCTION 13+ STUDIES $ 8,432.00 4500000037 HC INTRAOP NPHYS TESTING PER HR $ 963.00 4500000038 HC SOMATOSENSORY ER UPPER EXT $ 1,580.00 4500000039 HC SOMATOSENSORY ER LOWER EXT $ 1,580.00 4500000040 HC SOMATOSENSORY ER TRUNK/HEAD $ 1,288.00 4500000041 HC MOTOR EP UPPER EXT $ 752.00 4500000042 HC MOTOR EP LOWER EXT $ 752.00 4500000043 HC VISUAL EVOKED RESPONSE $ 997.00 4500000044 HC BLINK REFLEX TEST $ 371.00 4500000047 HC REP STIM TEST $ 1,053.00 4500000048 HC SMTSRY EVOKED UP & LOW EXT $ 3,161.00 4500000049 HC MOTOR EP UP & LOW EXT $ 1,504.00 4500000050 HC EEG CRITICAL CARE MONITORING $ 861.00 4500000051 HC EEG AMBULATORY W VIDEO $ 5,178.00 4500000052 HC EEG VIDEO EA 24 HR PHASE 2 $ 5,833.00 4500000053 HC EEG VIDEO TO 4 HRS $ 2,756.00 4500000054 HC EEG VIDEO TO 8 HRS $ 5,512.00 4500000055 HC EEG VIDEO SPECIAL 24 HRS $ 4,533.00 4500000056 HC EEG AMBULATORY UNATTENDED $ 3,673.00

4500000057 HC EEG MONIT EA 24 HRS UNATTENDED $ 5,241.00 4500000058 HC EEG W NONINTRACRANIAL SURG $ 1,661.00 4500000059 HC EEG MONITORING WADA TS $ 2,094.00 4500000060 HC EEG MAPPG CORTICL STIM 1ST $ 2,263.00 4500000061 HC EEG MAPPG CORTICL STIM EA ADL $ 1,584.00 4500000062 HC VIDEO ANALYSIS $ 661.00 4500000063 HC KINEMATICS - INTERVENTION $ 3,299.00 4500000064 HC KINEMATICS - LEVEL WALKING $ 3,299.00 4500000065 HC KINEMATICS - UPPER LIMB $ 3,299.00 4500000066 HC KINETICS-LEVEL WALKING $ 4,041.00 4500000067 HC KINETICS- INTERVENTION $ 4,041.00 4500000068 HC GAIT EMG-SURFACE 1-12 MUSCLES $ 1,769.00 4500000069 HC GAIT EMG-FINE WIRE 1 MUSCLE $ 586.00 4500000070 HC INTRAOP N-PHYS TST EA15M IN OR $ 262.00 4500000071 HC INTRAOP N-PHYS TST EA HR OUTOR $ 904.00 46010005 HC RBC REDUCED GLUTATHIONE GSH $ 109.00 46010013 HC PYRIMIDINE 5 NUCLEOT NONRAD EA $ 324.00 46010021 HC RBC ASSAY GLUTATHIONE GSH $ 196.00 46093217 HC HEMOGLOBIN QUANT & FRACT CHROM $ 257.00 46093233 HC ENZYME ACTIVITY - HEXOKINASE $ 324.00 46093266 HC SICKLING OF RBC-REDUCTION $ 92.00 46093274 HC G6 PD QUANT $ 199.00 46093282 HC PYRUVATE KINASE $ 165.00 46093290 HC ENZYME ACTIVITY - GPI $ 211.00 46093308 HC ENZYME ACTIVITY - ADA $ 324.00 46093324 HC ENZ ACT PURINE NEUC PHOSPHORYL $ 324.00 46093332 HC OSMATIC FRAGILITY RBC INCUB $ 200.00 46093357 HC HGB F QUANT CHROM $ 257.00 46093365 HC HGB S QUANT CHROM $ 257.00 46093373 HC HGB FRACT/QUANT ELECTROPH $ 250.00 46100012 HC CMV-IGM $ 314.00 46100152 HC HEPAT BS ANTIGEN $ 220.00 46100228 HC 092 HEPATITIS BE AB $ 16.45 46100251 HC RUBELL ANTIBODY $ 268.00 46100459 HC VIRUS ISOLATN CULTR $ 484.00 46100467 HC VIR ID ADDL STUDIES $ 349.00 46100475 HC VIRUS ISOL HERPES $ 484.00 46100848 HC VIRUS VIAL CULTURE $ 363.00 46120762 HC VIRAL AB MEASLES $ 240.00 46120887 HC VIRAL ANTIBODY CMV $ 268.00 46122867 HC C DIFF TOX CONF $ 106.00 46130126 HC CRPLB PA SCN EAAB CRYPTOCOCCAL $ 309.00 46130142 HC LATX CRYPTL AG(CSF) 86641 $ 309.00 46130191 HC AGGLUTINATN & TITRA $ 117.00 46130654 HC CLOST DIFF TOX A $ 93.00 46140000 HC VIRAL ID DFA $ 190.00 46140158 HC HSV ANTIGEN $ 319.00 46140166 HC VZV ANTIGEN $ 369.00 46140174 HC RSV ANTIGEN $ 66.00 46140182 HC FLU A ANTIGEN $ 221.00 46140208 HC ROTA VIRUS ANTIGEN $ 181.00 46140216 HC ADENO ANTIGEN $ 284.00 46140455 HC CRYPTO AG TITER $ 318.00

46140463 HC TOXOPLASMA IGG $ 231.00 46140471 HC HSV-1 AB IMMUNOBLOT $ 226.00 46140489 HC HSV-2 AB IMMUNOBLOT $ 240.00 46140497 HC VZ VIRUS AB IGG $ 251.00 46140505 HC FLU B DFA $ 165.00 46140513 HC PARAFLU DFA $ 324.00 46140547 HC PARFLU DFA POOL $ 319.00 46160263 HC 092 EBV EARLY AB (D&R) $ 23.75 46160271 HC 092 EB VCA IGG $ 23.75 46160289 HC 092 EB VCA IGM $ 23.75 46160297 HC 092 EB EBNA $ 23.75 46160321 HC HPVHR2 DNA HPV APT HRISK CV $ 372.00 46160420 HC HCV RNA QUANT ASSAY $ 874.00 46160438 HC HEP C VIRUS GENOTYPE $ 2,847.00 46160479 HC EPSTEIN BARR VIRUS PCR QUANT $ 650.00 46160503 HC HIV RNA PCR QUANT $ 1,377.00 46160578 HC HEPAT BS ANTIGEN $ 220.00 46160586 HC HEPATITIS C AB $ 193.00 46160735 HC MUMPS AB $ 212.00 46160743 HC METAPNEUMOVIRUS DFA $ 190.00 46160750 HC RSV DFA $ 249.00 46160768 HC FLUAPC FLU A RNA RT PCR AMP EA $ 651.00 46160776 HC FLUAPX FLU A RNA RT PCR AMP EA $ 651.00 46160792 HC HCV GENOTYPE $ 2,847.00 46160800 HC BK VIRUS NA PCR QUANT URINE $ 650.00 46160818 HC BK VIRUS NA PCR QUANT $ 650.00 46160826 HC ADENO VIRUS ANTIGEN $ 284.00 46160834 HC FLU B DFA $ 165.00 46160842 HC FLU A ANTIGEN $ 221.00 46160859 HC PARAFLU DFA ANTIGEN $ 324.00 46160867 HC RSV DFA $ 249.00 46160875 HC METAPNEUMOVIRUS DFA $ 190.00 46160883 HC FLU A ANTIGEN $ 221.00 46160891 HC TOXOIM TOXOPLASMA AB IGM $ 227.00 46160909 HC TOXOAB TOXOPLASMA AB IGG $ 231.00 46160917 HC TOXOAB TOXOPLASMA AB IGM $ 227.00 46160925 HC TOXOPR TOXOPLASMA AB IGG $ 231.00 46160933 HC TOXOPR TOXOPLASMA AB IGM $ 227.00 46160941 HC RSVPCR BY NA RNA APT EA $ 388.00 46160958 HC MPVPCR BY NA RNA APT EA $ 388.00 46160966 HC RMPCR BY NA RNA APT EA $ 388.00 46160982 HC H1N1PC H275Y MUT RT AMP 1ST 2 $ 1,180.00 46160990 HC HPVPCR HPV 16 DNA APT $ 555.00 46161006 HC HPVPCR HPV 18 DNA APT $ 555.00 46161014 HC HPV6PC HPV 6 AND 11 DNA APT $ 555.00 46161022 HC EAIGG EBV EA IGG $ 191.00 46161030 HC EBNABY EBV EBNA IGG $ 218.00 46161048 HC VCAIGM EBV VCA IGM $ 343.00 46161055 HC VCAIGG EBV VCA IGG $ 343.00 46161063 HC EBVPAN EBV EA IGG $ 191.00 46161071 HC EBVPAN EBV EBNA IGG $ 218.00 46161089 HC EBVPAN EBV VCA IGG IGM $ 343.00 46161097 HC HPVHRT DNA HPV APT HRISK CERV $ 555.00

46161105 HC ADVQT ADENOVRS DNA PCR QNT $ 650.00 46161113 HC ADVQL ADENOVRS DNA PCR QL $ 388.00 46161121 HC HPVHR2 DNA HPV APT HRISK CV $ 555.00 46161139 HC EBVQP EBV DNA PCR QUANT $ 650.00 46161147 HC EBVQL EBV DNA PCR APT QUAL $ 388.00 46161154 HC MUMPSG MUMPS AB IGG $ 212.00 46161162 HC HSVZL HSV AMP PCR LESION $ 637.00 46161170 HC HSVZL IAD NA APT EA ORG LESION $ 388.00 46161188 HC HHV6QT IAD NA PCR EA ORG QNT $ 650.00 46161196 HC HHV6QL IAD NA APT EA QUAL $ 388.00 46161204 HC VZVQL IAD NA APT EA PCR QUAL $ 388.00 46161212 HC CMVIGT CMV IGG AB TS ONLY $ 268.00 46161220 HC HSVQL HSV DNA AMP PCR QUAL CSF $ 637.00 46161238 HC TOXIG TOXOPLASMA AB IGG $ 231.00 46161246 HC HSVPCR HSV DNA AMP PCR QL CSF $ 637.00 46161253 HC DVEHVR VZV ANTIGEN $ 369.00 46161261 HC DVEHVR DET IMM EA PLY ASRM $ 319.00 46161279 HC VZVCSF IAD NA APT EA QL CSF $ 388.00 46161287 HC VZVQLP IAD NA APT EA QUAL $ 388.00 46161295 HC HSVCSF HSV DNA AMP PCR QL CSF $ 637.00 46161303 HC HSVQLP HSV DNA AMP PCR QUAL $ 637.00 46161311 HC CMVRO SHL VL ID IMM EA VRS $ 363.00 46161329 HC CMVRO CMV QUAL PCR AMP $ 651.00 46161337 HC CMVRC SHL VL ID IMM EA VRS $ 363.00 46161345 HC EBVQPB EBV IAD NA EA ORG $ 650.00 46161352 HC EBVBAM EBV IAD NA EA ORG $ 650.00 46161360 HC ADVRC SHL VL ID IMM EA VRS $ 363.00 46161378 HC MUMRC SHL VL ID IMM EA VRS $ 363.00 46161386 HC MEARC SHL VL ID IMM EA VRS $ 363.00 46161394 HC VCULF VRS ISOL CLT OBS ID FLD $ 484.00 46161402 HC VCULO VRS ISOL CLT OBS ID OCU $ 484.00 46161410 HC VCULR VRS ISOL CLT OBS ID RES $ 484.00 46161428 HC VCULS VRS ISOL CLT OBS ID REC $ 484.00 46161436 HC VCULT VRS ISOL CLT OBS ID TIS $ 484.00 46161444 HC VCULU VRS ISOL CLT OBS ID URN $ 484.00 46161451 HC HSVPAN HSV AB NON SPECIFIC $ 204.00 46161469 HC HSVPAN HSV AB TYPE 1 $ 226.00 46161477 HC HSVPAN HSV AB TYPE 2 $ 240.00 46161485 HC HSVIGG HSV AB TYPE 1 $ 226.00 46161493 HC HSVIGG HSV AB TYPE 2 $ 240.00 46161501 HC RESPCR IAD NA APT 1ST 2 TYPS $ 1,180.00 46161519 HC RESPCR IAD NA APT EA ADL BYND2 $ 294.00 46161527 HC RESPCR IAD NA NOS APT EA ORG $ 388.00 46161535 HC HHV6QL IAD NA HV6 APT PCR QUAL $ 497.00 46161543 HC HHV6QT IAD NA HRP VRS6 QNT $ 591.00 46161550 HC RESPCB IAD PCR EA ADL BYND2 $ 294.00 46161576 HC RESPCR RNA RSV 6-11 TARGETS $ 2,950.00 46161584 HC TOXOPLASMA $ 231.00 46161592 HC TOXOPLASMA, IGM $ 227.00 46161600 HC CMV IGG AB AVIDITY $ 268.00 46161618 HC HSVNEO HSV DNA PCR NEONATAL $ 637.00 46161626 HC VZV DNA PCR WITH & W/O LES EA $ 388.00 46161634 HC HSV DNA AMP PROBE $ 637.00

46161642 HC VZV IGG & IGM $ 251.00 46161659 HC HCV GENOTYPE $ 2,847.00 46161667 HC HCV TRANSCRIPTION & QUANT $ 874.00 46300489 HC CMV QUAL PCR AMP $ 651.00 46300505 HC CMV PCR QUANT $ 849.00 46310256 HC RPCR RPT IAD BY NA APT EA ORG $ 388.00 46310314 HC GC AMP PROBE $ 566.00 46310348 HC CHLAMYDIA MOLECULAR $ 566.00 46310355 HC GC LCR AMPLIFIED $ 566.00 46310397 HC HEP B PCR QUANT $ 794.00 46310660 HC VIR. GENE RT/PRO SEQ. $ 2,847.00 46330056 HC CHL. TRACH AMP PROBE $ 566.00 46330197 HC HSV DNA TYPE 1 $ 186.00 46330205 HC HSV DNA TYPE 2 $ 186.00 46330247 HC AVIN GNTYP NA HIV1 INTGRSE $ 4,147.00 46330254 HC HCV GENOTYPE $ 2,847.00 47200027 HC BLOOD IRRADIATION $ 278.00 47200126 HC AUTOLOGOUS PROCESSING $ 858.00 47200233 HC SPLIT BLOOD UNIT $ 71.00 47200514 HC ANTIGEN TYPE: PATIENT $ 245.00 47200555 HC COMPATIBILITY TEST:AHG $ 408.00 47200654 HC ABO TYPING $ 250.00 47200704 HC RH TYPING $ 220.00 47200803 HC DIRECT COOMBS:BRD SPECTRM $ 120.00 47200811 HC DIRECT COOMBS:C3 $ 120.00 47200837 HC ANTIB SCRN-3 CELL $ 310.00 47200902 HC BLD TYP ANTG SCRN DNR EA $ 214.00 47200985 HC THERMAL AMPLITUDE $ 126.00 47201017 HC COLD TITER $ 191.00 47201157 HC COOMBS AB TITER $ 259.00 47201355 HC DIRECT COOMBS:GAMMA $ 120.00 47201421 HC DONATH-LANDSTEINER $ 91.00 47201454 HC ANTIBODY ID PANEL $ 570.00 47201553 HC COLD SCREEN/PANEL $ 156.00 47201801 HC ABSORPTION $ 415.00 47202205 HC NEUTRALIZATION BR $ 580.00 47203047 HC ABID R/O $ 570.00 47203146 HC AB ELUTION RBC EA $ 535.00 47203286 HC INDIRECT COOMBS QUAL $ 126.00 47203369 HC PACK PLATELETS $ 282.00 47203823 HC IMMED-SPIN X-MATCH $ 378.00 47204060 HC ELECTRONIC CROSSMATCH $ 325.00 47204169 HC CRYO POOLING $ 1,701.00 47204730 HC ENZYME TREATMENT $ 380.00 47204748 HC RBC TREATMENT $ 350.00 47204805 HC AB ID PANEL - ADDTL $ 570.00 47204813 HC ABO CONFIRM UNIT TYPE $ 260.00 47204839 HC ABO CONFIRM PT TYPE $ 250.00 47204862 HC DAT NEG INVEST-ARC $ 133.00 47220041 HC VOLUME REDUCTION-BLOOD PROD $ 282.00 47220124 HC CMV TOTAL AB $ 268.00 47220140 HC THAMPS THRML CLD AGGLUT SCRN $ 156.00 47400023 HC CRYO & STOR. OF PROD. $ 9,662.00

47400046 HC ALLO CRYO & STOR OF PROD $ 9,662.00 47400122 HC THAW PREV. FROZ. PROD. $ 7,583.00 47400144 HC ALLO THAW PRV FROZ PROD EA DON $ 7,583.00 47400148 HC T CELL DEPLETION $ 35,198.00 47400213 HC RBC REMOVAL $ 3,420.00 47400226 HC ALLO RBC REMOVAL $ 3,420.00 47400270 HC AUTO WASHING OF HARVEST EA DON $ 3,467.00 47400288 HC PLASMA DEPLETION $ 2,913.00 47400296 HC CELL CONCENTRATION $ 7,160.00 50100775 HC JUMBO FP UNIT 1 $ 437.00 50100825 HC FFP SPLIT $ 751.00 50101153 HC RH IMMUNE GLOBULIN $ 324.00 50101518 HC WHOLE BLOOD AUTOGOLOUS $ 1,216.00 50110402 HC WHOLE BLOOD $ 1,216.00 50110808 HC RED BLOOD CELLS $ 665.00 50111301 HC RED BLOOD CELLS LR $ 909.00 50111509 HC RBC PARTIAL UNIT $ 751.00 50112929 HC PLATELET PHERESIS $ 2,035.00 50113208 HC FRESH FROZEN PLASMA $ 437.00 50113505 HC CRYOPOOR PLASMA $ 751.00 50113901 HC CRYOPRECIPITATE $ 275.00 50114651 HC RED CELLS AUTOLOGOUS $ 665.00 50114933 HC RED CELLS:DEGLYC $ 1,622.00 50115344 HC GRANULOCYTES $ 6,200.00 50115351 HC RED CELLS;LR IRRAD $ 1,152.00 50115369 HC RED CELLS;IRRAD $ 953.00 50115385 HC REDCELLS;DRY IRR CMV $ 1,253.00 50115393 HC RED CELLS;DRY LR $ 909.00 50115401 HC RED CELLS;DRY LR IR CM $ 1,253.00 50115427 HC PLT PHERESIS LR IRRAD $ 2,867.00 50115435 HC PLT PHERESIS;IRRAD $ 1,932.00 50115484 HC RED CELLS;WASHED $ 1,314.00 50115492 HC RED CELLS:LRIRRCMV $ 1,253.00 50115518 HC WHOLE BLOOD;LR IRRAD $ 1,216.00 50115542 HC PLT PHERE;LR HLA-XM $ 2,936.00 50115591 HC RED CELLS;PHERE IRR LR $ 1,152.00 50115609 HC RED CELLS;PHERE LR $ 909.00 50115641 HC WHOLE BLOOD;LR $ 1,216.00 50120294 HC CRYOPRECIPITATE-PREPOOLED $ 275.00 50120302 HC CRYOPRECIPITATE-PREPOOLED $ 275.00 50120310 HC CRYOPRECIPITATE-PREPOOLED $ 275.00 50120328 HC CRYOPRECIPITATE-PREPOOLED $ 275.00 50120336 HC CRYOPRECIPITATE-PREPOOLED $ 275.00 50120419 HC THAWED PLASMA-EA UNIT $ 437.00 50120468 HC LIQUID PLASMA $ 751.00 50120476 HC PLATELETS - PARTIAL UNIT $ 751.00 50120518 HC JUMBO FP UNIT 2 $ 437.00 50120526 HC LIQUID PLASMA - CRYO $ 751.00 50120534 HC GRANULOCYTES EA UN $ 6,944.00 50120559 HC FFP WITHIN 8 HRS COL EA UNIT $ 446.00 50200104 HC VENIPUNCTURE $ 50.00 50200203 HC COLLECTION CAPILL BLD SPECIMEN $ 50.00 50230051 HC SPECIMEN PROCESSING** $ 77.00

50240191 HC STORAGE - SPECIMEN $ 23.00 50300151 HC BLD SMR INTERP $ 51.00 50300235 HC 081 CBC AUTOMATED $ 216.00 50300250 HC IRON STAIN $ 546.00 50300359 HC CELL COUNT AND DIFF BODY FLD $ 252.00 50300573 HC HEINZ BODY PREP $ 66.00 50300714 HC HEMATOCRIT FLUID/URINE $ 55.00 50300755 HC HEMOGLOBIN H PREP $ 546.00 50300805 HC HEMOSIDERIN $ 145.00 50301100 HC NAS SHEAR EO CT $ 30.00 50301456 HC SERUM PREGNANCY SCR $ 332.00 50301464 HC URINE PREGNANCY SCR $ 102.00 50301654 HC SED RATE-WESTERGREN NON-AUTO $ 130.00 50301704 HC SEZARY CELL $ 116.00 50301803 HC SPECIFIC GRAVITY $ 115.00 50301811 HC SPEC GRAVITY-FLUID $ 53.00 50301837 HC CRYSTAL ID $ 244.00 50301878 HC URINE EOSINOPHIS $ 174.00 50302116 HC MYOGLOBIN SCRN URIN $ 115.00 50302231 HC URINALYSIS AUTO WITHOUT MICRO $ 108.00 50302355 HC URINE ROUTINE-MICRO $ 196.00 50303072 HC HEMOGLOBIN $ 48.00 50303080 HC HEMATOCRIT $ 217.00 50320258 HC CRYOPROTEIN $ 229.00 50320266 HC CRYOGLOBIN $ 229.00 50320407 HC G-6PD H SCREEN $ 176.00 50320613 HC CD3 $ 380.00 50320902 HC SRM VSCSTY $ 217.00 50323005 HC INFECT MONO SCRN $ 199.00 50323021 HC RAPID STREP A $ 239.00 50323047 HC RETIC COUNT BY FLOW $ 179.00 50324797 HC CELL COUNT BODY FLD $ 174.00 50325075 HC REDUCING SUBSTANCES $ 115.00 50325083 HC KIEIHAUER-BETKE $ 255.00 50325125 HC GASTRIC PH $ 50.00 50325133 HC OCCULT BLOOD, GASTRIC FLUID $ 101.00 50393172 HC URINE MICRO ONLY $ 60.00 50393263 HC SICKELDEX $ 92.00 50393339 HC OSMATIC FRAGILITY $ 200.00 50393370 HC HGB ELECTRO CELLULOSE $ 250.00 50393396 HC STOOL REDUCING SUBSTANCE $ 128.00 50393404 HC FECAL FAT $ 303.00 50393420 HC COMPLETE BLOOD COUNT $ 285.00 50393438 HC CBC W/AUTO DIFF $ 300.00 50393446 HC PLATELET COUNT AUTOMATED $ 138.00 50393461 HC SLIDE REVIEW $ 116.00 50393503 HC STOOL POLYS & EOS $ 154.00 50393529 HC CBC AUTOMATED $ 285.00 50393560 HC APT TEST - FETAL HGB $ 114.00 50393578 HC NBT NITROBLUE TETRAZOL $ 69.00 50393610 HC GYCATED HGB BY DCA 2000 $ 50.00 50393636 HC FLOW:T-CELLS TOTAL COUNT $ 538.00 50393719 HC RAPID HIV-1 ANTIBODY $ 121.00

50393735 HC OCCULT BLOOD GUAIAC STOOL $ 101.00 50393743 HC ESR AUTOMATED $ 75.00 50393750 HC GRAM STAIN $ 150.00 50393768 HC RSV AG BY EIA $ 66.00 50393776 HC RAPID FLU A AND B EIA $ 111.00 50393784 HC MALARIA PREP $ 379.00 50393792 HC OCCULT BLD GUAIAC COL SCRN $ 101.00 50393800 HC OCCULT BLD GUAIAC DIAG NON COL $ 130.00 50393818 HC OCCULT BLD IMMUNO COL SCRN $ 623.00 50393826 HC OCCULT BLD IMMUNO DIAG $ 425.00 50393867 HC LAMELLAR BODIES CNT FLD $ 156.00 50393875 HC CELL CNT AND DIFF APH BD FLD $ 252.00 50393883 HC CDTPCR C DIFF TOXIN AMP STOOL $ 486.00 50393891 HC SHIV12 HIV 1 AND 2 AB $ 280.00 50393909 HC EVPCR ENTEROVIRUS PCR AMP CSF $ 504.00 50393917 HC AROM PAMG1 QL CERVICOVAG AROM $ 408.00 50393925 HC MALSC ANTG IMM DIR OPT OBS NOS $ 132.00 50393933 HC HEMATOCRIT MANUAL $ 55.00 50400100 HC ACETONE SEMIQUANT $ 243.00 50400258 HC ALBUMIN $ 138.00 50400266 HC ALBUMIN BODY FLUID $ 126.00 50400365 HC IRON OD SCREEN $ 165.00 50400407 HC ALK PHOS TOTAL $ 155.00 50400605 HC AMYLASE TEST $ 395.00 50400621 HC BETA HCG-TUMOR MRKR $ 335.00 50400654 HC BILIRUBIN DIRECT $ 165.00 50400704 HC BILIRUBIN TOTAL $ 150.00 50400753 HC BLD AMMONIA TEST $ 334.00 50400902 HC CALCIUM TOTAL $ 143.00 50400969 HC CALCIUM QUANT. URINE $ 149.00 50400985 HC CALCIUM IONIZED $ 399.00 50401157 HC CHOLESTEROL $ 145.00 50401173 HC CHOLESTEROL SERUM/BLOOD TOTAL $ 145.00 50401181 HC HDL CHOLESTEROL $ 192.00 50401207 HC CHLORIDE SERUM/PLA $ 129.00 50401223 HC CHLORIDE BODY FLUID $ 199.00 50401249 HC CHLORIDE URINE $ 131.00 50401504 HC CPK TOTAL $ 254.00 50401546 HC CK-MB $ 446.00 50401553 HC CREATININE BLOOD $ 179.00 50401579 HC CREATININE CLEARANCE TEST $ 256.00 50401603 HC CARBON DIOXIDE $ 95.00 50401629 HC ELECTROLYTE PANEL $ 342.00 50401637 HC URINE LYTES SODIUM $ 134.00 50401645 HC MEDICAL EMER SODIUM $ 219.00 50401850 HC GAMMA GLUTAMYL TRAN $ 204.00 50401884 HC GLUCOSE SERUM/PLASMA $ 159.00 50402304 HC IRON TTL SERUM $ 165.00 50402403 HC LIPID PANEL - CALCULATED LD $ 415.00 50402551 HC LDH TOTAL $ 193.00 50402569 HC LDH FLUID $ 193.00 50402858 HC LITHIUM QAN $ 188.00 50402908 HC MAGNESIUM SERUM/PL $ 280.00

50403005 HC PH BY METER $ 50.00 50403104 HC PHOSPHORUS SERUM/ $ 225.00 50403120 HC PHOSPHORUS URINE $ 115.00 50403153 HC POTASSIUM $ 204.00 50403161 HC POTASSIUM $ 550.00 50403187 HC POTASSIUM URINE $ 158.00 50403252 HC PROT ELECTRO SERUM $ 180.00 50403351 HC PROTN TOTAL CSF $ 229.00 50403369 HC PROTN TOTL BDY FLUD $ 229.00 50403401 HC PROTEIN TOTAL SERUM/PLASMA $ 75.00 50403419 HC PROT TOTAL URINE $ 103.00 50403450 HC SGOT/AST $ 180.00 50403500 HC SGPT/ALT $ 190.00 50403559 HC SODIUM $ 219.00 50403567 HC SODIUM FLUID $ 55.00 50403583 HC SODIUM URINE $ 134.00 50403690 HC TRANSFERRIN $ 420.00 50403708 HC TRIGLYCERIDES-BLOOD $ 175.00 50403716 HC TRIGLYCERIDES FLUID $ 175.00 50403757 HC UREA NITROGEN $ 157.00 50403781 HC UREA NITROGEN URINE $ 93.00 50403807 HC URIC ACID SERUM/PL $ 135.00 50404094 HC BMT PANEL I SODIUM $ 219.00 50404110 HC BMT II PNL SODIUM $ 219.00 50404524 HC MYOGLOBIN $ 265.00 50404565 HC ADDL KIDNEY PNL CO2 $ 95.00 50405240 HC MAGNESIUM FOR CUSTOM PA $ 280.00 50405257 HC URIC ACID FOR CUSTOM PA $ 135.00 50405265 HC PHOSPHORUS FRO CUSTOM PNL $ 225.00 50405273 HC ALT FOR CUSTOM PNL $ 190.00 50405281 HC CHOL FOR CUSTOM PNL $ 145.00 50405299 HC LDH FOR CUSTOM PNL $ 193.00 50405307 HC POTASSIUM FOR CUSTOM PA $ 204.00 50405315 HC GLUCOSE FOR CUSTOM PNL $ 159.00 50405323 HC CREATININE FOR CUSTOM PNL $ 179.00 50405331 HC T BILI FOR CUSTOM PANEL $ 150.00 50405349 HC ALK PHOS FOR CUSTOM PNL $ 155.00 50405356 HC AST FOR CUSTOM PNL $ 180.00 50405364 HC ALBUMIN FOR CUSTOM PNL $ 138.00 50405372 HC CHLORIDE FOR CUSTOM PNL $ 129.00 50405398 HC C02 FOR CUSTOM PNL $ 95.00 50405653 HC FK506:TACROLIMUS $ 345.00 50405661 HC GLYCOLATED HEMOGLOBIN $ 145.00 50411008 HC SODIUM ARTERIAL LYTES $ 219.00 50411016 HC CHLORIDE CUSTOM BLOOD $ 129.00 50411024 HC POTASSIUM CUSTOM $ 204.00 50411032 HC CALCIUM IONIZED $ 399.00 50411040 HC HDL CHOLESTEROL $ 192.00 50411057 HC CHOLESTEROL TOTAL $ 145.00 50411065 HC CO2 - KIDNEY PANEL $ 95.00 50411073 HC MAGNESIUM CUSTOM $ 280.00 50411081 HC URIC ACID CUSTOM BLOOD $ 135.00 50411099 HC PHOSPORUS CUSTOM $ 225.00

50411107 HC ALT CUSTOM $ 190.00 50411115 HC CHOLESTEROL CUSTOM $ 145.00 50411123 HC LDH CUSTOM $ 193.00 50411131 HC BMT II SODIUM $ 219.00 50411149 HC BMT II POTASSIUM $ 204.00 50411156 HC BMT II GLUCOSE BLOOD QUANT $ 159.00 50411164 HC BMT II CREATININE BLOOD $ 179.00 50411172 HC BMT II CO2 $ 95.00 50411180 HC BMT I SODIUM $ 219.00 50411198 HC BMT I MAGNESIUM $ 280.00 50411206 HC BMT I POTASSIUM $ 204.00 50411214 HC BMT I AST $ 180.00 50411222 HC BMT I ALT $ 190.00 50411230 HC BMT I ALBUMIN $ 138.00 50411248 HC BMT I GLUCOSE BLOOD QUANT $ 159.00 50411255 HC BMT I CREATININE BLOOD $ 179.00 50411263 HC BMT I TOTAL BILI $ 150.00 50411271 HC BMT I ALK PHOS $ 155.00 50411289 HC MED EMERG SODIUM $ 219.00 50411297 HC MED EMERG POTASSIUM $ 204.00 50411305 HC MED EMERG GLUCOSE BLD QUANT $ 159.00 50411313 HC MED EMERG CHLORIDE BLOOD $ 129.00 50411321 HC MED EMERG CALCIUM IO $ 399.00 50411339 HC MED EMERG HCT $ 217.00 50450014 HC METABOLIC PANEL-BASIC W/CAI $ 487.00 50460054 HC ACETAMINOPHEN LVL $ 432.00 50460104 HC CARBAMAZEPINE TOTAL $ 352.00 50460237 HC BLOOD GASES $ 1,161.00 50460302 HC DIGOXIN LEVEL $ 389.00 50460708 HC LIDOCAINE LEVEL $ 264.00 50460906 HC PHENOBARITAL LEVEL $ 223.00 50461003 HC PHENYTOIN LEVEL $ 346.00 50461706 HC SALICYLATES LEVEL $ 264.00 50462050 HC VALPROATE LEVEL $ 391.00 50462100 HC AMYLASE BODY FLUID $ 395.00 50462126 HC AMYLASE URINE $ 395.00 50462159 HC CREATININE BDY FL $ 174.00 50462175 HC CREATININE URINE $ 174.00 50462209 HC FCO2 CO2 BICARB FLUID $ 95.00 50462258 HC GLUCOSE SERUM/PLASMA $ 159.00 50462266 HC GLUCOSE SPINAL FLD $ 250.00 50462274 HC GLUCOSE BODY FLUID $ 250.00 50462290 HC GLUCOSE URINE $ 250.00 50462324 HC URIC ACID URINE $ 89.00 50462571 HC LACTATE $ 330.00 50462605 HC AMIKACIN $ 191.00 50462621 HC GENTAMICIN $ 319.00 50462647 HC TOBRAMYCIN $ 314.00 50462662 HC VANCOMYCIN $ 263.00 50462829 HC VENOUS BLOOD GASES $ 1,161.00 50462878 HC HOMOCYSTINE $ 399.00 50463082 HC SODIUM ARTERIAL LYTES $ 219.00 50463413 HC I/IP PTH EACH SPECIMEN $ 786.00

50463421 HC TROPONIN T $ 520.00 50463439 HC HEPATIC FXN PANEL $ 342.00 50463447 HC METABOLIC PNL BASIC $ 350.00 50463454 HC METABOLIC PNL COMP $ 435.00 50463488 HC C REACTIVE PROTEIN $ 179.00 50463496 HC HAPTOGLOBIN $ 258.00 50463579 HC ANTI-NUC AB (FANA) $ 261.00 50463587 HC RHEUMATIOD FACTOR SERUM $ 129.00 50463660 HC CYCLOSPORINE WHOLE BLOOD $ 437.00 50463678 HC METHOTREXATE $ 291.00 50464528 HC LP(A) $ 194.00 50464551 HC LIPID (LPD) $ 415.00 50464569 HC LDLD - DIRECT LDL CHOLESTEROL $ 219.00 50464577 HC HIGH SENSITIVE CRP $ 190.00 50464585 HC SERUM PROTEIN IMMUNOFIX ELECT $ 497.00 50464601 HC LIPASE $ 213.00 50464619 HC SWEAT CHLORIDES $ 403.00 50464627 HC FETAL LUNG MATURITY $ 106.00 50464635 HC SCREEN: AMPHETAMINES $ 250.00 50464643 HC SCREEN: BARBITURATES $ 250.00 50464650 HC SCREEN: BENZODIAZEPINES $ 250.00 50464668 HC SCREEN: COCAINE $ 250.00 50464676 HC SCREEN: METHADONE $ 250.00 50464684 HC SCREEN: OPIATES $ 250.00 50464692 HC SCREEN: PCP $ 250.00 50464700 HC SCREEN: THC $ 250.00 50464718 HC SCREEN: TRICYCLICS $ 250.00 50464726 HC GLUCOSE,GDM(50G GLU) $ 298.00 50464734 HC HC GLUCOSE TOLER(75G GLU) $ 298.00 50464767 HC ALCOHOL $ 399.00 50464783 HC LIPID(LPDPC) $ 415.00 50464791 HC THEOPHYLLINE $ 275.00 50464809 HC URINE MAGNESIUM $ 280.00 50464817 HC RENAL FUNCTION PANEL $ 170.00 50464841 HC METHGB(METHHEMOGLOB) $ 81.00 50464965 HC OSMOLALITY SERUM $ 209.00 50464973 HC OSMOLALITY, URINE $ 255.00 50465004 HC NT-PROBNP $ 821.00 50465079 HC SIROLIMUS $ 293.00 50465111 HC CORD BLOOD GASES $ 815.00 50465129 HC CIRCUIT BLOOD GASES $ 1,161.00 50465137 HC CAPILLARY BLOOD GASES $ 1,161.00 50465160 HC HEPAT BS ATGN- EIA $ 220.00 50465186 HC HEPAT C AB $ 193.00 50465244 HC LP-PLA2 $ 117.00 50465251 HC FETAL SCALP PH $ 63.00 50465269 HC AMMONIA PLASMA $ 334.00 50470046 HC CREATININE KINASE $ 254.00 50470061 HC CARBON DIOXIDE $ 95.00 50470079 HC PROTEIN TOTAL $ 75.00 50470087 HC PROCAINAMIDE $ 186.00 50470095 HC PROCAINAMIDE PLUS NAPA $ 186.00 50470111 HC PALB PREALBUMIN $ 246.00

50470129 HC OD450 DELTA BDY FLUID AMNIOTIC $ 121.00 50470137 HC GDMTOL GTT 1 TO 3 SPEC $ 789.00 50470145 HC LACWB LACTATE $ 330.00 50470152 HC BHB BETAHDRXYBTRATE KETONE QNT $ 175.00 50470160 HC SPLAC LACTATE SEPSIS PROTCL $ 330.00 50470178 HC OGTT GLUCOSE POST DOSE $ 298.00 50470186 HC ICTO TEST $ 115.00 50470194 HC CORTISOL TOTAL $ 374.00 50470202 HC CORTISOL TOTAL $ 374.00 50500107 HC PROTHROMBIN TIME $ 190.00 50500206 HC THROMPLAS PTT $ 240.00 50500305 HC FIBRINOGEN SEMIQUAN $ 285.00 50500404 HC THROMBIN TIME $ 167.00 50500503 HC REPTILASE TIME $ 203.00 50501840 HC 5 MIN PT + BUFFER INHITR $ 62.00 50501857 HC 5 MIN PT + NORM PRO $ 62.00 50501865 HC 5 MIN NORM+BUFFER $ 62.00 50501964 HC 1 HR NORM + BUFFER PTT $ 92.00 50502202 HC HEPARIN CONCENTRATION $ 466.00 50502574 HC POC-PROTHROMBIN TIME $ 190.00 50502905 HC PLATELET FUNCTION SCRN ADP $ 469.00 50502913 HC PLATELET FUNCTION SCRN EPINEPH $ 469.00 50502954 HC D-DIMER ELISA QUANT $ 438.00 50503333 HC FIBRIN DEGRADATION PROD $ 107.00 50503341 HC PLT AGG-ARACH ACID $ 469.00 50503366 HC D DIMER LIA $ 438.00 50503416 HC PROTEIN C ACT (LILIY) $ 362.00 50570019 HC PROTHROMBIN TIME $ 190.00 50570027 HC THROMPLAS PTT $ 240.00 50570043 HC PROCALCITONIN $ 318.00 50570050 HC ANTIXA LMW HEPARIN ACT $ 466.00 50570068 HC PTEG CLOT ASS I&R PER DAY $ 747.00 50570076 HC RIVAROXOBAN PLASMA LVL $ 291.00 50570084 HC QUANT ASSAY DRUG $ 291.00 50641729 HC CHRM ISH MAR 3-5 CELL $ 295.00 50641752 HC CHRM ISH VCF 10-30 CELL $ 353.00 50641760 HC CHRM ISH PWS 10-30 CELL $ 353.00 50641778 HC CHRM ISH ANG 10-30 CELL $ 353.00 50641786 HC CHRM ISH WMS 10-30 CELL $ 353.00 50641794 HC CHRM ISH SMS 10-30 CELL $ 353.00 50641802 HC CHRM ISH NOS 10-30 CELL $ 353.00 50641810 HC INTPH ISH BCR 100-300 CELL $ 441.00 50641828 HC INTPH ISH PML 100-300 CELL $ 441.00 50641836 HC INTPH ISH TEL 100-300 CELL $ 441.00 50641844 HC INTPH ISH MLL 100-300 CELL $ 441.00 50641851 HC INTPH ISH NOS 100-300 CELL $ 441.00 50641869 HC INTPH ISH ENUM 100-300 CELL $ 441.00 50641877 HC INTPH ISH PNTL 100-300 CELL $ 441.00 50641893 HC PROBE MOL CYTOG EA $ 426.00 50641935 HC TIS CULT ROUT BLD NONNEO $ 1,000.00 50641943 HC TIS CULT HRES BLD NONNEO $ 1,000.00 50641950 HC TIS CULT FANC BLD NONNEO $ 1,000.00 50641968 HC TIS CULT ATAX BLD NONNEO $ 1,000.00

50641984 HC TIS CULT SKIN/TISS KAR $ 1,542.00 50641992 HC TIS CULT SKIN/TISS REF $ 1,542.00 50642016 HC TIS CULT AMNIO FLD $ 1,613.00 50642032 HC TIS CULT BONE MRW NEO $ 1,385.00 50642040 HC TIS CULT BLOOD NEO $ 1,385.00 50642065 HC TIS CULT TUMOR NEO $ 1,616.00 50642081 HC CRYOPRES FRZ/STORE EA LINE $ 195.00 50642099 HC CRYOPRES THAW EA LINE $ 35.00 50642107 HC CHRM ANAL BASE BREAK 50-100 CE $ 1,898.00 50642115 HC CHRM ANAL CLAST BRK 100 C $ 1,898.00 50642123 HC CHRM ANAL 15-20 CELLS 2KAR $ 1,000.00 50642149 HC CHRM ANAL 20-25 CELLS $ 1,365.00 50642156 HC CHRM ANAL AF 15 CELLS 1KAR $ 1,970.00 50642164 HC CHRM ANAL ADD KARYOTYPE $ 295.00 50642172 HC CHRM ANAL ADD STAIN $ 236.00 50642206 HC CHRM ANAL ADD CELLS $ 66.00 50642214 HC CHRM ANAL ADD HIGH RES $ 153.00 50642222 HC CYTOG AND MOLEC REPORT AND INT $ 79.00 50642230 HC CHRM ISH SUBTELOMERE 3-5 CELLS $ 295.00 50642248 HC INTPH ISH UROVY 25-99 CELL $ 383.00 50642289 HC TIS CULT CVS $ 1,613.00 50642347 HC INTPH ISH EWS 100-300 CELL $ 441.00 50642354 HC INTPH ISH MALT 100-300 CELL $ 441.00 50642362 HC INTPH ISH BCL6 100-300 CELL $ 441.00 50642370 HC INTPH ISH BCL2 100-300 CELL $ 441.00 50642388 HC INTPH ISH CMYC 100-300 CELL $ 441.00 50642396 HC INTPH ISH CCND1 100-300 CELL $ 441.00 50642404 HC FISH INTRPH ALK $ 441.00 50672468 HC FISH,CLL $ 441.00 50672476 HC INTPH ISH SYT 100-300 CELL $ 441.00 50672484 HC INTPH ISH CBFB 100-300 CELL $ 441.00 50672492 HC INTPH ISH ETO 100-300 CELL $ 441.00 50672500 HC INTPH ISH 5Q 100-300 CELL $ 441.00 50672518 HC INTPH ISH 7QS 100-300 CELL $ 441.00 50672526 HC FISH INTRPH DEL 13Q $ 441.00 50672542 HC ISH ADD MRPHMET MAN $ 1,383.00 50672559 HC ISH HER2 MRPHMET MAN $ 1,383.00 50672567 HC ISG EWS MRPHMET MAN $ 1,383.00 50672575 HC ISH SYT MRPHMET MAN $ 1,383.00 50672583 HC ISH FKHD MRPHMET MAN $ 1,383.00 50672591 HC ISH CMYC MRPHMET MAN $ 1,383.00 50672609 HC ISH MALT MRPHMET MAN $ 1,383.00 50672617 HC ISH ALK MRPHMET MAN $ 1,383.00 50672625 HC ISH GLIOMA MRPHMET MAN $ 1,383.00 50672633 HC ISH NOS MRPHMET MAN $ 1,383.00 50672641 HC CHRM ISH WCP 3-5 CELL $ 294.00 50672658 HC CHRM ISH MDK 10-30 CELL $ 353.00 50672674 HC INTPH ISH CHIC2 100-300 CELL $ 441.00 50672682 HC INTPH ISH 20Q 100-300 CELL $ 441.00 50672690 HC INTPH ISH TELBAP 100-300 CELL $ 441.00 50672716 HC INTPH ISH FGFR3 100-300 CELL $ 441.00 50672724 HC INTPH ISH MAF 100-300 CELL $ 441.00 50672732 HC CGHGEN CYTOGEN NA ISOL EA NA $ 123.00

50672740 HC CYTOGEN ENZYM DIGEST EA $ 89.00 50672757 HC ACGH GEN 251-500 PROBES $ 1,462.00 50672765 HC ACGH ADD 251-500 PROBES $ 1,462.00 50672773 HC INTPH ISH ENUM 100-300 CELL $ 441.00 50672781 HC INTPH ISH ENUM 100-300 CELL $ 441.00 50672799 HC INTPH ISH MDS 100-300 CELL $ 441.00 50672807 HC ISH BCL2 MRPHMET MAN EA $ 1,383.00 50672815 HC ISH BCL6 MRPHMET MAN EA $ 1,383.00 50672823 HC ISH TFE3 MRPHMET MAN EA $ 1,383.00 50672831 HC ISH MDM2 MRPHMET MAN EA PRB $ 1,383.00 50672849 HC ISH ROS1 MRPHMET MAN EA PRB $ 1,383.00 50672856 HC ISH EGFR MRPHMET MAN EA PRB $ 1,383.00 50672864 HC ACGH CYTOGEN MICRAR COPY NO $ 6,149.00 50672955 HC ISH FUS MORPHMET MAN EA $ 1,383.00 50672963 HC ISH CCND1 MRPHMET MAN EA $ 1,383.00 50672971 HC ISH MYC MRPHMET MAN EA $ 1,383.00 50672989 HC MYB GENE REARRANGEMENT $ 1,383.00 50672997 HC INTPH ISH 1Q1P 100-300 CELL $ 441.00 50673003 HC INTPH ISH FGFR1 100-300 CELL $ 441.00 50673011 HC INTPH ISH IGH 100-300 CELL $ 441.00 50710011 HC 100 RNP (ENA) ANTIBODY $ 16.50 50710029 HC 100 SMITH (ENA) ANTIBODY $ 16.50 50710037 HC 100 SSA (ENA) ANTIBODY $ 11.89 50710045 HC 100 SSB (ENA) ANTIBODY $ 11.89 50711175 HC 092 12869R B QUINTANA IGM $ 14.06 50711183 HC 092 12868R B HENSELAE IGM $ 14.06 50711191 HC 114 12804R KIT MUT EXON 17 $ 765.50 50711209 HC 114 13020R SLIDE REVIEW $ 73.22 50711217 HC 097 17-HYDROPROGES NEO/INFANT $ 112.00 50711225 HC 114 13024R KIT MUT EXON 13 $ 765.50 50711233 HC 100 13032R LACTO FECAL ELISA $ 38.00 50711241 HC 097 CGD ENZ ACT NONRAD EA $ 140.76 50711258 HC 427 12858R DNR HBV PROBE $ 105.33 50711266 HC 427 12858R DNR HCV PROB $ 105.33 50721034 HC 100 17OHPR 17OH PROGESTERONE $ 25.73 50721083 HC 100 DHEAS DHEA SULFATE $ 16.00 50721117 HC 100 ALPHA 1 ANTITRYPSIN $ 12.38 50721216 HC 100 CATHECHOLAMINES, URINE FR $ 30.87 50721232 HC 100 FLECAINIDE $ 26.00 50721281 HC 100 170H CORTICOSTEROID-URIN $ 36.04 50721380 HC 100 PYRUVIC ACID $ 20.50 50721505 HC 114 TESTOSTERONE FREE RIA $ 10.61 50721547 HC 100 C-1 ESTERASE INHIBITOR $ 18.80 50722198 HC 100 RUSSEL VIPER VENOM $ 10.80 50722230 HC 100 ANCA, IGG $ 27.56 50722255 HC 100 SCL-70 (SCLERODERMA) $ 13.75 50722263 HC 100 URINE VMA PANEL $ 10.84 50722370 HC 100 T3, FREE $ 6.19 50722396 HC 100 ISLET CELL AB, IGG $ 29.58 50722412 HC 100 VIT. E,SERUM OR PL $ 13.74 50722461 HC 100 PROTEIN C, TOTAL $ 12.53 50722594 HC 100 HISTAMINE, URINE $ 34.00 50722651 HC 100 ALBUMIN, CSF $ 8.17

50722677 HC 100 CLOMIPRAMINE & META $ 12.00 50722693 HC 114 DRUG ABUSE CONF-THC $ 1.50 50722842 HC ACE, CSF $ 23.81 50722867 HC 100 PORPHOBILINOGEN, UR QUANT $ 41.20 50722883 HC 100 COPPER, URINE $ 8.75 50722966 HC 100 LAMOTRIGINE $ 17.31 50722990 HC 097 STONE FORMATION $ 238.50 50723014 HC 100 C-1 ESTERASE INHIB, FUNCT $ 36.40 50723030 HC 100 PROTEIN S, TOTAL $ 12.53 50723220 HC 100 FIBRINOGEN ANTIGEN $ 52.00 50723295 HC 100 SELENIUM,SERUM OR $ 10.50 50723303 HC 100 NEURON SPECIFIC ENOLASE $ 38.59 50723378 HC 100 11060R THIAMINE VIT B1 $ 21.00 50723451 HC 100 CAROTENE, SERUM TOT $ 11.40 50723733 HC 100 BICRABONATE(HC03), URINE $ 9.20 50723766 HC 100 ADRENAL ANTIBODY QUANT $ 61.20 50723774 HC 100 THYROID BINDING INH $ 239.00 50723816 HC 100 HISTONE AB, IGG $ 22.50 50723832 HC 100 17-KETOSTEROIDS, TOTAL $ 27.23 50723881 HC 100 CIQ BINDING ASSAY $ 24.00 50724574 HC 100 IMMUNOFIXATION, IGD & IGE $ 151.20 50724665 HC 100 RABIES AB TITER $ 57.04 50724707 HC 100 ANTI NEURONAL CELL, SERUM $ 73.05 50725043 HC 100 BETA-2MICROGLOBULIN, URIN $ 16.00 50725134 HC 100 BILE ACIDS, TOTAL $ 11.06 50725175 HC 100 LGD, SERUM $ 24.80 50725209 HC 100 INSULIN, AB, HUMAN $ 29.74 50725217 HC 100 HEMOGLOBIN, SERUM $ 20.40 50725225 HC 100 HEMOGLOBIN, URINE $ 20.40 50725274 HC 100 CADMIUM, URINE $ 12.50 50725290 HC 100 CANDIDA AB (ID) $ 13.28 50725316 HC 100 C-ERB B-2,SERUM (HER 2 NE $ 165.00 50725373 HC 100 DOXEPIN & METABLITE $ 22.50 50725472 HC 100 MANGANESE, BLOOD $ 20.00 50725605 HC 100 INTERLEUKIN 6 $ 90.04 50725688 HC 100 TRAZODONE $ 26.00 50725704 HC 100 TRYPSINOGEN, SERUM $ 16.97 50725712 HC 100 VITAMIN B1, WHOLE BLOOD $ 19.80 50725720 HC 100 VMA, URINE $ 24.40 50726462 HC 097 DONOR HIV1/HCV BY AMP PROB $ 410.00 50726470 HC 114 AB ENA EVAL $ 3.92 50727007 HC 097 HTLVS 1 $ 15.36 50727015 HC 097 HTLVS 2 $ 25.64 50730050 HC REFERENCE LAB PROC FEE $ 39.00 50730266 HC 092 HEPATITIS BE AB $ 20.00 50730274 HC 092 HEPATITIS BE ANTGEN $ 18.00 50730282 HC 092 DELTA HEPAT AGENT $ 61.55 50730290 HC 092 AB SEROLOGY 2 $ 122.25 50730308 HC 092 Q FEVER ANTIBODY $ 15.75 50730324 HC 092 HIV P24 $ 150.00 50730332 HC 092 ARBOVIRUS TITER $ 474.40 50730340 HC 092 WEST BLOT CONFM SEN $ 102.00 50730357 HC 092 FPOLIO POLIOVIRUS AB $ 26.00

50730373 HC 097 HUM PAPILM VIS SCRN $ 54.00 50730381 HC 092 COXSACKIE AB PANEL $ 16.51 50730399 HC 092 ENTEROVIRUS AB PANL $ 19.46 50730407 HC 092 ADENOVIRUS AG BY EIA $ 52.00 50730415 HC 088 COCCI CF SERUM $ 40.00 50730423 HC 088 COCCIDIODOMYCOSIS $ 40.00 50730431 HC 092 HTLV 1/2 ANT WEST B $ 112.03 50730449 HC 092 HTLV 1 AB DIFFENT $ 88.80 50730456 HC 092 VIROLAB 2ND PCR $ 80.00 50730464 HC 427 HTLV 1/2 AB $ 27.00 50730472 HC 092 HTLV 2 AB DIFFENT $ 88.80 50730498 HC 092 COCCIIMMUNODIFFUSION $ 22.91 50730506 HC 092 HIV DNA PCR $ 126.88 50730514 HC 092 CHLAMYDIA TRACHOMATIS CU $ 57.68 50730530 HC 092 HHV-6 DNA PCR $ 106.58 50730548 HC 092 PARVOVIR (B19) PCR $ 126.88 50730555 HC 092 VZ DNA PCR $ 147.18 50730563 HC 092 JC VIRUS DNA PCR $ 147.18 50730571 HC 092 BK VIRUS DNA PCR $ 147.18 50730589 HC 092 EBV EARLY AB (D&R) $ 52.50 50730597 HC 092 EB VCA IGG $ 52.50 50730605 HC 092 EB VCA IGM $ 23.75 50730613 HC 092 EB EBNA $ 52.50 50730621 HC 092 EB VCA IGA $ 51.37 50730639 HC 430 PHENOSENSE HIV COMP $ 855.39 50730647 HC 431 HSV WESTERN BLOT $ 156.25 50730654 HC 092 BK VIRUS DNA QUANT $ 150.00 50730662 HC 092 QUANT LAL ASSAY $ 79.20 50730670 HC 092 MYCOPLASMA PCR $ 231.20 50730688 HC 084 TOXO IGA ELISA $ 126.00 50730696 HC 097 CHLAMYDIA/GC GENPROBE $ 36.30 50730704 HC 092 HIV-1 DIRECT AG $ 110.25 50730720 HC 092 HSV-1 IGM AB IFA $ 19.58 50730738 HC 092 HSV-2 IGM AB IFA $ 28.73 50730746 HC 432 HPV DNA PROBE HIGH RISK $ 42.00 50730753 HC 108 HIV BY BDNA $ 109.75 50730779 HC 092 BARTPC BRTNL HNSL&QNTN APT $ 223.50 50730787 HC 092 EB VCA IGG $ 32.00 50730795 HC 092 EB VCAM IGM $ 47.00 50730803 HC 092 EPSTEIN BARR EA $ 48.00 50730811 HC 092 NOROVIRUS-STOOL $ 98.00 50730845 HC 092 HS AB NON SPEC TYPE $ 32.08 50730852 HC 092 HS AB TYPE 1 $ 29.39 50730860 HC 092 HS AB TYPE 2 $ 43.12 50730894 HC 092 HISTOPLASMOSIS CF $ 32.61 50730902 HC 092 ASPERGILLUS-CF $ 33.54 50730910 HC 092 ASPGLUS IMMUNODIFSN $ 34.61 50730928 HC 092 BLASTOMYCOSIS $ 48.00 50730936 HC 092 CANDIDA PRECIPITANS $ 44.25 50730944 HC 092 CYSTICERCOSIS CSF $ 85.50 50730951 HC 092 CYSTICERCOSIS SERUM $ 83.25 50730969 HC 411 CYSTICERCOSIS WEST BLOT $ 90.00 50730985 HC 433 ECHINOCOCCOSIS $ 127.50

50730993 HC 092 FASCIOLIASIS $ 65.00 50731009 HC 092 FILARIASIS $ 157.00 50731017 HC 412 ANTIFUNGAL LEVEL $ 65.00 50731025 HC 092 LEGIONELLA AG URINE $ 45.22 50731033 HC 092 LEISHMANIASIS $ 10.03 50731041 HC 092 MALARIA $ 145.00 50731058 HC 092 PARAGONIMIASIS $ 75.00 50731066 HC 092 SCHISTOSOMIASIS $ 76.73 50731074 HC 092 FLURSC TREPONML AB $ 25.96 50731082 HC 092 STRONGYLOIDIASIS $ 65.54 50731108 HC 084 TOXO DYE TEST IGG $ 114.00 50731116 HC 084 TOXO IGM ELISA $ 121.00 50731124 HC 092 TRICHINOSIS $ 52.22 50731132 HC 092 TOXOCARIASIS $ 91.50 50731140 HC 092 YERSINIOSIS $ 88.00 50731157 HC 092 PNEUMOCOCCAL TITER $ 11.14 50731173 HC 092 HUMORAL IMMUN PANEL $ 375.20 50731231 HC 092 LEGIONELLA SEROTYP $ 149.60 50731264 HC 092 LYME AB IGM WB CONF $ 31.97 50731272 HC 092 LYME CSF WESTERN BLOT $ 81.00 50731280 HC 092 ASO TITER $ 22.84 50731298 HC 092 BLASTOMYCOSES AB ID $ 34.40 50731306 HC 092 COCCODOPDES AB CF $ 52.80 50731314 HC 092 HISTOPLASMA AB ID $ 33.60 50731330 HC 092 BARTONELLA AB PAN $ 27.38 50731348 HC 412 11131R CHMR QNT SNG ANLY $ 120.00 50731355 HC 092 ANTI-DNASE B TITER $ 52.00 50731363 HC 092 PNEUMOVAX 1 OF 12 $ 13.33 50731371 HC 092 LYME SCREEN $ 54.56 50731389 HC 092 F TULARENSIS AB $ 100.00 50731397 HC 412 CASPOFUNGIN LVL $ 95.00 50731405 HC 092 RUBELLA IGM $ 51.75 50731413 HC 114 GLIADIN DEMIDATED IGA $ 17.50 50731421 HC 114 GLIADIN DEMIDATED AB EVAL $ 14.25 50731439 HC 092 COXSACKIE B AB $ 16.51 50731447 HC 114 COCCIDIODES AB CSF $ 17.54 50731454 HC 118 ACETYLCHOLINESTERASE $ 330.00 50731462 HC 118 AFAFPN AFP AMNIOTIC FLUID $ 63.00 50734987 HC 114 COCCIDIOIDES AB SERUM $ 2.71 50740216 HC 100 PM-1 ANTIBODY $ 72.10 50740240 HC 100 PORPHYRINS, UR FRAC $ 36.40 50740257 HC 100 PROPAFENONE BY CHRO $ 39.20 50740265 HC 100 PSEUDOCHOLINESTRASE $ 12.80 50740273 HC 100 REDUCING SUBSTANCES $ 10.00 50740604 HC 100 CARDIOLIPIN AB, IGA $ 25.50 50740612 HC 100 CORTISOL, SERUM FREE $ 100.00 50740695 HC 100 GBM AB BY IFA-IGG $ 64.00 50740703 HC 100 GBM AB PNL BY IFA-IGA $ 56.25 50740711 HC 100 GBM AB PNL BY IFA-IGA $ 56.25 50740729 HC 100 HEPARIN CO-FACTOR $ 187.00 50740778 HC 100 ANCA MPO $ 19.20 50741248 HC 100 OKT3 AB $ 222.70 50741255 HC 100 OVARIAN AB $ 137.83

50741271 HC 100 PURKINJE CELL CYTOPLASMIC $ 22.00 50741339 HC 100 PROTEIN C, TOTAL $ 20.36 50741545 HC 100 C1 ESTERASE INHIB $ 6.72 50741586 HC 100 DIPTHERIA AB IGG $ 30.00 50741602 HC 100 ETHOSUXIMIDE $ 16.00 50741636 HC 100 ADENOSINE DEAMINASE, FLD $ 40.00 50741651 HC 100 FLUOXETINE/NORFLUOX $ 22.80 50742006 HC 100 PORPHYRINS-FECAL $ 168.00 50742014 HC 100 PORPHYRINS-SERUM TOTAL $ 25.60 50742154 HC 100 ACETYLCHOLINE BLO AB $ 48.00 50742261 HC 100 ASPERGILLUS AB CF $ 12.66 50742279 HC 100 ASPERGILLUS AB ID $ 12.54 50742287 HC 100 GBM AB BY IFA-IGA $ 67.50 50742378 HC 100 PBG DEAMINASE $ 71.20 50742428 HC 150 PROTHROMBIN FRAGMNT $ 120.00 50742964 HC 422 LDLGGE HRF&QNT LIP LIPSUB $ 45.08 50743095 HC 114 ARLY SULFATASE $ 86.26 50743103 HC 481 ANTI-68 (HSP70) AB $ 165.00 50743137 HC 100 VITAMIN A SERUM/PLA $ 15.66 50743186 HC 410 DYSTONIA $ 295.00 50743236 HC 100 LIVER-KIDNEY-MICRO $ 19.30 50743574 HC 100 ACETYLCHOLINE MOD AB $ 84.80 50744051 HC 420 SENSORY NEURO PROFI $ 103.27 50746833 HC 100 IGM, CSF $ 8.82 50747450 HC 200 HEMOGLOBIN F $ 78.26 50747468 HC 200 HEMOGLOBIN A2 $ 131.19 50747633 HC 100 ANTI NEURONAL NUC AB,CST $ 95.00 50747807 HC 095 BETA-2-GLYCOPROTEIN $ 40.00 50747864 HC 092 NATURAL KILLER CELLS ENUM $ 88.50 50747872 HC 092 NATURAL KILLER CELLS ENUM $ 43.00 50748201 HC 126 AFP,AMNIOTIC FLUID $ 38.00 50748581 HC 092 LYMPH. MITOGEN SCREEN, TR $ 89.33 50748623 HC 100 ALKALINE PHOSPHATASE $ 4.41 50748698 HC 114 PHENYTOIN TOTAL $ 11.82 50749035 HC 095 PAI-1 ACTIVITY $ 135.00 50749043 HC 095 PAI -1 ACTIGEN $ 148.50 50749050 HC 095 TPA ACTIVITY $ 165.00 50749068 HC 095 TPA ACTIGEN $ 135.00 50749472 HC ADMARK APO GENOTYPE SEP $ 95.16 50749530 HC 114 CLOZAPINE SERUM $ 11.77 50749555 HC 97 DONOR CHAGAS SCN W/REFL $ 71.25 50749571 HC 427 DONOR RPR $ 30.00 50750553 HC 100 INHIBIN B (INH B) $ 188.00 50750801 HC 114 17-HYDROXYPREGNENOLONE $ 110.50 50750819 HC 114 17-HYDROXYPROGESTERONE $ 20.50 50750827 HC 114 5-HIAA, URINE $ 12.97 50750843 HC 114 ACETYLCHOLINE BINDING AB $ 50.90 50750850 HC 114 ACTH $ 11.00 50750868 HC 114 ALDOLASE $ 9.00 50750876 HC 114 ALDOSTERONE, SERUM $ 32.55 50750884 HC 114 AMITRIPTYLINE/NORTRIPTYLI $ 12.53 50750900 HC 114 ANDROSTENEDIONE $ 37.40 50750918 HC 114 ANGIOTENSIN CONVERTING EN $ 14.66

50750926 HC 114 CAFFEINE $ 20.06 50750934 HC 114 CALCITONIN $ 43.56 50750942 HC 114 CANCER ANTIGEN-BREAST (CA $ 18.50 50750959 HC 114 CANCER ANTIGEN-GI(CA 19-9 $ 14.92 50750967 HC 114 CATECHOLAMINES, URINE (FR $ 22.83 50750983 HC 114 CITRIC ACID, URINE $ 23.75 50750991 HC 114 CLOZAPINE $ 23.54 50751007 HC 114 COPPER SERUM $ 24.17 50751015 HC 114 CORTISOL URINARY FREE $ 9.42 50751023 HC 114 C-PEPTIDE, SERUM $ 14.00 50751031 HC 114 DHEA, SERUM $ 22.10 50751056 HC ERYTHROPOIETIN $ 13.95 50751072 HC 114 GABAPENTIN $ 19.00 50751080 HC 114 GASTRIN $ 15.70 50751098 HC 114 GROWTH HORMONE $ 5.00 50751106 HC 114 IGF-1(INSULIN-LIKE GROWTH $ 27.85 50751114 HC 114 DESIPRAMINE $ 18.50 50751122 HC 114 IMMUNE COMPLEX PANEL $ 69.26 50751155 HC 114 11084R CHRM QNT SNGL ANLYT $ 63.59 50751163 HC 114 MARIJUANA CONF $ 12.50 50751171 HC 114 MITOCHONDRIAL M2 AB, IGG $ 13.00 50751189 HC 114 NORTRIPTYLINE $ 9.49 50751197 HC 114 N-TELOPEPTIDE, CROSS-LINK $ 46.22 50751205 HC 114 OXALATE, TOTAL, URINE $ 11.13 50751213 HC 114 PANCREATIC POLYPEPTIDE $ 89.13 50751221 HC 114 PHOSPHATIDYLSERINE ABS $ 75.15 50751247 HC 114 PROSTATIC ACID PHOSPHATAS $ 3.98 50751270 HC RENIN ACTIVITY $ 16.30 50751288 HC 114 SCLERODERMA (SCL-70)(ENA) $ 16.50 50751296 HC 114 SSA (RO) (ENA) AB IGG $ 27.00 50751304 HC 114 SSB (LA) (ENA) AB IGG $ 27.00 50751312 HC STONE ANALYSIS $ 21.42 50751320 HC 114 THYROID STIMULATING IMMUN $ 11.97 50751338 HC 114 VASOACTIVE INTESTINAL PEP $ 49.71 50751346 HC 114 VITAMIN D, 1,25-DIHYDROXY $ 43.32 50751353 HC 114 VITAMIN D,25-HYDROXY $ 31.90 50751361 HC 114 VITAMIN E, SERUM $ 25.00 50751379 HC 114 ALKALINE PHOSPHATASE ISOE $ 12.59 50751387 HC 114 ALPHA-1-ANTITRYPSIN PHENO $ 11.92 50751395 HC 114 ENDOMYSIAL AB, IGA $ 40.00 50751403 HC 114 PHENYTOIN, FREE $ 12.27 50751411 HC 114 SMOOTH MUSCLE AB, IGG $ 15.00 50751437 HC 114 ACETYLCHOLINESTERASE, RBC $ 24.90 50751445 HC 100 INSULIN, AB, HUMAN $ 14.20 50751452 HC 114 MYELOPEROXIDASE AB $ 27.90 50751460 HC 114 MYOGLOBIN, URINE $ 18.70 50751478 HC 114 MYCOPHENOLIC ACID $ 19.40 50751486 HC 114 APOLIPOPROTEIN A $ 45.29 50751494 HC 114 APOLIPRPTEIN B $ 18.05 50751692 HC 114 QUININDINE $ 41.17 50751700 HC 114 PROCAINAMIDE $ 20.00 50751718 HC 114 ALPHA-I ANTITRYPSIN, FECE $ 11.08 50751726 HC 100 ANCA INFLAMMATORY BOWEL D $ 90.00

50751759 HC 100 GAMMA HYDROXYBUTYRIC ACID $ 212.00 50751775 HC 114 NAPROXEN $ 97.00 50751783 HC 100 NIACIN $ 55.00 50751791 HC 100 OLANZAPINE $ 92.00 50751809 HC 114 PARIETAL CELL ANTIBODIES $ 23.50 50751833 HC 100 PROTOPORPHYRINS,ZINC, BLO $ 12.11 50751858 HC 114 VITAMIN B2 $ 54.85 50751866 HC 114 VITAMIN C $ 30.44 50751874 HC 400 VWF PROTEASE ACTIVITY $ 195.00 50751882 HC 095 VWF PROTEASE INHIBITOR $ 184.00 50751890 HC 100 ANNCA INDIR FLUOR AGENT AB $ 27.56 50751908 HC 100 ANCA TITER $ 53.60 50751916 HC 100 MPO AB REFLEX $ 25.50 50751924 HC 100 PR3 REFLEX $ 25.50 50751981 HC 114 CARBOHYDRATE DEFICIENT $ 43.53 50751999 HC 114 ACYLGLYCINE $ 135.01 50752005 HC 114 PURINE & PRYRMIDINIE PANEL $ 85.10 50752013 HC 114 FATTY ACID FLUX-OXIDA $ 188.83 50752021 HC 114 FATTY ACID FLUX FIBRO $ 181.21 50752104 HC 118 ENZYME CARRIER TESTING $ 91.00 50752138 HC 114 MYASTH GRA EVAL-ADULT $ 28.73 50752153 HC 114 TESTERONE, T&F, SERUM $ 10.76 50752187 HC 114 PREALBUMIN(PAB), SERUM $ 15.90 50752195 HC 114 CERULOPLASMIN, SERUM $ 10.22 50752203 HC 114 COMPLEMENT, TOTAL, SERUM $ 19.75 50752211 HC 114 GLIADIN AB, SERUM $ 14.25 50752237 HC 114 DRUG SCREEN, PLASME $ 32.98 50752245 HC 114 METANEPHRINES,FR,24H,UR $ 18.55 50752252 HC 114 VANILLYLMANDELIC(VMA),UR $ 18.05 50752260 HC 114 IGG $ 22.98 50752278 HC 114 VALPROIC ACID,T&F PLSMA $ 50.65 50752286 HC 114 BONE ALK PHOSP,SERUM $ 54.35 50752294 HC 114 HEAVY METALS SCR,BL $ 11.30 50752302 HC 114 MYELINE BSC PROT,CSF $ 25.65 50752310 HC 114 MERCURY, BLOOD $ 10.50 50752328 HC 114 CENTROMERE AB,SERUM $ 18.00 50752336 HC 114 TC(TRIIODOT),REVERSE $ 21.95 50752344 HC 114 AUTO AB TO JOL, SERUM $ 16.87 50752351 HC 114 LYSOZYME(MURA),PLASMA $ 22.50 50752369 HC 114 TRYPTASE, SERUM $ 62.60 50752377 HC 114 C1 ESTERASE INHBTR,PLSMA $ 20.29 50752450 HC 114 ALPHA-1-ANTITRYPSIN STL $ 31.46 50752468 HC 114 LAX PROF CHROM QUAL URINE $ 105.01 50752476 HC 114 LAX PROF MAG URINE $ 38.04 50752484 HC 114 LAX PROF PHOS INORG URINE $ 26.95 50752583 HC 114 LEAD, CHDP $ 6.65 50752591 HC 095 11-DEXOXYCORTISOL/SPEC C $ 43.99 50752609 HC 095 17-A-HYDROXYPROGESTERONE $ 31.85 50752617 HC 095 17-OH-PREGNENOLONE $ 34.45 50752625 HC 095 ALDOSTERONE $ 45.58 50752633 HC 095 ANDROSTENEDIONE $ 34.45 50752641 HC 095 CATECHOLAMINES,FRACT UR I $ 48.76 50752658 HC 095 CATECHOLAMINES,FRACT UR II $ 4.77

50752666 HC 095 CATECHOLAMINES,TOTAL UR I $ 24.92 50752674 HC 095 CATECHOLAMINES,TOTAL UR II $ 4.76 50752682 HC 095 CATECHOLAMINES-PLASMA $ 50.35 50752690 HC 095 DEHYDROEPINANDROSTERONE $ 41.87 50752708 HC 095 DHEA SULFATE $ 28.62 50752716 HC 095 DIHYDROTESTOSTERONE $ 38.16 50752724 HC 095 ESTERADIOL $ 44.10 50752732 HC 095 ESTROGENS TOTAL $ 29.88 50752740 HC 095 ESTRONE $ 47.70 50752757 HC 095 FOLLICLE STIM HORMONE $ 23.04 50752765 HC 095 FREE CORTISOL URINE I $ 34.66 50752773 HC 095 FREE CORTISOL URINE II $ 4.72 50752781 HC 095 TESTOSTERONE I $ 31.74 50752799 HC 095 TESTOSTERONE II $ 7.69 50752807 HC 095 FREE TESTOSTERONE III $ 20.99 50752815 HC 095 GROWTH HORMONE $ 20.67 50752823 HC 095 ICA-512 AUTOANTIBODIES $ 39.22 50752831 HC 095 IGF BINDING PROTEIN 3 $ 29.56 50752849 HC 095 IGF-I/SOMATOMEDIN-C $ 34.65 50752856 HC 095LUTEINIZING HORMONE $ 23.04 50752864 HC 095 MULLERIAN INHIBITING SUBS $ 37.10 50752872 HC 095 PROGESTERONE $ 28.62 50752880 HC 095 RENIN PLASMA $ 36.04 50752898 HC 095 RESIN T3 UPTAKE AND FTI $ 4.24 50752906 HC 095 REVERSE T3 $ 34.65 50752914 HC 095TESTOSTERONE TOTAL(500286) $ 38.71 50752922 HC 095 THYROXIN BINDING GLOBULIN $ 21.20 50752930 HC 095 VITAMIN D1,25-DIHYDROXY $ 58.83 50752948 HC 095 VITAMIN D 25-HYDROXY $ 44.59 50752955 HC 095 XGAD65 IMM ANYT QNT RIA $ 85.75 50752963 HC 107 GALACTOSE-1-PHOSPHATE $ 82.00 50752989 HC 092 LYMPHOCYTE FUNCTION I $ 76.53 50752997 HC 092 F200LYMPHOCYTE FUNCTION II $ 80.34 50753003 HC 114 AMIODARONE $ 25.60 50753029 HC 114 IBUPROFEN $ 51.40 50753037 HC 114 C4 FUNCTION $ 59.81 50753052 HC 115 CELIAC DISEASE SYS I $ 18.20 50753060 HC 115 CELIAC DISEASE SYS II $ 49.73 50753078 HC 115 CELIAC DISEASE SYS III $ 86.13 50753086 HC 115 CELIAC DISEASE SYS IV $ 18.20 50753094 HC 115 FIBROSPECT LIVERFIBRO I $ 82.50 50753102 HC 115 FIBROSPECT LIVERFIBRO II $ 97.50 50753110 HC 115 IBD DIAGNOSTIC SYS I $ 30.00 50753128 HC 115 IBD DIAGNOSTIC SYS II $ 91.87 50753144 HC 115 PRO-PREDICT ENAACT I $ 82.50 50753151 HC 115 PRO-PREDICT ENAACT II $ 82.50 50753201 HC 114 YUAMC AMPHET CONFIRM QN UR $ 22.76 50753219 HC 114 BARBITURATE CONFIRM,URINE $ 14.25 50753227 HC 114 BENZODIAZEPINE CONFIRM,URI $ 7.00 50753235 HC 114 COCAINE CONFIRM,URINE $ 15.50 50753243 HC 114 LSD CONFIRM,URINE $ 81.45 50753250 HC 114 METHADONE CONFIRM,URINE $ 74.74 50753268 HC 114 PROPOXYPHENE URINE $ 45.52

50753276 HC 114 OPIATE URINE EA $ 23.75 50753284 HC 114 PCP CONFIRM,URINE $ 15.91 50753342 HC 100 ANTI-NEUTROPHIL, AB $ 92.00 50753375 HC 100 CYCLIC CITTRUL PEP IGG $ 31.50 50753391 HC 100 F1610LIVER,KID MICROSOME-1 $ 19.30 50753417 HC 100 NEUTROPHIL OX BURST $ 75.00 50753433 HC 100 RETINOL BINDING PROT $ 20.00 50753441 HC 100 UTHI THIOCYANATE URINE $ 34.00 50753458 HC 100 TISS. TRANSGLUT, IGG $ 46.50 50753615 HC 114 NEWBORN SCREEN $ 20.00 50753631 HC 102 NBS/TANDEM MASS SPECT $ 16.00 50753649 HC 102 NBS/TRANSFERASE-SCREEN $ 15.95 50753656 HC 102 NBS/TSH $ 15.95 50753664 HC 102 NBS/HEMOGLOBIN CHROMAT $ 15.95 50753672 HC 114 VON WILLEBR MULTIMERS $ 19.30 50753680 HC 102 NBS/17HYDROXYPROG $ 15.95 50753706 HC 300 VAP LIPOPROTEIN HR FRAC QN $ 20.30 50753714 HC 300 VAP TRIGLYCERIDES $ 4.70 50753722 HC 100 INHIBIN A $ 35.99 50753730 HC 100 FREE T4 BY DIALYSIS $ 78.80 50753789 HC 400 ANTI-ADRENAL 21 OH AB $ 27.71 50753797 HC 401 MECONIUM TOX SCREEN $ 112.19 50753805 HC 495 11824R BUSULFAN CHRM MSQNT $ 233.25 50753813 HC 401 BUSULFAN ORAL $ 224.25 50753821 HC 402 CHLA IMMUNO CYTO $ 5.16 50753839 HC 402 CHLA IMMUNO CYTO $ 29.43 50753847 HC 402 CHLA IMMUNO CYTO $ 63.42 50753854 HC 402 CHLA IMMUNO CYTO $ 16.62 50753862 HC 402 CHLA IMMUNO CYTO $ 6.84 50753870 HC 402 CHLA IMMUNO CYTO $ 21.03 50753888 HC 402 CHLA IMMUNO CYTO $ 27.41 50753896 HC 402 CHLA IMMUNO CYTO $ 5.00 50753904 HC 402 CHLA IMMUNO CYTO $ 57.07 50753912 HC 402 CHLA IMMUNO CYTO $ 37.45 50753938 HC 402 CHLA IMMUNO CYTO $ 23.00 50753946 HC 402 CHLA IMMUNO CYTO $ 64.66 50753953 HC 402 CHLA IMMUNO CYTO $ 56.58 50753961 HC 402 CHLA IMMUNO CYTO $ 64.62 50753979 HC 402 CHLA IMMUNO CYTO $ 27.28 50753987 HC 402 CHLA IMMUNO CYTO $ 10.06 50754001 HC 100 HISTAMINE $ 34.00 50754019 HC 114 CPKI TOTAL $ 34.77 50754027 HC 114 CPKI CK ISOENZYMES $ 34.78 50754043 HC 114 AFP CSF $ 40.27 50754050 HC 114 BETA HCG QUANT $ 41.52 50754068 HC 114 HISTOPLASMA AG, SRM $ 109.00 50754076 HC 114 HISTOPLASMA AG, CSF $ 109.00 50754084 HC 114 YHISTU HISTOPLSM CAP AG UR $ 109.00 50754092 HC 114 BROMIDE, BLOOD $ 45.82 50754126 HC 092 EB NUCLEAR AB EBNA $ 47.00 50760008 HC 114 CADMINIUM $ 13.78 50760016 HC 114 LEAD $ 7.24 50760024 HC 114 MERCURY, QUANT $ 9.68

50760057 HC 114 MASS SPEC/TNDM MS QT $ 10.18 50760065 HC 114 IMMUNO ASSAY ANALYTE QUA $ 27.54 50760073 HC 114 NORTRIPTYLINE $ 9.49 50760081 HC 114 DRUG SCREEN $ 26.71 50760099 HC 114 DRUG SCREEN 12 $ 32.98 50760107 HC 114 IMIPRAMINE $ 18.50 50760115 HC 114 ALBUMIN CSF $ 12.78 50760123 HC 114 GC/MS - VIT D2 $ 12.09 50770015 HC 114 DRUG SCREEN, FLUIDS $ 68.77 50770031 HC 114 TCA SCREEN $ 95.75 50770049 HC 114 CLONAZEPAM $ 23.59 50770056 HC 114 DESIPRAMINE $ 27.40 50770064 HC 114 HALOPERIDOL $ 52.17 50770072 HC 114 TOPIRAMATE $ 28.13 50770080 HC 114 DISOPYRAMIDE $ 38.35 50770098 HC 114 MEXILETINE $ 89.60 50770106 HC 114 AMPHOTERICIN B $ 151.72 50770114 HC 114 FELBAMATE $ 38.32 50770122 HC 114 LAMOTRIGINE $ 12.00 50770130 HC 114 ITRACONAZOLE $ 38.35 50770148 HC 114 BUPROPION $ 56.71 50770155 HC 114 YSERTR ZOLOFT CHRM MS QNT $ 70.84 50770163 HC 114 FLUCONAZOLE $ 51.18 50770171 HC 114 ZONISAMIDE $ 46.10 50770189 HC 114 BETA-HYDROXYBUTYRATE $ 27.31 50770197 HC 114 ALDOSTERONE, URINE $ 12.56 50770213 HC 114 ALPHA-1-ANTITRYPSIN $ 12.14 50770221 HC 114 ALUMINUM $ 19.99 50770239 HC 114 CYSTINURIA PROF, QT $ 60.00 50770247 HC 114 ALA, URINE $ 28.27 50770254 HC 114 AMYLASE, PANCREATIC $ 40.70 50770262 HC 114 ANDROSTANEDIOL GLUC $ 64.50 50770270 HC 114 ARSENIC, RANDOM URINE $ 20.95 50770288 HC 114 ARSENIC, BLOOD $ 10.50 50770296 HC 114 ARSENIC FRACT, URINE $ 54.62 50770304 HC 114 PENTOBARBITAL $ 48.15 50770312 HC 114 BILE ACIDS, TOTAL $ 49.75 50770320 HC 114 CADMIUM, URINE $ 36.24 50770338 HC 114 CAROTENE $ 11.49 50770346 HC 114 CATECHOLAMINE FREE, P $ 26.65 50770353 HC 114 PTH-RELATED PEPTIDE, P $ 14.25 50770361 HC 114 5-FLUCYTOSINE $ 65.79 50770379 HC 114 DIPYRIDAMOLE $ 87.00 50770395 HC 114 CHROMIUM $ 24.16 50770403 HC 114 DIGITOXIN $ 66.00 50770411 HC 114 COPPER, URINE $ 10.50 50770429 HC 114 YRISPM COL CHROM MS QNT $ 75.96 50770437 HC 114 SYNTH GLUCOCORTIC SCR $ 65.16 50770445 HC 114 CYANIDE, BLOOD $ 45.23 50770452 HC 114 DHEAS $ 7.88 50770460 HC 114 DEOXYCORTICOSTEROIDS $ 34.90 50770478 HC 114 DIHYDROTESTOSTERONE $ 22.50 50770486 HC 114 ESTRIOL, FREE $ 17.56

50770494 HC 114 ESTRONE $ 8.90 50770502 HC 114 FAT, FECES $ 44.23 50770510 HC 114 FAT, FECES, RANDOM $ 5.99 50770528 HC 114 FATTY ACID PROF,PEROX $ 54.29 50770536 HC 114 FRUCTOSE, SEMEN $ 54.59 50770544 HC 114 GLUCAGON $ 18.81 50770551 HC 114 FRUCTOSAMINE $ 12.66 50770601 HC 114 PLASMA HEMOGLOBIN $ 35.68 50770619 HC 114 HEXOSAMINIDASE A/TOT $ 78.00 50770627 HC 114 HISTAMINE $ 46.03 50770635 HC 114 HOMOCYSTEINE, TOTAL, U $ 65.18 50770643 HC 114 HOMOVANILLIC ACID,URINE $ 23.34 50770676 HC 114 HISTONE AUTOANTIBODIES $ 22.50 50770684 HC 114 TTG AB, IGA $ 69.00 50770692 HC 114 PR3 AUTOANTIBODIES $ 34.03 50770700 HC 114 GLIADIN IGA $ 12.35 50770718 HC 114 LACTOFERRIN DETECT,STL $ 91.22 50770726 HC 114 ALPHA-SUBUNIT OF PGH $ 33.31 50770734 HC 114 IGF II $ 59.05 50770742 HC 114 THYROTROPIN RECEPT AB $ 42.00 50770759 HC 114 TRYPSIN-LKE IMMNREACT $ 57.33 50770767 HC 114 LEPTIN $ 103.00 50770775 HC 114 GBM AB, IGG, ELISA $ 28.28 50770783 HC 114 STRIATIONAL (SM) AB $ 7.13 50770791 HC 114 IGF BINDING PROTEIN-3 $ 14.25 50770809 HC 114 TAT COMPLEX $ 178.00 50770817 HC 114 INHIBIN B $ 162.04 50770825 HC 114 17-KETOSTEROID, U $ 62.74 50770833 HC 114 H PLACENTAL LACTOGEN $ 118.00 50770841 HC 114 LDL SUBFRACTIONATION $ 31.35 50770858 HC 114 MAGNESIUM, QUANT, FECES $ 37.75 50770866 HC 114 MANGANESE $ 29.01 50770874 HC 114 MERCURY, URINE $ 10.50 50770890 HC 114 NICKEL $ 10.50 50770908 HC 114 5'NUCLEOTIDASE $ 14.92 50770916 HC 114 OSTEOCALCIN $ 60.00 50770924 HC 114 THIORIDAZINE $ 28.12 50770932 HC 114 CHLORPROMAZINE $ 28.12 50770940 HC 114 YFLUP COL CHROM MS QNT $ 75.63 50770957 HC 114 ACID PHOSPHATASE $ 36.37 50770965 HC 114 PREGNANETRIOL, U $ 35.58 50770973 HC 114 PREGNENOLONE $ 106.00 50770999 HC 114 PROINSULIN, P $ 29.67 50771005 HC 114 VITAMIN B6 $ 15.18 50771013 HC 114 PYRUVIC ACID $ 21.43 50771021 HC 114 PYRUVATE, CSF $ 49.00 50771039 HC 114 SELENIUM $ 25.76 50771047 HC 114 SEROTONIN $ 45.10 50771054 HC 114 SEX HORMONE BIND GLOB $ 21.00 50771062 HC 114 SOMATOSTATIN $ 235.00 50771070 HC 114 PHOSPHOLIPIDS $ 35.83 50771088 HC 114 THIAMIN (VIT B1) $ 30.50 50771096 HC 114 THIOCYANATE $ 33.04

50771104 HC 114 THYROXINE-BINDING GLOB $ 29.21 50771112 HC 114 T-UPTAKE $ 7.00 50771120 HC 114 T3, FREE $ 4.30 50771138 HC 114 TRYPSIN, FECAL $ 45.43 50771146 HC 114 ARGININE VASOPRESSIN $ 24.00 50771153 HC 114 VITAMIN A $ 15.66 50771179 HC 114 ZINC $ 10.50 50771187 HC 114 ANTITHROMBIN III AG $ 17.00 50771195 HC 114 PROTEIN C AG $ 29.05 50771203 HC 114 PROTEIN S AG $ 36.16 50771211 HC 114 LAP SCORE $ 14.01 50771229 HC 114 LYSOZYME, URINE $ 45.26 50771245 HC 114 CARDIOLIPIN AB, IGA $ 19.00 50771252 HC 114 C5 COMPLEMENT AG $ 48.50 50771260 HC 114 C2 COMPLEMENT AG $ 131.78 50771278 HC 114 CYCLIC CITRULL PEPT $ 14.00 50771286 HC 114 STREPTOCOCCAL AB $ 22.80 50771294 HC 114 U1RNP AUTO AB $ 16.50 50771302 HC 114 SM AUTO AB $ 12.00 50771310 HC 114 ENA AG $ 23.52 50771328 HC 114 RIBOSOME P AB $ 39.55 50771336 HC 114 RETICULIN AB $ 7.13 50771344 HC 114 BCA AG (CA 27.29) $ 22.50 50771351 HC 114 CANCER ANTIGEN 15-3 $ 12.48 50771369 HC 114 CHROMOGRANIN A $ 14.25 50771385 HC 114 HEP B SURFACE AB $ 9.80 50771393 HC 114 RABIES ANTIBODY $ 53.66 50771401 HC 114 INTRINSIC FACT BLK AB $ 20.19 50771419 HC 114 LYMPH PROL,MITOGENS $ 106.00 50771427 HC 114 VDRL, CSF $ 6.50 50771435 HC 114 DIPHTH TOXOID IGG AB $ 31.92 50771443 HC 114 H. INFLU B AB, IGG $ 57.20 50771450 HC 114 LEPTOSPIRA AB $ 44.54 50771468 HC 114 E. HISTOLYTICA AB $ 26.60 50771476 HC 114 TRYPAN CRUZI AB, IGG $ 42.75 50771484 HC 114 RUBELLA AB, IGM $ 17.00 50771492 HC 114 MEASLES AB, IGM $ 12.37 50771500 HC 114 TETANUS TOXOID IGG AB $ 28.17 50771518 HC 114 TOXOPLASMA AB, IGM $ 18.54 50771526 HC 114 ANTI-HCV BY RIBA $ 25.65 50771542 HC 114 MYCOPLASMA CULT $ 74.93 50771567 HC 114 ENTEROVIRUS, PCR $ 62.43 50771575 HC 114 EBV BY PCR $ 84.79 50771583 HC 114 HUMAN METAPNEUMO RNA $ 246.85 50771609 HC 114 SPERM AB $ 110.82 50771617 HC 114 TTG AB, IGG/M $ 11.31 50771625 HC 114 IMMUNO FR LIGHT CHAINS $ 13.30 50771633 HC 114 PARAINFLUENZA AB $ 23.02 50771641 HC 114 CUTANEOUS IMMFLR IGG $ 21.37 50771658 HC 114 S. PNEUMO AB 23 SERO $ 2.60 50771666 HC 114 S. PNEUMO AB 7 SERO $ 7.24 50771674 HC 114 WEST NILE VIRUS, IGG/M $ 46.80 50771682 HC 114 IMMUNE CMPLX RAJI CELL $ 75.96

50771690 HC 114 ADENOVIRUS AB, IGG/M $ 26.27 50771708 HC 114 BLASTOMYCES AB $ 21.52 50771716 HC 114 B. PERTUSSIS AB, IGG/M $ 6.24 50771724 HC 114 BRUCELLA AB, IGG/M $ 26.05 50771732 HC 114 IBD PANEL $ 39.92 50771740 HC 114 INFLUENZA AB PANEL $ 12.43 50771757 HC 114 LEGIONELLA PNEUMO $ 10.51 50771765 HC 114 MUMPS VIRUS AB IGG/M $ 12.89 50771773 HC 114 MYCO PNEUMO AB IGG/M $ 15.20 50771781 HC 114 BABESIA MICROTI IGG/M $ 32.91 50771799 HC 114 RICKETTSIA AB PANEL $ 15.08 50771807 HC 114 COLORADO TICK FEVER $ 42.33 50771815 HC 114 HISTOPLASMA AB SCRN $ 20.10 50771823 HC 114 CHLAMYDIA $ 6.43 50771831 HC 114 CHLAMYDIA IGM $ 6.43 50771864 HC 114 PRIMIDONE $ 7.43 50771872 HC 114 PHENOBARBITAL $ 5.13 50771880 HC 114 ARSENIC $ 8.48 50771898 HC 114 LEAD $ 5.41 50771906 HC 114 MERCURY, QUANT $ 7.27 50771914 HC 114 CADMIUM $ 10.34 50771922 HC 114 LDH $ 6.46 50771930 HC 114 LD ISOENZYMES $ 13.70 50772086 HC 114 CARBAMAZEPINE, TOT $ 33.99 50772094 HC 114 CARBAMAZEPINE, FREE $ 30.94 50772102 HC 114 BILIRUBIN, TOTAL $ 8.74 50772110 HC 114 ELECTROPHORETIC $ 59.79 50772128 HC 114 SPECTROPHOTOMETRY $ 12.17 50772136 HC 114 TRIGLYCERIDES $ 10.01 50772144 HC 114 CALCIUM UR QUANT $ 11.28 50772151 HC 114 CHLORIDE, URINE $ 9.39 50772169 HC 114 CREATININE, URINE $ 9.67 50772177 HC 114 CITRATE $ 51.98 50772185 HC 114 MAGNESIUM $ 12.52 50772193 HC 114 OSMOLALITY, URINE $ 12.74 50772201 HC 114 OXALATE $ 24.07 50772219 HC 114 PH, URINE $ 6.69 50772227 HC 114 PHOSPHORS INORGANIC URINE $ 9.67 50772235 HC 114 POTASSIUM, URINE $ 8.04 50772243 HC 114 SODIUM, URINE $ 9.09 50772250 HC 114 SULFATE, URINE $ 8.88 50772268 HC 114 URIC ACID, URINE $ 8.88 50772276 HC 114 FLOW CYTO, 1ST MKR $ 67.36 50772284 HC 114 FLOW CYTO, EA ADDTL $ 32.87 50772342 HC 114 TESTOSTERONE, FREE $ 9.92 50772359 HC 114 TESTOSTERONE, TOTAL $ 17.08 50772367 HC 114 EBV, EBNA $ 5.70 50772375 HC 114 EBV, VCA $ 6.50 50772383 HC 114 EHRLICHIA $ 3.80 50772490 HC 114 CHROMATOGRAPHY $ 16.14 50772508 HC 114 YMETHS METHSUXIMIDE $ 65.44 50772524 HC 114 IFN-B AB NEUT $ 426.94 50772532 HC 114 IFN-B AB NEUT $ 357.45

50772540 HC 114 T3 UPTAKE $ 24.42 50772557 HC 114 THYROXINE, TOTAL $ 25.97 50772565 HC 114 ESTRONE $ 8.26 50772573 HC 114 ESTRADIOL $ 9.24 50772607 HC 114 INSULIN, TOTAL $ 14.76 50772615 HC 114 INSULIN, FREE $ 16.71 50772623 HC 114 INSULIN ANTIBODIES $ 13.00 50772664 HC 114 DIAZEPAM/NORDIAZEPAM $ 27.73 50772672 HC 114 RSV AB, IGG/M $ 22.82 50772698 HC 114 MYCO/UREAPLASMA $ 20.25 50772706 HC 114 OSMALALITY STOOL $ 40.67 50772714 HC 114 STREPTOCCAL AB $ 8.10 50772722 HC 114 STREPTOCCAL AB $ 14.70 50772730 HC 114 PARVOVIRUS B19 AB $ 9.95 50772748 HC 114 YCEAC CEA SPINAL FLUID $ 76.32 50772755 HC 114 POTASSIUM, FLUID $ 26.55 50772771 HC 114 SODIUM, FLUID $ 25.50 50772789 HC 114 GLUCOSE, FLUID $ 34.00 50772797 HC 114 AMYLASE, NON ASCITES $ 39.15 50772805 HC 114 SODIUM, STOOL $ 34.43 50772813 HC 114 POTSSIUM, STOOL $ 34.40 50772821 HC 114 CHLORIDE, STOOL $ 34.17 50772839 HC 114 CHLORIDE, FLUID $ 26.55 50772847 HC 114 MAGNESIUM, FLUID $ 33.50 50772854 HC 114 UREA NITROGEN, FLUID $ 29.50 50772862 HC 100 BILIRUBIN, FLUID $ 8.80 50772870 HC 100 CHOLESTEROL, FLUID $ 9.20 50772888 HC 100 TRIGLYCERIDES, NON PLEU $ 9.20 50772896 HC 100 URIC ACID, FLUID $ 8.80 50772904 HC 114 ANTI-DNASE B TITER $ 82.00 50772912 HC 114 DRUG SCREEN PRESC/OTC $ 55.18 50772946 HC 092 CGD FC $ 66.46 50772953 HC 092 HCV GENOTYPE $ 242.46 50773019 HC 092 S PNEUMONIAE AG DETECT LA $ 55.32 50773027 HC 092 CYSTICERCUS AB ELISA HLMTH $ 83.25 50773035 HC 092 DENGUE FEVER AB ELISA $ 30.19 50773092 HC 092 WESTNILE VIRUS RNA RT-PCR $ 223.50 50773100 HC 092 ADENOVIRUS DNA QUAL PCR $ 142.10 50773118 HC 092 MYCO FAST PATH CULT $ 229.50 50773126 HC 092 AFB MTB PCR $ 223.50 50773134 HC 092 W NILE AB PNL ELISA CSF $ 53.63 50773142 HC 092 POLIOVIRUS AB NEUTRALZTN $ 67.67 50773159 HC 114 FETAL LUNG AF $ 73.51 50773167 HC 114 FETAL LUNG AF $ 55.27 50773183 HC 114 LEVETIRACETAM $ 22.07 50773191 HC 114 NMO-IGG $ 161.40 50773209 HC 114 FATTY ACID ESSENTIAL $ 70.70 50773217 HC 092 ADENOVIRUS AB $ 14.00 50773225 HC 114 PLATELET AB $ 144.10 50773233 HC 092 ADENOVIRUS DNA QNT PCR $ 152.25 50773241 HC 092 HANTAVIRUS $ 47.25 50773266 HC 092 CISTICERCUS IGG AB $ 107.25 50773282 HC 092 EHRLICHIA CHAFFEENIS IGM $ 73.87

50773290 HC 428 GHRELIN TOTAL $ 275.00 50773308 HC 092 CHLAMYDIA PNEUM CULT $ 84.07 50773316 HC 092 CHLAMYDIA PNEUM CULT $ 23.93 50773324 HC 092 ECHOVIRUS AB PNL, CF $ 20.55 50773332 HC 092 ENTAMOEGA HISTOLYCIA AB $ 60.75 50773357 HC 114 BACTERIAL AG DETECT PNL $ 67.50 50773365 HC 092 HTLV I/II DNA QUANT $ 111.75 50773381 HC 100 FREE T4 EQUILIB DIALYSIS $ 40.00 50773399 HC 100 HOMOVANILLIC ACID URINE $ 22.00 50773407 HC 092 HERPES 6 IGG/M AB $ 45.50 50773415 HC 201 NBS/BIOTINIDASE $ 15.95 50773423 HC 201 NBS/IRT $ 15.95 50773431 HC 100 AFP AMNIOTIC FLUID $ 14.00 50773449 HC 100 OXICARBAZEPINE METAB $ 41.00 50773456 HC 100 NMP22 URINE $ 94.40 50773464 HC 427 DONOR HBC LIVING $ 41.00 50773472 HC 427 DONOR CMV AB LIVING $ 26.00 50773480 HC 092 HSV 1/2 PCR NONCSF $ 63.44 50773498 HC 092 HERPES SELECT 1/2 IGG $ 30.39 50773506 HC 092 HERPES SELECT 1/2 IGG $ 44.61 50773514 HC 092 HERPES VIRUS 7AB IGG/M $ 117.00 50773522 HC 092 PARVOVIRUS AB IGG/M $ 29.30 50773530 HC 114 LEFLUNOMIDE METABOLITE $ 194.00 50773548 HC 115 THIOPURINE METABOLITES $ 50.62 50773662 HC 092 CHLAMYDIA TRACH IGG/M AB $ 73.21 50773670 HC 092 CHLAMYDIA TRACH IGG/M AB $ 78.58 50773688 HC 092 MYCOPLASMA PNEUM IGG/M AB $ 51.75 50773696 HC 115 CELIAC PLUS $ 10.72 50773704 HC 115 CELIAC PLUS $ 14.92 50773753 HC 115 CELIAC PLUS $ 44.78 50773779 HC 425 OGILONUCLEOTIDE MICRO ARRA $ 265.83 50773787 HC 118 CVS ANALYSIS $ 34.07 50773795 HC 118 CVS ANALYSIS $ 464.00 50773803 HC 118 CVS ANALYSIS $ 65.00 50773829 HC 097 DNR HIVI/HCV PROCLEIX $ 370.00 50773837 HC 092 A PHAGOCYTOPHILUM AB $ 76.87 50773845 HC 100 ACETYLCHOLINESTERASE $ 135.00 50773852 HC 088 COCCI IMMUNODIFF QUAL $ 34.00 50773860 HC 095 ANDROSTENEDIONE $ 43.66 50773878 HC 095 DEOXYCORTISOL 11 $ 43.66 50773886 HC 095 CORTISOL TOTAL $ 24.31 50773894 HC 095 DHEA $ 37.69 50773902 HC 095 DESOXYCORTICOSTERONE 11 $ 46.20 50773910 HC 095 17 HYDROXYPREGNENOLONE $ 34.04 50773928 HC 095 PROGESTERONE $ 31.11 50773936 HC 095 HYDROXYPROGESTERONE 17D $ 40.51 50773944 HC 095 TESTOSTERONE; TOTAL $ 38.51 50773951 HC 095 CORTISOL TOTAL SERUM $ 17.32 50773969 HC 095 DEOXYCORTICOTESTERONE 11 $ 62.47 50773977 HC 097 DNR CMV TOTAL AB $ 100.00 50773985 HC 097 DNR HEP B CORE TTL AB $ 63.00 50773993 HC 097 DNR HEPC AB W/REFLX RIBA $ 70.00 50774009 HC 097 DNR HEP BS AG $ 54.00

50774017 HC 097 DNR HIV 1/2 AB $ 71.15 50774025 HC 097 HTLV 1/2 AB SCREEN $ 65.00 50774033 HC 097 DNR RPR W/RFLX SYPH IMMUNO $ 75.00 50774041 HC 097 DNR WEST NILE VIRUS APT $ 290.00 50774058 HC 092 VZV TOTAL AB $ 41.56 50774066 HC 092 VZV IGM AB $ 41.57 50774074 HC 092 HHV6 DNA QUANT $ 224.40 50774082 HC 092 AB EBV EA $ 13.69 50774090 HC 092 AB EBV EBNA $ 15.96 50774108 HC 092 AB EBV VCA $ 18.92 50774116 HC 430 11004R ACTINOMYCES AB $ 15.58 50774124 HC 430 11004R ASPERGILLUS AB $ 23.04 50774132 HC 430 11004R FUNGUS AB NOT SPEC $ 18.76 50774140 HC 429 11013R AB ID PLATELET $ 18.45 50774157 HC 114 11017R BRUCELLA AB $ 40.40 50774165 HC 092 FUNAB ASPERGILLUS AB $ 48.40 50774173 HC 92 FUNAB BLASTOMYCES AB $ 41.49 50774181 HC 92 FUNAB HISTOPLASMA AB SCR $ 40.18 50774199 HC 100 CHROMO QUANT SNGL $ 168.00 50774207 HC 100 IMMUNO ANLTY QUANT NOS $ 95.00 50774330 HC 411 ASCARIS IMM AB QUANT $ 75.00 50774348 HC 412 MIC SUSC EA $ 65.00 50774355 HC 427 HEP BS AG EIA $ 41.00 50774363 HC 427 HEP C AB $ 66.00 50774371 HC 440 PHENO DNA HIV W CLT 1ST 10 $ 812.07 50774389 HC 440 PHENO DNA HIV CLT EA ADTL $ 43.32 50774397 HC 100 ANNA SCRN IGG BY IFA $ 48.00 50774405 HC 100 N TELOPEPTD CRS LINK $ 158.80 50774413 HC 100 ALCOHOL $ 21.60 50774421 HC 100 BIND BLCK MOD AB QUANT RIA $ 42.45 50774439 HC 100 NICOTINE URINE $ 52.00 50774447 HC 100 DRUGS OF ABUSE PAN 9 $ 8.00 50774454 HC 100 TESTOS TOT NON MALE $ 33.47 50774462 HC 100 SEX HORM BIND GLOB $ 28.17 50774470 HC 100 ALCOHOL QUAL URINE $ 21.60 50774488 HC 100 ALLERGEN ASPER FUN $ 7.00 50774496 HC 100 PROCOLGN INTACT N QNT RIA $ 180.00 50774504 HC 100 MAGNESIUM $ 53.77 50774512 HC 100 SCREEN SULFON HYPO $ 82.00 50774520 HC 100 AFP TOTAL L3 PRCNT $ 150.00 50774538 HC 100 IGA $ 12.86 50774546 HC 100 SOL LIV AG AB IGG $ 18.40 50774553 HC 100 TESTOSTERONE TOTAL $ 16.90 50774561 HC 100 SEX HORM BIND GLOB $ 14.22 50774579 HC 100 CANNABINOIDS CONFIRM QUANT $ 68.52 50774587 HC 114 ESTRADIOL $ 37.67 50774595 HC 114 NICOTINE $ 50.93 50774603 HC 114 PREGABALIN QUANT $ 107.00 50774611 HC 114 IODINE $ 41.07 50774629 HC 114 LIPASE BODY FLUID $ 27.00 50774637 HC 114 NICTN AND MTABLIT URINE $ 22.92 50774645 HC 114 VITAMIN E $ 25.13 50774652 HC 114 VITAMIN A $ 20.55

50774660 HC 114 IMM ANLYT QUANT RIA $ 27.14 50774678 HC 114 IMM ANLYT QUANT NOS $ 25.97 50774686 HC 114 FLUOR AB TITER $ 24.21 50774694 HC 100 GMBIFA AB IGA IGG $ 64.00 50774702 HC 092 NATURAL KILLER CELLS ENUM $ 48.75 50774710 HC 092 LYMPH MITOGEN SCREEN $ 97.50 50774728 HC 420 MOTOR NP PROFILE $ 141.90 50774736 HC 420 MOTOR NP PROFILE $ 141.94 50774744 HC 420 SULFATIDE AUTO ELISA $ 202.50 50774868 HC 114 BETA2 TRSFRN BDY FLD $ 78.02 50774876 HC 114 IODINE URINE $ 35.95 50774884 HC 114 IRON LIVER TISSUE $ 59.84 50774892 HC 114 LEAD URINE $ 7.90 50774900 HC 114 METANEPH FRAC RAN UR $ 54.34 50774918 HC 092 AB EBV VCA IGG $ 32.00 50774926 HC 092 AB EBV VCA IGM $ 47.00 50774934 HC 092 AB EBV EA IGG $ 47.00 50774942 HC 092 AB EBV EBNA $ 47.00 50774959 HC 444 FLOW 1ST MARKER $ 39.76 50774967 HC 092 CHLAMYDIA $ 17.98 50774975 HC 92 M AVIUM COMPLEX MIC $ 120.75 50774983 HC 92 ENTAMOEBA HISTO ATGN $ 65.25 50774991 HC 92 HHV 8 IGG AB $ 116.25 50775006 HC 92 MEASLES IGG AB TIT $ 51.00 50775014 HC 92 VZV DNA PCR QUANT $ 261.75 50775022 HC 92 VZV AB IMM SCRN $ 66.00 50775030 HC 92 HHV 8 DNA QUANT $ 261.75 50775048 HC 92 H PYLORI IGA AB $ 107.00 50775055 HC 92 MYCO PNEUM DNA QUAL $ 250.00 50775063 HC 92 BORRELIA HERMII AB $ 85.00 50775121 HC 420 COGMI IMMUNO QUANT NOS $ 143.33 50775311 HC 441 CREA/GUAN MS QUANT U $ 70.00 50775329 HC 441 CREATININE URINE $ 25.06 50775337 HC 441 CREA/GUAN MS QUANT U $ 87.47 50775345 HC 441 POLYOLS MS URINE $ 186.55 50775352 HC 441 CREATININE URINE $ 53.45 50775360 HC 429 ADAMTS-13 $ 121.00 50775378 HC 429 FACTOR INHIBITOR TEST $ 121.00 50775386 HC 429 AB ID PLATELETS $ 148.00 50775394 HC 095 C-TELOPEPTIDE MS $ 66.15 50775543 HC 425 COWDEN AB EV 251-500 PROBE $ 712.57 50775618 HC 430 HISTAMINE URTICARIA $ 68.97 50775626 HC 430 AB ID URTICARIA $ 31.92 50775634 HC 430 LHR URTICARIA $ 29.11 50775642 HC 430 CUI HISTAMINE $ 84.64 50775659 HC 430 CUI TSH $ 48.15 50775667 HC 430 CUI LEUKOCYTE AB ID $ 39.18 50775675 HC 430 CUI LHR $ 35.73 50775683 HC 430 CUI MICROSOMAL AB $ 41.71 50775691 HC 430 CUI THYROGLOB AB $ 45.58 50775709 HC 430 MACADAMIA NUT QUANT IGE $ 11.90 50775717 HC 430 BEAN PINTO IGE $ 14.88 50775725 HC 430 GARBANZO BEAN IGE $ 23.40

50775733 HC 430 PINE NUT IGE $ 23.40 50775741 HC 430 GREEN BEAN IGE $ 11.90 50775758 HC 430 NECTARINE IGE $ 23.40 50775766 HC 430 SQUASH SUMMER IGE $ 14.88 50775774 HC 430 BEAN KIDNEY IGE $ 37.50 50775782 HC 430 SULFAMETHOXAZOL IGE $ 23.40 50775790 HC 430 FLAXSEED/LINSEED IGE $ 23.40 50775808 HC 430 ABALONE IGE $ 37.50 50775816 HC 430 PUMPKIN SEED IGE $ 37.50 50775824 HC 430 HALIBUT IGE $ 11.90 50775832 HC 430 ZUCCHINI IGE $ 14.88 50775840 HC 430 PENICILLIN II $ 23.40 50775857 HC 430 BEAN LIMA IGE $ 23.40 50775865 HC 430 RASPBERRY IGE $ 11.90 50775873 HC 430 BLUEBERRY IGE $ 37.50 50775881 HC 430 SOLE IGE $ 37.50 50775907 HC 430 AMOXICILLIN IGE $ 23.40 50775915 HC 430 CUMIN SEED IGE $ 14.88 50775923 HC 430 BEAN BLACK IGE $ 23.40 50775931 HC 430 SNAIL IGE $ 23.40 50775949 HC 430 CAULIFLOWER IGE $ 37.50 50775956 HC 430 CATFISH IGE $ 11.90 50775964 HC 430 BASS BLACK IGE $ 14.88 50775972 HC 430 RABBIT HAIR IGE $ 14.88 50775980 HC 430 LATEX IGE $ 23.40 50775998 HC 430 CEPHALOSPORIN IGE $ 23.40 50776004 HC 430 ERYTHROMYCIN IGE $ 23.40 50776012 HC 430 PENICILLIN I $ 23.40 50776103 HC 450 BH4/NEOPTEREIN PROF $ 190.00 50776111 HC 450 5-METHYLTHTRAHYDRO $ 180.00 50776129 HC 440 PHENOTYPE GENOTYP BIO $ 126.17 50776137 HC 440 HIV REV TRANS PROT $ 249.04 50776145 HC 440 DRUG SUSP PHENO 10 TSTD $ 472.69 50776152 HC 440 DRUG SUSP PHENO EA ADDT $ 25.21 50776160 HC 440 TROFILE CO-RECEPTOR $ 1,960.00 50776178 HC 114 6 MAM URINE EA $ 134.70 50776186 HC 100 MYELIN BAS PROT CSF $ 38.00 50776236 HC 115 INFLIX QUANT $ 168.75 50776244 HC 115 CHEMILUMINESCENT ANCA $ 19.82 50776251 HC 115 ANCA QUANT $ 18.46 50776269 HC 97 CULT CHLAMYDIA $ 75.51 50776277 HC 97 CULT TYPING PCR EA $ 21.49 50776285 HC 97 CHLAMYDIA APT $ 60.00 50776293 HC 97 NEISSERIA GH APT $ 60.00 50776301 HC 097 H PYLORI BREATH $ 180.00 50776319 HC 097 T4 FREE DIALYSIS $ 94.00 50776509 HC 446 LYSO ENZ ACT NON RA $ 316.19 50776517 HC 446 LYSO ENZ ACT RA $ 283.81 50776533 HC 443 RESP VIRAL PNL PCR $ 396.00 50776541 HC 121 SLO PRENAT COL CHROM QUANT $ 200.00 50776558 HC 444 FLOW EA ADD MARKER $ 39.75 50776566 HC 444 LEUK/LYMPH INTERP 9 TO 15 $ 83.24 50776681 HC 448 NF1 TISS CULTURE LYMPHO $ 146.80

50776699 HC 118 CHITO ENZ ACT $ 141.00 50776707 HC 118 CHITO PROTIEN TTL $ 141.00 50776756 HC 430 HIST PENICILLIN $ 52.74 50777010 HC 420 COGMI IMMUNO QUANT NOS $ 143.32 50777028 HC 092 CHLAMYDIA IGM $ 19.29 50777465 HC 100 CATECHOLOMINES FRAC $ 34.73 50777473 HC 100 GALACTOSE QUANT EA $ 154.00 50777523 HC 420 ANTI HU NOS $ 169.05 50777531 HC 420 GQ1B AB NOS $ 247.50 50777549 HC 420 NEUROPATHY PROF NOS $ 114.11 50777556 HC 420 MUSK AB QUANT RIA $ 773.50 50777564 HC 420 ANTI VGKC AB QUANT RIA $ 391.00 50777622 HC 420 PERIPH NEUR SCRN NOS $ 170.45 50777630 HC 420 ENCEPH SCRN NOS $ 209.36 50777648 HC 420 ENCEPH SCRN WB RPT $ 290.94 50777655 HC 420 ENCEPH SCRN QUANT RIA $ 218.43 50777663 HC 420 ENCEPH SCRN WB $ 275.33 50777671 HC 420 CEREB PARANEO NOS $ 186.20 50777689 HC 420 CEREB PARANEO WB $ 244.90 50777697 HC 420 CEREB PARANEO WB RPT $ 258.78 50777705 HC 420 PARANEO AB QUANT RIA $ 182.91 50777713 HC 420 PARANEO AB NOS $ 175.30 50777721 HC 420 PARANEO AB WB $ 230.56 50777739 HC 420 PARANEO AB WB RPT $ 243.63 50777838 HC 420 SENSORY MOTOR NOS $ 214.58 50777846 HC 420 SENSORY MOTOR WB $ 282.21 50777853 HC 420 SENSORY MOTOR WB RPT $ 298.21 50778182 HC 441 MITOCHOND ENZ ACT $ 60.39 50778216 HC 441 MITOCHOND SPECT NES $ 23.36 50778224 HC 441 MITOCHOND TISS CULT $ 470.65 50778232 HC 441 MITOCHOND CRYOPRES $ 33.80 50778281 HC 112 SULFOCYSTEINE URINE QUAL $ 101.93 50778299 HC 112 CREATINIE URINE $ 38.07 50778364 HC 459 NK FUNCTION $ 582.13 50778737 HC 425 JAG1 251 TO 500 PROBES $ 518.64 50778802 HC 114 TAY SACHS A $ 50.50 50778935 HC 425 SHH 251 TO 500 PROBES $ 99.44 50779255 HC 114 ARSENIC LEVEL $ 45.52 50779263 HC 114 COPPER LEVEL $ 61.09 50779271 HC 114 ETHYLENE GLYCO LEVEL $ 64.14 50779289 HC 114 HURLER ENZ ACT $ 106.28 50779297 HC 114 LYMPHOCYTE TRANSFORM $ 106.60 50779305 HC 114 NOC PROT TLP $ 917.30 50779388 HC 114 GANICICLOVIR LVL $ 64.78 50779396 HC 114 IL5 RIA QUANT NOS $ 46.42 50779453 HC 114 Q10 CHROM MULT ANAL QUANT $ 122.70 50779461 HC 114 FIBROBLAST CULTURE $ 262.40 50779479 HC 114 CRYOPRESERVATION $ 194.30 50779495 HC 114 FIBRO CULT GENE $ 220.74 50779503 HC 114 CRYOPRESERVATION $ 15.86 50779511 HC 114 AMNIOTIC FL CULT $ 236.26 50779529 HC 114 CRYOPRESERVATION $ 16.21 50779537 HC 92 BLASTOMYCES AB $ 48.75

50779545 HC 92 CMV AB $ 47.69 50779552 HC 92 CMV AB IGM $ 55.81 50779560 HC 92 BRUCELLA AB IGG $ 41.62 50779578 HC 92 HISTOPLASMA AB $ 72.00 50779586 HC 92 LEGIONELLA AB PNL $ 34.25 50779594 HC 92 LEPTOSPIRA AB $ 72.00 50779602 HC 92 LYMPH CHORIOMEN AB $ 49.50 50779610 HC 92 BABESIA AB $ 47.62 50779628 HC 92 PARVOVIRUS AB $ 23.50 50779636 HC 92 PARVO B19 DNA QUANT $ 261.75 50779644 HC 92 ENTEROVIRUS RNA QUAL APT $ 243.75 50779651 HC 92 HTLV 1 2 AB CSF $ 81.00 50779669 HC 92 BRUCELLA AB CSF $ 41.62 50779677 HC 460 NEURONAL CEROID ACT $ 204.00 50779685 HC 460 CLN2 ENZ ACTIVITY $ 204.00 50779750 HC 461 HEP C CONFIRM $ 116.97 50779909 HC 450 CSF CHROM MULT ANAL QUANT $ 190.00 50779917 HC 97 DONOR HTLVS QNS $ 65.00 50779925 HC 454 NA BENZOATE GC/MS SINGLE $ 150.00 50779933 HC 454 GC/MS GLUTARIC MULTIPLE $ 200.00 50779941 HC 453 INTREACYSTINE QUANT $ 395.00 50780006 HC 429 NAT PLAT AB ID $ 21.95 50780014 HC 92 BRUCELLA AB IGM $ 41.63 50780022 HC 92 BABESIA AB $ 47.63 50780030 HC 92 BRUCELLA AB CSF $ 41.63 50780048 HC 420 NEUROPATHY PROF NOS $ 114.13 50780055 HC 420 PERIPH NEUR SCRN NOS $ 170.50 50780063 HC 114 TAY SACHS B $ 50.49 50780337 HC 114 FREE FATTY ACIDS $ 40.47 50780402 HC 092 EB EBNA AB $ 44.27 50780410 HC 092 EB VCA AB $ 52.49 50780428 HC 097 MAGNESIUM RBC $ 41.50 50780436 HC 097 LIPID FECES TOTAL QUAN $ 44.23 50780444 HC 097 HEP C VIRAL RNA QUANT $ 396.00 50780451 HC 097 HEPTIMAX (R) HCV RNA $ 422.00 50780469 HC 097 VASC ENDOTHELIAL GF $ 168.75 50780477 HC 097 ASP RES CREATININE U $ 37.50 50780485 HC 097 ASP RES 11DEHY TBX B2 U $ 87.50 50780493 HC 097 C3A DESARG FRAG $ 123.00 50780501 HC 097 HCV RNA PCR QUAL APT $ 221.00 50780519 HC 097 HIV2 AB IMMUNOBLOT $ 100.00 50780527 HC 097 CORTISOL BIND GLOB $ 77.00 50780535 HC 097 C4D FRAGMENT EIA QUANT $ 48.00 50780543 HC 097 C TRACH RNA TMA RECTAL $ 60.00 50780550 HC 097 C TRACH RNA TMA THROAT $ 60.00 50780568 HC 097 T3 TOTAL $ 32.57 50780576 HC 114 POSACONAZOLE QUANT $ 76.35 50780584 HC 114 OXYGEN DISSOC P50 RBC $ 142.70 50780634 HC 100 INTERLEUKIN 5 QUANT $ 95.00 50780642 HC 095 17-D OHP NEO NATAL $ 101.00 50780659 HC 427 DHIVB DONOR HIV 1&2 $ 51.00 50780667 HC 462 12095R DARUNAVIR QUANT $ 84.00 50780675 HC 462 12096R LOPINAVIR QUANT $ 84.00

50780683 HC 462 12097R ATAZANAVIR QUANT $ 84.00 50780691 HC 092 EB EARLY ANTIGEN AB $ 13.70 50780709 HC 092 EB NUCLEAR ANTIGEN AB $ 15.96 50780717 HC 092 EB VIRAL CAPSID AB $ 18.92 50780725 HC 092 VZV AB TOTAL $ 41.56 50780733 HC 092 HUMAN HERPESVIRUS 6 AB IGG $ 68.25 50780790 HC 092 VZV AB IGM $ 41.57 50780808 HC 092 BARTONLA HENSELAE IGG AB $ 52.88 50780816 HC 092 BARTONLA QUINTANA IGG AB $ 52.87 50780873 HC 092 Q FEVER ANTIBODY $ 15.75 50780907 HC 092 CMV AB IGG $ 51.75 50780923 HC 092 EHRLICHIA CHAFFEENIS IGG $ 73.88 50780931 HC 092 HERPESVIRUS 6 AB IGM $ 68.25 50780949 HC 092 HERPESVIRUS 7 IGG AB $ 116.25 50780980 HC 092 LYME AB PNL IGG WB CONF $ 31.98 50780998 HC 092 LYME B BURGDORFERI IGG WB $ 73.50 50781004 HC 092 MYCOPLASMA PNEUM AB IGG $ 53.25 50781020 HC 092 PARVOVIRUS B19 AB IGG $ 23.50 50781046 HC 100 ECHOVIRUS AB EA TYPE $ 25.00 50781061 HC 114 NIACIN VITAMIN B3 $ 75.00 50781079 HC 100 DRUGS OF ABUSE MEC 9 $ 10.00 50781087 HC 100 DRUGS OF ABUSE MEC 9 $ 10.07 50781186 HC 092 EBV EA IGG IFA $ 37.41 50781194 HC 092 EBV EBNA AB ACIF $ 43.65 50781202 HC 092 EBV VCA IGG IGM AB IFA $ 51.76 50781210 HC 092 HSV AB NON SPEC TYPE $ 41.06 50781228 HC 092 HSV AB TYPE 1 $ 37.63 50781236 HC 092 HSV AB TYPE 2 $ 55.21 50781244 HC 092 VZV TOT AND IGM AB $ 36.76 50781251 HC 092 HHV-6 AB IGG $ 36.76 50781269 HC 092 HHV-6 QUANT PCR $ 119.11 50781277 HC 092 RICKETTSIA AB $ 35.81 50781285 HC 092 RICKETTSIA AB $ 35.82 50781392 HC 084 TOXO AB IGG DYE TEST $ 112.65 50781400 HC 084 TOXO AB IGM ISAGA $ 112.70 50781418 HC 084 TOXO AB IGA ELISA $ 112.65 50781426 HC 084 PRT AGG TIT EA AB ACHS $ 65.00 50781434 HC 084 TOXO AB AVIDITY $ 351.00 50781442 HC 084 TOXO AB IGM ISAGA $ 121.00 50781459 HC 084 TOXO AB IGG DYE TEST $ 100.91 50781467 HC 084 TOXO AB IGM ELISA $ 100.95 50781475 HC 084 PRT AGG TIT EA AB ACHS $ 74.57 50781632 HC 097 11899R GC RNA APT RCTL $ 60.00 50781640 HC 097 11901R GC RNA APT THRT $ 60.00 50781657 HC 097 11903R HIV1 WB CNFRM DONR $ 110.00 50781665 HC 097 11906R HIV2 AB DONOR $ 99.00 50781673 HC 097 11909R HIV2 WB CNFM DONOR $ 105.38 50781681 HC 097 11912R CHAGAS RIPA DNR $ 400.00 50781699 HC 097 11914R HBSAG CNFRM DNR $ 195.00 50781707 HC 097 11921R HEPC RIBA DNR $ 150.00 50781715 HC 097 11923R HCV NA APT DNR $ 221.00 50781723 HC 097 11925R HIV1 NA APT DNR $ 221.00 50781731 HC 097 11927R HBV NA APT DNR $ 221.00

50781749 HC 097 11929R RPR IGG T PLDM DNR $ 45.00 50781756 HC 097 11942R HTLV I&II WB $ 130.25 50781764 HC 430 BASO ACT CELL STIMULATION $ 94.00 50781772 HC 430 11408R BF HRT CEPHLSPRN C $ 79.25 50781781 HC 430 11409R BFHRT PENICLN MINOR $ 79.25 50781798 HC 430 11410R BF HRT AMOXICILLIN $ 79.25 50781806 HC 430 11411R BF HRT CEFUROXIME $ 79.25 50781814 HC 430 11425R BFHRT PENICLN MAJOR $ 79.25 50781822 HC 430 11426R BF HRT TETRACYCLIN $ 79.25 50781831 HC 430 11427R BF HRT AMPICILLIN $ 79.25 50781848 HC 430 11428R BFHRT TRIMETHOPRIM $ 79.25 50781855 HC 440 12098R TROFILE DNA $ 1,960.00 50782077 HC 097 12090R HUM EPDMS PROT 4 $ 256.00 50782151 HC 092 12055R RICKETTSIA RMSF IGG $ 82.50 50782168 HC 092 12057R RICKETTSIA RMSF IGM $ 90.00 50782176 HC 092 12059R RICKETTSIA TYPH IGG $ 82.50 50782184 HC 092 12061R RICKETTSIA TYPH IGM $ 90.00 50782192 HC 092 ASPID ASPGLUS IMMDIF AB $ 18.94 50782201 HC 092 ASPID ASPGLUS IMMDIF AB $ 18.95 50782218 HC 092 BARTONELLA AB PAN IGG IGM $ 28.11 50782226 HC 092 BARTONELLA AB PAN IGG IGM $ 28.13 50782234 HC 092 CHLAM CHLYM TRACHOMTS CUL $ 32.56 50782242 HC 092 CHLAM PSITTACI CULT TYPE $ 9.26 50782259 HC 092 DFA DENGUE FEVER AB $ 30.20 50782267 HC 092 FABRO ENCPHLTS CA LACRS AB $ 63.09 50782275 HC 092 FABRO ENCPHLTS ESTN EQN AB $ 63.09 50782283 HC 092 FABRO ENCPHLTS ST LOUIS AB $ 63.09 50782291 HC 092 FABRO ENCPHLTS WSTN EQN AB $ 63.09 50782309 HC 092 FABRO ENCPHLTS WSTN EQN AB $ 63.12 50782317 HC 092 FENTP ENTEROVIRUS AB $ 19.51 50782325 HC 092 HELPM H PYLORI IGM $ 80.25 50782333 HC 092 HEPDG HEP D ANTG EIA $ 101.25 50782341 HC 092 HEVG HEP E AB IGG $ 34.67 50782358 HC 092 HEVM HEP E VIRUS AB IGM $ 51.75 50782366 HC 092 HUMP STRP PNEU IGG AG AB $ 45.37 50782374 HC 092 HUMP DIPHTHERIA ANTXD AB $ 46.06 50782382 HC 092 HUMP HAEMOPHILUS INF B $ 47.95 50782391 HC 092 HUMP TETANUS ANTITOXOID AB $ 44.77 50782408 HC 092 LAS LYMPHOCYTE MIT&AG $ 57.09 50782416 HC 092 LAS LYMPHOCYTE MIT&AG $ 57.08 50782424 HC 092 LEGS LEGIONELLA AB IFA $ 51.38 50782432 HC 092 LEGS LEGIONELLA AB IFA $ 51.37 50782441 HC 092 LEISAB LEISHMANIA AB $ 10.04 50782457 HC 092 PBAN POLIOVRS AB NEUT $ 67.66 50782465 HC 092 PNAB STRP PNEU IGG AB $ 17.57 50782473 HC 092 PNAB STRP PNEU IGG AB $ 17.48 50782481 HC 092 PNET2 STRP PNEU IGG AB $ 25.61 50782499 HC 092 PNET2 STRP PNEU IGG AB $ 25.59 50782507 HC 092 WNVAB WEST NILE AB IGM CSF $ 57.83 50782515 HC 092 WNVAB WEST NILE AB IGG CSF $ 49.42 50782523 HC 092 YENTE YERSINIA AB IGG $ 46.88 50782531 HC 092 YENTE YERSINIA AB IGG $ 46.87 50782598 HC 100 C1INHP CMP C1 C4 AG EA $ 22.69

50782606 HC 100 C1INHP CMP FNCT ACT EA $ 22.69 50782614 HC 100 DT DIPHTH TETNS AB IGG QN $ 20.00 50782622 HC 100 IBD FLRSNT NONINF AB EA $ 26.98 50782631 HC 100 IBD FUNGUS AB SEMIQNT $ 27.43 50782648 HC 100 UVH HVA HOMOVNILLIC ACD UR $ 25.75 50782655 HC 100 UVH VMA VANLLYLMDLC ACD UR $ 20.65 50782664 HC 092 FCHGA ANAPLSMA AB EHRLCH $ 76.88 50782747 HC 114 12206R CYSTATIN C $ 7.13 50782754 HC 462 12208R FLOW TC 1ST MRK $ 37.80 50782762 HC 462 12208R FLOW TC EA ADL $ 37.80 50782771 HC 092 CGD ENZ ACT NONRAD SUB EA $ 132.93 50782788 HC 100 12210R LP PLA2 $ 125.00 50782796 HC 092 12212R PRTZ NES WA1 IGG AB $ 88.00 50783034 HC 114 12284R LYMP TRNS IND BLST $ 136.90 50783042 HC 430 12226R LTX FD ALRGN QNT EA $ 13.99 50783059 HC 430 12228R LTXSP IGE ALG QN EA $ 23.10 50783067 HC 459 12230R SOL IL2R IMM QN NOS $ 322.22 50783075 HC 484 12232R THYROGLOBULIN $ 37.69 50783083 HC 484 12232R THYRGLBLN AB $ 37.31 50783091 HC 485 12234R VOLATILES $ 48.00 50783109 HC 100 12236R IBUPROFEN $ 34.40 50783117 HC 100 11312R IMM QL SQ MLT STP $ 18.40 50783125 HC 114 12238R CCMS QUANT SS & MP $ 96.00 50783133 HC 114 12241R B CELL TOT CNT $ 34.01 50783141 HC 114 12241R MONO CL AG QN $ 24.13 50783158 HC 114 12241R NK CELL TOT CNT $ 34.01 50783166 HC 114 12241R T CELL TOT CNT $ 34.01 50783174 HC 114 12241R TCL ABS CD4 CD8 $ 42.36 50783182 HC 114 12241R FC INTRP 2-8 MRK $ 14.81 50783191 HC 114 12241R FC INTRP 9-15 MRK $ 14.81 50783208 HC 114 12279R FC INTRP 2-8 MRK $ 74.86 50783216 HC 114 12279R FC INTRP 9-15 MRK $ 74.87 50783224 HC 092 12214R B BRGDFRI LYMES DS $ 79.50 50783232 HC 430 12226R LTX FD ALRGN QNT EA $ 14.00 50783364 HC 114 12292R TCELL TOT CNT $ 230.10 50783372 HC 114 12292R TCELL CD4 CNT $ 163.31 50783381 HC 114 12292R FLOW 1ST MRKR $ 100.19 50783398 HC 114 YUCDA DRG SCR QL MDC EA U $ 12.00 50783406 HC 114 YUETHC ETHANOL CONF QN UR $ 50.75 50783414 HC 100 12320R THIOCYANATE $ 34.00 50783422 HC 429 12323R VON WILFAC MLT VIII $ 139.00 50783431 HC 114 12330R EVEROLIMS MS TMS QN $ 149.00 50783489 HC 100 12336R IMMUNO ALYT QNT $ 14.58 50783497 HC 100 12336R LYMPH TRANSFORM $ 55.21 50783562 HC 114 12358R PROPOXYPHENE QNT UR $ 45.52 50783571 HC 114 12371R COBALT MS TMS QN $ 55.01 50783588 HC 114 12373R CARBAMAZEPN TOT $ 17.36 50783596 HC 114 12373R CARB EPOXIDE TDA QN $ 16.32 50783646 HC 442 12334R ARR EVL 51-250 PRB $ 261.34 50783653 HC 114 12362R FL NONINF TIT EA AB $ 37.71 50783661 HC 114 12328R MS ANLY QUAN EA $ 72.48 50783679 HC 114 12328R SP STN GRP2 I&R $ 65.91 50783687 HC 114 12328R MICRODIS LZR CPTR $ 614.81

50783695 HC 442 12334R ARR EVL 251-500 PRB $ 395.85 50783828 HC 486 12324R HRP B VIR AB MNKYBT $ 60.00 50783919 HC 114 12390R IAD NA APT EA $ 103.48 50783927 HC 100 12401R ALK PHOS TOTAL $ 7.15 50783935 HC 100 12401R ALK PHOS ISOENZYMES $ 20.45 50784561 HC 114 12352R NMYLTSOP IMM QN NOS $ 161.40 50784651 HC 100 12395R 5 NUCLEOTINDASE $ 20.00 50784669 HC 100 12397R ACHR BLAB IM QN RIA $ 42.45 50784677 HC 100 12399R ACHR MAB IM QN RIA $ 84.80 50784685 HC 100 12406R GLCTS1PH UT QN $ 112.80 50784768 HC 100 12418R MS NES QL EA SPEC $ 115.00 50784776 HC 457 12514R ENZACT NONRD EA SP $ 242.00 50784842 HC 115 12507R CHMLMNSCNT ASSY $ 21.52 50784859 HC 115 12507R IMMUNO ALTY QNT NOS $ 19.73 50784909 HC 115 12507R C REACT PROTEIN $ 7.88 50784917 HC 115 12507R IMM EA AB INDRT $ 54.89 50785047 HC 425 12512R ARR 251-500 PRB $ 186.02 50785187 HC 114 12470R SP STN I&R GRP2 TIS $ 144.00 50785195 HC 114 12494R C&R SLD PREPREP $ 181.03 50785203 HC 114 12496R C&R SLIDE PREP $ 181.03 50785211 HC 114 12498R CNSLT COMP RVW $ 181.03 50785229 HC 114 12503R K 24HR FECES UNLST $ 34.40 50785237 HC 114 12505R SODIUM 24HR FECES $ 34.43 50785245 HC 114 12548R SIROLIMUS TDA $ 19.02 50785439 HC 425 12530R ARR EVL 251-500 PRB $ 65.44 50785830 HC 450 12560R CHR QN MLT ANL CSF $ 190.00 50786012 HC 457 12522R ANTI I EZYM ACE $ 151.46 50786020 HC 457 12522R ENZACT NONR EA SPEC $ 187.27 50786038 HC 114 12573R FLR NONINF AB SCRN $ 30.89 50786095 HC 420 12443R IMM QL SQNT MSM $ 304.58 50786103 HC 420 12443R IMM ANLY QNT RIA $ 304.58 50786111 HC 420 12443R PROT WB W/INTRP RP $ 304.63 50786129 HC 420 12443R PROT PRB ID EA $ 304.58 50786137 HC 420 12443R FL SCRN EA AB $ 304.58 50786145 HC 457 12524R ANGTSN I CE ACE $ 75.72 50786152 HC 457 12524R ENZ ACT NONRAD EA $ 93.64 50786389 HC 443 12580R TSH $ 27.07 50786397 HC 443 12580R CELL FNCT STM DET $ 218.86 50786405 HC 443 12580R MICAB ANTI THY IGG $ 23.44 50786413 HC 443 12580R THYROGLOB AB IGG $ 25.63 50786421 HC 114 12586R THIAMIN VIT B1 $ 30.50 50786439 HC 114 12099R BRUCELLA TOT AB $ 138.60 50786496 HC 114 12584R TIAGBN QUAN DRG NOS $ 51.42 50786504 HC 100 12605R FL NONIN SCRN EA AB $ 208.00 50786512 HC 100 12607R FL NONIN SRN EA CSF $ 208.00 50786520 HC 100 12602R FL NONIN TITR EA AB $ 144.00 50786595 HC 114 12601R OXALATE PED RND URN $ 11.13 50786645 HC 114 12652R TRYPTASE UNL CH PRC $ 100.00 50786652 HC 114 12631R VORI QNT DRG NES $ 57.50 50786660 HC 459 12633R FLOW TC 1ST MRKR $ 224.42 50786678 HC 459 12633R FLOW TC EA ADTL MRK $ 224.43 50786686 HC 459 12633R FLOW INTRP 2-8 MRKR $ 710.05 50786694 HC 494 12597R B CELLS TOT CNT $ 72.20

50786702 HC 494 12597R NK CELLS TOT CNT $ 72.20 50786710 HC 494 12597R T CELLS TOT CNT $ 72.20 50786728 HC 494 12597R TCELL ABS CD4&8 RAT $ 89.95 50786736 HC 494 12597R FLOW TC 1ST MRKR $ 32.01 50786744 HC 494 12597R FLOW TC EA ADDL MRK $ 32.01 50786751 HC 494 12597R FLOW INTRP 9-15 MRK $ 127.33 50786769 HC 459 11550R FLOW TC 1ST MRKR $ 469.05 50786777 HC 092 12582R LYMPH MIT ANTGN SCR $ 153.90 50786785 HC 114 12664R NTXTPD COL XLNK UR $ 46.22 50786889 HC 114 12733R ALPHA2 ANTIPLASMIN $ 68.20 50786897 HC 114 12635R B CELL TOT CNT $ 46.79 50786905 HC 114 12635R NAT KIL TOT CNT $ 46.79 50786913 HC 114 12635R T CELL TOT CNT $ 46.79 50786921 HC 114 12635R ABS CD4&8 CNT RAT $ 58.29 50786939 HC 114 12635R FLOW 1ST MRKR $ 20.74 50786947 HC 114 12635R CELL 1ST MRKR $ 20.74 50786954 HC 114 12635R CD40 1ST MRKR $ 20.74 50786962 HC 114 12635R EA ADDL MRKR $ 20.74 50786970 HC 114 12643R BTK FC 1ST MRKR $ 87.25 50786988 HC 114 12645R COMP FUNC ACT EA CM $ 49.75 50786996 HC 100 12721R SPCTM NES PLEU FLD $ 40.00 50787004 HC 100 12723R SPCTM NES PERI FLD $ 40.00 50787012 HC 100 12725R SPCTM ANLY NES CSF $ 40.00 50787020 HC 097 CYLEX CELL FNCT DETBIOMRK $ 275.00 50787210 HC 092 12581R IMM AB IGG QNT $ 17.83 50787228 HC 092 12581R IMM AB IGG QNT $ 17.79 50787236 HC 092 12583R ENZAC NONR EA SPEC $ 167.96 50787244 HC 092 12583R LEUK PHAGOCYTOSIS $ 74.29 50787251 HC 092 12585R IAD RNA APT EA QL $ 298.00 50787269 HC 092 12637R IMM AB IGG QNT $ 30.94 50787277 HC 092 12637R IMM AB IGG QNT $ 30.93 50787285 HC 092 12711R IMM AB IGG QNT $ 18.06 50787293 HC 092 12711R IMM AB IGG QNT $ 18.18 50787306 HC 494 12611R LYMPH TRAN $ 298.23 50787314 HC 494 12611R FC INTRP 2TO8 MRKR $ 321.77 50787322 HC 494 12655R LEUKCO PHAGOCYTOSIS $ 57.40 50787330 HC 494 12611R FC INTRP 2TO8 MRKR $ 380.20 50787348 HC 494 12657R B CELLS TOT CNT $ 88.79 50787355 HC 494 12657R NK CELLS TOT CNT $ 88.79 50787363 HC 494 12657R T CELLS TOT CNT $ 88.79 50787371 HC 494 12657R TCELL ABS CD4&8 RAT $ 110.60 50787389 HC 494 12657R FLOW TECH 1ST MRK $ 39.36 50787397 HC 494 12657R FLOW TC EA ADDL MRK $ 39.36 50787405 HC 494 12657R FLOW INTRP 2-8 MRK $ 124.51 50787413 HC 494 12659R B CELLS TOT CNT $ 79.46 50787421 HC 494 12659R NK CELLS TOT CNT $ 79.46 50787439 HC 494 12659R T CELLS TOT CNT $ 79.46 50787447 HC 494 12659R TCELL ABS CD4&8 RAT $ 98.98 50787454 HC 494 12659R FLOW TECH 1ST MRK $ 35.22 50787462 HC 494 12659R FLOW TC EA ADDL MRK $ 35.22 50787470 HC 494 12659R FLOW INTRP 9-15 MRK $ 140.10 50787488 HC 115 12689R CHEM IFXATI LVL QN $ 2,500.00 50787496 HC 459 12647R IMM ANLYT QNT NOS $ 233.55

50787504 HC 459 12649R IMM ANL QNT NOS CSF $ 233.55 50787637 HC 114 12762R TACROLIMUS $ 22.90 50787645 HC 441 12767R ARX SEQ ANALY $ 730.00 50787652 HC 118 11115R BLM SYND ANAL $ 105.00 50787660 HC 118 11116R FANCONI ANAL $ 105.00 50787678 HC 118 11117R Y CHROM MICRO $ 237.00 50787686 HC 442 11318R GCDH GENE SEQ $ 1,020.00 50787694 HC 11320R SCN1A DNA SEQ TST $ 2,941.00 50787702 HC 11324R CADASIL EVAL $ 2,840.50 50787710 HC 420 11326R TSC1 DELETION ANAL $ 848.93 50787744 HC 441 11328R ANGEL MET $ 350.00 50787751 HC 425 11357R FAM MEDI FEV $ 650.00 50787769 HC 425 11361R COWDEN PTEN $ 950.00 50787777 HC 425 11361R DUP/DEL VARI $ 900.00 50787785 HC 425 11365R FAM HIBER FEV $ 650.00 50787793 HC 11373R MARF FBN1 SEQ $ 1,400.00 50787806 HC 11375R OI(COLIA1,COLIA2) ANL $ 900.00 50787814 HC 442 11514R POMPE GAA SEQ $ 2,130.00 50787822 HC 442 11516R PANCRE FULL SEQ $ 655.00 50787830 HC 442 11516R PANCR 8 POLY-T $ 655.00 50787848 HC 442 11516R PRSSI GENE SEQ $ 655.00 50787863 HC 11521R DM1 DNA $ 674.15 50787871 HC 11527R SPINL MUSC ATR $ 611.00 50787889 HC 441 11534R MTDNA SCRN $ 190.00 50787897 HC 441 11535R POLG SEQ ANAL $ 1,750.00 50787905 HC 441 11540R OTC SEQ ANAL $ 710.00 50787913 HC 441 11544R SYDM UBE3A $ 2,120.00 50787921 HC 441 11545R DMPK DETECT $ 360.00 50787947 HC 441 11546R SPECTROP ANA $ 52.77 50787970 HC 11548R NATP IMMU TST $ 50.70 50787988 HC 429 11548R NATP AB $ 50.64 50787996 HC 118 11570R SMA CARRIER $ 875.00 50788004 HC 425 11573R CCN MUT ISOL/ET $ 731.50 50788012 HC 425 11576R MMACHC DEFIC $ 665.00 50788020 HC 425 11577R JAG1 MUTATION $ 1,530.00 50788038 HC 425 11579R PTPN11 MUT $ 1,235.00 50788046 HC 425 11580R CDH7 GENE SEQ $ 3,510.00 50788053 HC 445 11585R FRAGX CARRIER $ 350.00 50788061 HC 114 11606R P450 GENOTYPE $ 477.30 50788079 HC 11617R CMV AMP PROB $ 146.00 50788087 HC 11618R HSV 1/2 PCR AQ $ 531.00 50788095 HC 11619R VZV PCR AQUE $ 146.00 50788103 HC 11620R TOXO GONDII AQ $ 146.00 50788111 HC 425 11989R QT SYN ANAL $ 3,037.50 50788129 HC 118 12080R CANA DISEAS ANL $ 158.00 50788137 HC 118 12082R GSD1A MUTA ANAL $ 150.00 50788145 HC 118 12084R MLIV MUTA ANAL $ 140.00 50788152 HC 118 12086R NI-PICK TYPE A $ 123.00 50788160 HC 118 12088R TAY-SACHS MUT $ 158.00 50788178 HC 118 12216R FAM DYSAU MUT $ 140.00 50788186 HC 118 12218R GAUCH DISEA MUT $ 158.00 50788194 HC 118 12220R MSUD GENE ANLY $ 278.00 50788202 HC 441 12224R MTDNA SEQ ANLYS $ 78.05

50788210 HC 441 12224R MTDNA ANLYS $ 77.77 50788228 HC 114 12331R MLH1 HYPER ANL $ 453.40 50788236 HC 114 12332R KIT MUT EXON 11 $ 765.50 50788244 HC 114 12333R KIT MUT 9 EXON $ 765.50 50788251 HC 442 12334R XLID ANAL $ 62.40 50788285 HC 442 12334R DET MUT VARI $ 62.40 50788293 HC 442 12334R 1 EXON BY DNA $ 62.50 50788348 HC 442 12334R EXONS BY DNA $ 62.25 50788355 HC 441 12380R SCO1 SEQ ANAL $ 590.00 50788363 HC 441 12382R SCO2 SEQ ANAL $ 410.00 50788371 HC 441 12384R SLC22A5 SEQ ANL $ 1,120.00 50788397 HC 442 12386R DET DYNMC MUT $ 50.95 50788405 HC 442 12386R 1 EXON DNA SEQ $ 50.95 50788421 HC 442 12386R 6-10 EXONS DNA $ 50.85 50788439 HC 442 12386R 11-25 EXONS DNA $ 50.85 50788454 HC 442 12386R XLMR NXT GN PNL $ 50.85 50788462 HC 441 ACADVL SEQ ANLYS $ 1,220.00 50788470 HC 100 ACVRL1 SEQ DEL/DUP $ 867.50 50788488 HC 441 12435R MECP2 SEQ ANAL $ 670.00 50788496 HC 441 12435R DUP/DELETION $ 670.00 50788504 HC 441 MTDNA FULL GENE SEQ $ 1,000.00 50788512 HC 441 MTDNA MASS PARALEL SEQ $ 1,000.00 50788520 HC 425 12510R PERIOD FEV SYND $ 696.66 50788538 HC 425 12510R PERIOD FEV PNL $ 696.66 50788546 HC 425 12510R SPECTROPHOTOM $ 696.68 50788553 HC 425 12512R VHL DEL/DUP ANA $ 450.00 50788561 HC 425 12512R VHL FUL GNE SEQ $ 450.00 50788579 HC 12536R MARFAN DNA SEQ $ 1,570.00 50788587 HC 12538R TCS1 DNA SEQ $ 1,830.00 50788595 HC 425 12540R SCAD DEFICIENCY $ 1,064.00 50788603 HC 425 GLUTARIC ACIDURIA TYPE $ 1,116.00 50788611 HC 425 12544R ACADVL GENE ANL $ 1,431.00 50788629 HC 457 12546R NEIMA DIS TYP C $ 3,100.00 50788637 HC 489 12556R PNH SEQ DELETE $ 1,818.00 50788645 HC 490 TRIMETHYLAMINURIA FMO3 $ 690.00 50788652 HC 12566R PTT HOPKIN SYND $ 1,895.00 50788660 HC KABUKI SYNDRM (MLL2) $ 2,995.00 50788678 HC 12571R FLT3 GENE ANAL $ 150.00 50788686 HC 491 12571R FLT3-ITD/D835 $ 150.00 50788694 HC 425 12599R DILATED CARD SQ $ 759.37 50788702 HC 425 12599R DCM DIL CARDMYP $ 759.37 50788710 HC 425 12599R DCM/LVNC SEQ $ 759.37 50788728 HC 425 SPECTROPHOTO ANALYTE $ 759.39 50788736 HC 114 12603R TREC IMMUN RECN $ 272.10 50788744 HC OTOFERLIN KNOWN MUT $ 479.00 50788751 HC 459 12641R OTOFERLIN COMP $ 1,915.00 50788769 HC 425 12651R HCM PANEL $ 759.38 50788777 HC 425 12651R HCM 6-10 EN DNA $ 759.38 50788785 HC 425 12651R 11-25 EXONS DNA $ 759.37 50788793 HC 425 SPECTROPHOTO ANALYTE $ 759.37 50788806 HC ADMARK APOE GENOTYPE $ 485.00 50788814 HC 092 CMV GENOTYPE $ 637.50 50788848 HC HUNTINGTONS DISEASE $ 533.50

50788855 HC KENNEDYS DISEASE DNA $ 485.00 50788863 HC MELAS MTDNA PROFILE $ 1,411.00 50788871 HC TTR AMYLOIDOSIS DNA $ 948.45 50788889 HC 114 APLOPOPROTEIN GEN TYP $ 220.37 50788897 HC 114 HEMOCHROMA HFE GENE $ 118.75 50788905 HC 490 12562R MYH3 GENE SEQ $ 1,930.00 50788913 HC 114 AMINO ACID 24HR URINE $ 89.35 50788921 HC 000 ENCEPHALITIS AB SCRN $ 302.22 50788939 HC 000 QUANTITATIVE BY RIA $ 302.23 50788947 HC 000 12272R BLOT W/INTERP $ 302.23 50788954 HC 000 WEST W/PROBE IDENT $ 302.22 50788962 HC 000 NONINFECT AB SCRN $ 302.22 50788970 HC 000 12558R SNP MICROARRAY $ 2,100.00 50788988 HC 092 12781R BRUCELLA AB IGM $ 41.62 50789004 HC 114 REDUCE SUBSTANCE FECES $ 45.38 50789012 HC 092 ECHIG AB IGG, EIA $ 192.00 50789020 HC 088 COCCI AB IMMUNO CSF $ 34.00 50789038 HC 100 12788R OVARY AB TITER $ 82.00 50789046 HC 420 12774R MOTOR NEURO AB $ 218.25 50789053 HC 118 TAY SACHS ENZYME ANAL $ 91.00 50789061 HC 114 CRMP 5 IGG WEST BLOT $ 114.51 50789079 HC 449 11589R COL2A1 ANAL DNA $ 1,400.00 50789103 HC 092 BRUCELLA AB IGG $ 41.63 50789145 HC 100 12796R FLUCONAZOLE $ 53.75 50789152 HC 114 12798R CALPROTECTIN FECAL $ 197.00 50789160 HC 114 12790R CYST C W/GFR $ 7.13 50789178 HC 115 CEPLUS DGP IGAIGG TRAN IGA $ 87.28 50789186 HC 115 CEPLUS EMA IGA AB IFA $ 87.30 50789194 HC 115 CEPLUS TOTAL SERUM IGA $ 87.30 50789202 HC 115 CEPLUS HLA-DQA1/DQB1 $ 87.28 50789210 HC 115 12057R ELISA AB SPEC MARK $ 28.74 50789228 HC 115 12507R ICAM/VCAM/SAA $ 28.74 50789236 HC 115 12507R CRP $ 28.91 50789244 HC 115 12507R IBD IFA IGG DNASE $ 28.74 50789251 HC 115 12507R IBD SGI SNP $ 28.74 50789269 HC 115 PROTPM TPMT GENETICS $ 296.25 50789277 HC 115 11435R HLA DQA1/DQB1 $ 211.25 50789285 HC 092 12786R BRUCELLA AB AGG $ 68.25 50789293 HC 100 12802R HEP COFACT CHRM AS $ 174.00 50789306 HC 092 12815R LYME AB IGG IGM $ 54.56 50789314 HC 084 TOXPCR TOXOPLASMA PCR $ 389.00 50789322 HC 114 12756R PCA3 ASSAY $ 500.00 50789330 HC 114 12808R CK TOTAL $ 8.50 50789355 HC 097 12817R DONOR HEP C AB $ 210.00 50789363 HC 097 12817R DONOE 2 HEP C AB $ 70.00 50789371 HC 092 12813R PARVO B19 ABIGG $ 23.50 50789389 HC 114 12792R CITRATE EXCR UR $ 23.75 50789397 HC 114 12811R MYOGLOBIN URINE $ 18.70 50789405 HC 114 12810R CHLORIDE $ 13.43 50789413 HC 114 12810R MAGNESIUM $ 13.43 50789421 HC 114 12810R SODIUM $ 13.43 50789439 HC 114 12810R PHOSPHORUS $ 13.42 50789447 HC 114 12810R OSMOLALITY POTAS $ 13.42

50789454 HC 114 11608R FBN1 FULL GENE $ 2,092.70 50789462 HC 449 11589R COL2A1 DNA SEQ $ 1,400.00 50789470 HC 420 ADMARK TAU/AB42 CSF $ 349.20 50789488 HC 420 ADMARK PHOSPHO TAU/TOT $ 349.20 50789496 HC 420 DYSTON (DYT1) DNA $ 582.00 50789512 HC 114 12809R CK ISOENZ ELECT $ 20.24 50789520 HC 485 12836R EG ASSAY $ 50.00 50789538 HC 448 11443R NF1 RNA/CDNA SEQ $ 400.00 50789546 HC 097 12761R HEP B VIRUS GEN $ 396.00 50789553 HC 095 CAHD CAUDETYTM PCR $ 420.00 50789561 HC 441 11537R MTDNA DEPLETION $ 1,780.00 50789579 HC 441 11537R MTDNA SEQ ANLYS $ 1,780.00 50789587 HC 448 11443R 26-50 EXONS DNA $ 400.00 50789595 HC 448 11443R NF1 NONNEO CULT $ 400.00 50789603 HC 425 12530R NDS1 11-25 EXONS $ 1,350.00 50789611 HC 425 12530R NDS1 26-50 EXONS $ 1,350.00 50789629 HC 092 HBV HEP B GENO $ 254.12 50789637 HC 092 12814R MYCO PNM IGG IGM $ 51.75 50789645 HC 114 12838R IGF1 SOMATOMED $ 27.85 50789652 HC 445 11367R NDS1 11-25-EXON $ 2,400.00 50789660 HC 445 11584R MECP2 SEQ ANAL $ 900.00 50789678 HC 445 11586R MPS II ENZ ANAL EA $ 200.00 50789686 HC 441 12433R PAH DEFIC SEQ $ 810.00 50789694 HC 441 12222R MCCC1 SEQ ANAL $ 1,020.00 50789702 HC 441 11538R COX IV PANEL $ 555.00 50789710 HC 441 11539R MCAD DEFIC SEQ $ 820.00 50789728 HC 114 11583R NPC2 GENE SEQ $ 1,047.95 50789736 HC 114 11583R NPC1 GENE SEQ $ 1,047.95 50789744 HC 442 11517R PCD GENE SEQ $ 320.82 50789751 HC 442 11517R PCD 8 POLY-T ANAL $ 320.82 50789769 HC 442 11517R PCD MOLE PATH $ 320.76 50789777 HC 425 11359R KNOWN FAM MUTAT $ 350.00 50789785 HC 425 11574R HRAS GENE SEQ $ 674.50 50789793 HC 425 11578R CFC BRAF GENE SEQ $ 1,425.00 50789806 HC 441 11536R TK2-RELAT MTDNA $ 1,320.00 50789814 HC 425 12518R NPC1 GENE SEQ $ 2,650.50 50789822 HC 425 12520R NPC2 GENE SEQ $ 665.00 50789830 HC 425 12526R VDWS IRF6 SEQ $ 940.50 50789848 HC 425 12528R TBS SALL1 SEQ $ 1,653.00 50789855 HC 425 12532R PJS STK11 $ 150.00 50789863 HC 425 12532R PJS STK11 EA DNA $ 150.00 50789871 HC 425 12532R INTERP REPORT $ 150.00 50789889 HC 425 11581R HPE SEQ $ 187.50 50789897 HC 425 11581R HPE EA DNA PROBE $ 187.50 50789905 HC 425 11581R INTERP REPORT $ 187.50 50789913 HC 442 11513R CF YG ANALYSIS $ 400.00 50789921 HC 442 11515R PKU (PAH) SEQ $ 1,170.00 50789939 HC 442 11512R CF FULL GENE SEQ $ 665.00 50789947 HC 442 11512R CF 8 POLY-T ANAL $ 665.00 50789954 HC 100 11518R BCR-ABL1 QUANT $ 330.00 50789962 HC 487 12534R STL COL9A SEQ $ 890.00 50789996 HC 420 11528R PPN AB ANALYTE $ 209.10 50789997 HC 420 11528R PPN QUANT NONAB $ 209.09

50789998 HC 420 12439R 2-5 EXON DNA SEQ $ 82.91 50789999 HC 420 12439R 6-10 EXON DNA $ 82.91 50790000 HC 420 12439R 11-25 EXON DNA $ 82.91 50790001 HC 420 12439R DYSF GEN SEQ $ 82.95 50790002 HC 420 12439R LGMD $ 82.95 50790003 HC 425 11582R MMA GENE SEQ $ 1,605.50 50790004 HC 448 11443R NF1 RNA/CDNA SEQ $ 400.00 50790005 HC 420 11062R HNF4A DNA SEQ $ 455.00 50790006 HC 420 11062R HNF4A MOLE PATH $ 455.00 50790007 HC 420 11063R GCK DNA SEQ $ 590.00 50790008 HC 420 11063R GCK MOLE PATH $ 590.00 50790009 HC 420 11064R TCF1 MOLE PROCED $ 600.00 50790010 HC 420 11066R TCF2 2-5 EXONS DNA $ 417.50 50790011 HC 420 MODY 2-5 EXONS DNA $ 570.71 50790012 HC 420 MODY 11-25 EXONS DNA $ 570.71 50790014 HC 420 MODY 6-10 EXONS DNA $ 570.71 50790015 HC 420 MODY MOLE PROCED $ 570.74 50790016 HC 420 11064R TCF1 6-10 EXONS DNA $ 600.00 50790017 HC 420 11066R TCF2 6-10 EXONS DNA $ 417.50 50790018 HC 114 12849R AMPHIPHYSIN WBLOT $ 270.20 50790019 HC 114 12847R PARANEO AB WBLOT $ 140.93 50790020 HC 114 12853R EVEROLIMUS BLOOD $ 169.50 50790022 HC 114 12851R NMO/AQPA IGG CBA $ 161.40 50790052 HC 114 12845R HMVNLLC ACD UR $ 26.14 50790053 HC 114 12845R VMA URINE $ 26.15 50790071 HC 092 12866R B HENSELAE IGG $ 14.06 50790121 HC 092 12867R B QUINTANA IGG $ 14.06 50790261 HC 429 11013R AB ID PLATELETS $ 217.00 50790286 HC 114 HYDROXYLASE AB,SR $ 38.20 50790294 HC 114 METANEPHRINES FREE PL $ 68.45 50790328 HC 114 SOLUBLE TRANSFERRIN RE $ 29.16 50790369 HC 100 TRYPSIN,FECAL $ 13.87 50790377 HC 100 F1137VITAMIN KI, SERUM $ 74.00 50790393 HC 100 CREATINE,SERUM $ 68.25 50790401 HC 100 F1172EOSINOPHIL,CAT PROTEI $ 87.50 50790435 HC 095 INSULIN ANTIBODY $ 37.10 50790443 HC 120 ELESTASE-1 $ 55.00 50790450 HC 121 LONG CHAIN FATTY ACIDS $ 165.00 50790468 HC 121 DEHYDROCHOLESTEROL $ 150.00 50790807 HC 097 FREE T3 DIALYSIS $ 26.65 50791268 HC 427 CYLEX $ 272.00 50791425 HC 097 DNAEX SPLIT BLD EA UNIT $ 267.46 50799053 HC 114 12845R VMA URINE $ 26.15 50802594 HC ISOL NUC ACID B-CLONE PCR EA $ 146.00 50802602 HC ISOL NUC ACID BCR ABL EA NA $ 146.00 50802628 HC ISOL NUC ACID FCTR V LEIDEN EA $ 146.00 50802636 HC ISOL NUC ACID MTHFR EA NA $ 146.00 50802644 HC ISOL NUC ACID PRADER WILLI EA $ 146.00 50802651 HC ISOL NUC ACID PT20210A EA NA $ 146.00 50802669 HC ISOL NUC ACID T(14;18) EA NA $ 146.00 50802677 HC ISOL NUC ACID T-CLONE PCR EA $ 146.00 50802693 HC ISOLATION NUCLEIC ACID EA $ 146.00 50802719 HC ENSYMATIC DIGESTION EA $ 78.00

50802735 HC SEPARATION ELECTROPHORESIS EA $ 103.00 50802743 HC NUC ACID PROBE BLOT $ 53.00 50802750 HC NUCLEIC ACID TRANSFER EA NA $ 65.00 50802768 HC AMP NA EA $ 188.00 50802776 HC AMP MPLX NA ADD $ 90.00 50802784 HC REVERSE TRANSCRIPTION $ 140.00 50802792 HC MUTATION SCAN HETERODUPLEX $ 84.00 50802800 HC MUT ID SEQUN EA SEG $ 54.00 50802818 HC INTERP AND REPORT MOLECULAR $ 138.00 50802974 HC ISOL NUC ACID QUANT BCR ABL EA $ 146.00 50802982 HC NUC ACID PROBE PCR $ 53.00 50802990 HC AMP NE EA QUANT $ 188.00 50803006 HC ISOL NUC ACID CF EA NA $ 146.00 50803030 HC ISOLATION NUC ACID COENXIN SEQ $ 146.00 50803055 HC ISOL NUC ACID DBMD EA NA $ 146.00 50803089 HC SEP ELECTROPH CAPILLARY EA $ 112.00 50803097 HC ISO NUC ACID FRAGILE X EA NA $ 146.00 50803105 HC ISOL A-THAL EA NA $ 146.00 50803139 HC ISOL NA BTHAL SEQ EA $ 146.00 50803162 HC ISOL NA CHONDRO EA $ 146.00 50803261 HC ISOL NA CCND1/LGH EA $ 146.00 50803279 HC AMP NA EA CRANIO $ 188.00 50803287 HC ISOL NA MUNENKE EA $ 146.00 50803295 HC AMP NA EA PFEIFFER $ 188.00 50803345 HC ISOL NUC ACID MCC EA NA $ 146.00 50803352 HC ISOL NUC ACID CON30 EA NA $ 146.00 50803386 HC ISOL NA T(15;17) EA $ 146.00 50803394 HC ISOL NA MSAT INSTAB EA $ 146.00 50803451 HC FREE PROTEIN S $ 282.00 50803469 HC ISOL NA PENDRED EA $ 146.00 50803600 HC DRVVT $ 240.00 50803626 HC AMP MPLX NA 1-2 $ 172.00 50803634 HC MUT ID ENZ LIG/PRM EXT EA $ 71.00 50803642 HC INTERP AND REPORT, VH MUTATION $ 138.00 50803667 HC INTERP AND REPORT CDH1 $ 138.00 50803691 HC C-KIT MUT ISOL HP EA NA $ 146.00 50803709 HC C-KIT MUT SEP GEL ELECT EA NA $ 103.00 50803717 HC C-KIT MUT AMP EA NA SEQ $ 188.00 50803725 HC C-KIT MUT REVERSE TRANS $ 140.00 50803733 HC C-KIT MUT ID SEQ EA SEG $ 54.00 50803741 HC C-KIT MUT MOL INTRP RPT $ 138.00 50803758 HC BCRKDM ISOL EA NA $ 146.00 50803766 HC KRAS MOL ISOL EA NA $ 125.00 50803774 HC KRAS MUT ISOL EA NA $ 146.00 50803782 HC KRAS ENZYMATIC DIGEST EA $ 78.00 50803790 HC KRAS MUT AMP EA NA $ 188.00 50803808 HC KRAS AMP MPLX 1ST 2 NA SEQ $ 172.00 50803816 HC KRAS AMP MPLX NA EA ADD SEQ $ 90.00 50803824 HC KRAS LYSIS PRE NA EA SP $ 66.00 50803832 HC KRAS SEP ELECTRO CAP HI RES EA $ 112.00 50803840 HC KRAS MOL INTERP AND RPT $ 138.00 50803857 HC KRAS MUT ID EA SEGMENT $ 71.00 50803865 HC MGMT MUT ISOL EA NA $ 146.00

50803873 HC MGMT SEP GEL ELECT EA NA $ 103.00 50803881 HC MGMT MUT AMP TARGET NA $ 188.00 50803899 HC MGMT LYSIS PRE NA EA SP $ 66.00 50803907 HC MGMT INTERP AND RPT $ 138.00 50803915 HC EGFRP MUT ISOL EA NA $ 146.00 50803923 HC EGFRP ENZYMATIC DIGESTION EA $ 78.00 50803931 HC EGFRP MUT AMP NA $ 188.00 50803949 HC EGFRP LYSIS PRE NA EXTR EA SP $ 66.00 50803956 HC EGFRP SEP ELECTRO CAP EA $ 112.00 50803964 HC EGFRP INTERP AND RPT $ 138.00 50803972 HC BCDHPX ISOL OR EXT EA NA $ 125.00 50803980 HC BCDHPX MUT SEP GEL ELCT EA NA $ 103.00 50803998 HC BCDHPX MUT AMP EA NA SEQ $ 188.00 50804004 HC BCDHPX MUT ID EA SEG $ 54.00 50804012 HC BCDHPX LYSIS PRE NA EXTR EA SP $ 66.00 50804020 HC BCDHPX INTERP AND RPT $ 138.00 50804038 HC BCDHPT ISOL OR EXT EA NA $ 125.00 50804046 HC BCDHPT MUT SEP GEL ELCT EA NA $ 103.00 50804053 HC BCDHPT MUT AMP EA NA SEQ $ 188.00 50804061 HC BCDHPT MUT ID EA SEQ $ 54.00 50804079 HC BCDHPT LYSIS PRE NA EXTR EA SP $ 66.00 50804087 HC BCDHPT INTERP AND RPT $ 138.00 50804095 HC AMLP MUT AMP NA EA SEQ $ 188.00 50804103 HC AMLP INTERP AND RPT $ 138.00 50804111 HC CEPBA ISL EXT HP NA EA TYPE $ 146.00 50804129 HC CEPBA SEP GEL ELECT EA NA PREP $ 103.00 50804137 HC CEPBA AMP TRGT EA NA SEQ $ 188.00 50804145 HC CEPBA MUT ID SEQ SNGL SEG EA $ 54.00 50804152 HC CEPBA INTRP AND REPORT $ 138.00 50804160 HC ATHAL NA PROBE EA $ 53.00 50804178 HC ATHAL AMP EA NA SEQ $ 188.00 50804186 HC BCRABL KDM MUT ISOL NA $ 146.00 50804194 HC BCRABL KDM INTRP AND RPT $ 138.00 50804202 HC BTCRB AMP MPLX 1 2 $ 172.00 50804210 HC BTCRB AMP MPLX ADTL $ 90.00 50804228 HC BTCRB SEP ELEC CAP $ 112.00 50804236 HC BTCRB INTRP AND RPT $ 138.00 50804244 HC BIGK AMP MPLX 1 2 $ 172.00 50804251 HC BIGK AMP MPLX ADTL $ 90.00 50804269 HC BIGK SEP ELEC CAP $ 112.00 50804277 HC BIGK INTRP AND RPT $ 138.00 50804285 HC JAK2 MUT ISOL HP EA NA $ 146.00 50804293 HC JAK2 NA PROBE EA $ 53.00 50804301 HC JAK2 AMP EA NA SEQ $ 188.00 50804319 HC JAK2 INTRP AND RPT $ 138.00 50804327 HC BTCRB MUT ISOL HP EA NA $ 146.00 50804335 HC BTCRG MUT ISOL HP EA NA $ 146.00 50804343 HC BTCRG AMP MPLX 1ST 2 NA SEQ $ 172.00 50804350 HC BTCRG AMP MPLX ADTL BYND2 $ 90.00 50804368 HC BTCRG SEP ID ELEC CAP EA NA $ 112.00 50804376 HC BTCRG MOL INTRP & RPT $ 138.00 50804384 HC BTCRGB MUT ISOL HP EA NA $ 146.00 50804392 HC BTCRGB AMP MPLX 1ST 2 NA SEQ $ 172.00

50804400 HC BTCRGB AMP MPLX ADTL BYND2 $ 90.00 50804418 HC BTCRGB SEP ID ELEC CAP EA NA $ 112.00 50804426 HC BTCRGB MOL INTRP & RPT $ 138.00 50804434 HC BHEAV MUT ISOL EA NA $ 146.00 50804442 HC BHEAV AMP MPLX 1ST 2 NA SEQ $ 172.00 50804459 HC BHEAV AMP MPLX ADTL BYND2 $ 90.00 50804467 HC BHEAV SEP ELEC CAP EA NA $ 112.00 50804475 HC BHEAV INTRP AND RPT $ 138.00 50804483 HC BIGKH MUT ISOL EA NA $ 146.00 50804491 HC BIGKH AMP MPLX 1ST 2 NA SEQ $ 172.00 50804509 HC BIGKH AMP MPLX ADTL BYND2 $ 90.00 50804517 HC BIGKH SEP ELEC CAP EA NA $ 112.00 50804525 HC BIGKH INTRP AND RPT $ 138.00 50804533 HC BRAF MUT ISOL HP EA NA $ 146.00 50804541 HC BRAF MUT SEP GEL ELECT $ 103.00 50804558 HC BRAF MUT AMP EA NA SEQ $ 188.00 50804566 HC BRAF LYSIS PRE NA EA EXTRCT $ 66.00 50804574 HC BRAF MOL INTRP AND RPT $ 138.00 50804616 HC T1517 AMP EA NA SEQ $ 188.00 50804624 HC CFDS ISOL HP EA NA DNA $ 146.00 50804632 HC CFDS SEP GEL ELCT EA NA $ 103.00 50804640 HC CFDS AMP EA NA SEQ $ 188.00 50804657 HC CFDS MUT ID SEQ EA SEG $ 54.00 50804665 HC CFDS INTRP AND RPT $ 138.00 50804673 HC CFPT SEP GEL ELCT EA NA PRP $ 103.00 50804681 HC CFPT AMP EA NA SEQ $ 188.00 50804699 HC CFPT MUT ID SEQ EA SEG $ 54.00 50804707 HC CFPT INTRP AND RPT $ 138.00 50804715 HC BCFDSX ISOL HP EA NA DNA $ 146.00 50804723 HC BCFDSX SEP GEL ELCT EA NA $ 103.00 50804731 HC BCFDSX AMP EA NA SEQ $ 188.00 50804749 HC BCFDSX MUT ID SEQ EA SEG $ 54.00 50804756 HC BCFDSX INTRP AND RPT $ 138.00 50804764 HC BCFDS2 ISOL HP EA NA DNA $ 146.00 50804772 HC BCFDS2 SEP GEL ELCT EA NA $ 103.00 50804780 HC BCFDS2 AMP EA NA SEQ $ 188.00 50804798 HC BCFDS2 MUT ID SEQ EA SEG $ 54.00 50804806 HC BCFDS2 INTRP AND RPT $ 138.00 50804822 HC CFMLPA ISOL EXT HPA EA NA $ 146.00 50804830 HC CFMLPA NA PROBE EACH $ 53.00 50804848 HC CFMLPA AMP MPLX 1ST 2 NASEQ $ 172.00 50804855 HC CFMLPA AMP MPLX EA ADL NASQ $ 90.00 50804863 HC CFMLPA SEP ID HRT EA NA PRP $ 112.00 50804871 HC CFMLPA MUTID ENZ PRIM EA SG $ 71.00 50804889 HC CSMP ISOL EXT HPA EA NA $ 146.00 50804897 HC CSMP ENZY DIGEST EA TRMT $ 78.00 50804905 HC CSMP AMP MPLX 1ST 2 NA SEQ $ 172.00 50804913 HC CSMP AMP MPLX EA ADL NA SQ $ 90.00 50804921 HC CSMP SEP ID HRT EA NA PREP $ 112.00 50804939 HC CSMP INTRP AND RPT $ 138.00 50804947 HC CSMP MUTID ENZ PRIM EA SEG $ 71.00 50804954 HC BIOSA ISOL EXT HPA EA NA $ 146.00 50804962 HC BIOSA ENZY DIGEST EA TRMT $ 78.00

50804970 HC BIOSA SEP GEL ELCT EANA PRP $ 103.00 50804988 HC BIOSA AMP EA NA SEQ $ 188.00 50804996 HC BIOSA MUTID BY SEQ SS EA SG $ 54.00 50805001 HC BIOSA INTRP AND RPT $ 138.00 50805019 HC CFMLPA INTRP AND RPT $ 138.00 50805027 HC MGMTB ISOL EXT HPA EA NA $ 146.00 50805035 HC MGMTB SEP GEL ELCT EANA PRP $ 103.00 50805043 HC MGMTB AMP EA NA SEQ $ 188.00 50805050 HC MGMTB LYSIS CELL PRE NA EXT $ 66.00 50805068 HC MGMTB INTRP AND RPT $ 138.00 50805076 HC ND816V ISOL EXT HPA EANA NONBL $ 146.00 50805084 HC ND816V AMP EA NA SEQ NONBLD $ 188.00 50805092 HC ND816V SEP ID HRT EANA PREP NB $ 112.00 50805100 HC ND816V INTRP AND RPT NONBLD $ 138.00 50805118 HC D816V ISOL EXT HPA EA NA $ 146.00 50805126 HC D816V AMP EA NA SEQ $ 188.00 50805134 HC D816V SEP ID HRT EA NA PREP $ 112.00 50805142 HC D816V INTRP AND RPT $ 138.00 50805811 HC NPM1 ISL EXT HP EA NA $ 146.00 50805829 HC NPM1 ENZY DIG EA TRT $ 78.00 50805837 HC NPM1 AMP TRG EA NA SQ $ 188.00 50805845 HC NPM1 SEP ID HRT EA NA PR $ 112.00 50805852 HC NPM1 INTRP AND RPT $ 138.00 50805861 HC BMNPM1 ISL EXT HP EA NA $ 146.00 50805878 HC BMNPM1 ENZY DIG EA TRT $ 78.00 50805886 HC BMNPM1 AMP TRG EA NA SQ $ 188.00 50805894 HC BMNPM1 SEP ID HRT EA NA PR $ 112.00 50805902 HC BMNPM1 INTRP AND RPT $ 138.00 50805911 HC CFSS ISL EXT HP EA NA $ 146.00 50805928 HC CFSS SEP GEL ELCT EA $ 103.00 50805936 HC CFSS AMP TRG EA NA SQ $ 188.00 50805944 HC CFSS MUT ID SQ EA SG $ 54.00 50805951 HC CFSS INTRP AND RPT $ 138.00 50805969 HC CSMPB ISOL EXT HP EA NA $ 146.00 50805977 HC CSMPB ENZY DIGEST EA TRMT $ 78.00 50805985 HC CSMPB AMP MPLX 1ST 2 NA SEQ $ 172.00 50805993 HC CSMPB AMP MPLX EA ADL NA SQ $ 90.00 50806009 HC CSMPB SEP ID HRT EA NA PREP $ 112.00 50806012 HC CSMPB INTRP AND RPT $ 138.00 50806020 HC CSMPB MUTID ENZ PRIM EA SEG $ 71.00 50806038 HC CSMPBM ISOL EXT HP EA NA $ 146.00 50806046 HC CSMPBM ENZY DIGEST EA TRMT $ 78.00 50806053 HC CSMPBM AMP MPLX 1ST 2 NA SEQ $ 172.00 50806061 HC CSMPBM AMP MPLX EA ADL NA SQ $ 90.00 50806079 HC CSMPBM SEP ID HRT EA NA PREP $ 112.00 50806087 HC CSMPBM INTRP AND RPT $ 138.00 50806095 HC CSMPBM MUTID ENZ PRIM EA SEG $ 71.00 50806103 HC FFGFR1 ISL EXT HP EA NA FLUID $ 146.00 50806111 HC FFGFR1 SEP GEL ELCT EA NA FLD $ 103.00 50806129 HC FFGFR1 AMP TRG EA NA SEQ FLD $ 188.00 50806137 HC FFGFR1 MUT ID SEQ EA SEG FLD $ 54.00 50806145 HC FFGFR1 INTRP AND RPT FLUID $ 138.00 50806152 HC FFGFR2 ISL EXT HP EA NA FLUID $ 146.00

50806160 HC FFGFR2 SEP GEL ELCT EA NA FLD $ 103.00 50806178 HC FFGFR2 AMP TRG EA NA SEQ FLD $ 188.00 50806186 HC FFGFR2 MUT ID SEQ EA SEG FLD $ 54.00 50806194 HC FFGFR2 INTRP AND RPT FLUID $ 138.00 50806202 HC FFGFR3 ISL EXT HP EA NA FLUID $ 146.00 50806210 HC FFGFR3 ENZY DIGEST EA TRMT FL $ 78.00 50806228 HC FFGFR3 SEP GEL ELCT EA NA FLD $ 103.00 50806236 HC FFGFR3 AMP TRG EA NA SEQ FLD $ 188.00 50806244 HC FFGFR3 INTRP AND RPT FLUID $ 138.00 50806251 HC BPDX1 ISL EXT HP EA NA FL $ 146.00 50806269 HC BPDX1 SEP GEL ELC EA NA FL $ 103.00 50806277 HC BPDX1 AMP TRG EA NA SQ FL $ 188.00 50806285 HC BPDX1 MUT ID SEQ EA SG FL $ 54.00 50806293 HC BPDX1 INTRP AND RPT FLUID $ 138.00 50806301 HC BPDX2 ISL EXT HP EA NA FL $ 146.00 50806319 HC BPDX2 SEP GEL ELC EA NA FL $ 103.00 50806327 HC BPDX2 AMP TRG EA NA SQ FL $ 188.00 50806335 HC BPDX2 MUT ID SEQ EA SG FL $ 54.00 50806343 HC BPDX2 INTRP AND RPT FLUID $ 138.00 50806350 HC ATHAL ALPHA THALASSEMIA $ 1,303.00 50806368 HC BCDHPT L7 CDH1 FULL GN SEQ $ 4,789.00 50806376 HC BCDHPX CDH1 SPEC UNLSTD MOPATH $ 1,026.00 50806384 HC BCFDS CFTR FULL GENE SEQ $ 4,995.00 50806392 HC BCFDS2 CFTR 2 GENESQ KNWN FAM $ 980.00 50806400 HC BCFDSX CFTR 1 GENESQ KNWN FAM $ 683.00 50806418 HC BCRABL T922 MAJ BRKPNT QUAL $ 395.00 50806426 HC BCRABL T922 MIN BRKPNT QUAL $ 395.00 50806434 HC BCRKDM ABL1 KINASE DOM MUT $ 932.00 50806442 HC BHEAV BCLON IGH AMP PCR $ 1,264.00 50806459 HC BIGK BCLON IGK EVAL ABNML CLN $ 1,187.00 50806467 HC BIGKH BCLON IGH AMP PCR $ 1,200.00 50806475 HC BIGKH BCLON IGK EVAL ABNML CLN $ 1,251.00 50806483 HC BIOSA L5 BTD FULL GENE SEQ $ 3,384.00 50806491 HC BISOL NA ISOL SPC UNLST MOP $ 146.00 50806509 HC BM1114 L2 T1114 MAJ BRK BM $ 871.00 50806517 HC BM1418 T1418 UNLST MOP BM $ 932.00 50806525 HC BM1517 T1517 CMN BRKPT QNT BM $ 1,387.00 50806533 HC BMBCR T922 MAJ BRKPNT QUAL $ 395.00 50806541 HC BMBCR T922 MIN BRKPNT QUAL $ 395.00 50806558 HC BMCEBP L4 CEBPA FULL GN BM $ 1,881.00 50806566 HC BMNPM1 NPM1 EXON 12 BM $ 662.00 50806574 HC BPDX1 1 EXON UNLST MOPATH $ 629.00 50806582 HC BPDX2 2 EXON UNLST MOPATH $ 871.00 50806590 HC BRAF GENE ANLY V600E VAR $ 641.00 50806608 HC BTCRB TCLON TRB EVAL PCR $ 1,187.00 50806616 HC BTCRG TCLON TRG EVL ABNL $ 1,332.00 50806624 HC BTCRGB TCLON TRB EVAL PCR $ 1,260.00 50806632 HC BTCRGB TCLON TRG EVL ABNL $ 1,260.00 50806640 HC BTHSQ HBB THLSMIA FULL SEQ $ 1,067.00 50806657 HC CDH1B L7 FULL GENE SEQ $ 2,565.00 50806665 HC CDHEXB SPC GENE UNLST MOP $ 683.00 50806673 HC CEBPA FULL GENE SEQ $ 1,881.00 50806681 HC CF32 GENE ANLY COMMON VARS $ 909.00

50806699 HC CFMLPA CFTR DEL DUP VARS $ 1,120.00 50806707 HC CFPT CFTR INTRN8 POLYT ANLY $ 538.00 50806715 HC CFSS CFTR FULL GENE SEQ $ 4,259.00 50806723 HC CHON L2 FGFR3 ACHN HYPOCHN $ 1,088.00 50806731 HC CKITMU L5 KIT EXONS 8&17 $ 1,223.00 50806749 HC CSMP CANCR PNL UNLST MOP TS $ 4,389.00 50806756 HC CSMPB CANCER PAN UNLST MOP $ 4,389.00 50806764 HC CSMPBM CNCR PNL UNLST MOP BM $ 4,389.00 50806772 HC CX26 GJB2 FULL GENE SEQ $ 792.00 50806780 HC CX30 GJB6 GENE ANLY COM VAR $ 575.00 50806798 HC D816V L3 KIT COMMON VARNTS $ 771.00 50806806 HC DBMD DUCHN BECKER DEL AND DUP $ 2,925.00 50806814 HC DNAISO DNA ISOL UNLST MOP $ 146.00 50806822 HC EGFRP GN ANLY CMN VARNTS $ 840.00 50806830 HC FATHAL ALPHA THLSSMIA FLUID $ 1,303.00 50806848 HC FBTHSQ L5 HBB FUL SEQ FLD $ 1,067.00 50806855 HC FCHON L2 FGFR3 A/HYPOCHN FL $ 1,088.00 50806863 HC FCX26S GJB2 FUL GENE SEQ FL $ 792.00 50806871 HC FFGFR1 CRNSYNSTS UNLSMOP FL $ 683.00 50806889 HC FFGFR2 L5 CRNSYNSTSIS FLD $ 1,083.00 50806897 HC FFGFR3 L1 MUENKE FLUID $ 756.00 50806905 HC FGFR1 CRNSYNSTS UNLS MOPATH $ 683.00 50806913 HC FGFR2 L5 CRNSYNSTSIS $ 1,083.00 50806921 HC FGFR3 L1 MUENKE $ 756.00 50806939 HC FMCC STR PT&COMP SPEC FLD $ 1,461.00 50806947 HC FT1114 L2 T1114 MAJ BRK FLD $ 871.00 50806954 HC FT1418 UNLSTD MOPATH FLUID $ 932.00 50806962 HC FT1517 PMLRAR CMN BRK QN FL $ 1,387.00 50806970 HC JAK2 JAN KINASE V617F VRNT $ 765.00 50806988 HC KRAS VRNTS CODONS 12AND13 $ 2,556.00 50806996 HC LEID F5 LEIDEN VARIENT $ 578.00 50807001 HC MGMT METHYLN UNLS MOP PETMB $ 829.00 50807012 HC MGMTB METHYLN UNLS MOP $ 829.00 50807020 HC MTHFR CMN VAR 677 1298 $ 668.00 50807038 HC NCF32 CFTR CMN VARNT NONBLD $ 909.00 50807046 HC ND816V L3 KIT CMN VR NONBLD $ 771.00 50807053 HC NJAK2 JAN KINAS V617F NONBL $ 765.00 50807061 HC NPDS L7 SLC26A4 FULL SEQ NONBL $ 3,211.00 50807079 HC NPM1 GN ANLY EXON 12 VARNTS $ 662.00 50807087 HC NVHHA IGH VAR RGN SOMUT NONBLD $ 1,778.00 50807095 HC P20210 F2 GN ANLY PROTHMBN $ 578.00 50807103 HC PDS L7 SLC26A4 FULL SEQ $ 3,211.00 50807111 HC PMCC STR PT&COMP SPEC POC $ 1,461.00 50807129 HC PWS SNRPN UBE3A MTHYLTN ANL $ 715.00 50807137 HC RNAISO RNA ISOL UNLSTD MOP $ 146.00 50807145 HC T1114 L2 MAJOR BRKPNT $ 871.00 50807152 HC T1418 UNLSTD MOPATH $ 932.00 50807160 HC T1517 PMLRAR CMN BRKPT QN $ 1,387.00 50807178 HC TATHAL ALPHA THLSSMIA TISSUE $ 1,303.00 50807186 HC TBCR T922 MAJ BRKPNT QUAL $ 395.00 50807194 HC TBCR T922 MIN BRKPNT QUAL $ 395.00 50807202 HC TMCC STR PT&COMP SPEC TIS $ 1,371.00 50807210 HC TMSI MRK MRD NEO & NRM TIS $ 1,538.00

50807228 HC TT1114 L2 MAJOR BRKPNT TIS $ 871.00 50807236 HC TT1418 UNLST MOPATH TIS $ 932.00 50807244 HC TT1517 PMLRAR CMN BRK QN TS $ 1,387.00 50807251 HC VHHA IGH VAR RGN SOM MUT $ 1,778.00 50807269 HC FRAGX FMR1 EVAL DTCT ABNORM $ 1,143.00 50807277 HC BXBLOT FMR1 CHAR OF ALLELES $ 378.00 50807285 HC BMAJOR BCRQT MAJ BRKPNT QNT $ 905.00 50807293 HC BMINOR BCRQT MIN BRKPNT QNT $ 905.00 50807301 HC CSMP BRAF GENE ANLY V600E $ 239.00 50807319 HC CSMP EGFR GN ANLY CMN VAR $ 479.00 50807327 HC CSMP KRAS VAR CODONS 12&13 $ 1,197.00 50807335 HC CSMP L4 IDH1 CMN EX 4 VAR $ 239.00 50807343 HC CSMP L4 IDH2 CMN EX 4 VAR $ 239.00 50807350 HC CSMPB BRAF GENE ANLY V600E $ 239.00 50807368 HC CSMPB EGFR GN ANLY CMN VAR $ 479.00 50807376 HC CSMPB KRAS VAR CODNS 12&13 $ 1,197.00 50807384 HC CSMPB L4 IDH1 CMN EX 4 VAR $ 239.00 50807392 HC CSMPB L4 IDH2 CMN EX 4 VAR $ 239.00 50807400 HC CSMPBM BRAF GENE ANLY V600E BM $ 239.00 50807418 HC CSMPBM EGFR GN ANL CMN VAR BM $ 479.00 50807426 HC CSMPBM KRAS VAR CDNS 12&13 BM $ 1,197.00 50807434 HC CSMPBM L4 IDH1 CMN EX 4VAR BM $ 239.00 50807442 HC CSMPBM L4 IDH2 CMN EX 4VAR BM $ 239.00 50808368 HC MYD88 MUTATION BLOOD $ 2,194.50 50808376 HC NMYD88 MUTATION NON BLOOD $ 2,194.50 50808384 HC HEMOCHROMATOSIS GENO ANA $ 872.00 50808392 HC DEL/DUP ANAL CDH1-ECADHERIN $ 1,845.00 50808400 HC FACTOR VIII INTRON 22 INV $ 239.00 50808418 HC DEL/DUP ANAL AMD-BMD-BBMD $ 1,968.00 50808426 HC SF3B1 MUTATION ANAL BLOOD $ 949.00 50808434 HC SF3B1 MUTATION, NON BLOOD $ 949.00 50808442 HC HUNTINGTON'S DISEASE ANAL $ 871.00 50808491 HC AMLP GENE ANLYS DUP VAR $ 1,120.00 50808509 HC AMLP GENE ANLYS 12 EXON $ 662.00 50808517 HC BMAML GENE ANLYS DUP VAR $ 1,120.00 50808525 HC BMAML GENE ANLYS 12 EXON $ 662.00 50808616 HC MGMTB METHYLN UNLS MOP $ 829.00 50808624 HC MGMT METHYLNUNLS MOP PETMB $ 83.44 50808632 HC NCKIT KIT EXONS 8&17 $ 1,223.00 50808640 HC CALR CALRETICULIN ASSAY $ 2,195.00 5100000001 HC CLINIC USE LVL 1 NEW PT $ 50.00 5100000002 HC CLINIC USE LVL 2 NEW PT $ 84.00 5100000003 HC CLINIC USE LVL 3 NEW PT $ 120.00 5100000004 HC CLINIC USE LVL 4 NEW PT $ 181.00 5100000005 HC CLINIC USE LVL 5 NEW PT $ 223.00 5100000006 HC CLINIC USE LVL 1 ESTAB PT $ 27.00 5100000007 HC CLINIC USE LVL 2 ESTAB PT $ 50.00 5100000008 HC CLINIC USE LVL 3 ESTAB PT $ 81.00 5100000009 HC CLINIC USE LVL 4 ESTAB PT $ 119.00 5100000010 HC CLINIC USE LVL 5 ESTAB PT $ 158.00 5100000011 HC OFFICE CONSULT LVL 1 $ 58.00 5100000012 HC OFFICE CONSULT LVL 2 $ 108.00 5100000013 HC OFFICE CONSULT LVL 3 $ 148.00

5100000014 HC OFFICE CONSULT LVL 4 $ 219.00 5100000015 HC OFFICE CONSULT LVL 5 $ 267.00 5100000016 HC E&M LEVEL 2 NEW PATIENT $ 456.00 5100000017 HC CLINIC E&M NURSE ONLY VISIT $ 220.00 5100000018 HC DAY HOSP EST PATIENT EA $ 220.00 5100000019 HC E&M NURSE ONLY VISIT $ 220.00 5100000020 HC E&M ESTAB PT NON PHYS $ 320.00 5100000021 HC E&M LEVEL 3 ESTAB PATIENT $ 320.00 5100000022 HC OP LACTATION CONSULT: ASSESS $ 121.00 5100000023 HC OP LACTATION CONSULT: LMTD $ 202.00 5100000024 HC OP LACTATION CONSULT: FULL $ 326.00 5100000025 HC DIABETES MGMT INDIV 30 MIN $ 259.00 5100000026 HC DIABETES MGMT GROUP 30 MIN $ 118.00 5100000027 HC GENETIC COUNS EA15 MIN MCAL $ 121.00 5100000028 HC INIT NUTR ASSESS 1ST 30 MIN $ 70.00 5100000029 HC INIT NUTR ASSESS +15 MIN $ 35.00 5100000030 HC F/UP ANTEP NUTR INDIV 15/MIN $ 35.00 5100000031 HC F/UP ANTEP NUTR GROUP/15 MIN $ 15.00 5100000032 HC POSTPARTUM NUTR INDIV/15 MIN $ 35.00 5100000033 HC INIT SOCIAL ASSESS 1ST 30 MIN $ 70.00 5100000034 HC INIT SOCIAL ASSESS +15 MIN $ 35.00 5100000035 HC F/UP ANTEP SOCIAL INDIV/15 MIN $ 35.00 5100000036 HC POSTPARTUM SOCIAL INDIV/15 MIN $ 35.00 5100000037 HC HEALTH ED CLIENT ORIENT/15 MIN $ 35.00 5100000038 HC INIT HLTH ED ASSESS 1ST 30 MIN $ 70.00 5100000039 HC INIT HLTH ED ASSESS +15 MIN $ 35.00 5100000040 HC F/UP HEALTH ED INDIV/15 MIN $ 35.00 5100000041 HC F/UP HEALTH ED GROUP 15 MIN $ 15.00 5100000042 HC EDUC PERINATAL INDIV 15 MIN $ 35.00 5100000043 HC EDUC PERINATAL GROUP/15 MIN $ 15.00 5100000044 HC POSTPART HLTH ED INDIV/15 MIN $ 35.00 5100000045 HC INIT COMP ASSESS N/P/H <4 WKS $ 566.00 5100000046 HC ENT EXAM ROOM USE $ 91.00 5100000047 HC ESTABLISHED PATIENT RN 15 MIN $ 220.00 5100000048 HC USE OF ROOM $ 65.00 5100000049 HC PARENT GROUP TRAINING $ 100.00 5100000050 HC THERAPY FAMILY WO PATIENT $ 423.00 5100000051 HC THERAPY FAMILY CONJOINT $ 504.00 5100000052 HC BREATH HYDROGEN TESTING $ 660.00 5100000053 HC AMB BLOOD PRESSURE MONITORING $ 525.00 5100000054 HC AMB BP MONITOR SCAN & REPORT $ 525.00 5100000055 HC AERO ALLERGEN/FOOD PRICK TEST $ 68.00 5100000056 HC ALLERGY TEST VENOM PERC EA $ 111.00 5100000057 HC ALLERGY TEST DR&BIO ID EA $ 111.00 5100000058 HC ALLERGY TEST DR&BIO PERC EA $ 111.00 5100000059 HC ALLERGY TEST VENOM ID EA $ 111.00 5100000060 HC AERO ALLERGEN INTRADERMAL TEST $ 102.00 5100000061 HC DELAYED INTRADERMAL SKIN TEST $ 145.00 5100000063 HC PULMONARY - ADM OF METHACOLINE $ 586.00 5100000064 HC FOOD CHALLENGE TEST $ 1,015.00 5100000065 HC FOOD CHALLENGE TEST 61-120 MIN $ 1,015.00 5100000066 HC FOOD CHALLNG TEST ADL 31-60MIN $ 213.00 5100000067 HC ALLERGEN ADMIN INJ SGL $ 47.00

5100000068 HC ALLERGEN ADMIN INJ MULT $ 64.00 5100000069 HC RAPID DESENSITIZATION PER HR $ 1,161.00 5100000070 HC GLUCOSE MONITORING UP TO 72 HR $ 742.00 5100000071 HC GENETIC COUNS EA 30 MIN STD $ 244.00 5100000072 HC MNT INITIAL: EA 15 MIN $ 46.00 5100000073 HC MNT REASSESSMENT: EA 15 MIN $ 46.00 5100000074 HC MNT GROUP: EA 30 MIN $ 53.00 5100000075 HC EDUC/TRNG BY RN 30 MIN $ 70.00 5100000076 HC PHLEBOTOMY THERAPEUTIC $ 229.00 5100000077 HC LEVEL 3 MIDLEVEL CONSULT $ 455.00 5100000078 HC EDUC CHRONIC KIDNEY INDIV 1 HR $ 618.00 51300259 HC ALBUMIN $ 138.00 51300309 HC FIBRINOGEN SEMIQUANT $ 285.00 51300358 HC BODY FLUID CELL COUNT & DIFF $ 252.00 51300408 HC ALK PHOS TOTAL $ 155.00 51300655 HC BILIRUBIN DIRECT $ 165.00 51300705 HC BILIRUBIN TOTAL $ 150.00 51300903 HC CALCIUM TOTAL $ 143.00 51301158 HC CHOLESTEROL TOTAL $ 145.00 51301208 HC CHLORIDE SERUM/PLA $ 129.00 51301455 HC SERUM PREGNANCY SCR $ 332.00 51301554 HC CREATININE $ 179.00 51301620 HC ELECTROLYTE PANEL $ 342.00 51301653 HC SED RATE-WESTERGREN $ 130.00 51301851 HC GAMMA GLUTAMYL TRAN $ 204.00 51301885 HC GLUCOSE SERUM/PLASMA QUANT $ 159.00 51302230 HC URINE PRE-SURG SCRN $ 108.00 51302354 HC URINE ROUTINE - MICRO $ 196.00 51302404 HC LIPID PANEL - CALCULATED LDL $ 415.00 51302552 HC LDH TOTAL $ 193.00 51302909 HC MAGNESIUM SERUM/PL $ 280.00 51303071 HC HEMOGLOBIN $ 48.00 51303089 HC HEMATOCRIT $ 217.00 51303105 HC PHOSPHORUS SERUM $ 225.00 51303154 HC POTASSIUM $ 204.00 51303402 HC PROTEIN TOTAL SERUM/PLASMA $ 75.00 51303451 HC SGOT/AST $ 180.00 51303501 HC SGPT/ALT $ 190.00 51303550 HC SODIUM $ 219.00 51303709 HC TRIGLYCERIDES-BLOOD $ 175.00 51303758 HC UREA NITROGEN QUANT $ 157.00 51303808 HC URIC ACID SERUM/PL $ 135.00 51305662 HC A1C GLYCOSYLATED HEMOGLOBIN $ 50.00 51323020 HC RAPID STREP A $ 239.00 51323046 HC RETIC COUNT BY FLOW $ 179.00 51362259 HC GLUCOSE SERUM/PLASMA QUANT $ 159.00 51362572 HC LACTATE $ 330.00 51363430 HC HEPATIC FXN PANEL $ 342.00 51363448 HC METABOLIC PNL BASIC $ 350.00 51363455 HC METABOLIC PNL COMP $ 435.00 51364561 HC LDLD - DIRECT LDL CHOLESTEROL $ 219.00 51364818 HC RENAL FUNCTION PANEL $ 170.00 51365260 HC AMMONIA PLASMA $ 334.00

51370013 HC PROTHROMBIN TIME $ 190.00 51370021 HC THROMPLAS PTT $ 240.00 51370039 HC URINE PREGNANCY SCR $ 102.00 51370047 HC CREATININE KINASE $ 254.00 51370062 HC CARBON DIOXIDE $ 95.00 51393429 HC COMPLETE BLOOD COUNT $ 285.00 51393437 HC CBC W/AUTO DIFF $ 300.00 51393445 HC PLATELET COUNT AUTOMATED $ 138.00 51393460 HC SLIDE REVIEW BLOOD CNT & SMEAR $ 116.00 51393528 HC CBC AUTOMATED $ 285.00 51393619 HC GYCATED HGB BY DCE 2000 $ 50.00 51393742 HC ESR AUTOMATED $ 75.00 51393767 HC RSV AG BY EIA $ 66.00 51393775 HC RAPID FLU A AND B EIA $ 111.00 51393924 HC MALSC ANTG DIR OPT OBS NOS $ 132.00 51393932 HC HEMATOCRIT MANUAL $ 55.00 51400034 HC ALPHA-2-ANTIPLASMIN $ 86.00 51400380 HC PLASMINOGEN $ 90.00 51400554 HC ANTITHROBIN III $ 581.00 51400620 HC ROTEIN C FUNCTNAL $ 362.00 51400646 HC PROTEIN S FUNCTIONAL $ 282.00 51400752 HC EUGLOBULN CLOT LYSS $ 172.00 51400802 HC FACTOR II ASSAY $ 346.00 51400851 HC FACTOR V ASSAY $ 375.00 51400901 HC FACTOV VII ASSAY $ 285.00 51400950 HC FACTOR VIII ASSAY $ 375.00 51401008 HC FACTOR VIII INHIBTO $ 251.00 51401016 HC HEP IND PLT AGGR 1 $ 469.00 51401024 HC HEP IND PLT AGGR 2 $ 469.00 51401032 HC HEP IND PLT AGGR 3 $ 469.00 51401040 HC HEP IND PLT AGGR 4 $ 469.00 51401057 HC FACTOR IX ASSAY $ 406.00 51401065 HC FACT VIII INH PORCI $ 251.00 51401107 HC FACTOR X ASSAY $ 364.00 51401156 HC FACTOR XI ASSAY $ 375.00 51401206 HC FACTOR XII ASSAY $ 214.00 51401214 HC FACTOR XIII SCREEN $ 195.00 51401511 HC RISTOCTN CO-FCTR BR $ 496.00 51401602 HC PLT AGG-EPINEPH $ 469.00 51401610 HC PLT AGG-COLLAG $ 469.00 51401628 HC PLT AGG-RISTOC $ 469.00 51401636 HC PLT AGG-ADP $ 469.00 51401701 HC VW FACTOR ANTIGEN $ 328.00 51401750 HC SICKLE CELL PREP $ 92.00 51401842 HC 5 MIN PT + BUFFER INHITR $ 125.00 51401859 HC 5 MIN PT + NORM PRO $ 125.00 51401867 HC 5 MIN NORM+BUFFER PT $ 125.00 51401909 HC PTT INH 5 MIN PTT $ 92.00 51401917 HC 5 MIN PT + BUFFER PTT $ 92.00 51401925 HC 5 MIN NORM+BUFFER PTT $ 92.00 51401933 HC 1 HR PT +BUFFER PTT $ 92.00 51401941 HC 1 HR PT + BUFFER PTT $ 92.00 51401958 HC DIL RUSSELL VPR VNM $ 240.00

51401966 HC 1 HR NORM + BUFFER PTT $ 92.00 51402154 HC ANTI XZ/LMWH $ 466.00 51402352 HC ANTICARDIOLIPIN IGG AB $ 243.00 51402360 HC ANTICARDIOLIPIN IGM AB $ 243.00 51402410 HC PATIENT PT INH SCRN $ 190.00 51402428 HC CONTROL PT INH SCRN $ 190.00 51402436 HC PTTINH 5 MIN NORMAL PLASMA $ 240.00 51402444 HC PTT INH 5 MIN PT $ 240.00 51402451 HC PTTINH 1 HR NORMAL PLASMA $ 240.00 51402469 HC PTT INH 1 HR PT $ 240.00 51402477 HC LUPUS ANTICOAG PTT $ 92.00 51402485 HC LUPUS ANTICOAG PTT $ 92.00 51402493 HC LUPUS ANTICOAG PTT $ 92.00 51402501 HC LUPUS ANTICOAG PTT $ 92.00 51402519 HC LUPUS ANTICOAG PTT $ 92.00 51402527 HC LUPUS ANTICOAG PTT $ 92.00 51402535 HC LUPUS ANTICOAG PTT $ 240.00 51402543 HC LUPUS ANTICOAG PTT $ 240.00 51402550 HC LUPUS ANTICOAG PTT $ 240.00 51402568 HC LUPUS ANTICOAG PTT $ 240.00 51402741 HC TOTAL PROTEIN C $ 133.00 51402758 HC TOTAL PROTIEN S $ 269.00 51402907 HC PLATELET FUNCTION SCRN ADP $ 469.00 51402915 HC PLATELET FUNCTION SCRN EPINEPH $ 469.00 51402964 HC HEPARIN-INDUCED ANTIBODY $ 231.00 51403343 HC PLT AGG-ARACH ACID $ 469.00 51403350 HC ACT PROTEIN C RESIST $ 285.00 51403376 HC PLATELET MAPPING - ADP $ 469.00 51403384 HC PLATELET MAPPING - ARACHIDONIC $ 469.00 51403392 HC THROMBOELATROGRAPHY $ 747.00 51403400 HC STACLOT LA TEST PLATELET NEUT $ 268.00 51403459 HC FREE PROTEIN S $ 282.00 51420594 HC CD14 $ 380.00 51420610 HC FLOW CYTOMETRY, ADD'L MARKER C $ 380.00 51420628 HC CD5 $ 570.00 51420669 HC CD20 $ 570.00 51420735 HC CD 13 ANTIBODY $ 380.00 51421287 HC CD 7 $ 570.00 51421303 HC FLOW CYTO EA ADD MRKER CD34 AB $ 380.00 51424521 HC CD126 AB $ 570.00 51424794 HC CELL COUNT BODY FLUID $ 174.00 51424919 HC FLOW CD45 RA AB $ 570.00 51424927 HC FLOW CD45 RD AB $ 570.00 51493146 HC CD16 $ 570.00 51493492 HC FLOW CYTOSPIN $ 408.00 51493625 HC FLOW:B CELLS TOTAL COUNT $ 548.00 51493633 HC FLOW:T-CELLS TOTAL COUNT $ 538.00 51493641 HC FLOW:ABSLUTE CD4-CD8 CNTRATIO $ 575.00 51493658 HC FLOW:ABSOLUTE CD4 COUNT $ 522.00 51493666 HC FLOW:NK CELLS TOTAL COUNT $ 422.00 51493674 HC FLOW:STEM CELLS(CD34)TTL CNT $ 699.00 51493682 HC FLOW CYTOMETRY - 1ST MARKER $ 700.00 51493690 HC FLOW CYTOMETRY ADDTL MARKER $ 380.00

51493708 HC ADAMTS-13 ACTIVITY AG TESTING $ 427.00 51493724 HC FLOW T CELLS TOTAL COUNT $ 538.00 51493732 HC FLOW T CELLS TOTAL COUNT $ 538.00 51493781 HC HC ADAMTS FACTOR INHIBITOR $ 251.00 51493799 HC HC ADAMTS 13 ACT EA ANALYTE $ 427.00 51493807 HC B2GP1 BETA2 GLYPRTN I AB EA $ 243.00 51493815 HC FIBANT FIBRINOGEN ANTIGEN $ 255.00 51493823 HC BDRVC RUS VPR VNM DLT CONF $ 240.00 51493831 HC BDRVMX RUS VPR VNM DLT MIX $ 240.00 51493849 HC BPF4IG PF4 ID PLATELET AB IGG $ 231.00 51493856 HC HEP (HIT) PLATELET AB $ 231.00 51500452 HC ALPHA FETOPROTEIN $ 280.00 51500601 HC AMYLASE TEST $ 395.00 51500627 HC BETA HCG-TUMOR MRKR $ 335.00 51500759 HC ANTIB SEROL 1.2 $ 280.00 51501104 HC CEA $ 490.00 51501153 HC CHOLESTEROL $ 145.00 51501187 HC HDL CHOLESTEROL $ 192.00 51501419 HC CORTISOL TOTAL $ 374.00 51501450 HC SERUM PREGNANCY SCR $ 332.00 51501542 HC CK-MB $ 446.00 51501716 HC FERRITIN $ 375.00 51501930 HC TRAD GLUC TOLER(100G) $ 789.00 51502300 HC IRON TTL SERUM $ 165.00 51502854 HC LITHIUM QAN $ 188.00 51502946 HC OLOGOCLONAL BANDING $ 374.00 51503209 HC PROLACTIN $ 328.00 51503696 HC TRANSFERRIN $ 420.00 51503829 HC B12-SERUM $ 281.00 51503845 HC FOLATE-RBC $ 246.00 51503878 HC FOLIC ACID, SERUM $ 274.00 51503969 HC HIGHLY SENSITIVE TSH $ 380.00 51503985 HC PSA $ 342.00 51504009 HC T3 TOTAL $ 290.00 51504025 HC FREE T4 $ 246.00 51504033 HC THYROXINE (T4) TOTAL $ 158.00 51504058 HC ANTI-THYROID MICROSOMAL AB $ 270.00 51504066 HC ANTI-THYROGLBL ATBD $ 227.00 51504074 HC THYROGLOBULIN (TG) $ 226.00 51504520 HC MYOGLOBIN $ 265.00 51504587 HC C PEPTIDE $ 220.00 51505402 HC PSA ULTRASENSITIVE $ 342.00 51505519 HC ALLERGEN:CANARIES $ 79.00 51505527 HC ALLERGEN:FINCHES $ 79.00 51505535 HC ALLERGEN:PARAKEETS $ 79.00 51505543 HC ALLERGEN:PARROTS $ 79.00 51505550 HC ALLERGEN:FORMALDEHYDE $ 79.00 51505568 HC ALLERGEN:HDI $ 79.00 51505576 HC ALLERGEN:MDI $ 79.00 51505584 HC ALLERGEN:PHTHALIC ANHYDRIDE $ 79.00 51505592 HC ALLERGEN: RDI TMA $ 79.00 51505600 HC ALLERGEN:AMOXICILLIN $ 79.00 51505618 HC ALLERGEN:AMPICILLIN $ 79.00

51505626 HC ALLERGEN:PEHICILLIN G $ 79.00 51505634 HC ALLERGEN:PENICILLIN V $ 79.00 51505659 HC FK506:TACROLIMUS $ 345.00 51505667 HC GLYCOLATED HEMOGLOBIN $ 145.00 51510014 HC LH(LHOR) $ 344.00 51510022 HC FSH(FSHOR) $ 345.00 51510030 HC FREE T3 $ 285.00 51510048 HC ESTRADIOL(ESTDL) $ 499.00 51510055 HC PROGESTERONE (PGN) $ 273.00 51510063 HC TESTOSTERONE (TES) $ 290.00 51510089 HC PTH (PTH) $ 786.00 51510097 HC CA125 $ 386.00 51510105 HC INSULIN (FAST/UNSPEC) $ 181.00 51523009 HC INFECT MONO SCRN $ 199.00 51550010 HC ACTH $ 551.00 51560068 HC PREALBUMIN $ 246.00 51560076 HC RPR QUAL $ 238.00 51560084 HC RPR QUANT $ 117.00 51560092 HC SYPHILIS TREPONEMAL SCR $ 219.00 51560100 HC CARBAMAZEPINE, TOTAL $ 352.00 51560308 HC DIGOXIN LEVEL $ 389.00 51560704 HC LIDOCAINE LEVEL $ 264.00 51562056 HC VALPROATE LEVEL $ 391.00 51562577 HC LACTATE $ 330.00 51562601 HC AMIKACIN $ 191.00 51562668 HC VANCOMYCIN $ 263.00 51562874 HC HOMOCYSTINE $ 399.00 51563112 HC BETA 2 MICROGLOBULN $ 178.00 51563427 HC TROPONIN T $ 520.00 51563468 HC COMPLEMENT C3 SERUM $ 199.00 51563476 HC COMPLEMENT C4 SERUM $ 199.00 51563484 HC C REACTIVE PROTEIN $ 179.00 51563492 HC HAPTOGLOBIN $ 258.00 51563500 HC IGA SERUM $ 213.00 51563518 HC IGG SERUM $ 213.00 51563526 HC IGM SERUM $ 213.00 51563575 HC ANTI-NUC AB (FANA) $ 261.00 51563583 HC RHEUMATIOD FACTOR SERUM $ 129.00 51563625 HC DNA ANTIBODY $ 281.00 51563666 HC CYCLOSPORINE, WHOLE BLOOD $ 437.00 51563674 HC METHOTREXATE $ 291.00 51563690 HC ALRGY TST:ALDER TREE $ 79.00 51563708 HC ALRGY TST:ALTERNARIA MOLD $ 79.00 51563716 HC ALRGY TST:ASPERGILLUS MOLD $ 79.00 51563724 HC ALRGY TST:BERMUDA GRASS $ 79.00 51563732 HC ALRGY TST:CAT DANDER $ 79.00 51563740 HC ALRGY TST:CHICKEN $ 79.00 51563757 HC ALRGY TST:CLADOSPORIUM MOLD $ 79.00 51563765 HC ALRGY TST:COCKROACH $ 79.00 51563773 HC ALRGY TST:CORN $ 79.00 51563781 HC ALRGY TST:DOG DANDER $ 79.00 51563799 HC ALRGY TST:DUCK WEED $ 79.00 51563807 HC ALRGY TST:DUST MITE - DF $ 79.00

51563815 HC ALRGY TST:EGG WHITE $ 79.00 51563823 HC ALRGY TST:FISH $ 79.00 51563831 HC ALRGY TST:MILK $ 79.00 51563849 HC ALRGY TST:NUT $ 79.00 51563856 HC ALRGY TST:OAK TREE $ 79.00 51563864 HC ALRGY TST:OAT $ 79.00 51563872 HC ALRGY TST:OLIVE TREE $ 79.00 51563880 HC ALRGY TST:ORANGE $ 79.00 51563898 HC ALRGY TST:PEANUT $ 79.00 51563906 HC ALRGY TST:RYE GRASS $ 79.00 51563914 HC ALRGY TST:SAGE WEED, MUGWORT $ 79.00 51563922 HC ALRGY TST:SHRIMP $ 79.00 51563930 HC ALRGY TST:SOY $ 79.00 51563948 HC ALRGY TST:TIMOTHY GRASS $ 79.00 51563955 HC ALRGY TST:TOMATO $ 79.00 51563963 HC ALRGY TST:WESTERN RAGWEED $ 79.00 51563971 HC ALRGY TST:WHEAT $ 79.00 51563997 HC MISC ALLERGEN 1 $ 79.00 51564003 HC MISC. ALLERGEN 2 $ 79.00 51564011 HC MISC. ALLERGEN 3 $ 79.00 51564029 HC MISC. ALLERGEN 4 $ 79.00 51564037 HC MISC. ALLERGEN 5 $ 79.00 51564045 HC MISC. ALLERGEN 6 $ 79.00 51564052 HC MISC. ALLERGEN 7 $ 79.00 51564060 HC MISC. ALLERGEN 8 $ 79.00 51564078 HC MISC. ALLERGEN 9 $ 79.00 51564086 HC ALLERGEN $ 79.00 51564326 HC ALLERGEN:HONEY BEE $ 79.00 51564334 HC ALLERGEN:YELLOW JACKET $ 79.00 51564342 HC ALLERGEN:WASP $ 79.00 51564359 HC ALLERGEN:HORNET $ 79.00 51564383 HC ASPERGILLUS IGE $ 179.00 51564391 HC ASPERGILLUS IGG $ 179.00 51564409 HC TOTAL IGE $ 379.00 51564425 HC LGG 1 $ 186.00 51564433 HC LGG 2 $ 186.00 51564441 HC LGG 3 $ 186.00 51564458 HC LGG 4 $ 186.00 51564474 HC ALLERGEN:TDI $ 79.00 51564524 HC LP(A) $ 194.00 51564532 HC (HDQ)HDL CHOLESTEROL FRACTION $ 278.00 51564540 HC (DBQ)DIRECT LIPID FRACTIONATI $ 278.00 51564573 HC HIGH SENSITIVE CRP $ 190.00 51564581 HC SERUM PROTEIN IMMUNOFIX ELECT $ 497.00 51564599 HC URINE PROTEIN IMMUNOFIX ELECT $ 376.00 51564607 HC LIPASE $ 213.00 51564631 HC DRUG7 SCREEN: AMPHETAMINES $ 296.00 51564649 HC DRUG7 SCREEN: BARBITURATES $ 296.00 51564656 HC DRUG7 SCREEN: BENZODIAZEPINES $ 296.00 51564664 HC DRUG7 SCREEN: COCAINE $ 296.00 51564680 HC SCREEN: OPIATES $ 296.00 51564698 HC DRUG7 SCREEN: PCP $ 296.00 51564706 HC DRUG7 SCREEN: THC $ 296.00

51564730 HC GLUCOSE TOLER (75G GLU) $ 298.00 51564748 HC TOLERANCE W/INSULIN $ 181.00 51564755 HC GDM CONFIRM (100G GLU) $ 789.00 51564771 HC OD450 $ 121.00 51564821 HC INSULIN FASTING 2HR $ 181.00 51564961 HC OSMOLALITY, SERUM $ 209.00 51564995 HC ALBUMIN URINE QUANT $ 126.00 51565026 HC HEP B SUR AB (HATA) $ 231.00 51565034 HC HAV IGM AB (HAV) $ 268.00 51565042 HC HBV CORE IGM AB (HBC) $ 248.00 51565067 HC CYSTATIN C $ 56.00 51565109 HC PSA, FREE $ 281.00 51565158 HC HEP B CR TOTAL AB $ 189.00 51565166 HC HEPAT BS AG-EIA $ 220.00 51565174 HC HEPAT BS AG-EIA $ 197.00 51565216 HC ANA TITER $ 255.00 51565224 HC ANTI DNA $ 281.00 51565232 HC LDL PHENOTYPE $ 278.00 51565240 HC LP-PLA2 $ 324.00 51565273 HC PSA COMPLEXED $ 276.00 51565281 HC VIT D 25-HYDROXY $ 415.00 51565299 HC ZINC $ 126.00 51565307 HC IGA ANTI-DGP $ 273.00 51565315 HC LEFLUNOMIDE METABOLITE $ 200.00 51565323 HC GDMC GTT EA ADL BYND 3 $ 176.00 51565331 HC HMET HEAVY METAL QUANT EA $ 249.00 51565349 HC CAD HVY MTL CADMIUM QUAN $ 249.00 51565356 HC MERC HVY MTL MERCURY QUAN $ 249.00 51565364 HC ARS HVY MTL ARSENIC QUAN $ 249.00 51565372 HC TGWASH TYROGLOBULIN WO FLD $ 226.00 51565380 HC SSAABY EXT NA SSA ANTI RO AB $ 152.00 51565398 HC SSBABY EXT NA SSB ANTILA AB $ 152.00 51565406 HC SMABY EXT NA SM ANTISM AB $ 152.00 51565414 HC RNPABY EXT NA RNP ANTIRNP AB $ 152.00 51565422 HC SCLABY EXT NA ANTI SCL70 AB $ 152.00 51565430 HC CENABY EXT NA ANTI CNTRMR AB $ 152.00 51565448 HC JO1ABY EXT NA JO1 ANTI JO1 AB $ 152.00 51565463 HC TSHFT4 TSH $ 380.00 51565471 HC LAMOL LAMOTRIGINE QNT DRG NES $ 291.00 51565489 HC LEVETL LVTIRACETAM QNT DRG NES $ 291.00 51565497 HC UCORT CORTISOL FREE UR $ 235.00 51565505 HC SALCOR CORTISOL TOTAL SALIVA $ 374.00 51565513 HC GTTINS GTT 1-3 SPEC FASTING $ 789.00 51565521 HC GTTINS GTT EA ADDL BYND 3 SPEC $ 176.00 51565539 HC HBSQT HEP B SURF AB QUANT $ 197.00 51565547 HC TFPSA PSA TOTAL $ 342.00 51565554 HC TFPSA PSA FREE $ 281.00 51565562 HC PSARX PSA TOTAL $ 342.00 51565570 HC FRPSA PSA FREE $ 281.00 51565588 HC HCVA HEPATITIS C AB $ 193.00 51565596 HC ALLMC ALL SPEC IGE QNT SMQ $ 79.00 51565612 HC FK506:TACROLIMUS $ 345.00 51565620 HC SHBG BY ARCHITECT $ 308.00

51565638 HC TESTOTERONE BIO/FREE $ 361.00 51565646 HC TESTOTERONE TOTAL $ 290.00 51565653 HC PROTEIN TOTAL $ 75.00 51565661 HC PROT ELECTRO SERUM $ 180.00 51565670 HC LEVELTL QNT DRG NES $ 181.00 51565679 HC CORTISOL TOTAL $ 374.00 51565687 HC MYCOPENOLIC ACID $ 246.00 51565695 HC LAMOL QNT DRG NES $ 181.00 51565703 HC LEVETL QNT DRG NES $ 181.00 51565711 HC HAV ANITBODY TOTAL IGG $ 231.00 51565729 HC HIV-1 ANTIGEN W/HIV 1-2 AB $ 331.00 51571008 HC ASO TITER $ 186.00 51571016 HC NEPH IMM FR LIGHT CHAINS $ 189.00 51571024 HC GROWTH HORMONE $ 238.00 51571032 HC INSUL GRWTH FACT1 SOMATOMEDIN $ 304.00 51571040 HC MYCOPHENOLIC ACID $ 291.00 51580017 HC CANCER ANTIGEN 15-3 $ 336.00 51580025 HC LEAD WHOLE BLOOD $ 172.00 51593770 HC RSV AG BY EIA $ 66.00 51593788 HC DHEA-S $ 317.00 51593796 HC CERUPLASMIN $ 197.00 51593804 HC ERYTHROPOIETIN $ 208.00 51593812 HC OLIGOCLONAL IMMUNE $ 374.00 51593820 HC CANCER AG QUANT 19-9 $ 351.00 51593846 HC CCP ANTIBODY $ 122.00 51593853 HC RHEUMATOID FACTOR QUANT $ 129.00 51593861 HC RHEUMATOID FACTOR QUANT $ 129.00 51593879 HC CCP ANTIBODY $ 122.00 51593887 HC RUBELLA AB $ 268.00 51593895 HC IGA ANTI-TTG $ 273.00 51593903 HC IGG ANTI-DGP $ 273.00 51593911 HC IGA SERUM CDAS $ 213.00 51800100 HC ASQ ACETONE QUAL $ 243.00 51800605 HC AMYLASE TEST $ 395.00 51800621 HC BHCG BETA HCG QUANT $ 335.00 51801454 HC SERUM PREGNANCY SCR $ 332.00 51801462 HC URINE PREGNANCY SCR $ 102.00 51801546 HC CK-MB $ 446.00 51802858 HC LITHIUM $ 188.00 51803005 HC PH BY METER $ 50.00 51804524 HC MYOGLOBIN $ 265.00 51805653 HC FK506:TACROLIMUS $ 345.00 51823003 HC INFECT MONO SCRN $ 199.00 51823029 HC RAPID STREP A $ 239.00 51860054 HC ACETAMINOPHEN LEVEL $ 432.00 51860104 HC CARBAMAZEPINE TOTAL $ 352.00 51860302 HC DIGOXIN LEVEL $ 389.00 51860708 HC LIDOCAINE LEVEL $ 264.00 51860906 HC PHENOBARITAL LEVEL $ 223.00 51861003 HC PHENYTOIN LEVEL $ 346.00 51861706 HC SALICYLATES LEVEL $ 264.00 51862050 HC VALPROATE LEVEL $ 391.00 51862126 HC AMYLASE URINE $ 395.00

51862605 HC AMIKACIN $ 191.00 51862621 HC GENTAMICIN $ 319.00 51862647 HC TOBRAMYCIN $ 314.00 51862662 HC VANCOMYCIN $ 263.00 51863421 HC TROPONIN T $ 520.00 51863488 HC C REACTIVE PROTEIN $ 179.00 51863660 HC CYCLOSPORINE WHOLE BLOOD $ 437.00 51863678 HC METHOTREXATE $ 291.00 51864601 HC LIPASE $ 213.00 51864627 HC FETAL LUNG MATURITY $ 106.00 51864635 HC DOA SCREEN: AMPHETAMINES $ 296.00 51864643 HC DOA SCREEN: BARBITURATES $ 296.00 51864650 HC DOA SCREEN: BENZODIAZEPINES $ 296.00 51864668 HC DOA SCREEN: COCAINE $ 296.00 51864676 HC DOA SCREEN: METHADONE $ 296.00 51864684 HC DOA SCREEN: OPIATES $ 296.00 51864692 HC DOA SCREEN: PCP $ 296.00 51864700 HC DOA SCREEN: THC $ 296.00 51864718 HC DOA SCREEN: TRICYCLICS $ 296.00 51864767 HC ALCOHOL $ 399.00 51864775 HC OD450 $ 121.00 51864791 HC THEOPHYLLINE $ 275.00 51864841 HC METHGB(METHHEMOGLOB) $ 81.00 51864858 HC COHGB(CARBOSYHEMOGL) $ 334.00 51864965 HC OSMOLALITY SERUM $ 209.00 51864973 HC OSMOLALITY URINE $ 255.00 51865004 HC NT-PROBNP $ 821.00 51865079 HC SIROLIMUS THER DRUG ASSAY $ 293.00 51865269 HC BLD AMMONIA TEST $ 334.00 51870012 HC FETAL FIBRONECTIN $ 1,161.00 51870038 HC URINE PREGNANCY SCR $ 102.00 51893725 HC OCCULT BLOOD IMMUNO METH $ 425.00 51893733 HC OCCULT BLOOD GUAIAC STOOL $ 101.00 51893766 HC RAPID FLU A AND B EIA $ 111.00 51893774 HC RSV AG BY EIA $ 66.00 5200000001 HC CCS ASSESS/EVAL RT PULM $ 29.48 5200000002 HC CCS TCC PARTIC RT PULM $ 17.93 5200000003 HC CCS COMP TCC COORD PT HEMO $ 72.00 5200000004 HC CCS COMP TCC COORD RD AI $ 72.00 5200000005 HC CCS COMP TCC COORD RD BMT $ 72.00 5200000006 HC CCS COMP TCC COORD RD CARD $ 72.00 5200000007 HC CCS COMP TCC COORD RD CFA $ 72.00 5200000008 HC CCS COMP TCC COORD RD DIAB $ 72.00 5200000009 HC CCS COMP TCC COORD RD DIAL $ 72.00 5200000010 HC CCS COMP TCC COORD RD ENDO $ 72.00 5200000011 HC CCS COMP TCC COORD RD GENE $ 72.00 5200000012 HC CCS COMP TCC COORD RD GI $ 72.00 5200000013 HC CCS COMP TCC COORD RD HEMO $ 72.00 5200000014 HC CCS COMP TCC COORD RD HTLG $ 72.00 5200000015 HC CCS COMP TCC COORD RD HTTXP $ 72.00 5200000016 HC CCS COMP TCC COORD RD IDC $ 72.00 5200000017 HC CCS COMP TCC COORD RD INFD $ 72.00 5200000018 HC CCS COMP TCC COORD RD KTR $ 72.00

5200000019 HC CCS COMP TCC COORD RD LVTR $ 72.00 5200000020 HC CCS COMP TCC COORD RD NONC $ 72.00 5200000021 HC CCS COMP TCC COORD RD ONC $ 72.00 5200000022 HC CCS COMP TCC COORD RD RENAL $ 72.00 5200000023 HC CCS COMP TCC COORD RD RHEU $ 72.00 5200000024 HC CCS COMP TCC COORD RD SCELL $ 72.00 5200000025 HC CCS COMP TCC COORD RD SPBF $ 72.00 5200000026 HC CCS COMP TCC COORD RDR HEMA $ 72.00 5200000027 HC CCS TCC COORD RD CARD $ 72.00 5200000028 HC CCS TCC COORD RD HTLG $ 72.00 5200000029 HC CCS TCC COORD RD HTTXP $ 72.00 5200000030 HC CCS ASSESS/EVAL 30M RD AI $ 16.80 5200000031 HC CCS ASSESS/EVAL 30M RD BMT $ 16.80 5200000032 HC CCS ASSESS/EVAL 30M RD CARD $ 16.80 5200000033 HC CCS ASSESS/EVAL 30M RD CFA $ 16.80 5200000034 HC CCS ASSESS/EVAL 30M RD DERM $ 16.80 5200000035 HC CCS ASSESS/EVAL 30M RD DIAB $ 16.80 5200000036 HC CCS ASSESS/EVAL 30M RD DIAL $ 16.80 5200000037 HC CCS ASSESS/EVAL 30M RD ENDO $ 16.80 5200000038 HC CCS ASSESS/EVAL 30M RD GENE $ 16.80 5200000039 HC CCS ASSESS/EVAL 30M RD GI $ 16.80 5200000040 HC CCS ASSESS/EVAL 30M RD HEMA $ 16.80 5200000041 HC CCS ASSESS/EVAL 30M RD HEMO $ 16.80 5200000042 HC CCS ASSESS/EVAL 30M RD HTLG $ 16.80 5200000043 HC CCS ASSESS/EVAL 30M RD HTLG $ 16.80 5200000044 HC CCS ASSESS/EVAL 30M RD HTTXP $ 16.80 5200000045 HC CCS ASSESS/EVAL 30M RD HTTXP $ 16.80 5200000046 HC CCS ASSESS/EVAL 30M RD IDC $ 16.80 5200000047 HC CCS ASSESS/EVAL 30M RD INFD $ 16.80 5200000048 HC CCS ASSESS/EVAL 30M RD KTR $ 16.80 5200000049 HC CCS ASSESS/EVAL 30M RD LVTR $ 16.80 5200000050 HC CCS ASSESS/EVAL 30M RD NONC $ 16.80 5200000051 HC CCS ASSESS/EVAL 30M RD ONC $ 16.80 5200000052 HC CCS ASSESS/EVAL 30M RD RD SPB $ 16.80 5200000053 HC CCS ASSESS/EVAL 30M RD RENAL $ 16.80 5200000054 HC CCS ASSESS/EVAL 30M RD RHEU $ 16.80 5200000055 HC CCS ASSESS/EVAL 30M RD SCELL $ 16.80 5200000056 HC CCS TCC PARTIC 15M RD AI $ 8.40 5200000057 HC CCS TCC PARTIC 15M RD BMT $ 8.40 5200000058 HC CCS TCC PARTIC 15M RD CARD $ 8.40 5200000059 HC CCS TCC PARTIC 15M RD CFA $ 8.40 5200000060 HC CCS TCC PARTIC 15M RD DERM $ 8.40 5200000061 HC CCS TCC PARTIC 15M RD DIAB $ 8.40 5200000062 HC CCS TCC PARTIC 15M RD DIAL $ 8.40 5200000063 HC CCS TCC PARTIC 15M RD ENDO $ 8.40 5200000064 HC CCS TCC PARTIC 15M RD GENE $ 8.40 5200000065 HC CCS TCC PARTIC 15M RD GI $ 8.40 5200000066 HC CCS TCC PARTIC 15M RD HEMA $ 8.40 5200000067 HC CCS TCC PARTIC 15M RD HEMO $ 8.40 5200000068 HC CCS TCC PARTIC 15M RD HTLG $ 8.40 5200000069 HC CCS TCC PARTIC 15M RD HTLG $ 8.40 5200000070 HC CCS TCC PARTIC 15M RD HTTXP $ 8.40 5200000071 HC CCS TCC PARTIC 15M RD HTTXP $ 8.40

5200000072 HC CCS TCC PARTIC 15M RD IDC $ 8.40 5200000073 HC CCS TCC PARTIC 15M RD INFD $ 8.40 5200000074 HC CCS TCC PARTIC 15M RD KTR $ 8.40 5200000075 HC CCS TCC PARTIC 15M RD LVTR $ 8.40 5200000076 HC CCS TCC PARTIC 15M RD NONC $ 8.40 5200000077 HC CCS TCC PARTIC 15M RD ONC $ 8.40 5200000078 HC CCS TCC PARTIC 15M RD PULM $ 8.40 5200000079 HC CCS TCC PARTIC 15M RD RENAL $ 8.40 5200000080 HC CCS TCC PARTIC 15M RD RHEU $ 8.40 5200000081 HC CCS TCC PARTIC 15M RD SCELL $ 8.40 5200000082 HC CCS GROUP TEACHING RD AI $ 13.37 5200000083 HC CCS GROUP TEACHING RD BMT $ 13.37 5200000084 HC CCS GROUP TEACHING RD CARD $ 13.37 5200000085 HC CCS GROUP TEACHING RD CFA $ 13.37 5200000086 HC CCS GROUP TEACHING RD DERM $ 13.37 5200000087 HC CCS GROUP TEACHING RD DIAB $ 13.37 5200000088 HC CCS GROUP TEACHING RD DIAL $ 13.37 5200000089 HC CCS GROUP TEACHING RD ENDO $ 13.37 5200000090 HC CCS GROUP TEACHING RD GENE $ 13.37 5200000091 HC CCS GROUP TEACHING RD GI $ 13.37 5200000092 HC CCS GROUP TEACHING RD HEMA $ 13.37 5200000093 HC CCS GROUP TEACHING RD HEMO $ 13.37 5200000094 HC CCS GROUP TEACHING RD HTLG $ 13.37 5200000095 HC CCS GROUP TEACHING RD HTLG $ 13.37 5200000096 HC CCS GROUP TEACHING RD HTTXP $ 13.37 5200000097 HC CCS GROUP TEACHING RD HTTXP $ 13.37 5200000098 HC CCS GROUP TEACHING RD IDC $ 13.37 5200000099 HC CCS GROUP TEACHING RD INFD $ 13.37 5200000100 HC CCS GROUP TEACHING RD KTR $ 13.37 5200000101 HC CCS GROUP TEACHING RD LVTR $ 13.37 5200000102 HC CCS GROUP TEACHING RD NONC $ 13.37 5200000103 HC CCS GROUP TEACHING RD ONC $ 13.37 5200000104 HC CCS GROUP TEACHING RD RENAL $ 13.37 5200000105 HC CCS GROUP TEACHING RD RHEU $ 13.37 5200000106 HC CCS GROUP TEACHING RD SCELL $ 13.37 5200000107 HC CCS PHONE CONSULT 15M RD DIAL $ 8.40 5200000108 HC CCS PHONE CONSULT 15M RD GENE $ 8.40 5200000109 HC CCS PHONE CONSULT 15M RD GI $ 8.40 5200000110 HC CCS PHONE CONSULT 15M RD KTR $ 8.40 5200000111 HC CCS PHONE CONSULT 15M RD LVTR $ 8.40 5200000112 HC CCS PHONE CONSULT 15M RD PULM $ 8.40 5200000113 HC CCS PHONE CONSULT 15M RD RENAL $ 8.40 5200000114 HC CCS COMP TCC COORD RN $ 72.00 5200000115 HC CCS TCC COORD CDE DIAB $ 72.00 5200000116 HC CCS COMP TCC COOR RN IDC $ 87.00 5200000117 HC CCS ASSESS/EVAL 30M RN $ 16.80 5200000118 HC CCS TCC PARTIC 15M $ 12.00 5200000119 HC CCS TCC PARTIC 15M AUD CFA $ 12.00 5200000120 HC CCS TCC PARTIC 15M CI $ 16.80 5200000121 HC CCS TCC PARTIC 15M GC CFA $ 8.40 5200000122 HC CCS TCC PARTIC 15M GC GENE $ 8.40 5200000123 HC CCS TCC PARTIC 15M OT DERM $ 8.40 5200000124 HC CCS TCC PARTIC 15M OT RHEU $ 8.40

5200000125 HC CCS TCC PARTIC 15M PHD CFA $ 8.40 5200000126 HC CCS TCC PARTIC 15M PSYCH $ 16.80 5200000127 HC CCS TCC PARTIC 15M PT DERM $ 8.40 5200000128 HC CCS TCC PARTIC 15M PT HEMO $ 8.40 5200000129 HC CCS TCC PARTIC 15M PT RHEU $ 8.40 5200000130 HC CCS TCC PARTIC 15M ST CFA $ 8.40 5200000131 HC CCS CHART REV INT/PER RN $ 30.00 5200000132 HC CCS CHART REV INT/PER MD ONC $ 30.00 5200000133 HC CCS CHART REV EXT/COMP RN $ 54.00 5200000134 HC CCS CHART REV EXT/COMP MD ONC $ 54.00 5200000135 HC CCS COMP TCC 30M DDS CFA $ 36.00 5200000136 HC CCS ORTHODONTIST PARTIC CFA 30 $ 36.00 5200000137 HC CCS TCC PARTIC CFA MD CF 30MIN $ 36.00 5200000138 HC CCS ASSESS/EVAL 30M MSW $ 16.80 5200000139 HC CCS ASSESS/EVAL 30 MIN RD $ 16.80 5200000140 HC CCS ASSESS/EVAL 30M CDE DIAB $ 16.80 5200000141 HC CCS ASSESS/EVAL 30M GC GENE $ 16.80 5200000142 HC CCS TCC PARTIC 15M RN $ 8.40 5200000143 HC CCS TCC PARTIC 15M MSW $ 8.40 5200000144 HC CCS TCC PARTIC 15M CDE DIAB $ 8.40 5200000145 HC CCS TCC PARTIC 15M RD $ 8.40 5200000146 HC CCS GROUP TEACHING CDE DIAB $ 13.37 5200000147 HC CCS GROUP TEACHING GC GENE $ 13.37 5200000148 HC CCS GROUP TEACHING MSW $ 13.37 5200000149 HC CCS GROUP TEACHING PT HEMA $ 13.37 5200000150 HC CCS GROUP TEACHING PT HEMO $ 13.37 5200000151 HC CCS GROUP TEACHING PT PULM $ 13.37 5200000152 HC CCS GROUP TEACHING RD $ 13.37 5200000153 HC CCS GROUP TEACHING RN $ 13.37 5200000154 HC CCS GRP TEACHING SW CARD $ 13.37 5200000155 HC CCS PHONE CONSULT 15M RN $ 8.40 5200000156 HC CCS PHONE CONSULT 15M GC GENE $ 8.40 5200000157 HC CCS PHONE CONSULT 15M MSW $ 8.40 5200000158 HC CCS PHONE CONSULT 15M RN $ 8.40 5200000159 HC CCS PHONE CONSULT PER 15 MIN $ 12.00 5200000160 HC CCS HOUSING REIMBURSEMENT $ 1.00 5200000161 HC CCS FOOD VOUCHER $ 1.00 5200000162 HC CCS TRANSPORTATION REIMBRSMNT $ 5.00 5200000163 HC CCS EXAM ROOM $ 23.77 5200000165 HC CCS PT EVALUATION $ 21.00 5200000166 HC CCS TCC COORD 15M RD $ 72.00 5200000167 HC CCS TCC PART 15M SLP NEUR-ONC $ 8.40 5200000168 HC CCS COMP TCC 30M DDS CFA $ 36.00 52005105 HC GROSS EXAM-LEVEL I $ 265.00 52005204 HC MNR SPC/TIS ID-LVII $ 590.00 52005303 HC PTH EXM-UNCMP-LVIII $ 626.00 52005402 HC PATH EXM-COMPL-LV4 $ 850.00 52005501 HC PATH EXM-EXTND LV5 $ 1,653.00 52005600 HC PATH EXM-CMPLX LVL6 $ 2,000.00 52009800 HC FROZEN SECTION $ 544.00 52009859 HC ADDNLT FROZEN SECT $ 202.00 52012200 HC ELECTRN MICROSCOPY $ 3,868.00 52012309 HC EM THICK SCTN ONLY $ 3,868.00

52014107 HC CONSULTATION 2 $ 401.00 52020005 HC SPEC STAIN CLASS 1 $ 553.00 52020104 HC SPEC STAIN CLASS 2 $ 546.00 52022050 HC IMMUNOSTN/EA ANTBDY $ 968.00 52025244 HC SP BREAST BIOPSY-RA $ 839.00 52025319 HC INDIRECT IF AB (EACH) $ 355.00 52032042 HC NEUROPTH NRV TEASING $ 422.00 52032109 HC DECALCIFICATION $ 167.00 52032133 HC HISTOCHEM ENZYME $ 1,220.00 52032158 HC IN-SITU HYBRDIZATN $ 771.00 52032174 HC DERM:IMNOFLUOR-DIR $ 561.00 52032571 HC IMMUNOHISTO EA AB ADD SLIDE $ 537.00 52050135 HC HISTOCHEMICAL STN/FZN SECTION $ 619.00 52051356 HC MORPH ANALYSIS;MANUAL $ 464.00 52051430 HC PATH CONSULT SURG CYTO INIT $ 348.00 52051448 HC PATH CONSULT SURG CYTO EA ADD $ 217.00 52051463 HC EXM & SLCT ARCHV TIS MOL ANLY $ 82.00 52100120 HC SPEC STAIN CLASS I $ 553.00 52100138 HC SPEC STAIN CLASS 2 $ 546.00 52101623 HC CYTOSPIN $ 408.00 52101664 HC CYTO MISC SOURCES $ 371.00 52101854 HC EXTRAGENITAL SMEAR $ 91.00 52102050 HC TECHNOL IMMED EVAL $ 336.00 52102100 HC FNA EVAL $ 899.00 52102316 HC CYTO CELL BLOCK-LV4 $ 850.00 52102340 HC TECHNICAL CHRG THIN $ 376.00 52102399 HC CONV. PAP SMEAR $ 63.00 52110541 HC LIQUID-BASED PREP,INTERP, RPT $ 513.00 52110566 HC LOC GUIDE SCRN PAP W/REV $ 490.00 52110582 HC IMGD PAP DIAG TLP AUTO $ 416.00 52110590 HC CONV PAP DIAG MANUAL $ 51.00 52110616 HC AUTO THIN LAYER PAP DIAG MAN $ 294.00 52110632 HC CONV PAP SCREENING MANUAL $ 63.00 52110640 HC IMGD PAP SCRN AUTO TLP WRESCRN $ 490.00 52110665 HC AUTO THIN LAYER PAP SCRN $ 376.00 52110681 HC CYTO PREP MISC SOURCE $ 371.00 52110699 HC LIQUID BASED SLIDE PREP $ 513.00 52110731 HC US GUIDANCE NEEDLE PLCMT TC $ 1,555.00 52725504 HC METHYLMALONIC ACID $ 200.00 52751526 HC CARNITINE FREE AND TOTAL $ 187.00 52751591 HC ORGANIC ACID SCR URI $ 195.00 52751609 HC AMINO ACIDS PLASMA $ 307.00 52751617 HC AMINO ACIDS CSF $ 307.00 52751625 HC AMINO ACIDS URINE $ 307.00 52751674 HC ACYLCARNITINE PROFILE $ 187.00 52751682 HC BIOTINIDASE $ 274.00 52751930 HC BRANCHED-CHAIN AMINO $ 274.00 52751948 HC PHENLYLALAINE & TYROS $ 274.00 52751955 HC MUCOPOLYSACCHARIDES U $ 322.00 52751963 HC OLIGOSACCHARIDES U TLC $ 317.00 52751971 HC MUCOPOLYSACCHA U TLC $ 317.00 52752045 HC OROTIC ACID URINE $ 200.00 52753621 HC CARNITINE URINE $ 187.00

52753639 HC HEXOSAMINIDASE A & TOTAL $ 86.00 52753647 HC AMINO ACIDS BLOOD SPOT 6+ $ 307.00 5300000001 HC EVAL LCSW 15 MIN $ 70.00 5300000002 HC EVAL LCSW 30 MIN $ 142.00 5300000003 HC EVAL LCSW 90 MIN $ 380.00 5300000004 HC EVAL FOLLOW-UP LCSW 15 MIN $ 70.00 5300000005 HC EVAL FOLLOW-UP LCSW 30 MIN $ 142.00 5300000006 HC EVAL FOLLOW-UP LCSW 1 HR $ 272.00 5300000007 HC EVAL FOLLOW-UP LCSW 90 MIN $ 380.00 5300000008 HC EVAL LCSM 1 HR $ 272.00 5300000009 HC PSYCHOTHERAPY LCSW INDIV 30 MIN $ 142.00 5300000010 HC PSYCHOTHERAPY LCSW INDIV 50 MIN $ 272.00 5300000011 HC PSYSCHOTHERAPY LCSW INDIV 90 MIN $ 380.00 5300000012 HC THERAPY FAMILY LCSW 50 MIN $ 380.00 5300000013 HC THERAPY FAMILY LCSW 90 MIN $ 530.00 5300000014 HC THERAPY GROUP LCSW EA PERSON $ 121.00 5300000015 HC CASE CONFERENCE $ 31.00 5300000016 HC INDIVIDUAL SERVICE $ 70.00 5300000017 HC PHONE CONSULT PER 15 MIN $ 39.00 5300000018 HC MILEAGE PER MILE OVER 10 MILES $ 17.00 55000004 HC LAB BACTERIOLOGY $ 737.00 55000905 HC SENS PLATE SCREEN $ 226.00 55020051 HC BLOOD SMEAR EXAM $ 379.00 55020101 HC PINWORM PREP $ 76.00 55020150 HC DIR PARASIT EXAM $ 132.00 55020200 HC GIARDIA SCREEN $ 282.00 55020309 HC CRYPTOSPORIDIUM DFA $ 209.00 55020655 HC STOOL PARASITES CMPLX STAIN $ 457.00 55020754 HC ID WORM $ 167.00 55020804 HC R/O PAR/MOD ACD STN $ 162.00 55020820 HC MICROSPORIDIUM STAIN $ 379.00 55020861 HC URINE FULL ORG ID $ 226.00 55020879 HC URINE SPOT ORG ID $ 209.00 55020887 HC RESPIRATORY FULL ORD ID $ 226.00 55020903 HC WOUND FULL OR ID $ 226.00 55020929 HC OX/METH FOR MRSA $ 122.00 55020937 HC BETA LACTAMASE $ 125.00 55020945 HC R/O MRSA 87081 $ 165.00 55020960 HC ADDNL CONC. MTHDS $ 153.00 55032122 HC FUNGAL MIC ADDL $ 254.00 55032130 HC 412 FUNGAL SYNERGY $ 93.00 55033781 HC 092 AFB ID CONV. MRL $ 48.00 55033807 HC 092 AFB MIC PAN 1 DRG $ 57.60 55033880 HC 6939 FNGL ID, RNALDI LAB $ 50.00 55034250 HC 412 AGAR DIFFUSION SENS WALL $ 50.00 55034268 HC 412 MIC BY WALL LAB $ 50.00 55034276 HC 412 AFB ID WALLACE LAB $ 50.00 55034334 HC AFB CULT DIR TBRCL $ 337.00 55034342 HC AFB SMEAR $ 162.00 55034359 HC AFB CULT BLOOD $ 337.00 55034367 HC ADDTL METHODS CULT AER ISOL $ 226.00 55050009 HC BARTLETT CATH CULT $ 302.00 55050058 HC BIOPSY/TISS. (RESP) $ 302.00

55050108 HC NASAL NP CULTURE $ 302.00 55050256 HC RESPIRATORY CULT/SPUT $ 302.00 55050306 HC RESPIRATORY CULT $ 302.00 55050355 HC THROAT SCREEN $ 165.00 55060008 HC ANAEROBIC CULTURE $ 544.00 55060016 HC ANAEROBIC CULTURE DEFIN ID $ 226.00 55060107 HC BILE CULTURE $ 302.00 55060156 HC BONE MARROW CULT $ 302.00 55060206 HC BONE CULTURE $ 302.00 55060255 HC BIOPSY/TISSUE (GEN) $ 302.00 55060305 HC CSF CULTURE $ 302.00 55060354 HC CATHETER TIP CULTURE $ 302.00 55060370 HC DIAL CULT/LRG VOL $ 302.00 55060404 HC EAR CULTURE $ 302.00 55060453 HC EYE CULTURE $ 302.00 55060503 HC FLUID CULTURE $ 302.00 55060552 HC GENITAL CULTURE $ 302.00 55060602 HC JOINT FLUID/SITE $ 302.00 55060800 HC SKIN CULTURE $ 302.00 55060859 HC VALVE CULTURE $ 302.00 55060909 HC WOUND CULTURE $ 302.00 55060958 HC WOUND-DEEP/SURG/ASP $ 302.00 55061006 HC ARBC ORG ID NOT SUH $ 226.00 55061048 HC BODY FLUID CULT $ 302.00 55061055 HC STOOL ADDL SETUP $ 227.00 55061063 HC TRICHOMONAS EXAM $ 270.00 55070007 HC URINE CULTURE $ 317.00 55070015 HC ANAEROBIC LIMITED CULTURE $ 165.00 55080006 HC BLOOD CULTURE ID METHODS $ 499.00 55080063 HC BACTERIAL ID METHODS $ 226.00 55080204 HC ISOLATOR-BRUCELLA $ 499.00 55080261 HC ISOLATOR-FUNGUS $ 513.00 55080451 HC ISOLATOR-SPEC REG $ 499.00 55080568 HC SERUM SCREEN-RPR $ 238.00 55090005 HC AFB CULTURE/CONC. $ 337.00 55090039 HC SMEAR AFB $ 162.00 55090153 HC AFB (SMEAR ONLY) $ 162.00 55090203 HC DIALYSIS FLUID (PT) $ 302.00 55090252 HC MAC/OTHR WTR $ 302.00 55090302 HC FUNGUS CULTURE $ 309.00 55090401 HC GRAM STAIN $ 150.00 55090450 HC GASTRIC CLTR $ 302.00 55090500 HC INDIA INK $ 270.00 55090559 HC KOH PREP $ 270.00 55090658 HC LEGIONELLA/ACID $ 165.00 55090708 HC LEGIONELLA CULT/DIR $ 165.00 55090757 HC LEGIONELLA CULT/D&A $ 165.00 55090807 HC LEGIONELLA CULT/D&D $ 165.00 55090906 HC MIC BATTERY $ 254.00 55090914 HC ANA MIC SUSCEPTIBILITY $ 254.00 55091102 HC R/O GC CULTURE $ 165.00 55091250 HC STOOL CULTURE $ 384.00 55091425 HC MOLD ID $ 237.00

55091441 HC PRESUMPTIVE FUNGAL ID $ 309.00 55091466 HC YEAST ID ONLY $ 237.00 55091508 HC PNEUMOCYSTIS STAIN $ 289.00 55091557 HC R/O STREP BETA GPB 87081 $ 165.00 55091581 HC HELICOBACTER EIA AB $ 206.00 55091599 HC HELI PYL AG $ 376.00 55091615 HC ETEST MIC $ 122.00 55091649 HC TISSUE PREP ADDL $ 182.00 55091789 HC BONE MARROW STERLTY $ 302.00 55091797 HC CULTURE VRE $ 165.00 55091805 HC YEAST MIC $ 254.00 55091813 HC MRSA BY MECA LA $ 309.00 55091821 HC FLUID STERILITY TEST $ 302.00 55091888 HC BORDETELLA PERTUSSIS PCR $ 388.00 55091896 HC B.PARAPERTUSSIS PCR $ 388.00 55091904 HC B PERTUSSIS DFA $ 173.00 55091912 HC B, PARAPERTUSSIS DFA $ 173.00 55091953 HC ASPERGILLUS BY GALACTOMANNAN $ 105.00 55092019 HC FUNGUS CULTURE - SKIN,NAIL $ 307.00 55092027 HC QUANTIFERON $ 1,250.00 55092076 HC AFB PCR ID SPECIMAN $ 566.00 55092084 HC AFB PCR ID CULTURE $ 578.00 55092100 HC AFB ID RRNA SEQUENCE $ 1,653.00 55092118 HC AFB SUSCEP E-TEST $ 122.00 55092126 HC AFB SUSCEP MGIT MACROBOTH DIL $ 93.00 55092134 HC GRP B STREP PCR ID $ 578.00 55092142 HC CULT PCR ID NA PROBE $ 578.00 55092175 HC CLOSTIRIDIUM DIFFICILE APT $ 486.00 55092183 HC AFB CONCENTRATION $ 153.00 55092191 HC CYSTIC FIB RESP CULT $ 302.00 55092209 HC AFB CULT/BLOOD $ 337.00 55092217 HC FUNGAL ID EA ORGANISM $ 237.00 55092233 HC M TUBERCULOSIS PCR APT SPEC $ 566.00 55092241 HC AFB ID FROM ISOLATE APT $ 566.00 55092258 HC BACTERIA ID BY SEQ SPEC $ 1,653.00 55092266 HC BACTERIA ID BY SEQ ISOLATE $ 1,653.00 55092274 HC FUNGI ID BY SEQ ISOLATE $ 1,653.00 55092290 HC SHIGA TXN STOOL CLT PCR NA PRB $ 578.00 55092308 HC STOOL CULT AEROBIC $ 384.00 55092316 HC STOOL CULT AEROBIC ADDL $ 227.00 55092324 HC STOOL CULT ID NA PCR EA $ 578.00 55092332 HC ROSAUR STAPH AUREUS SCRN CULT $ 165.00 55092340 HC ROSTRO STRONGYLOIDES CUL STOOL $ 165.00 55092357 HC ROACAN ACANTHAMOEBA CUL $ 165.00 55092365 HC 092 STRPNE STREP PHEUM SRTYP $ 17.45 55092373 HC 092 STRPNE STREP PHEUM SRTYP $ 17.40 55092381 HC 092 SYNERG SUS ANTCRBL PERAGNT $ 15.00 55092399 HC 092 HAESTA CUL TYP IMMLG MTHD $ 12.25 55092407 HC 092 HAESTB PRTCL AGLTN LTX EA $ 62.25 55092415 HC 092 STSMIC SUSC MIC EA MLTMCBL $ 63.00 55092423 HC 092 ANTSUS SUSC MIC EA MLTMCBL $ 62.25 55092431 HC AETEST SUSC MTHD AGAR DIL $ 122.00 55092449 HC MOLDE SUSC MTHD AGAR DIL EA $ 122.00

55092456 HC MOLDB SUSC MTHD MIC PER PLT $ 254.00 55092464 HC BLAPCR BLAZ CULT APT EA ORG $ 578.00 55092472 HC STPCR STREP CULT APT EA ORG $ 578.00 55092480 HC AFBD SMEAR FLUR ACID FAST $ 162.00 55092498 HC MECAPC MEC ID CULT APT EA ORG $ 578.00 55092506 HC BLAZPC MEC ID CULT APT EA ORG $ 578.00 55092514 HC NFPCR MEC ID CULT APT EA ORG $ 578.00 55092522 HC FUNIDS FUNGUS ID NA SEQ EA $ 1,653.00 55092530 HC DNASE2 ID DNA SQ EA ISOL $ 1,653.00 55092548 HC MYET3 SUSC MTHD AGAR DIL EA $ 122.00 55092555 HC MYET8 SUSC MTHD AGAR DIL EA $ 122.00 55092605 HC CRYEIA CRYPTSPDM AG EIA MSM $ 231.00 55092613 HC NFPC2 ID CULT APT 2ND ORG $ 578.00 55092621 HC NFPC3 ID CULT APT 3RD ORG $ 578.00 55092639 HC MALPCR MALARIA PCR $ 388.00 55092654 HC ORTHO AERO CUL W/GRAM STAIN $ 302.00 55092662 HC SMEAR PRIM SOURCE W/INTERP $ 150.00 55092670 HC ANAERO CUL FOR ORTHO $ 544.00 55092688 HC CUL FOR MULTI ORTHO SPECI $ 544.00 55092696 HC E TEST MIC X6 $ 122.00 55092704 HC E TEST MIC X7 $ 122.00 55092712 HC CRYPTO ANTI LATERAL ASSAY $ 132.00 55092720 HC CRYPTO ANTI FLOW ASSAY CSF $ 132.00 55092746 HC STOOL CLTR ISOL NA DNN/RNA EA $ 578.00 56100050 HC ECG 12 LEAD $ 914.00 56100357 HC EX STRESS TEST INST $ 2,736.00 56101207 HC ECG SIGNAL-AVERAGED $ 1,542.00 56200702 HC ENDOMYOCARDIAL BIOP $ 4,650.00 56200801 HC PERICARDIOCENTESIS INIT $ 3,756.00 56200900 HC INSRT PCMKR/ICD SNGL LEAD $ 5,849.00 56200959 HC CARDIOVERSION $ 5,446.00 56201809 HC PTCA SGL MAJ CORON ART/BRANCH $ 16,995.00 56202054 HC HEART FLW RSRV MEAS EA ADD $ 1,185.00 56202088 HC PLACEMNT OF TEE PROBE $ 1,100.00 56202190 HC HC ECHO TEE ANOMALY CMPL W/PF $ 1,644.00 56202195 HC ECHO TEE 2D $ 1,574.00 56202203 HC CARDIOASSIST DEVICE $ 619.00 56202229 HC ACTIVATED COAG TIME AUTO $ 250.00 56202252 HC UNLISTED CARD SURG PROC $ 5,839.00 56202260 HC HC UNLISTED CVS PROCEDURE $ 319.00 56202294 HC HC RENAL ANGIO-NON-SEL $ 6,811.00 56202310 HC IV INFUSION THERAPY INIT HR $ 1,226.00 56203102 HC EVAL ICD LEADS AT IMP/REPL $ 6,693.00 56209018 HC CARDIAC MAPPING $ 15,182.00 56209026 HC ARRYTHMIA INDUCTION W/DRUG EV $ 15,497.00 56209034 HC INDCT ARYTH;ELCT PCG $ 4,144.00 56209067 HC PERM PCMR IMP ATRL $ 35,800.00 56209075 HC PERM PCMKR INMP VEN $ 38,945.00 56209083 HC PERM PCMKR IMPLT $ 7,686.00 56209117 HC PACG RT ATRIUM $ 7,636.00 56209125 HC RECORD RT ARTIUM $ 1,963.00 56209133 HC RECORD BNDL OF HIS $ 2,368.00 56209141 HC RT VENT RECORDING $ 2,255.00

56209174 HC INTRA-VENT PACG $ 4,144.00 56209216 HC EPS SVT BASELINE $ 6,691.00 56209224 HC VT BSLINE W/INDUCT $ 29,068.00 56209232 HC EPS VT/SVT F/U $ 11,380.00 56209786 HC ESFGL RCD W/PACING $ 2,292.00 56209810 HC EP EVAL;W/O IND ARYTH $ 22,209.00 56209828 HC VT BASELINE + VT 93622N $ 8,719.00 56209844 HC AA,AVN,WPW,ABLATION $ 22,625.00 56209869 HC PMKR REMOVAL GEN ONLY $ 4,740.00 56209877 HC PM REMV GEN + LEAD SINGLE $ 8,287.00 56209885 HC PM REMV + LEAD DUAL $ 4,740.00 56209919 HC VT ABLATION $ 22,579.00 56209943 HC PMKR GEN ONLY DUAL CHAMB $ 5,653.00 56209976 HC PM LEAD REPAIR SINGLE $ 4,740.00 56210016 HC ICD POCKET REVISION $ 8,533.00 56210032 HC ICD PCKT RMV GEN ONLY $ 17,827.00 56210040 HC EP LAB ICD TEST $ 9,007.00 56221567 HC INSERT OR REPLACE PMKR GEN $ 5,389.00 56221575 HC REV OF PCR PCKT $ 5,235.00 56222289 HC COMP EP STUDY/ABLT SUPRA TACHY $ 47,371.00 56222290 HC COMP EP STUDY/ABLT VENT TACHY $ 47,371.00 56222292 HC EPS & ABLT W PULM VEIN ISOL AF $ 47,371.00 56234561 HC REM LEAD EPICARDIAL DUAL $ 7,567.00 56240161 HC PTCA EA ADD CORONARY ART $ 16,995.00 56240526 HC CARDIAC CATH A-V NODE ABLATION $ 21,643.00 56240641 HC INTRAVASCULAR ULTRA $ 11,731.00 56263882 HC OR-ICD LEADS + GEN $ 11,500.00 56263932 HC INJ CARD CATH S&I SEL COR ANG $ 3,053.00 56264005 HC RIGHT HEART CATH $ 16,567.00 56264015 HC LEFT HEART CATH TRANS-SEPTA $ 7,637.00 56264020 HC ADD - PHARMACOLOGIC AGENT ADM $ 8,095.00 56264030 HC ADDL INJECTION CORONARY ARTERY $ 3,053.00 56264035 HC HC ADD - INJECTION BYPASSES $ 2,100.00 56264040 HC INJ LEFT ARTRIA/VENTRIC ANGIO $ 2,026.00 56264045 HC INJ RIGHT ATRIA/VENTRIC ANGIO $ 2,149.00 56264050 HC ADD SUPRAVALVULAR/AORTOGRAPHY $ 2,424.00 56264055 HC ADDL PULMONARY ANGIOGRAM $ 2,568.00 56264060 HC L&R HEART CATH W S&I $ 23,873.00 56264065 HC CATH PLACE COR ARTERY S&I $ 18,796.00 56264075 HC CATH PLACE W R HEART CATH $ 23,359.00 56264095 HC CATH PL L&R CATH L V-GRAM $ 25,803.00 56269087 HC UPGRADE PACMAKR SINGLE TO DUAL $ 39,758.00 56269103 HC INSERT DUAL CHAMBER ICD SGL LD $ 10,081.00 56269129 HC INSERT/REPOS LEAD DUAL/GEN $ 13,902.00 56269137 HC INST PCNG ELECT CVS-LV&PKT REV $ 24,867.00 56269145 HC RMV ELECTRODE BY TV EXT $ 9,053.00 56269152 HC CARDIOVERSION-INTERNAL $ 1,346.00 56269186 HC VENOGRAPHY SINUS OR JUGULAR $ 5,737.00 56269236 HC ECHO GUIDE CARDCENTS $ 498.00 56269251 HC IMPLNT PAT ACTV RECRD $ 21,749.00 56269301 HC REMVE PAT ACTV RECRD $ 2,193.00 56269327 HC REPOSITION PCMKR GEN $ 4,740.00 56269336 HC ATRIAL SEPTOSTOMY BALLOON $ 20,101.00

56269337 HC ANGIPLSTY PULM ART 1ST VESL $ 13,577.00 56269338 HC ANGIOPLAS PULM ART ADD VESL $ 13,577.00 56269343 HC PED AIRWAY INHALE TRT $ 625.00 56269350 HC PED ASD/PFO CLOSURE $ 36,899.00 56269351 HC ADULT ASD/PFO CLOSURE $ 36,899.00 56269368 HC PED BIOPSY HEART LNG $ 4,650.00 56269384 HC PED CNT VEN LN (<5YR) $ 5,677.00 56269392 HC CENTRAL VENOUS LINE >=5YR $ 7,725.00 56269400 HC PED DRAIN HEART SAC $ 3,756.00 56269426 HC US GUID PERICARDIOCENTESIS $ 498.00 56269434 HC FLUOROSCOPE EXAM $ 1,849.00 56269442 HC PED HRT FLW RSRV MEAS INIT $ 1,967.00 56269459 HC PED ICE ECG $ 10,926.00 56269460 HC ADULT ICE ECG $ 10,926.00 56269461 HC VENOUS PRESSURE DETERM $ 2,256.00 56269475 HC PED INCISION HRT SAC $ 1,155.00 56269541 HC INSRT CATHTR ART $ 3,241.00 56269558 HC PED RETRV BROKE CATH $ 8,815.00 56269566 HC PED REVISE AORTIC VLV $ 15,755.00 56269574 HC PED REVSN MITRAL VLVE $ 8,209.00 56269582 HC PED REVISE PLMNRY VLV $ 15,755.00 56269590 HC PED RVS HEART CHMBER $ 20,101.00 56269608 HC PED RMV TNLD PRTD CTH $ 3,651.00 56269616 HC PED RPR ARTERIAL BLCK $ 12,870.00 56269624 HC PED RPT DRAIN HRT SAC $ 1,314.00 56269632 HC PED RT HEART CATH $ 16,567.00 56269640 HC PED RT HRT CTH CNGNTL $ 15,802.00 56269657 HC PED RT LT HRT CATH $ 18,234.00 56269665 HC PED RT/LT HEART CATH $ 23,873.00 56269673 HC R/LHC EXIST SEPTAL OPENING $ 16,225.00 56269871 HC PED TRNSCATH RETRIEVE $ 7,875.00 56269897 HC PED TRNSCTH STENT ADD $ 18,985.00 56269913 HC VEIN XRAY CHEST $ 8,166.00 56269921 HC VEIN XRAY TRUNK $ 7,970.00 56269939 HC PED XRAY TRNCTH THRPY $ 16,094.00 56269941 HC RMV & REPLCE PERM PMKR DUAL LD $ 30,063.00 56269942 HC RMV&RPLC PERM PMKR GEN MLT LD $ 30,063.00 56269945 HC RMV RPLC CVD GEN SGL LEAD $ 100,928.00 56269946 HC RMV REPLC CVD GEN DUAL LEAD $ 100,928.00 56269947 HC PED INTVSC US HRT ADD $ 11,731.00 56269948 HC REMV REPLC CVD GEN MULT LEADS $ 100,928.00 56269988 HC PED LT HEART CATH $ 18,234.00 56270002 HC PED PTPA BALLOON SINGLE $ 13,577.00 56270010 HC PED PTPA BALLOON EA ADDTL $ 13,577.00 56270013 HC INJ LT ART/VENTR ANGIO $ 2,026.00 56270014 HC SEL RT VENTRICULAR/ATRIAL ANG $ 2,149.00 56270015 HC SUPRAVALVULAR AORTOGRAPHY $ 2,424.00 56270016 HC PULMONARY ANGIOGRAPHY $ 2,568.00 56270028 HC PED PICC FLR ULTS<5YR $ 3,628.00 56270036 HC PED PICC FLRO ULT >=5 $ 3,045.00 56270044 HC PED R HRT/RTRO L HRT CTH CNGTL $ 20,809.00 56270051 HC PED R HRT/TRNS L HRT CTH CNGTL $ 16,225.00 56270069 HC PED R&L HRT CTH W/TRNS L CNGTL $ 16,225.00

56270070 HC PERQ TRANSCATH CLOSURE PDA $ 53,670.00 56270077 HC PED REP VEN BLOCK $ 12,081.00 56270085 HC PED REPSTN CVC FLOURO $ 2,214.00 56270086 HC PEDS CORONARY ARTERY ANGIO S&I $ 18,796.00 56270088 HC PEDS RT HRT CORO ART ANGIO $ 23,359.00 56270091 HC PEDS RT< HRT ART/VENT ANGIO $ 25,803.00 56270092 HC PEDS DRUG ADMIN/HEMODYN MEAS $ 8,095.00 56270093 HC CPR $ 2,129.00 56270095 HC CATH RT HEART CONGEN ANOM $ 15,802.00 56270096 HC COMB RT & LT HRT TRANSSPT CATH $ 16,225.00 56270097 HC CATH RT/LT RETRO CONGE ANOM $ 20,809.00 56270101 HC INTRACARD EP 3D MAP $ 15,402.00 56270119 HC VSD CLOSURE W/IMPLANT $ 37,862.00 56270140 HC HC INS CANN ECMO $ 14,000.00 56270220 HC HYBRID HI COMPLX INIT 30 MIN $ 21,874.00 56270221 HC HYBRID HI COMPLX ADDTL 15 MIN $ 2,500.00 56270222 HC HYBRID COMPLX INIT 30 MIN $ 17,188.00 56270223 HC HYBRID COMPLX ADDTL 15 MIN $ 2,000.00 56283456 HC ADENOSINE CHALLENGE $ 747.00 56293534 HC PED OP/PERQ TRNSCTH PLMT STENT $ 39,282.00 56293539 HC PED VASC EMBOLIZE/OCCL ARTERY $ 52,746.00 56300486 HC CMV QUAL PCR AMP $ 651.00 56300502 HC CMV PCR QUANT $ 849.00 56310253 HC RFLX VIR NA QUANT $ 388.00 56310279 HC RFLX VIR NA QUANT $ 222.00 56310311 HC GC AMP PROBE $ 566.00 56310345 HC CHLAMYDIA MOLECULAR $ 566.00 56310352 HC GC LCR AMPLIFIED $ 566.00 56310394 HC HEP B PCR QUANT $ 794.00 56310667 HC VIR GENE RT/PRO SEQ $ 2,847.00 56330012 HC HIV PCR QUANT AVRT DIS $ 1,377.00 56330053 HC CHL.TRACH AMP PROBE $ 566.00 58000050 HC EMG TWO EXTREMITIES $ 1,230.00 58010042 HC WADA TS EEG MNTRG $ 1,941.00 58030008 HC EEG-AWAKE $ 1,996.00 58030057 HC EEG SLP ONLY $ 2,503.00 58031808 HC ADTRY BRN ST EVKD RES $ 2,609.00 58031857 HC SMTSRY EVKD RSPNS $ 2,518.00 58031858 HC SMTSRY EVKD UP & LOW EXTS $ 4,128.00 58031865 HC SER LOWER EXT $ 2,518.00 58032681 HC EEG EXTENDED > 1 HR $ 3,912.00 58033317 HC SUBDML NEEDLE ELECTD SET $ 213.00 58033341 HC MOTOR EP, UPPER EXT $ 616.00 58033342 HC MOTOR EP UP & LOW EXTS $ 684.00 58033358 HC MOTOR EP, LOWER EXT $ 616.00 58033370 HC CONTIN INTRAOP N-PHYS MONITOR $ 504.00 58100033 HC S EMG ONE EXTREMITY INST $ 1,141.00 58100314 HC TRANSCRANIAL DOPPLR $ 2,485.00 58100322 HC TRANSCRN DOPPLER LMTD $ 1,596.00 58700048 HC BLOOD GAS EG7 $ 815.00 58700055 HC LYTES BLOOD GAS G3 $ 815.00 58700097 HC SODIUM $ 219.00 58700105 HC POTASSIUM PCK $ 204.00

58700113 HC IONIZED CALCIUM $ 399.00 58700139 HC GLUCOSE PCGLUCOSE $ 159.00 58700147 HC HEMATOCRIT PCH $ 217.00 58700162 HC CREATININE POC $ 179.00 58700238 HC GLUCOSE POC $ 200.00 58700246 HC ACT CLOTT TIME(ACT+) $ 250.00 58700253 HC APTT $ 240.00 58700279 HC PROTHROMBIN TIME $ 190.00 58700295 HC PCLACT-LACTATE (CG4) $ 330.00 58700303 HC PCO2-O2 (CG4) $ 815.00 58700304 HC CHLORIDE POC $ 129.00 58700305 HC UREA NITROGEN (BUN) POC $ 157.00 58700311 HC PCPCO2-CO2 (CG4) $ 815.00 58700329 HC PCPH-PH (CG4) $ 815.00 58700337 HC PCTN1-TROPONIN 1 QUANT $ 520.00 62311030 HC CI NEURO RESP ASSESS $ 467.00 66690017 HC PLTAB:PLT ALLOANTIBODY $ 33.00 66690033 HC HLAAB:HLA-A, B TYPE(PCR) $ 133.00 66690041 HC HLAA:HLA-A TYPE(PCR) $ 58.00 66690058 HC HLAB:HLA-B TYPE(PCR) $ 58.00 66690066 HC ASR:HLA AB SCR(RAPID) $ 61.00 66690082 HC 427 ABTS:HLA-AB TYPE(SER) $ 120.00 66690090 HC BLX:HLA XM:B-CELL $ 82.00 66690108 HC SHLA:SPECIFIC HLA ANTIGEN TYPE $ 53.00 66690116 HC HLAC:HLA-C TYPE(PCR) $ 58.00 66690124 HC DRDQ:HLA-DR,DQ TYPE(PCR) $ 133.00 66690132 HC DRHR:HLA-DR TYPE(HI-RES) $ 58.00 66690140 HC KIT:KIT FEE $ 285.00 66690165 HC HLATX:HLA XM:T-CELL $ 82.00 66690173 HC FXMAT:HLA XM:T-CELL(FLOW) $ 82.00 66690181 HC VNTR:HLA STR/VNTR TESTING $ 257.00 66690199 HC HLAQM:HLA AB SCR:MONTHLY $ 61.00 66690207 HC PCRPL:PLT ANTIGEN TYPE(PCR) $ 133.00 66690215 HC HLAHX:HLA XM:PBL $ 396.00 66690231 HC DRSSP:HLA-DR TYPE(HI-RES SSP) $ 58.00 66690249 HC CD31:HLA CD31 TESTING $ 133.00 66690256 HC AXTF:HLA AUTO XM:T-CELL(FLOW) $ 82.00 66690264 HC AXBF:HLA AUTO XM:B-CELL(FLOW) $ 82.00 66690843 HC AXB:HLA AUTO XM:B-CELL $ 82.00 66690868 HC AXT:HLA AUTO XM:T-CELL $ 82.00 66690884 HC PCRDR:HLA-DR TYPE(PCR) $ 120.00 66690892 HC PCRDQ:HLA-DQ TYPE(PCR) $ 58.00 66690900 HC HRDQ:HLA-DQ TYPE(HI-RES) $ 58.00 66690918 HC STRID:HLA STR/VNTR IDENTITY $ 257.00 66690926 HC STRSU:HLA STR/VNTR SUBSETS $ 257.00 66690934 HC DRDQS:HLA-DR,DQ TYPE(SER) $ 120.00 66690942 HC 427 BCFRZ:CELL FREEZING $ 21.00 66690959 HC BIMMIS:IMMUNOBEAD ISOLATION $ 390.00 66690967 HC PLTAG:PLT ANTIGEN TYPE(SER) $ 120.00 66690983 HC AXBDT:HLA AUTO XM:B-CELL(DTT) $ 82.00 66690991 HC AXTDT:HLA AUTO XM:T-CELL(DTT) $ 82.00 66691007 HC DTTAB:HLA AB SCRN(DTT) $ 61.00 66691015 HC DTTAM:HLA AB MONTH(DTT) $ 61.00

66691023 HC DTTXB:HLA XM:B-CELL(DTT) $ 82.00 66691031 HC DTTXM:HLA XM:PBL(DTT) $ 82.00 66691049 HC DTTXT:HLA XM:T-CELL(DTT) $ 82.00 66691056 HC FXB:HLA XM:B-CELL(FLOW) $ 82.00 66691064 HC HLAABH:HLA-A,B TYPE(HI RES) $ 133.00 66691072 HC HLAAH:HLA-A TYPE(HI RES) $ 58.00 66691073 HC HLAAH:HLA-A TYPE(HI RES) $ 58.00 66691080 HC HLABH:HLA-B TYPE(HI RES) $ 58.00 66691098 HC HLACH:HLA-C TYPE(HI RES) $ 58.00 66691106 HC HLACS:HLA-C TYPE(SER) $ 53.00 66691114 HC HLAPLX:HLA XM:PLATELET $ 396.00 66691122 HC HLAQ:HLA MONTHLY AB SCRN $ 61.00 66691130 HC PATDA:DRUG ASSOC PLTLT AB $ 33.00 66691148 HC PCPR:HLA ANTIBODY ID(RAPID) $ 61.00 66691155 HC PCPSM:HLA AB MONTH(SHORT) $ 61.00 66691163 HC PLAB:PLATELET AUTO AB $ 33.00 66691171 HC B27:HLA B27 ANTIGEN TYPE $ 53.00 66691197 HC LMXSI:AB LUMINEX SA I $ 82.00 66691205 HC LMXSII:AB LUMINEX SA II $ 82.00 66691213 HC HLADQA:DQA TYPING (PCR) $ 58.00 66691221 HC 427 H097 SERUM ALIQ & STRG $ 210.00 66691239 HC 427 ADP: ADSORPTION $ 73.00 66691247 HC HAPLO: HAPLO PREP $ 82.00 66691254 HC HLADP: DP1 LOCUS TYPE PCR $ 82.00 66691262 HC 427 CYLEX $ 101.00 66691304 HC 427 H095 PATH CONSULT COMP $ 115.00 66691338 HC 427 H002 PATH CONSULT COMP $ 115.00 66691346 HC 427 C1Q1 FLOW 1ST MRKR $ 22.00 66691353 HC 427 C1Q1 FLOW ADDTL MARKER $ 80.00 66691361 HC 427 C1Q1 FLOW INTRP 16 PLUS $ 145.00 66691379 HC 427 C1Q2 FLOW 1ST MRKR $ 131.00 66691387 HC 427 C1Q2 FLOW ADDTL MARKER $ 80.00 66691395 HC 427 C1Q2 FLOW INTRP 16 PLUS $ 145.00 66691429 HC 427 DNAEX SPLIT BLD EA UNIT $ 76.00 66691437 HC 427 C1QV1 FLOW 1ST MRKR $ 131.00 66691443 HC 427 C1QV1 FLOW ADDTL MARKER $ 80.00 66691452 HC 427 C1QV1 FLOW INTRP 16 PLUS $ 145.00 66691460 HC 427 C1QV2 FLOW 1ST MRKR $ 131.00 66691478 HC 427 C1QV2 FLOW ADDTL MARKER $ 80.00 66691486 HC 427 C1QV2 FLOW INTRP 16 PLUS $ 145.00 66691544 HC 427 H059 PATH CONSULT COMP $ 115.00 66691619 HC 427 H003 PATH CONSULT COMP $ 115.00 66691668 HC 427 H072 PATH CONSULT COMP $ 115.00 66691684 HC 427 LMXSI FLOW 1ST MRKR TECH $ 131.00 66691692 HC 427 LMXSI FLOW ADTL MKR TECH $ 80.00 66691700 HC 427 LMXSI FLOW INTRP 16 PLUS $ 145.00 66691718 HC 427 LMXSII FLOW 1ST MRKR TECH $ 131.00 66691726 HC 427 LMXSII FLOW ADTL MKR TECH $ 80.00 66691734 HC 427 LMXSII FLOW INTRP 16 PLUS $ 145.00 66691767 HC 427 H062 PATH CONSULT COMP $ 115.00 66691809 HC 427 H114 PATH CONSULT COMP $ 115.00 66691841 HC 427 H115 PATH CONSULT COMP $ 115.00 66691874 HC 427 H004 PATH CONSULT COMP $ 115.00

66691908 HC 427 H029 PATH CONSULT COMP $ 115.00 66691957 HC 427 H069 PATH CONSULT COMP $ 115.00 66692005 HC 427 H075 PATH CONSULT COMP $ 115.00 66692054 HC 427 H076 PATH CONSULT COMP $ 115.00 66692120 HC 427 H058 PATH CONSULT COMP $ 115.00 66692153 HC 427 H022 PATH CONSULT COMP $ 115.00 66692161 HC 427 AXTF AUTOS PROC PRE $ 73.00 66692179 HC 427 AXTF FLOW 1ST MRKR TECH $ 131.00 66692187 HC 427 AXTF FLOW ADTL MKR TECH $ 80.00 66692195 HC 427 AXTF FLOW INTERP 2 TO 8 $ 87.00 66692203 HC 427 AXBF AUTOS PROC PRE $ 73.00 66692211 HC 427 AXBF FLOW 1ST MRKR TECH $ 131.00 66692229 HC 427 AXBF FLOW ADTL MKR TECH $ 80.00 66692237 HC 427 AXBF FLOW INTERP 2 TO 8 $ 87.00 66692245 HC 427 FXMAT AUTOS PROC PRE $ 73.00 66692252 HC 427 FXMAT FLOW 1ST MRKR TECH $ 131.00 66692260 HC 427 FXMAT FLOW ADTL MKR TECH $ 80.00 66692278 HC 427 FXMAT FLOW INTERP 2 TO 8 $ 87.00 66692286 HC 427 FXB AUTOS PROC $ 73.00 66692294 HC 427 FXB FLOW 1ST MRKR $ 131.00 66692302 HC 427 FXB FLOW ADTL MKR $ 80.00 66692310 HC 427 FXB FLOW INTERP 2 TO 8 $ 87.00 66692344 HC 427 H063 PATH CONSULT COMP $ 115.00 66692377 HC 427 H061 PATH CONSULT COMP $ 115.00 66692401 HC 427 H079 PATH CONSULT COMP $ 115.00 66692443 HC 427 H064 PATH CONSULT COMP $ 115.00 66692450 HC 427 H007 PATH CONSULT COMP $ 115.00 66692468 HC 427 HLATX LYMPH TITRAT $ 90.00 66692476 HC 427 HLATX AUTOS PROC $ 73.00 66692484 HC 427 HLATX SPLIT BLD EA UNIT $ 76.00 66692492 HC 427 H008 PATH CONSULT COMP $ 115.00 66692500 HC 427 BLX LYMPH TITRAT $ 90.00 66692518 HC 427 BLX AUTOS PROC $ 73.00 66692526 HC 427 BLX SPLIT BLD EA UNIT $ 76.00 66692534 HC 427 BIMMIS H134 AUTOS PROC $ 73.00 66692542 HC 427 BIMMIS H134 SPLT BLD EA UN $ 76.00 66692559 HC 427 BIMMIS H056 AUTOS PROC $ 73.00 66692567 HC 427 BIMMIS H056 SPLT BLD EA UN $ 76.00 66692591 HC 427 H016 HLAQ FLOW 1ST MRKR $ 131.00 66692609 HC 427 H016 HLAQ FLOW ADTL MKR $ 80.00 66692617 HC 427 H016 HLAQ INTRP 16 PLUS $ 145.00 66692625 HC 427 LDSAG1 FLOW 1ST MRKR $ 131.00 66692633 HC 427 LDSAG1 FLOW ADTL MKR $ 80.00 66692641 HC 427 LDSAG1 INTRP 16 PLUS $ 145.00 66692658 HC 427 LDSAG2 FLOW 1ST MRKR $ 131.00 66692666 HC 427 LDSAG2 FLOW ADTL MKR $ 80.00 66692674 HC 427 LDSAG2 INTRP 16 PLUS $ 145.00 66692682 HC 427 LDSAQ1 FLOW 1ST MRKR $ 131.00 66692690 HC 427 LDSAQ1 FLOW ADTL MKR $ 80.00 66692708 HC 427 LDSAQ1 INTRP 16 PLUS $ 145.00 66692716 HC 427 LDSAQ2 FLOW 1ST MRKR $ 131.00 66692724 HC 427 LDSAQ2 FLOW ADTL MKR $ 80.00 66692732 HC 427 LDSAQ2 INTRP 16 PLUS $ 145.00

66692740 HC 427 LMONQ1 FLOW 1ST MRKR $ 131.00 66692757 HC 427 LMONQ1 FLOW ADTL MKR $ 80.00 66692765 HC 427 LMONQ1 INTRP 16 PLUS $ 145.00 66692773 HC 427 LMONQ2 FLOW 1ST MRKR $ 131.00 66692781 HC 427 LMONQ2 FLOW ADTL MKR $ 80.00 66692799 HC 427 LMONQ2 INTRP 16 PLUS $ 145.00 66692807 HC 427 LSAG1A FLOW 1ST MRKR $ 131.00 66692815 HC 427 LSAG1A FLOW ADTL MKR $ 80.00 66692823 HC 427 LSAG1A INTRP 16 PLUS $ 145.00 66692831 HC 427 LSAG2A FLOW 1ST MRKR $ 131.00 66692849 HC 427 LSAG2A FLOW ADTL MKR $ 80.00 66692856 HC 427 LSAG2A INTRP 16 PLUS $ 145.00 66692864 HC 427 LMONG1 FLOW 1ST MRKR $ 131.00 66692872 HC 427 LMONG1 FLOW ADTL MKR $ 80.00 66692880 HC 427 LMONG1 INTRP 16 PLUS $ 145.00 66692898 HC 427 LMONG2 FLOW 1ST MRKR $ 131.00 66692906 HC 427 LMONG2 FLOW ADTL MKR $ 80.00 66692914 HC 427 LMONG2 INTRP 16 PLUS $ 145.00 66692948 HC 427 H080 PATH CONSULT COMP $ 115.00 66692971 HC 427 H060 PATH CONSULT COMP $ 115.00 66692989 HC 427 H012 PATH CONSULT COMP $ 115.00 66692997 HC 427 AXT LYMPH TITRAT $ 90.00 66693003 HC 427 AXT AUTOS PROC $ 73.00 66693011 HC 427 AXT SPLIT BLD EA UN $ 76.00 66693052 HC 427 H005 PATH CONSULT COMP $ 115.00 66693094 HC 427 H116 PATH CONSULT COMP $ 115.00 66693136 HC 427 H117 PATH CONSULT COMP $ 115.00 66693169 HC 427 H125 PATH CONSULT COMP $ 115.00 66693201 HC 427 H136 PATH CONSULT COMP $ 115.00 66693243 HC 427 H118 PATH CONSULT COMP $ 115.00 66693250 HC 427 H120 FLOW 1ST MARKER $ 131.00 66693268 HC 427 H120 FLOW ADTL MARKER $ 80.00 66693276 HC 427 H120 INTRP FC 16 PLUS $ 145.00 66693334 HC 427 H129 PATH CONSULT COMP $ 115.00 66693383 HC 427 H131 PATH CONSULT COMP $ 115.00 66693391 HC 427 H010 PATH CONSULT COMP $ 115.00 66693409 HC 427 H010 LYMPH TITRAT $ 90.00 66693417 HC 427 H010 AUTOS PROC $ 73.00 66693425 HC 427 H010 SPLIT BLD EA $ 76.00 66693433 HC 427 H011 PATH CONSULT COMP $ 115.00 66693441 HC 427 H011 LYMPH TITRAT $ 90.00 66693458 HC 427 H011 AUTOS PROC $ 73.00 66693466 HC 427 H011 SPLIT BLD EA $ 76.00 66693474 HC 427 H013 PATH CONSULT COMP $ 115.00 66693482 HC 427 H013 LYMPH TITRAT $ 90.00 66693490 HC 427 H013 AUTOS PROC $ 73.00 66693508 HC 427 H013 SPLIT BLD EA $ 76.00 66693516 HC 427 H023 PATH CONSULT COMP $ 115.00 66693524 HC 427 H023 LYMPH TITRAT $ 90.00 66693532 HC 427 H023 AUTOS PROC $ 73.00 66693540 HC 427 H023 SPLIT BLD EA $ 76.00 66693557 HC 427 H024 PATH CONSULT COMP $ 115.00 66693565 HC 427 H024 LYMPH TITRAT $ 90.00

66693573 HC 427 H024 AUTOS PROC $ 73.00 66693581 HC 427 H024 SPLIT BLD EA $ 76.00 66693656 HC 427 H057 PATH CONSULT COMP $ 115.00 66693664 HC 427 H088 PATH CONSULT COMP $ 115.00 66693672 HC 427 H088 LYMPH TITRAT $ 90.00 66693680 HC 427 H088 AUTOS PROC $ 73.00 66693698 HC 427 H088 SPLIT BLD EA $ 76.00 66693706 HC 427 H089 PATH CONSULT COMP $ 115.00 66693714 HC 427 H089 LYMPH TITRAT $ 90.00 66693722 HC 427 H089 AUTOS PROC $ 73.00 66693730 HC 427 H089 SPLIT BLD EA $ 76.00 66693805 HC 427 H128 PATH CONSULT COMP $ 115.00 66693847 HC 427 H138 PATH CONSULT COMP $ 115.00 66693888 HC 427 H139 PATH CONSULT COMP $ 115.00 66693953 HC 427 H132 PATH CONSULT COMP $ 115.00 66694019 HC 427 H130 PATH CONSULT COMP $ 115.00 66694050 HC 427 H133 PATH CONSULT COMP $ 115.00 66694092 HC 427 H140 PATH CONSULT COMP $ 115.00 66694126 HC 427 H141 PATH CONSULT COMP $ 115.00 66694134 HC 427 H090 PATH CONSULT COMP $ 115.00 66694142 HC 427 H090 LYMPH TITRAT $ 90.00 66694159 HC 427 H090 AUTOS PROC/STOR PRE $ 73.00 66694167 HC 427 H090 SPLIT BLD EA UNIT $ 76.00 66694175 HC 427 H091 PATH CONSULT COMP $ 115.00 66694183 HC 427 H091 LYMPH TITRAT $ 90.00 66694191 HC 427 H091 AUTOS PROC/STOR PRE $ 73.00 66694209 HC 427 H091 SPLIT BLD EA UNIT $ 76.00 66694217 HC 427 H119 TECH ONLY 1ST MRK $ 131.00 66694225 HC 427 H119 TECH EA ADDL MRKR $ 80.00 66694233 HC 427 H119 FLW INTRP 16 PLUS MRK $ 145.00 66694241 HC 427 H121 TECH ONLY 1ST MRK $ 131.00 66694258 HC 427 H121 TECH EA ADDL MRKR $ 80.00 66694266 HC 427 H121 FLW INTRP 16 PLUS MRK $ 145.00 66694282 HC 427 H095 HLACI EA LOC LMXA $ 1,429.00 66694291 HC 427 H002 HLA CII DRB1345 DQB1 $ 2,170.00 66694308 HC 427 H031 DNA EXT STR UNLS MOP $ 363.00 66694316 HC 427 H059 CHM CELL SELCT EA TYP $ 2,406.00 66694324 HC 427 H055 HAPLO C1 UNLS MOP $ 217.00 66694332 HC 427 H003 HLAC2 HI RES DRB1 $ 636.00 66694341 HC 427 H072 HLAC2 HI RES DQB1 $ 1,031.00 66694357 HC 427 H062 HLACI EA LOC PCRB $ 2,170.00 66694365 HC 427 H114 HLACI EA LOC LMXB $ 2,005.00 66694373 HC 427 H115 HLACI EA LOC LMXC $ 1,213.00 66694381 HC 427 H004 HLAC2 LOW EA PCRDQB1 $ 1,519.00 66694399 HC 427 H029 HLAC2 LOW EA PCRDRB1 $ 1,519.00 66694407 HC 427 H069 HLAC1 HI EA HLAC $ 1,438.00 66694415 HC 427 H075 HLAC1 HI EA HLAA $ 1,438.00 66694423 HC 427 H076 HLAC1 HI EA HLAB $ 1,438.00 66694431 HC 427 H058 STR PT AND COMP $ 103.00 66694449 HC 427 H058 STR PT&CMP EA ADL $ 2,303.00 66694456 HC 427 H022 HLACI EA LOC PCRC $ 4,122.00 66694464 HC 427 H063 HLAC1 EA LOC PCR A&B $ 3,959.00 66694472 HC 427 H061 HLACI EA LOC PCRA $ 2,170.00

66694481 HC 427 H079 HLAC2 LOW EA PCRDPB1 $ 2,170.00 66694498 HC 427 H064 CD31 MIN UNLS MOP $ 647.00 66694506 HC 427 H127 HAPLO CII UNLSMOP $ 217.00 66694514 HC 427 H080 HLAC2 LOW EA PCRDQA1 $ 1,194.00 66694522 HC 427 H060 HLAC2 HI ALL DRB1 $ 1,519.00 66694531 HC 427 H005 HLACI EA LOC B27 $ 2,005.00 66694548 HC 427 H116 HLAC2 LOW EA LMX DRB $ 1,483.00 66694555 HC 427 H117 HLAC2 LOW EA LMX DQB $ 1,969.00 66694564 HC 427 H125 HLA CII DRB1345 DQB1 $ 2,170.00 66694571 HC 427 H064 CD31 MIN AG TYP $ 648.00 66694572 HC 427 H136 HLAC2LOW EA LMXDQA&B $ 1,969.00 66694581 HC 427 H118 HLA CII DRB1345 DQB1 $ 925.00 66694598 HC 427 H129 CHM CELL SELCT EA TYP $ 2,406.00 66694606 HC 427 H131 HLAC2 HI RES DPB $ 828.00 66694614 HC 427 H057 STR PT AND COMP $ 2,406.00 66694622 HC 427 H128 STR PT AND COMP $ 103.00 66694631 HC 427 H128 STR PT&CMP EA ADL $ 2,303.00 66694647 HC 427 H138 HLAC2LOW EA LMXDPA&B $ 2,041.00 66694648 HC 427 H064 CD31 MIN AG TYP $ 648.00 66694655 HC 427 H139 HLAC2 LOW EA LMX DQA $ 1,969.00 66694663 HC 427 H132 HLAC2 LOW EA PCR DQA $ 869.00 66694671 HC 427 H130 STR PT AND COMP $ 103.00 66694689 HC 427 H130 STR PT&CMP EA ADL $ 2,303.00 66694697 HC 427 H133 HLACI EA LOC MICA $ 1,015.00 66694705 HC 427 H140 LMX KIR UNLS MOP $ 1,321.00 66694713 HC 427 H141 PCR KIR UNLS MOP $ 1,113.00 66695141 HC 427 H007 LYMPH TITRAT $ 247.00 66695158 HC 427 H008 LYMPH TITRAT $ 247.00 66695166 HC 427 H009 FLOW CYT TC 1ST MRK $ 113.00 66695174 HC 427 H009 FLOW CTY TC ADTL MKR $ 113.00 66695182 HC 427 H009 INTERP 2 TO 8 $ 112.00 66695191 HC 427 H010 LYMPH TITRAT $ 247.00 66695208 HC 427 H011 LYMPH TITRAT $ 247.00 66695216 HC 427 H012 LYMPH TITRAT $ 247.00 66695223 HC 427 H013 LYMPH TITRAT $ 247.00 66695231 HC 427 H016 IMMUNOASSAY NON AB $ 723.00 66695249 HC 427 H023 LYMPH TITRAT $ 247.00 66695257 HC 427 H024 LYMPH TITRAT $ 247.00 66695265 HC 427 H056 STR PT AND COMP $ 149.00 66695273 HC 427 H058 STR PT AND COMP $ 1,203.00 66695281 HC 427 H058 CHM CELL SEL EA TYPE $ 1,204.00 66695299 HC 427 H060 HLAC2 HI RES DRB1 $ 1,520.00 66695307 HC 427 H061 HLAC2 LOW RES EA PCRA $ 2,170.00 66695315 HC 427 H062 HLAC2 LOW RES EA PCRB $ 2,170.00 66695322 HC 427 H066 FLOW CYT TC 1ST MRK $ 113.00 66695331 HC 427 H066 FLOW CTY TC ADTL MKR $ 113.00 66695348 HC 427 H066 INTERP 2 TO 8 MARKERS $ 112.00 66695356 HC 427 H067 FLOW CYT TC 1ST MRK $ 113.00 66695364 HC 427 H067 FLOW CTY TC ADTL MKR $ 113.00 66695372 HC 427 H067 INTERP 2 TO 8 MARKERS $ 112.00 66695381 HC 427 H068 FLOW CYT TC 1ST MRK $ 113.00 66695398 HC 427 H068 FLOW CTY TC ADTL MKR $ 113.00 66695406 HC 427 H068 INTERP 9-15 MARKERS $ 112.00

66695414 HC 427 H086 IMMUNOASSAY NON AB $ 723.00 66695421 HC 427 H087 IMMUNOASSAY NON AB $ 635.00 66695431 HC 427 H088 LYMPH TITRAT $ 247.00 66695448 HC 427 H089 LYMPH TITRAT $ 247.00 66695456 HC 427 H090 LYMPH TITRAT $ 247.00 66695464 HC 427 H091 LYMPH TITRAT $ 247.00 66695472 HC 427 H104 IMMUNOASSAY NON AB $ 723.00 66695481 HC 427 H105 IMMUNOASSAY NON AB $ 635.00 66695498 HC 427 H110 IMMUNOASSAY NON AB $ 723.00 66695506 HC 427 H111 IMMUNOASSAY NON AB $ 635.00 66695513 HC 427 H112 IMMUNOASSAY NON AB $ 723.00 66695521 HC 427 H113 IMMUNOASSAY NON AB $ 635.00 66695539 HC 427 H119 IMMUNOASSAY NON AB $ 723.00 66695547 HC 427 H20 IMMUNOASSAY NON AB $ 635.00 66695555 HC 427 H121 IMMUNOASSAY NON AB $ 635.00 66695563 HC 427 H129 CHIM ANAL NO CELL $ 2,407.00 66695571 HC 427 H134 STR PT AND COMP $ 149.00 66695589 HC 427 H016 IMMUNOASSAY NON AB $ 726.00 66695597 HC 427 H086 IMMUNOASSAY NON AB $ 726.00 66695605 HC 427 H087 IMMUNOASSAY NON AB $ 726.00 66695612 HC 427 H111 IMMUNOASSAY NON AB $ 726.00 66695621 HC 427 H112 IMMUNOASSAY NON AB $ 726.00 66695638 HC 427 H119 IMMUNOASSAY NON AB $ 726.00 66695646 HC 427 H087 IMMUNOASSAY NON AB $ 641.00 66695654 HC 427 H105 IMMUNOASSAY NON AB $ 641.00 66695662 HC 427 H111 IMMUNOASSAY NON AB $ 641.00 66695671 HC 427 H113 IMMUNOASSAY NON AB $ 641.00 66695688 HC 427 H121 IMMUNOASSAY NON AB $ 641.00 66695696 HC 427 H120 IMMUNOASSAY NON AB $ 641.00 66696381 HC 427 H068 FLOW CYT TC 1ST MRK $ 113.00 66696654 HC 427 H105 IMMUNOASSAY NON AB $ 641.00 7100000001 HC XR EYE FOREIGN BODY $ 481.00 7100000002 HC XR MANDIBLE <4V $ 646.00 7100000003 HC XR MANDIBLE 4V+ $ 782.00 7100000004 HC XR FACIAL BONES <3V $ 662.00 7100000005 HC XR FACIAL BONES 3V+ $ 801.00 7100000006 HC XR NASAL BONES 3V+ $ 883.00 7100000007 HC XR ORBITS 4V+ $ 982.00 7100000008 HC XR PARANASAL SINUSES <3V $ 603.00 7100000009 HC XR PARANASAL SINUSES 3V+ $ 730.00 7100000010 HC XR SKULL <4V $ 776.00 7100000011 HC XR SKULL >4V $ 939.00 7100000012 HC XR TM JOINTS BILAT OPEN & CLSD $ 826.00 7100000013 HC NECK SOFT TISSUE $ 620.00 7100000014 HC CINE/VIDEO VOICE $ 1,053.00 7100000015 HC XR CHEST 1V $ 885.00 7100000016 HC XR CHEST 2V $ 1,012.00 7100000017 HC XR CHEST 2V + LORDOTIC $ 1,163.00 7100000018 HC XR CHEST 2V + OBLIQUE(S) $ 1,338.00 7100000019 HC XR CHEST 4V $ 803.00 7100000020 HC XR CHEST DECUB 1 OR 2V $ 2.00 7100000020 HC XR CHEST DECUB 1 OR 2V $ 1,248.00 7100000020 HC XR CHEST DECUB 1 OR 2V $ 3,147.00

7100000020 HC XR CHEST DECUB 1 OR 2V $ 9,613.00 7100000021 HC XR RIBS UNI 2V $ 204.50 7100000021 HC XR RIBS UNI 2V $ 210.93 7100000021 HC XR RIBS UNI 2V $ 213.50 7100000021 HC XR RIBS UNI 2V $ 287.50 7100000022 HC XR RIBS BIL 3V $ 133.00 7100000022 HC XR RIBS BIL 3V $ 138.00 7100000022 HC XR RIBS BIL 3V $ 175.00 7100000022 HC XR RIBS BIL 3V $ 204.50 7100000023 HC XR STERNUM 2V+ $ 44.90 7100000023 HC XR STERNUM 2V+ $ 61.00 7100000023 HC XR STERNUM 2V+ $ 67.00 7100000023 HC XR STERNUM 2V+ $ 81.33 7100000024 HC XR STERNOCLAV JTS 3V+ $ 91.84 7100000024 HC XR STERNOCLAV JTS 3V+ $ 112.50 7100000024 HC XR STERNOCLAV JTS 3V+ $ 117.00 7100000024 HC XR STERNOCLAV JTS 3V+ $ 125.00 7100000025 HC XR SPINE ENTIRE AP & LAT $ 67.50 7100000025 HC XR SPINE ENTIRE AP & LAT $ 73.50 7100000025 HC XR SPINE ENTIRE AP & LAT $ 81.68 7100000025 HC XR SPINE ENTIRE AP & LAT $ 87.50 7100000026 HC XR SPINE CERVICAL 1V $ 60.02 7100000026 HC XR SPINE CERVICAL 1V $ 91.00 7100000026 HC XR SPINE CERVICAL 1V $ 149.00 7100000027 HC XR SPINE CERVICAL 2 OR 3V $ 60.25 7100000027 HC XR SPINE CERVICAL 2 OR 3V $ 116.50 7100000027 HC XR SPINE CERVICAL 2 OR 3V $ 136.50 7100000027 HC XR SPINE CERVICAL 2 OR 3V $ 148.72 7100000028 HC XR SPINE CERVICAL 4 OR 5V $ 35.52 7100000028 HC XR SPINE CERVICAL 4 OR 5V $ 138.50 7100000029 HC XR SPINE CERVICAL 6V+ $ 53.40 7100000029 HC XR SPINE CERVICAL 6V+ $ 98.50 7100000029 HC XR SPINE CERVICAL 6V+ $ 161.46 7100000029 HC XR SPINE CERVICAL 6V+ $ 184.00 7100000030 HC XR SPINE LUMBAR 1V $ 11.87 7100000030 HC XR SPINE LUMBAR 1V $ 37.00 7100000030 HC XR SPINE LUMBAR 1V $ 220.84 7100000030 HC XR SPINE LUMBAR 1V $ 633.00 7100000031 HC XR SPINE LUMBAR 2 OR 3V $ 727.00 7100000032 HC XR L-SPINE BEND ONLY 2 OR 3V $ 727.00 7100000033 HC XR SPINE LUMBAR 4V+ $ 962.00 7100000034 HC XR L-SPINE COMP INCL BEND MIN 6V $ 1,272.00 7100000035 HC XR SPINE THORACIC 1V $ 633.00 7100000036 HC XR SPINE THORACIC 2V $ 727.00 7100000037 HC XR SPINE THORACOLUMBAR 2V $ 727.00 7100000038 HC XR SCOLIOSIS SPINE 1V $ 885.00 7100000039 HC XR SCOLIOSIS SUPINE & ERECT $ 1,137.00 7100000040 HC XR SI JOINTS 1 OR 2V $ 835.00 7100000041 HC XR SI JOINTS 3V+ $ 918.00 7100000042 HC XR SACRUM/COCCYX 2V+ $ 796.00 7100000043 HC MYELOGRAM CERVICAL $ 2,024.00 7100000044 HC MYELOGRAM THORACIC $ 2,024.00 7100000045 HC MYELOGRAM LUMBOSACRAL $ 2,024.00

7100000046 HC MYELOGRAM 2+ REGIONS $ 3,303.00 7100000047 HC XR CLAVICLE COMPLETE $ 698.00 7100000048 HC XR SCAPULA COMPLETE $ 748.00 7100000049 HC XR SHOULDER 1V $ 759.00 7100000050 HC XR SHOULDER 2V $ 873.00 7100000051 HC XR AC JTS W OR WO WEIGHT DIST $ 787.00 7100000052 HC XR HUMERUS 2V $ 667.00 7100000053 HC XR ELBOW 2V $ 633.00 7100000054 HC XR ELBOW 3V $ 697.00 7100000055 HC XR FOREARM 2V $ 667.00 7100000056 HC XR UPPER EXTREMITY INFANT 2V $ 667.00 7100000057 HC XR WRIST 2V $ 633.00 7100000058 HC XR WRIST 3V+ $ 697.00 7100000059 HC XR HAND 2V $ 633.00 7100000060 HC XR HAND 3V $ 697.00 7100000061 HC XR FINGER 2V+ $ 506.00 7100000062 HC XR HIP UNILATERAL 1V $ 759.00 7100000063 HC XR HIP UNILATERAL 2V $ 873.00 7100000064 HC XR PELVIS & BILAT HIPS $ 1,014.00 7100000065 HC XR PELVIS & HIPS INF/CHLD $ 1,014.00 7100000066 HC XR FEMUR 2V $ 763.00 7100000067 HC XR KNEE 1 OR 2V $ 759.00 7100000068 HC XR KNEE 3V $ 835.00 7100000069 HC XR KNEES TOTAL 4V+ $ 1,011.00 7100000070 HC XR KNEES STANDING BILAT AP $ 923.00 7100000071 HC XR TIBIA FIBULA 2V $ 763.00 7100000072 HC XR LOWER EXT INF 2V $ 572.00 7100000073 HC XR ANKLE 2V $ 633.00 7100000074 HC XR ANKLE 3V $ 697.00 7100000075 HC XR FOOT 2V $ 633.00 7100000076 HC XR FOOT 3V $ 697.00 7100000077 HC XR CALCANEUS 2V+ $ 759.00 7100000078 HC XR TOE 2V+ $ 506.00 7100000079 HC XR ABDOMEN 1V/KUB $ 1,012.00 7100000080 HC XR ABDOMEN 2V $ 1,163.00 7100000081 HC XR ABDOMEN 3V $ 1,338.00 7100000082 HC XR ESOPHAGRAM $ 1,493.00 7100000083 HC XR MODIFIED BARIUM SWALLOW $ 1,874.00 7100000084 HC XR UGI WO KUB $ 1,339.00 7100000085 HC XR UGI W KUB $ 1,518.00 7100000086 HC XR UGI W SM BOWEL $ 2,094.00 7100000087 HC XR SM BOWEL STUDY $ 1,445.00 7100000088 HC XR COLON ENEMA $ 1,518.00 7100000089 HC XR COLON ENEMA & AIR $ 1,966.00 7100000090 HC XR BARIUM ENEMA /INTUSSUSCEPTION $ 1,771.00 7100000091 HC XR CHOLANGIOGRAM SUP & INTERP $ 933.00 7100000092 HC FL NJ FEED TUBE PLCMNT $ 2,398.00 7100000093 HC XR UROGRAPHY IV W OR WO KUB $ 1,248.00 7100000094 HC XR UROGRAM RETROGRADE $ 2.00 7100000094 HC XR UROGRAM RETROGRADE $ 3,147.00 7100000094 HC XR UROGRAM RETROGRADE $ 9,613.00 7100000095 HC XR NEPHROSTOGRAM $ 210.93 7100000095 HC XR NEPHROSTOGRAM $ 213.50

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7400000008 HC CT FACIAL BONES W CONTRAST 3460.00 7400000009 HC CT SINUS WO CONTRAST 3146.00 7400000010 HC CT SINUS W CONTRAST 3460.00 7400000011 HC CT SINUS W&WO CONTRAST 3618.00 7400000012 HC CT NECK WO CONTRAST 5392.00 7400000013 HC CT NECK W CONTRAST 5932.00 7400000014 HC CT NECK W&WO CONTRAST 6200.00 7400000015 HC CT ANGIO HEAD W&WO CONTRAST 6537.00 7400000016 HC CT ANGIO NECK W&WO CONTRAST 6537.00 7400000017 HC CT CHEST WO CONTRAST 5392.00 7400000018 HC CT CHEST W CONTRAST 5932.00 7400000019 HC CT CHEST W&WO CONTRAST 6200.00 7400000020 HC CT ANGIO CHEST W&WO CONTRAST 5963.00 7400000021 HC CT C-SPINE WO CONTRAST 4451.00 7400000022 HC CT C-SPINE W CONTRAST 4449.00 7400000023 HC CT C-SPINE W&WO CONTRAST 4651.00 7400000024 HC CT T-SPINE WO CONTRAST 4451.00 7400000025 HC CT T-SPINE W CONTRAST 4449.00 7400000026 HC CT T-SPINE W&WO CONTRAST 4651.00 7400000027 HC CT L-SPINE WO CONTRAST 4451.00 7400000028 HC CT-L SPINE W CONTRAST 4449.00 7400000029 HC CT-L SPINE W&WO CONTRAST 4651.00 7400000030 HC CT ANGIO PELVIS W&WO CONTRAST 7023.00 7400000031 HC CT PELVIS WO CONTRAST 5392.00 7400000032 HC CT PELVIS W CONTRAST 5932.00 7400000033 HC CT PELVIS W&WO CONTRAST 6200.00 7400000034 HC CT UPPER EXTREM WO CONT 4494.00 7400000035 HC CT UPPER EXTREM W CONT 4943.00 7400000036 HC CT UPPER EXTREM W&WO CONT 5167.00 7400000037 HC CT ANGIO UPPER EXT W&WO CONT 8214.00 7400000038 HC CT LOWER EXT WO CONT 4494.00 7400000039 HC CT LOWER EXT W CONT 4943.00 7400000040 HC CT LOWER EXT W&WO CONT 5167.00 7400000041 HC CT ANGIO LOWER EXT W&WO CONT 7408.00 7400000042 HC CT ABDOMEN WO CONT 5392.00 7400000043 HC CT ABDOMEN W CONT 5932.00 7400000044 HC CT ABDOMEN W&WO CONT 6200.00 7400000045 HC CT ANGIO ABD & PELV W CONT 9613.00 7400000046 HC CT ANGIO ABD & PELV W CONT 8934.00 7400000047 HC CT ANGIO ABD & PELV W&WO CONT 9341.00 7400000048 HC CT ANGIO ABDOMEN W&WO CONT 7023.00 7400000049 HC CT ABD & PELV WO CONT 7190.00 7400000050 HC CT ABD & PELV W CONT 7909.00 7400000051 HC CT ABD & PELV W&WO CONT 8269.00 7400000052 HC CT HEART WO CONT 3431.00 7400000053 HC CT HEART W CONT 3946.00 7400000054 HC CT HEART CONGENITAL W CONT 4025.00 7400000055 HC CT ANGIO HEART W CONT 4025.00 7400000063 HC CT ABSCESS DRAINAGE 1 LESION 3599.00 7400000064 HC CT 3D RECON AT CONSOLE 1665.00 7400000065 HC CT 3D RECON REMOTE INDEP WKS 1665.00 7400000066 HC CT 3D RECON AT LAB SCAN CONSOLE 1665.00 7400000067 HC CT LOWER EXT SCANOGRAM 759.00

7500000001 HC 3D ECHOCARDIOGRAM 974.00 7500000002 HC ECHO CARDIOGRAM FETAL 1802.00 7500000003 HC ECHO CARDIOGRAM FETAL LMT OR FU 1678.00 7500000004 HC FETAL CARDIAC DOPPLER COMPL 929.00 7500000005 HC FETAL CARDIAC DOPPLER LTD OR FU 709.00 7500000006 HC ECHO GUID PERICARDIOCENTESIS 1772.00 7500000007 HC EKG PEDIATRIC 929.00 7500000008 HC CARDIOVASC STRESS TEST 1344.00 7500000009 HC PEDIATRIC RHYTHM STRIP 765.00 7500000011 HC HOLTER SCN/REP <=48HRS 1425.00 7500000012 HC TELE EKG HOOK UP/DISCONNECT 326.00 7500000013 HC PMKR PROGRAMMING SINGLE 929.00 7500000014 HC PMKR PROGRAMMING DUAL 1192.00 7500000015 HC PMKR PROGRAMMING MULT 1788.00 7500000016 HC ICD PROGRAMMING SINGLE 981.00 7500000017 HC ICD PROGRAMMING DUAL 1378.00 7500000018 HC ICD PROGRAMMING MULT 2067.00 7500000019 HC ILR PROGRAMMING 477.00 7500000020 HC PERI-PROCEDURAL PMKR EVAL 1192.00 7500000021 HC PERI-PROCEDURAL ICD EVAL 1378.00 7500000022 HC PMKR INTERROGATION 831.00 7500000023 HC ICD INTERROGATION 870.00 7500000024 HC ILR INTERROGATION 407.00 7500000025 HC TRANSTELEPHONIC PMKR 265.00 7500000026 HC PMKR INTERROGATION REMOTE 924.00 7500000027 HC ICD INTERROGATION REMOTE 969.00 7500000028 HC ILR INTERROGATION REMOTE 694.00 7500000029 HC ECHO CONGENITAL COMPLETE 3393.00 7500000030 HC ECHO CONGENITAL LIMITED 2479.00 7500000031 HC ECHO COMPL W DOPPL & COL FL 3937.00 7500000032 HC ECHO CARDEVIOL OPEN 1976.00 7500000033 HC ECHO COMPLETE WO DOPPL 1639.00 7500000034 HC ECHO W BUBBLE STUDY 1753.00 7500000035 HC ECHO SERIAL LIMITED 1517.00 7500000036 HC TEE NONCHD IMAG ACQ 1772.00 7500000037 HC TEE CHD IMAGE ACQ 3659.00 7500000038 HC ECHO CARDIAC DOPPL 1526.00 7500000039 HC ECHO CARDIAC DOPPL LIM OR FU 742.00 7500000040 HC ECHO COLOR FLOW IMAG 742.00 7500000041 HC ECHO STRESS PHARM INDUC 3550.00 7500000042 HC ECHO STRESS INCL CONT MONIT 3550.00 7500000043 HC EP ICD EVAL W/PROG ADJUSTMENT 4468.00 7500000044 HC ECHO INTRA-CARDIAC 2624.00 7500000045 HC VAD INTERROGATION 763.00 7500000046 HC CARDIO PULM EXERC STUDY COMPL 1399.00 7500000047 HC CARDIO PULM EXERC STUDY COMPL 1399.00 7500000048 HC ECHO CD RECORD 130.00 7500000049 HC HOLTER MONITOR RECORD <=48HRS 2035.00 7800000001 HC CT FINE NEEDLE ASPIRATION 1758.00 7800000002 HC XR FINE NEEDLE ASPIRATION 1589.00 7800000003 HC US FINE NEEDLE ASPIRATION 1589.00 7800000004 HC XR BIOPSY MUSCLE PERC 1622.00 7800000005 HC CT BIOPSY MUSCLE PERC 2771.00

7800000006 HC US BIOPSY MUSCLE PERC 2163.00 7800000007 HC XR BIOPSY BONE SUPERFICIAL 1920.00 7800000008 HC CT BIOPSY BONE SUPERFICIAL 2893.00 7800000009 HC US BIOPSY BONE SUPERFICIAL 1920.00 7800000010 HC XR BIOPSY BONE DEEP 1931.00 7800000011 HC CT BIOPSY BONE DEEP 2906.00 7800000012 HC US BIOPSY BONE DEEP 1931.00 7800000013 HC CT MUSCLE INJECTION 1 OR 2 1092.00 7800000014 HC XR MUSCLE INJECTION 1 OR 2 1087.00 7800000015 HC US MUSCLE INJECTION 1 OR 2 1087.00 7800000016 HC CT MUSCLE INJECTION 3+ 1346.00 7800000017 HC XR MUSCLE INJECTION 3+ 1341.00 7800000018 HC US MUSCLE INJECTION 3+ 1341.00 7800000019 HC CT ASPIRA/INJ JOINT FINGER/TOE 1246.00 7800000020 HC FL ASPIRATION FINGER/TOE 828.00 7800000021 HC US ASPIRATION FINGER/TOE 828.00 7800000022 HC CT ASP/INJ TMJ/ WRIST/ANKL/ELB 957.00 7800000023 HC FL ASPIRATION WRIST/ANKL/ELB 1048.00 7800000024 HC US ASPIRATION WRIST/ANKL/ELB 1048.00 7800000025 HC CT ASPIRA/INJ SHOULD/HIP/KNEE 1576.00 7800000026 HC FL ASPIRATION SHOULD/HIP/KNEE 669.00 7800000027 HC US ASPIRATION SHOULD/HIP/KNEE 669.00 7800000028 HC CT ABLATION BONE TUMOR W GUIDE 12524.00 7800000029 HC XR INJ SHOULDER ARTHRO 1102.00 7800000030 HC US INJ SHOULDER ARTHRO 1102.00 7800000031 HC XR INJ ELBOW ARTHRO 1102.00 7800000032 HC US INJ ELBOW ARTHRO 1102.00 7800000033 HC XR INJ WRIST ARTHRO 1102.00 7800000034 HC US INJ WRIST ARTHRO 1102.00 7800000035 HC XR INJ HIP ARTHRO WO GA 1102.00 7800000036 HC US INJ HIP ARTHRO WO GA 1102.00 7800000037 HC XR INJ HIP ARTHRO W GA 1775.00 7800000038 HC US INJ HIP ARTHRO W GA 1775.00 7800000039 HC XR INJ KNEE ARTHRO 1308.00 7800000040 HC US INJ KNEE ARTHRO 1308.00 7800000041 HC XR INJ ANKLE ARTHRO 1812.00 7800000042 HC US INJ ANKLE ARTHRO 1812.00 7800000043 HC CT BIOPSY LUNG/MEDIASTINUM 2758.00 7800000044 HC US BIOPSY LUNG/MEDIASTINUM 1938.00 7800000045 HC XR ASPIRATION BONE MARROW 970.00 7800000046 HC MRI ASPIRATION BONE MARROW 1457.00 7800000047 HC CT ASPIRATION BONE MARROW 1522.00 7800000048 HC US ASPIRATION BONE MARROW 970.00 7800000049 HC XR BIOPSY BONE MARROW NDL TROC 1299.00 7800000050 HC MRI BIOPSY BONE MARROW 1457.00 7800000051 HC CT BIOPSY BONE MARROW NDL TROC 1862.00 7800000052 HC US BIOPSY BONE MARROW NDL TROC 1299.00 7800000053 HC CT BIOPSY LYMPH NODE NDL SUP 2785.00 7800000054 HC US BIOPSY LYMPH NODE NDL SUP 1943.00 7800000055 HC FL NG FEEDING TUBE PLACEMENT 913.00 7800000056 HC FL GAST FEED TUBE REPO NAS OR 2068.00 7800000057 HC XR INTRO OF GI TUBE 872.00 7800000058 HC CT BIOPSY LIVER NDL PERC 2629.00

7800000059 HC US BIOPSY LIVER NDL PERC 1834.00 7800000060 HC CT RF ABLATION LIVER TUMOR 12524.00 7800000061 HC US RF ABLATION LIVER TUMOR 11321.00 7800000062 HC XR INJ CHOLANGIOGRAM 1051.00 7800000063 HC US ABD PARACENTESIS INIT W IMG 1557.00 7800000064 HC CT BIOPSY ABD/RETRO MASS PERC 2546.00 7800000065 HC US BIOPSY ABD/RETRO MASS PERC 2213.00 7800000066 HC CT BIOPSY RENAL/KIDNEY PERC 2546.00 7800000067 HC US BIOPSY RENAL/KIDNEY PERC 2213.00 7800000068 HC XR INJ NEPHROSTOGRAM 1273.00 7800000069 HC CT RF ABLATION RENAL TUMOR 12524.00 7800000070 HC US RF ABLATION RENAL TUMOR 8733.00 7800000071 HC FL INJ CONTRAST VCUG 1746.00 7800000072 HC FL INJ CONTRAST RETROGRADE 1465.00 7800000073 HC US BLADDER CAPACITY MEASURE 324.00 7800000074 HC CT BIOPSY SPINAL CORD 3521.00 7800000075 HC US BIOPSY SPINAL CORD 2455.00 7800000076 HC XR LUMBAR PUNCTURE DX 1165.00 7800000077 HC XR SPINAL PUNCTURE CSF DRAING 1717.00 7800000078 HC XR INJ MYELOGRAPHY 1523.00 7800000079 HC US GUID VASC ACCESS 2216.00 7800000080 HC US GUID TISSUE ABLATION 2504.00 7800000081 HC US GUID NDL PLACEMENT 1731.00 7800000082 HC FL GUIDANCE NEEDLE PLACEMENT 2152.00 7800000083 HC CT GUID STEREOTACTIC LOC 3836.00 7800000084 HC CT GUID NDL PLACEMENT 4684.00 7800000085 HC CT GUID TISSUE ABLATION 3743.00 7800000086 HC MRI GUID NDL PLACEMENT 5875.00 7800000087 HC MRI GUID TISSUE ABLATION 5875.00 7800000088 HC CT RF ABLATION PULMONARY TUMOR 12524.00 7800000089 HC US RF ABLATION PULMONARY TUMOR 8733.00 7800000090 HC ASP FINE NDL ANY SITE W GUID 1758.00 7800000091 HC ASP ABSCESS/CYST/HEMATOMA 2925.00 7800000092 HC BX CORE MUSCLE/SOFT TISSUE 2925.00 7800000093 HC BX CORE PARASPINAL 2625.00 7800000094 HC BX CORE BONE SUPERFICIAL 2925.00 7800000095 HC BX CORE BONE DEEP 4125.00 7800000096 HC SINOGRAM DIAGNOSTIC 1575.00 7800000097 HC INJ SGL TENDON LIGAMENT 2325.00 7800000098 HC INJ SGL TENDON ORIGIN INSERT 2325.00 7800000099 HC INJ MUSCLE TRIGGER POINTS 1-2 2325.00 7800000100 HC INJ MUSCLE TRIGGER POINTS 3 2925.00 7800000101 HC INJ OR ASP SMALL JOINT 2325.00 7800000102 HC INJ OR ASP INTERMEDIATE JOINT 1725.00 7800000103 HC INJ OR ASP LARGE JOINT 1725.00 7800000104 HC ASPIRATION CYST GANGLION 2325.00 7800000105 HC INJ OR ASP CYST BONE 2325.00 7800000106 HC INJ OR ASP SACROILIAC JOINT 2625.00 7800000107 HC CT BX CHEST PLEURA PERC NDL 3878.00 7800000108 HC BX CORE CHEST PLEURA 3525.00 7800000109 HC BX CORE MEDIASTINUM/LUNG PERC 3525.00 7800000110 HC ASPIRATION THORACENTESIS 2925.00 7800000111 HC PLCMT CHEST TUBE W CT GD 2558.00

7800000112 HC PLCMT CHEST TUBE W GUID 2325.00 7800000113 HC INJ VENOGRAM 1425.00 7800000114 HC INJ SCLEROTHERAPY LIMB/TRUNK 4125.00 7800000115 HC INJ SCLEROTHERAPY FACE 2925.00 7800000116 HC INJ SCLEROTHERAPY SGL VEIN 2925.00 7800000117 HC INJ SCLEROTHER MLT VEIN SM EXT 3525.00 7800000118 HC INSERT CVA < 5 YRS 2925.00 7800000119 HC INSERT CVA > 5 YRS 2925.00 7800000120 HC INSERT TUNNELED CVC <5 YRS 3525.00 7800000121 HC INSERT TUNNELED CVC >5 YRS 3525.00 7800000122 HC INSERT TUNNLD PORT CVAD <5 YRS 4125.00 7800000123 HC INSERT TUNNLD PORT CVAD >5 YRS 4125.00 7800000124 HC REPAIR CVAD W PORT 2925.00 7800000125 HC REPLACE CVAD CATH 2925.00 7800000126 HC REPLACE CVC COMPLETE 2925.00 7800000127 HC REPLACE TUNNELED CVC COMPL 2925.00 7800000128 HC REPLACE CVAD COMPLETE 2925.00 7800000129 HC REPLACE PICC LINE 2325.00 7800000130 HC REMOVAL TUNNELED CVC WO PORT 2325.00 7800000131 HC REMOVAL TUNNELED CVAD PORT 2925.00 7800000132 HC CHECK CENTRAL LINE W FL 1350.00 7800000133 HC DRNG LYMPH NODE SMPL PERC 2558.00 7800000134 HC DRNG LYMPH NODE SMPL PERC 2325.00 7800000135 HC BX CORE LYMPH NODE 3525.00 7800000136 HC BX CORE SALIVARY GLAND 2925.00 7800000137 HC PLCMT NG TUBE W GUID 3375.00 7800000138 HC REPOSITION NG TUBE 2175.00 7800000139 HC PLCMT GI LONG TUBE 1425.00 7800000140 HC I&D ABSCESS APPENDICEAL PERC 2558.00 7800000141 HC I&D ABSCESS APPENDICEAL PERC 2325.00 7800000142 HC DR ABSC/CYST LIVER PERC W CATH 3525.00 7800000143 HC INJ CHOLANGIOGRAM PERC 1725.00 7800000144 HC INJ CHOLANGIOGRAPHY EXIST CATH 1950.00 7800000145 HC INTRO CATH THANSHEPATIC PERC 4125.00 7800000146 HC INTRO STENT TRANSHEPATIC PERC 4925.00 7800000147 HC CHG BILIARY TUBE 2925.00 7800000148 HC REVISE &/OR REINS BILIARY TUBE 2925.00 7800000149 HC BX CORE PANCREAS 2925.00 7800000150 HC DR ABSCESS PERITONEAL PERC 2558.00 7800000151 HC DR ABSCESS PERITONEAL PERC 2325.00 7800000152 HC DR SUBDIAPHRAM/SUBPHRENIC PERC 2558.00 7800000153 HC DR SUBDIAPHRAM/SUBPHRENIC PERC 2325.00 7800000154 HC DR ABSCESS RETROPERITON PERC 2558.00 7800000155 HC DR ABSCESS RETROPERITON PERC 2325.00 7800000156 HC ABD PARACENTESIS W GUID 2925.00 7800000157 HC BX CORE ABD/RETROPERITON MASS 2925.00 7800000158 HC BX CORE ADRENAL GLAND 2925.00 7800000159 HC CHG ABSCESS DRAINAGE TUBE 2925.00 7800000160 HC CHECK ABSC DRAIN TUBE CONT INJ 1500.00 7800000161 HC INSERT G TUBE PERC W GUID 3525.00 7800000162 HC INSERT J TUBE PERC W GUID 4125.00 7800000163 HC CONVRT G TO J TUBE PERC W GUID 2925.00 7800000164 HC REPLACE PERC G TUBE W GUID 2625.00

7800000165 HC REPLACE J TUBE W GUID 2925.00 7800000166 HC REPLACE GJ TUBE W GUID 2775.00 7800000167 HC CHECK GI TUBE W GUID CONT INJ 2325.00 7800000168 HC DR RENAL-PERIRENAL PERC 2888.00 7800000169 HC DR RENAL-PERIRENAL PERC 2625.00 7800000170 HC BX CORE RENAL 2925.00 7800000171 HC INJ OR ASP RENAL CYST / PELVIS 2228.00 7800000172 HC INJ OR ASP RENAL CYST / PELVIS 2325.00 7800000173 HC PERC NEPHROSTOGRAM 2925.00 7800000174 HC INTRO CATH PERC NEPHROSTOMY 3525.00 7800000175 HC CHECK NEPHROSTOMY TUBE 2100.00 7800000176 HC CHG NEPHROSTOMY TUBE 2925.00 7800000177 HC BX CORE THYROID 2925.00 7800000178 HC INJ OR ASP THYROID CYST 2228.00 7800000179 HC INJ OR ASP THYROID CYST 2325.00 7800000180 HC CT BX PLEURA CHEST PERC NDL 2384.00 7800000181 HC CT ABD PARACENTESIS W GUIDANCE 2384.00 7800000182 HC ABD PARACENTESIS W CT GUID 3218.00 7900000001 HC GADOTERIDOL PROHANCE MP PER ML 12.80 7900000002 HC GADOB DIMEGLUMINE MH MP PER ML 38.00 7900000003 HC GAD/BASE CONTRAST NOS PER ML 34.90 7900000004 HC EOVIST PER ML 27.60 7900000005 HC ABLAVAR CONTRAST PER 1ML 78.80 7900000006 HC GADOBUTROL PER ML 81.80 7900000007 HC CONRAY 43 INJECTION USP PER ML 0.71 7900000008 HC CONRAY II 200-249MG PER ML 0.25 7900000009 HC CONRAY 60 250-299MG PER ML 10.40 7900000010 HC OMNIPAQUE 240 10ML VIAL PER ML 29.30 7900000011 HC OMNIPAQUE 240 20ML VIAL PER ML 15.00 7900000012 HC OMNIPAQUE 240 50ML VIAL PER ML 8.90 7900000013 HC LOCM 300-399 MG/ML ISOVUE 370 2.00 7900000014 HC LOCM 300-399 MG/ML OMNIPAQUE 1.60 7900000015 HC LOCM 300-399 MG/ML VISIPAQUE 7.30 7900000016 HC LOCM 300-399 50ML 1ML OMNIPAQUE 1.60 7900000017 HC LOCM 300-399 100ML 1ML OMNIPAQU 1.60 7900000018 HC OMNIPAQUE 240 10ML VIAL PER ML 8.90 8000400001 HC URINALYSIS-DIPSTICK WO MICRO 115.00 8000400002 HC URINE PREGNANCY SCN 102.00 8000400004 HC GLYCOSYLATED HEMOGLOBIN 50.00 8100000001 HC SPUTUM SPEC AEROSOL INDUCED 150.00 8100000003 HC GASTRIC PH DETERMINATION 50.00 8100000004 HC GLYCOSYLATED HEMOGLOBIN 50.00 8100000005 HC SKIN TEST -TB 151.00 8100000006 HC SKIN TEST TUBERCULOSIS 151.00 8100000007 HC TRICHOMONAS TEST 131.00 8100000008 HC OBTAIN SPUTUM SPECIMEN 150.00 8100000009 HC RAPID HIV TEST CASTRO 131.00 8100000010 HC CORD BLOOD TYPING $ 1,259.38 8100000012 HC ANTIBODY SCREEN (P) 55.12 8100000014 HC RED CELLS L/R EA 299.00 8100000015 HC PLATELET PHERES LEUKORDCD 704.00 8100100001 HC BASIC METABOLIC PANEL 279.30 8100100002 HC ELECTROLYTE PANEL 336.00

8100100003 HC ELECTROLYTE PANEL URINE 336.00 8100100004 HC COMPREHENSIVE METABOLIC PANEL 428.00 8100100005 HC LIPID PANEL 158.20 8100100006 HC HEPATIC FUNCTION PANEL 328.00 8100100007 HC DRUG SCR MULT MECONUM TOX 107.35 8100100008 HC DRUG SCR SGL AMPHETAMINES 26.00 8100100009 HC DRUG SCR SGL BARBITURATES 26.00 8100100010 HC DRUG SCR SGL BENZODIAZEPINES 26.00 8100100011 HC DRUG SCR SGL OCAINE & METABOL 26.00 8100100013 HC DRUG SCR SGL OPIATES (MORPHINE) 26.00 8100100014 HC DRUG SCR SGL PHENCYCLIDINES 26.00 8100100015 HC DRUG SCR SGL TETRAHYDROCANNAB 26.00 8100100016 HC DRUG SCR SGL TRICYCLIC ANTIDEP 26.00 8100100017 HC DIGOXIN 228.26 8100100021 HC GENTAMICIN RANDOM 646.00 8100100022 HC GENTAMICIN POST 678.00 8100100023 HC GENTAMICIN PRE 678.00 8100100025 HC PHENOBARBITAL 80.23 8100100026 HC THEOPHYLLLINE 132.21 8100100030 HC VANCOMYCIN 678.00 8100100032 HC UA AUTO W MICRO 432.00 8100100033 HC UA DIP STICK NON-AUTO WO MICRO 32.77 8100100034 HC UA AUTO WO MICRO 275.00 8100100035 HC UA MICRO QUAL 150.15 8100100036 HC ALBUMIN SERUM 328.00 8100100037 HC ALCOHOL 42.94 8100100041 HC AMMONIA 602.00 8100100045 HC BILIRUBIN TOTAL 343.00 8100100046 HC BILIRUBIN TOTAL NEWBORN 383.00 8100100047 HC BILIRUBIN DIRECT 348.00 8100100048 HC BILIRUBIN DIRECT NEWBORN 219.00 8100100051 HC BLOOD OCCULT GUAIAC FECAL 88.81 8100100052 HC BLOOD OCCULT FECAL ASSAY 461.00 8100100053 HC CALCIUM TOTAL 353.00 8100100054 HC CALCIUM TOTAL IONIZED 133.00 8100100055 HC CALCIUM TOTAL URINE QUANT 41.81 8100100059 HC CHLORIDE BLOOD OTH CSF ONLY 186.45 8100100061 HC CORTISOL SERIUM TOTAL 262.00 8100100062 HC CREATINE KINASE CPK TOTAL 203.00 8100100063 HC CREATININE BLOOD 374.00 8100100064 HC CREATININE URINE 74.58 8100100066 HC FOLIC ACID SERUM 58.76 8100100068 HC IMMUNOGLOBUL IGM, IGA, IGB EA 11.19 8100100071 HC BLOOD GAS VENOUS 2+ 293.00 8100100072 HC BLOOD GAS UMBILICAL 2+ 293.00 8100100073 HC BLOOD GAS ARTERIAL 2+ 293.00 8100100074 HC GLUCOSE CSF 390.00 8100100075 HC GLUCOSE BLOOD QUANT 169.00 8100100076 HC GLUCOSE G6PD QUANT 17.03 8100100077 HC GLUCOSE G6PD SCREEN 10.00 8100100078 HC GLUCOSE BLOOD BY DEVICE 346.00 8100100085 HC INSULIN TOTAL 108.00 8100100086 HC LACTIC ACID 387.00

8100100087 HC LACTATE DEHYDROGENASE - LDH 469.35 8100100089 HC MAGNESIUM SERUM 412.00 8100100090 HC IMMUNOGLOB (IGA,IGM,IGB) 29.38 8100100091 HC OSMOLALITY BLOOD 165.00 8100100092 HC OSMOLALITY URINE 432.00 8100100094 HC PH BODY FLUID NOT BLOOD NOS 147.00 8100100097 HC PHOSPHATASE ALKALINE ALK PTASE 363.00 8100100098 HC PHOSPHORUS SERUM INORGANIC 353.00 8100100099 HC PHOSPHORUS URINE INORGANIC 40.68 8100100100 HC POTASSIUM SERUM 169.00 8100100101 HC POTASSIUM URINE 330.75 8100100103 HC PROTEIN TOTAL 348.00 8100100104 HC PROTEIN CSF 126.00 8100100105 HC PROTEIN BODY FLUID NOT SERUM 126.00 8100100106 HC SODIUM SERUM 353.00 8100100107 HC SODIUM URINE 348.00 8100100108 HC FREE T4 399.00 8100100109 HC TSH 424.00 8100100112 HC VITAMIN E 37.29 8100100113 HC AST (SGOT) 428.00 8100100114 HC ALT (SGPT) 158.00 8100100115 HC TRIGLYCERIDES 424.00 8100100119 HC UREA NITROGEN BLOOD 338.00 8100100120 HC URIC ACID SERUM 116.39 8100100121 HC URIC ACID BODY FLUID 106.22 8100100122 HC VITAMIN A 32.21 8100100124 HC BLOOD SMEAR MAN DIFF WBC 278.00 8100100126 HC SPUN HCT 198.00 8100100129 HC CBC AUTO W DIFF 499.00 8100100130 HC CBC AUTO WO DIFF 435.00 8100100131 HC RETICULOCYTE MANUAL 330.75 8100100132 HC RETICULOCYTE AUTO 343.00 8100100138 HC FIBRINOGEN ACTIVITY 602.00 8100100141 HC PROTHROMBIN TIME (PT) 277.00 8100100142 HC SED RATE ESR NON AUTO 93.79 8100100143 HC THROMBOPLASTIN TIME PTT PLASMA 377.00 8100100144 HC C REACTIVE PROTEIN 140.00 8100100145 HC C REACTIVE PROTEIN HIGH SENS 133.35 8100100148 HC FL NON INF AGENT AB EA 68.93 8100100151 HC VDRL CSF QUAL 75.71 8100100153 HC CMV IGG 11.87 8100100154 HC CMV IGM 12.54 8100100156 HC HIV 1 AB 98.31 8100100160 HC RESP SYNCTIAL VIRUS AB 16.27 8100100162 HC TOXOPLASMA IGM AB 16.13 8100100166 HC RBC AB SCREEN 55.12 8100100168 HC BLOOD TYPING ABO 45.00 8100100169 HC BLOOD TYPING RH(D) 45.00 8100100170 HC CULTURE BLOOD AEROBIC ISOL 689.00 8100100171 HC CULTURE STOOL AEROBIC ISOL 177.41 8100100172 HC CULTURE CSF AEROBIC ISOL 574.00 8100100173 HC CULTURE EYE AEROBIC ISOL 328.00 8100100174 HC CULTURE WOUND AEROBIC ISOL 276.85

8100100179 HC CULTURE BODY FL ANAEROBIC ISOL 979.00 8100100183 HC CULTURE URINE BACTERIAL QUANT 616.00 8100100185 HC CULTURE FUNGUS OTHER 91.53 8100100186 HC CULTURE CHLAMYDIA 38.85 8100100187 HC SMEAR GRAM STAIN CSF 229.95 8100100188 HC SMEAR GRAM STAIN 242.00 8100100189 HC SMEAR STOOL WBC 150.00 8100100191 HC SMEAR WET MOUNT 128.26 8100100192 HC CULTURE TISSUE C DIFFICILE TOXIN 55.37 8100100193 HC VCULF VRS ISOL CLT OBS ID 129.15 8100100194 HC CYTOMEGL SHL VL ID IMM EA VRS 29.93 8100100195 HC CYTOMEGL SHL VL ID IMM EA VRS 29.93 8100100196 HC EIA INFLUENZA A/B EA 255.00 8100100197 HC EIA RESPIRATORY SYNCTIAL VIRUS 135.60 8100100199 HC EIA HERPES SIMPLEX VIRUS APT 64.05 8100100203 HC IAA DET RESP SYNCTIAL VIRUS 255.00 8100100209 HC CELL COUNT CSF W DIFF 230.00 8100100213 HC SPEC COLLECT NON BLOOD 39.00 8100100232 HC VITAMIN D 25 HYDROXY 71.57 8100300001 HC BASIC METABOLIC PANEL 213.50 8100300004 HC COMPREHENSIVE METABOLIC PANEL 287.50 8100300006 HC HEPATIC FUNCTION PANEL 210.93 8100300028 HC VANCOMYCIN RANDOM 204.50 8100300029 HC VANCOMYCIN TROUGH 204.50 8100300032 HC UA AUTO W MICRO 133.00 8100300041 HC AMMONIA 175.00 8100300043 HC AMYLASE 138.00 8100300045 HC BILIRUBIN TOTAL 61.00 8100300047 HC BILIRUBIN DIRECT 67.00 8100300054 HC CALCIUM TOTAL IONIZED 81.33 8100300064 HC CREATININE URINE 44.90 8100300065 HC FERRITIN 125.00 8100300086 HC LACTIC ACID 91.84 8100300088 HC LIPASE 112.50 8100300089 HC MAGNESIUM SERUM 117.00 8100300092 HC OSMOLALITY URINE 81.68 8100300098 HC PHOSPHORUS SERUM INORGANIC 73.50 8100300100 HC POTASSIUM SERUM 87.50 8100300106 HC SODIUM SERUM 67.50 8100300113 HC AST (SGOT) 91.00 8100300114 HC ALT (SGPT) 91.00 8100300128 HC HEMOGLOBIN HGB 60.02 8100300129 HC CBC AUTO W DIFF 149.00 8100300130 HC CBC AUTO WO DIFF 148.72 8100300132 HC RETICULOCYTE AUTO 60.25 8100300138 HC FIBRINOGEN ACTIVITY 136.50 8100300141 HC PROTHROMBIN TIME (PT) 116.50 8100300143 HC THROMBOPLASTIN TIME PTT PLASMA 138.50 8100300144 HC C REACTIVE PROTEIN 138.50 8100300163 HC WEST NILE VIRUS AB 1/2 IGM 35.52 8100300164 HC WEST NILE VIRUS AB 2/2 35.52 8100300167 HC COOMBS DIRECT EA ANTISERUM 53.40 8100300170 HC CULTURE BLOOD AEROBIC ISOL 184.00

8100300183 HC CULTURE URINE BACTERIAL QUANT 161.46 8100300190 HC SMEAR MALARIA 98.50 8100300193 HC VCULF VRS ISOL CLT OBS ID 11.87 8100300211 HC SEND OUT FEE 37.00 8100300233 HC FIBRIN DEGR PROD D-DIMER QUANT 220.84 81200057 HC HEART ACQUISITION $ 78,500.00 8200000001 HC CONF TYPE 644.00 8200000002 HC HR DQB1 TYPE,STNDRD 690.00 8200000003 HC INFECT DISEASE MRKR 514.00 8200000005 HC BMT STEM CELL TRANSPLT AUTOL 4030.00 8200000006 HC BMT STEM CELL ALLO LYMPH INFUS 1264.00 8200000007 HC ACTIVATION DONOR SEARCH 1885.00 8200000008 HC ADDL SMPL IDM 644.00 8200000010 HC AUTO BLOOD 982.00 8200000011 HC CB TYPE HR-A STNDRD 735.00 8200000012 HC CB TYPE HR-A URGENT 826.00 8200000013 HC CB TYPE HR-B STNDRD 735.00 8200000014 HC CB TYPE HR-B URGENT 826.00 8200000015 HC CB TYPE HR-C STNDRD 735.00 8200000016 HC CB TYPE HR-C URGENT 826.00 8200000017 HC CB TYPE HR-CT STNDRD 1404.00 8200000018 HC CB TYPE HR-CT URGENT 1781.00 8200000019 HC CB TYPE HR-DPB1 STNDRD 514.00 8200000020 HC CB TYPE HR-DPB1 URGENT 611.00 8200000021 HC CB TYPE HR-DQB1 STNDRD 442.00 8200000022 HC CB TYPE HR-DQB1 URGENT 540.00 8200000023 HC CB TYPE IR CT STNDRD 865.00 8200000024 HC CB TYPE IR CT URGENT 1229.00 8200000025 HC CB TYPE IR-C URGENT 1229.00 8200000026 HC CB TYPE IR-C, STNDRD 865.00 8200000027 HC CB TYPE IR-DRB3,4,5 STD 462.00 8200000028 HC CB TYPE IR-DRB3,4,5 URG 501.00 8200000030 HC CORD BLOOD ACQUISITION $ 48,616.75 8200000031 HC CUSTOM SEARCH FEE 1027.00 8200000032 HC DNR MARROW PROC 47073.00 8200000034 HC FILGR INJS 9386.00 8200000035 HC HR DQB1 TYPE ULTRA URGENT 962.00 8200000036 HC HR DQB1 TYPE,URGENT 774.00 8200000037 HC HR-A STNDRD 735.00 8200000038 HC HR-A ULTRA URGENT 1079.00 8200000039 HC HR-A URGENT 826.00 8200000040 HC HR-B STNDRD 735.00 8200000041 HC HR-B ULTRA URGENT 1079.00 8200000042 HC HR-B URGENT 826.00 8200000043 HC HR-C STNDRD 735.00 8200000044 HC HR-C ULTRA URGENT 1079.00 8200000045 HC HR-C URGENT 826.00 8200000046 HC HR-DPB1 STNDRD $ 332.00 8200000047 HC HR-DPB1 ULTRA URGENT $ 468.00 8200000048 HC HR-DPB1 URGENT $ 403.00 8200000049 HC HR-DRB1 STNDRD $ 650.00 8200000050 HC HR-DRB1 ULTRA URGENT $ 943.00 8200000051 HC HR-DRB1 URGENT $ 735.00

8200000052 HC INTL ADD'L SMPL IDM $ 835.25 8200000055 HC INTL CB HR-DRB1 $ 765.70 8200000059 HC INTL CB TYPE HR-C $ 1,170.00 8200000060 HC INTL CB TYPE HR-CT $ 2,363.83 8200000062 HC INTL CB TYPE HR-DQB1 $ 953.33 8200000068 HC INTL CONFIRM TYPING $ 679.25 8200000074 HC INTL HR-C STNDRD $ 838.50 8200000075 HC INTL HRDQB1 TYP STND $ 565.50 8200000095 HC IR-ABC TYPING ULTRA URGENT $ 1,086.00 8200000096 HC IR-ABC TYPING, STD $ 741.00 8200000097 HC IR-ABC TYPING, URGENT $ 845.00 8200000098 HC IR-DRB1 TYPE $ 631.00 8200000099 HC KIR TESTING $ 306.00 8200000100 HC LOW VOL MGMT FEE $ 1,274.00 8200000101 HC MRW DNR W/U CNCL $ 3,413.00 8200000102 HC MRW DONOR INFO SESS $ 949.00 8200000103 HC MRW DONOR PHYSICAL EXAM $ 3,146.00 8200000104 HC NON-NTWRK SEARCH FEE $ 1,424.00 8200000105 HC PBSC DNR INFO SESS $ 969.00 8200000106 HC PBSC DNR PHYS EXM $ 3,374.00 8200000107 HC PBSC DNR W/U CNCL $ 3,413.00 8200000108 HC PRI PBSC COL $ 45,858.00 8200000109 HC SEC PBSC COL $ 45,858.00 8200000110 HC T-CELL DNR PE $ 2,178.00 8200000111 HC T-CELL W/U CNCL $ 2,184.00 8200000112 HC THERAPEUTIC CELLS COUR $ 21,229.00 8200000113 HC THERAPEUTIC CELLS SHIP $ 18,545.00 8200000114 HC WHOLE BLD COURIER $ 9,776.00 8200000115 HC WHOLE BLD SHIP $ 7,105.00 8310000001 HC CAD KIDNEY ACQ PEDI RECIP $ 69,600.00 8310000002 HC CAD LIVER ACQ PEDI RECIP $ 136,608.00 8310000003 HC CAD SPLIT LIVER ACQ PEDI REC $ 136,608.00 8310000004 HC CAD PEDI LUNG ACQ $ 131,749.00 8310000005 HC CAD PEDI DOUBLE LUNG ACQ $ 166,137.00 8310000006 HC CAD PEDI INTESTINE ORGAN ACQ $ 115,961.00 8310000007 HC CAD PEDI HEART ACQ $ 132,987.00 8320000001 HC LD KIDNEY ACQ PEDI RECIP $ 69,600.00 8320000003 HC LD SPLIT LIVER ACQ PEDI REC $ 136,608.00 8320000004 HC LD LUNG ACQ PEDI REC $ 131,749.00 8320000006 HC LD PARTIAL INTESTINE ACQ PEDI $ 115,961.00 92200013 HC ECHOCARDIOGRAPHY 2D COMPLETE $ 2,761.00 92200021 HC ECHOCARDIOGRAPHY 2D F/U $ 2,853.00 92200047 HC DOPPLER COMPLETE $ 1,177.00 92200054 HC DOPPLER F/U $ 859.00 92200062 HC DOPPLER COLOR FLOW COMPLETE $ 1,182.00 92200070 HC TTE W DOPPLER W COLOR $ 5,966.00 92200260 HC EXERCISE/STRESS ECH $ 4,747.00 92200302 HC CARDIOVASCULAR STRE $ 2,736.00 94200136 HC MRI ABDOMEN $ 5,769.00 94200433 HC MRI BRAIN $ 6,610.00 94200441 HC MRI BRAIN W/CONTRAST $ 7,269.00 94201522 HC MRI L-SPINE $ 5,647.00 94205002 HC MRI GAD CONTRAST /ML $ 29.00

94205143 HC MRI CARD W&WO CON, W STRESS $ 8,794.00 94210028 HC MRI ANGIO HEAD $ 5,681.00 94210101 HC MRI PELVIS $ 5,566.00 94260338 HC MR BRAIN WO/W CONTRST $ 8,276.00 94316114 HC LOCM 350-399 MG/ML $ 3.00 94324951 HC CT ABDOMEN W/CONTRAST $ 6,285.00 94344470 HC CT ANGIO PELVIS WO/W CONTR $ 8,238.00 94344504 HC CT ANGIO ABD WO/W CONTRAST $ 8,709.00



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Stanford Lab LAB -75230Stanford Lab LAB -75230Stanford Lab LAB -75230Stanford Lab LAB -75230Stanford Lab LAB -75230Stanford Lab LAB -75230Stanford Lab LAB -75230Stanford Lab LAB -75230Stanford Lab LAB -75230Stanford Lab LAB -75230Stanford Lab LAB -75230Stanford Lab LAB -75230Stanford Lab LAB -75230Stanford Lab LAB -75230Stanford Lab LAB -75230Stanford Lab LAB -75230Stanford Lab LAB -75230Stanford Lab LAB -75230Stanford Lab LAB -75230Stanford Lab LAB -75230Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040

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Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Lab Sendout LAB -75040Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290

Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290Stanford Lab LAB -75290

Stanford Lab LAB -75002Stanford Lab LAB -75002Stanford Lab LAB -75002Stanford Lab LAB -75002Stanford Lab LAB -75002Stanford Lab LAB -75002Stanford Lab LAB -75002Stanford Lab LAB -75002Stanford Lab LAB -75002Stanford Lab LAB -75002Stanford Lab LAB -75002Stanford Lab LAB -75002Stanford Lab LAB -75002Stanford Lab LAB -75002Stanford Lab LAB -75002Stanford Lab LAB -75002Stanford Lab LAB -75002Stanford Lab LAB -75002Stanford Lab LAB -75002Stanford Lab LAB -75002Stanford Lab LAB -75002Stanford Lab LAB -75002Stanford Lab LAB -75002Stanford Lab LAB -75002Stanford Lab LAB -75002Stanford Lab LAB -75002Stanford Lab LAB -75002Stanford Lab LAB -75002Stanford Lab LAB -75002Stanford Lab LAB -75002Stanford Lab LAB -75002Stanford Lab LAB -75002Stanford Lab LAB -75002Stanford Lab LAB -75002Stanford Lab LAB -75002Stanford Lab LAB -75002Stanford Lab LAB -75002Stanford Lab LAB -75002Stanford Lab LAB -75002Stanford Lab LAB -75002Stanford Lab LAB -75002Stanford Lab LAB -75002

Stanford Lab LAB -75000Stanford Lab LAB -75000Stanford Lab LAB -75000Stanford Lab LAB -75000Stanford Lab LAB -75000Stanford Lab LAB -75000Stanford Lab LAB -75000Stanford Lab LAB -75000Stanford Lab LAB -75000Stanford Lab LAB -75000Stanford Lab LAB -75000Stanford Lab LAB -75000Stanford Lab LAB -75000Stanford Lab LAB -75000Stanford Lab LAB -75000Stanford Lab LAB -75000Stanford Lab LAB -75000Stanford Lab LAB -75000Stanford Lab LAB -75000Stanford Lab LAB -75000Stanford Lab LAB -75000Stanford Lab LAB -75000Stanford Lab LAB -75000Stanford Lab LAB -75000Stanford Lab LAB -75000Stanford Lab LAB -75000Stanford Lab LAB -75000Stanford Lab LAB -75000Stanford Lab LAB -75000Stanford Lab LAB -75000Stanford Lab LAB -75000Stanford Lab LAB -75000Stanford Lab LAB -75000Stanford Lab LAB -75000Stanford Lab LAB -75000

Stanford Lab LAB -75220Stanford Lab LAB -75220Stanford Lab LAB -75220Stanford Lab LAB -75220Stanford Lab LAB -75220Stanford Lab LAB -75220Stanford Lab LAB -75220Stanford Lab LAB -75220Stanford Lab LAB -75220Stanford Lab LAB -75220

Stanford Lab LAB -75220Stanford Lab LAB -75220Stanford Lab LAB -75220Stanford Lab LAB -75220Stanford Lab LAB -75220Stanford Lab LAB -75220Stanford Lab LAB -75220Stanford Lab LAB -75220Stanford Lab LAB -75220Stanford Lab LAB -75220Stanford Lab LAB -75220Stanford Lab LAB -75220Stanford Lab LAB -75220Stanford Lab LAB -75220Stanford Lab LAB -75220Stanford Lab LAB -75220Stanford Lab LAB -75220Stanford Lab LAB -75231Stanford Lab LAB -75231Stanford Lab LAB -75231Stanford Lab LAB -75231Stanford Lab LAB -75231Stanford Lab LAB -75231Stanford Lab LAB -75231Stanford Lab LAB -75231Stanford Lab LAB -75231Stanford Lab LAB -75231Stanford Lab LAB -75231Stanford Lab LAB -75231Stanford Lab LAB -75231Stanford Lab LAB -75231Stanford Lab LAB -75231Stanford Lab LAB -75231Stanford Lab LAB -75231Stanford Lab LAB -75231Stanford Lab LAB -75231Stanford Lab LAB -75231Stanford Lab LAB -75231Stanford Lab LAB - 75060Stanford Lab LAB - 75060Stanford Lab LAB - 75060Stanford Lab LAB - 75060Stanford Lab LAB - 75060Stanford Lab LAB - 75060Stanford Lab LAB - 75060Stanford Lab LAB - 75060Stanford Lab LAB - 75060Stanford Lab LAB - 75060Stanford Lab LAB - 75060Stanford Lab LAB - 75060Stanford Lab LAB - 75060Stanford Lab LAB - 75060Stanford Lab LAB - 75060

Stanford Lab LAB - 75060Stanford Lab LAB - 75060

Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020

Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Stanford Lab LAB -75020Purchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from Stanford

Purchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordStanford Lab LAB -75070Stanford Lab LAB -75070Stanford Lab LAB -75070Stanford Lab LAB -75070Stanford Lab LAB -75070Stanford Lab LAB -75070Stanford Lab LAB -75070Stanford Lab LAB -75070Stanford Lab LAB -75070Stanford Lab LAB -75070Stanford Lab LAB -75070Purchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordStanford Lab LAB -75001Stanford Lab LAB -75001Stanford Lab LAB -75001Stanford Lab LAB -75001

Stanford Lab LAB -75001Stanford Lab LAB -75001Stanford Lab LAB -75001Stanford Lab LAB -75001Stanford Lab LAB -75001Stanford Lab LAB -75001Stanford Lab LAB -75001Stanford Lab LAB -75001Stanford Lab LAB -75001Stanford Lab LAB -75001Stanford Lab LAB -75001Stanford Lab LAB -75001Stanford Lab LAB -75001Stanford Lab LAB -75001Stanford Lab LAB -75001Purchased from StanfordStanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291

Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291Stanford Lab LAB -75291

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Calculated Average Price / Based on Fee SchedulePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased Service

Purchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased Service

Purchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased ServicePurchased from Stanford

Calculated Average Price / Based on Fee Schedule

Calculated Average Price / Based on Fee ScheduleCalculated Average Price / Based on Fee ScheduleCalculated Average Price / Based on Fee ScheduleCalculated Average Price / Based on Fee ScheduleCalculated Average Price / Based on Fee ScheduleCalculated Average Price / Based on Fee ScheduleCalculated Average Price / Based on Fee ScheduleCalculated Average Price / Based on Fee Schedule

Purchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from StanfordPurchased from Stanford



Medication ID # Medication Description99 ACETAMINOPHEN 80 MG CHEWABLE TABLET99 ACETAMINOPHEN 80 MG CHEWABLE TABLET100 ACETAMINOPHEN 160 MG/5 ML ORAL LIQUID101 ACETAMINOPHEN 325 MG TABLET101 ACETAMINOPHEN 325 MG TABLET102 ACETAMINOPHEN 500 MG TABLET102 ACETAMINOPHEN 500 MG TABLET103 ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY103 ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY104 ACETAMINOPHEN 325 MG RECTAL SUPPOSITORY104 ACETAMINOPHEN 325 MG RECTAL SUPPOSITORY105 ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY105 ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY113 ACETAZOLAMIDE 250 MG TABLET114 ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION122 ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION122 ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION123 ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION123 ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION250 ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION251 ALBUTEROL SULFATE 5 MG/ML (0.5 %) SOLUTION FOR NEBULIZATION252 ALBUTEROL SULFATE 2 MG/5 ML SYRUP253 ALBUTEROL SULFATE 2 MG TABLET254 ALBUTEROL SULFATE 4 MG TABLET257 ETHANOL (ETHYL ALCOHOL) 98 % INJECTION SOLUTION257 ETHANOL (ETHYL ALCOHOL) 98 % INJECTION SOLUTION310 ALLOPURINOL 100 MG TABLET311 ALLOPURINOL 300 MG TABLET324 ALPRAZOLAM 0.25 MG TABLET325 ALPRAZOLAM 0.5 MG TABLET326 ALPRAZOLAM 1 MG TABLET353 ALUMINUM HYDROXIDE GEL 320 MG/5 ML ORAL SUSPENSION364 AMANTADINE HCL 100 MG CAPSULE365 AMANTADINE HCL 50 MG/5 ML SYRUP391 AMILORIDE 5 MG TABLET391 AMILORIDE 5 MG TABLET403 AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION407 AMINOPHYLLINE 250 MG/10 ML INTRAVENOUS SOLUTION432 AMITRIPTYLINE 10 MG TABLET433 AMITRIPTYLINE 100 MG TABLET434 AMITRIPTYLINE 150 MG TABLET435 AMITRIPTYLINE 25 MG TABLET436 AMITRIPTYLINE 50 MG TABLET437 AMITRIPTYLINE 75 MG TABLET439 AMMONIA AROMATIC 15 % (W/V) SOLUTION FOR INHALATION450 AMOXICILLIN 250 MG CAPSULE450 AMOXICILLIN 250 MG CAPSULE451 AMOXICILLIN 500 MG CAPSULE451 AMOXICILLIN 500 MG CAPSULE451 AMOXICILLIN 500 MG CAPSULE452 AMOXICILLIN 250 MG CHEWABLE TABLET

453 AMOXICILLIN 125 MG/5 ML ORAL SUSPENSION454 AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION454 AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION454 AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION464 AMPHOTERICIN B 50 MG SOLUTION FOR INJECTION465 AMPICILLIN 250 MG CAPSULE465 AMPICILLIN 250 MG CAPSULE466 AMPICILLIN 500 MG CAPSULE466 AMPICILLIN 500 MG CAPSULE467 AMPICILLIN 125 MG/5 ML ORAL SUSPENSION467 AMPICILLIN 125 MG/5 ML ORAL SUSPENSION468 AMPICILLIN 250 MG/5 ML ORAL SUSPENSION468 AMPICILLIN 250 MG/5 ML ORAL SUSPENSION469 AMPICILLIN 1 GRAM SOLUTION FOR INJECTION471 AMPICILLIN 125 MG SOLUTION FOR INJECTION472 AMPICILLIN 2 GRAM SOLUTION FOR INJECTION473 AMPICILLIN 250 MG SOLUTION FOR INJECTION474 AMPICILLIN 500 MG SOLUTION FOR INJECTION478 AMYL NITRITE 0.3 ML SOLUTION FOR INHALATION567 ANTIPYRINE-BENZOCAINE 5.4 %-1.4 % EAR DROPS567 ANTIPYRINE-BENZOCAINE 5.4 %-1.4 % EAR DROPS622 ARGININE (L-ARGININE) 500 MG TABLET654 ASCORBIC ACID 500 MG/ML INJECTION SOLUTION663 ASCORBIC ACID 250 MG TABLET664 ASCORBIC ACID 500 MG TABLET679 ASPIRIN 81 MG CHEWABLE TABLET679 ASPIRIN 81 MG CHEWABLE TABLET679 ASPIRIN 81 MG CHEWABLE TABLET681 ASPIRIN 325 MG TABLET681 ASPIRIN 325 MG TABLET685 ASPIRIN 325 MG TABLET,DELAYED RELEASE685 ASPIRIN 325 MG TABLET,DELAYED RELEASE688 ASPIRIN 81 MG TABLET,DELAYED RELEASE688 ASPIRIN 81 MG TABLET,DELAYED RELEASE693 ASPIRIN 300 MG RECTAL SUPPOSITORY696 ASPIRIN 600 MG RECTAL SUPPOSITORY716 ATENOLOL 100 MG TABLET717 ATENOLOL 25 MG TABLET718 ATENOLOL 50 MG TABLET730 ATROPINE 0.1 MG/ML INJECTION SYRINGE730 ATROPINE 0.1 MG/ML INJECTION SYRINGE731 ATROPINE 0.4 MG/ML INJECTION SOLUTION734 ATROPINE 1 MG/ML INJECTION SOLUTION735 ATROPINE 1 % EYE OINTMENT736 ATROPINE 1 % EYE DROPS767 AZATHIOPRINE 100 MG SOLUTION FOR INJECTION799 B COMPLEX VITAMINS TABLET804 B COMPLEX VITAMINS CAPSULE849 NEOMYCIN-BACITRACIN-POLY-HC 3.5 MG-400-10,000 UNIT/G-1 % EYE OINTMENT850 BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT850 BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT851 BACITRACIN 50,000 UNIT IRR852 BACITRACIN 500 UNIT/GRAM EYE OINTMENT854 NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OI854 NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OI855 BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM TOPICAL OINTMENT855 BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM TOPICAL OINTMENT

855 BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM TOPICAL OINTMENT856 BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT860 BACLOFEN 10 MG TABLET861 BACLOFEN 20 MG TABLET988 BENZONATATE 100 MG CAPSULE989 BENZOYL PEROXIDE 10 % TOPICAL GEL991 BENZOYL PEROXIDE 5 % TOPICAL GEL991 BENZOYL PEROXIDE 5 % TOPICAL GEL991 BENZOYL PEROXIDE 5 % TOPICAL GEL993 BENZOYL PEROXIDE 5 % TOPICAL CLEANSER996 BENZOYL PEROXIDE 10 % TOPICAL CLEANSER996 BENZOYL PEROXIDE 10 % TOPICAL CLEANSER996 BENZOYL PEROXIDE 10 % TOPICAL CLEANSER998 BENZTROPINE 0.5 MG TABLET999 BENZTROPINE 1 MG TABLET1000 BENZTROPINE 2 MG TABLET1027 BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL CREAM1029 BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL OINTMENT1031 BETAMETHASONE VALERATE 0.1 % TOPICAL CREAM1032 BETAMETHASONE VALERATE 0.1 % LOTION1033 BETAMETHASONE VALERATE 0.1 % TOPICAL OINTMENT1043 BETHANECHOL CHLORIDE 10 MG TABLET1044 BETHANECHOL CHLORIDE 25 MG TABLET1044 BETHANECHOL CHLORIDE 25 MG TABLET1045 BETHANECHOL CHLORIDE 5 MG TABLET1079 BISACODYL 5 MG TABLET,DELAYED RELEASE1080 BISACODYL 10 MG RECTAL SUPPOSITORY1080 BISACODYL 10 MG RECTAL SUPPOSITORY1090 BISMUTH SUBSALICYLATE 262 MG/15 ML ORAL SUSPENSION1090 BISMUTH SUBSALICYLATE 262 MG/15 ML ORAL SUSPENSION1131 BORIC ACID (BULK) POWDER1131 BORIC ACID (BULK) POWDER1222 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION1222 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION1224 BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJECTION SOLUTION1235 CODEINE-BUTALBITAL-ASA-CAFFEINE 30 MG-50 MG-325 MG-40 MG CAPSULE1259 CAFFEINE 200 MG TABLET1266 CALAMINE LOTION1299 CALCIUM CARBONATE 1,250 MG/5 ML (500 MG CALCIUM) SUSP1299 CALCIUM CARBONATE 1,250 MG/5 ML (500 MG CALCIUM) SUSP1300 CALCIUM CARBONATE 1,250 MG (500 MG CALCIUM) TABLET1306 CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE1308 CALCIUM CITRATE 200 MG (950 MG) TABLET1312 CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION1312 CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION1350 CAPSAICIN 0.025 % TOPICAL CREAM1355 CARBAMAZEPINE 100 MG CHEWABLE TABLET1357 CARBAMAZEPINE 200 MG TABLET1359 CARBAMIDE PEROXIDE 6.5 % EAR DROPS1395 CARISOPRODOL 350 MG TABLET1445 CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION1446 CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION1448 CEFAZOLIN 500 MG SOLUTION FOR INJECTION1463 CEFUROXIME SODIUM 1.5 GRAM SOLUTION FOR INJECTION1465 CEFUROXIME SODIUM 750 MG SOLUTION FOR INJECTION1533 ACTIVATED CHARCOAL 260 MG CAPSULE1562 CHERRY FLAVOR SYRUP

1621 CHLORAL HYDRATE 500 MG/5 ML SYRUP1621 CHLORAL HYDRATE 500 MG/5 ML SYRUP1622 CHLORDIAZEPOXIDE 10 MG CAPSULE1623 CHLORDIAZEPOXIDE 25 MG CAPSULE1624 CHLORDIAZEPOXIDE 5 MG CAPSULE1634 CHLOROPROCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION1635 CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION1638 CHLOROQUINE 500 MG TABLET1639 CHLOROTHIAZIDE 250 MG TABLET1640 CHLOROTHIAZIDE 500 MG TABLET1644 CHLORPHENIRAMINE 2 MG/5 ML SYRUP1645 CHLORPHENIRAMINE 4 MG TABLET1649 CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION1653 CHLORPROMAZINE 10 MG TABLET1654 CHLORPROMAZINE 100 MG TABLET1656 CHLORPROMAZINE 25 MG TABLET1657 CHLORPROMAZINE 50 MG TABLET1661 CHLORTHALIDONE 25 MG TABLET1664 CHLORZOXAZONE 500 MG TABLET1676 CHORIONIC GONADOTROPIN, HUMAN 10,000 UNIT INTRAMUSCULAR SOLUTION1688 CIMETIDINE 300 MG/5 ML ORAL SOLUTION1702 CITRIC ACID ANHYDROUS (BULK) 100 % GRANULES1702 CITRIC ACID ANHYDROUS (BULK) 100 % GRANULES1726 CLEMASTINE 1.34 MG TABLET1740 CLINDAMYCIN 150 MG CAPSULE1741 CLINDAMYCIN 75 MG CAPSULE1741 CLINDAMYCIN 75 MG CAPSULE1742 CLINDAMYCIN 1 % TOPICAL SOLUTION1754 CLOMIPRAMINE 50 MG CAPSULE1755 CLONIDINE 0.1 MG TABLET1756 CLONIDINE 0.2 MG TABLET1757 CLONIDINE 0.3 MG TABLET1758 CLORAZEPATE DIPOTASSIUM 15 MG TABLET1758 CLORAZEPATE DIPOTASSIUM 15 MG TABLET1759 CLORAZEPATE DIPOTASSIUM 3.75 MG TABLET1759 CLORAZEPATE DIPOTASSIUM 3.75 MG TABLET1760 CLORAZEPATE DIPOTASSIUM 7.5 MG TABLET1767 CLOTRIMAZOLE 1 % TOPICAL CREAM1768 CLOTRIMAZOLE 1 % TOPICAL SOLUTION1769 CLOTRIMAZOLE 1 % VAGINAL CREAM1784 ALOE VERA 75 % TOPICAL CREAM1792 COCAINE 4 % TOPICAL SOLUTION1792 COCAINE 4 % TOPICAL SOLUTION1801 CODEINE SULFATE 15 MG TABLET1802 CODEINE SULFATE 30 MG TABLET1803 CODEINE SULFATE 60 MG TABLET1821 COLCHICINE 0.6 MG TABLET1821 COLCHICINE 0.6 MG TABLET1901 CUPRIC SULFATE 0.4 MG/ML INTRAVENOUS SOLUTION2007 CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION2008 CYANOCOBALAMIN (VIT B-12) 100 MCG TABLET2008 CYANOCOBALAMIN (VIT B-12) 100 MCG TABLET2009 CYANOCOBALAMIN (VIT B-12) 1,000 MCG TABLET2010 CYANOCOBALAMIN (VIT B-12) 250 MCG TABLET2012 CYANOCOBALAMIN (VIT B-12) 500 MCG TABLET2017 CYCLOBENZAPRINE 10 MG TABLET2025 CYCLOPENTOLATE 1 % EYE DROPS

2032 CYPROHEPTADINE 2 MG/5 ML SYRUP2033 CYPROHEPTADINE 4 MG TABLET2033 CYPROHEPTADINE 4 MG TABLET2045 CYTARABINE (PF) 100 MG SOLUTION FOR INJECTION2046 CYTARABINE (PF) 500 MG SOLUTION FOR INJECTION2091 DACARBAZINE 200 MG INTRAVENOUS SOLUTION2110 SODIUM HYPOCHLORITE 0.5 % SOLUTION2132 DAPSONE 25 MG TABLET2283 DESIPRAMINE 10 MG TABLET2284 DESIPRAMINE 100 MG TABLET2286 DESIPRAMINE 25 MG TABLET2287 DESIPRAMINE 50 MG TABLET2291 DESONIDE 0.05 % TOPICAL CREAM2319 DEXAMETHASONE 0.5 MG/5 ML ORAL ELIXIR2322 DEXAMETHASONE 0.5 MG TABLET2323 DEXAMETHASONE 0.75 MG TABLET2324 DEXAMETHASONE 1 MG TABLET2325 DEXAMETHASONE 1.5 MG TABLET2326 DEXAMETHASONE 2 MG TABLET2327 DEXAMETHASONE 4 MG TABLET2331 DEXAMETHASONE 10 MG/ML INJECTION SOLUTION2332 DEXAMETHASONE 4 MG/ML INJECTION SOLUTION2335 DEXAMETHASONE 0.1 % EYE DROPS2350 DEXTRAN-40 10% IN 0.9% NACL INTRAVENOUS SOLUTION2353 DEXTROAMPHETAMINE 10 MG TABLET2354 DEXTROAMPHETAMINE 5 MG TABLET2357 DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION2357 DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION2357 DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION2359 DEXTROSE 20 % IN WATER (D20W) INTRAVENOUS SOLUTION2361 DEXTROSE 25 % IN WATER (D25W) INTRAVENOUS SYRINGE2364 DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION2364 DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION2364 DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION2364 DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION2364 DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION2365 DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION2365 DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION2367 DEXTROSE 70 % IN WATER (D70W) INTRAVENOUS SOLUTION2401 DIAZEPAM 5 MG/ML INJECTION SOLUTION2402 DIAZEPAM 5 MG/5 ML ORAL SOLUTION2403 DIAZEPAM 10 MG TABLET2404 DIAZEPAM 2 MG TABLET2405 DIAZEPAM 5 MG TABLET2412 DIBUCAINE 1 % TOPICAL OINTMENT2414 DICLOXACILLIN 250 MG CAPSULE2415 DICLOXACILLIN 500 MG CAPSULE2417 DICYCLOMINE 10 MG/ML INTRAMUSCULAR SOLUTION2418 DICYCLOMINE 10 MG CAPSULE2420 DICYCLOMINE 20 MG TABLET2436 DIFLUNISAL 500 MG TABLET2444 DIGOXIN 125 MCG TABLET2445 DIGOXIN 250 MCG TABLET2475 DILTIAZEM 30 MG TABLET2485 DIMENHYDRINATE 50 MG TABLET2505 DIPHENHYDRAMINE 25 MG TABLET2505 DIPHENHYDRAMINE 25 MG TABLET

2508 DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION2509 DIPHENHYDRAMINE 25 MG CAPSULE2510 DIPHENHYDRAMINE 50 MG CAPSULE2511 DIPHENHYDRAMINE 12.5 MG/5 ML ORAL ELIXIR2515 DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG/5 ML ORAL LIQUID2516 DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TABLET2528 DIPYRIDAMOLE 25 MG TABLET2529 DIPYRIDAMOLE 50 MG TABLET2535 DISOPYRAMIDE 100 MG CAPSULE2536 DISOPYRAMIDE 150 MG CAPSULE2537 DISOPYRAMIDE ER 100 MG CAPSULE,EXTENDED RELEASE2551 DIVALPROEX 125 MG TABLET,DELAYED RELEASE2551 DIVALPROEX 125 MG TABLET,DELAYED RELEASE2552 DIVALPROEX 250 MG TABLET,DELAYED RELEASE2552 DIVALPROEX 250 MG TABLET,DELAYED RELEASE2553 DIVALPROEX 500 MG TABLET,DELAYED RELEASE2553 DIVALPROEX 500 MG TABLET,DELAYED RELEASE2566 DOCUSATE SODIUM 100 MG CAPSULE2566 DOCUSATE SODIUM 100 MG CAPSULE2567 DOCUSATE SODIUM 250 MG CAPSULE2567 DOCUSATE SODIUM 250 MG CAPSULE2568 DOCUSATE SODIUM 50 MG CAPSULE2568 DOCUSATE SODIUM 50 MG CAPSULE2595 DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION2607 DOXAPRAM 20 MG/ML INTRAVENOUS SOLUTION2608 DOXEPIN 10 MG CAPSULE2611 DOXEPIN 25 MG CAPSULE2612 DOXEPIN 50 MG CAPSULE2614 DOXEPIN 10 MG/ML ORAL CONCENTRATE2616 DOXORUBICIN 2 MG/ML INTRAVENOUS SOLUTION2617 DOXORUBICIN 10 MG INTRAVENOUS SOLUTION2621 DOXYCYCLINE 50 MG/5 ML SYRUP2622 DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS SOLUTION2623 DOXYCYCLINE HYCLATE 100 MG CAPSULE2624 DOXYCYCLINE HYCLATE 50 MG CAPSULE2625 DOXYCYCLINE HYCLATE 100 MG TABLET2625 DOXYCYCLINE HYCLATE 100 MG TABLET2833 EPHEDRINE SULFATE 50 MG/ML INJECTION SOLUTION2848 EPINEPHRINE 0.1 MG/ML (1:10,000) INJECTION SYRINGE2850 EPINEPHRINE 1 MG/ML (1:1,000) INJECTION SOLUTION2851 RACEPINEPHRINE 2.25 % SOLUTION FOR NEBULIZATION2863 ERGOCALCIFEROL (VITAMIN D2) 50,000 UNIT CAPSULE2863 ERGOCALCIFEROL (VITAMIN D2) 50,000 UNIT CAPSULE2863 ERGOCALCIFEROL (VITAMIN D2) 50,000 UNIT CAPSULE2887 ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL SOLUTION2888 ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT2888 ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT2889 ERYTHROMYCIN 250 MG TABLET2889 ERYTHROMYCIN 250 MG TABLET2892 ERYTHROMYCIN 333 MG TABLET,DELAYED RELEASE2892 ERYTHROMYCIN 333 MG TABLET,DELAYED RELEASE2899 ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION2903 ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION2904 ERYTHROMYCIN STEARATE 250 MG TABLET2904 ERYTHROMYCIN STEARATE 250 MG TABLET2906 ERYTHROMYCIN-SULFISOXAZOLE 200 MG-600 MG/5 ML ORAL SUSPENSION2929 ESTRADIOL CYPIONATE 5 MG/ML INTRAMUSCULAR OIL

2938 CONJUGATED ESTROGENS 1.25 MG TABLET2951 ETHYL CHLORIDE 100 % TOPICAL SPRAY3013 FACTOR IX COMPLEX 500 (+/-) UNIT INTRAVENOUS SOLUTION3036 FENOPROFEN 600 MG TABLET3037 FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION3037 FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION3037 FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION3037 FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION3069 FERROUS SULFATE 220 MG (44 MG IRON)/5 ML ORAL SOLUTION3074 FERROUS SULFATE 325 MG (65 MG IRON) TABLET3077 FERROUS SULFATE 325 MG (65 MG IRON) TABLET,DELAYED RELEASE3077 FERROUS SULFATE 325 MG (65 MG IRON) TABLET,DELAYED RELEASE3183 FLUOCINOLONE 0.01 % TOPICAL CREAM3183 FLUOCINOLONE 0.01 % TOPICAL CREAM3184 FLUOCINOLONE 0.025 % TOPICAL CREAM3184 FLUOCINOLONE 0.025 % TOPICAL CREAM3185 FLUOCINOLONE 0.025 % TOPICAL OINTMENT3185 FLUOCINOLONE 0.025 % TOPICAL OINTMENT3186 FLUOCINOLONE 0.01 % TOPICAL SOLUTION3187 FLUOCINONIDE 0.05 % TOPICAL CREAM3187 FLUOCINONIDE 0.05 % TOPICAL CREAM3188 FLUOCINONIDE 0.05 % TOPICAL GEL3188 FLUOCINONIDE 0.05 % TOPICAL GEL3189 FLUOCINONIDE 0.05 % TOPICAL OINTMENT3190 FLUOCINONIDE 0.05 % TOPICAL SOLUTION3208 FLUOROMETHOLONE 0.1 % EYE DROPS,SUSPENSION3215 FLUPHENAZINE DECANOATE 25 MG/ML INJECTION SOLUTION3216 FLUPHENAZINE 2.5 MG/ML INJECTION SOLUTION3217 FLUPHENAZINE 5 MG/ML ORAL CONCENTRATE3218 FLUPHENAZINE 1 MG TABLET3219 FLUPHENAZINE 10 MG TABLET3220 FLUPHENAZINE 2.5 MG TABLET3221 FLUPHENAZINE 5 MG TABLET3223 FLURAZEPAM 15 MG CAPSULE3224 FLURAZEPAM 30 MG CAPSULE3232 FOLIC ACID 5 MG/ML INJECTION SOLUTION3233 FOLIC ACID 1 MG TABLET3270 FRUCTOSE GRANULES3291 FUROSEMIDE 10 MG/ML INJECTION SOLUTION3291 FUROSEMIDE 10 MG/ML INJECTION SOLUTION3291 FUROSEMIDE 10 MG/ML INJECTION SOLUTION3291 FUROSEMIDE 10 MG/ML INJECTION SOLUTION3291 FUROSEMIDE 10 MG/ML INJECTION SOLUTION3292 FUROSEMIDE 10 MG/ML ORAL SOLUTION3294 FUROSEMIDE 20 MG TABLET3295 FUROSEMIDE 40 MG TABLET3378 GEMFIBROZIL 600 MG TABLET3378 GEMFIBROZIL 600 MG TABLET3423 GENTAMICIN 0.1 % TOPICAL CREAM3424 GENTAMICIN 0.1 % TOPICAL OINTMENT3425 GENTAMICIN 20 MG/2 ML INJECTION SOLUTION3426 GENTAMICIN 40 MG/ML INJECTION SOLUTION3426 GENTAMICIN 40 MG/ML INJECTION SOLUTION3427 GENTAMICIN 0.3 % (3 MG/GRAM) EYE OINTMENT3428 GENTAMICIN 0.3 % EYE DROPS3430 GENTIAN VIOLET 1 % TOPICAL SOLUTION3430 GENTIAN VIOLET 1 % TOPICAL SOLUTION

3482 GLUTAMINE 500 MG TABLET3489 GLYBURIDE 5 MG TABLET3494 GLYCINE POWDER3497 GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION3497 GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION3497 GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION3497 GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION3536 GRISEOFULVIN ULTRAMICROSIZE 250 MG TABLET3542 GUAIFENESIN 100 MG/5 ML ORAL LIQUID3542 GUAIFENESIN 100 MG/5 ML ORAL LIQUID3542 GUAIFENESIN 100 MG/5 ML ORAL LIQUID3578 HALOPERIDOL 0.5 MG TABLET3579 HALOPERIDOL 1 MG TABLET3580 HALOPERIDOL 10 MG TABLET3581 HALOPERIDOL 2 MG TABLET3583 HALOPERIDOL 5 MG TABLET3584 HALOPERIDOL 5 MG/ML INJECTION SOLUTION3585 HALOPERIDOL 2 MG/ML ORAL CONCENTRATE3626 HEPARIN LOCK FLUSH (PORCINE) 10 UNIT/ML INTRAVENOUS SOLUTION3664 HOMATROPINE 5 % EYE DROPS3697 HYDRALAZINE 20 MG/ML INJECTION SOLUTION3698 HYDRALAZINE 10 MG TABLET3699 HYDRALAZINE 100 MG TABLET3700 HYDRALAZINE 25 MG TABLET3701 HYDRALAZINE 50 MG TABLET3720 HYDROCHLOROTHIAZIDE 25 MG TABLET3721 HYDROCHLOROTHIAZIDE 50 MG TABLET3725 HYDROCORTISONE 0.5 % TOPICAL CREAM3726 HYDROCORTISONE 1 % TOPICAL CREAM3726 HYDROCORTISONE 1 % TOPICAL CREAM3726 HYDROCORTISONE 1 % TOPICAL CREAM3726 HYDROCORTISONE 1 % TOPICAL CREAM3726 HYDROCORTISONE 1 % TOPICAL CREAM3727 HYDROCORTISONE 2.5 % TOPICAL CREAM3727 HYDROCORTISONE 2.5 % TOPICAL CREAM3728 HYDROCORTISONE 1 % LOTION3729 HYDROCORTISONE 2.5 % LOTION3730 HYDROCORTISONE 0.5 % TOPICAL OINTMENT3731 HYDROCORTISONE 1 % TOPICAL OINTMENT3731 HYDROCORTISONE 1 % TOPICAL OINTMENT3732 HYDROCORTISONE 2.5 % TOPICAL OINTMENT3733 HYDROCORTISONE 10 MG TABLET3734 HYDROCORTISONE 20 MG TABLET3738 HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY3752 HYDROGEN PEROXIDE 3 % SOLUTION3758 HYDROMORPHONE 2 MG/ML INJECTION SOLUTION3758 HYDROMORPHONE 2 MG/ML INJECTION SOLUTION3760 HYDROMORPHONE 2 MG TABLET3761 HYDROMORPHONE 4 MG TABLET3768 HYDROXOCOBALAMIN 1,000 MCG/ML INTRAMUSCULAR SOLUTION3769 HYDROXYZINE HCL 25 MG/ML INTRAMUSCULAR SOLUTION3770 HYDROXYZINE HCL 50 MG/ML INTRAMUSCULAR SOLUTION3771 HYDROXYZINE HCL 10 MG/5 ML SYRUP3772 HYDROXYZINE HCL 10 MG TABLET3774 HYDROXYZINE HCL 25 MG TABLET3775 HYDROXYZINE HCL 50 MG TABLET3777 HYDROXYZINE PAMOATE 25 MG CAPSULE

3778 HYDROXYZINE PAMOATE 50 MG CAPSULE3782 HYOSCYAMINE 0.125 MG/ML ORAL DROPS3783 HYOSCYAMINE SULFATE 0.125 MG TABLET3841 IBUPROFEN 200 MG TABLET3841 IBUPROFEN 200 MG TABLET3843 IBUPROFEN 400 MG TABLET3844 IBUPROFEN 600 MG TABLET3844 IBUPROFEN 600 MG TABLET3845 IBUPROFEN 800 MG TABLET3860 IMIPRAMINE 10 MG TABLET3861 IMIPRAMINE 25 MG TABLET3862 IMIPRAMINE 50 MG TABLET3897 INDOMETHACIN 25 MG CAPSULE3898 INDOMETHACIN 50 MG CAPSULE3900 INDOMETHACIN 25 MG/5 ML ORAL SUSPENSION3901 INDOMETHACIN 50 MG RECTAL SUPPOSITORY3965 IODOQUINOL 650 MG TABLET4024 ISONIAZID 100 MG/ML INJECTION SOLUTION4025 ISONIAZID 50 MG/5 ML ORAL SOLUTION4026 ISONIAZID 100 MG TABLET4027 ISONIAZID 300 MG TABLET4068 ISOSORBIDE DINITRATE 5 MG TABLET4068 ISOSORBIDE DINITRATE 5 MG TABLET4236 KETAMINE 10 MG/ML INJECTION SOLUTION4237 KETAMINE 100 MG/ML INJECTION SOLUTION4238 KETAMINE 50 MG/ML INJECTION SOLUTION4241 KETOPROFEN 50 MG CAPSULE4294 CYSTEINE (L-CYSTEINE) 50 MG/ML INTRAVENOUS SOLUTION4294 CYSTEINE (L-CYSTEINE) 50 MG/ML INTRAVENOUS SOLUTION4318 LACTATED RINGERS INTRAVENOUS SOLUTION4318 LACTATED RINGERS INTRAVENOUS SOLUTION4333 LACTOSE (BULK) POWDER4392 LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION4392 LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION4393 LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION4394 LEUCOVORIN CALCIUM 50 MG SOLUTION FOR INJECTION4394 LEUCOVORIN CALCIUM 50 MG SOLUTION FOR INJECTION4395 LEUCOVORIN CALCIUM 10 MG TABLET4395 LEUCOVORIN CALCIUM 10 MG TABLET4396 LEUCOVORIN CALCIUM 15 MG TABLET4397 LEUCOVORIN CALCIUM 25 MG TABLET4397 LEUCOVORIN CALCIUM 25 MG TABLET4398 LEUCOVORIN CALCIUM 5 MG TABLET4419 LEVOTHYROXINE 500 MCG INTRAVENOUS SOLUTION4420 LEVOTHYROXINE 25 MCG TABLET4421 LEVOTHYROXINE 50 MCG TABLET4422 LEVOTHYROXINE 75 MCG TABLET4423 LEVOTHYROXINE 100 MCG TABLET4423 LEVOTHYROXINE 100 MCG TABLET4424 LEVOTHYROXINE 125 MCG TABLET4425 LEVOTHYROXINE 150 MCG TABLET4426 LEVOTHYROXINE 200 MCG TABLET4427 LEVOTHYROXINE 300 MCG TABLET4448 LIDOCAINE 2 % MUCOSAL GEL4448 LIDOCAINE 2 % MUCOSAL GEL4450 LIDOCAINE 4 % MUCOSAL SOLUTION4451 LIDOCAINE 5 MG/ML (0.5 %) INJECTION SOLUTION

4452 LIDOCAINE 10 MG/ML (1 %) INJECTION SOLUTION4452 LIDOCAINE 10 MG/ML (1 %) INJECTION SOLUTION4453 LIDOCAINE (PF) 15 MG/ML (1.5 %) INJECTION SOLUTION4455 LIDOCAINE (PF) 40 MG/ML (4 %) INJECTION SOLUTION4457 LIDOCAINE (PF) 50 MG/5 ML (1 %) INTRAVENOUS SYRINGE4459 LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE4504 LIOTHYRONINE 25 MCG TABLET4526 LISINOPRIL 20 MG TABLET4528 LITHIUM CARBONATE 150 MG CAPSULE4529 LITHIUM CARBONATE 300 MG CAPSULE4531 LITHIUM CARBONATE 300 MG TABLET4533 LITHIUM CITRATE 8 MEQ/5 ML ORAL SOLUTION4560 LOPERAMIDE 2 MG CAPSULE4562 LOPERAMIDE 2 MG TABLET4562 LOPERAMIDE 2 MG TABLET4571 LORAZEPAM 2 MG/ML ORAL CONCENTRATE4572 LORAZEPAM 0.5 MG TABLET4573 LORAZEPAM 1 MG TABLET4574 LORAZEPAM 2 MG TABLET4712 MAGNESIUM CITRATE ORAL SOLUTION4716 MAGNESIUM OXIDE 250 MG TABLET4719 MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) INTRAVENOUS PIGGYBACK4720 MAGNESIUM SULFATE 4 MEQ/ML (50 %) INJECTION SOLUTION4720 MAGNESIUM SULFATE 4 MEQ/ML (50 %) INJECTION SOLUTION4720 MAGNESIUM SULFATE 4 MEQ/ML (50 %) INJECTION SOLUTION4749 MANNITOL 20 % INTRAVENOUS SOLUTION4750 MANNITOL 25 % INTRAVENOUS SOLUTION4759 MAPROTILINE 25 MG TABLET4854 MEDROXYPROGESTERONE 10 MG TABLET4855 MEDROXYPROGESTERONE 2.5 MG TABLET4856 MEDROXYPROGESTERONE 5 MG TABLET4871 MEGESTROL 40 MG TABLET4903 MEPERIDINE (PF) 25 MG/ML INJECTION SOLUTION4904 MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION4944 METAPROTERENOL 10 MG/5 ML SYRUP4945 METAPROTERENOL 10 MG TABLET4946 METAPROTERENOL 20 MG TABLET4952 METHADONE 5 MG/5 ML ORAL SOLUTION4953 METHADONE 10 MG TABLET4953 METHADONE 10 MG TABLET4954 METHADONE 5 MG TABLET4954 METHADONE 5 MG TABLET4966 METHENAMINE MANDELATE 1 GRAM TABLET4971 METHOCARBAMOL 500 MG TABLET4972 METHOCARBAMOL 750 MG TABLET4973 METHOTREXATE SODIUM 2.5 MG TABLET4974 METHOTREXATE SODIUM 25 MG/ML INJECTION SOLUTION4975 METHOTREXATE SODIUM (PF) 1 GRAM SOLUTION FOR INJECTION4978 METHYCLOTHIAZIDE 5 MG TABLET4982 METHYLDOPA 250 MG TABLET4983 METHYLDOPA 500 MG TABLET4984 METHYLDOPATE 250 MG/5 ML INTRAVENOUS SOLUTION4985 METHYLENE BLUE 1 % INJECTION4986 METHYLPHENIDATE 10 MG TABLET4986 METHYLPHENIDATE 10 MG TABLET4987 METHYLPHENIDATE 20 MG TABLET4988 METHYLPHENIDATE 5 MG TABLET

4988 METHYLPHENIDATE 5 MG TABLET4989 METHYLPHENIDATE ER 20 MG TABLET,EXTENDED RELEASE4991 METHYLPREDNISOLONE 4 MG TABLETS IN A DOSE PACK4992 METHYLPREDNISOLONE 16 MG TABLET4993 METHYLPREDNISOLONE 4 MG TABLET4993 METHYLPREDNISOLONE 4 MG TABLET4995 METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION5002 METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION5005 METOCLOPRAMIDE 10 MG TABLET5005 METOCLOPRAMIDE 10 MG TABLET5006 METOCLOPRAMIDE 5 MG TABLET5007 METOPROLOL 5 MG/5 ML INTRAVENOUS SOLUTION5008 METOPROLOL TARTRATE 100 MG TABLET5009 METOPROLOL TARTRATE 50 MG TABLET5015 METRONIDAZOLE 250 MG TABLET5015 METRONIDAZOLE 250 MG TABLET5016 METRONIDAZOLE 500 MG TABLET5016 METRONIDAZOLE 500 MG TABLET5018 METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGY5039 MICONAZOLE NITRATE 2 % TOPICAL CREAM5040 MICONAZOLE NITRATE 2 % VAGINAL CREAM5084 MINERAL OIL-CHONDRUS 2.5 ML/5 ML ORAL EMULSION5086 MINERAL OIL ORAL5087 MINERAL OIL ENEMA5110 MINOCYCLINE 100 MG CAPSULE5110 MINOCYCLINE 100 MG CAPSULE5111 MINOCYCLINE 50 MG CAPSULE5114 MINOXIDIL 10 MG TABLET5115 MINOXIDIL 2.5 MG TABLET5168 MORPHINE 10 MG/ML INJECTION SOLUTION5169 MORPHINE 15 MG/ML INJECTION SOLUTION5169 MORPHINE 15 MG/ML INJECTION SOLUTION5170 MORPHINE 2 MG/ML INJECTION SYRINGE5172 MORPHINE 4 MG/ML INJECTION SYRINGE5173 MORPHINE 5 MG/ML INJECTION SOLUTION5176 MORPHINE 10 MG/5 ML ORAL SOLUTION5178 MORPHINE 15 MG TABLET5180 MORPHINE 10 MG RECTAL SUPPOSITORY5185 MORRHUATE SODIUM 5 % INTRAVENOUS SOLUTION5245 MULTIVITAMIN TABLET5330 NADOLOL 20 MG TABLET5333 NAFCILLIN 1 GRAM SOLUTION FOR INJECTION5334 NAFCILLIN 10 GRAM SOLUTION FOR INJECTION5335 NAFCILLIN 2 GRAM SOLUTION FOR INJECTION5339 NALBUPHINE 10 MG/ML INJECTION SOLUTION5340 NALBUPHINE 20 MG/ML INJECTION SOLUTION5373 NALOXONE 0.4 MG/ML INJECTION SOLUTION5374 NALOXONE 1 MG/ML INJECTION SYRINGE5383 NAPHAZOLINE 0.1 % EYE DROPS5384 NAPHAZOLINE-PHENIRAMINE 0.025 %-0.3 % EYE DROPS5391 NAPROXEN 250 MG TABLET5392 NAPROXEN 375 MG TABLET5393 NAPROXEN 500 MG TABLET5393 NAPROXEN 500 MG TABLET5394 NAPROXEN SODIUM 275 MG TABLET5472 NEOMYCIN 500 MG TABLET5472 NEOMYCIN 500 MG TABLET

5473 NEOMYCIN SULFATE (BULK) POWDER5473 NEOMYCIN SULFATE (BULK) POWDER5474 NEOMYCIN-POLYMYXIN-GRAMICIDIN 1.75 MG-10K UNIT-0.025 MG/ML EYE DROPS5488 NEOSTIGMINE BROMIDE 15 MG TABLET5489 NEOSTIGMINE METHYLSULFATE 0.5 MG/ML INJECTION SOLUTION5490 NEOSTIGMINE METHYLSULFATE 1 MG/ML INJECTION SOLUTION5541 NIACIN 50 MG TABLET5545 NIACIN ER 500 MG TABLET,EXTENDED RELEASE5547 NIACINAMIDE 100 MG TABLET5548 NIACINAMIDE 500 MG TABLET5558 NIFEDIPINE 10 MG CAPSULE5558 NIFEDIPINE 10 MG CAPSULE5559 NIFEDIPINE 20 MG CAPSULE5559 NIFEDIPINE 20 MG CAPSULE5593 NITROFURANTOIN MACROCRYSTAL 100 MG CAPSULE5593 NITROFURANTOIN MACROCRYSTAL 100 MG CAPSULE5594 NITROFURANTOIN MACROCRYSTAL 25 MG CAPSULE5595 NITROFURANTOIN MACROCRYSTAL 50 MG CAPSULE5599 NITROGLYCERIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION5603 NITROGLYCERIN 0.3 MG SUBLINGUAL TABLET5604 NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET5606 NITROGLYCERIN 2 % TRANSDERMAL OINTMENT5606 NITROGLYCERIN 2 % TRANSDERMAL OINTMENT5606 NITROGLYCERIN 2 % TRANSDERMAL OINTMENT5674 NORTRIPTYLINE 10 MG CAPSULE5675 NORTRIPTYLINE 25 MG CAPSULE5749 NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM5750 NYSTATIN 100,000 UNIT/GRAM TOPICAL OINTMENT5751 NYSTATIN 100,000 UNIT/ML ORAL SUSPENSION5751 NYSTATIN 100,000 UNIT/ML ORAL SUSPENSION5752 NYSTATIN 500,000 UNIT TABLET5754 NYSTATIN-TRIAMCINOLONE 100,000 UNIT/G-0.1 % TOPICAL CREAM5755 NYSTATIN-TRIAMCINOLONE 100,000 UNIT/GRAM-0.1 % TOPICAL OINTMENT5924 OXACILLIN 1 GRAM SOLUTION FOR INJECTION5926 OXACILLIN 2 GRAM SOLUTION FOR INJECTION5931 OXAZEPAM 15 MG CAPSULE5932 OXAZEPAM 30 MG CAPSULE5938 OXYBUTYNIN CHLORIDE 5 MG TABLET5940 OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET5940 OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET5943 OXYMETAZOLINE 0.05 % NASAL SPRAY AEROSOL5944 OXYTOCIN 10 UNIT/ML INJECTION SOLUTION5944 OXYTOCIN 10 UNIT/ML INJECTION SOLUTION6013 PANCURONIUM 1 MG/ML INTRAVENOUS SOLUTION6013 PANCURONIUM 1 MG/ML INTRAVENOUS SOLUTION6029 PANTOTHENIC ACID 500 MG TABLET6030 PAPAVERINE 30 MG/ML INJECTION SOLUTION6030 PAPAVERINE 30 MG/ML INJECTION SOLUTION6047 PAREGORIC 2 MG/5 ML ORAL LIQUID6085 PENICILLIN G POTASSIUM 20 MILLION UNIT SOLUTION FOR INJECTION6086 PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION6090 PENICILLIN V POTASSIUM 125 MG/5 ML ORAL SOLUTION6091 PENICILLIN V POTASSIUM 250 MG/5 ML ORAL SOLUTION6091 PENICILLIN V POTASSIUM 250 MG/5 ML ORAL SOLUTION6092 PENICILLIN V POTASSIUM 250 MG TABLET6092 PENICILLIN V POTASSIUM 250 MG TABLET6093 PENICILLIN V POTASSIUM 500 MG TABLET

6097 PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION6097 PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION6157 PERPHENAZINE 2 MG TABLET6158 PERPHENAZINE 4 MG TABLET6193 PHENAZOPYRIDINE 100 MG TABLET6194 PHENAZOPYRIDINE 200 MG TABLET6212 PHENOBARBITAL 20 MG/5 ML ORAL ELIXIR6213 PHENOBARBITAL 100 MG TABLET6214 PHENOBARBITAL 15 MG TABLET6214 PHENOBARBITAL 15 MG TABLET6215 PHENOBARBITAL 16.2 MG TABLET6216 PHENOBARBITAL 30 MG TABLET6217 PHENOBARBITAL 32.4 MG TABLET6218 PHENOBARBITAL 60 MG TABLET6219 PHENOBARBITAL 64.8 MG TABLET6220 PHENOBARBITAL 97.2 MG TABLET6221 PHENOBARBITAL SODIUM 130 MG/ML INJECTION SOLUTION6224 PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION6225 PHENOBARB-HYOSCYAMN-ATROPINE-SCOP 16.2 MG-0.1037MG-0.0194MG/5ML EL6225 PHENOBARB-HYOSCYAMN-ATROPINE-SCOP 16.2 MG-0.1037MG-0.0194MG/5ML EL6234 PHENTERMINE 37.5 MG TABLET6242 PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION6242 PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION6243 PHENYLEPHRINE 0.25 % NASAL SPRAY6243 PHENYLEPHRINE 0.25 % NASAL SPRAY6244 PHENYLEPHRINE 0.5 % NASAL SPRAY6246 PHENYLEPHRINE 2.5 % EYE DROPS6246 PHENYLEPHRINE 2.5 % EYE DROPS6255 PHENYTOIN 125 MG/5 ML ORAL SUSPENSION6256 PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION6256 PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION6257 PHENYTOIN SODIUM EXTENDED 100 MG CAPSULE6270 PHYSOSTIGMINE 1 MG/ML INJECTION SOLUTION6271 PHYTONADIONE 1 MG/0.5 ML INJECTION SYRINGE6279 PILOCARPINE 1 % EYE DROPS6280 PILOCARPINE 2 % EYE DROPS6282 PILOCARPINE 4 % EYE DROPS6296 PINDOLOL 10 MG TABLET6297 PINDOLOL 5 MG TABLET6310 PIROXICAM 10 MG CAPSULE6311 PIROXICAM 20 MG CAPSULE6355 PODOPHYLLUM RESIN POWDER6356 PODOPHYLLUM RESIN 25 % TOPICAL LIQUID6393 POLYMYXIN B SULFATE 500,000 UNIT SOLUTION FOR INJECTION6420 POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION6420 POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION6423 POTASSIUM BICARBONATE-CITRIC ACID 25 MEQ EFFERVESCENT TABLET6429 POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS INJECTION SOLUTION6429 POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS INJECTION SOLUTION6429 POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS INJECTION SOLUTION6430 POTASSIUM CHLORIDE ER 10 MEQ CAPSULE,EXTENDED RELEASE6431 POTASSIUM CHLORIDE ER 8 MEQ CAPSULE,EXTENDED RELEASE6432 POTASSIUM CHLORIDE 10 % ORAL LIQUID6434 POTASSIUM CHLORIDE 20 MEQ ORAL PACKET6434 POTASSIUM CHLORIDE 20 MEQ ORAL PACKET6437 POTASSIUM CHLORIDE ER 8 MEQ TABLET,EXTENDED RELEASE6445 POTASSIUM IODIDE 1 GRAM/ML ORAL SOLUTION

6451 POTASSIUM PHOSPHATE DIBASIC 3 MILLIMOLE/ML INTRAVENOUS SOLUTION6451 POTASSIUM PHOSPHATE DIBASIC 3 MILLIMOLE/ML INTRAVENOUS SOLUTION6455 POVIDONE-IODINE 10 % TOPICAL OINTMENT6458 POVIDONE-IODINE 10 % TOPICAL SOLUTION6462 PRALIDOXIME 1 GRAM SOLUTION FOR INJECTION6468 PRAZOSIN 1 MG CAPSULE6469 PRAZOSIN 2 MG CAPSULE6470 PRAZOSIN 5 MG CAPSULE6487 PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION6493 PREDNISONE 1 MG TABLET6494 PREDNISONE 10 MG TABLET6494 PREDNISONE 10 MG TABLET6495 PREDNISONE 2.5 MG TABLET6496 PREDNISONE 20 MG TABLET6497 PREDNISONE 5 MG TABLET6541 PRIMAQUINE 26.3 MG TABLET6544 PRIMIDONE 250 MG TABLET6561 PROBENECID 500 MG TABLET6562 PROCAINAMIDE 100 MG/ML INJECTION SOLUTION6563 PROCAINAMIDE 500 MG/ML INJECTION SOLUTION6580 PROCHLORPERAZINE EDISYLATE 5 MG/ML INJECTION SOLUTION6582 PROCHLORPERAZINE MALEATE 10 MG TABLET6583 PROCHLORPERAZINE MALEATE 5 MG TABLET6597 PROGESTERONE 50 MG/ML INTRAMUSCULAR OIL6618 PROMETHAZINE 25 MG/ML INJECTION SOLUTION6620 PROMETHAZINE 6.25 MG/5 ML SYRUP6621 PROMETHAZINE 12.5 MG TABLET6622 PROMETHAZINE 25 MG TABLET6623 PROMETHAZINE 50 MG TABLET6624 PROMETHAZINE 50 MG RECTAL SUPPOSITORY6627 PROMETHAZINE-CODEINE 6.25 MG-10 MG/5 ML SYRUP6643 PROPANTHELINE 15 MG TABLET6644 PROPARACAINE 0.5 % EYE DROPS6654 PROPRANOLOL 20 MG/5 ML ORAL SOLUTION6656 PROPRANOLOL 10 MG TABLET6657 PROPRANOLOL 20 MG TABLET6658 PROPRANOLOL 40 MG TABLET6660 PROPRANOLOL 80 MG TABLET6662 PROPYLTHIOURACIL 50 MG TABLET6677 PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION6677 PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION6714 PSEUDOEPHEDRINE 30 MG TABLET6714 PSEUDOEPHEDRINE 30 MG TABLET6715 PSEUDOEPHEDRINE 60 MG TABLET6715 PSEUDOEPHEDRINE 60 MG TABLET6716 PSEUDOEPHEDRINE ER 120 MG TABLET,EXTENDED RELEASE6716 PSEUDOEPHEDRINE ER 120 MG TABLET,EXTENDED RELEASE6738 PYRAZINAMIDE 500 MG TABLET6744 PYRIDOXINE 100 MG/ML INJECTION SOLUTION6745 PYRIDOXINE 100 MG TABLET6746 PYRIDOXINE 25 MG TABLET6748 PYRIDOXINE 50 MG TABLET6775 QUINIDINE GLUCONATE 80 MG/ML INJECTION SOLUTION6777 QUINIDINE SULFATE 200 MG TABLET6778 QUINIDINE SULFATE 300 MG TABLET6778 QUINIDINE SULFATE 300 MG TABLET6802 RANITIDINE 15 MG/ML SYRUP

6802 RANITIDINE 15 MG/ML SYRUP6803 RASPBERRY SYRUP7028 BACTERIOSTATIC SODIUM CHLORIDE 0.9 % INJECTION SOLUTION7034 SALSALATE 500 MG TABLET7035 SALSALATE 750 MG TABLET7108 SCOPOLAMINE 0.4 MG/ML INJECTION SOLUTION7139 SELENIUM 200 MCG TABLET7140 SELENIUM 50 MCG TABLET7224 SILVER SULFADIAZINE 1 % TOPICAL CREAM7224 SILVER SULFADIAZINE 1 % TOPICAL CREAM7224 SILVER SULFADIAZINE 1 % TOPICAL CREAM7226 SIMETHICONE 125 MG CHEWABLE TABLET7227 SIMETHICONE 80 MG CHEWABLE TABLET7227 SIMETHICONE 80 MG CHEWABLE TABLET7228 SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION7242 SIMPLE SYRUP (SYRPALTA)7242 SIMPLE SYRUP (SYRPALTA)7301 SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION7302 SODIUM ACETATE 4 MEQ/ML INTRAVENOUS SOLUTION7302 SODIUM ACETATE 4 MEQ/ML INTRAVENOUS SOLUTION7305 SODIUM BENZOATE (BULK) POWDER7306 SODIUM BICARBONATE 4.2 % (0.5 MEQ/ML) INTRAVENOUS SYRINGE7309 SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE7310 SODIUM BICARBONATE (ANTACID) POWDER7311 SODIUM BICARBONATE 325 MG TABLET7311 SODIUM BICARBONATE 325 MG TABLET7312 SODIUM BICARBONATE 650 MG TABLET7312 SODIUM BICARBONATE 650 MG TABLET7318 SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION7318 SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION7319 SODIUM CHLORIDE 0.9 % INJ SYRG7320 SODIUM CHLORIDE 2.5 MEQ/ML INTRAVENOUS SOLUTION7321 SODIUM CHLORIDE 3 % INTRAVENOUS INJECTION SOLUTION7322 SODIUM CHLORIDE 4 MEQ/ML INTRAVENOUS SOLUTION7322 SODIUM CHLORIDE 4 MEQ/ML INTRAVENOUS SOLUTION7325 SODIUM CHLORIDE 0.9 % FOR NEBULIZATION7326 SODIUM CHLORIDE 10 % FOR NEBULIZATION7327 SODIUM CHLORIDE 3 % FOR NEBULIZATION7328 SODIUM CHLORIDE 1 GRAM TABLET7330 SODIUM CHLORIDE (BULK) GRANULES7336 SODIUM FLUORIDE 1.1 MG (0.5 MG FLUORIDE) CHEWABLE TABLET7337 SODIUM FLUORIDE 2.2 MG (1 MG FLUORIDE) CHEWABLE TAB7351 SODIUM PHOSPHATE 3 MILLIMOLE/ML INTRAVENOUS SOLUTION7351 SODIUM PHOSPHATE 3 MILLIMOLE/ML INTRAVENOUS SOLUTION7352 SODIUM PHOSPHATE,DIBASIC (BULK) 100 % GRANULES7352 SODIUM PHOSPHATE,DIBASIC (BULK) 100 % GRANULES7356 SODIUM POLYSTYRENE SULFONATE ORAL POWDER7359 SULFACETAMIDE SODIUM 10 % EYE DROPS7364 SODIUM THIOSULFATE 12.5 GRAM/50 ML (250 MG/ML) INTRAVENOUS SOLUTION7413 SORBITOL 70 % SOLUTION7437 SPIRONOLACTONE 25 MG TABLET7439 SPIRONOLACTONE 25 MG-HYDROCHLOROTHIAZIDE 25 MG TABLET7485 WATER FOR IRRIGATION, STERILE SOLUTION7485 WATER FOR IRRIGATION, STERILE SOLUTION7485 WATER FOR IRRIGATION, STERILE SOLUTION7508 STREPTOMYCIN 1 GRAM INTRAMUSCULAR SOLUTION7536 SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION

7540 SUCROSE CRYSTALS7554 SULFADIAZINE 500 MG TABLET7555 SULFAMETHOXAZOLE 800 MG-TRIMETHOPRIM 160 MG TABLET7556 SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUT7557 SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG TABLET7557 SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG TABLET7562 SULFASALAZINE 500 MG TABLET7563 SULFASALAZINE 500 MG TABLET,DELAYED RELEASE7578 SULINDAC 150 MG TABLET7579 SULINDAC 200 MG TABLET7711 TAMOXIFEN 10 MG TABLET7753 TEMAZEPAM 15 MG CAPSULE7753 TEMAZEPAM 15 MG CAPSULE7783 TESTOSTERONE CYPIONATE 100 MG/ML INTRAMUSCULAR OIL7784 TESTOSTERONE CYPIONATE 200 MG/ML INTRAMUSCULAR OIL7785 TESTOSTERONE ENANTHATE 200 MG/ML INTRAMUSCULAR OIL7791 TETANUS TOXOID,ADSORBED (PF) 5 LF UNIT/0.5 ML INTRAMUSCULAR SUSPENSIO7795 TETRACAINE 0.5 % EYE DROPS7796 TETRACYCLINE 250 MG CAPSULE7800 TETRAHYDROZOLINE 0.05 % EYE DROPS7820 THEOPHYLLINE 80 MG/15 ML ORAL ELIXIR7876 THIAMINE HCL 100 MG/ML INJECTION SOLUTION7877 THIAMINE 100 MG TABLET7879 THIAMINE 50 MG TABLET7886 THIOGUANINE 40 MG TABLET7894 THIORIDAZINE 10 MG TABLET7895 THIORIDAZINE 100 MG TABLET7899 THIORIDAZINE 25 MG TABLET7900 THIORIDAZINE 50 MG TABLET7901 THIOTEPA 15 MG SOLUTION FOR INJECTION7902 THIOTHIXENE 1 MG CAPSULE7904 THIOTHIXENE 2 MG CAPSULE7906 THIOTHIXENE 5 MG CAPSULE7993 TOBRAMYCIN 10 MG/ML INJECTION SOLUTION7995 TOBRAMYCIN 0.3 % EYE DROPS8008 TOLBUTAMIDE 500 MG TABLET8015 TOLMETIN 400 MG CAPSULE8016 TOLMETIN 200 MG TABLET8020 TOLNAFTATE 1 % TOPICAL CREAM8022 TOLNAFTATE 1 % TOPICAL SOLUTION8083 TRAZODONE 100 MG TABLET8085 TRAZODONE 50 MG TABLET8112 TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM8112 TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM8113 TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM8113 TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM8113 TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM8114 TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM8115 TRIAMCINOLONE ACETONIDE 0.025 % LOTION8116 TRIAMCINOLONE ACETONIDE 0.1 % LOTION8117 TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT8118 TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT8118 TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT8119 TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL OINTMENT8120 TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION8120 TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION8121 TRIAMCINOLONE ACETONIDE 0.1 % DENTAL PASTE

8125 TRIAMCINOLONE ACETONIDE 0.05 % TOPICAL OINTMENT8131 TRIAMTERENE 100 MG CAPSULE8132 TRIAMTERENE 37.5 MG-HYDROCHLOROTHIAZIDE 25 MG TABLET8134 TRIAMTERENE 75 MG-HYDROCHLOROTHIAZIDE 50 MG TABLET8138 TRIAZOLAM 0.125 MG TABLET8139 TRIAZOLAM 0.25 MG TABLET8139 TRIAZOLAM 0.25 MG TABLET8161 TRIFLUOPERAZINE 1 MG TABLET8163 TRIFLUOPERAZINE 2 MG TABLET8164 TRIFLUOPERAZINE 5 MG TABLET8165 TRIHEXYPHENIDYL 0.4 MG/ML ORAL ELIXIR8166 TRIHEXYPHENIDYL 2 MG TABLET8167 TRIHEXYPHENIDYL 5 MG TABLET8182 TRIMETHOPRIM 100 MG TABLET8249 TROPICAMIDE 0.5 % EYE DROPS8250 TROPICAMIDE 1 % EYE DROPS8250 TROPICAMIDE 1 % EYE DROPS8250 TROPICAMIDE 1 % EYE DROPS8259 TUBERCULIN PPD 5 TUB. UNIT/0.1 ML INTRADERMAL INJECTION SOLUTION8428 VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML ORAL SOLUTION8429 VALPROIC ACID 250 MG CAPSULE8442 VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION8443 VANCOMYCIN 500 MG INTRAVENOUS SOLUTION8444 VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION8454 VARICELLA-ZOSTER IMMUNE GLOBULIN 125 UNIT SOLUTION8478 VASOPRESSIN 20 UNIT/ML INJECTION SOLUTION8527 VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION8527 VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION8528 VERAPAMIL 120 MG TABLET8530 VERAPAMIL 80 MG TABLET8531 VERAPAMIL ER (SR) 240 MG TABLET,EXTENDED RELEASE8594 VINBLASTINE 1 MG/ML INTRAVENOUS SOLUTION8597 VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION8639 VITAMIN A 10,000 UNIT CAPSULE8698 VITAMIN E 100 UNIT CAPSULE8700 VITAMIN E 200 UNIT CAPSULE8701 VITAMIN E 400 UNIT CAPSULE8748 WARFARIN 10 MG TABLET8749 WARFARIN 2 MG TABLET8750 WARFARIN 2.5 MG TABLET8751 WARFARIN 5 MG TABLET8752 WARFARIN 7.5 MG TABLET8865 ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION8874 ZINC OXIDE 20 % TOPICAL OINTMENT8878 ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION8879 ZINC SULFATE 5 MG/ML INTRAVENOUS SOLUTION8880 ZINC SULFATE 220 MG (50 MG ZINC) CAPSULE8880 ZINC SULFATE 220 MG (50 MG ZINC) CAPSULE8922 BUTALBITAL-ASPIRIN-CAFFEINE 50 MG-325 MG-40 MG CAPSULE8943 ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION8946 ACETAMINOPHEN 80 MG RECTAL SUPPOSITORY8946 ACETAMINOPHEN 80 MG RECTAL SUPPOSITORY8950 ACETAMINOPHEN 300 MG-CODEINE 60 MG TABLET8958 BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET8962 ACETAZOLAMIDE ER 500 MG CAPSULE,EXTENDED RELEASE8963 ACETIC ACID 0.25 % IRRIGATION SOLUTION8965 ACETIC ACID-ALUMINUM ACETATE 2 % EAR DROPS

8967 ACYCLOVIR 5 % TOPICAL CREAM8968 ACYCLOVIR 5 % TOPICAL OINTMENT8969 ACYCLOVIR 200 MG CAPSULE8969 ACYCLOVIR 200 MG CAPSULE8970 ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION8971 ACYCLOVIR 400 MG TABLET8971 ACYCLOVIR 400 MG TABLET8971 ACYCLOVIR 400 MG TABLET8974 ACYCLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION8979 ALBENDAZOLE 200 MG TABLET8979 ALBENDAZOLE 200 MG TABLET8979 ALBENDAZOLE 200 MG TABLET8981 ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION8981 ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION8981 ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION8982 ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION8982 ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION8985 ALCLOMETASONE 0.05 % TOPICAL CREAM8985 ALCLOMETASONE 0.05 % TOPICAL CREAM8993 ALDESLEUKIN 22 MILLION UNIT INTRAVENOUS SOLUTION8994 ALFENTANIL 500 MCG/ML INJECTION SOLUTION9001 ALPROSTADIL 500 MCG/ML INJECTION SOLUTION9003 ALTEPLASE 50 MG INTRAVENOUS SOLUTION9007 ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-25 MG CHEWABLE 9007 ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-25 MG CHEWABLE 9015 ALUMINUM-MAG HYDROXIDE-SIMETHICONE 400 MG-400 MG-40 MG/5 ML ORAL 9015 ALUMINUM-MAG HYDROXIDE-SIMETHICONE 400 MG-400 MG-40 MG/5 ML ORAL 9028 ALUMINUM CHLORIDE 20 % TOPICAL SOLUTION9035 AMCINONIDE 0.1 % TOPICAL CREAM9035 AMCINONIDE 0.1 % TOPICAL CREAM9035 AMCINONIDE 0.1 % TOPICAL CREAM9062 AMINOCAPROIC ACID 25 % ORAL SOLUTION9063 AMINOCAPROIC ACID 500 MG TABLET9066 AMIODARONE 200 MG TABLET9066 AMIODARONE 200 MG TABLET9069 AMLODIPINE 10 MG TABLET9069 AMLODIPINE 10 MG TABLET9070 AMLODIPINE 2.5 MG TABLET9071 AMLODIPINE 5 MG TABLET9076 AMOXICILLIN 125 MG CHEWABLE TABLET9080 AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSIO9080 AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSIO9116 ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION9119 APRACLONIDINE 0.5 % EYE DROPS9120 APRACLONIDINE 1 % EYE DROPS IN A DROPPERETTE9123 ARGININE HCL (L-ARGININE) 10 % INTRAVENOUS SOLUTION9146 ASPARAGINASE 10,000 UNIT SOLUTION FOR INJECTION9158 ASPIRIN-ACETAMINOPHEN-CAFFEINE 250 MG-250 MG-65 MG TABLET9158 ASPIRIN-ACETAMINOPHEN-CAFFEINE 250 MG-250 MG-65 MG TABLET9168 ATRACURIUM 10 MG/ML INTRAVENOUS SOLUTION9168 ATRACURIUM 10 MG/ML INTRAVENOUS SOLUTION9175 BETAMETHASONE, AUGMENTED 0.05 % TOPICAL CREAM9175 BETAMETHASONE, AUGMENTED 0.05 % TOPICAL CREAM9178 BETAMETHASONE, AUGMENTED 0.05 % TOPICAL OINTMENT9183 AZATHIOPRINE 50 MG TABLET9185 AZTREONAM 1 GRAM SOLUTION FOR INJECTION9186 AZTREONAM 2 GRAM SOLUTION FOR INJECTION

9203 BACITRACIN-POLYMYXIN-NEOMYCIN-HYDROCORTISONE 1 % TOP OINTMENT9220 BENAZEPRIL 10 MG TABLET9221 BENAZEPRIL 20 MG TABLET9222 BENAZEPRIL 40 MG TABLET9250 BENZOYL PEROXIDE 2.5 % TOPICAL CLEANSER9254 ERYTHROMYCIN-BENZOYL PEROXIDE 3 %-5 % TOPICAL GEL9254 ERYTHROMYCIN-BENZOYL PEROXIDE 3 %-5 % TOPICAL GEL9259 BENZTROPINE 2 MG/2 ML INJECTION SOLUTION9260 BENZYLPENICILLOYL POLYLYSINE 0.25 ML INTRADERMAL INJECTION SOLUTION9266 BETAMETHASONE ACET & SOD PHOS 6 MG/ML SUSPENSION FOR INJECTION9277 BIOTIN 5 MG CAPSULE9285 BISMUTH SUBSALICYLATE 262 MG CHEWABLE TABLET9285 BISMUTH SUBSALICYLATE 262 MG CHEWABLE TABLET9289 BLEOMYCIN 15 UNIT SOLUTION FOR INJECTION9297 BROMOCRIPTINE 2.5 MG TABLET9308 BUMETANIDE 0.25 MG/ML INJECTION SOLUTION9308 BUMETANIDE 0.25 MG/ML INJECTION SOLUTION9309 BUMETANIDE 0.5 MG TABLET9310 BUMETANIDE 1 MG TABLET9316 BUPIVACAINE (PF) 7.5 MG/ML (0.75 %) IN 8.25 % DEXTROSE INJECTION9321 BUPROPION HCL 100 MG TABLET9322 BUPROPION HCL 75 MG TABLET9323 BUSPIRONE 10 MG TABLET9323 BUSPIRONE 10 MG TABLET9324 BUSPIRONE 5 MG TABLET9325 BUSULFAN 2 MG TABLET9328 BUTAMBEN-TETRACAINE-BENZOCAINE 2 %-2 %-14 % (200 MG/SEC) TOPICAL SPRA9333 BUTORPHANOL TARTRATE 1 MG/ML INJECTION SOLUTION9335 BUTORPHANOL TARTRATE 10 MG/ML NASAL SPRAY9347 CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION9348 CALCITRIOL 1 MCG/ML INTRAVENOUS SOLUTION9350 CALCITRIOL 0.25 MCG CAPSULE9351 CALCITRIOL 0.5 MCG CAPSULE9385 CALCIUM CARBONATE 500 MG (200 MG CALCIUM) CHEW TAB9385 CALCIUM CARBONATE 500 MG (200 MG CALCIUM) CHEW TAB9391 CAMPHOR-PHENOL 10.8 %-4.7 % TOPICAL GEL9391 CAMPHOR-PHENOL 10.8 %-4.7 % TOPICAL GEL9401 CAPTOPRIL 12.5 MG TABLET9402 CAPTOPRIL 25 MG TABLET9406 CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET9407 CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET9413 CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION9430 CEFACLOR 250 MG CAPSULE9431 CEFACLOR 500 MG CAPSULE9432 CEFACLOR 125 MG/5 ML ORAL SUSPENSION9434 CEFACLOR 250 MG/5 ML ORAL SUSPENSION9438 CEFADROXIL 250 MG/5 ML ORAL SUSPENSION9446 CEFIXIME 100 MG/5 ML ORAL SUSPENSION9448 CEFIXIME 400 MG TABLET9452 CEFOTAXIME 1 GRAM SOLUTION FOR INJECTION9453 CEFOTAXIME 10 GRAM SOLUTION FOR INJECTION9454 CEFOTAXIME 2 GRAM SOLUTION FOR INJECTION9455 CEFOTAXIME 500 MG SOLUTION FOR INJECTION9458 CEFOTETAN 1 GRAM SOLUTION FOR INJECTION9460 CEFOTETAN 2 GRAM SOLUTION FOR INJECTION9461 CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION9462 CEFOXITIN 10 GRAM INTRAVENOUS SOLUTION

9462 CEFOXITIN 10 GRAM INTRAVENOUS SOLUTION9463 CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION9466 CEFPODOXIME 100 MG/5 ML ORAL SUSPENSION9469 CEFPODOXIME 200 MG TABLET9472 CEFPROZIL 250 MG TABLET9474 CEFTAZIDIME 1 GRAM SOLUTION FOR INJECTION9476 CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION9477 CEFTAZIDIME 500 MG SOLUTION FOR INJECTION9478 CEFTAZIDIME 6 GRAM SOLUTION FOR INJECTION9487 CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION9488 CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION9489 CEFTRIAXONE 250 MG SOLUTION FOR INJECTION9490 CEFTRIAXONE 500 MG SOLUTION FOR INJECTION9491 CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION9495 CEFUROXIME AXETIL 250 MG TABLET9496 CEFUROXIME AXETIL 500 MG TABLET9499 CEPHALEXIN 250 MG CAPSULE9499 CEPHALEXIN 250 MG CAPSULE9500 CEPHALEXIN 500 MG CAPSULE9500 CEPHALEXIN 500 MG CAPSULE9501 CEPHALEXIN 125 MG/5 ML ORAL SUSPENSION9501 CEPHALEXIN 125 MG/5 ML ORAL SUSPENSION9502 CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION9506 CETIRIZINE 10 MG TABLET9506 CETIRIZINE 10 MG TABLET9513 CHLORAMBUCIL 2 MG TABLET9516 CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH9525 CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSPENSION9526 CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION9588 CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET9588 CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET9589 CHOLESTYRAMINE (WITH SUGAR) 4 GRAM ORAL POWDER9603 IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION9604 CIMETIDINE 200 MG TABLET9605 CIMETIDINE 300 MG TABLET9606 CIMETIDINE 400 MG TABLET9610 CIPROFLOXACIN 0.3 % EYE DROPS9613 CITRIC ACID-GLUCONOLAC-MAG CARB 6.602 G-0.198 G/100 ML IRRIGATION SOLN9615 CLADRIBINE 10 MG/10 ML INTRAVENOUS SOLUTION9616 CLARITHROMYCIN 250 MG TABLET9617 CLARITHROMYCIN 500 MG TABLET9617 CLARITHROMYCIN 500 MG TABLET9621 CLINDAMYCIN 300 MG CAPSULE9621 CLINDAMYCIN 300 MG CAPSULE9623 CLINDAMYCIN 1 % TOPICAL GEL9624 CLINDAMYCIN 2 % VAGINAL CREAM9627 CLINDAMYCIN 900 MG/50 ML IN DEXTROSE 5% INTRAVENOUS PIGGYBACK9630 CLOBETASOL 0.05 % TOPICAL CREAM9631 CLOBETASOL 0.05 % TOPICAL OINTMENT9631 CLOBETASOL 0.05 % TOPICAL OINTMENT9632 CLOBETASOL 0.05 % TOPICAL SOLUTION9635 CLOMIPRAMINE 25 MG CAPSULE9636 CLOMIPRAMINE 75 MG CAPSULE9637 CLONAZEPAM 0.5 MG TABLET9638 CLONAZEPAM 1 MG TABLET9639 CLONAZEPAM 2 MG TABLET9644 CLOTRIMAZOLE 10 MG TROCHE

9647 CLOZAPINE 100 MG TABLET9648 CLOZAPINE 25 MG TABLET9681 COLISTIN (COLISTIMETHATE SODIUM) 150 MG SOLUTION FOR INJECTION9682 COLLAGENASE CLOSTRIDIUM HISTOLYTICUM 250 UNIT/GRAM TOPICAL OINTMENT9685 CORTICOTROPIN 80 UNIT/ML INJECTION GEL9686 COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION9690 CROMOLYN 20 MG/2 ML SOLUTION FOR NEBULIZATION9691 CROMOLYN 4 % EYE DROPS9692 CROTAMITON 10 % TOPICAL CREAM9693 CROTAMITON 10 % LOTION9699 CYCLOPENTOLATE 0.5 % EYE DROPS9701 CYCLOPENTOLATE-PHENYLEPHRINE 0.2 %-1 % EYE DROPS9702 CYCLOPHOSPHAMIDE 25 MG TABLET9703 CYCLOPHOSPHAMIDE 50 MG TABLET9704 CYCLOSERINE 250 MG CAPSULE9705 CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION9706 CYCLOSPORINE 100 MG CAPSULE9707 CYCLOSPORINE 25 MG CAPSULE9708 CYCLOSPORINE 100 MG/ML ORAL SOLUTION9710 CYTARABINE (PF) 1 GRAM SOLUTION FOR INJECTION9715 DANAZOL 50 MG CAPSULE9716 DANTROLENE 20 MG INTRAVENOUS SOLUTION9717 DANTROLENE 100 MG CAPSULE9718 DANTROLENE 25 MG CAPSULE9718 DANTROLENE 25 MG CAPSULE9719 DANTROLENE 50 MG CAPSULE9722 DEFEROXAMINE 2 GRAM SOLUTION FOR INJECTION9723 DEFEROXAMINE 500 MG SOLUTION FOR INJECTION9748 DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION9748 DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION9750 DESONIDE 0.05 % LOTION9751 DESONIDE 0.05 % TOPICAL OINTMENT9751 DESONIDE 0.05 % TOPICAL OINTMENT9759 DEXTRAN-40 10% IN 5% DEXTROSE INTRAVENOUS9764 DEXTROAMPHETAMINE ER 10 MG CAPSULE,EXTENDED RELEASE9764 DEXTROAMPHETAMINE ER 10 MG CAPSULE,EXTENDED RELEASE9766 DEXTROAMPHETAMINE ER 5 MG CAPSULE,EXTENDED RELEASE9773 DEXTROMETHORPHAN POLY COMPLEX ER 30 MG/5 ML ORAL SUSP EXT.RELEASE 19774 DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML SYRUP9788 DEXTROSE 5% AND LACTATED RINGERS INTRAVENOUS SOLUTION9789 DEXTROSE 5 % IN RINGERS INTRAVENOUS SOLUTION9795 POTASSIUM CHLORIDE 20 MEQ/L IN D5 & 0.9 % SODIUM CHLORIDE INTRAVENOUS9796 POTASSIUM CHLORIDE 40 MEQ/L IN D5 & 0.9 % SODIUM CHLORIDE INTRAVENOUS9799 POTASSIUM CHLORIDE 10 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV9800 POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.2 % SODIUM CHLORIDE IV9801 POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV9804 POTASSIUM CHLORIDE 30 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV9807 POTASSIUM CHLORIDE 40 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV9808 DEXTROSE 10 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION9808 DEXTROSE 10 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION9809 DEXTROSE 10 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION9809 DEXTROSE 10 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION9809 DEXTROSE 10 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION9812 DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION9812 DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION9812 DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION9814 DEXTROSE 5 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION

9814 DEXTROSE 5 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION9815 DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION9815 DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION9828 DIATRIZOATE MEGLUMINE & SODIUM 66 %-10 % ORAL SOLUTION9844 DIDANOSINE 10 MG/ML (FINAL CONC.) ORAL SOLUTION9844 DIDANOSINE 10 MG/ML (FINAL CONC.) ORAL SOLUTION9853 DIGOXIN 100 MCG/ML INJECTION SOLUTION9859 DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION9872 DIMERCAPROL 100 MG/ML INTRAMUSCULAR SOLUTION9892 DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLUTION9894 DOXAZOSIN 1 MG TABLET9895 DOXAZOSIN 2 MG TABLET9896 DOXAZOSIN 4 MG TABLET9902 DOXYCYCLINE MONOHYDRATE 25 MG/5 ML ORAL SUSPENSION9903 DRONABINOL 10 MG CAPSULE9903 DRONABINOL 10 MG CAPSULE9904 DRONABINOL 2.5 MG CAPSULE9904 DRONABINOL 2.5 MG CAPSULE9904 DRONABINOL 2.5 MG CAPSULE9905 DRONABINOL 5 MG CAPSULE9905 DRONABINOL 5 MG CAPSULE9905 DRONABINOL 5 MG CAPSULE9915 ECONAZOLE 1 % TOPICAL CREAM9917 EDROPHONIUM CHLORIDE 10 MG/ML INJECTION SOLUTION9921 MINERAL OIL TOPICAL9924 ENALAPRIL MALEATE 10 MG TABLET9925 ENALAPRIL MALEATE 2.5 MG TABLET9926 ENALAPRIL MALEATE 20 MG TABLET9927 ENALAPRIL MALEATE 5 MG TABLET9929 ENALAPRILAT 1.25 MG/ML INTRAVENOUS9929 ENALAPRILAT 1.25 MG/ML INTRAVENOUS9938 EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION9939 EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION9940 EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION9941 EPOETIN ALFA 4,000 UNIT/ML INJECTION SOLUTION9943 ERGOCALCIFEROL (VITAMIN D2) 8,000 UNIT/ML ORAL DROPS9948 ERGOTAMINE TARTRATE 2 MG SUBLINGUAL TABLET9949 ERGOTAMINE 1 MG-CAFFEINE 100 MG TABLET9952 ERYTHROMYCIN WITH ETHANOL 2 % TOPICAL SWAB9957 ESMOLOL 100 MG/10 ML (10 MG/ML) INTRAVENOUS SOLUTION9959 ESTERIFIED ESTROGENS-METHYLTESTOSTERONE 0.625 MG-1.25 MG TABLET9961 ESTAZOLAM 1 MG TABLET9967 ESTRADIOL 1 MG TABLET9968 ESTRADIOL 2 MG TABLET9969 ESTRADIOL 0.01% (0.1 MG/GRAM) VAGINAL CREAM9972 CONJUGATED ESTROGENS 25 MG SOLUTION FOR INJECTION9973 CONJUGATED ESTROGENS 0.3 MG TABLET9974 CONJUGATED ESTROGENS 0.625 MG TABLET9975 CONJUGATED ESTROGENS 0.9 MG TABLET9977 CONJUGATED ESTROGENS 0.625 MG/GRAM VAGINAL CREAM9979 ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION9980 ETHACRYNIC ACID 25 MG TABLET9982 ETHAMBUTOL 100 MG TABLET9983 ETHAMBUTOL 400 MG TABLET9984 ETHANOLAMINE OLEATE 5 % INTRAVENOUS SOLUTION9988 ETHIONAMIDE 250 MG TABLET9989 ETHOSUXIMIDE 250 MG CAPSULE

9991 ETHOTOIN 250 MG TABLET9992 ETHYNODIOL DIAC-ETH ESTRADIOL 1 MG-35 MCG TABLET10000 ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION10000 ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION10000 ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION10001 ETOPOSIDE 50 MG CAPSULE10008 FACTOR IX COMPLEX 1,000 (+/-) UNIT INTRAVENOUS SOLUTION10009 FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION10010 FAMOTIDINE 40 MG/5 ML ORAL SUSPENSION10011 FAMOTIDINE 20 MG TABLET10012 FAMOTIDINE 40 MG TABLET10014 FAT EMULSION 20 % INTRAVENOUS10014 FAT EMULSION 20 % INTRAVENOUS10014 FAT EMULSION 20 % INTRAVENOUS10023 FELBAMATE 600 MG/5 ML ORAL SUSPENSION10023 FELBAMATE 600 MG/5 ML ORAL SUSPENSION10023 FELBAMATE 600 MG/5 ML ORAL SUSPENSION10024 FELBAMATE 400 MG TABLET10024 FELBAMATE 400 MG TABLET10025 FELBAMATE 600 MG TABLET10025 FELBAMATE 600 MG TABLET10036 FILGRASTIM 300 MCG/ML INJECTION SOLUTION10039 FLAVOXATE 100 MG TABLET10041 FLECAINIDE 100 MG TABLET10043 FLECAINIDE 50 MG TABLET10043 FLECAINIDE 50 MG TABLET10044 FLUCONAZOLE 100 MG TABLET10044 FLUCONAZOLE 100 MG TABLET10045 FLUCONAZOLE 200 MG TABLET10046 FLUCONAZOLE 50 MG TABLET10049 FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBAC10050 FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK10051 FLUCYTOSINE 250 MG CAPSULE10052 FLUCYTOSINE 500 MG CAPSULE10053 FLUDARABINE 50 MG INTRAVENOUS SOLUTION10054 FLUDROCORTISONE 0.1 MG TABLET10057 FLUOCINOLONE 0.01 % TOPICAL BODY OIL10059 FLUORESCEIN 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION10061 FLUORESCEIN-BENOXINATE 0.25 %-0.4 % EYE DROPS10069 FLUOXETINE 10 MG CAPSULE10070 FLUOXETINE 20 MG CAPSULE10072 FLUPHENAZINE 2.5 MG/5 ML ORAL ELIXIR10080 FLURBIPROFEN 0.03 % EYE DROPS10083 FLUTICASONE 0.005 % TOPICAL OINTMENT10085 FLUVOXAMINE 50 MG TABLET10093 FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION10101 GANCICLOVIR 500 MG INTRAVENOUS SOLUTION10108 GENTAMICIN 100 MG/100 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBA10111 GENTAMICIN 80 MG/50 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK10113 GENTAMICIN-PREDNISOLONE 0.3 %-0.6 % EYE OINTMENT10114 GENTAMICIN 0.3 %-PREDNISOLONE 1 % EYE DROPS,SUSPENSION10117 GLIPIZIDE 5 MG TABLET10125 GLYBURIDE 1.25 MG TABLET10126 GLYBURIDE 2.5 MG TABLET10130 GLYCOPYRROLATE 1 MG TABLET10138 GRISEOFULVIN MICROSIZE 125 MG/5 ML ORAL SUSPENSION10138 GRISEOFULVIN MICROSIZE 125 MG/5 ML ORAL SUSPENSION

10140 GRISEOFULVIN MICROSIZE 500 MG TABLET10149 GUANFACINE 1 MG TABLET10156 HALCINONIDE 0.1 % TOPICAL CREAM10157 HALCINONIDE 0.1 % TOPICAL OINTMENT10176 HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION10176 HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION10176 HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION10181 HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION10209 HYDROCORTISONE 5 MG TABLET10210 HYDROCORTISONE 100 MG/60 ML ENEMA10224 HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION10224 HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION10224 HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION10225 HYDROMORPHONE 1 MG/ML ORAL LIQUID10227 HYDROMORPHONE 3 MG RECTAL SUPPOSITORY10235 HYDROXYCHLOROQUINE 200 MG TABLET10236 HYDROXYUREA 500 MG CAPSULE10246 IBUPROFEN 20 MG/ML ORAL SUSPENSION10248 IFOSFAMIDE 1 GRAM INTRAVENOUS SOLUTION10249 IFOSFAMIDE 3 GRAM INTRAVENOUS SOLUTION10258 IMMUNE GLOBULIN (HUMAN) (IGG) 10 GRAM INTRAVENOUS SOLUTION10261 IMMUNE GLOBULIN (HUMAN) (IGG) 5 GRAM INTRAVENOUS SOLUTION10266 INDOCYANINE GREEN 25 MG INJECTION10266 INDOCYANINE GREEN 25 MG INJECTION10267 INDOMETHACIN 1 MG INTRAVENOUS SOLUTION10284 NPH INSULIN HUMAN RECOMB 100 UNIT/ML SUBCUTANEOUS SUSPENSION10286 INSULIN NPH & REG HUMAN INSULIN 100 UNIT/ML (70-30) SUBCUTANEOUS SUSP10286 INSULIN NPH & REG HUMAN INSULIN 100 UNIT/ML (70-30) SUBCUTANEOUS SUSP10289 INSULIN REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION10299 INTERFERON ALFA-2B 10 MILLION UNIT (1 ML) SOLUTION FOR INJECTION10300 INTERFERON ALFA-2B 18 MILLION UNIT (1 ML) SOLUTION FOR INJECTION10307 INTERFERON GAMMA-1B 100 MCG (2 MILLION UNIT)/0.5 ML SUBCUTANEOUS SOL10313 IODOQUINOL 210 MG TABLET10315 IODOQUINOL-HC 1 %-1 % TOPICAL CREAM10319 IOHEXOL 180 MG IODINE/ML INTRATHECAL SOLUTION10351 PHYSIOLOGICAL IRRIGATION COMB#1 140 MEQ-5 MEQ-3 MEQ-98 MEQ/L SOLUTI10358 ISOSULFAN BLUE 1 % SUBCUTANEOUS SOLUTION10359 ISOTRETINOIN 10 MG CAPSULE10359 ISOTRETINOIN 10 MG CAPSULE10359 ISOTRETINOIN 10 MG CAPSULE10360 ISOTRETINOIN 20 MG CAPSULE10361 ISOTRETINOIN 40 MG CAPSULE10362 ISRADIPINE 2.5 MG CAPSULE10362 ISRADIPINE 2.5 MG CAPSULE10363 ISRADIPINE 5 MG CAPSULE10363 ISRADIPINE 5 MG CAPSULE10364 ITRACONAZOLE 100 MG CAPSULE10368 KETOCONAZOLE 2 % TOPICAL CREAM10368 KETOCONAZOLE 2 % TOPICAL CREAM10368 KETOCONAZOLE 2 % TOPICAL CREAM10369 KETOCONAZOLE 200 MG TABLET10369 KETOCONAZOLE 200 MG TABLET10370 KETOROLAC 30 MG/ML INJECTION CARTRIDGE10370 KETOROLAC 30 MG/ML INJECTION CARTRIDGE10371 KETOROLAC 10 MG TABLET10372 LABETALOL 5 MG/ML INTRAVENOUS SOLUTION10373 LABETALOL 100 MG TABLET

10373 LABETALOL 100 MG TABLET10374 LABETALOL 200 MG TABLET10380 AMMONIUM LACTATE 12 % LOTION10390 LEUPROLIDE 11.25 MG INTRAMUSCULAR KIT10391 LEUPROLIDE 15 MG INTRAMUSCULAR KIT10401 LEVONORGESTREL-ETHINYL ESTRADIOL 0.15 MG-30 MCG TABLET10403 LEVOTHYROXINE 88 MCG TABLET10403 LEVOTHYROXINE 88 MCG TABLET10404 LEVOTHYROXINE 112 MCG TABLET10404 LEVOTHYROXINE 112 MCG TABLET10405 LEVOTHYROXINE 137 MCG TABLET10427 LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJECTION SOLUTION10427 LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJECTION SOLUTION10427 LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJECTION SOLUTION10430 LIDOCAINE-EPINEPHRINE 2 %-1:100,000 INJECTION SOLUTION10431 LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION10441 METHYL SALICYLATE-MENTHOL TOPICAL OINTMENT10442 LIOTHYRONINE 10 MCG/ML INTRAVENOUS SOLUTION10443 LIOTHYRONINE 5 MCG TABLET10449 LISINOPRIL 10 MG TABLET10450 LISINOPRIL 40 MG TABLET10451 LISINOPRIL 5 MG TABLET10454 LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE10455 LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE10455 LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE10459 LOMUSTINE 10 MG CAPSULE10460 LOMUSTINE 100 MG CAPSULE10461 LOMUSTINE 40 MG CAPSULE10466 LORATADINE 10 MG TABLET10466 LORATADINE 10 MG TABLET10466 LORATADINE 10 MG TABLET10467 LORAZEPAM 2 MG/ML INJECTION SOLUTION10467 LORAZEPAM 2 MG/ML INJECTION SOLUTION10467 LORAZEPAM 2 MG/ML INJECTION SOLUTION10468 LORAZEPAM 4 MG/ML INJECTION SOLUTION10469 LOVASTATIN 10 MG TABLET10470 LOVASTATIN 20 MG TABLET10475 LYMPHOCYTE,ANTI-THYMO IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS10478 MAFENIDE 85 MG/G TOPICAL CREAM10478 MAFENIDE 85 MG/G TOPICAL CREAM10478 MAFENIDE 85 MG/G TOPICAL CREAM10491 MAGNESIUM OXIDE 400 MG TABLET10491 MAGNESIUM OXIDE 400 MG TABLET10491 MAGNESIUM OXIDE 400 MG TABLET10502 MALATHION 0.5 % LOTION10512 MEASLES,MUMPS&RUBELLA VACCINE LIVE(PF) 1,000-12,500TCID50/0.5 ML SUB-Q10515 MECHLORETHAMINE 10 MG SOLUTION FOR INJECTION10518 MEDIUM CHAIN TRIGLYCERIDES 7.7 KCAL/ML ORAL OIL10521 MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION10521 MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION10522 MELPHALAN 50 MG INTRAVENOUS SOLUTION10523 MELPHALAN 2 MG TABLET10531 MERCAPTOPURINE 50 MG TABLET10531 MERCAPTOPURINE 50 MG TABLET10531 MERCAPTOPURINE 50 MG TABLET10531 MERCAPTOPURINE 50 MG TABLET10533 MESALAMINE ER 250 MG CAPSULE,EXTENDED RELEASE

10534 MESALAMINE 400 MG TABLET,DELAYED RELEASE10535 MESALAMINE 4 GRAM/60 ML ENEMA10537 MESNA 100 MG/ML INTRAVENOUS SOLUTION10544 METFORMIN 500 MG TABLET10546 METHADONE 10 MG/ML INJECTION SOLUTION10552 METHIMAZOLE 10 MG TABLET10553 METHIMAZOLE 5 MG TABLET10564 METHSUXIMIDE 300 MG CAPSULE10571 METHYLERGONOVINE 0.2 MG/ML (1 ML) INJECTION SOLUTION10572 METHYLERGONOVINE 0.2 MG TABLET10572 METHYLERGONOVINE 0.2 MG TABLET10572 METHYLERGONOVINE 0.2 MG TABLET10573 METHYLPREDNISOLONE 2 MG TABLET10575 METHYLPREDNISOLONE 32 MG TABLET10577 METHYLPREDNISOLONE SODIUM SUCC 1,000 MG INTRAVENOUS SOLUTION10578 METHYLPREDNISOLONE SODIUM SUCC 125 MG SOLUTION FOR INJECTION10580 METHYLPREDNISOLONE SODIUM SUCC 40 MG SOLUTION FOR INJECTION10581 METHYLPREDNISOLONE SODIUM SUCC 500 MG INTRAVENOUS SOLUTION10587 METOLAZONE 2.5 MG TABLET10588 METOLAZONE 5 MG TABLET10589 METOPROLOL TARTRATE 100 MG-HYDROCHLOROTHIAZIDE 25 MG TABLET10592 METRONIDAZOLE 0.75 % VAGINAL GEL10595 MEXILETINE 150 MG CAPSULE10596 MEXILETINE 200 MG CAPSULE10597 MEXILETINE 250 MG CAPSULE10603 MICONAZOLE NITRATE 100 MG VAGINAL SUPPOSITORY10606 MICROFIBRILLAR COLLAGEN HEMOSTAT POWDER10608 MIDAZOLAM 5 MG/ML INJECTION SOLUTION10608 MIDAZOLAM 5 MG/ML INJECTION SOLUTION10609 MIDODRINE 2.5 MG TABLET10610 MIDODRINE 5 MG TABLET10612 MINOCYCLINE 100 MG INTRAVENOUS SOLUTION10628 MISOPROSTOL 100 MCG TABLET10628 MISOPROSTOL 100 MCG TABLET10629 MISOPROSTOL 200 MCG TABLET10629 MISOPROSTOL 200 MCG TABLET10629 MISOPROSTOL 200 MCG TABLET10632 MITOMYCIN 5 MG INTRAVENOUS SOLUTION10633 MITOTANE 500 MG TABLET10646 MOMETASONE 0.1 % TOPICAL CREAM10648 MOMETASONE 0.1 % TOPICAL OINTMENT10655 MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION10660 MVI, ADULT NO.1 WITH VIT K 3,300 UNIT-150 MCG/10 ML INTRAVENOUS SOLN10662 THERAPEUTIC MULTIVITAMIN ORAL LIQUID10674 MUPIROCIN 2 % TOPICAL OINTMENT10685 NALTREXONE 50 MG TABLET10685 NALTREXONE 50 MG TABLET10691 NAPROXEN 125 MG/5 ML ORAL SUSPENSION10691 NAPROXEN 125 MG/5 ML ORAL SUSPENSION10708 NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG/ML-10,000 UNIT/ML-0.1% EYE DROPS10712 NICARDIPINE 20 MG CAPSULE10713 NICARDIPINE 30 MG CAPSULE10717 NICOTINE (POLACRILEX) 2 MG GUM10717 NICOTINE (POLACRILEX) 2 MG GUM10720 NIFEDIPINE ER 60 MG TABLET,EXTENDED RELEASE10722 NIMODIPINE 30 MG CAPSULE10723 NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION

10724 NITROFURANTOIN MONOHYDRATE/MACROCRYSTALS 100 MG CAPSULE10726 NITROGLYCERIN 100 MG/250 ML (400 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS10726 NITROGLYCERIN 100 MG/250 ML (400 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS10727 NIZATIDINE 150 MG CAPSULE10734 NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION10736 NORETHINDRONE-ETH. ESTRADIOL-IRON 1.5 MG-30 MCG TABLET10738 NORETHINDRONE-E.ESTRADIOL TRIPHASIC 0.5 MG/0.75 MG/1 MG-35 MCG TABLE10742 NORETHINDRONE-ETHINYL ESTRADIOL 1 MG-35 MCG TABLET10744 NORETHINDRONE-MESTRANOL 1 MG-50 MCG TABLET10747 NORETHINDRONE ACETATE 5 MG TABLET10749 NORGESTIMATE 0.25 MG-ETHINYL ESTRADIOL 35 MCG TABLET10752 NORGESTREL-ETHINYL ESTRADIOL 0.3 MG-30 MCG TABLET10753 NORGESTREL-ETHINYL ESTRADIOL 0.5 MG-50 MCG TABLET10762 ECHINACEA-GOLDEN SEAL CAPSULE10770 OFLOXACIN 200 MG TABLET10773 OLSALAZINE 250 MG CAPSULE10778 ONDANSETRON HCL 4 MG TABLET10779 ONDANSETRON HCL 8 MG TABLET10779 ONDANSETRON HCL 8 MG TABLET10780 BALANCED SALT SOLN NON-SURG #3 EYE10781 BALANCED SALT IRRIGATION INTRAOCULAR SOLUTION COMBINATION NO.210781 BALANCED SALT IRRIGATION INTRAOCULAR SOLUTION COMBINATION NO.210803 OXANDROLONE 2.5 MG TABLET10810 OXYBUTYNIN CHLORIDE 5 MG/5 ML SYRUP10812 OXYCODONE 20 MG/ML ORAL CONCENTRATE10813 OXYCODONE 5 MG/5 ML ORAL SOLUTION10813 OXYCODONE 5 MG/5 ML ORAL SOLUTION10814 OXYCODONE 5 MG TABLET10814 OXYCODONE 5 MG TABLET10821 OXYMETHOLONE 50 MG TABLET10839 PEG 3350-ELECTROLYTES 236 G-22.74 G-6.74 G-5.86 G ORAL SOLUTION10854 PAROMOMYCIN 250 MG CAPSULE10855 PAROXETINE 20 MG TABLET10855 PAROXETINE 20 MG TABLET10865 MULTIVITAMIN ORAL LIQUID10872 PEDIATRIC MULTIVITAMIN-FL 0.25 MG/ML ORAL DROPS10873 PEDIATRIC MULTIVITAMIN-FL 0.5 MG/ML ORAL DROPS10876 PEDIATRIC MULTIVIT WITH IRON &OTHER MINERALS CHEWABLE TABLET10876 PEDIATRIC MULTIVIT WITH IRON &OTHER MINERALS CHEWABLE TABLET10877 PEDIATRIC MULTIVITAMIN-IRON CHEWABLE TABLET10887 PEGADEMASE BOVINE 250 UNIT/ML INTRAMUSCULAR SOLUTION10894 PENICILLAMINE 250 MG CAPSULE10897 PENICILLIN G BENZATHINE 600,000 UNIT/ML INTRAMUSCULAR SYRINGE10904 PENICILLIN G PROCAINE 600,000 UNIT/ML INTRAMUSCULAR SYRINGE10908 PENTAZOCINE-NALOXONE 50 MG-0.5 MG TABLET10911 PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE10917 PERMETHRIN 5 % TOPICAL CREAM10918 PERMETHRIN 1 % TOPICAL LIQUID10918 PERMETHRIN 1 % TOPICAL LIQUID10945 PHENOXYBENZAMINE 10 MG CAPSULE10947 PHENTOLAMINE 5 MG INJECTION SOLUTION10964 PHENYLEPHRINE 0.25 % RECTAL SUPPOSITORY11018 PHENYTOIN 50 MG CHEWABLE TABLET11019 PHENYTOIN SODIUM EXTENDED 30 MG CAPSULE11021 BERACTANT 25 MG/ML IN 0.9 % SODIUM CHLORIDE INTRATRACHEAL SUSPENSION11021 BERACTANT 25 MG/ML IN 0.9 % SODIUM CHLORIDE INTRATRACHEAL SUSPENSION11023 PHYTONADIONE 10 MG/ML INJECTION SOLUTION

11024 PHYTONADIONE 5 MG TABLET11024 PHYTONADIONE 5 MG TABLET11029 PILOCARPINE 4 % EYE GEL11031 PIMOZIDE 2 MG TABLET11037 PNEUMOCOCCAL 23-VALPS VACCINE 25 MCG/0.5 ML INJECTION11042 POLIOVIRUS VACCINE 40 UNIT-8 UNIT-32 UNIT/0.5 ML INJECTION SYRINGE11050 POLYSACCHARIDE IRON COMPLEX 150 MG IRON CAPSULE11050 POLYSACCHARIDE IRON COMPLEX 150 MG IRON CAPSULE11057 POT & SOD CITRATE-CITRIC ACID 550 MG-500 MG-334 MG/5 ML ORAL SOLUTION11067 SODIUM DI- AND MONOPHOSPHATE-K PHOSPHATE MONO 250 MG TABLET11071 POTASSIUM BICARB & CHLORIDE 25 MEQ EFFERVESCENT TABLET11074 POTASSIUM CHLORIDE 10 MEQ/100 ML INTRAVENOUS PIGGYBACK11077 POTASSIUM CHLORIDE 20 MEQ/50 ML INTRAVENOUS PIGGYBACK11081 POTASSIUM CHLORIDE 20 MEQ/L IN 0.9 % SODIUM CHLORIDE INTRAVENOUS11082 POTASSIUM CHLORIDE 40 MEQ/L IN 0.9 % SODIUM CHLORIDE INTRAVENOUS11083 POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE11087 POTASSIUM PHOSPHATE, MONOBASIC 500 MG SOLUBLE TABLET11099 PRAMOXINE 1 % LOTION11099 PRAMOXINE 1 % LOTION11100 PRAMOXINE-MINERAL OIL-ZINC 1 %-12.5 % RECTAL OINTMENT11106 HYDROCORTISONE-PRAMOXINE 1 %-1 % LOTION11108 HYDROCORTISONE-PRAMOXINE 1 %-1 % TOPICAL OINTMENT11110 PRAVASTATIN 10 MG TABLET11111 PRAVASTATIN 20 MG TABLET11113 PRAZIQUANTEL 600 MG TABLET11129 PRIMIDONE 50 MG TABLET11136 PROCARBAZINE 50 MG CAPSULE11138 PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY11143 PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY11144 PROMETHAZINE 25 MG RECTAL SUPPOSITORY11144 PROMETHAZINE 25 MG RECTAL SUPPOSITORY11146 PROPAFENONE 150 MG TABLET11150 PROPOFOL 10 MG/ML INTRAVENOUS EMULSION11150 PROPOFOL 10 MG/ML INTRAVENOUS EMULSION11150 PROPOFOL 10 MG/ML INTRAVENOUS EMULSION11163 PROTRIPTYLINE 10 MG TABLET11164 PROTRIPTYLINE 5 MG TABLET11237 PYRIDOSTIGMINE BROMIDE 5 MG/ML INJECTION SOLUTION11238 PYRIDOSTIGMINE BROMIDE 60 MG/5 ML SYRUP11239 PYRIDOSTIGMINE BROMIDE 60 MG TABLET11240 PYRIDOSTIGMINE BROMIDE ER 180 MG TABLET,EXTENDED RELEASE11246 PYRIMETHAMINE 25 MG TABLET11257 RABIES VACCINE,HUMAN DIPLOID (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION11261 RAMIPRIL 5 MG CAPSULE11265 RANITIDINE 150 MG TABLET11266 RANITIDINE 300 MG TABLET11285 RIBAVIRIN 6 GRAM SOLUTION FOR INHALATION11286 RIBAVIRIN 200 MG CAPSULE11288 RIBOFLAVIN 100 MG TABLET11290 RIFABUTIN 150 MG CAPSULE11291 RIFAMPIN 600 MG INTRAVENOUS SOLUTION11292 RIFAMPIN 150 MG CAPSULE11293 RIFAMPIN 300 MG CAPSULE11293 RIFAMPIN 300 MG CAPSULE11318 SALICYLIC ACID 40 % ADHESIVE PATCH11323 SALICYLIC ACID 17 % TOPICAL LIQUID11327 SALICYLIC ACID-SULFUR 2 %-2 % SHAMPOO

11338 SARGRAMOSTIM 250 MCG SOLUTION FOR INJECTION11349 SENNOSIDES 8.6 MG TABLET11351 SERTRALINE 50 MG TABLET11359 SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK11364 SIMVASTATIN 10 MG TABLET11364 SIMVASTATIN 10 MG TABLET11364 SIMVASTATIN 10 MG TABLET11365 SIMVASTATIN 20 MG TABLET11366 SIMVASTATIN 40 MG TABLET11367 SIMVASTATIN 5 MG TABLET11371 WHITE PETROLATUM-MINERAL OIL TOPICAL CREAM11378 ZINC OXIDE-PETROLATUM 20 %-51 % TOPICAL PASTE11395 SODIUM PHOSPHATES 19 GRAM-7 GRAM/118 ML ENEMA11403 SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION11403 SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION11403 SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION11417 SOMATROPIN 10 MG/2 ML (5 MG/ML) SUBCUTANEOUS SOLN11418 SOMATROPIN 5 MG (15 UNIT) SOLUTION FOR INJECTION11421 SOTALOL 80 MG TABLET11421 SOTALOL 80 MG TABLET11425 SPIRONOLACTONE 100 MG TABLET11426 SPIRONOLACTONE 50 MG TABLET11441 SUCRALFATE 100 MG/ML ORAL SUSPENSION11442 SUCRALFATE 1 GRAM TABLET11442 SUCRALFATE 1 GRAM TABLET11443 SUFENTANIL CITRATE 50 MCG/ML INTRAVENOUS SOLUTION11443 SUFENTANIL CITRATE 50 MCG/ML INTRAVENOUS SOLUTION11448 SULFACETAMIDE-PREDNISOLONE 10 %-0.2 % EYE OINTMENT11452 SULFACETAMIDE 10 %-PREDNISOLONE 0.2 % EYE DROPS,SUSPENSION11452 SULFACETAMIDE 10 %-PREDNISOLONE 0.2 % EYE DROPS,SUSPENSION11468 SUNSCREEN LOTION11468 SUNSCREEN LOTION11498 TAMOXIFEN 20 MG TABLET11498 TAMOXIFEN 20 MG TABLET11501 TENIPOSIDE 50 MG/5 ML INTRAVENOUS SOLUTION11507 TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION11508 TERBUTALINE 2.5 MG TABLET11509 TERBUTALINE 5 MG TABLET11510 TERCONAZOLE 0.4 % VAGINAL CREAM11512 TERCONAZOLE 80 MG VAGINAL SUPPOSITORY11517 TETRACAINE HCL (PF) 1 % (10 MG/ML) INJECTION SOLUTION11518 TETRACAINE HCL (PF) 20 MG SOLUTION FOR INJECTION11523 TETRAHYDROZOLINE-ZINC 0.05 %-0.25 % EYE DROPS11555 TICARCILLIN-CLAVULANATE 3.1 G INTRAVENOUS SOLUTION11556 TICARCILLIN-CLAVULANATE 31 G INTRAVENOUS SOLUTION11559 TICLOPIDINE 250 MG TABLET11561 TIMOLOL MALEATE 0.25 % EYE DROPS11562 TIMOLOL MALEATE 0.5 % EYE DROPS11565 TOBRAMYCIN 1.2 G SOLUTION FOR INJECTION11566 TOBRAMYCIN-DEXAMETHASONE 0.3 %-0.1 % EYE OINTMENT11567 TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION11574 TRANYLCYPROMINE 10 MG TABLET11576 TRETINOIN 0.025 % TOPICAL CREAM11576 TRETINOIN 0.025 % TOPICAL CREAM11577 TRETINOIN 0.05 % TOPICAL CREAM11578 TRETINOIN 0.1 % TOPICAL CREAM11579 TRETINOIN 0.01 % TOPICAL GEL

11579 TRETINOIN 0.01 % TOPICAL GEL11580 TRETINOIN 0.025 % TOPICAL GEL11580 TRETINOIN 0.025 % TOPICAL GEL11584 TRIAMCINOLONE ACETONIDE 10 MG/ML SUSPENSION FOR INJECTION11586 TRIAMCINOLONE HEXACETONIDE 20 MG/ML SUSPENSION FOR INJECTION11586 TRIAMCINOLONE HEXACETONIDE 20 MG/ML SUSPENSION FOR INJECTION11588 TRIAMTERENE 50 MG CAPSULE11595 TRIFLURIDINE 1 % EYE DROPS11608 TROMETHAMINE 36 MG/ML (0.3 M) INTRAVENOUS SOLUTION11624 URSODIOL 300 MG CAPSULE11627 VANCOMYCIN 10 GRAM INTRAVENOUS SOLUTION11628 VANCOMYCIN 125 MG CAPSULE11629 VANCOMYCIN 250 MG CAPSULE11632 VANCOMYCIN 500 MG/100 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK11634 VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION11635 VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION11639 VERAPAMIL ER (SR) 120 MG TABLET,EXTENDED RELEASE11640 VERAPAMIL ER (SR) 180 MG TABLET,EXTENDED RELEASE11641 VITAMIN A PALMITATE 50,000 UNIT/ML INTRAMUSCULAR SOLUTION11648 VITAMIN E 50 UNIT/ML ORAL DROPS11648 VITAMIN E 50 UNIT/ML ORAL DROPS11664 WARFARIN 1 MG TABLET11664 WARFARIN 1 MG TABLET11671 WATER FOR INJECTION, STERILE INJECTION SOLUTION11671 WATER FOR INJECTION, STERILE INJECTION SOLUTION11671 WATER FOR INJECTION, STERILE INJECTION SOLUTION11691 ZIDOVUDINE 10 MG/ML INTRAVENOUS SOLUTION11692 ZIDOVUDINE 100 MG CAPSULE11693 ZIDOVUDINE 10 MG/ML SYRUP11700 ZOLPIDEM 10 MG TABLET11701 ZOLPIDEM 5 MG TABLET11931 HAEMOPHILUS B POLYSACCHARID CONJ-TETANUS TOX(PF) 10 MCG/0.5 ML IM SO12024 MECLIZINE 12.5 MG TABLET12025 MECLIZINE 25 MG TABLET12025 MECLIZINE 25 MG TABLET12097 THEOPHYLLINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR12098 THEOPHYLLINE ER 300 MG TABLET,EXTENDED RELEASE,12 HR12197 QUINIDINE GLUCONATE ER 324 MG TABLET,EXTENDED RELEASE12203 VENLAFAXINE 25 MG TABLET12206 VENLAFAXINE 75 MG TABLET12211 DORNASE ALFA 1 MG/ML SOLUTION FOR INHALATION12244 CALCIPOTRIENE 0.005 % TOPICAL OINTMENT12329 CARBIDOPA ER 25 MG-LEVODOPA 100 MG TABLET,EXTENDED RELEASE12370 NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION12411 FLUVASTATIN 20 MG CAPSULE12411 FLUVASTATIN 20 MG CAPSULE12491 ESTRADIOL 0.5 MG TABLET12519 PEGASPARGASE 750 UNIT/ML INJECTION SOLUTION12552 GRANISETRON 1 MG/ML (1 ML) INTRAVENOUS SOLUTION12556 DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID12562 CAMPHOR-PHENOL 10.8 %-4.7 % TOPICAL SOLUTION12580 IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION12587 PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION12639 COENZYME Q10 60 MG TABLET12666 DOXEPIN 5 % TOPICAL CREAM12666 DOXEPIN 5 % TOPICAL CREAM12683 FLEXIBLE COLLODION (BULK) LIQUID

12724 TERBINAFINE 250 MG TABLET12724 TERBINAFINE 250 MG TABLET12735 FAMOTIDINE (PF) 20 MG/50 ML IN 0.9 % NACL (ISO) INTRAVENOUS PIGGYBACK12739 FACTOR IX COMPLEX 700 (+/-) UNIT INTRAVENOUS SOLUTION12803 PILOCARPINE 5 MG TABLET12858 CADEXOMER IODINE 0.9 % TOPICAL GEL12885 CLARITHROMYCIN 125 MG/5 ML ORAL SUSPENSION12886 CLARITHROMYCIN 250 MG/5 ML ORAL SUSPENSION12933 TACROLIMUS 1 MG CAPSULE12933 TACROLIMUS 1 MG CAPSULE12934 TACROLIMUS 5 MG CAPSULE12935 TACROLIMUS 5 MG/ML INTRAVENOUS SOLUTION13089 LISINOPRIL 2.5 MG TABLET13132 VALACYCLOVIR 1 G TABLET13133 VALACYCLOVIR 500 MG TABLET13133 VALACYCLOVIR 500 MG TABLET13135 NAPROXEN SODIUM 220 MG TABLET13212 IMIGLUCERASE 200 UNIT INTRAVENOUS SOLUTION13257 COENZYME Q10 30 MG CAPSULE13295 SODIUM CHLORIDE POWDER13308 STAVUDINE 15 MG CAPSULE13310 STAVUDINE 30 MG CAPSULE13358 FAMCICLOVIR 500 MG TABLET13369 SUMATRIPTAN 100 MG TABLET13444 NEFAZODONE 100 MG TABLET13446 NEFAZODONE 200 MG TABLET13506 DESMOPRESSIN 150 MCG/SPRAY (0.1 ML) NASAL SPRAY13577 FLUCONAZOLE 150 MG TABLET13651 MICONAZOLE NITRATE 2 % TOPICAL OINTMENT13668 THEOPHYLLINE ER 100 MG TABLET,EXTENDED RELEASE,12 HR13691 LEUPROLIDE 3.75 MG INTRAMUSCULAR SYRINGE KIT13712 SODIUM PHOSPHATE MONOBASIC POWDER13713 GLUTAMINE POWDER13713 GLUTAMINE POWDER13818 BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINTMENT13818 BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINTMENT13980 ACITRETIN 10 MG CAPSULE13981 LAMOTRIGINE 25 MG TABLET13982 LAMOTRIGINE 100 MG TABLET13983 LAMOTRIGINE 200 MG TABLET14006 CEFUROXIME AXETIL 125 MG/5 ML ORAL SUSPENSION14087 ACETAMINOPHEN 300 MG-CODEINE 30 MG TABLET14100 DILTIAZEM ER 60 MG CAPSULE,EXTENDED RELEASE 12 HR14101 DILTIAZEM ER 90 MG CAPSULE,EXTENDED RELEASE 12 HR14132 KETOCONAZOLE 2 % SHAMPOO14135 LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS KIT14196 CONJ ESTROGEN-MEDROXYPROGESTERONE 0.625 MG-2.5 MG TABLET14203 VINORELBINE 10 MG/ML INTRAVENOUS SOLUTION14208 LEUCINE POWDER14210 VALINE POWDER14211 ISOLEUCINE POWDER14211 ISOLEUCINE POWDER14233 FLUCONAZOLE 40 MG/ML ORAL SUSPENSION14266 LAMOTRIGINE 150 MG TABLET14266 LAMOTRIGINE 150 MG TABLET14369 ABCIXIMAB 10 MG/5 ML INTRAVENOUS SOLUTION14471 DORZOLAMIDE 2 % EYE DROPS

14550 TERAZOSIN 1 MG CAPSULE14595 ARGININE (L-ARGININE) (BULK) 100 % POWDER14595 ARGININE (L-ARGININE) (BULK) 100 % POWDER14595 ARGININE (L-ARGININE) (BULK) 100 % POWDER14596 BIOTIN (BULK) 100 % POWDER14628 INDOMETHACIN ER 75 MG CAPSULE,EXTENDED RELEASE14632 TRAMADOL 50 MG TABLET14634 CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION14639 QUINIDINE SULFATE ER 300 MG TABLET,EXTENDED RELEASE14643 EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION14678 TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML INTRAMUSCULAR SYRINGE14719 METFORMIN 850 MG TABLET14720 GRANISETRON 1 MG TABLET14757 VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP14792 TIZANIDINE 2 MG TABLET14793 TIZANIDINE 4 MG TABLET14823 LOSARTAN 25 MG TABLET14824 LOSARTAN 50 MG TABLET14824 LOSARTAN 50 MG TABLET14845 DOPAMINE 400 MG/250 ML (1,600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SO14845 DOPAMINE 400 MG/250 ML (1,600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SO14846 DOPAMINE 800 MG/250 ML (3,200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SO14846 DOPAMINE 800 MG/250 ML (3,200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SO14847 DOXYLAMINE SUCCINATE 25 MG TABLET14869 LIDOCAINE (PF) 8 MG/ML (0.8 %) IN 5 % DEXTROSE IV14869 LIDOCAINE (PF) 8 MG/ML (0.8 %) IN 5 % DEXTROSE IV14870 LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION14953 ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION14963 HYDROCODONE 7.5 MG-ACETAMINOPHEN 500 MG TABLET14979 WATER FOR INJECT BACTERIOSTAT INJECTION SOLUTION15065 FAMOTIDINE 10 MG TABLET15113 MYCOPHENOLATE MOFETIL 250 MG CAPSULE15113 MYCOPHENOLATE MOFETIL 250 MG CAPSULE15114 TIMOLOL 0.25 % EYE DROPS15115 TIMOLOL 0.5 % EYE DROPS15156 DEXRAZOXANE 250 MG INTRAVENOUS SOLUTION15157 DEXRAZOXANE 500 MG INTRAVENOUS SOLUTION15168 SENNOSIDES 8.8 MG/5 ML SYRUP15200 STARCH 51 % RECTAL SUPPOSITORY15209 CASTOR OIL15255 PYRANTEL PAMOATE 50 MG/ML ORAL SUSPENSION15255 PYRANTEL PAMOATE 50 MG/ML ORAL SUSPENSION15327 SUMATRIPTAN 25 MG TABLET15328 SUMATRIPTAN 50 MG TABLET15330 ADENOSINE (DIAGNOSTIC) 3 MG/ML INTRAVENOUS SOLUTION15340 DICLOFENAC SODIUM 50 MG TABLET,DELAYED RELEASE15341 DICLOFENAC SODIUM 75 MG TABLET,DELAYED RELEASE15342 IMMUNE GLOBULIN (HUMAN) (IGG) 15 %-18 % RANGE INTRAMUSCULAR SOLUTIO15349 CETIRIZINE 5 MG TABLET15349 CETIRIZINE 5 MG TABLET15485 FLAXSEED OIL 1,000 MG CAPSULE15485 FLAXSEED OIL 1,000 MG CAPSULE15661 ALENDRONATE 10 MG TABLET15706 SODIUM CITRATE-CITRIC ACID 500 MG-334 MG/5 ML ORAL SOLUTION15706 SODIUM CITRATE-CITRIC ACID 500 MG-334 MG/5 ML ORAL SOLUTION15738 CALCITONIN (SALMON) 200 UNIT/ACTUATION NASAL SPRAY15747 CARVEDILOL 6.25 MG TABLET

15748 CARVEDILOL 25 MG TABLET15757 AZELAIC ACID 20 % TOPICAL CREAM15757 AZELAIC ACID 20 % TOPICAL CREAM15796 AZITHROMYCIN 100 MG/5 ML ORAL SUSPENSION15797 AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION15847 HEPARIN (PORCINE) (PF) 1,000 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE IV15852 MORPHINE (PF) 1 MG/ML INJECTION SOLUTION15858 NITROGLYCERIN 25 MG/250 ML (100 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS15858 NITROGLYCERIN 25 MG/250 ML (100 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS15859 NITROGLYCERIN 50 MG/250 ML (200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS15880 LAMIVUDINE 150 MG TABLET15881 LAMIVUDINE 10 MG/ML ORAL SOLUTION15897 EPOPROSTENOL (GLYCINE) 0.5 MG INTRAVENOUS SOLUTION15898 EPOPROSTENOL (GLYCINE) 1.5 MG INTRAVENOUS SOLUTION15950 SODIUM HYPOCHLORITE 0.25 % SOLUTION15956 LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200,000 INJECTION SOLUTION15996 METHADONE 10 MG/ML ORAL CONCENTRATE16005 TRETINOIN (CHEMOTHERAPY) 10 MG CAPSULE16005 TRETINOIN (CHEMOTHERAPY) 10 MG CAPSULE16006 SAQUINAVIR MESYLATE 200 MG CAPSULE16032 CONJ ESTROGEN-MEDROXYPROGESTERONE 0.625 MG(14)/0.625 MG-5MG(14) TAB16050 GLUCOSE 4 GRAM CHEWABLE TABLET16050 GLUCOSE 4 GRAM CHEWABLE TABLET16052 DESMOPRESSIN 0.1 MG TABLET16053 DESMOPRESSIN 0.2 MG TABLET16070 IPRATROPIUM BROMIDE 0.03 % NASAL SPRAY16071 IPRATROPIUM BROMIDE 0.06 % NASAL SPRAY16081 FAMCICLOVIR 250 MG TABLET16168 CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION16168 CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION16218 CALCITRIOL 1 MCG/ML ORAL SOLUTION16299 DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM16299 DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM16356 GLIMEPIRIDE 2 MG TABLET16369 CEFEPIME 1 GRAM SOLUTION FOR INJECTION16371 CEFEPIME 2 GRAM SOLUTION FOR INJECTION16439 RITONAVIR 100 MG CAPSULE16632 PAROXETINE 10 MG TABLET16644 INDINAVIR 200 MG CAPSULE16645 INDINAVIR 400 MG CAPSULE16956 RANITIDINE 75 MG TABLET16956 RANITIDINE 75 MG TABLET16956 RANITIDINE 75 MG TABLET16958 MUPIROCIN 2 % NASAL OINTMENT16983 ADAPALENE 0.1 % TOPICAL GEL17012 BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION17040 CANTHARIDIN (BULK) POWDER17040 CANTHARIDIN (BULK) POWDER17121 GEMCITABINE 200 MG INTRAVENOUS SOLUTION17122 GEMCITABINE 1 GRAM INTRAVENOUS SOLUTION17213 INTERFERON BETA-1A 30 MCG INTRAMUSCULAR KIT17285 TOPOTECAN 4 MG INTRAVENOUS SOLUTION17285 TOPOTECAN 4 MG INTRAVENOUS SOLUTION17377 RISPERIDONE 1 MG/ML ORAL SOLUTION17378 CIDOFOVIR 75 MG/ML INTRAVENOUS SOLUTION17379 MEROPENEM 500 MG INTRAVENOUS SOLUTION17380 MEROPENEM 1 GRAM INTRAVENOUS SOLUTION

17403 NEVIRAPINE 200 MG TABLET17403 NEVIRAPINE 200 MG TABLET17405 INSULIN LISPRO 100 UNIT/ML SUBCUTANEOUS SOLUTION17451 ETOPOSIDE PHOSPHATE 100 MG INTRAVENOUS SOLUTION17463 FLUOXETINE 20 MG TABLET17466 MIRTAZAPINE 15 MG TABLET17466 MIRTAZAPINE 15 MG TABLET17482 AZITHROMYCIN 500 MG TABLET17482 AZITHROMYCIN 500 MG TABLET17500 CAFFEINE (BULK) 100 % POWDER17600 SODIUM PHENYLBUTYRATE 500 MG TABLET17601 SODIUM PHENYLBUTYRATE 0.94 GRAM/GRAM ORAL POWDER17687 PEDIATRIC MULTIVITAMIN CHEWABLE TABLET17687 PEDIATRIC MULTIVITAMIN CHEWABLE TABLET17801 ACETIC ACID 2 % EAR SOLUTION17837 ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER17837 ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER17847 OXYCODONE-ACETAMINOPHEN 5 MG-325 MG/5 ML ORAL SOLUTION17847 OXYCODONE-ACETAMINOPHEN 5 MG-325 MG/5 ML ORAL SOLUTION17936 OLANZAPINE 5 MG TABLET17936 OLANZAPINE 5 MG TABLET17960 ZAFIRLUKAST 20 MG TABLET18192 ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION18192 ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION18225 SODIUM CHLORIDE 0.65 % NASAL DROPS18225 SODIUM CHLORIDE 0.65 % NASAL DROPS18260 TRACE ELEMENTS CR-CU-MN-SE-ZN 4-400-100-20 MCG-1000 MCG/ML IV SOLUTIO18266 TRACE ELEMENT PEDI CR-CU-MN-ZN 1 MCG-0.1 MG-25 MCG-1 MG/ML INTRAVEN18293 TORSEMIDE 20 MG TABLET18294 TORSEMIDE 100 MG TABLET18302 PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION18303 PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION18304 PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION18307 GABAPENTIN 400 MG CAPSULE18308 GABAPENTIN 300 MG CAPSULE18309 GABAPENTIN 100 MG CAPSULE18309 GABAPENTIN 100 MG CAPSULE18310 RISPERIDONE 4 MG TABLET18311 RISPERIDONE 2 MG TABLET18313 RISPERIDONE 1 MG TABLET18318 SOMATROPIN 10 MG SUBCUTANEOUS SOLUTION18385 BUPROPION HCL SR 100 MG TABLET,SUSTAINED-RELEASE18385 BUPROPION HCL SR 100 MG TABLET,SUSTAINED-RELEASE18386 BUPROPION HCL SR 150 MG TABLET,SUSTAINED-RELEASE18398 REMIFENTANIL 1 MG INTRAVENOUS SOLUTION18400 REMIFENTANIL 2 MG INTRAVENOUS SOLUTION18551 CARVEDILOL 3.125 MG TABLET18621 LATANOPROST 0.005 % EYE DROPS18787 DONEPEZIL 10 MG TABLET18848 CHOLINE & MAGNESIUM SALICYLATE 500 MG/5 ML ORAL LIQUID18877 ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION18908 NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION18918 LEVOFLOXACIN 250 MG TABLET18919 LEVOFLOXACIN 500 MG TABLET18920 TOPIRAMATE 25 MG TABLET18920 TOPIRAMATE 25 MG TABLET18921 TOPIRAMATE 200 MG TABLET

18922 TOPIRAMATE 100 MG TABLET18925 LEVOFLOXACIN 25 MG/ML INTRAVENOUS SOLUTION19153 CITRULLINE POWDER19176 ATORVASTATIN 10 MG TABLET19176 ATORVASTATIN 10 MG TABLET19177 ATORVASTATIN 40 MG TABLET19177 ATORVASTATIN 40 MG TABLET19178 ATORVASTATIN 20 MG TABLET19179 AZELASTINE 137 MCG NASAL SPRAY AEROSOL19226 CABERGOLINE 0.5 MG TABLET19254 ASPIRIN-SOD BICARB-CITRIC ACID 324 MG EFFERVESCENT TABLET19333 CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION19433 WARFARIN 3 MG TABLET19452 OLOPATADINE 0.1 % EYE DROPS19468 TRETINOIN MICROSPHERE 0.1 % TOPICAL GEL19474 ACETAMINOPHEN 300 MG-CODEINE 15 MG TABLET19490 IODINE-SODIUM IODIDE 2 % TOPICAL TINCTURE19490 IODINE-SODIUM IODIDE 2 % TOPICAL TINCTURE19596 DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION19636 PHENYLEPHRINE 10 % EYE DROPS19692 BENZOCAINE 7.5 % MUCOSAL GEL19696 BENZOCAINE 20 % MUCOSAL AEROSOL SPRAY19703 BETAXOLOL 0.25 % EYE DROPS,SUSPENSION19711 CLINDAMYCIN 1 % LOTION19713 DIAZOXIDE 50 MG/ML ORAL SUSPENSION19720 FLUNISOLIDE 25 MCG (0.025 %) NASAL SPRAY19721 FLUOROMETHOLONE 0.1 % EYE OINTMENT19732 HYDROCORTISONE ACETATE 10 % (80 MG) RECTAL FOAM19733 KETOROLAC 0.5 % EYE DROPS19733 KETOROLAC 0.5 % EYE DROPS19736 MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION19741 METRONIDAZOLE 0.75 % TOPICAL GEL19743 NORETHINDRONE (CONTRACEPTIVE) 0.35 MG TABLET19746 OFLOXACIN 0.3 % EYE DROPS19749 PRAMOXINE 1 % TOPICAL FOAM19769 TOBRAMYCIN 0.3 % EYE OINTMENT19776 UREA 20 % TOPICAL CREAM19791 POVIDONE-IODINE 5 % EYE SOLUTION19805 METRONIDAZOLE 0.75 % TOPICAL CREAM19808 TRIAMCINOLONE ACETONIDE 55 MCG NASAL SPRAY AEROSOL19809 CROMOLYN 100 MG/5 ML ORAL SOLUTION19812 COAGULATION FACTOR IX (RECOMB) 250 UNIT INTRAVENOUS KIT19813 COAGULATION FACTOR IX (RECOMB) 500 UNIT INTRAVENOUS KIT19814 COAGULATION FACTOR IX (RECOMB) 1,000 UNIT INTRAVENOUS KIT19880 NEOMYCIN-POLYMYXIN-PRAMOXINE 3.5 MG-10,000 UNIT-10 MG/GRAM TOP CR19880 NEOMYCIN-POLYMYXIN-PRAMOXINE 3.5 MG-10,000 UNIT-10 MG/GRAM TOP CR19882 SERTRALINE 25 MG TABLET19898 INTERFERON ALFA-2B 10 MILLION UNIT/ML INJECTION SOLUTION19928 ITRACONAZOLE 10 MG/ML ORAL SOLUTION20031 HYDROCODONE 10 MG-ACETAMINOPHEN 500 MG TABLET20032 NELFINAVIR 250 MG TABLET20038 SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY20038 SUMATRIPTAN 5 MG/ACTUATION NASAL SPRAY20039 SUMATRIPTAN 20 MG/ACTUATION NASAL SPRAY20039 SUMATRIPTAN 20 MG/ACTUATION NASAL SPRAY20077 MESNA 400 MG TABLET20156 CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION

20472 ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION20472 ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION20566 MELOXICAM 7.5 MG TABLET20615 STAVUDINE 1 MG/ML ORAL SOLUTION20638 LEVONORGESTREL-ETHINYL ESTRADIOL 0.1 MG-20 MCG TABLET20718 IMIQUIMOD 5 % TOPICAL CREAM PACKET20718 IMIQUIMOD 5 % TOPICAL CREAM PACKET20803 AMIFOSTINE CRYSTALLINE 500 MG INTRAVENOUS SOLUTION20887 VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION20920 MORPHINE ER 15 MG TABLET,EXTENDED RELEASE20920 MORPHINE ER 15 MG TABLET,EXTENDED RELEASE20921 MORPHINE ER 30 MG TABLET,EXTENDED RELEASE20921 MORPHINE ER 30 MG TABLET,EXTENDED RELEASE20922 MORPHINE ER 60 MG TABLET,EXTENDED RELEASE20943 AZITHROMYCIN 250 MG TABLET20943 AZITHROMYCIN 250 MG TABLET20943 AZITHROMYCIN 250 MG TABLET20943 AZITHROMYCIN 250 MG TABLET20951 FORMOTEROL FUMARATE 12 MCG CAPSULE WITH INHALATION DEVICE20951 FORMOTEROL FUMARATE 12 MCG CAPSULE WITH INHALATION DEVICE20952 LEVOCARNITINE 330 MG TABLET20954 LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION20969 CALCIUM CARBONATE-VITAMIN D3 1500 MG-200 UNIT TABLET20969 CALCIUM CARBONATE-VITAMIN D3 1500 MG-200 UNIT TABLET20969 CALCIUM CARBONATE-VITAMIN D3 1500 MG-200 UNIT TABLET21044 LEUPROLIDE (3 MONTH) 11.25 MG INTRAMUSCULAR SYRINGE KIT21045 LEUPROLIDE (3 MONTH) 22.5 MG INTRAMUSCULAR SYRINGE KIT21057 OLANZAPINE 2.5 MG TABLET21058 ARTIFICIAL TEAR (HYPROMELLOSE) 0.3 % EYE GEL21061 OXCARBAZEPINE 300 MG TABLET21062 CITALOPRAM 20 MG TABLET21063 AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION21090 HYDROCODONE 10 MG-ACETAMINOPHEN 650 MG TABLET21108 LEUPROLIDE (4 MONTH) 30 MG INTRAMUSCULAR SYRINGE KIT21135 DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY (NON-REFRIGERATED)21157 OXCARBAZEPINE 600 MG TABLET21374 MYCOPHENOLATE MOFETIL 500 MG TABLET21374 MYCOPHENOLATE MOFETIL 500 MG TABLET21382 ZINC SULFATE 110 MG (25 MG ZINC) TABLET21382 ZINC SULFATE 110 MG (25 MG ZINC) TABLET21396 CEFUROXIME AXETIL 250 MG/5 ML ORAL SUSPENSION21396 CEFUROXIME AXETIL 250 MG/5 ML ORAL SUSPENSION21529 FEXOFENADINE 60 MG TABLET21810 LAMIVUDINE-ZIDOVUDINE 150 MG-300 MG TABLET21811 DOLASETRON 100 MG TABLET21812 DOLASETRON 50 MG TABLET21815 DOLASETRON 12.5 MG/0.625 ML INTRAVENOUS SOLUTION21823 QUETIAPINE 25 MG TABLET21824 QUETIAPINE 100 MG TABLET21825 QUETIAPINE 200 MG TABLET21827 TIAGABINE 4 MG TABLET21831 ADAPALENE 0.1 % TOPICAL CREAM21900 AMPHOTERICIN B LIPOSOME 50 MG INTRAVENOUS SUSPENSION21905 MOMETASONE 50 MCG/ACTUATION NASAL SPRAY22120 RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM KIT22142 CLOPIDOGREL 75 MG TABLET22142 CLOPIDOGREL 75 MG TABLET

22142 CLOPIDOGREL 75 MG TABLET22149 RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS22149 RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS22150 NICOTINE 10 MG INHALATION CARTRIDGE22220 BECAPLERMIN 0.01 % TOPICAL GEL22240 TOBRAMYCIN 300 MG/5 ML IN 0.225 % SODIUM CHLORIDE FOR NEBULIZATION22251 MUPIROCIN 2 % TOPICAL CREAM22251 MUPIROCIN 2 % TOPICAL CREAM22257 OFLOXACIN 0.3 % EAR DROPS22289 CEFDINIR 300 MG CAPSULE22290 CEFDINIR 125 MG/5 ML ORAL SUSPENSION22290 CEFDINIR 125 MG/5 ML ORAL SUSPENSION22409 DIPHENHYDRAMINE-ZINC ACETATE 1 %-0.1 % TOPICAL CREAM22456 CALCIUM ACETATE 667 MG TABLET22469 LACTASE 3,000 UNIT TABLET22469 LACTASE 3,000 UNIT TABLET22472 KETOROLAC 15 MG/ML INJECTION SOLUTION22486 NARATRIPTAN 2.5 MG TABLET22509 MONTELUKAST 10 MG TABLET22509 MONTELUKAST 10 MG TABLET22510 MONTELUKAST 5 MG CHEWABLE TABLET22510 MONTELUKAST 5 MG CHEWABLE TABLET22528 SENNOSIDES 25 MG TABLET22560 SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION22646 POTASSIUM CITRATE-CITRIC ACID 1,100 MG-334 MG/5 ML ORAL SOLUTION22660 URSODIOL 250 MG TABLET22660 URSODIOL 250 MG TABLET22661 DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION22661 DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION22709 LOTEPREDNOL ETABONATE 0.2 % EYE DROPS,SUSPENSION22719 PRAMIPEXOLE 0.5 MG TABLET22782 TOLTERODINE 1 MG TABLET22836 SILDENAFIL 25 MG TABLET22838 SILDENAFIL 100 MG TABLET22953 BRINZOLAMIDE 1 % EYE DROPS,SUSPENSION22953 BRINZOLAMIDE 1 % EYE DROPS,SUSPENSION22959 PAROXETINE 10 MG/5 ML ORAL SUSPENSION22960 PARICALCITOL 5 MCG/ML INTRAVENOUS SOLUTION22981 AMPHOTERICIN B LIPID COMPLEX 5 MG/ML INTRAVENOUS SUSPENSION22986 CIPROFLOXACIN 0.2 %-HYDROCORTISONE 1 % EAR DROPS,SUSPENSION22987 CIPROFLOXACIN 250 MG/5 ML ORAL SUSPENSION22988 CIPROFLOXACIN 500 MG/5 ML ORAL SUSPENSION22992 AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 125 MG TABLET22994 CAPECITABINE 500 MG TABLET23082 BASILIXIMAB 20 MG INTRAVENOUS SOLUTION23123 EPTIFIBATIDE 0.75 MG/ML INTRAVENOUS SOLUTION23124 EPTIFIBATIDE 2 MG/ML INTRAVENOUS SOLUTION23128 ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION23128 ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION23151 VERAPAMIL ER 240 MG 24 HR CAPSULE,EXTENDED RELEASE23206 DESOGESTREL-E.ESTRADIOL 0.15 MG-0.02 MG(21)/E.ESTRAD 0.01 MG(5) TABLET23377 RIZATRIPTAN 10 MG TABLET23377 RIZATRIPTAN 10 MG TABLET23458 AMOXICILLIN 875 MG TABLET23458 AMOXICILLIN 875 MG TABLET23461 LIDOCAINE 4 % TOPICAL CREAM23500 CALFACTANT 35 MG/ML IN 0.9% SODIUM CHLORIDE INTRATRACHEAL SUSPENSIO

23599 THALIDOMIDE 50 MG CAPSULE23796 INFLIXIMAB 100 MG INTRAVENOUS SOLUTION23814 ATOVAQUONE-PROGUANIL 250 MG-100 MG TABLET23872 LEFLUNOMIDE 10 MG TABLET23873 LEFLUNOMIDE 20 MG TABLET23898 EFAVIRENZ 50 MG CAPSULE23900 EFAVIRENZ 200 MG CAPSULE23928 OXALIPLATIN 50 MG INTRAVENOUS SOLUTION23929 OXALIPLATIN 100 MG INTRAVENOUS SOLUTION23968 MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION23968 MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION24119 NEVIRAPINE 50 MG/5 ML ORAL SUSPENSION24176 MIDAZOLAM 2 MG/ML SYRUP24216 SENNOSIDES-DOCUSATE SODIUM 8.6 MG-50 MG TABLET24276 ETANERCEPT 25 MG (1 ML) SUBCUTANEOUS KIT24325 CROMOLYN 5.2 MG/SPRAY (4 %) NASAL SPRAY24398 METFORMIN 1,000 MG TABLET24419 LAMIVUDINE 100 MG TABLET24434 OCTREOTIDE ACETATE 10 MG INTRAMUSCULAR KIT24435 OCTREOTIDE ACETATE 20 MG INTRAMUSCULAR KIT24436 OCTREOTIDE ACETATE 30 MG INTRAMUSCULAR KIT24438 ABACAVIR 300 MG TABLET24439 ABACAVIR 20 MG/ML ORAL SOLUTION24470 OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR24471 OXYBUTYNIN CHLORIDE ER 10 MG TABLET,EXTENDED RELEASE 24 HR24500 CELECOXIB 100 MG CAPSULE24521 ISOSORBIDE MONONITRATE ER 30 MG TABLET,EXTENDED RELEASE 24 HR24559 CHOLECALCIFEROL (VITAMIN D3) 400 UNIT TABLET24559 CHOLECALCIFEROL (VITAMIN D3) 400 UNIT TABLET24576 TIMOLOL 0.5 % EYE GEL FORMING SOLUTION24585 ANTI-THYMOCYTE GLOBULIN (RABBIT) 25 MG INTRAVENOUS SOLUTION24684 COENZYME Q10 75 MG CAPSULE24695 BUSULFAN 60 MG/10 ML INTRAVENOUS SOLUTION24702 MODAFINIL 100 MG TABLET24711 LISINOPRIL 10 MG-HYDROCHLOROTHIAZIDE 12.5 MG TABLET24731 BELLADONNA ALKALOIDS-OPIUM 16.2 MG-60 MG RECTAL SUPPOSITORY24914 TACROLIMUS 0.5 MG CAPSULE24914 TACROLIMUS 0.5 MG CAPSULE24915 LEVALBUTEROL 0.63 MG/3 ML SOLUTION FOR NEBULIZATION24924 ANTIHEMOPHILIC FACTOR (RECOMB) 250 (+/-) UNIT INTRAVENOUS SOLUTION24925 ANTIHEMOPHILIC FACTOR (RECOMB) 500 (+/-) UNIT INTRAVENOUS SOLUTION24926 ANTIHEMOPHILIC FACTOR (RECOMB) 1,000 (+/-) UNIT INTRAVENOUS SOLUTION24932 SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS24933 METHOXSALEN 20 MCG/ML INJECTION SOLUTION24984 POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER25005 MYCOPHENOLATE MOFETIL 200 MG/ML ORAL SUSPENSION25117 CIPROFLOXACIN 100 MG TABLET25118 CIPROFLOXACIN 250 MG TABLET25119 CIPROFLOXACIN 500 MG TABLET25120 CIPROFLOXACIN 750 MG TABLET25123 OCTREOTIDE ACETATE 200 MCG/ML INJECTION SOLUTION25136 CALCIUM CARBONATE-VITAMIN D3 600 MG (1,500 MG)-400 UNIT TABLET25159 SODIUM BICARBONATE-SODIUM CHLORIDE NASAL PACKET25174 HETASTARCH 6 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION25246 AMOXICILLIN 400 MG/5 ML ORAL SUSPENSION25246 AMOXICILLIN 400 MG/5 ML ORAL SUSPENSION25246 AMOXICILLIN 400 MG/5 ML ORAL SUSPENSION

25333 COENZYME Q10 60 MG CAPSULE25354 DOXERCALCIFEROL 2.5 MCG CAPSULE25408 ALLOPURINOL 500 MG INTRAVENOUS SOLUTION25424 POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET25424 POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET25425 FEXOFENADINE 180 MG TABLET25516 BENZOYL PEROXIDE 4 % TOPICAL CLEANSER25518 CHLORAMPHENICOL SOD SUCCINATE 1 GRAM INTRAVENOUS SOLUTION25519 RISPERIDONE 0.25 MG TABLET25528 PIOGLITAZONE 15 MG TABLET25529 PIOGLITAZONE 30 MG TABLET25531 HETASTARCH IN LACT ELECTROLYTE 6 % INTRAVENOUS SOLUTION25820 IVERMECTIN 3 MG TABLET25855 GABAPENTIN 600 MG TABLET25855 GABAPENTIN 600 MG TABLET25892 TEMOZOLOMIDE 5 MG CAPSULE25892 TEMOZOLOMIDE 5 MG CAPSULE25893 TEMOZOLOMIDE 20 MG CAPSULE25893 TEMOZOLOMIDE 20 MG CAPSULE25893 TEMOZOLOMIDE 20 MG CAPSULE25894 TEMOZOLOMIDE 100 MG CAPSULE25895 TEMOZOLOMIDE 250 MG CAPSULE25896 RABEPRAZOLE 20 MG TABLET,DELAYED RELEASE25997 ZALEPLON 5 MG CAPSULE25998 ZALEPLON 10 MG CAPSULE26224 PANTOPRAZOLE 20 MG TABLET,DELAYED RELEASE26224 PANTOPRAZOLE 20 MG TABLET,DELAYED RELEASE26225 PANTOPRAZOLE 40 MG TABLET,DELAYED RELEASE26225 PANTOPRAZOLE 40 MG TABLET,DELAYED RELEASE26225 PANTOPRAZOLE 40 MG TABLET,DELAYED RELEASE26226 PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION26335 QUINUPRISTIN-DALFOPRISTIN 500 MG INTRAVENOUS SOLUTION26336 SIROLIMUS 1 MG/ML ORAL SOLUTION26431 IMIGLUCERASE 400 UNIT INTRAVENOUS SOLUTION26537 FLUTICASONE 100 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALAT26538 FLUTICASONE 250 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALAT26538 FLUTICASONE 250 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALAT26546 OSELTAMIVIR 75 MG CAPSULE26550 PROGESTERONE MICRONIZED 200 MG CAPSULE26703 CARBIDOPA 25 MG TABLET26816 LEVETIRACETAM 250 MG TABLET26816 LEVETIRACETAM 250 MG TABLET26817 LEVETIRACETAM 500 MG TABLET26818 LEVETIRACETAM 750 MG TABLET26854 MOXIFLOXACIN 400 MG TABLET26854 MOXIFLOXACIN 400 MG TABLET26953 BENZONATATE 200 MG CAPSULE26965 DOFETILIDE 125 MCG CAPSULE26965 DOFETILIDE 125 MCG CAPSULE26967 DOFETILIDE 500 MCG CAPSULE26968 IRON, CARBONYL 15 MG/1.25 ML ORAL SUSPENSION27022 BUDESONIDE 32 MCG/ACTUATION NASAL SPRAY27023 TERBINAFINE 1 % TOPICAL CREAM27023 TERBINAFINE 1 % TOPICAL CREAM27032 METHACHOLINE CHLORIDE 100 MG SOLUTION FOR INHALATION27038 PREDNISOLONE ACETATE 0.12 % EYE DROPS,SUSPENSION27047 PORACTANT ALFA 120 MG/1.5 ML INTRATRACHEAL SUSPENSION

27049 OXCARBAZEPINE 150 MG TABLET27096 NITROGLYCERIN 0.4 MG/DOSE TRANSLINGUAL SPRAY27103 DEXMEDETOMIDINE 200 MCG/2 ML INTRAVENOUS SOLUTION27113 CLONIDINE (PF) 5,000 MCG/10 ML EPIDURAL SOLUTION27123 LEUPROLIDE 7.5 MG (PED) INTRAMUSCULAR KIT27234 MONTELUKAST 4 MG CHEWABLE TABLET27234 MONTELUKAST 4 MG CHEWABLE TABLET27280 AMPICILLIN 1 GRAM (ADD-VANTAGE) INTRAVENOUS SOLUTION27281 AMPICILLIN 2 GRAM (ADD-VANTAGE) INTRAVENOUS SOLUTION27282 AMPICILLIN-SULBACTAM 1.5 GRAM INTRAVENOUS SOLUTION27282 AMPICILLIN-SULBACTAM 1.5 GRAM INTRAVENOUS SOLUTION27283 AMPICILLIN-SULBACTAM 3 GRAM INTRAVENOUS SOLUTION27283 AMPICILLIN-SULBACTAM 3 GRAM INTRAVENOUS SOLUTION27322 MAGNESIUM SULFATE (LAXATIVE) 495 MG/5 GRAM ORAL GRANULES27327 MILRINONE 1 MG/ML INTRAVENOUS SOLUTION27327 MILRINONE 1 MG/ML INTRAVENOUS SOLUTION27333 NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR27334 NIFEDIPINE ER 60 MG TABLET,EXTENDED RELEASE 24 HR27335 NIFEDIPINE ER 90 MG TABLET,EXTENDED RELEASE 24 HR27392 MORPHINE (PF) 25 MG/ML INJECTION SOLUTION27396 LIDOCAINE (PF) 50 MG/ML (5 %) IN 7.5 % DEXTROSE INTRATHECAL SOLUTION27418 THEOPHYLLINE ER 100 MG CAPSULE,EXTENDED RELEASE 24 HR27430 PENTAMIDINE 300 MG SOLUTION FOR INJECTION27431 DOXORUBICIN HCL PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SOLUTION27431 DOXORUBICIN HCL PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SOLUTION27446 PIRBUTEROL 200 MCG/INHALATION BREATH ACTIVATED AEROSOL27457 ESTRADIOL 0.025 MG/24 HR SEMIWEEKLY TRANSDERMAL PATCH27459 ESTRADIOL 0.05 MG/24 HR SEMIWEEKLY TRANSDERMAL PATCH27461 ESTRADIOL 0.1 MG/24 HR SEMIWEEKLY TRANSDERMAL PATCH27466 DEXTROSE 40 % ORAL GEL27467 DINOPROSTONE ER 10 MG VAGINAL INSERT,CONTROLLED RELEASE27471 NITROGLYCERIN 0.1 MG/HR TRANSDERMAL 24 HOUR PATCH27471 NITROGLYCERIN 0.1 MG/HR TRANSDERMAL 24 HOUR PATCH27472 NITROGLYCERIN 0.2 MG/HR TRANSDERMAL 24 HOUR PATCH27473 NITROGLYCERIN 0.3 MG/HR TRANSDERMAL 24 HOUR PATCH27474 NITROGLYCERIN 0.4 MG/HR TRANSDERMAL 24 HOUR PATCH27475 NITROGLYCERIN 0.6 MG/HR TRANSDERMAL 24 HOUR PATCH27476 NITROGLYCERIN 0.8 MG/HR TRANSDERMAL 24 HOUR PATCH27480 DILTIAZEM CD 120 MG CAPSULE,EXTENDED RELEASE 24 HR27480 DILTIAZEM CD 120 MG CAPSULE,EXTENDED RELEASE 24 HR27481 DILTIAZEM ER (XR/XT) 180 MG CAPSULE,EXTENDED RELEASE,CONTROLLED27482 DILTIAZEM ER (XR/XT) 240 MG CAPSULE,EXTENDED RELEASE,CONTROLLED27505 CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH27506 CLONIDINE 0.2 MG/24 HR WEEKLY TRANSDERMAL PATCH27507 CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH27512 LORATADINE 10 MG DISINTEGRATING TABLET27520 LORATADINE 5 MG-PSEUDOEPHEDRINE ER 120 MG TABLET,EXTENDED RELEASE,127520 LORATADINE 5 MG-PSEUDOEPHEDRINE ER 120 MG TABLET,EXTENDED RELEASE,127521 LORATADINE-PSEUDOEPHEDRINE ER 10 MG-240 MG TABLET,EXTENDED RELEASE227522 FEXOFENADINE 60 MG-PSEUDOEPHEDRINE ER 120 MG TABLET,EXT.RELEASE,12 HR27543 DEXTROMETHORPHAN-GUAIFENESIN 30 MG-600 MG TABLET EXTENDED RELEASE127543 DEXTROMETHORPHAN-GUAIFENESIN 30 MG-600 MG TABLET EXTENDED RELEASE127630 RIZATRIPTAN 10 MG DISINTEGRATING TABLET27631 DIVALPROEX 125 MG SPRINKLE CAPSULE27632 CARBAMAZEPINE ER 200 MG CAPSULE,EXTENDED RELEASE MPHASE12HR27633 CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR27634 CARBAMAZEPINE ER 100 MG TABLET,EXTENDED RELEASE,12 HR

27635 CARBAMAZEPINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR27636 CARBAMAZEPINE ER 400 MG TABLET,EXTENDED RELEASE,12 HR27636 CARBAMAZEPINE ER 400 MG TABLET,EXTENDED RELEASE,12 HR27641 TOPIRAMATE 15 MG SPRINKLE CAPSULE27642 TOPIRAMATE 25 MG SPRINKLE CAPSULE27644 DIPYRIDAMOLE-ASPIRIN ER 200 MG-25 MG CAPSULE,EXT.RELEASE 12 HR M-PHASE27661 AMINOSALICYLIC ACID 4 GRAM ORAL PACKET27663 FLUORESCEIN 1 MG EYE STRIPS27670 COAL TAR 0.5 % SHAMPOO27670 COAL TAR 0.5 % SHAMPOO27677 SALICYLIC ACID 40 % TOPICAL PLASTER27691 LANSOPRAZOLE 15 MG CAPSULE,DELAYED RELEASE27691 LANSOPRAZOLE 15 MG CAPSULE,DELAYED RELEASE27692 LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE27692 LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE27693 OMEPRAZOLE 10 MG CAPSULE,DELAYED RELEASE27694 OMEPRAZOLE 20 MG CAPSULE,DELAYED RELEASE27694 OMEPRAZOLE 20 MG CAPSULE,DELAYED RELEASE27695 OMEPRAZOLE 40 MG CAPSULE,DELAYED RELEASE27696 SCOPOLAMINE 1.5 MG TRANSDERMAL 72 HOUR PATCH27696 SCOPOLAMINE 1.5 MG TRANSDERMAL 72 HOUR PATCH27696 SCOPOLAMINE 1.5 MG TRANSDERMAL 72 HOUR PATCH27697 ONDANSETRON 4 MG DISINTEGRATING TABLET27697 ONDANSETRON 4 MG DISINTEGRATING TABLET27698 ONDANSETRON 8 MG DISINTEGRATING TABLET27770 DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY27780 ZONISAMIDE 100 MG CAPSULE27780 ZONISAMIDE 100 MG CAPSULE27796 PERITONEAL DIALYSIS SOLN 6 & DEX 1.5 % LOW CA+ 2.5 MEQ/L&MAG 0.5 MEQ/L27796 PERITONEAL DIALYSIS SOLN 6 & DEX 1.5 % LOW CA+ 2.5 MEQ/L&MAG 0.5 MEQ/L27797 PERITONEAL DIALYSIS SOLN 4 & DEX 1.5 % CA+ 3.5 MEQ/L&LOW MAG 0.5 MEQ/L27797 PERITONEAL DIALYSIS SOLN 4 & DEX 1.5 % CA+ 3.5 MEQ/L&LOW MAG 0.5 MEQ/L27797 PERITONEAL DIALYSIS SOLN 4 & DEX 1.5 % CA+ 3.5 MEQ/L&LOW MAG 0.5 MEQ/L27800 PERITONEAL DIALYSIS SOLN 7 & DEX 2.5 % LOW CA+ 2.5 MEQ/L&MAG 0.5 MEQ/L27800 PERITONEAL DIALYSIS SOLN 7 & DEX 2.5 % LOW CA+ 2.5 MEQ/L&MAG 0.5 MEQ/L27801 PERITONEAL DIALYSIS SOLN13 & DEX 2.5 % CA+ 3.5 MEQ/L&LOW MAG 0.5 MEQ/L27801 PERITONEAL DIALYSIS SOLN13 & DEX 2.5 % CA+ 3.5 MEQ/L&LOW MAG 0.5 MEQ/L27801 PERITONEAL DIALYSIS SOLN13 & DEX 2.5 % CA+ 3.5 MEQ/L&LOW MAG 0.5 MEQ/L27804 PERITONEAL DIALYSIS SOLN 8 & DEX 4.25 % LOW CA+ 2.5 MEQ/L&MAG 0.5MEQ/L27804 PERITONEAL DIALYSIS SOLN 8 & DEX 4.25 % LOW CA+ 2.5 MEQ/L&MAG 0.5MEQ/L27805 PERITONEAL DIALYSIS SOLN 3 & DEX 4.25 % CA+ 3.5MEQ/L&LOW MAG 0.5 MEQ/L27805 PERITONEAL DIALYSIS SOLN 3 & DEX 4.25 % CA+ 3.5MEQ/L&LOW MAG 0.5 MEQ/L27805 PERITONEAL DIALYSIS SOLN 3 & DEX 4.25 % CA+ 3.5MEQ/L&LOW MAG 0.5 MEQ/L27838 SODIUM CHLORIDE 0.9% IV SOLN27838 SODIUM CHLORIDE 0.9% IV SOLN27838 SODIUM CHLORIDE 0.9% IV SOLN27838 SODIUM CHLORIDE 0.9% IV SOLN27838 SODIUM CHLORIDE 0.9% IV SOLN27857 VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR27858 VENLAFAXINE ER 75 MG CAPSULE,EXTENDED RELEASE 24 HR27859 VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR27860 NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH27860 NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH27862 NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH27862 NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH27863 NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH27863 NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH

27883 ACETAMINOPHEN 80 MG DISINTEGRATING TABLET27883 ACETAMINOPHEN 80 MG DISINTEGRATING TABLET27889 PHENOL 1.4 % MUCOSAL AEROSOL SPRAY27905 FENTANYL 25 MCG/HR TRANSDERMAL PATCH27905 FENTANYL 25 MCG/HR TRANSDERMAL PATCH27906 FENTANYL 50 MCG/HR TRANSDERMAL PATCH27906 FENTANYL 50 MCG/HR TRANSDERMAL PATCH27907 FENTANYL 75 MCG/HR TRANSDERMAL PATCH27908 FENTANYL 100 MCG/HR TRANSDERMAL PATCH27913 FENTANYL 200 MCG LOZENGE ON A HANDLE27914 FENTANYL 400 MCG LOZENGE ON A HANDLE27920 OXYCODONE ER 10 MG TABLET,EXTENDED RELEASE,12 HR27921 OXYCODONE ER 20 MG TABLET,EXTENDED RELEASE,12 HR27921 OXYCODONE ER 20 MG TABLET,EXTENDED RELEASE,12 HR27922 OXYCODONE ER 40 MG TABLET,EXTENDED RELEASE,12 HR27923 OXYCODONE ER 80 MG TABLET,EXTENDED RELEASE,12 HR27974 LACTOBACILLUS RHAMNOSUS GG 10 BILLION CELL CAPSULE27974 LACTOBACILLUS RHAMNOSUS GG 10 BILLION CELL CAPSULE27979 DEXTRAN 70-HYPROMELLOSE EYE DROPS27980 ARTIFICIAL TEAR (HYPROMELLOSE) 0.5 % EYE DROPS27991 CARBOXYMETHYLCELLULOSE SODIUM 0.5 % EYE DROPS IN A DROPPERETTE27991 CARBOXYMETHYLCELLULOSE SODIUM 0.5 % EYE DROPS IN A DROPPERETTE27994 POLYVINYL ALCOHOL 1.4 % EYE DROPS27999 SODIUM POLYSTYRENE SULFONATE 15 GRAM/60 ML ORAL SUSPENSION27999 SODIUM POLYSTYRENE SULFONATE 15 GRAM/60 ML ORAL SUSPENSION27999 SODIUM POLYSTYRENE SULFONATE 15 GRAM/60 ML ORAL SUSPENSION28011 SERTRALINE 20 MG/ML ORAL CONCENTRATE28048 BENZOCAINE-MENTHOL 20 %-0.5 % TOPICAL AEROSOL28048 BENZOCAINE-MENTHOL 20 %-0.5 % TOPICAL AEROSOL28116 ELECTROLYTE-R (PH 7.4) INTRAVENOUS SOLUTION28134 PHENOBARB-HYOSCYAMN-ATROPINE-SCOP 16.2 MG-0.1037 MG-0.0194 MG TABL28159 OLANZAPINE 5 MG DISINTEGRATING TABLET28159 OLANZAPINE 5 MG DISINTEGRATING TABLET28188 CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQUID28188 CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQUID28188 CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQUID28189 ERYTHROMYCIN 250 MG CAPSULE,DELAYED RELEASE28203 LIDOCAINE 5 % (700 MG/PATCH) ADHESIVE PATCH28203 LIDOCAINE 5 % (700 MG/PATCH) ADHESIVE PATCH28224 LINEZOLID 600 MG TABLET28225 LINEZOLID 100 MG/5 ML ORAL SUSPENSION28226 LINEZOLID 200 MG/100 ML INTRAVENOUS SOLUTION28235 PENTAMIDINE 300 MG SOLUTION FOR INHALATION28245 ZANAMIVIR 5 MG/ACTUATION DISK POWDER FOR INHALATION28246 SALMETEROL 50 MCG/DOSE DISK POWDER FOR INHALATION28249 FLUTICASONE 250 MCG/ACTUATION DISK POWDER FOR INHALATION28282 INSULIN GLARGINE 100 UNIT/ML SUBCUTANEOUS SOLUTION28357 FERRIC SUBSULFATE 259 MG/G TOPICAL SOLUTION28384 HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET28400 WATER FOR INJECTION, STERILE INTRAVENOUS SOLUTION28400 WATER FOR INJECTION, STERILE INTRAVENOUS SOLUTION28408 ESTRADIOL 0.05 MG/24 HR WEEKLY TRANSDERMAL PATCH28409 ESTRADIOL 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH28418 AMMONIUM CHLORIDE 5 MEQ/ML INTRAVENOUS SOLUTION28534 INSULIN ASPART 100 UNIT/ML SUBCUTANEOUS SOLUTION28714 SEVELAMER HCL 400 MG TABLET28715 SEVELAMER HCL 800 MG TABLET

28750 METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR28750 METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR28751 METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR28762 EFLORNITHINE 13.9 % TOPICAL CREAM28774 BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION28775 BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION28810 NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG-10,000 UNIT/ML-1 % EAR DROPS,SU28815 GLYCERIN (BULK) 100 % LIQUID28824 HYDROCORTISONE 2.5 % RECTAL CREAM28824 HYDROCORTISONE 2.5 % RECTAL CREAM28829 METHYL SALICYLATE TOPICAL LIQUID28842 CYCLOSPORINE MODIFIED 25 MG CAPSULE28843 CYCLOSPORINE MODIFIED 100 MG CAPSULE28844 CYCLOSPORINE MODIFIED 100 MG/ML ORAL SOLUTION28848 HYDROCORTISONE-PRAMOXINE 2.5 %-1 % RECTAL CREAM28849 HYDROCORTISONE-PRAMOXINE 1 %-1 % RECTAL FOAM28899 OXYCODONE 15 MG TABLET28900 OXYCODONE 30 MG TABLET28911 CARMUSTINE 100 MG INTRAVENOUS SOLUTION28912 DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION28913 SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRINGE28917 CHONDROITIN-SOD HYALURON 3 %-4 % (0.5 ML) 1 %(0.55 ML) INTRAOCULAR KIT28929 LOPINAVIR-RITONAVIR 400 MG-100 MG/5 ML ORAL SOLUTION28947 ARGATROBAN 100 MG/ML INTRAVENOUS SOLUTION28958 SIROLIMUS 1 MG TABLET28964 LEVOFLOXACIN 750 MG TABLET28970 BECLOMETHASONE DIPROPIONATE 40 MCG/ACTUATION AEROSOL INHALER28971 BECLOMETHASONE DIPROPIONATE 80 MCG/ACTUATION AEROSOL INHALER28975 MIFEPRISTONE 200 MG TABLET28995 METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR28995 METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR28998 DESOGESTREL-ETHINYL ESTRADIOL 0.15 MG-30 MCG TABLET29031 EPINEPHRINE 0.15 MG/0.3 ML (1:2,000) INJECTION,AUTO-INJECTOR29031 EPINEPHRINE 0.15 MG/0.3 ML (1:2,000) INJECTION,AUTO-INJECTOR29048 ALENDRONATE 70 MG TABLET29069 TAZAROTENE 0.1 % TOPICAL CREAM29071 ARSENIC TRIOXIDE 10 MG/10 ML INTRAVENOUS SOLUTION29072 ALENDRONATE 35 MG TABLET29132 IRON SUCROSE 100 MG/5 ML IRON INTRAVENOUS SOLUTION29167 ABACAVIR-LAMIVUDINE-ZIDOVUDINE 300 MG-150 MG-300 MG TABLET29169 GABAPENTIN 250 MG/5 ML ORAL SOLUTION29268 TYPHOID VACCINE 2 BILLION UNIT CAPSULE,DELAYED RELEASE29272 DILTIAZEM CD 180 MG CAPSULE,EXTENDED RELEASE 24 HR29272 DILTIAZEM CD 180 MG CAPSULE,EXTENDED RELEASE 24 HR29272 DILTIAZEM CD 180 MG CAPSULE,EXTENDED RELEASE 24 HR29274 DILTIAZEM CD 240 MG CAPSULE,EXTENDED RELEASE 24 HR29280 LEVONORGESTREL 20 MCG/24 HOUR (5 YEARS) INTRAUTERINE DEVICE29299 BALSALAZIDE 750 MG CAPSULE29302 PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML ORAL SOLUTION29313 CROTALIDAE POLYVAL IMMUNE FAB SOLUTION FOR INJECTION29335 PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION29388 METHYLPHENIDATE ER 54 MG TABLET,EXTENDED RELEASE 24 HR29396 BIVALIRUDIN 250 MG INTRAVENOUS SOLUTION29424 CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM29434 TOLTERODINE ER 2 MG CAPSULE,EXTENDED RELEASE 24 HR29435 TOLTERODINE ER 4 MG CAPSULE,EXTENDED RELEASE 24 HR29442 TACROLIMUS 0.03 % TOPICAL OINTMENT

29442 TACROLIMUS 0.03 % TOPICAL OINTMENT29443 TACROLIMUS 0.1 % TOPICAL OINTMENT29449 RIMABOTULINUMTOXINB 5,000 UNIT/ML INTRAMUSCULAR SOLUTION29464 MORPHINE (PF) 0.5 MG/ML INJECTION SOLUTION29464 MORPHINE (PF) 0.5 MG/ML INJECTION SOLUTION29482 FOLIC ACID-VIT B6-VIT B12 2.2 MG-25 MG-0.5 MG TABLET29518 CLINDAMYCIN-BENZOYL PEROXIDE 1 %-5 % TOPICAL GEL29518 CLINDAMYCIN-BENZOYL PEROXIDE 1 %-5 % TOPICAL GEL29531 MIRTAZAPINE 15 MG DISINTEGRATING TABLET29567 CASPOFUNGIN 50 MG INTRAVENOUS SOLUTION29588 AMINOLEVULINIC ACID HCL 20 % TOPICAL SOLUTION29676 SODIUM CHLORIDE 0.65 % NASAL SPRAY AEROSOL29745 ESOMEPRAZOLE MAGNESIUM 20 MG CAPSULE,DELAYED RELEASE29746 ESOMEPRAZOLE MAGNESIUM 40 MG CAPSULE,DELAYED RELEASE29778 ZIPRASIDONE 20 MG CAPSULE29779 ZIPRASIDONE 40 MG CAPSULE29780 ZIPRASIDONE 60 MG CAPSULE29800 FLUOXETINE 90 MG CAPSULE,DELAYED RELEASE29805 ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV29805 ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV29833 B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET29858 METOPROLOL SUCCINATE ER 25 MG TABLET,EXTENDED RELEASE 24 HR30013 WHITE PETROLATUM-MINERAL OIL 85 %-15 % EYE OINTMENT30070 METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR30071 METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR30072 METOPROLOL SUCCINATE ER 200 MG TABLET,EXTENDED RELEASE 24 HR30148 VALGANCICLOVIR 450 MG TABLET30148 VALGANCICLOVIR 450 MG TABLET30183 LIDOCAINE-TRANSPARENT DRESSING 4 % TOPICAL KIT30213 METHOTREXATE SODIUM 15 MG TABLET30264 CITALOPRAM 10 MG TABLET30275 CARDIOPLEGIC SOLUTION 16 MEQ/L (POTASSIUM) FOR PERFUSION30279 PENTOXIFYLLINE (BULK) 100 % POWDER30279 PENTOXIFYLLINE (BULK) 100 % POWDER30433 DROSPIRENONE-ETHINYL ESTRADIOL 3 MG-0.03 MG TABLET30479 OXCARBAZEPINE 300 MG/5 ML ORAL SUSPENSION30510 IPRATROPIUM-ALBUTEROL 0.5 MG-3 MG(2.5 MG BASE)/3 ML NEBULIZATION SOLN30616 GUAR GUM ORAL POWDER30804 BUPIVACAINE (PF) 0.0625 % (625 MCG/ML)IN 0.9% SODIUM CHLORIDE EPIDURAL30805 BUPIVACAINE (PF) 0.125 %(1,250 MCG/ML)IN 0.9% SODIUM CHLORIDE EPIDURAL30810 FENTANYL-BUPIVACAINE-NACL (PF) 4 MCG/ML-0.0625 % INJECTION SOLUTION30961 CALCIUM ACETATE 667 MG CAPSULE31096 PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS31096 PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS31158 BRIMONIDINE 0.15 % EYE DROPS31158 BRIMONIDINE 0.15 % EYE DROPS31177 AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSIO31177 AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSIO31192 NESIRITIDE 1.5 MG INTRAVENOUS SOLUTION31209 VALSARTAN 80 MG TABLET31310 ALTEPLASE 2 MG SOLUTION FOR INJECTION31415 METHOXSALEN RAPID 10 MG CAPSULE31432 DIGOXIN IMMUNE FAB 40 MG INTRAVENOUS SOLUTION31470 ZOLMITRIPTAN 5 MG DISINTEGRATING TABLET31530 ETONOGESTREL-ETHINYL ESTRADIOL 0.12 MG -0.015 MG/24 HR VAGINAL RING31530 ETONOGESTREL-ETHINYL ESTRADIOL 0.12 MG -0.015 MG/24 HR VAGINAL RING31576 BUDESONIDE DR & ER 3 MG CAPSULE,DELAYED & EXTENDED RELEASE

31576 BUDESONIDE DR & ER 3 MG CAPSULE,DELAYED & EXTENDED RELEASE31578 ALBUTEROL SULFATE 1.25 MG/3 ML SOLUTION FOR NEBULIZATION31587 DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEAS31588 DEXTROAMPHETAMINE-AMPHETAMINE ER 20 MG 24HR CAPSULE,EXTEND RELEAS31684 TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET31688 PARICALCITOL 2 MCG/ML INTRAVENOUS SOLUTION31783 THEOPHYLLINE ER 400 MG CAPSULE,EXTENDED RELEASE 24 HR31784 ANAKINRA 100 MG/0.67 ML SUBCUTANEOUS SYRINGE31825 GRANISETRON 1 MG/5 ML ORAL SOLUTION31846 DEXMETHYLPHENIDATE 5 MG TABLET31847 DEXMETHYLPHENIDATE 10 MG TABLET31875 BOSENTAN 62.5 MG TABLET31875 BOSENTAN 62.5 MG TABLET31876 BOSENTAN 125 MG TABLET31882 FROVATRIPTAN 2.5 MG TABLET31906 MOXIFLOXACIN 400 MG/250 ML-SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBA31922 ERTAPENEM 1 GRAM SOLUTION FOR INJECTION32019 DESLORATADINE 5 MG TABLET32052 PIMECROLIMUS 1 % TOPICAL CREAM32215 FONDAPARINUX 2.5 MG/0.5 ML SUBCUTANEOUS SOLUTION SYRINGE32248 NORELGESTROM-ETHINYL ESTRADIOL 150 MCG-20 MCG/24 HR WEEKLY TRANSDE32267 PEGFILGRASTIM 6 MG/0.6 ML SUBCUTANEOUS SYRINGE32298 EFAVIRENZ 600 MG TABLET32299 NITISINONE 2 MG CAPSULE32300 NITISINONE 5 MG CAPSULE32311 TRIMETHOBENZAMIDE 300 MG CAPSULE32329 LEVALBUTEROL 0.31 MG/3 ML SOLUTION FOR NEBULIZATION32470 AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION32471 AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION32482 VALSARTAN 160 MG-HYDROCHLOROTHIAZIDE 25 MG TABLET32569 STERILE TALC 4 GRAM INTRAPLEURAL AEROSOL POWDER32589 PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION32631 PAROXETINE ER 12.5 MG TABLET,EXTENDED RELEASE 24 HR32632 PAROXETINE ER 25 MG TABLET,EXTENDED RELEASE 24 HR32633 PAROXETINE ER 37.5 MG TABLET,EXTENDED RELEASE 24 HR32654 METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR32700 ONABOTULINUMTOXINA 100 UNIT SOLUTION FOR INJECTION32785 GLATIRAMER 20 MG/ML SUBCUTANEOUS SYRINGE KIT32931 TREPROSTINIL SODIUM 1 MG/ML INJECTION SOLUTION32932 TREPROSTINIL SODIUM 2.5 MG/ML INJECTION SOLUTION32933 TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION32950 MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGY32950 MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGY32962 TRETINOIN MICROSPHERE 0.04 % TOPICAL GEL32979 IMATINIB 100 MG TABLET33005 DEXTROAMPHETAMINE-AMPHETAMINE ER 5 MG 24HR CAPSULE,EXTEND RELEASE33007 DEXTROAMPHETAMINE-AMPHETAMINE ER 25 MG 24HR CAPSULE,EXTEND RELEAS33008 VORICONAZOLE 50 MG TABLET33009 VORICONAZOLE 200 MG TABLET33009 VORICONAZOLE 200 MG TABLET33010 VORICONAZOLE 200 MG INTRAVENOUS SOLUTION33083 MIDODRINE 10 MG TABLET33130 METHENAMIN-HYOSC-M.BLUE-SALICYLT-NAPHOS 81 MG-0.12 MG TABLET33175 ZIPRASIDONE 20 MG/ML (FINAL CONCENTRATION) INTRAMUSCULAR SOLUTION33199 METHYLPHENIDATE LA 30 MG CAPSULE,EXTENDED RELEASE MULTIPHASE 50-5033225 AMOXICILLIN 200 MG-POTASSIUM CLAVULANATE 28.5 MG CHEWABLE TABLET33226 AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG CHEWABLE TABLET

33227 AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET33228 AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET33229 AMOXICILLIN 200 MG-POTASSIUM CLAVULANATE 28.5 MG/5 ML ORAL SUSPENSIO33229 AMOXICILLIN 200 MG-POTASSIUM CLAVULANATE 28.5 MG/5 ML ORAL SUSPENSIO33229 AMOXICILLIN 200 MG-POTASSIUM CLAVULANATE 28.5 MG/5 ML ORAL SUSPENSIO33230 AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG/5 ML ORAL SUSPENSION33230 AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG/5 ML ORAL SUSPENSION33512 ESCITALOPRAM 10 MG TABLET33512 ESCITALOPRAM 10 MG TABLET33513 ESCITALOPRAM 20 MG TABLET33513 ESCITALOPRAM 20 MG TABLET33591 RASBURICASE 1.5 MG INTRAVENOUS SOLUTION33862 AMOXICILLIN-POTASSIUM CLAVULANATE 1,000 MG-62.5 MG TABLET,EXT.REL 12H33937 LAMIVUDINE 300 MG TABLET34090 ALBUTEROL SULFATE ER 4 MG TABLET,EXTENDED RELEASE,12 HR34153 EZETIMIBE 10 MG TABLET34369 ARIPIPRAZOLE 10 MG TABLET34418 DIVALPROEX ER 250 MG TABLET,EXTENDED RELEASE 24 HR34444 ATOMOXETINE 10 MG CAPSULE34445 ATOMOXETINE 18 MG CAPSULE34446 ATOMOXETINE 25 MG CAPSULE34447 ATOMOXETINE 40 MG CAPSULE34505 HYDROCODONE 5 MG-ACETAMINOPHEN 325 MG TABLET34505 HYDROCODONE 5 MG-ACETAMINOPHEN 325 MG TABLET34550 HEP B-DP(A)T-POLIO VACC (PF) 10MCG-25LF-25MCG-10LF-40-8-32D IM SYRINGE34594 LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET34595 LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET34652 ADALIMUMAB 40 MG/0.8 ML SUBCUTANEOUS KIT34708 NITAZOXANIDE 100 MG/5 ML ORAL SUSPENSION34711 BUPRENORPHINE 2 MG SUBLINGUAL TABLET34711 BUPRENORPHINE 2 MG SUBLINGUAL TABLET34713 BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL TABLET34769 NICOTINE (POLACRILEX) 2 MG BUCCAL LOZENGE34770 NICOTINE (POLACRILEX) 4 MG BUCCAL LOZENGE34814 NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG-10,000 UNIT/ML-1 % EAR SOLUTION34897 ESCITALOPRAM 5 MG/5 ML ORAL SOLUTION35126 NEOMYCIN 3.5 MG-POLYMYXIN 10,000 UNIT-HYDROCORT 10 MG/ML EYE DROP,S35134 ROSUVASTATIN 10 MG TABLET35135 ROSUVASTATIN 20 MG TABLET35184 CYCLOBENZAPRINE 5 MG TABLET35209 CYCLOSPORINE 0.05 % EYE DROPS IN A DROPPERETTE35209 CYCLOSPORINE 0.05 % EYE DROPS IN A DROPPERETTE35220 BASILIXIMAB 10 MG INTRAVENOUS SOLUTION35228 COENZYME Q10 50 MG CAPSULE35488 APREPITANT 80 MG CAPSULE35489 APREPITANT 125 MG CAPSULE35489 APREPITANT 125 MG CAPSULE35495 OXYBUTYNIN 3.9 MG/24 HR SEMIWEEKLY TRANSDERMAL PATCH35499 PROPRANOLOL XL 80 MG CAPSULE,EXTENDED RELEASE 24 HR35500 PROPRANOLOL XL 120 MG CAPSULE,EXTENDED RELEASE 24 HR35626 CLONAZEPAM 0.25 MG DISINTEGRATING TABLET35626 CLONAZEPAM 0.25 MG DISINTEGRATING TABLET35639 ESMOLOL 2,000 MG/100 ML (20 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV35639 ESMOLOL 2,000 MG/100 ML (20 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV35639 ESMOLOL 2,000 MG/100 ML (20 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV35640 ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION35686 RISPERIDONE 0.5 MG DISINTEGRATING TABLET

35686 RISPERIDONE 0.5 MG DISINTEGRATING TABLET35699 MOXIFLOXACIN 0.5 % EYE DROPS35779 LARONIDASE 2.9 MG/5 ML INTRAVENOUS SOLUTION35839 BORTEZOMIB 3.5 MG SOLUTION FOR INJECTION35864 ALPRAZOLAM ER 0.5 MG TABLET,EXTENDED RELEASE 24 HR35942 POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)35942 POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)35943 POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)35943 POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)36023 MONTELUKAST 4 MG ORAL GRANULES IN PACKET36023 MONTELUKAST 4 MG ORAL GRANULES IN PACKET36046 POTASSIUM CHLORIDE 20 MEQ/L IN 0.45 % SODIUM CHLORIDE INTRAVENOUS SO36092 IMATINIB 400 MG TABLET36149 ATAZANAVIR 150 MG CAPSULE36150 ATAZANAVIR 200 MG CAPSULE36151 OMALIZUMAB 150 MG SUBCUTANEOUS SOLUTION36332 CITRATE DEXTROSE SOLUTION36349 METHYLPHENIDATE ER 30 MG MULTIPHASE CAPSULE 30-70,EXTENDED RELEASE36349 METHYLPHENIDATE ER 30 MG MULTIPHASE CAPSULE 30-70,EXTENDED RELEASE36438 ARIPIPRAZOLE 5 MG TABLET36438 ARIPIPRAZOLE 5 MG TABLET36576 CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION36590 LEVETIRACETAM 100 MG/ML ORAL SOLUTION36591 PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION36775 BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE36775 BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE36776 BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE36823 ALPHA LIPOIC ACID 100 MG CAPSULE36845 ISOTRETINOIN 30 MG CAPSULE36952 PHENYLEPHRINE 0.125 % NASAL DROPS36962 DOCUSATE SODIUM 10 MG/ML ORAL LIQUID36966 MEMANTINE 10 MG TABLET36983 EPLERENONE 25 MG TABLET36986 TADALAFIL 20 MG TABLET36986 TADALAFIL 20 MG TABLET36987 ZONISAMIDE 25 MG CAPSULE36988 ZONISAMIDE 50 MG CAPSULE36989 DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION37068 LANOLIN TOPICAL CREAM37170 MEMANTINE 5 MG TABLET37219 SODIUM FLUORIDE 1.1 MG/ML (0.5 MG/ML FLUORIDE) DROPS37343 SACCHAROMYCES BOULARDII 250 MG CAPSULE37343 SACCHAROMYCES BOULARDII 250 MG CAPSULE37567 CARBAMAZEPINE ER 100 MG CAPSULE,EXTENDED RELEASE MPHASE12HR37606 RIBAVIRIN 40 MG/ML ORAL SOLUTION37616 TOPIRAMATE 50 MG TABLET37630 SELENIUM SULFIDE 2.5 % TOPICAL SUSPENSION37635 ESCITALOPRAM 5 MG TABLET37635 ESCITALOPRAM 5 MG TABLET37637 METOPROLOL TARTRATE 25 MG TABLET37642 CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION37643 PROPAFENONE ER 225 MG CAPSULE,EXTENDED RELEASE 12 HR37651 GUAIFENESIN ER 600 MG TABLET,EXTENDED RELEASE37651 GUAIFENESIN ER 600 MG TABLET,EXTENDED RELEASE37653 DISOPYRAMIDE ER 150 MG CAPSULE,EXTENDED RELEASE37812 STERILE TALC 5 GRAM INTRAPLEURAL SUSPENSION37834 PEGINTERFERON ALFA-2A 180 MCG/0.5 ML SUBCUTANEOUS KIT

37848 HYDROCODONE 2.5 MG-ACETAMINOPHEN 108 MG/5 ML ORAL SOLUTION37848 HYDROCODONE 2.5 MG-ACETAMINOPHEN 108 MG/5 ML ORAL SOLUTION37894 PEMETREXED 500 MG INTRAVENOUS SOLUTION37989 CETUXIMAB 100 MG/50 ML INTRAVENOUS SOLUTION38004 IBUPROFEN 100 MG CHEWABLE TABLET38004 IBUPROFEN 100 MG CHEWABLE TABLET38062 MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE38062 MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE38062 MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE38063 MYCOPHENOLATE SODIUM 360 MG TABLET,DELAYED RELEASE38063 MYCOPHENOLATE SODIUM 360 MG TABLET,DELAYED RELEASE38092 ARTIFICIAL TEAR (GONIOSCOPIC HYPROMELLOSE) 2.5 % EYE DROPS38100 CINACALCET 30 MG TABLET38101 CINACALCET 60 MG TABLET38103 VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION38224 PROPRANOLOL ER 60 MG CAPSULE,24 HR,EXTENDED RELEASE38245 LACTULOSE 10 GRAM/15 ML ORAL SOLUTION38263 OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION38270 CYCLOPHOSPHAMIDE 1 GRAM INTRAVENOUS SOLUTION38271 CYCLOPHOSPHAMIDE 500 MG INTRAVENOUS SOLUTION38280 CYCLOPHOSPHAMIDE 2 GRAM INTRAVENOUS SOLUTION38285 ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL 38285 ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL 38303 ACETYLCYSTEINE 20 % (200 MG/ML) INTRAVENOUS SOLUTION38315 TIOTROPIUM BROMIDE 18 MCG CAPSULE WITH INHALATION DEVICE38318 NELFINAVIR 625 MG TABLET38321 CARBOXYMETHYLCELLULOSE SODIUM 1 % EYE GEL IN A DROPPERETTE38488 FLUOXETINE 20 MG/5 ML ORAL SOLUTION38489 ETHOSUXIMIDE 250 MG/5 ML ORAL SOLUTION38489 ETHOSUXIMIDE 250 MG/5 ML ORAL SOLUTION38961 SELENIUM SULFIDE 1 % TOPICAL SUSPENSION38977 TROSPIUM 20 MG TABLET38978 B COMPLEX-VITAMIN C-FOLIC ACID 1 MG CAPSULE39063 RIFAXIMIN 200 MG TABLET39136 NYSTATIN 100,000 UNIT/GRAM TOPICAL POWDER39255 EMTRICITABINE-TENOFOVIR 200 MG-300 MG TABLET39265 CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION39265 CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION39265 CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION39275 DULOXETINE 20 MG CAPSULE,DELAYED RELEASE39276 DULOXETINE 30 MG CAPSULE,DELAYED RELEASE39276 DULOXETINE 30 MG CAPSULE,DELAYED RELEASE39277 DULOXETINE 60 MG CAPSULE,DELAYED RELEASE39277 DULOXETINE 60 MG CAPSULE,DELAYED RELEASE39278 LEVALBUTEROL 1.25 MG/0.5 ML SOLUTION FOR NEBULIZATION39301 ABACAVIR-LAMIVUDINE 600 MG-300 MG TABLET39477 ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION39522 CEFDINIR 250 MG/5 ML ORAL SUSPENSION39744 FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION39758 FENOLDOPAM 10 MG/ML INTRAVENOUS SOLUTION39802 NORFLURANE-HFC 245FA TOPICAL SPRAY39970 LEVOFLOXACIN 250 MG/10 ML ORAL SOLUTION39972 HISTRELIN 50 MG IMPLANT KIT39984 LIDOCAINE-DIPHENHYD-AL-MAG-SIM 200 MG-25 MG-400 MG-40MG/30ML MOU40009 FENOFIBRATE NANOCRYSTALLIZED 48 MG TABLET40010 FENOFIBRATE NANOCRYSTALLIZED 145 MG TABLET40010 FENOFIBRATE NANOCRYSTALLIZED 145 MG TABLET

40089 ERLOTINIB 25 MG TABLET40090 ERLOTINIB 100 MG TABLET40091 ERLOTINIB 150 MG TABLET40109 RANITIDINE 50 MG/2 ML (25 MG/ML) INJECTION SOLUTION40158 SELENIUM SULFIDE 2.25 % SHAMPOO40320 ESZOPICLONE 1 MG TABLET40320 ESZOPICLONE 1 MG TABLET40322 ESZOPICLONE 3 MG TABLET40369 MESALAMINE 1,000 MG RECTAL SUPPOSITORY40389 FEXOFENADINE-PSEUDOEPHEDRINE ER 180 MG-240 MG TABLET,EXT.RELEASE 24 40392 SOLIFENACIN 5 MG TABLET40393 SOLIFENACIN 10 MG TABLET40400 PALIFERMIN 6.25 MG INTRAVENOUS SOLUTION40404 CLOFARABINE 20 MG/20 ML INTRAVENOUS SOLUTION40413 ILOPROST 10 MCG/ML SOLUTION FOR NEBULIZATION40446 ARIPIPRAZOLE 1 MG/ML ORAL SOLUTION40449 HYALURONIDASE (OVINE) 200 UNIT/ML INJECTION SOLUTION40539 SODIUM HYPOCHLORITE 0.0125 % TOPICAL SOLUTION40540 MENINGOC VAC A,C,Y,W-135 DIP (PF) 4 MCG/0.5 ML INTRAMUSCULAR SOLUTION40574 ZICONOTIDE 100 MCG/ML INTRATHECAL SOLUTION40647 BRILLIANT GREEN (BULK) CRYSTALS40661 ALEMTUZUMAB 30 MG/ML INTRAVENOUS SOLUTION40697 FLUTICASONE 44 MCG/ACTUATION AEROSOL INHALER40698 FLUTICASONE 110 MCG/ACTUATION AEROSOL INHALER40699 FLUTICASONE 220 MCG/ACTUATION AEROSOL INHALER40790 BETAINE (BULK) 100 % POWDER40917 SODIUM BENZOATE-SOD PHENYLACET 10 %-10 % INTRAVENOUS SOLUTION40932 PYRIDOXAL-5 PHOSPHATE (BULK) 100 % POWDER40932 PYRIDOXAL-5 PHOSPHATE (BULK) 100 % POWDER40994 GLYCERIN (ADULT) RECTAL SUPPOSITORY40994 GLYCERIN (ADULT) RECTAL SUPPOSITORY41141 MEDROXYPROGESTERONE 104 MG/0.65 ML SUBCUTANEOUS SYRINGE41142 IPRATROPIUM BROMIDE 17 MCG/ACTUATION HFA AEROSOL INHALER41144 MICAFUNGIN 50 MG INTRAVENOUS SOLUTION41147 ENTECAVIR 0.5 MG TABLET41294 FLUDARABINE 50 MG/2 ML INTRAVENOUS SOLUTION41382 FENTANYL 12 MCG/HR TRANSDERMAL PATCH41463 SODIUM CHLORIDE 0.9 % INJ SOLN41463 SODIUM CHLORIDE 0.9 % INJ SOLN41545 DEXMETHYLPHENIDATE ER 5 MG CAPSULE,EXTENDED RELEASE MPHASE 50-5041569 GLUCAGON (HUMAN RECOMBINANT) 1 MG SOLUTION FOR INJECTION41581 GLUCAGON (HUMAN RECOMBINANT) 1 MG INJECTION KIT41623 LEVOCARNITINE (WITH SUGAR) 100 MG/ML ORAL SOLUTION41628 DIPHTH,PERTUS(ACEL)TETANUS VAC(PF) 2 LF-(5-3-5MCG)-5 LF/0.5 ML IM SUSP41652 TIGECYCLINE 50 MG INTRAVENOUS SOLUTION41675 PALIVIZUMAB 100 MG/ML INTRAMUSCULAR SOLUTION41787 SODIUM TETRADECYL SULFATE 1 % (10 MG/ML) INTRAVENOUS SOLUTION41793 SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION41832 SILDENAFIL 20 MG TABLET41938 METHADONE 40 MG SOLUBLE TABLET42064 RAMELTEON 8 MG TABLET42162 PREGABALIN 25 MG CAPSULE42163 PREGABALIN 50 MG CAPSULE42164 PREGABALIN 75 MG CAPSULE42165 PREGABALIN 100 MG CAPSULE42166 PREGABALIN 150 MG CAPSULE42219 LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID

42677 ZOLPIDEM ER 6.25 MG TABLET,EXTENDED RELEASE,MULTIPHASE42677 ZOLPIDEM ER 6.25 MG TABLET,EXTENDED RELEASE,MULTIPHASE42678 ZOLPIDEM ER 12.5 MG TABLET,EXTENDED RELEASE,MULTIPHASE42944 EMOLLIENT COMBINATION NO.10 TOPICAL EMULSION42949 LACTOBACILLUS CMB2-BIFIDO CMB1-STREP. THERM 450 BILLION CELL PACKET42951 MELOXICAM 7.5 MG/5 ML ORAL SUSPENSION43391 LOPINAVIR-RITONAVIR 200 MG-50 MG TABLET43417 DEFERASIROX 500 MG DISPERSIBLE TABLET43444 CHLORPHENIRAMINE 4 MG-PHENYLEPHRINE 10 MG TABLET43472 LEVALBUTEROL HFA 45 MCG/ACTUATION AEROSOL INHALER43556 DIGOXIN 50 MCG/ML ORAL SOLUTION43675 SORAFENIB 200 MG TABLET43717 LIDOCAINE 4 % LARYNGOTRACHEAL SOLUTION70261 INSULIN DETEMIR 100 UNIT/ML SUBCUTANEOUS SOLUTION70267 NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION70284 POTASSIUM & SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PA70287 ABATACEPT (WITH MALTOSE) 250 MG INTRAVENOUS SOLUTION70306 ARIPIPRAZOLE 2 MG TABLET70383 CALCIPOTRIENE-BETAMETHASONE 0.005 %-0.064 % TOPICAL OINTMENT70392 SULFACETAMIDE-PREDNISOLONE 10 %-0.23 % (0.25 %) EYE DROPS70404 ANTIHEMOPHILIC FACTOR-VWF 250 UNIT-600 UNIT INTRAVENOUS KIT70405 ANTIHEMOPHILIC FACTOR-VWF 500 UNIT-1,200 UNIT INTRAVENOUS KIT70406 ANTIHEMOPHILIC FACTOR-VWF 1,000 UNIT-2,400 UNIT INTRAVENOUS KIT70476 ROTAVIRUS VACCINE LIVE, PENTAVALENT 2 ML ORAL SUSPENSION70536 FLUTICASONE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION70545 METHOHEXITAL 500 MG SOLUTION FOR INJECTION70556 NORETHINDRONE-ETH. ESTRADIOL-IRON 1 MG-20 MCG (24)/75 MG (4) TABLET70573 RHO(D) IMMUNE GLOBULIN-MALTOSE 2,500 UNIT/2.2 ML INJECTION SOLUTION70574 RHO(D) IMMUNE GLOBULIN-MALTOSE 5,000 UNIT/4.4 ML INJECTION SOLUTION70575 RHO(D) IMMUNE GLOBULIN-MALTOSE 1,500 UNIT/1.3 ML INJECTION SOLUTION70678 NEOMYCIN-POLYMYXIN B GU 40 MG-200,000 UNIT/ML IRRIGATION SOLUTION70761 DESMOPRESSIN 0.1 MG/ML (REFRIGERATE) NASAL SOLUTION70773 LEVETIRACETAM 1,000 MG TABLET70784 DROSPIRENONE-ETHINYL ESTRADIOL 3 MG-20 MCG (24) TABLET70838 CETIRIZINE 1 MG/ML ORAL SOLUTION76337 LIDOCAINE 70 MG-TETRACAINE 70 MG PATCH, MEDICATED SELF-HEATING76337 LIDOCAINE 70 MG-TETRACAINE 70 MG PATCH, MEDICATED SELF-HEATING76338 HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION76344 ANIDULAFUNGIN 50 MG INTRAVENOUS SOLUTION76345 OMEPRAZOLE 20 MG-SODIUM BICARBONATE 1,680 MG ORAL PACKET76353 ALGLUCOSIDASE ALFA 50 MG INTRAVENOUS SOLUTION76364 DECITABINE 50 MG INTRAVENOUS SOLUTION76365 ANTIHEMOPHILIC FACTOR VIII (PLASMA/ALB FREE) 250 (+/-) UNIT IV SOLN76366 ANTIHEMOPHILIC FACTOR VIII (PLASMA/ALB FREE) 500 (+/-) UNIT IV SOLN76367 ANTIHEMOPHILIC FACTOR VIII (PLASMA/ALB FREE) 1,000 (+/-) UNIT IV SOLN76368 ANTIHEMOPHILIC FACTOR VIII (PLASMA/ALB FREE) 1,500 (+/-) UNIT IV SOLN76393 METHYLPHENIDATE 10 MG/9 HR DAILY TRANSDERMAL PATCH76396 METHYLPHENIDATE 30 MG/9 HR DAILY TRANSDERMAL PATCH76472 LORATADINE 5 MG/5 ML ORAL SOLUTION76582 H PAPILLOMAVIRUS VAC,QVAL(PF) 20MCG-40MCG-40MCG-20MCG/0.5ML IM SYR76641 ACETYLCHOLINE CHLORIDE 1:100 (20 MG/2 ML) INTRAOCULAR KIT76717 DASATINIB 20 MG TABLET76718 DASATINIB 50 MG TABLET76719 DASATINIB 70 MG TABLET76720 SODIUM HYPOCHLORITE 0.125 % SOLUTION76780 IBUPROFEN LYSINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION76790 RANIBIZUMAB 0.5 MG/0.05 ML INTRAVITREAL SOLUTION FOR INJECTION

76835 EFAVIRENZ-EMTRICITABIN-TENOFOVIR 600 MG-200 MG-300 MG TABLET76843 APREPITANT 40 MG CAPSULE76868 RASBURICASE 7.5 MG INTRAVENOUS SOLUTION76878 IDURSULFASE 6 MG/3 ML INTRAVENOUS SOLUTION76950 CHOLECALCIFEROL (VITAMIN D3) 1,000 UNIT TABLET76962 DARBEPOETIN ALFA 25 MCG/ML IN POLYSORBATE INJECTION76965 DARBEPOETIN ALFA 100 MCG/ML IN POLYSORBATE INJECTION76974 GLYCERIN (CHILD) RECTAL SUPPOSITORY76974 GLYCERIN (CHILD) RECTAL SUPPOSITORY76974 GLYCERIN (CHILD) RECTAL SUPPOSITORY76979 OLOPATADINE 0.2 % EYE DROPS77012 ETONOGESTREL 68 MG SUBDERMAL IMPLANT77174 FLUTICASONE-SALMETEROL 115 MCG-21 MCG/ACTUATION HFA AEROSOL INHALE77174 FLUTICASONE-SALMETEROL 115 MCG-21 MCG/ACTUATION HFA AEROSOL INHALE77195 LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION77251 NORETHIN-ETHINYL ESTRADIOL-IRON 0.4 MG-35 MCG(21)/75 MG(7) CHEW TABLE77308 SELENIUM 40 MCG/ML INTRAVENOUS SOLUTION77371 POSACONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION77411 CAFFEINE CITRATED 60 MG/3 ML (20 MG/ML) ORAL SOLUTION77434 BROMPHENIRAMINE-PHENYLEPHRINE 1 MG-2.5 MG/5 ML ORAL SOLUTION77539 VORINOSTAT 100 MG CAPSULE77648 ATAZANAVIR 300 MG CAPSULE77725 METOCLOPRAMIDE 5 MG/5 ML ORAL SOLUTION77822 BECLOMETHASONE DIPROPIONATE (AQUEOUS) 42 MCG (0.042 %) NASAL SPRAY78003 CODEINE 10 MG-GUAIFENESIN 100 MG/5 ML ORAL LIQUID78150 CELECOXIB 50 MG CAPSULE78225 ANTIHEMOPHILIC FACTOR VIII (PLASMA/ALB FREE) 2,000 (+/-) UNIT IV SOLN78420 AZACITIDINE 100 MG SOLUTION FOR INJECTION78615 ESOMEPRAZOLE MAGNESIUM DR 20 MG GRANULES DELAYED RELEASE FOR SUSP78752 LAPATINIB 250 MG TABLET78994 DOXYCYCLINE MONOHYDRATE 75 MG CAPSULE81409 SELENIUM 200 MCG CAPSULE81420 BENZOCAINE 20 % TOPICAL OINTMENT81426 DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR81428 ACTIVATED CHARCOAL-SORBITOL 50 GRAM/240 ML ORAL SUSPENSION81434 ZOLEDRONIC ACID 5 MG/100 ML IN MANNITOL 5 % AND WATER INTRAVENOUS81453 BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER81454 BUDESONIDE-FORMOTEROL HFA 160 MCG-4.5 MCG/ACTUATION AEROSOL INHALE81461 TEMOZOLOMIDE 140 MG CAPSULE81462 TEMOZOLOMIDE 180 MG CAPSULE81475 LISDEXAMFETAMINE 50 MG CAPSULE81696 ECULIZUMAB 300 MG/30 ML INTRAVENOUS SOLUTION81838 RISPERIDONE MICROSPHERES 12.5 MG/2 ML INTRAMUSCULAR SYRINGE81870 COLLOIDAL OATMEAL TOPICAL PACKET82091 QUETIAPINE ER 400 MG TABLET,EXTENDED RELEASE 24 HR82134 SODIUM CHLORIDE 7 % FOR NEBULIZATION82177 PERFLUTREN PROTEIN-TYPE A MICROSPHERES 0.22 MG/ML INTRAVENOUS SUSP82180 FLUOROURACIL 2.5 GRAM/50 ML INTRAVENOUS SOLUTION82200 FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION82204 FLUOROURACIL 1 GRAM/20 ML INTRAVENOUS SOLUTION82228 TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FINAL) INTRAVENOUS SOLUTION82303 CLINDAMYCIN 150 MG/ML INJECTION SOLUTION82303 CLINDAMYCIN 150 MG/ML INJECTION SOLUTION82307 AMBRISENTAN 5 MG TABLET82308 AMBRISENTAN 10 MG TABLET82409 COAGULATION FACTOR IX (RECOMB) 2,000 UNIT INTRAVENOUS KIT82464 MELATONIN 1 MG TABLET

82464 MELATONIN 1 MG TABLET82525 ANTIHEMOPHILIC FACTOR VIII (PLASMA/ALB FREE) 3,000 (+/-) UNIT IV SOLN87834 BRIMONIDINE-TIMOLOL 0.2 %-0.5 % EYE DROPS87865 DIAZEPAM 2.5 MG RECTAL KIT87867 DIAZEPAM 5 MG-7.5 MG-10 MG RECTAL KIT87869 DIAZEPAM 12.5 MG-15 MG-17.5 MG-20 MG RECTAL KIT87877 ZILEUTON ER 600 MG TABLET,EXTENDED RELEASE 12HR MPHASE87889 INSULIN GLULISINE 100 UNIT/ML SUBCUTANEOUS SOLUTION88010 FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION88011 FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION88042 METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION88042 METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION88042 METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION88093 ANIDULAFUNGIN 100 MG INTRAVENOUS SOLUTION88242 IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION88242 IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION88317 TRYPAN BLUE 0.06 % INTRAOCULAR SYRINGE88336 ANTIHEMOPHILIC FACTOR-VWF 500 (200 VWF) UNIT/5 ML INTRAVENOUS SOLUTI88338 ANTIHEMOPHILIC FACTOR-VWF 1,500 (600 VWF) UNIT/10 ML INTRAVENOUS SOLN88377 CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION88377 CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION88504 ACETAMINOPHEN 325 MG/10.15 ML ORAL SUSPENSION88505 ACETAMINOPHEN 650 MG/20.3 ML ORAL SUSPENSION88608 RALTEGRAVIR 400 MG TABLET88704 OSELTAMIVIR 30 MG CAPSULE88705 OSELTAMIVIR 45 MG CAPSULE88720 NILOTINIB 200 MG CAPSULE89128 TRIAMCINOLONE ACETONIDE (PF) 40 MG/ML INTRAOCULAR SUSPENSION89201 SEVELAMER CARBONATE 800 MG TABLET89201 SEVELAMER CARBONATE 800 MG TABLET89253 SAPROPTERIN 100 MG SOLUBLE TABLET89387 OXYCODONE ER 15 MG TABLET,EXTENDED RELEASE,12 HR89388 OXYCODONE ER 30 MG TABLET,EXTENDED RELEASE,12 HR89389 OXYCODONE ER 60 MG TABLET,EXTENDED RELEASE,12 HR89570 THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION89595 TADALAFIL 2.5 MG TABLET89783 LISDEXAMFETAMINE 20 MG CAPSULE91031 ESOMEPRAZOLE MAGNESIUM DR 10 MG GRANULES DELAYED RELEASE FOR SUSP91054 IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION91055 IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION91185 SECRETIN (HUMAN) 16 MCG INTRAVENOUS SOLUTION91278 OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION91279 OCTREOTIDE ACETATE 100 MCG/ML INJECTION SOLUTION91281 OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION91300 BENDAMUSTINE 100 MG INTRAVENOUS SOLUTION91349 KETOROLAC 60 MG/2 ML INTRAMUSCULAR SOLUTION91651 METHYLNALTREXONE 12 MG/0.6 ML SUBCUTANEOUS SOLUTION91946 MORPHINE (PF) 150 MG/30 ML PCA INTRAVENOUS SOLUTION92074 DP(A)T-POLIO-HIB CONJ-TET (PF) 15 LF UNIT-20 MCG-5 LF /0.5 ML IM KIT92777 TETRABENAZINE 25 MG TABLET92818 DAPSONE 5 % TOPICAL GEL92818 DAPSONE 5 % TOPICAL GEL92832 CICLESONIDE HFA 160 MCG/ACTUATION AEROSOL INHALER92835 TOPOTECAN 0.25 MG CAPSULE92836 TOPOTECAN 1 MG CAPSULE92851 DARUNAVIR 600 MG TABLET92853 COAGULATION FACTOR VIIA RECOMB 1 MG (1,000 MCG) INTRAVENOUS SOLUTION

92854 COAGULATION FACTOR VIIA RECOMB 2 MG (2,000 MCG) INTRAVENOUS SOLUTION92855 COAGULATION FACTOR VIIA RECOMB 5 MG (5,000 MCG) INTRAVENOUS SOLUTION92895 VANCOMYCIN 1 GRAM/200 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK93073 ACETAMINOPHEN 160 MG/5 ML ORAL SUSPENSION93073 ACETAMINOPHEN 160 MG/5 ML ORAL SUSPENSION93084 AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION93566 ROMIPLOSTIM 250 MCG SUBCUTANEOUS SOLUTION93747 MITOXANTRONE 2 MG/ML CONCENTRATE,INTRAVENOUS93936 CLEVIDIPINE 25 MG/50 ML INTRAVENOUS EMULSION93997 GRANISETRON 3.1 MG/24 HOUR WEEKLY TRANSDERMAL PATCH94158 SODIUM CHLORIDE 1,000 MG SOLUBLE TABLET94218 NICARDIPINE 20 MG/200 ML IN DEXTROSE (ISO-OSM) INTRAVENOUS PIGGYBACK94218 NICARDIPINE 20 MG/200 ML IN DEXTROSE (ISO-OSM) INTRAVENOUS PIGGYBACK94219 NICARDIPINE 20 MG/200 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBAC94219 NICARDIPINE 20 MG/200 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBAC94220 LIDOCAINE (PF) 3.5 % EYE GEL94329 DARUNAVIR 400 MG TABLET94563 TETRABENAZINE 12.5 MG TABLET94579 ELTROMBOPAG 25 MG TABLET95691 RUFINAMIDE 200 MG TABLET95692 RUFINAMIDE 400 MG TABLET95693 FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS95747 DIMETHICONE-COLLOIDAL OATMEAL 1.3 % LOTION95812 ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION95812 ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION95843 ADAPALENE-BENZOYL PEROXIDE 0.1 %-2.5 % TOPICAL GEL95849 PLERIXAFOR 24 MG/1.2 ML (20 MG/ML) SUBCUTANEOUS SOLUTION96233 QUETIAPINE ER 150 MG TABLET,EXTENDED RELEASE 24 HR96930 CHOLECALCIFEROL (VITAMIN D3) 400 UNIT/ML ORAL DROPS96948 ARTEMETHER-LUMEFANTRINE 20 MG-120 MG TABLET96949 MESALAMINE 800 MG TABLET,DELAYED RELEASE96968 LACOSAMIDE 50 MG TABLET96969 LACOSAMIDE 100 MG TABLET96970 LACOSAMIDE 150 MG TABLET96972 LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION96976 BUDESONIDE 90 MCG/ACTUATION BREATH ACTIVATED POWDER INHALER96977 BUDESONIDE 180 MCG/ACTUATION BREATH ACTIVATED POWDER INHALER96988 CONIVAPTAN 20 MG/100 ML IN 5 % DEXTROSE IV96988 CONIVAPTAN 20 MG/100 ML IN 5 % DEXTROSE IV96989 FIBRINOGEN 1 GRAM (900 MG-1,300 MG) INTRAVENOUS SOLUTION97079 ANTITHROMBIN III, HUMAN RECOMBINANT 1,750 UNIT INTRAVENOUS SOLUTION97253 DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION97260 TEMOZOLOMIDE 100 MG INTRAVENOUS SOLUTION97343 SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION97391 PSYLLIUM HUSK (ASPARTAME) 3.5 GRAM ORAL POWDER PACKET97463 CHOLECALCIFEROL (VITAMIN D3) 5,000 UNIT TABLET97682 FACTOR IX COMPLEX 1,500 (+/-) UNIT INTRAVENOUS SOLUTION97790 TOBRAMYCIN 40 MG/ML INJECTION SOLUTION97790 TOBRAMYCIN 40 MG/ML INJECTION SOLUTION97893 TOLVAPTAN 15 MG TABLET97967 LAMOTRIGINE ER 200 MG TABLET,EXTENDED RELEASE 24 HR97979 IISPERIDONE 0.25 MG DISINTEGRATING TABLET98034 LIPASE-PROTEASE-AMYLASE 6,000-19,000-30,000 UNIT CAPSULE,DELAYED REL98035 LIPASE-PROTEASE-AMYLASE 12,000-38,000-60,000 UNIT CAPSULE,DELAYED REL98036 LIPASE-PROTEASE-AMYLASE 24,000-76,000-120,000 UNIT CAPSULE,DELAYED REL98249 FLUOROURACIL 5 GRAM/100 ML INTRAVENOUS SOLUTION98312 FERUMOXYTOL 510 MG/17 ML (30 MG/ML) INTRAVENOUS SOLUTION

98329 DRONEDARONE 400 MG TABLET98329 DRONEDARONE 400 MG TABLET99407 VIGABATRIN 500 MG TABLET99443 VALGANCICLOVIR 50 MG/ML ORAL SOLUTION99445 LEVONORGESTREL 1.5 MG TABLET99462 CANAKINUMAB (PF) 180 MG/1.2 ML (150 MG/ML) SUBCUTANEOUS SOLUTION99612 OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTION99694 SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET99695 SEVELAMER CARBONATE 2.4 GRAM ORAL POWDER PACKET99786 LIPASE-PROTEASE-AMYLASE 10,000-34,000-55,000 UNIT CAPSULE,DELAYED REL99787 LIPASE-PROTEASE-AMYLASE 15,000-51,000-82,000 UNIT CAPSULE,DELAYED REL99788 LIPASE-PROTEASE-AMYLASE 20,000-68,000-109,000 UNIT CAPSULE,DELAYED REL99824 MELATONIN-PYRIDOXINE HCL (B6) 1 MG-10 MG TABLET100154 PAZOPANIB 200 MG TABLET100231 BIOTIN 5 MG TABLET100491 EPINEPHRINE 0.3 MG/0.3 ML (1:1,000) INJECTION,AUTO-INJECTOR100491 EPINEPHRINE 0.3 MG/0.3 ML (1:1,000) INJECTION,AUTO-INJECTOR100548 DEXMETHYLPHENIDATE ER 30 MG CAPSULE,EXTENDED RELEASE MPHASE 50-50100614 DICLOFENAC EPOLAMINE 1.3 % TRANSDERMAL 12 HOUR PATCH100721 FLUCONAZOLE 100 MG/50 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBA100878 NORGESTIMATE 0.18 MG/0.215 MG/0.25 MG-ETHINYL ESTRAD. 25 MCG(28)TABLE100879 NORGESTIMATE-ETHINYL ESTRADIOL 0.18 MG/0.215MG/0.25MG-35 MCG(28)TABL100995 RITONAVIR 100 MG TABLET100997 LORATADINE 5 MG DISINTEGRATING TABLET100997 LORATADINE 5 MG DISINTEGRATING TABLET101034 MENINGOC VAC A,C,Y,W-135 DIP(PF) 10 MCG-5 MCG/0.5 ML INTRAMUSCULAR KIT103880 LAMOTRIGINE 25 MG CHEWABLE DISPERSIBLE TABLET103888 LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION103888 LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION103888 LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION103889 LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION103889 LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION103889 LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION103890 TAMSULOSIN ER 0.4 MG CAPSULE,EXTENDED RELEASE 24 HR103895 PNEUMOCOCCAL 13-VAL CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE103915 VELAGLUCERASE ALFA 400 UNIT INTRAVENOUS SOLUTION104258 CAPSAICIN-SKIN CLEANSER 8 % TOPICAL KIT104566 FLUTICASONE 500 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALAT104568 LAMOTRIGINE 5 MG CHEWABLE DISPERSIBLE TABLET104575 GANCICLOVIR 0.15 % EYE GEL104576 TRANEXAMIC ACID 650 MG TABLET104604 RIFAXIMIN 550 MG TABLET104764 SIROLIMUS 0.5 MG TABLET104993 BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-300 MG-40 MG CAPSULE105410 BIMATOPROST 0.01 % EYE DROPS105417 GEMCITABINE 2 GRAM INTRAVENOUS SOLUTION105424 CARGLUMIC ACID 200 MG DISPERSIBLE TABLET105425 LIPASE-PROTEASE-AMYLASE 4,200-10,000-17,500 UNIT CAPSULE,DELAYED REL105426 LIPASE-PROTEASE-AMYLASE 10,500-25,000-43,750 UNIT CAPSULE,DELAYED REL105427 LIPASE-PROTEASE-AMYLASE 16,800-40,000-70,000 UNIT CAPSULE,DELAYED REL105428 LIPASE-PROTEASE-AMYLASE 21,000-37,000-61,000 UNIT CAPSULE,DELAYED REL105460 HEPARIN, PORCINE (PF) 10 UNIT/ML INTRAVENOUS SYRINGE105482 LACOSAMIDE 10 MG/ML ORAL SOLUTION105633 BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION105633 BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION105634 BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION105634 BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION

105635 LIDOCAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION105637 MEPIVACAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION105638 MEPIVACAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION105640 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION105640 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION105640 BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION105730 MAGNESIUM CHLORIDE 71.5 MG TABLET,DELAYED RELEASE105899 ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE105900 ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE105901 ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE105902 ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE105903 ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE105904 ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE105940 ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION106079 ULIPRISTAL 30 MG TABLET106249 NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG-10,000 UNIT/G-0.1 % EYE OINTMENT106278 DIAZEPAM 5 MG/ML INJECTION SYRINGE106293 ANTIHEMOPHILIC FACTOR (RECOMB) 1,500 (+/-) UNIT INTRAVENOUS SOLUTION106294 ANTIHEMOPHILIC FACTOR (RECOMB) 2,000 (+/-) UNIT INTRAVENOUS SOLUTION106348 ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION106349 ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION106491 DABIGATRAN ETEXILATE 150 MG CAPSULE107671 CEFTAROLINE FOSAMIL 600 MG INTRAVENOUS SOLUTION107798 BACLOFEN 50 MCG/ML (1 ML) INTRATHECAL SYRINGE107799 BACLOFEN 10,000 MCG/20 ML (500 MCG/ML) INTRATHECAL SOLUTION107800 BACLOFEN 40,000 MCG/20 ML (2,000 MCG/ML) INTRATHECAL SOLUTION107829 GLYCOPYRROLATE 1 MG/5 ML (0.2 MG/ML) ORAL SOLUTION108013 HYDROXYPROGESTERONE CAPROATE 250 MG/ML INTRAMUSCULAR OIL108021 ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION108027 FONDAPARINUX 5 MG/0.4 ML SUBCUTANEOUS SOLUTION SYRINGE108028 FONDAPARINUX 7.5 MG/0.6 ML SUBCUTANEOUS SOLUTION SYRINGE108049 PENICILLIN G BENZATHINE 1,200,000 UNIT/2 ML INTRAMUSCULAR SYRINGE108050 PENICILLIN G BENZATHINE 2,400,000 UNIT/4 ML INTRAMUSCULAR SYRINGE108051 PENICILLIN G BENZATHINE & PROCAINE 1,200,000 UNIT/2 ML IM SYRINGE108058 CYTARABINE LIPOSOME (PF) 50 MG/5 ML (10 MG/ML) INTRATHECAL SUSPENSION108060 PALIVIZUMAB 50 MG/0.5 ML INTRAMUSCULAR SOLUTION108061 TOCILIZUMAB 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION108062 TOCILIZUMAB 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLUTION108066 BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLUTION108066 BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLUTION108068 IBUPROFEN 800 MG/8 ML (100 MG/ML) INTRAVENOUS SOLUTION108072 CETUXIMAB 200 MG/100 ML INTRAVENOUS SOLUTION108074 FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION108075 FILGRASTIM 300 MCG/0.5 ML INJECTION SYRINGE108076 FILGRASTIM 480 MCG/0.8 ML INJECTION SYRINGE108078 RIMABOTULINUMTOXINB 2,500 UNIT/0.5 ML INTRAMUSCULAR SOLUTION108079 RIMABOTULINUMTOXINB 10,000 UNIT/2 ML INTRAMUSCULAR SOLUTION108085 IMMUNE GLOBULIN(HUM),CAPR(IGG) 10 % INTRAVENOUS SOLUTION108085 IMMUNE GLOBULIN(HUM),CAPR(IGG) 10 % INTRAVENOUS SOLUTION108088 IMMUNE GLOBULIN (HUMAN) (IGG) 10 % INTRAVENOUS SOLUTION108088 IMMUNE GLOBULIN (HUMAN) (IGG) 10 % INTRAVENOUS SOLUTION108088 IMMUNE GLOBULIN (HUMAN) (IGG) 10 % INTRAVENOUS SOLUTION108088 IMMUNE GLOBULIN (HUMAN) (IGG) 10 % INTRAVENOUS SOLUTION108088 IMMUNE GLOBULIN (HUMAN) (IGG) 10 % INTRAVENOUS SOLUTION108090 IMMUNE GLOBULIN (HUMAN) (IGG) 1 GRAM/5 ML (20 %) SUBCUTANEOUS SOLUT108091 IMMUNE GLOBULIN (HUMAN) (IGG) 2 GRAM/10 ML (20 %) SUBCUTANEOUS SOLN108092 IMMUNE GLOBULIN (HUMAN) (IGG) 4 GRAM/20 ML (20 %) SUBCUTANEOUS SOLN

108110 SODIUM HYALURONATE 10 MG/ML INTRA-ARTICULAR SOLUTION108118 LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK108119 LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK108125 ETANERCEPT 25 MG/0.5 ML (0.51 ML) SUBCUTANEOUS SYRINGE108127 POLIOVIRUS VACCINE 40 UNIT-8 UNIT-32 UNIT/0.5 ML INJECTION SUSPENSION108128 CIPROFLOXACIN 200 MG/20 ML INTRAVENOUS SOLUTION108129 CIPROFLOXACIN 400 MG/40 ML INTRAVENOUS SOLUTION108130 CIPROFLOXACIN 200 MG/100 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK108132 CIPROFLOXACIN 400 MG/200 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK108139 RANITIDINE 25 MG/ML INJECTION SOLUTION108139 RANITIDINE 25 MG/ML INJECTION SOLUTION108140 KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION108590 TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION108721 FACTOR XIII 1,000 UNIT-1,600 UNIT INTRAVENOUS KIT108740 VANCOMYCIN 750 MG/150 ML IV IN DEXTROSE (ISO-OS) INTRAVENOUS PIGGYBAC108843 BELIMUMAB 400 MG INTRAVENOUS SOLUTION108850 VITAMIN E (DL, ACETATE) 400 UNIT CAPSULE108908 DOCETAXEL 160 MG/16 ML (10 MG/ML) INTRAVENOUS SOLUTION108910 DOCETAXEL 20 MG/2 ML (10 MG/ML) INTRAVENOUS SOLUTION108955 IPILIMUMAB 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION109034 CAFFEINE CITRATED 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION109404 VILAZODONE 40 MG TABLET109439 NEVIRAPINE ER 400 MG TABLET,EXTENDED RELEASE 24 HR109775 TESTOSTERONE 20.25 MG/1.25 GRAM (1.62 %) TRANSDERMAL GEL PUMP109817 ARGATROBAN 125 MG/125 ML (1 MG/ML) IN 0.9 % SODIUM CHLORIDE IV109817 ARGATROBAN 125 MG/125 ML (1 MG/ML) IN 0.9 % SODIUM CHLORIDE IV110998 OSELTAMIVIR 6 MG/ML ORAL SUSPENSION111147 LIPASE-PROTEASE-AMYLASE 3,000-9,500-15,000 UNIT CAPSULE,DELAYED RELEAS111196 FERROUS GLUCONATE 324 MG (37.5 MG IRON) TABLET111273 EMTRICITABINE-RILPIVIRINE-TENOFOVIR 200 MG-25 MG-300 MG TABLET111341 LEUPROLIDE (PEDIATRIC 3 MONTH) 30 MG INTRAMUSCULAR SYRINGE KIT111348 BRENTUXIMAB VEDOTIN 50 MG INTRAVENOUS SOLUTION111395 ICATIBANT 30 MG/3 ML SUBCUTANEOUS SYRINGE112793 NEOMYCIN-COLIST-HC-THONZONM 3.3 MG-3 MG-10 MG-0.5 MG/ML EAR DROPS,112831 ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION112836 PEGINTERFERON ALFA-2B 50 MCG/0.5 ML SUBCUTANEOUS KIT112868 WATER FOR INJECT BACT PARABENS INJECTION SOLUTION112888 RIBOFLAVIN 25 MG TABLET112896 CUPRIC CHLORIDE 0.4 MG/ML INTRAVENOUS SOLUTION112900 IODINE STRONG (LUGOLS) 5 % ORAL SOLUTION113014 PHYTONADIONE 1 MG/0.5 ML INJECTION SOLUTION113070 ACETAMINOPHEN 120 MG-CODEINE 12 MG/5 ML ORAL SOLUTION113070 ACETAMINOPHEN 120 MG-CODEINE 12 MG/5 ML ORAL SOLUTION113113 TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML INTRAMUSCULAR SOLUTION113139 PEGINTERFERON ALFA-2B 80 MCG/0.5 ML SUBCUTANEOUS KIT113163 DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET113344 FLAVORING AGENT (BULK) LIQUID113372 VALINE CRYSTALS113381 PREDNISONE 5 MG/ML ORAL CONCENTRATE113425 PEG-ELECTROLYTE SOLUTION 420 GRAM ORAL SOLUTION113430 INDIGOTINDISULFONATE SODIUM 8 MG/ML INJECTION SOLUTION113449 DEXAMETHASONE 1 MG/ML DROPS (CONCENTRATE)113479 TRIMETHOBENZAMIDE 100 MG/ML INTRAMUSCULAR SOLUTION113497 HYDROMORPHONE (PF) 1 MG/ML INJECTION SOLUTION113511 MORPHINE 25 MG/ML INTRAVENOUS SOLUTION113540 SODIUM BICARBONATE 8.4 % INTRAVENOUS SOLUTION113561 RABIES IMMUNE GLOBULIN (PF) 150 UNIT/ML INTRAMUSCULAR SOLUTION

113566 DIPH,PERTUS(ACEL),TET PEDI (PF) 25 LF UNIT-58 MCG-10 LF/0.5ML IM SUSP113609 SODIUM BICARBONATE 4.2 % INTRAVENOUS SOLUTION113687 CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SOLUTION113689 HYDROCORTISONE 100 MG SOLUTION FOR INJECTION113697 MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSPENSION113697 MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSPENSION113804 CARBOXYMETHYLCELLULOSE SODIUM 0.5 % EYE DROPS113833 BELLADONNA ALKALOIDS-OPIUM 16.2 MG-30 MG RECTAL SUPPOSITORY113850 PHENYLEPHRINE 1 % NASAL SPRAY113866 PROPYLENE GLYCOL TOPICAL SOLUTION113923 GLYCINE DILUENT INTRAVENOUS SOLUTION113983 TRIMETHOPRIM 0.1 %-POLYMYXIN B 10,000 UNIT/ML EYE DROPS114087 BUTALBITAL-ASPIRIN-CAFFEINE 50 MG-325 MG-40 MG TABLET114094 DEXTROAMPHETAMINE-AMPHETAMINE 15 MG TABLET114151 LIDOCAINE 2 % MUCOSAL SOLUTION114151 LIDOCAINE 2 % MUCOSAL SOLUTION114186 PRENATAL VIT-IRON FUMARATE-FA 27 MG-0.8 MG TABLET114186 PRENATAL VIT-IRON FUMARATE-FA 27 MG-0.8 MG TABLET114231 MICONAZOLE NITRATE 200 MG VAGINAL SUPPOSITORY114359 CARBAMAZEPINE 100 MG/5 ML ORAL SUSPENSION114406 PEGINTERFERON ALFA-2B 120 MCG/0.5 ML SUBCUTANEOUS KIT114407 DEXTROMETHORPHAN HBR 7.5 MG/5 ML SYRUP114576 DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET114576 DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET114614 PEDIATRIC MULTIVIT A,C,&D3 #21 1,500 UNIT-35 MG-400 UNIT/ML ORAL DROPS114850 MINERAL OIL-PETROLAT,WHT-WATER LOTION114850 MINERAL OIL-PETROLAT,WHT-WATER LOTION115511 SOMATROPIN 10 MG/2 ML (5 MG/ML) SUBCUTANEOUS CARTRIDGE115763 MULTIVITAMIN,TX-IRON-MINERALS TABLET115763 MULTIVITAMIN,TX-IRON-MINERALS TABLET115771 MULTIVITAMIN,TX WITH IRON,CALCIUM,FOLIC ACID & MIN 27 MG-0.4 MG TABLET115856 INSULIN ASPART 100 UNIT/ML SUBCUTANEOUS CARTRIDGE115858 INSULIN LISPRO 100 UNIT/ML SUBCUTANEOUS PEN116491 DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE116499 LINEZOLID 600 MG/300 ML INTRAVENOUS SOLUTION116658 LORAZEPAM 2 MG/ML INJECTION SYRINGE116821 SOFT LENS RINSE-STORE SOLUTION116953 POLYVINYL ALCOHOL-POVIDONE (PF) 1.4 %-0.6 % EYE DROPS IN A DROPPERETTE116953 POLYVINYL ALCOHOL-POVIDONE (PF) 1.4 %-0.6 % EYE DROPS IN A DROPPERETTE116989 NPH INSULIN HUMAN RECOMB 100 UNIT/ML (3 ML) SUBCUTANEOUS PEN117325 FENTANYL-BUPIVACAINE-NACL (PF) 4 MCG/ML-0.1% EPIDURAL SOLUTION117332 HEPARIN LOCK FLUSH (PORCINE) 100 UNIT/ML INTRAVENOUS SOLUTION117548 BACITRACIN ZINC 500 UNIT/GRAM TOPICAL PACKET117549 BACITRACIN 500 UNIT/GRAM TOPICAL PACKET117560 BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM TOPICAL PACKET117561 NEOMYCIN-BACITRACIN-POLYMYXIN TOPICAL PACKET117563 INHALATIONAL SPACING DEVICE117583 ASCORBIC ACID 500 MG/5 ML SYRUP117626 HARD LENS CLEANER SOLUTION117756 AMINOPHYLLINE 500 MG/20 ML INTRAVENOUS SOLUTION118306 PARAB-CETY&STEA ALC-PRO GL-SLS TOPICAL CLEANSER119219 FLUOCINONIDE-EMOLLIENT 0.05 % TOPICAL CREAM119286 ALBUTEROL SULFATE 2.5 MG/0.5 ML SOLUTION FOR NEBULIZATION119307 SILVER ER TOPICAL GEL,EXTENDED RELEASE119385 ACTIVATED CHARCOAL-SORBITOL 25 GRAM/120 ML ORAL SUSPENSION119387 ACTIVATED CHARCOAL 50 GRAM/240 ML ORAL SUSPENSION119436 CANDIDA ALBICANS SKIN TEST FDA STANDARD INTRADERMAL

119549 QUININE 324 MG CAPSULE119566 MVI, PEDI NO.1 WITH VIT K 80 MG-400 UNIT-200 MCG/5 ML INTRAVENOUS SOLN119628 ANTI-INHIBITOR COAGULANT COMPLEX 651 UNIT-1,200 UNIT INTRAVENOUS SOLN119629 ANTI-INHIBITOR COAGULANT COMPLEX 400 UNIT-650 UNIT INTRAVENOUS SOLN119731 EPOETIN ALFA 20,000 UNIT/2 ML INJECTION SOLUTION119842 FLUOCINOLONE-SHOWER CAP 0.01 % TOPICAL OIL119843 INSULIN NPH-REGULAR HUMAN INSULIN 100 UNIT/ML (70-30) SUBCUTANEOUS P119863 COMPOUNDING VEHICLE (ORA-BLEND SF) #1 SUSP119864 COMPOUNDING VEHICLE (ORA-BLEND) #2 SUSP119971 MOMETASONE 220 MCG (60 DOSES) BREATH ACTIVATED POWDER INHALER120086 MULTIVIT WITH MIN-FOLIC ACID-LUTEIN 0.4 MG-250 MCG TABLET120087 CALCIUM-VIT B COMPLX-FA ER 115 MG-50 MG-0.4 MG TABLET,EXTENDED RELEAS120139 MEPERIDINE (PF) 25 MG/ML INJECTION SYRINGE120140 MEPERIDINE (PF) 50 MG/ML INJECTION SYRINGE120142 MEPERIDINE (PF) 75 MG/ML INJECTION SYRINGE120143 MEPERIDINE (PF) 100 MG/ML INJECTION SOLUTION120144 MEPERIDINE (PF) 100 MG/ML INJECTION SYRINGE120160 SODIUM CHLORIDE 0.9 % IV PGBK120160 SODIUM CHLORIDE 0.9 % IV PGBK120161 DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS PIGGYBACK120161 DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS PIGGYBACK120211 PORACTANT ALFA 240 MG/3 ML INTRATRACHEAL SUSPENSION120255 OXYTOCIN IN LACTATED RINGERS 20 UNIT/1,000 ML INTRAVENOUS SOLUTION120256 OXYTOCIN IN LACTATED RINGERS 30 UNIT/1,000 ML INTRAVENOUS SOLUTION120283 ANTI-INHIBITOR COAGULANT COMPLX 1,750 UNIT-3,250 UNIT INTRAVENOUS SOL120293 VITAMIN E (DL, ACETATE) 15 UNIT/0.3 ML ORAL DROPS120300 HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE120303 HEPARIN, PORCINE (PF) 10 UNIT/ML INTRAVENOUS SOLUTION120303 HEPARIN, PORCINE (PF) 10 UNIT/ML INTRAVENOUS SOLUTION120305 HEPARIN, PORCINE (PF) 1,000 UNIT/ML INJECTION SOLUTION120332 GLYCERIN 99.5 % TOPICAL SOLUTION120358 COENZYME Q10 50 MG-VITAMIN E 5 UNIT CAPSULE120389 HEPATITIS B IMMUNE GLOBULIN-MALTOSE >312 UNIT/ML (5 ML) INJECTION SOLN120418 LIDOCAINE (PF) 20 MG/ML (2 %) INTRAVENOUS SOLUTION120431 LANOLIN-MINERAL OIL-PEGS TOPICAL120460 H PAPILLOMAVIRUS VAC,QVAL(PF) 20MCG-40MCG-40MCG-20MCG/0.5ML IM SUS120575 MAGNESIUM GLUCONATE 27 MG (500 MG) TABLET120575 MAGNESIUM GLUCONATE 27 MG (500 MG) TABLET120646 OMEGA-3 FATTY ACIDS-FISH OIL 1,000 MG CAPSULE120646 OMEGA-3 FATTY ACIDS-FISH OIL 1,000 MG CAPSULE120646 OMEGA-3 FATTY ACIDS-FISH OIL 1,000 MG CAPSULE120714 ETANERCEPT 50 MG/ML (0.98 ML) SUBCUTANEOUS PEN INJECTOR120723 PEDIATRIC MULTIVITAMIN COMB NO.40-PHYTONADIONE 400 MCG/ML ORAL DRO120730 EPINEPHRINE (PF) 1 MG/ML (1:1,000) (1 ML) INJECTION SOLUTION120752 DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION120764 HYDROMORPHONE 3 MG/30 ML IN 0.9 % SODIUM CHLORIDE PCA INTRAVENOUS 120766 HYDROMORPHONE 15 MG/30 ML (0.5 MG/ML) IN 0.9% SOD.CHLORIDE PCA IV SO120768 HYDROMORPHONE 30 MG/30 ML IN 0.9 % SOD. CHLORIDE PCA INTRAVENOUS SO120810 HEPATITIS B IMMUNE GLOBULIN 220 UNIT/ML INTRAMUSCULAR SOLUTION120822 HEPATITIS B IMMUNE GLOBULIN 220 UNIT/ML (5 ML) INTRAMUSCULAR SOLUTION120823 HEPATITIS B IMMUNE GLOBULIN 110 UNIT/0.5 ML INTRAMUSCULAR SYRINGE120889 PHENOL 14.5 MG LOZENGES120921 SODIUM PHOSPHATES 9.5 GRAM-3.5 GRAM/59 ML ENEMA120991 HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/0.5 ML IM SYRINGE120992 HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/0.5 ML INTRAMUSCULAR SUSP120995 HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML INTRAMUSCULAR SUSP121024 HEPATITIS A VIRUS VACCINE (PF) 720 ELISA UNIT/0.5 ML IM SUSPENSION

121050 HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION121057 HEPATITIS A VACCINE (PF) 1,440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE121058 BENZOIN-ALOE VERA-STORAX-TOLU BALSAM 10 %-2 %-8 %-4 % TOPICAL TINCTUR121282 INSULIN GLARGINE 100 UNIT/ML (3 ML) SUBCUTANEOUS PEN121550 GENTAMICIN SULFATE (PEDIATRIC) (PF) 20 MG/2 ML INJECTION SOLUTION121564 B COMPLEX-VITAMIN C-FOLIC ACID ER 400 MCG TABLET,EXTENDED RELEASE121579 HEPATITIS A VIRUS VACCINE (PF) 1,440 ELISA UNIT/ML IM SUSPENSION121636 WHITE PETROLATUM-MINERAL OIL 83 %-15 % EYE OINTMENT121640 TOCOPHERSOLAN 400 UNIT/15 ML ORAL LIQUID121669 FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION121729 MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) INTRAVENOUS PIGGYBACK121808 WHITE PETROLATUM-MINERAL OIL 56.8 %-42.5 % EYE OINTMENT121811 MAGNESIUM SULFATE 20 GRAM/500 ML (4 %) INTRAVENOUS SOLUTION121828 GRANISETRON (PF) 1 MG/ML (1 ML) INTRAVENOUS SOLUTION121895 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SYRINGE121896 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SUSP121965 PHENYLEPHRINE (PF) 1 MG/10 ML (100 MCG/ML) IN 0.9 % NACL IV SYRINGE122028 TETANUS IMMUNE GLOBULIN (PF) 250 UNIT INTRAMUSCULAR SYRINGE122061 CALCIUM GLUCONATE 60 MG (648 MG) TABLET122079 MORPHINE (PF) 30 MG/30 ML PCA INTRAVENOUS SOLUTION122111 DIPH,PERTUS(ACEL),TET,POLIO(PF) 25 LF-58 MCG-10 LF/0.5 ML IM SUSP122253 DIMETHYL SULFOXIDE 50 % INTRAVESICAL SOLUTION122257 LIDOCAINE 2 % MUCOUS MEMBRANE JELLY IN APPLICATOR122257 LIDOCAINE 2 % MUCOUS MEMBRANE JELLY IN APPLICATOR122259 VINCRISTINE 2 MG/2 ML INTRAVENOUS SOLUTION122292 DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION122293 DOXORUBICIN 10 MG/5 ML INTRAVENOUS SOLUTION122314 BICARBONATE HEMODIALYSIS SOLN WITHOUT CALCIUM#8 K (2 MEQ/L)-MG(1MEQ122384 DOPAMINE 400 MG/10 ML (40 MG/ML) INTRAVENOUS SOLUTION122387 DOPAMINE 200 MG/250 ML (800 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN122387 DOPAMINE 200 MG/250 ML (800 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN122467 EPHEDRINE (PF) 25 MG/5 ML (5 MG/ML) IN 0.9% SODIUM CHLORIDE IV SYRINGE122484 ATROPINE 0.8 MG/2 ML (0.4 MG/ML) IN 0.9 % SODIUM CHLORIDE IV SYRINGE122489 BUPIVACAINE(PF) 25 MG/10 ML(2.5 MG/ML)0.25%-0.9 %NACL EPIDURAL SYRINGE122493 VITAMINS A & D-WHITE PETROLATUM-LANOLIN TOPICAL OINTMENT122637 CALCIUM CARBONATE 750 MG (320 MG CALCIUM) CHEW TABLET122637 CALCIUM CARBONATE 750 MG (320 MG CALCIUM) CHEW TABLET122638 CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) INJECTION SOLUTION122675 COMPOUNDING VEHICLE (ORA-PLUS) #7 SUSP122681 MULTIVIT-IRON-FA-CALCIUM &MINERALS 9 MG IRON-400 MCG TABLET122796 CALCIUM GLUBIONATE 115 MG/5 ML (1.8 GRAM/5 ML) SYRUP122801 COMPOUNDING VEHICLE (ORA-SWEET SF) #9 SUSP122802 COMPOUNDING VEHICLE (ORA-SWEET) #8 SUSP122844 THYROID (PORK) 120 MG TABLET122893 TREPROSTINIL 1.74 MG/2.9 ML (0.6 MG/ML) SOLUTION FOR NEBULIZATION122895 UREA 10 %-ALPHA HYDROXY ACIDS 4 % TOPICAL CREAM122907 MAGNESIUM OXIDE-MAGNESIUM AMINO ACID CHELATE 133 MG TABLET123000 LIPASE-PROTEASE-AMYLASE 5,000-17,000-27,000 UNIT CAPSULE,DELAYED REL123086 L.ACIDOPHILUS-L.BULGAR-BIFIDO B-S.THERMOP 1 BILLION CELL-250 MG TABLET123086 L.ACIDOPHILUS-L.BULGAR-BIFIDO B-S.THERMOP 1 BILLION CELL-250 MG TABLET123086 L.ACIDOPHILUS-L.BULGAR-BIFIDO B-S.THERMOP 1 BILLION CELL-250 MG TABLET123129 TETRACAINE 0.5 % VISCOUS EYE DROPS IN A DROPPERETTE123133 WHITE PETROLATUM-MINERAL OIL 57.3 %-42.5 % EYE OINTMENT123153 METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION123153 METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION123154 METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION123171 USTEKINUMAB 45 MG/0.5 ML SUBCUTANEOUS SYRINGE

123206 ZINC OXIDE-COD LIVER OIL 40 % TOPICAL PASTE123246 CALCIUM GLUCONATE 45 MG (500 MG) TABLET123354 HYDROCORTISONE SOD SUCCINATE (PF) 500 MG/4 ML SOLUTION FOR INJECTION123355 HYDROCORTISONE SOD SUCCINATE (PF) 250 MG/2 ML SOLUTION FOR INJECTION123356 HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/2 ML SOLUTION FOR INJECTION123357 HYDROCORTISONE SOD SUCCINATE (PF) 1,000 MG/8 ML SOLUTION FOR INJECTIO123473 AMIKACIN 500 MG/2 ML INJECTION SOLUTION123478 AMIKACIN 1,000 MG/4 ML INJECTION SOLUTION123489 SUCCINYLCHOLINE CHLORIDE 200 MG/10 ML (20 MG/ML) INTRAVENOUS SYRINGE123532 GLUCAGON (HUMAN RECOMBINANT) 1 MG/ML SOLUTION FOR INJECTION123550 THIAMINE MONONITRATE 100 MG TABLET123600 FENTANYL (PF) 1,500 MCG/30 ML (50 MCG/ML) PCA INTRAVENOUS SOLUTION123630 HEPARIN (PORCINE) (PF) 30,000 UNIT/1,000 ML IN 0.9 % SOD CHLORIDE IV123703 MIDAZOLAM 10 MG/5 ML (2 MG/ML) SYRUP123751 MULTIVIT-MIN-FA-COENZYME Q10 100 MCG-5 MG CHEWABLE TABLET123751 MULTIVIT-MIN-FA-COENZYME Q10 100 MCG-5 MG CHEWABLE TABLET123770 IVIG (GAMUNEX-C) 10% 1 G/10 ML123771 IVIG (GAMUNEX-C) 10% 2.5 G/25 ML123772 IVIG (GAMUNEX-C) 10% 5 G/50 ML123773 IVIG (GAMUNEX-C) 10% 10 G/100 ML123774 IVIG (GAMUNEX-C) 10% 20 G/200 ML123817 TETRACAINE HCL (PF) 0.5 % EYE DROPS123818 MULTIVITAMIN-FOLIC ACID-ZINC ASCORBATE 200 MCG-15 MG CAPSULE123855 PEDIATRIC MULTIVIT #22-VIT D3 1,000 UNIT-VIT K 800 MCG CHEWABLE TABLET123943 IRON SUCROSE 50 MG/2.5 ML IRON INTRAVENOUS SOLUTION123994 LIDOCAINE 1 % BUFFERED WITH 8.4 % SODIUM BICARBONATE (3 ML)INJ SYRINGE124038 OCTREOTIDE ACETATE 50 MCG/ML (1 ML) INJECTION SYRINGE124039 OCTREOTIDE ACETATE 500 MCG/ML (1 ML) INJECTION SYRINGE124092 METHYLCELLULOSE 1500CPS (BULK) 27.5 % TO 31.5 % (USP) POWDER124092 METHYLCELLULOSE 1500CPS (BULK) 27.5 % TO 31.5 % (USP) POWDER124113 EPINEPHRINE 1 MG/ML (1:1,000) (1 ML) INJECTION SOLUTION124126 FERROUS SULFATE, DRIED ER 159 MG (45 MG IRON) TABLET,EXTENDED RELEASE124126 FERROUS SULFATE, DRIED ER 159 MG (45 MG IRON) TABLET,EXTENDED RELEASE124148 METHADONE 1 MG/ML (1 ML) IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SYRING124312 HEPARIN (PORCINE) 5,000 UNIT/500 ML(10 UNIT/ML) IN 0.9 % NACL IV SOLN124321 ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION124355 BENZOCAINE-MENTHOL 15 MG-3.6 MG LOZENGES124364 PEGINTERFERON ALFA-2A 180 MCG/0.5 ML SUBCUTANEOUS SYRINGE124383 METHADONE 10 MG/ML INTRAVENOUS SYRINGE124515 MULTIVIT-MIN-FA-COENZYME Q10 100 MCG-10 MG CAPSULE124515 MULTIVIT-MIN-FA-COENZYME Q10 100 MCG-10 MG CAPSULE154888 PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION154950 TESTOSTERONE 2 MG/24 HOUR TRANSDERMAL 24 HOUR PATCH154967 RIVAROXABAN 15 MG TABLET155021 LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGE155073 TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION155084 ASPARAGINASE (ERWINIA CHRYSANTHEMI) 10,000 UNIT INTRAMUSCULAR SOLUTI155084 ASPARAGINASE (ERWINIA CHRYSANTHEMI) 10,000 UNIT INTRAMUSCULAR SOLUTI155092 DOCUSATE SODIUM 283 MG/5 ML ENEMA155112 LEVOTHYROXINE 100 MCG INTRAVENOUS SOLUTION155133 PRENATAL VIT #96-FERROUS FUMARATE-FOLIC ACID 27 MG IRON-800 MCG TABLE155133 PRENATAL VIT #96-FERROUS FUMARATE-FOLIC ACID 27 MG IRON-800 MCG TABLE155158 CLOBAZAM 10 MG TABLET155158 CLOBAZAM 10 MG TABLET155207 COAGULATION FACTOR IX (RECOMB) 3,000 UNIT INTRAVENOUS KIT155325 OMEPRAZOLE 2 MG/ML ORAL SUSPENSION155371 LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION

155410 C1 ESTERASE INHIBITOR 500 UNIT (10 ML) INTRAVENOUS KIT155422 LEVETIRACETAM 1,500 MG/100 ML IN SOD.CHLORIDE (ISO-OSM) IV PIGGYBACK155472 GLUCARPIDASE 1,000 UNIT INTRAVENOUS SOLUTION155668 LIDOCAINE 5 % TOPICAL OINTMENT155827 DIAZEPAM 5 MG/5 ML (5 ML) ORAL SOLUTION155863 KARAYA GUM (BULK) POWDER155874 LIPASE-PROTEASE-AMYLASE 10,440-39,150-39,150 UNIT TABLET155875 LIPASE-PROTEASE-AMYLASE 20,880-78,300-78,300 UNIT TABLET155982 MICROFIBRILLAR COLLAGEN HEMOSTAT TOPICAL POWDER IN PACKET156068 CALCIUM ACETATE-ALUMINUM 952 MG-1,347 MG TOPICAL POWDER IN PACKET156068 CALCIUM ACETATE-ALUMINUM 952 MG-1,347 MG TOPICAL POWDER IN PACKET156330 NAPHAZOLINE-GLYCERIN 0.012 %-0.25 % EYE DROPS156402 SODIUM BICARBONATE 10 MEQ/10 ML (8.4 %) INTRAVENOUS SYRINGE156420 VITAMINS A & D-WHITE PETROLATUM-LANOLIN TOPICAL OINTMENT IN PACKET156547 PSEUDOEPHEDRINE 30 MG/5 ML ORAL LIQUID156673 IPRATROPIUM-ALBUTEROL 20 MCG-100 MCG/ACTUATION AEROSOL INHALER156734 ISOLEUCINE (BULK) 100 % CRYSTALS156847 HEPARIN (PORCINE) 250 UNIT/250 ML (1 UNIT/ML) IN 0.9 % NACL IV SOLN156889 ANTIHEMOPHILIC FACTOR VIII (PLASMA/ALB FREE) 4,000 (+/-) UNIT IV SOLN156970 TETANUS,DIPHTHERIA TOXOID PED (PF) 5 LF UNIT-25 LF UNIT/0.5 ML IM SUSP157294 PHENYLEPHRINE 0.25 %-MINERAL OIL 14 %-PETROLATM 71.9 % RECTAL OINTMEN157386 MORPHINE 2 MG/ML INTRAVENOUS CARTRIDGE157387 MORPHINE 4 MG/ML INTRAVENOUS CARTRIDGE157508 PEDIATRIC MULTIVIT COMB NO.2 1,500 UNIT-35 MG-400 UNIT/ML ORAL DROPS157509 PEDIATRIC MULTIVIT COMB NO.20 1,500 UNIT-35 MG-400 UNIT/ML ORAL DROPS157723 ACETAMINOPHEN 120 MG-CODEINE 12 MG/5 ML (5 ML) ORAL SOLUTION157778 DARUNAVIR 800 MG TABLET160281 IBUPROFEN 100 MG/5 ML ORAL PREPACK160347 DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE160348 DIPHTH,PERTUSSIS(ACELL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5 ML IM SUSP160355 IRON DEXTRAN 100 MG/2 ML (50 MG/ML) INJECTION SOLUTION160362 TACROLIMUS ER 5 MG CAPSULE,EXTENDED RELEASE 24 HR160413 MENINGOCOCCAL VACCINE C,Y-HIB-CONJ TETANUS(PF) 5 MCG-2.5 MCG/0.5 ML I160413 MENINGOCOCCAL VACCINE C,Y-HIB-CONJ TETANUS(PF) 5 MCG-2.5 MCG/0.5 ML I160453 MAGNESIUM CARBONATE 54 MG/5 ML ORAL LIQUID160719 LEVONORGESTREL 14 MCG/24 HOUR (3 YEARS) INTRAUTERINE DEVICE160967 LEVOMEFOLATE CA 3 MG-B6 35 MG-MEB12 2 MG-ALGAL OIL 90.314 MG CAPSULE160971 LACTOBACILLUS ACIDOPHILUS 1 MG (100 MILLION CELL) TABLET161193 SODIUM BORATE-BORIC ACID-SODIUM CHLORIDE-WATER EYE WASH SOLN161404 DEXMEDETOMIDINE 200 MCG/50 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV161404 DEXMEDETOMIDINE 200 MCG/50 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV161406 DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV161655 FLU VACCIN,QVAL 2013-14 (2-49YRS)10E6.5-7.5 FF UNIT/0.2 ML NASAL SPRAY161791 FLU VACCINE QS2013-14(36 MOS+)(PF) 60 MCG(15 MCG X4)/0.5 ML IM SYRINGE161900 PRENATAL VITAMIN NO.115-IRON 29 MG-FOLIC ACID 1 MG CHEWABLE TABLET161900 PRENATAL VITAMIN NO.115-IRON 29 MG-FOLIC ACID 1 MG CHEWABLE TABLET161968 COPPER 380 SQUARE MM INTRAUTERINE DEVICE161968 COPPER 380 SQUARE MM INTRAUTERINE DEVICE161982 FLU VACCINE TR-SP 2013-2014 (6-35 MOS)(PF) 22.5 MCG/0.25 ML IM SYRINGE162038 ALUMINUM HYDROXIDE 1.2 % TOPICAL OINTMENT162047 TACROLIMUS ER 0.5 MG CAPSULE,EXTENDED RELEASE 24 HR162048 TACROLIMUS ER 1 MG CAPSULE,EXTENDED RELEASE 24 HR162068 GOLIMUMAB 100 MG/ML SUBCUTANEOUS PEN INJECTOR162095 CLOBAZAM 2.5 MG/ML ORAL SUSPENSION162124 PHENYLEPHRINE 0.25 %-MINERAL OIL 14 %-PETROLATM 74.9 % RECTAL OINTMEN162184 ENALAPRIL MALEATE 1 MG/ML ORAL SOLUTION162289 OXYBUTYNIN 3.9 MG/24 HOUR TRANSDERMAL 4 DAY PATCH

162289 OXYBUTYNIN 3.9 MG/24 HOUR TRANSDERMAL 4 DAY PATCH164335 MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION164336 MIDAZOLAM (PF) 1 MG/ML INJECTION SOLUTION164494 MACITENTAN 10 MG TABLET164606 PHENYLEPHRINE HCL 0.25 %-COCOA BUTTER 88.44 % RECTAL SUPPOSITORY164649 PHENYLEPHRINE HCL 0.25 %-COCOA BUTTER 85.5 % RECTAL SUPPOSITORY164797 ORGAN PRESERVATION (BELZER UW) 125 MEQ/L PERFUSION IRRIGATION SOLUTI164885 PEDIATRIC MULTIVITAMIN NO.67-IRON FUMARATE 18 MG CHEWABLE TABLET500075 DEXTROSE 5% AND 0.45% SODIUM CHLORIDE IV (ONCOLOGY)500075 DEXTROSE 5% AND 0.45% SODIUM CHLORIDE IV (ONCOLOGY)500078 CYTARABINE 20 MG/ML EXTEMP INJ500081 DEXAMETHASONE 1 MG/ML (ONCOLOGY ANTI-EMETIC) SOLN500120 CYTARABINE 100 MG/ML SUB-Q EXTEMP INJ500125 LEUCOVORIN 10 MG/ML EXTEMP INJ500125 LEUCOVORIN 10 MG/ML EXTEMP INJ500137 BORTEZOMIB 1 MG/ML EXTEMP IV INJ500152 DEXAMETHASONE 4 MG (ONCOLOGY ANTI-EMETIC) TAB500153 DEXAMETHASONE 0.5 MG (ONCOLOGY ANTI-EMETIC) TAB500160 DEXAMETHASONE 1 MG (ONCOLOGY ANTI-EMETIC) TAB500170 DOXORUBICIN 2 MG/ML EXTEMP INJ500170 DOXORUBICIN 2 MG/ML EXTEMP INJ500171 DACTINOMYCIN EXTEMP INJ500173 DEXAMETHASONE (ONCOLOGY PREMED) 4 MG/ML EXTEMP INJ500187 ASPARAGINASE (ERWINIA CHRYSANTHEMI) IM EXTEMP INJ500187 ASPARAGINASE (ERWINIA CHRYSANTHEMI) IM EXTEMP INJ500188 FLUOROURACIL 50 MG/ML EXTEMP INJ500190 DAUNORUBICIN 5 MG/ML EXTEMP INJ500193 MECHLORETHAMINE 1 MG/ML EXTEMP INJ500199 VINBLASTINE 1 MG/ML EXTEMP INJ500205 DEXTROSE 5 % IN WATER (D5W) IV SOLN (ONCOLOGY)500205 DEXTROSE 5 % IN WATER (D5W) IV SOLN (ONCOLOGY)500205 DEXTROSE 5 % IN WATER (D5W) IV SOLN (ONCOLOGY)500205 DEXTROSE 5 % IN WATER (D5W) IV SOLN (ONCOLOGY)500205 DEXTROSE 5 % IN WATER (D5W) IV SOLN (ONCOLOGY)500206 DEXTROSE 5 % AND 0.45 % SODIUM CHLORIDE IV SOLN (ONCOLOGY)500206 DEXTROSE 5 % AND 0.45 % SODIUM CHLORIDE IV SOLN (ONCOLOGY)500207 DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE IV SOLN (ONCOLOGY)500207 DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE IV SOLN (ONCOLOGY)500207 DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE IV SOLN (ONCOLOGY)500208 DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE IV SOLN (ONCOLOGY)500208 DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE IV SOLN (ONCOLOGY)500209 SODIUM CHLORIDE 0.9 % IV SOLN (ONCOLOGY)500209 SODIUM CHLORIDE 0.9 % IV SOLN (ONCOLOGY)500209 SODIUM CHLORIDE 0.9 % IV SOLN (ONCOLOGY)500209 SODIUM CHLORIDE 0.9 % IV SOLN (ONCOLOGY)500209 SODIUM CHLORIDE 0.9 % IV SOLN (ONCOLOGY)500210 SODIUM CHLORIDE 0.45 % IV SOLN (ONCOLOGY)500210 SODIUM CHLORIDE 0.45 % IV SOLN (ONCOLOGY)500211 LACTATED RINGERS IV SOLN (ONCOLOGY)500211 LACTATED RINGERS IV SOLN (ONCOLOGY)500213 POTASSIUM CHLORIDE 20 MEQ/L IN 0.45% SODIUM CHLORIDE (ONCOLOGY)500214 POTASSIUM CHLORIDE 20 MEQ/L IN 0.9% SODIUM CHLORIDE (ONCOLOGY)500215 POTASSIUM CHLORIDE 20 MEQ/L IN D5 & 0.9& SODIUM CHLORIDE (ONCOLOGY)500216 POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.2% SODIUM CHLORIDE (ONCOLOGY)500217 POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.45% SODIUM CHLORIDE (ONCOLOGY)500218 POTASSIUM CHLORIDE 30 MEQ/L IN D5-0.45% SODIUM CHLORIDE (ONCOLOGY)500219 POTASSIUM CHLORIDE 40 MEQ/L IN 0.9% SODIUM CHLORIDE (ONCOLOGY)

500220 POTASSIUM CHLORIDE 40 MEQ/L IN D5-0.9% SODIUM CHLORIDE (ONCOLOGY)500221 POTASSIUM CHLORIDE 40 MEQ/L IN D5-0.45% SODIUM CHLORIDE (ONCOLOGY)500222 POTASSIUM CHLORIDE 10 MEQ/L IN D5-0.45% SODIUM CHLORIDE (ONCOLOGY)500223 HYDROCORTISONE (PF) 10 MG/ML FOR INTRATHECAL MIXTURE500255 NELARABINE 5 MG/ML EXTEMP INFUSION500256 TOPOTECAN 1 MG/ML ORAL SOLUTION500259 GLUCARPIDASE 1000 U/ML EXTEMP INJ500260 IDARUBICIN 1 MG/ML EXTEMP INJ500260 IDARUBICIN 1 MG/ML EXTEMP INJ500275 PEGASPARGASE IM 750 UNITS/ML EXTEMP INJ500290 IRINOTECAN 20 MG/ML ORAL SOLUTION500345 AZACITIDINE SUB-Q (25 MG/ML) EXTEMP INJ500401 METHOTREXATE SODIUM (PF) 25 MG/ML EXTEMP INJECTION600082 LACTATED RINGERS IV BOLUS600082 LACTATED RINGERS IV BOLUS600083 SODIUM CHLORIDE 0.9% IV BOLUS600083 SODIUM CHLORIDE 0.9% IV BOLUS600083 SODIUM CHLORIDE 0.9% IV BOLUS600083 SODIUM CHLORIDE 0.9% IV BOLUS600083 SODIUM CHLORIDE 0.9% IV BOLUS600105 FUROSEMIDE 10 MG/ML EXTEMP INJECTION600105 FUROSEMIDE 10 MG/ML EXTEMP INJECTION600105 FUROSEMIDE 10 MG/ML EXTEMP INJECTION600130 DIPHENHYDRAMINE 50 MG/ML EXTEMP INJECTION600134 FOSPHENYTOIN 50 MG PE/ML EXTEMP INJECTION600135 ONDANSETRON 2 MG/ML EXTEMP INJECTION600136 EPOETIN ALFA 2,000 UNIT/ML EXTEMP INJECTION600137 EPOETIN ALFA 3,000 UNIT/ML EXTEMP INJECTION600138 EPOETIN ALFA 4,000 UNIT/ML EXTEMP INJECTION600139 EPOETIN ALFA 10,000 UNIT/ML EXTEMP INJECTION600142 WATER FOR IRRIGATION, STERILE (OR USE)600142 WATER FOR IRRIGATION, STERILE (OR USE)600142 WATER FOR IRRIGATION, STERILE (OR USE)600178 HYDROCORTISONE SOD SUCC (PF) 50 MG/ML EXTEMP INJECTION600179 RANITIDINE 25 MG/ML EXTEMP INJECTION600197 TUBERCULIN PPD 5 TUB. UNIT/0.1 ML EXTEMP INJECTION600269 SODIUM CHLORIDE 0.45 % IV BOLUS600269 SODIUM CHLORIDE 0.45 % IV BOLUS600384 PENTOBARBITAL 50 MG/ML EXTEMP INJECTION600445 SODIUM CHLORIDE 0.9% IV CHASER SOLN (LPCH)600445 SODIUM CHLORIDE 0.9% IV CHASER SOLN (LPCH)600445 SODIUM CHLORIDE 0.9% IV CHASER SOLN (LPCH)600445 SODIUM CHLORIDE 0.9% IV CHASER SOLN (LPCH)600445 SODIUM CHLORIDE 0.9% IV CHASER SOLN (LPCH)600451 DEXTROSE 5% AND 0.45% NACL IV (LPCH MEDLINE)600451 DEXTROSE 5% AND 0.45% NACL IV (LPCH MEDLINE)600452 DEXTROSE 5% AND 0.2% NACL IV (LPCH MEDLINE)600452 DEXTROSE 5% AND 0.2% NACL IV (LPCH MEDLINE)600452 DEXTROSE 5% AND 0.2% NACL IV (LPCH MEDLINE)600453 DEXTROSE 5% IN WATER IV (LPCH MEDLINE)600453 DEXTROSE 5% IN WATER IV (LPCH MEDLINE)600454 SODIUM CHLORIDE 0.9% IV (LPCH MEDLINE)600454 SODIUM CHLORIDE 0.9% IV (LPCH MEDLINE)600454 SODIUM CHLORIDE 0.9% IV (LPCH MEDLINE)600454 SODIUM CHLORIDE 0.9% IV (LPCH MEDLINE)600454 SODIUM CHLORIDE 0.9% IV (LPCH MEDLINE)600506 ALBUMIN, HUMAN 5% IV BOLUS (ML,ML/KG)

600506 ALBUMIN, HUMAN 5% IV BOLUS (ML,ML/KG)600507 CALCITRIOL 1 MCG/ML EXTEMP INJ600508 DARBEPOETIN ALFA 100 MCG/ML EXTEMP INJ600509 DARBEPOETIN ALFA 25 MCG/ML EXTEMP INJ600512 THIAMINE HCL 100 MG/ML EXTEMP INJ600513 DEXAMETHASONE 10 MG/ML EXTEMP INJ600514 DEXAMETHASONE 4 MG/ML EXTEMP INJ600515 METOCLOPRAMIDE 5 MG/ML EXTEMP INJ600517 PARICALCITOL 2 MCG/ML IV EXTEMP INJ600518 PARICALCITOL 5 MCG/ML IV EXTEMP INJ600519 MANNITOL 25% IV (HEMODIALYSIS)600521 SODIUM CHLORIDE 0.9% (CADD)600521 SODIUM CHLORIDE 0.9% (CADD)600521 SODIUM CHLORIDE 0.9% (CADD)600521 SODIUM CHLORIDE 0.9% (CADD)600521 SODIUM CHLORIDE 0.9% (CADD)600522 SODIUM CHLORIDE 0.9% (ON-Q)600522 SODIUM CHLORIDE 0.9% (ON-Q)600522 SODIUM CHLORIDE 0.9% (ON-Q)600522 SODIUM CHLORIDE 0.9% (ON-Q)600522 SODIUM CHLORIDE 0.9% (ON-Q)600524 BUPIVACAINE (PF) 0.5% (FOR LPCH CUSTOM % MIXTURES)600524 BUPIVACAINE (PF) 0.5% (FOR LPCH CUSTOM % MIXTURES)600525 LIDOCAINE (PF) 2% (FOR LPCH CUSTOM % MIXTURES)600525 LIDOCAINE (PF) 2% (FOR LPCH CUSTOM % MIXTURES)600526 ROPIVACAINE (PF) 0.5% (FOR LPCH CUSTOM & MIXTURES)600544 NALBUPHINE 10 MG/ML EXTEMP INJ600545 NALBUPHINE 20 MG/ML EXTEMP INJ600546 ABCIXIMAB 2 MG/ML EXTEMP INJ600547 ACETAMINOPHEN 10 MG/ML EXTEMP INJ600548 ACETAZOLAMIDE 50 MG/ML EXTEMP INJ600549 ADALIMUMAB 50 MG/ML EXTEMP INJ600550 ADENOSINE 3 MG/ML EXTEMP INJ600552 ALTEPLASE (CATHFLO) 1 MG/ML EXTEMP INJ600554 AMINOCAPROIC ACID 250 MG/ML EXTEMP INJ600555 AMINOPHYLLINE 25 MG/ML EXTEMP INJ600556 ANAKINRA 150 MG/ML EXTEMP INJ600558 ARGININE HCL 10% EXTEMP INJ (MG/KG)600559 ATRACURIUM 10 MG/ML EXTEMP INJ600559 ATRACURIUM 10 MG/ML EXTEMP INJ600566 ADENOSINE (DIAGNOSTIC) 3 MG/ML EXTEMP INJ600567 ALTEPLASE (ACTIVASE) 1 MG/ML EXTEMP INJ600569 BASILIXIMAB 4 MG/ML EXTEMP INJ600572 PHENYLEPHRINE 10 MCG/ML IN NS CPD INJ600573 PHENYLEPHRINE 1 MCG/ML IN NS CPD INJ600575 SUFENTANIL (PF) 0.4 MCG/ML-BUPIVACAINE 0.1% IN NS600576 OXYMETAZOLINE 0.025% NASAL CPD SOLN600577 FENTANYL (PF) 50 MCG/ML PCA EXTEMP (FOR MIXTURES)600577 FENTANYL (PF) 50 MCG/ML PCA EXTEMP (FOR MIXTURES)600577 FENTANYL (PF) 50 MCG/ML PCA EXTEMP (FOR MIXTURES)600577 FENTANYL (PF) 50 MCG/ML PCA EXTEMP (FOR MIXTURES)600578 HYDROMORPHONE 2 MG/ML PCA EXTEMP600578 HYDROMORPHONE 2 MG/ML PCA EXTEMP600579 HYDROMORPHONE (PF) 10 MG/ML PCA EXTEMP (FOR MIXTURES)600579 HYDROMORPHONE (PF) 10 MG/ML PCA EXTEMP (FOR MIXTURES)600580 MORPHINE 15 MG/ML PCA EXTEMP (FOR MIXTURES)600580 MORPHINE 15 MG/ML PCA EXTEMP (FOR MIXTURES)

600581 KETAMINE 100 MG/ML PCA EXTEMP600582 METHADONE 10 MG/ML PCA EXTEMP600583 MIDAZOLAM 5 MG/ML PCA EXTEMP600584 NALBUPHINE 10 MG/ML PCA EXTEMP600585 SUFENTANIL 50 MCG/ML PCA EXTEMP600585 SUFENTANIL 50 MCG/ML PCA EXTEMP600586 BUPIVACAINE (PF) 0.25% (FOR LPCH CUSTOM % MIXTURES)600586 BUPIVACAINE (PF) 0.25% (FOR LPCH CUSTOM % MIXTURES)600587 COLISTIMETHATE 75 MG/ML EXTEMP INJ600588 BUPIVACAINE 2.5MG-SUFENTANIL 5MCG/1.1 ML INJ CPD600589 BUPIVACAINE 0.125%-SUFENTANIL 10 MCG/15 ML INJ CPD600590 BENZTROPINE 1 MG/ML EXTEMP INJ600591 BETAMETHASONE ACET & SOD PHOS 6 MG/ML SUSP EXTEMP INJ600592 BUMETANIDE 0.25 MG/ML EXTEMP INJ600592 BUMETANIDE 0.25 MG/ML EXTEMP INJ600594 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) EXTEMP INJ600594 BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) EXTEMP INJ600595 BUPIVACAINE (PF) 0.5 % (5 MG/ML) EXTEMP INJ600595 BUPIVACAINE (PF) 0.5 % (5 MG/ML) EXTEMP INJ600596 CAFFEINE CITRATED 20 MG/ML EXTEMP INJ600597 CALCITONIN (SALMON) 200 UNIT/ML EXTEMP INJ600598 CALCIUM CHLORIDE 100 MG/ML (10 %) EXTEMP INJ600599 CALCIUM GLUCONATE 100 MG/ML (10 %) EXTEMP INJ600599 CALCIUM GLUCONATE 100 MG/ML (10 %) EXTEMP INJ600600 CHLOROTHIAZIDE SODIUM 25 MG/ML EXTEMP INJ600601 CHLORPROMAZINE 25 MG/ML EXTEMP INJ600602 CISATRACURIUM 2 MG/ML EXTEMP INJ600603 CONJUGATED ESTROGENS 5 MG/ML EXTEMP INJ600604 COSYNTROPIN 0.25 MG/ML EXTEMP INJ600605 CYANOCOBALAMIN (VITAMIN B-12) 1,000 MCG/ML EXTEMP INJ600606 DESMOPRESSIN 4 MCG/ML EXTEMP INJ600606 DESMOPRESSIN 4 MCG/ML EXTEMP INJ600607 DEXTRAN-40 10% IN D5W EXTEMP SOLN600608 DEXTROSE 10 % AND 0.2 % SODIUM CHLORIDE BOLUS EXTEMP600609 DEXTROSE 10 % AND 0.45 % SODIUM CHLORIDE BOLUS EXTEMP600611 DICYCLOMINE 10 MG/ML EXTEMP INJ600612 DIGOXIN 100 MCG/ML EXTEMP INJ600614 DIHYDROERGOTAMINE 1 MG/ML EXTEMP INJ600616 DIMERCAPROL 100 MG/ML EXTEMP INJ600617 DOLASETRON 20 MG/ML EXTEMP INJ600621 DOXAPRAM 20 MG/ML EXTEMP INJ600622 EDROPHONIUM CHLORIDE 10 MG/ML EXTEMP INJ600623 ENALAPRILAT 1.25 MG/ML EXTEMP INJ600624 ENOXAPARIN 100 MG/ML EXTEMP INJ600625 ENOXAPARIN 150 MG/ML EXTEMP INJ600626 EPHEDRINE IN 0.9 % NACL (PF) 5 MG/ML EXTEMP INJ600629 ESTRADIOL CYPIONATE 5 MG/ML OIL EXTEMP INJ600630 ETANERCEPT 25 MG/ML EXTEMP INJ600631 ETANERCEPT 50 MG/ML EXTEMP INJ600632 ETHACRYNATE SODIUM 1 MG/ML EXTEMP INJ600633 FILGRASTIM 300 MCG/ML EXTEMP INJ600636 FONDAPARINUX 5 MG/ML EXTEMP INJ600637 FONDAPARINUX 12.5 MG/ML EXTEMP INJ600639 GENTAMICIN IN NACL 1.6 MG/ML EXTEMP INJ600640 GENTAMICIN SULFATE (PEDIATRIC) (PF) 10 MG/ML EXTEMP INJ600641 GLATIRAMER 20 MG/ML EXTEMP INJ600642 GLYCOPYRROLATE 0.2 MG/ML EXTEMP INJ

600642 GLYCOPYRROLATE 0.2 MG/ML EXTEMP INJ600643 GRANISETRON 1 MG/ML EXTEMP INJ600644 HALOPERIDOL 5 MG/ML EXTEMP INJ600645 HEPARIN (PORCINE) 1,000 UNIT/ML EXTEMP INJ600645 HEPARIN (PORCINE) 1,000 UNIT/ML EXTEMP INJ600645 HEPARIN (PORCINE) 1,000 UNIT/ML EXTEMP INJ600646 HEPARIN (PORCINE) 5,000 UNIT/ML EXTEMP INJ600648 HEPARIN LOCK FLUSH (PORCINE) 100 UNIT/ML EXTEMP INJ600649 HEPARIN, PORCINE (PF) 1,000 UNIT/ML EXTEMP INJ600650 HEPARIN, PORCINE (PF) 100 UNIT/ML EXTEMP INJ600652 HYDROCORTISONE SOD SUCC (PF) 125 MG/ML EXTEMP INJ600656 HYDROXYZINE 25 MG/ML IM EXTEMP INJ600657 HYDROXYZINE 50 MG/ML IM EXTEMP INJ600658 IBUPROFEN LYSINE (PF) 10 MG/ML EXTEMP INJ600659 INDOMETHACIN 0.5 MG/ML EXTEMP INJ600660 INTERFERON BETA-1A 30 MCG/ML EXTEMP INJ600661 IRON DEXTRAN 50 MG/ML EXTEMP INJ600663 ISOPROTERENOL 0.2 MG/ML EXTEMP INJ600665 KETOROLAC 15 MG/ML EXTEMP INJ600666 KETOROLAC 30 MG/ML EXTEMP INJ600669 LEVOCARNITINE 200 MG/ML EXTEMP INJ600672 LINEZOLID 2 MG/ML EXTEMP INJ600673 LIOTHYRONINE 10 MCG/ML EXTEMP INJ600674 MAGNESIUM SULFATE 40 MG/ML (4 %) EXTEMP INJ600676 METHYLERGONOVINE 0.2 MG/ML EXTEMP INJ600677 METHYLNALTREXONE 20 MG/ML EXTEMP INJ600678 METHYLPREDNISOLONE SODIUM SUCC 62.5 MG/ML EXTEMP INJ600679 METHYLPREDNISOLONE SODIUM SUCC 40 MG/ML EXTEMP INJ600680 METOPROLOL 5 MG/5 ML EXTEMP INJ600681 MOXIFLOXACIN IN SODIUM CHLORIDE (ISO-OSM) 1.6 MG/ML EXTEMP INJ600682 NESIRITIDE 0.3 MG/ML EXTEMP INJ600683 OCTREOTIDE ACETATE 100 MCG/ML EXTEMP INJ600684 OCTREOTIDE ACETATE 200 MCG/ML EXTEMP INJ600685 OCTREOTIDE ACETATE 500 MCG/ML EXTEMP INJ600686 OLANZAPINE 5 MG/ML EXTEMP INJ600687 OMALIZUMAB 125 MG/ML EXTEMP INJ600688 PALIFERMIN 5 MG/ML EXTEMP INJ600689 PALIVIZUMAB 100 MG/ML EXTEMP INJ600690 PALONOSETRON 0.05 MG/ML EXTEMP INJ600692 PANTOPRAZOLE 4 MG/ML EXTEMP INJ600693 PEGADEMASE BOVINE 250 UNIT/ML EXTEMP INJ600694 PEGFILGRASTIM 10 MG/ML EXTEMP INJ600695 PEGINTERFERON ALFA-2A 360 MCG/ML EXTEMP INJ600696 PEGINTERFERON ALFA-2B 240 MCG/ML EXTEMP INJ600697 PEGINTERFERON ALFA-2B 100 MCG/ML EXTEMP INJ600698 PEGINTERFERON ALFA-2B 160 MCG/ML EXTEMP INJ600699 PENICILLIN G BENZATHINE 600,000 UNIT/ML EXTEMP INIJ600700 PENICILLIN G BENZATHINE&PROCAIN 600,000 UNIT/ML EXTEMP INJ600701 PENICILLIN G PROCAINE 600,000 UNIT/ML EXTEMP INJ600705 PLERIXAFOR 20 MG/ML EXTEMP INJ600706 POTASSIUM CHLORIDE 0.4 MEQ/ML EXTEMP INJ (CENTRAL LINE)600707 PRALIDOXIME 50 MG/ML EXTEMP INJ600708 PROCHLORPERAZINE EDISYLATE 5 MG/ML EXTEMP INJ600709 PROMETHAZINE 25 MG/ML EXTEMP INJ600710 PROPRANOLOL 1 MG/ML EXTEMP INJ600711 PROTAMINE 10 MG/ML EXTEMP INJ600711 PROTAMINE 10 MG/ML EXTEMP INJ

600712 PYRIDOSTIGMINE BROMIDE 5 MG/ML EXTEMP INJ600713 PYRIDOXINE 100 MG/ML EXTEMP INJ600715 RABIES IMMUNE GLOBULIN (PF) 150 UNIT/ML EXTEMP INJ600716 RISPERIDONE MICROSPHERES 6.25 MG/ML EXTEMP INJ600718 SARGRAMOSTIM 250 MCG/ML EXTEMP INJ600719 SCOPOLAMINE 0.4 MG/ML EXTEMP INJ600720 SODIUM BICARBONATE 4.2 % (0.5 MEQ/ML) EXTEMP INJ600721 SODIUM BICARBONATE 8.4 % (1 MEQ/ML) EXTEMP INJ600722 SODIUM CHLORIDE 3 % BOLUS600723 SODIUM HYALURONATE (VISCOSUPPLEM) 10 MG/ML INTRA-ARTICULAR EXTEMP I600725 SUMATRIPTAN 12 MG/ML EXTEMP INJ600726 TERBUTALINE 1 MG/ML EXTEMP INJ600732 TRIMETHOBENZAMIDE 100 MG/ML EXTEMP INJ600733 TROMETHAMINE 36 MG/ML EXTEMP INJ600734 VASOPRESSIN 20 UNIT/ML EXTEMP INJ600735 VERAPAMIL 2.5 MG/ML EXTEMP INJ600735 VERAPAMIL 2.5 MG/ML EXTEMP INJ600736 VITAMIN A PALMITATE 50,000 UNIT/ML EXTEMP INJ600737 ZIPRASIDONE 20 MG/ML EXTEMP INJ600738 ZOLEDRONIC ACID IN MANNITOL & WATER 0.05 MG/ML EXTEMP INJ600739 DEXTROSE 5% IN WATER (D5W) IV BOLUS600739 DEXTROSE 5% IN WATER (D5W) IV BOLUS600739 DEXTROSE 5% IN WATER (D5W) IV BOLUS600739 DEXTROSE 5% IN WATER (D5W) IV BOLUS600739 DEXTROSE 5% IN WATER (D5W) IV BOLUS600741 SODIUM CHLORIDE 0.9% IV FLUSH (HEMODIALYSIS)600741 SODIUM CHLORIDE 0.9% IV FLUSH (HEMODIALYSIS)600741 SODIUM CHLORIDE 0.9% IV FLUSH (HEMODIALYSIS)600741 SODIUM CHLORIDE 0.9% IV FLUSH (HEMODIALYSIS)600741 SODIUM CHLORIDE 0.9% IV FLUSH (HEMODIALYSIS)600754 METRONIDAZOLE IN NACL 5 MG/ML EXTEMP INJ600755 PANCURONIUM 1 MG/ML EXTEMP INJ600756 CIPROFLOXACIN IN D5W 2 MG/ML EXTEMP INJ600757 CLINDAMYCIN 18 MG/ML EXTEMP INJ600758 FLUCONAZOLE IN NACL 2 MG/ML EXTEMP INJ600759 LEVOFLOXACIN IN D5W 5 MG/ML EXTEMP INJ600761 IVIG 10% (GAMMAGARD LIQUID) EXTEMP600761 IVIG 10% (GAMMAGARD LIQUID) EXTEMP600761 IVIG 10% (GAMMAGARD LIQUID) EXTEMP600761 IVIG 10% (GAMMAGARD LIQUID) EXTEMP600761 IVIG 10% (GAMMAGARD LIQUID) EXTEMP600762 IVIG 10% (GAMUNEX-C) EXTEMP600772 AMPHOTERICIN B 5 MG/ML INHALATION SOLN600776 D5-0.45% NACL & KCL 20 MEQ/L (1.5X 4-2-1 IV RATE)600778 FUROSEMIDE 10 MG/ML IV INFUSION600778 FUROSEMIDE 10 MG/ML IV INFUSION600778 FUROSEMIDE 10 MG/ML IV INFUSION600779 BUMETANIDE 0.25 MG/ML IV INFUSION600779 BUMETANIDE 0.25 MG/ML IV INFUSION600781 DEXTROSE 5 % IN WATER (D5W) IV BOLUS600781 DEXTROSE 5 % IN WATER (D5W) IV BOLUS600781 DEXTROSE 5 % IN WATER (D5W) IV BOLUS600781 DEXTROSE 5 % IN WATER (D5W) IV BOLUS600781 DEXTROSE 5 % IN WATER (D5W) IV BOLUS600782 SODIUM CHLORIDE 3% IV INFUSION (ML/HR, ML/KG/HR)600783 PROPOFOL 10 MG/ML IV INFUSION 600783 PROPOFOL 10 MG/ML IV INFUSION

600783 PROPOFOL 10 MG/ML IV INFUSION 600785 INSULIN REGULAR HUMAN 100 UNIT/ML EXTEMP INJECTION600786 DEXTROSE 10% IN WATER (D10W) IV BOLUS600792 INSULIN LISPRO HOME INFUSION PUMP REGIMEN600793 INSULIN ASPART HOME INFUSION PUMP REGIMEN600793 INSULIN ASPART HOME INFUSION PUMP REGIMEN600794 INSULIN GLULISINE HOME INFUSION PUMP REGIMEN600802 ESMOLOL 10 MG/ML IV EXTEMP INJECTION600824 VANCOMYCIN 50 MG/ML INJ FOR INHALATION600825 ARGININE HCL 10% EXTEMP INJ (G/M2)600826 ARGININE HCL 10% EXTEMP INJ (MEQ)600827 DEXTROSE 10% IN WATER (D10W) IV CHASER SOLN (LPCH)600827 DEXTROSE 10% IN WATER (D10W) IV CHASER SOLN (LPCH)600827 DEXTROSE 10% IN WATER (D10W) IV CHASER SOLN (LPCH)600841 TREPROSTINIL 3 MG/3 ML EXTEMP SUB-Q INFUSION600842 TREPROSTINIL 7.5 MG/3 ML EXTEMP SUB-Q INFUSION600843 TREPROSTINIL 15 MG/3 ML EXTEMP SUB-Q INFUSION600848 SODIUM CHLORIDE 0.9% (REGIONAL BLOCK)600848 SODIUM CHLORIDE 0.9% (REGIONAL BLOCK)600848 SODIUM CHLORIDE 0.9% (REGIONAL BLOCK)600848 SODIUM CHLORIDE 0.9% (REGIONAL BLOCK)600848 SODIUM CHLORIDE 0.9% (REGIONAL BLOCK)600849 AZTREONAM 100 MG/ML EXTEMP INJ600850 AMIFOSTINE 160 MG/ML SUBQ INJECTION600851 DEFEROXAMINE 250 MG/ML IM INJECTION600852 DEFEROXAMINE 100 MG/ML SUBQ INJECTION600853 CEFAZOLIN 100 MG/ML EXTEMP INJ600854 CEFOTAXIME 100 MG/ML EXTEMP INJ600855 CEFOXITIN 100 MG/ML EXTEMP INJ600856 CEFTAZIDIME 100 MG/ML EXTEMP INJ600857 CEFUROXIME 100 MG/ML EXTEMP INJ600858 NALBUPHINE 2.5 MG/0.25 ML INJ PREPACK600859 METHADONE 10 MG/1 ML INJ PREPACK600860 PENTOBARBITAL 100 MG/2 ML INJ PREPACK600864 CEFTRIAXONE 350 MG/ML IM EXTEMP INJ600865 CEFTRIAXONE IN LIDOCAINE 350 MG/ML IM EXTEMP INJ600866 LIDOCAINE/EPI 1%/1:1MMU BICARB BUFFER INJ CPD600867 LIDOCAINE/EPI 2%/1:2MMU BICARB BUFFER INJ CPD600868 ETHANOL (ETHYL ALCOHOL) 70 % INJ CPD600869 SUFENTANIL (PF) 0.4 MCG/ML-BUPIVACAINE 0.0625% IN NS600872 CEFAZOLIN 330 MG/ML IM EXTEMP INJ600873 CEFOTAXIME 300 MG/ML IM EXTEMP INJ600874 CEFTAZIDIME 280 MG/ML IM EXTEMP INJ600876 CEFUROXIME 225 MG/ML IM EXTEMP INJ600887 DOPAMINE IN D5W 3.2 MG/ML IV SOLUTION (FAILSAFE)600887 DOPAMINE IN D5W 3.2 MG/ML IV SOLUTION (FAILSAFE)600888 AMPICILLIN-SULBACTAM 250 MG/ML IM EXTEMP INJ600900 ACETYLCYSTEINE 200 MG/ML (FOR LPCH CUSTOM MIXTURES)600902 OXYTOCIN IN LR 20 UNITS/1000 ML IV (ML/HR)600922 MILRINONE 0.2 MG/ML IN D5W EXTEMP INJ600928 MORPHINE (PF) 0.5 MG/1 ML INJ PREPACK600929 MORPHINE (PF) 4 MG/8 ML INJ PREPACK600930 MORPHINE 2 MG/1 ML INJ PREPACK600931 LABETALOL 20 MG/4 ML INJ PREPACK600932 HEPARIN (PF) 30,000 UNIT/1L IN NS PREPACK600933 LIDOCAINE (MPF) 10 MG/ML (1 %) J-TIP 0.25 ML INJ SYR600934 LIDOCAINE 1 % BUFFERED WITH 8.4 % SODIUM BICARBONATE (3 ML) PREPACK

600936 ALTEPLASE 2 MG/2 ML INJ PREPACK600937 CEFOTAXIME 1 GRAM INTRAVENOUS PIGGYBACK (LPCH)600938 CEFOTAXIME 2 GRAM INTRAVENOUS PIGGYBACK (LPCH)600939 EPINEPHRINE (PF) 0.05 MG/ML (1 MG/20 ML) INJ PREPACK600943 D5-0.45% NACL + KCL 20 MEQ/L REPLACEMENT SOLN600944 LORAZEPAM 2 MG/ML IV INFUSION600945 PENTOBARBITAL 50 MG/ML IV INFUSION600945 PENTOBARBITAL 50 MG/ML IV INFUSION600946 PANCURONIUM 1 MG/ML IV INFUSION600952 ALPROSTADIL 10 MCG/ML INJ DILUTION600953 PHENTOLAMINE 0.4 MG/1.7 ML CARTRIDGE600954 DEXMEDETOMIDINE 4 MCG/ML EXTEMP INJ600966 POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.45% NACL IV BOLUS600968 DEXTROSE 5% IN WATER IV SOLN (FOR NAC DILUTION)600968 DEXTROSE 5% IN WATER IV SOLN (FOR NAC DILUTION)600968 DEXTROSE 5% IN WATER IV SOLN (FOR NAC DILUTION)600968 DEXTROSE 5% IN WATER IV SOLN (FOR NAC DILUTION)600968 DEXTROSE 5% IN WATER IV SOLN (FOR NAC DILUTION)600975 VECURONIUM 1 MG/ML IV INFN (FAILSAFE)600996 ESMOLOL 10 MG/ML IN SODIUM CHLORIDE (ISO-OSMOTIC) IV (FAILSAFE)600996 ESMOLOL 10 MG/ML IN SODIUM CHLORIDE (ISO-OSMOTIC) IV (FAILSAFE)601031 VANCOMYCIN 5 MG/ML EXTEMP INJ601032 VANCOMYCIN 0.5 MG/ML (PRE-DILUTION FOR CATHETER CARE)601033 HYDROCORTISONE SOD SUCC 10 MG/ML (PRE-DILUTION FOR CATHETER CARE)601034 SODIUM CHLORIDE 0.9% IV SOLN (FOR DILUTIONS)601037 SODIUM CHLORIDE 2.5 MEQ/ML IV SOLN (%)601038 SODIUM ACETATE 2 MEQ/ML IV SOLN (%)601044 SODIUM CHLORIDE 2.5 MEQ/ML IV SOLN (MEQ/L)601045 POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN (MEQ/L)601045 POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN (MEQ/L)601045 POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN (MEQ/L)601046 SODIUM ACETATE 2 MEQ/ML IV SOLN (MEQ/L)601047 POTASSIUM ACETATE 2 MEQ/ML IV SOLN (MEQ/L)601047 POTASSIUM ACETATE 2 MEQ/ML IV SOLN (MEQ/L)601048 SODIUM PHOSPHATE 3 MILLIMOLE/ML IV SOLN (MEQ/L)601048 SODIUM PHOSPHATE 3 MILLIMOLE/ML IV SOLN (MEQ/L)601049 POTASSIUM PHOSPHATE 3 MILLIMOLE/ML IV SOLN (MEQ/L)601049 POTASSIUM PHOSPHATE 3 MILLIMOLE/ML IV SOLN (MEQ/L)601050 CALCIUM GLUCONATE 100 MG/ML IV SOLN (GM/L)601050 CALCIUM GLUCONATE 100 MG/ML IV SOLN (GM/L)601051 SODIUM BICARBONATE 8.4% IV SOLN (MEQ/L)601052 MAGNESIUM SULFATE 4 MEQ/ML IV SOLN (G/L)601052 MAGNESIUM SULFATE 4 MEQ/ML IV SOLN (G/L)601056 NICARDIPINE 0.1 MG/ML IN DEXTROSE IV INFN (FAILSAFE)601056 NICARDIPINE 0.1 MG/ML IN DEXTROSE IV INFN (FAILSAFE)601057 NICARDIPINE 0.1 MG/ML IN SODIUM CHLORIDE IV INFN (FAILSAFE)601057 NICARDIPINE 0.1 MG/ML IN SODIUM CHLORIDE IV INFN (FAILSAFE)601058 MIDAZOLAM 1 MG/ML INJECTION (LPCH)601059 MIDAZOLAM 5 MG/ML INJECTION (LPCH)601059 MIDAZOLAM 5 MG/ML INJECTION (LPCH)601066 CONIVAPTAN IV LOADING DOSE601066 CONIVAPTAN IV LOADING DOSE601067 ATROPINE 0.1 MG/ML EXTEMP INJECTION601067 ATROPINE 0.1 MG/ML EXTEMP INJECTION601068 EPINEPHRINE 0.1 MG (1:10,000) EXTEMP INJECTION601069 NEOSTIGMINE METHYLSULFATE 0.5 MG/ML EXTEMP INJ601075 PANCURONIUM 2 MG/ML INTRAVENOUS SOLUTION (LPCH)

601076 IVIG (GAMMAGARD LIQUID) 10% 1 G/10 ML (LPCH)601077 IVIG (GAMMAGARD LIQUID) 10% 2.5 G/25 ML (LPCH)601078 IVIG (GAMMAGARD LIQUID) 10% 5 G/50 ML (LPCH)601079 IVIG (GAMMAGARD LIQUID) 10% 10 G/100 ML (LPCH)601080 IVIG (GAMMAGARD LIQUID) 10% 20 G/200 ML (LPCH)601091 SODIUM BICARBONATE 1 MEQ/ML IV INFUSION601091 SODIUM BICARBONATE 1 MEQ/ML IV INFUSION601094 DIGOXIN 100 MCG/ML EXTEMP INJ (LOADING DOSE)601095 DIGOXIN 100 MCG/ML INJECTION SOLUTION (LOADING DOSE)601096 DIGOXIN 125 MCG TABLET (LOADING DOSE)601097 DIGOXIN 250 MCG TABLET (LOADING DOSE)601098 DIGOXIN 50 MCG/ML ORAL SOLUTION (LOADING DOSE)601101 IVIG 10% (GAMMAGARD S/D) EXTEMP601102 SUB-Q IG 20% (HIZENTRA) EXTEMP601105 METHADONE 1 MG/1 ML INJ PREPACK601107 SODIUM CHLORIDE 0.45 % IV REPLACEMENT SOLN601107 SODIUM CHLORIDE 0.45 % IV REPLACEMENT SOLN601108 ALBUMIN, HUMAN 5 % IV REPLACEMENT SOLN601108 ALBUMIN, HUMAN 5 % IV REPLACEMENT SOLN601114 DEXTROSE 10% AND 0.2% NACL IV REPLACEMENT SOLN601118 DEXTROSE 10 % IN WATER (D10W) IV REPLACEMENT SOLN601118 DEXTROSE 10 % IN WATER (D10W) IV REPLACEMENT SOLN601118 DEXTROSE 10 % IN WATER (D10W) IV REPLACEMENT SOLN601119 DEXTROSE 5% + 0.45% NACL + KCL 10 MEQ/L IV REPLACEMENT SOLN601120 DEXTROSE 5% AND 0.45% NACL IV REPLACEMENT SOLN601120 DEXTROSE 5% AND 0.45% NACL IV REPLACEMENT SOLN601122 DEXTROSE 5% + 0.2% NACL + KCL 20 MEQ/L IV REPLACEMENT SOLN601123 DEXTROSE 5% AND 0.2% NACL IV REPLACEMENT SOLN601123 DEXTROSE 5% AND 0.2% NACL IV REPLACEMENT SOLN601123 DEXTROSE 5% AND 0.2% NACL IV REPLACEMENT SOLN601125 DEXTROSE 5% + 0.9% NACL + KCL 20 MEQ/L IV REPLACEMENT SOLN601126 DEXTROSE 5% AND 0.9% NACL IV REPLACEMENT SOLN601126 DEXTROSE 5% AND 0.9% NACL IV REPLACEMENT SOLN601127 DEXTROSE 5 % IN WATER (D5W) IV REPLACEMENT SOLN601127 DEXTROSE 5 % IN WATER (D5W) IV REPLACEMENT SOLN601127 DEXTROSE 5 % IN WATER (D5W) IV REPLACEMENT SOLN601127 DEXTROSE 5 % IN WATER (D5W) IV REPLACEMENT SOLN601127 DEXTROSE 5 % IN WATER (D5W) IV REPLACEMENT SOLN601128 DEXTROSE 5% AND LACTATED RINGERS IV BOLUS601129 DEXTROSE 5 % AND 0.9 % NACL IV BOLUS601129 DEXTROSE 5 % AND 0.9 % NACL IV BOLUS601134 CARDIOPLEGIC PEDIATRIC 16 MEQ/L (+KCL+NA BICARB) SOLN PREPACK601137 EPINEPHRINE 1 MG/200 ML (1:200,000) INJ PREPACK601138 DOXYCYCLINE 20 MG/ML SOLUTION (PLEURODESIS)601149 BOTULISM IMMUNE GLOBULIN 1 TREATMENT601163 FAT EMULSION 20 % INTRAVENOUS (G/KG)601163 FAT EMULSION 20 % INTRAVENOUS (G/KG)601163 FAT EMULSION 20 % INTRAVENOUS (G/KG)601175 RIBAVIRIN INJ FOR COMPASSIONATE USE601177 VECURONIUM 100 MG/100 ML IN NS601177 VECURONIUM 100 MG/100 ML IN NS601181 DEXTROSE 5% IN WATER (D5W) IV CHASER601181 DEXTROSE 5% IN WATER (D5W) IV CHASER601181 DEXTROSE 5% IN WATER (D5W) IV CHASER601181 DEXTROSE 5% IN WATER (D5W) IV CHASER601181 DEXTROSE 5% IN WATER (D5W) IV CHASER601185 HEPARIN 100 UNITS/ML (INGREDIENT FOR CUSTOM IV)

601196 VECURONIUM 10 MG IV SOLR (INGREDIENT FOR CUSTOM IV)601199 LEVETIRACETAM 15 MG/ML EXTEMP INJ601200 THIOTEPA 100 MG SOLUTION FOR INJECTION601201 SODIUM CHLORIDE 0.9 % IV REPLACEMENT SOLN601201 SODIUM CHLORIDE 0.9 % IV REPLACEMENT SOLN601201 SODIUM CHLORIDE 0.9 % IV REPLACEMENT SOLN601201 SODIUM CHLORIDE 0.9 % IV REPLACEMENT SOLN601201 SODIUM CHLORIDE 0.9 % IV REPLACEMENT SOLN601202 LACOSAMIDE 10 MG/ML EXTEMP INJ601203 PHENOBARBITAL 65 MG/ML EXTEMP INJ601227 BUPIVACAINE (PF) 0.5% (BOLUS INGREDIENT)601227 BUPIVACAINE (PF) 0.5% (BOLUS INGREDIENT)601228 LIDOCAINE (PF) 2% (BOLUS INGREDIENT)601228 LIDOCAINE (PF) 2% (BOLUS INGREDIENT)601229 ROPIVACAINE (PF) 0.5% (BOLUS INGREDIENT)601230 CLONIDINE (PF) 100 MCG/ML (BOLUS INGREDIENT)601231 FENTANYL (PF) 50 MCG/ML (BOLUS INGREDIENT)601231 FENTANYL (PF) 50 MCG/ML (BOLUS INGREDIENT)601232 HYDROMORPHONE 2 MG/ML (BOLUS INGREDIENT)601233 ZICONOTIDE 100 MCG/ML INTRATHECAL (BOLUS INGREDIENT)601234 SODIUM CHLORIDE 0.9% (BOLUS INGREDIENT)601236 HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML EXTEMP INJ601239 BORTEZOMIB 2.5 MG/ML EXTEMP SUB-Q INJECTION601244 LIDOCAINE (PF) 10 MG/ML (1%) 2 ML (FOR WBN)601245 HEPARIN (PORCINE) 5,000 UNIT/500ML(10 UNIT/ML)IN NS PREPACK601246 CEFTAROLINE 12 MG/ML EXTEMP INJ610040 PARENTERAL NUTRITION SOLUTION RATE ORDER620000 ACETAZOLAMIDE 25 MG/ML ORAL SUSPENSION620001 ALLOPURINOL 20 MG/ML ORAL SUSPENSION620002 AMBRISENTAN 2 MG/ML ORAL SUSPENSION620003 AMILORIDE 1 MG/ML ORAL SUSPENSION620004 AMIODARONE 5 MG/ML ORAL SUSPENSION620005 AMLODIPINE 1 MG/ML ORAL SUSPENSION620006 APREPITANT 20 MG/ML ORAL SUSPENSION620007 ATENOLOL 2 MG/ML ORAL SUSPENSION620008 AZATHIOPRINE 50 MG/ML ORAL SUSPENSION620009 BACLOFEN 10 MG/ML ORAL SUSPENSION620010 BETHANECHOL 5 MG/ML ORAL SUSPENSION620011 BOSENTAN 6.25 MG/ML ORAL SUSPENSION620012 CAPTOPRIL 1 MG/ML ORAL SUSPENSION620013 CARBIDOPA/LEVODOPA 1.25-5 MG/ML ORAL SUSPENSION620014 CARVEDILOL 1 MG/ML ORAL SUSPENSION620015 CELECOXIB 10 MG/ML ORAL SUSPENSION620016 CLONAZEPAM 0.1 MG/ML ORAL SUSPENSION620017 CLONIDINE 0.1 MG/ML ORAL SUSPENSION620018 CLOPIDOGREL 5 MG/ML ORAL SUSPENSION620019 CYCLOPHOSPHAMIDE 10 MG/ML ORAL SUSPENSION620020 DANTROLENE 5 MG/ML ORAL SUSPENSION620021 DILTIAZEM 12 MG/ML ORAL SUSPENSION620022 DIPYRIDAMOLE 10 MG/ML ORAL SUSPENSION620023 ENALAPRIL 1 MG/ML ORAL CPD SUSPENSION620025 FLUCYTOSINE 10 MG/ML ORAL SUSPENSION620026 FOLIC ACID 1 MG/ML ORAL SOLUTION620027 GLUTAMINE 500 MG/ML ORAL SUSPENSION620028 SPIRONOLACTONE-HYDROCHLOROTHIAZIDE 5 MG/ML PO SUSP620029 HYDROCHLOROTHIAZIDE 5 MG/ML ORAL SUSPENSION620030 HYDROCORTISONE 2 MG/ML ORAL SUSPENSION

620031 HYDROXYUREA 100 MG/ML ORAL SUSPENSION620032 ISRADIPINE 1 MG/ML ORAL SUSPENSION620033 LABETALOL 10 MG/ML ORAL SUSPENSION620034 LISINOPRIL 1 MG/ML ORAL SUSPENSION620035 LOSARTAN 2.5 MG/ML ORAL SUSPENSION620036 MERCAPTOPURINE 5 MG/ML ORAL SUSPENSION620037 METOLAZONE 1 MG/ML ORAL SUSPENSION620038 METOPROLOL 10 MG/ML ORAL SUSPENSION620039 METRONIDAZOLE 50 MG/ML ORAL SUSPENSION620040 MINOXIDIL 2 MG/ML ORAL SOLUTION620042 OMEPRAZOLE 2 MG/ML ORAL CPD SUSPENSION620043 PHENAZOPYRIDINE 10 MG/ML ORAL SUSPENSION620044 POTASSIUM SODIUM PHOSPHATE 0.32 MM/ML ORAL CPD SOLN620045 PROBENECID 50 MG/ML ORAL SUSPENSION620046 PYRAZINAMIDE 100 MG/ML ORAL SUSPENSION620048 LIPOIC ACID 50 MG TABLET620049 RIBOFLAVIN 25 MG/ML ORAL SUSPENSION620050 RIFAMPIN 10 MG/ML ORAL SUSPENSION620051 RIFAXIMIN 20 MG/ML ORAL SUSPENSION620052 SELENIUM 40 MCG/ML ORAL SUSPENSION620053 SEVELAMER HCL 50 MG/ML ORAL SUSPENSION620054 SILDENAFIL 2.5 MG/ML ORAL SUSPENSION620055 SODIUM BENZOATE 250 MG/ML ORAL SOLUTION620056 SODIUM CHLORIDE 1 MEQ/ML ORAL SOLUTION620057 SODIUM PHENYLBUTYRATE 200 MG/ML ORAL SUSPENSION620058 SOTALOL 5 MG/ML ORAL SUSPENSION620059 SPIRONOLACTONE 10 MG/ML ORAL SUSPENSION620060 SULFASALAZINE 100 MG/ML ORAL SUSPENSION620061 TACROLIMUS 0.5 MG/ML ORAL SUSPENSION620062 TEMOZOLOMIDE 10 MG/ML ORAL SUSPENSION620063 THIOGUANINE 20 MG/ML ORAL SUSPENSION620064 TOPIRAMATE 6 MG/ML ORAL SUSPENSION620065 URSODIOL 50 MG/ML ORAL SUSPENSION620066 VALACYCLOVIR 50 MG/ML ORAL SUSPENSION620067 VERAPAMIL 50 MG/ML ORAL SUSPENSION620068 VORINOSTAT 50 MG/ML ORAL SUSPENSION620069 ZINC SULFATE 44 MG/ML ORAL SUSPENSION620070 VANCOMYCIN 50 MG/ML INJ FOR ORAL SOLUTION620071 ACETYLCYSTEINE 200 MG/ML ORAL SOLUTION620071 ACETYLCYSTEINE 200 MG/ML ORAL SOLUTION620072 ARGININE (L-ARGININE) 50 MG/ML ORAL SOLUTION620073 BIOTIN 2.5 MG/ML ORAL SUSPENSION620074 BUSULFAN 2 MG/ML ORAL SUSPENSION620075 CAFFEINE CITRATE 20 MG/ML ORAL SOLUTION620076 FAMOTIDINE 8 MG/ML ORAL CPD SUSPENSION620077 FLECAINIDE 20 MG/ML ORAL SUSPENSION620079 CITRULLINE 50 MG/ML ORAL SUSPENSION620080 OSELTAMIVIR 6 MG/ML ORAL CPD SUSPENSION620082 PROPYLTHIOURACIL 5 MG/ML ORAL SUSPENSION620083 SODIUM BICARBONATE 1 MEQ/ML ORAL SOLUTION620084 TADALAFIL 5 MG/ML ORAL SUSPENSION620085 MEXILETENE 10 MG/ML ORAL SUSPENSION620086 TRIMETHOPRIM 10 MG/ML ORAL SUSPENSION620087 VALGANCICLOVIR 50 MG/ML ORAL SUSPENSION620088 ZONISAMIDE 10 MG/ML ORAL SUSPENSION620089 VANCOMYCIN/GENTAMICIN 25-20 MG/ML ORAL SOLUTION620090 MESNA 100 MG/ML ORAL SOLUTION

620091 ASPIRIN 20.25 MG CHEWABLE TABLET PREPACK620092 ASPIRIN 40.5 MG CHEWABLE TABLET PREPACK620093 CHLORHEXIDINE/HYDROGEN PEROXIDE/WATER (1:1:1) PO SOLN620094 MISOPROSTOL 50 MCG/0.5 TABLET PREPACK620095 ALBUTEROL SULFATE 2.5 MG/0.5 ML NEB SOLN SCHEDULED620096 ACETAMINOPHEN 40 MG/1.25 ML ORAL PREPACK620097 ACETAMINOPHEN 120 MG/3.75 ML ORAL PREPACK620098 ACETAMINOPHEN 60 MG/1.9 ML ORAL PREPACK620099 ACETAMINOPHEN 80 MG/2.5 ML ORAL PREPACK620100 ACETAMINOPHEN 160 MG/5 ML ORAL PREPACK620101 ACETAMINOPHEN 240 MG/7.5 ML ORAL PREPACK620102 DIPHENHYDRAMINE 12.5 MG/5 ML ORAL PREPACK620103 DIPHENHYDRAMINE 25 MG/10 ML ORAL PREPACK620104 DOCUSATE SODIUM 25 MG/2.5 ML ORAL PREPACK620105 DOCUSATE SODIUM 10 MG/1 ML ORAL PREPACK620106 DOCUSATE SODIUM 50 MG/5 ML ORAL PREPACK620107 KETAMINE 50 MG/ML ORAL PREPACK620108 IBUPROFEN 150 MG/7.5 ML ORAL PREPACK620109 IBUPROFEN 200 MG/10 ML ORAL PREPACK620110 IBUPROFEN 300 MG/15 ML ORAL PREPACK620111 IBUPROFEN 400 MG/20 ML ORAL PREPACK620112 IBUPROFEN 50 MG/2.5 ML ORAL PREPACK620113 IBUPROFEN 75 MG/3.75 ML ORAL PREPACK620114 LIDOCAINE 2% ORAL VISCOUS (15 ML) ORAL PREPACK620115 LORAZEPAM 1 MG/0.5 ML ORAL PREPACK620116 METHADONE 10 MG/ML ORAL PREPACK620117 METHADONE 2 MG/2 ML ORAL PREPACK620118 MIDAZOLAM 2 MG/ML (5 ML) ORAL PREPACK620119 MORPHINE (DILUTION) 0.5 MG/0.5 ML ORAL PREPACK620120 SIMETHICONE 20 MG/0.3 ML ORAL PREPACK620121 PREDNISOLONE 15 MG/5 ML ORAL PREPACK620122 MORPHINE 100 MG/5 ML (1 ML) ORAL PREPACK620123 SULFAMETHOXAZOLE-TMP 40 MG/5 ML ORAL PREPACK620125 MORPHINE 2 MG/2 ML ORAL PREPACK620127 CHLORHEXIDINE/WATER (1:1) PO SOLN620130 ONDANSETRON 2 MG/2.5 ML ORAL PREPACK620131 ACETAMINOPHEN 325 MG/10.15 ML ORAL PREPACK620133 DIAZEPAM 5 MG/5 ML ORAL PREPACK620138 SALT/SODA MOUTHWASH620139 CHLOROQUINE BASE 9 MG/ML ORAL SUSPENSION620140 POLYETHYLENE GLYCOL 4.25 G ORAL PREPACK620141 POLYETHYLENE GLYCOL 8.5 G ORAL PREPACK620142 ORASWEET COMPOUNDING ORAL SUSPENSION620143 SODIUM PHOSPHATE 3 MMOLES/ML ORAL SOLUTION620144 CHOLESTYRAMINE (WITH SUGAR) 1 GRAM ORAL PREPACK620145 SEVELAMER CARBONATE 400 MG/0.5 TABLET PREPACK620146 MULTIVITAMIN, PRENATAL (LPCH)620146 MULTIVITAMIN, PRENATAL (LPCH)620147 MULTIVITAMIN ORAL LIQUID (LPCH)620148 MULTIVITAMIN TAB FOR ADULTS (LPCH)620148 MULTIVITAMIN TAB FOR ADULTS (LPCH)620148 MULTIVITAMIN TAB FOR ADULTS (LPCH)620149 MULTIVITAMIN W/ MINERALS FOR ADULTS (LPCH)620149 MULTIVITAMIN W/ MINERALS FOR ADULTS (LPCH)620149 MULTIVITAMIN W/ MINERALS FOR ADULTS (LPCH)620150 MULTIVITAMIN TAB FOR PEDIATRICS (LPCH)620150 MULTIVITAMIN TAB FOR PEDIATRICS (LPCH)

620151 MULTIVITAMIN W/ IRON FOR PEDIATRICS (LPCH)620151 MULTIVITAMIN W/ IRON FOR PEDIATRICS (LPCH)620152 MULTIVITAMIN W/ MINERALS + IRON FOR PEDIATRICS (LPCH)620152 MULTIVITAMIN W/ MINERALS + IRON FOR PEDIATRICS (LPCH)620152 MULTIVITAMIN W/ MINERALS + IRON FOR PEDIATRICS (LPCH)620153 MULTIVITAMIN ADC DROPS, PEDIATRICS (LPCH)620153 MULTIVITAMIN ADC DROPS, PEDIATRICS (LPCH)620154 MULTIVITAMIN, POLYVITAMIN DROPS 1 ML ORAL PREPACK620155 MULTIVITAMIN, POLYVITAMIN DROPS 0.5 ML ORAL PREPACK620158 TACROLIMUS 0.5 MG/ML G-TUBE SUSPENSION620159 POLYETHYLENE GLYCOL 17 G ORAL PREPACK620161 SODIUM BICARBONATE 240 MEQ/240 ML ORAL SOLUTION620162 SODIUM CHLORIDE 240 MEQ/240 ML ORAL SOLUTION620163 DEXTROSE 20% (GLUCOSE) ORAL SOLUTION FOR BREATH TEST620164 FRUCTOSE 10% ORAL SOLUTION FOR BREATH TEST620165 DIATRIZOATE MEGLUMINE/SODIUM ORAL (DILUTED) SOLUTION620166 LACTOSE 20% ORAL SOLUTION FOR BREATH TEST620167 POTASSIUM ACID PHOSPHATE 0.32 MM/ML ORAL CPD SUSP620168 MAGNESIUM OXIDE-AMINO ACID 266 MG (2 TAB PREPACK)620169 MAGNESIUM OXIDE-AMINO ACID 133 MG (1 TAB PREPACK)620172 MULTIVITAMIN W/ MINERALS + IRON FOR ADULTS (LPCH)620172 MULTIVITAMIN W/ MINERALS + IRON FOR ADULTS (LPCH)620173 VITAMIN E 400 UNIT CAPSULE (LPCH)620174 COENZYME Q10 60 MG TABLET (LPCH)620175 SUCROSE 20% ORAL SOLUTION FOR BREATH TEST620185 MAGNESIUM HYDROXIDE/MINERAL OIL/SENNA (FULL STRENGTH) ORAL SUSPENSI620186 MAGNESIUM HYDROXIDE/MINERAL OIL/SENNA (HALF STRENGTH) ORAL SUSPENSI620191 LPCH GI ANTISPASMODIC MIX ORAL SUSPENSION620193 OXYCODONE 1 MG/ML ORAL PREPACK620194 HYDROMORPHONE 1 MG/ML ORAL PREPACK620195 MORPHINE 2 MG/ML ORAL PREPACK620196 DOCUSATE SODIUM 100 MG/10 ML UD ORAL LIQUID620197 POTASSIUM CHLORIDE 10% ORAL LIQUID (BULK)620198 SODIUM POLYSTYRENE SULFONATE 250 MG/ML EXTEMP PO SUSP620199 IBUPROFEN 100 MG/5 ML UD ORAL SUSPENSION620200 IBUPROFEN 200 MG/10 ML UD ORAL SUSPENSION620201 DEXTROMETHORPHAN-GUAIFENESIN 10MG-100MG/5ML UD CUP620202 DEXTROMETHORPHAN-GUAIFENESIN 20MG-200MG/10ML UD CUP620203 NYSTATIN 100,000 UNIT/ML ORAL SUSP (PO EXTEMP)620203 NYSTATIN 100,000 UNIT/ML ORAL SUSP (PO EXTEMP)640000 ACETIC ACID 3% IRRIGATION SOLUTION640001 RIBAVIRIN 6 GRAM/100 ML SOLUTION FOR INHALATION640002 AMIKACIN 250 MG/ML INJ FOR INHALATION640003 CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % INHALATION EXTEMP640004 MITOMYCIN 1 MG/ML TOPICAL CPD SOLUTION640005 MITOMYCIN 3 MG/ML TOPICAL CPD SOLUTION640006 MITOMYCIN 5 MG/ML TOPICAL CPD SOLUTION640007 MITOMYCIN 0.4 MG/ML TOPICAL CPD SOLUTION640008 MITOMYCIN 0.5 MG/ML TOPICAL CPD SOLUTION640009 ABIC OTIC POWDER COMPOUND640010 CEFAZOLIN 10 MG/ML OPHTH CPD SOLUTION640011 CEFAZOLIN 50 MG/ML OPHTH CPD SOLUTION640012 CEFAZOLIN 100 MG/ML OPHTH CPD SOLUTION640015 INHALATIONAL SPACING DEVICE (SMALL)640016 INHALATIONAL SPACING DEVICE (MEDIUM)640017 INHALATIONAL SPACING DEVICE (LARGE)640018 ALBOLENE CLEANSER

640018 ALBOLENE CLEANSER640019 CUSTODIOL HTK ORGAN PRESERVATION SOLUTION640020 CEFTAZIDIME 100 MG/ML OPHTH CPD SOLUTION640021 CEFUROXIME 10 MG/ML IN BSS OPHTH CPD SOLUTION640022 METHACHOLINE 16 MG/ML IN NS CPD SOLN FOR NEBULIZATION640023 METHACHOLINE 4 MG/ML IN NS CPD SOLN FOR NEBULIZATION640024 METHACHOLINE 1 MG/ML IN NS CPD SOLN FOR NEBULIZATION640025 METHACHOLINE 0.25 MG/ML IN NS CPD SOLN FOR NEBULIZATION640026 METHACHOLINE 0.0625 MG/ML IN NS CPD SOLN FOR NEBULIZATION640027 DOXYCYLINE 100 MG TOPICAL POWDER (OR USE)640028 PHENOL 5% TOPICAL CPD SOLUTION640029 HYDROGEN PEROXIDE 1.5 % SOLUTION640030 GANCICLOVIR 20 MG/ML OPHTH CPD SOLUTION640031 BACITRACIN 500 UNIT/GRAM TOPICAL PACKET (LPCH)640032 PHENYLEPHRINE HCL RECTAL SUPPOSITORY (LPCH)640034 FOSCARNET 24 MG/ML OPHTH CPD SOLUTION640036 SARGRAMOSTIM 62.5 MCG/ML INJ FOR INHALATION640037 VANCOMYCIN 25 MG/ML OPHTH CPD SOLUTION (LPCH OR)640038 ALLERGEN TEST CONCENTRATE ( 1 TO 6 INGREDIENTS)640039 ALLERGEN TEST CONCENTRATE (7 TO 12 INGREDIENTS)640040 ALLERGEN TEST SET (CONC + 1 DIL; 1 TO 6 INGREDIENTS)640041 ALLERGEN TEST SET (CONC + 1 DIL; 7 TO 12 INGREDIENTS)640042 ALLERGEN TEST SET (CONC + 4 DIL; 1 TO 6 INGREDIENTS)640043 ALLERGEN TEST SET (CONC + 4 DIL; 7 TO 12 INGREDIENTS)640044 GENTIAN VIOLET TOPICAL COMPOUND SOLN640045 LEECHES 640046 VANCOMYCIN 10 MG/ML OPHTH CPD SOLUTION (LPCH OR)640050 PENTAMIDINE EXTEMP SOLN FOR INHALATION (NEBUPENT)640051 PENTAMIDINE EXTEMP SOLN FOR INHALATION (PENTAM)640052 PORACTANT ALFA 80 MG/ML EXTEMP INTRATRACHEAL SUSP640054 EDETATE DISODIUM 3% OPHTH SOLUTION640055 EDETATE DISODIUM 3.7% OPHTH SOLUTION640057 SODIUM CHLORIDE 1 % FOR NEBULIZATION640058 SODIUM CHLORIDE 2 % FOR NEBULIZATION640059 SODIUM CHLORIDE 4 % FOR NEBULIZATION640060 SODIUM CHLORIDE 5 % FOR NEBULIZATION640061 SODIUM CHLORIDE 8 % FOR NEBULIZATION640062 SODIUM CHLORIDE 9 % FOR NEBULIZATION640063 SODIUM CHLORIDE 6 % FOR NEBULIZATION640064 OXYMETAZOLINE 0.025% WITH LIDOCAINE 2% TOPICAL SOLUTION670000 NF-UNLISTED MED670002 NF ADDITIVE COMPONENT



Charge Quantity Charge1 each $ 18.06 30 each $ 24.08 118 mL $ 26.49 100 each $ 32.00 150 each $ 28.87 100 each $ 33.71 150 each $ 34.85 1 each $ 19.51 12 each $ 51.06 12 each $ 53.59 50 each $ 167.09 12 each $ 41.01 50 each $ 97.27 100 each $ 1,332.74 1 each $ 301.55 30 mL $ 62.72 4 mL $ 41.99 10 mL $ 87.58 30 mL $ 63.92 3 mL $ 18.90 20 mL $ 42.76 473 mL $ 157.95 100 each $ 2,696.75 100 each $ 2,696.75 1 mL $ 122.00 5 mL $ 303.97 100 each $ 81.02 100 each $ 80.45 100 each $ 50.24 100 each $ 57.08 100 each $ 86.72 473 mL $ 36.62 100 each $ 938.30 473 mL $ 120.20 100 each $ 532.46 50 each $ 230.08 20 mL $ 79.82 10 mL $ 85.98 100 each $ 57.08 100 each $ 651.02 100 each $ 110.09 100 each $ 61.64 100 each $ 51.38 100 each $ 90.71 1 each $ 19.18 1 each $ 18.41 100 each $ 83.30 1 each $ 18.77 100 each $ 119.21 500 each $ 473.75 100 each $ 154.55

100 mL $ 31.43 100 mL $ 38.84 150 mL $ 44.26 80 mL $ 32.80 1 each $ 281.60 1 each $ 18.42 100 each $ 85.01 1 each $ 18.91 100 each $ 133.46 100 mL $ 54.23 200 mL $ 88.43 100 mL $ 79.31 200 mL $ 140.87 1 each $ 104.38 1 each $ 88.80 1 each $ 110.26 1 each $ 75.52 1 each $ 82.10 12 each $ 40.32 10 mL $ 72.03 15 mL $ 34.30 50 each $ 33.43 50 mL $ 149.08 100 each $ 26.30 100 each $ 36.56 1 each $ 17.97 36 each $ 25.75 750 each $ 227.23 1 each $ 17.84 100 each $ 26.87 1 each $ 17.81 100 each $ 24.02 100 each $ 39.41 45 each $ 27.50 12 each $ 97.57 12 each $ 100.31 100 each $ 103.25 100 each $ 78.17 100 each $ 69.62 10 mL $ 86.83 5 mL $ 112.31 1 mL $ 74.98 1 mL $ 76.40 3.5 g $ 43.53 2 mL $ 44.50 1 each $ 1,233.50 100 each $ 50.81 100 each $ 37.13 3.5 g $ 103.12 14 g $ 26.91 28 g $ 31.30 1 each $ 128.21 3.5 g $ 112.59 14.2 g $ 36.68 15 g $ 39.14 14.17 g $ 51.42 14.2 g $ 38.22

28.35 g $ 68.48 3.5 g $ 40.18 100 each $ 87.29 100 each $ 154.55 100 each $ 72.47 42.5 g $ 39.05 42.5 g $ 37.85 60 g $ 42.00 90 g $ 43.98 148 g $ 60.27 142 g $ 61.77 148 g $ 61.12 237 g $ 36.80 100 each $ 147.71 100 each $ 161.96 100 each $ 128.33 45 g $ 133.45 45 g $ 147.78 15 g $ 46.78 60 mL $ 116.25 15 g $ 44.10 1 each $ 21.40 100 each $ 538.73 50 each $ 131.75 100 each $ 138.59 100 each $ 33.14 12 each $ 29.86 8 each $ 28.01 236 mL $ 25.82 237 mL $ 28.56 170 g $ 41.98 500 g $ 431.00 10 mL $ 94.81 30 mL $ 74.41 10 mL $ 83.35 100 each $ 1,267.19 16 each $ 30.06 180 mL $ 31.61 473 mL $ 66.28 500 mL $ 69.05 100 each $ 36.56 10 mL $ 87.80 100 each $ 33.14 10 mL $ 83.92 100 mL $ 141.95 60 g $ 44.48 100 each $ 91.85 100 each $ 69.62 15 mL $ 23.83 100 each $ 63.35 1 each $ 70.99 1 each $ 107.57 1 each $ 71.84 1 each $ 90.65 1 each $ 88.37 60 each $ 58.79 473 mL $ 79.76

473 mL $ 303.54 5 mL $ 20.60 100 each $ 59.93 100 each $ 114.65 100 each $ 72.47 20 mL $ 140.58 20 mL $ 192.57 25 each $ 496.55 100 each $ 116.36 100 each $ 194.45 118 mL $ 29.86 100 each $ 35.99 1 mL $ 174.44 100 each $ 534.17 100 each $ 1,594.37 100 each $ 722.27 100 each $ 894.98 100 each $ 294.77 100 each $ 143.15 1 each $ 1,376.29 237 mL $ 97.45 113 g $ 77.01 454 g $ 116.09 100 each $ 116.93 100 each $ 339.80 1 each $ 30.31 100 each $ 1,273.46 60 mL $ 161.20 30 each $ 1,555.72 100 each $ 76.46 100 each $ 57.08 100 each $ 108.95 1 each $ 18.80 100 each $ 122.63 1 each $ 19.10 100 each $ 152.27 100 each $ 260.00 30 g $ 43.24 30 mL $ 37.40 45 g $ 40.84 240 g $ 33.67 10 mL $ 602.59 4 mL $ 251.42 100 each $ 228.08 100 each $ 269.12 100 each $ 433.28 100 each $ 2,950.40 30 each $ 897.55 10 mL $ 84.95 1 mL $ 78.91 100 each $ 25.73 130 each $ 25.90 100 each $ 35.99 130 each $ 28.12 100 each $ 30.86 100 each $ 84.44 2 mL $ 36.75

473 mL $ 322.41 1 each $ 21.50 100 each $ 392.81 10 each $ 428.00 10 each $ 684.50 1 each $ 268.40 473 mL $ 35.20 30 each $ 168.74 100 each $ 530.18 100 each $ 1,955.75 100 each $ 656.72 100 each $ 1,176.56 15 g $ 123.23 237 mL $ 262.26 100 each $ 57.08 100 each $ 85.01 100 each $ 176.78 100 each $ 86.15 100 each $ 319.28 100 each $ 90.14 1 mL $ 72.41 1 mL $ 74.63 5 mL $ 45.22 500 mL $ 227.45 100 each $ 1,442.75 100 each $ 1,328.75 1000 mL $ 93.50 250 mL $ 83.53 500 mL $ 87.80 500 mL $ 130.55 10 mL $ 104.50 100 mL $ 74.12 1000 mL $ 76.40 250 mL $ 83.53 50 mL $ 74.12 500 mL $ 73.55 50 mL $ 76.69 500 mL $ 136.25 2000 mL $ 167.60 10 mL $ 172.73 500 mL $ 302.75 100 each $ 70.76 100 each $ 54.23 100 each $ 61.64 28.35 g $ 45.69 100 each $ 188.75 100 each $ 359.75 2 mL $ 292.97 100 each $ 64.49 100 each $ 62.78 60 each $ 462.01 100 each $ 140.30 100 each $ 536.45 100 each $ 72.47 12 each $ 21.44 100 each $ 28.01 24 each $ 22.95

1 mL $ 69.67 100 each $ 37.13 100 each $ 42.26 5 mL $ 20.49 60 mL $ 64.95 100 each $ 251.45 100 each $ 148.28 100 each $ 218.39 100 each $ 1,264.91 100 each $ 256.58 100 each $ 1,383.47 1 each $ 18.83 100 each $ 126.62 1 each $ 19.86 100 each $ 143.15 1 each $ 21.68 100 each $ 409.91 1 each $ 17.83 100 each $ 35.42 1 each $ 17.99 100 each $ 41.69 1 each $ 18.92 60 each $ 87.86 5 mL $ 74.98 20 mL $ 378.50 100 each $ 103.25 100 each $ 130.61 100 each $ 158.54 120 mL $ 48.53 75 mL $ 798.50 10 each $ 827.00 473 mL $ 1,630.02 1 each $ 144.80 500 each $ 7,812.50 50 each $ 531.61 1 each $ 42.95 30 each $ 837.18 1 mL $ 124.36 10 mL $ 92.59 30 mL $ 110.66 1 each $ 24.59 1 each $ 21.17 100 each $ 359.75 50 each $ 752.20 60 mL $ 82.79 1 g $ 63.84 3.5 g $ 42.33 1 each $ 45.99 100 each $ 1,259.21 1 each $ 39.39 100 each $ 2,182.04 100 mL $ 1,019.81 1 each $ 311.87 1 each $ 41.43 100 each $ 2,386.10 100 mL $ 165.38 5 mL $ 343.96

100 each $ 1,742.57 103.5 mL $ 71.73 1 each $ 70.99 100 each $ 1,018.10 10 mL $ 78.17 2 mL $ 74.12 20 mL $ 74.12 5 mL $ 67.51 473 mL $ 33.93 100 each $ 113.51 1 each $ 18.95 100 each $ 155.12 15 g $ 79.03 60 g $ 201.09 15 g $ 65.51 60 g $ 156.74 15 g $ 63.93 60 g $ 156.74 60 mL $ 264.75 15 g $ 36.90 60 g $ 55.76 15 g $ 47.52 30 g $ 78.88 30 g $ 60.02 60 mL $ 150.90 15 mL $ 235.05 5 mL $ 833.13 10 mL $ 971.64 120 mL $ 651.82 100 each $ 81.02 100 each $ 157.40 100 each $ 117.50 100 each $ 140.30 100 each $ 151.07 100 each $ 168.74 10 mL $ 217.19 100 each $ 77.60 500 g $ 165.95 10 mL $ 76.40 100 mL $ 179.00 2 mL $ 73.15 4 mL $ 75.03 50 mL $ 122.00 120 mL $ 92.31 100 each $ 54.80 100 each $ 56.51 100 each $ 137.45 60 each $ 99.83 15 g $ 60.69 15 g $ 60.69 2 mL $ 87.80 2 mL $ 79.71 20 mL $ 157.34 3.5 g $ 41.59 5 mL $ 39.82 30 mL $ 24.95 59 mL $ 45.84

100 each $ 87.86 100 each $ 223.52 100 g $ 76.46 1 mL $ 72.13 2 mL $ 217.30 20 mL $ 133.40 5 mL $ 79.59 100 each $ 2,924.75 10 mL $ 20.89 473 mL $ 230.74 5 mL $ 20.74 100 each $ 71.33 100 each $ 251.45 100 each $ 971.93 100 each $ 86.72 100 each $ 583.70 1 mL $ 99.14 120 mL $ 69.05 10 mL $ 83.92 5 mL $ 45.86 1 mL $ 90.02 100 each $ 128.33 100 each $ 315.86 100 each $ 152.84 100 each $ 193.88 100 each $ 61.64 100 each $ 111.80 28.35 g $ 32.60 1.5 g $ 18.94 28 g $ 29.22 28.35 g $ 51.51 30 g $ 25.46 453.6 g $ 116.04 28.35 g $ 33.74 30 g $ 36.06 118 mL $ 50.21 59 mL $ 65.93 28.35 g $ 36.00 28 g $ 24.75 28.35 g $ 40.03 28.35 g $ 36.00 100 each $ 290.21 100 each $ 205.85 12 each $ 97.30 480 mL $ 71.97 1 mL $ 73.21 20 mL $ 139.10 100 each $ 112.94 100 each $ 140.87 30 mL $ 207.44 1 mL $ 82.10 10 mL $ 113.45 473 mL $ 201.09 100 each $ 171.65 100 each $ 384.83 100 each $ 234.35 100 each $ 87.29

100 each $ 77.60 15 mL $ 244.58 100 each $ 274.25 100 each $ 38.27 750 each $ 214.40 100 each $ 53.09 1 each $ 18.19 100 each $ 66.20 100 each $ 79.31 100 each $ 118.07 100 each $ 152.84 100 each $ 192.74 100 each $ 144.86 100 each $ 167.66 237 mL $ 1,672.60 30 each $ 656.35 100 each $ 731.96 10 mL $ 1,871.10 473 mL $ 608.20 100 each $ 62.78 100 each $ 132.89 100 each $ 317.00 1000 each $ 4,509.35 20 mL $ 149.47 5 mL $ 111.46 10 mL $ 99.20 100 each $ 144.86 10 mL $ 133.69 50 mL $ 159.05 1000 mL $ 82.10 500 mL $ 84.95 500 g $ 1,006.70 1 each $ 179.00 10 each $ 509.60 1 each $ 241.70 1 each $ 122.00 10 each $ 435.50 12 each $ 401.68 24 each $ 700.38 24 each $ 670.29 20 each $ 380.75 25 each $ 1,291.84 50 each $ 764.45 1 each $ 1,205.00 100 each $ 175.64 100 each $ 197.30 100 each $ 216.11 100 each $ 96.41 90 each $ 456.37 100 each $ 256.01 100 each $ 262.85 100 each $ 633.92 90 each $ 635.40 30 mL $ 34.43 5 mL $ 43.76 50 mL $ 47.39 50 mL $ 96.64

10 mL $ 74.29 20 mL $ 71.95 20 mL $ 111.17 5 mL $ 85.12 5 mL $ 93.79 5 mL $ 87.80 100 each $ 492.56 100 each $ 98.69 100 each $ 94.70 100 each $ 54.80 100 each $ 135.74 500 mL $ 197.30 100 each $ 97.55 12 each $ 31.43 24 each $ 31.02 30 mL $ 220.73 100 each $ 49.67 100 each $ 308.45 100 each $ 60.50 300 mL $ 28.01 100 each $ 31.43 100 mL $ 101.48 10 mL $ 72.58 2 mL $ 71.04 20 mL $ 96.58 500 mL $ 196.10 50 mL $ 73.55 100 each $ 456.08 100 each $ 168.80 100 each $ 98.69 100 each $ 139.73 100 each $ 291.35 1 mL $ 71.84 1 mL $ 80.90 473 mL $ 74.37 100 each $ 417.89 100 each $ 573.50 500 mL $ 200.15 1 each $ 19.63 100 each $ 204.71 1 each $ 19.40 100 each $ 193.31 100 each $ 801.50 100 each $ 136.88 100 each $ 141.44 100 each $ 1,596.65 10 mL $ 313.32 1 each $ 482.15 100 each $ 857.93 100 each $ 120.35 100 each $ 188.18 5 mL $ 293.00 1 mL $ 100.63 1 each $ 22.56 100 each $ 551.84 100 each $ 635.63 1 each $ 21.09

100 each $ 351.20 100 each $ 1,145.21 21 each $ 154.57 50 each $ 725.98 1 each $ 24.27 100 each $ 669.26 1 mL $ 112.20 2 mL $ 71.33 1 each $ 18.32 100 each $ 101.54 100 each $ 121.49 5 mL $ 70.70 100 each $ 66.20 100 each $ 50.24 1 each $ 19.98 100 each $ 247.46 1 each $ 21.52 100 each $ 308.45 100 mL $ 74.12 28.4 g $ 56.91 45 g $ 63.16 480 mL $ 72.47 480 mL $ 36.90 133 mL $ 26.85 1 each $ 20.95 50 each $ 176.50 100 each $ 168.80 100 each $ 282.80 100 each $ 282.23 1 mL $ 70.76 1 mL $ 70.93 20 mL $ 110.60 1 mL $ 74.29 1 mL $ 74.29 1 mL $ 70.64 500 mL $ 148.85 100 each $ 199.01 12 each $ 359.75 30 mL $ 132.73 1000 each $ 63.35 100 each $ 1,581.26 1 each $ 131.57 1 each $ 871.84 1 each $ 194.16 10 mL $ 232.18 10 mL $ 313.29 1 mL $ 190.34 2 mL $ 161.62 15 mL $ 44.35 15 mL $ 42.82 100 each $ 55.37 100 each $ 70.19 1 each $ 18.76 100 each $ 83.87 100 each $ 138.59 1 each $ 25.49 100 each $ 598.58

100 g $ 636.00 50 g $ 362.35 10 mL $ 93.89 100 each $ 1,227.86 10 mL $ 141.49 10 mL $ 86.38 100 each $ 25.16 100 each $ 86.72 100 each $ 26.30 100 each $ 33.14 1 each $ 25.09 100 each $ 751.34 1 each $ 28.25 100 each $ 1,067.69 1 each $ 33.15 100 each $ 1,557.32 100 each $ 1,058.57 100 each $ 924.62 10 mL $ 96.92 100 each $ 50.09 100 each $ 50.09 1 g $ 26.39 30 g $ 58.19 60 g $ 99.12 100 each $ 136.88 100 each $ 160.82 30 g $ 51.90 30 g $ 51.90 473 mL $ 524.62 60 mL $ 90.25 100 each $ 337.46 15 g $ 165.01 15 g $ 165.01 1 each $ 131.57 1 each $ 194.16 100 each $ 681.80 100 each $ 1,035.77 100 each $ 359.75 1 each $ 19.18 100 each $ 249.17 15 mL $ 21.61 1 mL $ 70.13 10 mL $ 109.46 10 mL $ 88.71 50 mL $ 183.56 100 each $ 42.26 10 mL $ 110.60 2 mL $ 90.65 473 mL $ 1,446.68 1 each $ 205.68 1 each $ 112.98 100 mL $ 35.42 100 mL $ 38.84 200 mL $ 47.39 1 each $ 19.32 100 each $ 98.12 100 each $ 283.94

20 mL $ 4,780.84 50 mL $ 8,859.82 100 each $ 548.42 100 each $ 743.93 100 each $ 114.65 100 each $ 137.45 473 mL $ 473.39 500 each $ 901.25 1000 each $ 291.35 500 each $ 416.75 100 each $ 204.14 500 each $ 519.35 100 each $ 285.02 500 each $ 644.75 100 each $ 183.05 100 each $ 250.88 1 mL $ 229.16 1 mL $ 72.75 120 mL $ 576.58 480 mL $ 2,138.15 100 each $ 371.15 1 mL $ 133.40 5 mL $ 117.10 15 mL $ 35.29 30 mL $ 29.90 15 mL $ 35.29 15 mL $ 165.75 3 mL $ 44.64 237 mL $ 173.10 2 mL $ 71.56 5 mL $ 74.41 100 each $ 189.32 2 mL $ 91.70 .5 mL $ 89.23 15 mL $ 140.01 15 mL $ 142.81 15 mL $ 148.85 100 each $ 701.18 100 each $ 519.35 100 each $ 659.57 100 each $ 1,221.02 30 g $ 133.58 15 mL $ 178.94 1 each $ 137.39 20 mL $ 84.38 50 mL $ 124.85 30 each $ 125.82 20 mL $ 78.91 250 mL $ 99.20 30 mL $ 77.48 100 each $ 445.25 100 each $ 446.39 15 mL $ 20.40 100 each $ 2,782.82 30 each $ 847.27 1 each $ 20.54 30 mL $ 83.24

15 mL $ 124.85 50 mL $ 99.20 28.35 g $ 25.82 473 mL $ 38.82 1 each $ 559.19 100 each $ 96.98 100 each $ 161.96 100 each $ 246.32 5 mL $ 90.26 100 each $ 144.86 1 each $ 18.86 100 each $ 139.73 100 each $ 100.40 100 each $ 147.71 100 each $ 131.18 100 each $ 978.20 100 each $ 224.09 100 each $ 356.33 10 mL $ 377.42 2 mL $ 324.29 10 mL $ 197.53 100 each $ 180.20 100 each $ 184.19 10 mL $ 216.05 1 mL $ 69.90 473 mL $ 144.47 100 each $ 273.68 100 each $ 253.16 100 each $ 349.49 12 each $ 548.85 473 mL $ 203.78 100 each $ 293.06 15 mL $ 68.55 500 mL $ 240.05 100 each $ 46.82 100 each $ 53.09 100 each $ 50.24 100 each $ 56.51 100 each $ 302.75 25 mL $ 218.90 5 mL $ 108.04 1 each $ 17.87 100 each $ 29.72 1 each $ 17.93 100 each $ 35.42 10 each $ 39.98 20 each $ 58.45 100 each $ 1,365.23 1 mL $ 116.24 100 each $ 29.72 100 each $ 30.29 100 each $ 32.00 10 mL $ 167.43 100 each $ 111.23 100 each $ 210.41 1000 each $ 1,630.85 473 mL $ 446.43

480 mL $ 444.57 480 mL $ 91.62 30 mL $ 69.79 100 each $ 884.15 100 each $ 1,271.75 1 mL $ 110.32 100 each $ 38.84 100 each $ 25.16 20 g $ 64.67 400 g $ 124.17 50 g $ 37.71 60 each $ 35.88 1 each $ 17.93 100 each $ 65.06 30 mL $ 30.58 480 mL $ 77.94 500 mL $ 1,400.00 100 mL $ 100.91 100 mL $ 115.16 50 mL $ 99.20 500 g $ 983.90 10 mL $ 111.40 50 mL $ 100.34 454 g $ 95.38 1 each $ 17.84 1000 each $ 103.25 1 each $ 17.84 1000 each $ 108.95 1000 mL $ 82.10 500 mL $ 84.95 10 mL $ 67.11 40 mL $ 69.33 500 mL $ 87.80 100 mL $ 112.31 30 mL $ 80.73 5 mL $ 18.89 15 mL $ 22.03 15 mL $ 22.03 100 each $ 49.10 500 g $ 445.25 120 each $ 40.32 120 each $ 39.64 15 mL $ 124.85 50 mL $ 99.20 100 g $ 46.25 500 g $ 86.15 454 g $ 594.83 15 mL $ 97.69 50 mL $ 591.68 473 mL $ 42.02 100 each $ 148.85 100 each $ 600.29 1000 mL $ 34.35 250 mL $ 35.78 500 mL $ 34.35 1 each $ 171.88 10 mL $ 82.21

500 g $ 368.30 100 each $ 1,763.09 100 each $ 129.47 10 mL $ 90.42 1 each $ 18.83 100 each $ 126.05 100 each $ 163.10 100 each $ 153.41 100 each $ 124.91 100 each $ 411.62 60 each $ 148.05 1 each $ 18.29 100 each $ 71.33 10 mL $ 483.89 1 mL $ 170.68 5 mL $ 452.37 .5 mL $ 290.74 15 mL $ 65.39 1000 each $ 291.35 15 mL $ 25.20 473 mL $ 451.82 2 mL $ 113.66 100 each $ 34.85 100 each $ 25.73 25 each $ 535.85 100 each $ 139.16 100 each $ 260.57 100 each $ 188.75 100 each $ 218.96 1 each $ 4,988.00 100 each $ 130.04 100 each $ 151.70 100 each $ 158.54 2 mL $ 81.76 5 mL $ 36.64 100 each $ 555.26 100 each $ 869.90 100 each $ 359.75 14 g $ 26.35 10 mL $ 29.51 100 each $ 54.80 100 each $ 49.10 15 g $ 38.45 80 g $ 70.15 15 g $ 50.51 30 g $ 72.31 80 g $ 41.27 15 g $ 63.93 60 mL $ 65.27 60 mL $ 165.75 15 g $ 45.55 15 g $ 43.76 80 g $ 36.39 15 g $ 63.85 1 mL $ 113.74 5 mL $ 312.32 5 g $ 123.63

17 g $ 145.22 100 each $ 1,910.15 100 each $ 174.50 100 each $ 74.75 10 each $ 142.81 1 each $ 30.26 10 each $ 142.81 100 each $ 366.59 100 each $ 622.52 100 each $ 779.84 473 mL $ 155.25 100 each $ 61.07 100 each $ 519.35 100 each $ 407.63 15 mL $ 52.57 15 mL $ 66.75 2 mL $ 62.85 3 mL $ 34.08 1 mL $ 290.49 473 mL $ 432.95 100 each $ 227.51 1 each $ 85.98 1 each $ 77.60 1 each $ 177.23 1 each $ 3,770.00 1 mL $ 89.35 2 mL $ 117.10 4 mL $ 156.95 100 each $ 72.47 100 each $ 63.35 100 each $ 194.45 10 mL $ 388.84 1 mL $ 232.32 100 each $ 29.15 100 each $ 27.44 100 each $ 32.00 100 each $ 54.23 100 each $ 1,307.09 100 each $ 885.29 100 each $ 912.65 100 each $ 950.27 100 each $ 1,260.92 10 mL $ 154.78 28.35 g $ 31.96 10 mL $ 79.25 5 mL $ 87.74 1 each $ 17.89 100 each $ 31.43 100 each $ 641.90 5 mL $ 25.36 50 each $ 186.76 6 each $ 41.69 100 each $ 114.65 100 each $ 143.72 30 each $ 687.39 1000 mL $ 40.05 60 mL $ 112.29

5 g $ 561.24 30 g $ 1,127.24 1 each $ 18.45 100 each $ 286.79 473 mL $ 640.55 100 each $ 118.64 50 each $ 187.90 500 each $ 507.95 1 each $ 90.65 112 each $ 1,594.60 2 each $ 354.32 28 each $ 4,729.60 100 mL $ 1,536.74 20 mL $ 204.08 50 mL $ 324.64 250 mL $ 606.50 50 mL $ 213.49 15 g $ 80.71 45 g $ 146.00 1 each $ 10,527.20 2 mL $ 104.90 1 mL $ 578.00 1 each $ 18,660.05 100 each $ 32.00 2 each $ 18.39 30 mL $ 21.51 355 mL $ 33.94 37.5 mL $ 48.03 15 g $ 225.15 30 g $ 329.10 60 g $ 551.85 473 mL $ 6,593.54 100 each $ 1,601.78 1 each $ 24.42 100 each $ 190.46 100 each $ 160.82 90 each $ 1,389.00 100 each $ 96.98 100 each $ 115.22 100 each $ 108.95 100 mL $ 707.45 75 mL $ 312.73 1 each $ 82.92 5 mL $ 123.26 24 each $ 816.68 300 mL $ 237.71 1 each $ 547.19 100 each $ 69.05 24 each $ 35.67 10 mL $ 156.20 5 mL $ 110.60 15 g $ 62.02 50 g $ 108.66 45 g $ 192.85 100 each $ 242.33 1 each $ 230.30 1 each $ 395.60

15 g $ 151.07 100 each $ 110.09 100 each $ 110.09 100 each $ 110.09 227 g $ 189.17 23.3 g $ 89.45 46.6 g $ 89.45 2 mL $ 378.50 .25 mL $ 521.00 5 mL $ 247.40 60 each $ 95.73 2 each $ 18.74 30 each $ 28.35 1 each $ 388.78 100 each $ 2,868.32 10 mL $ 82.96 4 mL $ 76.97 100 each $ 111.23 100 each $ 157.40 2 mL $ 86.55 100 each $ 1,703.24 100 each $ 322.70 1 each $ 18.54 100 each $ 168.23 100 each $ 62.78 25 each $ 459.95 56 g $ 101.98 1 mL $ 82.27 2.5 mL $ 43.82 2 mL $ 452.49 1 mL $ 99.09 100 each $ 416.18 100 each $ 888.71 1 each $ 17.85 500 each $ 177.35 14 g $ 39.91 6.5 g $ 35.48 100 each $ 46.82 100 each $ 51.38 100 each $ 245.75 100 each $ 196.16 1 mL $ 506.24 30 each $ 257.15 30 each $ 331.19 150 mL $ 684.65 150 mL $ 1,350.70 100 mL $ 294.77 50 mL $ 869.62 50 each $ 1,473.79 1 each $ 77.54 1 each $ 172.73 1 each $ 89.00 1 each $ 73.55 1 each $ 129.87 1 each $ 194.73 1 each $ 92.54 1 each $ 350.00

10 each $ 2,926.40 1 each $ 116.51 50 mL $ 410.77 20 each $ 789.07 100 each $ 1,889.63 1 each $ 83.87 1 each $ 126.22 1 each $ 98.80 1 each $ 174.95 1 each $ 91.62 1 each $ 90.08 1 each $ 75.13 1 each $ 70.42 1 each $ 217.19 20 each $ 227.28 20 each $ 423.02 1 each $ 18.50 100 each $ 92.99 1 each $ 18.99 100 each $ 142.01 100 mL $ 126.05 200 mL $ 81.59 200 mL $ 120.35 1 each $ 18.05 100 each $ 85.01 50 each $ 2,662.55 473 mL $ 44.21 237 mL $ 319.00 1 each $ 1,718.00 1 each $ 29.44 60 each $ 719.19 378 g $ 868.82 1 each $ 118.87 100 each $ 105.53 100 each $ 127.76 100 each $ 191.03 5 mL $ 58.88 500 mL $ 72.53 10 mL $ 2,679.50 100 each $ 3,192.65 100 each $ 4,469.45 50 each $ 1,605.20 100 each $ 262.85 16 each $ 291.35 30 g $ 112.09 40 g $ 141.07 50 mL $ 186.41 15 g $ 50.00 30 g $ 73.17 60 g $ 48.63 50 mL $ 56.85 30 each $ 1,555.72 100 each $ 5,144.33 100 each $ 73.61 100 each $ 78.74 100 each $ 94.70 70 each $ 412.36

100 each $ 1,455.86 100 each $ 571.79 1 each $ 63.95 30 g $ 309.15 5 mL $ 163,575.20 1 each $ 567.56 2 mL $ 26.51 10 mL $ 54.92 60 g $ 248.91 60 g $ 248.81 15 mL $ 117.66 2 mL $ 53.96 100 each $ 1,288.28 100 each $ 2,349.62 40 each $ 1,727.75 5 mL $ 289.69 30 each $ 1,009.04 30 each $ 278.01 50 mL $ 2,816.45 1 each $ 332.53 100 each $ 779.27 1 each $ 526.70 100 each $ 953.12 100 each $ 479.45 30 each $ 190.97 100 each $ 969.65 1 each $ 349.89 1 each $ 109.57 1 mL $ 175.12 10 mL $ 1,165.10 59 mL $ 408.11 15 g $ 96.57 60 g $ 334.55 500 mL $ 193.25 1 each $ 38.52 100 each $ 2,094.26 100 each $ 1,679.87 148 mL $ 74.27 118 mL $ 25.82 1000 mL $ 87.80 1000 mL $ 76.40 1000 mL $ 82.10 1000 mL $ 87.80 1000 mL $ 76.40 1000 mL $ 82.10 1000 mL $ 76.40 1000 mL $ 82.10 1000 mL $ 76.40 250 mL $ 97.78 50 mL $ 71.56 1000 mL $ 87.80 250 mL $ 70.70 50 mL $ 66.14 1000 mL $ 87.80 250 mL $ 83.53 500 mL $ 84.95 1000 mL $ 76.40

500 mL $ 73.55 1000 mL $ 87.80 500 mL $ 84.95 120 mL $ 17.75 100 mL $ 333.53 200 mL $ 707.45 1 mL $ 406.43 1 mL $ 464.81 3 mL $ 583.73 20 mL $ 90.19 100 each $ 401.93 100 each $ 397.37 100 each $ 418.46 60 mL $ 121.72 1 each $ 47.46 60 each $ 1,800.54 1 each $ 44.63 100 each $ 2,433.98 60 each $ 3,256.83 1 each $ 50.28 30 each $ 1,694.75 60 each $ 1,969.24 30 g $ 51.55 15 mL $ 520.97 25 mL $ 29.72 100 each $ 116.36 100 each $ 117.50 100 each $ 176.21 100 each $ 112.37 1 mL $ 74.52 2 mL $ 81.36 1 mL $ 850.46 1 mL $ 222.09 1 mL $ 300.64 1 mL $ 379.18 60 mL $ 362.83 20 each $ 511.10 100 each $ 1,745.99 60 each $ 127.93 10 mL $ 128.04 100 each $ 172.19 100 each $ 242.90 100 each $ 110.09 100 each $ 138.59 42.5 g $ 267.60 1 each $ 1,021.00 100 each $ 1,742.57 100 each $ 1,742.57 100 each $ 1,742.57 30 g $ 348.95 1 each $ 7,186.18 100 each $ 3,799.13 100 each $ 279.38 100 each $ 898.97 2 mL $ 1,772.15 100 each $ 2,022.44 100 each $ 562.10

100 each $ 764.45 28 each $ 53.84 25 mL $ 554.54 5 mL $ 247.31 50 mL $ 909.08 20 each $ 1,888.42 1 each $ 70.99 4 mL $ 75.15 50 mL $ 824.59 100 each $ 74.75 100 each $ 131.75 100 mL $ 210.92 250 mL $ 263.08 500 mL $ 261.65 237 mL $ 2,914.08 240 mL $ 2,943.90 473 mL $ 5,652.60 100 each $ 3,236.54 30 each $ 731.85 100 each $ 3,706.79 90 each $ 2,472.97 1 mL $ 1,732.82 50 each $ 389.39 100 each $ 552.41 100 each $ 344.93 60 each $ 214.06 100 each $ 347.78 30 each $ 318.88 30 each $ 510.40 30 each $ 209.27 100 mL $ 122.00 200 mL $ 101.48 100 each $ 3,202.25 100 each $ 6,180.50 1 each $ 827.00 100 each $ 417.89 118.28 mL $ 308.04 5 mL $ 105.93 5 mL $ 39.53 100 each $ 67.34 100 each $ 71.90 60 mL $ 131.64 2.5 mL $ 57.04 15 g $ 41.09 100 each $ 303.89 250 mL $ 1,410.20 1 each $ 527.04 100 mL $ 90.65 50 mL $ 83.81 3.5 g $ 164.10 5 mL $ 164.10 100 each $ 59.36 100 each $ 131.75 100 each $ 164.24 100 each $ 629.93 118 mL $ 370.87 120 mL $ 202.43

100 each $ 3,072.95 100 each $ 217.25 60 g $ 422.26 60 g $ 422.26 1 mL $ 78.68 10 mL $ 85.52 30 mL $ 96.46 1 mL $ 72.70 50 each $ 98.41 60 mL $ 75.55 1 mL $ 78.66 5 mL $ 184.36 50 mL $ 1,291.36 473 mL $ 1,371.19 6 each $ 353.36 100 each $ 237.77 100 each $ 330.11 473 mL $ 160.64 1 each $ 400.81 1 each $ 812.98 1 each $ 6,516.83 1 each $ 4,105.16 1 each $ 541.89 6 each $ 2,964.92 1 each $ 2,210.25 3 mL $ 62.20 10 mL $ 167.07 3 mL $ 62.20 3 mL $ 220.27 1 each $ 1,126.23 1 each $ 1,975.30 .5 mL $ 9,715.10 100 each $ 560.39 28.4 g $ 91.43 10 mL $ 293.29 1000 mL $ 45.75 5 mL $ 3,456.50 10 each $ 426.27 100 each $ 3,999.20 30 each $ 1,240.40 30 each $ 773.22 30 each $ 895.44 1 each $ 23.27 100 each $ 570.08 1 each $ 25.83 100 each $ 825.44 30 each $ 931.92 15 g $ 36.68 30 g $ 49.97 60 g $ 66.95 100 each $ 378.56 30 each $ 129.58 1 mL $ 76.97 2 mL $ 79.71 100 each $ 341.51 20 mL $ 73.21 1 each $ 20.32

100 each $ 251.45 100 each $ 380.27 225 g $ 33.96 1 each $ 10,734.66 1 each $ 11,816.52 28 each $ 55.50 100 each $ 189.32 90 each $ 172.16 100 each $ 217.25 90 each $ 462.52 90 each $ 478.94 10 mL $ 82.04 20 mL $ 75.03 30 mL $ 82.61 20 mL $ 86.66 20 mL $ 107.41 29 g $ 25.19 1 mL $ 2,352.13 100 each $ 382.55 100 each $ 51.95 100 each $ 127.19 100 each $ 46.25 100 each $ 208.13 1 each $ 20.94 100 each $ 237.77 5 each $ 135.56 5 each $ 471.72 5 each $ 283.22 1 each $ 20.11 100 each $ 153.98 30 each $ 36.05 1 mL $ 69.28 10 mL $ 103.65 50 mL $ 258.23 1 mL $ 75.26 60 each $ 89.23 60 each $ 91.28 5 mL $ 4,687.30 113.4 g $ 139.81 453.6 g $ 456.58 56.7 g $ 81.05 1 each $ 18.33 100 each $ 82.73 120 each $ 31.43 59 mL $ 257.51 1 each $ 358.78 4 each $ 3,595.38 946 mL $ 341.28 240 mL $ 222.95 480 mL $ 507.49 1 each $ 6,852.93 50 each $ 2,623.22 25 each $ 280.24 250 each $ 4,083.28 30 each $ 302.81 60 each $ 736.98 240 each $ 2,351.56

180 each $ 2,175.43 60 mL $ 94.02 10 mL $ 253.10 100 each $ 49.67 20 mL $ 915.44 100 each $ 295.34 100 each $ 154.55 100 each $ 1,258.07 1 mL $ 104.11 1 each $ 59.50 100 each $ 4,192.43 28 each $ 855.22 100 each $ 488.00 25 each $ 562.10 1 each $ 199.06 1 each $ 116.07 1 each $ 91.68 1 each $ 135.79 100 each $ 485.15 100 each $ 479.45 100 each $ 764.45 70 g $ 58.95 100 each $ 405.92 100 each $ 489.71 100 each $ 570.65 7 each $ 35.59 1 g $ 293.58 10 mL $ 103.59 2 mL $ 72.13 100 each $ 612.26 100 each $ 716.57 1 each $ 403.12 1 each $ 22.37 100 each $ 479.45 1 each $ 24.35 100 each $ 677.81 60 each $ 980.14 1 each $ 395.80 100 each $ 2,598.71 15 g $ 44.45 15 g $ 42.57 30 mL $ 115.73 100 mL $ 316.37 118 mL $ 30.53 22 g $ 70.47 100 each $ 1,368.65 30 each $ 503.90 480 mL $ 477.40 500 mL $ 334.10 5 mL $ 42.83 90 each $ 205.51 90 each $ 333.81 20 each $ 68.55 50 each $ 43.65 100 each $ 1,383.47 1 each $ 70.19 230 mL $ 3,487.97

100 each $ 1,479.23 250 mL $ 117.73 50 mL $ 75.55 60 each $ 345.73 4 mL $ 121.04 28 each $ 52.73 28 each $ 53.10 28 each $ 50.05 28 each $ 53.70 50 each $ 546.14 28 each $ 53.10 28 each $ 55.04 28 each $ 72.83 60 each $ 80.34 100 each $ 2,199.14 100 each $ 3,463.40 100 each $ 409.91 100 each $ 527.33 30 each $ 295.28 30 mL $ 44.08 15 mL $ 57.86 500 mL $ 58.50 100 each $ 3,182.96 473 mL $ 238.83 30 mL $ 1,703.98 5 mL $ 38.16 500 mL $ 667.55 1 each $ 20.32 100 each $ 159.11 100 each $ 4,809.85 4000 mL $ 50.25 100 each $ 2,326.25 100 each $ 201.86 30 each $ 58.45 473 mL $ 44.71 50 mL $ 71.62 50 mL $ 71.62 100 each $ 34.28 60 each $ 31.43 100 each $ 32.57 1.5 mL $ 22,762.86 100 each $ 3,919.18 1 mL $ 295.96 1 mL $ 171.21 100 each $ 977.06 100 each $ 174.50 60 g $ 180.60 118 mL $ 34.00 59 mL $ 63.32 100 each $ 5,506.85 1 each $ 920.00 12 each $ 29.65 100 each $ 474.32 100 each $ 314.15 4 mL $ 649.70 8 mL $ 1,136.25 1 mL $ 130.27

1 each $ 43.89 100 each $ 2,631.19 4 g $ 167.82 100 each $ 1,232.42 .5 mL $ 454.24 .5 mL $ 217.12 1 each $ 18.47 100 each $ 90.14 473 mL $ 112.11 100 each $ 210.98 30 each $ 262.11 100 mL $ 79.82 50 mL $ 78.68 1000 mL $ 82.10 1000 mL $ 82.10 100 each $ 894.41 100 each $ 216.11 118 mL $ 41.00 222 mL $ 53.95 28.3 g $ 36.93 236 mL $ 419.50 28.4 g $ 151.93 90 each $ 306.57 100 each $ 128.33 6 each $ 160.23 100 each $ 164.24 100 each $ 8,865.55 12 each $ 613.72 12 each $ 684.51 1 each $ 73.31 12 each $ 684.51 100 each $ 437.84 100 mL $ 108.89 20 mL $ 74.01 50 mL $ 87.23 100 each $ 1,414.25 100 each $ 1,414.25 2 mL $ 225.06 473 mL $ 1,559.92 100 each $ 290.78 30 each $ 1,097.44 100 each $ 2,254.33 1 each $ 1,483.56 100 each $ 212.12 100 each $ 97.55 100 each $ 100.40 4 each $ 41,656.87 56 each $ 450.91 100 each $ 39.41 100 each $ 2,690.59 1 each $ 435.50 100 each $ 653.87 100 each $ 639.05 50 each $ 358.33 1 each $ 22.42 15 mL $ 37.34 118 mL $ 33.39

1 each $ 1,310.54 100 each $ 37.70 100 each $ 234.35 10 each $ 31.50 100 each $ 114.08 30 each $ 54.17 90 each $ 56.23 30 each $ 31.77 30 each $ 36.05 30 each $ 35.19 113 g $ 47.52 71 g $ 56.10 133 mL $ 23.06 1000 mL $ 34.35 250 mL $ 35.78 500 mL $ 34.35 2 mL $ 4,723.04 1 each $ 2,600.08 1 each $ 26.81 100 each $ 216.11 100 each $ 495.98 100 each $ 304.46 420 mL $ 642.58 1 each $ 19.43 100 each $ 185.33 1 mL $ 90.57 2 mL $ 108.18 3.5 g $ 164.10 10 mL $ 310.95 5 mL $ 164.10 118 mL $ 63.66 237 mL $ 40.28 100 each $ 701.75 30 each $ 148.05 5 mL $ 1,988.60 1 mL $ 167.54 30 each $ 265.87 30 each $ 306.06 45 g $ 71.30 3 each $ 152.46 2 mL $ 111.08 1 each $ 134.43 15 mL $ 32.90 1 each $ 140.98 1 each $ 822.93 100 each $ 758.75 5 mL $ 34.35 5 mL $ 45.75 1 each $ 507.89 3.5 g $ 301.71 5 mL $ 170.75 100 each $ 1,541.36 20 g $ 60.74 45 g $ 94.92 20 g $ 72.79 20 g $ 82.06 15 g $ 70.39

45 g $ 387.16 15 g $ 70.88 45 g $ 143.70 5 mL $ 127.93 1 mL $ 142.69 5 mL $ 260.11 100 each $ 1,910.15 7.5 mL $ 230.50 500 mL $ 1,447.25 100 each $ 1,030.07 1 each $ 408.14 20 each $ 974.75 20 each $ 611.75 100 mL $ 102.62 1 each $ 99.20 1 each $ 127.24 100 each $ 360.89 100 each $ 201.86 2 mL $ 3,521.37 12 mL $ 194.77 30 mL $ 502.54 1 each $ 26.06 100 each $ 848.81 10 mL $ 69.22 100 mL $ 85.52 50 mL $ 76.12 20 mL $ 231.44 30 each $ 354.11 240 mL $ 222.95 100 each $ 54.23 100 each $ 43.97 1 each $ 210.13 100 each $ 34.85 1 each $ 21.65 100 each $ 407.63 100 each $ 161.39 100 each $ 190.46 100 each $ 4,150.25 100 each $ 200.15 100 each $ 437.84 2.5 mL $ 159.80 60 g $ 494.93 100 each $ 195.59 10 mL $ 930.03 100 each $ 2,658.56 30 each $ 811.36 100 each $ 1,545.35 5 mL $ 34,316.84 1 mL $ 172.56 473 mL $ 44.71 22 mL $ 32.42 2.5 mL $ 18.95 1 each $ 1,370.64 60 each $ 129.24 30 g $ 377.51 45 g $ 328.95 100 mL $ 620.81

100 each $ 219.53 30 each $ 117.10 50 mL $ 87.23 1 each $ 70.59 100 each $ 704.60 40 g $ 196.77 100 mL $ 268.55 100 mL $ 495.98 1 each $ 38.47 100 each $ 2,277.23 100 each $ 3,288.05 1 mL $ 843.73 100 each $ 387.11 30 each $ 518.39 1 each $ 35.99 90 each $ 2,834.12 50 each $ 36.28 1 each $ 4,585.10 30 each $ 49.04 500 g $ 456.65 60 each $ 532.12 60 each $ 585.81 30 each $ 868.65 9 each $ 108.65 60 each $ 197.30 60 each $ 215.43 2.5 mL $ 956.10 1 each $ 33.73 57 g $ 54.29 100 each $ 99.83 1 each $ 4,950.24 500 g $ 89.00 100 g $ 117.50 500 g $ 18,671.00 120 g $ 37.05 15 g $ 34.09 30 each $ 1,253.32 100 each $ 85.58 100 each $ 110.66 100 each $ 138.59 100 mL $ 505.67 100 each $ 91.85 100 each $ 645.89 100 each $ 702.32 120 mL $ 53.88 1 each $ 1,569.80 28 each $ 188.75 1 mL $ 302.60 50 g $ 147.71 100 g $ 1,426.22 100 g $ 307.88 50 g $ 149.42 35 mL $ 614.06 100 each $ 123.20 60 each $ 104.28 5 mL $ 5,063.33 10 mL $ 95.63

100 each $ 99.83 100 g $ 94.13 1000 g $ 3,563.15 500 g $ 1,790.45 25 g $ 4,547.83 60 each $ 839.58 100 each $ 44.54 50 mL $ 6,699.80 100 each $ 468.05 1 mL $ 2,376.92 .5 mL $ 435.33 100 each $ 73.61 20 each $ 656.15 1 each $ 597.33 150 each $ 252.02 100 each $ 154.55 90 each $ 90.08 30 each $ 50.24 90 each $ 1,488.01 250 mL $ 122.00 50 mL $ 76.40 250 mL $ 144.80 50 mL $ 80.96 32 each $ 54.78 250 mL $ 103.48 50 mL $ 72.70 50 mL $ 99.77 210 mL $ 7,299.10 100 each $ 54.23 30 mL $ 70.81 50 each $ 40.55 1 each $ 24.44 500 each $ 3,360.80 5 mL $ 117.98 5 mL $ 128.46 1 each $ 1,363.94 1 each $ 2,531.98 237 mL $ 70.44 24 each $ 74.25 60 mL $ 34.20 30 mL $ 66.83 60 mL $ 91.62 9 each $ 108.65 9 each $ 108.65 20 mL $ 1,306.12 60 each $ 111.80 60 each $ 151.13 2 mL $ 420.34 1 each $ 18.51 100 each $ 93.56 1 each $ 18.08 120 each $ 56.74 20 each $ 71.90 30 mL $ 20.83 473 mL $ 71.67 3.7 mL $ 115.44 100 each $ 51.95

100 each $ 91.85 30 g $ 432.51 50 g $ 627.92 15 mL $ 166.86 30 mL $ 166.86 500 mL $ 87.80 10 mL $ 102.28 250 mL $ 97.78 50 mL $ 71.56 250 mL $ 99.20 60 each $ 2,387.47 240 mL $ 649.77 1 each $ 171.53 1 each $ 322.30 473 mL $ 35.20 30 mL $ 104.16 30 mL $ 144.63 1 each $ 58.52 100 each $ 3,567.73 270 each $ 5,491.97 28 each $ 188.70 10 each $ 29.09 12 each $ 124.45 100 each $ 1,257.50 100 each $ 1,803.56 30 mL $ 66.01 15 mL $ 66.03 30 each $ 441.49 10 mL $ 221.75 5 mL $ 140.27 15 mL $ 834.02 28 g $ 27.31 28.4 g $ 31.82 100 each $ 100.40 1 each $ 145.62 1 each $ 149.96 30 each $ 1,483.56 100 each $ 707.45 360 each $ 2,621.74 180 each $ 2,621.74 1 each $ 18.14 30 each $ 31.26 60 each $ 41.35 1 g $ 38.06 45 g $ 705.10 1 each $ 505.24 .053 g $ 60.65 .075 g $ 73.85 1 each $ 886.03 1 each $ 920.00 1 each $ 5,401.63 1 each $ 998.00 5 each $ 18,811.93 30 mL $ 189.95 5 mL $ 4,283.00 1 each $ 256.27 1 each $ 133.40

14 each $ 278.43 60 each $ 1,134.87 3 mL $ 100.26 1 each $ 957.87 100 each $ 575.21 100 each $ 236.06 30 each $ 68.54 3 each $ 91.85 30 each $ 758.69 100 g $ 66.20 250 each $ 4,304.45 250 g $ 7,441.93 1 each $ 17.87 100 each $ 29.72 15 mL $ 63.46 18 g $ 87.67 8.5 g $ 95.12 5 mL $ 25.50 500 mL $ 288.50 100 each $ 2,036.86 30 each $ 130.61 30 each $ 267.24 10 mL $ 92.59 20 mL $ 120.18 30 mL $ 28.54 50 mL $ 28.65 10 mL $ 110.60 3 mL $ 87.80 100 each $ 368.30 100 each $ 274.25 1 each $ 202.76 1 each $ 173.77 1 each $ 137.50 100 each $ 408.77 100 each $ 245.75 1 each $ 18.26 100 each $ 69.05 100 each $ 314.15 100 each $ 1,886.78 100 each $ 225.80 1 each $ 4,760.03 100 each $ 20.03 60 each $ 171.31 100 each $ 269.12 1 each $ 327.03 1 each $ 589.06 100 each $ 91.85 2.5 mL $ 42.91 30 each $ 647.04 240 mL $ 192.85 50 mL $ 496.27 2 mL $ 337.12 100 each $ 147.71 100 each $ 4,120.97 100 each $ 114.65 60 each $ 40.66 30 each $ 103.25

100 each $ 159.11 30 mL $ 335.69 100 g $ 216.68 1 each $ 20.86 100 each $ 328.40 100 each $ 440.69 90 each $ 3,746.75 90 each $ 3,746.75 30 mL $ 239.90 8 each $ 232.25 36 each $ 39.71 10 mL $ 315.80 100 each $ 916.07 5 mL $ 257.33 20 g $ 429.82 100 each $ 191.03 30 mL $ 69.28 473 mL $ 191.72 5 mL $ 116.75 5 mL $ 40.85 9.4 g $ 35.95 57 g $ 58.35 10 mL $ 301.30 60 mL $ 149.22 30 mL $ 1,362.32 25 mL $ 108.00 3.5 g $ 164.10 15 g $ 466.59 3 mL $ 41.37 5 mL $ 104.87 1 mL $ 766.21 45 g $ 242.75 28 each $ 80.18 5 mL $ 36.86 15 g $ 97.09 3.5 g $ 180.60 85 g $ 33.80 30 mL $ 36.51 45 g $ 267.70 16.5 g $ 179.19 5 mL $ 47.56 1 each $ 71.78 1 each $ 71.78 1 each $ 71.78 14.2 g $ 40.72 28.3 g $ 55.32 100 each $ 103.25 3.2 mL $ 3,479.31 150 mL $ 1,413.97 100 each $ 245.75 300 each $ 5,212.73 1 each $ 82.76 6 each $ 407.84 1 each $ 82.76 6 each $ 453.52 10 each $ 1,314.50 20 mL $ 314.00

10 mL $ 120.92 20 mL $ 117.44 100 each $ 40.55 200 mL $ 391.67 28 each $ 56.34 12 each $ 309.15 24 each $ 1,235.29 3 each $ 8,615.00 5 mL $ 163.53 1 each $ 21.57 100 each $ 399.65 1 each $ 21.62 100 each $ 743.93 100 each $ 1,788.74 100 each $ 1,007.84 30 each $ 381.13 50 each $ 1,348.48 6 each $ 65.87 1 each $ 41.36 12 each $ 301.06 90 each $ 320.93 5 mL $ 253.78 1 each $ 17.84 120 each $ 43.06 150 each $ 31.43 1 each $ 14,721.01 1 each $ 17,529.69 30 each $ 113.51 10 g $ 55.61 100 each $ 258.29 100 each $ 52.52 1 each $ 107.35 100 each $ 62.21 1 each $ 23,351.27 5 mL $ 547.91 100 each $ 828.86 1 each $ 22.00 100 each $ 1,355.54 1 each $ 17.95 100 each $ 37.70 100 mL $ 848.24 50 mL $ 384.26 100 each $ 345.50 60 each $ 1,505.13 5 each $ 609.74 5 each $ 464.37 .625 mL $ 225.89 100 each $ 183.05 100 each $ 572.36 100 each $ 559.25 30 each $ 933.80 45 g $ 341.50 1 each $ 959.90 17 g $ 278.51 1 each $ 1,517.13 1 each $ 19.71 100 each $ 152.27

90 each $ 281.95 10 mL $ 3,975.71 50 mL $ 19,618.57 168 each $ 391.75 15 g $ 1,355.41 5 mL $ 214.48 15 g $ 112.46 30 g $ 232.33 5 mL $ 41.59 60 each $ 1,329.66 100 mL $ 363.17 60 mL $ 235.95 28.3 g $ 38.38 200 each $ 497.69 1 each $ 18.16 60 each $ 42.03 1 mL $ 69.39 9 each $ 180.37 1 each $ 51.23 30 each $ 440.98 1 each $ 22.37 90 each $ 3,031.11 24 each $ 43.06 473 mL $ 228.05 473 mL $ 219.96 1 each $ 29.98 100 each $ 1,703.24 1 mL $ 974.29 4 mL $ 649.71 5 mL $ 267.21 90 each $ 93.16 60 each $ 923.02 30 each $ 1,423.01 100 each $ 4,701.77 10 mL $ 252.38 15 mL $ 369.86 250 mL $ 1,291.70 1 mL $ 151.36 20 mL $ 1,119.50 10 mL $ 318.05 100 mL $ 603.14 100 mL $ 702.89 30 each $ 829.32 120 each $ 7,189.51 1 each $ 14,742.84 100 mL $ 2,510.30 100 mL $ 6,824.06 10 mL $ 129.13 20 mL $ 224.60 100 each $ 528.47 28 each $ 573.48 1 each $ 70.40 12 each $ 232.25 100 each $ 163.10 20 each $ 46.82 5 g $ 42.90 6 mL $ 1,125.09

28 each $ 7,460.16 1 each $ 4,873.24 24 each $ 957.16 30 each $ 1,617.44 30 each $ 326.75 30 each $ 359.24 90 each $ 4,113.03 1 each $ 1,710.50 1 each $ 3,221.00 1 each $ 540.26 4 each $ 1,966.02 240 mL $ 853.60 118 mL $ 388.35 100 each $ 59.36 4 each $ 7,265.47 26 mL $ 57.12 100 each $ 81.02 60 each $ 1,494.63 1 each $ 11,810.65 1 each $ 15,453.80 1 each $ 23,108.62 60 each $ 2,766.06 240 mL $ 854.97 100 each $ 1,515.71 100 each $ 1,573.28 100 each $ 2,195.72 100 each $ 253.16 1 each $ 17.83 100 each $ 25.16 5 mL $ 267.95 1 each $ 3,852.42 30 each $ 73.84 10 mL $ 9,726.87 30 each $ 928.06 100 each $ 238.34 12 each $ 508.38 1 each $ 29.05 100 each $ 1,147.49 3 mL $ 48.34 1 each $ 72.75 1 each $ 72.75 1 each $ 72.98 5 mL $ 246.26 10 mL $ 606.50 510 g $ 45.02 160 mL $ 6,172.84 6 each $ 94.97 100 each $ 189.89 100 each $ 216.68 100 each $ 284.51 5 mL $ 631.47 60 each $ 35.19 5 each $ 36.56 500 mL $ 136.25 100 mL $ 54.23 50 mL $ 35.99 75 mL $ 45.54

75 each $ 103.25 50 each $ 2,795.86 1 each $ 2,661.69 100 each $ 421.88 14 each $ 181.66 100 each $ 739.37 170.1 g $ 51.19 1 each $ 235.66 100 each $ 177.92 90 each $ 4,439.81 30 each $ 91.28 500 mL $ 335.75 20 each $ 548.19 1 each $ 21.48 100 each $ 520.49 1 each $ 37.09 14 each $ 795.72 1 each $ 91.85 14 each $ 913.94 5 each $ 337.87 14 each $ 5,204.02 5 each $ 4,019.63 30 each $ 595.07 100 each $ 288.50 100 each $ 294.20 50 each $ 107.53 90 each $ 2,110.79 1 each $ 19.81 100 each $ 188.75 90 each $ 203.46 1 each $ 93.50 1 each $ 1,416.73 60 mL $ 1,540.47 1 each $ 9,105.20 14 each $ 197.57 14 each $ 197.57 60 each $ 485.42 10 each $ 200.31 100 each $ 1,841.75 100 each $ 1,688.71 100 each $ 215.54 120 each $ 201.75 100 each $ 398.51 100 each $ 416.18 30 each $ 1,265.55 50 each $ 1,999.15 100 each $ 260.00 14 each $ 365.28 40 each $ 1,010.46 40 each $ 1,010.46 118 mL $ 291.50 8.6 g $ 262.51 15 g $ 53.93 30 g $ 72.14 1 each $ 96.95 5 mL $ 164.10 1.5 mL $ 2,088.44

100 each $ 201.86 4.9 g $ 325.90 2 mL $ 552.98 10 mL $ 1,319.00 1 each $ 5,941.99 30 each $ 241.76 90 each $ 3,031.11 1 each $ 146.68 1 each $ 223.46 1 each $ 88.43 10 each $ 284.45 1 each $ 103.87 10 each $ 408.71 454 g $ 22.43 10 mL $ 100.63 20 mL $ 117.33 100 each $ 541.01 100 each $ 885.86 100 each $ 1,172.00 20 mL $ 1,319.00 2 mL $ 104.33 100 each $ 726.26 1 each $ 627.88 10 mL $ 5,723.30 25 mL $ 14,008.54 14 g $ 1,050.54 8 each $ 156.39 8 each $ 156.44 8 each $ 156.65 37.5 g $ 35.71 1 each $ 399.86 1 each $ 22.20 30 each $ 151.13 30 each $ 138.48 30 each $ 717.31 30 each $ 157.29 30 each $ 178.83 30 each $ 813.93 1 each $ 19.63 100 each $ 205.85 100 each $ 462.92 100 each $ 545.00 4 each $ 192.82 4 each $ 516.83 4 each $ 710.06 10 each $ 40.27 10 each $ 63.41 20 each $ 95.16 15 each $ 77.00 10 each $ 74.18 20 each $ 69.28 40 each $ 115.56 18 each $ 184.37 100 each $ 379.70 120 each $ 1,230.48 120 each $ 1,056.75 100 each $ 454.94

100 each $ 656.15 100 each $ 1,293.41 30 each $ 546.14 60 each $ 388.14 60 each $ 470.90 60 each $ 1,753.06 30 each $ 529.04 100 each $ 36.06 114 mL $ 34.15 120 mL $ 43.93 18 each $ 63.31 1 each $ 43.60 30 each $ 793.24 1 each $ 29.15 80 each $ 1,090.26 30 each $ 175.93 1 each $ 20.22 100 each $ 364.31 100 each $ 347.21 10 each $ 280.93 24 each $ 649.37 4 each $ 118.22 1 each $ 24.34 30 each $ 215.43 30 each $ 331.19 5 mL $ 342.32 1 each $ 26.00 50 each $ 214.40 3000 mL $ 270.20 5000 mL $ 264.50 1000 mL $ 230.30 3000 mL $ 253.10 5000 mL $ 264.50 3000 mL $ 287.30 5000 mL $ 264.50 1000 mL $ 213.20 3000 mL $ 253.10 5000 mL $ 264.50 3000 mL $ 253.10 5000 mL $ 264.50 1000 mL $ 241.70 3000 mL $ 270.20 5000 mL $ 293.00 100 mL $ 74.12 1000 mL $ 76.40 250 mL $ 83.53 50 mL $ 72.98 500 mL $ 84.95 100 each $ 177.35 100 each $ 3,947.90 100 each $ 216.68 14 each $ 154.53 7 each $ 101.50 14 each $ 178.15 7 each $ 101.50 28 each $ 273.59 7 each $ 101.50

1 each $ 18.02 30 each $ 25.79 177 mL $ 42.47 1 each $ 58.39 5 each $ 220.96 1 each $ 38.65 5 each $ 122.25 5 each $ 182.92 5 each $ 245.10 30 each $ 620.91 30 each $ 781.93 20 each $ 284.74 100 each $ 2,505.80 20 each $ 528.13 20 each $ 923.02 20 each $ 510.74 1 each $ 23.45 100 each $ 502.25 15 mL $ 62.57 15 mL $ 55.19 30 each $ 55.73 50 each $ 34.58 15 mL $ 42.64 473 mL $ 405.99 480 mL $ 406.26 60 mL $ 69.05 60 mL $ 294.77 56 g $ 43.11 78 g $ 44.82 1000 mL $ 87.80 100 each $ 2,258.42 1 each $ 58.43 30 each $ 798.71 118 mL $ 46.85 237 mL $ 53.73 473 mL $ 68.48 100 each $ 1,687.85 1 each $ 60.43 30 each $ 1,499.81 30 each $ 6,354.89 150 mL $ 3,666.89 100 mL $ 440.06 1 each $ 180.69 20 each $ 114.60 28 each $ 215.40 60 each $ 317.32 10 mL $ 332.86 8 g $ 37.67 50 each $ 98.12 1000 mL $ 87.80 3000 mL $ 99.20 4 each $ 173.79 4 each $ 173.79 20 mL $ 123.37 10 mL $ 294.70 360 each $ 4,525.99 180 each $ 4,524.97

1 each $ 47.31 100 each $ 2,973.20 100 each $ 3,142.49 45 g $ 228.27 2 mL $ 60.68 2 mL $ 68.28 10 mL $ 50.28 500 mL $ 465.20 28.35 g $ 41.81 30 g $ 41.80 60 mL $ 49.06 1 each $ 26.19 1 each $ 51.38 50 mL $ 1,848.88 30 g $ 89.22 10 g $ 140.37 100 each $ 561.53 100 each $ 722.27 1 each $ 1,177.04 1 each $ 3,743.29 .4 mL $ 616.76 1 each $ 1,097.73 160 mL $ 2,338.79 2.5 mL $ 7,551.95 100 each $ 2,556.28 20 each $ 1,554.43 8.7 g $ 232.39 8.7 g $ 305.30 3 each $ 463.25 100 each $ 67.34 50 each $ 39.98 28 each $ 289.39 1 each $ 535.19 2 each $ 1,797.29 4 each $ 76.30 30 g $ 465.77 10 mL $ 2,987.39 4 each $ 76.30 5 mL $ 338.60 60 each $ 2,673.72 470 mL $ 652.67 4 each $ 307.25 1 each $ 19.97 100 each $ 240.05 90 each $ 497.41 30 each $ 251.51 1 each $ 1,292.12 280 each $ 2,287.26 237 mL $ 2,865.45 1 each $ 13,745.00 1 mL $ 110.60 100 each $ 3,417.80 1 each $ 4,947.05 15 g $ 58.06 30 each $ 1,289.99 30 each $ 1,289.99 30 g $ 367.71

60 g $ 718.17 30 g $ 367.71 1 mL $ 3,171.50 10 mL $ 162.13 2 mL $ 111.74 100 each $ 171.08 25 g $ 402.11 50 g $ 372.41 30 each $ 319.74 1 each $ 1,989.95 1 each $ 430.25 44 mL $ 21.77 30 each $ 1,367.11 30 each $ 1,367.11 80 each $ 2,297.75 80 each $ 2,297.75 80 each $ 2,726.85 4 each $ 233.37 250 mL $ 1,031.15 50 mL $ 258.23 100 each $ 85.01 100 each $ 597.44 3.5 g $ 55.62 100 each $ 615.11 100 each $ 659.57 90 each $ 1,039.13 1 each $ 39.72 60 each $ 1,336.16 5 g $ 347.75 30 each $ 1,640.21 100 each $ 81.59 1000 mL $ 112.95 100 g $ 3,884.06 25 g $ 984.33 28 each $ 108.36 250 mL $ 881.30 3 mL $ 27.73 205 g $ 123.43 100 mL $ 140.81 250 mL $ 183.28 125 mL $ 174.73 200 each $ 953.69 25 mL $ 576.20 50 mL $ 923.90 10 mL $ 276.09 5 mL $ 146.73 125 mL $ 117.50 75 mL $ 146.00 1 each $ 5,555.01 90 each $ 2,228.27 1 each $ 702.55 50 each $ 5,560.84 1 each $ 11,322.50 3 each $ 237.20 1 each $ 168.54 3 each $ 471.13 100 each $ 2,111.77

30 each $ 733.22 3 mL $ 25.33 100 each $ 4,077.86 100 each $ 4,077.86 30 each $ 1,458.40 1 mL $ 99.54 100 each $ 1,838.90 .67 mL $ 637.44 30 mL $ 1,157.81 100 each $ 461.78 100 each $ 656.15 30 each $ 5,834.00 60 each $ 11,650.25 60 each $ 11,650.25 9 each $ 523.74 250 mL $ 305.83 1 each $ 488.37 100 each $ 2,163.80 30 g $ 325.83 .5 mL $ 314.22 3 each $ 199.61 .6 mL $ 44,597.96 30 each $ 1,203.18 60 each $ 6,897.76 60 each $ 17,217.52 30 each $ 373.94 3 mL $ 48.33 1 each $ 82.10 1 each $ 99.20 90 each $ 780.58 30 g $ 225.15 10 mL $ 265.93 30 each $ 774.08 30 each $ 534.00 30 each $ 549.56 100 each $ 3,047.30 1 each $ 3,148.70 1 each $ 28,908.88 20 mL $ 6,785.30 20 mL $ 16,865.75 20 mL $ 33,666.50 100 mL $ 133.97 50 mL $ 99.49 20 g $ 523.07 90 each $ 10,541.35 100 each $ 4,077.86 100 each $ 2,813.60 1 each $ 71.22 1 each $ 118.34 100 each $ 6,209.38 1 each $ 915.38 100 each $ 2,399.78 90 each $ 2,291.93 1 each $ 190.65 100 each $ 2,664.26 20 each $ 172.45 20 each $ 312.44

20 each $ 178.60 20 each $ 442.63 100 mL $ 172.22 50 mL $ 96.70 75 mL $ 122.92 100 mL $ 100.97 50 mL $ 167.95 1 each $ 18.86 100 each $ 104.96 1 each $ 19.03 100 each $ 3,448.58 1 each $ 3,778.11 28 each $ 531.66 30 each $ 608.53 100 each $ 695.48 30 each $ 1,070.77 30 each $ 1,298.66 100 each $ 1,107.59 30 each $ 1,284.86 30 each $ 1,284.86 30 each $ 1,284.86 30 each $ 1,393.45 1 each $ 19.46 100 each $ 188.75 .5 mL $ 446.75 100 each $ 5,018.93 100 each $ 4,793.78 2 each $ 14,329.88 60 mL $ 538.62 1 each $ 31.91 30 each $ 442.51 30 each $ 861.86 72 each $ 209.41 72 each $ 209.41 10 mL $ 50.28 240 mL $ 885.06 7.5 mL $ 187.02 90 each $ 3,123.45 90 each $ 3,123.45 100 each $ 114.08 1 each $ 48.04 30 each $ 926.27 1 each $ 11,248.12 30 each $ 58.28 1 each $ 206.32 1 each $ 312.40 6 each $ 1,785.64 8 each $ 546.28 30 each $ 670.06 30 each $ 670.06 1 each $ 23.02 60 each $ 333.76 100 mL $ 1,092.14 250 mL $ 3,146.42 50 mL $ 578.57 5 mL $ 3,458.15 28 each $ 644.02

30 each $ 578.29 3 mL $ 191.16 5 mL $ 4,659.20 1 each $ 9,137.60 60 each $ 263.99 1 each $ 20.54 100 each $ 409.91 1 each $ 20.83 100 each $ 327.83 1 each $ 46.18 30 each $ 1,022.38 1000 mL $ 82.10 30 each $ 12,658.02 60 each $ 1,974.19 60 each $ 1,974.19 1 each $ 4,493.96 500 mL $ 102.05 1 each $ 53.46 100 each $ 3,588.80 100 each $ 4,287.13 30 each $ 1,298.66 7.5 mL $ 267.39 500 mL $ 391.10 5 mL $ 2,270.90 100 each $ 1,976.27 30 each $ 240.91 30 each $ 366.59 60 each $ 46.48 30 each $ 604.08 15 mL $ 34.44 473 mL $ 44.71 60 each $ 1,659.35 30 each $ 547.85 30 each $ 1,584.43 60 each $ 3,151.10 100 each $ 91.28 100 each $ 98.12 1 each $ 1,981.51 7 g $ 25.19 100 each $ 2,753.75 50 mL $ 88.15 20 each $ 92.99 50 each $ 171.65 120 each $ 1,036.91 100 mL $ 1,123.55 60 each $ 48.87 118 mL $ 73.75 100 each $ 135.74 90 each $ 696.45 100 each $ 71.90 100 mL $ 285.65 60 each $ 1,748.27 100 each $ 230.93 20 each $ 59.13 100 each $ 1,631.99 1 each $ 181.43 1 each $ 17,649.96

15 mL $ 33.14 473 mL $ 680.99 1 each $ 17,013.58 50 mL $ 3,132.94 1 each $ 18.82 24 each $ 43.33 1 each $ 40.85 100 each $ 2,327.39 120 each $ 2,914.49 1 each $ 63.94 120 each $ 5,017.79 15 mL $ 68.29 30 each $ 847.87 30 each $ 1,677.98 75 mL $ 1,744.81 100 each $ 976.49 473 mL $ 58.19 1 each $ 254.24 1 each $ 4,375.25 1 each $ 2,287.63 1 each $ 8,550.50 30 mL $ 21.17 355 mL $ 27.87 30 mL $ 1,198.56 5 each $ 147.70 120 each $ 5,213.41 30 each $ 69.41 120 mL $ 120.35 473 mL $ 902.07 474 mL $ 909.34 207 mL $ 33.77 60 each $ 1,226.04 100 each $ 449.81 30 each $ 679.37 15 g $ 53.21 30 each $ 2,135.11 15 mL $ 319.70 45 mL $ 570.39 5 mL $ 252.67 60 each $ 2,233.91 1 each $ 54.64 100 each $ 4,161.65 100 each $ 4,161.65 30 each $ 1,260.92 1 each $ 53.15 30 each $ 1,839.55 2 mL $ 99.20 100 mL $ 691.49 5 mL $ 102.05 1 mL $ 1,085.59 103.5 mL $ 76.85 480 mL $ 2,770.17 1 each $ 93,105.47 237 mL $ 160.95 90 each $ 1,113.01 1 each $ 36.56 30 each $ 581.88

30 each $ 3,317.02 30 each $ 31,370.31 30 each $ 10,267.62 2 mL $ 83.96 180 mL $ 198.12 1 each $ 35.59 30 each $ 552.85 100 each $ 1,801.40 30 each $ 1,082.45 10 each $ 95.78 30 each $ 1,174.39 30 each $ 1,174.39 1 each $ 10,249.00 20 mL $ 14,977.82 1 mL $ 157.18 150 mL $ 4,886.98 1.2 mL $ 444.57 473 mL $ 68.48 .5 mL $ 704.44 1 mL $ 3,853.68 25 g $ 709.02 1 mL $ 65.00 10.6 g $ 241.39 12 g $ 317.34 12 g $ 483.34 100 g $ 454.94 50 mL $ 90,381.50 1 g $ 69.05 25 g $ 1,300.17 1 each $ 18.51 25 each $ 28.30 .65 mL $ 744.16 12.9 g $ 407.45 1 each $ 597.95 30 each $ 1,939.09 2 mL $ 1,749.72 5 each $ 151.75 10 mL $ 69.22 50 mL $ 74.98 100 each $ 4,136.57 1 each $ 743.30 1 each $ 1,005.50 118 mL $ 134.78 .5 mL $ 286.21 1 each $ 414.13 1 mL $ 14,136.48 2 mL $ 302.12 2 mL $ 336.55 90 each $ 536.39 100 each $ 159.11 30 each $ 1,212.87 90 each $ 2,074.37 100 each $ 2,530.88 90 each $ 2,074.37 100 each $ 2,530.88 90 each $ 2,074.37 120 mL $ 82.10

1 each $ 43.90 100 each $ 2,632.91 30 each $ 792.89 45 g $ 99.74 30 each $ 394.98 100 mL $ 545.00 120 each $ 4,659.37 30 each $ 4,661.94 100 each $ 103.25 15 g $ 102.14 60 mL $ 228.76 120 each $ 17,383.74 4 mL $ 58.11 10 mL $ 332.86 50 mL $ 4,035.82 100 each $ 233.21 1 each $ 3,913.75 30 each $ 1,298.66 60 g $ 1,222.58 5 mL $ 42.00 1 each $ 71.04 1 each $ 71.04 1 each $ 71.04 2 mL $ 489.38 16 g $ 53.55 1 each $ 373.31 28 each $ 154.19 2.2 mL $ 3,275.30 4.4 mL $ 6,485.66 1.3 mL $ 1,979.29 1 mL $ 35.28 2.5 mL $ 324.12 60 each $ 338.55 28 each $ 145.55 120 mL $ 54.00 1 each $ 40.11 10 each $ 230.77 1 mL $ 359.52 1 each $ 578.00 30 each $ 592.94 1 each $ 5,622.50 1 each $ 9,952.70 1 each $ 72.98 1 each $ 72.98 1 each $ 72.98 1 each $ 72.98 30 each $ 1,319.40 30 each $ 1,319.40 120 mL $ 47.85 .5 mL $ 875.25 1 each $ 135.31 60 each $ 7,810.24 60 each $ 15,602.73 60 each $ 15,602.73 473 mL $ 68.48 2 mL $ 2,957.75 .05 mL $ 11,180.00

30 each $ 3,320.54 1 each $ 119.49 1 each $ 18,630.98 3 mL $ 15,956.60 300 each $ 48.53 1 mL $ 981.56 1 mL $ 3,731.24 1 each $ 18.08 10 each $ 25.10 25 each $ 29.15 2.5 mL $ 236.21 1 each $ 3,823.69 12 g $ 485.40 8 g $ 269.77 5 mL $ 254.35 28 each $ 113.86 10 mL $ 87.80 105 mL $ 5,429.99 3 mL $ 75.50 237 mL $ 59.63 120 each $ 18,282.85 30 each $ 1,955.68 473 mL $ 58.19 25 g $ 286.45 473 mL $ 290.06 60 each $ 628.56 1 each $ 72.98 1 each $ 3,407.56 30 each $ 1,367.11 150 each $ 8,226.83 100 each $ 2,182.22 60 each $ 34.85 28 g $ 39.44 100 each $ 1,875.38 240 mL $ 125.82 100 mL $ 6,242.66 6.9 g $ 265.18 6 g $ 302.45 5 each $ 2,258.20 5 each $ 2,898.32 100 each $ 3,799.13 30 mL $ 33,318.86 1 each $ 931.00 8 each $ 44.11 100 each $ 3,555.52 4 mL $ 19.64 3 mL $ 865.28 50 mL $ 273.25 10 mL $ 217.10 20 mL $ 234.20 1 mL $ 8,074.07 4 mL $ 85.02 6 mL $ 92.09 30 each $ 11,391.71 30 each $ 11,391.71 1 each $ 71.78 180 each $ 63.92

90 each $ 38.78 1 each $ 72.98 5 mL $ 182.78 1 each $ 389.45 1 each $ 458.68 1 each $ 458.68 120 each $ 3,605.71 10 mL $ 275.90 10 mL $ 136.02 2 mL $ 82.44 10 mL $ 251.47 2 mL $ 222.34 40 mL $ 406.34 1 each $ 1,091.00 10 mL $ 1,138.79 5 mL $ 1,625.00 .5 mL $ 353.14 1 each $ 71.27 1 each $ 71.27 100 mL $ 405.77 50 mL $ 296.90 10.15 mL $ 23.02 20.3 mL $ 24.12 60 each $ 1,876.87 10 each $ 643.55 10 each $ 643.55 28 each $ 3,437.57 1 mL $ 881.53 1 each $ 34.33 270 each $ 4,493.16 120 each $ 6,409.78 20 each $ 417.32 20 each $ 740.28 20 each $ 399.30 1 each $ 159.65 30 each $ 942.86 100 each $ 3,846.38 30 each $ 1,367.11 5 mL $ 556.25 2 mL $ 291.20 1 each $ 2,430.50 1 mL $ 93.84 1 mL $ 135.54 1 mL $ 348.23 1 each $ 12,352.40 2 mL $ 69.96 .6 mL $ 404.44 30 mL $ 119.04 1 each $ 502.07 112 each $ 20,771.53 30 g $ 1,203.35 90 g $ 3,309.21 6.1 g $ 304.10 10 each $ 1,535.17 10 each $ 6,087.34 60 each $ 1,941.72 1 each $ 74.80

1 each $ 75.09 1 each $ 75.09 200 mL $ 196.10 118 mL $ 43.31 120 mL $ 44.43 3 mL $ 84.87 1 each $ 7,444.79 10 mL $ 1,641.76 50 mL $ 1,205.00 1 each $ 670.99 1000 each $ 507.95 200 mL $ 606.50 50 mL $ 200.38 200 mL $ 606.50 50 mL $ 200.38 1 mL $ 52.31 60 each $ 1,941.72 112 each $ 10,394.64 30 each $ 4,472.31 120 each $ 3,876.88 120 each $ 2,251.78 50 mL $ 41.98 227 g $ 43.13 10 mL $ 104.90 5 mL $ 92.65 45 g $ 470.18 1.2 mL $ 39,665.92 60 each $ 1,269.31 50 mL $ 46.25 24 each $ 544.29 180 each $ 4,764.08 60 each $ 2,127.89 60 each $ 3,316.68 60 each $ 1,130.31 20 mL $ 353.65 1 each $ 226.93 1 each $ 298.03 100 mL $ 3,328.25 50 mL $ 1,696.63 1 each $ 70.47 1 each $ 81.02 10 mL $ 80.28 1 each $ 3,022.64 .5 mL $ 201.80 30 each $ 57.42 110 each $ 52.24 1 each $ 70.99 2 mL $ 76.29 30 mL $ 153.58 10 each $ 5,174.00 30 each $ 703.33 28 each $ 609.88 100 each $ 205.52 100 each $ 368.54 100 each $ 707.12 100 mL $ 331.10 17 mL $ 2,900.10

100 each $ 3,290.69 60 each $ 1,981.86 100 each $ 11,642.17 88 mL $ 4,461.43 1 each $ 78.07 1 each $ 91,578.56 20 mL $ 1,187.58 90 each $ 1,583.39 90 each $ 1,583.39 100 each $ 347.25 100 each $ 493.77 100 each $ 664.55 180 each $ 55.71 120 each $ 12,724.00 60 each $ 54.00 1 each $ 535.19 2 each $ 1,606.68 100 each $ 3,268.46 5 each $ 222.78 50 mL $ 122.00 28 each $ 208.01 28 each $ 57.77 30 each $ 1,483.56 10 each $ 61.58 30 each $ 115.56 5 each $ 3,390.04 30 each $ 140.53 2 mL $ 72.98 30 mL $ 123.48 5 mL $ 84.32 10 mL $ 82.39 2 mL $ 79.54 5 mL $ 81.25 100 each $ 354.62 .5 mL $ 834.81 1 each $ 7,913.90 1 each $ 1,175.55 14 each $ 311.15 100 each $ 253.73 5 g $ 1,409.46 30 each $ 844.19 60 each $ 2,198.23 100 each $ 4,402.19 100 each $ 1,135.52 2.5 mL $ 202.17 1 each $ 768.58 60 each $ 15,988.43 100 each $ 155.69 100 each $ 363.26 100 each $ 572.64 100 each $ 709.10 5 mL $ 68.31 200 mL $ 1,382.33 10 mL $ 74.12 30 mL $ 85.18 10 mL $ 77.88 30 mL $ 112.20

50 mL $ 136.82 30 mL $ 91.68 20 mL $ 94.64 10 mL $ 75.55 20 mL $ 86.66 30 mL $ 84.15 60 each $ 66.31 .3 mL $ 206.41 .4 mL $ 253.53 .6 mL $ 348.14 .8 mL $ 442.52 1 mL $ 536.89 .8 mL $ 631.45 3 mL $ 1,479.05 1 each $ 76.74 3.5 g $ 42.83 2 mL $ 128.04 1 each $ 72.75 1 each $ 72.75 2 mL $ 70.42 20 mL $ 150.50 60 each $ 1,680.21 1 each $ 402.94 1 mL $ 521.00 20 mL $ 1,290.50 20 mL $ 4,967.00 473 mL $ 2,231.25 5 mL $ 19,730.00 100 mL $ 149.36 .4 mL $ 743.81 .6 mL $ 651.46 2 mL $ 465.03 4 mL $ 884.71 2 mL $ 383.88 5 mL $ 15,662.62 .5 mL $ 7,516.95 4 mL $ 1,702.45 10 mL $ 4,158.63 16 mL $ 15,000.39 4 mL $ 3,900.10 8 mL $ 130.57 100 mL $ 6,065.87 1.6 mL $ 2,720.64 .5 mL $ 1,832.86 .8 mL $ 2,880.23 .5 mL $ 1,618.25 2 mL $ 6,278.00 100 mL $ 5,688.05 200 mL $ 11,311.10 10 mL $ 774.14 100 mL $ 7,156.37 200 mL $ 14,247.74 25 mL $ 1,837.84 50 mL $ 3,610.69 5 mL $ 843.34 10 mL $ 1,621.67 20 mL $ 3,178.34

2 mL $ 289.50 50 mL $ 99.20 100 mL $ 184.70 .51 mL $ 1,865.12 5 mL $ 1,586.22 20 mL $ 79.25 40 mL $ 84.84 100 mL $ 76.97 200 mL $ 79.82 40 mL $ 352.51 6 mL $ 109.02 1 mL $ 69.73 4 mL $ 1,610.59 1 each $ 111.68 150 mL $ 134.26 1 each $ 8,739.89 100 each $ 42.83 16 mL $ 14,622.64 2 mL $ 2,002.80 10 mL $ 35,962.20 3 mL $ 156.20 30 each $ 872.58 30 each $ 1,053.84 75 g $ 2,170.64 125 mL $ 3,299.04 50 mL $ 1,358.62 60 mL $ 648.40 70 each $ 130.90 100 each $ 35.99 30 each $ 3,404.89 1 each $ 35,319.67 1 each $ 29,982.50 3 mL $ 45,693.50 10 mL $ 131.35 5 mL $ 341.51 1 each $ 4,071.87 30 mL $ 75.77 100 each $ 29.15 10 mL $ 154.78 14 mL $ 118.06 .5 mL $ 87.00 118 mL $ 33.89 473 mL $ 63.58 10 mL $ 6,075.08 1 each $ 4,271.77 100 each $ 676.10 30 mL $ 99.83 25 g $ 472.61 30 mL $ 238.85 4000 mL $ 63.45 5 mL $ 108.63 30 mL $ 128.05 2 mL $ 210.12 1 mL $ 71.10 10 mL $ 103.93 50 mL $ 94.93 2 mL $ 2,520.73

.5 mL $ 171.62 5 mL $ 79.54 10 mL $ 83.53 1 each $ 92.70 30 mL $ 20.49 473 mL $ 28.54 15 mL $ 59.06 12 each $ 421.33 15 mL $ 37.51 473 mL $ 66.28 50 mL $ 145.37 10 mL $ 34.33 30 each $ 46.82 100 each $ 2,643.74 100 mL $ 98.69 15 mL $ 22.20 1 each $ 17.90 100 each $ 51.95 3 each $ 90.04 450 mL $ 358.90 1 each $ 4,482.33 118 mL $ 41.29 1 each $ 24.33 100 each $ 2,643.74 50 mL $ 46.82 177 mL $ 30.37 473 mL $ 52.30 2 mL $ 5,142.22 1 each $ 17.93 100 each $ 42.26 100 each $ 43.40 3 mL $ 120.33 3 mL $ 124.16 50 mL $ 97.21 300 mL $ 815.69 1 mL $ 79.48 355 mL $ 33.44 30 each $ 62.91 50 each $ 37.46 3 mL $ 112.29 250 mL $ 193.25 5 mL $ 76.34 144 each $ 181.91 144 each $ 112.14 144 each $ 173.70 144 each $ 138.41 1 each $ 45.30 118 mL $ 42.64 105 mL $ 63.93 20 mL $ 92.02 118 mL $ 34.74 15 g $ 41.73 1 each $ 19.92 44.4 mL $ 67.65 120 mL $ 93.67 240 mL $ 69.73 1 mL $ 743.30

30 each $ 1,019.98 50 mL $ 701.12 1 each $ 75.72 1 each $ 75.72 2 mL $ 1,635.92 118.28 mL $ 311.36 3 mL $ 112.29 473 mL $ 109.42 473 mL $ 109.42 1 each $ 292.69 130 each $ 41.46 60 each $ 38.27 1 mL $ 90.88 1 mL $ 91.68 1 mL $ 90.02 1 mL $ 72.81 1 mL $ 90.02 100 mL $ 93.50 50 mL $ 93.22 100 mL $ 93.50 50 mL $ 93.22 3 mL $ 4,054.89 1000 mL $ 150.50 1000 mL $ 161.90 1 each $ 75.72 12 mL $ 62.83 5 mL $ 68.31 1 mL $ 78.74 10 mL $ 107.35 2 mL $ 140.18 473 mL $ 112.11 30 each $ 59.82 5 mL $ 3,713.00 5 mL $ 76.97 236.6 mL $ 48.27 .5 mL $ 868.24 1 each $ 18.40 100 each $ 82.16 1 each $ 17.97 100 each $ 39.41 120 each $ 1,041.70 .98 mL $ 3,665.23 60 mL $ 136.77 1 mL $ 71.57 1 mL $ 88.03 30 mL $ 314.32 30 mL $ 197.70 30 mL $ 342.88 1 mL $ 1,015.70 5 mL $ 4,626.31 .5 mL $ 569.17 18 each $ 29.56 66 mL $ 24.52 .5 mL $ 182.52 .5 mL $ 182.52 1 mL $ 359.98 .5 mL $ 224.54

1 mL $ 71.38 1 mL $ 423.95 120 mL $ 56.92 3 mL $ 117.28 2 mL $ 87.46 100 each $ 46.82 1 mL $ 423.95 3.5 g $ 32.93 240 mL $ 138.13 2 mL $ 68.36 50 mL $ 104.62 3.5 g $ 68.39 500 mL $ 96.35 1 mL $ 122.00 .5 mL $ 180.36 .5 mL $ 183.82 10 mL $ 122.00 1 each $ 2,217.38 1000 each $ 126.05 30 mL $ 108.26 .5 mL $ 321.50 50 mL $ 535.03 10 mL $ 54.29 5 mL $ 50.53 2 mL $ 261.05 25 mL $ 389.95 5 mL $ 268.97 5000 mL $ 378.50 10 mL $ 71.21 250 mL $ 116.30 50 mL $ 75.26 5 mL $ 119.15 2 mL $ 102.05 10 mL $ 117.73 56.7 g $ 32.44 1 each $ 17.86 96 each $ 28.69 5 mL $ 231.86 473 mL $ 109.42 1 each $ 17.93 473 mL $ 93.24 473 mL $ 109.42 473 mL $ 109.42 100 each $ 171.65 11.6 mL $ 3,086.25 142 g $ 68.24 100 each $ 49.67 100 each $ 184.23 1 each $ 19.41 100 each $ 169.94 50 each $ 100.69 1 each $ 65.06 3.5 g $ 62.28 1 each $ 83.90 25 each $ 537.53 1 each $ 95.48 .5 mL $ 42,094.46

28 g $ 77.13 100 each $ 95.84 1 each $ 205.51 1 each $ 128.33 1 each $ 100.74 1 each $ 328.40 2 mL $ 103.19 4 mL $ 106.61 10 mL $ 171.88 1 each $ 743.30 100 each $ 45.68 30 mL $ 371.43 1000 mL $ 281.60 5 mL $ 88.20 1 each $ 20.59 60 each $ 188.07 10 mL $ 644.41 25 mL $ 1,513.51 50 mL $ 2,962.03 100 mL $ 5,859.05 200 mL $ 11,653.10 2 mL $ 64.73 60 each $ 123.77 90 each $ 181.40 2.5 mL $ 200.66 3 mL $ 114.88 1 mL $ 87.80 1 mL $ 291.29 100 g $ 889.85 500 g $ 4,378.25 1 mL $ 76.97 1 each $ 17.98 60 each $ 31.43 1 mL $ 136.25 500 mL $ 193.25 30 mL $ 183.85 16 each $ 30.75 .5 mL $ 4,461.24 1 mL $ 282.28 1 each $ 20.62 60 each $ 189.78 2 mL $ 91.22 60 each $ 2,150.12 100 each $ 5,059.97 4 mL $ 84.84 10 mL $ 399.53 1 each $ 19,306.95 5 each $ 96,274.84 5 mL $ 28.38 1 each $ 588.32 1 each $ 17.90 100 each $ 32.57 1 each $ 63.89 100 each $ 4,631.33 1 each $ 71.78 300 mL $ 366.59 300 mL $ 434.99

1 each $ 13,045.50 100 mL $ 296.42 1 each $ 134,727.50 35.44 g $ 116.25 5 mL $ 86.83 120 g $ 153.87 100 each $ 418.37 100 each $ 2,798.72 1 each $ 154.98 1 each $ 21.31 12 each $ 63.31 15 mL $ 32.90 10 mL $ 128.04 5 g $ 19.00 118 mL $ 29.19 4 g $ 451.50 25 g $ 774.85 250 mL $ 164.75 1 each $ 72.98 .5 mL $ 266.87 57 g $ 32.20 1 mL $ 75.43 1 mL $ 75.43 50 mL $ 105.76 50 mL $ 82.96 5 mL $ 23.37 30 each $ 1,941.72 5 mL $ 19.26 .5 mL $ 266.21 .5 mL $ 266.21 2 mL $ 202.12 30 each $ 998.84 1 each $ 190.97 10 each $ 1,324.70 355 mL $ 64.29 1 each $ 1,090.28 90 each $ 897.55 100 each $ 43.40 118 mL $ 25.32 250 mL $ 2,323.63 50 mL $ 516.73 100 mL $ 968.45 1 each $ 184.42 .5 mL $ 158.48 1 each $ 17.90 100 each $ 350.06 1 each $ 1,003.95 5 each $ 3,817.20 .25 mL $ 147.65 113 g $ 63.63 30 each $ 356.67 30 each $ 695.59 1 mL $ 17,832.70 120 mL $ 3,032.14 57 g $ 68.59 150 mL $ 1,642.25 4 each $ 80.45

8 each $ 130.88 2 mL $ 70.53 2 mL $ 67.68 30 each $ 12,770.93 12 each $ 50.79 12 each $ 28.28 1000 mL $ 640.95 1 each $ 17.92 1000 mL $ 87.80 500 mL $ 73.55 5 mL $ 231.86 30 mL $ 175.30 10 each $ 428.00 1 each $ 122.00 10 each $ 435.50 1 each $ 9,137.60 100 each $ 82.73 100 each $ 57.08 100 each $ 144.86 100 mL $ 998.00 75 mL $ 798.50 1 each $ 3,551.60 1 mL $ 74.63 1 each $ 19,306.95 5 each $ 96,274.84 10 mL $ 217.10 4 mL $ 649.71 4 each $ 3,595.38 10 mL $ 388.84 100 mL $ 74.12 1000 mL $ 76.40 250 mL $ 90.65 50 mL $ 74.12 500 mL $ 73.55 1000 mL $ 87.80 500 mL $ 73.55 1000 mL $ 87.80 250 mL $ 83.53 500 mL $ 84.95 1000 mL $ 87.80 500 mL $ 84.95 100 mL $ 74.12 1000 mL $ 82.10 250 mL $ 83.53 50 mL $ 72.98 500 mL $ 84.95 1000 mL $ 82.10 500 mL $ 84.95 1000 mL $ 82.10 500 mL $ 73.55 1000 mL $ 82.10 1000 mL $ 82.10 1000 mL $ 82.10 1000 mL $ 82.10 1000 mL $ 76.40 1000 mL $ 82.10 1000 mL $ 82.10

1000 mL $ 87.80 1000 mL $ 76.40 1000 mL $ 76.40 1 each $ 100.74 50 mL $ 3,900.82 4 mL $ 884.00 1 each $ 134,727.50 10 mL $ 1,138.79 5 mL $ 1,625.00 5 mL $ 34,316.84 5 mL $ 401.21 1 each $ 3,407.56 2 mL $ 221.66 1000 mL $ 82.10 500 mL $ 73.55 100 mL $ 74.12 1000 mL $ 76.40 250 mL $ 83.53 50 mL $ 72.98 500 mL $ 84.95 10 mL $ 76.40 2 mL $ 73.15 4 mL $ 75.03 1 mL $ 80.68 2 mL $ 82.44 2 mL $ 67.51 1 mL $ 222.09 1 mL $ 300.64 1 mL $ 379.18 1 mL $ 850.46 1000 mL $ 34.35 250 mL $ 35.78 500 mL $ 34.35 1 each $ 100.74 2 mL $ 83.96 1 mL $ 315.23 1000 mL $ 82.10 500 mL $ 84.95 50 mL $ 8,859.82 100 mL $ 74.12 1000 mL $ 82.10 250 mL $ 83.53 50 mL $ 72.98 500 mL $ 84.95 1000 mL $ 76.40 500 mL $ 73.55 1000 mL $ 87.80 250 mL $ 83.53 500 mL $ 84.95 1000 mL $ 76.40 500 mL $ 73.55 100 mL $ 74.12 1000 mL $ 82.10 250 mL $ 83.53 50 mL $ 72.98 500 mL $ 84.95 250 mL $ 606.50

50 mL $ 213.49 1 mL $ 99.09 1 mL $ 3,731.24 1 mL $ 981.56 2 mL $ 121.72 1 mL $ 72.41 1 mL $ 74.63 2 mL $ 71.33 1 mL $ 99.54 1 mL $ 151.36 50 mL $ 73.55 100 mL $ 74.12 1000 mL $ 76.40 250 mL $ 86.38 50 mL $ 72.98 500 mL $ 84.95 100 mL $ 74.12 1000 mL $ 76.40 250 mL $ 86.38 50 mL $ 72.98 500 mL $ 84.95 10 mL $ 75.55 30 mL $ 84.15 2 mL $ 79.54 5 mL $ 81.25 30 mL $ 188.80 10 mL $ 232.18 10 mL $ 313.29 5 mL $ 5,063.33 100 mL $ 149.36 1 each $ 301.55 2 each $ 14,329.88 2 mL $ 99.20 1 each $ 702.55 20 mL $ 79.82 10 mL $ 85.98 .67 mL $ 637.44 300 mL $ 237.71 10 mL $ 156.20 5 mL $ 110.60 20 mL $ 1,306.12 1 each $ 18,660.05 1 each $ 11,248.12 10 mL $ 749.00 10 mL $ 749.00 250 mL $ 180.43 15 mL $ 21.61 10 mL $ 78.17 2 mL $ 67.11 20 mL $ 74.12 5 mL $ 67.51 1 mL $ 73.21 20 mL $ 139.10 1 mL $ 78.66 5 mL $ 184.36 1 mL $ 70.93 20 mL $ 110.60

5 mL $ 111.46 20 mL $ 915.44 10 mL $ 103.59 10 mL $ 232.18 1 mL $ 90.57 2 mL $ 108.18 10 mL $ 94.81 30 mL $ 74.41 1 each $ 224.60 1.1 mL $ 93.12 15 mL $ 448.47 2 mL $ 378.50 5 mL $ 247.40 10 mL $ 82.96 4 mL $ 76.97 10 mL $ 94.81 30 mL $ 74.41 10 mL $ 90.99 30 mL $ 84.15 3 mL $ 156.20 2 mL $ 452.49 10 mL $ 83.53 10 mL $ 83.92 100 mL $ 141.95 1 each $ 1,718.00 1 mL $ 174.44 10 mL $ 221.75 1 each $ 1,021.00 1 each $ 567.56 1 mL $ 78.91 1 mL $ 377.59 10 mL $ 1,166.24 500 mL $ 193.25 250 mL $ 97.78 1000 mL $ 87.80 2 mL $ 292.97 1 mL $ 406.43 1 mL $ 464.81 3 mL $ 583.73 .625 mL $ 225.89 20 mL $ 378.50 15 mL $ 520.97 2 mL $ 93.50 1 mL $ 536.89 .8 mL $ 631.45 5 mL $ 119.15 5 mL $ 343.96 4 each $ 7,265.47 .98 mL $ 3,665.23 1 each $ 7,186.18 1 mL $ 1,732.82 .5 mL $ 314.22 .4 mL $ 651.46 50 mL $ 83.81 2 mL $ 87.46 1 each $ 28,908.88 2 mL $ 217.30

20 mL $ 1,269.75 1 mL $ 172.56 1 mL $ 99.14 1 mL $ 78.68 10 mL $ 85.52 30 mL $ 96.46 1 mL $ 79.82 5 mL $ 76.34 2 mL $ 140.18 5 mL $ 68.31 1 each $ 328.40 1 mL $ 82.10 10 mL $ 113.45 2 mL $ 2,957.75 1 each $ 2,686.72 1 each $ 5,401.63 2 mL $ 202.12 5 mL $ 341.51 1 mL $ 69.39 1 mL $ 69.73 5 mL $ 253.78 100 mL $ 440.06 1 mL $ 2,352.13 50 mL $ 104.62 1 mL $ 96.35 .6 mL $ 404.44 1 each $ 95.48 1 each $ 91.68 5 mL $ 70.70 250 mL $ 305.83 1 each $ 5,555.01 1 mL $ 121.66 5 mL $ 631.47 1 mL $ 348.23 1 each $ 254.24 1 each $ 4,493.96 1 each $ 10,249.00 .5 mL $ 7,516.95 5 mL $ 2,270.90 1 each $ 93.50 1.5 mL $ 22,762.86 .6 mL $ 44,597.96 1 each $ 17,649.96 1 each $ 4,482.33 1 each $ 4,071.87 1 each $ 4,271.77 1 mL $ 295.96 2 mL $ 383.88 1 mL $ 171.21 1.2 mL $ 39,665.92 50 mL $ 78.68 1 each $ 559.19 10 mL $ 197.53 1 mL $ 69.90 1 mL $ 110.60 25 mL $ 218.90 5 mL $ 116.30

2 mL $ 225.06 1 mL $ 116.24 2 mL $ 2,520.73 1 each $ 931.00 1 each $ 1,310.54 1 mL $ 110.32 10 mL $ 111.40 50 mL $ 94.93 500 mL $ 87.80 2 mL $ 289.50 .5 mL $ 213.20 1 mL $ 167.54 2 mL $ 210.12 500 mL $ 1,447.25 1 mL $ 89.35 2 mL $ 117.10 4 mL $ 156.95 2 mL $ 3,521.37 1 each $ 190.65 100 mL $ 6,242.66 100 mL $ 74.12 1000 mL $ 76.40 250 mL $ 83.53 50 mL $ 74.12 500 mL $ 73.55 100 mL $ 74.12 1000 mL $ 82.10 250 mL $ 83.53 50 mL $ 72.98 500 mL $ 84.95 100 mL $ 72.98 10 mL $ 88.71 100 mL $ 76.97 50 mL $ 186.41 50 mL $ 122.00 50 mL $ 99.20 10 mL $ 774.14 100 mL $ 7,156.37 200 mL $ 14,247.74 25 mL $ 1,837.84 50 mL $ 3,610.69 100 mL $ 5,859.05 1 each $ 80.45 1000 mL $ 76.40 100 mL $ 179.00 2 mL $ 71.95 50 mL $ 122.00 100 mL $ 244.55 50 mL $ 154.78 100 mL $ 74.12 1000 mL $ 76.40 250 mL $ 83.53 50 mL $ 74.12 500 mL $ 73.55 500 mL $ 79.25 100 mL $ 236.00 20 mL $ 99.20

50 mL $ 144.80 3 mL $ 220.27 500 mL $ 87.80 3 mL $ 124.16 10 mL $ 294.70 3 mL $ 120.33 10 mL $ 275.90 10 mL $ 128.04 1 each $ 30.35 300 mL $ 237.71 300 mL $ 237.71 1000 mL $ 93.50 250 mL $ 83.53 500 mL $ 87.80 20 mL $ 6,785.30 20 mL $ 16,865.75 20 mL $ 33,666.50 100 mL $ 74.12 1000 mL $ 82.10 250 mL $ 83.53 50 mL $ 72.98 500 mL $ 84.95 1 each $ 230.30 1 each $ 2,915.00 1 each $ 109.57 1 each $ 109.57 1 each $ 70.99 1 each $ 74.80 1 each $ 92.54 1 each $ 83.87 1 each $ 128.90 .25 mL $ 69.18 1 mL $ 107.52 2 mL $ 536.58 1 each $ 91.62 1 each $ 91.62 3 mL $ 66.51 10 mL $ 109.80 2 mL $ 179.00 150 mL $ 168.46 1 each $ 70.99 1 each $ 74.80 1 each $ 83.87 1 each $ 128.90 250 mL $ 144.80 50 mL $ 80.96 1 each $ 84.95 30 mL $ 1,136.66 1000 mL $ 150.50 100 mL $ 133.97 1 mL $ 88.37 8 mL $ 142.70 1 mL $ 74.29 4 mL $ 84.84 1000 mL $ 281.60 .25 mL $ 65.97 3 mL $ 114.88

1 each $ 702.55 50 mL $ 125.71 50 mL $ 166.75 20 mL $ 91.56 1000 mL $ 76.40 50 mL $ 258.23 20 mL $ 4,780.84 50 mL $ 8,859.82 50 mL $ 183.56 5 mL $ 116.30 1.7 mL $ 164.75 50 mL $ 516.73 1000 mL $ 76.40 100 mL $ 74.12 1000 mL $ 76.40 250 mL $ 83.53 50 mL $ 74.12 500 mL $ 73.55 50 mL $ 236.00 250 mL $ 1,031.15 50 mL $ 258.23 200 mL $ 196.10 1 mL $ 65.66 1 each $ 100.74 50 mL $ 72.98 40 mL $ 69.33 100 mL $ 100.91 40 mL $ 69.33 20 mL $ 78.91 250 mL $ 99.20 30 mL $ 77.48 100 mL $ 100.91 20 mL $ 84.38 50 mL $ 124.85 15 mL $ 124.85 50 mL $ 99.20 15 mL $ 124.85 50 mL $ 99.20 10 mL $ 83.92 100 mL $ 141.95 50 mL $ 94.93 10 mL $ 72.13 50 mL $ 135.68 200 mL $ 606.50 50 mL $ 200.38 200 mL $ 606.50 50 mL $ 200.38 2 mL $ 67.68 10 mL $ 103.59 2 mL $ 70.53 100 mL $ 3,328.25 50 mL $ 1,696.63 10 mL $ 86.83 5 mL $ 112.31 10 mL $ 92.59 10 mL $ 87.80 5 mL $ 112.23

10 mL $ 774.14 25 mL $ 1,837.84 50 mL $ 3,610.69 100 mL $ 7,156.37 200 mL $ 14,247.74 250 mL $ 214.63 50 mL $ 94.93 1 mL $ 406.43 1 mL $ 406.43 100 each $ 140.30 100 each $ 536.45 60 mL $ 228.76 1 each $ 3,290.92 5 mL $ 843.34 1 mL $ 107.52 1000 mL $ 82.10 500 mL $ 84.95 250 mL $ 606.50 50 mL $ 213.49 250 mL $ 97.78 1000 mL $ 93.50 250 mL $ 83.53 500 mL $ 87.80 1000 mL $ 76.40 1000 mL $ 87.80 500 mL $ 73.55 1000 mL $ 82.10 1000 mL $ 87.80 250 mL $ 83.53 500 mL $ 84.95 1000 mL $ 82.10 1000 mL $ 87.80 500 mL $ 84.95 100 mL $ 74.12 1000 mL $ 76.40 250 mL $ 83.53 50 mL $ 74.12 500 mL $ 73.55 1000 mL $ 87.80 1000 mL $ 87.80 500 mL $ 84.95 1000 mL $ 112.95 200 mL $ 330.62 1 each $ 202.71 1 each $ 45,000.00 100 mL $ 210.92 250 mL $ 263.08 500 mL $ 261.65 10 mL $ 686.30 100 mL $ 319.22 50 mL $ 192.11 100 mL $ 74.12 1000 mL $ 76.40 250 mL $ 83.53 50 mL $ 74.12 500 mL $ 73.55 5 mL $ 76.34

1 each $ 94.53 100 mL $ 296.42 1 each $ 32,091.50 100 mL $ 74.12 1000 mL $ 82.10 250 mL $ 83.53 50 mL $ 72.98 500 mL $ 84.95 20 mL $ 353.65 1 mL $ 72.75 10 mL $ 75.55 30 mL $ 84.15 2 mL $ 79.54 5 mL $ 81.25 30 mL $ 188.80 10 mL $ 304.40 2 mL $ 67.11 5 mL $ 67.51 1 mL $ 69.79 1 mL $ 3,853.68 50 mL $ 72.98 1 mL $ 303.53 1 each $ 9,137.60 2 mL $ 76.63 500 mL $ 193.25 1 each $ 402.94 1000 mL $ 475.00 120 mL $ 1,595.74 240 mL $ 168.23 2.5 mL $ 183.63 50 mL $ 275.11 240 mL $ 432.25 480 mL $ 315.97 25 mL $ 1,315.31 400 mL $ 357.47 30 mL $ 85.12 120 mL $ 181.91 60 mL $ 236.63 5 mL $ 101.28 200 mL $ 697.19 240 mL $ 424.05 200 mL $ 165.95 100 mL $ 2,195.72 480 mL $ 203.80 30 mL $ 45.11 120 mL $ 370.01 50 mL $ 2,105.38 120 mL $ 1,160.03 200 mL $ 127.19 240 mL $ 805.72 200 mL $ 33.71 100 mL $ 3,202.25 30 mL $ 474.32 200 mL $ 217.25 240 mL $ 1,415.85 100 mL $ 61.64 100 mL $ 534.17

100 mL $ 336.95 240 mL $ 1,956.21 120 mL $ 321.45 50 mL $ 32.00 200 mL $ 234.35 100 mL $ 967.94 120 mL $ 655.24 60 mL $ 56.40 240 mL $ 715.43 30 mL $ 97.09 480 mL $ 1,728.49 240 mL $ 250.31 400 mL $ 902.39 240 mL $ 879.59 200 mL $ 2,712.71 60 each $ 96.41 40 mL $ 37.81 240 mL $ 1,652.51 120 mL $ 2,664.22 60 mL $ 34.85 480 mL $ 7,974.04 400 mL $ 2,322.83 240 mL $ 481.50 480 mL $ 97.09 120 mL $ 3,581.35 80 mL $ 745.53 400 mL $ 1,930.67 100 mL $ 123.77 480 mL $ 15,715.19 100 mL $ 4,463.18 30 mL $ 530.24 400 mL $ 1,157.75 480 mL $ 1,191.49 200 mL $ 812.33 30 mL $ 34.17 50 mL $ 4,329.61 50 mL $ 24.59 1 each $ 38.73 10 mL $ 87.58 30 mL $ 112.83 100 mL $ 408.77 60 mL $ 1,648.58 100 mL $ 1,786.55 240 mL $ 681.23 60 mL $ 42.03 120 mL $ 659.34 100 mL $ 302.75 100 mL $ 1,279.16 30 mL $ 103.25 480 mL $ 105.30 60 mL $ 3,151.10 120 mL $ 483.55 10 mL $ 56.74 90 mL $ 1,995.37 60 mL $ 253.73 100 mL $ 587.75 10 mL $ 131.75

1 each $ 18.03 1 each $ 18.03 473 mL $ 44.21 1 each $ 28.55 1 each $ 19.92 1.25 mL $ 18.03 3.75 mL $ 18.58 1.9 mL $ 18.17 2.5 mL $ 18.31 5 mL $ 18.86 7.5 mL $ 19.42 5 mL $ 18.04 10 mL $ 18.32 2.5 mL $ 17.89 1 mL $ 17.81 5 mL $ 18.04 1 mL $ 67.37 7.5 mL $ 20.02 10 mL $ 20.77 15 mL $ 22.28 20 mL $ 23.79 2.5 mL $ 18.51 3.75 mL $ 18.88 15 mL $ 19.89 .5 mL $ 21.13 1 mL $ 21.60 2 mL $ 18.48 5 mL $ 33.45 .5 mL $ 17.88 .3 mL $ 17.86 5 mL $ 77.83 1 mL $ 21.02 5 mL $ 19.95 2 mL $ 18.28 473 mL $ 44.21 2.5 mL $ 51.48 10.15 mL $ 20.93 5 mL $ 20.60 1000 mL $ 34.35 100 mL $ 75.32 4.25 g $ 18.43 8.5 g $ 19.11 473 mL $ 109.42 100 mL $ 635.00 1 each $ 29.44 1 each $ 34.33 1 each $ 17.90 100 each $ 32.57 473 mL $ 44.71 1 each $ 17.80 100 each $ 27.44 1000 each $ 91.85 1 each $ 17.93 1000 each $ 160.25 130 each $ 38.50 1 each $ 17.87 100 each $ 29.72

1 each $ 17.92 100 each $ 32.57 1 each $ 17.98 100 each $ 34.28 60 each $ 31.43 1 mL $ 65.38 50 mL $ 82.96 1 mL $ 65.36 .5 mL $ 65.18 480 mL $ 15,715.19 17 g $ 20.95 240 mL $ 61.03 240 mL $ 57.42 400 mL $ 70.19 250 mL $ 91.85 120 mL $ 17.75 250 mL $ 512.23 480 mL $ 969.88 2 each $ 18.39 1 each $ 18.07 1 each $ 17.93 130 each $ 41.46 100 each $ 54.23 60 each $ 129.24 250 mL $ 1,442.75 67.5 mL $ 19.29 35 mL $ 18.55 30 mL $ 150.28 2.5 mL $ 21.00 1 mL $ 19.57 2 mL $ 18.28 10 mL $ 20.83 473 mL $ 50.10 473 mL $ 405.99 5 mL $ 21.74 10 mL $ 24.65 5 mL $ 20.86 10 mL $ 21.23 473 mL $ 524.62 60 mL $ 90.25 120 mL $ 71.29 4 each $ 41,656.87 4 mL $ 59.36 7.5 mL $ 267.89 1 each $ 449.03 1 each $ 449.03 1 each $ 449.03 1 each $ 449.03 1 each $ 449.03 1 each $ 32.00 1 each $ 24.20 1 each $ 26.03 1 each $ 26.03 1 each $ 45.30 1 each $ 45.30 1 each $ 48.60 170 g $ 49.23

180 g $ 48.03 1000 mL $ 386.85 1 each $ 54.87 1 each $ 49.40 1 each $ 96.95 1 each $ 96.95 1 each $ 96.95 1 each $ 96.95 1 each $ 96.95 1 each $ 202.71 20 mL $ 46.39 480 mL $ 71.97 1 each $ 151.00 144 each $ 112.14 12 each $ 28.28 .1 mL $ 17.79 1 each $ 1,310.54 1 each $ 30.35 1 each $ 219.08 1 each $ 234.16 1 each $ 249.50 1 each $ 315.11 1 each $ 295.97 1 each $ 333.36 30 mL $ 24.95 1 each $ 34.25 1 each $ 30.35 1 each $ 180.69 1 each $ 627.88 1.5 mL $ 2,088.44 10 mL $ 191.57 10 mL $ 191.57 15 mL $ 22.03 15 mL $ 22.03 15 mL $ 22.03 15 mL $ 22.03 15 mL $ 22.03 15 mL $ 22.03 15 mL $ 22.03 10 mL $ 19.02 1 each $ 17.75 1 each $ 65.00

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